PMID- 7770443
TI  - Confidentiality of HIV medical records.

PMID- 7770444
TI  - Pediatric tachycardias.

PMID- 7770445
TI  - Hospitals with strong nursing practice have better patient outcomes.

PMID- 7770446
TI  - DNA recognition by a beta-sheet.
AB  - DNA recognition by a beta-sheet is discussed in the light of crystal structures
      of the MetJ and Arc repressors. The DNA binding geometry of a beta-sheet can be
      understood in terms of (i) close fitting of the two surfaces and (ii) matching of
      residue and base positions. A beta-sheet is not entirely flat but has a
      curvature. A beta-sheet of the Met-Arc family faces the DNA major groove with its
      convex surface; the local DNA major groove is deepest at the centre. The beta
      sheet follows 6 bp; every two residues face the DNA and the first and fifth
      residues, which are separated by 13.2 A, bind, respectively, to the third and
      sixth bases, which are separated by 13.5 A, on the same DNA strand.

PMID- 7770447
TI  - Greek key jellyroll protein motif design: expression and characterization of a
      first-generation molecule.
AB  - A protein designed de novo to fold into the Greek key jellyroll structural motif
      has been studied. Theoretical analyses have indicated that the designed sequence
      should adopt the beta-strand arrangement of the Greek key jellyroll rather than
      any other arrangement. A synthetic gene was constructed and the protein expressed
      in Escherichia coli. Circular dichroism spectroscopy is consistent with the
      protein folding into the designed conformation and also suggests the presence of
      tertiary structure. Fluorescence spectroscopy showed the single tryptophan to be
      partially buried, while denaturation studies showed changes in fluorescence to
      precede alterations in secondary structure.

PMID- 7770448
TI  - Increasing thermal stability of subtilisin from mutations suggested by strongly
      interacting side-chain clusters.
AB  - In this paper we present for seven subtilisin structures a systematic comparison
      of densely packed side-group clusters (defined as an ensemble of side chains with
      extensive internal atomic contacts as compared with those made with the
      surrounding protein environment and measured relative to the maximum possible for
      each residue type). Spatially consistent clusters are observed at structurally
      equivalent positions in the proteins, as revealed by careful multiple
      superpositioning of the respective backbone atoms. The clusters are positioned at
      strategic loop-connecting sites near the protein surfaces. The residues within
      consistent clusters displaying extensive association show varying conservation at
      structurally equivalent alignment sites. Suggestions for residue substitutions,
      as observed over the seven tertiary structures, were taken from the cluster
      positions and were shown to be consistent with a number of point mutations in one
      of the seven structures (savinase) that result in increased thermal stability.

PMID- 7770449
TI  - Replacing the glutamate ligand in the structural zinc site of Sulfolobus
      solfataricus alcohol dehydrogenase with a cysteine decreases thermostability.
AB  - The alcohol dehydrogenase gene from the thermophilic archaeum Sulfolobus
      solfataricus has been subcloned and expressed in Escherichia coli under the
      control of the T7 inducible promoter. The recombinant protein shows properties
      analogous to those of the native enzyme, including thermostability, despite the
      fact that E.coli does not post-translationally modify two lysine residues which
      are N-epsilon-methylated in the native enzyme. We constructed a 3-D model of the
      S.solfataricus alcohol dehydrogenase using the known structure of its isozyme
      from horse liver as a template. Our analysis of the structural zinc binding site
      suggested that this site is present and functional in the S.solfataricus enzyme
      and that a glutamate ligand can contribute to thermostability by influencing
      electrostatic interactions around the metal centre. To investigate this
      hypothesis, we constructed, expressed and characterized a mutant where the
      glutamate is replaced by a cysteine, thus restoring the zinc binding site of
      mesophilic alcohol dehydrogenases. The mutant shows the same activity but a
      reduced thermostability with respect to the wild-type recombinant protein, as
      suggested by our model.

PMID- 7770450
TI  - Thermal stability of chimeric isopropylmalate dehydrogenase genes constructed
      from a thermophile and a mesophile.
AB  - Chimeric isopropylmalate dehydrogenases were constructed by connecting the genes
      isolated from an extreme thermophile, Thermus thermophilus, and a mesophile,
      Bacillus subtilis. These genes were expressed in Escherichia coli. The enzymes
      were purified and analysed. Enzymes of T.thermophilus and B.subtilis and chimeric
      enzymes showed similar enzymological characteristics except for thermal
      stability. The stability of each enzyme was approximately proportional to the
      content of the amino acid sequence from the T.thermophilus enzyme. The results
      suggested that amino acid residues contributing the thermal stability distribute
      themselves, in general, evenly at least in the N-terminal half of the amino acid
      sequence of T.thermophilus isopropylmalate dehydrogenase.

PMID- 7770451
TI  - Highly effective protease inhibitors from variants of human pancreatic secretory
      trypsin inhibitor (hPSTI): an assessment of 3-D structure-based protein design.
AB  - The results of a protein design project are used to compare different predictive
      strategies with respect to protein-protein interactions. We have been able to
      generate variants of human pancreatic secretory trypsin inhibitor (hPSTI)
      optimized with respect to the affinity and specificity for human leukocyte
      elastase relative to trypsin and chymotrypsin, and in particular chymotrypsin.
      The extremely strong and specific human leukocyte elastase inhibitors were thus
      developed in three rounds of mutagenesis and two rounds of 3-D modelling; only 24
      variants in total were synthesized, although variations at seven different amino
      acid positions were involved (i.e. from 20(7) possible variants). An excellent
      elastase inhibitor could be designed with the minimum of two amino acid
      exchanges. The value of structural modelling and actual structure determination
      is discussed in the light of the experimental results of the designed protein
      variants and the results of tertiary structure determinations of the free variant
      and the inhibitor-protease complex. Particular reference is given to the strategy
      to be followed in protein design projects in general and to the development of
      protease inhibitors in particular.

PMID- 7770452
TI  - L3 loop-mediated mechanisms of pore closing in porin: a molecular dynamics
      perturbation approach.
AB  - L3 loop-mediated mechanisms for pore closing in porin are investigated with
      molecular dynamics simulation, using an approach that can be related to the
      phenomenon of voltage gating. Voltage gating is seen as a perturbation of the
      electrostatic screening inside the porin pore where, by the influence of the
      potential gradient, water and counter-ion distribution can be slightly displaced
      from their equilibrium distribution. This is simulated by perturbing the
      screening electrostatics of ionizable groups inside the pore. Under these
      conditions, a localized conformational change takes place, involving 12 (Ile102
      Ala113) out of the 44 residues of the loop. The pore is reduced to a sixth of its
      open state size. The conformational change can be achieved with a small
      perturbation and it is reversible once the perturbation is switched off
      (relaxation process). Other types of behaviour predominating at higher simulation
      temperatures are found for the loop, involving an extra conformational change in
      the Thr92-Asp96 loop segment. This conformational change completely closes the
      pore, but is not reversible under the simulation conditions. Both zones involved
      in the conformational changes contain or overlap the zones which were described
      previously, using other techniques, to be the most flexible zones of the loop.

PMID- 7770453
TI  - Modification of S1 subsite specificity in the cysteine protease cathepsin B.
AB  - Cysteine proteases of the papain family generally exhibit broad P1 specificity. A
      notable exception is papaya proteinase IV (PPIV), which only accepts Gly at this
      position. In all other cysteine proteases the S1 subsite residues 23 and 65
      (papain numbering) are absolutely conserved as Gly, while in PPIV they are
      replaced by Glu and Arg, respectively. These differences appear to underlie both
      PPIV specificity and its resistance to inhibition by cystatins. To test this
      hypothesis, the equivalent residues (Gly27 and Gly73) in the mammalian cysteine
      protease cathepsin B were changed to Glu and Arg, respectively. Relative to the
      wild-type enzyme, the Gly27Glu and Gly73Arg mutants showed a drastic reduction in
      activity with substrates containing a P1 Arg. In contrast, substrates having a
      Gly residue in P1 were hydrolyzed effectively. The double mutant
      (Gly27Glu:Gly73Arg) exhibited no detectable activity against any substrate
      studied. Inhibition of the Gly73Arg mutant by E-64 [1-(L-trans-epoxysuccinyl-L
      leucylamino)-4-guanidinobutane] was found to be similar to that of the wild-type
      enzyme. In contrast, inhibition by cystatin C exhibited a 20,000-fold reduction.
      These results demonstrate the dramatic influence of side chains at sequence
      locations 27 and 73 on the S1 subsite specificity of cysteine proteases.

PMID- 7770454
TI  - Recombinant pro-regions from papain and papaya proteinase IV-are selective high
      affinity inhibitors of the mature papaya enzymes.
AB  - Proteolytic enzymes require the presence of their pro-regions for correct
      folding. Of the four proteolytic enzymes from Carica papaya, papain and papaya
      proteinase IV (PPIV) have 68% sequence identity. We find that their pro-regions
      are even more similar, exhibiting 73.6% identity. cDNAs encoding the pro-regions
      of these two proteinases have been expressed in Escherichia coli independently
      from their mature enzymes. The recombinant pro-regions of papain and PPIV have
      been shown to be high affinity inhibitors of all four of the mature native papaya
      cysteine proteinases. Their inhibition constants are in the range 10(-6) - 10(-9)
      M. PPIV was inhibited two to three orders of magnitude less effectively than
      papain, chymopapain and caricain. The pro-region of PPIV, however, inhibited its
      own mature enzyme more effectively than did the pro-region of papain. Alignment
      of the sequences of the four papaya enzymes shows that there is a highly variable
      section towards the C-terminal of the pro-region. This region may therefore
      confer selectivity to the pro-regions for the individual proteolytic enzymes.

PMID- 7770455
TI  - Interactions of (Ala*Ala*Lys*Pro)n and (Lys*Lys*Ser*Pro)n with DNA. Proposed
      coiled-coil structure of AlgR3 and AlgP from Pseudomonas aeruginosa.
AB  - The proteins, AlgR3 and AlgP, are involved in the regulation of alginate
      synthesis in Pseudomonas. They contain multiple repeats of Ala*Ala*Lys*Pro as do
      several other proteins that resemble histones. The interactions of synthesis
      oligopeptides composed of repeated Ala*Ala*Lys*Pro or Lys*Lys*Ser*Pro units with
      DNA were studied by fluorescence of the Fmoc (9-fluorenylmethyloxycarbonyl) group
      attached to the N-termini of the peptides. DNA quenching of the Fmoc fluorescence
      of the peptides was used to estimate the apparent association constants for the
      interaction of Fmoc(AAKP)nOH (n = 2, 4, 8, 18, 32) and of Fmoc (KKSP)nOH (n = 2,
      4, 8, 16, 20, 32) with DNA. The Fmoc(AAKP)nOH peptides bind to DNA only at low
      ionic strength; the Fmoc(KKSP)n OH peptides interact with DNA at both low (0.05 M
      KCl) and high (0.2 M KCl) salt. At low ionic strength an increase in the number
      of the repeat units causes an increase in the apparent association constant up to
      approximately 2 x 10(6) M-1 for both types of peptides at N congruent to 24. The
      insertion of an AAKTA unit into the middle of the Fmoc(AAKP)8OH peptide increases
      its affinity to DNA. We propose a model of (AAKP)n and of its interaction with
      DNA. The repeat unit consists of a single turn of alpha-helix followed by a bend
      necessitated by Pro. The resultant coiled-coil forms a right-handed superhelix
      with 10 AAKPs per repeat distance of approximately 33 A.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7770456
TI  - Progesterone binding to uteroglobin: two alternative orientations of the ligand.
AB  - Progesterone binding to a homodimer of uteroglobin takes place in a hydrophobic
      cavity formed by the two subunits. Previous mutational analyses have shown that
      the tyrosine (21 and 21') and threonine (60 and 60') residues of the uteroglobin
      dimer are directly involved in progesterone binding. To analyze the contribution
      of each of the two tyrosines and threonines in the dimer, we have constructed a
      covalently linked uteroglobin dimer (UGcl) by fusing two uteroglobin cDNAs via a
      synthetic linker sequence. Escherichia coli expressed UGcl bound progesterone
      with the same affinity as the native dimeric protein. Replacement of both
      tyrosines by phenylalanines abolished progesterone binding. Replacement of either
      the C-terminal tyrosine 21 or the N-terminal tyrosine 21' separately, reduced the
      affinity for progesterone 3- to 4-fold, suggesting that both tyrosines
      participate in progesterone binding. In contrast, substitutions of the threonine
      residues of the C- or N-terminal moities had no effect, whereas the replacement
      of both threonines reduced the affinity for progesterone 2- to 3-fold. These
      data, together with computer models, suggest that progesterone docks in the
      internal binding pocket of uteroglobin in two different orientations.

PMID- 7770457
TI  - Engineered turns of a recombinant antibody improve its in vivo folding.
AB  - Using recombinant antibodies functionally expressed by secretion to the periplasm
      in Escherichia coli as a model system, we identified mutations located in turns
      of the protein which reduce the formation of aggregates during in vivo folding or
      which influence cell stability during expression. Unexpectedly, the two effects
      are based on different mutations and could be separated, but both mutations act
      synergistically in vivo. Neither mutation increases the thermodynamic stability
      in vitro. However, the in vivo folding mutation correlates with the yield of
      oxidative folding in vitro, which is limited by the side reaction of aggregation.
      The in vivo folding data also correlate with the rate and activation entropy of
      thermally induced aggregation. This analysis shows that it is possible to
      engineer improved frameworks for semi-synthetic antibody libraries which may be
      important in maintaining library diversity. Moreover, limitations in recombinant
      protein expression can be overcome by single amino acid substitutions.

PMID- 7770458
TI  - Evidence against a potential endoplasmic reticulum transmembrane domain of 27K
      zein expressed in Xenopus oocytes.
AB  - During the cellular protein targeting process, zeins (maize storage proteins) are
      retained in the endoplasmic reticulum (ER) where they accumulate into protein
      bodies. There are circumstantial and preliminary data indicating that the 27K
      zein, a class of zein proteins, may span the ER membrane. This potential
      transmembrane domain is considered very significant with regard to the mechanism
      of ER retention for zeins. The potential transmembrane domain may permit the 27K
      zein to remain in the ER and to serve as an anchor for other classes of zein,
      thus acting as a nucleating factor for protein body formation. This study
      investigated the potential transmembrane feature in a heterologous system
      (Xenopus laevis oocyte). Following injection of synthetic 27K zein mRNA, isolated
      protein vesicles were subjected to proteinase K digestion, surface biotinylation
      and alkaline extraction. Throughout three categories of assay the possible role
      of the 27K zein as a transmembrane protein was consistently refuted in this
      study. The 27K zein polypeptide was affected by neither proteinase K digestion
      nor biotinylation and was released from alkali-stripped membranes. This study,
      therefore, concludes that the 27K zein is not a protein body nucleating factor by
      virtue of an ER transmembrane feature.

PMID- 7770459
TI  - Active oxygen intermediates--beneficial or deleterious? An introduction.

PMID- 7770460
TI  - Mechanisms of oxidant stress-induced acute tissue injury.
AB  - During the last 25 years, a large body of experimental evidence has accumulated
      from pharmacological intervention studies that suggests an important role for
      reactive oxygen species in numerous pathophysiological processes. While a variety
      of chemical mechanisms of reactive oxygen-induced damage to lipids, proteins, and
      DNA is fairly well understood, the molecular pathology of oxidant stress-induced
      tissue injury in vivo remains unclear in most cases. Recent advances indicate
      that the direct destructive potential of reactive oxygen in vivo is limited by
      the extensive detoxification capacity of most cells and may be restricted to a
      small fraction of cells exposed to a locally high oxidant stress. However,
      reactive oxygen species can participate in recruitment of inflammatory cells by
      upregulation of adhesion molecules and generation of chemotactic factors, and are
      necessary for protease-mediated cell injury in vivo. Reactive oxygen species can
      also scavenge other biologically active molecules (e.g., nitric oxide), thereby
      modulating indirectly their effector cells. In addition to the discussed effects
      relevant for acute injury, other oxidant stress-induced mechanisms (e.g., DNA
      modifications) may be relevant in chronic disease states. A solid mechanistic
      understanding of the role of reactive oxygen species in the overall
      pathophysiology is critical for providing a rationale for antioxidant therapy and
      the targeted development of new antioxidant drugs.

PMID- 7770461
TI  - Superoxide radical: controversies, contradictions, and paradoxes.
AB  - The study of free radical biology has engendered a great deal of controversy and
      apparently conflicting observations, particularly with regard to the use of the
      antioxidant enzyme superoxide dismutase as a protective or therapeutic agent.
      Slowly, the reasons behind the confusion are beginning to emerge. The superoxide
      radical, O2.-, has a number of paradoxical physiological and pathophysiological
      roles. Several examples of the radical's schizophrenic behavior include its roles
      in bactericidal action versus inflammation, as a modulator of cell division
      versus malignant transformation and apoptosis, and as both an initiator and a
      terminator of lipid peroxidation.

PMID- 7770462
TI  - Control of collagen deposition in mammalian lung.
AB  - This review considers the mechanisms controlling collagen deposition in mammalian
      lung in five different states: normal development, fibrosis, erosion,
      pneumonectomy, and the steady state. Deposition is the net result of positive and
      negative processes. The major positive processes are control of cell number and
      type, regulation of transcription and translation, post-translational
      modifications, fibril formation, and covalent cross-linking. The negative
      mechanisms are intracellular degradation, collagenase-mediated degradation, and
      phagocytosis, and they are integral to the life cycle of collagen. Cytokines and
      growth factors have many and complex effects on all the processes that constitute
      collagen metabolism. Interleukin-1 and tumor necrosis factor-alpha can either
      stimulate or inhibit collagen accumulation, presumably depending on the immediate
      environment. Interleukin-6 inhibits collagen degradation, and gamma-interferon
      inhibits collagen production. Platelet derived growth factor and fibroblast
      growth factor have powerful mitogenic effects on connective tissue cells in lung,
      and can also affect collagen production directly. Transforming growth factor-beta
      activates a battery of processes that uniformly contribute to accumulation of
      collagen. Transforming growth factor-beta may be the "master switch" for a
      fibrotic program in lung. Therapeutic approaches to controlling lung fibrosis by
      manipulating cytokine levels are promising. Prostaglandin E has uniformly
      negative effects on net collagen accumulation and may play a central role in an
      erosion program.

PMID- 7770463
TI  - Protection of mice from teratogen-induced cleft palate by exogenous methionine.
AB  - A major challenge for biomedical research is the reduction and/or prevention of
      congenital craniofacial abnormalities which can be induced by some extrinsic
      toxicants such as retinoic acids (e.g. isotretinoin, Accutane) and
      glucocorticoids (corticosteroid hormones) during embryonic craniofacial
      morphogenesis. Our present studies using a genetically susceptible mouse strain
      (B10.A) indicate that the teratogenic actions of exogenous retinoic acid or
      glucocorticoid in secondary cleft palate induction can be largely reduced or even
      completely rescued by subsequent administration of methionine. The greatest
      reduction in frequency of all-trans retinoic acid- or triamcinolone-induced
      secondary cleft palate was obtained by a single-dose IP administration of
      methionine at 187 mg/kg to pregnant mice on E13 21 hr. It appears that
      detrimental toxic effects were not observed in mice treated with this therapeutic
      level of methionine. Our present findings support the need for further research
      into the role of exogenous methionine in cleft palate reduction, that will
      provide a biological rationale for considering methionine as a therapeutic agent.

PMID- 7770464
TI  - Glucocorticoid metabolism in the newborn rat heart.
AB  - A relative cardiac hypertrophy has been observed in newborns chronically treated
      with dexamethasone. To test the hypothesis--that dexamethasone might alter
      steroid metabolism within the heart--rat pups were injected with vehicle,
      corticosterone (dosages 20 or 200 micrograms/pup/injection, or 1
      mg/pup/injection) or dexamethasone (5 micrograms/pup/injection) on Day 2-6 and
      sacrificed on Day 7-8. Injections with dexamethasone in this dosage have induced
      the cardiac changes in this rat model. 11 beta-Hydroxysteroid dehydrogenase (11
      beta-OHSD) activity was assessed in hearts from these adrenally intact rat pups
      by incubating tissues with 3H-corticosterone 10(-8) M for 60 min. On Day 7-8,
      controls transformed 10.3% +/- 1.1% (mean +/- SE) of the corticosterone (Compound
      B) to 11-dehydrocorticosterone (Compound A) generating 1.25 +/- 0.35 x 10(-12)
      moles A/mg protein (n = 8). Tissues from pups pretreated with corticosterone at
      all three dosages were not different from controls in percent metabolized and
      moles A/mg generated. In contrast, hearts from dexamethasone treated pups
      transformed only 4.5% +/- 1.0% of the corticosterone to A generating 3.19 +/-
      0.05 x 10(-13) moles A/mg protein (n = 10) (P < 0.05 versus control in moles/mg
      protein metabolized). Cultured cardiomyocytes exposed to dexamethasone for 4 days
      in vitro also decreased their expression of 11 beta-OHSD mRNA. Readily
      metabolized endogenous glucocorticoids produced little or no effect on developing
      heart muscle while treatment with dexamethasone, a potent synthetic
      glucocorticoid, induced relative cardiac hypertrophy and downregulated 11 beta
      OHSD mRNA expression and enzyme activity.

PMID- 7770465
TI  - Growth attenuation in a human prostate cell line mediated by a phorbol ester.
AB  - Human prostatic cancer cells JCA-1 were induced with a phorbol ester 12-o
      tetradecanoylphorbol-13-acetate (TPA), and cell growth differentiation were
      analyzed. Within hours of exposure to TPA, cell proliferation decreased and
      reached approximately 80% reduction after 3 days, as determined by [3H]thymidine
      incorporation and cell counting. Cell cycle analysis revealed a blocking of cells
      entering into the replicating S and G2M phases from the G1 phase. The TPA induced
      cells had a reduced growth rate but remained viable. The growth-modulating
      activity of TPA was similarly observed with LNCaP cells. Agarose gel
      electrophoresis of the chromosomal DNA from induced cells exhibited a non
      fragmented pattern excluding the possibility of cell apoptosis. In parallel to
      the growth reduction, the TPA induced cells became larger in size showing
      dendrite like cytoplasmic extensions. Furthermore, JCA-1 cells treated with TPA
      acquired the expression of cytokeratin 18 and increased the expression of actin
      and vimentin by 300%. These results indicate an induced growth reduction
      accompanied by cellular differentiation of the prostatic cancer cells.

PMID- 7770466
TI  - Beta-adrenoceptor changes in mononuclear leukocytes during pregnancy.
AB  - Leukocyte beta 2-adrenoceptors mirror similar receptors in the uterus. This study
      examined changes in beta 2-adrenoceptors and in cAMP production during pregnancy
      using peripheral mononuclear leukocytes isolated from 17 pregnant women and 5
      nonpregnant controls. beta 2-Adrenoceptor density was determined by 125I-pindolol
      binding. cAMP production under basal and stimulated (10 microM isoproterenol)
      conditions was determined by radioimmunoassay. Groups were compared by unpaired t
      test. There was a nonsignificant decrease in the density of beta-adrenoceptors
      during pregnancy. While basal cAMP production was unchanged during pregnancy,
      stimulated cAMP production was decreased (44% of control, P < 0.001; 95% CI 33%
      56%). Stimulated cAMP production per receptor was lower in leukocytes from
      pregnant women and was not a constant relationship, but was increased markedly in
      leukocytes having fewer than 400 beta-adrenoceptor sites per cell. There are
      significant changes in the coupling of beta-adrenoceptors to cAMP production
      during pregnancy without changes in beta-receptor density, affinity, or basal
      cAMP production.

PMID- 7770467
TI  - Possible changes in the regulatory mechanisms of pulsatile luteinizing hormone
      secretion in adult pituitary-grafted female rats.
AB  - It is well known that LH is released in an episodic fashion. However, the effects
      of hyperprolactinemia on luteinizing hormone (LH) pulsatility are not fully
      understood. The present study was undertaken to describe hyperprolactinemia
      effects on the regulatory mechanism of LH pulsatility. For this purpose
      hyperprolactinemia was induced in female rats by the transplantation of two
      pituitary glands beneath the kidney capsule. Age-matched sham-operated animals
      were used as controls. We have evaluated the pulsatile pattern of LH in both
      groups of animals. As expected, pituitary grafting increased mean serum prolactin
      levels compared with the values found in control animals. Luteinizing hormone
      releasing hormone (LHRH) administration did not change serum prolactin levels in
      control or in pituitary-grafted rats. Thyrotropin-releasing hormone (TRH)
      administration increased prolactin secretion in both groups. There is an increase
      in mean values of LH and in the absolute amplitude of LH peaks in pituitary
      grafted compared with control rats. No other parameters of LH pulsatility were
      changed by pituitary grafting. After LHRH administration, LH release was
      increased and a priming effect after the second administration of LHRH is
      observed in control rats. In pituitary-grafted animals the responses of LH to
      LHRH administration was diminished compared with the response observed in control
      rats. The administration of two pulses of TRH to control rats only decreases the
      duration of LH pulses. However, in pituitary-grafted animals, TRH administration
      was followed by a decrease in the mean values of LH and in the absolute amplitude
      of the LH peaks. Vasoactive intestinal peptide (VIP) administration increased
      mean values of LH and the absolute and relative amplitudes of LH pulses in sham
      operated animals, whereas only the relative amplitude of LH peaks was modified by
      VIP in pituitary-grafted rats. All these data suggest that hyperprolactinemia
      induced by pituitary-grafting interfere with the neuromodulator effects on the
      pulsatile regulatory center of the hypothalamus.

PMID- 7770468
TI  - Developmental changes in newborn lamb brain mitochondrial activity and
      postasphyxial lipid peroxidation.
AB  - Previously, our laboratory has demonstrated inhibition of mitochondrial state 3
      (ADP-dependent) respiration 5 min after resuscitation from an asphyxial insult in
      lambs less than 3 days of age. Older lambs were resistant to this transient
      mitochondrial dysfunction. This study was designed to examine if age-related
      differences in baseline state 3 mitochondrial respiration, electron transport
      chain activity, or susceptibility to oxygen free radical-mediated lipid
      peroxidation were related to the previously observed differences in postasphyxial
      mitochondrial respiration. Mitochondrial respiration was measured in 24
      nonasphyxiated control lambs aged 1-10 days using four different substrates.
      Electron transport chain activity was assessed in 15 of these lambs, and lipid
      peroxidation measured as conjugated diene production was measured in 11 of these
      lambs. These lambs were all ventilated to maintain normal blood gases for a time
      period equal to the length of the hypoxic insult in asphyxiated lambs (see
      below), after which samples of brain were removed for isolation of mitochondria.
      A second group of 11 lambs (seven < or = 3 days of age and four > 3 days of age)
      were asphyxiated. The insult was a 75-to-90-min episode of hypoxia and
      hypercarbia that resulted in bradycardia and systemic hypotension over the final
      15 min of the insult. At the end of asphyxia, the lambs were resuscitated and
      returned to control ventilator settings. Samples of brain were removed 5 min
      after resuscitation. Postasphyxia electron transport chain activity and lipid
      peroxidation were measured. All measurements described above were done in both
      nonsynaptic (primarily glial in origin) and synaptic mitochondria. State 3
      mitochondrial respiration varied significantly with age, decreasing by an average
      of 41.2% +/- 11.1% (mean +/- SEM) from Day 2 to Day 5-6 and then increasing back
      to levels similar to Day 2 by Day 8-10 in nonsynaptic mitochondria. State 3
      respiration in synaptic mitochondria decreased 60.6% +/- 5.2% from Day 2 to Day 5
      6 before returning to levels similar to Day 2 by Day 8-10. Resting (nonADP
      dependent) state 4 respiration demonstrated similar developmental patterns.
      Electron transport chain activities did not vary with age in the nonasphyxiated
      control animals. In addition, an asphyxial insult did not diminish electron
      transport chain activities in either lambs < or = 3 days old or those > 3 days of
      age.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7770469
TI  - Deleterious effects of buthionine sulfoximine on cardiac function during
      continuous endotoxemia.
AB  - Sepsis has been associated with reversible cardiac injury. To determine whether
      this injury is mediated by generation of reactive oxidants, tissue glutathione
      (GSH)--the major intracellular antioxidant--was depleted before endotoxemia.
      Basal values of cardiac contractile function, perfusion, and cardiac output were
      measured 5-7 days postsurgery. Salmonella enteritidis endotoxin was continuously
      infused at 3 micrograms/kg/hr iv via an osmotic pump (Alzet Corp). Endotoxemia
      significantly reduced myocardial glutathione content (394 +/- 46) to 206 +/- 9
      micrograms/g), indicating oxidant stress during endotoxemia. Buthionine
      sulfoximine (BSO) pretreatment significantly reduced cardiac glutathione in sham
      pigs from 394 +/- 46 to 199 +/- 26 micrograms/g; and in endotoxemic pigs, BSO
      pretreatment significantly reduced cardiac glutathione to 106 +/- 18
      micrograms/g. Vehicle- and BSO-treated endotoxemic groups demonstrated similar
      cardiovascular responses to endotoxin challenge. Heart rate increases (122 +/- 15
      to 140 +/- 17 bpm) and cardiac outputs decreases (1.50 +/- 0.24 to 1.11 +/- 0.35
      l/min) were similar, indicating similar cardiovascular insults induced by
      endotoxemia. Percent short axis shortening and end-systolic pressure-diameter
      relation (ESPDR) were significantly reduced in BSO pretreated compared with
      vehicle-treated endotoxemic pigs. Results support a conclusion that endotoxemia
      induced cardiac injury is mediated, in part, by free radical injury. This
      conclusion is based upon the finding that endogenous myocardial glutathione was
      depleted by continuous endotoxin infusion and that prior depletion of myocardial
      glutathione by buthionine sulfoximine exacerbated cardiac injury.

PMID- 7770470
TI  - Single nephron hemodynamics in spontaneously hypertensive rats.
AB  - This study was designed to determine whether glomerular hypertension develops as
      a function of age in the spontaneously hypertensive rat (SHR). Male SHR and age
      matched Wistar-Kyoto (WKY) normotensive controls were divided into three groups
      for measurements of whole kidney and single nephron hemodynamics at 5, 10, and 15
      months of age. As reported previously, SHR developed significant proteinuria
      which was predominantly an albuminuria, after 5 months of age. There were no
      differences in whole kidney or single nephron glomerular filtration rates between
      SHR and WKY. Afferent glomerular capillary hydraulic pressure (PGC) was slightly
      increased in SHR compared with WKY at 10 months of age. At 15 months of age, PGC
      in SHR was significantly lower than WKY. Our studies indicate that increased
      capillary pressure is not a major factor in the development and progression of
      renal injury in the spontaneously hypertensive rat.

PMID- 7770471
TI  - A method to quantitatively compare in vivo the effects of gallstone solvents on
      intestinal mucosal function: a controlled study comparing mono-octanoin with
      methyl tert-butyl ether in the rat.
AB  - During contact dissolution of gallstones, solvents may escape from the
      gallbladder and damage the intestinal mucosa. In order to compare the extent of
      this potential injury, we developed a method to objectively quantify the effects
      of two commonly used cholesterol solvents, methyl tert-butyl ether and mono
      octanoin, on mucosal transport function in the rat intestine. Two intestinal
      segments in each of 184 anesthetized rats were cannulated. Three milliliters of
      either solvent were instilled in one segment and left for varying periods of
      time, while saline was instilled in the other as control. The segments were then
      washed and perfused for 45 min with an isotonic solution containing
      [3H]polyethylene glycol 4000 (a nonabsorbable reference marker) and either
      [14C]alpha-aminoisobutyric acid (a marker for active absorption) or [14C]mannitol
      (a marker for passive permeability). Methyl tert-butyl ether caused more
      inhibition of alpha-aminoisobutyric acid absorption (64%) than mono-octanoin
      (48%) and a greater reduction of dry weight per centimeter of the perfused
      segment (22%) compared with mono-octanoin (10%). Such effects appeared after only
      1 min of solvent exposure and did not appreciably increase with longer exposures.
      Permeation of mannitol increased by 26% after 1 min of exposure to mono-octanoin
      and by 54% after a similar period of exposure to methyl tert-butyl ether. Longer
      exposures to both solvents did not seem to cause progressive increases in
      mannitol permeation. The results indicate that brief exposure of the rat jejunum
      to either of the two solvents causes a reduction in active transport ([14C]alpha
      aminoisobutyric acid absorption), an increase in passive permeability (mannitol
      permeation), and a loss of mucosal constituents. We conclude that the intestinal
      mucosa is susceptible to solvent damage and may be used as a selectively
      sensitive model that can characterize the biological injury of gallstone
      solvents. The study also suggests that escape of the currently available solvents
      into the small intestine in patients undergoing contact dissolution of
      gallbladder stones may cause injury to the small intestine.

PMID- 7770472
TI  - Cellular sterol accumulation stimulated by cholesterol 5 beta,6 beta-epoxide in
      J774 macrophages.
AB  - A significant accumulation of cellular free cholesterol and steryl esters is
      observed in J774 macrophages when cells are exposed to low-density lipoproteins
      (LDL) containing cholesterol 5 beta,6 beta-epoxide. This cellular sterol
      accumulation is mainly due to the formation of esterified cholesterol and
      desmosterol. Cellular steryl esters increased to 39.4 and 22.4 micrograms/mg cell
      protein with 0.8 microM of cholesterol 5 beta,6 beta-epoxide and 3,5-cholestadien
      7-one, respectively, whereas hardly detectable levels were observed with the
      absence of oxysterols. The total cellular sterols increased 45% above the value
      of control with cholesterol 5 beta,6 beta-epoxide. The uptake of [3H] cholesteryl
      oleate-LDL was also enhanced by cholesterol 5 beta,6 beta-epoxide. The rapid
      displacement of desmosterol with cholesterol was observed when cells were treated
      with cholesterol 5 beta,6 beta-epoxide or 3,5-cholestadien-7-one in the presence
      of LDL. Cholesterol 5 beta,6 beta-epoxide became associated with LDL in the
      culture conditions, and its uptake into J774 cells and the cytotoxicity were
      reduced significantly by the association with LDL. The comparison of selected
      oxysterols for their ability to stimulate cellular sterol accumulation indicated
      that cholesterol 5 beta,6 beta-epoxide is the most potent. Cholesterol
      esterification was enhanced significantly by cholesterol 5 beta,6 beta-epoxide
      whereas cholesterol 5 alpha,6 alpha-epoxide and 3,5-cholestadien-7-one produced a
      modest response. In contrast, although cholestantriol, the metabolic hydrolysis
      product of cholesterol epoxides, also associated with LDL, it showed no
      stimulating effect on both cellular sterol content and sterol esterification.
      These results indicate that some oxysterols, such as cholesterol 5 beta,6 beta
      epoxide and possibly 3,5-cholestadien-7-one, stimulate cellular sterol
      accumulation in J774 macrophages and may play an important role in atherogenesis.

PMID- 7770473
TI  - Ilya Mechnikov and his studies on comparative inflammation.
AB  - Mechnikov was born in Russia in 1845 and died in Paris in 1916. During his
      studies of embryogenesis and digestive function, he developed the concept of
      phagocytosis as a biologic phenomenon. He joined the Pasteur Institute in 1888 at
      Pasteur's invitation as Chef de Service there, studying inflammation and immunity
      in many species--both unicellular and high orders. In 1908, he was awarded the
      Nobel Prize in Medicine and Physiology with Paul Ehrlich.

PMID- 7770474
TI  - gamma-Propoxy-sulfo-lichenin, an antitumor polysaccharide derived from lichenin.
AB  - A water-soluble semisynthetic polysaccharide, gamma-propoxy-sulfo-lichenin (PSL),
      was prepared by reaction of propansultone with lichenin, a natural occurring beta
      1.3/1.4-linked glucan originating from Cetraria sp. PSL represents a class of
      mixed-linked beta-glucans with long and hydrophilic side chains in position C-6
      of the glucan backbone. PSL with a degree of substitution of 0.8 and an average
      molecular weight of 250 kDa exhibited a strong antitumor activity in doses of 25
      and 5 mg/kg against solid sarcoma 180 (100% resp. 82% tumor inhibition). The
      antitumor activity of PSL was shown to be dependent on the dimension of the
      molecule: the higher the average molecular weight, the higher was the inhibition
      rate obtained in the antitumor assay. No antitumor effect was observed by using a
      pretreatment of animals prior to transplantation of sarcoma 180. On syngenic
      DBA/2-MC.SC1 fibrosarcoma PSL inhibited tumor growth by about 88% at a
      concentration of 25 mg/kg. PSL failed to exhibit any direct cytotoxic effects on
      hormone-independent MDA-MB 231 mammacarcinoma. For PSL an indirect antitumor
      effect via modulation of the host mediate immune defence is postulated.

PMID- 7770475
TI  - Dermal metabolism of topically applied drugs: pathways and models reconsidered.
AB  - The study of skin metabolism is of prime importance not only in the field of
      transdermal drug delivery but also for the safe and efficient local skin
      treatment with topically applied substances. Since it has become clear that even
      peptides may be delivered across the permeation barrier of the stratum corneum,
      e.g. by means of iontophoresis, phonophoresis or electroporation, the enzymatic
      barrier of the epidermis deserves more attention as another important limiting
      factor for the dermal delivery of drugs. The purpose of this review is to give a
      survey of the major aspects concerning the assessment of the metabolism of
      xenobiotics in the skin. First, this review will focus on the localization of
      enzyme activity within the skin. Further, important aspects to be considered for
      the planning and evaluation of skin metabolism studies will be discussed:
      differences among species and requirements of skin quality. Among the various
      metabolic pathways within the skin broad interest will be concentrated on the
      metabolism of peptide drugs. Therefore, exopeptidases in the skin are the subject
      of an additional section. Also models for skin metabolism studies will be
      especially considered including the development of suitable cell culture models.
      Finally, major gap areas in the investigation of skin metabolism will be
      identified and summarized, namely; classes of xenobiotics, proteolytic enzyme
      activity in the skin, validity of experimental models, localization of enzyme
      activity and physical model development.

PMID- 7770476
TI  - Secondary structure prediction of adenylate kinase by circular dichroism
      spectroscopy of synthetic peptides.
AB  - The synthesis of 13 segments of porcine adenylate kinase (AK 1) consisting each
      of 15 residues and covering the whole sequence of AK 1 is reported. The peptides
      were obtained by multiple peptide synthesis applying Fmoc/tert. butyl strategy.
      For the conformational analysis by circular dichroism spectroscopy different
      mixtures of phosphate buffer (pH 7), trifluoroethanol and methanol were used. Ten
      peptides showed alpha-helical conformation in all solvents except of pure buffer.
      The conformation of these peptides correlated well with the secondary structure
      obtained by homology modelling and even more striking with the X-ray structure of
      adenylate kinase, which was published recently. In contrast, three peptides,
      which were suggested to adopt no helical conformation did not show any content of
      alpha-helicity in any of the solvents that we investigated. One peptide, which
      contains a beta-sheet according to the X-ray analysis revealed a high content of
      beta-conformation by CD in buffer and in mixtures with trifluoroethanol. The two
      other peptides revealed mainly random coil in all solvents which we investigated.
      Therefore, we conclude that synthetic peptides are suitable tools to investigate
      the secondary structure of protein segments and that this conformation is
      frequently preserved in the intact protein.

PMID- 7770477
TI  - The comparative histology of porcine and guinea pig skin with respect to
      iontophoretic drug delivery.
AB  - The anatomy of pig skin, neonatal pig skin, and hairless guinea pig skin was
      investigated with respect to iontophoretic drug transport. Fixed sections of skin
      were stained with hematoxylin and eosin, and the morphology of the skin
      appendages was examined. Quantitative measurements of the hair follicle density,
      diameter and lumen area were obtained, and the effective surface areas available
      for low resistance iontophoretic transport were calculated. The clustering and
      density of the follicles of neonatal porcine skin and hairless guinea pig skin
      suggest that linear mass transport may dominate iontophoretic flux. In contrast,
      the morphology and density of the hair follicles of porcine skin suggests that a
      radial mass transport mechanism may dominate iontophoretic transdermal drug
      delivery.

PMID- 7770478
TI  - The prediction of the lipophilicity of peptidomimetics. A comparison between
      experimental and theoretical lipophilicity values of renin inhibitors and their
      building blocks.
AB  - In order to test how well the lipophilicity of large and flexible molecules can
      be predicted by theoretical approaches, renin inhibitors and their building
      blocks have been investigated. Different experimental methods have been used for
      the determination of lipophilicity of the selected compounds, including RP-HPLC
      and a new pH-metric or two-phase titration method. This latter method appears to
      be well-suited for the log P measurement of lipophilic compounds. The
      experimental results have been compared to computer-assisted log P calculations
      (CLOGP and PrologP). Different correction terms have been introduced to correlate
      the experimental to the calculated results. Finally, in view of the poor oral
      bioavailability of most renin inhibitors, we have investigated the correlation
      between aqueous solubility data and their log P values.

PMID- 7770479
TI  - Principles of chaperone-mediated protein folding.
AB  - The recent discovery of molecular chaperones and their functions has changed
      dramatically our view of the processes underlying the folding of proteins in
      vivo. Rather than folding spontaneously, most newly synthesized polypeptide
      chains seem to acquire their native conformations in a reaction mediated by
      chaperone proteins. Different classes of molecular chaperones, such as the
      members of the Hsp70 and Hsp60 families of heat-shock proteins, cooperate in a
      coordinated pathway of cellular protein folding.

PMID- 7770480
TI  - Mapping the structures of transition states and intermediates in folding:
      delineation of pathways at high resolution.
AB  - The structures of all the intermediates and transition states, from the unfolded
      state to the native structure, are being determined at the level of individual
      residues in the folding pathways of barnase and chymotrypsin inhibitor 2 (CI2),
      using a combination of protein engineering and nuclear magnetic resonance
      methods. Barnase appears to refold according to a classical framework model in
      which elements of secondary structure are flickeringly present in the denatured
      state, consolidate as the reaction proceeds and, when nearly fully formed, dock
      in the rate-determining step. Unlike barnase, CI2 folds without a kinetically
      significant folding intermediate. The transition state for its formation has no
      fully formed elements of secondary structure, and the transition state is like an
      expanded form of the native structure. CI2 probably represents the folding of an
      individual domain in a larger protein, whereas barnase represents the folding of
      a multi-domain protein. The protein engineering methods are being extended to map
      the pathway in the presence of molecular chaperones. There are parallels between
      the folding of barnase when bound to GroEL and in solution.

PMID- 7770481
TI  - Unliganded GroEL at 2.8 A: structure and functional implications.
AB  - The three-dimensional structure of the E. coli chaperonin, GroEL, has been
      determined crystallographically and refined to 2.7 A in two crystal forms: an
      orthorhombic form from high salt and a monoclinic form from polyethylene glycol.
      The former is ligand free, the latter is both liganded with ATP analogues and
      ligand free. These structures provide a structural scaffold upon which to
      interpret extensive mutagenesis and biochemical studies. GroEL contains two
      sevenfold rotationally symmetric rings of identical 547-amino acid subunits. The
      rings are arranged 'back-to-back' with exact dyad symmetry to form a stubby
      cylinder that is 146 A high with an outer diameter of about 143 A. The cylinder
      has a substantial central channel that is unobstructed for the entire length of
      the cylinder and has a diameter of about 45 A except for large bulges that lead
      into a sevenfold symmetric array of elliptical side windows in each ring. Each
      subunit is composed of three distinct domains: (i) an 'equatorial' domain that
      contains the N- and C-terminus and the ATP-binding pocket, (ii) an 'apical
      domain' that forms the opening of the central channel and contains poorly ordered
      segments that mutational studies implicate in binding unfolded polypeptides and
      GroES, and (iii) an intermediate domain tht connects the other two domains and
      may serve to transmit allosteric adjustments.

PMID- 7770482
TI  - Insights into protein folding using physical techniques: studies of lysozyme and
      alpha-lactalbumin.
AB  - Understanding the process of protein folding, during which a disordered
      polypeptide chain is converted into a compact well-defined structure, is one of
      the major challenges of modern structural biology. In this article we discuss how
      a combination of physical techniques can provide a structural description of the
      events which occur during the folding of a protein. First, we discuss how the
      rapid kinetic events which take place during in vitro folding can be monitored
      and deciphered in structural terms. Then we consider how more detailed structural
      descriptions of intermediates may be obtained from NMR studies of stable, partly
      folded states. Finally, we discuss how these experimental strategies may be
      extended to relate the findings of in vitro studies to the events occurring
      during folding in vivo. The approaches will be illustrated using results
      primarily from our own studies of the c-type lysozymes and the homologous alpha
      lactalbumins. The conclusions from these studies are also related to those from
      other systems to highlight their unifying features. On the basis of these results
      we identify some of the determinants of the events in folding and we speculate on
      the importance of these in driving folding molecules to their native states.

PMID- 7770483
TI  - Initial studies of the equilibrium folding pathway of staphylococcal nuclease.
AB  - Spectroscopic methods were used to examine the sequential build up of structure
      in the denatured state of staphylococcal nuclease. The 'free energy distance'
      between the native and denatured states was manipulated by altering conditions in
      solution (for example altering urea or glycerol concentration) and by changing
      the amino acid sequences. Initial studies employed a fragment of nuclease,
      referred to as delta 131 delta, which lacks six structural residues from the
      amino terminus and one structural residue from the carboxy-terminus. Nuclear
      magnetic resonance analysis of this fragment in solution revealed a modest
      quantity of dynamic structure which is native-like in character. With the
      addition of urea, 12 new HN peaks appeared in the 1H-15N correlation spectrum,
      presumably as a result of the breakdown of residual structure involving the first
      three beta strands. With the addition of glycerol, there was a rapid increase in
      the quantity of beta sheet structure detected by circular dichroism spectroscopy.
      At very high glycerol concentrations, an increase in helical structure became
      apparent. These data in addition to previously published results suggest that:
      (i) a beta-meander (strands beta 1-beta 2-beta 3) and the second alpha helix
      (alpha 2) are among the most stable local structures; (ii) the five-strand beta
      barrel forms in a reaction which does not require the presence of several other
      native substructures; and (iii) the last step on the equilibrium folding pathway
      may be the formation and packing of the carboxy terminal alpha helix (alpha 3) to
      give the native state.

PMID- 7770484
TI  - Kinetic and equilibrium folding intermediates.
AB  - Our recent experiments on the molten globule state and other protein folding
      intermediates lead to following conclusions: (i) the molten globule is separated
      by intramolecular first-order phase transitions from the native and unfolded
      states and therefore is a specific thermodynamic state of protein molecules; (ii)
      the novel equilibrium folding intermediate (the 'pre-molten globule' state)
      exists which can be similar to the 'burst' kinetic intermediate of protein
      folding; (iii) proteins denature and release their non-polar ligands at
      moderately low pH and moderately low dielectric constant, i.e. under conditions
      which may be related to those near membranes.

PMID- 7770485
TI  - Does the molten globule have a native-like tertiary fold?
AB  - One of the mysteries in protein folding is how folding intermediates direct a
      protein to its unique final structure. To address this question, we have studied
      the molten globule formed by the alpha-helical domain of alpha-lactalbumin (alpha
      LA) and demonstrated that it has a native-like tertiary fold, even in the absence
      of rigid, extensive side chain packing. These studies suggest that the role of
      molten globule intermediates in protein folding is to maintain an approximate
      native backbone topology while still allowing minor structural rearrangements to
      occur.

PMID- 7770486
TI  - Investigation of protein unfolding and stability by computer simulation.
AB  - Structural, dynamic and energetic properties of proteins in solution can be
      studied in atomic detail by molecular dynamics computer simulation. Protein
      unfolding can be caused by a variety of driving forces induced in different ways:
      increased temperature or pressure, change of solvent composition, or protein
      amino acid mutation. The stability and unfolding of four different proteins
      (bovine pancreatic trypsin inhibitor, hen egg white lysozyme, the surfactant
      protein C and the DNA-binding domain of the 434 repressor) have been studied by
      applying the afore-mentioned driving forces and also to some artificial forces.
      The results give a picture of protein (in)stability and possible unfolding
      pathways, and are compared to experimental data where possible.

PMID- 7770487
TI  - Disulphide-coupled protein folding pathways.
AB  - Protein folding pathways that involve disulphide bond formation can be determined
      in great detail. Those of bovine pancreatic trypsin inhibitor, alpha-lactalbumin
      and ribonucleases A and T1 are compared and contrasted. In each species, whatever
      conformation favours one disulphide bond over another is stabilized to the same
      extent by the presence of that disulphide bond in the disulphide intermediates.
      The pathways differ markedly in the nature of that conformation: in bovine
      pancreatic trypsin inhibitor a crucial intermediate is partly folded, in alpha
      lactalbumin the intermediates tend to adopt to varying extents the molten globule
      conformation, while in the ribonucleases the early disulphide intermediates are
      largely unfolded, and none predominate. In each case, however, the slowest step
      is formation of a disulphide bond that will be buried in a stable folded
      conformation; the most rapid step is formation of an accessible disulphide bond
      on the surface of a folded conformation. Quasi-native species with the native
      conformation, but incomplete disulphide bonds, can either increase or decrease
      the rate of further disulphide formation.

PMID- 7770488
TI  - Models of cooperativity in protein folding.
AB  - What is the basis for the two-state cooperativity of protein folding? Since the
      1950s, three main models have been put forward. 1. In 'helix-coil' theory,
      cooperativity is due to local interactions among near neighbours in the sequence.
      Helix-coil cooperativity is probably not the principal basis for the folding of
      globular proteins because it is not two-state, the forces are weak, it does not
      account for sheet proteins, and there is no evidence that helix formation
      precedes the formation of a hydrophobic core in the following pathways. 2. In the
      'sidechain packing' model, cooperativity is attributed to the jigsaw-puzzle-like
      complementary fits of sidechains. This too is probably not the basis of folding
      cooperativity because exact models and experiments on homopolymers with
      sidechains give no evidence that sidechain freezing is two-state, sidechain
      complementarities in proteins are only weak trends, and the molten globule model
      predicted by this model is far more native-like than experiments indicate. 3. In
      the 'hydrophobic core collapse' model, cooperativity is due to the assembly of
      non-polar residues into a good core. Exact model studies show that this model
      gives two-state behaviour for some sequences of hydrophobic and polar monomers.
      It is based on strong forces. There is considerable experimental evidence for the
      kinetics this model predicts: the development of hydrophobic clusters and cores
      is concurrent with secondary structure formation. It predicts compact denatured
      states with sizes and degrees of disorder that are in reasonable agreement with
      experiments.

PMID- 7770489
TI  - Protein folds: towards understanding folding from inspection of native
      structures.
AB  - Following a short summary of some of the principal features of folded proteins,
      the results of two complementary studies of protein structure are presented, the
      first concerned with the factors which influence secondary structure propensity
      and the second an analysis of protein topology. In an attempt to deconvolute the
      physical contributions to secondary structure propensities, we have calculated
      intrinsic phi, psi propensities, derived from the coil regions of proteins.
      Comparison of intrinsic phi, psi propensities with their equivalent secondary
      structure values show correlations for both helix and strand. This suggests that
      the local dipeptide, steric and electrostatic interactions have a major influence
      on secondary structure propensity. We then proceed to inspect the distribution of
      protein domain folds observed to date. Several folds occur very commonly, so that
      46% of the current non-homologous database comprises only nine folds. The
      implications of these results for protein folding are discussed.

PMID- 7770490
TI  - Design of two-stranded and three-stranded coiled-coil peptides.
AB  - The structural features required for the formation of two- versus three-stranded
      coiled coils have been explored using de novo protein design. Peptides with
      leucine at the 'a' and 'd' positions of a coiled-coil (general sequence: Leua
      Xaab Xaac Leud Glue Xaaf Lysg) exist in a non-cooperative equilibrium between
      unstructured monomers and helical dimers and helical trimers. Substituting valine
      into each 'a' position produces peptides which still form trimers at high
      concentrations, whereas substitution of a single asparagine at the 'a' position
      of the third heptad yields a dimer. During the course of this work, we also re
      investigated a helical propensity scale derived using a series of coiled-coil
      peptides previously believed to exist in a monomer-dimer equilibrium (O'Neil &
      DeGrado 1990). Detailed analysis of the concentration dependence of ellipticity
      at 222 nm reveals that they exist in a non-cooperative monomer-dimer-trimer
      equilibrium. However, the concentration of trimer near the midpoint of the
      concentration-dependent transition is small, so the previously determined values
      of delta delta G alpha using the approximate monomer-dimer scheme are
      indistinguishable from the values obtained employing the complete monomer-dimer
      trimer equilibrium.

PMID- 7770491
TI  - Nascent chains: folding and chaperone interaction during elongation on ribosomes.
AB  - Monoclonal antibodies that detect folding intermediates in vitro were used to
      monitor the appearance of folded polypeptide chains during their synthesis on the
      ribosomes. Nascent immunoreactive chains of the bacteriophage P22 tail-spike
      protein and of the Escherichia coli beta 2 subunit of tryptophan-synthase were
      thus identified, suggesting that they can fold on the ribosomes. Moreover, the
      immunoreactivity of ribosome-bound tryptophan-synthase beta-chains of
      intermediate lengths was shown to appear with no detectable delay compared to
      their synthesis. This suggested that beta-chains start folding during their
      elongation on the ribosomes. However, newly synthesized incomplete beta-chains
      were shown to interact with chaperones while still bound to the ribosome. Because
      of the peculiar properties of the epitope recognized by the anti-tryptophan
      synthase monoclonal antibody used, it could not be concluded whether the
      immunoreactivity of the nascent beta-chains resulted from their ability to fold
      cotranslationally or from their association with chaperones which might maintain
      them in an unfolded, immunoreactive state.

PMID- 7770492
TI  - Folding and association versus misfolding and aggregation of proteins.
AB  - The acquisition of spatial structure in proteins may be described in terms of
      hierarchical condensation, with contributions of local interactions between next
      neighbours and the interactions between domains and subunits accumulating to
      create the marginal free energy of stabilization characteristic of the functional
      state of globular proteins. Domains represent independent folding units such that
      the overall kinetics divide into the sequential collapse of subdomains and
      domains and their merging to form the compact tertiary structure. In proceeding
      to oligomeric proteins, docking of subunits follows the formation of structured
      monomers. Thus, the overall mechanism of folding and association obeys
      consecutive uni-bimolecular kinetics. Beyond a limiting protein concentration,
      aggregation will outrun proper domain pairing and subunit association. In the
      cell, accessory proteins are involved in catalysis of the rate-determining steps
      of folding (proline isomerization and SH-SS exchange) and in the kinetic
      partitioning between folding and aggregation (chaperone action). The practical
      aspects of accessory proteins have been investigated in detail using immunotoxins
      and antibody fragments as examples. Additional concepts allowing off-pathway
      reactions in protein reconstruction to be kept to a minimum refer to pulse
      dilation, reverse micelles and immobilization of polypeptide chains on matrices.

PMID- 7770493
TI  - Screening for balance and mobility impairment in elderly individuals living in
      residential care facilities.
AB  - BACKGROUND AND PURPOSE: The rapid growth of the elderly population has resulted
      in a corresponding rise in the number of elderly individuals who experience
      disability during their lifetimes. The purpose of this study was to test the
      usefulness of four established clinical measures of balance, gait, and subjective
      perceptions of fear of falling as screening methods for referring community
      dwelling elderly individuals living in residential care facilities for detailed
      physical therapy evaluation and possible intervention. SUBJECTS: The subjects
      were a convenience sample of 53 elderly individuals living in two residential
      care facilities for the elderly. METHODS: Subjects were tested on each of four
      clinical measures of balance and mobility. Their performance on these measures
      was compared with a physical therapist's brief evaluation of disability and
      appropriateness for more detailed evaluation. The usefulness of these tools as
      screening methods was determined by calculating sensitivity and specificity
      levels using the physical therapist's evaluation as a standard. RESULTS: The
      sensitivity and specificity levels of the four clinical measures in their
      application as screening tests for referral to physical therapy were as follows:
      Berg Balance Scale, 84% and 78%; balance subscale of the Tinetti Performance
      Oriented Mobility Assessment, 68% and 78%; gait speed, 80% and 89%; and Tinetti
      Fall Efficacy Scale, 59% and 82%. The combination of two tests, Berg Balance
      Scale and gait speed, yielded the highest sensitivity of 91% and the highest
      specificity of 70% when a subject tested positive on at least one test.
      CONCLUSION AND DISCUSSION: These findings indicate the feasibility of developing
      screening methods for referring community-dwelling elderly individuals for a
      detailed physical therapy evaluation based on established clinical assessment
      measures, with a combination of tests measuring balance and gait demonstrating
      the most promising results.

PMID- 7770494
TI  - A treatment-based classification approach to low back syndrome: identifying and
      staging patients for conservative treatment.
AB  - We present a treatment-based classification approach to the conservative
      management of low back syndrome. The approach has three levels of classification
      based on historical information, behavior of symptoms, and clinical signs. We
      first distinguish patients whose conservative care can be managed predominantly
      and independently by physical therapists versus patients who require consultation
      with other services (eg, psychology) or who require referral because of possible
      serious nonmusculoskeletal pathology. Once patients who can be managed by
      physical therapists are identified, the next level of classification is to stage
      their condition with regard to severity. We propose three stages: stage I for
      patients in the acute phase where the therapeutic goal is symptom relief, stage
      II for patients in a subacute phase where symptom relief and quick return to
      normal function are encouraged, and stage III for selected patients who must
      return to activities requiring high physical demands and who demonstrate a lack
      of physical conditioning necessary to perform the desired activities safely. The
      remainder of the article focuses on a third level of classification for stage I
      only in which patients are classified into distinct categories that are treatment
      based and that specifically guide conservative management. The entire approach is
      diagnosis based, with specific algorithms and decision rules as well as examples
      presented.

PMID- 7770495
TI  - The rehabilitation of gait in patients with hemiplegia: a comparison between
      conventional therapy and multichannel functional electrical stimulation therapy.
AB  - BACKGROUND AND PURPOSE: Gait rehabilitation in patients with severe hemiplegia
      requires substantial effort. Preliminary studies indicate potential beneficial
      effects of using multichannel functional electrical stimulation (MFES) for gait
      rehabilitation in these patients. In this study, a new method of gait
      rehabilitation for nonambulatory patients with hemiplegia by means of MFES added
      to conventional therapy was introduced. The results of the method's application
      were evaluated by comparing it with conventional therapeutic methods. SUBJECTS:
      The proposed rehabilitation method was tested on a group of 20 patients with
      severe hemiplegia secondary to cerebrovascular accident. Subjects were randomly
      assigned to one of two groups. One group received 3 weeks of MFES followed by 3
      weeks of conventional therapy. The other group received 3 weeks of conventional
      therapy followed by 3 weeks of MFES. METHODS: The effects of each therapeutic
      method were evaluated by measurements of temporal-distance variables and ground
      reaction forces and by assessment of each subject's physical status according to
      the Fugl-Meyer evaluation scale. RESULTS: There was improved performance of the
      subjects during MFES combined with conventional therapy as compared with
      conventional therapy alone. CONCLUSION AND DISCUSSION: The superiority of the
      MFES method as compared with conventional therapy was mainly attributed to the
      enhanced motor learning accomplished by application of MFES. These results,
      however, are preliminary, and further research is needed.

PMID- 7770496
TI  - Enhancing service productivity in acute care inpatient settings using a
      collaborative clinical education model.
AB  - BACKGROUND AND PURPOSE: Exposure of physical therapy students to acute inpatient
      settings is difficult to achieve because of staff shortages and 1:1 supervision.
      The purpose of this study was to examine the productivity effects of the 2:1
      teaching model in the acute inpatient clinical setting. Changes in patient
      throughput and the amount of care provided were the measures used to define
      productivity. SUBJECTS: The work load measurement statistics of 8 Clinical
      Instructors (CIs) and 16 physical therapy students were examined. METHODS: The
      productivity of each CI during a control period was compared with the
      productivity of the CI-student team. RESULTS: Each CI-student team's mean
      productivity was greater during the clinical placement than during the control
      period when the CI worked independently. Even when the students' productivity
      measures were prorated by 0.6, the productivity was greater during the student
      placement than during the control period. CONCLUSION AND DISCUSSION: The study
      demonstrates that students make positive contributions to clinical service units
      that can exceed normal productivity levels of the CI. The 2:1 model has the
      potential to increase productivity while increasing the numbers of placements for
      academic programs in limited specialty areas.

PMID- 7770497
TI  - Rheumatoid arthritis: status of drug therapies.
AB  - This article describes the current drug therapies used to manage rheumatoid
      arthritis (RA). A brief description of the pathology, pathogenesis, and clinical
      features of RA is presented. The purpose of the article is to increase an
      awareness among physical therapists regarding the medications their patients
      might be taking and how these agents might influence the outcome of physical
      therapy intervention. The general approach to prescribing medication is presented
      according to the status of the disease. The attributes of nonsteroidal
      antiinflammatory drugs, corticosteroids, slow-acting antirheumatic drugs, and
      cytotoxic and experimental drugs used in RA are described. Given the potential
      benefits, side effects, and adverse reactions of these potentially powerful
      medications, it is important for the physical therapist to monitor closely what
      is happening to the patient with respect to the use or nonuse of the medication.

PMID- 7770498
TI  - Topical agents in burn and wound care.
AB  - With any open wound infection may occur. Many factors such as age and general
      health status may increase the likelihood of infection, but the size and depth of
      the wound are critical factors in determining the chronicity of any wound.
      Infection greatly adds to the morbidity associated with open wounds. An infected
      wound not only heals more slowly, there is also the risk of systemic infection
      and even death. Infected wounds also scar more severely and are associated with
      more prolonged rehabilitation. Topical therapeutic agents have been shown to be
      effective in the management of open skin wounds. These agents may assist less
      complicated healing and decrease the conversion of a partial-thickness injury to
      a full-thickness injury, and thereby reduce wound-related morbidity. Common
      topical agents with suggestions for application are discussed in this review.

PMID- 7770499
TI  - The use of ultrasound as an enhancer for transcutaneous drug delivery:
      phonophoresis.
AB  - Phonophoresis is the use of ultrasound (US) to enhance the delivery of topically
      applied drugs. The purposes of this article are (1) to review the basic
      principles of transcutaneous drug delivery, (2) to summarize the functional
      anatomy of the skin pertinent to phonophoresis, (3) to outline the physiological
      principles of US as an enhancer of topically applied drugs, (4) to review the
      literature on the efficacy of phonophoresis, (5) to discuss the relevance of US
      as an enhancer of topical drugs in the practice of physical therapy, and (6) to
      outline areas of needed research. Seventy-five percent of the studies reviewed
      reported positive effects of US on local subcutaneous drug diffusion, but some
      systemic effects were reported. This research review indicates that to maximize
      the clinical effectiveness of phonophoresis: (1) the topical drug (both the drug
      and the carrying agent) should transmit US; (2) the skin should be pretreated
      with US, heating, moistening, or shaving; (3) the patient needs to be positioned
      to maximize circulation during treatment; (4) a dressing that seals the area and
      prevents the escape of moisture should be applied after treatment; (5) an
      intensity of 1.5 W/cm2 should be used to capture both the thermal and nonthermal
      effects of the US; and (6) low-intensity US (0.5 W/cm2) should be used when
      treating open wounds or acute injuries. Research is needed to clarify what
      parameters of US will most efficiently facilitate topical drug diffusion, how
      often and for what duration US should be used to maximize local absorption of
      drugs, and which topical drugs can most effectively be used for phonophoresis.

PMID- 7770500
TI  - Iontophoresis: applications in transdermal medication delivery.
AB  - This article presents a review of the literature relating to iontophoresis. This
      technique has been used in physical therapy to introduce ionic medications
      through the skin, primarily for a local effect. Recently, there has been
      increased interest in using this technique for the transdermal delivery of
      medications, both ionic and nonionic. This article includes an overview of the
      history of iontophoresis and a discussion of the physico-chemical and biological
      factors affecting iontophoretic drug transfer for both local and systemic
      effects. Factors affecting skin injury and techniques for optimizing
      iontophoretic drug delivery through the use of current modulation, electrode
      construction, and skin permeation enhancers are also discussed. Clinical
      applications of iontophoresis in physical therapy and the pharmacology of
      selected medications are presented. Thoughts for future potential uses of this
      technique and needs for further research are also discussed.

PMID- 7770502
TI  - First, do no harm...

PMID- 7770501
TI  - Language that obscures.

PMID- 7770503
TI  - Life's lessons.

PMID- 7770504
TI  - Theoretical investigation of excimer and exciplex states of uracil and halogen
      derivatives: effect of nonparallelism of bases.
AB  - Theoretical modeling of initial steps of the photodimerization mechanism of
      uracil, 5-methyl-and 5-halogen derivatives was performed. The interaction energy
      of bases in stacked dimers in the ground and lowest excited states was calculated
      as a function of the distance between the base planes and of the rotation angles
      within the perturbation theory for the extended Huckel treatment. The existence
      of excimer and exciplex region on the potential surface of the excited state was
      revealed. The excimer (exciplex) geometry has the planes nonparallel with more
      close contact of the C5-C6 bonds as compared to the ground state of dimers. The
      results provide new information useful for understanding the photodimerization
      mechanism of bases and testifies that the singlet excimer state can be a
      precursor of the photodimerization reaction.

PMID- 7770505
TI  - Photophysical studies on human retinal lipofuscin.
AB  - Fluorescent material generated in the human retina accumulates within lipofuscin
      granules of the retinal pigment epithelium (RPE) during aging. Its presence has
      been suggested to contributed to various diseases including age-related macular
      degeneration. Because this material absorbs light at wave lengths as long as 550
      nm, photophysical studies were performed to determine whether lipofuscin could
      contribute to light damage and to determine if its composition is similar to a
      synthetically prepared lipofuscin. Time-resolved experiments were performed to
      monitor (1) fluorescence decay, (2) the UV-visible absorption of longer-lived
      excited states and (3) the formation and decay of singlet oxygen at 1270 nm.
      Steady-state and time-resolved fluorescence studies indicate that human and
      synthetic lipofuscin have fluorophores in common. Time-resolved absorption
      experiments on human retinal lipofuscin and synthetic lipofuscin showed the
      presence of at least two transient species, one absorbing at 430 nm (lifetime ca
      7 microseconds) and a second absorbing at 580 nm, which decays via second order
      kinetics. In addition, there is a third absorbing species stable to several
      hundred milliseconds. The transient species at 430 nm is quenched by oxygen,
      suggesting that it is a triplet state. Subsequent studies showed the formation of
      singlet oxygen, which was monitored by its phosphorescence decay at 1270 nm.
      These studies demonstrate that lipofuscin can act as a sensitizer for the
      generation of reactive oxygen species that may contribute to the age-related
      decline of RPE function and blue light damage.

PMID- 7770506
TI  - Ultraviolet-induced cell death is independent of DNA replication in rat kangaroo
      cells.
AB  - Rat kangaroo (Potorous tridactylus) cells have an efficient repair system for
      photoreactivation of lethal lesions induced by 254 nm UV. However, this ability
      is lost with increasing time after UV, being completely ineffective after 24 h.
      Critical events leading to UV-induced cell death must occur within this period of
      time. DNA synthesis was inhibited by the DNA polymerase inhibitor aphidicolin and
      the loss of the capability to photorepair lethal lesions was maintained as for
      replicating cells. Similar data were obtained in synchronized cells UV irradiated
      immediately before S phase. Under the same conditions, the ability to remove
      cyclobutane pyrimidine dimers by photoreactivation in these cells remained
      unchanged 24 h after irradiation. These data indicate that the critical events
      responsible for UV-induced cell death occur in the absence of DNA replication.

PMID- 7770507
TI  - Preferential inhibition of nucleosome assembly by ultraviolet-induced (6
      4)photoproducts.
AB  - We reconstituted nucleosomes in vitro using two kinds of damaged pBR322 plasmid
      DNA carrying cyclobutane pyrimidine dimers (CPD) or (6-4)photoproducts. The
      results indicate that nucleosome assembly is inhibited preferentially by (6
      4)photoproducts compared with CPD, suggesting that the regions carrying (6
      4)photoproducts retain their nucleosome-free form, i.e. linker-like conformation
      until completion of the repair processes.

PMID- 7770508
TI  - Photoinactivation (365 nm) of vaccinia and herpes simplex viruses induced by a
      new built-in DNA photosensitizer: 4-thiothymidine.
AB  - The thymidine analogue 4-thiothymidine (s4T) strongly absorbs light at
      wavelengths in the UVA range (lambda max 335 nm) and we have examined the
      photoinactivation of vaccinia and herpes simplex viruses grown in the presence of
      this nucleoside. The cells used in this study (Vero, mouse 1D-TK+) were able to
      grow at the same rate when cultured in the presence of 2 mM s4T or 2 mM
      thymidine, albeit at a slower rate than control cells. Consistent with this
      finding, viruses grown in the presence of 1-4 mM s4T were obtained in reduced
      yield but retained full infectivity. Both viruses were specifically inactivated
      by irradiation with 365 nm light and their photosensitivity, as measured by the
      initial slope of the inactivation curve, increased in parallel with the
      concentration of s4T added to the culture medium. More than 90% of vaccinia virus
      grown in the presence of 4 mM s4T was inactivated. Organomercurial agarose
      chromatography of sheared DNA isolated from vaccinia virus grown in the presence
      of 2 mM s4T showed that approximately 2.5% of DNA fragments were specifically
      retained, as compared to 0.2% for control DNA. This value corresponds to at least
      one s4T residue incorporated per 30,000 nucleotides of vaccinia virus DNA. In
      fact, it is likely that this ratio is actually approximately 10 times higher
      because of the incomplete retention of control thiolated
      oligodeoxynucleotides.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7770509
TI  - On the induction of protective responses in Salmonella typhimurium strain
      TA1535/pSK1002 by UVA (365 nm).
AB  - Exposure to UVA (365 nm) led to growth delay, loss of viability and inhibition of
      3H-thymidine incorporation into the cells of Salmonella typhimurium strain TA1535
      containing multiple copies of a plasmid pSK1002 carrying a umuC'-'lacZ fusion
      gene. Ultraviolet-A induced umu gene expression, as monitored by the estimation
      of beta-galactosidase, in a linear fluence-dependent manner. The induction of umu
      gene expression increased with the increase of postirradiation incubation period
      of the cells in the LB-ampicillin (LBA) medium at 37 degrees C and leveled off
      from 2 h onward. The induction of gene expression depended on concomitant protein
      synthesis and represented the induction of the SOS response in the particular S.
      typhimurium cells used. The exposure to low fluences (sublethal) of UVA also led
      to the induction of an adaptive response in the same bacterial cells, which made
      them resistant to subsequent challenge by a much higher fluence of the same
      radiation. The adaptive response, as monitored by the assays of viability and
      beta-galactosidase units, increased with the period of exposure to sublethal
      fluences of UVA, attained a maximum at the UVA exposure of 4.5 kJ/m2 (15 min) and
      thereafter gradually decreased with further increase of UVA exposure period.
      Modulation studies involving D2O, LBA growth medium, different scavengers of free
      radicals and quenchers of activated oxygen species indicated the involvement of
      both hydroxyl free radicals and singlet oxygen in the UVA-induced umu gene
      expression.

PMID- 7770510
TI  - A multitherapy resistance factor from melanoma reveals that killing by near UV is
      different from genotoxic agents.
AB  - A diffusible multitherapy resistance factor (MTRF) is produced by Cloudman S91
      melanoma cells in vitro. The MTRF decreases sensitivity of the target cell line,
      S91/amel, to gamma-irradiation, UVC (200-280 nm) and mitomycin C (MMC). In the
      present study, we demonstrate that MTRF also increases the survival of S91/amel
      after exposure to actinomycin D (AMD) and vinblastine (VBL). The MTRF is thus
      effective when target cells have been exposed to five genotoxic agents that act
      by different mechanisms. It does not alter the response to the same five agents
      of the S91/I3 producer cells, which are presumably saturated with the factor. The
      factor has no effect on the survival of S91/amel cells that have been exposed to
      lethal doses of near monochromatic UVB (280-320 nm) or UVA (320-400 nm) or to
      polychromatic FS20 lamps. The lack of effectiveness of MTRF after cells have been
      exposed to near (300-400 nm) UV radiation indicates that in this wavelength
      range, S91 melanoma cells are killed by mechanisms that are different from the
      lethal effects of the five genotoxic agents (gamma-irradiation, UVC, MMC, AMD and
      VBL) to which the target cells demonstrate a response.

PMID- 7770511
TI  - Induction of slowly developing alkali-labile sites in human P3 cell DNA by UVA
      and blue- and green-light photons: action spectrum.
AB  - Action spectra (365-520 nm) for the formation of DNA single-strand breaks (SSB)
      and slowly developing alkali-labile sites (SDALS) in human teratocarcinoma P3
      cells in culture were determined. Induction of SDALS results from the absorption
      of blue- and green-light photons. The spectrum has a broad peak that is maximal
      between 400 nm to 500 nm and declines sharply above and below these wavelength
      regions. Negligible yields of SDALS were produced by photons at wavelengths of
      365 nm or shorter and at 520 nm or longer, whereas for SSB, the action ioffeases
      with shorter wavelength throughout the whole spectral range studied. The
      configuration of the SDALS action spectrum suggests that the primary chromophore,
      and therefore possibly the photosensitizer, is a mixture of porphyrin and flavin
      residues.

PMID- 7770512
TI  - Local neurotoxicity of hematoporphyrin derivative following intracerebral
      injection.
AB  - The present study reports on toxicity of hematoporphyrin derivative (HpD) for
      normal brain tissue in vivo without the addition of light. Hematoporphyrin
      derivative was injected by slow infusion in rat brains. Histological examination
      was carried out for intervals after HpD administration, ranging from 0 h to 15
      days. Ultrastructural changes were examined with transmission electron
      microscopy. The extent of the necrosis was determined for different HpD
      concentrations and compared with control animals infused with 0.9% saline.
      Leukocytic infiltration was observed at day 5. Transmission electron microscopy
      showed that nuclei of neurons were completely disintegrated 4 h after HpD
      administration. Furthermore disruption of myelin sheaths was observed. The extent
      of the necrosis decreased with lower HpD doses. Injection of 2 micrograms HpD in
      a volume of 4 microL (0.5 mg/mL) resulted in a virtually equal extension of the
      tissue damage, as compared to the mechanical damage in the control animals caused
      by the infusion procedure.

PMID- 7770513
TI  - On the source of the oscillations observed during in vivo zinc phthalocyanine
      fluorescence pharmacokinetic measurements in mice.
AB  - Surface-detected fluorescence spectroscopy can be used to monitor the
      pharmacokinetics of uptake and clearance of red-absorbing fluorophores such as
      zinc(II) phthalocyanine (ZnPc) in vivo. When this technique is applied to mice
      that have been fed on a normal chlorophyll-based diet, and particularly when
      measurements are performed in the abdominal region, oscillations are sometimes
      observed superimposed on the pharmacokinetic curve of the ZnPc. An oscillatory
      signal has also been observed arising from the abdominal region of control mice
      fed a normal diet but not injected with the ZnPc photosensitizer; this
      oscillatory component to the signal is reduced when mice are fed a chlorophyll
      free diet. The oscillatory signal component has been attributed to fluorescence
      arising from chlorophyll derivatives (pheophorbide/pheophytin) contained in the
      rodent food, whose concentration in the measured abdominal region changes
      substantially with time, presumably due to digestive processes. Thus it is
      important to be aware of the possibility of such artifactual contributions to in
      vivo fluorescence pharmacokinetic measurements.

PMID- 7770514
TI  - The role of transferrin receptor (CD71) in photodynamic therapy of activated and
      malignant lymphocytes using the heme precursor delta-aminolevulinic acid (ALA).
AB  - Endogenously generated protoporphyrin IX (PpIX) from exogenous ALA can be an
      effective photosensitizer. PpIX accumulation is inversely dependent on available
      intracellular iron, which is required for the conversion of PpIX to heme. Iron
      also is necessary for cell replication. Since iron can be toxic, intracellular
      iron levels are tightly controlled. Activated and proliferating cells respond to
      the demand for intracellular iron by upregulating membrane expression of the
      transferrin receptor (CD71) which is needed for iron uptake. We predicted that
      activated lymphocytes (CD71+) would preferentially accumulate PpIX because of
      their lower intracellular iron levels and because of competition for iron between
      ALA-induced heme production and cellular growth processes. Thus, the CD71+ cells
      could serve as PDT targets. Stimulation of human peripheral blood lymphocytes
      (PBL) with the mitogens, phytohemagglutinin A, concanavalin A and pokeweed prior
      to incubation with ALA results in PpIX accumulation correlating with level of
      activation. Activated lymphocytes expressing high levels of surface CD71
      transferrin receptors generated more PpIX than those with low CD71 expression.
      Incubating activated cells in transferrin depleted medium (thereby decreasing the
      iron availability) further increased PpIX levels. Malignant, CD71+ T lymphocytes
      from a patient with cutaneous T-cell lymphoma (CTCL)/Sezary syndrome also
      accumulated increased PpIX levels in comparison to normal lymphocytes. PDT of
      activated lymphocytes and Sezary cells after ALA incubation demonstrated
      preferential killing compared to normal, unstimulated PBL. These findings suggest
      a possible mechanism for the selectivity of ALA PDT for activated CD71+ cells.
      They also indicate a clinical use for ALA-PDT in therapy directed towards the
      malignant lymphocytes in leukemias and lymphomas, and as animmunomodulatory
      agent.

PMID- 7770515
TI  - Transfer of T-DNA from Agrobacterium to the plant cell.
AB  - Agrobacterium tumefaciens is the causative agent of crown gall, a disease of
      dicotyledonous plants characterized by a tumorous phenotype. Earlier in this
      century, scientific interest in A. tumefaciens was based on the possibility that
      the study of plant tumors might reveal mechanisms that were also operating in
      animal neoplasia. In the recent past, the tumorous growth was shown to result
      from the expression of genes coded for by a DNA segment of bacterial origin that
      was transferred and became stably integrated into the plant genome. This initial
      molecular characterization of the infection process suggested that Agrobacterium
      might be used to deliver genetic material into plants. The potential to
      genetically engineer plants generated renewed interest in the study of A.
      tumefaciens. In this review, we concentrate on the most recent advances in the
      study of Agrobacterium-mediated gene transfer, its relationship to conjugation,
      DNA processing and transport, and nuclear targeting. In the following discussion,
      references for earlier work can be found in more comprehensive reviews (Hooykaas
      and Schilperoort, 1992; Zambryski, 1992; Hooykaas and Beijersbergen, 1994).

PMID- 7770516
TI  - Three classes of nuclear import signals bind to plant nuclei.
AB  - Three nuclear localization signals (NLS), including an unusual Mat alpha 2-like
      NLS from maize (Zea mays) R, were found to compete for binding to plant nuclei.
      In addition, the authentic yeast Mat alpha 2 NLS, which does not function in
      mammals, was shown to function in plants in vivo. Our results indicate that
      plants possess a site at the nuclear pore complex that recognizes the three known
      classes of NLSs.

PMID- 7770517
TI  - Cadmium-sensitive, cad1 mutants of Arabidopsis thaliana are phytochelatin
      deficient.
AB  - An allelic series of cad1, cadmium-sensitive mutants of Arabidopsis thaliana, was
      isolated. These mutants were sensitive to cadmium to different extents and were
      deficient in their ability to form cadmium-peptide complexes as detected by gel
      filtration chromatography. Each mutant was deficient in its ability to accumulate
      phytochelatins (PCs) as detected by high-performance liquid chromatography and
      the amount of PCs accumulated by each mutant correlated with its degree of
      sensitivity to cadmium. The mutants had wild-type levels of glutathione, the
      substrate for PC biosynthesis, and in vitro assays demonstrated that each of the
      mutants was deficient in PC synthase activity. These results demonstrate
      conclusively the importance of PCs for cadmium tolerance in plants.

PMID- 7770518
TI  - A cadmium-sensitive, glutathione-deficient mutant of Arabidopsis thaliana.
AB  - The roots of the cadmium-sensitive mutant of Arabidopsis thaliana, cad1-1, become
      brown in the presence of cadmium. A new cadmium-sensitive mutant affected at a
      second locus, cad2, has been identified using this phenotype. Genetic analysis
      has grown that the sensitive phenotype is recessive to the wild type and
      segregates as a single Mendelian locus. Assays of cadmium accumulation by intact
      plants indicated that the mutant is deficient in its ability to sequester
      cadmium. Undifferentiated callus tissue was also cadmium sensitive, suggesting
      that the mutant phenotype is expressed at the cellular level. The level of
      cadmium-binding complexes formed in vivo was decreased compared with the wild
      type and accumulation of phytochelatins was about 10% of that in the wild type.
      The level of glutathione, the substrate for phytochelatin biosynthesis, in
      tissues of the mutant was decreased to about 15 to 30% of that in the wild type.
      Thus, the deficiency in phytochelatin biosynthesis can be explained by a
      deficiency in glutathione.

PMID- 7770519
TI  - Cytokinin action is coupled to ethylene in its effects on the inhibition of root
      and hypocotyl elongation in Arabidopsis thaliana seedlings.
AB  - Cytokinins have profound effects on seedling development in Arabidopsis thaliana.
      Benzyladenine (BA) inhibits root elongation in light- or dark-grown seedlings,
      and in dark-grown seedlings BA inhibits hypocotyl elongation and exaggerates the
      curvature of apical hooks. The latter are characteristic ethylene responses and,
      therefore, the possible involvement of ethylene in BA responses was examined in
      seedlings. It was found that the inhibitory effects of BA on root and hypocotyl
      elongation were partially blocked by the action of ethylene inhibitors or
      ethylene-resistant mutations (ein1-1 and ein2-1). Ethylene production was
      stimulated by submicromolar concentrations of BA and could account, in part, for
      the inhibition of root and hypocotyl elongation. It was demonstrated further that
      BA did not affect the sensitivity of seedlings to ethylene. Thus, the effect of
      cytokinin on root and hypocotyl elongation in Arabidopsis appears to be mediated
      largely by the production of ethylene. The coupling between cytokinin and
      ethylene responses is further supported by the discovery that the cytokinin
      resistant mutant ckr1 is resistant to ethylene and is allelic to the ethylene
      resistant mutant ein2.

PMID- 7770520
TI  - Essential role of urease in germination of nitrogen-limited Arabidopsis thaliana
      seeds.
AB  - In Arabidopsis thaliana, urease transcript levels increased sharply between 2 and
      4 d after germination (DAG) and were maintained at maximal levels until at least
      8 DAG. Seed urease specific activity declined upon germination but began to
      increase in seedlings 2 DAG, reaching approximately 75% of seed activity by 8
      DAG. Urea levels showed a small transient increase 1 DAG and then approximately
      paralleled urease activity, reaching maximal levels at approximately 9 DAG.
      Urease inhibition with phenylphosphorodiamidate resulted in a 2- to 4-fold
      increase in urea levels throughout seedling development. Arginine pools (0-8 DAG)
      changed approximately in parallel with the urea pool. Consistent with arginine
      being a major source of urea, arginase activity increased 10-fold in the interval
      0 to 6 DAG. Allopurinol, a xanthine dehydrogenase inhibitor, had no effect on
      urea levels up to 3 DAG but reduced the urea pool by 30 to 40% during the
      interval 5 to 8 DAG, suggesting that purine degradation contributed to the urea
      pool well after germination, if at all. in aged Arabidopsis seeds, there was
      correlation between phenylphosphorodiamidate inactivation of urease and
      germination inhibition, the latter overcome by NH4NO3 or amino acids. Since
      urease activity, urea precursor, and urea increase in young seedlings, and since
      urease inactivation results in a nitrogen-reversible inhibition of germination,
      we propose that urease recycles urea-nitrogen in the seedling.

PMID- 7770521
TI  - Organ-specific differential regulation of a promoter subfamily for the ribulose
      1,5-bisphosphate carboxylase/oxygenase small subunit genes in tomato.
AB  - The tomato (Lycopersicon esculentum) gene family for the small subunit of
      ribulose-1,5-bisphosphate carboxylase/oxygenase (RBCS) has been investigated to
      determine the role of promoter regions and DNA-protein interactions in the
      differential organ-specific transcription of individual genes. Transgenic plants
      expressing RBCS-promoter-beta-glucuronidase fusion genes have confirmed that
      promoter fragments ranging from 0.6 to 3.0 kb of the RBCS1, RBCS2, and RBCS3A
      genes were sufficient to confer the temporal, organ-specific, and differential
      expression pattern observed for the endogenous genes. The individual temporal and
      organ-specific beta-glucuronidase enzyme activities closely reflect the
      qualitative and quantitative transcription activities of the respective RBCS
      genes, including the strongly reduced activity of RBCS3A (L.A. Wanner, W.
      Gruissem [1991] Plant Cell 3: 1289-1303). In particular, tissue-specific activity
      of all three promoters is similar in developing fruit, with high activity in the
      locular tissue and extremely reduced activity in the pericarp. This specific
      pattern of gene activity was further substantiated by in situ analysis of RBCS
      mRNA levels. Together, the data suggest an interesting correlation between RBCS
      gene activity and sink strength in different fruit tissues. DNA-protein
      interaction studies have revealed a novel fruit-specific DNA-binding protein
      called FBF that specifically interacts with a sequence element directly upstream
      of the G-box in the RBCS3A promoter. FBF binding thus correlates with the reduced
      activity of this promoter in developing tomato fruit, rendering it a candidate
      for a fruit-specific negative regulator of transcription in tomato.

PMID- 7770522
TI  - Characterization of the cell-wall polysaccharides of Arabidopsis thaliana leaves.
AB  - The cell-wall polysaccharides of Arabidopsis thaliana leaves have been isolated,
      purified, and characterized. The primary cell walls of all higher plants that
      have been studied contain cellulose, the three pectic polysaccharides
      homogalacturonan, rhamnogalacturonan I and rhamnogalacturonan II, the two
      hemicelluloses xyloglucan and glucuronoarabinoxylan, and structural
      glycoproteins. The cell walls of Arabidopsis leaves contain each of these
      components and no others that we could detect, and these cell walls are
      remarkable in that they are particularly rich in phosphate buffer-soluble
      polysaccharides (34% of the wall). The pectic polysaccharides of the purified
      cell walls consist of rhamnogalacturonan I (11%), rhamnogalacturonon II (8%), and
      homogalacturonan (23%). Xyloglucan (XG) accounts for 20% of the wall, and the
      oligosaccharide fragments generated from XG by endoglucanase consist of the
      typical subunits of other higher plant XGs. Glucuronoarabinoxylan (4%), cellulose
      (14%) and protein (14%) account for the remainder of the wall. Except for the
      phosphate buffer-soluble pectic polysaccharides, the polysaccharides of
      Arabidopsis leaf cell walls occur in proportions similar to those of other
      plants. The structure of the Arabidopsis cell-wall polysaccharides are typical of
      those of many other plants.

PMID- 7770523
TI  - The major tuber storage protein of araceae species is a lectin. Characterization
      and molecular cloning of the lectin from Arum maculatum L.
AB  - A new lectin was purified from tubers of Arum maculatum L. by affinity
      chromatography on immobilized asialofetuin. Although this lectin is also retained
      on mannose-Sepharose 4B, under the appropriate conditions free mannose is a poor
      inhibitor of its agglutination activity. Pure preparations of the Arum lectin
      apparently yielded a single polypeptide band of approximately 12 kD upon sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis. However, N-terminal
      sequencing of the purified protein combined with molecular cloning of the lectin
      have shown that the lectin is composed of two different 12-kD lectin subunits
      that are synthesized on a single large precursor translated from an mRNA of
      approximately 1400 nucleotides. Lectins with similar properties were also
      isolated from the Araceae species Colocasia esculenta (L.) Schott, Xanthosoma
      sagittifolium (L.) Schott, and Dieffenbachia sequina Schott. Sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis and gel filtration of the different
      Araceae lectins have shown that they are tetrameric proteins composed of lectin
      subunits of 12 to 14 kD. Interestingly, these lectins are the most prominent
      proteins in the tuber tissue. Evidence is presented that a previously described
      major storage protein of Colocasia tubers corresponds to the lectin.

PMID- 7770524
TI  - Development and application of an in vivo plant peroxisome import system.
AB  - The purposes of this study are to develop an in vivo cell system that is suitable
      for the immunofluorescent detection of transiently expressed proteins targeted to
      plant peroxisomes and to determine whether a C-terminal serine-lysine-leucine
      (SKL) tripeptide, a consensus-targeting signal for mammalian peroxisomes, also
      targets proteins to plant peroxisomes. Protoplasts from mesophyll cells and from
      suspension-cultured cells initially were examined for their potential as an in
      vivo import system. Several were found suitable, but based on a combination of
      criteria, suspension-cultured tobacco (Nicotiana tabacum L. cv Bright Yellow 2)
      cells (TBY-2) were chosen. The tobacco cell extracts had catalase activity, and
      two polypeptides of approximately 55 and 57 kD specifically were detected on
      immunoblots with anti-cottonseed catalase immunoglobulins G as the probe.
      Indirect immunofluorescence microscopy with these immunoglobulins G revealed a
      punctate labeling pattern indicative of endogenous catalase localization within
      putative TBY-2 peroxisomes. The cells did not have to be completely converted to
      protoplasts for optimal microscopy; treatment with 0.1% (w/v) pectolyase for 2 h
      was sufficient. Microprojectile bombardment proved superior for transient
      transformation of the TBY-2 cells with plasmids encoding beta-glucuronidase, or
      chloramphenicol acetyltransferase (CAT), or CAT with an added C-terminal
      tripeptide (CAT-SKL). C-terminal SKL is a consensus, type 1, peroxisome targeting
      signal. Double indirect immunofluorescent labeling showed that CAT-SKL co
      localized with endogenous catalase. Non-punctate, diffuse localization of CAT
      without SKL provided direct evidence that the C-terminal SKL tripeptide was
      necessary and sufficient for targeting of CAT to plant peroxisomes. These data
      demonstrate the effectiveness of this peroxisome targeting signal for plant
      cells.

PMID- 7770525
TI  - Molecular features and mitochondrial import pathway of the 14-kilodalton subunit
      of cytochrome c reductase from potato.
AB  - The cytochrome c reductase complexes from fungi and mammals both contain a 14-kD
      protein (yeast, 14.4 kD; bovine, 13.4 kD) that does not directly participate in
      electron transfer but possibly is indirectly involved in the function of the
      complex and has a role in assembly of the multimeric enzyme. A subunit of
      comparable size was identified for the bc1 complex of higher plants. The 14-kD
      protein from potato (Solanum tuberosum) was specifically separated from the
      isolated protein complex in the presence of 6 M urea and is, therefore, assumed
      to be a peripheral component. Direct sequence analysis of the proteins from
      potato and wheat (Triticum aestivum) and isolation of corresponding cDNA clones
      for the subunit from potato revealed clear similarity to the equivalent proteins
      from yeast and bovine. The wheat 14-kD protein seems to occur in two isoforms.
      The 14-kD protein from plants is very hydrophilic, has a characteristic charge
      distribution, and contains no potential membrane-spanning helices. In vitro
      import of the radiolabeled 14-kD protein from potato into isolated mitochondria
      depends on the membrane potential across the inner mitochondrial membrane. The
      protein seems to lack a cleavable mitochondrial presequence, because it is not
      processed upon translocation. Possible intramolecular regions involved in
      targeting of the 14-kD protein to plant mitochondria are discussed.

PMID- 7770527
TI  - Rice cationic peroxidase accumulates in xylem vessels during incompatible
      interactions with Xanthomonas oryzae pv oryzae.
AB  - A cationic peroxidase, PO-C1 (molecular mass 42 kD, isoelectric point 8.6), which
      is induced in incompatible interactions between the vascular pathogen Xanthomonas
      oryzae pv oryzae and rice (Oryza sativa L.), was purified. Amino acid sequences
      from chemically cleaved fragments of PO-C1 exhibited a high percentage of
      identity with deduced sequences of peroxidases from rice, barley, and wheat.
      Polyclonal antibodies were raised to an 11-amino acid oligopeptide (POC1a) that
      was derived from a domain where the sequence of the cationic peroxidase diverged
      from other known peroxidases. The anti-POC1a antibodies reacted only with a
      protein of the same mobility as PO-C1 in extracellular and guttation fluids from
      plants undergoing incompatible responses collected at 24 h after infection. In
      the compatible responses, the antibodies did not detect PO-C1 until 48 h after
      infection. Immunoelectron microscopy was used to demonstrate that PO-C1
      accumulated within the apoplast of mesophyll cells and within the cell walls and
      vessel lumen of xylem elements of plants undergoing incompatible interactions.

PMID- 7770526
TI  - Maize ribosome-inactivating protein (b-32). Homologs in related species, effects
      on maize ribosomes, and modulation of activity by pro-peptide deletions.
AB  - The ribosome-inactivating protein (RIP) from maize (Zea mays L.) is unusual in
      that it is produced in the endosperm as an inactive pro-form, also known as b-32,
      which can be converted by limited proteolysis to a two-chain active form, alpha
      beta RIP. Immunological analysis of seed extracts from a variety of species
      related to maize showed that pro/alpha beta forms of RIP are not unique to maize
      but are also found in other members of the Panicoideae, including Tripsacum and
      sorghum. Ribosomes isolated from maize were quite resistant to both purified pro-
      and alpha beta maize RIPs, whereas they were highly susceptible to the RIP from
      pokeweed. This suggests that the production of an inactive pro-RIP is not a
      mechanism to protect the plant's own ribosomes from deleterious action of the
      alpha beta RIP. RIP derivatives with various pro-segments removed were expressed
      at high levels in Escherichia coli. Measurement of their activity before and
      after treatment with subtilisin Carlsberg clearly identified the 25-amino acid
      intradomain insertion, rather than the N- or C-terminal extensions, as the major
      element responsible for suppression of enzymatic activity. A RIP with all three
      processed regions deleted had activity close to that of the native alpha beta
      form.

PMID- 7770528
TI  - The tomato Never-ripe locus regulates ethylene-inducible gene expression and is
      linked to a homolog of the Arabidopsis ETR1 gene.
AB  - Fruit ripening represents a complex system of genetic and hormonal regulation of
      eukaryotic development unique to plants. We are using tomato ripening mutants as
      tools to elucidate genetic components of ripening regulation and have recently
      demonstrated that the Never-ripe (Nr) mutant is insensitive to the plant growth
      regulator ethylene (M.B. Lanahan, H.-C. Yen, J.J. Giovannoni, H.J. Klee [1994]
      Plant Cell 6:521-530). We report here ethylene sensitivity over a range of
      concentrations in normal and Nr tomato seedlings and show that the Nr mutant
      retains residual sensitivity to as little as 1 part per million of ethylene.
      Analysis of ripening-related gene expression in normal and mutant ethylene
      treated fruit demonstrates that Nr exerts its influence on development at least
      in part at the level of ethylene-inducible gene expression. We have additionally
      used cloned tomato and Arabidopsis sequences known to influence ethylene
      perception as restriction fragment length polymorphism probes, and have
      identified a tomato locus linked to Nr that hybridizes to the Arabidopsis ETR1
      gene at low stringency, suggesting the possibility that Nr may be homologous to
      ETR1.

PMID- 7770529
TI  - Polysaccharide composition of unlignified cell walls of pineapple [Ananas comosus
      (L.) Merr.] fruit.
AB  - The polysaccharides of cell walls isolated from the fleshy, edible part of the
      fruit of the monocotyledon pineapple [Ananas comosus (L.) Merr.] (family
      Bromeliaceae) were analyzed chemically. These cell walls were derived mostly from
      parenchyma cells and were shown histochemically to be unlignified, but they
      contained ester-linked ferulic acid. The analyses indicated that the
      noncellulosic polysaccharide composition of the cell walls was intermediate
      between that of unlignified cell walls of species of the monocotyledon family
      Poaceae (grasses and cereals) and that of unlignified cell walls of dicotyledons.
      Glucuronoarabinoxylans were the major non-cellulosic polysaccharides in the
      pineapple cell walls. Xyloglucans were also present, together with small amounts
      of pectic polysaccharides and glucomannans (or galactoglucomannans). The large
      amounts of glucuronoarabinoxylans and small amounts of pectic polysaccharides
      resemble the noncellulosic polysaccharide composition of the unlignified cell
      walls of the Poaceae. However, the absence of (1-->3,1-->4)-beta-glucans, the
      presence of relatively large amounts of xyloglucans, and the possible structure
      of the xyloglucans resemble the noncellulosic polysaccharide composition of the
      unlignified cell walls of dicotyledons.

PMID- 7770530
TI  - Elevated mRNA levels of the ribosomal protein L19 and a calmodulin-like protein
      in assimilate-accumulating transgenic tobacco plants.

PMID- 7770531
TI  - Nucleotide sequence of genomic DNA encoding the potato beta-1,3-glucanase.

PMID- 7770532
TI  - Nucleotide sequence of a cDNA encoding mitochondrial malate dehydrogenase from
      Eucalyptus.

PMID- 7770533
TI  - PZF, a cDNA isolated from Lotus japonicus and soybean root nodule libraries,
      encodes a new plant member of the RING-finger family of zinc-binding proteins.

PMID- 7770534
TI  - Nucleotide sequence of a Populus tremuloides gene encoding bispecific caffeic
      acid/5-hydroxyferulic acid O-methyltransferase.

PMID- 7770535
TI  - A spinach cDNA with homology to S-Adenosylmethionine decarboxylase.

PMID- 7770536
TI  - Nucleotide sequence of a rice cDNA encoding a homolog of the eukaryotic ribosomal
      protein S8.

PMID- 7770537
TI  - Isolation and characterization of a cDNA clone encoding a lectin gene from
      Agaricus bisporus.

PMID- 7770538
TI  - Two cDNA clones encoding isoforms of the beta-subunit of the general
      mitochondrial processing peptidase from potato.

PMID- 7770539
TI  - Cloning of an additional cDNA for the alternative oxidase in tobacco.

PMID- 7770540
TI  - Characterization of a cDNA encoding ribosomal protein S16 in rice.

PMID- 7770541
TI  - Nucleotide sequence of a cDNA encoding the ADP/ATP carrier from wheat (Triticum
      turgidum).

PMID- 7770542
TI  - High conservation among sequences encoding type-V thionins in wheat and Aegilops.

PMID- 7770543
TI  - Characterization of a cotton (Gossypium hirsutum L.) fiber mRNA (Fb-B6).

PMID- 7770544
TI  - Nucleotide sequence of Arabidopsis thaliana arginase expressed in yeast.

PMID- 7770546
TI  - Nucleotide sequence of a wheat chloroplastic phosphoglycerate kinase gene.

PMID- 7770545
TI  - Isolation, sequencing, and analysis of a 14-3-3 brain protein homolog from pea
      (Pisum sativum L.).

PMID- 7770547
TI  - Cloning and sequencing of a cDNA clone encoding the photosystem I PsaD subunit
      from Chlamydomonas reinhardtii.

PMID- 7770548
TI  - Differential down-regulation of epidermal growth factor receptors expressed in
      the metastatic variants of human lung cancer adenocarcinoma cell line DMS4C.
AB  - The metastatic variants of human lung adenocarcinoma cell line DMS4C were
      established by selection in vivo. Lung, brain, spleen and liver metastatic tumors
      derived from intracarotid inoculation of athymic BALB/c mice were collected, and
      their corresponding variant cell lines established. The epidermal growth factor
      (EGF) receptor expression of the parental cell line as well as the metastatic
      variant cell lines were investigated. 125I-labeled EGF binding assays showed that
      there were two types of EGF receptors in both parental and metastatic variants.
      Compared to DMS4C, the EGF binding capacities were found to be down-regulated by
      70, 79, 85 and 89% for lung, spleen, liver and brain variant, respectively. The
      dissociation constants of spleen, liver and brain EGF receptors were distinct
      from that of the parental cell line. The EGF receptor autophosphorylation
      activity of lung variant was shown to be down-regulated as shown by immune
      complex kinase assay that corresponded to EGF receptor numbers whereas kinase
      activities of the liver, spleen and brain variants EGF receptors were completely
      abolished. However, the 170 kilodalton EGF receptor was shown to be unaltered
      during metastasis. The results indicated that, during metastasis progression, the
      proliferation of adenocarcinoma cells may have adopted a different growth
      regulation that is independent of EGF receptor kinase-modulated autocrine
      pathway. The result also implies that other oncogene may emerge as the major
      growth regulator for distant metastasis of adenocarcinoma cancer cells. This work
      provides a model for understanding tumor metastasis progression of human lung
      cancer.

PMID- 7770549
TI  - Gravity effect on lymphocyte deformation through cell shape change.
AB  - The effects on human cells (lymphocyte) immersed in a culture liquid under
      microgravity environment has been investigated. The study was based on the
      numerical simulation of the Morphology of human cells affected by the time
      dependent variation of gravity acceleration ranging from 10(-3) to 2 g(o) (g(o) =
      9.81 m/s2) in 15 s. Both the free floating cells and the cells which came into
      contact with the upper and lower inclined walls imposed by the time-dependent
      reduced gravity acceleration were considered in this study. The results show
      that, when the gravity acceleration increased, the cell morphology changed from
      spherical to horizontally elongated ellipsoid for both the free floating cells
      and the stationary cells on the lower inclined wall while the cell morphology
      varied from spherical to vertically-elongated ellipsoid for the cells hanging on
      the upper inclined wall. A test of the deformation of human cells exposed to the
      variation of gravity levels, carried out in the KC-135 free fall aircraft, show
      that the results of experimental observations agree exactly with the theoretical
      model computation described in this paper. These results will be useful for study
      of the behavior and morphology of cells in space.

PMID- 7770550
TI  - Detection of Rickettsia tsutsugamushi specific DNA from the lymphocyte of
      patients by polymerase chain reaction.
AB  - Polymerase chain reaction was used to detect Rickettsia tsutsugamushi specific
      DNA from the lymphocytes of patients in the acute phase of the disease. The
      primers used in the PCR were based on the nucleotide sequences of gene encoding
      of the 56 kDa antigen of the Gilliam strain. The PCR product is a 78 bp fragment
      which can be hybridized by the 78 bp DNA probe of the Gilliam strain. Comparison
      of the results obtained by polymerase chain reaction, immunofluorescent assay and
      cell culture suggests that the polymerase chain reaction method is the most
      sensitive one among the three in diagnosis of scrub typhus.

PMID- 7770551
TI  - Assessment of heart wall motion: modified spatial modulation of magnetization for
      MR imaging.
AB  - This paper reports a new noninvasive method for detecting a regional myocardial
      infarction. The method consists of superimposing a magnetization grid onto
      different image planes of the human heart. In this study the spatial modulation
      of magnetization (SPAMM) in magnetic resonance imaging was modified to
      accommodate the use of a conventional clinical magnet. The percentages of
      circumferential shortening (PCS) and the percentages of wall thickening (PWT)
      during a cardiac cycle were estimated by measuring the amount of deformation of
      each grid from the end of the diastole to the end of the systole. A small data
      base was established on 10 subjects (6 normal volunteers and 4 patients).
      Patients with regional myocardial infarction, when monitored by the modified
      SPAMM investigation, showed smaller values of PCS and PWT in the areas where
      myocardial infarction was diagnosed by catheterization. The amount in decrement
      was directly proportional to the severity of the regional lesions.

PMID- 7770552
TI  - The center of ground reaction force during lifting.
AB  - The center locations of the ground reaction force were estimated when subjects
      assumed upright and bending postures as well as when they lifted at low and high
      speeds. Ten subjects participated in this study and were instructed to assume two
      postures and to perform two liftings sequentially in a random order. The center
      locations of the ground reaction force were calculated using a Computerized Dyno
      Graphic system (INFOTRONIC). The center of the ground reaction force in the full
      bending posture had a more anterior location than it did in the upright standing
      posture. When measured during the lifting activity, the center of the ground
      reaction force shifted forward and then backward during the whole activity. The
      center location shifted to a more anterior location during high-speed lifting
      than it did during low-speed lifting.

PMID- 7770553
TI  - Suicide in Quebec, 1951-1986.
AB  - Data from Fortier, et al. (1989) were reanalysed using multiple regression. While
      birth and divorce rates were significantly associated with both male and female
      suicide rates, unemployment rates and cirrhosis death rates were associated only
      with male suicide rates.

PMID- 7770554
TI  - Toward a new approach to schizophrenic psychosis.
AB  - The author proposes a classifying principle for the various clinical aspects of
      schizophrenia. It is based on the hypothesis that thinking processes are carried
      on as the three temporal conditions of the experience (continuous, discontinuous
      and successive, and reversible or simultaneous) whose combination structures sane
      thoughts. Mental symptoms are proposed as indexed to the particular anomaly of
      one of those three components: disruption to the lack of simultaneity,
      hallucination to the lack of continuity, delusion and misinterpretation to the
      lack of successivity. Other symptoms (deficit, withdrawal, stereotypy) are
      reactional to one of the prior mechanisms.

PMID- 7770555
TI  - Uric acid levels and severity of aggression.

PMID- 7770556
TI  - Parents' perceptions of their adolescence: implications for parent-youth conflict
      and family satisfaction.
AB  - This study examined the relation between parents' perceptions of "storm and
      stress" in their own adolescence and their current relationships with their
      children. A sample of 121 adolescents and their parents (106 mothers) were
      surveyed. Analysis indicated that over 48% of these parents viewed their
      adolescence as being stormy and stressful. Parents who experienced greater storm
      and stress as youth had more conflict in their relationships with their children
      and were less satisfied with their families. Implications for intergenerational
      theory and family intervention are presented.

PMID- 7770557
TI  - Internal reliability and convergent validity of the Depression-Happiness Scale
      with the General Health Questionnaire in an employed adult sample.
AB  - The aim of this study was to investigate the internal reliability and convergent
      validity of the 1993 McGreal and Joseph Depression-Happiness Scale. Internal
      reliability was satisfactory and higher scores on the scale were associated with
      lower scores of 60 working adults on the General Health Questionnaire of Goldberg
      and Williams.

PMID- 7770558
TI  - MMPI scores of female victims.
AB  - Samples of MMPIs of women who were victims of abuse or manifested a Posttraumatic
      Stress Disorder were drawn from two private practice settings, one urban and one
      in a small town. Each PTSD sample included 21 persons. For comparison, two
      contrast samples of 15 persons each were drawn from the same populations. A cut
      off point of T = 65 for PK yielded a 69% hit rate for classifying PTSD and
      contrast subjects. Since scores on PS and PK were so highly correlated, no
      independent analyses were warranted. Although the PTSD group yielded a more
      elevated mean profile, there were no characteristic 2-point codes. Therefore, PK
      is more useful in identifying Posttraumatic Stress Disorder than either profile
      elevation or configuration.

PMID- 7770559
TI  - Naloxone blocks learned helplessness in the slug (Limax maximus).

PMID- 7770561
TI  - Open-area seclusion in the long-term treatment of aggressive and disruptive
      psychotic patients, an introduction to a ward procedure.
AB  - The clinical rationale and procedure of "open-area seclusion" as a treatment
      modality with psychotic patients is presented. This standard procedure was
      originally introduced as an alternative to arbitrary measures in response to
      aggressive and disruptive behavior. The seclusion area is locked, but the patient
      is never locked up alone in any single room. The method of open-area seclusion is
      composed of four overlapping phases: (1) assisting the patient to the seclusion
      area, (2) time for a "calming down" process, (3) debriefing, and (4)
      reintegration. Verbal confrontation is central in enhancing the secluded
      patient's reality-testing, for reinforcing responsibility for one's own behavior,
      and for encouraging alternative problem-solving. A step-by-step description of
      the procedure of open-area seclusion is presented and illustrated by a case
      history.

PMID- 7770560
TI  - Use of the Lollipop Test as a predictor of California Achievement Test scores in
      kindergarten and transitional first-grade status.

PMID- 7770562
TI  - Relationship of response-set differences on Beck Depression Inventory scores of
      undergraduate students.
AB  - The relationship of a ruminating and a distracting response style upon severity
      of depression and on gender were investigated. The Ways of Coping Questionnaire
      was modified to include ruminating and distracting scales and administered to 91
      undergraduate students who also completed the Beck Depression Inventory. It was
      hypothesized that (a) regardless of gender, people who ruminate would have
      greater rated severity of depression than people who distract themselves; (b)
      women ruminators would show higher rated severity of depression than women
      distractors; and (c) female and male ruminators would show the same ratings on
      severity of depression. A set of t ratios was computed for mean differences
      between the groups. An analysis of variance for response style x gender was also
      done with the women and men classified as ruminators. The results conformed to
      the predictions for women but not for men.

PMID- 7770563
TI  - MCMI-II profiles and typologies for patients seen in marital therapy.
AB  - The Millon Clinical Multiaxial Inventory-II profiles of 145 patients in marital
      therapy, seen in a private-practice outpatient setting, were subjected to a
      hierarchical cluster analysis. Four distinct clusters were found (MCMI-II
      Codetypes 58B4, 8A6B8B5, 3217, and 37). Each of these clusters suggested
      different therapeutic goals. There were some scale differences by gender, with
      women tending to score higher on the Dependent Scale. We argue that private
      practice settings generate a wealth of data which can be taken from such files
      and used to address empirical questions.

PMID- 7770565
TI  - Ireland: gender, psychological health, and attitudes toward emigration.
AB  - Ireland is experiencing one of the highest periods of emigration in its history.
      The current study collected demographic and psychological data on 203 Irish men
      and women in Ireland and in Northern Ireland, including measures of self-esteem,
      depression, attitudes toward immigration, and expectancies of emigration.
      Analysis indicated that approximately 81% of this Irish sample are considering
      emigration; however, the prospect of emigration is psychologically experienced
      differently by men and women. While there were no significant differences over
      all in scores on self-esteem between Irish men and women, men who contemplated
      emigration reported higher self-esteem scores, and women contemplating emigration
      reported lower self-esteem scores (relative to those who had no plan to
      emigrate). In addition, women who contemplated emigration had higher depression
      scores than women who did not contemplate emigration. This pattern was not
      evident for men. These results indicate that psychologically women view the
      prospect of emigration less positively than men.

PMID- 7770564
TI  - Temporal stability of psychophysiological stress profiles: a re-analysis using
      intraclass correlation coefficients.
AB  - This is a re-analysis of data from a previous study which examined the temporal
      stability of three psychophysiological responses [frontal electromyographic
      activity (EMG), hand surface temperature, and heart rate]. Each response was
      recorded on 64 subjects over four sessions, each of which consisted of a 20-min,
      adaptation period, a baseline condition, and two stressors (one cognitive, the
      other physical). Rather than using Pearson product-moment correlations, as nearly
      all psychophysiological test-retest reliability studies have, we have now
      analyzed the data using intraclass correlation coefficients. This type of
      correlation allows one to incorporate more than two test-retest values on the
      same subjects. Analysis indicated that, with the exception of EMG during the
      physical stressor, the absolute values of the responses had quite significant
      reliability (.70 or greater). Treating the responses as relative measures
      (percent change from baseline or simple change scores from baseline) produced
      smaller and frequently less stable coefficients. It is concluded that statistical
      estimates of psychophysiological response reliability are functions of the design
      and particular reliability analysis employed.

PMID- 7770566
TI  - Measures of treatment outcome of depression: an effect-size comparison.
AB  - Meta-analytic studies of the values of various measures of the outcome of
      antidepressive treatment have consistently shown that different scales produce
      different patterns of progress for the same patients, but results have differed
      somewhat in other respects. The present results suggest that these problems are
      probably related to use of different scales emphasizing different aspects of
      depression.

PMID- 7770567
TI  - Improving mental fitness reports of candidates for police officer and fire
      fighter.
AB  - On the basis of 18 years of experience on the Medical Review Panel of the New
      Jersey Department of Personnel, the author points out some shortcomings commonly
      observed in psychological/psychiatric evaluative reports on mental fitness of
      police officer and fire fighter candidates. Each shortcoming is noted under one
      of two headings, i.e., routine information or inferences.

PMID- 7770569
TI  - Community context and the underutilization of mental health services by minority
      patients.
AB  - An organization applying the principles of "community context" had 20 dropouts
      among 111 African American and Hispanic patients in its mental health services.
      Its sister organization applying conventional psychiatric service approaches had
      114 dropouts among 167 African American and Hispanic patients.

PMID- 7770568
TI  - FIRO-B: the power of love and the love of power.
AB  - Factor analysis of FIRO-B data obtained from new software product teams had led
      to a reformulation of Schutz's ideas on team compatibility. The concept of Group
      Warmth as a derivative of the FIRO-B Inclusion and Affection scales was developed
      and shown to be related to the commercial effectiveness of teams. In a like
      manner, the FIRO-B constructs of Control-Expressed and Control-Wanted were
      explored through concurrent factor analysis of 16 PF data. A new interpretation
      has been given to both FIRO-B Control scales, namely, Assertive-Impulsive.

PMID- 7770570
TI  - Sexual behavior and telling the truth on questionnaires.

PMID- 7770571
TI  - Relationship between the Bracken Basic Concept Scale and the Differential Ability
      Scales with an at-risk sample of preschoolers.
AB  - This study investigated the relationship between the Bracken Basic Concept Scale
      and the Differential Ability Scales with 35 at-risk preschoolers between the ages
      3-6 and 5-11. A Pearson product-moment correlation coefficient of .70 was
      obtained between the Bracken Basic Concept Scale Total Test scores and the
      General Conceptual Ability scores of the Differential Ability Scales. This
      association supports the use of the Bracken scale to predict intelligence if
      replicated with a larger sample and specific handicaps. In addition, support for
      the administration of the more brief Bracken School Readiness Composite compared
      to using the Bracken Total Test score in the prediction of the Differential
      Ability Scales General Conceptual Ability score was found.

PMID- 7770572
TI  - Gender and depression in undergraduates: a comment.

PMID- 7770573
TI  - Training effects of one academic year on instructional values of MA students in
      confluent education and counseling psychology.

PMID- 7770574
TI  - Chronic pain and depression: is social support relevant?
AB  - This study examined the relationship between social support and depression for 70
      patients with chronic back pain. We also explored whether the family environments
      of these patients related to depression and whether the patients' depression
      predicted outcome subsequent to involvement in a functional restoration program.
      The patients completed a battery of psychological questionnaires to assess
      depression, social support, and family environment. Outcome of a rehabilitation
      program was measured in terms of physical gains, vocational gains, and progress
      made toward program goals. Analysis indicated that the 25 depressed and 23
      nondepressed patients differed as to perceived social support and quality of
      family environment; however, no association was found between depression and
      rehabilitation outcome. Implications for family interventions are discussed.

PMID- 7770575
TI  - Animal rights activism and animal welfare concerns in the academic setting:
      levels of activism and the perceived importance of research with animals.
AB  - Past research suggests that public support for the use of animal models as means
      to improve the human condition is present but many individuals have expressed
      ambivalence. In the present study, various sectors of the academic community
      (students and faculty) as well as the general population, were surveyed to assess
      their positions on the need for, and value of animal research, the value of
      psychological research in which animals are employed, and the respondents'
      consummatory habits. The results suggested that more information needs to be
      provided about the role of animal experimentation, including a discussion of the
      benefits produced by using animals to answer psychological questions.

PMID- 7770576
TI  - Self-reported high-risk behavioral history of HIV positive prison inmates.
AB  - 30 male HIV positive prison inmates tended to deny high-risk behavior for
      infection, most notably homosexuality. The public health implications are that
      the veracity of such denial should not be assumed.

PMID- 7770577
TI  - Inner speech as a cognitive process mediating self-consciousness and inhibiting
      self-deception.
AB  - The cognitive processes which mediate self-consciousness are unknown. although
      Morin and others have suggested that inner speech may mediate self-consciousness.
      We developed a questionnaire which measures the extent to which one talks to
      oneself about oneself. As expected, the correlation between inner speech and self
      consciousness was significant. A German version of the 1979 self-deception
      questionnaire by Sackeim and Gur correlated negatively with the scores on inner
      speech, suggesting the validity of the questionnaire. We also replicated the
      negative association between depression and self-deception in a different
      culture.

PMID- 7770578
TI  - Attitudes of women toward homosexual behavior as a function of veteran status.

PMID- 7770579
TI  - Preliminary data on a relation between self-talk and complexity of the self
      concept.
AB  - Recent empirical work in social cognition suggests that in building a self
      concept people make inferences about themselves based on overt behavior or
      private thoughts and feelings. This article addresses the question of how,
      exactly, people make these inferences about themselves and raises the possibility
      that they do so through self-talk. It is proposed that the more on talks to
      oneself to construct a self-image, the more this image will gain coherence and
      sophistication. A correlational study was conducted to explore the relation
      between richness of the self-concept (using the W-A-Y) and natural disposition to
      talk to oneself (using a pilot questionnaire). A moderate but positive
      correlation of .30 is obtained. The article concludes with clinical implications.

PMID- 7770580
TI  - The Behavioral Academic Self-Esteem Scale with preschoolers.
AB  - 15 teachers completed the Behavioral Academic Self-Esteem Scale (alpha = .93) for
      71 preschoolers. Teachers rated self-esteem positively. Three factors were
      identified, confident approach, adaptability to routines, and dealing with
      failure/frustration.

PMID- 7770581
TI  - Chronic obstructive pulmonary disease and symptoms related to depression in
      elderly persons.
AB  - In a community study, 61 men and 21 women with mild to severe chronic obstructive
      pulmonary disease (COPD) were compared with age- and sex-matched controls (183
      men and 63 women) to identify and analyze the associations between the occurrence
      of COPD and depressive symptoms, the occurrence of previous or current
      psychiatric disorders, the use of psychiatric drugs, and satisfaction with one's
      marital relationship. In men, no associations between COPD and the above factors
      were found. More women with COPD than controls reported feelings of
      dissatisfaction with life. The female patients also tended to be less satisfied
      with their marital relationship than the controls. Multivariate analysis showed
      that this disease in women was associated with disability (odds ratio 3.25, 95%
      confidence interval 1.17-9.06), feelings of dissatisfaction with life (odds ratio
      3.56, 95% confidence interval 1.23-10.34), and low satisfaction with one's
      marital relationship (odds ratio 3.23, 95% confidence interval 1.10-9.47). These
      results seem to suggest that elderly female patients with COPD have more mental
      health problems than male patients and these will require more attention from the
      primary care providers.

PMID- 7770582
TI  - Some comments on the Gough Socialization Scale.

PMID- 7770583
TI  - Two investigations of the validity of the WISC-III.
AB  - Two studies were conducted in which the validity of the WISC-III was
      investigated. In Study 1, WISC-R and WISC-III IQs were correlated for a sample of
      53 students, who, although originally meeting criteria for a disability category
      through use of the WISC-R, did not meet eligibility criteria upon reevaluation
      with the WISC-III. Corrected correlations between IQs were high, ranging from .80
      to .87, and were comparable to figures reported in the WISC-III manual.
      Consistent with the WISC-III manual, WISC-III IQs were 8, 5, and 7 points lower
      than the WISC-R Full Scale, Verbal, and Performance IQs, respectively. In Study
      2, the criterion validity of the WISC-III with the WRAT-R Reading, Spelling, and
      Arithmetic subscales and with the PPVT-R was investigated for a sample of 32
      students with mental retardation. The WISC-III IQs and PPVT-R scores were highly
      correlated, sharing between 64 to 76% of variance. Correlations between WISC-III
      IQs and scores on the WRAT-R Reading and Arithmetic subscales were moderate.
      Surprisingly, the WISC-III IQs were not related to the WRAT-R Spelling scores.
      Implications of both studies for assessment specialists are discussed.

PMID- 7770584
TI  - The type 2 construct and its relation to coronary heart disease.
AB  - The main aim of this study was to scrutinize the link postulated in 1988 between
      the Type 2 construct of Grossarth-Maticek, Eysenck, and Vetter and the incidence
      of coronary heart disease. Self-report data were collected from 58 men who had
      suffered an infarct, had been hospitalised, and had later enrolled at a physical
      outpatient clinic as well as from a randomly assigned control group of 70 men.
      Analysis showed that the Type 2 scores in the infarct group did not differ
      significantly from those of the control group or from measures taken immediately
      after an acute myocardial infarction and measures taken 3 months later. The
      results do not support the hypothesis of a strong association between coronary
      heart disease and Type 2 scores.

PMID- 7770585
TI  - Race and crime: international data for 1989-1990.
AB  - The rate of murder, rape, and serious assault per 100,000 members of the
      population was tabulated for 76 countries from the 1989-1990 International Crime
      Statistics published by INTERPOL. Following previous research the countries were
      grouped into the three major populations of Asian, Caucasian, and African.
      Consistent with previous evidence the results showed that crime rates are highest
      for countries with predominantly African populations, lowest for those with
      predominantly Asian populations, and in-between for those with predominantly
      Caucasian populations. The 23 countries with predominantly African populations
      reported twice as high a rate for each type of crime as the 41 countries with
      predominantly Caucasian populations and over three times as high a rate as the 12
      countries with predominantly Asian populations. Summing the crimes gives figures,
      respectively, of 240, 75, and 32 violent crimes per 100,000 population.

PMID- 7770586
TI  - Survey of the nature and prevalence of patients' noncompliance and implications
      for intervention.
AB  - The problem of patients' noncompliance is discussed, noting possible biases in
      estimates of prevalence (18 to 82%) which may overestimate compliance rates and
      frequent failure to define conditions constituting compliance. This survey
      obtained information on the nature and incidence of noncompliance from a
      "healthy," Census-based, sample (n = 148), age 20 to 79 years. Data were examined
      to identify relationships among variables in compliance and demographic
      characteristics. The typical household had 3.9 prescribed drugs, 46% of
      respondents chose generic products, 54% preferred tablets or pills, and 69% cited
      physicians as their primary information source on medications. Rates were
      identified for obtaining and using all prescribed drugs and following frequency
      and dose instructions for prescriptions. Full compliance was reported by 25%, and
      seriousness of illness was the most important factor cited as an influence.

PMID- 7770587
TI  - Belief in lunar effects on human behavior.
AB  - Questionnaires sent to 325 people indicated that 140 people (43%) held the
      personal belief that lunar phenomena alter individual behavior. Specifically,
      mental health professionals (social workers, master's clinical psychologists,
      nurses' aides, LPNs) held this belief more strongly than other occupational
      groups.

PMID- 7770588
TI  - Attachment anxiety and reciprocity as moderators of interpersonal attraction.
AB  - In integrating the interpersonal domains of attraction, perceived reciprocity,
      and attachment security, the prediction was made that positive interpersonal
      feedback (reciprocity) would lead to a greater increase in attraction ratings for
      anxiously versus securely attached individuals and, correspondingly, negative
      interpersonal feedback would cause a greater diminution in attraction ratings for
      anxiously versus securely attached individuals, with neutral feedback having no
      differential effect. For a sample of 154 college students, these predictions as
      well as an unanticipated gender finding were supported. The findings and clinical
      implications concerning the susceptibility of anxiously attached individuals to
      positive interpersonal cues are discussed in terms of a compromised sense of the
      availability and responsiveness of attachment figures.

PMID- 7770589
TI  - Self-esteem, stress, and depression among graduate students.
AB  - In a study of 29 graduate students, self-ratings of stress correlated with low
      scores on self-esteem but were not related to an objective indicator of actual
      stress. Both self-rated stress and low self-esteem scores were related to scores
      on depression, with a weak interaction effect.

PMID- 7770590
TI  - Assessment of subjective distress by patients' self-report versus structured
      interview.
AB  - Comparison was made of symptom and behavior scores obtained by structured
      interview versus self-report using the Behavior and Symptom Identification Scale.
      Psychiatric hospital admissions were randomly assigned to 1 of 3 assessment
      groups, structured interview, self-report, or choice of procedure. Analysis
      indicated that patients in the self-report group reported significantly greater
      difficulty on 1 of 5 dimensions assessed by the scale. The results suggest that a
      self-report questionnaire form of the measure is a viable alternative to the
      structured interview.

PMID- 7770591
TI  - Factor analysis of the Center for Epidemiological Studies-Depression Scale.
AB  - The Center for Epidemiological Studies-Depression Scale is one of the most
      popular instruments for survey work with the general population. A 1993 study by
      Thorson and Powell reported a 5-factor solution. The present study was undertaken
      to replicate these findings; however, factor analysis with varimax rotation based
      on the responses of 187 students yielded 4 factors of depressed affect, somatic
      disturbance, positive affect, and interpersonal difficulties. Although these data
      do not replicate the 5-factor work of Thorson and Powell, they do largely confirm
      the previous research.

PMID- 7770592
TI  - Birth order and family size: influences on adolescents' achievement and related
      parenting behaviors.
AB  - The purposes of this study were to confirm birth-order and family-size
      differences in achievement, to confirm birth-order and family-size differences in
      parenting, and to examine whether parenting style and parental involvement serve
      as mediators of birth-order and family-size differences in achievement. Subjects
      were 195 ninth-grade boys and girls and their parents from urban, suburban, and
      rural communities in the southeast and the midwest. Questionnaire measures of
      adolescents' and parents' perceptions of parenting style and parental involvement
      were used. Birth-order and family-size differences were found in adolescents'
      achievement and perceptions of parenting style and parental involvement but not
      in parents' perceptions of parenting. However, these parenting characteristics
      did not mediate the differences seen in achievement by birth order and family
      size. Implications of these findings are discussed.

PMID- 7770593
TI  - Knowledge of basic emotions in adolescent and adult individuals with autism.
AB  - An experiment was carried out in which 30 adolescent and adult patients with
      autism and 30 age- and IQ-matched Down syndrome patients were instructed to
      choose one of the chocolates that were hanging near four pictures displaying
      facial expressions of basic emotions (fear, anger, happiness, and sadness). As
      predicted, most of the Down syndrome patients took the chocolate near the happy
      face picture. Unexpectedly, however, autistic patients made more responses to the
      fearful face picture. Also, Down syndrome patients were more capable of naming
      the four basic emotions than autistic patients.

PMID- 7770594
TI  - Retroductive reasoning in a proposed subtype of partial seizures, evoked by
      limbic "kindling".
AB  - This analysis provides a specific example of the generally applicable process of
      creative delineation of a novel pattern while searching for an explanatory
      hypothesis for puzzling observations. In so doing, the neglected retroductive
      form of inference or abduction was used. Central to such a process is the
      delineation of a specific "generative mechanism" capable of uniting and
      explaining heretofore unexplained phenomena. Herein the neurophysiologically
      known mechanism of limbic seizure "kindling" is offered as a unifying explanation
      for a dozen bizarre phenomena, proposed as a new subtype of partial seizures,
      "Limbic Psychotic Trigger Reaction." This new syndrome has been proposed over 15
      years in 17 male social loners. Upon encounter with an individualized stimulus,
      which revived in memory prior moderately hurtful experiences, these men suddenly
      committed motiveless, unplanned acts with flat affect, transient psychosis and
      autonomic arousal, showing no quantitative impairment of consciousness and so
      without memory loss for their perplexing homicidal acts (13 cases), firesetting
      (3 cases), or bank robbery (1 case). Events occurred in three phases reminiscent
      of seizures: (1) aura-like puzzlement, (2) transient ictus with a limbic release
      of predatory or defensive aggression (circa 20 min.), and (3) postictal
      inefficient actions, implicating a transient frontal lobe system dysfunction
      secondary to the limbic hyperactivation. The 17 men were of diverse backgrounds,
      but all without history of prior violence or severe emotional trauma. Seven of 17
      had some abnormal tests at some time during their lives and eight known histories
      of typically overlooked closed-brain injury. Brain damage may facilitate seizure
      "kindling" but has been traditionally observed in mammals and in a few humans
      without such damage.

PMID- 7770595
TI  - Examining the relationship between Machiavellianism and paranoia.
AB  - To investigate the relationship between Machiavellianism and paranoid tendencies
      we administered the Mach IV scale and Fenigstein and Vanable's Paranoia scale to
      150 students enrolled in 4 sections of a course, Introduction to Psychology, at a
      university in the Middle South. Scores on the 2 were significantly and positively
      correlated (Pearson r = .50). Men had a significantly higher mean score on
      Machiavellianism than women. Although men obtained a higher mean on the Paranoia
      scale than women, the difference was not statistically significant. Implications
      are discussed.

PMID- 7770596
TI  - Maintenance of weight loss after a very-low-calorie diet involving behavioral
      treatment.
AB  - The long-term effects of a very-low-calorie diet coupled with behavioral therapy
      were studied for 209 subjects. Although a low goal weight, frequent calorie
      counting and exercise, and a later age of onset of obesity predicted a low
      relative weight, most respondents had regained most of the weight they had lost.

PMID- 7770597
TI  - The Rotterdam Daytime Sleepiness Scale: a new daytime sleepiness scale.
AB  - A new daytime sleepiness scale was constructed on the basis of interviews with 96
      apnea patients (the Rotterdam Daytime Sleepiness Scale) and included three
      subscales of Global Evaluation, Behavioral Impact, and Affected Life Domains. The
      scale showed satisfactory convergent and discriminant validity.

PMID- 7770598
TI  - A quick screening test of competency to stand trial for defendants with mental
      retardation.
AB  - 19 terms and concepts from evaluations of competency to stand trial of 55
      defendants with mental retardation were rated to examine whether a quick
      screening test could be devised that would differentiate those who were judged
      competent or not competent. A multiple regression and discriminant analysis gave
      four items that yielded maximum predictability (R = .84): court strategy, plead,
      testify, and jury. Guilty, trial, and prosecutor were also significantly more
      difficult for those who were not competent than those who were.

PMID- 7770599
TI  - Risk factors for drug abuse in Pakistan: a replication.
AB  - While a number of risk factors have been identified for drug abuse in the United
      States, little evidence is available about such factors in some other counties.
      Among these latter is Pakistan, a nation in which heroin addiction is a major
      problem. The present study was done to examine those psychosocial characteristics
      which differentiated 60 heroin addicts from 60 nondrug-using controls in
      Pakistan. Most of the drug-abuse factors identified earlier were significant in
      Pakistan as well. Applying cut-off scores previously established for each of 9
      variables, the relationship between drug status and number of factors at risk was
      also examined. Over 98% of the addicts were at risk for five or more factors;
      only 15% of controls were at risk for 5 variables and none exceeded 5. Precursors
      for abuse appear to cut across cultural lines. The high-risk individual in
      Pakistan, as in the United States, is one with ready access to drugs and the
      social inducements to use them while lacking bonds with societal institutions or
      value systems which might mitigate against drug use. Because several of the risk
      factors represent deep and long-standing aspects of the addict's personality,
      both prevention and treatment confront formidable difficulties.

PMID- 7770600
TI  - Effects of ibogaine on responding maintained by food, cocaine and heroin
      reinforcement in rats.
AB  - The effects of ibogaine (40 and 80 mg/kg, i.p.), an indole alkaloid proposed for
      the treatment of drug abuse, were determined in three different groups of rats
      responding under an FR10 schedule of food, cocaine or heroin reinforcement.
      Ibogaine (80 mg/kg, i.p.) given 60 min before the start of the session resulted
      in a 97% decrease in the number of ratios completed under the food reinforcement
      schedule and resulted in a decrease in responding the following day. Neither 40
      mg/kg ibogaine given 60 min prior to the session nor 80 mg/kg given 24 h before
      the session suppressed responding maintained by cocaine infusions (0.33
      mg/infusion). Pretreatment with 80 mg/kg ibogaine either 60 or 90 min prior to
      the session suppressed cocaine self-administration on the day it was administered
      and the longer pretreatment continued to suppress responding for 48 h. Responding
      maintained by heroin (18 micrograms/infusion) was the most sensitive to the
      effects of ibogaine. Both 40 and 80 mg/kg ibogaine resulted in an almost complete
      suppression of responding following a 60-min pretreatment period. Responding
      maintained by heroin returned to control levels the day following the
      administration of ibogaine.

PMID- 7770601
TI  - Response-dependent versus response-independent presentation of cocaine:
      differences in the lethal effects of the drug.
AB  - The drug self-administration paradigm is routinely used to assess the abuse
      liability of psychoactive compounds. Investigations of the behavioral effects of
      drug use, however, often involve the response-independent (experiment-delivered)
      administration of the compound. It is frequently assumed that response
      independent presentation of a compound has the same effects as response dependent
      deliveries. The present study examined directly the effects of response-dependent
      (self-administered) versus response-independent (experimenter-delivered)
      administration of cocaine on food intake and lethality. Littermate triads were
      exposed to either cocaine (0.33 mg/infusion) or saline using a yoked-box
      procedure. One member of the triad self-administered the drug under a fixed-ratio
      2 schedule. The other two rats received response-independent infusions of either
      cocaine or saline. Groups of triads were exposed to two different cocaine access
      conditions. Daily sessions were terminated after 6 h for one group and after the
      delivery of 80 infusions for the other. The mean number of infusions delivered
      each session was 47 (+/- 12) and 70 (+/- 11), respectively, for the 6-h and 80
      infusion condition. Under the 80-infusion condition, response-independent
      infusions of cocaine resulted in a significantly higher rate of mortality
      compared to littermates self-administering identical amounts of the drug. A fewer
      number of deaths occurred under 6-h condition; however, only rats exposed to
      response-independent infusions died under both access conditions. These data
      indicate that the presence or absence of response dependency can profoundly alter
      the lethal effects of cocaine.

PMID- 7770602
TI  - Prepulse inhibition of the acoustic startle reflex using visual and auditory
      prepulses: disruption by apomorphine.
AB  - The amplitude of the acoustic startle reflex can be reduced reliably when
      preceded at short intervals by a weak stimulus (prepulse) which itself does not
      elicit startle. The magnitude of this prepulse inhibition effect is attenuated by
      several dopamine agonists, such as apomorphine, especially when there is a
      relatively small difference between the intensity of the prepulse and the
      intensity of the background noise over which the prepulse is superimposed. One
      goal of the present experiment was to test the generality of this disruptive
      effect of apomorphine on prepulse inhibition by using either an auditory prepulse
      that included both a change in intensity and a change in frequency relative to
      the background noise or a visual prepulse stimulus. Apomorphine reduced auditory
      prepulse inhibition when induced by a small change in stimulus intensity, but not
      when induced by a change in both intensity and frequency. Apomorphine
      consistently reduced visual prepulse inhibition with a complete blockade at 100
      ms test interval. However, it did not fully block the usual reduction in startle
      onset latency or even attenuate the increase in startle amplitude when a visual
      prepulse was presented 5, 10 or 15 ms before the startle stimulus. Consistent
      with conclusions from other laboratories using auditory prepulse inhibition,
      these data suggest that apomorphine did not prevent the animal from detecting
      prepulse presentation under conditions where the drug completely blocked prepulse
      inhibition. Moreover, they indicate that the blockade of prepulse inhibition by
      apomorphine was independent of prepulse modality, adding generality to the
      original finding. Visual prepulse inhibition may be a useful alternative
      procedure for evaluating the effects of drugs on this attentional process.

PMID- 7770603
TI  - Differential anti-parkinsonian effects of benzazepine D1 dopamine agonists with
      varying efficacies in the MPTP-treated common marmoset.
AB  - In common marmosets systemically treated with MPTP (1-methyl-4-phenyl-1,2,3,6
      tetrahydropyridine), the behavioural effects of benzazepine D1 dopamine (DA)
      agonists with full/supramaximal (SKF 80723 and SKF 82958), partial (SKF 38393,
      SKF 75670 and SKF 83565) and no efficacies (SKF 83959) in stimulating adenylate
      cyclase (AC) activity were investigated. The benzazepine derivatives, with the
      exception of SKF 82958 (8 fold D1 DA receptor selectivity), demonstrated high D1
      DA receptor affinity and selectivity (approximately 100 fold or more) in rat
      striatal homogenates. Administration of MPTP in marmosets induced locomotor
      hypoactivity, rigidity and motor disability. SKF 38393 (7,8-dihydroxy-1-phenyl
      2,3,4,5-tetrahydro-1H-3- benzazepine) and SKF 75670 (3-CH3 analogue) further
      reduced locomotor activity (by -70 to -80%) and increased motor disability (by
      +22 to +67%) in these animals. SKF 83565 (6-Cl, 3-CH3, 3'-Cl analogue) and SKF
      82958 (6-Cl, 3-C3H5 analogue) had only a slight effect on locomotor activity but
      decreased motor disability at high doses (-46 to -60%). In contrast, SKF 83959 (6
      Cl, 3-CH3, 3'-CH3 analogue) and SKF 80723 (6-Br analogue) produced pronounced
      increases in locomotion (6-10 fold) and a reversal in motor disability (by -64 to
      -77%). Oral activity, consisting largely of abnormal, 'dyskinetic' tongue
      protrusions and vacuous chews, was increased in animals treated with SKF 38393,
      SKF 83565, SKF 82958 and more especially with SKF 80723 and SKF 83959. Grooming
      was increased with SKF 82958 and more especially with SKF 80723 and SKF 83959. In
      contrast, quinpirole (D2 DA agonist), reversed the MPTP-induced motor deficits in
      the marmoset, with no effect on grooming and oral activity. The present findings
      further demonstrate the antiparkinsonian actions of some D1 DA agonists in MPTP
      treated primates. However, in general the behavioural effects of benzazepines
      failed to correlate with either their D1 DA receptor affinity/selectivity or
      their efficacy in stimulating adenylate cyclase (AC) activity. These observations
      further implicate a behavioural role for D1 DA receptors uncoupled to AC and/or a
      role for extrastriatal D1 DA receptors in mediating the behavioural response to
      D1 DA agonists.

PMID- 7770604
TI  - The differential behavioural effects of benzazepine D1 dopamine agonists with
      varying efficacies, co-administered with quinpirole in primate and rodent models
      of Parkinson's disease.
AB  - The effects of co-administration of quinpirole with benzazepine D1 dopamine (DA)
      agonists possessing full/supramaximal (SKF 80723 and SKF 82958), partial (SKF
      38393 and SKF 75670) and no efficacies (SKF 83959) in stimulating adenylate
      cyclase (AC) were investigated in rodent and primate models of Parkinson's
      disease (PD). In rats with a unilateral 6-hydroxydopamine (6-OHDA) lesion of the
      medial forebrain bundle, co-administration of SKF 38393 (7,8-dihydroxy-1-phenyl
      2,3,4,5-tetrahydro-1H-3-benzazepine), SKF 75670 (3-CH3 analogue), SKF 80723 (6-Br
      analogue), SKF 83959 (6-Cl, 3-CH3, 3'-CH3 analogue) and SKF 82958 (6-Cl, 3-C3H5
      analogue) strongly potentiated the contralateral circling induced by quinpirole.
      In MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) treated common marmosets,
      administration of quinpirole alone increased locomotor activity and reversed
      motor deficits. Grooming and oral activity were unaltered. Co-administration of
      SKF 38393 and SKF 75670 inhibited the quinpirole-induced changes in locomotor
      activity and motor disability. The combined treatment of SKF 80723 or SKF 82958
      with quinpirole had no overall effect on locomotor activity or motor disability.
      In contrast, SKF 83959 extended the duration of the quinpirole-induced increase
      in locomotor activity with corresponding decreases in motor disability. Co
      administration of high doses of SKF 82958 and more especially SKF 83959 and SKF
      80723, with quinpirole induced hyperexcitability and seizures. Oral activity and
      grooming were unaltered following the co-administration of benzazepine
      derivatives with quinpirole. The ability of some benzazepine D1 DA agonists to
      prolong the antiparkinsonian effects of quinpirole in the MPTP-treated marmoset
      may indicate a role for certain D1 DA agonists in the clinical treatment of PD.
      In general, the behavioural responses to the combined administration of
      benzazepines with quinpirole in the 6-OHDA lesioned rat and more especially the
      MPTP-treated marmoset failed to correlate with their ability to stimulate AC.
      These observations further implicate a behavioural role for D1 DA receptors not
      linked to AC.

PMID- 7770605
TI  - The impact of long-term vitamin supplementation on cognitive functioning.
AB  - The possibility that the taking of vitamin supplements may influence cognitive
      functioning was explored. One hundred and twenty-seven young healthy adults took
      either ten times the recommended daily dose of nine vitamins, or a placebo, under
      a double-blind procedure, for a year. After 12 months better performance on two
      measures of attention was found in females who had taken the vitamin supplement,
      even though the blood status of nine vitamins reached a plateau after 3 months.
      The use of regression equations demonstrated the association between improved
      thiamin status and improved performance on a range of measures of cognitive
      functioning in females rather than males. Although it was not possible to
      establish the reason for a beneficial response in females rather than males, the
      evidence that females respond differently to dietary factors was discussed.

PMID- 7770606
TI  - Profile of action of 5-HT3 receptor antagonists, ondansetron and WAY 100289, in
      the elevated plus-maze test of anxiety of mice.
AB  - The effects of ondansetron (0.001-0.1 mg/kg) and the novel 5-HT3 receptor
      antagonist, WAY 100289 (0.01-10.0 mg/kg), on anxiety were examined in male mice
      using an ethological version of the elevated plus-maze paradigm. This procedure
      involves scoring specific aspects of defensive behaviour in addition to the more
      usual spatiotemporal measures. Results show that, at the doses tested, neither
      compound produced a behavioural profile consistent with anxiety reduction.
      Indeed, the lowest dose of ondansetron (0.001 mg/kg) produced some behavioural
      trends more typically associated with mild anxiety enhancement. Data are
      discussed in relation to the enigmatic effects of 5-HT3 receptor antagonists in
      animal models of anxiety. It is suggested that the large within- and between-test
      variability observed with these compounds may indicate an action on mechanisms
      other than anxiety.

PMID- 7770607
TI  - Effects of the NMDA-antagonist, MK-801, on stress-induced alterations of dopamine
      dependent behavior.
AB  - The effects of pretreatment with the non-competitive NMDA antagonist (+)MK-801 on
      the behavioral alterations induced by repeated restraint stress were
      investigated. Repeatedly stressed (restraint stress 2 h a day x 10 days) mice
      showed enhanced sensitivity to the inhibitory effects of a low dose of direct
      dopamine agonist, apomorphine (0.25 mg/kg), on climbing behavior. On the other
      hand, no changes were observed for the stimulatory effect of the high dose of
      apomorphine (3 mg/kg) on this behavioral response. Mice pretreated with MK-801
      (0.15 mg/kg) before the stressful experience did not show altered response to the
      low dose of apomorphine (0.25 mg/kg). Finally, ten daily injections with 0.15
      mg/kg MK-801 did not affect the behavioral response to the low dose of
      apomorphine, but enhanced the stimulatory effect of the high dose of the
      dopaminergic agonist on climbing behavior. Therefore, it is possible that the
      protective action of MK-801 against stress-induced behavioral alteration is due
      to changes in sensitivity of postsynaptic receptors.

PMID- 7770609
TI  - Comparative anterograde amnestic and anticonvulsant effects of two types of NMDA
      receptor antagonists: MK-801 and HA-966.
AB  - The anterograde amnestic effects of non-competitive NMDA antagonists MK-801 and
      HA-966 on classic fear conditioning in goldfish (Carassius auratus) were examined
      in a series of experiments. Experiments 1 and 2 contrasted the anterograde
      amnestic effects of MK-801, (+)HA-966, and (-)HA-966. Experiment 3 examined the
      effects of MK-801 and (+)HA-966 on the expression of conditioned responses.
      Experiments 4 and 5 investigated whether the potency of MK-801, (+)HA-966 or (
      )HA-966 in blocking NMDA-induced convulsions paralleled their potency in
      producing amnesia. The results showed that MK-801 was more potent than (+)HA-966
      in producing anterograde amnesia and impairing expression, while (-)HA-966 did
      not produce anterograde amnesia. The anticonvulsant potency of MK-801, (+)HA-966,
      and (-)HA-966 paralleled their amnestic potency. These findings suggested that MK
      801 and (+)HA-966 produced anterograde amnesia by their specific antagonism of
      the NMDA receptor complex.

PMID- 7770611
TI  - Chronic treatment with fluvoxamine by osmotic minipumps fails to induce
      persistent functional changes in central 5-HT1A and 5-HT1B receptors, as measured
      by in vivo microdialysis in dorsal hippocampus of conscious rats.
AB  - This study investigated the alterations of the 5-HT1A and 5-HT1B autoreceptor
      function following chronic treatment with fluvoxamine using osmotic minipumps.
      The 5-HT1A and 5-HT1B autoreceptor function were studied using microdialysis in
      the dorsal hippocampus. The effect of the 5-HT1A receptor agonist 8-OH-DPAT (0.3
      mg/kg, SC) and the 5-HT1B receptor agonist RU-24969 (100 nM through the dialysis
      probe for 30 min) on 5-HT release was compared with rats chronically treated with
      saline. 8-OH-DPAT decreased 5-HT release to 55% and 60% of baseline, while RU
      24969 decreased 5-HT release to 66% and 70% of baseline value in the saline and
      fluvoxamine group, respectively. In both cases, differences between the saline
      and fluvoxamine groups were not statistically significant. Plasma levels of
      fluvoxamine after 21 days of treatment ranged from 3 to 5 ng/ml. Fluvoxamine
      concentration in rat brain during treatment was estimated between 100 and 200 nM,
      which approximates to the IC50 value of fluvoxamine on the 5-HT transporter in
      synaptosomes and is 50 times higher than the Kd value for the 5-HT reuptake site.
      In conclusion, no evidence was found for changes in 5-HT1A,B receptor function
      using 8-OH-DPAT and RU-24969 as probes after continuous treatment with
      fluvoxamine by means of osmotic minipumps.

PMID- 7770608
TI  - The selective 5-HT3 receptor antagonist, WAY100289, enhances spatial memory in
      rats with ibotenate lesions of the forebrain cholinergic projection system.
AB  - The effects of three doses (0.003, 0.03 and 1.0 mg/kg sc) of the 5-HT3 receptor
      antagonist, WAY 100289, on spatial learning and memory in the water maze were
      examined in rats before and after ibotenate lesions to the nucleus basalis and
      medial septal brain regions at the source of cholinergic projections to cortex
      and hippocampus. The representative cholinergic nicotinic and muscarinic receptor
      agonists nicotine (0.1 mg/kg) and arecoline (1.0 mg/kg) were also tested for
      comparison. Both arecoline and nicotine improved initial acquisition in rats
      before lesioning, in terms of latency to find a hidden platform and accuracy of
      search strategy. WAY100289 did not affect the performance of normal rats
      significantly, apart from some non-significant trends towards improvement with
      the highest dose. However, in animals showing transient navigational deficits in
      retention and relearning after lesioning, WAY100289 improved performance at all
      three doses, though ameliorative effects of nicotine and arecoline were more
      marked also in lesioned rats. These results show that WAY100289 improved spatial
      learning in animals impaired after lesions to cholinergic projection nuclei,
      which may reflect an interaction with cholinergic transmission to enhance
      cognitive function. However, in the present study, WAY100289 appeared to be less
      effective than direct cholinergic agonists.

PMID- 7770612
TI  - Sedative potency and 2-[125I]iodomelatonin binding affinity of melatonin
      analogues.
AB  - Melatonin (5-methoxy N-acetyltryptamine), the hormone synthesized and released
      from the pineal gland each night, has sedative and sleep-promoting effects in
      experimental animals and man. In the present study, the sedative effect of
      melatonin and a number of analogues was determined by examining their ability to
      extend the duration of the loss of righting reflex ("sleeping time") in mice
      injected with pentobarbitone (50 mg/kg i.v.). All of the analogues tested
      produced a dose-related (5-20 mg/kg) potentiation of pentobarbitone sleeping
      time. In radioligand binding assays using 2-[125I]iodomelatonin in chicken brain
      membranes, all of the analogues were competitive inhibitors. There was no
      correlation between their ability to inhibit 2-[125I]iodomelatonin binding in
      chick and sedative potency in the mouse. Potentiation of pentobarbitone sleeping
      time by diazepam (1 mg/kg i.p.), but not melatonin (10 mg/kg i.p.), was blocked
      by pretreatment with the benzodiazepine antagonist, flumazenil (10 mg/kg i.p.).
      Similarly, an increase in pentobarbitone sleeping time produced by the
      aminoalkylindole cannabinoid receptor agonist, WIN 55212-2 (0.5 mg/kg i.p.), but
      not that produced by melatonin (10 mg/kg i.p.) was reduced by the cannabinoid
      receptor antagonist WIN 56098 (5 mg/kg i.p.). These studies confirm that
      melatonin has sedative activity and show that this action is shared by several
      structurally-related analogues but does not appear to be mediated by an
      interaction with benzodiazepine or cannabinoid receptors.

PMID- 7770610
TI  - Behavioral vigilance in rats: task validation and effects of age, amphetamine,
      and benzodiazepine receptor ligands.
AB  - An operant task for the measurement of sustained attention or vigilance in rats
      was characterized. The task requires the animals to respond to the presentation
      of visual signals (presented for 25, 50, or 500 ms) by operating one lever
      ("hits") and to the absence of a signal by operating the opposite lever ("correct
      rejection"). Incorrect responses ("misses" and "false alarms", respectively) were
      not rewarded. Performance in this task is a function of signal length, i.e., the
      shorter the signals the higher the number of misses. An increase in "background
      noise" by flashing the chamber houselight (at 0.5 Hz) impaired the animals'
      ability to discriminate between signal and non-signal events. Also flashing the
      houselight augmented the vigilance decrement observed for shortest signals. An
      increase in the event-rate also resulted in a vigilance decrement. Finally, the
      inability of the animals to time signals was examined by testing the effects of
      an increase in event asynchrony. In a second experiment, the performance of
      differently aged rats (6- and 20 month-old male BNNia/F344 rats) was studied.
      Compared to young animals, 20-month-old rats showed a decrease in their ability
      to discriminate between shortest signals (25 ms) and non-signal events but did
      not differ in their ability to correctly reject non-signal trials. Administration
      of the benzodiazepine receptor (BZR) agonist chlordiazepoxide (CDP; 3, 5, 8
      mg/kg) resulted in an impairment of the animals' ability to discriminate between
      signal and non-signal events and, similar to the effects of age, this effect was
      exclusively due to an increase in the number of misses. CDP generally produced
      potent effects while affecting the aged animals to a greater degree. BZR-ligands
      with weak or "selective" inverse agonist properties (ZK 93426; beta-CCtB) did not
      affect vigilance performance. The BZR partial inverse agonist RU 33965 (0.1, 0.5
      mg/kg) dose-dependently impaired vigilance performance. The administration of
      amphetamine (0.4, 0.8 mg/kg) also impaired performance, but these impairments
      were possibly based on effects unrelated to attentional mechanisms. The finding
      that performance in this task revealed the interactions between the effects of
      age and BZR agonists on attentional abilities further supports the validity of
      measures of performance generated by this task.

PMID- 7770614
TI  - Effects of lorazepam on human contrast sensitivity.
AB  - The anxiolytic lorazepam was studied for its effects on contrast sensitivity to
      gratings flickering in counterphase in normal volunteers. The drug significantly
      reduced contrast sensitivity at low spatial frequencies in a dose-related manner.
      The results are discussed with reference to possible GABA-mediated processes in
      the retina and lateral geniculate nucleus.

PMID- 7770613
TI  - Clozapine serum levels and side effects during steady state treatment of
      schizophrenic patients: a cross-sectional study.
AB  - Serum clozapine (S-Cloza) and serum desmethyl-clozapine concentrations (S
      Descloza) were measured in 30 chronic schizophrenic in- and out-patients on a
      variable dose regimen. All patients were in steady state with respect to
      clozapine therapy and in a stable condition with respect to psychotic illness.
      The 24-h clozapine dose (median with interquartile range in parenthesis) was 350
      (228-425) mg/24 h (range 100-700). There was a weak positive correlation between
      doses and the BPRS total score (r = 0.44, P < 0.05). The median S-Cloza was 1076
      (706-1882) nmol/l (range 196-5581 corresponding to 64-1824 ng/ml). The S-Cloza
      was linearly correlated to dose but with a high interindividual variation at
      equal doses, e.g. a factor of 8 at 400 mg/24 h, but a low intraindividual
      variability of 20%. The S-Descloza averaged 77% of the S-Cloza and was highly
      correlated to S-Cloza (r = 0.90; P < 0.001). The S-Descloza/dose ratio increased
      with age and duration of treatment. The side effects registered were EEG
      abnormalities (83%), tachycardia (23%), increased liver enzyme activity (60%),
      orthostatic hypotension (17%), and moderate leucocytosis (17%). Only EEG changes
      were correlated to S-Cloza (r = 0.43; P < 0.05). The score values of the UKU Side
      Effect Scale were weakly (r = 0.36) correlated to S-Cloza. No side effects were
      correlated to S-Descloza, doses, or treatment duration. The frequency of side
      effects was higher than in studies using lower mean doses indicating a
      correlation between doses or S-Cloza and the frequency of side effects. It is
      concluded that clozapine fulfils the criteria for therapeutic drug monitoring.
      TDM may contribute to finding the lowest effective dose with the fewest possible
      side effects.

PMID- 7770615
TI  - Psychotherapeutic Medications Development Program (PMDP) Workshop on NMDA
      Receptor Antagonists: Neurotoxicity Evaluation.

PMID- 7770616
TI  - Psychotherapeutic Medications Development Program (PMDP) Workshop on NMDA
      Receptor Antagonists: neurotoxicity evaluation. Introduction.

PMID- 7770617
TI  - Neurotoxicity of NMDA receptor antagonists: an overview.
AB  - The glutamate transmitter system provides several benevolent/malevolent
      paradoxes. Glutamate itself serves vitally important functions in the CNS but has
      enormous neurodestructive potential. NMDA glutamate receptor antagonists protect
      many neurons against glutamate neurotoxicity, while injuring or destroying
      certain other neurons and inducing psychotic symptoms and memory impairment.
      Therefore, the challenge in developing protective therapies against glutamate's
      neurodestructive potential is to find benevolent agents that are not malevolent
      as well. There are two possible approaches. One is to develop neuroprotective
      agents that are free from neuropsychopathological side effects; the other is to
      use NMDA antagonists even though they have neuropsychopathological side effects,
      but to use them in combination with other agents that block the side effects
      without producing side effects of their own.

PMID- 7770618
TI  - Confocal microscopic visualization of MK-801-induced cytoplasmic vacuoles in
      vitro.
AB  - We examined neuroprotective and neurotoxic effects of the NMDA antagonist, MK
      801, in primary cell cultures derived from embryonic mouse neocortex. Brief
      deprivation of oxygen and glucose, or direct application of N-methyl-D-aspartate
      (NMDA), resulted in acute neuronal swelling followed by neuronal death during the
      next day. This excitotoxic neuronal injury could be blocked by inclusion of a
      wide variety of NMDA antagonists in the cell culture medium. MK-801 attenuated
      neuronal death in the low micromolar range; 1 to 10 microM concentrations were
      sufficient to maximally reduce injury from NMDA toxicity, oxygen deprivation, or
      combined deprivation of oxygen and glucose. MK-801 alone caused no apparent
      toxicity at these concentrations in exposures of 24 to 48 hours. However, 24-hour
      exposure to 100 microM MK-801 resulted in appearance of cytoplasmic vacuoles,
      which could be visualized with immunofluorescence against the microtubule
      associated protein, MAP2, together with laser scanning confocal microscopy. Thus,
      at concentrations sufficient to block NMDA receptors, MK-801 is neuroprotective
      rather than neurotoxic for cortical neurons in vitro. This model system may
      provide a method to examine cellular mechanisms underlying the neurotoxicity of
      MK-801 at very high concentrations.

PMID- 7770619
TI  - Biochemical analysis of glial fibrillary acidic protein as a quantitative
      approach to neurotoxicity assessment: advantages, disadvantages and application
      to the assessment of NMDA receptor antagonist-induced neurotoxicity.
AB  - Hypertrophy appears to be a universal response of astrocytes, a central nervous
      system (CNS) cell type, to all forms of brain injury. The hallmark of this
      response, often termed "reactive gliosis," is the enhanced expression of the
      major intermediate filament protein of astrocytes, glial fibrillary acidic
      protein (GFAP). Reactive gliosis traditionally has been examined qualitatively by
      immunohistochemistry of GFAP. But, the widespread availability of enzyme-linked
      immunosorbent assays (ELISAs) now makes it possible to quantify damage-induced
      expression of GFAP as a potential biomarker of diverse neurotoxic insults. To
      evaluate this possibility, we administered prototype neurotoxicants to
      experimental animals and then assessed the effects of these agents on the tissue
      content of GFAP, as determined by a recently developed sandwich ELISA. We found
      that assays of GFAP reveal dose-, time-, and region-dependent patterns of neural
      damage, often at toxicant dosages below those that cause light microscopic
      evidence of cell loss or damage. No false positives have been seen following
      exposure to a variety of pharmacological agents at therapeutic dosages. With
      respect to NMDA receptor antagonists, we find that MK-801 causes a large dose
      dependent increase in GFAP that, within the cortex, appears to be restricted to
      the retrosplenial zone. Among the advantages of the CFAP-based approach re its
      simplicity, objectivity, cost and the fact that the assay can be automated. Among
      the disadvantages are the need to perform brain dissections and the requirement
      for a time-course analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7770620
TI  - Neuronal injury produced by NMDA antagonists can be detected using heat shock
      proteins and can be blocked with antipsychotics.
AB  - Noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonists, including
      ketamine, MK-801, and phencyclidine (PCP), induce the HSP70 heat shock or stress
      gene in pyramidal neurons in rat posterior cingulate and retrosplenial cortex.
      PCP also induces HSP70 in many other pyramidal neurons in brain including
      neocortex, insular cortex, piriform cortex, hippocampus, and basal nuclei of the
      amygdala. Several neurotransmitter antagonists, including haloperidol, clozapine,
      SCH-22390, diazepam, and muscimol, inhibited induction of HSP70 produced by PCP.
      Baclofen had no effect. Nifedipine blocked induction of HSP70 by PCP in
      cingulate, neocortex, and insular cortex but only partially blocked HSP70 in
      piriform cortex and amygdala. These data suggest that phencyclidine injures
      pyramidal neurons via dopamine D1, D2, D4, sigma, and other receptors. Gamma
      aminobutyric acid (GABA) agonists ameliorate the injury. A model is proposed
      whereby NMDA receptor blockade on GABA neurons decreases inhibitory inputs onto
      cortical pyramidal neurons and makes them more vulnerable to injury from a
      variety of excitatory inputs. It is possible that psychosis produced by PCP and
      other NMDA antagonists correlates with overactivity and eventual injury to
      cingulate pyramidal neurons.

PMID- 7770621
TI  - Effects of NMDA receptor antagonists on the developing brain.
AB  - This overview describes two effects of N-methyl-D-aspartate (NMDA) receptor
      antagonists that are not strictly speaking toxic: There are no signs that cells
      are dying. Nevertheless, these antagonists, if applied for prolonged periods in
      young children, could permanently cripple normal brain function. Disturbing the
      function of the NMDA channel during development can severely disrupt the wiring
      of defined neural circuits. It also can disrupt the developmental upregulation of
      the receptor protein itself and possibly many other molecular components of the
      synapse.

PMID- 7770622
TI  - Developmental aspects of NMDA receptor agonists and antagonists in the central
      nervous system.
AB  - Electrophysiologic responses to the glutamate agonist analogue N-methyl-D
      aspartate (NMDA) are enhanced in the developing nervous system compared to
      responses in the adult. Neurotoxicity mediated by comparable amounts of NMDA and
      its endogenous analogue quinolinate is more than 50 times greater in the 7-day
      old rat brain than in the adult. NMDA antagonist drugs reduce this neurotoxicity
      with the same spectrum of activity with which they prevent injury from hypoxic
      ischemic damage. The greater vulnerability of the immature brain to NMDA mediated
      injury is probably related to the enhanced role that NMDA mechanisms play in long
      term potentiation and activity-dependent plasticity during development.

PMID- 7770624
TI  - Assessing structural changes in the brain to evaluate neurotoxicological effects
      of NMDA receptor antagonists.
AB  - Like all pharmacologic agents known, N-methyl-D-aspartate (NMDA) antagonist
      compounds have side effects. It is expected that neuroactive molecules have
      effects, including side effects, in the central nervous system (CNS). With NMDA
      antagonists in rodents, these side effects are remarkably focal in the cingulate
      and retrosplenial cortex. The salient features of NMDA antagonist neurotoxicity
      which should be underscored are hypermetabolism, lactate accumulation, neuronal
      vacuolization in aldehyde fixed material, and neuronal death in older rodents.
      The scope of this phenomenon must urgently be determined in non-rodent species,
      specifically primates. This is important from both a regulatory and
      neurotherapeutic point of view, since effective molecules having potential in
      human disease states may also have NMDA antagonist properties.

PMID- 7770623
TI  - Pathological effects of MK-801 in the rat posterior cingulate/retrosplenial
      cortex.
AB  - Many N-methyl-D-aspartate (NMDA) antagonists cause vacuolization and necrosis in
      the posterior cingulate/retrosplenial (PC/RS) cortex of rats after single-dose
      administration. This article reviews a series of investigational studies that
      have characterized this effect. All the studies have used single doses of MK-801
      in rats. Techniques employed were light microscopy, transmission electron
      microscopy, quantitative enzyme-linked immunosorbent assay (ELISA), and cell
      counting. Our studies demonstrated: (1) formation of vacuoles within 30 minutes
      of treatment, (2) dose-dependent necrosis of susceptible PC/RS neurons, (3)
      increased glial fibrillary acidic protein in response to neuronal necrosis, (4)
      significantly greater necrosis in female than in male rats, and (5) increases in
      necrosis along a rostrocaudal gradient within the PC/RS cortex. In addition,
      these studies illustrate a number of variables that impact the expression and
      detection of neuronal vacuolization and necrosis in rats after treatment with MK
      801.

PMID- 7770625
TI  - Introduction to principles and procedures in behavioral testing.
AB  - This article serves as an introduction to the following two articles which
      describe the effects of drugs that interact with N-methyl-D-aspartate (NMDA)
      receptors on a number of behavioral baselines. The discussion in the subsequent
      articles focuses on detailed examination of performance on complex learning
      tasks, although effects of drugs affecting NMDA receptors on simple learned and
      unlearned behaviors are also mentioned. This article will provide a framework for
      interpretation of the results reported. To that end, a short primer on the
      principles of behavior is provided, followed by a description of a number of
      behavioral tests and discussion of issues important for the interpretation of
      results from such tests. The behavioral baselines discussed are, for the most
      part, the specific tasks from which data are presented in the following reports.
      A few additional descriptions have been included to illustrate specific points
      regarding data interpretation. The examples discussed are not necessarily
      representative of behavioral endpoints used routinely in the assessment of the
      behavioral effects of drugs. A number of reviews are available to the interested
      reader (Cabe & Eckerman 1982; Heise 1984; Rice 1990; Thompson & Shuster 1968;
      World Health Organization 1986).

PMID- 7770626
TI  - The impact of NMDA receptor antagonists on learning and memory functions.

PMID- 7770628
TI  - New Clinical Drug Evaluation Unit (NCDEU) meeting. Marco Island, Florida, 1994.
      Abstracts.

PMID- 7770627
TI  - Acute behavioral toxicity of MK-801 and phencyclidine: effects on rhesus monkey
      performance in an operant test battery.
AB  - Monkey performance of operant tasks was used to model several brain functions and
      monitor the acute effects of MK-801 and phencyclidine (PCP). MK-801 is a
      relatively selective N-methyl-D-aspartate (NMDA) receptor antagonist, while PCP
      is an NMDA antagonist that is also active at sigma opiate receptors. A comparison
      of these drugs' effects may indicate the relative importance of certain
      neurotransmitter receptor systems for specific behaviors. Learning and time
      perception behaviors are more sensitive (affected at lower doses) to the
      disruptive effects of MK-801 than are behaviors that model short-term memory,
      motivation, and color and position discrimination. Such selective disruption was
      not obtained for PCP: learning, short-term memory and attention, time perception,
      and motivation tasks are all equally sensitive to disruption. These findings
      suggest that specific brain functions are differentially affected by modulation
      of the NMDA and sigma opiate systems.

PMID- 7770629
TI  - Inhibition of acid secretory response and induction of ornithine decarboxylase
      and its mRNA by TGF alpha and EGF in isolated rat gastric glands.
AB  - TGF alpha shows structural and functional homology to EGF, but TGF alpha's
      mitogenic potency is greater. Our previous study showed that EGF may inhibit
      parietal cell secretory response through the induction of ornithine decarboxylase
      (ODC). The aim of this study was to determine parietal cell acid production in
      vitro in response to stimulation by TGF alpha and EGF and to compare the effect
      of these two growth factors on ODC activity and ODC mRNA in isolated rat gastric
      glands. 45 min treatment with TGF alpha and EGF had no effect on basal acid
      production but did inhibit histamine-stimulated acid production in a dose
      dependent manner. The two growth factors did not inhibit histamine-stimulated
      aminopyrine (AP) uptake from incubation medium with concentration of KCl
      increased from 5 to 70 mM. In the presence of specific ODC inhibitor, alpha
      difluoromethylornithine (DFMO), both EGF and TGF alpha failed to inhibit
      histamine-stimulated AP accumulation. Polyamine spermine also inhibited AP
      accumulation but this inhibitory effect was not affected by DFMO. After 1 h
      treatment with TGF alpha and EGF, ODC activities increased to an average 283 +/-
      78% and 227 +/- 64% above the basal activity, respectively. 30 min treatment of
      gastric glands with TGF alpha and EGF resulted in, respectively, 2.9 +/- 0.4- and
      2.7 +/- 0.5-fold increases of ODC mRNA level, as assessed by RT-PCR.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7770630
TI  - Are enterochromaffinlike cell tumours reversible? An experimental study on
      gastric carcinoids induced in Mastomys by histamine2-receptor blockade.
AB  - A rapid induction of enterochromaffinlike (ECL) cell tumours has been shown in
      Praomys (Mastomys) natalensis subjected to histamine2-receptor blockade. In the
      present study the reversibility of ECL cell proliferation induced by acid
      inhibition was investigated. Short-term treatment (8 weeks) with the histamine2
      receptor antagonist loxtidine caused a moderate hypergastrinemia, accompanied by
      a minor increase in histamine contents and a 2-fold increased volume density of
      the endocrine cells in gastric oxyntic mucosa. Eight weeks after withdrawal of
      treatment the volume density of endocrine cells was normalised as were the tissue
      levels of histamine, indicating a total reversibility of ECL cell hyperplasia.
      Long-term treatment (24 weeks) caused severe changes in the endocrine cell
      population of the oxyntic mucosa with neoplasia (5/21), dysplasia (11/21) and
      nodular hyperplasia (5/21). The endocrine cell density increased twofold and
      tissue histamine levels fourfold. 24 weeks after cessation of treatment, the
      endocrine cell density had decreased to 136% of controls, while histamine
      concentrations were normalised. The frequency of invasive carcinoids after
      recovery (4/23) differed only slightly from that seen after treatment for 24
      weeks (5/21). Dysplastic lesions were only seen in 1/23 and hyperplastic lesions
      were of less severe type after recovery. The results demonstrate that ECL cell
      hyperplasia and dysplasia, induced by acid inhibition, are reversible after
      cessation of treatment. However, ECL cell tumours did not disappear, within the
      given observation period. One may therefore speculate that ECL cell proliferation
      is no longer reversible once the neoplastic (transformed) phenotype has
      developed.

PMID- 7770631
TI  - Pituitary adenylate cyclase activating polypeptide (PACAP) stimulates growth
      hormone release from GH3 cells through type II PACAP receptor.
AB  - Effect of pituitary adenylate cyclase activating polypeptide (PACAP) on growth
      hormone (GH) release from GH3 cells was studied in a dynamic superfusion system.
      PACAP-38 and PACAP-27 stimulated GH release from superfused GH3 cells. The
      stimulatory effect of PACAP-38 was comparable to those of vasoactive intestinal
      polypeptide (VIP) and PACAP-27 at a concentration of 1 nM, but the duration of
      action was more prolonged in PACAP-38 than in the other two peptides. PACAP(6
      38), a selective antagonist of PACAP, as well as a VIP antagonist blunted the GH
      release induced by PACAP-38 and VIP. An antagonist of GH-releasing factor (GRF)
      at a concentration of 1 microM, however, did not affect the GH release induced by
      PACAP-38. These findings suggest that PACAP and VIP stimulate GH release from GH3
      cells through type II PACAP receptor but not through the GRF receptors.

PMID- 7770632
TI  - Potencies of various neurotensin-(8-13) analogs for inhibition of heat-induced
      edema in the anesthetized rat.
AB  - Peptides of the neurotensin (NT) and xenopsin (XP) families inhibit vascular
      leakage in various models of tissue injury. In this study, we measured the
      potency of NT fragments, NT analogs and NT-(8-13) analogs for inhibition of
      thermal edema induced by immersion of the anesthetized rat's paw in 58 degrees C
      water for 1 min. The pattern of anti-edema potencies seen with sixteen NT-(8-13)
      analogs correlated well with the pattern of activities obtained in binding
      measurements to rat brain membrane preparations and to activities in isolated
      organ preparations. Replacement of Tyr11 with Trp in NT-(8-13) and Arg8 with D
      Arg resulted in an analog [D-Arg8, Trp11]NT-(8-13) which was 5-times more potent
      than NT-(8-13). Substitution of D-Arg for Arg8 and Arg9 in NT-(8-13) produced
      analogs that retained anti-edema activity but with decreased effects on gut
      motility and hypotension.

PMID- 7770633
TI  - Role of extracellular and intracellular calcium on proctolin-induced contractions
      in an insect visceral muscle.
AB  - The pentapeptide proctolin requires extracellular calcium to produce an increase
      in frequency and amplitude of myogenic contractions and an increase in basal
      tonus of the oviducts of the locust, Locusta migratoria. Decreasing saline
      calcium concentrations reduced myogenic contractions, the delay to reach maximum
      basal tonus and the maximum basal tonus achieved. Proctolin (5.10(-9) M) resulted
      in an immediate influx of extracellular calcium into locust oviduct muscle during
      the first 15 s of stimulation. This was followed by an increase in calcium efflux
      which was maintained over the time of proctolin stimulation. A Na+/Ca2+ exchanger
      is suggested to occur in the oviducts and may play a role in Ca2+ extrusion
      following proctolin stimulation.

PMID- 7770634
TI  - G protein-coupled corticotropin-releasing hormone receptors in rat retina.
AB  - The presence of corticotropin-releasing hormone (CRH) receptors in rat retinal
      membranes was investigated by using [125I-Tyro]-ovine CRH ([125I]oCRH) as
      radioligand. The receptor binding was rapid, reversible, saturable and specific.
      The [125I]oCRH binding was completely displaced by different CRH-related peptides
      with a rank order of potency similar to that displayed in stimulating rat retinal
      adenylyl cyclase activity. Two populations of binding sites were detected: one
      with high affinity (Kd = 1.7 nM) and the other with low-affinity (Kd = 130 nM).
      The GTP analogue guanosine 5'-O-(3'-thiotriphosphate) reduced the high-affinity
      binding and increased the relative proportion of sites with low-affinity.
      Incubation of rat retinal membranes with the RM/1 antibody, which recognizes the
      carboxyl-terminus of the alpha subunit of the G protein Gs, prevented the CRH
      stimulation of adenylyl cyclase. In immunoblots, the RM/1 antibody recognized an
      immunoreactive protein band of 45 kDa and a protein with a similar
      electrophoretic mobility was ADP-ribosylated by cholera toxin. These data provide
      evidence for the presence of specific CRH receptors in rat retina and contribute
      to define the CRH signalling system in this tissue.

PMID- 7770635
TI  - Recombinant human chromogranin A: expression, purification and characterization
      of the N-terminal derived peptides.
AB  - Chromogranin A (CGA) is an ubiquitous 48 kDa secretory protein stored and
      released from most endocrine cells and is present in nanomolar concentration in
      the human vascular system. Recent data suggest that CGA may be the precursor of
      several peptides with a defined biological activity. The present report describes
      the expression of human CGA in Escherichia coli using the pET3a vector system,
      the purification and characterization of the recombinant protein and the
      production of antibody against the expressed protein. The expressed CGA was
      purified by a multi-step protocol including heat treatment, gel filtration and
      high performance-anion exchange chromatography and two-dimensional gel
      electrophoresis. Two major forms of recombinant human CGA (rhCGA) were purified
      from the bacterial cytosol: a 70 kDa form which corresponded to the native full
      length CGA and a major proteolytic 63 kDa product recognized by antibodies raised
      against the 70 kDa rhCGA or to synthetic peptides localized in the N-terminal
      part of the bovine CGA sequence. This E. coli expression system provides a method
      for producing a suitable protein which will permit the identification of CGA
      derived peptides with defined biological function in human. Fragments containing
      the N-terminal domain were generated by acidic cleavage of the two forms of
      rhCGA. A two-step purification using high-performance reverse-phase
      chromatography yielded 6 peptide bands ranging in apparent molecular mass from 7
      to 18 kDa. Four components (molecular mass range 12-18 kDa) were immunostained
      with antibodies directed against synthetic sequences of bovine vasostatin II
      (bCGA1-113) while the two others (molecular mass range 7-8 kDa) were
      immunostained only with antibodies directed against vasostatin I (bCGA1-76). From
      protein staining the ratio vasostatins II/I was 10:1. The vasoinhibitory activity
      of this preparation was examined on isolated human saphenous vein segments. An
      inhibitory effect was obtained in paired vessel segments from 7 patients
      undergoing surgery for coronary artery bypass, however with low potency for
      supression of the endothelin-1 evoked sustained tension in these vessels.

PMID- 7770636
TI  - Mass spectrometric and biological characterization of guinea-pig corticotrophin.
AB  - Guinea-pig ACTH has been found to be distinct from other mammalian ACTHs in
      having an alanine for proline substitution at position 24 and in having
      superagonist aldosterone-stimulating activity relative to synthetic ACTH(1-24) in
      an isolated rat glomerulosa cell bioassay. We have purified ACTH from extracts of
      guinea-pig anterior pituitary and confirmed its unusual structural
      characteristics by amino acid analysis and mass spectrometry. Using isolated rat
      adrenal fasciculata-reticularis and glomerulosa cell bioassays, guinea pig ACTH
      was found to have similar activity to that of human ACTH with respect to
      corticosterone- and aldosterone-stimulating activity, in terms of maximal steroid
      output but was slightly more potent in terms of the concentration which elicited
      half-maximal steroid secretion. Under the assay conditions used, guinea-pig ACTH
      appeared not to be a superagonist as previously suggested. Various biosynthetic
      derivatives of guinea-pig pro-opiomelanocortin were identified by amino acid
      analysis and mass spectrometry. Joining peptide, a major product of pro
      opiomelanocortin processing, was found in extracts of both anterior and
      neurointermediate lobes of the pituitary. Post-translational modification of
      other products of intermediate lobe processing were observed. N- and O
      acetylation of alpha-melanotropin, partial O-phosphorylation of corticotropin
      like intermediate lobe peptide and carboxyl-terminal amidation of beta
      melanotropin were identified.

PMID- 7770637
TI  - Mesencephalic grafts increase preprotachykinin-A mRNA expression in striatal
      grafts in an in oculo co-graft model.
AB  - In oculo transplantation provides a powerful tool to study development and gene
      expression of isolated brain regions. In this study we grafted striatal and
      mesencephalic brain tissue to the anterior eye chamber and allowed it to survive
      for 2 and 6 weeks. Striatal or mesencephalic pieces were either grafted alone
      (single grafts) or together in close connection (co-grafts). As a control normal
      adult untreated rats were analyzed at the striatal and hippocampal level. Using
      non-radioactive in situ hybridization with digoxigenin-labeled riboprobes we
      detected preprotachykinin-A mRNA, a neuropeptide marker for striatal neurons. We
      report that adult normal rats show a strong expression of preprotachykinin-A mRNA
      in the striatum, medial habenula and piriform cortex, verifying the specificity
      of the method. Mesencephalic in oculo grafts did not reveal any staining for
      preprotachykinin-A mRNA. In single striatal grafts only a very weak expression of
      preprotachykinin-A mRNA was found at both time points investigated. Co-grafts
      grown for 2 weeks were not different from single striatal grafts, however, when
      striatum was grown together with ventral mesencephalon for 6 weeks the level of
      preprotachykinin-A mRNA was strong and near normal adult levels. We conclude that
      the mesencephalic dopaminergic innervation to the striatum might be a potent
      stimulus to neurons expressing preprotachykinin-A mRNA.

PMID- 7770638
TI  - Fundamental concepts and immunosuppressive treatment in the various forms of
      glomerulonephritis.
AB  - Immunosuppressive treatment in glomerulonephritis (GN) is still controversial.
      Most of the secondary forms of glomerulonephritis have the histologic features of
      one of the primary types of glomerulonephritis. Eight histologic expressions of
      primary glomerulonephritis can be distinguished and ordered in terms of severity
      of symptoms and prognosis: endocapillary GN, minimal change GN,
      mesangioproliferative GN, membranous GN, focal-sclerosing GN,
      membranoproliferative GN, focal-necrotizing GN, and rapidly progressive GN.
      Agreement exists only to the extent that immunosuppression is not required in
      endocapillary glomerulonephritis, although it is recommended in the other extreme
      of rapidly progressive GN. Primarily, an indication for immunosuppression is
      given by the severity of symptoms with a urinary protein excretion > 3.5 g per
      day and/or serum creatinine > 150 mumol per liter. As for anti-GBM, the type of
      glomerulonephritis is more important than the severity of symptoms in guiding
      therapy, whereas for IgA nephropathy it is controversial whether the prospective
      prognosis of even inexorably deteriorating renal function justifies
      immunosuppression. Renal biopsy is required to identify the type of
      glomerulonephritis so as to establish the specific immunosuppressive concept with
      different intensity and duration of treatment. Immunosuppression can reduce
      urinary protein excretion and improve deterioration of renal function; however,
      the proportion of patients responding varies with and depends on the different
      forms of GN.

PMID- 7770639
TI  - Effects of ursodeoxycholic acid on hemodynamic and renal function abnormalities
      induced by obstructive jaundice in rats.
AB  - The mechanism of renal function abnormalities in experimental biliary cirrhosis
      can be partially explained by the absence of gastrointestinal bile flow, which
      predisposes to translocation of intestinal endotoxin, a potent renal
      vasoconstrictor. Since bile acids prevent the absorption of intestinal
      endotoxins, we aimed to evaluate the effects of ursodeoxycholic acid (UDCA)
      administration on renal function and hemodynamic abnormalities induced by 1 week
      of obstructive jaundice in rats. METHODS: Fifty-two rats were used; 30 had
      ligation of the common bile duct, 22 were sham operated. Bile duct ligated rats
      were randomly and blindly assigned to receive UDCA (25 mg/kg/day, n = 14) or
      placebo (n = 16) during 1 week. Sham rats received no treatment. Portal pressure
      (PP) as well as creatinine clearance (CrCl), urinary sodium (US), and plasma
      renin activity (PRA) were evaluated. Results are mean +/- SEM, with a significant
      value of p < 0.05. RESULTS: Portal pressure (10.4 +/- 1.1 vs. 12.1 +/- 0.8 mm Hg)
      was significantly lower in UDCA than in placebo-treated rats. ALT serum levels
      were also significantly lower in bile duct ligated rats receiving UDCA (77.3 +/-
      28 IU/L) than in placebo-treated rats (162 +/- 65 IU/L). US (1.1 +/- 0.5 vs. 2.1
      +/- 0.3 mEq/24 h) was significantly lower and PRA (6.0 +/- 2.6 vs. 1.9 +/- 1.0 ng
      Ang 1/mL/h) higher in bile duct ligated than in sham-operated rats. No
      differences were found between UDCA or placebo-treated bile duct ligated rats.
      CrCl was similar between sham (0.39 +/- 0.12 mL/min/100 g BW) and UDCA (0.32 +/-
      0.16) but significantly lower in placebo-treated (0.28 +/- 0.07) than sham
      operated rats (p < 0.05). CONCLUSION: UDCA administration had very mild effects
      on renal function abnormalities induced by experimental obstructive jaundice in
      rats. However, portal hypertension and biochemical abnormalities were partially
      improved.

PMID- 7770640
TI  - Renal cortical mitochondria are the source of oxygen free radicals enhanced by
      gentamicin.
AB  - Rat renal cortical mitochondria were isolated from Wistar male rats weighing 80
      to 120 g to investigate whether the source of oxygen free radicals was renal
      cortical mitochondria enhanced by gentamicin. In renal cortical mitochondria with
      or without the addition of gentamicin, DMSO, DFO, CAT, SOD, and MT1 were added
      separately, then incubated at 37 degrees C for 90 min. Superoxide anions and
      hydroxyl radicals were then determined. The results showed that superoxide anions
      and hydroxyl radicals generated in mitochondria were enhanced by the addition of
      in vitro gentamicin (12.4 mg/mL) when compared to those without the addition of
      gentamicin. Dimethylsulfoxide (DMSO), catalase (CAT), and deferoxamine (DFO)
      significantly inhibited hydroxyl radicals enhanced by gentamicin, but superoxide
      dismutase (SOD) and metallothionein-1 (MT1) did not. SOD significantly inhibited
      the production of superoxide anions. Our data indicated that renal cortical
      mitochondria are the source of oxygen free radicals and that production is
      enhanced by gentamicin. This provides more insight on the pathogenetic role of
      hydroxyl radicals and superoxide anions in gentamicin-induced nephrotoxicity in
      vitro.

PMID- 7770641
TI  - A comparison of the effect of feeding a low-protein diet and of pharmacological
      intervention on the course of ablation nephropathy in the rat.
AB  - In Wistar rats just after weaning, 5/6 of renal parenchyma were removed
      surgically. Thereafter, the rats were fed either a "high-protein" (21%) or two
      types of a "low-protein" (6%) diet; in one of the latter the lack of protein was
      substituted by saccharide, in the other by fat, making the substitution
      "isocaloric" in either case. In all three diet groups, subgroups were formed
      drinking either tap water or water containing either the ACE inhibitor enalapril
      (Ena) or the calcium antagonist diltiazem (Dil), or both (Ena + Dil). In the high
      protein diet group, increases in the weight of kidney remnants, in proteinuria
      and in systolic blood pressure (SBP) were seen. This was prevented by feeding
      either type of the low-protein diet but also by Ena and Ena + Dil. Ena and Ena +
      Dil not only prevented the increase in SBP but actually lowered it significantly.
      Dil alone also had a SBP-lowering action but offered no protection from kidney
      hypertrophy and proteinuria. No additive protective action of Ena + Dil or Ena +
      low protein or Ena + Dil + low protein was seen, suggesting that a bottom limit
      of these protective action was reached by the low-protein diet alone. There was
      no substantial difference between either type of the low-protein diet except a
      small and transient decrease in body weight in the first week of fat-rich diet
      administration.

PMID- 7770642
TI  - Age-related ANP release in response to acute vs. chronic sodium loading.
AB  - Atrial natriuretic peptide (ANP) levels were studied in young (2-week-old) and
      old (age 20 months) rats following acute (20 mL/kg bolus of normal saline i.v.)
      vs. chronic sodium loading (high-salt diet for 21 days). In both groups serum ANP
      rose significantly 1 h post i.v. loading. However, the increment was greater in
      the old animals. On chronic sodium load, in the young group, ANP rose
      significantly on days 3 and 7, subsequently declining to baseline. In the old
      animals, no increase in ANP was noted throughout the chronic experiment. Twenty
      four-hour urinary sodium excretion was similar in the two groups following acute
      or chronic salt load. The results suggest that: (1) The old kidney requires a
      greater ANP stimulus to excrete a given acute i.v. sodium load. (2) The
      relatively diminished elasticity of the old heart plays a major role in the
      exaggerated ANP release in response to a bolus i.v. load of saline. (3) The role
      of ANP in maintaining homeostatic renal sodium excretion during short-term sodium
      oral loading is different in the two age groups.

PMID- 7770643
TI  - Tubular damage in microalbuminuric patients with primary glomerulonephritis and
      diabetic nephropathy.
AB  - Tubular damage as suggested by enzymuria and tubular proteinuria is a recognized
      feature of glomerulonephritis (GN) with clinical proteinuria and both incipient
      and overt diabetic nephropathy (DN). However, little is known about the presence
      of tubulopathy in patients with primary GN, microalbuminuria [albumin excretion
      (AER) 30-300 mg/d] and microhematuria. Three groups were studied. The GN group
      comprised 17 (2 F) patients with biopsy-proven GN with microalbuminuria. The DN
      group comprised 35 (14 F) patients with incipient diabetic nephropathy with AER
      30-300 mg/d, and controls comprised 38 (15 F) normal subjects with normal AER <
      30 mg/d. Serum creatinine, albuminurinuria, transferrinuria, and markers of
      tubular damage such as urinary excretion of N-acetyl-glucosaminidase (NAG),
      leucine aminopeptidase (LAP), gamma-glutamyl transferase (gGT), and retinol
      binding protein (RBP) were measured. GN and DN had comparable degrees of
      albuminuria, transferrinuria, and LAP excretion, and these were significantly
      higher than controls. Serum creatinine was significantly higher in GN than DN and
      controls. DN had significantly higher NAG and RBP, and lower gGT than GN and
      controls. In both GN and DN groups, both glomerular proteins correlated with each
      other and NAG correlated significantly to LAP and gGT. Albuminuria correlated to
      tubular enzymuria in GN group but not in patients with DN. The results suggest
      that tubular damage is less marked in microalbuminuric patients with GN than
      those with DN despite similar degree of glomerular proteinuria. The pattern of
      tubulopathy is also different in the two groups, indicating differences in the
      pathogenesis of tubular damage in these two clinical settings.

PMID- 7770644
TI  - Daily peritoneal dialysis using a surgically placed Tenckhoff catheter for acute
      renal failure in children.
AB  - Thirty-one infants and children with acute failure were treated with peritoneal
      dialysis using a surgically placed Tenckhoff catheter. In 10 patients a
      peritoneal dialysis cycler was used, and 21 were dialyzed by the manual method.
      Initially, hourly exchanges were given for 24 to 48 h and, as the patients
      stabilized, 10 exchanges per day at 1-h intervals were given. The mean
      stabilization period was 36 +/- 8 h. The predialysis mean serum creatinine was
      5.8 +/- 1.8 mg% and the serum creatinine while on daily dialysis was 2.8 +/- 1.1
      mg%. Peritoneal dialysis succeeded in controlling metabolic abnormalities and
      improving fluid balance. All the catheters except one functioned immediately
      following insertion. Median duration of catheter placement for dialysis was 18
      days (range 2 to 90). The incidence of peritonitis was 12.8%, and exit site
      infection was 6.4%. The infection rate was decreased when a cycler was used
      compared with the manual method (23.8% vs. 10.0%), though not statistically
      significant. Two patients developed hypothermia while being dialyzed via the
      manual method. To conclude, 10 daily peritoneal dialysis exchanges performed at 1
      h intervals after initial stabilization using a surgically placed Tenckhoff
      catheter is an effective and safe mode of dialytic therapy for children with
      acute renal failure. Complications (infection and hypothermia) are reduced with
      the use of a cycler.

PMID- 7770645
TI  - Decreased urinary excretion of beta-glucuronidase in sickle cell anemia in
      Nigeria.
AB  - The activities of five lysosomal hydrolases--namely beta-glucuronidase, beta
      hexosaminidase, beta-galactosidase, alpha-galactosidase, and alpha-mannosidase-
      were measured in the plasma and urine of children (ages, 7 to 15 years) with
      sickle cell anemia (n = 11) and controls (n = 11) from Jos, Nigeria. The presence
      of SS hemoglobin was confirmed by electrophoresis of red cell hemolysates.
      Albuminuria was absent in all of the patients with sickle cell anemia. The
      creatinine-indexed urinary activity level (units of enzyme activity/milligrams
      creatinine) and the fractional enzyme excretion (FEE) value, which is defined as
      the ratio of enzyme clearance to creatinine clearance, were determined for each
      of the five lysosomal enzymes and compared between the two groups. The mean FEE
      values for beta-glucuronidase and alpha-galactosidase in the sickle cell patients
      were 10- and 3.5-fold lower, respectively, than the corresponding control values,
      and these differences were statistically significant (p < .03) for both enzymes;
      however, beta-hexosaminidase, beta-galactosidase, and alpha-mannosidase levels in
      urine were not different between the two groups. When indexed to creatinine, a
      comparison of the urinary enzyme levels of control and sickle cell patients
      showed significant differences for beta-glucuronidase (p < .01) and alpha
      galactosidase (p < .05) but not for the other three enzymes. Differences in level
      of plasma enzyme activity between control and sickle cell patients were not
      significant, except for alpha-galactosidase (p < .05), which was increased
      slightly (25%) in the sickle cell group. These data indicate that there may be
      abnormalities in the metabolism of lysosomal enzymes in the kidneys of patients
      with sickle cell anemia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7770646
TI  - Interpretation of positive edrophonium (Tensilon) test in patients with end-stage
      renal disease.
AB  - Many patients with end-stage renal disease (ESRD) have signs and symptoms of easy
      fatigability, fluctuating weakness, apathy, dry mouth, and blurring of vision.
      These symptoms can be confused with disorders of neuromuscular transmission. When
      present, the physician may want to determine whether the patient has myasthenia
      gravis--the commonest of all neuromuscular disorders--and administer the
      edrophonium (Tensilon) test. An unequivocally positive response to the test must
      be interpreted with caution in ESRD. However, the exact mechanism of a positive
      response is unclear but may be explained by metabolic abnormalities related to
      end-stage renal disease, i.e., uremic toxins, disordered calcium metabolism,
      abnormal neuromuscular mechanism, associated neurological disorders, or myopathic
      processes in uremia, all of which can affect neuromuscular transmission.

PMID- 7770647
TI  - Safe employment of recombinant human erythropoietin in pregnancy in two anuric
      patients on regular dialysis treatment.

PMID- 7770648
TI  - Was Beethoven's cirrhosis due to hemochromatosis?
AB  - Dr. Wagner's description of an advanced macronodular cirrhosis is compatible with
      end-stage liver disease due to a variety of causes. An alcoholic etiology seems
      more probable than chronic viral hepatitis since such a diagnosis might also
      account for the chronic pancreatitis, unless it was related to the
      cholelithiasis. However, Dr. Wagner's description favors a diagnosis of biliary
      pigment sludge related to hemolysis. Furthermore, the controversy over the extent
      of Beethoven's alcohol consumption and the absence of mention of pancreatic
      calcification weakens the case for an alcoholic etiology. On the other hand, Dr.
      Wagner's emphasis of bluish-green pigmentation of the liver, blackish
      pigmentation of the spleen, and an arteropathy of the hepatic vessels suggests
      the probability of hemochromatosis, which diagnosis is also in keeping with
      Beethoven's medical history. In this regard the composer's history of recurrent
      obscure abdominal pain, commencing in his third decade, is especially in keeping
      with hemochromatosis. As many as a third of patients present with recurrent
      abdominal pain, and eventually up to 40% of cases develop significant abdominal
      pain in the course of their disease. While some of these cases of abdominal pain
      have been attributed to hepatoma, ascites, pancreatitis, perisplenitis, or
      diabetic neuropathy, the majority remain ill-defined (32). Even so, the diagnosis
      of hemochromatosis remains unproved in the absence of a histological examination
      and measurement of hepatic iron concentration. It is proposed that the combined
      additive, toxic effects of alcohol and iron were the most likely cause of
      Beethoven's cirrhosis.

PMID- 7770649
TI  - [Post-therapeutic follow-up of oral spinocellular epithelioma].
AB  - During the follow-up of patients treated for squamous cell carcinoma, dentists
      have to look for recurrences and metastases. They play also a very important role
      in the prevention and treatment of the different treatment induced oral sequelae.
      Special attention is drawn to the postradiation complications like mucositis,
      xerostomia, radiation caries, trismus and osteoradionecrosis. Despite the fact
      that no universal accepted protocols are available, the author presents some
      therapeutic procedures, based on the review of the literature and clinical
      experience. The importance of a long time follow-up is underlined.

PMID- 7770650
TI  - [Oral cancer. Precancerous conditions].
AB  - In the precancerous lesions leukoplakia is the most frequent. This is only a
      clinical diagnose and a biopsy is necessary to see if there is a malignant
      transformation. A mycosis in a leukoplakia may be an important indicator for a
      local or system impairment of the immune system.

PMID- 7770651
TI  - [Oral cancer. The importance of early diagnosis and role of the dentist].
AB  - Early diagnosis is an significantly relevant factor in the prognosis of oral
      cavity carcinomas. Knowledge of the clinical and oral manifestations of pre
      cancerous lesions in general dentistry is of paramount importance. The initial
      treatment, follow-up schedule and reference timing are given in a decision chart.
      Special attention is given to the timing of biopsies in the treatment plan.

PMID- 7770652
TI  - [Spinocellular epithelioma of the oral mucosa. Description, development,
      localization].
AB  - The presentation of the oral squamous carcinoma is described. The oral cavity has
      been divided into five sites: the tongue, the floor of the mouth, the gingiva,
      the cheek and the palate. For each location the presentation and the evolution of
      the squamous carcinoma is described.

PMID- 7770653
TI  - [Assessment of extension and staging of oral cancers].
AB  - Cancers of the oral cavity are most frequent during the 6th to 8th decades and
      tobacco and alcohol are major risk factors. Diagnosis must be made by bimanual
      palpation and biopsy. Local invasion is best evaluated by CT-scanner and Magnetic
      Resonance Imaging for the primary tumor and by ultrasonography for neck nodes.
      For therapeutic and prognostic goals, staging of the tumor must be estimated
      before first treatment according to the AJCC and the UICC classification.

PMID- 7770655
TI  - [Prosthetic rehabilitation following surgical removal of a maxillary or
      mandibular tumor].
AB  - Modern oral cancer therapeutic techniques unfortunately remain too often
      impairing. On the other hand, rebuilding techniques fortunately allow the patient
      as well as the practitioner to expect with increasing optimism the restoration of
      a satisfying function. Those techniques resort, among others, to grafting by bone
      pedicled transplants and endosseous osseointegratable implants. Irradiated
      tissues, however, require the utmost care.

PMID- 7770654
TI  - [Treatment of oral epidermoid carcinoma].
AB  - This review analyses systematically all therapeutical known features about oral
      cancer. Every therapeutic modality involving surgery, radiotherapy and
      chemotherapy is detailed and an exhaustive literature review about each therapy
      concept is made.

PMID- 7770656
TI  - [Oral cancer: epidemiology and prognosis].
AB  - More than 90% of intra-oral malignancies are squamous cell carcinomas. Oral
      cancer is far more frequent in developing countries than in developed ones. This
      has probably to do with the differences in the use of tobacco and alcohol and
      with factors such as oral hygiene, nutrition and general resistance. Through an
      increased interest for epidemiological studies certain factors are suspected as
      carcinogenic. They can grossly be divided into chemical, physical and biological.
      Even though it is often hard to prove the real relation of cause to effect, one
      can no longer deny the detrimental role of tobacco, of many alcoholic drinks, of
      poor oral hygiene, of nutritional deficiencies, of short wave irradiation, and
      possibly of certain viruses. These factors must further be investigated because
      the overall prognosis of oral cancer is not very good. Determinant in survival
      are the volume of tumor present (surface and depth), its growth pattern, its
      localisation, eventual lymph node involvement and general hematogenic metastases,
      ... The overall five-year survival seems to range between 10% for T4N3 and 95%
      for T1N0 cases. Early detection and efficient prevention must therefore be
      encouraged.

PMID- 7770657
TI  - [Dental prosthesis rehabilitation following oral carcinologic treatment].
AB  - Following the different treatments applied on patients suffering of a mouth
      cancer, often these are confronted with a functional and esthetic handicap.
      Thanks to the prosthetic techniques and an eventual resort to implantation, it is
      possible to improve their quality of life. Different prosthetic reconstructions
      are considered.

PMID- 7770658
TI  - [Experimental vaccination of SPF chickens against Newcastle disease using the
      method of coated-millet vaccine from a thermotolerant variant of the LaSota
      virus].
AB  - The thermotolerant variant A300 of LaSota virus was used to vaccinate 4 week old
      specified pathogen-free (SPF) chickens by feeding them with virus coated-millet.
      With vaccine doses above 10(6)EID50/bird, HI antibodies developed and protection
      to challenge was seen 2 months after vaccination, while 100% mortality occurred
      in the control groups. The PD50 was estimated to 10(6.85) EID50. This lyophilized
      vaccine intended for African village chickens can be kept at ambient temperature
      for at last 1 week up to 35 degrees C. Other trials on a large scale are still
      needed to determine the potential of this vaccine in the field conditions of
      rural Africa.

PMID- 7770659
TI  - First report on the isolation of Brucella abortus biovar 3 from camel (Camelus
      dromedarius) in the Sudan.
AB  - Three isolates of Brucella abortus biovar 3 were recovered out of 38 different
      samples obtained from free-ranging camels (Camelus dromedarius) in Eastern Sudan.
      The biochemical characters of the isolates were identical to those of the other
      types of B. abortus except that they were oxidase negative.

PMID- 7770660
TI  - [Epidemiology of digestive parasitic diseases of young cattle in northern
      Cameroon].
AB  - Studies of gastro-intestinal parasites of zebu calves were carried out in
      traditional herds in Northern Cameroon through monthly faecal analysis in 17
      herds for a period of two years. Toxocarosis appeared to be the most important
      parasitic infection in the North province where its prevalence reached 58% in
      calves aged 0-6 months; 60% of the infested calves passed large numbers of eggs
      at least once. Samples revealing high egg counts were more frequent in the dry
      season. Deworming calves aged one month with a cheap anthelmintic against
      Toxocara is likely to be economically profitable in the North. Seventy-five and a
      half per cent of the calves 0-12 months old were infested with Strongyloides;
      high counts of Strongyloides eggs were registered at least once for 31% of these
      calves. As for toxocarosis, calves seemed to be more often and more heavily
      infested with Strongyloides in the North than in the Far North province.
      Strongyloidosis was apparently of low clinical importance, with the rare clinical
      manifestations accompanied by toxocarosis. The importance of digestive tract
      strongylosis was difficult to evaluate. Every steer was affected at one stage of
      its life in a similar manner in the two provinces; 6.8% of samples showed high
      egg counts and 35% of the steers aged over six months passed large numbers of
      eggs at least once. These results did not permit a priori recommendation of a
      systematic deworming programme against strongyles; instead, several less
      intensive deworming programmes have to be tested in order to determine their
      economic profitability. Coccidia were found in 77.4% of calves aged 0-12 months,
      with heavier and more frequent infections in the North. However, infections of
      high intensity were generally rare. Trichuris, Moniezia, Fasciola and
      paramphistomes were rarely found. Concerning nematodosis, curative treatments and
      cost-profit studies of deworming programmes should be aimed at toxocarosis in
      calves aged 0-3 months in the North, and strongylosis in steers aged 6-12 months,
      in both provinces.

PMID- 7770661
TI  - Efficacy of chlortetracycline for controlling goat coccidiosis in Burundi.
AB  - Eighteen cross-bred goats of Burundi naturally infected to varying degrees with
      multiple coccidia species of the genus Eimeria were orally administered 25 mg/kg
      body weight/day chlortetracycline. Effectiveness percentages more elevated than
      99.0% were reached within the 9th day of treatment. No adverse reactions have
      ever been reported. Results demonstrate that the antibiotic is effective for the
      control of coccidiosis of goats naturally infected in Burundi.

PMID- 7770662
TI  - Pig trypanosomosis: prevalence and significance in the endemic Middle Belt zone
      of southern Nigeria.
AB  - Abattoir and field/market surveys of 1,954 crossbred pigs aged 6 to 30 months,
      for trypanosomosis in the Middle Belt zone of Southern Nigeria, revealed a 26.8
      infection rate. Of those infected, 66.5, 23.9 and 8.2 % were due to mixed, single
      Trypanosoma brucei and T. congolense infections respectively. Although 1.5 % of
      the infections were unidentified, there was no evidence of T simiae. The
      infection rate was significantly higher (p < 0.05) among the abattoir pigs (37.8
      %) than among the farm pigs (21.8 %) in both sexes. Peak infection was noted
      among pigs aged 11 to 15 months and during the end of the rainy season and the
      beginning of the dry season (September to December). Complementary mice
      inoculation tests revealed 83 subpatent and prepatent cases and are being
      recommended as a confirmatory diagnostic technique. The disease poses problems
      for pig productivity and the cooperation of scientists is essential.

PMID- 7770663
TI  - Efficacy of Cymelarsan in the treatment of natural chronic Trypanosoma evansi
      infection in camels in the Sudan.
AB  - The efficacy of Cymelarsan, administered by intramuscular (i/m) injection in the
      treatment of chronic cases of camel trypanosomosis due to Trypanosoma evansi, was
      tested under controlled laboratory conditions. It was confirmed that Cymelarsan
      is a safe drug for use in dromedary camels when administered i/m at dose rates of
      0.25 or 0.50 mg/kg body weight. During the 90 days post-treatment no relapses
      occurred at either dose rate. Hence, the drug was found to be fully effective
      against the chronic form of the natural disease. A dose of 0.25 mg/kg body weight
      of Cymelarsan given i/m is recommended.

PMID- 7770664
TI  - [Field trial of an attenuated vaccine against heartwater disease].
AB  - The results are given of a field trial using a Senegalese stock of Cowdria
      ruminantium which had been attenuated by passage in cell culture. Thirty
      vaccinated and thirty control sheep were exposed in the Niayes region of Senegal
      and were monitored daily. In the control group, 22 animals died of heartwater,
      associated in one case with anaplasmosis. In the vaccinated group, 13 animals
      died; Cowdria was found only in two sheep which had previously suffered from
      ehrlichiosis or anaplasmosis; three other cases of ehrlichiosis and two of
      anaplasmosis were also observed among these 13 animals. The resistance of the two
      vaccinated animals which showed Cowdria in their cerebral cortex was apparently
      lowered by the intercurrent infections. The other animals of the vaccinated group
      showed no evidence of Cowdria infection.

PMID- 7770665
TI  - Effects of potassium and lactic acid on chemoreceptor discharge in anaesthetized
      cats.
AB  - Both increasing [K+]a and falling pHa stimulate ventilation through an action on
      the peripheral chemoreceptors. We have examined the effect on afferent carotid
      chemoreceptor discharge, of intravenous infusion of lactic acid alone, KCl alone,
      and both combined at constant PETCO2 in anaesthetized, artificially ventilated
      cats. Infusions of lactic acid alone and KCl alone caused similar increases in
      both the mean and amplitude of oscillation of chemoreceptor discharge. In the
      case of the lactic acid alone infusion the increase in the amplitude of
      oscillation could be accounted for by the resultant increase in carbon dioxide
      production. Simultaneous infusion of KCl and lactic acid caused an increase in
      the mean and amplitude of the discharge which was greater than either given
      alone, although the combined effect was less than additive. The alterations in
      mean and amplitude of oscillation of discharge during infusion of both agents
      together may be completely accounted for by a combined effect of increased carbon
      dioxide production and elevated [K+]a.

PMID- 7770666
TI  - Scaling of hypercapnic ventilatory responsiveness in birds and mammals.
AB  - The possible relationship between CO2 responsiveness and body mass in birds was
      explored using newly acquired ventilatory data from the barn swallow, Hirundo
      rustica, and the pigeon, Columbia livia, and that from the literature on four
      other species. Ventilatory responsiveness (% delta V) of birds to 5% inspired CO2
      is scaled to body mass to the 0.145 power (% delta V alpha Mb 0.145). A similar
      allometric relationship exists for data on 7 species of eutherian mammals taken
      from the literature (% delta V alpha Mb0.130). The The reduced responsiveness to
      CO2 in small birds and mammals may be related to an elevated hypoxic ventilatory
      sensitivity, as demonstrated in mammals (Boggs and Tenney, Respir. Physiol. 58:
      245-251, 1984). These scaling relationships may reflect a mechanism for
      minimizing the inhibition of ventilation resulting from excessive loss of CO2
      which thereby permits a higher hypoxic ventilatory response in small species.
      Other mechanisms, however, could include size related differences in mechanics or
      alveolar ventilation.

PMID- 7770667
TI  - Diaphragm and phrenic nerve activities during inspiratory loading in anesthetized
      rabbits.
AB  - To determine whether decreases in neural activation and/or neuromuscular
      transmission to the diaphragm contribute to ventilatory failure observed during
      inspiratory resistive loaded breathing, peak integrated activity of the intact
      phrenic nerve (ENGdi) and costal diaphragm (EMGdi), transdiaphragmatic pressure
      swings (Pdi) and evoked diaphragm compound action potentials (M-wave) were
      measured in anesthetized rabbits subjected to inspiratory resistive loads of
      varying intensities and duration breathing supplemental oxygen. Sustainable loads
      were studied for 4 h. Severe loads were applied in increments and studied for 50
      min each. Loading resulted in parallel increases in ENGdi, EMGdi and Pdi that
      stabilized within 20 min. With severe loading, peak inspiratory pressure (Pao = 
      55 +/- 4 cm H2O) was maintained for 30 min after which there was a significant
      drop in inspiratory pressure (task failure). Despite hypoventilation and profound
      changes in blood gases, both activation (ENGdi) and neuromuscular transmission
      (ENGdi/EMGdi ratio or M-wave) were maintained throughout all loads even at task
      failure when a critical level of PaO2 (27 +/- 1 mm Hg) was reached. We conclude
      that neural activation and neuromuscular transmission to the diaphragm do not
      fail during inspiratory resistive breathing and discuss our findings in terms of
      current concepts of diaphragm fatigue and control of breathing in this model.

PMID- 7770668
TI  - Changes in pharyngeal respiratory muscle force produced by K+ channel blockade.
AB  - The purpose of the present study was to determine whether the contractility of
      pharyngeal respiratory muscles can be augmented by altering membranous K+ channel
      conductance. The effects on twitch force of two K+ channel blockers,
      tetraethylammonium (TEA, 10 mM) and 4-aminopyridine (4-AP, 0.3 mM), were examined
      in vitro for sternohyoid and diaphragm muscle strips. Both agents augmented
      isometric twitch force of both muscles. In response to TEA twitch force of the
      sternohyoid muscle increased significantly more than that of the diaphragm (by 33
      +/- 7 vs. 9 +/- 1%, P = 0.004), whereas with 4-AP the increase in twitch force of
      the sternohyoid muscle was comparable to that of the diaphragm (55 +/- 15 vs. 64
      +/- 6%, P = 0.50). 4-AP shifted the force-frequency relationship of both muscles
      leftward but did not alter peak tetanic force, so that force with 4-AP exceeded
      that without drug at stimulation frequencies below 60 Hz. In contrast TEA reduced
      force at stimulation frequencies > 20 Hz. The isometric contraction times of both
      muscles was variably prolonged, more so with 4-AP (by 30 +/- 15% for the
      sternohyoid and 32 +/- 3% for the diaphragm) than with TEA (by 9 +/- 2% for the
      sternohyoid and 5 +/- 2% for the diaphragm). For the group of muscles and K+
      channel blockers, the degree of augmentation of twitch force correlated with the
      degree of prolongation of contraction time (r = 0.82, P < 0.001), consistent with
      blocking delayed rectifier K+ channels as the mechanism of increasing muscle
      force.

PMID- 7770669
TI  - A finite element analysis of the effects of the abdomen on regional lung
      expansion.
AB  - A finite element model of the dog lung, heart and abdomen, consisting of three
      solid linearly elastic bodies, was developed to study the effects of gravity on
      the vertical stress distribution and lung volume in different body positions at
      functional residual capacity (FRC). The geometry of the lung was obtained from an
      isolated dried dog lung after inflation to total lung capacity (TLC). The
      compliance of the rib cage, diaphragm and the abdomen was simulated by spring
      elements located on their surfaces. In the prone position, gravitational forces
      acting only on the lung contributed to the vertical gradient (0.19 cmH2O/cm) in
      transpulmonary pressure (Ptp). This result was independent of chest wall
      compliance. In the supine position, the addition of the heart and abdomen with a
      compliant diaphragm and abdominal walls increased the vertical Ptp gradient to
      0.53 cmH2O/cm. In the head-up (upright) position, both heart and abdominal weight
      contributed to the vertical gradient (0.47 cmH2O/cm). Diaphragmatic compliance
      was of less importance to the vertical gradient in the head-up and head-down
      positions in the absence of the abdomen. The smallest vertical gradient (0.11
      cmH2O/cm) was obtained in the head-down position with abdominal weight reducing
      the gradient caused by lung weight. Lung volume at FRC was virtually unaffected
      by gravity in the prone body position, was reduced by gravity in the supine and
      head-down positions but increased in the head-up position. The effects of a
      compliant diaphragm and abdominal weight are important contributors to the
      distribution of stress and volume in the intact lung.

PMID- 7770670
TI  - Increased insensible water loss in feline retrovirus-infected cats.
AB  - Feline retroviruses such as feline leukemia virus (FeLV) adversely affect the
      regulation of many vital host systems such as the immune response,
      erythropoiesis, and nutrient metabolism. In this paper, we describe the
      disruption of an additional homeostatic mechanism-evaporative water loss-by FeLV.
      Viremic cats had greater evaporative water losses (24.0 +/- 1.4 gm water/kg per
      day) at low relative humidity levels (19% to 25% relative humidity) when compared
      to age- and sex-matched control cats (19.7 +/- 1.4 gm of water/kg per day [P <
      0.05]). At relative humidity levels greater than 50%, viremic and control cats
      had similar evaporative water losses. Viremia also resulted in an elevation in
      the average body temperature (39.1 +/- 0.5 degrees C) compared to control cats
      (38.4 +/- 0.3 degrees C) (P < 0.001). However, the energy expenditure of viremic
      cats (17.14 +/- 1.60 kJ/kg/h) was not significantly different from the energy
      expenditure of control cats (17.02 +/- 2.22 kJ/kg/h). The elevated body
      temperature of viremic cats likely causes a greater increase in evaporative water
      loss at low relative humidity levels and suggests further study of water balance
      in retroviral infection is warranted.

PMID- 7770671
TI  - Malignant lesions of the female genital tract and peritoneum that may be
      underdiagnosed.
AB  - Female genital tract neoplasms that may have a deceptively benign appearance and
      selected frankly malignant neoplasms that may be misinterpreted as less
      aggressive lesions are reviewed. In the uterine cervix, the two major neoplasms
      in this group are the minimal deviation adenocarcinomas of mucinous and
      endometrioid types. The latter subtype has only recently been described.
      Endometrioid adenocarcinomas, usually of the uterine corpus, but occasionally of
      other sites, may have microglandular patterns that can lead to their
      misdiagnosis, sometimes as microglandular hyperplasia. Pure squamous cell
      carcinomas of the uterine corpus frequently are composed of very well
      differentiated epithelium, so that it is possible to misinterpret them as
      nonneoplastic, and a similar phenomenon may occur in association with the
      squamous element in some adenocarcinomas with squamous differentiation. Other
      uterine entities that may be underdiagnosed are malignant lymphoma of the cervix,
      placental site trophoblastic tumor, myxoid leiomyosarcoma, endometrial stromal
      sarcoma with glandular differentiation, and mullerian adenosarcoma. Consideration
      of a variety of architectural and cytological features should facilitate their
      interpretation. One recently described variant of adenocarcinoma of the fallopian
      tube that may be confused with the usually clinically benign female adnexal
      tumors of probable Wolffian origin is microfollicular endometrioid
      adenocarcinoma. Ovarian tumors subject to misinterpretation that are reviewed
      herein include metastatic tumors with deceptively benign foci, endometrioid
      adenocarcinomas that may be misdiagnosed as sex cord tumors, and cystic granulosa
      cell tumors that may be misinterpreted as follicle cysts. Finally, rare variants
      of malignant mesothelioma that may be underdiagnosed are reviewed.

PMID- 7770672
TI  - Malignant breast lesions that may mimic benign tumors.
AB  - It has been estimated that approximately 1 in 9 women (living to age 85 years) in
      the United States will develop breast cancer at some time in their lives; hence
      the interpretation of breast biopsies has become a large and important component
      of the surgical pathologist's practice. Indeed, there is great pressure on
      surgical pathologists to make accurate diagnoses of breast lesions because of
      their high incidence, the increased public awareness of breast disease, the
      greater use of screening mammography to detect early carcinomas, the development
      of multiple therapeutic options (which is often determined by tumor pathology),
      and the harsh medical-legal climate. The focus of this article will be to define
      the clinicopathologic features of two malignant breast lesions that are
      particularly prone to simulate benign lesions, and thus pose important diagnostic
      problems to surgical pathologists. The two lesions include spindle-cell carcinoma
      and low-grade duct carcinoma in situ.

PMID- 7770673
TI  - Malignancies in the lung and pleura mimicking benign processes.
AB  - As pathologists, we are most concerned about overcalling reactive changes in the
      lung as carcinoma and the fact that malignant processes may be misinterpreted as
      benign processes in the lung is less well recognized. This review covers five
      such lesions. Well-differentiated adenocarcinomas, especially bronchioloalveolar
      carcinomas, are frequently undercalled, particularly in small biopsy and cytology
      specimens. In such cases, one must pay particular attention to the uniformity and
      monotony of the epithelium even though it may be extremely well differentiated.
      Spindle cell carcinomas may have necrosis and cavitation, interstitial growth,
      and a reactive fibroblastic reaction, and thus be mistaken as organizing
      inflammatory processes. Careful attention to the atypical cytological features,
      prominent vascular invasion, and getting immunohistochemical supports helps in
      recognizing them. Lymphoid lesions of the lung present a number of problems;
      small lymphocytic lymphomas and Hodgkin's disease are often misinterpreted as
      inflammatory processes. Intravascular lymphomatosis in the lung may be
      misinterpreted as an interstitial pneumonia if one does not appreciate the
      atypical lymphoid cells within the capillaries. The desmoplastic variant of
      sarcomatous mesothelioma may be extremely difficult to diagnose, because large
      portions of the tumors are composed of bland-appearing fibrous tissue. A case of
      desmoplastic mesothelioma presenting predominantly as a mediastinal mass is
      discussed, and problems in differential diagnosis are outlined. Angiosarcomas are
      rare tumors, but an appreciable percentage of them present as pulmonary
      metastases which may be interpreted as pulmonary hemorrhage or organizing
      infarction. The clinical and radiographic pattern, usually mimicking metastatic
      disease, and the fact that atypical spindle cells occlude small pulmonary
      arteries with surrounding alveolar hemorrhage are clues to the recognition of
      these lesions.

PMID- 7770674
TI  - Endocrine malignancies that may mimic benign lesions.
AB  - A variety of malignant tumors that occur in endocrine organs may mimic benign
      lesions histologically. In this article, a number of such tumors are selected for
      discussion, including several variants of papillary thyroid carcinoma
      (encapsulated follicular, diffuse sclerosing, diffuse follicular,
      macrofollicular, cystic, and stroma-rich), paucicellular anaplastic thyroid
      carcinoma, primary thyroid low grade B-cell lymphoma of mucosa-associated
      lymphoid tissue type, adrenocortical carcinoma, and parathyroid carcinoma.
      Emphasis is placed on the histological clues that are helpful for recognizing the
      malignant nature of these lesions.

PMID- 7770675
TI  - Malignant liver tumors that mimic benign lesions: analysis of five distinct
      lesions.
AB  - The diagnosis of malignant liver tumors has long been an important part of
      surgical pathology, but now with improved radiographic and biopsy techniques, the
      appropriate pathological identification and differentiation of malignant from
      benign liver lesions has become even more critical. This review discusses five
      examples of malignant lesions that may be underdiagnosed as benign: well
      differentiated hepatocellular carcinoma, fetal and macrotrabecular
      hepatoblastoma, well-differentiated cholangiocarcinoma, Kaposi's sarcoma, and
      epithelioid hemangioendothelioma.

PMID- 7770676
TI  - Malignant lymphomas that mimic benign lymphoid lesions: a review of four
      lymphomas.
AB  - Lymphomas that may be misdiagnosed as benign lymphoid lesions are described and
      illustrated in this review. Differential diagnoses are considered, and the use of
      specialized techniques in diagnostic pathology are discussed. The four lymphomas
      selected for review include follicular lymphoma, mantle cell lymphoma with mantle
      zone pattern, interfollicular Hodgkin's disease, and nodular lymphocyte
      predominance Hodgkin's disease.

PMID- 7770678
TI  - Malignant thymic neoplasms that may mimic benign conditions.
AB  - The thymus is a complex, highly specialized organ that is derived from the third
      and fourth pharyngeal pouches and contains elements that originate from all three
      germinal layers. As such, it shows certain specific and distinctive reaction
      patterns to injury that are frequently encountered in a variety of reactive and
      inflammatory conditions. These reaction patterns, however, can also often be
      associated with neoplastic diseases arising from this organ, and in some
      instances, their presence may contribute to obscure the malignant nature of the
      underlying process. We present a review of the main tumor entities that may be
      mistaken for benign conditions of the thymus, with emphasis on the three major
      reaction patterns to injury that may be associated with malignant neoplasms of
      this organ: prominent cystic changes, stromal fibrosis, and reactive and
      hyperplastic changes of thymic epithelium. Histologic clues helpful for diagnosis
      and the differential diagnosis of these lesions are discussed.

PMID- 7770677
TI  - Soft tissue sarcomas that mimic benign lesions.
AB  - Although it is well known that a variety of benign mesenchymal neoplasms and
      reactive proliferations may mimic sarcomas, the fact that some types of sarcoma
      commonly are misinterpreted as benign is less widely appreciated. This review
      considers five such lesions in soft tissue: low grade fibromyxoid sarcoma, low
      grade myxofibrosarcoma (myxoid "MFH"), well differentiated liposarcoma (atypical
      lipoma), epithelioid sarcoma, and so-called inflammatory fibrosarcoma. Principal
      reasons for their underrecognition are their generally bland cytology, often
      relative hypocellularity, and indolent clinical course. Common to several of
      these lesions, however, is a tendency for histological and hence biological
      progression in local recurrences, underlining the importance of accurate
      diagnosis and adequate treatment of the primary lesion. This review considers the
      principal clinicopathologic features, differential diagnosis and (where
      appropriate) nosologic status of this treacherous group of neoplasms.

PMID- 7770679
TI  - [Hormone substitution following a gynecological cancer].

PMID- 7770680
TI  - [Can tamoxifen prevent breast cancer?].

PMID- 7770681
TI  - [Hormone substitution following breast cancer: caution].

PMID- 7770682
TI  - [Diagnostic approach to precocious puberty].

PMID- 7770683
TI  - [Gynecologic endocrinology of the adolescent. Basic management and gynecological
      endocrinology in adolescents].

PMID- 7770684
TI  - [Role of echography and Doppler flowmetry in the diagnosis of ovarian masses].

PMID- 7770685
TI  - [Diagnosis and treatment of mastodynia].
AB  - Breast pain or mastalgia is a frequent complaint and it may represent various
      pathological conditions. After a thorough evaluation and reassurance of the
      patients, only those whose symptoms are severe enough to alter their life-style
      still require therapy. In some cases it will be indicated to modify or to stop an
      oral contraception or to adapt a hormone replacement therapy. Those women still
      resistant to treatment may experience relief from evening primrose oil
      supplements, bromocriptine, danazol, some progestins, tamoxifen or GnRH
      analogues. Therapy of non cyclic breast pain is made according to the underlying
      pathology. If no substrate is present, treatment is the same as for cyclical
      mastalgia but the response is diminished.

PMID- 7770686
TI  - [Importance of the thyroid before, during and after pregnancy].

PMID- 7770687
TI  - [Diagnostic and therapeutic approach to hyperprolactinemia].

PMID- 7770688
TI  - [Prospective study of abuse treatment. Lausanne, 1994].

PMID- 7770689
TI  - [Informed consent in the framework of biomedical research: a survey].
AB  - Inquiry on the quality and steps taken to obtain informed consents for biomedical
      research projects, based on the cases of 39 patients coming from 15 different
      projects with immediate therapeutic goals and 16 healthy subjects coming from 4
      different projects without immediate therapeutic goals. Comparison between
      observed reality and the more or less demanding norms that were recommended. We
      noted a much bigger gap (therefore a consent actually informed in a lesser way)
      in the group of patients than in the group of healthy subjects. Explanatory
      hypotheses: the healthy subjects' higher social and cultural level, but also the
      investigators' difficulty and comprehensible discomfort to integrate, with
      respect to the patient, the essentially different and possibly contradictory
      points of view of scientific research and medical care; the "double market"
      notion.

PMID- 7770690
TI  - [Paraneoplastic subacute sensory Denny-Brown neuronopathy or anti-Hu syndrome: a
      classical paraneoplastic syndrome].
AB  - Paraneoplastic syndromes, or the remote non metastatic effects of cancer, are
      wellknown entities that may affect any organ or tissue in the body, including the
      central nervous system. Some have been shown to be associated with autoantibodies
      against the nervous system. One typical example ist the subacute sensory
      neuronopathy of Denny-Brown, classically associated with small cell lung cancer.
      These patients present with the subacute onset of a sensory neuronopathy which
      may appear as much as one year before the primary tumour is detected. An antibody
      called anti-Hu has been found in the serum in these patients, which recognizes a
      neuronal protein called Hu (M.W. 30 to 40 kD). This antibody can currently be
      detected by a combination of immunological methods such as Western blot analysis
      or immunohistochemistry.

PMID- 7770692
TI  - [Why history of medicine?].

PMID- 7770691
TI  - [Which fly has bitten? Apropos of skin lesions induced by Simulium].

PMID- 7770693
TI  - [Recollection of an assistant of Professor Cesar Roux].

PMID- 7770694
TI  - [National Gastroenterology Week. Postgraduate Course and Annual Congress of the
      Mexican Association of Gastroenterology. Guadalajara, Jalisco, December 11-16,
      1994. Abstracts].

PMID- 7770695
TI  - Proliferating cell nuclear antigen staining of Fischer-344/N rat spleens affected
      by large granular lymphocyte leukemia.
AB  - Large granular lymphocyte (LGL) leukemia commonly occurs in the Fischer-344/N
      rat. The high spontaneous incidence complicates the interpretation of results
      from chronic carcinogenicity studies that use this rat strain. As a result, a
      comprehensive characterization of LGL leukemia is necessary to help understand
      the leukemogenic process and the applicability of staging for assessing the
      progression of this disease. In the current study, the proliferation rate of LGL
      leukemia cells from untreated control Fischer-344 (F-344) rats in 3 stages of
      leukemia compared to nonleukemic age-matched rats was determined by
      immunohistochemical staining for proliferating cell nuclear antigen (PCNA). In
      histologic sections of spleen from aged F-344/N rats affected by LGL leukemia,
      there was a significant increase of both PCNA labeling and mitotic indices that
      was most advanced in the spleen of rats with more severe LGL leukemia. These
      results support biological significance for the morphologic staging system
      currently in use.

PMID- 7770696
TI  - Pathology and incidence of amelanotic melanomas of the skin in F-344/N rats.
AB  - A total of 121 spontaneous amelanotic melanomas of the skin were identified in 70
      of 11,171 male and 51 of 10,927 female Fischer-344/N rats in 63 2-yr
      carcinogenicity studies conducted by the National Cancer Institute's
      Carcinogenicity Testing Program/National Toxicology Program. Amelanotic melanomas
      had characteristic anatomical locations and histologic features distinguishable
      from Schwann cell tumors. Of the 121 tumors, 84, 19, 10, and 8 cases occurred in
      the pinna, eyelid, scrotum, and perianal region (anus and tail), respectively.
      Amelanotic melanomas originated from the dermis and consisted of spindle cells
      arranged in an interlacing fascicular pattern often with a perivascular
      orientation; epithelioid cells were rarely seen. Only the tumors arising in the
      pinna metastasized to the lung and/or mandibular lymph nodes. The metastatic rate
      was 19% (16/84) of the tumors and was clearly increased with an increase in tumor
      size. Most metastasizing tumors had focal areas consisting of anaplastic spindle
      cells with an increased number of mitosis. The tumor cells stained positive for S
      100 protein but negative for melanin. Ultrastructurally, the tumors were
      diagnosed as amelanotic melanomas based on the identification of numerous,
      intracytoplasmic premelanosomes without melanin formation in the tumor cells
      which were not enveloped by pericytoplasmic basal laminae. One localized
      amelanotic melanoma of the pinna was successfully transplanted to the
      subcutaneous tissue in the flank of 3 Fischer-344/N rats.

PMID- 7770697
TI  - Comparative 90-day feeding study with low-viscosity white mineral oil in Fischer
      344 and Sprague-Dawley-derived CRL:CD rats.
AB  - A 90-day study was conducted to compare the effects of dietary administration of
      a food-grade white oil in female Fischer-344 (F-344) and Sprague-Dawley-derived
      (CRL:CD) rats. Animals were fed a low viscosity (15 mm2/sec at 40 degrees C)
      paraffinic white oil (designated as P 15[H]) at 0, 0.2, or 2.0% of the diet for
      30, 61, or 92 days. There were no significant adverse clinical observations or
      unscheduled deaths. In the F-344 rats, occasional treatment-related changes were
      seen in hematology and clinical chemistry parameters. At necropsy, mesenteric
      lymph nodes were enlarged, and there was an increase in absolute and relative
      liver, mesenteric lymph node, and spleen weights as compared to controls.
      Histopathologic effects included hepatic and mesenteric lymph node
      microgranulomas and mesenteric lymph node histiocytosis. In CRL:CD rats, the only
      effects noted were accumulations of chronic inflammatory cells in the liver at
      the high dose only, without the formation of discrete microgranulomas. A dose
      related increase in mineral hydrocarbon (MCH) material in the liver and
      mesenteric lymph nodes was observed in both F-344 and CRL:CD rats. Although
      increased, liver MhC content was significantly less (approximately 50%) in CRL:CD
      rats than the levels detected in the F-344 rats. Mesenteric lymph node MHC levels
      did not differ significantly between the strains. This study demonstrated strain
      differences among rats in histopathologic effects of white oil, with the CRL:CD
      rat essentially showing no response compared to the F-344 rat.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7770699
TI  - Suppressive effect of beta-carotene on the development of pulmonary foam cells in
      rats with hyper beta-lipoproteinemia.
AB  - The effect of beta-carotene (BC) on the development of pulmonary foam cells
      (PFCs) was studied in rats with diet-induced hyper beta-lipoproteinemia. Rats
      were fed a standard diet; a hyper-beta-lipoproteinemia diet (HB) consisting of
      the standard diet, 4% cholesterol, and 1% cholic acid; or the standard diet plus
      0.1% BC; or the HB diet plus 0.1% BC diet (HBC). Rats in the HB and HBC groups
      developed hyper-beta-lipoproteinemia, but no significant differences were
      observed in serum levels of total cholesterol, phospholipid, and beta-
      lipoprotein (B-LP) between both groups. The percentages of foamy, lipid-ingested
      monocytes (FMs) to the number of blood monocytes (BMs), the number and size of
      lipid droplets in FMs, the percentages of PFCs to the number of alveolar
      macrophages from bronchopulmonary lavage fluid, and the score of PFC development
      in the lungs of rats in the HBC group were reduced compared to those of rats in
      the HB group. There were no differences in latex-phagocytotic activity of BMs
      among rats in the control, HB, BC, and HBC groups. BC suppressed the foamy
      transformation of BMs and development of PFCs deriving from the influx of FMs
      into the alveoli of hyper-beta-lipoproteinemic rats. Based on the present
      results, it is presumed that the antioxidative property of BC may prevent an
      oxidative modification of B-LP under the hyper-beta-lipoproteinemic condition,
      leading to a decrease in the uptake of oxidatively modified B-LP by BMs.

PMID- 7770700
TI  - A simple method for performing routine histopathological examination of the
      cardiac conduction tissue in the dog.
AB  - In standard toxicity studies, the cardiac conduction tissue is not systematically
      sampled and examined for histopathological changes. Most methods described use
      serial sectioning perpendicular to the long axis of the sinoauricular node (SAN)
      and atrioventricular node (AVN). Dozens of slides are needed to allow examination
      of a significant portion of the SAN and AVN. A simple method was developed to be
      used in routine histopathologic examination of the dog heart. With a plane
      parallel to the external wall and the upper edge of the right auricle, the SAN
      and its arterial supply were easily sectioned and examined. The frontal plane
      parallel to the interventricular crest was the most appropriate plane for
      observing a large portion of the AVN and the bundle of His. Based on these
      results, the heart of 240 dogs from toxicology studies were successfully sampled
      and processed utilizing this technique. An average of 5 slides per node was
      needed to perform a satisfactory examination of each of the SANs and AVNs.

PMID- 7770698
TI  - Changes associated with long-term oral administration of the penem antibiotic FCE
      22891 to rats and monkeys with particular emphasis on the urinary tract and the
      urine.
AB  - FCE 22891, a synthetic beta-lactam antibiotic of the penem class, was
      administered by gavage to Sprague-Dawley rats and cynomolgus monkeys for 26 wk
      (with and without a 6-wk recovery). Rats received the test material at doses of
      0, 200, 500, and 1,250 mg/kg/day, and monkeys were given doses of 0, 100, 200,
      400, and 600 mg/kg/day. At the end of the 26-wk treatment period, approximately
      two-thirds of the animals (both species) were sacrificed, and the remaining
      animals were held without treatment for a further 6 wk. A treatment-related
      mortality occurred in female monkeys receiving 600 mg/kg. There was a reduction
      in body weight gain in the high-dose groups of both species. Male rats were more
      affected than the females and, conversely, female monkeys were affected more than
      the males. At higher dose levels, both species exhibited an early, but transient,
      azotemia and oliguria with an increase in specific gravity and reduced pH. In
      rats, microscopic examination revealed treatment-related renal cortical tubular
      degenerative and regenerative changes with associated interstitial inflammation
      and fibrosis and diffuse urothelial hyperplasia in the urinary bladder. In
      general, female rats were less severely affected, and in both sexes there was a
      trend to recovery of most of these effects. In monkeys given 600 mg/kg of the
      test material, renal cortical tubular degeneration was seen only in those females
      that died in the first 5 wk of dosing. In other animals at this dose level, the
      renal lesions were determined to be reversible.

PMID- 7770701
TI  - Establishment of an animal model for pulmonary fibrosis in mice using
      monocrotaline.
AB  - A preliminary attempt at experimental induction of pulmonary fibrosis in which
      male ICR mice received 15 weekly sc injections of 200 or 100 mg/kg monocrotaline
      (MC) revealed that most animals treated with the larger dose died of severe
      interstitial pneumonia, whereas those given 100 mg/kg exhibited only relatively
      slight lung injury. Based on these results, male mice were administered sc
      injections of 200 and 100 mg/kg MC once a week for 9 and 18 times, respectively,
      and then maintained without any further treatment until week 28 after the start.
      Mice treated with 200 mg/kg MC showed severe pulmonary damage and died by week
      25. Mortalities also occurred in the 100-mg group from week 16, with 11 of 40
      animals surviving at the termination of the experiment. Histologically, both dose
      groups demonstrated severe interstitial pneumonia and/or pulmonary fibrosis.
      Ultrastructurally, inflammatory edema possibly attributable to injuries of
      alveolar capillary endothelial cells was observed in the high-dose group at week
      8, and there was a remarkable increase in collagen fibers in alveolar septa in
      this group thereafter. The present study results suggest that lung injuries
      induced by MC treatment progress to irreversible lung fibrosis and that this
      animal model may have advantage for studying the pathogenesis of lung cancers in
      patients with pulmonary fibrosis.

PMID- 7770704
TI  - Interstitial cell adenoma of the rat testis: why is it such a problem in
      toxicology studies using Sprague-Dawley rats?
AB  - Arbitrary criteria can give unreliable diagnoses. Conditions that occupy the same
      marginal diagnostic space, such as interstitial cell hyperplasia and interstitial
      cell adenoma, sometimes will be mistaken for one another. When the true
      prevalence is low, the risk of false positives, as a percentage of all positives,
      is high. The preceding analysis predicts that, with currently recommended
      diagnostic criteria, any compound that causes nonneoplastic interstitial cell
      hyperplasia will be interpreted to cause interstitial cell neoplasia if SD rats
      are used and only microscopic diagnoses are considered. Conversely, the analysis
      predicts that no compound that actually causes neoplasia in interstitial cells
      will be identified as an interstitial cell tumorigen if F-344 rats are used and
      only microscopic diagnoses are considered. These predictions are consistent with
      experience.

PMID- 7770703
TI  - Electron microscopic study on the effect of alternate-day hydrocortisone therapy
      on lymphocyte populations in rat spleen and lymph nodes.
AB  - The ultrastructural effects of 400 mg/M2/day of hydrocortisone sc, given
      alternatively from day 7 through day 19, were studied on the lymphocyte
      populations in the white pulp of the spleen and in the cortex of the mesenteric
      lymph nodes of the immunologically immature rat. Results were consistent with
      both a direct lytic effect of hydrocortisone on small lymphocytes of the nodular
      cortex of the mesenteric lymph nodes and an indirect effect on small lymphocytes
      of the periarterial lymphatic sheath (PALS) of the spleen supplied via the
      thymus. In contrast, medium-sized lymphocytes in the PALS appeared to be
      unaffected by hydrocortisone, while medium-sized lymphocytes of the nodular
      cortex of the mesenteric lymph nodes exhibited a temporary depletion of
      cytoplasmic organelles. Hydrocortisone appeared to depress protein synthesis in
      these latter cells. The decrease in numbers of lymphoblasts and plasmablasts
      observed in the nodular cortex of the mesenteric lymph nodes and the white pulp
      of the spleen is consistent with hydrocortisone interference with proliferation
      and differentiation of activated B cells.

PMID- 7770702
TI  - Histopathological and ultrastructural changes in the juxtaglomerular apparatus of
      the rat following administration of ZENECA ZD6888 (2-ethyl-5,6,7,8-tetrahydro-4
      [(2'-(1H-tetrazol-5-yl)biphenyl-4-yl)- methoxy]quinoline), an angiotensin II
      antagonist.
AB  - Male and female Alderley Park rats were treated for 26 wk with ZENECA ZD6888, an
      angiotensin II (AII) antagonist, at doses of 25, 50, and 250 mg/kg/day and the
      kidneys examined by light and electron microscopy. Nephropathy (tubular
      degeneration and regeneration), thickening of the basal lamina, mononuclear cell
      infiltration, and hypertrophy and hyperplasia of the juxtaglomerular apparatus
      were seen by light microscopy. Ultrastructurally, juxtaglomerular cell granules
      were increased in number and displayed substantial structural heterogeneity. In
      some cells, granules contained paracrystalline inclusions while others consisted
      predominantly of myelinic debris. Evidence of conversion of arteriolar smooth
      muscle cells into juxtaglomerular cells and their degeneration was also obtained
      by electron microscopy. The juxtaglomerular changes were treatment- and dose
      related and were attributed to an exaggerated pharmacological action of the
      compound, that is, ZD6888-mediated blockade of AII receptors leading to
      competitive inhibition of the AII-mediated release of renin. The resemblance
      between the findings seen in the present study following administration of an AII
      antagonist and those due to angiotensin-converting enzyme inhibitors reported by
      others was striking.

PMID- 7770705
TI  - Hepatocyte transplantation: a potential treatment for acute liver failure.

PMID- 7770706
TI  - Effects of Nissen fundoplication on gastro-oesophageal reflux and oesophageal
      motor function.
AB  - BACKGROUND: Nissen fundoplication reduces gastro-oesophageal reflux effectively,
      but the mechanisms through which this effect is brought about have remained
      rather obscure. METHODS: In this study the effect of fundoplication on
      oesophageal acid exposure, oesophageal body motility, and lower oesophageal
      sphincter pressure (LOSP) was assessed prospectively. Eleven patients were
      studied before and 3 months after a floppy Nissen fundoplication. A Dent sleeve
      was used to measure LOSP, and ambulatory pH and pressure monitoring were used to
      evaluate oesophageal motor function. RESULTS: Gastro-oesophageal reflux was
      significantly decreased after fundoplication without an increase in LOSP. The
      motor function of the oesophageal body was not affected by the antireflux
      procedure. CONCLUSIONS: Nissen fundoplication is an effective antireflux
      operation, even though the procedure does not increase LOSP, and the motility
      pattern of the oesophageal body is not affected by the construction of a floppy
      fundic wrap.

PMID- 7770707
TI  - Parietal cell kinetics after administration of omeprazole and ranitidine in the
      rat.
AB  - BACKGROUND: This study aimed at determining the turnover rate of parietal cells
      after inhibition of acid secretion. METHODS: Rats were given omeprazole (80
      mumol/kg) by gavage once daily or ranitidine (1200 mumol/kg) by osmotic minipump
      for 5 days. Control rats received saline only. All rats were also given 3H
      thymidine by osmotic minipumps. The animals were killed, 5, 14, 28, or 56 days
      after the start of the 3H-thymidine infusion. After formaldehyde fixation by
      perfusion through the aorta, light microscopic autoradiography was carried out on
      plastic sections of the oxyntic mucosa to determine the labeling index of the
      parietal cells. RESULTS: The average turnover rate in the control rats was
      calculated to be 0.61% per day, corresponding to a mean turnover time of 164
      days. In the rats given inhibitors of acid secretion, the turnover rates did not
      differ significantly from those of the control group. CONCLUSION: Inhibition of
      gastric acid secretion did not significantly change the turnover rate of the
      parietal cells.

PMID- 7770708
TI  - Lansoprazole versus omeprazole in active duodenal ulcer. A double-blind,
      randomized, comparative study.
AB  - BACKGROUND: Lansoprazole is a new substituted benzimidazole that inhibits the
      H+,K(+)-adenosine triphosphatase in the parietal cell and, like the first
      developed proton pump inhibitor omeprazole, gives a strong inhibition of gastric
      acid output. METHODS: In this double-blind randomized comparative study patients
      with active duodenal ulcers were treated with either 30 mg lansoprazole or 20 mg
      omeprazole in the morning. All demographic data in the two treatment groups were
      comparable. RESULTS: A total of 279 patients entered the study. There was no
      difference in healing rates between the groups either after 2 weeks (86.2% for
      lansoprazole and 82.1% for omeprazole) or after 4 weeks (97.1% and 96.2%). No
      patient ceased treatment owing to side effects. CONCLUSIONS: Both lansoprazole
      and omeprazole generate very high healing rates and good symptom relief in active
      duodenal ulcer. Side effects are few and mild.

PMID- 7770709
TI  - Omeprazole and dry mouth.
AB  - BACKGROUND: Omeprazole causes irreversible inhibition of the hydrogen/potassium
      adenosine triphosphatase enzyme, leading to a marked reduction in both acid
      secretion and volume of gastric juice. Reported side-effects include nausea,
      vomiting, diarrhoea, constipation, and headache. We report the development of dry
      mouth during omeprazole therapy. METHODS: We have identified six patients taking
      omeprazole for more than 6 weeks who complained of a dry mouth. Salivary
      production was measured as whole salivary flow produced over a 10-min period spat
      into a collecting vessel and as 5% citric acid-stimulated parotid salivary flow
      collected with a Lashley cup device placed over the parotid duct. Flow rates were
      evaluated both during and after cessation of treatment. Saliva produced was then
      cultured for microbes. RESULTS: Four of the six had subnormal parotid or whole
      salivary flow rates on treatment that recovered after stopping treatment. The
      increase after treatment was marked in four. Significant amounts of Candida
      albicans grew from the saliva of the three patients with the lowest salivary
      flows; one saliva also grew Staphylococcus aureus. CONCLUSION: Salivary flow is
      reduced in some patients treated with omeprazole, returning to normal after
      cessation of treatment. This reduction may predispose to opportunistic infection,
      particularly in the edentulous.

PMID- 7770710
TI  - Effects of insulin and beta-adrenergic blockade on the migrating motor complex in
      humans.
AB  - BACKGROUND: Interdigestive small-intestinal motility is suppressed by
      hyperglycemia and also by hyperinsulinemia per se. Since hyperinsulinemia may
      increase sympathetic activity, the present study was undertaken to ascertain to
      what extent insulin affects phase III of the migrating motor complex (MMC) and
      MMC-related duodenal retroperistalsis and whether beta-adrenergic receptors may
      mediate the effects of insulin. METHODS: Fasting motility was studied in eight
      healthy volunteers on three occasions with an eight-lumen perfused pressure
      catheter, with closely spaced recording points in the proximal duodenum. On the
      control day 5-h antroduodenojejunal manometry was performed. On another study day
      euglycemic hyperinsulinemic clamping was performed for 2 h after an initial basal
      recording. On a 3rd day motility was recorded during propranolol infusion,
      combined with a period of euglycemic hyperinsulinemia. RESULTS: During
      hyperinsulinemia complete absence of phase III of the MMC in the gastric antrum
      was observed, whereas 55% of the MMC had a gastric phase-III component on the
      control day. The duration of phase III in the proximal duodenum was decreased
      during hyperinsulinemia compared with the control period (p < 0.05). This
      inhibitory effect of insulin on the activity front was not prevented by beta
      blockade. Under control conditions the proportion of retroperistaltic pressure
      waves in the proximal duodenum was 13 +/- 8% in early phase III, increasing in
      late phase III to 79 +/- 15% (p < 0.01). Duodenal phase III during
      hyperinsulinemia showed a similar increase in retroperistalsis, from 4 +/- 4% in
      early phase III to 67 +/- 21% in late phase III (p < 0.01). The corresponding
      proportions during beta blockade were 16 +/- 10% and 86 +/- 14%, respectively.
      CONCLUSIONS: Hyperinsulinemia per se abolishes antral phase III and makes the
      duodenal phase III shorter but does not interrupt the distinct pattern of
      retroperistalsis in late phase III. Beta-adrenergic receptors seem not to be
      important for these effects of insulin or for the retroperistalsis in duodenal
      phase III.

PMID- 7770711
TI  - Lactose malabsorption in Khants in western Siberia.
AB  - BACKGROUND: We wanted to estimate the prevalence of selective lactose
      malabsorption (SLM) in Khants, a small Finno-Ugric population living in Western
      Siberia who have traditionally consumed no milk in adulthood. METHODS: A total of
      80 Khants, aged 8-57 years and living on the middle reaches of the River Ob, were
      studied. The diagnosis was based on a lactose tolerance test; general
      malabsorption was excluded by a glucose-galactose tolerance test whenever
      possible. In six subjects electronmicroscopic examination of the duodenal mucosa
      was performed. RESULTS: The prevalence of SLM in the Khants was 94%. CONCLUSION:
      This is the highest prevalence found in the previous Soviet Union.

PMID- 7770712
TI  - Intestinal disaccharidase activity in human immunodeficiency virus disease.
AB  - BACKGROUND: The relationship between disaccharidase activity, progression of
      human immunodeficiency virus (HIV) disease, and diarrhoea and weight loss was
      investigated. METHODS: Forty-six HIV-positive patients ingested a solution of
      lactose, palatinose, sucrose, and lactulose after 24 h of dietary exclusion and
      overnight fasting, after which urine was collected for 10 h. Urinary disaccharide
      (activity) ratios-lactose/lactulose (L/LL), palatinose/lactulose (P/LL), and
      sucrose/lactulose (S/LL)-were measured by thin-layer chromatography. RESULTS:
      There was a significant decrease in disaccharidase activity (L/LL, P/LL, and
      S/LL) with advancing clinical stage of HIV disease (p < 0.05, Wilcoxon rank sum
      test) as well as decreasing CD4 count (p < 0.05, Spearman correlation). Patients
      with weight loss/diarrhoea also had significantly (p < 0.05) decreased
      disaccharidase activity compared with control but not as compared with AIDS
      patients. Anti-retroviral therapy did not influence disaccharidase activity.
      CONCLUSION: Impairment of disaccharidase activity occurs with advancing HIV
      disease, but its role in HIV patients with weight loss and diarrhoea remains to
      be determined.

PMID- 7770713
TI  - The presence of bicarbonate in oral rehydration solution does not influence fluid
      absorption in cholera.
AB  - BACKGROUND: On the basis of human perfusion studies it has been speculated that
      bicarbonate ions in oral rehydration salt solutions (ORS) to treat diarrhoea are
      more efficiently absorbed from the small bowel. We evaluated the role of
      bicarbonate in ORS by using a reduced purging rate in cholera as a proxy
      indicator for absorption efficiency in cholera-like severe diarrhoea. METHODS: In
      a double-blind randomized trial 60 patients received standard ORS containing
      bicarbonate or an identical solution except that sodium bicarbonate was replaced
      by an equimolar amount of sodium chloride (sodium, 90 mmol/l; potassium, 20
      mmol/l; chloride, 80 mmol/l; bicarbonate, 30 mmol/l; glucose, 111 mmol/l; and
      osmolality, 331 mmol/l) after initial intravenous rehydration to correct initial
      dehydration and shock and until diarrhoea ceased. RESULTS: Five patients
      receiving standard ORS and eight receiving bicarbonate-free ORS required
      unscheduled intravenous therapy for recurrence of severe dehydration in spite of
      receiving ORS solution. ORS intake and purging rate, in ml/kg body weight/day,
      both including and excluding stool output during unscheduled intravenous therapy
      are closely similar in the two treatment groups. CONCLUSION: The results indicate
      that bicarbonate-containing ORS solution does not have any clinically significant
      effect on the absorption efficiency of ORS, either beneficial or adverse, and its
      use is relevant only for correction of metabolic acidosis of diarrhoeal
      dehydration.

PMID- 7770714
TI  - Trophic effects of biosynthetic growth hormone on normal and defunctioned left
      colon in rats.
AB  - BACKGROUND: In rats with diverting colostomies the effects of growth hormone can
      be differentiated from the actions of fecal passage. METHODS: After sham
      operation or diverting colostomy rats were treated with biosynthetic growth
      hormone (b-hGH) for 4 weeks. RESULTS: In defunctioned colon of b-hGH-treated rats
      there were increases in mucosal surface area and the weight of mucosa and
      muscularis propria compared with the atrophic colon of saline-treated rats. The
      breaking strength of defunctioned colon rings was greater and the defatted dry
      weight and hydroxyproline content of these specimens were also increased. In
      intact colon b-hGH stimulated luminal surface area, the weight of mucosal and
      submucosal layers, and the hydroxyproline content compared with controls. The
      breaking strength was highest in specimens from saline-treated rats. CONCLUSIONS:
      B-hGH has a growth-promoting role throughout the whole thickness of the colonic
      wall in rats also in the absence of fecal passage.

PMID- 7770715
TI  - Fasting breath hydrogen concentrations in gastric and small-intestinal bacterial
      overgrowth.
AB  - BACKGROUND: Although elevated fasting breath hydrogen concentrations have been
      reported in small-intestinal bacterial overgrowth, this diagnosis has been
      presumptive or based on definitions that vary from study to study. The influence
      of gastric bacterial overgrowth and gastroduodenal pH has not been documented.
      Conflicting evidence exists as to the reproducibility of breath hydrogen
      measurements. METHODS: Forty-two subjects underwent culture of gastric and
      duodenal aspirates. The pH was measured by indicator paper. Paired fasting breath
      hydrogen concentrations were measured by gas chromatography within 7 days of
      endoscopy. RESULTS: Paired fasting breath hydrogen concentrations differed in
      terms of normality or abnormality in 21% of subjects. Paired concentrations
      correlated significantly in overgrowth but not in culture-negative subjects.
      Sensitivity for bacterial overgrowth was 4-29%, and specificity 71-100%. No
      correlation with gastroduodenal pH was found. CONCLUSIONS: The clinical relevance
      of a single fasting breath hydrogen concentration is limited. The efficacy of
      paired measurements for gastric or small-intestinal bacterial overgrowth is poor.

PMID- 7770716
TI  - DNA aneuploidy in gastric carcinoma. Flow cytometric data related to survival,
      location, and histopathologic findings.
AB  - BACKGROUND: The aim of the study was to evaluate the prognostic significance of
      DNA ploidy of gastric carcinomas. METHODS: The DNA content was analyzed by flow
      cytometry on archival paraffin-embedded material from tumors of 97 consecutive
      patients. RESULTS: A multivariate analysis showed that the DNA ploidy pattern and
      lymph node metastasis were the only independent prognostic markers for survival
      (p = 0.01 and p = 0.02, respectively). The relative risk of death due to gastric
      cancer was three times greater for patients with DNA hypertetraploid tumors than
      for patients with DNA diploid tumors and twice as high for patients with lymph
      node metastasis as for patients without. Well and moderately differentiated
      carcinomas were more frequently aneuploid than tumors with poor differentiation
      (p = 0.047). There was no correlation between tumor ploidy pattern and location.
      In univariate analysis tumor growth through the serosal wall was predictive of
      poor survival (p = 0.003). CONCLUSIONS: DNA ploidy is an independent prognostic
      indicator for cancer-specific survival in gastric cancer.

PMID- 7770717
TI  - Comparison of immunomodulative effects of the histamine-2 receptor antagonists
      cimetidine, ranitidine, and famotidine on peripheral blood mononuclear cells in
      gastric cancer patients.
AB  - BACKGROUND: Histamine-2 receptor antagonist (H2-RA) have been shown to improve
      the function of various parts of the immune system. The proposed mechanism of the
      immunomodulative effects of H2-RA has been considered to be the inhibition of
      suppressor T-lymphocyte activity, an increase in interleukin-2 production, and an
      enhancement of natural killer cell activity. Most of these studies were done with
      cimetidine. Comparative data with other H2-RA are limited and conflict on
      immunomodulative effects. Comparison of the actions of H2-RA on the immune system
      is required. METHODS: We compared the immunodulative effect of the H2-RAs
      cimetidine, ranitidine, and famotidine on peripheral blood mononuclear cells
      (PBMC) in normal controls and patients with gastric cancer. DNA synthesis,
      cytotoxicity against K562 cells, and the levels of soluble interleukin-2 receptor
      (sIL-2R) in supernatant were measured after addition of the various H2-RA to PBMC
      cultures. RESULTS: Subjects with gastric cancer showed significantly higher
      levels of suppressor lymphocyte activity than normal controls. These levels were
      restored to levels of normal controls by the addition of cimetidine.
      Statistically significant lymphoblastogenesis and cytotoxicity against K562 cells
      were observed only in cimetidine-treated PBMC (p < 0.05); such effects were not
      observed in ranitidine- or famotidine-treated PBMC. Significantly increased
      levels of sIL-2R were found in supernatants obtained from culture flasks treated
      with cimetidine and phytohemagglutinin or ranitidine and phytohemagglutinin (p <
      0.01). CONCLUSIONS: Of the three H2-RAs tested, cimetidine had the strongest and
      famotidine the weakest immunomodulating effect. Only cimetidine augmented the
      cytotoxicity and proliferative response of lymphocyte to mitogen; neither
      ranitidine nor famotidine had such an effect. These results might be due to their
      structural differences. In addition, the immunologic effects of H2-RA are
      unlikely to be mediated via specific interaction at the H2 receptor.

PMID- 7770718
TI  - Septic acute cholecystitis.
AB  - BACKGROUND: Bacteremia occurs frequently in cholangitis, but the incidence of
      bacteremia in acute cholecystitis has not previously been examined. METHODS:
      Seventy-eight cases (46 men and 32 women; mean age, 63 +/- 10 years) of acute
      cholecystitis with positive blood cultures were analyzed for clinical
      manifestation, bacteriology, and what consequences ensued. Seventy-eight non
      bacteremic cholecystitis patients, matched for age and sex, served as the control
      group. RESULTS: The prevalence of bacteremia in acute cholecystitis was 7.65% (78
      of 1020). A single microorganism was isolated from the blood and bile in 87.2%
      and 27.3%, respectively. The commonest organisms were Escherichia coli and
      Klebsiella pneumoniae. The source of bacteremia could be identified from the
      infected bile in 80% of cases. Compared with the non-bacteremia group,
      significant increases in liver biochemical test results (aspartate and alanine
      aminotransferases and bilirubin, and so forth), more complications (acute renal
      failure and septic shock), and higher mortality (9.0%) were found in the
      bacteremic group. CONCLUSION: Acute cholecystitis is not often complicated by
      bacteremia, but when bacteremia is present, morbidity and death more consistently
      ensue.

PMID- 7770719
TI  - Small colorectal polyps.

PMID- 7770720
TI  - The two-signal model and 'self'-reactivity: are they really incompatible?

PMID- 7770721
TI  - Natural killer suppressor factors in sera from HIV-infected subjects.
AB  - We investigated the presence of NK suppressor factors in HIV+ sera. We further
      investigated if gp120 could be one of the substances responsible for the
      impairment of NKC regulation found in HIV+ asymptomatic patients. Our results
      indicate that HIV+ sera inhibit significantly normal NKC in a dose-dependent way,
      even at concentrations as low as 1%. The inhibitory effect of HIV+ sera
      decreased, but was not completely removed, by adsorptions of IgG or by treatment
      with a MoAb against human FcIgG. Pretreatment of normal effector cells with anti
      CD16 MoAb slightly reduced their cytotoxic capability, but did not modify the
      suppressor effect of HIV+ sera. The The preincubation of normal PBMC with
      recombinant gp120 had also a suppressor effect even at 10 ng/ml. Pretreatment of
      HIV+ sera with anti-gp120 or anti-FcIgG MoAb reduced, but not completely, their
      inhibitory effect. In conclusion, HIV+ serum has a dose-dependent inhibitory
      effect on normal NKC. Most of this inhibition is caused by IgG, but other
      substances, such as gp120, can also contribute to it. Since the removal of IgG
      and further treatments of HIV+ sera were not able to abrogate completely the NK
      suppression, other serum factors still undetermined (TNF-alpha, other cytokines),
      should be considered.

PMID- 7770722
TI  - A correlation between the expression of the bcr-abl chimeric gene and severity of
      the clinical state of CML patients with time.
AB  - Using the reverse polymerase chain reaction, four Ph' positive CML patients were
      followed for 2 years; a correlation between the severity of the clinical state
      and the b3a2 expression was noted with time. Additionally, amplification of the c
      myc proto-oncogene was observed, using Southern blot analysis, in one patient
      prior to his entry to the blast phase. No reorganization of the bcr-abl
      rearrangement site was found in the latter patient. The data suggest that a
      routine follow-up of CML patients using the Southern blot analysis and the
      reverse transcription-polymerase chain reaction might be of importance in
      evaluating the progression of the disease.

PMID- 7770723
TI  - Opposing effects of interleukin-10 on mouse macrophage functions.
AB  - Interleukin (IL)-10 generally is considered a macrophage deactivating factor and
      thus inhibits the cell-mediated responses against intracellular parasites. We
      evaluated the in vitro effects of IL-10 on three different parameters of
      macrophage function. We found that IL-10 inhibited gamma interferon (IFN-gamma)
      priming for enhanced O2- release of mouse bone marrow-derived macrophages but had
      opposing effects on NO2- secretion according to the sequence of the treatment
      with IL-10 and the agonists of NO2- secretion. Likewise, IL-10 was able to induce
      a small but consistent degree of bacteriostasis of Mycobacterium avium and, also,
      to inhibit the bacteriostasis induced by IFN-gamma. Thus, we show that, according
      to the timing of exposure of macrophages to stimulating and inhibiting cytokines
      and agonists of their functions, IL-10 shows different effects on macrophage
      function.

PMID- 7770724
TI  - Chemospecificity and cross-reactivity of target cell recognition by human CD56+
      NK and LAK cells.
AB  - Inhibition of specific cytotoxicity of highly purified (> 95%) human CD56+ NK and
      LAK cells against K562 tumour cells was studied with various sugar acetates.
      Maximum inhibitory specificity was obtained with 60%-deacetylated penta-acetates
      of mannose, galactose, glucose, or 80%-deacetylated penta-O-acetate of N-acetyl
      neuraminic acid. The inhibition was strictly dosedependent and 100% inhibition
      was achieved in the concentration range of 500-1000 nmoles/ml with all four sugar
      acetate samples. Enhancement of specific cytotoxicity in the presence of
      rhamnogalacturonan (RG; 500 ng/ml), acting as a bridging molecule, was also
      inhibited in a dose-dependent manner with the same inhibitory specificity and
      within the same concentration range indicating involvement of the same number of
      sugar acetate-specific receptors. Moreover, formation of lytic CD56+ effector
      cell/tumour cell (E/T) conjugates was equally well inhibited whereas formation of
      total E/T conjugates was only partially inhibited (NK: 44-73%; LAK: 46-50%). E/T
      conjugate formation in the presence of RG was enhanced. Inhibition of the
      enhancement of formation of lytic E/T conjugates in the presence of RG was again
      completely accomplished with the same inhibitory specificity and within the same
      concentration ranges as recorded for E/T conjugate formation in the absence of
      RG. However, inhibition of total E/T conjugate formation was again only partially
      achieved at the given concentrations. The data support the assumption of an NK
      cell receptor with specificity for acetylated carbohydrate moieties on target
      cells or on bridging molecules such as RG.

PMID- 7770725
TI  - Expression of the human mucosal lymphocyte antigen, HML-1, by T cells activated
      with mitogen or specific antigen in vitro.
AB  - Expression of the human mucosal lymphocyte antigen, HML-1 (CD103), recently
      identified as a novel alpha E beta 7 integrin, was studied on peripheral blood
      lymphocytes activated with mitogen or specific antigen. HML-1 was up-regulated on
      PHA activated T-lymphoblasts cultured in 100IU/ml interleukin-2 (IL-2), reaching
      a peak of > 50% positive cells at day 7, and expression was maintained at this
      level throughout the 28-day culture period. Following a transient decrease in the
      percentage of L-selectin cells, expression of this molecule was maintained on
      most PHA T-lymphoblasts. Cells activated by purified protein derivative of M.
      tuberculosis (PPD) or in mixed lymphocyte culture also up-regulated and
      maintained HML-1 expression for 14 days. In contrast, in all cases the percentage
      of CD25+ cells rose initially but subsequently declined over the same time
      periods. When freshly isolated cells from tonsil, spleen, mesenteric lymph node
      and lung were analysed, only lung contained significant numbers (39 +/- 6%) of
      HML-1+ cells. In both freshly isolated and activated cell populations the great
      majority of HML-1+ cells co-expressed CD8 although some HML-1+ CD8- cells were
      also present. Production of TGF-beta 1 peaked early during T-lymphoblast and MLR
      cultures and was not related to induction of HML-1 expression.
      Immunoprecipitation studies showed that the HML-1 molecule expressed on 10-day
      PHA T-lymphoblasts was indistinguishable from that found on intestinal
      intraepithelial lymphocytes and that no alpha 4 beta 7 integrin was expressed by
      these cells. Although HML-1 expression is essentially restricted to mucosal
      leucocytes in vivo, these experiments show that it is readily induced and
      maintained along with co-expression of L-selectin following CD8+ T-lymphocyte
      activation in vitro.

PMID- 7770726
TI  - Cytotoxic potency of CD22-ricin A depends on intracellular routing rather than on
      the number of internalized molecules.
AB  - Cytotoxicity of immunotoxins (ITs) varies considerably depending on factors like
      the capability of the target antigen to internalize IT molecules, intracellular
      processing and routing of the IT. We studied factors that may influence
      cytotoxicity of CD22-ricin A IT to several B cell lines. The antigen density
      varied from 5.9 x 10(3) to 6.0 x 10(4) molecules/cell. The ID50, determined by
      protein synthesis inhibition, varied from 2.1 x 10(-12) to 3.8 x 10(-11) M IT in
      absence and from 2.8 x 10(-14) M to 5.2 x 10(-12) M IT in presence of the
      cytotoxicity enhancer NH4Cl (6 mM). In absence as well as in presence of NH4Cl no
      correlation could be found between antigen density and ID50. No relation was
      observed either with the rate of cytotoxicity. Even in cell lines with a low
      antigen density, such as KM3, protein synthesis was quickly inhibited. In order
      to investigate whether the cytotoxicity was dependent on the number of
      internalized molecules the kinetics of internalization and exocytosis of degraded
      125I-labelled CD22 molecules were studied. After 24 h the number of internalized
      CD22 molecules was highest in Ramos (154,500), followed by Daudi (110,300) and
      KM3 (69,900). However, despite the higher internalization rate of Daudi the rate
      of cytotoxicity of 10(-8) M IT was comparable with KM3. NH4Cl did not influence
      the number of internalized molecules but postponed degradation of CD22. In
      conclusion, CD22-ricin A is a very potent and fast acting IT even for elimination
      of target cells that express low numbers of antigen. These results may have
      implication for treatment of different B cell malignancies with CD22-ricin A.

PMID- 7770727
TI  - In vitro degradation of serum amyloid A by cathepsin D and other acid proteases:
      possible protection against amyloid fibril formation.
AB  - The effects of acid proteases on degradation of serum amyloid A protein (SAA)
      were investigated in vitro. Human recombinant SAA1 (rSAA1), when incubated with
      human spleen extracts at pH 3.2, was degraded in the amino-terminal portion of
      the molecule. This reaction was inhibited by an acid protease inhibitor,
      pepstatin. The degraded SAA molecules lacking nine or more amino-terminal
      residues, when exposed to in vitro fibril-forming conditions, failed to form
      Congo red positive precipitates and did not show amyloid fibril-like structure by
      electron microscopy. This suggests that the amino-terminal portion of SAA is
      essential for fibril formation. Cathepsin D, one of the lysosomal enzymes, also
      initiated degradation of rSAA1 at the amino-terminus. Cathepsin D
      immunoreactivity was detected in marginal areas of amyloid deposits in spleens
      from patients with reactive amyloidosis. These findings suggest that cathepsin D
      or similar acid proteases may be involved in SAA catabolism and may protect
      against amyloid formation.

PMID- 7770728
TI  - Human IgG rheumatoid factors and RF-like immune complexes induce IgG1 rheumatoid
      factor production in mice.
AB  - The synovial fluid of patients with rheumatoid arthritis (RA) was found to
      contain IgG and/or IgG-containing immune complexes (ICs) that stimulated an
      intense antibody formation when injected into mice of certain strains, notably of
      NZ background. The response was characterized by high and sustained levels of
      IgG1 antibodies with rheumatoid factor (RF) activity. In the study described, we
      investigated whether it is the antibodies with RF activity in the synovial fluid,
      that are responsible for stimulation of mouse RF in vivo. Different mouse strains
      were injected with synovial fluid from a seropositive RA patient (RA-SF), with
      human monoclonal antibodies with RF activity, with a human non-RF monoclonal
      antibody or with different preformed RF-like antibody-antibody (Ab-Ab) ICs. The
      experimental mice were monitored subsequently for IgG1 RF production. IgG1 RF
      antibodies were found in all strains (NZB, BALB/c and CBA) injected with Ab-Ab
      ICs formed at equivalence, but only in NZB using RA-SF or human monoclonal
      antibodies with RF activity. Optimal production of IgG1 RF by Ab-Ab ICs required
      the integrity of Fc and F(ab)'2 portions respectively of the antibodies; soluble
      and truncated ICs were less effective. Further studies demonstrated that the IgG1
      RF response was not simply the result of a specific immune response against human
      IgG, since humoral immunity against human IgG was induced only when combined with
      an efficient adjuvant. During a typical adjuvant-associated primary response
      specific antibodies of IgM, IgG1 and IgG2a isotypes were found, i.e. quite
      different from the selective IgG1 response induced by RF-like containing immune
      complexes. This conclusion is substantiated further by the clear differences in
      responses to IgG containing fraction obtained from RA-SF in NZ mice compared to
      other strains. Our findings argue for a different type of reaction leading to the
      selective IgG1 response and might aid in elucidating the mechanisms for chronic
      production of antibodies with RF activity in patients with RA.

PMID- 7770729
TI  - Molecular analyses of anti-DNA antibodies induced by polyomavirus BK in BALB/c
      mice.
AB  - In the present experiments, two groups of BALB/c mice (five individuals in each
      group) were hyperimmunized through four consecutive immunizations with either BK
      virus (Group 1) or BK dsDNA complexed with methylated BSA (Group 2). All immune
      sera taken after the fourth immunization from both groups reacted strongly with
      polyomavirus BK dsDNA as well as with calf thymus dsDNA, and all sera contained
      antibodies that bound in the Crithidia luciliae assay. This indicates that
      polyomavirus BK was able to induce antibodies with binding characteristics
      similar to SLE anti-DNA antibodies. To further characterize these induced anti
      DNA responses, 10 monoclonal anti-DNA antibodies (four from Group 1, and six from
      Group 2) were generated and selected for reactivity with S1-nuclease digested CT
      dsDNA. Their specificity for BK and CT dsDNA molecules, as well as their light
      and heavy chain variable region cDNA nucleotide sequences were analysed to
      compare them with known SLE derived anti-DNA antibodies. All of the 10 antibodies
      bound strongly to BK dsDNA, while seven also bound to CT dsDNA in competitive
      ELISA experiments. V-region analysis revealed that the induced antibodies
      resembled anti-DNA antibodies characteristic for murine SLE, and all but one
      contained arginine in the VH CDR3 region. The arginines present in the monoclonal
      antibodies originated either from an RF shift from RF1-->RF3 of the D-genes or
      from N-sequence additions. Taken together, the data demonstrate that anti-DNA
      antibodies in response to hyperimmunization with polyomavirus BK have the same
      characteristics as of those occurring spontaneously in SLE. As virus
      infection/replication in vivo implies expression of immunogenic (non-self) DNA
      binding proteins that may render DNA immunogenic, the present results may
      therefore suggest one physiological mechanism for production of SLE-related anti
      DNA antibodies.

PMID- 7770730
TI  - Technical aspects of the determination of myeloperoxidase antibodies in systemic
      vasculitis.

PMID- 7770731
TI  - Gender differences in schizophrenia: hormonal effect or subtypes?
AB  - Compared with their male counterparts, females with schizophrenia, on average,
      show better premorbid functioning, later onset, and a more benign course of
      illness. They are also more likely to have a family history of schizophrenia
      and/or affective illness, to exhibit "atypical" and affective features, and to
      show a seasonal pattern of hospital admission that mimics that of patients with
      mania. However, there exists a paradox. Although schizophrenia in females has
      much in common with affective disorder, the "schizophrenogenic" effect of
      maternal influenza also appears to be more significant in female than in male
      schizophrenia. Perhaps females with a predisposition to affective psychosis who
      have also been subject to the effects of maternal viral infection during
      gestation develop some subtle neurodevelopmental damage that renders their
      psychosis schizophrenia-like.

PMID- 7770732
TI  - Abnormal photic driving responses in never-medicated schizophrenia patients.
AB  - The present study was conducted to compare electroencephalogram (EEG) driving
      responses to 10 hertz photic stimulation in 14 drug-naive schizophrenia patients
      and 16 sex- and age-matched control subjects. The amplitude of photic driving
      responses (PDRs) recorded from the occipital region was significantly lower in
      schizophrenia patients than in controls. In eight schizophrenia patients (vs.
      none in the control group) the PDR amplitudes recorded at the frontal region were
      higher than those at the occipital region, and frontal to occipital PDR ratios
      were significantly larger in schizophrenia subjects than in controls.
      Quantitative analysis of the resting EEG showed that the patients also had a
      significantly lower amplitude for the alpha frequency band. These findings
      suggest that the PDRs of schizophrenia patients are abnormal in their amplitude
      and distribution.

PMID- 7770733
TI  - Seasonality of birth in schizophrenia in Taiwan.
AB  - The phenomenon of seasonality of birth in schizophrenia is important to the study
      of the etiology of this mental disorder because it helps give directions for
      further research. Patients' hospital files from 1981 to 1991 at two of the
      largest hospitals with psychiatric wards in Taiwan were reviewed, and dates of
      birth were collected on 3,346 patients diagnosed with schizophrenia. After
      adjusting for the variations of the total monthly births in the population, an
      Auto-Regressive Integrated Moving Average model was applied. Results support a
      seasonality phenomenon and indicate a disproportional excess of births in
      schizophrenia in the cold months (November to February) compared with the hot
      months (May to August). These findings are compatible with many other studies in
      other countries and climates. Further investigations of season-related
      environmental factors in the etiology of schizophrenia are recommended.

PMID- 7770734
TI  - Multisite experimental cost study of intensive psychiatric community care.
AB  - A 2-year experimental cost study of 10 Intensive Psychiatric Community Care
      (IPCC) programs was conducted at Department of Veterans Affairs (VA) medical
      centers in the Northeast. High hospital users were randomly assigned to either
      IPCC (n = 454) or standard VA care (n = 419) at four neuropsychiatric (NP) and
      six general medical and surgical (GMS) hospitals. National computerized data were
      used to track all VA health care service usage and costs for 2 years following
      program entry. At 9 of the 10 sites, IPCC treatment resulted in reduced inpatient
      service usage. Overall, for IPCC patients compared with control patients, average
      inpatient usage was 89 days (33%) less while average cost per patient (for IPCC
      inpatient, and outpatient services) was $15,556 (20%) less. Additionally, costs
      for IPCC patients compared with control patients were $33,295 (29%) less at NP
      sites but were $6,273 (15%) greater at GMS sites. At both NP and GMS sites, costs
      were lower for IPCC patients in two subgroups: veterans over age 45 and veterans
      with high levels of inpatient service use before program entry. No interaction
      was noted between the impact of IPCC on costs and other clinical or
      sociodemographic characteristics. Similarly, no linear relationship was observed
      between the intensity of IPCC services and the impact of IPCC on VA costs,
      although the two sites that did not fully implement the IPCC program had the
      poorest results. With these sites excluded, the total cost of care for IPCC
      patients at GMS sites was $579 (3%) more per year than that for the control
      patients.

PMID- 7770735
TI  - Twins with schizophrenia: genes or germs?
AB  - High concordance for schizophrenia in monozygotic (MZ) twins is often cited as
      evidence for the etiological influence of genetics; however, even if twins are
      separated at birth, MZ twin concordance is influenced by the shared prenatal
      environment. Study of the placentation status of MZ twins provides a way to
      investigate some prenatal influences, including the possible role of viral
      infections. The probability of shared infections is likely to be greater in
      monochorionic MZ twin pairs than in dichorionic pairs because of shared fetal
      circulation in the monochorionic pairs. We drew from published twin studies and
      used reported concordance for handedness as a retrospective marker of
      placentation status. We found that MZ twin pairs with opposite-hand preferences
      were concordant for psychosis in 9 of 15 cases (60%), while only 18 of 56 twin
      pairs (32%) with same-hand preferences were concordant for psychosis. These
      results suggest that shared prenatal viral infection may account for much of the
      high concordance for schizophrenia in identical twins.

PMID- 7770736
TI  - Costs of schizophrenia in The Netherlands.
AB  - This study tries to identify and estimate the health care costs of schizophrenia
      in The Netherlands and to determine in a broader sense the total costs of
      schizophrenia for society in terms of productivity loss caused by absence from
      work and early retirement. The study can be described as a "cost-of-illness"
      study based on prevalence data. It shows that in The Netherlands about 2 percent
      of the total health care budget is spent on the treatment of schizophrenia
      patients. This figure is rather high, since the prevalence rate of schizophrenia
      in The Netherlands is only 0.6 percent. The indirect costs--production lost
      because of absence from work, disability, and early death--were very low, but
      these costs are underestimated because schizophrenia patients are unlikely to
      become active participants in the labor force. It is also difficult to identify
      people who have died of schizophrenia in national data because schizophrenia in
      itself is not lethal, but individuals with schizophrenia may die because of
      suicide or violent death.

PMID- 7770737
TI  - First person account: living in a nightmare.

PMID- 7770738
TI  - The multidimensionality of schizotypy.
AB  - We present an overview of self-report scales for measuring schizotypy and a
      review of factor-analytical studies of these scales. These studies show that
      schizotypy is a multidimensional construct consisting of three or four factors.
      Positive Schizotypy, Negative Schizotypy, Nonconformity, and possibly Social
      Anxiety/Cognitive Disorganization. Clinical and external validation studies
      provide support for the construct validity of the Positive Schizotypy and
      Negative Schizotypy factors, but as yet fail to support the Nonconformity and
      Social Anxiety/Cognitive Disorganization factors. In accordance with this
      multidimensional structure, the scales for measuring schizotypy can be classified
      as factor-specific scales. We consider the striking similarities between the
      multidimensionality of schizotypal traits and the multidimensionality of
      schizophrenic symptoms. We also look at the similarities and differences between
      schizotypy and normal personality traits. Some practical and theoretical
      implications of these relationships are discussed.

PMID- 7770739
TI  - A family study of schizotypal disorder.
AB  - Direct, blind interviews were used to study the risk for and prevalence of DSM
      III-R Axis I and II disorders in 93 first-degree relatives of outpatients with
      schizotypal personality disorder (SPD) and outpatients with other personality
      disorders. Risks for SPD (at a slightly loosened diagnostic threshold) and
      schizoid personality disorder were significantly higher in the families of
      probands with SPD. Schizophrenia was present only among relatives of probands
      with SPD, accounting for a morbid risk of 4.1 percent. Neither familial risks for
      mood and anxiety disorders nor the prevalence of other Axis II disorders
      significantly differed in the two groups of relatives. It is suggested that SPD
      is a familial disorder representing a phenotypic expression of liability to
      schizophrenia.

PMID- 7770740
TI  - Schizotypal personality disorder in parents and the risk for schizophrenia in
      siblings.
AB  - With on exception, previous studies examining the familial relationship between
      schizotypal personality disorder (SPD) and schizophrenia have compared rates of
      SPD in relatives of probands with schizophrenia versus control probands. In the
      Roscommon Family Study, an epidemiologically based family study of major
      psychiatric disorders conducted in the west of Ireland, we used a Cox
      proportional hazards model to examine the impact of a parental diagnosis of SPD
      on the risk for psychiatric disorders in siblings of probands with schizophrenia
      or schizophrenia spectrum disorders. In siblings of probands with schizophrenia
      or schizophrenia spectrum, a parental diagnosis of SPD significantly increased
      the risk for schizophrenia and schizophrenia spectrum disorders, but not for
      affective illness or anxiety disorders. These findings replicate our previous
      results from the Roscommon Family Study, further supporting the hypothesis that
      SPD has a substantial familial relationship with schizophrenia and other
      schizophrenia spectrum disorders, but not with affective illness.

PMID- 7770741
TI  - Assessment of the central dopaminergic index of plasma HVA in schizophrenia.
AB  - Under fasting conditions, the dopamine (DA) metabolite homovanillic acid (HVA) in
      plasma originates mainly from central DA neurons or from central and peripheral
      noradrenergic (NA) neurons. The latter source contributes, in addition to HVA,
      the norepinephrine metabolites, for example, 3-methoxy-4-hydroxyphenylglycol
      (MHPG). It has been shown in primates that the association between HVA and MHPG
      in plasma or urine under varying rates of NA metabolism can be used to obtain an
      estimate of the central DA neuronal contribution of HVA to plasma or urine. This
      estimate is called the central dopaminergic index (CDI). Two studies presented
      here examine the applicability of this model in schizophrenia patients. The
      results were consistent with the proposed model and suggested that only about 30
      percent of the total plasma HVA concentrations in our patients were derived from
      central DA neurons. A convenient modification of this model is proposed for
      future studies. Since the CDI of plasma HVA is not likely to be confounded by NA
      activity, this tool may prove useful in disentangling the roles played by the DA
      and NA systems in schizophrenia.

PMID- 7770742
TI  - Reevaluation of the mesolimbic hypothesis of antipsychotic drug action.
AB  - Conventional neuroleptic drugs are thought to derive their antipsychotic efficacy
      through influences on the mesolimbic dopamine (DA) system. In contrast, motor
      side effects of these drugs are suggested to follow from influences on the
      nigrostriatal DA system. This conceptualization is based on the assumption that
      behaviors mediated by the mesolimbic DA system are involved in schizophrenia
      while behaviors controlled by the nigrostriatal system are not. In this article,
      it is argued that although assumptions about mesolimbic activities may indeed be
      correct, those concerning the nigrostriatal system certainly are not. This being
      the case, drugs with mesolimbic-specific activity may not have significant
      antipsychotic potency and probably will not be free of motor side effects. The
      current thrust of neuropharmacology, which emphasizes development of drugs with
      pharmacological specificity rather than anatomical selectivity, is more likely to
      generate new antipsychotic agents with a reduced risk of motor side effects.

PMID- 7770743
TI  - Trends in the inpatient care of persons with schizophrenia.
AB  - This report analyzes nationally representative data to examine inpatient services
      provided to persons with schizophrenia. The data are for patients admitted to
      general hospitals, private psychiatric hospitals, and State and county mental
      hospitals between 1970 and 1986 (weighted n = 860,637). The proportion of
      admissions diagnosed as having schizophrenia decreased from 21 percent in 1970 to
      16 percent in 1986; this proportion decreased in public general hospitals and
      increased in private general hospitals. The rate of admissions for schizophrenia
      decreased in public general hospitals and State and county mental hospitals and
      increased in private general hospitals. The overall admissions rate decreased for
      whites with schizophrenia and increased for African-Americans, owing entirely to
      increased admissions of African-American males. Private general hospitals and
      State and county mental hospitals relied less over time on private insurance; the
      use of Medicare increased in both public and private general hospitals; and
      Medicaid use increased in private general hospitals. Further research on services
      for this population is necessary as a baseline for health care reform.

PMID- 7770747
TI  - Zoonoses in the world: current and future trends.
AB  - Zoonoses still represent significant health problems in many developed and
      developing countries. Whereas rabies, brucellosis, and echinococcosis will remain
      the major zoonotic diseases to be tackled in developing countries for the next 20
      years, it is very likely that many developed countries will have eliminated these
      diseases by then. As observed repeatedly in the past few years, new zoonoses are,
      however, expected to emerge in the near future. Due to ever-increasing animal and
      human movements these new agents, whether originating from the southern or
      northern hemisphere, will most probably spread throughout the globe very quickly.
      It is very probable, in view of the foreseeable changes in the developed (e.g.
      population aging) and developing world (e.g. population growth, urbanization) or
      both (e.g. AIDS pandemic, environmental changes), that this trend will continue
      and even intensify.

PMID- 7770746
TI  - Annual meeting of the Swiss Society of Tropical Medicine and Parasitology.
      Leysin, 20-22 October 1994. Report and abstracts.

PMID- 7770744
TI  - Patients' assessment of treatment predicting outcome.
AB  - Using a visual analog scale, 34 schizophrenia patients receiving long-term
      treatment in community care rated the extent to which their treatment was right
      for them. We investigated whether these assessments would predict the duration of
      patient hospitalization during an initial followup period of 12 months and a
      longer followup period of 30 months. The duration of full and partial
      hospitalization was assessed by means of a hospitalization index. Patients who
      assessed their treatment more negatively had significantly higher hospitalization
      indices in the two followup periods. The predictive value of the patients'
      assessments of treatment was not explained by the influence of other variables.

PMID- 7770748
TI  - Human rabies: a continuing challenge in the tropical world.
AB  - More than 99% of all human rabies deaths in the world occur in tropical
      developing countries. In India alone, 30,000 to 50,000 people may die of rabies
      each year. The Lyssaviruses (Family Rhabdoviridae) include rabies and rabies
      related viruses, 3 of which have caused human disease. Rabies is a zoonosis,
      principally affecting domestic and stray dogs in most parts of Africa, Asia and
      Latin America. In North America, southern Africa, parts of the Caribbean and
      Europe, the principal mammalian reservoir species are wild carnivores. The
      pathogenesis, clinical features and differential diagnosis of rabies are
      discussed. The planning of rabies control strategies requires background
      information on the distribution and incidence of rabies in animals and the
      species involved. In some parts of the world, such as Latin American cities, most
      domestic dogs, even apparent strays, have an owner and can be immunized with
      conventional canine vaccines during well publicized campaigns. However, in areas
      such as India, where there may be a high proportion of stray domestic dogs
      without owners, and in those areas where wild mammals are the principal reservoir
      species, immunization may be possible using live attenuated or recombinant oral
      vaccines distributed in baits. In the poor tropical developing countries,
      unsatisfactory nervous tissue vaccines are still widely used. However, economical
      multisite intradermal regimens using tissue culture vaccines have proved
      effective and have begun to replace nervous tissue vaccines in some countries.

PMID- 7770745
TI  - Vulnerability to delusions over time in schizophrenia and affective disorders.
AB  - This research used a prospective longitudinal design to study differences in
      vulnerability to delusions over time in 234 subjects with schizophrenia,
      schizoaffective disorder, or bipolar or unipolar affective disorder. Patients
      were assessed at three successive followups over a 7- to 8-year period. Over 60
      percent of the schizophrenia and schizoaffective patients assessed experienced
      delusional activity at one of the three followups. Over 60 percent of the
      patients who initially had psychotic affective disorders also showed posthospital
      delusional activity. Significantly more schizophrenia patients than psychotic
      affective-disordered patients experienced consistent posthospital delusional
      activity at three successive followups. Unlike the schizophrenia subjects,
      affective patients showed a significant reduction in delusions after the first
      followup. After the initial acute psychotic episode that led to hospitalization,
      psychotic bipolar and unipolar affective patients showed a traitlike
      vulnerability to episodic delusional activity over time, but schizophrenia
      patients were vulnerable to more severe delusional activity and to more
      frequently recurring or sustained delusions. The study results question the views
      of several major theorists on the importance, persistance, and prognostic
      significance of delusions in schizophrenia.

PMID- 7770749
TI  - [Babesiosis, a little-known zoonosis].
AB  - Babesiosis or piroplasmosis is a common zoonotic disease among wild and domestic
      animals. Man can be infected by this hemoprotozoan parasite transmitted by ixodid
      ticks. More than 400 cases have been observed in the United States, but only 21
      cases have been reported in Europe. The American form, caused by B. microti,
      ranges in severity from asymptomatic to prolonged severe illness. It is
      characterized by irregular fever and moderate hemolytic anemia. The European
      form, caused by B. divergens, is a medical emergency with lethality close to 50%,
      most cases of which are seen in splenectomized patients. The diagnosis requires
      the identification of the parasite on blood smears (Giemsa). Its morphology is
      different from that of Plasmodium, but the parasites can be mis-identified, as
      was the case for the first patient with human babesiosis reported in Switzerland,
      probably imported from Wales. For clinicians early identification of this
      disease, which may require renal dialysis and exchange transfusion is essential.
      The treatment of choice is clindamycin and quinine.

PMID- 7770751
TI  - Cryptosporidia--who is at risk?
AB  - Cryptosporidium parvum is a coccidian parasite originally described a century ago
      and, until recently, not considered to be a human pathogen. It has a complex life
      cycle, including both sexual and asexual reproduction, an auto-infectious cycle,
      and the ability to complete its development within a single host. The
      transmission form is a robust, environmentally resistant oocyst, excreted in the
      stool, which can exist for long periods of time in the environment. Because
      animals, in particular domesticated livestock, are its primary host, human
      infection is usually zoonotic. Oocysts often find their way into water supplies,
      and it resists chlorination and is incompletely filtered from processed drinking
      water supplies, even when filtration is working optimally. Transmission via
      ingestion of fecally contaminated swimming pool water, food, fomites, and sexual
      activities facilitating fecal-oral inoculation have been demonstrated. The major
      target of C. parvum in the host is the intestinal epithelial cell, resulting in
      diarrhea, sometimes profuse and persistent, although it may also infect other
      organs such as the gall bladder and lungs. Pathogenesis involves attachment,
      probably via a sporozoite lectin, invasion, probably involving apical organelles,
      replication within a parasitophorous vacuole with the host cell membrane, causing
      cellular dysfunction. Diagnosis is generally made by visualization of the oocyst
      form in stool by staining methods, the best of which appears to be auramine and
      fluorescence microscopy. Those at greatest risk are immunocompromised adults and
      children, especially those with AIDS, children in day care, travelers to endemic
      regions, dairy or cattle farm workers of their families or contacts, household
      contacts of cases or carriers, and possibly owners of infected dogs or cats or
      their neighbors. There is no specific therapy available, however in the
      immunocompetent host the illness is self-limited, lasting from a few days to 3
      weeks, and long term carriage is uncommon. In the immunocompromised host,
      infection is prolonged, sometimes asymptomatic, but may result in chronic
      debilitating diarrhea with dehydration, malabsorption and wasting. Public health
      measures to reduce contamination of water supplies and vigilant surveillance will
      reduce the risk to populations. Reducing behaviors favoring fecal-oral
      transmission, such as certain sexual activities, and scrupulous hygiene in the
      day care setting would also reduce the likelihood of transmission but not
      eliminate it. Given our lack of knowledge about Cryptosporidium biology and
      pathogenesis, high priority should be given to research designed to increase our
      understanding of the organism and improve the chance of developing useful
      therapeutic or preventative drugs or strategies.

PMID- 7770750
TI  - [Cyst-forming Coccidia: Toxoplasma, Neospora, Sarcocystis].
AB  - The most important cyst-forming coccidian parasites in human and veterinary
      medicine belong the genera of Toxoplasma, Neospora and Sarcocystis. Toxoplasma
      gondii shows its clinical relevance in congenital infections and opportunistic
      infections in immunodeficient patients. In veterinary medicine the parasite is
      predominantly the cause of important economic loss in livestock production.
      Neospora causes diseases resembling toxoplasmosis; neosporosis is one of the most
      important causes of bovine abortion in the US. Neospora caninum leads to myositis
      and paralysis in dogs. The potential implication of Neospora in toxoplasmosis
      like diseases in humans is not yet known. Sarcocystis is usually a relatively
      harmless intestinal parasite in humans. Recent data from tropical areas suggest
      that man can also become an intermediate host for certain Sarcocystis species,
      which potentially represents a source of opportunistic infection and disease in
      areas with increasing HIV prevalence. In veterinary medicine, Sarcocystis causes
      muscle diseases and also abortion or myeloencephalitis with lethal outcome in
      certain animal species. Molecular-epidemiological investigations have resulted in
      a new understanding of biological and population-genetic mechanisms relevant to
      the disease. Recently developed molecular techniques, such as transfection in
      protozoan parasites, are presently used not only to elucidate molecular
      pathogenetic events in the course of disease, but also to prepare potential new
      immuno-therapeutic tools for future vaccination against infection or disease.

PMID- 7770753
TI  - [Scientific raisins from 125 years SMW (Swiss Medical Weekly). On porphyrinuria
      with acute ascending paralysis. 1919].

PMID- 7770752
TI  - [New parasitic diseases in man: infections caused by Microsporida and Cyclospora
      species].
AB  - The non-taxonomic term microsporidia relates to a group of organisms belonging to
      the order Microsporida of the phylum Microspora. Microsporidia are obligate
      intracellular spore-forming protozoa and have no metabolically active stages
      outside the host cell. Their host range is extensive and includes most
      invertebrates and all 5 classes of vertebrates. More than 100 microsporidial
      genera and almost 1000 species have now been identified. 5 genera
      (Enterocytozoon, Encephalitozoon, Septata, Pleistophora and Nosema) and
      unclassified microsporidia have been associated with human disease. Only 10 cases
      of microsporidiosis have been described among persons not infected with HIV. In
      contrast, microsporidia have gained increasing attention as important
      opportunistic pathogens in the evolving pandemic of HIV infection. Diagnosis
      depends on morphological demonstration of the organisms themselves. The potential
      sources and modes of transmission of human microsporidial infections are
      uncertain. The clinical manifestations of microsporidiosis are diverse and
      include intestinal, pulmonary, ocular, muscular, and renal disease. Preliminary
      observations of the possible utility of albendazole for infections due to Septata
      intestinalis and Encephalitozoon sp. have been reported. The success of therapy
      for intestinal Enterocytozoon bieneusi infection has been limited. Cyclospora sp.
      are recently described protozoa capable of causing diarrhea in immunocompetent
      and immunodeficient patients. Groups at risk for infection are children in the
      developing world, travellers and HIV-infected patients. Diagnosis depends on
      light-microscopic detection of oocysts in stool smears stained with acid-fast
      stains. Diarrhea is usually self-limiting. Diarrhea, however, may often last
      weeks to months, causing significant morbidity. Cotrimoxazole appears to be the
      drug of choice for treatment of Cyclospora infection.

PMID- 7770754
TI  - [Uncomplicated second pregnancy following acute fatty liver of pregnancy].
AB  - Acute fatty liver is a rare but usually severe and frightening complication of
      the last trimester of pregnancy. Many patients therefore do not want or are
      warned against having another child. This report adds another case of successful
      consecutive pregnancy to the 28 documented cases in 24 patients. On the other
      hand, only 2 recurrences have been reported. Therefore, the wish for another
      pregnancy may be supported, provided the gravida is well informed and the
      necessary (bi)weekly clinical and laboratory checks are carried out in the last
      trimester (liver tests, uric acid, prothrombin time and, in case of doubt,
      further coagulation tests including antithrombin III).

PMID- 7770756
TI  - [Scientific raisins from 125 year SMW (Swiss Medical Weekly). "Parkinsonism" as
      sequela to encephalitis lethargica. 1916].

PMID- 7770757
TI  - [Snoring--harmless or harmful?].

PMID- 7770755
TI  - [Obstructive sleep apnea syndrome].
AB  - This is an overview for the non-specialist of the pathophysiology, workup and
      treatment of the obstructive sleep apnea syndrome. The mechanisms leading to
      upper airway closure during sleep are discussed, as well as the current
      theoretical and experimental concepts for the apnea-induced arousal response and
      the consequent changes in sleep architecture and quality. Epidemiological data
      are summarized, with special reference to the problems of non-uniform definition
      criteria and examination techniques applied. In conclusion, a practical workup
      strategy and the current treatment options are summarized.

PMID- 7770758
TI  - [Screening for sleep apnea: clinical use of Mesam IV and Apnoe-Check].
AB  - With the introduction of nasal continuous positive airway pressure as an
      effective treatment of the sleep apnea syndrome, the demand for costly
      polysomnographic investigations has markedly increased. Hence a reliable
      screening method would be desirable. Patients undergoing overnight oxymetry were
      simultaneously examined by MESAM (n = 54) and by Apnoe-Check (n = 23) in a
      prospective manner. The results were compared among themselves and with the
      complete overnight polysomnography (MESAM n = 38, Apnoe-Check n = 20). Simple
      overnight oxymetry, automatically assessed oxymetry by MESAM and apnea
      identification by Apnoe-Check correlated well with the polysomnographic findings.
      On the other hand, variation of heart rate, snoring events and changes of body
      position as identified by MESAM did not add relevant information. Only the
      detection of moderate to severe sleep apnea syndrome was satisfactory, though not
      infallible. Thus, there is still no screening method available to identify or
      exclude sleep apnea syndrome, particularly the milder form, which is nevertheless
      a significant disease.

PMID- 7770759
TI  - [Intensive care aspects in severe tropical malaria: clinical aspects, therapy and
      prognostic factors].
AB  - In a retrospective study we analyzed the clinical and blood chemical data of 12
      patients with severe tropical malaria in the intensive care units of the
      University Hospital Zurich and the Stadtspital Triemli, Zurich, between 1991 and
      1994. None of the 12 patients had been exposed to malaria before or had taken
      drugs for chemoprophylaxis. 7 patients survived, 5 died from complications of
      malaria. According to the criteria of severe tropical malaria defined by the WHO,
      the following pathological clinical and blood chemical parameters were noted on
      admission: cerebral coma (2/12); blood hemoglobin < 5 g/dl (0/12), < 8 g/dl
      (2/12); serum creatinine > 265 mumol/l (3/12); blood glucose < 2.2 mmol/l (0.12);
      circulatory collapse/shock (0/12); bleeding/signs of disseminated intravascular
      coagulation in laboratory tests (4/12); acidosis with pH < 7.25 (1/12). Further
      signs of severe tropical malaria were: hyperparasitemia > 5% (9/12); qualitative
      and quantitative disturbances of consciousness (6/12); thrombocytopenia < 30 x
      10(9)/l (9/12); hyponatremia 125-135 mmol/l (9/12), < 125 mmol/l (2/12);
      rhabdomyolysis with creatine kinase > 1000 U/l (4/12). The basic treatment
      consisted of parenteral quinine hydrochloride in all patients; doxycycline was
      added in 8 cases, clindamycin in 3. Adjuvant therapy with desferrioxamin was
      given in 3 cases. 6 patients had exchange transfusions. Parasitemia cleared in
      all patients within 5 to 6 days. Later in the course, 5 patients developed acute
      respiratory distress syndrome, 6 required hemofiltration due to oliguria, and one
      became comatose.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7770760
TI  - [Incidence of insulin-dependent diabetes mellitus in Switzerland (1972-1993) in
      19-year-old men].
AB  - There is current debate whether prevalence of insulin-dependent diabetes mellitus
      is increasing in western countries. In Switzerland every male at age 19 years is
      legally obligated to appear before the Military Conscript Board, where health
      status is determined by physicians. We analyzed prevalence data concerning the
      diagnosis of diabetes mellitus in four full surveys (1972, 1982, 1987, 1993). The
      study included data from 162,607 Swiss males at age 19 years. Case numbers of
      birth cohorts and prevalence rates per 1000 are the following: [table: see text]
      Although the number of years surveyed is limited, trend analysis showed no
      evidence of an increase in the diabetes rates (total chi 2 = 4.953, DF = 3, 0.1 <
      p 0.2; chi 2 due to linear regression = 3.013, DF = 1, 0.05 < p < 0.1; chi 2 due
      to departure from linear regression = 1.940, DF = 2, 0.3 < p < 0.5). Overall
      cumulative incidence of diabetes mellitus was 1.30/1000 conscripts (95%
      confidence interval: 1.13-1.48/1000). We conclude that, in contrast to reports
      from other European countries, the cumulative incidence of insulin dependent
      diabetes mellitus has not increased among cohorts of Swiss males at age 19 years.

PMID- 7770761
TI  - [Protein antigens in case of asthma, rhinitis and dermatitis in patients
      occupationally exposed to flour].
AB  - 21 patients gave sera to clarify their clinical hypersensitivity towards flour
      proteins. 6 had dermatitis, 3 rhinitis and the others asthma. 3 patients showed a
      control reactivity towards the electrophoretically separated flour protein
      antigens while others had antibodies to flour antigen with molecular weights less
      than 100 kD or 80 kD in the case of rye. Reactivity towards antigens with
      molecular weight higher than 50 kD was typical of dermatitis patients, while the
      rhinitis and asthma cases' sera reacted towards lighter flour proteins in the 20
      30 kD range. The procedure is simple, a random serum sample (5 ml) suffices, and
      it allows demonstration of sensitization to flour protein in a way which may be
      helpful in the evaluation of exposure and the diagnosis of allergic conditions
      due to flour dust, a major etiology of occupational respiratory disease.

PMID- 7770762
TI  - [Scientific raisons from 125 years SMW (Swiss Medical Weekly). The active
      substances of ergot. 1921].

PMID- 7770763
TI  - [Annual meeting of the Swiss Society of Pneumology. Fribourg, 6-7 April 1995.
      Abstracts].

PMID- 7770764
TI  - Punctuated equilibrium in scientific publishing.

PMID- 7770765
TI  - High-frequency outer hair cell motility: corrections and addendum.

PMID- 7770766
TI  - Who owns the past?

PMID- 7770767
TI  - IL-12 at the crossroads.

PMID- 7770768
TI  - Origins of lichen fungi explored.

PMID- 7770769
TI  - Revisiting the fluid mosaic model of membranes.

PMID- 7770770
TI  - Evidence for a basalt-free surface on Mercury and implications for internal heat.
AB  - Microwave and mid-infrared observations reveal that Mercury's surface contains
      less FeO + TiO2 and at least as much feldspar as the lunar highlands. The results
      are compatible with the high albedo (brightness) of Mercury's surface at visible
      wavelengths in suggesting a rock and soil composition that is devoid of basalt,
      the primary differentiate of terrestrial mantles. The occurrence of a basalt
      free, highly differentiated crust is in accord with recent models of the planet's
      thermal evolution and suggests that Mercury has retained a hot interior as a
      result of a combination of inefficient mantle convection and minimal volcanic
      heat loss.

PMID- 7770771
TI  - Deregulated T cell activation and autoimmunity in mice lacking interleukin-2
      receptor beta.
AB  - In mice lacking the interleukin-2 receptor beta chain (IL-2R beta), T cells were
      shown to be spontaneously activated, resulting in exhaustive differentiation of B
      cells into plasma cells and the appearance of high serum concentrations of
      immunoglobulins G1 and E as well as autoantibodies that cause hemolytic anemia.
      Marked infiltrative granulocytopoiesis was also apparent, and the animals died
      after about 12 weeks. Depletion of CD4+ T cells in mutant mice rescued B cells
      without reversion of granulocyte abnormalities. T cells did not proliferate in
      response to polyclonal activators, nor could antigen-specific immune responses be
      elicited. Thus, IL-2R beta is required to keep the activation programs of T cells
      under control, to maintain homeostasis, and to prevent autoimmunity.

PMID- 7770772
TI  - Superresolution three-dimensional images of fluorescence in cells with minimal
      light exposure.
AB  - Fluorescent probes offer insight into the highly localized and rapid molecular
      events that underlie cell function. However, methods are required that can
      efficiently transform the limited signals from such probes into high-resolution
      images. An algorithm has now been developed that produces highly accurate images
      of fluorescent probe distribution inside cells with minimal light exposure and a
      conventional light microscope. This method provides resolution nearly four times
      greater than that currently available from any fluorescence microscope and was
      used to study several biological problems.

PMID- 7770773
TI  - Repositioning of a domain in a modular polyketide synthase to promote specific
      chain cleavage.
AB  - Macrocyclic polyketides exhibit an impressive range of medically useful
      activities, and there is great interest in manipulating the genes that govern
      their synthesis. The 6-deoxyerythronolide B synthase (DEBS) of Saccharopolyspora
      erythraea, which synthesizes the aglycone core of the antibiotic erythromycin A,
      has been modified by repositioning of a chain-terminating cyclase domain to the
      carboxyl-terminus of DEBS1, the multienzyme that catalyzes the first two rounds
      of polyketide chain extension. The resulting mutant markedly accelerates
      formation of the predicted triketide lactone, compared to a control in which the
      repositioned domain is inactive. Repositioning of the cyclase should be generally
      useful for redirecting polyketide synthesis to obtain polyketides of specified
      chain lengths.

PMID- 7770774
TI  - Crystal structure of a purple acid phosphatase containing a dinuclear Fe(III)
      Zn(II) active site.
AB  - Kidney bean purple acid phosphatase (KBPAP) is an Fe(III)-Zn(II) metalloenzyme
      resembling the mammalian Fe(III)-Fe(II) purple acid phosphatases. The structure
      of the homodimeric 111-kilodalton KBPAP was determined at a resolution of 2.9
      angstroms. The enzyme contains two domains in each subunit. The active site is
      located in the carboxyl-terminal domain at the carboxy end of two sandwiched beta
      alpha beta alpha beta motifs. The two metal ions are 3.1 angstroms apart and
      bridged monodentately by Asp164. The iron is further coordinated by Tyr167,
      His325, and Asp135, and the zinc by His286, His323, and Asn201. The active-site
      structure is consistent with previous proposals regarding the mechanism of
      phosphate ester hydrolysis involving nucleophilic attack on the phosphate group
      by an Fe(III)-coordinated hydroxide ion.

PMID- 7770775
TI  - Multiple origins of lichen symbioses in fungi suggested by SSU rDNA phylogeny.
AB  - Phylogenetic hypotheses provide a context for examining the evolution of
      heterotrophic lifestyles. The lichen lifestyle, which is the symbiotic
      association of fungi with algae, is found in various representatives of
      Dicaryomycotina, both Ascomycetes and Basidiomycetes. A highly resolved parsimony
      analysis of small subunit ribosomal DNA (SSU rDNA) sequences suggests at least
      five independent origins of the lichen habit in disparate groups of Ascomycetes
      and Basidiomycetes. Because lichen associations arose from parasitic,
      mycorrhizal, or free-living saprobic fungi, neither mutualism nor parasitism
      should be construed as endpoints in symbiont evolution.

PMID- 7770776
TI  - Muscle-derived neurotrophin-4 as an activity-dependent trophic signal for adult
      motor neurons.
AB  - The production of neurotrophin-4 (NT-4) in rat skeletal muscle was found to
      depend on muscle activity. The amounts of NT-4 messenger RNA present decreased
      after blockade of neuromuscular transmission with alpha-bungarotoxin and
      increased during postnatal development and after electrical stimulation in a dose
      dependent manner. NT-4 immunoreactivity was detected in slow, type I muscle
      fibers. Intramuscular administration of NT-4 induced sprouting of intact adult
      motor nerves. Thus, muscle-derived NT-4 acted as an activity-dependent
      neurotrophic signal for growth and remodeling of adult motor neuron innervation.
      NT-4 may thus be partly responsible for the effects of exercise and electrical
      stimulation on neuromuscular performance.

PMID- 7770777
TI  - Progesterone synthesis and myelin formation by Schwann cells.
AB  - Progesterone is shown here to be produced from pregnenolone by Schwann cells in
      peripheral nerves. After cryolesion of the sciatic nerve in male mice, axons
      regenerate and become myelinated. Blocking either the local synthesis or the
      receptor-mediated action of progesterone impaired remyelination. Administration
      of progesterone or its precursor, pregnenolone, to the lesion site increased the
      extent of myelin sheath formation. Myelination of axons was also increased when
      progesterone was added to cultures of rat dorsal root ganglia. These observations
      indicate a role for locally produced progesterone in myelination, demonstrate
      that progesterone is not simply a sex steroid, and suggest a new therapeutic
      approach to promote myelin repair.

PMID- 7770778
TI  - Reliability of spike timing in neocortical neurons.
AB  - It is not known whether the variability of neural activity in the cerebral cortex
      carries information or reflects noisy underlying mechanisms. In an examination of
      the reliability of spike generation using recordings from neurons in rat
      neocortical slices, the precision of spike timing was found to depend on stimulus
      transients. Constant stimuli led to imprecise spike trains, whereas stimuli with
      fluctuations resembling synaptic activity produced spike trains with timing
      reproducible to less than 1 millisecond. These data suggest a low intrinsic noise
      level in spike generation, which could allow cortical neurons to accurately
      transform synaptic input into spike sequences, supporting a possible role for
      spike timing in the processing of cortical information by the neocortex.

PMID- 7770779
TI  - Chemical characterization of a family of brain lipids that induce sleep.
AB  - A molecule isolated from the cerebrospinal fluid of sleep-deprived cats has been
      chemically characterized and identified as cis-9,10-octadecenoamide. Other fatty
      acid primary amides in addition to cis-9,10-octadecenoamide were identified as
      natural constituents of the cerebrospinal fluid of cat, rat, and human,
      indicating that these compounds compose a distinct family of brain lipids.
      Synthetic cis-9,10-octadecenoamide induced physiological sleep when injected into
      rats. Together, these results suggest that fatty acid primary amides may
      represent a previously unrecognized class of biological signaling molecules.

PMID- 7770780
TI  - Hyperthermia--its actual role in radiation oncology. Part III: Clinical rationale
      and results in deep seated tumors.
AB  - PURPOSE: Combined hyperthermia and radiation therapy has been reported to yield
      higher complete and durable responses than radiotherapy alone in superficial
      tumors. In deep seated tumors the effect of the combined treatment is still under
      research. METHODS: The literature and own clinical data are reviewed with regard
      to biological and physical fundamentals and clinical results. RESULTS: Clinical
      phase I to II studies have applied regional hyperthermia in the abdomen, the
      pelvic region and the extremities. Usually primary advanced, persistent or local
      recurrent and metastatic tumors were selected for treatment either due to poor
      response to conventional therapy or for effective palliation. The clinical data
      are presented concerning the following topics: invasive thermometry, temperature
      parameter in tumor and normal tissue, toxicity, tumor response, treatment
      planning, clinical trials and prognostic factors. Clinical results of
      thermoradiotherapy for advanced or recurrent rectal cancer, cervical cancer and
      soft tissue sarcomas are reviewed in detail. In addition, the prognostic
      relevance of temperature parameters and physiological conditions such as global
      tumor perfusion are discussed. CONCLUSION: Clinical issues of optimization of
      regional thermoradiotherapy are: improvement of hyperthermia technique, analysis
      of biological effects and mechanisms involved in temperature elevation, selection
      of appropriate study concepts for specific tumor sites. Part I has covered
      biological and technical fundamentals of clinical hyperthermia and has been
      published in Strahlenther. Onkol. 168 (1992), 183-190. Part II has covered
      clinical fundamentals and results in superficial tumors of clinical hyperthermia
      and has been published in Strahlenther.

PMID- 7770781
TI  - [Results of neutron therapy in recurrent malignant salivary gland tumors in the
      head and neck area].
AB  - PURPOSE: The records of 33 patients of recurrent salivary gland tumors of the
      head and neck regions were analysed. PATIENTS AND METHODS: 33 patients with
      recurrent salivary gland tumors were treated with fast neutrons of a 14 MeV DT
      generator. All patients had been operated several times. 10 patients had been
      irradiated before with photons or electrons. 24 patients had macroscopic tumor.
      In many cases advanced tumors were treated. RESULTS: The median follow-up of our
      patients is 33 months. 6 patients are still alive without disease. 5 patients are
      alive with local recurrence or tumor progression. The calculated survival rate
      for all patients is 45% at 5 years. The calculated control rate for all patients
      is 43% at 5 years. Most of the late side effects according to the RTOG/EORTC
      score were moderate. Only in one case severe late side effects could be observed.
      CONCLUSION: According to the literature advanced recurrences of salivary gland
      tumors should be treated with fast neutrons.

PMID- 7770782
TI  - Radiographic changes following radiotherapy in the patients with lung cancer. Is
      the irradiated area of the mediastinum in the simulation film a significant
      factor?
AB  - BACKGROUND: Radiation induced lung injury is an ominous adverse reaction in the
      management of thoracic disease by radiation therapy. Although the importance of
      the area of irradiated lung is well known, the irradiated area of mediastinum is
      little to be considered in the routine treatment. PURPOSE: To evaluate the
      significance of the irradiated area of the mediastinum in the simulation film for
      radiation induced lung injury. PATIENTS AND METHODS: A total of 208 patients with
      primary lung cancer treated with radiation therapy were analyzed for incidence of
      radiation induced lung injury. Lung injury was defined as the appearance of an
      abnormal shadow on the chest radiograph. CT images were used to differentiate
      recurrence or other conditions. Age, sex, irradiation dose, irradiated lung area,
      T and N factors of the tumor, irradiated mediastinum area, performance status of
      patients, location of irradiated fields and use of chemotherapy were analyzed
      with Cox's multivariate regression model. RESULTS: The cumulative rate of
      radiation induced lung injury at 12 months was 85%. Significant factor of
      radiation induced lung injury was irradiated area of the mediastinum (p = 0.03).
      Irradiated area of the lung (p = 0.18, n.s.), total tumor dose (p = 0.1, n.s.),
      use of chemotherapy (p = 0.08, n.s.) and location of irradiated field (p = 0.08,
      n.s.) may also have an effect on radiation induced lung injury. CONCLUSION: The
      irradiated area of the mediastinum is one of the significant factors in radiation
      induced lung injury.

PMID- 7770783
TI  - [Value of SPECT-immunoscintigraphy in radiation treatment planning for patients
      with squamous cell carcinomas in the head and neck area].
AB  - PURPOSE: Introduction of monoclonal antibodies (immunoscintigraphy) has
      significantly extended the diagnostic spectrum of nuclear medicine in oncology.
      The detection rate of this new method in patients bearing squamous cell carcinoma
      of head and neck is better compared to computed tomography and magnetic resonance
      imaging. In a prospective study, we examined whether immunoscintigraphy in
      addition to other imaging procedures is able to provide additional diagnostic
      information for radiation treatment planning.

PMID- 7770784
TI  - [Usefulness of prophylactic whole brain irradiation in small-cell bronchial
      carcinoma].
AB  - PURPOSE: An analysis of the incidence of brain metastases in small cell lung
      cancer, time of occurring during the course of disease, and the prognosis of
      these patients depending on the use of prophylactic cranial irradiation for three
      well defined patient groups. MATERIAL AND METHODS: A retrospective study included
      133 unselected patients with histologically proven SCLC who were treated from
      1985-1990 in our department. From these, 118 patients without CNS metastases at
      primary diagnosis were divided into three well defined patient groups: group I
      consisted of 23 patients who achieved a complete remission after primary therapy
      and who were subsequently treated with PCI, group II consisted of 23 patients in
      complete remission without PCI. Group III consisted of 72 patients without CNS
      metastases at the primary diagnosis and without PCI treatment since they did not
      achieve a complete response after primary therapy. The primary therapy consisted
      of combined radiochemotherapy or only chemotherapy. Sixteen patients were treated
      only by irradiation. RESULTS: The overall incidence of CNS metastases for all 133
      patients was 33.1%. The incidence of new CNS metastases in group I was 21.7% in
      group II 26.1%, and in group III 22.2%. The average time to development of CNS
      metastases after primary diagnosis was different for the three groups: in group I
      15.4 months, in group II 9.5 months and in group III 8.4 months. No statistical
      significance was noted. Median survival time for group I was 16.1 months, for
      group II 13.8 months and 8.4 months for the group III. No statistical
      significance was achieved between group I and II (P > 0.05). CONCLUSIONS: These
      data suggest that treatment with PCI appears to be ineffective in reducing the
      incidence of subsequently CNS metastases or to improve survival of SCLC patients.
      We recommend the use of PCI only in well defined clinical studies.

PMID- 7770786
TI  - [Intraspinal metastasis of stage I anaplastic Wilms tumor].
AB  - PURPOSE: Intraspinal metastasis of Wilms' tumors is a rare event with only 6
      cases documented in the literature. PATIENT AND METHODS: We report a case of an
      intraspinal metastasis by a young child with anaplastic Wilms' tumor (stage I). A
      9-year-old girl developed 8 months following nephrectomy and pre-operative
      chemotherapy strong back pain. Within 2 weeks signs of beginning of spinal cord
      compression were obtained. The magnetic resonance imaging showed a spinal cord
      compression with an intraspinal tumor mass Th 8 to 10. RESULTS: The child
      underwent immediate spinal cord decompression followed by chemotherapy and an
      additional radiotherapy of the metastatic region up to 30 Gy with most of
      neurologic recovery within 6 weeks. CONCLUSIONS: The case illustrates the
      importance of rapidly responding neurologic complications in patients with Wilms'
      tumor, even in stage I.

PMID- 7770785
TI  - Long-term survival after brain metastases in breast cancer.
AB  - PURPOSE: Long-term survival after whole brain irradiation for cerebral metastases
      is rare. In order to identify a possible subgroup of patients with a prolonged
      survival time, a retrospective analysis was carried out. PATIENTS AND METHODS:
      From 1977 to 1991, 197 patients with singular (51%) or multiple (49%) brain
      metastases were treated with whole brain irradiation (30 to 36 Gy, 2 to 3 Gy
      daily fractions, an additional boost of 8 to 20 Gy in 8%) or resection of a
      singular metastasis and postoperative irradiation (36 patients, 30 to 36 Gy, 2 to
      3 Gy fractions whole brain irradiation, boost of 8 to 20 Gy in 31%). RESULTS:
      Fifty-seven patients (24%) had metastases of breast cancer. In this group, 3 of 8
      patients with combined treatment of a singular metastasis survived more than 5
      years from the onset of brain irradiation, compared to 1 of 8 patients with non
      small-cell lung cancer and none of 14 patients with unknown primaries. In the
      group which was treated with irradiation only, breast cancer patients with an
      interval of more than 5 years between primary and brain metastasis had the best
      prognosis with 4 of 12 patients surviving more than 3 years, but less than 5
      years. CONCLUSION: These results demonstrate that long-term survival is not only
      possible in the known cases of solitary brain metastasis in non-small-cell lung
      cancer but also in breast cancer, combined treatment provided.

PMID- 7770787
TI  - [Hyperfractionated irradiation in bladder carcinoma].

PMID- 7770788
TI  - [Survival of children with primitive neuroectodermal tumors and malignant
      ependymomas of the central nervous system after treatment with 8 cytostatic
      agents in one day. A report of the Children's Cancer Group].

PMID- 7770789
TI  - [Minimal lymphatic tumor cell dissemination as a prognostic factor in non-small
      cell lung carcinoma].

PMID- 7770790
TI  - [Role of radiotherapy in the framework of curative chemotherapy concept in local
      advanced non-small-cell bronchial carcinoma].

PMID- 7770791
TI  - [In reference to the article by Dahl et al: Do acute side effects during
      radiotherapy predict tumour response in rectal carcinoma? Acta Oncol. 33 (1994),
      409-413, and to Commented Literature by J. Dunst: Acute side effects and
      therapeutic success in preoperative radiotherapy of rectal carcinoma.
      Strahlenther. Onkol. 171 (1995), issue 1, 54-55].

PMID- 7770792
TI  - [Pulmonary ventilation function in middle-aged and elderly patients with chronic
      bronchitis].
AB  - The indices of lung ventilation and biomechanics of breathing were determined in
      48 patients with chronic obstructive bronchitis (COB) aged 60-79 and 45 healthy
      subjects of the same age. Inpatients with COB a rise of lung ventilation, work of
      breathing, ventilation equivalent, positive reaction to oxygen, a decrease of
      maximal breathing capacity and reserve of breathing take place that reflect
      excessive and uneffective ventilation, limitation of its functional performance.
      These specific features are due to an increase in the total lung capacity at the
      expense of residual volume against a decrease of vital capacity with diminution
      of alveolar ventilation to lung ventilation ratio. But of decisive significance
      was disturbance of bronchial patency manifesting in a decrease of Tiffeneau
      index, midexpiratory flow, respiratory flows in forced respiration, especially in
      expiratory phase, concavity of flow-volume curve to volume axis, a rise of
      bronchial resistance.

PMID- 7770793
TI  - [The cholesterol esterase activity of the blood monocytes and alveolar
      macrophages in patients with chronic bronchitis].
AB  - The activity of cholesterol esterase (CE) in blood monocytes and alveolar
      macrophages (AMF) of bronchoalveolar fluid (BAF) according to Brecher et al.,
      cell composition of endobronchial cytogram were investigated in 32 patients with
      chronic bronchitis (CB) and control subjects. In CB sufferers CE activity in AMF
      was inhibited, while in monocytes it was elevated reaching maximal values in
      purulent bronchopulmonary CB. Determination of CE activity in AMF and peripheral
      blood monocytes in CB may serve an additional diagnostic indicator of impaired
      lipid metabolism and suggests new approaches to investigation of CB pathogenesis.

PMID- 7770794
TI  - [The dynamic indices of external respiratory function in patients with chronic
      obstructive bronchitis during the course of the work week under manufacturing
      conditions].

PMID- 7770795
TI  - [A trial of the use of the new Russian preparation oxymetacil in patients with
      chronic nonspecific lung diseases].
AB  - The trial of oxymethacyl was conducted in 20 CNSPD patients. Clinicoimmunological
      examinations provided evidence on the drug effectiveness as it stimulated cell
      immunity, phagocytosis, was well tolerated, caused no side effects. The highest
      response was achieved in combination of oxymethacyl with antibacterial therapy.
      Normalization of clinical and immunological indices in CNPD patients suggests
      immunocorrective effect of oxymethacyl.

PMID- 7770796
TI  - [Changes in the sensitivity of leukocytes to the inhibiting effect of CO2 on
      their generation of active forms of oxygen in bronchial asthma patients].
AB  - 30 bronchial asthma (BA) patients and 15 donors were exposed to 8.3% and 20.8%
      CO2 to bring out leukocytes sensitivity to CO2 by generation of active oxygen
      (AO) in bronchial asthma. CO2 effects on leukocyte AO generation were defined by
      luminol-dependent chemiluminescence (CL) before and after the exposure to CO2. It
      was found that in healthy subjects 8.3% and 20.8% CO2 noticeably inhibits
      leukocyte CL. However, in 70% of asthmatics with BA exacerbation leukocyte
      sensitivity to CO2 inhibition diminished. This was normal in 30% of BA patients.
      With BA aggravation, leukocyte sensitivity to CO2 tended to a decrease. Remission
      brought a complete or partial recovery of the above sensitivity. Thus, on the one
      hand, CO2 is involved in BA pathogenesis in terms of its inhibitory effect on AO
      generation by leukocytes; on the other hand, only in 30% of BA patients high CO2
      concentrations as a treatment may be justified.

PMID- 7770797
TI  - [A comparative study of the expression of activation markers on T-lymphocyte
      subpopulations in different forms of bronchial asthma].
AB  - In this study we investigated a phenotype of intact and PHA-stimulated T
      lymphocytes from peripheral blood of patients with allergic and nonallergic
      asthma. Expression of the activation markers (CD25, CD71, HLA-DR) on subsets of T
      lymphocytes (CD4+ and CD8+) was determined using double-colour flow cytometry. It
      was found that nonallergic patients had increased percentages of CD4+CD25+,
      CD8+CD25+, CD4+HLA-DR+, CD8+HLA-DR+ cells. Allergic patients had a significant
      increase of CD4+CD25+ cells only. To examine functional significance of these
      changes mononuclear cells were cultivated with PHA in vitro. Thus, our findings
      improve our knowledge about asthma pathogenesis and create the grounds for
      pathogenetically validated immunocorrection.

PMID- 7770798
TI  - [An analysis of the data from the neurophysiological examination of patients with
      bronchial asthma and hyperventilation].
AB  - Bronchial asthma (BA) patients with hyperventilation (HV) were examined by means
      of evoked cutaneous sympathetic potential (ECSP) and short-latency evoked stem
      potentials to acoustic stimulation (SLESP to AS). Measurements of these
      parameters allowed quantitation and differentiation of hyperventilation disorders
      in BA patients. The latter were divided into 4 groups: BA patients with HV
      syndrome (HVS), BA patients with functional HV (FHV), BA patients with
      spontaneous HV (SHV) and BA patients without HV. BA patients with HVS exhibited a
      significant increase of latent ECSP period and latent periods III and V SLESP to
      AS peaks. This evidences for vegetative neuropathy and dysfunction of the pons
      and mesencephalic brain compartments. In BA patients with FHV there was a longer
      latent period II of SLESP to AS peak indicating dysfunction of caudal brain stem.
      BA patients with SHV and without HV had no significant shifts.

PMID- 7770799
TI  - [Pneumonia--a topical problem of medicine].

PMID- 7770800
TI  - [The therapeutic potentials of Ditec in bronchial asthma patients].
AB  - Ditec effects on clinicofunctional status were investigated in 15 patients with
      mild and moderate atopic bronchial asthma (ABA) aged 20-50 (5 males and 10
      females). A single ditec dose had a broncholytic effect along the entire
      bronchial tree and reduced sensitivity to acetylcholine. Magnesium sulfate (a
      single dose 3 mmol Mg2+, pH 6.6, the solution osmolality 260 mmol/l) potentiated
      ditec action on nonspecific hyperreactivity of the bronchial tree. Four-week
      ditec course induced no considerable changes in bronchial permeability, but
      increased reversibility of bronchial obstruction, inhibited sensitivity and
      response of the bronchial tree to acetylcholine. Course administration of ditec
      lowered endobronchial concentration of histamine and lipid peroxidation intensity
      showing antiallergic and antiinflammatory properties of the drug. Ditec is
      recommended for ABA and other asthma forms treatment as a safe and effective
      modality.

PMID- 7770801
TI  - [Beclomethasone dipropionate, budesonide and flunisolide in the treatment of
      bronchial asthma (a review of the literature and the authors' own research)].
AB  - Inhalation corticosteroids (beclometasone dipropionate, budesonide, flunisolide)
      proved effective against bronchial asthma (BA) and safe as they induce no severe
      systemic side effects. Of these three drugs side effects arise most frequently in
      administration of beclometasone dipropionate, least frequently of flunisolide.
      These inhalation corticosteroids are indicated both in non-steroid-dependent and
      steroid-dependent BA to reduce the dose of oral steroids or, if possible, for
      their complete discontinuation. Flunisolide is the most potent and effective of
      all inhalation corticosteroids used in current practice.

PMID- 7770802
TI  - The morphological properties of the blood thrombocytes in bronchial asthma
      patients before and after thrombocytapheresis.
AB  - Morphological characteristics of platelets were assessed electron microscopically
      in 15 patients with atopic and aspirin bronchial asthma (BA) before and after
      thrombocytapheresis (TA). All the patients had a definite shift of platelet
      subpopulations to greater percentage of spherical forms as well as defects in
      cell ultrastructure. This makes evident platelet activation in patients with BA
      aggravation. TA entails a positive trend to normalization of platelet
      subpopulations and cytoskeleton. The ability to normalize platelet
      morphofunctional status determines its clinical effectiveness in bronchial
      asthma.

PMID- 7770804
TI  - [A comparative assessment of the effect of different methods of
      glucocorticosteroid therapy on the hypophyseal-adrenal system in bronchial asthma
      patients].
AB  - As shown by morphofunctional examinations of hypophyseal-adrenal system in 137 BA
      patients and post mortem examinations of adrenal cortex in 72 BA cases, most
      pronounced defects in glucocorticosteroid (GCS) biosynthesis and metabolism were
      recorded in patients on long-term GCS regiments (5-10 years and more). They
      displayed low levels of 11-OCS and 17-OCS, enhanced transcortin binding capacity,
      diminished adrenocortical reserves. Beclometasone propionate, endobronchial
      liposomes with hydrocortisone had no negative adrenal effects.

PMID- 7770803
TI  - [The function of the hypothalamo-hypophyseal-gonadal system in patients with
      bronchial asthma without and in combination with arterial hypertension].
AB  - In the origin of arterial hypertension in bronchial asthma a significant role is
      played by the involvement of the lungs in metabolism of steroid hormones.
      Hypothalamo-hypophyseal-gonadal system was studied in 39 females suffering from
      bronchial asthma alone and in 47 asthmatic females suffering from bronchial
      asthma alone and in 47 asthmatic females with arterial hypertension. As indicated
      by radioimmunoassay, the impaired feedback between hypothalamo-hypophyseal and
      sexual functions may be responsible for stabilization of arterial hypertension in
      bronchial asthma.

PMID- 7770805
TI  - [The diastolic function of the right and left heart ventricles in patients with
      primary pulmonary hypertension].
AB  - To evaluate the condition of left and right ventricular functions in patients
      with primary pulmonary hypertension (PPH) 21 patients (13 females and 8 males,
      mean age 35.4 +/- 10.0) were examined. The patients were ill for 5.7 +/- 3.5
      years. Ventricular filling was characterized basing on computer data of
      transmitral and transtricuspid diastolic flow obtained at doppler
      echocardiography. Right ventricular function proved impaired in all the
      examinees: early in the disease the speed of early filling (Ve) was inhibited,
      while late filling was enhanced (Va). At terminal stages of the disease Ve
      increased, but Va reduced. Left ventricular function was also involved in all the
      patients: low Ve with the disease progression became more and more evident.

PMID- 7770806
TI  - [The current status of the problem of the surfactant system of the lungs].

PMID- 7770807
TI  - [The basic trends in the research on and treatment of chronic obstructive lung
      diseases. The Working Group of the Canadian Thoracic Society].

PMID- 7770808
TI  - [The diagnosis and treatment of tuberculosis of the respiratory organs].

PMID- 7770809
TI  - [The use of specific bronchial provocation tests in the diagnosis of atopic
      bronchial asthma].

PMID- 7770810
TI  - [A case of leiomyomatosis with a clinical picture of chylopericardium and
      chylothorax].

PMID- 7770812
TI  - [[One needs certain experience--and quality control. Interview with Prof. D.J.
      Vonderschmitt. Interview by K. Reinhardt].

PMID- 7770811
TI  - [Rovamycin (spiramycin)--a macrolide antibiotic for intravenous administration: a
      trial in the treatment of pneumonia].
AB  - An open non-comparative study of rovamycin (spiramycin produced by Rhone-Poulenc
      Rorer) for intravenous administration was performed to evaluate its clinical and
      bacteriological efficacy, safety and tolerance. Thirty patients (adults aged 16
      65 years) with community-acquired pneumonia were involved into the study. Two
      patients were dropped out because of adverse events. Dosage regimen was 1,500,000
      I.U. three times a day (intravenous infusion). The treatment was continued after
      partial recovery (3,000,000 I.U. per os). Spiramycin showed a high clinical
      efficacy. Approximately half of the patients (41.4-55.6%) had positive clinical
      trends by third day of spiramycin treatment. The overall clinical efficacy by the
      completion of the drug administration reached 90.0%. Bacteriological activity was
      observed in 93.4% of the patients treated. Adverse events were observed in 6
      (20.0%) patients, including 2 dropouts. Serious side effects were not registered.
      As rovamycin showed high clinical efficacy and good safety the drug may be
      recommended for the treatment of adult pneumonia.

PMID- 7770813
TI  - [50 years of clinical chemistry, first hand experience].
AB  - Approximately since 1945, progress in the field of photometric analysis also
      found its way into the laboratories of clinical chemistry. These techniques
      almost completely replaced the then prevailing gravimetric and titrimetric
      methods. At the same epoch, many of the biochemical reagents which up to then had
      to be prepared by the clinical laboratories themselves with great expenditure of
      work became commercially available. The increasing number of analytical orders
      could only be mastered thanks to the newly developed analyzers. Novel microliter
      techniques made it possible to diminish drastically the volumes of samples and
      reagents necessary. The radioimmunoassay opened up new analytical dimensions, the
      limits of detection and of quantification were expanded downwards to the picomol
      range. Soon afterwards, enzymes and/or fluorochromes were used as markers in
      immunoassays. The development of monoclonal antibodies constituted further
      important progress in this field. The latest revolutionary invention is
      doubtlessly the polymerase chain reaction (PCR), and related techniques. These
      methods are bound to bring about fundamental change not only in clinical
      chemistry but in the medical laboratory diagnostics in general.

PMID- 7770814
TI  - [Interpretation of numerical laboratory values].
AB  - Numerical values for laboratory tests ae usually divided into positive and
      negative results by a discriminating value. This raises the question of the
      reliability of the results, i.e. the probability of the presence of the tested
      disorder, if the result is positive. The present paper shows that this
      probability depends on the sensitivity and the specificity of the test as well as
      on the prevalence of the disorder in the population of patients under
      investigation. The usual reference values for laboratory tests turns out to be
      highly specific. The predictive value of a test result can be considerably
      improved by limiting the diagnostic possibilities. Tests with insufficient
      sensitivity and specificity are not applicable in screening for disorders or
      diseases.

PMID- 7770815
TI  - [Quality control in the physician's laboratory].
AB  - All measures in quality assurance, including quality control, aim at minimizing
      and detecting errors in the clinical laboratory. Quality control is performed by
      using internal quality control material and by participating in external quality
      assessment schemes. These measures for quality assurance are an essential part of
      the new index of clinical tests, issued by the federal department for internal
      affairs on 1 January 1994. An agreement has been signed by the representatives of
      the associations performing laboratory analyses (hospitals, physicians, private
      laboratories) and by the health insurances, saying that internal as well as
      external quality control will be mandatory in Switzerland beginning 1 July 1995.
      The FMH is now asked to supply the health insurances with a list of physicians
      performing laboratory analyses until 1 July. For physicians who will not have
      registered neither with the respective professional organization nor one of the
      health care insurances by July 1995, the reimbursements will be reduced.

PMID- 7770816
TI  - [Influence factors in the physician's laboratory].
AB  - Preanalytical influence factors are of paramount significance for the quality of
      a laboratory result. As a rule, their importance is greater than the inadequacies
      of the analytical process. Examples from the physician's laboratory concerning
      adult patients and primary samples are discussed. Weak points can be a lack of
      professionalism in the personnel involved as well as the need to send out and
      transport samples. The strong point of the office laboratory is its orientation
      towards a specific patient.

PMID- 7770817
TI  - [Urine analysis in the physician's laboratory].
AB  - The practitioner who wants to perform urinalysis by means of rapid tests either
      in his office or at the bedside is informed of the available possibilities.
      Directives for the choice of appropriate reagents and for their interpretation
      are presented.

PMID- 7770818
TI  - [Nephrological basis diagnosis in clinical practice].
AB  - The traditional urinalysis program, consisting of qualitative tests and the
      microscopical analysis of the urinary sediment, does no longer seem to be an
      adequate strategy to meet current medical quality requirements. New sensitive
      tests allow to exclude dysfunctions of glomerular and tubular function with
      hitherto unknown efficiency. This is possible by application of simple assays
      based on immunological techniques for albumin and alpha-1-microglobulin, which
      can be used in any medical office without technical equipment. Any finding of
      proteinuria, haematuria or leukocyturia may be differentiated by simple
      turbidimetric and microscopic procedures to separate renal from prerenal and
      postrenal causes. The new techniques have been successfully applied in early
      detection of renal complications in diabetics and hypertonics as well as
      immunological forms of renal disease. It is to be expected that the broader
      application of the new strategy helps to reduce many invasive investigations for
      the benefit of patients.

PMID- 7770819
TI  - [The hematological laboratory of clinical practice].
AB  - The spectrum of analyses of a hematological laboratory comprises the counts of
      erythrocytes, leukocytes and platelets, the determinations of the hemoglobin
      concentration and of the hematocrit, the calculation of the red cell indices and
      the microscopic examination of the blood film. The determination of white blood
      cells, platelets, hematocrit and MCV as well as staining of the blood film should
      be performed within two hours after blood sampling. The hemoglobin concentration,
      red-cell count and MCH value remain constant for five days, provided that the
      blood samples is stored at 4 degrees C. The recognition of morphologically
      'minor' pathological findings is important in view of the possible clinical
      significance that they might have. In the case of thrombotic-thrombocytopenic
      purpura, for instance, it is very important that the fragmentocytes are
      recognized and recorded. The grading of pathological findings by use of +, ++, is
      based on strict limits of ranges. Quality control and quality assurance are
      integral parts of the daily laboratory performance; moreover, the importance of
      external quality control in morphological hematology is stressed as being a
      challenge to the hematological laboratory technologist.

PMID- 7770820
TI  - [Lipid status in the physician's laboratory].
AB  - Lipid analysis should be tailored to the likelihood of hyperlipidemia and
      atherosclerosis. In healthy individuals without a family history of
      hyperlipidemia, it is sufficient to obtain readings of total cholesterol and high
      density lipoprotein (HDL) cholesterol. In patients with a family history of
      hyperlipidemia, in addition, triglycerides should be measured. In patients with
      manifest atherosclerotic disease, the lipid profile should always include plasma
      cholesterol and triglycerides as well as HDL cholesterol; if these do not explain
      presence or extent of atherosclerosis, apolipoprotein (a) should be measured.
      Patients with diabetes mellitus should undergo the same diagnostic work-up as
      those with atherosclerotic disease. An apolipoprotein B reading (together with
      triglyceride levels) is sometimes helpful in patients with diabetes mellitus,
      allowing to estimate the size of triglyceride-rich lipoproteins. In patients with
      pancreatitis, longitudinal assessment of plasma triglycerides and, if available,
      measurement of HDL triglyceride are useful to unmask underlying hyperlipidemia.

PMID- 7770821
TI  - [Monitoring of coagulation status in the physician's laboratory].
AB  - The usual coagulation tests performed in the medical practitioner's office are
      the prothrombin time (PT) and, less frequently, the activated partial
      thromboplastin time (aPTT, PTT), PT and aPTT are used as screening tests for
      coagulation disorders and for the monitoring of oral anticoagulation or home
      treatment with unfractionated heparin, respectively. Considered a 'simple test',
      the PT requires important conditions to be fulfilled by the laboratory. The
      results expressed in seconds, as a ratio, as PT-index and in activity percentages
      depend on the PT method and its local adaptation. The only way to communicate the
      intensity of oral anticoagulation to other doctors, hospitals and countries is to
      convert the PT seconds into international normalized ratios (INR). This requires
      the determination of the mean normal prothrombin time by each laboratory and the
      knowledge of the appropriate international sensitivity index (ISI). Reference
      curves are needed for PT expression as activity percentages. The PT of capillary
      blood deserves special consideration. Test performance is guided by regular
      internal and external quality control procedures.

PMID- 7770822
TI  - [C-reactive protein or blood sedimentation reaction os preventive studies in the
      physician's laboratory?].
AB  - The laboratory examinations are more and more significant in the practical
      internal medicine. The results are basic for decision-making in medicine. The
      patients are asking for check-up examinations, including screening examinations
      in the laboratory. We try to compare the significance of two important laboratory
      tests. The C-reactive protein (CRP) is very sensitive and allows a graduation of
      the inflammatory reaction. It is useful to take the CRP in a valuable screening
      examination. Compared with the erythrocyte sedimentation rate (ESR), an elevated
      CRP always signifies an organic illness. A normal ESR has a poor predictive
      value. An elevated ESR supports only the history and the clinical findings of a
      suspected diagnoses. There is no possibility to screen patients without symptoms
      by ESR. We use ESR to follow-up diseases like arteritis temporalis and
      polymyalgia rheumatica and to measure the therapeutic effect.

PMID- 7770823
TI  - [Microbiological diagnosis in the clinical laboratory].
AB  - In general, microbiological diagnostic procedures in the practitioner's office
      are limited to direct detection of group A streptococci in throat swabs in
      patients with pharyngitis and to semiquantitative urine culture with Uricult or
      Urotube test kits in patients in whom urinary tract infection is suspected.
      Negative direct tests with throat swabs should be confirmed by culture in the
      clinical microbiology laboratory, as several test kits have only moderate
      sensitivity in detecting group-A beta-hemolytic streptococci and do not detect
      other groups of beta-hemolytic streptococci. The results of semiquantitative
      urine cultures should always be interpreted together with clinical data. Quality
      control procedures are necessary for the accurate performance of these tests, and
      an external quality assessment program will probably be introduced in the near
      future.

PMID- 7770824
TI  - [A memorandum at a milestone--memories, wormwood and joint responsibility].

PMID- 7770825
TI  - [Treatment of acute respiratory failure].

PMID- 7770826
TI  - [Not all people live in the same community--obligation to report infectious
      diseases].

PMID- 7770827
TI  - [Evaluation of the National Notification System for infectious diseases during an
      outbreak of Shigella epidemic in Norway 1994].
AB  - The National Notification System for Infectious Diseases, in Norwegian
      abbreviated to MSIS, registered 110 cases of Shigella sonnei-infection in persons
      with debut of symptoms during weeks 21 to 25, 1994, and where we did not receive
      information that the patients had been abroad. We evaluated the notification
      system during this outbreak of infectious disease by looking at delays in the
      notification process and estimating the proportion of patients who received an
      etiological diagnosis. It took a median time of seven days from onset of illness
      until a faecal specimen was obtained and a further ten days (maximum 15 days)
      until the result was registered in MSIS. The time lapse between receiving the
      specimen until MSIS had registered the result varied from six to 15 days among
      the laboratories which sent more than four notifications. In the summarical
      notification system we registered an increase of 712 cases (86%) of acute
      gastroenteritis compared with the same week the previous two years.

PMID- 7770828
TI  - [Use of a mask as an alternative to endotracheal intubation in acute respiratory
      failure].
AB  - Acute respiratory failure that is unresponsive to medical treatment requires
      ventilatory support. Non-invasive treatment with a nose or face mask is an
      alternative to endotracheal intubation in awake and cooperative patients. In
      patients with acute cardiogenic pulmonary oedema the application of continuous
      positive airway pressure (CPAP) increases cardiac output. CPAP-treatment is also
      effective in acute hypercapnic respiratory failure and oxygenation difficulties,
      but in these conditions pressure or volume-cycled positive pressure ventilation
      with a mask as an interface often has more to offer. The method reduces the need
      for endotracheal intubation and hence the time spent by the patient in the
      intensive care unit, but the need for personnel resources is equal. Possible
      clinical problems are skin erosions on the bridge of the nose due to pressure
      from the mask, and systemic hypotension.

PMID- 7770829
TI  - [Multiple sclerosis and prerequisites for driver's licence. A retrospective study
      of 33 patients with multiple sclerosis assessed at Sunnaas hospital].
AB  - There is increasing interest in assessing the prerequisites for a driver's
      licence among patients with traumatic brain injury, cerebrovascular accidents and
      other diseases of the central nervous system which cause cognitive impairments.
      In the present study, 33 patients with multiple sclerosis, 20 females and 13
      males of mean age 43 years, were medically and neuropsychologically examined, and
      some were assessed in a practical driving test. In total, 19 patients were
      allowed to drive and 14 were refused. Regression analysis showed that, when
      deciding for or against driving, cognitive and emotional deficits were given more
      weight than duration of illness and degree of neurologic deficit. The authors
      discuss guidelines for assessing the prerequisites for a driver's licence among
      patients with multiple sclerosis, and indicators for when assessment is
      warranted.

PMID- 7770830
TI  - [Bismuth. An old medicine of current interest].
AB  - Bismuth has been used to treat dyspepsia for more than a hundred years, and has
      now become an important element in the treatment of peptic ulcer disease. Less
      than 1% of ingested bismuth is absorbed in the gastrointestinal tract and is
      excreted in the urine. Bismuth forms a protective coating on the mucosa, it
      stimulates secretion of bicarbonate and has an effect on the G-cell and
      Helicobacter pylori. Bismuth gives equal ulcer healing rates as H2-receptor
      blocking agents, but causes significantly less relapses. Triple treatment with
      bismuth, tetracycline and metronidazole eradicates H pylori in 95% of patients.
      Bismuth accumulates in the body during treatment and is neurotoxic, and it cannot
      be excluded that even short-term treatment may cause subclinical damage to the
      central nervous system.

PMID- 7770831
TI  - [Diet and lipid status in pregnant women].
AB  - Pregnancy increases the requirement for nutrients and changes the metabolism of
      lipids and other compounds. We investigated the dietary composition and followed
      the changes in serum lipids during pregnancy among 20 women age 25-36 years. The
      women's diet was stable during pregnancy, but the intake of vitamin D, iron and
      fibre was lower than the national recommendations. Fat provided about 31% of the
      energy, saturated fat 12%. The total cholesterol concentration rose from 4.4 (95%
      confidence interval 4.2-4.6) to 7.0 mmol/l (6.5-7.5) (p < 0.0001) without changes
      in dietary composition. Even in this group of health-conscious, pregnant women
      the diet did not meet the national dietary recommendations. In addition, the
      composition of the fat in the diet was unfavourable. Optimal follow-up of
      pregnant women should include dietary counselling.

PMID- 7770832
TI  - [Clostridium difficile infection. The nosocomial aspect].
AB  - Clostridium difficile infection is discussed relatively rarely as a nosocomial
      problem in Norway. Epidemiological studies have shown Clostridium difficile
      diarrhoea to be frequently an antibiotica-associated nosocomial disease. We
      describe a material consisting of 22 patients with Clostridium difficile
      infection from a county hospital in Norway. The inclusion criteria were a
      clinical disease with diarrhoea and a positive test for Clostridium difficile
      toxin A and/or B in the faeces. 11 patients were or had been hospitalized for a
      short period in one specific medical ward when diagnosed. These and five other
      patients probably had a hospital-acquired Clostridium difficile infection. We
      discuss the nosocomial aspect and the clinical characteristics of the disease in
      our material.

PMID- 7770833
TI  - [Surgical treatment of symptomatic pancreas divisum].
AB  - Pancreas divisum is found in 5% of the population. It is linked to three clinical
      entities; recurrent epigastric pain, and acute and chronic pancreatitis. The
      relation between chronic pancreatitis and pancreas divisum is, however,
      uncertain. Pancreas divisum is controversial as a cause of acute pancreatitis and
      abdominal pain. However, this association probably exists as surgical
      sphincteroplasty of the minor papilla alleviate symptoms in a high proportion of
      patients. We have treated two patients surgically. Patient 1 was hospitalized 11
      times because of recurrent acute pancreatitis. Two and a half years after
      sphincteroplasty he has had no further attacks of abdominal pain. Patient 2 had
      had recurrent epigastric pain, mostly related to meals, since early childhood.
      Secretin stimulation initially showed normal pancreatic duct dilatation and
      emptying. After sphincteroplasty, and reoperation for stricture, she can eat
      normally without pain one year after the last operation. We conclude that in
      selected patients surgical treatment of symptomatic pancreas divisum is
      beneficial. Sphincteroplasty should be considered as treatment in patients with
      pancreas divisum and recurrent acute pancreatitis or pain, as long as other
      causes are excluded.

PMID- 7770835
TI  - [Learning and memory].
AB  - The ability to learn and to remember increases the adaptability of organisms. The
      article contains a brief survey of different types of learning and memory and of
      brain areas of particular importance for these functions. The lessons learnt from
      patient HM and a personal account of his appearance are given. Finally selected
      cellular and molecular models for learning and memory in lower and higher animals
      are briefly reviewed.

PMID- 7770834
TI  - [Clinical examination in general practice--a consulatation. Experiences after the
      first examination].
AB  - In 1994 the first examination in general practice was arranged for graduate
      students at the medical school in Bergen. The examination consisted of a written
      part, and an oral, clinical examination. We report some experiences and
      reflections concerning the latter. Patients with commonly occurring health
      disorders were recruited from the practices of internal and external examiners.
      The performance of the student was assessed according to the skills in respect of
      clinical issues, communication, consultation tasks, and theoretical matters. The
      correspondence between the assessment of different examinators was very good, and
      the marks were well distributed. The students' evaluation and our own experiences
      lead to the conclusion that this kind of examination seems to be suitable for
      differentiated testing of skills and knowledge in general practice.

PMID- 7770836
TI  - [Language disorders].
AB  - Language is the basis for acquisition and execution of communicative skills. The
      neurological structures underlying language can be localized through clinical
      pathological studies and neuroimaging studies. The classical language areas
      (Broca and Wernicke areas) are involved in lesions causing aphasia, and the main
      types of aphasia are motor (Broca), sensory (Wernicke), global and anomic
      aphasia. In stable lesions a negatively accelerated recovery curve is observed.
      Age and severity of aphasia are important prognostic factors. Treatment consists
      of broadly targeted language stimulation, but specialists services are important
      for assessment, education, and selection of patients for special forms of
      therapy.

PMID- 7770837
TI  - [Norwegian front fighters 1940-1945, 50 years later. Experiences, strains,
      medical and social conditions].
AB  - The author describes a medical and social investigation of 181 Norwegian war
      veterans who served on the Eastern Front during World War II. To ensure
      representativity, special emphasis is placed on 76 Norwegians in 1st Company,
      Regiment Norge, as listed in January 1944. They have been interviewed about
      hardships during war service in the civil war in Spain and until spring 1945,
      during captivity in Russia, in other Allied forces' camps and in Norwegian camps
      and prisons after the war. Their medical and social status from 1940 until today
      has been studied. The "front fighters" are a heavily strained group. This is best
      illustrated by their death rates during the war and in the first years after the
      war. However, as a group, they have more resources than the general population,
      and have done comparatively well since the war, in spite of physical and social
      handicaps.

PMID- 7770839
TI  - [EDTA in the treatment of arteriosclerosis].
AB  - EDTA has been used since the early fifties in the treatment of arteriosclerosis.
      There are few serious complications connected with using therapeutic doses of
      EDTA, although numerous side effects can arise. Several theories exist which
      suggest that the drug has a positive effect on atheromatous plaque; no such
      effect has been proven in vivo. Many papers claim to show the positive effect of
      EDTA on angina pectoris and intermittent claudication, but only one double blind
      placebo controlled experiment has been reported. In a sample of 153 claudicatio
      intermittens patients, no significant improvement in the distance walked nor in
      the ankle/brachial-index was proven, nor did the patients themselves notice any
      improvement. A professional investigation of the treatment, carried out by
      Norwegian Health Authority in 1981, concluded by advising Norwegian physicians
      not to recommend this kind of treatment for their patients. Since then, no
      clinical documentation of the effect of the treatment has become available. It
      must therefore be regarded as ethically unsound practice to start such treatment,
      unless as part of a clinically controlled experiment.

PMID- 7770838
TI  - [The Norwegian Medical Association under German control. Intrigues, the power
      game, the breakdown].
AB  - Norway was occupied by the Germans from April-May 1940 until May 1945. As from
      September 1940, Hitler decided to establish a civilian administration in Norway
      with the help of the collaborating party "Nasjonal Samling" (NS). NS quickly
      tried to gain control over the professional organizations, with the aim of
      legalizing the NS administration in the eyes of the Germans. They met great
      resistance, also at the Norwegian Medical Association. The legal executive
      committee refused to cooperate with the NS leadership, and 85% of the members
      left the Association in 1941. A strong secret resistance movement began among the
      doctors, and the strongly curtailed NS-controlled Medical Association attained no
      political influence during the war, and was finally reduced to an appendix of the
      Ministry.

PMID- 7770840
TI  - [A political prisoner in Norway and Germany 1941-1945. Experiences of a medical
      student].

PMID- 7770841
TI  - [SS physicians].

PMID- 7770842
TI  - [Use of results of unethical research--will the use ethically legitimise this
      research?].

PMID- 7770843
TI  - [Prevention is more difficult than treatment--and it is not easy to see its
      effect].

PMID- 7770844
TI  - [Unreasonable PR-campaign of the Norwegian Radium Hospital on the treatment of
      basalioma].

PMID- 7770845
TI  - [Smoking, risk and the Norwegians].

PMID- 7770846
TI  - [When should patients be admitted to hospital?].

PMID- 7770847
TI  - [Non-steroidal anti-inflammatory agents--are they used correctly?].

PMID- 7770848
TI  - [Epilepsy service. From individual to special care].

PMID- 7770849
TI  - [Children with asthma--does society respond to the challenge?].

PMID- 7770850
TI  - [To how much strain are families with asthmatic children exposed?].
AB  - Children with bronchial asthma may have coping problems which involve the whole
      family. The aim of this study was to find out what strain such families may
      experience. A questionnaire was sent to all children who, during a five year
      period, were registered as having a diagnosis of bronchial obstruction in the
      Department of Paediatrics, Innherred Hospital, Norway. The parents of a sample of
      the children were interviewed, and the parents of 42 children also answered a
      questionnaire about coping problems and strain. The results showed that the
      prevalence of coping problems and strain was low for these families at the time
      of the interview. Coping problems were greater during the first two years after
      asthma debut. Mothers felt more strain than the fathers during the two first
      years.

PMID- 7770851
TI  - [Should older patients be admitted for coronary evaluation and treatment? With
      special emphasis on a survey and catheter-based revascularization of patients
      over 70 years of age].
AB  - A three year survey of patients undergoing diagnostic left heart catheterization
      and PTCA treatment is presented from Feiringklinikken. Data on patients over and
      under 70 years have been analysed separately. The fraction of patients over 70
      years admitted for catheterization increased significantly from 18.8% to 23.4%
      during the survey period. Angiography was associated with a low mortality of
      0.04% and incidence of cerebrovascular complications with 0.1%, with no increased
      risk in patients over 70 years. The proportion of patients treated with PTCA
      increased significantly during the survey from 25% to 39% for patients over 70
      years and from 31% to 42% for patients under 70 years (p < 0.01). The initial
      success rate of PTCA was 89% and 92% for patients over and under 70 years
      respectively (not significant). The rate of serious complications was low in both
      age groups, 3.2% and 1.0% in patients over and under 70 years respectively (p <
      0.01). Older patients can be examined invasively with low risk of complications.
      A substantial number of patients, also among the elderly, can be treated safely
      with PTCA with good initial results. Thus, elderly patients should be offered the
      benefit of invasive diagnosis and treatment for coronary heart disease.

PMID- 7770852
TI  - [Celiac disease in the elderly].
AB  - Coeliac disease appears at all ages and increasing prevalence in advanced age has
      been reported. We registered and followed up all coeliac patients during an 11
      year period. The article describes the occurrence in elderly persons. Data were
      collected on symptomatology, laboratory test results, complications, dietary
      treatment, and progress. A total of 69 coeliacs were registered, giving a crude
      prevalence of 148/100,000. 13 patients (19%) were 65 years old or older at the
      time of diagnosis. Mean estimated diagnostic delay in this group was 21.5 years
      (range 5-40). The symptomatology was uncharacteristic in most patients and not
      dominated by malabsorption symptoms. Laboratory investigations were generally
      unhelpful for diagnosis. There was a high frequency of associated disorders,
      notably malignant diseases. Histology is a sine qua non in the diagnosis of
      coeliac disease, especially in elderly patients. Wide indications for biopsy are
      strongly recommended in this age group.

PMID- 7770853
TI  - [Malignant hyperthermia--still a current and dangerous problem].
AB  - Malignant hyperthermia is a potentially fatal condition inducible by volatile
      anaesthetics and/or suxamethonium in genetically susceptible individuals. A
      disturbed calcium homeostasis in skeletal muscle (possibly in the ryanodin
      receptor) results in elevated myoplasmatic calcium. The latter causes muscle
      contraction and a hypermetabolic state, clinically observed as rigidity, fever,
      hypercarbia, metabolic acidosis and hyperkalemia. Arythmia ensues. Dantrolene
      inhibits the release of calcium and can halt the process if the diagnosis is made
      early. A fatal incident of probable malignant hyperthermia in a 13 year old boy
      is described and evaluated according to a multifactorial clinical grading scale.
      The value of the in vitro contracture test to diagnose malignant hyperthermia is
      discussed. Suggestions concerning the treatment of masseterspasm rigidity, an
      acute episode of malignant hyperthermia, and safe anaesthesia for susceptible
      patients are presented.

PMID- 7770854
TI  - [Transfusion-associated graft-versus-host disease. Increased risk when using HLA
      matched donors].
AB  - For 30 years it has been known that immunodeficient patients can have a fatal
      reaction to transfused blood components containing viable lymphocytes. This risk
      of a transfusion-associated graft-versus-host reaction can be totally eliminated
      by irradiation of the blood prior to transfusion. Immunocompetent individuals can
      have this potentially fatal reaction if the blood donor is homozygous for one of
      the HLA-haplotypes of the recipient. The probability of this coincidence is low
      when donor and recipient are unrelated, but considerably higher when they are
      genetically related. When HLA-matched blood platelets are indicated for
      transfusing patients refractory to random platelets, the platelets must always be
      irradiated with minimum 25 Gy, since a large proportion of the donors will be
      homozygous with one of the HLA-haplotypes of the recipient.

PMID- 7770855
TI  - [Epilepsy].
AB  - Epilepsy is a common neurological disorder which affects about 30,000 persons in
      Norway. 10% of the population may have experienced a single seizure, most of them
      occurring as a febrile seizure in childhood. Specialists in neurology and
      pediatrics are responsible for the diagnostic procedures and treatment. However,
      most doctors will see patients with seizures. This must be recognized as a
      symptom with many causes, rather than as a specific kind of disease. The author
      briefly reviews diagnosis, classification and treatment, with special emphasis on
      aspects which may be of importance for the general practitioner.

PMID- 7770856
TI  - [Unusual intracranial infections].
AB  - The frequency of intracranial infections caused by microorganisms which have been
      uncommon in Norway is increasing. Contributing factors are travel, immigration
      and acquired immune deficiency, either as the result of disease or medical
      treatment. This article presents some of these infections, and also briefly
      reviews some other unusual infections which should be considered as differential
      diagnoses in unclear disease of the central nervous system.

PMID- 7770857
TI  - [What kind of information does the health services give to children with asthma
      and their parents?].
AB  - Good information to families who have children with bronchial asthma is essential
      for treatment and in helping the family to cope. The aim of this study was to
      find out what kind of information the parents meant they had received, their
      knowledge about asthma, and what sanitary measures had been taken at home. A
      questionnaire was sent to all children (N = 431) who, during a five year period,
      were entered into the records of the Department of Paediatrics, Innherred
      Hospital, Norway, with the diagnosis bronchial obstruction. A selected group of
      55 children and their parents were also interviewed. The results showed that the
      parents were not satisfied with the information they had received about the
      illness and about effects and side effects of the medication. Furthermore, their
      knowledge about these matters was not satisfactory, judged both by themselves and
      by the interviewer. It was more difficult to quit smoking or to stop keeping
      animals than to do extra cleaning at home. Few parents were informed about their
      possibilities of receiving financial support and about patient organisations.
      Only in a few cases did the health service provide the school with information on
      the child's disease.

PMID- 7770858
TI  - [Exchange of information between community and central health authorities.
      Development of an EDP system for information processing in the communities].
AB  - The Ministry of Health and Social Affairs has started a research program
      introducing information technology into the float of information between central
      and local authorities. The prospect is to make a better platform for statistics
      and planning. This article describes the process of designing a computer program
      designed to meet the needs of the local authorities. The result is a program that
      integrates sending and receiving of data with preparation of the local annual
      report. An evaluation revealed that the need of such computer tools and support
      is greatest in the small municipalities.

PMID- 7770859
TI  - [Confidentiality in HIV-infection/AIDS--a comment on the Communicable Disease
      Control Act].
AB  - The new Communicable Diseases Control Act has come into force in Norway. It makes
      it compulsory for a physician to warn a third party if it is obvious that a HIV
      positive patient, with a high degree of certainty, puts the third party at risk
      of being infected with HIV. Some philosophers characterize medical
      confidentiality as an intransigent and absolute obligation, others as a prima
      facie duty. This article supports the latter view, but the author still argues
      that strict conditions have to be fulfilled before a physician should consider
      breaking medical confidentiality: The doctor must try repeatedly to gain the
      consent or co-operation of the patient involved. Possible negative long-term
      consequences for the preventive HIV-work support strict medical confidentiality.

PMID- 7770860
TI  - [The first Norwegian physician in the USA? John M. Kalberlahn emigrated 70 years
      before Cleng Peerson].

PMID- 7770861
TI  - [Cooperation in health care services].

PMID- 7770862
TI  - [Alcohol--not good for the brain?].

PMID- 7770863
TI  - [Insomnia and hypnotics].

PMID- 7770864
TI  - [Do physicians know this about amalgam?].

PMID- 7770865
TI  - [Reporting adverse effects to the Reporting Center at the National Board of
      Health and Welfare].

PMID- 7770866
TI  - [Acting as a physician, even on a bad day].

PMID- 7770867
TI  - [Social inequality and health].

PMID- 7770868
TI  - [Use of organs of executed prisoners].

PMID- 7770869
TI  - [The prospects for using the new macrolide antibiotic azithromycin (Sumamed) in
      the combined treatment of periodontitis].
AB  - Antibacterial activity of sumamed, a macrolide antibiotic, in respect of
      anaerobic microflora of the oral cavity, such as Bacteroides, Prevotella,
      Porphyromonas, Fusobacterium, Peptostreptococcus, Str. sanguis and Staph. aureus,
      was assessed. The drug was found to be highly effective in respect of bacteroids
      (MPC90: 1,4 to 30 mg/mlMg/ml, this permitting the use of sumamed in the treatment
      of 9 patients with chronic generalized periodontitis in the exacerbation stage.
      Bacteriological and clinical control of the results of therapy demonstrated the
      drug efficacy in respect of periodontopathogenous flora, particularly as regards
      bacteroids and fusobacteria which maintain the inflammatory process in
      periodontitis.

PMID- 7770870
TI  - [The clinico-immunological characteristics of the course of recurrent aphthous
      stomatitis].
AB  - Clinical and laboratory examinations of 86 patients with relapsing aphthous
      stomatitis making use of a complex of clinical, immunological, cytochemical, and
      microbiological methods, helped specify the clinico-anamnestic features in the
      course of this disease. An immunobacterial concept of the pathogenesis of
      relapsing aphthous stomatitis has been formulated; according to this concept, the
      disease is initiated by disorders of T and B immunity system and nonspecific
      defense factors, leading to increase of the content and virulence of oral
      microflora, and thus stimulating the bacterial sensitization of the organism of
      patients with relapsing aphthous stomatitis.

PMID- 7770872
TI  - [The use of eiconol in the combined treatment of lichen ruber planus of the oral
      mucosa].
AB  - Clinical and laboratory examinations of patients with lichen ruber planus
      revealed diseases of the hepatobiliary system in 85%, pancreatic diseases in 29%,
      chronic gastritis with manifest secretory insufficiency in 32.5%, and fatty
      hepatosis in 17.5% of patients. Biochemical analysis of the peripheral blood in
      patients with the exudative hyperemic and erosive ulcerative forms of the disease
      revealed hypercholesterolemia and hypertriglyceridemia. Administration of eikonol
      in a dose of 6 g/day led to reduction of triglyceride level by 18% and of total
      cholesterol by 6%, the hypocholesterolemic and hypotriglyceridemic effect of the
      drug being more expressed in the patients with initially higher levels of these
      parameters. Eikonol therapy promoted an improvement in the clinical course of
      lichen planus. A positive time course of changes was observed in 69% of patients
      with the exudative hyperemic form of the disease (less expressed unpleasant
      subjective sensations, decrease of hyperemia of the buccal mucosa and of the size
      of foci of lesions, less pronounced papular pattern). In the group with the
      erosive ulcerative form of the disease only 18% of patients developed positive
      changes under the effect of therapy (epithelialization of erosions, attenuation
      of the inflammatory reaction, less expressed papular pattern). Combination of
      eikonol with applications of keratoplasties to the foci of lesions in patients
      with the erosive ulcerative condition brought about a better therapeutic effect,
      with the periods of epithelialization reducing by 7 to 10 days.

PMID- 7770871
TI  - [Experience in treating patients with lichen ruber planus by using a helium-neon
      laser].

PMID- 7770873
TI  - [Diphtheria of the oral mucosa].
AB  - High incidence of diphtheria became a pressing problem in recent years. The age
      structure of patients has changed. A specific feature of diphtheria in adults is
      a high share of toxic forms and a higher incidence of grave combined forms and
      rare localizations of the disease focus. The oral cavity proper is one of rare
      localizations of this infection. The authors examined 12 patients in whom the
      process was localized in various parts of the buccal mucosa: on the upper and
      lower lips, on the hard and soft palate, on the cheeks and tongue. Morphologic
      disturbances presenting as necrosis and inflammatory infiltration were detected
      in sites involved in the diphtheritic process. Changes whose manifestation was
      related to the diseases severity were found in zones adjacent to the foci. The
      authors come to a conclusion on a higher incidence of heretofore rare
      localizations of diphtheria than previously, this making difficult the diagnosis
      and treatment of the disease.

PMID- 7770874
TI  - [The use of the analgesic preparation Ketorol in the combined treatment of
      pulpitis and periodontitis].

PMID- 7770875
TI  - [Ways to prevent and treat disseminated inflammatory diseases of the
      maxillofacial area and their complications].
AB  - The authors analyze the results of diagnosis and treatment in 1062 patients with
      diffuse inflammatory diseases of the maxillofacial area and of complications of
      these diseases, such as mediastinitis, thrombosis of the cavernous sinus of the
      dura mater, meningoencephalitis. Improvement of the program of diagnosis and
      treatment helped improve the results: mortality from sepsis reduced from 50 to
      26%. Approaches to prevention of progressive purulent infection are outlined.

PMID- 7770877
TI  - [The use of immunoenzyme analysis for the diagnosis of an anaerobic infection of
      the maxillofacial area].
AB  - Solid-phase EIA was used to titer antibodies to polysaccharide and ultrasonic
      disintegrate antigens of the most incident agents of anaerobic infections of the
      maxillofacial area. Comparison of the results of EIA with polysaccharide antigens
      of B.melaninogenicus, B.asaccharolyticus, F.nucleatum, P.intermedius, and
      Str.sanguis and the results of bacteriological detection of these bacteria in a
      closed pyoinflammatory focus in 283 patients with maxillofacial abscesses and
      phlegmons brought the authors to a conclusion that the suggested EIA technique
      may be used to prove the contribution of these bacteria to the development of an
      inflammatory process in a patient. Data are presented on the frequency of
      detection of a diagnostically significant level of antibodies in patients with
      positive results of bacteriological investigation.

PMID- 7770876
TI  - [The complicated course of an acute inflammatory process: its early diagnosis and
      the treatment principles].

PMID- 7770878
TI  - [Changes in the permeability of pigmented mineralized dental tissues for
      carbonate and chlorine (radioisotope research)].

PMID- 7770879
TI  - [An analysis of the late treatment results in patients with odontogenic
      perforated maxillary sinusitis].
AB  - The authors analyze the results of sparing sinusotomy in 685 patients with
      chronic odontogenic perforative sinusitis. This effective method helped
      appreciably reduce the incidence of complications after surgical treatment of the
      said patient population.

PMID- 7770880
TI  - [Changes in the oral microflora under the influence of pulsed periodic CO2 laser
      radiation in operations on the jaw bones].
AB  - Effects of pulsed periodical laser exposure on oral microflora were studied.
      Bacterial growth was suppressed immediately after surgery if pulsed periodical
      CO2 laser was used. Later only quantitative changes in the bacterial composition
      were observed. Asepticism of laser radiation does not depend on the discreteness
      of laser beam, radiation frequency, pulse duration, but depended on the radiation
      power, exposure duration, and area of exposure.

PMID- 7770881
TI  - [The immune status of patients who have undergone reconstructive operations on
      the jaws using different types of transplants].
AB  - Lymphocyte subpopulations were studied in 18 patients by flow cytometry using
      monoclonal antibodies before and after surgical repair of the mandible with
      different transplants. All the transplants used had a stimulating effect on the
      immunity system. The most marked changes in the time course of immunologic
      parameters were observed after transplantation of frozen bone and formalin
      treated grafts.

PMID- 7770882
TI  - [Immunological and biochemical indices during the use of hyperbaric oxygenation
      for treating patients with jaw deformities].
AB  - Analysis of changes in immunological and biochemical parameters in patients
      operated on for congenital deformations of the jaw bones and improperly grown
      fractures showed that postoperative therapy including hyperbaric oxygenation
      sessions was conducive to increase of immunological reactivity in patients with
      initially reduced immunological reactivity. No changes in urinary excretion of
      hydroxyproline were observed in the patients with deformations of the jaws.

PMID- 7770883
TI  - [The prevention of intolerance for metal inclusions in the oral cavity].
AB  - The authors assessed the informative value of the Nakatani-ryodaraku and I.
      A.Lednev's methods of electroacupuncture diagnosis used to rule out the
      development of intolerance to metal inclusions in the oral cavity. Intratok and
      Eledia devices were used. Preliminary results are encouraging.

PMID- 7770884
TI  - [The determination of oral care habits by surveying the children of Russia and
      Finland].
AB  - Questionnaires were distributed among 1187 children aged 7, 9 and 12 living in
      Moscow, St. Petersburg, Helsinki and Kuopio and dental examinations of these
      children were carried out. Children together with their parents answered the
      questions concerning tooth cleaning, consumption of sweets, parents' education.
      Analysis of the results helped detect the population motivation to proper care of
      the oral cavity and time course of this motivation.

PMID- 7770885
TI  - [The immediate and late results of treating the teeth of children after trauma].
AB  - A total of 132 teeth were treated in 105 children and adolescents aged 4, 5 to
      15. All the patients were divided into 8 groups in accordance with the WHO
      classification; treatment policy and follow-up results over a period of 6 months
      to 5 years presented. Satisfactory remote results were attained in 91.8% of
      cases, in 4.9% complications occurred: pulp death and inflammatory processes,
      delayed formation of the roots of permanent teeth after a complete dislocation of
      deciduous ones. The authors enumerate the major components in comprehensive
      treatment providing the optimal conditions for formation of permanent teeth
      roots: removal of pulp irritation by special remineralizing dressings; splint
      application, if indicated; preservation of viability of at least the radical
      pulp, and in case of its death a timely removal thereof; creation of conditions
      for the tooth participation in mastication by replacing dental crown defects with
      fillings and dentures a month after injury.

PMID- 7770887
TI  - [Changes in the cranial bones in distal bite based on x-ray study data].

PMID- 7770886
TI  - [The effect of the implantation of calcium-phosphate materials on the healing
      process in a periodontal defect (an experimental study on monkeys)].
AB  - Experiments on 10 green monkeys were carried out to elucidate the effect of
      implantation of calcium phosphate materials on the course of healing of the
      periodontium after surgery. Periodontal defects were formed in the 654/456 area
      and filled with the implant on the right. The results were assessed two months
      later microscopically. The periodontium healed in both cases, but after
      implantation new bone formed at the site of the graft, cementogenesis and
      formation of new connective tissue adhesion were observed. The control sites
      healed with formation of cicatricial tissue.

PMID- 7770888
TI  - [An appliance for occlusion correction].

PMID- 7770889
TI  - [The organization of dental service under market conditions and insurance
      medicine].

PMID- 7770890
TI  - [A system of therapeutic, diagnostic and organizational measures in periodontal
      diseases].

PMID- 7770891
TI  - [The clinico-anatomical tasks in a course on general pathological anatomy in a
      dentistry department].

PMID- 7770892
TI  - [The characteristics of the development of caries in human dental fissures based
      on microhardness data. Its diagnosis, treatment and prevention].
AB  - Hygienic status of the teeth was assessed after Fyodorov-Volodkina and Green
      Vermillion in 500 patients aged 26 to 68 consulted for caries, chronic and acute
      periodontitis. A good hygienic status of the teeth was observed in 70 subjects:
      the Fyodorov-Volodkina hygienic index was 1, the Green-Vermillion index O. The
      Fyodorov-Volodkina index from 1,7 to 5 in 430 patients, depending on the hygienic
      habits. Patients whose hygienic index was still unsatisfactory despite special
      training, were subjected to hygienic treatment of teeth with a drill fitted with
      a modified toothbrush, using water suspension of tooth powder, zink oxide,
      phosphate cement powder, or tooth paste. Hygienic treatment of teeth by this
      method proved to be highly effective. The duration of the procedure is 3 to 5
      min.

PMID- 7770893
TI  - Curricula: already too comprehensive.

PMID- 7770894
TI  - Investigations using a novel monoclonal antibody to the
      glycosylphosphatidylinositol-anchored protein that carries Gregory, Holley, and
      Dombrock blood group antigens.
AB  - BACKGROUND: The high-frequency Hy and Gya antigens have been shown to reside on
      the same protein. Gy(a-) Hy-negative red cells are also Do(a-b-). A mouse
      monoclonal antibody, 5B10, was produced with specificity related to the human
      Gregory, Holley, and Dombrock blood group antigens. STUDY DESIGN AND METHODS: The
      antibody reacted in direct hemagglutination assays, and its specificity was
      investigated by radioimmunoassay, inhibition assay, and Western blotting.
      RESULTS: The 5B10 antibody failed to bind to abnormal paroxysmal nocturnal
      hemoglobinuria red cells and human erythroleukemia cell line K562, but it was
      weakly reactive with HEL cells. Red cells, but not other circulating
      hematopoietic cells, express the 5B10 antigen. The 5B10 antibody had a
      specificity similar but not identical to that of Gya. Gy(a-) Hy-negative red
      cells reacted extremely weakly with 5B10 antibody, but Gy(a-) Hy-negative red
      cells treated with a variety of proteases bound 5B10 antibody strongly. This
      suggests that these cells express a variant form of the protein recognized by
      5B10. CONCLUSION: Identification of a monoclonal antibody to this
      glycosylphosphatidylinositol-linked protein opens a new avenue for investigation
      of the biochemistry, genetics, and function of the glycosylphosphatidylinositol
      linked protein that bears the Gya, Hy, and Do antigens.

PMID- 7770895
TI  - A comprehensive transfusion medicine curriculum for medical students. Transfusion
      Medicine Academic Award Group.
AB  - BACKGROUND: The Transfusion Medicine Academic Awards (TMAA) program, sponsored by
      the National Heart, Lung, and Blood Institute, has provided grants to medical
      schools to help them develop comprehensive curricula in transfusion medicine. In
      1989, the TMAA Group published a set of comprehensive curricular goals for
      teaching transfusion medicine. The medical student portion of this curriculum has
      now been revised to reflect new developments in transfusion medicine and recent
      trends in medical school education. STUDY DESIGN AND METHODS: Two medical schools
      independently revised the 1989 curriculum for their students. Because significant
      similarities were noted between curricula of the two institutions, the two
      revisions were combined and submitted to all TMAA institutions for comment. As a
      result, a revised medical school curriculum was developed and approved by the
      TMAA Group. RESULTS: The revised curriculum consists of 28 objectives in six
      major areas of transfusion medicine. It is presented in its entirety in this
      article. CONCLUSION: The TMAA transfusion medicine curriculum should provide to
      medical schools a valuable resource for evaluating their teaching of transfusion
      medicine and should provide to medical school deans and curriculum committees an
      authoritative source of transfusion medicine expertise.

PMID- 7770896
TI  - Adverse reactions in blood donors with a history of seizures or epilepsy.
AB  - BACKGROUND: Individuals with epilepsy or seizure disorders are restricted from
      donating blood because of concern that they are prone to adverse donor reactions
      such as syncope and convulsions. A study evaluating whether that concern is
      warranted is reported. STUDY DESIGN AND METHODS: During a 2-year period beginning
      in 1987, blood donors in Maryland with a history of seizures were actively
      recruited by the American Red Cross. Adverse donor reactions were classified as
      "slight", indicating dizziness and nausea without loss of consciousness;
      "moderate," denoting syncope; and "severe," indicating convulsive syncope.
      RESULTS: There were 329,143 satisfactory blood donations; 613 individuals
      reporting a history of seizures donated blood a total of 723 times. Among donors
      with seizures, 186 (35.7%) were taking antiepileptic medication, and 61 (8.4%)
      had had one or more seizures in the preceding year. Individuals with seizures had
      a low incidence of adverse reactions (3.34%). Although this incidence was
      slightly higher than that in the entire population (2.24%), the difference was
      not significant. In particular, the risk of syncope with or without convulsive
      activity was low for people with seizures (0.21%) and not significantly greater
      than that in other donors (0.28%). CONCLUSION: Individuals with seizures or
      epilepsy are not at greater risk for adverse reactions after blood donation, and
      major restrictions on their participation as blood donors are not warranted.

PMID- 7770897
TI  - Hepatitis B surface antigenemia in blood donors following vaccination.
AB  - BACKGROUND: Detection of hepatitis B surface antigen (HBsAg) in recently
      vaccinated adults has not previously been reported. Transient detectable HBsAg
      has been observed in newborn infants immunized with a recombinant hepatitis B
      vaccine. STUDY DESIGN AND METHODS: Over a 1-year period, eight HBsAg-positive
      blood donors mentioned during donor notification that they had been vaccinated
      for hepatitis B virus 1 to 3 days before donation. Follow-up tests for HBsAg,
      antibodies to HBsAg, and antibodies to hepatitis B core antigen were performed 3
      to 37 weeks after immunization. Four months later, a group of 19 donors who were
      coworkers received hepatitis B vaccination and then donated blood the next day.
      The coworkers were observed for duration of antigenemia. RESULTS: A total of nine
      cases of transient, confirmed (neutralizable) antigenemia occurred in healthy
      individuals who donated blood 1 to 3 days following vaccination with a
      recombinant hepatitis B vaccine. Follow-up testing showed no evidence of
      infection by hepatitis B virus. One (5.3%) of 19 blood donors vaccinated as a
      group had antigenemia at Day 1 but not on Days 2 and 3 following immunization.
      CONCLUSION: Individuals recently vaccinated for hepatitis B may test positive for
      HBsAg and become permanently disqualified as blood donors. Therefore, blood
      collection centers should consider temporary deferral of potential donors who
      recently received hepatitis B vaccine.

PMID- 7770898
TI  - Low-oxygen-affinity red cells produced in a large-volume, continuous-flow
      electroporation system.
AB  - BACKGROUND: Human red cells containing inositol hexaphosphate (IHP) have a
      lowered O2 affinity, though they are able to bind and carry about the same amount
      of oxygen as native cells. These modified cells therefore deliver oxygen more
      efficiently to the tissues, which is a property of potential clinical utility.
      Investigators set out to devise a system and procedure by which large volumes of
      IHP-containing red cells, suitable for transfusion, could be produced quickly and
      efficiently. STUDY DESIGN AND METHODS: The encapsulation of IHP into human red
      cells by use of several variations of static electroporation was performed to
      define the conditions necessary for optimal IHP incorporation and cell survival.
      These conditions were used as a starting point for optimization of a flow
      electroporation system. RESULTS: When fresh human red cells in a 35 mM IHP
      solution are subjected to three exponential pulses of field strength of 2.98 +/-
      0.064 kV per cm per pulse and pulse length of 2.0 +/- 0.2 msec per pulse while
      flowing through a cooled electroporation chamber, the condition of the resultant
      cells, according to the criteria used here, is optimized. After storage for 24
      hours in plasma at 37 degrees C, the cells show more than 85-percent survival (in
      vitro) and hematologic indices nearly identical to those of unpulsed control
      cells. The p50 value of these cells, however, has doubled to 50.4 +/- 2.0 torr.
      The processing time for 1 unit of blood is 90 minutes. CONCLUSION: These data
      indicate that the system described here can efficiently produce low-oxygen
      affinity red cells in volumes that are useful in clinical applications.

PMID- 7770899
TI  - The effect of solvent/detergent-treated plasma on red cells stored in vitro.
AB  - BACKGROUND: The potential use of solvent/detergent-treated plasma (S/D plasma) in
      transfusion practice raises concerns about the cytolytic effects that any
      residual solvent and detergent in the virally inactivated blood component might
      have on units of red cells in vitro, if the two components are mixed during
      preparation. STUDY DESIGN AND METHODS: S/D plasma was mixed with variously
      processed units of stored red cells, in vitro, to evaluate the effect the
      residual solvent and detergent would have on cell membrane integrity. A paired
      protocol design was used in which half-units of red cells were exposed to S/D
      plasma (test), and the matched half-units were exposed to either the supernatant
      additive solution from the original red cell unit or standard fresh-frozen plasma
      (FFP) (control). After incubation for up to 5 days, the units were evaluated for
      evidence of hemolysis or changes in other red cell storage assays. RESULTS: This
      study showed that, for fresh additive solution red cells (AS-1), the 5-day
      storage plasma hemoglobin levels were comparable in the red cells exposed to S/D
      plasma (21 mg/dL) and in the paired half-units stored in the original AS-1
      supernatant (31 mg/dL) (p > 0.05). Similar findings were recorded for stored AS-1
      red cells (S/D plasma; 111 mg/dL vs. AS-1 supernatant, 147 mg/dL; p > 0.05);
      stored CPDA-1 red cells (S/D plasma, 133 mg/dL vs. FFP, 103 mg/dL; p > 0.05);
      frozen red cells (S/D plasma, 28 mg/dL vs. FFP, 18 mg/dL; p > 0.017); and stored
      irradiated AS-1 red cells (S/D plasma, 608 mg/dL vs. AS-1 supernatant, 726 mg/dL;
      p > 0.05). Comparable results were found for other assays, including levels of
      plasma potassium, osmotic fragility, and red cell antigen titer. CONCLUSION:
      These data show that S/D plasma does not induce red cell lysis even after 5 days
      of in vitro storage. These results are consistent with previous findings by this
      laboratory that platelets are not harmed by storage in S/D plasma. Red cells
      resuspended in S/D plasma and stored for up to 5 days maintain in vitro storage
      characteristics that are acceptable for the use of the cells in clinical
      transfusion practice.

PMID- 7770900
TI  - Collection of mobilized blood progenitor cells for hematopoietic rescue by large
      volume leukapheresis.
AB  - BACKGROUND: Mobilized blood progenitor cells rapidly reconstitute hematopoiesis
      in patients after dose-intensive chemotherapy. However, optimal timing and
      methods of mobilized blood progenitor cell collection have yet to be fully
      defined. STUDY DESIGN AND METHODS: The utility of large-volume leukapheresis
      (LVL; > 15 L blood processed) in collecting target doses of mononuclear cells (7
      x 10(8)/kg) for use in autologous hematopoietic rescue was investigated. LVL was
      begun at a standardized interval (14 days) after a course of limited chemotherapy
      and subsequent daily recombinant human granulocyte-macrophage-colony-stimulating
      factor administration to mobilize blood progenitor cells into the circulation.
      With each LVL procedure, mononuclear cells, colony-forming units-granulocyte
      macrophage (CFU-GM), burst-forming units-erythroid, mixed colonies, total
      clonogenic progenitor cells, and CD34+ cells collected per kg of patient weight
      were counted. After high-dose chemotherapy and infusion of cryopreserved
      mobilized blood progenitor cells, the days needed for neutrophils to reach levels
      of > 0.5 x 10(9) per L and for platelets to reach levels of > 20 x 10(9) per L
      were recorded. RESULTS: In 14 previously treated cancer patients, an average of
      28.9 +/- 4.9 L of blood was processed per LVL (n = 35) to collect medians of 2.5
      x 10(8) mononuclear cells per kg (range, 1.0-7.4), 14 x 10(4) CFU-GM per kg (0
      208), 27 x 10(4) clonogenic progenitor cells per kg (0-370), and 2.8 x 10(6)
      CD34+ cells per kg (0-112.5). Fifty-seven percent of patients (8/14) required one
      or two LVL procedures to collect adequate blood progenitor cells (range, 1-4).
      After dose-intensive chemotherapy, 13 patients received medians of 6.8 x 10(8)
      mononuclear cells per kg (range, 5.1-9.9), 53 x 10(4) CFU-GM per kg (9-208), and
      12 x 10(6) CD34+ cells per kg (3.6-112.5). Rapid hematopoietic reconstitution
      occurred with 10 days (range, 8-12) and 9 days (6-15), respectively, for
      neutrophil and platelet recoveries. CONCLUSION: Scheduled LVL, beginning on Day
      14 after the administration of granulocyte-macrophage-colony-stimulating factor
      following chemotherapy, is a convenient and efficient method of collecting blood
      progenitor cells. The mononuclear cells so obtained effected consistent and rapid
      hematopoietic reconstitution in a highly reproducible manner in a group of
      heavily treated patients.

PMID- 7770901
TI  - Prophylactic versus therapeutic platelet transfusion practices in hematology
      and/or oncology patients.
AB  - BACKGROUND: Platelet utilization has steadily increased throughout the past three
      decades. At the same time, there has been very little study of the current
      transfusion practices. STUDY DESIGN AND METHODS: A survey was conducted of
      institutional members of the American Association of Blood Banks (hospitals) that
      were actively involved in the care of pediatric and/or adult hematology and/or
      oncology patients. Inquiries were made relating to the extent of prophylactic
      versus therapeutic use of platelets, criteria used for prophylactic transfusion
      of platelets and type, and dose of platelets used. Data were analyzed according
      to patient age and type of hospital. RESULTS: Of 786 responding hospitals, 630
      (80.2%) provided sufficient data for analysis; 126 of that 630 provided care for
      pediatric patients. The majority (60.9%) of responding hospitals had a minimum of
      four hematologists and/or oncologists. Eighty-four percent of hospitals reported
      transfusing some apheresis platelets. The dose of platelet concentrates most
      frequently used for adults ranged from 6 to 10, with pools of 10 more commonly
      used in community hospitals. More than 70 percent of hospitals reported
      transfusing platelets primarily for prophylaxis: 60 percent of hospitals set the
      threshold platelet count for prophylactic platelet transfusion at 20,000 per
      microL, with approximately 20 percent each transfusing at higher and lower
      levels. A platelet count of 50,000 per microL was most frequently required for
      performance of a minor invasive procedure. CONCLUSION: The data from this study
      show that the majority of institutions use prophylactic platelet transfusion in
      both pediatric and adult hematology and/or oncology patients. However, there is
      considerable variation in platelet transfusion practice.

PMID- 7770902
TI  - Prevalence of antibodies to human T-lymphotropic virus types I and II in
      volunteer blood donors and high-risk groups in northwestern Greece.
AB  - BACKGROUND: In addition to human immunodeficiency virus, human T-lymphotropic
      virus types I and II (HTLV-I/II) is prevalent among blood donors in the United
      States. In Greece, there are no epidemiologic data regarding the prevalence of
      HTLV-I/II among volunteer blood donors and high-risk groups. STUDY DESIGN AND
      METHODS: To determine the prevalence of HTLV-I/II infections in northwestern
      Greece, a seroepidemiologic study was conducted among volunteer blood donors,
      multiply transfused patients, heroin addicts, and chronic hemodialysis patients.
      The subjects were tested for serologic evidence of HTLV-I/II infection by enzyme
      immunoassays and specific protein immunoblot confirmatory test. RESULTS: None of
      the volunteer blood donors and heroin addicts had detectable antibodies to HTLV
      I/II. Only 1 (1.45%) of the 69 multiply transfused patients had indeterminate
      results, while 2 (1.2%) of 163 hemodialysis patients were positive. CONCLUSION:
      In northwestern Greece, routine screening for HTLV-I and HTLV-II infections does
      not appear to be required. However, the finding of seropositivity among
      hemodialysis patients requires further evaluation of the origin of the infection,
      as its zero prevalence in this population seems to exclude transfusion
      transmission.

PMID- 7770903
TI  - Red cell alloimmunization after a bone allograft.
AB  - BACKGROUND: Alloimmunization to blood group antigens other than ABH after bone
      allografting is uncommon. To date, examples of alloimmunization to blood group
      antigens other than ABH have been limited to the Rh system. CASE REPORT: A 20
      year-old woman received an allogeneic bone graft following resection of an
      osteosarcoma. The patient had received no blood components and denied any
      pregnancies. Alloimmunization was detected and alloantibodies were identified by
      standard serologic techniques. Fourteen months after the bone graft, anti-Fya and
      anti-Jkb were identified in her serum. CONCLUSION: Alloimmunization to blood
      group antigens other than ABO and Rh may follow bone allografting.

PMID- 7770904
TI  - Vascular erosion caused by a double-lumen central venous catheter during
      therapeutic plasma exchange.
AB  - BACKGROUND: The use of large-bore double-lumen dialysis catheters has simplified
      the procedure of therapeutic plasma exchange, but these catheters are associated
      with unusual and possibly life-threatening complications. CASE REPORT: A 46-year
      old black man was admitted to the hospital with acute onset of paresthesia and
      weakness. A diagnosis of Guillain-Barre syndrome was made. Plasma exchange
      therapy was instituted by peripheral venous access. After three such exchanges, a
      double-lumen central venous catheter was placed via the left subclavian vein on
      hospital Day 7. The patient experienced a sudden onset of severe chest pain and
      dyspnea during the fourth plasma exchange. He became diaphoretic and hypotensive
      and experienced tachycardia. The apheresis procedure was stopped. Because of
      worsening respiratory distress, endotracheal intubation was performed. A chest x
      ray revealed a large right pleural effusion. The central venous catheter was
      removed. A chest tube was placed, and a large amount of bloody fluid was drained.
      Several days later, the endotracheal and chest tubes were removed. CONCLUSION: An
      unusual complication of the use of a central venous catheter, erosion of the
      superior vena cava, occurred during therapeutic plasma exchange. Prompt
      recognition of this complication and appropriate therapy can be life-saving.

PMID- 7770906
TI  - ISO 9000 quality standards: a model for blood banking?
AB  - The recent American Association of Blood Banks publications Quality Program and
      Quality Systems in the Blood Bank and Laboratory Environment, the FDA's draft
      guidelines, and recent changes in the GMP regulations all discuss the benefits of
      implementing quality systems in blood center and/or manufacturing operations.
      While the medical device GMPs in the United States have been rewritten to
      accommodate a quality system approach similar to ISO 9000, the Center for
      Biologics Evaluation and Research of the FDA is also beginning to make moves
      toward adopting "quality systems audits" as an inspection process rather than
      using the historical approach of record reviews. The approach is one of
      prevention of errors rather than detection after the fact (Tourault MA, oral
      communication, November 1994). The ISO 9000 series of standards is a quality
      system that has worldwide scope and can be applied in any industry or service.
      The use of such international standards in blood banking should raise the level
      of quality within an organization, among organizations on a regional level,
      within a country, and among nations on a worldwide basis. Whether an organization
      wishes to become registered to a voluntary standard or not, the use of such
      standards to become ISO 9000-compliant would be a move in the right direction and
      would be a positive sign to the regulatory authorities and the public that blood
      banking is making a visible effort to implement world-class quality systems in
      its operations. Implementation of quality system standards such as the ISO 9000
      series will provide an organized approach for blood banks and blood bank testing
      operations. With the continued trend toward consolidation and mergers, resulting
      in larger operational units with more complexity, quality systems will become
      even more important as the industry moves into the future.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7770905
TI  - Acute hemolytic transfusion reaction, a paradigm of the systemic inflammatory
      response: new insights into pathophysiology and treatment.

PMID- 7770908
TI  - Algorithms, coagulation monitoring, and transfusion practice.

PMID- 7770907
TI  - Autologous transfusion: current trends and research issues. National Heart, Lung,
      and Blood Institute Autologous Transfusion Symposium Working Group.
AB  - Dr. Toy concluded the meeting by summarizing the major controversial issues
      highlighted by the speakers. PABD PABD is, in principle, a safe and effective
      method for avoiding exposure to allogeneic blood in appropriate circumstances,
      and a substantial amount of clinical literature has been published to support its
      role. However, additional research is needed in the following areas: The optimal
      number of units that should be collected for specific surgical procedures to
      ensure maximum savings in use of allogenic blood and minimum wastage; The safety
      of PABD in patients, including a better understanding of which patients are at
      risk for complications, what the risks are, and what alternative collection
      strategies should be employed. Adequate control groups are needed in these
      studies; A definition of the transfusion trigger as it applies to autologous
      RBCs; An investigation of the role of rEPO in facilitating PABDs; The development
      of better collection logistics (e.g., double-unit collections) and storage
      protocols (e.g., improved additive solutions); and Additional studies of the
      costs associated with autologous blood collection and development of more cost
      effective strategies. Acute normovolemic hemodilution Much of the published
      literature related to hemodilution describes the concept and specific protocols;
      in contrast, relatively little clinical research relating to the efficacy of this
      technique exists.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7770909
TI  - Coiled-coil regions in the carboxy-terminal domains of dystrophin and related
      proteins: potentials for protein-protein interactions.

PMID- 7770910
TI  - Learning about DNA polymerase function by studying antimutator DNA polymerases.
AB  - Mutant bacteriophage T4 DNA polymerases exist that appear primarily to reduce the
      frequency of AT-to-GC transitions when this [antimutator' phenotype is assessed
      by genetic methods. This observation disagrees with in vitro studies, which
      indicate that T4 antimutator DNA polymerases have increased proofreading
      abilities and effectively edit all types of base substitution errors. One
      explanation that reconciles the apparent in vivo mutational specificity of
      antimutator DNA polymerases with their biochemical properties is that the in vivo
      mutational specificity identifies mismatched primer-termini that are corrected
      less efficiently by the wild-type level of proofreading activity, but are
      corrected if proofreading is increased.

PMID- 7770911
TI  - The eubacterial transcriptional activator Lrp is present in the archaeon
      Pyrococcus furiosus.

PMID- 7770912
TI  - A protein splice-junction motif in hedgehog family proteins.

PMID- 7770913
TI  - The SWI-SNF complex: a chromatin remodeling machine?
AB  - The SWI-SNF complex plays a key role in the regulation of eukaryotic gene
      expression. Genetic studies in the yeast Saccharomyces cerevisiae suggest that
      one role for the complex is to antagonize chromatin-mediated repression of
      transcription. Recent biochemical studies indicate that S. cerevisiae and
      putative human SWI-SNF complexes use the energy of ATP hydrolysis to disrupt
      nucleosome structure.

PMID- 7770914
TI  - Arf proteins: the membrane traffic police?
AB  - Cofactor for cholera toxin; activator of phospholipase D; regulator of coat
      protein assembly; inhibitor of membrane traffic; ability to cause expansion of
      the endoplasmic reticulum and vesiculation of the Golgi; sensitivity to membrane
      phospholipids--each of these activities has been attributed to Arf proteins. Can
      a single molecular mechanism link them all?

PMID- 7770915
TI  - G beta gamma interactions with PH domains and Ras-MAPK signaling pathways.
AB  - G-protein-coupled receptor signaling and receptor tyrosine kinase (RTK) signaling
      are two mechanisms of transmembrane communication used by numerous extracellular
      agents and stimuli. The beta gamma-subunit complex of G proteins mediates many of
      the functions associated with G-protein-coupled receptor signaling and may even
      provide a means to link G proteins to RTK-initiated cascades. This connection may
      be mediated by the pleckstrin homology domain, a modular domain found in many
      signaling proteins that interact with G beta gamma.

PMID- 7770916
TI  - The mechanisms of DNA topoisomerases.
AB  - Recent structural and mechanistic studies, as well as the discovery of new
      enzymes in the DNA topoisomerase family, allow these enzymes to be classified
      into three groups. Each group reflects the evolution of three different
      mechanistic strategies to manipulate DNA topology.

PMID- 7770918
TI  - Working on the assembly line.

PMID- 7770917
TI  - Caring for your hybridization membranes.
AB  - Methods and reagents is a unique monthly column that highlights current
      discussions in the newsgroup bionet.molbio.methds-reagnts, available on the
      Internet. This month's column discusses the time limitation for using nylon-based
      and nitrocellulose membranes for Southern hybridizations, and there are a few
      other helpful hints. For details on how to partake in the newsgroup, see the
      accompanying box.

PMID- 7770919
TI  - How I learned to stop worrying and love Cell.

PMID- 7770920
TI  - Donor-recipient microchimerism is not required for tolerance induction following
      recipient pretreatment with donor-specific transfusion and anti-CD4 antibody.
      Evidence of a clear role for short-term antigen persistence.
AB  - There is considerable current interest in the possibility that long-term graft
      acceptance in clinical solid-organ transplantation might be dependent upon the
      development of a microchimeric state between the donor and recipient. This
      possibility has been prompted by the observation that in some transplant patients
      cells of donor origin can be detected in peripheral sites such as the skin, and
      it has been proposed that these cells play an essential role in maintaining graft
      survival. The hypothesis that peripheral microchimerism is an absolute
      requirement for the long-term survival of solid-organ allografts was tested in a
      well-characterized model of transplantation tolerance in which adult recipient
      mice are pretreated 28 days before transplant with a single donor-specific
      transfusion under the cover of a depleting anti-CD4 antibody. Mice pretreated
      with this protocol accept donor-specific cardiac allografts (MST > 100 days) but
      reject those of a third party (MST 16.5 days). The protocol leads to operational
      tolerance in the long term in that donor-specific skin grafts show prolonged
      survival while those from a third party strain are rejected acutely. Since
      peripheral blood contains haematopoietic stem cells we speculated that the
      success of the anti-CD4/DST protocol might be dependent on the development of
      microchimerism. To address this possibility the DST was irradiated before
      administration under anti-CD4 antibody cover in order to prevent donor stem cells
      in the transfusion from establishing a microchimeric state in the recipient
      animals. Mice in this group rejected their grafts acutely (MST 12 days),
      suggesting indeed that stem cells might be very important in the success of this
      model. However, when the protocol was modified by giving three additional doses
      of irradiated whole blood to increase the possibility that recipient T cells
      would be engaged during antibody-induced immunocompromise, graft prolongation was
      restored (MST > 100 days). These results demonstrate that persistence of donor
      antigen at the time of anti-CD4 antibody treatment is critical for the induction
      of unresponsiveness in this model and show that microchimerism is not an absolute
      requirement for long-term graft survival.

PMID- 7770921
TI  - Split liver transplantation in Europe--1988 to 1993.
AB  - The shortage of liver grafts results in the fact that 8% of potential recipients
      die before receiving a graft. Liver graft division has therefore been proposed to
      maximize the current available liver graft pool. However, the question of benefit
      or additional risk for the recipient that this technique might carry remains
      unanswered. The European Split Liver Registry was opened in March 1993 and
      reviewed retrospectively the clinical experience obtained at nine European
      centers regarding the use of split liver transplants, during the five year period
      from March 1988 to March 1993. From 50 donor livers, 100 grafts were prepared: 2
      grafts were discarded and the other 98 were transplanted in 53 children (2 times
      in 3 children) and 42 adults (2/42 in heterotopic position). Sixty-three grafts
      were implanted in an urgent recipient (half of whom had acute hepatic failure).
      Portal vein thrombosis, hepatic artery thrombosis, biliary complications, and
      retransplantation rates were 4%, 11.5%, 18.7%, and 18.7%, respectively. Most of
      these complications were unrelated to the technique itself. Actual 6-month graft
      survivals of elective and urgent orthotopic transplants were 80% and 61.3% in
      children, and 72.2% and 55.6% in adults; actual 6-month patient survival rates
      for similar groupings were 88.9% and 61.1%, and 80% and 67.7%, respectively.
      Similar rates are reported after conventional transplants in Europe. It is
      concluded that split liver transplantation is an efficient transplant technique
      that benefits both urgent patients who otherwise could have died before getting a
      graft in time and elective patients.

PMID- 7770922
TI  - Xenotransplantation of porcine and bovine islets without immunosuppression using
      uncoated alginate microspheres.
AB  - Uncoated spherical hydrogel microspheres (calcium alginate, nominal M(r)
      exclusion of > 600 kD) 800-900 microns in diameter were employed to prevent
      immune rejection of discordant islet xenografts isolated from pigs and cows. The
      islets were immobilized in the microspheres and injected into the peritoneum of
      14 nonimmunosuppressed streptozotocin (STZ)-induced diabetic C57BL/6J mice. Four
      recipients received islet grafts from bovine calves, and 10 received islet grafts
      from pigs. In the control group of 15 diabetic mice implanted with
      nonencapsulated islets, 6 received i.p. porcine islets and 5 received i.p. bovine
      islets, whereas remaining 4 received porcine islets under the kidney capsule.
      Plasma glucose concentrations in recipients of the alginate-encapsulated islets
      promptly dropped from a preimplantation value of 498 +/- 47 (mean +/- SEM) to 142
      +/- 6 (bovine) and 178 +/- 7 mg/dl (porcine) during the first wk. All the animals
      sustained these levels for at least 1 mo. Two mice implanted with bovine islets
      subsequently reverted to diabetes (plasma glucose > 250 mg/dl) at 43 days
      postimplantation. The remaining grafts maintained function for > 10 wk. In
      contrast, nonencapsulated islets failed to function, or sustained euglycemia for
      < 4 days. Mice receiving encapsulated islets showed a 23-38% gain in body weight
      during the first mo after implantation, compared with < 1% (P < 0.002) and 32% (P
      = 0.84) for the untreated diabetic (n = 6) and normal control (n = 6) groups.
      Immunohistochemical staining of long-term grafts (> 10 wk) revealed viable
      islets, with well-granulated alpha, beta, and delta cells; the external surfaces
      of the microreactors were free of fibrotic overgrowth and exhibited only
      occasional host cell adherence. Uptake studies with IgG and thyroglobulin (M(r)
      of 669 kD) suggest that the microreactors were permeable to molecules with a
      molecular weight of up to > 600 kD (including the various proteins of the
      complement system, M(r) of 24-570 kD). Spheres implanted in the peritoneum after
      only 1 wk stained positive for both IgG and for the C3 component of complement.
      These findings suggest that prolonged survival of discordant xenografts of
      porcine and bovine islets in the STZ diabetic mouse model can be achieved with
      uncoated alginate microspheres that are permeable to IgG and complement. The
      question of whether similar results can be achieved with uncoated alginate
      microspheres in higher animals remains to be fully determined.

PMID- 7770923
TI  - Evidence that portal vein decompression improves survival of canine quarter
      orthotopic liver transplantation.
AB  - The minimum graft volume still remains unclear in reduced-size liver
      transplantation (RLT). This study reports the improved survival of canine RLT
      using a quarter graft with the aid of a portahepatic vein shunt (PHVS). In
      beagles, the donor liver was reduced to the right lateral and caudate lobes
      (quarter graft) with or without provision of PHVS, and transplanted
      orthotopically in the recipient. The PHVS was established by an end-to-end
      anastomosis of the portal vein branch and the hepatic vein in the resected left
      lateral lobe. Liver chemistries including arterial blood ketone body ratio (AKBR)
      were serially measured during and after surgery. All seven animals with PHVS
      survived more than 3 days (mean +/- SD; 5.3 +/- 1.7 days), whereas all six
      without PHVS died within 3 days (1.8 +/- 0.8 days, P < 0.01). Portal vein
      pressures immediately after recirculation in animals with and without PHVS were
      8.5 +/- 1.2 mmHg and 16.9 +/- 3.1 mmHg, respectively (P < 0.01). Regardless of
      the presence or absence of PHVS, AKBR dropped to a level lower than 0.7 during
      the anhepatic period and returned promptly to above 1.0 as early as 30 min after
      recirculation. Thereafter, the AKBR values in animals with PHVS remained higher
      than 1.0, whereas those in animals without PHVS showed a progressive decrease,
      showing a statistically significant difference between the two groups after 12 hr
      (P < 0.05). Graft function, as assessed by AKBR, was well correlated with
      survival and other liver chemistries. These results indicate that, in an extreme
      RLT, portal hypertension is a risk factor predisposing to graft failure, most
      likely by increasing microvascular injury after recirculation.

PMID- 7770924
TI  - Prevention of cancellous bone loss but persistence of renal bone disease despite
      normal 1,25 vitamin D levels two years after kidney transplantation.
AB  - Osteopenia has been observed to occur frequently after renal transplantation. The
      present study was undertaken to assess whether an immunosuppressive regimen
      combining cyclosporine with no or the lowest possible maintenance doses of
      glucocorticoid may prevent osteopenia after kidney transplantation. Thirty-four
      patients were prospectively followed for two years. Serial blood drawings were
      done for determination of serum indices of calcium and bone metabolism and an
      iliac crest bone biopsy was performed at time of transplantation. A second bone
      biopsy was done in 20 patients during the second year of observation. Creatinine
      clearance was 56 +/- 6 ml/min one year and 46 +/- 6 ml/min two years after
      transplantation. Serum parathyroid hormone levels were elevated in 24 patients at
      time of grafting, decreased significantly thereafter, but remained above the
      normal range. Ten patients had low or normal serum parathyroid hormone levels at
      time of transplantation and showed a significant increase after grafting. Two
      years after transplantation, the mean cumulative dose of prednisone was 5.9 +/-
      0.5 g. After the first six months, 30-40% of the patients were not on maintenance
      doses of steroids. None of the patients experienced fractures, and cancellous
      bone volume was within or above the normal range in all repeat bone biopsies. It
      is of note that metabolic bone abnormalities did not resolve 1-2 years after
      transplantation despite normalization of serum 1,25 vitamin D levels. The
      histologic abnormalities at the time were consistent with the bone findings in
      renal failure suggesting resistance of bone to normal circulating levels of 1,25
      vitamin D.

PMID- 7770925
TI  - Calcineurin activity is only partially inhibited in leukocytes of cyclosporine
      treated patients.
AB  - Measurement of the degree of immunosuppression induced clinically by drugs such
      as cyclosporine is an important but elusive goal. In lymphocytes in vitro,
      cyclosporine (CsA) blocks the phosphatase activity of the enzyme calcineurin,
      preventing cytokine induction. We sought to measure the degree of calcineurin
      blockade in patients on CsA. Calcineurin activity was measured in peripheral
      blood mononuclear cells (PBL) from stable CsA-treated renal transplant patients,
      compared with controls. Cytokine expression was assessed by challenging ex vivo
      PBL with calcium ionophore A23187 (5 microM) for 60 min and measuring interferon
      gamma (IFN-gamma) and interleukin 2 (IL-2) mRNA induction. In vitro, CsA
      inhibited both calcineurin activity and cytokine induction with an IC50 of 10-20
      micrograms/L. In CsA-treated patients with therapeutic CsA levels (mean trough
      CsA blood level = 180 +/- 55 micrograms/L), calcineurin activity was detectable
      but reduced by 50% compared with controls (P < or = 0.001) and correlated with
      CsA trough levels (r = -0.390, P < or = 0.01). The induction of cytokine mRNA in
      such patients was not blocked, but was sensitive to CsA in vitro, suggesting that
      CsA is much less available in vivo in body fluids than it is for isolated cells
      in vitro. In lymphocytes of patients on CsA, calcineurin activity is reduced but
      50% of the activity persists, permitting strong signals to trigger cytokine
      expression. Partial calcineurin inhibition may explain why the immune
      responsiveness of patients on CsA is reduced but still sufficient for host
      defense.

PMID- 7770926
TI  - The magnetic resonance renogram in renal transplant evaluation using dynamic
      contrast-enhanced MR imaging.
AB  - To assess the role of the dynamic gadolinium DTPA (Gd-DTPA) magnetic resonance
      (MR) renogram in differentiating various causes of renal allograft dysfunction,
      contrast-enhanced MR imaging studies were performed in 5 normal renal allografts,
      5 patients with acute rejection (AR), and 7 patients with cyclosporine
      nephrotoxicity. Time-versus-signal intensity (SI) curves were plotted. Normal
      renal allografts showed a rapid increase and slow decay, with a definite peak in
      cortical (CX) SI curves (peak mean signal intensity (Amax 338.6 +/- 46.5). The
      outer medullary (OM) (Amax 306.5 +/- 59) and inner medullary (IM) (Amax 263.4 +/-
      47.4) curves did not show a definite peak. The OM curve slowly reached a steady
      state and caught up with the CX curve. AR episodes were characterized by a
      blunted uprise and delayed peak of CX (Amax 180 +/- 70.9) and a low-amplitude
      vascular phase with a slow constant uprise of the inner medullary curve (Amax
      120.35 +/- 42.4). The OM signal intensity curve (Amax 150.73 +/- 78) failed to
      catch up with the CX curve. The maximum amplitude of SI curves in CsA-induced
      allograft dysfunction were low, with no definite peak, and CX, OM, and IM curves
      ran parallel to each other with a constant gap. Dynamic Gd-DTPA, MR imaging is a
      noninvasive technique that shows distinct characteristics in acute rejection,
      cyclosporine nephrotoxicity, and normally functioning renal allografts.

PMID- 7770927
TI  - An analysis of renal function in pancreas-kidney and diabetic kidney-alone
      recipients at two years following transplantation.
AB  - Pancreas-kidney recipients (SPK) are at higher risk for rejection than diabetic
      kidney-alone recipients (KA), and thus generally receive higher doses of
      maintenance immunosuppression. This has lead to concern that the potential
      benefits to renal function, brought about by posttransplant euglycemia, may be
      negated by the nephrotoxicity of immunosuppression. We therefore sought to
      compare patterns of renal function in diabetic patients following SPK and KA
      transplantation. Serum creatinine levels, corrected glomerular filtration rates
      (cGFR), and whole blood TDX cyclosporine levels were recorded on 25 SPK and 17 KA
      at 3, 6, 12, and 24 months posttransplant when patients were free of acute renal
      dysfunction. The SPK recipients had significantly higher cyclosporine levels at
      each of the measurement points as compared with the KA recipients (P < or = .01).
      In spite of these higher cyclosporine levels, the SPK recipients showed stable
      creatinine and cGFR levels throughout the study, as did the KA group until 24
      months. At 24 months, the KA group experienced a rise in creatinine from 1.3 +/-
      .09 ng/dl at 3 months to 1.6 +/- .07 ng/dl at 24 months (P < or = 0.006). Urine
      albumin excretion was examined at 24 months, and 6 of 8 KA patients found to have
      abnormally elevated levels compared with only 3 of 9 SPK patients. These findings
      indicate that SPK recipients experience stable renal function despite
      significantly higher cyclosporine levels, while KA recipients demonstrate early
      signs of deteriorating function at the 2-year follow-up.

PMID- 7770928
TI  - Reduced fibrinolytic potential one year after kidney transplantation.
      Relationship to long-term steroid treatment.
AB  - Thromboembolic complications constitute an important risk in renal transplant
      patients, in whom a hypercoagulable state is associated with immunosuppressive
      treatment, and the presence of hypercoagulability and hypofibrinolysis
      specifically with cyclosporine. Hypercorticism secondary to steroid treatment has
      been associated with a thrombophilic state and the presence of a reduced
      fibrinolytic potential in particular. The aims of this study were to first
      evaluate the fibrinolytic potential by the venous occlusion (VO) test in 19 renal
      transplant (RT) patients, and then compare these findings with those obtained in
      similar groups of normal subjects and patients with Cushing's disease. The
      following tests were carried out before and after the VO test: euglobulin lysis
      time and t-PA and PAI-1 activities and antigen. Compared with normal controls, RT
      and Cushing's patients both showed a similar significant increase in PAI-1
      activity and concentration. The VO test revealed a similar impairment in
      fibrinolytic potential in both the RT and Cushing groups. High and pathological
      PAI-1 levels before and after the VO test were consistent with a defective
      fibrinolytic potential due to the inhibitory effect of PAI-1 on plasminogen
      activation. A hypofibrinolytic state was found in 68.4% of RT patients. Our
      results suggest that an imbalance in the fibrinolytic system is a typical feature
      of RT patients one year after transplantation. Steroids appear to be the
      immunosuppressive drug mainly involved in determining thromboembolic risk after
      renal transplantation.

PMID- 7770929
TI  - Endocapillary glomerulitis in the renal allograft.
AB  - Endocapillary glomerulitis is characterized by an increase in number of
      mononuclear cells in the glomerular capillary lumina. This lesion has been
      described in the early posttransplant period, but its pathogenesis, relation to
      conventional rejection, and prognostic impact is not well known. Using the
      definitions, scorings, and gradings of the Banff system for classification and
      grading of histopathologic changes in the renal allograft, we have analyzed 444
      consecutive renal allograft biopsies from the first 90 days posttransplant.
      Moderate or severe glomerulitis occurred in 13.5% of the biopsies. There was a
      strong tendency toward clustering of glomerulitis: if one biopsy from a patient
      had glomerulitis, there was a high probability that it occurred in other biopsies
      from the same patient. There was some correlation with conventional acute
      rejection, but 40% of all biopsies with glomerulitis had no rejection and 53% of
      all biopsies with rejection had no glomerulitis. Graft function at biopsy was nil
      or decreased in many patients, but this could largely be explained by the
      independent presence of primary graft dysfunction or conventional rejection,
      these conditions being a frequent indication for performing a graft biopsy.
      Moderate or even severe glomerulitis was, however, compatible with a functioning
      graft. No correlation between glomerulitis and active CMV infection was found.
      The one-year graft survival of grafts with early posttransplant glomerulitis was
      66%. If early conventional acute rejection is taken into consideration, graft
      survival does not seem to be influenced by the presence of glomerulitis. Early
      posttransplant endocapillary glomerulitis may be a peculiar pattern of rejection
      with a pathogenesis different from that of conventional rejection, but the
      present investigation does not demonstrate any adverse effects on graft function
      or graft prognosis.

PMID- 7770931
TI  - Red cell alloantibody development associated with heart and lung transplantation.
AB  - The development and persistence of clinically significant red cell alloantibodies
      were studied in 1132 patients who underwent a heart and/or lung transplant at
      Harefield Hospital. Clinically significant antibodies were detected in 15
      patients (1.3%) preoperatively and appeared in a further 15 (2.1%) of 704
      patients followed up 1-404 weeks after surgery. Anti-D developed in only 1 of 52
      D-negative recipients of a D-positive donor graft and in only 2 of 6 D-negative
      patients who were transfused with between 6 and 32 units of D-positive red cells.
      Most antibodies that appeared after transplantation remained detectable for only
      a few weeks. Antibodies detected preoperatively that reacted only with papain
      treated cells became persistently undetectable in 4 patients who were transfused
      with red cells expressing the corresponding antigen specificity. By contrast,
      antibodies detected preoperatively by indirect antiglobulin test were still
      detectable after periods of up to 260 weeks in 4 patients who received only
      antigen-negative red cells. Immunosuppressive therapy appeared to profoundly
      affect the natural history of red cell alloantibody production in these patients.
      The underlying mechanisms warrant further study.

PMID- 7770930
TI  - Treatment of chronic hepatitis C with recombinant interferon alpha in kidney
      transplant recipients.
AB  - Chronic hepatitis C is a common cause of viral liver disease in kidney transplant
      (KT) recipients. To assess the efficacy and safety of therapy with interferon
      alpha we conducted a prospective study where 14 cadaveric KT recipients with
      chronic hepatitis C received recombinant interferon alpha-2b (IFNa) 3 million
      units three times weekly (scheduled) for 6 months (group A). 14 KT recipients
      with chronic hepatitis C were not treated and served as controls for the study
      period (group B). All the patients in both groups had had stable renal function
      for at least one year. All patients in both groups had a positive HCV viremia at
      the beginning of the study. Patients of group A were treated for 142 +/- 34.8
      days (range 65-168); elevated serum aminotransferase (ALT) levels decreased
      rapidly and significantly from 100.3 +/- 48.9 to 37.7 +/- 13.9 IU/L (P = 0.001);
      10 patients (77%) were "responders," whereas the others experienced a decrease in
      ALT values but without reaching the normal ranges. With a mean follow-up of
      twelve months after discontinuation of IFNa therapy, 8 responders--i.e., 80%-
      relapsed within 1-20 weeks. Only 4 patients had no detectable HCV viremia at the
      end of the IFNa; two of them already have abnormal values of ALT. Moreover HCV
      viremia was present in all patients one month after the cessation of IFNa
      treatment. Side effects of IFNa (fatigue, anorexia, weight loss) were frequent,
      and 3 patients decided to drop out of the treatment. The hematological tolerance
      was good although there was a significant decrease in hemoglobin (11.9 +/- 1.7
      vs. 13.4 +/- 1.7 g/dl; P = 0.0044). In group B, serum ALT levels did not
      significantly decrease (84.2 +/- 47.6 vs. 105.2 +/- 68.8 IU/L). At the end of the
      study period serum ALT levels were significantly lower in group A than in group B
      (37.7 +/- 13.9 vs. 84.2 +/- 47.6 IU/L, P = 0.013). The major concern in group A
      was the occurrence of 5 renal failures. Kidney transplant biopsies showed edema,
      no significant tubulitis, scarcely scattered interstitial inflammatory cellular
      infiltration, and mesangial thickening. Four patients received methylprednisolone
      pulses but renal function improved in only two cases. We were not able to
      discover predictive factors of renal failure. We conclude that IFNa therapy is
      effective in controlling disease activity--i.e., reducing amino-transferase
      levels in KT patients with chronic hepatitis C, although relapse and detection of
      HCV RNA after the cessation of treatment were observed, respectively, in 80% and
      100% of patients.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7770932
TI  - Immunohistochemical analysis of T cell phenotypes in patients with graft-versus
      host disease following allogeneic bone marrow transplantation.
AB  - Allogeneic bone marrow transplantation has become the therapy of choice in many
      cases of hematologic malignancy. In both matched related donor transplants--and,
      to a greater degree, in unrelated donor transplant situations--a major
      complication of the procedure is GVHD. This problem is caused by mature T cells
      in the graft, which also facilitate engraftment, and mediate an antitumor effect
      to reduce relapse. In order to further characterize the T cells that are present
      at the GVHD site of injury, we have studied 134 fresh tissue biopsies using
      immunohistochemical methods from 50 consecutive ABMT recipients clinically
      suspected of having acute GVHD. Antibodies specific for T cells, T cell receptor
      subsets, B cells, and NK cells were used to characterize the lymphocytic
      infiltrate in the biopsy tissue from GVHD patients. The data showed that the
      majority of lymphocytes that had infiltrated the epithelium or epidermis were
      CD3+ T cells. Using antibodies that distinguished the alpha/beta (beta F1) from
      the gamma/delta TCR (TCR delta 1)-expressing T cells, we observed that the
      lymphocytic infiltrates from involved tissues of the gastrointestinal tract,
      skin, and liver are almost exclusively derived from the alpha/beta expressing T
      cell subset, and are of the memory cell subset of T cells (CD45RO). This is in
      contrast to some examples from other disease states, in which a significant
      proportion of the lymphocytes that infiltrate the epidermal layers are of the
      gamma/delta type.

PMID- 7770933
TI  - Bone marrow cell transplants involving donors and hosts with haplotypes derived
      from spretus mice.
AB  - Intra-H2 recombinant inbred mice derived from matings between B10 (H2b) and
      B10.SP2 (H2sp2) mice, with an H2 haplotype derived from Mus spretus, have been
      used to map genes at H2. Recombinants 10115, 10484, R40, 9347, and 9950 were used
      as donors or hosts in bone marrow cell (BMC) transplants in irradiated mice. From
      previous studies of Mus musculus mice, the antigens (Ag) on BMC appear to be
      inherited recessively. The mechanisms offered include codominant inheritance of
      transacting genes that regulate expression of BMC Ag (Hh hypothesis) and
      codominant inheritance of class I Ag motifs capable of sending "negative signals"
      to effector natural killer (NK) cells (missing self hypothesis). Our results
      indicate that stem cell donors that express the same class I Ag, but differ at
      genes between Bat2 and Tnfa in the H2-S/D interval, can differ in immunogenicity
      of transplanted stem cells. The structural gene for the H2sp2 Ag appears to map
      telomeric of Bat2 and is codominantly inherited. An H2b gene capable of
      inhibiting expression of the H2sp2 Ag (or contributing to class I motifs capable
      of inhibiting NK cell mediated lysis of H2sp2 BMC) maps in the Bat2/Tnfa gene
      segment, but requires homozygosity for this function and may require the H2-Db
      gene as well. Although H2sp2 hosts reject H2b BMC, hosts (10115, 10484, R40, and
      9347 strain) that are H2b in the centromeric, and H2sp2 in the telomeric, portion
      of H2 accept H2b BMC grafts. These two observations have not been made with
      haplotypes entirely of Mus musculus origin. The data do not support the Hh
      hypothesis, and are consistent with the missing self hypothesis only if the gene
      (requiring homozygozity for function) in the Bat2/Tnfa region codes for a
      particular protein or peptide that associates with Db to generate a "protective
      motif."

PMID- 7770934
TI  - A technique for porcine hepatocyte harvest and description of differentiated
      metabolic functions in static culture.
AB  - Current bioartificial liver devices are based on the use of a large mass of
      hepatocytes exhibiting differentiated metabolic function. The pig has become a
      source of interest for the acquisition of such cells-however, harvesting a large
      mass of highly viable cells has met with difficulty. This study describes a
      technique for harvesting large quantities of hepatocytes at viabilities greater
      than 90% and also describes several features documenting differentiated function.
      Pigs, 6 to 10 kg body weight, underwent in situ two-step whole liver perfusion
      (ethylene glycol tetraacetic acid and collagenase) and ex vivo cell harvest.
      Harvests yielded an average of 19.5 billion cells with an average viability of
      94.6%. Hepatocytes were then entrapped in type I collagen (3 x 10(5) cells/well)
      and cultured in serum-free media for 5 days. Pig hepatocytes produced stable
      amounts of albumin and maintained cytochrome P-450 and glucuronidation activity
      over 5 days, as shown by the metabolism of lidocaine and 4-methylumbelliferone.
      These data indicate that pig hepatocytes can be harvested with high yields and
      can retain viability and differentiated function over at least 5 days of culture,
      and therefore should prove to be an excellent source of hepatocytes for
      bioartificial liver devices.

PMID- 7770935
TI  - Insulin action in previously diabetic rats receiving graded numbers of islets of
      Langerhans.
AB  - We characterized insulin sensitivity in islet transplanted rats receiving from
      500 to 3000 islets. Male Wistar Furth rats made previously diabetic with
      streptozotocin (55 mg/kg) were infused intraportally with islets of Langerhans
      (500 islets: n = 8; 1000: n = 6; 2000: n = 6; 3000: n = 5) from syngeneic donors
      and compared with sham-operated controls (n = 7). At four weeks after islet
      transplantation, fasting blood glucose was not significantly different between
      groups (500: 5.1 +/- 0.3; 1000: 4.8 +/- 0.3; 2000: 5.1 +/- 0.3; 3000: 4.6 +/-
      0.1; control: 4.7 +/- 0.2 mM; P = 0.6146), and fasting plasma insulin was also
      not different (P = 0.28). The acute insulin response to glucose (0.3 g/kg i.v.)
      was correlated with islet equivalent mass (r = 0.63, P = 0.004; transplant rats
      only); islet transplant animals presented a range of acute insulin secretion from
      3 to 90% of control values. Insulin action was measured in vivo in fasted,
      conscious animals during a hyperinsulinemic-euglycemic glucose clamp with insulin
      infused at 29 and 72 nmol/kg/min. Despite a wide range of islet mass and insulin
      secretory capacity, there was no significant difference in the glucose infusion
      rate between islet groups at either insulin level (P = 0.8211, P = 0.8021). There
      was also no difference in the glucose infusion rate normalized to the prevailing
      insulin level (P = 0.1638, P = 0.2302). Thus, our results demonstrate that the
      islet transplanted rat is consistent with other animal studies and human studies
      illustrating that a diminished insulin secretion does not necessarily precipitate
      insulin resistance.

PMID- 7770936
TI  - In vivo soluble tumor necrosis factor receptor release in OKT3-treated patients.
      Differential regulation of TNF-sR55 and TNF-sR75.
AB  - Administration of monoclonal antibodies to CD3 triggers acute and massive release
      of several cytokines, including tumor necrosis factor alpha (TNF-alpha),
      essentially T cell-derived. This cytokine release is responsible for the
      spontaneously reversible acute clinical syndrome observed in most OKT3-treated
      patients. We found that the first OKT3 injection in human renal allograft
      recipients led to the release in significant amounts of soluble TNF receptors
      (TNF-sR55 and TNF-sR75) that are considered main natural inhibitors of TNF
      bioactivity. As for OKT3-induced TNF-alpha, peak TNF-sR levels were observed 1 hr
      postinjection, and this release was limited to the first monoclonal antibody
      injection. A distinct regulation of OKT3-mediated release of TNF-sR75 and TNF
      sR55 was observed, since (1) in clear contrast with OKT3-mediated TNF-sR75
      induction, TNF-sR55 release was completely blocked by a high dose of
      corticosteroids prior to OKT3 injection and (2) secretion of TNF-sR75 but not TNF
      sR55 correlated with immunoreactive TNF-alpha release. In hemodialyzed patients
      prior to transplantation and OKT3 treatment, a condition characterized by chronic
      TNF-alpha release, TNF-sR efficiently block TNF bioactivity. In contrast, the
      system is overwhelmed by the massive acute TNF-alpha release that follows the
      first OKT3 injection: in such a condition TNF-sR looses its capacity to
      counteract TNF bioactivity.

PMID- 7770937
TI  - DLA-identical marrow grafts after low-dose total-body irradiation. Addition of
      viable donor peripheral blood mononuclear cells does not enhance engraftment.

PMID- 7770938
TI  - Site-specific immune suppression with topical cyclosporine. Synergism with
      combined topical corticosteroid added during the maintenance phase.

PMID- 7770939
TI  - A simple method for transplanting discordant islets into rats using alginate gel
      spheres.

PMID- 7770940
TI  - Progressive plexogenic pulmonary hypertension following liver transplantation.

PMID- 7770941
TI  - Liver transplantation in a child with sickle cell anemia.

PMID- 7770942
TI  - Malakoplakia in the gastrointestinal tract of a liver transplant recipient.

PMID- 7770943
TI  - Xenotransplantation of UV-B-irradiated hepatocytes. Survival and immune response.

PMID- 7770945
TI  - Pros and cons of the hyperfiltration theory in human renal transplantation.

PMID- 7770944
TI  - Retention of endocrine function in the SCID-Hu pancreas mouse--a model for the
      development of human fetal islet tissue.

PMID- 7770946
TI  - Effect of stocking rates and anthelminthic treatments on weight gains in weaned
      Nellore cattle on improved pasture in the Brazilian cerrado.
AB  - The results are presented of 6 years of field trials with weaned Nellore cattle
      on improved pasture in the midwest of Brazil, using 2 stocking rates and 4
      anthelminthic treatment regimes. The most profitable regime included treatments
      in May, June and September, which yielded an additional 41 and 42 kg of
      liveweight on the 2 stocking rates. No significant additional gains were obtained
      by treating during the rainy season, or by treating animals more than 24 months
      of age. The higher stocking rate (1.8 AU/ha) proved excessive on the improved
      pasture which deteriorated during the 6 year experimental period, yielding
      suboptimal liveweight gains.

PMID- 7770947
TI  - Theileria parva carrier state in naturally infected and artificially immunised
      cattle.
AB  - Rhipicephalus appendiculatus adult ticks, collected in the field from zebu (Bos
      indicus) and exotic (Bos tarus) cattle with high antibody titres to Theileria
      parva schizont antigen, transmitted Theileria parva infection typical of East
      Coast fever to susceptible cattle. Uninfected R. appendiculatus nymphs applied to
      naturally recovered zebu and exotic cattle kept under tick-free conditions in the
      laboratory for 16 and 7 months respectively, transmitted fatal theileriosis to
      susceptible cattle. Cattle immunised by the infection and treatment method were
      shown to be carriers of Theileria parva by examination of the salivary glands of
      ticks applied to them and by tick transmission. Three and 7 months after
      immunisation, Theileria parva infected lymphocytes were established in vitro from
      peripheral blood lymphocytes. This was the first demonstration, in vitro, of the
      existence of schizonts in Theileria parva (East Coast fever) infection carrier
      status. These studies show that cattle from endemic and epidemic areas of East
      Coast fever (ECF) become carriers thereby maintaining the T. parva population.
      The relevance of the findings in this study to the control of ECF by dipping,
      immunisation and treatment is discussed.

PMID- 7770948
TI  - Humoral antibody response in animals infected with virulent rinderpest virus.
AB  - Humoral antibody responses in cattle or rabbits infected with virulent rinderpest
      virus or lapinised rinderpest virus respectively were assessed. Rinderpest
      specific antibodies could be first detected 6 days post-infection. No correlation
      could be established between antibody response and the course of the disease in
      infected animals during the early stages of infection. The animals with fatal
      infection either did not respond or had a transient antibody response. A gradual
      increase in antibody titre from 7 days post-infection was observed in animals
      which ultimately recovered.

PMID- 7770949
TI  - An outbreak of bacillary haemoglobinuria in sheep in India.
AB  - An outbreak of bacillary haemoglobinuria was recorded in 60 out of 110 sheep in
      Ludhiana, Punjab, India. The condition was clinically characterised by fever,
      haemoglobinuria, constipation, weakness of hind quarters followed by recumbency,
      respiratory distress and death in 16 sheep. Haematological studies revealed
      moderate to severe degrees of anaemia associated with leucocytosis. Plasma gamma
      glutamyl transferase, alkaline phosphatase and creatinine phosphokinase
      activities were significantly higher in haemoglobinuric sheep. Babesiosis and
      copper poisoning were ruled out on stained blood film examination and from blood
      mineral profiles, respectively. Post-mortem examination of affected sheep
      revealed no gross changes. Pure cultures of Clostridium haemolyticum isolated
      from heart blood, liver, kidney and spleen of freshly killed sheep confirmed the
      disease. Parenteral administration of procaine penicillin was effective in the
      treatment of affected sheep.

PMID- 7770950
TI  - Isolation of multiple serotypes of bluetongue virus from sentinel livestock in
      Malaysia.
AB  - Sixteen isolations of bluetongue virus (BTV) were made from the heparinised
      bloods of 4 groups of cattle and sheep in Peninsular Malaysia. These viruses were
      typed as BTV serotypes 1, 2, 3, 9, 16 and 23. Multiple serotypes of BTV are
      apparently endemic in Malaysia and in other countries in the region.

PMID- 7770951
TI  - Reverse passive haemagglutination test in the diagnosis of infectious bursal
      disease.
AB  - The reverse passive haemagglutination test (RPHA) was used to detect infectious
      bursal disease (IBD) virus antigen in various organs of experimentally infected
      chickens and field cases. The results of RPHA were compared with those of agar
      gel immunodiffusion (AGID) and latex agglutination (LAT) tests. IBD antigen was
      detected in 86.4%, 80.4% and 80.5% of different organs by RHPA, LAT and AGID
      respectively. Although the differences are not statistically significant, the LAT
      is recommended because of cost and speed of obtaining results.

PMID- 7770952
TI  - Infectious bursal disease in 14-week-old turkeys in Nigeria.

PMID- 7770954
TI  - Sedentarisation of cattle farmers in the derived savannah region of south-west
      Nigeria: results of a survey.
AB  - The aim of this study was to assess the process and extent of sedentarisation
      among Fulani cattle owners in the derived savannah zone of south-west Nigeria.
      The results, based on a survey of 66 randomly-selected cattle owners, indicate an
      on-going process of settlement. Previously cattle owners visited the zone for dry
      season grazing but an increasing number were found to be settling and becoming
      mixed livestock/crop farmers. Generally herd sizes were larger among recent
      settlers but with longer duration of settlement and with cattle rearers'
      involvement in crop production, the herds became less mobile between seasons and
      herd size decreased and the proportion of farms with mixed zebu/trypanotolerant
      cattle herds increased. There was also evidence that some indigenous Yoruba crop
      farmers were becoming mixed farmers by purchasing cattle, hiring Fulani herdsmen
      for management, then taking up the management themselves.

PMID- 7770953
TI  - Milk yield of Chios-Ossimi crossbred ewes in relation to the yield of the
      parental breeds.
AB  - A study was carried out at Mallawi Research Station, 300 km south of Cairo, in
      which 16 Chios (CC), 31 Ossimi (OO) and 21 of their F1 crossbred ewes (50% Chios-
      50% Ossimi (CO)). The CO crossbred ewes were mated to CC rams, whereas OO and CC
      ewes were mated to rams of the same breeds. The study included only ewes having
      single lambs in 2 lambing seasons; summer and winter. In the summer, total 8-week
      milk yield (suckling period) averaged 128.9, 53.4 and 77.1 kg in CC, OO and the
      crossbred ewes, respectively (P < 0.01). Total milk yield averaged 201.6, 65.0
      and 110.2 and days of lactation were 151.1, 79.6 and 106.7, respectively (P <
      0.01). In the winter, total 8-week milk yield averaged 138.6 (P < 0.01), 55.0 and
      59.5 kg for CC, OO and the crossbred ewes, respectively. Total yield averaged
      209.1 (P < 0.01), 65.9 and 76.5 kg and days of lactation were 153.3, 79.8 and
      93.4, respectively (P < 0.01).

PMID- 7770956
TI  - [XXIIIm Maghrebin Medical Congress. Tunis, 9-11 May 1994. Abstracts].

PMID- 7770955
TI  - Trypanosomosis and reproduction: II. Effect of Trypanosoma vivax infection on
      pregnancy and post-partum cyclicity in ewes.
AB  - The effect of infection with Trypanosoma vivax on pregnancy and post-partum
      cyclicity in ewes was investigated. Of the 5 ewes infected in the first
      trimester, 3 died without aborting and 2 after aborting. Intrauterine infection
      occurred in 2 of the foetuses removed at post mortem. Of the 5 infected in the
      third trimester, one ewe died without aborting, one lambed prematurely and 3 at
      term. Intrauterine infection occurred in one of the lambs born at term. None of
      the lambs were viable. The termination of pregnancy may be as a result of stress.
      The ewes infected in the third trimester commenced irregular cyclicity 13 to 23
      days post partum.

PMID- 7770957
TI  - Electron microscopic studies of peripheral blood mononuclear cells in chronic
      type C hepatitis treated with interferon-alpha.
AB  - Electron microscopic studies of peripheral blood mononuclear cells (PBMC) in
      chronic type C hepatitis revealed several interesting structures after interferon
      alpha (IFN-alpha) therapy. Fifteen of 20 patients were treated with IFN-alpha.
      Tubuloreticular inclusions (TRI) were observed in only one patient who did not
      receive therapy. In contrast, TRI were observed in 10 of 15 (66.7%) patients who
      underwent the therapy for 2 weeks to 6 months. Cylindric confronting cisternae
      (CCC) were identified in the cytoplasm of PBMC in 4 of 16 (25%) patients who
      underwent the therapy. CCC were found only after IFN-alpha therapy. The
      appearance of both TRI and CCC in the PBMC was significantly correlated to IFN
      alpha therapy. Although there is little evidence about the morphogenesis of TRI
      and CCC, these structures may be a host response to IFN-alpha induced by
      hepatitis C virus infection.

PMID- 7770958
TI  - Intestinal spirochetosis and acquired immunodeficiency syndrome: ultrastructural
      studies of two cases.
AB  - Two cases of intestinal spirochetosis (IS) with acquired immunodeficiency
      syndrome are reported. In case 1, a 48-year-old homosexual black man presented
      with a 1-month history of alternating watery diarrhea and constipation, which
      dissipated following the removal of two colonic hyperplastic polyps containing
      IS. In case 2, a 26-year-old homosexual black man presented with a 3-month
      history of persistent bloody diarrhea and was found to have chronic shigellosis
      and IS. Pathologic findings of IS were similar in both cases. Basophilic fringes
      typical of IS covered the surfacing colonic epithelium and consisted of dense
      growths of spirochetes adherent to and oriented perpendicular to the plasma
      membranes of the surfacing epithelium. The spirochetes measured 3 to 5 microns in
      length and 0.2 micron in width, contained four to eight axial fibrils, and
      closely resembled Brachyspira aalborgi ultrastructurally. These cases are notable
      because the histopathologic changes of IS were more extensive than generally
      described. There was involvement of both the right colon and rectum by IS in case
      2, and in both cases there was extension of the IS down into the crypts of
      Lieberkuhn, spirochetal invasion of the colonic mucosa, and a conspicuous
      inflammatory response by macrophages in the underlying lamina propria.

PMID- 7770959
TI  - Ultrastructural pathology of Gerstmann-Straussler-Scheinker disease.
AB  - We report a detailed ultrastructural study based on a large series of samples
      from a recent case of Gerstmann-Straussler-Scheinker disease from the original
      Austrian family. Numerous PrP-immunopositive plaques dominated light microscopic
      neuropathology. Ultrastructurally, several types of plaques were observed:
      unicentric "kuru," multicentric, and neuritic. Dystrophic neurites accompanied
      amyloid plaques to differing degrees. Plaques were enveloped by astrocytic
      processes and invaded by microglial cells. A prominent astrocytic reaction
      accompanied abundant spongiform change. Unusual crystalloids were observed in
      mitochondria while another type of crystalloid was seen within lysosomes. We
      conclude that Gerstmann-Straussler-Scheinker disease is distinct also at the
      ultrastructural level.

PMID- 7770960
TI  - Immunolocalization of cellular fibronectins in the normal liver, cirrhosis, and
      hepatocellular carcinoma.
AB  - Cellular (c) fibronectins (Fn) differ biochemically, immunologically, and
      functionally from plasma fibronectins (pFn). Most existing data on Fn
      distribution in the normal and diseased liver require revision because those
      studies were based on reagents that did not distinguish pFn from cFn and predated
      the development of specific cFn monoclonal antibodies (Mabs). We immunostained
      cryosections of normal adult livers (n = 5), cirrhotic livers (n = 20), and
      livers with hepatocellular carcinoma (HCC) (n = 10) by the avidin-biotin-complex
      method with specific Mabs to the extradomains A and B (EDA, EDB) and oncofetal
      (Onc) isoforms of cFn. Selected samples were stained with an antiserum to pFn;
      fetal livers served as controls. Normal and cirrhotic livers showed EDA-cFn
      staining in the portal, septal, and perisinusoidal matrix; its distribution was
      more restricted than that of pFn. In cirrhosis, EDA-cFn reactions were strongest
      at sites of piecemeal necrosis and around proliferating ductules in biliary
      cirrhosis. EDA-cFn reactions were consistently most intense in the matrix of HCC.
      Distinct from adult normal and cirrhotic livers, reactions for EDB- and Onc-cFn
      were noted exclusively in most cases of HCC. We conclude that the only cFn
      isoform indigenous to the normal adult liver matrix is EDA-cFn. Enhanced EDA-cFn
      in cirrhotic livers may serve as indicator of active stromal remodeling. The
      restriction of EDB- and Onc-cFn to a large subset of HCC and the putative role of
      cFn in modulating cell-matrix adhesive interactions would suggest that the
      emergence of these molecules may be related to the variably invasive and
      metastatic properties of these tumors.

PMID- 7770961
TI  - "Aberrant elastic" in elastofibroma: an immunohistochemical and ultrastructural
      study.
AB  - Elastofibroma is a rare lesion characterized by the presence of abundant abnormal
      elastic fibers with a unique morphology, fibroblastic proliferation, and collagen
      deposition. Whether the altered morphology of the elastic fibers is a
      degenerative phenomenon or is due to abnormal elastogenesis is controversial. We
      studied fetal skin and three cases of elastofibroma by light microscopy and
      immunohistochemistry using an antibody to lysozyme, and one case of elastofibroma
      by electron microscopy (EM). Our previous studies have shown that normal elastic
      fibers in adult skin do not stain for lysozyme whereas abnormal elastic fibers in
      solar elastosis and pseudoxanthoma elasticum react positively for lysozyme. In
      the fetal skin and all three cases of elastofibroma the elastic fibers were
      negative for lysozyme. EM showed the abnormal flowerlike configuration of the
      elastic fibers, which consisted of a central core of normal or degenerating
      elastin surrounded by radiating spokes of granular and filamentous material of
      variable electron densities, suggesting that the structure and organization of
      the microfibrils is abnormal. The absence of lysozyme in the aberrant elastic did
      not differentiate whether there was excessive production of fetal or adult
      elastic. However, the excessive amount of microfibrils seen at the
      ultrastructural level suggests that there may be excessive fetal elastic
      production. The elastic fibers were intimately related to the fibroblasts and
      were often present within their caveolae, suggesting that the abnormal elastic
      fibers are produced by the fibroblast. Our study suggests that abnormal
      elastogenesis with subsequent degeneration plays a role in the production of the
      abnormal elastic fibers in elastofibroma.

PMID- 7770962
TI  - Ultrastructural localization of Helix pomatia agglutinin (HPA)-binding sites in
      human breast cancer cell lines and characterization of HPA-binding glycoproteins
      by western blotting.
AB  - Ultrastructurally, cells of five human breast cancer cell lines (MCF7, BT549,
      BT20, T47D, and HBL100) generally displayed many characteristics of their
      epithelial origin. The most distinctive features were observed in MCF7 cells,
      which consistently showed microvilli and submembranous granules. These
      ultrastructural findings served as a basis for localizing the binding sites of
      the lectin Helix pomatia agglutinin (HPA). After use of the pre-embedding method
      consistent HPA labeling of the cell membrane was obtained in all the cell lines,
      and in association with microvilli and submembranous granules in the MCF7 cells.
      The HBL 100 cells were not labeled by HPA irrespective of the method used. In
      addition, lysates from these cell lines were subjected to polyacrylamide gel
      electrophoresis and Western blotting with HPA to analyze these binding sites
      further. In the Western blots, however, lysates of JBL100 cells, in common with
      all those from the other cell lines, revealed a number of HPA-reactive bands,
      indicating the greater sensitivity of Western blots compared with the
      histochemical preparation. The principal band was of approximately 90 kDa, and it
      was suggested that this could be related to the transferrin receptor.

PMID- 7770966
TI  - [Community psychiatry--is it functioning?].

PMID- 7770964
TI  - Proliferating thymolipoma: ultrastructural, immunohistochemical, and
      flowcytometric study.
AB  - A superior-anterior mediastinal tumor was excised from a 50-year-old man. The 207
      g mass was encapsulated and multilobulated. It contained adipose tissue and
      abnormal thymic tissue. In some areas the thymic tissue was characterized by
      cords and nests of epithelial cells lying within either the adipose tissue or a
      myxoid matrix. Other areas were characterized by cortical thymic tissue with
      increased numbers of epithelial cells. Foci of normal medullary tissue were
      present. The prominent epithelial cells were immunoreactive for cytokeratin and
      nonimmunoreactive for vimentin, S-100, chromogranin, and parathyroid hormone.
      Flow cytometry showed that the lymphocyte populations were consistent with a late
      cortical thymic phenotype. The tumor was diploid. By electron microscopy, the
      prominent epithelial cells had desmosomes and a few tonofilaments. The cytoplasm
      contained additional organelles including mitochondria, polyribosomes, and
      occasional lysosomes. Nuclei were oval and had relatively smooth contours,
      prominent nucleoli, and moderate quantities of heterochromatin. Basal lamina was
      present around many nests and cords of cells. This is the first such study of a
      tumor with this histology.

PMID- 7770963
TI  - Divergent differentiative histogenetic lines in lung tumors: identification of
      histotypes with pure or mixed ultrastructural phenotype and their prognostic
      significance.
AB  - We performed an electron microscopic study of 50 lung tumors, previously
      diagnosed by light microscopy, and compared the results of the two techniques.
      Data analysis identified two ultrastructural phenotypes: pure and mixed. The
      former was characterized by a constant differentiative pattern and the latter by
      diverging differentiative histogenetic lines. We observed six differentiative
      lines as follows: squamous, glandular, neuroendocrine, villopodial, intestinal,
      and apocrine sudoriparous. Features of divergent differentiative lines were
      observed in 36 cases (64%), throughout the histotypes, sometimes with
      coexpression of more than one differentiation in a single case and/or cell.
      Adenocarcinoma was the histotype most frequently observed in pure form whereas
      most squamous cell carcinomas showed a mixed phenotype. This suggests that the
      histotype of the different lung tumors arises from a single glandular pluripotent
      cell, able to differentiate toward divergent differentiative lines. The clinical
      stage at onset and at the end of the follow-up indicates that the biologic
      behavior of lung tumors varies according to whether the ultrastructural phenotype
      is pure or mixed.

PMID- 7770965
TI  - Heterogeneity of acute myeloblastic leukemia without maturation: an
      ultrastructural study.
AB  - We demonstrated by ultrastructural examination that the leukemic blasts of 13
      patients with acute myeloblastic leukemia (AML) without maturation (M1 in the
      French-American-British classification) showed heterogeneous features. In 7
      patients, the leukemic blasts had a high level of light microscopic
      myeloperoxidase positivity (> 50%). Ultrastructurally, the cells were myeloblast
      promyelocytes with 100% myeloperoxidase positivity, and these 7 patients appeared
      to have typical AML. In contrast, the remaining 6 patients had leukemic blasts
      with a low myeloperoxidase positivity (< 50%) and heterogeneous features. Three
      had ultrastructural features of myelomonocytic or monocytic lineage, 1 had
      myelomonocytic cells associated with megakaryoblasts, and 1 had undifferentiated
      blasts. The former group had a better prognosis than the latter, indicating that
      ultrastructural analysis of M1 leukemia may help predict the response to therapy.

PMID- 7770967
TI  - [Community psychiatry in Copenhagen. Referrals during the first four years].
AB  - The purpose was to estimate the number of referrals and patients, referral
      source, problems, diagnoses, demographic data and treatment offered in a
      community mental health centre. All referrals were systematically registered for
      statistical purposes. The referral rate stabilised at around 11 promille, point
      prevalence about 13 promille and one year prevalence above 20 promille. The
      centre was able to offer treatment to the majority of the patients referred.
      General practice referred about half of the patients, a quarter were self
      referred and one sixth each came from the social welfare services and the
      hospital. The number of patients referred from each GP varied considerably. As
      seen in other community mental health centres, patients with non-psychotic
      illness (2/3) and women (2/3) were in the majority. The older age groups were
      under-represented, and the social situation among the patients was worse than the
      general level in the district. It is concluded that a community mental health
      centre can fulfil the need for psychiatric treatment in an area and at the same
      time have the chronic psychotic patients as the priority group.

PMID- 7770968
TI  - [Renal side-effects of intraoperative and postoperative pain treatment with non
      steroidal anti-inflammatory drugs].
AB  - Non-steroidal anti-inflammatory drugs (NSAID) are now commonly used in the
      treatment of postoperative pain. In normovolaemic conditions, prostaglandins do
      not seem to play a substantial role in maintaining renal function. However,
      numerous studies have shown that during activation of vasoconstrictor systems the
      synthesis of renal prostaglandins counteracts the vasoconstrictor effects and
      thereby maintains renal function. In animals, renal blood flow and GFR are
      markedly decreased when an NSAID is administered in the presence of renal
      hypoperfusion. Major surgery decreases renal function secondary to stimulation of
      the adrenosympathetic system and the renin-angiotensin system, and it has
      previously been demonstrated that maintenance of renal blood flow during
      laparotomy in dogs depends on an intact prostaglandin synthesis. Perioperative
      effects of NSAIDs are only sparsely investigated in humans, and studies on the
      effect on renal haemodynamics have not been presented. As in unanaesthetized
      volunteers, NSAID have been found to decrease the postoperative excretion of
      water, sodium and potassium. It therefore still remains unclarified whether
      general anaesthesia and surgery increase the risk of renal side effects of
      NSAIDs. Because of the potential risk of peri- and postoperative complications
      that may further deteriorate renal function, NSAIDs should not be used
      preoperatively, and not in patients in unstable haemodynamic states.

PMID- 7770969
TI  - [Hereditary optic nerve atrophy. A clinical-genealogical status over Danish
      families with Leber disease].
AB  - An update on Leber's hereditary optic neuropathy (LHON) in Denmark disclosed 32
      families with at least one live affected member, or recent disease onset (Table
      1). Mitochondrial DNA analysis in the 30 families available for blood sampling
      identified the pathogenic mutation in all of them: ND4/11778 (26 families),
      ND1/3460 (three families), and ND6/14484 (one family). A previous distinct male
      dominance (sex ratio 4.6:1 in 157 ND4-patients with onset before 1968) seems to
      level (sex ratio 2.6:1 in 69 ND4-patients with onset in 1968 or later). Among
      possible explanations, we discuss improved diagnostic abilities and possible
      changes in women's alcohol consumption and smoking habits.

PMID- 7770970
TI  - [The effect of a three-year trial of a community dental care program for aged
      pensioners in Denmark].
AB  - Recently, one Danish municipality established a programme of systematic dental
      care free of charge to citizens 67 through 70 years of age. The old-age
      pensioners were offered care according to the principles of the Danish Municipal
      Dental Service, including comprehensive curative and preventive care as well as
      oral health education. The present report describes the results achieved after
      three years of the programme in terms of changes in oral health status, oral
      health behaviour, and life-quality. Longitudinal data were collected for
      evaluation. Personal interviews were conducted at baseline (n = 216) and at
      follow-up (n = 235), comprising participants in the municipal programme as well
      as non-participants. Moreover, clinical follow-up data of participants were
      provided (n = 187, at follow-up). At base-line, 46% of all respondents had
      regular dental visits at least once a year and the proportion increased to 86% at
      the follow-up. A total of 75% participated in the municipal programme and the
      self-assessment of dental health improved significantly over time. The percentage
      of participants who reported poor function of dentures declined and, at follow
      up, less of the elderly felt embarrassed by teeth or preferred food that was easy
      to chew. The changes in self-reported oral health status were supported
      clinically by a reduction both in the number of untreated decayed tooth surfaces
      and in the number of teeth with gingival bleeding and pockets. Finally, gradually
      more attenders of the municipal service showed frequent oral hygiene habits and
      positive attitudes to oral health.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7770971
TI  - [Quality of data on computerized registration of postoperative wound infections].
AB  - At the Department of General Surgery, Hillerod Hospital, the quality of data from
      a continuous registration of post-operative wound infection was evaluated. Data
      registered over a six-month period were compared with data available in
      caserecords and data from a questionnaire sent to the patients. During the period
      1.2-31.7.1990 924 operations were registered in 864 patients. Eight hundred and
      ninety-five patient records could be traced and 770 questionnaires were sent. The
      remaining 125 were dead or had unknown addresses. Six hundred eighty-seven
      questionnaires were returned. The data-registered overall infection rate was
      3.0%. The actual infection rate was 8.9%. Fifty-eight percent of the infections
      noted in the records were registered. Approximately 40% of the infections were
      diagnosed and treated in general practice only. It is concluded that in order to
      compare infection rates between departments, it is necessary to ensure that equal
      definitions and equal quality of the data are used. Strict routines in the
      department and a close contact to the general practitioners are essential to
      achieve a satisfactory quality of data.

PMID- 7770972
TI  - [Plasma total cholesterol, high density lipoprotein-cholesterol and triglycerides
      as risk factors for cerebrovascular diseases. A 12-year follow-up by the Osterbro
      survey].
AB  - The aim of this study was to estimate the effect of plasma total cholesterol, HDL
      cholesterol and triglycerides on risk of cerebrovascular disease. The Copenhagen
      City Heart Study is a prospective population study with 14.223 and 12.411
      participants in first (1976-78) and second (1981-83) examination, respectively,
      where plasma lipids were measured along with other variables. Acute
      cerebrovascular cases were recorded during 12-year follow-up and the associations
      between lipid levels and risk of cerebrovascular disease were estimated using the
      Cox regression model. Significantly increased risk of ischaemic cerebrovascular
      disease was associated with: total cholesterol levels > 8 mmol/l, decreasing HDL
      cholesterol, and increasing triglyceride levels. The association with HDL
      cholesterol and triglycerides was log-linear and relative risks (95% confidence
      intervals) corresponding to increase by 1 mmol/l were: 0.53 (0.34-0.83) and 1.12
      (1.07-1.16), respectively. The relative risk for total cholesterol < or = 8
      mmol/l was constant (non log-linear association). These associations did not vary
      significantly between women and men.

PMID- 7770974
TI  - [Subcutaneous fat necrosis of the newborn].
AB  - Subcutaneous fat necrosis (SFN) of the newborn is an uncommon disorder, which
      occurs during the first years of life, and has been attributed to perinatal
      stress. Two typical cases are presented. This inflammatory disorder of adipose
      tissue affects primarily the back, buttocks, arms and thighs, and consists of
      sharply circumscribed, subcutaneous nodules and plaques. The lesions are red or
      violaceous and initially tender. Usually they involute spontaneously within
      months. Hypercalcemia, hypotonia, poor feeding, vomiting and fever are associated
      with SFN. The aetiology is still incompletely understood. Therapy is not
      required, except when associated with hypercalcemia.

PMID- 7770973
TI  - [Sensitivity of farmers to swine protein].

PMID- 7770975
TI  - [Meta-analysis of magnesium therapy in myocardial infarction].

PMID- 7770976
TI  - [Cancer morbidity among alcoholics].

PMID- 7770977
TI  - [Sperm bank--a public task?].

PMID- 7770978
TI  - [Water, health and Vibrionaceae infections].

PMID- 7770979
TI  - [Psychosocial development of children with physical disabilities. Experiences
      from a Nordic study of 527 children with myelomeningocele].
AB  - Data from a Nordic study on children with meningomyelocele (MMC), aged 4-18
      years, are related to studies on the social and personal situation of children
      with physical disabilities. The data were collected in 1984 from medical records
      and by means of a postal questionnaire. In total 527 children with MMC and 7792
      control children were included; the parents of the latter answered the same
      questionnaire as the former. As many as 80% of the children with MMC were
      integrated in ordinary school classes. However they had fewer friends and were
      less active outside home than children in general. Children with MMC need to
      develop autonomy and independence of their parents, especially with regard to
      their leisure activities and personal matters including personal hygiene.
      Concerning personal hygiene, independence could be developed for most of the
      children by systematic training, even among those who regularly use
      catheterisation. Both child and parents need support from multidisciplinary
      habilitation teams in order to develop the coping ability of the child. In
      school, along with assessment of the disabled child's learning ability, there is
      also a need to assess its personal and social functioning. According to studies
      by A. Antonovsky, people who experience their situation as comprehensible,
      manageable and meaningful are more healthy than others. It seems valuable to
      apply these three aspects to the way of thinking in work with habilitation.

PMID- 7770981
TI  - [The hepatorenal syndrome].
AB  - Renal dysfunction and abnormal sodium-water handling are frequent in liver
      disease. The term hepatorenal syndrome (HRS) denotes a functional type of renal
      failure characterized by a progressive decrease in the glomerular filtration rate
      (GFR), greatly increased sodium retention, a high urine/plasma ratio of solutes,
      azotaemia, and oliguria. The main pathogenic feature is reduced renal blood flow
      (RBF), especially in the cortex. The kidney is morphologically intact and has
      been shown to rapidly regain normal function after transplantation to a recipient
      with a healthy liver. Three factors should be considered in the pathogenesis of
      HRS: 1) decreased liver function; 2) deranged haemodynamics, including abnormal
      blood pressure, blood volume, and blood flow distribution; and 3) deranged neuro
      humoral regulation. The prognosis in HRS is very poor, and therapy for HRS has
      proved disappointing. However future studies should be directed towards the
      reduced liver function and the haemodynamic abnormalities, especially the
      abnormal renal vasoconstriction. Implantation of a peritoneovenous shunt,
      paracentesis with plasma expansion, certain "blockers", and normalization of
      arterial blood pressure have reversed the HRS only in the more early stages.
      Liver transplantation is the ultimate treatment for the HRS.

PMID- 7770982
TI  - [Differential neuronal loss in the hippocampus in normal aging and in patients
      with Alzheimer disease].
AB  - The causal relationship between the neurodegenerative changes that accompany
      normal ageing and those that characterize Alzheimer's disease is unclear. The
      high incidence of Alzheimer's disease associated with old age and the presence of
      its neuropathological signs in non-demented older individuals suggest that these
      two phenomena involve the same neurodegenerative processes and mechanisms and
      that Alzheimer's disease is an extension of normal ageing. On the other hand, the
      identification of environmental and genetic risk factors associated with
      Alzheimer's disease suggests the involvement of a specific disease process that
      is not related to normal ageing. The resolution of this fundamental issue is of
      importance in the design of investigative and therapeutic strategies. In this
      report, we describe differences in the regional patterns of neuronal loss, in the
      hippocampal region of the brains of Alzheimer's patients and normal ageing
      subjects, that indicate that Alzheimer's disease is not the manifestation of
      accelerated ageing, but the expression of a distinct pathological process.

PMID- 7770983
TI  - [The urethral plug--an alternative treatment of women with urinary stress
      incontinence].
AB  - A developed urethral plug was evaluated for the treatment of women with genuine
      urinary stress incontinence. The plug consists of an oval meatal plate, a soft
      stalk and one or two spheres along the stalk with fixed distances between the
      meatal plate and the spheres. Inside the stalk is a removable semi-rigid guide
      pin to ease insertion. Forty women were randomly allocated to treatment with
      either the two-sphere or the one-sphere plug during period one (two weeks). In
      period two (two weeks) the patients used the other plug. They then continued with
      what they judged to be the better plug in period three (two months). Eighteen
      patients (45%) completed period three with the "preference" plug and 17 were
      subjectively and objectively continent or improved. Fourteen of these women
      preferred the two-sphere device. The plugs were equally effective in patients
      with mild or severe incontinence. Six women developed urinary tract infections
      and two of these had a plug in the bladder. The urethral plug is an effective
      treatment in a group of women with stress incontinence. Removal by hand is
      advisable in order to avoid retention of plugs in the bladder.

PMID- 7770980
TI  - [Hemoglobinopathies. Current therapeutic possibilities].
AB  - In recent years, the number of immigrants has increased considerably in Denmark.
      Consequently, a series of new clinical pictures has appeared in the Danish health
      care system. Typical examples are the genetic diseases, the haemoglobinopathies.
      Most of the immigrants come from areas, where the gene frequency of these
      disorders is widely distributed, for instance the Mediterranean countries, the
      Middle East, Southeast Asia and Africa. Most frequent are the heterozygous
      thalassaemias, but also the number of patients with severe thalassaemia and other
      clinically important haemoglobinopathies such as sickle cell anaemia has also
      increased in recent years. The clinical problems concerning these patients focus
      on two important topics, namely genetic counselling of heterozygous individuals
      (in some cases combined with prenatal diagnostics) and the treatment of patients
      with clinically severe haemoglobinopathy. The only curative treatment of the
      haemoglobinopathies is allogeneic bone marrow transplantation, but this treatment
      can only be offered to a few of these patients. However, a variety of therapeutic
      options exist which can improve their prognosis and quality of life. Since the
      number of patients with these diseases will probably increase over the next years
      we find it relevant, based on typical case stories, to give a review of the
      present therapeutic possibilities for these disorders.

PMID- 7770984
TI  - [Medical audit in laboratory medicine. A description of the course and some
      results].
AB  - All general practitioners of the Danish counties of Funen, Vejle and North
      Jutland were invited to participate in a medical audit concerning laboratory
      medicine organised by the Audit Project Odense (APO) in co-operation with the
      Consultative Arrangement for General Practice, emanating from the
      clinical/chemical departments of Funen. During three weeks the participants
      registered all clinical problems which would result in one or more laboratory
      tests. APO performed computer registrations and analyses of the results where
      upon each participant received a reply letter indicating the results of his own
      as well as the group's registrations. At a subsequent meeting the participants
      discussed the conception of "good general practice" as regards the use of
      laboratory medicine within defined clinical problems. The course of the audit
      demonstrated that the APO method is suitable for identification of a number of
      professional problems related to general practitioners' use of laboratory
      medicine and to reveal the variation in general practitioners' handling of
      laboratory medicine. Furthermore, the project showed that continuous quality
      development demands profound study of and research into the professional problems
      which the general practitioners encounter when using laboratory medicine.

PMID- 7770985
TI  - [Severe systemic infection with Vibrio vulnificus].
AB  - Infections with Vibrio vulnificus are not common in Denmark, but in 1994 several
      cases were identified, probably due to the very hot weather conditions, with
      seawater temperatures above 20 degrees C. Two cases of infection with V.
      vulnificus are presented.

PMID- 7770986
TI  - [Fulminant myonecrosis and sepsis caused by Aeromonas hydrophila].
AB  - A case of fatal bilateral lower extremity myonecrosis in a nonimmunocompromized
      man with septicaemia caused by Aeromonas hydrophila is described. Immediate
      surgical revision combined with treatment with new cephalosporins should be
      considered in the treatment of severe soft tissue infections, especially when the
      patient is known to have a trauma with waterborne contamination or is
      immunocompromised.

PMID- 7770987
TI  - [Angiotensin converting enzyme inhibitor renography should be done after acute
      intake of angiotensin enzyme inhibitor].

PMID- 7770988
TI  - [Smoking cessation and nicotine therapy].

PMID- 7770989
TI  - [Keys or chaos].

PMID- 7770990
TI  - [Response to the comment by K. M. Sturmer on the contribution by B. Hausmann, K.
      Hudabiunigg: On the risk of fat embolism syndrome after intramedullary nailing in
      femoral fracture and thoracic injuries].

PMID- 7770991
TI  - [MRI results in experimental muscle injuries].
AB  - We performed an incision of standardized size and location on the suprascapularic
      muscle of 18 rabbits by a stab with a scalpel and measured the signal intensity
      of the muscle 2, 5, 11, 21, 35 and 64 days after injury (3 rabbits on each day).
      We did not find any detectable changes in the MRI pictures but a characteristic
      graph of the calculated T2-times (a mathematical procedure of the MRI software).
      The MRI changes correlate with the histopathological changes after muscle injury.
      The MRI method allows the evaluation of minor muscle trauma by the detection of a
      changed liquid content by using calculated T2 times.

PMID- 7770992
TI  - [Magnetic resonance tomography evaluation of the lower limb after compartment
      syndrome].
AB  - For the purpose of follow-up of the disease as well as the availability of
      magnetic resonance imaging (MRI) as a method for diagnosing soft tissue changes
      20 patients with imminent and manifest compartment syndrome were examined for
      their fluid content of the lower limb. Considering the normal side as well as 10
      healthy volunteers a significant reduction of fluid content was diagnosed in the
      manifest compartment syndrome after fasciotomy in the late phase of disease (r =
      0.49, p > 0.005, n = 29). This was interpreted as a sign of fibrosis. The
      patients with imminent compartment syndrome and fasciotomy (r = 0.83, p > 0.001,
      n = 19) demonstrated no significant changes compared to the normal volunteers (r
      = 0.91, p > 0.001, n = 40) as well as the normal compartments of the diseased
      lower extremities (r = 0.85, p > 0.001, n = 32). MRI is a useful method in the
      examination of soft tissue changes and underlines the importance of an early
      fasciotomy in case of imminent compartment syndrome.

PMID- 7770993
TI  - [New aspects in the treatment of complete and isolated diaphyseal fracture of the
      forearm in childhood].
AB  - From 1984 to 1992 153 children were treated at the pediatric surgical department
      of the University of Mainz, of whom 19 had fractures of the radius, 9 of the ulna
      and 125 had a combination of both in the diaphysis of the forearm. Factors like
      patient's age, type of fracture and therapeutic methods were analyzed. One
      hundred and forty-one children were treated conservatively, 12 by operation. One
      hundred and one of these patients were healthy, when discharged (about 8 weeks
      after accident). Follow-up was possible in 69 cases. We found that occasional a
      remaining dislocation angle does not impair function: in 65 cases the result was
      "good" and "very good", but only "moderate" in 4 cases. These 4 children had been
      treated conservatively by reposition and plaster cast; 2 of these 4 children
      showed bone reconstruction without dislocation. Twenty-two of the 56 X-ray follow
      up's showed persisting dislocation. To prevent functional problems (2 of our
      cases) it is essential to obtain a very exact reposition of diaphyseal forearm
      fractures. Therefore we would recommend a more generous indication for operation,
      preferably using elastic-stable Nancy pins.

PMID- 7770994
TI  - [The "inserted" condylar plate].
AB  - Twelve extensive segmental and comminuted fractures of the femur affecting the
      metaphyseal areas (7 times proximal, 5 times distal) and the diaphysis were
      treated with extremely long condylar plates (16 to 20 holes). The condylar plates
      were inserted via a proximal and a distal incision leaving the Musculus vastus
      lateralis intact at the fracture site in all cases. Following standard
      preparation of the blade position using the seating chisel, the condylar plate
      was inserted behind the musculus vastus lateralis with the blade pointing towards
      the surgeon. The condyles or the trochanteric area were tilted slightly and the
      plate was turned 180 degrees and driven home. No screws were inserted in the area
      of the fracture, in particular, lag screws were not used. Ten out of 12 fractures
      healed without problems, in 2 cases bone grafting was necessary. Three main
      observations resulted from analysis of the operations and subsequent clinical and
      radiographical assessments. In the presence of relatively intact soft tissue
      covering, an astonishingly good reduction of the fragments was achieved after
      restoration of leg length and extension. In the healing process, callus formed
      rapidly and provided medial support. The bone structure was found to be more
      homogeneous than in the case for plate fixation involving several screws at the
      fracture site around which considerable fluctuations in bone density frequently
      occur. The application of condylar plates behind the musculus vastus lateralis by
      only proximal and distal incision for osteosyntheses of extensive multifragmental
      fractures is a further development of bridge-plating and can be recommended for
      long fractures.

PMID- 7770995
TI  - [Can the results of cruciate ligament operations be arthrometrically evaluated? A
      comparison of subjective assessment, Lysholm score, clinical stability
      classification and measuring stability with the KT 1000 after complex knee
      injuries].
AB  - In a long-term follow-up of 88 patients with complex ligament knee injuries we
      examined 70 of these who were operated upon between 1.4. 1988 and 31.3. 1990. We
      specifically looked at local complications, clinical results and knee stability,
      using subjective and arthrometrical (KT-1000) results 1 or 2 years after
      operation. The only parameters with a good correlation with stability were the
      clinical examination (Lachman-test) and the results with the arthrometer in the
      anterior-posterior translation. Stability after ACL-reconstruction with
      augmentation with a polydiaxonaon (PDS) augmentation band was physiological (2 mm
      under 89 N anterior-posterior traction) in 77% of all knees but only in 57% under
      maximal anterior-posterior manual stress. Neither the subjective outcome of
      Lysholm-Score correlated with arthrometry and clinical examination.

PMID- 7770996
TI  - [Protective air bags in traffic accidents. Change in the injury pattern and
      reduction in the severity of injuries].
AB  - The effectiveness of air bags, drivers-side and passenger-side, as an additional
      passive safety system in motor vehicles was tested in a collective study in which
      47 trauma centers in Germany participated. The inquiry was answered by 80% of 181
      hospitals. The evaluation of a total of 119 air bag-protected patients involved
      in accidents, who were treated in German trauma centers in the year 1993 shows
      predominant minor injuries on the head-, cervical- and thorax-region. Some
      patients had superficial injuries caused by air bag in their face and chest area,
      such as abrasions and contusions. It is notable, that a large number of patients
      continue to suffer severe injuries (AIS 3+) in their lower extremities. The trend
      of the industry to equip more and more vehicles with air bags must be sustained.
      According to manufacturer statements, in 1994 already more than 60% of all mass
      produced vehicles in Germany will be provided with this modern passive safety
      system.

PMID- 7770998
TI  - Flow cytometric DNA/cytokeratin analysis of bladder lavage: methodical aspects
      and clinical implications.
AB  - Over the last few years cytological investigations of bladder lavage have gained
      ever-increasing importance in the diagnosis and follow-up of bladder tumors. Flow
      cytometric DNA analysis is searching for more objective ways to characterize
      tumor tissue beyond its morphological differentiation. Since the end of 1987 more
      than 400 bladder lavages have been analyzed both cytologically and by
      multiparameter flow cytometry. DNA/cytokeratin-8,18 antibody labelling of
      methanol-fixed single cells provides a standardized method which is not liable to
      disturbances and enables use in a routine laboratory. Aneuploidy was divided in
      several subgroups according to the DNA index. Proliferation of the urothelial
      population as a diagnostic parameter was investigated. Multiparameter flow
      cytometric measurement can identify and assess all subpopulations of bladder
      lavage such as inflammatory cells, squamous cells and squamous cell metaplasia.
      Cytokeratins enable a selective examination of the urothelial population after
      gating; the diagnostic accuracy for aneuploid tumor stem lines is markedly
      increased when compared to single-parameter DNA analysis. Higher specificity is
      reached by excluding falsely positive 'aneuploid' squamous cells; higher
      sensitivity is made possible by lowering the limit of detection for actual
      aneuploidy within a specimen, especially for near-diploid and tetraploid
      carcinomas. When compared to cytological malignancy grading, the aneuploidy rate
      is 26% in G1/2 tumors, 42% in G2 and 78% in G3 tumors (p < 0.005). More than half
      of the aneuploid bladder lavages with a negative or suspect cytology were
      diagnosed as tumor recurrences either histologically or cytologically in the
      following year. Moderately differentiated carcinomas with an aneuploid DNA
      distribution had a higher rate of recurrence than tumors with euploid
      distributions when treated curatively by organ-conserving therapy.
      DNA/cytokeratin analysis of bladder lavage enables an artefact-free measurement
      of tumor criterium aneuploidy; this is more specific and less sensitive than
      cytology. Due to the lack of separability of urothelial proliferation in euploid
      specimens, the aim to make flow cytometry a method equaling cytology cannot be
      reached. Therefore, the greatest value of flow cytometry is not in tumor
      screening, but in reliable detection of highly malignant aneuploid tumors at
      initial diagnosis, during therapy and recognition of recurrence of superficial
      bladder carcinomas. Reviewing the literature, flow cytometrically proven
      aneuploidy, especially triploid tumor stemlines, can be used to predict possible
      invasive growth. DNA/cytokeratin measurements are hence indicated when an exact
      assessment of prognosis can influence the therapeutic procedures.

PMID- 7770997
TI  - Androgen receptor alterations in patients with disturbances in male sexual
      development and in prostatic carcinoma.
AB  - The androgen receptor, a ligand-activated nuclear transcription factor belonging
      to the large superfamily of nuclear receptors, mediates the intracellular action
      of androgens. It plays a central role in male sexual development and in prostatic
      carcinoma as a target of endocrine therapy. We have looked for androgen receptor
      mutations as a cause of male sexual ambiguity and as a possible reason for
      failure of androgen ablation therapy on prostatic carcinoma. In 5 patients of 2
      families with perineoscrotal hypospadia and undescended testes, we have
      identified a mutation ala596-->thr in the DNA-binding domain of the androgen
      receptor. This mutation interferes with DNA binding of the receptor. Reactivation
      of this mutant receptor by binding of an antibody or by interaction with other
      proteins and by exchange of the amino acid thr602-->ala indicates that the
      dimerization step is affected. A point mutation ser703-->gly was detected in a
      newborn male child with perineoscrotal hypospadias. This mutation decreased
      receptor-hormone affinity. As a consequence its transactivation activity was
      dependent on the androgen concentration. Although the molecular mechanisms of
      these two mutations are completely different, both resulted in partial androgen
      insensitivity and interfered with virilization in the affected patients. A
      different kind of mutation was present in a tumor specimen derived from an
      advanced therapy-resistant prostatic carcinoma. This point mutation resulted in
      exchange of valine-->methionine at amino acid position 715 in the receptor
      protein. In contrast to the former two mutations this receptor showed a gain in
      function.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771000
TI  - Testicular metastasis of cerebral malignant lymphoma.
AB  - Cerebral metastases of testicular malignant lymphomas have been reported. In this
      case a testicular metastasis secondary to a primary cerebral malignant lymphoma
      is presented. This unusual case does not correspond to the known metastatic
      pattern of malignant lymphoma.

PMID- 7770999
TI  - Morphological and functional changes in canine kidneys following extracorporeal
      shock-wave treatment.
AB  - Extracorporeal shock-wave lithotripsy (ESWL) has rapidly become established
      worldwide as a routine method for treatment of nephro- and ureterolithiasis.
      Although initial studies showed no tissue-damaging effect by the shock waves, we
      found, in an animal experiment using canine kidneys, that the ESWL-induced damage
      to the renal parenchyma is more marked than originally assumed. The damage is
      limited to the area that was focused on, and heals relatively rapidly by
      connective tissue encapsulation with final cicatrisation without any further
      residual effects being observed up to the present. This parenchymal damage is
      probably also the cause of the macrohematuria that is always observed during
      therapy. The resulting tissue damage is not extensive enough to cause a
      demonstrable reduction of function as measured by the usual methods (serum
      creatinine, creatinine clearance, isotopy renography, i.v. urography). In serum
      we observed a transient decrease of calcium, an immediate increase of lactate
      dehydrogenase, transaminases (SGOT and SGPT) and a delayed increase of alkaline
      phosphates. Creatinine, blood urea nitrogen, sodium, potassium and amylase
      remained within normal limits. In urine, a decrease of creatinine and an increase
      of glucose excretion were noted. We believe that these changes represent a
      relatively mild and transient damage of renal cells and do not reflect the
      occasionally heavy morphological changes observed after shock-wave exposure. The
      main clinical complication is the large subcapsular hematoma which, according to
      the present knowledge, could well result from a lesion of the larger peripheral
      vessels. Damage to other organs such as subserous colonic and small bowel
      hematomata are to be expected although they do not lead to clinical symptoms.

PMID- 7771001
TI  - Incontinence and vesical neck strictures following radical retropubic
      prostatectomy.
AB  - OBJECTIVES: To evaluate the incidence and severity of vesical neck strictures and
      urinary incontinence after radical retropubic prostatectomy (RRP) for prostate
      cancer. METHODS: Between August 1983 and December 1991, 481 consecutive patients
      underwent RRP by 1 of 2 senior surgeons. Strictures were treated by passing a
      urethral sound. Incontinence was measured by asking patients for a daily "pad
      count" of pads required to control urinary leakage. Results were compared to
      patient age, tumor volume, number of neurovascular bundles spared, preoperative
      urinary complaints, and previous transurethral resection of the prostate.
      RESULTS: Of 456 patients with adequate follow-up to determine stricture
      formation, 82.5% had no strictures, 6.8% required a single dilation, 3.7%
      required 2 dilations, 3.1% required 3 dilations, and 3.9% required more than 3
      dilations. Risk of stricture formation was unrelated to every variable studied.
      Of 458 patients with adequate follow-up to determine recovery of continence,
      80.1% required no pads, 8.1% required 1 to 2 pads a day, 6.6% required 3 to 5
      pads a day, and 5.2% were totally incontinent 1 year or more after surgery.
      Incontinence was closely associated with postoperative urinary urgency.
      CONCLUSIONS: Strictures are a common but easily managed complication of RRP for
      prostate cancer. Despite substantial surgical experience, we report a somewhat
      higher rate of postoperative incontinence than other recently reported series.
      Our experience is more closely matched by published surveys of patient-reported
      complications after RRP.

PMID- 7771002
TI  - Effect of radical prostatectomy for prostate cancer on patient quality of life:
      results from a Medicare survey.
AB  - OBJECTIVES: To assess patient responses to radical prostatectomy and its effects.
      METHODS: A national sample was taken of 1072 Medicare patients who underwent
      radical prostatectomy for prostate cancer (1988 through 1990) by mail, telephone,
      and personal interviews. The effects of the surgery and its complications on
      these patients' lives were studied through: (1) patient ratings of the extent to
      which sexual and urinary dysfunctions were "problems" in their lives; (2) two
      general measures of quality of life, the Mental Health Index and the General
      Health Index; (3) patient reports of how they felt about the results of treatment
      and whether they would choose surgery again. RESULTS: On average, dripping urine,
      particularly to the point where subjects were wearing pads, had a more
      significant effect on patients than loss of sexual function; incontinence had
      significant adverse effects on the measures of quality of life and self-reported
      results of surgery. Overall, postsurgical patients scored comparatively high on
      the quality of life measures (similar to a cohort of patients with benigh
      prostatic hyperplasia who had undergone transurethral resection of the prostate),
      reported feeling positive about the results (81%), and would choose surgical
      treatment again (89%). Nonetheless, there was variability in patient response to
      the effects of surgery. CONCLUSIONS: The results demonstrate the ability of many
      Medicare patients to adapt to adverse outcomes, such as loss of sexual function
      and incontinence. They also provide evidence of the variability of individual
      patients' responses to surgical results and reinforce the importance of
      individualized decision making for patients facing a decision about radical
      prostatectomy for prostate cancer.

PMID- 7771003
TI  - Contact neodymium:yttrium-aluminum-garnet laser ablation of the external
      sphincter in spinal cord injured men with detrusor sphincter dyssynergia.
AB  - OBJECTIVES: The purpose of this study was to determine the efficacy and safety of
      contact neodymium:yttrium-aluminum-garnet (Nd:YAG) laser external sphincterotomy
      as an alternative treatment of detrusor-external sphincter dyssynergia (DESD).
      METHODS: Twenty-two spinal cord injured men with video-urodynamically verified
      DESD underwent external urinary sphincter ablation using the contact Nd:YAG
      laser. Three patients with bladder neck obstruction required concurrent contact
      laser bladder neck incision. Preoperative urodynamic parameters of voiding
      pressure, bladder capacity, and residual urine were compared with those obtained
      1 year postoperatively. RESULTS: Each procedure was performed with the Nd:YAG
      contact laser set at 40 to 50 W, with a total accumulated energy of 23,800 to
      60,000 J for each patient. The mean duration of surgery was 45 +/- 21 minutes.
      Bladder voiding pressure decreased from 87 +/- 23 preoperatively to 47 +/- 11 cm
      H2O at 12 months (P < 0.01). Residual urine volume decreased significantly, from
      122 +/- 77 to 33 +/- 19 mL at 12 months (P < 0.01), and bladder capacity remained
      unchanged at 174 +/- 84 and 230 +/- 92 mL (P = 0.57). Three patients were found
      to have recurrent sphincter obstruction 1 year after laser sphincterotomy. Two
      patients experienced complications associated with condom catheter urinary
      drainage and returned to the use of an indwelling catheter. One patient
      experienced diminished reflex erectile function postoperatively. No patient
      required blood transfusion. No deleterious effects on renal function or symptoms
      of autonomic dysreflexia were noted. CONCLUSIONS: External urinary sphincter
      ablation using the contact Nd:YAG laser compares favorably with electrosurgical
      techniques.

PMID- 7771004
TI  - Double-blind randomized crossover study comparing intracorporeal prostaglandin E1
      with combination of prostaglandin E1 and lidocaine in the treatment of organic
      impotence.
AB  - OBJECTIVES: To study the efficacy of lidocaine 1% in relieving pain associated
      with intracorporeal prostaglandin E1 and to assess its effect on the
      pharmacological erection. METHODS: Twenty-two patients who had previously
      experienced pain with intracorporeal prostaglandin E1 injections were submitted
      to a double-blind randomized crossover study to evaluate comparatively the
      effects of intracorporeal prostaglandin E1 alone and in combination with
      lidocaine. The signed rank test was used for statistical analysis of the results.
      RESULTS: With prostaglandin E1 monotherapy (20 micrograms) 86.3% of patients
      experienced pain and 27.2% had an adequate erection. With combination therapy
      (prostaglandin E1 20 micrograms plus lidocaine 1% 1 cc) 45.4% of patients
      experienced pain and 57.8% of patients had improvement of pain compared with
      prostaglandin E1 monotherapy. The adequate erectile response rate with
      combination therapy was 63.6%; in addition, 31.8% of patients noted enhancement
      in the duration of erection. The signed rank test was significant for the pain
      response (P < 0.01) and for the degree of erection (P < 0.01). The signed rank
      test was not, however, significant for the increase in duration of erection after
      combination therapy. No significant side effects were noted after either
      injection. CONCLUSIONS: Lidocaine 1% can be safely and usefully combined with
      intracorporeal prostaglandin E1 in the treatment of erectile dysfunction with
      alleviation of pain and enhancement of erectile effect.

PMID- 7771005
TI  - Sequential penile ultrasound monitoring of patients treated with chronic
      intracavernous prostaglandin E1.
AB  - OBJECTIVES: Clinical outcome studies of prostaglandin E1 (PGE1) have shown a
      markedly decreased rate of palpable fibrosis and plaque formation. In this
      prospective study we investigate the potential of this agent to produce
      subclinical fibrotic changes. METHODS: Real-time high-resolution ultrasound
      scanning of the corpora was performed using a 7.5 to 10 MHz linear array
      transducer in 80 men on initiation of treatment with self-administered PGE1 and
      at quarterly intervals during the course of following (3 to 28 months). The
      dorsal portion of the penile shaft was scanned in the transverse and sagittal
      planes from base to glans for a side by side comparison of the cavernosal tissue,
      evaluating local abnormalities of tissue echogenicity. RESULTS: Palpable lesions
      were not detected in any men on quarterly follow-up examination. Thirteen (16.5%)
      men developed new echogenic foci not present on pretreatment scanning at the
      following locations: proximal corpus cavernosum, subcutaneous tissues, and corpus
      spongiosum. These changes were observed both as single and multiple lesions
      ranging in size from 1 to 10 mm. The presence of these findings was independent
      of the etiology of impotence, dose frequency, and duration of intracavernous
      therapy. CONCLUSIONS: The significance of these subclinical changes is unknown
      but their low incidence should be recognized when considering long-term
      intracavernous therapy.

PMID- 7771006
TI  - Prospective evaluation of neomycin serum concentrations after direct corpora
      cavernosa irrigation during penile prosthesis placement.
AB  - OBJECTIVES: To determine if toxic serum levels of neomycin are generated after
      direct corpora cavernosa irrigation during penile prosthesis placement. METHODS:
      We have used an infection prophylaxis technique that involves directly irrigating
      the corpora cavernosa tissue (through the corporotomy) with 0.5% neomycin
      solution. Serum neomycin concentrations were measured at 1 hour and 4 hours after
      irrigation in 13 patients undergoing penile prosthesis placement. A subset of
      patients who had preimplant and postimplant serum creatinine concentrations was
      evaluated for changes in renal function. RESULTS: The mean 1-hour postirrigation
      serum neomycin level was 1.2 micrograms/mL and the mean 4-hour postirrigation
      level was 1.2 micrograms/mL. These serum neomycin concentrations are lower than
      those thought to be necessary to produce nephrotoxicity or ototoxicity. Renal
      function was not significantly affected by the neomycin irrigation. CONCLUSIONS:
      Although aminoglycosides are ototoxic and neomycin has the highest nephrotoxic
      potential of the aminoglycosides, we conclude that direct irrigation of the
      corpora cavernosa with 0.5% neomycin solution does not produce significant
      systemic exposure to result in nephrotoxicity or ototoxicity. One-time
      prophylactic neomycin irrigation remains an effective, safe, and economic adjunct
      to penile prosthesis placement.

PMID- 7771007
TI  - Fascial closure of laparoscopic port sites: a new technique.
AB  - The laparoscopic operative procedure is not complete until the port sites are
      closed with a fascial suture. Herein, we report a simple new technique that uses
      a venous catheter for suture placement and direct laparoscopic visualization to
      secure the abdominal wall fascia and peritoneum.

PMID- 7771008
TI  - Use of a catheter limiter during intermittent catheterization.
AB  - We report on the use of a new device, the catheter limiter, to facilitate clean
      intermittent catheterization. The device limits the length of catheter entering
      the urethra. This provides a means to reduce the risk of mechanical injury and
      perforation, minimizes incomplete emptying, and improves safety and patient
      acceptance of intermittent catheterization.

PMID- 7771009
TI  - Adrenal cortical carcinoma with tumor thrombus invasion of inferior vena cava.
AB  - A case of adrenal cortical carcinoma with inferior vena cava (IVC) involvement is
      presented. Ultrasonography, computed tomography, and venacavography all
      presumptively showed a large mass over the upper pole of the left kidney with
      tumor thrombus in the IVC. However, aortography demonstrated that this mass was
      receiving its blood supply from the left inferior phrenic artery, aorta, and left
      renal artery. Radical surgery, including resection of the tumor and its adjacent
      organs (kidney, distal pancreas, spleen) and the tumor thrombus in the IVC, with
      the aid of cardiopulmonary bypass, was performed. We emphasize that adrenal
      cortical carcinoma can have tumor thrombi invading the IVC, and in such cases we
      suggest radical surgical removal of the tumor and the thrombus.

PMID- 7771010
TI  - Adult Wilms' tumor: prognostic and management considerations.
AB  - Wilms' tumor is the most common malignant tumor of the urinary tract in children
      but is rare in adults. Although histologically the tumors appear to be the same,
      successful treatment with multimodal therapy is much more common in childhood. We
      report on 2 patients with adult, anaplastic, Stage IV Wilms' tumor, one of which
      was discovered during pregnancy and was managed successfully with chemotherapy,
      including ifosfamide, carboplatinum, and etoposide. As more patients are properly
      identified and treatment outcomes with chemotherapeutic regimens documented,
      better therapeutic approaches in adult Wilm's tumor will be developed, resulting
      in improved survival.

PMID- 7771011
TI  - Femoral neuropathy following percutaneous nephrolithotomy of a pelvic kidney.
AB  - Management of nephrolithiasis within a pelvic kidney presents a novel challenge
      to the urologist. We report on a patient who underwent ureteral stent placement
      prior to extracorporeal shock-wave lithotripsy (ESWL). Following ESWL, the
      ureteral stent calcified at the vesical and renal ends, requiring "sandwich
      therapy" of percutaneous nephrolithotripsy, ESWL, and percutaneous nephroscopy.
      Percutaneous access to the pelvic kidney through a posterior approach was
      complicated by femoral neuropathy manifested by an ability to walk. With 6 months
      of aggressive physical therapy, the patient is now able to ambulate with
      difficulty using a walker.

PMID- 7771012
TI  - Penile Merkel cell carcinoma.
AB  - Merkel cell carcinoma of the genitalia is very rare and to date has been found
      only in vulvar mucosa. We describe an aggressive Merkel cell tumor in the
      frenulum of the penis with lymph node metastases, local recurrence, and
      eventually widespread dissemination. The primary tumor was associated with
      discontiguous squamous cell carcinoma in situ. This is the first report of Merkel
      cell (neuroendocrine) carcinoma in this anatomic site.

PMID- 7771013
TI  - Laparoscopic evaluation of indeterminate renal cysts.
AB  - OBJECTIVES: To determine the efficacy and safety of laparoscopic evaluation of
      indeterminate renal cysts. METHODS: Ten patients with indeterminate renal cysts
      (5 Bosniak type II and 5 Bosniak type III) underwent transperitoneal laparoscopic
      aspiration of cyst fluid for cytologic analysis with examination, biopsy, and
      excision of the cyst wall and base. RESULTS: All procedures were successful and
      without complications. All the lesions were benign. CONCLUSIONS: Laparoscopic
      evaluation of indeterminate renal cysts is safe and effective. The procedure
      alleviates patient anxiety about the nature of the lesion and obviates years of
      radiologic surveillance, thus reducing costs.

PMID- 7771014
TI  - Nitric oxide control of lower genitourinary tract functions: a review.
AB  - It is apparent that evolving concepts of the regulatory basis for functions in
      the pelvis must take into account the role exerted by nitric oxide. A recently
      characterized messenger molecule, nitric oxide has been associated with numerous
      physiologic processes. Intense investigations of this molecule have extended its
      importance to several genitourinary functions. Penile erection, micturition,
      peristalsis of the male excurrent duct system, contractile properties of the
      prostate, and lumbosacral spinal cord neurotransmission are all functions that
      may transpire under some degree of control by nitric oxide. Impotence, urinary
      obstruction, or ejaculatory problems, in turn, may represent alterations of
      nitric oxide production or action. The strategic manipulation of nitric oxide or
      its mechanism of action, possibly by pharmacologic means, may restore or produce
      desired functional effects. These possibilities, therefore, suggest that the
      advancing knowledge of nitric oxide in the genitourinary tract may be of enormous
      clinical value in the future.

PMID- 7771015
TI  - The loin pain--hematuria syndrome.

PMID- 7771016
TI  - Crossed fused renal ectopy and myelodysplasia.

PMID- 7771017
TI  - Pediatric ureteropelvic junction obstruction treated with retrograde
      endopyelotomy.

PMID- 7771018
TI  - Cimetidine in treatment of interstitial cystitis.

PMID- 7771019
TI  - The use of methylene blue in the identification of lymphoceles after renal
      transplantation.

PMID- 7771020
TI  - Femoral neuropathy following abdominal operations for genitourinary malignancies.

PMID- 7771021
TI  - In support of behavioral treatment for day wetting in children.

PMID- 7771022
TI  - Enuresis: a practical approach to a common problem.

PMID- 7771023
TI  - Immunotherapy for renal cell carcinoma: the era of interleukin-2-based treatment.

PMID- 7771024
TI  - Ejaculatory duct obstruction in the infertile male.

PMID- 7771025
TI  - Complications of cryosurgical ablation of the prostate to treat localized
      adenocarcinoma of the prostate.
AB  - OBJECTIVES: To review the complications associated with cryosurgical ablation of
      the prostate (CSAP) for localized adenocarcinoma of the prostate in the first 69
      procedures performed at our institution. METHODS: A retrospective review of the
      charts of 63 patients (69 procedures) performed at our institution between June,
      1993, and December, 1994, was undertaken with an emphasis on the complications,
      their management, and outcome. RESULTS: Thirty-seven of the 63 patients (59%) had
      at least one significant adverse event. Although no patient died or required a
      transfusion, other significant complications, including prolonged urinary
      retention, incontinence, sloughing of prostatic tissue, fistula formation,
      prolonged perineal pain, bowel dysfunction, and other problems were observed.
      CONCLUSIONS: CSAP is associated with a significant complication rate. These
      complications are more common in patients who have had prior CSAP or radiation
      therapy. Instead of decreasing with experience, the complication rate increased
      later in the series. In our patients, the complication rate increased after the
      use of an investigational urethral warmer was discontinued. CSAP is an
      investigational procedure of unproved long-term efficacy. It can be associated
      with substantial patient morbidity and should be performed under carefully
      controlled circumstances. Patients should be made aware of the potential for
      debilitating complications.

PMID- 7771026
TI  - Salvage radical prostatectomy after failed transperineal cryotherapy: histologic
      findings from prostate whole-mount specimens correlated with intraoperative
      transrectal ultrasound images.
AB  - OBJECTIVES: This study evaluates the potential for salvage radical prostatectomy
      after failure of transrectal ultrasound (TRUS)-guided percutaneous cryosurgical
      ablation of the prostate. An additional purpose was to determine the accuracy of
      intraoperative TRUS to delineate the extent of freeze destruction that results
      from cryosurgery. METHODS: Six patients with biopsy-confirmed, Stage T3 prostate
      cancer underwent salvage radical prostatectomy 3 to 10 months after failing
      prostate cryosurgery. Zones of freeze destruction (resolving coagulative
      necrosis) and residual adenocarcinoma were mapped on the coverslips of whole
      mount sections. Histologically proven zones of freeze destruction correlating to
      successfully treated prostatic tissue were compared to the hypoechoic ice ball
      treatment zones seen on intraoperative TRUS images. RESULTS: The whole mounts
      were found to contain necrotic areas of cryodestruction that appeared much
      smaller than predicted by intraoperative ultrasound. Each of the cases also
      contained residual viable adenocarcinoma. All patients are alive and clinically
      free of localized disease 0.5 to 12 months after salvage radical prostatectomy.
      CONCLUSIONS: Salvage radical prostatectomy offers an effective treatment option
      in patients who have failed transperineal cryosurgery of the prostate.
      Intraoperative TRUS predicted that the entire prostate would show freeze
      destruction. Whole-mount analysis, however, revealed areas of remaining
      unaffected adenocarcinoma and normal prostatic parenchyma. TRUS, therefore,
      overstimates the area of prostatic tissue destroyed by extreme cold. This finding
      challenges the assumption that the entire prostate is lethally frozen when its
      boundaries are included within the hypoechoic ice ball witnessed on TRUS.

PMID- 7771027
TI  - Urinary Tamm-Horsfall protein increased after potassium citrate therapy in
      calcium stone formers.
AB  - OBJECTIVES: To evaluate the effect of oral potassium citrate therapy on urinary
      excretion rates of citrate. Tamm-Horsfall protein (THP), and on calcium oxalate
      monohydrate crystal agglomeration inhibition [tm], in patients with recurrent
      calcium stone formation. METHODS: To evaluate the effect of oral therapy with
      potassium citrate on urinary citrate, THP, and [tm], 24-hour urine samples were
      collected before and at least 2 months after initiation of oral potassium citrate
      therapy in 33 calcium stone-forming patients who had no dietary restrictions. The
      citrate concentration was measured by an adaptation of a citrate lyase method.
      Urinary disaggregated THP concentration was determined with a quantitative enzyme
      linked immunosorbent assay. The [tm] was determined by observing the effects of
      patients' urine, before and after oral potassium citrate therapy, on the uptake
      of 45Ca2+ onto the surfaces of added preformed calcium oxalate crystals in a
      supersaturated solution of calcium oxalate, using the in vitro kinetic method
      described by other investigators. RESULTS: We observed an increased urinary
      excretion rate of citrate from a mean of 1.9 mmol/24 h prealkali to 2.6 mmol/24 h
      postalkali (P < 0.0004) and of THP from a mean of 94.0 mg/24 h prealkali to 199.3
      mg/24 h postalkali (P < 0.0016). A corresponding increase in [tm] from a mean of
      177.1 minutes prealkali to 221.0 minutes postalkali (P < 0.024) was also
      observed. CONCLUSIONS: To our knowledge this is the first report correlating
      increased urinary citrate with THP excretion rate following oral alkalinization
      with potassium citrate in calcium stone formers. Of clinical importance is the
      corresponding increase in [tm], which was previously shown to be inversely
      related to stone-forming activity. Moreover, urinary citrate and THP are known to
      have a synergistic effect on [tm]. Our data suggest that the effectiveness of
      potassium citrate therapy in calcium stone-forming patients may, at least in
      part, be due to increased levels of THP.

PMID- 7771028
TI  - Holmium: yttrium-aluminum-garnet laser for endoscopic lithotripsy.
AB  - OBJECTIVES: To evaluate the holmium:yttrium-aluminum-garnet (Ho:YAG) laser for
      endoscopic lithotripsy on patients diagnosed with urinary tract calculi. METHODS:
      Thirty-eight procedures utilizing transurethral ureterolithotripsy or
      percutaneous nephroureteral lithotripsy were evaluated: 5 renal calculi, 31
      ureteral calculi (most in the upper ureter), 1 ureteropelvic junction calculus,
      and 1 bladder calculus. These were mainly in cases that, after being treated with
      extracorporeal shock-wave lithotripsy (ESWL), were contraindicated for further
      ESWL. Laser parameters included energy of 0.5 to 1.0 J/pulse and pulse rate of 5
      to 10 Hz. RESULTS: Composition of calculi was determined in 26 procedures. The
      Ho:YAG laser was effective for fragmenting all types of calculi. Patient outcome
      evaluated at 6 weeks after treatment showed that 33 of 38 procedures (87%) were
      effective. Residual calculi in 4 of the 5 unsuccessful procedures were less than
      5 mm in size and judged to be able to pass spontaneously. In the remaining
      procedure, the calculus was passed spontaneously 3 months after treatment. No
      severe damage to tissues or adverse effects to the body were observed due to the
      Ho:YAG laser. CONCLUSIONS: On the basis of these results, we determine that this
      wavelength is effective for lithotripsy in addition to its previously reported
      usefulness for soft tissue applications, and, thus, is a cost-effective and
      highly useful clinical device.

PMID- 7771029
TI  - Partial ureteral obstruction: a new variable and reversible canine experimental
      model.
AB  - OBJECTIVES: To develop a new experimental model of partial ureteral obstruction
      that is simple, reliable, variable, and reversible. METHODS: A 6 F ureteral
      catheter was inserted into the left ureteral orifice and was cut 2 cm distal to
      the orifice. The most distal part of the ureter was ligated around the catheter.
      The catheter lumen was partially obstructed by insertion of stylets of three
      different diameters. The catheter and the stylet were fixed inside the bladder.
      The model was tested in 12 dogs, which were stratified into three groups
      according to the diameter of the obstructing stylet. All the dogs were subjected
      to intravenous urography (IVU) and technetium-99m-mercaptoacetyltriglycine (99mTc
      MAG3) renal scan at 2 and 4 weeks following induction of partial ureteral
      obstruction. RESULTS: Three different grades of hydroureteronephrosis were
      obtained according to the diameter of the obstructing stylet. The IVU and 99mTc
      MAG3 renal scan studies were repeated at 2 and 4 weeks following removal of the
      ureteral catheter and ureteroneocystostomy and showed marked improvement in the
      configuration and function of the corresponding renoureteral units. CONCLUSIONS:
      Our experimental model fulfills the requirements for a useful model of partial
      ureteral obstruction, namely, simplicity, reliability, variability, and
      reversibility.

PMID- 7771030
TI  - Five-year results of a phase II study with low-dose bacille Calmette-Guerin
      therapy in high-risk superficial bladder cancer.
AB  - OBJECTIVES: Numerous studies have shown bacille Calmette-Guerin (BCG) to be an
      effective prophylactic and therapeutic agent for superficial transitional cell
      carcinoma of the bladder. The high-grade T1 lesion treated by transurethral
      resection alone is reported to progress to muscle invasion in 30% to 50% of the
      patients. Until now, optimal treatment schedule and optimal dose have not been
      defined. As suggested by Pagano's group, we used BCG in a lower dose than
      hitherto usual in our high-risk cancer patients. METHODS: Five years ago, we
      treated 32 Stage T1 cancer patients who were described as at high risk based on
      the criteria of histologic grade 3 in 21 patients, grade 2, but multiple in 11
      patients, and with carcinoma in situ in 17 patients. Follow-up ranged from 51 to
      63 months, with a mean of 57 months. We used BCG strain Pasteur Paris 75 mg
      weekly for 6 weeks and then maintenance therapy monthly for the first year and
      every 3 months for the second year. Complete remission was defined as negative
      cystoscopy, biopsy, and cytology. RESULTS: After a single 6-week course of BCG,
      25 patients had negative cytology and biopsy findings after 3 months; 2 other
      patients needed a second 6-week cycle of BCG, for an overall response rate of
      80%. Five patients underwent cystectomy because of multiple recurrences and tumor
      progression. After 2 years of follow-up, but under continuing maintenance
      therapy, 3 additional patients had tumor recurrences and also underwent
      cystectomy. Now, after 5 years' follow-up, the overall progression rate to
      cystectomy was 25% (8 of 32 patients), but none of the patients had progression
      to metastasis. Treatment-related toxicity did not appear to be lower at a lower
      dose of BCG. CONCLUSIONS: Low-dose BCG therapy is also an effective treatment in
      high-risk T1 bladder cancer (especially with maintenance therapy and short-term
      evaluations of the patients always by the same controlling physician) to prevent
      progression and recurrence and to preserve bladder function.

PMID- 7771031
TI  - Core cancer length in ultrasound-guided systematic sextant biopsies: a
      preoperative evaluation of prostate cancer volume.
AB  - OBJECTIVES: Evidence has been presented that biologic aggressiveness of prostate
      carcinoma increases with volume and that cancers less than 0.5 cc may be regarded
      as clinically insignificant for immediate treatment. We have analyzed the ability
      of core cancer length on needle biopsy to predict cancer volumes near the 0.5 cc
      threshold for distinction between incidental versus clinical carcinoma. METHODS:
      Systematic sextant transrectal ultrasound-guided prostate biopsies were performed
      on 110 men who then underwent radical prostatectomy for adenocarcinoma. The core
      cancer length within each biopsy was compared with the volumes of clinical and
      incidental carcinomas in the prostatectomy specimen. RESULTS: Among incidental
      (nonpalpable) cancers, 14% of those under 0.2 cc were detected, but 44% at 0.2 to
      0.5 cc and 92% of those more than 0.5 cc were detected. Among clinically
      suspected carcinomas, 2 mm or longer core cancer length reliably predicted a
      cancer of 0.5 cc or larger, but among incidental cancers, it predicted a tumor of
      0.2 cc or larger. A 3-mm core cancer length threshold predicted 0.5 cc for both
      groups. The high frequency of incidental cancers under 0.5 cc impaired the
      predictive value of multiple positive needle cores. Bilateral positive biopsy
      results indicated bilateral extension of clinical cancer in only 59% of cases.
      CONCLUSIONS: A core cancer length of 3 mm or more on one or two needle biopsies
      reliably predicts cancer of clinically significant volume (0.5 cc or larger). The
      high detection frequency of smaller incidental carcinomas on biopsy impairs the
      reliability of volume estimation from multiple positive needle cores and mandates
      that treatment decisions be made with knowledge of core cancer length.

PMID- 7771032
TI  - Intraoperative blood loss during radical retropubic prostatectomy: epidural
      versus general anesthesia.
AB  - OBJECTIVES: There are conflicting reports on the influence of different
      anesthetic techniques, such as regional versus general anesthesia, on
      intraoperative blood loss. The purpose of this study was to elucidate the effects
      of anesthetic technique on intraoperative blood loss in men undergoing radical
      retropubic prostatectomy (RRP). METHODS: One hundred patients undergoing RRP for
      prostate cancer were randomly assigned to receive either epidural anesthesia
      (EA), combined epidural and general anesthesia (EG), or general anesthesia alone
      (GA). Intraoperative blood loss was calculated by using a formula that accounted
      for the volume and hematocrit of the fluid suctioned from the surgical field,
      blood absorbed on surgical pads, and the patient's hematocrit. RESULTS: Mean
      blood loss in the EA group (1490 +/- 90 mL; mean +/- SEM) was significantly less
      than mean blood loss in both the EG group (1810 +/- 100 mL) and the GA group
      (1940 +/- 130 mL) (P = 0.01). Blood loss was not different between the EG and the
      GA groups (P = 0.7). Significantly less blood was transfused during surgery in
      the EA group (730 +/- 50 mL) compared with the EG (960 +/- 60 mL) and GA (950 +/-
      70 mL) groups (P = 0.02). CONCLUSIONS: Similar blood loss in patients receiving
      general anesthesia, either alone or when combined with epidural anesthesia,
      implies that epidural anesthesia did not reduce bleeding, but, rather, that
      general anesthesia increased blood loss.

PMID- 7771033
TI  - [A morphological study of tissues in the posterior segment of the eye after
      modified experimental revascularization of the choroid].
AB  - Morphologic examination of ocular tissues at the site of revascularization with
      two flaps was carried out to detect the changes in the architectonics of these
      flaps' vessels, vascular coating at the site of intervention, and assess the
      formation of relation with the vascular system of the external tissues of the
      eye. Experiments were carried out on the eyes of 8 cats. All the animals were
      subjected to local revascularization of the vascular coating with two flaps.
      Enucleation was carried out 1 to 6 months after the operation. The eyes were
      fixed in 10% neutral formalin solution, paraffin slices and blocks were prepared,
      stained with hematoxylin and eosin, with pyrofucin after Van Gieson, and with
      toluidine blue after Lison. Histologic study of ocular tissue slices 2-3 weeks
      after surgery showed that the flaps introduced into the supra-arachnoidal space
      tightly fitted each other forming a subconjunctival-episcleral transplant in
      which a moderate number of newly formed vessels was detected. Three to six months
      after surgery vascularization of the transplant proper and around it grew more
      and more intensive, the number of new vessels increased with their walls looking
      more compact; basal membrane appeared well shaped. The walls of new vessels did
      not differ by structure from normal vascular walls in the vascular coating.

PMID- 7771034
TI  - [Use of immobilized collagenase-collapor in the treatment of eye diseases].
AB  - Immobilized collagenase (collapor) applied as ophthalmic medicinal films has been
      developed and clinically tried. A new long-acting base (aubasidan, a
      mucopolysaccharide of a bacterial origin), similar as the main medicinal
      component, collagenase, exerts a therapeutic effect. Collapor is characterized by
      a pronounced resolving and proteolytic action causing no appreciable side
      effects. Altogether 134 patients with various inflammatory and vascular diseases
      of the eyes were observed. An instruction for collapor application in
      ophthalmology is offered.

PMID- 7771035
TI  - [Role of immunological factors in peripheral vitreo-chorioretinal dystrophies and
      macular ruptures of the retina].
AB  - The authors analyze the results of clinical and immunological examinations of
      patients with peripheral vitreo-chorioretinal dystrophies (PVCRD) and macular
      ruptures of the retina. No antibodies to S-AG were detected in the lacrimal fluid
      in 87.5% of patients with PVCRD without retinal defects. In patients with PVCRD
      with retinal defects antibodies to S-AG were detected in 70% of cases. These
      antibodies were absent in the patients with macular ruptures of the retina. In
      none of the patients were these antibodies detected in the blood serum. The
      levels of circulating immune complexes were normal in the patients PVCRD and
      increased in those with macular ruptures of the retina. These data permit a
      hypothesis on the development of local autoimmune reactions in PVCRD patients in
      response to the appearance of AG of the injured tissues.

PMID- 7771036
TI  - [Dynamic rigidometry].
AB  - A new method for assessment of the rigidity of corneoscleral membrane is offered:
      dynamic rigidometry permitting assessment of the real rigidity of the sclera
      (Eo). The studies were carried out in 106 normal subjects and 154 patients with
      glaucoma. In normal controls Eo coefficient was 0.0044 +/- 0.0008 on an average,
      whereas in glaucoma patients it was two times higher (0.0109 +/- 0.0018). This
      coefficient virtually did not depend on the level of intraocular pressure. A
      relationship between Eo and glaucoma stage was detected.

PMID- 7771037
TI  - [State of accommodation depending on age of emmetropic and hypermetropic subjects
      engaged in diamond sorting].
AB  - Accommodation was studied in 449 diamond sorters aged 17 to 51 engaged in this
      work for 1 to 34 years with emmetropic and hypermetropic refraction.
      Questionnaires helped detect subjects who had no complaints of vision (group A)
      and those with asthenopia complaints (group B). In both groups, in emmetropic and
      hypermetropic subjects, the furthest point of clear vision was converging the eye
      by 1.96 +/- 0.04 diopters on an average, that is, there was pseudomyopia. In
      hypermetropic subjects with occupational ophthalmopathy the nearest point is
      withdrawn starting from the age of 31-35 till it merges with the furthest point
      in subjects over 45, that is, the accommodation volume becomes nearly nuel. The
      results of this study contradict the assumption existing in ophthalmology about
      an earlier onset of presbyopia in hypermetropia than in other types of
      refraction. Early correction of near vision is connected with superimposition of
      accommodation deterioration in ametropia. It is recommended to carry out
      rehabilitative measure as soon as the first asthenopia signs manifest; these
      measures should be aimed at weakening of refraction by the site of the furthest
      clear vision point. In subjects aged 31-35 with occupational ophthalmopathy
      refraction by the nearest clear vision point should be enhanced if possible.

PMID- 7771038
TI  - [Tactics in choosing a vascular collector and drug administration method in intra
      arterial infusion therapy of organs of vision].
AB  - Anatomical variants of the direction and diameter of the supraorbital artery
      revealed by the authors and the clinical variants of the intensity and direction
      of periorbital bloodstream shown by doppler studies helped optimize the selection
      of a facial artery for inserting an infusion system for drug delivery to the
      vascular system of the eye. The advantages of intraarterial infusion of drugs in
      the system of ocular blood supply using an automated thermo-infusion dispenser
      vs. the traditional methods are demonstrated: no side effects on the intraocular
      and regional hemodynamics, purposeful delivery of drugs to the site of ocular
      blood supply with a simple and convenient device. This method for the choice of a
      collector for intraarterial infusions and the method of drug infusion were
      clinically tried in 2 groups of patients: with retrobulbar intoxication neuritis
      and partial atrophy of the optic nerve (a total of 21 patients, 23 operations for
      implantation of infusion system; control group consisted of 11 patients). 120
      Hour infusion therapy with, alternately, trental and actovegin resulted in
      improvement of the vision acuity from 0.03-0.06 to 0.3-0.8 in virtually all group
      1 patients. Moreover, central scotomas disappeared and the conductivity of the
      axial bundle of the optic nerve recovered from 28-32 to 38-40 Hz. In group 2
      defects in the visual field disappeared and its peripheral borders widened. In
      controls no improvement of the visual function was observed.

PMID- 7771039
TI  - [Perfusion pressure in ocular vessels of patients with open-angle glaucoma].
AB  - Perfusion pressure in ophthalmic vessels was measured by computer-aided
      ophthalmodynamography in health, stenoses of the internal carotid artery, and
      open-angle glaucoma. A total of 70 subjects were examined. Stenoses of the
      internal carotid artery are associated with a noticeable reduction of perfusion
      pressure on the side of stenosis. Some patients develop optic nerve atrophy
      (without excavation). Secondary neovascular glaucoma was diagnosed in 1 patient.
      Primary open-angle glaucoma was revealed in none of the patients. Increase of
      intraocular pressure in patients with open-angle glaucoma was associated with a
      reduction of perfusion pressure. However, in more than 50% of patients a higher
      pressure was observed in the orbital artery corresponding to the eye with a
      higher ophthalmic tone than in the contralateral eye. This was conducive to a
      certain leveling of perfusion pressure. Such a reaction is regarded as a
      manifestation of autoregulation of ocular vessels, important for blood delivery
      to the eyes.

PMID- 7771040
TI  - [Tissue micro-diastasis and closed micro-cavities of the surgical zone in
      glaucoma surgery].
AB  - Investigation of methods of antiglaucoma surgery in order to control the
      cicatrization of filtration routes of intraocular fluid discharge is carried out
      at the Vladivostok Medical Institute since 1989. A total of 662 operations are
      analyzed, which were carried out using an original method with "inverted
      trapezium"-shaped dissection of the deep tissues of the sclera. A microsurgical
      knife designed by the authors and patented was used. The results of operations
      indicate their sufficiently high hypotensive effect and a low incidence of
      complications. The authors claim that several filtering components are advisable
      in antiglaucoma surgery. Simplification of the technique of antiglaucoma
      operation, based on the concept of micro-diastasis and micro-cavities, deserves
      to be further researched.

PMID- 7771041
TI  - [Results of intraocular pharmaco-physical therapy in inflammatory diseases of the
      cornea].

PMID- 7771042
TI  - [Results of the treatment of congenital ptosis in children using the Friedenwald
      Guyton method].
AB  - Results of 28 surgeries for congenital ptosis after Friedenwald-Guyton's method
      modified by V.L. Mikheyev are analyzed. A thick woven dacron thread was used for
      suturing. Good results were attained in 24 cases: the pupil area was covered with
      the upper lid by not more than 1/5. No effect was attained in 4 cases. Cases of
      ineffective surgeries are analyzed. A conclusion is made that the aforesaid
      surgery is simple, low traumatic, and sufficiently effective. Dacron thread may
      be effectively used for suturing.

PMID- 7771043
TI  - [Characteristics of the course of phlegmon of the lacrimal sac in newborn
      infants].
AB  - The authors describe an uncommonly stubborn course of a phlegmon of the lacrimal
      sac in two newborns, developing after latent ethmoiditis. They emphasize the
      necessity of a timely consultation of a qualified ENT specialist to plan the
      rational treatment strategy in such patients.

PMID- 7771044
TI  - [Let's recollect their names. The collaboration of V. P. Filatov and A. M.
      Shcherbina (archival materials)].

PMID- 7771045
TI  - [Causes of insufficient effectiveness of collagen plasty (an experimental
      study)].
AB  - Morphological and biomechanical features of the sclera after collagen plasty were
      studied in 90 eyes of 45 chinchilla rabbits. A reduction of the viscous elastic
      properties of the sclera 1 month after surgery was revealed, not described
      previously. The data on the changed mechanical characteristics of the sclera
      following collagen plasty are confirmed by the results of optic and electron
      microscopy; these data permit us to propose that the sclera in the immediate
      postoperative period (less than 1 month after the operation) represents a
      somewhat chaotic structure at the stage of active restructuring. Rational
      postoperative management of patients after collagen plasty is recommended.

PMID- 7771046
TI  - [A new method of formation of chorioretinal adhesions in retinal detachment].
AB  - A method of intrascleral transplantation of foam gel providing the creation of
      stable chorioretinal adhesion at the site of the retinal defect has been
      experimentally developed and clinically tried. A special injector has been
      designed for the realization of the method, permitting stratification of the
      scleral capsule at a given depth. The suggested method is recommended for
      practical use in patients with rheumatogenic detachment of the retina in the
      initial and moderate degrees of vitreoretinal proliferation.

PMID- 7771047
TI  - [Acute retinal necrosis syndrome: diagnosis and treatment strategy].
AB  - The authors describe the clinical picture, diagnostic criteria, and treatment
      strategy in patients with the syndrome of acute retinal necrosis, based on their
      own findings and published data. The syndrome of acute retinal necrosis is
      binocular, the difference in the time of involvement of the paired eye varying
      from 3 weeks to 18 months; the course of the disease is extremely severe.
      Starting as acute iridocyclitis, the disease rapidly progresses and leads to the
      development of vaso-occlusive necrotic retinitis, eventuating in retinal tissue
      degradation at the site of involvement, formation of ruptures and detachment of
      the retina. Detachment of the retina developing during its acute necrosis is
      associated with a drastic hypotension and rapid proliferative changes in the
      retina and vitreous body with the formation of numerous "dense" epiretinal
      membranes and funnel-shaped detachment of the retina. Active treatment strategy
      is recommended: emergency surgical intervention aimed at blocking of necrosis
      sites and ruptures of the retina. Such an approach helped attain adherence of the
      retina and stabilize the course of the disease. Prolonged conservative therapy of
      this syndrome is ineffective.

PMID- 7771048
TI  - Spontaneous equine pulmonary granular cell tumors: morphologic, histochemical,
      and immunohistochemical characterization.
AB  - Spontaneous equine pulmonary granular cell tumors were diagnosed in six mature
      horses at slaughter. These tumors were grossly recognized as multiple (5/6) or
      single (1/6) creamy white, firm nodules. The tumors, located adjacent to bronchi
      and bronchioles, often invaded airways, resulting in partial to complete
      occlusion of the lumina. Neoplastic cells were rounded to polyhedral with
      numerous eosinophilic cytoplasmic granules that reacted uniformly positive with S
      100 and neuron-specific enolase antibodies and multifocally with glial fibrillary
      acidic protein antibodies. These cells were negative for muscle-specific actin,
      lysozyme, cytokeratin, chromogranin A, and myelin basic protein antigens and did
      not stain with silver by the Grimelius technique. Uniformly blue-green and
      scattered pink intracytoplasmic granules were evident with luxol fast blue and
      periodic acid-Schiff counterstain for myelin and myelin breakdown products.
      Histochemical and immunohistochemical staining results of these tumors suggest
      that they are composed primarily of myelinating Schwann cells with lesser numbers
      of scattered nonmyelinating Schwann cells. The morphologic features of the equine
      pulmonary granular cell tumors are strikingly similar to those of endobronchial
      granular cell tumors of human beings.

PMID- 7771049
TI  - Demonstration of Mycoplasma hyorhinis as a possible primary pathogen for porcine
      otitis media.
AB  - A study of the pathology of the ear was performed on 479 pigs ranging in age from
      1 day to 1 year. Histologically, 364 (76.0%) of 479 pigs were affected with
      otitis. Eustachitis was the most common and preceded an inflammation of other
      sites of the ear, and an acute eustachitis occurred from as early as 1 week of
      life. Immunohistochemical examination of frozen cryostat sections revealed
      Mycoplasma hyorhinis (Mhr) antigens on the luminal surface of the eustachian
      epithelia in 14 (50.0%) of 28 piglets examined. All the pigs positive for Mhr had
      an acute eustachitis. Ultrastructural examination on the auditory tubes with
      positive immunostaining disclosed many mycoplasmas among the cilia. Mhr was
      isolated from the auditory tubes and tympanic cavities of 19 (67.9%) and 16
      (57.1%) of 28 piglets examined, respectively. Porcine otitis media may be caused
      primarily by Mhr infection in the auditory tube.

PMID- 7771050
TI  - Clinical pathology and hemostatic abnormalities in experimental African
      horsesickness.
AB  - Infection of naive North American horses with 10(4) cell culture infectious doses
      (CCID50) of virulence variants of African horsesickness virus (AHSV), designated
      AHSV/4SP, AHSV/9PI, and AHSV/4PI, reproduced three classical forms of African
      horsesickness: acute (pulmonary), subacute (cardiac), and febrile, respectively.
      Distinct clinicopathologic and hemostatic abnormalities were associated with each
      form of disease. Hemostatic abnormalities included increased concentration of
      fibrin degradation products and prolongation of prothrombin, activated partial
      thromboplastin, and thrombin clotting times. Hemostatic findings indicated
      activation of the coagulation and fibrinolytic systems with clotting factor
      consumption in acute and subacute cases of African horsesickness. Hematologic
      abnormalities in acute and subacute cases of African horsesickness included
      leukopenia, decreased platelet counts, elevated hematocrit, and increased
      erythrocyte counts and hemoglobin concentration. Leukopenia was characterized by
      lymphopenia, neutropenia, and a left shift. Increased levels of serum creatine
      kinase, lactate dehydrogenase, aspartate aminotransferase, and alkaline
      phosphatase, hypocalcemia, hypoalbuminemia, hypoproteinemia, and elevated
      creatinine, phosphorus, and total bilirubin levels were present in some but not
      all horses. Metabolic acidosis, indicated by decreased total bicarbonate and
      increased lactate and anion gap, was present in horses with the acute form of
      disease. Mild thrombocytopenia and leukopenia were occasionally associated with
      the febrile form of disease. These results suggest a role for intravascular
      coagulation in the pathogenesis of African horsesickness.

PMID- 7771051
TI  - Feline endomyocarditis and left ventricular endocardial fibrosis.
AB  - A retrospective study was conducted of all feline necropsies over a 7-year
      period. Of a total of 1,472 necropsies, 37 cases of endomyocarditis (EMC) and 25
      cases of left ventricular endocardial fibrosis (LVEF) (previously called
      restrictive or intermediate cardiomyopathy) were identified. There was a subset
      of four cats with EMC that had histologic features of both diseases. Interstitial
      pneumonia was seen in 25 of 35 cats (71%) with EMC but in only seven of 25 cats
      (28%) with LVEF. Thrombi or thromboemboli were seen in 14 of 25 cats (56%) with
      LVEF but in only six of 37 of cats (16%) with EMC. In both LVEF and EMC,
      thromboemboli were located in the abdominal aorta, left atrium and ventricle of
      the heart, femoral artery, cranial mesenteric artery, liver, pulmonary artery,
      jugular vein, or a meningeal vessel. Each cat had a single
      thrombus/thromboembolus, except for four cats with LVEF that had more than one.
      The histologic and clinical findings suggest that EMC and LVEF represent
      temporally different manifestations of a single disease entity.

PMID- 7771052
TI  - Murine cytomegalovirus-associated arteritis.
AB  - Unique inflammatory lesions affecting the ascending aorta and pulmonary artery of
      BALB/c and C57BL/6 mice infected with murine cytomegalovirus (MCMV) were
      identified in a pilot and two subsequent experiments to characterize the
      potential effect of MCMV infection on diet-induced atherosclerotic lesions.
      Suckling BALB/c and C57BL/6 mice were inoculated with MCMV and subsequently fed
      either a commercial mouse diet or a synthetic atherogenic diet from weaning. The
      three experiments varied with respect to the age of the mice at the time of MCMV
      inoculation and the dose of virus given. The conditions of MCMV exposure were
      progressively modified in the three experiments to increase the prevalence of
      MCMV-associated inflammatory lesions in the pulmonary artery and aorta. In the
      final experiment, in which suckling mice were inoculated at 9 days of age, MCMV
      associated arteritic lesions had an observed prevalence at 8 weeks post
      inoculation of 87.5% (7/8) in BALB/c mice on the normal diet and 100% (8/8) in
      C57BL/6 mice on the normal diet and in both strains on the atherogenic diet. The
      inflammatory lesions in both vessels were characterized by mononuclear cell
      infiltrates containing CD3+, CD4+, and CD8+ lymphocytes. The cellular infiltrates
      were often more intense on the adventitial surface and infiltrated into the
      overlying tunica media. The intima was infiltrated by mononuclear cell
      infiltrates that appeared to contain more macrophages and fewer lymphocytes than
      did the adventitial infiltrates.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771053
TI  - Higher incidence of Gastrospirillum sp. in swine with gastric ulcer of the pars
      oesophagea.
AB  - Gastric ulcer in swine is characterized by an area of acid-peptic digestion,
      occurs usually in the pars oesophagea of the stomach, and has unknown
      etiopathogenesis. The present work was carried out to investigate the prevalence
      of the newly described spiral-shaped microorganism Gastrospirillum sp.
      ("Gastrospirillum suis") in stomachs of abattoir pigs with and without gastric
      ulcer. Stomachs were removed from 32 consecutive pigs presenting apparently
      normal mucosa and from 32 additional consecutive pigs presenting frank, chronic
      gastric ulcer of the pars oesophagea. Fragments of antral, oxyntic, cardiac and
      pars oesophagea regions were taken from each stomach and processed for histology
      and for identification of Gastrospirillum sp. in tissue sections. The
      microorganisms were identified mainly in the mucous layer and in gastric foveolas
      of the antral and oxyntic mucosa. Forty pigs (62.5%) were positive for
      Gastrospirillum sp.; among them, 27 (67.5%) had gastric ulcer, and 13 (32.5%) had
      no ulcer. Twenty-four pigs (37.5%) were negative for Gastrospirillum sp.; among
      them, five (20.8%) presented with gastric ulcer, and 19 (79.2%) had no ulcer.
      There was a significant difference between pigs with and without gastric ulcer in
      regard to the presence of Gastrospirillum sp. (P < 0.01). The spiral-shaped
      microorganism Gastrospirillum sp. that inhabits the stomach of pigs should be
      considered a possible factor connected with the etiopathogenesis of swine gastric
      ulcer.

PMID- 7771054
TI  - Lectin histochemistry of normal and herpesvirus-infected bovine nasal mucosa.
AB  - Proliferation of Pasteurella haemolytica serotype 1 in the nasal cavity following
      stress or viral infection is an important event in the pathogenesis of bovine
      pneumonic pasteurellosis. Enhanced adhesion of P. haemolytica to nasal mucosa
      could be one factor that predisposes animals to this proliferation. Nasal mucosa
      from normal and bovine herpesvirus-1 (BHV1)-infected cattle were examined
      histochemically for their glycoconjugate composition. Twenty lectins were
      screened, six of which were chosen for subsequent study. Three of these were
      specific for N-acetylgalactosamine (NAGal) (Dolichos biflorus, Glycine max, and
      Vicia villosa), and one each was specific for N-acetylgalactosamine/galactose
      (Griffonia simplicifolia-I), mannose/glucose (Canavalia ensiformis), and N
      acetylglucosamine (Triticum vulgaris). For the surface mucosa and submucosal
      glands, there was greater reactivity in samples from BHV1-infected than from
      normal cattle for all six lectins. Reactivity was most prominent for the NAGal
      specific lectins. Neuraminidase treatment of samples from normal and BHV1
      infected cattle tended to result in greater lectin reactivity. Lectin reactivity
      was generally more intense in focally inflamed areas, but diffuse reactivity was
      not substantially affected by inflammation. BHV1-induced alteration of nasal
      mucosal glycoconjugates could enhance adhesion and colonization of P. haemolytica
      to nasal surfaces and may be one factor responsible for the increased number of
      P. haemolytica serotype 1 in the nasal cavity following viral infection.

PMID- 7771055
TI  - Immunoreactivity of canine epithelial and nonepithelial neoplasms with monoclonal
      antibody B72.3.
AB  - Monoclonal antibody (MAb) B72.3, which binds to a human tumor-associated
      glycoprotein termed TAG-72, was applied to a wide range of epithelial and
      nonepithelial neoplasms from dogs. Immunoreactivity was detected by the use of an
      avidin-biotin complex (ABC) immunoperoxidase method. A variety of epithelial
      neoplasms, but none of the nonepithelial neoplasms, were positive (> or = 5%
      staining) for MAb B72.3. MAb B72.3 stained 100% (4/4) of gastric, 100% (6/6) of
      intestinal, 50% (2/4) of pancreatic, and 80% (4/5) of rectal adenocarcinomas but
      only 20% (1/5) of squamous cell carcinomas and 20% (1/5) of complex tubular
      mammary gland adenocarcinomas. None of the hepatocellular carcinomas and perianal
      and sebaceous gland adenocarcinomas stained. Most types of benign epithelial
      neoplasms did not stain, except for 75% (6/8) of rectal adenomas and 25% (1/4) of
      squamous cell papillomas. Normal gastrointestinal mucosa adjacent to and
      entrapped in neoplasms did stain with MAb B72.3. None of the benign and malignant
      nonepithelial neoplasms of mesenchymal, neuroendocrine, or lymphohematopoietic
      tissue origin stained. The results of this study demonstrate that MAb B72.3 has
      selective immunoreactivity for adenocarcinomas, especially those arising from the
      digestive tract; however, limited immunoreactivity was observed for other types
      of carcinomas and benign epithelial neoplasms and for normal gastrointestinal
      mucosa in the dog.

PMID- 7771056
TI  - Immunoreactivity of canine transitional cell carcinoma of the urinary bladder
      with monoclonal antibodies to tumor-associated glycoprotein 72.
AB  - Tumor-associated glycoprotein 72 (TAG-72) is a large, high molecular weight,
      mucinlike antigen that is expressed in a wide variety of human carcinomas. Three
      different TAG-72 monoclonal antibodies (MAbs), designated B72.3, CC49, and CC83,
      were applied to the following archived samples from the dog: 1) 51 transitional
      cell carcinomas of the urinary bladder, 2) 15 hyperplastic/inflamed urinary
      bladders, and 3) eight normal urinary bladders. Immunoreactivity was detected
      with an avidin-biotin complex immunoperoxidase method. Fifty-three percent
      (27/51) of transitional cell carcinomas were positive (> or = 5% staining) for
      MAb B72.3. MAb B72.3 staining of these transitional cell carcinomas did not
      statistically correlate with any of the examined features of malignancy,
      including histologic grade, clinical stage, DNA ploidy, or presence of
      vascular/lymphatic invasion. In regard to the staining of transitional cell
      carcinoma by the other two TAG-72 antibodies, 53% (27/51) of the samples were
      positive for MAb CC83 and 63% (32/51) were positive for MAb CC49. The finding
      that similar populations of neoplastic urothelial cells in serial sections from
      the same neoplasm stained with all three TAG-72 antibodies supports the
      hypothesis that an antigen similar to TAG-72 was expressed in canine transitional
      cell carcinoma. None of the normal urinary bladders nor any of the
      hyperplastic/inflamed urinary bladders stained with any of the three TAG-72
      antibodies tested. The results of these studies demonstrated that the staining of
      canine transitional cell carcinoma with all three TAG-72 antibodies was specific
      for neoplastic urothelial cells and that an antigen similar to TAG-72 was
      expressed.

PMID- 7771057
TI  - In situ hybridization and immunohistochemical study of walleye dermal sarcoma
      virus (WDSV) nucleic acids and proteins in spontaneous sarcomas of adult walleyes
      (Stizostedion vitreum).
AB  - Twenty-two anatomically independent dermal sarcomas from six adult walleye fish
      (Stizostedion vitreum) collected during the spring from Oneida Lake, New York,
      were examined by in situ hybridization and immunohistochemistry for the presence
      of walleye dermal sarcoma virus (WDSV). The viral RNA, DNA, and 90-kd protein
      were localized at the cellular level. Riboprobes complementary to the 5' terminal
      region of WDSV genome were used to detect viral nucleic acids. Rabbit polyclonal
      antiserum was generated against the 90-kd virus-associated antigen, presumably a
      product of the env gene, for immunohistochemical studies. Viral transcripts were
      detected in the neoplastic cells of all dermal sarcomas, in which they were
      generally abundant. Rare mononuclear inflammatory cells and cells within the
      epidermis also expressed viral RNA. In all sarcomas, low to moderate levels of
      viral DNA were present in all neoplastic and most mononuclear inflammatory and
      epidermal cells. Many neoplastic cells were immunopositive for the virus
      associated protein. The distribution of immunopositive neoplastic cells mimicked
      approximately that of cells containing viral transcripts. The number of
      neoplastic cells with transcripts exceeded that of cells with protein, suggesting
      that productively infected neoplastic cells constituted a subset of the
      neoplastic cells that expressed WDSV transcripts. The viral antigen was also
      present within many mononuclear inflammatory cells. These data suggested that 1)
      dermal sarcomas were associated with elevated transcriptional activity of WDSV in
      the neoplastic cells and 2) the cell tropism of WDSV extended beyond the
      mesenchymal fibroblast-like neoplastic cells and included at least mononuclear
      inflammatory and epidermal cells.

PMID- 7771058
TI  - Pasteurella haemolytica lipopolysaccharide-induced cytotoxicity in bovine
      pulmonary artery endothelial monolayers: inhibition by indomethacin.
AB  - Exposure of bovine pulmonary artery endothelial cells to Pasteurella haemolytica
      lipopolysaccharide caused severe morphologic changes. Initially, there was
      dilatation of the rough endoplasmic reticulum and mitochondrial swelling followed
      by cell retraction, membrane bleb formation, and cell detachment. The affected
      endothelial cells had severe membrane damage resulting in the leakage of lactate
      dehydrogenase. Indomethacin in concentrations of 0.5 mM or greater caused marked
      decreases in the lipopolysaccharide-induced leakage of lactate dehydrogenase.
      Indomethacin at 5 mM also caused a marked reduction of the lipopolysaccharide
      induced morphologic changes resulting in apparent maintenance of the monolayer
      integrity for 8 hours versus 1 hour in the lipopolysaccharide-treated control. A
      marked decrease in the cell and nuclear membrane effects resulted, but the rough
      endoplasmic reticulum dilatation and mitochondrial changes proceeded. These
      results indicate that indomethacin does not prevent lipopolysaccharide binding
      but interferes with later events in lipopolysaccharide-induced cytotoxicity in
      the bovine pulmonary endothelial cell. The concentration of indomethacin required
      to produce this inhibition suggests that the primary mechanism is not
      cyclooxygenase inhibition.

PMID- 7771059
TI  - Early development of encephalomyocarditis (EMC) virus-induced orchitis in Syrian
      hamsters.
AB  - Lesions associated with encephalomyocarditis (EMC) virus in the testes of Syrian
      hamsters were investigated. Histopathologic changes were first detectable by
      light microscopy at 3 days postinoculation (DPI). Immunohistochemically, virus
      antigens were detected in the cytoplasm of germ cells and Sertoli cells in some
      seminiferous tubules beginning at 2 DPI. The following ultrastructural changes
      were observed: 1) swelling of mitochondria and dilatation of endoplasmic
      reticulum in germ cells, 2) large number of residual bodies in seminiferous
      tubules, 3) aggregates of virus-like particles in the cytoplasm of degenerated
      cells and tubular lumen, 4) condensation of cytoplasm and dilatation of
      endoplasmic reticulum in Sertoli cells, and 5) degenerative changes in capillary
      endothelial cells.

PMID- 7771060
TI  - Symmetric bilateral brachymetacarpalia of a dog.
AB  - Malformations of the canine manus are infrequently cited in the literature but
      include polydactylia and syndactylia. Here, a case of brachymetacarpalia
      affecting the second and fifth metacarpal bones of both forelimbs of a mixed
      breed dog is described. The initial impression of shortened digits was disproved
      by statistical comparison with normal skeletons, but the presence of shortened
      metacarpal bones was demonstrated. Other malformations of the manus and
      appropriate terminology are briefly discussed.

PMID- 7771061
TI  - Intracranial gangliocytoma in a dog.
AB  - The clinical, pathologic, immunohistochemical, and electron microscopic
      characteristics of a pure intracranial gangliocytoma in a 6-year-old spayed
      female dog are presented. The tumor is very rare in humans, and has not been
      previously reported in the dog. The most remarkable feature of this tumor was
      that it was composed of a single neuronal cell type without the presence of glial
      elements, as demonstrated by the negative immunohistochemical reaction to glial
      fibrillary acidic protein.

PMID- 7771062
TI  - Rapid diagnosis of Listeria monocytogenes by immunohistochemistry in formalin
      fixed brain tissue.

PMID- 7771063
TI  - Assignment of islet amyloid polypeptide (IAPP) gene to feline chromosome B4 using
      the polymerase chain reaction technique on feline-rodent hybrid cell lines.
AB  - The most characteristic morphologic features of the pancreatic islets of human
      non-insulin-dependent diabetes mellitus (NIDDM, or type 2 diabetes mellitus) and
      of similar forms of diabetes in cats and macaques are the deposition of amyloid
      (islet amyloid) and the loss of beta cells. Islet amyloid is derived from islet
      amyloid polypeptide (IAPP), which is a normal secretory product of the beta
      cells. Therefore, knowledge of the IAPP gene is of potential importance in
      defining the pathogenesis of NIDDM. To identify the feline chromosome(s) on which
      the IAPP gene is located, we screened genomic DNA obtained from 38 feline-rodent
      hybrid cell lines that have a known feline chromosome content. Feline IAPP DNA
      was amplified and detected using the polymerase chain reaction technique.
      Discordancy analysis for each feline chromosome showed that chromosome B4 had the
      lowest discordancy (P < 0.0001). Feline chromosome B4 shows an extensive
      conserved syntenic relationship with human chromosome 12, on which the human IAPP
      gene is located. This study therefore extends and confirms the homology between
      human chromosome 12 and feline chromosome B4 and provides an additional genetic
      marker for feline chromosome B4.

PMID- 7771064
TI  - Giant cell glioblastoma in the frontal cortex of a dog.
AB  - A dark gray mass 3 cm in diameter replacing the right frontal cortex was found in
      the brain of a 5-year-old male Doberman Pinscher dog at necropsy. Microscopic
      studies revealed that the mass consisted of a proliferation of pleomorphic tumor
      cells: large bizarre or plump eosinophilic cells, multinucleated giant cells, and
      small lymphocytic cells. These neoplastic cells at the margin of the necrotic
      area had a psuedopalisade arrangement and tended to proliferate around blood
      vessels. Immunohistochemically, the tumor cells reacted intensely with the
      antibody for vimentin and moderately with those for S-100 and glial fibrillary
      acidic protein. This canine tumor is placed in the category of glioblastoma or
      undifferentiated astrocytoma, which is analogous to human giant cell
      glioblastoma.

PMID- 7771065
TI  - Immunohistochemical identification of porcine reproductive and respiratory
      syndrome virus (PRRSV) antigen in the heart and lymphoid system of three-week-old
      colostrum-deprived pigs.
AB  - Porcine reproductive and respiratory syndrome virus (PRRSV) antigens were
      detected by a streptavidin-biotin complex technique in tissues of 3-week-old
      colostrum-deprived pigs that had been inoculated intranasally with PRRSV and had
      developed moderate respiratory disease. Moderate, multifocal, tan-colored
      consolidation of the lungs and severe enlargement of the lymph nodes were noted
      at necropsy. Severe interstitial pneumonia characterized by type 2 pneumocyte
      proliferation, septal infiltration with mononuclear cells, and accumulation of
      macrophages and necrotic cells in alveolar spaces was observed at 4 and 9 days
      postinoculation. Moderate multifocal perivascular lymphohistiocytic myocarditis
      was observed at 9 days postinoculation. Marked lymphoid follicular hyperplasia
      and follicular necrosis in the tonsil, spleen, and lymph nodes was observed. A
      monoclonal antibody that recognizes a conserved epitope of PRRSV nucleocapsid
      protein was used as primary antibody for immunohistochemistry. Antigen was
      readily detected in alveolar macrophages in the lung and in endothelial cells and
      macrophages in the heart. Macrophages and cells resembling dendritic cells in
      tonsil, lymph nodes, thymus, and spleen also stained intensely positive for viral
      antigen. PRRSV appears to replicate primarily within macrophages in the
      respiratory and lymphoid systems of the pig.

PMID- 7771067
TI  - Pathologic lesions: they're the worst kind.

PMID- 7771066
TI  - Spontaneous osteosarcoma of the meninges in an albino rat.
AB  - A search of the rat tumor literature revealed no papers on naturally occurring
      primary osteosarcoma of meninges. In humans, this tumor, arising primarily from
      the meninges, is unusual; only two cases have been reported. We report on a
      spontaneously occurring osteosarcoma arising from meninges in a 2-year-old female
      albino rat. The diagnosis was made on the basis of gross, microscopic, and
      ultrastructural findings. The diagnosis of this neoplasm is supported by the fact
      that a primitive mesenchymal cell in the meninges is capable of giving rise to a
      wide variety of neoplasms.

PMID- 7771068
TI  - Tumors in St. Lawrence beluga whales (Delphinapterus leucas)

PMID- 7771069
TI  - More about carcinogens and tumors.

PMID- 7771070
TI  - Clinical and epidemiological correlates of the neurohistology of cases of
      histologically unconfirmed, clinically suspect bovine spongiform encephalopathy.
AB  - The associations between three major categories of the neurohistological
      diagnoses and the epidemiological data were examined in unconfirmed cases of
      clinically suspect bovine spongiform encephalopathy (BSE). The diagnostic
      categories were focal spongiosis of white matter (37 cases), encephalic
      listeriosis (13 cases) and no significant lesions (78 cases). An additional
      control category of 200 confirmed cases of BSE were included for comparison.
      Epidemiological variables were the frequencies of specific clinical signs, the
      season of clinical onset, the age, the duration of the clinical signs and the
      geographical origin of the cases. Discriminant analysis was used to assess the
      contribution of these variables to the distinction between the diagnostic
      categories. The analyses characterised the cases of listeriosis by their shortest
      clinical duration, the greater prevalences of certain clinical signs and their
      occurrence mainly in winter and spring, consistent with current understanding of
      the disease. Cases of focal spongiosis, a lesion of unknown significance, but
      potentially with a metabolic causation, were tentatively separable from cases
      with no significant lesions by their winter onset. The results also confirmed
      that among the categories, the cases of BSE had the longest clinical duration.
      Despite their statistical significance, the findings do not have sufficient
      predictive power to be of value in making clinical decisions.

PMID- 7771072
TI  - Clinical and pathological changes associated with atoxoplasma in a captive
      bullfinch (Pyrrhula pyrrhula).

PMID- 7771071
TI  - Severe post-dipping dermatitis and subcutaneous fluid swellings associated with
      two outbreaks of sheep scab (Psoroptes ovis infestation)
AB  - Large subcutaneous fluid swellings developed on some of the sheep in two flocks
      infested with Psoroptes ovis during the two weeks after they had been plunge
      dipped in phenol-based solutions. The swellings contained between 1 and 10 litres
      of exudate and affected 4 per cent of the sheep in each flock. The sheep with
      subcutaneous fluid swellings or exudative dermatitis had significantly lower
      serum albumin concentrations than the unaffected sheep (P < 0.05). In most cases
      secondary bacterial infections of the exudate occurred and these necessitated
      intensive antibiotic therapy. The severity of the skin lesions posed a serious
      welfare problem.

PMID- 7771073
TI  - Primary transmissible venereal tumour in the nasal cavity of a dog.

PMID- 7771075
TI  - New rules on medicines.

PMID- 7771074
TI  - Persistent efficacy of moxidectin against Dictyocaulus viviparus and Ostertagia
      ostertagi in cattle.

PMID- 7771076
TI  - New rules on medicines.

PMID- 7771077
TI  - New rules on medicines.

PMID- 7771078
TI  - New rules on medicines.

PMID- 7771079
TI  - New rules on medicines.

PMID- 7771080
TI  - Hydatid disease.

PMID- 7771081
TI  - [Antioxidant activity of natural and synthetic quinones].
AB  - Antioxidation activity (AOA) of ubiquinone (Q10), phylloquinone (vitamin K1),
      menadione as well as of the newly synthesized analogues of vitamin K1--N
      derivatives of 2-methyl-3-aminomethyl 1.4-naphthoquinone, producing autocomplexes
      with intramolecular transfer of electrons, was studied in the model system of the
      methyl oleate initiated oxidation. The menadione AOA was shown to be 2-fold
      higher as compared with the inhibitory activity of natural quinones. Activity of
      AK-40 and AK-49, artificial analogues of vitamin K1, was higher 2.6-fold than
      that of ubiquinone and phylloquinone and 1.4-fold higher than menadione activity.
      At the same time, AOA of ubiquinone and phylloquinone was 1.5-fold lower than the
      tocopherol activity, while naphthoquinones AK-40 and AK-49 were 2-fold more
      active as compared with tocopherol but their activity was 2-fold lower than
      ionol. Mechanism of natural and synthetic quinones action as well as properties
      of their long chain analogues are discussed.

PMID- 7771082
TI  - [Structure and function of lipoproteins from the aspect of protein biochemistry
      (hypothesis)].

PMID- 7771083
TI  - [Biochemical bases for the antiseizure role of the pineal gland].
AB  - Metabolism of serotonin was studied in pineal gland of Wistar rats with low and
      high rate of audio excitability as well as in the Krushinsky-Molodkina rat
      population genetically predisposed to audio-dependent convulsions. Intensive
      turnover of serotonin via N-acetyl serotonin into melatonin was found in pineal
      gland of rats insensitive to sensory stimulus, whereas the rate of this response
      was decreased in the gland tissue of animals sensitive to audio effects as well
      as inhibition of serotonin turnover into melatonin was noticed in pineal gland of
      rats predisposed genetically to audio-dependent convulsions.

PMID- 7771085
TI  - [The effect of neuroleptics on blood proteins during development of toxic
      cerebral edema-brain swelling].
AB  - Simulation of toxic brain edema-swelling allowed one to analyze the dynamics of
      blood protein alteration in presence of various neuroleptics. Alterations in
      blood protein fractions correlated with dynamics of nervous tissue impairments.
      All the drugs studied exhibited similar antiswelling action involving the gamma
      globulin sub-system activation. At the same time, the neuroleptics with
      activating and depriving effects demonstrated an oppositely directed influence on
      blood albumins.

PMID- 7771084
TI  - [Oxidative modification of human serum proteins. A method of determining it].
AB  - A rate of protein oxidative destruction may be estimated from the reaction of the
      resultant carbonyl derivatives of amino acids reaction with 2,4-dinitrophenyl
      hydrazine. The procedure for estimation of 2,4-dinitrophenyl hydrazones was
      modified for clinical application. The initiating effect of nonenzymatic
      components (Fe(3+)-ascorbic acid, Fe(2+)-O2, Fe(2+)-H2O2) was in the metal
      catalyzing oxidation of proteins. Estimation of derivatives of 2,4-dinitrophenyl
      hydrazones in tissues may serve as a pattern of protein oxidative modification
      during oxidative stress in the body.

PMID- 7771086
TI  - [The role of proteins in the immunomodulating effect of bioginseng products].
AB  - Immunomodulating properties of the bioginseng preparations (Panax ginseng),
      isolated from the cell culture of ginseng calluses, were studied in model
      experiments of acquired immunodeficiency developed as a result of long-term
      protein starvation or after vinblastin administration. The following preparations
      were studied: 1) preparation obtained by means of the cell culture
      cryoconcentration, 2) ethanol extract of the cell culture, 3) high-molecular
      protein containing fraction of the bioginseng I. Under conditions of acquired
      immunodeficiency all the preparations studied were shown to increase the content
      of antibody producing cells developed in response to sheep erythrocytes
      administration, while the highest effect exhibited the bioginseng preparation
      III. These data suggest that proteins are of great importance in the
      immunomodulating effects of bioginseng preparations.

PMID- 7771087
TI  - [Antioxidant effect of a Ural licorice product in acute impairment of pulmonary
      surfactant by total gamma irradiation].
AB  - Total single irradiation of rats at a dose of 2 Gy caused activation of lipid
      peroxidation in lung surfactant and blood serum within 7 days. Most pronounced
      alterations occurred in content of 2-thiobarbituric acid-positive substances and
      in activity of the antioxidant system enzymes. Administration of the preparation
      isolated from Liquorice uraliensis within 2 weeks before the irradiation and
      within 7 days after the treatment contributed to inhibition of the radiation
      induced lipid peroxidation.

PMID- 7771088
TI  - [An enterosorbent with trimethylaminoethanol chloride. 2. Hypolipidemic action
      and effect on cholesterol absorption in the intestine (experimental data)].
AB  - Enterosorbent containing trimethyl aminoethanol chloride administered per os into
      rabbits accelerated the rate of experimental hypercholesterolemia regression.
      Moreover, this substance decreased 4-14C-cholesterol absorption in the rat
      intestine.

PMID- 7771089
TI  - [Correcting effect of nicotinamide on hemoglobin glycosylation in streptozotocin
      diabetes in rats].
AB  - Streptozotocin induced diabetes in rats was accompanied by development of
      hyperglycemia, by increase in the rate of hemoglobin and albumin glycosylation in
      blood and by elevation of 2,3-diphosphoglycerate content in erythrocytes.
      Alterations of the dissociation properties and the decrease in Hb P50 value
      suggested the reduced affinity of hemoglobin to oxygen. Injection of
      nicotinamide, which is involved in NAD+ biosynthesis, caused a decrease of
      glucose content in blood, stabilized the content of 2,3-diphosphoglycerate and of
      glycosylated hemoglobin in erythrocytes. Nicotinamide appears to decrease the
      rate of hemoglobin glycosylation and enhanced the tissue oxygen utilization under
      hypoxic conditions.

PMID- 7771090
TI  - [Expression of lysosomal enzymes in pregnancy].
AB  - Activities of 6 lysosomal enzymes in leukocytes and 3 enzymes in blood serum were
      studied in pregnant women. Only activity of beta-D-glucosidase was not altered
      within all the pregnancy of I-III trimesters, while activity of all the other
      enzymes studied was distinctly increased to the third trimester. Use of the data
      obtained in prenatal diagnosis of lysosomal storage diseases is discussed.

PMID- 7771091
TI  - [Effect of carnosine and its derivatives on ADP-induced human platelet
      aggregation].
AB  - ADP-induced aggregation of thrombocytes was studied in patients with
      cerebrovascular impairments as well as after treatment with carnosine and its
      native derivatives; these drugs proved to be modulators of the cell aggregation.
      Carnosine decreased the rate of thrombocyte aggregation in patients with high
      index of aggregation and exhibited the proaggregation activity in patients with
      low rate of aggregation. The antiaggregation activity of the preparations
      studied, used at physiological concentrations 3.5 mM, was increased as follows:
      carnosine (17%) < histidine < acetyl anserine < ophidine < anserine (35%).
      Application of carnosine and its native derivatives may be promising and
      effective in correction of thrombocyte functional properties in patients with
      cerebrovascular impairments.

PMID- 7771092
TI  - [Level of lipid-bound sialic acids in blood from brain tumor patients].
AB  - Content of lipid-bound sialic acids was studied in blood serum of patients with
      benign tumors--gliomas, neurinomas, meningiomas, with malignant tumors--gliomas
      and anaplasia, glioblastomas, sarcoma, as well as of patients with impairment of
      peripheral nervous system (without any tumors) and of healthy volunteers. Content
      of lipid-bound sialic acids in blood serum of patients with benign tumors was
      similar to that of controls, while it was distinctly increased in all the
      patients with malignant tumors. These results corresponded to literature data,
      where the patients with non-brain localization of tumors are considered.

PMID- 7771093
TI  - [Status of the antioxidant enzyme system in benign symmetrical lipomatosis and
      changes in it from the use of antioxidant therapy].
AB  - Activity of the antioxidation enzymatic system, involving evaluation of
      glutathione-reductase, -peroxidase and -S-transferase as well as glucose-6
      phosphate dehydrogenase activities, was studied in blood plasma, leukocytes,
      lymphocytes and erythrocytes of patients with benign symmetric lipomatosis.
      Elevation in the rate of lipid peroxidation induced the antioxidation enzymatic
      system and caused a imbalance of its individual units. Intensive antioxidation
      therapy using "Aevit" allowed correction of the imbalance observed in the
      enzymatic activity.

PMID- 7771094
TI  - [Dynamics of the level of plasma myoglobin in oncology patients with and without
      complications in the postoperative period].
AB  - Initial hypermyoglobinemia was found in patients with cancer of lungs, large
      intestine and rectum. Within early postoperational period under favourable
      conditions moderate increase in content of free myoglobin was detected, most
      pronounced in patients with lung cancer. Maximum concentration of myoglobin was
      estimated within first postoperational day, normalization occurred within 3-4
      days after the operation. In patients with postoperational complications
      (peritonitis, pneumonia, sepsis, etc) increase in content of myoglobin was more
      distinct (1.6-2-fold) and was maintained within the longer period. Increase in
      content of blood plasma myoglobin occurred usually before manifestations of
      clinical symptoms related to postoperational complications.

PMID- 7771095
TI  - [Refining criteria for supplying the body with vitamin C].
AB  - As shown by mathematical analysis of a dependence of vitamin C excretion with
      urine on its content in blood as well as by plotting and mathematical
      interpretation of the variation curves exhibiting distribution of the ascorbic
      acid detected in blood plasma of persons additionally treated with vitamin C, the
      values 0.4-0.5 mg/dl of vitamin C (lower limit of normal values) may be
      recommended as a criterion of the vitamin normal consumption which corresponded
      to literature data. The value 0.7 mg/dl used in literature is the optimum content
      of vitamin C in blood. Excretion of vitamin C with urine, corresponding to lower
      limits of the vitamin consumption, constituted 0.4 mg/h in adults and 0.2 mg/h-in
      children of 5-14 years old. Metabolism of vitamin C in patients with diabetes
      mellitus was considerably distinct from that of healthy persons. As a criterion
      of normal vitamin C consumption in children of 9-13 years old impaired with
      diabetes mellitus, the content 1 mg/dl of vitamin C in blood plasma should be
      considered and its excretion with urine--more than 1.8 mg/h.

PMID- 7771096
TI  - [A micromethod for determining tissue lipase activity using gas-liquid
      chromatography].
AB  - Lipase activity was studied in preparations of skeletal muscles and fatty tissue
      by means of measurement of oleic acid methyl ester concentration developed after
      triolein hydrolysis using gas-liquid chromatography apparatus. The procedure
      described helped unify the methodology approaches in estimation of tissue lipases
      activity and of free fatty acid spectrum of blood serum in microquantities of the
      material studied, it exhibited high sensitivity and specificity.

PMID- 7771097
TI  - [The effect of covalently and noncovalently bound complexes of albumin with
      bilirubin on DNA and protein synthesis in liver and spleen of rats subjected to
      splenectomy and partial hepatectomy].
AB  - Noncovalently bound complexes of albumin and bilirubin were found to stimulate
      DNA and protein synthesis in partially hepatectomized regenerating rat liver
      tissue, while the covalently bound complex inhibited both these synthesis types
      in liver tissue after partial hepatectomy. Splenectomy of intact rats caused an
      induction of DNA and protein synthesis in liver tissue but partial hepatectomy
      decreased drastically the synthesis rate in spleen, thus suggesting that humoral
      factors stimulating the proliferation response in liver and spleen tissues were
      developed after spleen- and hepatectomies. The covalently bound albumin and
      bilirubin complex did not affect the rate of DNA and protein synthesis in liver
      tissue of splenectomized rats, while the complex with noncovalent bonds restored
      the rate of DNA and protein synthesis in the spleen of rats with partial
      hepatectomy. Only the noncovalently bound complex of albumin and bilirubin
      exhibited the properties inherent in hepatotropic growing factor whereas albumin
      administration was not effective. Possible structure and action of the
      noncovalently bound albumin and bilirubin complex are discussed.

PMID- 7771098
TI  - [Clinical study of the effectiveness of filters in vacuum cleaners for reducing
      the concentration of dust mites in the household].
AB  - The faeces of the dust mite are the most significant source of allergy for those
      allergic to the dust mite. During vacuum cleaning, faecal particles are emitted
      from the cleaner and into the air to form pathological concentrations. The aim of
      the study was to discover if these extreme concentrations could be prevented by
      the use of appropriate filters. As the allergen source, dust mite faeces were
      used. A Miele vacuum cleaner type S424i was used without filter, with S-Class
      filter, and with Super Air Clean Filter. In the first test 1 g, and in the second
      test 2 g of dust mite faecal particles were evenly spread and then vacumed up.
      While using each filter in turn, the expelled air was measured for faecal
      concentrations. The analysis was performed by counting the number of faecal
      particles, and determining the content of major allergen Der p I in the expelled
      air. Without a filter there was a massive concentration of faecal particles in
      the expelled air. The simple filter Type (S-class-filter) achieved a significant
      reduction on the emission of allergens. The more complex special filter (Super
      air clean filter), was able to remove all traces of allergens from the expelled
      air.

PMID- 7771099
TI  - [Kidney function and electrolyte metabolism in healthy pregnant women].
AB  - In pregnant women alterations in kidney function, hormone, electrolyte and water
      metabolism are common findings. In 15 healthy pregnant women the kidney function
      and electrolyte metabolism were investigated during pregnancy and after delivery.
      The glomerular filtration rate measured by creatinine clearance was 20% higher in
      the I. trimester than in the II. and the III. trimesters and after the delivery.
      The sodium clearance was in the III. trimester significantly lower than in both
      the I. and the II. trimesters (p < 0.001, p < 0.01); the fractional sodium
      excretion was lowest in the third trimester. Furthermore the serum calcium
      concentration decreased significantly in the II. and III. trimester in comparison
      to the I. trimester (p < 0.01, p < 0.001), which was associated with a moderate
      increased urinary calcium excretion. The phosphate clearance increased during
      pregnancy and decreased approximately 50% after delivery (p < 0.01). The
      magnesium clearance was 40% higher in the third trimester in comparison to the I.
      trimester (p < 0.05) and 61% higher than the value post delivery (p < 0.01). The
      uric acid clearance during pregnancy was markedly increased and decreased 70%
      after delivery (p < 0.05). The results showed that in the III. trimester an
      intensive sodium retention occurred, which is associated with an increase of the
      plasma volume, interstitial fluid and body weight. The decreased serum calcium
      concentration in the II. and III. trimesters, the increased urinary calcium
      excretion as well as increased phosphate clearance suggest an increased
      parathyroid-hormone secretion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771100
TI  - [Comment on Edith Szanto, Doris Gruber, M. Sator, W. Knogler and J. C. Huber:
      Placebo controlled study of Melbrosia in treatment of climacteric symptoms].

PMID- 7771101
TI  - [Hormone substitution with premarin plus. Results of an Austrian multicenter
      treatment study].
AB  - Estrogen/progestin hormone replacement therapy in menopausal women has 2
      important medical rationales. First of all, patients are relieved from the
      subjective symptoms almost fully. In addition patients benefit from prophylaxis
      of long term even life threatening sequelae of estrogen deficiency. This paper
      documents the results of a multicenter phase IV study, performed nationwide in
      Austria with 158 participating gynaecologists. Objective of this phase IV study
      was the analysis of efficacy and safety data of a new estrogen/progestin hormone
      replacement therapy scheme under almost practice conditions in the gynaecological
      context. The therapy supplied was Premarin plus, containing 28 coated tablets of
      0.625 or 1.25 mg conjugated estrogens and in addition 12 tablets for the last
      cycle days containing 5 mg medrogeston. Thus, the dispensing gynaecologists had
      the option of an individual estrogen dose adjustment in case the low starting
      dose showed lack of efficacy. The results are based on the data of 1508 recruited
      female patients. A very high degree of representativeness is attributable to the
      high number of recruited patients. Overall judgement of the results shows a very
      high level of efficacy and a well tolerated scheme of hormone replacement therapy
      with the option of individual estrogen dose adjustments.

PMID- 7771103
TI  - [Clinical trials--methodological gold standard or naive reductionism?].
AB  - The methodological concept of the randomized controlled clinical trial is a
      relatively recent invention. It is widely accepted to be the only means of
      conclusively establishing a cause effect relationship between a given therapeutic
      intervention and an observed outcome. There are, however, numerous pitfalls.
      Ethical concerns and/or practical problems can seriously affect both proper
      randomisation as well as the use of a placebo treatment as the control
      intervention. Sometimes blinding of the patients or the therapist may be
      difficult or even impossible, depending on the availability of a similar
      treatment without the specific therapeutic effect, whereas a satisfactory
      investigator blinding can be achieved in most instances. Practical problems can
      be minimised by adapting the trial design to the given clinical situation. The
      fact that a number of drawbacks exist, must, however, not be used as an argument
      to abstain from performing such studies--simply because there is no better
      alternative.

PMID- 7771102
TI  - [Iontophoresis in the treatment of pain].
AB  - The objective has been to verify the effectiveness of iontophoresis in
      alleviating conditions of pain by means of a computer-assisted search of the
      pertinent literature. The search was performed with the aid of the Medline
      database (1984 bis 1993) and reference lists (studies from 1954). SELECTION
      CRITERIA: all clinical trials performed with at least one control group as well
      as all experimental studies conducted within the same period. The selection
      criteria were met by 10 experimental and 15 clinical studies. The studies were
      categorized by substance group. The following groups of substances were applied
      (experimentally/clinically): local anaesthetics (0/6), non steroidal anti
      inflammatory drugs (2/3), vinca-alkaloids (1/2), corticosteroids (3/1), morphine
      (0/1), iodide (4/1) and fluoride (0/1). Both short-term effects (lidocaine,
      procaine, flufenamic acid, morphine) and long-term effects (benzocaine
      salicylamide, diclofenac, Mobilat, vinca-alkaloids, dexamethasone-lidocaine,
      iodide, fluoride) were studied. Comparisons were made against placebo
      iontophoresis (lidocaine, procaine, flufenamic acid, diclofenac, Mobilat, vinca
      alkaloids, dexamethasone-lidocaine, morphine, fluoride), solely topical
      administration (procaine, benzocaine-salicylamide, flufenamic acid), placebo
      administration without current (procaine, flufenamic acid), and other methods
      (lidocaine, iodide). With one single exception (lidocaine), none of the studies
      included groups without treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771104
TI  - P450 in the rat and man: methods of investigation, substrate specificities and
      relevance to cancer.
AB  - 1. Considerable evidence has been accumulated that orthologous rat and human P450
      forms oxidize numerous chemicals in a highly similar manner, including the
      detoxication and activation of mutagens and carcinogens. 2. Nevertheless, certain
      specific substrates of rat P450s are not so well oxidized by the orthologous
      human forms, and vice versa. 3. Certain mutagens and carcinogens can be activated
      in a similar way by different (non-orthologous) forms in rat and man, confirming
      that studies on animals, directed ultimately to man, can be indicative but not
      predicative of chemical mutagenesis and carcinogenesis.

PMID- 7771105
TI  - Biotransformation of a new synthetic retinoid, 4-[(5,6,7, 8-tetrahydro-5,5,8,8
      tetramethyl-2-naphthyl)carbamoyl] benzoic acid (Am-80), in the rat. Structure
      elucidation of the metabolites by mass and nmr spectrometry.
AB  - 1. The major metabolites of Am-80 in rat bile were examined by tlc
      radiochromatography and hplc-radiochromatography after the intravenous
      administration of 14C-Am-80, and > 15 metabolites were detected. 2. Intact and
      Glusulase-treated bile were analysed by both tlc-radiochromatography and hplc
      radiochromatography. As both samples gave similar patterns in both chromatography
      systems, we have concluded that neither glucuronide nor sulphate conjugates were
      present. 3. 2H3-Am-80 and 2H6-Am-80 were administered to rats, and the major
      metabolites in bile were detected and their structures elucidated by GC-MS. 4.
      The chemical structures of seven major biliary metabolites, including unchanged
      Am-80, were identified by mass and two-dimensional nmr spectrometry, and included
      6-hydroxy-Am-80 (M-3), 7-hydroxy-Am-80 (M-4), 6-oxo-Am-80 (M-5), unchanged Am-80
      (M-0) and the taurine conjugates of M-3 (M-1), M-4 (M-2) and M-0 (M-6).

PMID- 7771107
TI  - Metabolism of tetramethrin isomers in rat: II. Identification and quantitation of
      metabolites.
AB  - 1. To examine the metabolic fate of (1RS, trans)- or (1RS, cis)-tetramethrin [3,
      4, 5, 6-tetrahydrophthalimidomethyl (1RS, trans)- or (1RS, cis)-chrysanthemate],
      rat was administered a single oral dose of trans- or cis-[alcohol
      14C]tetramethrin at dose levels of 2 or 250 mg/kg. 2. The radiocarbon was almost
      completely eliminated from rat within 7 days after administration in all groups.
      14C-recoveries (expressed as percentages relative to the dosed 14C) in faeces and
      urine were 38-58 and 42-58% respectively in rat administrated trans-[alcohol
      14C]tetramethrin, and in faeces and urine were 66-91 and 9-31% respectively in
      rat administered cis-[alcohol-14C]tetramethrin. 3. Fourteen metabolites found in
      excreta were purified by using several chromatographic techniques and identified
      by spectroanalyses (nmr and MS). Five sulphonate derivatives and three
      dicarboxylic acid derivatives were found. 4. The main metabolites were sulphonate
      derivatives in the faeces, and in the urine, alcohols, dicarboxylic acid and
      reduced metabolites derived from the 3,4,5,6-tetrahydrophthalimide moiety.

PMID- 7771108
TI  - Fate of dimethylamine in rat and mouse.
AB  - 1. [U-14C]-dimethylamine hydrochloride was administered by gavage (20 mumol/kg
      body weight) to adult male Wistar rat and CD1 strain mouse. 2. In both species,
      urine was the main route of excretion with the majority of radiolabel (91%) being
      voided during the first day. Additional small amounts of radioactivity were
      detected in the 24-72 h urine (2%), in faeces (2%) and amidst exhaled air (1%),
      with minor amounts remaining within the carcass (1%) after 3 days. 3. Metabolism
      was limited to demethylation, with the majority of the compound (89% dose; 96%
      urinary radioactivity) being excreted unchanged.

PMID- 7771106
TI  - Piperine effects on the expression of P4502E1, P4502B and P4501A in rat.
AB  - 1. Treatment of rat with piperine (PIP) (1.4 mmol/kg, 3 days ip injections)
      resulted in an approximate two-fold increase in total liver microsomal P450
      content relative to that in uninduced animals. 2. 4-Nitrophenol and aniline
      hyroxylase activities in the hepatic microsomes prepared from rat treated with
      PIP decreased by 30 and 28% respectively as compared with control. Immunoblot
      analyses also revealed decreased P4502E1 levels in hepatic microsomes from PIP
      treated animals. 3. In contrast with P4502E1 suppression, hepatic 2B1 and 2B2
      levels were significantly increased in PIP-induced animals, as evidence by both
      metabolic activity and immunoblot analysis of the liver microsomal fractions. The
      rate of hexobarbital hydroxylase activity in microsomes from PIP-treated animals
      was markedly elevated and was inhibited by approximately 62% in the presence of
      monoclonal anti-P4502B IgG. Immunoblot analyses demonstrated that P4502B1 and 2B2
      levels in hepatic microsomes from PIP-treated animals were comparable with those
      from phenobarbital-treated animals. 4. 7-Ethoxycoumarin deethylase activity was
      elevated approximately two-fold in PIP-induced animals and was 17% of that
      derived from 3-methylcholanthrene-induced animals. 7-ethoxycoumarin deethylase
      activity in PIP-induced hepatic microsomes was inhibited 63% in the presence of
      monoclonal anti-P4501A antibody. Immunoblot analysis confirmed the increase in
      P4501A levels by PIP, which was 15% of that in hepatic microsomes from 3
      methylcholanthrene-induced animals. 5. PIP treatment failed to affect microsomal
      epoxide hydrolase (mEH) and glutathione S-transferases (GST) expression, as
      indicated by immunoblot analyses using polyclonal antibodies toward mEH and GST
      subunits Ya, Yb1, Yb2 and Yc. 6. These results demonstrate that PIP treatment
      suppressed P4502E1 expression and enhanced 2B and 1A expression, whereas this
      agent failed to affect hepatic mEH and GST expression.

PMID- 7771109
TI  - Disposition and metabolism of a novel diurea inhibitor of acyl CoA: cholesterol
      acyltransferase (YM17E) in the rat and dog.
AB  - 1. We have investigated the disposition and metabolism of YM17E after intravenous
      and oral administration in the rat and dog. 2. Bioavailability of YM17E was 5-9%
      at oral doses of 3-30 mg/kg in rat, and 9 and 13% at oral doses of 10 and 30
      mg/kg in dog. 3. Five N-demethylated metabolites, which have significant
      pharmacological activity, were found in rat and dog plasma after oral
      administration. Plasma concentrations of each of these metabolites were
      comparable with that of unchanged drug. 4. When 14C-YM17E was administered to
      rat, AUC of unchanged drug was 7% of that of radioactivity. However, AUC of the
      combined concentration of unchanged drug and five active metabolites was about
      50% of that of radioactivity, indicating that the pharmacological activity of the
      agent was maintained in spite of its biotransformation. 5. After oral
      administration of 14C-YM17E at a dose of 10 mg/kg to rat, radioactivity was
      distributed widely to almost all tissues except the brain. The concentration of
      radioactivity in the liver, one of the target organs, was 65 times higher than
      that in plasma at 1 h after administration. 6. A significant amount of
      radioactivity in the liver was located in the microsomal subfraction, which
      contains much acyl CoA:cholesterol acyl transferase activity. More than 50% of
      this microsomal radioactivity was derived from unchanged YM17E and five active
      metabolites. 7. From excretion data in the bile duct-cannulated rat, the
      absorption ratio of YM17E from the gastrointestinal tract in this species was
      estimated to be at least 40%, suggesting that the low bioavailability of the drug
      is due to extensive first-pass metabolism. 8. Some 95% of the administered
      radioactivity was excreted in the faeces of rat following iv or po doses of 14C
      YM17E.

PMID- 7771110
TI  - Metabolism of illudin S, a toxic substance of Lampteromyces japonicus. IV.
      Urinary excretion of an illudin S metabolite in rat.
AB  - 1. The urinary excretion of a metabolite of illudin S after oral administration
      to rat has been studied. 2. From an ethyl acetate extract of urine, metabolite 1,
      a cyclopropane ring-cleavage compound, was identified by liquid chromatographic
      mass spectrometric analysis 3. A hplc method for determination of the metabolite
      in rat urine was developed with extraction using Sep-Pak C18 cartridge followed
      by liquid-liquid extraction. 4. The metabolite excreted during 3 days after
      administration of illudin S to rat amounted to approximately 10-19% of the dose
      as free form and 3-5% of the dose as glucuronide.

PMID- 7771112
TI  - Endemic goitre and cretinism in the Simbai and Tep-Tep areas of Madang Province,
      Papua New Guinea.
AB  - In the late 1960s and early 1970s a mass campaign of iodized oil injections was
      carried out in Papua New Guinea as an interim measure to improve iodine status in
      the population and to prevent endemic goitre and endemic cretinism. Following
      informal reports of children with neurological abnormalities resembling endemic
      cretinism in two areas of Madang Province, the Simbai and Tep-Tep Subdistricts,
      surveys were conducted in these areas in 1985 to establish prevalence rates of
      goitre and cretinism in order to determine whether they had returned as public
      health problems. 42% of the Simbai population and 38% of the Tep-Tep population
      attended for examination. Amongst those surveyed, the visible goitre rate was
      low: 0.1% in the Simbai and 2.5% in the Tep-Tep area. Although the iodized oil
      patrols were carried out a decade previously, goitre does not seem to have re
      emerged in the area to the levels reported previously. In the Simbai villages
      surveyed, there were nine individuals diagnosed as suffering from cretinism,
      three of whom were thought to have been born after the last iodized oil patrol in
      the area. In the Tep-Tep villages, eight subjects were diagnosed as suffering
      from cretinism, all of whom were thought to have been born before the iodized oil
      patrols. A number of younger children with neurological abnormalities which did
      not fulfil criteria for endemic cretinism were also seen in both areas. Because
      of the difficulties in diagnosing endemic cretinism in young children, it is not
      possible to conclude that endemic cretinism is no longer a problem in these
      areas. More work is needed to confirm the results of these studies. This will
      enable a rational control program to be designed and implemented.

PMID- 7771111
TI  - Blood pressure, hypertension and other cardiovascular risk factors in six
      communities in Papua New Guinea, 1985-1986.
AB  - Surveys of noncommunicable diseases were performed in six communities in Papua
      New Guinea during 1985-1986. Results are reported here with respect to blood
      pressure and associated factors in adults. Mean systolic and diastolic blood
      pressures were lowest, and hypertension was rarest (less than 2%), in three
      rural/semirural villages on Karkar Island, Madang Province. Intermediate values
      for blood pressure and moderate prevalence of hypertension (3-6%) were observed
      in rural and urban Tolai communities in East New Britain Province. A periurban
      village in the Eastern Highlands Province displayed the highest mean blood
      pressures and prevalence of hypertension (12% in men and 5% in women). There was
      a modest rise in mean systolic blood pressure with age in most groups, but the
      age-related rise in diastolic pressure was much less pronounced. Other
      cardiovascular risk factors--body mass index (BMI), and plasma cholesterol,
      glucose and insulin concentrations--were lowest in the least developed rural
      villages on Karkar Island and highest in the urban Tolai and periurban highland
      communities. Both systolic and diastolic blood pressures were significantly (and
      positively) related to age, male sex, BMI and speaking a non-Austronesian
      language. It is concluded that there is now a considerable variation in the
      prevalence of hypertension, and the levels of blood pressure and other
      cardiovascular risk factors, in different communities in Papua New Guinea.

PMID- 7771113
TI  - Arbovirus disease in Papua New Guinea.
AB  - It is clear that exposure to arthropod-borne viruses is common in the populations
      of both Papua New Guinea and Irian Jaya. Clinical disease resulting from these
      infections has been reported although the paucity of case reports and combined
      clinical experience suggest that it is rare. Dengue epidemics due to dengue-1 and
      dengue-2 have occurred and it is likely that dengue-3 is also present in the
      region. No cases of dengue haemorrhagic fever have been described. Murray Valley
      encephalitis, Ross River and antigenically related viruses are widespread in
      Papua New Guinea and Irian Jaya, particularly in the lowland and coastal areas.
      Antibodies to Japanese encephalitis virus have not been found in blood samples
      from Papua New Guinea or Irian Jaya. As Papua New Guinea is developed, new areas
      of the country are opened up and ecosystems are altered. It is important that
      physicians based in Papua New Guinea, and those who deal with patients living or
      working here, are aware of the arbovirus diseases which occur and the potential
      and preventable problems posed by them to both the individual and the community.

PMID- 7771114
TI  - The role of corticosteroids in the management of infections in Papua New Guinea.

PMID- 7771116
TI  - Can lymphatic filariasis be eradicated in Papua New Guinea?

PMID- 7771115
TI  - Blood transfusion services.

PMID- 7771117
TI  - Diethylcarbamazine in the control of bancroftian filariasis in the Ok Tedi area
      of Papua New Guinea: phase 2--annual single-dose treatment.
AB  - The Phase 1 semiannual single-dose 6 mg/kg diethylcarbamazine (DEC) treatment
      program demonstrated a significant reduction for Wuchereria bancrofti in the Ok
      Tedi area of Western Province, Papua New Guinea. The rate of detectable
      microfilaraemia was effectively reduced from 39% to 11% and mean microfilarial
      (mf) densities from 79mf/20 microliters to 19mf/20 microliters. The Phase 2
      annual single-dose treatment of 6mg/kg DEC not only maintained the gains made
      during Phase 1 but reduced the microfilaraemia rate to less than 5% by 1990, with
      mf densities remaining stable at less than 20mf/20 microliters, amongst all
      participating villagers screened within the 5 original villages. The annual
      treatment program was expanded into 7 remote villages not subject to any form of
      active vector control. The microfilaraemia rate in these villages declined from
      41% before treatment to 17% after only two annual administrations of 6mg/kg DEC,
      and mf blood densities were reduced from 71mf/20 microliters to 20mf/20
      microliters. As was observed in the 5 original villages participating in the
      program, a significant reduction in splenomegaly associated with the DEC
      treatment was reported for the 7 villages in the expanded program during Phase 2;
      enlarged spleen rates were reduced from 50% (1986) to 32% (1990) and from 76%
      (1988) to 48% (1990), respectively. Malaria rates on the other hand increased
      slightly or remained stable. Malaria infections associated with W. bancrofti
      (mixed parasite infections) stimulated a greater splenic response than either
      parasite detected on its own.

PMID- 7771119
TI  - Betelnut chewing causes bronchoconstriction in some asthma patients.
AB  - A previous questionnaire interview had revealed that betelnut chewing may
      aggravate asthma in 61% of asthma patients attending an outpatient clinic at Port
      Moresby General Hospital; the rest said it had no effect. The aim of the present
      study was to verify patients' subjective feelings through objective measurements.
      7 asthma patients (Group C) who said betelnut aggravated their asthma, 8 asthma
      patients (Group B) who denied any effect and 8 nonasthmatic, healthy subjects
      (Group A) were given betelnut with accompanying ingredients and asked to chew as
      they would usually chew it. Their spirometric forced expiratory volume in the
      first second (FEV1) readings, heart rate and blood pressure were monitored before
      and after this challenge. Group A nonasthmatic subjects experienced only minor
      rises and falls in their FEV1 in response to betelnut chewing. 3 patients in
      Group B experienced overall rises (mean maximal % rise 25 +/- 19) while 5
      patients had overall falls (mean maximal % fall 11 +/- 6). In Group C 1 patient
      had an overall rise in her FEV1 (maximal rise 10%) while 6 patients had falls
      (mean maximal % fall 22 +/- 7). In all groups the heart rate increased in
      response to betelnut. Betelnut chewing caused bronchoconstriction as demonstrated
      by decreases in FEV1 in a majority of the asthmatic patients studied; hence
      betelnut may act as a trigger factor for their asthma. In a few others increases
      in FEV1 were noted, while the rest experienced only minor changes.

PMID- 7771118
TI  - Introduction of an integrated community-based bancroftian filariasis control
      program into the Mt Bosavi region of the Southern Highlands of Papua New Guinea.
AB  - In mid-1987 a baseline microfilarial prevalence survey was conducted among five
      villages in the Mt Bosavi region of the Southern Highlands Province of Papua New
      Guinea. Through use of the Nucleopore filtration technique, it was determined
      that 48% of villagers had detectable microfilaraemia. The highest prevalence was
      documented in Fogomaiyu, where the microfilaraemia rate was 92%. On the basis of
      this initial survey and the expressed interest of the community, the Division of
      Health in the Southern Highlands Province undertook an integrated community-based
      pilot control program. The project used two principal control methods: (a) drug
      treatment with low-dose diethylcarbamazine citrate (DEC) distributed to the
      community weekly and (b) vector control with permethrin-impregnated bednets.
      Results six months after the intervention indicate that the program was
      successful in reducing microfilaraemia at Fogomaiyu village from 92% to 6%. The
      reduction is principally related to the effects of DEC, although the bednets, by
      limiting vector-person contact, are expected to reduce the incidence of both
      filariasis and malaria.

PMID- 7771120
TI  - [Assessing credibility in suspected sexual abuse of children].
AB  - Systematic methods for obtaining and evaluating information from children in an
      interview situation in cases of alleged sexual abuse are described and objections
      to assessments of credibility are discussed. It is shown that psychological
      knowledge exists that can contribute substantially to the investigation of sexual
      abuse allegations.

PMID- 7771121
TI  - [Children as witnesses of violence: consequences for determining reliability].
AB  - For many years testimony by children was considered to be of little value. The
      authors of the present article do not share the view that the credibility of
      children should generally be questioned. Different investigations show that even
      young children are able to make forensically relevant depositions. The roles of
      developmental stage, memory and suggestibility of children are discussed in
      detail. A case report of a child who witnessed the murder of both parents
      demonstrates the importance of age-related aspects of emotional experience,
      development of memory and the ability of children to recall memories. Even at the
      first hearings it is important to establish a nonthreatening atmosphere in which
      the child can feel safe and protected. An experienced child and adolescent
      psychiatrist should be consulted early on.

PMID- 7771122
TI  - [School refusal--a catamnestic study on the diagnostic concept ov "school phobia"
      and "school anxiety"].
AB  - Twenty-six patients diagnosed with school refusal were examined 2.4 years after
      inpatient treatment. The long-term course of patients with "school phobia"
      (school refusal unrelated to school) and that of patients with "school anxiety"
      (school refusal related to school) were compared. In addition, an attempt was
      made to identify variables predictive of a good outcome. The mean age of the 12
      patients with "school phobia" and the 14 patients with "school anxiety" was 12.7
      years at the start of inpatient treatment. The assessment of psychiatric
      disturbances was based on structured interviews for parents and adolescents (MEI
      and MADEL, 1989) and the dimensional assessment scales of functioning for
      children and adolescents (MSBF). The variables assessed for predictive value were
      taken from the patients' records during inpatient treatment and from the hospital
      documentation system. There was no difference in outcome between the two syndrome
      groups. There was a tendency to less autonomy in the patients with "school
      phobia". Girls had a better outcome than boys, as did patients with less absence
      from school prior to inpatient treatment. Overall there was no difference in the
      outcome of "school phobia" and "school anxiety". Therefore a new classification
      should be considered.

PMID- 7771124
TI  - [Credibility and further psychological problems of young children as witnesses in
      criminal justice procedures: a case study].
AB  - A pair of 3 1/2-year-old twins who had possibly witnessed their mother's murder
      were examined by a child psychiatrist and a child psychologist as part of a
      judicial inquiry. The procedure developed specially for this purpose, the actual
      course of the investigation and the evaluation of the findings with regard to
      psychological aspects of evidence are discussed. The theoretical part of the
      study deals with the current state of knowledge and the problems relating to
      evidence given by young children as witnesses. The main emphasis is on general
      and specific credibility, identification of people associated with the crime,
      suggestibility and probabilities related to guessing, perceptual and memory
      performance, and minimization of emotional sequelae in children who are witnesses
      to violent crimes. The authors conclude that preschool children can be reliable
      witnesses in preliminary hearings and court proceedings.

PMID- 7771123
TI  - [Requests for compensation for immaterial damage: child and adolescent
      psychiatric legal assessment in conjunction with the revised legislation].
AB  - Child and adolescent psychiatry is concerned with many forensic questions. Among
      these, expert testimony about immaterial injury (pain, suffering) in conjunction
      with claims for compensation is being requested with increasing frequency. Until
      recently German law took the position that in cases of severe brain damage
      compensation (smart money) had to be granted only as a symbolic payment because
      the loss of cognition and lack of suffering excluded a feeling of satisfaction
      resulting from compensation. The highest court in Germany has now revised its
      position by introducing a new category of immaterial injury. This additional
      category refers to cases of severe brain damage where the "loss of personal
      quality" in itself creates the basis for a claim for compensation. As a result,
      related medical examinations and evaluations require as careful a description as
      possible and the use of scales to assess quality of life.

PMID- 7771125
TI  - [Child psychiatric assessment and the debate regarding the abuse of abuse].
AB  - The current discussion on false allegations in sexual abuse cases has led to a
      polarization in the views expressed about the credibility of children. Some
      authors even speak of a "child sexual accuse syndrome" or of a "sexual abuse
      allegation in divorce" (SAID) syndrome. A phenomenological analysis of the
      multiple reasons for misinterpretations is presented. Instead of stressing the
      importance only of false positives in child sexual abuse questions, an attempt is
      made to describe reasons for false negatives. Based on a retrospective analysis
      of 50 consecutive child psychiatric experts in connection with court cases, there
      does not appear to be an increase in false accusations. Rather, only about one
      third of the cases even involved suspected sexual abuse. Sexual abuse allegations
      were much more frequent in girls than in boys. Of 20 abuse allegations we judge
      four to be false allegations. In only one of these cases, that of an adolescent
      girl who had been abused in childhood, was the false allegation intended.

PMID- 7771126
TI  - The German-Japanese-relationship in medicine.

PMID- 7771127
TI  - [Differential diagnosis of lumbar intervertebral disk syndrome from the
      neurosurgical viewpoint--personal surgical experiences with over 3,000 lumbar
      operations].
AB  - Lumbar syndromes belong to the most frequent complaints in medical practice. In a
      series of 3110 lumbar spine operations differential diagnoses of neurosurgical
      relevance are represented. Diagnostic measures and operative indications are
      discussed.

PMID- 7771128
TI  - [Lumbar nerve root compression: a cooperative project for quality assurance in
      neurosurgery].
AB  - In 1993 a total of 4152 cases of lumbar nerv root compression have been
      investigated in 11 neurosurgical departments. Beside patient data diagnostics,
      treatment and course as well as neurological status before and after treatment
      were subjects of this quality assurance study. Special emphasis was put on a
      detailed evaluation of complications. In more than 91% surgical treatment has
      been performed, in 5% of these cases after an attempt of conservative treatment.
      Nearly 9% of the patients have not been operated upon. Recurrent disease has been
      treated surgically in 10.5%. Most common procedure was flavectomy (69%) with
      discectomy (80%). The all over complication rate was 14%. Typical surgical
      complications have been rare with 5%. Neurological deterioration after treatment
      was also rare with less than 2%. The study was able to reflect the present state
      of treatment in patients with lumbar nerve root compression and the subjects
      investigated served well as parameters of quality assurance.

PMID- 7771129
TI  - [Use of GDC coils in treatment of inoperable aneurysms: report of initial
      experiences].
AB  - The authors report on the endovascular occlusion of intracranial aneurysms with
      GDC coils in 8 patients. In 2 cases, the diagnosis was made because of
      subarachnoidal hemorrhage. Three patients complained about headache, and one
      patient had an oculomotor palsy. The findings were incidental in 2 cases.
      Angiography demonstrated an aneurysm of the internal carotid artery in 4 of the 6
      females and in the 2 males (mean age 50 years) and a basilar artery aneurysm in 4
      cases. The indication for endovascular treatment was established after carefully
      weighing the risks against those of a neurosurgical intervention. It was possible
      to occlude completely the aneurysm by induced electrothrombosis and to preserve
      the patency of the main vessel in all cases. One female (case 6) developed a
      hemiparesis due to embolism of a medial branch six hours after treatment. This
      receded completely after thrombolysis with urokinase. A second patient showed
      further growth of the internal carotid aneurysm on the control angiogram obtained
      after six months. Our initial results are encouraging. With increasing
      experience, endovascular treatment is expected to become the method of choice for
      the treatment of most inoperable cerebral aneurysms.

PMID- 7771130
TI  - [3-dimensional computerized tomography in diagnosis and surgical planning of
      intracranial aneurysms].
AB  - Established alternative methods of visualisation of intracranial vessels--MR
      angiography and angio-CT--give only two dimensional views similar to angiography.
      It is a subjective matter of the neurosurgeon's imagination to produce three
      dimensional views on the basis of these methods. Three dimensional processing of
      dynamic sequence or helical axial computed tomograms give any number you like of
      stereo-scopic views of the Willisi circulus. Comparing the usefulness of DSA and
      3D-CT in 34 aneurysms, the latter often gives supplementary information
      concerning the direction, neck and adjacent arteries, helpful in planning surgery
      treatment. It is difficult or sometimes impossible to separate basal aneurysms
      (a.c.i.) from sinus cavernosus and skull base by this method, but especially in
      aneurysms located in the area of a.com.a. and c.m.a. the 3D-CT is sufficient for
      diagnosis and planning surgical treatment without DSA.

PMID- 7771131
TI  - Three-dimensional videomonitor in neurosurgery--technical note.
AB  - The operation microscope was equipped with two small camera heads on both sides,
      with a 35-mm still camera, and with or without a binocular observer tube. These
      camera heads were connected with 3-dimensional (3D) converter. Authors can
      observed the 3D images of the operation field on a monitor T.V. through
      polarization glasses. The microscope with two camera heads is easy to handle
      because these camera heads are small and light. This is a promising monitor
      system in microsurgery.

PMID- 7771132
TI  - [Correlation between the gradient constant of the theoretical pressure volume
      diagram (PVD) and the pressure volume index (PVI) in relation to brain pulse
      amplitude-mean pressure function].
AB  - In 54 neurosurgical patients--suffering from intracranial tumors, hydrocephalus
      or different kinds of brain injury--a catheter was implanted in the lateral
      ventricle for continuously monitoring of the intracranial pressure (ICP). The
      intraventricular injection of defined amounts of sodium clearance (1-2 cm3) was
      followed by increased values of intracranial mean pressure--(pm) and pulse
      amplitude- (PA). The recorded data showed a high significant correlation after
      regression analysis. After determination of the pressure-volume-index (PVI) and
      the theoretical pressure-volume-diagram it was examined whether there is a linear
      correlation between the parameters of the craniospinal space (id) reserves
      (constant of gradient, (PVI, K of PVD)) and the gradients (CA) of the linear PA
      PM-function. A significant linear relationship, however of weak degree, could be
      found between these two parameters. The linear PA-PM-function, therefore, can
      only be understood in restricted circumstances as a direct parameter of the
      intracranial spacial reserves. The underlying facts of these problems are dealt
      within this paper.

PMID- 7771134
TI  - [Endemic cholera foci in Africa].

PMID- 7771133
TI  - Computerized tomography in the assessment of brain shifts in acute subdural
      hematoma.
AB  - Computed tomography (CT) was used to characterize brain shifts in 30 adult
      patients (mean age 51.9 years) with fatal supratentorial acute subdural hematomes
      (ASH) who were admitted within 3 hours of the head trauma. The Glasgow Coma Scale
      (GCS) score, hematoma width, and midline shift were tabulated. The width of the
      cistern surrounding the brainstem (CSBS) and the distance from the floor of the
      fourth ventricle to the posterior clinoid process (IVv-PC) were measured. Opening
      (+) or disappearance (-) of the suprasellar cistern (SC) was determined using
      axial CT. The data were compared with those in agematched controls (n = 26) using
      the Wilcoxon and Kruskal-Wallis tests. The hematomas in the SC(-) group (n = 22,
      mean GCS score: 3.8 +/- 1.0) were wider (p = 0.02) than those in the SC(+) group
      (n = 8, mean GCS score: 4.7 +/- 1.5). The CSBS in the SC(+) group was
      significantly smaller than that in the controls (p < 0.01). In the SC(-) group
      the CSBS was smaller and the IVv-PC was significantly larger than those in the
      controls (IVv-PC; p < 0.01) and the SC(+) group (IVv-PC; p < 0.05). In the
      evolution of brainstem shifts in ASH, when the SC is open the predominant vector
      is in the direction of the skull base, while when the SC is not observed, an
      axial vector shifts the brainstem.

PMID- 7771135
TI  - [An operative analysis of the cholera epidemic in the Republic of Dagestan using
      a computer database].
AB  - The epidemiological information on cholera epidemic in Daghestan during the
      period of June 6 to October 21, 1994, based on the data obtained from 2,327
      patients and Vibrio carriers in 184 settlements of 27 regions, 8 towns and 1
      housing estate, was collected, systematized and analyzed with the use of the data
      base (DB). The use of DB made it possible to carry out the surveillance of the
      level of and dynamics of morbidity and infections rates, to determine the
      territories of risk, the age and social groups of risk, the active routes and
      factors of transmission. DB may be used for analyzing of operative and current
      epidemiological information in cholera and other infections.

PMID- 7771136
TI  - [The mechanisms of the intrafocal and territorial spread of cholera in the
      Republic of Dagestan].
AB  - The description of the epidemic manifestations of cholera in the Republic of
      Daghestan at the period of the seventh pandemic, linked with the action of such
      common transmission factors as water, food and everyday contacts, is presented
      and their role in the territorial spread of this infection is evaluated. The
      analysis of family foci in the Derbent and Kaiakent regions in 1994 is given; the
      conclusion is made that a low sanitary level of human dwellings leads to a wide
      spread of cholera among close relations due to the action of water, alimentary
      and contact factors of transmission.

PMID- 7771137
TI  - [Cholera in the Republic of Dagestan].
AB  - Cases of cholera were registered in Daghestan in all pandemics with the exception
      of the fourth one. For the first time the import this infection by pilgrims
      returning from their hajj by motor transport and traveling through the countries
      of southwest Asia was registered. 184 settlements of 27 regions, 8 towns and 1
      housing estate were involved in the epidemic process, the number of registered
      cholera cases and Vibrio carriers being 2,327. High contamination rates were
      detected in regions situated in different geographical zones. Everyday contacts
      and the alimentary route were the main routes of transmission during this
      epidemic, while the role of the water route was considerably less important.

PMID- 7771138
TI  - [The use of a cholera coagulating diagnostic agent under the cholera epidemic
      conditions in Dagestan].
AB  - Dried cholera diagnosticum for the slide coagglutination test was obtained. The
      diagnosticum, found to be highly active and specific, permitted the detection of
      Vibrio cholerae in the analyzed material at a concentration of 10(6)-10(8)
      microbial cells/ml. The diagnosticum was used during cholera epidemic in
      Daghestan for the detection and rapid identification of cholera vibrios. In all
      cases the positive results of the coagglutination test were confirmed by other
      investigation methods (no cases of hyperdiagnosis was registered). The production
      of these diagnostica in small batches on the basis of specialized research
      laboratories was recommended.

PMID- 7771139
TI  - [The epidemiological characteristics of cholera in the Shamil'skii Mountain
      District of Dagestan].

PMID- 7771140
TI  - [Cholera in the plains area of Dagestan].

PMID- 7771141
TI  - [The characteristics of cholera prevalence and of the performance of epidemic
      control measures in small settlements of Dagestan].
AB  - The present work deals with summarizing the experience obtained by the
      specialized antiepidemic brigade of the Rostov-on-Don Research Institute for
      Plague Control in the work on the liquidation of cholera in some regions of
      Daghestan with a view to discussing the problems of improvement of anticholera
      measures. The characteristic features of the epidemic process were its explosive
      character, sparseness of the foci of infection, the prevalence of its
      transmission through everyday contacts (family contacts and intensive tribal
      contacts) and essential delays in taking anticholera measures due to sudden
      appearance of outbreaks, remoteness of small settlements and the lack of manpower
      and means for carrying out anticholera measures at a given place and time, as
      well as delays in epidemiological analysis carried out by local health service
      bodies. Delays in carrying out such measures led to the spread of infection both
      within settlements and in the whole region and further in the republic. The
      epidemic process was complicated by the antibiotic resistance of V.cholerae
      strains circulating on this territory. All these factors formed specific epidemic
      situation which introduced amendments into the organization of anticholera
      measures.

PMID- 7771142
TI  - [Cholera in a remote region of Dagestan].
AB  - The epidemic situation in a remote region of Daghestan at the period of the
      cholera outbreak in the republic is considered with the use of concrete examples.
      The analysis of cases of cholera, as well as Vibrio carriership, at the period of
      August 5 to October 5, 1994, is presented. The territorial and temporal
      separation of different cases of the disease and Vibrio carriership were
      indicative of the periodic import of the causative agent to the territory of the
      town and the region from other places, unfavorable with respect to cholera,
      without the involvement of the water factor of infection transmission. Timely and
      complete antiepidemic measures prevented this infection from acquiring the
      character of developed epidemic.

PMID- 7771143
TI  - [The characteristics of the cholera epidemic situation in a separate region of
      Dagestan].

PMID- 7771144
TI  - [Cholera in Makhachkala during the 1994 epidemic].
AB  - During the period of epidemic in the Daghestan 51 patients and 27 Vibrio carriers
      were detected in Makhachkala. A considerable proportion (30.7%) of cholera cases
      caused by infection imported from regions, unfavorable with respect to cholera,
      in the presence of pronounced migration of the population was registered. The
      role of different transmission routes in cases of cholera was as follows: day
      contacts were responsible for 43.3%, the alimentary route for 28.4% and the water
      route for 14.9% of cases. The epidemic situation was characterized by a mild and
      prolonged type of the epidemic process. Mass diseases were prevented by a complex
      of cholera control measures, among them the emphasis was made on various
      limitations and prophylactic measures aimed at the rupture of the transmission
      routes of V. cholerae.

PMID- 7771146
TI  - [The cholera outbreak in one of the central regions of Dagestan].
AB  - The data on the epidemiological analysis of cholera cases in the epicenter of
      this infection in the Daghestan, viz. in the village of Gerga, Kaiakent District,
      are presented. The outbreak of cholera was due to the import of this infection by
      pilgrims from their hajj to Saudi Arabia. The causative agent of the outbreak was
      the epidemic variant of V. cholerae eltor Ogawa. Everyday contacts were the main
      route of the transmission and spread of this infection, the water factor playing
      an insignificant role. Two epidemic waves of cholera were registered in Gerga,
      each of them provoked the penetration of the infection to other regions of the
      Republic of Daghestan.

PMID- 7771145
TI  - [The routes of the spread of cholera in the Shamil'skii Mountain District of
      Dagestan].
AB  - The routes of the spread of cholera were analyzed in 273 patients and Vibrio
      carriers during the outbreak of cholera in a mountainous region of Daghestan
      during the period of July 18 to September 4, 1994. Cholera was found to spread
      mainly after funeral repasts and condolence visits accompanied by the
      dispensation of foodstuffs, transmission being realized through alimentary and
      contact routes. Under the conditions of the absence of the centralized water
      supply system in mountain villages and the contamination of water in open
      reservoirs it was found to be expedient to use, in addition to the recommended
      complex of antiepidemic measures, small automatic filtration units.

PMID- 7771147
TI  - [The epidemiology of cholera in Derbent District, Dagestan. The routes of the
      importation and spread of cholera].
AB  - The epidemic of cholera in the Derbent District of the Daghestan was imported
      into the region. 172 cholera patients and 204 Vibrio carriers were registered in
      23 settlements of the region during the period of June 26 to October 12, 1994.
      The wide spread of this infection was facilitated by high migration activity of
      the population and the belated introduction of measures for limiting migration.
      The most severe outbreaks of cholera were observed in Derbent and in the villages
      of Mamedkala and Morskoe.

PMID- 7771148
TI  - [The epidemiology of cholera in Derbent District. The characteristics of the
      epidemic process].
AB  - Cases of cholera in the Derbent District of the Daghestan took predominantly mild
      and moderate clinical forms. The ratio of patients to Vibrio carriers was 1:1.25.
      The etiological agent of the epidemic was V. eltor, serovar Ogawa. Cholera
      patients were of greater epidemiological importance as the sources of infection
      in comparison with Vibrio carriers. Carrier state after convalescence was
      observed in 1.1% of cases. The population was infected with cholera, as a rule,
      through everyday contacts and in more rare cases by the water route. The highest
      rate of contamination with V. cholerae was registered in the age group of 0-2
      years.

PMID- 7771149
TI  - [The cholera epidemic in mountainous regions of Dagestan in relation to the
      probable role of the water factor in its spread].
AB  - The follow-up of dynamics of cholera epidemic in 1994 was made in 4 mountain
      regions of Daghestan with shared river system. There were 537 infection cases in
      these regions, which was equal to 1/4 from the total number of cholera patients
      in Daghestan. The probability of cholera distribution by water way has been
      shown, which can be related to massive dissemination with V. cholerae in river,
      drink and waste water both from active, and from local (intrahospital) epidemic
      sources. Vibrio's exit from cholera hospital became possible after dissemination
      intrahospital V. cholerae of waste water, after contamination of river water and
      after formation of secondary sources and cholera waves, which resulted in the
      prolongation up to 40 days of this infection in mountain regions of Daghestan.

PMID- 7771150
TI  - [The prevalence of El Tor cholera in 2 regions of Dagestan remote from each
      other].

PMID- 7771151
TI  - [The characteristics of the antibacterial therapy for cholera in Dagestan].
AB  - Wide circulation of antibiotic-resistant Vibrio cholerae strains again gives
      prominence to the problem of etiotropic therapy. The results of the treatment of
      428 persons infected with V.cholerae (237 cholera patients and 191 Vibrio
      carriers) in different regions of Daghestan during the outbreak of epidemic in
      1994 are presented. The main criterion of the effectiveness of antibacterial
      therapy was the determination of the percentage of bacterial relapses. The
      sensitivity of 118 V.cholerae strains to different antibacterial preparations was
      studied by the method of serial dilutions. After the clinical use of
      chloramphenicol 29.7% of bacterial relapses were registered, the in vitro
      resistance of V. cholerae being 32-64 mkg/ml. After the use of tetracycline 16.5%
      bacterial relapses were registered with in vitro resistance being the same. The
      use of the combination of these preparations gave 15% of bacterial relapses.
      Furazolidone gave 4.3% of bacteria relapses, while after the use of ciprofloxacin
      2.8% of bacterial relapses were registered with in vitro sensitivity equal to
      0.25-0.5 mkg/ml. Ciprofloxacin was recommended for the treatment of cholera
      patients and furazolidone, for the treatment of Vibrio carriers.

PMID- 7771153
TI  - [The bacteriophage lysis-susceptibility properties of Vibrio cholerae strains
      isolated in separate regions of Dagestan in 1994].
AB  - The study of the properties of V. cholerae strains isolated in June-September
      1994 in the Daghestan revealed that they belonged, according to their specific
      properties, to typical representatives of V. eltor, serovar Ogawa, but a great
      part of them (67.2%) was not lysed by diagnostic cholera bacteriophages.
      Experiments with different batches of diagnostic cholera bacteriophages showed
      the necessity of their further improvement.

PMID- 7771152
TI  - [The characteristics of Vibrio cholerae isolated in Dagestan in 1994].
AB  - A high degree of resistance to cholera diagnostic phages and carriership of
      prophages characteristic of V. cholerae eltor strains vct+ were shown to be the
      specific features V. cholerae isolated in Daghestan during the period of June
      October 1994. Among the strains under study, isolated respectively in 12 and 18
      out of 19 regions of Daghestan, a high proportion was found to have resistance to
      tetracycline (65%) and chloramphenicol (28.6%). Moreover, some strains were found
      to be resistant to furagin and erythromycin. Out of 242 strains resistant to
      antibacterial preparations, 163 strains were found to have multiple resistance.
      Gentamicin, cipropfloxacin and doxicycline were shown to have high in vitro
      activity with respect to the strains under study.

PMID- 7771154
TI  - [The preservation of the causative agent of cholera in the water supplies of the
      central regions of Dagestan (experimental data)].
AB  - The acidic pH of water of surface water reservoirs in Izberbash and two adjoining
      regions, including sea water, seems to be unfavorable for the prolonged
      preservation of Vibrio cholerae eltor, but additional ecological investigations
      are necessary to study the possibility for infection to take root at this
      territory. Water from the Zam-Zam spring, if contaminated with V. cholerae, may
      serve as a transmission factor, but the duration of its action is limited by the
      survival term of V. cholerae. The water route of transmission did not play any
      essential role in the spread of cholera in the central regions of Daghestan.

PMID- 7771156
TI  - [The outer membranes of Vibrio cholerae as a potential component in a chemical
      vaccine].
AB  - The results of the study of the preparation of V. cholerae eltor membrane,
      obtained by the lysis and inactivation of microbial cells with urea and the
      subsequent differential centrifugation and nuclease treatment. As revealed in
      this study, the outer membrane preparation, when introduced parenterally and
      orally to mice, induced pronounced immunity to experimental cholera infection and
      the production of vibriocidal antibodies in high titers. The treatment of V.
      cholerae eltor membranes with trypsin led to further increase of the immunogenic
      potency of the preparation. The protective action of V. cholerae eltor outer
      membranes considerably exceeded the protective effect of currently used whole
      cell eltor vaccine. This opens prospects for using the above-mentioned
      preparation for the improvement of chemical vaccine as a component ensuring the
      formation of antibacterial immunity.

PMID- 7771155
TI  - [The properties of the Vibrio cholerae strains isolated in large districts in
      western Dagestan in 1994].
AB  - 190 V. cholerae cultures isolated by the specialized antiepidemic brigade of the
      Rostov-on-Don Research Institute for Plague Control in the Khasavyurt, Babayurt
      and Novolaksk regions of Daghestan in August-October 1994. All isolated strains
      were typical with respect to their morphological and cultural properties and
      could be agglutinated (with the exception of one strain) to the titer or half
      titer with diagnostic cholera serum and Ogawa serum. 4 strains had signs of RO
      dissociation, 4 strains were agglutinated with Inaba serum in a low titer. All
      strains were resistant to diagnostic bacteriophages. Cyproxin and doxicycline
      proved to be the most active agents for the treatment of patients. Agglutinins,
      vibriocidins and antidermonectrotic antibodies in diagnostic titers were detected
      in the sera of all patients and Vibrio carriers.

PMID- 7771157
TI  - [The epidemiological characteristics of cholera in the Republic of Dagestan. An
      assessment of the epidemic-control measures].
AB  - Retrospective analysis of epidemic cholera manifestations was made in Daghestan
      using the data of operative epidemic analysis of the break in 1994. Unexpected
      prolongation of epidemic process of cholera for Daghestan, which was imported by
      pilgrims from Southern-Western Asia, has been shown using climate-geographical
      social-demographical and sanitary-hygienic peculiarities. Common laws of
      development of epidemic complications were demonstrated, as well as the main ways
      of infection transmission of great number of Daghestan settlements in epidemic
      process. The importance of antiepidemic means and significant role of created
      specialized antiepidemic groups have been emphasized in rapid carrying out of
      means in infection focus, including massive investigation of people in
      settlements.

PMID- 7771158
TI  - [The isolation of the Vibrio cholerae dermotoxin and the characterization of its
      biological properties].
AB  - The dermonecrotic factor (dermotoxin) inducing skin necrosis in rabbits has been
      isolated from V. cholerae strain B-53-2-38 and partially purified. Dermotoxin has
      a molecular weight of about 110 kD and possesses pronounced cytotoxic and general
      toxic action, differing from that of enterotoxin. The introduction of this factor
      into the blood and peritoneum of laboratory animals causes their death.

PMID- 7771159
TI  - [The destructive activity of vibrios].

PMID- 7771161
TI  - [New species of pathogenic vibrios isolated from people and the water of the
      Black and Baltic seas].

PMID- 7771160
TI  - [The discovery of a dermonecrotic factor in Vibrio cholerae non O1 and other
      pathogenic vibrios].

PMID- 7771162
TI  - [Cases of intrahospital cholera infection].

PMID- 7771164
TI  - Torsades de pointes and aborted sudden death after implantation of a cardioverter
      defibrillator.
AB  - Recent publications have demonstrated that the implantable cardioverter
      defibrillator (ICD) improves survival in patients with ventricular tachycardia
      (VT) or fibrillation (VF) by reducing arrhythmic death. We report the case of a
      patient with a history of an old myocardial infarction and a left ventricular
      dysfunction, who presented four episodes of syncope associated with a
      hemodynamically not well tolerated sustained VT, who had easy inductible clinical
      VT during electrophysiologic study and required an ICD. After a follow-up of 2
      months, the patient presents a complete AV block and multiple episodes of
      torsades de pointes that sometimes degenerate into VF. The ICD delivered 64
      adequate and well-tolerated shocks during 10 hours before and during the hospital
      admission. We programmed a VVI pacing rate at 65 bpm and no more arrhythmia was
      observed. The left ventricular ejection fraction was not altered afterwards. In
      conclusion, we experienced the temporary efficacy of the ICD in the treatment of
      incessant torsades de pointes, without myocardial injury.

PMID- 7771163
TI  - [A case of the importation onto the territory of Russia of cholera caused by a
      new serovar].
AB  - Materials on the import of rarely occurring Vibrio cholerae, not belonging to
      group O1 of serovar O139, to the territory of Russia are presented. The clinical
      picture of a cholera case is described and the biological properties of V.
      cholerae, serovar O139, are presented. A suggestion has been made concerning the
      appearance of a new V. cholerae serovar, capable of ousting V. cholerae eltor,
      the cause of the seventh pandemic.

PMID- 7771165
TI  - Percutaneous balloon pericardiotomy for management of cardiac tamponade in a
      patient with lung cancer and large pericardial effusion.
AB  - We describe the case of a 32-year-old man with lung cancer involving the
      pericardium on which we performed pericardiotomy, using a balloon dilating
      catheter, to create a non-surgical pericardial window. For the percutaneous
      creation of pericardial window we advanced into the pericardium by subxiphoid
      approach a 0.035 inch guide wire through a 7f. pig-tail catheter. Subsequently a
      22 mm diameter, 4 cm long balloon dilating catheter was advanced to the parietal
      pericardium and inflated for about 60 seconds until a tear in the pericardium was
      formed. We believe that percutaneous balloon pericardiotomy is helpful in the
      management of large pericardial effusions particularly in patients with
      malignancies and poor condition.

PMID- 7771166
TI  - In memoriam. Professor Rene Pannier (1913-1994).

PMID- 7771167
TI  - Platypnea-orthodeoxia syndrome.

PMID- 7771168
TI  - The response of the ageing heart to regular physical exercise. An echo and
      Doppler study.
AB  - In upper middle age healthy subjects the functional cardiac reserve is known to
      be decreased (Port et al., 1980; Aubert et al., 1994). On the other hand regular
      physical exercise improves the cardiovascular function (Nishimura et al., 1980).
      The aim of this study was to establish whether regular physical exercise is
      associated with a significant change in the ageing process of the cardiovascular
      system.

PMID- 7771169
TI  - An estimation of the left ventricular diastolic function from the spectral
      analysis of the fourth heart sound. A Doppler validated study in hypertrophic
      cardiomyopathy.
AB  - Hypertrophic cardiomyopathy (HCM) is a typical primary cardiac disease
      characterized by diastolic abnormal function due to both prolonged relaxation and
      decreased compliance (Sanderson et al., 1977; Spirito & Maron, 1990). Since the
      contribution of the atrial systole to ventricular filling is usually increased,
      the appearance of a fourth heart sound (S4) is a common finding in HCM. This
      sound is related to the ventricular compliance and to the atrial contractility.
      It is generated during the rapid setting into vibration of the left ventricular
      walls that results from the rapid rush of the blood due to the atrial contraction
      (Nishimura et al., 1989; Tavel, 1978). The aim of this study is to look for
      relationships between the frequency peak of S4 and various mono- and two
      dimensional echocardiographic parameters in order to identify those cardiac
      structures involved in its genesis and obtaining an estimation of the stiffness
      of the acoustic vibrating system with a simply vibratory model (Baracca et al.,
      1991).

PMID- 7771170
TI  - Genesis and acoustic quality of the physiological fourth heart sound.
AB  - The genesis of the fourth heart sound (S4) is commonly related to the rapid set
      in vibration of the left ventricular walls, resulting from the rapid inflow of
      the blood due to the atrial contraction (Nishimura et al., 1989). S4 can be
      recorded in normal young subjects as an expression of physiologic atrial dynamics
      but it is more common in pathologic conditions characterized by decreased
      ventricular distensibility (Tavel, 1978). Employing the spectral analysis of
      heart sounds (Longhini et al., 1979; Longhini et al., 1981; Aubert et al., 1984)
      we searched for the relationship between different components of the frequency
      spectrum of S4 and various echocardiographic parameters, with the aim of
      identifying the cardiac structures involved in its genesis (Longhini et al.,
      1989; Baracca et al., 1991).

PMID- 7771171
TI  - Phonomechanocardiographic parameters in patients with atrial septal defect.
AB  - The purpose of the present study was to noninvasively evaluate left (LV) systolic
      and diastolic function in patients with atrial septal defect (ASD) using the
      phonomechanocardiogram. We studied 40 patients with atrial septal defect, 16
      males and 24 females, ages ranging from 6 to 56 years (mean 21.1 years),
      consecutively observed before surgery in our institution, during a four year
      period. We measured the systolic time intervals (Q-A2c, Q-S1, ICT, PEP, LVETc,
      PEP/LVET), the Apex Cardiographic (ACG) diastolic parameters A2-Oc and A/H and
      the hemodynamic variables Qp/Qs, Pulmonary Vascular Resistance (PVR) and Left
      Ventricular End Diastolic Pressure (LVEDP). We compared the data with 74 normal
      individuals using the Student t-test and linear regression analysis. We found
      significant Q-S1 lengthening (81.2 +/- 16.4 ms, p < 0.001); PEP, ICT and A2-Oc
      were significantly reduced (101.2 +/- 21.7 ms, p < 0.001, 20.0 +/- 5.3 ms, p <
      0.05 and 117.1 +/- 26.3 ms, p < 0.001, respectively) and A/H was significantly
      increased (17.4 +/- 12.1%, p < 0.005). Except for the case of Q-S1, where there
      was a weak positive linear correlation with Qp/Qs (r = 0.37), we found no
      correlation between the other parameters and Qp/Qs or PVR. Sixty-seven percent of
      the patients had Q-S1 prolongation and a Q-S1 > 76.2 ms identified left-right
      shunts > 2 with a positive predictive value of 82%; 62% of the patients had a
      reduced A2-Oc and a A2-Oc < 110 ms identified shunts > 2 with a positive
      predictive value of 90%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771172
TI  - Diltiazem effects on left ventricular function preliminary results of 12 patients
      evaluated by calibrated apexcardiogram.
AB  - Diltiazem is a calcium channel blocker whose effects on left ventricular function
      (LVF) are controversial. We studied 12 patients with ischemic heart disease (IHD)
      before starting and 15 and 30 days after having initiated Diltiazem 60 mg t.i.d.
      LVF was accessed by means of the normalized indexes of the calibrated
      apexcardiogram: nS for systolic LVF evaluation and nA for diastolic LVF
      evaluation. Recent works have shown that these indexes have a good correlation
      with invasive parameters of LVF. We verified that nS did not change and nA
      decreased significantly (p < 0.05) after Diltiazem. We preliminary concluded that
      Diltiazem has no deleterious effect on LV systolic function and improves LV
      diastolic function, by decreasing nA, a parameter which correlates well with LV
      end diastolic pressure.

PMID- 7771173
TI  - Doppler echocardiographic evaluation of left ventricular relaxation in patients
      with coronary artery disease.
AB  - The time constant of the left ventricular isovolumic pressure decline (Tc) was
      determined according to the Weiss equation in 23 patients with chest pain who
      underwent cardiac catheterization. Out of them 15 patients had significant
      coronary artery stenosis (CAD). Tc was compared to 21 diastolic Doppler data
      derived from the transmitral inflow. We could predict the Tc from Doppler data
      using a stepwise multiple regression model, Tc = (0.072 x A-Vpeak)-(0.387 x A
      dect)-(0.137 x E-dect) + 0.050 (r = 0.7493, p < 0.0011 SEE = 0.007 All Doppler
      data and the predicted Tc were examined among the CAD and the healthy groups, the
      predicted Tc and E/A ratio indicated the best discriminant functions.

PMID- 7771174
TI  - Prognostic value of simple exercise test parameters in patients with dilated
      cardiomyopathy.
AB  - The prognostic value of maximal exercise capacity as well as that of the simple
      exercise systolic blood pressure and heart rate variables were evaluated in 50
      patients with dilated cardiomyopathy. Patients were treated beside digitalis
      and/or diuretics with vasodilators aggressively. Exercise was performed on an
      upright bicycle ergometer. Continuous, multistage, symptom limited, maximal tests
      were carried out. Patients were followed up for 23.5 +/- 15.2 months. Both one
      way and multivariate analyses of data showed, that not only the maximal exercise
      capacity related significantly to the survival, but the several simple systolic
      blood pressure and heart rate variables (their values at peak exercise and their
      increase during the test) did so as well. Considering parameters separately,
      maximal exercise capacity was found the strongest predictor of survival, though
      the power of the calculated rate-pressure product at peak exercise, that of the
      systolic blood pressure at peak exercise as well as that of the increase in heart
      rate during the test proved nearly as strong as the maximal exercise capacity
      did. Anyway, the multivariate analysis showed that the former parameters were
      dependent on maximal exercise capacity. Some parameters with individual
      prognostic value proved independent from each other. Combined consideration of
      the systolic blood pressure at peak exercise and the increase of heart rate
      during exercise resulted in the highest predictive power which exceeded even the
      power of maximal exercise capacity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771175
TI  - Cibenzoline in the prevention of recurrence of supraventricular arrhythmias.
AB  - Hundred and twenty-three outpatients were treated with oral cibenzoline for 3
      months in order to test the efficacy and safety of the compound in the prevention
      of the recurrence of supraventricular arrhythmias. The dose was 260-390 mg/day
      for those under 70 and 130-260 mg/day for those over 70 years. All patients were
      converted to sinus rhythm before entry to the study and 95 patients had
      previously been treated with one or more drugs which had been discontinued due to
      lack of effect and/or poor tolerability. In 21 patients (17%) recurrence was
      documented by ECG or Holter monitoring, cibenzoline thus being effective in 83%.
      In 35 other patients there was a return of symptoms but no confirmation of
      recurrence. There were no relevant changes in blood pressure or heart rate. PR,
      QT and QTc intervals were stable but mean QRS interval increased slightly during
      the first week before stabilizing. Cibenzoline was discontinued because of
      adverse events in only 10 patients (8.1%). The most frequent complaints were
      nausea, vertigo and faintness. Seventy-two per cent of patients rated their well
      being as "well/very well" at month one compared with 84% at month three.
      Cibenzoline is an appropriate first line choice in this indication.

PMID- 7771176
TI  - Percutaneous balloon pericardiotomy as a therapeutic alternative for cardiac
      tamponade and recurrent pericardial effusion.
AB  - A terminally ill patient with cardiac tamponade secondary to metastatic breast
      cancer was successfully treated by percutaneous balloon pericardiotomy. The
      procedure was performed through subxiphoid approach under local anaesthesia and
      its beneficial effect was maintained until the patient's death from her primary
      disease. A second, 86-year-old, debilitated patient and a third 52-year-old
      patient were managed likewise and both left hospital relieved from recurrent
      severe pericardial effusions. The later two patients have shown no signs of
      recurrence for fifteen and twelve months respectively.

PMID- 7771177
TI  - "Accurate" noninvasive detection of diastolic dysfunction by current techniques:
      fact or fancy?
AB  - To evaluate clinically left ventricular (LV) diastolic performance has been
      recognized in recent years to be an important part in cardiac evaluation, since
      diastolic abnormalities occur early and are sensitive indicators of diseased
      myocardium as well as determinants of cardiac output. Data on LV diastolic
      function are noninvasively acquired in recent years in most laboratories from: 1)
      radionuclide angiography, 2) echocardiography (M-mode and 2D) and 3) Doppler
      echocardiography. All these widely accepted and used methods for the detection
      and quantification of diastolic dysfunction are based on the assessment of
      indices of either rate of ventricular filling or rate of change of LV diameter
      and wall thickness during diastole.

PMID- 7771179
TI  - XIIIth Annual scientific sessions of the Belgian Working Group on Cardiac Pacing
      and Electrophysiology. October 1, 1994. Abstracts.

PMID- 7771178
TI  - Systolic segmental disappearance of internal mammary artery graft. Correlation
      with prolonged spasm of the graft.
AB  - Vasospasm of the saphenous vein and internal mammary grafts may develop
      spontaneously under several conditions. We present for the first time spasm of a
      left internal mammary artery bypass graft during coronary arteriography. A
      patient who underwent coronary artery bypass operation 4 years ago was
      recatheterized because he developed chest pain. Selective catheterization of the
      left internal mammary artery graft showed disappearance of its lumen at its
      distal part during systole, whereas the patient developed angina. These phenomena
      disappeared after intravenous nitroglycerin administration.

PMID- 7771180
TI  - GLUT-1 glucose transporter is localized heterogeneously within the microvessels
      of the mouse hippocampus.
AB  - We investigated the distribution of the glucose transporter protein within the
      microvessels in the mouse hippocampus by immunohistochemical methods with an anti
      rat brain glucose transporter 1 (GLUT-1) and confocal laser scanning microscopy.
      All intraparenchymal microvessels in the hippocampus showed intensive
      immunoreactivity and a heterogeneous distribution of GLUT-1 was seen in the
      microvessels. These data may suggest that glucose could be heterogeneously
      incorporated into the endothelial cells of the cerebral microvessels, and
      therefore morphological and physiological differences may be present among the
      endothelial cells.

PMID- 7771181
TI  - Peptidergic innervation of the human prostate, seminal vesicle and vas deferens.
AB  - Neuropeptidergic innervation of the human prostate, seminal vesicle and vas
      deferens was investigated by immunohistochemical methods. The innervation pattern
      of all organs was very dense. Neuropeptide Y- and tyrosine hydroxylase-positive
      nerve fibers were most abundant and localized mainly in the smooth muscle layer.
      On the contrary, vasoactive intestinal polypeptide-positive nerve fibers were
      mainly found beneath the epithelium. Also leu-enkephaline-, peptide histidine
      isoleusine- and calcitonin gene-related peptide-positive nerve fibers could be
      observed in all organs, but somatostatin-positive nerves only in the prostate and
      seminal vesicle and met-enkephalin- and substance P-positive nerves only in the
      prostate.

PMID- 7771182
TI  - Hydrogen peroxide (H2O2) production by monoamine oxidase in rat tissues using
      endogenous catecholamines as substrates. A comparison of catalytic monoamine
      oxidase histochemistry and recently published catechol-O-methyltransferase
      immunohistochemistry.
AB  - Histochemical studies on hydrogen peroxide (H2O2) production by monoamine oxidase
      (MAOX) using xenobiotic (foreign) catecholamines such as tryptamine or tyramine
      as substrates may not reveal the true H2O2-production capacity of this enzyme and
      the potential co-localization and cooperation of MAOX with catechol-O
      methyltransferase (COMT), the other catecholamine-degrading enzyme. Therefore, in
      the present study the catecholamine hormones adrenaline (epinephrine) and
      noradrenaline (norepinephrine) and the catecholamine neurotransmitter
      noradrenaline as well as the COMT metabolites metanephrine and normetanephrine,
      which are likely to be the more important MAOX substrates, were used for MAOX
      visualization in many rat tissues with a cerium-diaminobenzidine-H2O2-Co method.
      Adrenaline and noradrenaline were autooxidized by Ce3+ and could not be employed;
      with metanephrine or normetanephrine as substrates MAOX produced considerable
      amounts of H2O2 in many cells and tissues. Comparisons with immunohistochemical
      COMT-data for rats from the literature show that MAOX and COMT are co-localized
      or not. Therefore, different from our current knowledge in rats COMT and MAOX
      either co-operate in catecholamine degradation or they degrade the respective
      catecholamines alone.

PMID- 7771183
TI  - New monoclonal antibodies recognizing phosphorylated proteins in mitotic cells.
AB  - Three monoclonal antibodies which showed strong staining of mitotic cells by
      screening on the human cell line MCF-7 were isolated. The antigens detected by
      the DH7 and BF6 monoclonal antibodies were located predominantly in multiple
      extranucleolar patches in interphase cell nuclei. In mitotic cells a strong
      increase in the fluorescence intensity was accompanied by its redistribution into
      a fine speckled form. Metaphase chromosomes were unstained. Centrosomes, spindle
      poles or midbodies were not stained either before or after extraction of the
      cells with Triton X-100 under conditions which preserve microtubular structures.
      In immunoblots of interphase cell extracts only very few bands reacted with DH7
      whereas in mitotic cell extracts approximately 30 bands were stained. BF6 also
      showed an increase in the intensity and number of bands detected in mitotic
      compared to interphase cell extracts, and the pattern was clearly different from
      that obtained with DH7. The BF6 antigen were extracted by 0.5% Triton X-100,
      whereas the DH7 antigen was not. Dephosphorylation of the antigens strongly
      reduced the binding of both antibodies as measured by immunoblotting and ELISA
      assays. The results suggested that BF6 and DH7 detect two different
      phosphorylated epitopes, each of which is shared by a different subset of
      proteins from mitotic cells. The third antibody, BD 12, bound to several
      polypeptides, including one of high molecular weight that appeared to correspond
      to the NuMA antigen. The epitope recognized by BD 12 was not sensitive to
      phosphatases.

PMID- 7771184
TI  - Peptidergic innervation of the bovine vagina and uterus.
AB  - The distribution of neuropeptide Y, substance P, vasoactive intestinal
      polypeptide, Leu5-enkephalin, bombesin/gastrin-releasing peptide, calcitonin gene
      related peptide, somatostatin, cholecystokinin and catecholamine synthesizing
      enzymes, tyrosine hydroxylase and dopamine-beta-hydroxylase was studied
      immunohistochemically in nerve fibres supplying the bovine vagina and uterus. The
      nerves containing tyrosine hydroxylase or dopamine-beta-hydroxylase and
      neuropeptide Y-immunoreactivity were particularly numerous in both organs.
      Substance P, vasoactive intestinal polypeptide and Leu5-enkephalin-containing
      nerves were less numerous whereas somatostatin and calcitonin gene-related
      peptide-immunoreactive nerves occurred occasionally. Bombesin/gastrin-releasing
      peptide and cholecystokinin immunoreactivities were not present in nervous fibers
      of the bovine uterus and vagina. Generally, the immunoreactive nerve terminals,
      fibers, networks or nerve bundles were present below the serous membrane, between
      smooth muscle cells of muscular layers, around blood vessels, in the submucosal
      layer and below the luminal epithelium of the uterus and cervix.

PMID- 7771186
TI  - Flow cytometric measurements of intracellular Ca2+ mobilization in isolated rat
      pancreatic acinar cells after hormone stimulation and action of lectins.
AB  - Isolated rat pancreatic acinar cells were loaded with the Ca(2+)-sensitive
      fluorescence dye Fluo 3 in vitro and the intracellular Ca2+ changes were analysed
      by flow cytometry. Morphology, viability, and loading with the dye were studied
      by light microscopy. Stimulation with cholecystokinin/pancreozymin (CCK) and its
      agonist caerulein as well as with carbamylcholine (Jestryl) led to an increase of
      intracellular calcium ions and a fluorescence peak. The slope and height of the
      Ca2+ signals were found to be influenced by preincubation of cells with some
      plant lectins (WGA, UEA, PHA, Con A, LCA, PNA). These effects are discussed with
      respect to the interaction of lectins with the carbohydrate chains of cell
      membrane receptors.

PMID- 7771185
TI  - Changes of enzyme activities in the rat myocardium caused by experimental hypoxia
      with and without ginkgo biloba extract EGb 761 pretreatment. A cytophotometrical
      study.
AB  - Using cytophotometry activity changes of succinate dehydrogenase, glycerol-3
      phosphate dehydrogenase and myofibrillar adenosine triphosphatase, were measured
      in the rat myocardium under normal and different experimental conditions. After
      hypoxia all enzyme activities were significantly decreased in comparison to the
      normal situation, and the alterations differed in both ventricles. Ginkgo biloba
      extract treatment over three months before exposition to hypoxia resulted in a
      lower inhibition of succinate dehydrogenase, a higher inhibition of glycerol-3
      phosphate dehydrogenase and an unchanged activity of adenosine triphosphatase
      after hypoxia of 20 min. These results were interpreted as a protective effect of
      the Ginkgo biloba extract on the hypoxic myocardium.

PMID- 7771188
TI  - A flow cytometric analysis of the DNA content of Paget cells in the epidermis and
      the tumor of extramammary Paget's disease.
AB  - In the present study, we have examined whether or not the Paget cells in cases
      with dermal invasion or metastasis exhibit a different DNA distribution pattern
      to that seen in the epidermis in extramammary Paget's disease. The DNA contents
      of Paget cells from the epidermis and the tumor were determined by flow cytometry
      in two cases of extramammary Paget's disease with tumor formation, dermal
      invasion and metastases. The DNA histogram of Paget cells from the epidermis of
      two cases appeared to be close to the normal ploidy, whereas the histogram from
      the tumors was aneuploid in both cases. Our data suggest that the behavior of
      Paget cells in the epidermis is different from that in the tumor.

PMID- 7771187
TI  - A rapid lectin receptor binding assay: comparative evaluation of sea urchin
      embryo cell surface lectin receptors.
AB  - Lectin receptor binding assays, such as those that utilize fluorescence,
      radioactivity or electron microscopy are not designed for rapidly screening
      hundreds of cell types for the presence or absence of specific lectin receptors.
      An assay is described here that is designated for this purpose. It utilizes
      lectins derivatized to agarose beads and can be used to screen many cell types in
      min. This assay was used to examine lectin receptors on the surfaces of 1-8 cell
      stage Strongylocentrotus purpuratus sea urchin embryos. The same cells were also
      assayed using standard fluorescence and agglutinability procedures to ascertain
      the type of information obtained by the new assay and how it correlates with
      results from the standard methods. The bead results correlated well with results
      using fluorescent lectin. Only wheat germ agglutinin bound very strongly in both
      bead and fluorescence assays, while concanavalin A, Dolichos biflorus, Lens
      culinaris and Tetragonolobus purpureas did not bind or bound weakly using both
      methods. Results using a third method, lectin mediated cell agglutination, did
      not correlate with the bead or fluorescence assays. Lectin receptors were also
      examined on embryos prepared by two different methods of preventing formation of
      fertilization membranes, so that coat-free cell surfaces could be studied, the
      standard dithiothreitol method and a new method using alpha-amylase. Lectin
      receptors on the cell surfaces of embryos prepared by both methods were nearly
      identical. The possible functions of WGA receptors, the most prevalent lectin
      receptors of those studied, that were uniformly present throughout early
      development of this sea urchin species, are considered.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7771189
TI  - Detection of 54-kDa protein overexpressed by chloroquine-resistant Plasmodium
      berghei ANKA strain in pyronaridine-resistant P berghei ANKA strain.
AB  - AIM: A 54-kDa protein overexpressed by chloroquine-resistant (CR) Plasmodium
      berghei ANKA strain was first reported by us. This study is conducted to detect
      the protein in pyronaridine-resistant (PR) P berghei ANKA strain. METHODS:
      Immunoblotting analysis and immunoelectron microscopy were used. RESULTS: PR
      parasites, like CR parasites, mainly overexpressed 2 major bands of 37 (36-38)
      kDa and 16 (15-17) kDa which were considered to be 2 subunits of 54 (52-62) kDa
      protein. Three of 7 times of experiments showed a 54-kDa and a 96 (95-100) kDa
      bands. The proteins were localized to be mainly scattered in cytoplasm of
      trophozoites, schizonts, and merozoites of erythrocytic stage of P berghei. Some
      of them were distributed in cytoplasm of erythrocytes infected with parasites.
      CONCLUSION: Both PR and CR parasites overexpressed the same proteins.

PMID- 7771190
TI  - Effects of isovanihuperzine A on cholinesterase and scopolamine-induced memory
      impairment.
AB  - AIM: To study the effects of isovanihuperzine A (IVHA) on cholinesterase and
      scopolamine-induced memory deficit. METHODS: AChE and BuChE activities were
      determined by the colorimetric method of Ellman. The Ki value was determined by
      the plotting method of Lineweaver and Burk. In a behavioral test, rats were
      trained to perform a radial arm maze task using a partially baited procedure.
      RESULTS: The anti-AChE activity of IVHA was comparable to huperzine A (Hup-A),
      and was more potent than those of physostigmine and galanthamine with an IC50
      value of 0.11 mumol.L-1. IVHA was a mixed competitive type with a Ki value of 32
      nmol.L-1. It bound to AChE in a reversible manner. IVHA at a dose of 0.2 mg.kg-1
      ip significantly reversed scopolamine-induced working memory and reference memory
      impairments in radial arm maze. CONCLUSION: IVHA is a new potential reversible
      AChE inhibitor and merits further study as a cognitive enhancer.

PMID- 7771191
TI  - QSAR of 3-methylfentanyl derivatives studied with neural networks method.
AB  - AIM: To use neural networks, which simulate the functions of living nervous
      systems, in QSAR studies; METHODS: Using the back-propagation neural networks
      program devised by us, combining with partial least squares (PLS) method, we
      studied the relationships of quantum chemical indices and analgesic activities of
      25 3-methylfentanyl derivatives; RESULTS: Through learning process, a good QSAR
      model was established, and the activities of these compounds were predicted; the
      correlation between the activities and quantum chemical indices: the net charge
      of the atom N1, the net charge of the atom O16, the torsional angle of atoms C10
      C9-N8-C4, the interatomic distance between atom C7 and the center of phenyl plane
      C9-14 (PhA), is quite well-matched. Based on these results, an interactive
      pattern between 3-methylfentanyl derivatives and opioid receptors was suggested;
      CONCLUSION: Not only are the results of neural networks superior to those of PLS
      method but they also provide accurate predictions of the activity of the
      compounds and also combine the PLS method with neural networks.

PMID- 7771192
TI  - Assay of metoprolol and alpha-hydroxymetoprolol in human urine by reversed-phase
      liquid chromatography with direct-injection.
AB  - AIM: To develop an HPLC method with direct injection for the simultaneous
      determination of metoprolol (M) and alpha-hydroxymetoprolol (HM) in human urine.
      METHODS: Urine (200 microliters) was diluted with eluate and injected into the
      chromatograph. Samples were separated on an ODS column by isocratic binary
      elution and monitored by fluorescence detection. RESULTS: No potential
      interfering peaks were identified. M and HM gave rapid elution and baseline
      resolution. The linear curves of both analytes ranged between 0.2 and 100 mg.L-1.
      The response sensitivity was approximately 0.1 mg.L-1 and the coefficients of
      variation in the assay were within 8% for both compounds. A typical application
      in oxidation phenotyping was presented for one healthy volunteer who received 100
      mg of oral metoprolol. CONCLUSION: The method can be used for the investigation
      of genetic polymorphism of metoprolol oxidation in the large populations.

PMID- 7771194
TI  - Effect of colchicine on hepatic glycosaminoglycan metabolism in mice infected
      with Schistosoma japonicum.
AB  - AIM: To study the effect of colchicine on hepatic glycosaminoglycan (GAG)
      metabolism in mice infected with Schistosoma japonicum. METHODS: The amount of
      GAG was measured in the liver of mice infected with Schistosoma japonicum for 6
      16 wk and treated with colchicine. RESULTS: Six weeks after infection, the GAG
      content of infected mice's livers and uninfected control was 14 +/- 2
      micrograms/g liver and 4 +/- 1 microgram/g liver, respectively. The GAG content
      reached a peak about 6 times of the normal level in the 10th wk after infection,
      being 56 +/- 9 micrograms/g and 10 +/- 1 microgram/g for infected and uninfected
      mice respectively, and then declined. Treatment of infected mice with colchicine
      reduced the total GAG content to 22 +/- 3 micrograms/g liver, but not suppress
      the GAG content below the normal level in the 10th wk. Microscopic hepatic egg
      granuloma. CONCLUSION: Colchicine may exerts its GAG reduction effect through the
      suppression of granuloma formation.

PMID- 7771193
TI  - Effects of nimodipine, felodipine, and verapamil on isolated human arteries.
AB  - AIM: To evaluate whether there might be some difference in the action modes of
      nimodipine (Nim) and felodipine (Fel). METHODS: Compare the inhibitory effects of
      Nim and Fel with that of verapamil (Ver) as a representative of phenylalklamine
      on norepinephrine (NE)- and CaCl2-evoked contractions of human arteries. RESULTS:
      In Ca(2+)-free and high K+ depolarized solution, inhibitory effects of Nim, Fel,
      and Ver were more potent on CaCl2-induced contractions on isolated human arteries
      than those on NE-induced contractions. In CaCl2-induced contraction, the pD2
      values for Nim, Fel, and Ver were 7.5, 7.42, 6.35 on uterine arteries; 7.38,
      7.65, 7.20 on mesenteric arteries and 7.87, 9.10, 7.32 on renal arteries,
      respectively. Ver inhibited 2 components of NE-evoked contraction, while Nim and
      Fel only inhibited extracellular Ca(2+)-dependent contractions. CONCLUSION: The
      result indicates that Fel has a selective action on human renal arteries.

PMID- 7771195
TI  - Endogenous adenosine and ATP-sensitive potassium channel modulate anoxia-induced
      electrophysiological changes of pacemaker cells in sinoatrial node of guinea
      pigs.
AB  - AIM: To investigate the electrophysiological effects of adenosine deaminase
      (ADase, an enzyme converting adenosine to inosine and ammonia), 8
      phenyltheophylline (8-PT, a nonselective antagonist of adenosine receptors) and
      glibenclamide (Gli, a potent blocker of ATP-sensitive K+ channels) on anoxic
      pacemaker cells of SA node. METHODS: Anoxia of pacemaker cells in SA node of
      guinea-pig was induced by perfused for 20 min with a modified K-H solution gassed
      with 100% N2 deprived of glucose. Parameters of action potentials including
      maximal diastolic potential (MDP), amplitude of action potential (APA), duration
      of 90% repolarization (APD90), maximal rate of depolarization (Vmax), rate of
      pacemaker firing (RPF), and velocity of diastolic (phase 4) depolarization (VDD)
      were recorded using intracellular microelectrodes. RESULTS: Anoxia increased MDP,
      APA, and Vmax and decreased VDD, RPF in a time-dependent manner. ADase 10 U.L-1,
      8-PT 0.1 mumol.L-1 and Gli 10 mumol.L-1 significantly attenuated the
      electrophysiological changes of pacemaker cells in sincatrial node induced by
      anoxia. CONCLUSION: Endogenous adenosine and ATP-sensitive K+ channels may play
      an important role in the generation of anoxic bradycardia in guinea pigs.

PMID- 7771196
TI  - Determination of free digoxin in sera of 8 patients with chronic cardiac
      insufficiency.
AB  - AIM: To establish a method for the determination of free digoxin in serum for
      clinical use and to study the relationship between the free and total digoxin
      concentrations in chronic cardiac insufficiency patients receiving digoxin with
      different renal function. METHODS: The ultrafiltration with fluorescence
      polarization immunoassay was used to determine the concentration of free digoxin.
      RESULTS: The concentrations of digoxin standards in serum were 0.96, 1.92, and
      3.84 nmol.L-1. The relative standard deviation was < 7% for intra-day and < 6%
      for inter-day determinations. The average recovery was 99.95 +/- 2.18%. The ratio
      of free/total digoxin in chronic cardiac insufficiency patients with renal
      dysfunction was lower than that in patients with normal kidneys (63.5 +/- 4.7% vs
      75.1 +/- 3.9%, P < 0.01). CONCLUSION: The present method is simple and reliable.
      In these patients there is an over-measurement for total digoxin concentration,
      suggesting the presence of elevated endogenous digoxin-like immunoreactive
      substances.

PMID- 7771198
TI  - Effects of pineal body and melatonin on lymphocyte proliferation and dinoprostone
      production in rat spleen.
AB  - AIM: To determine the effects of pineal body and melatonin (Mel) on lymphocyte
      proliferation and dinoprostone production in rat spleen. METHODS: Pinealectomy
      (PE), lymphocyte proliferation assay and dinoprostone radioimmunoassay were used.
      RESULTS: A circadian rhythm of splenic lymphocyte proliferation which peaked at
      22:00 was obliterated by PE in rats. PE led to an impairment of lymphocyte
      proliferation and an increase of dinoprostone production, which were restored by
      ip Mel 10 micrograms.kg-1.d-1 at 16:00 for 7 d. Mel promoted lymphocyte
      proliferation and inhibited dinoprostone production in intact rats. A negative
      correlation between the change in lymphocyte proliferation and dinoprostone
      production was seen. CONCLUSION: The pineal body and its main hormone Mel play a
      regulatory role in circadian lymphocyte proliferation which is related to
      dinoprostone production in rat spleen.

PMID- 7771197
TI  - Effects of glutamate dehydrogenase, choline oxidase, and glucose-6-phosphatase on
      67Ga accumulation in lysosome.
AB  - AIM: To clarify the effects of the activities of hepatic enzymes in liver,
      hepatoma, and malignant tumor on 67Ga accumulation in lysosome. METHODS: 67Ga
      citrate solution was prepared from carrier-free 67Ga-citrate solution 0.08 mol.L
      1 and sodium citrate solution 0.08 mol.L-1, and was injected iv 0.4 ml to the
      rats. Subcellular fractions of the liver were measured for radioactivity of 67Ga
      by a well-type scintillation counter (Aloka JDC-701). Glutamate dehydrogenase,
      choline oxidase, and G-6-P activities were calculated as described by Shimizu H,
      Ikuta S, and Baginski E, respectivily. RESULTS: 67Ga radioactivity in normal
      liver lysosome (55%) was significantly higher than those in hepatoma AH 109A
      (32%) and Yoshida sarcoma (18%). Glutamate dehydrogenase activities were 1830 +/-
      s 320 U.L-1 in normal liver while 23 +/- s 6 U.L-1 in hepatoma AH 109A, and 7 +/-
      s 2 U.L-1 in Yoshida sarcoma. Choline oxidase activities were 46 +/- s 10 U.L-1
      for normal, 25.0 +/- s 0.4 U.L-1 for hepatoma AH 109A, and 2.0 +/- s 0.4 U.L-1
      for Yoshida sarcoma. G-6-P activities were 2550 +/- s 180 U.L-1 in normal, 84 +/-
      s 14 U.L-1 in hepatoma AH 109A, and 78 +/- s 13 U.L-1 in Yoshida sarcoma.
      CONCLUSION: Lysosome of normal rat liver in which hepatic enzymes work actively
      played a major role in the tissue concentration of 67Ga, but the role diminishes
      with the neoplastic transformation into hepatoma. The lysosome of Yoshida sarcoma
      does not play any role in 67Ga accumulation because it does not possess any
      features of liver.

PMID- 7771199
TI  - Phencyclidine receptors in brain and spinal cord of spontaneously hypertensive
      rats aged 4-16 wk.
AB  - AIM: To study the relationship between the density of phencyclidine [1-(1
      phenylcyclohexyl)piperidine hydrochloride, Phe] receptor binding sites in brain
      and thoracic spinal cord (T4-6) and the development of hypertension in
      spontaneously hypertensive rat (SHR). METHODS: The density of Phe binding sites
      was determined by autoradiography using [3H]Phe in 4-, 8-, 12- and 16-wk-old
      rats. RESULTS: There were fewer Phe binding sites in the hippocampus and dorsal
      horn of thoracic spinal cord of SHR at 12 and 16 wk (P < 0.01), when hypertension
      has established; while at 4 wk of age, before the development of hypertension,
      more Phe binding sites were found in SHR. As blood pressure began to rise at 8
      wk, SHR had more Phe binding sites in hippocampus vs WKY, but no difference was
      seen between 2 strains in the dorsal horn of thoracic spinal cord. CONCLUSION:
      Phe receptors might be involved in the genesis of SHR hypertension.

PMID- 7771200
TI  - [A simple method for estimating half-life of drugs obeying Michaelis-Menten
      elimination kinetics].
AB  - AIM: To establish a simple method for estimating half-life of drugs obeying
      Michaelis-Menten elimination kinetics. METHODS: A linear relationship is sketched
      between elimination half-life and drug concentration in blood that obey Michaelis
      Menten elimination kinetics. A simple method is proposed to draw a regression
      line of blood drug concentration vs time after a single bolus intravenous
      injection. RESULTS & CONCLUSION: The elimination half-life can be read from the
      regression line. The method can also be used to estimate the time required for
      the plasma concentration of a drug to decrease any fraction.

PMID- 7771201
TI  - Proceedings of the Fifth China-Japan Joint Meeting on Pharmacology (CJP-94), 1994
      Oct 28-31 Hangzhou, China. Abstracts.

PMID- 7771202
TI  - [Lumbar spinal stenosis. Significance of neurophysiologic tests].
AB  - The authors review Lumbar Spinal Stenosis discussing the diagnostic criteria, the
      etiopathogenesis, and clinical manifestations. Imaging and neurophysiological
      investigations are also discussed. EMG, Sensory Evoked Potencials and Motor
      Stimulation are described stressing their role in differential diagnosis. The
      therapeutic approach is briefly commented.

PMID- 7771203
TI  - [Neurologic paraneoplastic syndromes].
AB  - Some neurologic syndromes are often associated with neoplasm, as a paraneoplastic
      disorder. Among them, namely, subacute cerebellar degeneration, sensory
      neuronopathy, dermatomyositis/polymyositis, Lambert-Eaton myasthenic syndrome and
      subacute motor neuronopathy, prove sooner or later to be harbouring a neoplasm,
      therefore a thorough clinical evaluation should be carried out to identify the
      primary tumour site. The AA present a brief review of these neurologic syndromes,
      illustrating the first three mentioned with clinical cases. A reference is made
      to the immunological associated aspects and their clinical importance.

PMID- 7771204
TI  - [Sleep, depression, and antidepressive treatments (1)].
AB  - Sleep research in depressive disorders has advanced considerably in the last two
      decades. In this review we highlight the different facets of this research,
      including neurophysiological descriptions of sleep disturbances in depression and
      data regarding the effects of antidepressant treatments on sleep. The available
      information is discussed taking into consideration a possible pathogenic role of
      certain sleep changes in depression, as assumed by several theoretical models.
      The scope of these models and their explanatory power are briefly analysed. Some
      comments are made on conceptual and methodological problems in the field of sleep
      research in psychiatric disorders.

PMID- 7771205
TI  - [Evaluation and quality assurance of mental health services].
AB  - Evaluation and quality assurance are primary issues in mental health care today.
      An up-date of current knowledge and experience in this domain is the main
      objective of this paper. The authors begin by describing the reasons that justify
      the current interest in this subject, defining concepts and summarizing the most
      relevant historical antecedents. This is followed by a discussion of the main
      methodological aspects--basic concepts (particularly those related to structure,
      process and outcome), specific issues in mental health service evaluation,
      difficulties in the implementation of evaluation procedures and choice of
      indicators. Special attention has been given to the most recent developments in
      mental health service evaluation--namely those related to assessment needs and
      quality of life measurement. The impact of the regular use of evaluation
      instruments on the transformation and development of mental health services is
      also discussed. The contributions that can be made by evaluation procedures to
      the definition of mental health policies and to overcome mental health service
      deficiencies are stressed. Finally, the necessity of joining efforts in order to
      generalize the use of evaluation and quality assurance instruments in the mental
      health services in this country is pointed out.

PMID- 7771206
TI  - [Prenatal diagnosis of congenital cardiopathies. Dissemination and education].

PMID- 7771207
TI  - [Fetal arrhythmia. A case load of 4 years and a half].
AB  - In a 4 1/2 year period fetal, echocardiographic studies were performed on 1600
      fetuses. In 55 with arrhythmia, 44 had supraventricular ectopic beats, resolved
      in all, and none had heart disease. Sustained arrhythmias occurred in 11 fetuses.
      Atrial flutter was present in 3 all with heart disease (Ebstein disease, right
      atrial tumour and WPW diagnosed after birth). Another 3 fetuses had
      supraventricular tachycardia (SVT), all with a normal heart. In the bradycardia
      group, 2 had complete heart block (CHB) associated with AVSD; 2 sinus bradycardia
      and one had non conducted atrial ectopic beats. Digoxin was the first choice drug
      for tachyarrhythmia therapy; association with Verapamil, Flecainide, Quinidine
      and Procainamide was used in 4 of the 6. One fetus with CHB received
      Orciprenaline with no results. Atrial flutter resolved or improved; in SVT 2
      fetuses converted to sinus rhythm and one died in utero. All fetuses with CHB
      died in cardiac failure. Mortality was 27% (3 cases) in utero and global 36%. In
      our experience most fetal arrhythmias (90%) were transitory ectopic beats or non
      lasting bradycardia in normal heart and did not trigger other kinds of
      arrhythmias. In sustained arrhythmias, heart failure and heart disease had a
      negative effect on prognosis.

PMID- 7771208
TI  - [Mother-child transmission of immunoglobulins G].
AB  - The placental transfer of immunoglobulins is made by active transport and only
      IgG class of immunoglobulins is transferred. In a full-term gestation IgG
      concentration is usually higher in the cord serum than in the mother serum. It
      has been shown that the ratio of cord/maternal IgG is higher when maternal IgG
      values are low. A series of 44 mother-child pairs from the north of Portugal were
      studied. Quantitative determination of IgG in all sera was made by single radial
      immunodiffusion and results were expressed in milligrams/deciliter (mg/dl). In
      the first 48 hours after delivery, mothers were interviewed and clinical, social
      and demographic data were collected. In 35 pairs, cord IgG exceeded the
      corresponding maternal concentration. The ratio of cord/maternal IgG ranged from
      0.75 to 2.86 (mean 1.27). From all studied variables only maternal IgG
      concentration and age were correlated with that ratio. Transplacental
      concentration (ratio of cord/maternal IgG) was higher for lower levels of
      maternal IgG. Significant contribution of maternal age did not stand when a woman
      with extreme values of IgG and age was withdrawn from the analysis. Values found
      for this series of Portuguese mother-child pairs were similar to those found for
      other caucasian populations and are in agreement with current proposed models for
      placental transfer of IgG.

PMID- 7771210
TI  - [Diagnostic criteria for primary dyslipidemia].
AB  - The accurate treatment of a dyslipidaemia is based on correct diagnosis. Together
      with the laboratory values. A good clinical interview, focusing on the family
      history, is the bases for a good diagnosis strategy. The author schematze the
      rules of etiological diagnosis of inherited defects of lipid metabolism.

PMID- 7771209
TI  - [Hospital prevalence of kidney failure. Consequences and reflections for the
      planning of nephrology services].
AB  - A prospective prevalence study of Renal Failure (RF) in inhospital patients
      (creatinine > = 1.7 mg/dl) was carried out during March 1994, in two hospitals
      covering well defined and mutually exclusive populations. Cases were selected by
      screening all urea and creatinine blood tests performed in both laboratories, and
      registered in an individual form for daily follow-up of their nephrologic
      outcome. We registered 242 RF cases among 3525 patients admitted (6.8%), with an
      A.R.F. prevalence of 5.2%, 46% of all patients had a serum creatinine > 3 mg/dl
      and 71% were older than 65 years. In 55% RF was acquired inside the hospital. The
      most frequent cause of A.R.F. was pre-renal failure with 37%, followed by 32% of
      ischemic acute tubular necrosis and 13% toxic ATN. Nephrology was consulted in
      only 29% of all hospital RF cases. Only 17% of the RF patients were submitted to
      dialysis procedures, overall mortality was 31%, and 30% had normal renal function
      at discharge. Our results provide a data base to rethink the organization,
      staffing and role of nephrology departments inside general hospitals.

PMID- 7771211
TI  - [Primary lymphoma of the lung].
AB  - Primary lymphomas of the lung are rare neoplasias that can be easily diagnosed
      when enough tissue is available, but are easily mistaken for lung carcinomas or
      mesotheliomas on clinical evaluation. Two surgical cases are described with
      reference made to their morphological and immunohistochemical characteristics.

PMID- 7771212
TI  - [Hemangiopericytoma].
AB  - A case of hemangiopericytoma located in the left upper thigh is presented. The
      literature is reviewed, particularly the clinical aspects and reference is made
      to arteriography and preoperative embolization.

PMID- 7771213
TI  - Minimally invasive neurosurgery II. Proceedings of the 2nd meeting on
      endoneurosurgery. Marburg, Germany, January 30-February 1, 1992.

PMID- 7771214
TI  - Minimally invasive endoscopic neurosurgery--a survey.
AB  - In 1989 we introduced "endoscopic stereotaxy" as a new operative procedure into
      neurosurgery. This technique was first scheduled to optimize stereotactic biopsy.
      In its further development it proved to be effective for other indications. We
      choose the term "Minimal Invasive (Endoscopic) Neurosurgery (MIEN)" for these
      interventions. Minimal invasive endoscopic techniques are applied preferably for
      diagnostic and therapeutic interventions on preformed or pathological cavities of
      the central nervous system. The indications are, endoscopic-stereotactic biopsy
      of space-occupying lesions, ventriculoscopy and endoscopic ventriculostomy in
      diagnosis and treatment of hydrocephalus, endoscopic evacuation of cystic space
      occupying lesions, endoscopic evacuation of intracerebral haematoma, endoscopic
      evacuation of septated chronic subdural haematoma, endoscopic evacuation of
      subacute or chronic brain abscesses, endocavitary syringostomy. Our results with
      minimal invasive endoscopic interventions for different indications are
      encouraging when compared to conventional microsurgical techniques. We have
      performed more than 300 minimal invasive endoscopic interventions. The mortality
      rate was below 1%, the operative morbidity was below 2%.

PMID- 7771216
TI  - Epiduroscopy and spinaloscopy: endoscopic studies of lumbar spinal spaces.

PMID- 7771217
TI  - Operative spinal endoscopy: stereotopography and surgical possibilities.
AB  - The polyprojective microstereotopography of spinal canal structures at the
      cerebello-spinal, cervical, thoracic, lumbosacral and cauda equina levels on 20
      fresh cadavers is presented using flexiscopes 3.7-3.9 mm diameter. This is
      possible due to the space between spinal cord-vertebral canal which is about 10
      mm at all levels. This also allows one to insert the endoscopic tube by posterior
      or interradicular approach. The subdural and subarachnoid endoscopic examinations
      have been performed through small foraminotomic openings with resection of the
      base of the spinous process. The anterior and posterior roots, the spinal cord,
      dural root sleeves, cerebellar tonsils, orifice of the IV ventricle, vertebral
      artery and its lower branches can be visualised. On the stereotopographic basis
      the first operations in patients with severe spinal cord injury (detection of
      multilevel cord compression, removal of massive subarachnoid bleeding),
      syringomyelia and haemorrhage into the IV ventricle (clot removal by the
      ascending cervical route) were undertaken. More than 10 real and probable
      indications for operative spinal endofiberoscopy are discussed.

PMID- 7771215
TI  - Endoscopic stereotactic treatment of brain abscesses.
AB  - Treatment of brain abscess is still a subject of controversy. Craniotomy with
      primary extirpation and resection of the abscess membrane, burrhole craniotomy
      with puncture or insertion of a drain, marsupialization, or stereotactic
      aspiration are different therapeutic approaches. As a consequence of our
      experiences and results with neuro-endoscopic interventions we have introduced
      endoscopic stereotactic techniques in brain abscess treatment. Seven patients
      with brain abscesses were operated on stereotactically using an endoscope. In all
      cases the abscess contents were aspirated, while the abscess membrane was left in
      situ. The patients received postoperative antibiotic therapy according to
      microbial diagnosis. The longest follow-up period was 48 months. Six patients
      showed a marked improvement of neurological deficit after treatment. One patient
      died from sepsis caused by a bacterial endocarditis. The results emphasize that
      endoscopic stereotactic technique as a minimally invasive neurosurgical method
      can also be used for treatment of brain abscess.

PMID- 7771218
TI  - Technology assessment of endoscopic surgery.
AB  - Endoscopic surgery is considered a milestone in the evolution of surgical
      technique in nearly all fields of surgery. However, the inappropriate use of the
      new technology in medicine has also been heavily criticised. Systematic
      technology assessment of endoscopic surgical techniques is mandatory to prove the
      real benefits and complications, so defining the indications for their
      appropriate use. This article describes methods of technology assessment suitable
      for endoscopic techniques with emphasis on relevant endpoints for surgeons and
      patients. The general stages of a comprehensive technology assessment include: 1.
      feasibility (safety and technical performance) 2. efficacy (patient benefits in
      pioneering places) 3. effectiveness (patient benefits in average hospitals in the
      community as a whole) and 4. economic evaluation (cost-benefit analyses). We used
      the example of laparoscopic cholecystectomy to describe the methods of technology
      assessment. A cohort study on 500 patients revealed that laparoscopic
      cholecystectomy is as safe as the conventional standard open technique. The
      results on efficacy strongly support the hypothesis of more comfort and less
      trauma with the endoscopic technique. Major endpoints evaluated were
      postoperative pain, convalescence, fatigue and quality of life. Data on
      effectiveness and economics are still in a "premature" state and should be the
      subject of further analyses. It is concluded, that other disciplines such as
      neurosurgery should evaluate their endoscopic surgical techniques according to
      the rules of technology assessment outlined in this paper.

PMID- 7771219
TI  - Fundamentals of laser science.
AB  - The importance of laser application in minimal invasive neurosurgery is
      emphasized. Physical fundamentals of laser energy are described, and the physics
      of laser tissue interactions are discussed. Different surgical laser types as the
      carbon dioxide laser, the argon laser, and the Nd:YAG laser as well as the
      application mode (contact versus non-contact mode) are compared according
      application. The main indication for the use of laser in minimal invasive
      neurosurgery is cutting, coagulation, vaporization, and interstitial irradiation.

PMID- 7771220
TI  - Magnetic field guided endoscopic dissection through a burr hole may avoid more
      invasive craniotomies. A preliminary report.
AB  - The neuroendoscope, coupled with radiofrequency or laser dissecting tools, can
      effectively resect obstructing membranes, biopsy and debulk tumor, and evacuate
      hematomas when the pathology is within the ventricular system. This less invasive
      approach through a burr hole usually avoids craniotomies. When the abnormal
      condition is within parenchyma or in the presence of opacifying bloody fluid,
      landmarks are not recognizable and the neurosurgeon quickly becomes disoriented.
      A more extensive craniotomy or a stereotaxic-guided procedure is then necessary.
      We describe our preliminary experience with a geographic intracranial navigation
      system using realtime measurement of electromagnetic field strength in multiple
      planes to precisely indicate the position of the tip of the endoscope. A
      transmitting antenna is positioned beneath the patient's head. A 1.5 centimeter
      cubic antenna receiver is mounted upon a lenscope with instrument channel. The
      scope is guided into the surgical field after insertion through a burr hole. A
      square wave pulsed electromagnetic field measurement is made 140 times per second
      with correction for the earth's magnetic field once per second. Intracranial
      position data for the dissecting tip in regard to X, Y, Z, pitch, roll and yaw
      are output to a digitized computer map of the patient's MRI or CT scan. Also
      displayed on the computer screen is the video image from the endoscope. The
      neurosurgeon thus has simultaneous realtime geographic and near-field
      localization as he dissects. Electromagnetic field guided accuracy is within 2.0
      mm inside the allowable 24 inch working sphere about the patient's head. Coupled
      with near-field video precision, accuracy is within 1 mm of recognizable
      dissection planes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771221
TI  - New kinds of microneuroprotectors for microsurgery and endoscopy of
      cerebellopontine angle neurovascular decompression.
AB  - New microsurgical devices for neurovascular decompression--microneuroprotectors
      (MNP)--are described. Four constructive kinds of MNP have been developed
      according to topographic peculiarities of pathological neurovascular contacts.
      The hydrodynamic and biological testing of MNP has been concluded. The methods of
      microsurgical and endoscopic techniques of MNP insertion on the cranial nerves or
      posterior fossa vessels are reported.

PMID- 7771222
TI  - A computer assisted toolholder to guide surgery in stereotactic space.
AB  - A computer assisted toolholder, integrated with an anatomical graphic 3-D
      rendering programme, is presented. Stereotactic neuroanatomical images are
      acquired, and the same reference system is employed to represent the position of
      the toolholder on the monitor. The surgeon can check the orientation of different
      approach trajectories, moving the toolholder in a situation of virtual reality.
      Angular values expressed by high precision encoders on the five joints of the
      toolholder modify "on line" the representation of the configuration of the
      toolholder within the three dimensional representation of the patient's anatomy.

PMID- 7771224
TI  - A multipurpose cerebral endoscope and reflections on technique and
      instrumentation in endoscopic neurosurgery.
AB  - We discuss our experiences concerning our cerebral endoscope with reflections on
      various techniques used since 1986. During this time we have had experience with
      four prototypes. This minimal invasive procedure has been successful to a certain
      extent both in paediatric and adult patients, stereotactically and by freehand
      method or both. Further modification for flexibility and manipulation of the
      optic element is under development.

PMID- 7771223
TI  - Ultrasound guided endoscopic neurosurgery--new surgical instrument and technique.
AB  - For minimal invasive endoscopic neurosurgery, a mini-caliber endoscope equipped
      with a useful working channel and its guidance system is basically essential. We
      developed the device for ultrasound guided endoscopic neurosurgery. A minicaliber
      fiberscope with an outer diameter of 3.4 mm equipped with 2.5 mm of working
      channel for forceps, suction, and coagulation probe was developed. A 5 MHz phase
      arrayed 12 mm ultrasound probe was used as guidance system. A fixation device for
      the mini-caliber fiberscope and ultrasound probe was also constructed. The
      surgical procedure is very simple, and can be performed through a 2 cm burr hole.
      Real-time and a directly visualized image might provide more safety and
      reliability during brain surgery.

PMID- 7771225
TI  - Endoscopic anatomy of the third ventricle.
AB  - 42 cadaver brains in situ were examined endoscopically to work out topographical
      anatomical landmarks for orientation. The endoscopic route from the chosen
      precoronal trepanation point to the defined ventricular landmarks has been
      measured in 22 cases. The identification and measurements of the anatomical
      landmarks are helpful for safe and atraumatic endoscopical navigation within the
      ventricular system. Furthermore this article describes and discusses cerebral
      lesions during ventriculoscopy.

PMID- 7771226
TI  - Endoscopic anatomy of the ventricles.
AB  - The endoscopic view offers a new anatomical dimension to the neurosurgeon. The
      fact makes it basically necessary to study the topographic anatomy under
      endoscopic conditions. In this paper attention was drawn to the ventricles
      because they are the most common region of clinical application. In 25 specimens
      neuroendoscopic explorations of the ventricles have been done. The dissections
      have been carried out through one- and two burr hole approaches (two working
      endoscopes at the same time). The instrumentation includes rigid 4 mm and 6 mm
      endoscopes. The procedures have been documented by continuous video recording and
      parallel photography.

PMID- 7771227
TI  - "Stereology" of intracranial lesions.
AB  - Endoscopy of the intracranial space requires a new understanding of the anatomy
      and pathology of pertinent structures. This meets with the new development of
      imaging methods which equally require three dimensional interpretation of
      intracranial pathology. The stereological arrangement of intracranial lesions is
      examplified on three neuropathological conditions: brain tumours, territorial
      infarction and mass displacement.

PMID- 7771228
TI  - Endoscopic diagnosis and treatment of para- and intra-ventricular cystic lesions.
AB  - Different cystic lesions can be located in or around the ventricular system,
      eventually causing hydrocephalus. Twenty-one patients are described where
      endoscopic intervention, mainly large fenestration towards the ventricular
      cavity, has been performed. This treatment can sometimes replace open surgery or
      extracranial shunting. Most rewarding are the arachnoid and ependymal intra- and
      paraventricular cysts. With careful and adequate endoscopic technique this
      procedure is safe and much less invasive than other methods described.

PMID- 7771230
TI  - Neuroendoscopic third ventriculostomy. A practical alternative to extracranial
      shunts in non-communicating hydrocephalus.
AB  - The outcomes in 103 patients who have undergone third ventriculostomy for non
      communicating hydrocephalus at our institution form 1978-1994 have been analysed.
      The group has been sub-divided by age, cause of hydrocephalus and whether the
      third ventriculostomy was the initial definitive procedure or whether progression
      of their hydrocephalus had been arrested for a long time (usually years) by an
      extracranial shunt prior to third ventriculostomy. At the time of shunt
      malfunction (usually blockage) a third ventriculostomy was performed if the
      anatomy was, or could be made suitable for the safe performance of the procedure.
      Third ventriculostomy under the age of 6 months was successful in only 8 of 25
      patients. Seventeen patients in whom the onset of hydrocephalus was under the age
      of six months and the ventriculostomy was performed between 6 months and 18
      years, 8 were successful. Sixteen of these had had previous long term shunts. In
      40 patients in whom the onset of hydrocephalus was over the age of 6 months and
      the ventriculostomy performed after the age of 19 years, 32 were successful. In
      28 patients over the age of 20 years, 13 had previously been shunted and in 8 of
      these the procedure was successful. In 15 patients not previously shunted, 9
      ventriculostomies were successful. Three failed, 2 died before evaluation could
      be done and one was lost to follow-up. There were no deaths caused by the
      procedure. Two patients suffered from a hemiparesis, (1 transient) 1 patient
      suffered mid-brain damage. There were 2 subdural effusions. Two patients had
      infections, 1 superficial and 1 a ventriculitis.

PMID- 7771229
TI  - Stereotactic techniques for colloid cysts: roles of aspiration, endoscopy, and
      microsurgery.
AB  - Stereotactic surgical techniques were used to manage 25 consecutive patients with
      colloid cysts of the third ventricle. All patients had stereotactic aspiration as
      the initial procedure; it was successful in 13 (52%). In patients in whom
      aspiration failed, endoscopic visualization of the cyst and attempted removal, or
      microsurgical cyst resection via a transcortical approach was performed. Three
      elderly patients did not have a second procedure and were shunted. The computed
      tomographic appearance of a hypodense or isodense cyst indicates low-viscosity
      contents and predicts successful stereotactic aspiration. Stereotactic
      microsurgery is used in hyperdense cysts, or in those which cannot be aspirated.

PMID- 7771231
TI  - Endoscopic surgery of traumatic intracranial haemorrhages.
AB  - The results of endofiberscopic removal of traumatic intracranial haematomas and
      hygromas in 180 patients are analysed. Peculiarities of the surgical techniques
      using flexiscopes and original devices in epidural, subdural, intracerebral,
      intraventricular haemorrhages of various consistencies, size and location are
      reported. A technique of the trephination access and delayed cranioplasty for
      endoscopic removal of extensive subdural and intracerebral haematomas is
      presented. Indications, contra-indications for endoscopic haematoma surgery,
      advantages, disadvantages, failures of the techniques are discussed.

PMID- 7771232
TI  - Endoscopic stereotactic interventions in the treatment of brain lesions.
AB  - Image-guided stereotaxis is an accurate and safe method of directing therapy to
      target volumes defined in two-dimensional (2D) multiplanes or three-dimensional
      (3D) perspectives using computer reconstruction of image data. The major
      limitations of stereotactic techniques are a lack of intraoperative visualization
      and direct monitoring of the procedures, and changes of intracranial coordinates
      after decompression of cystic lesions or aspiration of cerebrospinal fluid in the
      management of intraventricular lesions. Endoscopic laser stereotaxis (ELS)
      involves integration of rigid-flexible endoscopy and Nd-YAG laser to 3D-2D
      multiplanar image-guided stereotactic procedures. The major advantages of ELS
      include: minimally invasive (burrhole or small craniotomy surgery), direct
      intraoperative visualization, hemostasis, evacuation or resection assessment, and
      wide exploration of intracranial cavities or ventricles. ELS has been used in the
      management of 152 clinical cases including biopsy, aspiration, resection and
      internal decompression of deep and subcortical intracranial lesions, and
      different types of fenestration procedures. Image-guidance combined with
      endoscopic techniques may offer a safe, accurate alternative to conventional
      neurosurgical procedures in treating small solid, cystic, and intraventricular
      lesions as well as fenestration procedures.

PMID- 7771233
TI  - Stereotactic endoscopic resection of angiographically occult vascular
      malformations.
AB  - Total resection of angiographically occult vascular malformations was performed
      in four patients using stereotactic open-system endoscopy. The lesions were
      relatively small but localized deep in the brain or involving eloquent cortex.
      Fiber-guided YAG laser coagulation was efficient for haemostasis and no
      significant complication was seen in any case. Endoscopic stereotactic laser
      surgery by open-system endoscopy is considered a safe and promising treatment for
      small AOVM's located in deep or eloquent neural structures.

PMID- 7771234
TI  - [Uroflowmetric nomogram in the adult population of Canary Islands].
AB  - In order to know the uroflowmetric values of our healthy population, a
      uroflowmetry was made to 214 healthy subjects of both sexes. 75% of our group of
      volunteers collected mictional volumes under 300 ml. with no differences either
      by age or sex. The corresponding nomograms, in the form of percentile, for peak
      and mean flow in both sexes, were created. We found a progressive increase of
      peak and mean flow values with regard to mictional volume. Time to peak flow is
      shorter in women than in men. Volume at peak flow represents under 50% of total
      mictional volume. No significant differences in the uroflowmetric data of our
      healthy population and those from Anglo-Saxon authors was found.

PMID- 7771236
TI  - [Occupation and bladder tumor. Results of a study of incident cases].
AB  - Presentation of the results from the occupation analysis in a study of incident
      cases of vesical tumour over a 16-year interval (1975-1991) conducted in La Rioja
      Autonomous Community. Out of the 557 cases identified, occupation was found in
      455, 151 of them are farmers (33.18%), 71 are in the industrial sector (15.60%),
      and 233 in the services sector (51.20%). Percentage of individuals affected by
      production sectors according to 1985 data are 1.22% farmers, 0.3% industrial
      sector and 0.6% services sector.

PMID- 7771235
TI  - [Clinical features, diagnosis, and treatment of tumor lesions arising in the
      adrenal gland].
AB  - Between 1981 and 1993, 14 patients with tumoral adrenal disease were diagnosed
      and treated in the Urology Services of both Hospitals. Nature of the adrenal
      disease was functional in 8 patients (two carcinomas and six pheochromocytomas)
      and non-functional in the rest (three carcinomas, two adenomas and one
      myelolipoma). Reference is made to the clinical manifestations and laboratory
      tests related to hormonal activity, depending on whether the tumour is functional
      or non-functional, chromaffin or non-chromaffin. Patients with functional
      carcinomas had Cushing's syndrome, with very clear virtilization signs. Urine 17
      hydroxycorticosteroid, 17-cetosteroides and cortisol were all increased, same as
      plasma cortisol. Patients with pheochromocytomas had hypertension and headaches
      (six patients), sweating (five patients), anxiety (four patients) and loss of
      weight (two patients). All of them had increased urine vainillylmandelic acid and
      catecholamines. Clinical signs and symptoms of non-functional tumours were
      related to bulk growth and size (in the three carcinomas), and sometimes was
      highly anodyne, or even absent (in the two adenomas and the myelolipoma), the
      cause of discovery being accidental during an ultrasound examination. An analysis
      is made of the different imaging diagnostic procedures performed, such as IVU
      (performed in 13 patients) with a 38.4% resolutory power; ultrasound (performed
      in 11 patients) with an 81.8% resolution; CAT (performed in 6 patients) with a
      100% resolution capacity and arteriography (performed in 3 patients) with a 100%
      resolution power, although patients had previously undergone ultrasound and
      CAT.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771237
TI  - [Vestibular approach in urinary incontinence in women. Original technic.
      Experience. Results].
AB  - Presentation of an original technique to treat S.U.I. in women. This technique
      contains in itself many others, both in terms of the conceptual anatomical base
      on which it is inspired, and in the possibilities of its surgical application.
      Lisfranc's approach, supra-meatic and infra-clitoridean, allows to section both
      the pubo-urethral ligament and Colles fascia thus reaching into the Retzius. It
      makes possible the use of solid anatomical elements (pelvian fascia, elevator,
      urethro-vaginal septum, etc...) thus allowing to suspend the pelvian base from
      fascia ligaments or from the abdominal wall muscles. Sixty patient who had simple
      S.U.I. received treatment, with a 95% efficacy index based on the evaluation of
      the urodynamic, bacteriological and clinical studies. We conclude with an
      evaluation on the validity of the results obtained by emphasizing the high
      efficacy index, simplicity, low morbidity and short hospital stay.

PMID- 7771238
TI  - [Endoscopic internal urethrotomy guided with transrectal echography].
AB  - Internal urethrotomy is the endoscopic technique most commonly performed in order
      to resolve urethral stenosis. This paper describes a new technique which
      associates transrectal ultrasound to internal endoscopic urethrotomy for the
      resolution of unsurmountable stenosis of the urethra. Presentation of 6 cases,
      with a 100% success rate. The authors believe that the association of transrectal
      ultrasound with internal endoscopic urethrotomy is a simple technique, and very
      useful for the resolution of unsurmountable stenosis of the urethra.

PMID- 7771239
TI  - [Extracorporeal shockwave lithotripsy in patients with urinary diversion].
AB  - Presentation of a review on nine patients (10 renal units) with urinary by-pass
      and renoureteral lithiasis who underwent shock wave extracorporeal lithotrity in
      our hospital. The justification for the by-pass was an infiltrant vesical tumour
      in 6 patients, myelomeningocele in 2, and vesicourethral trauma in the remaining
      one. All cases were being treated for a Bricker-type by-pass except the last one
      (bilateral ureterosigmoidostomy). Outcome of treatment was: absence of residual
      lithiasis in 6, minimal residues in 1 (2 renal units), failure in 1. The
      remaining patient suffered anaphylactic shock induced by the latex in the
      ureteral catheter placed prior to lithotrity which caused the patient's death.

PMID- 7771240
TI  - [Enzyme-induced masculinization].
AB  - Contribution of two cases of congenital adrenal hyperplasia by blockade in the 21
      hydroxylase enzyme synthesis. Diagnosis was reached from the clinical signs and
      symptoms (virilization syndrome), and was confirmed by radiological and
      laboratory tests. Hormone treatment was done with hydrocortisone and
      fludrocortisone, but surgical correction of external genitalia was required to
      improve cosmetic appearance.

PMID- 7771241
TI  - [Bilateral primary ureteral endometriosis].
AB  - Exposition of a new case of primary bilateral ureteral endometriosis, a very
      infrequent condition where early diagnosis before treatment is difficult since no
      other endometrial foci are found at either the uterus or ovary level or any
      sites. This condition has an enormous clinical significance because in a very
      short interval and in a silent manner can cause complete and irreversible damage
      to the upper urinary tract. The article explains the clinical characteristics of
      the disease, and discusses the diagnostic procedures available which are
      generally insufficient. The importance of the histological study is emphasized,
      and the surgical technique and its complications are described. Also, a
      literature review is included.

PMID- 7771242
TI  - [Necrosis of undescended testis caused by incarcerated inguino-scrotal hernia in
      a newborn].
AB  - Presentation of an uncommon case referring necrosis of an ectopic inguino-femoral
      testis caused by an incarcerated inguino-scrotal hernia in a 15-days old baby
      with a permeable peritoneum-vaginal process. In this case, the hernial
      incarceration episode was responsible for the organ necrosis due to an
      haemorrhagic infarction. Orchiectomy was performed, and the pathoanatomical
      diagnosis was testicular haemorrhagic infarction. Review of the pathogenic
      mechanisms of testicular ectopia, associated anomalies and likely acute
      complications: torsion, hernial strangulation, traumatism and infections
      simulating acute abdomen which, in spite of their rarity, may have serious
      consequences with regard to testicular viability.

PMID- 7771243
TI  - [Small cell undifferentiated carcinoma of the urinary bladder: report of a case].
AB  - Small cell carcinoma of the urinary bladder is an uncommon tumor. We report a
      case in a 80 year-old man. The patient had gross hematuria. Urographic and
      echographic studies revealed a sold tumor on the right wall of bladder.
      Pathologic study revealed a deeply invasive tumor composed of small, uniform,
      round and spindled shaped cells with hyperchromatic nuclei and numerous mitosis.
      The immunohistochemical reaction was positive for Neuron Especific Enolase and
      Keratin. No metastasis were found at clinical stating (T2 No Mo). We discuss the
      differencial diagnosis, prognosis and histogenesis of this tumor.

PMID- 7771244
TI  - [Scrotal verrucous carcinoma].
AB  - Cancer of scrotum is of interest, despite its relative infrequency, because of
      its historical importance (was the first known occupational cancer) and also of
      its aggressive behavior. We report a rare case of verrucous carcinoma in a 67
      years old man, without recrudescence six months after surgical treatment.

PMID- 7771245
TI  - [The calvary of biomedical literature].

PMID- 7771246
TI  - Lipid peroxides and related radicals in clinical medicine.

PMID- 7771248
TI  - Tissue iron overload and mechanisms of iron-catalyzed oxidative injury.
AB  - Tissue iron overload causes clinical syndromes that involve the heart, liver, and
      pancreas. While tissue iron uptake occurs by both transferrin-dependent and
      independent processes, tissue uptake in the iron overload syndromes occurs
      predominantly via transferrin-independent mechanisms. Increased redox-active iron
      present in hemeproteins and the cytosolic iron pool can catalyze oxidative damage
      to lipids, proteins, and nucleic acids, either by oxyradical dependent or
      independent mechanisms. Iron-catalyzed injury results in damage to cell
      constituents, including mitochondria, lysosomes, and the sarcolemmal membrane.
      These mechanisms of iron-mediated damage are involved in the pathogenesis of
      organ dysfunction in primary hemochromatosis, transfusion-related iron overload,
      ischemia-reperfusion injury, and cardiac anthracycline toxicity.

PMID- 7771247
TI  - Mechanisms of atherosclerosis: role of LDL oxidation.

PMID- 7771249
TI  - Free radicals in the pathophysiology of pulmonary injury and disease.

PMID- 7771250
TI  - Lipid peroxides in hepatic, gastrointestinal, and pancreatic diseases.

PMID- 7771251
TI  - Reactive oxygen species in normal physiology, cell injury and phagocytosis.
AB  - Formation of free radicals and other ROS is a continuous aspect of life. Examples
      include the free radical intermediates which are formed by the nonenzymatic
      peroxidation of polyunsaturated fatty acids of membrane lipids in a destructive
      process and which are also formed by the enzymatic peroxidation of arachidonic
      acid in the biosynthesis of potent chemoattractants. Organisms cope with these
      reactive species by a variety of strategies that limit formation of ROS or remove
      cytotoxic products. Oxidative burst reactions that yield ROS provide an
      effective, vital process for killing invading organisms. Research on why ROS
      formation is impaired in phagocytic cells of people with chronic granulomatous
      disease has provided new insights into the complexity of the factors that prevent
      inadvertent activation of this destructive force.

PMID- 7771252
TI  - Reactive oxygen molecules in the kidney.

PMID- 7771253
TI  - Reactive oxygen species (ROS) and reproduction.

PMID- 7771255
TI  - Antioxidants and cancer: molecular mechanisms.

PMID- 7771254
TI  - Autoimmune and inflammatory diseases.

PMID- 7771256
TI  - New directions for free radical cancer research and medical applications.
AB  - The nitroxides are stable, low molecular weight free radical compounds which are
      freely membrane permeable. These properties make the nitroxides valuable for the
      study of and possible protection against oxidative stresses. It is becoming
      increasingly clear that oxidative stress is important to the pathogenesis of
      cancer as well as to the development of treatments for cancer. Several nitroxides
      have been shown to interrupt the toxicity of oxidative stress with the protection
      against H2O2 toxicity and possibly ischemia/reperfusion injury being of primary
      importance. With respect to radiation, the nitroxides have afforded both in vitro
      and in vivo protection. The redox activity of the nitroxides may allow for the
      differential activity of these agents in normal versus tumor tissues. Further
      study of these compounds may yield a nitroxide with clinical applications as well
      as provide insight into the mechanisms of radiation cytotoxicity. Finally, the
      nitroxides have allowed us to explore the mechanisms of action of several
      chemotherapeutic agents. Understanding these processes is important to the
      process of ameliorating the toxicity of therapies and to the rationale design of
      future agents.

PMID- 7771257
TI  - Shock and multiple organ failure.

PMID- 7771258
TI  - Role of nutrients in the cause and prevention of oxygen radical pathology.

PMID- 7771259
TI  - Free radical mechanisms for chromosomal instability in Bloom's syndrome.

PMID- 7771260
TI  - Involvement of free radical mechanism in the toxic effects of alcohol:
      implications for fetal alcohol syndrome.

PMID- 7771261
TI  - 21-Aminosteroids ("lazaroids").

PMID- 7771263
TI  - Interactions between vitamin E, free radicals, and immunity during the aging
      process.

PMID- 7771262
TI  - The potential of gliclazide, a sulphonylurea to influence the oxidative processes
      within the pathogenesis of diabetic vascular disease.
AB  - The clinical studies have demonstrated that patients showed significant
      improvements in their oxidative status after 3 months treatment. This improvement
      in oxidative status which was associated with a reduction in platelet reactivity,
      remained constant for the rest of the study period. The effect was independent of
      glycaemic control. The demonstration of a benefit to clinical vascular disease
      has proved difficult to achieve in all studies of non-insulin dependent diabetes.
      This is due to the multifactorial nature of complications and the long duration
      of disease required before microvascular complications such as retinopathy became
      apparent. The Japanese Diabetic Retinopathy Program24 studied the progression of
      retinopathy over a 5 year period comparing Gliclazide with other sulphonylureas
      and with placebo. The study suggested that with equivalent metabolic control
      there was a trend towards a lower rate of deterioration of retinopathy and a
      significantly lower incidence of pre-proliferative retinopathy in the group
      receiving Gliclazide compared with patients receiving other sulphonylureas or
      placebo. There is little comparative evidence on the effect of specific
      sulphonylureas on large vessel disease. Although improvement in parameters of
      hyperglycaemia is associated with an improvement in morbidity from large vessel
      disease. In Type II diabetes atherosclerosis coexists in the majority of patients
      and often predates the clinical diagnosis of diabetes. The presence of
      atherosclerosis which often determines the ultimate fate of the patient, further
      increases the level of lipid peroxidation of oxidative stress, amplifying the
      effects of hyperglycaemia and potentiating vascular damage. In diabetes,
      therefore where increased glycation and oxidation are fundamental in the
      pathogenesis of diabetic vascular disease agents such as Gliclazide with anti
      oxidant activities may have an enhanced therapeutic role.

PMID- 7771264
TI  - Vitamins and carotenoids--a promising approach to reducing the risk of coronary
      heart disease, cancer and eye diseases.

PMID- 7771265
TI  - Free radical scavenging and antioxidant activity of plant flavonoids.

PMID- 7771266
TI  - Plasma clearance and immunologic properties of long-acting superoxide dismutase
      prepared using 35,000 to 120,000 dalton poly-ethylene glycol.
AB  - Some biological properties of bovine and recombinant human Cu,Zn superoxide
      dismutase (bSOD and rhSOD)-poly-ethylene glycol (PEG) adducts prepared by
      coupling 1-9 strands of high molecular weight PEG (35,000-120,000 daltons) are
      compared to SOD adducts coupled with 7 or 15 strands of low molecular weight PEG
      (5,000 daltons). Plasma clearance after i.v. injection was measured in mice and
      dogs. Conjugates of bSOD with 2 strands of PEG 40,000, 3 strands of PEG 72,000 or
      1 strand of PEG 100,000 demonstrated half-lives of about 36 hours in mice,
      whereas the half-life of a conjugate with 7 strands of PEG 5,000 was about 24
      hours. A PEG-bSOD with an average of 3.3 strands of PEG 41,000 was cleared from
      plasma with a terminal half-life of 36 to 48 hours after intraperitoneal
      injection in mice. PEG-SODs prepared from bSOD and rhSOD with 3 strands of PEG
      50,000 each had plasma half-lives of approximately five days in dogs. An enzyme
      immunoassay (ELISA) was employed to measure cross-reactivity with a rabbit
      antibody directed against bSOD. A series of bSOD adducts with 2 to 9 strands of
      PEG 35,000-120,000 were compared to PEG-bSODs with 7 or 15 strands of PEG 5,000.
      Attaching larger PEG strands was at least 3 times more effective in reducing
      antigenicity, compared to PEG 5,000. Ability to induce sensitizing antibodies was
      measured using subcutaneous sensitization followed by i.v. or s.c. challenge in
      mice. Some bSOD conjugates with either 7 or 15 strands of PEG 5,000 induced
      sensitization reactions before the sixth challenge. Fewer than 1% of the animals
      tested with bSOD or rhSOD adducts with 3 or 4 strands of PEG 65,000, or 3 strands
      of PEG in the 30,000-50,000 molecular weight range, showed signs of anaphylaxis
      during six or seven challenges. In a passive cutaneous anaphylaxis test
      (optimized to measure mouse IgE), neither bSOD coupled to 2 strands of PEG
      120,000 nor bSOD coupled to 9 strands of PEG 35,000 induced detectable antibodies
      against either of these PEG-bSOD preparations or against bSOD; however, the
      adduct with 2 strands of PEG 120,000 reacted weakly with pre-formed antibodies to
      bSOD. The high molecular weight PEG-bSODs tested were not immunogenic, but were
      weakly antigenic, compared to bSOD.

PMID- 7771267
TI  - Clinical trials with Dismutec (pegorgotein; polyethylene glycol-conjugated
      superoxide dismutase; PEG-SOD) in the treatment of severe closed head injury.

PMID- 7771268
TI  - A new method for detecting lipid peroxidation by using dye sensitized
      chemiluminescence.

PMID- 7771269
TI  - Chemiluminescence and the challenge to attomole detection.

PMID- 7771270
TI  - Evidence against malondialdehyde bound to cellular constituents in phospholipid
      peroxidation.

PMID- 7771271
TI  - Evaluation of in vivo free radical activity during endotoxic shock using
      scavengers, electron microscopy, spin traps, and electron paramagnetic resonance
      spectroscopy.

PMID- 7771272
TI  - Involvement of hydroxyl radicals in endotoxin-evoked shock.

PMID- 7771273
TI  - The role of nitric oxide in endotoxin-elicited hypodynamic circulatory failure.

PMID- 7771275
TI  - Photosensitized formation of 8-hydroxy-2'-deoxyguanosine by a cationic meso
      substituted porphyrin.

PMID- 7771274
TI  - In vivo evaluation of the role of neutrophil-derived free radicals in the
      development of endotoxic shock.

PMID- 7771276
TI  - Aging associated declines in the antioxidant enzymes of human testis.

PMID- 7771277
TI  - Lipid peroxidation in normal pregnancy and preeclampsia.

PMID- 7771278
TI  - Cytochrome biochemistry in sheep retina following exposure to oxygen.

PMID- 7771279
TI  - Cytochrome oxidase activity in the fetal sheep retina.

PMID- 7771280
TI  - Age-related phospholipid hydroperoxide levels in gerbil brain measured by HPLC
      chemiluminescence assay and their relation to hydroxyl radical stress--clinical
      implications.

PMID- 7771281
TI  - The analysis of free radicals, lipid peroxides, antioxidant enzymes and compounds
      related to oxidative stress as applied to the clinical chemistry laboratory.

PMID- 7771282
TI  - Lipid peroxidation and diabetic complications: effect of antioxidant vitamins C
      and E.

PMID- 7771283
TI  - Vascular complications of patients in Kuwait with type 2 diabetes mellitus
      (NIDDM) and elevated serum lipid peroxides.

PMID- 7771284
TI  - Vascular and cellular protein changes precede hippocampal pyramidal cell loss
      following global ischemia in the rat.

PMID- 7771285
TI  - Dietary antioxidants and breast cancer risk: effect modification by family
      history.

PMID- 7771286
TI  - Effect of MAK-4 and MAK-5 on endothelial cell and soyabean lipoxygenase-induced
      LDL oxidation.

PMID- 7771287
TI  - Prevention of oxidant stress by Student Rasayana (SR).

PMID- 7771289
TI  - In vitro ergothioneine administration failed to protect isolated ischaemic and
      reperfused rabbit heart.

PMID- 7771288
TI  - Biochemical changes induced by Maharishi Amrit Kalash (MAK-4) and MA-208 in diet
      induced hypercholesterolemic rabbits.

PMID- 7771291
TI  - Free radicals and the pathogenesis of neuronal death: cooperative role of
      excitatory amino acids.

PMID- 7771290
TI  - Pentoxifylline interferes with potential sources of free radical generation
      during endotoxemia.

PMID- 7771292
TI  - Free radicals and ocular disease.
AB  - Ames, Shigenaga, and Hagen recently published a thorough review of the
      relationship between oxidants, antioxidants, and degenerative diseases of ageing.
      They point out that only 9% of Americans daily consume the two fruits and three
      vegetables recommended by the National Cancer Institute and the National Research
      Council/National Academy of Science. In addition to antioxidants, these
      foodstuffs contain many essential micronutrients. To date, specific
      recommendations for antioxidant supplementation have not been made by any
      governmental agency or professional association. A number of clinical, basic, and
      epidemiological studies have implicated free radical induced lipid peroxidation
      in various ocular disorders. It would seem prudent that those persons at greatest
      risk for these disorders take some precautions, which could include sunglasses
      that filter ultraviolet light; hats that shield the eyes from direct sunlight;
      and the ingestion of fruits, vegetables, and antioxidants.

PMID- 7771293
TI  - Active oxygen mechanisms of UV inflammation.
AB  - Active oxygen radicals are important in the pathogenesis of UV irradiation
      injury. The initiating mechanisms involve the generation of hydroxyl radicals,
      superoxide, and organic hydroperoxides due to photochemical reactions. These
      active oxygen species lead to DNA strand breakage, mutation and the generation of
      inflammatory mediators such as cytokines and arachidonic acid metabolites which
      amplify the irradiation-induced inflammation. Several compounds have recently
      been utilized to successfully decrease these effects. Improved understanding of
      the mechanisms by which active oxygen species induce injury in skin now promises
      improved treatment.

PMID- 7771295
TI  - The development of the frontal lobe. A view from the rear of the brain.

PMID- 7771294
TI  - Oxygen-free radicals at myocardial level: effects of ischaemia and reperfusion.

PMID- 7771296
TI  - The clinical signs and symptoms of frontal lobe seizures. Phenomenology and
      classification.

PMID- 7771297
TI  - Frontal lobe epilepsy. Some clinical characteristics.

PMID- 7771299
TI  - Preoperative digital electroencephalography in frontal lobe epilepsy.

PMID- 7771298
TI  - Repetitive motor activity in frontal lobe epilepsy.

PMID- 7771300
TI  - High-resolution electroencephalographic studies of cognition.

PMID- 7771301
TI  - Magnetic resonance imaging in frontal lobe epilepsy.

PMID- 7771302
TI  - Role of human prefrontal cortex in attention control.
AB  - Without a functioning dorsolateral prefrontal cortex, humans are stimulus bound
      and have little confidence in their ability to interact with the environment.
      Deficits in inhibitory control of external and internal processes coupled with
      impaired temporal coding of stimuli and detection capacity for novel events leave
      the patient functioning in a noisy internal environment without critical
      spatiotemporal cues. Some of these proposals are similar to those of Nauta (104).
      Based on connectivity of the prefrontal cortex, Nauta suggested that this region
      was ideally suited to generate and evaluate internal models of action. It is
      proposed that, in addition to this generation function, the prefrontal cortex is
      crucial for detecting changes in the external environment and for discriminating
      internally and externally derived models of the world. This chapter has described
      a cascade of deficits that result from damage to the dorsolateral prefrontal
      cortex. Awareness of the sensory world, and of the apparent stream of internal
      and external events, is impaired by deficits in novelty detection. Changes in the
      world, internal or external, may not be noticed in a noisy internal milieu. These
      deficits contribute to impaired reality monitoring and to a subsequent lack of
      confidence in behavior. An inability to bridge temporal gaps and temporally
      sequence internal events, together with deficits in inhibitory control systems,
      contribute to an impairment in the ability to generate coherent representations
      of alternate or counterfactual realities.

PMID- 7771303
TI  - Presurgical evaluation in frontal lobe epilepsy. A multimethodological approach.

PMID- 7771305
TI  - Intracranial electroencephalographic investigation in frontal lobe epilepsy.

PMID- 7771304
TI  - Positron emission tomography in frontal lobe epilepsy.

PMID- 7771306
TI  - Human supplementary sensorimotor area. Electrical stimulation and movement
      related potential studies.

PMID- 7771308
TI  - Frontal lobe epilepsy. Compartmentalization, presurgical evaluation, and
      operative results.

PMID- 7771307
TI  - Video-stereo-electroencephalographic investigation of orbitofrontal cortex. Ictal
      electroclinical patterns.

PMID- 7771309
TI  - Surgery of frontal lobe epilepsy.

PMID- 7771310
TI  - Frontal degenerative dementia and neuroimaging.

PMID- 7771312
TI  - Aspects of human frontal lobe function.

PMID- 7771313
TI  - Lateralization in the frontal lobes.

PMID- 7771311
TI  - Anatomical and functional circuits in prefrontal cortex of nonhuman primates.
      Relevance to epilepsy.

PMID- 7771314
TI  - Memory and planning. Two temporal perspectives of frontal lobe function.

PMID- 7771316
TI  - Protein destabilization at low temperatures.

PMID- 7771315
TI  - A historical perspective. The rise and fall of prefrontal lobotomy.

PMID- 7771317
TI  - Stability of alpha-helices.

PMID- 7771318
TI  - Engineering the stability and function of gene V protein.

PMID- 7771319
TI  - Staphylococcal nuclease: a showcase of m-value effects.

PMID- 7771321
TI  - Free energy balance in protein folding.

PMID- 7771320
TI  - Studies on protein stability with T4 lysozyme.
AB  - A series of mutants of phage T4 lysozyme have been constructed and have permitted
      a systematic analysis of different aspects of protein stability and folding. One
      striking result has been the ability of the protein to accommodate changes at
      many sites, yet still fold and retain activity. This shows that many amino acids
      in the sequence of the protein are nonessential for protein folding and
      stability. Such amino acids appear, predominantly, to be those that are mobile
      and/or largely exposed to solvent. Even though buried residues seem to be more
      important, it is still possible to change these as well. In some cases individual
      amino acids have been replaced. In other cases it has been found that a
      combination of substitutions permits repacking of the core. Such repacking is
      associated with adjustments of both the main chain and side chains. Only rarely
      do side chains rotate into radically new orientations. Taken together,
      substitutions of core residues confirm the overall importance of the hydrophobic
      effect as the dominant factor in stabilizing the folded structures of proteins.
      "Cavity-creating" substitutions of the form Leu-->Ala show, as expected, that the
      burial of the bulky leucine side chain within the core of the protein confers
      greater hydrophobic stabilization than is the case for the smaller alanine side
      chain. Leu-->Ala substitutions that create large cavities are especially
      destabilizing because they result in a loss of both hydrophobic and van der Waals
      interactions. In cases where the protein relaxes to reduce the size of the
      putative cavity, alternative van der Waals interactions are generated and the
      overall destabilization of the protein may be less severe than in cases where a
      large cavity is formed.

PMID- 7771322
TI  - Structure and stability of membrane proteins.

PMID- 7771323
TI  - Modeling protein stability as heteropolymer collapse.

PMID- 7771324
TI  - Studies on denaturation of proteins. XIII. A theory of denaturation. 1931.

PMID- 7771325
TI  - Leukotrienes as Mediators of Asthma and Inflammation: Basic and Applied Research.
      Proceedings of an international workshop. Interlaken, Switzerland, September 7
      12, 1992.

PMID- 7771326
TI  - Prostaglandin E2 regulation of the immune response.

PMID- 7771327
TI  - 5-Lipoxygenase inhibitors in the treatment of inflammatory bowel disease.

PMID- 7771329
TI  - The interaction among granulocyte lipid mediators and the generation of oxygen
      radicals in antigen-induced airway hyperresponsiveness.

PMID- 7771328
TI  - 5-Lipoxygenase activating protein and leukotriene C4 synthase: therapeutic
      targets for inhibiting the leukotriene cascade.

PMID- 7771330
TI  - Clinical and experimental studies of leukotrienes as mediators of airway
      obstruction in humans.

PMID- 7771331
TI  - Release of urinary leukotriene E4 in asthmatic subjects: a review.

PMID- 7771332
TI  - Aspirin-induced asthma: an update and novel findings.

PMID- 7771333
TI  - Summary: leukotrienes as mediators of asthma in humans but not always in
      experimental animals.

PMID- 7771334
TI  - Bronchial provocation with leukotrienes and other stimuli.

PMID- 7771335
TI  - Influence of leukotriene antagonists on baseline pulmonary function and asthmatic
      responses.

PMID- 7771336
TI  - Evidence for a specific role of leukotriene E4 in asthma and airway
      hyperresponsiveness.

PMID- 7771337
TI  - Mode of action of the leukotriene synthesis (FLAP) inhibitor BAY X1005.
      Implications for biological regulation of 5-lipoxygenase.

PMID- 7771338
TI  - Eosinophil eicosanoid relations in allergic inflammation of the airways.
AB  - Eosinophils are prominent features of allergic inflammation and can contribute to
      this process through release of inflammatory enzymes, granule-associated
      proteins, and leukotriene products. There is considerable interest in the fact
      that selected cytokines enhance eosinophil generation of leukotrienes. Therefore,
      future directions must include efforts to identify factors that regulate
      eosinophil synthesis of leukotrienes and therapeutic agents that might control
      these specific inflammatory responses.

PMID- 7771339
TI  - Role of cysteinyl leukotrienes in spontaneous asthmatic responses.

PMID- 7771340
TI  - Summary: the pharmacology of leukotrienes in asthma.

PMID- 7771341
TI  - The mediators of the early and late phases of allergic rhinitis.

PMID- 7771342
TI  - Leukotrienes as mediators of nasal inflammation.
AB  - The three sets of studies that we have described support the notion that
      leukotrienes play a role in the nasal inflammatory response to allergen
      challenge. Strong inhibition of both leukotrienes and symptoms by A-64077, a
      trend toward inhibition of both leukotrienes and symptoms by SC-45662, and a lack
      of effect on either leukotrienes or symptoms by dietary eicosapentaenoic acid
      provide a consistent association between alterations of leukotrienes and nasal
      symptoms. A great deal of evidence has now accumulated that leukotrienes are
      important mediators of inflammation in vivo, but we also know that the chronic
      stimulus of hay fever produces a much more complex picture than seen in an acute
      challenge model and that many other mediators such as kinins, other peptides,
      histamine, and eicosanoids produced outside the 5-lipoxygenase pathway are
      involved (34,35). Further clinical research will be needed to develop optimal
      dosing regimens and delivery systems to achieve high concentrations of potent and
      safe 5-lipoxygenase inhibitors at sites that are critical for producing
      clinically useful results by modulation of the 5-lipoxygenase pathway.

PMID- 7771343
TI  - Basic mechanisms in rheumatoid arthritis: the role of T lymphocytes in rheumatoid
      synovitis.
AB  - Undoubtedly, synovitis is a cell-mediated process involving various cell types,
      such as T cells, B cells, APC, monocytes/macrophages, synoviocytes, chondrocytes,
      and cytokines. Therefore, it is difficult to clarify the cell type that plays the
      central role in the inflammatory process. Despite this difficulty, there is
      strong evidence that T cells mediate the disease in collaboration with APC that
      bear specific antigenic peptides. The mediators released could perpetuate an
      ongoing inflammatory process in the joints irrespective of the nature of the
      initiating agents. Therefore, many approaches to a more specific immunotherapy
      for RA have been developed, directed toward the modulation of T cell function.
      Thus far, various forms of chemical and biologic treatment have been used, such
      as cyclosporin A and monoclonal antibodies directed against T-cell epitopes and
      IL-2 receptor, with some beneficial effects on the course of RA. The development
      of a more specific immunotherapy using reagents directed against the T-cell
      receptor and vaccination with specific T cells await further studies, since we
      still do not know the inciting antigen(s) in RA. Nevertheless, we are hopeful
      that the ongoing search for the still unknown antigen(s) will be successful, thus
      providing new and better treatment regimens for a still uncurable disease.

PMID- 7771344
TI  - Novel structural and functional properties of leukotriene A4 hydrolase.
      Implications for the development of enzyme inhibitors.
AB  - Recent work in our laboratory, some of which is described in this report, has
      established that LTA4 hydrolase is a bifunctional metalloenzyme that contains one
      zinc atom, essential for both catalytic activities. The well-characterized
      epoxide hydrolase activity, i.e., the conversion of LTA4 into LTB4 is inhibited
      by exposure to LTA4, and this irreversible enzyme inactivation also affects the
      peptidase activity. In contrast, the peptide hydrolysis proceeds without any
      signs of enzyme inactivation, can be stimulated by physiologic concentrations of
      chloride ions, and is critically dependent on the presence of a Glu residue in
      position 296 of the protein. A model of the active center, which summarizes these
      novel structural and functional properties of LTA4 hydrolase, is presented in
      Fig. 6.

PMID- 7771346
TI  - Regulation of leukotriene production by cytokines.

PMID- 7771345
TI  - Lipoxin recognition sites of human neutrophils.

PMID- 7771347
TI  - Inhibition of leukotriene production by inhibitors of lipoxygenation.

PMID- 7771348
TI  - Current approaches to estimation of eicosanoid formation in vivo.

PMID- 7771349
TI  - Leukotriene receptors and their selective antagonists.

PMID- 7771350
TI  - Summary: the enzymes, accessory proteins, and receptors of leukotriene metabolism
      and their inhibition and antagonism.

PMID- 7771351
TI  - Cytokine regulation of mouse mast-cell-specific protease genes.

PMID- 7771352
TI  - Transport and metabolism of leukotrienes.

PMID- 7771353
TI  - Microvascular mechanisms in inflammation.

PMID- 7771354
TI  - [The use of T650 in bony filling: experimental and clinical results].

PMID- 7771355
TI  - [Relationship between endocrinology and craniofacial growth. I: Puberty and
      craniofacial growth. II: Growth of the craniofacial skeleton].
AB  - In this literature, a review is given of the endocrinology and morphology of the
      craniofacial complex. This article reviews in a first part the endocrinology of
      puberty and general growth aspects. Afterwards the adolescence growth spurt of
      the face and the hormonal regulation will be focused. In a second part the
      morphogenetic aspects together with growth area's and growth theories of the
      craniofacial complex will be discussed. At last a detailed description of the
      maxillary and mandibular growth is given.

PMID- 7771356
TI  - It's not business as usual anymore!

PMID- 7771357
TI  - The primrose path.

PMID- 7771359
TI  - Comment on superimposition techniques.

PMID- 7771360
TI  - More comments on superimposition techniques.

PMID- 7771358
TI  - Cost, risk, regulation, fees.

PMID- 7771361
TI  - Condylar movement and mandibular rotation during jaw opening.
AB  - Inaccurate description of mandibular rotation can have profound effects on
      orthognathic surgical treatment planning and surgical outcome, as well as affect
      the precision of appliances fabricated on articulators. Disagreement exists
      concerning movements of the condyle during jaw opening. Although mandibular
      function is often described as rotation around an instantaneous center located
      outside of the condyle, many believe that jaw opening occurs around an axis of
      rotation that remains fixed at the center of the condylar head. In this study,
      condylar movements and centers of mandibular rotation during jaw opening were
      examined in normal subjects with the Dolphin Sonic Digitizing System. All of the
      subjects demonstrated both translation and rotation of the condyle during
      initiation of jaw opening, and none had a center of mandibular rotation located
      at the condylar head. The findings support the theory of a constantly moving,
      instantaneous center of jaw rotation during opening that is different in every
      person. There were also differences in movement within the subjects between
      experimental trials. The uncertainty of predicting mandibular rotation for a
      given patient should be considered when planning surgical treatment and
      fabricating orthodontic appliances.

PMID- 7771362
TI  - The effects of samarium-cobalt magnets and pulsed electromagnetic fields on tooth
      movement.
AB  - The purpose of this study was to determine whether the application of either
      samarium cobalt magnets or pulsed electromagnetic fields could increase the rate
      and amount of orthodontic tooth movement observed in guinea pigs. In addition,
      the objective was to evaluate the effect of a magnetic field on bony physiology
      and metabolism and to monitor for possible systemic side effects. Fifteen grams
      of laterally directed orthodontic force were applied to move the maxillary
      central incisors of a sample of 18 young male Hartley guinea pigs divided into
      three groups: group 1, an orthodontic coil spring was used to move the incisors;
      group 2, a pair of samarium-cobalt magnets provided the tooth moving force; and
      group 3, a coil spring was used in combination with a pulsed electromagnetic
      field. The results showed that both the static magnetic field produced by the
      samarium-cobalt magnets and the pulsed electromagnetic field used in combination
      with the coil spring were successful in increasing the rate of tooth movement
      over that produced by the coil springs alone. The mechanism producing this effect
      appears to have involved a reduction in the "lag" phase often seen in orthodontic
      tooth movement. Both magnetically stimulated groups also showed increases in both
      the organization and amount of new bone deposited in the area of tension between
      the orthodontically moved maxillary incisors.

PMID- 7771363
TI  - Cephalometric and computed tomographic predictors of obstructive sleep apnea
      severity.
AB  - The interaction between craniofacial structure assessed by lateral cephalometry,
      and tongue, soft palate, and upper airway size determined from computed
      tomography (CT) scans was examined in 25 control subjects and 80 patients with
      obstructive sleep apnea (OSA). On the basis of the cephalometric analyses, the
      patients with OSA had retruded mandibles with larger ANB angle differences,
      elongated maxillary and mandibular incisors and mandibular molars, and high total
      upper and lower face heights The computed tomographic evaluations revealed that
      patients with OSA also had larger tongue, soft palate, and upper airway volumes.
      Men with OSA and skeletal Class I malocclusions had significantly larger soft
      palates than comparable controls. Both tongue and soft palate volumes were
      positively correlated with body mass index. A principal component analysis
      reduced the database, and one significant correlation was identified. Subjects
      with high total, upper and lower face heights, elongated maxillary and mandibular
      teeth, and proclined lower incisors were observed to have large tongue, soft
      palate, and upper airway volumes, to have a higher apnea index and to be obese.
      Linear regression analysis indicated that a high apnea index was seen in
      association with large tongue and soft palate volumes, a retrognathic mandible,
      an anteroposterior discrepancy between the maxilla and mandible, an open bite
      tendency between the incisors, and obesity.

PMID- 7771364
TI  - Retention capacity of the bracket bases of new esthetic orthodontic brackets.
AB  - Tensile bond strength and bond failure locations were evaluated in vitro for
      three types of direct bonding cements (self-cured diacrylate, dual-cured
      diacrylate, and dual-cured glass ionomer) with four types of brackets (stainless
      steel, polycarbonate, ceramic, and ceramic-polycarbonate) by using a plastic
      cylinder as the substrate. A highly filled, self-cured diacrylate cement gave the
      highest bond strength values with the polycarbonate, stainless steel, and ceramic
      polycarbonate brackets. A dual-cured diacrylate cement gave the highest bond
      strength with a mechanically retained ceramic bracket. The dual-cured glass
      ionomer cement gave the highest bond strength values with a silanated ceramic
      bracket. All bond failures occurred at the bracket/cement interface with the
      stainless steel bracket, whereas failure locations were at the bracket/cement
      interface and within the cement with the polycarbonate bracket. Bond failures
      occurred between bracket and cement, within the cement, and within the bracket
      with the ceramic brackets.

PMID- 7771365
TI  - X-ray diffraction of nitinol orthodontic arch wires.
AB  - Superelastic mechanical behavior of nitinol alloy orthodontic wires is thought to
      be the result of a stress induced crystallographic transformation from austenite
      to martensite. The purpose of the study was to compare the SE mechanical behavior
      of nitinol wires to stress-induced phase changes. Eight nitinol arch wires having
      rectangular cross-sections were strained from 0% to 10% in tension with a
      mechanical testing machine. Load/extension plots were subjectively ranked for SE
      behavior. X-ray diffraction patterns were collected with and without 6% strain.
      Without strain, nitinol wires were found to be predominantly austenite with some
      wires containing a small amount of martensite. When strained 6%, superelastic
      wires demonstrated a phase transformation from austenite to martensite. XRD
      patterns were ranked for percent transformation and 110 peak width. Product
      rankings of the degree of superelasticity were positively correlated with the
      rank of martensitic transformation (p < 0.05). Superelasticity ranks were
      negatively correlated with XRD peak width ranks (p < 0.01). Increased peak width
      indicates greater cold work. A range of superelastic mechanical behavior and
      martensitic transformation is exhibited by wires currently on the market. Cold
      work and heat treatments are important variables to be controlled during the
      manufacture of nitinol products.

PMID- 7771366
TI  - Late lower arch crowding: the role of the transverse dimension.
AB  - Fifty subjects who were followed longitudinally between 13 and 18 years showed an
      average increase in lower arch crowding of 2.36 mm. This increase in crowding was
      examined in relation to tooth width, arch width and jaw width, actual and
      relative, and to changes in these dimensions with correlation and multiple
      regression analyses. No relationship was found between width dimensions and late
      crowding in the lower arch.

PMID- 7771367
TI  - Biomechanics of orthodontic correction of dental asymmetries.
AB  - Correction of dental asymmetries requires special attention in orthodontic
      treatment. Several types of asymmetries are described, along with the
      biomechanics needed for correction. Treatment with different appliance designs
      that correct these asymmetries with the lowest level of negative contribution
      from side effects will be compared with conventional treatment.

PMID- 7771368
TI  - The effect of mechanical deformation on the distribution of ions in fibroblasts.
AB  - The extracellular and intracellular sodium, potassium and chloride concentrations
      were determined in fibroblast cells located in the rat calvarium. The ionic
      values were determined by fluorescence microscopy after incubation with the
      fluorescent probes, sodium-binding benzofuran isophthalate (SBFI), potassium
      binding benzofuran isophthalate (PBFI) and 6-methoxy-N-(3-sulfopropyl)
      quinolinium (SPQ) (Dyes were supplied by CALBIOCHEM, Nottingham, England). After
      determination of the resting membrane potential, the calvaria were placed under
      tension by retraction of a micromanipulator. The fluorescence was measured again.
      A statistically significant difference was found in the calculated potassium ion
      concentration (Mann-Whitney; p < 0.05). This affected the resting cell membrane
      potential by an average of 5.2 mV. This effect was blocked by the addition of a
      potassium channel blocker, tetraethylammonium (TEA).

PMID- 7771369
TI  - A computer assisted photogrammetric analysis of soft tissue changes after
      orthodontic treatment. Part I: Methodology and reliability.
AB  - The purpose of this study was to use standardized facial photographs to compare
      the soft tissue profile changes in persons with Class II, Division 1
      malocclusions who were treated with either an extraction or a nonextraction
      treatment modality. Ninety-one patients (44 extraction and 47 nonextraction) were
      evaluated with standardized facial photographs, available at pretreatment,
      posttreatment, and 2 years in retention. The photographs were digitized and
      displayed on a computer monitor. Thirty-eight landmarks (18 frontal and 20
      lateral) were located. From these landmarks, 29 angular and linear dimensions (8
      frontal and 21 lateral) were constructed. Descriptive and analytical statistics
      were used to compare the absolute dimensions, as well as the incremental changes,
      between the extraction and nonextraction groups. The present findings indicate
      that (1) Photographs allow for measurement of structures from a profile, as well
      as frontal orientations. (2) Measurement of profile changes from facial
      photographs appear to be fairly reliable but also have significant limitations.
      (3) Certain landmarks tended to be less reliable than others, e.g., subnasale and
      gnathion. In general, measurements from frontal photographs were more reliable
      than those obtained from lateral photographs and linear measurements were more
      reliable than angular measurements. (4) Changes in head posture within the
      cephalostat have an impact on vertical facial dimensions measured from frontal
      photographs. Horizontal dimensions were effected to a lesser degree. (5) Facial
      structures that lie closer to the camera appeared to be relatively larger than
      structures located farther from the camera. (6) The overall process of evaluating
      facial changes from photographs is both technique and operator sensitive. (7)
      More research specifically testing the photogrammetric method in a clinical
      setting is needed.

PMID- 7771370
TI  - The reproducibility and repeatability of the Wits analysis.
AB  - Since the introduction of the Wits analysis, the validity of the method has been
      questioned, as the functional occlusal plane in particular has been cited as a
      major source of error. This may be either subjectively placed or defined by
      existing cephalometric methods. A study is therefore reported of the
      repeatability (intraobserver comparison) and reproducibility (interobserver
      comparison) of the Wits assessment on the basis of a double series of tracings by
      each of two observers. No statistically significant difference was found for the
      repeatability of distance AO-BO by either observer, but interobserver
      repeatability was less satisfactory, and the mean values varied by approximately
      75%. It was also found that the highest single error between two series of
      tracings was 3.1 mm (observer A) and 5.8 mm (observer B).

PMID- 7771373
TI  - Editorial: In which orthodontics discovers a defender. 1973.

PMID- 7771372
TI  - Adult versus adolescent Class II correction: a comparison.
AB  - The interest of the adult patient in orthodontics has increased as the
      demographics of the specialty of orthodontics has changed. There are major
      intreatment and posttreatment differences in Class II malocclusion correction
      between the adolescent and the adult. This article outlines the differences--and
      the similarities--between adolescent and adult Class II malocclusion correction.
      The differences and similarities are illustrated with case reports of a
      representative adolescent from the adolescent group and a representative adult
      from the adult group.

PMID- 7771371
TI  - Odontogenic adenomatoid tumors associated with orthodontic treatment.
AB  - Because of a predilection for occurrence in the anterior jaw in association with
      an unerupted tooth, the odontogenic adenomatoid tumor (OAT) will sometimes be
      discovered in the context of an orthodontic procedure to promote and guide
      eruption of the tooth. Two cases illustrate this situation. Some other lesions
      that might have a clinical presentation similar to the OAT are named.

PMID- 7771374
TI  - Medical examiners' attitudes toward organ procurement from child abuse/homicide
      victims.
AB  - Solid organ transplant provides lifesaving therapy for infants and children with
      otherwise terminal diseases, but it is severely limited by donor organ supply.
      Medical examiners perform a pivotal role in the organ procurement process by
      determining whether a "heartbeating cadaver" on life support is a medicolegally
      suitable donor. This descriptive questionnaire study assesses medical examiner
      practice and behavior regarding organ procurement from child abuse/homicide
      victims. Obtaining forensic evidence for judicial purposes and releasing organs
      to children awaiting transplantation are not necessarily conflicting values.
      Greater than 60% of medical examiners sampled would agree to release organs from
      abuse/homicide victims in the scenarios presented here if provided with requested
      information. Further confronting the origins of variable medical examiner
      practice in this area might result in the availability of additional solid organs
      for pediatric transplantation.

PMID- 7771376
TI  - An isolated perforation of the jejunum caused by child abuse. A case report.
AB  - Presented is the case of a 10-month-old boy who died of general peritonitis due
      to an isolated perforation of the proximal jejunum. The autopsy findings included
      multiple bruises and abrasions inflicted at different times, probable bite marks,
      an old cerebral contusion tear, malnutrition, and an involution of the thymus,
      this evidence cumulatively suggesting that the decedent was a battered child. The
      abdomen showed a general peritonitis, and the wall of the jejunum was ruptured on
      the antimesenteric surface, 2 cm from the duodenojejunal junction (the ligament
      of Treitz). Microscopically, the ruptured area showed a linear rent in the mucosa
      and muscularis, and the narrow necrotic lesion was surrounded by normal-appearing
      bowel tissue. Therefore, it appeared that an external force had compressed the
      jejunum against the spine, thus rupturing the jejunum near the duodenojejunal
      junction, a point of fixation.

PMID- 7771375
TI  - Traumatic pericallosal artery aneurysm.
AB  - We present the case of a 33-year-old man who sustained head trauma in a motor
      vehicle accident. He remained unconscious from the time of the accident until his
      death 10 days later. He was shown to have severe hemorrhage that destroyed the
      corpus callosum from genu to splenium in association with a pericallosal artery
      aneurysm (distal anterior cerebral artery aneurysm). In addition, hemorrhages
      typical of traumatic hemorrhages were found elsewhere in the brain. Clinically,
      he was considered to have suffered the rupture of a berry pericallosal artery
      aneurysm, which caused the motor vehicle accident. Review of the angiograms in
      relation to the forensic neuropathologic examination revealed features indicating
      that the aneurysm had a traumatic origin. We also discuss traumatic pericallosal
      artery aneurysms in the wider context of traumatic cerebral artery aneurysms.
      Features that aid in distinguishing traumatic from spontaneous berry aneurysm are
      considered. Only 17 cases of traumatic cerebral artery aneurysms have been
      reported in this site. To the best of our knowledge, this is the first such case
      to be reported in the forensic setting.

PMID- 7771377
TI  - Sudden death in elderly women with Fabry's disease.
AB  - We report two cases of elderly women who died unexpectedly. In both cases, light-
      and electron-microscopical examination proved a diagnosis of Fabry's disease. The
      major pathological changes were myocardial mottling, foamy vacuolation of
      myocytes and glomerular endothelial cells, and characteristic lamellar
      inclusions. Neither woman had either a personal or family history of Fabry's
      disease. Fabry's disease presenting as sudden death is very rare. We present the
      findings in two cases together with a review of literature particularly relevant
      to the cardiovascular system.

PMID- 7771378
TI  - Congenital diaphragmatic hernia. A case of sudden unexpected death in childhood.
AB  - A case is reported in which a congenital posterolateral diaphragmatic hernia of
      the Bochdalek type was the cause of sudden unexpected death in a 22-month-old
      girl. This case shows that not all late-presenting diaphragmatic hernias have a
      favorable prognosis.

PMID- 7771379
TI  - Sudden death in epilepsy due to an isolated subependymal giant cell astrocytoma
      of the septum pellucidum.
AB  - We report a case of sudden unexpected death in an individual with epilepsy.
      Autopsy revealed a subependymal giant cell astrocytoma of the septum pellucidum,
      but there were no other lesions of tuberous sclerosis. We discuss sudden death in
      epilepsy, deaths related to primary brain tumors, the pathology of subependymal
      giant cell astrocytoma, and whether or not such a tumor can exist outside the
      setting of tuberous sclerosis. We also discuss the implications such findings may
      have on surviving family members, as well as the important role of the forensic
      pathologist in such cases.

PMID- 7771380
TI  - Disseminated cryptococcosis and sudden death. Report of an autopsy case.
AB  - We report a case of sudden death due to terminal cryptococcal pneumonia in a
      patient not suspected to have AIDS. The correct diagnosis was found only by
      microscopic examination and serologic workup, illustrating the hazards faced by
      forensic pathologists and their assistants working without adequate information
      about the bodies under study. This case illustrates the need for the highest
      levels of caution and compliance with universal precautionary measures during
      autopsy procedures in the present days of the AIDS epidemic.

PMID- 7771383
TI  - Insertion of foreign bodies into the abdominal cavity. An unusual form of self
      mutilation.
AB  - Self-mutilation is self-infliction of bodily injury without a conscious suicidal
      intent. Repeated self-inflicted abdominal stab wounds with insertion of foreign
      bodies into the abdominal cavity is an uncommon form of self-mutilation. We
      describe such a case in a 35-year-old male inmate who committed suicide by
      hanging. At autopsy metallic foreign bodies were found in the liver and
      paraduodenal soft tissue. Because of its high prevalence in the incarcerated
      population, self-mutilation among prisoners should be given attention. Self
      mutilation should also be considered in cases of atypical behavior, psychiatric
      disorders, intoxication, mental retardation, and sudden death from unexplained
      causes.

PMID- 7771381
TI  - Death by fraternity hazing.
AB  - Fraternity hazing can cause a variety of injuries and deaths. We recently had the
      opportunity to investigate a heat-related death that occurred during a college
      fraternity event. The original death investigation did not consider the
      circumstances of death, environmental conditions, or the subtle autopsy findings
      related to heat stroke. This case is intended to alert health care professionals
      that deaths on college campuses may be related to fraternity hazing and may
      require in-depth investigations. An analysis of the death and a discussion of
      heat-related injuries are presented.

PMID- 7771382
TI  - Death caused by an allergic reaction to ethanol.
AB  - Death as a result of anaphylaxis remains rare and is only occasionally related to
      ingestion of common substances. This article reports a death due to an allergic
      reaction to ethanol, as well as a review of the reported deaths in the literature
      attributed to ethanol. This report emphasizes the importance of awareness of such
      obscure allergies by forensic pathologists, the significance of antemortem
      testing, and the value of gathering accurate medical information, both antemortem
      and postmortem.

PMID- 7771384
TI  - Pulmonary cartilage embolism: fact or artefact?
AB  - Microscopic examination of the lungs of a victim of traumatic asphyxia showed the
      presence of isolated foci of pulmonary bone marrow and cartilage embolism,
      although no macroscopic fractures were found. This condition could have resulted
      from a microfracture at a costochondral junction caused by the severe chest
      compression that led to the victim's death, or it might have been a resuscitation
      artefact. The possible role of pulmonary cartilage embolism as a marker of
      antemortem injury is considered.

PMID- 7771385
TI  - Splenic odyssey. Traumatic retropharyngeal displacement of thoracoabdominal
      viscera.
AB  - The retropharyngeal space (RPS) is a fascial compartment of the midline of neck,
      posterior to the pharynx, anterior to the spine. Pathologic involvement of RPS
      includes tumors, abscesses, and traumatic hematomas, all of which may dissect
      inferiorly into the thoracic compartment. We describe two cases in which severe
      trauma of the torso resulted in dissection of thoracoabdominal contents upward
      into the RPS--an apparently undocumented phenomenon.

PMID- 7771386
TI  - Suicidal ingestion of barium-sulfide-containing shaving powder.
AB  - Physicians, familiar with the common usage of barium medicinally as the contrast
      agent barium sulfate, may consider it an innocuous or at most a minimally harmful
      compound. The barium cation is extremely toxic and produces characteristic
      gastrointestinal symptoms, periorbital and extremity paresthesia, hypertension,
      and progressive flaccid muscular paralysis. Profound hypokalemia also may be
      induced. Overdose may be rapidly fatal unless the ingestion is recognized and
      appropriate treatment is instituted expediently.

PMID- 7771387
TI  - Fatal acute pancreatitis caused by valproic acid.
AB  - We describe a case of a 31-year-old woman with cerebral palsy who developed fatal
      acute hemorrhagic pancreatitis while being treated with valproic acid to control
      her seizure activity. Acute pancreatitis is usually due to alcohol ingestion or
      biliary tract disease, and unusual causes include trauma, metabolic diseases, or
      drugs. Valproic acid is considered a safe drug, although rare cases of severe
      toxicity such as hepatitis and acute pancreatitis, including two fatalities, have
      been reported. Our review of the literature revealed that most patients who
      developed acute pancreatitis had serum levels of the drug within the therapeutic
      range, and most of the cases occurred either secondary to a recent increase in
      the dose or to initiation of treatment. It also appeared that the fatalities
      occurred due to a delayed diagnosis of acute pancreatitis, either resulting from
      an unsuspected diagnosis or to the deteriorated mental status of the patients
      receiving the drug, which precluded their ability to elaborate symptomatology. We
      believe that early diagnosis and withdrawal of the drug are significant factors
      determining the course of valproic-acid-associated pancreatitis.

PMID- 7771388
TI  - Death caused by triazolam and ethanol intoxication.
AB  - Gas chromatography-mass spectrometry was used for the quantification of the
      hypnotic drug triazolam in human samples. In our case, death was attributed to
      triazolam and ethanol intoxication. The whole blood concentration of triazolam
      was 7.0 ng/ml and that of ethanol was 230 mg/dl. Based on the literature, this is
      the lowest triazolam concentration that has been associated with death.

PMID- 7771389
TI  - Death by bull-edger. An unusual homicide using a woodworking implement.
AB  - Impulsive killers often use whatever instrument is close at hand in the
      perpetration of their deed. We describe a homicidal death, first thought to be
      accidental, in a rural sawmill where the assailant manipulated a large board of
      wood into a machine known as a bull-edger (which cuts logs into rough boards) in
      such a fashion as to cause the death of his work partner. The physics of the
      events at the scene as well as the subsequent investigation are discussed.

PMID- 7771390
TI  - Sudden death in an infant due to histiocytoid cardiomyopathy. A light
      microscopic, ultrastructural, and immunohistochemical study.
AB  - Histiocytoid cardiomyopathy is a rare cardiac disorder of infancy and childhood
      that predominantly affects girls under the age of 2 years. The clinical picture
      is usually dominated by severe cardiac arrhythmias, and sudden death may occur.
      In such instances, sudden infant death syndrome (SIDS) is often considered.
      Grossly, the affected heart usually shows small, multifocal, subendocardial or
      myocardial yellow-tan nodular lesions or poorly defined plaques. Occasionally,
      the lesional tissue is not apparent. Histological findings include sharply
      demarcated groups and sheets of cells with abundant foamy or granular cytoplasm,
      justifying the use of the term "histiocytoid" cardiomyopathy. The abnormal cells
      appear to be transformed cardiac myocytes that possess some features of the
      conducting system fibers; therefore, Purkinje cells are now believed to be the
      origin of these distinctive lesions. We describe and discuss the light
      microscopic, immunocytochemical, and ultrastructural findings in a previously
      healthy 12-month-old boy who died suddenly.

PMID- 7771391
TI  - Fatal impalement injuries after falls at construction sites.
AB  - Three fatal accidents suffered by men at construction sites are reported. The
      victims fell from a considerable height onto metal construction rods and died
      from impalement injuries. The particular features of wound morphology are
      discussed. The influence of alcohol and medicines is also considered as a
      contributory cause of the falls.

PMID- 7771392
TI  - Judicial hanging.

PMID- 7771393
TI  - Crohn's disease of the esophagus.
AB  - A 26-yr-old woman presented with odynophagia, dysphagia, and intermittent bloody
      stools. Clinical, endoscopic, and microscopic evidence confirmed the diagnosis of
      severe Crohn's disease of the oropharynx, esophagus, proximal stomach, terminal
      ileum, and colon.

PMID- 7771394
TI  - Acute hepatitis A with coexistent hepatitis C virus infection presenting as a
      virus-associated hemophagocytic syndrome: a case report.
AB  - A 23-yr-old male with acute hepatitis A and coexistent hepatitis C became
      critically ill 3 wk after the onset of fever and jaundice with progressive
      anemia, thrombocytopenia, and hepatosplenomegaly. Bone marrow biopsy revealed
      hemophagocytosis. Despite aggressive supportive treatment with parenteral
      steroids, the patient died of disseminated intravascular coagulopathy with
      gastrointestinal bleeding. Necropsy of the liver showed histiocyte aggregation in
      the portal area with hemophagocytosis.

PMID- 7771395
TI  - A lethal course of chronic hepatitis C, glomerulonephritis, and pulmonary
      vasculitis unresponsive to interferon treatment.
AB  - Several extrahepatic syndromes have been associated with chronic hepatitis C
      virus infection. In our patient (a 57-yr-old woman without risk factors for
      hepatitis), chronic active hepatitis C was diagnosed serologically and
      histologically. Three months later, membranoproliferative glomerulonephritis with
      compromised renal function and peripheral edema, cryoglobulinemia, and a
      vasculitis of the finger tips developed. During interferon treatment for 3
      months, neither the clinical condition nor serological parameters improved
      significantly. Progressive dyspnea was due to bilobar pulmonary infiltration.
      Despite antibiotic, virostatic, and corticosteroid therapy, the patient died from
      respiratory failure. Autopsy revealed diffuse pulmonary vasculitis. Thus, this is
      the first description of chronic hepatitis C virus infection, glomerulonephritis,
      and cryoglobulinemia complicated by immunologically mediated pulmonary
      vasculitis. Because interferon therapy may be ineffective, immunosuppressive
      therapy should be considered.

PMID- 7771396
TI  - Dramatic improvement of watermelon stomach with alpha-interferon.
AB  - Watermelon stomach is a rare disorder causing gastric blood loss and iron
      deficiency anemia. We report a case that occurred during the course of post
      hepatitis C cirrhosis, which condition was dramatically improved by alpha
      interferon treatment.

PMID- 7771397
TI  - Metoclopramide-induced sulfhemoglobinemia.
AB  - Metoclopramide, a drug with oxidant activity, has infrequently been reported to
      cause methemoglobinemia in infants. We present a unique case in which a patient
      on chronic metoclopramide therapy developed sulfhemoglobinemia that resolved with
      subsequent discontinuation of the drug. Mechanisms that may be important in the
      formation of sulfhemoglobin also are discussed.

PMID- 7771398
TI  - Giardiasis diagnosed by biopsy of the colon and terminal ileum: unusual sites for
      a common pathogen.
AB  - Giardiasis is a common intestinal infection which commonly presents with
      nonspecific symptoms. Suspected cases are usually diagnosed by stool examination
      or duodenal aspirates or biopsies. The purpose of this case report is to alert
      physicians to the fact that the organism may be present in colonic and ileal
      biopsies when clinical symptoms prompt a clinician to perform colonic biopsies
      rather than the usual tests of stools and duodenal aspirates or biopsies.

PMID- 7771399
TI  - Megacolon as a presenting finding of acute pancreatitis associated with chronic
      ulcerative colitis: unusual presentation of an unusual association.

PMID- 7771400
TI  - A case of triple early gastric cancer in the remnant stomach.
AB  - A 63-yr-old man, who had undergone distal gastrectomy and gastrojejunostomy
      (Billroth II method) 32 yr previously for duodenal ulcer, was admitted with
      suspected gastric remnant cancer. An upper gastrointestinal series and endoscopy
      revealed a protruding lesion at the stoma of the remnant stomach. Total
      gastrectomy with resection of the adjacent jejunum was performed. Histological
      examination demonstrated two well-differentiated adenocarcinomas (a mixed type I
      and IIc lesion with submucosal invasion and a type IIa lesion with intramucosal
      invasion) and a type IIc mucocellular carcinoma located in the mucosa. Gastritis
      cystica polyposa also was observed in the remnant stomach. The combination of
      three early gastric cancers and gastritis cystica polyposa suggests that the
      mucosa of the remnant stomach had a high malignant potential. The patient has
      survived without recurrence for 5 yr since the operation.

PMID- 7771402
TI  - Agenesis of the gallbladder found at laparoscopy for cholecystectomy: an
      unpleasant surprise.
AB  - Gallbladder agenesis is a rare condition that results from the failure of the
      cystic bud to develop in the 4th wk of intrauterine life. Agenesis is usually
      discovered at laparotomy for cholecystectomy since ultrasound examination of a
      patient with suggestive symptoms not visualizing the gallbladder is compatible
      with chronic cholecystitis (shrunken gallbladder). The surgeon must prove
      agenesis by thoroughly examining the most common sites for ectopic gallbladders
      and by performing intraoperative cholangiograms. For unexplained reasons, most of
      the patients become asymptomatic after the operation. We present a new case of
      adult agenesis of the gallbladder in a patient who was taken to laparoscopic
      cholecystectomy for presumptive cholelithiasis.

PMID- 7771401
TI  - Melanin-like pigmentation of the duodenum.
AB  - We report a case of brown-black pigmentation of the duodenum found in an elderly
      female during endoscopy for unrelated reasons. Melanin-like pigmentation of the
      duodenum is a rare endoscopic entity of uncertain etiology and significance.
      Various theories related to the etiology and pathogenesis, as well as
      histochemical and electron microscopic characteristics, are discussed.

PMID- 7771403
TI  - Can we reliably diagnose neoplastic cysts preoperatively?

PMID- 7771404
TI  - Another treatment option for biliary strictures from chronic pancreatitis.

PMID- 7771406
TI  - Treatment of acute pancreatic pseudocyst.

PMID- 7771405
TI  - The mechanisms of penicillamine, trientine, and zinc in the treatment of Wilson's
      disease.

PMID- 7771407
TI  - Hepatic insufficiency developing as a result of flutamide treatment.

PMID- 7771408
TI  - Endoscopic sphincterotomy without fluoroscopic control in pregnancy.

PMID- 7771409
TI  - Gynecomastia and sexual disorders after the administration of omeprazole.

PMID- 7771410
TI  - Hepatitis C virus infection and angioimmunoblastic lymphadenopathy.

PMID- 7771411
TI  - Overwhelming eosinophilic gastroenterocolitis associated with intestinal
      obstruction and carcinoma of the colon.

PMID- 7771413
TI  - Helicobacter pylori in pediatric nonulcer dyspepsia: pathogen or commensal?

PMID- 7771412
TI  - Sensory testing of the gastrointestinal tract: is there a better way?

PMID- 7771414
TI  - Radiation safety reviewed.

PMID- 7771415
TI  - Gastroduodenal motility and dysmotility: an update on techniques available for
      evaluation.

PMID- 7771416
TI  - Immunogenetic aspects of primary sclerosing cholangitis: implications for
      therapeutic strategies.
AB  - Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease
      characterized by fibro-obliterative inflammation of the intra- and extrahepatic
      bile ducts; in 70% of cases, it is associated with inflammatory bowel disease.
      The disease usually runs a progressive course, ultimately leading to biliary
      cirrhosis, hepatic failure, and sometimes cholangiocarcinoma, with a median
      survival of 12 yr after diagnosis. As yet, the etiology of primary sclerosing
      cholangitis remains unknown, although several recent studies have implicated
      immunogenetic factors as important pathogenic mechanisms. Besides liver
      transplantation for patients with end-stage cirrhotic liver disease and
      endoscopic therapy for patients with dominant extrahepatic bile duct strictures,
      recent studies have also shown promising results of drug therapy with
      ursodeoxycholic acid in the treatment of PSC. The purpose of this article is to
      summarize our current knowledge of the immunogenetic factors in the pathogenesis
      of PSC and to present support for drug therapy with ursodeoxycholic acid in the
      treatment of PSC. The genetic and immunological factors in the pathogenesis of
      PSC are outlined first, followed by a rationale of drug therapy with
      ursodeoxycholic acid in the treatment of PSC.

PMID- 7771417
TI  - Evidence of gender differences in esophageal pain threshold.
AB  - OBJECTIVE: To compare esophageal sensation thresholds between healthy males and
      females. METHODS: We used esophageal balloon distention to compare sensory
      thresholds between nine male and 10 female volunteers with a latex balloon
      (length 3 cm) positioned 5 cm proximal to the lower esophageal sphincter.
      Subjects indicated feeling: 0 (no sensation), 1 (aware of balloon but no
      discomfort), 2 (pain or discomfort) during rapid (170 cc/s) or slow (0.7 cc/s)
      balloon inflation rates as the balloon was inflated with increasing volumes of 2
      cc. Females were studied on two separate occasions, days 5-7 and days 20-22 of
      their menstrual cycles, with day 1 being the first day of menses. RESULTS:
      Females had a significantly lower pain threshold and a trend toward lower
      awareness level. No significant differences in sensory perception were found
      between the two phases of the female cycle. Poor correlation (r = 0.35 in rapid,
      r = 0.4 in slow inflation) was found between subject height and balloon volume at
      perception of pain. CONCLUSION: Healthy females demonstrate a lower threshold to
      esophageal pain induced by balloon distention than healthy males. This difference
      is not explained by hormonal changes during normal menstrual cycle or by body
      size. This observation may explain in part the observed preponderance of females
      with unexplained chest pain of possible esophageal origin.

PMID- 7771419
TI  - Esophageal aperistalsis and gastroesophageal reflux disorder: return of
      peristalsis after H2-blocker therapy.
AB  - OBJECTIVES: Distal esophageal aperistalsis has rarely been reported among
      patients with gastroesophageal reflux disorder. The purpose of this study,
      therefore, was to address the frequency with which disorders of peristalsis in
      general--and distal esophageal aperistalsis in particular--occur in adults with
      gastroesophageal reflux disorder. PATIENTS AND METHODS: We studied 314 patients
      who were referred to our gastrointestinal motility laboratory. On the basis of
      the endoscopic data, they were divided into three groups: group I, symptomatic
      patients without endoscopic esophagitis; group II, patients with mild endoscopic
      esophagitis; and group III, patients with erosive esophagitis. An age-matched
      group of patients with chest pain unrelated to reflux served as the control.
      RESULTS: Some form of peristaltic dysfunction was recorded in 56% of the patients
      with gastroesophageal reflux disorder, significantly more than in the control
      group (p < 0.01). A significant correlation existed between the esophageal motor
      dysfunction scores and the severity of reflux disease. Distal esophageal
      aperistalsis was present in 3.1% of the reflux groups. There was a correlation
      between severity of reflux disease and the prevalence of aperistalsis.
      Aperistalsis occurred in none of the patients in group I, in 3.6% of group II,
      and in 12.5% of group III (p < 0.0001). Seven of the patients with aperistalsis
      who has been treated with H2-blockers were reexamined 4 months later. Return of
      peristalsis was seen in three of them. CONCLUSION: Esophageal aperistalsis can be
      seen in a minority of patients with severe gastroesophageal reflux disorder and
      is probably a reversible condition.

PMID- 7771418
TI  - The role of Helicobacter pylori in children with recurrent abdominal pain.
AB  - OBJECTIVES: Our major goals in this study were to determine the prevalence of
      Helicobacter pylori among Israeli children with recurrent abdominal pain and to
      establish whether a link exists between eradication of Helicobacter pylori and
      the recovery from abdominal pain. The alternative target was to examine whether
      the serological test can replace endoscopy in children. METHODS: Upper
      gastrointestinal endoscopy was performed in 80 children with recurrent abdominal
      pain. During endoscopy, antral biopsies were taken and sent for histological and
      bacteriological examination. RESULTS: The prevalence of H. pylori, which was
      indicated by Gram stain and urease test, was 54%. The positive cases were treated
      with bismuth combined with amoxycillin and metronidazole. Two months after
      completion of the treatment, 34 patients were reexamined. Twenty-nine of them
      (85%) became symptom free, and five (15%) remained symptomatic. These five
      children were retreated, and they also became symptom free. Eight months after
      completion of treatment, all 34 patients were reexamined and found to be
      asymptomatic. CONCLUSIONS: We found a high prevalence of H. pylori (54%) among
      Israeli children with recurrent abdominal pain; we also found that symptoms were
      effectively and significantly reduced by the eradication of H. pylori. The
      endoscopic examination cannot be replaced by serological test.

PMID- 7771420
TI  - The effects of antireflux therapy on pulmonary function in patients with severe
      gastroesophageal reflux disease. Department of Veterans Affairs Gastroesophageal
      Reflux Disease Study Group.
AB  - OBJECTIVES: Gastroesophageal reflux can induce bronchospasm, and antireflux
      therapy has been shown to improve pulmonary function in patients who have
      gastroesophageal reflux disease (GERD) associated with asthma. Our objective was
      to study the pulmonary effects of antireflux therapy in patients who had severe
      GERD without clinically apparent lung disease. METHODS: In a Department of
      Veterans Affairs Cooperative Study, patients who had complicated GERD without
      important lung disease were randomly assigned to receive one of three types of
      antireflux treatment, including two kinds of medical therapy and a surgical
      therapy. Patients had pulmonary function tests (PFTs), including total lung
      capacity, residual volume, forced vital capacity, forced expiratory volume in 1
      s, maximal midexpiratory flow, and diffusing capacity for carbon monoxide.
      RESULTS: Two hundred forty-seven patients (243 men, four women; mean age 58 yr)
      entered the randomized trial, and 151 returned for PFTs at 1 yr. For the entire
      study group and for all three treatment groups, mean values for PFTs at 1 yr did
      not differ significantly from those at baseline. Even in subgroups of patients
      whose baseline PFTs were abnormal and whose esophagitis had healed completely,
      there were no significant changes in results of PFTs. CONCLUSIONS: For veteran
      patients with severe GERD and no obvious lung disease, 1 yr of antireflux therapy
      had no important effect on pulmonary function. These findings suggest that GERD
      is not commonly associated with inapparent, reversible pulmonary dysfunction.

PMID- 7771421
TI  - Transdermal nicotine and gastroesophageal reflux.
AB  - OBJECTIVES: Studies have shown that cigarette smoking acutely increases
      gastroesophageal reflux (GER). Patients prescribed transdermal nicotine often
      complain of pyrosis. The purpose of this study was to ascertain the effect of
      transdermal nicotine on GER. METHODS: Twenty volunteers (12 smokers and eight
      nonsmokers) were studied with a 24-h pH/motility apparatus while wearing a
      placebo patch for 24 h and a nicotine patch for a subsequent 24-h period. Each
      subject completed the entire 48-h monitoring session. RESULTS: A significant
      increase in the total acid score (p = 0.005), duration of acid exposure (p =
      0.010), and supine duration of acid exposure (p = 0.004) were noted with
      transdermal nicotine versus placebo. There were no significant differences in
      esophageal motility after transdermal nicotine. CONCLUSIONS: Whether enhanced
      supine reflux is related to lower esophageal sphincter dysfunction, increased
      acid secretion, or defective acid clearance is not clear. Nonetheless, it may be
      prudent to recommend removal of the transdermal nicotine patch at night in the
      patient with symptomatic nocturnal GERD.

PMID- 7771422
TI  - Congenital markers for chronic intestinal pseudoobstruction.
AB  - OBJECTIVES: Chronic intestinal pseudoobstruction (CIP) is difficult to
      differentiate from true mechanical obstruction, so many patients undergo multiple
      operations before the diagnosis is established. This is because of a lack of
      easily identifiable signs and symptoms that can differentiate true intestinal
      obstruction from pseudoobstruction. The digital arch is the least common (10%) of
      the three patterns of fingerprints (arches, loops, and whorls) found in primates.
      Digital arches have also been reported in association with mitral valve prolapse,
      which in turn is associated with joint laxity. Fingerprints and mitral valve
      prolapse are congenital features and are influenced by heredity, so we evaluated
      CIP patients for coexistence of these clinical markers. METHODS: Fingerprints
      were examined in 1566 consecutive gastrointestinal specialty referrals. In 43
      patients, the initial diagnosis of CIP was confirmed by subsequent testing.
      Because of the clinical impression that four features were present with increased
      frequency in CIP patients, these signs and symptoms were recorded prospectively:
      1) number of digital arches (DA); 2) presence of mitral valve prolapse (MVP), 3)
      presence of joint laxity (JL), and 4) onset of constipation before age 10 (C <
      10). RESULTS: Forty-three CIP patients (39 female, four male, ages 18-62) were
      seen. Using the test for significance of differences in proportions, the presence
      of DA, MVP, JL, and C < 10 proved significantly higher (p < 0.001) in CIP
      patients than in age- and sex-matched controls and the general population.
      CONCLUSIONS: We conclude that: 1) CIP may be a heritable syndrome because it is
      associated with heritable congenital markers (DA, MVP, JL, and C < 10; 2) these
      markers are identified with higher frequency in CIP patients than in the general
      population and in age- and sex-matched patients with other gastrointestinal
      disorders; 3) all four markers are easily detectable, and their recognition could
      lead to earlier diagnosis of the disorder.

PMID- 7771423
TI  - The cause of death in inflammatory bowel disease: a comparison of death
      certificates and hospital charts in Rochester, New York.
AB  - OBJECTIVE: This study examines the causes of death from Crohn's disease and
      ulcerative colitis by comparing death certificates with hospital charts as part
      of an ongoing, community-based analysis in Rochester, NY. METHODS: A registry of
      1358 inflammatory bowel disease patients followed from January 1973 to December
      1989 was analyzed for the cause of death by a study of death certificates as well
      as by a study of hospital records, including surgical pathology and autopsy
      records. A panel of physicians defined specific criteria for diagnosis, cause of
      death, and relation of death to inflammatory bowel disease. RESULTS: One hundred
      and thirty patients (59 with ulcerative colitis and 71 with Crohn's disease) from
      the registry were found to have death certificates recorded by Monroe County
      during this period. There was an 80% concordance of the death certificate to the
      hospital record for the cause of death and its relationship to inflammatory bowel
      disease. Discordance was noted in cases of colon cancer and surgical
      complications. CONCLUSIONS: Sixty-eight percent of Crohn's disease and 78% of
      ulcerative colitis patients died from causes unrelated to their inflammatory
      bowel disease. Deaths caused by Crohn's disease decreased from 44% in the 1973
      1980 period to 6% in the 1981-1989 period. Crohn's disease was a direct cause of
      death in 25% of the female patients, whereas only 6% of male patients died
      directly of Crohn's disease. Colorectal cancer caused 14% of the deaths in
      ulcerative colitis patients, three times more often than in Crohn's disease
      patients. Excluding cancer, there were only two deaths directly due to ulcerative
      colitis, both in the first 2 yr after diagnosis.

PMID- 7771424
TI  - Limitations of continuous 24-h intragastric pH monitoring in the diagnosis of
      duodenogastric reflux.
AB  - OBJECTIVE: Long term gastric pH monitoring has been proposed to diagnose abnormal
      duodenogastric reflux. This study analyses the in situ reproducibility of
      continuous intragastric pH measurements to assess the influence of artifactual
      factors in producing spontaneous variations of pH values that might be frequently
      misinterpreted as episodes of duodenogastric reflux. METHODS: The investigation
      was carried out in 301 endoscopically proven duodenal ulcer patients (87 female,
      214 male, mean age 46 yr). Each patient underwent 24-h gastric pH monitoring with
      two closely adjacent pH electrodes whose tips were about 2 mm apart. The two
      simultaneous pH tracings obtained from each patient were analyzed with regard to
      the number, characteristics, and discrepancies of unexpected alkalinization waves
      over the entire circadian cycle. RESULTS: The simultaneous pH tracings of the two
      channel datalogger we used ran almost superimposed for more than 23 h in 224 out
      of 301 (74%) duodenal ulcer patients. Major discrepancies between the two pH
      tracings of each recording were obtained in the remaining cases (77/301 = 26%).
      The most frequent event was represented by unexpected alkalinization waves that
      occurred mainly during nighttime and were recorded by only one of the two
      simultaneously measuring electrodes. As few as 16/244 (7%) patients showed
      synchronous, unexpected alkalinization waves that one might eventually consider
      to be duodenogastric refluxes. CONCLUSIONS: It is rather common that only one of
      two closely adjacent pH electrodes placed within the stomach measures longlasting
      pH elevations, particularly during the nocturnal period. This discrepancy is due
      to a poor in situ reproducibility of simultaneous pH recordings and indicates
      that pH readings might be influenced by interference and artifacts. Thus, the
      frequent differences between two simultaneous pH readings and the indirect
      measurement of the backflow of duodenal contents with long term gastric pH-metry
      do not allow us to rely on this technique to diagnose duodenogastric reflux.

PMID- 7771425
TI  - Scintigraphic evaluation of small bowel transit in healthy subjects: inter- and
      intrasubject variability.
AB  - OBJECTIVES: This study was performed to evaluate inter- and intrasubject
      variability of small bowel transit time and the effect of age and sex on transit
      in the small bowel. METHODS: Ten young subjects (five females) and nine elderly
      subjects (four females) were studied. Small bowel transit time was assessed by
      scintigraphic method using 99mtechnetium-sulfur colloid-labeled eggs. To evaluate
      intrasubject variability, 10 subjects underwent a second study on a later
      occasion. RESULTS: Mean small bowel transit time was 220.9 +/- 49 min with a
      range of 131 to 322 min, with no significant difference between the young and
      elderly groups or between sexes. There was a good intraobserver and interobserver
      reproducibility within the same test (r = 0.92 and r = 0.85, respectively). There
      was a significant biological variability between the first and the second
      studies, which was true whether the studies were processed independently (r =
      0.43) or whether identical regions of interest were applied (r = 0.50).
      CONCLUSION: The normal range of small bowel transit time is wide in normal
      subjects; and there is a significant intrasubject biological variability for
      small bowel transit time. These findings should be kept in mind when using
      scintigraphic techniques for assessment of patients with motility disorders or
      when using the test repeatedly in the same subject in the evaluation of
      therapeutic measures. The results do not seem to be affected by age or sex.

PMID- 7771426
TI  - Low dose, short-term triple therapy for cure of Helicobacter pylori infection and
      healing of peptic ulcers.
AB  - OBJECTIVES: The aim of this study was to confirm the efficacy and tolerability of
      a new, low dose, short-term triple therapy for cure of Helicobacter pylori
      infection, as suggested by Bazzoli, in a larger population. METHODS: On an
      "intention-to-treat" basis, 116 patients with active (n = 41) or healed (n = 47)
      peptic ulcer disease or ulcer-like dyspepsia (n = 28) and H. pylori infection
      received a 1-wk course of omeprazole 20 mg b.i.d., clarythromycin 250 mg b.i.d.,
      and tinidazole 500 mg b.i.d.. Four weeks after treatment withdrawal, cure of H.
      pylori infection was evaluated by rapid urease test and histology. RESULTS: One
      hundred and sixteen patients returned for follow-up. In 108 patients, H. pylori
      could not be identified 4 wk after cessation of therapy. The eradication rate was
      calculated to 93%. In addition, all patients with active peptic ulcers showed
      complete healing at follow-up despite no further treatment. Drug acceptance and
      compliance was excellent. CONCLUSION: Triple therapy as suggested by Bazzoli with
      omeprazole (in this study given b.i.d. for better compliance), clarythromycin,
      and tinidazole is indeed highly effective for both cure of H. pylori infection
      and for healing of peptic ulcers, is easy to perform, is cheap, and is without
      clinically significant side effects, even in a larger population.

PMID- 7771428
TI  - The breakthrough phenomenon during alpha-interferon therapy of chronic hepatitis
      C: incidence, management, and outcome.
AB  - OBJECTIVES: Some patients treated with alpha-interferon (alpha-IFN) for chronic
      hepatitis C (CHC) initially respond with normalization of ALT only to encounter a
      rise in ALT while still on the drug. This phenomenon is called breakthrough (BT).
      We reviewed our experience with BT to clarify its incidence, pathogenesis,
      management, and outcome. METHODS: Charts from 71 consecutive patients with CHC
      treated with alpha-IFN were reviewed. Forty of these patients were part of a
      study of 1-yr escalating dose alpha-IFN, initiated at 2 million units (MU) 3
      times per week. Endpoints that were evaluated were: reachievement of normal ALT,
      complete response (CR) (defined as normal ALT at the end of therapy), and
      sustained CR maintained for 6 months after therapy. RESULTS: Twenty-one (29.5%)
      patients sustained 28 BT events. Thirteen (46.4%) BT events occurred during the
      first 6 months of a course of alpha-IFN therapy, and 15 (53.6%) occurred during
      months 7 through 12. Of patients experiencing BT, six (28.6%) completed their
      course of therapy with a CR, of which two (9.5%) were sustained. By comparison,
      of 22 patients who normalized ALT without BT, all completed their course with a
      CR by definition (p < 0.0001), and nine (40.9%, p < 0.05) had a sustained CR. Of
      28 BT events, 13 (46.4%) were followed by reattainment of normal ALT. Of 16 BT
      events managed with continuation of the same dose of alpha-IFN, normal ALT was
      reachieved in seven (43.8%). Of 12 BT events managed with an escalation in alpha
      IFN dose, six (50%) reachieved normal ALT. A full sequential series of hepatitis
      C virus RNA PCR from periods of elevated, normal, and again elevated ALT was
      available for 12 BT events. The pattern was +/+/+ in six, +/-/+ in five, and +/-/
      in one. In one additional patient, an apparent BT was attributable to alpha-IFN
      induced autoimmune hepatitis. CONCLUSIONS: BT is a common event that may occur at
      any point during alpha-IFN therapy of CHC. This may limit the benefits of
      maintenance strategies. After a BT event, normal ALT can be reestablished in
      about 50% of cases, although the chance of a sustained CR falls to less than 10%.
      No advantage was demonstrated for escalating the alpha-IFN dose after a BT event.
      Therefore, we recommend continuation of the same dose as the initial approach. We
      suspect that BT relates to nonspecific ALT fluctuation in some patients and to
      emergence of resistant hepatitis C virus strains in others. Other causes of ALT
      elevation must also be considered in patients with apparent BT.

PMID- 7771427
TI  - Endoscopic appearances of colonic lymphoid nodules: new faces of an old
      histopathological entity.
AB  - OBJECTIVES: Colonic lymphoid nodules, also known as focal colonic lymphoid
      hyperplasia, have been previously described either as an indication of disease or
      as a normal variant in adults, with current opinion favoring the latter. The
      finding of isolated or confluent colonic lymphoid nodules on colonoscopy may
      nevertheless cause confusion with other endoscopic diagnoses. METHODS: In this
      study, we describe new endoscopic features of colonic lymphoid nodules, and we
      correlate them with other clinical and histopathological characteristics. Our
      experience is based on thorough evaluation of 13 cases of colonic lymphoid
      nodules that were consecutively observed during colonoscopy over the past 2 yr.
      RESULTS: Colonic lymphoid nodules may appear as red macules, as circumferential
      target lesions (halo sign), or as raised papules; they occur in both men and
      women, predominantly affect the rectum, and appear to be of no clinical
      significance. Histologically, colonic lymphoid nodules may involve the mucosa or
      the submucosa, in the form of either lymphoid aggregates or lymphatic nodules.
      CONCLUSIONS: With the widespread use of video colonoscopy, the macular or papular
      endoscopic characteristics of colonic lymphoid nodules should be increasingly
      recognized, confirmed histologically, and distinguished from other pathological
      lesions. Improved endoscopic recognition will allow the potential association of
      colonic lymphoid nodules with other colonic pathology to be eventually
      elucidated.

PMID- 7771429
TI  - Chronic hepatitis in patients with active hepatitis B virus and hepatitis C virus
      combined infections: a histological study.
AB  - OBJECTIVES: To evaluate whether peculiar histological changes are present in
      liver tissue of patients with chronic hepatitis by hepatitis B and hepatitis C
      (HBV and HCV) virus combined infections. METHODS: We studied liver biopsy
      specimens from 14 HB surface antigen/anti-HCV-positive patients consecutively
      admitted to hospital because of chronic liver disease from 1987 to 1992. Alcohol
      abusers, drug addicts, hepatitis delta virus- and HIV-infected subjects were
      excluded from the study. All of them were positive for serum HBV-DNA and/or
      intrahepatic HB core antigen and for serum HCV-RNA. Histological examination
      showed mild or moderate chronic hepatitis in nine cases and severe chronic
      hepatitis with cirrhosis in five cases. Two additional sets of liver biopsy
      specimens were also included in the study, consisting of liver samples from 14
      patients with chronic liver disease due to active HBV infection alone (group B)
      and from 14 patients with active HCV infection alone (group C). Cases from group
      B and C matched for age, sex, and histological diagnosis with those from group B
      + C. Histological patterns of all the liver specimens of the three groups were re
      examined by two authors who scored the found features using a scale from 0 to 3.
      RESULTS: No peculiar histological pattern was revealed in group B + C, and most
      of the detected microscopic features were similarly present in all three groups.
      Bile duct lesions and well defined lymphoid follicles were found only in liver
      samples of patients from groups C and B + C. Ground-glass hepatocytes were
      observed only in cases from the groups B and B + C. CONCLUSIONS: Histological
      examination of liver tissue from patients with chronic HBV and HCV combined
      infection does not show either typical patterns or evidence that this subgroup of
      chronic viral hepatitis is a more severe form of liver disease than that caused
      by a single virus infection. The observation in liver samples of peculiar lesions
      by HBV or HCV infection does not exclude a combined infection by both viruses.

PMID- 7771430
TI  - The platelet count as a predictor of variceal hemorrhage in primary biliary
      cirrhosis.
AB  - BACKGROUND: Variceal bleeding is a common, life-threatening complication of
      primary biliary cirrhosis (PBC) that remains difficult to predict. OBJECTIVE: The
      aim of this study was to identify whether certain biochemical and hematological
      parameters may be used as predictors of variceal bleeding in patients with PBC.
      METHODS: Cox proportional hazard regression analysis was used to test whether
      various prognostic factors were significantly associated with the time of first
      bleeding in 63 patients with proven PBC, of whom 11 had subsequent bleeding.
      RESULTS: Both the first available platelet count and the bilirubin level were of
      significant value in predicting variceal bleeding, but only the platelet count
      was an independent predictor of bleeding. In the group of patients who
      subsequently bled, there was a progressive drop in the platelet count over the
      follow-up period, with a proportional increase in the risk of bleeding; a
      platelet count below 200 x 10(9)/L was strongly associated with variceal bleeding
      (p < 0.001). None of the patients with platelet count above 200 x 10(9)/L bled
      over a total of 136 patient-years follow-up. In the group who did not bleed, no
      change in platelet count was identified during follow up. CONCLUSION: We conclude
      that the platelet count can be used as a predictor of variceal bleeding in PBC.

PMID- 7771431
TI  - Evidence for an immunological pathogenesis of thrombocytopenia in chronic liver
      disease.
AB  - OBJECTIVES: To elucidate the role of platelet-associated IgG (PA-IgG) in the
      mechanism of thrombocytopenia associated with chronic liver disease. METHODS:
      Platelet count in blood, PA-IgG, and scintigraphic spleen/liver ratio as a marker
      of splenomegaly was examined in 214 individuals, including 16 controls showing
      nonspecific reactive change in liver biopsy and 198 patients with chronic liver
      disease. RESULTS: The mean blood platelet count decreased significantly according
      to severity of liver disease, from control to liver cirrhosis. PA-IgG levels
      increased significantly in relation to severity of liver disease, as did
      spleen/liver ratio. In chronic hepatitis or liver cirrhosis, an inverse
      correlation was found between platelet counts and PA-IgG levels. An inverse
      correlation was also observed between platelet count and spleen/liver ratio in
      liver cirrhosis. The splenic embolization resulted in a significant rise in
      platelet count and a significant fall in PA-IgG in the 14 cirrhotic patients.
      CONCLUSIONS: These results may give support to evidence for an immunological
      mechanism mediated by PA-IgG for the thrombocytopenia occurring in chronic liver
      disease. In the case of liver cirrhosis, this mechanism would act in addition to
      platelet pooling in the spleen on thrombocytopenia. PA-IgG may also have an
      important role in thrombocytopenia associated with chronic hepatitis, in which
      splenic platelet pooling is less marked.

PMID- 7771432
TI  - Clinical correlates of gallstone composition: distinguishing pigment from
      cholesterol stones.
AB  - OBJECTIVES: The prevalence of cholelithiasis has been established in population
      based surveys employing ultrasonography, and major risk factors have been
      identified. However, the clinical and epidemiological features that distinguish
      patients with pigment gallstones from those with cholesterol stones have received
      little attention. METHODS: We prospectively surveyed 551 patients undergoing
      cholecystectomy for gallstones at two teaching hospitals. Clinical and
      epidemiological data were collected during patient interviews and by chart
      review. Gallstones were collected at surgery; physical measurements were
      recorded, and stone composition was determined by visual inspection and infrared
      spectroscopy. RESULTS: Patients with pigment stones were older than patients with
      cholesterol stones (p < 0.00001). Almost all patients under age 40 yr old had
      cholesterol stones, but most patients over 70 had pigment stones. Cirrhosis was
      strongly associated with pigment gallstones (p < 0.00001), although alcohol
      consumption was unrelated. Univariate analyses suggested associations of stone
      composition with male sex, diabetes mellitus, educational attainment, and use of
      thiazides or oral contraceptives, but these were not significant in a logistic
      regression that adjusted for age, cirrhosis, and other variables. Patients with
      pigment cholelithiasis had stones that were generally smaller in diameter and
      fewer in number than those with cholesterol stones. CONCLUSIONS: Compared to
      patients with cholesterol gallstones, those with pigment stones are older and
      more likely to have a diagnosis of cirrhosis. In addition, their stones are
      smaller in size and fewer in number than those from patients with cholesterol
      cholelithiasis.

PMID- 7771433
TI  - Effect of erythromycin on gallbladder emptying in patients with antrectomy or
      truncal vagotomy.
AB  - OBJECTIVES: Erythromycin, a motilin-like agent, stimulates gallbladder
      contraction in healthy control subjects. Because the action of erythromycin is
      cholinergic dependent and possibly related to premature phase III migrating motor
      complex activity in the antrum, we investigated the effect of erythromycin on
      gallbladder volume in six patients with truncal vagotomy without gastric
      resection and 14 patients with antrectomy (6 with Billroth I anastomosis, 8 with
      Billroth II anastomosis), and we compared the results obtained with those in
      eight healthy controls. In addition, the effect of meal ingestion on gallbladder
      volume was studied. METHODS: Gallbladder volumes, measured with ultrasonography,
      were determined every 15 min for 180 min after erythromycin infusion (3 mg/kg
      i.v.), as well as 30 and 60 min after meal ingestion. RESULTS: Basal gallbladder
      volumes were not significantly different among the four groups. Erythromycin
      induced a significant (p < 0.01-0.05) gallbladder contraction of maximal 46 +/-
      6% in the controls, 49 +/- 9% in the patients with truncal vagotomy, and 38 +/-
      7% in the patients with antrectomy and Billroth I anastomosis. In the patients
      with antrectomy and Billroth II anastomosis, no significant reduction in
      gallbladder volume after erythromycin was observed. Meal-induced gallbladder
      contraction was normal in all patients, including those with Billroth II
      anastomosis. CONCLUSIONS: These results indicate that neither the long vagus
      nerve nor the antrum is essential for erythromycin-induced effects on the
      gallbladder. Because no significant reduction in gallbladder volume in response
      to erythromycin was observed in the patients with antrectomy and Billroth II
      anastomosis, we suggest that duodenojejunal anatomical integrity is essential for
      erythromycin-induced gallbladder contraction.

PMID- 7771435
TI  - The relationship between insurance class and severity of presentation of
      inflammatory bowel disease in children.
AB  - OBJECTIVE: To determine whether there is an association between insurance class
      and the severity of presentation of inflammatory bowel disease in children.
      METHODS: Twenty underinsured (either no insurance or Medicaid) children were
      computer-matched with 20 children with private insurance with regard to diagnosis
      and age but without regard to severity of disease from a pool of 63 patients (20
      underinsured patients and 43 insured patients). We compared four patient-reported
      parameters and eight laboratory values. RESULTS: There were 22 patients with
      Crohn's disease (11 underinsured and 11 insured) and 18 patients with ulcerative
      colitis (nine underinsured and nine insured), with a mean age at diagnosis of
      13.7 +/- 4.2 yr in the underinsured and 13.4 +/- 3.8 yr in the privately insured
      patients. Patients in the underinsured category had more than 2.5 times the
      weight loss of the privately insured patients (20.0 +/- 13.9 vs. 7.8 +/- 8.6, p <
      0.005) and longer delay in months (10.3 +/- 10.9 vs. 2.7 +/- 2.6, p < 0.005)
      before the diagnosis was made. Laboratory data in the underinsured children
      indicated that they were more ill at time of presentation than the insured
      patients. The underinsured patients had significantly lower hemoglobins (10.5 +/-
      2.4 vs. 12.5 +/- 2.1, p < 0.01), a higher erythrocyte sedimentation rate (59 +/-
      35 vs. 21 +/- 24, p < 0.005), and higher platelet counts (536 +/- 205 x 10(3) vs.
      418 +/- 140 x 10(3), p < 0.05) compared to the insured group. Alkaline
      phosphatase levels, normally elevated in children during osseous growth, were
      significantly depressed in the underinsured group when compared with the insured
      group (117 +/- 42 vs. 155 +/- 71, p = 0.05). CONCLUSION: Underinsured children
      have clinical and laboratory parameters that indicate that their disease is more
      severe at presentation than privately insured patients. We postulate that this is
      partly related to the fact that underinsured patients have inferior access to
      quality healthcare when compared to privately insured patients.

PMID- 7771434
TI  - Acquired gallstone opacification during cholelitholytic treatment with
      chenodeoxyholic, ursodeoxycholic, and tauroursodeoxycholic acids.
AB  - OBJECTIVES: The appearance of gallstone opacification during oral bile acid
      administration indicates that stones are no longer susceptible to dissolution and
      represents, therefore, a definitive treatment failure. Ursodeoxycholic acid
      (UDCA) has been imputed to facilitate gallstone opacification; however, data
      regarding the comparative occurrence of gallstone opacification during UDCA and
      chenodeoxycholic acid (CDCA) administration are not yet available. Our objectives
      were to evaluate the frequency of acquired opacification in gallstone patients
      taking UDCA and in gallstone patients taking CDCA, to verify whether or not
      gallstone opacification is a peculiar side effect of UDCA treatment and, further,
      to evaluate gallstone opacification in gallstone patients receiving tauro-UDCA
      (TUDCA) to verify whether the administration of the more soluble tauroconjugate
      might prevent the deposition of calcium salts on the stone surface. METHODS: 106
      gallstone patients on UDCA, 125 gallstone patients on CDCA, and 31 gallstone
      patients on TUDCA were evaluated. Before treatment, all patients had radiolucent
      gallstones as assessed by oral cholecystography; further cholecystographic
      evaluations were performed every 6 months during treatment. RESULTS: The
      frequency of gallstone opacification was 13.2% (14/106) in UDCA patients, 8.8%
      (11/125) in the CDCA patients, and 12.9% (4/31) in the TUDCA patients. The
      differences were not statistically significant (p = NS). Sex, stone size, dose of
      bile acid, and duration of treatment were not significantly related to an
      increased frequency of gallstone calcification in any of the treatment groups.
      The frequency of gallstone opacification appeared to be higher in older patients.
      CONCLUSIONS: 1) UDCA rich bile is not a major predisposing factor for acquired
      gallstone opacification; 2) the administration of TUDCA does not prevent
      gallstone opacification; 3) opacification could be related to the natural history
      of gallstone disease.

PMID- 7771436
TI  - Small colorectal polyps: histopathology and clinical significance.
AB  - OBJECTIVES: The development of colorectal adenomas and carcinoma involves both
      environmental and genetic factors. Wide variations among populations have been
      observed in the prevalence of adenoma. Investigations of the small colorectal
      polyps have been divergent. The distribution of these small polyps remains in
      controversy. The histology, clinical significance, and optimal treatment of such
      lesions have yet to be defined. The aim of the present prospective study is to
      ascertain the importance of small colorectal polyps in the Taiwanese and to
      define their histopathological nature, spatial distribution, and clinical
      significance. METHODS: We prospectively evaluated all patients referred for
      colonoscopy for miscellaneous indications. All raised lesions encountered during
      the procedure were removed or biopsied. Each polyp was estimated in situ by
      visual comparison with the known width of a standard fully opened biopsy forceps.
      Small colorectal polyps were defined as those measuring 8 mm or less in diameter.
      Histopathology of these small polyps were reviewed and correlated clinically.
      RESULTS: 124 patients were found to have 159 small colorectal polyps. There were
      88 men (71%) and 36 women (29%). The mean ages were 60.2 yr for men and 50.8 yr
      for women. Solitary polyps were present in 68.5% of patients while 26.6% had two
      polyps and 4.9% had between 3 and 10 polyps; 60.4% of the small polyps were
      neoplastic, while 39.6% including 23.9% hyperplastic polyps were nonneoplastic;
      50.3% of the small polyps were located in the rectosigmoid. Tubular adenomas
      accounted for 90.6% of the small neoplastic polyps. The neoplastic polyps
      predominated in each colorectal segment. The proportion of small neoplastic
      polyps was higher in older patients; 2.8% of the small adenomas showed moderate
      dysplasia. Severe dysplasia was noted in only one polyp. No malignancy was
      observed. The chi-square test with Yates' correction was used for statistical
      analysis. CONCLUSIONS: These findings reveal that a large share of the small
      colorectal polyps are neoplastic and therefore at risk to progress to carcinoma.
      The location of small polyps distributed at the rectosigmoid or the proximal
      colon was of no significance (p > 0.2) for the proportion of neoplastic polyps.
      The older patients probably have higher risk because of their higher proportions
      of small neoplastic polyps. All polyps should be removed when encountered during
      colonoscopy due to the high prevalence of adenomas among small colorectal polyps.

PMID- 7771437
TI  - Presentation and treatment of annular pancreas in an adult population.
AB  - OBJECTIVE: To describe a series of adult patients with annular pancreas, their
      presentation, and treatment modalities. METHOD: A retrospective chart review of
      patients seen at a multispecialty referral center from 1977 to 1994. RESULTS:
      Seven adult patients (ages ranging from 33 to 77 yr, four females and three
      males) presented with various symptoms and signs: abdominal pain (six patients)
      gastric outlet obstruction (two), pancreatitis (two), pancreatic mass (two),
      gastric/duodenal ulcer (one), and/or postoperative obstructive jaundice (one).
      The duration of symptoms ranged from 1 wk to 16 yr before diagnosis (median 18
      months). Upper GI radiography was consistent with annular pancreas in two cases,
      CT scan in two cases (neither of which actually depicted the annulus), and four
      of six successful endoscopic retrograde cholangiopancreatographies. Three
      patients were diagnosed during operative procedures. Five of the seven patients
      required therapeutic operative procedures that included transduodenal
      sphincteroplasty, duodenojejunostomy, gastrojejunostomy, subtotal gastrectomy, or
      Whipple procedure. Four of the five had significant symptomatic relief. In one
      case, endoscopic sphincterotomy and biliary stent placement was therapeutic.
      CONCLUSIONS: 1) Annular pancreas occasionally presents in the adult population.
      2) Although gastric outlet obstruction was seen in two of seven patients, a
      plethora of additional presentations included pancreatic mass, pancreatitis,
      peptic ulcer disease, and post-operative obstructive jaundice. 3) Diagnosis of
      annular pancreas was most commonly suggested by upper GI series or endoscopic
      retrograde cholangiopancreatography. However, fully 40% of diagnoses required
      surgery for confirmation. 4) In contrast to the pediatric population in whom
      gastrojejunostomy or duodenojejunostomy is the treatment of choice, a variety of
      surgical as well as interventional endoscopic procedures were utilized for
      effective treatment in adults with annular pancreas.

PMID- 7771439
TI  - Reliability of reported sunburn history in a case-control study of cutaneous
      malignant melanoma.
AB  - Reliability of reported sunburn history was assessed. Fifty cases and 50 controls
      were randomly selected from a population-based case-control study of skin
      examination practices and lethal melanoma in Connecticut. Eighty-two percent of
      these participants were interviewed from January 15, 1987, to May 15, 1989, and
      reinterviewed in 1990. The kappa coefficients ranged between 0.37 and 0.57; the
      intraclass correlation coefficients were similar and ranged between 0.34 and
      0.69. There were no significant differences found by case-control status or sex
      for any variables, and the degree of disagreement was similar for cases and
      controls and could be considered free of recall bias.

PMID- 7771438
TI  - Previous lung disease and risk of lung cancer among lifetime nonsmoking women in
      the United States.
AB  - The authors conducted a population-based case-control study of lung cancer in
      nonsmoking women in five metropolitan areas of the United States between December
      1, 1985, and November 30, 1990. In-person interviews were conducted with 412 lung
      cancer cases and 1,253 population controls, yielding information on history of
      nonmalignant lung diseases that were diagnosed by a physician. When lung cancer
      cases were compared with controls, history of any previous lung disease was
      associated with a significant increased risk of lung cancer (adjusted odds ratio
      (AOR) = 1.56, 95% confidence interval (CI) 1.2-2.0). Several lung diseases,
      including asthma, chronic bronchitis, pneumonia, and tuberculosis, were reported
      more often by lung cancer cases than by controls, and the difference was
      statistically significant for asthma (AOR = 1.67, 95% CI 1.1-2.5) and chronic
      bronchitis (AOR = 1.60, 95% CI 1.1-2.4). Since significant increased risks were
      observed for asthma and tuberculosis diagnosed before age 21 years, it is
      unlikely that reported prior lung diseases were prediagnostic manifestations of
      lung cancers. The increased risks associated with previous lung disease were
      observed for adenocarcinomas and other carcinomas of the lung; the point
      estimates were generally higher for the latter category. The risks associated
      with previous lung diseases remained unchanged after adjustment for potential
      confounders, including environmental tobacco smoke exposure during childhood and
      adult life and dietary factors.

PMID- 7771440
TI  - Tobacco, alcohol, and colorectal tumors: a multistep process.
AB  - A case-control study in the Cote d'Or area of France used the multistep concept
      of colorectal carcinogenesis to compare lifetime tobacco consumption and present
      alcohol consumption in patients with small adenomas (less than 1 cm, n = 154) or
      large adenomas (n = 208) and in polyp-free controls (n = 427). Cancer patients (n
      = 171) were compared with population controls (n = 309). In men, smoking was
      associated with the risk of adenomas (odds ratio = 3.6 over 20 pack-years vs.
      nonsmokers, p < 0.001). Alcohol was a risk factor for large adenomas only, with
      relative risks of 4.2 (p < 0.01), 3.0 (p < 0.05), and 4.4 (p < 0.01) for
      consumptions of 20-39, 40-59, and 60 g/day compared with less than 10 g/day. When
      patients with large adenomas were compared with polyp-free controls, both alcohol
      and tobacco were independently related to the risk of tumor. There was no
      association between tobacco or alcohol intakes and cancer risk. In women,
      consumption was much lower in all groups, and no significant association with
      either risk factor was observed. These data suggest for the first time that there
      is an independent effect of alcohol and tobacco in men at different early steps
      of the adenoma-carcinoma sequence. They demonstrate the usefulness of such a
      model for etiologic studies on cancer.

PMID- 7771441
TI  - Blood lead levels in relation to menopause, smoking, and pregnancy history.
AB  - Postmenopausal bone loss may result in the release of lead stored in bone. This
      study examined Mexican-American women aged 20 years and older who participated in
      the Hispanic Health and Nutrition Examination Survey (1982-1984) to assess the
      influence of menopause, pregnancy history, and smoking on blood lead levels.
      After adjustment for factors likely to influence blood lead levels and for design
      effects, the authors confirmed associations with age, income level, education,
      degree of urbanization, and body mass. Blood lead concentrations were markedly
      higher among current smokers and postmenopausal women, with these two factors
      showing separate, roughly additive effects. Gravidity had little impact on blood
      lead level among premenopausal women. However, among postmenopausal women, never
      pregnant women had higher blood lead levels than did those who had ever been
      pregnant. The largest increase (4.4 micrograms/dl, 95 percent confidence interval
      0.95, 7.8) was observed among smokers. In a separate analysis of postmenopausal
      women, women with recent menopause (4 years or less) had blood lead
      concentrations 1.4 micrograms/dl higher (95 percent confidence interval 0.20,
      2.7) than did those whose menopause occurred more than 4 years previously. This
      finding, along with an overall slow decline in blood lead levels with each year
      after menopause, suggests that lead is being mobilized at rates consistent with
      the patterns of bone loss, placing women with recent menopause at increased risk
      for higher blood lead levels.

PMID- 7771443
TI  - Educational level and obstructive lung disease given smoking habits and
      occupational airborne exposure: a Norwegian community study.
AB  - The relation of educational level to obstructive lung disease, spirometric
      airflow limitation, and respiratory symptoms was examined in a two-phase cross
      sectional study of a Norwegian general population aged 18-73 years in 1985-1988.
      The first phase was a questionnaire survey. In the second phase, a stratified
      sample of those who responded in the first phase was invited to a clinical and
      respiratory physiologic examination. Altogether, 714 subjects attended,
      representing 84% of those invited. The prevalences of obstructive lung disease
      and spirometric airflow limitation were 7.8% and 4.5%, respectively. A total of
      18% of the population had completed college, a further 60% had completed
      secondary school, and 21% had obtained a primary school education alone. The
      prevalence of both smoking and occupational airborne exposure decreased with
      increasing educational level. The sex-, age-, smoking-, and occupational exposure
      adjusted odds ratio of obstructive lung disease in primary-versus university
      educated subjects was 2.9 (95% confidence interval (CI) 1.3-6.5); in secondary-
      versus university-educated subjects it was 1.4 (95% CI 0.7-2.8). The
      corresponding values for spirometric airflow limitations were 5.2 (95% CI 2.0
      13.4) and 1.8 (95% CI 1.2-2.7). All of the respiratory symptoms except
      breathlessness grade 2 were significantly associated with educational level after
      allowing for sex, age, smoking, and occupational airborne exposure. The survey
      indicates that educational level is a risk factor for airway disorders
      independent of smoking and occupational airborne exposure.

PMID- 7771442
TI  - Solvent exposure as a risk factor for Alzheimer's disease: a case-control study.
AB  - This case-control study investigates whether history of organic solvent exposure
      is associated with increased risk of Alzheimer's disease. The study base includes
      about 23,000 persons aged 60 years or more from the local membership of a health
      maintenance organization in Seattle, Washington, who entered the study between
      1987 and 1992. Probable Alzheimer's disease cases (n = 193) who had presented
      with new dementia symptoms were identified, enrolled, and diagnosed by our
      Alzheimer's Disease Patient Registry following standardized criteria. Control
      subjects (n = 243), free of dementia and neurologic disease causing dementia,
      were selected randomly from the study base and frequency matched to cases for age
      and sex. Proxy informants provided specific solvent exposure history as well as
      job descriptions likely to involve solvent use as part of a comprehensive risk
      factor interview. Kappa statistics indicated substantial agreement for control
      control proxy solvent responses. History of exposure to one or more solvent
      groups (benzene and toluene; phenols and alcohols; ketones; other solvents)
      yielded an adjusted Alzheimer's disease odds ratio of 2.3 (95 percent confidence
      interval 1.1-4.7); among males only, it increased to 6.0 (95% confidence interval
      2.1-17.2). Thus, past exposure to organic solvents may be associated with onset
      of Alzheimer's disease.

PMID- 7771444
TI  - Reproducibility of responses to telephone interviews: demographic predictors of
      discordance in risk factor status.
AB  - The reproducibility of responses to the Behavioral Risk Factor Surveillance
      System questionnaire was examined across the demographic strata used by the
      Centers for Disease Control and Prevention and state health departments for
      reporting prevalence estimates (specifically age, sex, income, employment, and
      marital status), as well as race/ethnicity, which has been previously examined.
      The authors administered the questionnaire twice, 21-94 days apart, to randomly
      selected residents of Massachusetts (response rates: first administration, 68% of
      eligible households; second administration, 68% of persons who completed the
      first interview). Initial interviews were conducted in March and October 1992.
      Among 448 respondents to both interviews, group mean distributions of seven
      demographic characteristics and 19 risk factors were highly consistent across the
      two interviews. Discordance in individual risk factor status ranged from 1.2% to
      21.8% (median, 7.8%) and was symmetric in direction, i.e., as many respondents
      were considered at increased risk on the basis of the first interview and at low
      risk on the basis of the second interview as the reverse. Kappas ranged from 0.30
      to 0.90 (median, 0.75). Education, household income, and interval between
      administrations were not associated with prevalence of discordance for any risk
      factor. Sex, age, race/ethnicity, marital status, and employment status were each
      predictive of variation in discordance for one or more risk factors, but no
      consistent effect of any individual demographic characteristic across risk
      factors was observed. The questionnaire has relatively uniform and generally good
      reproducibility across all demographic strata used for monitoring the Health
      Objectives for Year 2000 and other chronic disease surveillance activities.

PMID- 7771445
TI  - Re: "Vegetables, fruit, and colon cancer in the Iowa Women's Health Study".

PMID- 7771446
TI  - Re: "Male and female factors in fertility".

PMID- 7771447
TI  - Re: "Prevalence of low birth weight among Hispanic infants with United States
      born and foreign-born mothers: the effect of urban poverty".

PMID- 7771448
TI  - A short method for constructing an abridged life table. 1939.

PMID- 7771449
TI  - Confounding and effect-modification. 1974.
AB  - Confounding and effect-modification--both very central to epidemiologic thinking
      and research on causality--are closely related but distinctly separate concepts
      and phenomena. Both of them involve considerable subleties, with implications for
      problem conceptualization, study design, data analysis and inference. Some of
      these subtleties and their implications may warrant greater appreciation in the
      practice of epidemiologic research, while others require further conceptual
      development.

PMID- 7771450
TI  - Body size and fat distribution as predictors of coronary heart disease among
      middle-aged and older US men.
AB  - Obesity, android fat distribution, and other anthropometric measures have been
      associated with coronary heart disease in long-term prospective studies. However,
      fluctuations in weight due to age-related hormonal changes and changes in
      lifestyle practices may bias relative risk estimates over a long follow-up
      period. The authors prospectively studied the association between body mass index
      (BMI) (kg/m2), waist-to-hip ratio, and height as independent predictors of
      incident coronary heart disease in a 3-year prospective study among 29,122 US men
      aged 40-75 years in 1986. The authors documented 420 incident coronary events
      during the follow-up period. Body mass index, waist-to-hip ratio, short stature,
      and weight gain since age 21 were associated with an increased risk of coronary
      heart disease. Among men younger than 65, after adjusting for other coronary risk
      factors, the relative risk was 1.72 (95% confidence interval (CI) 1.10-2.69) for
      men with BMI of 25-28.9, 2.61 (95% CI 1.54-4.42) for BMI of 29.0-32.9, and 3.44
      (95% CI 1.67-7.09) for obese men with BMI > or = 33 compared with lean men with
      BMI < 23.0. Among men > or = 65 years of age, the association between BMI and
      risk of coronary heart disease was much weaker. However, in this age group, the
      waist-to-hip ratio was a much stronger predictor of risk (relative risk = 2.76,
      95% CI 1.22-6.23 between extreme quintiles). These results suggest that for
      younger men, obesity, independent of fat distribution, is a strong risk factor
      for coronary heart disease. For older men, measures of fat distribution may be
      better than body mass index at predicting risk of coronary disease.

PMID- 7771451
TI  - Prospective study of intentional weight loss and mortality in never-smoking
      overweight US white women aged 40-64 years.
AB  - Although 40% of US women indicate they are currently trying to lose weight, the
      association between intentional weight loss and longevity is unknown. The authors
      analyzed prospective data from 43,457 overweight, never-smoking US white women
      aged 40-64 years who in 1959-1960 completed a questionnaire that included
      questions on weight change direction, amount, time interval, and intentionality.
      Vital status was determined in 1972. Proportional hazards regression was used to
      estimate mortality rate ratios for women who intentionally lost weight compared
      with women who had no change in weight. Women who died within the first 3 years
      of follow-up were excluded. Analyses were stratified by preexisting illness and
      adjusted for age, beginning body mass index, alcohol intake, education, physical
      activity, and health conditions. In women with obesity-related health conditions
      (n = 15,069), intentional weight loss of any amount was associated with a 20%
      reduction in all-cause mortality, primarily due to a 40-50% reduction in
      mortality from obesity-related cancers; diabetes-associated mortality was also
      reduced by 30-40% in those who intentionally lost weight. In women with no
      preexisting illness (n = 28,388), intentional weight loss of > or = 20 lb (> or =
      9.1 kg) that occurred within the previous year was associated with about a 25%
      reduction in all-cause, cardiovascular, and cancer mortality; however, loss of <
      20 lb (< 9.1 kg) or loss that occurred over an interval of > or = 1 year was
      generally associated with small to modest increases in mortality. The association
      between intentional weight loss and longevity in middle-aged overweight women
      appears to depend on their health status. Intentional weight loss among women
      with obesity-related conditions is generally associated with decreased premature
      mortality, whereas among women with no preexisting illness, the association is
      equivocal.

PMID- 7771452
TI  - Mortality following conjugal bereavement and the effects of a shared environment.
AB  - The effect of bereavement on mortality among surviving spouses was examined in a
      cohort of 12,522 spouse pairs belonging to a prepaid health care plan in northern
      California. Both spouses were examined and completed a questionnaire between 1964
      and 1973, and they were followed for mortality through 1987. Between 1964 and
      1987, 1,453 men (12%) and 3,294 women (26%) were bereaved; 440 bereaved men (30%)
      and 510 women (15%) died during follow-up. Mortality following bereavement was
      significantly elevated in both men and women after adjusting for age, education,
      and other predictors of mortality in proportional hazards analyses. The highest
      relative risks (RRs) of mortality occurred 7-12 months following bereavement.
      Among women, the RR was 1.9 (95% confidence interval (CI) 1.35-2.71) 7-12 months
      after bereavement. Among men, the effect of bereavement interacted with prior
      health status as follows: In men with few health problems, the RR of mortality
      was 2.12 (95% CI 1.42-3.17); men with many health problems had a RR of 1.56 (95%
      CI 0.98-2.55) 7-12 months after bereavement. In both men and women, the RR
      declined after the first year of bereavement but remained above 1.0 for more than
      2 years after bereavement. The addition of terms reflecting the influence of the
      other spouse's characteristics and behaviors did not alter the RR of mortality,
      indicating no effect of a shared unfavorable environment on mortality following
      bereavement.

PMID- 7771454
TI  - Air pollution and lung cancer in Trieste, Italy.
AB  - To investigate the relation between air pollution and histologic type of lung
      cancer, the authors conducted a case-control study among men who had died in
      Trieste, Italy, from 1979 to 1981 and from 1985 to 1986. Through the local
      autopsy registry, 755 cases of lung cancer and 755 controls were identified.
      Information on smoking habits, occupation, and place of residence was obtained
      from each subject's next of kin. Air pollution at the residence of each subject
      was estimated from the average value of total particulate at the nearest
      monitoring station. Logistic regression was used to evaluate the effect of
      residence and air pollution on lung cancer after adjustment for age, smoking
      habits, likelihood of exposure to occupational carcinogens, and social group. The
      risk of lung cancer increased with increasing level of air pollution for all
      types of lung cancer combined (p = 0.022), for small cell carcinoma (p = 0.016),
      and for large cell carcinoma (p = 0.049). Compared with inhabitants of the
      residential area, residents of the rural area had a relative risk (RR) of 0.6
      (95% confidence interval (CI) 0.4-1.0). The RR was 1.5 (95% CI 1.0-2.2) for
      residents of the center of the city and 1.4 (95% CI 1.0-2.1) for residents of the
      industrial area. In the center of the city, the excess risk was almost completely
      restricted to small cell carcinoma (RR = 2.0) and to large cell carcinoma (RR =
      2.6). In the industrial area, the risk was increased especially for
      adenocarcinoma (RR = 2.1). These results provide evidence that air pollution is a
      moderate risk factor for certain histologic types of lung cancer.

PMID- 7771453
TI  - Relation of benzodiazepine use to the risk of selected cancers: breast, large
      bowel, malignant melanoma, lung, endometrium, ovary, non-Hodgkin's lymphoma,
      testis, Hodgkin's disease, thyroid, and liver.
AB  - Some animal data have raised the possibility that benzodiazepines influence the
      risk of selected cancers. With data collected in 1977-1991 in a US hospital-based
      study, the authors assessed the relation of benzodiazepine use to the risk of 11
      cancers: breast (6,056 patients), large bowel (2,203), malignant melanoma
      (1,457), lung (1,365), endometrium (812), ovary (767), non-Hodgkin's lymphoma
      (382), testis (314), Hodgkin's disease (299), thyroid (111), and liver (37).
      Cases were compared with cancer controls (3,777 patients with other cancers) and
      noncancer controls (1,919 patients admitted for acute nonmalignant disorders).
      Relative risks were estimated for benzodiazepine use at least 4 days a week for
      at least 1 month, initiated at least 2 years before admission (sustained use) by
      multiple logistic regression with control for confounding factors. Results
      derived with noncancer controls were similar to those derived with cancer
      controls. For sustained benzodiazepine use relative to no use, relative risk
      estimates for all 11 cancers were compatible with 1.0 at the 0.05 level of
      significance. Relative risk estimates for durations of at least 5 years were also
      compatible with 1.0, with the exceptions of an increased estimate, of borderline
      statistical significance, for endometrial cancer, and a decreased estimate for
      ovarian cancer. Relative risk estimates both for sustained use that continued
      into the 2-year period before admission and for sustained use that ended up to >
      or = 10 years previously were compatible with 1.0, suggesting a lack of tumor
      promotion and no increase in the risk after a latent interval. Results were also
      null for diazepam, chlordiazepoxide, and other benzodiazepines considered
      separately. The results suggest absence of association between benzodiazepine use
      and the cancers considered, with the evidence stronger for the cancers with
      larger numbers of subjects. The similarity of results derived with cancer and
      noncancer controls suggests that benzodiazepines do not influence the risk of
      cancer as a whole.

PMID- 7771455
TI  - Association of medically treated depression and age at natural menopause.
AB  - Between October 1989 and November 1992, the authors surveyed approximately 10,000
      women between 45 and 54 years of age residing in western metropolitan Boston and
      selected as cases all women naturally menopausal before age 40 and a sample of
      women naturally menopausal between ages 40 and 46. Controls were a random sample
      of women who were premenopausal or naturally menopausal after age 47. Based on
      the results of an in-person interview to assess past reproductive and medical
      history, 14% of 344 cases compared with 6% of 344 controls reported a history of
      medically treated depression at least 1 year prior to menopause or comparable
      reference age in controls (adjusted odds ratio (OR) = 1.9, 95% confidence
      interval (CI) 1.1-3.3). The association of medically treated depression and early
      menopause was greatest in women naturally menopausal before age 40 compared with
      their age-and residence-matched controls (OR = 6.6, 95% CI 0.7-58.9) and in women
      who reported a history of medically treated depression that required more than 3
      years of treatment (OR = 4.0, 95% CI = 1.3-12.0). This is the first study to
      suggest a link between a self-reported history of medically treated depression
      and early menopause. Additional studies are necessary to clarify the basis for
      this association.

PMID- 7771456
TI  - Comparison of birth weight distributions between Chinese and Caucasian infants.
AB  - To assess the reasons for the Chinese-Caucasian differences in birth weight
      distributions, a cohort study was carried out involving 18,665 Caucasian and
      1,597 immigrant Chinese infants born at Montreal's Royal Victoria Hospital from
      January 1978 to March 1990 and 1,862 native Chinese infants born at Hefei
      Maternal and Infant Hospital in Hefei, People's Republic of China, from September
      1990 to August 1991. Mean (standard deviation) birth weights in grams were 3,369
      (567), 3,195 (493), and 3,171 (428) (p < 0.01 for differences in mean and
      variance), and mean (standard deviation) fetal growth ratios (ratio of observed
      birth weight to average birth weight at the same gestational age) were 0.994
      (0.124), 0.963 (0.114), and 0.935 (0.112) (p < 0.01 for differences in mean and
      variance), respectively, in the Caucasian, immigrant Chinese, and native Chinese
      groups. No important or consistent Chinese-Caucasian differences in gestational
      age were found. When mothers with extreme values for demographic, anthropometric,
      nutritional, and lifestyle determinants of fetal growth were excluded, the mean
      fetal growth ratio in Caucasian infants remained significantly higher (p < 0.01),
      but the standard deviations became more similar (p > 0.05): Mean (standard
      deviation) fetal growth ratios were 1.001 (0.111), 0.966 (0.108), and 0.946
      (0.114), respectively. The race-specific rate of growth differed according to
      period of gestation, with Chinese infants showing more rapid fetal growth early
      in the third trimester but slower growth near and after term. The authors
      conclude that the lower mean birth weight in Chinese infants is due to
      differences in fetal growth (rather than gestational duration) and by their
      inherently slower growth at or after term. The tight distribution of birth weight
      among the Chinese is caused partly by their reduced exposure to extremes of
      maternal determinants of fetal growth (mediated largely by environmental
      mechanisms) and partly by their inherently different growth pattern, with faster
      growth at earlier gestations but slower growth at later gestations.

PMID- 7771457
TI  - Outcome of very low birth weight infants in industrialized countries: 1947-1987.
AB  - Neonatal intensive care has led to a progressive improvement in the survival of
      very low birth weight (VLBW, < 1,500 g) infants. However, it has not been
      established whether there has been a simultaneous increase or decrease in the
      prevalence of handicapping conditions in this group of children. To explore this
      question, a meta-analysis was performed using outcome data of 32 developmental
      studies of VLBW infants born in industrialized countries between 1947 and 1987.
      The authors' results show that the proportion of VLBW infants who survived and
      had an intact outcome progressively increased between 1947 and 1987--from 147 per
      1,000 live births in the period 1947-1965 to 498 per 1,000 in the period 1980
      1987 (p < 0.01). The prevalence of major handicapping conditions for the subset
      of VLBW infants who weighed < 1,000 g at birth increased, resulting from the
      increasing survival rates. However, the prevalence of major handicapping
      conditions among all children with VLBW decreased from 147 per 1,000 live births
      in 1947-1965 to 45 per 1,000 in 1980-1987 (p = 0.02). The authors' meta-analysis
      suggests that improved survival of VLBW infants has not been accompanied by an
      increase, but more likely a decrease, in the prevalence of handicapping
      conditions in this birth weight group.

PMID- 7771459
TI  - Re: "Menstrual cycle patterns and risk of breast cancer".

PMID- 7771460
TI  - Re: "Risk attribution and tobacco-related deaths".

PMID- 7771458
TI  - Reliability of reports of sexual behavior: a study of married couples in rural
      west Africa.
AB  - A heterosexual partners survey in rural Senegal, Africa, was carried out in 1992
      to evaluate the reliability of self-reported answers about sexual practices. The
      authors followed 62 married couples weekly during a 5-week period to assess the
      level of agreement 1) between answers made by members of the same couple but
      collected separately, 2) between retrospective reporting of sexual activity
      during the last 4 weeks versus weekly reporting of sexual activity during 4
      weeks, and 3) between answers to a set of identical retrospective questions asked
      5 weeks apart. Reports over recent and short periods of time such as 7 days are
      reliable: The dates of sexual acts with spouse reported during the weekly
      interviews were concordant between members of a couple at 0-day or 1-day
      intervals in 72% of cases. The concordance of weeks reported with or without
      intercourse was also high. Reports over longer periods of time are less reliable:
      The comparison of retrospective reports versus weekly reports regarding mean
      number of sexual acts during the last 4 weeks shows a clear overreporting that
      was higher among men (4.5 vs. 2.7 sexual acts) than among women (3.7 vs. 2.7).

PMID- 7771461
TI  - Treatment of aggressive non-Hodgkin's lymphoma in the elderly.
AB  - A nonanthracycline-containing chemotherapeutic combination for the treatment of
      intermediate and high-grade non-Hodgkin's lymphoma was evaluated. Thirty-four
      consecutive and previously untreated patients, with a median age of 75 (range 54
      86) years, with aggressive lymphoma, received daily etoposide (60 mg/m2
      intravenous infusion [IVI]), cytosine arabinoside (50 mg/m2 subcutaneously), and
      methylprednisolone (60 mg/m2 IVI) on each of 5 consecutive days. Individuals with
      limited disease (stages I and II) (n = 9) received six, 3-day cycles of the same
      therapy and involved field radiation (36 Gy in 20 fractions) between the third
      and fourth courses. Patients with disseminated lymphoma (n = 25) received 10
      cycles over 8 months of the same combination, with the addition of methotrexate
      (200 mg/m2 on days 8 and 15), followed by leucovorin rescue (10 mg/m2 orally
      every 6 hr for 8 doses). Of the 34 patients, 44% entered complete remission (CR),
      and 7 died before completing the first cycle of chemotherapy. Fifty-six percent
      of the patients with limited disease and 40% with disseminated lymphoma (P >
      0.05) achieved CR. For all patients, median survival was 14 months (range 3 days-
      > 54 months), this being 12 and 15 months, respectively. For the entire
      population of responding patients, median survival has not been reached at a
      median follow-up of 39 months, while the median CR duration is 21 months. Ten of
      the 15 responders are alive in unmaintained CR at a median of 41 (range 30-54)
      months. Myelotoxicity was the major side effect, leading to adjustments in dose
      and schedule in two-thirds of the patients, although treatment changes did not
      affect outcome. Of the 15 deaths that occurred in this trial, in 53.3% it was
      unrelated to lymphoma or its therapy. Four patients that had achieved CR died of
      cardiovascular events (n = 2) or of progressive second malignancies (n = 2). It
      is concluded that cytosine arabinoside in combination regimens is effective in
      selected patients; this is particularly relevant in the elderly.

PMID- 7771462
TI  - Peripheral blood neutrophil morphology reflects bone marrow dysplasia in
      myelodysplastic syndromes.
AB  - Dysplastic features of cells in peripheral blood and bone marrow were studied in
      51 patients with myelodysplastic syndromes (MDS) to evaluate the significance of
      the degree of neutrophil granulation (G-score) and the percentage of pelgeroid
      polymorphs (ppp) in the peripheral blood, as indices of dysplastic changes in the
      bone marrow. There was a good correlation between peripheral blood and bone
      marrow findings, both for G-score figures (r = 0.92, P < 0.01) and ppp (r = 0.82,
      P < 0.01). Significantly lower G-score figures were found among patients with an
      increased percentage of bone marrow blasts (P < 0.05), while high ppp correlated
      with the presence of ring sideroblasts, the degree of bone marrow fibrosis, and
      findings of complex chromosomal abnormalities. Patients with a high degree of
      bone marrow dysplasia had significantly lower G-score (P < 0.01) and
      significantly higher ppp (P < 0.05) figures, than those with less pronounced
      myelodysplasia. In addition, extreme hypogranulation (G-score < 150) or very high
      ppp (> or = 20%) was generally a sign of bi- and tri-lineage dysplasia in the
      bone marrow. The results thus show that quantitative estimation of peripheral
      blood polymorph dysplasia by G-score figures and ppp seems to reflect the total
      degree of bone marrow dysplasia in MDS and may serve as a complement to bone
      marrow evaluation when the diagnosis of MDS is difficult.

PMID- 7771464
TI  - Hb Lepore (Pylos)/Hb S compounds heterozygosity in two Greek families.
AB  - We have studied three compound heterozygotes for Hb Lepore ("Pylos")/HbS
      hemoglobin, a combination quite uncommon in the literature. It is of interest
      that while two of these cases are clinically similar to those thus far reported,
      the third one is free of symptoms and the diagnosis was put incidentally. This
      mild condition may be due to the high level of fetal hemoglobin produced.

PMID- 7771463
TI  - Cobalamin-dependent metabolism in chronic myelogenous leukemia determined by
      deoxyuridine suppression test and the formiminoglutamic acid and methylmalonate
      excretion in urine.
AB  - The cobalamin metabolism in chronic myelogenous leukemia (CML) was evaluated in
      18 newly diagnosed and untreated patients by formiminoglutamic acid (FiGlu) and
      methyl malonic acid excretion (MMA) tests. A deoxyuridine (dU) suppression test
      of bone marrow cells was compared in patients with acute myelogenous leukemia (N
      = 5), myelodysplastic disease (N = 3), untreated pernicious anemia (N = 16),
      folate deficiency (N = 7), and a hospital reference group without signs of
      cobalamin or folate deficiency (N = 22). All had normal MMA excretion but 3 of 15
      patients had increased FiGlu excretion. In vitro thymidine uptake in bone marrow
      cells of CML patients were lower (mean 40 fmol/106 cells) than pernicious anemia
      patients (115 fmol/106 cells). Methotrexate (MTX) increased the uptake in all
      cases. Addition of formyl-THF, methyltetrahydrofolate (methyl-THF), and
      pteroylglutamic acid (PGA) tended to normalize the effect of MTX. In pernicious
      anemia methyl-THF only decreased the uptake in combination with CN-Cbl. dU
      suppression values were significantly higher (6.3%) in CML than in the reference
      group (4.4%), but significantly lower than in pernicious anemia (41.6%) and
      folate deficiency (28.5%). The dU suppression values in bone marrow cells of CML
      patients correlated significantly with the transferrin saturation. In buffy coat
      cells dU suppression values were even higher (9.3%) than in bone marrow cells of
      the same CML patients. Addition of folate forms and CN-Cbl did not change the dU
      suppression values in CML, as it did in pernicious anemia. MTX increased dU
      suppression values significantly in all patients, but more in CML (64.5%) than in
      pernicious anemia (48.6%) and controls (49.8%). The MTX effect was to some extent
      neutralized by folate analogues with formyl-THF as the most effective followed by
      methyl-THF and lastly PGA. Methyl-THF also neutralized MTX in pernicious anemia,
      but its effect was certainly enhanced by addition of CN-Cbl. Thymidine uptake and
      dU suppression patterns were not significantly changed in CML after treatment
      with busulfan for 1 week or in accelerated phase. We concluded that signs of
      cobalamin or folate deficiency (apart from one patient) cannot be demonstrated in
      untreated CML. However, dU suppression was significantly increased and more so in
      circulating myeloid cells than in bone marrow. This indicates a deranged
      metabolism of deoxynucleotides which is independent of cobalamin and folates, and
      a difference between bone marrow cells and circulating cells. dU suppression is a
      valuable indicator of cobalamin deficiency.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7771465
TI  - Opportunistic pulmonary infections with fludarabine in previously treated
      patients with low-grade lymphoid malignancies: a role for Pneumocystis carinii
      pneumonia prophylaxis.
AB  - The high incidence of opportunistic pulmonary infections in fludarabine-treated
      patients at Walter Reed Army Medical Center (WRAMC) and in the literature are
      described. A CancerLit search of fludarabine from June 1983-April 1994 with
      subsequent cross referencing and a retrospective review of all patients receiving
      fludarabine at WRAMC was performed. A total of 2,269 patients with low-grade
      lymphoid malignancies who received 7,547 + cycles of fludarabine were identified
      from the literature. Seventy-three (3.2%) of these patients developed
      opportunistic infections. Seventy-one (97%) of these infections occurred in
      patients who were pretreated with alkylator regimens or corticosteroids. Forty
      five (2%) of these were of respiratory origin and associated with a 56% mortality
      rate. In contrast, 6 of the 21 patients (29%) treated with fludarabine at WRAMC
      developed opportunistic pulmonary infections which included three Pneumocystis
      carinii (PCP), one PCP/disseminated Candidiasis, one Mycobacterium avium
      intracellulare, and one Aspergillus niger pneumonia. These infections developed
      during and after treatment with fludarabine in alkylator-resistant patients who
      had received corticosteroids before (n = 6), during (n = 1), or after (n = 4)
      fludarabine therapy. Lack of PCP prophylaxis was the only significant (P = .018)
      variable that differentiated patients who developed opportunistic pulmonary
      infections. Corticosteroid treatment before, during, or after fludarabine
      treatment in patients with alkylator-resistant, low-grade lymphoid malignancies
      who have not received PCP prophylaxis is associated with an increased risk of
      opportunistic pulmonary infections. Aggressive work-up of pulmonary syndromes and
      PCP prophylaxis in these patients should be considered during and after treatment
      with fludarabine.

PMID- 7771466
TI  - Pretreatment fibrinogen levels are associated with response to chemotherapy in
      patients with small cell carcinoma of the lung: Department of Veterans Affairs
      Cooperative Study 188.
AB  - Small cell carcinoma of the lung (SCCL) responds commonly to combination
      chemotherapy but resistance to therapy follows. Prior reports have suggested that
      a relationship may exist between plasma fibrinogen levels and response to therapy
      in SCCL. This study was designed to determine the possible predictive value of
      the fibrinogen level for tumor response (chemoresistance) in SCCL. Pretreatment
      fibrinogen levels were correlated with outcome and response to therapy in a
      cohort of 119 previously untreated patients with SCCL who were admitted to VA
      Cooperative Study 188. Higher pretreatment fibrinogen levels at diagnosis
      correlated significantly with more advanced stage of disease at entry (P < 0.001)
      and with reduced overall survival (P = 0.030). In addition, higher pretreatment
      fibrinogen levels were correlated significantly with a reduced likelihood of
      achieving subsequent disease regression with combination chemotherapy (P =
      0.005). Because several clinical trials have shown that anticoagulant therapy
      improves tumor response rates and survival of SCCL, we postulate that tumor cell
      thrombin generation not only promotes SCCL growth but may also be primarily
      responsible for both increased fibrinogen levels and for resistance to
      chemotherapy. These findings provide incentive for studies of thrombin effects on
      the development of multidrug resistance, and for new clinical trials of more
      potent and specific inhibitors of thrombin that may further improve tumor
      response and survival in SCCL.

PMID- 7771467
TI  - Large molecule fraction of plasma separated with polyethylene glycol in treatment
      of chronic relapsing thrombotic thrombocytopenic purpura.
AB  - Plasma exchange and plasma infusion are effective in the treatment of patients
      with thrombotic thrombocytopenic purpura (TTP). It has been proposed that some
      component in normal plasma may be deficient in TTP patients. In this experiment
      normal plasma was fractionated and an effective fraction for the treatment of TTP
      was sought. Plasma was fractionated with 5% polyethylene glycol and a large
      molecule fraction was obtained which was composed mainly of proteins and
      lipoproteins with molecules larger than that of IgG. The fraction was dissolved
      in physiological saline and infused in two patients with chronic relapsing TTP
      who had been successfully treated periodically with plasma infusion. Peripheral
      platelet counts and serum LDH levels were measured, and the efficacy of the
      treatment was assessed. Infusion of the large molecule fraction elevated platelet
      counts and lowered the LDH level. However, the efficacy of the large molecule
      fraction was 25 to 50% that of plasma. Components in the fraction may have been
      inactivated partially during preparation. We propose that the large molecule
      fraction contains factors which are effective in some patients with TTP.

PMID- 7771468
TI  - Familial myelodysplastic syndrome with onset late in life.
AB  - A family is described in which three, and possibly four members, namely, the
      propositus, two paternal uncles, and possibly his paternal grandfather, developed
      a myelodysplastic syndrome (MDS) after the age of 60 years. This late onset
      resembles sporadic cases which are commoner in older age, rather than the
      previously reported familial cases most of whom have been children or young
      adults. The three affected members had megaloblastoid bone marrows with an
      increased proportion of bone marrow blasts and developed progressive bone marrow
      failure without leukemic transformation. The propositus showed a dramatic but
      temporary response to GM-CSF therapy but eventually became unresponsive with a
      marked increase in bone marrow reticulin and reduction in hemopoietic elements.
      Affected members had no recognisable bone marrow cytogenetic abnormality but the
      pattern of inheritance and similarity in clinical features suggest an inherited
      genetic defect which predisposes to the development of MDS.

PMID- 7771469
TI  - Transformation of chronic myelomonocytic leukemia to acute lymphoblastic
      leukemia: case report and review of the literature of lymphoblastic
      transformation of myelodysplastic syndrome.
AB  - If chronic myelomonocytic leukemia (CMML) transforms into an acute leukemic
      phase, the blast crisis is invariably myeloid. Occasionally, the other subtypes
      of myelodysplastic syndrome (MDS) (refractory anemia, refractory anemia with
      ringed sideroblasts, refractory anemia with excess blasts, refractory anemia with
      excess blasts in transformation) have been noted to transform into acute
      lymphoblastic leukemia (ALL). We now report a case of CMML that transformed into
      ALL and we review the literature of 13 other cases of MDS with ALL
      transformation. Such cases provide suggestive clinical evidence that MDS can
      involve a pluripotent stem cell.

PMID- 7771470
TI  - Sickle cell anemia and beta-gene cluster haplotypes in Cuba.
AB  - We have studied 91 patients with SS genotype, 44 children and 47 adults.
      Excluding the Cameroon and atypical haplotypes, the distribution in the
      children's sample exhibited 43% Benin, 38% Bantu, and 3% Senegal. In adults, the
      sample exhibited 46% Benin, 30% Bantu, and 9% Senegal (chi 2: 13.511, 2 df, P =
      0.001). When the whole sample of 198 chromosomes (SS, SC, and S/beta thal) is
      considered, we find that the beta s chromosome is linked 51% to the Benin
      haplotype, 41% with the Bantu, and 8% with the Senegal. After adjusting for the
      different frequencies of beta s in Africa, these numbers would predict the port
      of origin to be 16% from Atlantic West Africa, 37.3% from Central West Africa,
      and 46% from Bantu-speaking Africa. This is in direct contradiction with the
      historical record that establishes a higher percentage from Bantu-speaking Africa
      (55%) and a much lower percentage from Senegal (3.4%). The overall conclusions
      from these findings is that there is a loss of Bantu haplotypes in sickle cell
      syndromes in Cuba, particularly among adults, and that there is an excess of
      Senegal haplotype, also among adults. These differences might reflect the
      differential survival and severity of the sickle cell disease linked to these
      haplotypes.

PMID- 7771471
TI  - Treatment of platelet alloimmunization with intravenous immunoglobulin in a child
      with aplastic anemia.
AB  - A 9-year-old girl with severe refractory aplastic anemia had become refractory to
      platelet transfusion due to platelet alloimmunization. As a result, a huge right
      parieto-temporo-occipital cerebral hematoma and a subarachnoid hemorrhage
      subsequently occurred. Intravenous immunoglobulin (IVIG) (Green Cross, Taiwan) at
      a dose of 0.4 g/kg/day for 5 days, followed by another 3 doses during the
      following 5 days, and combined with large-dose platelet transfusions effectively
      controlled the bleeding by elevating the platelet count to above 100 x 10(3)/mm3.
      The patient soon recovered with only a mild sequela. Two months later, because of
      multiple caries and a periodontal abscess, dental extraction needed to be
      performed. IVIG (0.4 g/kg/day x 6 days) enabled surgery to proceed by elevating
      the platelet count to above 55 x 10(3)/mm3, and no bleeding complications
      occurred during or after the procedure. The potential benefit of high-dose IVIG
      in modulating platelet alloimmunization is a result of increasing the survival of
      transfused platelets. Thus, this therapy is recommended when patients with
      platelet alloimmunization have critical bleeding episodes or undergo surgical
      procedures.

PMID- 7771472
TI  - Proposal for a type IV blast in the FAB classification.

PMID- 7771473
TI  - Giant dysplastic neutrophils: possible morphologic evidence of in vivo
      differentiation of leukemia in acute myeloblastic leukemia.

PMID- 7771474
TI  - Serous fat atrophy with leukopenia in severe anorexia nervosa.

PMID- 7771475
TI  - Pure red cell aplasia and cyclosporine.

PMID- 7771476
TI  - Bartter's syndrome: the unsolved puzzle.
AB  - Bartter's syndrome is a congenital abnormality characterized by metabolic
      alkalosis [corrected], hyperreninemic hyperaldosteronism, and hypokalemia. Most
      patients present early in life with symptoms such as muscle weakness and
      polyuria, which may be attributed to potassium depletion. Despite the
      hyperaldosteronism, the patients tend to be normotensive, which is at least
      partially explained by vascular hyporesponsiveness to pressor hormones. Numerous
      studies have documented increased renal excretion of prostaglandins. Several
      different patterns of aberrant renal ion transport have been observed in patients
      with the syndrome, suggesting that it actually may represent a family of related
      but distinct tubular disorders. Therapeutic approaches to Bartter's syndrome
      include potassium supplementation, prostaglandin synthesis inhibitors
      (nonsteroidal anti-inflammatory agents), aldosterone antagonists, and converting
      enzyme inhibitors. During the first two decades following its initial
      description, Bartter's syndrome was the focus of widespread interest, based on
      the likelihood that its investigation might provide insight into the normal
      functioning of the renin-angiotensin-aldosterone and prostanoid hormone systems.
      During the past decade, however, little additional progress has been made in
      Bartter's syndrome, and its patho-physiology remains poorly understood.

PMID- 7771477
TI  - Normal prostaglandinuria E2 in Gitelman's syndrome, the hypocalciuric variant of
      Bartter's syndrome.
AB  - In familial Bartter's syndrome, hyperprostaglandinuria is considered a constant
      feature and prostanoid synthetase inhibition often positively influences the
      disease course. The urinary calcium excretion distinguishes two clinically and
      biochemically different variants, namely, classic Bartter's syndrome
      (normocalciuric or hypercalciuric variant; urinary calcium to creatinine > or =
      35.3 mg/mg 10(-3)) and Gitelman's syndrome (hypocalciuric variant; urinary
      calcium to creatinine < 35.3 mg/mg 10(-3)). In the hypocalciuric variant of
      Bartter's syndrome prostanoid synthetase inhibition is of little benefit. Since
      the production of prostanoids has not been extensively studied in Gitelman's
      syndrome, the urinary excretion of prostaglandin E2 was assessed by
      radioimmunoassay in 11 untreated patients with Gitelman's syndrome (aged 10 to 21
      years; five females and six males) and in 11 healthy controls (aged 11 to 20
      years; five females and six males). The urinary excretion of prostaglandin E2 was
      similar in both study groups. The study provides the rationale for the poor
      effect of prostanoid synthetase inhibition in the hypocalciuric variant of
      Bartter's syndrome. The assessment of urinary excretion of prostaglandin E2 does
      not represent a diagnostic sine qua non in the context of familial Bartter's
      syndrome.

PMID- 7771478
TI  - Liddle's syndrome, an underrecognized entity: a report of four cases, including
      the first report in black individuals.
AB  - Liddle's syndrome, a rare cause of hypokalemic hypertension, is characterized by
      a renal tubular sodium channel defect resulting in excessive sodium absorption
      and concomitant potassium wasting. In this disorder, although the clinical
      manifestations resemble primary aldosteronism, serum and urine aldosterone are
      suppressed. The syndrome is transmitted in an autosomal dominant pattern. It has
      been reported previously in white and oriental populations but not in the black
      individuals. We identified four patients (two of whom are black) in our
      nephrology clinic, with severe hypokalemic hypertension not correctly diagnosed
      for several years. All patients underwent an extensive work-up for secondary
      hypertension because of persistent severe hypertension (average blood pressure,
      210/130 mm Hg) despite high-dose multi-drug therapy. Primary aldosteronism was
      excluded because of low serum aldosterone. Cushing's syndrome, pheochromocytoma,
      renal artery stenosis, and enzymatic deficiencies of cortisol synthesis (11 beta
      hydroxylase, 17 alpha-hydroxylase, 5 beta-reductase, and 11 beta-hydroxysteroid
      dehydrogenase) were ruled out with extensive endocrine and radiologic studies.
      Once the diagnosis of Liddle's syndrome was suspected, all patients were treated
      with either triamterene or ameloride, with resolution of hypokalemia and
      correction of hypertension occurring within 5 to 7 days. Our findings suggest
      that Liddle's syndrome can occur in the black population. Although the actual
      incidence of this syndrome remains unknown, it may be significantly more common
      than we are led to believe since it is inherited in a Mendelian pattern. Whether
      there is a subset of low-renin, salt-sensitive black hypertensive patients who
      have the same or similar sodium channel defect remains to be elucidated.

PMID- 7771479
TI  - Clinical factors associated with urinary albumin excretion in type II diabetes.
AB  - Clinical factors associated with urinary albumin excretion (UAE) in type II
      diabetes are less well known than in type I diabetes. To examine the factors
      associated with UAE in type II diabetes, 933 Appropriate Blood Pressure Control
      in Diabetes Trial patients were classified according to UAE status:
      normoalbuminuria (< 20 micrograms/min), microalbuminuria (20 to 200
      micrograms/min), and macroalbuminuria (> 200 micrograms/min). The class of UAE
      was then correlated with various clinical factors. Using univariate analyses,
      Hispanic ethnicity, African-American race, male gender, poor glycemic control,
      insulin use, long duration of diabetes, dyslipidemia, diastolic and systolic
      hypertension, smoking, and obesity were significantly correlated with
      microalbuminuria and macroalbuminuria. Using multivariate logistic regression
      analyses controlling for diabetes duration, glycosylated hemoglobin, gender, and
      race, the most significant predictors of microalbuminuria and macroalbuminuria
      were systolic hypertension, body mass index, high-density lipoprotein
      cholesterol, insulin use, and smoking pack-years. Of these factors, several are
      potentially reversible with aggressive intervention.

PMID- 7771480
TI  - Primary focal segmental glomerular sclerosis in adults: prognostic value of
      histologic variants.
AB  - Primary focal segmental glomerular sclerosis (FSGS) is a clinicopathologic
      syndrome in which variable amounts of proteinuria are associated with the renal
      biopsy finding of segmental glomerular scarring in some, but not all, of the
      glomeruli. Additional histologic features have been described in FSGS, including
      the position of the scar relative to the vascular and tubular pole of the
      glomerulus, foam cells, hyalinosis, mesangial deposits of immunoglobulin M,
      diffuse mesangial hypercellularity, glomerular visceral epithelial cell
      hyperplasia and hypertrophy, and the extent of associated interstitial fibrosis
      and tubular atrophy. We performed a retrospective study on 81 patients with
      biopsy-proven, primary FSGS to determine whether any of the histologic features
      of FSGS correlated with renal function at the time of biopsy and the incidence of
      end-stage renal disease at follow-up. Sixty patients were nephrotic and 21 had
      nonnephrotic proteinuria. Only the degree of interstitial fibrosis correlated
      with the initial serum creatinine (r = 0.536) and none of the histologic features
      predicted the presence of nephrotic-range proteinuria at the time of biopsy.
      Segmental scars involved 21% +/- 14% of the glomeruli per biopsy specimen, but
      their position within the glomerulus was uniform in only 13% of the cases.
      Diffuse mesangial hypercellularity was present in 17% of the biopsy specimens,
      and glomerular epithelial cell lesions were present in 57% of the biopsy
      specimens. Multivariate analysis showed that only the degree of interstitial
      fibrosis predicted end-stage renal disease in all 81 patients and in the 60
      patients with nephrotic-range proteinuria. The current data do not support
      different therapeutic approaches in primary FSGS based on histologic subtypes.

PMID- 7771481
TI  - Paramesangial glomerular deposits in membranoproliferative glomerulonephritis
      type II correlate with hypocomplementemia.
AB  - To gain support for a previously proposed hypothesis that nephritic factors
      predispose to chronic glomerulonephritis, the glomerular deposits of patients
      with membranoproliferative glomerulonephritis type II have been studied by
      electron microscopy and immunofluorescence and the results correlated with the C3
      level at the time of biopsy. If, as hypothesized, circulating convertase
      predisposes to nephritis, finding that the glomeruli of patients
      hypocomplementemic at biopsy, presumably with nephritic factor-stabilized
      convertase in their circulation, differ from those of patients
      normocomplementemic at biopsy would suggest that circulating convertase in some
      way alters the glomerulus. Among 25 biopsy specimens from 12 patients,
      hypocomplementemia did not correlate with capillary loop deposits, but there was
      strong correlation with deposits in the paramesangial region as detected by
      electron microscopy. Of 11 patients who were normocomplementemic at biopsy, none
      had paramesangial deposits in their glomeruli. Of 14 patients who were
      hypocomplementemic at biopsy, deposits were present in the paramesangium in 12
      patients (P < 0.001). The deposits were either on both sides of the paramesangial
      segment of the basement membrane (waist basement membrane related) or in
      apposition to the paramesangial basement membrane in a subepithelial position
      only. The detection of paramesangial deposits in the ultrastructure correlated
      with the detection of C3-containing mesangial granules by immunofluorescence;
      immunoglobulin G, C5, properdin, and factor B could not be demonstrated in these
      granules. The study identifies the mesangial deposits described by others in
      membranoproliferative glomerulonephritis type II as paramesangial deposits and,
      more importantly, demonstrates that their presence correlates closely with
      hypocomplementemia. It is likely that these deposits in some way result from the
      presence in the circulation of convertase stabilized by the nephritic factor of
      the amplification loop.

PMID- 7771482
TI  - A review of therapeutic studies of idiopathic membranous glomerulopathy.
AB  - The treatment of idiopathic membranous glomerulopathy remains an enigma. We have
      reviewed many of the important clinical trials concerning membranous
      glomerulopathy using a meta-analysis and a secondary pooled analysis to test the
      effects of corticosteroid or alkylating, therapy compared with no treatment on
      renal survival and complete remission of the nephrotic syndrome. A search was
      performed using MEDLINE (1968 through 1993) for articles on idiopathic membranous
      glomerulopathy and glomerulonephritis. Bibliographies of articles were reviewed
      for completeness. Sixty-nine articles were reviewed. Meta-analysis was performed
      for four trials that evaluated corticosteroids compared with no treatment and for
      three trials that evaluated alkylating therapy compared with no treatment. Pooled
      analysis was performed on randomized and prospective studies (10 studies) and
      then with 22 case series added. All studies evaluated renal biopsy-proven
      disease. Meta-analysis was performed on the relative chance of being in complete
      remission for each study. Renal survival could be evaluated by pooled analysis
      only. For pooled analyses, Cox's proportional hazard and logistic regression
      models were used to test the effect of therapy on renal survival and the
      nephrotic syndrome, respectively. Data concerning gender, nephrotic syndrome, and
      geographic region were used in all statistical models. Evaluation of renal
      survival revealed no differences by treatment group (P > 0.1). By meta-analysis,
      the relative chance of complete remission was not improved for corticosteroid
      treated patients (1.55; 95% confidence interval, 0.99 to 2.44; P > 0.1), but was
      improved for patients treated with alkylating agents (4.8; 95% confidence
      interval, 1.44 to 15.96; P < 0.05) when compared with no treatment. Pooled
      analysis of randomized and prospective studies, as well pooled analysis with all
      studies, supported the findings of the meta-analysis. Corticosteroids or
      alkylating therapy did not improve renal survival in idiopathic membranous
      glomerulopathy. Complete remission of the nephrotic syndrome was observed more
      frequently with the use of alkylating agents.

PMID- 7771483
TI  - Renal biopsy as an outpatient procedure.
AB  - We evaluated the safety and efficacy of outpatient renal biopsy by prospectively
      comparing outpatient and inpatient renal biopsies in which patients were given
      the choice between having the procedure as an inpatient or an outpatient. Three
      hundred fifty renal biopsies were performed between January 1992 and August 1994;
      118 patients had the procedure as an outpatient and 232 patients had the
      procedure with discharge planned for the following day. There was no difference
      between the two groups in terms of patient age, sex, or renal function. The
      complication rate for the two groups was not significantly different, with two
      inpatients having loin pain and one having macroscopic hematuria compared with
      one outpatient having loin pain and one having macroscopic hematuria. The
      biopsies provided samples of comparable size. We conclude that outpatient renal
      biopsy is a safe procedure and provides adequate tissue samples.

PMID- 7771484
TI  - Effect of administering calcium carbonate to treat secondary hyperparathyroidism
      in nondialyzed patients with chronic renal failure.
AB  - We administered calcium carbonate orally to determine its safety and efficacy in
      treating nondialyzed patients with mild to moderate renal failure and secondary
      hyperparathyroidism. Twenty patients with chronic renal failure (creatinine
      clearance levels ranging from 7.9 to 42.7 mL/min) participated in this study.
      After a 6-month control period, 3 g calcium carbonate was administered daily for
      6 months. We studied the effect for another 6 months after discontinuation of the
      regimen. We found that serum-intact parathyroid hormone was suppressed from 183
      +/- 149 pg/mL to 85 +/- 61 pg/mL (P < 0.05) by treatment. This suppression was
      achieved with no increase in serum concentrations of 1,25(OH)2D3. Serum
      phosphorus levels decreased from 3.4 +/- 0.7 to 3.0 +/- 0.7 mg/dL (P < 0.01) and
      Ca2+ concentration increased significantly from 2.40 +/- 0.12 mEq/L to 2.57 +/-
      0.08 mEq/L (P < 0.001) at 6 months. These changes were reversed after the 6-month
      period of withdrawal from calcium carbonate. Deterioration of renal function was
      not exacerbated by the therapy. Calcium carbonate administration also suppressed
      the serum concentrations of alkaline phosphatase and osteocalcin, indicating that
      improvement of hyperparathyroid bone disease is possible without a vitamin D3
      supplement at an earlier stage of renal failure. Thus, administration of 3 g oral
      calcium carbonate daily was highly effective in treating secondary
      hyperparathyroidism in patients with mild to moderate renal failure.

PMID- 7771485
TI  - Determination of protein catabolic rate in patients on chronic intermittent
      hemodialysis: urea output measurements compared with dietary protein intake and
      with calculation of urea generation rate.
AB  - We assessed the agreement between different methods of determining protein
      catabolic rate (PCR) in hemodialysis patients and the possible influence of
      postdialysis urea rebound and the length of the interdialytic interval on the PCR
      determination. Protein catabolic rate derived from measured total urea output was
      compared with recorded daily protein intake (DPI) and calculated urea generation
      rate (G), calculated by the interdialytic increase in serum urea and an estimated
      urea distribution volume using either the Watson equation or 58% of postdialysis
      body weight, and by single-pool urea kinetic modelling. In 16 patients PCR
      derived from calculated G by fixed urea distribution volume showed a significant
      decrease with blood samples obtained 10 minutes after dialysis onward as compared
      with immediately after dialysis, leading to an approximately 6% decrease at 60
      minutes. Protein catabolic rate values derived from blood samples taken 15 to 60
      minutes after dialysis were not significantly different. Urea kinetic modelling
      led to a significant increase in calculated PCR with samples from 5 minutes after
      dialysis onward and a total increase by 11.5% at 60 minutes. Different methods
      for determining PCR were compared in 13 clinically stable outpatients treated
      with conventional hemodialysis on cellulose acetate membrane dialyzers during 1
      week. The mean PCR calculated from measured total urea output was 61.3 g/24 hr
      (range, 43.7 to 83.2 g/24 hr). Assessment of DPI as compared with PCR calculated
      from measured total urea output was lower by 7.5% (95% confidence intervale [CI],
      1.4 to 17.5).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771486
TI  - On complement net generation in fast hemodialysis: are high blood flow rates
      bioincompatible?
AB  - Arterial and venous concentrations of complement (C3a) and leukocyte count were
      determined in 17 patients during 201 hemodialysis sessions by 12 different
      treatment modes executed in random order using cuprophan, hemophan, or polyamide
      membranes with small or large membrane areas and high blood flow (Qb) (400
      mL/min) for 2 hours or low Qb (200 mL/min) for 4 hours. With all membrane types,
      the number of leukocytes was significantly higher after 120 minutes of dialysis
      and by the end of treatment at high Qb compared with low Qb. C3a concentrations
      (microgram/mL) in the arterial and venous blood lines were significantly higher
      during cuprophan dialysis compared with hemophan and polyamide dialyses (P <
      0.001). In addition, the net generation of C3a (microgram/min) was significantly
      higher during hemodialysis with cuprophan compared with hemophan and polyamide (P
      < 0.001). After 2 hours at high Qb for each of the three membranes, the net
      generation of C3a was significantly higher compared with low Qb (P < 0.05 for all
      comparisons). Possible reasons for the increase in the net generation of C3a
      (microgram/min) at high Qb are less protein deposition on the membrane at high Qb
      or the fact that the protein coat is stripped off in the dialyzer, thereby
      recreating a less biocompatible surface. Hemodialysis at high Qb may thus be less
      biocompatible than dialysis at low Qb.

PMID- 7771487
TI  - The efficacy of erythropoietin in human immunodeficiency virus-infected end-stage
      renal disease patients treated by maintenance hemodialysis.
AB  - The superimposition of human immunodeficiency virus (HIV) infection, associated
      opportunistic infections, and anti-retroviral therapy further worsens the
      severity of anemia in patients also suffering from end-stage renal disease. A
      major cause of anemia in renal failure is a deficiency of erythropoietin. The
      causes of anemia in HIV disease include direct and indirect stem cell inhibition
      by the virus, increased peripheral destruction of red blood cells, and bone
      marrow suppression by various opportunistic infections and therapeutic drugs,
      particularly zidovudine. We compared the efficacy of recombinant human
      erythropoietin (rHuEPO) therapy in improving the anemia in HIV-infected end-stage
      renal disease patients (group I) with that in nondiabetic (group II) and diabetic
      (group III) hemodialysis patients without HIV infection. All three groups of
      patients were comparable in dialysis prescription and serum iron studies. Iron
      supplementation was prescribed to all patients, and none received blood
      transfusions. After 8 weeks of rHuEPO therapy (administered intravenously in a
      dose of 100 U/kg body weight thrice weekly), the mean increase in hematocrit was
      similar in all responders (5.8% increase in hematocrit in 23 of 30 HIV patients
      and 6.7% increase in 24 of 30 non-HIV patients). Response in hematocrit was noted
      in HIV patients despite the presence of opportunistic infections in 15 and
      zidovudine administration in 11. Seven HIV-positive patients and six non-HIV
      patients failed to respond to rHuEPO. Irrespective of the HIV status, the
      baseline serum EPO levels in patients responding to rHuEPO were significantly
      lower than those in nonresponders.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771488
TI  - Oral calcium carbonate administration ameliorates the progression of renal
      failure in rats with hypertension.
AB  - Oral calcium supplementation is reported to have phosphate-binding and
      antihypertensive effects. Since both phosphate binders and antihypertensive
      agents are reported to attenuate renal injury, we studied the effect of oral
      calcium carbonate (CaCO3) administration on the course of renal deterioration
      using doxorubicin-induced renal failure in rats treated with deoxycorticosterone
      acetate and salt for 10 weeks. Rats were divided into four groups: the CaCO3 (6.0
      g/kg/d) group (n = 12), the aluminum hydroxide (Al(OH)3; 6.0 g/kg/d) group (n =
      11, as a phosphate-binder control), the hydralazine (10 mg/kg/d) group (n = 11,
      as an antihypertensive control), and the control group (n = 12). All agents were
      given as a mixed chow diet. Blood pressure and urinary protein excretion
      progressively increased in the control rats. CaCO3 and hydralazine lowered blood
      pressure, but Al(OH)3 did not (185 +/- 4 mm Hg, control; 160 +/- 5 mm Hg, CaCO3;
      171 +/- 8 mm Hg, Al(OH)3; 156 +/- 5 mm Hg, hydralazine at week 10). Proteinuria
      was reduced in the rats treated with CaCO3 and Al(OH)3 compared with those
      without the treatment (986 +/- 86 mg/d, control; 551 +/- 54 mg/d, CaCO3; 527 +/-
      31 mg/d, Al(OH)3; and 955 +/- 68 mg/d, hydralazine at week 10). Serum phosphate
      concentration and calcium phosphate products also were significantly lower in
      both the CaCO3 and Al(OH)3 groups than in the control group. At week 10,
      increased serum urea nitrogen, impaired renal function, and glomerular sclerosis
      present in the control group were significantly attenuated in both in the CaCO3
      and Al(OH)3 groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771489
TI  - Alterations in renal endothelin production in rats with reduced renal mass.
AB  - Renal endothelin-1 (ET-1) production is diminished in spontaneously hypertensive
      rats. An increase has been reported of renal ET-1 production associated with
      progression of renal disease in rats with reduced renal mass. The purpose of the
      present study was to investigate the evolution over time of the urinary ET-1
      excretion in an experimental model of renal mass reduction not caused by renal
      infarction. Rats were subjected to 2/3 nephrectomy (right nephrectomy and
      resection of the lower left renal pole) and thereafter randomly assigned to a no
      treatment control group or to treatment with recombinant erythropoietin,
      recombinant erythropoietin plus verapamil, or recombinant erythropoietin plus
      enalapril. The urinary ET-1 excretion was decreased by week 16 after nephrectomy
      as compared with healthy animals and with the levels 6 weeks after nephrectomy.
      The temporal evolution of urinary ET-1 excretion in the various groups of rats
      showed a trend toward decrease in all groups except the one receiving enalapril.
      The urinary ET-1 excretion correlated directly with creatinine clearance and
      inversely with tubulointerstitial damage. We observed an inverse correlation
      between urinary ET-1 excretion and arterial blood pressure 16 weeks after
      nephrectomy. These results indicate that renal ET-1 production decreases with the
      progression of renal disease and in relation with the severity of
      tubulointerstitial damage. The decrease in renal ET-1 production might contribute
      to the development and perpetuation of renal disease-associated arterial
      hypertension; this situation may be favorably modified by the use of enalapril.

PMID- 7771490
TI  - Liddle's syndrome: a public health menace?

PMID- 7771491
TI  - Tumefactive megalocytic interstitial nephritis in a patient with Escherichia coli
      bacteremia.
AB  - Megalocytic interstitial nephritis is rare and primarily affects the cortex in an
      otherwise normal kidney. We recently encountered a patient with Escherichia coli
      bacteremia and oliguric acute renal failure who died of gram-negative septicemia.
      At autopsy, this patient's kidneys displayed typical features of megalocytic
      interstitial nephritis. We were able to perform special stains suggesting that
      the histiocytic interstitial cells originated from infiltrating macrophages. Our
      patient illustrates that macrophage proliferation can result in interstitial
      inflammation sufficiently severe to cause anuric acute renal failure.

PMID- 7771492
TI  - Acute interstitial nephritis associated with ticlopidine.
AB  - Ticlopidine, a platelet aggregation inhibitor, has been approved to decrease the
      risk of thrombotic stroke. We describe a 75-year-old white woman who developed
      acute renal failure 10 days after initiating ticlopidine therapy. A renal biopsy
      revealed interstitial infiltrates containing lymphocytes and eosinophils. To our
      knowledge this is the first report of ticlopidine-induced acute interstitial
      nephritis.

PMID- 7771493
TI  - Renal hypouricemia: prevention of exercise-induced acute renal failure and a
      review of the literature.
AB  - Isolated renal hypouricemia from defective uric acid reabsorption and/or
      secretion is a well-described entity, with a prevalence of 0.12% to 0.20% in
      Japan. It is rarely associated with exercise-induced acute renal failure (ARF).
      The etiology of ARF is debated. Prevention of ARF in renal hypouricemia has not
      been previously addressed. A 29-year-old Pakistani man had recurrent exercise
      induced ARF. He was found to have isolated renal hypouricemia; serum uric acid
      0.5 mg/dL, 24-hour urine uric acid 472 +/- 25 mg (+/- SD), and fractional
      excretion of uric acid 55.2% to 69.4%. Both pyrazinamide and probenecid decreased
      fractional excretion of uric acid and uric acid excretion rate (UV(Urate)) in our
      patient, suggesting either a partial presecretory and postsecretory reabsorption
      defect or increased secretion. We investigated renal uric acid excretion during
      exercise in our patient and four control subjects. All five subjects underwent a
      physical fitness test (PFT). Our patient developed ARF. Uric acid excretion rate
      increased in our patient, from 0.48 mg/min at baseline to 1.49 mg/min 4 hours
      after the PFT, as did the urine uric acid to urine creatinine ratio (UUa)/UCr)
      (0.29 to 1.49). In the controls, UV(Urate) and UUA/UCr were unchanged after the
      PFT: UV(Urate) was 0.46 +/- 0.10 mg/min at baseline and 0.59 +/- 0.04 mg/min 4
      hours after the PFT, while UUA/UCr was 0.30 +/- 0.04 at baseline and 0.36 +/-
      0.04 at 4 hours. All five subjects took allopurinol 300 mg daily for 5 days and
      repeated the PFT. In our patient, allopurinol prevented the ARF as well as the
      exercise-induced increases in UV(Urate) (0.28 mg/min to 0.22 mg/min) and UUA/UCr
      (0.25 to 0.17). In the controls, the UV(Urate) and UUA/UCr responses to exercise
      were not altered. We conclude that increased renal excretion of uric acid during
      exercise was responsible for the ARF in our patient with renal hypouricemia and
      that successful prophylaxis with allopurinol is possible.

PMID- 7771494
TI  - Common variable immunodeficiency in a renal transplant patient with severe
      recurrent bacterial infection: a case report and review of the literature.
AB  - The second reported case of common variable immunodeficiency (acquired
      agammaglobulinemia) after renal transplantation is presented. Agammaglobulinemia
      presumably resulted from long-standing immunosuppression. This case and our
      review of the literature indicate that agammaglobulinemia is a rare event after
      transplantation but can be treated successfully with intravenous immunoglobulin.
      Additionally, hypogammaglobulinemia occurs frequently after transplantation and
      should be monitored and treated in appropriate clinical situations. The treatment
      of our patient with intravenous immunoglobulin also suggests that patients with
      common variable immunodeficiency can undergo renal transplantation.

PMID- 7771495
TI  - Lipoprotein glomerulopathy with a new apolipoprotein E phenotype.

PMID- 7771496
TI  - Biologic control of the tumor necrosis factor and interleukin-1 signaling
      cascade.
AB  - It is clear that activation of the proinflammatory cytokine cascade is both the
      cause and the consequence of renal injury. Recently, it has been appreciated that
      a rich network of signaling pathways contributes to modulation of tumor necrosis
      factor-alpha (TNF) and interleukin-1 (IL-1) bioactivity, both in vitro and in
      vivo. Insight into the checks and balances that intervene or temper endogenous
      cytokine effector mechanisms has arisen from an explosion of new information on
      the cell biology of proinflammatory cytokines. Novel mechanisms of cytokine
      regulation are currently being described and hold promise for therapeutic
      potential: soluble cytokine receptors, endogenous receptor antagonists, and anti
      inflammatory cytokines such as IL-4, IL-10, and IL-13.

PMID- 7771497
TI  - Magnesium deficiency: pathophysiologic and clinical overview.

PMID- 7771498
TI  - Percutaneous transhepatic PermCath for hemodialysis vascular access.

PMID- 7771499
TI  - Early repolarization on scalar electrocardiogram.
AB  - Sixty thousand electrocardiograms were analyzed for 5 years. Six hundred (1%)
      revealed early repolarization (ER). Features of ER were compared with race-, age
      , and sex-matched controls (93.5% were Caucasians, 77% were males, 78.3% were
      younger than 50 years, and only 3.5% were older than 70). Those with ER had
      elevated, concave, ST segments in all electrocardiograms (1-5 mv), which were
      located most commonly in precordial leads (73%), with reciprocal ST depression
      (50%) in a VR, and notch and slur on R wave (56%). Other results included sinus
      bradycardia in 22%, shorter and depressed PR interval in 38%, slightly
      asymmetrical T waves in 96.7%, and U waves in 50%. Sixty patients exercised
      normalized ST segment and shortened QT interval (83%). In another 60 patients,
      serial studies for 10 years showed disappearance of ER in 18%, and was seen
      intermittently in the rest of the patients. The authors conclude that in these
      patients with ER: 1) male preponderance was found; 2) incidence in Caucasians was
      as common as in blacks; 3) patients often were younger than 50 years; 4) sinus
      bradycardia was the most common arrhythmia; 5) the PR interval was short and
      depressed; 6) the T wave was slightly asymmetrical; 7) exercise normalized ST
      segment; 8) incidence and degree of ST elevation reduced as age advanced; 9)
      possible mechanisms of ER are vagotonia, sympathetic stimulation, early
      repolarization of sub-epicardium, and difference in monophasic action potential
      observed on the endocardium and epicardium.

PMID- 7771500
TI  - Case report: lanreotide in the management of hypercalcemia of malignancy.
AB  - The management of hypercalcemia of malignancy (HCM) is difficult if the
      underlying neoplasm cannot be treated successfully. The overexpression of
      parathyroid hormone-related protein (PTHrP) by various neoplasms is a common
      mechanism of HCM and usually is a premorbid event. Current pharmacologic measures
      to control HCM are directed more toward inhibiting the action rather than
      inhibiting the secretion of PTHrP. The somatostatin congeners are a novel class
      of drugs that can inhibit some excessive hormonal states. In this report, the
      authors summarize an observation made using lanreotide, an investigational
      somatostatin congener, in treating a patient with a neuroendocrine neoplasm.
      Lanreotide administration resulted in normalizing the serum calcium levels while
      decreasing plasma PTHrP concentrations. The chronic administration of lanreotide
      produced a stable radiographic response and controlled the HCM without adverse
      side effects. The somatostatin congeners potentially offer another therapeutic
      modality in managing HCM.

PMID- 7771501
TI  - Case report: reversible QT prolongation with torsades de pointes in a patient
      with pimozide intoxication.
AB  - Pimozide is a diphenylpiperidine neuroleptic with well characterized
      cardiovascular side effects including QT prolongation. So far, life-threatening
      cardiac arrhythmias, in particular torsades de pointes, have not been described
      in patients treated with pimozide. The authors describe a patient in whom
      torsades de pointes developed after the ingestion of 800 mg pimozide as a suicide
      attempt. After intravenous treatment with lidocaine and magnesium, the patient
      recovered completely and the QT interval had normalized 5 days after the
      intoxication. Potential mechanisms leading to torsades de pointes in patients
      treated with pimozide are discussed.

PMID- 7771502
TI  - Case report: hypoglycemia secondary to a meningioma.
AB  - Hypoglycemia secondary to a meningioma that has not metastasized to the liver has
      not been reported previously. A 41-year-old woman with a spinal cord meningioma
      first diagnosed 5 years previously with 3 recurrences in the spinal cord
      resulting in 4 neurosurgical procedures was admitted with a serum glucose of 23
      mg/dL. Six months before the current admission, the patient was noted to have an
      abdominal mass of 10 cm not present on previous computed tomography. Three months
      later, the mass was 15.2 cm, and on the current admission, had increased to 23 cm
      and encased both the aorta and inferior vena cava. A needle biopsy of this mass
      before referral to the authors' hospital with hypoglycemia revealed that it was a
      meningioma. Evaluation of the etiology of the hypoglycemia, which required
      continuous intravenous glucose therapy, revealed that circulating insulin, C
      peptide (i.e., connecting peptide), insulin-like growth factor-I (i.e.,
      somatomedin-C) and insulin-like growth factor-II were all normal or low. Serum
      cortisol also was not low. Based on her endocrine evaluation, the hypoglycemia
      was secondary to the large mass of tumor cells, requiring a large glucose uptake
      to sustain its growth. After radiation therapy of 3,770 CGy to the meningioma,
      the patient became euglycemic without glucose supplementation.

PMID- 7771503
TI  - Case report: diabetic ketoacidosis in a patient with glucagonoma.
AB  - The development of diabetic ketoacidosis is an unusual complication of a glucagon
      secreting pancreatic islet cell neoplasm, with only four reported cases in the
      literature. In this article, the authors report on a 46-year-old woman with a
      glucagonoma cosecreting pancreatic polypeptide, somatostatin, and serotonin
      diagnosed 8 months before the onset of diabetic ketoacidosis. She was treated
      with hydration, insulin, and octreotide, with improvement in her clinical course
      and a decrease in the glucagon, pancreatic polypeptide, and chromogranin A plasma
      levels. With the addition of weekly 5-FU, she has maintained a partial
      radiographic response and has had no further episodes of diabetic ketoacidosis
      for a 4.5-year period. Diabetic ketoacidosis can develop in the presence of a
      glucagonoma, and the pathophysiology remains unknown.

PMID- 7771504
TI  - Southwestern Internal Medicine Conference: mastocytosis: developments during the
      past decade.
AB  - Mastocytosis is a spectrum of disorders characterized by an aberrant
      proliferation of tissue mast cells. Although this disease process often affects
      the skin, it may involve multiple organs. The clinical disorder varies according
      to patient age, the clinical manifestations demonstrated, and the extent of the
      mast cell proliferative process. A myriad of clinical symptoms occur, and these
      may be localized to the organ system involved or may be systemic, depending on
      whether there is local or generalized mast cell mediator release. Diagnosis
      includes the demonstration of increased tissue mast cells in involved organs as
      well as increased levels of biochemical mediators. Patients with cutaneous
      involvement only have the best prognosis. Treatment is directed toward
      stabilizing mast cell mediator release and blocking the effects of those
      mediators generated.

PMID- 7771505
TI  - Southwestern Internal Medicine Conference: difficult-to-treat hypertension.
AB  - In this article, the author identifies the major causes of difficult-to-treat
      hypertension and provides guidelines for its management. The data were obtained
      from multiple clinical series of patients with hypertension resistant to therapy,
      reports of over-sensitivity to antihypertensive drugs, and the effects of anxiety
      induced hyperventilation. As many as 15% of patients are resistant to
      antihypertensive therapy. Of the multiple possible causes for resistance, volume
      overload is the most common. Volume overload, in turn, is related to multiple
      factors, with inadequate diuretic therapy playing a major role. Many patients may
      experience tissue hypoperfusion when given usual doses of antihypertensive
      therapy, making their hypertension difficult to treat. In the author's
      experience, an even larger number of patients have psychosomatic symptoms,
      usually attributable to anxiety-induced hyperventilation, that often are blamed
      on their therapy. Therefore, hypertension may be difficult to treat for various
      reasons. When the cause is recognized, appropriate management almost always can
      be provided.

PMID- 7771506
TI  - 64th Annual meeting of the American Association of Physical Anthropologists.
      Oakland, California, March 28-April 1, 1995. Abstracts.

PMID- 7771507
TI  - Neutral phosphate administration generates and maintains renal metabolic
      alkalosis and hyperparathyroidism.
AB  - We examined the effects of chronic intravenous neutral phosphate administration
      on systemic acid-base equilibrium and parathyroid function in six normal, NaCl
      replete male human subjects under metabolic balance conditions. The subjects
      received 4.35 mmol of neutral sodium phosphate.kg body wt-1.day-1 intravenously
      and continuously for 7 days and the same amount of sodium as NaCl during control
      and recovery. Blood pH increased from 7.388 to 7.411 (P < 0.001) and plasma
      bicarbonate from 23.5 to 26.0 mmol/l (P < 0.001). Urinary pH increased from 6.58
      to 6.79 (P < 0.001). Net acid excretion increased from 59 to 100 mmol/24 h (P <
      0.001). Plasma ionized calcium concentration decreased and plasma phosphate
      concentration increased transiently. Serum intact parathyroid hormone increased
      from 24 to 62 pg/ml (P < 0.001). Chronic phosphate administration also resulted
      in a significant increase in renal phosphate clearance (35 to 229 ml/min) and
      decrease in the fractional excretion of calcium (1.8 to 0.9%). Thus chronic
      intravenous phosphate administration generates and maintains renal metabolic
      alkalosis in salt-replete humans and induces hyperparathyroidism. The severity of
      metabolic alkalosis is mitigated by an apparent increase in effective endogenous
      acid production as evidenced by the significant increase in steady-state net acid
      excretion.

PMID- 7771508
TI  - Activation of protein kinase C stimulates cAMP phosphodiesterase in rat renal
      collecting tubule.
AB  - The present study was undertaken to evaluate whether protein kinase C (PKC)
      affects adenosine 3',5'-cyclic monophosphate phosphodiesterase (cAMP-PDIE)
      activity in microdissected rat renal medullary collecting tubules (MCT). Phorbol
      12-myristate 13-acetate (PMA, 10(-8) M), an activator of PKC, significantly
      stimulated cAMP-PDIE activity in intact MCT (29.5 +/- 1.5 to 38.3 +/- 3.7
      fmol.min-1.mm-1, P < 0.05) but not in the proximal straight tubule [4.7 +/- 0.8
      vs. 4.8 +/- 0.8, not significant (NS)] or the medullary ascending limb of Henle's
      loop (20.5 +/- 2.1 vs. 22.4 +/- 2.8, NS). PMA-stimulated cAMP-PDIE activity was
      reversed by PKC inhibitors, staurosporine (10(-8) M) and calphostin C (10(-8) M),
      but not by the cyclooxygenase inhibitor, indomethacin (5 x 10(-6) M). 1,2
      Dioctanoyl-sn-glycerol (50 micrograms/ml), a synthetic analogue of diacylglycerol
      that stimulates PKC, also increased cAMP-PDIE activity in broken-cell
      preparations from MCT. This stimulation was also suppressed by staurosporine (10(
      8) M) and calphostin C (10(-8) M). The stimulatory effect of PMA on cAMP-PDIE
      activity was lost with rolipram (10(-4) M), a type IV PDIE inhibitor, whereas it
      was preserved with N-(6-amino-hexyl)-5-chloro-1-naphthalenesulfonamide
      hydrochloride (W-7) (10(-4) M), a calmodulin inhibitor, or vinpocetin (10(-4) M),
      a direct inhibitor of type I PDIE. From these results, we suggest that activation
      of PKC specifically stimulates rolipram-sensitive cAMP-PDIE, but not the
      calmodulin-sensitive isozyme, in rat MCT.

PMID- 7771509
TI  - Ontogeny of rabbit renal cortical NHE3 and NHE1: effect of glucocorticoids.
AB  - The neonatal proximal tubule has a lower rate of bicarbonate absorption and
      Na+/H+ antiporter activity than the proximal tubule of adult animals. Two
      isoforms of the Na+/H+ antiporter have been localized to the proximal tubule.
      NHE3 is located on the apical membrane, whereas NHE1, the isoform found on most
      mammalian cells, is present on the basolateral membrane. The Na+/H+ antiporter
      isoforms that increase with renal maturation are unknown. The purpose of the
      present study was to examine the maturation of rabbit renal cortical NHE3 and
      NHE1 mRNA and protein abundance and to determine whether the rate of maturation
      of these isoforms was affected by glucocorticoids. Renal cortex from neonatal
      rabbits (1 wk) had approximately one-fourth the NHE3 mRNA and protein abundance
      as that from adult animals. Renal cortical NHE1 mRNA and protein abundance did
      not change significantly during maturation. Glucocorticoids have been shown to
      accelerate the maturation of neonatal bicarbonate absorption and apical membrane
      Na+/H+ antiporter activity. Daily subcutaneous administration of dexamethasone
      starting at 4 days of age (10 micrograms/100 g body wt) for 3 days and 2 h before
      being killed resulted in a twofold increase in NHE3 mRNA abundance and a
      threefold increase in NHE3 protein abundance. NHE1 mRNA and protein abundance
      were unaffected. These data show that there is selective maturation of NHE3
      during renal cortical development, which can be accelerated by administration of
      glucocorticoids.

PMID- 7771510
TI  - ANG II dependence of tubuloglomerular feedback responsiveness in hypertensive ren
      2 transgenic rats.
AB  - The present study was performed to determine the angiotensin II (ANG II)
      dependence of stop-flow pressure (SFP) tubuloglomerular feedback responses in
      hypertensive transgenic rats [strain name: TGR(mRen2)27] harboring the mouse ren
      2 renin gene. SFP feedback responses to increases in late proximal perfusion rate
      were assessed in pentobarbital-anesthetized male ren-2 transgenic rats during
      control conditions and after administration of the AT1 receptor antagonist, L
      158,809 (1 mg/kg iv). During control conditions, increases in late proximal
      perfusion rate elicited flow-dependent decreases in SFP. The magnitude of the
      maximal SFP feedback response to a late proximal perfusion rate of 40 nl/min
      averaged 16.1 +/- 1.4 mmHg (n = 7), a value higher than that normally observed in
      normotensive rats. Administration of L-158,809 decreased mean arterial blood
      pressure (174 +/- 6 vs. 117 +/- mmHg, P < 0.01, n = 10) and attenuated the
      magnitude of the maximal SFP feedback response by 84 +/- 4% (16.1 +/- 1.4 vs. 2.6
      +/- 0.5 mmHg, P < 0.01, n = 7). In contrast, mechanical reduction of renal
      arterial pressure from 179 +/- 5 to 113 +/- 1 mmHg (P < 0.01, n = 7) attenuated
      the magnitude of the maximal SFP feedback response by only 43 +/- 5% (14.4 +/-
      1.9 vs. 7.9 +/- 0.7 mmHg, P < 0.01, n = 7), indicating that approximately one
      half of the attenuation of SFP feed-back responses elicited by AT1 receptor
      blockade was due to removal of the stimulatory effect of ANG II on the
      sensitivity of the tubuloglomerular feedback mechanism.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7771511
TI  - Convergence of apical and basolateral endocytic pathways for beta 2-microglobulin
      in LLC-PK1 cells.
AB  - Polarized epithelial cells internalize molecules from both apical and basolateral
      (BL) plasma membrane (PM) domains via receptor-mediated endocytosis. In the
      kidney, low-molecular-weight proteins (LMWP) are internalized across the apical
      membrane of proximal tubule cells and degraded in lysosomes. Although indirect
      evidence suggests some uptake may occur at the BL surface, in vivo studies
      performed in rats suggest little if any LMWP uptake occurs at the BL surface. The
      studies presented here showed that native human beta 2-microglobulin (beta 2M)
      was internalized across the apical surface and followed the same intracellular
      pathway in the proximal tubule-derived cell line LLC-PK1 as that described in
      vivo. Either 125I- or gold-labeled beta 2M (125I-beta 2M and gold-beta 2M) bound
      specifically and reversibly to the apical surface of confluent LLC-PK1 cells.
      These results were qualitatively similar to previously documented in vivo
      results. Subsequently, using gold-beta 2M and LLC-PK1 cells grown on porous
      supports, we showed that a functional uptake system for the LMWP beta 2M was
      present at the BL surface. Finally, using different-size gold particles
      conjugated to beta 2M applied simultaneously to the apical and BL surfaces, we
      observed that apical and BL endocytic routes converged in multivesicular acid
      phosphatase-negative endosomal structures. Taken together, these data imply that
      beta 2M can be internalized across both apical and BL domains and that the two
      pathways converge at a multivesicular level within the endosomal pathway.

PMID- 7771512
TI  - Disturbances in renal microcirculation induced by myoglobin and hemorrhagic
      hypotension in anesthetized rat.
AB  - The question was studied of whether myoglobin (Mb), when released into the
      general circulation during hemorrhagic hypotension (HH), causes disturbances of
      renal blood flow. In anesthetized rats 250 mg/kg Mb was intravenously infused
      within 1 h; HH at 50 mmHg with subsequent retransfusion was induced for 30 min.
      By allowing two dyes to circulate for 1 and 3 min, respectively, and detecting
      their localization histologically after rapid freezing of the organ, intrarenal
      distribution of capillary blood flow was studied. In contrast to the results
      obtained with Mb or HH alone, when Mb was infused during HH, the development of
      large areas within cortex and medulla lacking any capillary perfusion was
      observed. In > 70% of the tissue, a distance > 60 microns to the next dye-labeled
      capillary was found (in controls 0%). At this time total renal flow had decreased
      from 5.3 to 0.20 ml/min (HH without Mb: 5.1 to 1.1 ml/min). It is concluded that
      the observed changes in renal blood flow contribute to the known direct
      nephrotoxic potential of Mb.

PMID- 7771513
TI  - Heterogeneity of chloride/base exchange in rabbit superficial and juxtamedullary
      proximal convoluted tubules.
AB  - Active transcellular NaCl transport in the proximal convoluted tubule (PCT) is
      via apical parallel Na/H and Cl/base exchange. The mechanism of Cl/base exchange
      remains unclear. The present in vitro microperfusion study examined the mechanism
      of Cl/base exchange in superficial and juxtamedullary PCT by examining the rate
      of change in intracellular pH in response to luminal Cl removal. In superficial
      PCT the rate of Cl/base exchange was 24.0 +/- 2.3 without formate, 36.4 +/- 6.6
      with 10 microM formate (P < 0.05), and 43.6 +/- 2.8 pmol.mm-1.min-1 (P < 0.001)
      with 1 mM luminal formate. Cl/base exchange was inhibited by luminal 4,4'
      diisothiocyanostilbene-2,2'-disulfonic acid (DIDS) in the presence and absence of
      formate. In juxtamedullary PCT, Cl/base exchange was 22.2 +/- 3.8 without formate
      and 25.0 +/- 5.4 pmol.mm-1.min-1 in the presence of 1 mM luminal formate [P = not
      significant (NS)]. Cl/base exchange was inhibited by luminal DIDS in
      juxtamedullary PCT. The rates of Cl/base exchange in both superficial and
      juxtamedullary PCT were not affected by 0.1 mM acetazolamide and 2 mM cyanide and
      were the same in the presence and absence of HCO3/CO2, consistent with Cl/OH
      rather than Cl/HCO3 exchange. To examine the effect of formate on PCT transport,
      tubules were perfused with a high-Cl solution without organics simulating late
      proximal tubular fluid. In superficial PCT net volume absorption (JV) was 0.00 +/
      0.05 in the absence of formate and 0.14 +/- 0.06 nl.mm-1.min-1 in the presence
      of 1 mM formate (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771514
TI  - Vasopressin and cAMP stimulate electrogenic chloride secretion in an IMCD cell
      line.
AB  - Previously, we demonstrated that the mIMCD-K2 cell line, derived from the inner
      medullary collecting duct (IMCD) of a transgenic mouse, secretes Cl- by an
      electrogenic mechanism [N. L. Kizer, B. Lewis, and B. A. Stanton, Am. J. Physiol.
      268 (Renal Fluid Electrolyte Physiol. 37): F347-F355, 1995]. The objective of the
      present study was to characterize the cellular mechanisms of electrogenic Cl-
      secretion (IscCl) and to determine whether arginine vasopressin (AVP) and
      adenosine 3',5'-cyclic monophosphate (cAMP) stimulate IscCl. To this end, we
      measured IscCl across monolayers of mIMCD-K2 cells mounted in Ussing-type
      chambers. AVP increased IscCl with a Michaelis constant (Km) of 2.1 +/- 0.7 x 10(
      12) M. 1-Desamino-8-D-AVP, a specific V2 receptor agonist, increased IscCl from
      3.3 +/- 0.4 to 17.4 +/- 1.3 microA/cm2, 8-(4-Chlorophenylthio)-cAMP, a cell
      permanent analogue of cAMP, a second messenger of AVP, increased IscCl from 1.4
      +/- 0.3 to 15.2 +/- 1.2 microA/cm2. Furosemide and bumetanide, inhibitors of
      Na(+)-2Cl(-)-K+ cotransport, and 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid
      (DIDS), an inhibitor of Cl-/HCO3- exchange, reduced IscCl when added to the
      basolateral solution. Our data suggest that AVP, via V2 receptors, and the second
      messenger cAMP stimulate IscCl and that Cl- secretion by mIMCD-K2 cells involves
      uptake of Cl- across the basolateral membrane by Na(+)-2Cl(-)-K+ cotransport and
      Cl-/HCO3- exchange and diffusion out of the cells across the apical membrane by
      cystic fibrosis transmembrane conductance regulator Cl- channels.

PMID- 7771515
TI  - Glucocorticoid upregulates Na-K-ATPase alpha- and beta-mRNA via an indirect
      mechanism in proximal tubule cell primary cultures.
AB  - Adrenalectomy leads to the decline in the levels of renal Na-K
      adenosinetriphosphatase (Na-K-ATPase) alpha- and beta-subunit protein and mRNA.
      Both alpha- and beta-mRNA, however, return to the control level within 1 h after
      corticosterone administration. Whether or not glucocorticoid acts directly on a
      specific segment of nephron to upregulate Na-K-ATPase has not been determined.
      Studies were undertaken in an attempt to elucidate this problem. Using primary
      cultures of renal proximal tubules, we found that 24-h treatment with
      dexamethasone augmented Na-K-ATPase activity and induced coordinate increase of
      alpha- and beta-protein and mRNA abundance dependent on the doses in the range of
      10(-8) to 10(-6) M. We further demonstrated that 24-h incubation of dexamethasone
      (10(-7) M) enhanced Na-K-ATPase activity by 58 +/- 14%, alpha- and beta-protein
      abundance by 70 +/- 18 and 51 +/- 10%, and alpha- and beta-mRNA levels by 87 +/-
      12 and 62 +/- 11%, respectively. The time course studies revealed that
      significant increase of Na-K-ATPase activity and alpha and beta-protein abundance
      was reached within 4 hr of dexamethasone treatment. Pretreatment of cultured
      proximal tubule cells with cycloheximide (20 micrograms/ml) completely inhibited
      dexamethasone-induced increase of Na-K-ATPase alpha- and beta-mRNA. Our results
      indicate that dexamethasone upregulates Na-K-ATPase in proximal tubule cells via
      pretranslational mechanisms, which may be mediated by proteins.

PMID- 7771516
TI  - Endocrine responses of fetal sheep to prolonged hypoxemia with and without
      acidemia: relation to urine production.
AB  - Our aim was to examine the endocrine changes associated with alterations in fetal
      urine production during 24 h of hypoxemia induced by either reduced uterine blood
      flow (RUBF) or maternal N2 inhalation (N2). In contrast to RUBF, which caused a
      diuresis, N2 caused a transient antidiuresis; during both posthypoxemia periods
      (RUBF and N2), fetal urine production was increased. RUBF, but not N2, was
      associated with a transient acidemia. Fetal plasma arginine vasopressin (AVP) and
      atrial natriuretic factor (ANF) concentrations increased during RUBF and were
      inversely correlated to pH; there were no detectable AVP or ANF responses to N2.
      Fetal prostaglandin E2 (PGE2) increased during the hypoxemia and posthypoxemia
      periods induced by both methods, but RUBF caused the greater increase. AVP and
      PGE2 concentrations were positively correlated with urine production. Fetal
      arterial blood pressure increased during RUBF but not N2. During RUBF, the
      increases in AVP and PGE2 concentrations and/or fetal arterial blood pressure may
      have contributed to the diuresis. During N2, we suggest that low, but increased,
      levels of AVP may have caused the transient antidiuresis, whereas the diuresis
      observed during both posthypoxemia periods may have been mediated by elevated
      PGE2 concentrations and/or increased fetal arterial blood pressure.

PMID- 7771517
TI  - Calcium activation mechanisms in the renal microvascular response to
      extracellular ATP.
AB  - Previous studies have suggested a paracrine role for extracellular ATP in the
      regulation of afferent arteriolar tone. The current study was conducted to
      determine the dependence of this response on calcium entry mechanisms.
      Experiments were performed in vitro using the blood-perfused juxtamedullary
      nephron technique combined with video microscopy. The afferent arteriolar
      response to alpha, beta-methylene ATP was determined before and after treatment
      with the calcium channel blockers, diltiazem or felodipine. alpha, beta-Methylene
      ATP was used to obviate concerns over responses being elicited by ATP or by ATP
      hydrolysis products such as adenosine. Previous studies have shown that afferent
      arteriolar responses to alpha, beta-methylene ATP are comparable to those
      elicited by ATP. alpha, beta-Methylene ATP (1.0 microM) induced a rapid initial
      afferent vasoconstriction of 72.5 +/- 10.6%, which partially recovered to a
      stable diameter 11.3 +/- 1.7% smaller than control (P < 0.01 vs control).
      Afferent diameter returned to control diameter on removal of ATP from the bath.
      Diltiazem or felodipine treatment significantly increased afferent diameter by
      5.6 +/- 2.3 and 16.4 +/- 4.6%, respectively (P < 0.05). In the presence of either
      diltiazem or felodipine, the initial vasoconstriction to alpha, beta-methylene
      ATP was attenuated, and the sustained vasoconstriction was completely blocked.
      Removal of calcium from the extracellular medium completely abolished both the
      initial and sustained vasoconstrictor response.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771518
TI  - Restoration of vasa recta hemodynamics and pressure natriuresis in SHR by L
      arginine.
AB  - An increase in medullary blood flow has been implicated as a mediator of the
      natriuresis following increases in renal perfusion pressure (RPP). We examined
      whether administration of L-arginine, the substrate for nitric oxide production,
      restores the impaired vasa recta hemodynamic response to increases in RPP and the
      blunted pressure natriuresis of the spontaneously hypertensive rat (SHR). The
      response of descending (QDVR) and ascending vasa recta blood flow (QAVR) and of
      urinary sodium excretion (UNaV) was examined as RPP was increased by means of an
      adjustable aortic clamp placed above the renal arteries in young SHR and Wistar
      Kyoto (WKY) rats. When RPP was increased in SHR receiving infusion of L-arginine
      (n = 7), QDVR and QAVR increased significantly in association with increases in
      UNaV. In SHR receiving the inactive enantiomer, D-arginine (n = 7), similar
      increases in RPP failed to increase QAVR and QDVR and were associated with an
      attenuated increase in UNaV. WKY animals infused with either D-arginine or L
      arginine had increases in QDVR, QAVR, and UNaV in response to increases in RPP
      that were of similar magnitude to SHR receiving L-arginine. Thus the
      administration of L-arginine to SHR restores the pressure-dependent increases in
      renal medullary hemodynamics in association with restoration of pressure
      natriuresis.

PMID- 7771519
TI  - Glomerular handling of circulating glycated albumin in the normal mouse kidney.
AB  - In the present study, we have evaluated the glomerular handling of circulating
      glycated albumin in the normal mouse kidney by quantitative immunocytochemistry.
      Bovine serum albumin (BSA) was glycated in vitro and dinitrophenylated. Glycated
      and nonglycated probes were introduced into the circulation of anesthetized mice
      and traced by postembedding immunogold cytochemistry after 10 and 30 min of
      circulation. Endogenous albumin, as well as dinitrophenylated native BSA (DNP
      BSA) and glycated albumins (DNP-gBSA), were localized within the capillary lumen,
      glomerular and peritubular basement membranes, and the mesangial matrix.
      Morphometric evaluation of the labeling over the glomerular basement membrane
      (GBM) revealed a peak of labeling in the endothelial side for either endogenous
      albumin or DNP-BSA. In contrast, the labeling distribution for DNP-gBSA showed a
      shift toward the epithelial side, suggesting a further penetration of the
      glycated probe into the GBM. When coinjected with gBSA, DNP-BSA was found to
      display a labeling distribution similar to that displayed by DNP-gBSA. These
      results indicate that the glycated tracer penetrates the normal glomerular wall
      deeper than the nonglycated one. Moreover, glycated albumin increases the
      infiltration of the nonglycated tracer through the normal glomerular wall.
      Circulating glycated serum proteins thus appear to play an important role in the
      onset of the glomerular dysfunction and proteinuria, which take place in long
      term hyperglycemic states.

PMID- 7771520
TI  - Expression of angiotensin II AT2 receptor mRNA during development of rat kidney
      and adrenal gland.
AB  - The angiotensin II (ANG II) receptors have been pharmacologically classified into
      two major distinct types, designated AT1 and AT2. A high transient expression of
      AT2 receptors in the fetal tissues has been previously demonstrated. This study
      describes the cellular distribution of AT2 receptor mRNA in the developing rat
      kidney and adrenal gland by in situ hybridization with 35S-labeled cRNA probes.
      From day 12 of fetal life (F12) to day 15 postpartum (D15) AT2 mRNA was detected
      in the undifferentiated nephrogenic mesenchymal tissue but not in the immature
      and mature glomeruli and tubules of the kidney. No AT2 mRNA was observed in the
      kidney after D22. The adrenal gland also expressed AT2 receptor mRNA early during
      development from F12 but, unlike the kidney, continuously expressed the mRNA at
      high levels through to adulthood. The disappearance of AT2 mRNA in the kidney was
      synchronous with the completion of nephrogenesis and suggests that ANG II might
      act through this receptor as a differentiation/growth factor during nephron
      development. In the adrenal gland ANG II could act as a hormone and also as a
      differentiation/growth factor via the AT2 receptor.

PMID- 7771521
TI  - 5,6-EET inhibits ion transport in collecting duct by stimulating endogenous
      prostaglandin synthesis.
AB  - We examined the mechanism by which the cytochrome P-450 metabolite of
      arachidonate, 5,6-epoxyeicosatrienoic acid (5,6-EET), modulates electrogenic
      transport in the rabbit cortical collecting duct (CCD). 5,6-EET depolarized
      transepithelial voltage (VT) in a concentration-dependent manner with a maximal
      effect at 1 microM. None of the other EET regioisomers (8,9-, 11,12-, or 14,15
      EET; all at 1 microM) affected VT, This action was also stereoselective, with
      5(S),6(R)-EET producing a 2.5-fold greater effect on VT than 5(R),6(S)-EET (1
      microM each). Like basolateral prostaglandin E2 (PGE2), both luminal and
      basolateral 5,6-EET increased cytosolic Ca2+ concentration ([Ca2+]i) in the
      rabbit CCD. Pretreatment with cyclooxygenase inhibitors (10 microM ibuprofen or 5
      microM indomethacin) completely blocked both the [Ca2+]i increase and the change
      in VT. Neither 5,6-epoxy-PGE1 nor 5-hydroxy-PGI1, cyclooxygenase metabolites of
      5,6-EET, affected VT. However, when added to primary cultures of rabbit CCDs, 5,6
      EET stimulated endogenous PGE2 synthesis. We propose that 5,6-EET stimulates
      endogenous prostaglandin synthesis, which inhibits electrogenic ion transport in
      the CCD.

PMID- 7771522
TI  - ANG II is a mitogen for a murine cell line isolated from medullary thick
      ascending limb of Henle's loop.
AB  - A murine SV40-transformed renal epithelial cell line derived from medullary thick
      ascending limb of Henle's loop (MTAL) was established and characterized by
      morphology, antigen expression, and biochemical criteria. These MTAL cells
      express a single class of high-affinity receptors for angiotensin II (ANG II) and
      transcripts for the AT1 subtype of ANG II receptors. ANG II, in a dose-dependent
      manner, induced proliferation of MTAL cells. This observation is in striking
      contrast to syngeneic proximal tubular cells in which it was previously shown
      that the peptide induced cellular hypertrophy and slightly inhibited
      proliferation [G. Wolf and E. G. Neilson. Am. J. Physiol. 259 (Renal Fluid
      Electrolyte Physiol. 28: F768-F777, 1990]. The AT1-receptor antagonist losartan
      (10(-6) M), but not an AT2-receptor antagonist, blocked the mitogenic effects of
      ANG II in MTAL cells. Coincubation of quiescent MTAL cells with ANG II and 5%
      fetal calf serum further increased proliferation compared with cells grown only
      in serum. In contrast to proximal tubular cells, ANG II failed to induce
      transforming growth factor-beta 1 mRNA and protein synthesis in MTAL cells. Our
      data collectively suggest that ANG II is a mitogen for MTAL cells in vitro.
      Therefore, epithelial cells derived from different parts of the nephron, even
      when transformed with SV40 virus and while under cell culture conditions, exhibit
      a distinct pattern of growth behavior after stimulation with ANG II.

PMID- 7771524
TI  - Effect of nitric oxide on renin secretion. II. Studies in the perfused
      juxtaglomerular apparatus.
AB  - To examine the possible role of NO in macula densa control of renin secretion, we
      examined the effects of varying NO availability on renin release in the isolated
      perfused rabbit juxtaglomerular apparatus (JGA). Gradual increments of luminal
      Na/Cl concentration ratio (mM/mM) from 26/7 over 46/27, 66/47, to 86/67 caused a
      progressive decrease in renin secretion from (as log of nano-Goldblatt hog units
      vs. time, i.e., log nGU/min) 1.09 +/- 0.34 to 0.46 +/- 0.24 log nGU/min, with the
      greatest change occurring at the first concentration step. The presence of 0.7 mM
      N omega-nitro-L-arginine (NNA), an NO synthase inhibitor, in the luminal fluid
      significantly reduced renin secretion at the lowest Na/Cl concentration ratio to
      0.65 +/- 0.32 log nGU/min (P < 0.01 compared with control). Renin secretion at
      the higher Na/Cl concentration ratios was not significantly affected by NNA
      compared with control. In contrast to these results, the addition of the NO donor
      nitroprusside (1 mM) to the bath caused a reduction in renin secretion from 1.0
      +/- 0.39 to 0.47 +/- 0.46 log nGU/min (P < 0.05), an effect that was reversed by
      bath addition of 0.01 mM methylene blue. Similarly, addition of L-arginine (0.7
      mM) to the bath reduced renin secretion from 0.99 +/- 0.37 to 0.81 +/- 0.38 log
      nGU/min (P < 0.01), whereas addition of L-arginine to the luminal fluid increased
      renin secretion from 0.85 +/- 0.43 to 1.94 +/- 0.46 log nGU/min (P < 0.05). The
      stimulatory effect of luminal L-arginine was reversed by the luminal addition of
      NNA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771523
TI  - Effect of nitric oxide on renin secretion. I. Studies in isolated juxtaglomerular
      granular cells.
AB  - Experiments were performed on juxtaglomerular granular cells (JGC) in short-term
      primary culture to determine the direct immediate effect of NO on renin secretion
      and to test whether JGC are able to generate NO. Renin secretion was measured
      repeatedly over short time intervals in a cell superfusion system. Renin release
      did not significantly decrease over a 40-min observation period in untreated JGC.
      Addition of sodium nitroprusside (SNP) caused a reduction in renin release
      (measured in nano-Goldblatt hog units vs. time, i.e., nGU/min) from 479 +/- 25,
      423 +/- 70, and 388 +/- 54 nGU/min to 295 +/- 19 (n = 5), 102 +/- 21 (n = 7), and
      71 +/- 9 nGU/min (n = 6) with 10(-5), 10(-4), and 10(-3) M SNP, respectively. In
      the presence of the guanylate cyclase inhibitor methylene blue at 10(-4) M, SNP
      at 10(-4) M had no significant effect on renin secretion. 8-Bromoguanosine 3',5'
      cyclic monophosphate at 10(-4) M in the presence of the phosphodiesterase
      inhibitor 3-isobutyl-1-methylxanthine (10(-3) M) caused a reduction of renin
      secretion to 50.1 +/- 3.6% of control. To examine the possibility that renin
      secretion is affected by NO release from JGC, we assessed the effect of the NO
      synthase (NOS) substrate L-arginine (10(-3) M) and the NOS blocker N omega-nitro
      L-arginine (10(-4) M) on renin secretion. Renin release was not significantly
      altered by either stimulation or inhibition of NOS activity.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7771525
TI  - Effects of barium ions on tubuloglomerular feedback.
AB  - The furosemide sensitivity of the tubuloglomerular feedback (TGF) response has
      suggested an important role for the Na-2Cl-K cotransporter in the mechanism by
      which increased luminal NaCl concentration causes afferent arteriolar
      vasoconstriction. The present experiments in anesthetized rats were performed to
      evaluate the effect of K channel blockade with Ba on TGF, since Ba has been shown
      to inhibit NaCl transport in the thick ascending limb. The presence of either 1.5
      or 2 mM BaCl2 during retrograde perfusion with a 135 mM NaCl solution reduced the
      decrease of early proximal flow rate (VEP) by 2.7 +/- 0.76 (P < 0.02) and 4.2 +/-
      0.8 nl/min (P < 0.01) compared with perfusion without BaCl2. Retrograde perfusion
      with 38 mM NaCl + 5 mM KCl reduced VEP by 10.4 +/- 1.3 nl/min, whereas 40 mM NaCl
      + 1.5 mM BaCl2 caused a reduction by only 6.1 +/- 1.4 nl/min (P < 0.001). In
      contrast to the inhibition caused by retrograde perfusion with low concentrations
      of BaCl2, increased vasoconstriction was seen during retrograde perfusion with 5
      mM BaCl2 or during orthograde perfusion with 10 mM BaCl2. The addition of 10(-4)
      M furosemide to a solution containing 5 mM BaCl2 largely blocked the increased
      vasoconstrictor response. Peritubular perfusion with a solution containing 5 mM
      BaCl2 caused a fall in stop-flow pressure in an adjacent nephron by 10.7 +/- 1.5
      mmHg (P < 0.001). These results indicate that under our experimental conditions
      Ba ions exert a dual effect on vascular responses to changes in luminal NaCl
      concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771527
TI  - Capillary network structure does not affect theoretical analysis of glomerular
      size selectivity.
AB  - Anatomical studies have demonstrated that the glomerular capillaries are complex
      and heterogeneous networks. Conventional models of glomerular size selectivity,
      however, are based on the assumption of simplified geometries. We developed a
      theoretical model of glomerular size-selective function based on the geometric
      data obtained in a previous reconstruction of a glomerular network from a normal
      Munich-Wistar rat. This heterogeneous model was compared with the homogeneous
      model conventionally used to calculate membrane selective parameters from the
      fractional clearance of two test solutes, neutral dextran and Ficoll. For both
      models we assumed a hypothetical log-normal distribution of pore sizes and
      calculated optimal membrane pore-size parameters using previously published
      values of fractional clearances. The difference between the sieving coefficients
      calculated with the two models was negligible, never exceeding 5.5%. Since the
      homogeneous model does not consider the pressure drop along the glomerular
      capillary, we also computed fractional clearances with the homogeneous model,
      assuming the same pressure drop as in the heterogeneous one. The differences in
      computed fractional clearances using the homogeneous model with and without a
      pressure drop were less than 1.2%. We concluded that models based on identical
      capillary networks can therefore be used for interpreting sieving coefficients
      for macromolecules.

PMID- 7771526
TI  - A novel method for infusing drugs continuously into the renal artery of rats.
AB  - A method is described to achieve a homogeneous intravascular distribution of
      drugs infused into the renal artery of anesthetized rats. The device for
      intrarenal infusion consisted of a multiple-catheter system with a cannula
      inserted into the renal artery, which was connected to different lines for drug
      infusions and to one line for oscillating blood back and forth in the renal
      cannula with a magnetic membrane pump. The blood oscillation served to mix the
      drugs with renal arterial blood. To verify the usefulness of this procedure,
      Lissamine green was infused into the renal artery; without the mixing pump the
      dye was located on a small portion of the kidney surface, whereas the dye could
      be visualized evenly distributed and less concentrated over the entire kidney
      with the pump. With the mixing device, intrarenal infusion of angiotensin II, 5
      pmol.kg-1.min-1, or norepinephrine, 150 pmol.kg-1.min-1, reduced renal blood flow
      by approximately 25% without affecting blood pressure. Tenfold higher doses given
      intravenously had comparable renal effects, but these increased systemic
      pressure. Without the mixing pump, vasoactive drugs given into the renal artery
      had a distinctly smaller effect on renal blood flow than with the pump
      (angiotensin II, 39%; norepinephrine, 49%; and acetylcholine, at 5 nmol.kg-1.min
      1, 33%). The results show that intrarenally infused drugs, without a mixing
      device, have access to an unpredictably small kidney volume, and estimation of
      their effects on kidney functions can be equivocal. The present device ensures an
      adequate mixing of drugs with renal blood.

PMID- 7771528
TI  - Viscoelastic behavior of "in situ" aortic wall during hemorrhagic hypotension.
AB  - Viscoelastic and electrophysiological mechanisms have been implicated in
      resetting of baroreceptors in hypertension, but resetting in response to
      hypotension has been less exhaustively studied. To assess the importance of
      viscoelastic mechanisms in hypotension, we examined the behavior of the "in situ"
      aorta during hemorrhage. Fifteen minutes of hemorrhage in anesthetized Wistar
      rats produced stable hypotension (30 mmHg) and a progressive contraction of the
      mean aortic caliber (-93.8 +/- 18.0 microns, P < 0.05) compared with control
      measurements. Contraction was not altered by sinoaortic denervation, vagotomy,
      nephrectomy, adrenalectomy, hexamethonium (30 mg/kg), losartan (10 mg/kg), V1
      antagonist (10 micrograms/kg), arterial pH and blood gas control, or indomethacin
      (3.0 mg/kg). Aortic contraction was greater in rats treated with N omega-nitro-L
      arginine (-164.0 +/- 43.0 microns, P < 0.05) than in those treated with sodium
      nitroprusside (-54.1 +/- 7.5 microns, P < 0.05). The results indicate that aortic
      contraction is compatible with viscoelastic contraction and suggest that
      shortening of viscoelastic elements in series with baroreceptor endings increases
      stress at the baroreceptor membrane and contributes to the development of
      baroreceptor resetting to hypotension.

PMID- 7771529
TI  - Unaltered size of right ventricular infarct in dogs with right ventricular
      hypertrophy induced by pressure overload.
AB  - We investigated whether right ventricular infarct size is increased in the
      hypertrophied right ventricle. In dogs, we produced chronic pressure overload
      induced right ventricular hypertrophy (RVH) and acute pulmonary stenosis (APS)
      with a similar right ventricular systolic pressure to RVH. Then, in an open-chest
      model, right coronary artery occlusion for 4 h followed by 1 h of reperfusion was
      performed in animals with RVH or APS or in controls. Regional myocardial blood
      flow was measured with nonradioactive colored microspheres. Compared with the
      control group, regional myocardial oxygen consumption in the right ventricle was
      increased in the APS but not in the RVH group. The risk area and collateral blood
      flow were comparable in the three groups. However, the infarct size relative to
      risk area was increased in the APS group (42.3 +/- 4.9%), but that in the RVH
      group (21.1 +/- 4.4%) was not different from controls (26.1 +/- 4.2%). Thus right
      ventricular infarction in the heart with RVH was not increased compared with the
      normal heart.

PMID- 7771530
TI  - Impaired subendocardial function in tachycardia-induced cardiac failure.
AB  - Chronic rapid ventricular pacing (CRVP) in many experimental models induces
      ventricular dilatation, reduced ejection fraction, and symptomatic congestive
      heart failure. We have investigated transmural mechanical function in the left
      ventricular (LV) wall of five Hanford miniature swine before and after CRVP
      induced failure. Three columns of radiopaque markers 1 mm in diameter were
      implanted in the anterior LV wall through a median sternotomy. A pair of LV
      pacing wires were sutured into the myocardium, a pneumatic cuff was placed around
      the inferior vena cava (IVC), and two fluid-filled Silastic catheters were
      implanted into the LV apex. Two weeks after surgery, the pigs were suspended
      awake in a sling, and markers were tracked with biplane cineradiography. The
      hearts were paced for 3 wk (225-240 beats/min), and the study was repeated with
      the pacemaker off. Saline infusion and IVC occlusion were used to vary LV end
      diastolic pressure (EDP) so control-to-failure comparisons could be made at
      matched LV EDPs. End-systolic strains in the circumferential (E11), longitudinal
      (E22), and transmural (E33) directions were quantified using finite element
      methods. There was a significant reduction in E11 and E33 for the subendocardium:
      in E11, from -0.27 to -0.18; in E33, from 0.83 to 0.46. There were no significant
      changes in subendocardial E22 or in any of the outer wall normal strains. These
      results indicate that CRVP causes substantial reduction of subendocardial, but
      not subepicardial, function; taken together with previous data indicating
      subendocardial hypoperfusion, these results support the contention that an
      imbalance between blood flow and oxygen demand plays a role in the etiology of
      heart failure in this model.

PMID- 7771531
TI  - Calcium- and sodium-dependent modulation of stretch-induced arrhythmias in
      isolated canine ventricles.
AB  - Gadolinium-sensitive stretch-activated channels have been implicated in the
      process of mechanotransduction signaling of ventricular myocardium. Such channels
      nonspecifically transport Na+ and Ca2+ in the inward direction. We tested the
      hypothesis that Na+ and Ca2+ influx are important in the genesis of stretch
      induced arrhythmias (SIAs) in an isolated, blood-perfused canine ventricle. To
      elicit SIAs, left ventricular volume was transiently increased in early diastole
      using a computerized servo-pump system. Monophasic action potential recordings
      revealed stretch-induced depolarizations (SIDs) that preceded the arrhythmias. In
      five ventricles, raising the perfusate Ca2+ concentration from 1 to 3 mM
      increased ventricular sensitivity to SIAs, manifested by a decrease in the volume
      change required to precipitate an arrhythmia 50% of the time (delta V50) from
      19.5 +/- 2.7 to 15.2 +/- 1.9 ml (P < 0.05). When the perfusate Na+ concentration
      was decreased from 150 to 90 mM in seven ventricles, delta V50 greatly increased
      (31.1 +/- 14.4 vs. 17.7 +/- 5.3 ml, P < 0.05), and SID amplitude decreased by 47%
      (P = 0.002). The suppression of SIAs with low extracellular Na+ is unlikely to be
      mediated by voltage-gated Na+ channels because lidocaine (5 mg/dl) did not alter
      SID amplitude. Thus the transsarcolemmal Na+ gradient (and probably that of Ca2+)
      modulates the amplitude of SIDs, which, in turn, initiate SIAs. These data
      provide initial evidence that Na+ and Ca2+ help mediate the mechanotransduction
      processes that underly the genesis of SIAs.

PMID- 7771532
TI  - Vascular compliance and mean circulatory filling pressure in trout: effects of
      ACE inhibition.
AB  - Mean circulatory filling pressure (MCFP), whole body vascular compliance (C), and
      unstressed blood volume (USV) are important indexes of cardiovascular function in
      mammals, but they have not been measured in fish. In the present experiments,
      dorsal aortic (PDA) and sinus venosus (PSV) pressures were measured in
      unanesthetized trout before and during electrical cardiac fibrillation, while
      blood volume (BV) was manipulated between 50 and 150% of normal. Measurements
      were repeated after angiotensin-converting enzyme (ACE) inhibition with
      lisinopril. Cardiac fibrillation (zero-flow condition) rapidly (approximately 5
      s) dropped PDA and increased PSV (equals MCFP). MCFP in normovolemic trout (4.8
      +/- 0.3 mmHg) varied directly with BV. C determined from in vivo capacitance
      curves was similar to that obtained gravimetrically, in vitro (3.4 and 3.5
      ml.mmHg-1.kg body wt-1, respectively). USV was 13.3 ml/kg body wt (approximately
      45% of BV). ACE inhibition reduced PDA in unfibrillated trout at all BV and
      reduced PDA in fibrillated fish at BV > or = 80%. ACE inhibition did not affect
      PSV, MCFP, C, or USV. The systemic arteriovenous pressure gradient at zero flow
      (delta PF0) was greatest at 100% BV (8.2 +/- 0.5 mmHg) and was reduced by ACE
      inhibition at 80-120% BV. These results show that key indexes of venous function
      are readily measured in fish and that the trout venous system is not an effector
      of angiotensin-mediated regulation of arterial blood pressure. Thus angiotensin
      acts solely on arterial resistance vessels. Furthermore, the drop in delta PF0
      during ACE inhibition is due to a decrease in arteriolar resistance.

PMID- 7771533
TI  - Effects of inotropic stimulation on energy metabolism and systolic function of
      ischemic right ventricle.
AB  - This study determined whether dobutamine enhances regional systolic function in
      the ischemic right ventricle (RV) at the cost of adverse effects on regional
      energy metabolism. Seventeen alpha-chloralose-anesthetized, open-chest pigs were
      studied under four conditions: 1) control; 2) dobutamine infusion (mean dose 9
      micrograms.kg-1.min-1); 3) RV ischemia (45 +/- 5% reduction in RV free wall blood
      flow for 100 min); and 4) continued ischemia with dobutamine. Regional RV free
      wall high-energy phosphate metabolites were measured by 31P nuclear magnetic
      resonance (NMR) spectroscopy or by high-speed drill biopsies of the RV free wall.
      Regional RV free wall substrate and O2 consumption were measured using coronary
      venous blood sampling. Global RV systolic function was assessed by the maximal
      first derivative of RV pressure (dP/dtmax), and regional RV free wall systolic
      function was assessed by systolic segment shortening in the ischemic zone. Right
      coronary artery constriction caused markedly depressed regional RV systolic
      function, net lactate production, and coronary venous acidosis. Surprisingly,
      high-energy phosphates were unchanged compared with control. Addition of
      dobutamine caused a further decline in coronary venous pH and continued lactate
      production but did not reduce high-energy phosphates. While dobutamine markedly
      enhanced global RV systolic function (RV dP/dtmax 201 +/- 19% of control),
      systolic shortening in the ischemic RV free wall remained severely depressed (47
      +/- 18% of control) despite dobutamine. The mechanism of high-energy phosphate
      preservation is likely due to diminished consumption of ATP in the
      hypocontractile ischemic region.

PMID- 7771535
TI  - Thyroid status and Na(+)-K+ pump current, intracellular sodium, and action
      potential duration in rabbit heart.
AB  - Thyroid status influences the abundance of Na(+)-K+ pumps in the heart. To
      evaluate whether this phenomenon may contribute to a dependence of the action
      potential duration (APD) on thyroid status, we induced hypothyroidism in a group
      of New Zealand White rabbits. Another group was treated similarly but also
      received triiodothyronine (T3). Right ventricular myocytes were isolated and
      voltage clamped at -40 mV. We identified Na(+)-K+ pump current (Ipump) as a
      ouabain-induced shift in holding current. Mean Ipump, measured using patch
      pipettes containing 10 mM Na+, was 0.24 +/- 0.02 pA/pF in 9 cells from 4
      hypothyroid rabbits and 0.48 +/- 0.05 in 10 cells from 4 rabbits treated with T3
      (P < 0.001). Because thyroid status influences Na+ influx, we measured
      intracellular Na+ activity (aiNa) in right ventricular papillary muscles. We
      found that aiNa was 5.20 +/- 0.42 mM in nine papillary muscles from seven
      hypothyroid rabbits and 7.62 +/- 0.69 mM in nine papillary muscles from six
      rabbits treated with T3 (P < 0.01). The effect of thyroid-induced changes in
      Ipump and aiNa on APD was stimulated with a computer model. The simulations
      predicted that thyroid-induced changes in Ipump can influence APD. The predicted
      changes were similar to changes in APD measured in isolated papillary muscles.

PMID- 7771534
TI  - Plasma endothelin and renal endothelin are two distinct systems involved in
      volume homeostasis.
AB  - This study of seven healthy young subjects was designed both to establish whether
      endothelin-1 (ET-1) is involved in the homeostasis of blood volume and to clarify
      the relationship between plasma and urinary ET-1. Acute volume expansion (+17%)
      caused increases in venous blood pressure (+4.4 mmHg) and the plasma
      concentration of ET-1 (+129%) and a decrease (-99%) in the urinary excretion of
      ET-1. Volume depletion (-8.5%) provoked an increase in the plasma concentration
      of ET-1 without altering the urinary excretion of ET-1. Passive elevation of an
      arm resulting in a local decrease of venous blood pressure (-17 mmHg) elicited an
      increase of the local formation of ET-1, with a 10-fold increase in the venous
      arterial gradient compared with the opposite arm, which lay at the level of the
      heart. The increased local formation of ET-1 was blunted by volume expansion. The
      results indicate that 1) plasma ET-1 and urinary ET-1 represent two different
      endothelin-generating systems, both of which are involved in the regulation of
      blood volume, and 2) plasma ET-1 appears to be an important mechanism for the
      long-lasting adaptations of venous wall tension to changes in blood volume.

PMID- 7771536
TI  - Tirilazad mesylate (U-74006F) inhibits effects of endotoxin in dogs.
AB  - The present study explored the effects of a potent antioxidant, the 21
      aminosteroid U-74006F, on the systemic and regional hemodynamics and the oxygen
      extraction capabilities during endotoxic shock. Twenty-four anesthetized dogs
      were randomized into three groups. Group 1 (n = 8) served as control. Group 2 (n
      = 8) and group 3 (n = 8) received 2 mg/kg iv of Escherichia coli endotoxin,
      followed 30 min later by saline infusion. Group 3 was given U-74006F as an
      intravenous bolus of 80 micrograms/kg followed by an infusion of 10 micrograms.kg
      1.min-1, and group 2 received an equivalent volume of vehicle. Tamponade was
      induced 30 min later to study the oxygen extraction capabilities of the animals.
      Compared with the endotoxin-alone group, the U-74006F-treated dogs maintained
      higher mean arterial pressure, cardiac index, stroke volume index, and left
      ventricular stroke work index and lower pulmonary vascular resistance. They also
      showed a higher fractional blood flow to mesenteric and renal beds. Endotoxin
      administration increased whole body critical oxygen delivery (DO2crit) from 7.7
      +/- 2.4 to 12.0 +/- 1.9 ml.kg-1.min-1 (P < 0.05), but U-74006F decreased DO2crit
      to 7.8 +/- 2.0 ml.kg-1.min-1 (P < 0.05 vs. endotoxin alone). Endotoxin decreased
      critical oxygen extraction ratio (O2ERcrit) from 75.0 +/- 12.7 to 44.3 +/- 8.7%
      (P < 0.05), but U-74006F increased O2ERcrit to 64.1 +/- 11.2% (P < 0.05 vs.
      endotoxin alone). U-74006F also decreased endotoxin-induced elevation of
      mesenteric and renal DO2crit and markedly increased regional O2ERcrit. Systemic
      and regional blood lactate concentrations were lower in the U-74006F-treated
      animals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771538
TI  - ANP secretion from small cell lung cancer cell lines: a potential model of ANP
      release.
AB  - Although atrial distension is widely accepted as the primary stimulus for atrial
      natriuretic peptide (ANP) release, a number of agonists are also known to induce
      its secretion. The mechanisms underlying these processes are not well understood.
      Studies of this nature are hampered by the inherent difficulty in culturing
      homogeneous populations of cardiac myocytes in sufficient quantities to perform
      molecular investigations. For this reason, we have examined the possibility of
      using other cell types as a model of ANP release. It has been reported that a
      number of tumor samples from small cell lung cancer (SCLC) patients express the
      ANP gene. Characterization of a large number of cell lines derived from SCLC
      tumor samples indicated that two of these cell lines, OS-A and SHP-77, secrete
      ANP at rates of approximately 10(-20) g.cell-1.min-1. This is a sufficient
      quantity to facilitate secretion studies using a perifusion system. We have
      demonstrated that ANP is released through regulated secretory pathways, as the
      Ca2+ ionophore A-23187, arginine vasopressin (AVP), and the sodium ionophore,
      monensin, were capable of modifying secretion rates. High-pressure liquid
      chromatography (HPLC) analysis indicated that the primary secretory product is
      ANP-(99-126), the circulating form of this hormone. Intracellularly, both ANP-(99
      126) and ANP-(1-126) were present, suggesting the synthesis and appropriate
      cleavage of pro-ANP-(1-126). Because both of these cell lines have doubling times
      in the range of 3-5 days, they could serve as a rapidly proliferating and easily
      maintainable supply of homogeneous tissue for release studies.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7771537
TI  - Adenosine-induced vasodilation: receptor characterization in pulmonary
      circulation.
AB  - Adenosine mediates vascular smooth muscle relaxation in the pulmonary
      circulation. The A2 receptor has been suggested to mediate adenosine-induced
      vasodilation (AIV). In this study, the effect(s) of selective adenosine agonist
      and antagonist on the hypoxic pressor response (HPR) was assessed in the isolated
      blood-perfused rat lung. Adenosine (0.075-7.5 mM) infusion (0.125 ml/min) into
      the pulmonary artery dose dependently attenuated the HPR. AIV was mimicked by 10
      microM 5'-(N-ethylcarboxamido)adenosine (NECA), a nonselective adenosine agonist.
      Adenosine- and NECA-induced vasodilation were attenuated by 67 microM 8-(p
      sulfophenyl)theophylline. In contrast, NECA-induced vasodilation was not
      attenuated by the A1 antagonist 8-cyclopentyl-1,3-dipropylxanthine (1 microM). At
      10 microM, a minimal vasodilatory effect was seen with the nonselective adenosine
      agonists CV-1808 and N6-(2-phenylisopropyl)adenosine (R-PIA) compared with NECA.
      The highly selective A2a agonist 2-[p-(2-carboxyethyl)phenyl amino]-5'-N-ethyl
      carboxamido adenosine (CGS-21680C, 10 microM) and A1 agonist 2-chloro-N6
      cyclopentyladenosine (CCPA, 10 microM) had no vasodilatory effect. Neither the K+
      channel blockers tetraethylammonium chloride (10 mM) and glibenclamide (100
      microM) nor the NO synthase inhibitor N omega-nitro-L-arginine methyl ester
      attenuated NECA-induced vasodilation. These findings suggest that AIV is mediated
      via the A2b receptor and that AIV occurs via an NO-independent mechanism.

PMID- 7771540
TI  - Indirect stimulation of Ca(2+)-activated Cl- current by Na+/Ca2+ exchange in
      rabbit portal vein smooth muscle.
AB  - Macroscopic currents were recorded in freshly dissociated smooth muscle cells
      from the rabbit portal vein using the tight seal whole cell recording mode (22
      degrees C). In some experiments, the indo 1 fluorescence technique was used to
      simultaneously monitor the changes in the concentration of free intracellular
      Ca2+ ([Ca2+]i; indo 1 ratio, 400/500 nm). In cells exposed to tetraethylammonium
      chloride (TEA) to inhibit K+ channels and 1-10 microM nifedipine or nicardipine
      to inhibit L-type Ca2+ channels, cell dialysis with 30 mM Na+ increased [Ca2+]i
      and induced membrane current consistent with the activation of Ca(2+)-activated
      Cl- channels [ICl(Ca)]. From holding potential (HP) of -60 mV, high intracellular
      Na+ concentration ([Na+]i)-mediated current was instantaneous in response to 0.5-
      to 10-s voltage clamp pulses from -80 to +20 mV; steps ranging from +20 to +80 mV
      evoked slow time-dependent outward current (I(t); superimposed on the
      instantaneous current) and voltage-dependent Ca2+ transient; on return to HP,
      slow inward tail current appeared that reflected deactivation of I(t). Both
      current components 1) exhibited outward rectifying properties, 2) reversed near
      the predicted equilibrium potential for Cl-, 3) were stimulated by elevation of
      extracellular Ca2+ concentration, 4) were abolished when the cells were dialyzed
      with 5 mM ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid,
      and 5) were inhibited by extracellular application of niflumic acid (50 microM).
      Complete replacement of extracellular Na+ concentration with tetramethylammonium
      increased both the instantaneous and time-dependent components of ICl(Ca),
      resting [Ca2+]i at -60 mV and Ca2+ transient at +40 mV. Cell dialysis with Na(+)
      free pipette solution prevented these effects. Our results are consistent with an
      indirect mechanism of stimulation of ICl(Ca), which involves intracellular Ca2+
      accumulation via reverse-mode electrogenic Na+/Ca2+ exchange activity.

PMID- 7771539
TI  - Transmural bioenergetic responses of normal myocardium to high workstates.
AB  - The response of myocardial high-energy and inorganic phosphates (HEP and Pi,
      respectively) and associated changes in myocardial blood flow, lactate uptake,
      and O2 consumption (MVo2) rates were examined in an open-chest canine model
      during progressively increasing workloads achieved by catecholamine infusion. HEP
      and Pi levels (measured with transmurally localized 31P-nuclear magnetic
      resonance spectroscopy) were unaffected by moderate increases in the level of
      energy expenditure but were significantly altered by high workloads, especially
      in the subepicardium. The MVo2 and HEP data from three different protocols that
      utilized pharmacological augmentation of blood flow demonstrated that the maximal
      rate of myocardial energy production during inotropic stimulation was dictated by
      perfusion limitation. This limitation was more severe in the subepicardial layer
      at the high workloads despite equivalent or even higher increases in blood flow
      to this layer, reflecting a preferential enhancement of demand in the outer layer
      by catecholamines. In contrast, under basal conditions, existence of a marginal
      perfusion limitation was evident in the inner but not in the outer layer.

PMID- 7771541
TI  - A noninvasive comparative study of myocardial strains in ischemic canine hearts
      using tagged MRI in 3-D.
AB  - Regional reduction in myocardial function has long been utilized for noninvasive
      detection and localization of ischemic regions in the left ventricle. In this
      study, we compared the ability of 13 different myocardial strain indexes to
      discriminate between ischemic and nonischemic tissue. Using magnetic resonance
      imaging with tagging and three-dimensional reconstruction, we noninvasively
      tracked the deformation of 24 myocardial cuboids in each of nine canine hearts
      with acute ischemia induced by coronary artery ligation. Monastral blue staining
      was used for postmortem assessment of ischemia. The ability of each index to
      discriminate between normal and ischemic zones was evaluated using the "t"
      statistic. The best discrimination was obtained by the endocardial area strain [t
      = 7.5 +/- 3.0 (SD)], a local measure of systolic shrinkage on the endocardial
      surface, and by the magnitude of the endocardial principal strain (t = 7.0 +/-
      1.9). Transmural wall thickening (t = 6.1 +/- 2.3) was the third best functional
      index. The same three indexes correlated most closely with perfusion, as assessed
      by monastral blue staining. These findings imply that these are the preferable
      functional indexes for mapping of ischemic myocardial regions.

PMID- 7771542
TI  - Adult cardiomyocytes express functional high-affinity receptors for basic
      fibroblast growth factor.
AB  - As a first step in addressing the question of function for basic fibroblast
      growth factor (bFGF) in the adult myocardium, expression of bFGF receptors by
      adult rat myocytes was investigated. Cross-linking of 125I-labeled bFGF to
      purified sarcolemmal vesicles from adult hearts indicated specific binding to 90-
      to 104-kDa proteins, whereas equilibrium binding studies revealed the presence of
      "low"-affinity (1 nM) and "high"-affinity (115 pM) sites. Adult myocytes were
      found to express short and long variants of bFGF receptor 1 (FGFR-1, tyrosine
      kinase) mRNA. Adult heart overall levels of FGFR-1 mRNA were decreased by about
      one-third of corresponding fetal values. Several lines of evidence indicated that
      bFGF receptors in adult cardiomyocytes in situ and/or in isolation are
      functional. Isolated adult myocytes were found to be capable of heparin-resistant
      internalization of 125I-labeled bFGF, to lose their viability after interaction
      with bFGF-saporin (a mitotoxin known to kill cells after entry via the bFGF
      receptor), and to respond to bFGF by activation of mitogen-activated protein
      kinase. In addition, introduction of exogenous bFGF into the myocardium by
      Langendorff perfusion resulted in stimulation of tyrosine phosphorylation in
      association with cardiomyocyte intercalated disks, as assessed by
      immunofluorescence. It is concluded that adult cardiomyocytes express
      functionally coupled high-affinity bFGF receptors and that they are capable of a
      biologic response to bFGF in vivo.

PMID- 7771543
TI  - Effects of repetitive vagal stimulation on heart rate and on cardiac vasoactive
      intestinal polypeptide efflux.
AB  - In dogs anesthetized with alpha-chloralose, we assessed the "vagally induced
      tachycardia" elicited by successive 2-min periods of intense vagal stimulation
      (0.5 ms, 10 mA, 20 Hz) after we had blocked the animals' muscarinic and beta
      adrenergic receptors with atropine and propranolol, respectively. We found that
      the tachycardia produced by the successive vagal stimulations progressively
      decreased to < 20% of the initial tachycardia response within 84 min. We also
      observed that the chronotropic response to vasoactive intestinal polypeptide
      (VIP) injected into the sinus node artery after the vagal stimulation regimen did
      not differ significantly from the response to the same dose of VIP injected prior
      to vagal stimulation. This finding indicates that the postjunctional
      responsiveness of the cardiac pacemaker cells had not diminished over the course
      of the vagal stimulation regimen. In isolated, perfused right atrial
      preparations, we observed a close correlation between the efflux of VIP from the
      atrial tissues and the chronotropic responses to vagal stimulation. Our results
      support the hypotheses that 1) VIP is a mediator of vagally induced tachycardia,
      2) the reduction in VIP efflux is associated with a diminished vagally induced
      tachycardia, and 3) the reduced efflux of VIP probably reflects a diminution in
      neuronal release, perhaps by depletion of this peptide from the vagus nerve
      endings consequent to the prolonged neural stimulation.

PMID- 7771544
TI  - Sarcoplasmic reticulum Ca2+ pumps in heart and diaphragm of cardiomyopathic
      hamster: effects of perindopril.
AB  - The polymyopathy of the Syrian hamster is associated with alterations of cellular
      calcium regulation and contractile performance of cardiac and skeletal muscles
      and, in particular, the diaphragm. Angiotensin-converting enzyme (ACE) inhibitors
      have been shown to preserve contractile performance. Therefore we analyzed the
      expression of the genes coding for the sarco(endo)plasmic reticulum Ca(2+)
      adenosinetriphosphatase (SERCA) in heart and diaphragm of the cardiomyopathic
      Syrian hamster (CSH) from the dilated strain Bio 53-58, and we tested the
      influence of ACE inhibition on accumulation of the different SERCA mRNAs. In the
      diaphragm of healthy hamsters, two SERCA mRNA isoforms were present: SERCA 1 and
      SERCA 2. At 6 mo of age, the myopathic process resulted in decreased levels of
      SERCA 1, whereas the level of SERCA 2 was unchanged. The ACE inhibitor
      perindopril (1 mg.kg-1.day-1), administered by force feeding from 1 to 6 mo of
      age, had no effect on the SERCA 1 mRNA level. In heart, the myopathy was
      associated with a depressed level of SERCA 2 mRNA in 9- but not in 6-mo-old
      animals. Perindopril treatment from 6 to 9 mo reversed cardiac hypertrophy and
      the relative decrease in SERCA 2 mRNA level. Preventive treatment with
      perindopril from 1 to 9 mo tended to prevent (not significantly) the development
      of cardiac hypertrophy and reduction in SERCA gene expression. In conclusion, the
      myopathic process affects SERCA gene expression in the diaphragm and subsequently
      in the heart. Perindopril treatment can prevent SERCA mRNA loss in heart but not
      in diaphragm.

PMID- 7771545
TI  - Platelet-activating factor increases vascular resistance in rat hindquarters by
      thromboxane A2.
AB  - The effects of platelet-activating factor (PAF) on vascular resistance and
      capillary permeability were studied in the isolated rat hindquarter. Six groups
      were studied (n = 30): control; PAF alone (1.4 microM); and PAF (1.4 microM)
      pretreated with ibuprofen (30 mg/kg), thromboxane A2 (TxA2)-receptor antagonist
      (BM-13505, 2 mg/kg), PAF-receptor antagonist (WEB-2086, 5 mg/kg), or
      dexamethasone (5 mg/kg). The vascular resistance was calculated, and the
      reflection coefficient (sigma) was determined as an index of capillary
      permeability. Exogenous PAF caused a threefold increase in vascular resistance
      peaking at 5 min and a 2.5-fold increase in capillary permeability. The increased
      vascular resistance caused by PAF alone was significantly attenuated by
      ibuprofen, BM-13505, and dexamethasone. The PAF-induced permeability was neither
      attenuated by ibuprofen nor BM-13505. However, both the increased vascular
      resistance and permeability were blocked and attenuated by WEB-2086 and
      dexamethasone, respectively. We conclude that TxA2 mediates the PAF-induced
      increased vascular resistance; however, the increased vascular permeability is
      independent of the formation of TxA2 in the isolated hindquarter.

PMID- 7771547
TI  - EDRF and norepinephrine-induced vasodilation in the canine coronary circulation.
AB  - Experiments were performed to characterize the role of endothelium-derived
      relaxing factor (EDRF) in coronary vasodilation caused by norepinephrine. The
      circumflex or left anterior descending coronary artery was cannulated and pump
      perfused with constant pressure or constant flow in closed-chest anesthetized
      dogs. Prostaglandin synthesis was blocked with ibuprofen. During constant
      pressure perfusion, EDRF inhibition with intracoronary N omega-nitro-L-arginine
      (L-NNA) did not affect the vasodilation due to nitroglycerin (an endothelium
      independent process). However, L-NNA did significantly inhibit (P < 0.001) the
      vasodilation due to acetylcholine (an endothelium-dependent process). In response
      to bolus injections of norepinephrine, EDRF inhibition with L-NNA significantly
      reduced coronary vasodilation (P < 0.001). This inhibition was partially reversed
      with L-arginine infusion. To determine whether an increase in shear stress due to
      an increase in flow was the stimulus for EDRF release, experiments were performed
      during constant-flow conditions. Vasodilation caused by nitroglycerin was not
      inhibited by L-NNA, but EDRF inhibition did blunt acetylcholine-induced
      vasodilation significantly (P < 0.001) during constant-flow perfusion. During
      EDRF inhibition with L-NNA, vasodilation due to norepinephrine was not
      significantly altered when coronary flow was held constant (P = 0.19). In
      conclusion, EDRF plays a role in norepinephrine-induced coronary vasodilation
      that is largely flow dependent.

PMID- 7771546
TI  - Effects of L-arginine analogues on vasomotion of isolated porcine coronary
      arteries.
AB  - L-Arginine analogues have been widely used to examine the role of endothelium
      derived nitric oxide (NO) in vascular responses; however, the effects of the
      agents on coronary vasomotion are not fully understood. In this study, we
      examined the effects of the analogues on vasomotion of isolated porcine coronary
      arteries. Strips of the porcine coronary artery were suspended for isometric
      tension recording in Krebs-Henseleit solution. L-Arginine analogues, N omega
      nitro-L-arginine methyl ester (L-NAME, 10(-9)-10(-3) M), NG-monomethyl-L-arginine
      (L-NMMA, 10(-9)-10(-3) M), and NG-nitro-L-arginine (L-NNA, 10(-9)-10(-3) M),
      caused dose-dependent contractions, which were greater in strips with than in
      those without endothelium. Those endothelium-dependent contractions were almost
      abolished by indomethacin (10(-5) M) and FeCl2 (10(-3) M). The latter reduces
      prostaglandin H2 to 12-heptadecatrienoic acid, which has no vasoconstrictor
      effect. These results indicate that the L-arginine analogues cause endothelium
      dependent contractions that are mediated by prostaglandin endoperoxides and
      suggest that they have properties other than simple inhibition of NO synthesis in
      porcine coronary arteries.

PMID- 7771548
TI  - Solvent drag of LDL across mammalian endothelial barriers with increased
      permeability.
AB  - We investigated the mechanisms of hamster low-density lipoprotein (LDL) transport
      across the endothelial barrier in individually perfused venular microvessels in
      hamster mesentery. These experiments are the first to use microperfusion
      techniques and quantitative fluorescence microscopy to investigate LDL transport
      across mammalian microvessel endothelium. The apparent permeability coefficient
      for hamster LDL, PsLDL, rose from 2.7 x 10(-7) cm/s at control to 23.2 x 10(-7)
      cm/s at the peak of the biphasic increase in microvessel permeability after
      exposure of the vessels to 100 microM histamine. Close to the peak, PsLDL rose
      1.85 x 10(-7) cm/s for every centimeter of H2O increase in hydrostatic pressure.
      Thus, at a mean pressure of 11.3 cmH2O, 90% of the LDL flux was coupled to
      transendothelial water flow by a solvent drag mechanism. The corresponding
      solvent drag reflection coefficient for hamster LDL was estimated to be
      approximately 0.8. These results are consistent with sieving hamster LDL
      (effective radius 14.9 nm) through equivalent pores of approximately 22 nm
      radius. Similar results were found with human LDL (effective radius 13.2 nm) in
      hamster microvessels. The results provide a bridge between studies of LDL
      transport across cultured endothelial barriers, where high diffusive permeability
      coefficients to LDL may obscure the contributions of solvent drag, and studies in
      whole animals, where the consequences of sieving of LDL at the vessel wall, even
      in the high permeability state, have not received much attention.

PMID- 7771549
TI  - Role of chloride currents in repolarizing rabbit atrial myocytes.
AB  - Rabbit atrial cells manifest a prominent transient outward K+ current (Ito1), but
      this current recovers slowly from inactivation and is unlikely to be important at
      physiological rates (3-5 Hz). Depolarization of rabbit atrial cells also elicits
      a transient Ca(2+)-dependent outward Cl- current (Ito2). To compare the relative
      magnitude of these transient outward currents at various rates, we applied whole
      cell voltage-clamp techniques to isolated rabbit atrial myocytes. Whereas peak
      Ito1 exceeded Ito2 at slow rates (0.1 Hz), Ito1 was strongly reduced as rate was
      increased (by 97 +/- 2%, mean +/- SE, at 4 Hz), while Ito2 was slightly reduced
      (by 28 +/- 4%, 4 Hz). The reversal potential of transient outward tail currents
      at 0.07 Hz was -49 +/- 9 mV, while at 2.5 Hz the reversal potential became -18 +/
      7 mV (calculated Cl- reversal potential -18 mV). The addition of the Cl-
      transport blocker 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS; 150
      microM) or the replacement of external Cl- with methanesulfonate inhibited a
      large part of the transient outward current elicited by depolarization at 4 Hz.
      DIDS and Cl- replacement increased action potential duration in both single
      rabbit atrial cells and multicellular rabbit atrial preparations. We conclude
      that the Ca(2+)-dependent Cl- current is substantially larger than the transient
      K+ current at physiological rates in the rabbit and is likely to play a more
      important role in action potential repolarization than the latter current in this
      tissue in vivo.

PMID- 7771550
TI  - Contributions of sickle hemoglobin polymer and sickle cell membranes to impaired
      filterability.
AB  - Sickle cell anemia is a disease of abnormal rheology caused by acute and
      reversible, as well as chronic and irreversible, changes in the properties and
      deformability of sickle erythrocytes. Deformability is determined by several
      factors, including intracellular sickle hemoglobin polymerization, the abnormal
      membrane properties of sickle cells, and the abnormal rheological properties of
      the soluble concentrated hemoglobin solution within dense sickle red blood cells.
      In this study, we used a 5-microns pore nickel mesh filter to evaluate
      quantitatively the effects of these factors on the filterability of erythrocytes
      containing sickle hemoglobin. We used sickle trait and sickle/beta(+)-thalassemia
      cells, because they have minimal membrane abnormalities or density heterogeneity,
      to investigate the effects of polymer formation on rheological properties. We
      found that filterability of these cells is sensitive to small amounts of
      intracellular polymer and that impaired filtration is linearly related to oxygen
      dependent polymer formation, up to a polymer fraction of 0.3. By increasing the
      proportion of dense cells in populations of normal cells or cells from
      individuals with sickle syndromes and equilibrating these cells with gas ligands,
      we estimate that polymerization, even at 95% saturation, contributes twice as
      much to impaired filterability of sickle erythrocytes as the abnormal membranes
      in homozygous sickle cell disease. At lower saturation values, the effects of
      polymer are even greater. The viscosity of the concentrated hemoglobin in dense
      cells had the smallest effect, over physiologically relevant saturation values.
      These results emphasize the importance of sickle hemoglobin polymerization in the
      pathogenesis of sickle cell disease and should help define its pathophysiology
      and responses to therapy in quantitative terms.

PMID- 7771551
TI  - Potentiation of angiotensin II-stimulated vascular contraction by lithium.
AB  - Previous studies have suggested that lithium prolongs or enhances vascular
      contractions stimulated by alpha-adrenergic agents. The present study was
      performed to determine whether a similar phenomenon occurs with angiotensin II
      (ANG II)-stimulated contractions and whether this phenomenon results from
      interactions with the phosphoinositide signaling system. Contractions of rat
      aortic rings with 100 nM ANG II were 38% greater in the presence of 20 mM LiCl
      than in its absence (0.47 +/- 0.07 vs. 0.34 +/- 0.05 g tension/mg dry tissue wt,
      P < 0.01). The effects of lithium on inositol phosphate responses, diacylglycerol
      responses, and intracellular calcium concentration on single or repeated
      stimulations with ANG II were then examined in vascular smooth muscle cells
      cultured from rat aorta. Cells exposed twice to 100 nM ANG II contained 50% lower
      inositol trisphosphate levels (InsP3) and 10% lower diacylglycerol levels than
      cells exposed to ANG II only once. LiCl or lithium acetate abolished these
      desensitizations in a concentration-dependent manner. Similarly, InsP3 and
      diacylglycerol responses to a single exposure of ANG II were heightened by
      lithium (by 75 and 25%, respectively), and the duration of the responses was
      prolonged by lithium (5- and 2-fold, respectively). In contrast, ANG II
      stimulated calcium transients were not enhanced or prolonged by lithium, nor was
      desensitization of ANG II-stimulated cytosolic calcium mobilization upon serial
      exposures abolished by lithium. When ring contraction studies were repeated in
      the presence of the protein kinase C inhibitor staurosporine (150 nM), lithium no
      longer potentiated ANG II contractions [0.38 +/- 0.03 (control) vs. 0.35 +/- 0.06
      g tension/mg dry tissue wt (lithium)].(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771552
TI  - Electrophysiological effects of alpha 2-adrenergic stimulation in canine cardiac
      Purkinje fibers.
AB  - The effects of alpha 2-adrenergic stimulation on action potentials were measured
      in isolated canine Purkinje fibers. Action potential durations at 50 and 90% of
      repolarization (APD50 and APD90) were significantly prolonged by 0.25 microM l
      norepinephrine + 0.5 microM dl-propranolol (NE+P) from baseline values of 166 +/-
      7 and 249 +/- 9 (SE) ms (n = 7) to 174 +/- 7 and 265 +/- 9 ms, respectively (P <
      0.05 for both). Selective alpha 2-blockade with 0.01 microM yohimbine (YO)
      reduced this prolongation by NE+P in APD50 and APD90 to 169 +/- 7 and 256 +/- 8
      ms, respectively (P < 0.05 compared with NE+P). Additional selective alpha 1
      blockade with 0.01 microM prazosin (PZ) completely blocked the effects of NE+P,
      returning APD50 and APD90 to 163 +/- 7 and 250 +/- 9 ms (not different from
      baseline). After incubation of isolated Purkinje fibers with pertussis toxin (1
      microgram/ml), which reduced the availability of a 41-kDa membrane protein for
      ADP ribosylation by 70 +/- 7% (n = 4, P < 0.05), YO failed to reverse the
      prolongation in action potential durations brought on by NE+P, but the effects of
      PZ were intact. The effects of alpha 2-stimulation on beta-adrenergic-induced
      delayed afterdepolarizations (DADs) were studied by burst pacing of Purkinje
      fibers in Tyrode solution containing 7.5 mM Ca2+. The DADs induced in the
      presence of NE+PZ (beta- + alpha 2-stimulation) were significantly smaller in
      amplitude and required a shorter pacing cycle length to reach threshold than
      those induced in the presence of NE+PZ+YO (unopposed beta-adrenergic
      stimulation). Furthermore sustained triggered activity, seen in five of eight
      preparations under beta-stimulation, could no longer be elicited in the presence
      of beta- + alpha 2-stimulation. These results suggest that the postjunctional
      alpha 2-adrenergic receptors in canine Purkinje fibers are coupled to a pertussis
      toxin-sensitive G protein and that stimulation of these receptors leads to action
      potential prolongation and suppression of DADs induced by beta-adrenergic
      stimulation.

PMID- 7771553
TI  - Whole cell membrane currents in cultured pig endocardial endothelial cells.
AB  - The whole cell mode of the patch-clamp technique was applied to cultured
      endocardial endothelial cells from the porcine right ventricle to study their
      electrophysiological properties. With isotonic pipette and bathing solutions (300
      310 mosmol/kgH2O), single endocardial endothelial cells had resting membrane
      potentials ranging from -20 to -90 mV (mean = -55 +/- 20 mV, n = 48). In voltage
      clamp experiments, the main membrane current was an inwardly rectifying K+
      current with all characteristics described for the inwardly rectifying K+ current
      in vascular endothelium. Outward currents at positive clamp potentials were
      small, but when cell swelling was induced by means of a hypertonic pipette or
      hypotonic bathing solution and ATP (5 mM) was present in the pipette solution, a
      large outwardly rectifying current developed. This volume-activated current was
      insensitive to extracellular K+ or Na+ concentration variations but sensitive to
      changes in extracellular Cl- concentrations. It was inhibited in the presence of
      4,4'-diisothiocyanostilbene-2,2 disulfonic acid (100-300 microM) and flufenamic
      acid (50-100 microM). Volume-activated Cl- channels are different from the
      stretch-activated cationic channels described in vascular endothelium and might
      be involved in the regulation of cell volume or the response to mechanical
      stretch.

PMID- 7771554
TI  - Lysophosphatidic acid alters cerebrovascular reactivity in piglets.
AB  - Effects of the lipid mediator lysophosphatidic acid (LPA) were studied on the
      cerebral circulation of newborn pigs using closed cranial windows. Topical
      application of synthetic LPA caused dose-dependent vasoconstriction and inhibited
      vasodilation to hypercapnia and isoproterenol. These vasodilators elicited a rise
      in the adenosine 3',5'-cyclic monophosphate (cAMP) content of the cerebrospinal
      fluid, which was inhibited dose dependently by LPA. Pertussis toxin (1
      microgram/ml) completely abolished LPA-induced vasoconstriction and the altered
      vascular reactivity, and LPA no longer decreased cAMP. Electrophysiological
      recording of currents evoked by LPA-like lipids in Xenopus oocytes showed that
      cerebrospinal fluid is normally devoid of LPA-like factors. In contrast, the
      amount of LPA-like factors generated 4 days after intrathecal injection of
      autologous blood was in the range of 1-10 microM LPA equivalents. The data
      indicate that LPA-like bioactive mediators were generated in an intracranial
      hematoma model and that these phospholipids might play a role in the
      pathophysiology of altered vascular reactivity often found in posthemorrhagic
      conditions and could also contribute to the development of posthemorrhagic
      vasoconstriction.

PMID- 7771555
TI  - Selective reduction of PVR by inhalation of a cGMP analogue in a porcine model of
      pulmonary hypertension.
AB  - Selective reduction of pulmonary vascular resistance (PVR) remains a therapeutic
      goal for the treatment of pulmonary hypertension, but current therapeutic options
      remain limited. Although the gas nitric oxide (NO) selectively dilates the
      pulmonary vascular bed, it requires special equipment for administration, has a
      short biologic half-life, and is potentially toxic. We hypothesized that
      stimulation of the NO pathway at the level of its second messenger, guanosine
      3',5'-cyclic monophosphate (cGMP), by targeted pulmonary delivery of a membrane
      permeable nonhydrolyzable cGMP analogue would cause selective pulmonary
      vasodilation. Pulmonary hypertension was induced in 21 pigs by the intravenous
      infusion of a thromboxane A2 analogue (9,11-dideoxy-9 alpha,11 alpha
      epoxymethanoprostaglandin F2 alpha). Inhaled 8-bromoguanosine 3',5'-cyclic
      monophosphate (8-BrcGMP) lowered PVR in a time- and dose-dependent manner, with
      maximal effect achieved after 20 min. Compared with physiological saline control,
      8-BrcGMP inhalation (3.0 micrograms/kg) lowered PVR by 25 +/- 3% (P < 0.01),
      whereas there was no significant decline in systemic vascular resistance (4 +/-
      6%); mean pulmonary arterial pressure declined 13 +/- 3% (P < 0.01), whereas
      there was little change in mean arterial pressure; cardiac output increased 10 +/
      4% (P < 0.05). PVR did not decrease after inhalation of noncyclic 8
      bromoguanosine 5'-monophosphate, indicating that stimulation of the NO-cGMP
      pathway beyond the level of NO results in pulmonary vasodilation independent of
      stimulation of purinergic receptors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771556
TI  - Ischemic preconditioning attenuates capillary no-reflow induced by prolonged
      ischemia and reperfusion.
AB  - Ischemic preconditioning (IPC) refers to a phenomenon in which a tissue is
      rendered resistant to the deleterious effects of prolonged ischemia and
      reperfusion by prior exposure to brief, repeated periods of vascular occlusion.
      The purposes of this study were to determine whether IPC would reduce the extent
      of capillary no-reflow in postischemic skeletal muscle and whether the protective
      effect of IPC was due to activation of ATP-sensitive potassium (KATP) channels.
      To address the first aim, capillary perfusion was assessed in vascularly isolated
      canine gracilis muscles subjected to 4.5 h of continuous perfusion, 4 h of
      ischemia followed by 30 min of reperfusion (I-R), and IPC (4 periods of 5 min
      ischemia followed by 5 min reperfusion) before I-R. I-R was associated with a
      reduction in the number of patent capillaries per fiber (0.6 +/- 0.1) relative to
      nonischemic control muscles (2.5 +/- 0.1), an effect that was attenuated by IPC
      (1.3 +/- 0.1 patent capillaries fiber). A role for KATP channels in the
      protective effect of IPC is supported by the observation that administration of a
      KATP channel antagonist (glibenclamide) 10 min before induction of IPC abolished
      the protective effect of preconditioning (0.6 +/- 0.1 patent capillaries/fiber).
      On the other hand, treatment of nonpreconditioned muscles with a KATP channel
      agonist (pinacidil) mimicked the protection afforded by IPC (1.2 +/- 0.1 patent
      capillaries/fiber). Moreover, the protective effect of pinacidil treatment was
      reversed by prior administration of glibenclamide (0.5 +/- 0.1 patient
      capillaries/fiber). These data indicate that IPC improves postischemic capillary
      perfusion by a mechanism that involves activation of KATP channels.

PMID- 7771557
TI  - Inhibition of arteriole alpha 2- but not alpha 1-adrenoceptor constriction by
      acidosis and hypoxia in vitro.
AB  - We have found that hypoxia and acidosis inhibit constriction by alpha 2D
      adrenoceptors but not by alpha 1D-adrenoceptors on arterioles of rat skeletal
      muscle, facilitating local metabolic control of blood flow. When activated by
      full agonists like norepinephrine, this alpha 2D-constriction relies on Ca2+
      influx through dihydropyridine-sensitive, voltage-operated Ca2+ channels (VOC),
      while alpha 1D-constriction does not. The purpose of the present study was to
      examine the dose sensitivity of this selective metabolic inhibition of alpha 2D
      constriction and determine whether inhibition of VOCs is involved. Changes in
      lumen diameter of microcannulated arterioles isolated from rat skeletal muscle
      (107 +/- 3 microns control diam) were measured by videomicroscopy for bath-added
      agents. Decreases in pH (7.4-7.0) or PO2 (70 to 10 mmHg) caused graded inhibition
      of alpha 2D-adrenoceptor constriction (UK-14304 plus prazosin); the half-maximum
      inhibitory concentration for acidosis was 7.1 and for PO2 was 24 mmHg. alpha 1D
      Adrenoceptor constriction by the respective full and partial alpha 1-agonists,
      phenylephrine (PE) and St-587 (both plus rauwolscine), was unaffected. Because St
      587 but not PE constriction was dependent on VOC activation, the sensitivity of
      alpha 2D- but not alpha 1D-constriction to acidosis and hypoxia appeared to be
      independent of reliance on VOCs. This was examined directly; contractile
      sensitivity to KCl and the VOC agonist, SDZ-202-791, was unaffected by pH 7.0 or
      PO2 10 mmHg. These data suggest that alpha 2D-constriction is sensitive to
      inhibition by hypoxia and acidosis through a mechanism that does not involve
      direct blockade of dihydropyridine-sensitive Ca2+ channels.

PMID- 7771558
TI  - Episodic hypertension due to autonomic dysreflexia in acute and chronic spinal
      cord-injured rats.
AB  - Spinal cord injury results in abnormal sympathetic control of the cardiovascular
      system, consisting of exaggerated reflexes with resulting hypertension and
      bradycardia that has been termed autonomic dysreflexia. We studied changes in
      arterial pressure and heart rate caused by colon or urinary bladder distension in
      unanesthetized acute (7 day) and chronic (30 day) spinal cord-injured rats to
      evaluate the time course of these responses in an animal model of spinal cord
      injury. In conscious control rats colon and bladder distension caused brief (2-10
      s) pressor responses of 10 mmHg associated with tachycardia and escape reactions.
      Colon distension in spinal cord-injured rats increased arterial pressure by 41 +/
      2, 22 +/- 3; and 49 +/- 5 mmHg at 24 h and 7 and 30 days after cord transection,
      respectively. These responses lasted 30 s-5 min and were accompanied by
      bradycardia. Distension of the urinary bladder caused similar responses in spinal
      rats after 24 h and 30 days of cord transection. We propose that the initial
      responses may be related to loss of descending inhibition of spinal reflexes but
      that plastic changes in the spinal cord is one of the mechanisms for the
      autonomic dysreflexia occurring 1 mo after injury.

PMID- 7771560
TI  - Large artery remodeling after myocardial infarction.
AB  - Rats with myocardial infarction (MI) after coronary artery ligation (n = 75) and
      sham operated rats (n = 40) were treated with captopril (2 g/l drinking water),
      hydralazine (80 mg/l drinking water), or untreated water for 3 wk. Arterial
      hemodynamics, carotid artery mechanical properties, and water permeability were
      measured. Arterial wall stress and interstitial fluid velocity were calculated.
      In infarcted rats, the characteristic impedance at matched pressure was increased
      by 135% (P < 0.02); captopril and hydralazine decreased characteristic impedance
      (P < 0.015). MI altered the material constants; captopril but not hydralazine
      normalized these constants. Water permeability was increased by 221% (P < 0.001)
      in infarcted rats; captopril but not hydralazine reversed water permeability (P <
      0.05). MI resulted in a 59% increase (P < 0.05) in the arterial collagen area and
      a 22% decrease (P < 0.05) in the media thickness. Captopril but not hydralazine
      decreased (P < 0.03) collagen area. In conclusion, 1) arterial remodeling defined
      by alterations in the passive mechanical properties, water permeability, and
      structure occurs in rats after MI; and 2) captopril but not hydralazine reverses
      the arterial remodeling.

PMID- 7771559
TI  - Endothelin-1 and its binding sites are upregulated in pressure overload cardiac
      hypertrophy.
AB  - The purpose of this study was to determine whether endothelin and endothelin
      receptors play an important role in the development of cardiac hypertrophy due to
      pressure overload in vivo. Cardiac hypertrophy was produced by placing a
      constricting clip around the suprarenal abdominal aorta of rats. Hemodynamic
      parameters and plasma and ventricular concentrations of endothelin-1 (ET-1) were
      measured in control unoperated rats, and 30 min, 2 and 6 h, and 1 and 8 days
      after operation in pressure overload rats and sham-operated rats. The density and
      dissociation constant of ET-1 binding sites were also measured in control rats
      and 1 and 8 days after pressure overload and sham operation. Additionally, in
      situ mRNA hybridization for preproendothelin-1 (preproET-1) mRNA was performed to
      determine which cells were responsible for increased ET-1 levels. Ventricular ET
      1 levels increased markedly on day 8 of pressure overload, whereas plasma ET-1
      levels increased transiently only 30 min after operation, quickly returning to
      control level. In addition, ventricular ET-1 levels on day 8 showed a significant
      positive correlation with the degree of cardiac hypertrophy. In situ mRNA
      hybridization revealed that cardiac myocytes expressed preproET-1 mRNA in
      hypertrophied hearts in vivo. In accord with the elevation of ventricular ET-1
      levels, the density of ET-1 binding sites was increased significantly, without
      affecting their binding affinity, on day 8 of pressure overload. These data are
      compatible with the hypothesis that increases in locally produced ET-1 and the
      density of ET-1 binding sites have an important relationship with the development
      of cardiac hypertrophy in vivo.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771561
TI  - Effects of chronic supraventricular pacing tachycardia on relaxation rate in
      isolated cardiac muscle cells.
AB  - Chronic supraventricular pacing tachycardia (SVT) causes abnormalities in both
      ventricular and cellular relaxation. The mechanisms causing these abnormalities
      have not been fully determined. To examine two of the possible mechanisms, a
      decrease in restoring force or an impairment of the intrinsic myocardial
      relaxation process, cardiocytes were enzymatically isolated from the left
      ventricle of pigs subjected to left atrial pacing at 240 beats/min for 3 wk and
      normal control pigs. SVT caused a decrease in the extent of cardiocyte shortening
      and the velocity of cardiocyte lengthening. To determine whether the changes in
      the relaxation velocity merely reflected a concomitant decrease in the extent of
      cardiocyte shortening (and a resultant decrease in restoring forces) or, in
      addition, reflected impairment in intrinsic relaxation properties, the relation
      between cardiocyte relaxation velocity and cardiocyte shortening extent was
      examined. There was a direct relation between relaxation velocity and shortening
      extent in both control and SVT cardiocytes. However, SVT decreased the relaxation
      velocity at any common extent of shortening and decreased the slope of the direct
      relation (slope 5.91 in control vs. 3.51 s-1 in SVT, P < 0.05). Therefore, these
      data suggested that SVT caused a primary impairment in the intrinsic myocardial
      relaxation process independently of a decrease in restoring force.

PMID- 7771562
TI  - Cardiac-cardiovascular reflexes induced by hydrogen peroxide in cats.
AB  - We have shown previously that reactive oxygen species stimulate abdominal
      sympathetic afferents to cause reflex cardiovascular activation. Because
      myocardial ischemia and reperfusion also generate reactive oxygen species, we
      investigated the possibility that cardiovascular reflexes could be induced by
      topical application of H2O2 to the anterior or posterior ventricular surface in
      cats anesthetized with alpha-chloralose. Mean arterial pressure (MAP), heart rate
      (HR), left ventricular (LV) pressure, aortic flow (AF), and first derivative of
      LV pressure at 40 mmHg developed pressure (LV dP/dt40) were monitored. H2O2 (44
      and 130 mumol) significantly increased MAP but not HR or LV dP/dt40 in intact
      cats (n = 8). Application of H2O2 (44 mumol) significantly increased MAP (129 +/-
      9 to 152 +/- 10 mmHg), HR (240 +/- 11 to 245 +/- 10 beats/min), AF (191 +/- 13 to
      212 +/- 17 ml/min), total peripheral resistance (0.68 +/- 0.13 to 0.73 +/- 0.04
      peripheral resistance units), and LV dP/dt40 (2,666 +/- 145 to 3,012 +/- 205
      mmHg/s) after bilateral cervical vagotomy (n = 6). These H2O2-induced excitatory
      responses were abolished after bilateral T1-T4 ganglionectomy. In six additional
      cats, H2O2 (44 mumol) significantly decreased MAP (114 +/- 5 to 102 +/- 5 mmHg),
      HR (207 +/- 7 to 190 +/- 7 beats/min), and LV dP/dt40 (2,776 +/- 168 to 2,600 +/-
      153 mmHg/s) after sympathectomy. These depressor responses were eliminated after
      vagotomy. The magnitude of the cardiovascular reflexes was increased or decreased
      in a dose-dependent fashion in vagotomized or sympathectomized cats,
      respectively, over a range of 440 nmol to 44 mumol H2O2. Application of H2O2 to
      the anterior or posterior ventricular surface resulted in similar pressor or
      depressor reflexes. Dimethylthiourea and deferoxamine abolished pressor or
      depressor responses evoked by H2O2 in both vagotomized (n = 8) and
      sympathectomized (n = 8) cats. We conclude that reactive oxygen species,
      particularly the hydroxyl radical, can participate in activating cardiac
      afferents responsible for reflex cardiovascular responses during myocardial
      ischemia and reperfusion. An inhibitory reflex is transmitted through vagal
      afferents, whereas an excitatory reflex is conducted by sympathetic cardiac
      afferents.

PMID- 7771563
TI  - Left ventricular mechanics in arrested dog heart: effects of ventricular
      interaction and vascular volumes.
AB  - The present study was designed to determine the effects of right heart pressure
      on the compliance of the left ventricle (LV). The studies were conducted on
      isolated, blood-perfused, potassium-arrested dog hearts with vasomotor tone
      either present (n = 5) or absent (n = 8). A balloon was used to control LV
      volume, whereas right heart (RHP) or coronary sinus (CSP) pressures were
      controlled via a column placed in the right heart or coronary sinus,
      respectively. Control of CSP independently of RHP allowed us to assess the
      relative contribution of coronary venous pressure to changes in LV compliance
      under conditions of elevated RHP. LV volume and compliance at a LV pressure of 15
      mmHg (V15 and C15, respectively) were calculated to quantify the shift and slope
      changes of the LV pressure-volume (P-V) relationships. V15 and C15 decreased with
      vasomotor tone present from 52.8 +/- 1.4 ml and 1.7 +/- 0.1 ml/mmHg at control,
      to 43.3 +/- 2.1 ml and 1.4 +/- 0.1 ml/mmHg (P < 0.05) with RHP = 0 and 20 mmHg,
      respectively. Similar effects were obtained with vasodilation, but C15 was
      significantly lower relative to autoregulation but C15 was significantly lower
      relative to autoregulation (1.0 +/- 0.1 at control RHP, P < 0.05). Elevation of
      CSP with vasomotor tone resulted in an upward shift in the LV P-V relationship:
      V15 decreased from 53.4 +/- 2.1 at CSP = 0 mmHg to 50.9 +/- 1.6 ml at CSP = 20
      mmHg (P < 0.05). After vasodilation there was no detectable shift in the LV P-V
      relationship with elevation of CSP.

PMID- 7771564
TI  - Roles of colloidal molecules in Starling's hypothesis and in returning
      interstitial fluid to the vasa recta.
AB  - To begin to understand the role of colloidal molecules, a simple question
      requires an answer: How do the solutes alter water in an aqueous solution?
      Hulett's answer deserves attention, namely, the water in the solution at
      temperature and external pressure applied to solution (T,pe1) is altered in the
      same way that pure water is altered by reducing the pressure applied to it by the
      osmotic pressure of the water at a free surface of the solution. It is nonsense
      to relate the lower chemical potential of water in a solution to a lower fugacity
      or to a lower activity of the water in the solution, since these terms have no
      physical meaning. It is also incorrect to attribute the lower chemical potential
      of the water to a lower concentration of water in the solution. Both claims are
      derived from the teachings of G. N. Lewis and are erroneous. Textbook accounts of
      the flux of fluid to and from capillaries in the kidney and other tissues are
      inadequate, if not in error, as they are based on these bogus claims. An
      understanding of the process by which colloidal proteins in plasma affect the
      flux of nearly protein-free fluid across the capillary endothelium must start
      with insights derived from the teachings of G. Hulett and H. Dixon. The main
      points are 1) colloidal molecules can exert a pressure against a membrane that
      reflects them and, thereby, displace a distensible membrane; 2) they can alter
      the internal tension of the fluid through which they diffuse when there is a
      concentration gradient of the molecules; and 3) only by these means can they
      influence the flux of plasma fluid across the capillary endothelium. However, the
      process is complex, since both the hydrostatic pressure and protein
      concentrations of fluids inside and outside the capillary vary with both position
      and time as plasma flows through the capillary.

PMID- 7771565
TI  - A chemoreflex model of relation between blood pressure and heart rate in sleep
      apnea syndrome.
AB  - In obstructive sleep apnea syndrome (OSAS), pronounced low-frequency (LF)
      oscillations of blood pressure and interbeat interval (I) occur during recurrent
      apneas. We investigated the time relations between LF oscillations of diastolic
      pressure (D) and I in 12 patients with OSAS by means of spectral analysis. A high
      coherency between I and D was found, allowing a description of the relation by
      gain and phase. Oscillations in I and D were almost in counterphase in the LF
      range. Simple physiological models were implemented to interpret the observed
      features of LF oscillations. Model 1 describes the vagal and sympathetic
      influence by the carotid body chemoreflex on the circulation. From derivation of
      the frequency response of this model, gain and phase relations were obtained as
      would be expected from the action of the chemoreflex. We found that a range of
      phase relations can be induced by this reflex, depending on the relative vagal
      and sympathetic efferent influence on the circulation. This range of phase
      relations was indeed observed in 10 patients. Extended models that also included
      the orienting reflex (model 1a) or the baroreflex and a mechanical influence of
      breathing on the circulation (model 2) could not fit the data without a major
      contribution of the chemoreflex. We conclude that the relation between LF
      oscillations in I and D in OSAS can be explained by assuming that stimulation of
      the carotid body chemoreflex is the main source of these oscillations.

PMID- 7771566
TI  - Evidence for involvement of opioid receptors in ischemic preconditioning in rat
      hearts.
AB  - The purpose of the present study was to investigate a possible role of opioid
      receptors in ischemic preconditioning (PC). To test this hypothesis,
      anesthetized, open-chest, male Wistar rats were subjected to five different
      protocols. In group I, the control group was subjected to 30 min of left coronary
      artery occlusion and 2 h of reperfusion. In group II, ischemic PC was elicited by
      three 5-min occlusion periods interspersed with 5 min of reperfusion. In group
      III, naloxone (NL, 3 mg/kg iv), a nonselective opioid antagonist, was given to
      nonpreconditioned rats 10 min before the 30-min occlusion period. Finally, NL was
      administered 10 min before preconditioning (NL + PC, group IV) or immediately
      after the last 5-min preconditioning period (PC + NL, group V). Infarct size (IS)
      as a percentage of the area at risk (AAR) (IS/AAR) was determined by 2,3,5
      triphenyltetrazolium chloride staining. PC resulted in a marked reduction in
      myocardial IS from 45 +/- 5 to 8 +/- 1 (P < 0.05). NL treatment before or
      immediately after PC abolished this protective effect; however, NL had no effect
      on IS in non-PC rats. These results are the first to support the hypothesis that
      activation of opioid receptors may play an important role in ischemic PC in the
      rat myocardium.

PMID- 7771567
TI  - Left ventricular pressure is an important determinant of coronary oscillatory
      flow amplitude.

PMID- 7771568
TI  - Metabolic adaptations for desert survival in the Bedouin goat.
AB  - Energy conservation is a key adaptation for desert survival in the Bedouin goat.
      When food is scarce, metabolism is reduced and body weight can be maintained
      indefinitely on less than one-half of normal intake. We hypothesized that
      metabolism would be turned down during both rest and exercise, but it was not. It
      was low when animals rested and returned to normal during exercise. We expected
      catecholamines and thyroid hormones would modulate metabolism, but they did not.
      The reduction in metabolism preceded any change in thyroid hormone
      concentrations, and infusions of epinephrine did not restore reduced metabolism
      to normal levels. Finally, we expected the gut would be the major organ system
      involved in the metabolic reduction because less food is eaten, processed, and
      absorbed. Contrary to our expectations, we found that muscle is the primary organ
      system responsible for the reduction. It appears that the adaptations of the
      Bedouin goat for surviving on limited food supplies involve different organ
      systems and different modulators to reduce metabolism from those known for other
      mammals.

PMID- 7771569
TI  - Light-induced suppression of the rat circadian system.
AB  - In a constant environment, circadian rhythms persist with slightly altered period
      lengths. Results of studies with continuous light exposure are less clear,
      because of short exposure durations and single-variable monitoring. This study
      sought to characterize properties of the oscillator(s) controlling the rat's
      circadian system by monitoring both body temperature and locomotor activity. We
      observed that prolonged exposure of male Sprague-Dawley rats to continuous light
      (LL) systematically induced complete suppression of body temperature and
      locomotor activity circadian rhythms and their replacement by ultradian rhythms.
      This was preceded by a transient loss of coupling between both functions.
      Continuous darkness (DD) restored circadian synchronization of temperature and
      activity circadian rhythms within 1 wk. The absence of circadian rhythms in LL
      coincided with a mean sixfold decrease in plasma melatonin and a marked dampening
      but no abolition of its circadian rhythmicity. Restoration of temperature and
      activity circadian rhythms in DD was associated with normalization of melatonin
      rhythm. These results demonstrated a transient internal desynchronization of two
      simultaneously monitored functions in the rat and suggested the existence of two
      or more circadian oscillators. Such a hypothesis was further strengthened by the
      observation of a circadian rhythm in melatonin, despite complete suppression of
      body temperature and locomotor activity rhythms. This rat model should be useful
      for investigating the physiology of the circadian timing system as well as to
      identify agents and schedules having specific pharmacological actions on this
      system.

PMID- 7771570
TI  - Metabolism of erythropoietin in conscious pregnant rats.
AB  - Circulating erythropoietin (EPO) concentration increases during human and rat
      gestation, thereby contributing to the expansion of red cell mass. However, the
      mechanism(s) underlying gestational increases of the hormone is unknown. Our
      objective was to define whether the elevated EPO levels are secondary to
      decreased metabolic clearance or to enhanced production. The half-life of the
      hormone was also measured. A bolus and a constant infusion of 125I-labeled
      recombinant human EPO (125I-rhEPO) were administered to chronically instrumented
      conscious pregnant and virgin rats. The metabolic clearance rate of the 125I
      rhEPO was slightly but significantly higher in gravid rats than in the virgin
      control animals (0.13 +/- 0.01 vs. 0.10 +/- 0.01 ml/min). The plasma half-life of
      125I-rhEPO was 2.9 +/- 0.1 h for the pregnant rats and 2.9 +/- 0.2 h for the
      virgin controls. To confirm these results obtained by using 125I-rhEPO, EPO-rich
      plasma was generated in anemic rats and administered to another group of
      conscious virgin and pregnant rats. The half-life of homologous EPO was 2.9 +/-
      0.5 and 3.3 +/- 0.1 h for gravid and virgin rats, respectively (P = NS). We
      conclude that elevated circulating EPO in rat gestation is secondary to increased
      biosynthesis and not to decreased metabolic clearance.

PMID- 7771571
TI  - Lactate influx into red blood cells of athletic and nonathletic species.
AB  - Transport of lactate across the erythrocyte membrane proceeds by three distinct
      pathways: 1) nonionic diffusion of lactic acid, 2) inorganic anion exchange (band
      3), and 3) a monocarboxylate-specific (MC) carrier mechanism. This study
      determined the contributions of these three pathways in the red blood cells
      (RBCs) of "athletic" and "nonathletic" species. Blood samples were obtained from
      four male animals of each species: 1) Canis familiaris (dogs), 2) Capra hircus
      (goats), 3) Equus caballus (horses), and 4) Bos taurus (cattle). Contribution of
      each pathway to total lactate influx was determined by measuring L-[14C]lactate
      influx into lactate-depleted control RBCs, p-chloromercuribenzenesulfonic acid
      (PCMBS)-treated (1 mM) RBCs, and 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid
      (DIDS)-treated (0.2 mM) RBCs at three lactate concentrations ([La] values 1.6,
      8.1, and 41 mM). PCMBS blocked MC transport and DIDS blocked the band 3 pathway.
      Lactate influx into the RBCs of the athletic species was 4-160 times faster (P <
      0.05) than influx into the RBCs of the nonathletic species at 8.1 and 41 mM [La]
      values. Nonionic diffusion was greater in the RBCs of nonathletic animals
      (approximately 7-25%) than in the RBCs of athletic animals (approximately 4%). A
      significantly higher percentage of the total lactate influx occurred via the band
      3 system in the RBCs from the nonathletic animals (approximately 56-83%) vs. the
      RBCs from the athletic animals (approximately 6-7%) at all [La] values.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7771572
TI  - Mechanical basis of ANP secretion in beating atria: atrial stroke volume and ECF
      translocation.
AB  - To investigate the mechanism by which an increase in pacing frequency or
      distension increases the secretion of atrial natriuretic peptide (ANP), the
      changes in atrial volume during contraction (atrial stroke volume), transmural
      transport of the extracellular fluid (ECF), and ANP secretion were quantified in
      the beating perfused rabbit atria. The atrium was stimulated by transmural field
      stimulation or by atrial distension induced by an increase in intraatrial
      pressure. Atrial stretch and incremental increases in pacing frequency up to 2 Hz
      activated the secretion of ANP coincident with an increase in atrial stroke
      volume and the transendocardial translocation of the ECF. These results showed
      positive relationships between changes in the secretion of ANP and the atrial
      stroke volume or the translocation of the ECF. The translocation of the ECF was
      also positively correlated with the change in atrial stroke volume. The
      accentuated secretion of ANP and translocation of the ECF waned at higher
      stimulating rates to show a peak value. Even under this condition, the secretion
      of ANP was a function of the translocation of the ECF. These data suggest that
      the increases in atrial stroke volume and translocation of ECF are fundamental
      factors in the ANP stimulation in response to atrial stretch and increases in
      atrial rate.

PMID- 7771573
TI  - L-arginine analogues inhibit aldosterone secretion in rats.
AB  - L-Arginine analogues, e.g., NG-nitro-L-arginine methyl ester (L-NAME), increase
      arterial pressure and suppress renin release in the rat. On the basis of these
      observations, it was hypothesized that L-arginine analogues also would attenuate
      aldosterone secretion. This hypothesis was tested in anesthetized rats treated
      with L-NAME or NG-nitro-L-arginine (L-NNA, 185 mumol/kg ip). The aldosterone
      secretion rate, plasma renin activity, and adrenal blood flow were attenuated in
      rats treated with L-NAME and L-NNA compared with control animals. Similar
      experiments were performed in anephric rats to examine the effects of L-NAME on
      aldosterone secretion independent of the circulating reninangiotensin system. The
      administration of L-NAME reduced adrenal blood flow but failed to reduce
      aldosterone secretion in these anephric rats. Bilateral nephrectomy reduced
      plasma renin activity essentially to undetectable levels in these animals. In a
      third series of experiments, two groups of anephric rats were infused with
      angiotensin II (3 micrograms/kg body wt iv) to provide a stimulus for aldosterone
      secretion. Aldosterone secretion and adrenal blood flow were markedly reduced in
      angiotensin II-infused rats pretreated with L-NAME compared with the control
      anephric animals infused with angiotensin II. Overall these results suggest that
      L-arginine analogues attenuate aldosterone secretion by inhibiting the adrenal
      steroidogenic effects of endogenous or exogenous angiotensin II and/or by
      reducing plasma levels of renin/angiotensin.

PMID- 7771575
TI  - Effect of arterially infused catecholamines and insulin on plasma glucose and
      free fatty acids in carp.
AB  - Common carp (Cyprinus carpio L.), kept at 20 degrees C, were fitted with an
      indwelling PE-50 cannula in the dorsal aorta. Hormones dissolved in Ringer saline
      were arterially infused at a rate of 1 microgram.kg-1.min-1 for epinephrine
      (Epi), 2 micrograms.kg-1.min-1 for norepinephrine (NE), and 1.33 micrograms.kg
      1.min-1 for insulin. INfusion of bovine insulin in carp resulted in a long
      lasting (24 h) decrease of plasma free fatty acids (FFA; -0.41 +/- 0.06 mM) and
      glucose levels (-3.14 +/- 0.25 mM) compared with preinfusion levels at t = 0.
      Both Epi and NE induced a marked hyperglycemia although Epi was more potent (+8.2
      +/- 0.9 and +6.9 +/- 0.8 mM, respectively). Plasma FFA levels increased by 0.25
      +/- 0.03 mM compared with preinfusion levels on Epi infusion. In contrast, during
      NE infusion, plasma FFA levels decreased significantly by -0.21 +/- 0.03 mM.
      Plasma insulin titers did not significantly change during infusion of NE or Epi.
      It is concluded that the ratio of NE to Epi is the major factor that determines
      the effect of catecholamines on plasma FFA levels in carp. These results may
      explain species-dependent different effects of hypoxia on FFA metabolism in fish.

PMID- 7771574
TI  - Age, gender, and vasopressin affect survival and brain adaptation in rats with
      metabolic encephalopathy.
AB  - Children and menstruant women are far more likely than men to develop metabolic
      brain damage from hyponatremia. We evaluated brain adaptation and mortality from
      hyponatremia in male and female rats of three different age groups. With acute
      hyponatremia, the mortality was 84% in prepubertal rats vs. 15% in adults and 0%
      in elderly rats. With chronic hyponatremia, mortality was 13% in adult males vs.
      62% in females. Testosterone pretreatment significantly decreased mortality (from
      62 to 9% in adult females, and from 100% to zero in prepubertal rats), but
      estrogen significantly increased mortality (from 13 to 44% in adult males). With
      acute hyponatremia in adult rats, brain sodium was significantly decreased (
      17%), but in prepubertal rats it was actually increased (+ 37%). Cerebral
      perfusion during chronic hyponatremia was significantly impaired in adult females
      vs. males or controls (P < 0.01). Neither vasopressin administration nor chronic
      hyponatremia induced with desmopressin resulted in any mortality or decrement of
      cerebral perfusion. Thus age, gender, and the cerebral effects of vasopressin are
      major determinants of mortality in experimental metabolic encephalopathy.

PMID- 7771576
TI  - Central nucleus of the amygdala and the development of hypertension in
      spontaneously hypertensive rats.
AB  - Electrolytic lesions of the central nucleus of the amygdala (ACe) have been shown
      to attenuate the development of hypertension in spontaneously hypertensive rats
      (SHR). Whether this was due to destruction of local neurons and/or fibers is
      unknown. In the present study, neuronal perikarya in the ACe of 4-wk-old SHR were
      selectively destroyed with ibotenic acid. In two experiments, each comprising
      lesioned and sham-lesioned SHR, mean arterial blood pressure (MAP) was measured 7
      and 15 wk after operation in the second experiment also at 22 wk. In the first
      experiment, in which rats were fed ad libitum, lesioned SHR had significantly
      lower body weights from 5 wk postoperation onward, and at 15 wk postoperation
      their average MAP [173 +/- 7 mmHg (SE)] was significantly lower vs. sham-lesioned
      SHR (201 +/- 4 mmHg). In the second experiment, food intake, and hence body
      weight, among the lesioned and sham-lesioned rats was equalized. Average MAP in
      the lesioned SHR at 7 and 15 wk postoperation was not different vs. sham-lesioned
      SHR but was significantly higher (191 +/- 6 mmHg) vs. sham-lesioned SHR but was
      significantly higher (191 +/- 6 mmHg) vs. sham-lesioned SHR (164 +/- 5 mmHg) 22
      wk postoperation. These results indicate that destruction of neuronal perikarya
      in the ACe in young SHR merely delays the development of hypertension, due to a
      reduced weight gain.

PMID- 7771577
TI  - Fish muscle energy metabolism measured during hypoxia and recovery: an in vivo
      31P-NMR study.
AB  - Three fish species were exposed to graded hypoxia levels and allowed to recover.
      Levels of high-energy phosphate compounds in epaxial white muscle were monitored
      by in vivo 31P nuclear magnetic resonance (NMR) spectroscopy. Furthermore, O2
      consumption of the animals was measured. With increasing hypoxia load, metabolic
      parameters started to change in the following order: phosphocreatine (PCr)-to-Pi
      ratio (decrease), O2 consumption (decrease), [PCr] (decrease), intracellular pH
      (pHi; decrease), Pi (increase), free ADP concentration ([ADP]free; increase),
      [ATP] (decrease). PCr levels fell with the PO2. After each increment, the [PCr]
      reached a stable plateau value while, in some cases, a recovery was observed.
      This recovery could be explained because the balance between anaerobic and
      aerobic metabolism is continuously fluctuating during hypoxia as a consequence of
      changes in the activity of the fish. Consequently the [ADP]free are fluctuating,
      resulting in an activation of the creatine kinase reaction and the anaerobic
      glycolysis. In all three species, anaerobic glycolysis was activated, but in
      contrast to anoxia exposure, metabolic suppression was absent. The changes of
      [ADP]free and [H+] (which influences the position of the creatine kinase
      equilibrium) are species dependent. Species differences observed in the other
      parameters were small. It is concluded that the pattern of the activation of
      anaerobic metabolism under deep hypoxia is different from that under anoxia.

PMID- 7771578
TI  - Low-frequency subthreshold sympathetic stimulation augments maximal reflex
      parasympathetic salivary secretion in cats.
AB  - Electrical stimulation of the peripheral cut end of the cervical sympathetic
      trunk for 3 min at frequencies < 1 Hz with pulses of 2-ms duration at
      supramaximal intensities did not elicit any salivary secretion, but an increase
      of stimulus frequency over the range 2-10 Hz produced progressively greater
      salivary secretion, the maximum volume of salivary secretion being evoked at 10
      Hz. Frequency-dependent augmentation of parasympathetic reflex submandibular
      salivary secretion occurred when the lingual nerve was stimulated during
      repetitive sympathetic stimulation (at frequencies of 0.1-2 Hz) in our
      sympathectomized cats. The augmentation was found to be linearly related to
      sympathetic stimulus frequency (regression line calculated by method of least
      squares; r = 0.939, P < 0.01). This augmentation was abolished by prior treatment
      with the beta-adrenoceptor blocking drug propranolol (1 mg/kg, P < 0.01 vs.
      before propranolol) but not by the alpha-adrenoceptor blocking agent phentolamine
      (1 mg/kg), indicating that the augmented response was mediated via an activation
      of beta-adrenoceptors. The reduction of the augmentation caused by propranolol
      had diminished 1 h after its administration, showing that the effect was
      reversible.

PMID- 7771579
TI  - Effects of clonidine and yohimbine on parasympathetic reflex salivation and
      vasodilatation in cat SMG.
AB  - The present experiments were designed to examine the site of action of the alpha
      2-adrenoceptor agonist, clonidine, and the alpha 2-antagonist, yohimbine, on the
      salivary secretion response to parasympathetic and sympathetic stimulation in the
      cat submandibular gland (SMG). The parasympathetic reflex salivary secretion was
      significantly affected by both clonidine and yohimbine (clonidine reduced and
      yohimbine increased the amount of saliva secreted) while the reflex vasodilator
      response was not affected by either agent. No degree of methacholine-induced
      salivation was affected by prior treatment with either clonidine or yohimbine.
      The salivation elicited by facial nerve root stimulation was markedly reduced by
      clonidine but potentiated by yohimbine. Prior treatment with scopolamine
      completely abolished the salivary secretion induced by either methacholine or
      facial nerve root stimulation. Clonidine and yohimbine had no effect on SMG
      salivation elicited by sympathetic stimulation. These results indicate that the
      alpha 2-agonist and antagonist act specifically on parasympathetic salivary
      fibers but have no effect on parasympathetic vasodilator fibers. They thus
      suggest that postganglionic parasympathetic innervation is differentiated into
      salivary and vasodilator fibers.

PMID- 7771580
TI  - Serotonin3 antagonists block aversion to saccharin in an amino acid-imbalanced
      diet.
AB  - Conditioned taste aversion presumably plays a role in the anorectic responses to
      amino acid-imbalanced diets that induce acute amino acid deficiency. The
      serotonin3 (5-HT3) receptor antagonists, tropisetron (Trop), MDL-72222 (MDL), and
      ondansetron, increase intake of imbalanced amino acid diets. Therefore, we tested
      whether 5-HT3 receptor antagonists would block an aversion to powdered saccharin
      after it was included in an amino acid-imbalanced diet. Rats were given an
      intraperitoneal injection of Trop, MDL, or vehicle (Veh), just before introducing
      one of four diets: imbalanced amino acid diet +/- saccharin (Imb or ImbSac) or a
      balanced (corrected) diet +/- saccharin (Cor or CorSac). Subsequent aversion to
      saccharin was shown in preference tests using Cor and CorSac. Saccharin
      preference was significantly decreased (8.3% on test day 1) in the Veh/ImbSac
      group, but the Trop/ImbSac group's saccharin preference (57.8%) was similar to
      controls (49.6-70.3%); MDL also blocked the aversion to saccharin after ImbSac.
      This confirms previous reports of conditioned taste aversions with amino acid
      limitation and suggests a role for the 5-HT3 receptor in the development of these
      aversions.

PMID- 7771581
TI  - Glucocorticoids and insulin: complex interaction on brown adipose tissue.
AB  - Glucocorticoids and insulin effect long-term reciprocal changes in food intake
      and body weight. We tested the interactions of corticosterone and insulin on
      caloric efficiency, white adipose tissue (WAT) stores, and brown adipose tissue
      (BAT). Two experiments were performed: 1) adrenalectomized rats were treated with
      corticosterone with or without streptozotocin-induced diabetes and 2)
      adrenalectomized, corticosterone-treated, diabetic rats were treated with
      insulin. By 4-5 days later, > or = 50% of the variance in caloric efficiency,
      plasma triglycerides, and WAT stores was explained by regression of these
      variables on corticosterone (catabolic) and insulin (anabolic). When the ratio of
      the hormones was normal, but concentrations high, overall gain of energy stores
      decreased and energy was redistributed to fat. Both hormones were anabolic on BAT
      lipid storage; the hormones played a complex role in the regulation of uncoupling
      protein (UCP) in BAT. Although corticosterone inhibited and insulin stimulated
      UCP, these effects were only evident in diabetics and with normoglycemia,
      respectively. For BAT variables, < or = 50% of the variance was explained by
      regression on corticosterone and insulin, suggesting that the effects of these
      hormones are mediated through an intermediate such as sympathetic nervous system
      input to BAT.

PMID- 7771582
TI  - Vasoconstrictors alter oxygen, lactate, and glycerol metabolism in the perfused
      hindlimb of a rat kangaroo.
AB  - The Tasmanian bettong (Bettongia gaimardi) is a small marsupial rat kangaroo
      without detectable brown adipose tissue (BAT). The hindlimb was perfused with
      constant flow at 25 degrees C after cannulation under anesthesia of the femoral
      artery and vein to one hindlimb. Norepinephrine (NE, 25 nM-2.5 microM) and
      vasopressin (VP, 10 nM-0.1 microM) each increased perfusion pressure, oxygen
      consumption (VO2), and lactate and glycerol efflux of the perfused hindlimb. NE
      mediated increases in VO2 and the efflux of lactate and glycerol were unaffected
      by propranolol (10 microM) but were completely blocked by the further addition of
      phentolamine (10 microM). In contrast, serotonin (5-HT; 0.1-2.5 microM) inhibited
      VO2 and inhibited lactate efflux. The changes induced by NE, VP, and 5-HT were
      all rapidly reversed by nitroprusside. These results suggest that resting
      thermogenesis in bettong hindlimb can be differentially controlled by the
      vasculature, which may also contribute to the induced VO2. This vascular control
      of skeletal muscle VO2 appears widespread in homeotherm evolution.

PMID- 7771583
TI  - Control of gill filament blood flow by serotonin in the rainbow trout,
      Oncorhynchus mykiss.
AB  - The effects of exogenously applied serotonin [5-hydroxytryptamine (5-HT)] on the
      distal arterial vasculature of gill filaments were observed using an epi
      illumination microscope equipped with a water-immersion objective and connected
      to a video camera. In addition, ventral aortic flow (Q) and celiac artery
      pressure (PCA) were measured. Intra-arterial injection of serotonin (100 nmol/kg)
      completely stopped the blood flow in the distal part of the filaments and caused
      a rapid decrease of PCA. Repeatedly, the flow reduction was found to coincide
      with a constriction of the distal portion of the efferent filamental vasculature.
      Because there was no concomitant reduction in Q, it is concluded that a
      redistribution of blood to more proximal parts of the filaments occurred. After
      treatment with the serotonergic receptor antagonist methysergide, the
      vasoconstrictor effect of serotonin on the filamental vasculature was eliminated,
      while a decrease in PCA was still observed. The results demonstrate a specific
      site(s) for the serotonergic vasoconstriction in the distal portion of the
      filament.

PMID- 7771585
TI  - Kinetic studies and production rate of melatonin in pony mares.
AB  - The aims of the present study were to determine basic kinetic parameters and the
      nycthemeral production rate of melatonin in the horse. Seven pony mares were used
      for the kinetic studies. Five other pony mares were used under long and short
      days for the production rate studies. Melatonin was administered by intravenous,
      oral, and intragastric routes at different dose levels. The plasma melatonin
      clearance was 1.02 +/- 0.31 l.kg-1.h-1, and the volume of distribution was 0.89
      +/- 0.53 l/kg for the 0.4 microgram/kg melatonin dose. The systemic availability
      after oral and intragastric administration was consistently low (< or = 10%). The
      hourly melatonin production rates during short (36 +/- 33.6 ng.kg-1.h-1) and long
      nights (42 +/- 24.0 ng.kg-1.h-1) were not significantly different. It is
      concluded that the oral dose of exogenous melatonin required to control
      reproductive pattern in horses would need to be 10 times higher than the
      nocturnal melatonin production (0.5 microgram/kg) to obtain a physiological
      plasma melatonin concentration.

PMID- 7771584
TI  - Sympathoexcitatory influence of a fast conducting raphe-spinal pathway in the
      rat.
AB  - Experiments were carried out on 20 pentobarbitone sodium (alpha-chloralose
      supplemented)-anesthetized, artificially ventilated, and paralyzed rats. The
      possibility was explored that raphe-spinal neurons with myelinated axons arising
      in the rostral part of raphe obscurus provide excitatory drive to sympathetic
      neurons. Electrical stimulation within obscurus was observed to evoke an "early"
      sympathoexcitatory response compatible with its conduction over such a pathway.
      The effect of the microinjection of excitatory and inhibitory amino acids [DL
      homocysteic acid (DLH) and gamma-aminobutyric acid (GABA), respectively] on the
      evoked response was studied at the sites of electrical stimulation. The size of
      the early response was increased by 91.7 +/- 24.4% (n = 7) and depressed by -48
      +/- 4.8% (n = 7) by DLH and GABA, respectively. Saline was without effect (-14.5
      +/- 12.2%, n = 6). The evoked responses were decreased when blood pressure was
      raised by administration of phenylephrine (2-6 micrograms/kg iv) and totally
      suppressed by an increase in blood pressure of 19.3 +/- 4.3 mmHg (baseline 89.1
      +/- 2.5 mmHg, n = 7). It is concluded that some cell bodies located in rostral
      raphe obscurus that project to the spinal cord relay excitatory drive to
      sympathetic neurons.

PMID- 7771587
TI  - Physiological correlates of vagal nerve innervation in lower vertebrates.
AB  - In lower vertebrates, cardiac vagal innervation shows less anatomic complexity
      and specialization than in mammals. To assess the physiological development of
      vagal specialization in the vertebrates, we investigated cardiac chronotropic
      effects of electrical stimulation of left and right vagus nerves separately and
      the interactions between both nerves in anesthetized animals from three
      vertebrate groups, toad (Bufo marinus), shark (Heterodontus portusjacksoni), and
      lizard (Physignathus lesueurii). Atropine-sensitive slowing was effected equally
      by left or right vagi in all species, and chronotropic effects of simultaneous
      stimulation were the same as the sum of left and right responses. In sharks and
      lizards, no slowing after atropine was detected (10 Hz stimulation). In toads,
      after atropine, cardiac slowing was elicited equally by left or right vagal
      stimulation > 2 Hz. Simultaneous stimulation of both vagi after atropine caused
      significantly greater slowing than the sum of left and right responses. The
      results suggest even distribution of left and right vagal nerve endings to
      pacemaker cells, and limited competition for cardiac receptor sites in lower
      vertebrates.

PMID- 7771586
TI  - Central effect of angiotensin III on caudal hypoglossal neurons in rats.
AB  - We communicated the central effect of angiotensin III (ANG III), a potent signal
      for extracellular dehydration, on single neurons in the caudal hypoglossal
      nucleus of Sprague-Dawley rats anesthetized with pentobarbital sodium. A
      significant number (121 of 168) of caudal hypoglossal neurons responded to
      intracerebroventricular application of ANG III (80 or 160 pmol), with either an
      increase (n = 83) or decrease (n = 38) in their spontaneous discharge. These
      effects of ANG III were significantly reversed by intracerebroventricular
      application of the nonpeptide angiotensin AT1 receptor antagonist losartan (40
      nmol), but not by the AT2 antagonist, PD-123319. The hypoglossal neuronal
      responses to repeated administration of ANG III (80 pmol), delivered at an
      interval < or = 18 min, exhibited acute tachyphylaxis. Intracerebroventricular
      administration of the cholinergic dipsogen, carbachol (50 ng), or the osmotic
      stimulant, hypertonic saline (0.5 M), also elicited responses in ANG III
      responsive hypoglossal neurons. These results suggest that neurons in the caudal
      hypoglossal nucleus may serve as the final common pathway for extracellular and,
      possibly, intracellular thirst in the rat. Furthermore, it is likely that the
      action of ANG III is mediated by the AT1 subtype of angiotensin receptors.

PMID- 7771588
TI  - Effect of total body core cooling during poly I:C-induced fever in rabbits.
AB  - At ambient temperature (Ta) 20 and 10 degrees C, metabolic heat production and
      hypothalamic temperature (Thypo) were measured to determine the fever response in
      six rabbits injected with polyriboinosinic-polyribocytidylic acid (poly I:C; 5
      mg/kg iv). Similar measurements were made in afebrile and febrile animals
      subjected to 3 h of body cooling, in which heat was extracted with a chronically
      implanted intravascular heat exchanger in a ramplike manner. The fever time
      course showed a biphasic pattern. During cooling in the febrile experiments,
      Thypo remained constant or even slightly increased during the time corresponding
      to the first phase of fever but rapidly fell during the second phase because of a
      depressed shivering response. The net effect at the end of the cooling period was
      that Thypo decreased by 0.4 and 0.6 degree C more than in the afebrile cooling
      experiments at Ta 20 and 10 degrees C, respectively. The results indicate normal
      shivering responses during phase I of poly I:C-induced fever and depressed
      shivering in phase I, possibly because of a reduced thermosensitivity.

PMID- 7771589
TI  - Poly I:C-induced fever elevates threshold for shivering but reduces
      thermosensitivity in rabbits.
AB  - Shivering threshold and thermosensitivity were determined in six conscious
      rabbits at ambient temperature (Ta) 20 and 10 degrees C before and at six
      different times after saline injection (0.15 ml iv) and polyriboinosinic
      polyribocytidylic acid (poly I:C)-induced fever (5 micrograms/kg iv).
      Thermosensitivity was calculated by regression of metabolic heat production (M)
      and hypothalamic temperature (Thypo) during short periods (5-10 min) of square
      wave cooling. Heat was extracted with a chronically implanted intravascular heat
      exchanger. Shivering threshold was calculated as the Thypo at which the
      thermosensitivity line crossed resting M as measured in afebrile animals at Ta 20
      degrees C. There were negligible changes in shivering threshold and
      thermosensitivity in saline-injected rabbits. In the febrile animals, shivering
      threshold generally followed the shape of the biphasic fever response. At Ta 20
      degrees C, shivering threshold was higher than regulated Thypo during the initial
      rising phase of fever and was lower during recovery. At Ta 10 degrees C the
      shivering thresholds were always higher than regulated Thypo except during
      recovery. Thermosensitivity was reduced by 30-41% during fever.

PMID- 7771590
TI  - Cardiovascular effects of arginine vasotocin, atrial natriuretic peptide, and
      epinephrine in freshwater eels.
AB  - The effects of 150 ng/kg iv injections of arginine vasotocin (AVT), eel atrial
      natriuretic peptide (ANP), and epinephrine (Epi) on the cardiovascular dynamics
      of resting freshwater eels, Anguilla rostrata were studied. Injection of AVT into
      the caudal vein significantly increased cardiac output (CO) from 15.3 to 23.6
      ml.min-1.kg-1 primarily by increasing stroke volume. Mean dorsal aortic pressure
      (PDA) also increased. Estimated branchial shunting (2.54 ml.min-1.kg-1) was
      elevated by 130% because of an increased proportion of CO, indicating a
      vasoconstriction of the branchial arterioarterial pathway. In contrast, Epi
      reduced the fraction of CO perfusing the arteriovenous pathway. Epi also produced
      a positive chronotropic effect, increased CO and systemic vasoconstriction,
      resulting in a vasopressor response. These changes occurred earlier than those of
      AVT and ANP. Pressor responses triggered by AVT and Epi preceded the increases in
      CO. Injections of 150 and 200 ng/kg ANP caused a reduction in PDA due to a
      decrease in CO (and SV) but failed to modulate systemic resistance. The change in
      CO was the primary contributor to the pressor (and depressor) responses elicited
      by the three hormones.

PMID- 7771591
TI  - Chemical sympathectomy and maternal separation affect neonatal stress responses
      and adrenal sensitivity to ACTH.
AB  - The participation of sympathetic adrenal innervation in the control of the
      neonatal adrenocortical system and in changes in adrenal sensitivity after
      maternal separation for 24 h was tested in 10- and 23-day-old pups. Chemical
      sympathectomy by guanethidine (20 mg/kg body wt) decreased basal and stimulated
      corticosterone compound B (B) secretion without affecting adrenocorticotropic
      hormone (ACTH) release, abolished the enhanced adrenal sensitivity to ACTH
      induced by maternal separation in 10-day-old pups, but did not modify adrenal
      sensitivity following ether stress in 23-day-old pups. Guanethidine treatment did
      not affect body and adrenal weight or adrenal choline acetyltransferase activity,
      but it increased tyrosine hydroxylase activity at both ages. Both chronic
      guanethidine treatment and acute corticotropin-releasing factor
      immunoneutralization reduced plasma B levels after maternal separation without
      affecting plasma ACTH levels. Maternal separation in 10-day-old pups enhanced
      basal and stimulated ACTH and B secretion after exposure to ether vapors and
      insulin-induced hypoglycemia (IIH). In nonseparated pups, IIH did not stimulate
      ACTH secretion and caused small increases in B secretion; however, the enhanced
      response of separated pups to IIH was due to the effects of intraperitoneal
      injection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771592
TI  - Responses of the circulatory system and muscle sympathetic nerve activity to head
      down tilt in humans.
AB  - These experiments were conducted to examine whether changes in central and
      peripheral hemodynamics were proportional to muscle sympathetic nerve activity
      (MSNA) during graded head-down tilt (HDT). Twelve healthy males (19-42 yr old)
      underwent HDT at 15 degrees and 30 degrees for 10 min each with a 10-min rest
      period between the trials. MSNA at 15 degrees HDT declined by 31 +/- 5% (P <
      0.05) for burst rate and by 37 +/- 3% (P < 0.05) for total activity. At 30
      degrees HDT, the reduction in MSNA was 51 +/- 5% for burst rate (P < 0.05 vs. 15
      degrees HDT) and 46 +/- 5% for total activity (P < 0.05 vs. 15 degrees HDT).
      Stroke volume increased (P < 0.05) during both 15 degrees and 30 degrees HDT, but
      heart rate and blood pressure remained unchanged. A concurrent increase in
      central venous pressure (P < 0.05) and stroke volume with a reduction of thoracic
      impedance (P < 0.05) suggests that both pressure and volume in the atrium were
      elevated during HDT, and the magnitude of these changes was greater (P < 0.05) at
      30 degrees HDT than at 15 degrees HDT. Forearm blood flow increased during HDT at
      both 15 degrees and 30 degrees, and the magnitude of the increase was greater (P
      < 0.05) at 30 degrees HDT. It is concluded that the magnitude of the loading of
      the cardiopulmonary mechanoreceptors during HDT was higher at 30 degrees in
      comparison to 15 degrees. This increased the afferent firing rate by the
      cardiopulmonary receptors and probably inhibited sympathetic outflow in the
      central nervous system.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771593
TI  - Powerful depressor and sympathoinhibitory effects evoked from neurons in the
      caudal raphe pallidus and obscurus.
AB  - Microinjection of glutamate into sites within the medullary raphe nuclei
      (pallidus and obscurus) at levels caudal to the obex resulted in a dose-dependent
      decrease in mean arterial pressure (MAP), renal sympathetic nerve activity
      (RSNA), and heart rate in anesthetized rabbits. The depressor and
      sympathoinhibitory responses were similar in magnitude to those elicited from the
      previously described depressor region in the caudal ventrolateral medulla (CVLM)
      but had a shorter duration, in both intact and barodenervated animals. The
      bradycardia was not altered by barodenervation but was reduced after
      administration of propranolol or atropine and abolished after administration of
      both drugs. The neuroinhibitory compounds gamma-aminobutyric acid or muscimol had
      no effect on MAP or RSNA when injected into the caudal medullary raphe nuclei but
      evoked a pressor and sympathoexcitatory response when injected into the CVLM. The
      results indicate that neurons within the caudal raphe pallidus and obscurus can
      powerfully inhibit sympathetic activity, but unlike sympathoinhibitory neurons in
      the CVLM, they are not tonically active and are not capable of producing
      sustained changes in arterial pressure and sympathetic activity.

PMID- 7771594
TI  - Seasonal influences on the control of plasma sex hormone-binding globulin by T4
      in male little brown bats.
AB  - Male little brown bats showed a well-defined seasonal cycle of plasma thyroxine
      (T4). Total T4 concentrations increased during hibernation, reached peak levels
      in May at spring emergence, and subsequently declined to lowest levels in
      September. Thyroxine-binding globulin (TBG) activity increased only in summer,
      and seasonal changes in non-TBG-bound T4 generally paralleled those of total T4.
      During the fall and early hibernation period, bats studied under feral conditions
      or following photoperiod manipulation showed coincident changes in plasma T4 and
      sex hormone-binding globulin (SHBG) levels. In contrast, males studied during
      late hibernation or following spring arousal exhibited declining plasma T4 levels
      during periods of increased SHBG activity. Additionally, the prehibernation
      decline in SHBG did not depend on changing environmental conditions. Bats
      maintained under summerlike conditions during the fall showed normal seasonal
      reductions in SHBG and T4. These studies indicate that T4 is the likely
      physiological regulator of plasma SHBG activity during the fall and early
      hibernation, but that other factors modulate the timing of SHBG induction in the
      spring.

PMID- 7771595
TI  - Lipopolysaccharide increases EEG delta activity within non-REM sleep and disrupts
      sleep continuity in rats.
AB  - Activation of the immune system by microorganisms or specific microbial
      constituents promotes non-rapid-eye-movement (REM) sleep (non-REMS). In this
      study, we assessed the effects of lipopolysaccharide (LPS) on sleep duration,
      electroencephalogram (EEG) power spectra, and brain temperature (Tbr) in rats.
      Twenty-four hour recordings were made before and after intraperitoneal injection
      of vehicle or 30 or 100 micrograms/kg LPS at lights on. During the first 12 h
      after administration of both doses of LPS, Tbr was elevated, REMS duration was
      reduced, and non-REMS duration was unchanged, whereas the non-REMS episodes were
      shortened. EEG activity within non-REMS from 0.5 to 7 Hz was enhanced during
      hours 3-12. During the second 12-h period, the number of non-REMS and REMS
      episodes and the total time in both states were increased. EEG activity within
      non-REMS was mainly reduced in the entire frequency range (0.5-25.5 Hz). The
      effects of LPS did not differ between the doses. The effects of LPS on EEG power
      spectra are similar to those observed after sleep deprivation, i.e., a
      physiological intensification of non-REMS, indicating that both manipulations may
      activate common sleep EEG regulatory mechanisms. However, the disruption of non
      REMS continuity following LPS administration at light onset contrasts the changes
      induced by sleep deprivation and may reflect an effect of a systemic inflammatory
      response on sleep maintenance.

PMID- 7771596
TI  - Regulation of neurohypophysial hormone secretion in an Australian marsupial.
AB  - The brushtail possum secretes the typically reptilian mesotocin (MT) and arginine
      vasopressin (AVP) as its neurohypophysial hormones. In this study we have looked
      at the regulation of MT and AVP secretion in conscious possums by studying the
      effects of surgical stress and handling of animals, hypertonic saline infusion,
      hemorrhage, and angiotensin II (ANG II) infusion on the plasma concentrations of
      MT and AVP. Surgical insertion of a jugular catheter and handling stress
      increased MT secretion for 3 days after surgery without affecting plasma AVP
      concentrations. Hypertonic saline infusion induced a gradual increase in plasma
      osmolarity and Na+ concentration throughout the infusion, which steadily
      increased plasma AVP without affecting plasma K+ or hematocrit. The relationship
      between plasma osmolarity and AVP was exponential. Plasma MT was stimulated only
      by supraphysiological plasma osmolarities. ANG II increased plasma MT and AVP
      concentrations equipotently throughout the infusion. Hemorrhage was a relatively
      specific stimulus for AVP secretion, but MT secretion was highly stimulated
      during severe hypovolemia. It was concluded that MT and AVP secretion is
      differentially regulated in the possum.

PMID- 7771597
TI  - Subdiaphragmatic vagotomy blocks induction of IL-1 beta mRNA in mice brain in
      response to peripheral LPS.
AB  - To test the possibility that the vagus nerve is involved in the communication
      between the immune system and the brain, we injected sham-operated and
      vagotomized mice with physiological saline or lipopolysaccharide (LPS; 400
      micrograms/kg ip). Vagotomy attenuated LPS-induced depression of general activity
      measured 2 h after treatment but did not alter the increase in plasma levels of
      IL-1 beta in response to LPS. In addition, vagotomy abrogated the LPS-induced
      increase in the levels of transcripts for IL-1 beta, as determined by
      semiquantitative polymerase chain reaction after reverse transcription, in the
      hypothalamus and hippocampus, but not in the pituitary of vagotomized mice. This
      relationship between the effects of vagotomy on the behavioral effects of LPS and
      the LPS-induced brain expression of IL-1 beta mRNA indicates that vagal afferent
      fibers play a prominent role in the pathways of communication between the immune
      system and the brain.

PMID- 7771598
TI  - Upregulation of the GABAA/benzodiazepine receptor during anoxia in the freshwater
      turtle brain.
AB  - The freshwater turtle brain survives anoxia by decreasing its energy expenditure.
      During this anoxic period there is a sustained release of the inhibitory
      neurotransmitter gamma-aminobutyric acid (GABA). This study investigated whether
      there was a corresponding change in the binding properties of the
      GABAA/benzodiazepine (GABA/BDZ) receptor. Turtles (Trachemys scripta) were
      subjected to a 100% N2 atmosphere for up to 24 h. After exposure, the cerebral
      cortex was dissected out, and saturation binding assays for GABA/BDZ receptors
      were performed using the radioligand [3H]flunitrazepam. Control turtles had a
      dissociation constant (Kd) of 1.97 +/- 0.54 nM and a receptor density (Bmax) of
      2,404 +/- 221 fmol/mg protein. The Kd showed no significant change over 24 h of
      anoxia. However, significant increases were seen in Bmax after 12 h (21%, P <
      0.05) and 24 h (29%, P < 0.01) of anoxia. We suggest that a long-term
      upregulation of GABAA receptors occurs in the anoxic turtle brain that acts to
      increase the inhibitory effectiveness of the released GABA and thereby
      contributes to anoxia survival of the turtle.

PMID- 7771599
TI  - Rat vasopressin cell responses to simulated hemorrhage: stimulus-dependent role
      for A1 noradrenergic neurons.
AB  - c-fos expression mapping and electrophysiological recording experiments were done
      to clarify the role of the A1 noradrenergic cell group in the vasopressin
      response to hypotensive hemorrhage. In pentobarbital-anesthetized rats, moderate
      and severe hypotensive hemorrhages were simulated by brief occlusion of the
      inferior vena cava sufficient to reduce mean arterial pressure to approximately
      50 or 30 mmHg, respectively. Both stimuli significantly increased the number of
      A1 region catecholamine cells displaying Fos-like immunoreactivity, this effect
      being most prominent at the level of the area postrema. Both stimuli also
      increased the number of supraoptic nucleus vasopressin cells displaying Fos-like
      immunoreactivity. Accordingly, electrophysiological studies involving separate
      animals confirmed that both moderate and severe caval occlusion significantly
      increased the firing of functionally identified vasopressin cells recorded in the
      supraoptic nucleus. However, although interruption of A1 region neuronal function
      by injection of gamma-aminobutyric acid at the level of the area postrema
      eliminated the increase in vasopressin cell firing elicited by moderate caval
      occlusion, it did not block the response to severe caval occlusion. These
      findings suggest that, in the rat, the vasopressin response to an acute reduction
      in central blood volume, such as that produced by hemorrhage, depends on the A1
      projection only if the stimulus is of moderate intensity. Severe stimuli appear
      to involve activation of both the A1 projection and an additional vasopressin
      stimulatory pathway that bypasses the A1 region.

PMID- 7771600
TI  - The effectiveness of insecticide-impregnated bed nets in reducing cases of
      malaria infection: a meta-analysis of published results.
AB  - The use of insecticide-impregnated bed nets to minimize human-vector contact may
      reduce the incidence of malaria. Consequently, several field trials have
      evaluated their effectiveness as a malaria prevention strategy. A meta-analysis
      of published reports of field trials that measured the incidence of infections
      was performed to provide a measure of the effectiveness of insecticide-treated
      bed nets in preventing clinical malaria. Subsetted analyses were performed on the
      10 field trials to calculate pooled incidence rate ratios of infection among the
      study groups. For the studies comparing insecticide-impregnated bed nets with
      untreated bed nets, the summary incidence rate ratio for acquiring malarial
      infections was 0.757 (95% confidence interval [CI] = 0.612-0.938), representing a
      reduction of 24%. For the studies comparing permethrin-impregnated bed nets with
      controls without bed nets, the summary incidence rate ratio was 0.497 (95% CI =
      0.417-0.592) (Rothman-Boice heterogeneity statistics = 17.27 [P = 0.004] and
      23.55 [P = 0.0003], respectively). These data suggest that insecticide
      impregnated bed nets are effective in preventing malaria, decreasing the
      incidence rate ratio by approximately 50% in field trials performed to date.

PMID- 7771601
TI  - Knowledge, beliefs, and practices in relation to malaria transmission and vector
      control in Guatemala.
AB  - As part of an effort to involve community members in malaria control activities,
      we studied knowledge, beliefs, and practices of residents of both the Pacific
      coastal plain and northeastern Guatemala related to malaria transmission and
      Anopheles albimanus control. Most residents recognized the role of mosquitoes in
      malaria transmission, but few knew how mosquitoes acquired their infections or
      understood the risk of having an untreated person in their midst. If this were
      more widely known, residents might put greater pressure on infected patients to
      seek timely and appropriate antimalarial treatment. Seventy-three percent of
      families owned one or more bed nets; however, even though most informants
      believed that bed nets help protect against malaria, the major reason for using
      them was to prevent nuisance mosquito bites. It is concluded that efforts should
      be made to promote bed net use by seeking ways to make them more affordable and
      by emphasizing their effectiveness as a barrier to nuisance mosquitoes. Although
      residents have a very positive opinion of the National Malaria Service spray
      teams, it is proposed that cooperation might be improved if malaria workers would
      emphasize the fact that house spraying reduces the numbers of nuisance mosquitoes
      and other pest insects, rather than focusing solely on malaria prevention, which
      most informants believed was less important. This study emphasizes the importance
      of understanding community beliefs and practices when planning or evaluating
      vector control activities.

PMID- 7771603
TI  - A household-based, case-control study of environmental factors associated with
      hantavirus pulmonary syndrome in the southwestern United States.
AB  - During an outbreak of hantavirus pulmonary syndrome (HPS) in the southwestern
      United States, trained environmental assessment teams conducted surveys at 17
      case-patient homes and matched controls from June through August 1993. Variables
      related to rodent abundance were quantified and standardized rodent trapping was
      conducted around and within households. The majority of households were located
      in pinon-juniper vegetation zones, and there were no significant differences in
      the type of house in which cases and controls lived. The only environmental
      factor that distinguished case households from controls was significantly higher
      small rodent densities (median trap success for case sites = 17.3%, 12.7% for
      near controls, and 8.3% for far controls). Frequency of hantaviral infection in
      deer mice (Peromyscus maniculatus) did not vary significantly among households of
      cases and controls, with a range of 27.5-32.5% antibody-positive. Indices of
      rodent fecal contamination were slightly higher in case houses. The data indicate
      that higher rodent densities were associated with households in which HPS cases
      occurred. Strategies that control rodent numbers and decrease rodent access to
      dwellings may reduce risk of human infection.

PMID- 7771602
TI  - Short report: a placebo-controlled study of Lactobacillus GG colonization in one
      to-three-year-old Peruvian children.
AB  - A pilot, placebo-controlled study conducted in Peruvian toddlers in a periurban
      shanty-town community demonstrates that 1) a simple fluorescent antibody test
      performed on bacteria from colonies grown on solid culture media can be used as a
      presumptive screening tool for Lactobacillus GG, 2) Lactobacillus GG powder
      sprinkled on flavored gelatin as a nutritional supplement is well-accepted by
      infants and mothers in this population, and 3) daily doses of Lactobacillus GG
      result in efficient colonization of the gastrointestinal tract of Peruvian
      infants. This study demonstrates that Lactobacillus GG should be evaluated as an
      adjunct for diarrhea control programs at the community level as well as in
      hospital-based settings.

PMID- 7771604
TI  - Hepatitis B virus infection on a tropical island: sociodemographic and geographic
      risk factors in Guadeloupe.
AB  - A seroepidemiologic study on a cross-sectional sample of blood donors was carried
      out in Guadeloupe, a French West Indies island, to estimate the prevalence of
      hepatitis B virus (HBV) markers, and to investigate the influence of age,
      socioeconomic, and geographic factors on prior HBV infection. Blood specimens and
      sociodemographic data were collected in 1989 from 2,339 blood donors residing on
      the island. A total of 73 (3.1%) of 2,339 were found to be HBV surface antigen
      carriers, and 518 (22.1%) were positive for antibody to HBV core antigen. Among
      them, 61 were positive for both markers and consequently 530 persons (22.7%) were
      considered to have evidence of prior HBV infection. Multivariate logistic
      regression analyses identified age and low socioprofessional status as being
      related to HBV infection, as in many endemic areas. In addition, some major
      geographic risk factors were highlighted, reflecting a strongly hyperendemic
      situation in specific areas and the potential influence of horizontal
      transmission or unknown environmental factors on these particular populations.

PMID- 7771605
TI  - Short report: Rift Valley fever in western Africa: isolations from Aedes
      mosquitoes during an interepizootic period.
AB  - Thirteen strains of Rift Valley fever virus were isolated from Aedes vexans and
      Ae. ochraceus mosquitoes collected in October and November 1993 in northern
      Senegal. Entomologic and serologic data show that the risk of a new epizootic is
      increasing in this region.

PMID- 7771606
TI  - National surveillance for Rocky Mountain spotted fever, 1981-1992: epidemiologic
      summary and evaluation of risk factors for fatal outcome.
AB  - Between 1981 and 1992, the Centers for Disease Control collected and summarized
      9,223 cases of Rocky Mountain spotted fever (RMSF) reported from 46 states. Four
      states (North Carolina, Oklahoma, Tennessee, and South Carolina) accounted for
      48% of the reports. The annual incidence per million U.S. population decreased
      from a high in 1981 of 5.2 to a low in 1992 of 2.0, primarily due to decreased
      incidence in the southeast. Case report forms were filed on 7,650 patients, of
      whom 4,217 had laboratory-confirmed RMSF. The age group with the highest
      incidence was those 5-9 years of age. Most cases (90.0%) occurred between April 1
      and September 30 and included a history of tick attachment (59.6%). Reported
      symptoms included fever (94.0%), headache (86.2%), myalgia (82.5%), and rash
      (80.2%). The case-fatality ratio was 4.0%. Risk factors associated with death
      included older age, delay in treatment or no treatment, and treatment with
      chloramphenicol (compared with tetracycline); however, insufficient data existed
      to fully assess the confounding effect of severity of illness on antibiotic
      choice.

PMID- 7771607
TI  - A space-occupying lesion in the liver due to Capillaria infection.
AB  - A space-occupying lesion 3.5 by 2.0 cm in size caused by Capillaria infection was
      revealed ultrasonographically in segment 6 (S6) of the liver of a 32-year-old
      woman from Okinawa, Japan, who was hospitalized with a complaint of pain in the
      right upper quadrant. Laboratory examination showed leukocytosis of 10,400/mm3
      with 22% eosinophils and slight impairment of liver function. The tumor was
      removed surgically and found to be a necrotic granuloma with eosinophilic
      infiltration formed around a degenerated nematode. The causative agent was
      presumed to be Capillaria hepatica based on the morphology of the bacillary bands
      and stichosome observed in the sectioned worm and in the fragments of worm
      recovered by dissecting the tumor tissue that was embedded in paraffin.

PMID- 7771608
TI  - Prevention of thromboses in human patients with Bothrops lanceolatus envenoming
      in Martinique: failure of anticoagulants and efficacy of a monospecific
      antivenom. Research Group on Snake Bites in Martinique.
AB  - Envenomation by the Bothrops lanceolatus, a snake found only in Martinique, leads
      to swelling and pain, and occasionally to systemic signs and/or coagulopathy.
      Severe thromboses at some distance from the site of the bite may appear within 48
      hr. Uncertainties as to the actual development of thrombotic complications in
      patients appearing to be suffering from moderate poisoning and as to the
      availability and the toxicity of a monospecific antivenom (AVS) initially led us
      to reserve antivenom for the most severe cases, and to use anticoagulants to
      prevent thromboses in all patients. This approach was modified after we observed
      serious thromboses in patients with moderate poisoning. Of 50 adult snake bite
      cases hospitalized between June 1991 and August 1994, 11 developed serious
      thrombotic complications at 36 /+- 27 hr (mean +/- SD) (range 12-96) following
      envenomation, despite early preventive anticoagulant therapy. Those included
      pulmonary embolism (two cases), cerebral infarction (six cases), myocardial
      infarction (one case), and cerebral and myocardial infarctions (two cases).
      Sixteen patients were not treated with AVS: 10 of these recovered without
      complications and six developed systemic thrombosis causing permanent disability
      in three cases. Thirty were treated with an intravenous infusion of 2-6 vials of
      AVS given 2-48 hr after the bite. Of these, three died of cerebral infarction
      that developed before the initiation of serotherapy. All others recovered. Among
      patients treated with AVS, three presented with mild anaphylactic reactions,
      while one developed serum sickness that responded to steroids. These data
      indicate that preventive anticoagulant therapy is of limited efficacy in
      Martinique.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771609
TI  - Effect of semiannual treatments of ivermectin on the prevalence and intensity of
      Onchocerca volvulus skin infection, ocular lesions, and infectivity of Simulium
      ochraceum populations in southern Mexico.
AB  - The effect of semiannual ivermectin treatment along with nodulectomy on filarial
      transmission levels were estimated during the three dry seasons of 1991-1993 in a
      hyperendemic village in southern Mexico. Parasitologic and ophthalmologic
      examinations were carried out every six months until five drug treatments were
      completed. Ivermectin mass treatment with a coverage of approximately 80% had a
      significant impact (P < 0.05) on the prevalence of skin infection and the mean
      microfilarial skin density (CMFL), which were reduced 38% and 89%, respectively.
      A gradual and significant (P < 0.05) decrease in the mean microfilariae number in
      the anterior chamber of the eye and in corneal opacities was also observed as the
      CMFL was reduced. After three treatments, these were reduced 84% and 69%,
      respectively. However, after two years of continuous intervention, no significant
      differences (P > 0.05) were observed in either the daily mean infective biting
      density and the daily mean transmission potential. This was probably due to the
      remaining microfilarial load provided by the untreated resident population and
      migrant groups. On the whole, our results confirm both the efficacy of ivermectin
      to alleviate the clinical manifestations of the disease and its minimal impact on
      Onchocerca volvulus transmission, and indicate the need both to achieve higher
      levels of drug coverage and to incorporate other measures to stop transmission
      until a macrofilaricide drug is found.

PMID- 7771610
TI  - Antimony oxidation states in antileishmanial drugs.
AB  - Chemical methods specific for the determination of the levels of trivalent
      antimony (Sb+3) and pentavalent antimony (Sb+5) were used to investigate
      proprietary formulas used to treat leishmaniasis. Trivalent antimony was
      determined by differential pulse polarography, whereas Sb+5 was determined by
      iodine titration. Proprietary formulas based on N-meglumine antimoniate
      (Glucantime) were analyzed in detail. The results showed Sb+3 in all ampules of
      Glucantime. In formulations said to contain either 85 or 100 mg of Sb+5/ml, we
      found both forms of antimony. The amount of Sb+3 ranged from 10.5 to 15.8% (10.06
      18.96 mg of Sb/ml). These findings raise issues on product stability and
      standardization and may help to clarify resistance to antimonial drugs and the
      reducing effect of tissue on Sb+5.

PMID- 7771611
TI  - The pathology of cutaneous leishmaniasis due to Leishmania major in Sudan.
AB  - The pathology of cutaneous leishmaniasis in Sudan, where the disease is caused by
      Leishmania major, was studied by light and electron microscopy. Lesions were
      classified into four distinct groups based on the ratio of different cell types,
      especially lymphocytes, macrophages, and plasma cells in the inflammatory
      infiltrate, and the formation of compact epithelioid granulomas or the presence
      of necrosis. In the lesions, there was a positive correlation between the number
      of lymphocytes and the number of activated macrophages and epithelioid cells. We
      suggest that the parasites are eliminated from the lesion by two processes: 1) a
      lytic mechanism in which parasites are lysed within activated macrophages and 2)
      necrosis of parasitized macrophages. Morphologic evidence for these two
      mechanisms of parasite elimination was detected by both light and electron
      microscopy. The evolution of the pathology of the lesions was followed by
      rebiopsy when the lesion had regressed in size under antileishmanial therapy.

PMID- 7771612
TI  - Plasmodium vivax: freeze-fracture studies on the ultrastructure of the
      sporozoites within the salivary gland of the mosquito Anopheles stephensi.
AB  - Freeze-fracturing has been used to study the ultrastructure of the sporozoites of
      the malarial parasite Plasmodium vivax within the salivary gland of the mosquito
      Anopheles stephensi. The architecture of the pellicular complex of the salivary
      gland sporozoites was essentially the same as that reported for the intraoocystic
      forms, but the outline of cross-fractured P. vivax sporozoites was more flattened
      and crescent shaped as opposed to the circular outline described for the
      intraoocystic sporozoites. The salivary gland sporozoites of P. vivax also
      exhibited apical rosettes and a cytosome connected to a food vacuole, two unique
      structures not previously reported for malarial sporozoites.

PMID- 7771613
TI  - Transient expression of a promoter-reporter construct in differentiated adult
      salivary glands and embryos of the mosquito Aedes aegypti.
AB  - Vector-borne pathogens develop in close association with specific tissues in
      their insect hosts. Efforts are being made to characterize insect genes that are
      expressed in tissues that have important roles in pathogen propagation.
      Successful transfection and expression of exogenous genes in terminally
      differentiated tissues of insects has previously proven difficult. Here we report
      a method that should allow the analysis of genes that are expressed in adult
      tissues and organs. Transient expression assays have been developed using the
      salivary glands of the mosquito, Aedes aegypti, which can now be used to analyze
      salivary gland-specific promoter sequences. A liposome-based transfection reagent
      was used to transfect cultured adult salivary glands with a DNA construct
      carrying the luciferase reporter gene under the control of the Drosophila
      melanogaster heat shock 70 promoter. Luciferase activity was detected in glands
      18-20 hr post-transfection. This assay can now be used to determine the
      regulatory activity of other putative promoter sequences from salivary gland
      specific genes. Alternatively, the assay may be used to study the effect of
      recombinant gene expression on parasite invasion and development. In addition,
      transient expression of gene constructs in embryos is shown to be a powerful tool
      for analyzing genes that are expressed at this stage of the mosquito life cycle.

PMID- 7771615
TI  - Health care reform: residency training and medical education.

PMID- 7771614
TI  - Evaluation of the severe combined immunodeficient (SCID) mouse as an animal model
      for dengue viral infection.
AB  - Severe combined immunodeficient (SCID) mice reconstituted with human peripheral
      blood lymphocytes (hu-PBL) were evaluated as an animal model for demonstrating
      dengue (DEN) viral infection. Reconstituted mice (hu-PBL-SCID) that demonstrated
      successful engraftment by the presence of serum titers of human immunoglobulin
      (Ig) were inoculated intraperitoneally with DEN virus serotype 1 (DEN-1). Serial
      blood samples were taken postinoculation and assayed for virus in C6/36 cells.
      The identity of all viral isolates was confirmed by an immunofluorescence
      antibody assay using DEN-1 monoclonal antibody. A total of six experiments were
      performed using different procedures of reconstitution and infection, and in
      three of these experiments, DEN-1 virus was recovered from the hu-PBL-SCID mice.
      In the first successful experiment, DEN-1 virus was recovered on postinoculation
      day (PID) 24 from blood, spleen, thymus, and lung tissues of one of eight hu-PBL
      SCID mice. A second group of eight hu-PBL-SCID mice were inoculated with human
      monocytes infected in vitro with DEN-1 virus. Virus was recovered from the blood
      of mice between PID 15 and 23, and from lung tissue of one of these mice. In a
      third experiment, seven SCID mice were treated initially with anti-asialo GM1
      antibody to eliminate natural killer cells, and then were injected simultaneously
      with a mixture of hu-PBL and DEN-1 virus. Virus was demonstrated in the blood of
      one mouse on PID 38, and in another mouse on PID 8, 12, 20, 24, and 36.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7771616
TI  - Effect of multilevel sequential stenosis on lower extremity arterial duplex
      scanning.
AB  - BACKGROUND: The sensitivity of lower extremity arterial duplex scanning in
      detecting a > 50% stenosis may be decreased in extremities with multilevel
      sequential stenosis. PATIENTS AND METHODS: The results of lower extremity
      arterial duplex scanning of the common femoral, upper and lower superficial
      femoral, above- and below-knee popliteal arteries, and tibioperoneal trunk in 80
      extremities of 44 patients were compared to those of arteriography. Thirty-one
      arterial segments in 27 extremities had a > 50% stenosis. The stenoses were
      categorized as first order (first or only stenotic segment in the extremity, n =
      23) and second order (stenosis occurring distal to a > 50% stenosis, n = 4, or
      occlusion, n = 4). RESULTS: The sensitivity, specificity, and positive predictive
      values of duplex scan detection of a > 50% arterial stenosis or occlusion were
      86%, 96%, and 67% for the common femoral artery; 95%, 98%, and 95% for the upper
      superficial femoral artery; 97%, 90%, and 88%, for the lower superficial femoral
      artery; 84%, 90%, and 87% for the above-knee popliteal artery; 47%, 98%, and 90%
      for the below-knee popliteal artery; and 25%, 100%, and 100% for the
      tibioperoneal trunk. Duplex scanning detected 18 (78%) of the 23 first-order
      stenoses compared to only 1 (13%) of the 8 second-order stenoses in limbs with
      multilevel sequential disease (P < 0.01). The peak systolic velocity at the
      stenotic site was significantly higher for first-order (mean +/- SD 168 +/- 54
      cm/s) compared to second-order (38 +/- 13 cm/s) stenoses (P < 0.00002).
      CONCLUSIONS: Duplex scanning was highly sensitive in detecting lower extremity
      first-order stenoses. Low peak systolic velocities at second-order stenoses of
      limbs with multilevel sequential disease significantly decreased the sensitivity
      of duplex scanning.

PMID- 7771617
TI  - A comparative trial of a low molecular weight heparin (enoxaparin) versus
      standard heparin for the prophylaxis of postoperative deep vein thrombosis in
      general surgery.
AB  - BACKGROUND: Various studies have been performed in general surgery patients
      comparing low molecular weight heparin (LMWH) with standard heparin (SH) for the
      prevention of postoperative deep vein thrombosis (DVT), revealing contradicting
      results. Therefore, we have compared the efficacy and safety of a LMWH for the
      prevention of DVT after major general surgery. PATIENTS AND METHODS: Patients
      received either 20 mg LMWH (enoxaparin) once daily, or 5,000 IU SH TID, starting
      preoperatively in a prospective, randomized, double-blind international
      multicenter trial. DVT was diagnosed using fibrinogen I 125 leg scanning. Major
      and minor bleeding were assessed clinically. RESULTS: A total of 718 patients
      were randomized to LMWH, and 709 patients to SH. DVT was detected in 58 LMWH
      treated patients (8.1%, 95% confidence interval [CI] 6.2% to 10.3%) and in 45
      patients allocated to SH (6.3%, 95% CI 4.7% to 8.4%, P > 0.05). Major bleeding
      complications occurred in 11 LMWH-treated patients (1.5%, 95% CI 0.8% to 2.7%)
      and in 18 patients to whom standard heparin was administered (2.5%, 95% CI 1.5%
      to 3.9%, P > 0.05). Four LMWH-treated patients (0.6%) required reoperation for
      bleeding as compared to 13 patients in the SH group (1.8%, P = 0.03). CONCLUSION:
      This LMWH appeared as effective and safe as SH. In view of its more convenient
      way of administration, this LMWH might be preferred for thromboprophylaxis.

PMID- 7771618
TI  - Venous hemodynamic abnormalities in patients with leg ulceration.
AB  - PURPOSE: Venous ulceration in the leg has been predominantly associated with deep
      venous insufficiency, although a few reports have implicated the superficial
      veins. The aim of this study was to identify the distribution of valvular
      incompetence in patients with active leg ulceration. PATIENTS AND METHODS: Color
      flow duplex imaging (CFDI) ultrasonography was used to evaluate the entire venous
      system--superficial, perforator and deep--from groin to ankle in 112 limbs of 94
      patients with venous leg ulcers. RESULTS: Seventy two limbs (64%) had multisystem
      incompetence and 36 (32%) had one system involved only, whereas in 4 limbs (4%)
      there was no venous incompetence. Deep venous reflux exclusively was present in 7
      limbs (6%) and the perforator system alone was involved only in 3 limbs (3%).
      However, isolated superficial incompetence was seen in 26 extremities (23%) and
      combination of superficial with perforator system alone in 23 (21%). In addition,
      reflux overall in the superficial system (alone and in combination with
      perforator and deep systems) was seen in 94 limbs (84%). The most common pattern
      (28%) of abnormality was reflux in all systems, superficial, perforator, and
      deep. CONCLUSIONS: The results of this study show that variable combined patterns
      account for over two thirds of patients with ulceration. No comprehensive
      surgical policy for alleviating ulceration can be justified; we suggest that a
      complete evaluation of all venous systems from groin to ankle with CFDI
      ultrasonography in patients with venous ulceration is practical on a routine
      basis and will be particularly valuable before surgery in order to target
      intervention at specific incompetent sites.

PMID- 7771619
TI  - The natural history of breast cancer with more than 10 positive nodes.
AB  - BACKGROUND: Experimental protocols are being used increasingly to treat breast
      cancer with > 10 positive nodes. An appreciation of the natural history of this
      disease is crucial for choosing the optimal therapeutic approach. PATIENTS AND
      METHODS: We retrospectively reviewed the records of 141 patients who had breast
      cancer with > 10 positive nodes and received definitive therapy at our
      institution in the years 1969 through 1991. Because therapy evolved during this
      period, we compared the results from 1969 through 1981 to those from 1982 through
      1991. RESULTS: Ninety-one patients (65%) were > or = 50 years of age. Fifty-four
      (38%) were estrogen receptor (ER) positive, the remainder were ER negative or ER
      status unknown. Fifty-seven (40%) had 10 to 15 positive nodes, 63 (45%) had 16 to
      25, and 21 (15%) had > 25. The ratio of positive nodes to total nodes was < 50%
      in 22 patients, 50% to 75% in 49, and > 75% in 70. One hundred thirty-four
      patients (95%) underwent modified or radical mastectomy. Forty (28%) received
      adjuvant chemotherapy, including 16 (11%) of 58 patients treated prior to 1981.
      Eleven patients (8%) were treated with adjuvant radiation therapy. The median
      survival for all patients was 52 months, with an actuarial survival of 29% at 10
      years. Patients treated after 1981 had significantly improved survival. They
      lived a median of 68 months postoperatively, as compared to 41 months among
      patients treated earlier. CONCLUSIONS: This is a high-risk group of patients, yet
      there is a small subset who can obtain a long survival with standard treatment
      modalities.

PMID- 7771620
TI  - The management of splenic artery aneurysms: experience with 23 cases.
AB  - BACKGROUND: Splenic artery aneurysms (SAA) are rare clinical entities that carry
      the risk of rupture and fatal hemorrhage. They are being detected with increased
      frequency and often cause a clinical dilemma, particularly when small lesions
      occur in compromised patients. This paper relates our experience in the
      management of SAA over a 14-year period. PATIENTS AND METHODS: We analyzed data
      from the medical charts and radiological images of all patients diagnosed with
      SAA at Emory University Hospital from December 1979 to January 1993. RESULTS: A
      search of medical records discovered 23 patients who experienced 44 SAAs during
      the time period under study. Twelve patients had multiple SAAs, most of them in
      the distal third of the artery. Seven had SAAs > 2 cm in diameter. Modalities
      used to diagnose SAA included Doppler ultrasound in 9 patients, computerized
      tomography in 10, and arteriography in 21. Sixteen patients had portal
      hypertension. Splenomegaly was present in 13 of those with portal hypertension.
      Aneurysm excision and splenectomy were carried out emergently on 2 patients and
      electively on 1. Aneurysm ligation was performed on 3 patients. One patient
      underwent embolization of the lesion. Sixteen asymptomatic patients whose
      aneurysms were < 2 cm in diameter were treated expectantly for a mean period of 3
      years. One patient who received active treatment died. There were no documented
      deaths attributable to SAA among patients treated by observation. Six patients in
      this group died of unrelated causes. The longest follow-up was 7 years.
      CONCLUSIONS: We support current criteria that call for active treatment of
      symptomatic or enlarging SAAs, with particular emphasis on treating women
      anticipating pregnancy and patients undergoing orthotopic liver transplantations.
      For most other cases, expectant treatment is acceptable.

PMID- 7771622
TI  - Criteria for safe hepatic resection.
AB  - BACKGROUND: To lower morbidity after hepatic resection, the authors examined the
      influence of predictor variables including: age, sex, preoperative risk factors,
      serum total bilirubin level, plasma retention rate of indocyanine green at 15
      minutes, underlying liver disease, operative blood loss, operation time, amount
      of whole blood transfused, vascular occlusion time, surgical procedure employed,
      and extent of hepatic resection. PATIENTS AND METHODS: Between January 1990 and
      December 1992, 172 patients underwent hepatic resection based on our own criteria
      for hepatectomy, including the presence or absence of ascites, serum total
      bilirubin level, and the plasma retention rate of indocyanine green at 15 minutes
      in patients with chronic liver disease. The morbidity rate was 37.2%, and the
      hospital and operative mortality rates were 2.3% and 0.6%. RESULTS: The multiple
      logistic model revealed that the risk of morbidity was increased by longer
      operation time, major hepatic resection, and preoperative cardiovascular disease.
      CONCLUSIONS: Shortening the operation time without increasing operative blood
      loss and further modalities for making major hepatectomy safer are future
      problems to be addressed.

PMID- 7771621
TI  - Pancreaticojejunostomy versus controlled pancreaticocutaneous fistula in
      pancreaticoduodenectomy for periampullary carcinoma.
AB  - BACKGROUND: Anastomotic leak of the pancreaticojejunostomy is a major cause of
      morbidity and mortality following pancreaticoduodenectomy. Reports have described
      a large variety of techniques for performing this anastomosis and managing the
      pancreatic stump. In an attempt to obviate the pancreaticojejunostomy, we
      prospectively studied the technique of ligating the pancreatic duct and using
      external drains to create a temporary controlled pancreaticocutaneous fistula.
      PATIENTS AND METHODS: Thirty-five consecutive patients who were to undergo
      pancreaticoduodenectomy for periampullary carcinoma were prospectively randomized
      to one of two groups: pancreaticojejunostomy (PJ) (n = 18) or controlled
      pancreaticocutaneous fistula (CPF) (n = 17). The groups were well matched for
      age, sex, coexisting medical illnesses, type of tumor, and preoperative
      condition. Except for the management of the pancreatic remnant, all patients in
      both groups underwent an identical procedure. Major morbidity, length of
      hospitalization, duration of the controlled pancreatic fistula, and mortality
      were analyzed over a mean follow-up interval of 26 months (range 5 months to 7.5
      years). RESULTS: The CPF group experienced lower overall operative morbidity
      rates than the PJ group (24% versus 56%, P < 0.01). Two patients (11%) in the PJ
      group and none in the CPF group died (P = NS). Half the morbidity in the PJ group
      and both mortalities were related to anastomotic leak. The CPF and PJ groups left
      the hospital after mean stays of 26.4 and 42.2 days respectively (< 0.01).
      CONCLUSIONS: Compared to pancreaticojejunal anastomosis, creation of a temporary
      controlled pancreaticocutaneous fistula in patients who undergo
      pancreaticoduodenectomy for periampullary malignancy has no appreciable risk. It
      is associated with reduced morbidity and shorter length of hospitalization.

PMID- 7771623
TI  - Comparison of serum CA 72-4 and CA 19-9 levels in gastric cancer patients and
      correlation with recurrence.
AB  - BACKGROUND: This longitudinal prospective study evaluates the serum levels of the
      tumor markers CA 72-4 and CA 19-9, alone or in combination, in gastric cancer
      patients. PATIENTS AND METHODS: Serum tumor markers CA 72-4 and CA 19-9 were
      measured in 52 patients who had gastric adenocarcinomas and 32 with benign
      gastric disorders. Serial measurements of these markers were carried out in 30
      cancer patients at a median follow-up time of 38 months. RESULTS: CA 72-4 and CA
      19-9 had sensitivities of 42% and 46% for the preoperative detection of gastric
      cancer. Sensitivity for the two combined was 63%. CA 72-4 provided 100%
      specificity, compared to 72% for CA 19-9. Postoperatively, 17 cancer patients
      remained disease-free. Sixteen of these maintained normal levels of CA 72-4, and
      10 of CA 19-9. Thirteen patients developed recurrent disease. In 9, serum CA 72-4
      levels rose from near-normal after surgery and reached diagnostic values
      approximately 6 months before clinical diagnosis of recurrence. Only 3 patients
      exhibited such a pattern with CA 19-9. CONCLUSIONS: CA 72-4 is a reliable marker
      in gastric cancer. Postoperative serial sampling of CA 72-4 may facilitate early
      identification of recurrences.

PMID- 7771624
TI  - Atrial myxomas: experiences with 35 patients in Hawaii.
AB  - BACKGROUND: Thirty-five patients with an intracardiac myxoma underwent excision
      of the tumor in Hawaii between 1974 and 1993. PATIENTS AND METHODS: There were 28
      female and 7 male patients in the group. Their ages ranged from 11 to 79 years
      (mean 48) with the majority (71%) between 30 and 60 years old. The patients'
      medical records were reviewed and special attention was paid to clinical
      presentation, methods of diagnosis, operative findings, and postoperative course.
      RESULTS: No ethnic predisposition was found. Forty-six percent of the presenting
      symptoms were cardiac (congestive heart failure 26%, palpitations 14%, and
      syncope 6%) while arterial embolization accounted for 11%. Diagnosis was made by
      angiography, echocardiography, or gated cardiac blood pool imaging. All were
      reliable, but two-dimensional (2-D) echocardiography was used most often, with no
      false-positive or false-negative results. There were 32 left atrial, 2 right
      atrial, and 1 biatrial myxomas. Limited septectomy was performed in most cases,
      but 9 patients (26%) required Dacron patch repair of the atrial septum. There was
      1 death from a cerebrovascular accident the day after the removal of a left-sided
      atrial myxoma. Other patients had few minor postoperative complications. One
      patient presented with a recurrence 8 years after resection at another
      institution; no further recurrences were found. CONCLUSIONS: We conclude that due
      to the non-specific presentation of atrial myxoma, a high index of suspicion is
      needed. The diagnostic method of choice is 2-D echocardiography. Limited
      septectomy is a safe procedure, but close follow-up for at least 10 years may be
      needed to rule out recurrence.

PMID- 7771625
TI  - Possible role for oxygen free radicals in the regulation of renal nitric oxide
      synthesis and blood flow.
AB  - BACKGROUND: This study examines the hypothesis that oxygen radicals down-regulate
      renal nitric oxide synthesis and contribute to renal vasoconstriction after
      hemorrhage/reperfusion injury. METHODS: Arterial pressure and renal artery blood
      flow were measured in anesthetized rats subjected to sham or hemorrhage (30 mm Hg
      for 30 minutes) followed by blood reperfusion without or with superoxide
      dismutase, an oxygen radical scavenger. Animals were sequentially injected with
      10 mg/kg NG-nitro-L-arginine methyl ester (L-NAME), a nitric oxide synthase
      inhibitor, and 200 mg/kg and 400 mg/kg L-arginine, a nitric oxide precursor.
      RESULTS: The L-NAME treatment increased arterial pressure and decreased renal
      artery blood flow whereas L-arginine decreased arterial pressure and decreased
      renal blood flow in the sham animals. Hemorrhage/reperfusion injury attenuated
      the pressure and renal blood flow changes following L-NAME and L-arginine
      treatment, which was reversed by superoxide dismutase. CONCLUSIONS: These data
      suggest that oxygen radicals contribute to the regulation of renal nitric oxide
      synthesis, contributing to renal artery vasoconstriction following
      hemorrhage/reperfusion injury.

PMID- 7771626
TI  - Changes in the surgical management of esophageal cancer from 1970 to 1993.
AB  - PURPOSE: To evaluate the changes since 1970 in the management and outcome of
      esophageal resection for cancer. METHODS: The records of all 316 patients who
      underwent esophageal resection for cancer at University of California Los Angeles
      Medical Center during the years 1970 to 1993 were reviewed. RESULTS: When records
      from 1984 to 1993 were compared to those from 1970 to 1983, significant decreases
      were seen in operative mortality (10% to 3%, P < 0.01), morbidity (72% to 60%, P
      < 0.05), anastomotic leaks (12% to 5%, P < 0.03), and reoperations (20% to 8%, P
      < 0.003). Time spent in hospital and in intensive care decreased 40%. These
      improvements in short-term outcome were most evident in patients with disease in
      later stages. The 5-year survival rate increased (12% to 21%, P < 0.01). A
      greater percentage of tumors presented in early stages (21% versus 37%).
      CONCLUSIONS: Short-term outcome of surgical resection for esophageal carcinoma
      improved between 1970 and 1993, in part because of changes in perioperative and
      surgical management. Long-term survival improved, probably due to earlier
      detection of tumors.

PMID- 7771627
TI  - Current results of therapy for esophageal perforation.
AB  - BACKGROUND: Prior reviews of esophageal perforation with delayed recognition have
      reported mortality rates as high as 66%. We performed a retrospective review of
      patients with nonmalignant esophageal perforation to assess the outcome of
      current management techniques. PATIENTS AND METHODS: Charts were reviewed of all
      patients who were treated for nonmalignant esophageal perforation between 1980
      and 1993. They were 23 men and 10 women, mean age 49 +/- 3 years, 19 of whom were
      diagnosed early (< or = 24 hours) and 14 of whom were diagnosed late (> 24
      hours). RESULTS: Perforations were due to instrumentation (16), operative injury
      (7), spontaneous rupture (4), trauma (4), and other causes (2). Pre-existing
      esophageal disease was identified in 23 patients (70%), including achalasia (9),
      stricture (7), varices (5), and other (2). Treatment included closure and
      fundoplication or muscle wrap (10), closure with or without pleural flap (7),
      resection only (7), resection and reconstruction (3), drainage only (4), and
      observation (2). Nonfatal complications included empyema (4), arrhythmia (3),
      persistent leak following attempted closure (2), and other (5). They occurred in
      50% of both the early and late diagnosis groups and were of comparable severity
      in both. The overall mortality was 9% (3/33). Causes of death were sepsis (1) and
      multisystem organ failure (2). Mortality was 5% (1/19) in patients diagnosed
      early and 14% (2/14) of those diagnosed late. CONCLUSIONS: Current mortality
      rates in nonmalignant esophageal perforation are improved compared to previously
      published rates of 19% for all patients with the condition, 9% following early
      and 29% following late diagnosis (47 patients overall). We conclude that, despite
      a high incidence of associated complications, the survival rate following
      nonmalignant esophageal perforation is improving and the impact of delayed
      recognition is decreasing.

PMID- 7771628
TI  - The effect of Roux-en-Y diversion on gastric and Roux-limb emptying in a rodent
      model.
AB  - BACKGROUND: The "Roux stasis syndrome" is characterized by symptoms of upper gut
      stasis following Roux-en-Y gastrojejunostomy (RG). Whether symptoms result from
      delayed gastric emptying, altered Roux-limb transit, or both has never been
      settled, partly because of the difficulty of measuring Roux-limb transit. The aim
      of this study was to develop a model to simultaneously quantitate Roux-limb
      transit and gastric emptying. METHODS: Rats underwent vagotomy and antrectomy
      with RG or Billroth II reconstruction (B-II). Gastrointestinal transit of a solid
      meal (Technetium-99m sulfur colloid-labelled egg white) was assessed 0.5, 1, and
      1.5 hours postprandial (pp). Transit of a liquid marker (Na51-CrO4 injected
      through an efferent-limb catheter) was measured at 25 minutes pp. RESULTS: Solid
      gastric emptying was slower in RG than in B-II rats at 60 and 90 minutes pp. More
      of the solid meal and of the liquid marker was retained in the Roux limb than the
      efferent limb of the B-II at all time points (P < 0.05). CONCLUSIONS: In a rodent
      model, Roux-en-Y gastrojejunostomy is associated with delayed gastric emptying
      and slowed efferent-limb transit of solids and liquids.

PMID- 7771629
TI  - Conversions and complications of laparoscopic treatment of gastroesophageal
      reflux disease. Formation for the Development of Laparoscopic Surgery for
      Gastroesophageal Reflux Disease Group.
AB  - BACKGROUND: It is now known that laparoscopic surgery is associated with less
      discomfort and less pain during the patient's postoperative course. Laparoscopic
      treatment of gastroesophageal reflux disease (GERD) is technically feasible. The
      advantages of this minimally invasive surgical route seem well adapted to a
      basically functional surgery. However, it is important to know whether
      laparoscopic access adds a specific risk to this type of surgery. PATIENTS AND
      METHODS: A retrospective survey was conducted among members of the Formation for
      the Development of Laparoscopic Surgery (FDCL) group during 1993. A form was
      filled in anonymously for each patient who had had either a conversion or a
      postoperative complication following a laparoscopic procedure for GERD. Items
      concerned preoperative workup, technical details of surgery, and postoperative
      course. Another form was used to ascertain how many surgical procedures for GERD
      had been performed during the same period, either laparoscopically or via an
      elective laparotomy. Nineteen surgeons from the FDCL group took part in the
      study. From 1991 to 1993, 758 patients underwent a laparoscopic procedure for
      GERD, while during the same period 38 patients underwent an elective laparotomy.
      RESULTS: In the laparoscopic group, there were 294 Nissen, 334 Nissen-Rossetti,
      and 106 Toupet procedures, and 24 Angelchik prosthesis placements. No deaths
      occurred. The operation had to be converted to an open procedure in 32 cases
      (4.2% conversion rate). In 7 cases the conversion was due to an intraoperative
      complication, whereas in 25 cases the conversion was done because of technical
      difficulties. In 6 cases an intraoperative complication was treated
      laparoscopically without conversion. Thirty post-operative complications were
      recorded (morbidity 4%), leading to a reoperation in 12 cases. Five major
      complications were observed: 2 esophageal perforations, 2 gastric perforations,
      and 1 bowel perforation. CONCLUSION: These results compare favorably with those
      of open surgery and suggest that laparoscopic treatment of GERD is as safe as
      open surgery when performed by a surgeon experienced in laparoscopy.

PMID- 7771630
TI  - Endoscopic jejunal access for enteral feeding.
AB  - Enteral (gut) alimentation appears to offer greater benefit for patients than
      calories delivered via a parenteral (intravenous) route. Enteral alimentation
      prevents mucosal atrophy, maintains normal gut flora, decreases bacterial
      translocation, and enhances enteral immunological competence. Reliable delivery
      into the jejunum without the placement of an operative feeding tube is difficult,
      however. We have been interested for some time in endoscopically placing a
      jejunal tube for enteral nutrition early (within 24 hours) after trauma
      resuscitation or operation. A simplified technique is described for the
      endoscopic placement of a jejunal feeding tube, with or without a concomitant
      percutaneous endoscopic gastrostomy.

PMID- 7771631
TI  - Laparoscopic continent gastrostomy.
AB  - Surgical feeding gastrostomy is attended by a significant morbidity and
      mortality. The percutaneous endoscopic route is regarded as the best method, but
      it is not feasible in cases with pharyngoesophageal stenosis. We here describe a
      new method using laparoscopy. The technique is easy to perform. The patient
      retains continence, with the abdominal wall muscle acting as a sphincteric
      mechanism around the gastric tube.

PMID- 7771632
TI  - A technique for the exchange of tunneled polymeric silicone catheters and
      implantable infusion ports.
AB  - Tunneled polymeric silicone catheters and implantable infusion ports are used
      with increasing frequency. Complications may occur with catheter placement or
      ongoing use. A new technique is described that minimizes the risks associated
      with catheter reinsertion in patients with tunneled polymeric silicone catheters
      that are either malfunctioning or mispositioned. This procedure allows for the
      exchange of these catheters without incurring the risk of a new venipuncture.

PMID- 7771633
TI  - Esophagogastrostomy anastomotic leaks complicating esophagectomy: a review.
AB  - PURPOSE: To summarize the most current information about the etiology,
      pathophysiology, clinical presentation, treatment, and outcome of
      esophagogastrostomy leaks following esophagectomy. METHOD: The English language
      literature was searched by manual methods and MEDLINE for original articles
      reporting results and complications of esophagectomy. RESULTS:
      Esophagogastrostomy anastomotic leaks cause considerable morbidity and mortality
      after esophagectomy. Their major etiologic factors are ischemia of the gastric
      fundus and errors in surgical technique. The clinical presentation of
      postoperative anastomotic leak ranges from an asymptomatic radiographic finding
      to a necrotizing thoracic infection. Severity of illness is largely dependent on
      four factors: gastric viability, the site (thorax or neck) and time of the leak,
      and its containment by surrounding tissues. Cervical anastomoses have a higher
      leak rate than thoracic anastomoses, but leaks from thoracic anastomoses are more
      morbid. CONCLUSION: Leaks from thoracic anastomoses require aggressive surgical
      treatment. Cervical anastomotic leaks that are truly confined to the neck can
      usually be managed at the bedside with wound drainage and packing. However, the
      seriousness of cervical anastomotic leaks should not be underestimated. Some
      leaks from anastomoses constructed in the neck are, in reality, mediastinal
      leaks. Selected patients with radiologically detected asymptomatic leaks can be
      managed conservatively.

PMID- 7771634
TI  - Carbohydrate-deficient transferrin levels in a female population.
AB  - Female college students (n = 49) from a small southwestern United States
      university participated in the 9-month study. Data collected included the
      assessment of drinking habits and other related substance use habits and serum
      levels of carbohydrate-deficient transferrin (CDT). Each subject provided an
      interview and blood sample on three occasions at 90-day intervals. Appended to
      the interview were a series of questions regarding stage of menstrual cycle and
      the diagnoses of certain diseases. The CDT values obtained were consistent with
      those obtained in other studies. Moderate-drinking subjects had significantly
      higher CDT values than did the abstainers and light drinkers. Females using oral
      contraceptives had significantly higher CDT values than those who were not taking
      oral contraceptives. Finally, although CDT values varied over time, they did not
      appear to vary as a function of menstrual cycle stage.

PMID- 7771635
TI  - Alcohol and the mystique of flushing.

PMID- 7771636
TI  - Anterior hippocampal volume deficits in nonamnesic, aging chronic alcoholics.
AB  - Magnetic resonance imaging was used to quantify the volume of the hippocampus in
      47 men with chronic alcoholism and 72 healthy male control subjects. The subjects
      ranged in age from 21 to 70 years, thus permitting a test of whether older
      alcoholics suffer greater brain tissue volume reduction than do younger ones.
      Comparison brain regions included temporal lobe gray matter, white matter, and
      cerebrospinal fluid, as well as measures of the lateral ventricles, third
      ventricle, and temporal horns. The results of this cross-sectional study showed
      that the anterior, but not the posterior, portions of the hippocampus in both
      hemispheres were significantly smaller in the alcoholic than the healthy control
      group. Furthermore, the bilateral anterior hippocampal volume loss was greater in
      older than younger alcoholics. Despite the hippocampal volume deficit, these
      alcoholics did not demonstrate an explicit memory impairment; furthermore, memory
      test scores did not correlate significantly with hippocampal volumes. In the
      alcoholics, the age-related volume loss, which was over and above that expected
      in normal aging, was also evident in the temporal cortex and white matter.
      Likewise, alcoholic ventricular enlargement was age-related. Analysis of
      covariance revealed that the anterior hippocampal deficit persisted after
      accounting for the temporal lobe gray matter volume deficit. Multiple regression
      analysis revealed that the age-related brain volume abnormalities observed in the
      alcoholics could not be attributed to duration of alcoholism or total lifetime
      consumption of alcohol.

PMID- 7771638
TI  - Alcohol-related aggression in males and females: effects of blood alcohol
      concentration, subjective intoxication, personality, and provocation.
AB  - This study tested the combined predictive ability of blood alcohol concentration
      (BAC), subjective intoxication, and aggressive personality traits on physical
      aggression in males and females in High- and Low-provocation conditions. Sixty
      intoxicated White social drinkers (30 males and 30 females) competed against a
      fictitious opponent on a modified version of the Taylor aggression paradigm in
      which subjects both received and delivered electric shocks to their opponents in
      provoking and nonprovoking conditions. Provocation conditions (High and Low) were
      defined by the intensity of the shocks the subjects received. Aggression was
      operationalized as the intensity of the shocks selected by the subjects. Results
      indicated that, for males in the High-provocation condition, aggressive
      personality traits, subjective intoxication, and BAC were effective predictors of
      physical aggression. However, in the Low-provocation condition, only aggressive
      personality traits and BAC predicted aggression. None of the variables were
      effective predictors of aggression for intoxicated females.

PMID- 7771637
TI  - Vasodilatory state of decompensated cirrhosis: relation to hepatic dysfunction,
      ascites, and vasoactive substances.
AB  - The objective of this study was to determine the relations between the hallmark
      circulatory finding of decompensated cirrhosis, a reduced systemic vascular
      resistance (SVR), and the indices of hepatic decompensation, the accumulation of
      ascites, and the concentrations of various vasoactive substances. At a university
      affiliated teaching hospital, eighteen hospitalized patients with cirrhosis and
      18 age- and sex-matched healthy subjects were used. This was a case-control
      study. Measurements included cardiac dimensions and indices derived from
      echocardiograms and Doppler studies, abdominal ultrasound estimates of ascites,
      indices of hepatic function, and various serum (S) and urinary (U) substances.
      Results showed that cirrhotics had increased left atrial and left ventricular
      dimensions, left ventricular mass, heart rate, cardiac output (CO), transvalvular
      velocities, and a decreased SVR. SVR was related to hepatic dysfunction, as
      reflected by an abnormal prothrombin time ratio (r = -0.64, p = 0.006), and also
      related to overall severity of liver disease as estimated by the Child-Pugh score
      (r = -0.53, p = 0.044). Although cirrhotics with ascites generally had a reduced
      SVR, estimates of ascites were directly related to SVR (r = 0.57, p = 0.03) and
      inversely related to CO (r = -0.53, p = 0.04). Concentrations of S and U digoxin
      like immunoreactive substance (DLIS) were also increased, but the concentrations
      of S glucagon and estradiol were not elevated. The accumulations of S and U DLIS,
      S glucagon, and S estradiol were all related to hepatic dysfunction.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7771639
TI  - Independent associations among maternal alcohol consumption and infant thyroxine
      levels and pregnancy outcome.
AB  - Studies with animal models of alcohol-related birth defects (ARBDs) suggest that
      reductions in circulating thyroid hormones, including thyroxine (T4), may be a
      persistent postnatal effect of fetal alcohol exposure. The few clinical reports
      of children with fetal alcohol syndrome (FAS) that address thyroid system
      function generally reported that FAS children have thyroid hormone levels within
      normal limits. For the current study, data bases from the Fetal Alcohol Research
      Center and the Michigan Department of Public Health Newborn Screening Program
      were assessed to correlate measures of maternal drug use during pregnancy and
      infant outcome (gestational age at birth, birthweight, "fetal growth"), with
      infant whole-blood T4 levels. Multiple regression analyses accounted for
      demographic factors, infant age at testing, and variation in the T4 assay. As
      expected, alcohol intake and smoking each had a substantial negative impact on
      birthweight, gestational age at birth, and fetal growth, assessed as birthweight
      corrected for gestational age. Infant T4 levels were positively related to
      birthweight and gestational age and were more strongly related to fetal growth.
      Infant T4 levels were not influenced significantly by either maternal smoking or
      alcohol consumption. Smoking- and alcohol-related reductions in birthweight,
      gestational age, or fetal growth were not associated significantly with
      variations in infant T4. Interesting questions remain regarding species
      differences and the influences of maternal alcohol consumption on T4 metabolism
      as a mechanism for ARBDs. However, the current data do not support the hypothesis
      that maternal alcohol consumption, or smoking, during pregnancy leads to
      compromised thyroid system function in newborn humans.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7771640
TI  - Stress, depression, irrational beliefs, and alcohol use and problems in a college
      student sample.
AB  - One-hundred thirty-five alcohol-using college students completed a questionnaire
      on their levels of alcohol use, moderate-to-severe problems with alcohol use, the
      Eysenck 1.7 measure of impulsiveness and venturesomeness, the Zung depression
      scale, the "Hassles and Uplifts" scale of life stresses, and a scale of proneness
      to irrational beliefs. Impulsivity and venturesomeness were significantly
      correlated with quantity-frequency of alcohol use, but not with the occurrence of
      alcohol use problems; whereas depression, stress, and irrational beliefs were
      significantly correlated with alcohol problems, but not with alcohol use.
      Multiple regression analyses indicated that the effect of stress on alcohol
      problems was mediated by depression, whereas the effect of depression, in turn,
      was mediated by irrational beliefs.

PMID- 7771641
TI  - Effect of alcohol and electrical stimulation on leakage of creatine kinase from
      isolated fast and slow muscles of rat.
AB  - Binge drinking of alcohol may lead to acute alcoholic myopathy with
      rhabdomyolysis, which is characterized by skeletal muscle damage, elevated serum
      creatine kinase (CK), and myoglobinuria. This study was undertaken to test
      whether alcohol acts directly on the skeletal muscles to enhance the leakage of
      CK, and to assess the influence of fiber-type composition and repetitive
      contractions of the muscle on the effect of alcohol. After 4 hr of incubation in
      normal physiological solution at 37 degrees C, mean leakage of CK was 0.7
      units/mg from isolated rat extensor digitorum longus (EDL), which has more fast
      twitch glycolytic muscle fibers, and 1.2 units/mg from the soleus, which has more
      slow-twitch oxidative muscle fibers. Ethanol at 0.1, 0.2, and 0.5% concentrations
      caused significantly greater increase in leakage of CK from soleus than from EDL.
      In normal physiological solution, electrical stimulation at 1 Hz for 4 hr
      increased the leakage of CK by about the same degree in both EDL and soleus. In
      the presence of 0.1 and 0.2% ethanol, electrical stimulation markedly potentiated
      the alcohol-induced leakage of CK from both soleus and EDL. These results
      indicate that alcohol increases the leakage of CK by acting directly on skeletal
      muscle fibers, especially of the slow-twitch oxidative type, and that repeated
      muscle contractions potentiate the alcohol effect. These studies suggest that
      exercise may increase the chances of rhabdomyolysis in the alcoholics.

PMID- 7771642
TI  - Acute prenatal ethanol exposure and luteinizing hormone-releasing hormone
      messenger RNA expression in the fetal mouse brain.
AB  - Ethanol exposure during critical periods of development results in alterations of
      central nervous system morphology and function. In this study, the effects of
      acute ethanol exposure on the number of neurons expressing luteinizing hormone
      releasing hormone (LHRH) messenger RNA (mRNA) has been analyzed. Also, the
      expression of LHRH mRNA in the diagonal band of Broca/preoptic area (DBB/POA) was
      determined. Pregnant C57BL/6J mice were intubated with two doses of a 25%
      solution of ethanol or water (2.9 g/kg body weight) 4 hr apart on gestation day 7
      (G7), G10, or G11. Animals were killed on G18, and in situ hybridization was
      utilized to detect neurons expressing LHRH mRNA. The number of neurons expressing
      LHRH mRNA was determined along their migration route from the rostrum into the
      forebrain. Ethanol exposure on G7 did not significantly change the number of
      neurons expressing LHRH mRNA on G18 compared with that in control animals.
      However, the number of neurons expressing LHRH mRNA in the nasal septum area in
      animals exposed to ethanol on G10 or G11 was significantly less than the number
      in control animals (p < 0.05). Prenatal ethanol exposure on any of the
      aforementioned treatment days did not alter the expression of LHRH mRNA at the
      level of the DBB/POA on G18 in ethanol-treated animals compared with control
      animals. Also, neuron-specific enolase mRNA expression at the level of the
      DBB/POA was not altered by prenatal ethanol exposure. Therefore, ethanol exposure
      on the aforementioned treatment days did not differentially affect LHRH mRNA
      expression compared with neuron-specific enolase mRNA expression at the level of
      the DBB/POA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771643
TI  - Novel synergistic treatment of ethanol withdrawal seizures in rats with dopamine
      and serotonin agonists.
AB  - A recent observation in this laboratory of a simultaneous increase in striatal
      dopamine and a decrease in serotonin in ethanol-dependent rats during ethanol
      withdrawal prompted studies with combined dopaminergic + serotoninergic agonists
      to stop withdrawal seizures. Amphetamine (2 mg/kg) + fenfluramine (8 mg/kg) given
      jointly, but not separately, prevented ethanol withdrawal seizures as effectively
      as benzodiazepines (chlordiazepoxide), the current drugs of choice. The
      combination of amphetamine and fenfluramine, unlike chlordiazepoxide,
      significantly reduced intake of ethanol during and immediately following ethanol
      withdrawal.

PMID- 7771644
TI  - Sensitivity of nucleus accumbens neurons in vivo to intoxicating doses of
      ethanol.
AB  - The nucleus accumbens septi (NAcc) is considered an important component of the
      final common pathway involved in the reinforcing properties of ethanol. We
      studied the effects of intraperitoneal administration of ethanol on spontaneous,
      glutamate-activated, and fimbria-activated NAcc neurons in acute anesthetized and
      freely moving unanesthetized rats. Ethanol significantly reduced the firing rate
      of spontaneous and glutamate-activated NAcc neurons in both electrophysiological
      preparations. Stimulation of the ipsilateral fimbria evoked single-unit activity
      in NAcc neurons with two characteristic latencies (early, 7.21 +/- 0.74 msec;
      late, 18.24 +/- 0.66 msec). Intoxicating doses of ethanol inhibited the
      recruitment of late, but not of early, fimbria-activated NAcc neurons. These data
      demonstrate electrophysiological evidence for the existence of neurons in the
      core region of the NAcc that are sensitive and insensitive to acute systemic
      ethanol administration.

PMID- 7771645
TI  - Alcohol, tumor necrosis factor, and tuberculosis.
AB  - Alcohol exerts potent suppressive effects on the immune system that significantly
      increase host susceptibility to a variety of infections, particularly pneumonia.
      Historically, tuberculosis has been strongly associated with alcohol abuse.
      Although the relationship between alcohol abuse and tuberculosis is widely
      appreciated, the basic mechanisms by which alcohol immunosuppresses the host
      remain to be clarified. A major obstacle in furthering our understanding of this
      association has been the difficulty in distinguishing between the effects of
      alcohol per se and the other frequent sequelae of alcoholism such as nutritional
      deficiencies, liver disease, cigarette smoking, hygienic factors, and lifestyle.
      This article focuses on the role of tumor necrosis factor-alpha (TNF) in host
      defense and how alcohol modulates the activity of this important cytokine. While
      TNF's role in mediating the lethal consequences of infection has been the subject
      of much conjecture, this review focuses on the emerging evidence that TNF is an
      essential factor in the normal immune response to numerous infections, including
      tuberculosis.

PMID- 7771646
TI  - In utero exposure to ethanol affects postnatal development of T- and B
      lymphocytes, but not natural killer cells.
AB  - The effect of intrauterine exposure to ethanol on lymphocyte development in the
      neonatal period was studied in C57BI/6J mice. Mice were bred, and then the female
      mice were assigned to 1 of 3 diet groups, 25% ethanol-derived calories (EDC),
      pair-fed control, or ad libitum laboratory chow. At birth, all offspring were
      cross-fostered to surrogate mothers who had been fed laboratory chow. At weekly
      intervals, the neonatal mice were weighed, and 4 mice from each group were used
      to assess the development of splenic lymphocytes. The total number of splenocytes
      was similar in all three groups at each sampling. The number of T-cells, B-cells,
      and natural killer (NK) cells was measured by flow cytometry. T-cells and NK
      cells did not vary significantly among the three diet groups. However, the total
      number of B-cells was decreased for the first 3 weeks of life in the ethanol
      exposed animals. The function of the T-cells and B-cells was determined by
      assessing the response to lipopolysaccharide, pokeweed mitogen,
      phytohemagglutinin, and concanavalin A. The response to all four mitogens was
      significantly reduced in the ethanol-exposed animals and did not recover to
      control levels until 4-5 weeks of life. Ethanol exposure had no significant
      effect on the kinetics of acquisition of NK lytic function, as assessed by
      determining the killing of chromium-51 labeled YAC-1 tumor target cells. These
      data show that prenatal exposure to ethanol causes a transient immunodeficiency
      in some, but not all compartments of the immune system.

PMID- 7771647
TI  - Ethanol elevates fetal serum glutamate levels in the rat.
AB  - Glutamate is an important excitatory neurotransmitter. However, a sustained
      elevation of glutamate in the extracellular space may be toxic to neurons.
      Because the blood-brain barrier is incomplete in the developing fetus, an
      elevation of fetal serum glutamate could expose the immature, growing brain to
      potentially toxic levels of extracellular glutamate. Chronic ethanol consumption
      during pregnancy is associated with an increased risk for a complex array of
      congenital anomalies, including alterations in the CNS, a hallmark of the fetal
      alcohol syndrome. Some central nervous system changes appear to involve the
      glutamate receptor, including reduced number and altered function. One mechanism
      for receptor downregulation may be a sustained elevation in extracellular
      glutamate. We hypothesize that chronic ethanol exposure during pregnancy leads to
      an elevation in fetal serum glutamate. When rats were fed ethanol-containing
      liquid diet throughout pregnancy, growth retardation of fetuses was observed at
      sacrifice (gestation day 20). Within each group, ethanol-fed, pair-fed, and ad
      libitum chow-fed, serum glutamate levels were generally higher in the fetus than
      in the dam. Ethanol treatment had no effect on fetal or maternal serum glutamine,
      a reciprocal metabolite of glutamate. In contrast, ethanol treatment increased
      serum glutamate levels in the fetal serum by nearly 50%, compared with either of
      the control groups. Maternal serum glutamate was not affected. The finding of
      ethanol-induced elevation of fetal serum glutamate suggests that the developing
      brain might be concurrently exposed to elevated levels of extracellular
      glutamate. Chronic exposure to elevated glutamate during critical periods of
      brain development may contribute to the pathogenesis of the fetal alcohol
      syndrome.

PMID- 7771648
TI  - Polymorphism at the P450IIE1 locus is not associated with alcoholic liver disease
      in Caucasian men.
AB  - Because alcoholic hepatitis and cirrhosis, well-known complications of alcohol
      abuse, do not occur in all alcoholics, genetic factors such as differences in
      alcohol-metabolizing enzymes may play a role in the development of alcoholic
      liver disease. Cytochrome P450IIE1 catalyzes the oxidation of ethanol, producing
      acetaldehyde and free radicals capable of reacting with and peroxidizing cell
      membranes. Polymorphisms have been identified in the 5'-flanking region of the
      P450IIE1 gene that may alter the transcriptional activity of the gene. In this
      study, we analyzed the P450IIE1 genotypes at the polymorphic PstI and RsaI
      restriction enzyme sites in 53 Caucasians with severe alcoholic liver disease to
      determine if there is an association between these polymorphisms and alcoholic
      liver disease. Subjects that tested positive for the hepatitis C virus were
      eliminated from the study. To identify the type A (homozygous for the c1 gene),
      type B (heterozygous for the c1 and c2 genes), and type C (homozygous for the c2
      gene) genotypes at the P450IIE1 locus, DNA encompassing the polymorphisms was
      amplified by polymerase chain reaction, slot-blotted, and probed with allele
      specific oligonucleotides. Allele frequencies for the c1 allele were 0.95 for
      alcoholics with severe liver disease, 0.95 for alcoholics without liver disease,
      and 0.98 for the general population. No differences in allele frequencies between
      alcoholic patients with severe liver disease and alcoholics without liver disease
      were observed.

PMID- 7771649
TI  - Human stomach class IV alcohol dehydrogenase: molecular genetic analysis.
AB  - A partial human stomach alcohol dehydrogenase (ADH) encoding cDNA has been
      isolated, cloned, and sequenced, which contains 222 nucleotides encoding amino
      acid residues 227-299 of the ADH subunit. The amino acid sequence deduced from
      this cDNA was highly homologous with the rat stomach class IV ADH sequence
      recently reported (81.1% sequence identity). Homology with other human ADH
      classes was also observed: class I, 58.1% sequence identity; class II, 39.2%
      sequence identity; class III, 55.4% sequence identity; and class V, 50.0%
      sequence identity. These results support a proposal that the isolated cDNA
      encodes a partial sequence for human stomach class IV ADH. This sequence retains
      val294 for all other human ADH classes reported, as compared with an ala294 at
      this position reported for rat class IV ADH. This ala residue may contribute to
      the very high Km values with ethanol for the latter enzyme. In addition, three
      substitutions are reported for key residues in the coenzyme binding site: 251,
      gln/ser; 260, gly/asn; and 261, gly/asn, which may contribute to the weak
      coenzyme binding properties reported for human class IV ADH.

PMID- 7771650
TI  - Quantitative changes in G proteins do not mediate ethanol-induced downregulation
      of adenylyl cyclase in mouse cerebral cortex.
AB  - Our prior work, and the work of others, demonstrated that chronic administration
      of ethanol to cells in culture or to mice resulted in decreased responsiveness of
      adenylyl cyclase (EC4.6.1.1) to a number of stimulatory agents. In this study, we
      substantiated the ethanol-induced changes in cerebral cortical adenylyl cyclase
      activity in alcohol-tolerant and alcohol-dependent mice, and we examined whether
      chronic ethanol treatment of mice altered the quantity of heterotrimeric guanine
      nucleotide-binding regulatory proteins (G proteins) in cerebral cortex and other
      mouse brain areas. Amounts of various G protein subunits--including the alpha
      subunits of GS (GS alpha), Gi alpha 1-3, G(o) alpha, and beta subunits--were
      examined by Western blot analysis. There was no change in quantity of these G
      protein subunits in cerebral cortex, hippocampus, or cerebellum of ethanol-fed
      mice, compared with controls. In striatum of ethanol-fed mice, small increases in
      Gi alpha 1 and G(o) alpha were observed, but these changes could not explain the
      ethanol-induced desensitization of adenylyl cyclase in brain areas such as the
      cerebral cortex. Forskolin activation of cerebral cortical adenylyl cyclase
      activity showed two components of activation, with high and low "affinity" for
      forskolin. Ethanol treatment caused a decrease in the efficacy of forskolin for
      both components, whereas the EC50 of forskolin for each component did not change.
      Adenylyl cyclase activity measured in the presence of manganese was also
      diminished in cortical membranes of ethanol-treated mice.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7771651
TI  - Altered ACTH and corticosterone responses to interleukin-1 beta in male rats
      exposed to an alcohol diet: possible role of vasopressin and testosterone.
AB  - We have previously shown that female rats exposed to an alcohol (ethanol, E) diet
      exhibited a blunted ACTH response to systemically administered interleukin-1 beta
      (IL-1 beta). Because of the presence of gender differences in the activity of the
      hypothalamic-pituitary-adrenal (HPA) axis, and of the possible role played by sex
      steroids in modulating the inhibitory influence of E in females, we studied the
      ability of a 10-day E diet to alter ACTH and corticosterone secretion of intact
      or castrated male rats injected with IL-1 beta or endotoxin, a releaser of
      endogenous cytokines. Pituitary responsiveness to secretagogues that mediate the
      endocrine effects of IL-1 beta, namely corticotropin-releasing factor (CRF) and
      vasopressin (VP), was also investigated. The ACTH responses of animals fed ad
      libitum (C group) or pair-fed (PF group) to the intravenous administration of IL
      1 beta or endotoxin were not statistically different (p > 0.05); therefore,
      results from these two groups were combined in the initial experiments.
      Subsequent experiments only used E and C animals. When compared with this latter
      group, intact E males showed a significant (p < 0.01) decrease in ACTH levels
      measured 30 and 60 min after the intravenous injection of IL-1 beta or endotoxin.
      In contrast, E rats released as much corticosterone as C rats in response to IL-1
      beta, but significantly (p < 0.05) more following administration of endotoxin
      (lipopolysaccharide). The stimulatory effect of VP on ACTH release was also
      measurably blunted by alcohol, whereas that of CRF was not. In none of these
      experiments were any significant differences observed between C and PF
      rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771652
TI  - Ethanol's effect on tissue polyamines and ornithine decarboxylase activity: a
      concise review.
AB  - An extraordinarily diverse literature describes the cellular/tissue systems in
      which the molecular effects of both acute and chronic alcohol exposure seem to be
      mediated by changes in polyamine levels and/or ornithine decarboxylase (ODC)
      activity. The single unifying factor that links most of these studies is that
      they all, in some way, involve tissues that are undergoing relatively rapid cell
      division. Non-dividing cells expressing the NMDA receptor are a notable exception
      in that ethanol and the polyamines seem to act via discrete regions of that
      receptor. Under most cellular conditions, ODC activity is a reflection of the
      relative tissue polyamine content, and an increase in ODC activity and polyamine
      content seems to be one of the early events in the progression of quiescent cells
      toward cell division. Thus, it is not surprising that ethanol, which has been
      widely reported to delay cell division, should be found to interact with the
      ODC/polyamine pathway. Perhaps the most unique aspect of these studies is the
      fact that, with rare exception, both acute and chronic ethanol exposure have been
      found to slow growth and to lower tissue polyamine (putrescine) content.
      Furthermore, in most studies, the ethanol-induced suppression of cell division
      could be overcome by the administration of exogenous putrescine. These data
      suggest that the ethanol-induced suppression of cell division resulted from the
      loss of putrescine. In addition, because the cells were able to respond to the
      exogenous putrescine, the studies suggest that the signaling pathway remained
      intact beyond the polyamine synthesis step.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771653
TI  - Ethanol increases GABAA responses in cells stably transfected with receptor
      subunits.
AB  - Ethanol enhancement of GABAA receptor function has been found in some, but not
      all, studies. These results suggest the existence of ethanol-sensitive and 
      resistant receptors that may differ in subunit composition, although
      methodological differences (e.g., 36Cl- flux versus membrane currents) could also
      contribute to the different results. To examine these possibilities, we used
      mouse L(tk-) cells stably transfected with alpha 1 + beta 1 or alpha 1 + beta 1 +
      gamma 2L GABAA receptor subunit DNAs and compared 36Cl- flux with whole-cell,
      patch-clamp measurements of GABAA receptor function. Both techniques detected a
      similar modulation of the GABA receptor by ethanol, flunitrazepam, and
      pentobarbital. The potentiating action of ethanol required the gamma-subunit and
      was maximal at a concentration of 10 mM. Similar ethanol potentiation was
      obtained with brief (20 msec) or long (2 sec) applications of GABA. Analysis of
      data obtained from individual cells expressing alpha 1 beta 1-gamma 2L subunits
      showed considerable variability in sensitivity to ethanol, particularly with
      concentrations of 30 and 100 mM. Ethanol potentiated GABA action if the cells
      were grown on coverslips coated with polylysine, but had no effect on GABAA
      receptors of cells grown on uncoated coverslips. Thus, ethanol action was
      influenced by the growth matrix. Taken together, these data indicate that a gamma
      subunit is necessary, but not sufficient, for ethanol sensitivity in this cell
      system. We suggest that posttranslational processing, particularly receptor
      phosphorylation, may also be important and that stably transfected cells will be
      useful in elucidating these events.

PMID- 7771654
TI  - Cell cycle kinetics in fetal rat cerebral cortex: effects of prenatal treatment
      with ethanol assessed by a cumulative labeling technique with flow cytometry.
AB  - The effects of ethanol on the cell cycle kinetics of cortical precursor cells
      during the period of cortical neuronogenesis [between gestational day (G) 12 and
      G21] was systematically examined. Samples of dissociated cortical cells were
      harvested from the cerebral cortices of 13-, 15-, 17-, 19-, and 21-day-old
      fetuses. The fetuses were obtained from pregnant rats: (a) fed a liquid diet
      containing 6.7% (v/v) ethanol (Et) ad libitum, (b) pair-fed an isocaloric liquid
      control diet (Ct), or (c) fed chow and water (Ch) ad libitum. Before harvesting
      the cells, the fetuses were administered a series of 1-5 injections of
      bromodeoxyuridine (BrdU). The proportion of cells that incorporated the BrdU was
      assessed. Using these raw data, the S-phase length (Ts), total cell cycle length
      (Tc), and the growth fraction (GF; the fraction of the total population that was
      actively cycling) were determined with a cumulative labeling procedure. The Ts
      was approximately 8-9 hr, regardless of either the date of the injection or the
      dietary treatment of the dam. On the other hand, the Tc for the Ct- and Ch
      treated rats increased over the gestational period. That is, the Tc was shortest
      on G13 and longest on G21. The Tc for Et-treated rats, however, did not change
      between G13 and G21. For the Ch- and Ct-treated groups, the GF decreased > 15
      fold between G13 and G21. The decline (5-fold) for the Et-treated group over the
      same period, however, was not as great as it was for the Ct-treated
      fetuses.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771655
TI  - Effects of prenatal exposure to alcohol plus caffeine in rats: pregnancy outcome
      and early offspring development.
AB  - The factors determining susceptibility to fetal alcohol syndrome (FAS) are not
      fully understood. We used an animal model of alcohol-related birth defects to
      assess the coteratogenic potential of caffeine as a risk factor in FAS. Rats were
      exposed prenatally to alcohol (approximately 15 g/kg/day) with or without
      caffeine (approximately 84 mg/kg/day) from gestation days 6 through 20 via liquid
      diet. All control groups were pair-fed to the alcohol-exposed groups. In
      addition, some controls had free access to lab chow and water. Prenatal exposure
      to alcohol or caffeine reduced both maternal weight gain during pregnancy and
      birth-weight of offspring. The combination of alcohol plus caffeine produced an
      additive effect in reducing birthweight and synergistic effects in increasing
      postnatal offspring mortality. Prenatal alcohol exposure had a significant
      negative impact on several developmental indices, including grip strength and
      negative geotaxis. Prenatal caffeine exposure did not affect maturational
      measures and did reduce offspring serum levels of the zinc-dependent enzyme
      alkaline phosphatase. This study in rats demonstrated that caffeine can
      exacerbate some of the effects of alcohol on prenatal development, specifically
      reduced birthweight, litter size, and postnatal survival, but that caffeine does
      not appear to alter prenatal alcohol-induced delays in early postnatal maturation
      of survivors. The relative impact of intralitter birthweight rank on
      developmental outcome was also assessed.

PMID- 7771656
TI  - Molecular biological aspects of alcohol-induced liver disease.
AB  - Molecular biological investigations have become a predominant methodology applied
      to the study of alcohol-induced liver disease. The enzymatic pathways responsible
      for ethanol metabolism, and their genetic as well as environmental control, have
      become the focus of detailed investigation. More recently, the significance of
      cytokines in the pathogenesis of alcohol-induced liver disease has also become a
      major area of speculation. This review focuses on the advances made in studies of
      two important enzymes responsible for alcohol metabolism, alcohol dehydrogenase
      and aldehyde dehydrogenase, as well as the investigation of the proinflammatory
      and profibrogenic cytokines involved in the process of hepatic fibrogenesis. The
      quality and quantity of new discoveries made in the field of alcohol-induced
      liver disease is impressive, especially when one realizes that molecular
      biological approaches have been employed in this area for only 15 years. However,
      in most cases the studies have been predominantly descriptive, with little direct
      relevance to the therapeutics of alcoholism and alcohol-induced organ injury.
      Because the groundwork has been laid, one hopes that the next 15 years will
      rectify this failure.

PMID- 7771657
TI  - Correlates of alcohol-related problems in African-American and white gynecologic
      patients.
AB  - The purpose of this study was to assess racial differences in the risk of alcohol
      related problems associated with alcohol consumption, regular psychoactive drug
      use, a family history of alcohol-related problems, sociodemographic factors (age
      and education), and social roles (work, marital, and parental) among
      nonabstaining African-American and White gynecologic outpatients. In addition,
      work, marital, and parental roles were investigated to determine whether they
      mediated or explained racial differences observed in relationships between these
      factors and alcohol-related problems. Respondents were 630 African-American women
      and 769 White women aged 13-77 who were systematically sampled from three
      obstetric/gynecologic clinics and two private practices in Erie County, New York.
      Hierarchical multiple regression analysis was used to test the significance of
      main effects of these factors on alcohol-related problems, to test the
      interactive effects of race with each factor, and to test the interactive effects
      of social roles with alcohol consumption, the only factor for which a racial
      difference was observed in its relationship with alcohol-related problems.
      Overall, results indicated that correlates of alcohol-related problems were
      similar for African-American and White women. Higher risk of alcohol-related
      problems was associated with lower levels of education and lack of work and
      parental roles. In addition, married women who drank heavily were at higher risk
      of alcohol-related women who drank heavily were at higher risk of alcohol-related
      problems than unmarried women who drank heavily.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771658
TI  - Effects of neonatal ethanol exposure on saccharin consumption.
AB  - Prenatal ethanol exposure has been associated with alterations in a variety of
      sexually dimorphic behaviors in rats. This study examined the effects of neonatal
      ethanol exposure on saccharin consumption, a sexually dimorphic behavior in rats.
      Subjects were Sprague-Dawley rats that were artificially reared (AR) from
      postnatal day (PN) 4-PN12 through gastrostomy tubes with ethanol exposure limited
      to PN4-PN10. The AR groups included two ethanol doses (6 g/kg/day and 4 g/kg/day)
      and an isocaloric maltose-dextrin control. A sham surgery control group was also
      included. The AR subjects were returned to their dams on PN13. At 21 days of age,
      subjects were housed with one same-sex sibling and free access to rat chow and
      water until testing. Subjects were tested for saccharin preference and
      consumption at 110 days of age. Typically, male rats consume less saccharin than
      females, and this was evident in the 4 g/kg ethanol group and both control
      groups. However, this was not apparent among the 6 g/kg ethanol-exposed males.
      Furthermore, saccharin preference seemed to be reduced in the females exposed to
      6 g/kg ethanol. These data suggest that the "sensitive period" for ethanol's
      effects on sex differences in saccharin consumption extends into postnatal life.

PMID- 7771659
TI  - Tuberculosis in the 1990s.
AB  - The steady decline in tuberculosis case rate reversed in the mid-1980s, and
      tuberculosis cases have increased dramatically since that time. Important factors
      contributing to this increase are the human immunodeficiency virus (HIV) epidemic
      and tuberculosis occurring in foreign-born persons. Tuberculosis outbreaks have
      occurred in HIV clinics and wards, prisons, homeless shelters, nursing homes, and
      health care facilities. Some of the outbreaks have involved strains of
      tuberculosis resistant to multiple antituberculosis drugs. Recent recommendations
      for initial therapy of tuberculosis include the use of four drugs and directly
      observed therapy in an effort to prevent the emergence of further drug
      resistance.

PMID- 7771660
TI  - Antisocial tendencies and cortical sensory-evoked responses in alcoholism.
AB  - Alcohol-dependent patients with antisocial, aggressive, and impulsive behaviors
      form a subgroup, in which a dysfunction of the brain serotonin system is
      discussed as a pathogenetic factor. Early onset and a transmission from fathers
      to sons (type II alcoholism; Cloninger, 1987) are supposedly further
      characteristics of this subgroup. The response pattern of primary auditory
      cortices to auditory stimuli with different intensities is discussed as a
      noninvasive indicator of the level of central serotonergic neurotransmission. A
      strong intensity dependence of these responses is supposed to indicate low
      serotonergic neurotransmission and vice versa. A strong intensity dependence is
      therefore expected to characterize patients with antisocial tendencies. Auditory
      evoked potentials (N1/P2 component) to stimuli in five different intensities were
      recorded in 53 hospitalized patients after 1 week of withdrawal. Dipole source
      analysis was performed to separate responses of primary and secondary auditory
      cortices. Patients with antisocial tendencies showed a significantly stronger
      intensity dependence of their evoked responses of primary auditory cortices
      (tangential dipoles). Age at onset and family history were not related to the
      intensity dependence of the evoked responses. The results support the notion that
      alcohol-dependent patients with strong intensity dependence and antisocial
      tendencies form a subgroup with a serotonergic hypofunction. These patients may
      respond favorably to a relapse prevention with serotonergic drugs.

PMID- 7771661
TI  - Personality and EEG beta in older adults with alcoholic relatives.
AB  - Research indicates that biological relatives of alcoholics are more likely to
      develop alcoholism than individuals without alcoholic relatives. Most research on
      these groups had focused on individuals who were relatively young (i.e., under 30
      years old). In the present study, we evaluated middle-aged and elderly
      nonalcoholic men and women who did and did not have alcoholic biological
      relatives to assess factors that might be involved in a later, rather than an
      earlier, onset of alcoholism. Psychological characteristics were assessed using
      the Tridimensional Personality Questionnaire. Biological characteristics were
      assessed using quantitative measures of the spontaneous electroencephalogram. The
      psychological measures did not distinguish the groups, but biological measures
      did. The results indicated that nonalcoholic individuals with alcoholic relatives
      showed elevated beta as compared with sex- and age-matched control subjects.
      Factors that might have mediated these findings are discussed, as are the
      implications of these outcomes.

PMID- 7771662
TI  - Routine activities and alcohol use: constraints on outlet utilization.
AB  - Studies of consumers' use of alcohol beverage outlets have provided a basis for
      understanding drinking behaviors in different drinking environments. These
      studies have shown that drinking environments are related to both demographic and
      drinking pattern measures. Absent from these studies has been a theoretical basis
      on which to make predictions regarding drinking patterns and choices of drinking
      environments under the various social, economic, and environmental constraints
      typically confronting alcohol consumers. This study presents one such theoretical
      approach. The approach assumes that, in the context of individual preferences for
      alcohol, drinking choices are constrained by consumers' economic and time-energy
      budgets for consumption. All other things being equal, it is suggested that
      greater budgets for consumption will be related to greater alcohol use, quality
      of beverages purchased, amenity values of purchase locations, or all three.
      Because on-premise drinking entails greater economic costs, greater drinking
      levels will be related to lower utilization of on-premise establishments. The
      predictions of this approach were tested using data obtained from telephone
      surveys of consumers conducted in 1990 and 1991. The results showed that
      controlling for income, variables related to greater time-energy budgets for
      consumption (i.e., marital status and household composition) were related to
      greater consumption levels and greater utilization of on-premise establishments.
      Controlling for demographic measures, greater income was related to greater
      utilization of restaurants and increased beverage quality. Controlling for all
      other measures, frequencies of consumption were inversely related to consumption
      at on-premise establishments, reflecting the expected moderation in costs for
      heavier consumers on a limited alcohol budget.

PMID- 7771663
TI  - High-risk drinking across the transition from high school to college.
AB  - Alcohol use and related problems were studied from the senior year in high school
      to the first autumn in college for 366 heavy drinking students. Four risk factors
      subject sex, family history of drinking problems, prior conduct problems, and
      type of college residence-were evaluated as predictors of: (1) differential
      changes in drinking rates, (2) differential changes in alcohol-related problems,
      and (3) alcohol dependence symptoms during the first college term. Results
      suggest that both dispositional and environmental factors are associated with
      changes in drinking rates and the existence of dependence symptoms. Increases in
      the frequency of drinking were specifically and strongly associated with
      residence in a fraternity (men) or sorority (women). Three risk factors were
      associated with increased quantity of drinking: male gender, residence in a
      fraternity or sorority, and a history of conduct problems. Prior conduct problems
      were also consistently associated with dependence symptoms during the first term
      in college. A family history of alcohol problems was not consistently related to
      changes in use rates or problems, although some analyses suggest interactive
      effects. Early interventions on college campuses should target individuals using
      additive risk profiles.

PMID- 7771664
TI  - Pulmonary host defenses.
AB  - Well functioning host defenses in the respiratory tract effectively remove
      microbes and other debris that reach the conducting airways and alveoli, and this
      usually prevents infections. People with acute and chronic illnesses can
      experience failure of any number of these defense mechanisms that allow pneumonia
      (and bacteremia) to occur, often with considerable morbidity and mortality.
      People with alcohol-related illnesses are a susceptible group for infections, and
      many strategies are needed to help them such as moderating alcohol abuse and
      dependence, providing timely immunizations to create antibody against
      encapsulated bacteria, anticipating microbial colonization of mucosal areas that
      can promote infection, giving excellent supporting medical care in crisis
      situations, and prescribing appropriate antibiotics. New approaches to boosting
      inflammatory reactions to control lung infections better with cytokines and new
      immunomodulator therapies must be investigated now.

PMID- 7771666
TI  - Variation in the association of alcohol consumption with five DSM-IV alcohol
      problem domains.
AB  - Data from a nationally representative sample of the U.S. adult population were
      used to investigate the association between alcohol consumption and five discrete
      problem domains included in the DSM-IV formulations for alcohol abuse and
      dependence. Two dimensions of consumption were considered in the analysis:
      average daily ethanol intake and the relative frequency of drinking five or more
      drinks. The sample consisted of 22,102 adults defined as current drinkers. After
      controlling for various sociodemographic characteristics, family history of
      alcoholism, and age at onset of drinking, both consumption measures retained
      significant levels of association within all five problem domains. The magnitudes
      of the odds ratios at selected levels of consumption were approximately 50%
      greater for the domains of impaired control, continued drinking despite problems
      and hazardous drinking than for the domains of tolerance and withdrawal.
      Moreover, the factors that modified the effect of the consumption measures varied
      markedly across domains, with age, college education, and race the most
      consistent modifiers of the effect of alcohol consumption.

PMID- 7771665
TI  - Blunted growth hormone response is associated with early relapse in alcohol
      dependent patients.
AB  - Growth hormone (GH) secretion, stimulated by the dopamine D1 and D2 receptor
      agonist apomorphine, was assessed in 55 alcohol-dependent patients before
      detoxification (on the day of admittance to hospital) and after 7 days of
      treatment on the ward (day 8). Patients who relapsed early (i.e., within 3 months
      after detoxification) showed significantly blunted GH secretion before
      detoxification, compared with both healthy controls and patients who abstained
      for 6 months. Among early relapsing patients, GH secretion was blunted whether or
      not patients were acutely intoxicated on the day of admittance to hospital.
      However, for patients who abstained during observation, a blunting effect of
      acute ethanol consumption on GH secretion was demonstrated. On day 8, a trend
      toward blunted GH secretion was found in early relapsing patients only when GH
      response over infusion time was assessed. Therefore, GH blunting, and no other
      variable indicating the clinical course of the disease, was associated with early
      relapse in alcohol-dependent patients. These findings are evidence of reduced
      dopamine receptor function in a subgroup of early relapsing alcohol-dependent
      patients during chronic intoxication.

PMID- 7771667
TI  - Prevalence of cholelithiasis according to alcoholic liver disease: a possible
      role of apolipoproteins AI and AII.
AB  - Moderate alcohol intakes decreases the risk of gallstones; in contrast, the
      prevalence of gallstones is increased in patients with alcoholic cirrhosis. The
      aims of this prospective study were to assess the prevalence of cholelithiasis
      among drinkers according to the histological severity of liver disease, and to
      estimate the importance of serum apolipoproteins AI and apolipoprotein AII as
      risk factors for gallstones. Among the 320 drinkers included, 53 patients had
      cholelithiasis. The prevalence increased (p < 0.0001) from 5% in patients with
      normal liver (1 of 22) and 6% in patients with steatosis only (3 of 47) to 13% in
      patients with fibrosis (7 of 54), reaching 27% among patients with biopsy-proven
      cirrhosis (28 of 103). Among patients with clinically obvious cirrhosis on whom
      biopsy was not performed mainly because of the severity of liver disease, the
      prevalence of cholelithiasis reached a maximum of 46% (6 of 13). Among drinkers
      with nonsevere liver disease, patients with cholelithiasis were older (59 +/- 9
      years, mean +/- SD vs. 45 +/- 11, p = 0.003) with lower apolipoprotein AI (118 +/
      37 vs. 163 +/- 45 mg/dl; p = 0.002) and apolipoprotein AII (30 +/- 12 vs. 53 +/-
      20 mg/dl; p = 0.0002) in comparison with patients without cholelithiasis. These
      differences persisted after considering by multiple logistic regression analysis,
      sex, and ideal body weight. Alcohol consumption during the last 5 years was lower
      in patients with cholelithiasis (83 g/day) in comparison with patients without
      cholelithiasis (142 g/day; p = 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771669
TI  - The Obsessive Compulsive Drinking Scale: a self-rated instrument for the
      quantification of thoughts about alcohol and drinking behavior.
AB  - It has been suggested that a crucial dimension of alcohol "craving" includes the
      concept of both obsessive thoughts about alcohol use and compulsive behaviors
      toward drinking. An interview-based rating scale, the Yale-Brown Obsessive
      Compulsive Scale-heavy drinkers (YBOCS-hd), has been found useful in quantifying
      this concept in alcohol-dependent individuals. A self-rating scale, the Obsessive
      Compulsive Drinking Scale (OCDS) has been developed by us as a modification of
      the YBOCS-hd. The YBOCS-hd showed excellent interrater reliability in our hands.
      The correlation between the YBOCS-hd and the OCDS total scores obtained on 60
      alcohol-dependent individuals was 0.83. The test-retest correlation for the OCDS
      total score was 0.96, and the obsessive and compulsive subscales test-retest
      correlations were 0.94 and 0.86, respectively. The internal consistency of the
      items in the OCDS was high (0.86) and did not improve significantly with removal
      of individual items. The shared variance between the OCDS scores and alcohol
      consumption during the period of evaluation was only approximately 20%,
      indicating that the dimension measured by the scale was somewhat independent of
      actual drinking. As such, it might act as an independent measure of the "state of
      illness" for alcohol-dependent individuals. When used during a prospective 12
      week treatment research study, initial results indicate that the OCDS seems to
      validly measure a dimension of alcohol dependence, because it decreased from
      baseline during alcohol reduction and increased in relationship to relapse
      drinking.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771668
TI  - Alcoholism among four aboriginal groups in Taiwan: high prevalences and their
      implications.
AB  - An epidemiological study of alcohol use disorders was conducted on population
      samples from four aboriginal groups in Taiwan (a total of 993 subjects). The
      survey involved ethnographic observation and a semistructured psychiatric
      interview. The interview covered a detailed symptom profile that allowed
      diagnoses to be made according to different diagnostic criteria. The lifetime
      prevalences of alcoholism according to the ICD-10 (research criteria) and the DSM
      III-R criteria were found to be 42.2-54.7% and 44.2-55.5%, respectively, much
      higher than the rates found in an earlier study (0.11-0.16%) conducted 40 years
      ago. Men in all groups were found to have higher prevalences, a lower mean age at
      onset, and a longer mean duration (except in one group) of alcoholism than women.
      Differences in the distribution of sociodemographic correlates (age, sex, marital
      status, education, and ethnicity) of ICD-10 harmful use of alcohol and alcohol
      dependence were examined by case-control analysis with logistic regression. The
      lifetime prevalences of alcohol use disorders were higher than in recent
      epidemiological surveys conducted elsewhere. Possible biological and
      sociocultural explanations for the high prevalence of alcoholism among the study
      populations are discussed.

PMID- 7771670
TI  - 1995 Research Society on Alcoholism Meeting. Steamboat Springs, Colorado, June 17
      22, 1995. Abstracts.

PMID- 7771671
TI  - Sensing with chemically and biologically modified carbon electrodes. A review.

PMID- 7771672
TI  - Development of a novel luminol-related compound, 3-propyl-7,8-dihydropyridazino
      [4,5-g]quinoxaline-2,6,9(1H)- trione, and its application to hydrogen peroxide
      and serum glucose assays.
AB  - Manual and flow injection methods with chemiluminescence detection were developed
      for the determination of hydrogen peroxide (H2O2) using a novel luminol-related
      compound, 3-propyl-7,8-dihydropyridazino[4,5-g]quinoxaline-2,6,9(1H)-trione
      (PDIQ), having a higher efficiency than luminol. The methods are based on the
      chemiluminescence produced by the reaction of H2O2 with PDIQ in the presence of
      microperoxidase in alkaline media. Detection limits for manual and flow injection
      methods are 13 pmol per 100 microliter of test solution and 1.3 pmol per 100
      microliter injection volume, respectively, at a ratio of chemiluminescence
      intensities (or peak heights) of test to blank of 2. The manual method was
      applied to the determination of glucose in human serum. The method correlated
      well with the conventional spectrophotometric method (4 = 0.998).

PMID- 7771673
TI  - Involvement of sulfhydryl groups in the stable fluorescent derivatization of
      proteins by o-phthalaldehyde.
AB  - Treatment of human alpha-1-proteinase inhibitor (alpha-1-PI) with o
      phthalaldehyde (OPA) at pH 8.0 and 25 degrees C, in the absence of added thiol
      resulted in the formation of a mixed population of fluorescent and non
      fluorescent isoindoles. The stoichiometry of isoindole formation was tentatively
      calculated to be 6:1 for unreduced alpha-1-PI and 10:1 for inhibitor treated with
      dithioerythritol, implicating not only cysteine but also non-sulfur nucleophilic
      centres as reaction partners. Despite the apparent involvement of the single
      cysteine residue in alpha-1-PI in the over-all derivatization process, the extent
      of fluorescent derivatization was independent of the redox state of the
      inhibitor. Hence the fluorescing moiety was not a 1-alkylthio-2-alkyl-substituted
      isoindole, as generally observed. The finding that isoindole formation in
      proteins is not limited by sulfhydryl content and that fluorescent products may
      originate from amino acid(s) other than cysteine cautions against interpreting
      fluorescent derivatization by OPA as evidence for cross-linking of lysine to
      cysteine residues.

PMID- 7771674
TI  - Determination of substrates using poly(ethylene glycol)-stabilized dehydrogenase
      enzymes by microlitre per minute flow injection.
AB  - Flow injection (FI), at a flow rate of microliter min-1, is an effective method
      for enzymic substrate determination using low concentrations of poly(ethylene
      glycol) (PEG)-stabilized soluble enzymes. PEG stabilizes dehydrogenase enzymes
      for at least several days by promoting sub-unit association. Band broadening of
      knitted open tubular reactors is reduced as flow rate decreases below 300
      microliter min-1 and a small tubing diameter is important for a faster rate of
      absorbance signal increase with residence time. Small (0.5 microliter) sample
      injections also ensure narrow FI peaks. The determination of several substrates
      such as pyruvate, lactate, and cortisone using appropriate PEG-stabilized enzymes
      is demonstrated with this FI instrument at 25 or 50 microliters min-1 with sample
      throughputs of the order of 2-3 min per sample. The determination of lactate in
      serum samples is also possible. The advantage of this method, sample throughput,
      is not sacrificed but enzyme consumption is considerably less, compared to
      standard ml min-1 FI.

PMID- 7771675
TI  - Orthogonal array design as a chemometric method for the optimization of
      analytical procedures. Part 5. Three-level design and its application in
      microwave dissolution of biological samples.
AB  - The theory and methodology of a three-level orthogonal array design as a
      chemometric method for the optimization of analytical procedures were developed.
      In the theoretical section, firstly, the matrix of a three-level orthogonal array
      design is described and orthogonality is proved by a quadratic regression model.
      Next, the assignment of experiments in a three-level orthogonal array design and
      the use of the triangular table associated with the corresponding orthogonal
      array matrix are illustrated, followed by the data analysis strategy, in which
      significance of the different factor effects is quantitatively evaluated by the
      analysis of variance (ANOVA) technique and the percentage contribution method.
      Then, a quadratic regression equation representing the response surface is
      established to estimate each factor that has a significant influence. Finally, on
      the basis of the quadratic regression equation established, the derivative
      algorithm is used to find the optimum value for each variable considered. In the
      application section, microwave dissolution for the determination of selenium in
      biological samples by hydride generation atomic absorption spectrometry is
      employed, as a practical example, to demonstrate the application of the proposed
      three-level orthogonal array design in analytical chemistry.

PMID- 7771677
TI  - Determination of lasalocid in eggs using liquid chromatography-electrospray mass
      spectrometry.
AB  - A method is presented for the determination of the polyether ionophore,
      lasalocid, in eggs. Samples are extracted under acidic conditions using
      acetonitrile and the extracts are cleaned up using a simple liquid-liquid
      extraction step. Lasalocid is detected and quantified using liquid chromatography
      electrospray mass spectrometry on a quadrupole bench-top instrument. The
      technique is highly sensitive, with a detection limit of about 0.5 ng g-1 of
      lasalocid in homogenized egg samples.

PMID- 7771676
TI  - Naphthalene contamination of sterilized milk drinks contained in low-density
      polyethylene bottles. Part 2. Effect of naphthalene vapour in air.
AB  - A survey on naphthalene vapour in air was conducted, revealing that the ambient
      atmosphere contained concentrations of naphthalene in the range of 0.005-0.100 mg
      m-3. The level of naphthalene vapour in air increased to 0.35 and 4.00 mg m-3 in
      places exposed to lacquer paint and naphthalene-based moth-repellent,
      respectively. The effect of naphthalene vapour in air on milk drinks contained in
      low-density polyethylene (LDPE) bottles was assessed. A mathematical model was
      suggested to describe the migration of naphthalene from the atmosphere into milk.
      The model was proved to be valid for milk drinks exposed to naphthalene-based
      moth-repellent during storage. Moreover, the extent of migration was found to
      increase with the fat content of foods, which might be ascribed to an increase in
      diffusion, in addition to the kinetic factor, that affects naphthalene migration.

PMID- 7771678
TI  - Determination of free hydroxyproline and proline in human serum by high
      performance liquid chromatography using 4-(5,6-dimethoxy-2
      phthalimidinyl)phenylsulfonyl chloride as a pre-column fluorescent labelling
      reagent.
AB  - A fluorescent labelling reagent, 4-(5,6-dimethoxy-2-phthalimidinyl)phenylsulfonyl
      chloride, was designed for the determination of amines by precolumn HPLC and was
      applied to the simultaneous determination of hydroxyproline and proline in serum.
      The reagent reacted with hydroxyproline and proline at 30 degrees C for 10 min to
      produce the fluorescent derivatives, which were separated on a reversed-phase
      column by gradient elution with phosphate buffer (1 mmol l-1, pH 7) and
      acetonitrile and detected by fluorescence measurement at 315 nm (excitation) and
      385 nm (emission). The detection limits (signal-to-noise ratio = 3) for both
      hydroxyproline and proline were 10 fmol per injection. The within-day (n = 10)
      and day-to-day (n = 5) relative standard deviations using human sera were less
      than 2.16% and 2.75%, respectively, for hydroxyproline and less than 2.30% and
      3.25%, respectively, for proline. The concentrations of free hydroxyproline and
      proline in normal human sera (n = 13) were 5.6-18.0 and 137.6-252.6 mumol l-1,
      respectively. The proposed method was also applied to the determination of
      hydroxyproline and proline in sera from patients with chronic renal failure. The
      mean concentrations of hydroxyproline and proline in chronic renal failure were
      about 2.6 and 1.6 times higher, respectively, than those in normal human sera.

PMID- 7771679
TI  - Fractionation of an antiserum to progesterone by affinity chromatography: effect
      of pH, solvents and biospecific adsorbents.
AB  - Several progesterone-AH Sepharose 4B matrices were prepared as biospecific
      adsorbents suitable for affinity chromatography to fractionate antibodies of
      different affinity and specificity from a polyclonal antiserum to progesterone-11
      alpha-hemisuccinate-BSA. From an affinity column of progesterone-11 alpha
      hemisuccinate-AH Sepharose 4B no antibodies can be eluted, even with glycine
      buffer (pH 2.6) and 30% of 2-methoxyethanol. The use of biospecific adsorbents,
      prepared by coupling with AH Sepharose 4B progesterone derivatives [5-pregnene
      3,20-dione di(ethyleneacetal)-11 alpha-ol-11 alpha-hemisuccinate; 4-pregnene
      11,20 beta-diol-3-one-11 alpha-hemisuccinate 20 beta-benzoate; progesterone-3
      carboxymethyloxime] having a low cross-reactivity with the antiserum, makes the
      elution of various antibody fractions of variable affinity and specificity
      possible. 2-Methoxyethanol or N,N-dimethylformamide gradients, in acetate or TRIS
      buffer, were equally efficient for fractionating the antiprogesterone serum,
      while a decreasing pH gradient was less effective and eluted antibody fractions
      that were further separated into various binding components by a solvent
      gradient. Antibodies eluted from the affinity columns by an eluent containing a
      high solvent concentration have affinities higher than antibodies eluted at lower
      solvent concentration.

PMID- 7771680
TI  - Determination of manganese in Chinese tea leaves by a catalytic kinetic
      spectrophotometric method.
AB  - The catalytic effect of manganese(II) on the oxidation of Rhodamine B with
      potassium periodate in the presence of 1,10-phenanthroline in acetic acid-sodium
      acetate was studied. A catalytic kinetic spectrophotometric method for
      determination of manganese(II) was developed. Manganese in the range 0.1-5.0 ng
      ml-1 can be determined, and the detection limit is 0.02 ng ml-1. Manganese in
      Chinese tea leaves was successfully determined.

PMID- 7771681
TI  - Automated determination of inorganic mercury in blood after sulfuric acid
      treatment using cold vapour atomic absorption spectrometry and an inductively
      heated gold trap.
AB  - Inorganic mercury (InoHg) in whole blood and erythrocytes was determined by cold
      vapour atomic absorption spectrometry (CVAAS) after overnight treatment with
      sulfuric acid at 45 degrees C and reduction with SnII in the acidic mixture.
      Total mercury (TotHg) was determined after digestion with a mixture of nitric and
      perchloric acids. Mercury vapour was preconcentrated on an amalgamation trap made
      of gold wire. The mercury was rapidly released by inductive heating of the trap.
      InoHg could be determined specifically in the presence of methylmercury (MeHg).
      The concentration of MeHg could be calculated by subtracting the concentration of
      InoHg from that of TotHg. Calculated concentrations of MeHg in erythrocytes
      showed a strong correlation with the results of a gas chromatographic method,
      though a discrepancy in calibration was indicated. The detection limits (3 s) in
      blood (0.5 g) were 0.06 ng g-1 for TotHg and 0.04 ng g-1 for InoHg and S(r) for a
      5 ng g-1 whole blood sample was 2% (n = 10) for both TotHg and InoHg.

PMID- 7771682
TI  - Three-dimensional observation with a confocal scanning laser microscope of
      fibronectin immunolabeling during cardiac looping in the chick embryo.
AB  - From the beginning of cardiac myofibrillogenesis in the chick embryo, developing
      myofibrils at the bottom of the inner myocardial cell layer facing the cardiac
      jelly are already aligned circumferentially in the direction of the heart tube.
      To elucidate the mechanism of this alignment, we investigated the temporal and
      spatial expression of fibronectin and its relationship to actin filaments before
      and during looping (4- to 13-somite stages) by using a confocal scanning laser
      microscope. Serial optical tomograms were obtained from whole-mounted heart tubes
      stained with fluorescein-conjugated antibody against cellular fibronectin and
      rhodamine-conjugated phalloidin. Before looping (4- to 7-somite stages),
      particulate and speckled fibronectin formed loose networks. At the onset of
      looping (8- to 9-somite stages), fine fibrils of fibronectin appeared. They
      became dense and were arranged circumferentially in the direction of the heart
      tube. They were aligned parallel with the thick actin bundles that appeared as an
      initial stage of developing myofibrils. During looping, (10- to 13-somite
      stages), fibronectin fibrils were fragmented and showed a speckled pattern, while
      the number of circumferentially aligned mature striated myofibrils increased.
      These observations suggest that the temporal arrangement of fibronectin fibrils
      at the beginning of looping plays a role in the circumferential alignment of
      developing myofibrils.

PMID- 7771683
TI  - Vagal sensors in the rat duodenal mucosa: distribution and structure as revealed
      by in vivo DiI-tracing.
AB  - Results from functional studies point to the importance of chemoreceptive endings
      in the duodenum innervated by vagal afferents in the regulation of
      gastrointestinal functions such as gastric emptying and acid secretion, as well
      as in the process of satiation. In order to visualize the vagal sensory
      innervation of this gut segment, vagal afferents were selectively labeled in vivo
      by injecting the lipophilic carbocyanine dye DiI into either the left or the
      right nodose ganglion of young adult rats. Thick cryostat sections or whole
      mounted peels of muscularis externa or submucosa of formalin-fixed tissue were
      analyzed with conventional and/or confocal microscopy. In the mucosa, many DiI
      labeled vagal afferent fibers were found with terminal arborizations mainly
      between the crypts and the villous lamina propria. In both areas, vagal terminal
      branches came in close contact with the basal lamina, but did not appear to
      penetrate it so as to make direct contact with epithelial cells. Labeled vagal
      afferent fibers in the villous and cryptic lamina propria were found to be in
      intimate anatomical contact with fibrocyte-like cells that may belong to the
      class of interstitial cells of Cajal, and with small granular cells that might be
      granulocytes or histiocytes. Although our analysis was not quantitative, and
      considering that labeling was unilateral and not complete, it appears that the
      overall density of vagal afferent mucosal innervation was variable; many villi
      showed no evidence for innervation while other areas had quite dense networks of
      arborizing terminal fibers in several neighboring villi. Analysis of separate
      whole-mounted muscularis externa and submucosa peels revealed the presence of
      large bundles of labeled afferent fibers running within the myenteric plexus
      along the mesenteric attachment primarily in an aboral direction, with individual
      fibers turning towards the antimesenteric pole, and either penetrating into the
      submucosa or forming the characteristic intraganglionic laminar endings (IGLEs).
      Although the possibility of individual fibers issuing collaterals to myenteric
      IGLEs and at the same time to mucosal terminals was not demonstrated, it cannot
      be ruled out. These anatomical findings are discussed in the context of
      absorptive mechanisms for the different macronutrients and the implication of
      enteroendocrine cells such as CCK-containing cells that may function as
      intestinal "taste cells".

PMID- 7771685
TI  - Distribution of neurons of origin of zinc-containing projections in the amygdala
      of the rat.
AB  - The present study describes the distribution of neurons of origin of zinc
      containing pathways in the amygdaloid complex of the rat, using the selenium
      method for simultaneous retrograde labeling of all zinc-containing neurons. With
      this method, vesicular ionic zinc is precipitated intravitally with selenium
      compounds and transported retrogradely to the parent neurons, where it can be
      visualized by silver amplification. Neurons labeled retrogradely with silver
      amplified precipitate were observed in all amygdaloid nuclei except for the
      lateral olfactory tract nucleus, the accessory olfactory tract nucleus and the
      central nucleus. Very few labeled cell bodies were seen in the anterior
      amygdaloid area and the medial nucleus. The amygdalo-hippocampal area and the
      amygdalo-piriform transition area both showed a substantial number of labeled
      somata throughout their rostrocaudal extent. In the anterior cortical nucleus,
      very few labeled cell bodies were found in the rostral pole, whereas they were
      abundant in the caudal quarter of the nucleus. In the posterolateral cortical
      nucleus, the number of labeled cell bodies increased gradually; there were none
      in the rostral pole, but most of the neurons in the caudal part were labeled. The
      posteromedial cortical nucleus contained a great number of labeled somata, but
      with some variation in the rostrocaudal extent of the nucleus. Considerable
      numbers of labeled neurons were observed throughout the lateral nucleus. In the
      basolateral nucleus, a small number of labeled cell bodies was present in the
      rostral half, but a gradual increase was observed in the caudal direction.
      Finally, in the basomedial nucleus, very few labeled cell bodies were present in
      the rostral two-thirds, whilst a considerable number was encountered in the
      caudal one-third. Possible functional implications of neuronal zinc are
      considered. The distribution of neurons of origin of zinc-containing projections
      has been compared with previously described intrinsic connections of the rat
      amygdala, and tracts that may possibly be zinc-containing are outlined and
      discussed. It is concluded that in all probability a substantial proportion of
      the intrinsic connectivity of the rat amygdaloid complex is zinc-containing.

PMID- 7771684
TI  - Quantitative receptor autoradiography of eight different transmitter-binding
      sites in the hippocampus of the common marmoset, Callithrix jacchus.
AB  - The regional and laminar distributions of eight different transmitter-binding
      sites were measured in the marmoset hippocampus by means of quantitative in vitro
      receptor autoradiography. Receptors for 5-HT1, L-glutamate, N-methyl-D-aspartate
      (NMDA) and GABAA were similarly distributed. The highest concentrations of these
      receptors were found in the pyramidal layer of CA1 and the molecular layer of the
      dentate gyrus. The 5-HT2 receptors showed the highest concentrations in the
      oriens layer of CA2. The highest concentrations of muscarinic M1 receptors were
      seen in the pyramidal layer of CA1. Muscarinic M2 receptors were most densely
      concentrated in the pyramidal layers of CA1, CA2 and CA3. The noradrenergic alpha
      1 receptors were most densely packed in the radiatum-lacunosum-molecular layer of
      CA2 and the molecular layer of the dentate gyrus. Statistically significant co
      distributions of serotoninergic, glutamatergic and GABAergic receptors point to
      possible interactions between these receptor systems in the same hippocampal
      regions and layers. Comparisons of marmoset distribution patterns for GABAA,
      NMDA, L-glutamate and 5-HT1 receptors with those in human hippocampi and those of
      other primates showed similarities between them. Clear differences in the
      patterns of alpha 1, M1, M2 and 5-HT2 receptors could be seen between marmoset
      and human hippocampi, indicating a high degree of species specificity in a
      presumably "conservative" brain region. More similarities, however, could be
      found between marmoset and human hippocampi than between those of rat and human
      brains, especially in relation to 5-HT1 and GABAA receptors and L-glutamate
      binding sites.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771686
TI  - Comparison of the patterns of callosal connections in lateral parietal cortex of
      the rat, mouse and hamster.
AB  - In a recent study of the second somatosensory area (SmII) in the rat it was
      reported that the somatotopic map in the cortex lateral to the primary
      somatosensory area (SmI) is closely related to local features of the callosal
      pattern. The existence of this relationship suggests that knowledge of the
      overall pattern of callosal connections in the cortex lateral to SmI may
      facilitate the description of the somatotopic organization of lateral parietal
      cortex in other rodents. We tested this suggestion by comparing the callosal
      patterns in lateral parietal cortex in the rat, mouse and hamster. Our finding
      that the callosal pattern in the mouse closely resembles that in the rat supports
      the idea that the callosal pattern reflects the underlying somatotopy because the
      maps of SmII described previously in the mouse and rat are very similar to each
      other. In addition, on the basis of our observation that the callosal pattern in
      the hamster is very similar to that in the rat and mouse, we predict that these
      three rodent species share a common somatotopic plan in lateral parietal cortex.

PMID- 7771687
TI  - A time-dependent loss of retrograde transport ability in distally axotomized
      rubrospinal neurons.
AB  - Studies on the effect of axotomy on adult intrinsic central projection neurons
      have generally assumed that the severed proximal axonal stumps were still capable
      of retrogradely transporting tracer at varying times after injury. Failure of
      transport was interpreted as neuronal death, which is at odds with current
      understanding that central projection neurons survived distal axotomy. We used
      lumbar spinal cord-projecting rubrospinal neurons of the rat as a model to
      evaluate the ability of injured neurons to transport tracer retrogradely at
      different times after distal axotomy. We examined only the caudal part of the red
      nucleus, since rubrospinal neurons are concentrated here. In control animals,
      tracer applied to the rubrospinal tract at the T10 vertebral level labeled
      ventrolateral rubral neurons, while C3 application marked all rubral neurons.
      From 3 days after a T10 axotomy and tracer application, most ventrolateral
      neurons were no longer labeled by another tracer application at the C3 vertebral
      level via an axonal cut. The phenomenon was not caused by tracer toxicity, since
      a T10 tractotomy without tracer application also prevented these axotomized
      neurons from being labeled when treated similarly. Thus, neuronal retrograde
      transport capability was seriously retarded 3 days after a distal axotomy. Loss
      of retrograde transport may merely suggest that a mechanism no longer in service
      has been switched off, or perhaps it may insulate injured neurons from the effect
      of lesion site-derived factors. Using this property, we were able to localize
      cervical spinal cord-projecting rubrospinal neurons in the caudal red
      nucleus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771688
TI  - Distribution of GABA immunoreactivity in the retino-recipient layer of the viper
      optic tectum. A light and electron microscope quantitative study.
AB  - The distribution of GABA-immunoreactivity was investigated in the principal
      retino-recipient layer of the optic tectum in the snake Vipera aspis. This layer,
      the stratum griseum et fibrosum superficiale, contained an important proportion
      (approximately 50%) of small GABA-immunoreactive interneurons, characterized by a
      voluminous invaginated nucleus surrounded by a thin rim of cytoplasm poor in
      organelles and occasionally showing pleiomorphic synaptic vesicles, which could
      also be observed in some of the dendrites that contained synaptic vesicles. In
      the neuropile, the GABA-immunoreactive profiles containing synaptic vesicles
      could be subdivided into dendrites containing synaptic vesicles and axon
      terminals with pleiomorphic synaptic vesicles. The dendrites containing synaptic
      vesicles (23.4% of all profiles containing synaptic vesicles) were postsynaptic
      either to optic terminals (39.2%), GABA-immunoreactive axon terminals with
      pleiomorphic synaptic vesicles (48.2%) or to immunonegative (S1) boutons with
      round synaptic vesicles (12.6%). These dendrites were presynaptic to GABA
      immunoreactive (18%) neurons or immunonegative (82%) neurons. The axon terminals
      with pleiomorphic synaptic vesicles, which represented 47.4% of all profiles,
      were predominantly (99%) GABA-immunoreactive and four types could be
      distinguished according to cytological criteria. These axon terminals made
      synaptic contacts for the most part (78%) with immunonegative profiles, and more
      rarely (22%) with immunoreactive neurons. These data are compared to those
      previously obtained in the homologous structure of other vertebrate species,
      birds and mammals in particular.

PMID- 7771689
TI  - Expression of gap junction genes, connexin40 and connexin43, during fetal mouse
      development.
AB  - The expression patterns of the gap junction genes connexin40 and connexin43 have
      been analyzed during late mouse fetal development, i.e., at embryonic days 14.5
      and 16.5, by in situ hybridization and immunofluorescence. Connexin40 was found
      in endothelial cells of vessels, cardiomyocytes and in developing myoblasts and
      myotubes. Expression of connexin40 in developing muscle fibers was strong in the
      back muscles and weaker in the muscles of the limbs. The number of labeled cells
      in the back muscle decreased with ongoing differentiation of myoblasts, in
      accordance with the idea that connexin40 is only expressed in the early stages of
      muscle cell differentiation. Within a muscle bundle, connexin40 expression was
      predominantly found at the outermost side where myoblasts fuse to multinucleated
      myotubes. In contrast, connexin43 exhibits a wide and complex pattern of
      expression in fetal mouse development. It is found in organs originating from all
      three germ layers, such as epidermis, heart, lung, muscle, kidney and gut.
      Connexin43 transcript and protein were very abundant in tissues that had been
      undergoing inductive interactions, e.g., the inner enamel epithelium of the
      teeth, the glomeruli of the kidneys and the infundibulum forming the neural part
      of the pituitary gland. Very high connexin43 expression was found in the
      embryonic meninges (dura mater) and in the fetal adrenal cortex. During
      keratinocyte differentiation connexin43 mRNA expression decreased, being much
      stronger in the stratum basale than in stratum granulosum. No obvious discrepancy
      between the amount of mRNA and protein of either connexin was noticed, suggesting
      that there is no specific translational regulation at these developmental stages.

PMID- 7771690
TI  - Measurement of upper airway pressures in exercising horses with dorsal
      displacement of the soft palate.
AB  - To determine whether abnormal airway pressures have a role in development of
      dorsal displacement of the soft palate (DDSP), measurements of tracheal and
      pharyngeal pressures were correlated with nasopharyngeal morphology in exercising
      horses. Exercising videoendoscopy and measurement of tracheal and pharyngeal
      pressures were used in 14 clinically normal horses and 19 horses with
      intermittent DDSP. The pressure signals were superimposed on the videoendoscope
      image, and both images were saved simultaneously on a videocassette for slow
      motion analysis to determine the instant displacement occurred in the respiratory
      cycle. Horses were submitted to an escalating 8-minute high-speed test with a
      maximal speed of 14 m/s. Compared with clinically normal horses, horses with
      intermittent DDSP did not have excessively negative inspiratory pressures during
      exercise. Eight horses displaced the soft palate during inspiration, 4 horses
      displaced it during expiration, and 7 displaced it by swallowing. Some horses
      displaced the soft palate at the beginning of the exercise trial, before reaching
      maximal speed, some horses displaced it at the peak speed, and some horses
      displaced it when slowing down. Epiglottic size in horses with DDSP was within
      normal limits, ruling out epiglottic hypoplasia as a cause of DDSP during
      exercise. Airway pressures were significantly (P < 0.002) altered after DDSP.
      Pharyngeal and tracheal inspiratory pressures were less negative, whereas
      pharyngeal expiratory pressure became less positive and tracheal expiratory
      pressure became more positive after displacement, suggesting a decrease in
      airflow and an increase in expiratory resistance in the upper airway.

PMID- 7771691
TI  - Arrhythmia prevalence during ambulatory electrocardiographic monitoring of
      beagles.
AB  - Ambulatory ECG, approximately 18 to 24 hours in duration, were obtained from 113
      male and 115 female clinically normal, purpose-bred Beagles. The ECG analyzed
      semi-automatically (44 males, 46 females) were evaluated for heart rate,
      ventricular ectopic complexes (VEC), bradycardia, and sinus pause; those analyzed
      by visual inspection (69 males, 69 females) were evaluated for VEC, second-degree
      atrioventricular block, and supraventricular escape complexes. Mean heart rate
      was highest at times of maximal human contact (eg, feeding, cleaning) and lowest
      at periods of no human contact. Bradycardia was observed in 27 of 44 males
      (61.4%) and 18 of 46 females (39.1%). Sinus pause was identified in 33 of 44
      males (75%) and 30 of 46 females (65.2%). Frequency of bradycardia and sinus
      pause tended to vary inversely with mean heart rate. Ventricular ectopic
      complexes were detected in 18.8 to 26.1% of the ECG analyzed by use of either
      method. Although VEC runs and bigeminy were observed, most VEC were single and
      occurred sporadically. Second-degree atrioventricular block was observed in 6 of
      69 males (8.7%) and 14 of 69 females (20.3%); episodes often were single and
      occurred sporadically. Supraventricular escape complex occurred in 2 of 69
      females (2.9%). Multiple types of abnormal complexes were observed in 2 of 69
      males (2.9%) and 6 of 69 females (8.7%). Among clinically normal Beagles,
      ambulatory electrocardiography detects a higher percentage of dogs with VEC,
      second-degree atrioventricular block, and supraventricular ectopic complexes than
      does resting electrocardiography.

PMID- 7771692
TI  - Differential cell analysis and phenotypic subtyping of lymphocytes in
      bronchoalveolar lavage fluid from clinically normal dogs.
AB  - In 33 healthy dogs, 66 bronchoalveolar lavage samples from the right and left
      caudal lung lobes were analyzed for volume of return, cellularity, differential
      cellularity, and immunophenotypic lymphocyte subpopulations. Lavage return was
      64.8% (mean) following 3 sequential 25-ml lavages, for a total lavage volume of
      75 ml. With this technique, 21.1 x 10(6) cells/sample (mean) were obtained. The
      cellular components of bronchoalveolar lavage samples, in decreasing order of
      frequency, were alveolar macrophages (79.4%), lymphocytes (13.5%), eosinophils
      (3.6%), mast cells (2.1%), epithelial cells (0.8%), and neutrophils (0.6%). Mean
      alveolar lymphocyte subpopulation frequencies, determined in 18 samples, for pan
      T, CD4, and CD8 cells were 52, 21.9, and 17.8%, respectively, with a CD4/CD8
      ratio of 1.3. Variables analyzed did not vary between right and left caudal lung
      lobes, nor were they affected by body weight.

PMID- 7771693
TI  - Magnetic resonance arthrography of the scapulohumeral joint in dogs, using
      gadopentetate dimeglumine.
AB  - Six scapulohumeral joints (3 normal joints and 3 joints with radiographic
      evidence of osteochondrosis) underwent conventional magnetic resonance (MR)
      imaging and MR scapulohumeral arthrography to evaluate delineation of the
      articular cartilage. The MR arthrography was performed, using 5 ml of 500 microM
      gadopentetate dimeglumine (Gd-DTPA) as a contrast medium. Delineation of normal
      articular cartilage and cartilage defects was less accurate after intra-articular
      administration of Gd-DTPA. Therefore, it was concluded that MR arthrography with
      Gd-DTPA is unrewarding for evaluation of osteochondrosis lesions.

PMID- 7771695
TI  - Simultaneous identification and determination of residual penicillins by use of
      high-performance liquid chromatography with spectrophotometric or fluorometric
      detectors.
AB  - Using 7 penicillins (amoxicillin, ampicillin, methicillin, penicillin G,
      oxacillin, cloxacillin, and dicloxacillin), simultaneous and direct determination
      of residual penicillins in biological samples was carried out by use of bioassay
      and high-performance liquid chromatography with spectrophotometric or
      fluorometric detectors. By use of assay medium seeded with penicillin-sensitive
      Micrococcus luteus (ATCC No. 9341) as a test organism, we were able to detect
      penicillins even at low concentrations. All penicillins treated with 10 U of
      penicillinase/ml did not produce inhibition zones by disk testing, even at a
      concentration of 100 micrograms of penicillin/ml/assay plate. Using a mobile
      phase of acetonitrile:methanol: 0.01M KH2PO4 (19:11:70, v/v/v; pH, 7.1), standard
      solutions of the penicillins were separated from each other by use of high
      performance liquid chromatography analysis, producing symmetric peaks without
      tailing, each of which had a characteristic retention time. Simultaneous
      detection of residual penicillins in bovine serum, kidneys, and liver, for the 5
      penicillins for which analysis was possible by use of the UV method, yielded
      recovery rates from 71.4 to 102.3%; for the 2 amino-penicillins, amoxicillin and
      ampicillin, which could only be detected by use of the fluorometric method,
      recovery rate ranged from 72.9 to 103%.

PMID- 7771694
TI  - Development of methods for analyzing plasma lipoprotein concentrations and
      associated enzyme activities and their use to measure the effects of pregnancy
      and lactation in cats.
AB  - Methods available for measurement of plasma lipoprotein-cholesterol
      concentrations and activities of lipoprotein lipase, hepatic lipase,
      lecithin:cholesterol acyl transferase (LCAT), and cholesteryl ester transfer
      protein were adapted for use in cats. A combined
      ultracentrifugation/precipitation procedure was used to isolate very low-density
      lipoproteins (VLDL), then to separate low-density lipoproteins (LDL) from high
      density lipoproteins (HDL). The reagent used, 92 mM heparin-manganese chloride,
      provided complete precipitation of LDL with only trace and insignificant
      contamination by HDL. Efforts to selectively measure lipoprotein lipase activity
      in plasma, collected after IV injection of heparin, by inhibiting hepatic lipase
      with sodium dodecyl sulfate were unsuccessful, and the activity of this enzyme
      was calculated as the difference between total and hepatic lipase activities. The
      latter was measured in the presence of high salt concentration to inhibit
      lipoprotein lipase. Cholesterol esterifying activity was identified in feline
      plasma and was typical of LCAT, in that it was dependent on apolipoprotein A-I as
      a cofactor. The intra-assay and interassay coefficients of variation for
      measurement of lipoprotein lipase, hepatic lipase, and LCAT activities were 18.4,
      4.6, and 7.2%, and 20.4, 10.7, and 5.3%, respectively. Appreciable cholesteryl
      ester transfer protein activity was not detected in either undiluted or diluted
      plasma. These methods were subsequently used to investigate the effects of
      pregnancy and lactation on lipoprotein metabolism in a group of 10 queens. Plasma
      concentrations of cholesterol and triglycerides were unaltered during pregnancy,
      but the concentrations of VLDL-cholesterol increased and those of HDL-cholesterol
      decreased.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771696
TI  - Effects of storage on serum ionized calcium and pH values in clinically normal
      dogs.
AB  - The stability of ionized calcium (CaI) concentration and pH in sera (n = 14)
      stored at 23 or 4 C for 6, 9, 12, 24, 48, or 72 hours, or -10 C for 1, 3, 7, 14,
      or 30 days was evaluated. Also studied were the effects of oxygen exposure, cold
      handling, and feeding on CaI and pH values. Results indicated that serum CaI
      concentration was stable throughout 72 hours of storage at 23 or 4 C, and for 7
      days at -10 C. Serum CaI concentration significantly (P < 0.05) decreased by 14
      days of storage at -10 C. Serum pH was stable for 6 hours at 23 or 4 C, and for
      24 hours at -10 C, but significantly (P < 0.05) increased by 9 hours of storage
      at 23 or 4 C and by 3 days at -10 C. Exposure of the surface of the serum to air
      immediately before measurement had no effect on CaI or pH values, but mixing
      serum with air resulted in significantly (P < 0.05) decreased CaI concentration
      and increased pH. Handling of blood on ice resulted in significantly (P < 0.05)
      higher serum pH, compared with blood handled at 23 C, but serum CaI concentration
      was unaffected. Serum obtained at 2 hours after feeding did not have any
      significant changes in CaI, total calcium, or pH values. It appears that if
      canine serum is obtained, handled, and stored anaerobically, CaI concentration
      can be accurately measured after 72 hours at 23 or 4 C, or after 7 days at -10 C.

PMID- 7771697
TI  - Application of pulsed-field gel electrophoresis for differentiation of vaccine
      strain RB51 from field isolates of Brucella abortus from cattle, bison, and elk.
AB  - Restriction endonuclease patterns of genomic fragments separated by use of pulsed
      field gel electrophoresis were used to differentiate Brucella abortus strain
      RB51, a rifampin-resistant mutant of the standard virulent strain 2308, from
      other brucellae. Results were compared with results obtained by use of standard
      methods for characterizing brucellae. Electrophoretic patterns of the ATCC type
      strains allowed identification of the strains to the level of species. Genomic
      profiles of B abortus biovars 1, 2, and 4 were similar, as were those of biovars
      5, 6, and of biovar 3 was similar to that of biovars 5, 6, and 9, except for a
      missing band at 93 kb and additional bands at 65 and 67 kb. A different
      fingerprint was detected in B abortus strain RB51, using the pulsed-field gel
      electrophoresis patterns of genomic DNA digested with restrictive endonuclease
      Xba I. The profile of B abortus strain RB51 contained a band at 104 kb, as
      opposed to a 109-kb fragment within profiles of B abortus isolates from naturally
      infected cattle, bison, and elk. Despite known biochemical and biological
      differences between RB51 and its parent strain (2308), restriction endonuclease
      analysis results were similar.

PMID- 7771699
TI  - Antiphagocytic properties of uterine isolates of Streptococcus zooepidemicus and
      mechanisms of killing in freshly obtained blood of horses.
AB  - A total of 22 clinical streptococcal isolates, predominantly Streptococcus
      zooepidemicus, associated with endometritis in horses were tested for their
      ability to withstand the natural bactericidal properties of freshly obtained
      blood. During a 3-hour incubation in blood from a single horse, 8 of these
      isolates survived and grew, the remainder were killed. To determine whether this
      ability to grow extended to blood of other horses, 5 of these growing isolates
      were tested for their ability to grow in the blood of 5 additional horses. The
      same 5 horses were used for each isolate. The isolates grew in blood of some of
      the horses, but were killed in blood of the others. However, the horse's blood
      that mediated killing was different for each isolate. Killing required
      leukocytes, but the specificity for killing appeared to reside in plasma,
      although plasma by itself was not bactericidal. Heat-stable and heat-labile
      components in plasma, interpreted as antibody and complement, respectively,
      appeared necessary for killing. Isolates that could grow in fresh blood lost this
      ability after 10 passages in artificial media. Results of these experiments of
      phagocytosis in fresh blood may provide helpful insights into the phagocytosis of
      S zooepidemicus in equine uterine fluid.

PMID- 7771698
TI  - Administration of recombinant human interleukin 1 receptor antagonist during
      endotoxin-induced mastitis in cows.
AB  - The role of interleukin 1 (IL-1) as an inflammatory mediator during mastitis and
      the therapeutic effect of recombinant human IL-1 receptor antagonist (IL-1ra) for
      bovine mastitis was studied. Cows were intramammarily infused with
      lipopolysaccharide (25 micrograms) in 1 mammary gland. Half the cows also
      received infusions of 5 mg of IL-1ra into the same mammary gland just prior to
      endotoxin infusion and 4, 8, and 12 hours later. After endotoxin infusion, tumor
      necrosis factor and high IL-1 bioactivity were detected in whey from infused
      glands. Vascular permeability changes and neutrophil accumulation in milk
      paralleled the appearance of cytokines. A systemic reaction, characterized by
      pyrexia and an increase in blood cortisol concentration, also were observed. Milk
      yield was inhibited and milk composition was altered in infused and noninfused
      glands. The increase in IL-1 bioactivity in milk after endotoxin infusion was
      almost completely prevented in glands receiving IL-1ra. However, IL-1ra had no
      effect on local inflammation, systemic reaction, or impairment in productive
      performance. These results indicate that IL-1 does not mediate its effect within
      the milk compartment, and suggest either that IL-1 is not critical to the
      mastitic response or that intramammary infusion of IL-1ra does not place the
      antagonist where IL-1 interacts with its receptor.

PMID- 7771700
TI  - Diet effect on activity product ratios of uric acid, sodium urate, and ammonium
      urate in urine formed by healthy beagles.
AB  - Urine activity product ratios of uric acid, sodium urate, and ammonium urate and
      urinary excretion of metabolites were determined in 24-hour samples produced by 6
      healthy Beagles during periods of consumption of a low-protein, casein-based diet
      (diet A) and a high-protein, meat-based diet (diet B). Comparison of effects of
      diet A with those of diet B revealed: significantly lower activity product ratios
      of uric acid (P = 0.025), sodium urate (P = 0.045), and ammonium urate (P =
      0.0045); significantly lower 24-hour urinary excretion of uric acid (P = 0.002),
      ammonia (P = 0.0002), sodium (P = 0.01), calcium (P = 0.005), phosphorus (P =
      0.0003), magnesium (P = 0.01), and oxalic acid (P = 0.004); significantly (P =
      0.0001) higher 24-hour urine pH; and significantly (P = 0.01) lower endogenous
      creatinine clearance. These results suggest that consumption of diet A minimizes
      changes in urine that predispose dogs to uric acid, sodium urate, and ammonium
      urate urolithiasis.

PMID- 7771701
TI  - Prophylactic effect of dietary zinc in a laboratory mouse model of swine
      dysentery.
AB  - Reduced prevalence of diarrhea and mortality has been reported after dietary
      supplementation with zinc compounds in swine with naturally acquired
      colibacillosis and those challenge-exposed with Serpulina hyodysenteriae;
      however, the usefulness of this approach for control of enteric diseases of swine
      remains to be determined. To examine the effect of dietary zinc-containing
      compounds on the colonization and development of cecal lesions associated with S
      hyodysenteriae infection, a defined diet alone or with added ZnO, ZnSO4, or Zn
      methionine complex to a final concentration of approximately 6,000 mg of Zn2+/kg
      of complete feed was fed ad libitum to 156 female mice (strain C3H/HeN) for 10
      days prior to oral inoculation either with S hyodysenteriae or sterile trypticase
      soy broth. Rations were continued for 42 days, while at weekly intervals, 3
      mice/group were necropsied for determination of body weight, cecal weight, liver
      zinc concentration, presence of S hyodysenteriae in the cecum, and gross and
      histologic assessments of cecal lesions. From postinoculation day 0 to 42, the
      liver zinc concentration of mice fed the zinc-supplemented diets was
      approximately twice that of mice fed the basal diet, irrespective of the source
      of zinc. From postinoculation day 7 through 42, the overall recovery rate of S
      hyodysenteriae in infected mice fed the basal diet was 77.8%. In contrast,
      recovery rates of S hyodysenteriae from S hyodysenteriae-inoculated mice fed the
      zinc-supplemented diets were 0% for Zn-methionine and ZnO and 16.7% for ZnSO4.
      Mice fed the basal diet had significantly (P < 0.05) higher weight gain than mice
      fed the zinc-supplemented diets.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771703
TI  - Histochemical and morphometric study of fiber types in ten skeletal muscles of
      healthy young adult cats.
AB  - A histochemical and morphometric study of fiber types in a variety of skeletal
      muscles of healthy young adult cats was undertaken to provide normative data not
      available previously. Using a standardized system of nomenclature, fiber types 1,
      2A, 2B, and 2C were identified in most cat muscles on the basis of myosin ATPase
      staining at pH 4.45. Type-2M fibers were present in temporalis (TEM) and masseter
      (MAS) muscles. Type-1 fibers predominated in medial head of triceps (MHT) and
      soleus muscles. Type-2B fibers were dominant in biceps femoris, lateral head of
      gastrocnemius cranial tibial, long head of triceps, and superficial digital
      flexor muscles; type-2A fibers were dominant in buccinator muscle samples; and
      type-2M fibers were dominant in TEM and MAS muscles. Numbers of type-2C fibers
      did not exceed 2 to 3% of the myofiber population in any muscle. In CT and LHT
      muscles, a gradient of fiber type distribution was observed, with significant (P
      < 0.05) increase in numbers of type-1 and type-2A fibers in deeper regions of the
      muscles. The distribution of fiber types was compartmentalized in MHT and MAS
      specimens. Diameter of type-2B fibers was significantly (P < 0.05) larger than
      that of type-1 and type-2A fibers in biceps femoris, lateral head of
      gastrocnemius, cranial tibial, long head of triceps, and superficial MHT muscles.
      Diameter of type-2M fibers was significantly (P < 0.05) larger than that of type
      1 fibers in TEM and MAS muscles. The soleus type-1 muscle fibers were the largest
      fibers encountered in any muscle.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771702
TI  - Changes in the intestinal mucosal cell populations of German shepherd dogs fed
      diets containing different protein sources.
AB  - Sixteen German Shepherd Dogs from 4 litters were IgA-deficient on the basis of at
      least 1 of 2 serum IgA determinations, and all had small intestinal bacterial
      overgrowth, as documented by quantitated small intestinal bacterial culture in
      another study. These dogs were fed 2 diets that differed principally in their
      protein source (chicken vs beef, milk, and wheat). All dogs were fed each diet
      for 2 weeks before the study began. Next, all dogs were fed the chicken-based
      diet for 2 months. Then, half the dogs (group 1) were randomly assigned to
      continue eating the chicken-based diet, while the other half (group 2) ate a diet
      containing beef, milk, and wheat proteins. The small intestine was biopsied at
      the beginning of the study and after dogs had eaten the assigned diet for 2 and 4
      months. At 2 months, group-2 dogs had more colonic mucosal mast cells, but this
      difference did not persist at 4 months. At the end of the study (ie, 4 months),
      although all dogs were clinically normal, group-2 dogs had significantly (P =
      0.010) decreased numbers of jejunal villus plasma cells. However, these
      histologic changes were not considered clinically important. There were no
      significant differences in blood eosinophil counts, serum trypsin-like
      immunoreactivity, or cobalamin, folate, or IgA concentration. Clinical
      differences were not detected between the 2 groups, before or after the study.
      Changes were seen in serum IgM and IgG concentrations.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7771704
TI  - Enantioselective glucuronidation and subsequent biliary excretion of carprofen in
      horses.
AB  - Carprofen (CPF) enantiomers and their glucuronide conjugates (GLUC) were measured
      in plasma and bile of horses after IV administration of the racemic compound (0.7
      mg/kg of body weight). The CPF was detectable in plasma for up to 72 hours after
      dosing, whereas GLUC appeared early (time for maximal plasma concentration, 1
      hour) and was measurable transiently at low concentration (maximal plasma
      concentration, 0.5 microgram/ml). The enantiospecific plasma profiles indicated a
      clear predominance of R-CPF, whereas the stereoselectivity of the glucuronides
      favored S-GLUC. At 1, 2, and 12 hours after administration of the drug, bile
      concentrations of GLUC were high compared with those in plasma and
      enantioselectivity favored S-GLUC. These data indicate that the higher body
      clearance observed for S-CPF is a consequence of the enantioselectivity in liver
      glucuronidation and subsequent biliary excretion of the S enantiomer of the drug.

PMID- 7771705
TI  - Impact of age-related alteration of plasma alpha 1-acid glycoprotein
      concentration on erythromycin pharmacokinetics in pigs.
AB  - Erythromycin (EM) pharmacokinetic variables were studied after IV administration
      of the drug (10 mg/kg of body weight) to 1-, 6-, and 15-day-old pigs. With
      advancing age, from 1 day to 15 days after birth, half-life of EM became shorter
      (3.0 hours to 1.4 hour), whereas apparent volume of distribution, total body
      clearance (CLt), and intrinsic clearance became greater: 0.68 to 3.28 (L/kg),
      0.15 to 1.42 (L/h/kg), and 1.81 to 3.56 (L/h/kg), respectively. The percentage of
      plasma protein binding of EM decreased from 91 to 56%, correlating well with
      volume of distribution and CLt values. The altered binding percentage depended on
      plasma alpha 1-acid glycoprotein (AGP) concentration, but not on albumin
      concentration. With advancing age, plasma AGP concentration was markedly
      decreased from approximately 6,000 micrograms/ml to 700 micrograms/ml. Despite a
      twofold increase in intrinsic clearance with advancing age, CLt increased
      ninefold, implying that the decreased protein binding contributed to the increase
      of CLt more preferentially than did maturational development of elimination
      capacity. Therefore, the altered protein binding of EM attributable to the change
      in plasma AGP concentration could be a major causal factor of the age-related
      pharmacokinetic variables of EM in pigs.

PMID- 7771706
TI  - Regulation of respiratory muscle activities during chemoreceptor stimulation in
      adult horses.
AB  - We examined the electromyographic activity of the costal portion of the diaphragm
      and the transverse abdominal and external oblique muscles in 6 chronically
      instrumented awake adult horses during eupneic breathing, during 2 levels of
      hypercapnia (fractional concentration of inspired CO2; FICO2 = 0.4 and 0.6), and
      during 2 levels of hypocapnic hypoxia (FIO2 = 0.15 and 0.12). Using the inert gas
      technique, we also measured the end-expiratory lung volumes of the 6 horses
      during eupnea, 6% CO2 challenge, and 12% O2 breathing. During eupneic breathing,
      phasic electrical activity of these 3 muscles was always present and was preceded
      by the onset of mechanical flow. At progressive levels of hypercapnia, the
      magnitude of inspiratory and expiratory electrical activity increased, and for
      the expiratory muscles, this recruitment coincided with significant (P < 0.05)
      increases in peak expiratory gastric pressure. However, during hypocapnic
      hypoxia, differential recruitment patterns of the respiratory muscles were found.
      The electrical activity of the diaphragm increased in magnitude and occurred
      sooner relative to the onset of mechanical flow. The magnitude and onset of
      abdominal expiratory activity failed to increase significantly during these
      episodes of hyperpnea and this pattern of activity coincided with decrements in
      peak expiratory gastric pressure. Despite alterations in muscle recruitment
      patterns during these hyperpneic episodes, end-expiratory lung volume remained
      unchanged. Thus, we conclude that adult horses respond similarly to awake dogs
      during peripheral and central chemoreceptor stimulation.

PMID- 7771707
TI  - Quantitative electroencephalographic evaluation to determine the quality of
      analgesia during anesthesia of horses for arthroscopic surgery.
AB  - We compared the anesthetic combination of detomidine, ketamine, and halothane in
      control horses not undergoing apparently painful procedures with that in horses
      during arthroscopic surgery. The effectiveness of this regimen in suppressing
      neurologic response to surgery was, thus, evaluated. In this study, significant
      differences were not observed in electroencephalographic total amplitude,
      spectral edge, or beta-to-delta frequency ratio between surgically treated and
      nonsurgically treated (control) horses. On the basis of its attenuation of
      encephalographic responses, we conclude that detomidine (20 micrograms/kg of body
      weight, IV) and ketamine (2.2 mg/kg, IV) induction of anesthesia followed by
      maintenance with halothane is an effective regimen for control of pain in horses
      during arthroscopic surgery. The insignificant frequency changes observed without
      any other signs of inadequate anesthesia or pain may indicate a surgical stress
      response. We hypothesize that brain activity monitoring may give an earlier index
      to initiation of surgically induced stress than do hormonal responses, because
      endocrine alterations are not as rapidly perceived as is the
      electroencephalogram. Analysis of spectral edge frequency changes could be used
      to evaluate anesthetic regimens to find those that cause the least stress to the
      CNS during surgery in horses. Differences in species responses to an anesthetic
      agent or the regimen's effectiveness in prevention of pain during surgery may be
      identified by adoption of the study model. Evaluation of cardiopulmonary
      variables during anesthesia, with and without surgery, did not reveal any
      alterations that would be relevant to CNS responses.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7771708
TI  - Parathyroid hormone-related protein and calcium homeostasis during the
      periparturient period of dairy cows.
AB  - Plasma and milk concentrations of parathyroid hormone-related protein (PTHrP) at
      various stages of pregnancy and lactation were determined in thirty-nine 3- to 16
      year-old Brown Swiss and Red Holstein x Simmental dairy cows originating from 4
      herds. Eighteen of the cows were separated into 2 groups: low-parity (LP, n = 8)
      cows if they were in their first or second pregnancy and high-parity (HP, n = 10)
      cows if they were in their third or greater pregnancy. Blood samples were
      collected from each cow on 1 occasion, 15 to 5 days before calving, and blood and
      milk samples were collected daily during 6 days after calving. Serum total and
      ionized calcium (Ca(tot) and Ca2+, respectively) and milk Ca(tot) concentrations
      were also quantified. A transient postpartum decrease of serum Ca(tot) and Ca2+
      concentrations was observed, whereas milk Ca(tot) concentration was constant.
      Plasma concentration of PTHrP was detected in 11 of 21 cows by use of an
      immunoradiometric assay (range, 0.45 to 1.82 pmol/L). Daily mean (+/- SD)
      colostrum and milk PTHrP concentrations ranged from 3.25 (+/- 3.23) to 4.69 (+/-
      1.36) nmol/L in LP cows and 2.74 (+/- 0.5) to 5.95 (+/- 0.33) nmol/L in HP cows.
      In all cows of the HP group and most cows of the LP group, milk PTHrP
      concentration was highest in the day-1 sample. Milk PTHrP concentration
      correlated positively with milk Ca(tot) concentration in HP cows (r = 0.5959, P <
      0.0001). In contrast, there was a negative relation between milk PTHrP and milk
      Ca(tot) concentrations in LP cows (r = -0.3285, P < 0.02).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7771709
TI  - Enrofloxacin concentrations in dogs with normal prostate and dogs with chronic
      bacterial prostatitis.
AB  - Chronic Escherichia coli-associated prostatitis was induced in 16 dogs; 9
      noninfected dogs served as controls; and all dogs were vasectomized. Two to 3
      weeks after instillation of bacteria directly into the prostate, the urine or
      prostatic fluid or both from 13 of 16 dogs were culture positive. Enrofloxacin, a
      fluoroquinolone antimicrobial agent, was administered orally to all dogs during
      the third or fourth week after surgery, at a dosage of approximately 5 mg/kg of
      body weight, every 12 hours for 7 days. Serum and prostatic fluid concentrations
      of enrofloxacin were concurrently measured in all dogs on days 2, 4, and 6 at 2
      hours after dosing. Serum and prostatic tissue concentrations of enrofloxacin
      were concurrently measured in all dogs on day 7, at 1.5, 3, 4.5, and 6 hours
      after dosing. When values for these samples were compared, using a two-factor
      ANOVA, significant differences were not found. Use of this dosing regimen of
      enrofloxacin resulted in prostatic fluid and prostatic tissue concentrations
      exceeding the minimum inhibitory concentration of most pathogens that cause
      bacterial prostatitis. In addition, prostatic fluid-to-serum and prostatic tissue
      to-serum concentration ratios were greater than 1.0.

PMID- 7771710
TI  - Comparison of volume-conducted far-field short-latency glossopharyngeal nerve
      evoked potentials recorded from the scalp with similarly obtained near-field
      potentials from the solitary nucleus in dogs.
AB  - In 11 dogs, potentials recorded from the scalp and from the solitary nucleus
      after stimulation of the glossopharyngeal nerve were compared. The far-field
      potentials recorded from the scalp consisted of negativity, with peak latency of
      2.10 to 3.45 milliseconds (mean, 2.93 milliseconds), followed by positivity, with
      peak latency of 3.20 to 5.95 milliseconds (mean, 4.86 milliseconds) and duration
      of 4.65 to 6.95 milliseconds (mean, 5.70 milliseconds). The near-field potentials
      recorded from the solitary nucleus consisted of positivity, with peak latency of
      2.15 to 2.70 milliseconds (mean, 2.45 milliseconds), followed by negativity, with
      peak latency of 4.05 to 5.05 milliseconds (mean, 4.39 milliseconds) and duration
      of 4.45 to 5.80 milliseconds (mean, 5.21 milliseconds). Comparison of the far
      field potentials (n = 10) with the near-field potentials (n = 5) indicated that
      polarity of the waves was reversed and that the first peak's latency was slightly
      (approx 0.5 milliseconds) longer in the scalp-recorded far-field potentials.
      Neither the difference in latency of the second peak nor the difference in its
      duration, measured from the onset of the potentials to the return to the baseline
      of the activity, was significant. The results strongly suggest that the response
      in the solitary nucleus evoked by electrical stimulation of the glossopharyngeal
      nerve is the source of at least part of the scalp-recorded responses to
      stimulation of the same nerve. The scalp-recorded far-field potentials could,
      therefore, be characterized as volume conducted from the evoked response in the
      solitary nucleus.

PMID- 7771711
TI  - Bioequivalency comparison between two gonadotropin-releasing hormone products.
AB  - The bioequivalency of 2 gondatropin-releasing hormone (GnRH) preparations,
      gonadorelin diacetate tetrahydrate and gonadorelin semicarbonate, was compared on
      the basis of luteinizing hormone (LH)-releasing ability of the 2 products in
      diestrous dairy cows. Twenty-four cycling, nonlactating Holstein cows were
      subjected to a double prostaglandin estrus synchronization treatment to
      simultaneously control stage of the estrous cycle and time factors as potential
      variables effecting LH responses to the treatments being studied. Circulating
      progesterone concentration was determined to verify stage of cycle at strategic
      times throughout the study. Twelve days after the second prostaglandin treatment,
      all cows were randomly assigned to 1 of 2 groups (n = 12). Each group of 12 cows
      received single doses (100 micrograms) of either GnRH preparation at the start of
      each test period in a 2-period crossover design. Serum samples were obtained
      prior to and at 12 times (10, 20, 30, 45, 60, 90, 120, 180, 240, 360, 480, and
      1,440 minutes) after treatment and were assayed to determine circulating LH
      concentration. Significant difference between the 2 GnRH products was not found
      with respect to: mean concentration of LH in the blood during the 24 hours after
      treatment; maximal LH concentration; time from treatment to maximal LH
      concentration; and area under the LH concentration curve from time 0 through each
      of 7 times after treatment (0.5, 1, 1.5, 2, 4, 8, and 24 hours). These data
      confirm the bioequivalency of the 2 GnRH products.

PMID- 7771712
TI  - Gender differences in cancer of the larynx.
AB  - Gender differences in the incidence and mortality rates for cancers of the lung,
      colon, and larynx have previously been noted. The goal of this project was to
      identify gender differences in prognostic variables for survival and recurrence
      for patients with cancer of the larynx. The medical records of 193 patients with
      cancer of the larynx treated initially between 1973 and 1985 were examined
      retrospectively. A total of 151 men and 42 women were included. A majority of men
      developed glottic cancers, whereas a majority of women developed supraglottic
      cancers. Age was prognostically important for both genders; however, comorbidity,
      symptom severity, anatomic subsite, and TNM stage all had different impacts on
      survival and recurrence in men and women. No gender difference in initial
      treatment was found. This study suggests that when designing and analyzing the
      results from clinical studies of cancer of the larynx, it is important to employ
      stratification based on gender.

PMID- 7771713
TI  - Three-dimensional imaging of the hypopharynx and larynx by means of helical
      (spiral) computed tomography. Comparison of radiological and otolaryngological
      evaluation.
AB  - A new computed tomography (CT) technology, helical (spiral) CT, allows the entire
      neck to be imaged in only 30 seconds. Although multiplanar and three-dimensional
      (3-D) imaging could be performed with conventional CT, the volumetric acquisition
      provided by helical (spiral) CT allows significantly improved quality and easier
      reconstruction for more applications. These 3-D models show an airway appearance
      similar to that obtained with laryngography. Independent review of the 3-D images
      in 12 patients with lesions by two radiologists and one otolaryngologist was
      performed to assess 1) image quality, 2) ability to judge lesion extent, and 3)
      assistance in understanding the lesion compared to that provided by routine axial
      scans. Rating scores of 1 to 5 were assigned, with 5 representing the best
      quality or greatest value. The results showed that both groups scored image
      quality equally: 4.7. Lesion extent for the radiologists was 2.6, while the
      otolaryngologist's ranking was 3.7 (p < .01). In assisting understanding of
      lesions versus axial scans, radiologists ranked 3-D images 2.1, while the
      otolaryngologist ranked them 3.1 (p < .01). In summary, 3-D models provide a
      complementary imaging technique in understanding upper airway disease.

PMID- 7771714
TI  - Laser aryepiglottoplasty for the treatment of neurasthenic laryngomalacia in
      cerebral palsy.
AB  - Patients with cerebral palsy usually suffer from lack of coordination in the
      neuromuscular mechanism in their upper airway and digestive tract. Difficulty in
      swallowing and aspiration are common problems in these patients, and stridorous
      breathing sometimes develops as a secondary symptom. Laryngoscopic examination
      revealed that redundant tissue in the aryepiglottic fold area was the cause of
      stridor and upper airway obstruction in four patients with cerebral palsy. We
      report on these four patients in whom laser reduction of the redundant mucosa led
      to dramatic improvements in stridor. Secondary benefits to family members and
      others were equally impressive.

PMID- 7771715
TI  - Treatment of vocal fold immobility by glutaraldehyde-cross-linked collagen
      injection: long-term results.
AB  - Fifty-three cases of unilateral vocal fold immobility treated by glutaraldehyde
      cross-linked (GAX) collagen over a 6-year period with a mean follow-up of 4.5
      years were reviewed for assessment of the immediate and long-term effects on
      phonation. The mean amount injected was 1.47 mL. No long-term local or systemic
      reaction to the collagen was seen. The median preoperative maximum phonation time
      (MPT) was 7.5 seconds, the median immediate postoperative MPT 12 seconds, and the
      median long-term postoperative MPT 11 seconds. The median preoperative phonatory
      quotient (PQ) was 564 mL/s. The median immediate postoperative PQ was 320 mL/s,
      whereas the median long-term postoperative PQ was 385 mL/s. The quantitative
      improvement in the voice as measured by the PQ was thus 67% for the short range
      and 49% for the long range. The decline in the results over time was 20.3%. Vocal
      frequency analysis showed that the fundamental frequency and harmonics returned
      and were maintained in the long term for more than 80% of the patients with the
      help of speech therapy. This relative stability is explained by the findings of
      previous histological work. The fact that collagen, unlike Teflon, does not cause
      an inflammatory reaction and the partial maintenance of the improvement achieved,
      which is to be compared with the instability of the effects produced by
      resorbable substances, make it the "least objectionable" injectable for the
      treatment of unilateral glottic fold immobility. One must overcompensate 20% to
      30%, given the results of the long-term stability studies.

PMID- 7771716
TI  - Factors influencing regional lymph node metastasis from laryngeal carcinoma.
AB  - A series of 103 cases of laryngeal carcinoma subjected either to a unilateral or
      to a bilateral comprehensive neck dissection was reviewed with reference to risk
      factors influencing regional lymph node metastasis. The sensitivity of clinical
      examination was only 67.4%, while the specificity was 88.3%. Most metastases were
      in the upper and middle jugular chain of nodes (levels 2 and 3). Only patients
      with positive nodes at levels 2, 3, and/or 4 had histologically positive nodes at
      levels 1 or 5. Selected demographic, clinical, and pathologic variables were
      analyzed with respect to their potential predictive value regarding the risk of
      histologically proven neck node metastasis. Logistic regression analysis
      demonstrated that tumor site and histologic grade were the most important
      predictors of lymph node metastasis. Considering only NO cases, the likelihood of
      occult metastasis was significantly affected exclusively by tumor site (higher
      risk for supraglottic lesions).

PMID- 7771717
TI  - Effect of magnetic resonance imaging on implantable eyelid weights.
AB  - Implanted upper eyelid gold weights are used to prevent corneal injury in
      patients with facial nerve paralysis. Some of these individuals require
      postoperative radiographic surveillance for recurrent lateral skull base disease.
      Magnetic resonance imaging (MRI) provides the most accurate radiologic
      assessment; however, there is concern about the safety of performing MRI in
      patients with any metallic implant. Potential risks include local tissue heating
      and implant migration. Gold weights of 0.8 and 1.4 g were placed in an open
      chamber and were exposed to a magnetic field of 1.5 T. There was no measurable
      motion or displacement of the weights. The results were similar in 6 rats in
      which gold weights were subcutaneously implanted. Additionally, histologic
      examination of the implant sites revealed no adverse tissue effects attributable
      to MRI-generated heating of the implants. When carbon steel implants in the rat
      model were subjected to the magnetic field, there was no displacement of the
      implants and no adverse tissue effects were noted, despite the fact that a carbon
      steel implant in an open chamber demonstrated significant migration. The absence
      of motion of the gold weight implants combined with the lack of adverse tissue
      effects suggests the relative safety of performing MRI in patients with
      previously placed gold weights as upper eyelid implants.

PMID- 7771718
TI  - Eustachian tube function of patients with nasopharyngeal carcinoma.
AB  - Prolonged observations of the eustachian tube (ET) function were made on 40 ears
      of 20 patients with nasopharyngeal carcinoma (NPC) who survived more than 5 years
      after radiotherapy in a state of remission. The ET function tests included
      passive opening, inflation-deflation, and clearance, and were performed before,
      at 6 months, and at 5 years after radiotherapy. The test results were found to be
      worst at 6 months after radiotherapy and improved at 5 years after radiotherapy.
      Tubal obstruction and inflammation are the main causes of the ET malfunction that
      results in otitis media with effusion (OME) in NPC patients after radiotherapy.
      Insertion of a ventilation tube into the ear with OME can relieve tubal
      obstruction but can aggravate inflammation. Thus, myringotomy and aspiration of
      effusion and local treatment may be preferable to insertion of a ventilation tube
      in NPC patients with OME. When hearing improvement in prolonged survival of NPC
      patients with OME is needed, the use of amplification is recommended.

PMID- 7771719
TI  - Evoked otoacoustic emissions and electrocochleography in a patient with multiple
      sclerosis.
AB  - A 24-year-old woman with multiple sclerosis had right-sided hearing impairment
      with tinnitus. She underwent electrocochleography (ECochG) and examination of
      evoked otoacoustic emissions (EOAEs) to assess cochlear function. An acoustic
      probe to measure EOAEs was inserted into the external ear canal. The ECochG
      action potential and cochlear microphonics were recorded by a transtympanic
      needle electrode technique. Both fast and slow components of EOAEs appeared in
      either the period of deteriorated hearing acuity or when it was improved. They
      showed normal detection thresholds and input-output curves during both periods.
      Cochlear microphonics with almost normal detection thresholds and input-output
      functions were obtained during the period of deteriorated hearing acuity. Action
      potential (N1) input-output curves during relapse with hearing loss were notably
      lower in amplitude and longer in latency than those obtained at the time hearing
      impairment showed improvement. The EOAE and ECochG findings suggested that this
      patient had almost normal cochlear function, and we assumed from the magnetic
      resonance imaging and auditory brain stem response findings as well as the ECochG
      that the hearing impairment was caused by dysfunction of auditory pathways in the
      brain stem, including structures that contribute to generation of the N1
      potential of the ECochG.

PMID- 7771720
TI  - Bone resorption in human cholesteatoma: morphological study with scanning
      electron microscopy.
AB  - The detailed mechanism of bone resorption in cholesteatoma was investigated by
      means of eroded ossicles obtained during middle ear surgery for cholesteatoma. In
      the light microscopic study, multinucleate osteoclasts with ruffled borders were
      found in contact with the eroded bone, which appeared to be osteoclastic lacunae.
      Scanning electron microscopy revealed the lacunae to be many absorption bays, 30
      to 100 microns in diameter, clustered on the surface of eroded areas. Numerous
      cone-shaped stubs of digested collagen fiber bundles, consisting of scores of
      collagen fibrils and degenerated extracellular organic substances, were visible
      at higher magnification on the bottom of the absorption bay. The pattern of
      fusion and twining of the disarranged collagen fibrils at the top of the partly
      digested fiber bundles was clearly rendered by the alkali-water maceration method
      for scanning electron microscopy. We infer from the morphological evidence that
      osteoclastic resorption may be one of the major mechanisms of bone destruction in
      cholesteatoma, and that demineralization and degeneration of extracellular
      organic substances precede disruption of collagen fibrils at the front of bone
      resorption.

PMID- 7771721
TI  - Postnatal development of the internal auditory canal studied by computer-aided
      three-dimensional reconstruction and measurement.
AB  - Postnatal development of the internal auditory canal (IAC) was investigated in 20
      normal human temporal bones obtained from individuals 1 month to 72 years old.
      Computer-aided three-dimensional reconstruction and measurement of bones showed
      that the superior, inferior, anterior, and posterior walls of the IAC lengthen
      significantly from birth until about 10 years of age, with development mainly
      attributable to lengthening of the part of the IAC medial to the foramen
      singulare. The lengths of the part of the IAC lateral to the foramen singulare
      and of the transverse crest and Bill's bar did not appear to develop postnatally.
      The IAC diameter increased slightly at the porus for about the first year after
      birth, but not at the fundus or the middle portion of the canal. This finding was
      confirmed by studying the shape of the IAC. Postnatal increases in the volume of
      the IAC followed patterns similar to that of increases in length of studying the
      shape of the IAC. Postnatal increases in the volume of the IAC followed patterns
      similar to that of increases in length of the IAC walls. These results show that
      postnatally the IAC increases significantly in length until about 10 years of age
      and slightly in diameter until about 1 year of age, especially medial to the
      foramen singulare. This concentration of growth of the IAC medially implies that
      its postnatal development is mainly due to growth of the bone around the otic
      capsule, which has implications for IAC surgery.

PMID- 7771723
TI  - Recovery of caloric function in experimental perilymph fistula.
AB  - Twenty of 46 guinea pigs with experimental perilymph fistula that showed canal
      paresis on an ice water caloric test during the first week after operation were
      studied on the following days to observe the progression and final outcome of the
      caloric test. Two weeks after operation, 12 animals showed persistent canal
      paresis, whereas 8 animals developed a normal caloric response. Resolution of the
      caloric response progressed from canal paresis, via caloric irregularity, to a
      final return of normal caloric response. Morphological study of animals with
      recovery of caloric function shows healing of the previously ruptured membrane,
      with preservation of the contour of the membranous labyrinth in the lateral
      semicircular duct, and intact sensorineural elements. Recovery of caloric
      function may serve not only as an important diagnostic sign in patients with
      healed perilymph fistula, even without surgical proof, but also as an expectation
      for the recovery of hearing loss.

PMID- 7771722
TI  - Hydrops-induced changes in cochlear blood flow.
AB  - Laser Doppler flowmetry was used to assess cochlear blood flow (CBF) in the
      hydropic ear in four experiments. 1) The increase in CBF elicited by local
      electrical stimulation of the cochlea in the hydropic ear was compared to that
      observed in normal controls. The magnitude of the evoked CBF change was reduced
      by approximately 30% in the hydropic ear compared to the normal ear. 2) The
      reduction in CBF evoked by direct electrical stimulation of the superior cervical
      ganglion was reduced by approximately one third in the hydropic ear compared to a
      normal ear. 3) Rhythmic (flux motion or vasomotion) variations in CBF, observed
      in association with lower blood pressure and thought to extend the autoregulatory
      range in an organ system, were reduced or eliminated in the hydropic ear. 4) The
      autoregulatory response to a decreased perfusion pressure, produced by decreased
      cardiac output, was clearly reduced relative to control in the hydropic ear.
      These findings represent the first report of significant CBF changes with
      hydrops. They are consistent with reports of increased sensitivity of the
      hydropic ear to trauma and stress and may be relevant considerations in the
      treatment of hydrops in humans.

PMID- 7771724
TI  - Hypoglossal schwannoma.

PMID- 7771725
TI  - Maxillary carcinoma arising in a postoperative sinus.

PMID- 7771726
TI  - Teratomas of the head and neck with emphasis on malignancy.
AB  - The great majority of teratomas of the head and neck present in the neonate or
      infant and are biologically benign and yet with a high mortality because of their
      space-occupying and obstructive character. Teratomas in the adult neck and
      sinonasal tract are histologically and biologically malignant, with an often
      unpredictable response to therapy.

PMID- 7771727
TI  - Value of radiography in the management of possible fishbone ingestion.

PMID- 7771728
TI  - [Study of hair in type I tricho-rhino-phalangeal syndrome].
AB  - Trichorhinophalangeal syndrome has three characteristic signs: slow-growing hair,
      pearshaped nose with high philtrum and bradyphalangia with wedge-shaped
      epiphyses. We report two familial cases of type I trichorhinophalangeal syndrome.
      Our aim was to better identify the hair anomalies. A 22-year-old boy and his 65
      year-old mother had thin sparse hair with recessed fronto-temporo-occipital hair
      lines. The trichogramme of the occipital region showed 52% dystrophic roots and
      48% telogenic roots. Polarized light revealed monochromal hair with clear <<
      finger-end >> rhexis. Electron scan microscopy showed thin, oval, flat or
      cannulated hairs and folded cuticle cells. A transverse zone in the prerhexis
      area had no cuticle cells and << finger-end >> fractures. Histological
      examination showed a normal follicle count. Sebaceous and sudoriparous glands
      were normal. Other characteristics of trichorhinophalangeal syndrome (facial
      deformity with pear-shaped nose with high philtrum, clinobrachydactylia of the
      fingers and toes, and radiologically wedge-shaped epiphyses) were also noted.
      Caryotypes were normal. We emphasize the importance of folded cuticle cells and
      clear rhexis leading to << finger-end >> fractures. These anomalies could serve
      as markers in cases with few suggestive signs.

PMID- 7771729
TI  - [Pemphigoid in children].
AB  - INTRODUCTION: Bullous pemphigoid is rare during the childhood. The authors report
      the 51st case. CASE REPORT: Jeremie, a seven-month-old baby, had atypical bullous
      lesions. Histological examination, direct and indirect immunofluorescence were in
      favor of bullous pemphigoid. COMMENTS: Clinical and biological features of
      bullous pemphigoid are similar in the adult and in the infant. First treatment is
      represented by corticosteroids. Evolution is generally very good.

PMID- 7771730
TI  - [Facial granuloma].
AB  - INTRODUCTION: The aim of this case report is to show the results of therapeutical
      procedures in the facial granuloma. CASE: A 48 year old male patient had multiple
      facial granulomas persisting for at least 8 years. They were unresponsive to
      dapsone. The surgical removal of two lesions and the liquid nitrogen cryotherapy
      of the remaining lesions were efficient without recurrence in a follow-up time of
      6 months. COMMENTS: Lesions of facial granuloma do not spontaneously regress;
      they are easily recognized and differentiated from other conditions occurring on
      the face. New therapeutical approaches are welcome, even if they are empirical,
      in so far as they are efficient and reproducible.

PMID- 7771732
TI  - [Pachydermodactyly].
AB  - INTRODUCTION: Histologically pachydermodactyly results from fibromatosis.
      Characteristically, the clinical picture occurs almost exclusively in young men.
      The lesion is localized on the laterodorsal aspect of the proximal phalanges of
      both hands. CASE REPORT: We observed a 19-year-old man with deformity of the
      laterodorsal aspect of the first phalanx of the fingers on both hands which had
      been present for several years. The clinical course and histology of the
      deformity as well as the lack of any bone lesions led to the diagnosis of
      pachydermodactyly. COMMENTS: Pachydermodactyl is a rare disease. Our case was
      comparable to those reported in the literature. A mechanical cause is accepted by
      most authors.

PMID- 7771731
TI  - [Pustular vasculitis disclosing Behcet disease].
AB  - INTRODUCTION: Pustular vasculitis is a classical manifestation of Behcet's
      disease. We report a case where the papulopustular eruption formed an arch on the
      skin and the histology examination showed predominant lymphocytic infiltration.
      CASE REPORT: A 29 year-old with a past history of recurrent buccal aphthosis had
      developed episodic papulopustular eruptions over the past 3 years. The diagnostic
      of Behcet's disease was made on the basis of an association with lymphocytic
      meningis, uveitis and erythema nodosum. General corticosteroid therapy was
      effective, but did not prevent skin relapse, controlled with colchicine.
      DISCUSSION: Pustular vasculitis usually presents with pustular eruptions on
      purpuric lesions and polynuclear infiltration of the dermis. Predominant
      lymphocytic infiltration is usually due to a pathergy phenomenon and would be
      specific for Behcet's disease. In our patient, colchicine was effective, although
      the mechanism remains to be explained.

PMID- 7771733
TI  - [Acquired zinc deficiency in a breast-fed premature infant].
AB  - Acquired zinc deficiency in exclusively breast-fed premature babies is a recently
      described entity which surprisingly, has not been reported more frequently. Its
      pathogenesis would appear to be the result of various factors, prematurity,
      exclusive breast-feeding and a suspected maternal defect, acquired or inherited,
      for the transfer of zinc from the blood to the breast milk. We report the case of
      a girl who was born at 31 weeks, exclusively breast-fed for 28 weeks and who
      presented a characteristic clinical feature of zinc deficiency. The mother's zinc
      level in the breast-milk was abnormally low. After zinc therapy and progressive
      weaning, the lesions dramatically improved in few days. There was no recurrence
      of the lesions one year after the treatment was completely stopped. With regard
      to this characteristic case, we outline the many pathophysiological mechanisms
      involved in acquired zinc deficiency. Recognition of this clinical feature by
      dermatologists seems essential because the required treatment is spectacularly
      effective and definitive. Finally, we also examine possible forms with few
      symptoms and we wonder if serum zinc levels should be checked in at-risk babies.

PMID- 7771734
TI  - [Role of sun exposure on benign melanocytic nevi. A first study in populations
      controlled for age, sex and phenotype].
AB  - BACKGROUND: These studies were designed to assess the influence of sun exposure
      on nevi in white people. In order to eliminate the confounding effect of age, sex
      and phenotype, two parallel studies were conducted in people of the same age (17
      to 24 years), sex (males) and phenotype: one in people with "red" phenotype and
      one in people with "dark" phenotype. RESULTS: In both groups, comparison of nevus
      counts on the inner and outer side of the upper extremities and comparison of
      mean density of nevi (number per square meter) in always-exposed and never
      exposed skin show that number of nevi is higher in sun exposed areas. In both
      groups the density of large and atypical nevi was maximal on intermittently sun
      exposed skin while the density of small nevi was maximal on always-exposed skin.
      The number of large nevi on intermittently-exposed skin correlated with
      cumulative intensive exposure during beach recreation in the red phenotype group.
      The number of large nevi was significantly higher in red phenotypes who
      repeatedly experienced severe sunburns in their first 20 years of life.
      CONCLUSIONS: The number of nevi at the end of the second decade is influenced by
      cumulative sun exposure from birth. "Traumatizing" sun exposure, which is more
      frequent in "red" phenotype than in "dark" one, has an influence on the number of
      large nevi and is therefore likely to make small nevi grow.

PMID- 7771735
TI  - [A case for diagnosis: lepromatous leprosy].

PMID- 7771736
TI  - [Cutaneous cysts and pseudocysts. II].

PMID- 7771737
TI  - [T lymphocytes in the pathogenesis of chronic inflammatory skin diseases].

PMID- 7771738
TI  - [Smell in dermatology].

PMID- 7771740
TI  - [Can NSAID be prescribed in psoriasis?].

PMID- 7771739
TI  - [Neural crest derived structures. Works on embryonal chimera and their
      application to neurocristopathies].

PMID- 7771741
TI  - [New face lifts: preface].

PMID- 7771742
TI  - [New face lifts: foreward].

PMID- 7771743
TI  - [New face lifts: introduction].

PMID- 7771744
TI  - [Anatomy of the superficial parts of the face and neck].
AB  - The author presents four chapters concerning classical anatomy, an anatomical
      contribution to new facelifts, aesthetic anatomy, which recalls the aesthetic
      relations of the face, and finally a brief review of the mode of ageing of the
      face. The embryology of the superficial plane of the face and neck shows that the
      development of muscles of facial expression, deep and superficial fatty tissues,
      the facial nerve and the parotid is the result of divergent migratory movements
      and confluences. The anatomy is discussed in two parts: the first concerns
      conventional anatomy, and reviews the anatomical data acquired to date, the
      second proposes anatomical conclusions adapted to new surgical techniques of
      rejuvenation. The branches of the facial nerve are unusual in terms of their
      great variability. However, by using anatomical landmarks, it is possible to
      localize them precisely. The blood supply of the superficial tissues of the face
      and neck has been the subject of many studies. Deep monoblock facelifts, by
      sparing the blood supply of certain anatomical planes, allow the perfectly safe
      creation of extensive skin flaps. Some muscles of the face and neck are useful
      surgically. The orbicularis oculi muscle is also a muscle of the orbital margins
      by its depressing action on the eyebrows and levator action on the superficial
      malar adipose tissue. The corrugator muscle is a central element of new frontal
      endoscopy techniques. Elevation of the eyebrows is then ensured by the
      occipitofrontal complex which occupies only the medial two-thirds of the
      eyebrows. The zygomaticus major muscle must be released over its entire length
      because excessive traction on a SMAS flap can induce a disorder of facial
      expression. The platysma muscle plays an increasingly important role in cervical
      surgery and constitutes the deep guarantee of the cervical corset. The four fixed
      osteocutaneous points of the face: zygomatic (Mac Gregor), mandibular (Furnas),
      orbital (Psillakis) and masseteric play an antigravitational and functional role
      in facial expression. A macroscopic anatomical and histological study, performed
      on 60 dissections of hemifaces with several preparations defined the anatomy of
      the superficial musculoaponeurotic system (SMAS), jugomalar adipose planes and
      the nasolabial fold. The SMAS is a strictly superficial surgical anatomy
      structure derived from the primitive platysma muscle, and does not possess any
      bony insertion. It is composed exclusively of platysma and risorius muscles.
      There is no parotid aponeurosis. The parotid is surrounded by a capsule. Its is
      limited in depth by the superficial cervical aponeurosis which lines the styloid
      curtain (Jost, Levet).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7771745
TI  - [Subperiosteal face lift or "mask-lift"].
AB  - The subperiosteal facelift is, as its name indicates, a deep technique
      essentially adapted to the upper two-thirds of the face. It is performed via a
      bicoronal incision, often associated with a vestibular incision, which allows
      frontal, maxillary, malar, zygomatic and orbital dissection. Section of the
      superficial leaflet of the temporal aponeurosis reveals the DMAS (Deep Musculo
      Aponeurotic System) which can be used to raise all of the soft tissues of the
      face while protecting the frontal branch of the facial nerve. Elevation of the
      tissues of the face is essentially vertical and acts on the forehead, temporal
      region, gaze and cheekbones. Current incisions allow maximal preservation of hair
      and avoid ascension of the sideburns. This technique is particularly indicated in
      relatively young subjects.

PMID- 7771746
TI  - [Frontal face lift. Temporal face lift. Extraperiosteal face lift].
AB  - The author describes the anatomical structures and various incisions responsible
      for progress in frontal facelift. He describes the technique currently adopted by
      the majority of authors to perform this operation. The incision has been the site
      of the greatest progress and the use of myoplasties remains a controversial
      issue. Possible combinations with blepharoplasty and with procedures used to
      complete the facelift at various levels are discussed. These procedures may
      consist of bone remodelling performed in combination with the operation or
      osteotomies to modify bony contours, or the use of various filling materials with
      their respective advantages and disadvantages. The author then describes a
      temporal facelift technique, which has fallen out of use, under the name of
      "mannequin facelift" and which, as a result of a better understanding of the
      planes of dissection has a renewed value in certain indications. It is an
      incision rather than a technique, but it should also be used with the development
      of endoscopy. The extraperiostal masklift is a technique which treats the middle
      part of the face. Its extraperiostal approach, in contrast with the subperiosteal
      masklift, can be used to release soft tissues and to act more precisely than by
      raising the periosteum which is considered to be inextensible. Its rejuvenating
      effect is dramatic, but it does not allow the bony appositions which can be
      performed via a subperiosteal approach. This technique is very well defined and
      allows easy progression to a complementary cervicofacial facelift.

PMID- 7771747
TI  - [Face lifts of the malar, jugal and nasolabial area].
AB  - The author describes the various techniques, now classical, allowing correction
      of ageing of the middle third of the face: subcutaneous facelift, retightening of
      the deep planes, SMAS, platysma, as well as more recent procedures: deep
      facelift, composite facelift, facelift of the Superficial Adipo Cutaneous System
      (SACS). These techniques are designed to restore a normal position to tissues
      which have migrated with time: skin, fat and fibromuscular planes. The most
      difficult correction is that of the nasolabial pouch.

PMID- 7771748
TI  - [Cervical face lift].
AB  - In the context of cervical facelift, classical techniques, constituting the basis
      for current techniques or still in use, are described in terms of the incisions,
      detachments and treatment of the deep adipose, muscular and glandular planes. The
      author then describes the technique commonly used in modern cervical
      restructuration before describing the possible complications and defects.

PMID- 7771749
TI  - [Contribution of videoendoscopy to the surgery of face rejuvenation].
AB  - After a delay of several years, endoscopic surgery was introduced into cosmetic
      surgery of the face in 1992. Initially, its indications were very limited as they
      only concerned resection of corrugator muscles for the treatment of wrinkles
      between the eyebrows. Today, it has a new lease of life, with the ambition of
      replacing classical forehead facelift, by constituting a surgical approach. It
      replaces the bicoronal incision by means of 5 small incisions which allow
      detachment and resection of the depressor supercilii muscles similar to that
      obtained via a bicoronal incision. The skin or scalp excess is absorbed by
      various techniques. However, endoscopy now has other ambitions: functional fronto
      orbital surgery. It tries to achieve a new muscular equilibrium by resection of
      the depressor supercilii muscles and release of the levators: occipitofrontal
      muscle. In this way, this new technique achieves an entirely natural
      repositioning of the eyebrow. The authors describe all of the technical
      possibilities by endoscopy, median frontal endoscopy, endoscopic frontal
      facelift, endoscopic extraperiosteal masklift and endoscopic subperiosteal
      masklift, in the case of the forehead. A special technique has been developed:
      temporomalar facelift. Lastly, although cervicofacial dissection is technically
      possible using videoendoscopy, there nevertheless remains a major stumbling
      block: the excess skin. Based on an experience of more than a hundred cases over
      a period of more than 18 months, this technique provides extremely encouraging
      results leading the authors to adopt this technique definitively.

PMID- 7771750
TI  - [Intestinal perforations in percutaneous surgery of the kidney].
AB  - Using 9 personal surveys and 11 cases found in the literature, the authors
      analyse the etiologies of this iatrogenic accident, the often secondary
      modalities of the diagnosis and the benign nature of the fistula which usually
      heals spontaneously.

PMID- 7771751
TI  - [Uretero-intestinal fistulas].
AB  - Reporting their experience of these seldom described fistulas, the authors
      specify their etiological modalities, mainly the infected stones, the multiple
      clinical symptomatology and specify the various locations between the ureter and
      the enteral duct from the duodenum to the anal channel at any point.

PMID- 7771752
TI  - [Vesico-intestinal fistulas].
AB  - The authors report the various locations (ileal, appendicular, colic, rectal and
      through Meckel diverticulum) of the fistulas between the bladder and the
      digestive tract and specify the mainly inflammatory etiologies and specifically
      those due to the Crohn disease or those caused by tumors aggravated by
      irradiation and repeated surgery.

PMID- 7771753
TI  - [Vesico-sigmoidal fistulas of diverticular origin].
AB  - From 1984 to 1993, 11 patients (7 men and 4 women, mean aged 70 years) underwent
      surgical procedure for sigmoido-vesical fistula due to diverticulitis. Fecaluria
      and/or pneumaturia was present in 10 patients. The diagnosis of sigmoido-vesical
      fistula due to diverticulitis was confirmed by urologic and colonic
      investigations. All patients underwent surgical treatment. One patient underwent
      creation of a diverting colostomy alone because of a poor general status.
      Definitive surgical correction of the fistula with resection of the diverticular
      colon was attempted in the remaining 10 patients, including colo-rectal
      anastomosis. A temporary diverting colostomy was performed in 5 cases. There was
      no post operative death. One small wound infection occurred. All the diverting
      colostomies have been closed, meanly 2 months after the operation. Concerning
      long-term results, 3 patients died from an independant reason. All the other
      patients are alive and asymptomatic from the urologic as well as the digestive
      point of view. Based on these results, we advocate single stage repair, including
      correction of the fistula and resection of the diverticular colon with colo
      rectal anastomosis, in cases of good local and general conditions.

PMID- 7771754
TI  - [Prostatic or urethral rectal fistulas].
AB  - Reporting 7 new observations of prostatic or urethro-rectal fistulas, the authors
      insist on their etiological modalities specially of traumatical, inflammatory,
      post-irradiation, cancerous and congenital origin. The diagnosis methods and
      surgical techniques are also mentioned.

PMID- 7771755
TI  - [Congenital uro-intestinal fistulas].
AB  - The congenital uro-enteral fistula are observed essentially in boy and quite
      exclusively with anorectal malformation. Cloacal anomaly in girl and cloacal
      exstrophy in both sexes are so exceptional than complex malformations.

PMID- 7771756
TI  - [Uro-intestinal fistulas of cancerous origin].
AB  - Malignant entero-vesical fistulas are uncommon. Colonic malignancy is the main
      cause although fistula are present in just 1%. Pneumaturia and fecaluria are
      pathognomonic for entero-vesico-fistula and are present in half of cases. By
      combining the results of cystoscopy, barium enema and urine culture, fistula can
      be identified in almost all the cases. Escherichia coli, Streptococcus faecalis
      and Proteus mirabilis are very often isolated from the urine cultures. The
      management of entero-vesical-fistula depends of the etiology. The treatment
      requires in most of the case resection of the diseased bowel with partial
      cystectomy and primary anastomosis. But sometimes, is necessary to perform a
      diverting colostomy and urinary diversion.

PMID- 7771757
TI  - [News from the 23rd International Congress of Urology. Sydney, 18-22 September
      1994].

PMID- 7771758
TI  - [Uro-intestinal fistulas].

PMID- 7771759
TI  - [Intestinal urinary fistulas of renal and pelvis origin].
AB  - As the authors point out the uncommon occurrence of these fistulas between the
      calicopyelic cavities with the colon, the duodenum and still more unusually with
      the stomach and the jejunum, they report the etiological and clinical features
      found in the published cases. Usually the only solution is a nephrectomy.

PMID- 7771760
TI  - The 8th International Conference on Antiviral Research. Santa Fe, New Mexico,
      April 23-28, 1995. Abstracts.

PMID- 7771761
TI  - Protein splicing--the lengths some proteins will go to.
AB  - We review the recently discovered phenomenon of protein splicing which is the
      excision of an internal protein sequence at the protein level rather than at the
      RNA level. The means by which examples of protein splicing have been identified
      are described, and the similarities of the internally spliced protein products
      (or inteins) are discussed. Comparisons are made between inteins and group I RNA
      introns. We describe the evidence supporting excision of intiens by a post
      translational autocatalytic reaction of a full length polypeptide precursor,
      rather than by RNA splicing. An examination is made of some of the proposed
      mechanism schemes and the supporting them presented.

PMID- 7771763
TI  - Ballistosporous yeasts found on the surface of plant materials collected in New
      Zealand. 1. Six new species in the genus Sporobolomyces.
AB  - Six new species of ballistosporous yeast, the genus Sporobolomyces, were isolated
      from dead leaves and fruit of plants collected in New Zealand; Sp.
      novazealandicus, Sp. dimmenae, Sp. coprosmicola, Sp. coprosmae, Sp. dracophyllus,
      and Sp. taupoensis. These species differ from any hitherto known species of
      Sporobolomyces based on chemotaxonomic characteristics.

PMID- 7771762
TI  - Evaluation of image analysis and laser granulometry for microbial cell sizing.
AB  - A direct cell size measurement technique and an image analysis based sizing
      method were developed. The former consisted of a manual size measurement of the
      two-dimensional cell images on a video screen, with automatic data recording.
      This method was chosen as the reference. The latter, a semiautomatic method took
      advantage of a commercial computer program designed for image processing and
      particle morphology analysis. It gave average and median size values which were
      compatible with the manual method. However, the performance of these time
      consuming methods is limited. Hence, the laser granulometry technique,
      intrinsically far more powerful while capable of analysing millions of sample
      objects in a short time delay, was applied. The comparison revealed that this
      method gives too low size values, particularly in disagreement with the known
      dimensions of the bacterial (Zymomonas mobilis) cells. A size correction method
      was developed to realign the granulometry results of Z mobilis cell samples with
      those of the direct manual measurement method.

PMID- 7771764
TI  - Confirmation of the nomenclatural status of Malassezia pachydermatis.
AB  - Malassezia strains from dogs and rhinoceros all proved identical using mole% G+C
      and nDNA/DNA reassociation experiments. The use of the name Malassezia
      pachydermatis, originally described for a strain isolated from a rhinoceros, is
      thus justified for non lipid-dependent strains of other sources.

PMID- 7771765
TI  - Babjevia gen. nov.--a new genus of the Lipomycetaceae.
AB  - The species described as Lipomyces anomalus Babjeva & Gorin shows significant
      genetic and phenotypic divergence from the type species Lipomyces starkeyi Lodder
      & Kreger-van Rij in terms of rRNA base sequence substitution and ascosporal and
      septal ultrastructure. The species is consequently reclassified in the new,
      unispecific genus Babjevia, as Babjevia anomala.

PMID- 7771767
TI  - Cloning of genes required for hypersensitivity and pathogenicity in Pseudomonas
      syringae pv. aptata.
AB  - A genomic library of Pseudomonas syringae pv. aptata strain NCPPB 2664, which
      causes bacterial blight of sugar beet, lettuce and other plants, was constructed
      in the cosmid vector pCPP31. The 13.4 kb EcoRI fragment of the cosmid pHIR11,
      containing the hrp (hypersensitive response and pathogenicity) gene cluster of
      the closely related bacterium Pseudomonas syringae pv. syringae strain 61, was
      used as a probe to identify a homologous hrp gene cluster in P. syringae pv.
      aptata. Thirty of 2500 cosmid clones, screened by colony hybridization, gave a
      strong hybridization signal with the probe, but none of these conferred to the
      non-pathogenic bacterium, Pseudomonas fluorescens, the ability to elicit the
      hypersensitive response (HR) in tobacco. Southern blot analysis of EcoRI-digested
      genomic DNA of P. syringae pv. aptata showed hybridizing bands of 12 kb and 4.4
      kb. Only a 12 kb fragment hybridized in digests of the cosmids. Cosmid clone
      pCPP1069 was mutagenized with Tn10-minitet and marker-exchanged into the genome
      of P. syringae pv. aptata. Three resulting prototrophic mutant strains failed to
      elicit the HR in tobacco and to cause disease in lettuce. The DNA flanking the
      Tn10-minitet insertions from mutated derivatives of pCPP1069 hybridized with the
      10.6 kb Bg/II fragment of pHIR11. These results indicate that P. syringae pv.
      aptata harbours hrp genes that are similar to, but arranged differently from,
      homologous hrp genes of P. syringae pv. syringae.

PMID- 7771768
TI  - Properties of enzymes involved in D-galactonate catabolism in fungi.
AB  - Two enzymes catalyze the two step reactions in the D-galactonate
      nonphosphorolytic catabolic pathway of Aspergillus terreus, namely D-galactonate
      dehydratase and 2-keto-3-deoxy-D-galactonate (KDGal) aldolase. Maximum enzyme
      activities were obtained at 40 degrees C and pH 8.0 or at 50 degrees C and pH 7.5
      for these two enzymes, respectively. Stability of the two enzymes under different
      conditions was investigated. From a Lineweaver-Burk plot of the reciprocal of
      initial velocities and substrate concentrations, apparent Km values were
      calculated for D-galactonate, pyruvate and glyceraldehyde and found to be 8.33,
      14.28 and 5.55 mM, respectively, in crude cell-free extracts. Results indicated
      the requirement of magnesium cation for D-galactonate dehydratase activity at an
      initial concentrations of 10(-2) M. The presence of Mg2+ in the reaction mixture
      seems to induce greatly the fitness of the dehydratase with D-galactonate as no
      activity could be detected with 24-h dialyzed extract in the absence of magnesium
      cation.

PMID- 7771769
TI  - Partial conversion of cinnamic acid into styrene by growing cultures and cell
      free extracts of the yeast Cryptococcus elinovii.
AB  - Cultures of Cryptococcus elinovii CBS 7051 grown at the expense of cinnamic acid
      as the sole source of carbon and energy partially converted this substrate into
      styrene. The latter is toxic and eventually kills the culture. Cell-free extracts
      of cultures grown on cinnamic acid produced styrene from cinnamate. Other
      basidiomycetous yeasts tested did not produce styrene from cinnamic acid.

PMID- 7771766
TI  - Genes for beta-lactam antibiotic biosynthesis.
AB  - The genes pcbAB, pcbC and penDE encoding enzymes involved in the biosynthesis of
      penicillin have been cloned from Penicillium chrysogenum and Aspergillus
      nidulans. They are clustered in chromosome I (10.4 Mb) of P. chrysogenum, but
      they are located in chromosome II of Penicillium notatum (9.6 Mb) and in
      chromosome VI (3.0 Mb) of A. nidulans. Expression studies have shown that each
      gene is expressed as a single transcript from separate promoters. Enzyme
      regulation studies and gene expression analysis have provided useful information
      to understand the control of gene expression leading to overexpression of the
      genes involved in penicillin biosynthesis. Cephalosporin genes have been studied
      in Cephalosporium acremonium and also in cephalosporin-producing bacteria. In C.
      acremonium the genes involved in cephalosporin biosynthesis are separated in at
      least two clusters. Cluster I (pcbAB-pcbC) encodes the first two enzymes of the
      cephalosporin pathway which are very similar to those involved in penicillin
      biosynthesis. Cluster II (cefEF-cefG), encodes the last three enzymatic
      activities of the cephalosporin pathway. It is unknown, at this time, if the cefD
      gene encoding isopenicillin epimerase is linked to any of the two clusters. In
      cephamycin producing bacteria the genes encoding the entire biosynthetic pathway
      are located in a single cluster extending for about 30 kb in Nocardia
      lactamdurans, and in Streptomyces clavuligerus. The cephamycin clusters of N.
      lactamdurans and S. clavuligerus include a gene lat which encodes lysine-6
      aminotransferase an enzyme involved in formation of the precursor alpha
      aminoadipic acid. The N. lactamdurans cephamycin cluster includes, in addition, a
      beta-lactamase (bla) gene, a penicillin binding protein (pbp), and a
      transmembrane protein gene (cmcT) that is probably involved in secretion of the
      cephamycin. Little is known however about the mechanism of control of gene
      expression in the different beta-lactam producers. The availability of most of
      the structural genes provides a good basis for further studies on gene
      expression. This knowledge should lead in the next decade to a rational design of
      strain improvement procedures. The origin and evolution of beta-lactam genes is
      intriguing since their nucleotide sequences are extremely conserved despite their
      restricted distribution in the microbial world.

PMID- 7771770
TI  - Purification and properties of oxaloacetate decarboxylase from Corynebacterium
      glutamicum.
AB  - Oxaloacetate (OAA) decarboxylase (E.C. 4.1.1.3) was isolated from Corynebacterium
      glutamicum. In five steps the enzyme was purified 300-fold to apparent
      homogeneity. The molecular mass estimated by gel filtration was 118 +/- 6 kDa.
      SDS-PAGE showed a single subunit of 31.7 KDa, indicating an alpha 4 subunit
      structure for the native enzyme. The enzyme catalyzed the decarboxylation of OAA
      to pyruvate and CO2, but no other alpha-ketoacids were used as substrate. The
      cation Mn2+ was required for full activity, but could be substituted by Mg2+,
      CO2+, Ni2+ and Ca2+. Monovalent ions like Na+, K+ or NH4+ were not required for
      activity. The enzyme was inhibited by Cu2+, Zn2+, ADP, coenzyme A and succinate.
      Avidin did not inhibit the enzyme activity, indicating that biotin is not
      involved in decarboxylation of OAA. Analysis of the kinetic properties revealed a
      Km for OAA of 2.1 mM and a Km of 1.2 mM for Mn2+. The Vmax was 158 mumol of OAA
      converted per min per mg of protein, which corresponds to an apparent kcat of 311
      s-1.

PMID- 7771771
TI  - Protein sulfhydryls and their role in the antioxidant function of protein S
      thiolation.
AB  - Protein S-thiolation/dethiolation, i.e., the oxidation of protein sulfhydryls to
      mixed disulfides and their reduction back to sulfhydryls, is an early cellular
      response to oxidative stress (1-5). This response may be elicited by oxidative
      phenomena of diverse origins, and the few cases that have been studied
      extensively give a limited insight into the metabolic roles and the molecular
      mechanism of the process. Much of our current understanding arose from
      experiences with isolated proteins containing "reactive" sulfhydryls (6, 7), but
      recent experiments at the cellular level have begun to reveal interesting
      insights that suggest a complexity and importance not appreciated previously (8).
      This article will discuss the current status of experiments that relate to both
      the role of the cellular process and to the reactivity of selected proteins that
      participate in the cellular processes. The discussion will center on the role of
      glutathione, a molecule of central interest in every aspect of protein S
      thiolation and dethiolation.

PMID- 7771772
TI  - Dihydroxy-acid dehydratase, a [4Fe-4S] cluster-containing enzyme in Escherichia
      coli: effects of intracellular superoxide dismutase on its inactivation by
      oxidant stress.
AB  - Dihydroxy-acid dehydratase (DHAD) has a [4Fe-4S] cluster and is reported to be
      facilely inactivated by oxidant stress. To directly assess the biological effects
      in vivo of superoxide dismutase (SOD) on the oxidant sensitivity of DHAD, we used
      an Escherichia coli K-12 parent strain (CGSC5073) and derived strains OB 1, OB 2,
      and OB 3 that lacked one of or both FeSOD and MnSOD. In the K-12 parent strain
      half the cellular DHAD activity was lost in 15 min at 0.8 atm oxygen, less than
      10 microM aerobic nitrofurantoin, or about 5 microM aerobic paraquat (PQ) and in
      about 1 min at 10 microM aerobic PQ. Oxygen and metabolism were required for PQ
      to inactivate DHAD in cells; adding dithiothreitol to cell-free extracts did not
      restore DHAD activity. The Km was not appreciably changed for DHAD that was 50
      and 70% inactivated in cells, respectively, by hyperbaric oxygen (HBO) and PQ,
      compared to cells in exponential, aerobic growth. Thus, active site oxidative
      impairment of individual enzyme molecules apparently was all-or-none. DHAD
      activity was greatly decreased when measured in extracts made from strains that
      lacked both SODs unless SOD was added to cell suspensions before extracts were
      made. DHAD was more sensitive in strains lacking both SODs than in the parent
      strain to inactivation by aerobic PQ and HBO. Anaerobic (compared to aerobic)
      growth increased DHAD specific activity by 20% or less in the parent strain and
      in strains OB 1 and OB 2 (lacking MnSOD and FeSOD, respectively); however, in
      strain OB 3 (lacking both SODs) DHAD was increased 60%. DHAD was partially
      inactivated by the oxidant stress of aerobic growth, but remained in a form
      detectable by DHAD antibody, and the ratio of active to inactive DHAD decreased
      greatly in cells lacking SOD. Thus, SOD helped maintain DHAD as an active
      holoenzyme and benefitted cells growing aerobically or when exposed to low levels
      of PQ.

PMID- 7771773
TI  - Relative alpha-tocopherol deficiency in cultured cells: free radical-mediated
      lipid peroxidation, lipid oxidizability, and cellular polyunsaturated fatty acid
      content.
AB  - We propose that most cultured cells are deficient in vitamin E. Using our
      optimized assay for tocopherol, we find that L1210 lymphoblastic leukemia cells,
      cultured in standard growth media, contain only 2.3 +/- 0.03 micrograms of
      tocopherol/10(8) cells, whereas when they are transplanted and grown for the same
      time in the ascites fluid of mice fed standard diets, this increases to 5.8 +/-
      0.6 micrograms of tocopherol/10(8) cells. This apparent tocopherol deficiency in
      cultured cells is likely due to the low concentrations of tocopherol contained in
      most tissue culture media, even with the addition of serum. To further study this
      apparent deficiency and the relationship of cellular tocopherol to membrane lipid
      bis-allylic hydrogen positions, we supplemented the growth media of L1210
      lymphoblastic leukemia cells with alpha-tocopherol and compared the resultant
      cellular tocopherol content to the degree of unsaturation of cellular lipids,
      alpha-Tocopherol was incorporated by cells in a time- and concentration-dependent
      manner with plateaus at 24 h and 100 microM, respectively. A maximum 400%
      increase in cellular tocopherol was easily achieved. By experimentally modifying
      the fatty acid content of cellular lipids, we were able to determine that
      cellular tocopherol uptake and content is not a function of cellular lipid
      composition; cells enriched with polyunsaturated lipids incorporated tocopherol
      to the same extent as those enriched with more saturated lipids. Thus, as the
      cellular polyunsaturated fatty acid content increases, the tocopherol:bis-allylic
      position ratio in the cells decreases, resulting in less antioxidant protection
      for each lipid double bond. Consequently, when polyunsaturated fatty acid
      enriched cells are exposed to an oxidative stress, such as Fe2+, their tocopherol
      levels decline much faster than cells enriched with saturated fatty acids. This
      decline is consistent with their respective tocopherol:bis-allylic position
      ratio. These results provide a basis, at the cellular level, for investigators to
      consider vitamin E when studying cell response to oxidative stress.

PMID- 7771774
TI  - Solution structure and function in trifluoroethanol of PP-50, an ATP-binding
      peptide from F1ATPase.
AB  - PP-50, a synthetic peptide, based on residues 141-190 of the beta-subunit of
      mitochondrial F1ATPase, containing the GX4GKT consensus sequence for nucleoside
      triphosphate binding, binds ATP tightly (Kd = 17.5 microM) as found by
      fluorescence titration at pH 4.0. CD and 2D proton NMR studies at pH 4.0 revealed
      two beta-turns, regions of extended secondary structure, transient tertiary
      structure, and flexibility in the GX4GKT region (W.J. Chuang, C. Abeygunawardana,
      P. L. Pedersen, and A. S. Mildvan, 1992, Biochemistry 31, 7915-7921). CD
      titration of PP-50 with trifluoroethanol (TFE) reveals a decrease in ellipticity
      at 208 and 222 nm, saturating at 25% TFE. Computer analysis indicates that 25%
      TFE increases the helix content from 5.8 to 28.6%, decreases the beta-structure
      from 30.2 to 20.2% and decreases the coil content from 64 to 51.2%. Fluorescence
      titrations of H2ATP2- with PP-50 in 25% TFE yields a Kd of 7.3 microM, 2.4-fold
      tighter than in H2O, probably due to TFE increasing the activity of H2ATP2- . PP
      50 completely quenches the fluorescence of H2ATP2- in 25% TFE, while in H2O the
      fluorescence quenching is only 62%. In H2O the binding of H2ATP2- increases the
      structure of PP-50 as detected by CD, but in 25% TFE no significant change in CD
      is found on binding either H2ATP2- or Mg2+ HATP (Kd = 14 microM). The complete
      proton NMR spectrum of PP-50 in 25% TFE has been assigned. The solution
      structure, determined by distance geometry, molecular dynamics with simulated
      annealing, and energy minimization, consists of a coil (residues 1-8), a strand
      (residues 9-12), a loop (residues 13-22) containing the GX4GKT consensus sequence
      (residues 16-23), an alpha-helix (residues 23-36), a turn (residues 38-41), and a
      coil (residues 42-50), similar to that of the corresponding region of the X-ray
      structure of F1ATPase (J.P. Abrahams, A.G.W. Leslie, R. Lutter, and J. E. Walker,
      1994 Nature 370, 621-628) and to the structure of a homologous peptide from the
      ATP-binding site of adenylate kinase (D. C. Fry, D. M. Byler, H. Susi, E. M.
      Brown, S. A. Kuby, and A. S. Mildvan, 1988 Biochemistry 27, 3588-3598), beta,
      gamma-Bidentate Cr3+ ATP binds to PP-50 with the Cr3+ pyrophosphate moiety
      approaching the epsilon-methylene group of K22 in the GX4GKT consensus sequence,
      in agreement with the X-ray structure of the Mg2+ AMPPNP complex of F1ATPase.

PMID- 7771775
TI  - Site-directed mutagenesis of the substrate binding site of porcine fructose-1,6
      bisphosphatase.
AB  - Asn 212, Arg 243, Tyr 244, Tyr 264, and Lys 274, which are conserved in all known
      primary sequences of fructose-1, 6-bisphosphatase, are located in the substrate
      binding domain on the basis of the crystal structure of the enzyme. Mutations of
      the five residues of porcine liver fructose-1,6-bisphosphatase (Asn212Ala, Arg243
      Met, Tyr244Phe, Tyr264Phe, and Lys274Leu) were carried out by site-directed
      mutagenesis. The wild-type and mutant forms of the enzyme were purified to
      homogeneity and characterized by initial rate kinetics and circular dichroism
      spectrometry. The mutants exhibited kcat values that are similar to those of the
      wild-type enzyme. The Km values for fructose 1,6-bisphosphate of the mutants are
      6- to 44-fold higher than that of the wild-type enzyme. The Ki values for
      fructose 2,6-bisphosphate and AMP of the mutants increased from 56- to 1950-fold
      and 12- to 27-fold, respectively, relative to the wild-type enzyme. The
      alteration of inhibition constants for both inhibitors suggest that these five
      active site residues are involved in the inhibition by fructose 2,6-bisphosphate
      and AMP. No apparent differences in secondary structure of the wild-type and
      mutant forms of fructose-1,6-bisphosphatase were observed as measured by circular
      dichroism spectrometry. This report demonstrates that Asn 212, Arg 243, Tyr 244,
      Tyr 264, and Lys 274 not only are the sites for substrate binding, but also play
      an important role in the binding affinity of inhibitors fructose 2,6-bisphosphate
      and AMP.

PMID- 7771776
TI  - Influence of glucose on pyruvate carboxylase expression in pancreatic islets.
AB  - Pancreatic islets were cultured for 1 day in the presence of 1 to 20 mM glucose
      and islet proteins were separated on polyacrylamide gels and transferred to
      nitrocellulose. Pyruvate carboxylase and an unidentified biotin-containing
      protein were visualized with [125I]streptavidin followed by autoradiography. The
      amount of pyruvate carboxylase was proportional to the concentration of glucose.
      Estimates of the amount of the enzyme in islets were made by comparing the
      density of the islet pyruvate carboxylase band with a standard curve of various
      amounts of authentic pyruvate carboxylase. This indicated that the enzyme
      comprised 0.4% of total islet protein. Net synthesis of the enzyme was increased
      by cAMP and methyl succinate. A nuclear run-on assay showed that glucose caused
      increases in pyruvate carboxylase and pyruvate dehydrogenase E1 alpha subunit
      transcripts and decreases in branched chain ketoacid dehydrogenase E1 alpha
      transcripts in rat insulinoma (RINm5F) cells. Pancreatic islets cultured in the
      presence of 1 mM glucose for 1 day cannot respond to glucose with insulin
      release. Previous studies demonstrated that carbon flux into the citric acid
      cycle intermediates via both carboxylation and decarboxylation is decreased in
      glucose-incapacitated islets (M. J. MacDonald, 1993, Arch. Biochem. Biophys. 300,
      205-214), 1993). The current results support the idea that carboxylation of
      glucose-derived pyruvate, as well as decarboxylation of pyruvate, is important
      for glucose-induced insulin secretion.

PMID- 7771777
TI  - Studies on the catalytic mechanism of pig purple acid phosphatase.
AB  - Several independent experiments failed to reveal any evidence in support of the
      involvement of a phosphoryl-enzyme intermediate in the catalytic mechanism of pig
      allantoic fluid purple acid phosphatase: (i) attempts to label enzyme with
      phosphate derived from [32P]p-nitrophenyl phosphate were unsuccessful; (ii)
      values of kcat for a series of phosphate derivative varied over a wide range,
      with the enzyme showing a marked preference for activated ester and anhydride
      substrates over those with a stable leaving group; (iii) burst titrations
      revealed a "burst" of p-nitrophenol from p-nitrophenyl phosphate only when the
      enzyme was added after the substrate, suggesting that this result was an artifact
      of the order of addition of reagents; (iv) transphosphorylation from p
      nitrophenyl phosphate to acceptor alcohols could not be detected, even under
      conditions where a transphosphorylation to hydrolysis ratio as low as 0.015 could
      have been measured; (v) enzyme-catalyzed exchange of 180 between phosphate and
      water was demonstrated, although at a rate much slower than that observed for
      other phosphatases where the involvement of a phosphoryl-enzyme intermediate in
      the mechanism has been clearly established. The present results are compared with
      those obtained in similar studies on other phosphatases, particularly the highly
      homologous beef spleen purple acid phosphatase, and their implications for the
      catalytic mechanism of the purple acid phosphatases are discussed.

PMID- 7771778
TI  - Antioxidant action of neuromelanin: the mechanism of inhibitory effect on lipid
      peroxidation.
AB  - Iron and lipid peroxidation are believed to be involved in the degeneration of
      pigmented neurons in Parkinson's disease. Melanin-iron interaction is thought to
      play a role in iron accumulation and reactivity. The purpose of this study was to
      examine antioxidant properties of isolated natural and synthetic neuromelanin.
      Effect of neuromelanin from substantia nigra and its synthetic model, dopamine
      melanin, on lipid peroxidation, induced by ferrous ions and free-radical
      initiators, has been studied in methyl linoleate aqueous dispersions. 2,2'
      Azobis(amidinopropane)dihydrochloride and 2,2'-azobis(2,4-dimethyl-valeronitrile)
      were used as water-soluble and lipid-soluble radical initiator, respectively.
      Rate of oxidation was followed quantitatively by measuring oxygen uptake and
      accumulation of lipid hydroperoxides. Melanin had a distinct protective effect on
      lipid peroxidation induced by ferrous ions or water-soluble free-radical
      initiator but was relatively inefficient when peroxidation was initiated with
      lipid-soluble compound. It also inhibited iron-catalyzed decomposition of methyl
      linoleate hydroperoxides in the presence of ascorbate. Extent of the inhibition
      depended on the ratio of melanin to iron. Taken together, these results provide
      strong support for the idea that neuromelanin of pigmented neurons can act as a
      natural antioxidant by sequestering redox-active metal ions.

PMID- 7771779
TI  - Purification, cloning, and sequencing of archaebacterial pyrophosphatase from the
      extreme thermoacidophile Sulfolobus acidocaldarius.
AB  - Cytoplasmic pyrophosphatases are indispensible for the function of cellular
      bioenergetics. From the extreme thermoacidophilic archaeon Sulfolobus
      acidocaldarius, situated at one of the lowest branches of the phylogenetic tree,
      a cytosolic pyrophosphatase has been isolated and purified 200-fold to
      electrophoretic homogeneity by combining ion-exchange and gel-exclusion
      chromatography. The native enzyme consists of a homotetramer of 71 kDa apparent
      molecular mass; the subunit displays an apparent molecular mass of 17 kDa on
      sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The enzyme has an
      absolute requirement for divalent cations (Mg2+) and a temperature optimum of 75
      degrees C coinciding with the growth optimum of the organism; the apparent
      estimated activation energy is 79.5 kJ/mol. A large variety of cytosolic extracts
      from other archaebacteria has been probed with a polyclonal antiserum raised
      against the purified protein; surprisingly, except for an extremely weak signal
      with S. solfataricus none of the other organisms showed any cross-reactivity.
      Also, Escherichia coli PPase does not cross-react. Based on N-terminal sequencing
      the gene has been cloned and sequenced. It codes for a 173-amino-acid protein
      with a calculated molecular mass of 19,365 kDa. Alignment with known eucaryotic
      and procaryotic PPases reveals invariant conservation of all residues presently
      assumed to be involved in metal and substrate binding. Unexpectedly, the highest
      similarity is found with the enzyme from the phylogenetically extremely distant
      eubacterium E. coli, but immunological cross-reactivity is absent. Similarity to
      the only known other archaebacterial PPase is much weaker. Using the 3D structure
      of the Thermus thermophilus enzyme as a scaffold an energy-minimized structural
      model is presented, deviating only minimally from the former. The structural
      features are discussed. The enzyme provides an excellent model for studies of
      thermostability and folding dynamics since heterologous overexpression has been
      achieved and genetically mutated forms become accessible.

PMID- 7771780
TI  - CYP3A4 expressed by insect cells infected with a recombinant baculovirus
      containing both CYP3A4 and human NADPH-cytochrome P450 reductase is catalytically
      similar to human liver microsomal CYP3A4.
AB  - Human cytochrome CYP3A4 is the most abundant of all the P450s in human liver and
      is involved in the metabolism of many environmental toxicants and drugs. Kinetic
      studies with CYP3A4 have been hampered due to low activity of this enzyme
      obtained from recombinant gene expression systems or difficulty in reconstituting
      activity with the native enzyme purified from human liver. To overcome these
      obstacles, we have expressed high levels of catalytically active CYP3A4 and human
      NADPH-cytochrome P450 reductase (CYPOR) together in two insect cell lines,
      Spodoptera frugiperda (Sf9) and Trichoplusia ni (T.ni), via a single recombinant
      baculovirus carrying both cDNAs (CYP3A4-OR). Microsomes containing recombinant
      CYP3A4-OR from these cell lines were up to 50-times more active in testosterone 6
      beta-hydroxylase activity than recombinant CYP3A4 expressed alone and
      supplemented with purified rabbit CYPOR. The spectral P450 content of CYP3A4-OR
      T.ni microsomes was 107 pmol/mg microsomal protein and the cytochrome c reductase
      activity was 3904 units/mg. Recombinant CYP3A4-OR was catalytically similar to
      human liver CYP3A4 based on similarities in the testosterone metabolite profile,
      time course of metabolite formation, Vmax and Km values (for CYP3A4-OR, Vmax was
      8.8 nmol/min/mg microsomal protein [70 nmol/min/nmol CYP3A4] and Km was 33
      microM), the extent of inhibition by 100 microM troleandomycin (> 75%) in the
      presence of 25 microM testosterone, and the degree of P450 activation in the
      presence of 20 microM 7,8-benzoflavone. The coexpression of recombinant
      cytochrome b5 with CYP3A4-OR did not result in an additional increase in CYP3A4
      OR activity.

PMID- 7771781
TI  - Generation and remodeling of phospholipid molecular species in rat hepatocytes.
AB  - In order to assess the relationship between de novo phospholipid synthesis and
      remodeling by deacylation-reacylation, we have pulse-labeled glycerolipids by
      incubating rat hepatocytes in media containing either [U-14C]glycerol or H218O.
      Further incubation for up to 2 h in the absence of the labeled substrates and
      analysis of phosphatidylcholine (PC) and phosphatidylethanolamine (PE) provided
      information on the remodeling of newly synthesized molecular species by
      deacylation-reacylation at the sn-1 or sn-2 positions of glycerol. We conclude
      that de novo synthesis of PC and PE yields primarily four molecular species: 16:0
      18:2 (n-6), 16:0-18:1, 16:0-22:6 (n-3), and 18:1-18:2 (n-6). Remodeling occurs in
      both lipid classes by replacement of the fatty acids at the sn-1 position with
      stearic acid, 18:0, or at the sn-2 position with arachidonic acid, 20:4 (n-6). A
      major molecular species of both PC and PE, 18:0-20:4 (n-6), appears to be
      produced by deacylation-reacylation at both the sn-1 and sn-2 positions and not
      to be further remodeled. De novo synthesis and remodeling of PC and PE in rat
      hepatocytes occur at similar rates, involve precursor-product relationships among
      newly synthesized molecular species, and therefore may be regulated as a single
      metabolic process.

PMID- 7771782
TI  - Identification of a 10 S trypsin-like protease that cross-reacts with anti
      proteasome antibody in sea urchin egg jelly.
AB  - We have identified 27- and 26-kDa polypeptides in sea urchin egg jelly, both of
      which cross-reacted with the antibody against 20 S proteasome (multicatalytic
      proteinase) isolated from sea urchin sperm. Separation of egg jelly fraction by
      gel filtration or sucrose density gradient centrifugation revealed that these
      polypeptides comigrated as a complex with a molecular size much smaller than that
      of proteasome: the apparent molecular mass and the sedimentation coefficient were
      200 kDa and 10 S, respectively. This protease significantly hydrolyzed the
      fluorogenic synthetic substrates for trypsin-like protease but little hydrolyzed
      those for chymotrypsin-like protease. Trypsin-like activity of sperm proteasome
      was activated up to more than threefold by a low concentration of sodium dodecyl
      sulfate (SDS), whereas the egg jelly 10 S protease was inhibited by SDS. Two
      dimensional immunoblot and peptide mapping revealed that the 26-kDa polypeptide
      is a degradative product of 27-kDa polypeptide and that the 10 S protease is
      composed of a proteasome-related single 27-kDa polypeptide and its modified
      forms. These results indicate the presence of a 10 S novel assembly of a
      proteasome subunit only with trypsin-like activity.

PMID- 7771783
TI  - Cyanide inhibition of porcine kidney diamine oxidase and bovine plasma amine
      oxidase: evidence for multiple interaction sites.
AB  - The interactions of cyanide and phenylhydrazine with porcine kidney diamine
      oxidase (PKDAO) and bovine plasma amine oxidase (BPAO) (EC 1.4.3.6) have been
      investigated. Cyanide displays mixed noncompetitive inhibition against amine
      substrates and also against O2. EPR spectroscopy shows that cyanide binds to an
      equatorial site on Cu(II) and can be displaced by chloride, which is not an
      inhibitor, without recovery of activity, indicating that Cu(II)-bound cyanide is
      not inhibitory. 14CN-. studies have shown that one cyanide in PKDAO and two in
      BPAO are covalently and irreversibly bound per enzyme dimer at an unknown site,
      even under conditions where cyanide is not bound to Cu(II). These cyanides have
      no effect on activity or on binding of phenylhydrazine to the enzymes. Cyanide
      also binds reversibly to the organic cofactor in both enzymes, presumably as a
      cyanohydrin, leading to the observed mixed noncompetitive inhibition against
      substrate. In both enzymes, two phenylhydrazines react per enzyme dimer. The
      kinetics of phenylhydrazine titration are affected by cyanide, which indicates
      that phenylhydrazine and cyanide react at the same carbonyl group in the enzymes.
      The results suggest that inhibition of amine oxidases by cyanide is through a
      carbonyl reagent and a Cu(I) ligand rather than through a Cu(II) ligand.

PMID- 7771784
TI  - The ESR properties, DNA nicking, and DNA association of aged solutions of
      catechol versus aqueous extracts of tar from cigarette smoke.
AB  - Previous studies in our laboratories have shown that extracts from mainstream or
      sidestream tobacco smoke nick DNA. These solutions contain the tar semiquinone
      free radical, and the tar radical becomes associated with cellular DNA. Aged
      solutions of catechol contain a semiquinone species that has ESR properties
      similar to those of the radical in cigarette tar extracts, and we have used these
      catechol solutions as a model for the tar radical. Both the radical in aged
      catechol solutions and the cigarette tar radical become associated with the DNA
      in mammalian cells and also nick DNA. The nicking of DNA caused by both tar and
      aged catechol solutions follows saturation kinetics. Aged catechol solutions thus
      allow the study of a model for the radical present in cigarette tar, without
      interference from the other toxic constituents in tar extracts.

PMID- 7771785
TI  - Kinetic, binding, and NMR studies of perdeuterated yeast phosphoglycerate kinase
      and its interactions with substrates.
AB  - Perdeuterated yeast phosphoglycerate kinase (2HPGK) was prepared from yeast cells
      grown in 99.9% 2H2O and an acid hydrolysate from deuterated algal cells. Kinetic
      and binding studies suggested that perdeuterated enzyme was similar to the
      isotopically normal PGK. The use of 2HPGK not only eliminated the spectral
      overlap between the enzyme and substrate nuclear Overhauser effect (NOE) cross
      peaks, but also permitted observation of weak transfer NOE cross-peaks between
      the substrate protons that are greater than 4 A apart. Intensity of NOE cross
      peaks was used to determine the interproton distances of enzyme-bound Mg(II)dATP.
      These distances were then used in model building studies to determine the
      conformation of Mg(II)dATP. The average conformation of enzyme-bound dATP is anti
      with O4'/C2' endo ribose pucker and trans, gauche about the C4'-C5' bond.
      Although many spin diffusion pathways were eliminated by protein deuteration,
      spin diffusion was still observed between the protons of the substrate at mixing
      times longer than 25 ms.

PMID- 7771786
TI  - Casein zymography: a method to study mu-calpain, m-calpain, and their inhibitory
      agents.
AB  - A zymographic assay for calpains in nondenaturing casein-containing
      polyacrylamide gels was developed. Calpain samples were run into the
      polyacrylamide gels by electrophoresis using a Tris-glycine buffer containing 1
      mM EGTA to stabilize calpains. Upon completion of the electrophoresis, the gels
      were washed and incubated in a calpain activation buffer containing 1-4 mM
      calcium and 10 mM dithiothreitol for 20-24 h. After staining of the casein gels
      with Coomassie blue G250, both mu-calpain and m-calpain showed up as clearing
      bands. The amount of calpain loaded was proportional to the brightness of the
      clearing band. m-calpain can be easily distinguished from mu-calpain due to its
      higher mobility in the gel. Irreversible inhibitor (e.g., E64c) or tight-binding
      calmidazolium-treated mu-calpain remained inactive in the casein zymogram,
      whereas reversible inhibitor (e.g., calpain inhibitor I) was released from the
      protease by migration and dilution, lifting its inhibition. Crude homogenate of
      cultured cells (erythrocytes, Molt-4 and cerebrocortical neurons) or tissue (rat
      brain) can be directly analyzed for the presence of calpain isoforms despite the
      presence of endogenous calpastatin. Using this technique, mu-calpain activity in
      Molt-4 cells was found to decrease progressively with A23187 treatment, as a
      reflection of autolytic inactivation.

PMID- 7771787
TI  - Identification of two binding proteins for halogenated aromatic hydrocarbons in
      the hard-shell clam, Mercenaria mercenaria.
AB  - Earlier studies have reported an unusually high incidence of gonadal tumors in
      marine bivalves in areas of potentially high exposure to herbicides including 2,4
      dichlorophenoxyacetic acid and 2,4,5-trichlorophe-noxyacetic acid. Some
      herbicides can be contaminated by halogenated aromatic compounds including
      2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Most of the effects of planar
      halogenated aromatic compounds, including carcinogenic effects in vertebrates,
      appear to be mediated through binding to the aryl hydrocarbon receptor. The
      current study investigated whether halogenated aromatic hydrocarbon-binding
      proteins are present in the marine bivalve, Mercenaria mercenaria. We used the
      TCDD photoaffinity analog 2-azido-3-[125I]-iodo-7, 8-dibromodibenzo-p-dioxin to
      detect the presence of two proteins (28 and 39 kDa) in cytosols prepared from M.
      mercenaria that specifically bound this ligand. Expression of these proteins is
      tissue-dependent with the highest concentrations being observed in gill and
      gonadal tissue. Gonadal tissue also exhibited gender-specific expression with
      female clams exhibiting higher levels of the 39-kDa protein. Gender-and tissue
      specific expression are consistent with the hypothesis that these proteins might
      be involved in the carcinogenic response observed in clams exposed to herbicides.

PMID- 7771788
TI  - Inhibition of rat liver mitochondrial permeability transition by respiratory
      substrates.
AB  - The mitochondrial inner membrane can undergo a permeability increase known as
      "permeability transition" elicited by Ca2+ and several other inducing agents. In
      general, the condition of oxidative stress acts as an inducer, at variance with
      antioxidants and reducing agents that inhibit the permeability transition. The
      action of mitochondrial respiratory substrates in preventing the permeability
      transition induced by Ca2+ and phosphate was examined; pyruvate, isocitrate, and
      glutamate proved to be particularly effective. The effect of substrates was
      evident also in the presence of an uncoupler, and, in addition, they were able to
      counteract the swelling stimulated by acetoacetate and tert-butylhydroperoxide.
      In the presence of various pyridine nucleotide-dependent substrates, mitochondria
      are able to reduce the disulfide 5,5'-dithiobis (2-nitrobenzoic acid) (DTNB) to
      an extent far larger than that calculated from the theoretical amount of total
      mitochondrial thiol groups, indicating the occurrence of a catalytic system.
      Similarly, the enzymes of the mitochondrial matrix in the presence of either NADH
      or NADPH are able to reduce DTNB. The results are discussed considering the
      existence of a close redox communication between pyridine nucleotides and
      membrane thiol groups, possibly mediated by dithiols such as thioredoxin and
      lipoic acid.

PMID- 7771789
TI  - Sublethal levels of oxidant stress stimulate multiple serine/threonine kinases
      and suppress protein phosphatases in Jurkat T cells.
AB  - Sublethal concentrations of reactive oxygen intermediates including H2O2 can
      alter human T cell function and inhibit proliferative responses but relatively
      little is known about the effects of low levels of oxidant stress on signaling
      pathways. In the present study, we investigated whether the exposure of Jurkat T
      cells to micromolar concentrations of H2O2 might influence the activity of
      certain serine/threonine kinases and protein phosphatases important for T cell
      signaling as well as initiation of nuclear events. Jurkat cells treated with 100
      200 microM H2O2 exhibited rapid increases in cytosolic protein kinase C (PKC)
      activity without detectable translocation of PKC to the membrane/particulate
      compartment. The stimulation of PKC activity by H2O2 was associated with an
      increase in the activation of kinases phosphorylating myelin basic protein (MBP),
      a substrate for mitogen-activated protein (MAP) kinase and RRLSSLRA (S6 peptide;
      a substrate for the approximately 90-kDa ribosomal S6 kinases). Optimal
      activation of MAP kinase in cells treated with H2O2 was preceded by increases in
      protein tyrosine phosphorylations and occurred at sublethal concentrations of
      H2O2 which did not markedly deplete intracellular ATP. Pretreatment of cells with
      the PKC inhibitors sangivamycin and H7 suppressed but did not block the
      stimulation of MAP kinase activity in response to H2O2 or phytohemagglutinin. The
      activities of both protein tyrosine phosphatase (PTP) and protein phosphatase 2A
      (PP2A) were reduced after H2O2 treatment of intact cells. Furthermore, kinetic
      studies showed that H2O2 was capable of suppressing the activities of PTP and
      PP2A before inducing optimal increases in MAP kinase activity. These results
      demonstrate that the exposure of T cells to sublethal levels of oxidant stress
      acutely stimulates the MAP kinase cascade and suggest that this activation may
      involve PKC-dependent and -independent pathways as well as inhibition of certain
      protein phosphatases.

PMID- 7771790
TI  - Three-dimensional reconstruction of the hemocyanin of the protobranch bivalve
      mollusc Nucula hanleyi from frozen-hydrated specimens.
AB  - The didecameric hemocyanin of the bivalve mollusc Nucula hanleyi, observed in the
      electron microscope in vitreous ice, was subjected to a three-dimensional (3D)
      reconstruction by the random conical tilt series method. The 3D volume was
      analyzed by computing solid-body surface representations and slices through the
      volume and by eroding the structure progressively. The molecule was reconstructed
      from 288 and 63 images in the side- and end-on view orientations, respectively.
      It comprises three parts: one cylindrical wall composed of 10 oblique wall units
      and two collar complexes located at both ends of the cylinder and made up each of
      five arches and one annular collar. Erosion of the volume reveals that the wall
      looks like a segment of a five-stranded right-handed helix and that each oblique
      wall unit resembles a figure 8 inclined to the right. The 3D volumes
      reconstructed from Helix pomatia and N. hanleyi hemocyanins look perfectly
      similar, except that when the threshold is expressed as a function of the
      molecular volume left apparent, the various connections between the wall, the
      arches, and the collar disappear at a lower threshold in N. hanleyi than in H.
      pomatia. Conversely, with thresholds expressed as a fraction of the dynamic range
      of the 3D volume, the two structures are quite similar. This behavior means
      either that the molecular weights of Helix and Nucula hemocyanins (and therefore
      their molecular volumes) are not so different as indicated in the literature or
      that all the portions of Nucula hemocyanin have molecular weights lower than
      those of Helix hemocyanins.

PMID- 7771791
TI  - The electrochemistry of 5-hydroxybenzimidazolylcobamide.
AB  - Methanogenic archaea typically contain 5-hydroxybenzimidazolylcobamide (cba-HBI)
      as the prosthetic group of a number of methyltransferases involved in their
      central metabolic pathways. In this paper the (acidic) dissociation constants and
      standard oxidation-reduction potentials of the Co3+/Co2+ and Co2+/Co1+ couples of
      isolated aquo-cba-HBI were measured. Comparison of the data to those established
      for 5,6-dimethylbenzimidazolylcobamide (cobalamin) showed that the 5
      hydroxybenzimidazolyl (HBI) nucleotidic base hardly affected the redox
      potentials. HBI, however, proved to be the weaker ligand, thus favoring "base
      off" formation. The implications for the functioning of cba-HBI in biochemical
      methyl group transfer reactions are discussed.

PMID- 7771792
TI  - Import of subunit VII of the cytochrome bc1 complex into yeast mitochondrial.
AB  - The import of subunit VII, the so-called ubiquinol binding protein of the
      cytochrome bc1 complex of yeast mitochondria, has been investigated by subcloning
      the gene for subunit VII into the expression vector pSP64. The precursor to
      subunit VII synthesized in vitro by a transcription/translation system had the
      same molecular weight as the mature form of this protein present in mitochondria,
      confirming earlier reports that subunit VII does not contain a cleavable
      presequence. The subunit VII precursor was imported efficiently into a protease
      resistant compartment of isolated yeast mitochondria in a reaction dependent upon
      a membrane potential and the presence of ATP both in the mitochondrial matrix and
      in the extramitochondrial space. After import, the radiolabeled subunit VII was
      bound to the mitochondrial inner membrane through protein-protein interactions
      and could not be detected in the matrix fraction or in the intermembrane space.
      Subunit VII was also imported into mitoplasts, where the protein was associated
      with the inner membrane facing the matrix side of the membrane. By contrast,
      after import into mitochondria obtained from yeast cells lacking cytochrome b,
      subunit VII was localized in the supernatant fraction, suggesting that the
      presence of cytochrome b may be required for the association of subunit VII with
      the inner mitochondrial membrane.

PMID- 7771793
TI  - What does ozone react with at the air/lung interface? Model studies using human
      red blood cell membranes.
AB  - We exposed human red blood cell (RBC) membranes to low levels of ozone and
      measured the oxidative damage that occurs to the proteins and the unsaturated
      lipids that are present. Oxidative damage to proteins causes significant
      decreases in the content of thiol groups, the fluorescence of protein-tryptophan
      residues, and the activity of membrane-bound acetylcholinesterase. Oxidative
      damage to lipids causes changes in some of the unsaturated fatty acids (UFA) in
      the lipid fraction of these RBC membranes. Significant amounts of hexanal,
      heptanal, and nonanal are formed from the ozonation of UFA. Although no decrease
      in the amount of oleate is detected, it does undergo ozonation to yield nonanal;
      thus, as would be expected, product appearance is a more sensitive measure of
      ozonation than is substrate disappearance. These results imply that both proteins
      and unsaturated lipids undergo simultaneous and competitive ozonation in human
      RBC membranes when ozone is the limiting reactant. The ratios of reaction of
      ozone with different targets can be predicted in reasonably good agreement with
      the observed values using calculations (W. A. Pryor and R. M. Uppu (1993) J.
      Biol. Chem. 268, 3120-3126; R. M. Uppu and W. A. Pryor (1994) Chem. Res. Toxicol.
      7, 47-55) that take into account the reactivities and relative amounts of protein
      and lipid functionalities present in the RBC membranes. Similar calculations are
      used to predict the reaction of ozone with unsaturated lipids and proteins at the
      air/lung interface, and both UFA and proteins are predicted to react with ozone
      in the lung, as in RBC membranes.

PMID- 7771794
TI  - Isolation and characterization of a new cDNA clone belonging to the cytochrome
      P450 2C gene subfamily in hamsters.
AB  - Cytochrome P450s are heme-containing proteins which evolved from an ancestral
      gene to form a large superfamily of enzymes. We previously isolated three
      distinct CYP2C cDNAs, namely CYP2C25, 2C26, and 2C27, from liver cDNA libraries
      of male and female Syrian hamsters. In the present study, we isolated another
      cDNA clone, assigned as CYP2C28, from the same male cDNA library. This cDNA
      consisted of 1556 nucleotides and encoded a polypeptide of 490 amino acids.
      CYP2C28 showed relatively low identities to other hamster CYP2C forms (71.4-72.6%
      in amino acid sequences) and showed the highest similarity to rat CYP2C24
      (88.7%), while the other hamster CYP2C forms showed high similarities among
      themselves (> 90.2%). CYP2C28 protein expressed in yeast catalyzed the N
      demethylation of aminopyrine and benzphetamine, but did not catalyze the
      hydroxylation of tolbutamide, testosterone, and progesterone. Northern blot
      analysis demonstrated that CYP2C28 mRNA was expressed in hamster livers 1 week
      after birth, when the other hamster CYP2C forms were not detectable. The level of
      CYP2C28 mRNA increased to 3 weeks and then decreased with time in males. The
      level in females was lower than that in males. In adult hamsters, CYP2C28 was
      induced almost threefold by administration of phenobarbital but not affected by 3
      methycholanthrene. On the other hand, administration of pregnenolone 16 alpha
      carbonitrile induced CYP2C28 in females but not in males. These results indicate
      that CYP2C28 is a unique form in the hamster CYP2C subfamily.

PMID- 7771795
TI  - Metabolic fate of platelet-activating factor in the rat enterocyte: the role of a
      specific lysophospholipase D.
AB  - The metabolism of platelet-activating factor (PAF) by isolated rat intestinal
      epithelial cells was investigated using 1-[3H]octadecyl-2-acetyl-sn-glycero-3
      phosphocholine. The principal metabolite produced by the cells was 1-O
      alkylglycerol, which was found in association with the cells and the medium. When
      similar studies were conducted employing an intestinal epithelial cell line (INT
      407), PAF was almost quantitatively converted into 1-alkyl-2-acyl-sn-glycero-3
      phosphocholine (AAGPC). When the intestinal epithelial cell microsomes were
      incubated in the presence of fluoride to inhibit phosphohydrolase activity, the
      formation of 1-alkylglycerol was decreased in association with a stoichiometric
      increase in 1-alkyl-glycerophosphate, indicating the presence of a
      lysophospholipase D in the intestinal cells. When the phospholipase D activity
      was examined in the microsomal fraction prepared from intestinal epithelial
      cells, lyso-PAF was the preferred substrate and only trace amounts of lyso-PAF
      were converted into alkylacyl-GPC. Acyllyso-GPC was rapidly cleaved to form free
      fatty acids. The absence of lysophospholipase D activity in INT 407 cells cannot
      be attributed to the absence of brush border in these cells since no
      lysophospholipase D activity was present in isolated brush border preparations.

PMID- 7771796
TI  - Molecular cloning and sequence analysis of flavastacin: an O-glycosylated
      prokaryotic zinc metalloendopeptidase.
AB  - A new zinc metalloendopeptidase that cleaves peptides on the amino-terminal side
      of aspartic acid was isolated from the cultural filtrate of Flavobacterium
      meningosepticum. The gene for this new enzyme was cloned into pBluescript, and
      the complete nucleotide sequence was determined. Over 40% of the deduced amino
      acid sequence was verified independently by direct protein microsequencing. The
      most important structural features of this new enzyme include (i) the presence of
      an unusual O-linked oligosaccharide of unknown function located at a unique
      consensus site near the C-terminus and (ii) a characteristic extended zinc
      binding site and corresponding Met-turn that places this metalloendopeptidase in
      the astacin family. This is the first example of a prokaryotic enzyme related to
      the eukaryotic astacin group; it is being designated hereafter as flavastacin.

PMID- 7771797
TI  - Glucocorticoid and sex hormones as activating or modulating factors for
      expression of Cyp2b-9 and Cyp2b-10 in the mouse liver and hepatocytes.
AB  - The effects of male and female hormones as well as glucocorticoid upon the
      expression of Cyp2b-9 and Cyp2b-10 were investigated in C57BL/6 mouse liver and
      hepatocytes in primary culture. Their expression in the untreated female liver
      was higher than that in the male liver. More Cyp2b-9 mRNA than Cyp2b-10 was
      present in the female than in the male liver, whereas the levels of Cyp2b-10 were
      higher in the male. Phenobarbital increased Cyp2b-10 expression more than that of
      Cyp2b-9 in both sexes. Treatment with beta-estradiol also induced both in the
      male liver, with more Cyp2b-10 than Cyp2b-9 being found. In the female liver beta
      estradiol and testosterone slightly increased the levels of Cyp2b-10, whereas the
      expression of Cyp2b-9 was reduced. Ovarectomy did not reduce the expression of
      the two mRNAs, but rather increased them. Using the spheroid culture system, in
      which mouse hepatocytes were cultured as multicellular aggregates and in which
      both mRNAs were expressed for a number of days, beta-estradiol as well as
      phenobarbital potently induced mRNA in hepatocytes from either sex and the
      inducibility at 10(-5) M corresponded to 10(-3) M phenobarbital. The expression
      level of Cyp2b-10 mRNA by phenobarbital or beta-estradiol was higher than that of
      Cyp2b-9, as observed in vivo, and > 10(-7) M beta-estradiol induced both in
      vitro. Dexamethasone induced the expression of more Cyp2b-10 mRNA than Cyp2b-9,
      and it was necessary for the expression by either phenobarbital or beta
      estradiol. The expression was not enhanced in vitro by concomitant exposure of
      beta-estradiol and phenobarbital. Among the other female hormones tested, estrone
      induced Cyp2b-9 and Cyp2b-10 mRNAs at levels equivalent to those induced by beta
      estradiol, and estriol and progesterone had a lower potential for the induction.
      Male hormones, such as androstenedione and testosterone, also had inducing
      potency in vitro. However, testosterone concentration dependently reduced the
      expression in cells cultured without dexamethasone. Tamoxifen or cryproterone,
      having antiestrogenic or antiandrogenic effects, respectively, also induced Cyp2b
      9 and Cyp2b-10 mRNA. The suppressive effect of growth hormone on the expression
      of the mRNA was slight. The observation that endogenous hormones altered the
      expression of Cyp2b-9 and Cyp2b-10 in vivo and in vitro suggested that male and
      female hormones, as well as glucocorticoid, play activating or modulating roles
      in the constitutive expression of P450s.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771798
TI  - Mechanism of glycogenin self-glucosylation.
AB  - Glycogenin, the proposed initiator of mammalian glycogen biosynthesis, transfers
      glucose residues from UDP-glucose to an oligosaccharide chain attached to Tyr-194
      in a self-glucosylation reaction. Mutation of Tyr-194 to either Phe or Thr
      residues results in the loss of this self-glucosylating activity since the site
      of oligosaccharide attachment has been lost (Y. Cao, A. M. Mahrenholz, A. A.
      DePaoli-Roach, and P. J. Roach (1993) J. Biol. Chem. 268, 14687-14693). We
      describe here that Phe-194 and Thr-194 mutants of glycogenin, as well as wild
      type protein, were active in transferring glucose to an exogenous acceptor,
      maltose, a known inhibitor of the self-glucosylation reaction. The reaction
      product was exclusively maltotriose with no evidence for further elongation to
      maltotetraose or maltopentaose. The values of Vmax/Km for maltotriose synthesis
      for the mutant proteins were 1.5-3.5 times greater than that of the wild type.
      Analysis of crystals of wild-type glycogenin by X-ray diffraction gives a
      tetragonal unit cell of a = b = 130 A and c = 174 A in space group I4 with four
      glycogenin molecules in one asymmetric unit. Considerations of the symmetry and
      the crystal packing indicate the existence of dimers of glycogenin which may
      further associate to form a tetramer. The existence of oligomeric forms of
      glycogenin, together with the idea that glucose transfer to an exogenous acceptor
      is possible, raises the possibility that the intramolecular self-glucosylation of
      glycogenin could involve an intersubunit transfer of glucose.

PMID- 7771799
TI  - Bacterial production and characterization of ATP11, a yeast protein required for
      mitochondrial F1-ATPase assembly.
AB  - ATP11 is a nuclear gene product that is required for assembly of mitochondrial F1
      ATPase in the yeast Saccharomyces cerevisiae. ATP11 is synthesized in the yeast
      cytoplasm with an N-terminal targeting sequence. Following import into
      mitochondria, the leader sequence is cleaved, generating the functional form of
      the protein. ATP11 is present in small amounts in yeast mitochondria, which has
      made it difficult to study its role in F1 assembly. We have developed a bacterial
      expression system for the overproduction of the mature form of ATP11 and its
      biotinated derivative, BTATP11. Yeast complementation assays showed that the DNA
      fragments used to produce ATP11 and BTATP11 in bacteria encode biologically
      active proteins. The recombinant proteins produced in bacteria were purified to
      homogeneity and their physical characteristics were shown to be similar to those
      of the mitochondrial ATP11 protein synthesized in yeast.

PMID- 7771800
TI  - The amino acid sequence of the pancreatic islet mitochondrial glycerol phosphate
      dehydrogenase is not unique and the enzyme is not thyroid or glucose responsive.
AB  - The mitochondrial glycerol phosphate dehydrogenase (mGPD) is one of several
      proteins that are abundant in the pancreatic islet. Hormonal and nutritional
      influences confer tissue-specific patterns of expression on many of these
      proteins and the primary amino acid sequence of these proteins in the islet often
      differs from those in other tissues. However, the deduced amino acid sequence of
      the rat islet mGPD was identical to that of testis and liver. (The islet mGPD
      also possesses calmodulin-like calcium-binding sequences.) Islet mGPD activity
      and amount of protein were not changed by culturing islets at various
      concentrations of the insulin secretagogues, glucose, leucine, glutamine, or
      methyl succinate, which are conditions that alter the amounts of other enzymes in
      the islet. Unlike mGPD in tissues, such as liver, where mGPD activity is low, the
      high amount of islet mGPD was not further induced in hyperthyroid rats or by
      adding T3 to cultured islets or rat insulinoma cells. This suggests that the
      islet mGPD is under different regulation than the enzyme in tissues where its
      activity is low.

PMID- 7771801
TI  - Reversal of multidrug resistance phenotype by surfactants: relationship to
      membrane lipid fluidity.
AB  - Previous studies have suggested that multidrug resistance (MDR) reversal by
      polyoxyethylene surfactants involves alterations in plasma membrane lipid
      physical state of resistant cells as one of the possible mechanism(s). To date,
      however, a detailed and critical examination of the relationship between membrane
      lipid fluidity and MDR reversal by these surfactants has not been performed. In
      the present studies, therefore, a series of experiments were conducted to
      critically examine the role of membrane lipid physical state in MDR reversal by
      employing a unique class of clinically important nontoxic lipophilic surfactants
      and the KB-8-5-11 drug-resistant cell line. MDR reversal was assessed by
      rhodamine-123 uptake. The effect of surfactants on plasma membrane lipid fluidity
      of these cells was assessed utilizing a fluorescence polarization technique with
      fluorophores DPH, TMA. DPH, 2-AS, and 12-AS. Our studies demonstrated that: (i)
      in vitro addition of active MDR-reversing surfactants (Solutol HS-15, Tween 40,
      and Cremophor EL, 10 micrograms/ml each) decreased lipid fluidity of isolated
      crude plasma membranes of resistant cells; (ii) the inactive surfactants
      (octylglucoside, hecameg) failed to influence membrane lipid fluidity; (iii)
      cells grown in the presence of active surfactants also exhibited a decreased
      plasma membrane lipid fluidity as measured with intact cells utilizing the probe
      TMA.DPH; and (iv) active surfactants did not influence lifetimes of the excited
      state of the fluorophores. These findings demonstrate that decrease of the plasma
      membrane lipid fluidity of KB 8-5-11 resistant cells may be one of the important
      mechanism(s) of MDR reversal by polyoxyethylene surfactants.

PMID- 7771803
TI  - Nucleotide recognition by histone H1 involves specific protein structures.

PMID- 7771802
TI  - Comparison of the primary structure of nuclear and mitochondrial glutamate
      dehydrogenase from bovine liver.
AB  - Glutamate dehydrogenase (GDH) from bovine liver nuclei was compared to bovine
      liver mitochondrial GDH. The nuclei were isolated in sucrose buffer and
      sonicated, and glutamate dehydrogenase activity was extracted with 0.1 M
      potassium phosphate buffer. The enzyme was purified by ammonium sulfate
      fractionation, heating, gel filtration, affinity chromatography, and absorption
      chromatography to homogeniety. Nuclear GDH had the same apparent molecular weight
      on SDS-PAGE as mitochondrial GDH. The overall charge was slightly more negative.
      Cyanogen bromide and tryptic peptides of bovine nuclear and mitochondrial
      glutamate dehydrogenase were separated by HPLC reverse-phase chromatography using
      a linear gradient of 0-60% acetonitrile. Only about half of the nuclear and
      mitochondrial peptides had the same retention time. Several nuclear peptides from
      the tryptic digest were sequenced. Eight of the amino acids differed from the
      published sequence of mitochondrial GDH (of 99 that were sequenced). The amino
      acid composition of one peptide was determined and it contained 4 (of 37 amino
      acids) that were different from the published composition of the corresponding
      peptide from bovine mitochondrial GDH. The composition data agree with the
      sequence data from this peptide. We conclude that GDH does exist in bovine liver
      nuclei and that it probably differs by less than 10% in amino acid sequence from
      mitochondrial GDH.

PMID- 7771804
TI  - Proton translocation linked to the activity of the bi-trans-membrane electron
      transport chain.
AB  - Recently we have proposed and presented evidence suggesting the existence of a
      "bi-trans-membrane" electron transport chain, located at the contact sites
      between outer and inner mitochondrial membranes, which can be utilized to promote
      either the oxidation of exogenous NADH in the presence of catalytic amounts of
      added cytochrome c or the reduction of exogenous cytochrome c supported by the
      oxidation of respiratory substrates present inside the mitochondria. Here we show
      that the oxidation of exogenous NADH is accompanied by a net alkalinization of
      the incubation medium preceded by a transient acidification phase. In oxygen
      pulse experiments, the alcohol oxidation (induced by the addition of alcohol
      dehydrogenase) was used to mimic a cytosolic source of reducing equivalents.
      Oxygen pulses promote an acidification-alkalinization proton cycle which is
      insensitive to antimycin and myxothiazol inhibitory effect, is stimulated by
      valinomycin, inhibited by trypsin-aprotinin complex, abolished by the
      protonophore carbonyl cyanide-p-trifluoromethoxy phenylhydrazone (FCCP), and is
      absent or at least inverted (alkalinization-acidification cycle) in broken
      mitochondria. The oxidation of cytosolic substrates, mediated by the bi-trans
      membrane electron transport chain, does not involve endogenous cytochrome c and
      is associated with a vectorial proton translocation from the inside to the
      outside of the mitochondria. In the out-->in electron transport pathway the
      components involved appear to be cytosolic reduced substrates-->NADH produced by
      cytosolic dehydrogenases activity-->NADH-cytochrome b5 oxidoreductase complex
      leaning out the external side of the external membrane-->exogenous cytochrome c-
      >cytochrome oxidase of contact sites-->molecular oxygen. The possible components
      of the in-->out pathway are matrix respiratory substrates-->primary
      dehydrogenases of the matrix-->Complexes I, II, and III of the respiratory chain
      present in the inner membrane-->NADH-cytochrome b5 oxidoreductase system of the
      external membrane-->exogenous cytochrome c-->additional cytosolic electron
      acceptors or, alternatively, cytochrome oxidase of contact sites. The two
      pathways can be considered a bi-trans-membrane electron channeling system which,
      at the level of bridges set up by the contact points between the outer and the
      inner mitochondrial membrane, may represent a link between the redox processes
      occurring inside with those present outside the mitochondrion.

PMID- 7771805
TI  - Accumulation of the quinonoid intermediate in the reaction catalyzed by aspartate
      aminotransferase with cysteine sulfinic acid.
AB  - The pyridoxal phosphate form of aspartate aminotransferase from Escherichia coli
      catalyzes the irreversible conversion of L-cysteine sulfinate to the pyridoxamine
      phosphate form of the enzyme, bisulfite, and pyruvate. The addition of L-cysteine
      sulfinate to a solution containing a high concentration of enzyme (approximately
      10 microM) yields a rapidly appearing red color (lambda max = 520 nm) which
      decays with a rate constant which is only about 1% of kcat (2-3 s-1 versus 250 s
      1 at 15 degrees C, pH 7). The red color can be assigned to the quinonoid form of
      the enzyme substrate complex, which accumulates under these single turnover
      conditions. The rate of decay of this species is dependent on that for the
      decomposition of beta-sulfinylpyruvate (beta-SP), the initial product of the
      reaction between aspartate aminotransferase and L-cysteine sulfinate. Trapping
      beta-SP with morpholine or malate dehydrogenase plus NADH abolishes the transient
      red color; therefore, the intermediate accumulates by virtue of the reverse
      reaction of beta-SP with the pyridoxamine phosphate form of the enzyme. The
      association and dissociation rate constants of beta-SP with the pyridoxamine-5'
      phosphate form of the enzyme are 2 x 10(7) M-1 s-1 and 400 s-1, respectively, at
      15 degrees C. No red transient species is observed under these conditions when
      aspartate is substituted for L-cysteine sulfinate.

PMID- 7771806
TI  - Identification of liver endothelial cells as the primary site of IgM catabolism
      in the rat.
AB  - Rat IgMs, both monoclonal protein from ascites fluid and total serum IgM, were
      purified by sequential gel filtration and metal chelate affinity chromatography
      on immobilized zinc-iminodiacetate. Two monoclonal IgMs, IR202 and IR968,
      chromatographed identically on gel filtration, but required different pHs for
      elution from the zinc affinity column. IR202 behaved like a euglobulin, being
      readily precipitated in low-ionic-strength buffers, while IR968 remained soluble
      under these conditions. IgM was isolated from serum in 30-50% yield by
      chromatographic procedures similar to those used for the monoclonal proteins, and
      20-30% of the isolated serum IgM was precipitable as a euglobulin. The half-life
      of both monoclonal and serum euglobulin IgMs was 0.8 days, while the polyclonal
      globulin and IR968 had half-lives of 1.8 and 2.8 days, respectively, in the rat
      circulation. The tissue and cellular sites of catabolism of the monoclonal IgMs
      were determined after labeling with the residualizing label, dilactitol
      [125I]tyramine. For both proteins the liver was identified as the major tissue
      site of catabolism, accounting for 60-80% of degraded protein in the body. When
      liver was fractionated into parenchymal and nonparenchymal cells (NPC), the NPC
      were found to account for 86 and 69% of protein recovered in liver, for IR202 and
      IR968, respectively. Separation of NPC into endothelial (EC) and Kupffer cell
      populations by elutriation centrifugation revealed that EC contained the
      majority, approximately 70% of total NPC radioactivity from either IgM. Based on
      the ratios of endocytic indices (microliter of plasma/10(6) cells/day) for each
      cell type, the EC also had a higher efficiency for uptake of both IgMs,
      approximately threefold greater, than for the fluid phase marker,
      polyvinylpyrrolidone, or for rat serum albumin. We conclude that hepatic EC are a
      major site of IgM catabolism, regardless of the heterogeneity in physical and
      biological properties of various IgM populations.

PMID- 7771807
TI  - All-trans-retinoic acid interacts synergistically with basic fibroblast growth
      factor and epidermal growth factor to stimulate the production of tissue
      inhibitor of metalloproteinases from fibroblasts.
AB  - This report examines the effect of all-trans-retinoic acid in combination with
      basic fibroblast growth factor (bFGF) or epidermal growth factor (EGF) on
      collagenase and tissue inhibitor of metalloproteinases (TIMP) production from
      human foreskin and synovial fibroblasts. When 10(-5) M retinoic acid is applied
      in combination with 1, 10, and 100 ng/ml of either FGF or EGF to foreskin or
      synovial fibroblasts, this results in a dose-dependent synergistic increase in
      TIMP protein production which is greater than the additive effect of the agents
      by up to fourfold. These responses can be inhibited by the presence of specific
      neutralizing antibodies to bFGF and EGF, demonstrating that they result from the
      presence of the growth factors and not from an experimental artifact such as
      bacterial endotoxin. We have also found that retinoic acid potently inhibits bFGF
      and EGF-stimulated collagenase protein production in both skin and synovial
      fibroblasts.

PMID- 7771808
TI  - Role of calcium and protein kinase C in the activation of phospholipase D by
      angiotensin II in vascular smooth muscle cells.
AB  - We previously showed that cultured rat aortic vascular smooth muscle cells (VSMC)
      possess an AT1 angiotensin (Ang) receptor coupled to the activation of a
      phospholipase D (PLD). AT1 receptors in VSMC are also coupled to the activation
      of a phosphoinositide-specific phospholipase C (PLC), mobilization of
      intracellular Ca2+, and activation of protein kinase C (PKC). To determine
      whether PLD stimulation by Ang II is the result of PLC activation and the
      subsequent elevation of cytosolic free Ca2+ and PKC activation, we investigated
      the role of Ca2+ and PKC in the activation of PLD. Chelation of extracellular
      Ca2+ by EGTA, blockade of voltage-sensitive Ca2+ channels, or chelation of
      intracellular Ca2+ with BAPTA partially attenuated PLD activation and Ca2+
      mobilization in response to Ang II. However, the simultaneous chelation of
      extracellular Ca2+ with EGTA and intracellular Ca2+ with BAPTA completely
      attenuated both PLD activation and Ca2+ accumulation. Ca2+ ionophores mimicked
      Ang II and the combined effects of Ang II and ionophore resulted in no further
      stimulation of PLD activity above that observed in the presence of either agonist
      alone. Although the putative PLC inhibitor U73122 blocked the activation of PLD
      by Ang II, it also may inhibit PLD activation directly, since it attenuated both
      Ca2+ ionophore and phorbol 12-myristate 13-acetate (PMA)-mediated increases in
      PLD activity. PMA also activated PLD in VSMC in a dose-dependent manner; however,
      Ang II and PMA stimulation were additive. Down-regulation of PKC via exposure to
      phorbol dibutyrate almost completely blocked PMA-induced stimulation of PLD while
      it had no effect on Ang II- or Ca(2+)-ionophore-mediated increases in PLD
      activity. The PKC inhibitor staurosporine augmented basal PLD activity and
      partially inhibited PMA stimulation of PLD while it had little effect on Ang II
      induced increases in PLD activity. Thus, optimal Ang II stimulation of PLD is
      dependent on the availability of both intracellular and extracellular Ca2+ and
      independent of PMA-mediated effects. Furthermore, these data suggest that Ang II
      stimulation of PLD may occur subsequent to activation of PLC, since Ang II
      activates PLC and PLC is shown to be responsible for increases in intracellular
      Ca2- in response to Ang II.

PMID- 7771809
TI  - Cloning and expression of the alpha subunit of succinyl-CoA synthetase from
      Dictyostelium discoideum.
AB  - We have isolated and characterized a genomic fragment and a cDNA clone for the
      alpha subunit of succinyl-CoA synthetase (SCS) from Dictyostelium discoideum. The
      coding region predicts a protein of 310 amino acids. Direct amino acid sequence
      data indicate that the first 16 amino acids encoded by the cDNA comprise a
      mitochondrial targeting sequence. The predicted molecular mass of the mature
      protein is 31 kDa on sodium dodecyl sulfate-polyacrylamide gel electrophoresis.
      The deduced amino acid sequence of the alpha subunit from D. discoideum shows 75%
      identity to that from rat liver, which represents a GTP-utilizing form of SCS,
      and 62% identity to the Escherichia coli protein, which is an ATP-utilizing form.
      We have previously shown that the enzyme purified from growing D. discoideum is a
      GTP-utilizing enzyme. In D. discoideum, the alpha subunit is a single copy gene
      that is developmentally regulated. Highest levels of its mRNA are seen in growing
      cells, which is followed by a relatively dramatic decline at the time cells
      complete their aggregation program. In contrast, the level of the protein, as
      determined by Western blots, remains unchanged throughout development. This
      indicates that any developmental changes in SCS activity reflect changes in the
      availability of its substrates or effectors and not changes in the level of
      enzyme.

PMID- 7771810
TI  - Transatrial repair of tetralogy of Fallot.

PMID- 7771811
TI  - Herbert Sloan Lecture. Introduction to the Sloan Lecture.

PMID- 7771812
TI  - Understanding cardiac anatomy: the prerequisite for optimal cardiac surgery.
AB  - If advances in cardiac surgery are to continue into the twenty-first century, it
      will be necessary to concentrate on details of matters such as the anatomy of the
      heart. This will be achieved best when anatomy is described as it is observed.
      This approach is obscured when words are used in inappropriate fashion, or else
      assigned a function separate from their everyday meaning. Examples of how the
      congenitally malformed heart and the normal heart have been described in the past
      are examined within the framework of using words in their vernacular meaning.
      Suggestions are made to improve descriptions and understanding for the 21st
      century. Using the example of the "univentricular heart", it is shown how
      conventions debarring ventricular status to discrete chambers within the
      ventricular mass are, of necessity, artificial. Similar examples are used to
      distinguish septal from parietal structures within the heart and to elucidate the
      structure of some congenital malformations. For values, it is shown how proper
      description requires assessment of these structures in their closed as well as
      their open positions. Understanding of cardiac anatomy, truly a prerequisite for
      successful cardiac surgery, will be facilitated in future if words are used in
      their generally accepted sense, and if artificial conventions are avoided.

PMID- 7771813
TI  - The STS Cardiac Surgery National Database: an update.
AB  - Since inception in 1990, The Society of Thoracic Surgeons (STS) National Cardiac
      Database has grown rapidly. More than 1,500 surgeons working in 706 hospitals
      have contributed more than one half million patient records. Geographic
      distribution of those participating is proportional to the number of centers
      performing heart surgery. The STS system is in use in all 49 states where centers
      are operating. There has been a significant decrease in length of stay for most
      patients having heart operations and a modest fall in coronary artery bypass
      grafting operative mortality from 3.7% to 3.3% over the past 3 years. Coronary
      artery bypass grafting case mix also is changing nationally as evidenced by a
      decline of 17% in the best-risk cases and concomitant increases in those with
      predicted risks of 5% to 10% and greater. New uses for local data in addition to
      self assessment and quality assurance include development of critical clinical
      pathways, support for managed-care group applications, and regional use.
      Minnesota has established a statewide STS system and Florida is soon to follow.
      The key to acceptance has been a peer-reviewed risk-stratification system that
      continues to be refined each year. Finally, a major effort will be made this year
      to increase the participation of general thoracic surgeons, particularly with
      respect to lung cancer.

PMID- 7771814
TI  - Esophageal replacement by colon interposition.
AB  - Between 1985 and 1993, 32 patients (24 male and 8 female) underwent colon
      interposition for replacement of the esophagus at the Mayo Clinic. Median age was
      58.5 years (range, 1 to 79 years). The colon was used because of an inadequate
      stomach in 27 patients (84%) and as the conduit of choice in 5 (16%). Esophageal
      cancer was present in 15 patients (47%). The left colon was used in 20 patients
      (63%) and the right, in 12 (38%). The colon was placed substernally in 19
      patients (59%) and in the esophageal bed in 13 (41%). The operative mortality was
      9%; cause of death was ischemic necrosis of right colon conduits in 2 patients
      and adult respiratory distress syndrome in 1 patient. Major complications
      occurred in 4 additional patients and included ischemic colitis of a right colon
      conduit, Roux-en-Y limb obstruction, chylothorax, and an anastomotic leak. Follow
      up was complete for all patients and ranged from 15 months to 7 years (median
      follow-up, 2.3 years). Eleven patients died during follow-up. The cause of death
      was metastatic esophageal cancer in 9 patients, myocardial infarction in 1
      patient, and respiratory failure in 1 patient. At last follow-up, 26 of the 29
      operative survivors had little or no difficulty eating. Two patients had dumping
      symptoms, and 1 patient had severe dysphagia. Seven patients required dilation of
      the esophagocolonic anastomosis. We conclude that colon interposition for
      esophageal replacement provides acceptable long-term function; however, early
      morbidity and mortality are considerable.

PMID- 7771815
TI  - Metastasectomy for sarcomatous pediatric histologies: results and prognostic
      factors.
AB  - We reviewed our experience of pediatric metastasectomy to define (1)
      morbidity/mortality in this population and (2) any preoperative or intraoperative
      prognostic predictors of survival. One hundred fifty-two patients with median age
      19 years (range, 5 to 33 years) had 258 thoracic explorations (Ewing's sarcoma,
      28; rhabdomyosarcoma, 6; nonrhabdomyosarcoma soft tissue sarcoma, 42; and
      osteosarcoma, 76). Resections were accomplished by 218 wedge resections, 19
      anatomic resections, 14 wedge and anatomic resections, 4 wedge and chest wall
      resections, and 3 wedge resections/other procedures. An initial complete
      resection was accomplished in 121/152 patients (80%). With a median potential
      follow-up of 10.6 years, median survival from initial thoracotomy is 2.2 years.
      By the Cox proportional hazards model, three or more positive nodules (p =
      0.021), histology other than osteosarcoma (p = 0.0054), and incomplete resection
      (p < 0.0001) were unfavorable prognostic factors for survival. Two or more
      positive nodules (p = 0.0049), left location (p = 0.0031), age 14 years or
      greater at diagnosis (p = 0.0052), or rhabdomyosarcoma (p = 0.0066) predicted
      shorter pulmonary progression-free survivals after resection. Nonrhabdomyosarcoma
      pediatric metastasectomy can yield selected long-term survival.
      Morbidity/mortality is low, and a complete resection, if possible, is paramount.
      Prognostic factors can be defined that can be used to define the limits of this
      therapy to the patient and family.

PMID- 7771816
TI  - CABG after successful PTCA: a case-control study.
AB  - We sought characteristics predictive of the need for operative revascularization
      subsequent to a successful coronary angioplasty. Through June 1993, 128 patients
      who had successful percutaneous transluminal coronary angioplasty (PTCA) between
      January 1982 and March 1989 required subsequent coronary artery bypass grafting
      (CABG) at our hospital. These cases were matched with 128 controls who had a
      successful PTCA but did not require subsequent CABG. Controls were matched to
      cases by the date of their initial PTCA. Before initial PTCA there were no
      differences between the cases and controls in terms of age, sex, prior myocardial
      infarction, ejection fraction, duration of anginal symptoms, hypertension,
      hyperlipidemia, family history, or obesity (all not significant). A greater
      number of cases had diabetes (35 versus 18; p = 0.009). Angiography before
      initial PTCA revealed that cases had a greater mean number of total lesions (4.1
      versus 3.3; p = 0.002) and a higher incidence of left anterior descending and
      circumflex artery stenoses of 70% or greater (98 versus 75 and 57 versus 34,
      respectively; p = 0.006). The mean number of lesions successfully dilated was
      greater in cases (2.4 versus 1.7; p = 0.0001). Cases had CABG at a mean interval
      of 16.7 +/- 23 months. There were 17 late deaths among cases and 9 among the
      controls at a mean of 38.6 +/- 30 months. The survival probability at 5 years was
      94.5% for controls and 87.9% for cases (p = 0.048). Initial revascularization by
      PTCA is followed by CABG at a brief interval in a subset of patients who have
      markers of more severe disease than do patients who do not require early
      CABG.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771817
TI  - Should the freehand allograft be abandoned as a reliable alternative for aortic
      valve replacement?
AB  - Cryopreserved aortic allografts were used for aortic valve replacement in 80
      patients between 1986 and 1994 (infracoronary in 46 and complete root replacement
      in 34). Hospital mortality was 6.3% (5/80) with all deaths occurring in the
      infracoronary group. Three of five deaths were in patients with endocarditis and
      valve ring abscess. Left ventricular-aortic mean pressure gradients across the
      allograft valves were significantly lower for root replacement patients (mean,
      9.0 +/- 6.9 mm Hg versus 18.1 +/- 8.7 mm Hg for infracoronary patients) (p =
      0.0001). No patient having root allograft replacement had early echocardiographic
      aortic insufficiency greater than grade 1 versus 28% of those having
      infracoronary implantations. Late aortic insufficiency of grade 2 or greater was
      seen in 46% of patients having infracoronary implantation versus 17% of patients
      having root implantation. Nine patients had explantation of an aortic allograft
      (eight infracoronary and one root). Reasons for explantation were as follows:
      endocarditis (three infracoronary, one root), technical (three infracoronary),
      undiagnosed idiopathic hypertrophic subaortic stenosis (1 patient), and
      prolapsing infracoronary leaflet (1 patient). Actuarial freedom from grade 3 and
      4 aortic insufficiency or explantation was 77% at 7 years for infracoronary
      implantations. We conclude that the infracoronary aortic allograft has an
      unacceptable frequency of late insufficiency and its use in this position should
      be abandoned. The substantial incidence of late endocarditis in the infracoronary
      (free-hand) aortic allograft was surprising.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771818
TI  - Current role of surgery in Mycobacterium tuberculosis.
AB  - From January 1986 through December 1993, we operated on 59 patients with
      documented Mycobacterium tuberculosis infection. Indications for operation were
      as follows: multidrug-resistant tuberculosis (MDRTB) in 19 patients;
      bronchopleural fistula secondary to Mycobacterium tuberculosis infection in 12;
      massive hemoptysis in 5; destroyed lung in 7; solitary nodule in 7; trapped lung
      in 3; complicated cavity in 4; and empyema in 2. Sixty-five operative procedures
      were performed: pneumonectomy with latissimus muscle flap in 15 patients;
      pneumonectomy in 3; lobectomy in 16; segmental or wedge resection in 11;
      decortication in 5; window thoracostomy in 3; thoracoplasty with myoplasty in 4;
      tube thoracostomy in 4; return to operating room for bleeding in 2; Clagett
      procedure in 1; and drainage of a cold abscess in 1. There were no operative
      deaths. Major postoperative complications occurred in 5 patients. The two late
      deaths were in patients with MDRTB: 1 with progressive disease and massive
      hemoptysis and the other with a relapse of MDRTB. Of the patients operated on as
      part of their therapeutic regimen for MDRTB, 17 (89%) of 19 have remained culture
      negative. We conclude that (1) surgery still plays an important role in the
      management of patients with Mycobacterium tuberculosis infection; (2) surgical
      intervention can be performed with acceptable mortality and morbidity; (3) a
      variety of procedures are needed to effect cure; and (4) encouraging results in
      patients with MDRTB support surgical therapy in this difficult group of patients.

PMID- 7771819
TI  - Paraplegia after thoracotomy: report of five cases and review of the literature.
AB  - Paraplegia complicating thoracotomy is rare but catastrophic. This report
      comprises 40 cases: 5 of our cases and 35 reported cases. Our cases comprised a
      stab wound of the left chest (1), decortication (1), lobectomy for bronchogenic
      carcinoma (2), and segmental resection for tuberculosis (1). The reported cases
      included 25 cases following thoracotomy for thoracic pathology (bronchogenic
      carcinoma, 12; pulmonary tuberculosis, 7; thoracic trauma, 2; bronchiectasis, 1;
      peptic esophagitis, 1; neurogenic tumors, 2; and benign lung lesion, 1 and 10
      cases following operation for malignant hypertension. The surgical procedures
      performed on the 25 patients with thoracic pathology were lobectomy (8),
      bilobectomy (1), pneumonectomy (7), decortication (1), thoracoplasty (1),
      excision of neurogenic tumors (2), drainage of tuberculous cavity (1), and Nissen
      procedure (1). The intraoperative factors contributing to the neurologic deficit
      were bleeding at the costovertebral angle (9), migration of oxidized cellulose
      into spinal canal (9), thrombosis of anterior spinal artery (4), epidural
      hematoma (2), epidural narcotic (2), metastatic carcinoma (1), and hypotension
      (1). This serious complication can be prevented by meticulous operation and
      careful hemostasis. The immediate use of tomographic scanning or magnetic
      resonance imaging followed by surgical decompression might avert this serious
      complication.

PMID- 7771820
TI  - Experimental supplemental vein grafting and hypoperfusion syndrome.
AB  - An additional saphenous vein graft (SVG) sometimes is required to the same
      coronary system if acute internal thoracic artery (ITA) graft flow is inadequate.
      These experiments were conducted to determine the consequences produced by ITA
      SVG dual grafting. Fourteen dogs each received two coronary grafts (without
      bypass, using local occlusion) to the proximal circumflex coronary artery, using
      the ITA and an SVG, and then the circumflex artery was ligated proximally.
      Simultaneous flow in both grafts was determined at rest and after pharmacologic
      (adenosine, phenylephrine) or physiologic (cardiac pacing) stimulation. Serial
      angiography was performed during the first 4 weeks after grafting to determine
      patency patterns of the ITAs and SVGs. In the resting heart, flow was 7.5 +/- 1.6
      mL/min (17.5%) in the ITA graft and 35.3 +/- 5.2 mL/min (82.5%) in the SVG (mean
      +/- standard deviation [% total distal perfusion]), and the combined flow was not
      significantly different from the original native flow. Intravenous adenosine (0.2
      mg.kg-1.min-1) preferentially increased both the total ITA flow and its
      fractional contribution to total distal perfusion (18.4 +/- 3.2 [31.1%]; p < 0.05
      versus rest). Saphenous vein graft flow was not changed significantly (40.3 +/-
      6.0 mL/min), in part due to a modest decrease in arterial pressure. In contrast,
      intravenous phenylephrine (0.003 mg.kg-1.min-1) decreased both absolute ITA flow
      and its relative contribution to distal perfusion (6.1 +/- 1.1 [10.9%]; p < 0.05
      versus rest), despite an increased systemic perfusion pressure, which increased
      SVG flow significantly (50.1 +/- 4.8 [89.1%]; p < 0.05 versus rest).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7771821
TI  - Neurologic events after coronary bypass grafting: further observations with warm
      cardioplegia.
AB  - Warm heart surgery has documented myocardial protection benefit, but with an
      added neurologic threat. It is hypothesized that moderately hypothermic aerobic
      heart surgery will maintain the myocardial protection and reduce neurologic risk.
      This study compared 493 patients undergoing coronary artery bypass graft
      operations with normothermic (35 degrees to 37% degrees C) continuous blood
      cardioplegia and normothermic perfusion to 379 coronary artery bypass grafting
      patients with hypothermic (33 degrees to 29 degrees C) continuous blood
      cardioplegia and hypothermic perfusion to test this hypothesis. There was no
      difference in age, sex, prior myocardial infarction, hypertension, prior
      neurologic event, congestive failure, or diabetes. The hypothermic group had more
      reoperations (24% versus 14%; p = 0.0002), class III/IV angina (83% versus 71%; p
      = 0.002), a trend to more triple-vessel (54% versus 47%; p = 0.10) and left main
      disease (18% versus 14%; p = 0.10), lower ejection fractions (0.52 +/- 0.15
      versus 0.55 +/- 0.13), more grafts placed (3.6 +/- 1.1 versus 3.4 +/- 1.1; p =
      0.04), but fewer internal mammary arteries (62% versus 78%; p < 0.0001).
      Postoperative myocardial infarction rate was 1.2% in the hypothermic group and
      1.3% in the normothermic group (p = not significant). Intraaortic balloon pump
      requirement was 3.4% with hypothermic and 1.4% with normothermic groups (p =
      0.05). The incidence of postoperative neurologic events was significantly higher
      in the normothermic group (4.7% versus 1.8%; p = 0.038). The multivariate
      correlates of stroke were older age and normothermic cardioplegia, whereas the
      only multivariate correlate of death was older age.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7771822
TI  - Pharmacologic support with high-energy phosphate preservation in the postischemic
      neonatal heart.
AB  - Milrinone improves function in failing adult hearts. This study examined its
      effect on immature myocardium. Using an isolated working neonatal rabbit heart
      preparation, we measured myocardial function, high-energy compounds, and cyclic
      adenosine monophosphate. Hearts were subjected to 1 hour of normothermic
      ischemia, 10 minutes of reperfusion with Ringer's solution, and 30 minutes of
      reperfusion with either unaltered Ringer's, Ringer's with dobutamine (0.1
      microgram/mL), or Ringer's with milrinone (1 microgram/mL). These hearts were
      compared with each other, with a control group continuously perfused for 70
      minutes, and with a group of hearts that were made ischemic and reperfused for
      only 10 minutes. There was a progressive decline in adenosine triphosphate levels
      measured in hearts from the groups receiving 10 and 40 minutes of reperfusion
      with unaltered perfusate, and cardiac output fell to 82% +/- 4% of preischemic
      control in the latter group. When either dobutamine or milrinone was added to the
      reperfusion solution, postischemic myocardial function was restored completely,
      and the loss of adenosine triphosphate with reperfusion was halted. Cyclic
      adenosine monophosphate level was highest in ischemic/40-minute reperfused
      hearts, and there was no measurable increase in cyclic adenosine monophosphate
      level in the group of hearts receiving milrinone. The mechanism of preservation
      of high-energy stores with inotropic agents is not known but may involve
      potentiation of mitochondrial oxidative phosphorylation.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7771823
TI  - Effects of intracoronary calcium chloride on the postischemic heart in pigs.
AB  - Whether calcium chloride (CaCl2) should be used to reverse myocardial dysfunction
      during cardiac operations remains a controversial issue. Calcium chloride may
      reduce, rather than increase, myocardial contractility and may produce
      exaggerated vasoconstriction in postischemic vessels in which the endothelium has
      been damaged. These possibilities were investigated in an open-chest porcine
      model that allowed control of systemic hemodynamics. Incremental doses of CaCl2
      (1, 3, and 10 mg/min) were infused directly into a coronary artery before and
      after 10 or 15 minutes of ischemia followed by 15 minutes of reperfusion. Calcium
      chloride increased regional contraction, coronary blood flow, and oxygen
      consumption before ischemia, whereas oxygen and lactate extraction were
      unchanged. After ischemia and reperfusion, contraction was impaired and lactate
      extraction was reduced, but a similar response to CaCl2 was observed. Contraction
      returned to baseline values promptly after CaCl2. Thus, CaCl2 exerts a positive
      inotropic effect both in normal and in postischemic myocardium. Calcium chloride
      does not cause direct coronary constriction nor does it worsen myocardial
      stunning after a short period of normothermic myocardial ischemia.

PMID- 7771824
TI  - Does it make sense to use two internal thoracic arteries?
AB  - Retrospectively, the first 143 patients who were operated on with bilateral
      internal thoracic arteries (BITA group) were matched with 143 patients operated
      on with only one left internal thoracic artery anastomosed on the left anterior
      descending artery and additional vein grafts (LITA group) and followed up for a
      maximum of 8 years. At 5 years follow-up there were no significant differences in
      event-free survival between the groups. After 8 years, the overall survival was
      96% and 92% (not significant [NS]), cardiac survival 99% and 97% (NS), angina
      free cardiac survival 51% and 35% (NS), infarction-free cardiac survival 95% and
      78% (NS), reintervention-free cardiac survival 87% and 88% (NS), and all cardiac
      event-free survival 49% and 31% (NS) for the BITA and LITA groups, respectively.
      The incidence of late pulmonary, wound, and other complications was comparable.
      Cox proportional hazards analysis showed that a higher left ventricular end
      diastolic pressure and female sex were predictors of recurrent angina and late
      cardiac events. During this intermediate-term follow-up, the use of one or two
      internal thoracic arteries was of no value in predicting angina-free or cardiac
      event-free survival.

PMID- 7771825
TI  - Intrapulmonary reconstruction of pulmonary arteries using a heterologous
      pericardial roll.
AB  - Pulmonary artery reconstruction using a handmade heterologous pericardial roll
      was achieved in 5 patients with severe hypoplasia of the intrapericardial
      pulmonary arteries and in 9 patients with critical hilar pulmonary stenosis
      occurring subsequent to previous construction of a systemic-pulmonary shunt. The
      pericardial roll was 12 to 16 mm in diameter and was anastomosed to the pulmonary
      arteries through divided interlobar fissures. At the opposite end, it was fixed
      anteriorly to the chest wall and connected to a prosthetic tube so as to obtain a
      blood supply from the systemic circulation. The flow through the roll measured
      intraoperatively was 95 +/- 23 mL.kg-1.min-1. Postoperative catheterization
      showed that the mean pressure in the roll was 31 +/- 18 mm Hg. Eleven patients
      have subsequently undergone anatomic repair using an external conduit after 8 +/-
      4 months. There were no operative deaths, but 1 patient died of esophageal
      bleeding after the definitive intracardiac repair. We conclude that this
      technique is a feasible surgical option as a part of staged operations leading to
      biventricular repair.

PMID- 7771826
TI  - Repair of anomalous pulmonary venous connection to the superior vena cava.
AB  - Complex forms of anomalous pulmonary venous connection to the superior vena cava
      (SVC) can be difficult to correct surgically. Since 1987, 11 patients have
      undergone repair of anomalous pulmonary venous connection to the SVC by diversion
      of the pulmonary venous drainage to the left atrium using a baffle with division
      of the SVC and reimplantation on the right atrial appendage to restore normal
      systemic venous drainage. Total anomalous pulmonary venous connection was present
      in 3 patients and partial anomalous pulmonary venous connection, in 8. All
      patients are alive and asymptomatic at a mean follow-up of 2.3 +/- 1.4 years.
      Postoperative echo-cardiograms (8 patients) revealed pulmonary venous obstruction
      requiring reoperation in 1 patient. No patient has clinical evidence of SVC
      obstruction, and all are in sinus rhythm. This is a safe and effective technique
      for repair of complex forms of anomalous pulmonary venous connection to the SVC,
      and the incidence of postoperative venous obstruction and rhythm disturbances is
      low.

PMID- 7771827
TI  - Surgical management of tricuspid malinsertion in the Rastelli operation: conal
      flap method.
AB  - From June 1986 to May 1994, 25 patients underwent the Rastelli operation for
      complete transposition of the great arteries with ventricular septal defect and
      pulmonary stenosis or atresia. Fourteen patients whose tricuspid valve chordae
      were normal underwent the conventional Rastelli procedure (conventional group),
      whereas 11 patients who had tricuspid malinsertion into the infundibular septum
      underwent the Rastelli operation concomitant with mobilization of the
      infundibular septal flap, with the tricuspid valve chordae, to the right
      ventricular side of the intraventricular conduit (conal flap method) (conal flap
      group). In relation to the mobilization of the tricuspid valve chordae, right
      heart function and tricuspid regurgitation were compared between the two groups.
      There was one early death after the conventional Rastelli procedure and no early
      death after the Rastelli operation with a conal flap. There was one late death in
      the conventional group and two late deaths in the conal flap group. The mean
      follow-up was 50.8 +/- 5.1 months in the conventional group and 54.9 +/- 7.5
      months in the conal flap group (p = 0.43). Reoperation was necessary for 1
      patient in the conal flap group during follow-up. At the most recent follow-up,
      all patients in both groups were in New York Heart Association functional class
      I. Tricuspid regurgitation was estimated from the echocardiograms. Mild to
      moderate regurgitation was noted in 6 patients in the conventional group and 8 in
      the conal flap group. However, postoperative right heart catheterization data did
      not show any significant differences.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771828
TI  - Platelet activation in warm and cold heart surgery.
AB  - Recent studies suggest that patients undergoing warm heart surgical procedures
      have reduced postoperative bleeding. To determine if this is due to differences
      in platelet activation, we measured platelet membrane glycoproteins (GPIb,
      GPIIb/IIIa, GMP 140), platelet fragments, and platelet counts before, during, and
      after normothermic (37 degrees C) or hypothermic (28 degrees to 30 degrees C)
      cardiopulmonary bypass. Cardiopulmonary bypass was associated with a significant
      decrease in platelet count, platelet membrane GPIb, and platelet fragments, and
      an increase in GMP 140 (p < 0.05). Normothermic cardiopulmonary bypass induced an
      early significant increase in granulocytes, whereas this was delayed until after
      rewarming in the hypothermic group. Mean 24-hour postoperative blood loss was 786
      +/- 226 mL in the cold group versus 547 +/- 56 mL in the warm group (p = not
      significant). We conclude that cardiopulmonary bypass affects platelet activation
      and integrity and that these changes are similar in direction and magnitude for
      hypothermic and normothermic techniques.

PMID- 7771829
TI  - Primary pulmonary artery sarcoma: a report of six cases.
AB  - Pulmonary artery tumors are rare and a frequently overlooked cause of pulmonary
      artery occlusion. The presentation is one of progressive pulmonary dysfunction
      and right ventricular failure. The diagnosis seldom is made preoperatively. We
      report 6 cases of primary sarcoma of the pulmonary artery identified at
      operation, which were treated surgically. Resection with or without adjuvant
      therapy currently offers the only chance for survival. Emphasis must be placed on
      earlier identification of these tumors.

PMID- 7771830
TI  - Cardiovascular dynamics and dimensions after bicaval and standard cardiac
      transplantation.
AB  - Bicaval orthotopic cardiac transplantation leaving the right atrium intact has
      been introduced recently into clinical practice as an alternative to the standard
      method. To determine the effect of the surgical technique, 27 patients were
      studied at rest and supine exercise 19 +/- 5 months after bicaval orthotopic
      cardiac transplantation (group A, n = 15) and 22 +/- 7 months after standard
      orthotopic cardiac transplantation (group B, n = 12). Resting hemodynamics showed
      no difference between groups. With exercise, a significantly higher right atrial
      pressure was noted in group B. Echocardiographic analysis showed asynchronous
      right atrial contraction in 83% of group B patients versus none in group A.
      Resting right ventricular dimensions were significantly greater in group B (right
      ventricular end-diastolic diameter, 3.27 +/- 0.44 cm versus 2.88 +/- 0.35 cm [p <
      0.05]; right ventricular end-diastolic area, 21.3 +/- 2.85 cm2 versus 17.1 +/-
      2.01 cm2 [p < 0.005]). A higher incidence and significantly higher grade of
      tricuspid regurgitation were found throughout exercise in group B. The exercise
      duration (17.34 +/- 3.53 minutes versus 14.04 +/- 4.11 minutes [p < 0.05]) and
      the exercise capacity (1.17 +/- 0.25 W/kg versus 0.93 +/- 0.34 W/kg [p < 0.05])
      were increased in group A. These data provide some evidence that the bicaval
      technique of cardiac transplantation improves cardiovascular dynamics and
      dimensions as well as exercise capacity.

PMID- 7771831
TI  - Prospective evaluation of minimal blood use for ascending aorta and aortic arch
      operations.
AB  - The feasibility, safety, and impact on postoperative hospital stay of performing
      ascending aorta and aortic arch operations without homologous blood transfusions
      have not been evaluated. Sixty consecutive patients, 38 (63%) of whom also had
      aortic valve replacements and 17 (28%) of whom also had coronary artery bypass
      grafting, were evaluated for participation in blood conservation measures. Of the
      45 who were able to use blood conservation techniques, 87% (39/45) required no
      intraoperative and 69% (31/45) required no in-hospital homologous blood
      transfusions. The 30-day survival rate was 98.3% (59/60), and no patient
      sustained a new stroke, neurologic cognitive deficit, or infection. Multivariate
      analysis of the 60 patients showed that the predictors of in-hospital homologous
      transfusion were (p < 0.05) age, cardiopulmonary bypass time, and postoperative
      chest tube drainage. Preoperative autologous blood donation was associated with a
      significantly lower risk of homologous transfusion (p = 0.0006). Indeed, patients
      participating in blood conservation techniques had a significantly (p < 0.05)
      lower incidence of homologous transfusions, required less intraoperative shed
      blood washing, were extubated earlier, gained less weight, had shorter hospital
      stays, and were discharged in a better dyspnea functional class. Most major
      elective cardiovascular operations on the ascending aorta and aortic arch can be
      safely performed without homologous transfusions.

PMID- 7771832
TI  - Reoperation in patients with closed SVG and patient LITA-LAD graft: T-graft
      approach.
AB  - Selection of the bypass graft that the patient has demonstrated will remain
      patent and free from critical atherosclerosis is a most important part of
      coronary artery bypass reoperations. Sixteen patients in whom a patent left
      internal thoracic artery-left anterior descending coronary artery bypass graft
      and obstructed or closed saphenous vein grafts to other coronary arteries were
      visualized underwent reoperation. To reach the inadequately perfused circumflex
      and right coronary arteries, the right internal thoracic artery was anastomosed
      to the left internal thoracic artery as a T graft and then was attached to the
      circumflex and right coronary artery branches. All patients survived the
      procedure and are free from angina. There were no perioperative myocardial
      infarctions, and there was no suggestion of hypoperfusion by the grafts. We
      believe this technique may reduce the incidence of graft failure in patients
      undergoing reoperative coronary artery bypass grafting.

PMID- 7771833
TI  - Improved lung function by urokinase infusion in canine lung transplantation using
      non-heart-beating donors.
AB  - We evaluated the effect of urokinase on pulmonary microthrombi formation of the
      donor lung using a canine cadaver left lung allotransplantation model. Donor
      animals were sacrificed with an intravenous injection of potassium chloride
      without heparinization and were divided into three groups. In group 1 (n = 6),
      cadavers were left at room temperature for 1 hour, and lung retrieval was then
      performed after flushing the lung block with low potassium-dextran-glucose
      solution. Donor lungs were stored for 3 hours at 8 degrees C. In group 2 (n = 6),
      donor lungs were treated as in group 1 except that the cadavers were left at room
      temperature for 2 hours instead of 1 hour before lung retrieval. In group 3 (n =
      6), donor lungs were treated as in group 2 except that high-dose urokinase
      (120,000 IU) was injected into the main pulmonary artery after flushing with low
      potassium-dextrose-glucose solution. In all groups after left lung
      transplantation, the right pulmonary artery was ligated, and recipient animals
      were followed up for 6 hours after reperfusion. The fibrin degradation product
      level in the donor lung tissue was also measured. All recipient animals in group
      1 survived the 6-hour observation period with excellent gas exchange and stable
      hemodynamics. Group 3 had significantly better gas exchange than group 2 and
      similar cardiopulmonary function as group 1. The fibrin degradation product level
      in the donor lungs before transplantation was significantly higher in group 3
      than in group 2.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771834
TI  - Pretreatment with antioxidants and allopurinol diminishes cardiac onset events in
      coronary artery bypass grafting.
AB  - Oxygen-derived free radicals constitute one part of the etiologic factors for
      cardiac onset harmful events. Allopurinol is able to reduce the generation of
      free radicals. Vitamins E and C scavenge radicals after their formation. Eighty
      one patients with coronary artery disease were randomized into four study groups:
      Group 1 (n = 20) patients had stable disease and received oral vitamin E for 4
      weeks, and vitamin C and allopurinol 2 days before and 1 day after coronary
      artery bypass grafting. Group 2 (n = 25) consisted of their controls. Group 3
      patients (n = 17) had more unstable disease and received the same medications as
      group 1, except that vitamin E was given only 2 days before the operation. Group
      4 (n = 19) was their controls. Groups 1 and 3 had fewer ischemic
      electrocardiographic events and required less dopamine perioperatively than
      corresponding control groups 2 and 4. Group 3 had fewer perioperative infarctions
      and less creatine kinase-MB release than the respective controls (group 4).
      Plasma levels of vitamins E and C, urate, and total free radical trapping ability
      were considered to support the theory about the role of free radicals in
      reperfusion injury. Especially the unstable patients, but also patients with
      stable coronary artery disease requiring coronary artery bypass grafting benefit
      from perioperative allopurinol and vitamin E and C treatment.

PMID- 7771835
TI  - Traumatic tricuspid valve rupture with luxation of the heart.
AB  - Three patients are described with the combination of a luxation of the heart
      through a pericardial tear and traumatic rupture of the papillary muscle of the
      tricuspid valve. In only 1 patient was the dislocation of the heart suspected
      preoperatively. In all 3 patients operative treatment was performed with
      considerable delay after the accident; nevertheless, all 3 patients survived. In
      all cases treatment consisted of repositioning of the heart, closure of the
      pericardium, and valvular repair of the tricuspid valve.

PMID- 7771836
TI  - Clinical significance of reverse redistribution phenomenon after coronary artery
      bypass grafting.
AB  - The reverse redistribution (RR) phenomenon is a decrease in thallium 201 uptake
      during redistribution compared with 201Tl uptake immediately after exercise. We
      evaluated RR in 23 patients after coronary artery bypass grafting. Postoperative
      RR was present in 48% and was significantly more common in patients with a
      history of myocardial infarction (62%). The patients were classified according to
      the presence (+) or absence (-) of RR. An analysis of left ventricular wall
      motion showed significant improvement after coronary artery bypass grafting in
      the RR+ group (n = 12) but not in the RR- group (n = 11). Quantitative myocardial
      viability was evaluated using the defect volume ratio, mean defect severity, and
      defect severity index. The preoperative defect volume ratio was higher in the RR+
      group than in the RR- group (p < 0.05). In the RR- group, no improvement in these
      indices was observed after operation. In contrast, the RR+ group showed
      significant improvement in all three indices (p < 0.05). These results indicate
      that after coronary artery bypass grafting, an adequate blood supply to the
      remaining myocardium may induce RR. This phenomenon, therefore, may be a
      significant indicator of postoperative myocardial viability.

PMID- 7771837
TI  - Differing protection with aspartate and glutamate cardioplegia in the isolated
      rat heart.
AB  - Aspartate and glutamate each have been shown to improve cardiac recovery after
      hypoxia or ischemia under normothermic conditions, but whether their effects are
      additive and to what extent they are modified by hypothermia has not been studied
      systematically. We set out to compare the individual and combined protective
      effects of aspartate and glutamate during cardioplegic arrest under normothermic
      and hypothermic conditions in the rat. Using isolated working rat hearts,
      functional and metabolic recovery was assessed after 0.5 hours of potassium
      arrest at 37 degrees C or 5 hours at 2 degrees C in control hearts (C) and in
      hearts in which 20 mmol/L glutamate (G), 20 mmol/L aspartate (A), or both (A + G)
      was added to the cardioplegic solution. Under normothermic conditions, percentage
      recovery of prearrest work (mean +/- standard error of the mean) was as follows:
      C = 31.7 +/- 2.8, G = 34.8 +/- 0.2, A = 49.6 +/- 2.8*, A + G = 53.7 +/- 2.3*.
      Under hypothermic conditions, the values were as follows: C = 40.4 +/- 4.0, G =
      45.2 +/- 2.3, A = 59.4 +/- 1.8*, A + G = 54.1 +/- 1.2* (*p < 0.01 versus C and
      G). Recovery of postischemic high-energy phosphate content followed the same
      pattern: A = A + G > G or C. Measurement of postischemic myocardial content of
      amino acids showed that recovery of function and energy status correlated with
      maintenance of myocardial levels of aspartate (r = 0.9; p < 0.01) but not
      glutamate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771839
TI  - Patency of an internal thoracic artery graft despite maximal competitive flow.
AB  - Recent evidence has suggested that competitive flow is an important factor in
      early graft failure. In this case report an internal thoracic artery graft was
      used to revascularize an acute coronary artery dissection after balloon
      angioplasty. Subsequent angiography 4 months later showed complete healing of the
      dissection, yet the internal thoracic artery graft remained widely patent in
      spite of the maximal competitive flow from the native coronary artery. This
      concurs with experimental results recently reported in The Annals regarding the
      physiologic adaptability of the internal thoracic artery graft to suit flow
      requirements and its versatility as the conduit of choice.

PMID- 7771838
TI  - Systemic blood activation with open and closed venous reservoirs.
AB  - In 20 patients undergoing coronary artery bypass grafting, we studied
      prospectively systemic blood activation, blood loss, and the need for donor blood
      when using an extracorporeal circuit equipped at random with one of two different
      venous reservoirs. In 10 patients we used an open venous reservoir system (ORS)
      consisting of a hard shell venous reservoir with an integral cardiotomy filter,
      and in 10 patients we used a closed reservoir system consisting of a collapsible
      venous reservoir and separate cardiotomy reservoir. Concentrations of complement
      3a, elastase, thromboxane B2, and fibrin degradation products showed a biphasic
      course, especially in ORS patients. During bypass, we observed a first peak of
      levels of complement 3a, thromboxane B2, fibrin degradation products, and
      elastase, which was higher in ORS patients than in patients with the closed
      system, because their blood continuously contacted the foreign materials of the
      filter and air in the open reservoir, which was avoided in the closed reservoir.
      Intensive blood-foreign material contact also caused the highest (p < 0.05)
      hemolysis in ORS patients. The larger amount of hemolytic products in ORS
      patients theoretically resulted in a temporary decrease in capacity of their
      Kupffer cells to clear endotoxin released after aortic declamping. This theory
      might explain the significantly (p < 0.01) higher second peak of activated
      products after declamping that was observed in ORS patients. Due to increased
      blood activation, the largest (p < 0.001) amount of shed blood loss, greatest (p
      < 0.05) need for colloid-crystalloid infusion, and largest (not significant) need
      for donor blood were found in ORS patients (0.8 +/- 0.4 versus 0.2 +/- 0.2 units
      of packed cells).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771840
TI  - Successful heart transplantation with acquired pulmonary artery atresia.
AB  - Orthotopic cardiac transplantation was performed successfully in a patient with
      acquired atresia of the left pulmonary artery 19 years after repair of tetralogy
      of Fallot. Only the right lung could be incorporated into the cardiopulmonary
      circulation at transplantation, resulting in transient right ventricular
      dysfunction, which resolved with vasodilator therapy. Perfusion of a single
      pulmonary vascular bed does not preclude successful heart transplantation,
      provided there is a low pulmonary vascular resistance and pulmonary artery
      architecture free of stenoses.

PMID- 7771842
TI  - Multiple aneurysms of the internal thoracic artery.
AB  - Nontraumatic aneurysms of the internal thoracic artery are rare. We report a case
      where multiple aneurysms of the right internal thoracic artery presented as an
      asymptomatic density on the chest radiograph. Operative findings and pathology
      are reviewed.

PMID- 7771841
TI  - Surgical treatment of impending paradoxical embolism through patent foramen
      ovale.
AB  - We describe the case of a patient with deep venous thrombosis who had cerebral
      and extremity paradoxical emboli and an intracardiac thrombus crossing a patent
      foramen ovale identified by echocardiography. He was treated successfully with
      immediate intracardiac embolectomy and closure of the patent foramen ovale.

PMID- 7771843
TI  - Aortopulmonary fistula: an uncommon complication in dystrophic aortic aneurysm.
AB  - Wall dissection is a typical complication in the evolution of Marfan aortic
      aneurysm and usually is associated with valve regurgitation. Formation of a
      fistula with adjacent structures is very uncommon. We report the case of a 32
      year-old man who presented with the typical features of Marfan's syndrome, with
      chronic aneurysm of the ascending aorta and acute aortopulmonary fistula.
      Diagnosis was made preoperatively by aortography; operation was performed
      successfully. A review of the literature only shows a few cases of aortopulmonary
      fistula in atherosclerotic, syphilitic, or postendocarditis disease.

PMID- 7771844
TI  - Donor-acquired fat embolism causing primary organ failure after lung
      transplantation.
AB  - Technically successful bilateral sequential lung transplantation in a 40-year-old
      man was complicated by the immediate development of pulmonary edema on
      reperfusion of the allograft. Death resulted within 12 hours and was caused by
      the fat embolism syndrome confirmed on premortem open-lung biopsy. The donor had
      satisfied current selection criteria but had sustained a femoral and multiple rib
      fractures. This case highlights the potential risks of transplanting lungs from
      traumatic donors and the deficiencies in current methods of donor assessment.

PMID- 7771845
TI  - Complete myocardial revascularization through a right thoracotomy.
AB  - We report the case of a 57-year-old woman who benefited from a complete
      revascularization of the heart, including a circumflex marginal coronary bypass
      grafting, through a right thoracotomy. This approach avoids sternal wound
      complications that can occur after high-dose mediastinal radiotherapy and omental
      flap reconstruction on the sternum.

PMID- 7771846
TI  - Pedicled jejunal seromuscular flap for bronchocutaneous fistula.
AB  - We report the successful closure of a complicated bronchocutaneous fistula using
      a pedicled jejunal flap. The fistula, secondary to tuberculosis and irradiation,
      previously had been closed with a latissimus dorsi musculocutaneous flap. This
      initial repair failed. The recurrent fistulas were closed again using a jejunal
      seromuscular flap, and the chest wall defect was reconstructed with a rectus
      abdominis musculocutaneous flap.

PMID- 7771847
TI  - CABG in calcified aorta under circulatory arrest.
AB  - Coronary artery bypass grafting in patients with calcified aorta presents a
      formidable problem in terms of cannulation and proximal anastomosis with its
      attending risks of cerebral and peripheral embolism. Coronary artery bypass
      grafting without cross-clamping and proximal anastomosis to the aorta at a soft
      spot under circulatory arrest may be a simple and safe alternative to a difficult
      clinical problem.

PMID- 7771848
TI  - Hemolytic anemia secondary to a porcine mitral prosthetic valve leaflet
      dissection.
AB  - This is a case of a dissecting cusp of a mitral porcine xenograft causing severe
      hemolytic anemia in the absence of valvular dysfunction and regurgitation. Six
      months after valve replacement, the patient had no evidence of hemolytic anemia.
      A cuspal dissection between the atrial and ventricular membranes was found on
      histologic evaluation.

PMID- 7771849
TI  - Arterial switch and resection of hepatic hemangioendothelioma.
AB  - We report on the management of a neonate undergoing arterial switch for
      transposition of the great arteries and concomitant resection of a hepatic
      infantile hemangioendothelioma. A preoperative aortogram demonstrated the
      arterial supply of the hepatic hemangioendothelioma. Pulmonary artery
      hypertension and myocardial ischemia were noted after separation from
      cardiopulmonary bypass. Resection of the hepatic malformation produced an
      immediate reduction in pulmonary hypertension and resolution of the myocardial
      ischemia. The patient had an uneventful postoperative recovery.

PMID- 7771850
TI  - Electron beam computed tomography: use in pulmonary embolectomy.
AB  - Proximal chronic pulmonary emboli with severe pulmonary hypertension were
      diagnosed by electron-beam computed tomography and Doppler echocardiography.
      After successful embolectomy, repeat examinations showed normal pulmonary artery
      pressures and patency. Electron beam computed tomography can noninvasively
      identify surgically treatable pulmonary emboli.

PMID- 7771851
TI  - Intercostal lung hernia subsequent to harvesting of the left internal mammary
      artery.
AB  - We report a case of an intercostal lung hernia developing subsequent to
      harvesting of the left internal mammary artery. Intercostal lung hernia is
      extremely rare, with most cases reported after blunt thoracic trauma. In the
      absence of symptoms, this was treated conservatively.

PMID- 7771852
TI  - Lung reduction as bridge to lung transplantation in pulmonary emphysema.
AB  - We present a case of bridging to lung transplantation by means of laser ablation
      of emphysematous bullae in a lung transplant candidate. The patient underwent
      successful left single-lung transplantation 17 months after lung reduction. He is
      now well 3 months after transplantation.

PMID- 7771853
TI  - Primary amyloidoma of the chest wall.
AB  - Primary amyloidoma of the chest wall presents as an aggressive tumor that causes
      local destruction. It is best treated with wide local excision and reconstruction
      as required, which usually is curative. A search for occult systemic disease also
      is recommended.

PMID- 7771854
TI  - Thoracoscopic excision of a malignant schwannoma of the intrathoracic vagus
      nerve.
AB  - Malignant schwannomas of the intrathoracic vagus nerve are rare tumors. A patient
      underwent resection of a mediastinal malignant schwannoma of the vagus nerve
      using video-assisted thoracoscopy, with no recurrence at 18 months.

PMID- 7771855
TI  - Sinus venosus defect: single-patch repair with caval enlargement.
AB  - We present a single pericardial patch repair of the sinus venosus defect with
      anomalously connected pulmonary veins, incorporating enlargement of the superior
      vena cava. In our small series to date this procedure has been carried out
      without morbidity or mortality. Noninvasive follow-up by echocardiography and
      electrocardiography, over the short term, has not detected any stenosis of the
      venous pathways or sinus node dysfunction.

PMID- 7771856
TI  - Surgical technique and application of pericardial fat pad and pericardiophrenic
      grafts.
AB  - Oncologic developments in stage IIIA lung cancer and complex tracheal
      reconstruction have renewed interest in bronchial stump and tracheal coverage.
      The surgical techniques to mobilize and apply pericardial fat pad and
      pericardiophrenic grafts are discussed.

PMID- 7771857
TI  - Simplified technique of heart-lung transplantation.
AB  - Well-known complications of heart-lung transplantation include mediastinal
      bleeding and phrenic nerve injury. Conventional technique places the hila behind
      the phrenic nerves. We have placed the hila in front of the phrenic nerve in our
      last 10 patients, using direct caval anastomoses when feasible. This minimizes
      traction on and dissection around the phrenic nerves, and allows anterior
      rotation of the heart-lung block for easier hemostasis of the posterior
      mediastinum after implantation.

PMID- 7771858
TI  - Pressure-induced arterial wall stress and atherosclerosis.
AB  - We present the hypothesis that high wall stress and accompanying stretch,
      particularly that caused by arterial pressure, are the primary factors
      responsible for the topography of atherosclerotic lesions. In our view the
      pattern in the localization of atherosclerotic lesions indicates that the artery
      behaves as both a pressure vessel and a conduit of blood flow. The phenomenon of
      "stress concentration" in the artery wall is described and the area of pressure
      induced high stress is related to the sites of atherosclerotic plaques. Data are
      presented indicating that reduction of pressure-induced stress may lead to
      absence of atherosclerotic changes. The proposed mechanism explains the
      prevalence of atherosclerotic lesions at the ostia of major arterial branches, at
      the aortic bifurcation, at the carotid bifurcation, and in the descending
      thoracic aorta, and also explains the absence of atherosclerosis in the
      intramyocardial coronary arteries and in the intraosseal portions of the
      vertebral vessels and why a reduction in heart rate, blood pressure, or wall
      stress by external support reduces the occurrence of atherosclerosis. The effect
      of wall stress and stretch on atherosclerosis could be mediated by the
      endothelial cells, the smooth muscle cells, and the penetration of low-density
      lipoproteins. The comprehensive presentation made in this article could lead to a
      better understanding of atherosclerosis, its treatment, and its prevention.

PMID- 7771859
TI  - Achalasia and squamous cell carcinoma of the esophagus: analysis of 241 patients.
AB  - Achalasia of the esophagus is presumed by many to be a premalignant lesion
      leading to an increased risk of squamous cell carcinoma. There is disagreement,
      however, as to the precise risk of malignant degeneration and there is no
      consensus as to either the need for close surveillance of achalasia patients or
      the surveillance technique that should be employed. A review of the available
      literature on the subject has disclosed a wide range of reported cancer risks in
      achalasia patients, from zero to 33 times that of the normal population. Cancers,
      when discovered, are often unresectable and the median survival when they are
      resectable is low. A personal experience with 241 achalasia patients treated
      during the past quarter of a century disclosed that 9 had carcinoma, for a
      prevalence of 3.7%. Carcinoma developed in 3 of these 9 while they were under our
      observation. This translates into one cancer per 1,138 patient-years of follow
      up, an incidence of 88 per 100,000 population, and a risk 14.5 times that of the
      age-adjusted and sex-adjusted general population. Because of the low
      postresection survival rate if treatment is delayed until carcinoma of the
      esophagus becomes symptomatic, closer surveillance of achalasia patients is
      recommended than has been the case. Because it seems unlikely that close
      endoscopic surveillance will prove to be cost-effective, periodic (every 2 to 3
      years) blind brush biopsy warrants further study as a means of surveillance.

PMID- 7771860
TI  - 1988: unilateral high-frequency jet ventilation during one-lung ventilation for
      thoracotomy. Updated in 1995.
AB  - One-lung ventilation is indicated during thoracic operations for bronchopleural
      fistula, pulmonary abscess, and pulmonary hemorrhage in spite of the possibility
      of the development of severe hypoxemia. To evaluate methods for improving oxygen
      transport during one-lung ventilation, we applied high-frequency jet ventilation
      (HFJV) and continuous positive airway pressure (CPAP) to the nondependent lung
      following deflation to atmospheric pressure in each procedure, and measured the
      effects on cardiac output and arterial oxygenation. In each case, the dependent
      lung was ventilated with conventional intermittent positive pressure ventilation
      (IPPV). Eight patients were studied during posterolateral thoracotomy using
      double-lumen endobronchial tubes. HFJV or CPAP to the nondependent lung improved
      arterial oxygenation significantly during both closed and open stages of the
      surgical procedures (p < 0.008). When the chest was open, HFJV maintained
      satisfactory cardiac output, whereas CPAP usually decreased cardiac output (p <
      0.008). There were no significant differences in mean partial pressure of
      arterial carbon dioxide between HFJV, CPAP, and deflation to atmospheric
      pressure. In conclusion, HFJV to the nondependent lung provides not only
      satisfactory oxygenation but also good cardiac output, thereby maintaining better
      oxygen transport than CPAP or deflation to atmospheric pressure, while the
      dependent lung is ventilated with IPPV during one-lung ventilation for
      thoracotomy.

PMID- 7771861
TI  - 1988: use of a Bayesian statistical model for risk assessment in coronary artery
      surgery. Updated in 1995.
AB  - A computerized statistical model based on the theorem of Bayes was developed to
      predict mortality after coronary artery bypass grafting. From January, 1984, to
      April, 1987, at our hospital, 700 patients underwent isolated coronary artery
      bypass grafting. The presence or absence of 20 risk factors was determined for
      each patient. The first 300 patients formed the initial database of the Bayesian
      predictive model, and the remaining 400 patients were prospectively evaluated in
      four groups of 100 each. Each group was prospectively evaluated and then
      incorporated into the database to update the model. There was good agreement
      between predicted and observed results. Bayesian theory is particularly suited to
      this task because it (1) accommodates multiple risk factors, (2) is tailored to
      one's specific practice, (3) determines individual, rather than group, prognosis,
      and (4) can be updated with time to compensate for a changing patient population.
      These flexible attributes are especially valuable in light of recent changes in
      the coronary artery bypass graft patient profile.

PMID- 7771862
TI  - Practice guidelines in cardiothoracic surgery. Ad Hoc Committee for
      Cardiothoracic Surgical Practice Guidelines.

PMID- 7771863
TI  - Thoracic Surgery Directors Association: 1994 in review.

PMID- 7771864
TI  - Closed mitral valvotomy: TEE probe or tactile control.

PMID- 7771865
TI  - A few issues involving the maze procedure.

PMID- 7771866
TI  - Intraoperative hematocrit and viscosity do not correlate with postoperative white
      blood cell count.

PMID- 7771867
TI  - Dissection with double arch.

PMID- 7771868
TI  - Balloon occlusion of the aortic valve for antegrade continuous warm blood
      cardioplegia.

PMID- 7771870
TI  - [Cooperative survey of the results of coronary surgery during cardiac
      rehabilitation].
AB  - The aim of this study was to assess the type and frequency of cardiac and
      extracardiac complications of coronary artery surgery in patients referred for
      cardiac rehabilitation (for which it is one of the principal indications): this
      was a prospective study carried out simultaneously in 30 cardiac rehabilitation
      units during December 1992 and including 533 patients (81 women, 452 men) with a
      mean age of 62.1 years. The total number of coronary grafts was 1,361 (on average
      2.5 per patient); the internal mammary artery was used in 87% of cases;
      revascularisation was complete in 66.4% of patients. One or more complications
      were observed in 79% of patients during the hospital period (68.9%) and/or during
      the rehabilitation phase (44.7%), independently of age, sex, duration of
      cardiopulmonary bypass, or the interval to cardiac rehabilitation. The main
      extracardiac complications were respiratory (31.5%), disturbances of cerebral
      function (15.6%) and renal failure (10.3%). Cardiac complications comprised
      arrhythmias, essentially supraventricular (21.3%), infarction and residual
      postoperative ischaemia (8.4%), large pericardial effusion (7.5%), cardiac
      failure (4.5%), and wound infection (4.3% including 2.8% mediastinitis). Anaemia,
      a secondary effect of cardiopulmonary bypass, was observed in 25% of patients.
      This prospective study, though affected by a bias of selection and not fully
      representative of the surgical outcome, shows the need for a personalised
      management of these patients, the early indication of cardiovascular
      rehabilitation contributing to the optimisation of coronary artery surgery at
      less cost and with improved safety.

PMID- 7771869
TI  - Vladimir Demikhov.

PMID- 7771871
TI  - [Is the quantification of mitral valve involvement by transesophageal echography
      useful before percutaneous mitral commissurotomy?].
AB  - The aims of this study were to determine the value of quantifying mitral valve
      disease by transoesophageal echocardiography before percutaneous mitral
      commissurotomy (PMC) and to analyse the incidence of embolic complications during
      PMC since the introduction of transoesophageal echocardiography. From March 1987
      to December 1991, 317 patients with pure or dominant mitral stenosis were
      selected by Doppler echocardiography to undergo PMC at the Montreal Institute of
      Cardiology. The clinical features of the first 138 patients (Group I) were the
      same as those of the last 179 patients (Group 2) who also underwent routine
      transoesophageal echocardiography the day before the procedure. A thrombus in the
      left atrial appendage was observed in 8 patients in Group 2 (4.4%). No embolic
      complications have occurred since the protocol was changed to include routine
      transoesophageal echocardiography, whereas 4 embolic episodes, 3 of which were
      fatal, occurred in patients in group 1. The indication of PMC was turned down
      because of angiographically severe mitral regurgitation which was underestimated
      by transthoracic echocardiography in 2 patients in Group 1 (1.4%) and in 3
      patients in group 2 (1.6%). The mobility, thickness and degree of calcification
      of the valves were attributed a score from 0-4 at transthoracic and
      transoesophageal echocardiography. No difference was observed in the scores of
      mobility (2.3 +/- 0.5 versus 2.3 +/- 0.05, NS) or valve thickness (2.1 +/- 0.4
      versus 2.1 +/- 0.4, NS).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771872
TI  - [The exercise-recovery loop and exercise slope of ST segment changes/heart rate
      in the diagnosis of coronary disease and restenosis after angioplasty].
AB  - This study addresses the diagnostic value of two new criteria of exercise stress
      testing for primary coronary artery disease and restenosis after angioplasty: the
      slope of the linear relation between ST segment changes and heart rate during
      exercise; the exercise-recovery loop (clockwise direction in normal subjects and
      anticlockwise direction in coronary patients). These two criteria were compared
      with the standard diagnostic criteria (horizontal or descending ST segment
      depression greater than 1 mm or ascending ST segment depression greater than 2
      mm) in 125 patients with suspected coronary artery disease who underwent
      computerised exercise stress testing and coronary angiography (30 single, 31
      double and 30 triple vessel disease; 34 without significant stenosis) and in 24
      patients with single vessel disease who underwent successful angioplasty and who
      performed exercise stress testing before, immediately after and 6 months after
      angioplasty before routine control coronary angiography. The sensitivity (Se),
      specificity (Sp), positive predictive value (PPV) of the exercise-recovery loop
      for the diagnosis of coronary disease were 81 %, 82 %, 89 %, respectively, versus
      69 %, 71 % and 88 % for the standard criteria. The detection of restenosis by
      these criteria also appeared to be better (71 %, 91% and 91 % versus 46 %, 63 %
      and 60 %, respectively). However, for the classical threshold value of 2.4
      mv/beat/min, the ST/HR criteria seemed to be less useful (Se : 80 %, Sp : 26 %).

PMID- 7771873
TI  - [Production of oxygen free radicals in myocardial infarction treated by
      thrombolysis. Analysis of glutathione peroxidase, superoxide dismutase and
      malondialdehyde].
AB  - Many enzyme systems such as glutathione peroxidase (GPx) or superoxide dismutase
      (SOD) neutralise the oxygen derived free radicals produced during myocardial
      reperfusion by thrombolysis. Erythrocytic SOD, plasma and erythrocytic GPx and
      their cofactor selenium, substances reacting with thiobarbituric acid (TBARS)
      were analysed by repeated sampling between T0 and 48 hours in 24 patients treated
      by thrombolysis for acute myocardial infarction. Angiographic control was
      undertaken systematically between 60 and 180 minutes after initiating
      thrombolytic therapy: 18 patients had a patent vessel and 6 patients had an
      occluded vessel recanalised in 5 cases by angioplasty. Biological analysis was
      performed in the 23 patients successfully revascularised by thrombolysis,
      eventually completed by angioplasty. The plasma GPx decreased non-significantly
      between T0 and 2 hours from 246.8 +/- 53.3 to 233 +/- 39 U/ml with a significant
      increase between 2 and 48 hours from 233 +/- 39.2 to 294 +/- 76 U/ml, whereas the
      erythrocytic GPx rose significantly and constantly between T0 and 48 hours from
      34.8 +/- 7.1 to 37.6 +/- 7.5 U/gHb with significant consumption of selenium
      between T0 and 4 hours from 81.2 +/- 14 to 68.5 +/- 12.6 micrograms/l. The
      erythrocytic SOD increased significantly between T0 and 48 hours from 318.9 +/-
      40.8 to 337 +/- 59 U/gHb. Finally, the analysis of plasma TBARS showed a non
      significant rise between T0 and 30 minutes from 1.59 +/- 0.30 to 1.71 +/- 1.43
      mm/l with a return to the basic line values after about 2 hours. These results
      show a significant increase in the activity of enzymes protecting against the
      liberation of oxygen free radicals, such as erythrocyte or plasma GPx and
      erythrocyte SOD between T0 and 48 hours with consumption of selenium, cofactor of
      GPx, and an increase in circulating lipid peroxydes in acute myocardial
      infarction treated by thrombolysis. They also illustrate the oxidative stress
      which occurs in this situation.

PMID- 7771874
TI  - [Changes in heart rate after ventricular stimulation; correlations with vagal
      tone].
AB  - The authors report a new method of studying the autonomic nervous system,
      especially vagal tone, during endocavitary electrophysiological studies. After
      termination of fixed ventricular pacing at incremental rates to 200/min, an
      initial acceleration of the heart rate is observed followed about 5 seconds later
      by a sudden slowing. This phenomenon was studied in 278 patients. Ninety seven
      patients had no cardiac disease: the variation in heart rate was 33 +/- 18%. In
      the 181 other patients with cardiac disease (ejection fraction 35 +/- 16%) the
      variation was only 21 +/- 16% (p < 0.01). When the ejection fraction was less
      than 30%, the variation was only 13 +/- 4%. When the heart rate variation was
      less than 10%, the prognosis was poor because, of the 48 patients with this sign,
      13 died, whereas there were only 2 deaths in the 133 other patients with cardiac
      disease and preserved adaptation. In 14 patients without cardiac disease the
      injection of 2 mg of atropine suppressed all adaptation of the heart rate, whilst
      in 18 other patients, oral betablockers reduced the variation but it persisted to
      a significant degree. The authors conclude that the adaptation of the heart rate
      after rapid ventricular stimulation is probably a reflection of vagal tone and
      may be used to assess the prognosis of subjects undergoing electrophysiological
      investigations.

PMID- 7771875
TI  - [Influence of gender and size on parameters measured by signal-averaged
      electrocardiography in healthy subjects: preliminary study].
AB  - The aim of this study was to determine the influence of electrocardiographic and
      biomorphometric factors on the parameters measured by signal averaged
      electrocardiography (SA-ECG) in normal subjects. The study population comprised
      40 Caucasian students (20 men, 20 women). The SA-ECG measured 6 parameters: total
      duration of the averaged QRS, the root mean square of the voltage of the last 40
      ms of the QRS (RMS 40) and the length duration of the terminal signal of under 40
      microV (LAS), each parameter being measured with a band pass filter of 25 and 40
      Hz. The echocardiographic recording included measurement of 12 parameters
      including left ventricular mass and ventricular volumes. Five morphological
      parameters were measured, including height, weight and body surface area. The
      duration of QRS measured with a 25 Hz band pass filter was significantly longer
      by 9.7 ms in men than in women (102.9 +/- 8.5 ms versus 93.2 +/- 8.1 ms; p <
      0.001). Similarly, QRS duration measured with the 40 Hz band pass filter was
      longer in men by 11.4 ms than in women (102.1 +/- 9.6 ms versus 90.7 +/- 7.5 ms;
      p < 0.001). Multiple linear regression analyses showed that in both men and
      women, the duration of the QRS measured with either a 25 or 40 Hz band pass
      filter was correlated to size: the taller the subject, the longer the QRS
      duration. A negative correlation was observed between size and RMS 40 measured
      with both 25 and 40 Hz band pass filters: the taller the subject, the smaller the
      value of RMS 40.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771876
TI  - [Value of permanent cardiac pacing in hypertrophic and obstructive
      cardiomyopathies resistant to medical treatment].
AB  - The authors report their experience of long-term dual-chamber pacing in the
      treatment of hypertrophic and obstructive cardiomyopathy. Between August 1990 and
      March 1993, 16 patients (8 men, average age 53.5 +/- 18.9 years, range 21 and 79
      years) with symptomatic hypertrophic obstructive cardiomyopathy resistant to
      medical therapy underwent electrophysiological investigation to assess
      atrioventricular conduction and the effects of temporary atrioventricular pacing
      on the intraventricular pressure gradient before implantation of a dual-chamber
      pacing system. The decision to implant was taken if the endocavitary studies
      showed severe atrioventricular conduction defects and/or if temporary pacing
      reduced the systolic pressure gradient by more than 30%. Temporary dual-chamber
      pacing led to a decrease of 48% of the systolic pressure gradient from 78.6 +/-
      21.3 to 40.1 +/- 23.6 mmHg (p < 0.0005), a regression observed in 15 of the 16
      patients. After an average follow-up period of 18.7 +/- 9.5 months (range 6 and
      37 months), all 15 patients who received a dual-chamber pacing system were alive
      and were clinically improved. The systolic pressure gradient continued to
      decrease during the follow-up period (24.4 +/- 17.2 mmHg at the 6th month
      compared with 36.5 +/- 18.6 mmHg at the time of implantation; p = 0.014). The
      clinical improvement was dependent on careful adjustment of the atrioventricular
      delay which was programmed at relatively short values (65.6 +/- 14 ms, range 47
      and 75 ms) to obtain permanent right ventricular capture. The authors conclude
      that dual-chamber pacing is an effective means of treating symptomatic
      hypertrophic obstructive cardiomyopathy resistant to medical therapy, even in the
      absence of preexisting conduction defects.

PMID- 7771877
TI  - [Surgical plasty of the coronary trunks: an alternative to bypass techniques].
AB  - Between January 1991 and December 1993, surgical coronary angioplasty was
      performed in 12 patients with an average age of 59 years: right coronary artery
      (17), left main coronary artery (3) and bilateral angioplasty (2). Internal
      mammary or gastroepiploic artery bypass grafts were associated on another vessel
      in 5 patients and 1 patient also underwent aortic valve replacement. There was no
      early mortality (1 month), or perioperative myocardial infarction. At the 15th
      postoperative day, the angiographic result was satisfactory in all patients. At 6
      months, exercise testing was negative in all cases (maximum load 140 +/- 20
      watts). Reoperation for bypass surgery was necessary in 1 patient because of
      symptomatic occlusion of the left anterior descending left anterior descending
      artery, one year after angioplasty of the left main coronary extending to the
      proximal left anterior descending. With a mean postoperative follow-up of 19 +/-
      7 months (6 to 31 months), all patients are asymptomatic: 5 of the 6
      angioplasties controlled angiographically at 1 year were patent without any signs
      of progression (1 occlusion/reoperation). Surgical angioplasty of the main
      coronary vessels is a sure and reliable procedure: it restores physiological
      coronary perfusion, economises venous and arterial vessels and is no obstacle to
      percutaneous transluminal coronary angioplasty.

PMID- 7771878
TI  - [Cardiac tamponade disclosing neoplasm: apropos of 23 cases].
AB  - The authors report a series of cardio-pericardial metastases presenting acutely
      with tamponade. There were 14 men and 9 women with an average age of 39 years.
      The primary tumour was mainly bronchial in the men (5 cases: 20.8%) and breast (3
      cases: 16.6%) or uterine (4 cases: 16.6%) in the women. The other malignancies
      were blood dyscrasias (5 NHL and 1 MHL) one pericardial mesothelioma, one
      Schwannoma, one Ewing's sarcoma and one carcinoma of the larynx. The primary
      tumour was not found in one case. Echocardiography showed a large,
      circumferential pericardial effusion in all cases and compressing the right heart
      chambers (RA and/or RV) in half the cases. Rounded echogenic masses implanted on
      the pericardial membranes (2 cases) or images of false membranes (10 cases) were
      also demonstrated. The clinical emergency led to pericardiocentesis with surgical
      drainage in 5 cases. A pleuro-pericardial window was fashioned in 4 cases. The
      effusion was important in all cases and bloody in 75% of cases. Cytology of the
      pericardial liquid was positive for malignant cells in 1 out of 2 cases. The
      diagnosis was made after death in 3 cases. The other biopsies, bronchial, lymph
      node, pleural and bone marrow also provided valuable diagnostic information.
      Undifferentiated carcinoma was found in 75% of bronchial carcinomas. In all three
      breast tumours, the histology showed moderately well differentiated
      adenocarcinoma. The authors underline the paucity of therapeutic measures: at
      this stage, pericardiocentesis is almost the only procedure apart from the cases
      of haemopathy. Some authors have suggested radiotherapy of the precordial region
      and others, intrapericardial chemotherapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771880
TI  - [Physiopathology of mitral mechanics in hypertrophic cardiomyopathy. Groupe de
      travail "Cardiomyopathies et insuffisance cardiaque" de la Societe Francaise de
      Cardiologie].
AB  - Ventricular hypertrophy, the only indisputable phenotypical marker of
      hypertrophic cardiomyopathy, is the basis of the physiopathology and treatment of
      the disease. Mitral valve abnormalities are usually considered to be secondary to
      the hypertrophy but the genesis of systolic anterior motion by the Venturi effect
      has been questioned by many clinical and experimental observations. Abnormalities
      of the mitral valve apparatus may in themselves (elongation of the valves, antero
      internal malposition of the mitral papillary muscles and/or hyperlaxicity of
      antero-internal corhdae tendinae) create systolic anterior motion or subaortic
      obstruction in the absence of septal hypertrophy and/or increased subaortic flow
      velocities. Anatomo-clinical studies have confirmed this hypothesis: a high
      prevalence of mitral valve disease (increased valvular surface and length) has
      been found in hypertrophic cardiomyopathy. The recognition of these abnormalities
      is of value from the therapeutic (mitral valvuloplasty) diagnostic (in borderline
      cases) and genetic (when the primary nature of the abnormalities is confirmed)
      points of view.

PMID- 7771879
TI  - [Automatic implantable defibrillators; subdiaphragmatic insertion].
AB  - Although the material and techniques of implantation of the electrodes of
      implantable defibrillators have been improved, the abdominal implantation of the
      generator remains widely used as described by Mirowski in 1980. Despite a
      progressive reduction in their size, the generators remain bulky and a source of
      local complications. The risks and discomfort of implantation in the abdominal
      wall led the authors to try subdiaphragmatic implantation in 22 patients. There
      was no morbidity with perfect healing in all 22 cases. The mean follow-up period
      was 11 months. The patients felt very comfortable, a significant advance with
      respect to abdominal implantations.

PMID- 7771881
TI  - [Functional capacity after cardiac transplantation].
AB  - Cardiac transplantation has transformed the prognosis of NYHA Class IV severe
      cardiac failure. However, despite a "new heart", the exercise tolerance of
      transplanted patients remains poor for a long time. Cardiac denervation which
      decreases the chronotropic reserve, diastolic left ventricular dysfunction and
      intrinsic muscular abnormalities related to lack of training and to treatment are
      the underlying causes.

PMID- 7771882
TI  - [Primary ventricular fibrillation and early recurrence: apropos of a case of
      association of right bundle branch block and persistent ST segment elevation].
AB  - The authors report the case of a 36 year old man who presented with an early
      recurrence of primary ventricular fibrillation. The initial investigations were
      normal apart from the finding of complete right bundle branch block with
      persistent ST segment elevation in the right precordial leads. The recurrence was
      observed 6 weeks after the initial diagnosis which led to the implantation of an
      automatic defibrillator. This clinical case is similar to a syndrome recently
      described of sudden death without obvious cardiac disease but with right bundle
      branch block and ST segment elevation.

PMID- 7771883
TI  - [Syncopal angina caused by sinus arrest; cured by transluminal coronary
      angioplasty and calcium inhibitor].
AB  - The authors report the case of a 42 year old man who smoked and who presented
      with recurrent spontaneous anginal chest pain followed by syncope due to sinus
      arrest. The mechanism underlying these symptoms was spasm of the left circumflex
      artery at the site of severe stenosis of its middle segment just before the
      origin of the sinus node artery. Treatment with a calcium antagonist with
      transluminal coronary angioplasty of the narrowed segment of the circumflex
      artery resulted in complete regression of all symptoms with a follow-up of 15
      months. Seven other reports of the same type were found in the literature
      concerning 6 men and 1 woman, with an average age of 49 years, presenting with
      the same symptoms and sinus arrest associated with the minimal coronary artery
      disease. The proof of coronary spasm was documented in 6 of the 7 cases by a
      positive ergometrine stress test or by the observation of spontaneous spasm
      during coronary angiography or rapid atrial pacing. The outcome was good with
      calcium antagonist therapy in 5 cases, and with slow release nitrate derivatives
      in 1 case. One patient, treated by betablockers, died. It is useful to
      investigate some sino-atrial blocks to diagnose the underlying ischaemic
      mechanism as the patients may be treated simply with calcium antagonists rather
      than undergo implantation of a pacemaker.

PMID- 7771884
TI  - [A rare clinical form of angioneurotic edema caused by enalapril: acute abdomen].
AB  - The authors reports an unrecognised secondary effect, but perhaps not as rare as
      has been thought, of enalapril: the acute abdomen. Three similar cases have
      previously been reported. The underlying mechanism is probably the inhibition of
      degradation of tissue kinins to inactive peptides as in subcutaneous and/or
      submucous angioneurotic oedema. Todate, this secondary effect has not been
      reported with other angiotensin converting enzyme inhibitors. The relationship
      between the acute abdomen and angioneurotic oedema with primary
      hyperaldosteronism is discussed.

PMID- 7771885
TI  - [Cardiopulmonary exercise evaluation: value and influence of the use of a ramp
      protocol versus triangular protocol].
AB  - The aim of the study was to evaluate a ramp bicycle ergometer exercise protocol
      consisting of a very small but rapid increase in load (2 watts/12 seconds) for
      direct measurement of the VO2 max. Eighteen sedentary healthy subjects were in
      Group I (16 men, mean age 29 +/- 6 years) and 10 men with chronic stable cardiac
      failure in Group II (mean age: 51 +/- 16 years). All subjects performed two
      exercise tests within a period of 8 days, one with a ramp protocol (protocol R)
      and the other with a standard triangular exercise protocol (protocol T) of 30
      watts/3 minutes for Group I and 20 watts/2 minutes for Group II. All procedures
      were performed until the subjects were exhausted. Direct measurement of VO2 max
      was performed by rapid response analysers enabling a cycle to cycle study. The
      parameters were measured and compared by a paired Student t test at each stage of
      the test: at rest, at submaximal exercise (third level), at anaerobic threshold
      and at maximal exercise. There was no significant difference between VO2 max and
      VO2 at the threshold of ventilation between the two populations. An increase in
      carbon dioxide production at different stages was observed with the ramp
      protocol. Furthermore, the highest maximal respiratory quotient and anaerobic
      threshold appeared earlier in Group II with the ramp protocol. Therefore, with
      respect to the standard triangular protocol, the ramp protocol provides
      comparable VO2 values. Its potential value, reported in the literature, is a
      better correlation between the observed and theoretical VO2 values. However, an
      increase in CO2 production should be underlined, probably related to greater
      recruitment of anaerobic metabolism in the absence of a steady state. This may be
      the reason for attaining the anaerobic threshold earlier.

PMID- 7771886
TI  - [Complications of percutaneous mitral valvuloplasty; comparison of the double
      balloon and the Inoue techniques].
AB  - Percutaneous mitral valvuloplasty is a non-surgical procedure for treating mitral
      stenosis. There are two techniques of performing this procedure, the double
      balloon and the Inoue techniques. The aim of this study was to compare the
      immediate complications of percutaneous mitral valvuloplasty in two consecutive
      series of unselected patients undergoing the double balloon (131 patients) and
      the Inoue (131 patients) techniques. The two series were comparable before
      valvuloplasty with respect to demographic, clinical, echocardiographic and
      haemodynamic criteria. The increase in valvular surface area and the decrease in
      pressure gradient after valvuloplasty were not significantly different (1.1 +/-
      0.2 to 1.95 +/- 0.5 cm2 in the Inoue series and 1.0 +/- 0.2 to 1.95 +/- 0.5 cm2
      in the double-balloon series; 12 +/- 3 to 5 +/- 2 mmHg in the Inoue series and 13
      +/- 4 to 5 +/- 2 mmHg in the double-balloon series for the mean transvalvular
      pressure gradient). A good immediate result was defined as a valve surface are >
      1.5 cm2 and < or = 2 + mitral regurgitation after the series, and this was
      obtained in 78% of cases in both series. Severe mitral regurgitation (3 +)
      requiring immediate or elective mitral valve replacement was observed in 7 cases
      in the Inoue series and in 5 cases in the double-balloon series (NS). One
      cerebral embolism occurred in the double balloon series and two systemic
      embolisms, one cerebral and one coronary, in the Inoue series.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7771887
TI  - [Long-term hematological management of cyanotic congenital heart diseases].
AB  - The long-term management of cyanotic congenital heart disease requires treatment
      of raised haematocrit (> 65%) whilst conserving the quality of the red blood
      cells [mean corpuscular volume, mean corpuscular haemoglobin concentration
      (MCHC)]. Since 1975, the author has chosen chemotherapy (hydroxyurea, pipobroman)
      as first-line treatment, reserving iron supplements, phlebotomy and platelet
      antagonists as adjuvant therapy. Pre-treatment data of 170 patients showed: a
      high prevalence of hypochromic microcytosis due to iron deficiency and of
      thrombopaenia, in relation to the severity and duration of the polycythaemia.
      Hyperuricaemia was greater than 420 mumol/l in 67% of cases; effort tolerance and
      hyperviscosity were related to the haematocrit and iron deficiency. One hundred
      and forty seven patients were followed up for a total duration of 769 years of
      chemotherapy. Clinical tolerance was good: biological tolerance was marked by a
      high frequency of thrombocytopaenia requiring withdrawal (10 cases) or reduction
      of treatment (34 cases). The causes of the 39 deaths observed are analysed: none
      was related to the hydroxyurea or pipobroman. The treatment or follow-up was
      stopped in 29 cases: the reasons are reported. Seventy eight patients under
      treatment had a favourable outcome with normal social reinsertion in 74 cases.
      This efficiency was related to maintenance of a haematocrit < 65%, to correction
      of the iron deficiency and increase in the MCHC. These results were obtained with
      an average dosage of 19 +/- 4.5 mg/kg/day of hydroxyurea (69 patients). By
      slowing erythropoiesis, chemotherapy reduces the indication of phlebotomy, so
      reducing iron loss: it also inhibits excessive bouts of polycythaemia in cases of
      iron therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771888
TI  - New FDA guidelines on the treatment of hypertension: comparison of different
      therapeutic classes according to trough/peak blood pressure responses.
AB  - The FDA guidelines, recommending a trough/peak blood pressure response ratio of
      at least 50%, were formulated with a view to providing a definitive index of
      duration of action of an antihypertensive drug. The aim was to prevent the use of
      drug regimens that utilised high doses of drug with the aim of maintaining a
      significant reduction in blood pressure at the end of the steady state dosage
      interval. The calculation of trough/peak ratios is subject to significant
      variability but much of this can be directly attributed to different
      methodological approaches. However, when conditions are standardised it has been
      shown that trough/peak ratios are reproducible in individual patients.
      Trough/peak ratios defined for different antihypertensive drugs often exhibit as
      many differences within a therapeutic class as between therapeutic classes. Thus
      there is no single therapeutic class of drugs that offers high trough/peak ratios
      compared to an alternative class. The possible exception to this are the
      diuretics which probably all have comparatively high trough/peak ratios although
      this has never formally been defined. With respect to the beta adrenoceptor
      antagonists there is discernible discrimination between the once a day agents
      with betaxolol, bisoprolol and acebutolol all having a longer duration of action
      as defined by a higher trough/peak response than atenolol. Calcium antagonists
      show considerable variability in trough/peak ratio between different drugs. In
      particular the first generation agents, verapamil, nifedipine and diltiazem all
      had relatively low values. Not all the second generation agents were superior to
      this and at present only amlodipine and lacidipine and some of the "reformulated"
      agents meet the recommendations of the Guidelines for once a day drugs.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7771889
TI  - [Pilot study of the efficacy of ticlopidine in early patency of coronary
      endoprostheses].
AB  - Subacute thrombosis of coronary stents is the main complication of this
      technique. The authors studied the outcome of 387 patients and 400 coronary
      arteries who underwent implantation of 427 stents between December 1989 and
      February 1994 and followed up one month after the procedure: all patients receive
      500 mg of ticlopidine daily from three days before angioplasty throughout the
      hospital period and continued for at least one month. Anticoagulation with
      heparin was undertaken by the intravenous route after implantation and relayed
      with subcutaneous heparin for one week until control coronary angiography
      performed in the first 300 patients. At one month, 96.9% of patients were free of
      clinical coronary events. The following major complications were observed: 5
      deaths (1.3%), 5 Q wave myocardial infarctions (1.3%); no emergency bypass
      surgery. The peripheral vascular complication rate was 3.6%. Univariate analysis
      three risk factors of subacute thrombosis: age (p = 0.0058), arterial diameter of
      less than 3 mm (p < 0.01) and implantation for occlusive dissection (p = 0.03).
      Multivariate analysis showed two independent risk factors: age (p = 0.001) and
      arterial diameter of less than 3 mm (p = 0.01). This pilot study shows a
      particularly low subacute thrombosis rate in unselected indications with an
      acceptable level of vascular complications.

PMID- 7771890
TI  - [Value and limitations of diagnostic function of bradycardia of a ventricular
      pacemaker].
AB  - The indication for permanent pacing may be confirmed by a bradycardia counter in
      patients without ECG or Holter recording of the causal bradycardia. The algorithm
      was assessed in a multicenter register with the SORIN Theorema model. The
      activation of the device was programmed on a double hysteresis of 2 seconds with
      a programmable histogramme of detections and sensing and pacing counters. One
      hundred and forty five patients were recruited in 50 centers over 2 years: 89 men
      and 56 women aged 33 to 96 years (average 72 years), 87 of whom had no other
      obvious cardiac disease. One hundred and ten had typical syncopal episodes, 19
      had atypical or minor syncopal attacks and 16 were asymptomatic, one with sinus
      node dysfunction and the others with pathological prolongation of the HV interval
      (> or = 70 ms) during endocavitary electrophysiological investigation. The
      mechanism of the bradycardia was considered to be infra-hisian in 62 patients who
      had HV intervals > or = 70 ms. This was also the probable mechanism in 20 others
      who had bundle branch block and typical syncope despite a HV interval < 70 ms and
      in 6 patients with bundle branch block and typical syncope who did not undergo
      electrophysiological investigation before implantation. Twenty one patients had
      sinus node dysfunction during electrophysiological investigation and 8 had a
      carotid sinus syndrome. The remaining 28 cases had transient syncope but no ECG
      changes or abnormality on electrophysiological investigation. Permanent pacing
      was proposed when an extracardiac origin of the syncope was excluded.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7771891
TI  - [Long-term course after electric ablation of the bundle of His in the treatment
      of supraventricular tachycardia].
AB  - The authors report the long term results of His bundle ablation for
      supraventricular tachycardia in a series of 49 patients. This retrospective study
      was based on a patient population of 27 men and 22 women with an average age of
      59 at the time of ablation, between 1984 and 1993. The indication for His bundle
      ablation was invalidating supraventricular tachycardia resistant to
      antiarrhythmic therapy in all cases. One group of patients (Group I, n = 31
      patients) underwent high energy electrical shock and the second group (Group II,
      n = 18 patients) recruited after 1991, underwent radiofrequency catheter
      ablation. Complete atrioventricular block was obtained in the first group in 1 to
      4 sessions whereas 17 patients of Group II were treated in a single session.
      During a follow-up period of an average of 40 months, 2 patients were lost to
      follow-up and 6 died, 3 of cardiac failure, 1 of a cerebrovascular accident, 1 of
      pulmonary carcinoma and 1 of unknown cause. In Group I, atrioventricular
      conduction persisted in 1 patient (primary failure) and reappeared in one other
      patient, but, in Group II, complete atrioventricular block persisted even in the
      patient in whom the interruption was not obtained with a single session of
      radiofrequency ablation. The patients were generally physically improved and
      satisfied not to have any palpitations. A decrease in exercise capacity estimated
      by the NYHA classification was observed in 38% of patients without apparent
      cardiac disease who developed dyspnea. On the other hand, 43% of patients with
      cardiac disease and in NYHA class > or = 2 were improved.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7771892
TI  - [Results, complications and long-term follow-up of percutaneous ablation of
      atrioventricular conduction. Apropos of 85 cases].
AB  - This retrospective study reports the immediate and long-term results of
      percutaneous ablation of atrioventricular conduction. Between July 1983 and
      January 1992, 85 consecutive patients (51 men, age 64 +/- 10 years, range 43-84
      years) presenting with supraventricular arrhythmias (atrial fibrillation n = 53;
      atrial flutter n = 50; atrial tachycardia n = 17; junctional tachycardia n = 6)
      resistant to antiarrhythmic therapy (number of drugs used: 4 +/- 1.3, range 1-6)
      underwent interruption of atrioventricular conduction by fulguration (n = 65) or
      radiofrequency energy (n = 13) or by an association of the two methods (n = 7).
      The 75 pacemakers implanted (10 patients had pacemakers before the procedure)
      comprised 55 VVIR, 11 VVI, 5 DDD and 4 DDDR units. The immediate results included
      two sudden deaths at the 4th and 7th day in patients undergoing fulguration and
      three complications with a favourable outcome (staphylococcal septicaemia,
      pulmonary embolism and haematoma at the site of implantation of the pacemaker).
      None of the patients was lost to follow-up and the average follow-up was 31 +/-
      18 months (range 2-108 months). During follow-up, 15 patients died and there was
      a recurrence of symptoms in 11 patients after 1 to 9 months requiring a repeat
      procedure. In the 68 survivors, the follow-up is now 38 +/- 18 months (range 12
      108 months). Sixty one patients have 2nd (2) or 3rd (59) degree atrioventricular
      block, giving 90% good electrocardiographic results.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7771893
TI  - [Prevalence of intra-auricular thrombi detected by transesophageal
      echocardiography in patients with cardiac transplants].
AB  - The aim of this study was to determine the prevalence of intra-atrial thrombi or
      spontaneous contrast by transoesophageal echocardiography in patients who
      underwent cardiac transplantation by Lower and Shumway's technique.
      Transoesophageal echocardiography was performed in 52 transplant patients (43
      men, 9 women: average age 51 years) with a high frequency biplane transducer.
      After surgery, all patients received platelet antiaggregant therapy. Despite this
      treatment, 4 patients had a sudden systemic embolic episode and were then placed
      on oral anticoagulants. All patients were in sinus rhythm at the time of the
      examination and some had signs of acute rejection on endomyocardial biopsy
      performed the same day. Spontaneous contrast was observed in 27 patients (52%)
      and was associated with thrombosis in 15 patients (29%). These thrombi were
      located in the left atrial appendage in 8 cases, on the left atrial posterior
      wall in 5 cases and on the left atrial sutures in 2 cases. None of these thrombi
      had been detected by transthoracic echocardiography. No significant difference
      was observed between those with and those without thrombosis with respect to left
      atrial dimensions, left ventricular ejection fraction, cardiac index, pulmonary
      pressures and the number of episodes of acute rejection. The 4 patients with a
      history of arterial embolism all had an intra-atrial thrombus. This study
      demonstrates a high incidence of spontaneous contrast and intracardiac thrombi in
      the dilated left atrium of patients transplanted by Lower and Shumway's
      technique. It also underlines the value of transoesophageal echocardiography in
      the follow-up of transplant patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771894
TI  - [Oxidative stress and lipid-protein peroxidation after cardiac transplantation.
      New hypotheses for explaining pathogenesis of accelerated forms of ischemic heart
      disease].
AB  - The ischaemic heart disease developed by cardiac transplant patients is
      characterised by its rapid onset, which accounts for a number of its special
      features when compared with the usual form observed in non-immunosuppressed
      patients. However, the two forms of the disease are basically similar, that of
      the transplanted patients being practically a caricature of the non
      immunosuppressed patients and thereby allowing a quasi-experimental model for the
      study of the metabolic causes of the disease which remains the leading cause of
      death in the world, all ages and sexes included, irrespective of the economic
      wealth of the countries.

PMID- 7771895
TI  - [Surgery for atrial fibrillation by the Cox technique. Apropos of 2 cases].
AB  - The authors report the cases of two patients who underwent surgery of atrial
      fibrillation by Cox's technique. In one case, it was associated with mitral
      valvuloplasty for atrial fibrillation of 4 years' duration; sinus rhythm was
      restored on the 19th postoperative day; it persisted at 11 months without
      antiarrhythmic drugs. On the other case, it was associated with mitral valve
      replacement for atrial fibrillation of 7 years' duration in a patient with
      dilated cardiomyopathy and a poor left ventricle; sinus rhythm was restored by
      electrical cardioversion during the 4th postoperative month; it persisted at 9
      months with antiarrhythmic therapy. Cox's technique allows: 1) definitive
      suppression of atrial fibrillation, 2) restoration of atrioventricular
      synchronisation, 3) preservation of atrial transport function. The indications
      are paroxysmal or permanent atrial fibrillation, invalidating and resistant to
      medical therapy; atrial fibrillation of over 3 years' duration associated with
      mitral regurgitation requiring valvular repair and atrial fibrillation of
      invalidating primary cardiomyopathy.

PMID- 7771896
TI  - [Subannular pseudoaneurysm of the left ventricle complicating mitral valve
      replacement; apropos of a case].
AB  - The authors report the case of a 72 year old woman with a Carpentier-Edwards
      bioprosthesis implanted in March 1981 for severe mitral stenosis, asymptomatic
      until 1986. The progression of effort dyspnoea with prosthetic valve dysfunction
      despite digitalo-diuretic therapy and severe ventricular subannular
      pseudoaneurysm. Doppler echocardiography and cardiac catheterisation and
      angiography confirmed the mitral subannular pseudoaneurysm and led to surgical
      cure of this fibrous structure and implantation of a mechanical mitral valve
      prosthesis. This complication of mitral valve replacement is a cause of
      pseudoaneurysm which should not be overlooked.

PMID- 7771897
TI  - [Campylobacter fetus subspecies fetus endoaortitis on a Bentall tube prosthesis.
      Apropos of a case].
AB  - Campylobacter fetus is a rare cause of endocarditis and endoaortitis: the authors
      believe this to be the second reported case of infection of an intracardiac
      prosthesis. The patient was a man who had already undergone replacement of the
      aortic valve and ascending aorta, and a gastrectomy, which were predisposing
      factors. The portal of entry was not found. The diagnosis was confirmed by
      positive blood cultures and transoesophageal echocardiography. The outcome was
      rapidly fatal despite antibiotic therapy and surgery, because of the seriousness
      of the lesions (pseudo-aneurysm of the aorta ruptured into the right atrium), the
      precarity of the terrain and surgical difficulties.

PMID- 7771898
TI  - [Fissuration of thoracic aneurysm in Horton disease, favourable course after
      surgery].
AB  - The authors report another case of rupture of the thoracic aorta in Giant Cell
      arteritis. The progressive nature of the rupture enabled life-saving aortic
      replacement with a vascular prosthesis. Only one previous report of this type of
      operation was found in a search of the literature. The prevalence of aortitis in
      Giant Cell arteritis would appear to be underestimated after autopsy studies. It
      affects the thoracic aorta mainly in the ascending segment but sometimes involves
      the whole aorta. It may remain asymptomatic or be complicated by arterial
      occlusion, aortic regurgitation, aneurysm, dissection or rupture. Effective
      steroid therapy could prevent these complications.

PMID- 7771899
TI  - [Technical problems posed by automatic treatment of arrhythmia by an implanted
      pacemaker].
AB  - The automatic treatment of arrhythmias by cardiac pacemakers requires a phase of
      recognition of the arrhythmia followed by its treatment. Different factors limit
      the analysis and recognition ranging from the quality of detection of spontaneous
      events to the recognition of the arrhythmias. Bipolar dual chamber pacing is
      essential: it allows minimisation of the detection of interference or cross talk
      between the atrial and ventricular chambers and better discrimination of episodes
      of rapid rhythm. The treatment algorithms are multiple, difficult to investigate
      in the laboratory, and their efficacy varies with the evolution of the pathology
      or with medical treatment. There is not a single response but a programme where
      the antitachycardia modes of pacing succeed one another until the reduction of
      the arrhythmia. This instability of treatment implies a capacity of memorization
      with a double objective: to authorize a posteriori diagnosis of the treated
      pathology and to analyse the evolution of the antitachycardia response. These
      diagnostic functions are also dependent on the quality of detection and pacing.
      The automaticity of the treatment, when essential, can only be envisaged in
      patients available for strict and regular clinical follow-up.

PMID- 7771900
TI  - [Treatment of supraventricular arrhythmia by permanent cardiac pacing].
AB  - Most pacemakers are used for the treatment of bradyarrhythmias. However, a small
      number of pacemakers has been implanted for the treatment of supraventricular
      tachycardia resistant to medical therapy. The results of small reported series
      show long-term pacing to be effective in terminating reentrant atrial and
      junctional tachycardia. This has led to an improved quality of life and fewer
      hospital admissions in the majority of patients. Although there are a number of
      limitations to the widespread use of this mode of treatment, the development of
      pacing techniques has improved our understanding of the mechanism of termination
      of tachycardia which has been fully used in ventricular tachyarrhythmias. In
      addition to the curative treatment of sustained junctional tachycardia,
      pacemakers have been implanted to prevent the occurrence of new episodes with
      seemingly equally satisfactory results. However, cardiac pacing for this
      indication is much less common now because of the very good results obtained
      recently by radiofrequency ablation techniques. The prevention of atrial
      arrhythmias, vagally-induced atrial tachyarrhythmias and the bradycardia
      tachycardia syndrome are good indications for permanent pacing. The prevention of
      atrial fibrillation in sinus node dysfunction by pacing is becoming more popular
      with the emergence of new modes (DDI and rate-adjusted modes) and original
      arrhythmia preventing algorithms. The discussion about the real efficacy of
      atrial pacing in sinus node dysfunction is disappearing as results of prospective
      randomised trials confirming this efficacy become available, especially in
      preventing atrial fibrillation.

PMID- 7771901
TI  - [Permanent atrial resynchronization by synchronous bi-atrial pacing in the
      preventive treatment of atrial flutter associated with high degree interatrial
      block].
AB  - Interatrial conduction block results in a very delayed and retrograde activation
      of the left atrium and is associated with a high incidence of atrial
      tachyarrhythmias, especially a particular (and specific) form of atypical atrial
      flutter. Electrophysiologic studies have suggested that these arrhythmias were
      usually due to reentry and could be directly related to the conduction
      disturbances in the atrium. If so, we can expect reasonably that permanent atrial
      resynchronization resulting from simultaneous pacing in different target sites in
      the atria, may not only correct for interatrial dysynchrony, but also may
      significantly contribute to prevent arrhythmia recurrences. Twenty-eight
      patients, mean age 68 years, were included. The mean P wave duration in
      spontaneous sinus rhythm was 181 +/- 28 ms. In all patients, many recurrences of
      atrial tachyarrhythmia were documented, especially a specific form of atypical
      atrial flutter. Medical therapy was constantly ineffective. Three different
      pacing modes were used: 6 patients, with normal A-V conduction were implanted
      with a SSI device, programmed in AAT mode and connected, using a Y bifurcated
      connector, to two atrial leads, one positioned in the right atrium, the second
      one into the coronary sinus-in 14 patients, with A-V conduction defects, a
      conventional DDDR unit was implanted and connected to a composite biatrial
      electrode and a ventricular lead. In that configuration atrial resynchronization
      was only effective on paced atrial cycles -a specific DDD Chorus ELA Medical
      device with a special algorithm loaded into the RAM memory was implanted in 14
      patients (8 new indications, and 6 patients first implanted with a DDDR unit).
      RESULTS: during sinus rhythm atrial resynchronization induced a reduction of the
      P wave duration from 181 +/- 28 ms to 116 +/- 12 ms. During permanent pacing the
      mean value decreased from 209 +/- 38 ms to 108 +/- 13 ms. During follow-up (34 +/
      15 months) arrhythmia prevention was assessed by history, by monthly surface
      ECG's and by bimonthly 24 hours Holters recordings and telemetric interrogation
      of the pacemaker statistics. Twenty-one patients did not experienced any
      recurrence of arrhythmia. One to three recurrences occurred in the other seven
      patients, including six patients implanted with a conventional DDDR unit. These
      preliminary results seem validate the new concept of atrial resynchronization for
      prevention of atrial arrhythmia associated with interatrial conduction block.

PMID- 7771902
TI  - [Radiofrequency catheter ablation: theoretical and technical aspects].
AB  - Radiofrequency currents produce circumscribed tissue necrosis by progressive and
      localised heating. Endocardial application via the percutaneous approach with a
      specific electrophysiological catheter enables destruction of the anatomical
      substrate of many cardiac arrhythmias. The technique is well tolerated due to the
      absence of barometric phenomena and general anaesthesia, and the possibility of
      modulating the energy delivered, which explains why it has supplanted fulguration
      in most indications. The technological evolution aims to increase the lesional
      power and decrease the number of complications. This implies the development of
      catheters capable of delivering greater currents without the risk of thrombus
      formation and of generators dependent on electrical or thermal parameters. The
      low incidence of complications reported by centres using the technique is based
      on an excellent understanding of the technique, the use of appropriate material,
      the surveillance of parameters which allow detection of unwanted effects and the
      respect of a strict operation protocol. In the absence of these precautions, the
      wide diffusion of this technique, favored by its low cost and relative
      simplicity, may be associated with an increase in the number of side effects
      which could be lethal. This cannot be accepted in a technique with such wide
      indications, including arrhythmias with a usually benign long-term prognosis.

PMID- 7771903
TI  - [Intracardiac treatment of atrial flutter by radiofrequency currents].
AB  - Though not as common as atrial fibrillation, atrial flutter is frequently
      encountered in everyday cardiological practice. Though generally thought to be
      benign, it may be difficult to treat both in respect to its conversion to sinus
      rhythm and prevention of recurrences. It is often poorly tolerated. There are
      resistant, invalidating forms for which catheter ablation of the His bundle may
      be considered as a last resort. This is only a palliative measure even if
      effective from the functional point of view. A new technique for treating atrial
      flutter by a direct action on the atrial tissue has been recently introduced. The
      basis of this method is the concept of circus movement of the activation in the
      right atrium, the wave front circulating in an anti-clockwise direction in common
      atrial flutter. The postero-inferior region of the right atrium, at Koch's
      triangle, is the site of slow conduction and the target of choice for catheter
      ablation. The detection of this zone is determined by the endocavitary recording
      of fragmented, prolonged electrogrammes and by atrial stimulation techniques. The
      application of radiofrequency currents on these bases (high energy shocks are
      rarely used nowadays) results in interruption of atrial flutter. However, there
      are no data available concerning the long-term efficacy of this technique. Since
      1992, our group has used an anatomical approach for catheter ablation. This aims
      to apply the radiofrequency current on the isthmus of atrial tissue between the
      orifice of the inferior vena cava and the tricuspid annulus through which the
      flutter wave front passes to reach the interatrial septum.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7771904
TI  - [Ablation of the accessory pathways by radiofrequency currents].
AB  - The introduction of ablative methods has revolutionised therapeutic strategy in
      cardiac arrhythmias. Accessory pathways are the most commonly targeted
      arrhythmogenic substrate. Several parameter may be used to determine the optimal
      site of ablation: accessory pathway potential, atrioventricular interval, atrial
      or ventricular pole of the pathway, morphology of the unipolar wave. The
      localisation of the accessory pathway sometimes requires specific techniques. The
      success rate reported in the literature is generally over 90%. However, the
      number of applications of radiofrequency current varies according to the authors
      from an average of three to eight. A combination of "timing related" criteria and
      direction of activation and the use of infraliminal stimuli minimise the number
      of radiofrequency applications. The incidence of complications in multicenter
      registers is 5% and the relapse rate is 8%. The long-term effects of catheter
      ablation are unknown, especially when used in childhood. A certain reserve should
      be maintained in the indications of ablation. Only high-risk, life-threatening
      arrhythmias, or those resistant to pharmacological intervention, are formal
      indications. Other (so-called "convenience") indications depend on the express
      wish of patients clearly informed of the advantages and risks of this method.

PMID- 7771905
TI  - [Catheter ablation of atrioventricular nodal reentrant tachycardia].
AB  - Electrophysiological data of atrioventricular nodal reentrant tachycardia
      recensed over the last 40 years in the animal and in man has not resolved the
      question as to the exact site of the reentry circuit: an exclusively intranodal
      pathway or a pathway involving part of the atrium? The remarkable efficacy of
      modern radical therapy of this arrhythmia with preservation of atrioventricular
      conduction reinforces the concept of reentry involving not only the
      atrioventricular node but also the juxta nodal atrium and the superior and
      inferior atrionodal connections. Radical treatment was initially surgical and
      then by catheter ablation. The technique of specific ablation of the rapid
      anterior pathway was the first to be described. Its limitation is the relatively
      high risk (about 10%) of complete atrioventricular block. Very quickly,
      radiofrequency ablation of the slow posterior pathway became the method of
      reference. Most patients do not have retrograde conduction in the slow pathway.
      The pathway is located in sinus rhythm by recording its specific potentials:
      either the rapid potential described by Jackman et al or the fragmented potential
      described by Haissaguerre and Warin. The former is recorded from the posterior
      septal position anterior to the orifice of the coronary sinus; the second is
      recorded at the same level but slightly above in the mid septal position.
      Ablation of the slow pathway can be performed on these purely anatomical
      criteria. Using these approaches, an immediate success rate of over 90% may be
      obtained. The recurrence rate is 0 to 5%; that of complete atrioventricular block
      ranges from 0 to 4%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771906
TI  - [Choice of the mode of stimulation after ablation of the bundle of His.
      Experience based on a retrospective survey of 192 patients].
AB  - A retrospective study of 192 patients centered on the outcome of supraventricular
      arrhythmias after catheter ablation of the atrioventricular junction provided
      some useful information concerning the choice of pacing mode in these patients.
      With the exception of atrioventricular bloc after ablation of the rapid nodal
      pathway where simple DDD pacing is adequate, rate adaptive pacing would seem to
      be essential. The VVIR mode should be the mode of choice in atrial flutter,
      permanent atrial fibrillation, poorly controlled atrial fibrillation and
      paroxysmal atrial fibrillation of elderly subjects (over 70 years) and/or of male
      sex, and/or complicating advanced cardiac disease (valvular, ischaemic or
      primary). The DDDR mode (with an algorithm to prevent endless loop tachycardia)
      is the mode of choice in sinus node dysfunction and/or in young patients (under
      60), and/or females and/or in idiopathic arrhythmias and/or when retrograde VA
      conduction persists. When the pacemaker is replaced, the indication should be
      reviewed with respect to the outcome of the arrhythmia, which underlines the
      value of accurate implanted Holter systems.

PMID- 7771907
TI  - [Fulguration and radiofrequency in ventricular tachycardia].
AB  - Eighty-nine cases of ventricular tachycardia, resistant to antiarrhythmic
      therapy, were treated over a 10 year period by high energy D ablation
      (fulguration). This series included 37 cases of myocardial infarction with a mean
      ejection fraction of 30%. The mean follow-up period of the survivors was 61
      months and clinical efficacy was 87.9%. Twenty-three cases of arrhythmogenic
      right ventricular dysplasia, aged 40 years, and with an ejection fraction of 57%,
      followed up for 71 months, had a clinical efficacy of 83%. Twelve patients had
      verapamil sensitive (fascicular) ventricular tachycardia. Their age was 30, their
      ejection fraction 65%, the follow-up period 55 months, and the clinical efficacy
      was 100%. Ten patients had primary dilated cardiomyopathy. Their age was 35,
      their ejection fraction 23%, the follow-up period of 38 months with a clinical
      efficacy of 80%. Four patients, aged 21, had operated congenital heart disease
      with an ejection fraction of 60%, a follow-up of 36 months and a clinical
      efficacy of 100%. Finally, 3 patients had idiopathic infundibular ventricular
      tachycardia. Their age was 36, the ejection fraction 62%, the follow-up period
      was 72 months and the clinical efficacy was 67%. Non lethal complications were
      observed in 16% of cases, mainly haemopericardium requiring pericardocentesis in
      4.5% of cases. The operative mortality and in the month following ablation was
      9.2%, observed mainly during the learning period. These results show that
      fulguration is not without risk, but in skilled hands, it gives remarkable
      results in the majority of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771908
TI  - [Clinical aspects of implantable defibrillators: indication].
AB  - The rapidity of technological progress has now made available a device which was
      only a dream a few years ago, a nearly ideal implantable defibrillator. Despite
      the persistence of a number of technical and clinical problems, the fourth
      generation defibrillators are multiprogrammable, with antitachycardia and
      antibradycardia functions, implantable by the endocavitary approach in most cases
      thanks to the introduction of biphasic shocks, fitted with constantly improving
      systems of telemetry, and are progressively smaller in size. The selection of a
      defibrillator device requires consideration of the patient's needs and the
      technical characteristics of the defibrillator. Apart from special situations in
      which the indications of the implantable defibrillator are generally accepted, it
      is only possible in the absence of results of prospective clinical trials, to use
      data accumulated on the place of defibrillation compared with other forms of
      management of severe ventricular arrhythmias. As there is a wide choice of
      treatment of these ventricular arrhythmias, the role of each must be defined for
      each individual patient. With regards to the implantable defibrillator, it is
      essential to take into consideration a number of clinical and paraclinical
      factors such as the clinical preservation of the arrhythmia, the underlying
      cardiac disease, left ventricular function and the type of arrhythmia induced by
      programmed ventricular stimulation.

PMID- 7771909
TI  - [Automatic implantable defibrillators: long-term results].
AB  - The automatic implantable defibrillator is an essential component of the
      preventive management of sudden death of patients with malignant ventricular
      arrhythmias. Though its efficacy in this indication is not contested, the data
      concerning its influence on global cardiac mortality is more controversial. The
      elements of this controversy are reviewed. Several prognostic factors are
      implicated, the principal of which being the patient's haemodynamic status as
      assessed by objective evaluation of left ventricular function. Prospective
      randomised studies comparing medical therapy with the automatic implantable
      defibrillator are under way and should provide a better understanding of its
      indications in the future.

PMID- 7771910
TI  - [Surgery for arrhythmias].
AB  - The role of surgery in the treatment of cardiac arrhythmias has been marginalized
      in recent years with the rise in eminence of radiofrequency current ablation
      especially in the Wolff-Parkinson-White syndrome and nodal reentrant tachycardia.
      The indications of antiarrhythmia surgery for ventricular arrhythmias have become
      standardised. The unquestioned efficacy of the surgical techniques proposed
      (endarterectomy or cryosurgery with or without peroperative mapping) should not
      be associated with unacceptable mortality rates as when left ventricular function
      is too poor, implantation of a defibrillator is always possible. In the domain of
      atrial fibrillation, the interventions proposed (corridor or maze procedures) do
      not have the foundations that the follow-up of a sufficient number of cases would
      confer but they have the merit, especially the latter, of taking the underlying
      physiopathological mechanisms into consideration.

PMID- 7771911
TI  - [Lesions caused by techniques of endocavitary ablation using high frequency
      currents: anatomo-pathological aspects].
AB  - Anatomopathological studies have considerably increased our understanding of the
      ablative technique by radiofrequency current. They have provided information on
      the nature, extent and time dependency of the lesions induced. Despite variable
      results according to whether the experiments were performed in vitro or in vivo,
      a correlation has been observed between the volumes of the lesions and the
      energies used. One factor is unquestionable: monitoring the temperature allows
      better control of the lesion size than monitoring current intensity. However,
      other technical points are essential for this control such as ensuring good
      contact between the catheter and the endocardium and the definition of the
      optimal surface area of the electrode. Now that the conditions of efficacy and
      security of ablation by high frequency currents are known, anatomopathological
      studies in man have become rare. These studies, which will take a long time to
      perform due to the very nature of the technique and pathologies treated, should
      provide interesting anatomo-electrical comparisons to increase our understanding
      of certain arrhythmias.

PMID- 7771912
TI  - The role of methylphenidate in psychiatry.

PMID- 7771913
TI  - A double-blind, crossover comparison of methylphenidate and placebo in adults
      with childhood-onset attention-deficit hyperactivity disorder.
AB  - BACKGROUND: There are few controlled studies of methylphenidate hydrochloride in
      adults with attention-deficit hyperactivity disorder (ADHD), and their results
      have been equivocal. The discrepancies among these studies may be related to low
      doses, diagnostic uncertainties, and lack of attention to comorbid disorders.
      METHODS: We conducted a randomized, 7-week, placebo-controlled, crossover study
      of methylphenidate in 23 adult patients with DSM-III-R ADHD using standardized
      instruments for diagnosis, separate assessments of ADHD and depressive and
      anxiety symptoms, and a robust daily dose of methylphenidate hydrochloride, 1.0
      mg/kg per day. RESULTS: We found a marked therapeutic response for
      methylphenidate treatment of ADHD symptoms that exceeded the placebo response
      (78% vs 4%, P < .0001). Response to methylphenidate was independent of gender,
      psychiatric comorbidity with anxiety or moderate depression, or family history of
      psychiatric disorders. CONCLUSION: Robust doses of methylphenidate are effective
      in the treatment of adult ADHD.

PMID- 7771914
TI  - Efficacy of methylphenidate for attention-deficit hyperactivity disorder in
      children with tic disorder.
AB  - BACKGROUND: The findings from case reports and patient questionnaire surveys have
      been interpreted as indicating that administration of stimulants is ill-advised
      for the treatment of attention-deficit hyperactivity disorder in children with
      tic disorder. METHODS: Thirty-four prepubertal children with attention-deficit
      hyperactivity disorder and tic disorder received placebo and three dosages of
      methylphenidate hydrochloride (0.1, 0.3, and 0.5 mg/kg) twice daily for 2 weeks
      each, under double-blind conditions. Treatment effects were assessed using direct
      observations of child behavior in a simulated (clinic-based) classroom and using
      rating scales completed by the parents, teachers, and physician. RESULTS:
      Methylphenidate effectively suppressed hyperactive, disruptive, and aggressive
      behavior. There was no evidence that methylphenidate altered the severity of tic
      disorder, but it may have a weak effect on the frequency of motor (increase) and
      vocal (decrease) tics. CONCLUSION: Methylphenidate appears to be a safe and
      effective treatment for attention-deficit hyperactivity disorder in the majority
      of children with comorbid tic disorder.

PMID- 7771915
TI  - Is methylphenidate like cocaine? Studies on their pharmacokinetics and
      distribution in the human brain.
AB  - BACKGROUND: The purposes of this study were to investigate the pharmacokinetics
      of methylphenidate hydrochloride (Ritalin) in the human brain, to compare them
      with those of cocaine, and to evaluate whether cocaine and methylphenidate
      compete for the same binding sites. METHODS: We used positron emission tomography
      to measure the temporal and spatial distribution of carbon 11 (11C)-labeled
      methylphenidate. These results were compared with those obtained previously for
      [11C]cocaine. Eight healthy male subjects, 20 to 51 years of age, were scanned
      with [11C]methylphenidate. Three were tested twice to assess test-retest
      variability, four were tested at baseline and after administration of
      methylphenidate, and one was tested with [11C]methylphenidate and [11C]cocaine.
      Two baboons were scanned to evaluate whether there was competition between
      cocaine and methylphenidate for the same binding sites in the brain. RESULTS: The
      uptake of [11C]methylphenidate in the brain was high (mean +/- SD, 7.5% +/-
      1.5%), and the maximal concentration occurred in striatum. Pretreatment with
      methylphenidate decreased binding only in striatum (40%). Although the regional
      distribution of [11C]methylphenidate, was identical to that of [11C]cocaine and
      they competed with each other for the same binding sites, these two drugs
      differed markedly in their pharmacokinetics. Clearance of [11C]methylphenidate
      from striatum (90 minutes) was significantly slower than that of [11C]cocaine (20
      minutes). For both drugs, their fast uptake in striatum paralleled the experience
      of the "high." For methylphenidate, the high decreased very rapidly despite
      significant binding of the drug in the brain. In contrast, for cocaine, the
      decline in the high paralleled its fast rate of clearance from the brain.
      CONCLUSION: We speculate that because the experience of the high is associated
      with the fast uptake of cocaine and methylphenidate in the brain, the slow
      clearance of methylphenidate from the brain may serve as a limiting factor in
      promoting its frequent self-administration.

PMID- 7771916
TI  - Family-environment risk factors for attention-deficit hyperactivity disorder. A
      test of Rutter's indicators of adversity.
AB  - BACKGROUND: This study investigated whether family-environment risk factors are
      associated with attention-deficit hyperactivity disorder (ADHD). Compelling work
      by Rutter and coworkers revealed that it was the aggregate of adversity factors
      (severe marital discord, low social class, large family size, paternal
      criminality, maternal mental disorder, and foster care placement) rather than the
      presence of any single factor that led to impaired development. Based on the work
      of Rutter, we hypothesized a positive association between indicators of adversity
      and the diagnosis of ADHD and ADHD-associated impairments. METHODS: We studied
      140 ADHD and 120 normal control probands. Subjects were non-Hispanic white boys
      between the ages of 6 and 17 years. Rutter's indicators of adversity were used to
      predict ADHD-related psychopathology as well as impaired cognitive and
      psychosocial functioning. RESULTS: The odds ratio for the diagnosis of ADHD
      increased as the number of Rutter's adversity index predicted ADHD-related
      psychopathology (depression, anxiety, and conduct disorder), learning
      disabilities, cognitive impairment, and psychosocial dysfunction. CONCLUSIONS: A
      positive association appears to exist between adversity indicators and the risk
      for ADHD as well as for its associated psychiatric, cognitive, and psychosocial
      impairments. These findings support the work of Rutter and stress the importance
      of adverse family-environment variables as risk factors for children with ADHD.

PMID- 7771917
TI  - In vivo D2 dopamine receptor density in psychotic and nonpsychotic patients with
      bipolar disorder.
AB  - BACKGROUND: A prior positron emission tomographic study from The Johns Hopkins
      University, Baltimore, Md, using N-methylspiperone labeled with carbon 11
      reported elevated basal ganglia D2 dopamine receptor density (Bmax) values in
      neuroleptic-naive schizophrenic patients compared with controls. We have now
      extended these studies to include patients with bipolar disorder. METHODS:
      Patients with bipolar disorder (n = 14) either had never received neuroleptic
      medication or had been neuroleptic-free for more than 6 months, and they met DSM
      III criteria for currently symptomatic affective disorder. Patients with bipolar
      disorder were compared with matched schizophrenic patients and normal controls.
      All received two positron emission tomographic scans, the second of which was
      preceded by oral administration of haloperidol lactate, to permit the calculation
      of D2 dopamine receptor Bmax. RESULTS: Diagnostic groups differed in Bmax by
      analysis of variance (P < .0001); post hoc tests showed higher Bmax values for
      psychotic patients with bipolar disorder and schizophrenic patients compared with
      normal controls and for schizophrenic patients and psychotic patients with
      bipolar disorder compared with nonpsychotic patients with bipolar disorder. Among
      patients with bipolar disorder, Bmax values correlated significantly with the
      severity of psychotic symptoms (r = .63) on the Present State Examination but not
      with the severity of nonpsychotic mood symptoms. CONCLUSIONS: We conclude that,
      like schizophrenic patients, patients with psychotic bipolar disorder have
      elevations of D2 dopamine receptor Bmax values and that such elevations in
      affective disorder are more closely associated with the presence of psychosis
      than with mood abnormality. Elevations in dopamine receptor values thus may occur
      in psychiatric states that are characterized by psychotic symptoms rather than
      being specific to schizophrenia.

PMID- 7771918
TI  - Duration of neuroleptic treatment and prevalence of tardive dyskinesia in late
      life.
AB  - BACKGROUND: Although increasing age is the most consistently cited risk factor
      for the development of tardive dyskinesia for patients in the second to sixth
      decades of life, this relationship may not hold within geriatric populations.
      METHODS: Consecutively admitted geropsychiatric inpatients were examined with the
      Abnormal Involuntary Movement Scale within 72 hours of admission; comprehensive
      demographic, diagnostic, and psychometric data were also obtained. RESULTS:
      Seventy-four (19.2%) of 386 patients received diagnoses of dyskinesia. Lifetime
      duration of neuroleptic use was strongly correlated with dyskinesia rates. After
      accounting for the effect of lifetime duration of neuroleptic use in a stepwise
      logistic regression, only associations with Global Assessment Scale score and
      presence of dental problems remained statistically significant. In comparison
      with the duration of neuroleptic use, however, the contribution of these factors
      was minor. Sixteen percent of patients with less than 3 months of neuroleptic
      use, 29% with 3 to 12 months of neuroleptic use, 30% with 1 to 10 years of
      neuroleptic use, and 41% with more than 10 years of neuroleptic use had
      dyskinesia. Compared with patients with no history of neuroleptic treatment, the
      relative risks for these durations of neuroleptic use were 1.62 (95% confidence
      limits [CL], 0.81, 3.24), 2.89 (95% CL, 1.50, 5.55), 3.08 (95% CL, 1.66, 5.70),
      and 4.11 (95% CL, 2.12, 7.96), respectively. CONCLUSIONS: Within elderly
      populations, duration of exposure to neuroleptics is the strongest predictor of
      risk for tardive dyskinesia, and this risk increases rapidly within the first
      year of total lifetime neuroleptic use.

PMID- 7771919
TI  - Family study of early-onset dysthymia. Mood and personality disorders in
      relatives of outpatients with dysthymia and episodic major depression and normal
      controls.
AB  - BACKGROUND: The nosological status of dysthymia has generated considerable
      controversy. The major issues include whether dysthymia should be classified as a
      form of mood or personality disorder and, if dysthymia is classified as a mood
      disorder, whether it is sufficiently distinct from major depression to warrant a
      separate category. METHODS: We conducted a family study of 97 outpatients with
      early-onset dysthymia, 45 outpatients with episodic major depression, and 45
      normal controls, and their 882 first-degree relatives. Axis I and II disorders
      were assessed in relatives using direct and informant interviews and all
      available medical records. RESULTS: The rate of major depression in the relatives
      of early-onset dysthymic probands was significantly greater than in the relatives
      of normal controls and non-significantly greater than in the relatives of
      episodic major depressive probands. The rate of dysthymia was significantly
      greater in the relatives of dysthymic probands than in relatives of both major
      depressive probands and normal controls. Rates of most personality disorders were
      increased in the relatives of the dysthymic and major depressive probands
      compared with relatives of normal controls. In addition, the relatives of
      dysthymic probands had significantly higher rates of any personality disorder and
      any cluster B disorder than those of episodic major depressive probands, although
      these differences disappeared after controlling for Axis II comorbidity in the
      probands. Finally, dysthymic probands with and without a lifetime history of
      major depression did not differ on rates of psychiatric disorders in relatives.
      CONCLUSIONS: There is a strong familial relationship between dysthymia and major
      depression. However, dysthymia is also somewhat distinct in that it aggregates
      specifically in the families of patients with dysthymia. Finally, dysthymia and
      episodic major depression both appear to have a familial association with the
      personality disorders, although the link appears to be somewhat stronger for
      dysthymia.

PMID- 7771920
TI  - The prevalence of dementia and depression in the elderly community in a southern
      European population. The Zaragoza study.
AB  - BACKGROUND: Provocative international disparities reported in the prevalence
      rates of dementia and depression require further investigation. This is the first
      psychiatric study, to the best of our knowledge, about the prevalence of DSM-III
      R dementing and depressive disorders and their relationships in a representative,
      stratified community sample of the elderly in both a Spanish-speaking country and
      southern Europe. METHODS: A two-stage screening was completed in 1080 elderly.
      Sampling with replacement was done, and the cumulative response rate was 88%. In
      phase 1, lay interviewers administered the Spanish versions of the Mini-Mental
      State examination and the Geriatric Mental State Schedule-Automated Geriatric
      Examination for Computer Assisted Taxonomy package. In phase 2, research
      psychiatrists administered the same instruments and the History and Aetiology
      Schedule to all the probable cases and a similar number of randomly selected,
      probably normal subjects. RESULTS: An estimated 5.5% of the elderly were
      considered to have a dementing disorder, the most prevalent types being primary
      degenerative dementia, Alzheimer's type (4.3%), and multi-infarct dementia
      (0.6%). Depressive disorders were found in 4.8% of the elderly. Psychiatric
      morbidity, specifically depression, was associated with lower educational levels.
      "Case levels" of depression were documented in 25.4% of the demented cases and
      case levels of "organic" disturbance were seen in 18.2% of cases of major
      depression. CONCLUSIONS: Among the elderly, the prevalence of Alzheimer's disease
      and multi-infarct dementia, as opposed to depression, increases steeply with age.
      The overlap found between dementia and depression may have nosological
      implications. There could be an effect of lower education levels on psychiatric
      morbidity, particularly on depression.

PMID- 7771921
TI  - Clozapine-associated postoperative ileus: case report and review of the
      literature.

PMID- 7771922
TI  - The prevalence of schizophrenia in Ireland: readdressing the enigma.

PMID- 7771923
TI  - [Lymphoepithelial organs in the local immunity system of the mucous membranes].
AB  - The review deals with modern concepts of morphofunctional organization of
      lymphoepithelial organs relating to the lymphoid tissue associated with mucous
      membranes of the gastro-intestinal and respiratory tracts. They are unique among
      the peripheral immunogenesis organs due to their combination of lymphopoietic
      function with a function of the mucous membrane immunity. Their peculiar feature
      is their border location and close interrelation with epithelium which is an
      obligatory participant of the immune response.

PMID- 7771924
TI  - [Peripheral primitive neuroectodermal tumors of the soft tissues and bones].
AB  - Large group of small-round-cell tumours of soft tissues and bone represents a
      complex diagnostic problem for the pathologists. Neuronal nature of many tumours
      from this group is proven by means of new methods--immunophenotypic analysis,
      tissue culture, cytogenetics. Peripheral neuroepithelioma, Ewing tumour,
      primitive neuroectodermal tumour (PNET), Askin tumour belong to these neoplasms.
      These tumours anatomically have no connection with the structures of the central
      nervous system or autonomous sympathetic nervous system.

PMID- 7771925
TI  - [Malignant chondroblastoma of bone (variants in its structure and histological
      diagnosis)].
AB  - 16 tumours developing mainly in the adult patients are studied histologically.
      Several morphological variants and transitional forms are distinguished, their
      characteristics are presented.

PMID- 7771926
TI  - [Solitary eosinophilic granuloma of bone].
AB  - Clinico-anatomical and pathomorphological analysis is carried out in 80 cases of
      SEBG that were treated or consulted in the Institute during 1963-1993. The
      following stages of SEBG are distinguished: 1--accumulation and proliferation of
      histiocytes; 2--granulomatosis; 3--regression. Obviously all SEBG which regress
      spontaneously or by means of punctures with intrafocal administration of medical
      drugs pass through these stages. Distinguishing these stages is of practical
      significance as well for the differential diagnosis and prognosis. When
      granulomatous process is persistent, Langerhans cells having little proliferative
      potencies and apparently releasing biologically active substances, are able to
      stimulate the formation of their precursors in the marrow and thus of supporting
      the pathological focus.

PMID- 7771927
TI  - [Tumors of the tracheal and bronchial glands].

PMID- 7771928
TI  - [Osteochondroplastic tracheobronchopathy].
AB  - 14 cases of osteochondroplastic tracheobronchopathy (OT) are studied
      histologically. The disease is characterized by formation of cartilage and bone
      tissue in the submucosa of the trachea and bronchi outside their own
      cartilagenous carcass. Its histogenesis is not clear and is attributed to chronic
      bronchitis, specific inflammation, dysembryogenetic alterations, endocrine
      disorders, environmental and occupational hazards, amyloidosis of the trachea.
      The process is localized in the trachea and bronchi as an isolated and rarely as
      a diffuse lesion. Morphologically, normal or atrophic mucous membrane is
      observed, at some places with a squamous metaplasia. Areas of cartilage with
      calcium deposits and foci of bone having a trabecular structure with formation of
      spongious bone tissue, sometimes with bone marrow, were found.

PMID- 7771929
TI  - [An immunohistochemical study of pepsinogen type C in the gastric mucosa and in
      stomach cancer].
AB  - 129 cases of non-malignant gastric lesions and 171 cases of gastric carcinoma
      were studied immunohistochemically for pepsinogen C. PgC was constantly expressed
      at the bottom of the gastric glands irrespective of the disease. PgC was much
      more frequently observed in cancer patients (p < 0.001). PgC-positive were
      carcinoma tissues (38%), particularly of the intestinal type (53.4%), but also in
      mixed (40%) and diffuse (15.5%) types. PgC-negative carcinomas were more
      frequently observed in combination with PgC-positive areas of the surface
      epithelium (p < 0.001) and intestinal metaplasia (p < 0.05). PgC-positive
      dysplastic foci were observed in both groups of PgC-positive and PgC-negative
      malignant tumours.

PMID- 7771930
TI  - [Embryonal neuroepithelial tumors of the cerebral hemispheres].
AB  - 33 embryonal neuroepithelial tumours of the cerebral hemispheres were examined
      light- and electron-microscopically, immunohistochemically. 4 types of tumours
      were distinguished: neuroblastoma, neuroepithelioma, ependymoblastoma and choroid
      carcinoma. Each type was characterised by its own pathohistological,
      immunohistochemical and ultrastructural features. Our results and literature data
      prove immunophenotypic and ultrastructural heterogeneity of embryonal
      neuroepithelial tumors of the cerebral hemispheres, in spite of some similarities
      in their pathohistological features.

PMID- 7771931
TI  - [The differential diagnosis of peripheral lung formations (cytological
      research)].
AB  - The following pulmonary lesions were studied: carcinoma, carcinoid, tuberculoma,
      chondromatous hamartoma, chronic non-specific inflammatory process. Material was
      obtained through fiber bronchoscopy and roentgeno-endoscopical examination.
      Pappenheim staining in the modification of Astrakhantsev-Nechaeva and Ziehl
      Neelsen staining were used. 80 cases within 1993 were studied, among them 71
      peripheral lung carcinomas. 3 carcinoids, 3 tuberculoses, 1 non-specific
      inflammation. Basic cytological criteria are summarized which will improve the
      quality of the presurgical diagnosis.

PMID- 7771932
TI  - [The functional morphology of the spleen and lymphoid apparatus of the intestines
      in stress].
AB  - Structural and functional changes in the spleen and in the Payer plaques of the
      intestine under stress have been studied in 46 male rats. Stress activation of
      the adrenal cortex was blocked by metapiron injections. In cases of chronic
      stress along with the evident structural and functional damages in the immune
      system, in the spleen and in the peripheral blood there was a suppression of
      proliferative activity of T- and B-lymphocytes and an increase of functional
      activity of immuno-regulatory cells (T-suppressors). In chronic stress, specific
      compensatory changes due to the protective effect of metapiron preventing
      immunodepressive action of the adrenal gland hyperactivity were noted as well.

PMID- 7771933
TI  - [The age-related characteristics of the immune reaction of the mucosa of the
      gastric antrum in chronic gastritis].
AB  - Stomach biopsies from 16 adult patients at the age from 18 to 55 years, 16 adults
      of 56-68 years and 23 children were studied histologically, immunohistochemically
      and morphometrically. The frequency of Helicobacter pylori findings was dependent
      on the age. Local production of IgM and IgG was higher in the adults of young and
      mature age. Number of IgA producing cells decreased and that of IgG producing
      cells sharply increased in the aged persons; in this category also was increased
      the number of intraepithelial lymphocytes and of T-lymphocytes relating to the
      subpopulation of suppressor cytotoxic cells.

PMID- 7771935
TI  - [Cerebral sarcoidosis diagnosed by biopsy].
AB  - Space-occupying lesion was found by head computer tomography in the left brain
      hemisphere of the patients with lung and lymph node sarcoidosis. Neurologic
      symptoms and clinical course did not allow to exclude brain tumour. Granulomas
      typical for sarcoidosis were found in the stereotaxis biopsy of the parietal
      brain region.

PMID- 7771934
TI  - [The hyperinnervation phenomenon and the gradient distribution of nerve-growth
      factor activity in the tissue of the regenerating rat liver].
AB  - An increase in the number and fluorescence intensity of liver nerve structures
      was recorded using fluorescent-histochemical method following 50% resection of
      the left lobe of the liver. Simultaneous isolation of liver NGF showed its
      activity in the operated lobe to have had gradient distribution, which motivated
      successful growth of nerve fibers to the zone of regeneration and development of
      hyperinnervation in it.

PMID- 7771936
TI  - [Chondrosarcoma of the lung].
AB  - The description of this rare tumor in a male of 68 is reported. Clinical symptoms
      were hemoptysis, fever; was hospitalized with a suspicion of tuberculosis
      recurrence. Roentgenologically atelectasis of upper lobe of the right lung and
      obturation of the corresponding bronchus. Tumour had a diameter of 3 cm,
      histologically chondrosarcoma of the II degree of maturation with the inclusion
      of small cell sarcomatous areas (chondrosarcoma with a "mesenchymal" sarcomatous
      component).

PMID- 7771938
TI  - [Syringoma].

PMID- 7771937
TI  - [Carcinoid of the kidney].
AB  - Rare location of carcinoid tumour in the kidney is reported. The diagnosis was
      established on the basis of histological and ultrastructural investigation.

PMID- 7771939
TI  - [Vladimir Germanovich Shtefko--biologist, anatomist, anthropologist and
      pathologist (on the centenary of his birth)].

PMID- 7771941
TI  - [The working out of the problems of tissue transplantation for the restoration of
      the locomotor organs by the school of T. P. Vinogradova].

PMID- 7771940
TI  - [Prof. Tat'iana Pavlovna Vinogradova (on the centenary of her birth)].

PMID- 7771942
TI  - [Lack of correlation between distension of papillary muscles and the magnitude of
      mitral valve prolapse].

PMID- 7771943
TI  - [Early and delayed cardiac mortality after acute myocardial infarction in the pre
      thrombolytic era. Prognosis value of an ergometric test and coronary
      arteriography].
AB  - PURPOSE: To determine the relationship among clinical data, attenuated treadmill
      stress test (ST), cinecoronaryarteriography (CINE), ejection fraction (EF) with
      early-late mortality in patients after acute myocardial infarction (AMI).
      METHODS: Prospective study in 96 consecutive patients aged < 70 with AMI that
      were submitted to ST and CINE. Assessment of cardiac mortality was made 1-3 years
      post-AMI (period I) and at the end of follow-up (7-10 years-period II). RESULTS:
      First year and 10th year mortalities were 8% and 36%, respectively. Positive
      predictive value for cardiac death in period I was 10% for ST, 7% for multivessel
      coronary artery disease (MVCAD) and 9% for left ventricular ejection fraction
      (LVEF) < 30, while in period II they were 45%, 42% and 50%, respectively.
      Actuarial survival analysis (Kaplan-Meyer) disclosed mortality rates of 53% and
      20% (p = 0.06) on period II for positive and negative ST, respectively, 45% and
      22% (p < 0.03) for MVCAD and single-vessel disease, respectively, and 73% and 35%
      (p < 0.001) for those with and without left main coronary artery obstruction,
      respectively. In the multivariate regression analysis (Cox's model), only MVCAD
      (p < 0.002), LVEF < 30 (p < 0.003), positive ST (p < 0.007) and post-AMI angina
      (p < 0.01) were independently related to late mortality. CONCLUSION: Both
      attenuated ST and CINE are poor predictors of post-AMI early and late
      mortalities. However, multivariate regression analysis disclosed positive ST,
      MVCAD and LVEF < 30 as independent variables related to late mortality. This data
      indicate that myocardial ischemia, number of obstructed coronary arteries and
      poor left ventricular systolic function are the true determinants of post
      infarction cardiac mortality.

PMID- 7771944
TI  - [Chronic phase of Chagas disease. Clinical aspects and course of the disease].
AB  - PURPOSE: To evaluate the clinical and evolutive aspects of chronic chagasic
      patients. METHODS: Three hundred chronic chagasic patients, 180 females, with age
      ranging from 19 to 81 years (55.6 +/- 13.1) were retrospectively studied.
      Patients were divided according to the following clinical types: indeterminated,
      cardiac (with the subtypes: arrhythmogenic, dilated and mixed), digestive
      isolated and digestive plus cardiac involvement. The following variables were
      analysed: prevalence of each clinical forms, symptoms, electrocardiographic
      pattern and clinical outcome. RESULTS: At the start of the study, 73 (24.3%)
      patients were in indetermined type, 106 (35.3%) in cardiac arrhythmogenic, 95
      (31.6%) in mixed, 7 (2.3%) in dilated, 16 (5.3%) in digestive plus cardiac type
      and 3 (1%) in the pure digestive type. The most prevalent symptoms were dyspnea
      on efforts (57%), palpitations (41.33%) and chest pain (33%). The most frequent
      electrocardiographic pattern was right bundle branch block plus antero-superior
      fascicular block, in 30% of the patients. The average follow-up time was 7.8 +/-
      6.1 years and the outcome was considered good in 20 patients (6.6%), stable in
      214 (71.3%) and bad in 66 (23%). At the end of the follow-up, 9 patients have
      evaluated from the indeterminated to the cardiac and digestive types, and 19
      (17.92%), from the arrhythmogenic to mixed cardiac subtype. The follow-up was
      lost in 79 patients (26.3%), most of them, probably dead. CONCLUSION: With a mean
      time of 7.8 years, 12.3% of the patients in the indeterminated type evolved to
      the cardiac and/or digestive type; right brundle branch block with antero
      superior fascicular block was the most prevalent electrocardiographic pattern;
      the outcome was stable or good in the majority of these patients.

PMID- 7771945
TI  - [Initial heart rate transient at dynamic exercise performed in apnea. Influence
      of the variation rate of previous lung volume].
AB  - PURPOSE: To study the influence of inspiratory flow on the heart rate (HR)
      responses during the four-second exercise test (4sET) as a method to estimate
      cardiac vagal activity. METHODS: Fifteen healthy subjects performed the 4sET
      under two experimental situations: a) with maximal individual inspiratory flow
      (MIF) and b) with a slow inspiratory flow adjusted to reach total lung capacity
      in 4s (SIF). Vagal activity was estimated from B/C ratio obtained in ECG
      tracings, where B is the last R-R interval before the onset of exercise and C is
      the shortest R-R interval during exertion. RESULTS: Similar inspiratory
      capacities were reached, with significantly different inspiratory flows [mean
      (se)] [MIF = 2.23 (0.28) 1.s-1 and SIF = 0.59 (0.06) 1.s-1; t = 6.69; p <
      0.0001]; as a result, it was observed a greater B/C ratio in MIF [1.36 (0.05)] as
      compared to SIF [1.13 (0.04); t = 4.42; p = 0.0006]. The inspiratory flow
      influenced HR responses in the 4sET. The biphasic transient induced by
      inspiration, with a HR acceleration followed by a relative bradycardia, has not
      been completed before exercise in the 4sET with SIF. CONCLUSION: Lower values of
      B/C in the 4sET with SIF seemed to be due to overlapping effects of apnea and
      exertion on HR during cycling. On the other hand, when the inspiration was
      performed at MIF, the oscillatory effect of respiration upon HR was completed
      before the onset of exercise. Therefore, the tachycardia observed during the 4sET
      performed after individual maximal inspiratory flow represents the isolated
      effect of dynamic exercise.

PMID- 7771946
TI  - [Emergency valvuloplasty with a balloon catheter of a tricuspid bioprosthesis in
      Ebstein's anomaly].
AB  - A case of severe stenosis of a tricuspid bioprosthesis was successfully dilated
      in a 13 year old young male with Ebstein's anomaly. The patient had congestive
      heart failure and developed cardiogenic shock; angiography revealed absence of
      emptying of the right atrium. Multiple size balloons (#4 to 23) were sequentially
      introduced with successful bioprosthesis dilation and shock resolution. Tricuspid
      bioprosthesis can be dilated even in critical conditions and, although a
      palliative procedure, balloon valvuloplasty can be a lifesaving procedure in
      patients with cardiogenic shock.

PMID- 7771947
TI  - [Use of sympathomimetic agents in fetal atrioventricular heart block].
AB  - A healthy pregnant was referred at 34 weeks gestation because an obstetrical
      ultrasound examination had shown fetal bradycardia and nonimmune hydrops. The
      heart was anatomically normal but complete heart block was present with a
      ventricular rate of 22bpm and atrial of 101bpm. We injected isoproterenol by
      cordocentesis direct in the umbilical vein of the fetus and a significant
      increase into the ventricular and atrial rates were obtained. The direct therapy
      with sympathomimetic drugs is a simple technique and may save fetuses with
      complete heart block and hidrops.

PMID- 7771948
TI  - [Prolonged respiratory support with extracorporeal membrane oxygenation in lung
      transplantation].
AB  - A 42 year-old woman with terminal chronic lung disease underwent to left lung
      transplantation. Extracorporeal membrane oxigenation (ECMO) was required because
      dysfunction of transplanted organ occurred and was non-responsive to conventional
      therapy. The time of assistance was 47 hours and after this, the dysfunction of
      the transplanted lung reversed and the patient was weaned from the oxigenator.
      During hospital stay, she developed sepsis and died. In conclusion, ECMO was
      decisive to the treatment of pulmonary dysfunction, allowing time to the
      resolution of lung lesion.

PMID- 7771949
TI  - [Aneurysms of the left and non coronary sinus of Valsalva associated to mitral
      and aortic rheumatic valves and obstructive coronary disease].
AB  - A 30 years old, male, patient with rare multiple aneurysms of sinus of Valsalva
      associated to mitral and aortic regurgitation and total occlusion of circumflex
      artery had the clinical diagnosis made accidentally. The multiple aneurysms were
      detected by transesophageal echodopplercardiography and hemodynamic study. The
      diagnosis were confirmed at surgery and the patient underwent correction of the
      aneurysms through the use of pericardial patches and mitral and aortic valve
      replacement.

PMID- 7771950
TI  - [Chronic high levels of CK-MB].
AB  - We presented two cases of falsely elevated CK-MB due to the presence of a type 2
      macro CK, showed by isoenzymes electrophoresis. The association of this CK-MB
      falsely elevated with some digestive diseases are frequent. Quantification of CK
      isoenzymes by electrophoresis could be indicated in those cases in which the
      clinical course or ECG changes do not correlate with the CK-MB values.

PMID- 7771951
TI  - [Treatment of orthostatic hypotension with metoclopramide].
AB  - A 38 year-old woman, with orthostatic hypotension secondary to autonomic
      dysfunction accompanied by sympathetic hyperactivity and excess of dopamine, was
      treated with an antagonistic dopaminergic drug, metoclopramide, 30 mg/day, with
      good tolerance. Support intervention as well as the use of various drugs (beta
      blockers, caffeine, fludrocortisone, haloperidol) showed no effect. The answer to
      metoclopramide both subjective and objective were remarkable. The way in which
      metoclopramide acts has not yet been fully clarified. Being a widely used drug,
      well tolerated, its use must be considered in cases of severe orthostatic
      hypotension, especially those with an excess of dopamine.

PMID- 7771952
TI  - [Rheumatic fever. Advances in the study of its pathogenesis in the most recent
      decades].

PMID- 7771953
TI  - [Evaluation of the therapeutic efficacy of delayed-action diltiazem in the
      treatment of mild and moderate hypertension, with ambulatory of blood pressure
      monitoring].
AB  - PURPOSE: To evaluate the behaviour of 24 hour blood pressure and the therapeutic
      efficacy of diltiazem 240mg (slow release) in mild and moderate hypertension.
      METHODS: In an open noncomparative study 20 hypertensive patients were evaluated
      after two weeks of wash out and eight weeks of therapy. Diltiazem 240mg, slow
      release, was used in once a day basis. The blood pressure was evaluated through
      casual measures and by ambulatorial (ABPM) blood pressure monitorization.
      RESULTS: Sixteen patients (80%) reached therapeutic success (PAD nomalization or
      at least a reduction of 10mmHg), after six weeks of therapy. There were no
      changes in heart rate nor orthostatic hypotension. The mean reduction for the
      systolic blood pressure (PAS) was the 19.25mmHg and for PAD 11.60mmHg. The
      variables identified in ABPM (systolic and dyastolic load, SBP and DBP) showed
      significant reduction with maintenance of the circadian rhythm. CONCLUSION:
      Diltiazem 240mg, slow release, showed significant reduction (therapeutic success
      = 80%) in blood pressure of mild and moderate hypertensive patients associated
      with excellent tolerability. The circadian rhythm has been kept. The variables
      measured by ABPM were significantly reduced. Diltiazem demonstrated to be an
      important alternative for the treatment of mild to moderate hypertension due to
      its beneficial therapeutic effects associated to the once daily dosage.

PMID- 7771955
TI  - [Second Brazilian consensus on the treatment of arterial hypertension].

PMID- 7771954
TI  - [Randomized, double-blind comparative study between pravastatin and lovastatin.
      Evaluation of efficacy and safety].
AB  - PURPOSE: To verify eventual difference observed in the efficacy and safety of
      lovastatin (L) when compared to pravastatin (P), considering increasing doses up
      to the maximum and recommended ones in clinical practice. METHODS: Forty-eight
      hypercholesterolemic patients (LDL-C > 160 mg/dl after a placebo seven-day
      period) were studied and randomly assigned to constitute groups of 24 patients
      (GL and GP groups). The patients from GL group received L 20 mg/day and those
      from GP group P 10 mg/day, in a double-blind fashion. Six and 12 weeks later, the
      those were doubled. At the end of the placebo period and at weeks 6, 12 and 18
      they were evaluated for clinical data and laboratorial parameters, such as: lipid
      profile (TC, TG, HDL-C and LDL-C); enzymes AST, ALT, CPK, gamma-GT, alkalin
      phosphatase); biochemical data (urea, creatinine, bilirubin, uric acid, glucose);
      complete blood count and urinalysis. RESULTS: Both drugs have shown significant
      reductions in TC and LDL-C levels at the lowest clinical doses (L 20 mg/day; P 10
      mg/day), which became more marked as doses were gradually increased. However, the
      responses were always significantly greater for L in all doses employed. No
      adverse effects requiring treatment discontinuation were observed for both drugs.
      CONCLUSION: L showed a higher TC and LDL-C lowering effect than that observed
      with P, when the doses recommended by the respective manufacturers were compared.

PMID- 7771956
TI  - Trusting trials: can science help improve pharmaceutical health for all?

PMID- 7771957
TI  - A diabetes practice assessment activity--Part 3.

PMID- 7771958
TI  - An overview of medical imaging in the Roentgen centenary year.
AB  - This article reviews briefly current opinion regarding optimal imaging in a
      number of clinical situations presenting in family practice. The choice of
      imaging procedure, of course, depends upon availability, particularly in country
      areas. Nuclear medicine especially has not yet become as widely disseminated
      outside the large cities. To exclude repetition, topics that are the subject of
      more extensive review later in this issue have been excluded from this article.

PMID- 7771959
TI  - Cost versus efficacy of magnetic resonance imaging.
AB  - Magnetic resonance imaging offers new and improved diagnostic capabilities in all
      body parts and organ systems. Examinations can be quicker, safer and less
      expensive than traditional radiological procedures. The cost/efficiency of
      magnetic resonance imaging is under active evaluation.

PMID- 7771960
TI  - Aspects of musculoskeletal magnetic resonance imaging.
AB  - MRI can clearly identify many pathological processes in the musculoskeletal
      system. Because it is a non invasive investigation, it plays an important role in
      assessing joint pathology and musculoskeletal masses prior to any interventional
      procedure. If used properly, it can be cost effective and redundant diagnostic
      tests can be reduced, appropriate therapy can be instituted and unnecessary
      surgical intervention and hospitalisation can be avoided.

PMID- 7771961
TI  - Prostatic imaging: the role of transrectal ultrasound.
AB  - Until a few years ago, there was no acceptable imaging modality available for the
      prostate gland. Since the high frequency endo-rectal ultrasound transducers have
      been developed, transrectal ultrasound (TRUS) has gained wide acceptance as the
      method of choice for imaging assessment of common prostate conditions including
      prostate carcinoma.

PMID- 7771962
TI  - Musculoskeletal and small parts ultrasound.
AB  - Since the mid 1980s there has been a marked improvement in the technical quality
      of high frequency ultrasound probes for small part imaging Many superficial
      organs are ideally suited for ultrasound examination. The addition of colour
      doppler facilities has further enhanced ultrasounds' diagnostic capabilities
      particularly with scrotal ultrasound.

PMID- 7771963
TI  - Radiology and low back pain.
AB  - An outline of radiological investigations for patients with low back pain is
      presented. The article emphasises the need for thorough clinical evaluation of
      patients before any radiological investigations are undertaken. The types of
      radiological tests best suited to particular clinical problems are highlighted.

PMID- 7771964
TI  - Abdominal ultrasound. An overview for general practitioners.
AB  - The authors review some of the commoner indications and pathologies encountered
      in the context of general practice in which ultrasound has a role. Gynaecological
      indications and paediatric ultrasound will not be discussed.

PMID- 7771965
TI  - What's new in pulmonary radiology?
AB  - Research is still continuing to produce the ideal radiographic emulsion and the
      film plate will be in use for some time yet. Digital imaging will develop, but
      there are problems to overcome. Computerised tomography (CT) continues to improve
      despite early predictions to the contrary, and magnetic resonance imaging (MRI)
      will make an impact, especially with MRI angiography and fast-gated scanning
      techniques.

PMID- 7771966
TI  - The management of work caused lumbosacral injury. Development and content of
      professionally agreed guidelines.
AB  - A guidelines committee representing 20 professional organisations involved in the
      management of work related lumbo-sacral injury was convened in South Australia to
      formulate a consensus plan of management for this complex problem. This paper
      outlines the development and the content of the agreed guidelines.

PMID- 7771968
TI  - General practice medical records: why code? Why classify?
AB  - Recently, the Information Management Steering Group (IMSG) [a RACGP-AMA
      Commonwealth Government committee responsible for the planning of information
      management in general practice], held a Coding Workshop at which available coding
      systems and their application in general practice computerised medical records
      were reviewed. As there has been in the past some discussion as to the value of
      coding, the workshop participants agreed that a paper outlining the reasons for
      coding and classifying clinical data should be prepared and disseminated to all
      general practitioners.

PMID- 7771967
TI  - Assessing work capacity. Implications for medical practitioners.
AB  - Work capacity assessments have become an important area of clinical practice. The
      authors discuss some key concepts and common problems when conducting such
      assessments.

PMID- 7771969
TI  - Conolly Oration. The skilled doctor: in defence of the pursuit of excellence.

PMID- 7771970
TI  - Incidence patterns of respiratory illness in Queensland estimated from sentinel
      general practice.
AB  - Incidence rates of six respiratory infections were calculated from sentinel
      practice data of 33,407 reports coming from 31 general practitioners in
      Queensland over 34 months in 1986/1988. Upper respiratory tract infection had an
      annual incidence of 301 per 1000 people, most in children aged under five, and a
      winter rate twice the summer rate. Sore throat (incidence 112:1000) and
      Infectious mononucleosis (incidence 2.7:1000) had little seasonal variation and
      were maximal among those aged 15-19 (in whom there was one case of Infectious
      mononucleosis for every 14 sore throats). Influenza (incidence 44:1000) underwent
      a prominent epidemic in the winter of 1988. Measles (incidence 1.9:1000), and
      pertussis and pertussis-like syndrome (incidence 0.8:1000) were most commonly
      reported in the under-fives, and rarely among adults. Sentinel practices networks
      collect useful epidemiological data from which disease incidences can be
      calculated.

PMID- 7771971
TI  - Helen Mary Caldicott. Doctor to the planet.
AB  - A very strong sense of vocation to become a doctor since the age of eleven led
      Helen Caldicott into her profession of healing. This passion to heal has become
      global in the sense that Helen sees the earth as a living organism requiring the
      fundamentals of caring-preventive care, continuing care and fighting chronic
      'illness'. General practitioners who were present at her keynote opening address
      at WONCA in Vancouver 1992, marvelled at the powerful and logical impact of her
      presentation about the preservation of our earth.

PMID- 7771972
TI  - Critical assessment of ACE inhibitors. Part 2.
AB  - Angiotensin converting enzyme (ACE) inhibitors are now widely used for the
      treatment of hypertension and heart failure. They are of particular value in
      treating hypertensive patients with left ventricular dysfunction, and in
      diabetics where they have been shown to delay the progression of diabetic
      nephropathy. Differences in the metabolism, pharmacokinetics, and
      pharmacodynamics between the various ACE inhibitors generally do not translate
      into significant clinical differences in the majority of patients. However,
      fosinopril may be the preferred ACE inhibitor in patients with significant renal
      dysfunction because of a reduced requirement for dosage reduction. The duration
      of action of ACE inhibitors is determined by two properties, the plasma half-life
      and the affinity of binding to tissue ACE. All of the ACE inhibitors (with the
      possible exception of captopril) can provide satisfactory 24-hour blood pressure
      control in the majority of patients with mild to moderate hypertension when given
      once daily. Lisinopril provides consistently better 24-hour control of blood
      pressure than either captopril or enalapril. Evidence for superior 24-hour blood
      pressure control over enalapril has not been as well established for the other
      ACE inhibitors. Captopril may be preferred for initiating therapy in patients
      with severe heart failure who are at risk of first dose hypertension because of
      its rapid onset of action and relatively short duration of action. There is
      evidence, however, that perindopril may have a low risk of first dose
      hypertension in heart failure because of its gradual onset of action. Long-acting
      ACE inhibitors may be preferable for chronic therapy of heart failure. All of the
      ACE inhibitors have a low incidence of adverse effects in both young and elderly
      patients, and there is no convincing evidence of differences in tolerability
      between the drugs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7771973
TI  - Common facial skin disorders.

PMID- 7771974
TI  - Patient education. Halitosis.

PMID- 7771975
TI  - Tarsal tunnel syndrome.

PMID- 7771976
TI  - Ode to mortality.

PMID- 7771977
TI  - Chronic diarrhoea with relapse after treatment.

PMID- 7771978
TI  - Accident and emergency medicine. Acute dyspnoea.

PMID- 7771979
TI  - Removal of embedded fish-hook.

PMID- 7771980
TI  - 'Supermarket' v 'boutique' general practices.

PMID- 7771981
TI  - CARE Germany in Zaire: a clarification.

PMID- 7771982
TI  - Working in Zaire.

PMID- 7771983
TI  - Major fetal malformations and perinatal mortality rates: the place of late
      terminations.

PMID- 7771984
TI  - Successful pregnancy in the DIDMOAD syndrome (diabetes insipidus, diabetes
      mellitus, optic atrophy, deafness).
AB  - A case of successful pregnancy in a patient with the complete DIDMOAD syndrome is
      described. Attention is drawn to the need to monitor fluid balance carefully
      during and after pregnancy in this condition. The current literature in the area
      is reviewed.

PMID- 7771985
TI  - Neonatal infection due to Haemophilus influenzae biotype IV.
AB  - Neonatal infection due to Haemophilus influenzae has several clinical
      similarities to infection by the more common Streptococcus agalactiae (Strep
      group B). A high frequency of H. influenzae biotype IV in association with
      genital, maternal and neonatal infections has been reported in the literature,
      suggesting this biotype has an affinity for the female genital tract. Cefotaxime
      should be considered as part of the treatment regimen when this organism is
      suspected because of the emerging resistance of H. influenzae to ampicillin. We
      present a case of H. influenzae biotype IV infection in a premature (32 weeks)
      neonate.

PMID- 7771986
TI  - Ogilvie syndrome with caecal perforation in the post-caesarean patient.

PMID- 7771987
TI  - Insertion of a permanent electrode for intractable detrusor instability.

PMID- 7771988
TI  - Goserelin reduction of uterine fibroids prior to vaginal hysterectomy.

PMID- 7771989
TI  - Early severe haemorrhage complicating GnRH analogue treatment of submucous
      uterine fibroids.

PMID- 7771990
TI  - Falloposcopy can be useful.

PMID- 7771991
TI  - Nulliparous caesarean section in the home of active management of labour.
AB  - The world-wide incidence of Caesarean section continues to rise with dystocia
      recognized as the major indication. Active management of labour has been proposed
      as an alternative treatment to Caesarean section for dystocia. At the National
      Maternity Hospital, Dublin, a recent increase in the Caesarean section rate has
      been observed. This retrospective review reveals this to be due to other
      indications.

PMID- 7771992
TI  - Severe twin-twin transfusion syndrome: current management concepts.
AB  - The presence of functioning vascular anastomoses within the monochorionic
      placentation of a monozygotic twin pregnancy is responsible for the twin-twin
      transfusion syndrome. This is a heterogeneous disorder with a wide spectrum of
      severity. In the most severe form it results in the oligohydramnios
      polyhydramnios sequence with a marked disparity in intertwin biometry and
      amniotic fluid volume. Without therapy, the perinatal mortality of severe twin
      twin transfusion syndrome is 60-100%. Several therapeutic interventions have been
      attempted with therapeutic amniocentesis producing the most consistent
      improvement in fetal survival rates. The outcome of 10 cases of severe twin-twin
      transfusion syndrome, presenting as the oligohydramnios-polyhydramnios sequence,
      is presented. Gestational age at presentation ranged from 20-34 weeks. Three
      fetuses were hydropic at initial presentation and of these only 1 survived. All
      cases were treated with serial aggressive therapeutic amniocentesis, the number
      of procedures ranging from 1-9/patient. The volume of amniotic fluid removed
      ranged from 3,200-14,000 mL. Gestation was prolonged a mean of 46 days (range 1
      106 days). The perinatal survival rate was 65% (13/20 infants). Preterm premature
      rupture of membranes and secondary preterm birth complicated 1 pregnancy treated
      with therapeutic amniocentesis. Short-term morbidity in the liveborn infants was
      predominantly secondary to prematurity and renal cortical necrosis. Severe twin
      twin transfusion syndrome is the most common aetiology of the oligohydramnios
      polyhydramnios sequence. Therapeutic amniocentesis offers an intervention that
      may reduce the high perinatal loss rate previously observed with this disorder.

PMID- 7771993
TI  - Twin-twin transfusion syndrome: intraamniotic pressure measurement in the
      assessment of volume reduction at serial amniocenteses.
AB  - Two cases of severe twin-twin transfusion syndrome are described. In both, serial
      amniocenteses were followed by resolution of the disordered inter-twin
      haemodynamics with 4 intact term survivors. In all reports to date of aggressive
      reduction with or without successful outcome, volume reduction has been dictated
      by subjective or semiquantitative ultrasonic estimates of liquor volume. With the
      use of intraamniotic pressure estimation we describe a more rational basis for
      the removal of these large volumes of amniotic fluid.

PMID- 7771994
TI  - Singleton and twin confinements associated with infertility treatments.
AB  - A cross-sectional sample of 150 singleton and 159 twin confinements delivered in
      Western Australia in 1991 were randomly sampled in 1993; 63% of the women
      responded to a postal questionnaire. Thirteen percent of respondents with
      singletons and 26% of those with twins reported having problems conceiving at
      some stage in their life. Six percent of those who had singleton confinements and
      22% of those women who had twin confinements sought fertility advice prior to the
      conception of the index pregnancy. One percent (95% CI 0.03%, 5.5%) of women with
      singletons received infertility treatment compared with 17% (95% CI 10.4%, 26.3%)
      of those with twins. Overall 82.7% (95% CI 75.2%, 90.1%) of twin confinements
      followed spontaneous conception, 11.2% (95% CI 5.7%, 19.2%) followed ovarian
      stimulation treatment alone and 6.1% (95% CI 2.3%, 12.9%) followed IVF or GIFT
      procedures. The probability of a spontaneous twin confinement was 1 in 95. It was
      concluded that nearly twice as many twin pregnancies were associated with ovarian
      stimulation treatment given alone than with IVF and GIFT combined. The routinely
      collected data about assisted twin conceptions provide an incomplete picture with
      regard to the role of different infertility treatment modalities.

PMID- 7771996
TI  - Measurements of blood pressure, oedema and proteinuria in a pregnant population
      of New Zealand.
AB  - This is the first report of the largest study of blood pressure measurement in
      pregnancy in a New Zealand population using standardized definitions and
      methodology. Over 3,800 women who delivered in an 8-month period in the
      Wellington region were included in the study. Blood pressure measurement and the
      presence of oedema and proteinuria were recorded from booking until delivery and
      in the puerperium. Only 2.7% of women were unable to be contacted after delivery
      for details on outcomes. The results established normal ranges for blood pressure
      throughout pregnancy. The data show that blood pressure greater than 140/90 until
      35 weeks' gestation is outside 2 standard deviations at all gestations and
      justifies using these measurements as the definition of hypertension in
      pregnancy. The fall in blood pressure in the 2nd trimester was less than 1 mm Hg
      per week in both the systolic and diastolic pressures. This fall was smaller than
      previously recorded in other studies. Gestational hypertension was the commonest
      blood pressure abnormality occurring in 15.2% of the population. This represented
      69% of the pregnant women with a hypertensive disorder. The overall incidence of
      both gestational hypertension and preeclampsia was 18.5% which is higher than
      reported in other parts of the world. In this study obesity was significantly
      associated with hypertensive disorders in pregnancy. An arm circumference of > 33
      cm, one of the measurements of obesity, was found in 6.8% of the study
      population. Even after the effect of arm circumference was taken into account,
      hypertensive disorders were also more common in Pacific Island women.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7771995
TI  - Prenatal diagnosis and late termination: a legal perspective.
AB  - The purpose of prenatal screening is obviously to identify genetic and other
      disorders before a child is born. In the majority of cases, the intention is that
      the pregnancy should be terminated if the child is found to be affected by a
      serious disorder. Despite this expectation, the law in Victoria does not
      recognize fetal abnormality as a ground for abortion. For an abortion to be
      lawful, the doctor must honestly believe, on reasonable grounds, that the
      abortion is 'necessary to preserve the woman from a serious danger to her life or
      her physical or mental health' and that the abortion is 'not out of proportion to
      the danger to be averted' (the Menhennitt rules). Although the danger to health
      has been extended to include danger on economic and social grounds, it is still
      necessary for a doctor to base the decision to abort on the risk to the mother's
      health, and not on the abnormal fetus. When the fetus is older, a doctor may be
      charged with child destruction as well as abortion. This requires proof that the
      doctor 'unlawfully cause[d] such child to die' and acted 'with intent to destroy
      the life of a child capable of being born alive'. These terms are open to
      interpretation but it is not necessarily a defence that the child had a serious
      abnormality.

PMID- 7771997
TI  - Aspirin and prevention of preeclampsia. Position statement of the use of low-dose
      aspirin in pregnancy by the Australasian Society for the Study of Hypertension in
      Pregnancy.
AB  - 1. A heterogeneous group of randomized trials have been conducted using low-dose
      aspirin to prevent preeclampsia. The results do not support widespread use of low
      dose aspirin to prevent preeclampsia. 2. On the basis of existing literature, it
      is reasonable to use prophylactic low-dose aspirin from early pregnancy in the
      following groups: (i) Women with prior fetal loss after the first trimester, with
      placental insufficiency (ii) Women with severe fetal growth retardation in a
      preceding pregnancy either due to preeclampsia or unexplained (iii) Women with
      severe early-onset preeclampsia in a previous pregnancy necessitating delivery at
      or before 32 weeks' gestation. 3. On the basis of existing literature, it is
      recommended that aspirin not be used in the following groups: (i) Healthy
      nulliparous women (ii) Women with mild chronic hypertension (iii) Women with
      established preeclampsia. 4. The data are sufficient to support further trials in
      more homogeneous select subgroups of women considered at risk of developing
      preeclampsia.

PMID- 7771998
TI  - The role of transvaginal sonography in the diagnosis of placenta praevia.
AB  - Transvaginal sonography was performed in 70 patients diagnosed to have placenta
      praevia by transabdominal sonography. The diagnosis was confirmed either by
      digital examination in theatre at term or operative finding at delivery. Forty
      nine cases (70%) were correctly diagnosed to have placenta praevia by both modes
      of sonography. Transvaginal sonography ruled out placenta praevia in 12 cases
      (17%) thought to be placenta praevia by transabdominal ultrasound. Both
      transabdominal and transvaginal sonography demonstrated 'placental migration' in
      4 cases (6%) which were no longer praevia at delivery. Five patients (7%) were
      erroneously believed to have placenta praevia by both sonographic techniques.
      Overall, the diagnostic accuracy of transvaginal sonography was 92.8% compared
      with 75.7% for transabdominal sonography. None of the subjects experienced any
      exacerbation of bleeding or other complications. The results suggest that
      transvaginal sonographic localization of the placenta is safe and superior to the
      transabdominal route.

PMID- 7771999
TI  - The effect of vigorous exercise during pregnancy on birth-weight.
AB  - The aim of this study was to assess the effect on birth-weight of continuing a
      programme of vigorous exercise into late pregnancy. 'Potential exercisers' were
      women who had been doing vigorous exercise prior to pregnancy and intended to
      continue exercising during pregnancy. Controls were healthy pregnant women who
      did not do regular vigorous exercise. Both groups kept 2, 7-day food +/- exercise
      diaries at 25 and 35 weeks. The primary outcome variable was birth-weight. Women
      who continued doing at least 30 minutes of vigorous exercise at least 3 times
      weekly at 25 weeks and either maintained this minimum level or had delivered by
      35 weeks were classified as 'exercisers'. Women doing more than 4 sessions of
      vigorous exercise weekly at 25 weeks had babies whose mean birth-weight was 315 g
      lower than the mean birth-weight of babies born to controls.

PMID- 7772000
TI  - The feasibility of early second trimester pregnancy (12 to 14 weeks) termination
      with single intra-amniotic injection of 15-methyl PGF2 alpha.
AB  - Prostaglandin analogues have proven to be safe and effective for second trimester
      pregnancy terminations when given by various routes. Of these, the intra-amniotic
      (IA) route has proven to be safer, especially in women with medical disorders, as
      it causes the least occurrence of systemic side-effects. Previously, blind
      transabdominal IA instillation of the analogue 15-methyl PGF2 alpha was routinely
      possible only after 16 weeks' gestation. With the advent of ultrasound-guided
      techniques, it has now become possible to use the IA route for very early second
      trimester pregnancies. This study examines the use of single 1.5 mg 15-methyl
      PGF2 alpha IA injection for termination of 12-14 weeks pregnancies. Single
      injection resulted in successful abortion in 76.5% of women and, in the
      unsuccessful cases, additional prostaglandin injection resulted in successful
      abortion in all women within 48 hours without problems. It is therefore feasible
      to use ultrasound-guided IA prostaglandin injection for successful termination of
      early second trimester pregnancies.

PMID- 7772001
TI  - Intravaginal misoprostol for termination of midtrimester pregnancy.
AB  - Misoprostol seems to be a drug with many potential uses apart from the treatment
      of gastric and duodenal ulcers. The oral tablet appears to be effective for
      termination of midtrimester pregnancy when administered intravaginally. Further
      research should be carried out to determine its full range of action in order
      that the drug can be utilized to its maximum potential.

PMID- 7772002
TI  - Vaginal and speculum examination in medical curricula.
AB  - Medical students' perception of their own psychomotor skills and attitudes to
      different methods of teaching the gynaecological examination were studied.
      Students rated their physical skills poorly, only 7% feeling confident they could
      detect an abnormality and only 14% considering their ability to perform a Pap
      smear was good or very good. They rated their doctor/patient skills better, 55%
      considering they are good at conducting an examination with sensitivity and 67%
      at explaining to their patient what they were doing and why. Students' first
      preference for instruction was to examine patients in the Outpatient Clinic under
      the supervision of a doctor, a method experienced by most students on one
      occasion. The next preferred method was for students to work with 2 trained
      gynaecological assistants, acting as patient and instructor, with discussion of
      feelings and feedback (see Subjects and Methods). The option of student
      volunteers was a least favoured method but was cited as first preference by 5% of
      students. Over 25% of the female students considered volunteering for vaginal
      examination a 'possibility' if they were examined by a student of the same sex.
      Over 25% of males would 'possibly' volunteer for rectal examination only if the
      same sex was present. The comments by the students offer help in the future
      planning of teaching vaginal examination.

PMID- 7772003
TI  - Variation in caesarean and instrumental delivery rates in New Zealand hospitals.
AB  - A study of Caesarean section and instrumental delivery rates in the maternity
      hospitals in New Zealand delivering over 1,000 women per year was undertaken. The
      results at Middlemore Hospital were compared with those seen elsewhere. The
      Caesarean section rate at Middlemore Hospital in 1993 was significantly lower
      than the other large maternity hospitals in New Zealand. The Caesarean section
      rate at Middlemore from 1988 to 1993 has shown a significant downward trend which
      is different from the trends at other hospitals. The spontaneous vaginal delivery
      rates at Middlemore Hospital were higher than at other New Zealand hospitals
      between 1988 and 1993. We conclude that Middlemore Hospital has been successful
      in maintaining low interventional delivery rates by New Zealand and international
      standards--the Caesarean section rate remains below 10% and the spontaneous
      vaginal delivery rate approaches 85%. This is likely to be a consequence of a
      number of factors operating together but there is evidence to suggest that
      obstetric management policies at Middlemore do play a role in this.

PMID- 7772004
TI  - Education and hysterectomy.
AB  - A small Canberra survey provided the opportunity to investigate the observation
      that tertiary education is associated with lower hysterectomy rates. Despite the
      sample's being small and unrepresentative of either the Australian or even the
      Canberra population, it was possible to replicate a simple version of a national
      model of hysterectomy. Tertiary education remained strongly predictive of a low
      rate of hysterectomy. Additionally, the study showed, first, the tertiary
      educated women were less likely than others to be told that they needed a
      hysterectomy in the first place. Secondly, they were less likely to accept such
      advice: hysterectomy was undergone by only 1 of 5 of the better educated women to
      whom it had been suggested, but by 4 of 5 of the less educated.

PMID- 7772005
TI  - Vulvar cancer.

PMID- 7772006
TI  - Vulvar cancer: the Cinderella of gynaecological oncology.
AB  - Cancer of the vulva is a rare malignancy that increases progressively with age.
      The age-standardized incidence averages between 1 and 2 per 100,000 women in
      Western countries. The majority (80-90%) are squamous cell carcinomas, melanoma
      and adenocarcinoma each accounting for about 5% of cases. Internationally, the
      incidence of vulvar cancer varies more than 30-fold, the highest rates being seen
      in populations of Portuguese South America. In many populations the incidence
      appears to be stable but there is some evidence that the incidence of in situ
      carcinoma is increasing in the United States of America. Epidemiological studies
      have identified sexual factors, particularly human papilloma virus (HPV)
      infection, as increasing risk. Smoking also increases risk by interacting
      synergistically with HPV infection and genital warts. The aetiologies of vulvar
      intraepithelial neoplasia (VIN)3/in situ disease and invasive cancer appear to
      differ. VIN does not automatically progress to invasive cancer and is strongly
      associated with HPV infection. Many older women with invasive vulvar cancer do
      not have evidence of HPV and do not smoke. More research is needed on the cause
      of vulvar carcinoma in this group. Treatment has become more conservative over
      the years and this has reduced morbidity and probably mortality. Although FIGO
      data do not show much by way of improvement in survival, data from population
      based cancer registries have shown definite increases in survival (5-year
      survival proportions in excess of 80%, when age and Stage have been taken into
      account). Improvement is particularly related to the preponderance of early stage
      disease.

PMID- 7772007
TI  - Endoscopic minilaparotomy.
AB  - In a preliminary study the principles of standard gynaecological surgery, new
      operative laparoscopic techniques and mechanical elevation of the abdominal wall
      are combined. These early results indicate an advantage to both patient and
      hospitals from this approach. Further studies are required to verify our
      impressions that minilaparotomy combined with no insufflation laparoendoscopy
      will open up the concept of operative laparoscopic surgery to most
      gynaecologists.

PMID- 7772008
TI  - Laparoscopically-assisted vaginal hysterectomy.
AB  - A series of 153 consecutive patients is presented in whom a laparoscopically
      assisted vaginal hysterectomy was planned and was performed in 147 of them (96%).
      Bipolar diathermy was utilized to diathermy the upper uterine pedicles above the
      uterine arteries. Neither the uterine arteries nor the uterosacral ligaments were
      ligated laparoscopically and the remainder of the hysterectomy was performed
      vaginally. In the other 6 patients in whom the operation was commenced
      laparoscopically, it was discontinued and the operation concluded vaginally in 1
      patient and abdominally in the other 5 patients. The aim of using the
      laparoscopic technique has been to convert a potential abdominal hysterectomy
      into a vaginal hysterectomy. The technique and the results are discussed.

PMID- 7772009
TI  - Female circumcision.
AB  - Three cases of female circumcision are presented together with a literature
      review. Unfortunately, this procedure frequently results in genital mutilation.
      Treatment with deinfibulation enables restoration of the external genitalia and
      vagina. Obstetric and gynaecological complications have been documented, but
      emotional and psychological effects may be difficult to assess. These women
      should be treated without bias and with sensitivity.

PMID- 7772010
TI  - Sacrospinous colpopexy.
AB  - Sacrospinous colpopexy is a useful procedure in the cure of pulsion enterocele,
      high rectocele, and posthysterectomy vault prolapse. It allows the surgeon to
      correct coincident cystocele and rectocele and permits restoration of a
      relatively normal and comfortable vaginal depth and axis. It is a quick
      procedure, avoids intraabdominal trauma, has a high success rate and a low
      complication rate (1) and is useful in the management of patients who wish to
      maintain coital function. This paper retrospectively reviews the techniques,
      results and complications of 107 sacrospinous colpopexies performed in 104
      patients over an 8-year interval.

PMID- 7772011
TI  - Spontaneous uterine perforation as a serious complication of pyometra in elderly
      females.

PMID- 7772012
TI  - Continuous combined piperazine oestrone sulphate and medroxyprogesterone acetate
      hormone replacement therapy--a study of bleeding pattern, endometrial response,
      serum lipid and bone density changes.
AB  - This pilot study was conducted to establish the optimum oral dosage of
      medroxyprogesterone acetate (Provera) given daily in combination with a fixed
      dose of piperazine oestrone sulphate (Ogen), as hormone replacement therapy. A
      group of 32 nonhysterectomized, symptomatic menopausal women were randomly
      allocated to receive piperazine oestrone sulphate 1.25 mg daily and
      medroxyprogesterone acetate 2.5 mg, 5 mg or 10 mg daily for a 2-year period. This
      was an open study and the patients were reviewed at 3-monthly intervals for 2
      years. Vaginal bleeding was reported by 58% of patients after the first 3 months
      of treatment. There was a gradual decline in the reported incidence of bleeding
      over the following 6 months particularly by women in the 5 mg and 10 mg Provera
      group. Only 10% of patients were still recording slight bleeding in the 10 mg
      group at 12 months. By 24 months all the women in the 5 mg and 10 mg Provera
      groups had ceased bleeding. There were 2 patients in the 2.5 mg Provera group
      with persistent proliferative endometrium at 24 months. All the remaining
      patients had atrophic endometrium. There was no significant difference in serum
      lipid changes between the 3 groups, but there was an overall reduction in total
      cholesterol, triglycerides and low density lipoprotein cholesterol in all women.
      There was no significant difference in bone mineral density changes between the
      groups over the 2-year period. Endometrial protection with increased incidence of
      amenorrhoea, without significant adverse effects, was seen with the use of 5 mg
      and 10 mg of provera.

PMID- 7772013
TI  - First trimester antigen typing of fetal red cells using a flow cytometric
      technique.

PMID- 7772014
TI  - Falciparum malaria in pregnancy.

PMID- 7772016
TI  - The structure of the quinoprotein alcohol dehydrogenase of Acetobacter aceti
      modelled on that of methanol dehydrogenase from Methylobacterium extorquens.
AB  - The 1.94 A structure of methanol dehydrogenase has been used to provide a model
      structure for part of a membrane quinohaemoprotein alcohol dehydrogenase. The
      basic superbarrel structure and the active-site region are retained, indicating
      essentially similar mechanisms of action, but there are considerable differences
      in the external loops, particularly those involved in formation of the shallow
      funnel leading to the active site.

PMID- 7772018
TI  - Effect of intracellular iron depletion by picolinic acid on expression of the
      lactoferrin receptor in the human colon carcinoma cell subclone HT29-18-C1.
AB  - A lactoferrin receptor has been found on the brush-border membrane of intestinal
      epithelial cells of several species, including humans. A role for this receptor
      in intestinal iron absorption, which is well regulated in response to body iron
      stores, has been proposed. We have investigated the effect of intracellular iron
      depletion by picolinic acid, an iron chelator, on the cell surface binding of
      human lactoferrin to human enterocytes and its intracellular uptake, using HT29
      18-C1 cells, an enterocyte-like differentiable cell line. The confluent cells
      exhibited 5.8 x 10(6) specific binding sites per cell for diferric human 125I
      labelled lactoferrin with relatively low affinity (Kd 8.4 x 10(-7) M). The
      addition of picolinic acid to the culture medium resulted in a concentration- and
      time-dependent increase in lactoferrin binding that was correlated with a
      decrease in intracellular iron content. The maximum effect of picolinic acid on
      lactoferrin binding (approx. 2-fold increase), which appeared between 12 and 18 h
      after its addition, was obtained at a picolinic acid concentration of 2 mM.
      Scatchard analysis showed that the enhanced lactoferrin binding resulted from an
      increase in the number of lactoferrin receptors rather than an alteration in the
      binding affinity for lactoferrin. The time-dependent effect of picolinic acid was
      completely abolished in the presence of 1 microM anisomycin, a protein synthesis
      inhibitor, indicating that ongoing protein synthesis is involved in this effect.
      The enhanced lactoferrin binding induced by picolinic acid produced an increase
      of approx. 30% in the uptake of lactoferrin-bound 59Fe, indicating the existence
      of functional receptors. These results suggest that biosynthesis of lactoferrin
      receptors in intestinal epithelial cells can be regulated in response to the
      levels of intracellular chelatable iron, consistent with intestinal iron
      absorption dependent on body iron stores.

PMID- 7772017
TI  - Characterization of the ATPase activity of P-glycoprotein from multidrug
      resistant Chinese hamster ovary cells.
AB  - P-Glycoprotein (Pgp) was isolated from CHRC5 membranes by selective detergent
      extraction and further purified by lentil lectin affinity chromatography. The
      purified product displayed a very high basal ATPase activity (1.65 mumol/min per
      mg protein in the absence of added drugs or lipids) with an apparent Km for ATP
      of 0.4 mM. There was no evidence of cooperativity, suggesting that the two ATP
      sites operate independently of each other. Pgp ATPase activity was stimulated by
      verapamil, trifluoperazine and colchicine, and inhibited by daunomycin and
      vinblastine. All drugs and chemosensitizers acted as mixed activators or
      inhibitors, producing changes in both the Vmax of the ATPase and the Km for ATP.
      ADP competitively inhibited Pgp ATPase, with a Ki of 0.2 mM. The macrolide
      antibiotics bafilomycin A1, concanamycin A and concanamycin B, inhibited Pgp
      ATPase at concentrations of 0.1-10 microM, and at an inhibitor:protein
      stoichiometry of 0.65-1.0 mumol/mg protein, which is at the low end of the range
      characteristic of P-type ATPases. Pgp ATPase was relatively selective for adenine
      nucleotides. Several phospholipids stimulated Pgp ATPase activity in a dose
      dependent manner, whereas others produced inhibition. Metabolic labelling showed
      that the endogenous phospholipids associated with purified Pgp consisted largely
      of phosphatidylethanolamine and phosphatidylserine, with only a small amount of
      phosphatidylcholine. 32P-Labelling studies indicated that purified Pgp was
      partially phosphorylated. It can be concluded that Pgp is a constitutively
      active, adenine nucleotide-specific ATPase whose catalytic activity can be
      modulated by both drugs and phospholipids.

PMID- 7772015
TI  - Parasite-regulated membrane transport processes and metabolic control in malaria
      infected erythrocytes.

PMID- 7772019
TI  - Characterization of ATP receptor responsible for the activation of phospholipase
      A2 and stimulation of prostaglandin E2 production in thymic epithelial cells.
AB  - In TEA3A1 rat thymic epithelial cells, ATP stimulates prostaglandin E2 (PGE2)
      production through activation of phospholipase A2 (PLA2) enzymic activity. The
      stimulation of PGE2 production tested with other nucleotides indicated the
      agonist potency of adenosine 5'-[gamma-thio]triphosphate (ATP[S]) > or = UTP >
      ATP, with ED50 of about 10 microM for ATP[S]. In TEA3A1 cells, cross-linking
      studies with ATP[35S] revealed the presence of four cell-surface cross-linked
      bands of 42 kDa, 53 kDa, 83 kDa and 100 kDa in Triton X-100 extracts of TEA3A1
      cells by fluorography. Guanosine 5'-[gamma-thio]triphosphate specifically blocked
      the cross-linking of ATP[35S] to the 53 kDa, 83 kDa and 100 kDa ATP-binding
      proteins, and inhibited the ATP[S]-mediated stimulation of PGE2 production with
      an ED50 of about 25 microM. On the other hand, 2-methylthioadenosine triphosphate
      (2MeSATP) blocked ATP[35S] cross-linking to the 42 kDa protein, but had no effect
      on ATP[S]-mediated stimulation of PGE2 production. In a variant cell line,
      TEAvarl, derived from TEA3A1 cells that lost their response to ATP in the
      activation of PLA2, the presence of 83 kDa ATP-binding protein was not detected.
      Results from our study suggest that ATP activates PLA2 enzymic activity in TEA3A1
      cells by binding to an atypical ATP receptor that has not been described
      previously.

PMID- 7772020
TI  - Cloning and expression of the carboxypeptidase gene from Aspergillus saitoi and
      determination of the catalytic residues by site-directed mutagenesis.
AB  - Carboxypeptidase from Aspergillus saitoi removes acidic, neutral and basic amino
      acids as well as proline from the C-terminal position at pH 2-5. cpdS, a cDNA
      encoding A. saitoi carboxypeptidase, was cloned and expressed. Analysis of the
      1816-nucleotide sequence revealed a single open reading frame coding for 523
      amino acids. When A. saitoi carboxypeptidase cDNA was expressed in yeast cells,
      carboxypeptidase activity was detected in the cell extract and was immunostained
      with a 72 kDa protein with polyclonal anti-(A. saitoi carboxypeptidase) serum.
      The recombinant enzyme treated with glycopeptidase F migrated with an apparent
      molecular mass of 60 kDa on SDS/PAGE, which was the same as that of the de-N
      glycosylated carboxypeptidase from A. saitoi. Site-directed mutagenesis of the
      cpdS indicated that Ser-153, Asp-357 and His-436 residues were essential for the
      enzymic catalysis. It can be concluded that A. saitoi carboxypeptidase has a
      catalytic triad comprising Asp-His-Ser and is a member of serine carboxypeptidase
      family (EC 3.4.16.1).

PMID- 7772021
TI  - Metabolic response of sheep skin to a chronic infusion of a variant of insulin
      like growth factor I.
AB  - The effects of a chronic (21-day) skin infusion of a variant of insulin-like
      growth factor I (IGF-I) (long-Arg3-IGF-I; LR3IGF-I) on short-term (48 h)
      responses of skin metabolism and 21-day plasma hormone concentration, wool
      follicle characteristics and wool production were investigated in well-fed
      castrated Romney sheep. A bilateral arteriovenous preparation was used to infuse
      LR3IGF-I continuously into the skin on one abdominal flank and saline into the
      other abdominal flank of six sheep; a further six sheep had one flank infused
      with saline (controls). LR3IGF-I caused an initial (4-24 h) reduction in the
      plasma concentrations of amino acids, especially tyrosine, valine and lysine,
      and, after 24 h, significant (P < 0.05) reductions in blood oxygen and plasma
      glucose concentrations. After 4 h of LR3IGF-I infusion, there was a significant
      increase in blood flow (P < 0.05) and oxygen uptake (P < 0.05), and net uptake of
      amino acids [which was significant (P < 0.05) for valine and phenylalanine] by
      the LR3IGF-I-infused skin was increased. Total uptake of phenylalanine for skin
      protein synthesis, measured using [3H]phenylalanine uptake, was also
      significantly increased after 4 and 24 h of infusion. After 48 h of infusion all
      LR3IGF-I-dependent measurements of metabolic parameters had fallen to preinfusion
      values. By day 7 of the 21-day infusion there was a significant (P < 0.05)
      decrease in circulating endogenous IGF-I in plasma of treated sheep compared with
      that of control sheep, followed by a significant (P < 0.05) increase between day
      7 and 21. Plasma insulin levels followed a similar pattern. There was no change
      at any stage of infusion in IGF-binding proteins in the plasma of the two LR3IGF
      I-infused sheep tested, and it is concluded that LR3IGF-I caused a down
      regulation of the type-I IGF-I receptors followed by a rise in endogenous IGF-I
      concentration consequent on lack of feedback regulation. After 21 days of
      infusion there was no effect of LR3IGF-I on wool-follicle-bulb-cell mitotic rate,
      bulb diameter or wool production.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7772022
TI  - Amino acids important in enzyme activity and dimer stability for Drosophila
      alcohol dehydrogenase.
AB  - We have determined the nucleotide sequences of eight ethyl methanesulphonate
      induced mutants in Drosophila alcohol dehydrogenase (ADH), of which six were
      previously characterized by Hollocher and Place [(1988) Genetics 116, 253-263 and
      265-274]. Four of these ADH mutants contain a single amino acid change: glycine
      17 to arginine, glycine-93 to glutamic acid, alanine-159 to threonine, and
      glycine-184 to aspartic acid. Although these mutants are inactive, three mutants
      (Gly17Arg, Gly93Glu and Gly184Asp) form stable homodimers, as well as
      heterodimers with wild-type ADH, in which the wild-type ADH subunit retains full
      enzyme activity [Hollocher and Place (1988) Genetics 116, 265-274].
      Interestingly, the Ala159Thr mutant does not form either stable homodimers or
      heterodimers with wild-type ADH, suggesting that alanine-159 is important in
      stabilizing ADH dimers. The mutations were analysed in terms of a three
      dimensional model of ADH using bacterial 20 beta-hydroxysteroid dehydrogenase and
      rat dihydropteridine reductase as templates. The model indicates that mutations
      in glycine-17 and glycine-93 affect the binding of NAD+. It also shows that
      alanine-159 is part of a hydrophobic anchor on the dimer interface of ADH.
      Replacement of alanine-159 with threonine, which has a larger side chain and can
      hydrogen bond with water, is likely to reduce the strength of the hydrophobic
      interaction. The three-dimensional model shows that glycine-184 is close to the
      substrate binding site. Replacement of glycine-184 with aspartic acid is likely
      to alter the position of threonine-186, which we propose hydrogen bonds to the
      carboxamide moiety of NAD+. Also, the negative charge on the aspartic acid side
      chain may interact with the substrate and/or residues in the substrate binding
      site. These mutations provide information about ADH catalysis and the stability
      of dimers, which may also be useful in understanding homologous dehydrogenases,
      which include the human 17 beta-hydroxysteroid, 11 beta-hydroxysteroid and 15
      hydroxyprostaglandin dehydrogenases.

PMID- 7772023
TI  - Murine protein tyrosine phosphatase-PEST, a stable cytosolic protein tyrosine
      phosphatase.
AB  - We have isolated the murine cDNA homologue of the human protein tyrosine
      phosphatase PTP-PEST (MPTP-PEST) from an 18.5-day mouse embryonic kidney library.
      The cDNA isolated has a single open reading frame predicting a protein of 775
      amino acids. When expressed in vitro as a glutathione S-transferase fusion
      protein, the catalytic domain (residues 1-453) shows intrinsic phosphatase
      activity. Reverse transcriptase PCR and Northern-blot analysis show that MPTP
      PEST mRNA is expressed throughout murine development. Indirect immunofluorescence
      in COS-1 cells against a heterologous epitope tag attached to the N-terminus of
      MPTP-PEST, together with cellular fractionation and Western-blot experiments from
      different murine cell lines, indicate that MPTP-PEST is a free cytosolic protein
      of 112 kDa. Finally, sequence analysis indicates that the C-terminal portion of
      the protein contains four regions rich in proline, glutamate, serine and
      threonine, otherwise known as PEST sequences. These are characteristic of
      proteins that display very short intracellular half-lives. Despite the presence
      of these motifs, pulse-chase labelling experiments demonstrate that MPTP-PEST has
      a half-life of more than 4 h.

PMID- 7772024
TI  - Mouse aggrecan, a large cartilage proteoglycan: protein sequence, gene structure
      and promoter sequence.
AB  - Seven genomic clones for mouse aggrecan core protein have been isolated including
      3 kb of 5'- and 7 kb of 3'-flanking sequences. All exon sequences and their
      intron boundary sequences in these clones were identified and mapped by DNA
      sequencing. The gene spans at least 61 kb and contains 18 exons. Exon 1 encodes
      5'-untranslated sequence and exon 2 contains a translation start codon,
      methionine. The coding sequence is 6545 bp for a 2132-amino-acid protein with
      calculated M(r) = 259,131 including an 18-amino-acid signal peptide. There is a
      strong correlation between structural domains and exons. Notably, the chondroitin
      sulphate domain consisting of 1161 amino acids is encoded by a single exon of 3.6
      kb. Although link protein has similar structural domains and subdomains, the
      sequence identity and the organization of exons encoding the subdomains B and B'
      of G1 and G2 domains revealed a strong similarity of mouse aggrecan to both human
      versican and rat neurocan. Primer extension analysis identified four
      transcription start sites which are close together. The promoter sequence showed
      high G/C content (65%) and contained several consensus binding motifs for
      transcription factors including Sp-1 and the glucocorticoid receptor. There are
      stretches of sequences similar to the promoter region of both the type-II
      collagen and link protein genes. These sequences may be important for cartilage
      gene expression.

PMID- 7772025
TI  - Characterization of the manganese superoxide dismutase cDNA and gene from the
      human parasite Onchocerca volvulus.
AB  - The manganese-containing superoxide dismutase (MnSOD) is a major component of the
      cellular defence mechanisms against the toxic effects of the superoxide radical.
      Within the framework of studies on anti-oxidant enzymes and their protective role
      in the human parasitic nematode Onchocerca volvulus, sequences encoding the MnSOD
      were isolated and examined in this study. Degenerate primers were designed based
      upon conserved regions of MnSOD sequences from other organisms, and were used in
      PCR on reverse-transcribed O. volvulus total RNA and genomic DNA to identify
      partial cDNA and genomic DNA fragments encoding the O. volvulus MnSOD (OvMnSOD).
      The genomic DNA PCR product was used to screen an O. volvulus adult worm lambda
      unizap II cDNA library and the nucleotide sequence of the longest clone
      determined. The complete 5'-end of the OvMnSOD cDNA was obtained using the rapid
      amplification of cDNA ends (RACE) procedure with O. volvulus total RNA and was
      found to possess a spliced leader sequence at the 5'-terminus. The deduced
      primary sequence encodes a 25 kDa protein, which has the conserved residues
      required for enzyme activity and metal binding. The 24 N-terminal amino acids
      encoded by the OvMnSOD cDNA comprise a putative mitochondrial transit peptide.
      The OvMnSOD gene was also isolated from an O. volvulus adult worm lambda fix II
      genomic library, a restriction map was constructed and the nucleotide sequence
      determined. The OvMnSOD gene was found to possess five exons and four introns
      with consensus splice-site junctions. Potential regulatory elements were
      identified in the 5' genomic flanking sequence. Southern-blot analysis with total
      worm genomic DNA indicates a single-copy gene, with a restriction pattern
      consistent with that of the isolated gene.

PMID- 7772026
TI  - Probing the details of the HIV-1 Rev-Rev-responsive element interaction: effects
      of modified nucleotides on protein affinity and conformational changes during
      complex formation.
AB  - The solution structure of the human immunodeficiency virus type 1 (HIV-1) Rev
      responsive element (RRE) has been investigated by enzymic and chemical structural
      probing of a 71 nt RRE transcript. The minimum sequence information required to
      maintain recognition by the Rev protein has previously been mapped to a 29 nt
      stem-loop structure, known as minSLIIB. The key recognition target is a single
      stranded RNA bubble at the base of the RNA stem. The fine details of RNA
      recognition have been probed using chemically synthesized minSLIIBs containing
      variant base or sugar residues at sites within the bubble. These have been
      analysed by gel retardation assays and their relative affinities for Rev protein
      determined. Complex formation between the wild-type minSLIIB RRE and Rev protein
      was also monitored using CD spectroscopy, which suggests a change in RNA
      conformation upon Rev binding. The spectral change is consistent with localized
      melting of RNA, leading to a decrease in the level of base stacking and/or a
      change in base tilting, during formation of the complex. Deoxynucleotide
      substitutions on just one side, the 5' side, of the bubble inhibit the
      conformational change detected by CD. The data are consistent with a dynamic
      interaction between Rev and its target site. The contact points between Rev and
      the RRE were probed directly using photo-cross-linking with either ribo-5
      bromouridine- or ribo-4-thiouridine-substituted minSLIIBs. The data are
      consistent with protein-RNA contacts at the bottom of the bubble.

PMID- 7772028
TI  - The temporal and cellular expression of c-fos and c-jun in mechanically
      stimulated rabbit latissimus dorsi muscle.
AB  - The levels of c-fos and c-jun mRNA were measured by reverse transcription PCR in
      the rabbit latissimus dorsi muscle following three separate training regimes,
      i.e. passive stretch, 10 Hz electrical stimulation or a combination of the two.
      Both c-fos and c-jun mRNA expression peaked at around 1 h after imposing stretch
      and at around 4.5-6 h after the initiation of electrical stimulation. The
      combined stretch/electrical stimulation regime induced biphasic expression of
      both c-fos and c-jun mRNA, with peaks coinciding temporally with those for the
      individual regimes. Immunostaining with anti-Fos and anti-Jun antibodies revealed
      the accumulation of these proteins in both myofibre and interstitial cell nuclei
      following passive stretch. In contrast, following electrical stimulation the
      localization of immunoreactive c-Fos and c-Jun proteins was predominantly in
      interstitial cell nuclei. c-Fos and c-Jun immunoreactivity was also clearly
      colocalized in a proportion of myonuclei from stretched muscle. These findings
      suggest that the rapid induction of c-fos and c-jun is an early event in response
      to mechanical stretch and might trigger [via activator protein-1 (AP-1)
      transcriptional factors] events leading to muscle fibre hypertrophy. However, the
      involvement of AP-1 in inducing the phenotypic changes in muscle fibres as a
      result of electrical stimulation appears less clear.

PMID- 7772027
TI  - Induction by prostaglandin A1 of haem oxygenase in myoblastic cells: an effect
      independent of expression of the 70 kDa heat shock protein.
AB  - Prostaglandins of the A type (PGA) induce the synthesis of 70 kDa heat shock
      proteins (hsp70) in a large variety of mammalian cells. Induction of hsp70 has
      been associated with a cytoprotective effect of PGA1 after virus infection or
      thermal injury. In the present report we provide evidence that, in murine
      myoblasts, PGA1 is not able to induce hsp70 expression, whereas it increases the
      synthesis of the constitutive protein, hsc70, and dramatically induces the
      synthesis of a 32 kDa protein (p32). The p32 protein has been identified as haem
      oxygenase. PGA1 acts at the transcriptional level by inducing haem oxygenase mRNA
      synthesis, and the signal for induction appears to be associated with decreased
      intracellular GSH levels. Haem oxygenase, a low-molecular-mass stress protein
      induced in mammalian cells by oxidant stress, is known to be part of a general
      inducible antioxidant defence pathway. The fact that prostaglandin synthesis is
      stimulated in muscle during contraction and in the heart in response to ischaemia
      raises the possibility that induction of haem oxygenase by PGA in myoblasts could
      be part of a protective mechanisms in operation during stress and hypoxia.

PMID- 7772029
TI  - Accumulation of phosphatidylalcohol in cultured cells: use of subcellular
      fractionation to investigate phospholipase D activity during signal transduction.
AB  - Phosphatidylalcohol accumulates as a product of a phospholipase D (PLD)-catalysed
      transphosphatidylation reaction in cells incubated in the presence of a primary
      alcohol. In the presence of ethanol the phorbol ester, phorbol 12-myristate 13
      acetate (PMA), stimulated the accumulation of [3H]phosphatidylethanol (PEth) in
      HeLa cells prelabelled with [3H]palmitic acid. Radioactivity associated with PEth
      increased linearly during a 30 min incubation, indicating that a sustained
      activation of PLD is caused by PMA in these cells. This was accompanied by the
      membrane association of protein kinase C-alpha (PKC-alpha), the PKC isoform that
      recent studies indicate is involved in the activation of PLD. In similar
      experiments, the neuropeptide bradykinin stimulated an accumulation of PEth in
      3T3 Li cells. The radioactivity associated with PEth increased to a maximal level
      at 30 s and plateaued after this time, suggesting that bradykinin induces only a
      transient activation of PLD in these cells. This is consistent with the effects
      of bradykinin on PKC-alpha, which underwent a rapid and transient association
      with cell membranes. The subcellular localization of PEth was examined using the
      technique of subcellular fractionation on Percoll density gradients to isolate
      organelle-enriched fractions from HeLa and 3T3 Li cells. An accumulation of
      [3H]PEth was measured in the plasma-membrane (PM)-enriched fractions of both HeLa
      and 3T3 Li cells after incubation with PMA and bradykinin respectively. This was
      accompanied by a time-dependent accumulation of [3H]PEth in the combined
      mitochondrial and endoplasmic reticulum (MER)-enriched fractions of both cell
      lines. PMA was also found to cause translocation of PKC-alpha to both the PM- and
      MER-enriched fractions in HeLa cells. However, bradykinin stimulated the
      translocation of PKC-alpha to the PM-enriched fractions only of 3T3 Li cells. The
      results show that PLD activation leads to the accumulation of PEth in both the PM
      and MER fractions. We therefore propose that either bradykinin activates a PM
      associated PLD and the PLD reaction product is rapidly translocated to other
      membrane systems or it activates an MER-associated PLD by a mechanism that does
      not involve PKC-alpha.

PMID- 7772030
TI  - Evidence for a protein S receptor(s) on human vascular smooth muscle cells.
      Analysis of the binding characteristics and mitogenic properties of protein S on
      human vascular smooth muscle cells.
AB  - The presence of specific binding sites for the coagulation factor protein S (PS)
      on the surface of human vascular smooth muscle cells (HVSMC) is described. The
      binding characteristics of 125I-PS to HVSMC were studied and found to be
      saturable, reversible and, as described by the Hill equation, co-operative (h
      1.74; Kd 0.33 nM). Autoradiographic analysis of detergent extracts of HVSMC
      chemically cross-linked with 125I-PS and separated by SDS/PAGE revealed
      radioactivity associated with two proteins with apparent molecular masses of 220
      and 230 kDa respectively. The mitogenic activity of PS on HVSMC was also
      investigated. Protein S was shown to stimulate DNA synthesis of growth-arrested
      HVSMC and to support their proliferation under low-serum conditions in a
      sustained and dose-dependent manner.

PMID- 7772031
TI  - Mechanism of reaction of allylamine with the quinoprotein methylamine
      dehydrogenase.
AB  - Allylamine did not serve as an efficient substrate for methylamine dehydrogenase
      (EC 1.4.99.3) in a steady-state assay of activity and appeared to act as a
      competitive inhibitor of methylamine oxidation by methylamine dehydrogenase.
      Transient kinetic studies, however, revealed that allylamine rapidly reduced the
      tryptophan tryptophylquinone (TTQ) cofactor of methylamine dehydrogenase. The
      rate of TTQ reduction by allylamine was 322 s-1, slightly faster than the rate of
      reduction by methylamine. These data were explained by a kinetic mechanism in
      which allylamine and methylamine are alternative substrates for methylamine
      dehydrogenase. The apparent competitive inhibition by allylamine is due to a very
      slow rate of release of the aldehyde product, 0.28 s-1, relative to a rate of
      18.6 s-1 for the release of the aldehyde product of methylamine oxidation. A
      reaction mechanism is proposed for the oxidative deamination of allylamine by
      methylamine dehydrogenase. This mechanism is discussed in relation to the
      reaction mechanisms of topa-bearing quinoprotein amine oxidases, the flavoprotein
      monoamine oxidase and the mammalian semicarbazide-sensitive amine oxidase.

PMID- 7772032
TI  - Effects of polycations on Ca2+ binding to the Ca(2+)-ATPase.
AB  - Spermine and polyarginine have been shown to increase the rate of dissociation of
      Ca2+ from the Ca(2+)-ATPase of skeletal-muscle sarcoplasmic reticulum. They also
      decrease the affinity of the ATPase for Mg2+ as detected by changes in the
      fluorescence intensity of the ATPase labelled with 4-(bromomethyl)-6,7
      dimethoxycoumarin (DMC). Polyarginine itself also decreases the fluorescence
      intensity of DMC-labelled ATPase. These results are consistent with binding of
      spermine and polyarginine to a gating site controlling the rate of access of Ca2+
      to its binding sites on the ATPase. A basic peptide PLN-(1-25) corresponding to
      residues 1-25 of phospholamban had no effect on the rate of dissociation of Ca2+
      or on the fluorescence of DMC-labelled ATPase. Spermine, polyarginine and PLN-(1
      25) all increased the equilibrium constant E1/E2, and spermine and polyarginine
      increased the rate of Ca2+ binding to the ATPase, consistent with an increase in
      the rate of the E2-->E1 transition. Spermine displaced Tb3+ and Ruthenium Red
      from the ATPase, consistent with binding in the stalk region of the ATPase.
      Polyarginine and PLN-(1-25), however, had no effect on Tb3+ or Ruthenium Red
      binding, suggesting a greater specificity in binding basic peptides to the ATPase
      than spermine.

PMID- 7772033
TI  - N-acetyl-D-neuraminic acid synthesis in Escherichia coli K1 occurs through
      condensation of N-acetyl-D-mannosamine and pyruvate.
AB  - Two enzymes have been found to be involved in bacterial N-acetyl-D-neuraminic
      acid (NeuAc) synthesis: NeuAc synthase, which condenses N-acetyl-L,D-mannosamine
      and phosphoenolpyruvate, and NeuAc lyase or NeuAc aldolase, which condenses N
      acetyl-D-mannosamine and pyruvate. When we used Escherichia coli K1 crude
      extracts, we observed the generation of NeuAc in the presence of N
      acetylmannosamine and both phosphoenolpyruvate (NeuAc synthase activity) or
      pyruvate (NeuAc lyase activity). However, when crude extracts were fractionated
      by Sephacryl S-200 chromatography, NeuAc synthase activity disappeared. A
      chromatographic peak of NeuAc synthase activity was detected when column
      fractions were re-tested in the presence of the active NeuAc lyase peak.
      Furthermore, crude extracts converted phosphoenolpyruvate into pyruvate. Pyruvate
      depletion, due to the addition of pyruvate decarboxylase to the NeuAc synthase
      reaction mixture, blocked NeuAc formation. Moreover, after NeuAc lyase
      immunoprecipitation no NeuAc synthase was detected. These findings suggest that
      NeuAc synthase is not present in E. coli K1 and therefore that NeuAc lyase is the
      only enzyme responsible for NeuAc synthesis in this bacterium.

PMID- 7772035
TI  - Differential effects of distamycin analogues on amplification of human gene
      sequences by polymerase-chain reaction.
AB  - In this report we analyse the effects of distamycin and five distamycin analogues
      on amplification by polymerase-chain reaction (PCR) of two gene sequences
      displaying a different A+T/G+C content. The first was a 5' region of the human
      oestrogen receptor (ER) gene, containing a (TA)26 stretch; the second was a CG
      rich sequence of the human Ha-ras oncogene. The results obtained unequivocally
      demonstrate that the addition of one pyrrole ring significantly improves the
      ability of distamycin derivatives to interfere with PCR-mediated amplification of
      the human ER genomic region carrying a (TA)26 stretch. The distamycin analogues
      analysed differ in the number of pyrrole rings and in the presence of an N
      formyl, an N-formimidoyl or a retroamide group at position X1. Among compounds
      carrying the same number of pyrrole rings, those carrying an N-formyl or an N
      formimidoyl group retain a similar inhibitory activity. The retroamide analogues,
      on the contrary, are much less efficient in inhibiting PCR-mediated amplification
      of the 5'ER region. With respect to sequence selectivity both distamycin and
      distamycin analogues exhibit a sequence preference, since they do not inhibit PCR
      amplification of Ha-ras CG-rich gene regions, with the exception of a distamycin
      analogue carrying four pyrrole rings.

PMID- 7772034
TI  - Enhanced hydrolysis of phosphatidylcholine by human group II non-pancreatic
      secreted phospholipase A2 as a result of interfacial activation by specific
      anions. Potential role of cholesterol sulphate.
AB  - The extracellular concentration of the Group II human non-pancreatic secreted
      phospholipase A2 (hnpsPLA2) is elevated in a variety of inflammatory disorders.
      This enzyme is remarkable because it demonstrates almost zero activity with egg
      phosphatidylcholine (PC) or synthetic dioleoyl-phosphatidylcholine (DOPC) as
      substrate, but expresses high activity with the anionic phospholipid dioleoyl
      phosphatidylglycerol (DOPG), a feature shared with the Group II enzyme from rat
      liver. The presence of certain membrane-bound anions can enhance hydrolysis of PC
      by the mammalian secreted PLA2S. In this study the ability of various non-polar
      anions to stimulate DOPC hydrolysis by secreted PLA2S has been investigated. The
      naturally occurring membrane anion, cholesterol sulphate, was particularly
      effective in stimulating the hydrolysis of both DOPC and also 1-stearoyl-2
      arachidonyl phosphatidylcholine by hnpsPLA2. Activation of DOPC hydrolysis was
      also achieved with dioleoyl-phosphatidylserine (DOPS); however, DOPS was less
      effective than cholesterol sulphate. In contrast, the dianion dioleoyl
      phosphatidic acid, a known activator of pig pancreatic PLA2, failed to activate
      the human enzyme. It remains to be established whether cell plasma-membrane
      hydrolysis by extracellular hnpsPLA2 can be activated in vivo by the presence of
      suitable membrane anions such as cholesterol sulphate and thus promote an
      inflammatory response within the cell.

PMID- 7772036
TI  - DNase I hypersensitivity sites and nuclear protein binding on the fatty acid
      synthase gene: identification of an element with properties similar to known
      glucose-responsive elements.
AB  - We have shown previously that fatty acid synthase (FAS) gene expression is
      positively regulated by glucose in rat adipose tissue and liver. In the present
      study, we have identified in the first intron of the gene a sequence closely
      related to known glucose-responsive elements such as in the L-pyruvate kinase and
      S14 genes, including a putative upstream stimulatory factor/major late
      transcription factor (USF/MLTF) binding site (E-box) (+ 292 nt to + 297 nt).
      Location of this sequence corresponds to a site of hypersensitivity to DNase I
      which is present in the liver but not in the spleen. Moreover, using this
      information from a preliminary report of the present work, others have shown that
      a + 283 nt to + 303 nt sequence of the FAS gene can confer glucose responsiveness
      to a heterologous promoter. The protein binding to this region has been
      investigated in vitro by a combination of DNase I footprinting and gel
      retardation experiments with synthetic oligonucleotides and known nuclear
      proteins. DNase I footprinting experiments using a + 161 nt to + 405 nt fragment
      of the FAS gene demonstrate that a region from + 290 nt to + 316 nt is protected
      by nuclear extracts from liver and spleen. This region binds two ubiquitous
      nuclear factors, USF/MLTF and the CAAT-binding transcription factor/nuclear
      factor 1 (CTF/NF1). Binding of these factors is similar in nuclear extracts from
      liver which does or does not express the FAS gene as observed for glucose
      responsive elements in the L-pyruvate kinase and S14 genes. This suggests a
      posttranslational modification of a factor of the complex after glucose
      stimulation.

PMID- 7772037
TI  - Inhibition of proteolysis by cell swelling in the liver requires intact
      microtubular structures.
AB  - In the perfused rat liver, proteolysis is inhibited by cell swelling in response
      to hypo-osmotic media, glutamine and insulin. Colchicine, an inhibitor of
      microtubules, did not affect cell swelling in response to these agonists.
      However, the antiproteolytic action of these effectors was largely blunted in the
      presence of colchicine or the microtubule inhibitors colcemid and taxol. On the
      other hand, inhibition of proteolysis by phenylalanine, asparagine or NH4Cl, i.e.
      compounds which exert their antiproteolytic effects by mechanisms distinct from
      cell swelling, was not sensitive to colchicine. Swelling-induced inhibition of
      proteolysis was not affected by cytochalasin B. The anti-proteolytic effect of
      hypo-osmotic cell swelling and insulin was largely abolished in freshly isolated
      rat hepatocytes; however, it reappeared upon cultivation of the hepatocytes for 6
      10 h. The restoration of the sensitivity of proteolysis to cell volume changes
      was accompanied by a progressive reorganization of microtubule structures, as
      shown by immunohistochemical staining for tubulin. It is concluded that intact
      microtubules are required for the control of proteolysis by cell volume, but not
      for the control of proteolysis by phenylalanine, asparagine or NH4Cl. These
      findings may explain why others [Meijer, Gustafson, Luiken, Blommaart, Caro, Van
      Woerkom, Spronk and Boon (1993) Eur. J. Biochem. 215, 449-454] failed to detect
      an antiproteolytic effect of hypo-osmotic exposure of freshly isolated
      hepatocytes. This effect, however, which is consistently found in the intact
      perfused rat liver, also reappeared in isolated hepatocytes when they were
      allowed to reorganize their microtubular structures in culture.

PMID- 7772038
TI  - Quantification in vivo of the effects of different types of dietary fat on the
      loci of control involved in hepatic triacylglycerol secretion.
AB  - Polyunsaturated fatty acids (PUFA) have been suggested to exert their
      hypotriglyceridaemic effect through several possible mechanisms that would be
      expected to decrease the rate of hepatic very-low-density-lipoprotein
      triacylglycerol secretion. We have quantified the role played in vivo by changes
      in the pattern of partitioning of (i) acyl-CoA between oxidation and
      esterification, (ii) diacylglycerol between synthesis of triacylglycerol and of
      the major phospholipids, and (iii) triacylglycerol between secretion and storage
      within the liver, in response to two dietary levels of n-6 and n-3 PUFA. In order
      to achieve this we used the technique of selective labelling of hepatic fatty
      acids in vivo. Compared with a predominantly saturated fatty acid diet, both n-6
      and n-3 PUFA intake resulted in a decrease in the proportion of acyl moieties
      that were secreted by the liver, through an increased diversion of acyl-CoA
      towards oxidation and a lower fractional rate of secretion of newly synthesized
      triacylglycerol. In addition, a diet rich in n-3 fatty acids resulted not only in
      a greater magnitude of these effects but also in a doubling of the partitioning
      of diacylglycerol towards phospholipid labelling. It is shown that the overall
      50% reduction achieved by fish oil feeding in the proportion of acyl groups that
      were secreted by the liver was distributed over all three branch points. The
      contribution of each of these adaptations was quantified. The application of such
      an approach, i.e. the localization and in vivo quantification of the importance
      of loci of control, in studies on dietary and pharmacological agents that affect
      lipaemia, is discussed.

PMID- 7772039
TI  - Endotoxin-induced inflammation does not cause hepatic zinc accumulation in mice
      lacking metallothionein gene expression.
AB  - The action of endotoxin lipopolysaccharide (LPS) on hepatic Zn uptake was
      examined in mice lacking expression of metallothionein (MT)-1 and MT-II genes.
      Hepatic Zn concentrations, which in normal control mice increased by a mean 29%
      (MT elevated 20-fold) 16 h post-LPS exposure, did not increase in MT-null mice.
      Plasma Zn fell by 68% in controls and 32% in MT-null mice. The time course of LPS
      action in normal mice was characterized by a rapid reduction (-74% at 4 h, -81%
      at 8 h) and partial recovery (-39% at 24 h) in plasma Zn, with a progressive
      increase over 24 h in hepatic concentrations of MT (by 36-fold) and Zn (by 40%).
      In contrast, the MT-null mice had a linear decrease in plasma Zn (-15% at 8 h, 
      41% at 24 h) and early loss of Zn from the liver. The Zn changes seen in MT-null
      mice were largely attributable to LPS-associated anorexia. Food deprivation (20
      h) alone caused respective 14% and 30% decreases in hepatic and plasma Zn
      concentrations and a 27% reduction in total liver Zn reserves, whereas fasted
      normal mice conserved Zn with a 4-fold increase in hepatic MT. This study
      confirms that MT synthesis is essential for endotoxin-induced liver Zn
      accumulation.

PMID- 7772040
TI  - Catalytic activity of bovine seminal ribonuclease is essential for its
      immunosuppressive and other biological activities.
AB  - Bovine seminal ribonuclease (BS-RNase) is a homologue of RNase A with special
      biological properties, including potent immunosuppressive activity. A mutant BS
      RNase was created in which His-119, the active-site residue that acts as a
      general acid during catalysis, was changed to an aspartic acid. H119D BS-RNase
      formed a dimer with quaternary structure similar to that of the wild-type enzyme
      but with values of kcat. and kcat./Km for the cleavage of UpA [uridylyl(3'-
      >5')adenosine] that were 4 x 10(3)-fold lower. The mutant protein also
      demonstrated dramatically decreased immunosuppressive, anti-tumour,
      aspermatogenic, and embryotoxic activities. The catalytic activity of BS-RNase is
      therefore necessary for its special biological properties.

PMID- 7772042
TI  - Inhibition of myeloperoxidase by benzoic acid hydrazides.
AB  - Myeloperoxidase is the most abundant protein in neutrophils and catalyses the
      conversion of H2O2 and chloride into HOCl. To help clarify the role of this
      enzyme in bacterial killing and inflammation, a specific and potent inhibitor
      needs to be identified. We have studied a series of benzoic acid hydrazides and
      found that in general they inhibit the peroxidation activity of myeloperoxidase
      with an IC50 value of less than 10 microM. The IC50 values of derivatives with
      substituents containing oxygen or nitrogen were related to their Hammett
      substituent constants. This indicates that myeloperoxidase oxidizes the hydrazide
      group of these compounds, and the degree to which they inhibit the enzyme is
      dependent on the ease of their oxidation. Unsubstituted benzoic acid hydrazide
      and its 4-chloro derivative were poor inhibitors of peroxidation. Thus it is
      likely that hydrogen-bonding of the enzyme to substituents containing oxygen or
      nitrogen increases the binding affinity of the hydrazides and enhances their
      oxidation by myeloperoxidase. 4-Aminobenzoic acid hydrazide (ABAH) was the most
      potent inhibitor of peroxidation. It irreversibly inhibited HOCl production by
      the purified enzyme, having an IC50 value of 0.3 microM. With neutrophils
      stimulated with opsonized zymosan or phorbol myristate acetate, ABAH inhibited
      HOCl production by up to 90% and the IC50 values were 16 microM and 2.2 microM
      respectively. In the presence of superoxide dismutase, these values decreased to
      6.4 microM and 0.6 microM respectively. ABAH had no effect on superoxide radical
      (O2-.) production and degranulation by neutrophils, nor did it inhibit catalase
      or glutathione peroxidase. Thus ABAH is an effective and selective inhibitor that
      should be useful for determining the contribution of myeloperoxidase to oxidant
      mediated reactions of neutrophils.

PMID- 7772041
TI  - Purification and properties of lysophospholipase isoenzymes from pig gastric
      mucosa.
AB  - Two lysophospholipases, named gastric lysophospholipases I and II (enzymes I and
      II), were purified 3730- and 2680-fold from pig gastric mucosa. The preparations
      showed 22 and 23 kDa single protein bands on SDS/PAGE respectively. Both enzymes
      lacked transacylase activity and appeared to exist as monomers. Their activities
      were not affected by Ca2+, Mg2+ or EDTA. Enzyme I was most active at pH 8.5 and
      hydrolysed a variety of lysophospholipids including acidic lysophospholipids and
      the acyl analogue of platelet-activating factor, whereas enzyme II was most
      active at pH 8 and its activity was confined to lysophosphatidylcholine and
      lysophosphatidylethanolamine. When 1-palmitoylglycerophosphocholine was used as
      substrate, enzymes I and II showed half-maximal activities at 11 and 12 microM
      respectively. The enzymes exhibited no phospholipase B, lipase or general
      esterase activity. Enzyme II was significantly inhibited by lysophosphatidic acid
      whereas enzyme I was only moderately inhibited. Peptide mapping with V8 protease
      and papain revealed structural dissimilarity between the two enzymes. Antiserum
      raised against enzyme I did not recognize enzyme II, but did recognize the small
      sized lysophospholipase purified from rat liver. Anti-(enzyme II) consistently
      did not cross-react with enzyme I or the liver enzyme. These antisera
      specifically recognized neither the 60 kDa lysophospholipase transacylase
      purified from liver nor any peritoneal macrophage protein. Thus gastric mucosa
      contains two different small-sized lysophospholipases: one is closely related to
      the small-sized lysophospholipase of liver, but the other appears to be a novel
      isoform.

PMID- 7772044
TI  - Simultaneous purification of biotin-binding proteins-I and -II from chicken egg
      yolk and their characterization.
AB  - Chicken egg yolk biotin-binding protein-I (BBP-I) has been purified to
      homogeneity along with the tetrameric BBP-II by a common protocol. The
      purification includes delipidation of egg yolk by butanol extraction, DEAE
      Sephacel chromatography, treatment with guanidinium chloride and biotin
      aminohexyl-Sepharose affinity chromatography. The identity of purified BBP-I was
      ascertained by its physicochemical properties as well as by its immunological
      cross-reactivity and precursor-product relationship with BBP-II.

PMID- 7772043
TI  - Study of the rat liver S-adenosylmethionine synthetase active site with 8-azido
      ATP.
AB  - The active site of rat liver S-adenosylmethionine synthetase was studied using 8
      azido ATP, a photolabile analogue of ATP. Both forms of the enzyme, tetramer and
      dimer, could be labelled by using concentrations of the analogue similar to the
      KmATP values for each form, 350 microM and 1 mM respectively. Labelling of both S
      adenosylmethionine synthetase forms with 8-azido [alpha-32P]ATP, followed by
      tryptic digestion and purification by HPLC, afforded one specifically labelled
      peptide in each case. Identification of the labelled peptide by amino acid
      analysis and peptide sequencing, and comparison with the enzyme sequence,
      indicated that the same peptide (267-286) was modified in both enzyme forms. The
      results are discussed on the basis of the high degree of similarity that this
      peptide shows in all the known S-adenosylmethionine synthetase sequences.

PMID- 7772045
TI  - The complete amino acid sequence confirms the presence of pseudoazurin in
      Thiosphaera pantotropha.
AB  - The complete amino acid sequence, obtained by direct protein sequencing, of the
      pseudoazurin from Thiosphaera pantotropha is reported. It shows sequence
      identities varying from 46 to 66% with previously sequenced pseudoazurins.
      Previously identified conserved residues with key functions in pseudoazurins are
      found in the protein from T. pantotropha with the exception of glycine-39, the
      carbonyl group of which has been considered as a ligand to the copper, which is
      replaced by a serine residue. Electrospray-ionization MS (ESI-MS) has shown that
      pseudoazurin from T. pantotropha often contains two polypeptide species differing
      in molecular mass by 16 Da, presumably owing to oxidation of a methionine residue
      to a sulphoxide derivative. These two species have different endoproteinase Arg-C
      digestion patterns. Conditions for ESI-MS were identified that permitted either
      the retention or the loss of the single copper ion associated with the
      pseudoazurin. The aberrant tendency of T. pantotropha pseudoazurin to form a
      disulphide-bridged dimer on SDS/PAGE under some conditions is described.

PMID- 7772046
TI  - Ca2+ concentration during binding determines the manner in which annexin V binds
      to membranes.
AB  - Annexins are a family of calcium-binding proteins that have been implicated in a
      wide range of intracellular processes. We have previously reported that
      stimulation of platelets with thrombin can induce the association of
      intracellular annexin V with membranes in two distinct ways. First, in such a way
      that it can be eluted from the membrane with EGTA and secondly in a manner such
      that it is tightly bound to the membrane and requires the non-ionic detergent
      Triton X-100 for its solubilization. We report that exposure of platelets to the
      calcium ionophore A23187 mimics the relocation induced by stimulation with
      thrombin. In separate experiments we demonstrate that a calcium ion concentration
      [Ca2+] of 0.8 microM is sufficient for maximum binding of the EGTA-resistant form
      to membranes. In contrast a higher [Ca2+] was required to induce maximal binding
      of the annexin V which could be extracted with EGTA. We demonstrate that
      following temperature-induced phase separation in Triton X-114, the membrane
      associated annexin V partitions predominantly into the aqueous phase. We also
      show that the isoelectric point of annexin V does not change following membrane
      association. These observations suggest that a covalent modification, of annexin
      V itself, is not responsible for its association with the membrane. Millimolar
      [Ca2+] is required for maximal binding of purified annexin V to phospholipid
      vesicles. We show that binding to phospholipids can be reversed entirely by
      subsequent treatment with EGTA. This suggests that the EGTA-resistant form of
      annexin V is binding to a membrane component other than phosphatidylserine.
      Annexin V has previously been shown to bind to protein kinase C. Relocation of
      annexin V to membranes paralleled that of protein kinase C in thrombin-stimulated
      cells but not in cells treated with A23187, suggesting that these proteins are
      not functionally linked in platelet activation. Using bifunctional cross-linking
      reagents we have identified an 85 kDa complex containing annexin V. This may
      represent an association between annexin V and an annexin V-binding protein with
      a molecular mass of approximately 50 kDa.

PMID- 7772047
TI  - Differential localization of the mRNA of the M and B isoforms of creatine kinase
      in myoblasts.
AB  - Creatine kinase (CK) plays an important role in buffering ATP and ADP levels in
      tissues which have intermittently high and fluctuating energy demands, such as
      skeletal muscle. This buffering function has a spatial, as well as a temporal
      aspect, which is dependent on the localization of different enzyme isoforms
      within the cell. We show here, by in situ hybridization, that the mRNAs for the
      cytoplasmic isoforms of CK are differentially localized in a mouse myoblast cell
      line (C2C12). The mRNA for the M form is localized at the cell periphery, while
      that for the B form is localized in the perinuclear region. Deletion of segments
      of the 3' untranslated regions of these mRNAs or swapping of these segments
      between the mRNAs for the two isoforms demonstrated that localization signals lie
      within these regions. Localization appears to be tissue-specific, since both the
      M and B mRNAs were distributed uniformly over the cytoplasm in a non-muscle cell
      line. These results, in conjunction with other studies which have shown that mRNA
      localization can lead to co-localization of the encoded protein, suggest that the
      localization of the mRNAs for the cytoplasmic isoforms of CK may be involved in
      the localization of the enzymes themselves.

PMID- 7772048
TI  - Localization of Ca(2+)-dependent conformational changes of calretinin by limited
      tryptic proteolysis.
AB  - Calretinin is an EF-hand Ca(2+)-binding protein expressed predominantly in some
      neurons. We have found that the tryptic digestion pattern of rat recombinant
      calretinin depends on Ca2+ concentration as determined by SDS/PAGE, amino-acid
      sequence analysis and electrospray-ionization MS. Ca(2+)-saturated calretinin was
      cleaved between amino acids 60 and 61 to yield two fragments, which accumulated
      during cleavage. Small amounts of the larger fragment (amino acid residues 61
      271) were further cleaved from the C-terminal end. Ca(2+)-free calretinin was
      also cleaved between residues 60 and 61; however, under the latter conditions the
      fragment 61-271 was further cleaved from the N-terminal end. Native rat
      calretinin was cleaved by trypsin in a similar Ca(2+)-dependent fashion. All
      identified fragments of recombinant calretinin bound 45Ca2+ on nitrocellulose
      filters, although to a different extent. The 61-271 fragment was released by EGTA
      from an octyl-agarose column in a manner similar to intact calretinin, while
      fragment 61-233 was not eluted by EGTA. These observations show that there are
      trypsin cleavage sites in calretinin that are available regardless of Ca2+
      binding, other sites that are completely protected against trypsin on Ca(2+)
      binding and sites which become partially available on Ca(2+)-binding. Together
      these data show that calretinin changes its conformation on Ca2+ binding and
      identify the regions which are exposed in apo and Ca(2+)-bound form.

PMID- 7772049
TI  - Expression of the human gene coding for the alpha-chain of C4b-binding protein,
      C4BPA, is controlled by an HNF1-dependent hepatic-specific promoter.
AB  - C4b-binding protein (C4BP) is an abundant oligomeric plasma glycoprotein which
      controls the activation of the complement cascade through the classical pathway.
      In humans, the majority form of C4BP is composed of seven alpha-chains and one
      beta-chain, covalently linked by their C-termini. C4BP is mainly expressed in the
      liver. We have previously cloned and characterized the structure of the genes
      encoding the alpha and beta chains, C4BPA and C4BPB, respectively. Here we
      addressed the characterization of the mechanisms controlling the hepatic
      restricted expression of the C4BPA gene. We found that the C4BPA promoter is
      contained within the first 369 bp upstream of the transcription start site. The
      activity of this promoter is restricted to hepatic cells in transfection
      experiments. The hepatic transcription factor HNF1 interacts with a region of
      this promoter at -38 bp. This region is absolutely required for the activity of
      this promoter, suggesting that HNF1 is essential for the hepatic activity of the
      C4BPA promoter. We speculate that this extreme requirement of HNF1 for the
      activity of the human C4BPA promoter is related to the fact that this promoter
      lacks a TATA box.

PMID- 7772050
TI  - Functional differences between dimeric and octameric mitochondrial creatine
      kinase.
AB  - Mitochondrial creatine kinase (Mi-CK) consists of octameric and dimeric molecules
      that are interconvertible. In the present study, the kinetic properties of
      purified chicken heart Mi-CK (Mib-CK) dimers and octamers were investigated
      separately under highly controlled conditions. Gel-permeation chromatography was
      performed before and after kinetic measurements in order to clearly define the
      proportions of octamers and dimers. 'Dimeric' Mi-CK solutions consisted of > or =
      90% dimers throughout the experiment whereas 'octameric' Mi-CK solutions
      consisted in the beginning of 90% octamers, but upon measuring with the highest
      concentrations of creatine (Cr) and ATP approximately one-third of the octamers
      dissociated into dimers. These proper controls enabled us to pinpoint the
      observed kinetic differences between dimers and octamers solely to the oligomeric
      state of Mib-CK. Both dimeric and octameric Mi-CK displayed synergism in
      substrate binding (Kd values are higher than Km values), meaning that binding of
      the first substrate facilities subsequent binding of the second substrate. Most
      interestingly, Km(Cr) and Kd(Cr) values are both 2-3 times higher for octameric
      than for dimeric Mi-CK. Thus, at low Cr concentrations, the dimer is kinetically
      favoured for the forward direction of the reaction (phosphorylcreatine synthesis)
      compared with the octamer. The possible physiological significance of the lower
      Kd(Cr) value of dimeric versus octameric Mib-CK, as well as the apparent negative
      cooperativity of ATP binding at higher [Cr], are discussed within the context of
      a possible functional role for dimeric Mib-CK in vivo.

PMID- 7772051
TI  - Glutamine transport by vesicles isolated from tumour-cell mitochondrial inner
      membrane.
AB  - Mitochondrial-inner-membrane vesicles, isolated from Ehrlich ascites carcinoma
      cells by titration with detergents, accumulated L-glutamine by a very efficient
      transport system. The vesicles lack any phosphate-activated glutaminase activity,
      allowing measurement of transport rates without interference by L-glutamine
      metabolism. The time course of the transport was linear for the first 60 s,
      reaching a steady state after 120 min. L-Glutamine transport showed co
      operativity, with a Hill coefficient of 2.2; the kinetic parameters S0.5 and Vmax
      had values of 5 mM and 26 nmol/30 s per mg of protein respectively. The pH
      dependence curve showed a bell shape, with a pH optimum about 8.0. The uptake of
      L-glutamine was not affected by the presence of a 50-fold molar excess of D
      glutamine, L-cysteine, L-histidine, L-alanine, L-serine and L-leucine, whereas L
      glutamate behaved as a poor inhibitor. The structural analogue L-glutamate gamma
      hydroxamate (5mM) inhibited the net uptake by 68%; interestingly, other analogues
      (6-diazo-5-oxo-L-norleucine, acivicin and L-glutamate gamma-hydrazide) were
      ineffective. The impermeant thiol reagent p-chloromercuriphenylsulphonic acid
      (0.5mM) completely abolished the mitochondrial L-glutamine uptake; in contrast,
      other thiol reagents (mersalyl and N-ethylmaleimide) did not significantly affect
      the transport. These data confirm the existence of a specific transport system
      with high capacity for L-glutamine in the mitochondrial inner membrane, a step
      preceding the highly operative glutaminolysis in tumour cells.

PMID- 7772052
TI  - Molecular cloning and characterization of ornithine decarboxylase cDNA of the
      nematode Panagrellus redivivus.
AB  - In a PCR with degenerate primers encoding highly conserved amino acids within
      ornithine decarboxylases (ODCs) of several organisms, a fragment of the ODC gene
      of the free-living nematode Panagrellus redivivus was isolated. Northern blot
      analysis revealed a single 1.7 kb transcript in a mixed-stage population of
      animals. From this RNA source, a cDNA library was constructed and screened with
      the PCR fragment. Several cDNA clones were isolated, one of which encodes the
      complete 435-amino-acid ODC enzyme with a calculated molecular mass of 47.1 kDa.
      The P. redivivus ODC possesses 126 of the 136 highly conserved amino acids in the
      enzymes from fungi, invertebrates and vertebrates. Functional amino acids are
      conserved, suggesting that the two active sites of the P. redivivus ODC are
      formed at the interface of a homodimer, as described for mammalian ODCs.

PMID- 7772054
TI  - Steps involved in activation of the complex of pro-matrix metalloproteinase 2
      (progelatinase A) and tissue inhibitor of metalloproteinases (TIMP)-2 by 4
      aminophenylmercuric acetate.
AB  - Tissue inhibitor of metalloproteinases (TIMP)-2 forms a noncovalent complex with
      the precursor of matrix metalloproteinase 2 (proMMP-2, progelatinase A) through
      interaction of the C-terminal domain of each molecule. We have isolated the
      proMMP-2-TIMP-2 complex from the medium of human uterine cervical fibroblasts and
      investigated the processes involved in its activation by 4-aminophenylmercuric
      acetate (APMA). The treatment of the complex with APMA-activated proMMP-2 by
      disrupting the Cys73-Zn2+ interaction of the zymogen. This is triggered by
      perturbation of the proMMP-2 molecule, but not by the reaction of the SH group of
      Cys73 with APMA. The 'activated' proMMP-2 (proMMP-2*) formed a new complex with
      TIMP-2 by binding to the N-terminal inhibitory domain of the inhibitor without
      processing the propeptide. Thus the APMA-treated proMMP-2*-TIMP-2 complex
      exhibited no gelatinolytic activity. In the presence of a small amount of free
      MMP-2, however, proMMP-2* in the complex was converted into the 65 kDa MMP-2 by
      proteolytic attack of MMP-2, but the complex did not exhibit gelatinolytic
      activity. The gelatinolytic activity detected after APMA treatment was solely
      derived from the activation of free proMMP-2. The removal of the propeptide of
      the proMMP-2* bound to TIMP-2 was also observed by MMP-3 (stromelysin 1), but not
      by MMP-1 (interstitial collagenase). MMP-3 cleaved the Asn80-Tyr81 bond of proMMP
      2*. On the other hand, when MMP-3 was incubated with the proMMP-2-TIMP-2 complex,
      it bound to TIMP-2 and rendered proMMP-2 readily activatable by APMA. These
      results indicate that the blockage of TIMP-2 of the complex with an active MMP is
      essential for the activation of proMMP-2 when it is complexed with TIMP-2.

PMID- 7772055
TI  - Effects of magnesium on cyclic GMP hydrolysis by the bovine retinal rod cyclic
      GMP phosphodiesterase.
AB  - Knowledge of the kinetics of the rod cyclic GMP phosphodiesterase is essential
      for understanding the kinetics and gain of the light response. Therefore, the
      interactions between Mg2+, cyclic GMP, and purified, trypsin-activated bovine rod
      cyclic GMP phosphodiesterase (EC 3.1.4.17) were examined. The effects of Mg2+ and
      of cyclic GMP on the rod phosphodiesterase activity were mutually concentration
      dependent. Formation of a free Mg-cyclic GMP complex is unlikely due to its high
      dissociation constant (Kd = 19 mM). Plots of 1/velocity versus 1/[cyclic GMP] as
      a function of [Mg2+] and 1/velocity versus 1/[Mg2+] as a function of [cyclic GMP]
      intersected to the left of the 1/velocity axis. This is consistent with the
      formation of a ternary complex between the phosphodiesterase, Mg2+, and cyclic
      GMP. A competitive inhibitor of the phosphodiesterase relative to cyclic GMP, 3
      isobutyl-1-methylxanthine, non-competitively inhibited the enzyme relative to
      Mg2+, Pb2+, a competitive inhibitor of the phosphodiesterase relative to Mg2+ [D.
      Srivastava, R.L. Hurwitz and D. A. Fox (1995) Toxicol. Appl. Pharmacol, in the
      press] non-competitively inhibited the enzyme relative to cyclic GMP.
      Collectively these results are suggestive of a rapid equilibrium random binding
      order of Mg2+ and cyclic GMP to the rod phosphodiesterase.

PMID- 7772053
TI  - The haem b558 component of the cytochrome bd quinol oxidase complex from
      Escherichia coli has histidine-methionine axial ligation.
AB  - The cytochrome bd ubiquinol oxidase from Escherichia coli is induced when the
      bacteria are cultured under microaerophilic or low-aeration conditions. This
      membrane-bound respiratory oxidase catalyses the two-electron oxidation of
      ubiquinol and the four-electron reduction of dioxygen to water. The oxidase
      contains three haem prosthetic groups: haem b558, haem b595 and haem d. Haem d is
      the oxygen binding site, and it is likely that haem d and b595 form a bimetallic
      site in the enzyme. Haem b558 has been previously characterized spectroscopically
      as being low spin and has been shown to be located within subunit I (CydA) of
      this two-subunit enzyme. It is likely that haem b558 is associated with the
      quinol oxidation site, which has also been shown to be within subunit I. In a
      previous effort to locate the specific amino acids axially ligated to haem b558,
      all six histidines within subunit I were altered by site-directed mutagenesis.
      Only one, histidine-186, was identified as a likely ligand to haem b558. Hence it
      was suggested that haem b558 could not have bis(histidine) ligation. In the
      current work, a combination of low-temperature near-infrared magnetic circular
      dichroism (NIR-MCD) and EPR spectroscopies have been employed to identify the
      nature of the haem b558 axial ligands. The NIR-MCD spectrum at cryogenic
      temperatures is dominated by the low-spin haem b558 component of the complex, and
      the low-energy band near 1800 nm is strong evidence for histidine-methionine
      ligation. It is concluded that haem b558 is ligated to histidine-186 plus one of
      the methionines located within subunit I of the oxidase.

PMID- 7772056
TI  - Role of the promoter in the sensitivity of human thymidine kinase to lack of
      Zn2+.
AB  - Previous studies had indicated that lack of Zn2+ inhibits the expression of
      thymidine kinase activity and produces a corresponding reduction in the
      concentration of its mRNA. The present investigations have shown that with human
      thymidine kinase this is associated with increased binding of a specific protein
      to the gene's promoter in the region between -55 and -83 bp 5' to the
      transcription initiation site. A second binding site for the protein is present
      within the sixth exon of the human thymidine kinase gene.

PMID- 7772057
TI  - Chimeric constructs show that the unique N-terminal domain of the cyclic AMP
      phosphodiesterase RD1 (RNPDE4A1A; rPDE-IVA1) can confer membrane association upon
      the normally cytosolic protein chloramphenicol acetyltransferase.
AB  - A novel plasmid was generated which allowed the expression of the cytosolic
      bacterial enzyme chloramphenicol acetyl transferase (CAT) in COS-7 cells. Upon
      transfection, the majority of the novel CAT activity was found in the cytosol
      fraction of COS cells. Chimeric molecules were made between N-terminal portions
      of the type IVA cyclic AMP-specific rat 'dunce-like' phosphodiesterase (RD1)
      (RNPDE4A1A; rPDE-IVA1) fused to CAT at its N-terminus. Expression in COS-7 cells
      of chimeras formed from 1-100RD1-CAT and 1-25RD1-CAT now showed CAT activity
      associated with the membrane fraction. In contrast, a chimera formed from 26
      100RD1-CAT showed an identical expression pattern to native CAT, with the major
      fraction of CAT activity occurring in the cytosol fraction. Membrane-bound CAT
      activity provided by 1-100RD1-CAT and 1-25RD1-CAT was not released by either high
      salt or washing treatments but was solubilized in a dose-dependent fashion by the
      non-ionic detergent Triton X-100. Subcellular fractionation of COS-7 cells showed
      that, as with RD1, the membrane-bound activity of the RD1-CAT chimera followed
      that of the plasma membrane marker 5'-nucleotidase. Plasmids containing chimeric
      cDNAs were exposed to a coupled transcription-translation system that, in
      addition to the full-length chimeras, was found to generate a range of N-terminal
      truncated species due to initiation at different methionine residues. Incubation
      of the mature protein products formed in this system with a COS cell membrane
      fraction showed that only those chimeric CAT constructs containing the first 25
      amino acids of RD1 became membrane-associated. The unique 25 amino acid N
      terminal domain of RD1 contains structural information that can confer membrane
      association upon an essentially soluble protein.

PMID- 7772059
TI  - Insulin inhibits the phosphorylation of alpha-Gi-2 in intact hepatocytes.
AB  - Challenge of intact hepatocytes with insulin reduced the level of phosphorylated
      alpha-Gi-2 found under basal (resting) conditions. At maximally effective
      concentrations of insulin the steady-state labelling of alpha-Gi-2 was reduced by
      approximately 21%. Insulin achieved this in a time- and dose-dependent fashion,
      exhibiting an IC50 value of 109 +/- 22 pM. The increased labelling of alpha-Gi-2
      seen after challenge of cells with phorbol 12-myristate 13-acetate was also
      attenuated by insulin. Treatment of hepatocytes with the protein phosphatase
      inhibitor okadaic acid increased the labelling of alpha-Gi-2 in a fashion which
      was insensitive to the action of insulin. It is suggested that insulin may reduce
      the level of phosphorylation of alpha-Gi-2 by stimulating intracellular protein
      phosphatase activity and that this action may offer a molecular explanation for
      the ability of insulin to inhibit adenylate cyclase activity in hepatocytes by
      increasing the level of non-phosphorylated alpha-Gi-2.

PMID- 7772060
TI  - Radiolabeled cholesteryl ethers trace LDL cholesteryl esters but not HDL
      cholesteryl esters in the rat.
AB  - The intravascular metabolism of cholesteryl [1-14C]oleoyl ester and [1,2
      3H(N)]cholesteryl palmityl ether was compared in the rat, an animal species
      without plasma cholesteryl ester transfer activity (CETA). The tracers had
      identical plasma disappearance rates when they were incorporated into human or
      rat low density lipoproteins (LDL). Fractional catabolic rates (FCR) were 0.081
      +/- 0.014 h-1 and 0.080 +/- 0.013 h-1 for human LDL ester and ether and 0.098 +/-
      0.007 h-1 and 0.101 +/- 0.007 h-1 for rat LDL ester and ether, respectively. In
      contrast, the ether had plasma disappearance rates that were 24%-25% lower than
      the ester when they were incorporated into human or rat high density lipoproteins
      (HDL). FCR were 0.230 +/- 0.020 and 0.173 +/- 0.030 h-1 for human HDL ester and
      ether and 0.131 +/- 0.020 h-1 and 0.100 +/- 0.017 h-1 for rat HDL ester and ether
      respectively. Biological screening of the rat HDL preparations did not affect
      these differences. The results of these studies indicate that in the absence of
      plasma CETA, cholesteryl ethers can be used to trace LDL cholesteryl esters but
      not to trace HDL cholesteryl esters.

PMID- 7772058
TI  - Molecular cloning of a novel splice variant of human type IVA (PDE-IVA) cyclic
      AMP phosphodiesterase and localization of the gene to the p13.2-q12 region of
      human chromosome 19 [corrected].
AB  - We have isolated from a human T-cell Jurkat cDNA library a novel human cDNA (2EL)
      that is closely related to the human type-IV PDE splice variant family 'A' (PDE
      IVA) cDNA characterized previously by us [Sullivan, Egerton, Shakur, Marquardsen
      and Houslay (1994) Cell. Signalling 6, 793-812]; (h6.1, PDE-IVA/h6.1; HSPDE4A7).
      (PDE stands for cyclic nucleotide phosphodiesterase). The novel cDNA 2EL (PDE
      IVA/2EL; HSPDE4A8) contains two regions of unique sequence not found in PDE
      IVA/h6.1. These are a distinct 5'-end and a 34 bp insert which occurs within a
      domain thought to encode the type-IV PDE catalytic site and which can be expected
      to result in premature truncation of any expressed protein. HSPDE4A8 appeared to
      be catalytically inactive. Isolation and characterization of a human genomic
      cosmid clone revealed that 2EL and h6.1 represent alternative splice variants of
      the human PDE-IVA gene. Using a unique sequence found at the 5'-end of the 2EL
      cDNA, a probe was generated which was used to screen the DNA of human-hamster
      hybrids. This located the human gene for PDE-IVA to human chromosome 19. Through
      both the analysis of genomic DNAs from a human-hamster somatic cell hybrid panel
      and also using fluorescent in situ hybridization, it was shown that the human PDE
      IVA gene is located on human chromosome 19, between p13.2 [corrected] and q12.
      This region on chromosome 19 has been shown to be related to genetic diseases
      such as the autosomal dominant cerebrovascular disease CADASIL, susceptibility to
      late-onset Alzheimer's disease and changes seen in benign pituitary and thyroid
      adenomas.

PMID- 7772061
TI  - Intimal thickenings of human aorta contain modified reassembled lipoproteins.
AB  - The aim of this study was to determine whether in human aortas early minute
      changes such as minimal intimal thickenings (MIT), developed in areas known to
      have a predilection to atherosclerosis, contain modified reassembled lipoproteins
      (MRLp) such as extracellular liposomes (EL) and lipid droplets (LD). These
      features have been previously detected in the aortic lesion-prone areas of
      rabbits and hamsters fed a fat-rich diet. Tissue samples of the aortic arch and
      thoracic aorta from 12 young subjects who died in accidents were selectively
      collected from grossly normal regions. By light microscopy, some of these regions
      were found to contain MIT. The normal areas and the MIT were separately examined
      by electron microscopy or subjected to fractionation and partial biochemical
      characterization. The MIT (approximately 25-100 microns thick) were constituted
      by a pronounced proliferation of extracellular matrix, especially elastin and
      microfibrils, with interspersed lipid deposits appearing as EL and LD. Commonly,
      MIT did not contain smooth muscle cells, macrophages, foam cells or cytolytic
      debris. Such components were only occasionally found in specimens excised from
      the vicinity of fatty streaks. Saline extracts of MIT or grossly normal aortic
      regions were subjected to a four-step purification procedure consisting of gel
      filtration, affinity chromatography on anti-apo B and anti-albumin Sepharose,
      followed by density gradient ultracentrifugation. The entire procedure was
      monitored by negative staining, lipid assays, SDS PAGE and immunoblotting. From
      the initial MRLp mixture, two fractions were obtained: fraction 1 containing
      multilamellar EL and LD, and fraction 2 composed mostly of unilamellar EL. As
      compared with serum LDL, the cholesteryl ester/unesterified cholesterol ratio was
      4-6-fold lower in fraction 1 and 15-19-fold lower in fraction 2. On SDS-PAGE the
      fraction 2 displayed a single protein band of 66 kDa, immunochemically identified
      as albumin. The MRLp isolated from human aortas with minimal intimal thickenings
      appeared to be similar to those purified from the prelesional stage aorta of
      hyperlipidemic rabbits and hamsters.

PMID- 7772062
TI  - Spontaneous platelet aggregation in whole blood is increased in non-insulin
      dependent diabetes mellitus and in female but not male patients with primary
      dyslipidemia.
AB  - Increased platelet aggregability has been shown in hypercholesterolemia, and
      stirring-induced spontaneous aggregation in whole blood is increased in insulin
      dependent diabetes mellitus (DM). We have determined spontaneous aggregation in
      citrated (10 mM) whole blood, from 27 primary dyslipidemic patients (DYS; 14F,
      13M), 16 male non-insulin-dependent DM (NIDDM) patients, and 17 normolipidemic
      controls (N; 6F, 11M), using platelet counting to quantify aggregation.
      Spontaneous aggregation was significantly higher, both in the female DYS group
      (median 30% [interquartile range 25,50], P < 0.005) and the NIDDM group (33%
      [25,41], P < 0.005), than in the N group (17% [12,27]), but did not differ
      significantly in the male DYS group (23% [10,33]). Similar results were obtained
      in the presence of indomethacin (25 mumol/l) to prevent artefactual thromboxane
      (TX) A2 formation, indicating that increased spontaneous aggregation was TXA2
      independent. Interestingly, increased spontaneous aggregation appeared to be
      independent of serum cholesterol and triglyceride concentrations, as well as age
      and sex per se. We conclude that spontaneous platelet aggregation was increased
      both in female primary dyslipidemic patients and NIDDM patients, but not in male
      DYS patients. The clinical significance of increased spontaneous platelet
      aggregability is that it may favour shear-induced aggregation which may occur at
      critical arterial stenoses in vivo leading to thrombus formation.

PMID- 7772063
TI  - Identification of a new apolipoprotein E variant (E2 Arg142-->Leu) in type III
      hyperlipidemia.
AB  - A new rare apolipoprotein E mutant was identified as we were investigating the
      apolipoprotein E genotype of patients with type III hyperlipidemia (HLP III). The
      unusual DNA restriction fragment length polymorphism profile and then the
      sequence analysis of a PCR amplified fragment of the proband's apo E gene
      revealed a simple base substitution (G-->T) at nucleotide 3836. This mutation
      leads to the replacement of arginine by leucine at position 142 of the mature
      protein. The proband carried the mutant allele at the heterozygous status with an
      epsilon 3 allele. Subsequently, analysis of the proband's father's apo E gene
      showed that same mutated allele associated with an epsilon 2 allele. The two
      subjects presented a dysbetalipoproteinemia in which this new apo E variant could
      be implicated.

PMID- 7772064
TI  - Distribution, fatty acid composition and apolipoprotein A-I immunoreactivity of
      high density lipoprotein subfractions in myocardial infarction.
AB  - The lipoprotein profile, the HDL subfractions and the apolipoprotein (apo) A-I
      conformation of HDL were determined in 119 patients with myocardial infarction
      and 119 controls, paired for age. Apo A-I conformation was assessed by its
      immunoreactivity towards two monoclonal antibodies, 5F6 and 3G10. HDL
      phospholipid levels and fatty acid composition were also determined. HDL and HDL3
      cholesterol, apo A-I, LpA-I and LpA-I:A-II levels were significantly lower in
      patients than in controls, whereas the levels of total and LDL-cholesterol and of
      apo B were not different. Apo A-I immunoreactivity against MAb 5F6 was
      significantly better in patients than in controls, while the immunoreactivity
      against 3G10 was similar. Paired stepwise logistic regression showed only apo A
      I, HDL3 cholesterol and 5F6 immunoreactivity to be significantly related to
      myocardial infarction. After adjustment for HDL cholesterol, lower levels of HDL
      phospholipids and polyunsaturated fatty acids (PUFA) were found in patients
      compared with controls. Hence, of all HDL markers, apo A-I and HDL3 cholesterol
      appear to be the most informative. Also, lower HDL phospholipid and PUFA content
      may explain a different apo A-I conformation in patients with myocardial
      infarction.

PMID- 7772065
TI  - Quantitation of the crosslinks, pyridinoline, deoxypyridinoline and pentosidine,
      in human aorta with dystrophic calcification.
AB  - Pyridinoline and, its minor analogue deoxypyridinoline, are trifunctional
      crosslinks of mature collagen in the connective tissues. Pentosidine, a new type
      of fluorescent crosslink, is possibly one of the senescent crosslinks but its
      function and metabolism are still unclear. In this study, we quantitated the
      crosslinks, pyridinoline, deoxypyridinoline and pentosidine, in human aorta which
      were obtained from 21 autopsy cases. In each case, the existence of dystrophic
      calcification in the aorta and complications (diabetes, chronic renal failure and
      hypertension) were examined. The determination of the content of the three
      crosslinks was carried out using high performance liquid chromatography (HPLC)
      analysis. In calcified lesions, the amount of deoxypyridinoline/collagen showed a
      decrease and the amount of deoxypyridinoline/pyridinoline showed a prominent
      decrease compared to those in non-calcified lesions (deoxypyridinoline/collagen,
      P < 0.005; deoxypyridinoline/pyridinoline, P < 0.0001). In non-calcified lesions
      without complications, the amount of pentosidine/pyridinoline and that of
      pentosidine/deoxypyridinoline significantly increased with age
      (pentosidine/pyridinoline, r = 0.704, P < 0.05; pentosidine/deoxypyridinoline, r
      = 0.624, P < 0.05). This result suggests a possible relationship between
      dystrophic calcification and crosslink formation of collagen in human aorta.

PMID- 7772066
TI  - The ansamycins: a novel class of hypolipidemic agents with a high affinity for
      lipoproteins.
AB  - The ansamycins are derivatives of 3-piperazino rifamycin with potent
      hypolipidemic activity in nonprimate and primate species. Since the cholesterol
      reduction results from increased uptake and catabolism of lipoprotein
      cholesterol, it was hypothesized that the hydrophobicity of the ansamycins could
      result in a lipoprotein association which facilitates clearance. When
      radiolabeled ansamycins CGP 43371 or CGS 24565 were incubated with human plasma,
      > 95% was lipoprotein-bound up to drug levels of 25 microM. With plasma from chow
      fed rats, radiolabeled compounds again distributed with the lipoproteins. Feeding
      a cholesterol/cholic acid diet to rats shifted the cholesterol distribution to
      lower density lipoproteins and in vitro incubation resulted in a shift of
      radiolabeled drug to lower density lipoproteins as well. Intravenous
      administration of radiolabeled ansamycins to chow-fed or cholesterol-fed rats
      resulted in a plasma lipoprotein binding profile indistinguishable from the
      corresponding in vitro incubations. When [14C]-CGP 43371 bound in vitro to high
      density lipoprotein (HDL) was reincubated with increasing concentrations of low
      density lipoprotein (LDL), a concentration-dependent fall in HDL association and
      increase in LDL binding was observed. Thus, the ansamycins have a high affinity
      for all plasma lipoproteins and can transfer between lipoprotein fractions. When
      [125I]-labeled LDL or HDL was incubated with CGP 43371 and Hep G2 cells, the cell
      association of the 125I label was significantly increased in a dose-dependent
      manner. In addition, plasma clearance of [14C]cholesterol oleate-labeled HDL
      coinjected with CGP 43371 was accelerated relative to control rats and
      radioactivity was specifically increased in livers of CGP 43371-treated rats. The
      physical association of the ansamycins with lipoproteins may thus lead to subtle
      conformational changes and enhanced hepatic uptake.

PMID- 7772067
TI  - Similar to oleic acid, eicosapentaenoic acid stimulates apolipoprotein B
      secretion by inhibiting its intracellular degradation in Hep G2 cells.
AB  - We previously reported that oleic acid (OA) rapidly increased apolipoprotein
      (apo) B secretion by suppressing early intracellular degradation of nascent apo B
      in Hep G2 cells and suggested that the suppression of apo B degradation is
      associated with triglyceride (TG) biosynthesis from OA. To determine whether the
      inhibition of apo B degradation is associated with increased TG synthesis or is a
      direct effect of OA, we examined the effect of another fatty acid,
      eicosapentoenoic acid (EPA), on apo B kinetics in Hep G2 cells, since it is well
      known to have hypolipidemic action in clinical studies. The incorporation of
      [3H]glycerol into cellular TG was stimulated five-fold when Hep G2 cells were
      incubated for 2 h with EPA or OA (0.4 or 0.8 mM-1.5% bovine serum albumin (BSA)
      complex). The incorporation of [14C]acetic acid into cellular cholesteryl ester
      (CE) was significantly decreased by EPA treatment, whereas OA did not affect CE
      synthesis. Similar effects of these fatty acids on cellular lipid synthesis were
      observed in long-term incubation (24 h). Apo B was linearly secreted into the
      medium during 3 h, and EPA and OA doubled the rate of secretion. In long-term (24
      h) incubations, both fatty acids significantly increased the incorporation of
      [3H]leucine into secreted apo B radioactivity or the accumulation of apo B mass
      in the medium. Pulse-chase studies revealed that both EPA and OA reduced
      intracellular apo B degradation to a similar degree. The inhibition of apo B
      degradation was also observed when the cells were preincubated with either EPA or
      OA for 24 h. These results suggest that increased TG synthesis leads to
      suppression of intracellular apo B degradation, which is independent of the
      source of exogenous fatty acid.

PMID- 7772069
TI  - Acyl-coenzyme A:cholesterol-acyltransferase (ACAT) inhibitors modulate monocyte
      adhesion to aortic endothelial cells.
AB  - Increased monocyte adhesion to aortic endothelium is observed in the pathogenesis
      of atherosclerosis. The role of endothelial acyl-coenzyme A:cholesterol
      acyltransferase (ACAT) in the regulation of monocyte adhesion is not known. To
      examine the potential role of this enzyme in monocyte adhesion, a specific ACAT
      inhibitor, CI-976, was utilized. Although the basal adhesion of U937 monocytic
      cells to porcine aortic endothelial cells was low, treatment of the endothelial
      cells with lipopolysaccharide (LPS) markedly increased monocyte adhesion.
      Monocyte adhesion to LPS-treated endothelial cells was markedly inhibited by CI
      976 treatment of the endothelial cells. Similarly, another ACAT inhibitor, PD
      132301-2, whose structure is distinct from CI-976, also decreased monocyte
      adhesion. CI-976 treatment of endothelial cells also decreased endothelial cell
      ACAT activity. Since leukotriene B4 (LTB4) is known to promote leukocyte
      endothelial cell adhesion, endothelial cell production of this leukotriene was
      examined after incubation with CI-976. CI-976 treatment markedly decreased LTB4
      synthesis. Exogenous LTB4 addition to CI-976 treated cells reversed the effects
      of this compound on monocyte adhesion. These data demonstrate that ACAT
      inhibitors decrease monocyte adhesion to endothelial cells. Similar mechanisms
      may contribute to antiatherosclerotic effects of ACAT inhibitors in vivo.

PMID- 7772068
TI  - Lysophosphatidylcholine causes Ca2+ influx, enhanced DNA synthesis and
      cytotoxicity in cultured vascular smooth muscle cells.
AB  - The effects of lysophosphatidylcholine (LPC), a vasoactive phospholipid, on
      intracellular free calcium concentration ([Ca2+]i), DNA synthesis and
      cytotoxicity of vascular smooth muscle cells (VSMC) were studied. LPC from 10(-7)
      to 10(-5) mol/l dose-dependently induced a sustained increase in [Ca2+]i. In
      contrast to the response of [Ca2+]i induced by angiotensin II, that induced by
      LPC was totally abolished when extracellular Ca2+ was removed, was not affected
      by pretreatment of the cells with islet-activating protein, and was not
      desensitized by repeated addition. 8-(N,N-Diethylamino)octyl 3,4,5
      trimethoxybenzoic acid (TMB-8), an inhibitor of Ca2+ release from intracellular
      Ca2+ stores, 1-(5-isoquinolinesulfonyl)-2-methylpiperadine dihydrochloride (H-7),
      an inhibitor of protein kinase C, KT5823, an inhibitor of protein kinase G, and
      Ca2+ channel blockers failed to suppress the LPC-induced increase in [Ca2+]i. LPC
      at 10(-5) mol/l caused significant stimulation of [3H]thymidine incorporation
      into VSMC, and at concentrations of 10(-5) mol/l and higher dose-dependently
      stimulated release of lactate dehydrogenase in cell culture supernatants.
      Moreover, digitonin mimicked the effects of LPC on [Ca2+]i, and also caused
      similar effects to those of LPC on DNA synthesis and cytotoxicity in VSMC. These
      observations suggest that LPC causes both cell growth and cell injury of VSMC, at
      least partly, through its detergent action, causing membrane leakiness and
      resultant [Ca2+]i overload in vitro, thus indicating the possible participation
      of LPC in atherosclerosis and/or injury of the vascular wall.

PMID- 7772070
TI  - Oxidisability of low density lipoproteins in patients with carotid or femoral
      artery atherosclerosis.
AB  - Oxidation of low density lipoprotein (LDL) is implicated in the pathogenesis of
      atherosclerosis. In this study the susceptibility to oxidation of LDL (from
      patients with atherosclerosis) is related to the progression of the disease. LDL
      were isolated from 37 patients with demonstrable atherosclerotic plaques. The
      susceptibility of LDL to oxidation (induced by an exogenous oxidative stress) was
      assessed by measuring the breakdown products of lipid peroxidation, the increased
      formation of conjugated dienes, and changes in surface charge of the
      apolipoprotein B (apo B). Progression of the atherosclerotic plaque was assessed
      by measuring the maximum velocity of blood through the narrowest portion of the
      vessel at inclusion and after one year. Twenty-nine of the 37 samples taken were
      found to have LDL that were partially oxidised, whereas 8 samples showed LDL
      whose state of oxidation was within the normal range. Progression of the
      atherosclerotic plaque occurred in 19 (66%) of the 29 patients whose lipoproteins
      were partially oxidised compared with only 2 (25%) of the 8 patients with normal
      lipoproteins (P = 0.055, Fisher's exact test). These data support an association
      between the progression of atherosclerotic plaques in carotid and femoral vessels
      and the susceptibility to oxidation of LDL.

PMID- 7772071
TI  - Arginine residues at codons 112 and 158 in the apolipoprotein E gene correspond
      to the ancestral state in humans.
AB  - Apolipoprotein E is a secretory glycoprotein that associates with lipoprotein
      particles and is coded for by a single locus on chromosome 19. The three common
      allelic isoforms of this protein (apo E2, apo E3 and apo E4) are associated with
      distinct patterns of lipoprotein metabolism and variable risks for coronary
      artery disease. In addition, recent work has shown that the presence of the apo
      E4 isoform constitutes a major risk for developing late-onset Alzheimer's disease
      as well as hypercholesterolaemia. The only differences between these isoforms
      result from cysteine-arginine interchanges at codons 112 and 158. There is
      considerable disagreement in the literature concerning the identity of the
      ancestral allele. In order to resolve this, 24 chimpanzees and individuals from a
      number of other primate species were analysed. All were similar to apo E4. This
      suggests that apo E4 is the ancestral allele and that apo E2 and apo E3 arose
      after the split of the human and chimpanzee lineages.

PMID- 7772072
TI  - Vitamins E, C and lipid peroxidation in plasma and arterial tissue of smokers and
      non-smokers.
AB  - An imbalance between pro-oxidants and antioxidants is operative in
      atherosclerosis. Cigarette smoke is a major risk factor of atherosclerosis and
      has been reported to contain large amounts of oxidants. We assessed arterial
      (internal mammary artery) and plasma levels of vitamins E and C and lipid
      peroxides in 48 male patients, 24 smokers and 24 non-smokers, undergoing coronary
      bypass surgery. Lipid peroxidation was studied using fluorescent products of
      lipid peroxidation (FPLs). Tissue vitamins E and C levels were significantly
      lower and FPLs significantly higher in smokers than in non-smokers (P < 0.0006,
      0.0005 and 0.0005, respectively). This pattern was associated with lower vitamin
      C and higher lipid peroxide plasma levels in smokers than in non-smokers (P <
      0.0002 and 0.0005, respectively). Vitamins E and C plasma levels were strongly
      related to their tissue content both in smokers (r = 0.60, P < 0.005 and r =
      0.57, P < 0.01) and in non-smokers (r = 0.42, P < 0.05 and r = 0.46, P < 0.05).
      Moreover, vitamin E content was significantly related to that of vitamin C only
      in the arterial tissue of both groups, pointing to the existence of a functional
      interaction between these antioxidants. In both groups, FPLs were significantly
      and inversely related to vitamin C in plasma and to vitamin E in tissue,
      suggesting the antioxidant primary of vitamin C and vitamin E in the plasma and
      arterial tissue compartments, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772073
TI  - Metabolism of modified LDL by cultured human placental cells.
AB  - All major classes of normal circulating lipoproteins can be metabolized by human
      placental cells. However, the metabolism of abnormal or modified lipoproteins has
      been little studied. We therefore investigated whether placental cells metabolize
      acetylated low density lipoprotein (ac-LDL) or oxidatively-modified LDL (ox-LDL),
      both of which are metabolized by scavenger receptors, and if so, whether modified
      LDL stimulates progesterone secretion as does normal LDL. Placental macrophages
      and trophoblasts were isolated on a 40% Percoll gradient after enzymatic
      digestion. The cellular uptake and degradation of [125I]-ac-LDL was 20-fold
      higher than [125I]-LDL in both macrophages and trophoblasts. Both cell types
      demonstrated high affinity and saturable degradation. Similarly, increased
      esterification of [14C]-labelled oleic acid to cholesterol was observed when
      cells were incubated with ac-LDL vs. LDL. Uptake of ac-LDL by trophoblasts also
      was demonstrated by colocalization of fluorescently labelled ac-LDL and
      fluorescent antibodies specific for trophoblasts. Similar colocalization of
      fluorescent ac-LDL and fluorescent anti-macrophage specific epitopes was seen in
      macrophages. Uptake and degradation of [125I]-ac-LDL by placental cells was
      inhibited by increasing concentrations of unlabelled ac-LDL or fucoidin but not
      LDL, indicating uptake by a scavenger receptor. Both unlabelled ac-LDL and ox-LDL
      inhibited uptake of [125I]-labelled ox-LDL, suggesting uptake by a common
      mechanism. Although secretion of progesterone by trophoblasts was stimulated by
      incubation with LDL, progesterone secretion by trophoblasts was not stimulated by
      ac-LDL and only minimally stimulated by ox-LDL. CONCLUSIONS: Scavenger receptors
      are present in human placental trophoblasts as well as macrophages. Scavenger
      receptor activity greatly exceeds that of LDL receptor activity in both cell
      types. However, cholesterol assimilated via the scavenger receptor pathway
      appears to be disconnected from endocrine steroidogenesis in trophoblasts. Thus,
      we hypothesize that scavenger receptors function in trophoblasts to degrade
      modified lipoproteins and prevent toxic effects on placental cellular function
      and fetal growth and development.

PMID- 7772074
TI  - A deletion polymorphism in the angiotensin converting enzyme gene is not
      associated with coronary heart disease in an Austrian population.
AB  - This study examined a possible relationship between genetic variation in the gene
      coding for the angiotensin converting enzyme (ACE) and increased risk for
      coronary heart disease (CHD) in an Austrian population. Polymerase chain reaction
      (PCR) was used to determine the genotypes for an insertion/deletion polymorphism
      in intron 16 of the ACE gene in 315 patients with CHD and in 149 normal controls.
      In the control group, the relative allele frequencies of the polymorphism were
      similar to those of previously published European studies. The genotype
      distribution among our patients was not significantly different from that among
      controls. We were not able to show a significant association of the DD genotype
      with coronary heart disease in subgroups containing patients considered at low
      coronary risk. There was no association of lipid parameters and ACE genotype.
      From these data we conclude that, in the Austrian population, the
      insertion/deletion polymorphism in the ACE gene cannot be used as a marker for
      coronary risk assessment.

PMID- 7772075
TI  - The relationship of APOE polymorphism and cholesterol levels in normoglycemic and
      diabetic subjects in a biethnic population from the San Luis Valley, Colorado.
AB  - We have determined apolipoprotein E (apoE = protein, APOE = gene) polymorphism
      and its relationship with total cholesterol (TC), low density lipoprotein
      cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and
      triglyceride levels in normoglycemic Hispanics (n = 446) and non-Hispanic whites
      (NHWs) (n = 659) as well as in diabetic Hispanics (n = 235) and NHWs (n = 116)
      from the San Luis Valley, Colorado. Effects were estimated separately for each
      group, and within each group men and women were analyzed separately; women were
      further categorized into pre- and post-menopausal status. The distribution of the
      APOE genotype pattern was comparable between the NHW normoglycemics and diabetics
      but it was significantly different among Hispanic normoglycemics and diabetics (P
      < 0.005). In the normoglycemic sample the APOE allele frequencies were
      significantly different between the two ethnic groups: the APOE*2 (0.09 vs. 0.05;
      P < 0.01) and APOE*4 (0.15 vs. 0.09; P < 0.002) allele frequencies were higher
      while the APOE*3 (0.76 vs. 0.86; P < 0.0001) allele frequency was lower in NHWs
      than in Hispanics. Significant variability among the three common APOE genotypes
      (3-2, 3-3, and 4-3) was observed for TC and LDL-C in normoglycemic Hispanic women
      (P = 0.09 and P = 0.03) but not in Hispanic men. In normoglycemic NHWs, however,
      significant mean differences among APOE genotypes were observed for TC and LDL-C
      in both women (P < 0.0001 and P < 0.0001) and men (P = 0.009 and P = 0.01). In
      Hispanic females, the APOE polymorphism accounted for 5.6% and 7.6% of the
      phenotypic variance for TC and LDL-C, respectively. In NHW females, the APOE
      polymorphism explained 10.2% of the phenotypic variance for TC and LDL-C, and in
      NHW males these values were 6.2% and 7.5%, respectively. There was no evidence of
      physiologic interaction between the APOE polymorphism and menopause status in
      affecting TC and LDL-C in NHW women (P = 0.65 and P = 0.55) but a suggestion of
      interaction was observed in Hispanic women for TC and LDL-C (P = 0.11 and 0.07).
      After the Hispanic women were stratified into pre- and postmenopausal groups, the
      effect of the APOE polymorphism on TC and LDL-C was significant only in the
      premenopausal group. Among diabetics, no significant effect of the APOE
      polymorphism was seen on cholesterol levels.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7772077
TI  - Cigarette smoke extract inhibits oxidative modification of low density
      lipoprotein.
AB  - Oxidative modification of low density lipoprotein (LDL) by cigarette smoke has
      been suggested in several recent studies. To characterize possible modification
      of LDL by cigarette smoke extract (CSE), we incubated LDL with CSE either in the
      presence or absence of the chemical pro-oxidants, cupric chloride or 2,2'-azo
      bis(2-amidinopropane) hydrochloride (AAPH). Surprisingly, CSE inhibited oxidative
      modification of LDL induced by either copper or AAPH. Under such oxidant stress
      conditions, CSE inhibited formation of thiobarbituric acid-reactive substances
      and also inhibited the increased agarose gel electrophoretic mobility of LDL in a
      dose-response manner. In addition, CSE prevented degradation of
      phosphatidylcholine to lysophosphatidylcholine and also fragmentation of the
      apolipoprotein B-100 moiety of LDL. Finally, CSE inhibited loss of
      immunoreactivity of the treated LDL with a murine monoclonal antibody against
      human apolipoprotein B-100. On the other hand, at higher concentrations, CSE per
      se was still able to cause structural changes in LDL. After incubation with CSE
      for 24 h, LDL showed a slight increase in agarose gel electrophoretic mobility, a
      slight loss of immunoreactivity with monoclonal antibody, and a marked increase
      in protein carbonyl formation. Lipid peroxidation did not appear to be involved
      in the modification of LDL caused by CSE. It is suggested that reactive aldehydes
      present in cigarette smoke may cause direct chemical modification of LDL.
      Furthermore, the free radical-scavenging potential of the tar fraction of
      cigarette smoke may be responsible for the apparent antioxidant properties of CSE
      against LDL oxidation.

PMID- 7772076
TI  - High density lipoprotein metabolism is altered by dietary cholesterol but not fat
      saturation in guinea pigs.
AB  - To study dietary fat and cholesterol effects on plasma high density lipoprotein
      (HDL) metabolism and rates of apolipoprotein (apo) A-I catabolism, guinea pigs
      were fed 15% (wt/wt) lard- or corn oil-based diets with 0.01% (basal), 0.08%,
      0.17% or 0.33% cholesterol. Absorbed dietary cholesterol provided 6%, 50%, 100%
      and 200%, respectively, of the daily endogenous cholesterol synthetic mass. While
      total plasma cholesterol concentrations increased significantly above basal
      levels at the 0.17% and 0.33% cholesterol intakes, plasma apo E-free HDL (EoHDL)
      cholesterol concentrations did not increase significantly until the 0.33%
      cholesterol level (P < 0.001). Fractional catabolic rates (FCR) of injected
      [131I]-apo A-I were not altered by dietary treatment, either fat saturation or
      cholesterol, but were inversely correlated with plasma EoHDL cholesterol levels
      (r = -0.622), suggestive of a regulatory role of turnover rates on HDL
      cholesterol levels independent of dietary treatment. Analysis of the high
      affinity EoHDL binding to isolated hepatic membranes suggested that hepatic
      binding was not a determinant of HDL catabolism, as dietary cholesterol-induced
      decreases in Bmax (binding capacity) were not correlated with changes in apo A-I
      FCR. Even though dietary cholesterol was associated with increased plasma EoHDL
      cholesterol and with decreased HDL binding protein Bmax, these values did not
      correlate with each other nor with effects on apo A-I FCR.

PMID- 7772078
TI  - Supplementation with beta-carotene in vivo and in vitro does not inhibit low
      density lipoprotein oxidation.
AB  - The inhibition of low density lipoprotein (LDL) oxidation has been postulated as
      one mechanism by which antioxidants may prevent the development of
      atherosclerosis. Available data on the ability of beta-carotene to inhibit LDL
      oxidation are conflicting. We examined the role of in vivo and in vitro
      supplementation with beta-carotene on metal ion-dependent (cupric ions, Cu2+) and
      metal ion-independent (2,2'-azobis[2-amidinopropane]dihydrochloride, AAPH)
      oxidation of LDL as measured by the formation of conjugated dienes (absorbance at
      234 nm). Sixteen subjects were supplemented with 50-100 mg of beta-carotene on
      alternate days for 3 weeks following a week-long loading dose of 100 mg/day.
      Plasma beta-carotene levels rose 5.5-fold, while LDL beta-carotene levels rose
      8.5-fold. Oxidation of LDL by Cu2+ or AAPH was not significantly delayed after in
      vivo supplementation with beta-carotene compared with baseline. For AAPH, the lag
      phase (in minutes) was 75 +/- 8 at baseline and 83 +/- 14 after supplementation
      (P = 0.07). For Cu2+, the lag phase was 172 +/- 41 at baseline and decreased to
      130 +/- 24 after supplementation (P < 0.01). Similarly, no protective effect
      against Cu(2+)-induced oxidation was observed when beta-carotene was added to LDL
      in vitro. Supplementation of plasma with beta-carotene in vitro prior to LDL
      isolation also did not enhance LDL's resistance to Cu(2+)- or AAPH-induced
      oxidation, despite a 5-fold increase in LDL beta-carotene levels over vehicle
      control.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772079
TI  - Identification of a variant collagen alpha 3 (VI) in early-stage avian
      arteriosclerotic plaques.
AB  - A 170 kD protein, prominent in soluble extracts of rooster arteriosclerotic
      plaques, has been partially characterized. The protein was eluted from a size
      exclusion column in a broad molecular weight fraction > 100 kD. Concanavalin A
      and a murine polyclonal antibody raised against the isolated 170 kD protein
      reacted with the protein on Western blots. The 170 kD protein had an isoelectric
      point of approximately 5.4 and was digested by collagenase treatment. Amino acid
      analysis of a 70 kD fragment of the protein closely resembled that for chick
      collagen alpha 3 (VI). A 13 amino acid sequence within this 70 kD fragment had
      69% identity and 85% homology to chicken collagen alpha 3 (VI). Soluble protein
      extracts from cultured plaque smooth muscle cells (SMC), and from healthy artery
      SMC, contained low levels of the protein. These cellular extracts also reacted
      with the polyclonal antibody described above. Although the protein lacks absolute
      amino acid sequence identity with collagen alpha 3 (VI) it shares with it many
      biochemical features, suggesting that the 170 kD protein is a variant species of
      chick collagen alpha 3 (VI).

PMID- 7772080
TI  - Inverse relationship between cardiorespiratory fitness and carotid
      atherosclerosis.
AB  - The association between cardiorespiratory fitness (VO2max) and carotid
      atherosclerosis was analyzed in 163 men, aged 50 to 60 years. VO2max was assessed
      using breath-by-breath respiratory gas analyses during maximal exercise stress
      test. Atherosclerosis was evaluated quantitatively as intima-media thickness
      (IMT) of the right and left carotid arteries by high-resolution B-mode
      ultrasonography. Mean VO2max was 29.6 ml/kg per min (95%CI 28.7;30.5), common
      carotid IMT 1.04 mm (95%CI 1.01;1.07) and carotid bifurcation IMT 1.73 mm (95%CI
      1.66;1.81). VO2max correlated inversely with carotid bifurcation IMT (r = -0.31,
      P < 0.001), but not with common carotid IMT (r = -0.13, P = 0.102). Men in the
      highest quartile of VO2max had lower (P < 0.001) bifurcation IMT 1.51 mm (95%CI
      1.41;1.61) than men in the lowest (1.95 mm (95%CI 1.75;2.16)) and in the second
      lowest VO2max quartile (1.79 mm (1.63; 1.95)). The difference persisted (P =
      0.014) after controlling for age, LDL-cholesterol, systolic blood pressure,
      saturated fat intake, current health status and exercise-induced ST-segment
      depression. These data suggest that cardiorespiratory fitness is an important
      independent predictor of carotid atherosclerosis in middle-aged men.

PMID- 7772081
TI  - The effects of colestipol tablets compared with colestipol granules on plasma
      cholesterol and other lipids in moderately hypercholesterolemic patients.
AB  - The purpose of this study was to investigate and compare the efficacy, safety,
      and patient acceptability of a new formulation of colestipol, colestipol tablets
      (T), with those of colestipol granules (G), in a randomized, double-blind,
      placebo-controlled, multicenter study. Three hundred and seventeen patients with
      primary hypercholesterolemia who were following a low-fat, low-cholesterol diet
      (NCEP Step I diet), and had low-density lipoprotein cholesterol (LDL-C) levels >
      or = 4.14 mmol/l (160 mg/dl) and < or = 6.46 mmol/l (250 mg/dl) were studied.
      Study medication was taken twice a day, with breakfast and supper, for 8 weeks.
      The six parallel treatment groups consisted of colestipol tablets 2 g b.i.d. and
      8 g b.i.d., matching placebo tablets b.i.d., colestipol granules 2 g b.i.d. and 8
      g b.i.d., and matching placebo granules b.i.d.. Study endpoints included absolute
      change and percentage change from baseline in selected lipid, lipoprotein, and
      apolipoprotein measurements; LDL-C lowering was the primary efficacy endpoint.
      Treatment with colestipol tablets and colestipol granules resulted in virtually
      identical, statistically significant (P < or = 0.05) reductions of LDL-C, total
      cholesterol (TC), TC/HDL-C, and apolipoprotein B (apo B). Compared with placebo,
      all active treatments (tablets 4 g/day, tablets 16 g/day, granules 4 g/day,
      granules 16 g/day) significantly reduced LDL-C (12%, 24%, 12%, 25%,
      respectively), TC (7%, 15%, 8%, 15%, respectively), TC/HDL-C (8%, 14%, 9%, 15%,
      respectively) and apo B (12%, 20%, 13%, 22%, respectively). All active treatments
      significantly increased lipoprotein particle AI (LpAI) (5%, 23%, 14%, 18%,
      respectively). VLDL-C and triglycerides increased significantly in the high-dose
      groups. The proportions of patients reporting adverse events, largely
      gastrointestinal-related, were not different among the active treatment groups.
      The treatments were well-tolerated, and no drug-related serious adverse events
      were reported. Patients experienced with granule medication prior to this study
      preferred tablets over granules. This study demonstrates that colestipol tablets
      are an effective treatment to reduce LDL-C in patients with primary
      hypercholesterolemia, are equivalent to colestipol granules, are well-tolerated,
      and are preferred over granules by patients.

PMID- 7772082
TI  - Atypical xanthomatosis in apolipoprotein E-deficient mice after cholesterol
      feeding.
AB  - Apolipoprotein (apo) E-deficient mice were fed a hypercholesterolemic diet for 14
      weeks. Mean serum cholesterol levels rose to 37.5 mM. Upon complete necroscopy,
      massive xanthomatous lesions were noticed in various tissues, with a predilection
      for subcutaneous and peritendinous tissues, while control animals on the same
      diet (3.4 mM serum cholesterol) and apo E-deficient mice on a regular chow diet
      (20 mM serum cholesterol) did not show such lesions. Also, apo E3-Leiden
      transgenic mice fed a high fat diet, with 60 mM of serum cholesterol, did not
      exhibit any xanthomatosis. The xanthomatous lesions found in the Apoe knock-out
      mouse clearly differed in location from xanthomas previously found in low density
      lipoprotein receptor-deficient mice. We conclude that the lack of apo E results
      in atypical disseminated xanthomatosis, suggesting that apo E has an important
      role in determining the tissue distribution of cholesterol deposition.

PMID- 7772083
TI  - Atherosclerotic risk factors are increased in clinically healthy subjects with
      microalbuminuria.
AB  - Increased morbidity and mortality from atherosclerotic vascular disease were
      observed in subjects with slightly elevated urinary albumin excretion rate
      (UAER), known as microalbuminuria. Therefore, the association between
      microalbuminuria and established atherogenic risk factors was studied in
      clinically healthy subjects. All healthy 40-65 year-old participants with
      microalbuminuria, examined within the first 21 months of The Copenhagen City
      Heart Study, were invited, and 28 were studied. An age- and sex-matched group of
      60 randomly chosen subjects with normoalbuminuria served as control.
      Microalbuminuria was defined as a UAER of 6.6-150 micrograms/min, and
      normoalbuminuria as a UAER < or = 6.6 micrograms/min. In the microalbuminuric
      group, systolic and diastolic blood pressures were both elevated (mean (95% C.I.)
      128 (123-134) vs. 119 (116-122) mmHg; P = 0.005, and 75 (71-78) vs. 69 (67-71)
      mmHg; P = 0.008, respectively), and serum apolipoprotein (apo) A-1 concentration
      was lower (1.30 (1.20-1.37) vs. 1.42 (1.36-1.47) milligrams; P = 0.02) in
      comparison with the normoalbuminuric group. Furthermore, serum HDL-cholesterol
      concentration tended to be lower, whereas body weight, body mass index and
      fasting serum insulin concentration were slightly elevated in the
      microalbuminuric group but not statistically significant. It is concluded that
      microalbuminuria in clinically healthy subjects is associated with increased
      levels of atherogenic risk factors. This may contribute to the increased vascular
      morbidity and mortality observed in these individuals.

PMID- 7772085
TI  - Rapid development of umbilical metastases after laparoscopic cholecystectomy for
      unsuspected gallbladder carcinoma.
AB  - Unsuspected microscopic adenocarcinoma of the gallbladder was identified after
      operation in a 66-year-old woman undergoing elective laparoscopic cholecystectomy
      for symptomatic cholelithiasis. An abdominal wall metastasis developed at the
      periumbilical incision site through which the laparoscope was introduced and
      through which the gallbladder was removed. A review of the available information
      on tumor seeding of laparoscopic tracts and drain tracts is presented, as well as
      implications for the further management of gallbladder cancer and other
      intraabdominal malignancies.

PMID- 7772084
TI  - High levels of serum lipoprotein(a) in patients with ischemic heart disease with
      normal coronary angiogram and thromboangiitis obliterans.
AB  - To determine whether lipoprotein(a) (Lp(a)) contributes to the acceleration of
      cardiovascular diseases without atherosclerotic lesion, we have measured serum
      Lp(a) level in male subjects aged 40-69 years with thromboangiitis obliterans (n
      = 40) and ischemic heart disease (IHD) with normal coronary angiogram (n = 35) in
      addition to subjects with arteriosclerosis obliterans (n = 123) and IHD with
      atherosclerotic coronary lesion (n = 203). Cases who had no IHD, arteriosclerosis
      obliterans or thromboangiitis obliterans were selected as a control group (n =
      316). Subjects without any diseases or abnormal findings in physical examination
      and laboratory data were selected from the control group as the healthy control
      group (n = 156). The Lp(a) levels of arteriosclerosis obliterans and IHD with
      atherosclerotic coronary lesion were significantly higher (17.0 mg/dl and 13.1
      mg/dl; median) than those of control and healthy control groups (9.9 mg/dl and
      9.4 mg/dl, respectively) (P < 0.01), in agreement with previous reports.
      Furthermore, the Lp(a) level of IHD with normal coronary angiogram group was
      significantly higher (18.9 mg/dl) than those of the control and healthy control
      groups (P < 0.05). The Lp(a) level of thromboangiitis obliterans group was also
      much higher (21.3 mg/dl) than that of the healthy control group (P < 0.05). The
      current study suggests that Lp(a) is one of the independent risk factors for the
      development of atherosclerotic diseases such as arteriosclerosis obliterans and
      IHD with atherosclerotic coronary lesion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772086
TI  - Psoralen photochemotherapy (PUVA) and pregnancy.
AB  - BACKGROUND AND DESIGN: Psoralen photochemotherapy (PUVA) may carry a risk of
      mutagenesis and teratogenesis. Using a medical birth registry and other health
      registries, infants born to women who had been treated with PUVA were identified.
      Exposure information was obtained from treating hospitals and from the license
      granting agency. A total of 504 infants were born of pregnancies occurring after
      PUVA treatment, and 689 infants were born of pregnancies occurring before such
      treatment. In another 14 cases, treatment occurred during pregnancy. RESULTS: No
      increase in infant or child mortality or in the presence of congenital
      malformations could be seen after PUVA treatment. There was a marked increase in
      low-birth-weight infants when pregnancy occurred after treatment, and this is
      probably not explained by maternal smoking, but could be an effect of the
      underlying disease. CONCLUSIONS: The theoretical mutagenic and teratogenic effect
      of PUVA treatment apparently does not carry any significant risk for abnormal
      delivery outcome.

PMID- 7772087
TI  - Meralgia paresthetica mimicking lumbar radiculopathy.

PMID- 7772088
TI  - [Diagnosis and therapy of functional dyspepsia].

PMID- 7772090
TI  - [Violence. The need for preventive health activity].

PMID- 7772089
TI  - [Complications following axillary dissection for breast carcinoma].
AB  - Axillary dissection in breast cancer is performed to stage the tumor and to
      obtain regional tumour control. It is associated with some morbidity. Recently
      mention was made of post-axillary dissection pain of the arm following damage to
      one or more of the intercostobrachial nerves. In the University Hospital of
      Utrecht a radical axillary dissection is routinely performed for breast cancer
      with transection of the sensory intercostobrachial nerve(s). To evaluate the
      inherent morbidity of this operation, we interviewed and examined 71 women (75
      axillae) who had undergone an axillary dissection for carcinoma of the breast
      between January 1987 and January 1990. In almost all cases a sensory deficit was
      present in the axilla and/or arm. In 23 patients (26 sides; 35%) there was pain
      in the arm, always in the innervation area of the intercostobrachial nerves. One
      third of these cases had a NRS score of 5 or higher, indicating moderate to
      severe pain. Seroma and lymphedema were found in 21 patients. In 6 shoulders
      abduction was reduced to 90 degrees. The several complaints were non-invalidating
      to 48 patients, slightly invalidating to 13 and moderately invalidating to 10
      patients. At present, histological examination of the axillary nodes is still the
      best way to detect metastases, and it has implications for adjuvant therapies.
      The results of this study indicate that routinely sacrificing the
      intercostobrachial nerves during axillary dissection may result in annoying
      sensory changes and that efforts should be made to preserve one or two of these
      nerves during the operation.

PMID- 7772091
TI  - Use of the CORB needle biopsy for the harvesting of iliac crest bone graft.
AB  - A technique for iliac crest bone grafting has been described which allows rapid
      harvesting of bone with a significant reduction in the pain, scarring, and
      distortion traditionally associated with this technique.

PMID- 7772092
TI  - [Use of alternative medical procedures: between hope and fear].

PMID- 7772093
TI  - [Adequate regulation of diabetes mellitus decreases the possibility of diabetic
      complications].

PMID- 7772094
TI  - [Screening for early diagnosis of prostatic cancer].
AB  - Early diagnosis is a prerequisite for permanent cure of prostatic carcinoma, and
      screening of asymptomatic men has been suggested. This proposal is discussed in
      relation to criteria for meaningful screening, and we conclude that most of these
      criteria are not fulfilled. While prostatic carcinoma is a major health problem,
      it has not been proved that early diagnosis and treatment, although undoubtedly
      useful for some, is profitable for the population as a whole. Many cases of early
      disease represent latent or slowly growing disease, for whom radical surgery or
      irradiation, with possible complications, would mean overtreatment. At present,
      screening cannot be advised for the general population, but should be considered
      for men at risk because of a history of prostatic cancer among close relatives.

PMID- 7772095
TI  - Limb-sequencing deficits after left but not right hemisphere damage.
AB  - The performance of right and left hemisphere stroke patients was compared to
      normal control groups on a task where subjects alternately hit two targets which
      varied in size from 0.5 to 6.5 cm. The stroke patients used the arm ipsilateral
      to damage, and the control groups used the same arm as their respective stroke
      group. Lesion size and location were similar for the two stroke groups. No
      deficits were found for the right hemisphere stroke group. The left stroke
      group's tapping speed was not slower at the smallest target, but became
      progressively slower relative to the control group's as target size increased.
      Variability in tapping speed increased as target size increased for all except
      the left stroke group. While the entire left stroke group was as accurate as
      their controls, the apraxic, but not nonapraxic, patients made more errors on
      smaller targets only. Two explanations for these findings both emphasize the left
      hemisphere's special role in motor programming; one focuses upon its dominance
      for movements which are independent of sensory feedback and the other emphasizes
      its specialization for processing rapid temporal information.

PMID- 7772096
TI  - [Sialidase activity in the cervical connective tissue].

PMID- 7772097
TI  - [Folic acid for all women desiring a child: a wrong recommendation].

PMID- 7772098
TI  - [Alternative professional practice: a health and jurisprudence consideration].

PMID- 7772099
TI  - Can primary care physicians' questions be answered using the medical journal
      literature?
AB  - Medical librarians and informatics professionals believe the medical journal
      literature can be useful in clinical practice, but evidence suggests that
      practicing physicians do not share this belief. The authors designed a study to
      determine whether a random sample of "native" questions asked by primary care
      practitioners could be answered using the journal literature. Participants
      included forty-nine active, nonacademic primary care physicians providing
      ambulatory care in rural and nonrural Oregon, and seven medical librarians. The
      study was conducted in three stages: (1) office interviews with physicians to
      record clinical questions; (2) online searches to locate answers to selected
      questions; and (3) clinician feedback regarding the relevance and usefulness of
      the information retrieved. Of 295 questions recorded during forty-nine
      interviews, 60 questions were selected at random for searches. The average total
      time spent searching for and selecting articles for each question was forty-three
      minutes. The average cost per question searched was $27.37. Clinician feedback
      was received for 48 of 56 questions (four physicians could not be located, so
      their questions were not used in tabulating the results). For 28 questions (56%),
      clinicians judged the material relevant; for 22 questions (46%) the information
      provided a "clear answer" to their question. They expected the information would
      have had an impact on their patient in nineteen (40%) cases, and an impact on
      themselves or their practice in twenty-four (51%) cases. If the results can be
      generalized, and if the time and cost of performing searches can be reduced,
      increased use of the journal literature could significantly improve the extent to
      which primary care physicians' information needs are met.

PMID- 7772100
TI  - Differences in the treatment of patients with acute myocardial infarction
      according to patient age.
AB  - OBJECTIVE: To identify age-related differences in the treatment of patients with
      acute myocardial infarction. DESIGN: Retrospective cohort study. SETTING: Two
      university-affiliated medical centers with integrated clinical programs.
      PATIENTS: 329 patients admitted with acute myocardial infarction in 1988-1990 for
      whom complete medical records were available. Study exclusions included patients
      transferred from other hospitals specifically to undergo angiography or other
      cardiac procedures, nursing home residents, patients with metastatic cancer or
      dementia, and patients in whom "do not resuscitate" orders were written during
      the first 2 hospital days. MEASUREMENTS: Medical records were reviewed to
      determine socio-demographic data, comorbidity, admission severity of illness,
      medications, the use of specific diagnostic and therapeutic modalities during and
      after hospitalization, treatment limitations, and patient outcomes. MAIN RESULTS:
      Chronological age of patients was related to the use of several diagnostic and
      therapeutic modalities. Using logistic regression to adjust for comorbidity,
      severity, infarct size and location, and other covariates, patients 75 years and
      older were 12 times less likely to receive thrombolytic therapy, 8 times less
      likely to undergo coronary angiography, and 7 times less likely to undergo
      coronary angioplasty than patients less than 65 years of age. However, age was
      not related to the use of other modalities, including echocardiography or gated
      blood pool scanning, pulmonary artery catheterization, and transvenous pacing.
      Finally, in a logistic regression model, the risk of in-hospital death was 4
      times greater for patients 75 years and older than patients less than 65 years.
      CONCLUSIONS: Physicians' management of patients with acute myocardial infarction
      differed greatly according to patient age for some diagnostic and therapeutic
      modalities, but not for others. These findings indicate that generalizations
      about age-related practice variations should not be based on analysis of a single
      procedure. Moreover, judgments about the appropriateness of age-related
      differences in management require knowledge of the relative effectiveness of
      management strategies in older and younger patients.

PMID- 7772101
TI  - The risk of ovarian cancer after treatment for infertility.

PMID- 7772102
TI  - The yield of flexible fiberoptic sigmoidoscopy in the detection of asymptomatic
      colorectal neoplasia.
AB  - Recent evidence of a reduction in mortality rates from distal colorectal cancers
      in populations screened by rigid sigmoidoscopy suggests that further benefits may
      be achieved by the use of fiberoptic sigmoidoscopy as the screening modality.
      However, there is limited evidence as to the expected yield of neoplasia using
      the standard 60-cm instrument. The aim of this study was to determine the yield
      of neoplasia in an asymptomatic population in the at-risk age group undergoing
      fiberoptic sigmoidoscopy. Recruitment into the screening program was among State
      Department personnel. In total, 4,216 asymptomatic subjects (50-65 years) were
      offered flexible sigmoidoscopic screening performed following a simple enema
      bowel preparation. Those in whom a neoplastic condition was identified underwent
      further investigation (colonoscopy or barium enema). Of those offered screening
      4,005 (95%) underwent the examination. Eleven carcinomas were detected at
      flexible sigmoidoscopy and two carcinomas were detected at further investigation
      in subjects with rectosigmoid polyps. The overall detection rate of carcinomas
      was 3.2 per 1,000 subjects screened. Histologically proven adenomas were detected
      in 217 subjects, 5.4% of the population screened. In this cohort of individuals
      flexible sigmoidoscopy appears to have been an acceptable form of screening. The
      detection rate of neoplasia, particularly colorectal adenomas, is higher than
      that reported from studies of fecal occult blood screening.

PMID- 7772103
TI  - Quantitative analysis of Le(a) and Le(b) antigens in human saliva.
AB  - We have measured the H type 1, Le(a) and Le(b) antigens in the saliva from 129
      Japanese individuals by a time-resolved europium ion fluorometric immunoassay
      using artificial antigen-albumin complexes as the reference substances. We
      confirmed that the amount of Le(b) was larger than that of Le(a) in the saliva
      from secretors (Le(a-b+)) and vice versa in the saliva from nonsecretors (Le(a+b
      )). Unexpectedly, we discovered appreciable amounts of Le(b) with small amounts
      of H type 1 in the saliva from the nonsecretors. The concentration of Le(b) was
      about 10, 6 and 35% of the concentration of the Le(a) in the saliva from the
      nonsecretors of the A, B and O groups, respectively. The possible formation of
      Le(b) from Le(a), in addition to the formation of Le(b) from H type 1, in the
      salivary glands is discussed.

PMID- 7772104
TI  - Health reform and the health of the public. Forging community health
      partnerships.

PMID- 7772105
TI  - Lack of association between cholesterol and coronary heart disease mortality and
      morbidity and all-cause mortality in persons older than 70 years.
AB  - OBJECTIVES: To determine whether elevated serum cholesterol level is associated
      with all-cause mortality, mortality from coronary heart disease, or
      hospitalization for acute myocardial infarction and unstable angina in persons
      older than 70 years. Also, to evaluate the association between low levels of high
      density lipoprotein cholesterol (HDL-C) and elevated ratio of serum cholesterol
      to HDL-C with these outcomes. DESIGN: Prospective, community-based cohort study
      with yearly interviews. PARTICIPANTS: A total of 997 subjects who were
      interviewed in 1988 as part of the New Haven, Conn, cohort of the Established
      Population for the Epidemiologic Study of the Elderly (EPESE) and consented to
      have blood drawn. MAIN OUTCOME MEASURES: The risk factor-adjusted odds ratios of
      the 4-year incidence of all-cause mortality, mortality from coronary heart
      disease, and hospitalization for myocardial infarction or unstable angina were
      calculated for the following: subjects with total serum cholesterol levels
      greater than or equal to 6.20 mmol/L (> or = 240 mg/dL) compared with subjects
      with cholesterol levels less than 5.20 mmol/L (< 200 mg/dL); subjects in the
      lowest tertile of HDL-C level compared with those in the highest tertile; and
      subjects in the highest tertile of the ratio of total serum cholesterol to HDL-C
      level compared with those in the lowest tertile. RESULTS: Elevated total serum
      cholesterol level, low HDL-C, and high total serum cholesterol to HDL-C ratio
      were not associated with a significantly higher rate of all-cause mortality,
      coronary heart disease mortality, or hospitalization for myocardial infarction or
      unstable angina after adjustment for cardiovascular risk factors. The risk factor
      adjusted odds ratio for all-cause mortality was 0.99 (95% confidence interval
      [CI], 0.56 to 2.69) for the group who had cholesterol levels greater than or
      equal to 6.20 mmol/L (> or = 240 mg/dL) compared with the group that had levels
      less than 5.20 mmol/L (< 200 mg/dL); 1.00 (95% CI, 0.59 to 1.70) for the group in
      the lowest tertile of HDL-C compared with those in the highest tertile; and 1.03
      (95% CK, 0.62 to 1.71) for subjects in the highest tertile of the ratio of total
      serum cholesterol to HDL-C compared with those in the lowest tertile.
      CONCLUSIONS: Our findings do not support the hypothesis that hypercholesterolemia
      or low HDL-C are important risk factors for all-cause mortality, coronary heart
      disease mortality, or hospitalization for myocardial infarction or unstable
      angina in this cohort of persons older than 70 years.

PMID- 7772107
TI  - De novo purine nucleotide synthesis in total peripheral blood lymphocytes from
      patients with B-chronic lymphocytic leukemia (B-CLL)

PMID- 7772106
TI  - Randomised trial of hysterectomy, endometrial laser ablation, and transcervical
      endometrial resection for dysfunctional uterine bleeding.
AB  - OBJECTIVE: To evaluate the effectiveness and safety of endometrial laser ablation
      and transcervical resection of the endometrium compared with hysterectomy in the
      surgical treatment of women with dysfunctional uterine bleeding. DESIGN:
      Prospective randomised controlled trial. SETTING: Gynaecology department of a
      large teaching hospital. SUBJECTS: 204 women who would otherwise have been
      undergoing hysterectomy for menorrhagia were recruited between August 1990 and
      March 1992 and randomly allocated to hysterectomy (n = 99) or conservative
      (hysteroscopic) surgery (transcervical resection (n = 52) and laser ablation (n =
      53)). MAIN OUTCOME MEASURES: Operative complications, postoperative recovery,
      relief of menstrual and other symptoms, patient satisfaction with treatment after
      six and 12 months. RESULTS: Women treated by hysteroscopic surgery had less early
      morbidity and a significantly shorter recovery period than those treated by
      hysterectomy (median time to full recovery 2-4 weeks v 2-3 months, P < 0.001).
      Twelve months later 17 women in the hysteroscopy group had had a hysterectomy, 11
      for continuing symptoms; 11 women had had a repeat hysteroscopic procedure; 45
      were amenorrhoeic or had only a brown discharge; and 35 had light periods.
      Dysmenorrhoea and premenstrual symptoms improved in most women in both groups.
      After 12 months 89% (79/89) in the hysterectomy group and 78% (75/96) in the
      hysteroscopy group were very satisfied with the effect of surgery (P < 0.05); 95%
      (85/89) and 90% (86/96) thought that there had been an acceptable improvement in
      symptoms, and 72% (64/89) and 71% (68/96) would recommend the same operation to
      others. CONCLUSIONS: Hysteroscopic endometrial ablation was superior to
      hysterectomy in terms of operative complications and postoperative recovery.
      Satisfaction after hysterectomy was significantly higher, but between 70% and 90%
      of the women were satisfied with the outcome of hysteroscopic surgery.
      Hysteroscopic surgery can be recommended as an alternative to hysterectomy for
      dysfunctional uterine bleeding.

PMID- 7772108
TI  - Images in clinical medicine. Mycoplasma pneumoniae.

PMID- 7772109
TI  - Preventing deaths from asthma.

PMID- 7772110
TI  - Deep-vein thrombosis.

PMID- 7772111
TI  - Using newly deceased patients to teach resuscitation procedures.

PMID- 7772112
TI  - Chest roentgenogram demonstrates cephalad movement of the carina during
      laparoscopic cholecystectomy.

PMID- 7772113
TI  - Increased resting metabolic rate in patients with congestive heart failure.
AB  - OBJECTIVE: To examine resting metabolic rate in patients with congestive heart
      failure as a cause of cardiac cachexia and associated weight loss. DESIGN: Cross
      sectional study. SETTING: Baltimore Veterans Affairs Medical Center. PATIENTS: 20
      men with heart failure (mean age +/- SD, 69 +/- 7 years) and reduced ejection
      fraction (mean, 0.24 +/- 0.10) and 40 healthy men (mean age, 69 +/- 7 years).
      RESULTS: Patients with heart failure had smaller fat-free mass than did controls
      (53 +/- 8 kg compared with 56 +/- 6 kg; P < 0.09), but no difference in fat mass
      existed (21 +/- 8 kg compared with 19 +/- 8 kg). Measured resting metabolic rate
      was 18% higher in patients with heart failure than in controls (1828 +/- 275
      kcal/d compared with 1543 +/- 219 kcal/d; P < 0.01); no difference in caloric
      intake existed (2144 +/- 479 kcal/d compared with 2174 +/- 826 kcal/d). The
      difference in resting metabolic rate between the two groups was even more
      striking when indexed per kilogram of fat-free mass. CONCLUSIONS: Higher resting
      metabolic rate in patients with heart failure at least partially accounts for
      otherwise unexplained weight loss. Present caloric guidelines, which were
      established in healthy elderly persons, substantially underestimate the resting
      caloric needs of elderly persons with heart failure.

PMID- 7772115
TI  - Symmetry: Matte-Blanco's theory and Borges's fiction.
AB  - Matte-Blanco's theory reformulates the Freudian unconscious from the perspective
      of mathematical set theory, pointing to symmetric logic as the distinctive mark
      of the unconscious. Borges's fictional creations are presented as thematising and
      dramatising, in the act of reading, Matte-Blanco's main concepts of symmetry, bi
      logic and the fundamental antinomy of human beings. This study's main thesis is
      that aesthetic experiences, such as the reading of Borges's literary creation,
      may allow for a broader experience of symmetrical being than the one conveyed
      through everyday language. In this context, the analysis of some of Borge's
      themes and main stylistic devices seems to shed light on bi-logic, from the
      perspective of the reader's experience and creation of meaning. Borge's
      characteristic use of literary allusions, as well as the suggested
      interchangeability of reader, writer and character, are understood as devices
      which increase the reader's awareness of relations of resemblance, destroying
      chronology and differences, uniting the text and the reference. From this
      perspective, a main effect of Borges's creation stems from an enhanced awareness
      of the interplay of symmetry and asymmetry, and the problem of the translation of
      symmetric into asymmetric being. Borges's stories effect in the reader an
      experience of infiniteness, timelessness, multidimensionality and assimilation of
      the proper part to the whole, as the background of the theme of (asymmetric)
      story-telling.

PMID- 7772114
TI  - Does sedation help in fibreoptic bronchoscopy?

PMID- 7772116
TI  - Decline of serum cobalamin levels with increasing age among geriatric
      outpatients.
AB  - The level of serum cobalamin declines with increasing age. Among 100 consecutive
      geriatric outpatients who were seen in office-based settings for various acute
      and chronic medical illnesses but not for cobalamin deficiency-related diseases,
      11% had serum cobalamin levels from 148 to 295 pmol/L. The average annual serum
      cobalamin level decline was 18 pmol/L for patients who had higher initial serum
      cobalamin levels (actual range, from 224 to 292 pmol/L). The average annual serum
      cobalamin decline was 28 pmol/L, which was much higher, for patients who had
      lower initial serum cobalamin levels (actual range, from 157 to 221 pmol/L).
      Patients with initial serum cobalamin levels of 148 pmol/L or below received
      treatment immediately, and their declines could not be studied.

PMID- 7772117
TI  - Going private: time for change.

PMID- 7772118
TI  - Identifying relevant studies for systematic reviews.

PMID- 7772119
TI  - Nutrition and lung health.

PMID- 7772120
TI  - Identifying complex disease genes: progress and paradigms.

PMID- 7772121
TI  - Should morbidity replace mortality as an endpoint for clinical trials in
      intensive care?

PMID- 7772122
TI  - Smoking, Alzheimer's disease, and confounding with genes.

PMID- 7772124
TI  - Sexual abuse and recovered memories.

PMID- 7772123
TI  - HCV-associated liver cancer without cirrhosis.
AB  - Chronic infection with hepatitis C virus (HCV) is regarded as a risk factor for
      hepatocellular cancer, mostly in patients with liver cirrhosis. We looked for HCV
      genomes in the livers of patients with hepatocellular cancer who did not have
      cirrhosis to see whether HCV was directly oncogenic. Cancerous and non-cancerous
      liver tissue, and serum samples from 19 patients negative for hepatitis B surface
      antigen were analysed by polymerase chain reaction for the presence of HCV
      genome, HCV replication, HCV genotyping, and HBV genome. 13 of 19 patients were
      HCV RNA-positive in cancerous and non-cancerous liver tissue; 8 of 17 tested were
      anti-HCV positive. Among the 13 HCV RNA-positive patients, 11 had genotype 1b and
      2 had genotype 2a. 7 of 13 serum samples were HCV RNA positive. 7 of 19 patients
      were HBV DNA positive in cancerous and non-cancerous liver tissue, 5 of them anti
      HBc positive. 4 patients were both HCV RNA and HBV DNA positive and 3 were both
      HCV RNA and HBV DNA negative. Our results provide evidence for the association of
      HCV, mostly genotype 1b, with hepatocellular cancer without the intermediate step
      of cirrhosis.

PMID- 7772125
TI  - Community practice. A positive exercise in damage limitation. Management of
      aggression in elderly confused people.
AB  - 1. Aggression in the elderly demented person is not uncommon, and should be
      clearly recognised. 2. Validation and reminiscence therapy can help reduce the
      risk of aggressive outbursts. 3. A better understanding of how to communicate
      with an aggressive person can help the carers to maintain interpersonal
      relationships with loved ones. 4. Carers provide the main bulk of care for
      elderly people and therefore require help and support to enable them to do this
      satisfactorily.

PMID- 7772126
TI  - Rising emergency admissions.

PMID- 7772127
TI  - [Non-ketotic hyperglycinemia].
AB  - Three children with non-ketotic hyperglycinaemia (NKH) is reported. Two patients
      had typical neonatal form of NKH, one patients had atypical form of NKH. The
      clinical symptoms laboratory findings and therapeutical approach are discussed.
      One of the patients with typical neonatal form of NKH is died, neuropatological
      examination revealed corpus callosal agenesis and diffuse hypomyelinisation. The
      two children treated with N-methyl-D-aspartate-antagonist drugs reached a
      significantly better clinical condition. The authors reviewed the data of the
      literature, especially focused on the therapeutical possibilities.

PMID- 7772128
TI  - Trypanosome infections of the tsetse fly Glossina pallidipes in the Luangwa
      Valley, Zambia.
AB  - Trypanosome infections of Glossina pallidipes were investigated at a site in the
      Luangwa Valley, Zambia between June 1991 and September 1992. Almost 3700 flies
      were captured, dissected, screened for trypanosome infection, and aged using both
      wing fray and (for females) ovarian categories. DNA probes were used to identify
      midgut infections. Prevalences of mature infections were 6.2% Trypanosoma vivax
      type and 3.1% T. congolense-type (including low prevalances of T. brucei, T.
      simiae and another Nannomonas species). The prevalence of infection increased
      with age. For both types of infection this relationship could be described by a
      simple 'catalytic' model which generates estimates of per capita rates of
      infection. Prevalences varied significantly with time independently of any
      changes in the age structure of the tsetse population. This may reflect temporal
      variation in the per capita rates of infection.

PMID- 7772129
TI  - Questionnaires and copyright.

PMID- 7772130
TI  - Health promotion in general practice. Any beneficial effect was lost in
      background statistical noise.

PMID- 7772131
TI  - Increased intracellular and plasma levels of basic fibroblast growth factor in B
      cell chronic lymphocytic leukemia.

PMID- 7772132
TI  - Growing pressure on BMJ's obituaries.

PMID- 7772133
TI  - Obituaries. More pages should be given to obituaries.

PMID- 7772134
TI  - Obituaries. Put them on an electronic bulletin board.

PMID- 7772135
TI  - Treating heart disease. Benefits of thrombolysis were overstated.

PMID- 7772136
TI  - Life expectancy in children with cerebral palsy.

PMID- 7772137
TI  - Changes in autonomic nervous function over a five-year period in diabetic
      patients.

PMID- 7772138
TI  - Clarifying characteristics of pericardial tamponade.

PMID- 7772140
TI  - Partial splenic embolization for hypersplenism.

PMID- 7772139
TI  - What is a normal CA-125 level?

PMID- 7772141
TI  - An outbreak of penicillin-sensitive strain of Neisseria gonorrhoeae in Sydney
      men.

PMID- 7772142
TI  - Distal transfer of the greater trochanter.

PMID- 7772143
TI  - Genetic testing for children and adolescents.

PMID- 7772144
TI  - Screening for prostate cancer.

PMID- 7772145
TI  - Mandated choice for organ donation.

PMID- 7772146
TI  - Risk of ovarian cancer after treatment for infertility.

PMID- 7772147
TI  - Nifedipine in severe aortic regurgitation.

PMID- 7772148
TI  - More on breast implants and connective-tissue diseases.

PMID- 7772149
TI  - Microalbuminuria, cardiovascular risk factors, and secondary prevention of non
      insulin-dependent diabetes.

PMID- 7772150
TI  - Oncologic aspects of augmentation mammaplasty.

PMID- 7772151
TI  - Pain during injection of propofol.

PMID- 7772152
TI  - Optic nerve ischemia: optic nerve sheath decompression alone or with optic nerve
      decompression.

PMID- 7772153
TI  - Emergency care in general practice. British Heart Foundation recommends early
      defibrillation.

PMID- 7772154
TI  - Emergency care in general practice. Courses are available.

PMID- 7772155
TI  - Antibiotics carried in general practitioners' emergency bags. Penicillin is
      necessary for suspected meningococcal disease.

PMID- 7772156
TI  - Handedness among surgeons.

PMID- 7772157
TI  - Treatment of dysfunctional uterine bleeding. Laparoscopic hysterectomy is an
      alternative.

PMID- 7772158
TI  - Care in a midwife managed delivery unit. Pregnancy and delivery require a joint
      midwifery and medical approach.

PMID- 7772159
TI  - Rising emergency admissions. Managing emergency admissions is no longer the first
      priority.

PMID- 7772160
TI  - Continuing medical education and gift authorship.

PMID- 7772161
TI  - Perinatal and infant postmortem examination. Postmortem reports provide valuable
      information.

PMID- 7772162
TI  - Immunisation against chickenpox. Pregnant women should be screened.

PMID- 7772163
TI  - Acute dissection of the thoracic aorta. Transoesophageal echocardiography has
      wider uses.

PMID- 7772164
TI  - Utility of rapid monoclonal antibody-based coagglutination test for direct
      detection of Vibrio cholerae O1 and/or O139 in stool samples.

PMID- 7772165
TI  - Sex and gender bias in illustrations in anatomy and physical diagnosis texts.

PMID- 7772166
TI  - Cholesterol and coronary heart disease risk in elderly patients.

PMID- 7772167
TI  - Airway complications after lung transplantation: is there a left-sided
      predilection?

PMID- 7772168
TI  - Coronary risk factors in people from the Indian subcontinent.

PMID- 7772170
TI  - Patterns of abuse in political dissidents.

PMID- 7772169
TI  - Response to a specific antioestrogen (ICI 182780) in tamoxifen-resistant breast
      cancer.

PMID- 7772171
TI  - Restriction of fat in the diet of infants.

PMID- 7772172
TI  - The meaning of overseas specialist training.

PMID- 7772173
TI  - Patterns of mortality from asthma.

PMID- 7772174
TI  - Idiopathic dilated cardiomyopathy.

PMID- 7772175
TI  - Cold war against the Vatican?

PMID- 7772176
TI  - Myalgic encephalomyelitis and chronic fatigue syndrome.

PMID- 7772177
TI  - Re: "Suicidal behaviors in young adolescents" and "major depressive disorder and
      dysthymia in young adolescents".

PMID- 7772178
TI  - Laryngotracheal stenosis after percutaneous tracheostomy.

PMID- 7772179
TI  - Propofol as the sole agent for paediatric day case dental surgery.

PMID- 7772180
TI  - Endoscopic transthoracic sympathectomy: successful in hyperhidrosis but can the
      indications be extended?

PMID- 7772181
TI  - Posterior column sensory impairment during ambulatory extradural analgesia in
      labour.

PMID- 7772182
TI  - A case of pancreatic ascites in which endoscopic retrograde pancreatography (ERP)
      was used to confirm a leaking pancreatic duct.

PMID- 7772183
TI  - Consequences of percutaneous endoscopic gastrostomy (PEG) tubes in nursing home
      patients.

PMID- 7772184
TI  - Cutaneous involvement with Cryptococcus neoformans in AIDS.

PMID- 7772185
TI  - Cot mattresses and sudden infant death syndrome.

PMID- 7772186
TI  - Accidental hypothermia.

PMID- 7772187
TI  - Insecticide-treated bed nets in control of malaria in Africa.

PMID- 7772188
TI  - Using newly deceased patients in teaching procedures.

PMID- 7772189
TI  - Deep-vein thrombosis.

PMID- 7772190
TI  - Efficacy of validation therapy is unproven.

PMID- 7772191
TI  - Origin and distribution of B mtDNA lineage in South America.

PMID- 7772192
TI  - Variants of liposarcoma.

PMID- 7772194
TI  - Kafka, V. (1993) letter to the editor: On hydraulic strengthening of bones.

PMID- 7772193
TI  - Patient-controlled epidural analgesia for labor.

PMID- 7772195
TI  - The use of hope as a coping mechanism in abused women.
AB  - The purpose of this study was to identify how abused women use hope and to
      determine whether hope is a coping mechanism in their relationship with the
      abusers. Four focus group sessions were conducted with a sample of 24 women using
      a phenomenological methodology. The data analysis indicated that abused women
      maintain hope in four major dimensions: hope for change in their partner's
      behavior, hope for survival, hope as something to cling to, and hope for control
      of the situation. The subjects stated that hope was used as a coping mechanism to
      help them keep their sanity; but in this context, the subjects often saw hope as
      false or unreal. Thus some abused women used hope as a mechanism to attempt to
      resolve cognitive dissonance between their internal beliefs and the external
      reality of physical violence.

PMID- 7772196
TI  - Modelling different strategies to prevent coronary heart disease in primary care.
AB  - Strategies for prevention of coronary heart disease (CHD) in primary care need to
      take into account the number of people who require screening, further assessment,
      intervention and follow-up (i.e. the patient workload generated for the general
      practitioner) as well as the anticipated reductions in morbidity and mortality.
      Risks of CHD for various risk profiles were estimated from equations produced by
      the Framingham study. This enabled an estimate of the number of avertable CHD
      events to be compared against the patient workload implications for the general
      practitioner when different screening and intervention strategies were used. The
      Framingham equations were applied to a population of 5727 men and women aged 35
      64 years of age registered with general practices in the south of England.
      Adopting an unselective approach to screening resulted in 14.1% (n = 73) of the
      517 CHD events predicted over a 10 year period being averted. A limited screening
      strategy, involving 25% (n = 1436) of the patients would avert 5.6% (n = 29) of
      the predicted CHD events, whilst more extended strategies involving between 37%
      (n = 2131) and 46% (n = 2660) of the practice population respectively would
      result in between 6.9% (n = 36) and 9.3% (n = 48) of events being averted. The
      marginal benefit in averting CHD events decreased as more screening criteria were
      included. Almost all (99%) of the people identified by the selective screening
      strategies would require some form of intervention, predominantly lifestyle
      advice. Lowering the systolic blood pressure by 15 mmHg instead of 10 mmHg was
      equally effective as a 5% improvement in the overall rate of smoking
      cessation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772197
TI  - Forensic odontology: age determination from adult human teeth.
AB  - Dentistry has several recognized specialities. Age, race and sex determination
      together with dental identification and facial reconstruction on skeletal
      material are procedures that the forensic odontologist has to master. The use of
      Gustafson's method to determine age in an examination of 350 teeth of living
      and/or dead males and females from the Heidelberg area, Germany is discussed.

PMID- 7772198
TI  - Blood coagulation and fibrinolysis in eclamptic patients and their correlation
      with the clinical signs.
AB  - We studied the impact of blood coagulation and fibrinolysis on the clinical
      features of eclamptic patients (n = 20) in Bangladesh. The variables used were
      edema, proteinuria, blood pressure, number of convulsions, level of consciousness
      at the time of admission, thrombin antithrombin complexes (TAT), antithrombin
      (AT) III (%) activity and antigen, D dimer fibrin degradation product and alpha 2
      plasmin inhibitor-plasmin complex (PIC) in plasma. Canonical correlation analysis
      was made to obtain clinical index, eclampsia index and two coagulation indices.
      On admission, the mean values of coagulation parameters were AT III activity:
      83.2% (range 57-108), TAT complex: 47.6 ng/ml (range 11.5-60), D dimer: 1,693
      ng/ml (range 417-8,276) and PIC 1.4 mg/ml (range 0.4-3.3). We found a significant
      correlation between the eclampsia index and clinical index (r = 0.601; p = 0.01).
      Gestosis index, clinical index, and eclampsia index have also a strong
      correlation with the coagulation index (r = 0.695, p < 0.005; r = 0.871, p <
      0.0001 and r = 0.805, p < 0.0001, respectively). Coagulation and fibrinolysis
      were markedly activated in eclampsia. The correlation between the clinical status
      and coagulation status in this study suggested a close relation between the
      coagulation and the development and progression of the disease.

PMID- 7772199
TI  - Protein kinase C activation is not a key step in ADP-mediated exposure of
      fibrinogen receptors on human platelets.
AB  - A selective inhibitor of protein kinase C (PKC), Ro 31-8220, blocks pleckstrin
      (P47) phosphorylation in platelets activated with either ADP, ADP plus synthetic
      thromboxane agonist U46619 and ADP plus U46619 plus epinephrine, while inducing a
      weak inhibition of platelet aggregation, and no significant effect on the
      fibrinogen binding. In platelets activated by U46619 alone, P47 phosphorylation,
      platelet aggregation, fibrinogen binding and serotonin release are all inhibited
      by Ro 31-8220. In the presence of an ADP scavenger system, U46619 induces
      pleckstrin phosphorylation, serotonin release and calcium mobilization but not
      platelet aggregation and fibrinogen binding, unless epinephrine is added. IN
      CONCLUSION: (1) PKC activation is required for ADP secretion; (2) ADP or
      epinephrine are essential for fibrinogen receptor exposure induced by U46619; (3)
      fibrinogen receptor exposure induced by ADP is independent of activation of PKC.

PMID- 7772200
TI  - A 10-year experience of pediatric brachytherapy.
AB  - PURPOSE: The purpose of this project was to review the brachytherapy experience
      in the pediatric population at the Joint Center for Radiation Therapy (JCRT) with
      respect to efficacy and morbidity. METHODS AND MATERIALS: Treatment outcome was
      reviewed for 18 children between the ages of 6 months and 23 years who received
      19 implants between 1982 and 1992 at JCRT. Fourteen children received permanent
      Iodine-125 seed implants placed in the operative tumor bed at the time of
      resection. Two children received sterotactically placed afterloaded high-activity
      I-125 seed brain implants, and one child received a high-activity I-125 brain
      implant followed by a permanent I-125 seed brain implants 3 years later. One girl
      received a temporary Iridium-192 volume implant for a vulvar rhabdomyosarcoma.
      Among the 15 permanent I-125 implants, the cases included five primary brain
      tumors, one metastatic brain tumor, six sarcomas, and one each of the following:
      suprarenal neuroblastoma, hepatoblastoma, and adenocarcinoma of the pancreas. All
      patients underwent surgery and most patients (15 out of 18) received external
      beam radiotherapy to a field that included the implant. RESULTS: The median
      follow-up from the time of diagnosis for patients who remain alive is 55 months
      (range 24 to 119 months), and the median follow-up from the time of implant is 46
      months (15 to 60 months). Disease was controlled in the area of the implant in 13
      of 17 evaluable cases. Two patients experienced treatment-related morbidity; one
      patient developed severe desquamation related to an "adriamycin recall reaction,"
      and one patient died of postoperative complications. CONCLUSION: Despite the
      heterogeneous mix of cases, the use of brachytherapy in this pediatric population
      resulted in several cases of long-term disease control, and the overall morbidity
      was very low. Therefore, in properly selected pediatric cases, brachytherapy
      appears to be an efficacious adjunct to multimodality cancer management.

PMID- 7772201
TI  - AAOHN. Accident investigation.

PMID- 7772202
TI  - Adolescents and work: risks and benefits of teenage employment.
AB  - 1. Adolescent employment, both legal and illegal, has been on the increase in the
      U.S. during the past 2 decades. According to the U.S. Department of Labor, more
      than 5.9 million children between the ages of 16 and 19 were legally employed in
      May 1994. 2. Benefits of employment include self reliance and discipline,
      improved organizational skills, and financial management as well as a sense of
      responsibility, teamwork, and exposure to occupational choices. 3. Negative
      effects of employment include threats to completion of developmental tasks and
      education, injury, toxic exposure, and illness.

PMID- 7772203
TI  - Latex sensitivity: an occupational health strategic plan.
AB  - 1. Health care workers, due to ongoing exposure to latex products, may be at risk
      of developing latex sensitivity. 2. The spectrum of reactions related to medical
      glove use varies in severity. Awareness of latex sensitivity is heightened
      through worker education. 3. Guidelines and interventions for occupational health
      nurses are outlined so that workers who present with symptoms of occupational
      sensitivities related to latex products can be identified and assessed. 4.
      Occupational health nurses are effective resources for workers and managers on
      issues of latex allergy and appropriate accommodation.

PMID- 7772204
TI  - Design of a questionnaire: occupational and environmental risks for Parkinson's
      disease.
AB  - 1. Research linking disease with occupational and environmental exposures is
      often predicated on obtaining accurate exposure information from affected
      persons. 2. Exposure history questionnaires are used to obtain comprehensive
      information about work history, residential history, behavioral patterns, and
      lifetime exposures. 3. The process of questionnaire development includes:
      establishing the conceptual background of the research; assuring integrity of the
      research questions; specifying the content domain of the questionnaire; wording,
      level, and formatting decisions; establishing evidence for questionnaire
      validity; assessment of questionnaire reliability; and final edit and polishing.
      4. The careful and systematic development of an exposure history questionnaire
      can be a key determinant in the success of occupational health research.

PMID- 7772205
TI  - The economic impact of corporate wellness programs: past and future
      considerations.
AB  - 1. A primary goal of health promotion is to motivate individuals to make positive
      life-style changes. 2. Health promotion is multifaceted and each company must
      select the most appropriate method(s) of intervention for their employees. 3. In
      any company, a successful health promotion program requires an advocate or
      champion who functions as the initiator and leader for program development.
      Employee involvement, from inception to ongoing development of all programs, is
      also necessary for success. 4. To positively impact health care costs, health
      promotion programs should be well planned, well timed, and appropriately
      marketed. Needs of all workers (i.e., blue collar, minorities) should be
      considered.

PMID- 7772206
TI  - Revised NIOSH equation for manual lifting: a method for job evaluation.

PMID- 7772207
TI  - Readability in research.

PMID- 7772208
TI  - The Fifth Report of the Joint National Committee on Detection, Evaluation, and
      Treatment of High Blood Pressure: a resource for occupational health.
AB  - 1. Hypertension continues to be a significant medical and public health concern
      affecting as many as 50 million Americans. 2. Early detection, treatment, and
      control of hypertension is important in reducing coronary heart disease, stroke,
      and mortality. 3. Occupational health professionals have a great opportunity to
      enhance detection, treatment, and control of hypertension through worksite health
      programs. 4. The Joint National Committee on Detection, Evaluation, and Treatment
      of High Blood Pressure's publication, "The Fifth Report of the Joint National
      Committee," is a valuable resource to occupational health professionals in
      addressing employee hypertension in the workplace.

PMID- 7772209
TI  - Primary prevention of hypertension: a challenge for occupational health nurses.
AB  - 1. About one in four adults in the United States has high blood pressure on the
      basis of a single evaluation. Hypertension is associated with an increased risk
      of developing coronary heart disease, stroke, congestive heart failure, renal
      insufficiency, and peripheral vascular disease. 2. Weight loss, reduced sodium
      intake, reduced alcohol consumption, and exercise have documented efficacy as
      interventions to decrease high blood pressure. A number of intervention programs
      in community based settings and in health care provider practice based settings
      have documented that behavioral change and relevant reductions in blood pressure
      are feasible. 3. Occupational health nurses are in unique positions to both
      initiate and support intervention programs. Interventions could be conducted by
      individual occupational health nurses as well as sponsored by corporate employers
      or local occupational health nursing constituencies.

PMID- 7772210
TI  - Dealing with hypertension: using theory to promote behavioral change.
AB  - 1. Controlling hypertension and related disease requires that health
      professionals focus more attention on primary prevention strategies as a means of
      decreasing hypertensive risks. 2. Behavioral theories help identify attitudes,
      beliefs, and knowledge influencing behaviors that increase one's risk for
      hypertension. 3. Using information based on the behavioral theories will help
      occupational health nurses develop more effective programs for primary prevention
      of hypertension.

PMID- 7772211
TI  - Physical activity: one approach to the primary prevention of hypertension.
AB  - 1. Despite the merits of physical activity reducing the risk of hypertension and
      showing other health benefits, Americans continue to be relatively sedentary. 2.
      Low to high intensity physical activities result in a reduction in both systolic
      and diastolic blood pressure in middle aged to older adults. Individuals can
      obtain benefits by engaging in aerobic exercise, a wide variety of leisure time
      activities, short bouts of exercise, and even isometric work. 3. Behavioral
      techniques of contracting, self monitoring, and relapse prevention training offer
      important methods to help clients adopt and maintain physical activity.

PMID- 7772212
TI  - Hypertension: resources for client information.

PMID- 7772213
TI  - Migraine headache in occupational health settings.

PMID- 7772214
TI  - Linking the professional literature to nursing practice: challenges and
      opportunities.
AB  - Occupational health nurses face the challenge of rapidly changing, increasingly
      complex work environments. To respond, they must have access to information and
      know how to manage it effectively to improve their clinical performance and
      achieve better client outcomes. Information technology has already had an impact
      on nursing. Many nurses routinely use computers to access laboratory reports,
      client records, and administrative programs. However few nurses make use of
      opportunities provided by information technology to access professional
      literature as a tool for applying new research to their practice.

PMID- 7772215
TI  - Health promotion by mail.

PMID- 7772216
TI  - [Culturing autologous cartilage tissue for reconstructive surgery: possibilities
      and limits].
AB  - The engineering of cartilage tissue in vitro for transplantation requires new
      concepts in cell culture technology. In this study a new approach is presented
      for an in vitro formation of cartilage transplants. First isolated chondrocytes
      obtained from a cartilage biopsy have to be substantially increased using
      monolayer culture systems. In contrast to cell amplification, the development of
      cartilage depends on a three-dimensional arrangement of cells and the formation
      or synthesis of an appropriate extracellular matrix. Bioresorbable polymer
      fleeces of polyglycolic acid and polylactic acid can be used as temporary cell
      carrier matrices to establish three-dimensional cultures of human chondrocytes.
      Furthermore, a perfusion culture system to provide a constant supply of nutrient
      into the cultures is also advantageous. With the described culture procedure, the
      chondrocytes maintained a differentiated phenotype showing a synthesis of new
      cartilage matrix. After transplantation in nude mice the pieces of solid
      cartilage are not resorbed or rejected and remain intact. The experiments
      demonstrate a promising pathway for in vitro engineering of vital tissues
      suitable to be used as autologous transplants in reconstructive surgery of the
      head and neck.

PMID- 7772217
TI  - [Experimental studies of chondrosynthesis for the larynx].
AB  - The aim of this study was to develop and investigate techniques for stabilising
      and reconstruction of defects in the larynx similar to osteosynthesis. MATERIAL
      AND METHODS: (1) 400 extrusion forces of sutures and various screws (Howmedica)
      in thyroid cartilage of fresh cadavers were measured. (2) A new screw specially
      designed for cartilage was developed. (3) A new technique for stabilising
      cartilage with a screw nut made out of bone was developed. RESULTS: The extrusion
      forces correlate with the calcification of the laryngeal skeleton depending on
      the investigated area of the thyroid cartilage and the type of suture and screws
      that are used, respectively. Besides the increased extrusion forces the
      advantages of chondrosynthesis are the possibility of axial stabilisation and of
      exact bridging of defects with or without implants.

PMID- 7772218
TI  - [Treatment of acute and chronic laryngeal and tracheal stenoses in the 19th and
      beginning of the 20th century by tracheotomy, coniotomy, intubation and
      dilatation. Pictures from the history of otorhinolaryngology illustrated by
      instruments from the collection of the Ingolstadt Medical History Museum].
AB  - Although tracheotomy had been described in the Middle Ages and especially in the
      17th century in writings (Fabricius d'Aquapendente 1620) and illustrations
      (Scultetus 1645), there was hardly any possibility of actually performing this
      operation as a life-saving intervention until the middle of the 19th century. It
      was only after suitable cannulae had been introduced by Trousseau in 1851 (double
      cannula with removeable insert) that tracheotomy became a routine procedure, and
      it was immediately carried out in a great many cases of diphtheria, croup,
      typhus, and lues, which often caused critical dispnea. Within the following 25
      years, all technical modifications of cannulae were devised that are in use up to
      this day: the flap valve for the artificial larynx (1861), inflatable cuff
      (1871), and extra long flexible cannula. Beginning in 1885, O'Dwyer's method of
      intubation became established as an alternative to tracheotomy. Both procedures,
      like the underlying disease itself, frequently resulted in a permanent stenosis
      of the larynx or the trachea rendering decannulation impossible. Since about 1870
      the treatment of these stenoses, primarily by bougienage, became an important
      issue in laryngology, which had just been established as a discipline in its own
      right. The history of this evolution and the therapeutic approaches by Schrotter
      in Vienna and Thost in Hamburg are described in detail, including their specially
      devised equipment. Apart from that, other medical aspects of historical interest
      around the turn of the century are mentioned, such as artificial nutrition by
      subcutaneous injections and tracheotomy in horses.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7772219
TI  - [Ventilation during tracheotomy in extensive, 90% laryngeal stenosis using
      superimposed high frequency jet ventilation via the jet laryngoscope].
AB  - In a 35-year old male patient with laryngeal carcinoma an acute respiratory
      insufficiency with early hypoxaemia developed due to massive laryngeal stenosis.
      An endotracheal intubation was not possible since the available lumen was too
      small. Tracheotomy using local anaesthesia was not possible since spontaneous
      respiration with a Venturi mask applying 100% oxygen was not sufficient and the
      patient was becoming restless and agitated due to the hypoxaemia. Transcutaneous
      jet ventilation was considered to be too risky since the needle would have to
      pass highly vascularised tumour tissue and the detection of such a small rest
      lumen would have been quite difficult. Ventilating the patient using a
      percutaneous catheter would have been very risky as well since, due to the
      massive stenosis, a sufficient expiration would not be likely and therefore was
      considered to carry a high risk of barotrauma. The patient was ventilated under
      general anaesthesia via a specially designed endoscopy tube with integrated jet
      nozzles applying superimposed high frequency jet ventilation above the stenosis.
      Since it was possible to achieve sufficient ventilation during the inspection of
      the larynx the jet laryngoscope was left in place and the supporting apparatus
      was covered with sterile drapes. The tracheotomy was performed using the
      superimposed high frequency jet ventilation. Throughout the procedure oxygenation
      and ventilation were adequate. The laryngectomy performed several days later
      revealed a cauliflower type protrusion into the tracheal lumen and a 5 cm long
      stenosis of the larynx with a lumen of 3 mm.

PMID- 7772220
TI  - [Endoscopic techniques for the diagnosis of laryngotracheal airway obstruction in
      newborn infants, infants and children].

PMID- 7772221
TI  - [Intubation and tracheotomy of young children with pseudocroup. Guidelines of the
      state attorney of the Bamberg federal court-107 UJS 382/89 (restrictions
      according to section 170 ABs. 2 StPO)].

PMID- 7772222
TI  - [Microvascular anastomoses in reconstructive head and neck surgery].
AB  - At the ENT Department of the University of Lubeck, 57 microvascular tissue
      transplants with 129 anastomoses (61 arterial and 68 venous) have been performed
      in the last three years. Arteries have always been anastomosed end to end. The
      venous anastomoses have primarily been performed as end-to-side unions with the
      jugular vein. In nine patients, great distances between the donor and recipient
      vessel had to be connected with venous interponates. In two cases in which veins
      were lacking in the neck after radical neck dissection or radiation fibrosis, we
      used the cephalic vein or veins of the capsule of the thyroid gland as recipient
      vessels. The jejunal or osteomyocutaneous transplants were first fitted into the
      defect before performing the anastomosis. The jejunal peristalsis and the
      required freedom of movement in shaping the bone necessitated this technique.
      Microvascular anastomosis was first performed on the transplant of the radialis
      flap and the neurovascular infrahyoid muscular flap, and then they were
      integrated into the defect. We lost two transplants postoperatively because of
      venous thrombosis. In this article wie describe our anastomosis technique, the
      frequency distribution of recipient vessels, and the rules and characteristics of
      microvascular anastomosis after radiation and neck dissection.

PMID- 7772224
TI  - [Paralysis of the facial nerve caused by "low-grade" adenocarcinoma of the
      parotid gland--a contribution to the differential diagnosis of Bell's palsy].
AB  - Facial paresis is the only clinical symptom of two deep-seated, moderately
      malignant salivary duct carcinomas. The unusual course of the pareses
      (recurrences, varying degrees of severity) prompts the diagnosis of Bell's palsy.
      The final, exact diagnosis of a epithelial-myoepithelial intercalated duct
      carcinoma, respectively of a polymorphic low-grade adenocarcinoma, is made as
      late as six, respectively three, years after onset of the paresis.

PMID- 7772225
TI  - [Exulcerating cystadenolymphoma of the parotid gland. A case report].
AB  - A recurrent adenolymphoma of the left parotid gland occurring in a 79-year-old
      woman is reported having caused an extensive ulceration of the epidermis,
      clinically suggestive of a malignant tumour. The ulcerative tumour process cannot
      be explained by a particular pattern of growth or a malignant transformation of
      the adenolymphoma. It is assumed that residual tumour cells of the initially
      incompletely removed adenolymphoma spread via a long-standing postoperative
      fistula to the epidermis leading to the uncommon ulceration.

PMID- 7772223
TI  - [Therapeutic concept in hemangioma--photocoagulation with the copper vapor
      laser].
AB  - The copper vapor laser emits light with a wavelength of 578 nm and is well suited
      for photocoagulation of oxyhemoglobin and for selective destruction of vascular
      tissue. In 46 children hemangioma of different proliferation stages was treated
      by yellow laser photocoagulation. In 15 cases surgical treatment of the
      subcutaneous component of the hemangioma was necessary in addition to the laser
      photocoagulation. Most of the children in early proliferation stages could be
      treated with a single session of photocoagulation. The risk of hypotrophic oder
      hypertrophic scaring using the copper vapor laser is minimum (less than 1%)
      because the overlying dermis remains largely unaffected. In this article we
      present a therapy plan for conservative treatment and laser photocoagulation
      using the copper vapor laser.

PMID- 7772226
TI  - [Grass seed kernel in the efferent duct as a rare cause of acute parotitis].
AB  - A patient with a case of acute parotitis resulting from a foreign body is
      reported. In the case presented, Stensen's duct was found to be blocked by a
      grass seed. Removal of this foreign body resulted in quick resolution of the
      patient's symptoms.

PMID- 7772227
TI  - [Endoscopic and extracorporeal shock wave lithotripsy of salivary calculi].
AB  - Shock wave lithotripsy of salivary gland stones has become more and more
      efficient in the treatment of sialolithiasis during the last years. We use two
      different methods in our hospital: Extracorporeal shock wave lithotripsy (ESWL)
      and endoscopically intracorporeal lithotripsy (EISL). The results of both
      therapies are compatible; 60-70% could be successfully treated. The indication is
      different due to the localisation of the salivary gland stone. Stones that are
      located in the glandula or very proximal in the duct should be fragmented by
      extracorporeal lithotripsy. Stones located in the duct and multiple intraductal
      stones should be treated by the intracorporeal method. Clinical experiments
      showed that some salivary stones do not fragment easily. The reason is still
      unknown. We examined the ability of fragmentation in relation to the
      physicochemical analysis of the stone. The stones were examined by infrared
      spectroscopy. This study revealed that pure carbonate apatite stones are more
      difficult to destroy than stones containing some protein.

PMID- 7772228
TI  - [Practical significance of measuring high formant spectra in phoniatric voice
      assessment].
AB  - The measurement of sound energy in the spectral region between 2 and 5 kHz
      provides additional information to the auditive assessment of voice quality. It
      can be applied to healthy an sick voices, e. g. in tracing the therapeutic
      course. Devices for measuring voice range profiles with the possibility of
      evaluating the high formant region are especially useful and valuable. But,
      nonetheless, simultaneous auditive assessment is crucial to avoid
      misinterpretation. Calculation of the quotient of the sound pressure level in the
      region between 2 and 5 kHz by the total sound pressure level allows to determine
      vocal sound characteristics and changes of the sound. Pre- and postoperative
      sound spectra obtained from the voices of patients with diseases of the vocal
      folds illustrate the improvement of the harmonic structure and the decrease of
      noise components. The measurement of the high formant intensity has proven to be
      appropriate for the registration of the voice quality before and after therapy in
      130 cases. Although the value of these measurements is highly validated in the
      phoniatric practice, extensive studies and, especially, expert discussions are
      still needed. The authors come to terms with opinions that question the validity
      of the described methods.

PMID- 7772229
TI  - [Context effects in speech recognition of sentences].
AB  - Context plays an important role in speech recognition. The goal of the present
      study was to quantify context effects in speech recognition using the Basle
      Sentence Understanding Test. This test consists of two types of sentences
      according to the amount of contextual information: they contain sentences with
      highly predictable (HP) final words and sentences with low predictable (LP) final
      words. The effect of different contextual situations on speech recognition was
      investigated in this study using the Basle Sentence Understanding Test. The
      speech recognition threshold of HP sentences was found to be 6 dB lower than that
      of LP sentences. However, contextual effects can only be demonstrated if the
      context is clearly understandable. In the Basle Sentence Understanding Test, this
      is achieved by special masking techniques. The significance of the recognition of
      the contextual part of the sentence with respect to the recognition of the whole
      sentence is different in HP and LP sentences.

PMID- 7772230
TI  - [Security the continuous intracutaneous suture].

PMID- 7772231
TI  - [Cosmetically reliable removal of small benign skin tumors].

PMID- 7772232
TI  - [A new surgical system for endoscopic paranasal sinus surgery].
AB  - Functional endoscopic sinus surgery (FESS) is the treatment of choice in the
      majority of chronic inflammatory diseases of the paranasal sinuses. Currently
      used surgical instruments for FESS are based on a "grab and tear"-approach, thus
      predisposing to increased bleeding--especially in nasal polyps--which can
      significantly reduce the visual field and might lead to consecutive
      complications, including the injury of the anterior skull base and optic nerve.
      In the present paper the author introduces a new surgical system, invented by
      Setliff and Parsons (8), which enables the rhinosurgeon to operate in a near
      bloodless field, thus providing an unimpaired vision for a safer approach to the
      paranasal sinuses. In addition, the system ensures meticulous cutting of tissue
      instead of tearing, which also reduces the risk of complications. Our experiences
      with the "micro debrider system" have confirmed the usefulness of this
      instrumentarium, especially in the operative management of nasal polyps, in terms
      of less traumatic surgery and better visual field, thus implying fewer
      complications during FESS.

PMID- 7772234
TI  - Developmental and glucocorticoid regulation of pituitary 11 beta-hydroxysteroid
      dehydrogenase 1 gene expression in the ovine fetus and lamb.
AB  - To examine the role of 11 beta-hydroxysteroid dehydrogenase 1 (11 beta-HSD1) in
      the control of glucocorticoid actions in the ovine pituitary during development,
      we have sought developmental changes in the distribution and the level of 11 beta
      HSD1 mRNA by in situ hybridization. In the pars distalis, 11 beta-HSD1 mRNA was
      present by day 60; its amount did not change significantly until term (days 145
      147) when it increased dramatically. The level of 11 beta-HSD1 mRNA increased
      further during the postnatal period. In contrast, 11 beta-HSD1 mRNA in the pars
      intermedia was not detectable until day 135; it increased in amount at days 140
      143, but did not change significantly thereafter through to adulthood. We have
      also measured levels of both dehydrogenase and reductase activities of 11 beta
      HSD1 in the pars distalis of fetal sheep at day 140 and term, and of postnatal
      sheep at 1-2 months of age, to determine whether changes in 11 beta-HSD1 mRNA are
      reflected in the levels of enzyme activities. There were progressive increases in
      both dehydrogenase and reductase activities from day 140 to 1-2 months
      postnatally, although dehydrogenase activity was consistently higher than
      reductase activity. Finally, we have determined the effect of short-term
      intrafetal cortisol infusion (5 micrograms/min for 12 h) on levels of pituitary
      11 beta-HSD1 mRNA by in situ hybridization. There was no effect of cortisol
      infusion on 11 beta-HSD1 mRNA expression.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772233
TI  - Mechanism of action of gamma-aminobutyric acid on frog melanotrophs.
AB  - We have previously demonstrated that gamma-aminobutyric acid (GABA) is a potent
      regulator of secretory and electrical activity in melanotrophs of the frog
      pituitary. The aim of the present study was to investigate the intracellular
      events which mediate the response of melanotrophs to GABA. We first observed that
      GABA (1-100 microM) inhibited both basal and forskolin-stimulated cyclic AMP
      (cAMP) formation. The inhibitory effect of GABA on cAMP levels was mimicked by
      the GABAB receptor agonist baclofen (100 microM) and totally abolished by a 4-h
      pretreatment with pertussis toxin (0.1 microgram/ml). In contrast, the specific
      GABAA agonist 3-aminopropane sulphonic acid (3APS) did not affect cAMP
      production. Both GABA and 3APS (100 microM each) induced a biphasic effect on
      alpha-MSH release from perifused frog neurointermediate lobes, i.e. a transient
      stimulation followed by an inhibition of alpha-MSH secretion. Administration of
      forskolin (10 microM) prolonged the stimulatory phase and attenuated the
      inhibitory phase evoked by GABA and 3APS, indicating that cAMP modulates the
      response of melanotrophs to GABAA agonists. Ejection of 3APS (1 microM) in the
      vicinity of cultured melanotrophs caused a massive increase in intracellular
      calcium concentration ([Ca2+]i). The stimulatory effect of 3APS on [Ca2+]i was
      abolished when the cells were incubated in a chloride-free medium. The formation
      of inositol trisphosphate was not affected by 3APS, suggesting that the increase
      in [Ca2+]i cannot be ascribed to mobilization of intracellular calcium stores.
      omega-Conotoxin did not alter the secretory response of frog neurointermediate
      lobes to 3APS, while nifedipine blocked the stimulation of alpha-MSH secretion
      induced by 3APS. In conclusion, the present data indicate that, in frog pituitary
      melanotrophs, (i) the stimulatory phase evoked by GABAA agonists can be accounted
      for by an influx of calcium through L-type calcium channels, (ii) the inhibitory
      effect evoked by GABAB agonists can be ascribed to inhibition of adenylate
      cyclase activity and (iii) cAMP attenuates the inhibitory phase evoked by GABAA
      agonists. Taken together, these data suggest that activation of GABAB receptors
      may modulate GABAA receptor function.

PMID- 7772235
TI  - Sequence analysis of the turkey LH beta subunit and its regulation by
      gonadotrophin-releasing hormone and prolactin in cultured pituitary cells.
AB  - cDNAs encoding the precursor molecule of the turkey LH beta subunit (tLH beta)
      were cloned from a turkey pituitary cDNA library. The nucleotide sequence of the
      longest of two different tLH beta cDNA clones contained 592 bp, and included 23
      bp of the 5' untranslated region (UTR) and 92 bp of the 3' UTR in addition to a
      477 bp open reading frame that encoded a 39 amino acid leader polypeptide and a
      120 amino acid mature apoprotein. Turkey and chicken LH beta sequences shared
      approximately 92 and 93% nucleotide and amino acid sequence similarities
      respectively. Northern blot analysis of total cellular anterior pituitary RNA
      showed that an approximate 800 base transcript hybridized to a 32P-labelled tLH
      beta cDNA probe. The gonadotrophin-releasing hormone (GnRH)- and prolactin (PRL)
      regulated expression of LH and PRL in dispersed pituitary cells was determined by
      Northern blot analysis of tLH beta and PRL steady-state mRNA levels and by RIA
      analysis of secreted LH and PRL. GnRH-treated cells showed increased levels of
      both tLH beta mRNA and secreted LH, whereas mRNA and secreted levels of PRL did
      not change significantly. Cells treated with PRL showed lower levels of tLH beta
      and PRL mRNA as well as decreased release of LH and PRL. When cells were treated
      with both PRL and GnRH, increases in tLH beta mRNA and secreted levels of LH
      observed with GnRH alone were negated, whereas the decreases in mRNA and secreted
      levels of PRL observed with PRL alone were abrogated. These findings suggest that
      PRL can down-regulate tLH beta gene expression and spontaneous release of LH as
      well as autoregulate PRL gene expression and spontaneous release of PRL, while
      GnRH appears capable of modulating the effects of PRL-regulated LH and PRL gene
      expression and spontaneous release.

PMID- 7772236
TI  - Effect of oestradiol-17 beta on the expression of oestrogen receptor mRNA in
      human tonsillar cells.
AB  - We have investigated the expression of oestrogen receptor (ER) mRNA in Ficoll
      separated tonsillar cells and the changes that occur with the addition of
      oestradiol (OE2) both in the presence and the absence of the T cell mitogen
      phytohaemagglutinin (PHA). The amounts of ER mRNA and beta-actin mRNA in the
      samples were determined by slot blotting and hybridization and quantified by
      densitometry. The levels of ER mRNA were normalized against the beta-actin mRNA
      content. In the presence of OE2 (7 x 10(-8) M) after a 10-h culture there was a
      significant decrease (P < 0.05) to about 66% of the control (0-h culture) ER mRNA
      levels. Stimulating the cultures with PHA (1 microgram/ml), without the presence
      of OE2, had no effect on the expression of ER mRNA. However, when OE2 was present
      in a 10-h culture of PHA-stimulated cells, the ER mRNA level was significantly
      decreased (P < 0.05) to about 60% of control levels. In 24-h cultures, the
      presence of OE2 and/or PHA had no effect. When separated T cell preparations from
      the tonsils were used, no significant effects of OE2 were seen in either the 10-h
      or 24-h cultures. In conclusion, OE2 downregulates the ER mRNA content in a
      tonsillar mononuclear cell system in vitro as it does in many primary oestrogen
      target cells.

PMID- 7772237
TI  - Thyroid hormone receptor beta mRNA expression in Sertoli cells isolated from
      prepubertal testis.
AB  - A polymerase chain reaction (PCR)-based assay was used to evaluate the expression
      of thyroid hormone receptor beta mRNA in Sertoli cells isolated from both
      prepubertal rat and piglet testes. The expression of an mRNA coding for the
      functional thyroid hormone receptor beta isoform, as established by the PCR
      assay, agrees with the presence of specific tri-iodothyronine (T3) -binding sites
      in the Sertoli cell nuclei of both species, as previously evaluated by
      displacement analysis. The results ratify the existence of a functional T3
      receptor in the prepubertal testis and confirm the Sertoli cell as a specific
      target for thyroid hormone action on the developing testis.

PMID- 7772238
TI  - Growth hormone releasing peptide (GHRP-6) stimulates phosphatidylinositol (PI)
      turnover in human pituitary somatotroph cells.
AB  - Growth hormone releasing peptide (GHRP-6) is a synthetic hexapeptide which
      specifically stimulates secretion of growth hormone (GH) by pituitary
      somatotrophs. The precise intracellular mechanism by which this is achieved has
      not been deciphered although it is known to involve protein kinase C (PKC) and
      Ca2+ but to be cAMP-independent. We have used cell cultures of human pituitary
      somatotrophinomas to demonstrate powerful effects of GHRP-6 on membrane
      phosphatidylinositol (PI) turnover, a second messenger system which leads to
      activation of PKC and mobilisation of intracellular Ca2+ reserves. Incubation of
      somatotrophinoma cells with GHRP-6 led to a dose-dependent stimulation of rate of
      PI turnover. GH secretion was increased in parallel. Effects were discernable
      after only 15 minutes incubation and rose to a maximum at 2 hours. PI turnover
      was stimulated by GHRP-6 in 8 of 8 tumours examined, effects ranging from 2.1 -
      7.9 fold increases. Stimulation of GH secretion by GHRP-6 was independent of
      presence of gsp oncogenes, emphasising the cAMP-independent nature of its
      effects. These results provide evidence that the GH-stimulatory effects of GHRP-6
      are achieved through activation of the PI second messenger system and thus
      support earlier findings that PKC and Ca2+ play central roles in mediating the
      effects of GHRP-6.

PMID- 7772239
TI  - Sexual dimorphism and growth hormone induction of murine pheromone-binding
      proteins.
AB  - A number of structurally very similar pheromone-binding proteins (major urinary
      proteins; MUPs) are synthesized in mouse liver and rapidly excreted in the urine.
      Male and female inbred mice display different characteristic patterns of MUP
      expression. Here we present a detailed study of the RNA and protein products
      corresponding to specific MUP genes previously isolated from genomic DNA of the
      Balb/c strain. By in vitro transcription of equivalent cDNA clones, translation
      of the resulting RNA in the reticulocyte lysate system and isoelectric focusing,
      the protein products of genes BL1, BS1 and BS6 were shown to be MUP 2a, MUP 2b
      and MUP 4 respectively. MUPs 2a and 2b were shown to be abundant both in Balb/c
      male urine and among the translation products of total Balb/c male liver mRNA.
      Two oligodeoxynucleotide probes, oBL1A and oBS1, selective for BL1 and BS1 mRNA
      respectively, were chemically synthesized. mRNA that hybridized with these probes
      (oBL1A mRNA and oBS1 mRNA) was present at different characteristic levels in the
      Balb/c and C57BL/6 inbred strains. In both strains the level of expression was
      much higher in males than females and the male/female expression ratio of oBS1
      RNA was higher than that of oBL1A RNA. Comparison of these mRNA levels with the
      amounts of different MUP proteins present in urine and the translation products
      of liver mRNA indicated that proteins other than MUP 2a and MUP 2b are coded for
      by the C57BL/6 oBL1A and oBS1 mRNAs. C57BL/6 mice homozygous for the lit mutation
      are GH deficient and transcribe MUP genes at a level much lower than that
      obtaining in normal mice of either sex, indicating that transcription is induced
      by GH in both males and females. When lit/lit mice were treated with GH under two
      different regimes, MUP gene transcription was partially induced to different
      degrees and the level of oBL1A mRNA was induced more highly than that of oBS1
      mRNA. Thus there exists a correlation between the inducibility of these mRNAs and
      their level of expression in females relative to males; oBL1A mRNA is both more
      highly expressed in females and more readily induced by GH than oBS1 mRNA. This
      suggests that the male and female expression patterns are due to differential
      inducibility of different MUP genes together with a stronger inducing stimulus in
      males. GH administered continuously by infusion repressed MUP gene
      expression.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7772240
TI  - High-level expression of recombinant porcine LH receptor in baculovirus-infected
      insect cells or caterpillars.
AB  - Porcine LH receptor ectodomain was overexpressed in insect cells and lepidopteran
      larvae using the recombinant baculovirus expression system. A low multiplicity of
      infection yielded the largest active production, of approximately 10(7)
      receptors/cell or 3 micrograms active receptor/mg total protein in infected
      cells. The truncated ectodomain solubilized with Triton X-100 bound its ligand
      with a high affinity which was comparable with that of the native membrane
      receptor. Increasing the multiplicity of infection resulted in an optimum protein
      production of 0.6 mg receptor/mg total protein in infected cells. This receptor
      was largely inactive, probably trapped within aggregation pools. Active receptor
      could be recovered by dilution of the samples. No secretion of recombinant
      receptor was ever observed whatever the conditions of infection. Expression of
      the recombinant receptor in insect larvae was also tested. This low-cost system
      failed both to increase the amount of active receptor and to induce secretion
      into the haemolymph. Two methods remain for producing sizeable amounts of active
      receptor with this baculovirus/insect cell system. One relies on immunoaffinity
      purification of the active protein and requires large-scale production, and the
      other is based on the purification of overexpressed inactive receptor followed by
      renaturation.

PMID- 7772241
TI  - Sequence analysis of vasotocin cDNAs of the lamprey, Lampetra japonica, and the
      hagfish, Eptatretus burgeri: evolution of cyclostome vasotocin precursors.
AB  - We determined the nucleotide sequences of cDNAs encoding precursors of vasotocin
      (VT) from two cyclostomes, the lamprey Lampetra japonica and the hagfish
      Eptatretus burgeri, for estimation of their phylogenetic relationships. Although
      only 47% similarity was found between the VT cDNAs, the predicted VT precursors
      of the lamprey and the hagfish were both composed of a single peptide, VT, Gly
      Lys-Arg and a neurophysin, as has been shown for precursors of vasopressin (VP)
      family hormones, including VP, VT and molluscan conopressin. The central region
      of the lamprey neurophysin was very similar to those of previously characterized
      gnathostome neurophysins. Conspicuously, all the positions of 14 Cys residues
      were conserved in the lamprey neurophysin. The C-terminal region did not have a
      distinctive Leu-rich core segment, which is always found in the glycopeptide
      (copeptin) moiety of VP precursors. In contrast, the hagfish neurophysin showed
      at least two insertions and one deletion in the conserved central region
      including 14 Cys residues, but contained a potential N-linked glycosylation site
      and had a high proportion of Leu residues in the C-terminal region, like the
      neurophysin of another hagfish, Eptatretus stouti. The evolutionary relationships
      of the precursors of VP family hormones among the lamprey, hagfish, gnathostomes
      and a mollusc were estimated by a maximum likelihood method. The phylogenetic
      tree with the highest bootstrap probability showed that the lamprey VT precursor
      is more closely related to the gnathostome VT and VP precursors than to the
      hagfish VT precursors.

PMID- 7772242
TI  - Production and characterization of recombinant chicken insulin-like growth factor
      II from Escherichia coli.
AB  - Recombinant chicken (c)IGF-II has been produced in Escherichia coli after first
      modifying a plasmid that coded for a human (h)IGF-II fusion protein. The cIGF-II
      fusion protein, deposited in bacterial inclusion bodies, was dissolved under
      reducing conditions, desalted, subjected to anion-exchange chromatography and
      refolded. Recombinant cIGF-II was then released from the fusion protein using a
      genetically engineered serine protease and purified to homogeneity by reverse
      phase HPLC. In vitro analysis of recombinant cIGF-II revealed differences between
      cIGF-II and its human counterpart. Recombinant cIGF-II was less potent than hIGF
      II in stimulating protein synthesis in rat myoblasts. This appeared to be due to
      a decreased affinity for the type-1 IGF receptor. The human and chicken peptides
      were similar, however, in studies assessing binding to the type-2 IGF receptor
      and to IGF-binding proteins. Moreover, recombinant cIGF-II and hIGF-II were
      equipotent in both biological and receptor binding studies in chick embryo
      fibroblasts, suggesting that there may be a difference between mammalian and
      avian type-1 IGF receptors.

PMID- 7772243
TI  - Interaction of LHRH with growth hormone-releasing factor-dependent and 
      independent postnatal development of somatotrophs in rat pituitary cell
      aggregates.
AB  - Addition of LHRH for 40 h to aggregate cell cultures of 14-day-old rat pituitary
      significantly decreased the number of [3H]thymidine ([3H]T)-incorporating cells
      which immunostained for GH protein as well as the number of [3H]T-labelled cells
      expressing GH mRNA detectable by in situ hybridization with a digoxigenin
      labelled riboprobe. The effect at the level of GH protein was seen at a dose of 1
      nM LHRH. However, the effect at the GH mRNA level required a higher dose of LHRH
      (10 nM) or a longer incubation time (64 h). Treatment of the cultures for 40 h
      with 0.1 nM GH-releasing factor (GRF) provoked a 54% increase in the number of
      [3H]T-labelled cells containing GH mRNA and a 30% increase in the number of cells
      immunostained for GH protein. The latter effects of GRF were completely blocked
      by simultaneous addition of LHRH (1 nM) to the cultures. In the absence of GRF,
      LHRH (1 nM) also had an inhibitory effect on the total number of cells containing
      GH mRNA and a comparable effect on the total number of cells stained for GH
      protein. The present data show that LHRH is capable of inhibiting the GRF
      independent as well as the GRF-dependent development of somatotrophs in postnatal
      rat pituitary in culture.

PMID- 7772244
TI  - [Cell adhesion molecules and the immune system].
AB  - Cellular interactions are controlled by complex mechanisms which come into play
      at the receptors on the cell surface (adhesion molecules: selectins, integrins,
      superfamily of immunoglobulins), the soluble cell mediators (cytokines) and the
      components of the tissue matrix (fibronectin, collagen, etc.). Disturbance of one
      of these systems may induce a pathological condition. The physiological state of
      the individual therefore depends on the balance of all these components. In the
      development of inflammation, adhesion molecules play an essential role in the
      localisation of the inflammatory response. At this level, the vascular
      endothelium, a governing barrier for the exchanges between blood and the tissues,
      plays an active part in regulation of the transcapillary permeability, control of
      proliferation of haematopoietic cells and the phases of the inflammatory
      response. After they have marginated, the active cells migrate by diapedesis
      towards the site of inflammation by creation of chemotactic signals as the
      adhesion between the cells is insufficient to induce their migration. The
      adherence phenomena depend on a process that is strictly controlled by the
      cytokines and enable intervention of cell-cell reactions and cell-protein
      recognition of the extra-cellular matrix. Cytokines play a key role in control of
      the expression and/or avidity of membrane receptors for ligand(s). An appropriate
      and rapid response of the circulating cells depends on coordination of the train
      of events that regulate the functional expression of the adhesion molecules. Use
      of specific antibodies that prevent cell adherence opens very important
      therapeutic possibilities because a single blockage of cell adhesion can have an
      immediate direct impact on development of the inflammatory response.

PMID- 7772245
TI  - [From IgE to the cell adhesion molecule].
AB  - The aim of this work is to contribute to increasing our knowledge of asthma. The
      IgE can't alone be imputed in the anaphylactic reaction. Asthma is a bronchial
      inflammatory disease. The secretion of lymphokines increases the inflammatory
      response. The eosinophils cells damage the respiratory epithelium. The mast cells
      and the basophils cells release the chemical mediators and also the cytokines.
      The adhesion molecules situated in the cell membrane permit leukocyte cells to
      integrate with extracellular matrix during intra-tissue migration. Adhesion
      molecules may play a primary role in the pathogenesis of inflammatory response.
      The key role of the CD4 + T lymphocytes subset appeared in the last years.

PMID- 7772246
TI  - [Methods for studying cytokines in biological media].
AB  - Accurate and sensitive methods for the measurement of cytokines in biological
      fluids are an absolute prerequisite for a proper use of these mediators in
      clinical practice. The authors describe the numerous molecular forms under which
      cytokines can possibly circulate. The potential influence of inhibitors
      (autoantibodies, soluble receptors) on cytokine assays is discussed. Blood
      collection for cytokines needs a particular attention to prevent a possible
      contamination by endotoxins which can trigger cytokines cellular production after
      sampling. If bioassays historically preceded immunoassays, these last techniques
      are now very popular, but there is an urgent need for standardisation between the
      different kits commercially available. In addition, in situ detection of
      cytokines using molecular biology is an helpful complementary technique to the
      measurement of circulating cytokines.

PMID- 7772247
TI  - [Therapeutic strategy in asthma: special cases and pseudo-asthma].
AB  - Therapeutic strategy of asthma such as that described by international consensus
      must sometimes be modified in certain situations, the triggering agent or
      subsequent complications. Account should also be taken of pseudo-asthmas, i.e.
      other illnesses accompanying the sibilant dyspnoea. The therapeutic principles of
      each of these conditions are set out and specially emphasize asthma in pregnancy
      and states of resistance to corticosteroids.

PMID- 7772248
TI  - Budesonide: treatment of bronchial asthma during childhood.
AB  - Nowadays inhaled corticosteroids are the first step in treating inflammation of
      the airways. It is evident that these drugs are not free of side effects;
      however, the fact that at present the most commonly used method is by inhalation
      and that these drugs undergo metabolic changes in the lung, makes them safe in
      that a part of the side effects, which are observed when they are administered
      systemically, disappear. Budesonide was one of the last corticosteroids for
      topical application to appear on the market and its powerful anti-inflammatory
      action together with in versatility (it can come in aerosol form using MDI or in
      solution for nebulizers as well as in dry powder) make it possible to use during
      all stages of a child's development. In 75 children treated with Budesonide over
      a long period (18-24 months) we were able to evaluate the drug's clinical
      efficacy in the reduction in number and intensity of attacks registered together
      with their accompanying symptoms. Significantly (p < 0.001) it were able to
      restrict the bronchodilatory medication needed to control their asthma.
      Similarly, we were able to verify that the FEV1 was normalized and that the Peack
      Flow was stabilized. We were not able to find any interruption in the hypothalamo
      hypophysio-suprarenal axis and the weight-height curves continued to evolve
      chronologically. With regards to the side effects, three cases of colonization
      candidiasis were recorded through there were no clinical repercussions and
      treatment did not need to be suspended.

PMID- 7772249
TI  - Evolutionary conservation of function among mammalian, avian, and viral homologs
      of the Bcl-2 oncoprotein.
AB  - The bcl-2 gene was originally cloned because of its involvement in B-cell
      lymphomas and encodes a 25-kD integral membrane protein that has been shown to
      inhibit programmed cell death (also termed apoptosis) in a wide variety of
      circumstances. The Epstein-Barr Virus (EBV) also has been implicated in B-cell
      malignancies and interestingly contains an open reading frame (BHRF-1) predicting
      a 19-kD protein with 22% homology to Bcl-2. To compare the functions of p26-Bcl-2
      and p19-BHRF-1, we stably introduced expression plasmids encoding these proteins
      into a murine interleukin-3 (IL-3)-dependent hemopoietic cell line, 32D. Removal
      of IL-3 from cultures of control-transfected 32D cells resulted in
      internucleosomal DNA cleavage (a hallmark of programmed cell death) and loss of
      cell survival. In contrast, 32D cells containing high levels of p26-Bcl-2 or p19
      BHRF-2 proteins exhibited prolonged survival and markedly delayed DNA degradation
      under the same conditions of IL-3 deprivation. As a first attempt to determine
      the functional importance of amino acid sequences that are conserved between the
      Bcl-2 and BHRF-1 proteins, we used site-specific mutagenesis to replace two
      conserved cysteine residues with alanines (positions 158 and 219) in the human
      Bcl-2 protein. Comparisons of the wild-type and cysteine-minus human Bcl-2
      proteins in S49 lymphoma cells revealed equivalent ability to block
      glucocorticoid-induced cell death and DNA fragmentation, indicating that these
      two conserved cysteines are not critical for Bcl-2 oncoprotein function.
      Investigations in 32D cells of an avian homolog of Bcl-2 cloned from the chicken
      also revealed conservation of function with the human Bcl-2 protein, despite the
      presence of a 48-amino-acid region of divergent sequence. Taken together, these
      data demonstrate that despite marked differences in their predicted amino-acid
      sequences, the human, chicken, and EBV versions of Bcl-2 have retained the
      structural characteristics necessary to interface with pathways involved in the
      regulation of programmed cell death in murine cells. The findings thus contribute
      to the mapping of functional domains in Bcl-2 proteins, and raise the possibility
      that the EBV-encoded p19-BHRF-1 protein may be able to substitute for p26-Bcl-2
      in the development of some types of cancer.

PMID- 7772250
TI  - Retinoblastoma control element binding proteins are induced during in vivo
      terminal differentiation of the liver and bind to the DBP promoter.
AB  - Growth regulation of terminal differentiation was studied by analysis of the
      promoter of the transcription factor D-site binding protein (DBP) using nuclear
      extracts from rat liver undergoing regeneration or from normal liver early in
      development. Four proximal binding sites for nuclear proteins were identified,
      three of which showed significant quantitative or qualitative changes in
      associated factors upon growth induction. Two of these sites bound factors common
      to the retinoblastoma control element and these proteins were induced upon
      terminal differentiation of the liver. These factors were also rapidly down
      regulated upon induction of regenerative growth and consequent dedifferentiation.
      These results provide a link between the regulation of growth and differentiation
      in an in vivo model system.

PMID- 7772251
TI  - SV40 T antigen directed by a powerful erythroid enhancer-promoter produced
      sarcomas and pancreatic tumors but not erythroid-specific tumors in transgenic
      mice.
AB  - We have expressed the simian virus 40 (SV40) large T antigen oncogene in
      erythroid tissues of mice to test its ability to immortilize erythroid cells. A
      transgene construct was built in which the SV40 large T antigen structural gene
      was linked to erythroid-specific enhancer and promoter sequences. The enhancer
      employed was the human beta-globin family microlocus control region, and the
      promoter sequences were derived from the human beta-globin promoter. Transgenic
      mice were generated and they expressed T antigen in the bone marrow and spleen
      cells. Yet, no hematopoietic neoplasia arose in these mice. Instead, after a lag
      period of 2-6 months, the mice developed soft tissue sarcomas and pancreatic
      islet-cell tumors that expressed high levels of T antigen.

PMID- 7772252
TI  - Cloning and characterization of human tissue inhibitor of metalloproteinases-3.
AB  - The tissue inhibitors of metalloproteinases (TIMPs) comprise a family of
      proteins, of which two members have so far been described in humans. We have
      cloned and sequenced a third human TIMP (hTIMP-3) from phorbol ester
      differentiated THP-1 cells stimulated with bacterial lipopolysaccharide. The open
      reading frame encodes a 211-amino-acid precursor including a 23-residue secretion
      signal. The mature polypeptide has a calculated molecular weight of 21.6 kD and
      includes an N-linked glycosylation site near the carboxyl terminus. The protein
      is quite basic, having a predicted isoelectric point of 9.04. We have mapped the
      single gene encoding human TIMP-3 to chromosome 22. By Northern analysis,
      transcripts for TIMP-3 were identified in a broad cross-section of tissues
      examined from both embryonic and adult origin. In all tissues except the
      placenta, the predominant transcript was 5.0 kb in size, with minor bands around
      2.4 and 2.6 kb comprising no more than about 10% of the signal. In the placenta,
      the smaller bands accounted for close to 50% of the signal. Human TIMP-3 shows
      slightly closer amino acid sequence similarity to TIMP-2 (44.3%) than to TIMP-1
      (38.4%), but is most closely related to a recently reported chicken TIMP, chIMP-3
      (80.8% amino acid; 77.7% nucleic acid similarity.

PMID- 7772253
TI  - An analysis of Xenopus tyrosine kinase genes and their expression in early
      development.
AB  - Xenopus laevis and X. borealis were screened for tyrosine kinase genes using the
      polymerase chain reaction (PCR) and reverse transcriptase (RT)-PCR and 34 X.
      laevis and 23 X. borealis tyrosine genes were identified. Eighteen of the genes
      represented novel tyrosine kinase family members. The rest could be classified
      into known tyrosine kinase subfamilies, of which however only three have been
      previously identified in Xenopus. Eight clones, including bFGFR (xFGFR1) and
      potential Trk, Ins R., Fak, Fyn, and Abl homologs, were used to probe temporal
      and spatial gene expression in early development. Quantitative RT-PCR and whole
      mount and in situ hybridization showed that most of these mRNAs were present
      throughout development and were broadly distributed, mainly in ectodermal and
      mesodermal derived tissues. At the blastula stage, bFGFR mRNA was detected within
      the ectoderm and a gradient of expression was noted within the invaginating
      mesoderm. The unexpected promiscuous expression of many tyrosine kinase genes in
      early development is discussed.

PMID- 7772254
TI  - Isolation of a cDNA encoding a metal response element binding protein using a
      novel expression cloning procedure: the one hybrid system.
AB  - A new method for isolation of cDNA clones encoding sequence-specific DNA-binding
      proteins is described. This method, the one-hybrid system, is based on the use of
      reporter genes whose transcription can be activated through synthetic cis
      elements recognized by the sought-after DNA-binding protein. These reporter genes
      are used for in vivo screening of a library of cDNAs fused to a DNA fragment
      encoding the GAL4 activation domain. cDNA clones expressing the appropriate
      fusion proteins lead to activation of these reporter genes in transformed yeast
      cells. We have used this approach to isolate a mammalian cDNA clone encoding a
      sequence-specific DNA-binding protein that recognizes the metal response elements
      (MREs) of the metallothionein (MT) genes. The protein encoded by this cDNA, M96,
      shows similarity to the trithorax proteins. Expression of a functional DNA
      binding form of M96 requires Zn2+ ions. The recombinant protein binds to several
      different MREs but fails to recognize nonfunctional mutant MREs. M96 may be
      involved in the activation of MT genes in response to heavy-metal ions.

PMID- 7772255
TI  - Cloning and characterization of the promoter region of the murine alpha-4
      integrin subunit.
AB  - To study the differential expression of the murine VLA-4 (alpha 4 beta 1)
      integrin, the 5'-flanking region of the gene for the alpha subunit (alpha 4m) was
      isolated and a cDNA for alpha 4m was obtained with reverse transcriptase
      polymerase chain reaction (RT-PCR). The cDNA sequence contained a difference in
      the signal peptide region compared to the previously described cDNA (Neuhaus et
      al., 1991). As a consequence, another start codon is predicted, resulting in a
      decrease in size of the signal peptide. This was confirmed by genomic sequencing.
      The promoter region was delimited by ribonuclease protection assay (RPA) and
      transfection experiments fusing 5'-upstream fragments to the luciferase gene. A
      fragment extending from -936 to +221 was capable of controlling the expected cell
      type-specific expression. Sequence comparison of the mouse alpha 4m promoter
      region with the human alpha 4h promoter revealed little homology. Like most
      integrin subunits, alpha 4m lacks TATA anc CCAAT boxes. Putative recognition
      sites for DNA-binding nuclear factors (AP1, AP2, Sp1, and PU1) were identified.
      The characterization of the promoter region and further identification of the
      transcription regulatory elements should provide insight in the regulation of
      alpha 4m integrin gene expression.

PMID- 7772256
TI  - Functional analysis of the cell-specific enhancer in the human
      proopiomelanocortin gene by beta-galactosidase histochemical staining.
AB  - Nucleotide sequences responsible for the cell-specific expression of the human
      proopiomelanocortin (POMC) gene were analyzed by histochemical staining of beta
      galactosidase in culture cells transfected with chimeric genes containing the 5'
      flanking regions of the human POMC gene fused to the Escherichia coli lacZ gene.
      The chimeric genes were stably introduced into various culture cells, including
      AtT-20 cells, which express the endogenous mouse POMC gene. Whereas the control
      gene containing the cytomegalovirus enhancer was expressed in all cell lines
      tested, only AtT-20 cells supported the efficient transcription of the gene
      containing 2.9 kb of the human POMC 5'-flanking region. These results indicate
      that the stable transfection-expression system utilizing the histochemical
      detection of the gene expression is a useful method for the analysis of cell
      specific gene expression. These results have also confirmed that the trans-acting
      factors in mouse AtT-20 cells interact with the human POMC gene promoter region
      and activate the transcription of the gene. Deletion analysis has demonstrated
      that the profiles of the transcriptional activity of the various human POMC-lacZ
      fusion genes are similar to those of the rat POMC gene described previously.
      Comparison of the human and the rat 5'-flanking sequences revealed close homology
      in several regions, which might be involved in the efficient transcription of the
      POMC gene in AtT-20 cells.

PMID- 7772257
TI  - cDNA cloning, sequence analysis, and induction by aryl hydrocarbons of a murine
      cytochrome P450 gene, Cyp1b1.
AB  - C3H mouse embryo fibroblast cells, designated 10T1/2, can be transformed by
      physical and chemical agents including polycyclic aromatic hydrocarbons. In a
      previous report (Shen et al., Proc. Natl. Acad. Sci. USA 90, 11483-11487, 1993),
      we identified a cytochrome P450 gene induced by polycyclic aromatic hydrocarbons
      (PAHs) that is different from 1A1 or 1A2, and which we tentatively named
      P450CMEF. Here, we report the entire cDNA sequence of P450CMEF (5,128 bp) and the
      amino acid sequence deduced from it (543 residues). A comparison of the latter
      sequence with known cytochrome P450s indicates that P450CMEF is in a new
      subfamily of family 1 of the P450 superfamily. Accordingly, the Committee on
      Standardized Cytochrome P450 Nomenclature designated the gene Cyp1b1. Exposure to
      various aryl hydrocarbons (2.5 hr) induced Cyp1b1 mRNA in 10T1/2 cells to
      different degrees: 2,3,7,8-tetrachlorodibenzo-p-dioxin, 7,12
      dimethylbenz[a]anthracene, benz[a]anthracene, benzo[a]pyrene, and beta
      naphthoflavone were strong inducers; alpha-naphthoflavone and 3
      methylcholanthrene, were moderate inducers; and benzo[e]pyrene was a weak
      inducer.

PMID- 7772258
TI  - Differential protein binding and transcriptional activities of HNF-4 elements in
      three closely related CYP2C genes.
AB  - A functional binding site for a liver-enriched transcription factor, hepatocyte
      nuclear factor-4 (HNF-4), has previously been identified around -100 in the
      CYP2C2 promoter and proposed to be a common regulatory motif for the hepatic
      expression of many CYP2 genes. The transcriptional activity of the proximal
      promoters of three closely related cytochrome P450 genes (CYP2C1, CYP2C2, and
      CYP2C3) have been compared in HepG2 cells and correlated with the relative
      binding affinities of the HNF-4 motifs in the genes for proteins in liver,
      kidney, and HepG2 extracts that react with antisera to HNF-4. Gel-shift assays
      suggested that these highly similar motifs bound HNF-4 with significantly
      different affinities. The relative binding affinities to the protein in liver
      extracts were estimated by competitive gel-shift binding, and the binding
      affinity of CYP2C2 was two-fold and eight-fold greater than that of CYP2C1 and
      CYP2C3, respectively. These affinity differences correlated well with the
      transcriptional activities of either the minimal hepatic promoters (117 to 135 bp
      of 5'-flanking region) of the genes in HepG2 cells or minimal CYP2C2 promoters
      containing the HNF-4 motif from each gene. Identification of the CYP2C3 site was
      somewhat indirect; the HNF-4 element in the CYP2C3 promoter could be converted to
      a motif with binding affinity and hepatic cell-specific transcriptional activity
      similar to that of CYP2C2 by a single nucleotide substitution. The activities of
      the minimal promoters did not correlate well with hepatic expression of each gene
      in vivo, as estimated previously by the concentration of mRNA in livers of
      untreated animals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772259
TI  - Is alcohol consumption a cofactor in the development of acquired immunodeficiency
      syndrome?
AB  - Excessive alcohol (EtOH) consumption and acquired immunodeficiency syndrome
      (AIDS) are two major public health problems in the United States. Overwhelming
      evidence is showing that heavy EtOH ingestion broadly suppresses the various arms
      of immune response, seriously impairing the body's normal host defense to
      invading microbes and tumorigenesis. The onset of clinical symptoms of AIDS (low
      CD4+ T cells count, opportunistic infections, and tumors) is quite variable among
      HIV+ individuals with a mean incubation time 3-10 years following seroconversion.
      Because of the deleterious effects of chronic EtOH consumption on cytokine
      release, immune response, host defense, nutritional status, and oxidative stress,
      it has been believed to be a possible cofactor that could enhance the host's
      susceptibility to infections, and subsequently increase the rate of AIDS
      development. The purpose of this review is to present evidence indicating
      clinical disorders during EtOH ingestion in murine AIDS. These EtOH-induced
      abnormalities may promote a more rapid development of AIDS in HIV-infected
      individuals.

PMID- 7772260
TI  - Effect of alcohol on gastrointestinal cell regeneration as a possible mechanism
      in alcohol-associated carcinogenesis.
AB  - Chronic ethanol consumption is a major risk factor for oropharyngeal, esophageal,
      and rectal cancer. Because hyperregenerative gastrointestinal mucosa has an
      increased susceptibility towards chemical carcinogens and thus influences
      carcinogenesis, various studies have been performed to evaluate the effect of
      chronic ethanol consumption on mucosal cell turnover. In the rat, morphometric
      analysis showed that in chronically ethanol-fed rats the size of the basal cell
      nuclei of the oral mucosa from the floor of the mouth, the edge of the tongue,
      and the base of the tongue were significantly enlarged. The size of the basal
      cell layer was increased and the stratification of the cells was altered. The
      percentage of cells in S-phase of the cell cycle was significantly higher in
      ethanol-fed rats compared to controls. In addition, mucosal atrophy was found.
      Similar to the oropharynx, in the esophagus chronic ethanol consumption increased
      cell proliferation depending on salivary gland function, because only in the
      presence of the salivary glands was this stimulative effect of alcohol on cell
      turnover found. Subsequently, chronic ethanol ingestion significantly stimulated
      crypt cell production rate in the rectum, in an age-dependent manner. This
      hyperregeneration, which was only observed in the rectum but not in the remaining
      colon, was associated with an expansion of the proliferative compartment of the
      crypt. Such an expansion is correlated with increased risk for rectal cancer. In
      addition, crypt cell production rates in the rectal crypts can be correlated with
      mucosal acetaldehyde concentrations, underlining a toxic effect of acetaldehyde
      on the rectal mucosa that is answered by compansatory hyperregeneration. These
      data from the rat model could be confirmed in humans. In conclusion, chronic
      ethanol consumption leads to mucosal hyperregeneration in gastrointestinal mucosa
      associated with a high risk for cancer and may therefore be at least one
      mechanism by which alcohol exerts its cocarcinogenic effect.

PMID- 7772261
TI  - Hepatocellular carcinoma in alcoholics.

PMID- 7772262
TI  - Alcohol drinking in rats injected ICV with 6-OHDA: effect of 8-OHDPAT and
      tropisetron (ICS 205930).
AB  - 6-Hydroxydopamine (6-OHDA) was administered ICV to Wistar male rats. Lesioned
      animals displayed lower preference for ethanol (ETOH) than sham-operated rats.
      Among 6-OHDA lesioned rats only 9% became high-preferring whereas 20% of sham
      operated animals became high-preferring ones. Both tropisetron (the antagonist of
      5-HT3 receptors) and 8-OHDPAT (the 5-HT1A receptor agonist) reduced ETOH drinking
      in high-preferring rats. However, in 6-OHDA lesioned rats the effect of
      tropisetron was reduced although 8-OHDA retained its effect on ETOH consumption.
      These results suggest that brain DA neurons are involved in tropisetron action
      but are not responsible for antipreference effect of 8-OHDPAT.

PMID- 7772263
TI  - Altered brain sensitivity to ethanol in mice after MPTP treatment.
AB  - Previous studies demonstrated the role of the dopaminergic receptors in brain
      sensitivity to ethanol. The present study was designed to assess the relative
      contribution of the nigrostriatal component to this brain sensitivity. Adult male
      C57BL mice were given 1-Methyl-4-Phenyl-1,2,3,6-Tetrahydropyridine (MPTP)
      injections (30 mg/kg daily for 2 consecutive days). The treatment decreased the
      striatal dopamine level by 35% from the control level, and the number (Bmax) of
      dopaminergic receptors was increased by 67%. Ethanol-induced sleep time was
      reduced in the MPTP-treated mice, as compared to controls, and this gap
      progressively widened during the 3 weeks of testing to 29%. Brain ethanol levels
      upon awakening increased by 22%. The results suggest that the nigrostriatal
      dopaminergic pathways play a major role in determining brain sensitivity to
      ethanol which may represent an important component in the addictive process.

PMID- 7772264
TI  - Role of brain [Mg2+]i in alcohol-induced hemorrhagic stroke in a rat model: a 31P
      NMR in vivo study.
AB  - One hundred percent of anesthetized rats administered 6.6 gm/kg of ethanol IP
      died within 10-35 min of alcohol injection; upon autopsy of the brain all
      demonstrated profound subarachnoid and intracranial bleeding, clear signs of
      hemorrhagic stroke. Pretreatment of rats with 4 mumol/min MgCl2, but not saline,
      via IV administration (for 30-45 min), prevented hemorrhagic stroke in all
      animals so treated with 6.6 gm/kg ethanol. Administration of the stroke dose of
      alcohol resulted in rapid (within 3-5 min) and marked deficits in whole brain
      intracellular free Mg ([Mg2++]i) as observed by in vivo 31P-NMR spectroscopy.
      Intracellular pH (pHi) and the phosphocreatine [PCr]/[ATP] ratio also fell
      following a significant fall in brain [Mg2+]i). Brains of rats that exhibited
      strokelike events, upon death and autopsy, demonstrated continued and marked
      intracellular acidosis with progressive fall in the [PCr]/[ATP] ratio and
      elevation of inorganic phosphate (Pi) and [H+]i; these events were not
      accompanied by any rises in systemic arterial blood pressure. Rats pretreated
      with MgCl2 exhibited relatively stable brain [Mg2+]i, and essentially unchanged
      pHi, [PCr], [ATP], or [Pi] following alcohol administration, although such
      animals exhibited threefold alterations in plasma Mg2+, as measured by ion
      selective electrodes. These observations suggest that high alcohol ingestion can
      result in severe vasospasm, ischemia, and rupture of blood vessels probably as a
      consequence of depletion of brain [Mg2+]i, events that can be prevented by Mg2+
      pretreatment.

PMID- 7772265
TI  - Effects of chronic alcohol administration on lactational performance in the rat.
AB  - Lactating rats, with litters adjusted to eight pups on day 2, were implanted with
      an atrial catheter on day 3 of lactation. Alcohol in doses of 0.0, 1.0, or 2.0
      g/kg BW was infused from day 5 to 12. The blood alcohol levels (BALs) achieved
      following infusion of the initial doses were maintained for 4 hours daily by
      infusion. To control for the reduced food intake in alcohol administered groups,
      rats receiving alcohol doses of 0.0 and 1.0 g/kg BW were pairfed to 2.0 g/kg BW
      alcohol group. For infusion, combinations of 50% dextrose, 30% alcohol in saline
      and saline solutions were used for 0.0 and 1.0 g/kg BW alcohol groups whereas the
      2.0 g/kg BW alcohol group received 30% alcohol in saline thereby equilizing the
      calorie intake of the three experimental groups. On day 12, pups were separated
      from the dams at 0800 h, a catheter extension was attached at 0900 h and baseline
      blood samples for prolactin level were taken at 1000 h. Following infusion of
      initial alcohol doses, samples were taken for BALs. Additional samples for BALs
      were removed 2 h after continuing the infusion. At the end of 4-h infusion, blood
      samples were taken for alcohol and postinfusion prolactin levels. In groups
      designed to study the suckling-induced prolactin release, pups were weighed and
      returned to the dams. Subsequent blood samples were taken 30 min after initiation
      of suckling. In nonsuckled groups, blood samples were obtained at corresponding
      time periods. BALs were determined by head space gas chromatography and plasma
      prolactin by a double antibody radioimmunoassay. Suckling latency and milk
      consumption during the 30 min of suckling were measured. Dams' and litter weights
      were determined on days 2, 5, and 12 of lactation. Infusion of alcohol for 8 days
      from day 5 to 12 of lactation did not affect maternal body weight. However,
      litters nursed by dams receiving 2.0 g/kg BW alcohol weighted less on day 12
      compared to all other groups. Suckling latencies did not differ among groups.
      Milk consumed during the 30 min of suckling was lower for the alcohol
      administered groups. The inhibitory effect on milk consumption was greater for
      the 2.0 g/kg BW group than in the 1.0 g/kg BW alcohol group. Alcohol infusion did
      not affect the basal prolactin, whereas, the higher dose (2.0 g/kg BW) inhibited
      suckling-induced prolactin release.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7772266
TI  - Creatine kinase release from isolated EDL muscles in chronic ethanol-treated
      rats.
AB  - Chronic ethanol abuse has been shown to cause damage to skeletal muscle in
      animals and patients as reflected by elevated serum levels of cytosolic enzymes
      and histological examination. The present study investigated the hypothesis that
      elevated serum creatine kinase levels in ethanol-treated animals vs. sucrose
      control animals may result from increased enzyme release or efflux from muscle.
      Creatine kinase release was measured from extensor digitorum longus (EDL) muscles
      isolated from rats chronically treated for 28 weeks with ethanol and from sucrose
      fed controls. The in vitro cumulative release of creatine kinase over a 2-h
      period was significantly higher in the ethanol-treated animals. Consistent with
      an increased release of enzyme into the bath, creatine kinase levels in muscle
      homogenates at the end of the incubation period were lower in the ethanol-treated
      animals. Creatine kinase levels in serum obtained from trunk blood samples were
      statistically higher in the ethanol-treated animals compared to sucrose controls.
      These findings demonstrate increased enzyme release from fast-twitch skeletal
      muscle in chronic ethanol-treated rats.

PMID- 7772267
TI  - The role of adenosine A1 receptor activation in ethanol-induced inhibition of
      stimulated glutamate release in the hippocampus of the fetal and adult guinea
      pig.
AB  - The role of adenosine A1 receptor activation in ethanol-induced inhibition of
      stimulated L-glutamate (Glu) release was determined in transverse hippocampal
      slices of the near-term fetal guinea pig and the adult guinea pig. Exposure of
      the slices to 48 mM ethanol inhibited K(+)-stimulated Glu efflux. Pretreatment
      with 8-cyclopentyltheophylline (CPT), a selective adenosine A1 receptor
      antagonist, blocked the ethanol-induced inhibition of K(+)-stimulated Glu efflux
      in the near-term fetal and adult hippocampus. In the near-term fetus, 2-chloro-N6
      cyclopentyladenosine (CCPA), a selective adenosine A1 agonist, and exogenous
      adenosine each blocked K(+)-stimulated Glu efflux similar to that produced by 48
      mM ethanol. In the adult, although K+ increased Glu efflux in the presence of
      CCPA or adenosine, the magnitude of increase was less than that of the K(+)
      stimulated Glu efflux for the control conditions. Exposure to ethanol alone or
      ethanol plus CPT produced a transient increase in endogenous adenosine efflux in
      the near-term fetal and adult hippocampus, which was not temporally related to
      the ethanol-induced inhibition of K(+)-stimulated Glu efflux. Overall, the data
      indicate that adenosine A1 receptor activation mediates ethanol-induced
      inhibition of stimulated Glu release in the hippocampus of the near-term fetal
      and adult guinea pig.

PMID- 7772268
TI  - Detection of aldehyde dehydrogenase deficiency in Chachi Indians, Ecuador.
AB  - The activity of mitochondrial aldehyde dehydrogenase (ALDH2) was tested by
      isoelectric focusing of hair root extracts from 50 Chachi Indians (Ecuador).
      Quality of extracts and the intactness of cytoplasmic and mitochondrial enzymes
      were ascertained by assaying of phosphoglucomutase (PGM) and malate dehydrogenase
      (MDH) in the same extracts. Three of the 39 successfully assayed Chachi Indian
      samples showed virtual absence of the ALDH2 band on the isoelectropherogram, and
      the control enzymes were stained normally in these subjects. These data confirm
      the existence of a mitochondrial ALDH deficiency among South American Indians.
      The molecular origin of the ALDH2 deficiency in this population is unknown.

PMID- 7772269
TI  - Apparent monomorphism of ALDH2 in seven American Indian populations.
AB  - Deficiency of mitochondrial aldehyde dehydrogenase (ALDH2) has been previously
      reported in South American Indians. We therefore assayed five individuals from
      each of five South American Indian populations (Quechua, Karitiana, Ticuna,
      Surui, Guahiba), and two North American populations (Maya and Moskoke) for the
      presence of the Oriental ALDH2(2) variant. These samples were also surveyed for
      other alleles altering ALDH2 function. Allele-specific amplification assay (ASA)
      did not detect the ALDH2(2) allele in any of the New World populations studied.
      The entire coding sequence of the ALDH2 cDNA was enzymatically amplified in
      partially overlapping fragments. Each fragment was digested using restriction
      endonucleases and subfragments 148-285 b.p. in length were analyzed by the single
      stranded conformation polymorphism (SSCP) technique. No variants were detected
      within the coding region of the ALDH2 gene in any of the seven American Indian
      populations. Three potentially correct explanations for these results are
      suggested. First, an ALDH2 polymorphism is present but undetectable by SSCP;
      second, none of the studied individuals were ALDH2 negative; third, the
      polymorphism occurs beyond the coding region of ALDH2 gene.

PMID- 7772270
TI  - Acetaldehyde-modified lysozyme function: its potential implication in the
      promotion of infection in alcoholics.
AB  - Incubation of lysozyme with acetaldehyde (0.44 M) at room temperature for 2 h
      produces a 62% inhibition of enzymic activity. Because the active site cleft
      contains tryptophyls, asparagine, glutamine, and an arginine residue, and because
      acetaldehyde reacts with indoles, amides, and guanidines, it is suggested that
      these sites are likely ones for alkylation. The epsilon-amino groups of lysines
      on the surface of the molecule are also susceptible to covalent modification.
      Total acetylation of lysozyme has been reported to inactivate the enzyme. These
      results suggest the possibility that inactivation of a fraction of the lysozyme
      activity by acetaldehyde may decrease the effectiveness of the enzyme in chronic
      alcoholics, thereby leading to an increased potential for susceptibility to
      bacterial infection.

PMID- 7772271
TI  - Alcohol consumption and risk of cancer in humans: an overview.
AB  - Recent epidemiologic data continue to support alcoholic beverage consumption as a
      cause of cancer of the mouth, pharynx, larynx, esophagus, and liver. The effect
      of a given alcohol intake on absolute risk of these cancers depends on the
      prevalence of other risk factors. Whether alcoholic beverage consumption is a
      cause of cancer of the breast or large bowel is unclear. Alcohol intake appears
      not to increase risk of cancer of the lung, bladder, prostate, stomach, ovary,
      endometrium, or of melanoma. Indirect epidemiologic evidence suggests that
      alcohol may be a weak causal factor for pancreatic cancer. Additional research is
      needed to determine whether middle-aged women who drink moderately may experience
      a slight increase in longevity if they decrease alcohol intake. A number of
      biologically plausible mechanisms exist by which alcohol may cause cancer.

PMID- 7772272
TI  - Alcohol-related cancer risk: a toxicokinetic hypothesis.
AB  - Consumption of alcoholic beverages is an accepted social custom world-wide. This
      makes its involvement in events contributing to human cancer risk very important.
      Although it is neither tumorigenic nor genotoxic in animals, ethanol can
      potentiate the carcinogenic risk associated with certain environmentally present
      agents. The reasons for such a synergistic action are speculative, but among
      theories postulated may be ethanol's ability to modify the
      toxicokinetics/dynamics of carcinogen metabolism. Experiments conducted with
      rodents and primates support this hypothesis, demonstrating increased exposure of
      posthepatic organs to nitrosamines when given in combination with ethanol,
      followed by enhancement of DNA adduct formation and, at least in rodents, of
      tumor development. In addition, ethanol may induce enzymes responsible for
      carcinogen activation, including hepatic cytochrome P450 2E1 in rodents and
      humans, and in lung, kidney, and brain in rodents. Studies have also shown that
      these effects can extend to the next generation via maternal and in utero fetal
      exposure. What impact such ethanol-induced modulations have on tumorigenesis
      during childhood and later stages of life needs to be investigated further.

PMID- 7772273
TI  - Significance of T-cell stimulation by altered peptide ligands in T cell biology.
AB  - Investigations of T-cell responses to altered peptide ligands have provided
      functional evidence that a T-cell receptor can interpret subtle structural
      changes in its ligand, highlighting the complexity of this antigen receptor
      signaling system. Over the past year, observations from many studies have
      suggested several roles for such analog peptides in various aspects of immune
      responses. Collectively, these data strongly suggest the existence of naturally
      occurring altered peptide ligands in the endogenous peptide repertoire, that can
      actively participate in the development and shaping of T-cell immunity.

PMID- 7772274
TI  - Natural killer cell receptors.
AB  - In the past year, significant strides have been made in understanding natural
      killing, the process whereby natural killer cells lyse target cells. Recognition
      of susceptible targets and activation now appear to be mediated by a natural
      killer cell receptor that binds carbohydrate determinants on target cells and
      initiates target lysis. Conversely, receptors have been identified that bind MHC
      class I molecules on targets that inhibit natural killer cell activation. These
      findings provide the basis for understanding the molecular processes in the
      initial steps of natural killing.

PMID- 7772275
TI  - B cell activation, tolerance and antigen-presenting function.
AB  - Recent advances in the understanding of the collaboration between T cells and B
      cells have provided a novel framework within which to analyse the mechanisms of B
      cell tolerance and its breakdown. Of particular interest has been the finding
      that B cell anergy is due to defective antigen receptor mediated functions, while
      the antigen-processing machinery and CD40-dependent activation pathways are
      unaffected. Thus, the anergic B cell, which otherwise has a short lifespan, can
      be rescued by a number of regimes to participate in autoimmune responses.

PMID- 7772276
TI  - Innate immunity.

PMID- 7772277
TI  - Signaling mechanisms through cytokine receptors that share signal transducing
      receptor components.
AB  - Most of the receptors for soluble factors functioning in immune and hematopoietic
      systems belong to the cytokine receptor family. These receptors often share
      common signal transducing receptor components with other members of the same
      family. Such receptors and signal transducers possess no intrinsic tyrosine
      kinase domain but have recently been found to be associated with members of a JAK
      family of cytoplasmic tyrosine kinases. The JAK kinases become activated after
      ligand-induced dimerization of the receptor components. This activation appears
      to link the cell surface receptors to the nuclear genes through tyrosine
      phosphorylation and activation of latent cytoplasmic transcription factors called
      signal transducers and activators of transcription (STATs).

PMID- 7772278
TI  - Molecular immunobiology of macrophages: recent progress.
AB  - Macrophage molecules involved in adhesion, signalling, secretion and interactions
      with pathogens and T-helper lymphocytes have been cloned and defined using
      monoclonal antibodies and genetic disruption. Studies of the regulation of
      macrophage differentiation and activation by cytokines have yielded insights into
      the heterogeneity of their functions in natural and acquired immunity, including
      immunity to infections by mycobacteria and HIV.

PMID- 7772279
TI  - The role of natural killer cells in host-parasite interactions.
AB  - Natural killer cells contribute to resistance to infectious organisms, and may
      also influence the nature of the adaptive immune response associated with
      infection. During the past year, their role in these events has been more clearly
      defined. In addition, the results of several recent studies that have begun to
      define the mechanisms by which natural killer cells recognize their targets will
      be important in further elucidating their role in infectious disease.

PMID- 7772280
TI  - Innate immunity of insects.
AB  - Insects are particularly resistant to microorganisms. Their host-defense system
      relies on several innate reactions: upon injury, the immediate onset of two
      proteolytic cascades leading to localized blood clotting and to melanization, the
      latter process involving production of cytotoxic molecules (namely reactive
      oxygen intermediates); the phagocytosis of bacteria and the encapsulation of
      larger parasites by blood cells; the induced synthesis by the fat body of a
      battery of potent antimicrobial peptides/polypeptides which are secreted into the
      hemolymph where they act synergistically to kill the invading microorganisms. The
      insect host defence system shares many of the basic characteristics of the
      mammalian acute phase response, especially at the level of the coordinate control
      of gene expression, where similar cis-regulatory and inducible transactivators
      appear to play key functions. The powerful techniques developed to study the
      genetics of Drosophila provide a unique opportunity to dissect the development
      and differentiation of this primordial immune system and may contribute to our
      understanding of the innate immune response in higher organisms.

PMID- 7772281
TI  - Complement-immunoglobulin interactions.
AB  - Normal circulating immunoglobulin may control complement binding to targets and
      thereby the manifestations of autoimmune disease. Molecular analysis of IgG and
      IgM mutants suggests that C1q binding by IgG utilizes a core Glu-X-Lys-X-Lys
      motif (where X is any amino acid). Additional amino acids, particularly
      homologous proline residues at position 331 in IgG and 436 in IgM, appear
      critical for classical pathway initiation. Glycosylation of IgG heavy chain is
      important in C1q binding, as well as glycosylation of IgA heavy chain for
      alternative pathway initiation. Additional recent evidence suggests an important
      role for C3 in antigen presentation. The data also raise the possibility that C3
      plays a significant role in the intracellular antigen processing pathway.

PMID- 7772282
TI  - Structure, function and cellular expression of complement anaphylatoxin
      receptors.
AB  - The past year has seen significant advances in determining the important
      structural-functional domains of the complement C5a anaphylatoxin receptor. The
      current model suggests a two-site binding motif in which part of the amino
      terminal extracellular domain of the receptor is recognized first by the amino
      terminal end and disulfide-linked core of the C5a ligand. This is followed by
      interaction of the carboxy-terminal end of C5a with a second, and as yet
      undefined, site on the receptor that results in activating appropriate signal
      transduction pathways via receptor coupled G proteins. Another recent advance has
      been the discovery that the C5a receptor is expressed on non-myeloid cells,
      suggesting that C5a confers previously unexpected functions on certain target
      tissue cells, including bronchial and alveolar epithelial cells, hepatocytes,
      astrocytes, and vascular endothelial cells.

PMID- 7772283
TI  - Structure and function of the pentraxins.
AB  - Over the past two years, the three-dimensional structure of the serum amyloid P
      component was defined by X-ray diffraction, the first such visualization of a
      pentraxin. Binding sites for calcium, ligands and complement were identified. New
      fusion proteins with amino acid sequence homology to the pentraxins were
      described, and new insights were gained into pentraxin phylogeny, biosynthesis,
      ligands, complement activation, leukocyte reactivity and biological functions in
      vivo.

PMID- 7772284
TI  - Supply and transport of peptides presented by class I MHC molecules.
AB  - Three observations suggest that the proteasome, transporter associated with
      antigen processing (TAP) and class I MHC molecules are co-adapted for the
      generation, transport and loading of specific peptides. Firstly, TAP
      preferentially transports peptides close in length to the optimum for class I
      loading; secondly, genetic variation in TAP specificity focusing in the carboxy
      terminal of the peptide correlates with preferences among class I molecules for
      different peptide carboxy-termini; thirdly, TAP associates directly with empty
      class I molecules and is released by successful peptide loading. This conclusion
      puts in question the significance for class I loading of proteolytic processing
      and peptide generation in the endoplasmic reticulum.

PMID- 7772285
TI  - Molecular chaperones in antigen presentation.
AB  - As is the case with most proteins of the secretory pathway, the biogenesis of MHC
      class I and class II molecules occurs in association with molecular chaperones.
      Considerable progress has been made in identifying the chaperones involved and
      recent studies on two of these, calnexin and invariant chain, have shown that
      they influence multiple processes including protein stability, folding, assembly
      and intercellular retention.

PMID- 7772286
TI  - Chemistry of peptides associated with MHC class I and class II molecules.
AB  - Recent developments have led to a clearer understanding of the association
      between peptides and MHC molecules. It is now clear that the peptides presented
      by MHC class I or class II molecules follow stringent rules that are different
      for each allelic product. The allele-specific interaction usually involves a
      sequence of nine amino acids spanning the MHC groove. For class I molecules, the
      entire peptide ligand is involved in allele-specific interaction with MHC but for
      class II, the peptides are longer and the nine amino acid sequence is roughly
      central to the peptide. Allele-specific interactions are brought about by
      anchoring peptide side chains in complementary pockets in the MHC groove. The sum
      of allele-specific peptide-MHC interaction requirements can be described as a
      motif, characterized by number, spacing and specificities of anchors, as well as
      the more degenerate preferences at non-anchor positions within the nonamer
      stretches. Such information is useful for T-cell epitope predictions.

PMID- 7772287
TI  - Novel molecules related to MHC antigens.
AB  - Several types of molecules related to classical class I and II antigens of the
      MHC have been recently discovered. At the same time we have learnt more about the
      functions of non-classical (class Ib) antigens. This has shed light on the
      possible evolutionary origins and the likely roles that these molecules may play
      in the immune response.

PMID- 7772288
TI  - [XV Congreso Nacional de Microbiologia (Madrid, 25-28 September 1995). 50 years
      of microbiology in Spain].

PMID- 7772289
TI  - Forty years of screening programmes for antibiotics.
AB  - The article gathers the reflections on the experiences of forty years doing
      research on the screening of natural product in the pharmaceutical industry. Over
      those years new technologies have improved the methodology. However, the steps
      followed in such a research are the same: the isolation and cultivation of
      microorganisms; the definition of assays with well defined targets; the
      demonstration of their efficacy for the discovery and selection of active
      substances produced by microorganisms; the classification and structural
      determination of the new products; and the study of their therapeutical
      efficiency. Examples of the processes which led to the production of several
      antibiotics (fosfomycin, cefoxitin and thienamycin) are described. One important
      lesson that the author has learnt is that microorganisms have unique fingerprints
      and that generalization should be avoided in the planning of this work.

PMID- 7772290
TI  - [History of microscopy in Spain].
AB  - Nowadays, many Spanish research centers have excellent electronic microscopy
      services. The current situation, however, should not allow us to forget that the
      initial steps of microscopy in Spain were very difficult. The construction of
      excellent optical microscopies in the late XIX century, and their almost
      immediate introduction in Spain, coincides with a period of thriving scientific
      activity in our country. Both micrography and histology saw the highlights of
      their development in Spain, with scientists such as Ramon y Cajal, Rio Hortega,
      Ferran, Simarro, among others, all of them widely known at present. This article
      evokes briefly the vicissitudes of Spanish microscopy, from its very beginning in
      1843, when the Allgemeine Anatomie by Jacob Henle was translated into Spanish, to
      present. Scientific historical facts in this article are often accompanied with
      anecdotes, which show the human aspect of those great scientists. The persevering
      task carried out by researchers whose names have been recorded in the history of
      Spanish science and technology, have established the grounds in which our current
      development is based.

PMID- 7772291
TI  - New methods in Salmonella genetics.
AB  - This review summarizes several recent developments in Salmonella genetics; some
      of the procedures described can be easily adapted to Escherichia coli and have
      also potential applications in non-enteric bacteria. The novel methods outlined
      include genetic mapping procedures, ancillary tools for cloning, a strategy for
      analyzing DNA-protein interactions in vivo, a method for plasmid curing and a
      procedure for the detection of bacterial virulence genes.

PMID- 7772292
TI  - Genetic regulation of nitrogen fixation in Rhizobium meliloti.
AB  - The soil bacterium Rhizobium meliloti fixes dinitrogen when associated with root
      nodules formed on its plant host, Medicago sativa (alfalfa). The expression of
      most of the known genes required for nitrogen fixation (nif and fix genes),
      including the structural genes for nitrogenase, is induced in response to a
      decrease in oxygen concentration. Induction of nif and fix gene expression by low
      oxygen is physiologically relevant because a low-oxygen environment is maintained
      in root nodules to prevent inactivation of the highly oxygen-sensitive
      nitrogenase enzyme. The genes responsible for sensing and transducing the low
      oxygen signal, fixL and fixJ, encode proteins (FixL and FixJ, respectively) that
      are homologous to a large family of bacterial proteins involved in signal
      transduction, the two component regulatory system proteins. The two components
      consist of a sensor protein, to which FixL is homologous, and a response
      regulator protein, to which FixJ is homologous. The sensor protein respond to an
      activating signal by autophosphorylating and then transferring the phosphate to
      its cognate response regulator protein. The phosphorylated response regulator,
      which is often a transcriptional activator, is then able to activate its target.
      A cascade model of nif and fix gene regulation in R. meliloti has been proposed,
      whereby FixL acts as an oxygen sensor as the initial event in the cascade and
      transmits this information to FixJ. FixJ, which possesses a putative helix-turn
      helix DNA-binding motif, then activates transcription of the nifA and fixK genes.
      The nifA and fixK gene products, are transcriptional activators of at least 14
      other nif and fix genes.

PMID- 7772293
TI  - Genes involved in the regulation of invertase production in Saccharomyces
      cerevisiae.
AB  - The expression of Saccharomyces cerevisiae SUC genes is exclusively regulated by
      catabolic repression, mediated by glucose. Genes involved in this process have
      been defined by means of mutants either unable to express invertase or with
      constitutive phenotype, although none of the genes is specific for invertase
      regulation. The affected genes in mutants unable to produce invertase are
      designated SNFX. These genes can be assorted into two groups considering either
      their function in regulation of gene expression or their epistatic relationships.
      Mutants with constitutive phenotype have been selected either by resistance to 2
      deoxyglucose or by suppression of snf mutations. Among the different genes
      previously outlined, some of which code for transcription factors, only the MIG1
      product, a "zinc finger" protein, shows a clear capacity of binding DNA in vitro.
      Besides the ON/OFF switch mechanism of the expression of SUC genes, some genes
      seem to play a role in modulating invertase expression, either hindering or
      stimulating transcription. A model to define the relationship between the
      different gene products involved in the regulation of transcription of the SUC
      genes is proposed.

PMID- 7772294
TI  - Sibling species of the Saccharomyces sensu stricto complex in Spain.
AB  - By genetic hybridization, molecular karyotyping and Southern hybridization with
      the ADC1 promoter probe three species Saccharomyces cerevisiae, S. paradoxus and
      S. bayanus were identified among wild Saccharomyces sensu stricto yeast in Spain.
      Wine strains fermenting melibiose belong to the biological species S. bayanus
      (syn. S. uvarum). S. kluyveri has been detected karyotypically.

PMID- 7772295
TI  - Diversity of actinomycetes and fungi on seaweeds from the Iberian coasts.
AB  - As a part of a screening program for natural products from microorganisms, 465
      actinomycetes strains and 278 fungal strains were isolated from 44 seaweed
      specimens (Rhodophyta and Phaeophyta), collected in the Iberian peninsula
      seashore (Atlantic and Mediterranean coasts). Six different isolation procedures
      were followed, and seven isolation media were used, some of which included
      seawater in their composition. The isolated microorganisms were identified to the
      level of species or genus by microscopic morphology. Determination of species of
      Streptomyces was performed through total fatty acid analysis by gas
      chromatography. Richness and diversity of the Streptomyces and actinoplanetes
      species isolated from the seaweeds are compared, taking into account the
      geographic location of the samples. Most of the fungi recovered from these
      samples were terrestrial, although several marine species (Dendryphiella
      arenaria, Dendryphiella salina, Varicosporina ramulosa, Corollospora intermedia
      and Asteromyces cruciatus) were also isolated.

PMID- 7772296
TI  - [In vitro tests of the antagonistic behavior of Trichoderma spp. against
      pathogenic species of the horticultural region of La Plata, Argentina].
AB  - The antagonistic properties of seven Trichoderma species in front of the
      pathogens Fusarium oxysporum, F. equiseti, F. solani, Sclerotinia sclerotiorum,
      S. minor, Rhizoctonia sp. and Sclerotium rolfsii was evaluated in vitro. Those
      microorganisms were isolated from horticultural soils of La Plata in order to
      test the antagonistic-pathogenic relationship. Dual cultures on PDA 2% were used.
      All the species of Trichoderma grew in the culture medium with a colonization
      value higher than 50%. Differences in the antagonistic behaviour of the pathogens
      were observed depending on the species with which they interacted. The presence
      of diffusible metabolites to the medium was demonstrated in almost 80% of the
      pathogens antagonists tested.

PMID- 7772297
TI  - [Maclyn McCarty: a forgotten genius. 50 years after the rediscovery of DNA].

PMID- 7772298
TI  - [Andre Lwoff (1902-1994)].

PMID- 7772299
TI  - [10 suggestions for the Spanish scientist].

PMID- 7772301
TI  - Inhibition of signal-regulated protein kinases by plant-derived hydrolysable
      tannins.
AB  - A variety of hydrolysable tannins purified from Phyllanthus amarus are potent
      inhibitors of rat liver cyclic AMP-dependent protein kinase catalytic subunit
      (cAK) with IC50 values (concentrations for 50% inhibition) in the range 0.2-1.7
      microM. The three most effective compounds of this series of hydrolysable tannins
      have five phenolic substituents. These three compounds are also the most
      effective inhibitors of wheat embryo Ca(2+)-dependent protein kinase (CDPK), rat
      brain Ca(2+)- and phospholipid-dependent protein kinase C (PKC) and Ca(2+)
      calmodulin-dependent myosin light chain kinase (MLCK). The order of sensitivity
      for protein kinase inhibition by the hydrolysable tannins studied is cAK > CDPK >
      PKC > MLCK. Thus the IC50 values for protein kinase inhibition by the most potent
      compound are 0.2 microM (for cAK), 1.8 microM (for CDPK), 26 microM (for PKC) and
      56 microM (for MLCK) when protein kinase affinity is measured using synthetic
      peptide substrates. These hydrolysable tannin inhibitors found are the most
      specific and potent plant-derived inhibitors of cAK yet found.

PMID- 7772300
TI  - Synthesis of enantio-manoyl oxides: modifiers of the activity of adenylatecyclase
      enzyme.
AB  - Cyclization of methyl ent-8 alpha-hydroxylabd-13(16),14-dien-18-oate with m
      chloroperbenzoic acid gave methyl (13S)-ent-16-hydroxy-8 alpha,13-epoxylabd-14-en
      18-oate and its epimer at C-13. Biotransformation of the former (which exhibits
      antileishmania activity) with Rhizopus nigricans cultures produced the methyl
      (13S)-ent-11 beta,16-dihydroxy-8 alpha,13-epoxilabd-14-en-18-oate (carbomanoyl,
      which inhibits the activity of the adenylatecyclase enzyme), methyl (13S)-ent-3
      beta,16-dihydroxy-8 alpha,13-epoxilabd-14-en-18-oate, methyl (13S)-ent-3 beta,11
      beta,16-trihydroxy-8 alpha,13-epoxilabd-14-en-18-oate and the (14S)-ent-3 beta
      hydroxy-14,15-epoxy derivative that cyclized spontaneously to a spiran compound.
      Biotransformation of methyl (13S)-ent-16-hydroxy-3-oxo-8 alpha,13-epoxilabd-14-en
      18-oate with R. nigricans produced ent-11 beta-hydroxylation, reduction of the
      keto group at C-3 (to give 3S-alcohol) and 14(S),15-epoxidation, which also
      rearranged to a spiro compound.

PMID- 7772302
TI  - A novel protein from mung bean hypocotyl cell walls with acetyl esterase
      activity.
AB  - An acetyl esterase was purified from cell walls isolated from mung bean
      hypocotyls. The purified enzyme had an apparent Mr of 43,300 and an apparent pI >
      9. It rapidly deesterified triacetin and p-nitrophenylacetate and slowly released
      acetate from beet and flax pectins, the deesterification rate being increased by
      previous demethylation of the pectins. No significant peptide sequence identity
      between the acetyl esterase and any known protein could be found in protein data
      bases.

PMID- 7772304
TI  - Biotransformation of an acyclic neolignan in rats.
AB  - The biotransformation of an acyclic neolignan, (+)-erythro-(4,7-dihydroxy-3
      methoxy-1'-allyl-3',5'-dimethoxy)-8-O-4' neolignan, in rats has been
      investigated. After administration of (+)-erythro-(4,7-dihydroxy-3-methoxy-1'
      allyl-3',5'-dimethoxy)-8-O-4'-++ +neolignan to rat by intraperitoneal injection,
      urine and faeces were collected. A small amount of (+)-erythro-(4,7-dihydroxy-3
      methoxy-1'-allyl-3',5'- dimethoxy)-8-O-4'-neolignan and its metabolic product
      were obtained from an ethyl acetate extract of the urine, and the largest amount
      of the same metabolic product was obtained from a dichloromethane extract of the
      faeces. The sole metabolic product was identified as (+)-(4-hydroxy-3-methoxy-1'
      allyl-3',5'-dimethoxy)-8-O-4'-neolignan++ + by spectroscopic methods.
      Furthermore, biotransformation of (+)-erythro-(4,7-dihydro-3-methoxy-1'-allyl
      3',5'- dimethoxy)-8-O-4'-neolignan by intestinal bacteria in rat faeces was also
      investigated in vitro. Consequently, (+)-erythro-(4,7-dihydroxy-3-methoxy-1'
      allyl-3',5'-dimethoxy)-8-O-4'-++ +neolignan was reduced to the same metabolic
      product and no other metabolic products were produced. These results suggested
      that intestinal bacteria were concerned in the specific dehydroxylation of (+)
      erythro-(4,7-dihydroxy-3-methoxy-1'-allyl-3',5'-dimethoxy)-8-O-4'-++ +neolignan
      in rats.

PMID- 7772303
TI  - Isolation of dihydrofolate and folylpolyglutamate synthetase activities from
      Neurospora.
AB  - The possible association of dihydrofolate synthetase (DHFS) and
      folylpolyglutamate synthetase (FPGS) in Neurospora crassa (FGSC 853, wild type)
      has been examined using mycelial extracts prepared and fractionated in the
      presence of protease inhibitors. DHFS and FPGS were assayed by following the
      incorporation of labelled glutamate into dihydrofolate and
      methylenetetrahydrofolate polyglutamate, respectively. Both of these activities
      were predominately cytosolic in mycelia that were harvested 24 hr after spore
      inoculation of defined minimal medium. Relatively small amounts of total mycelial
      DHFS activity were associated with mitochondrial fractions isolated by
      differential centrifugation. In contrast, ca 20% of the mycelial FPGS activity
      was mitochondrial. Treatment of the mitochondrial fractions with Triton X-100
      suggested that these activities were not latent under the assay conditions
      employed. Separate peaks of DHFS and FPGS activity were observed when (NH4)2SO4
      fractionated protein was desalted and chromatographed on columns of either Mono Q
      HR, DEAE-cellulose, heparin agarose, Matrex Green A or Reactive Green 5. Gel
      filtration indicated average Mr values of 52 and 66 x 10(3) for DHFS and FPGS
      protein, respectively. Dihydrofolate synthetase protein was purified over 1000
      fold by a protocol that included chromatography on DEAE-cellulose, DEAE-Sephacel,
      heparin agarose and Matrex Green A. The isolated protein lacked ability to
      glutamyl conjugate 5,10-methylene tetrahydrofolate. SDS-polyacrylamide gel
      electrophoresis of the Matrex Green A peak fractions revealed a major protein
      band of average Mr 52 x 10(3) whose concentration appeared to parallel DHFS
      activity. FPGS protein (average Mr 66 x 10(3)), which lacked ability to glutamyl
      conjugate dihydropteroate, was recovered by a similar protocol.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7772305
TI  - Cyclosporins from Tolypocladium terricola.
AB  - New natural cyclosporins were isolated from the mycelium of surface cultivated
      fungus Tolypocladium terricola. The chemical structures of [Leu4] CS and [MeLeu1]
      CS = cyclosporin-J, were deduced from the NMR and mass spectral data. Biological
      activity of new cyclosporins is reported based on the proliferative mitogen
      stimulation test.

PMID- 7772306
TI  - Diterpenes from Solidago rugosa.
AB  - Investigation of the roots and aerial parts of Solidago rugosa afforded the known
      diterpenes kolavenol, hardwickiic acid, (-)-kaur-16-en-19-oic acid, (+)-manool,
      (+)-3 beta-hydroxymanool, manoyl oxide and ent-abietic acid. In addition, the new
      labdane diterpene (+)-18-tigloyloxymanool and four new ent-abietanes were
      obtained. The structures of all known and new compounds were elucidated by
      spectroscopic methods, especially high-field 1H and 13C NMR, and inverse 1H-13C
      correlation techniques, as well as chemical transformations. Six diterpenes were
      tested against Mycobacterium tuberculosis and M. avium, but showed no significant
      activities with minimum inhibitory concentrations of > 100 micrograms ml-1.

PMID- 7772307
TI  - Bioactive anthraquinone glycosides from Picramnia antidesma spp. fessonia.
AB  - A bioactivity guided fractionation, using KB cells and brine shrimp assays, of
      the methanolic extract from the leaves of Picramnia antidesma yielded two known
      anthraquinones, aloe-emodin and aloe-emodin anthrone, and three new aloe-emodin C
      glycosides, named picramnioside A, picramnioside B and picramnioside C.
      Structures were established by spectroscopic methods (UV, IR, mass spectrometry,
      1H and 13C and 2D NMR including COSY 45, HMQC, HMBC and ROESY). CD was used to
      establish the absolute configuration of the picramniosides.

PMID- 7772309
TI  - The restoration or preservation of sensation in the oral cavity following
      ablative surgery.
AB  - The importance of sensory feedback from the oral cavity is evaluated in the
      context of functional rehabilitation following ablative surgery using three
      techniques that restore or preserve sensation. Nerve grafts to restore the
      continuity of sensory nerves interrupted during ablative surgery, as well as the
      role of sensate flaps and the protection of palatal sensation following soft
      palate resection or total glossectomy, are discussed.

PMID- 7772308
TI  - Three acylated flavone glycosides from Sideritis syriaca.
AB  - From the aerial parts of Sideritis syriaca a new flavone glycoside, 5,8,3'
      trihydroxy-4'-methoxyflavone 7-(6"'-O-acetylsophoroside) was identified together
      with apigenin 7-(6"-p-coumaroylglucoside) and apigenin 7-(4"-p
      coumaroylglucoside) which are reported for the first time in the genus Sideritis.
      The compounds were characterized using 1H NMR, 13C NMR, MS and chemical methods.

PMID- 7772310
TI  - The anterior extension face-lift.
AB  - OBJECTIVE: To describe a face-lift technique with emphasis on extension of the
      temporal incision into the lateral orbital area. This modification serves several
      beneficial ends but must be used only in carefully selected patients. Gathering
      of excess skin in the lateral orbital area is prevented, eliminating the typical
      disparity between relatively tight lower and middle facial skin and flaccid upper
      facial skin, which is commonly seen after rhytidectomy. The anterior extension
      also helps to support the lower eyelid, which is helpful when lid laxity exists
      or when concomitant blepharoplasty is performed. SETTING: A private cosmetic
      surgery center. PARTICIPANTS: Thirty-five patients undergoing rhytidectomy (15
      primary and 20 revision procedures). OUTCOME MEASURE: Patient satisfaction at 3
      months after surgery. RESULTS: Thirty-four (97%) of 35 patients were pleased with
      their results. CONCLUSIONS: The anterior extension face-lift can provide
      excellent results in carefully selected patients. We have found this procedure to
      be especially helpful in patients undergoing revision surgery and in older
      patients with facial skin laxity.

PMID- 7772311
TI  - The importance of maintaining the alar-facial sulcus in nasal reconstruction.
AB  - The alar-facial sulcus is an important topographical region because it represents
      a junctional zone of three cosmetic units: the nasal base, the medial aspect of
      the cheek, and the upper lip. Too often, the sulcus is violated by transposition
      flaps that have been harvested from the cheek to reconstruct defects of the nasal
      alar lobule. When the sulcus is violated by surgery, it is difficult to restore a
      completely natural appearance. For this reason, we suggest an alternative method
      of reconstructing the alar lobule through the use of an interpolated flap. When
      defects extend into the alar-facial sulcus, reconstruction of the sulcus is
      necessary and should be accomplished with a separate skin flap from that used to
      repair the nasal component of the defect. When a single flap is used to
      reconstruct both lobule and sulcus, restoration of a completely natural-appearing
      sulcus is rarely achieved and usually involves multiple surgical procedures often
      facilitated by aggressive flap contouring, secondary intention healing, and Z
      plasty. We describe our methodology in restoring the alar-facial sulcus after
      nasal reconstruction.

PMID- 7772312
TI  - A graduated method of tip graft fixation in rhinoplasty.
AB  - Projection of the nasal tip has gained increased recognition as a measurable and
      visual characteristic that has an impact on the results of aesthetic rhinoplasty.
      Autologous cartilage tip grafts have been used in many techniques to increase tip
      projection and contour the tip during rhinoplasty. This article introduces a
      graduated method of tip graft fixation correlated with specific clinical
      measurements related to tip projection. After careful analysis of tip projection
      and contour, a predictable graft fixation technique can be selected to obtain the
      desired degree of nasal tip projection and sculpting.

PMID- 7772313
TI  - Role of the argon beam coagulator in facial rejuvenation surgery.
AB  - OBJECTIVE: To compare the hemostatic effectiveness of a new electrosurgical unit,
      the argon beam coagulator, with current methods of electrocoagulation. DESIGN: A
      nonrandomized control trial of 20 patients undergoing rhytidectomy. SETTING: Two
      academic tertiary referral medical centers. PARTICIPANTS: Twenty male patients
      having moderate to major degrees of facial ptosis. INTERVENTION: All 20 patients
      underwent a standard rhytidectomy with hemostasis provided by the argon beam
      coagulator on the right side and conventional electrocoagulation on the left
      side. OUTCOME MEASURES: Improved hemostasis with minimal depth of injury, length
      of procedure, decreased blood loss, edema, and ecchymosis, and the ability to
      coagulate indiscriminately around and over neural tissue without damage (all
      listed in the literature as advantages of the argon beam coagulator). RESULTS:
      Poor hemostatic ability was observed with concomitant increased incidence of
      blood loss, edema and ecchymosis, major hematoma, and length of surgery. Also
      noted were increased rates of flap compromise and the potential for damage to
      vital neural structures. CONCLUSION: Our results do not agree with the list of
      advantages attributed to the argon beam coagulator in the literature.

PMID- 7772314
TI  - The Rieger flap for nasal reconstruction.
AB  - OBJECTIVE: To repair surgical defects of the middle and distal third of the nose.
      DESIGN: The anatomic and technical design of the Rieger (dorsonasal) flap is
      described. CONCLUSION: When performed on properly selected patients, the Rieger
      flap is an aesthetically predictable, one-stage procedure.

PMID- 7772315
TI  - Maxillary swing approach for resection of tumors in and around the nasopharynx.
AB  - The efficacy of the anterolateral approach to the nasopharynx and its vicinity
      was evaluated. Using this maxillary swing approach, we have removed tumors in and
      around the nasopharyngeal region in 26 patients. Among them, 18 suffered from
      recurrent primary nasopharyngeal carcinoma after external radiotherapy, three
      patients had chordoma, two had schwannoma, one had adenocarcinoma of the
      nasopharynx, and one had malignant fibrous histiocytoma. The last patient had a
      recurrent deep-lobe parotid gland tumor localized in the paranasopharyngeal
      space. The facial wounds in all 26 patients healed primarily with no evidence of
      necrosis of the maxilla. Seven patients developed palatal fistula, five of them
      subsequently healed, whereas one patient required surgical closure and one had to
      wear a dental plate. This group of patients was followed up from 4 to 42 months
      (median, 15 months). Among the 18 patients with recurrent nasopharyngeal
      carcinoma, five had local recurrence, four died of other conditions, and nine of
      them are still alive with no evidence of disease. This gives an actuarial control
      of tumor in the nasopharynx of 42% at 3.5 years. In the eight patients remaining,
      one died of recurrent chordoma, two are alive with recurrent disease, and five
      are free of disease. Exposure of the nasopharynx and the paranasopharyngeal space
      is possible using the anterolateral approach. The associated morbidity is low.

PMID- 7772316
TI  - The use of calvarial bone in nasal reconstruction.
AB  - OBJECTIVE: To demonstrate the utility of calvarial bone as a primary graft choice
      in nasal reconstruction. DESIGN: Case series. SETTING: Academic tertiary care
      center. PATTERN: Thirty-five consecutive patients who underwent split calvarial
      bone grafting to the nasal dorsum between June 1988 and September 1993 and who
      had post-operative follow-up. OUTCOME MEASURES: Serial clinical examination to
      assess volume loss, movement of the graft, and complications. Standardized
      photographs to assess nasal contour. RESULTS: Fixation of the graft was
      accomplished using a technique that promotes bone-to-bone healing without
      fixation screws or wires. The most common complication was seroma or hematoma of
      the scalp (8%). There were no dural tears or intracranial complications. Long
      term donor site morbidity consisted of one case of local alopecia (2.8%). A good
      nasal contour was achieved in 97% of patients. CONCLUSION: Based on the
      experimental evidence reviewed and our clinical experience, split calvarial bone
      is recommended as a material of choice for nasal dorsal reconstruction.

PMID- 7772317
TI  - Late proptosis following orbital floor fracture repair.
AB  - OBJECTIVE: Late proptosis is an unusual complication of orbital floor fracture
      repair. We report 12 cases and propose a classification scheme and differential
      diagnosis for this rare complication. DESIGN: Retrospective multi-institutional
      case review. SETTING: Two tertiary referral centers. RESULTS: We report 12 cases
      of late proptosis following orbital floor fracture repair. Causes of late
      proptosis include peri-implant inflammation, capsular hemorrhage, gelatin film
      cyst, implant infection, sino-orbital fistula, intraorbital sinus mucocele, and
      carotid-cavernous fistula. We describe the treatment of each case individually;
      in most cases, the implant was removed. All 12 patients had a satisfactory
      outcome after treatment. CONCLUSIONS: Proptosis presenting 2 months or more after
      orbital floor fracture is rare. We classify the origin of late proptosis into
      three groups: implant, sinus, and neurovascular. We describe the diagnosis and
      management of this unusual complication.

PMID- 7772318
TI  - The effect of intradermal corticosteroids on skin flap edema.
AB  - OBJECTIVE: To validate a model for skin flap edema in the piglet and determine
      whether intraoperative and postoperative intradermal corticosteroids reduce the
      edema created. DESIGN: Prospective, randomized, matched-control animal model.
      SETTING: Animal laboratory. PARTICIPANTS: Twenty-five weight-matched purebred
      Yorkshire piglets. INTERVENTION: Intraoperative and postoperative injections of
      intradermal triamcinolone. MAIN OUTCOME MEASURED: Flap edema. RESULTS: A
      reproducible skin flap edema model was validated in the piglet. Intraoperative
      intradermal corticosteroids decreased flap edema but postoperative
      corticosteroids did not. CONCLUSION: Clinical improvement in skin flap and
      supratip fullness may result from mechanisms other than edema.

PMID- 7772319
TI  - The effect of propofol on hematoma formation in rhytidectomy.
AB  - Significant surgical advances in face-lift surgery have evolved over the years,
      including wider flap undermining, the development of the superficial
      musculoaponeurotic system as a separate layer, and appropriate platysmal and
      coronal procedures. These more radical concepts offer improved results, but they
      may be associated with more complications, the most frequent being hematoma
      formation. A retrospective study of 386 patients was undertaken over a period of
      5 years. Patients were separated into two groups: those that were sedated with a
      drug combination of diazepam, meperidine hydrochloride, and methohexital sodium;
      and those sedated with propofol. Patients sedated with propofol were more than
      twice as likely to develop a hematoma than those sedated with the other drug
      regimen. Although the hematoma rate with propofol is similar to that reported
      with other drugs, this increased risk must be carefully considered when one is
      choosing an anesthetic for rhytidectomy.

PMID- 7772320
TI  - Reduction of tissue edema by microdialysis.
AB  - OBJECTIVE: This is the first report (to our knowledge) of the use of tissue
      microdialysis to reduce tissue edema. In this study, a hyperosmotic solution was
      perfused through microdialysis catheters, allowing direct treatment of
      interstitial edema by osmosis. DESIGN: First, the catheter and perfusate
      characteristics were tested in vitro. A physiologic, controlled trial was then
      performed, with two outcome variables: osmolarity of the effluent and tissue
      water content. SUBJECTS: Twenty male Sprague-Dawley rats. One rat was withdrawn.
      INTERVENTIONS: Tissue microdialysis catheters were implanted in the rats. The
      control side of the animals was not perfused. The experimental side was perfused
      for 9 hours. RESULTS: Osmolarity of the perfusate was reduced 16.5 mOsm after
      passing through the catheter, indicating that fluid was removed from the tissue.
      Tissue edema was reduced by an average 1.8 mL of fluid per 100 g of wet tissue.
      CONCLUSIONS: Tissue microdialysis removed tissue fluid and reduced edema. This
      treatment may have a beneficial effect on edematous tissues. Potential use and
      limitations of this therapeutic modality are discussed.

PMID- 7772321
TI  - Ketorolac (Toradol) and acute random-pattern skin flap survival in rat.
AB  - OBJECTIVE: To assess the efficacy of sustained postoperative intramuscular
      ketorolac tromethamine (Toradol) at analgesic levels in the augmentation of
      acute, random-pattern skin flaps in rat. DESIGN: Prospective, randomized, placebo
      controlled, animal trial. SETTING: Animal research laboratory, School of
      Medicine, Oregon Health Sciences University, Portland. SUBJECTS: Forty-four adult
      male Sprague-Dawley rats (260 to 280 g). INTERVENTIONS: Twenty-two treatment
      animals underwent modified McFarlane random-pattern skin flaps followed
      immediately by intramuscular loading doses of ketorolac. Treatment animals were
      then maintained on a regimen of intramuscular ketorolac using a three times a day
      dosing schedule for 14 days postoperatively. Twenty-two control animals underwent
      identical modified McFarlane random-pattern skin flaps and were given equivalent
      volumes of intramuscular saline on the same dosing schedule for the 14-day
      treatment period. MAIN OUTCOME MEASURES: Postmortem measurements of skin flap
      ischemia (expressed as a percentage of total flap surface area) were performed
      for both treatment and control animals by three independent, non-blinded
      observers using the acetate tracing technique. Both pooled and individual data
      were statistically analyzed using personal computer software. RESULTS: Forty
      three of the 44 animals successfully completed the experimental trial. One animal
      in the treatment group died on postoperative day 3 of unknown causes. During the
      study period, one postoperative hematoma was detected in both the treatment and
      control groups. The mean percentage of skin flap ischemic necrosis observed in
      control animals (35.4%) was consistently less than that measured in the treatment
      group (36.4%). However, the difference in ischemic flap necrosis between control
      and treatment groups was not statistically significant (P = .6919). CONCLUSIONS:
      Comparatively high-dose intramuscular ketorolac failed to augment acute, random
      pattern skin flap survival in rat when initiated in the immediate postoperative
      period. Complications of prolonged, intramuscular ketorolac were not observed in
      this trial. Further studies using preoperative initiation of drug therapy may
      help to clarify the true efficacy of ketorolac in flap augmentation.

PMID- 7772322
TI  - Treatment of experimental frostbite with pentoxifylline and aloe vera cream.
AB  - OBJECTIVE: To compare the therapeutic effects of systemic pentoxifylline and
      topical aloe vera cream in the treatment of frostbite. DESIGN: The frostbitten
      ears of 10 New Zealand white rabbits were assigned to one of four treatment
      groups: untreated controls, those treated with aloe vera cream, those treated
      with pentoxifylline, and those treated with aloe vera cream and pentoxifylline.
      MAIN OUTCOME MEASURES: Tissue survival was calculated as the percent of total
      frostbite area that remained after 2 weeks. RESULTS: The control group had a 6%
      tissue survival. Tissue survival was notably improved with pentoxifylline (20%),
      better with aloe vera cream (24%), and the best with the combination therapy
      (30%). CONCLUSION: Pentoxifylline is as effective as aloe vera cream in improving
      tissue survival after frostbite injury.

PMID- 7772323
TI  - Cardiac complication from use of cocaine and phenylephrine in nasal septoplasty.
AB  - Cocaine hydrochloride is widely used as a topical anesthetic for otolaryngologic
      surgery. Cardiovascular complications, including myocardial injury, are well
      documented side effects of illicit cocaine use. We describe a 23-year-old woman
      without coronary artery disease who had an acute non-Q-wave myocardial infarction
      and stunned myocardium after receiving topical phenylephrine hydrochloride and
      cocaine anesthesia for elective nasal septoplasty. These cases are rare; however,
      we hope to heighten the awareness of the potential lethal complications of using
      cocaine, phenylephrine, or the combination of both as topical anesthetics in
      otolaryngologic practice.

PMID- 7772324
TI  - Clear cell odontogenic carcinoma. A clinicopathologic analysis.
AB  - Clear cell odontogenic tumor is a rare neoplasm of the jaws that histologically
      may be confused with metastatic renal cell carcinoma. A review of 17 cases
      revealed that these tumors are aggressive, with a tendency to recur locally after
      surgery; they also may metastasize both regionally and distantly. There is a
      marked female predilection, and most cases are discovered during the fifth to
      seventh decades of life. Seventy percent occur in the mandible, appearing as
      poorly marginated radiolucencies. We conclude that this tumor is malignant and
      should be referred to as clear cell odontogenic carcinoma; it requires an
      aggressive surgical approach.

PMID- 7772326
TI  - Pathologic quiz case 1. Chondrosarcoma of the mandible.

PMID- 7772325
TI  - The use of interferon alfa-2a for life-threatening hemangiomas.
AB  - Hemangiomas are the most common benign neoplasm in the neonatal period. While
      most small hemangiomas involute spontaneously, up to 20% may grow to a massive
      size and never completely involute. Massive hemangiomas are also frequently
      associated with life-threatening complications, such as airway obstruction,
      platelet trapping (Kasabach-Merritt syndrome), and high-output heart failure. The
      use of interferon alfa-2a for the treatment of massive hemangiomas not responsive
      to traditional therapy has recently been reported. We present the successful use
      of interferon alfa-2a in a series of five patients with massive hemangiomas
      complicated by airway compromise, congestive heart failure, need for tracheotomy,
      Kasabach-Merritt syndrome, and failure to thrive, despite traditional therapy.

PMID- 7772327
TI  - Pathologic quiz case 2. Moderately differentiated neuroendocrine carcinoma of the
      larynx.

PMID- 7772328
TI  - Current concepts in the treatment of sinusitis.

PMID- 7772329
TI  - Botulinum toxin.

PMID- 7772330
TI  - Sex and familial sinistrality differences in cognitive abilities.
AB  - Cognitive functioning was assessed in 69 left-handed males and females with a
      positive family history of left-handedness and in 77 left-handed and 55 right
      handed males and females without familial left-handedness. Compared to females,
      males performed better on numerical reasoning and on two visuospatial tasks
      involving spatial manipulations (Figure Rotation and Surface Development). Within
      the group of left-handers, the multivariate effect for Familial Sinistrality was
      significant. Left-handers with familial left-handedness exhibited better scores
      on numerical reasoning, on verbal reasoning, and on two visuospatial tasks
      involving visual closure (Hidden Figures, Picture Completion) than did left
      handers without left-handed relatives. The nonfamilial left-handers also
      exhibited lower scores on both inductive reasoning tasks when they were compared
      to their right-handed counterparts. The outcome runs contrary to the prevalent
      conclusion that left-handers with left-handed relatives are more likely to
      exhibit lower performances on visuospatial tasks than left-handers without such
      relatives.

PMID- 7772331
TI  - A model and diagnostic measures for response time series on tests of
      concentration: historical background, conceptual framework, and some
      applications.
AB  - Based upon classical hypotheses about accumulating mental fatigue and distraction
      and its effect on response times, put forward in late 19th and early 20th century
      papers, a mathematical model is proposed for response times on tests of speed and
      concentration. The model assumes the random occurrence of very short distractions
      during information processing. It explains fluctuation and the increasing trend
      in response times on successive equivalent task units and leads to some simple
      diagnostic RT measures of speed and concentration as alternatives to the mean RT.
      A review is given of several experimental applications of the model, with
      subjects with and without concentration problems, using cancellation and digit
      addition tasks. The results demonstrate the potential usefulness of the model and
      the diagnostic measures derived from it. As predicted by the model, prolonged
      task performance yields an increasing trend in RT mean and variance that can be
      strongly reduced by giving very short resting periods very frequently, and to a
      lesser extent also by task alternation, but not by simply motivating the subjects
      to concentrate. Some practical implications for the administration and scoring of
      tests of speed and concentration are discussed, as well as limitations of the
      present results and the complementary relation of our approach to popular ones
      such as "stage analysis."

PMID- 7772332
TI  - Item and order recognition memory in subjects with hypoxic brain injury.
AB  - Subjects with hypoxic brain injury resulting in significant cell loss in the
      hippocampus but not the parahippocampal gyrus or temporal lobes and normal
      control subjects were tested for memory impairments. The Denman Memory Scale was
      given to all subjects as a baseline memory assessment. All subjects were then
      tested for item and order recognition memory for lists of six words, pictures,
      abstract pictures, spatial locations, and motor responses. Results indicated that
      hypoxic subjects are impaired compared to control subjects on the Denman memory
      scale for verbal, non-verbal, and full-scale memory quotients. In addition,
      results indicated that compared to control subjects, hypoxic subjects displayed
      item and order recognition deficits for words, pictures, abstract pictures, and
      spatial locations. A recency effect for item recognition of abstract pictures,
      spatial locations, and hand positions was found. For motor response order
      recognition, both primacy and recency effects were found, with deficits in
      performance for the middle items of the list. It appears that subjects with
      hypoxic brain injury in the face of severe memory deficits for words, pictures,
      abstract pictures, and spatial locations display residual capacity for
      remembering the last items for spatial locations, abstract designs, and hand
      positions. Hypoxic subjects also display residual capacity for remembering motor
      responses using episodic or data-based memory.

PMID- 7772333
TI  - Frontal lobe dysfunction in schizophrenia and obsessive-compulsive disorder: a
      neuropsychological study.
AB  - Converging evidence suggests there is a specific role of dorso-lateral-prefrontal
      cortex (DLPC) in schizophrenic disorders and of orbito-frontal cortex (OFC) in
      obsessive-compulsive disorder (OCD). Here, 25 schizophrenic and 25 OCD patients
      were evaluated with Wisconsin Card Sorting Test and Object Alternation Test;
      neuropsychological tools sensitive to DLPC and OFC damage, respectively; and
      compared with 25 subjects of a control group. Moreover, they all underwent
      Weigl's Sorting Test and the Word Fluency Test to assess global frontal
      functioning. The results indicated a DLPC deficit in schizophrenia and an OFC
      involvement in OCD. These data suggest that functional disorders of the central
      nervous system can be explored with neuropsychological instruments.

PMID- 7772334
TI  - Progressive ideomotor apraxia: evidence for a selective impairment of the action
      production system.
AB  - We report a patient with slowly progressive bilateral limb apraxia associated
      with an asymmetrical focal degenerative process of the parietal lobes. Clinical
      assessment of praxis production suggested a striking deficit in controlling the
      spatiotemporal attributes of purposeful skilled limb movements, consistent with
      ideomotor apraxia. The precise nature of the action production impairment was
      further defined by objective three-dimensional computergraphic analysis of
      transitive movements which demonstrated significant kinematic deficits in spatial
      accuracy, timing, spatiotemporal coupling, and joint coordination. Gesture
      comprehension and discrimination were spared. Furthermore, detailed evaluation of
      the conceptual praxis system revealed that despite an almost complete inability
      to perform transitive movements accurately, abstract knowledge of tool function
      and action was remarkably well preserved. The critical dissociation between
      intact conceptual knowledge of action and impaired movement execution documented
      in this case points to a fundamental competence/performance dichotomy in apraxia
      and provides empirical support for cognitive models of praxis that divide the
      action system into distinct conceptual and production subcomponents. Within this
      theoretical framework, our patient's severe ideomotor apraxia is interpreted to
      represent a selective disruption of the action production system.

PMID- 7772335
TI  - As the twig is bent: the biology and socialization of gender roles in women.
AB  - The present study supports the view that biological predisposition interacts with
      perceived parental influences to affect cross-gender role identity. Geschwind and
      colleagues have identified two patterns of brain organization (anomalous and
      standard dominance) assessed through individual and familial handedness.
      Anomalous dominant women who perceived their parents as definitely giving them
      permission for cross-gender behavior demonstrated high masculine/low feminine
      characteristics on the Bem Sex Role Inventory. The cross-gender role identity in
      this group differed significantly from the traditional gender role identity found
      in all other groups of females (including anomalous dominant women whose parents
      were perceived as less permissive and the women with standard dominance reporting
      both styles of parenting.

PMID- 7772336
TI  - Production of live offspring with predicted genotypes using PCR-RFLP analysis of
      polar bodies from mouse oocytes.
AB  - Accurate identification of genotypes in gametes and early embryos could
      facilitate the efficient production of offspring with desirable traits. This
      study demonstrates the feasibility of producing offspring with predictable
      genotypes from micromanipulated mouse oocytes. The Polymerase Chain Reaction
      (PCR) was used to amplify genes in the IA subregion of the major
      histocompatibility complex of the mouse. The validity of the approach was
      demonstrated in experiment 1 with IA haplotypes of unfertilized mouse ova
      amplified via PCR and distinguished by restriction fragment length polymorphism
      (RFLP) analysis. In experiment 2, fertilized oocytes were micromanipulated to
      remove the first and second polar bodies, which were then genotyped by validated
      PCR-RFLP procedures. Primary oocytes of heterozygous females contain two copies
      of each of the different alleles. Following meiosis I and II, the genotype of the
      ovum was predicted by subtracting the alleles observed in micromanipulated polar
      body samples. Sixty-two fertilized ova were micromanipulated and transferred to
      recipient females resulting in 27 live offspring (44%). The correct maternal
      contribution to the embryonic genotype was predicted in 19 of 27 (71%) offspring
      as confirmed by PCR-RFLP analysis of DNA from pup tails. Predicted genotypes of
      two pups were not confirmed (7%), whereas no prediction could be made in six
      cases (22%).

PMID- 7772337
TI  - Poly (A) binding protein is bound to both stored and polysomal mRNAs in the
      mammalian testis.
AB  - RNA-binding proteins that bind to the 3' untranslated region of mRNAs play
      important roles in regulating gene expression. Here we examine the association
      between the 70 kDa poly (A) binding protein (PABP) and stored (RNP) and polysomal
      mRNAs during mammalian male germ cell development. PABP mRNA levels increase as
      germ cells enter meiosis, reaching a maximum in the early postmeiotic stages, and
      decreasing to a nearly nondetectable level towards the end of spermatogenesis.
      Most of the PABP mRNA is found in the nonpolysomal fractions of postmitochondrial
      extracts, suggesting that PABP mRNA is either inefficiently translated or stored
      as RNPs during spermatogenesis. Virtually all of the testicular PABP is bound to
      either polysomal or nonpolysomal mRNAs, with little, if any, free PABP
      detectable. Analysis of several specific mRNAs reveals PABP is bound to both
      stored (RNP) and translated forms of the mRNAs. Western blot analysis and
      immunocytochemistry indicate PABP is widespread in the mammalian testis, with
      maximal amounts detected in postmeiotic round spermatids. The presence of PABP in
      elongating spermatids, a cell type in which PABP mRNA is nearly absent, suggests
      that PABP is a stable protein in the later stages of male germ cell development.
      The high level of testicular PABP in round spermatids and in mRNPs suggests a
      role for PABP in the storage as well as in the subsequent translation of
      developmentally regulated mRNAs in the mammalian testis.

PMID- 7772338
TI  - Activin beta A subunit is expressed in bovine oviduct.
AB  - It is evident that members of several growth factor families are actively
      involved in embryogenesis from its earliest phases. Several reports also indicate
      the oviduct as a possible source of growth factors, suggesting an active role of
      this organ in mammalian embryonic development. The aim of this study was to
      investigate the presence of activin/inhibin subunits in bovine oviduct since
      activin is a well-characterised morphogen in amphibian development. The presence
      of transcripts for alpha, beta A, and beta B subunits was investigated by
      analysing oviduct epithelial cells mRNA with reverse transcription-polymerase
      chain reaction (RT-PCR). Moreover, antisera specific for the three subunits were
      used for the Western blot analysis of the proteins secreted by oviduct epithelial
      cells in vitro and for their immunohistochemical localisation in different
      oviductal regions. Oviduct epithelial cells expressed only the beta A-subunit
      gene. Immunoreactive material was present among in vitro secreted proteins,
      indicating that the transcript is translated into a polypeptide that has been
      localised in the epithelium of both the ampullary and isthmic tract of the organ.
      Consistent with these results, the antisera for the alpha and beta B subunits did
      not recognise any specific antigen either among secreted proteins or in the
      sections. These results indicate that beta A subunit gene is expressed in bovine
      oviduct epithelial cells, and the protein is secreted in vitro and can be found
      along the whole extension of the organ. In the absence of alpha or beta B
      subunits, this suggests that activin A is present in bovine oviduct.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7772340
TI  - Localization of fibrillarin and nucleolin in nucleoli of mouse preimplantation
      embryos.
AB  - The localization of fibrillarin and nucleolin in the nuclei of mouse two-cell,
      four-cell, and eight-cell embryos has been studied using immunofluorescent
      staining with specific antibodies. In all of these cleavage stages, both antigens
      were associated exclusively with the peripheral region of the nucleolus precursor
      bodies (NPBs). The original speckled fluorescent staining pattern in the early
      two-cell stage was progressively changed into a continuous fluorescent-positive
      layer localized in the cortex of the NPBs in the four-cell embryos. The compact
      central area of NPBs was never stained. Both proteins were colocalized in the
      same substructures of developing nucleoli. In order to analyze the interaction of
      chromatin with NPBs, DNA structures were specifically immunolabelled. At the time
      of resumption of nucleolar transcription (in the two-cell mouse embryo), DNA was
      detected at the periphery of, but not penetrating into, NPBs. Our results confirm
      the view that the cortical region of NPBs could represent a nucleolonemal area
      involved in the resumption of nucleolar transcription in the early mouse embryo.

PMID- 7772339
TI  - Factors involved in nuclear reprogramming during early development in the rabbit.
AB  - Mechanisms of nuclear reprogramming and assessment of potential malfunctions that
      could be deleterious for development were evaluated in rabbit zygotes,
      parthenotes, and nuclear transfer embryos by analysis of DNA replication,
      nucleolar fibrillarin label, and localization of nuclear material reactive to the
      MPM-2 antibody. Nuclear transfer embryos were derived from G1/early S-phase donor
      nuclei and MII oocytes. In nuclear transfer embryos, DNA rereplication was likely
      to have occurred because label was incorporated, possibly in the centromeric
      regions of the chromosomes, prior to premature chromosome condensation and again
      following pronuclear formation. In parthenotes, DNA replication began very late
      in the cell cycle, which may be due to deficiencies in the artificial activation
      stimulus. The presence of fibrillarin label in the nucleolus was used as an
      indication of nucleolar transcriptional activity. Fibrillarin label was absent in
      embryos of all types up to the 16-32-cell stage. Although fibrillarin reappeared
      in nuclear transfer and parthenote embryos at the appropriate stage, not all
      blastomeres showed label indicating impaired development in these embryos.
      Labelling of phosphorylated epitopes by MPM-2 antibody showed a change in pattern
      of labelling during early development. Early cleavage stage embryos did not
      exhibit labelling over the spindle poles as did blastomeres from 32-cell embryos
      and tissue culture cells. All cell types exhibited labelling during interphase as
      dots located primarily over the nucleus in blastomeres from 32-cell embryos and
      in tissue culture cells, together with cytoplasmic label in embryos at early
      cleavage stages. Nuclear transplant embryos had a normal pattern of MPM-2 label.
      In contrast, the appearance of MPM-2 label in parthenotes depended on the type of
      calcium stimulation. These results demonstrate defects in DNA synthesis,
      nucleolar activity, and specific phosphorylation events, likely resulting from an
      improper activation stimulus and chromosome condensation in the transplanted
      nucleus.

PMID- 7772341
TI  - Initial culture behaviour of rat blastocysts on selected feeder cell lines.
AB  - To increase our understanding of rat embryos in culture and to attempt the
      isolation of blastocyst-derived cell lines, we examined the initial growth
      behaviour of rat blastocysts from four strains of rat on four different feeder
      cell layers. The feeders used were a continuous cell line of murine embryonic
      fibroblasts (STO), primary mouse (MEF) or primary rat (REF) embryonic
      fibroblasts, and a continuous cell line of rat uterine epithelial cells (RUCs). A
      medium that gave optimum plating efficiencies for murine ES cells was used in the
      rat embryo culture. Each culture system allowed hatching and attachment of the
      blastocysts, that is, the behaviour was similar on each feeder and each strain
      for the first 2 days in culture. Subsequently, there was a rapid differentiation
      of the Inner Cell Mass (ICM) cells on fibroblastic feeder cell layers (STO > MEF
      > REF), and this was generally complete after 3-6 days in primary culture. On
      RUCs, the ICM was found to increase in size without differentiation up to and
      including day 4 and in some cases longer. Embryo-derived cells were obtained by
      disaggregating and passaging ICMs on REF and RUC feeders. Rounded, refractile,
      and epithelial-like cells were isolated on REF and colonies of ES-like cells on
      the RUCs. The ES-like cells were positive for expression of alkaline phosphatase
      and stage-specific embryonic-antigen 1. This is an important first step towards
      the derivation and culture of pluripotent ES cells from the rat.

PMID- 7772342
TI  - DNA synthesis and pronucleus development in pig zygotes obtained in vivo: an
      autoradiographic and ultrastructural study.
AB  - Porcine zygotes flushed from oviducts 48, 52, 56, 60, or 64 hr after hCG were
      incubated 30 min in 3H-thymidine, transferred to nonradioactive medium for 2 hr,
      and incubated for 30 min with 14C-thymidine. After this procedure, ova were
      prepared (i.e., at 51, 55, 59, 63, or 67 hr after hCG) for autoradiography and
      ultrastructural observations, respectively. The first autoradiographic labelling,
      i.e., DNA synthesis, was observed at 56-56.5 hr after hCG, while the latest
      labelling was seen at 60-60.5 hr. At 51 hr after hCG, formation of the pronuclear
      envelope was observed, while no nucleolus precursor bodies or prestages to these
      structures were found. At 55 hr a few clusters of small electron-dense granules
      were observed, together with condensed chromatin in the pronuclei. At 59 hr the
      apposed regions of both pronuclei contained nucleolus precursor bodies and
      condensed chromatin, in close contact with both clusters of small granules and
      clusters of an additional category of large granules and the nuclear envelope.
      Additionally, large accumulations of the small granules were found in the
      vicinity of similarly sized accumulations of the large granules without chromatin
      association. At 63 hr the spherical accumulations of large granules on some
      occasions presented a central vacuole, and condensed chromatin and clusters of
      small granules were attached to its periphery. Within the vacuole, electron-dense
      material was found.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772343
TI  - PRINS as a method for rapid chromosomal labeling on human spermatozoa.
AB  - Direct in situ labeling of human spermatozoa was performed using the PRINS
      method. This technique is based on annealing of specific oligonucleotide primers,
      and subsequent primer extension by a Taq DNA polymerase. The reaction was carried
      out on a programmable temperature cycler, and labeling was obtained in a 1-hr
      reaction. The method was successfully tested with specific primers for
      chromosomes 13, 16, and 21. This suggests that PRINS may be a fast and reliable
      technique for detecting aneuploidies.

PMID- 7772344
TI  - Cumulus cell function during bovine oocyte maturation, fertilization, and embryo
      development in vitro.
AB  - Several contemporary micromanipulation techniques, such as sperm microinjection,
      nuclear transfer, and gene transfer by pronuclear injection, require removal of
      cumulus cells from oocytes or zygotes at various stages. In humans, the cumulus
      cells are often removed after 15-18 hr of sperm-oocyte coincubation to assist the
      identification of the fertilization status. This study was designed to evaluate
      the function of cumulus cells during oocyte maturation, fertilization, and in
      vitro development in cattle. Cumulus cells were removed before and after
      maturation and after fertilization for 0, 7, 20, and 48 hr. The cumulus-free
      oocytes or embryos were cultured either alone or on cumulus cell monolayers
      prepared on the day of maturation culture. Percentages of oocyte maturation,
      fertilization, and development to cleavage, morula, and blastocyst stages and to
      expanding or hatched blastocysts were recorded for statistical analysis by
      categorical data modeling (CATMOD) procedures. Cumulus cells removed before
      maturation significantly reduced the rate of oocyte maturation (4-26% vs. 93
      96%), fertilization (0-9% vs. 91-92%), and in vitro development at all stages
      evaluated. Cumulus cells removed immediately prior to in vitro fertilization
      (IVF) or 7 hr after IVF reduced the rates of fertilization (58-60% and 71%,
      respectively, vs. 91-92% for controls), cleavage development (40-47% and 53-54%
      vs. 74-78% for controls), and morula plus blastocyst development (15% and 24% vs.
      45%, P < 0.05). Cumulus cell co-culture started at various stages had no effect
      on fertilization and cleavage development but significantly improved rates of
      embryo development to morula or blastocyst stages (P < 0.05).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7772345
TI  - Identification of heterotrimeric G proteins in human sperm tail membranes.
AB  - Heterotrimeric G proteins play important roles as signal transducing components
      in various mammalian sperm functions. We were interested in the distribution of G
      proteins in human sperm tails. Prior to membrane preparation, spermatozoa were
      separated from contaminating cells which are frequently present in human
      ejaculates. Enriched human sperm tail membranes were generated by using
      hypoosmotic swelling and homogenization procedures. Antisera against synthetic
      peptides were used to identify G proteins in immunoblots. AS 8, an antiserum
      directed against an amino acid sequence that is found in most G protein alpha
      subunits, and A 86, which detects all known pertussis toxin-sensitive alpha
      subunits, reacted specifically with a 40-kDa protein. Antisera against individual
      G protein alpha-subunits failed to detect any specific antigens in enriched tail
      membranes. AS 36, recognizing the beta 2-subunit of G proteins, identified a 35
      kDa protein in sperm tail membranes. Antisera against the 36-kDa beta 1-subunit
      did not detect any relevant proteins in the membrane fraction. Neither G protein
      alpha-subunits nor G protein beta-subunits were found in the cytosol. ADP
      ribosylation of spermatozoal membrane or cytosolic proteins revealed no pertussis
      toxin-sensitive alpha-subunits. However, membrane preparations of nonpurified
      human spermatozoa contained alpha i2 subunits, as shown immunologically and by
      ADP ribosylation; they most probably derived from somatic cells which are
      frequently present in human ejaculates. Our results stress the fact that
      spermatozoa need to be purified before sperm membrane preparation to avoid
      misinterpretations caused by contaminating cells. Furthermore, we suggest that G
      proteins in membranes of human sperm tails belong to a novel subtype of G protein
      alpha-subunits; the putative beta-subunit was identified as a beta 2-subunit.

PMID- 7772346
TI  - Activation of a Gi protein in digitonin/cholate-solubilized membrane preparations
      of mouse sperm by the zona pellucida, an egg-specific extracellular matrix.
AB  - Mammalian sperm possess guanine nucleotide-binding regulatory proteins (G
      proteins) that are involved in signal transduction pathways leading to zona
      pellucida (ZP)-mediated acrosomal exocytosis. We have previously examined ZP-G
      protein dynamics in mouse sperm homogenates, as well as cell-free membrane
      preparations, and our data support the existence of ZP receptor-G protein
      complexes in sperm membranes. However, the composition of this complex has not
      been identified due to experimental limitations of the membrane preparations. In
      the present study, a detergent-solubilized preparation from mouse sperm membranes
      that retained the signaling properties of cell homogenates and cell-free membrane
      preparations was developed using buffers containing digitonin and cholate. GTP
      gamma S, a poorly hydrolyzable analogue of GTP, bound to these solubilized
      preparations in a specific and concentration-dependent fashion that reached
      saturation at 100 nM. Incubation of this solubilized membrane preparation with
      heat-solubilized ZP resulted in an increase in specific GTP gamma S binding in a
      concentration-dependent manner, with a maximal response at 4-6 ZP/microliters.
      Mastoparan (50 microM) increased GTP gamma S binding to levels similar to that
      seen with solubilized ZP. Mastoparan plus ZP stimulated GTP gamma S binding to
      the same extent as mastoparan or ZP alone. Pertussis toxin completely inhibited
      ZP-stimulated GTP gamma S binding and decreased mastoparan-stimulated GTP gamma S
      binding by 50-60%. Purified ZP3, the ZP component that possesses quantitatively
      all of the sperm binding and acrosomal exocytosis-inducing activities of the
      intact ZP, stimulated GTP gamma S binding to an extent similar to that of
      solubilized ZP.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772347
TI  - Effects of stimulators of protein kinases A and C and modulators of
      phosphorylation on plasminogen activator activity in porcine oocyte-cumulus cell
      complexes during in vitro maturation.
AB  - Effects of phorbol myristate acetate (PMA), dibutyryl cyclic AMP (dbcAMP), 6
      dimethylaminopurine (6-DMAP), and okadaic acid (OA) on plasminogen activator (PA)
      activity in porcine oocyte-cumulus cell complexes (POCC) in vitro were
      determined. Cumulus cell-enclosed oocytes were collected from 1-4 mm antral
      follicles and cultured in TCM-199 with 0.3% polyvinylpyrrolidone for 48 hr. PA
      activities in POCC were quantified using SDS-PAGE, casein-agar zymography, and
      densitometry. Two plasminogen-dependent lytic zones (93-96 kD and 71-79 kD) were
      observed in POCC. Addition of amiloride to the zymography, a competitive
      inhibitor of urokinase-type PA, failed to reduce activities in either zone,
      suggesting that the 71-79 kD band is a tissue-type PA (tPA) and the 93-96 kD band
      is possibly a tPA-inhibitor complex. Changes in PA activity due to the various
      treatments were expressed relative to the PA activity in 40 POCC. Increasing
      dbcAMP increased PA (P < 0.05) activity in dose-dependent fashion, whereas 6-DMAP
      and 10 and 100 ng/ml PMA inhibited (P < 0.05) PA activity. PA activity increased
      (P < 0.05) in POCC treated with up to 25 nM OA; however, activity decreased (P <
      0.05) at concentrations > 75 nM. Treatment with 25 nM OA also induced the
      expression of an amiloride-sensitive PA (49-52 kD). Germinal vesicle breakdown
      and progression to metaphase II were inhibited (P < 0.05) by 2.5 mM dbcAMP and 2
      mM 6-DMAP, whereas 100 ng/ml PMA and 25 nM OA inhibited (P < 0.05) only
      progression to metaphase II.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772348
TI  - Atrial natriuretic peptide: a chemoattractant of human spermatozoa by a guanylate
      cyclase-dependent pathway.
AB  - Atrial natriuretic peptide (ANP), found in mammalian ovarian granulosa cells and
      oocytes (Kim et al., 1992, 1993), induces the human acrosome reaction (Anderson
      et al., 1994). The purpose of the present study was to determine whether ANP, as
      egg-derived peptides from sea urchins, can act as a chemoattractant to human
      spermatozoa. Small lengths of capillary tubing that contained different
      concentrations of ANP were suspended over a suspension of washed spermatozoa. The
      number of spermatozoa that entered the tubing was determined. More than twice the
      number of spermatozoa moved into the tubing that contained a maximally effective
      concentration of ANP, as compared with tubing that contained only medium. The
      concentration of ANP that produced a half-maximal effect was 0.7 nM. The effect
      was blocked by LY83583, an inhibitor of guanylate cyclase. ANP produced more than
      a twofold increase in the rate of cGMP formation, an effect that was blocked by
      LY83583. Human ANP (5-27), a fragment of the intact peptide, had no
      chemoattractant activity. These findings suggest that a specific sperm receptor
      exists for the chemoattractant activity of ANP that is associated with guanylate
      cyclase. The chemoattractant activity of ANP is independent of the presence of
      extracellular calcium ions and is independent of the action of ANP as a stimulus
      of the acrosome reaction. There is no association between the chemoattractant
      activity of follicular fluid and the follicular fluid concentration of ANP. These
      data suggest that factors besides ANP are responsible for the chemoattractant
      activity of follicular fluid.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772349
TI  - Changes in dopamine uptake and developmental effects of dopamine receptor
      inactivation in the sea urchin.
AB  - [3H]-dopamine ([3H]-DA) uptake was measured in the presence or absence of the
      catecholamine uptake inhibitor nomifensine in both unfertilized and fertilized
      eggs. Specific [3H]-DA uptake depended on time and [3H]-DA concentration; it was
      high in unfertilized eggs, declined 20-30 min after fertilization, and rose again
      during cleavage. Irreversible inactivation of dopamine receptors by N
      ethoxycarbonyl-2-ethoxy-1,2-dihydroquinoline (EEDQ) resulted in a complete loss
      of sensitivity of egg adenylate cyclase to dopamine stimulation. In fertilized
      eggs treated with EEDQ for 1 hr, restoration of adenylate cyclase activity
      sensitive to dopamine stimulation could be observed 4 hr after the end of
      treatment, thus suggesting the appearance of new dopamine receptors in cleaving
      eggs. Short-term EEDQ treatment on unfertilized eggs, although not impairing
      fertilization, resulted in cleavage inhibition; the same treatment carried out
      soon after fertilization, on the other hand, elicited no effect on development.
      On the contrary, in embryos subjected to continuous treatment with EEDQ,
      development was impaired independent of the stage at which the treatment was
      started.

PMID- 7772350
TI  - Efficient production of transgenic cattle by retroviral infection of early
      embryos.
AB  - Production of transgenic cattle by microinjection of DNA has been difficult and
      costly. To explore an alternative method, one- to four-cell bovine embryos were
      exposed to a replication-defective retrovirus by microinjection of retrovirus
      producer cells into the perivitelline space. Embryos were cultured in vitro for 3
      4 days, then transferred to recipient cows for further development. Thirteen of
      22 embryos recovered at 15 days gestation and each of four fetuses recovered at
      90 days gestation were transgenic. Fetuses harbored between 2 and 12 proviruses,
      and within each fetus, identical patterns of integration were observed in seven
      tissues tested. Estimates of the number of proviruses per cell suggested that in
      three of the four fetuses, most, and possibly all, cells were transgenic. This
      technique should facilitate application of transgenic technology to cattle and
      other agriculturally important species.

PMID- 7772351
TI  - Parturient's posture during epidural puncture affects the distance from skin to
      epidural space.
AB  - STUDY OBJECTIVE: To assess the factors affecting the distance from skin to
      epidural space. DESIGN: Prospective observational study of consecutive cases over
      a 2-year period. SETTING: Inpatient obstetric unit in a French university
      hospital. PATIENTS: 2,123 consecutive term parturients who received epidural
      anesthesia for cesarean section or epidural analgesia for labor and vaginal
      delivery. INTERVENTIONS: At the time of epidural puncture, the interspace used
      and the patient's posture (sitting or left lateral decubitus) were recorded, and
      the distance from the skin to the epidural space (DS-ES) was measured to the
      nearest 0.5 cm using a marked epidural needle. MEASUREMENTS AND MAIN RESULTS: The
      relationship between patient factors [height, weight, body mass index (BMI;
      weight/height2), presence of scoliosis] and technical factors (interspace,
      patient's posture at puncture) versus DS-ES was investigated using multiple
      regression analysis. DS-ES correlated positively with the parturient's weight and
      BMI. In addition, DS-ES was significantly greater when epidural puncture was
      performed in the lateral position as compared with the sitting position.
      CONCLUSION: Both the patient's weight and position during epidural needle
      placement are important factors influencing DS-ES. A change from the sitting to
      the lateral position may increase DS-ES, causing catheter dislodgment and
      consequent inadequate analgesia. Clinical studies relating DS-ES to inadequate
      analgesia must take these factors into account.

PMID- 7772352
TI  - Comparison of cardiovascular responses to airway management: fiberoptic
      intubation using a new adapter, laryngeal mask insertion, or conventional
      laryngoscopic intubation.
AB  - STUDY OBJECTIVES: To evaluate the circulatory effects of fiberoptic intubation
      with a newly developed mask adapter and to compare these effects with those
      obtained with a conventional laryngoscope and laryngeal mask airway with general
      anesthesia. DESIGN: Randomized study. SETTING: Operating room at a university
      hospital. PATIENTS: 30 ASA physical status I adult patients scheduled for minor
      elective surgery. INTERVENTIONS: A Macintosh laryngoscope was used for intubation
      in Group L (n = 10), a fiberoptic bronchoscope with newly developed mask adapter
      was used in Group FI (n = 10), and a laryngeal mask airway was used in Group LMA
      (n = 10). Anesthesia was induced with thiamylal, fentanyl, and vecuronium.
      Patients were manually ventilated for 4 minutes with sevoflurane. Then their
      tracheas were intubated with a laryngoscope or fiberoptic bronchoscope, or a
      laryngeal mask airway was inserted. MEASUREMENTS AND MAIN RESULTS: Blood pressure
      (BP) and heart rate (HR) were measured continuously. After intubation, the
      magnitude of change of both BP and HR was greatest in Group L, next highest in
      Group FI, and lowest in Group LMA. CONCLUSION: Fiberoptic intubation with general
      anesthesia using the newly developed mask adapter offers an advantage over the
      standard laryngoscope for patients in whom pressor response of intubation is
      potentially hazardous.

PMID- 7772353
TI  - High-frequency jet ventilation in endolaryngeal surgery.
AB  - STUDY OBJECTIVE: To describe the clinical experience with high-frequency jet
      ventilation (HFJV) of the lungs during endolaryngeal surgery and its effect on
      acid-base balance and capillary PO2 (PcO2), PCO2, central hemodynamics, and
      tracheobronchial mucous membrane. DESIGN: Evaluation of different modalities of
      HFJV. SETTING: Operating rooms and otolaryngology intensive care unit in a
      medical institute. PATIENTS: 218 patients undergoing elective endolaryngeal
      surgery. INTERVENTIONS: Patients receive HFJV through catheters with an inner
      diameter of 1.4 to 1.8 mm. Catheters were introduced orotracheally,
      nasotracheally, percutaneously, or through a fenestrated tracheostomy tube.
      Minute volume was based on body weight times 0.2, corrected for acid-base
      balance. MEASUREMENTS AND MAIN RESULTS: Intraoperative cardiac output, airway
      pressure, changes in tracheobronchial mucosa, and acid-base balance were
      monitored. HFJV changed central hemodynamics slightly and preserved gas exchange:
      PcCO2 remained within normal limits, while PcO2 increased. Use of thin catheters
      enhanced largyneal exposure and surgical manipulation. Percutaneous
      catheterization permitted resumption of HFJV in the event of laryngeal edema and
      inadequate spontaneous respiration after surgery. CONCLUSION: HFJV leads to
      optimal conditions for endolaryngeal surgery, reverses constant outflow of the
      respiratory gas mixture, prevents aspiration of tissue products and blood, and
      removes smoke from the operative site when using laser surgery.

PMID- 7772354
TI  - Postoperative analgesia and plasma levels after transdermal fentanyl for
      orthopedic surgery: double-blind comparison with placebo.
AB  - STUDY OBJECTIVE: To determine whether transdermal fentanyl can provide a
      significant component of postoperative analgesia. DESIGN: Randomized, double
      blind study. SETTING: Inpatient surgery in a university hospital. PATIENTS: 40
      adult patients scheduled for orthopedic surgery with general anesthesia.
      INTERVENTIONS: 20 patients in each group had general anesthesia with propofol,
      isoflurane in nitrous oxide and oxygen (O2), and small boli of alfentanil or
      sufentanil. Preoperatively, the first group (F) received a transdermal
      therapeutic system fentanyl patch (75 micrograms/hr) for 72 hours, and the second
      group (P) received a placebo patch. Morphine was given postoperatively according
      to clinical necessity. MEASUREMENTS AND MAIN RESULTS: Morphine consumption, pain
      visual analog scale, and eventual sedation were assessed, as well as respiratory
      rate and blood pressure. Plasma fentanyl concentrations were determined. Only 11
      Group F patients needed morphine compared with 19 Group P patients, and mean
      morphine dose was significantly lower in Group F. One Group F patient had
      decreased O2 saturation and intense sedation, necessitating administration of
      naloxone. The mean maximum plasma fentanyl concentration in Group F was 1.63
      ng/ml. CONCLUSION: Efficacy of transdermal fentanyl for postoperative pain relief
      is shown, but intense respiratory depression is sometimes seen.

PMID- 7772355
TI  - Assessment of patient position for fiberoptic intubation using videolaryngoscopy.
AB  - STUDY OBJECTIVE: To compare laryngoscopic appearance obtained during flexible
      fiberoptic laryngoscopy with the patient's atlanto-occipital joint in the neutral
      and extended positions. DESIGN: Controlled clinical trial with each patient (in
      the neutral position) acting as his or her own control. SETTING: University
      teaching hospital. PATIENTS: 20 adult ASA physical status I and II patients,
      without anatomical airway abnormalities, undergoing elective surgical procedures.
      INTERVENTIONS: Fiberoptic laryngoscopy was performed on each patient with his or
      her atlanto-occipital joint in the neutral and extended positions. MEASUREMENTS
      AND MAIN RESULTS: Photographs of the laryngoscopic appearances were graded on a
      scale of 1 to 4 by a blinded observer according to the proportion of the
      laryngeal inlet visible. Atlanto-occipital extension improved laryngoscopic
      appearance in 14 cases and produced no change in the remaining 6. CONCLUSION:
      Atlanto-occipital extension is a useful maneuver during attempted fiberoptic
      intubation.

PMID- 7772356
TI  - The effects of oral droperidol versus oral metoclopramide versus both oral
      droperidol and metoclopramide on postoperative vomiting when used as a
      premedicant for strabismus surgery.
AB  - STUDY OBJECTIVE: To compare the efficacy of oral droperidol versus oral
      metoclopramide, or both oral droperidol and metoclopramide, on postoperative
      vomiting when used as a premedicant for strabismus surgery. DESIGN: Double-blind,
      randomized, prospective study. SETTING: Academic children's hospital. PATIENTS:
      154 ASA physical status I and II ambulatory patients, ages 1 to 15 years,
      scheduled for strabismus surgery. INTERVENTIONS: Patients were randomly assigned
      to receive colored sugar water containing either droperidol 300 mcg/kg orally,
      metoclopramide 0.15 mg/kg orally, both droperidol 300 mcg/kg and metoclopramide
      0.15 mg/kg orally, or no active ingredient (placebo group) as a premedicant. The
      premedications were given orally 1 to 1.5 hours prior to the operation.
      MEASUREMENTS AND MAIN RESULTS: Patients were analyzed for the number of episodes
      of vomiting from the time of their emergence from anesthesia through the first 24
      hours postoperatively, including the convalescent period at home. Patients were
      also analyzed for length of hospital stay. There were no statistically
      significant differences between groups regarding age, premedication time, surgery
      time, or discharge time. Droperidol and droperidol-metoclopramide were
      significantly more effective (p < 0.012) than either the metoclopramide group or
      the placebo group in preventing postoperative nausea and vomiting following
      strabismus surgery. CONCLUSIONS: Our data suggest that oral droperidol 300 mcg/kg
      and the combination of oral droperidol 300 mcg/kg and metoclopramide 0.15 mg/kg
      are effective in reducing the frequency of vomiting within the first 24 hours
      after strabismus surgery. The combination of oral droperidol and oral
      metoclopramide is highly effective in reducing the frequency of vomiting
      postoperatively in strabismus ambulatory surgery patients (p = 0.017). This
      combination seems to represent an inexpensive alternative to the more costly
      ondansetron.

PMID- 7772357
TI  - Pharmacodynamics of rocuronium with and without prior administration of
      succinylcholine.
AB  - STUDY OBJECTIVES: To compare succinylcholine (S) and rocuronium (R) used for
      endotracheal intubation, and to assess the possible action of S on subsequently
      administered R. DESIGN: Double-blind, randomized, phase III study. SETTING:
      University Medical Center. PATIENTS: 24 ASA physical status I and II patients,
      ages 28 to 65, undergoing general anesthesia for abdominal procedures.
      INTERVENTION: Double-blind administration of R 600 mcg/kg (Group A) or S 1 mg/kg
      was achieved with open label R 150 mcg/kg. Standardized general anesthetic
      technique with sodium thiopental, fentanyl, and nitrous oxide in oxygen was
      administered. MEASUREMENTS AND MAIN RESULTS: Neuromuscular junction was tested by
      ulnar nerve stimulation and mechanomyograph. Intubation was attempted at 80%
      first twitch depression of train-of-four. Heart rate and blood pressure were
      recorded throughout. Onset times were 74 +/- 37 seconds for S and 130 +/- 46
      seconds for R. Intubation times were 76 +/- 29 seconds for S and 85 +/- 23
      seconds for R (no significant difference). Good to excellent intubation
      conditions were achieved in both groups. S given prior to R decreased onset time
      and increased duration of R, when compared with R given alone. No drug related
      cardiovascular events were noted. CONCLUSION: Rapid intubation conditions can be
      obtained after both S and R. Given its overall safety profile, R can be used when
      S is contraindicated, or in healthy patients with no apparent difficult airway,
      when procedures are expected to last more than 25 minutes.

PMID- 7772358
TI  - A lower solubility recommends the use of desflurane more than isoflurane,
      halothane, and enflurane under low-flow conditions.
AB  - STUDY OBJECTIVE: To determine whether the lower solubility of desflurane, over
      that of isoflurane, enflurane, and halothane, favors its use in low-flow
      anesthesia. DESIGN: Prospective clinical study. SETTING: Technical University of
      Munich. PATIENTS: 40 elderly (> or = 65 yrs), ASA physical status II and III
      surgical patients. INTERVENTIONS: All patients were anesthetized and received
      delivered concentrations (FD) of 4% desflurane, 1.5% isoflurane, 1.8% enflurane,
      or 0.9% halothane (n = 10 patients for each anesthetic) in a fresh gas inflow of
      3 L/min (high-flow), until end-tidal target concentrations (FA) of 2% desflurane,
      0.5% isoflurane, 0.6% enflurane, and 0.3% halothane were obtained. After 30
      minutes, the inflow was decreased to 1 L/min (low-flow), and the FD and the
      inspired concentration (FI) were adjusted to maintain the target concentration.
      MEASUREMENTS AND MAIN RESULTS: The concentrations of the halogenated anesthetics,
      as well as nitrous oxide, oxygen (O2), and carbon dioxide, were measured in
      delivered gas at the common gas outlet and at the endotracheal tube connector.
      Transcutaneous O2 saturation, noninvasive blood pressure, and heart rate were
      also measured. During the first 30 minutes of high-flow administration, the
      target concentration was attained sooner with desflurane than with isoflurane,
      enflurane, or halothane (median levels: 4 min vs. 6 min, 8 min, or 10 min; p <
      0.01). After the reduction of inflow to 1 L/min, FD had to be materially
      increased to maintain F1 and FA for the more soluble anesthetics, but not for
      desflurane. CONCLUSIONS: At low flows, FD provides a reasonable surrogate of F1
      and FA for desflurane, but not for isoflurane, enflurane, or halothane. The rapid
      and predictable titrability of desflurane favors its safe use in low-flow
      technique.

PMID- 7772359
TI  - Comparative effects of lidocaine, esmolol, and nitroglycerin in modifying the
      hemodynamic response to laryngoscopy and intubation.
AB  - STUDY OBJECTIVE: To compare the safety and efficacy of lidocaine, esmolol, and
      nitroglycerin in modifying the hemodynamic response to laryngoscopy and
      intubation. DESIGN: Randomized, placebo-controlled, double-blind study. SETTING:
      University-affiliated VA medical center. PATIENTS: 40 ASA physical status I and
      II patients undergoing electric surgery with general endotracheal anesthesia.
      INTERVENTIONS: Anesthesia was induced with thiopental sodium 5 mg/kg, and
      intubation was facilitated with vecuronium 0.15 mg/kg. Isoflurane (0.5% to 1%)
      and 50% nitrous oxide in oxygen were used for maintenance of anesthesia. In
      addition, patients received one of the following four study drugs intravenously
      (i.v.) prior to laryngoscopy: Group 1 (control) = saline 5 ml; Group 2 =
      lidocaine 1.5 mg/kg; Group 3 = esmolol 1.4 mg/kg; Group 4 = nitroglycerin 2
      micrograms/kg. MEASUREMENTS AND MAIN RESULTS: Mean arterial pressure (MAP) and
      heart rate (HR) were recorded every minute for 20 minutes following induction of
      anesthesia. Following laryngoscopy and intubation, MAP increased significantly in
      all four treatment groups (control 49% +/- 19%, lidocaine 55% +/- 26%, esmolol
      25% +/- 11%, nitroglycerin 45% +/- 21%) compared with preinduction baseline
      values. In the esmolol-pretreated patients, the increase in HR was significantly
      lower (20% +/- 3%) compared with the nitroglycerin (37% +/- 8%), lidocaine (52%
      +/- 8%), and control (29% +/- 4%) groups. CONCLUSIONS: Lidocaine 1.5 mg/kg i.v.
      and nitroglycerin 2 micrograms/kg i.v. were ineffective in controlling the acute
      hemodynamic response following laryngoscopy and intubation. Esmolol 1.4 mg/kg
      i.v. was significantly more effective than either lidocaine or nitroglycerin in
      controlling the HR response to laryngoscopy and intubation (p < 0.05). Esmolol
      also was significantly more effective than lidocaine in minimizing the increase
      in MAP (25% vs. 55%).

PMID- 7772360
TI  - Acquired QT interval changes and neck dissections.
AB  - STUDY OBJECTIVE: To determine if acquired long QT syndrome following right or
      left, radical or modified, neck dissections result in malignant arrhythmias or
      deaths. DESIGN: Prospective study. SETTING: Inpatient head and neck service of
      the Massachusetts Eye and Ear Infirmary. PATIENTS: 69 patients who underwent
      extensive neck surgery, without congenital long QT syndrome, medications known to
      prolong the QT interval, preoperative ventricular arrhythmias, or electrolyte
      abnormalities. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Preoperative
      and postoperative electrolytes were evaluated. Preoperative and postoperative
      electrocardiograms and QT intervals were evaluated. Continuous intraoperative and
      10- to 12-hour postoperative monitoring of lead II or V5 were evaluated. Twenty
      six patients (Group 1) underwent either right radical neck dissection or modified
      right radical neck dissection, 25 patients (Group 2) underwent either left
      radical neck dissection or modified left neck dissection, and 18 patients (Group
      3) underwent extensive neck surgery without radical or modified neck dissection.
      Postoperatively, 38 patients (19 Group 1, 11 Group 2, and 8 Group 3 patients)
      developed a QT interval corrected for heart rate (QTc) of greater than 440
      milliseconds. Repeated measures analysis of variance, comparing preoperative and
      postoperative QTc showed a statistically significant preoperative to
      postoperative change, but no significant difference among the three groups. No
      malignant arrhythmias or deaths were recorded in any of the three groups.
      CONCLUSIONS: Acquired long QT syndrome following radical neck dissection, without
      congenital, metabolic, or pharmacologic disturbance, is unlikely to trigger
      malignant arrhythmias, as previously reported for right radical neck dissection.

PMID- 7772361
TI  - Prevention of emesis after strabismus repair in children: a prospective, double
      blinded, randomized comparison of droperidol versus ondansetron.
AB  - STUDY OBJECTIVE: To compare the effectiveness of ondansetron with droperidol in
      preventing postoperative emesis in children after strabismus repair. DESIGN:
      Randomized, double-blind study. PATIENTS AND SETTING: 57 ASA physical status I
      and II children aged 3 to 14 years, undergoing outpatient strabismus repair in
      two separate study centers. INTERVENTIONS: Patients were randomized to receive
      either 0.15 mg/kg intravenous (i.v.) ondansetron or 0.075 mg/kg i.v. droperidol
      shortly after induction of anesthesia. MEASUREMENTS AND MAIN RESULTS: Number of
      episodes of emesis and times to discharge from the recovery room and ambulatory
      center were assessed. Twenty-nine (94%) of 31 children who received ondansetron
      and 21 (81%) of 26 children who received droperidol were emesis-free (p = NS).
      There were no significant differences in the number of episodes of emesis on the
      day after surgery or times to discharge. CONCLUSIONS: Ondansetron is at least as
      effective as droperidol in reducing the frequency of emesis in children after
      strabismus repair, and it did not shorten times to discharge home. The low number
      of patients in our study may have masked a difference in effect between the two
      groups. The clinician should decide whether the increased cost of ondansetron
      justifies its use over other antiemetics.

PMID- 7772362
TI  - A random trial comparing recovery after midazolam-alfentanil anesthesia with and
      without reversal with flumazenil, and standardized neurolept anesthesia for major
      gynecologic surgery.
AB  - STUDY OBJECTIVE: To compare the recovery characteristics of total intravenous
      anesthesia (TIVA) using midazolam-alfentanil, with or without reversal with
      flumazenil to a standardized neurolept anesthesia with nitrous oxide (N2O).
      DESIGN: Randomized, double-blinded clinical study. SETTING: University medical
      center. PATIENTS: 80 ASA physical status I and II women scheduled for major
      elective gynecologic surgery. INTERVENTIONS: Patients were anesthetized with one
      of three different anesthetic techniques. Patients in the TIVA group with
      reversal received midazolam-alfentanil reversed with flumazenil (Group 1), the
      TIVA group without reversal received midazolam-alfentanil reversed with placebo
      (Group 2), and patients in the neurolept group received anesthesia using
      thiopental sodium, droperidol, fentanyl, and N2O (Group 3). MEASUREMENTS AND MAIN
      RESULTS: Recovery was assessed by an observer blinded to the treatment
      allocation, using a Modified Steward Recovery Score and judgment of orientation
      and comprehension, collaboration and degree of sedation for the first 4 hours
      after extubation. Arterial blood gases were measured 30 minutes after extubation.
      A questionnaire regarding the degree of perioperative amnesia was presented to
      the patients 4 and 24 hours after surgery. The recovery scores were better in the
      TIVA group with reversal than in the other two groups from 0 to 30 minutes
      postoperatively. No difference between the groups could be found thereafter,
      although after 30 minutes some resedation occurred in the TIVA group with
      reversal. The median injected amount of flumazenil in Group 1 was 0.5 mg.
      Respiratory depression (breathing frequency below 10 breaths/min) was reversed
      with naloxone in one patient in the TIVA group with reversal, five patients in
      the TIVA group without reversal, and no patient in the neurolept group (p <
      0.001). On blood gas analysis, there was no evidence of hypoxemia or carbon
      dioxide retention. No difference was seen between the groups regarding
      consumption of analgesics, degree of amnesia, or patient rating of the quality of
      anesthesia. One patient in Group 2, however, recorded awareness at skin incision
      when questioned 4 hours after the operation, but could not recall this 20 hours
      later. CONCLUSIONS: TIVA with midazolam and alfentanil can be used for major
      gynecologic surgery. Recovery in the neurolept group was equal to recovery in the
      TIVA group without reversal, and flumazenil improves the recovery after midazolam
      anesthesia. Overall, in comparison with the neurolept technique no major
      advantage could be demonstrated using TIVA with midazolam-alfentanil.

PMID- 7772363
TI  - Risk of high spinal anesthesia following failed epidural block for cesarean
      delivery.
AB  - Recent case reports suggest there may be an increased risk of abnormally high
      blockade ("high spinal") from subarachnoid anesthesia if it is performed
      immediately after epidural anesthesia. We describe two cases of high spinal
      anesthesia following failed epidural block in obstetric patients scheduled for
      cesarean delivery. Using a retrospective chart review, we estimate the incidence
      of high spinal anesthesia to be 11% in patients after prior failed epidural
      blockade versus fewer than 1% in patients undergoing spinal anesthesia alone.

PMID- 7772364
TI  - Phrenic nerve injury following scalenectomy in a patient with thoracic outlet
      obstruction.
AB  - We present a case in which a patient with normal pulmonary reserve experienced
      orthopnea and hypoxia secondary to unilateral diaphragmatic paralysis following
      right scalenectomy. This operation was performed in an attempt to relieve
      neurovascular compromise at the thoracic outlet. To our knowledge, this
      association has not been previously described in the literature.

PMID- 7772365
TI  - The cost of modern technology.
AB  - Continuous infusion of intravenous (i.v.) drugs is increasing in popularity, as
      technological advances in equipment (such as "smart" pumps) and pharmacologic
      improvements of drugs (such as ultra-short acting drugs) are introduced into
      clinical anesthesia practice. Such new technology, however, also introduces
      potential new complications. We report one such complication associated with the
      improper manufacturing of a proprietary i.v. tubing and cassette system.

PMID- 7772366
TI  - Carbon monoxide intoxication during pregnancy: a case presentation and
      pathophysiologic discussion, with emphasis on molecular mechanisms.
AB  - In carbon monoxide (CO) poisoning, the mortality and morbidity risk does not
      always correlate with the level of carboxyhemoglobin (COHb). Recent studies
      confirm that the mitochondrial cytochrome portion of the respiratory chain is
      susceptible to CO toxicity at concentrations traditionally considered nontoxic.
      These laboratory findings correlate with subtle neurologic symptoms detected by
      psychometric studies in individuals many days from the time of acute
      intoxication. Additionally, in the pregnant patient, a time lag for both uptake
      and elimination of CO between the mother and fetus has been demonstrated, with
      the fetus at risk for hypoxia even when the mother's blood level of CO is
      nontoxic. Hyperbaric oxygen (HBO) therapy in pregnant patients has not been shown
      to have adverse effects on the fetus. We present a case of CO intoxication in
      late pregnancy treated with HBO therapy without adverse consequences.

PMID- 7772367
TI  - Anesthesia in the presence of complete heart block.

PMID- 7772368
TI  - The post-anesthesia recovery score revisited.

PMID- 7772369
TI  - Nebulized bupivacaine attenuates the heart rate response following tracheal
      intubation.
AB  - STUDY OBJECTIVE: To determine whether nebulized bupivacaine attenuates the acute
      hemodynamic response to laryngoscopy and intubation. DESIGN: Prospective,
      randomized, placebo-controlled study. SETTING: Operating room at a university
      medical center. PATIENTS: 40 health ASA physical status I and II patients
      scheduled for minor surgical procedures. INTERVENTIONS: Patients were randomized
      to receive 4 ml of a nebulized solution of either saline (n = 20) or 0.75%
      bupivacaine (n = 20) 15 minutes before induction of anesthesia. On completion of
      the aerosol treatment, fentanyl 1.5 micrograms/kg was given intravenously (i.v.),
      and 3 minutes later anesthesia was induced with thiopental sodium 5 mg/kg i.v.
      and succinylcholine 1.5 mg/kg i.v.. Laryngoscopy was begun 60 seconds after
      induction, and the trachea was intubated at 90 seconds. Anesthesia was maintained
      with 50% nitrous oxide in oxygen following intubation, and 1% isoflurane was
      administered at 180 seconds. MEASUREMENTS AND MAIN RESULTS: Heart rate (HR) and
      blood pressure were recorded automatically every 30 seconds for 5 minutes.
      Bupivacaine significantly attenuated HR (p < 0.05) but not the hypertensive
      response to laryngoscopy and intubation. CONCLUSION: Nebulized 0.75% bupivacaine
      was only partially effective in blunting the hemodynamic response to tracheal
      intubation.

PMID- 7772370
TI  - MR imaging of the retroperitoneum.
AB  - The diagnosis of retroperitoneal pathology has historically presented a challenge
      to physicians. The signs and symptoms of retroperitoneal diseases are myriad and
      often subtle. Cross-sectional imaging techniques have therefore had a major
      impact on retroperitoneal diagnosis. Computed tomography (CT) is currently the
      standard imaging technique for evaluating the retroperitoneum. Magnetic resonance
      (MR) imaging is also well suited for retroperitoneal imaging and has several
      advantages over CT. MR imaging is the preferred technique in patients with
      contraindications to iodinated contrast material due to renal dysfunction or
      allergy. It excels at evaluating the blood vessels, providing a reliable
      assessment of vessel patency, aneurysm, or dissection. The ability of MR imaging
      to acquire images without exposure to ionizing radiation facilitates imaging of
      obstetric and pediatric patients. The ability to acquire images in any plane is a
      distinct advantage for assessing the extent and origin of retroperitoneal
      pathology, although this can now be accomplished with spiral CT as well as MR
      imaging. The spatial resolution of CT is currently superior to MR imaging for
      most retroperitoneal studies, but this may change with continued technological
      advances such as improved phased array coil systems (Bidgood WD Jr, Schiebler ML.
      Retroperitoneum and mesentery. In: Ros PR, Bidgood WD Jr, eds. Abdominal magnetic
      resonance imaging. St. Louis: Mosby Year Book, 1993:310-47). Finally, MR imaging
      provides the flexibility to tailor each examination to the specific clinical
      question. With few exceptions, anything CT can do in the retroperitoneum, MR
      imaging can do as well or better.

PMID- 7772371
TI  - Echo planar imaging of the abdomen.
AB  - Echo planar imaging (EPI) is an ultrafast magnetic resonance (MR) imaging method
      first proposed more than 15 years ago. With EPI, all the information necessary to
      create an image is obtained very rapidly (typically on the order of 50-150 ms).
      Special hardware modifications are needed, particularly in the magnetic field
      gradients and data acquisition systems, to permit such high-speed imaging. In the
      abdomen, EPI images are insensitive to degradation from breathing or peristaltic
      motion. The essentially infinite repetition time and lack of motion-induced
      blurring can improve lesion characterization compared with standard imaging
      methods. Segmented EPI permits high-resolution T2-weighted images to be acquired
      within a single breath-hold. Diffusion imaging, which was previously restricted
      to the brain, can now be done in the abdomen because of the relative
      insensitivity of EPI images to bulk motion. Diffusion imaging of the kidney has
      been found to correlate with its functional status. By using EPI readouts, MR
      angiography can be done more quickly. Further work is needed to improve the
      spatial resolution and overcome magnetic susceptibility artifacts, particularly
      with single-shot EPI. Nonetheless, EPI offers considerable potential for improved
      anatomical and functional imaging of the abdomen.

PMID- 7772372
TI  - Magnetic resonance imaging of the liver.
AB  - A variety of diffuse and focal disease processes affect the liver. MRI is likely
      the imaging modality of choice for investigation of patients suspected of having
      diffuse disease such as cirrhosis, hemochromatosis, or fatty infiltration. MRI is
      extremely effective at detecting and characterizing focal hepatic lesions. In
      particular, patients suspected of possessing hemangiomas, hepatocellular
      carcinoma, or hypervascular liver metastases are better evaluated by MRI than
      other imaging modalities. Immediate post gadolinium spoiled gradient echo and T2
      weighted fat suppressed spin echo are very effective at lesion detection, whereas
      serial post gadolinium spoiled gradient echo is essential for lesion
      characterization. New fast T2-weighted sequences and tissue specific contrast
      agents may further increase the role of liver MRI by shortening exam time and
      increasing sensitivity and specificity, respectively.

PMID- 7772373
TI  - Magnetic resonance imaging of the spleen and pancreas.
AB  - MRI of the spleen and pancreas requires specialized sequences which diminish
      artifacts in the upper abdomen. High temporal resolution sequences (e.g., spoiled
      gradient echo) acquired immediately after intravenous Gd-DTPA administration are
      necessary for imaging both the spleen and pancreas. In evaluating the spleen,
      early post Gd-DTPA images are essential as many focal disease processes (e.g.,
      lymphomatous deposits or metastases) equilibrate rapidly (< 2 min) with splenic
      parenchyma. Complete pancreatic examination also requires the use of T1-weighted
      fat suppressed spin echo. T2-weighted images provide complementary information in
      a number of settings, in particular in the evaluation of islet cell tumors.
      Pancreatic ductal carcinoma is low signal on T1-weighted images and enhances in a
      diminished fashion on immediate post Gd-DTPA images. These tumors are well
      differentiated from focal chronic pancreatitis and islet celltumors based on
      their appearances on combined T1, T2-weighted and immediate post Gd-DTPA enhanced
      images.

PMID- 7772374
TI  - Magnetic resonance imaging of the adrenal gland and kidney.
AB  - MR is able to detect and characterize the majority of disease entities which
      affect the adrenal glands and kidneys. In the evaluation of the adrenal glands in
      phase and out-of-phase T1-weighted imaging may be the most effective noninvasive
      method to distinguish benign adenomas from malignant masses. T2-weighted images
      are sensitive and relatively specific for the investigation of pheochromocytoma.
      Although MRI is excellent at evaluating the kidneys, the lower cost and good
      image quality of CT render it the primary diagnostic tool for renal imaging. The
      major current applications for MRI of the kidneys include evaluation of patients
      with allergy to iodinated contrast, renal failure, and the characterization of
      complicated renal lesions. Evaluation of venous thrombus in the context of renal
      cancer is likely also a useful role for MRI.

PMID- 7772375
TI  - A practical method for fission yeast transformation by electroporation.
AB  - High-voltage shock within a very short duration under the proper conditions
      causes cells to incorporate exogenous macromolecules. This technique,
      electroporation, has been widely used in recent years to transform many
      organisms. We determined optimum conditions for fission yeast transformation
      using this method. Of nineteen combinations of electric field strength and pulse
      time examined, 1.75 kV/0.2 cm, 4 msec pulse was found to provide approximately
      4.0 x 10(5) transformants per micrograms of DNA. Other factors responsible for
      the transformation efficiency in fission yeast are also discussed.

PMID- 7772377
TI  - New DNA data collected and processed at DNA Data Bank of Japan.

PMID- 7772376
TI  - Phenotypic and molecular characterization of croaker, a new mating behavior
      mutant of Drosophila melanogaster.
AB  - Mating of Drosophila melanogaster is a stereotypically patterned behavior
      consisting of a fixed sequence of actions that is primarily under genetic
      control. Although courtship can be easily monitored and quantified, little is
      known about its neural basis. To obtain a better understanding of cellular and
      molecular mechanisms underlying courtship, we have isolated mutants that disrupt
      specific aspects of mating behavior. The croaker mutant was isolated from
      approximately 1,000 lines harboring single P-element insertions by screening for
      aberrant courtship song: croaker males often generate polycyclic pulse song while
      most of the song pulses are monocyclic in the wild-type. The mutant is also
      defective in flight. Intracellular recordings of excitatory junction potentials
      from larval body wall muscles and Ca++ action potentials from adult indirect
      flight muscles demonstrated that neuromuscular transmission and Ca++
      electrogenesis in the muscle fibers are not impaired by the croaker mutation. To
      define the croaker gene molecularly, genomic DNA surrounding the P-element
      insertion site was cloned by plasmid rescue and subsequent screening of a cosmid
      library. Northern blotting with the genomic DNA probes detected three transcripts
      in the wild-type, which were not expressed in the croaker mutant.

PMID- 7772378
TI  - Geographical distribution of the Hbb haplotypes in the Mus musculus subspecies in
      eastern Asia.
AB  - We surveyed the geographical distribution of Hbb haplotypes of the house mouse,
      Mus musculus, in the former USSR and the northern part of China. Mice with the w1
      haplotype were distributed from the coastal area of the Black Sea to the Maritime
      Province of Siberia in the former USSR and in the area north of the Yangtze River
      in China. Mice with the p haplotype were found in the areas surrounding those
      populated with the w1 haplotype mice. In the Maritime Province and the southern
      part of Siberia, the d haplotype was predominant. The correlation between the
      geographical variation of the Hbb haplotypes and the distribution of the Mus
      musculus subspecies in the eastern part of the Eurasian Continent, is discussed.

PMID- 7772379
TI  - Deletion of the Wilson's disease gene in hereditary hepatitis LEC rats.
AB  - LEC rats develop disorder of cooper metabolism and hepatitis similar to those of
      human Wilson's disease. We recently demonstrated that the gene responsible for
      hepatitis (hts) of LEC rats is homologous to Wilson's disease gene (WD). The
      present study showed a deletion of at least 90 base pair of WD cDNA in LEC rats,
      which corresponds to nucleotides 3981 to 4071 in human WD cDNA sequence. This
      deletion was linked with hepatic copper accumulation and hepatitis, and
      considered to be a primary mutation for hepatic disorder in the LEC rat. The WD
      gene was assigned to rat chromosome 16 at band q12.2-q12.4 by fluorescence in
      situ hybridization (FISH).

PMID- 7772380
TI  - DNA sequence changes in mutations in the tonB gene on the chromosome of
      Escherichia coli K12: insertion elements dominate the spontaneous spectra.
AB  - To obtain insight into the nature and mechanisms of spontaneous mutations,
      Escherichia coli K12 strain TM31 was constructed to determine, by DNA sequencing,
      the mutational spectrum of the tonB gene on the chromosome. We inserted the
      chloramphenicol resistant gene 1.6 kb upstream of the tonB gene, thus making it
      possible to retrieve the mutated tonB gene from the chromosome by shotgun cloning
      using a drug-resistant marker. The spontaneous mutation frequency in the tonB
      gene, which was judged by its colicin B-resistant phenotype, is 3-10 x 10(-7).
      Spontaneous mutations were dominated by large insertions that are identified by
      DNA sequencing to be IS elements; IS1 dominated, but IS2, IS5, and IS10 were also
      obtained. In uvrA- strain, transposition of both IS10-R and IS10-L are equally
      increased, suggesting the interaction of the UvrA protein and IS10 transposition.
      The base substitutions are the second largest group of mutations, among which G:C
      ->A:T transition is predominant. Deletions also contribute significantly in wild
      type with regard to DNA repair and uvrA- strains, but not recA- strain,
      suggesting that the RecA protein is involved to some extent in deletion
      formation. Endpoints of these deletions do not always correlate with the presence
      of repeated sequences, indicating the absence of homologous recombination for
      deletion formation.

PMID- 7772381
TI  - Cytogenetical studies on the genus Oryza. XIV. Intergeneric hybridizations
      between tetraploid Oryza species and diploid Leersia species.
AB  - Intergeneric hybrids involving Oryza punctata (2n = 48, BBCC) with Leersia
      tisseranti (2n = 24), O. punctata with L. perrieri (2n = 24), O. latifolia (2n =
      48, CCDD) with L. tisseranti and O. latifolia with L. perrieri were produced at
      frequencies varying from 0.11% to 0.23% of the pollinated spikelets. Plant
      morphologies of the hybrids strongly resembled the tetraploid Oryza species. Five
      hybrids obtained from the four cross-combinations had the expected chromosome
      number of 2n = 36 (trihaploid) in the somatic cells. The average meiotic
      chromosome pairings per cell were 0.23II + 35.58I + 0.14(1)/2I (dividing
      univalent) for O. punctata x L. tisseranti; 0.11II + 35.51I + 0.22(1)/2I for O.
      punctata x L. perrieri; 0.17II + 35.63I + 0.11(1)/2I for O. latifolia x L.
      tisseranti; and 0.25II + 35.49I + 0.15(1)/2I for O. latifolia x L. perrieri. From
      these results, it seems that most of the bivalents observed at MI with a low
      frequency had originated from the autosyndetic association of the chromosomes of
      O. punctata or O. latifolia. The results described above suggest that there is no
      genomic relationship between the parental species in each cross combination.

PMID- 7772382
TI  - Relationships between morphometric and mitochondrial DNA differentiation in
      laboratory strains of musk shrews (Suncus murinus).
AB  - Morphometric differentiation among six strains of musk shrews (Suncus murinus)
      originating in Bangladesh (BAN), Sri Lanka (SRI), and four Japanese areas,
      Nagasaki (NAG), Okinawa Island (OKI), Tokunoshima Island (TKU), and Taramajima
      Island (TR), was examined by use of skull and external measurements. These data
      were compared with mitochondrial DNA (mtDNA) differentiation previously reported.
      Significant sexual dimorphism was observed in all morphometric characters of the
      six strains, except for two characters in the TR strain. The six strains were
      clearly grouped by principal component analysis into three body-size types: large
      BAN shrews, intermediate SRI shrews, and small Japanese shrews. By canonical
      discriminant analysis, the NAG strain was further distinct from the other three
      Japanese strains despite their apparent similarities in external morphology, and
      was characterized by having the most unusual shape in the six strains. No
      individuals were misclassified as to their geographic origin for both sexes of
      the six strains. The morphometric differentiation pattern based on only the first
      canonical variate, extracting an overall size factor, was concordant with the
      mtDNA differentiation pattern (rss = 0.944, P < 0.001 in males and rss = 0.930, P
      < 0.001 in females). In contrast, the morphometric differentiation pattern
      estimated from the second to the fifth canonical variates, representing shape
      factors, was apparently discordant with the mtDNA differentiation pattern (rss =
      0.467, P > 0.05 in both sexes). It was previously reported that a partial
      premating reproductive isolation mechanism is caused by the difference in body
      size between mating pairs. Thus, body size may be a factor useful for
      understanding the mechanisms of population differentiation in this species.

PMID- 7772383
TI  - Repetitive DNA sequence families in Hemitaxonus minomensis and H. athyrii
      (Hymenoptera; Tenthredinidae).
AB  - Families of the repetitive DNA sequences from Hemitaxonus minomensis and H.
      athyrii were characterized. pHMS family and pHME family in H. minomensis consist
      of tandemly arranged arrays whose basic repeat units are 260 bp and 330 bp,
      respectively. pHAE family in H. athyrii consists of a tandemly arranged array
      whose basic repeat unit is 330 bp. pHMS family and pHME family occupy
      approximately 4.8% and 0.07% of the genome of H. minomensis, respectively. By
      contrast, in H. athyrii, pHAE family comprise 0.04% of the genome. Nucleotide
      sequence comparison of these three repetitive families showed very little
      homology. Southern blot hybridization using six species of Hemitaxonus showed
      that these repetitive families are species specific.

PMID- 7772384
TI  - DNA fingerprinting of animal genomes by CA-repeat primed polymerase chain
      reaction.
AB  - CA-repeat primed polymerase chain reaction (CAP-PCR), using degenerate primers
      which anneal at the ends of (CA)n sequences in eukaryotic genomes, was attempted
      to assess its potential to monitor the genomic polymorphisms in various animals.
      Three mammalian, three avian, one fish and one insect species were examined and
      all showed primer-specific DNA fingerprints by CAP-PCR. Polymorphic bands
      observed in a laboratory-bred vole family were segregated in Mendelian manner.
      The present CAP-PCR DNA fingerprinting therefore is a simple and useful method
      for examining genomic variations in most animals without prerequisite knowledge
      of DNA sequences.

PMID- 7772385
TI  - Analysis of the tyrosinase gene of the Japanese pond frog, Rana nigromaculata:
      cloning and nucleotide sequence of the genomic DNA containing the tyrosinase gene
      and its flanking regions.
AB  - Three genomic DNA fragments containing the tyrosinase-encoding gene (TYR) of the
      Japanese pond frog, Rana nigromaculata, were cloned. The first, clone I, was
      isolated from a genomic library of sperm DNA using the mouse TYR cDNA as the
      probe and contained a DNA segment similar to exon 4 of the mouse TYR gene.
      Subsequently, the TYR cDNA was isolated by screening a frog embryo cDNA library
      using clone I as the probe. Two clones that contain genomic DNA of the TYR gene
      were isolated also from a blood cell DNA library using the frog TYR cDNA as the
      probe. Comparison of the nucleotide (nt) sequences of the genomic clone II DNA
      and the cDNA revealed that clone II contained a 3,140-bp DNA fragment consisting
      of the 5'-flanking region, the first exon, and a part of the first intron. The
      region upstream of the coding region contained the characteristic sequences for
      regulatory elements, including TATA- and CAAT-motifs, and also a pigment cell
      specific promoter element, which is shared by the promoter regions of the
      vertebrate TYR genes. A 764-bp segment containing an upstream 748-bp non-coding
      region and 16-bp coding region was functional for expression of the promoter-less
      cat gene on a plasmid in the transiently transformed albino frog melanophore. The
      genomic clone III contained the 3'-untranslated region of the mRNA and its 3'
      flanking region. Thus, the cDNA plus genomic DNA fragments isolated here cover
      the entire TYR gene and its flanking regions.

PMID- 7772386
TI  - Measuring outcome in counselling: a brief exploration of the issues.

PMID- 7772387
TI  - General practice fundholding: time for a cool appraisal.

PMID- 7772388
TI  - Care of patients with selected health problems in fundholding practices in
      Scotland in 1990 and 1992: needs, process and outcome.
AB  - BACKGROUND: At the time of the introduction of fundholding, a number of potential
      benefits and concerns about fundholding were debated. AIM: A study was undertaken
      to compare process and outcome of care in patients with different levels of
      physical, social and psychological need in 1990 and 1992 in six fundholding
      groups in Scotland. METHOD: Patients aged 16 years and over consulting with a
      range of marker conditions in 1990 and 1992 completed a pre-consultation health
      status questionnaire asking about physical, social and psychological problems,
      and a postconsultation satisfaction/enablement questionnaire asking about their
      ability to cope, and understand their illness. Main outcome measures were
      consultation length and satisfaction/enablement score. RESULTS: Of patients
      attending in the study period, 39% consulted for one or more marker condition.
      The proportion of patients reporting social problems rose between 1990 and 1992
      for 11 out of 12 conditions. Overall, consultation lengths remained constant.
      Patients wanting to discuss social problems had significantly longer
      consultations than those reporting no social problems or problems they did not
      wish to discuss. The proportion of patients expressing enablement dropped for
      eight conditions and rose for four between 1990 and 1992. The decrease in the
      proportion expressing enablement remained after controlling for the rise in the
      percentage reporting social problems. Patients who had social problems they did
      not wish to discuss but a general health questionnaire score of five or more were
      the group reporting lowest enablement. Significantly more patients with pain,
      skin problems and digestive problems reported social problems and significantly
      fewer of them reported enablement in 1992 compared with 1990. Patients with
      diabetes, angina, chronic bronchitis and problems seeing fared relatively well
      over the study period. Some patients with psychosocial problems fared poorly
      (they had relatively short consultations and were unlikely to express an ability
      to cope/understand their illness). CONCLUSION: The issue of whether benefits to
      some patient groups from recent health service changes may be matched by
      disadvantage to other groups, for example those with clinical problems with no
      financial incentive to provide pro-active care or with psychosocial difficulties,
      is discussed.

PMID- 7772389
TI  - From the surgery to the surgeon: does deprivation influence consultation and
      operation rates?
AB  - BACKGROUND: Concern about equity of access to health care has increased since the
      health care reforms implemented in the 1990s. Access to specialist health care is
      controlled by general practitioners; assessing and ensuring equity should
      therefore begin in general practice. AIM: This study set out to determine whether
      there are socioeconomic differences in the relationship between expressed need
      for possible surgical intervention (consulting a general practitioner) and
      surgical provision. METHOD: Information on the social class distribution of
      expressed need was obtained from the third national morbidity survey (1981-82)
      for 140,049 patients consulting a general practitioner. The conditions examined
      were: inguinal hernia, gallstones, tonsillitis, varicose veins, cataract and
      osteoarthritis. This expressed need was compared with the appropriate operation
      for all residents of North East Thames Regional Health Authority from January
      1991 to July 1992 classified, according to area of residence, by the Townsend
      deprivation score. RESULTS: The relationship between expressed need and provision
      by deprivation was concordant for some conditions, but discordant for others. For
      cataract and tonsillitis, there was an inverse U pattern between increasing
      deprivation and both patient consultation and operation ratios. For varicose
      veins, deprivation was associated with higher patient consultation and operation
      ratios. For hernia, gallstones and osteoarthritis, consultations increased with
      deprivation, but operation ratios were either unrelated to deprivation scores
      (hernia and gallstones) or decreased by deprivation score (hip operations).
      CONCLUSION: There are marked socioeconomic differences in consultation ratios for
      these common conditions which may not be matched by operation ratios. For
      discordant comparisons, people in the most deprived quartiles were generally
      least likely to receive surgery despite being most likely to consult a general
      practitioner with symptoms. If validated, these findings have important
      implications for general practice and service providers.

PMID- 7772390
TI  - Patients who do not receive continuity of care from their general practitioner-
      are they a vulnerable group?
AB  - BACKGROUND: Continuity of care is much valued by general practitioners but little
      is known about those patients who do not receive continuity of care. AIM: This
      study set out to identify and describe a group of patients who did not receive
      continuity of care from the general practitioner with whom they were personally
      registered. METHOD: A total of 110 patients (71 female and 39 male) were
      identified, who did not receive continuity of care, defined as four consecutive
      face to face consultations which did not take place with the doctor with whom
      they were registered. This group was compared with an age and sex matched control
      group who did receive continuity of care, using general practice records, for
      demographic characteristics, morbidity, relationship problems, number of
      'difficult' consultations, failure to attend appointments, and use of an accident
      and emergency department and of open access clinics. RESULTS: Patients in the
      study group were more likely to be under the age of 65 years than all patients on
      the doctor's list. Study patients were more likely than control patients to be in
      social class 4 or 5 living in a council house. Patients in the study group were
      more likely than controls to be depressed. Women patients in the study group were
      more likely to suffer from vaginal discharge. Men patients in the study group
      were more likely to complain of non-cardiac chest pain. The study group had more
      marital problems, parent-child relationship problems, and problems involving
      violence in the family, as well as other relationship problems. Relationship
      problems included the relationship with the doctor, since a third of all the
      consultations in the study group were recorded as 'difficult', compared with 3%
      in the control group. The study group patients were more likely than controls not
      to attend appointments which they had made, to use the accident and emergency
      department repeatedly, and to have used other open access clinics. CONCLUSION:
      Lack of continuity of care is associated with some additional morbidity, an
      increased number of relationship problems, 'difficult' consultations, and non
      attendances, and an increase in the use of open access clinics. The
      characteristics of this group of patients represent a syndrome which merits
      further study.

PMID- 7772391
TI  - Use of videotaped consultations in summative assessment of trainees in general
      practice.
AB  - BACKGROUND: There are many different methods by which trainees may be assessed
      summatively. AIM: The objective of the study was to determine if videotaped
      consultations could be used to identify reliably those general practitioner
      trainees who have not yet reached acceptable levels of competence. METHOD:
      Videotapes of 10 trainees carrying out normal consultations were assessed by 20
      assessors for acceptable competence using a rating scale specifically developed
      for the purpose. RESULTS: A principal components analysis showed a strong
      correlation among the items in the rating scale used, indicating that a single
      underlying factor accounted for 76% of the overall scores. Agreement between
      assessors on the scoring of individual consultations was limited. There was much
      greater consistency with regard to the decision on overall competence, examined
      for the first consultation. A non-competent trainee would have a 95% probability
      of being identified by the process as described using two assessors for each
      videotape. The assessors had reached firm judgements on each trainee by the time
      four consultations had been viewed. CONCLUSION: The workload involved in
      producing and analysing the tapes is discussed. Considerations of patient consent
      are addressed. It is concluded that the use of videotaped consultations appears
      to offer a feasible and reliable method of summative assessment of general
      practitioner trainees.

PMID- 7772392
TI  - Somatic presentation of psychiatric morbidity in general practice.
AB  - BACKGROUND: Twenty per cent of new illnesses in general practice, and 3% of
      consecutive attenders, are incident cases of 'pure' somatization. AIM: This study
      set out to estimate the prevalence of consultations by patients with psychiatric
      morbidity who present only somatic symptoms (somatic presentation), and to
      compare this with the likely prevalence of pure somatization. METHOD: A cross
      sectional survey of consecutive general practice attenders was carried out.
      Psychiatric morbidity was measured using the general health questionnaire. Pure
      somatization was defined as medical consultation for somatic symptoms that were
      judged by a psychiatrist during an interview to be aetiologically attributable to
      an underlying psychiatric disorder but which were not recognized as such by the
      patient. RESULTS: Of attenders 25% were identified as somatic presenters. Of the
      somatic presenters interviewed one in six were estimated to be pure somatizers,
      which would extrapolate to 4% of attenders. Though all somatic presenters were
      probable cases of psychiatric disorder, subjects in this group had lower scores
      on the general health questionnaire than those who presented with psychological
      symptoms. General practitioner recognition of psychiatric morbidity was
      significantly lower among somatic presenters than for other subjects with
      psychiatric morbidity. CONCLUSION: General practitioner recognition of
      psychiatric morbidity could be improved for all types of somatic presentation,
      regardless of the aetiology of patients' somatic symptoms. There is a danger that
      concentrating attention on pure somatization may mean that psychiatric morbidity
      in the more common undifferentiated form of somatic presentation will be
      overlooked.

PMID- 7772393
TI  - Effect of structured postgraduate medical education on the care of patients with
      diabetes.
AB  - BACKGROUND: Diabetes can be effectively treated and monitored in general
      practice. Postgraduate medical education at a local level is required to support
      this strategic shift of medical care from hospital to general practice. AIM: This
      study set out to determine whether a structured educational programme initiated
      by and led by general practitioners, but involving all health professionals,
      leads to improved care for diabetic patients. METHOD: The primary health care
      teams from 12 of the general practices in Tynedale, Northumberland who attend the
      local postgraduate centre and refer patients to the local general hospital were
      involved in the educational initiative which led to a locally agreed protocol for
      diabetic care. A comparison was made of data for all diabetic patients,
      registered with the general practitioners in 1991, in the years 1986 and 1991
      (before and after the educational initiative) in order to determine the
      prevalence of diabetes, place of care and treatment received, and to collect
      clinical information. RESULTS: More patients received general practice care only
      or shared care in 1991 than in 1986. There was a reduction in the use of oral
      hypoglycaemic agents among non-insulin dependent diabetic patients and more
      patients were maintained on diet alone. A greater proportion of patients were
      referred to dietitians, ophthalmologists and chiropodists in 1991 than 1986, and
      there was increased recording of, examination of, and identification of, diabetic
      complications. Little change was found in the mean values for clinical parameters
      between the two years. CONCLUSION: Structured educational programmes involving
      all professionals are an effective way of producing protocols that are adhered to
      by all concerned, and lead to improved clinical care for diabetic patients.

PMID- 7772395
TI  - Promoting exercise in primary care.

PMID- 7772394
TI  - Use of warfarin in non-rheumatic atrial fibrillation: a commentary from general
      practice.
AB  - Seven randomized trials published in the last six years have shown that warfarin
      reduces the risk of ischaemic strokes and death in patients with atrial
      fibrillation. The annual rates of major bleeding episodes in all these trials
      were low and, as a result, doctors in primary and secondary care are being
      encouraged to consider using warfarin for patients with atrial fibrillation
      unless there are obvious contraindications. However, the populations used in
      these studies were highly selected and rigorously monitored throughout the trial
      period to minimize the risk of bleeding in a way which probably could not be
      expected in routine primary care. Although the rates of major bleeding episodes
      were uniformly low, the rates of minor bleeding episodes were much higher and
      these could impact substantially on patients' views of the treatment and on the
      workload of the primary care team. Evidence is now at hand which allows the
      stratification of risk in patients with atrial fibrillation which should enable
      those who are at greatest risk to be considered for this form of treatment.
      Patients may develop risk factors over time which could render them unsuitable
      for continuation of warfarin therapy. The general practitioner is centrally
      placed to make the decision about initiating or continuing treatment or indeed
      stopping it. Several models for decision making in warfarin treatment from
      primary and secondary care are proposed.

PMID- 7772396
TI  - Teenage health.

PMID- 7772397
TI  - Stinging nettles for osteoarthritis pain of the hip.

PMID- 7772399
TI  - [Traumatic brain injury & mild hypothermia].

PMID- 7772398
TI  - [A review on adjuvant analgesics for chronic pain with emphasis on neurogenic
      pain].

PMID- 7772400
TI  - [Surgical outcome of cervical flexion myelopathy in young adults].
AB  - We encountered five young male patients with cervical flexion myelopathy, and
      treated them all surgically. Symptoms were first noted at 15 to 18 years of age
      (mean: 16.6 years), and their ages at the time of admission to our hospital,
      ranged from 19 to 25 years old (mean: 20.8 years). Anterior decompression and
      fusion of the cervical spine with long bone graft following resection of two
      vertebrae was performed in three cases. The other two patients were treated by
      posterior fusion of five laminas (C3-C7) using Rogers' method. In selecting the
      surgical approach, we favored anterior fusion because it allows removal of
      anterior structures (vertebral bodies, intervertebral discs or osteophytes)
      compressing the cervical spinal cord in flexed neck position. Posterior fusion
      was performed in patients whose anterior structures compressing the cervical
      spinal cord extended over a wide area. Postoperative improvement of muscle
      weakness was observed in four patients, and sensory disturbance was alleviated in
      the remaining patient. However, the abnormal deep tendon reflexes and muscle
      atrophy in the upper extremities observed in all of the patients preoperatively
      improved in only two of them. Thus, all of the patients showed some neurological
      improvement, and surgical fusion of the cervical spine appeared to be an
      effective means of treating cervical flexion myelopathy in young adults. Both the
      anterior and the posterior approach were useful in treating cervical flexion
      myelopathy, but it was impossible to conclude which approach is more effective
      based on this small number of cases.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772401
TI  - [Detection of subclinical sensory nerve dysfunction in amyotrophic lateral
      sclerosis--a microneurographic study].
AB  - In amyotrophic lateral sclerosis (ALS) sensory function has been considered to be
      normal on a clinical basis. There are, however, several pathologic reports
      indicating that peripheral sensory fibers are involved in ALS. To evaluate
      changes in sensory nerve function quantitatively, we measured compound nerve
      action potentials (CNAP) of the median nerve by means of intraneural
      microneurography (MNG) and compared the results between 16 patients with ALS, age
      matched 13 patients with Parkinson disease (PD) and 13 healthy controls. A
      tungsten microelectrode with a tip diameter of 1 micron was inserted
      percutaneously into the median nerve trunk at the elbow. With supramaximal
      electric stimulation on the median nerve at the wrist, the largest CNAP was
      recorded. The configuration of the CNAP was similar among three groups,
      consisting of a large triphasic wave followed by small multiphaic waves. In ALS
      patients the peak to peak amplitude (Amp) of the triphasic wave was 189.0 +/-
      49.8 microV (mean +/- SD), which was significantly smaller than 273.1 +/- 90.0
      microV in PD patients and 325.4 +/- 81.0 microV in normal controls (p < 0.01).
      The maximal nerve conduction velocity (NCV) in ALS was also reduced when compared
      with that in PD patients and in normal controls (p < 0.05). The average reduction
      in Amp in ALS was 58% of that in normal controls, while decrease in NCV was less
      apparent than Amp and 96% of normal controls. The Amplitude of nerve action
      potentials is considered to represent the density of large myelinated fibers more
      than 7 microns around the microelectrode.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772402
TI  - [Role of nitric oxide produced by activated macrophages in their cytocidal
      activity against glial tumor cells].
AB  - This study investigated the role of activated macrophages (M phi) in nitric oxide
      (NO) production and the tumoricidal effect of NO on glioma cells. Induced
      peritoneal M phi were prepared 6 days following the injection of thioglycollate
      broth into C3H/He N (H-2 kappa) mice. M phi were activated in vitro recombinant
      human interferon-gamma (IFN gamma) and lipopolysaccharide (LPS) into the culture
      medium of the elicited M phi. Two kinds of murine malignant glioma cell lines,
      RSV-M glioma (H-2 kappa) and VM-glioma (H-2b) were used as targets. P815
      mastocytoma cells (H-2d) were used as a control target, since they are
      insensitive to tumor necrosis factor-alpha, but susceptible to NO derived from M
      phi. L-arginine-depleted medium was used to inhibit NO-mediated cytocidal
      activity against tumor cells. Cytotoxicity was assayed at various effector-to
      target ratios using an admixture of M phi and 1.5 x 10(4) 125I-labeled target
      cells 48 hours following co-culture. NO was measured in culture medium using
      Griess reagent, and the concentration of NO was expressed as mu mol/ml NaNO2.
      Peritoneal M phi induced only 10% and 15% lysis of RSV-M glioma and VM glioma
      cells, respective, and LPS augmented this killing activity of M phi to a maximum
      of 1.2 to 1.4 fold in a dose-dependent manner with dosages from 1 to 50 ng/ml.
      LPS demonstrated a synergistic action on M phi-mediated cytotoxicity 4 hours
      following pretreatment with IFN gamma. Alternatively, low doses of IFN gamma
      alone had no enhancing effect on M phi tumoricidal activity.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7772403
TI  - [The practical benefits of magnetoencephalography in comparison with
      electroencephalography in a patient with epilepsia partialis continua].
AB  - A concurrent recording of electroencephalography (EEG), magnetoencephalography
      (MEG) and electromyography (EMG) was carried out in a patient with epilepsia
      partialis continua. He had continuous clonic jerks in his right hand and fingers.
      The EMG electrodes were placed on the thumb of his right hand. We observed
      numerous MEG spikes in the left central region and about half of them were
      accompanied by EMG potentials with a latency of about 20 msec. The EEG spikes
      appeared less frequently, had low amplitudes, and had unclear morphologies and
      further, no clear association with EMG potentials. MEG spikes were more reliably
      associated with individual jerks, exemplified by EMG potentials, than the EEG
      spikes. The MEG spikes were sharper than EEG spikes and were about 20 msec wide.
      The intracranial dipole localization of the MEG spikes was estimated by
      overlaying the calculated generator sites on magnetic resonance images. It was
      found that the spikes converged along a line, presumably the central sulcus. The
      practical benefits of the MEG as a diagnostic tool in epilepsy are illustrated.

PMID- 7772404
TI  - [Transcranial magnetic stimulation of the accesory nerve--investigation of the
      site and mechanism of excitation in the cat].
AB  - The site where transcranial magnetic stimulation excites the accessory nerve was
      studied in 5 cats. Transcranial magnetic stimulation of the accessory nerve was
      recorded from the right trapezius. The accessory nerve was stimulated
      electrically at the C1 level, jugular tubercle and jugular foramen. The latencies
      of the compound muscle action potentials (CMAPs) for each portion were measured
      and compared with the magnetic response, which was coincidental with that of the
      jugular tubercle. The accessory nerve was then transected in steps distally from
      the C1 level, and CMAPs following magnetic stimulation were recorded at each
      step. The CMAPs disappeared following the nerve transection at the jugular
      tubercle. The results of both approaches in this study conclude that transcranial
      magnetic stimulation excites the accessory nerve at jugular tubercle. This
      stimulation site was anatomically coincidental with that of the facial nerve and
      trigeminal nerve in being right before the point where the nerve bends. Following
      the accessory nerve transection at the C1 level, the amputation stump was moved
      cranially, and CMAPs disappeared. CMAPs recorded after the accessory nerve was
      returned to its original position. These examinations suggested that sudden
      alteration of the traveling lie of the nerve participates in the mechanism of
      transcranial magnetic stimulation.

PMID- 7772405
TI  - [Improvement of highly reproducible technique of four-vessel occlusion model and
      its study on metabolic changes of cerebral reperfusion in rats].
AB  - The four-vessel occlusion method introduced by Pulsinelli et al is widely used as
      an experimental model for reversible forebrain ischemia in rats. However, this
      model has a major problem in the difficulty assuring complete occlusion of the
      vertebral arteries by electrocauterization through the alar foramina of the first
      cervical vertebra. Anatomical basis of the vertebral artery suggested by Sugio et
      al indicates that the vertebral artery at the level of the second cervical
      vertebral is visible. In this study, we further developed highly reproducible
      model of reversible forebrain ischemia, which is modified four-vessel occlusion
      in rats. Male Wistar rats were subjected to four-vessel occlusion. Under
      microscope the visible vertebral arteries at the second vertebra could be easily
      electrocauterized and completely cut by microscissors to yield complete cessation
      of circulation of bilateral vertebral arteries without failure. After 24 hours,
      animals were subjected to 15, 30 and 45 minutes of forebrain ischemia by
      occluding both common carotid arteries with Sugita's temporary clips. 31P
      magnetic resonance spectroscopy (31P-MRS) were obtained with a 6.3-T spectrometer
      to investigate sequential change of the in vivo brain energy metabolism. Our
      studies indicated that high energy phosphorus compounds were reduced in a few
      minutes after the induction of the forebrain ischemia, and they returned to the
      normal level after the recirculation. In addition, we monitored
      electroencephalogram (EEG) during the whole experimental period. The EEG showed a
      flat pattern after the induction of ischemia, and EEG recovered normal pattern
      within 12 hours.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772406
TI  - [A left-handed patient with disturbance of manipulating objects].
AB  - We reported a left-handed patient with the disturbance of manipulating objects
      and the object pantomime. The patient was a 72-year-old man, admitted to Osaka
      Medical College Hospital complaint of the difficulty of object manipulation. The
      patient was alert, well oriented and attentive. On neurological examination the
      patient revealed grasp reflex in his left hand. On neuropsychological examination
      the patient spoke fluently, but his verbal comprehension was slightly disturbed.
      He could name popular objects only 9 out of 20 objects. On praxis examination he
      could pantomime the socially accustomed movements by command visually pantomime.
      He did not reveal buccofacial apraxia and constructional apraxia. However, the
      patient could not manipulate both single and pleural objects actually and
      pantomime without objects. On MRI the lesion was found in both frontal lobe,
      right medial frontal lobe and right temporal lobe. SPECT findings demonstrated
      that the bilateral parietal lobes were preserved and we speculated that the right
      supplementary motor area was assumed to be a crucial lesion for manipulating
      objects in the patient.

PMID- 7772407
TI  - [Positron emission tomographic findings of subependymal giant cell astrocytoma
      developed in tuberous sclerosis--a case report].
AB  - Tuberous sclerosis (TS) is well known to be occasionally associated with
      subependymal giant cell astrocytoma (SGCA). SGCA is considered to be a benign
      tumor in its clinical course and morphology. However, this tumor is grown
      sometimes so rapid and caused hydrocephalus. To our knowledge, little is known
      about hemocirculation and metabolism, particularly in relation with proliferating
      activity of TS and SGCA. We measured hemocirculation and metabolism of SGCA
      developed in a case of TS using positron emission tomography (PET). A 13-year-old
      boy who had frequently developed convulsions four months after birth. He was
      diagnosed as TS and had been medically treated with anticonvulsants, since
      multiple intraventricular calcifications were detected by CT, at the age of five
      months. The convulsions had been well controlled. In March 1993, he presented
      with syncopal attack and admitted to our hospital. CT showed multiple
      subependymal nodules. Among the nodules, one of the left anterior horn exceeded
      2cm in size obliterated Monro's foramen. The tumor was homogeneously enhanced
      with contrast medium. The lesion detected by postcontrast T1-weighted MR imaging
      had almost the same status as that by CT. T2-weighted image revealed cortical
      tubers as high intensity area at the left frontal and parietooccipital regions.
      PET was performed with the Headtome IV. Hemocirculation of the tumor was lower
      than that of contralateral gray matter, which suggested poor blood supply. The
      oxygen and glucose metabolism of the tumor were decreased compared with
      contralateral gray matter, indicative of a low activity of proliferation and a
      clinically benign tumor in the present case.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772408
TI  - [A case of malignant rheumatoid arthritis with lupus anticoagulant and cerebral
      infarction].
AB  - We reported a case of malignant rheumatoid arthritis (MRA) with cerebral
      infarction associated with a possible cause of lupus anticoagulant. The patient
      was a 68-year-old woman who had received treatment for rheumatoid arthritis (RA)
      from 15 to 16 years ago. She consulted to our hospital with a major complaint of
      right hemiplegia. Brain CT revealed a low density area in the left hemisphere.
      She was diagnosed as cerebral infarction and hospitalized. Since she was noted to
      have hypocomplementemia, interstitial pneumonia and pericarditis, she was
      diagnosed as MRA. Coagulation test disclosed positive lupus anticoagulant (LA).
      Generally, CNS disorders in MRA are uncommon. Cerebral infarction was complicated
      in the present case, suggesting the involvement of antiphospholipid antibodies as
      its pathogenesis.

PMID- 7772409
TI  - [Cerebellar ataxia, 2) dementia, 3) syncopal attack, 4) character change].

PMID- 7772410
TI  - [A 65-year-old woman with dysarthria, dysphagia, weakness, and gait disturbance].
AB  - We report a 65-year-old woman with progressive dysarthria, dysphagia, weakness,
      and gait disturbance. The patient was well until 59 years of age (January of
      1986) when she noted bilateral ptosis. One year later, she noted a gradual onset
      of difficulty in speech (articulation). Her speech slowly deteriorated and she
      noted weakness in chewing power and difficulty in swallowing in addition. In
      October 1987, she developed emotional incontinence. In January of 1988, she
      started to drag her left foot. She was admitted to our hospital on June 13 of
      1988. On admission, she was alert and general physical examination was
      unremarkable. Neurologic examination revealed no dementia; her higher cerebral
      functions appeared intact. Ptosis was present bilaterally more on the right. She
      showed difficulty in opening her eyes on command; no contraction of the frontal
      muscles was seen upon attempted eye opening. There was a moderate limitation in
      the vertical gaze. Forced laughing and crying were seen. Facial muscles were
      moderately weak without apparent atrophy. The movement of the soft palate was
      very weak, and swallowing disturbance was more prominent for liquid staff. The
      tongue appeared somewhat small, however, no fasciculation was noted. Her step was
      small and the posture was stooped. Retropulsion was present, however, Romberg's
      sign was absent. No muscle atrophy was apparent, however, diffuse mile to
      moderate muscle weakness was noted in all four limbs. Cerebellar sign was absent.
      Deep tendon reflexes were exaggerated bilaterally, and Babinski sign was present
      on the left side. Sensation was intact. Routine blood tests were unremarkable as
      was a cranial CT scan. Her ptosis did not improve after 10 mg of edrophonium
      injection. CSF was also normal. She was transferred to another hospital but her
      neurological disabilities further progressed. In 1989, she was totally unable to
      move her limbs; she could only move her eyes; still consciousness was clear
      without dementia. She developed respiratory difficulty and expired on July 25,
      1992. She was discussed in a neurological CPC, and the opinions were divided into
      ALS and primary lateral sclerosis (PLS). The chief discussant arrived at the
      conclusion that the patient might have had the pyramidal form of ALS. Postmorten
      examination revealed marked myelin pallor in the anterior as well as lateral
      corticospinal tracts. Pyramidal tract degeneration was prominent starting at the
      level of the cerebral peduncle and was continued to be seen until the level of
      lumbar cord. The number of anterior horn cells showed only slight decrease in the
      cervical level, however, it was normal in the lumbar cord.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 7772411
TI  - Facile desulfurization of cyclic thioureas by hydrogen peroxide in acetic acid.
AB  - A simple, mild and synthetically useful method for the desulfurization of cyclic
      thioureas and related compounds, existing as thiol-thione tautomeric mixtures, by
      hydrogen peroxide in acetic acid is proposed. The effect of substituting
      different solvents for the acetic acid was investigated.

PMID- 7772412
TI  - An alternative synthesis of the NMDA antagonist CGS 19755 via free radical
      carbamoylation of ethyl isonicotinate.
AB  - The NMDA antagonist CGS 19755 (cis-4-phosphonomethyl-2-piperidinecarboxylic acid)
      has been prepared by applying Minisci reaction conditions [formamide, hydrogen
      peroxide, iron(II) sulfate] to ethyl isonicotinate, reduction of the ester with
      sodium borohydride, alcoholysis of the 2-carboxamide, formation of 4
      (diethylphosphonomethyl)-2-pyridinecarboxylate, hydrogenation of the pyridine
      nucleus, and acid hydrolysis. The overall, unoptimized yield was around 11%. The
      procedure employs cheap starting materials, is practical and avoids the use of
      toxic and hazardous cyanotrimethylsilane which is used in the published
      procedure.

PMID- 7772413
TI  - Incrustoporin, a new antibiotic from Incrustoporia carneola (Bres.) Ryv.
      (Basidiomycetes).

PMID- 7772414
TI  - Does the synthesis of ribosomal RNA take place within nucleolar fibrillar centers
      or dense fibrillar components? A critical appraisal.
AB  - The localization of transcribing rRNA genes within nucleoli of mammalian cells,
      although intensively studied, has not been established. Most published papers on
      this topic situate transcribing ribosomal genes either to nucleolar fibrillar
      centers or to nucleolar dense fibrillar components. To clarify this point, we
      have generated the electron microscopic affinity cytochemistry picture of the
      nucleolus of cultured mammalian cells. Three kinds of affinity probes have been
      used: (1) probes to nucleolar chromatin, including rDNA sequences; (2) probes to
      a number of macromolecules (such as RNA polymerase I) which are directly, or
      indirectly, involved in the synthesis and processing of rRNA and formation of
      preribosomes; (3) antibodies to bromouridine for a recently standardized
      nonisotopical method depicting incorporated bromouridine within RNA. The results
      suggest the localization of transcription sites not only to dense fibrillar
      components but also to the border region between these components and fibrillar
      centers. Our data support a hypothesis that in metabolically active mammalian
      nucleoli, fibrillar centers and dense fibrillar components form a single
      functional domain for the transcription of rRNA genes, with nascent transcripts
      generating "automatically" dense fibrillar components. Through the active process
      of transcription, individual rRNA genes thus become engulfed within dense
      fibrillar components.

PMID- 7772415
TI  - FTIR spectroscopy of alanine-based peptides: assignment of the amide I' modes for
      random coil and helix.
AB  - Fourier transform infrared (FTIR) spectroscopy has been used to explore the
      thermal unfolding of three helical, alanine-based peptides. Each of the peptides
      follows the general sequence Ac-(AAAX)nA-NH2 where X is either Lys+ or Arg+ and n
      = 3 or 4. These particular peptides were chosen because they contain varying
      amounts of 3(10)- and alpha-helix. The amide I' bands for all three peptides,
      under helix forming conditions, are between 1632 and 1635 cm-1. These results are
      incongruous with the assignment for alpha-helices in proteins where amide I'
      bands are usually found above 1650 cm-1. At elevated temperatures, all the
      peptides exhibit amide I' bands of 1642 cm-1, which is the accepted value for
      random coil. Variable temperature spectra for the 4K peptide (n = 4, X = Lys+),
      which is the most alpha-helical of the three peptides at 1 degree C, reveal an
      isosbestic point suggesting a cooperative two-state unfolding transition. The
      other peptides, however, did not reveal an isosbestic point, thereby indicating
      the presence of an intermediate, perhaps 3(10)-helix, along the thermal unfolding
      pathway.

PMID- 7772416
TI  - Structure of Lumbricus terrestris hemoglobin at 30 A resolution determined using
      angular reconstitution.
AB  - The three-dimensional (3D) structure of the giant hemoglobin of the common
      earthworm Lumbricus terrestris was determined from cryomicroscopical images of a
      vitrified molecular solution. From about 5000 molecular images, the best-fit 3D
      structure was calculated using recently developed analysis techniques.
      Multivariate statistical analysis data compression and automatic classification
      were used to find the characteristic projection images of the oligomer. The
      angular reconstitution approach was then applied to find the Euler angle
      orientations of these characteristic views. The Lumbricus hemoglobin molecule has
      an overall D6 (622) point-group symmetry and is found to have a local threefold
      symmetry axis within the 1/12th subunit. This additional symmetry appears to
      predict the presence of 36 abcd globin tetramers in the Lumbricus hemoglobin or a
      total of 144 heme chains for the whole oligomer. A distinct doughnut-shaped
      structure is elucidated in the center of the molecule. This central subunit,
      representing around 10% of the protein volume, may consist of non-heme-containing
      linker chains found generally in giant annelid hemoglobins.

PMID- 7772417
TI  - Molecular design of the voltage-dependent, anion-selective channel in the
      mitochondrial outer membrane.
AB  - The mitochondrial outer membrane contains numerous copies of a channel protein,
      VDAC, that is thought to be the main permeability pathway through this membrane
      for polar molecules and ions. Low-dose electron microscopy has been used to
      obtain images of two-dimensional crystals of this channel (produced by treating
      outer membranes from fungal mitochondria with phospholipase A2) embedded in
      vitreous ice or aurothioglucose. The angular orientation of the channels in the
      unit cell of one type of array has been determined by rotational correlation
      analysis. The location of the amino-terminal segment of the protein (which,
      according to circular dichroism, forms an alpha-helix in nonpolar solvents and
      detergent solutions) has been determined by labeling arrays with Fab prepared
      from antibodies directed against residues 1-20. The three-dimensional structure
      of the channel has been obtained by applying Fourier reconstruction methods to
      projections of tilted crystals embedded in aurothioglucose, followed by averaging
      of the three non-symmetry-related channels in the unit cell. The results of this
      study indicate that the wall of VDAC's lumen has several irregular features
      (uneven height, grooves) and that the aminoterminal segment extends away from the
      lumen in this crystalline state.

PMID- 7772418
TI  - A novel method for transfer of two-dimensional crystals from the air/water
      interface to specimen grids. EM sample preparation/lipid-layer crystallization.
AB  - Transfer of two-dimensional (2-D) crystals formed on lipid layers by suspension
      from a wire loop is described. This method gives better recovery and better
      preservation of 2-D crystals than attained in the past. The method has been
      applied to crystals of yeast RNA polymerase II to enable their analysis in the
      frozen hydrated state.

PMID- 7772419
TI  - Muscarinic receptor subtypes: do they have a place in clinical anaesthesia?

PMID- 7772420
TI  - Metabolic control of non-insulin-dependent diabetic patients undergoing cataract
      surgery: comparison of local and general anaesthesia.
AB  - We studied 40 elderly patients undergoing cataract surgery. Ten non-insulin
      dependent diabetes mellitus (NIDDM) patients received standardized general
      anaesthesia, 10 NIDDM patients received local anaesthesia using retrobulbar
      block, 10 non-diabetic control patients received general anaesthesia and 10 non
      diabetic controls received retrobulbar block. We measured sequential changes in
      blood glucose, lactate and beta-hydroxybutyrate, serum cortisol and insulin, and
      plasma non-esterified fatty acid concentrations until 4 h after operation. The
      results showed that in both general anaesthesia groups, NIDDM and control, blood
      glucose and serum cortisol concentrations increased significantly during surgery,
      before returning to normal by 4 h after operation; in both local anaesthesia
      groups, glucose and cortisol concentrations changed little during surgery. Serum
      insulin concentrations increased 30 min after operation to coincide with the peak
      of the glucose increase in the non-diabetic patients who received general
      anaesthesia, but no insulin response was seen in the diabetic general anaesthesia
      patients. Blood glucose and insulin concentrations increased in patients who
      received local anaesthesia (NIDDM and controls) when they ate after operation.
      The results show that cataract surgery under local anaesthesia provides improved
      metabolic control for the diabetic patient. Its use maintains glucose
      homeostasis, prevents the increases in cortisol and glucose which are seen under
      general anaesthesia and obviates the need for postoperative starvation.

PMID- 7772421
TI  - Infraorbital nerve block in neonates for cleft lip repair: anatomical study and
      clinical application.
AB  - Infraorbital nerve block in neonates is not well described although it has been
      suggested that bilateral infraorbital nerve block is the local analgesic
      technique of choice for early repair of cleft lip. The purpose of this study was
      to determine the location of the infraorbital nerve in neonatal cadavers and to
      identify clinically useful landmarks. Thirty infraorbital nerves were identified
      in 15 neonatal cadavers with a mean weight of 2.85 (SD 0.32) kg (range 2.45-3.5
      kg) via an upper buccal sulcus incision. The mean distance from the infraorbital
      nerve to the base of the alae nasi was 7.7 (SD 1.3) mm on the left and 7.5 (0.8)
      mm on the right. A line drawn from the angle of the mouth to the midpoint of the
      palpebral fissure measured 30.6 (1.9) mm (left) and 30.7 (1.8) mm (right). The
      nerve was situated approximately halfway along this line at a point 15.5 (1.5) mm
      (left) and 15.2 (1.4) mm (right) from the angle of the mouth. These measurements
      were used to perform bilateral infraorbital nerve blocks in four neonates
      undergoing cleft lip surgery under general anaesthesia, thereby providing
      analgesia with minimal risk of respiratory depression.

PMID- 7772422
TI  - Low-dose droperidol reduces postoperative vomiting in paediatric day surgery.
AB  - In a prospective, randomized, blind study, we assessed the effectiveness of
      droperidol 20 micrograms kg-1 i.v., given at induction of anaesthesia, in
      preventing postoperative vomiting in paediatric day-case patients. We studied 270
      children, aged 1-15 yr, undergoing body surface surgery. There was a significant
      reduction in the incidence of vomiting in the recovery room (1.4% vs 9.2%, P <
      0.005) and in the day ward (9.4% vs 18.3%, P < 0.05) in patients receiving
      droperidol. There was no significant difference on the journey home (9.5% vs
      17.83%, ns) or at home (16.7% vs 10.3%, ns). There was also a reduction in the
      severity of vomiting in the droperidol group. There were no adverse side effects.

PMID- 7772423
TI  - Extradural anaesthesia for caesarean section: a double-blind comparison of 0.5%
      ropivacaine with 0.5% bupivacaine.
AB  - Seventy-three parturients for elective Caesarean section were allocated randomly
      to receive extradural block with 20 ml of either 0.5% ropivacaine or 0.5%
      bupivacaine. If the block did not reach T6 within 30 min, another 5 ml of
      solution was given. If needed, a further 5 ml was given 45 min after the main
      dose. The mean total dose of bupivacaine was 23.1 ml (n = 35) and of ropivacaine
      23.7 ml (n = 37). There was no significant difference between the groups in the
      profile of sensory block produced. There was no significant difference in the
      time of onset, or intensity of motor block between the groups but the duration of
      motor block was significantly shorter in the ropivacaine group. There was no
      significant difference in neonatal outcome, as assessed by Apgar score, umbilical
      cord blood-gas tensions at delivery or the neurological and adaptive capacity
      score 2 and 24 h after delivery.

PMID- 7772424
TI  - Prophylactic i.m. ephedrine in bupivacaine spinal anaesthesia.
AB  - In a double-blind, placebo-controlled, randomized study, we have investigated the
      efficacy of i.m. ephedrine in 98 elderly patients undergoing hip arthroplasty
      under spinal anaesthesia with plain bupivacaine. Fifty patients received
      ephedrine 0.6 mg kg-1 body weight, deep in the paravertebral muscles immediately
      after injection of bupivacaine, and 48 received an equal volume of saline.
      Patients in both groups were given the same volumes of fluid before anaesthesia.
      Systolic arterial pressure during the first 60 min after anaesthesia remained
      significantly more stable in the ephedrine-treated group, and there was also a
      significantly smaller number of patients in this group who had decreases in
      pressure of more than 30% of pre-block levels, and fewer required rescue i.v.
      ephedrine. An increase in heart rate or systolic pressure of > or = 20% from
      baseline was found in two patients in the ephedrine group and in one patient in
      the placebo group. We conclude that ephedrine 0.6 mg kg-1 body weight
      administered in the paravertebral muscles immediately after plain bupivacaine
      spinal anaesthesia is a simple and effective means of reducing the incidence of
      hypotensive episodes in the elderly patient.

PMID- 7772425
TI  - Cricoid pressure impedes placement of the laryngeal mask airway.
AB  - We have studied 22 patients to examine whether or not cricoid pressure affects
      ventilation of the lungs via the laryngeal mask and its correct positioning. In a
      randomized, crossover design, the laryngeal mask was inserted with or without
      cricoid pressure applied with a standardized force of 30 N using a cricoid yoke.
      A standardized pillow (6 cm in height) was placed under the patient's occiput,
      but the neck was not supported. Ventilation of the lungs via the laryngeal mask
      was adequate in all patients when no cricoid pressure was applied, but in only
      three of 22 patients when cricoid pressure was applied (P << 0.001; 95%
      confidence interval (CI) 0.72-1.0). The mask was positioned correctly in 18
      patients when no pressure was applied, and in none after application of cricoid
      pressure (P << 0.001; 95% CI 0.66-0.98). We had planned to study, in an
      additional 20 patients, the effect of cricoid pressure without a pillow under the
      occiput; placement of the mask, however, was difficult even when cricoid pressure
      was not applied and there was a high incidence of bleeding from the oropharynx.
      We thus abandoned that part of the study after eight patients. In those eight
      patients, the success rate of ventilation via the laryngeal mask was lower when
      cricoid pressure was applied. We conclude that when sufficient force was applied,
      cricoid pressure, regardless of the method of application, did impede placement
      of the laryngeal mask.

PMID- 7772426
TI  - Continuous infusion of nimodipine during coronary artery surgery: haemodynamic
      and pharmacokinetic study.
AB  - A continuous infusion of nimodipine 15 or 30 micrograms kg-1 h-1 was administered
      from the evening before operation to the second morning after operation to 14
      patients undergoing elective coronary artery bypass grafting (CABG) surgery.
      Nimodipine was tolerated well by all seven patients who received the lower dose.
      However, of the seven patients who received the higher dose, in two patients the
      infusion had to be discontinued after induction of anaesthesia and immediately
      after surgery, respectively, because of excessive vasodilatation and hypotension.
      At steady state before cardiopulmonary bypass (CPB), total plasma nimodipine
      concentration was higher than expected on the basis of previous reports in non
      surgical subjects. Similarly, mean clearance of nimodipine was lower than
      predicted, that is 0.53 (range 0.40-0.72) litre kg-1 h-1. Initiation of CPB
      decreased total plasma nimodipine concentration, but the unbound plasma
      concentration did not decrease because of the increase observed in the free
      fraction of nimodipine in plasma. As evaluated in a separate closed
      extracorporeal circuit, nimodipine was sequestered into the circuit. Addition of
      stored whole blood to the priming solution attenuated this sequestration. It is
      concluded that clearance of nimodipine, as assessed before CPB at steady state,
      was reduced in patients undergoing CABG and receiving a continuous infusion of
      nimodipine. Using this finding of decreased clearance in designing infusion
      schemes of nimodipine for cardiac-surgical patients, it should be possible to
      predict more accurately the desired plasma nimodipine concentration and therefore
      reduce the possibility of unexpected haemodynamic responses.

PMID- 7772427
TI  - Tranexamic acid (Cyklokapron) reduces perioperative blood loss associated with
      total knee arthroplasty.
AB  - In this prospective, randomized, double-blind study, we have investigated the
      effect of an antifibrinolytic agent, tranexamic acid (Cyklokapron), on blood loss
      and transfusion requirements associated with total knee arthroplasty. Twenty-nine
      patients were allocated randomly to receive either tranexamic acid 15 mg kg-1 or
      an equal volume of placebo a few minutes before a tourniquet was deflated. Blood
      loss during surgery, in the recovery room and on the surgical ward was recorded,
      together with the number of units of blood transfused in hospital. Mean blood
      loss during surgery was 428 (SD 254) ml in the tranexamic acid group (n = 15)
      compared with 415 (244) ml in the placebo group (n = 13). In the recovery room
      the tranexamic acid group lost 127 (95) ml and the placebo group 576 (245) ml (P
      < 0.001). On the ward the respective volumes were 293 (200) ml and 558 (293) ml
      (P < 0.01). Total blood loss was 847 (356) ml in the tranexamic acid group and
      1549 (574) ml in the placebo group (P < 0.001). During the hospital stay the
      treatment group received 1.5 (1.3) units of blood compared with 3.3 (1.8) in the
      control group (P < 0.005). Two patients in the placebo group experienced a
      thrombotic complication compared with none in the treatment group. We conclude
      that tranexamic acid reduced perioperative blood loss and transfusion
      requirements associated with total knee arthroplasty.

PMID- 7772428
TI  - Non-invasive estimation of venous admixture: validation of a new formula.
AB  - We have developed a computer program that estimates venous admixture (intra
      pulmonary shunt) from four measurements: haemoglobin concentration, end-tidal
      carbon dioxide tension (PE'CO2), fractional inspired oxygen concentration (FIO2)
      and pulse oximetry (SpO2). The formula was tested on patients in an intensive
      therapy unit by using it to estimate shunt while it was measured simultaneously
      by a standard, invasive method. A total of 101 measurements were made in 29
      patients. After correcting the systematic errors in the assumed differences
      between PE'CO2 and arterial PCO2, and between SpO2 and co-oximetrically measured
      SaO2, and correcting for a trend in the arteriovenous oxygen concentration
      difference (C(a-v))2) with shunt, the bias of the non-invasive minus invasive
      shunt differences was negligible, with no significant dependence on shunt. The
      limits of agreement were then +/- 16% shunt overall (+/- 13% within patients).
      When SaO2 was used instead of SpO2, the limits were +/- 11% (+/- 8% within
      patients).

PMID- 7772429
TI  - Halothane affects ventilatory afterdischarge in humans.
AB  - In awake humans, when ventilatory stimulation is suddenly removed, the subsequent
      change in minute ventilation (which remains at higher levels for longer times
      than expected from the dynamics of the chemoreceptors) is termed ventilatory
      after discharge. In this study we investigated the effects of subanaesthetic
      concentrations of halothane on afterdischarge. The ventilatory pattern after
      sudden termination of brief periods (90-180 s) of isocapnic hypoxia (PE'cO2
      approximately 0.1 kPa above initial resting values; PE'O2 6.5 kPa) by normoxia
      (PE'O2 14 kPa) was determined in healthy volunteers. Six subjects underwent 13
      studies without halothane (control) and six others 10 studies during inhalation
      of 0.22% halothane. Isocapnic hypoxia caused a mean increase in ventilation of
      10.8 (SD 2.4) litre min-1 in the control and 4.2 (2.4) litre min-1 in the
      halothane studies (P < 0.01). The transition to normoxia caused a slow
      ventilatory decay in the control and a fast decay in the halothane groups: the
      interval that occurred between the "last hypoxic" breath and the time required
      for ventilation to return to 110% of baseline was 60.7 (23) s for the control and
      12.3 (6.0) s for the halothane studies (P < 0.05). Taking into consideration the
      different factors that determine the pattern of breathing immediately after
      termination of a brief period of hypoxia by normoxia (PE'O2 waveform, transport
      delay time between lungs and carotid bodies, time constant of the peripheral
      chemoreflex loop and afterdischarge), the faster ventilatory decay observed with
      halothane is probably related to suppression of afterdischarge.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7772430
TI  - Atropine and glycopyrronium show similar binding patterns to M2 (cardiac) and M3
      (submandibular gland) muscarinic receptor subtypes in the rat.
AB  - Atropine and glycopyrronium are frequently used for premedication to reduce oral
      and respiratory secretions and prevent bradycardia. Glycopyrronium is said to
      have similar antisialagogue effects, but is less likely to cause significant
      tachycardia than atropine. Different antimuscarinic receptor selectivity patterns
      could explain the differences. The aim of this investigation was to determine the
      possible selectivity of glycopyrronium for M2 and M3 muscarinic receptor
      subtypes. Muscarinic receptor subtypes in Wistar rat ventricle and submandibular
      gland homogenates were characterized with [3H]-N-methylscopolamine ([3H]-NMS) by
      ligand binding studies. Inhibition of [3H]-NMS binding by non-labelled compounds
      showed the following order: in rat ventricle: glycopyrronium > atropine >>
      otenzepad > hexahydrosiladiphenidol (HHSiD) > pirenzepine; in rat submandibular
      gland: glycopyrronium > atropine >> HHSiD >> pirenzepine > otenzepad. These were
      similar to the expected order of frequency of M2 and M3 subtypes, respectively.
      Glycopyrronium showed similarly high affinities for both M2 (Ki = 1.889 (SEM
      0.049) nmol litre-1) and M3 (Ki = 1.686 (0.184) nmol litre-1) subtypes.
      Glycopyrronium bound to a homogeneous population of binding sites in both tissues
      and showed no selectivity for M2 or M3 muscarinic receptor subtypes.

PMID- 7772431
TI  - Potency of lipid and protein formulation of 5 alpha-pregnanolone at induction of
      anaesthesia and the corresponding regional brain distribution.
AB  - We have studied the anaesthetic potencies of 5 alpha-pregnanolone albumin
      solution (PAS) and 5 alpha-pregnanolone Intralipid emulsion (PLE) at equivalent
      concentrations in male rats using an EEG threshold method. The criterion of
      anaesthesia was burst suppression of the EEG of 1 s or more (the "silent second"
      (SS)) as a sign of deep anaesthesia. The potency of the two formulations was
      assessed by comparing the threshold doses of 5 alpha-pregnanolone at three dose
      rates (1.0, 2.0 and 3.0 mg kg-1 min-1). We found that SS was initiated in all
      rats after infusions of PAS, while no SS could be induced in rats after infusion
      of PLE at a larger dose. A higher concentration of 5 alpha-pregnanolone was found
      in all brain and peripheral tissues of PAS-treated rats than in those treated
      with PLE. In rats with PAS-induced anaesthesia (3.0 mg kg-1 min-1), the highest
      concentrations were detected in striatum (mean 19.40 (SD 1.21) ng mg-1). Although
      there was a small insignificant reduction in threshold doses with dose rates at
      2.0-3.0 mg kg-1 min-1, the tissue concentrations in striatum, frontal cortex and
      occipital cortex were found to be significantly increased. We conclude that PAS
      was more potent than PLE in inducing anaesthesia. Brain distribution of 5 alpha
      pregnanolone varied regionally in a manner similar to the variation in GABAA
      receptor sensitivity to this neuroactive steroid.

PMID- 7772432
TI  - Human cytochrome P450 mono-oxygenase system is suppressed by propofol.
AB  - We have studied the effect of propofol on the cytochrome P450-dependent mono
      oxygenase system in human liver microsomes by assaying mono-oxygenase activities
      toward specific cytochrome P450 isoform test substrates, aniline, 7
      ethoxycoumarin, benzphetamine and benzo(a) pyrene. Propofol inhibited
      benzo(a)pyrene hydroxylation to a greater extent than the oxidative metabolism of
      the other test substrates, even at 0.05 mmol litre-1. The degrees of inhibition
      of benzphetamine N-demethylation and 7-ethoxy-coumarin O-de-ethylation were
      similar, while aniline hydroxylation was least affected by propofol. Spectral
      analysis showed that propofol competed with carbon monoxide for binding to the
      haem moiety of haemoprotein in the P450 enzyme. The variable inhibition observed
      may be caused by the differential binding of propofol to P450 isoforms. Propofol
      0.05-1.0 mmol litre-1 exhibited a concentration-dependent inhibitory effect on
      human cytochrome P450 2E1, 2B1 and 1A1. These inhibitory actions of propofol on
      human liver microsomal enzymes in vitro suggest that potential drug interactions
      may exist between propofol and other drugs administered clinically.

PMID- 7772433
TI  - ATP sparing effect of isoflurane during ischaemia and reperfusion of the canine
      heart.
AB  - Sustained dysfunction of myocardial contractility after short periods of coronary
      artery occlusion and reperfusion has been termed "stunned myocardium". Isoflurane
      may improve the recovery of regional myocardial contractility in stunned
      myocardium. The purpose of the present study was to determine if isoflurane
      prevents depletion of high energy phosphates after myocardial ischaemia
      reperfusion and if the reduction in cardiac work during isoflurane anaesthesia
      contributes to the preservation of high energy phosphate metabolism in an acute
      canine model. Mongrel dogs were allocated to one of three groups: controls,
      anaesthetized with urethane and chloralose; ISO group, isoflurane administered
      before ischaemia; and ISOc group, heart rate and mean arterial pressure
      controlled to approximately match baseline values. The left anterior descending
      (LAD) coronary artery was occluded for 15 min and then reperfused for 60 min
      during 1.5% end-tidal isoflurane anaesthesia. Full thickness samples of
      myocardium were obtained from the reperfused area (supplied by the LAD) and the
      non-ischaemic area (supplied by the left circumflex coronary artery). The
      concentrations of adenosine monophosphate (AMP), adenosine diphosphate (ADP),
      adenosine triphosphate (ATP), creatine phosphate (CP) and lactate in the
      endocardial portion of the myocardium were measured. Arterial pressure, aortic
      flow in the ascending aorta and rate-pressure product decreased significantly
      after isoflurane. Although the concentration of ATP of the reperfused area in the
      control group showed a significant reduction 60 min after reperfusion, the ISO
      and ISOc groups had significantly greater concentrations. Isoflurane anaesthesia
      maintained myocardial high energy phosphate metabolism in reperfused myocardium.
      We conclude that the reduction in cardiac work played only a minor role in the
      ATP-sparing effect of isoflurane.

PMID- 7772435
TI  - Effect of sevoflurane on the vascular reactivity of rabbit mesenteric artery.
AB  - Sevoflurane is well known to cause depression of cardiovascular function, but
      detailed information on its actions on the contractility and reactivity of blood
      vessels is lacking. We have assessed therefore the direct effect of this
      anaesthetic on the functional reactivity of isolated rabbit mesenteric artery
      ring preparations. We found that contractions of endothelium intact rings induced
      by noradrenaline and phenylephrine were significantly attenuated by 4%
      sevoflurane; the observation that the maximal tension generation decreased
      without a significant reduction in pD2 is consistent with the view that receptor
      dysfunction was not involved. The effect of sevoflurane was not affected by NG
      monomethyl-L-arginine. Sevoflurane 4% also produced attenuation of noradrenaline
      induced contractions of endothelium denuded ring preparations. The contractions
      of endothelium denuded ring preparations produced by noradrenaline in Ca(2+)-free
      media in the presence of K+ were not affected by 4% sevoflurane, but sevoflurane
      depressed external Ca(2+)-dependent contractions. When vasodilators
      (acetylcholine and nitroglycerin) were added to the bathing media in the presence
      of 2% sevoflurane, the endothelium-dependent relaxation produced by
      acetylcholine, but not the endothelium-independent relaxation produced by
      nitroglycerin, was attenuated; superoxide dismutase inhibited the effect of
      sevoflurane on endothelium-dependent relaxation. These results are consistent
      with the view that sevoflurane inhibits alpha adrenoceptor-mediated contractions
      of isolated rabbit mesenteric artery ring preparations; this effect may be caused
      by reduced Ca2+ influx, as estimated from the effect on external Ca(2+)-dependent
      contractions, but is unlikely to be caused by reduced Ca2+ release from the
      sarcoplasmic reticulum of vascular smooth muscle, as estimated from noradrenaline
      induced contractions in Ca(2+)-free bathing media.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7772434
TI  - Comparative effects of halothane, enflurane, isoflurane and sevoflurane on
      function and metabolism in the ischaemic rat heart.
AB  - This study was designed to examined the effects of inhalation anaesthetics on
      function and metabolism in isolated ischaemic rat hearts. Four volatile
      anaesthetics in two different concentrations (1.0 to 1.5 MAC) were used before
      whole heart ischaemia was induced for 15 min followed by reperfusion for 30 min.
      The data were compared with a control group in which inhalation anaesthetics were
      not used. Before ischaemia, volatile anaesthetics depressed ventricular function.
      During reperfusion, ventricular function and coronary flow in both halothane
      groups were significantly lower than those in the control group. Myocardial ATP
      concentrations in the 1.0 MAC of enflurane and isoflurane groups were
      significantly higher than those in the control group. We conclude that halothane
      had more depressant effects than the other anaesthetics and that enflurane and
      isoflurane may enhance metabolic recovery in the ischaemic working rat heart.

PMID- 7772436
TI  - Cardiovascular responses to graded doses of three catecholamines during lactic
      and hydrochloric acidosis in dogs.
AB  - We have studied the cardiovascular effects of incremental doses of three
      catecholamines in dogs subjected to lactic (LAC) and hydrochloric (HCl) acidosis.
      Fifty-four dogs were allocated randomly to one of three groups: control, LAC and
      HCl acidosis (n = 18 each group). In the acidotic models, 2 mol litre-1 of lactic
      acid (4 ml kg-1 h-1) or 2 mol litre-1 of HCl (1 ml kg-1 h-1) was infused i.v.
      until arterial pH was reduced to 7.00 +/- 0.1. Within each group, six dogs
      received one of three different drugs in logarithmically incremental doses:
      adrenaline 0.1, 0.2, 0.4, 0.8, 1.6, 3.2 micrograms kg-1 min-1, noradrenaline 0.1,
      0.2, 0.4, 0.8, 1.6, 3.2 micrograms kg-1 min-1 and dobutamine 5, 10, 20, 40, 80,
      160 micrograms kg-1 min-1. Cardiovascular variables were monitored, with periodic
      measurements of plasma electrolyte and lactate concentrations. The pH reduction
      induced by HCl or lactic acid was associated with a statistically significant
      increase in mean pulmonary arterial pressure (MPAP), prominent especially in the
      LAC group where MPAP increased from mean 18 (SD 5) to 27 (6) mm Hg. In the
      acidotic models, the reduction in myocardial responsiveness to adrenaline or
      noradrenaline was more prominent than that for the control for corresponding
      doses of drugs. In the LAC group mean cardiac index decreased significantly from
      5.2 (1.8) to 2.2 (0.7) litre min-1 m-2 after infusion of adrenaline 3.2
      micrograms kg-1 min-1 and decreased from 5.1 (1.1 to 2.4 (0.9) litre min-1 m-2
      after infusion of noradrenaline 3.2 micrograms kg-1 min-1.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7772437
TI  - Gastric intramucosal pH, tissue oxygenation and acid-base balance.

PMID- 7772438
TI  - Comparison of three devices for oxygen administration in the late postoperative
      period.
AB  - We have evaluated three different devices for oxygen administration in the
      surgical ward, the Hudson face mask (oxygen 3 litre min-1, air 12 litre min-1),
      the nasal prong (oxygen 3 litre min-1) and the binasal catheter (oxygen 3 litre
      min-1). We evaluated the three devices in random order for periods of 30 min each
      in 25 patients with postoperative hypoxaemia (SpO2 < or = 94%). Arterial oxygen
      saturation was measured by continuous pulse oximetry and comfort was evaluated
      with a questionnaire after each treatment period. The three systems increased
      arterial oxygen saturation to similar levels, but the highest degree of comfort
      was found with the binasal catheter. Use of the binasal catheter is recommended
      for oxygen administration in the late postoperative period.

PMID- 7772439
TI  - Effect of i.v. diamorphine on the regression of spinal block.
AB  - Twenty patients undergoing transurethral prostatectomy under spinal anaesthesia
      were allocated randomly in one of two groups. After operation dermatomal levels
      to cold were measured every 30 min until they had receded to T10. Patients in
      group 1 were then given diamorphine 5 mg in 0.9% saline 5 ml i.v. and in group 2
      0.9% saline 5 ml i.v. Block level to cold and degree of motor block were assessed
      at 15-min intervals for 1 h after injection. Block regression continued in the
      control group while there was no decrease in the diamorphine group for 30 min (P
      < 0.01) after which it then receded at a similar rate as the control group. There
      was no significant difference in motor block between the two groups.

PMID- 7772440
TI  - Intra-vas deferens bupivacaine for prevention of acute pain and chronic
      discomfort after vasectomy.
AB  - We have studied the use of intra-vas deferens local anaesthesia in 70 patients
      undergoing vasectomy as day-case patients. Patients were allocated randomly to
      either a control or treatment group. In the treatment group, 0.5% bupivacaine 1
      ml or 0.9% saline 1 ml was injected into the lumen of the right or left vas
      deferens in a randomized blinded design. The control group did not receive an
      injection. Patients were discharged with a questionnaire for recording visual
      analogue scores (VAS) for both the right and left sides to be scored on days 1
      and 7 after operation. One year after the procedure a second questionnaire was
      sent out asking about the presence or absence of chronic testicular discomfort,
      its duration and any surgical intervention required to relieve it. There were no
      differences between the control group and the saline side of the treatment group
      in VAS scores on both day 1 and day 7 after operation or in the incidence and
      duration of chronic testicular discomfort (mean 30 (SD 53) and 34 (50) days,
      respectively). The VAS scores were, however, significantly less (P < 0.005) and
      testicular discomfort was absent on the bupivacaine-treated side.

PMID- 7772441
TI  - Lansoprazole in the prophylaxis of acid aspiration during elective surgery.
AB  - We have assessed the efficacy of a single dose of lansoprazole in increasing the
      pH and decreasing the volume of gastric residue at induction of anaesthesia in
      adult patients undergoing elective orthopaedic surgery. We studied 66 ASAI-II
      patients, allocated to one of three groups to receive either placebo (group 1),
      lansoprazole 30 mg (group 2) or lansoprazole 60 mg (group 3), 8-12 h before
      induction of anaesthesia. Volume and pH of gastric contents were measured after
      induction of anaesthesia by aspiration via a 16-French gauge gastric tube.
      Patients who received lansoprazole had a significantly higher pH than the placebo
      group (P < 0.01) but there was no difference between the two lansoprazole groups.
      The volume of gastric residue was significantly smaller (P < 0.01) in both
      lansoprazole groups compared with the placebo group: 28% of those in group 3 had
      a pH of gastric residue < 2.5 and volume > 25 ml compared with 30% in group 2 and
      63% in group 1, respectively.

PMID- 7772442
TI  - Hyperventilation reverses the nitrous oxide-induced increase in cerebral blood
      flow velocity in human volunteers.
AB  - Because hypocapnia is routine during general anaesthesia for intracranial
      procedures, we have compared, in 13 healthy volunteers, the effect of normocapnia
      (PE'CO2 5.3 kPa) and hypocapnia (PE'CO2 3.3 kPa) on mean blood flow velocity in
      the middle cerebral artery (Vmca) during normoventilation and hyperventilation
      with air and with 50% nitrous oxide in oxygen. After replacement of air with 50%
      nitrous oxide in oxygen, there was an increase in mean Vmca during
      normoventilation (air: mean 68.23 (SD 16.98) cm s-1 vs nitrous oxide in oxygen:
      90.69 (20.41) cm s-1; P < 0.01), whereas during hyperventilation mean Vmca values
      were similar regardless of the inhaled gas mixture (air: 43.46 (9.97) cm s-1 vs
      nitrous oxide in oxygen: 41.69 (8.08) cm s-1. Our data suggest that the nitrous
      oxide-induced increase in mean Vmca can be blocked by hyperventilation.

PMID- 7772443
TI  - Effect of automatic record keeping on vigilance and record keeping time.
AB  - We have evaluated the effect of an automatic anaesthesia record keeper (AARK) on
      record keeping time and vigilance. With informed patient consent and
      institutional approval, we videotaped the attending anaesthetist and his/her
      immediate surroundings during 66 surgical procedures. Thirty-seven cases were
      charted manually and the remaining 29 were charted with a commercially available
      AARK. In order to evaluate vigilance, a physician examiner entered the operating
      room unannounced once during 33 of the manually charted cases and during 22 of
      the automatically charted cases and asked the anaesthetist to turn away from the
      monitors and recall the current value of eight patient physiological variables.
      The examiner recorded the recalled values and also the actual current monitor
      values of these variables. The videotapes were reviewed and the anaesthetist's
      intraoperative time was categorized into 15 predefined activities, including
      intraoperative anaesthesia record keeping time. We compared recalled and actual
      variable values to determine if the recalled values were within clinically
      relevant error limits. There was no statistical difference between the mean
      percentage case time spent recording manually (14.11 (SD 3.98)%) and
      automatically (12.39 (3.92)%). Moreover, use of the AARK did not significantly
      affect vigilance. Despite major advances in monitoring technology over the past
      14 years, record keeping still occupies 10-15% of the anaesthetist's
      intraoperative time. It appears that in using an AARK, the anaesthetist
      reallocates intraoperative record keeping time from manual charting to dealing
      with problems in the anaesthetist machine interface caused by inadequate design.

PMID- 7772444
TI  - Circumcision analgesia.

PMID- 7772445
TI  - Fresh gas flow rate and enflurane consumption.

PMID- 7772447
TI  - Methoxamine and blood loss in prostatic surgery.

PMID- 7772446
TI  - Methoxamine and blood loss in prostatic surgery.

PMID- 7772448
TI  - Posture and autonomic cardiac control.

PMID- 7772449
TI  - Hyperventilation-induced unconsciousness during labour.

PMID- 7772450
TI  - Nitric oxide delivery system.

PMID- 7772451
TI  - Nitric oxide delivery system.

PMID- 7772452
TI  - Help-seeking for AIDS high-risk sexual behavior among gay and bisexual African
      American men.
AB  - Help-seeking for AIDS high-risk sexual behavior and its association with HIV
      status were examined among 318 gay and bisexual men in the San Francisco Bay Area
      who participated in the African American Men's Health Project, a longitudinal
      survey of gay and bisexual African-American men. A third (36%) of the sample
      reported seeking help regarding their concerns about HIV high-risk sexual
      behavior. Peers and professionals were the most widely sought sources of help and
      the sources perceived to be the most helpful. Men (39%) who had received the HIV
      antibody test and who were HIV seropositive were more likely to seek help than
      men who were HIV seronegative or did not know their HIV status (25%).
      Furthermore, gay men who were HIV seropositive or who knew their serostatus were
      more likely to seek help from professionals and peers. Explanations for the
      differences in help-seeking by HIV-seropositive men are discussed with
      implications for the development of social support for HIV risk reduction among
      gay and bisexual African-American men.

PMID- 7772453
TI  - Planning and evaluating strategies for AIDS health education interventions in the
      Muslim community in Uganda.
AB  - In 1992 the Islamic Medical Association of Uganda designed an AIDS prevention
      project. A baseline survey was conducted to assess prevailing knowledge,
      attitudes, and practices among the Muslim communities in two districts. A low
      rate of incorrect beliefs about HIV transmission was found, although gaps in
      knowledge remain, particularly regarding vertical transmission and asymptomatic
      HIV infection. Less than 10% knew that condoms can protect against HIV
      transmission. Lack of knowledge was documented regarding the risk of HIV
      transmission associated with practices common in the Islamic community, such as
      polygamous marriages, circumcision, and ablution of the dead. The AIDS prevention
      project has incorporated specific messages and interventions as a result of these
      findings.

PMID- 7772454
TI  - HIV risk behavior among homeless adults.
AB  - Very little information is available regarding HIV risk behavior among homeless
      adults despite increasing evidence that HIV infection disproportionately affects
      inner-city residents and disadvantaged populations. In the present study, adults
      (N = 94) entering a storefront medical clinic for the homeless completed an AIDS
      risk survey. The results suggest that homeless adults are engaging in sexual and
      substance-use behaviors that place them at high risk for HIV infection. Sixty
      nine percent of the present sample was at risk for HIV infection from either 1)
      unprotected intercourse with multiple partners, 2) intravenous drug use (IVDU),
      3) sex with an IVDU partner, or 4) exchanging unprotected sex for money or drugs.
      Many persons within the sample evidenced multiple risk factors: 45% reported at
      least two of the risk factors described above and 26% reported three or more risk
      factors. The results suggest there is an urgent need to develop and evaluate AIDS
      prevention strategies for homeless adults.

PMID- 7772455
TI  - Health belief and self-efficacy models: their utility in explaining college
      student condom use.
AB  - This investigation tested the ability of the Health Belief Model (HBM),
      dimensions of self-efficacy, various behavioral variables (i.e., number of sex
      partners in the past 12 months, frequency of drunkenness during sexual
      intercourse, and number of diagnosed sexually transmitted diseases), and
      demographic measures to distinguish between three condom user groups (i.e.,
      nonusers, sporadic users, and consistent users). The usable sample consisted of
      366 college students, ages 18 to 24. The study operationalized the following HBM
      components: perceived susceptibility, perceived benefits, and perceived barriers.
      The multidimensional Condom Use Self-Efficacy Scale (CUSES) was also used in this
      investigation. Results from a discriminant analysis indicated that sporadic users
      were best distinguished from both consistent and nonusers by number of sex
      partners in the past year, frequency of drunkenness during sexual intercourse,
      perceived susceptibility to HIV/AIDS and other STDs, and a self-efficacy factor
      labeled Assertive. The sporadic users had significantly more sex partners, were
      drunk more often when engaging in sexual intercourse, perceived themselves as
      more susceptible to HIV/AIDS and other STDs, and were less confident in their
      ability to discuss and insist on condom use with a partner. It was also
      discovered that each condom user group was best defined by different subsets of
      discriminating variables. Implications of these findings for campus-based
      prevention programs and future research are discussed.

PMID- 7772456
TI  - Behavioral training and AIDS risk reduction: overcoming barriers to condom use.
AB  - To assess the short- and long-term effects of an AIDS-prevention workshop on
      undergraduates' attitudes about condom use and AIDS, 31 participants and 31
      controls were studied immediately after training sessions as well as three months
      later. The workshop was aimed at reducing embarrassment to purchase condoms,
      encouraging positive attitudes about condoms, and promoting knowledge about AIDS.
      To help students overcome their embarrassment over condom purchases, a behavioral
      intervention was included allowing students to make condom purchases at nearby
      drug stores. Results revealed that participants reported less embarrassment over
      condom purchases after training sessions and that this effect became even
      stronger over time. Knowledge about AIDS and positive attitudes about condoms
      also increased immediately after the workshop, but these changes did not persist.
      Results suggest that AIDS prevention workshops may lead to transient changes
      unless a specific skill (i.e., condom purchasing) is targeted via behavioral
      training.

PMID- 7772457
TI  - Using students' salient beliefs to design an instructional intervention to
      promote AIDS compassion and understanding in the middle school.
AB  - This article documents the construction and validation of a videotaped message to
      persuade middle school students to volunteer as the laboratory partner of a
      classmate who has AIDS. Based on well-established social-psychological models of
      persuasion, message arguments are designed either to reinforce or to downplay the
      modal salient beliefs held by message recipients about the intended behavior. The
      end-product of this precisely tailored, six-step process is instruction which not
      only promotes the adoption of tolerant and compassionate attitudes, but also
      provides an opportunity for the practice of essential life skills such as
      decision making and problem solving. The process itself is offered as a model for
      designing any instructional material which addresses today's growing list of AIDS
      related issues having both moral and ethical implications.

PMID- 7772458
TI  - Determinants of safe and risk-taking sexual behavior among gay men: a review.
AB  - Since the outbreak of the AIDS epidemic, gay men have made impressive changes in
      their sexual behavior. Notwithstanding these changes, there are several studies
      that show considerable within-subject variability in risk categories, indicating
      that for a substantial number of gay men it is difficult to be consistently safe.
      A large number of studies have examined the relationship between sexual behavior
      and determinants of that behavior. This review reports and discusses the findings
      with regard to demographic, situational, behavioral, and psychosocial
      determinants.

PMID- 7772459
TI  - Samuel Broder, MD, resigns as NCI Director: a highly effective champion of cancer
      education.

PMID- 7772460
TI  - Can practicing physicians improve their counseling and physical examination
      skills in breast cancer screening? A feasibility study.
AB  - OBJECTIVE: To improve breast cancer screening skills, practicing non-academic
      primary care physicians were offered an opportunity to participate in a one-hour
      private skills-assessment session with a patient instructor. Research questions
      included: would physicians in non-academic practice be interested in a skills
      course; would the course improve their skills in breast examination and/or in
      counseling for mammography; and if they did improve, would the effect endure?
      DESIGN: Pilot study with cohort follow-up. INTERVENTIONS: Physicians were offered
      an opportunity to have their counseling and physical examination skills evaluated
      in a one-on-one interaction with standardized patients. The protocol included
      patient instructors who were trained to use a uniform breast health history that
      emphasized their increased risk of breast cancer, scant knowledge of breast
      cancer screening, and fear of medical tests and cancer. The standardized patients
      were trained using a 77-point checklist. They demonstrated a high degree of
      consistency and reproducibility. A critical part of the learning experience was
      immediate feedback to the physicians regarding their performances. Physicians who
      took the course were given an opportunity to repeat it approximately 18 months
      later. MEASUREMENTS AND MAIN RESULTS: Of the 82 primary care physicians in the
      community, 49 (60%) were eligible to have their skills evaluated. Of these, 38
      (77.6%) participated in the intervention. Baseline skills had mean scores
      (correct responses) better than 50% in most aspects of the physical examination
      but less than 35% in several critical counseling areas: reviewing mechanics of
      getting mammography, actually recommending mammography, and directing the patient
      regarding scheduling. Of the 38 physicians, 15 repeated the course. There was a
      significant improvement in their overall performance: 49% vs 67% (p = 0.002).
      CONCLUSIONS: Primary care physicians in a non-academic practice are interested in
      reviewing and improving their counseling skills. They are capable of improving
      their skills after receiving background information, instruction, and brief
      feedback. They maintain these improvements over time.

PMID- 7772461
TI  - Breast cancer screening practices for hospitalized women.
AB  - The increasing prevalence of breast cancer and the demonstrated benefits of
      routine breast screening activities have prompted considerable attention to the
      use of screening procedures. In addition to public education efforts, physicians
      have been encouraged to incorporate breast screening guidelines into their daily
      practice. This study was undertaken to examine the current practice of breast
      screening activities for women hospitalized on a general medical or surgical unit
      at a university medical center. A retrospective chart review of 159 women
      hospitalized during a six-month period demonstrated that breast screening
      activity in the sample was similar to national rates of breast cancer screening.
      Within the year, 43% of these women had had a clinical breast examination and 21%
      had had mammography. This suggests that the period of hospitalization had not
      been used by practitioners as an opportunity to initiate breast screening
      activities in the patient's care.

PMID- 7772462
TI  - Low-cost flexible sigmoidoscopy screening: a community demonstration and
      education project.
AB  - The purpose of this project was to demonstrate that a low-cost, community-based
      screening and education approach (for both patients and physicians), as has been
      used with mammography, can be successful with flexible sigmoidoscopy. One hundred
      appointments over four days were made available via a targeted mailing to 12,000
      health-interested community members if they were asymptomatic, 50 years old or
      older, and had never before been screened by flexible sigmoidoscopy. The cost for
      the procedure was set at $50. Professional education was accomplished by having
      local physicians interested in gaining greater experience with flexible
      sigmoidoscopy provide the screenings under supervision. All 100 patient
      appointments and seven physician-training slots were quickly filled. Ninety-five
      procedures were performed by seven local physicians, averaging 10 minutes per
      procedure, with an average insertion depth of 31 cm and a 4.2% premalignant-polyp
      detection rate. The patients were also given education and counseling about
      colorectal cancer screening and prevention, and were evaluated by pre- and post
      testing, and satisfaction questionnaires. The patients demonstrated markedly
      significant knowledge gains about colorectal cancer prevention and early
      detection, with 99% agreeable to having the procedure repeated in the future.
      This project demonstrated a high level of both public and professional
      willingness to participate in a flexible sigmoidoscopy screening program. The
      project method is presented in detail to encourage future such programs.

PMID- 7772463
TI  - Evaluation of alternate messages on an electronic message strip to recruit
      subjects to a smoking-cessation program.
AB  - The authors previously published details of a method to evaluate the
      effectiveness of electronic message strips in recruiting subjects to a smoking
      cessation program. They now report data suggesting that a shorter, more negative
      message yields better results than a longer, more positive message. The data also
      show that this approach increases the number of subjects who enroll in a smoking
      cessation program and the number of subjects who actually quit smoking.

PMID- 7772464
TI  - The carcinogenic risks of alcoholic beverages: implications for cancer education.
AB  - The proper analysis of the data generated by studies of carcinogenic risks of
      drinking alcoholic beverages would be the application of models from the
      relatively new approach of meta-analysis. In this study, 441 articles were
      generated by a 1992 MEDLINE search of the key words "alcohol drinking" and
      "cancer." Of these, only 29 met the criteria for a formal meta-analysis. For
      these 29 research reports, the 95% confidence limits for the odds ratio were 1.28
      and 1.15, suggesting a weak association between drinking and cancer. This
      conclusion was rendered even less decisive by the following problems in the
      studies analyzed: 1) absence of comparable measures of either dosages or drinking
      patterns; 2) absence of comparable methods of data analysis; 3) absence of
      comparable measures of other population characteristics; and 4) widely varying
      results from study to study. For example, the 95% confidence limits for the odds
      radio of the 16 European studies were 1.14 and 0.98, indicating not even a
      reliable directional difference between drinking and nondrinking populations.
      Although the World Health Organization International Agency for Research on
      Cancer concluded in 1987 that alcoholic beverages are carcinogenic, the
      scientific literature extant in 1992 provides only very weak support for that
      finding. There is a need for multiple nonexperimental investigations using
      methods that will produce results sufficiently comparable to justify the
      application of the statistical models being generated for the meta-analysis of
      important questions not subject to direct experimentation.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7772465
TI  - A survey to determine the knowledge of military members about the hazards of
      tobacco use, and a resulting tobacco-hazard education project.
AB  - A questionnaire and an intraoral examination were administered to 340 U.S. Navy
      personnel in order to ascertain the use of tobacco and its effect within the oral
      cavity. The rate of tobacco use among these military personnel was about twice
      that of the general public. About 45% of the patients were not well informed of
      the systemic or intraoral hazard of tobacco usage. With a need for tobacco-hazard
      awareness documented, an educational project was designed and administered to
      over 4,000 military and civilian participants. This education program has now
      been expanded to train health care professionals so that they can perform their
      own tobacco-hazard education with patients and small groups.

PMID- 7772467
TI  - Cancer education and the primary school teacher in England and Wales.
AB  - Many adult behaviors and attitudes develop in early childhood. There is a growing
      acceptance of the need for health education of children of primary school age.
      Cancer is an important topic within health education, and this study was designed
      to assess the level of cancer education in schools. Data were collected from a
      randomly selected sample of over 1,000 teachers of children in primary school
      years 3-6 (ages 7-11 years). Cancer had been taught about by 18% of the sample,
      and their pupils' ages had no significant effect on whether they had taught about
      cancer. Cancer was most often taught about in response to a real-life situation,
      and the majority of the teachers did not use cancer education resources to help
      them. The study sought to ascertain why so many teachers had taught about cancer.
      It appears that concerns over their own lack of personal knowledge, and a
      perceived lack of resources, were the most common reasons. The young age of the
      pupils was also a deterrent to cancer education, especially among the teachers of
      the younger pupils. The results indicate various interventions that may increase
      the level of primary-school-based cancer education. These include improving
      teachers' awareness of cancer education issues and providing appropriate cancer
      education resources.

PMID- 7772466
TI  - Oncology education needs survey of registered nurses in Texas.
AB  - In response to the need to determine continuing education priorities in oncology
      nursing, the Nurse Oncology Education Program surveyed a geographically
      stratified random sample of Texas registered nurses concerning their oncology
      practices, perceived skill levels, and personal needs for training in 61 topics
      areas. The 378 respondents rated their skill levels low to medium, although 62%
      cared directly for patients with cancer. The highest-rated priorities for
      professional education were: legal issues, issues and trends in cancer care,
      investigational/new drug development, and bone marrow transplantation. Nurses
      employed in community settings and those living outside metropolitan areas tended
      to indicate the highest numbers of strong training needs. However, comparison of
      the needs for cancer prevention and detection education by regions showed that
      for none of the geographic regions was a high training need for cancer prevention
      and detection identified.

PMID- 7772468
TI  - Problem-based learning: innovative approach to studying chronic disease in
      dentistry.

PMID- 7772469
TI  - Improving residents' knowledge of cancer prevention: are physicians prepared for
      prevention?
AB  - BACKGROUND: Primary care physicians recognize the goal of integrating cancer
      prevention strategies into clinical practice. However, there is little formal
      training in cancer prevention and early detection. This study describes the
      effectiveness of a cancer-prevention curriculum called "Recommendations for
      Cancer Prevention (ReCaP) for Residents" for primary care residency programs.
      METHODS: The ReCaP for Residents curriculum was organized into eight
      instructional modules by organ site-specific areas for which there are
      established primary and secondary cancer-prevention recommendations. The modules
      include content outlines, learning objectives, slides, and case studies. In-house
      faculty and 21 residents of two family practice programs participated in an
      intervention comprising seven one-hour modular presentations during their regular
      summer teaching program. An established cancer-prevention knowledge test with 100
      test items was used to test the residents' knowledge before and after the
      intervention; the data were analyzed by factor analysis with principal-component
      extraction and varimax rotation. RESULTS: The residents knew significantly more
      about cancer prevention after the ReCaP for Residents program. The mean overall
      prevention knowledge increased significantly (p < .05), and the scores of six of
      eight specific organ-site areas also increased. CONCLUSION: This study provided
      evidence that ReCaP for Residents was an effective curriculum for increasing
      residents' knowledge of cancer prevention. The authors recommend that more
      extensive programs of this type be implemented.

PMID- 7772470
TI  - Biological activity of vitamin D analogues in the skin, with special reference to
      antipsoriatic mechanisms.
AB  - Active vitamin D3 modulates epidermal growth, keratinization and inflammation,
      and various vitamin D3 analogues have been shown to be effective in the treatment
      of psoriasis. These analogues now provide a useful addition to the therapeutic
      modalities available for the treatment of psoriasis. Epidermal
      hyperproliferation, abnormal keratinization and inflammation are the well
      established hallmarks of the psoriatic plaque. The aim of this review is to
      provide an update of information on the cell biological effects of vitamin D3,
      and the influence of vitamin D analogues on the pathomechanisms of psoriasis.

PMID- 7772471
TI  - Overview of the use of terbinafine (Lamisil) in children.
AB  - This review summarizes the efficacy and tolerability of terbinafine (Lamisil) in
      the treatment of dermatophytoses in children. In six clinical studies, 152
      children who received terbinafine were evaluable for efficacy and 196 were
      evaluable for tolerability. In these studies, terbinafine was used for between 1
      and 28 weeks. The median treatment was 4 weeks, the duration of treatment in the
      tinea capitis studies. As a result of extensive experience in adults at doses of
      10 mg/kg and less, and the overall pharmacokinetic profile in children, including
      the lower volume of distribution of terbinafine into lipophilic tissue, the use
      of a dose of 125 mg/day for children weighing 20-40 kg, and 62.5 mg/day in
      children weighing less than 20 kg, has been proposed. This dose was shown to be
      well tolerated and effective. For children weighing > 40 kg, the adult dose of
      250 mg is appropriate. Terbinafine was shown to be very effective (93% cured), in
      the treatment of children with tinea capitis, using a shorter treatment duration
      (4 weeks) than that usually employed with presently available antifungal drugs.
      It is also effective in children with various dermatophyte infections of the
      skin, with a cure rate of more than 90%. Terbinafine was shown to be well
      tolerated in children aged between 2 and 17 years. The recommended duration of
      treatment for tinea capitis is 4 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772472
TI  - Reduced wound contraction and scar formation in punch biopsy wounds. Native
      collagen dermal substitutes. A clinical study.
AB  - In full-thickness skin wounds dermal regeneration usually fails, resulting in
      scar formation and wound contraction. We studied dermal regeneration by
      implantation of collagenous matrices in a human punch biopsy wound model.
      Matrices were made of native bovine collagen I fibres, and either hyaluronic
      acid, fibronectin, or elastin was added. Matrices were placed in 6-mm punch
      biopsy holes in seven patients (biopsies were used for the grafting of leg
      ulcers), and covered with a protective semi-permeable polyether urethane
      membrane. Histology, wound contraction and dermal architecture were studied.
      Dermal architecture was evaluated using a recently developed laser scatter
      technique. All collagen matrices showed a tendency to reduce wound contraction,
      compared with control wounds; elastin- and fibronectin-treated matrices showed
      significantly less contraction than control wounds. Only the addition of elastin
      had a clear beneficial effect on dermal architecture; collagen bundles were more
      randomly organized, compared with control wounds, and wounds treated with
      collagen matrices coated with fibronectin or hyaluronic acid, or without coating.
      We conclude that the punch biopsy wound model provides important information on
      dermal regeneration in humans. Native collagen matrices with elastin contributed
      to dermal regeneration and reduced wound contraction, in contrast with matrices
      coated with fibronectin or hyaluronic acid, or without coating. Future clinical
      studies of large-area, full-thickness wounds will be required to establish their
      clinical relevance for leg ulcer and burn treatment.

PMID- 7772473
TI  - Failure of intradermal skin testing with gluten to produce delayed
      hypersensitivity reactions in patients with dermatitis herpetiformis.
AB  - Dermatitis herpetiformis (DH) is characterized by a rash and a gluten-sensitive
      enteropathy (GSE) indistinguishable from that of coeliac disease. T-cell-mediated
      mechanisms have been implicated in the pathogenesis of GSE. It seems feasible
      that intradermal injection of gluten, in patients known to have GSE, could lead
      to an influx of T cells sensitized to gluten, with subsequent development of a
      delayed hypersensitivity-type reaction. Six patients with DH and three normal
      subjects had intradermal injections of 'Frazer's fraction III' (FFIII; the
      partial peptic tryptic digest of gluten which is known to be antigenic) and
      phosphate-buffered saline (PBS) as a control. Skin biopsies were taken at PBS and
      FFIII injection sites at 48 h. In addition, two of the patients with DH had
      biopsies taken of FFIII injection sites at 6 h. Monoclonal antibodies and the
      avidin-biotin-peroxidase technique were used to stain for T cells in the skin
      biopsies. A monoclonal antibody to a neoepitope exposed in the terminal
      complement complex and an immunofluorescent method were used to detect the
      presence of terminal complement component in biopsies taken from two of the
      control subjects and two of the patients. Both patients and control subjects
      developed a weal and flare within a few minutes of injecting the FFIII, and this
      persisted for up to 6 h. No skin reaction was present in either the patients or
      the control subjects at 48 h. No skin reaction was visible at any time following
      injection of PBS.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772474
TI  - Effects of cyclosporin and ultraviolet radiation on growth and ornithine
      decarboxylase activity in cultured human epidermal keratinocytes.
AB  - Both cyclosporin (CyA) and ultraviolet radiation are effective in the treatment
      of psoriasis, but their precise mechanisms of action are uncertain. We
      investigated their effects on ornithine decarboxylase (ODC) activity, ODC gene
      expression, and cellular proliferation stimulated by epidermal growth factor
      (EGF), in cultured normal human epidermal keratinocytes. CyA (5 micrograms/ml)
      inhibited ODC activity, ODC mRNA level, and cell growth induced by 50 ng/ml EGF.
      Ultraviolet B (10 mJ/cm2) irradiation suppressed the induction of ODC, ODC mRNA,
      and cell proliferation stimulated by EGF, but ultraviolet A (0-15 J/cm2)
      irradiation inhibited neither EGF-stimulated ODC activity nor cell proliferation.
      These findings indicate that reduction of ODC activity in CyA- or ultraviolet B
      treated human keratinocytes may contribute to the antiproliferative mechanism of
      these agents. These results also suggest that the regulation of ODC activity by
      ultraviolet B and A irradiation may be mediated by different signal transduction
      pathways.

PMID- 7772475
TI  - Localization of anionic sites in normal and psoriatic epidermis: the effect of
      enzyme digestion on these anionic sites.
AB  - Cell surface anionic charge is known to be related to various cellular functions.
      Therefore, we ultrastructurally localized anionic sites in normal and psoriatic
      human epidermis, using poly-L-lysine-gold complex (cationic gold), to assess
      their possible participation in the differentiation of keratinocytes and the
      pathogenesis of psoriasis. In normal and psoriatic epidermis, the cell membrane
      of keratinocytes showed positive staining at pH 2.0. At pH 7.4 the cytoplasm and
      nucleus were diffusely stained, in addition to the cell membrane. In normal
      epidermis, the intensity of labelling on the cell membrane at pH 2.0 was strong
      in the basal layer and lower stratum spinosum, and decreased in parallel with
      differentiation of keratinocytes. In psoriatic epidermis, the intensity of
      labelling on the cell membrane at pH 2.0 was stronger than in normal epidermis.
      In normal epidermis, heparitinase digested 63% and chondroitinase ABC digested
      80% of cationic labelling. This suggests that heparan sulphate and chondroitin
      sulphate (and/or dermatan sulphate) constitute anionic sites in normal epidermis.
      In psoriatic epidermis, chondroitinase ABC-sensitive anionic sites were greatly
      increased, whereas heparitinase-sensitive anionic sites were the same, when
      compared with normal epidermis. This suggests that chondroitin sulphate and/or
      dermatan sulphate constitute anionic sites which are increased in psoriatic
      epidermis.

PMID- 7772476
TI  - Electrical impedance measured to five skin depths in mild irritant dermatitis
      induced by sodium lauryl sulphate.
AB  - The non-invasive electrical impedance technique used in this study reflects
      structural changes in a tissue, and provides an estimate of the level of oedema
      by a simple impedance index. Sodium lauryl sulphate (SLS), dissolved in water at
      concentrations of 0.1, 0.5 and 2.0%, was applied for 24 h in 12 mm Finn chambers
      on both volar forearms of 12 healthy volunteers. An unoccluded area was used as a
      reference site. Readings from all sites were taken before the application of the
      irritant, and 24 h after its removal. After the last reading, a 3-mm punch biopsy
      was taken from each test site for histological examination. The results obtained
      from electrical impedance measurements at five different skin depths were
      correlated with those obtained from histological examination, visual scoring and
      transepidermal water loss (TEWL). For all of the methods used the responses were
      proportional to the concentration of the irritant. Statistically significant
      changes of electrical impedance were found for all depths and concentrations,
      except for 0.1% SLS at the most superficial depth. The histological changes were
      focused in the epidermis, and mainly consisted of oedema. Alterations in the
      thickness of the epidermis due to oedema were used as a quantitative parameter
      for correlation with the assessment of irritation using the electrical impedance
      technique. For the detection of irritant reactions, TEWL and electrical impedance
      are more sensitive than visual scoring, and selection of the optimum depth
      penetration further increases the sensitivity of the electrical impedance
      measurement.

PMID- 7772477
TI  - Defective in vivo expression and apparently normal in vitro expression of a newly
      identified 105-kDa lower lamina lucida protein in dystrophic epidermolysis
      bullosa.
AB  - We have previously identified a novel 105-kDa lower lamina lucida protein
      detected by the autoantibodies from a group of patients who developed a unique
      immune-mediated subepidermal bullous dermatosis. We sought to determine if this
      novel basement membrane zone (BMZ) protein is normally expressed in the skin of
      patients with various subsets of epidermolysis bullosa (EB). Indirect
      immunofluorescence microscopy performed on non-lesional skin sections from
      patients with three major EB subsets revealed absence or significantly reduced
      expression of this novel BMZ protein in 20 out of 23 skin sections from patients
      with generalized dominant and recessive dystrophic EB. However, immunoblot
      analyses with the autoantibodies on Western-blotted proteins revealed that a
      comigrating 105-kDa protein is present in both cytosol extracts (n = 6) and
      conditioned media (n = 3) of cultured dermal fibroblasts derived from patients
      with dystrophic EB, as well as those cultured from two healthy individuals.
      Although the reason for such disparate findings is not known, the defective in
      vivo expression of this novel 105-kDa protein in dystrophic EB is presumably not
      due to a failure of fibroblasts to synthesize or secrete the protein. It is
      possible, however, that the 105-kDa protein may be unable to incorporate into the
      BMZ because it is produced in a dysfunctional form, or its BMZ binding site is
      missing. It is also possible that other structural alterations in skin BMZ, which
      occur in dystrophic EB, result in masking of the antigenic binding by the
      autoantibody when intact BMZ is probed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772478
TI  - Expression of the apoptosis-suppressing protein Bcl-2 in non-melanoma skin
      cancer.
AB  - Basal cell carcinoma (BCC) is typically a slow-growing malignant tumour, composed
      of cells similar to those in the basal area of the epidermis. We investigated the
      expression of bcl-2 (B-cell leukaemia/lymphoma-2) in BCC, and also in squamous
      cell carcinoma (SCC) of the skin. The proto-oncogene bcl-2 encodes a protein
      which inhibits programmed cell death (apoptosis). The protein is expressed in
      basal cells in normal human epithelium, but not in the suprabasal cell layers.
      Immunohistochemical localization using a monoclonal anti-Bcl-2 antibody revealed
      bcl-2 expression in all the BCCs (15 patients). SCCs did not express bcl-2 (five
      patients). The positive Bcl-2 staining of BCC tumour cells supports the
      hypothesis that BCCs originate from the basal layer of the epidermis. The bcl-2
      expression of BCC tumour cells also suggests a neoplastic transformation caused
      by extended cell survival rather than increased cell proliferation. This type of
      neoplastic growth is possibly associated with less aggressive tumour behaviour.

PMID- 7772479
TI  - Soluble E-cadherin: a novel cutaneous disease marker.
AB  - E-cadherin is a major homophilic cell-cell adhesion molecule of the skin. There
      are two forms of E-cadherin--membrane and soluble types. Although various
      abnormalities of the former type have been identified in some cutaneous diseases,
      information relating to the latter is sparse. We measured the concentrations of
      soluble E-cadherin in several cutaneous diseases, and found higher levels in sera
      from patients with bullous pemphigoid, pemphigus vulgaris, psoriasis vulgaris and
      inflammatory skin diseases, compared with controls. In psoriasis vulgaris the
      levels of soluble E-cadherin in sera correlated with the PASI score. In normal
      individuals, levels in suction blister fluid were double those in sera. These
      findings suggest that changes occur in circulating levels of soluble E-cadherin
      in skin disease, possibly reflecting increased turnover and/or proteolysis of
      cell-surface molecules in the epidermis.

PMID- 7772480
TI  - The localization of the target antigens and antibodies in linear IgA disease is
      heterogeneous, and dependent on the methods used.
AB  - Fifty-nine patients with linear IgA disease, 24 with onset in childhood and 35
      with adult onset, were studied. Sera from all patients were tested by indirect
      immunofluorescence, using as substrates intact normal skin and normal skin which
      had been split through the lamina lucida region of the basement membrane zone by
      suction and by prolonged incubation with molar NaCl. This enabled the site of the
      target antigen for the circulating IgA antibodies to be determined. The sites of
      deposition of the IgA antibodies in vivo were detected by raising a suction
      blister in eight patients, and splitting seven patients' biopsies by prolonged
      incubation with molar NaCl. Eighteen sera were positive with intact skin, and 34
      with split skin. Twenty-nine sera were positive with suction blisters as
      substrate; 14 bound to the epidermal aspect of the split skin, seven in a
      combined pattern (binding to the epidermis and dermis) and six to the dermal
      aspect. Thirty-one sera bound to salt-split skin, 24 to the epidermal side and
      seven on the dermal side. There was discordance between the two methods of skin
      splitting in 15 sera. Seven sera gave a combined pattern with suction but with
      salt-split skin, five of these bound epidermally, one was dermal, and one
      negative. Five sera showed epidermal binding on salt-split skin and were negative
      on suction blisters, and the reverse was seen with one serum. Two sera gave
      variable results on suction blisters. Direct immunofluorescence studies showed
      dermal binding on all eight patients with suction blisters, and epidermal binding
      in four and dermal binding in three patients with salt splitting.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7772481
TI  - Prevalence of dermatophyte onychomycosis in Spain: a cross-sectional study.
AB  - To evaluate the prevalence of dermatophyte onychomycosis in Spain, a cross
      sectional study was conducted between 1992 and 1993. A total of 10,007 subjects
      over the age of 15 years were interviewed (using the computer-assisted telephone
      interview system), completed a directed questionnaire, and reviewed a series of
      photographs of diverse nail disorders. The period prevalence of onychomycosis was
      2.6% and the point prevalence 1.7%. The prevalence of onychomycosis was higher in
      women (1.8%) than in men (0.8%). Age group distribution showed a higher
      onychomycosis prevalence (1.2%) in the oldest age group (> 55 years). With regard
      to localization, the prevalence of toenail onychomycosis was higher than that of
      fingernail onychomycosis and of concurrent infection in both sites. The results
      of this study suggest that 802,893 inhabitants of Spain have, or have previously
      suffered from dermatophyte onychomycosis. Only 38.6% have sought medical advice,
      and only 14% of those who did so consulted a dermatologist.

PMID- 7772482
TI  - The effects of topical indomethacin and clobetasol propionate on post-cryotherapy
      inflammation.
AB  - The effects of topical indomethacin and clobetasol propionate on erythema and
      oedema following low-dose cryotherapy to normal skin were examined using a single
      blind technique. Both agents significantly reduced erythema, but neither had a
      significant effect on oedema. A further, controlled, double-blind study comparing
      topical indomethacin and inert gel base was performed after cryotherapy to hand
      warts. In this study, topical indomethacin had no significant effect on post
      cryotherapy oedema, erythema, pain or blister formation 48 and 96 h after
      treatment. Both potent topical steroids and cyclo-oxygenase inhibitors reduce
      erythema after low-dose cryotherapy. In clinical practice, there is no evidence
      that topical indomethacin significantly inhibits the inflammatory response to
      cryotherapy.

PMID- 7772483
TI  - Reactions to other corticosteroids in patients with allergic contact dermatitis
      from hydrocortisone.
AB  - It has been proposed that corticosteroid cross-reactions occur more frequently
      within structurally well-defined groups. To test this hypothesis we have compared
      the patch-test reactions to other corticosteroids in 96 patients allergic to
      hydrocortisone. We found that our data did not agree with the previously proposed
      classification. The presence of a substitution at the C6 or C9 position was the
      most important factor in determining whether a patient would be allergic to
      another corticosteroid. This information should facilitate the choice of an
      alternative corticosteroid in patients allergic to hydrocortisone, if facilities
      for patch testing to other corticosteroids are not available.

PMID- 7772484
TI  - Prevalence of atopic dermatitis in Leicester: a study of methodology and
      examination of possible ethnic variation.
AB  - A study was undertaken to investigate and compare various methods of estimating
      the prevalence of atopic dermatitis (AD), and to investigate a possible ethnic
      difference in our local community. Preschool children attending routine child
      health surveillance clinics and Social Services day nurseries were examined by a
      trained observer, and their parents were interviewed. In addition, general
      practice records from a health centre were scrutinized. Three hundred and twenty
      two children aged 1-4 years were examined, and the point prevalence of AD was 14%
      [95% confidence interval (CI) 10-18]. There was no apparent ethnic difference in
      prevalence. Twenty-seven per cent (95% CI 22-32) of parents reported that their
      children had suffered from 'eczema' at some time. General practitioners' records
      contained a diagnosis of 'eczema' in 32% (95% CI 28-36) of 446 children aged 1-4
      years. It is clear that methodology must be carefully standardized if comparisons
      are to be made between different studies. Accurate estimations of the prevalence
      of AD can probably only be obtained by examination of a population sample by a
      trained observer. However, the estimates obtained in this study are high, and
      would tend to support existing evidence that the prevalence of AD is rising.

PMID- 7772485
TI  - Hypnotherapy as a treatment for atopic dermatitis in adults and children.
AB  - Eighteen adults with extensive atopic dermatitis, resistant to conventional
      treatment, were treated by hypnotherapy, with statistically significant benefit
      (P < 0.01) measured both subjectively and objectively, which was maintained at up
      to 2 years where results were available. Twenty children with severe, resistant
      atopic dermatitis were treated by hypnosis. All but one showed immediate
      improvement, which was maintained at the following two clinic appointments. In 12
      children, replies to a questionnaire at up to 18 months after treatment, showed
      that 10 had maintained improvement in itching and scratching, nine in sleep
      disturbance, and seven maintained improvement in itching and scratching, nine in
      sleep disturbance, and seven maintained improvement in mood.

PMID- 7772486
TI  - Minimizing cicatricial pemphigoid orodynia with minocycline.
AB  - Cicatricial pemphigoid is a rare autoimmune blistering disease of the elderly. It
      predominantly affects the mucosae, causing pain and scarring. the target antigen
      is within the lamina lucida of the basement membrane zone. Potential
      complications of systemic steroid and other immunosuppressive therapy have
      prompted trials of other means of treatment. We describe a series of seven
      patients treated with minocycline, six of whom derived sustained alleviation of
      orodynia. Four patients developed hyperpigmentation, and two complained of
      gastrointestinal discomfort which necessitated cessation of minocycline. Complete
      steroid withdrawal was achieved in two cases. Neither the disease progression nor
      the response to treatment was influenced by the immunoglobulin isotype or titre.
      The role of minocycline as a useful adjunct to therapy is discussed.

PMID- 7772488
TI  - Nodular prurigo responds to cyclosporin.
AB  - Nodular prurigo is a distressing disease which is difficult to treat. Two
      patients with severe nodular prurigo were treated with cyclosporin for periods of
      36 and 24 weeks, respectively, using doses of 3-4.5 mg/kg per day. In both cases
      there was a reduction in the severity of pruritus after 2 weeks of treatment. In
      one patient there was a considerable, although incomplete response, and in the
      other almost complete resolution of the disease was achieved. The improvement was
      maintained throughout the treatment period, and the drug was generally well
      tolerated, although in one patient there was a rise in serum creatinine during
      treatment, which later returned to normal.

PMID- 7772487
TI  - Topical cyclosporin in oral lichen planus: a controlled, randomized, prospective
      trial.
AB  - The published studies of topical cyclosporin (CyA) therapy in chronic oral lichen
      planus (OLP) have shown conflicting results. We report an investigator-blinded
      study of 13 patients with OLP, who were randomly assigned to treatment with CyA
      (500 mg as a swish-and-spit medication for 5 min three times daily) or a
      corticosteroid oral paste (triamcinolone acetonide). The duration of treatment
      was 6 weeks. Thereafter, patients on corticosteroid therapy were treated with
      CyA. Only slight, transient clinical improvement was observed in both groups
      after 6 weeks of treatment, compared with baseline. No significant differences
      could be demonstrated between the two groups. CyA therapy following
      corticosteroid treatment did not produce any further clinical improvement. During
      follow-up of the disease for up to 1 year after treatment, neither the CyA nor
      the corticosteroid group exhibited long-term improvement in disease activity.
      Contradictory results from earlier reports are discussed.

PMID- 7772489
TI  - Cutaneous infection with Mycobacterium abscessus.
AB  - Cutaneous infection with rapidly growing mycobacteria is uncommon and diagnosis
      may be difficult. However, the histopathological features are distinctive and may
      aid diagnosis. The three pathogenic species, Mycobacterium fortuitum, M. chelonae
      and M. abscessus, show major differences in their antimicrobial sensitivities,
      and species identification is therefore important. We describe a case of
      infection with M. abscessus, and discuss the clinical and pathological features
      of such infections, and approaches to their treatment.

PMID- 7772490
TI  - Subcutaneous fat necrosis of the newborn complicating hypothermic cardiac
      surgery.
AB  - A newborn male infant developed subcutaneous fat necrosis (SCFN) with extensive
      calcification, 1 week after hypothermic cardiac surgery. The lesions resolved
      spontaneously, without sequelae, within 10 weeks. Five cases of SCFN occurring
      after induced hypothermia, used as an adjuvant in cardiac surgery, have been
      reported to date in the English literature. Our description of a sixth case re
      emphasizes hypothermia as one possible cause of SCFN of the newborn.

PMID- 7772492
TI  - Regressing cutaneous lymphomas of T-cell and B-cell lineage.
AB  - We report two cases of regressing cutaneous lymphoma. The first case is a CD30
      positive T-cell lymphoma with immunogenetic evidence of clonality. The second
      case is a diffuse large-cell non-Hodgkin's lymphoma of B-cell lineage in which
      clonality was established by immunogenetic analysis and in situ hybridization for
      light-chain mRNA.

PMID- 7772491
TI  - Cutaneous myiasis due to Dermatobia hominis: a report of six cases.
AB  - We report six cases of Dermatobia hominis myiasis imported into the U.K. from
      Belize. With increasing international travel, myiasis may be encountered more
      frequently in countries in which the parasites are not indigenous. The life-cycle
      of D. hominis is described, and scanning electron micrographs show the detailed
      appearance of the larva.

PMID- 7772493
TI  - Hypocomplementaemic urticarial vasculitis, interstitial lung disease and
      hepatitis C.
AB  - A 42-year-old man developed persistent urticaria and angio-oedema responsive to
      systemic steroids. A skin biopsy revealed leucocytoclastic vasculitis. C4 levels
      were consistently decreased in the setting of a mildly elevated erythrocyte
      sedimentation rate. Pulmonary function studies revealed a restrictive pattern,
      and there was eosinophilia in bronchial lavage fluid. Antibody to hepatitis C
      virus was positive, and there was mild elevation of serum aminotransferase. We
      believe that this case represents another possible manifestation of immunological
      disease associated with hepatitis C virus infection.

PMID- 7772495
TI  - 'Dermatitis neglecta': unwashed dermatosis.

PMID- 7772494
TI  - Successful treatment of epidermolysis bullosa acquisita using intravenous
      immunoglobulins.
AB  - We report a 55-year-old man with severe inflammatory epidermolysis bullosa
      acquisita. The skin lesions did not respond to various immunosuppressive
      treatments. The combined administration of prednisone, azathioprine, dapsone and
      colchicine resulted only in a transient and incomplete resolution of the lesions.
      The bullae and increased skin fragility were successfully controlled by the
      addition of high-dose intravenous immunoglobulin therapy.

PMID- 7772496
TI  - Cyclosporin-induced periungual granulation tissue.

PMID- 7772498
TI  - Induced bullous pemphigoid.

PMID- 7772497
TI  - PUVA therapy in disabling pansclerotic morphoea of children.

PMID- 7772499
TI  - Treatment of Grover's disease with calcipotriol (Dovonex)

PMID- 7772500
TI  - Dermatophyte infection associated with a local recurrence of bullous pemphigoid.

PMID- 7772501
TI  - Alopecia areata arising in patients receiving cyclosporin immunosuppression.

PMID- 7772502
TI  - Contact urticaria to rice.

PMID- 7772503
TI  - Treatment of inflammatory linear verrucous epidermal naevus with calcipotriol.

PMID- 7772504
TI  - Quantitative PCR techniques and applications.

PMID- 7772505
TI  - In vitro inhibition of tumour necrosis factor-alpha and interleukin-6 production
      by intravenous immunoglobulins.
AB  - In vitro data about the action of pooled immunoglobulins (Ig) on cytokine (CK)
      production are controversial. The recent finding of natural antibodies against
      staphylococcal toxins neutralizing superantigen-induced activation prompted us to
      design an assay determining their ability to modulate staphylococcal enterotoxin
      B (SEB) induced CK production (IL-6 and TNF-alpha). Presence of anti-SEB
      antibodies was demonstrated by a dot-blot assay in the three preparations tested.
      Preincubation of SEB with pooled Ig prior to addition into the test tube
      containing PBMCs (neutralizing condition) resulted in a strong inhibition of both
      TNF-alpha and IL-6 release (TNF alpha: 59 +/- 5% inhibition, P < 0.0001; IL-6: 71
      +/- 7% inhibition, P < 0.0001, n = 15). Anti-CD3 MoAb-induced CK production was
      not modified. During our study it was found that experimental conditions were
      critical to observe this inhibitory effect. Reversing the previous procedure by
      adding PBMCs into the test tube containing pooled Ig mixed with SEB resulted in a
      marked induction of TNF-alpha and IL-6 production. The same observation was made
      when pooled Ig solely was added (coating condition). F(ab')2 fragments of pooled
      Ig displayed similar inhibitory capacity when added in neutralizing condition,
      indicating that the mechanism involved was not Fc dependent. The fragments lost
      the activating properties of intact Ig when incubated in coating condition,
      showing that Fc receptor activation occurs in this setting. The present work
      demonstrates that inhibition of SEB-induced CKs release by pooled Ig can be
      achieved by SEB neutralization, provided that the experimental conditions avoid
      activation through the Fc receptor. It can be assumed that similar mechanisms
      take place in some clinical conditions during which pooled Ig are infused.

PMID- 7772506
TI  - B lymphocytes with latent EBV infection appearing in long-term bone marrow
      cultures (HLTBMCs) from haematological patients induce lysis of stromal
      microenvironment.
AB  - Human long-term bone marrow cultures (HLTBMCs) are a valuable in vitro model for
      studying the role of the haemopoietic microenvironment. Here we report the
      spontaneous appearance of EBV-positive B cells in 6/40 HLTBMCs from patients with
      various haematological diseases after 3-5 months of culture. After subcultivation
      of these cells, a novel type of cell line could be characterized, which displayed
      surface markers and morphological features typical for EBV transformed B-cell
      lines. As the deproteinized and ultrafiltrated culture supernatants of these cell
      lines were found to contain an agent with stroma toxic properties, they were
      termed SSB lines (stroma-toxic-agent-secreting B-cell lines). This agent also
      exhibited a colony-inhibitory activity on in vitro myelopoiesis and
      erythropoiesis. These properties are typical for the two polyamines spermine and
      spermidine which were detected at elevated levels in the culture supernatants of
      SSB lines. The hypothesis that latent presence of EBV in bone marrow may induce
      an increased synthesis of spermine and spermidine, which are known to be
      associated with malignant haematological diseases and bone marrow aplasia, is
      discussed.

PMID- 7772507
TI  - Potentiation of lysis of leukaemia cells by a bispecific antibody to CD33 and
      CD16 (Fc gamma RIII) expressed by human natural killer (NK) cells.
AB  - Bispecific antibodies recognizing tumour-associated antigens and trigger
      molecules expressed on immune effector cells have been shown to redirect
      cytotoxicity of several types of peripheral blood cells against relevant tumour
      targets. Among various effector cells, natural killer (NK) cells appear to play a
      role in defence against leukaemia. Here we report the successful chemical
      conjugation of monoclonal antibodies to CD33 and CD16 to create a bispecific
      antibody (BsAb 251 x 3G8). This bispecific antibody is capable of augmenting the
      killing of otherwise resistant leukaemia cells by peripheral blood lymphocytes
      (PBL), purified resting NK (R-NK) cells, and activated NK (A-NK) cells. BsAb 251
      x 3G8 may play a role in the therapy of acute myeloid leukaemia (AML) through
      redirecting the cytotoxic activity of endogenous or adoptively transferred NK
      cells.

PMID- 7772508
TI  - Soluble tumour necrosis factor receptors, tumour necrosis factor and interleukin
      6 in serum in granulocytopenic patients with fever.
AB  - Serum levels of TNF, IL-6 and soluble TNF receptors p55 and p75 (sTNFR-p55 and
      sTNFR-p75) were examined in 14 patients with acute myeloid leukaemia during 43
      courses of chemotherapy. The patients experienced 30 episodes of fever which
      occurred during granulocytopenia (defined as granulocyte counts < 0.2 x 10(9)/l)
      and six fever episodes when granulocyte counts were > 1.0 x 10(9)/l. Febrile
      episodes were classified as microbiologically defined infection, clinically
      defined infection, and unexplained fever. Levels of bioactive IL-6 and
      immunoreactive TNF increased in response to fever during granulocytopenia,
      whereas bioactive TNF was not detected in any sample in this study. During
      granulocytopenia, both sTNFR rose significantly in microbiologically defined
      infection (P < 0.01 for sTNFR-p55 and P < 0.05 for sTNFR-p75), but not in the
      other two categories. The ratio of sTNFR-p55 to sTNFR-p75 was higher during
      febrile periods in granulocytopenia than in a non-granulocytopenic situation with
      granulocyte counts > 1.0 x 10(9)/l (P < 0.01). We conclude that granulocytopenia
      affects release of the two sTNFR differently during febrile periods, and that
      release of sTNFR-p75 in response to fever is reduced during granulocytopenia,
      suggesting a role for the granulocytes in systemic release of sTNFR-p75.

PMID- 7772509
TI  - Phenotypic analysis of functional T-lymphocyte subtypes and natural killer cells
      in human cord blood: relevance to umbilical cord blood transplantation.
AB  - Cord blood has been used successfully for stem cell transplantation in several
      haematological conditions: Fanconi's anaemia, leukaemia and Wiskott-Aldrich
      syndrome. On account of the low incidence of GVHD observed following cord blood
      transplantation, it has been suggested that cord blood be used for HLA-matched,
      or perhaps one or two antigens mismatched, and unrelated stem cell
      transplantation. Based on an extensive immunophenotype-functional correlation, we
      determined that cord blood contains mainly immature unprimed T lymphocytes that
      are predominantly suppressor cells. Recent findings suggest that dysregulated
      production of cytokines (IL-1, IL-2, TNF alpha) plays a role in GVHD. We showed
      that T cells in cord blood express receptors for IL-2, TNF alpha, but no
      receptors for IL-1. Similarly, NK cells, one of the effector cells of GVHD,
      express receptors for TNF alpha and gamma IFN but do not express receptors for IL
      1, nor IL-2R alpha-chain (CD25) although IL-2R beta-chain is expressed. The
      potential for activation of T lymphocytes and NK cells therefore exists in the
      context of bone marrow transplantation. However, the high number of suppressor
      cells in cord blood most likely modulate the activation of lymphocytes and NK
      cells thereby minimizing GVHD.

PMID- 7772510
TI  - Flow cytometry analysis of dual red blood cell populations after bone marrow
      transplantation.
AB  - Flow cytometry represents an alternative method to agglutination assays for the
      accurate quantification of mixed field populations of erythrocytes observed after
      bone marrow transplantation. Murine monoclonal antibodies directed against the
      blood group ABH antigens were selected and processed in order to prepare ready-to
      use fluorescent reagents. Anti-A (NaM87-1F6; IgG3), anti-B (NaM9-2E11; IgG3) and
      anti-H (NaM19-7E11; IgM) were purified, labelled with fluorescein isothiocyanate,
      and used in a direct flow cytometry assay. Anti-A1 (NaM1-1C9; IgG3) was no longer
      active after FITC-labelling and then was used in an indirect assay. The
      agglutination was prevented by formaldehyde pretreatment of erythrocytes. Using
      artificially-made double populations of erythrocytes, measured values with
      mixtures of 1-100% of cells were very closely related to expected values, showing
      both the sensitivity and the accuracy of the method. From careful investigation
      of a series of bone-marrow transplanted patients, we conclude that engraftments
      could be demonstrated earlier by flow cytometry than by agglutination, because
      minor populations (1-10%) of cells could be determined accurately only with
      labelled reagents. In addition, the disappearance of the donor cells on a long
      term follow-up of patients enabled an earlier detection of graft failure in one
      case. The proposed method provides appreciable help to follow engraftment in
      patients and may have more general applications for the study of other
      haemopoietic chimaeras.

PMID- 7772511
TI  - Interpretation of measured red cell mass and plasma volume in adults: Expert
      Panel on Radionuclides of the International Council for Standardization in
      Haematology.
AB  - Four European centres provided height and weight data on 202 males and 204
      females undergoing red cell mass (RCM) and plasma volume (PV) measurements. For
      these populations, the RCM and PV predictions by the various published methods
      were compared. It was shown clearly that predictions based solely on body weight
      were inappropriate, particularly because approximately half of the male and
      female populations could be regarded as overweight or obese. Although there was
      reasonable agreement in the prediction values given by the formulae based on both
      height and weight, it was not possible to establish which formulae could be
      recommended. For that reason, the published literature containing normal RCM and
      PV measurements were re-examined. RCM data for 283 males and 171 females and PV
      data for 100 males and 67 females were included. Measurements were standardized
      for variables such as trapped plasma in the PCV, exclusion of buffy coat in the
      PCV and calculation of PV at zero time. As a result of this analysis, prediction
      formulae based on surface area for RCM and PV with 98/99% reference ranges have
      been established.

PMID- 7772512
TI  - Needle liver biopsy in thalassaemia: analyses of diagnostic accuracy and safety
      in 1184 consecutive biopsies.
AB  - We report the reliability and safety of percutaneous liver biopsy in the
      evaluation of hepatic iron loading and histology in patients with homozygous beta
      thalassaemia prior to and in serial biopsies following allogeneic bone marrow
      transplantation for this disorder. 501 thalassaemic patients aged 11 +/- 4.5
      years (range 1-32 years) underwent 1184 consecutive percutaneous liver biopsies
      without ultrasound guidance. Overall, 81% of biopsies were evaluable for
      histological examination and grading of iron. The adequacy of liver biopsy
      specimens increased with patient age: evaluable specimens were obtained in 73% of
      patients < 5 years of age and in 86% of samples in patients aged > 15 years. The
      degree of iron overload and fibrosis in each biopsy was reported separately by at
      least two pathologists who did not know the clinical status of each patient. In
      103 biopsies, iron grade by light microscopy corresponded to an iron
      concentration varying between a mean of 32.46 +/- 14 mumol/g dry weight liver
      tissue for iron stores graded by light microscopy as absent to 417.6 +/- 150
      mumol/g dry weight liver tissue for stores graded as severe. The fibrosis score
      of multiple samples of liver obtained at autopsy within 100 d of the percutaneous
      biopsy in 41 patients who died following BMT correlated perfectly with that of
      the first sample in > 60% biopsies; in most of the discordant cases fibrosis had
      been underestimated in the percutaneous biopsy. Liver biopsy demonstrated
      evidence of chronic hepatitis in 30% of patients with normal transaminase and in
      57% of patients with transaminase within twice the normal range. Liver biopsy was
      complicated in six patients (0.5%) by haemoperitoneum, periocholecystic
      haematoma, kidney haematoma, or bile peritonitis; no complication was fatal.
      These data demonstrate that percutaneous liver biopsy provides reliable
      information regarding liver iron and histology in homozygous beta-thalassaemia
      with an extremely low risk of complications.

PMID- 7772513
TI  - A point mutation in the protein 4.2 gene (allele 4.2 Tozeur) associated with
      hereditary haemolytic anaemia.
AB  - A recessively transmitted haemolytic anaemia associated with the lack of protein
      4.2 was found in a Tunisian kindred. Trace amounts of this protein (72 kD
      component) became visible using high-sensitivity Western blots. Band 3 and
      ankyrin genes were excluded as candidate genes by linkage studies, and nucleotide
      sequencing of band 3 cytoplasmic domain cDNA revealed no alteration. In contrast,
      protein 4.2 gene contained in the homozygous state a mutation at position 310:
      CGA-->CAA (Arg-->Gln). This mutation defining allele 4.2 Tozeur was co-inherited
      with the disease. The mRNA encoding the variant protein was normal in size and
      approximately normal in amount. Recombinant protein 4.2 Tozeur bound normally to
      red cell IOVs but disclosed an increased susceptibility to proteolysis in vitro.
      We infer that the nearly total absence of protein 4.2 in the patients results
      from imbalance between destruction and synthesis of mutated protein 4.2 prior to
      its binding to the membrane.

PMID- 7772514
TI  - High-dose vincristine, fractionated total-body irradiation and cyclophosphamide
      as conditioning regimen in allogeneic and autologous bone marrow transplantation
      for childhood acute lymphoblastic leukaemia in second remission: a 7-year Italian
      multicentre study.
AB  - We investigated the feasibility and efficacy of high-dose vincristine (4 mg/m2
      over 4 d) combined with fractionated total body irradiation (F-TBI) (200 cGy x 2
      over 3 d) and cyclophosphamide (60 mg/kg for 2 d) as a preparative regimen in
      allogeneic (AlloBMT) and autologous (ABMT) bone marrow transplantation for 75
      consecutive children (median age at transplant 8.5 years) with acute
      lymphoblastic leukaemia in second complete remission (CR). Median duration of
      first CR was 26 and 25 months in the AlloBMT and ABMT group, respectively. Of the
      46 patients who underwent AlloBMT, 33 had isolated or combined marrow relapse and
      13 isolated extramedullary relapse. Of the 29 patients given ABMT, 23 had preBMT
      isolated or combined marrow relapse and six isolated extramedullary relapse.
      44/75 patients are alive and in CR at a median follow-up of 35 months (range 10
      90 months). Seven children given AlloBMT (15.8%) and two given ABMT (7%) died
      from transplant-related causes. No major early organ toxicity, including
      vincristine-related toxicity, was recorded. The overall 3-year EFS estimate (95%
      CL) was 53.8% (42-66%): in particular, 58.2% (40-76%) for AlloBMT and 27.6% (9
      46%) for ABMT patients who experienced a marrow relapse before transplant. The
      overall 3-year relapse rate estimate (95% CL) was 39.2% (27-51%): in particular,
      30.1% (12-49%) in the AlloBMT group and 72% (54-91%) in the ABMT group (P < 0.01)
      who presented a preBMT isolated or combined marrow relapse. We conclude that the
      conditioning regimen with high-dose vincristine combined with cyclophosphamide
      and F-TBI is feasible and promising, although its therapeutic advantage should be
      tested in larger series of patients enrolled in randomized studies.

PMID- 7772515
TI  - Over-expression of cyclin D1 in chronic B-cell malignancies with abnormality of
      chromosome 11q13.
AB  - Accurate identification of B-cell chronic malignancies is sometimes uncertain,
      despite careful cytologic and immunophenotypic evaluation. Cytogenetics and
      molecular biology studies may therefore prove useful, because some of these
      disorders are associated with non-random abnormalities, such as the
      t(11;14)(q13;q32) translocation and bcl-1 rearrangement mainly observed in mantle
      cell lymphoma (MCL). We studied the expression of cyclin D1 in malignant lymphoid
      cells from the peripheral blood of 32 patients with various B-cell chronic
      lymphoproliferative disorders, using Northern blot (NB) and RNA in situ
      hybridization (ISH). Cytogenetic analysis was informative in 18 cases, and most
      of the missing karyotype data were from typical B-CLL cases where a t(11;14) is
      unlikely to be found. Over-expression of cyclin D1 mRNA was observed by both NB
      and ISH in four samples (MCL; two cases; lymphoplasmacytic lymphoma: one case,
      unclassified B-cell chronic disorder: one case). In each of these cases there was
      an abnormality of chromosome 11q13, either a t(11;14)(q13;q32) translocation
      (three cases) or a del(11)(q13) without evidence of chromosome 14 involvement
      (one case). Cytogenetic and gene rearrangement studies are not available in all
      institutions and have some technical pitfalls. Because of its close association
      with bcl-1 rearrangement and/or t(11;14), the demonstration of cyclin D1 mRNA
      over-expression either by NB, or, more conveniently, by ISH, may represent
      additional information which could be of help for the identification of B-cell
      malignancies.

PMID- 7772516
TI  - Establishment of a myeloid leukaemic cell line (SKNO-1) from a patient with
      t(8;21) who acquired monosomy 17 during disease progression.
AB  - A novel cell line SKNO-1 was established from the bone marrow cells of a 22-year
      old male suffering from acute myeloblastic leukaemia (AML) M2 with t(8;21) whose
      disease became resistant to chemotherapy after acquisition of 17 monosomy. SKNO-1
      has been maintained for more than 36 months as a granulocyte-macrophage colony
      stimulating factor (GM-CSF) dependent line. Morphologically, SKNO-1 cells were
      myeloblasts somewhat matured. The cells grow in suspension with a doubling time
      of 48-72 h. The survival and growth of SKNO-1 cells was absolutely dependent on
      granulocyte-macrophage colony stimulating factor (GM-CSF). SKNO-1 cells possessed
      t(8;21) and monosomy 17 which were observed in original leukaemic cells. We
      confirmed that the AML1 gene, located on chromosome 21, was rearranged and the
      AML1-MTG8 fusion transcript was expressed in SKNO-1 cells. Over-expression and
      mutation of the p53 gene were also detected in SKNO-1. It is likely that
      alterations of AML1 or MTG8 gene and p53 gene contribute to a disease progression
      in this case. Since t(8;21) translocation is a common chromosome abnormality in
      AML, and inactivation of the p53 gene may play a crucial role in disease
      progression in AML, SKNO-1 would be a useful tool for analysing the molecular
      mechanisms in myeloid leukaemogenesis.

PMID- 7772517
TI  - Cobalamin forms and analogues in plasma and myeloid cells during chronic
      myelogenous leukaemia related to clinical condition.
AB  - Plasma and buffy coat specimens of CML patients with untreated disease, in
      chronic and accelerated phase, and in overt blastic crises were analysed for the
      cobalamin patterns using non-polar extraction, thin-layer chromatography and
      bioautography. Splenic tissue specimens from four splenectomized patients in
      accelerated phase were analysed similarly. Cellular extracts were separated into
      two compartments by adsorption to haptocorrin antibodies. Plasma concentrations
      of all cobalamin forms were increased in CML. The proportion of methylcobalamin
      was significantly lower than in a reference population, and a low plasma
      proportion of methylcobalamin was associated with a poor prognosis. Buffy coat
      cells and splenic tissue had a higher proportion of 5'-deoxyadenosylcobalamin and
      a lower proportion of methylcobalamin than plasma; still, there was relatively
      more methylcobalamin than in normal tissue. The haptocorrin-bound compartment
      differed from the non-haptocorrin compartment in untreated or chronic phase
      patients by binding less methylcobalamin. An estimate of cobalamin analogues in
      plasma was achieved by comparing two different isotope dilution assays employing
      a cobalamin-specific binder, intrinsic factor, and a nonspecific binder, hog non
      intrinsic factor. Values for total cobalamin and analogues were increased to the
      same degree in CML plasma.

PMID- 7772518
TI  - Bone marrow pathology in relapsing polychondritis: high frequency of
      myelodysplastic syndromes.
AB  - Haemopathologic changes were studied in 19 patients (13 male, six female, age 33
      85 years, mean 56 years) with relapsing polychondritis (RP). Anaemia was found in
      eight, thrombocytopenia in two and splenomegaly in three patients. A total of 17
      bone marrow biopsies were obtained from seven individuals. Bone marrow evaluation
      revealed myelodysplastic syndromes (MDS) with marked trilineage hyperplasia and
      dysplasia in three cases. Since an excess of myeloblasts or an increase of CD34
      positive progenitor cells was not seen, the disorders were designated as
      'refractory anaemia' or with regard to the dysplastic megakaryopoiesis 'MDS,
      unclassifiable'. Two of the three patients died after 10 and 55 months of follow
      up due to infectious complications. In a further patient, bone marrow analysis
      repeatedly showed an unexplained granulopoietic hyperplasia, which, however, was
      not dysplastic enough to allow a diagnosis of MDS. The remaining patients had
      clearly reactive changes. Our findings support the notion that RP is a
      heterogenous disorder and suggest that RP may at times represent a paraneoplastic
      phenomenon of an underlying MDS. Since HLA typing revealed a significantly
      increased frequency of the antigen DR4 (10/17 patients positive = 59%), we
      hypothesize that immunological imbalances due to the MDS in conjunction with a
      specific immunogenetic background may play key roles in the pathogenesis of RP in
      these patients.

PMID- 7772519
TI  - The use of r-HuEpo in the treatment of anaemia related to myelodysplasia (MDS).
AB  - One hundred and sixteen (116) anaemic patients with myelodysplastic syndromes
      (MDS) were treated with recombinant human erythropoietin (r-HuEpo) in an open
      label, multicentre, compassionate treatment trial; 100 patients received therapy
      for > or = 4 weeks and were evaluable for efficacy. The distribution of FAB
      subtypes was: 44 RA, 40 RARS, eight RAEB, two RAEB-t, one CMML, and five not
      specified. Mean baseline haematocrit was 24.5%, and the mean prestudy transfusion
      requirement in the 12 weeks immediately prior to study entry was 6.5 units. r
      HuEpo treatment was initiated at a dose of 150 U/kg three times weekly, with dose
      escalations of 50 U/kg monthly (up to 300 U/kg 3x/week) permitted if the
      haematocrit failed to rise. Response to therapy was defined as either an increase
      in haematocrit of > or = 6 percentage points over baseline, unrelated to
      transfusion, or a > or = 50% decrease in transfusion requirement in the last 3
      months of study treatment, compared to the baseline period (12 weeks). By these
      criteria, 28% (28/100) of patients responded to r-HuEpo treatment. Overall, 86%
      (24/28) of patients responding to therapy had baseline Epo levels < or = 100
      mU/ml. Response rates by FAB subtype were: RA 39% (17/44), RARS 17.5% (7/40) and
      RAEB 12.5% (1/8). Additionally, a 54% (15/28) response rate was seen in RA
      patients with baseline Epo levels < or = 100 mU/ml. Responses to therapy were
      durable and generally occurred at r-HuEpo doses of 150-200 U/kg t.i.w. There were
      no reports of thrombosis, seizures or therapy-related hypertension. The data show
      that patients with MDS, especially those with the RA and RARS subtypes, can
      benefit from treatment with r-HuEpo. Those patients with baseline Epo levels < or
      = 100 mU/ml were most likely to respond to therapy.

PMID- 7772520
TI  - Clonal analysis of peripheral blood and haemopoietic colonies in patients with
      aplastic anaemia and refractory anaemia using the polymorphic short tandem repeat
      on the human androgen-receptor (HUMARA) gene.
AB  - The clonalities in white blood cells (WBC) of blood and nucleated bone marrow
      cells from patients with refractory anaemia and aplastic anaemia were examined by
      polymerase chain reaction (PCR) methods using the polymorphic short tandem repeat
      (STR) on the human androgen-receptor gene (HUMARA). Peripheral blood samples were
      obtained from 12 female patients, six with aplastic anaemia (AA) and six with
      refractory anaemia (RA). Peripheral blood was fractionated into granulocytes,
      lymphocytes, T lymphocytes and B lymphocytes. DNA was extracted from each
      fraction. Bone marrow samples were obtained from seven female patients (three
      with AA and four with RA). Sorted CD34 positive cells were cultured in a
      semisolid culture system. DNA was extracted from a 14-day haemopoietic colony.
      The clonal pattern was assessed using HUMARA gene STR polymorphism and the
      differential methylation pattern of nearby cytosine residues by PCR methods. Four
      of six (67%) AA and two of six (33%) RA patients had a monoclonal proliferating
      pattern in their granulocytes. The ratio of the numbers of minority colonies per
      majority colonies (m/M ratio) was examined for seven patients (three AA and four
      RA). In patients who had a clonal haemopoietic pattern in peripheral WBC the
      ratio was under 0.4 but not zero. In contrast, patients exhibiting a polyclonal
      pattern had an m/M ratio above 0.8. We concluded that some normal or heterogenous
      haemopoietic clones, not only MDS but also AA, may remain in the bone marrow,
      although almost all colonies were derived from a single pathogenic clone when the
      clonality pattern exhibited monoclonality in peripheral blood analysis.

PMID- 7772521
TI  - A specific allele of the histidine-rich glycoprotein (HRG) locus is linked with
      elevated plasma levels of HRG in a Dutch family with thrombosis.
AB  - Recent studies describe families with both elevated plasma HRG levels and
      thrombosis. In order to study the possibility that allelic variants of the HRG
      locus are associated with differences in HRG level, we studied linkage between
      HRG levels and a dinucleotide repeat polymorphism in a Dutch family which was
      selected on the presence of both thrombosis and elevated plasma HRG levels. No
      other known risk factors from thrombosis were found in this family. Linkage was
      calculated between the dinucleotide repeat and the HRG level considering the HRG
      level as a quantitative phenotype assuming a population prevalence of elevated
      HRG of 5%. Two classes of HRG levels were defined by a mean and a variance: one
      class with normal HRG levels and a second class with high HRG levels. Using a
      mean HRG level of 99% for individuals with a normal HRG level and 145% for
      individuals with high HRG, a maximum lod score of 4.17 (odds in favour of linkage
      of 22,000:1) was found at a recombination fraction of 0, indicating linkage.
      Considering the pedigree, an association was found between the presence of a
      specific allele (no. 6) of the dinucleotide repeat polymorphism and plasma HRG
      levels. Family members carrying allele 6 were found to have higher HRG plasma
      levels compared with family members lacking allele 6 (149% v 109% respectively).
      We conclude that in this family, linkage is found between the HRG locus and the
      HRG level, and that a HRG gene coupled to allele 6 of the dinucleotide
      polymorphism is associated with elevated plasma HRG levels. No evidence was found
      for a causal relationship between elevated plasma HRG levels and thrombosis in
      this family.

PMID- 7772522
TI  - Platelet activation induced by a murine monoclonal antibody directed against a
      novel tetra-span antigen.
AB  - MAb 14A2.H1 identifies a novel low-abundance platelet surface antigen, PETA-3,
      which is a member of the tetra-span (TM4) family. This MAb brings about platelet
      aggregation and mediator release, which is completely inhibitable by
      prostaglandin E1, and partially inhibitable by aspirin and ketanserin. Platelet
      activation by MAb 14A2.H1 is dependent on interaction with both the platelet Fc
      receptor, Fc gamma RII, and the specific antigen as it was prevented by either a
      blocking MAb to Fc gamma RII (IV.3) or F(ab')2 fragments of 14A2.H1. The extent
      of platelet activation by the antibody varied considerably between donors, and is
      believed to reflect the polymorphism of Fc gamma RII. Subaggregating
      concentrations of 14A2.H1 synergized with other platelet agonists, ADP,
      adrenaline, collagen and serotonin, indicating signalling via a pathway distinct
      from these activators. Synergy was also blocked by MAb IV.3, or F(ab')2 fragments
      of 14A2.H1. The similar low copy number of PETA-3 and Fc gamma RII in the
      platelet membrane (approximately 1000/platelet), together with the dependence on
      Fc gamma RII for activation by MAb 14A2.H1, suggests that PETA-3 may be a
      component of the Fc gamma RII signal transducing complex in platelets.

PMID- 7772523
TI  - Impaired high-shear-stress-induced platelet aggregation in patients with chronic
      renal failure undergoing haemodialysis.
AB  - We investigated shear-induced platelet aggregation (SIPA) in 30 patients with
      chronic renal failure (CRF) undergoing haemodialysis. 26 patients showed a
      significant decrease in SIPA at high shear stress but no change in SIPA at low
      shear stress. The former reaction reflects the interaction between plasma von
      Willebrand factor (vWF) and its platelet receptors, glycoprotein (GP) Ib-IX and
      IIb/IIIa complex, whereas the latter is assumed to involve the binding of plasma
      fibrinogen to GP IIb/IIIa complex. These SIPA profiles in CRF patients after
      haemodialysis showed almost no change compared to those before haemodialysis. The
      ratio of ristocetin cofactor/vWF antigen in plasma was slightly lower in CRF
      patients than in controls (P < 0.01). However, the level of GPIb antigen in the
      platelets of these patients was significantly reduced (42.1 +/- 20.3% of normal
      platelets), with partial destruction of GPIb antigen. The number of vWF receptors
      on the GPIb molecule was quantitated using the GPIb-binding protein alboaggregin
      B (AL-B), purified from the snake venom of Trimeresurus albolabris. AL-B bound to
      GPIb at a total of 48,760 +/- 9944 molecules per normal platelet and a Kd of
      85.44 +/- 15.70 nM at saturation. In contrast, binding in CRF platelets was
      22,980 +/- 6395 molecules per platelet and Kd was 50.08 +/- 13.83 nM. Taking
      these results together, we conclude that the impaired SIPA found in CRF patients
      is due to both abnormalities in plasma vWF and in its platelet GPIb receptor.

PMID- 7772524
TI  - Desferrioxamine therapy accelerates clearance of iron deposits after bone marrow
      transplantation for thalassaemia.
AB  - We treated 18 heavily iron-loaded patients who had become ex-thalassaemics after
      bone marrow transplantation with subcutaneous desferrioxamine therapy for 5-20
      months. As determined using serum ferritin concentration, transferrin saturation
      and stainable liver iron obtained in follow-up biopsies, marked decreases in body
      iron stores were observed with this regimen. Moreover, the liver function tests
      demonstrate a trend to normalization in all cases. Local skin reactions to
      desferrioxamine were the only toxicities observed. We conclude that
      pharmacological iron chelation is a safe and effective therapy in the reduction
      of iron deposits in this clinical situation; it therefore represents a valid
      alternative to phlebotomy in selected patients.

PMID- 7772525
TI  - Assessment of intestinal blood-flux by laser Doppler fluxmetry in mice with
      altered intestinal iron absorption.
AB  - Laser Doppler fluxmetry (LDF) has been used to assess mucosal blood-flux in the
      intestine of normal CD1 mice and groups of animals with altered iron metabolism
      (i.e. iron-deficient, hypoxic and hypotransferrinaemic [hpx/hpx]). All
      experimental animals showed a 2-3-fold increase in duodenal iron absorption,
      mainly due to changes in the 'mucosal transfer' phase. However, only the hypoxic
      mice exhibited any increases in duodenal blood-flux. In the hpx/hpx group, blood
      flux was maintained at control levels despite the anaemia and without any
      significant alterations in red blood cell velocity. Moreover, these two groups
      demonstrated a further capacity to increase blood-flux above basal levels during
      onset of acute hypoxia (inhalation of 10% O2). Changes in duodenal blood-flux
      were apparent on both the mucosal and serosal surfaces, suggesting that the LDF
      signal reflects flux throughout the thickness of the mouse intestine. Iron
      absorption is likely to be more related to plasma flux changes than to blood-flux
      changes. Deduction of plasma flux changes from blood-flux changes is complicated
      by vasodilation effects on capillary haematocrits. It is clear from the data,
      however, that plasma flux changes do not parallel changes in iron absorption in
      the experimental models. The lack of correlation between the duodenal blood-flux
      and iron absorption values in the experimental models argues against the possible
      involvement of blood-flux in the control of duodenal iron absorption.

PMID- 7772526
TI  - Evaluation of transfusional iron overload before and during iron chelation by
      magnetic resonance imaging of the liver and determination of serum ferritin in
      adult non-thalassaemic patients.
AB  - The ability to quantitate transfusional iron overload is crucial for determining
      the need for and the efficacy of chelation therapy in patients with long-standing
      transfusion-dependent anaemias. We evaluated the usefulness of some indirect
      measures of iron overload in estimating the iron concentration in the liver--the
      most important iron storage organ--in 26 non-chelated adult non-thalassaemic
      patients. Liver iron concentration was determined non-invasively by magnetic
      resonance imaging (MRI). The standard error of the estimated liver iron
      concentration was 80 mumol Fe/g dried liver tissue when using the number of
      transfused blood units, and 93 mumol Fe/g when using a serum ferritin assay.
      Follow-up in 11 patients (12-48 months) revealed that serum ferritin is a poor
      measure of the liver iron concentration during iron chelation. However, this
      discrepancy was individually different and seemed to be dependent on the
      erythropoietic marrow activity. By monitoring the liver iron concentration by
      MRI, we compared the efficacy of chelation with desferrioxamine given either by
      subcutaneous continuous infusions or by bolus injections. Depletion of liver iron
      stores could be achieved efficiently by both regimens.

PMID- 7772527
TI  - t(8;21) myelodysplasia, an early presentation of M2 AML.
AB  - The reciprocal translocation of genetic material between chromosomes 8 and 21,
      t(8;21), is usually restricted to cases of acute myeloid leukaemia (AML). Cases
      of AML with t(8;21) exhibit characteristic dysplastic features in myeloid and
      erythroid lineages with reduction in megakaryocytes. We report details of three
      patients presenting with myelodysplastic features; two had a typical t(8;21), and
      the third had a variant t(8;21) translocation. We discuss the significance of
      t(8;21) in the aetiology of myelodysplastic syndrome (MDS) and implications for
      the management of such patients.

PMID- 7772528
TI  - Factor V inhibitor associated with Sjogren's syndrome.
AB  - We report an unusual case of a 74-year-old male who developed a serum
      autoantibody reactive with human coagulation factor V (FV) in an activated form,
      as demonstrated by coagulation studies and immunoblotting analysis. Despite
      marked prolongation of a prothrombin time and an activated partial thromboplastin
      time in this patient, the inhibitor was not associated with clinical bleeding but
      with multiple cerebral infarctions. The patient had suffered from Sjogren's
      syndrome with polyclonal hypergammaglobulinaemia. The patient's purified IgG, an
      immediately acting inhibitor to FV, reacted with a light chain of thrombin
      activated FV (FVa) and inhibited the procoagulant activity of FVa without
      affecting the cleavage of FVa by activated protein C. The FV inhibitor may arise
      from activation of FV with consequent exposure of neoantigen during the
      activation of coagulation cascade in the patient with an autoimmune disorder for
      the background.

PMID- 7772529
TI  - Familial thrombocytosis.
AB  - Four cases of thrombocytosis in three successive generations of a family are
      described. High peripheral platelet count was found incidentally in the proband
      with cutaneous malignant lymphoma. Bone marrow examination showed megakaryocytic
      hyperplasia. Neither Philadelphia chromosome nor chimaeric bcr/abl junction was
      detected in marrow cells. In this family, thrombocytosis was thought to be
      transmitted by an autosomal dominant mode of inheritance.

PMID- 7772530
TI  - A possible anti-emetic role for sodium valproate in cytotoxic chemotherapy.
AB  - We report two patients with acute leukaemia who received emetogenic cytotoxic
      drugs and were on therapeutic doses of sodium valproate for epilepsy. Neither
      patient reported significant nausea nor vomited at any time during the
      chemotherapy, at times requiring no anti-emetic treatment whatsoever. We suggest
      that this absence of nausea was due to an anti-emetic effect of sodium valproate.

PMID- 7772532
TI  - The incidence of factor VIII inhibitors in the United Kingdom, 1990-93. Inhibitor
      Working Party. United Kingdom Haemophilia Centre Directors Organization.
AB  - Reports of all the factor VIII inhibitors arising in the United Kingdom in
      patients with haemophilia A during the years 1990-93 have been collated by the
      United Kingdom Haemophilia Centre Directors Organization. 32 new inhibitors were
      reported during this period, giving an average incidence of new inhibitors of 1.5
      per 1000 patients registered per year. Although most occurred in patients with
      severe haemophilia under the age of 10, 29% occurred in patients whose VIIIC was
      > 3 iu/dl, and 38% in patients over the age of 10 years. The incidence of
      inhibitors rose during the study period, but this change was not statistically
      significant.

PMID- 7772531
TI  - Detection of NPM-ALK DNA rearrangement in CD30 positive anaplastic large cell
      lymphoma.
AB  - CD30 positive anaplastic large cell lymphoma (ALCL) is a type of non-Hodgkin's
      lymphoma associated with a specific chromosome translocation between chromosomes
      2 and 5. Recent molecular characterization of the translocation breakpoint has
      identified a gene fusion between NPM (nucleophosmin) and ALK (anaplastic lymphoma
      kinase). Using a DNA hybridization technique, the NPM rearrangement was found
      among 5/5 ALCL samples. We have developed a PCT methodology which has enabled the
      detection of the NPM-ALK rearrangements amongst seven t(2;5)(p23;q35) ALCL cases
      based on a long-range PCR of genomic DNA. The rapidity and robustness of this
      method may have diagnostic applications for ALCL.

PMID- 7772533
TI  - Correction of anaemia and thrombocytopenia in a case of adult type I
      osteopetrosis with recombinant human erythropoietin (rHuEPO).
AB  - A case of adult osteopetrosis Type I was diagnosed in a 22-year-old female. She
      presented for investigation of anaemia with 'myelophthisic' characteristics and
      extramedullary haemopoiesis which was resistant to haematinics, nandrolone and
      low-dose corticosteroids. She became progressively transfusion-dependent with
      gradually worsening thrombocytopenia. She was successfully treated with
      recombinant erythropoietin. Anaemia as well as thrombocytopenia were corrected.
      There appeared to be a synergistic action of erythropoietin with steroids.

PMID- 7772534
TI  - Long-term disease-free survival after autologous bone marrow transplantation in a
      primary plasma cell leukaemia: detection of minimal residual disease in the
      transplant marrow by third-complementarity-determining region-specific probes.
AB  - Primary plasma cell leukaemia (PPCL) is a rare form of plasma cell neoplasm.
      Treatments of PPCL have been most disappointing. A patient with PPCL received
      high-dose melphalan plus total body irradiation and autologous bone marrow
      transplantation (ABMT). By using third-complementarity-determining region
      (CDRIII)-specific probes, minimal residual disease (MRD) was detected in
      remission marrow, collected 1 month before ABMT. MRD was no longer detected by
      CDRIII-specific probes 6, 19 and 26 months after transplantation. The patient
      remained in complete remission up to 59 months after ABMT.

PMID- 7772535
TI  - AcSDKP serum concentrations vary during chemotherapy in patients with acute
      myeloid leukaemia.
AB  - AcSDKP is a physiological negative regulator of cell proliferation in mammals. In
      Ara-C-treated mice its plasmatic concentrations decrease while the CFU-S start
      cycling. Infusion of AcSDKP protects these animals from death by blocking the
      proliferation of primitive haemopoietic cells. We measured AcSDKP serum
      concentrations in 20 AML patients during the course of high-dose cytoreductive
      treatment. We observed an early and sharp increase of AcSDKP during the induction
      treatment in 12 patients, reaching a peak during the initial 3 d of treatment in
      nine of them. These results are contrary to those observed in mice treated with
      high doses of Ara-C. They encourage further clinical investigation, and suggest
      that treatments with synthetic AcSDKP (Seraspenide) will perhaps have to be
      adjusted to the type of disease and the schedule of chemotherapy in order to
      optimize its myeloprotective effect.

PMID- 7772536
TI  - Acute lymphoblastic transformation of essential thrombocythaemia.
AB  - Essential thrombocythaemia is a myeloproliferative disorder which may transform
      to acute myeloid leukaemia, especially following therapy with alkylating agents
      or radioactive phosphorus. We describe the rare occurrence of acute lymphoblastic
      leukaemia transformation in a patient with known essential thrombocythaemia.

PMID- 7772537
TI  - Parvovirus B19-associated haemophagocytic syndrome in healthy adults.
AB  - Between August 1992 and August 1994 we found seven adult patients with
      haemophagocytic syndrome associated with human parvovirus B19 (HPV) infection.
      Five of the patients were previously healthy but the other two had underlying
      immunosuppressive disease; the former five patients recovered spontaneously
      without any treatment. Eight cases of HPV-associated haemophagocytic syndrome
      have been reported; six of them were children and the remainder were adults with
      immunosuppressive disease or haematological disorder. Our study suggests that HPV
      is not a rare cause of virus-associated haemophagocytic syndrome (VAHS).
      Moreover, HPV-associated haemophagocytic syndrome could occur more frequently
      than previously thought, not only in children and adults with underlying disease
      but also in adults, even in good health.

PMID- 7772538
TI  - alpha-Interferon therapy for congenital dyserythropoiesis type I.
AB  - We report the case of a 28-year-old female followed for congenital
      dyserythropoiesis type I which required repeated transfusions. Alpha-2a
      interferon treatment was started because of post-transfusion chronic viral
      hepatitis type C. Following this treatment, haemoglobin level increased and
      reached normal value during the 24 weeks of interferon treatment. When interferon
      therapy was stopped, haemoglobin level returned to previous values, requiring
      more transfusions. Resumption of interferon therapy resulted again in a complete
      normalization of haemoglobin level. Erythrokinetic studies demonstrated a
      striking reduction of the ineffective erythropoiesis, and electron microscopy
      study a reduction in nuclear structure abnormalities. To our knowledge, this is
      the first report of the efficacy of interferon in congenital dyserythropoiesis.

PMID- 7772539
TI  - Spectrin Anastasia (alpha I/78): a new spectrin variant (alpha 45 Arg-->Thr) with
      moderate elliptocytogenic potential.
AB  - We describe a white Italian kindred in which hereditary elliptocytosis (HE) is
      associated with abnormal level of alpha I/78 peptide in spectrin digest. Clinical
      phenotype varied among the family members ranging from asymptomatic to mild
      haemolytic HE. The original mutation responsible is a G-C substitution of the
      spectrin alpha-gene: alpha 45 Arg-->Thr (AGG-->ACG). The corresponding spectrin
      is designated spectrin Anastasia. Utilizing a secondary structure predictive
      method we suggest that this mutation has a poor capability to induce
      conformational changes of the tetramerization site and thus shows a moderate
      elliptocytogenic potential.

PMID- 7772540
TI  - PCR-monitoring of minimal residual leukaemia after conventional chemotherapy and
      bone marrow transplantation in BCR-ABL-positive acute lymphoblastic leukaemia.
AB  - We report the results of consecutive tests in nine BCR-ABL-positive ALL patients
      by one-step and two-step (nested primer) reverse transcriptase-polymerase chain
      reaction (RT-PCR). Six patients could be tested in complete haematological
      remission (CHR). One patient remained one-step positive; four patients became one
      step negative, but remained two-step positive; only one patient became two-step
      negative. In five patients the haematological relapse was preceded by one-step
      positivity by 1.5-5 weeks. In two patients who received autologous BMT in CHR,
      BCR-ABL was still detectable by two-step PCR, whereas allogeneic BMT was able to
      transiently reduce BCR-ABL below the two-step detection level. Our results show
      that one-step combined with two-step RT-PCR analysis gives valuable information
      about the efficacy of treatment and the dynamics of the leukaemic clone.

PMID- 7772541
TI  - Is hairy cell leukaemia more common among farmers?

PMID- 7772542
TI  - Human herpesvirus-6 (HHV-6) in blood donors.

PMID- 7772543
TI  - Prophylaxis against infections with intravenous immunoglobulins in multiple
      myeloma.

PMID- 7772544
TI  - Methods of measurement of Rh haemolytic disease.

PMID- 7772545
TI  - Spontaneous remission in monosomy 7 myelodysplastic syndrome.

PMID- 7772546
TI  - Theoretical issues in symmetry perception.

PMID- 7772547
TI  - Detection of bilateral symmetry using spatial filters.
AB  - When bilaterally symmetric images are spatially filtered and thresholded, a
      subset of the resultant 'blobs' cluster around the axis of symmetry.
      Consequently, a quantitative measure of blob alignment can be used to code the
      degree of symmetry and to locate the axis of symmetry. Four alternative models
      were tested to examine which components of this scheme might be involved in human
      detection of symmetry. Two used a blob-alignment measure, operating on the output
      of either isotropic or oriented filters. The other two used similar filtering
      schemes, but measured symmetry by calculating the correlation of one half of the
      pattern with a reflection of the other. Simulations compared the effect of
      spatial jitter, proportion of matched to unmatched dots and width or location of
      embedded symmetrical regions, on models' detection of symmetry. Only the
      performance of the oriented filter + blob-alignment model was consistent with
      human performance in all conditions. It is concluded that the degree of feature
      co-alignment in the output of oriented filters is the cue used by human vision to
      perform these tasks. The broader computational role that feature alignment
      detection could play in early vision is discussed, particularly for object
      detection and image segmentation. In this framework, symmetry is a consequence of
      a more general-purpose grouping scheme.

PMID- 7772548
TI  - Modelling symmetry detection with back-propagation networks.
AB  - This paper reports experimental data and results of network simulations in a
      project on symmetry detection in small 6 x 6 binary patterns. Patterns were
      symmetrical about the vertical, horizontal, positive-oblique, or negative-oblique
      axis, and were viewed on a computer screen. Encouraged to react quickly and
      accurately, subjects indicated axis of symmetry by pressing one of four
      designated keys. Detection times and errors were recorded. Back-propagation
      networks were trained to categorize the patterns on the basis of axis of
      symmetry, and, by employing cascaded activation functions on their output units,
      it was possible to compare network performance with subjects' detection times.
      Best correspondence between simulated and human detection-time functions was
      observed after the networks had been given significantly more training on
      patterns symmetrical about the vertical and the horizontal axes. In comparison
      with no pre-training and pre-training with asymmetric patterns, pre-training
      networks with sets of single vertical, horizontal, positive-oblique or negative
      oblique bars speeded subsequent learning of symmetrical patterns. Results are
      discussed within the context of theories suggesting that faster detection of
      symmetries about the vertical and horizontal axes may be due to significantly
      more early experience with stimuli oriented on these axes.

PMID- 7772549
TI  - A network model for generating differential symmetry axes of shapes via receptive
      fields.
AB  - Some symmetries (e.g. bilateral, rotational, translational) only describe quite
      specialized shapes, but differential symmetry axes (e.g. Blum, J. Theoret. Biol.
      38, 205-287, 1973; Brady and Asada, Int. J. Robotics Res. 3, 36-61, 1984)
      describe more general shapes. Such axes are of interest in part because they form
      the 'backbone' of generalized cylinder and other shape representations used in
      shape recognition (e.g. Marr, Vision, W. H. Freeman and Co., NY, 1982; Biederman,
      Psychol. Rev. 94, 115-147, 1987). However, despite the popularity of these
      representations as psychological models, algorithms from machine vision for
      computing them have strong limitations as psychological models. This paper
      presents two versions of a network model, one of which is more plausible as a
      psychological model because it derives symmetry axes from the activations of
      idealized visual receptive fields.

PMID- 7772550
TI  - Symmetric 3D objects are an easy case for 2D object recognition.
AB  - According to the 1.5-views theorem (Poggio, Technical Report #9005-03, IRST,
      Povo, 1990; Ullman and Basri, IEEE Trans. PAMI 13, 992-1006, 1991) recognition of
      a specific 3D object (defined in terms of pointwise features) from a novel 2D
      view can be achieved from at least two 2D model views (for each object, for
      orthographic projection). This note considers how recognition can be achieved
      from a single 2D model view by exploiting prior knowledge of an object's
      symmetry. It is proved that, for any bilaterally symmetric 3D object, one non
      accidental 2D model view is sufficient for recognition since it can be used to
      generate additional 'virtual' views. It is also proved that, for bilaterally
      symmetric objects, the correspondence of four points between two views determines
      the correspondence of all other points. Symmetries of higher order allow the
      recovery of Euclidean structure from a single 2D view.

PMID- 7772551
TI  - Continuous symmetry: a model for human figural perception.
AB  - Symmetry is usually viewed as a discrete feature: an object is either symmetric
      or non-symmetric. In this presentation, symmetry is treated as a continuous
      feature and a continuous measure of symmetry (the Symmetry Distance) is defined.
      This measure can be easily evaluated for any shape or pattern in any dimension. A
      preliminary study presented here shows that the Symmetry Distance is commensurate
      with human perceptual experience. Good correlation is found between the
      continuous symmetry values and the perceived goodness of figures.

PMID- 7772552
TI  - Mirror symmetry and parallelism: two opposite rules for the identity transform in
      space perception and their unified treatment by the Great Circle Model.
AB  - Two opposite rules control the contributions of individual lines to the
      perceptual processing of two different spatial dimensions of egocentric
      localization and orientation. For lines restricted to the frontal plane, a tilted
      line on one side of the median plane induces a rotation of the orientation
      visually perceived as vertical (VPV) identical to that induced by the same tilt
      on the other side of the median plane, but the influences exerted on the
      elevation of visually perceived eye level (VPEL) are mirror symmetric. The rule
      for VPV fits our intuitions; the rule for VPEL does not. However, the reverse
      peculiarity holds when the inducing lines are rotated within sagittal planes
      (pitched): Two parallel, pitched-from-vertical lines on opposite sides of the
      median plane generate identical effects on VPEL but mirror symmetric effects on
      VPV. These counterintuitive symmetry reversals are reconciled by the Great Circle
      Model of spatial orientation (GCM), in which line orientations are represented by
      the great circle coordinates of their images on a sphere centered at the nodal
      point of the eye via central projection.

PMID- 7772553
TI  - The generalized cone in human spatial organization.
AB  - The generalized cone is one of the newer concepts useful for describing spatial
      structures, and it has become popular as a volumetric primitive in models of
      object recognition. Apart from this use of the concept (or perhaps underlying
      it), the generalized cone can be considered a species of spatial regularity. In
      the general definition of symmetry as invariance across transformation, the
      generalized cone is a combination of translation and dilation symmetry. In such
      symmetry, there is homogeneity both of the slants of edges and surfaces of an
      object about an axis and the radial positions of these features about the axis.
      The results of two research projects are reviewed suggesting that the generalized
      cone is useful in human spatial organization. In the first instance, each of the
      three simpler regular polyhedra, the Platonic Solids, are easiest to perceive and
      imaging when they are organized as generalized cones. In the second instance,
      people imagine simple rotations best when the symmetric space that would be
      traced by the motion is aligned with salient spatial reference systems.

PMID- 7772554
TI  - A continuum of non-Gaussian self-similar image ensembles with white power
      spectra.
AB  - We introduce a scaling procedure that acts on visual textures to produce new
      textures having the same resolution, display size, and mean contrast power. We
      derive the form of the scaling fixed-point textures (image ensembles) resulting
      from repeated application of this scale transformation to the 'even' texture with
      an arbitrary amount of sporadic decorrelation. The result is a continuum of
      scaling fixed-point or 'self-similar' image ensembles, ranging from a strongly
      non-Gaussian white texture with higher-order spatial correlations at one extreme
      to Gaussian white noise at the other. The simple construction of a continuum of
      self-similar ensembles possessing phase correlations provides a tool for
      investigating human perception of structure in the absence of useful length
      scales. The fixed-point textures have luminance histogram differences, a direct
      result of their higher-order spatial properties. This suggests that scaling might
      afford an extension of our understanding of IID (independent identically
      distributed) texture discrimination (Chubb et al., J. Opt. Soc. Am. A 11, 2350
      2374, 1994) to more general texture discrimination tasks in which spatial
      correlations play a role.

PMID- 7772555
TI  - Quantification of local symmetry: application to texture discrimination.
AB  - Symmetry is one of the most prominent cues in visual perception as well as in
      computer vision. We have recently presented a Generalized Symmetry Transform that
      receives as input an edge map, and outputs a symmetry map, where every point
      marks the intensity and orientation of the local generalized symmetry. In the
      context of computer vision, this map emphasizes points of high symmetry, which,
      in turn, are used to detect regions of interest for active vision systems. Many
      psychophysical experiments in texture discrimination use images that consist of
      various micro-patterns. Since the Generalized Symmetry Transform captures local
      spatial relations between image edges, it has been used here to predict human
      performance in discrimination tasks. Applying the transform to micro-patterns in
      some well-studied quantitative experiments of human texture discrimination, it is
      shown that symmetry, as characterized by the present computational scheme, can
      account for most of them.

PMID- 7772556
TI  - 1995 Annual Meeting of the American Society of Regional Anesthesia. Orlando,
      Florida, March 30-April 2, 1995. Abstracts.

PMID- 7772557
TI  - Galactomannans from Brazilian seeds: characterization of the oligosaccharides
      produced by mild acid hydrolysis.
AB  - Galactomannans with Man:Gal ratios ranging from 1.1:1 to 3:1, obtained from the
      seeds of Mimosa scabrella, Stryphnodendron barbatiman, Schizolobium parahybum and
      Schizolobium amazonicum, were submitted to mild acid hydrolysis. The products
      were fractionated by gel permeation chromatography on BioGel P2 yielding
      fractions with degrees of polymerization (DP) of 1 to 6. Those with DP 2 to 6
      from each species were analysed by ion-exchange high-performance liquid
      chromatography and characterized by 13C- and 1H-nuclear magnetic resonance (NMR)
      spectroscopy. The distribution of the oligosaccharides of each degree of
      polymerization was very similar for the products from S. parahybum and S.
      amazonicum, indicating the same D-galactosyl distribution on the D-mannan
      backbone, in agreement with the 13C-NMR splitting in the C4 region of the D
      mannosyl units in the original polymers. The hydrolytic conditions adopted
      allowed characterization of compounds that are not generally produced by
      enzymatic treatments. The results show that the structures of the
      oligosaccharides, even if there is a preferential hydrolysis of Gal-Man linkages,
      reflect the composition of the parent polymer.

PMID- 7772558
TI  - Synthesis of chitosan-amino acid conjugates and their use in heavy metal uptake.
AB  - Chitosan-amino acid conjugates were prepared by coupling amino acid esters to the
      carboxyl group of glyoxylic acid-substituted chitosan. The removal of heavy
      metals (Cu, Ni, Co and Mn) was increased by introduction of amino acids to
      chitosan, especially for Mn. Heavy metals were almost completely removed by
      chitosan-amino acid conjugates from solutions at an initial concentration of 100
      parts per million.

PMID- 7772559
TI  - Kinetics and thermal behaviour of the structure formation process in HMP/sucrose
      gelation.
AB  - The concentration and temperature dependence of the gelation kinetics of high
      methoxyl pectin (HMP; 60% sucrose, pH 3) was investigated using measurements of
      small-amplitude oscillatory shear. The rate of gelation close to the gel point
      can be described as a second-order rate process using the kinetic model of Ross
      Murphy (Carbohydr. Polym. 1991, 14, 281) and a critical exponent close to that
      predicted by the percolation approach. The modulus after a long ageing time
      showed a power concentration dependence with an exponent around 3.1, higher than
      the classical square of concentration dependence, which was probably either due
      to the nonequilibrium state of the HMP gels even after long ageing times, or due
      to the proximity of the concentration range studied to the critical gelling
      concentration. The gelation rate of HMP/sucrose systems is strongly dependent on
      the temperature. An Arrhenius relationship was applied to describe this
      dependence. Two different processes are proposed to explain the discontinuity
      observed, each one having rates with different temperature dependence. The
      applicable kinetics at longer times are quite different, with a lower dependence
      on polymer concentration and ageing temperature. A non-isothermal kinetic model
      was used to describe the gelation process of the HMP/sucrose system during
      cooling.

PMID- 7772560
TI  - Temperature variation of the relaxation time of alpha-dispersion for gamma
      irradiated collagen.
AB  - The effect of gamma irradiation, with doses from 10(2) to 10(3) kGy, on the
      dielectric relaxation time of solid-state collagen was studied. Temperature
      measurements of the relaxation time were made over a range of frequency of the
      electric field from 10(1) to 10(5) Hz and at temperatures from 298 to 480 K. The
      samples contained 0.06 g H2O/g dry collagen. The dependencies obtained indicate
      that values for the relaxation time decrease with increasing temperature for all
      samples of collagen. In addition, an increase in the irradiation dose resulted in
      a decreased relaxation time for collagen at each temperature studied. These
      changes can be interpreted on the basis of proton conduction processes. Such
      effects occurring in a heterogeneous medium such as a collagen-water system are
      caused by the localized jumping of free protons between neighbouring sites. In
      the system of irradiated collagen studied, the sites are formed by structural
      water molecules, the products of its radiolysis and also by elements of the
      damaged first-order structure of the collagen macromolecule.

PMID- 7772561
TI  - Effect of acetylation on conformation and bilirubin-binding properties of goat
      serum albumin.
AB  - Four acetylated derivatives of goat serum albumin with percentage modifications
      of 18, 40, 53 and 93% were checked for bilirubin-binding and conformational
      properties. Acetylation caused marked changes in protein conformation, as
      evidenced by double immunodiffusion and proteolytic digestion results, as well as
      a decrease in bilirubin binding. An increase in ionic strength had a dramatic
      effect on the bilirubin-binding characteristics of modified proteins. The results
      suggest that the lysine residues of goat serum albumin modified in this study are
      not involved in bilirubin-albumin interaction.

PMID- 7772562
TI  - Identification of framework residues required to restore antigen binding during
      reshaping of a monoclonal antibody against the glycoprotein gB of human
      cytomegalovirus.
AB  - Introduction of the complementary determining regions (CDRs) from a murine
      antibody to a human monoclonal antibody is an important technique (humanization)
      in the development of human immunotherapeutics. We have humanized murine
      monoclonal antibody HCMV37 which binds to the gB envelope glycoprotein of human
      cytomegalovirus. Simple transfer of the murine HCMV37 CDRs into heavy- and light
      chain framework regions (FRs) based on human NEW and REI, respectively, together
      with human IgGI and K constant regions, abolished antigen binding because of a
      suboptimal heavy chain. Replacement of human VH amino acids Leu70, Val71 and
      Arg94 with murine residues Thr70, Arg71 and Asn94 was insufficient to improve
      affinity. However, significant restoration of binding was obtained by
      substitution of human VH amino acids Thr28, Phe29, Ser30 with murine residues
      Ser28, Ile29, Thr30, in conjunction with the position 94 change. Residue 71,
      often regarded as critical for antigen binding, was not a major factor.

PMID- 7772563
TI  - Denaturation of horseradish peroxidase with urea and guanidine hydrochloride.
AB  - Favourable effects of urea and guanidine hydrochloride (Gdn HCl) on
      solubilization of the polar, non-polar and peptide groups of horseradish
      peroxidase (HRP), an example of a globular protein, provide the driving force for
      unfolding of HRP, in a reversible two-state process. The intrinsic or
      conformational stability of HRP at various pH values and temperatures has been
      estimated by the linear extrapolation method (LEM), a denaturant binding model
      (DBM) and Tanford's model. There is good agreement between these methods.
      Tanford's model shows that urea interacts with non-polar groups to a greater
      extent than Gdn HCl does, whereas Gdn HCl interacts more effectively with the
      peptide groups of HRP.

PMID- 7772564
TI  - Molecular interaction of tubulin with 1-deaza-7,8-dihydropteridines: a
      comparative study of enantiomers NSC 613862 (S) and NSC 613863 (R) by Raman and
      Fourier transform infrared spectroscopy.
AB  - Pre-resonance Raman spectroscopy has been applied to compare the vibrational
      modes of the R and S chiral isomers of 1-deaza-7,8-dihydropteridine when they are
      bound to tubulin. The main Raman bands are due to the chromophore and are coupled
      with the pi-pi electronic transition of C = C and C = N vibrational stretching.
      On binding to tubulin, the Raman spectra of both isomers are modified. However,
      the modifications induced are different for each isomer. The Raman bands due to C
      = C stretching from the phenyl ring are more strongly modified for the bound R
      isomer than for the S isomer. This leads us to suggest that R and S isomers
      differ in terms of their orientation in front of the binding locus of tubulin. In
      fact, with respect to the orientation of the bulky methyl group, the chromophore
      of the R isomer is more likely to be positioned against the external surface of
      either tubulin or GTPase proteins, while that of the S isomer is likely to be
      positioned away from the surface. The conformational changes induced in tubulin
      by R and S isomers have also been studied by Fourier transform infrared
      spectroscopy and by the analysis of amide I and II absorption bands. Both
      enantiomers induce similar minor changes to the tubulin secondary structure,
      corresponding to a decrease in the disordered alpha-helical content and
      accompanied by an increase in the undefined conformation content.

PMID- 7772566
TI  - Biodegradable polymers as biomaterials.
AB  - Biomaterials are used in prostheses and medical devices for different purposes.
      Polymers are the most diverse class of biomaterials. All biomaterials must meet
      certain criteria and regulatory requirements before they can be qualified for use
      in medical applications. Biocompatibility is one of the most important
      requirements. Both nondegradable polymers are designed to degrade in vivo in a
      controlled manner over a predetermined time. The main mechanism of in vivo
      degradation of polymers is 'hydrolytic degradation', in which enzymes may also
      play a role (i.e. 'enzymatic degradation'). Both natural e.g., collagen, and
      synthetic e.g., poly(alpha-hydroxy) acids, biodegradable polymers are used in
      biomedical applications. Many of the current polymers and processing techniques
      need to be improved in order to produce polymers with better performance in
      biological media. An important trend in related research and development is the
      synthesis of novel polymers, which would exhibit improved biocompatibility, and
      be bioresponsive.

PMID- 7772565
TI  - Synthesis of high-molecular-weight poly([R]-(-)-3-hydroxybutyrate) in transgenic
      Arabidopsis thaliana plant cells.
AB  - High-molecular-weight poly([R]-(-)-3-hydroxybutyrate) (PHB), a biodegradable
      thermoplastic, was produced from a suspension culture of transgenic Arabidopsis
      thaliana plant cells expressing two genes from the bacterium Alcaligenes
      eutrophus involved in the synthesis of PHB. The molecular structure of the plant
      produced polymer was analysed by gas chromatography, mass spectrometry, proton
      nuclear magnetic resonance spectroscopy, infra-red spectroscopy,
      spectropolarimetry, differential scanning calorimetry, X-ray diffraction and size
      exclusion chromatography. The results indicate that the polymer from transgenic
      plants appears to have a chemical structure identical to that of PHB produced by
      bacteria. However, the molecular weight distribution of the plant-produced PHB
      was much broader than that of typical bacterial PHB.

PMID- 7772567
TI  - In vitro study of biodegradation of a Co-Cr alloy using a human cell culture
      model.
AB  - The evaluation of a potential biomaterial is based on two approaches: firstly,
      the study of the local and systemic effects of the biomaterial implanted in the
      host; and secondly the study of the behaviour of the biomaterial itself with
      increasing time. The progress achieved in human cell culturing allows in vitro
      evaluation of a new biomaterial using the human cell(s) system(s) characteristic
      of the tissue which it will be exposed to in vivo. This kind of approach permits
      the assessment of the biodegradation of a biomaterial whatever it is: metal;
      alloy; ceramic; glass; polymer; with or without specialized coating.... The
      experimental approach is as follows: discs representative of the biomaterial
      (surface state, cleaning, sterilization process) are manufactured in order to
      cover the bottom of the culture wells. Thereafter, they are either brought in the
      presence of complete culture medium alone, or in the presence of a subconfluent
      cell layer. A kinetic analysis is performed using various incubation periods at
      37 degrees C. Released biodegradation products are identified and quantified, in
      both the medium and cell compartment, and on the other hand cytotoxicity is
      assessed. A Co-Cr alloy was studied over a 9-day period according to the
      experimental schedule, and showed a higher corrosion rate in the presence of
      osteoblasts in the range of 25-30%. Moreover, an intracellular uptake of both Cr
      and Co was detected, which will have physiological importance.

PMID- 7772568
TI  - Rifampicin-carrying poly(D,L-lactide) microspheres: loading and release.
AB  - Rifampicin-loaded poly(D,L-lactide) (PDLLA) microspheres in the size range of 0.8
      8.0 microns were prepared by a modified solvent evaporation method. Rifampicin
      loading was changed by using different types of solvents (i.e. methylene
      chloride, chloroform, and carbon tetrachloride) with different solvent/polymer
      ratios and different emulsifiers (i.e. methyl cellulose, gelatin, and Tween-20),
      and by changing the initial drug/polymer ratio. These rifampicin-loaded PDLLA
      microspheres degraded much faster in the medium at basic pH (9.8) and at high
      temperatures (55 degrees C). Rifampicin release was also high under these
      conditions. It was concluded that rifampicin release was both degradation- and
      diffusion-controlled.

PMID- 7772569
TI  - Test methodology for characterizing in vitro biodegradation.
AB  - In this paper mechanical tests for the characterization of the time-dependent
      behaviour of absorbable osteosynthetic materials are described. The tensile test
      is performed according to International Standard Organization (ISO) 3268/1978 and
      provides Young's modulus, tensile strength, elongation at tensile strength, and
      rupture force. The bending test is performed according to ISO 178/1975 and gives
      the flexural stress at various deflections, the force and deflection at break and
      the initial bending modulus. The torsional test is carried out according to ISO
      458-1 and gives torsional load. The bending and torsional stress relaxation are
      measured. Relaxation modulus and the creep compliance are then determined. The
      parameters to be recorded in a cyclic bending test include the number of cycles
      or, in the case of sample survival, the remaining force at break at a bending
      test. The cyclic torsion test is carried out according to ISO 537/1989. The
      parameters to be recorded are the number of cycles or, in case of sample
      survival, the remaining force at a torsional test at 45 deg. Simulation tests
      provide a comparative assessment of the degradation phenomena under cyclic
      mechanical loading in bending or in torsion at elevated temperatures.

PMID- 7772571
TI  - Degradation and drug release characteristics of monosize polyethylcyanoacrylate
      microspheres.
AB  - Monosize, biodegradable poly(ethylcyanoacrylate) (PECA) microspheres with a
      diameter of 1.3 microns were prepared by a relatively new polymerization method,
      the so-called phase inversion polymerization. The effects of pH and temperature
      on the degradation behavior of PECA particles were investigated. PECA
      microspheres were degraded mainly by surface erosion. The degradation rate
      increased with increasing pH temperature. A model drug, i.e. 2,4
      dinitrophenylhydrazine (DNPH) was loaded into the monosize PECA microspheres
      during polymerization. The drug incorporation into the PECA microspheres
      increased with increasing initial drug concentration in the monomer phase. Drug
      release from the PECA microspheres was investigated at different pH. Higher drug
      release rates were observed in the neutral and alkaline media as compared with
      the acidic medium.

PMID- 7772570
TI  - Degradation behaviour of ionic stepwise polyaddition polymers of medical
      interest.
AB  - The aim of this presentation is to review some of our recent work mostly on
      poly(amidoamine)s (PAAs) and some other families of polymers structurally related
      to PAAs of medical interest. PAAs are obtained by stepwise polyaddition of
      primary monoamines, or bis secondary amines, to bisacrylamides. There are several
      other ter-amino polymers structurally related to PAAs, such poly(amido
      phosphine)s (PAPs), poly(ester-amine)s (PEAs), poly(ketone-amine)s (PKAs),
      poly(amidothioeteramine)s (PATAs) poly(esterthioether amine)s (PTEAs), and
      poly(sulphone thioetheramine)s (PSTAs). Most of the PAAs exhibit heparin
      complexing ability. PAAs are also being considered as soluble carriers for
      delivering anti-cancer drugs. Some of these polymers have been studied as
      antimicrobial agents. PAAs with different structures degrade at different rates
      under physiological conditions. The degradation rate is also strongly influenced
      by pH. The quaternarized PATAs and PTEAs are reasonably stable over a period of
      some days, but ultimately degrade to oligomeric products, while the quaternized
      PAAs do rapidly degrade.

PMID- 7772572
TI  - 20 MHz sonography, colorimetry and image analysis in the evaluation of psoriasis
      vulgaris.
AB  - For objective evaluation of the treatment of psoriasis vulgaris standard
      techniques are desirable. They should be reproducible, sensitive and non
      invasive. In this study non-invasive bioengineering techniques, especially high
      frequency/high resolution ultrasound for measurement of the healing of psoriasis
      vulgaris were evaluated. Fifty patients with chronic stationary plaque type
      psoriasis participated in a prospective study; in each patient two psoriatic
      plaques were examined by means of sonography, colorimetry and image analysis
      during treatment until complete resolution had occurred. Skin thickness and
      density could be quantified by means of high frequency ultrasound. In active
      psoriatic lesions, an echopoor area underneath the entry echo in the ultrasound
      image caused by acanthosis and inflammatory infiltrate is typical. Under therapy
      the thickness of this echopoor area diminishes while its density increases.
      Intensity of the erythema especially the decrease of erythema through healing
      could not exactly be quantified with the colorimeter because the 'Lab'-CIE-colour
      representation system cannot distinguish well enough between the colours red and
      brown. Image analysis allowed to measure the sizes of the psoriatic plaques and
      to quantify their resolution under therapy. The measuring of plaque size by the
      aid of computer based image analysis is possible and useful.

PMID- 7772573
TI  - Involvement of protein kinase C in bradykinin-induced intracellular calcium
      increase in primary cultured human keratinocytes.
AB  - Bradykinin (BK) is one of the key mediators of inflammation and a weak mitogen.
      We have previously demonstrated that BK induced the generation of inositol 1,4,5
      trisphosphate (Ins(1,4,5)P3) which caused Ca2+ mobilization in human
      keratinocytes. In this study, BK-induced Ca2+ responses were examined in primary
      cultured human keratinocytes by video imaging fluorescence microscopy using fura
      2. Intracellular calcium concentration ([Ca2+]i) level increased to a peak within
      30 s after BK addition and decreased gradually to the basal level. The existence
      of the broad shoulder in the [Ca2+]i profile was suggested to be due to the Ca2+
      influx from the external medium, because this disappeared in the presence of 0.5
      mM EGTA. Pretreatment with phorbol-12-myristate-13-acetate (PMA), a protein
      kinase C (PKC) activator, significantly resulted in reduction of the descending
      shoulder of BK-induced increase in [Ca2+]i. A 20-min pretreatment with PKC
      inhibitors, H-7 or staurosporine, reversed the decrease by PMA in the shoulder of
      BK-induced Ca2+ response. Furthermore, the BK-induced [45Ca] uptake was inhibited
      by EGTA and PMA. Ins(1,4,5)P3 generation induced by BK peaked at 20 s and
      returned to the basal level at 60 s. There were no significant differences in
      Ins(1,4,5)P3 levels at 20 and 60 s among the cells exposed to BK alone, BK with
      PMA pretreatment (20 min) and BK with PMA+H-7 pretreatment. These results suggest
      that the BK-induced Ca2+ influx, which was shown as shoulder, may be negatively
      modulated by PKC in primary cultured human keratinocytes.

PMID- 7772574
TI  - The effect of anemia on skin blood flow in human.
AB  - The skin blood flow in the deltoid region was measured in 78 males by the Xenon
      133 clearance method. A correlation was then made between age, hematocrit value,
      hemoglobin value and total protein determined at the time of skin blood flow
      measurement. From the data obtained, the following conclusions could be drawn:
      (1) skin blood flow significantly decreased with increasing age and with
      decreasing hematocrit and hemoglobin values; (2) skin blood flow showed the
      closest correlation with age (P < 0.001) and a weaker correlation (P < 0.01) with
      hematocrit and hemoglobin; (3) total protein demonstrated a significant decrease
      (P < 0.01) with a decrease in hematocrit and hemoglobin values giving rise to
      hypoproteinemia.

PMID- 7772575
TI  - Keratinocytes differentiate in response to inhibitors of deoxyribonucleotide
      synthesis.
AB  - We previously reported that methotrexate (MTX) caused an irreversible inhibition
      of growth and induced terminal differentiation of human keratinocytes. These
      effects of methotrexate were prevented by thymidine and thus, were attributed to
      depletion of thymine deoxyribonucleotides. The purpose of the research reported
      in this paper was to determine whether differentiation was induced by the general
      class of agents which are known to interfere with synthesis or utilization of
      deoxyribonucleotides. Agents examined included 5-fluorouracil, 5
      bromodeoxyuridine, hydroxyurea, high-dose thymidine, aphidicolin, and AG#85, a
      newly reported thymidylate synthase inhibitor. All these agents increased the
      expression of involucrin and increased the amount of cornified envelope protein
      at doses that inhibited proliferation by > 75%. We demonstrated, however, that in
      our cell culture system not all conditions producing inhibition of proliferation
      induced differentiation; withdrawal of growth factors and supplemental amino
      acids inhibited proliferation but did not increase involucrin expression or
      production of cornified envelope protein.

PMID- 7772576
TI  - The incidence of internal malignancies in pemphigus and bullous pemphigoid in
      Japan.
AB  - To evaluate the significance of the association of malignancy with autoimmune
      blistering diseases, we studied the incidence of internal malignancies in
      pemphigus and bullous pemphigoid based upon 496 cases of pemphigus and 1113 cases
      of bullous pemphigoid in Japan. Results showed that (1) an association between
      internal malignancies and pemphigus was observed in 25 out of 496 cases (5.0%),
      while that with bullous pemphigoid was seen in 64 out of 1113 cases (5.8%). Such
      association ratios were significantly higher than that of the controls aged over
      70 years old (0.61%); (2) The average ages of pemphigus/bullous pemphigoid with
      malignancy were 64.7 and 69.2 years, respectively. The association ratio of
      malignancy with pemphigus increased by age, while that with pemphigoid was not
      correlated with aging; (3) Lung cancer was most common in pemphigus and gastric
      cancer in bullous pemphigoid; (4) There were no significant differences in the
      titers of circulating antibody, the presence or extent of mucous involvement or
      annular erythema between bullous pemphigoid patients with malignancy and without
      malignancy. Our results indicated that detailed examination for internal
      malignancy is essential for those patients with pemphigus or bullous pemphigoid.

PMID- 7772577
TI  - Modulation of collagen synthesis and cell proliferation by retinoids in human
      skin fibroblasts.
AB  - The effect of the retinoids, 13-cis-retinoic acid (-RA), etretinate and all-trans
      RA on collagen synthesis and cell proliferation of human skin fibroblasts was
      studied. These compounds all inhibited collagen synthesis at concentrations
      between 10(-8) and 10(-5) M after 48 h treatments. The inhibitory effect of 13
      cis-RA was the most pronounced. Both all-trans-RA and etretinate inhibited DNA
      synthesis, to 60% and 53% of control value, respectively, at 10(-5) M. In
      contrast, 13-cis-RA did not show any significant effect on DNA synthesis at the
      concentrations used. 13-cis-RA appears to be a unique drug showing a pronounced
      inhibitor effect on collagen synthesis without affecting DNA synthesis and may
      prove a useful tool for the treatment of fibrotic diseases.

PMID- 7772578
TI  - Photoaging from an oxidative standpoint.
AB  - The free radical theory proposes that photoaging, which is both qualitatively and
      quantitatively different from chronological aging, may result from imperfect
      protection against cumulative stress of free radicals produced by chronic and
      repeated ultraviolet irradiation. Since the skin is always in contact with oxygen
      and is occasionally exposed to ultraviolet light, skin is one of the best target
      organs of environmental photo-oxidative stress. A growing body of evidence
      suggests that reactive oxygen species are generated by ultraviolet irradiation
      resulting in the structural and functional alteration of cutaneous components
      which should affect the photoaging process over a long period. The age-related
      alteration of cutaneous antioxidant defense capacity against cumulative effects
      of continual photo-oxidative stress to the skin may also affect the photoaging.
      Thus the possible use of antioxidants that attenuate photo-oxidative toxicity is
      believed to be an important strategy modulating photoaging. Several antioxidants
      have readily been proved to work in the experimental conditions. This paper
      reviews photoaging from a photo-oxidative standpoint and discusses the possible
      regulation of photoaging by antioxidants that is an important issue in the
      photodermatological field.

PMID- 7772579
TI  - Effect of ultraviolet A on IL-1 production by ultraviolet B in cultured human
      keratinocytes.
AB  - Human skin is exposed to significant amounts of UVA and UVB radiation
      simultaneously. The effects of UVA and UVB interactions have been examined in
      many aspects such as erythema response. The effects of UVA on the production of
      cytokines by UVB have not been studied yet. The purpose of this study is to
      observe the effect of UVB and UVA on the production of IL-1 in cultured human
      keratinocytes and to determine whether UVA can modify the effects of UVB on the
      IL-1 production. Human keratinocytes derived from normal foreskin were exposed to
      UVA (0-30 J/cm2) and subsequently to UVB (0-50 mJ/cm2). After 48 h incubation, IL
      1 levels in the culture supernatants and cell extracts of the cultured
      keratinocytes were measured by thymocyte proliferation assay. We have observed
      that UVB increased the production of IL-1 in cultured keratinocytes. However, UVA
      suppressed the production of IL-1 and also the stimulatory effect of UVB on the
      IL-1 production. We think that the opposite effects of UVB and UVA on the IL-1
      production in human keratinocytes might explain the different action mechanisms
      of UVB and UVA in many cutaneous responses.

PMID- 7772580
TI  - Sequence analysis and characterization of FAR-17c, an androgen-dependent gene in
      the flank organs of hamsters.
AB  - This study reports on the isolation and characterization of a cDNA clone,
      regulated by androgen transcriptionally, in male Golden hamsters' flank organs.
      Previous studies have reported on the cloning of an androgen-dependent gene, FAR
      17a, from the same hamster organ. After castration, the FAR-17c transcription
      rate decreases faster than FAR-17a but is not suppressed completely. The recovery
      of transcription by androgen injection is also faster than FAR-17a. In male
      hamsters, it is expressed strongly in the sebaceous glands and liver, and weakly
      in the lungs and brain. It has never been expressed in the testes. In the female,
      it is strongly expressed in the liver and brain and weakly in the lungs and flank
      organs. Sequence analysis shows that FAR-17c has a long 1062 bp open reading
      frame and its deduced amino acid sequence (354 residues) is highly homologous to
      the stearyl-CoA desaturases of the rat liver and mouse adipocytes. Stearyl-CoA
      desaturase, either in the liver or adipocytes appears to be independent of
      androgen regulation. Since stearyl-CoA desaturase plays a key role in fatty acid
      metabolism, further studies on its regulation by androgen are warranted in
      relation to acne vulgaris.

PMID- 7772581
TI  - Thromboembolic disease and thromboprophylaxis in oral and maxillofacial surgery:
      experience and practice.
AB  - OBJECTIVE: (i) To determine the incidence of thromboembolic disease (TED) in
      major maxillofacial surgery and in particular deep vein thrombosis (DVT) and
      pulmonary embolism (PE). (ii) To determine current thromboprophylactic practice
      in the specialty. DESIGN: Retrospective survey by questionnaire of five year
      experience and current practice in UK maxillofacial surgical units. SUBJECTS: The
      patients of 130 consultants carrying out major maxillofacial surgery. MAIN
      OUTCOME MEASURES: (i) The number of cases of fatal and non-fatal PE and the
      number of diagnosed cases of DVT not progressing to PE. (ii) The frequency of use
      of mechanical and pharmacological thromboprophylactic measures. RESULTS: (i)
      There was a 79% return of questionnaires and from these were reported 60 cases of
      PE of which 14 were fatal with 64 cases of DVT not progressing to PE. Of the PE
      group almost 60% followed operations for orocervical malignancy while 25% were
      related to maxillofacial trauma. 64% of respondents had encountered no episodes
      of perioperative DVT and 68% no cases of PE. (ii) Mechanical thromboprophylactic
      measures included the use by 76% of respondents of a graduated compression
      garment, ripple mattress by 47% and intermittent inter-operative calf pressure by
      38.5%. Of pharmacological agents 45% used low dose heparin, 14.5% a dextran
      infusion and 6% an antiplatelet agent. 58.3% gave advice about smoking and 37.5%
      recommended temporary discontinuation of the contraceptive pill. CONCLUSIONS: The
      incidence of DVT and PE in major maxillofacial surgery is low. Nevertheless it is
      recommended that there is rigid compliance with the recommendations for surgery
      in general from the thromboembolic risk factors consensus group (THRIFT) and from
      similar groups in Europe and the USA.

PMID- 7772582
TI  - Protective ptosis after parotid surgery induced with botulinum toxin.

PMID- 7772583
TI  - 'Hydroplastic'--a new material for orthognathic surgical splints.

PMID- 7772584
TI  - Recording the facial midline for orthognathic planning.

PMID- 7772585
TI  - Down Surgical Prize 1994: Mr L.D. Finch FRCSED, FDSRCSED.

PMID- 7772586
TI  - Full thickness skin grafting for donor defect repair.

PMID- 7772587
TI  - The diagnostic yield of only one occipitomental radiograph in cases of suspected
      midfacial trauma.

PMID- 7772588
TI  - Percutaneous subcricoid dilatational tracheostomy.

PMID- 7772589
TI  - Future of biodegradable osteosynthesis in maxillofacial fracture surgery.

PMID- 7772590
TI  - Convergence insufficiency and failure of accommodation following midfacial
      trauma.
AB  - A prospective evaluation of patients who had sustained midfacial trauma was
      carried out in order to determine the prevalence of impaired convergence and
      accommodation and to establish the risk factors for such defects. Of 52 patients
      in this study, 11 suffered accommodation and/or convergence disturbances. They
      included 6 males (17% of the male population) and 5 females (29% of the female
      population). Nine of these 11 patients sustained their injuries due to alleged
      assaults (24.3% of all assaulted patients) and 2 following simple falls (25% of
      all fall victims). Five patients complained of double vision for near (5/11 =
      45.5%) and another 4 had blurred vision and/or difficulty with reading (4/11 =
      36.4%). The remaining two were asymptomatic. Six patients were randomly selected
      to receive orthoptic exercises/treatment while the other five were monitored for
      signs of spontaneous recovery. Within six months of injury/surgery, 83% of the
      treated patients (n = 5) and 80% of the non-treated patients (n = 4) recovered to
      within the normal values of accommodation and convergence. No significant
      statistical relationship was found between the incidence of accommodation and/or
      convergence failure, and the cause or the type of fracture sustained. It may,
      however, be related to the severity of both the impact and the associated closed
      head trauma.

PMID- 7772591
TI  - The management of soft tissue facial wounds.
AB  - The physiological and physical principles involved in the management of facial
      lacerations are reviewed. Because there have been no previously published
      descriptions of the actual problems encountered in clinical practice in A & E
      Departments, a prospective clinical survey of 100 consecutive patients with
      facial lacerations repaired by oral & maxillofacial house surgeons was undertaken
      and a series of lacerations was studied in detail. These included periorbital,
      nasal, labial and neck injuries. High magnification revealed irregularity of
      wound margins in almost all cases, frequent localised ischaemia, necrosis,
      localised dehiscence and infection or inadequate closure. Because all of these
      problems are likely to increase scarring and deformity, this study suggests the
      need for a re-appraisal of the management of facial lacerations, particularly in
      relation to local skin edge excision, prevention of infection, and the use of
      magnification during closure.

PMID- 7772592
TI  - Morphological and morphometric studies of exfoliated oral squames from chronic
      inflammatory oral ulcers using light and scanning electron microscopy.
AB  - The morphological and morphometric features of exfoliated squames from the
      margins of chronic oral ulcers were studied by light and scanning electron
      microscopy. A variety of features consistent with a mixture of degenerative
      changes and regenerative activity were observed. None was sufficiently reliable
      to distinguish chronic inflammatory from malignant ulcers.

PMID- 7772593
TI  - The diagnostic yield of only one occipito-mental radiograph in cases of suspected
      midfacial trauma--or is one enough?
AB  - The number of radiographic examinations should be reduced to clinical needs.
      Often in cases of suspected midfacial injury three views comprise a routine
      'facial view' survey. A reduction in patient radiation exposure and X-ray costs
      would be achieved if only one occipito-mental radiograph was used. In this study
      the ability of Accident and Emergency staff to diagnose the presence of fractures
      using the standard occipito-mental view was assessed. The specificity value was
      90% and the sensitivity was 75%. Few fractures were missed on initial scrutiny
      and in cases of doubt further views would be requested. Therefore the findings
      would suggest that only one view is sufficient for routine assessment.

PMID- 7772594
TI  - Augmentation of the atrophic maxillary alveolar ridge with hydroxyapatite
      granules in a Vicryl (polyglactin 910) knitted tube and simultaneous open
      vestibuloplasty.
AB  - A modified technique for augmentation of the severely atrophic edentulous
      maxillary alveolar ridge is described. The augmentation was carried out using a
      knitted polyglactin 910 mesh tube filled with porous hydroxyapatite granules, the
      tube being inserted through the access achieved by an open vestibuloplasty. The
      results of an in-vivo animal study showed that the absorption of the mesh was
      complete between 49 and 70 days. The clinical study included 11 patients in all
      of whom there was severe maxillary ridge atrophy and major prosthetic problems;
      follow-up was for a mean of 25 months. The procedure was without significant
      complication and produced a mean immediate absolute augmentation of 5.5 mm and
      substantially increased vestibular depth. A gradual reduction of ridge height was
      found over time. Nevertheless all patients showed significantly increased ability
      to wear their dentures. The technique is presented as a safe and predictable
      alternative to the use of bone grafts and titanium implants in these severely
      atrophic cases.

PMID- 7772595
TI  - Unusual presentation of Paget's disease of the maxilla.
AB  - Paget's disease is a disorder of bone metabolism that is relatively common in the
      elderly population. The jaw bones are affected in 17% of cases. A case of
      maxillary involvement with unusual clinical and radiographic findings is
      presented.

PMID- 7772597
TI  - Nucleophosmin/B23 (NPM) oligomer is a major and stable entity in HeLa cells.
AB  - HeLa cell extract was separated by 7% polyacrylamide gel electrophoresis without
      SDS and subsequently stained with anti-nucleophosmin/B23 (NPM) antibody in a
      Western blot analysis. Two immunobands were obtained. The major band with a
      slower electromobility (RF = 0.23) is the NPM oligomer, while the fast-moving
      minor band is the monomer (RF = 0.56). The oligomer constitutes about 95% of
      total NPM. The oligomer sedimented faster (10 s) than the monomer in sucrose
      density gradient centrifugation. Three oligomer bands were identified. NPM
      oligomer is not affected by treatments with DNase. RNase, 10 mM EDTA, 1 M NaCl,
      and lyophilization. However, 3 M urea causes reversible dissociation of NPM
      oligomer into monomer. The level of NPM oligomer remains unchanged in HeLa cells
      after treatment with the cytotoxic agents, actinomycin D, toyocamycin and
      camptothecin. These results indicate that NPM oligomer is the major and stable
      NPM entity in HeLa cells.

PMID- 7772596
TI  - Eukaryotic DNA topoisomerases I.

PMID- 7772598
TI  - Differential display analysis of gene expression in developing embryos of Xenopus
      laevis.
AB  - Differential display (DD), an arbitrarily primed RT-PCR fingerprinting technique,
      is a novel approach for the search of differentially expressed transcripts. Using
      our improved DD protocol, reproducible cDNA fingerprints were successfully
      obtained from RNAs of Xenopus laevis embryos at six representative stages.
      Parallel comparison among the fingerprints revealed a number of bands with
      differential expression patterns. Analysis with clones of three randomly chosen
      bands confirmed that their expression patterns were faithfully reflected on
      fingerprints, thereby proving the reliability and validity of the approach.
      Nucleotide sequencing of these clones revealed that one is identical with a known
      transcript (cardiac actin), the second is a novel developmentally regulated gene
      showing no significant homology with those reported previously, and the last is a
      close but unique relative of XK endo B gene showing somewhat different spatial
      expression pattern. These results indicated that the DD analysis provides a rapid
      and reliable way for the identification of novel differentially expressed genes
      as well as a unique 'scope' for the survey of the changes in overall gene
      expression profiles occurring in the early embryonic development of Xenopus as
      well as of other organisms.

PMID- 7772599
TI  - Effect of cations on the volume of the helix-coil transition of poly[d(A-T)].
AB  - The pressure dependence of the helix-coil transition temperature of poly[d(A-T)]
      has been measured in aqueous solutions of NaCl, KCl, and CsCl at concentrations
      between 0.02 and 1 M. In all cases the transition temperature increases with
      pressure. For solutions of NaCl, KCl and dilute CsCl the change in the transition
      temperature is linear with pressure up to 200 MPa. In more concentrated CsCl
      solutions the change in Tm with pressure was hyperbolic. The molar volume change
      of the transition (delta Vt) was calculated using the Clapeyron equation. At the
      lower salt concentrations, the derived values of delta Vt increase with the
      radius of the cation (Na+ < K+ < Cs+). At the higher salt concentrations delta Vt
      of poly[d(A-T)] in Na+ and K+ became equal; however, in CsCl solutions delta Vt
      was approximately twice as large as delta Vt in solutions containing the other
      two ions. In solutions of NaCl and KCl, delta Vt increased linearly with the
      logarithm of the salt concentration while in aqueous CsCl the concentration
      dependence of delta Vt was hyperbolic. The results are interpreted in terms of
      the role played by the radius of the cation in deciding the strength of the
      interactions formed with water.

PMID- 7772600
TI  - Topoisomerase activity associated with polyoma virus large tumor antigen.
AB  - Polyomavirus (Py) large tumor antigen (LT) was produced in mammalian or insect
      cells infected with a suitable viral expression vector, and purified by a
      procedure combining immunoprecipitation with ion-exchange chromatography.
      Fractions containing the bulk of LT displayed a DNA-relaxing activity (LT-topo)
      which could be attributed neither to topoisomerase II (topo II) nor to
      topoisomerase I (topo I) encoded by the cell or the viral vector. On the one
      hand, LT-topo relaxed pBR322 DNA in a reaction which, unlike that characteristic
      of topo II, was ATP-independent and inhibited by camptothecin. On the other hand,
      serum from scleroderma patients which strongly inhibited calf thymus topo I had
      no effect on LT-topo, which absolutely required Mg2+ ions to relax DNA. Thus, LT
      topo is either inherent to LT or belongs to a LT-bound enzyme similar to, but
      distinct from, topo I.

PMID- 7772601
TI  - Cloning, sequencing and expression of the L5, L21, L27a, L28, S5, S9, S10 and S29
      human ribosomal protein mRNAs.
AB  - During systematic analysis of the mRNAs expressed in a human colorectal carcinoma
      with the aim of evidencing new makers of the disease (Frigerio et al. (1995), in
      press), we isolated several clones corresponding to homologs of rat ribosomal
      protein mRNAs L5, L21, L27a, L28, S5, S9, S10 and S29. Because expression of
      several mRNAs encoding ribosomal proteins was found strongly altered during
      colorectal carcinogenesis, sequence of these transcripts, not previously
      described in human, was completed and their expression analyzed. Northern blot
      analysis of RNAs extracted from colorectal cancer and ajdacent normal tissue from
      6 patients revealed in all of them perturbations of expression in cancer,
      compared to normal. No correlation could however be made between the level of
      expression and the severity of the disease. Yet, abnormal patterns with
      additional larger transcripts were observed in some patients for rpL5, rpL28 and
      rpS10.

PMID- 7772602
TI  - Sequence of the gat operon for galactitol utilization from a wild-type strain
      EC3132 of Escherichia coli.
AB  - The sequence of the gat operon for galactitol (Gat) utilization from a wild-type
      isolate of Escherichia coli, strain EC3132, is presented. The operon comprises 7
      open reading frames (ORFs) called gatYZABCDR. The genes are transcribed from a
      promoter located upstream of gatY. Genes gatABC encode the substrate-specific
      domains IIA, IIB and IIC of a galactitol-specific Enzyme II (EIIGat) of the
      phospho enol pyruvate-dependent carbohydrate:phosphotransferase system (PTS);
      gatD encodes an NAD-dependent Gat 1-phosphate dehydrogenase; and gatY an enzyme
      which hydrolyses tagatose 1,6-bisphosphate; gene gatZ is required in a cell to
      show a Gat+ phenotype, but its physiological function has not yet been
      identified; gatR encodes a repressor for the gat operon. All genes are highly
      similar to the gat genes from E. coli K-12; in this organism they map at 46.70
      min of the gene map, equivalent to about 2180-2186 kbp.

PMID- 7772603
TI  - Nucleotide sequence of the Staphylococcus aureus RNA polymerase rpoB gene and
      comparison of its predicted amino acid sequence with those of other bacteria.
AB  - The complete nucleotide sequence of the rpoB gene which encodes the beta subunit
      of S. aureus RNA polymerase has been determined. The RpoB protein, consists of
      1182 amino acids and has a novel initiation codon UUG which initiates protein
      synthesis with methionine. There is a very strong Shine-Dalgarno complementarity
      and the -10 and -35 promoter hexameric sequences are TAATAT and CCGTTT,
      respectively. A rho-dependent termination site, CAATCAA, is present which
      overlaps the -35 promoter sequence of the adjacent rpoC gene a feature which may
      have a role in the co-ordinate expression of the two genes. A strong homology and
      conserved regions were found to exist over the predicted amino acid sequences
      coding for S. aureus rpoB and the equivalent proteins in Escherichia coli,
      Pseudomonas putida, Salmonella typhimurium, Chlamydia trachomatis, cyanobacterium
      Anabaena sp. strain PCC 7120.

PMID- 7772604
TI  - Cloning and characterization of rat cysteine sulfinic acid decarboxylase.
AB  - Cysteine sulfinic acid decarboxylase (CSAD) is a key enzyme in taurine
      biosynthesis. CSAD activity and enzyme protein concentration are both repressed
      by the action of the steroid family hormones triiodothyronine and estrogen. To
      characterize this suppression, a cDNA clone for CSAD was isolated from a rat
      liver cDNA expression library using polyclonal antibodies to CSAD. The cDNA was
      sequenced in its entirety and confirmed to be a clone of CSAD. In a Northern blot
      comparing liver and kidney RNA of male and female rats, the CSAD cDNA probe
      detected a 2.5 kb mRNA band which was present at levels corresponding to the
      concentration of enzyme protein. Hyperthyroidism decreased CSAD mRNA as compared
      to euthyroid controls, providing evidence that negative regulation of CSAD
      activity occurs at the level of mRNA.

PMID- 7772605
TI  - Nucleotide sequence of ornithine decarboxylase antizyme cDNA from Xenopus laevis.
AB  - An ornithine decarboxylase antizyme cDNA was obtained from Xenopus laevis liver
      and its sequence was determined. The cDNA consists of two major open reading
      frames as found in mammalian antizymes, which require +1 ribosomal frameshifting
      for its translation. Sequences important for frameshifting, namely the frameshift
      site and downstream stimulatory pseudoknot determined in the rat mRNA, are
      conserved.

PMID- 7772606
TI  - A cDNA of Schizosaccharomyces pombe encoding a homologue of DnaJ-like protein.
AB  - A Schizosaccharomyces pombe homologue, Psi, was cloned from Schizosaccharomyces
      pombe cDNA library. Deduced amino acid sequence of the cDNA has 55% sequence
      homology with the Saccharomyces cerevisiae Sis1 protein and contains the
      structural features of a family of DnaJ proteins. This homology suggests Psi
      protein may be implicated in the initiation of translation as like Sis1 function
      of Saccharomyces cerevisiae.

PMID- 7772607
TI  - Molecular cloning, sequencing and expression of a cDNA encoding a human liver NAD
      dependent alpha-glycerol-3-phosphate dehydrogenase.
AB  - This work reports the primary nucleotide structure and in vitro translation of a
      cDNA, expressed by a gene mapping on chromosome 12, that encodes a human hepatic
      alpha-glycerol-3-phosphate dehydrogenase (L-glycerol-3-phosphate:NAD
      oxidoreductase, E.C. 1.1.1.8). The 1413 bp cDNA comprises an ORF of 1050 bp that
      encodes a 349 amino acid protein of 37.5 kDa. Northern blot analysis of poly(A)+
      mRNA from human liver showed three transcripts, while from human placenta only
      two transcripts were detected.

PMID- 7772609
TI  - Isolation and characterization of the gene encoding the Drosophila melanogaster
      transcriptional elongation factor, TFIIS.
AB  - We have characterized a genomic clone encoding the Drosophila melanogaster
      transcriptional elongation factor, TFIIS. The coding region of the TFIIS gene is
      interrupted by a short intron. The potential promoter region, deduced from the
      determination of the transcription start point (tsp), lacks distinct TATAAA or
      CCAAT box consensus sequences. Southern analysis and the in situ hybridization to
      chromosomes suggests that it is single-copy gene which is localized to the 35B
      region on the left arm of the second chromosome.

PMID- 7772608
TI  - XB/U-cadherin mRNA contains cytoplasmic polyadenylation elements and is
      polyadenylated during oocyte maturation in Xenopus laevis.
AB  - Cytoplasmic polyadenylation elements (CPE) are distinct sequence motifs in the 3'
      untranslated region of mRNAs. They control translation of these RNAs by
      cytoplasmic polyadenylation. We show that the mRNA of the cell adhesion molecule
      XB/U-cadherin contains two CPE motifs. With oocyte maturation this mRNA becomes
      polyadenylated and increasingly recruited into the polysomal fraction. Our
      results give evidence that CPEs of the XB/U-cadherin mRNA are responsible for the
      XB/U-cadherin protein increase during oocyte maturation.

PMID- 7772610
TI  - Social phobia.

PMID- 7772611
TI  - Classification and epidemiology of social phobia.
AB  - The individualization of social phobia among other phobic disorders is very
      recent, although previous clinical descriptions can be found in the literature.
      The new classifications (DSM-III, DSM-IV and ICD-10) have provided
      operationalized criteria for this disorder, which have allowed researchers to
      conduct epidemiological studies. However, some diagnostic issues are not
      completely solved, namely, those with other boundary disorders. Cross-cultural
      prevalence and risk factors of social phobia are reviewed. Results of a French
      community study have found a lifetime prevalence rate of 2.1% in males and 5.4%
      in females. Comorbidity of social phobia with other anxiety disorders and major
      depression was high. Suicidal tendencies, family history and health services
      utilization were analyzed according to the lifetime comorbidity pattern of social
      phobia and depression.

PMID- 7772612
TI  - Comorbidity and social phobia: evidence from clinical, epidemiologic, and genetic
      studies.
AB  - This paper reviews evidence from clinical, epidemiologic, and family studies
      regarding the association between social phobia and other syndromes. Social
      phobia is strongly associated with other anxiety disorders, substance abuse, and
      affective disorders in both clinical and community samples. An average of 80% of
      social phobics identified in community samples meet diagnostic criteria for
      another lifetime condition. Social phobia is most strongly associated with other
      subtypes of anxiety disorders, with an average of 50% of social phobics in the
      community reporting a concomitant anxiety disorder including another phobic
      disorder, generalized anxiety, or panic disorder. Approximately 20% of subjects
      in the community meet lifetime criteria for a major depressive disorder. The
      onset of social phobia generally precedes that of all other disorders, with the
      exception of simple phobia. Both clinical severity and treated prevalence are
      consistently greater among social phobics with comorbid disorders. The results of
      family and twin studies reveal that shared etiologic factors explain a
      substantial proportion of the comorbidity between social phobia and depression,
      whereas the association between social phobia and alcoholism derives from a
      nonfamilial causal relationship between the two conditions. Clinical and
      phenomenologic implications of these findings are discussed.

PMID- 7772613
TI  - Biological characterization of social phobia.
AB  - As social phobia has become clinically more clearly characterized, the search for
      biologic features of the disorder has been instituted. As with most psychiatric
      disorders, this undertaking is difficult, because of the heterogeneity of the
      disorder in affected individuals. However, with investigation into several
      different areas, i.e., the neuroendocrine system, neurotransmitter function via
      naturalistic challenges, chemical and pharmacologic probes, response to
      pharmacologic interventions, and neuroimaging, theories about the biologic
      characteristics of social phobia have been advanced. Neuroendocrine studies have
      not yet revealed any clear abnormalities specific to individuals with social
      phobia. Based on studies of neurotransmitter functions and pharmacologic
      response, the major neurotransmitter systems that have been implicated are the
      serotonergic, dopaminergic, and noradrenergic. Neuroimaging studies have
      demonstrated possible structural and metabolic differences in some patients with
      social phobia.

PMID- 7772615
TI  - Can digit symbol-verbal fluency comparisons facilitate detection of
      pseudodementia? A preliminary study.
AB  - Depressive psychomotor retardation may impair performance on timed tests. By
      comparison word association measures of verbal fluency are reportedly unaffected
      by depression. Comparisons of a brief psychomotor test with a measure of verbal
      fluency may therefore prove useful when there is a concern that depression may be
      undermining adaptive functioning, assuming both measures display: (1) broad
      spectrum sensitivity to brain impairment, (2) differential vulnerability to
      depression, and (3) moderate correlation in nondepressed persons. Digit Symbol
      (DS) and the "FAS" measure of verbal fluency are sensitive to genuine dementia,
      satisfying the first criterion. We found that depressed schizophrenics performed
      at significantly lower levels on DS, but not on FAS, than nondepressed
      schizophrenics. The two groups differed significantly on a discrepancy score
      derived by subtracting FAS from DS scores; normals obtained discrepancy scores
      highly similar to those of nondepressed schizophrenics. As the normals had higher
      DS and FAS scores, this discrepancy-score similarity suggests that this index may
      have wide application. The third criterion is satisfied by the findings of a 0.64
      correlation between DS and FAS scores adjusted for age (DS and FAS) as well as
      gender and educational attainment (FAS) in nondepressed samples. Implications for
      further research and clinical applications are discussed.

PMID- 7772614
TI  - Recent developments in the psychopharmacology of social phobia.
AB  - The past 2 decades have witnessed an upsurge in the interest in anxiety
      disorders. Much research effort has been dedicated to panic disorder and
      obsessive-compulsive disorder. However, it is only very recently that we have
      begun to understand some of the basic principles about the psychopharmacology of
      social phobia. Drug classes thus far studied include beta-blockers, nonselective
      and irreversible monoamine oxidase inhibitors (MAOIs), and benzodiazepines. Beta
      blockers appear to be of use in specific social phobias, such as public speaking,
      whereas they are of little use in generalized social phobia. There is
      considerable evidence suggesting that MAOIs are effective in reducing both social
      anxiety as well as social avoidance in generalized social phobia. A disadvantage
      of the conventional irreversible MAOIs is their risk for hypertensive crises when
      combined with dietary tyramine. Thus far only a small number of studies with
      selective MAO-A inhibitors, such as moclobemide and brofaromine, have been
      conducted in social phobia, and the results indicate that both compounds are
      effective. Drugs exerting selective and specific actions on certain components
      of, for example, the serotonergic system, can now be studied, and it is hoped
      that the role of 5-hydroxytryptamine) and other neuronal systems in social phobia
      can be elucidated. In order to gain more information about selective serotonergic
      drugs, the first double-blind placebo-controlled study with fluvoxamine was
      recently published. Preliminary results indicate a reduction in social anxiety
      after a prolonged treatment period. Finally, the role of peptides in the
      treatment of social phobia is critically reviewed. The MSH/ACTH analog Org 2766
      was investigated in patients suffering from social phobia.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7772616
TI  - Mianserin treatment of patients with psychosis induced by antiparkinsonian drugs.
AB  - We evaluated the effects of mianserin, a relatively selective 5-HT2 receptor
      antagonist, on symptoms related to drug-induced psychosis in patients with
      Parkinson's disease (PD). A total of 12 patients with PD who had developed drug
      induced psychosis showed delirium (DSM-III-R criteria; n = 10) and pure visual
      hallucinations (n = 2). The antiparkinsonian drugs involved in the drug-induced
      psychosis were L-DOPA/carbidopa, bromocriptine, trihexyphenidyl, and amantadine.
      They received mianserin (mean 36.7 mg, range 20-60 mg) given orally for 8 weeks.
      Complete relief or marked improvement in psychotic symptoms was noted in 8
      patients, moderate improvement in 2 patients, and no effect in 2 patients. The
      parkinsonian disability also decreased slightly in 8 patients. These results
      suggest that serotonin antagonism at 5-HT2 receptors may not only play an
      important role in the treatment of drug-induced psychosis in PD, but may also
      ameliorate the symptoms of parkinsonism.

PMID- 7772618
TI  - [Hepatitis A virus].

PMID- 7772619
TI  - [Hepatitis B virus: biology, natural history, and diagnosis of the infection].

PMID- 7772617
TI  - Plasma-soluble interleukin-2 and transferrin receptor in schizophrenia and major
      depression.
AB  - This study was carried out to examine some components of in vivo immune function
      in major depression and schizophrenia. Toward this end, plasma concentrations of
      interleukin-1 beta (IL-1 beta) and IL-6, soluble IL-2 receptor (sIL-2R), and
      transferrin receptor (TfR) were measured in 28 normal controls, 11 schizophrenics
      and 13 major-depressed patients. Schizophrenic and major-depressed patients
      showed significantly higher plasma sIL-2R and TfR than normal controls. There was
      a trend toward higher plasma IL-6 in the psychiatric patients, and particularly
      in schizophrenic patients, than in normal volunteers. In normal controls and in
      the total study group, there were highly significant and positive correlations
      between plasma TfR and sIL-2R concentrations. It is suggested that schizophrenia
      and major depression are characterized by immune disorders that may indicate
      activation of cell-mediated immunity such as T-cell activation.

PMID- 7772620
TI  - [Hepatitis virus].

PMID- 7772622
TI  - [Hepatitis D virus: biology, natural history, and laboratory diagnosis].

PMID- 7772621
TI  - [Hepatitis C].

PMID- 7772623
TI  - [Hepatitis E: enterically transmitted Non-A, Non-B hepatitis].

PMID- 7772624
TI  - [Epidemiology of viral hepatitis].

PMID- 7772625
TI  - [Prophylaxis of viral hepatitis].

PMID- 7772626
TI  - [Clinical features of viral hepatitis. Acute hepatitis. Chronic hepatitis.
      Hepatocellular carcinoma].

PMID- 7772627
TI  - Necrosectomy and laparostomy--a combined therapeutic concept in acute necrotising
      pancreatitis.
AB  - OBJECTIVE: To present our experience with laparostomy and necrosectomy in the
      treatment of acute necrotising pancreatitis, and to show how refinements in our
      treatment regimen improved mortality over the years despite no reduction in the
      severity of the disease. DESIGN: Retrospective study. SETTING: University
      hospital, Austria. SUBJECTS: 125 patients treated by laparostomy/necrosectomy
      with repeated revisions during the period January 1983 to December 1991.
      INTERVENTIONS: Laparostomy, blunt necrosectomy, operative lavage, and open
      drainage. MAIN OUTCOME MEASURES: Mortality and morbidity. RESULTS: The severity
      of disease was assessed by the APACHE II score (median 15, range 4-30). In 106 of
      the 125 patients (85%) the necrotic pancreatic tissue was infected. Patients were
      operated on if they deteriorated clinically or if organ failure was suspected. A
      change in the protocol from revisions on demand (1983/4) to planned re
      exploration at 48 hour intervals (1985/8) was associated with a reduction in
      mortality from 53% (16/30) to 28% (20/72). This was further reduced in 1989/91 to
      17% (4/23) when a protocol of revisions planned for individual patients was
      introduced (p = 0.02). The incidence of gastrointestinal fistulas during the
      three periods was 6/30 (20%); 24/72 (33%); and 1/23 (4%); (p = 0.022), whereas
      that of intraabdominal bleeding remained much the same (7/23, 23%; 13/72, 18%;
      and 4/23, 17%; p = 0.56). The median (range) APACHE II scores for the three
      periods were 12 (4-27), 15 (5-30), and 14 (4-25). CONCLUSION: By continual
      revision of our protocol, together with accompanying improvements in intensive
      care, our mortality decreased significantly during the nine year period.

PMID- 7772628
TI  - Reduction of postoperative immunosuppression with ranitidine in patients with
      cancer of the stomach or large bowel.
AB  - OBJECTIVE: To assess the effect of ranitidine on cellular immune response (and
      postoperative infective morbidity) in a homogeneous group of patients. DESIGN:
      Prospective randomized controlled trial. SETTING: University hospital, Italy.
      SUBJECTS: 42 patients about to undergo curative resection for carcinoma of the
      colon, rectum, or stomach. INTERVENTIONS: Cell mediated immunity was tested 3
      days before, and 4 days after, operation by reactions to 7 recall antigens
      (Multitest, Merieux). 21 patients were randomly allocated to receive ranitidine
      100 mg twice daily intravenously from the day before operation until the third
      postoperative day. MAIN OUTCOME MEASURES: Comparison of the number of reactive
      patients and number of positive antigens before and after operation; and
      correlation between reactivity and incidence of postoperative infective
      complications. RESULTS: The median (range) skin test scores preoperatively were:
      ranitidine group 8.5 (0-17), and control group 10 (0-19). The postoperative
      figures were 7 (0-28) and 4.5 (0-15.5) respectively. The corresponding numbers of
      positive antigens were 1 (0-4) and 3 (0-4) compared with 1 (0-5) and 1 (0-3). The
      changes in the scores did not seem to be influenced by blood transfusion, serum
      albumin concentration, age of the patient, or type of tumour. Two patients died
      in the ranitidine group (pulmonary embulus, n = 1, necrotising pancreatitis, n =
      1) and there were 4 wound infections. There were no deaths in the control group,
      one intra-abdominal abscess, and 8 wound infections. Median hospital stay was
      similar, 10 (8-16) in the ranitidine group, and 11 (5-20) in the control group.
      CONCLUSION: Ranitidine had a beneficial effect on cell-mediated immunity as it
      seemed to prevent the usual postoperative reduction in reactivity, but there was
      no significant difference in the incidence of infective complications though it
      was lower in the ranitidine group.

PMID- 7772629
TI  - Effect of hepatocytes from normal or endotoxin treated animals on the production
      of tumour necrosis factor, interleukin-6, and prostaglandin-E2 by macrophages
      incubated in vitro with various fatty acids.
AB  - OBJECTIVE: To find out if the in vitro production of tumour necrosis factor
      (TNF), interleukin 6 (IL-6) and prostaglandin E2 (PGE2) by macrophages (P3888D1)
      were influenced by the addition to the culture media of hepatocytes from normal
      guinea pigs and from guinea pigs after infusion with endotoxin with and without
      fatty acids. DESIGN: Laboratory experiment. SETTING: University hospital, United
      States MATERIAL: 12 male Hartley guinea pigs. MAIN OUTCOME MEASURES:
      Concentrations of TNF-alpha, IL-6, and PGE2. RESULTS: Hepatocytes inhibited the
      production of TNF by macrophages. Those from animals pretreated with endotoxin
      caused a large increase in the production of PGE2 and affected the production of
      IL-6 only in the presence of fatty acids. Fatty acids differed from each other in
      their effects on production of TNF-alpha and PGE2, but had no effect on the
      production of IL-6. CONCLUSION: These results support the concept that
      hepatocytes and macrophages may interact in vivo, and this interaction may be
      influenced both by fatty acids that arise from lipid metabolism and from
      endotoxin present during sepsis and translocation.

PMID- 7772630
TI  - Postoperative complications predict recurrence of Crohn's disease.
AB  - OBJECTIVE: To find out if any of six variables influenced the incidence and
      timing of recurrence after a first resection for Crohn's disease. DESIGN: Open
      study. SETTING: University hospital, Germany. SUBJECTS: 104 surviving patients of
      106 who underwent a first resection for Crohn's disease between January 1976 and
      December 1990. MAIN OUTCOME MEASURES: Association between 6 variables (age, sex,
      site of diseased bowel, histological evidence of Crohn's disease, indication for
      operation, and incidence of postoperative complications) and incidence and time
      of recurrence after the first operation. RESULTS: Patients were followed up for a
      mean of 4.5 years (range 1-16). Presentation with acute perforation was
      associated with a higher incidence of recurrence (10/14 compared with 26/90), chi
      square 7.90, p = 0.005) and more than doubled the risk of that recurrence
      developing with six years (log rank chi square 11.7, p = 0.02); the same was true
      for development of a postoperative complication for which the corresponding
      figures were 14/26 compared with 22/78, chi square 4.59, p = 0.03, and log rank
      chi square 6.1, p = 0.01. CONCLUSION: These data support the hypothesis that
      there may be two types of Crohn's disease: an aggressive type that perforates and
      is prone to early relapse, and one that develops more slowly with an obstructive
      pattern, and which relapses less often and after a longer disease free interval.
      The development of postoperative complications is a previously unrecognised risk
      factor for early recurrence in Crohn's disease.

PMID- 7772631
TI  - Use of subcutaneous implantable infusion systems in neoplastic and AIDS patients
      requiring long-term venous access.
AB  - OBJECTIVE: To evaluate the life span and complication rates of totally
      implantable infusion devices in patients with short bowel syndrome and in
      immunocompromised patients with AIDS, lymphoma, and myeloma who required long
      term central venous access. DESIGN: Prospective open study. SETTING: University
      hospital, Italy. SUBJECTS: Group I - 5 patients with short bowel syndrome; group
      II - 11 patients with AIDS; and group III - 15 patients with lymphoma or multiple
      myeloma (1 of whom had 2 devices implanted). MAIN OUTCOME MEASURES: Duration of
      implantation and incidence of catheter-related complications. RESULTS: The mean
      duration/patient of the catheter was 422 days (range 20-1257) in group I; 104
      days (range 43-262) in group II; and 415 days (range 62-1280) in group III. There
      were no catheter related complications in the patients in group I (short bowel
      syndrome). Of the 11 patients with AIDS (group II) 4 developed catheter related
      infections (0.32/100 catheter days), and 1 developed a thrombotic occlusion. All
      5 catheters were removed (3 for infection). Of the 15 patients with lymphoma or
      myeloma who had 16 catheters implanted (group III), 1 patient developed 3
      infective episodes (0.05/100 catheter days), 1 catheter migrated and 1 occluded.
      All 3 catheters were removed. CONCLUSION: Totally implantable infusion systems
      can safely be used for prolonged periods in immunocompromised patients, including
      those with AIDS if their life expectancy is reasonable.

PMID- 7772632
TI  - Papers presented at the Surgical Infection Society of Europe meeting. Varese,
      Italy, June 1993.

PMID- 7772633
TI  - Food deprivation increases bacterial translocation after non-lethal haemorrhage
      in rats.
AB  - OBJECTIVE: To investigate whether brief fasting before the induction of
      hypotension by non-lethal haemorrhage may induce translocation of enteric
      bacteria to mesenteric lymph nodes or blood in rats. DESIGN: Laboratory
      experiment. SETTING: University departments of surgery and microbiology, Sweden.
      MATERIAL: 39 Male Sprague-Dawley rats. INTERVENTIONS: 20 animals were fasted for
      24 hours, all 39 then underwent controlled haemorrhage for 60 minutes that
      reduced the blood pressure to 55 mm Hg. MAIN OUTCOME MEASURES: Differences in
      blood loss, blood glucose concentrations, and packed cell volume; and aerobic
      cultures of mesenteric lymph nodes and blood. RESULTS: Fasted rats (n = 20) lost
      2.3% of blood volume compared with 2.8% in fed rats (p < 0.001). Packed cell
      volume dropped by 11.3% in fasted rats and 16.5% in fed rats (p < 0.001). Glucose
      concentrations rose by 7.0 mmol/l in fasted rats compared with 21.0 mmol/l in fed
      rats (p < 0.001). Mesenteric lymph nodes contained enteric bacteria in 14/20
      fasted rats compared with 6/19 fed rats (p < 0.05). In 4 fasted rats blood
      cultures grew pathogenic bacteria compared with no fed rats (p = 0.11). The
      number of bacteria found in mesenteric lymph nodes was significantly greater in
      fasted than in fed rats (p = 0.01). CONCLUSIONS: Brief fasting before hypotension
      caused by non-lethal haemorrhage was associated with significantly increased
      bacterial translocation compared with fed animals. Increases in blood glucose
      concentrations and plasma refill may have had a protective effect in fed rats.
      These experiments may be of clinical relevance as elective operations are usually
      preceded by overnight fasting.

PMID- 7772634
TI  - Early thoracoscopic debridement and drainage as definite treatment for pleural
      empyema.
AB  - OBJECTIVE: To report our experience with early thoracoscopic debridement and
      drainage in the treatment of pleural empyema in the fibrinopurulent or early
      organising phase. DESIGN: Prospective open study. SETTING: District hospital,
      Germany. SUBJECTS: 10 Patients operated on between August 1991 and April 1993.
      INTERVENTIONS: Double lumen intubation, followed by thoracoscopic opening of the
      empyema, evacuation of all pus under vision, debridement of the lung, irrigation
      of the thoracic cavity and insertion of a chest drain. MAIN OUTCOME MEASURES:
      Morbidity and mortality. RESULTS: Cultures taken during the operation grew no
      pathogens in five cases; Streptococcus pneumoniae, and haemolytic streptococci
      (once in combination with Staphylococcus aureus), were cultured in two cases
      each; and Mycobacterium tuberculosis in one. Chest drains were removed a mean of
      8.5 days after operation. All patients were well without signs of infection 1-21
      months later, and in no case was conversion to open operation necessary.
      CONCLUSION: Early thoracoscopic debridement and drainage is a safe and effective
      alternative to open treatment of patients with pleural empyema in the
      fibrinopurulent or early organising phase.

PMID- 7772635
TI  - Adverse effect of abdominal operations on production of interferon-gamma.
AB  - OBJECTIVE: To assess the effects of abdominal operations on the production of
      cytokines as one of the mechanisms of postoperative immunosuppression. DESIGN:
      Prospective study. SETTING: University hospital, Belgium. SUBJECTS: 19 Selected
      patients who underwent operations for benign (n = 10) or malignant (n = 9)
      diseases. INTERVENTIONS: Whole blood was collected in heparinised tubes before
      operation and on postoperative days 1, 2, 3, 5, 7, and 9. After 1/10 dilution in
      culture medium the whole blood cells were stimulated with 5 micrograms/ml
      phytohaemagglutinin and 25 micrograms/ml lipopolysaccharide, and incubated at 37
      degrees C in 5% carbon dioxide. Concentrations of interleukin 1 (IL-1), tumour
      necrosis factor alpha (TNF alpha), and interleukin 6 (IL-6) were measured at 24
      hours, and interferon-gamma and interleukin 2 (IL-2) were measured at 72 hours,
      with commercially available assays. OUTCOME MEASURES: Production of the monokines
      IL-1, TNF alpha, and IL-6, and of the lymphokines IL-2 and interferon-gamma,
      postoperatively. The monokines were expressed as a percentage of the preoperative
      values/monocyte, and the lymphokines as a percentage of preoperative
      values/lymphocyte. RESULTS: Production of IL-1 and TNF alpha, but not IL-6,
      decreased immediately after operation then returned to preoperative values.
      Production of IL-2 and interferon-gamma were significantly reduced immediately
      after operation, and that of interferon-gamma was still depressed on the ninth
      postoperative day. CONCLUSION: Cytokine production is altered after abdominal
      operations. The production of interferon-gamma may be a more sensitive indicator
      of altered immune response and vulnerability to infections and tumour growth than
      concentrations of other cytokines.

PMID- 7772636
TI  - Effect of different regimens of gut decontamination on bacterial translocation
      and mortality in experimental acute pancreatitis.
AB  - OBJECTIVE: To assess the effect of four regimens of antibiotics (compared with a
      control regimen of distilled water) given orally on gut decontamination,
      bacterial translocation, and mortality in acute necrotising pancreatitis in mice.
      DESIGN: Randomised experimental study. SETTING: University hospitals, USA and
      Italy. MATERIALS: 150 young Swiss Webster mice. INTERVENTION: All mice were fed a
      diet deficient in choline and supplemented with ethionine. They were then
      randomised to be given by gavage (36 hours after starting the diet): distilled
      water (controls, group 1); aztreonam along (group 2); neomycin, erythromycin,
      metronidazole (group 3); polymyxin B and amikacin (group 4); polymyxin B,
      amikacin, amphotericin B (group 5). 20 Mice in each group were treated for 10
      days, and the remaining 10 in each group were killed after 3 days. MAIN OUTCOME
      MEASURES: Survival, and qualitative and quantitative cultures of the liver,
      lungs, pancreas and caecum. RESULTS: The best survival rate during the first 7
      days was in group 5, but by day 10 there was no difference among the groups. All
      the antibiotic regimens reduced the number of bacteria in the caecum and all but
      aztreonam alone (group 2) reduced the rate of translocation of both Gram negative
      and Gram positive bacteria to all organs studied. Translocation of yeast occurred
      in those animals in groups 2, 3, and 4 in which there was overgrowth of fungi in
      the caecum. CONCLUSION: Gram negative and Gram positive organisms and fungi may
      have an important role in infective morbidity and mortality in acute
      pancreatitis, and selective decontamination with polymyxin B, amikacin,
      amphotericin B reduced the incidence of translocation related infections and
      early mortality in mice with acute necrotising pancreatitis.

PMID- 7772637
TI  - Luminal bacterial overgrowth and intestinal translocation in pigs given either
      cyclosporin A or 15-deoxyspergualin after small bowel transplantation.
AB  - OBJECTIVE: To examine the effects of two immunosuppressant regimens on
      composition of the bowel flora and rate of translocation after transplantation of
      the small bowel in pigs. DESIGN: Randomised controlled study. SETTING: University
      hospital, Italy. MATERIAL: 35 female Large White pigs. INTERVENTIONS: 9 Animals
      were not operated on (normal controls). 19 Animals underwent total orthotopic
      small bowel allotransplantation and were then randomised to receive: group A (n =
      8) cyclosporin A 25 mg/kg subcutaneously and cephazolin 2 g intramuscularly
      daily; group B (n = 6) 15-deoxyspergualin (15-dos) 3 mg/kg for 7 days then 1.5
      mg/kg, cephazolin 2 g intramuscularly daily for 4 days then selective intestinal
      decontamination with colistin 1.5 million U, tobramycin 100 mg, vancomycin 1 g,
      and nystatin 500,000 U daily; and group C (n = 5) cephazolin 2 g intramuscularly
      daily for 8 days. A further group (D, n = 7) underwent orthotopic
      autotransplantation and received the same antibiotic and selective
      decontamination regimens as group B. Animals in group C were killed on day 8, and
      the rest on day 29. MAIN OUTCOME MEASURES: Signs of rejection, graft versus host
      disease, luminal overgrowth, and evidence of translocation to mesenteric lymph
      nodes. RESULTS: All animals in group C, and 2 in group B, showed signs of acute
      rejection. There was a significant overgrowth of both aerobic and anaerobic
      bacteria in all 3 groups after allotransplantation compared with normal controls.
      Bacterial translocation was similar in autografted and allotransplanted animals.
      Mesenteric lymph nodes were colonised in 4/9 controls, 7/8 in group A, 4/4 in
      group B, 5/5 in group C, and 7/7 in group D. CONCLUSION: Neither cyclosporin A
      nor 15-dos prevented luminal overgrowth or bacterial translocation to mesenteric
      nodes up to one month after operation. The rate of translocation was similar in
      autotransplantation and allotransplantation, suggesting that non-immunological
      factors (for example, denervation and interruption of lymphatics) may have a role
      in these alterations.

PMID- 7772638
TI  - Tumour necrosis factor-alpha and interleukin-6: early indicators of bacterial
      infection after human orthotopic liver transplantation.
AB  - OBJECTIVE: To see if it was possible to predict the development of infection
      after liver transplantation from concentrations of endotoxin, tumour necrosis
      factor-alpha (TNF-alpha), or interleukin-6 (IL-6) in plasma. DESIGN: Prospective
      open study. SETTING: University hospital, Austria. SUBJECTS: 46 Consecutive
      patients who underwent liver transplantation for end stage liver disease, 1989
      90. INTERVENTIONS: Samples of 4 ml blood were taken in endotoxin free tubes, and
      of 10 ml into heparinised tubes at the beginning of the operation, during
      hepatectomy, at the beginning and end of the anhepatic phase, 10 minutes after
      reperfusion, and at the end of the operation. MAIN OUTCOME MEASURES: Correlation
      between development of infections postoperatively and operative release of
      endotoxin, TNF-alpha, and IL-6. RESULTS: There was no correlation between
      development of postoperative infections and operative concentrations of
      endotoxin, and of TNF-alpha and IL-6 up to the end of the anhepatic phase. There
      was, however, a sixfold increase in TNF-alpha and IL-6 concentrations between the
      end of the anhepatic phase and the end of the operation in patients who
      subsequently developed infections (p = 0.01). CONCLUSION: The increase in the
      concentrations of these two cytokines in the blood after reperfusion of the
      transplanted liver seems to predict the development of subsequent bacterial
      infection.

PMID- 7772639
TI  - Modulation of rabbit articular chondrocyte (RAC) proliferation by TGF-beta
      isoforms.
AB  - We have previously shown that TGF-beta 1 exerts a bifunctional effect on RAC
      proliferation. Added to quiescent cultures, it inhibits the entry of G0/G1 cells
      into S phase whereas in S phase synchronized populations, it stimulates the DNA
      replication rate with a delayed G2 + M phase and a subsequent transient increase
      of cell number. As TGF-beta 2 and beta 3 isoforms are also expressed in bone and
      cartilage tissues, it was of interest to study their effect on RAC proliferation,
      in comparison to that of TGF-beta 1. Using cell counting and tritiated thymidine
      incorporation, we found that all the TGF-beta s used here induced an increase of
      RAC proliferation rate occurring between 24 and 48 h of exposure. TGF-beta 2
      appeared as the most efficient form as judged from the maximum of thymidine
      labelling. However, TGF-beta 3 induced an increase of cell number slightly higher
      than both TGF-beta 1 and TGF-beta 2 (+30% versus 20% for TGF-beta 1 and beta 2).
      TGF-beta 2 and beta 3 were able to stimulate the DNA replication rate as
      previously demonstrated for TGF-beta 1. However, the effect occurred later for
      TGF-beta 2 and beta 3 (12 h) than for TGF-beta 1 (6 h). This was confirmed by
      flow cytometric analysis of DNA content. In addition, immunodetection by flow
      cytometry demonstrated that all TGF-beta isoforms enhanced endogenous expression
      of TGF-beta-related peptides. The effect was shown to be associated with the cell
      cycle S phase and was greater for TGF-beta 3 than for TGF-beta 1 and beta 2.
      These findings suggest that TGF-beta s could act on RAC functions via autocrine
      and paracrine ways. Taken together, these data indicate that TGF-beta s may
      modulate proliferation of articular chondrocytes and therefore could play a role
      in the activation of these cells in the early stages of osteoarthritis.

PMID- 7772640
TI  - Streaming of labelled cells in the conjunctival epithelium.
AB  - This study examines epithelial cell streaming and turnover in normal rat bulbar
      conjunctiva. Twenty seven male adult random-bred Hebrew rats weighing between 250
      300 g, were injected i.p. with [3H]-thymidine. Three rats were killed at various
      times, thereafter from 1 h to 28 days. The enucleated eyes were fixed in
      formalin, cut into 5 microns thick sections, dipped into liquid emulsion, exposed
      for three weeks and stained with haematoxylin and eosin. Conjunctival epithelium
      was scanned from the limbus and outward, using an ocular micrometer grid with 10
      x 10 divisions. In each consecutive field the grid was positioned along the
      basement membrane which was defined as the x-axis. The y-axis extended from the
      basement membrane outward. The x, y coordinate of each nucleus with three grains
      or more and its grain content were recorded along the entire epithelium.
      Conjunctival epithelium is divided into two cell kinetic compartments: a
      progenitor (P), along the basal and supra basal layer, in which cells
      proliferate, and a non proliferating Q-compartment, in the layers above. One hour
      after labelling most of the labelled cells were in the basal and supra basal
      layers. From then onward labelled cells streamed along both axes. Their x
      velocity was 10.5 +/- 2.4 microns/day and the y-velocity 9.3 +/- 5.4 microns/day.
      Cells are eliminated at the epithelial surface which is the outer Q-compartment
      boundary. Basal cell turnover was estimated from grain count dilution curves. The
      time it takes for the grains in a cell to reach half of their initial value was
      8.3 days. It is closely related to the cell's generation time. The present study
      demonstrates that conjunctival epithelium in the rat streams along two axes, x,
      and y: 1. The x-axis extends along the basal layer, from the limbus and outward.
      2. The y-axis extends from the basal layer into the layers above it. Cells first
      stream along the x-direction and then turn y-ward. Since cells are ultimately
      exfoliated from the conjunctival surface, and since the conjunctiva maintains
      steady state, we propose that stem cells located in the limbus generate
      transitional cells that stream along the two axes. Macroscopically the limbus is
      circular, and the stem cells are situated around the cornea. Each stem cell and
      its streaming progeny can be viewed as a conjunctival epithelial unit. We propose
      that conjunctival and corneal epithelium, are the descendants of an uncommitted
      stem cell that generates two differentiation pathways, a corneal and a
      conjunctival.

PMID- 7772641
TI  - The effect of extracellular calcium on colonocytes: evidence for differential
      responsiveness based upon degree of cell differentiation.
AB  - Calcium supplementation decreases the incidence of colon cancer in animal models
      and may prevent colon cancer in man. Potential mechanisms include binding of
      mitogens and direct effects of calcium on colonic epithelial cells. In this
      study, the effects of extracellular calcium on epithelial cell growth and
      differentiation were studied in three colon carcinoma and two colonic adenoma
      cell lines. The characteristics studied included morphology, cell cycle kinetics,
      [Ca2+]IC (intracellular calcium concentration), proliferation, and expression of
      differentiation markers such as carcinoembryonic antigen (CEA) and alkaline
      phosphatase (AP). Sodium butyrate (NaB) and 1,25-dihydroxyvitamin D3 were used as
      controls in the latter three assays as these two agents are known differentiating
      agents. Alteration of [Ca+2]EC (extracellular calcium concentration) did not
      affect carcinoembryonic antigen (CEA) or alkaline phosphatase (AP) expression.
      NaB enhanced the expression of AP three-fold and CEA five-fold. This effect was
      augmented by increasing [Ca2+]EC. The exposure of cells to 1,25-(OH)2-Vitamin D3
      increased CEA but not AP. [Ca2+]IC increased in response to 1,25-(OH)2-vitamin D3
      and NaB but not with variation in [Ca2+]EC. Increased [Ca2+]EC inhibited
      proliferation of well-differentiated cells, but had no effect on poorly
      differentiated cells. Morphological studies showed that extracellular calcium was
      necessary for normal cell-cell interactions. These studies have demonstrated
      direct effects of calcium on colonic epithelial cells which may contribute to the
      protective effects of dietary calcium against colon cancer. Loss of
      responsiveness to the antiproliferative effects of [Ca2+]EC with de
      differentiation suggests that calcium supplementation may be most beneficial
      prior to the development of neoplastic changes in colonic epithelium.

PMID- 7772642
TI  - The World Federation of Societies of Biological Psychiatry. How it began: a
      historical note.

PMID- 7772643
TI  - Evidence against changes in corticotroph CRF receptors in depressed patients.
AB  - Previous studies by a number have investigators have documented a decreased
      adrenocortotropic hormone (ACTH) and beta-lipotropin/beta-endorphin (beta-End)
      response to ovine corticotropin-releasing factor (oCRF) in depressed patients.
      Since depressed patients demonstrate higher plasma cortisol concentrations at the
      time of oCRF challenge, it is difficult to determine if the decreased ACTH
      response is due to enhanced negative feedback of cortisol on ACTH release or an
      alteration in CRF receptors in depressed patients. To evaluate the response to
      oCRF in an "open feedback loop" system, we administered metyrapone 750 mg at 4 PM
      and 7:30 PM, followed by administration of oCRF 0.3 microgram/kg at 8 PM in 10
      normal controls and 10 depressed patients. Administration of metyrapone at this
      time in the circadian rhythm clamped plasma cortisol concentrations to less than
      2 micrograms/dl but did not result in rebound ACTH or beta-End secretion in
      control subjects. In control subjects, metyrapone administration produced a 85%
      blockade of the cortisol response as well as a 3-fold greater beta-End response
      compared to administration of the same dose of oCRF without metyrapone. The 10
      depressed patients and their matched controls demonstrated identical beta-End
      responses (integrated response for controls = 291 +/- 61, for patients = 352 +/-
      86) and cortisol responses (integrated response for controls = 187 +/- 38, for
      patients = 206 +/- 52) to oCRF following metyrapone pretreatment. These data
      confirm that corticotroph CRF receptors are normal in depressed patients, and
      that cortisol feedback plays an essential role in the abnormal ACTH and beta-End
      response to oCRF in depressed patients.

PMID- 7772644
TI  - Cortisol synthesis inhibition: a new treatment strategy for the clinical and
      endocrine manifestations of depression.
AB  - Evidence exists that oversecretion of cortisol may be responsible for the
      clinical manifestations and serotonergic abnormality in depressive illness. Using
      the cortisol synthesis inhibitor ketoconazole, we investigated the effects of
      directly lowering cortisol on the symptoms and the response of prolactin (PRL) to
      d-fenfluramine in eight patients suffering from major depression. Prolactin
      responses to d-fenfluramine were measured, and patients were treated with 400-600
      mg of ketoconazole for 4 weeks, after which they were retested. Five patients
      treated with ketoconazole recovered from their depression, while the other three
      had decreases in their Hamilton Depression Rating Scale (HAMD) scores of < or =
      50% and were deemed partial responders. Posttreatment prolactin responses to d
      fenfluramine were higher than pretreatment values. Ketoconazole normalizes the
      blunted prolactin responses to d-fenfluramine and may be an effective method by
      which to treat depression. This implies that hypercortisolemia may be responsible
      for the clinical features and serotonergic subsensitivity observed in depression.

PMID- 7772645
TI  - The psychotropic effects of inhibitors of steroid biosynthesis in depressed
      patients refractory to treatment.
AB  - Twenty patients, diagnosed as suffering from treatment-resistant major
      depression, were treated with one or more drugs that decrease corticosteroid
      biosynthesis. Nine were psychotic, 11 nonpsychotic. Seventeen completed the
      treatment (8 psychotic, 9 nonpsychotic); 13 responded (5 psychotic, 8
      nonpsychotic; 11 responded completely (i.e., a drop in the Hamilton Depression
      Scale of at least 50%, to < or = 15), and 2 responded partially. The mean age of
      the responders (45.2 +/- 12.6 years) did not differ significantly from that of
      the nonresponders (48.7 +/- 12/3). Data were analyzed in the following
      categories; (1) the presence or absence of psychosis, (2) response or nonresponse
      to treatment, and (3) the drug(s) used (aminoglutethimide, ketoconazole, or a
      combination of either of these with metyrapone). The patients improved over time
      on the Hamilton Depression Scale independent of the medication used. Responders
      demonstrated improvement in mood, insomnia, anxiety, diurnal variation, paranoia
      and obsessive compulsiveness. Nonpsychotics responded better than psychotics.

PMID- 7772646
TI  - CRH challenge test in anxious depression.
AB  - Recently, renewed interest has developed in the concept of anxious depression.
      Using an operational definition of "anxious depression" based on the SADS
      interview, 25 patients with major depressive disorder were separated into anxious
      (n = 14) and nonanxious (n = 11) subtypes. These two patient groups and normal
      control subjects received an intravenous corticotropin-releasing hormone
      challenge test. Adrenocorticotropic hormone (ACTH) and cortisol responses were
      compared among the three groups. Patients with anxious depression had significant
      attenuation of ACTH response when compared to nonanxious patients and normal
      control subjects.

PMID- 7772647
TI  - Serotonin receptor binding in a colony model of chronic social stress.
AB  - Male rats housed in mixed-sex groups quickly established dominance hierarchies in
      which subordinates appeared severely stressed. Subordinate rats had elevated
      basal corticosterone (CORT) levels relative to dominants and individually housed
      controls. Several subordinates had blunted CORT responses to a novel stressor,
      leading to the classification of subordinates as either stress-responsive or
      nonresponsive. Binding to 5-HT1A receptors was reduced in stress-responsive
      subordinates compared to controls throughout hippocampus and dentate gyrus.
      Decreased binding was observed in nonresponsive subordinates only in CA3 of
      hippocampus. In addition, 5-HT1A binding was decreased in CA1, CA3, and CA4 in
      dominants compared to controls. Binding to 5-HT2 receptors was increased in
      parietal cortex in both responsive and nonresponsive subordinates compared to
      controls. No changes were observed in binding to 5-HT1B receptors. These results
      are discussed in the context of regulation of the serotonergic system by stress
      and glucocorticoids and possible relevance to the pathophysiology of depression.

PMID- 7772648
TI  - Antisaccades and smooth pursuit eye movements in schizophrenia.
AB  - Saccadic and smooth pursuit eye movements were recorded in schizophrenic
      patients, nonschizophrenic psychiatric patients, and normal controls. Both
      schizophrenic subjects and psychiatric controls demonstrated greater increases in
      error rates and greater delays in generating antisaccades than did normal
      controls. Schizophrenic patients with impaired smooth pursuit tracking showed
      greater increases in error rates in the antisaccade task than did schizophrenic
      patients with normal pursuit. Among psychiatric controls, increased errors on the
      antisaccade task were unrelated to pursuit performance. The small size of this
      group, however, reduces the power to detect a relation between smooth pursuit
      tracking and performance on the antisaccade task. Although most patients were
      receiving one or more medications, some of which can affect eye movements,
      medication state in this study did not account for differences we report in
      dependent variables.

PMID- 7772649
TI  - First month of neuroleptic treatment in schizophrenia: only partial normalization
      of the late positive components of visual ERP.
AB  - In a previous study we recorded visual event-related potentials (ERP) in drug
      naive schizophrenics during passive-attention and active-attention tasks.
      Patients, compared to normal controls, had much lower late positive components
      (LPC) in both sessions, but nearly normal LPC increase from passive to active
      task. The present sample consisted of drug-naive and drug-free patients who were
      tested before and during the first month of neuroleptic treatment. Neuroleptics
      initiated gradual amelioration of psychiatric symptoms expressed by reduced Brief
      Psychiatric Rating Scale (BPRS) scores. Schizophrenics compared to controls
      showed a session-related increase in LPC amplitude, but this process of LPC
      recovery was too minor to fully normalize the low LPC amplitudes in patients.
      Furthermore, the treatment either did not improve or even reduce the LPC reaction
      to the active-attention task. These findings indicate that normalization of low
      LPC in schizophrenia might require a long period of treatment, and that patients'
      reduced LPC reactivity to the task might be contributed, rather than treated, by
      neuroleptics.

PMID- 7772650
TI  - Specific IgA antibody increases in schizophrenia.
AB  - IgA antibody levels in serum were examined in two groups of schizophrenic
      patients. All were diagnosed according to DSM-III-R criteria. One group of 36
      males and 12 females were compared to historical controls. The other group
      consisted of 13 males off drugs for at least 3 months; these were compared with
      age- and sex-matched controls. An increase in specific IgA antibodies was found.
      More schizophrenics than controls showed IgA antibody levels above the upper
      normal limit to gliadin, beta-lactoglobulin, and casein.

PMID- 7772651
TI  - Serotonergic responsivity in trichotillomania: neuroendrocrine effects of m
      chlorophenylpiperazine.

PMID- 7772652
TI  - Neurochemistry and paroxetine response in major depression.

PMID- 7772653
TI  - Attention and formal thought disorder in mixed and pure mania.

PMID- 7772654
TI  - [Effects of lumbar peridural anesthesia on tissue pO2 of the large intestine in
      man].
AB  - AIM: The aim of this study was to investigate the effect of 15 ml bupivacaine
      0.25%, given via an epidural catheter, on the tissue-PO2 of the colon wall in
      humans. METHODS: Nine patients were studied during elective colorectal surgery.
      The tissue-PO2 was measured by polarography, using a multiwire surface probe.
      RESULTS: There was no significant change in cardiac index and arterial oxygen
      delivery after the injection of bupivacaine. At the serosal side of the colon
      wall the tissue-PO2 increased from 34 to 51 mmHg after epidural bupivacaine,
      which is statistically significant. Spinal nerve block produces sympathetic
      denervation of the bowel with an increase of regional nutritive blood flow.
      CONCLUSION: It is concluded that epidural bupivacaine has a favourable effect on
      tissue oxygenation of the colon during colorectal surgery.

PMID- 7772655
TI  - [Indications for anesthesia?].

PMID- 7772656
TI  - [Amniotic fluid embolism--a case report with positive outcome].
AB  - While inducing delivery, shock occurred in a 23-year old primipara (41 weeks and
      5 days of gestation). She showed symptoms of cyanosis, unconsciousness and
      asystoly. During cardiopulmonary resuscitation an emergency Caesarean section was
      performed. The resuscitation had to be continued for 1.5 hours and was followed
      by severe haemorrhage. Hysterectomy had to be performed, because the substitution
      of packed red blood cells, whole blood, fresh frozen plasma and other blood
      derivatives could not stop bleeding. Although the prognosis seemed to be very
      poor, mother and child survived without any physical damage or neurological
      deficit until now. Because of the clinical pattern we diagnosed an AFE syndrome
      (amniotic fluid embolism).

PMID- 7772657
TI  - [Central anticholinergic syndrome after propofol anesthesia].
AB  - A 37-year old patient was anaesthetised twice within 4 weeks for surgery of a
      vertebral disc prolapse. The first anaesthesia was performed with volatile
      anaesthetics without any anomalies. After the second operation in total
      intravenous anaesthesia with propofol and alfentanil the excitatory form of a
      central anticholinergic syndrome occurred. The application of physostigmine
      resulted in an immediate and complete disappearance of the symptoms.

PMID- 7772658
TI  - The laryngeal mask airway--fixation, gags and stability.

PMID- 7772659
TI  - [Anesthesia in ambulatory surgery].

PMID- 7772660
TI  - [Allergic and pseudo-allergic reactions in anesthesia. II: Symptoms, diagnosis,
      therapy, prevention].
AB  - In this article we present the symptomatic features and discuss relevant
      diagnostic and therapeutic aspects of anaphylactoid reactions. In addition we
      give practical advice as to how to avoid and manage allergic or pseudoallergic
      reactions during anaesthesia. Measurements of serum tryptase-levels and of
      methylhistamine in urine have been introduced in clinical diagnostic routine.
      Skin tests and determination of specific antibodies are essential to identify
      responsible substances. Preventive measures like careful premedication, calm
      atmosphere, slow injection of drugs, the use of diluted solutions, and the use of
      drugs with a low potential for anaphylactoid reactions are important. Substances
      like inhalation anaesthetics, propofol, etomidate, ketamine, midazolam, fentanyl,
      alfentanil and bupivacain without epinephrine should be used.

PMID- 7772661
TI  - [Anesthesia for surgery in ambulatory patients: organizational aspects of the
      hospital physician].
AB  - At first sight it seems impossible to put into practice the 1992 resolution of
      the German Federal Council recommending increased frequency of hospital based
      operative care for ambulatory patients and the duty to do so under full financial
      coverage. A detailed analysis of the current situation suggests that this may be
      possible even today--with some reservations regarding the infrastructure of the
      hospitals. Selection and preparation of the patient is a process in which the
      anaesthesiologist must play an important role. Delegation of this duty to the
      surgeon or the general practitioner is not permitted. The anaesthesiologist must
      have sufficient time, prior to the procedure, to meet the patient; meeting the
      patient for the first time a few minutes before induction of anaesthesia is
      unacceptable. Even if one concedes freedom of methods, one drug and one procedure
      should be avoided while caring for surgical ambulatory patients: this drug is
      succinylcholine, because of life-threatening hyperkaliaemia in children with
      occult myopathy and severe and frequent myalgia especially in ambulatory
      patients. The procedure not suitable in ambulatory patients is subarachnoidal
      analgesia--due to an unacceptably high percentage of headaches in young
      ambulatory patients. The postoperative care and observation must be delegated to
      especially qualified persons only--and these persons should not be distracted by
      duties outside the recovery area. The anaesthetist must--in addition--be
      available at all times without delay. Pain, nausea and emesis molest the
      ambulatory patient during the postoperative course to a particular extent. The
      anaesthesiologist must take care of these complaints--even if the patient is
      discharged.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772662
TI  - [Current status of ambulatory pediatric anesthesia].
AB  - Anaesthesia in paediatric outpatients represents a multi-facetted challenge for
      the anaesthesiologist. Certain steps have to be taken to allow preoperative
      examination of the patient on an outpatient basis. Preoperative screening should
      identify patients whom it is preferable to treat as inpatients. During the
      preoperative visit, the patient must be prepared for anaesthesia, and the
      importance of preoperative fasting must be stressed. The anaesthetic technique
      used has to take into consideration the fact that the patient must be awake and
      alert in the early postoperative period. Adequate pain treatment is essential
      postoperatively. Prophylactic administration of antiemetic agents must be
      considered for special operations. Patients should also be discharged according
      to standardised guidelines. In this way, the risks involved in anaesthesia and
      surgery should not be higher for outpatients than they are for inpatients.

PMID- 7772663
TI  - [Behavior of intraocular pressure in anesthesia with isoflurane in comparison
      with propofol/alfentanil].
AB  - AIM: To investigate the influence of isoflurane anaesthesia versus total
      intravenous anaesthesia with propofol/alfentanil on intraocular pressure (IOP).
      METHODS: 40 patients undergoing ophthalmic surgery were randomly allocated to two
      study groups. In group 1 (n = 20), anaesthesia was induced with thiopentone 4
      mg/kg and alfentanil 15 micrograms/kg. Maintenance of anaesthesia was achieved
      with isoflurane 0.5-0.8 Vol.% and 70% nitrous oxide in oxygen. Patients in group
      2 (n = 20) received propofol 1.5 mg/kg, which was followed by a continuous
      infusion of 6 mg/kg/h. In addition, alfentanil 15 micrograms/kg was administered,
      followed by a continuous infusion of 15 micrograms/kg/h. In both groups,
      endotracheal intubation was facilitated by succinylcholine 1 mg/kg, and further
      muscle relaxation was achieved with vecuronium 0.07 mg/kg. Measurements of IOP
      using an applanation tonometer were taken in each patient at 10 different time
      points. RESULTS: In both groups, there was a significant decrease in IOP after
      induction of anaesthesia. No significant differences in IOP occurred between
      groups, with patients in group 2 showing a trend towards lower IOP values.
      CONCLUSION: We conclude from our results that both anaesthetic techniques can be
      administered if increases in IOP have to be avoided.

PMID- 7772664
TI  - [Incidents, events and complications in the perioperative period in normal and
      malnurished patients--results of 23,056 patients].
AB  - AIM: Prevalence of cardiovascular risk factors in anaesthetic patients and
      perioperative pitfalls, events and complications (PECs) in different nutritional
      states were examined. The results should contribute to a current project of the
      German Society of Anaesthesiology and Intensive Care, established for quality
      assurance. METHOD: Preoperative data (age, sex, defined preexisting diseases,
      nutritional state, grade of urgency and ASA-class) were integrated in an
      automatically readable paper record, as well as the perioperative interventions
      and events, type of anaesthesia, and kind of operation. The records were
      routinely in use for every patient. After control and correction the data were
      stored in a modern data base. Data of patients under 16 years of age and
      incomplete sets of data were excluded from analysis. MAIN RESULTS: From July 1,
      1992 to December 31, 1993 23,056 anaesthesias were recorded, 5,852 (25.4%) of
      them with a total of 8,107 PECs. 17,255 patients had normal body weight and 23%
      of them PECs. 4,484 obese (but not extremely) patients had a PEC rate of 31.2%,
      330 extremely obese patients had a PEC rate of 38.2%, 966 patients with
      underweight (but not extremely) had a PEC rate of 36.1% and 21 with extreme
      underweight had a PEC rate of 38.1%. Obese patients had a higher prevalence of
      preexisting cardiovascular disturbances (angina pectoris, myocardial infarction
      and hypertension) and tended to a higher incidence of perioperative hypertensive,
      bronchospastic and hypoxic events as well as more difficulties in application of
      regional anaesthesia. Young adult patients (16-39 years) had a PEC rate of 14% in
      case of normal nutritional state but of 20% in case of obesity. The incidence of
      respiratory PECs and of PECs of higher severity was almost double in obese young
      patients compared to normal weight patients of the same age. When preoperative
      cardiovascular disease was known there was little difference between the
      different states of nutrition in respect of perioperative PECs. CONCLUSIONS:
      Nutritional disorder is an important epidemiological factor in anaesthesia.
      Particularly in younger patients without defined preoperative cardiovascular
      disturbance but with obesity the anaesthesist may be surprised by a remarkable
      incidence of relevant problems during and immediately after anaesthesia. We
      should consider the possible phenomenon that we are underestimating the
      anaesthetic challenge in young obese patients in a "healthy" cardiovascular
      state.

PMID- 7772665
TI  - In vivo degradation and biocompatibility study of in vitro pre-degraded as
      polymerized polyactide particles.
AB  - The degradation of high molecular weight as-polymerized poly(L-lactide) (PLLA) is
      very slow; it takes more than 5.6 yr for total resorption. Moreover, the
      degradation products of as-polymerized PLLA bone plates, consisting of numerous
      stable particles of high crystallinity, are related with a subcutaneous swelling
      in patients 3 yr postoperatively. In order to avoid these complications, polymers
      were developed that are anticipated to have comparable mechanical properties but
      a higher degradation rate and do not degrade into highly stable particles that
      can induce a subcutaneous swelling. On chemical grounds it can be expected that
      copolymerization of PLLA with 4% D-lactide (PLA96) or by modifying PLLA through
      cross-linking (CL-PLLA) will lead to less stable particles and a higher
      degradation rate. To evaluate the long-term suitability of these as-polymerized
      polymers, the biocompatibility of the degradation products should be studied.
      Considering the very slow degradation rate of as-polymerized PLLA, in vitro pre
      degradation at elevated temperatures was used to shorten the in vivo follow-up
      periods. In this study, the biocompatibility and degradation of as-polymerized
      PLLA, PLA96 and CL-PLLA were investigated by implanting pre-degraded particulate
      materials subcutaneously in rats. Animals were killed after a postoperative
      period varying from 3 to 80 wk. Light and electron microscopical analysis and
      quantitative measurements were performed. The histological response of all three
      pre-degraded materials showed a good similarity with in vivo implanted material.
      Pre-degraded PLLA induced a mild foreign body reaction and showed a slow
      degradation rate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772666
TI  - Subperiosteal behaviour of alginate and cellulose wound dressing materials.
AB  - A histological comparison was undertaken of the tissue response to a new sodium
      calcium alginate material (Kaltostat) and an oxidized regenerated cellulose wound
      dressing (Surgicel) when implanted between bone and periosteum in the jaws at
      intervals of up to 24 wk. Both biomaterials caused a foreign body reaction,
      persisting up to 12 wk after surgery. New bone formation occurred along the
      surface of the mandible in some specimens, but was not apparently related to the
      implants. It was concluded that the implantation of Kaltostat or Surgicel between
      bone and periosteum in the jaws caused a delay in wound healing, and had no
      effect on bone induction.

PMID- 7772667
TI  - Calcification and fatigue failure in a polyurethane heart value.
AB  - The prosthetic heart valves were fabricated from a polyurethane containing a 4,4'
      diphenylmethane diisocyanate hard segment, chain-extended with butanediol and
      with a polyether soft segment. The rate of calcification of these polyurethane
      heart valves was much slower in a dynamic in vitro test system than similar
      bioprosthetic heart valves. The calcified deposits were located exclusively at
      regions of material failure. Fourier transform infrared (FTIR) spectroscopy
      indicated the involvement of the polyether soft segments of the polymer directly
      in the calcification process. Calcification of polymer fractions also suggested
      that small molecular weight extractable components are accelerating factors in
      the calcification process.

PMID- 7772668
TI  - Attachment and proliferation of osteoblasts and fibroblasts on biomaterials for
      orthopaedic use.
AB  - Using a variety of cell types, cell attachment and growth was studied on
      prospective (polyethersulphone (PES) and polyetheretherketone) and currently used
      (titanium 318 alloy, cobalt chrome molybdenum alloy and ultra-high molecular
      weight polyethylene (UHMWPE)) orthopaedic biomaterials. Proliferation of
      fibroblasts and osteoblasts was measured using incorporation of tritiated
      thymidine into total DNA. Attachment of cells was assessed by indirect
      immunofluorescent labelling of vinculin, a component of the cell's focal adhesion
      plaque. The degree of cell attachment was quantified on the materials by
      determining the mean number of adhesion plaques and using an image analysis
      system to determine the mean total area of plaques per cell. Fibroblasts and
      osteoblasts responded differently to the materials tested. When grown on PES
      surfaces, rat tail fibroblasts synthesized significantly greater amounts of DNA
      than cells on all other surfaces, whilst fibroblasts on UHMWPE synthesized
      significantly less DNA than cells on all other materials. Interestingly, there
      was no significant difference between the amounts of DNA synthesized by
      osteoblasts grown on the various materials. Determination of the number of
      vinculin adhesion plaques per cell and the mean total area of the plaques per
      cell showed that the attachment of fibroblasts to UHMWPE was significantly
      reduced compared with other materials. In contrast there was no significant
      difference in the adhesion of osteoblasts to different materials. Scanning
      electron microscope (SEM) observations of cells on the materials correlated with
      the morphometric data. Cells with the greatest number and area of adhesion
      plaques were well spread and flattened whilst those with the least number of
      adhesion plaques were more rounded and less spread.

PMID- 7772669
TI  - Mechanism of cell detachment from temperature-modulated, hydrophilic-hydrophobic
      polymer surfaces.
AB  - Poly(N-isopropylacrylamide) (PIPAAm), exhibiting a lower critical solution
      temperature (LCST) at 25 degrees C in physiological phosphate buffered saline
      solution (pH 7.4) and at 32 degrees C in pure water, was grafted onto the
      surfaces of commercial polystyrene cell culture dishes. This PIPAAm-grafted
      surface exhibited hydrophobic surface properties at temperatures over the LCST
      and hydrophilic surface properties below the LCST. Endothelial cells and
      hepatocytes attached and proliferated on PIPAAm-grafted surfaces at 37 degrees C,
      above the LCST. The cultured cells were readily detached from these surfaces by
      lowering the incubation temperature without the usual damage associated with
      trypsinization. In this case, the optimum temperature for cell detachment was 10
      degrees C for hepatocytes and 20 degrees C for endothelial cells. Cell detachment
      was partially inhibited by sodium azide treatment, suggesting that cell
      metabolism directly affects cell detachment. Morphological changes of the
      adherent cells during cell detachment experiments indicated further involvement
      of active cellular metabolic processes. Cells detached from hydrophobic
      hydrophilic PIPAAm surfaces not only via reduced cell-surface interactions caused
      by the spontaneous hydration of grafted PIPAAm chains, but also by active cell
      morphological changes which were a function of cell metabolism.

PMID- 7772671
TI  - Development of a drug delivery system for the treatment of periodontal disease
      based on bioerodible poly(ortho esters).
AB  - Poly(ortho esters) prepared by the condensation of 1,2,6-hexanetriol and an alkyl
      orthoacetate are viscous, semisolid materials at room temperature that can be
      injected using a blunt needle. When tetracycline was incorporated into these
      materials, complete release occurred within about 24 hours, but when small
      amounts of Mg(OH)2 were incorporated into the polymer release could be extended
      to many weeks, and a loading of 0.5 wt% resulted in sustained release of about 10
      days. When adhesion was tested using bovine teeth, cohesive failure of the pure
      polymer occurred at a force of about 392 mN cm-2 and cohesive failure of a
      polymer incorporating 10 wt% tetracycline and 1 wt% (Mg(OH)2 occurred at about
      118 mN cm-2. The combination of injectability, dentoadhesiveness and ability to
      control accurately the release of incorporated antibiotics makes these materials
      promising candidates for bioerodible delivery systems useful in the treatment of
      periodontitis. Toxicological studies are currently in progress.

PMID- 7772670
TI  - Hydrolytic degradation of devices based on poly(DL-lactic acid) size-dependence.
AB  - The hydrolytic degradation of aliphatic polyesters derived from lactic and
      glycolic acids (PLA/GA polymers) has been previously shown to proceed
      heterogeneously in the case of large size devices, the rate of degradation being
      greater inside than at the surface. A qualitative model based on diffusion
      reaction phenomena was proposed which accounts for the formation of the more
      stable outer layer. However, this model also suggested that devices with
      dimensions smaller than the thickness of the outer layer should degrade less
      rapidly than larger ones. In an attempt to check this hypothesis, 15 x 10 x 2 mm
      compression moulded plates, millimetric beads and submillimetric microspheres and
      cast films, derived from the same batch of poly (DL-lactic acid) polymer were
      allowed to age comparatively in isoosmolar 0.13 M phosphate buffer, pH 7.4, at 37
      degrees C. Ageing of the various devices was monitored by measuring water
      absorption, weight loss, L-lactic acid formation, pH and molar mass changes. As
      expected, large size plates and millimetric beads degraded heterogeneously and
      much faster than homogeneously degraded submillimetric films and particles.

PMID- 7772672
TI  - In vivo and in vitro elimination of aliphatic polyanhydrides.
AB  - The hydrolysis and elimination processes of biopolyanhydrides has been studied
      using a polymer series of linear aliphatic diacids. This polymer series degrade
      into their monomer counterparts at about the same rate but differ in the water
      solubility of their degradation products. Polymers based on natural diacids of
      the general structure -[OOC-(CH2)x-CO]n- where x is between 4 and 12 were
      implanted subcutaneously in rats and the elimination of the polymers from the
      implantation site was observed. The in vitro hydrolysis of this polymer series
      was studied by monitoring the weight loss, release of monomer degradation
      products and the content of anhydride bonds in the polymer as a function of time.
      A dependence was found between the monomer solubility and the rate of polymer
      elimination in both in vivo and in vitro. The elimination time for polymers based
      on soluble monomers (x = 4-8) was 7-14 days, while the polymers based on low
      monomer solubility (x = 10-12) were eliminated only after 8 weeks. The in vitro
      degradation of polyanhydrides in the presence of several common hydrolytic
      enzymes found around implants did not affect polymer degradation. All polymers
      were biocompatible and found to be useful as carriers for drug delivery.

PMID- 7772673
TI  - Microcapsules through polymer complexation. Part 3: Encapsulation and culture of
      human Burkitt lymphoma cells in vitro.
AB  - Methacrylic acid (MAA) based polyelectrolytes were complexed with protonated or
      quaternized dimethylaminoethyl methacrylate (DMAEMA) containing polyelectrolytes
      to form microcapsules in vitro. Anchorage independent human Burkitt lymphoma
      (Raji) cells were successfully cultured in the presence of dissolved MAA
      containing polymer. Capsule morphology was investigated by light microscopy and
      by scanning electron microscopy (SEM). Capsules based on quaternized DMAEMA
      containing polymer were found to be more stable than capsules containing
      protonated DMAEMA functionality. Raji cells were successfully encapsulated in
      both systems and divided to confluence; thereafter sufficient pressure was
      exerted to burst open the capsules. Cells released from these capsules appeared
      to suffer no discernible trauma and were successfully isolated and subcultured to
      confluence.

PMID- 7772674
TI  - Cytotoxicity and mutagenicity of Kevlar: an in vitro evaluation.
AB  - Toxicity and mutagenicity of Kevlar 49 (PPPT; poly-para-phenylene
      terephthalamide) was tested in six strains of Salmonella typhimurium (Ames test;
      TA97, TA98, TA100, TA102, TA1535, TA1537) with and without an external metabolic
      activation system (S9), as well as in a mammalian cell mutagenesis assay using
      V79 Chinese hamster cells. For the Ames test, liquid preincubation, which is
      considered particularly sensitive, was used. The cells were incubated for 24 h at
      a temperature of 37 degrees C either directly with Kevlar49 or with ethanol- or
      chloroform-extracted Kevlar49. The experiments were performed at least twice. The
      Ames test with six different Salmonella typhimurium strains featuring either base
      pair substitution or frameshift mutations revealed no cytotoxic or mutagenic
      activity of Kevlar49. In the mammalian cell mutagenesis assay, using 8-azaguanine
      (AG) as a selective agent, Kevlar49 was also devoid of cytotoxic or mutagenic
      activity. Both tests have to be regarded as an initial exploratory screening due
      to the chosen testing conditions and should be supplemented by tests at different
      temperatures.

PMID- 7772675
TI  - Enzymatic assay of hydroxybutyric acid monomer formation in poly(beta
      hydroxybutyrate) degradation studies.
AB  - A novel method for monitoring the degradation of poly(beta-hydroxybutyrate) based
      on the enzymatic assay of beta-hydroxybutyrate (HBA) monomers has been developed.
      The method is particularly applicable to forms of the polymer, such as fibre and
      microcapsules, for which conventional surface and gravimetric monitoring
      techniques are not readily applicable. The method involves the use of enzyme HBA
      dehydrogenase in a reaction that converts nicotinamide adenine dinucleotide (NAD)
      to its reduced form (NADH). The conversion is associated with an increase in
      light absorption at 340 nm which thus serves to indicate the concentration of HBA
      monomer in the sample. The application of the methodology to the degradation of
      poly(beta-hydroxybutyrate) gel spun fibres has been used to demonstrate its
      potential use as a quantitative monitoring technique in the study of the
      hydrolysis of this polymer.

PMID- 7772676
TI  - Nitric oxide in cardiovascular disorders.
AB  - Nitric oxide derived from the vascular endothelium and other cells of the
      cardiovascular system has important roles in physiological regulation of blood
      flow and may have pathophysiological functions in cardiovascular disease. Nitric
      oxide can be synthesised from L-arginine by any of three isoforms of nitric oxide
      synthase (NOS), and its interaction with prostacyclin, its proposed mechanisms of
      action and cytotoxicity are briefly reviewed in the context of cardiovascular
      function. Although nitric oxide can hyperpolarize vascular smooth muscle,
      activation of the endothelium can induce hyperpolarization and vasodilatation by
      other means. Nitric oxide has important roles in the physiological regulation of
      local blood flow and blood pressure, especially during exercise and in response
      to shear stresses and other local factors in arterioles. Nitric oxide is also
      involved in neurogenic control of the microcirculation through autonomic efferent
      nerves and it contributes to vasodilatation and inflammation associated with
      activation of sensory nerves. In pathological circumstances, excess nitric oxide
      produced by inducible NOS compromises circulatory function in septic shock,
      during transplant rejection, and during myocardial ischaemia and reperfusion
      injury. Immunosuppressant drugs like cyclosporin A inhibit the expression of NOS
      through complex intracellular intermediates. Disturbances in the activity of
      constitutive and inducible NOS in the artery wall accompany the development of
      atherosclerosis, vasospasm and thrombosis, and may contribute to some forms of
      hypertension and diabetic vascular disease. Reversing the nitric oxide defect
      with therapeutic agents including angiotensin-converting enzyme inhibitors offers
      promise in protecting against some manifestations of vascular disease.

PMID- 7772677
TI  - Distribution of biglycan and its propeptide form in rat and bovine aortic tissue.
AB  - The matrix proteoglycan biglycan was identified in bovine and rat aortic tissue
      by Western blot analysis and by immunohistochemistry, using polyclonal antibodies
      raised against peptides of the propeptide and the hypervariable region of the rat
      biglycan core protein. Western blot analysis of proteoglycans isolated from
      bovine and rat aortas by ion exchange chromatography and treated with chondroitin
      ABC lyase, with antibody against propeptide, demonstrated core proteins with
      molecular weights ranging from 43,000 to 45,000 daltons. Similar results were
      obtained with Western blot studies using the peptide antibody to the
      hypervariable region of biglycan, except the antibody did not recognize the core
      protein of bovine biglycan. Location of biglycan within bovine and rat aortic
      tissue sections by immunoperoxidase histochemistry using the antibody raised
      against the propeptide revealed intense intracellular staining of medial myocytes
      and endothelial cells but no extracellular staining. In contrast,
      immunohistochemistry performed with the purified antibody to the hypervariable
      region revealed significant extracellular staining of the adventitia proximate to
      the media and of the endothelial lining but no intracellular staining of rat
      aortic tissue, with no observable staining of bovine aortic tissue. These data
      demonstrate that, in contrast to cultured smooth muscle cells, biglycan
      containing the propeptide is not secreted and deposited within the extracellular
      matrix by smooth muscle cells and endothelial cells from aortic tissue.

PMID- 7772678
TI  - Angiotensin-converting enzyme inhibition reduces diabetes-induced vascular
      hypertrophy: morphometric studies.
AB  - Angiotensin-converting enzyme (ACE) activity and vascular mass are both increased
      in the mesenteric arteries of diabetic rats. As vascular hypertrophy may result
      from smooth muscle growth following increased formation of angiotensin II, we
      have examined the histological nature of the increase in mesenteric arterial mass
      and the role of elevated ACE activity in diabetic vascular hypertrophy by
      administration of an ACE inhibitor (perindopril). Cross-sectional area of the
      media was measured in perfusion-fixed mesenteric vessels of diabetic rats 3 weeks
      after streptozotocin injection. The media was significantly larger (63%) in
      mesenteric vessels of diabetic rats compared to age-matched control animals.
      Medial hypertrophy in these vessels was not associated with increased blood
      pressure or plasma renin activity but there was evidence for increased
      hemodynamic load due to hyperphagia and intestinal enlargement. Increased
      mesenteric ACE activity was involved in this process as there was significant
      inhibition of medial hypertrophy by perindopril. Other markers of cardiovascular
      hypertrophy such as left ventricular weight and aortic medial area were less
      affected, but increased in the diabetic group when corrected for significant body
      weight effects, consistent with a systemic influence of diabetes on
      cardiovascular mass. These data provide new insights into the mechanisms of
      vascular complications of diabetes and may have implications for the use of ACE
      inhibitors in preventing or arresting diabetes-associated vascular pathology.

PMID- 7772679
TI  - Impaired endothelial relaxations induced by agonists and flow in spontaneously
      hypertensive rat compared to Wistar-Kyoto rat perfused coronary arteries.
AB  - The study was designed to compare the effects of agonists and flow on endothelial
      reactivity in perfused coronary arteries of spontaneously hypertensive rats
      (SHRs) and Wistar-Kyoto (WKY) rats. To this end, coronary arteries were
      cannulated at both ends using an arteriograph system. In the absence of flow and
      under an intraluminal pressure of 30 mm Hg, SHR arteries had larger internal
      diameters compared to those of WKY rats (275 +/- 10 vs. 239 +/- 7 microns, p <
      0.01). In preparations preconstricted with serotonin HT, concentration-effect
      curves were constructed by adding acetylcholine or bradykinin in the bath. On the
      other hand, the effect of a stepwise increase in intraluminal flow (50-450
      microliters/min) of physiological salt solution was observed. Agonist-induced
      dilations were significantly smaller in arteries of SHRs compared to those of WKY
      rats. Starting flow at the plateau of constriction led to dilations that were
      also weaker in SHR compared to WKY vessels: 27 +/- 6 vs. 61 +/- 3, p < 0.001,
      when expressed as percentage of maximal initial constrictions. The maximal
      dilation induced by flow in SHR arteries was obtained for a greater value of
      shear stress compared to that determined in WKY preparations: 81 +/- 6 vs. 60 +/-
      4 dyn/cm2, p < 0.01. After endothelium destruction, flow-induced dilation was
      totally abolished in SHR arteries but only reduced in those of WKY rats.
      Subsequent additions of sodium nitroprusside induced complete dilations in
      vessels from both strains. The same protocol was performed in arteries submitted
      to a perfusion pressure of 90 mm Hg. In these conditions, impairments of agonist-
      and flow-induced dilations were also evidenced in SHR arteries. These results
      show that both the endothelium-dependent dilation induced by acetylcholine or
      bradykinin and the flow-induced dilation are impaired in coronary arteries of
      SHRs compared to WKY rats. These alterations appear to be due to a deterioration
      of endothelial cell function in the presence of a normal reactivity of the smooth
      muscle cells.

PMID- 7772680
TI  - Localization of dopamine receptors in the rabbit lung vasculature.
AB  - The localization of dopamine receptor subtypes in the rabbit pulmonary
      circulation was investigated by using combined radioligand binding and light
      microscope autoradiography techniques. Dopamine D1-like receptors, probably
      belonging to the dopamine D1 receptor subtype, were demonstrated in sections of
      rabbit lung using [3H]-SCH 23390 as a ligand. This site is located within the
      tunica intima and the tunica media of large intrapulmonary artery branches
      (diameter > 300 microns) as well as within the tunica media of medium-sized
      pulmonary artery branches (diameter between 100 and 300 microns). No [3H]-SCH
      23390 binding sites were found in small-sized pulmonary artery branches (diameter
      < 100 microns) or in pulmonary veins. Dopamine D2-like receptors, probably
      belonging to the dopamine D2 receptor subtype, were demonstrated with radioligand
      binding techniques in sections of extrapulmonary arteries but not of lung using
      [3H]-spiroperidol as a ligand. Light microscope autoradiography revealed the
      localization of this site within the tunica adventitia of extrapulmonary arteries
      as well as of large- and medium-sized intrapulmonary artery branches. The
      different anatomical localization of dopamine D1- and D2-like receptors in the
      rabbit pulmonary vasculature suggests that these sites are involved in the
      modulation of pulmonary vascular tone by interacting with different receptors
      having endothelial, muscular and probably prejunctional localization. The
      functional significance of the uneven distribution of dopamine receptor subtypes
      throughout the pulmonary vascular bed should be clarified in future studies.

PMID- 7772681
TI  - [Sjogren's syndrome: current concept].

PMID- 7772682
TI  - [Correlation between clinical and autopsy diagnoses at a general hospital].
AB  - In the past years, the number of hospital clinical autopsies have significantly
      decreased, with the risk of loosing some of the functions of this procedure,
      among which the evaluation of the diagnostic accuracy, which has been considered
      as a health care quality index, stands out. In this paper, the consistency
      between clinical diagnosis and autopsies in a general hospital is studied, as
      well as its association to some potentially relevant factors. We review 91
      autopsies performed in patients dying in the Service of Internal Medicine during
      a period of six years. Each case was classified though consensus among a
      clinician and a pathologist into: mayor clinicopathological discrepancy, minor
      discrepancy or complete consistency. The relationship between consistency and
      age, sex, average length of stay in the hospital and study period was analyzed.
      The 91 autopsies were performed on 64 men and 27 women. The mean age was 63 years
      and the average length of study in the hospital was 9.7 days. The global
      consistency was 71.4%. In 15 (16.5%) cases, a major discrepancy was observed and
      in 11 (12.1%), a minor discrepancy. No differences were observed in the degree of
      consistency with respect to age, sex, average length of stay and study period.
      Cardiovascular diseases showed the greatest proportion of major discrepancies at
      the expense of three cases of pulmonary thromboembolism. We conclude that the
      degree of concordance in this study is consistent with other studies and we
      discuss the relevance of clinical autopsies regarding several aspects of health
      care.

PMID- 7772683
TI  - [Carcinomatous lymphangitis. Clinical study of 10 cases].
AB  - We analyze the clinical characteristics, the diagnostic criteria and the
      radiological aspects of 10 cases of Carcinomatous Lymphangitis. The quickly
      progressing exercise dyspnea and the constitutional syndrome were the most
      frequent symptoms. In nine patients, the tumor was previously unknown. The image
      methods (adbominal CAT and Echography) and the fibrobronchoscopic exam allowed a
      correct diagnosis. The most frequent neoplasia had a pulmonary origin and the
      most frequent histology was adenocarcinoma. The histological tests (bronchial and
      transbronchial biopsies) were more effective for the diagnosis than the
      cytological test (bronchoalveolar lavage, bronchoaspiration and bronchial
      brushing), although these were complemented. The radiology showed a reticulo
      linear pattern in all the cases. The finding of macroscopic disorders in the
      fibrobronchoscopy, the presence of a local infiltration or a node/mass image in
      the thoracic radiography were highly suggestive of primary pulmonary neoplasia.

PMID- 7772684
TI  - [Hospital mortality at the internal medicine service of a local hospital].
AB  - We conducted a retrospective study of the hospital mortality in a service of
      Internal Medicine at the Hospital de Barbastro during the years 1991 and 1992,
      recording 97 deaths during 1991 and 87 during 1992, with a mortality rate of 6.7%
      and 6.6% respectively. The mean age was 77.2% +/- 9 years with a 93% > or = 65
      years. The average length of stay of the dead patients was 8.9 days.
      Cardiovascular diseases were the most frequent cause of death (41.85%), followed
      by respiratory diseases (17.93%) and neoplasias (15.76%). CVA was the single most
      frequent disease (17.9%). Ten autopsies (5.4%) were performed. In 16 cases
      (8.6%), we obtained data suggesting iatrogenesis, which in 7 cases (3.8%) clearly
      contributed to the direct cause of death.

PMID- 7772685
TI  - [Hemangioma, the most frequent hepatic tumor. Diagnosis with dynamic CAT].
AB  - The sensitivity, specificity and predictive values of dynamic CAT with contrast
      piston-stroke performed at a single cut are described for the diagnosis of
      hepatic hemangiomas. We analyzed the correlation between the findings obtained
      through dynamic CAT and those obtained through echography, PAAF, analytic and
      clinical study of the patients with suspicion of hepatic hemangioma. The
      following values were obtained: sensitivity 92.3%; specificity 50%; VPP 88.8%;
      VPN 60%; and global diagnostic affectivity 84.37%. According to these results, we
      think that dynamic CAT is a highly reliable test for the diagnosis of hepatic
      hemangiomas.

PMID- 7772686
TI  - [Digestive hemorrhage caused by duodenal ectopic pancreas and diffuse
      angiodysplasia of the colon].
AB  - We present the case of a 79-years-old male with episodes of digestive bleeding in
      the form of melenas in which two pathological findings were observed as potential
      causes: ectopic pancreas in subpyloric position and diffuse colon angiodysplasia.
      The difficult management of the digestive bleeding when two lesions are
      associated as potential causes is stressed.

PMID- 7772687
TI  - [Acute poisoning caused by hydrogen sulphide: clinical features of 3 cases].
AB  - We describe three cases of acute intoxication by hydrogen sulphide which were
      produced after remaining between 50 and 60 minutes inside a cellulose tank. The
      three patients had loss of conscience. One of the patients developed a persistent
      vegetative state; another patient recovered although with neurological post
      anoxic sequelas and the third case completely recovered one week after his
      hospitalization. The patients underwent symptomatic treatment and the
      environmental concentrations of hydrogen sulphide were measured at the site of
      the accident. Finally, the application of preventive measures is stressed.

PMID- 7772688
TI  - [S. pneumoniae sternoclavicular arthritis in a patient with HIV infection].
AB  - HIV infection is a predisposing factor for pneumococcic infection. While
      pneumonia is the most frequent location, other locations (articular, meningeal,
      endocardiac, etc) have been less frequently described. Among the articular
      infections described in patients with HIV infection, the sternoclavicular
      affection is extremely rare and it usually develops in association with
      parenterally drug addiction, being Staphylococcus aureus and Pseudomonas
      aeruginosa the most frequently germs involved. We describe the first case of
      sternoclavicular arthritis by Streptococcus pneumoniae in a patient with HIV
      infection. In our case, the chronic hepatopathy associated to alcohol consumption
      is a predisposing factor related to the pneumococcic infection. Our case suggests
      the need to formally investigate the HIV infection in young patients with
      invasive pneumococcic infection.

PMID- 7772689
TI  - [Visceral leishmaniasis and AIDS. Report of 2 cases with cutaneous
      dissemination].
AB  - The cutaneous affection in visceral leishmaniasis (VL) or Kala-azar, is well
      known although poorly documented. The coinfection by the human immunodeficiency
      virus (HIV) has resulted in the development of frequent atypical forms of VL,
      increasing the descriptions of cutaneous affection in its evolution. We present
      two cases of VL-HIV, stressing the location of Leishmania in cutaneous lesions
      and in apparently normal skin. We suggest the cutaneous biopsy as diagnostic
      procedure and criteria for the definition of VL-HIV as indicative of AIDS.

PMID- 7772690
TI  - [Neutrophilic dermatosis in ulcerative colitis occurring in advanced age].
AB  - The Neutrophilic dermatosis (ND) is considered as an independent entity with
      diverse clinical manifestations among which there are: gangrenous pyoderma,
      nodous erythema, Sweets Syndrome, vesiculopustula eruptions associated to
      ulcerous colitis and intestinal short circuit syndrome with or without short
      circuit. Histologically, they are characterized by infiltration of
      polymorphonuclear neutrophils, generally at the dermic level, but also at the
      epidermic. They are usually associated to systemic diseases, especially to
      chronic intestinal inflammatory disease. Our aim was to describe two forms of
      clinical presentation of neutrophilic dermatosis: gangrenous pyoderma and
      vesiculopustula eruption, associated to ulcerous colitis starting at advances
      ages.

PMID- 7772691
TI  - [Infective esophagitis].

PMID- 7772692
TI  - [Occupational asthma].

PMID- 7772693
TI  - [Acute abdomen secondary to intestinal tuberculosis in a patient with HIV
      infection].

PMID- 7772694
TI  - [Subacute infective endocarditis complicated with mitral abscess and severe
      mitral insufficiency].

PMID- 7772695
TI  - [Prolonged febrile syndrome without apparent focus and Coxiella burnetti
      infection].

PMID- 7772696
TI  - [Significant high levels of transaminases in a patient with choledocholithiasis].

PMID- 7772697
TI  - [Appetite increase and weight gain following treatment with megestrol acetate in
      patients with advanced cancer].

PMID- 7772698
TI  - [Brucellar splenic abscess].

PMID- 7772699
TI  - [Round pneumonia mimicking solitary lung nodule].

PMID- 7772700
TI  - Preferential adsorption of cationic anti-DNA antibodies with immobilized
      polyanionic compounds, dextran sulfate.
AB  - It has been shown that cationic anti-DNA antibodies have nephritogenic potential
      in murine models of lupus nephritis. More recently, we have reported that there
      is a close relationship between the presence of circulating cationic anti-DNA
      antibodies and the development of lupus nephritis in humans, and that the
      cationic anti-DNA antibodies bind to heparan sulfate, a major glycosaminoglycan
      in glomerular basement membrane, much better than neutral anti-DNA antibodies.
      This suggests that cationic anti-DNA antibodies of the IgG class may be
      responsible for development of nephritis in vivo in patients with systemic lupus
      erythematosus. In this study, we first studied reactivity of anti-DNA antibodies
      with a panel of glycosaminoglycans in vitro using ELISA methods, and found that
      anti-DNA antibodies cross-react with dextran sulfate, hyaluronic acid and
      chrondroitin sulfate. The reactivity and selectivity of dextran sulfate with anti
      DNA antibodies was confirmed by in vitro immunoadsorption of the patient's sera
      with dextran sulfate-fixed column; incubation of auto-antibody-positive sera with
      dextran sulfate cellulose column removed anti-DNA, but not anti-RNP, anti-Sm,
      anti-SSA and anti-SSB antibodies from the sera in vitro. Of note is that dextran
      sulfate cellulose column absorbed exclusively, if not all, cationic anti-DNA
      antibodies in their sera. Nonspecific binding of total immunoglobulins as well as
      total proteins to the column was marginal. It has been suggested that cationic
      anti-DNA antibodies in sera of patients with refractory lupus nephritis could be
      efficiently removed by apheresis using dextran sulfate column.

PMID- 7772702
TI  - Cryptic antiphospholipid autoantibodies and serum co-inhibitors.

PMID- 7772701
TI  - Radioimmunoassay detects the frequent occurrence of autoantibodies to the Mr
      65,000 isoform of glutamic acid decarboxylase in Japanese insulin-dependent
      diabetes.
AB  - Glutamic acid decarboxylase antibodies (GAD65Ab) are common in new onset
      Caucasian insulin-dependent diabetic (IDDM) patients but it is unclear if this
      marker is also prevalent in patients of other ethnic backgrounds. We determined
      antibodies against human recombinant GAD in Japanese diabetic patients using a
      radioimmunoassay with competition between in vitro translated 35S-GAD65 and non
      labelled recombinant human GAD65 (rhGAD65). GAD67 antibodies (GAD67Ab) were
      similarly analyzed but without antigen competition. In 73 Japanese diabetic
      patients, GAD65Ab were found in 11/16 (69%) of patients with short-duration (less
      than 5 yrs) IDDM, 6/23 (26%) with long-duration (5 or more yrs) IDDM and 10/20
      (50%) with slowly progressive diabetes. High GAD65Ab levels were associated with
      concomitant autoimmune diseases (p = 0.021). GAD67Ab were found in 4/16 (25%) of
      patients with short-duration IDDM, 3/23 (13%) with long-duration IDDM and 2/20
      (10%) with slowly progressive diabetes. In 14 non-insulin dependent diabetic
      (NIDDM) patients, GAD65Ab and GAD67Ab were not found (0/14) and 1/50 (2%) healthy
      controls were positive in either assay. Among the GAD67Ab-positive samples, 8/9
      (88%) were also high level GAD65Ab positive, 7/9 (77%) were displaced by an
      excess of rhGAD65 and the antibody levels correlated (r2 = 0.573; p = 0.003). Our
      data are consistent with a strong association of GAD65Ab also in Japanese IDDM,
      and suggest that, when present, GAD67Ab are frequently directed to epitope(s)
      common to GAD65 and GAD67.

PMID- 7772703
TI  - Whither the anergic B-cell?
AB  - The kinetics of potentially autoreactive B-cells were investigated in a double
      transgenic model of self-tolerance. Two types of transgenic mice were created for
      this purpose. In the first the great majority of B-cells expressed the rearranged
      heavy and light chain genes encoding a high affinity receptor for hen egg
      lysozyme (HEL), while the second type expressed HEL in either soluble (sHEL) or
      membrane-bound (mHEL) form. Double-transgenic (Dbl-Tg) mice were produced either
      by mating the two types of founders or by transferring bone marrow cells from Ig
      transgenic (Ig-Tg) donors into irradiated HEL-Tg recipients. The lifespan of B
      cells from the Dbl-Tg mice was measured by oral loading with the thymidine
      analogue, 5-bromo-2'-deoxyuridine (BrdU) for periods varying from three days to
      six weeks. Experiments in various combinations of Dbl-Tg mice revealed a three
      tiered hierarchy of B-cell unresponsiveness, each level of which was
      characterised by a different B-cell lifespan. Exposure to mHEL led to rapid
      deletion of B-cells at an immature stage in their development with a median
      lifespan of approximately 15 hours. B-cells exposed to sHEL above a critical
      tolerogenic threshold were not deleted in the bone marrow but migrated to the
      spleen in an anergic state where they died within three days. If the receptor
      occupancy of sHEL was below the tolerogenic threshold, B-cells were neither
      deleted nor rendered anergic (ie were "indifferent") and had a normal median
      lifespan of four to five weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772704
TI  - Nerve growth factor and autoimmune diseases.
AB  - The initiation of a humoral immune response to a foreign antigen is a complex
      biologic process involving the interaction of many cell types and their secreted
      products. Autoimmune diseases, which are characterized by an abnormal activation
      of the immune system, probably result from the failure of normal self-tolerance
      mechanisms. The etiology of such illnesses, however, is far from being
      understood. While there have been extensive studies on the participation of the
      immune and endocrine systems in autoimmune diseases, few have dealt with nervous
      system-mediated immunoregulation in such situations. Evidence continues to grow
      suggesting that nerve growth factor (NGF), first identified for its activity in
      promoting the growth and differentiation of sensory and sympathetic neurons, may
      exert a modulatory role on neuroimmunoendocrine functions of vital importance in
      the regulation of homeostatic processes. Newly detected NGF-responsive cells
      belong to the hemopoietic-immune system and to populations in the brain involved
      in neuroendocrine functions. NGF levels are elevated in a number of autoimmune
      states, along with increased accumulation of mast cells. NGF and mast cells both
      appear to be involved in neuroimmune interactions and tissue inflammation.
      Moreover, mast cells themselves synthesize, store, and release NGF, proposing
      that alterations in normal mast cell behaviors may provoke maladaptive
      neuroimmune tissue responses whose consequences could have profound implications
      in inflammatory disease states, including those of an autoimmune nature. This
      review focuses on these cellular events and presents a working model which
      attempts to explain the close interrelationships of the neuroendocrinoimmune
      triade via a modulatory action of NGF.

PMID- 7772705
TI  - Autoantibodies against GAD65 rather than GAD67 precede the onset of type 1
      diabetes.
AB  - The enzyme glutamate decarboxylase (GAD) is considered one of the major Beta cell
      antigens in Type 1 diabetes mellitus. The GAD autoantibody (GAD-AAb) prevalence
      in newly diagnosed Type 1 diabetic patients has been described up to 80%,
      depending on the detection method used. The aim of this study was to evaluate a
      simple, specific, and sensitive radioimmunoassay (RIA) method for detection of
      AAb against both isoforms of the enzyme, GAD65 and GAD67, in a cross-sectional
      study using sera from newly diagnosed Type 1 diabetic patients and in a
      longitudinal study using sera from prediabetic patients and individuals at risk
      of developing the disease. The 125I-labelled full-length human recombinant
      proteins of GAD65 and GAD67 expressed in SF9 cells were used as the antigen
      source. The prevalence of GAD65-AAb in newly diagnosed Type 1 diabetic patients
      was found to be 73% (112/153), in contrast to 19% (14/72) of GAD67-AAb. Only one
      patient produced AAb restricted to GAD67. Furthermore, GAD65-AAb could also be
      detected in 73% (11/15) of prediabetic patients (up to 122 months before clinical
      manifestation of the disease), whereas only 27% (4/15) of them were positive for
      GAD67-AAb. In the group at risk of developing Type 1 diabetes, these prevalences
      were 77% (10/13) and 46% (6/13), respectively. In all GAD67-AAb-positive patients
      investigated in the longitudinal study, AAb to GAD65 were detectable. In 47% of
      patients positive for both GAD65-AAb and ICA, the GAD65-AAb appeared by up to 46
      months before the occurrence of ICA was detected. The data illustrated that GAD65
      is the main immunogenic isoform of the enzyme in the preclinical and clinical
      stages. The RIA detecting AAb against this isoform may facilitate the screening
      for individuals at risk of developing the disease.

PMID- 7772706
TI  - Enhanced transcription of the gene encoding the SmN autoantigen in patients with
      systemic lupus erythematosus does not result in enhanced levels of the SmN
      protein.
AB  - The SmN, protein is closely related to the constitutively expressed SmB and SmB'
      autoantigens and can also act as a target for human autoimmune sera. In contrast
      to the single gene encoding SmB and SmB' which is expressed in all tissues, the
      distinct gene encoding SmN is expressed at high levels only in brain and heart
      tissue. We show that the SmN gene is transcribed at significantly elevated levels
      in peripheral blood mononuclear cells (PBMCs) from SLE patients compared to
      normal controls. In contrast no significant elevation in transcription of the
      genes encoding SmB/B' or the U1-associated 70kD RNP autoantigen is observed in
      these patients. The elevation in SmN gene transcription in patient PBMCs does not
      result however, in enhanced levels of the SmN protein in the PBMCs of these
      patients. The significance of transcriptional and post-transcriptional processes
      in regulating the expression in SLE patients of SmN and other autoantigens is
      discussed.

PMID- 7772707
TI  - Complement-mediated cytotoxic activity of anti-heart antibodies present in the
      sera of patients with dilated cardiomyopathy.
AB  - A microcytotoxicity assay has been used to determine the cytotoxic activity of
      anti-heart antibodies which we have previously shown to be present with greater
      frequencies and reactivities in patients with dilated cardiomyopathy (DCM) than
      in patients with ischaemic heart disease (IHD). Serum samples from 45 patients
      with DCM and 43 patients with IHD were screened against W1, a transformed human
      fetal cardiac cell line and also against EA.hy 926, an endothelial and IBR3, a
      fibroblast cell line. In the presence of complement, sera from 28 (62%) DCM
      patients showed killing of the W1 cell line as compared to sera from 13 (30%) of
      IHD patients (p < 0.005) and 3 (15%) of normal individuals. In contrast, only 1
      patient with DCM showed killing of the endothelial cell line and 1 patient with
      IHD showed killing of the fibroblast cell line. These results provide evidence
      for a complement-dependent, antibody-mediated mechanism of damage to cardiac
      myocytes which may contribute to the pathogenesis of DCM.

PMID- 7772708
TI  - [The temperature dynamics during the healing processing of a surgical wound].
AB  - Using biomechanical principles, the qualitative occurrences in the wound were
      quantified. On the basis of the empirical knowledge that the wound, from its
      inception to healing, is warmer than its surroundings, we presumed that there was
      a certain regularity in the course of temperature values of the wound during
      primary healing. For measuring the temperature of the wound and its surroundings
      an electric thermometer of the ELLAB type was used. First, the temperature of the
      skin in the epigastric region in 30 healthy examinees, who were due to undergo a
      gall-bladder concrements operation was determined. The temperatures were measured
      within a traced dotted network. After the operation, in the same examinees, the
      temperatures were registered proximal to the wound and in its closer surroundings
      throughout the first eight post-operative days. Statistically evaluated the
      results showed that the temperature of the wound and of its surroundings,
      measured after operation, was higher than prior to operation. The temperature of
      the wound gradually rises up to the third post-operative day, and then gradually
      falls from the fourth post-operative day. This course of temperature is explained
      in part by the biological occurrences in the wound. The inflammatory reaction as
      a consequence of damage to the tissue is responsible for the initial increase of
      wound temperature. It lasts a limited time and has a limited intensity. This
      could be proved by histological preparations of the wound. The persistence of
      increased temperature after the third post-operative day is a sign of disturbed
      healing and predicts infection and secondary healing.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7772709
TI  - [An optimized filter system for eliminating 50 Hz interference from high
      resolution ECG].
AB  - A 50/60 Hz notch filter system was designed to eliminate powerline interferences
      from the high-resolution ECG. This special filter causes only minimal distortions
      of the power spectra and thus permits us to filter high-resolution ECG's without
      any appreciable changes in the frequency distribution of the original signal.
      Since the filter is based on an integer coefficient filter technique, the
      calculation time is relatively short, and the programming effort comparatively
      low. Three different automatically selected transfer functions ensure that an
      optimal filtered signal is obtained despite variations in the value of the
      interference.

PMID- 7772710
TI  - [Effect of the manufacturing process on creep and wear properties of UHMWPE
      (ultra-high molecular weight polyethylene)].
AB  - The creep and wear behaviour of pressed UHMWPE and extruded UHMWPE was compared,
      taking Chirulen and extruded UHMWPE of the Lennite type as examples. Using the
      ring-on-disc test, the wear and deformation volumes per 360,000 cycles were
      determined. The static tests were performed at surface pressures of 5.62 MPa and
      9.37 MPa, while the test duration was 41.86 and 100 hours, respectively. The
      surface pressures result from the axial forces of 900 N and 1500 N, respectively,
      and a ring surface analogous to the DIN 58,835 and ISO 6474 standards. Between
      conventionally pressed and the extruded UHMWPE material differences of up to 350%
      in the sums of wear and deformation were found. It was noted that already at low
      surface pressures the extruded UHMWPE is more susceptible to creep deformation
      than is the conventionally pressed material, and that this effect dramatically
      increases at high surface pressures.

PMID- 7772712
TI  - [Osseointegration of titanium test bodies of different surface properties in
      metaphyseal bone sites of the dog--a biomechanical and histological analysis].
AB  - The alternative to the anchoring of an endoprosthesis by means of cement is the
      biological fixation by an ingrowth of bone into the implant surface
      (osseointegration). We examined the implant fixation properties of titanium
      experimental devices with 3 different surface structures after press-fit
      implantation into the bony bed of 12 dogs. One third of the 48 implants had a
      micro-structured surface roughened by grit-blasting, one third a roughened
      surface with an additional macro-groove structure (combination surface), and the
      remaining third a porous hydroxyapatite (HA) coating. Twelve weeks after
      implantation the bony ingrowth was evaluated biomechanically by measuring the
      force required to pull out the implant from the surrounding bone and
      histologically by morphometric assessment of microradiographs. In the pull-out
      experiment the shearing forces were significantly lower (p < 0.01) in the devices
      with a roughened surface in comparison to the devices with a micro- and macro
      structured surface and the HA surface. Thus, there was no significant difference
      between the forces required to pull out the devices with the porous HA surface
      and those with the combination surface. The histomorphometric assessment of bone
      density in the immediate vicinity of the implant and the extent of the direct
      contact surface of the bone implant resulted in no significant difference in all
      3 groups. We did not find an interposing layer of fibrous tissue at the
      interface. We can demonstrate that roughening of the surface in combination with
      a groove structure creates a better bond between implant and bone than a
      roughening alone.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772713
TI  - 4th International Conference on Human Antibodies and Hybridomas. Amsterdam, The
      Netherlands, 26-28 April 1995. Abstracts.

PMID- 7772711
TI  - [A CAE (computer aided engineering) approach to dynamic whole body modeling--the
      forces iin the lumbar spine in asymmetrical lifting].
AB  - Biomechanical models of the human body play an important role in the analysis of
      the mechanical loading of the musculo-skeletal system. The whole-body model
      presented in this paper is based on a CAE (Computer Aided Engineering) program
      that permits the dynamic simulation of complex systems of rigid bodies. The model
      we developed on this basis consisted of 19 segments and 18 joints. The
      experimental data are derived from the 3D motion analysis system VICON, which is
      provided with 5 cameras, a force-plate and a 10-channel EMG recorder. The
      kinematic data are fed into the simulator after first being processed in a
      special manner to generate drivers for joint angles. The model was first used to
      calculate the compression forces generated within the lumbar spine during the
      asymmetric lifting and putting down of a 15 kg stone. The quasistatic calculation
      shows a dynamic contribution to the compression forces generated during the
      lifting of 11%. Increasing or decreasing the inertial moments of the segments by
      the factor 2 had an effect of less than 1% with the identical movement.

PMID- 7772714
TI  - Effect of insulin on the incorporation of 3H-inositol into the inositol
      phospholipids (PI, PIP, PIP2) and glycosyl-phosphatidylinositols (GPIs) of
      tetrahymena pyriformis.
AB  - The unicellular tetrahymena contains inositol phospholipids (PI, PIP, PIP2) and
      GPIs. Treatment with 10(-5) M insulin decreases the total 3H-inositol
      incorporation and incorporation into PI. 24 h after 10(-6) M insulin treatment
      there is an elevation of these parameters. Second treatment with 10(-6) M insulin
      doubles and 10(-5) M decreases these levels. This means that the effect on
      phosphoinositide turnover by insulin in Tetrahymena is rather concentration
      dependent. Inositol incorporation into GPIs is also influenced by insulin.

PMID- 7772715
TI  - Different secretory actions of pancreastatin in bovine and human parathyroid
      cells.
AB  - Chromogranin A is an acidic protein that is costored and cosecreted with
      parathyroid hormone (PTH) from parathyroid cells. Pancreastatin (PST), is derived
      from chromogranin A, and inhibits secretion from several endocrine/neuroendocrine
      tissues. Effects of different pancreastatin peptides were investigated on
      dispersed cells from bovine and human parathyroid glands. Bovine PST(1-47) and
      bovine PST(32-47) inhibited PTH release from bovine cells in a dose-dependent
      manner. The former peptide was more potent and suppressed the secretion at 1-100
      nM. This inhibition was evident in 0.5 and 1.25 mM, but not in 3.0 mM external
      Ca2+. Both peptides failed to alter the concentration of cytoplasmic Ca2+
      ([Ca2+]i) of bovine cells. Human PST(1-52) and PST(34-52) did not affect PTH
      release or [Ca2+]i of parathyroid cells from patients with hyperparathyroidism,
      nor [Ca2+]i of normal human parathyroid cells. Furthermore, bovine PST(1-47) and
      bovine PST(32-47) failed to alter the secretion of abnormal human parathyroid
      cells. The study indicates that PST exerts secretory inhibition on bovine but not
      human parathyroid cells, and that this action does not involve alterations of
      [Ca2+]i.

PMID- 7772716
TI  - Interaction of hypothalamic Na,K-ATPase inhibitor with isolated human peripheral
      blood mononuclear cells.
AB  - A ligand for the digitalis receptor located on the membrane-embedded Na,K-ATPase
      (NKA; EC 3.6.1.37) has been isolated from bovine hypothalamus (hypothalamic
      inhibitory factor; HIF) and identified as isomeric ouabain (Tymiak et al., 1993,
      Proc. Natl. Acad. Sci. 90: 8189-8193). In analogy to cardioactive steroids (CS)
      derived from plants or from toad, HIF inhibits the Na/K-exchange process and the
      ATPase activity of isolated Na,K-ATPase although by a different molecular action
      mechanism. In the present work we show that, as plant-derived ouabain, HIF
      inhibits 86Rb-uptake by isolated human lymphocytes with an IC50 of about 20 nM;
      above this concentration HIF reduces cell viability in contrast to ouabain. The
      decrease in cell viability by excess HIF is accompanied by discrete morphological
      alterations (mitochondrial swelling) visible by transmission electron microscopy
      of ultra-thin sectioned peripheral blood mononuclear cells. Taken together the
      results show that the hypothalamic NKA inhibitor blocks NKA of isolated human
      lymphocytes with high potency at nanomolar concentrations without toxicity;
      concentrations exceeding the ones required to block 86Rb-uptake reduce cell
      viability, probably due to leak formation across the NKA molecule. Thus,
      lymphocytes constitute a potential target for HIF action and by their altered NKA
      status a possible messenger between the nervous and the immune system.

PMID- 7772717
TI  - Treatment of cultured pancreatic B-cells with streptozotocin induces cell death
      by apoptosis.
AB  - Treatment of cultured pancreatic B-cells (HIT-T15 and RINm5F) with the
      diabetogenic drug streptozotocin resulted in a significant increase in the number
      of cells that became detached from the substrate during a subsequent culture
      period. Examination of the detached cells by fluorescence microscopy after
      staining with acridine orange or by electron microscopy revealed evidence of
      chromatin condensation and margination. Isolation and fractionation of DNA from
      these cells revealed a pattern of oligonucleosomal fragmentation that was not
      evident in untreated cells. All of these features are characteristic of entry of
      the cells into apoptosis and the results suggest that the diabetogenic action of
      streptozotocin involves induction of apoptosis in pancreatic B-cells.

PMID- 7772718
TI  - Peptide T from human immunodeficiency virus does not interact with VIP receptor
      effector system in immunocompetent cells of rat and mouse.
AB  - Human immunodeficiency virus (HIV) infection is initiated by attachment of the
      virus to specific target cells. An octapeptide sequence contained within the
      envelope of HIV, peptide T, mediates the viral binding. Since there is an
      appreciable structural similarity between peptide T and an eight amino acid
      sequence of VIP, it is interesting to investigate the interaction of peptide T
      with the VIP receptor-effector system of immunocompetent cells from both rat and
      mouse. In this paper, we show the lack of interaction between peptide T and VIP
      receptor-effector system in peripheral blood lymphocytes, spleen lymphocytes and
      macrophages of rat and in macrophages of mouse. These results do not support the
      hypothesis that HIV through peptide T may interact with the VIP receptor-effector
      system present in immunocompetent cells.

PMID- 7772719
TI  - Dynamic behavior in glycolytic oscillations with phase shifts.
AB  - Practically all of the studies of glycolytic oscillations in homogeneous spatial
      mediums have been performed through the construction of systems of ordinary
      differential equations and the search for their solutions. In this kind of
      modelling, the system dynamic behavior is considered to depend only on the values
      adopted by the parameters related to the dependent variables. In the present
      work, the modeling of a biochemical system through a system of functional
      differential equations with delay allows us to analyse the consequences that the
      variations in the parametric values linked to the independent variable (time)
      have upon the integral solutions of the system. In our model, the delays
      correspond with phase shifts in the initial functions for two dependent
      variables. The results of our researches show that when a instability-generating
      multienzymatic mechanism suffers variations of the delay time in any of its
      variables, a wide range of different dynamic responses can be produced. Our work
      is presented as an enlargement on the dynamic study of biochemical oscillations
      in general and, particularly, the glycolytic oscillations, under the
      consideration of the existence of variations in the phase shifts during the
      oscillations of metabolites involved in the studied reactive processes.

PMID- 7772720
TI  - Turing structures in a system with regulated gap-junctions.
AB  - In two coupled cells, each containing a bisubstrate-kinetics reaction system, the
      two substrates can cross the membranes through gap-junction protein channels
      (gating). Passing through the gap-junctions is controlled by one of the
      substrates, thus resulting in non-linear diffusion. Linear stability analysis
      gives the conditions, under which the symmetric fixpoint becomes unstable,
      leading to spatial asymmetry (Turing structures). The implications for
      morphogenesis are discussed.

PMID- 7772721
TI  - VIR: a computational tool for analysis of immunoglobulin sequences.
AB  - In this paper a microcomputer software named VIR (Variable domains of the Immune
      Receptors) is reported. This package can be used in sequence studies of
      immunoglobulin variable domains. The main features of the VIR software in the
      sequences management are: (1) ease of information recovery/extraction from amino
      acid sequences; and (2) its capability to obtain multiple sequence alignments
      with predefined characteristics (i.e. specie and/or specificity). As an
      analytical tool, the VIR package employs such multiple sequence alignments to
      compute: (1) tables showing amino acid frequencies; (2) three variability
      indexes; (3) identity matrices; (4) random samples; and (5) sequences with
      possible canonical structures. Thus the software reported here is proposed as a
      useful tool to carry out detailed studies of immunoglobulin variable domains.

PMID- 7772722
TI  - Global logic resulting from disequilibration process.
AB  - Describing a system in which internal detection or observation proceeds at a
      finite velocity is always destined to end up with a form of self-contradiction.
      For any formal language, for such a description, we must assume that the velocity
      of observation propagation or VOP be infinity. In the present paper, we propose a
      self-referential scheme intended for formally describing a system exhibiting the
      process of disequilibration propagating at a finite VOP, and find that a global
      logic can emerge from local disequilibration. Conservative cellular automata of
      Margolus type, for instance, enable disequilibration to be replaced by such a
      process that the number of particles is not conserved globally while appearing to
      be conserved by local observers. One cannot determine local rules universally.
      Nevertheless, global logic emerges as a result of the dynamics of a one-to-many
      type mapping. This is a fundamental aspect of natural languages or communication
      relevant to natural life and intelligence.

PMID- 7772723
TI  - Photosynthetic oscillations and the interdependence of photophosphorylation and
      electron transport as studied by a mathematical model.
AB  - A simple mathematical model of photosynthetic carbon metabolism as driven by ATP
      and NADPH has been formulated to analyse photosynthetic oscillations. Two
      essential assumptions of this model are: (i) reduction of 3-phosphoglycerate to
      triosephosphate in the Clavin cycle is limited by ATP, not by NADPH, and (ii)
      photophosphorylation is affected by the availability of both ADP and NADP, while
      electron transport is limited by NADP only. The model produces oscillations of
      observed damping and period in ATP and NADP concentrations which are about 180
      degrees out of phase, while three alternative proposals regarding coupling of
      electron transport and photophosphorylation do not produce oscillatory model
      solutions. The phases of ATP and NADPH are in reasonable agreement with the
      available experimental data. The model (which assumes that redox control of
      photophosphorylation is part of the oscillatory mechanism) is compared with an
      alternative proposal (that oscillations are due to interdependence of turnover of
      adenylates and Calvin cycle intermediates). From the similarity of the
      mathematical structures of both models it is inviting to speculate that both
      models are partial aspects of 'the oscillatory mechanism'.

PMID- 7772724
TI  - Community treatment of HIV-1: initial stage and asymptotic dynamics.
AB  - Treatment with antiviral drugs (zidovudine and ddI) has been reported to delay
      progression to AIDS, and may even possibly lower the infectiousness of the
      infectives. However, its effect on the community level is still uncertain. The
      latter is important since a successful community treatment program must meet both
      public health and individual health goals. Our study will focus on the effect of
      a community-wide treatment program initiated at the early stages of the disease
      as well as the long-term effect of the program. Using a simple mathematical
      model, we demonstrate that a community-wide treatment program could be
      instrumental in decreasing HIV incidence rate and eradicating the disease in the
      future if certain conditions on the parameters are met. On the other hand, when
      the above mentioned conditions on the parameters are not satisfied, we show that
      even if the treatment does improve survival in AIDS patients and decrease the
      rate at which HIV infection spreads in the community, it is still possible for
      the treatment program to have an adverse effect on the spread of AIDS in the
      population in the long run. Hence, a public health policy maker must exercise
      caution in order to design an effective treatment program for HIV/AIDS.

PMID- 7772725
TI  - A dynamical model of the pulsatile secretion of the hypothalamo-pituitary-thyroid
      axis.
AB  - We propose a dynamical model for the hypothalamo-pituitary-thyroid axis. This
      model takes into account both the interactions of hormones in this axis and the
      binding of thyroid hormones with proteins in plasma and tissues. It can account
      for the pulsatile character of hormone secretion in this axis as well as many
      experimental results.

PMID- 7772726
TI  - Effects of danazol on thrombopoiesis in rats.
AB  - A synthetic analog of ethinyltestosterone, Danazol, has been used clinically for
      the treatment of immune thrombocytopenia. We investigated the effects of Danazol
      on thrombopoiesis in normal rats. Though 4-week treatment by Danazol slightly
      enhanced the DNA synthesizing enzyme activities and the number of S-phase cells
      in bone marrow and spleen, the number of megakaryocytes and thrombocytes were not
      increased in bone marrow and peripheral blood, respectively. These findings
      suggest that Danazol treatment will not induce thrombosis with thrombocytosis in
      normal human beings and animals.

PMID- 7772727
TI  - Prevalence of human T-cell leukemia virus type 1 (HTLV-I) in adult T-cell
      leukemia (ATL) in non-ATL-endemic Hokkaido of Japan.
AB  - Sera and peripheral blood lymphocytes of 40 adult T-cell leukemia (ATL) patients
      in non-ATL-endemic Hokkaido were examined for the prevalence of human T-cell
      leukemia virus type 1 (HTLV-I). All patients had HTLV-I-specific antibodies. When
      the peripheral lymphocytes were assessed after short-term cultivation, HTLV-I
      antigens and virus particles were detected. The seroprevalence in 96 cases of non
      T-cell leukemias and lymphomas and in 30,056 healthy individuals in Hokkaido were
      3.1% and 0.7%, respectively. HTLV-I seropositive inhabitants of Hokkaido can be
      estimated at about 40,000, and one out of every few thousand HTLV-I carriers is
      likely to develop ATL.

PMID- 7772728
TI  - Prevalence of human T-cell leukemia virus type 1 (HTLV-I) in general inhabitants
      in non-adult T-cell leukemia (ATL)-endemic Hokkaido, Japan.
AB  - In contrast to adult T-cell leukemia (ATL)-endemic southwestern Japan, the
      northernmost island Hokkaido has a small number of ATL patients annually. In this
      study, we surveyed 32,587 healthy inhabitants throughout Hokkaido for antibodies
      to human T-cell leukemia virus type 1 (HTLV-I). Only 244 individuals (0.8%) were
      seropositive as HTLV-I carriers; 0.6% (123 of 19,512) in males and 0.9% (121 of
      13,075) in females. In some areas, however, the inhabitants had relatively high
      seropositivity (> 2%). The highest rate was 5.2% with a cluster of ATL patients
      in a certain town of the Hidaka area near the Pacific Ocean, in southeast
      Hokkaido.

PMID- 7772729
TI  - Modulation of cytokine secretion by mesenteric lymph node cells from vitamin A
      deficient mice during Hymenolepis nana infection.
AB  - The influence of vitamin A deficiency on the development of cellular immune
      responses was examined using vitamin A-deficient mice (A mice)/Hymenolepis nana
      system. Mesenteric lymph node cells (MLNC) prepared from both normal BALB/c mice
      and A mice during H. nana infection proliferated extensively when cultured with
      soluble egg antigen of H. nana as assessed by 3H-thymidine incorporation. MLNC
      from normal mice secreted significantly more IL-2 and significantly less IFN
      gamma than A mice when the cells were cultured in the presence of soluble egg
      antigen.

PMID- 7772730
TI  - Cryptic dysfunction of cellular immunity in asymptomatic human immunodeficiency
      virus (HIV) carriers and its actualization by an environmental immunosuppressive
      factor.
AB  - Peripheral blood lymphocytes from 4 asymptomatic HIV-1 carriers with normally
      retained EBV-specific cytotoxic T-cell activity were exposed to EBV and incubated
      with 0.2 ng/ml 4-deoxyphorbol ester, an immunosuppressive substance derived from
      an African plant Euphorbia tirucalli. The regression of EBV-induced B-cell
      transformation by EBV-specific cytotoxic T-cells was significantly impaired in
      the presence of a small amount of 4-deoxyphorbol ester, but not so in 5 HIV-1
      seronegative healthy counterparts. When the EBV-specific cytotoxic T-cells from
      the asymptomatic carriers were exposed to 0.2ng/ml 4-deoxyphorbol ester and
      incubated with 51Cr-labeled autologous EBV-transformed B lymphocytes, the
      released radioactivity was significantly smaller than that of the healthy
      counterparts. The results suggest that the cellular immunity of the asymptomatic
      HIV-1 carriers is cryptically impaired, and the cryptic immunological dysfunction
      is actualized by exposure to a small amount of the immunosuppressive substance, a
      dose which does not affect the immunity of uninfected healthy individuals.

PMID- 7772731
TI  - High frequency of telomeric association in a family with multiple congenital
      neoplasia.
AB  - Chromosomal analysis of the peripheral blood cultures of a married couple whose
      second pregnancy gave birth to twin daughters with multiple congenital
      malignancies revealed normal karyotypes of 46,XX and 46,XY, respectively.
      However, in the father's blood, 23.3% of metaphases showed telomere-telomere
      associations involving single-single and double-double chromatids. Such
      associations were not observed in the metaphases of the mother. We speculate from
      these observations that the father's genotype may somehow be responsible for the
      congenital malignancies in their twin daughters.

PMID- 7772732
TI  - The effects of inhalational anesthetics on ischemic injury of rat kidney with
      renovascular occlusion.
AB  - The effects of halogenated inhalational anesthetics, viz. halothane, enflurane,
      isoflurane and sevoflurane, on ischemic rat kidneys were studied through the
      response of renal gamma-glutamyl transpeptidase in the brush border of proximal
      tubules to monoclonal antibodies. Brush border staining characteristics were
      evaluated as follows: a) continuous (normal), b) discontinuous (damaged) and c)
      indistinct (necrotic). The isoflurane group had significantly fewer damaged
      and/or necrotic proximal tubules compared to the other groups. These results
      suggest that isoflurane is the most appropriate inhalational anesthetic when
      renal circulation is impaired.

PMID- 7772733
TI  - Antitumor and cardiotonic activity of imidazo[2,1-b]thiazole guanylhydrazones.
AB  - A number of imidazo[2,1-b]thiazole guanylhydrazones, whose antitumor activity has
      already been described, were tested as potential cardiotonic agents. The
      guanylhydrazone of 2,3-dihydro-6-chloroimidazo[2,1-b]thiazole-5-carboxaldehyde
      (2a) was the most interesting compound showing both antitumor and cardiotonic
      activity.

PMID- 7772736
TI  - Proliferating cell nuclear antigen (PCNA) expression in patients with breast
      carcinoma in comparison to patients with benign breast diseases.
AB  - The proliferating cell nuclear antigen (PCNA) was studied by immunohistochemistry
      on FNA specimens of 20 breast (ductal) carcinomas, 20 fibroadenomas and 20
      atypical fibrocystic lesions of the breast. Sixteen cases of breast carcinomas,
      eight fibroadenomas but no atypical fibrocystic lesions were found to display
      nuclear PCNA staining. A significant difference was found, between PCNA index of
      breast carcinomas (mean PCNA index 56%) and fibroadenomas (mean PCNA 21, 25%).
      This suggests that breast carcinomas display a higher proliferation index than
      fibroadenomas and fibrocystic disease. Furthermore, we found variations in PCNA
      among individual cases of breast carcinomas. This suggests that PCNA index can
      help in the individual approach of the proliferation rate of each tumour, a
      parameter of potentially importance for predicting the biological behaviour of
      the tumour in association with other proliferation markers.

PMID- 7772734
TI  - Aphidicolin inhibits in vitro the activity of pseudorabies virus (PRV) DNA
      polymerase and in vivo the viral proliferation.
AB  - We have purified and characterized Pseudorabies virus (PRV) DNA polymerase from
      infected TK- mouse cells. PRV DNA polymerase has a 3'- > 5' exonuclease activity;
      it is stimulated by ionic strength, requires magnesium for optimal activity and
      it is more sensitive to aphidicolin than eukaryotic and HSV-1 replicative DNA
      polymerases. Aphidicolin inhibits in vitro PRV DNA polymerase competitively with
      respect to dCTP with a Ki of 0.06 microM and completely blocks viral growth in
      vivo at 4.4 microM. The high sensitivity to aphidicolin of animal herpesvirus DNA
      polymerases might allow a topical use of this drug in the treatment of animal
      herpesvirus keratitis and stomatitis.

PMID- 7772735
TI  - Induction of endometrial adenocarcinomas in persistent estrous Donryu rats by a
      single intra-uterine administration of N-ethyl-N'-nitro-N-nitrosoguanidine.
AB  - Induction of endometrial adenocarcinomas in persistent estrous Donryu rats by a
      single intra-uterine administration of N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG)
      was examined. Female Donryu rats were divided into four groups at 7 weeks of age.
      Rats in Croup 1 were controls under a 12-h light/12-h dark regimen while Groups 2
      4 were persistent estrous animals maintained under 24-h light conditions. At 10
      weeks of age, rats in Group 1 and 2 were given a single intra-uterine
      administration of polyethylene glycol(PEG), and those in Groups 3 and 4 received
      ENNG(20 mg/kg body weight), dissolved in PEG, in the same manner. Group 4 rats
      also received an s.c. 17 beta-estradiol(E2) implant one week thereafter. At the
      termination of the experiment (week 42 after the ENNG-treatment), all surviving
      rats were killed and the development of uterine proliferative lesions assessed.
      All groups demonstrated hyperplasias, the incidence and severity being higher in
      ENNG-treated animals. The incidence of uterine adenocarcinomas in Group 2(2/20,
      10%) was slightly higher than that in Group 1(0/16, 0%), although this difference
      was not significant. In Groups 3(7/19, 37%) and 4(6/20, 30%) statistically
      significant induction of adenocarcinomas was noted, two lesions in the latter
      case being very large with prominent invasion of tumor cells into the
      perimetrium. At 10 and 25 weeks after ENNG-treatment, the E2-progesterone(E2:P)
      ratios in Groups 2, 3 and 4 were significantly higher than in Group 1.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7772737
TI  - Effects of clinofibrate on plasma fibrinogen level in high fructose diet-induced
      hyperlipidemic rats.
AB  - Effects of clinofibrate on the coagulative and fibrinolytic activity in an
      intrinsic hyperlipidemia induced by a cholesterol free-high fructose diet (HFD)
      for 14 days were studied using male Wistar rats. There were significant and
      positive correlations between plasma fibrinogen level and serum lipid content,
      and between fibrinogen level and VLDL-LDL-lipid content. Clinofibrate
      administration (50 and 100 mg/kg/day, p.o.) significantly inhibited the increase
      in plasma fibrinogen level as well as serum- and VLDL-LDL-lipids. It is concluded
      that clinofibrate, in addition to its beneficial effect on the serum lipid
      profile, can effectively reduce the plasma fibrinogen level.

PMID- 7772738
TI  - Malignant squamous cell elements in the ovarian cancer: report of 5 cases and
      review of the literature.
AB  - Five cases of ovarian cancer are presented in which malignant squamous cell
      elements were present. Three of the cases were adenosquamous carcinoma without
      composite endometriosis, mature cystic teratoma or with mixed mesodermal tumor.
      The other two cases were squamous cell carcinoma which arose in mature cystic
      teratoma, one of them being in situ carcinoma. Among cases of adenosquamous
      carcinoma, one composed predominantly of squamous cell element and foci of
      endometrioid adenocarcinoma was found. In this case, transitional figures between
      the two components were found. In other cases of adenosquamous carcinoma,
      components of adeno- and squamous cell carcinoma were intermingled in each
      carcinoma cell nests. Thus a large variety of histogenesis and microscopic
      figures were seen in malignant squamous cell elements in the ovarian cancer.

PMID- 7772739
TI  - Measurement of ras p21 in the urine of patients with urological tumours.
AB  - We have measured the product of the ras oncogene, ras p21, in random un-timed
      urine samples using an immunoblotting method which relies upon enhanced
      chemiluminescence for visualisation of the nitrocellulose filter. Urine samples
      were analysed from groups of patients with prostate (n = 10) or bladder (n = 25)
      cancer and a control group (n = 30) with no apparent urological disease. The mean
      concentration of urinary ras p21 in the groups with either bladder or prostate
      cancer was not significantly higher than that of the control group. The most
      striking difference between the control and clinical groups was the presence of a
      previously un-reported ras p21 "doublet" in the electrophoretic patterns obtained
      from 20% of the bladder cancer group and 10% of the prostate cancer group. This
      doublet was not present in any of the control samples analysed. This doublet is
      strongly suggestive of a mutation within the ras oncogene.

PMID- 7772740
TI  - Effects of chronic administration of adenosine antagonists on adenosine A1 and
      A2a receptors in mouse brain.
AB  - In the present study the effects of chronic in vivo treatments with caffeine and
      more selective antagonists (PACPX and PD115,199) on the binding parameters of 3H
      CHA and 3H-NECA to cortical A1 and striatal A2a adenosine receptors of mouse
      brain are shown. The drugs were injected intraperitoneally once a day for 6 or 20
      days. Treatment for 20 days with caffeine (250 mumol/kg), PD115,199 (50-250
      nmol/kg) and PACPX (250 nmol/kg) shifted the A1 low affinity receptors into an
      agonist-specific high affinity state. Moreover, after 20 days of treatment, the
      antagonists decreased the affinity of 3H-CHA to A1 receptors in the high affinity
      state. Antagonist treatments for 6 days did not modify the 3H-CHA binding
      parameters. The A2a striatal receptors were dose- and time-dependently up
      regulated by caffeine and PD115,199, whereas PACPX displayed an up-regulation
      independent of dose or length of treatment. Moreover, PD115,199 decreased the
      affinity of 3H-NECA to A2a striatal receptors. This effect on affinity was
      visible after 20 days of treatment with 50 and 250 nmol/kg. This study provides
      evidence for a sensitivity of A2a receptors greater than that of A1 receptors and
      for a different regulation of cortical A1 and striatal A2a adenosine receptors of
      mouse brain after chronic treatment with antagonists.

PMID- 7772741
TI  - Vitamin C infusion treatment enhances cortisol production of the adrenal via the
      pituitary ACTH route.
AB  - The present study is an extension of our past study on the clinical use of
      vitamin C infusion or injection treatment in autoimmune disease and allergy which
      suggests that the intravenous introduction of vitamin C may enhance the activity
      of the endogenous cortisol in such a way as to allow clinical control of immune
      disorders. This time, we investigated the relation between ACTH, cortisol and
      vitamin C in plasma in the course of vitamin C infusion or injection treatment
      with and without the use of methyl-prednisolone annex, a suppressor of the
      homeostatic mechanism of the pituitary ACTH. A total of 4 experiments were
      conducted using a healthy male volunteer. Results obtained are as follows: 1) the
      practice of the steroid-free vitamin C infusion treatment induced a) distinct
      depletion of both cortisol and vitamin C from the circulation at the initial to
      moderate stages of the experiment, b) a small surge of plasma cortisol at the
      middle stage, and c) skyrocket-like rises of ACTH and cortisol of plasma at the
      terminal stage. 2) The use of methylprednisolone annex in the vitamin C infusion
      set completely suppressed the emergence of the plasma ACTH/cortisol surges of the
      terminal stage, but not the small surge of plasma cortisol. The synthetic steroid
      also suppressed the depletion of vitamin C and cortisol of the initial to
      moderate stages. 3) The terminal ACTH/cortisol surges of plasma were less
      distinct in the vitamin C infection experiment than in the vitamin C infusion
      experiment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772742
TI  - Evaluation of genotoxicity of a technical grade organophosphate insecticide,
      Tafethion (ethion), in chicks.
AB  - The genotoxicity of a technical grade organophosphate insecticide, Tafethion
      (ethion), was evaluated in a chick in vivo test system employing the chromosome
      aberration assay (CA). Chicks in their neonatal life period are particularly
      susceptible to environmental contaminants due to the high rate of cell
      proliferation and ongoing process of development. This provides a new methodology
      to screen the genotoxic effect of environmental pollutants. The chemical was
      tested for three different doses (20, 15 and 10 mg/kg b.w.), in two routes of
      administration (i.p. and p.o.), after three different durations of acute exposure
      (6, 24 and 48 h) as well as chronic exposure (4 mg/kg day for 5 days), for the
      induction of chromosomal aberrations. Mitomycin C was used as the positive
      control. In general, the chemical induced higher frequencies of chromosomal
      aberrations than the controls, indicating the genotoxic property of the chemical
      in the tested system.

PMID- 7772743
TI  - An immuno-electron microscopic study on the relationship between nuclear matrix
      and DNA in rat spermatocytes.
AB  - The nucleus of the mammalian spermatid undergoes a series of changes in its
      chromatin and nucleoprotein composition during transport from testis to
      epididymis. The sperm DNA is very tightly packaged by protamines instead of
      histones in somatic cells. However, the nuclear matrix and its association with
      DNA have not yet been definitively scrutinized with the electron microscope. The
      present study reveals that the protamine-depleted sperm nuclear matrix appears as
      a network of thick and thin filaments with glodular structures attached the these
      fibers. Monoclonal antibody to single- and doublestranded DNA was used to
      localize remnant DNA after extraction. By immunofluorescence microscopy,
      monoclonal antibody against DNA was localized outside the nucleus as a halo.
      Immuno-electron microscopy showed that gold particles were mainly associated with
      nuclear matrix surrounding the sperm head. Our results suggest a specific
      structural organization of sperm DNA with its matrix.

PMID- 7772744
TI  - In vivo effect of dietary factors on the molecular action of aflatoxin B1: role
      of non-nutrient phenolic compounds on the catalytic activity of liver fractions.
AB  - Young adult rats were kept on a synthetic diet containing various food associated
      phenolic compounds each at 0.5% level. The ability of liver microsomes to
      catalyze reactions of aflatoxin B1 leading to its activation and DNA adduct
      formation was measured after an experimental feeding period of 3 weeks. A
      decrease in both activities was observed with several flavonoids (fisetin,
      kaempferol, morin, naringin and (+/-)catechin), phenolic acids (caffeic acid and
      chlorogenic acid), other phenolics (eugenol, vanillin) and synthetic phenolic
      antioxidants butylated hydroxyanisole and butylated hydroxytoluene. Certain
      phenolics notably naringin, (+/-) catechin, eugenol, vanillin and butylated
      hydroxyanisole were also found to induce cytosolic glutathione S-transferase
      activity that stimulated the formation of specific aflatoxin B1-glutathione
      conjugate. The results emphasize the role of phenolic compounds in the activation
      and detoxification processes, and hence in modulating the carcinogenicity of
      aflatoxin B1.

PMID- 7772745
TI  - Experimental diets for the study of lipid influence on the induced mammary
      carcinoma in rats: I--Diet definition.
AB  - There is a considerable variation in the diets used in studies on the influence
      of dietary fat on rat mammary cancer. In view of the fact that diet is the most
      remarkable factor in these studies, the aim of this work was to define two
      experimental diets, one of them normal (N3) and another hyperlipidic (HL20), both
      allowing the normal growth of the rat and neither of them containing factors that
      could unspecifically affect mammary carcinogenesis. Semisynthetic diets were
      selected instead of natural ones. A normal diet (3% corn oil, 18% casein, 67.9%
      dextrose) and a hyperlipidic diet (20% corn oil, 23% casein, 45.9% dextrose) were
      defined for the rat. Both diets also contain 5% cellulose, 5.9% salt mix and
      0.24% vitamin mix. In order to avoid the influence of the above mentioned
      unspecific factors, the control of specificity and quality of nutrients is
      proposed as an essential measure. Moreover, it is also necessary to adopt
      measures to avoid the presence of fatty acid metabolites, including the
      calculation of the necessary vitamin E, selenium and sulfur amino acid and the
      determination of factors potentially able to stimulate or inhibit carcinogenesis
      such as phenolic antioxidants, retinoids or the trans isomer of fatty acids. On
      the other had, casein, dextrose, choline and folic acid contents were modified in
      order to equilibrate the lipid increase experimentally introduced in the HL20
      diet or to ensure the normal maintenance of the animals' metabolism. The method
      used is based on the concept of quality assurance.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7772746
TI  - Experimental diets for the study of lipid influence on the induced mammary
      carcinoma in rats: II--Suitability of the diets.
AB  - We have previously reported one method for obtention of experimental diets for
      the study of the effects of dietary lipids on the rat breast carcinoma. The
      purpose of this second part of the study was to develop a quality control system
      for demonstrating the suitability of these diets. This system is essentially
      based on the animals' growth control, their period clinical examination as well
      as the anatomopathological postmortem study of the animals submitted to such
      diets. Two groups of weaning rats, control (C) and hyperlipidic (HL), were
      submitted to a low-fat diet (N3) or a high-fat polyunsaturated--corn oil--diet
      (HL20) respectively. At 53 days of age all animals were induced with 5mg of
      dimethylbenz (a) anthracene. Experiments were ended when animals reached a mean
      age of 214 days. The results show: 1) a normal ponderal evolution of the animals
      in the two experimental groups with respect to two series of the same strain fed
      with a standard diet, and 2) the homogeneity of growth determined by the
      coefficient of variance study. On the other hand, neither the weekly clinical
      examination nor the anatomopathological post-mortem studies revealed any
      pathology that could be specifically attributed to nutritional imbalance. These
      results confirm the suitability of both diets for rat growth. Their use in the
      study of the effects of dietary lipids on the mammary carcinoma would satisfy the
      initial aim of guaranteeing the specificity of the results.

PMID- 7772747
TI  - Clonal outgrowths of T and B cells in SCID mice reconstituted with cells from
      mice with MAIDS.
AB  - Murine acquired immunodeficiency syndrome (MAIDS), induce in mice by a defective
      murine retrovirus (BM5def), is characterized by development of severe
      immunodeficiency and polyclonal lymphoid proliferation which progress to yield
      oligoclonal populations of T and B cells. Oligoclonal populations transferred to
      SCID mice grew as clonal CD4+ T cell or B cell lineage transplants having one or
      more unique clonal integrations of BM5def. In some cases, spleens of single donor
      mice were shown to contain both B cell and T cell lineage clones that could be
      transferred individually after separation and were clonally unrelated. Successful
      transplants were obtained from oligoclonal populations as early as 63 days after
      infection. Mouse strains both sensitive or moderately resistant to MAIDS yielded
      clonal transplants.

PMID- 7772748
TI  - Embryonal carcinoma cells differentiate into parietal endoderm via an
      intermediate stage corresponding to primitive endoderm.
AB  - F9 embryonal carcinoma (EC) cells were used as a model system to study endoderm
      formation during mammalian embryogenesis. F9 cells treated with retinoic acid
      (RA) or RA plus dibutyryl cyclic AMP (cAMP) were examined for the expression of
      stage-specific embryonic antigen-3 (SSEA-3), a cell surface marker of primitive
      and visceral endoderm. SSEA-3 was not detected by indirect immunofluorescence on
      the surface of undifferentiated stem cells; however, a subset of SSEA-3-positive
      cells appeared with time in culture, amounting to 20% of cells 10 days after
      plating. When cultured in the presence of RA, the percentage of SSEA-3-positive
      cells increased to 70% of cells 10 days after plating. In contrast, treatment of
      cells with RA plus cAMP yielded differentiated cells that were SSEA-3-negative.
      These SSEA-3-negative cells exhibited ultrastructural features of parietal yolk
      sac endoderm. In contrast, SSEA-3-positive cells appearing in cultures treated
      with RA alone exhibited ultrastructural features of primitive endoderm on day 3,
      switching to ultrastructural features of parietal endoderm on day 10. Cells with
      hybrid features, resembling both visceral and parietal yolk sac, were also seen.
      We suggest that differentiation of F9 EC cells into parietal yolk sac-like cells
      can occur along two distinct pathways: 1) direct under the combined influence of
      RA and cAMP; and 2) indirect, under the influence of RA alone, in which cells
      first differentiate into primitive endoderm. Parietal yolk sac-like cells induced
      through the latter pathway continue to express SSEA-3, a cell surface marker of
      primitive endoderm that is not normally found on parietal endodermal cells in
      vivo.

PMID- 7772749
TI  - Preclinical toxicology study of liposome encapsulated doxorubicin (TLC D-99)
      given intraperitoneally to dogs.
AB  - A preclinical toxicology study of intraperitoneally administered liposome
      encapsulated doxorubicin and free doxorubicin was carried out in beagle dogs.
      Dogs received single intraperitoneal infusions of 1.5 mg free or 1.5, 2.25 or
      3.37 mg liposomal doxorubicin/kg. One group of four dogs received 1.5 mg
      liposomal doxorubicin/kg every three weeks for 4 cycles. The dose limiting
      toxicity of free or liposomal doxorubicin given by the intraperitoneal route was
      a dose-related chemical peritonitis. This toxicity was more severe in dogs that
      received by the intraperitoneal route the previously determined maximally
      tolerated intravenous dose of liposomal doxorubicin (2.25 mg/kg). The abdominal
      toxicity was characterized by capsular fibrosis and ascites formation. Abdominal
      toxicity was life threatening after single doses of 3.37 mg liposomal doxorubicin
      kg, or after multiple (4) doses of 1.5 mg liposomal doxorubicin/kg. Thoracic
      toxicity (increased fluid, mediastinal edema, thickening of the parietal pleura)
      was seen after multiple (every 3 weeks for 4 cycles) intraperitoneal doses of 1.5
      mg or single doses of 3.37 mg liposomal doxorubicin/kg. Myelosuppression was seen
      in all groups, but was less severe after intraperitoneal dosage than after
      intravenous dosage of liposomal doxorubicin.

PMID- 7772750
TI  - Immunomagnetic isolation of endothelial cells from normal rat prostate tissue.
AB  - Angiogenesis, or the process of the formation of new blood vessels, is an
      essential event for the successful growth of tumors in vivo. The discovery of
      agents which inhibit angiogenesis has been limited by the lack of available
      experimental endothelial cell systems which mimic specific organ- or tumor
      derived endothelial cells. It is well recognized that there are measurable
      functional and morphological differences between normal tissue endothelium and
      tumor vessels, however, the cause of these differences remains unclear. We report
      here a technique for tissue specific endothelial cell isolation from the rat
      prostate utilizing immunomagnetic techniques, providing a tool for the study of
      endothelial cells and their inhibition.

PMID- 7772751
TI  - Immunoprotective activity of the galactoside-specific mistletoe lectin in
      cortisone-treated BALB/c-mice.
AB  - Hydrocortisone-acetate (HA)-treatment of BALB/c-mice induced a profound
      suppression of the lymphatic immune system with statistically significant
      decreases of thymocyte proliferation and maturation rates as well as peripheral
      blood lymphocyte (PBL) counts. To check its putative
      immunoprotective/immunorestoring activity, the optimal immunomodulating dosage of
      commercially available mistletoe extract standardized for the galactoside
      specific mistletoe lectin (ML-1) was regularly administered (1 ng ML-1 per kg
      body weight; subcutaneously). As compared to counts of thymic lymphatic subsets
      of HA-treated mice, a considerable up regulation of mature cells expressing
      helper/inducer (L3T4+) as well as cytotoxic/suppressor (Lyt-2+) phenotypes and
      immature cells expressing both antigens (L3T4+/Lyt-2+) could be found after ML-1
      co-administration. Counts of BALB/c-mouse peripheral blood mononuclear cells also
      revealed statistically significant increases after ML-1 co-administration, as
      compared to HA-treated animals. Accordingly, ML-1 treatment may be supposed to
      restore the lymphatic system after immunosuppressive corticoid treatment and thus
      this treatment may be of great benefit to patients.

PMID- 7772753
TI  - Gyromitra esculenta mushroom: a comparative assessment of its carcinogenic
      potency.
AB  - A comparative assessment is performed on one of the false morel mushrooms,
      Gyromitra esculenta, including the amounts of some hydrazines present in this
      fungus, the cancer-inducing doses of these chemicals or the mushroom used in
      animal experiments, the total amounts of the hydrazines or mushroom needed to
      induce neoplasms in mice and the estimated total amounts of hydrazines or
      mushroom needed to induce cancer in humans. When one compares the estimated
      amounts of hydrazines required to induce cancer with the amount of raw Gyromitra
      esculenta needed to yield a similar effect, it becomes clear that to date 37
      percent of the carcinogenic ingredients of this fungus have been identified.

PMID- 7772754
TI  - [The first specialist of radiology....].

PMID- 7772752
TI  - Hypocholesterolemic effect of exogenous dehydroepiandrosterone administration in
      the rhesus monkey.
AB  - The effect(s) of exogenous dehydroepiandrosterone (DHEA) was studied in healthy
      non-obese rhesus monkeys. Six monkeys were given 60 mg/kg/day DHEA for 4 weeks.
      The dose was then increased to 75 mg/kg/day for an additional 4 weeks. Another
      six monkeys were given placebo, daily for 8 weeks. Body weight, activity level,
      average daily food intake, and plasma T4, insulin, total androgen and cortisol
      concentrations remained unchanged for all 12 monkeys throughout the 8 weeks. Both
      groups had a significant (p < 0.05) decrease in total plasma cholesterol, however
      the DHEA treated monkeys were significantly lower than the placebo monkeys. The
      change in cholesterol in the DHEA treated group primarily affected the fraction
      containing the low density lipoprotein cholesterol which remained overall
      unchanged for the placebo monkeys. Both groups had a decrease in high density
      lipoprotein cholesterol, however there was no difference between the treatment
      groups. We conclude that in the rhesus monkey, exogenous administration of DHEA
      acutely reduces cholesterol concentration, particularly the lipoprotein fraction
      containing low density lipoprotein, without changing food intake, activity level,
      or body weight.

PMID- 7772755
TI  - [The filmless hospital: reality or illusion].

PMID- 7772756
TI  - [The riddle of the first clinical x-ray solved].

PMID- 7772757
TI  - [Value of thoracic radiography in the assessment of cardiac size. A comparison
      with left ventricular cardiography].
AB  - PURPOSE: To determine the value of standard chest radiographs in the assessment
      of cardiac size. METHODS: In 193 patients cardiac size was compared between
      standard chest radiographs in the posteroanterior and lateral projection and left
      ventricular angiograms. The following parameters were determined: transverse
      diameter, lateral horizontal transverse diameter, cardiothoracic ratio and end
      diastolic volume index (EDVI) and ejection fraction (EF). RESULTS: Subjective
      assessment of the left ventricular size resulted in a mean
      sensitivity/specificity/accuracy of 69.7%/87.4%/82.0% respectively, in comparison
      to EDVI. Estimation of global heart size yielded a mean
      sensitivity/specificity/accuracy of 48.8%/93.6%/77.8%, respectively, in
      comparison to EF. Cardiothoracic ratio for the detection of pathological EDVI or
      EF had a sensitivity of 77.3%/57.4% a specificity of 79.3%/80.8% and an accuracy
      of 78.9%/72.5%. CONCLUSIONS: Standard chest radiographs with the determination of
      cardiothoracic ratio remain a clinically relevant procedure for screening and
      follow-up of heart disease.

PMID- 7772758
TI  - [CT angiography in carotid stenosis. Diagnostic value compared to color-coded
      duplex ultrasonography and MR angiography].
AB  - PURPOSE: To evaluate the accuracy of different diagnostic methods for the
      visualization of the carotid arteries and their pathological changes in order to
      avoid invasive angiography whenever surgery was considered. MATERIAL AND METHODS:
      24 patients with clinically suspected stenosis or occlusion of the carotid
      arteries were prospectively examined via CT angiography. MR angiography and
      colour-coded duplex sonography (ccds) to evaluate the degree of stenosis and the
      extent of calcification. RESULTS: In 36 cases stenoses of different extent could
      be documented with CT angiography, 33 cases were found using colour-coded duplex
      sonography and MRA. Sonography could not prove mild stenoses (< 30%), and in two
      patients with sonographically suspected total occlusion vessel perfusion was
      documented via CT angiography. MR angiography led to a overestimation in patients
      with high-grade stenosis compared to the degree of stenosis obtained via ccds and
      CTA. With regard to the diagnosis of calcification MIP, reconstructions after CT
      examination showed best correlation to the plain CT slices referring to length
      (94.6%) and thickness (89.2%). CONCLUSION: CTA with MIP reconstructions is an
      excellent screening method and, in combination with ccds, CT angiography may
      replace DSA before surgery or intervention.

PMID- 7772759
TI  - [MR mammography at 0.5 tesla. I. Comparison of image quality and sensitivity of
      MR mammography at 0.5 and 1.5 T].
AB  - PURPOSE: To determine whether dynamic MR mammography is possible on midfield
      systems without loss of diagnostic sensitivity when compared to the standard
      highfield technique. MATERIALS AND METHODS: 42 consecutive patients were examined
      twice: Once using the standard dynamic 2D gradient echo technique at 1.5 T; a
      second examination was performed on a 0.5 T system. For the midfield examinations
      a 3D sequence with optimized T1 contrast was used to compensate for the shorter
      T1 relaxation times at 0.5 T. Subtraction images were calculated to improve
      detectability of enhancing lesions. RESULTS: Image quality was comparable on both
      systems. Mean enhancement of lesions was higher at 0.5 T/3D as compared to 1.5
      T/2D (161% versus 112%). In malignant lesions, enhancement at 0.5 T/3D surpassed
      that at 1.5 T/2D in 88% of cases; average maximum signal intensity increase of
      cancers was significantly higher at 0.5 T/3D as compared to 1.5 T/2D (183% versus
      108% relative to baseline). One satellite lesion of a recurrent carcinoma was
      detected on the 0.5 T/3D images only. CONCLUSION: A 3D gradient echo pulse
      sequence can be used to compensate for the T1 shortening effect of the lower
      field strength. With a 3D sequence, sensitivity of MRM at 0.5 T is even superior
      to that of the standard 2D highfield technique.

PMID- 7772760
TI  - [MRI of the knee joint: first results of a comparison of 0,2-T specialized system
      and 1,5-T high field strength magnet].
AB  - PURPOSE: Diagnostic accuracy and image quality of a specialised system for MR
      examinations of peripheral joints were evaluated. MATERIALS AND METHODS: 20
      patients with acute or chronic injuries of the knee were examined using a low
      field MR system (0.2 T). For comparison, all patients were also studied with a
      1.5 T high field strength magnet and all diagnoses were correlated with
      arthroscopic findings. RESULTS: We found compatible diagnostic accuracies
      (cruciate ligaments 90%, menisci 75-90%) and good image quality ratings for the
      low field system ("good" and "excellent" image quality in 83% of cases).
      CONCLUSION: The low-field MR-system offers low-cost MR examinations of peripheral
      joints with good image quality and reliable diagnostic information.

PMID- 7772761
TI  - [Static and dynamic MR tomography of the pancreas: contrast media kinetics of the
      normal pancreatic parenchyma in pancreatic carcinoma and chronic pancreatitis].
AB  - PURPOSE: We aimed both at improving image quality and diagnostic value of
      pancreatic MRI by using fast multislice imaging techniques and at demonstrating
      normal and pathologic signal enhancement in the pancreas after i.v. gadopentate
      dimeglumine. METHODS: MR imaging at was performed in 30 patients with suspicion
      of pancreatic neoplasm or chronic disease and in 15 patients without pancreatic
      abnormalities. RESULTS: SNR, CNR, mean signal enhancement, and time/signal
      intensity curves were calculated. Signal enhancement after i.v. Gd-DTPA averaged
      34.4% in neoplasms (n = 14) vs 58.8% in pancreatic tissue not involved by tumour
      (p < 0.05) in T1-w SE and was also significant in the T1-w GE sequence (p <
      0.005). CNR (pancreas vs lesion) and SNR improved significantly (p < 0.005;
      pancreas: p < 0.001; lesion: p < 0.05) after i.v. Gd-DTPA administration. In
      patients without pancreatic disease enhancement curves of pancreas demonstrate a
      rapid signal increase (79.0% after 34 s). Patients with adenocarcinoma or chronic
      pancreatitis demonstrated flattened signal intensity curves and higher peak
      signal intensity values (90.1, 111.3% after 68 s). The slope of signal increase
      of neoplastic tissue was significantly different (p < 0.01) from unaffected
      parenchyma (48.3% after 51 s, 90.1% after 68 s). CONCLUSION: MR imaging with fast
      T2-w SE and T1-w SE sequences provides excellent visualisation of the pancreas
      and adequate conspicuity of pancreatic adenocarcinoma. Following i.v. Gd-DTPA
      significant enhancement of tumour/parenchyma contrast is found.

PMID- 7772763
TI  - [Color-coded duplex ultrasonography in the diagnosis of renal artery stenosis].
AB  - PURPOSE: Colour-coded duplex sonography was performed for diagnosis of renal
      artery stenosis to define standards and criteria for stenosis. MATERIAL AND
      METHODS: In 20 normotensive volunteers and 123 patients with arterial
      hypertension, bilateral intrarenal Doppler spectra were examined and the
      following parameters including side ratios were calculated: pulsatility index
      (PI), resistance index (RI), acceleration time index (AT) and acceleration index
      (AI). RESULTS: In 29 of the 123 patients, angiography showed unilateral renal
      artery stenosis. Acceleration index (AI) was found as the most reliable parameter
      with a sensitivity of 100% and a specificity of about 94% for stenoses grading at
      least 70%. CONCLUSIONS: Colour-coded duplex sonography can depict relevant
      stenoses reliably, but anatomical variations may limit its value as a single
      screening method. Colour-coded duplex sonography can be, therefore, recommended
      as an adjunct to angiography for assessment of haemodynamic relevance.

PMID- 7772762
TI  - [Multiple slab MR angiography of the A. carotis interna: a preoperative
      comparative study].
AB  - PURPOSE: With the introduction of MR angiography (MRA) into clinical routine,
      arteriosclerotic lesions of the supraaortic vessels may be well demonstrated.
      MATERIAL AND METHODS: The comparison between Multislab MRA (gradient echo, TOF)
      and X-ray angiography (XRA) as reference in 70 patients suspicious of stenotic
      lesions in the internal carotid artery proved the high reliability of these
      methods. RESULTS: In determining the degree of stenosis, according to the NASCET
      study (North American Symptomatic Endarterectomy Trial), a correlation between
      MRA and XRA of 92.3% could be calculated. The principal problem of MRA is the
      overestimation of high-grade stenoses; we observed 5 false-positive results in
      severe stenosis. Sensitivity and specificity were 95.6 and 92.6%, respectively,
      for detection of severe (> 60%) stenosis. CONCLUSION: Despite its limitations,
      MRA is a clinically important noninvasive technique for preoperative evaluation
      of patients undergoing carotid endarterectomy.

PMID- 7772765
TI  - [First clinical experience with a new nitinol stent in the biliary system].
AB  - PURPOSE: To evaluate the clinical usefulness of a new nitinol biliary stent
      (Memotherm) in patients with malignant biliary obstruction. 32 self expanding
      nitinol stents were applied in 17 patients. The following parameters were
      investigated: Difficulty of placement, lateral stability and patency over an
      observation time between 3 weeks and 11 months. RESULTS: In 29/32 stent
      application could be performed with high precision. In 3/32 we observed a
      displacement about 1 cm--according to the optimal stent position. Stent
      shortening was about 5 mm in 31/32 stents, secondary shortening only occurred in
      one patient with primarily distracted stent design. Lateral stability was
      sufficient in 21/25 stenoses with the consequence that dilatation was only
      performed in 4 cases. Average stent patency was 4.8 months, the average survival
      5.1 months. Because of his special design, this stent may not be used for a
      stenosis with angulation higher than 90 degrees. CONCLUSION: Basing on a small
      calibre introducing system, easy placement, predictable minimal shortening and
      good lateral stability, the Memotherm seems an interesting alternative to other
      metal stents.

PMID- 7772764
TI  - [Duplex ultrasonographic diagnosis of renal artery stenosis by intrarenal
      acceleration determination and recognition of the tardus-parvus phenomenon with
      special regard to multiple renal arteries].
AB  - PURPOSE: Use of the "tardus and parvus" abnormalities for the exclusion of
      significant renal artery stenosis, including multiple renal arteries. METHOD: The
      lobar and interlobar renal arteries of 50 hypertensive patients were examined by
      colour duplex sonography at three different levels. Analysis included
      determination of the early systolic acceleration time and evaluation of the early
      diastolic complexes. In all patients, intra-arterial catheter angiography was
      performed on the following day. RESULTS: 48 out of the 50 colour duplex
      examinations could be properly evaluated. Angiography showed that 21 patients
      (42%) had multiple renal arteries, in 13 there was a haemodynamically significant
      renal artery stenosis and amongst these 4 patients had bilateral renal artery
      stenoses. The sensitivity and specificity of the early systolic acceleration time
      at > or = 0.120 sec. was 77 and 46% respectively. Amongst the 17 haemodynamically
      significant stenoses shown by angiography, 10 demonstrated changes in the early
      systolic peaks of the Doppler spectrum, a sensitivity of 69% and specificity of
      90%. CONCLUSION: Use of acceleration time and of the early systolic complexes
      cannot be recommended as sole methods during a screening procedure.

PMID- 7772766
TI  - [Adaptable hourglass stent to reduce shunt flow after TIPS insertion].

PMID- 7772767
TI  - [CSF fistula through the clivus Blumenbachii].

PMID- 7772768
TI  - [Juvenile nasopharyngeal angiofibroma and antro-choanal polyp: role of MRT in the
      differential diagnosis].

PMID- 7772769
TI  - [Pseudotumorous heterotopic ossification of the hand].

PMID- 7772770
TI  - [Long-term follow up of therapy-conditioned cerebral changes in acute lymphatic
      leukemia].

PMID- 7772771
TI  - [Catheter lysis in embolism of the superior mesenteric artery].

PMID- 7772772
TI  - 5th International Conference on Adjuvant Therapy of Primary Breast Cancer. St.
      Gallen, Switzerland, 1-4 March 1995. Abstracts.

PMID- 7772773
TI  - [Remission and recurrence of chronic obstructive lung disease in air pollution
      caused lung disease patients in the Yokkaichi area].
AB  - A study was conducted of patients covered by National Health Insurance (NHI) with
      chronic obstructive lung diseases legally-recognized as being caused by air
      pollution (Group A) and those not legally-recognized as air pollution caused
      (Group B) in the Yokkaichi area. Records of medical examinations (medical fee NHI
      statement), were examined, focusing on recurrence and remission. Over all
      incidence of recurrence after remission in asthmatic bronchitis and bronchial
      asthma conditions was 25% in Group A and 18% in Group B patients although with
      differences observed in different age groups. Approximately 50%-70% of the
      recurrence occurred within 3 years, and this incidence decreased approximately in
      proportion to time elapsed. Total remission rates for patients who had remission
      without recurrence and those who had remission after recurrence of bronchial
      asthma was approximately 39% in Group A and about 77% in Group B.

PMID- 7772774
TI  - [Childcare problems and maternal fatigue symptoms in families with twins and
      triplets].
AB  - A mailed questionnaire survey was conducted on a population of 123 mothers of
      twins and 96 mothers of triplets to study problems in the families and maternal
      fatigue symptoms. The following results were obtained. 1) The prevalence rate of
      handicap was 9.7 per 100 for triplets, and 4.9 per 100 for twins. The risk of
      handicap in triplet pregnancy was approximately 25%, and in twin pregnancy was
      approximately 10%. Therefore 1 in 4 mothers with triplets and 1 in 10 mothers
      with twins had one and more handicapped children. 2) Mothers with triplets aged 0
      11 months reported significantly poorer sleep quality than mothers with triplets
      aged one year or more with shorter sleeping time, greater frequency of awakening
      during the night, and more complaints of inadequate sleep. Mothers with twins
      aged 0-11 months showed a greater tendency for poor sleep quality than mothers
      with twins aged one year or more. 3) Approximately 70% of mothers with twins and
      triplets aged up to two reported lack of time to care for the other children.
      When the age of twin was 3 or more, lack of time to take care of other children
      was reported by only 13.3% of mothers, while it was 41.7% for mothers with
      triplets. 4) Mothers of twins and triplets who did not receive assistance from
      others for childcare reported severe physical fatigue, compared to mothers who
      received assistance from others. Mothers of twins and triplets aged 3 or more
      showed a tendency of less physical fatigue, compared to mothers of twins and
      triplets aged up to two.

PMID- 7772775
TI  - [Yearly changes and geographical distribution of allergic rhinitis morbidity
      estimated from records of the national health insurance].
AB  - The age-adjusted morbidity of allergic rhinitis (AR) in Ibaraki prefecture in
      May, estimated from data of national health insurance records, increased
      remarkably from 1980 to 1992 with varying yearly rates of increase. High AR
      morbidity years coincided with years of high Japanese cedar and cypress pollen
      counts, and moreover, an estimate equation of the morbidity using as explanatory
      variables, year and the yearly total count of pollen, accurately estimated AR
      morbidity. The AR morbidity varied with the size of the municipality. The AR
      morbidity of the town group and village group were about 80% and about 60%
      respectively of the city group in 1992. The map of the AR morbidity of each
      municipality showed that urbanized districts had higher morbidity than areas with
      cedar forests, which are supposedly sources of the cedar pollen. Continuous
      increase of morbidity of districts with much cedar forests terminated in 1986.
      Since then only the fluctuation of the morbidity corresponding to the pollen
      count was observed. The ratio of the morbidity of the years with much pollen to
      that of the years with little pollen was mapped. The map showed good agreement
      with the map of cedar forests. The results obtained above demonstrate the
      usefulness of the data of the national health insurance records.

PMID- 7772776
TI  - [Psychosocial determinants of changes in activities of daily living and
      depressive status among stroke patients at home].
AB  - Using a longitudinal study of 79 stroke patients, factors that are predictive of
      change in activities of daily living (ADL) and depressive status over three and a
      half-year period were examined. Social activities, health behavior, and
      depressive status were entered as predictive variables. Those who participated in
      community activities, had significantly less decline in ADL than those who did
      not, and those who reported a greater variety of leisure activities had less
      decline in depressive status during the follow-up period.

PMID- 7772777
TI  - [Health screening behavior in the past 5 years and the next year of attendance of
      40 and 50 years of age at individual screening and the related factors].

PMID- 7772778
TI  - [A follow-up study for length of stay and readmission rate of psychiatric
      inpatients in a rural area].

PMID- 7772779
TI  - [Childbirth by traditional birth attendants in a remote island of Okinawa].

PMID- 7772780
TI  - Development of hearing. Part III. Postnatal development.
AB  - As humans, we hear the way we do because of at least three major forces. The
      first is phylogeny, the evolutionary changes in the auditory system since its
      beginnings. The second is embryology, the formation of the system in each
      individual. Finally, there is the interaction between the biologically determined
      mechanism we are born with and the environment. This series of articles reviews
      each aspect in turn, so that we may have a fuller appreciation of how it is we
      come to hear the way we do. Part I examined how the auditory system evolved, and
      Part II outlined the sequence of ear formation in prenatal life. In this
      concluding article, we examine the development of auditory perception from when
      we first hear (in utero) through 12 months of age, which is when speech usually
      appears. Humans seem to come "programmed" to perform all the processes necessary
      to learn the language of their environment. Interaction with the environment
      hones our abilities to process sound and thereby optimizes language acquisition
      and production.

PMID- 7772781
TI  - Differences in localization ability in cases of right versus left unilateral
      simulated conductive hearing loss.
AB  - The purpose of this study was to determine whether localization errors were
      greater in cases of right ear unilateral simulated conductive loss, as compared
      to left ear simulated conductive loss of the same degree and configuration.
      Thirty adults were asked to localize a 3-kHz warbled pure tone with their left
      and right ears alternately occluded with an earplug. Significantly greater
      localization difficulty was found when the right ear was occluded. The average
      error was 58 degrees with the left ear plugged and 64 degrees when the right ear
      was occluded, which approximates the 65-degree average error that would have
      resulted from random guessing. This suggests that short-term conductive losses
      result in unusually poor localization ability, which is worse if the right ear is
      affected.

PMID- 7772782
TI  - Disabilities and handicaps associated with impaired auditory localization.
AB  - A questionnaire on (1) difficulties in everyday sound localization (localization
      disabilities), (2) limitations and disadvantages related to such disabilities
      (localization handicaps), and (3) everyday speech hearing disabilities was
      completed by 104 people with symmetrical hearing losses. Respondents considered
      situations when listening with and without their usual hearing aid fittings. The
      hearing-impaired group rated their unaided localization ability as significantly
      poorer than a sample with no reported hearing loss, particularly discrimination
      of distance. Only slight limitations on everyday activity due to localization
      disability were found, but disadvantage was reported in the form of experiences
      of confusion of sounds, of resultant loss of concentration, and of a wish to
      escape settings where this occurred. There was a moderate correlation between
      localization and speech hearing, even when hearing level was controlled for.
      Aided listening, whether with one or with two hearing aids, was reported as
      enabling significant improvements in both functions.

PMID- 7772783
TI  - Long-term recovery and no recovery from the auditory deprivation effect with
      binaural amplification: six cases.
AB  - Six subjects who developed individually significant auditory deprivation effects
      associated with monaural amplification were tracked for 6.2 to 15.1 years from
      the time of their initial hearing aid fitting. Each subject received binaural
      hearing aids after the auditory deprivation effect became apparent and used
      binaural amplification for at least 4 years. The findings corroborate and expand
      upon existing case reports. Several general configurations of recovery and no
      recovery following the introduction of binaural amplification were identified:
      (1) cases in which auditory deprivation effects developed within about 2 years
      and recovered completely within about 2 years of binaural use; (2) cases with
      significant but incomplete recovery; and (3) cases in which the auditory
      deprivation effect took several years to develop and did not recover following
      several years of binaural amplification. Clinical implications of the results are
      proposed.

PMID- 7772784
TI  - Preliminary descriptions of transient-evoked and distortion-product otoacoustic
      emissions from graduates of an intensive care nursery.
AB  - Transient-evoked (TEOAE) and distortion-product otoacoustic emissions (DPOAE)
      were measured in 51 graduates of an intensive care nursery and compared to data
      obtained from 80 normal-hearing children and adults. All infants had click-evoked
      auditory brainstem responses (ABR) at 30 dB nHL or less while the older subjects
      had pure-tone thresholds of 20 dB HL or less for octave frequencies from 250 to
      8000 Hz. OAE data were collected using commercially available devices. All data
      were analyzed in terms of emission amplitude, emission-to-noise ratio, and
      response reproducibility as a function of frequency. DPOAEs were measured at
      three points per octave between f2 frequencies of approximately 500 and 8000 Hz.
      TEOAEs were elicited by clicks and were analyzed in both octave and 1/3-octave
      bands centered at frequencies from 500 to 4000 Hz, as well as in the broadband
      condition. In addition, stimulus amplitudes for the clicks used to elicit TEOAEs
      were analyzed within octave and 1/3-octave bands to determine whether any age
      related differences in responses can be accounted for on the basis of stimulus
      differences. Both emission amplitude and noise amplitude were greater in neonates
      than adults, although there was variability across frequency. Emission-to-noise
      ratio and response reproducibility were more similar between groups. For TEOAEs,
      high-frequency emission-to-noise ratios were larger in neonates compared to older
      subjects, while the reverse was true in the lower frequencies. Less obvious
      frequency effects were observed for DPOAEs. These findings are discussed in
      relation to the potential use of OAEs as screening measures for neonatal hearing
      loss.

PMID- 7772785
TI  - Case of recurrent, reversible, sudden sensorineural hearing loss in a child.
AB  - This paper describes audiologic, electrophysiologic, and medical test results for
      a now 10-year-old girl who has had 45 episodes of reversible, sudden
      sensorineural hearing loss over the last 8 years. Episodes have lasted from 6 to
      72 hours and often have been accompanied by a mild illness. Acoustic immittance
      measures have been consistent with normal middle-ear function with the exception
      of absent ipsilateral and contralateral acoustic reflexes. Mechanically evoked
      perioral reflex activity was markedly asymmetric following lower lip stimulation.
      The asymmetry of R1 activation between right and left side lower lip inputs
      raises questions about the integrity of central connections within the brain
      stem, including internuncial pathways coursing between trigeminal sensory relay
      nuclei and the facial motor nucleus. An electrocochleographic evaluation revealed
      cochlear microphonic but absent or markedly abnormal whole nerve action
      potentials. Auditory brainstem responses (ABR) have been either absent or poorly
      formed and significantly delayed, regardless of hearing sensitivity. Middle and
      late auditory evoked potentials were essentially normal. Both transient-evoked
      and distortion-product otoacoustic emissions were present regardless of
      peripheral auditory sensitivity. All medical tests have been essentially normal.
      Although no definitive diagnosis has been reached, beta blockers have been used
      with some success. Taken together, these data document a very unusual case of
      fluctuating hearing loss. The electrocochleographic and otoacoustic emission data
      suggest that the outer hair cells are functioning normally and that the loss is
      not cochlear in origin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772786
TI  - Evaluating relative speech recognition performance using the proficiency factor
      and rationalized arcsine differences.
AB  - This study evaluated two measures that have been used to compare the performance
      of particular subjects to outcomes predicted by the articulation index (Al). One
      measure was the proficiency factor, that is, the ratio between the Al derived
      from a test score and the Al derived from objective measurements of speech and
      noise spectra. The other measure was the difference between rationalized arcsine
      transforms of the observed score and the score predicted from the Al. The results
      indicated that rationalized arcsine differences are statistically superior to
      proficiency factors for comparing two sets of scores. Proficiency factors are
      best used to correct the Al, and thus an expected score, for the effects of
      subject variables that might bias the comparison. An assessment procedure that
      combines the strengths of both measures is described.

PMID- 7772787
TI  - Relative intelligibility of the revised CID W-1s as presented via MLV and auditec
      recordings.
AB  - The relative intelligibility of the revised CID W-1 spondaic word list, as
      developed and recommended for clinical use by ASHA, was evaluated in two
      experiments. In Experiment 1, the revised W-1s were presented via monitored live
      voice to 25 subjects with normal hearing. Mean minimum recognition levels for
      each of the 36 spondees varied between 16.8 and 25.2 dB SPL, a range of 8.4 dB.
      In Experiment 2, the Auditec recordings of the revised W-1s were presented to a
      different group of 20 subjects with normal hearing. Mean minimum recognition
      values for the individual spondees varied between 18.1 and 30.6 dB SPL, a range
      of 12.5 dB. Thus, the homogeneity of audibility for the revised W-1s is no better
      than has been noted in the past for the original W-1s and, in the case of the
      Auditec recording, is considerably worse. A reduced list of spondees with
      improved homogeneity of audibility is recommended for clinical use.

PMID- 7772788
TI  - Use of maximum length sequence analysis in newborn hearing testing.
AB  - The use of maximum length sequence analysis (MLSA) with rapid click rates may be
      of clinical value in newborn hearing screening because a greater number of
      individual responses can be signal averaged without adding to test time. To
      examine the potential clinical value of MLSA in newborn screening, auditory
      brainstem responses (ABRs) from 50 premature newborns were studied. ABRs were
      acquired with conventional signal averaging at four stimulus intensity levels (50
      dB, 40 dB, 30 dB, and 20 dB nHL) using a click rate of 33.3/sec. These responses
      were directly compared with the ABRs acquired with MLSA using a rate of
      227.3/sec. MLSA and conventional signal averaging yielded similar results with no
      statistically significant differences in the number of responses detected. Across
      babies, the overall quality of the tracings slightly favored MLSA, particularly
      when recording conditions were poor. Though the results of this investigation do
      not support the use of MLSA as the primary technique in newborn screening in the
      neonatal intensive care unit (NICU), they do support consideration of the use of
      MLSA as an alternative technique when the responses obtained with conventional
      signal averaging are poorly defined.

PMID- 7772789
TI  - Infant hearing screening.

PMID- 7772790
TI  - An ultrashort clock mutation at the period locus of Drosophila melanogaster that
      reveals some new features of the fly's circadian system.
AB  - A rhythm mutant of Drosophila melanogaster was induced by chemical mutagenesis
      and isolated by testing for locomotor activity rhythms, which in the new variant
      had periods of approximately 16 hr. The sex-linked mutation responsible for this
      ultrashort period causes 20-hr rhythms when heterozygous with a normal X. This
      semidominance notwithstanding, the new mutation was revealed to be an allele of
      the period (per) gene by noncomplementation with per-null variants, in the sense
      that females heterozygous for perT (as the ultrafast-clock allele is called) and
      per- exhibited periods that were much shorter than in the case of perT/+. These
      tests also revealed in a clearer manner than in previous cases that two "doses"
      of a fast-clock per mutation lead to appreciably shorter periods than those
      exhibited by one-dose females whose other per allele is a loss-of-function
      variant. In light-dark cycles (LD 12:12), flies carrying perT in a genotypic
      condition leading to free-running periods that are 8 hr faster than normal
      nevertheless entrained, by phase-shifting that large number of hours each day;
      the evening peak of locomotor activity was, however, many hours earlier than
      normal. The use of a newly developed device for monitoring Drosophila eclosion
      automatically showed that perT exhibits a very marginal emergence rhythm at 25
      degrees C, but periodicity of ca. 17-18 hr at 19 degrees. Staining of the per
      encoded protein (PER) in sections of perT versus normal pharate adults revealed
      for the first time that the immunohistochemically detected signal cycles in its
      intensity in wild-type, in a manner that is similar to the PER rhythm previously
      demonstrated in adults. The staining cycle in pharate adults expressing perT
      differed from that of wild-type. Temperature compensation of the adult activity
      rhythm of perT was found to be faulty, in that periods became appreciably shorter
      as the flies were heated. However, the mutant exhibited a normal degree of period
      lengthening when its locomotor activity was monitored in the presence of heavy
      water. The perT mutation interacted with the long-period Andante allele of the
      dusky locus in a manner that was anomalous (in comparison to dyAnd interactions
      with per+ or another short-period per mutation). This and other unique features
      of perT are discussed from the standpoint of the new mutation's heuristic value,
      including that which may stimulate a deeper understanding of the period gene's
      action at the molecular level.

PMID- 7772791
TI  - Differential photoperiodic control of seasonal variations in pulsatile
      luteinizing hormone release in long-day (ferret) and short-day (mink) mammals.
AB  - The aim of this study was to elucidate the pituitary adjustments implicated in
      photoperiodic control of reproduction in two mammalian species, the ferret and
      the mink. In the ferret, which displays renewed testicular activity when the days
      lengthen, we observed a stimulation of the pulsatile liberation of luteinizing
      hormone (LH) reflecting the pulsatile activity of the gonadotropin-releasing
      hormone (GnRH) system when daylight was equal to or in excess of LD 8:16. This
      photoperiod coincides precisely with the phase of photosensitivity known to be
      essential for gonadal stimulation in this species. In the mink, which displays
      renewed testicular activity when the days shorten, pituitary stimulation was
      activated when daylight was reduced to LD 11:13, and gonadal stimulation occurred
      only when daylight was further reduced to LD 10:14. In addition to requiring
      different photoperiodic stimuli to trigger the seasonal reproductive process, the
      two species display variations in the "timing" of pituitary control of renewed
      gonadal activity.

PMID- 7772793
TI  - Inhibition of GABA transaminase enhances light-induced circadian phase delays but
      not advances.
AB  - The CNS neurotransmitter GABA is distributed extensively throughout the
      suprachiasmatic nucleus, the site of circadian pacemaker cells in mammals.
      Pharmacological agents that act at GABAA receptors alter specific circadian
      responses to light and may induce phase shifts of circadian rhythms. In the
      present study, the role of endogenously released GABA in rhythm regulation was
      investigated using vigabatrin (gamma-vinyl GABA), an agent that has been shown to
      increase chronically or acutely the CNS levels of this neurotransmitter by
      inhibiting GABA transaminase. In Experiment 1, hamsters in constant darkness (DD)
      received a saline or a vigabatrin injection 1 hr before a 15-min, 700-lux light
      pulse. Vigabatrin increased photic phase delays but did not affect advances. In
      Experiment 2, vigabatrin delivered chronically via osmotic minipump treatment did
      not affect locomotor activity period in DD. However, after 14 days of infusion,
      photic phase delays (but not advances) were greatly increased in the vigabatrin
      group. In Experiment 3, in constant light (LL), chronic vigabatrin-treated
      animals showed an increased period that returned to pretreatment values after the
      14-day drug infusion. The results are consistent with the phase-dependent effects
      of other agents that alter GABA neurotransmission. The data support the general
      hypothesis that GABA modulates the circadian responses to light in a phase
      dependent manner, and may participate in entrainment to light-dark cycles by
      influencing the relative responsiveness to light in the early and late subjective
      night.

PMID- 7772792
TI  - Photoperiodic effects on tumor development and immune function.
AB  - Seasonal changes in adaptations associated with winter coping strategies have
      been frequently studied. Central among the suite of energy-saving, winter-coping
      strategies is the suspension of reproductive activities. The inhibition of
      reproduction by nontropical rodents is mediated by daylength changes. Although
      balanced annual energy budgets are critical, survival and subsequent reproductive
      success also require avoiding predators, illness, and early death. Because the
      stressors of winter could lead to suppressed immune function, we hypothesized
      that animals should have evolved survival strategies involving immunoenhancement.
      Short daylengths provide a predictive cue to individuals that could be used to
      enhance immune function in advance of stress-induced immunosuppression. In
      Experiment 1, adult female deer mice (Peromyscus maniculatus) were housed in
      either long (LD 16:8) or short (LD 8:16) days for 8 weeks, then injected with the
      chemical carcinogen 9,10-dimethyl-1,2-benzanthracene (DMBA) dissolved in dimethyl
      sulfoxide (DMSO) or with the DMSO vehicle alone. Animals were evaluated weekly
      for 8 weeks after injection. None of the animals treated with DMSO developed
      tumors in any of the experiments. Nearly 90% of the long-day deer mice injected
      with DMBA developed squamous cell carcinoma. None of the short-day deer mice
      injected with DMBA developed tumors. Small lesions developed at the site of
      injection; short-day females had less severe lesions and healed faster than long
      day females. Immunoglobulin G (IgG) response to i.p. injection of sheep red blood
      cells (SRBC) did not differ photoperiodic conditions. The role of estrogens in
      the photoperiodic responses was evaluated in Experiment 2: Ovariectomized or sham
      ovariectomized deer mice received estradiol benzoate replacement therapy or a
      control procedure in long daylengths for 8 weeks prior to injection of DMBA or
      DMSO, then were monitored for 8 additional weeks. Females treated with DMBA
      developed tumors at the same rate, regardless of estrogen manipulation. Estrogen
      did not affect healing rates. In Experiment 3, female deer mice were injected
      with a slurry of microspheres that either contained bromocriptine or were empty.
      Suppression of prolactin with bromocriptine resulted in a decrease of tumor
      incidence from 55.6% to 24% in long-day females 8 weeks after injection with
      DMBA. Healing rates were not affected by prolactin manipulations. Silastic
      capsules that were filled with either melatonin or cholesterol were implanted
      into long-day female deer mice in Experiment 4; 8 weeks later, females received
      an injection of either DMBA or DMSO, then were monitored for 8 weeks.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 7772794
TI  - Different phase responses of the two circadian oscillators in Gonyaulax.
AB  - Two circadian oscillators have been previously shown to exist in the unicellular
      alga Gonyaulax polyedra by virtue of different periods for two different rhythms,
      which occur under certain experimental conditions. Here we show that phase shifts
      in response to light pulses also differ for these two rhythms. The phase response
      curves (PRCs) for white or blue light pulses are similar in shape and amplitude,
      but are somewhat displaced in time and have a slightly larger delay portion for
      the aggregation rhythm, corresponding to the A oscillator. In contrast, the
      aggregation rhythm PRC for dark pulses in a red light background has a much
      larger amplitude than that for the bioluminescence rhythm (B oscillator). These
      results suggest that the light input mechanism of the B oscillator is mainly blue
      sensitive, whereas that of the A oscillator is sensitive to both red and blue
      light. This is supported by entrainment experiments: Dark pulses given as a
      skeleton 24-hr scotoperiod in a blue light background act as a strong zeitgeber
      for both oscillators. But if red light is used as background, there is
      bistability in the entrainment of the B oscillator, whereas the A oscillator is
      entrained to a definitive phase angle, regardless of the cells' prior phase of
      entrainment. Finally, the two oscillators can be differentially entrained with 22
      hr T cycles using 3-hr dark pulses interrupting red light (19 hr), whereas both
      oscillators are entrained when the dark pulses interrupt blue light.

PMID- 7772795
TI  - Deriving a "phase response curve" from adjustment to simulated time zone
      transitions.
AB  - Thirty-eight subjects in groups of two to four have been subjected to simulated
      time zone transitions of 8 hr eastward, 8 hr westward, or 12 hr; all experiments
      have taken place in a temporal isolation unit, in which the light intensity
      during the waking periods was 250-300 lux. Circadian rhythms of rectal
      temperature have been used as a marker of the process of adjustment, the data
      being analyzed before (raw) and after "purification." Conventional results have
      been obtained, but when the data have been treated appropriately, they have
      produced a relationship between shift of the sleep-activity cycle and shift of
      the temperature rhythms that shows many characteristics of a phase response
      curve. Even though the factor or factors causing such adjustment are unknown, the
      results confirm that changes of a consonant set of "weak" zeitgebers is
      sufficient for entrainment to a new time zone to occur.

PMID- 7772796
TI  - Twenty-four-hour rhythms in relation to the natural photoperiod: a field study in
      humans.
AB  - The daily rhythms of salivary melatonin, salivary cortisol, and axillary body
      temperature were measured in nine healthy volunteers in midsummer, around the
      autumn equinox, and in midwinter, at a latitude of 60 degrees N. The aim was to
      find out whether these rhythms were dependent on variations of the natural
      daylength. The samples were collected every 2 hr during 24-hr periods in everyday
      conditions. The individual rhythms were characterized with the acrophase
      estimates of the best-fitting cosine curve models and with the half-rise and half
      decline times calculated from the raw data. The melatonin and cortisol rhythms
      were delayed significantly (about 1 hr) in midwinter as compared with summer and
      autumn. The most advanced rhythms were found in autumn. The shifts of the
      melatonin and cortisol rhythms could be explained as a result of the changes of
      natural illumination. The overt temperature rhythms did not differ significantly
      among the sampling months. The lack of seasonal patterns in temperature rhythms
      probably primarily reflected the socially determined rest-activity cycles of the
      subjects.

PMID- 7772797
TI  - Phase-amplitude resetting of the human circadian pacemaker via bright light: a
      further analysis.
AB  - We present here an analysis of strong, weak, and critical bright-light resetting
      trials in humans, and report not only phase but also amplitude data for the first
      time. For this analysis, an appropriate iterative smoothing procedure for phase
      transition curves is introduced, in which the data are sequenced so as to
      minimize the perpendicular distance from the data to the smoothed fit. From these
      smoothed data, we create polar phase-amplitude resetting maps (PARMs) in order to
      fully illustrate the effects of the resetting stimuli on both circadian amplitude
      and phase, and thereby to determine whether these resetting results can be
      described by a phase-only model or whether a phase-amplitude model is required.
      Our results indicate that a single 5-hr episode of bright light induces weak type
      1 resetting of the human circadian pacemaker. Two cycles of exposure to the same
      stimulus on consecutive days induce critical resetting, in which significant
      amplitude reduction may be observed. A three-cycle stimulus induces strong type 0
      resetting with different effects on circadian amplitude, depending on the initial
      phase of the stimulus application. When a three-cycle stimulus is centered near
      the nadir of the temperature cycle, large phase shifts are achieved via amplitude
      suppression. However, when this stimulus is centered away from the temperature
      nadir, smaller phase shifts are achieved in which both small increases and small
      decreases in circadian amplitude are observed. These data indicate that the human
      circadian pacemaker is not a simple, phase-only oscillator. Instead, a full
      description of human circadian resetting responses to light requires analysis of
      both phase and amplitude data--a finding that is consistent with a phase
      amplitude model of the circadian resetting mechanism.

PMID- 7772798
TI  - Sensitivity of the human circadian pacemaker to moderately bright light.
AB  - The aim of the present study was to evaluate the sensitivity of the human
      circadian pacemaker to the resetting effect of moderately bright light
      (approximately 1260 lux), and to assess the direct effect of such light exposure
      by comparison to a control group of subjects undergoing the same behavioral
      manipulations but with a similarly timed exposure to darkness instead of light.
      Endogenous circadian phase and amplitude were assessed in dim light
      (approximately 10-15 lux) before and after two consecutive series of three 5-hr
      exposures to approximately 1260 lux or to darkness (approximately 0.03 lux) in
      two different groups of young healthy men, using the constant-routine technique.
      The light or darkness exposure was centered 1.5 hr after the initial fitted
      endogenous temperature minimum and 12 hr opposite the newly scheduled midpoint of
      the sleep episode, in order to induce a phase advance in the light-exposed
      subjects. The phase of the endogenous circadian pacemaker was assessed by a dual
      harmonic regression model from core body temperature recorded every minute during
      constant routines. Urinary volume was measured at each micturition, subjective
      alertness every 20 min, and cognitive performance hourly. The endogenous
      circadian phase shifted to a significantly earlier time after each series of
      light exposures in the treatment group than it did in the control group (two-way
      analysis of variance for repeated measures: F = 67.91, p = 0.0001). The analysis
      of circadian curves of urine production, subjective alertness, and cognitive
      performance scores revealed that all variables maintained stable temporal
      relationships with the endogenous circadian temperature minimum--an indication
      that these rhythms shifted in the same direction and by an equivalent amount.
      Despite comparable behavioral schedules, including the timing of bedrest/sleep
      and social contacts, circadian temperature rhythm of control subjects free-ran
      under dim light conditions, indicating that moderately bright light exerted a
      direct biological effect on the human circadian pacemaker in the treatment group.
      The present study also demonstrated that light of approximately 1260 lux (which
      is of substantially lower intensity that the approximately 7000-12,000 lux used
      in prior experiments) produces robust phase advances of the endogenous circadian
      temperature rhythm, which has been shown to be an accurate marker of the output
      of the circadian pacemaker (Czeisler et al., 1989). These results support the
      hypothesis that the phase-shifting effect of light on the human circadian
      pacemaker has a strongly nonlinear relationship to illuminance levels, such that
      it is preserved despite marked reductions in light intensity.

PMID- 7772799
TI  - The nodS gene of Rhizobium tropici strain CIAT899 is necessary for nodulation on
      Phaseolus vulgaris and on Leucaena leucocephala.
AB  - Rhizobium tropici strain CIAT899 induces nitrogen-fixing nodules on the roots of
      a wide range of tropical legumes, including Phaseolus vulgaris and Leucaena
      leucocephala. Previously, a DNA region of the CIAT899 pSym plasmid containing the
      common nodulation genes nodABC and one of the nodD alleles was characterized (P.
      van Rhijn, B. Feys, C. Verreth, and J. Vanderleyden, J. Bacteriol. 175: 438-447,
      1993). As reported here, the region immediately downstream of nodC contains the
      nodSU genes. The nucleotide sequence of these genes is presented. CIAT899 nodS
      and nodU mutants were constructed. The nodS mutant was completely deficient in
      nodulation on the host plants P. vulgaris and L. leucocephala. The nodU mutation
      caused a decrease in nodulation on Leucaena but resorted no effect on Phaseolus.
      Introduction of the CIAT899 nodABCSU region in R. etli CE-3, a strain that only
      nodulates P. vulgaris, caused an extension of the host range of strain CE-3 to L.
      leucocephala.

PMID- 7772800
TI  - Virus-induced gene expression for enzymes of ethylene biosynthesis in
      hypersensitively reacting tobacco.
AB  - A full-length cDNA clone (cEFE-26) encoding ethylene-forming enzyme (EFE) was
      isolated from a cDNA library, prepared from leaves of tobacco mosaic virus (TMV)
      infected tobacco cultivar Samsun NN. The cDNA clone encodes a protein with 90%
      amino acid sequence similarity to established EFEs of tomato and other plants. By
      using cEFE-26 cDNA and the insert from cDNA clone pACC13 (B. A. Bailey, A. Avni,
      N. Li, A. K. Mattoo, and J. D. Anderson, Plant Physiol. 100:1615-1616, 1992)
      encoding tobacco 1-aminocyclopropane-1-carboxylic acid synthase as probes, it was
      established that tobacco contains small gene families for these proteins.
      Furthermore, RNA blot analyses indicated that transcript levels in leaves for the
      two ethylene pathway genes were elevated after infection with TMV. The results
      are discussed in relation to a possible signalling role of ethylene in induced
      resistance and gene expression for pathogenesis-related proteins.

PMID- 7772801
TI  - Mutational analysis of the coat protein gene of brome mosaic virus: effects on
      replication and movement in barley and in Chenopodium hybridum.
AB  - The coat protein (CP) open reading frame (ORF) of brome mosaic virus (BMV) has
      been mutated to study host-related CP functions in barley, a systemic host, and
      in Chenopodium hybridum L. which supports both local lesion formation and
      systemic spread of BMV. To test the role of the N-terminal region of CP, mutants
      C1 to C3, which synthesized the CP lacking first seven amino acids, and mutant
      D1, which had Trp 22 and Thr 23 replaced with Phe-Gly-Ser, were generated. C1 to
      C3 inhibited virus systemic spread in C. hybridum but not in barley while D1 only
      reduced virus accumulation in noninoculated leaves of C. hybridum. More internal
      CP regions were tested by mutation of Lys 63 to Leu (mutant SP3) and Lys 129 to
      Arg (mutant SP1). SP1 behaved similarly to C1 to C3 while SP3 similarly to D1. In
      addition, SP3 reduced concentrations of RNA3 and RNA4 in both hosts. Apparently,
      various CP regions differentially affect, either directly or indirectly, virus
      translocation in different hosts, suggesting both the CP and host factors to be
      important for virus spread. Larger deletions in the CP ORF (mutants BB4 and SX1)
      or a decrease of CP production by using a frameshift mutant C, inhibited virus
      systemic spread in both hosts, and delayed the appearance of smaller local
      lesions on C. hybridum. Thus, the CP is not required for cell-to-cell movement
      but is required for systemic translocation of BMV.

PMID- 7772802
TI  - Purification and immunological characterization of toxic components from cultures
      of Pyrenophora tritici-repentis.
AB  - To facilitate the genetic analysis of pathogenicity in the wheat-Pyrenophora
      tritici-repentis interaction, a host-selective toxic protein, designated ToxA,
      was purified from culture filtrates of this fungus. ToxA was shown to be a 13.2
      kDa heat-stable protein which induced visible necrosis in sensitive wheat
      cultivars at an average minimum concentration of 60 nM. Polyclonal antibodies
      raised against ToxA were shown by Western analysis and indirect
      immunoprecipitation to be specific for this protein. Bioassays of
      immunoprecipitated protein and ToxA protein eluted from polyacrylamide gels
      indicated that ToxA protein is the toxic agent. Other less abundant necrosis
      inducing components that are chromatographically and immunologically distinct
      from ToxA were also detected in culture filtrates of P. tritici-repentis. These
      components were found in cationic and anionic protein fractions and, like ToxA,
      induced cultivar-specific necrosis.

PMID- 7772803
TI  - Characterization of avrE from Pseudomonas syringae pv. tomato: a hrp-linked
      avirulence locus consisting of at least two transcriptional units.
AB  - Cosmid clone pPT10E9 from Pseudomonas syringae pv. tomato caused P. s pv.
      glycinea to elicit the HR on leaves of all tested soybean cultivars. The
      avirulence function of pPT10E9, called avrE, occurred on an 11.3-kb DNA fragment
      located immediately adjacent to the P. s. pv. tomato hrp gene cluster. Tn3-gus
      saturation mutagenesis of the avrE locus and adjacent DNA revealed at least four
      transcriptional units occurring immediately adjacent to the hrpRS locus that were
      all regulated in a manner similar to hrp genes (induced only in minimal induction
      media or in planta and required the hrpL and hrpRS loci for expression).
      Transcriptional units III and IV, but not II or V, were required for avrE
      function. P. s. pv. tomato DC3000 carrying mutations in each of the four
      transcripts retained full virulence on tomato leaves and elicited the HR on
      tobacco and soybean plants. This was unlike strain PT23, where mutation of avrE
      greatly decreased virulence on tomato leaves. The promoter regions for three of
      the investigated transcriptional units contained a consensus sequence occurring
      in the promoter regions of several other P. syringae avirulence and hrp genes.
      The promoter region of transcriptional unit IV, required for avrE function, did
      not contain such a sequence, but included an element which may function as a
      sigma-54 promoter. Introduction of the cloned P. s. pv. tomato avrE locus into
      five other P. syringae pathovars did not cause them to elicit the HR on their
      normal host plants.

PMID- 7772804
TI  - Transgenic tobacco plants expressing a truncated form of the PAMV capsid protein
      (CP) gene show CP-mediated resistance to potato aucuba mosaic virus.
AB  - Four constructs of the potato aucuba mosaic virus (PAMV) coat protein (CP) gene
      were engineered for expression in tobacco plants: The full-length CP sequence (FL
      CP), two truncated forms--one at the N terminus (46 amino acid residues are
      deleted) (NT138), one in the conserved core portion (86 amino acids deleted)
      (CT258) of the gene--and an antisense RNA construct. These constructs were
      introduced into tobacco plants (Nicotiana tabacum) via Agrobacterium tumefaciens
      mediated transformation. The plants transformed with the NT138 and FL CP
      constructs produced the mRNAs and proteins from the respective transgene.
      Transformants with the CT258 construct produced the transgenic mRNA, but the
      modified CP was not detected in the 20 different transformants tested. Transgenic
      R0 and R1 tobacco plants expressing the full-length, CT258, and the antisense
      constructs exhibited protection to PAMV infection and a delay in symptom
      development when inoculated with 0.1 and 0.5 microgram/ml of purified PAMV.
      Transgenic plants expressing the NT138 construct did not confer any detectable
      protection to PAMV infection. These results suggest that an engineered coat
      protein mediated resistance (CPMR) can be obtained from a CP gene truncated in
      its core region. The role of the N-terminal domain of the CP in the CPMR of PAMV
      and the implication of either the RNA or the protein in the protection is
      discussed.

PMID- 7772805
TI  - Antimicrobial peptides.

PMID- 7772806
TI  - Resistance to tospoviruses in Nicotiana benthamiana transformed with the N gene
      of tomato spotted wilt virus: correlation between transgene expression and
      protection in primary transformants.
AB  - Nicotiana benthamiana was transformed with the nucleoprotein (N) gene of an
      Italian isolate of tomato spotted wilt virus (TSWV). Forty-five T1 primary
      transformant lines were analyzed for the expression of N protein and for
      resistance to TSWV and three other tospoviruses: impatiens necrotic spot virus
      (INSV), groundnut bud necrosis virus (GBNV), and groundnut ringspot virus (GRSV).
      Thirteen of these lines were further characterized. Resistance to all TSWV
      isolates tested was found in two lines. The expression of the transgene (N mRNA)
      was lower in these resistant lines than in any of the susceptible lines, and the
      transgene N protein was either absent or present below detectable levels. These
      lines were susceptible to the other tospoviruses tested, but they developed
      symptoms milder than controls when inoculated with GRSV. Some of the lines
      producing high levels of N protein showed delays (of 2-3 weeks) in symptom
      expression with at least one of the TSWV isolates tested and symptom delay or
      attenuation with INSV or GRSV (or both). From our results it appears that high
      expression of TSWV N protein retards, in some cases, disease development by TSWV
      and INSV. In contrast, the lack of detectable expression of the transgenic N
      protein, accompanied by limited production of N transcripts, conferred TSWV
      specific resistance.

PMID- 7772807
TI  - Broad resistance to tospoviruses in transgenic tobacco plants expressing three
      tospoviral nucleoprotein gene sequences.
AB  - Transgenic tobacco plants have been obtained expressing nucleoprotein (N) gene
      sequences of three different tospoviruses known to affect vegetable crops: tomato
      spotted wilt virus (TSWV), tomato chlorotic spot virus (TCSV), and groundnut
      ringspot virus (GRSV). The chimeric plant transformation vector used comprised
      the three viral N gene sequences, each with a copy of the CaMV 35S promoter and
      the nos terminator. Despite the high levels of homology between the different N
      gene sequences (74-82%) and the presence of repeated promoter and terminator
      sequences in this construct, unrearranged copies of this triple N gene construct
      were stably maintained in both Escherichia coli and Agrobacterium tumefaciens
      plasmids used during the cloning process, as well as in several generations of
      transgenic tobacco plants. A transgenic tobacco line was obtained that exhibited
      high levels of resistance to all three tospoviruses, showing the possibility of
      producing transgenic plants with a broad resistance to tospoviruses by
      introducing tandemly cloned viral N gene sequences. DNA analysis of this
      transgenic plant line shows that the multivirus resistance trait is confined to a
      single genetic locus, which is very convenient for further breeding purposes.

PMID- 7772808
TI  - Nucleotide sequence of a pectate lyase structural gene, pel1 of Erwinia
      carotovora subsp. carotovora strain 71 and structural relationship of pel1 with
      other pel genes of Erwinia species.
AB  - Of the various exoproteins secreted by Erwinia carotovora subsp. carotovora
      strain 71, Pel1 is the major pectate lyase species with tissue macerating
      activity. Nucleotide sequencing of a 2.2-kb pel1+ DNA segment revealed a 1,122
      base pair open reading frame which could encode pre-Pel1 of 374 amino acid
      residues. A signal peptide of 22 amino acid residues is present within the NH2
      terminal region of pre-Pel1. Transcription of pel1 was initiated at the guanine
      residue 111 base pairs upstream of the start codon. Consensus sequences for the
      binding of KdgR, a negative regulatory factor known to control some of the E.
      chrysanthemi pectinases, flank the promoter of pel1. Although pel1 belongs to the
      pelBC family, it is more closely related to the pel genes of E. carotovora than
      to the pelBC genes of E. chrysanthemi.

PMID- 7772809
TI  - Imaging and intervention in abdominal emergencies.
AB  - While plain abdominal radiographs retain an essential place in acute abdominal
      emergencies, the dramatic advances in ultrasound, computed tomography and
      magnetic resonance imaging witnessed over the past two decades have
      revolutionized the practice of emergency medicine. Cross-sectional imaging
      techniques now play a key role in evaluating patients with abdominal emergencies,
      and allow confident diagnoses to be made in an ever increasing proportion of
      these patients. Unnecessary laparotomies are now uncommon, and a wide array of
      interventional radiological techniques can be used to treat abdominal emergencies
      without surgery.

PMID- 7772810
TI  - 3-D reconstruction of hepatic neoplasms: a preoperative planning procedure.
AB  - Three-dimensional display of intrahepatic vascular structures, tumour(s) and
      liver surface offers the possibility of perceiving the complex individual anatomy
      in a coherent fashion. Since this presentation of anatomical structures can be
      varied at will, the resulting interactive dynamic display of the 3-D data sets
      can be considered an example of Virtual Reality; the surgeon experiences the
      interactive 3-D display as a realistic presentation of the patient's surgical
      anatomy. Three-dimensional display offers the possibility of planning a specific
      resection in detail, tailored to the individual anatomy. The benefits and
      problems of various surgical approaches can be worked out in detail, and
      potential hazardous phases in the operation can be anticipated, thus minimizing
      unexpected complications. However, because the generation of detailed 3-D
      renderings takes considerable time investment by an experienced operator it is
      important to select patients, in whom such an effort is warranted. In our
      experience, 3-D display of the liver is most likely to be of benefit in the
      presence of central tumours, or if segmental resections are considered.

PMID- 7772811
TI  - Cross-sectional imaging of the pancreas.
AB  - CT is the primary modality for the evaluation of patients with pancreatic
      disease. A number of pitfalls can occur in interpretation of the scans, but most
      can be avoided by using state-of-the-art scanners and dynamic contrast
      enhancement techniques and by recognizing normal anatomic variants. However, in
      other cases, CT may show only nonspecific findings and a correct diagnosis can be
      reached only by utilization of additional imaging techniques or guided FNAB.

PMID- 7772812
TI  - Current applicability of duplex Doppler ultrasonography in pancreatic head and
      biliary malignancies.
AB  - In most patients with a pancreatic head carcinoma or a cholangiocarcinoma of the
      liver (Klatskin tumour) US is the first imaging modality. Tumour detection using
      US can exceed that of CT. For small tumours, endosonography or ERCP is
      recommended. Enlarged lymph nodes are not a major diagnostic parameter, because a
      reliable differentiation between reactive and malignant lymph nodes is generally
      not possible. Very tiny liver and peritoneal metastases are missed by the current
      imaging modalities including US and only detectable by laparoscopy and/or
      laparoscopic US. Tumour involvement of the portal venous system is an important
      determinant for irresectability which can often be assessed by duplex Doppler US
      obviating invasive or expensive imaging modalities. In pancreatic head carcinoma
      an abnormal pulsed Doppler signal is highly suspicious for involvement of the
      portal venous system. However, a normal pulsed Doppler signal does not exclude
      involvement at all. In Klatskin tumour, Doppler US had an accuracy of 91%
      compared with surgical findings in predicting portal venous involvement. In most
      cases of pancreatic head carcinoma or Klatskin tumour, US can assess
      irresectability. However, assessment of curative resectability in these tumours
      remains a problem.

PMID- 7772813
TI  - Imaging and intervention in patients with acute right upper quadrant disease.
AB  - Because of the high diagnostic yield, its widespread availability and the
      possibility of bedside examinations, US has become the imaging modality of choice
      in patients with acute right upper quadrant pain caused by inflammatory disorders
      such as liver abscesses, acute cholangitis and acute cholecystitis. Computed
      tomography (CT) can be reserved for more complex cases. US, often in combination
      with fluoroscopy, is also widely used to control interventions. In patients with
      liver abscesses the therapeutic strategy is determined by the size of the
      abscess, its uni- or multifocal presentation and the causative micro-organisms
      cultured after diagnostic percutaneous aspiration. Small-sized pyogenic abscesses
      (< 3 cm), most fungal and amoebic abscesses can be treated medically. Large-sized
      pyogenic abscesses should be drained percutaneously and can be cured in 75-90%.
      Surgery should be restricted to patients with prolonged sepsis after percutaneous
      drainage and patients with infected pre-existing hepatic lesions. In patients
      with acute cholangitis drainage of the infected bile is essential. Invasive
      imaging such as percutaneous or endoscopic cholangiography procedures such as
      nasobiliary drainage, stent placement and sphincterotomy has decreased mortality
      rates dramatically. Percutaneous drainage should be considered in patients in
      whom endoscopic procedures fail. Surgery may have a place in the treatment of
      bile duct obstruction which causes cholangitis. In patients with suspected acute
      cholecystitis, imaging modalities such as cholescintigraphy and CT can be
      reserved for patients with inconclusive sonographic studies and more complex
      cases. The contribution of percutaneous gallbladder aspiration and culture to
      diagnose acute cholecystitis seems limited. Percutaneous cholecystostomy is an
      effective procedure with a low morbidity and mortality for high-risk patients.
      The drainage catheter in the gallbladder does not interfere with cholecystectomy
      at a later stage in patients with calculous cholecystitis. In most patients with
      acalculous cholecystitis, percutaneous cholecystectomy provides a definitive
      treatment.

PMID- 7772814
TI  - Imaging and intervention in patients with acute right lower quadrant disease.
AB  - US using graded compression plays a central role in the diagnostic work-up of
      acute right lower quadrant disease, but its results should always be integrated
      with clinical data and results of other possible radiological examinations.
      Direct US visualization of an inflamed appendix is solid proof of appendicitis.
      Pitfalls are secondary enlargement in perforated peptic ulcer, caecal carcinoma
      or Crohn's disease. If a normal appendix is visualized in its full length,
      appendicitis can be excluded. However, this is rarely the case. In practice, the
      only means to exclude appendicitis is to demonstrate an alternative condition,
      which in most cases is possible by US alone. Concomitant adynamic ileus is a
      valuable US finding. Abscesses related to appendicitis, Crohn's disease and
      colonic carcinoma respond well to percutaneous drainage, which is technically
      possible in 95% of cases. Some of these abscesses evacuate spontaneously to
      neighbouring bowel. For abscesses due to caecal diverticulitis spontaneous
      evacuation to the caecal lumen is the rule. For indication and drainage strategy,
      integration of US, CT and clinical data are indispensable. The use of US in right
      lower quadrant disease will not only lead to a strong improvement of diagnostic
      accuracy, but also to better understanding of the incidence and natural course of
      various conditions such as abortive appendicitis, appendiceal abscess, caecal
      diverticulitis, bacterial ileocaecitis and right-sided segmental infarction of
      the omentum.

PMID- 7772815
TI  - Radiological intervention in upper and lower gastrointestinal bleeding.
AB  - The role of angiography in acute upper GI tract bleeding is less a diagnostic
      than a therapeutic one because it provides a guide to selective embolization of
      either the left gastric artery, or the gastroduodenal artery and its two
      principal branches, the pancreaticoduodenal and the right gastroepiploic artery.
      Angiographic catheter techniques may also provide substantial diagnostic and
      therapeutic support for the management of acute lower GI bleeding from a variety
      of bleeding sources. The advantages are minimal invasion and relatively low risk.
      The intermittent nature of GI bleeding often interferes with the ability of
      angiography to demonstrate the source of bleeding. However, at times angiographic
      techniques provide the only reasonable means of localizing and controlling
      bleeding.

PMID- 7772816
TI  - Current applicability of scintigraphic methods in gastroenterology.
AB  - Patients are often referred for evaluation of a wide range of GI complaints
      including dysphagia, abdominal pain, bloating, nausea, constipation or diarrhoea.
      Many are diagnosed with 'functional' disease when endoscopy or conventional
      radiological studies fail to identify an anatomic cause for the patient's
      symptoms. In such cases nuclear medicine offers non-invasive methods for
      objectively demonstrating disease involving different areas of the
      gastrointestinal tract. Increasingly scintigraphy is playing a primary role in
      the evaluation of patients with suspected acute cholecystitis, active
      gastrointestinal bleeding, gastroparesis, and small and large bowel motility
      disorders. In addition, it supplements other studies when results are
      inconclusive in diagnosing oesophageal dysmotility, gastro-oesophageal reflux,
      acalculous cholecystitis, and postoperative complications of gastrointestinal
      surgery.

PMID- 7772817
TI  - Cross-sectional imaging of the liver.
AB  - The liver can be affected by a number of conditions that can involve the liver
      focally or diffusely. CT and MRI are reliable techniques for demonstrating these
      abnormalities, and both imaging tools play an important role in the clinical
      evaluation of the patients. However, each technique provides different
      information, and the most appropriate cross-sectional technique used should be
      tailored in each instance to the individual patient situation.

PMID- 7772818
TI  - Antitumor active fucoidan from the brown seaweed, umitoranoo (Sargassum
      thunbergii).
AB  - Neutral and acidic polysaccharides and their protein complexes were fractionated
      and purified from the brown seaweed umitoranoo (Sargassum thunbergii) by
      fractional extraction, iron-exchange chromatography, and gel filtration. Thirty
      one polysaccharide fractions were obtained and tested for antitumor activity in
      mice with Ehrlich carcinoma transplanted i.p. Two of the fractions, GIV-A
      ([alpha]25D -127 degrees and mol. wt., 19,000) and GIV-B ([alpha]25D -110 degrees
      and mol. wt., 13,500) had such activity. On the basis of chemical and spectral
      analyses, these compounds were found to be a fucoidan or L-fucan containing
      approx. 30% sulfate ester groups per fucose residue, about 10% uronic acid, and
      less than 2% protein.

PMID- 7772819
TI  - Antitumor-active heteroglycans from niohshimeji mushroom, Tricholoma giganteum.
AB  - Water-soluble polysaccharide FI and water-insoluble polysaccharides FII, FIII-1,
      and FIII-2 were obtained from fruiting bodies of Tricholoma giganteum.
      Polysaccharides were further fractionated by ion-exchange chromatography, gel
      filtration, and affinity chromatography. The 24 polysaccharide fractions obtained
      were examined for their antitumor effect on Sarcoma 180 implanted in mice. The
      following antitumor-active polysaccharides were identified: FIo-a, a mixture of
      alpha-D-glucan and xyloglucomannan with an average molecular weight of 1.6 x
      10(6); FA-1, a beta-D-glucan containing 1% protein and with a molecular weight of
      4.0 x 10(4); FII-1, a (1-->3)-beta-D-glucan containing 7.8% protein, with a
      molecular weight of 5.2 x 10(4); FIII-1-b, a protein-polysaccharide complex
      (ratio, 37.5:62.5, w/w), with a molecular weight of 6.8 x 10(4) and with xylose,
      galactose, mannose, and glucose in the polysaccharide moiety (proportions of
      8.9:14.9:29.3:46.9 by weight), and FIII-2-a, b, and c, three (1-->6)-beta-D
      glucosyl-branched (1-->3)-beta-D-glucans with a molecular weight from 2.6 x 10(5)
      to 4.1 x 10(5) and containing small amounts of xylose and galactose and 3.5-8.3%
      protein.

PMID- 7772820
TI  - Oxidation of ethylene glycol and glycolic acid by glycerol oxidase.
AB  - A glycerol oxidase from Aspergillus japonicus oxidized ethylene glycol to glyoxal
      by the same reaction pathway as alcohol oxidases from methanol yeast. The optimum
      pH and temperature for the oxidation of ethylene glycol were around 7.0 and 40
      degrees C, respectively. Those of glycolaldehyde were similar to those of
      ethylene glycol. The apparent Kms for ethylene glycol and glycolaldehyde were 195
      and 48.8 mM, respectively. The maximum velocities for ethylene glycol and
      glycolaldehyde were 89.1 and 62.2 mumol/min/mg of protein, respectively. Glycerol
      oxidase also oxidized glycolic acid, which is not oxidized by the alcohol
      oxidases, to glyoxylic acid like glycolate oxidases from green plants, and the
      apparent Km and Vmax for glycolic acid were 114 mM and 2.68 mumol/min/mg of
      protein, respectively. The glycerol oxidase was applicable to the production of
      glyoxal and glyoxylic acid.

PMID- 7772821
TI  - Nucleotide sequence analysis of the carbomycin biosynthetic genes including the 3
      O-acyltransferase gene from Streptomyces thermotolerans.
AB  - A 3.2-kb DNA fragment of the carbomycin biosynthetic region including the 3-O
      acyltransferase gene (acyA) from Streptomyces thermotolerans was sequenced, and
      four ORFs were found in the fragment. The second ORF, designated ORF-A, was
      transcribed in the opposite direction to the other three ORFs. The first ORF was
      identified as carA, a gene for carbomycin resistance. The amino acid sequence of
      ORF-A was homologous to proteins of the cytochrome P-450 family. Streptomyces
      lividans transformed with pCB20, in which ORF-A was subcloned, epoxidized
      carbomycin B at its C-12, 13 positions, thus producing carbomycin A. The third
      ORF, the amino acid sequence of which showed a homology to macrolide antibiotics
      O-acyltransferases was identified as acyA. The last ORF (ORF-B), which starts
      just 3 bp downstream from the TGA termination codon of acyA, was thought to be a
      carbomycin 4-O-methyltransferase gene, because the amino acid sequence deduced
      from ORF-B showed high homology to a putative midecamycin 4-O-methyltransferase
      encoded on mdmC.

PMID- 7772822
TI  - Efficient production and purification of extracellular 1,2-alpha-L-fucosidase of
      Bacillus sp. K40T.
AB  - When Bacillus sp. K40T was cultured in the presence of L-fucose, 1,2-alpha-L
      fucosidase was found to be produced specifically in the culture fluid. The enzyme
      was purified to homogeneity from a culture containing only L-fucose by
      chromatography on hydroxylapatite and chromatofocusing. The molecular weight of
      the enzyme was estimated to be 200,000 by gel filtration on Sephadex G-200. The
      enzyme was optimal at pH 5.5-7.0 and was stable at pH 6.0-9.0. The enzyme
      hydrolyzed the alpha-(1-->2)- L-fucosidic linkages in various oligosaccharides
      and glycoproteins such as lacto-N-fucopentaose (LNF)-I <O-alpha-L-fucose-(1-->2)
      O-beta-D-galactose-(1-->3)-N-acetyl-O-beta-D- glucosamine-(1-->3)-O-beta-D
      galactose-(1-->4)-D-glucose>, porcine gastric mucin, and porcine submaxillary
      mucin. The enzyme also acted on human erythrocytes, which was confirmed by the
      hemagglutination test using Ulex anti-H lectin. The enzyme did not hydrolyze
      alpha-(1-->3)-, alpha-(1-->4)- and alpha-(1-->6)-L-fucosidic linkages in LNF-III
      <O-beta-D-galactose-(1-->4)[O- alpha-L-fucose-(1-->3)-]-N-acetyl-O-beta-D
      glucosamine-(1-->3)-O-beta-D- galactose-(1-->4)-D-glucose>, LNF-II <O-beta-D
      galactose-(1-->3)[O-alpha-L- fucose-(1-->4)-]-N-acetyl-O-beta-D-glucosamine-(1-
      >3)-O-beta-D- galactose-(1-->4)-D-glucose> or 6-O-alpha-L-fucopyranosyl-N
      acetylglucosamine.

PMID- 7772824
TI  - Inhibitory activity of 8-azadecalin derivatives towards 2,3
      oxidosqualene:lanosterol cyclases from baker's yeast and pig's liver.
AB  - The inhibitors of 2,3-oxidosqualene:lanosterol cyclase were investigated by
      comparative studies between pig's liver and Baker's yeast. The fundamental
      skeleton of the inhibitors was 8-azadecalin. To the nitrogen atom, an isoprenoid
      like chain [nerylacetone (Z-form), geranylacetone (E-form) or its hydrogenated
      form] was attached by the reaction of reductive amination with NaCNBH3. Among the
      three forms, the Z-isomer was the most potent inhibitors toward both the pig's
      liver and yeast cyclases. To examine the effect of carbon chain length
      (lipophilicity), various fatty acids (C6-C18) were appended to the 8-azadecalin
      derivatives. Strong inhibitory activity was observed for those compounds having
      carbon chains around C12. Interestingly, the amide compounds (not the
      carbocationic intermediate) exhibited remarkably strong inhibition toward the
      liver cyclase, whereas they had an insignificant effect on the yeast cyclase
      (about 10(2)-fold less active). The yeast cyclase needed the amine functionality
      (carbocationic intermediate), which was prepared by using LiAlH4 from the
      corresponding amides, to exhibit potent inhibition. We found that N-dodecyl-8-aza
      4,4,10 beta-trimethyl-trans-decal-3 beta-ol (7i) was the most potent inhibitor
      (IC50 = 1 microM) toward the yeast cyclase amongst any known material. Kinetic
      studies showed that the inhibition pattern was dependent only on whether the side
      chains on the 8-azadecalin were linear or branched; the compounds having
      isoprenoid-like chains were non-competitive inhibitors, while those having linear
      hydrocarbon chains (amides or amines) were competitive inhibitors.

PMID- 7772823
TI  - Effects of isorhamnetin, rhamnetin, and quercetin on the concentrations of
      cholesterol and lipoperoxide in the serum and liver and on the blood and liver
      antioxidative enzyme activities of rats.
AB  - The effects of isorhamnetin, rhamnetin and quercetin on the serum and liver
      cholesterol concentrations, liver lipoperoxide (thiobarbituric acid-reactive
      substances: TBARS) content, and antioxidative enzyme activities were examined
      with rats fed on cholesterol-enriched and cholesterol-free diets. The total serum
      cholesterol of those rats fed with the cholesterol-enriched diet was decreased by
      feeding each all these flavonoids. The total liver cholesterol concentration and
      TBARS content in the rats fed with the cholesterol-free diet were decreased by
      feeding isorhamnetin, rhamnetin and quercetin. The activities of liver superoxide
      dismutase and catalase were almost unaffected by feeding these flavonoids. These
      results, the in vitro antioxidative activities of isorhamnetin, rhamnetin and
      quercetin, and the activities of these flavonoids in suppressing the generation
      of the superoxide anion in vitro suggest the possibility that the lower liver
      TBARS content in those rats fed on the cholesterol-free diet with added
      flavonoids is ascribable in part to the direct antioxidative and superoxide anion
      generation-suppressing activities of flavonoids and/or their metabolites absorbed
      from the gastrointestinal tract.

PMID- 7772825
TI  - Cloning, purification, and properties of a cofactor-independent glutamate
      racemase from Lactobacillus brevis ATCC 8287.
AB  - A glutamate racemase gene of Lactobacillus brevis ATCC 8287 was cloned into
      Escherichia coli TM93 by the phenotypic complementation of a phosphoenolpyruvate
      carboxylase deficiency on minimum agar medium containing D-glutamate. The gene
      was localized to a 1.4-kb HindIII-EcoRI DNA fragment and the total nucleotide
      sequence of the fragment was analyzed. The gene has typical promoter and SD
      sequences which appeared to function in E. coli. The deduced amino acid sequence
      of the enzyme had 276 amino acids and the molecular weight was calculated as
      29,426. Two cysteine residues and their surrounding regions of the enzyme are
      homologous to those of other cofactor-independent racemases. The glutamate
      racemase was purified from recombinant E. coli to homogeneity and characterized.
      The enzyme required no cofactors for the activity, and retained its activity even
      in 2 M (300 g/l) L-glutamate.

PMID- 7772826
TI  - Transgalactosylation catalyzed by alpha-galactosidase from Candida guilliermondii
      H-404.
AB  - The thermostable alpha-galactosidase from Candida guilliermondii H-404
      synthesized self-transfer products in the absence of a suitable acceptor. The
      main self-transfer product, using melibiose as a donor substrate, was O-alpha-D
      galactosyl-(1,6)-O-alpha-D-galactosyl-(1,6)-D-glucose. This enzyme had a wide
      acceptor specificity. D-Glucose, D-galactose, maltose, maltitol, and 1,4
      butandiol were the most effective acceptors in the transgalactosylation catalyzed
      by this enzyme. The enzyme could also transfer alpha-galactosyl residues to
      pentoses (L-arabinose, D-xylose, and D-ribose) and methyl pentoses (D-fucose and
      L-rhamnose). The main transfer products to lactose, maltose, and sucrose as
      acceptors were identified as O-alpha-D-galactosyl-(1,6)-O-beta-D-galactosyl-(1,4)
      D-glucose, O-alpha-D-galactosyl-(1,6)-O-alpha-D-glucosyl-(1,4)-D-glucose, and O
      alpha-D-galactosyl-(1,6)-O-alpha-D-glucosyl-(1,2)-beta-D-fructoside (raffinose),
      respectively.

PMID- 7772828
TI  - Purification and characterization of extracellular alginate lyase from
      Enterobacter cloacae M-1.
AB  - An alginate lyase from the culture supernatant of Enterobacter cloacae M-1 was
      purified by ammonium sulfate precipitation, cation-exchange chromatography (SP
      Toyopearl), and gel filtration (Ultrogel AcA44). The final preparation thus
      obtained showed a single band on SDS-PAGE. The purified enzyme had the molecular
      weight of 38,000 and 32,000 by SDS-PAGE and gel filtration, respectively. The pI
      of the enzyme was 8.9. The optimum pH and temperature for the enzyme reaction
      were around 7.8 and 30 degrees C, respectively. The enzyme was unstable on
      heating. EDTA completely inhibited the enzyme activity, but the activity was
      completely restored by the treatment with CaCl2. The enzyme was specific for poly
      guluronate and produced several kinds of unsaturated oligomers from the
      gluluronate. This suggested that the enzyme could be classified as an endo poly
      guluronate lyase.

PMID- 7772827
TI  - Free bile acids inhibit IgE production by mouse spleen lymphocytes stimulated by
      lipopolysaccharide and interleukins.
AB  - The interaction of IL-4, IL-5, and free bile acids with the immunoglobulin
      production by mouse spleen lymphocytes was studied to examine their
      immunoregulatory activity. In the absence of lipopolysaccharide (LPS), IL-4
      enhanced the IgE and IgG production significantly and the IgA production weakly,
      but not the IgM production. On the other hand, IL-5 had an inhibitory tendency on
      the IgE and IgA production, though not significantly. In the presence of LPS,
      both IL-4 and IL-5 significantly enhanced the IgE production by mouse splenic
      lymphocytes. When the lymphocytes were cultured with the physiological
      concentration of free bile acids (10 microM) and LPS for 3 days, chenodeoxycholic
      acid inhibited the IgE production, but cholic and deoxycholic acids did not. In
      the presence of IL-4 or IL-5, these bile acids cancelled the stimulatory effects
      of interleukins and rather significantly inhibited the IgE production. These
      results suggest that these free bile acids act as an anti-allergic agent.

PMID- 7772829
TI  - A system for sialic acid transfer by colominic acid and a sialidase that
      preferentially hydrolyzes sialyl alpha-2,8 linkages.

PMID- 7772830
TI  - Selective incorporation of n-3 and n-6 unsaturated fatty acids into animal cell
      phospholipids.
AB  - The selective incorporation of n-3 and n-6 unsaturated fatty acids into
      phospholipids was investigated by changing the ratio of n-3 unsaturated fatty
      acids against n-6 unsaturated fatty acids in the medium where Chinese hamster V79
      R cells were grown. Unsaturated fatty acids with lower degrees of unsaturation
      were abundantly incorporated into phosphatidylcholine independently of n-3 and n
      6. Unsaturated fatty acids with higher degrees of unsaturation were more
      predominantly incorporated into phosphatidylethanolamine. When the difference in
      the numbers of double bond between unsaturated fatty acids was more than two, the
      unsaturated fatty acids with a higher degree of unsaturation was more selectively
      incorporated into phosphatidylethanolamine than the unsaturated fatty acids with
      a lower degree of unsaturation. By the analysis of molecular species, n-3 and n-6
      unsaturated fatty acids with higher degrees of unsaturation were incorporated
      competitively into phosphatidylethanolamine. Finally, docosahexaenoic acid was
      incorporated into diacyl phosphatidylethanolamine more selectively than the other
      unsaturated fatty acids.

PMID- 7772831
TI  - Purification and characterization of two chitinases from the leaves of pokeweed
      (Phytolacca americana).
AB  - Two chitinases, designated PLC-A and PLC-B, were purified from the leaves of
      pokeweed (Phytolacca americana) using DEAE-cellulose column chromatography
      followed by gel filtration on Sephadex G-75, hydrophobic column chromatography,
      and ion-exchange FPLC. PLC-A and PLC-B are acidic and basic proteins having
      molecular masses of 25 and 29 kDa, and isoelectric points of 3.7 and 9.5,
      respectively. On the basis of their partial amino acid sequences, it was seen
      that PLC-A and PLC-B belong to class II and class III chitinases, respectively.
      The optimal pH of PLC-A toward glycolchitin is pH 4.5 and hydrolyzed (GlcNAc)4
      into 2(GlcNAc)2, and (GlcNAc)5-6 into (GlcNAc)2 and (GlcNAc)3. on the other hand,
      PLC-B has two optimal pHs at 3 and 7 toward glycolchitin and hydrolyzed (GlcNAc)5
      into GlcNAc and (GlcNAc)4, and (GlcNAc)6 into GlcNAc, (GlcNAc)2, and (GlcNAc)4.

PMID- 7772832
TI  - Phosphatidylinositol-3 kinase in fission yeast: a possible role in stress
      responses.
AB  - A DNA fragment coding for a part of a putative phosphatidylinositol 3 kinase was
      cloned from Schizosaccharomyces pombe by cross-hybridization with Saccharomyces
      cerevisiae VPS34 gene, a yeast homologue of mammalian PI-3 kinase. The clone
      contained an open reading frame of 797 amino acids but lacked the initiation
      codon, ATG. The predicted amino acid sequence was homologous to those of S.
      cerevisiae VPS34 and mammalian PI-3 kinase genes. Disruption of the gene resulted
      in extremely low levels of PI-3-P and higher levels of PI-4-P, supporting the
      idea that the gene codes for the PI-3 kinase of S. pombe. The disruptants
      harbored large vacuoles and were sensitive to stresses such as high temperature
      or high concentration of monovalent and divalent cations.

PMID- 7772833
TI  - Purification and characterization of three mitogenic lectins from the roots of
      pokeweed (Phytolacca americana).
AB  - Three mitogenic lectins, designated PL-A, PL-B, and PL-C, were purified from the
      roots of pokeweed (Phytolacca americana) using Q-Sepharose column chromatography
      followed by gel filtration on Sephadex G-75, hydrophobic chromatography on Butyl
      Toyopearl, and FPLC on a Mono-Q column. PL-A, PL-B, and PL-C are acidic proteins
      having isoelectric points of 4.35 and their apparent molecular masses were 22,
      48, and 21 kDa by SDS-polyacrylamide gel electrophoresis in the presence of 2
      mercaptoethanol, respectively. The three lectins have similar amino acid
      compositions rich in half-cystine and similar N-terminal sequences, indicating
      that they are homologous proteins. Identical sequences of N-terminal regions and
      six corresponding tryptic peptides in PL-A and PL-B suggested that PL-A may be an
      N-terminal half fragment of PL-B. Although all of three lectins have mitogenic
      activities, PL-B is a mitogenic lectin with the most potent hemagglutinating and
      mitogenic activities, and PL-C has almost no hemagglutinating activity.

PMID- 7772834
TI  - Role of basic and acidic fragments in delicious peptides (Lys-Gly-Asp-Glu-Glu-Ser
      Leu-Ala) and the taste behavior of sodium and potassium salts in acidic
      oligopeptides.
AB  - The role of the acidic fragment (Asp-Glu-Glu) in delicious peptides was
      investigated in detail by using the Na+ or K+ salts of acidic oligopeptides so
      that amount of Na+ or K+ intake of peptides composed of acidic amino acids could
      be varied by changing their sequences. The taste of these peptides was confirmed
      to vary with Na+ or K+ intake. Additionally, in order to study the role of basic
      (Lys-Gly) and acidic (Asp-Glu-Glu) fragments in delicious peptides for producing
      the taste, five delicious peptide analogs, Ser-Leu-Ala-Lys-Gly-Asp-Glu-Glu, Ser
      Leu-Ala-Asp-Glu-Glu-Lys-Gly, Lys-Gly-Ser-Leu-Ala-Asp-Glu-Glu, Lys-Gly-Asp-Glu
      Glu, and Glu-Glu-Asp-Gly-Lys, were synthesized. The intensity of the umami and/or
      salty taste of these peptides and their Na salts was almost the same, despite
      their chemical structures being different. These results indicate that the acidic
      fragment as well as the basic fragment plays an important role in the taste
      production and intensity of delicious peptides, and that an umami or salty taste
      can be produced by the localization of the cation of the basic fragment and the
      anion of the acidic fragment.

PMID- 7772835
TI  - Nucleotide sequence of the FAD synthetase gene from Corynebacterium ammoniagenes
      and its expression in Escherichia coli.
AB  - The nucleotides of a bifunctional enzyme FAD synthetase gene, which showed both
      flavokinase and ATP:FMN adenylyltransferase activities, from Corynebacterium
      ammoniagenes were sequenced. The FAD synthetase gene product consisted of 338
      amino acids and had a calculated molecular weight of 37,712. The deduced protein
      sequence of the FAD synthetase shared a homology with those of the protein X of
      Escherichia coli, which has been reported to have both flavokinase and ATP:FMN
      adenylyltransferase activities like the FAD synthetase of C. ammoniagenes, and
      the protein X of Pseudomonas fluorescens. From the analysis of the flanking
      sequences of the FAD synthetase gene, the gene organization and the operon
      structure around the FAD synthetase gene of C. ammoniagenes were thought to be
      different from those of Gram-negative bacteria. An over-expression system of the
      FAD synthetase of C. ammoniagenes was constructed in E. coli to study the
      structure and function of the protein. Under the tandem tryptophan promoter, the
      FAD synthetase activity increased 2231 times compared to that of non-transformed
      C. ammoniagenes.

PMID- 7772836
TI  - Isolation and structure of the Enterococcus faecalis sex pheromone, cOB1, that
      induces conjugal transfer of the hemolysin/bacteriocin plasmids, pOB1 and pYI1.
AB  - A bacterial sex pheromone, cOB1, which induces conjugal transfer of the
      Enterococcus faecalis hemolysin-bacteriocin (Hly/Bac) plasmid, pOB1, was isolated
      from the culture broth of pOB1-free E. faecalis. Its structure was found to be a
      hydrophobic octapeptide, H-Val-Ala-Val-Leu-Val-Leu-Gly-Ala-OH. The cOB1 peptide
      induced the mating response of not only pOB1 but also another incompatibility
      group Hly/Bac plasmid, pYI1.

PMID- 7772837
TI  - Taste evaluations of angiotensin I converting enzyme inhibitors, Leu-Lys-Tyr
      analogues.
AB  - Tastes of Leu-Lys-Tyr (LKY) analogues, a series of potent angiotensin I
      converting enzyme (ACE) inhibitory peptides were evaluated. Some of these
      analogues were found to be sweet, such as Val-Lys-Tyr and Ala-Orn-Tyr.
      Furthermore, the structural requirements for sweetness or decreasing the
      bitterness were investigated by considerations of the structure-taste
      relationship with LKY analogues.

PMID- 7772838
TI  - Ceruloplasmin concentration in human colostrum and mature milk.
AB  - The concentration of ceruloplasmin (CP) in human milk was obtained by measuring
      the increased absorbance of a solution containing apotransferrin and Fe2+ at 460
      nm after adding the milk. The CP concentrations in colostrum and mature milk at
      less than 1 month after parturition were 4.45 +/- 1.23 mg and 4.09 mg +/- 1.47
      mg/100 ml, respectively. In mature milk after more than one month, the CP
      concentration had decreased to 1.72 +/- 0.91 mg/100 ml.

PMID- 7772839
TI  - Conversion ratio of tryptophan to niacin in rats fed with a nicotinic acid-free,
      tryptophan-limiting diet.
AB  - The effects of amino acid composition on the conversion ratio of Trp to niacin in
      rats were investigated. The ratio in the group fed with a nicotinic acid-free, 9%
      casein-sucrose diet (basal diet) was 3.5%. This ratio was statistically decreased
      to 0.2% by the addition of 2% glycine, 0.078% L-threonine, and 0.2% L-cystine,
      and restored to 3.2% by the further addition of 0.1% tryptophan. From these
      results and our previous findings, it was considered that Trp imbalance might be
      a manifestation of niacin deficiency.

PMID- 7772840
TI  - A DNA region that complements on Escherichia coli cysG mutation in Thiobacillus
      ferrooxidans.
AB  - Thiobacillus ferrooxidans AP19-3 has a novel NADH-dependent sulfite reductase in
      the periplasmic space. The gene responsible for the appearance of NADH-dependent
      sulfite reductase activity was cloned into a vector plasmid pBR322 to give a 5.7
      kb hybrid plasmid, pTHS1, which contains a 1.3-kb DNA fragment of T. ferrooxidans
      AP19-3. When pTHS1 was used to transform sulfite reductase deficient E. coli
      mutants, strain AT2455 (cysG), JM246 (cysI), and AT2427 (cysJ), it complemented
      only the E. coli cysG mutation. Since cysG codes for S-adenosyl-L-methionine:
      uroporphyrinogen III methyltransferase, the enzyme involved in siroheme
      synthesis, the results indicate that the DNA region that codes for S-adenosyl-L
      methionine: uroporphyrinogen III methyltransferase is present in a T.
      ferrooxidans 1.3 kb DNA fragment on pTHS1.

PMID- 7772841
TI  - Effects of a peptide mixture with a high Fischer's ratio on serum and cerebral
      cortex amino acid levels and on cerebral cortex monoamine levels, compared with
      an amino acid mixture with a high Fischer's ratio.
AB  - Peptide mixtures with high and low Fischer's ratios (i.e., the ratio of branched
      chain amino acids to aromatic amino acids), obtained from an enzymatic
      hydrolysate of casein, and the corresponding amino acid mixtures were
      intragastrically force-fed to rats. Cerebral cortex monoamines were more
      influenced by the ingestion of the peptide than that of the amino acid mixture.

PMID- 7772842
TI  - Construction of a plasmid for high level expression of Escherichia coli
      phosphoenolpyruvate carboxylase.
AB  - The minimum size DNA fragment (3011 bp) containing the entire phosphoenolpyruvate
      carboxylase [EC 4.1.1.31] gene of E. coli was cloned into a modified plasmid
      vector of high copy-number. The gene expression was directed by its own promoter
      and the content of the enzyme reached about 30% of total soluble protein of the
      transformed cells.

PMID- 7772843
TI  - Antioxidative activity of hop bitter acids and their analogues.
AB  - Hop bitter acids, humulones (1) and lupulones (2), were shown to have potent DPPH
      radical scavenging activity (RSA) and lipid peroxidation inhibitory activity
      (LIA). Furthermore, 5-acetyl lupulones (3) and 4-methyl lupulones (4) had more
      potent LIA than native lupulones but no RSA. This result indicates that the beta,
      beta'-triketone moiety of the lupulones has LIA.

PMID- 7772845
TI  - Extraction of extracellular L-asparaginase from Candida utilis.
AB  - L-Asparaginase was extracted from Candida utilis cells using various reducing
      agents, 2-mercaptoethanol, dithiothreitol, or cysteine. The extraction of the
      enzyme depended upon the kind and concentration of reducing agents, temperature,
      time of incubation, and pH of buffer used. The enzyme was typically extracted by
      incubating the cells at 50 degrees C for 4 h in extraction solution containing 20
      mM 2-mercaptoethanol in 20 mM potassium phosphate buffer (pH 7.0). The enzyme can
      be extracted from either cell precipitate or cell culture broth. The yeast cells
      were viable after extraction of L-asparaginase.

PMID- 7772844
TI  - Development of a protein-free medium with iron salts replacing transferrin for a
      human-human hybridoma.
AB  - Many protein-free media have been developed, because protein-free media are
      usually more economical than serum-free or serum-containing media and facilitate
      the purification of bioactive materials. We evaluated various iron salts and
      chelating agents replacing transferrin to develop a protein-free medium for a
      human-human hybridoma, HB4C5, and found out that ferric citrate was favorable for
      the production and the productivity of monoclonal antibodies.

PMID- 7772846
TI  - Application of direct current to protect bioreactor against contamination.
AB  - Bacteria cell suspensions were sterilized by direct electric current and the cell
      death rate was proportional to the current. When repeated hydrolysis of casein by
      immobilized mycelia was done under 0.06 A of direct electric current,
      contaminants were inhibited while the hydrolysis was stable for more than 10
      batches (250 h).

PMID- 7772847
TI  - Two distinct species of corn cystatin in corn kernels.
AB  - Besides corn cystatin I (CC-I) we found, by cloning, another molecular species of
      cystatin, named corn cystatin II (CC-II), which was found by screening with CC-I
      cDNA as a probe. The dissimilarity in amino acid sequence between CC-I and CC-II
      was distinct around the N-terminal region. Enzymologically, CC-II protein
      expressed in Escherichia coli was a stronger inhibitor of cathepsin L than CC-I.

PMID- 7772848
TI  - Tissue- and development-specific expression of goat insulin-like growth factor-I
      (IGF-I) mRNAs.
AB  - We cloned four kinds of goat insulin-like growth factor-I (IGF-I) cDNAs. Each of
      them encodes the same mature IGF-I and different signal peptides. In this study,
      we analyzed expression of the four kinds of mRNAs in tissues in various
      developmental stages by a reverse transcriptase-polymerase chain reaction assay.
      The results suggest that their expression may be controlled by different
      promoters, the activities of which are tissue- and development-specific.

PMID- 7772849
TI  - pH-dependent inactivation and reactivation of recombinant sheep angiotensinogen.
AB  - Purified recombinant sheep angiotensinogen (rsAngn) lost 74% of the reactivity
      with human renin during storage at pH 8.0 and 4 degrees C. The inactivated rsAngn
      was reactivated by incubation at acidic pHs. This indicates that pH-dependent
      inactivation and reactivation occur in rsAngn.

PMID- 7772850
TI  - The Nurses and Midwives Pay Review Body.

PMID- 7772851
TI  - Patient assessment for day surgery.
AB  - Following medical selection of a patient for day surgery in either a hospital out
      patient clinic or general practitioner surgery, the patient requires assessment.
      This is usually achieved in one of two ways. The patient may be sent a postal
      questionnaire which is followed up on the telephone if a query occurs or he or
      she attends an assessment interview in the day surgery unit (D.S.U.) with a
      member of the nursing staff. From personal experience as a nurse teacher, patient
      assessment for day surgery is the one area of concern for theatre nurses if they
      are asked to work in the day surgery unit. This article is a brief overview of
      this area. Initially, assessment will be defined. Following this, patient
      assessment in the theatre setting will be compared with assessment of a patient
      about to undergo day surgery. To conclude, a summary of selected nursing
      competencies will be listed for successful day surgery patient assessment.

PMID- 7772852
TI  - Advances in anaesthesia. Some recent developments in techniques for short stay
      surgery.
AB  - Anaesthesia is now a world away from the single agent techniques of the 19th and
      early 20th centuries. There is an ever increasing requirement to obtain quicker
      throughput and minimal post-operative morbidity in every surgical specialty.
      Patients and managers expect a shorter and shorter hospital stay after surgery
      which would have required two or three times as long in hospital as little as ten
      years ago. Many, or perhaps most, of the advances in surgery since anaesthesia
      began in the 1840s have depended on advances in anaesthesia. The current trend to
      short stay surgery is no exception. I will give an historical perspective of the
      development of anaesthetic techniques which have permitted this development. I
      will describe some of the practical and theoretical considerations behind the
      techniques and a forecast of some of the techniques which are in development or
      might be anticipated in the future.

PMID- 7772853
TI  - The use of computer systems dedicated to day surgery.
AB  - As a management consulting firm and a system house which has developed computer
      systems specifically to support Day Surgery activities, we are often asked by
      nurses, doctors and managers of Day Surgery units to help clarify their needs for
      an information system. This article summarises the key questions which are asked,
      together with answers which we have given, based on our in-depth reviews at many
      hospitals which are reorganising and making significant investments in Day
      Surgery facilities.

PMID- 7772854
TI  - Re-using or mis-using?

PMID- 7772855
TI  - Safe disinfection of endoscopes.

PMID- 7772856
TI  - The mission statement formulated at the last meeting of the European Chief Nurses
      and WHO Collaborating Centres for Nursing and Midwifery.

PMID- 7772857
TI  - Day surgery: cheap option or challenge to care?
AB  - The tendency for surgery and associated nursing care to become short-stay is
      driven by so many considerations (of both dubious and desirable kinds) that it
      may be useful to attempt a little stock-taking on previous patterns of day
      operating and, by consulting a crystal ball, to consider possible implications
      for nursing and patient aftercare.

PMID- 7772858
TI  - Carbohydrate structures of a normal counterpart of the carcinoembryonic antigen
      produced by colon epithelial cells of normal adults.
AB  - Normal faecal antigen-2 (NFA-2) and non-specific cross-reacting antigen-2 (NCA
      2), cross-reacting with anticarcinoembryonic antigen (CEA) antibodies, were found
      in normal human faeces and meconium, respectively. Because NFA-2, NCA-2 and CEA
      are considered as the same gene products, NFA-2 and NCA-2 should be normal
      counterparts of CEA produced by colon epithelial cells of normal adults and
      fetuses, respectively. Comparison of sugar chain structures of these three
      antigens is indispensable in order to unravel the structural alteration induced
      by malignant transformation and development of colon epithelial cells. The sugar
      chain structures of CEA (Yamashita, K. et al., Cancer Res., 47, 3451-3459, 1987)
      and NCA-2 (Yamashita, K. et al., J. Biol. Chem., 264, 17873-17881, 1989) were
      previously reported. In this paper, the structures of the oligosaccharides
      released from four NFA-2 samples by hydrazinolysis were studied by means of
      lectin-affinity column chromatography, endo- and exo-glycosidase digestion,
      methylation analysis, hydrazinolysis-nitrous acid deamination and electrospray
      ionization mass spectrometry. NFA-2 contains 24-27 mol of N-linked sugar
      chains/molecule, which is similar to NCA-2 (27 mol) and CEA (24-27 mol). In
      contrast to CEA, which contains approximately 8% high-mannose-type sugar chains,
      all sugar chains of NFA-2 are mono- to tetra-antennary complex-type chains having
      four types of tri-mannosyl cores, with or without bisecting N-acetylglucosamine
      and fucose residues. The structures of their outer chain moieties comprise Gal
      beta 1-->3(HSO(3-)-->6)GlcNAc, Neu5Ac alpha 2-->3Gal beta 1-->3GlcNAc, Type 1,
      repeating chain, Type 2, Type 2H, Type 1H, Lex, Lea and Leb antigenic
      determinants. Approximately 50% of the outer chain moieties of the
      oligosaccharides of NFA-2 contain Type 1 chain, in contrast to those of CEAs
      produced by the liver metastases of colon tumours in which only a trace amount of
      Type 1 chain was detected.

PMID- 7772859
TI  - The involvement of O-linked oligosaccharide chains of the sea urchin egg receptor
      for sperm in fertilization.
AB  - Recent investigations on the sea urchin egg receptor for sperm have led to its
      sequencing and the demonstration that it is a 350 kDa glycoprotein. In the
      current study, the N- and O-linked oligosaccharide chains were cleaved from the
      protein fractionated on concanavalin A-agarose. The putative O-linked
      oligosaccharide chains that did not bind to the lectin were further fractionated
      by anion-exchange chromatography. Using a competition bioassay that measured the
      ability of these oligosaccharide chains to inhibit fertilization, it was found
      that the N-linked chains were devoid of inhibitory activity. Rather, the
      inhibitory activity was localized to the O-linked chains, with the most highly
      charged, sulphated chains showing the highest inhibitory activity. The bioactive
      oligosaccharides were labelled by reduction and assayed for binding to sperm. The
      results of the binding assay, coupled with the fertilization bioassay, indicate
      that the oligosaccharides inhibit fertilization by binding to acrosome-reacted
      sperm. The bioactive oligosaccharide lacked species specificity in fertilization
      bioassays, unlike the intact receptor and a recombinant aglyco protein containing
      only the extracellular domain of the receptor. Since previous work showed that
      the recombinant protein inhibits fertilization species specifically and binds to
      acrosome-reacted sperm, a two-step model of sperm-egg interaction is proposed.
      The first step is postulated to be a low-affinity ionic interaction of the
      sulphated O-linked oligosaccharide chains of the receptor with sperm that is not
      species specific. This is followed by a high-affinity, species-specific
      interaction of the sperm with one or more binding sites on the polypeptide chain
      of the receptor.

PMID- 7772860
TI  - Structural definition of acylated phosphatidylinositol mannosides from
      Mycobacterium tuberculosis: definition of a common anchor for lipomannan and
      lipoarabinomannan.
AB  - Based on chemical analysis, we have previously concluded that the biologically
      important lipoarabinomannan (LAM) and lipomannan (LM) from Mycobacterium are
      multiglycosylated forms of the phosphatidylinositol mannosides (PIMs), the
      characteristic cell envelope mannophosphoinositides of mycobacteria. Using
      definitive analytical techniques, we have now re-examined the reported
      multiacylated nature of PIMs in order to gain a better insight into their
      possible roles as biosynthetic precursors of LM and LAM. High-sensitivity fast
      atom bombardment-mass spectrometry analyses of the perdeuteroacetyl and permethyl
      derivatives of PIMs from Mycobacterium tuberculosis and Mycobacterium leprae
      enabled us to define the exact fatty acyl compositions of the multiacylated,
      heterogeneous PIM families, notably the dimannoside (PIM2) and the hexamannoside
      (PIM6). Specifically, in conjunction with other chemical and gas chromatography
      mass spectrometry (GC-MS) analyses, the additional C16 fatty acyl substituent on
      PIM2 and its lyso form were defined as attached to the C6 position of mannose. We
      also present evidence for triacylated mannophosphoinositide as a common lipid
      anchor for both LM and LAM, and further postulate that acylation of PIM2 may
      constitute a key regulatory step in their biosynthesis.

PMID- 7772861
TI  - Genomic organization and expression of hamster UDP-N-acetylglucosamine:dolichyl
      phosphate N-acetylglucosaminyl phosphoryl transferase.
AB  - The hamster gene for uridine diphosphate N-acetyl-D-glucosamine:dolichyl
      phosphate N-acetylglucosaminyl phosphoryl transferase (L-G1PT) was found to
      extend over 6.5 kb and to contain nine exons. The exons ranged in size from 63 to
      214 bp, encoding the 408 amino acid protein. The introns ranged from 85 bp to 1.4
      kb. Upstream 5' sequences included two possible TATA boxes, one possible CCAAT
      box and at least two potential GC boxes. Heterologous expression was successful
      in Schizosaccharomyces pombe, and resulted in cells that were tunicamycin
      resistant and had 12-fold more L-G1PT activity than wild-type cells. Antiserum
      prepared to a hydrophilic peptide (residues 300-320) of the L-G1PT protein
      reacted with a 35-36 kDa protein in membrane samples from Chinese hamster ovary
      (CHO) cells and S. pombe cells that had increased levels of L-G1PT activity. In
      both cases, antigenic peptide competed with the 35-36 kDa protein detected by the
      antiserum.

PMID- 7772862
TI  - Primary structure of 12 neutral oligosaccharide-alditols released from the jelly
      coats of the anuran Xenopus laevis by reductive beta-elimination.
AB  - The O-linked oligosaccharides of the jelly coat surrounding the eggs of Xenopus
      laevis were analysed by 1H-NMR spectroscopy. Among the 12 neutral oligosaccharide
      alditols which have been characterized, three of them possess the following
      unusual structures: [sequence: see text] As previously observed for six other
      amphibian species, the carbohydrate chains of the jelly coat of Xenopus eggs
      display a high species specificity which could support a biological role during
      the fertilization processes.

PMID- 7772864
TI  - Purification and characterization of novel glycosidases from the bacterial genus
      Xanthomonas.
AB  - Enzymatic analysis of oligosaccharides using exoglycosidases has become a
      powerful tool for determining the sequence and structure of sugar chains. The
      principal limitation to these methods has been the lack of highly purified and
      well-characterized enzymes. Using fluorescently labelled carbohydrate substrates
      and TLC, we have developed a method to identify glycosidases with novel
      specificities. This screening method led to the discovery that bacteria of the
      genus Xanthomonas are a rich source of exoglycosidases. From Xanthomonas
      manihotis, eight novel exoglycosidases have been isolated and characterized. A
      novel beta-N-acetylglucosaminidase has been purified that, unlike those
      previously described, will cleave N-acetylglucosamine without cleaving N
      acetylgalactosamine residues. A novel beta-galactosidase has been isolated that
      preferentially hydrolyses beta(1-->3) galactosyl linkages. Three alpha
      mannosidases have been isolated that serve as useful reagents in the analysis of
      high-mannose oligosaccharide structures: alpha 1-3,6 mannosidase, alpha 1-6
      mannosidase and alpha 1-2,3 mannosidase. An alpha 1-3,6 galactosidase has been
      purified that does not hydrolyse terminal alpha 1-4 galactose residues. Two
      fucosidases, alpha 1-3,4 fucosidase and alpha 1-2 fucosidase, are similar to
      enzymes purified from other sources. Together, these glycosidases provide
      powerful reagents for determining the sequence of complex carbohydrates. Equally
      important is their usefulness in selectively removing specific sugar residues and
      thereby creating novel carbohydrates for analysing the biological roles of
      oligosaccharides.

PMID- 7772863
TI  - Castanospermine analogues: their inhibition of glycoprotein processing alpha
      glucosidases from porcine kidney and B16F10 cells.
AB  - We have used a simple and efficient procedure for the synthesis of N-5
      carboxypentyl-1-deoxynojirimycin, an affinity ligand for alpha-glucosidase I
      (Bernotas, R. C. and Ganem, B., Biochem. J., 270, 539-540, 1990). The affinity
      gel was used to purify alpha-glucosidase I in one step from crude extract. In
      subsequent steps, partially purified alpha-glucosidase II was obtained. We have
      synthesized several analogues of castanospermine and studied their inhibition of
      alpha-glucosidase I in vitro using purified alpha-glucosidase I and in vivo in
      cultured B16F10 cells. Although the castanospermine analogues were significantly
      less active against the purified enzyme (IC50 approximately 1-23 micrograms/ml)
      as compared to castanospermine (IC50 = 0.02 microgram/ml), several compounds had
      up to 30-fold higher activity than castanospermine against alpha-glucosidase I in
      B16F10 cells, based on the accumulation of G3M7-9N2 oligosaccharide-containing
      glycoproteins. These results suggest that these analogues with lipophilic side
      chains cross the membrane barrier more efficiently than castanospermine. Once
      inside the cell, they may be converted to their active metabolite,
      castanospermine, by cellular esterases to give enzyme inhibition.

PMID- 7772865
TI  - A beta-linked mannan inhibits adherence of Pseudomonas aeruginosa to human lung
      epithelial cells.
AB  - Adherence through carbohydrate-binding adhesins is an early step in colonization
      of the lung by gram-negative organisms, and because published data indicate that
      binding involves mannose groups, we tested the ability of a beta-linked acetyl
      mannan (acemannan) to inhibit adherence of Pseudomonas aeruginosa to cultures of
      human lung epithelial cells. Adherence of radiolabelled P.aeruginosa to A549
      cells (a type II-like pneumocyte line) increased linearly with the duration of
      the incubation. Acemannan inhibited adherence of bacteria, and the extent of
      inhibition was related to the concentration of the mannan. Inhibition required
      continued contact between acemannan and the target epithelial cells; cells washed
      free of acemannan no longer discouraged bacterial binding. Comparison of binding
      between seven different strains of P.aeruginosa indicated that fewer mucoid than
      non-mucoid bacteria adhered, but binding of either phenotype was inhibited by
      acemannan. Mannose, methyl alpha-D-mannopyranoside, methyl beta-D-mannopyranoside
      and dextran did not affect adherence of any of the non-mucoid strains. Mannose
      inhibited adherence by one mucoid strain, but not the other, indicating
      differences between strains of the same phenotype. Since prior treatment of
      epithelial cells with concanavalin A did not affect acemannan-induced inhibition
      of bacterial adherence, we concluded that the inhibitory effect of acemannan
      probably does not involve mannose-containing receptors.

PMID- 7772866
TI  - Location of the active site of the bean alpha-amylase inhibitor and involvement
      of a Trp, Arg, Tyr triad.
AB  - Seeds of the common bean contain three homologous proteins: phytohaemagglutinin
      E, phytohaemagglutinin L and the lectin-like protein alpha-amylase inhibitor
      (alpha AI). Whereas the active site of lectins has been studied in great detail,
      there is no information on the active site of the related protein alpha AI, which
      exerts its biological activity by making a 1:1 complex with alpha-amylase. alpha
      amylase inhibitor is synthesized as a 30 kDa precursor glycoprotein that needs to
      be processed at Asn77 to form an active molecule. Comparison of the amino acid
      sequence of the bean alpha AI with that of the bacterial amylase inhibitor,
      tendamistat, suggested that a region around Trp188 might be involved in the
      inhibitory site. When a three-dimensional model of the bean alpha AI was
      constructed based on its homology to the legume lectins, this Trp region was
      alongside Asn77. To test this site hypothesis, mutants of alpha AI were created
      by site-directed mutagenesis of the cDNA and expressed in transgenic tobacco. The
      mutant proteins R74N and WSY188-190GNV, as well as the double mutant, were
      inactive as inhibitors. These findings suggest that the active site of alpha AI
      consists of W188, R74 and Y190, in analogy to the Trp-Arg-Tyr motif of
      tendamistat, and that the processing of the polypeptide at Asn77 may be necessary
      to bring these residues in close proximity.

PMID- 7772867
TI  - Genomic organization of human histo-blood group ABO genes.
AB  - We have isolated human genomic DNA clones encompassing 30 kbp of the histo-blood
      group ABO locus. The locations of the exons have been mapped and the nucleotide
      sequences of the exon-intron boundaries have been determined. The human ABO genes
      consist of at least seven exons, and the coding sequence in the seven coding
      exons spans over 18 kb of the genomic DNA. The exons range in size from 28 to 688
      bp, with most of the coding sequence lying in exon 7.

PMID- 7772868
TI  - HL 60 leukaemia cells chemically induced to differentiate retain some surface
      glycan features of undifferentiated cells not found in normal leukocytes.
AB  - Human HL 60 myeloid leukaemia cells have the potential to differentiate into
      either macrophage-like cells or granulocyte-like cells under the stimulus of
      chemical treatments. Using glycotechnology procedures, the glycosylation patterns
      of differentiated and undifferentiated HL 60 cells were analysed and compared
      with those of normal human peripheral monocytes. Both in vitro differentiations
      result in significant morphologic and functional changes, but we observed that
      the glycosylation patterns of undifferentiated and differentiated HL 60 cells
      exhibit several common glycosidic features that are absent in normal peripheral
      monocytes: the presence of (i) bisecting beta-N-acetylglucosamine attached at the
      C-4 position of the beta-mannose of polyantennary complex-type carbohydrate
      chains and (ii) complex-type carbohydrate chains enriched with non-reducing
      terminal beta-N-acetylglucosamine residues. Moreover, the three populations of HL
      60 cells express small amounts of biantennary complex-type structures (< 6%),
      whereas normal peripheral monocytes expressed > 20% of such structures. Thus, the
      cell glycosylation pattern could reflect the pathological state of the HL 60
      cells.

PMID- 7772869
TI  - In situ accessibility of murine macrophage gangliosides.
AB  - Gangliosides are implicated in cell signal transduction. Prior to investigating
      this phenomenon in macrophages, the in situ accessibility of gangliosides to
      macromolecules was assessed for peritoneal macrophages isolated from normal
      C3H/HeN and endotoxin-hyporesponsive C3H/HeJ mice. C3H/HeJ resident and
      thioglycolate-elicited macrophage ganglioside patterns are the same as normal
      strains, and no strain differences in galactose oxidase accessibility for
      resident or thioglycolate-elicited macrophage gangliosides were found. The only
      gangliosides accessible to galactose oxidase in resident macrophages are GM1a
      structures. In thioglycolate-elicited macrophages, an additional ganglioside is
      accessible. For Escherichia coli-activated macrophages, where ganglioside
      distribution differs between strains, a difference in galactose oxidase
      accessible gangliosides also exists. Escherichia coli-activated C3H/HeN patterns
      show three triplets absent in C3H/HeJ patterns. There were no differences in
      ganglioside accessibility to Vibrio cholerae sialidase between the thioglycolate
      elicited C3H/HeJ and C3H/HeN macrophages. However, despite differences in
      sialidase-sensitive ganglioside content between E.coli-activated macrophages of
      these strains, sialidase accessibility for E.coli-activated macrophages was also
      similar. Sialidase-susceptible GM3 was cryptic in either strain under all
      conditions examined. The accessibility of murine macrophage gangliosides to
      galactose oxidase or sialidase was independent of their sialic acid species and
      chain length of the ceramide fatty acid. With the exception of GM3, major murine
      macrophage gangliosides are accessible in situ to macromolecules, especially to
      exogenous pathogenic bacterial sialidase which can alter macrophage cell surface
      characteristics. Altered macrophage ganglioside accessibility appears sometimes
      as a consequence, but not a cause, of C3H/HeJ endotoxin hyporesponsiveness.

PMID- 7772870
TI  - A new Dol-P-Man:protein O-D-mannosyltransferase activity from Saccharomyces
      cerevisiae.
AB  - The deletion of the protein mannosyltransferase 1 gene (PMT1) of Saccharomyces
      cerevisiae results in viable cells. O-Mannosylation of proteins is reduced to
      about half of the value in comparison to wild-type cells. In order to distinguish
      between the the PMT1 gene product (= Pmt1p) and residual transferase activity, an
      in vitro assay to measure Dol-P-Man:protein mannosyltransferase activity in cells
      deleted for PMT1 has been developed. The transferase activity of these cells
      exhibits a pH optimum of 6.5 as compared to pH 7.5 for Pmt1p. The Km value of the
      residual enzyme activity for the hexapeptide YNPTSV is 7 times higher than that
      of Pmt1p and shows a clear preference for the seryl residue. Differences in
      substrate affinities as well as in seryl/threonyl depend on the specific sequence
      of the peptides used in the enzyme assay. The new enzyme activity shows a
      significantly lower thermal stability as compared to Pmt1p.

PMID- 7772871
TI  - Preparation and structural characterization of large heparin-derived
      oligosaccharides.
AB  - Porcine mucosal heparin was partially depolymerized with heparin lyase I and then
      fractionated into low-molecular-weight (< 5000) and high-molecular-weight (>
      5000) oligosaccharides by pressure filtration. The high-molecular-weight
      oligosaccharide mixture (approximately 50 wt% of the starting heparin) also
      contained intact heparin. This intact polymer complicates oligosaccharide
      purification. Thus, the low-molecular-weight fraction was used to prepare
      homogeneous oligosaccharides for structural characterization. The low-molecular
      weight oligosaccharide mixture was first fractionated by low-pressure gel
      permeation chromatography into size-uniform mixtures of disaccharides,
      tetrasaccharides, hexasaccharides, octasaccharides, decasaccharides,
      dodecasaccharides, tetradecasaccharides and higher oligosaccharides. Each size
      fractionated mixture was then purified on the basis of charge by repetitive semi
      preparative strong-anion-exchange high-performance liquid chromatography. This
      approach has led to the isolation of 14 homogeneous oligosaccharides from
      disaccharide to tetradecasaccharide. The purity of these heparin-derived
      oligosaccharides was determined by gradient polyacrylamide gel electrophoresis,
      analytical strong-anion-exchange high-performance liquid chromatography,
      capillary electrophoresis and one-dimensional nuclear resonance spectroscopy. The
      structure of these oligosaccharides was established using 600 MHz two-dimensional
      nuclear resonance spectroscopy. The spectral methods used included homonuclear
      correlation spectroscopy, nuclear Overhauser effect spectroscopy and
      heteronuclear multiple quantum coherence spectroscopy. The 1H/1H connectivities
      of the protons of each sugar residue in an oligosaccharide were established by
      two-dimensional homonuclear correlation spectroscopy, while 1H/13C assignments
      were made using 1H inverse detection. One- and two-dimensional nuclear resonance
      spectroscopic analysis of these heparin oligosaccharides showed two closely
      related groups of heparin-oligosaccharides are afforded by enzymatic
      depolymerization of heparin. One group is fully sulphated, having the structures
      delta UAp2S(1[-->4)-alpha-D-GlcNpS6S(1-->4)-alpha-L-IdoAp2S( 1]n-->4)-alpha- D
      GlcNpS6S, where delta UAp is 4-deoxy-alpha-L-threo-hex-4-eno-pyranosyluronic
      acid, GlcNp is 2-deoxy-2-aminoglucopyranose, IdoAp is idopyranosyluronic acid, S
      is sulphate and n = 0-6. The other group of oligosaccharides differ in that they
      contain beta-D-glucuronic acid in place of the alpha-L-iduronic acid residue
      nearest to the reducing end. The present study describes the isolation and
      structural elucidation of seven new oligosaccharides: an octasaccharide, two
      decasaccharides, two dodecasaccharides and two tetradecasaccharides. The utility
      of two-dimensional nuclear resonance spectroscopy to determine the structure of
      complex heparin oligosaccharides is also illustrated.

PMID- 7772872
TI  - A 23 kDa membrane glycoprotein bearing NeuNAc alpha 2-3Gal beta 1-3GalNAc O
      linked carbohydrate chains acts as a receptor for Streptococcus sanguis OMZ 9 on
      human buccal epithelial cells.
AB  - Streptococcus sanguis colonizes several human oral surfaces, including both hard
      and soft tissues. Large salivary mucin-like glycoproteins bearing sialic acid
      residues are known to bind various S.sanguis strains. However, the molecular
      basis for the adhesion of S.sanguis to human buccal epithelial cells (HBEC) has
      not been established. The present study shows that S.sanguis OMZ 9 binds to
      exfoliated HBEC in a sialic acid-sensitive manner. The desialylation of such
      cells invariably abolishes adhesion of S.sanguis OMZ 9 to the cell surface. A
      soluble glycopeptide bearing short sialylated O-linked carbohydrate chains
      behaves as a potent inhibitor of the attachment of S.sanguis OMZ 9 to exfoliated
      HBEC. The resialylation of desialylated HBEC with CMP-sialic acid and Gal beta
      1,3GalNAc alpha 2,3-sialyltransferase specific for O-glycans restores the
      receptor function for S.sanguis OMZ 9, whereas a similar cell resialylation with
      the Gal beta 1,4GlcNAc alpha 2,6-sialyltransferase specific for N-glycans is
      without effect. Finally, the same resialylation reaction carried out with CMP-9
      fluoresceinyl-sialic acid as a substrate yields exfoliated HBEC bearing
      fluorescence on a single 23 kDa protein, when using the alpha 2,3
      sialyltransferase as the catalyst. The latter finding demonstrates that this 23
      kDa cell surface glycoprotein bears NeuNAc alpha 2-3Gal beta 1-3GalNAc O-linked
      sugar chains, a carbohydrate sequence which is recognized by S.sanguis OMZ 9 on
      exfoliated HBEC. In similar experiments carried out with a buccal carcinoma cell
      line termed SqCC/Y1, S.sanguis OMZ 9 did not attach in great numbers to such
      cultured cells, and these cells were shown to not express membrane glycoprotein
      bearing alpha 2,3-sialylated O-linked carbohydrate chains.

PMID- 7772873
TI  - Cardiomyoplasty: preservation of the latissimus dorsi muscle.
AB  - Muscle necrosis has been frequently observed in cardiomyoplasty patients and in
      experimental animal studies. The purpose of this study was to determine if heat
      shock could provide protection to skeletal muscle as has been shown in cardiac
      muscle. A 15-minute heat shock at 42 degrees C resulted in an immediate increase
      in HSP72 mRNA and was followed within 3 hours by a two-fold increase in HSP72.
      Surgical dissection of the latissimus dorsi muscle (LDM) followed by an ischemic
      period resulted in a two-fold increase in HSP72 in control LDM, whereas the
      already high levels in the heat-shocked LDM increased only slightly with surgery
      and ischemia. Citrate synthase activity and tissue histology indicated that heat
      shock did not protect the LDM from the imposed surgical trauma and ischemia
      insults used in this study.

PMID- 7772874
TI  - Renin, angiotensin II, and the development of effusions following bidirectional
      Glenn and Fontan procedures.
AB  - Pleural effusions are a troublesome complication following bidirectional Glenn
      and Fontan procedures. It was our hypothesis that effusions may be related to
      alterations in hormones that regulate fluid homeostasis. We made serial
      determinations (by radioimmunoassay) of antidiuretic hormone, cortisol,
      aldosterone, angiotensin II, and renin in patients undergoing bidirectional Glenn
      (n = 16) and Fontan procedures (n = 24). There were six patients who developed
      effusions following surgery. These patients had a different endocrinological
      pattern characterized by persistent elevation in renin (28 +/- 9 vs 9 +/- 5 ng/mL
      per hour, p < 0.01) and angiotensin II (110 +/- 33 vs 33 +/- 14 ng/L, p < 0.01)
      on the fifth postoperative day as compared to patients who did not develop
      effusions. These data demonstrate that patients who develop effusions following
      bidirectional Glenn and Fontan procedures have activation of their renin
      angiotensin system.

PMID- 7772875
TI  - Enhancement of ventricular mechanics following bidirectional superior
      cavopulmonary anastomosis in patients with single ventricle.
AB  - Seventeen consecutive patients undergoing bidirectional cavopulmonary anastomosis
      (BDCPA) using normothermic, noncardioplegic, cardiopulmonary bypass were studied
      preoperatively and early postoperatively (12.2 days) using transthoracic
      echocardiographic techniques. The purpose of the study was to assess the changes
      in left ventricular mechanics associated with the change in blood flow related to
      the BDCPA. Of the 17 patients, pulmonary atresia and tricuspid stenosis was
      present in 7, tricuspid atresia in 6, double inlet left ventricle in 3, and
      severe pulmonic stenosis with straddling of the tricuspid valve in 1. All other
      forms of single ventricle type anatomy and other patients undergoing BDCPA were
      excluded for the purposes of this study. The mean left ventricular end-diastolic
      volume index fell from 120 mL/m2 to 91.1 mL/m2 (p < 0.05). Similarly the left
      ventricular end-systolic volume index fell from 55.8 mL/m2 to 42.3 mL/m2,
      respectively (p < 0.05). The stroke volume index also fell from 64.5 mL/m2 to
      48.8 mL/m2. Left ventricular ejection fraction was preserved and was unchanged in
      every patient. It was concluded that BDCPA, performed as described above,
      preserves left ventricular function and that the systolic and diastolic volumes
      as well as the stroke volume are significantly decreased as evidence of
      improvement of left ventricular mechanics. The continued use of the BDCPA either
      as a definitive procedure or as a staged procedure in preparation for total
      cavopulmonary connection is therefore endorsed.

PMID- 7772876
TI  - Pituitary adenomas complicating cardiac surgery: summary and review of 11 cases.
AB  - From the literature and our own experience, 11 cases of hemorrhage or infarction
      of a pituitary adenoma associated with cardiac surgery have been identified over
      a 13-year period. Males outnumbered females by 10 to 1. Symptoms observed were
      headache, lethargy, confusion, obtundation, unilateral ptosis, meiosis, and
      opthalmoplegia involving cranial nerves III, IV, and VI, visual field deficits,
      and hemiparesis. Diagnosis in most recent cases has been confirmed with
      computerized tomography or magnetic resonance imaging. All patients received
      adrenocortical steroid therapy initially. Eight patients underwent
      transsphenoidal hypophysectomy and all survived. One patient underwent
      decompression craniotomy and died. Intracranial surgery was deferred in 1 patient
      who survived and in another who died of a massive stroke. Residual neurological
      deficits were noted to be either absent, minimal, or resolving in 7 of the 9
      patients who survived their initial hospitalization. While numerous mechanisms
      have been proposed to explain the hemorrhage and necrosis of a pituitary adenoma
      during heart surgery, no direct cause has been clearly identified. Surgical
      treatment is commonly necessary since untreated pituitary apoplexy is often
      fatal. Transsphenoidal hypophysectomy with decompression is the preferred method
      of treatment with a low perioperative mortality and fairly good long-term
      prognosis.

PMID- 7772877
TI  - Etiology and management of chronic valve disease in antiphospholipid antibody
      syndrome and systemic lupus erythematosus.
AB  - Unlike the Libman-Sacks vegetations of acute systemic lupus erythematosus (SLE),
      which are usually asymptomatic, valve involvement in chronic SLE and primary
      antiphospholipid antibody syndrome (APLAS) is similar to that of chronic
      rheumatic disease. Typical findings include valve thickening and nodularity, poor
      coaptation, and regurgitation. Elevated levels of antiphospholipid antibodies
      have been associated with the development of these valvular abnormalities in some
      but not all reported cases, and there are undoubtedly other etiologic cofactors.
      When cardiac valvular replacement is required, special attention must be given to
      preoperative reduction of elevated antibody levels, prevention of intraoperative
      thromboembolism, and prompt and aggressive postoperative anticoagulation.

PMID- 7772878
TI  - Coronary revascularization with the radial artery: new interest for an old
      conduit.
AB  - Between July 1992 and May 1994, 148 patients (18 females) underwent myocardial
      revascularization with a radial artery (RA) graft. The left RA was used in 97.3%
      of cases. All but two patients received at least one additional arterial conduit:
      137 left and 59 right internal mammary arteries (IMA); 23 inferior epigastric
      arteries; and 21 right gastroepiploic arteries. Total arterial revascularization
      was achieved in 127 patients (85.8%). An average of 3.0 anastomoses/patient were
      constructed, 2.8 of which were arterial. RA proximal anastomoses were placed on
      the IMA in 75% of cases, while direct anastomosis to the aorta (23.7%) or to a
      saphenous vein (1.3%) was performed in the remainder. When anastomosed to an IMA,
      the RA was subsequently infused intraluminally with 10 mg of papaverine (1
      mg/mL). The target artery was the left anterior descending or one of its branches
      in 14.7% of cases, the circumflex system in 76.3%, and the native right coronary
      or one of its branches in the remaining 9%. An infusion of diltiazem (4 mg/hour)
      was started once the aorta was unclamped, and patients were maintained on oral
      diltiazem for 6 months postoperatively. Operative mortality was 1.4% (2
      patients), with the additional late deaths from noncardiac causes. In one patient
      there was a prolonged serous drainage from the RA donor site. Of the 144
      survivors 140 are asymptomatic. Follow-up angiography demonstrated 100% early
      patency (< 30 days, 41 patients), and 94% late patency (6 to 20 months, mean 14
      months, 30/32 patients). This study suggests the RA can be used safely as an
      alternative to saphenous vein in coronary bypass surgery.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7772879
TI  - Thermal coronary angiography for intraoperative patency control of arterial and
      saphenous vein coronary artery bypass grafts: results in 370 patients.
AB  - BACKGROUND AND AIM OF THE STUDY: Early graft failure is often associated with
      technical failures and is therefore potentially avoidable. We used thermal
      coronary angiography (TCA) for intraoperative graft patency control in 370
      patients undergoing routine coronary artery bypass graft surgery to determine
      whether consequent intraoperative bypass graft control may result in improved
      patency rates. METHODS: The temperature differences generated in between the
      myocardium and the grafts by injecting cold cardioplegic solution into the
      proximal end of a vein graft or by warmer blood running through an internal
      thoracic artery (ITA) graft were detected using three different infrared camera
      systems. The resulting "heat pictures" were evaluated for anastomotic patency and
      to outline graft anatomy. RESULTS: A total of 693 vein grafts were visualized. In
      9.4% TCA failed to produce usable images. In the remaining 628 grafts, TCA
      revealed intraoperative patency in 98.8%. Out of 370 ITA grafts, only 14 could
      not be sufficiently visualized by TCA. Nineteen ITA occlusions (5.3%) were found:
      5 intimal flaps; 11 suture imposed strictures; and 3 proximal ITA occlusions. All
      occluded grafts were subsequently revised or replaced. All sequential ITA as well
      as 15 right ITA grafts proved to have patent anastomoses. CONCLUSION: Using TCA
      an early graft dysfunction rate of 1% for vein grafts and 5.3% for ITA grafts
      could be demonstrated. Most occlusions were due to technical mistakes at the
      distal anastomosis. TCA outlines grafts and the attached coronaries by
      temperature differences without the need for a contrast agent. There is no
      interference with the surgical procedure. It is an ideal, noninvasive method to
      immediately document the success or failure of myocardial revascularization.

PMID- 7772880
TI  - Evaluation of St. Jude Medical mitral valve function by exercise Doppler
      echocardiography.
AB  - The aim of this study was to detect borderline mitral valve dysfunction in 100
      asymptomatic patients with a St. Jude Medical valve. We studied rest and exercise
      hemodynamics by Doppler echocardiography. Study patients were divided into two
      groups according to the time since surgery: group A had valves implanted less
      than 5 years ago (44 patients), group B had valves implanted more than 5 years
      ago (56 patients). Although patients had no clinical signs of valve dysfunction,
      group B was found to have significant reduction of mitral valve area (p < 0.05).
      In the group A patients, mean gradients at rest increased from 4 +/- 2, 4 +/- 2,
      and 3 +/- 1 mmHg in valve sizes of 25, 27, and 29 mm, respectively, to 7 +/- 2, 7
      +/- 3, and 5 +/- 2 mmHg with exercise. In the group B patients, mean gradients at
      rest increased from 7 +/- 1, 6 +/- 2, and 5 +/- 1 mmHg to 14 +/- 3, 13 +/- 3, and
      10 +/- 4 mmHg, respectively, after exercise. The percent increase (mean) in peak
      pressure gradient with exercise was significantly higher in group B (more than
      100%) than in group A (less than 80%) (p < 0.01). The percent increase in mean
      gradient with exercise was also significantly higher in group B (more than 100%)
      than in group A (less than 75%). In conclusion, patients with reduced valve area
      and more than a 100% increase of peak and mean gradients should be followed up
      carefully. If any signs or symptoms of heart failure develop, they must be
      considered as candidates for surgery.

PMID- 7772881
TI  - Management strategies for pulmonary vein thrombosis following single lung
      transplantation.
AB  - Pulmonary vein thrombosis following lung transplantation is an infrequently
      reported and often fatal vascular complication. Two cases of early pulmonary vein
      thrombosis following single lung transplantation are described. Both patients
      underwent surgical thrombectomy and anastomotic reconstruction following
      institution of cardiopulmonary bypass, but died of multiorgan failure within 5
      days of diagnosis. The efficacy of transesophageal echocardiography as a
      diagnostic modality, as well as medical and surgical management strategies for
      thrombectomy, are discussed.

PMID- 7772882
TI  - Concomitant coronary artery bypass grafting and adrenalectomy for
      pheochromocytoma.
AB  - We report the first case of concomitant coronary artery bypass grafting (CABG)
      and adrenalectomy for pheochromocytoma. Which lesion to correct first and staging
      of the corrective procedures are highly controversial issues. Issues concerning
      pre- and intraoperative control of hemodynamic instability from catecholamine
      release are discussed. Preoperative alpha and beta blockade permitted excellent
      hemodynamic control in the operating room. Operative and postoperative courses
      were uneventful and the patient had complete resolution of his angina and
      hypertension. We conclude that concomitant CABG and adrenalectomy is the
      preferred approach when pheochromocytoma and symptomatic coronary artery
      atherosclerosis coexist.

PMID- 7772883
TI  - Mitral annuloplasty with a flexible linear reducer.
AB  - Although the ideal technique is still controversial, mitral valve reconstruction
      for mitral insufficiency usually includes an annuloplasty. From August 1985 to
      June 1993, 126 cases of pure, acquired mitral insufficiency were repaired by
      means of a posterior annuloplasty. Whatever the etiology, all types of mitral
      insufficiency allowing a mitral reconstruction were included. The annuloplasty,
      performed with a flexible linear reducer, was associated with valvular (62%) and
      subvalvular (11%) repairs. An associated surgical procedure was necessary in 62%
      of the patients. Operative mortality was 2.4%, and follow-up (mean 29 months) was
      complete for all survivors. Five-year survival was 90%. Five-year complication
      free rate for emboli was 91%. Only one patient at 12 months underwent reoperation
      to treat recurrent mitral insufficiency. Ninety-seven patients were in New York
      Heart Association Class I or II. Follow-up echocardiographic studies on 75% of
      eligible patients showed a free rate for significant regurgitation of 99%. Mean
      valve area was estimated at 2.88 +/- 0.85 cm2. These findings suggest that the
      flexible linear reducer seems to be a reliable device and a valid alternative for
      annuloplasty.

PMID- 7772884
TI  - [Molecular chaperones].

PMID- 7772885
TI  - [Testing the knowledge of pupils and students about cancer and HIV/AIDS before
      and after the transmission of an educational message].

PMID- 7772887
TI  - [The surveillance of streptococcal infections at the level of the National
      Reference Center for Streptococcus in 1987-1993].

PMID- 7772886
TI  - [A prevalence study of serum markers in hepatitis virus infection in the
      epidemiological anamnesis of the population].
AB  - Pandemic of the infections with hepatitis viruses is a priority in public health.
      In Romania, the very high acute and chronic morbidity by viral hepatitis demands
      the rapid implementation of a feasible preventive program. In the population of 5
      districts from Transylvania we conducted a sero-epidemiological survey in order
      to find the real and specific characteristics of the prevalence of the infections
      with hepatitis viruses. The study was a cross-sectional study on the anamnestic
      presence of the infections in the population. The evolution of the cumulative
      prevalence of infections with HAV (74.3%) and HBV (31.7%) are proving a high
      endemoepidemicity. For the infections with HCV (4.9%) and HDV (1.7%) we observed
      an active process of endemicity. The high rate of persistent infections following
      HBV acute infections (19.1%) suggests a growing-up tendency of chronic hepatic
      diseases. In actual epidemiologic conditions, the rate of exposure to a potential
      hepatic viral infections in the population we studied could be 1.68
      infections/person, during a period equal to life expectancy at birth.

PMID- 7772889
TI  - [Nosocomial infections: past, present and future].

PMID- 7772888
TI  - [A comparison of an immunoenzyme reaction (Platelia R) with a complement fixation
      reaction for detecting antibodies against M. pneumoniae].

PMID- 7772890
TI  - [Susceptibility to nosocomial infections].

PMID- 7772891
TI  - [The estimation of the risk of nosocomial infections in maternity hospitals].

PMID- 7772892
TI  - [The epidemiological approach to health problems].

PMID- 7772894
TI  - [A prevalence study of viral hepatitis B infection in a closed-type children's
      collective--the Cluj-Napoca Children's Orphanage].

PMID- 7772893
TI  - [Epidemiological observations on the evolution of influenza in the city of Iasi
      in the epidemic season of 1993-1994].
AB  - The epidemiological, clinical and laboratory data of influenza and other
      respiratory diseases recorded during the epidemic season 1993-1994, as they
      resulted from the comparative analysis of the cases reported weekly and those
      recorded through the "sentinel" collectivities method, are presented. The
      findings at admissions to the Infectious Diseases Hospital, Military Hospital,
      Diagnosis and Treatment Centre for Pupils and Students and the solicitation for
      medical care at the Emergency Ambulance Service were also interpreted. The
      involvement of A/Beijing/32/92/(H3N2) influenza virus was confirmed by evidencing
      the seroconversion on two serum samples tested through RIH, while for others
      antigens anamnestic reactions were recorded. The influenza epidemic had affected
      all age groups, with horizontal extension, a first rise in December 1993 followed
      by the decline determined by winter vacation being notice. A second epidemic
      rise, much stronger, started beginning with the last month of January and reached
      a peak at mid February, followed by a marked decline.

PMID- 7772895
TI  - [Preliminary considerations in a semiquantitative microbiological study in
      catheter-related infection].
AB  - In the interval September 1993-April 1994, 38 catheters from children admitted to
      the Children's Hospital of Iasi were examined microscopically and by
      semiquantitative culture, in the children with sepsis and/or positive catheters
      hemocultures being performed concurrently. Twenty eight of these catheters proved
      to be sterile, the other 10 being positive to coagulase-negative staphylococci,
      gram-negative bacilli from Klebsiella-Enterobacter group, Candida species, the
      number of colonies/plate varying generally in concordance with the microscopic
      positive score. Of the 6 cases with > 50 colonies/plate, 3 progressed to
      septicemia, their hemocultures being positive to the same bacterial species
      demonstrating an identical sensitivity spectrum to antibiotics (2 cases with
      Enterobacter cloacae, 1 case with Klebsiella oxytoca). These results correlated
      with a bacterioscopic score > +1, in a case, which concomitantly presented local
      phenomena of phlebitis, a PNC score +3 being recorded. To conclude with, the
      results of microscopic examinations and semiquantitative culture can
      differentiate the contaminated catheters from those at bacteremic risk. For
      defining the cutoff level of the significant number of colonies/plate, more
      positive samples are needed.

PMID- 7772896
TI  - [The infectious process. The pathogenicity factors of bacteria].

PMID- 7772897
TI  - Liposarcoma of the mesocolon--case report of a rare lesion.
AB  - A middle-aged man with a 2-month history of lower abdominal pain was found to
      have a large left-sided abdominal lump. Radiological investigations (barium
      enema, ultrasound, and computed tomography scan) revealed a mass lesion in the
      area of the descending colon, the sigmoid colon, and the rectum. Flexible
      sigmoidoscopy showed only mucosal edema and luminal narrowing. At laparotomy, a
      diffuse thickening of both the descending and sigmoid mesocolon extending into
      the mesorectum was seen, which suggested an inflammatory pathology. A left
      hemicolectomy with Hartmann's procedure was performed. After obtaining a
      histopathological diagnosis of liposarcoma of the mesocolon, an abdominoperineal
      resection of the rectum was done. The patient was advised to undergo
      postoperative radiotherapy but he did not comply and was thereafter lost to
      follow-up.

PMID- 7772898
TI  - Nonanastomotic aneurysm formation in a Dacron arterial graft: report of a case.
AB  - Dacron prostheses are the most widely used grafts in replacement procedures for
      abdominal aortic aneurysms, having been proven as the most reliable substitute
      for arterial replacement. However, we present herein the rare case of an 82-year
      old woman in whom nonanastomotic aneurysm formation occurred in the graft as a
      complication associated with a Dacron prosthesis. The patient presented with a
      pulsatile mass in the right inguinal region. She had undergone surgery 13 years
      earlier for an abdominal aortic aneurysm, at which time an aortobifemoral graft
      reconstruction had been performed with a double-velour knitted Dacron prosthesis.
      The pulsatile mass was found to be a nonanastomotic aneurysm of the right limb of
      the bifurcated graft with an intact distal anastomosis. In this case, the
      development of the graft aneurysm seemed to result from deterioration of the
      Dacron prosthesis itself due to mechanical fatigue caused by the inguinal band.

PMID- 7772899
TI  - A small pedunculated adenomatous polyp of the colon found to contain the focus of
      invasive carcinoma extending to the serosa: report of a case.
AB  - A small pedunculated polyp was detected among other polyps in the transverse
      colon of a 64-year-old man, the resected specimen of which showed an adenomatous
      polyp 1 cm in diameter, containing the foci of adenocarcinoma invading the
      submucosa, muscularis, and serosa. This case report stresses the importance of
      performing careful pathologic examination of resected specimens obtained from
      endoscopic polypectomy, even for small pedunculated colon polyps.

PMID- 7772900
TI  - Use of the sandwich method with an ultra-high-molecular-weight polyethylene
      prosthesis and Marlex mesh in sternal reconstruction: report of a case.
AB  - A 52-year-old Japanese man with a slow-growing chondroma originating from the
      sternal bone was referred to our hospital. A subtotal resection of the sternum
      was performed, hereafter termed the "sandwich method," and an originally designed
      prosthesis made from ultra-high-molecular-weight polyethylene and Marlex mesh was
      used for reconstruction. The postoperative course was uneventful without any
      symptoms due to paradoxical movement of the chest or regional abscess, and no
      disturbance in the movement of the upper limbs, such as a surgical sequelae, was
      observed.

PMID- 7772901
TI  - Successful surgical treatment of a pseudoaneurysm after composite graft
      replacement of the aortic valve and ascending aorta: report of two cases.
AB  - Composite graft replacement of the ascending aorta and aortic valve has now
      become a safe surgical procedure; however, early and late complications still
      frequently occur. Anastomotic dehiscence after a composite graft replacement is
      one potentially lethal complication. We herein report two cases of a
      pseudoaneurysm caused by dehiscence of the right coronary anastomosis, and the
      proximal aortic anastomosis. A follow-up with an echocardiogram and computed
      tomography scan was found to be very useful and accurate. We thus successfully
      treated two cases of pseudoaneurysm using either Bentall's or Carbrol's
      procedures.

PMID- 7772902
TI  - Advanced primary non-Hodgkin's lymphoma of the small intestine in childhood:
      report of four cases.
AB  - Primary non-Hodgkin's lymphoma of the small intestine (PLI) is an uncommon
      malignancy in childhood which carries a poor prognosis. Consideration of the
      possible diagnosis of PLI is important when children have vague abdominal
      symptoms, since thoughtful multidisciplinary treatment can result in a better
      prognosis. This paper reports the cases of four children who have presented to
      our hospital since 1985 with advanced stage III or IV PLI. All the children had a
      huge abdominal mass but none of them had complete intestinal obstruction.
      Regarding the diagnosis, ultrasonography frequently reveals a hypoechoic
      thickening of the intestinal wall with dilated intestinal loops. A delayed
      primary or second-look operation may be the treatment of choice following
      adequate chemotherapy, while total parenteral nutritional support may prevent
      gastrointestinal complications. Three of the four patients have been in complete
      remission for 2 to 4 1/2 years since their initial treatment.

PMID- 7772903
TI  - The effect of intraportal PGE1 on warm ischemic liver damage.
AB  - To determine the most effective route of administering prostaglandin E1 (PGE1) to
      inhibit warm ischemic liver damage, 90-min warm ischemia was established in a
      canine model. The dogs were divided into three groups according to the treatment
      given. Thus, group A (n = 10) was the control group which received no treatment,
      group B (n = 7) was administered PGE1 intravenously, and group C (n = 7) was
      administered PGE1 intraportally. PGE1 was continuously administered before and
      after the ischemia at a rate of 0.02 microgram/kg/min. The branched-chain amino
      acid to aromatic amino acid ratio in the hepatic vein, and the arterial ketone
      body ratio of acetoacetic acid to beta-hydroxybutyric acid, were examined to
      observe the metabolism of each amino acid and the oxidation-reduction ability of
      hepatocytes. Both ratios were maintained only in the group C dogs, three of which
      survived for over 3 days, whereas in groups A and B, all the dogs died within 24
      h. The results of this study imply that the intraportal administration of PGE1
      was more effective against warm ischemic liver damage than the intravenous
      administration of PGE1.

PMID- 7772904
TI  - Direct hemoperfusion under infrahepatic inferior vena caval isolation for the
      intraarterial chemotherapy of pelvic tumors.
AB  - A new simple technique consisting of direct hemoperfusion under infrahepatic
      inferior vena caval isolation for intraarterial chemotherapy of pelvic tumors is
      herein described. The inferior vena cava is occluded at the infrahepatic level by
      means of balloon inflation using a balloon-tipped catheter (16F), which is placed
      through the right greater saphenous vein. The isolated infrahepatic vena caval
      blood is withdrawn by a centrifugal pump through a catheter (16F) in the
      contralateral greater saphenous vein and is filtered by direct hemoperfusion
      during intraarterial infusion of anticancer drugs. Venous reentry is provided by
      the central lumen of the balloon-tipped catheter. This procedure was used
      sequentially on two different occasions to treat a patient with an extensive
      pelvic tumor. Good hemodynamic stability and a reduction of the systemic drug
      toxicities were confirmed in both trials. Therefore, we believe that this
      technique is technically feasible and highly effective in reducing systemic
      toxicities during high-dose intraarterial chemotherapy for pelvic tumors.

PMID- 7772905
TI  - Classical and endovascular surgery: indications and outcomes.
AB  - For more than 40 years, endarterectomy and bypass grafting have been the primary
      means of surgically revascularizing peripheral vessels threatened by
      atherosclerotic disease. However, with today's endovascular technology, stenoses
      and occlusions in nearly every circulatory system can be approached
      intraluminally with a wide variety of techniques: thrombolysis, laser
      angioplasty, atherectomy, balloon dilation, and intravascular stents. Just as
      exciting is the newer technique of endoluminal grafting, which has extended
      percutaneous therapy to aneurysmal disease in the thoracic and abdominal aorta
      and distal arteries, as well as to long-segment occlusive disease. Today's
      vascular surgeon is in a unique position to combine his or her classical surgical
      training with these catheter-based interventions. Certainly, the potential
      advantages of percutaneous therapy as compared to surgical reconstruction are
      significant: no general anesthesia or lengthy incisions, shorter hospitalization,
      lower morbidity and mortality, earlier intervention in the course of the disease,
      and less complicated reapplication in the event of disease recurrence.
      Undoubtedly, endovascular techniques will become a major component of the
      vascular surgeon's armamentarium, and as we approach the year 2000, they will be
      the treatment of choice in nearly every vascular pathology and circulatory
      system.

PMID- 7772906
TI  - Lymphangitis carcinomatosis of the lesser omentum: a prognostic factor in gastric
      cancer.
AB  - A series of 126 patients with gastric cancer who underwent radical gastrectomy
      with systemic lymph node dissection revealed 9 patients who survived for a median
      time of only 3 months. Of these 9 patients, 4 were classified by the UICC system
      as stage II and 5 as stage III, all of whom had lymphangitis carcinomatosis of
      the lesser omentum. These data suggest that although lymphangitis carcinomatosis
      of the lesser omentum is an uncommon finding, if it is present, curative surgery
      is impossible and an operation should therefore be limited to tumor palliation.

PMID- 7772907
TI  - The effects of using a leukocyte removal filter during cold blood cardioplegia.
AB  - During myocardial ischemia, neutrophils and platelets exert negative effects on
      the myocardium. In this study, we used a leukocyte removal filter during
      cardioplegia, and investigated its effect on myocardial damage during reperfusion
      by measuring the plasma levels of granulocyte components, platelet components,
      and cardiac enzymes [creatinine phosphokinase (CK) and creatinine phosphokinase
      myocardial band (CK-MB)] in 24 patients who underwent cardiopulmonary bypass. The
      patients were divided into two groups of 12 according to whether or not a filter
      was placed in the cardioplegic route. Blood samples were drawn directly from the
      coronary sinus before aortic cross clamping, and at 1, 5, and 15 min after
      declamping. Group F, which had the filter, showed better cardiac enzyme and lipid
      peroxidation results than group N, which did not. The results of this study
      suggest that the application of a filter during cold blood cardioplegia may
      reduce myocardial damage.

PMID- 7772908
TI  - Intravenous digital subtraction angiography for the evaluation of renal artery
      blood flow following the removal of a neuroblastoma.
AB  - There have been several reports of acute renal failure following the resection of
      an abdominal neuroblastoma combined with ipsilateral nephrectomy as well as the
      atrophy or disappearance of an unresected kidney after tumor resection. Spasms or
      thrombosis of the renal artery during tumor excision are considered to be the
      major cause. Since 1989, intravenous digital subtraction angiography (IVDSA) has
      been used to evaluate the renal artery blood flow immediately following surgery
      in seven patients with abdominal neuroblastomas. IVDSA was performed using a
      central venous catheter inserted prior to surgery. In all seven patients, IVDSA
      provided clear images for the evaluation of renal artery blood flow. In one of
      the two patients whose kidneys briefly became cyanosed during tumor excision,
      IVDSA demonstrated an occlusion of the renal artery and prompt measures could be
      taken to reestablish the blood flow. No complications of IVDSA occurred in any of
      the seven patients. IVDSA using a central venous catheter was thus considered to
      be useful for evaluating the renal artery blood flow in patients with a suspected
      renal artery blood flow disturbance without any risk of complications, and this
      modality obviated the need for intraarterial angiography.

PMID- 7772909
TI  - One hundred and one cases of bronchoplasty for primary lung cancer.
AB  - The results of 101 consecutive bronchoplasties performed between 1979 and 1993,
      including 8 cases of pneumonectomy, 88 cases of lobectomy, 3 cases of
      segmentectomy, and 2 cases of bronchial resection, are herein reported. Squamous
      cell carcinoma was the most common disease (59%) followed by adenocarcinoma (30%)
      and other diseases (11%). Anastomosis was satisfactory in 96 cases. Among the
      five stenosed cases, local recurrence was found in two cases, and there were
      three benign strictures. Two of the three benign strictures were treated with
      bouginage. The pulmonary artery was concomitantly reconstructed in seven cases
      with satisfactory results. Preoperative chemoradiotherapy was performed in 15
      advanced cases and was followed by acceptable surgical results. The 5-year
      survival rate, according to the postoperative staging of the 86 patients without
      induction therapy, was 86% in stage I (19 patients), 49% in stage II (21
      patients), and 27% in stage IIIA (40 patients). The overall survival rate was 46%
      at 5 years. There were two indications for this procedure i.e., a positive
      resection margin in 59 cases and positive hilar nodes in 42 cases. Better
      survival was noted in patients with squamous cell carcinoma, stage I, and surgery
      was thus selected for a positive resection margin, and not for a positive node.

PMID- 7772910
TI  - Glucagon responses in rabbits with obstructive jaundice and a low energy status
      in the liver.
AB  - Glucagon has a choleretic effect and also stimulates energy-consuming reactions,
      such as gluconeogenesis and ureogenesis in the liver. The effect of glucagon on
      energy metabolism in the liver was analyzed in rabbits with obstructive jaundice
      that had severe liver damage, indicated by significantly lower hepatic energy
      charge levels. The gluconeogenetic responses to glucagon administration, as shown
      by increases in the plasma glucose levels, were usually observed in normal
      rabbits, but these responses were completely depressed after glucagon
      administration in rabbits with obstructive jaundice. The energy charge levels in
      the latter animals decreased even further after glucagon administration. Even
      though the energy consumption for gluconeogenesis after glucagon administration
      was limited in the jaundiced rabbits, it was sufficient to cause a deterioration
      in the hepatic energy balance. The above findings show that the administration of
      glucagon increases the amount of energy expended in the liver following a
      reduction in the hepatic energy charge in rabbits with obstructive jaundice.
      Therefore, even though glucagon has a choleretic effect, it should be
      administered carefully to patients with obstructive jaundice, especially in those
      with severe liver damage, such as in patients with cholangitis.

PMID- 7772911
TI  - The effect of prolonged hyperglycemia on metabolic alterations in the subtotally
      pancreatectomized rat.
AB  - A delayed onset of diabetes is characteristic of subtotally pancreatectomized
      patients in whom persistent hyperglycemia per se is documented to lead to the
      development of insulin resistance. This study was conducted to elucidate the
      metabolic alterations seen during transition of the acute to chronic phase after
      subtotal pancreatectomy (SP). Eight male Sprague-Dawley rats were studied 2 weeks
      after surgery in the acute phase, and the other eight at 4 weeks in the chronic
      phase. Phosphoenolpyruvate carboxykinase (PEPck) for gluconeogenesis and the
      malic enzyme for de novo fatty acid synthesis in the liver showed a reciprocal
      change, the former activity being increased, while the latter was suppressed.
      Both alterations were more pronounced in the chronic phase. In the acute phase,
      lipoprotein lipase (LPL) for triglyceride clearance decreased in the adipose
      tissue, while that in the cardiac and skeletal muscle became significantly
      elevated. The latter elevations were decreased in the chronic phase. Sustained
      hyperglycemia in the SP rats not only increased the changes in PEPck and malic
      enzyme activities but reversed the tissue-specific muscle LPL elevations. These
      changes might help to explain the wasting condition seen in surgically induced
      diabetic patients.

PMID- 7772912
TI  - The preoperative nutritional assessment of surgical patients with hepatic
      dysfunction.
AB  - The precise influence of malnutrition on postoperative complications in patients
      with hepatic dysfunction is not well known. In phase I of the present study, we
      evaluated the nutritional status of 102 patients with hepatic dysfunction who
      were admitted for elective hepatobiliary or pancreatic surgery, and a model for
      the prediction of postoperative complications was developed using a computer
      based stepwise regression procedure. The equation for this Prognostic Nutritional
      Index for Surgery (PNIS) was calculated by [-0.147 x (% weight change) + 0.046 x
      (% ideal body weight) + 0.010 x (actual triceps skinfold thickness as a % of
      standard value) + 0.051 x (hepaplastintest)]. In phase II this model was
      prospectively tested in 182 patients, including 145 with hepatic dysfunction. A
      total of 18 patients were classified as having a poor prognosis (PNIS < 5) and
      all of these patients in fact developed postoperative complications: 128 patients
      were classified as having an intermediate prognosis (5 < or = PNIS < 10), 23
      (18.0%) of whom developed postoperative complications, and none of the 36
      patients who were classified as having a good prognosis (PNIS > or = 10)
      developed any postoperative complications. These results demonstrate the
      importance of performing a thorough preoperative nutritional assessment of
      patients with hepatic dysfunction as malnourished patients with PNIS < 10 may
      need preoperative nutritional management, even when their surgical procedures are
      not major.

PMID- 7772913
TI  - Emergency management of caustic ingestion in adults.
AB  - A study of 57 patients admitted to the Department of Emergency Surgery at the
      Ospedale Maggiore in Milan between 1980 and 1992 following the recent ingestion
      of a caustic substance is presented herein. Through this study, an aggressive
      diagnostic and therapeutic approach has been employed, including early surgery
      which plays a fundamental role in the prevention of acute hemorrhagic or
      perforative complications as well as in the development of scar tissue and
      neoplastic strictures over time. The criteria for early emergency surgery were
      the presence of endoscopic grade 3 and 4 lesions as well as those on the
      borderline between grades 2 and 3 with clinical symptoms. In 11 patients with
      lesions of moderate severity, the treatment of choice was medical therapy, which
      required subsequent surgical intervention for strictures in 5 patients. In 13
      patients with severe lesions, an early surgical approach was performed with a
      mortality rate of 23%.

PMID- 7772914
TI  - Lymph node metastasis and the recurrence of esophageal carcinoma with emphasis on
      lymphadenectomy in the neck and superior mediastinum.
AB  - A series of 335 patients with squamous cell carcinoma of the thoracic esophagus
      undergoing resection and reconstruction via a right thoracotomy and laparotomy
      with cervical anastomosis between 1973 and 1990, were reviewed. Prior to 1982,
      the removal of lymph nodes was limited to the nodes in the mediastinum below the
      tracheal bifurcation and upper abdomen (142 patients). Nodal metastases were
      found in 89 of these patients at operation. The upper abdominal nodes were the
      most frequent sites of metastasis (47.2%). None of the 38 patients with positive
      nodes sampled from the neck and superior mediastinum survived for more than 45
      months. In the 50 patients with recurrences, 30 were in the neck and/or superior
      mediastinum. During or after 1983, the superior mediastinal nodes, particularly
      the bilateral recurrent nerve nodal chains, were routinely removed (193
      patients). Nodal metastasis was proven in 131 of the 193 patients, in whom 87
      (45.1%) had metastasis in the neck and superior mediastinum. Eleven of these 87
      patients survived for 45 months or more. In the 61 patients with recurrences, 20
      were in the neck and/or superior mediastinum. These data suggest that recurrent
      nerve nodal chains should be removed to improve survival in patients with
      esophageal carcinoma.

PMID- 7772915
TI  - Concomitant coronary bypass grafting and curative surgery for cancer.
AB  - The surgical management of patients with concomitant critical coronary artery
      disease (CAD) and surgically resectable cancer is controversial. We evaluated 19
      patients who underwent concomitant coronary artery bypass grafting (CABG) and
      curative operation for cancer of the stomach in 9 patients, the colon in 4, the
      lung in 4, and the breast in 2. Each cancer operation was performed under stable
      hemodynamics without any serious bleeding tendency, immediately after CABG with
      an average of 2.5 +/- 0.8 grafts. There were no operative deaths and no
      incidences of perioperative myocardial infarction. Postoperative complications
      developed in three of the patients with lung cancer: respiratory dysfunction
      caused by phrenic nerve paralysis in two and mediastinitis in one. During the
      mean follow-up period of 33 +/- 23 months, 5 patients died of recurrent cancer or
      non-cardiac disease; however, all 19 patients remained free from any
      postoperative cardiac events and their quality of life apparently improved. This
      experience suggests that such simultaneous correction would be safe and
      beneficial in carefully selected patients who have surgically correctable CAD and
      potentially curable cancer.

PMID- 7772916
TI  - Effects of left intraatrial infusion of prostaglandin E1 after open-heart
      surgery.
AB  - The hemodynamic effects of a left intraatrial infusion of prostaglandin E1 (PGE1)
      given to ten patients after open-heart surgery (LA group), were compared with
      those following no treatment in a control group of ten patients, and to those
      following a right intraatrial infusion given to another ten patients (RA group).
      PGE1 was infused at a rate of 0.03 microgram/kg/min in the RA group and at 0.003
      microgram/kg/min in the LA group, and hemodynamics were measured immediately
      after surgery, then 3, 6, and 12 h after the PGE1 infusion was commenced. The
      heart rate, right atrial pressure, left atrial pressure, and mean pulmonary
      arterial pressure remained almost unchanged in all three groups; however, the
      mean radial arterial pressure and systemic vascular resistance index decreased,
      and the cardiac index increased in the RA and LA groups. The pulmonary vascular
      resistance index decreased only in the LA group. Thus, a much smaller dose of
      PGE1, being one-tenth of that used for the right atrial infusion, administered
      directly into the left atrium yielded almost the same hemodynamic effects as the
      larger dose infused into the right atrium. Furthermore, this method of infusing
      PGE1 is safe, efficacious, and cost-efficient.

PMID- 7772917
TI  - Identification and biochemical characterization of human plasma neutrophil
      inhibitor in vitro.
AB  - In this study, assessment by a flow cytometric method using dichlorhydroxy
      fluorescin diacetate (DCFADH) in vitro revealed that human peripheral blood
      inhibits the production of active oxygen species by human peripheral neutrophils.
      It was also revealed that among the blood components, the plasma fraction
      inhibits active oxygen production most strongly. This plasma inhibitory activity
      was dose-dependent. Human serum also exerted an inhibitory activity; however, its
      activity was only one-third that of plasma. Moreover, when HL-60 human
      promyelocytic leukemic cells, with or without differentiation into the
      neutrophils by culturing with dimethyl sulfoxide (DMSO), active oxygen, which was
      also inhibited by plasma, was produced. Heat inactivation of the plasma did not
      alter the inhibitory activity, and gel filtration analysis showed that the peak
      activity was associated with a molecular mass of 70,000. The results of this
      study indicate that human plasma contains one or more substances that inhibit the
      active oxygen production of neutrophils, which may play an important role in
      inhibiting unneeded neutrophil activation in the bloodstream.

PMID- 7772918
TI  - Malignant lymphoma of the thyroid with evidence of an Epstein-Barr viral
      infection concomitant with thalassemia minor: report of a case.
AB  - We report herein the unusual case of a 53-year-old Japanese man in whom malignant
      lymphoma of the thyroid was found to coexist with asymptomatic thalassemia minor
      and an elevated titer (1:80) of immunoglobulin G against the Epstein-Barr viral
      capsid antigen. A total thyroidectomy with lymphadenectomy was performed, and the
      thyroid was found to be almost replaced by the neoplasm, the microscopy of which
      revealed malignant lymphoma of the diffuse, large-cell type. The existence of
      this case led us to question whether malignant lymphoma of the thyroid and an
      elevated titer for the Epstein-Barr virus might have a possible mutual
      association.

PMID- 7772919
TI  - The safe and complete removal of a carotid body tumor with elements suggestive of
      a malignant potential by employing an intraluminal shunt: report of a case.
AB  - The carotid body tumor is a relatively rare neoplasm arising from the
      intercarotid paraganglions. We report herein the case of a patient with a
      Shamblin group 2 type carotid body tumor for which safe and successful removal
      was facilitated by the insertion of an intraluminal shunt. The patient was a 54
      year-old man who presented with a spherical elastic mass, 4.8 x 3.7 cm in size,
      on the right anterior aspect of his neck, which was diagnosed as a carotid body
      tumor by diagnostic imaging. Because the tumor was suspected to be malignant
      based on the operative findings, which included invasive adhesion to the carotid
      artery, an intraluminal shunt was inserted, allowing for safe and complete
      removal. Histologically, this tumor showed malignant potential with sporadic
      mitoses and incomplete capsular invasion. Thus, it is recommended that an
      intraluminal shunt be employed for the removal of a carotid body tumor when it is
      found to be tightly adherent to the carotid artery during the operation.

PMID- 7772920
TI  - Complete endobronchial obstruction and left non-aerated hemithorax caused by a
      leiomyoma: report of a case.
AB  - Presented herein is the case of a 27-year-old man in whom an endobronchial tumor
      was found causing complete obstruction of the left main bronchus. The tumor was
      successfully removed by performing sleeve resection of the left main bronchus
      without pulmonary resection, immediately following which the left lung became
      reinflated. Subsequent histological study of the resected tumor confirmed that it
      was a leiomyoma, a type of benign tumor that is rarely found in the lung.

PMID- 7772921
TI  - Thrombosed tricuspid valves presenting some 20 years after the surgical
      correction of Ebstein's anomaly: report of two cases.
AB  - We present herein the cases of two patients who were diagnosed as having
      thrombosed tricuspid valves by electrocardiography after undergoing valve
      replacement with Starr-Edwards caged ball valves for Ebstein's anomaly 19 and 27
      years earlier. In both patients, the valves were found to be attached to the
      right ventricular septum and covered with massive thrombus, the balls being
      completely jammed in a half-open position in the cages. Re-replacement of the
      valves was successfully performed with Hancock II porcine heterograft prostheses
      and both patients are now classified as being in Functional Class I or II.

PMID- 7772922
TI  - Recurrent splenic artery aneurysms developing after aneurysmectomy without
      splenectomy: report of a case.
AB  - We report herein the case of a 47-year-old man who developed a huge splenic
      artery aneurysm (SAA) with splenomegaly, for which ligation of the splenic artery
      and partial aneurysmectomy was performed. A celiac arteriogram taken 2 months
      postoperatively revealed that two small aneurysms had developed in the collateral
      vessels, indicating that increased blood flow through the collateral circulation
      could be responsible for the formation of secondary aneurysms. This postoperative
      change suggests that the etiology is related to the SAA and thus, the possibility
      that aneurysms may develop in the collateral vessels following spleen-preserving
      procedures for SAA must be borne in mind and careful follow-up performed at
      regular intervals.

PMID- 7772923
TI  - Familial nesidioblastosis in two sisters.
AB  - We herein present two female siblings with persistent hyperinsulinemic
      hypoglycemia in the neonatal period who were diagnosed as having familial
      nesidioblastosis. Despite both the administration of diazoxide and the
      intravenous infusion of glucose, one of the affected infants died of severe
      metabolic acidosis at about 1 month of age, before pancreatectomy could be
      performed. The other, in whom the disorder was diagnosed early, also failed to
      respond to conservative medical treatment and ultimately required a 99%
      pancreatectomy for control of hypoglycemia. A third female sibling was normal.
      The possibility of familial nesidioblastosis should thus be considered in the
      case of neonatal intractable hypoglycemia to ensure a prompt diagnosis and allow
      for early surgical intervention when indicated. The relevant literature on this
      life-threatening disorder is also reviewed.

PMID- 7772924
TI  - The endoscopic removal of a foreign body in the pericardial cavity following
      cardiac surgery.
AB  - We were able to successfully remove a needle and suture through a pericardial
      drain following cardiac surgery by means of a simple method using a
      bronchofiberscope without having to perform a re-median sternotomy. The technique
      of endoscopic removal of cardiac surgical misplacement is described.

PMID- 7772925
TI  - Thoracoscopic sympathectomy for Buerger's disease: a report on the successful
      treatment of four patients.
AB  - We describe herein the successful treatment of four patients with ischemic ulcers
      or gangrene of the fingers due to Buerger's disease by thoracoscopic
      sympathectomy, a new method of surgery which eliminates the difficulties
      associated with the traditional "open" approaches to the thoracic sympathetic
      chain, such as poor exposure, risk of damage to the adjacent structures, and
      postoperative pain. After the patients were placed in the lateral decubitus
      position with unilateral pulmonary ventilation, the thoracic sympathetic ganglia
      (T) from the lower third of T1 to T3 were resected endoscopically. The operative
      results were excellent, with improvement or complete resolution of the ulcer
      being achieved in all four patients. All of the patients were satisfied with the
      results in terms of ulcer healing, postoperative pain, and cosmetic appearance.
      Although a postoperative air leakage developed in one patient with a history of
      pulmonary tuberculosis, it was successfully treated with an adhesive agent. None
      of the patients developed Horner's syndrome. Thus, because thoracoscopic
      sympathectomy is easier to perform with a lower risk of complications than
      conventional thoracic sympathectomy, we recommend this operative approach as the
      procedure of choice for surgical thoracic sympathectomy.

PMID- 7772926
TI  - The anti-proliferative effect of proliferating cell nuclear antigen-specific
      antisense oligonucleotides on human gastric cancer cell lines.
AB  - The proliferating cell nuclear antigen (PCNA) is a nuclear protein that leads DNA
      synthesis by the DNA polymerase delta. As the PCNA gene is strongly expressed in
      invasive gastric cancer cells with high proliferative activity, PCNA is suspected
      of playing an important role in the proliferation and advancement of gastric
      cancer. Thus, the effects of antisense oligonucleotides specific for PCNA mRNA
      were examined in seven gastric cancer cell lines. It was found that treatment
      with antisense oligonucleotides at concentrations of 10-40 microM dose
      dependently inhibited the growth of all cell lines; however, random sequence
      oligonucleotides did not modify the proliferation of any type of cells. These
      results indicate that PCNA is essential for cell proliferation in gastric cancer
      cells, and that the growth inhibitory effect results from the inhibition of PCNA
      gene expression. Therefore, PCNA-specific antisense oligonucleotides may be
      effective in the treatment of gastric cancer.

PMID- 7772927
TI  - Terminal motor latency in the pudendal nerves after colectomy with mucosal
      proctectomy and ileal J pouch-anal anastomosis for ulcerative colitis.
AB  - Pudendal nerve terminal motor latencies (PNTML) were measured in eight patients
      with ulcerative colitis who underwent colectomy with mucosal proctectomy and
      ileal J pouch-anal anastomosis, using a new digitally directed transrectal
      stimulation and recording technique, and the results were compared with data
      obtained from 15 control subjects. The conduction delay of PNTML in the patients
      with some degree of fecal incontinence was the longest, followed by those without
      any incontinence, and then the control subjects. These findings support the
      hypothesis that fecal incontinence after this procedure may be partially caused
      by damage to the pudendal nerve.

PMID- 7772929
TI  - AHNA certificate program in holistic nursing courses: AHNA certificate program in
      healing touch courses.

PMID- 7772930
TI  - Is there a scent in your future?

PMID- 7772928
TI  - Complex abdominal and thoracoabdominal aortic aneurysm reconstruction.
AB  - Complex reconstructions of the abdominal aorta are required for aneurysms that
      require visceral or splanchnic revascularization, when the aorta is inflammatory
      or infected, when a fistula to the vena cava or bowel is present, and when the
      aneurysm involves the juxtarenal, pararenal segments, or the full length of the
      abdominal aorta. The technique for full-length abdominal and thoracoabdominal
      aortic reconstructions has been modified to separate the visceral and spinal cord
      revascularization from the body of the main graft. The visceral, renal, and
      intercostal arteries are not directly reimplanted into the aortic graft but
      rather into sidearm grafts using a patch inclusion technique. The reconstruction
      commences distally by anastomosing the main graft to the aortic bifurcation or to
      the iliac arteries as appropriate. The main graft is then anastomosed to the
      proximal aorta after which the aortic clamps are released to perfuse the lower
      limbs. The intercostal arteries are reimplanted into a posterior sidearm graft
      followed by visceral and renal artery reimplantation into an anterior sidearm
      graft. This technique reimplantation into an anterior sidearm graft. This
      technique reduces the period of left ventricular strain to the time taken to
      complete the upper aortic anastomosis. It also allows separate control of the
      visceral and intercostal implantations should bleeding occur, without the
      necessity to reclamp the main body of the graft.

PMID- 7772931
TI  - On holism--accepting one another.

PMID- 7772932
TI  - AHNA certificate program in holistic nursing courses; AHNA certificate program in
      healing touch courses.

PMID- 7772933
TI  - When we really discover the world is round ... we can no longer choose sides.

PMID- 7772934
TI  - Differential perceptions, behaviors, and motivations among African Americans,
      Latinos, and whites suspected of heart attacks in two hospital populations.
AB  - To evaluate the hypothesis that socioeconomic status would exert greater
      influence on patients' care-seeking behavior than racial/ethnic group status, we
      undertook a sequential study of African-American, Latino, and white patients
      hospitalized for acute chest pain from August 1988 through July 1990 at two
      sites. The study took place in an urban public medical center and an urban
      private health maintenance organization medical center, which provide care to
      mixed racial/ethnic groups of lower and middle socioeconomic status,
      respectively, in Los Angeles. Three concurrent case series of African-American,
      Latino, and white patients hospitalized for acute chest pain were recruited. The
      racial/ethnic distribution of the total group was African Americans, 448;
      Latinos, 487; and whites, 499. The main outcome measure was the length of time
      patients spent in deciding to seek emergency medical care for acute chest pain
      and the associated perceptions, behaviors, and motivations involved in deciding
      to seek care. For the total group, public hospital site and lack of health
      insurance were the strongest significant predictors of a longer decision phase,
      whereas differential symptom perceptions, consultation with medical
      professionals, and use of paramedic transport were significant predictors of
      shorter duration. Multiple regression results were similar in separate analyses
      demonstrated significant differences in patients' perceptions of symptom
      intensity and incapacitation within racial/ethnic groups related to socioeconomic
      status, as well as in specific behavior and motivation in seeking care. The study
      concluded that socioeconomic status as determined by hospital site exerted a
      stronger influence on patients' care-seeking behavior for acute chest pain than
      racial/ethnic status. Specific care-seeking behaviors of minority and lower
      socioeconomic-status patients in the use of medications and paramedics in the
      face of acute symptoms should be targeted in future educational programs.

PMID- 7772935
TI  - Variations in oral glucose tolerance tests: the 100- versus 75-g controversy.
AB  - This study compared the results of a 75-g, 3-hour oral glucose tolerance test
      with those of a traditional 100-g oral glucose tolerance test. Thirty-two
      pregnant women participated in the study. Each patient served as her own control,
      undergoing both a 100- and a 75-g oral glucose tolerance test within 1 week.
      Despite a strong positive correlation between the results of the two tests, the 1
      , 2-, and 3-hour glucose values of the 100-g glucose load were significantly
      higher than the comparable values of the 75-g oral glucose tolerance test.
      Sixteen of 32 women were diagnosed as having gestational diabetes mellitus using
      the National Diabetes Data Group criteria and the 100-g oral glucose tolerance
      test, whereas only 6 of these 16 women would have been identified with the 75-g
      oral glucose tolerance test. If data from one test are to be compared with the
      other, new thresholds of glucose abnormality need to be developed.

PMID- 7772936
TI  - Cultural diversity as a factor in self-monitoring blood glucose in gestational
      diabetes.
AB  - The routine use of self-monitoring of capillary blood glucose by pregnant
      diabetic patients currently provides the basis for both clinical management and
      ongoing investigation. Strategies must therefore be developed to ensure that
      these data are reliable and accurately reported by patients and are not
      influenced by diverse socioeconomic levels or varied geographic locations. To
      explore this issue, we used glucose reflectance meters with a memory microchip
      capable of storing up to 440 consecutive blood glucose determinations. Two
      diverse groups of women from Texas and New York who had gestational diabetes
      performed self-monitoring of blood glucose from diagnosis until delivery. Both
      groups recorded their blood glucose results daily in a logbook. The reporting
      performance of all the participating subjects resulted in an actual compliance
      rate of 60% to 70% of testings required of the patients. Comparison of African
      American, Mexican-American, and white populations revealed no significant
      differences in patient performance or compliance. Moreover, no differences were
      found between the groups at different geographic locations (New York, Texas) in
      patients' willingness and ability to comply with the regimen of self-monitoring
      blood glucose. These findings suggest that the use of memory reflectance meters,
      in conjunction with patient education and positive interaction between patient
      and care provider, will result in high patient compliance regardless of
      socioeconomic level or ethnic diversity.

PMID- 7772937
TI  - Impact of an inner-city, hospital-based preterm prevention program on preterm
      births in twin gestation.
AB  - The objective of this study was to determine the impact of an inner-city,
      hospital-based preterm-birth prevention program on the outcome of twin
      pregnancies. A retrospective study of delivery outcomes from 1985 to 1992 of
      eligible consecutive twin deliveries that were > or = 20 weeks' gestation
      compared two inner-city hospitals in the Bronx, New York: one with a preterm
      prevention program for twin births and a comparable site offering conventional
      prenatal care. A group of patients receiving no prenatal care was also included.
      Outcomes were evaluated by prenatal-care site, except for those who received no
      prenatal care and delivered at either site. Data were analyzed by chi-square
      analysis and analysis of variance. Of the 377 twin pregnancies, 330 pregnancies
      were eligible deliveries. One hundred thirty-four women received prenatal care
      from the preterm prevention program, 161 received conventional prenatal care at a
      comparable site, and 35 received no prenatal care. Maternal age, parity, and mode
      of delivery were similar in the two delivery sites. There was an increased
      incidence of complications in the no-prenatal-care group compared with the groups
      who received the preterm prevention or conventional prenatal care. The percentage
      of low-birth-weight (< 2500 g) and very-low-birth-weight (< 1000 g) infants was
      similar in the preterm prevention and the conventional care groups. The
      percentage of extremely low-birth-weight (< 1000 g) infants was significantly
      lower in twin births of the preterm prevention site (9.7%) and the conventional
      site (11.3%) compared with the no-prenatal-care group (28.6%) (P < .01).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7772938
TI  - Metabolism of halohydroquinones in Rhodococcus chlorophenolicus PCP-1.
AB  - The actinomycete Rhodococcus chlorophenolicus PCP-1 metabolizes pentachlorophenol
      into ultimate inorganic end products via tetrachloro-p-hydroquinone. This
      intermediate was further dehalogenated in the cytoplasm requiring reductant in
      the cell free system. Tetrafluoro-p-hydroquinone and tetrabromo-p-hydroquinone
      were also dehalogenated. Chlorophenol analogs, thiol blocking agents and
      molecular oxygen inhibited the activity. The dehalogenating reactions led to
      1,2,4-trihydroxybenzene, which was further metabolized into maleic acid.

PMID- 7772939
TI  - Effects of oxygen, nitrogen, and temperature on gasoline biodegradation in soil.
AB  - Biodegradation was considered to be a feasible approach to remediate petroleum
      hydrocarbon-contaminated soil from a site at the University of Idaho. Before a
      full-scale treatment process was designed, the biodegradative capacity of the
      soil's indigenous microorganisms was tested. Gas chromatography was used to
      measure gasoline vapor components in the headspace above the contaminated soils
      held in closed containers. In a study of biodegradation kinetics, gasoline
      degradation rates under various conditions (different soil cores, temperatures,
      oxygen concentrations, and nutrient concentrations) were tested. It was found
      that gasoline hydrocarbons could be biodegraded at relatively high rates after
      appropriate nutrient additions. An unexpected observation was that the optimal
      concentration of oxygen for the gasoline-degrading microorganisms in these soils
      was only 10%.

PMID- 7772940
TI  - Transformation of o-xylene to o-methyl benzoic acid by a denitrifying enrichment
      culture using toluene as the primary substrate.
AB  - A highly enriched denitrifying mixed culture transformed o-xylene co
      metabolically along with toluene by methyl group oxidation. o-Methyl benzaldehyde
      and o-methyl benzoic acid accumulated transiently as metabolic products of o
      xylene transformation. Transformation of o-methyl benzyl alcohol and o-methyl
      benzaldehyde occurred independently of toluene degradation and resulted in the
      formation of a compound coeluting with o-methyl benzoic acid on a gas
      chromatograph. The co-metabolic relationship between toluene and o-xylene could
      be attributed to a mechanism linked to the initial oxidation of the methyl group.

PMID- 7772941
TI  - Stoichiometry and kinetics of microbial toluene degradation under denitrifying
      conditions.
AB  - Batch experiments were carried out to investigate the stoichiometry and kinetics
      of microbial degradation of toluene under denitrifying conditions. The inoculum
      originated from a mixture of sludges from sewage treatment plants with
      alternating nitrification and denitrification. The culture was able to degrade
      toluene under anaerobic conditions in the presence of nitrate, nitrite, nitric
      oxide, or nitrous oxide. No degradation occurred in the absence of Noxides. The
      culture was also able to use oxygen, but ferric iron could not be used as an
      electron acceptor. In experiments with 14C-labeled toluene, 34% +/- 8% of the
      carbon was incorporated into the biomass, while 53% +/- 10% was recovered as
      14CO2, and 6% +/- 2% remained in the medium as nonvolatile water soluble
      products. The average consumption of nitrate in experiments, where all the
      reduced nitrate was recovered as nitrite, was 1.3 +/- 0.2 mg of nitrate-N per mg
      of toluene. This nitrate reduction accounted for 70% of the electrons donated
      during the oxidation of toluene. When nitrate was reduced to nitrogen gas, the
      consumption was 0.7 +/- 0.2 mg per mg of toluene, accounting for 97% of the
      donated electrons. Since the ammonia concentration decreased during degradation,
      dissimilatory reduction of nitrate to ammonia was not the reductive process. The
      degradation of toluene was modelled by classical Monod kinetics. The maximum
      specific rate of degradation, k, was estimated to be 0.71 mg toluene per mg of
      protein per hour, and the Monod saturation constant, Ks, to be 0.2 mg toluene/l.
      The maximum specific growth rate, mu max, was estimated to be 0.1 per hour, and
      the yield coefficient, Y, was 0.14 mg protein per mg toluene.

PMID- 7772942
TI  - Tetrachloroethene and 3-chlorobenzoate dechlorination activities are co-induced
      in Desulfomonile tiedjei DCB-1.
AB  - Desulfomonile tiedjei, a strict anaerobe capable of reductively dechlorinating 3
      chlorobenzoate, also dechlorinates tetrachloroethene and trichloroethene. It is
      not known, however, if the aryl and aliphatic dechlorination activities are
      catalyzed by the same enzymatic system. Cultures induced for 3-chlorobenzoate
      activity dechlorinated tetrachloroethene and trichloroethene to lower chlorinated
      products while uninduced parallel cultures did not dechlorinate either substrate.
      The observed rate of PCE dechlorination in induced cultures was 22 mumol h-1 g
      protein-1, which is considerably faster than previous rates obtained with defined
      cultures of this organism. These results show that both dechlorination activities
      are co-induced and therefore, that the dechlorination mechanisms may share at
      least some components.

PMID- 7772943
TI  - Biotransformation of diphenyl ether by the yeast Trichosporon beigelii SBUG 752.
AB  - Trichosporon beigelii SBUG 752 was able to transform diphenyl ether. By TLC,
      HPLC, GC, GC-MS, NMR- and UV-spectroscopy, several oxidation products were
      identified. The primary attack was initiated by a monooxygenation step, resulting
      in the formation of 4-hydroxydiphenyl ether, 2-hydroxydiphenyl ether and 3
      hydroxydiphenyl ether (48:47:5). Further oxidation led to 3,4-dihydroxydiphenyl
      ether. As a characteristic product resulting from the cleavage of an aromatic
      ring, the lactone of 2-hydroxy-4-phenoxymuconic acid was identified. The possible
      mechanism of ring cleavage to yield this metabolite is discussed.

PMID- 7772944
TI  - Degradation of 4-chloro-2-methylphenol by an activated sludge isolate and its
      taxonomic description.
AB  - The Gram-negative strain S1, isolated from activated sludge, metabolized 4-chloro
      2-methylphenol by an inducible pathway via a modified ortho-cleavage route as
      indicated by a transiently secreted intermediate, identified as 2-methyl-4
      carboxymethylenebut-2-en-4-olide by gas chromatography/mass spectrometry. Beside
      4-chloro-2-methylphenol only 2,4-dichlorophenol and 4-chlorophenol were totally
      degraded, without an accumulation of intermediates. The chlorinated phenols
      tested induced activities of 2,4-dichlorophenol hydroxylase and catechol 1,2
      dioxygenase type II. Phenol itself appeared to be degraded more efficiently via a
      separate, inducible ortho-cleavage pathway. The strain was characterized with
      respect to its physiological and chemotaxonomic properties. The fatty acid
      profile, the presence of spermidine as main polyamine, and of ubiquinone Q-10
      allowed the allocation of the strain into the alpha-2 subclass of the
      Proteobacteria. Ochrobactrum anthropi was indicated by fatty acid analysis as the
      most similar organism, however, differences in a number of physiological features
      (e.g. absence of nitrate reduction) and pattern of soluble proteins distinguished
      strain S1 from this species.

PMID- 7772945
TI  - The development of a novel strategy for the microbial treatment of acrylonitrile
      effluents.
AB  - Effluent from the manufacture of acrylonitrile is difficult to biodegrade. It
      contains nine major organic components: acetic acid, acrylonitrile, acrylamide,
      acrylic acid, acrolein, cyanopyridine, fumaronitrile, succinonitrile, and
      maleimide. A range of bacteria have been isolated that can grow on, or convert
      all of the organic components of effluent from the manufacture of acrylonitrile.
      These bacteria can be used as the basis of a mixed culture system to treat the
      effluent. The bacteria were utilised in batch and continuous cultures to degrade
      a synthetic wastewater containing acrylonitrile, acrylamide, acrylic acid,
      cyanopyridine and succinonitrile. The mixed microbial population was adapted by
      varying the growth rate and switching from continuous to batch and back to
      continuous growth, to degrade these five compounds as well as acrolein,
      fumaronitrile and maleimide.

PMID- 7772946
TI  - Purification of virus like particles from yeast cells using aqueous two-phase
      systems.
AB  - Aqueous two-phase systems have been used for the separation and purification of
      recombinant virus-like particles (VLPs) from a yeast cell homogenate. Systems
      have been evaluated on the basis of their ability to separate VLPs from cell
      debris and from contaminating proteins. Two strategies are proposed for VLP
      separation, both involve the use of two PEG/salt aqueous two-phase systems. For
      separation of VLPs from cell debris systems composed of PEG 400 or 600 and
      (NH4)2SO4 or PEG 4000/MgSO4 can be used and for separation of VLPs from proteins
      PEG 4000/(NH4)2SO4 or MgSO4 and Na2SO4 are effective. The molecular weight of the
      PEG used and the use of additional salts (e.g. NaCl) greatly influence the
      effectiveness of the systems.

PMID- 7772947
TI  - Use of multifactorial analysis to develop aqueous two-phase systems for isolation
      of non-native IGF-I.
AB  - A high yield procedure was developed to solubilize and extract IGF-I from
      recombinant E. coli by adding chaotrope and disulfide reductant to alkaline
      fermentation broth. To enhance centrifugation performance and recovery yield, a
      salt/polymer aqueous two-phase extraction procedure was developed whereby soluble
      non-native IGF-I and biomass solids are enriched in separate liquid phases. To
      develop this extraction system a multifactorial experimental approach was used to
      simultaneously map the phase diagram and identify conditions to suitably
      partition IGF-I and cell remnants. The presence of urea in these systems tended
      to disrupt two-phase formation and solids sedimentation. This, in turn,
      constrained the concentrations of phase forming solutes which could be
      effectively used. Systems containing low levels of salt (less than about 4% w/w)
      and polymer (less than about 10% w/w) did not form two phases. Systems containing
      high levels of salt (greater than about 7% w/w) and polymer (greater than about
      18% w/w) formed two phases with floating solids. Intermediate levels of salt
      (between about 4% and 7% w/w) and polymer (between about 10% and 18% w/w) formed
      two phases in which solids were enriched in the heavy phase. Systems in this
      latter desired category were produced with a variety of different salts and
      polymers and all enriched non-native IGF-I in the light phase. Highest recovery
      yield (about 90%) was obtained with systems composed of 5% sodium sulfate and 14%
      PEG-8000.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772948
TI  - Synthesis of thiophilic adsorbents, containing amine spacer arms, and adsorption
      of immunoglobulins from adult bovine serum.
AB  - In order to remove immunoglobulins from adult bovine serum (ABS), adsorptions
      were carried out in suspension with thiophilic adsorbents without (T-gel) and
      with (ST-gels) short amine spacer. The developed ST-gels could be cleaned in
      sodium hydroxide and specifically adsorbed immunoglobulins from ABS at a lower
      ionic strength of the adsorption buffer than a T-gel. The ST-gels are suited for
      the performance of adsorptions in a suspension with a high concentration of the
      adsorbent. For an almost complete removal of immunoglobulins from ABS in 0.5 M
      potassium sulfate and 0.1 M potassium phosphate (pH 7), up to 75 g ST-gel per 1
      suspension may process up to 100 ml ABS. The synthesized ST-gels contained an
      equal amount of amine spacers and sulfone groups. The ratio between coupled 2
      mercaptoethanol molecules and sulfone groups was about 0.4. In comparison with
      the T-gel, the chemical stability of the ST-gels in solutions of 0.1 to 1 M
      sodium hydroxide was higher. The capacity for adsorbing pure immunoglobulins of
      the T-gel was 0.329 g g-1 (10.9 g l-1) and of the ST2-gel, 0.677 g g1 (52.3 g l
      1). The capacity for adsorbing IgG from ABS of the T-gel was 0.177 g g1 (5.88 g l
      1) and of the ST2-gel, 0.152 g g-1 (11.7 g l-1). This reduced capacity was
      attributed to a low affinity binding to the adsorbents of other proteins from
      ABS. When an incubation of the adsorbent with ABS was performed in 0.5 M
      potassium sulfate and 0.1 M potassium phosphate (pH 7), the affinity constant
      (Ka) for IgG of the T-gel was 2.5 x 10(6) M-1 and of the ST-gel, 3.1 x 10(7) M-1.
      In this adsorption buffer at a protein concentration above 5 g l-1, salt-promoted
      precipitation of IgG took place. When an adsorption was performed at the minimal
      ionic strength of the adsorption buffer, the Ka of the T-gel for IgG was about 9
      x 10(3) M-1 and of the ST-gel, about 2.3 x 10(5) M-1. In this case, the removal
      of Igs from ABS was achieved by means of a partition equilibrium, rather than by
      high affinity adsorption.

PMID- 7772949
TI  - Preparation of high purity alkaline phosphatase from calf intestine using dye
      ligand chromatography.
AB  - For the effective application of alkaline phosphatase from calf intestine in
      Molecular Biology research highly purified enzyme and free from contaminating
      DNases, DNA nicking, ribonuclease and phosphodiesterase activities is required.
      We now report the use of a two-step procedure which involves chromatography on a
      Mimetic Blue AP-Agarose, a commercially available adsorbent and Heparin Sepharose
      to purify calf intestinal alkaline phosphatase from a crude commercial
      preparation to homogeneity. Purified enzyme preparations were free from
      contaminating DNases, DNA nicking, ribonuclease and phosphodiesterase activities
      and exhibited a specific activity (3.800 units/mg) which is one of the highest
      reported among the existing high purity commercial preparations. It is therefore
      concluded that the reported purification protocol can be used routinely to
      prepare high purity alkaline phosphatase suitable for use in Molecular Biology
      research.

PMID- 7772950
TI  - Purification of human interleukin-2 using the cellulose-binding domain of a
      prokaryotic cellulase.
AB  - Engineering gene fusions which introduce an affinity tag linked to the target
      polypeptide by a specific protease cleavage site is widely used to facilitate
      recombinant protein purification. A fusion protein CBDAPT-IL-2, comprised of the
      cellulose-binding domain (CBD) and Pro-Thr (PT) rich linker of the Cellulomonas
      fimi endo-beta-1,4-glucanase A (CenA) and a factor Xa cleavage sequence
      (IleGluGlyArg) fused to the N terminus of human interleukin-2, was produced in
      Escherichia coli, Streptomyces lividans and mammalian COS cells. CBDAPT-IL-2,
      secreted from S. lividans or COS cells or recovered from the insoluble fraction
      of E. coli, could be purified by adsorption on cellulose. The intact fusion
      protein adsorbed to cellulose was hydrolyzed in situ with factor Xa to release
      active interleukin-2.

PMID- 7772952
TI  - Nurse-patient communication in intensive care: a low priority?
AB  - Nursing literature is well endowed with information supporting the importance of
      maintaining optimal communication between nurses and critically ill patients
      (Rundell 1991). There is, however, evidence to suggest that although critical
      care nurses are aware of the need to communicate effectively with their patients,
      this often does not occur (Mallett 1990).

PMID- 7772951
TI  - Caring for children in an adult intensive care unit--Part I.
AB  - Various reports draw attention to the deficiency of services available for
      critically ill children. In December 1993 the British Paediatric Association
      published a report by a multidisciplinary working party on intensive care. The
      Minister of Health has apparently promised to act on the recommendations the
      working party made. In fact, purchasers are being encouraged to act and ask
      questions about the provision of paediatric intensive care--but no extra funding
      is available to provide it. However, this will all take time and until more
      resources are available children are still being cared for on adult intensive
      care units by nurses who may not be experienced in caring for sick children. One
      of the main areas of concern nurses have when caring for children is the
      physiological differences between an adult and a child. This paper is designed to
      assist in identifying the differences and consequent nursing implications. In an
      attempt to prioritize the nursing care a systems/modified model has been used
      over 2 papers. The review of the systems demonstrates the differences between
      adults and children and, where possible, highlights the nursing care and medical
      treatment a child requires. All aspects of care have been included as well as the
      psychological problems (see Part 2 which will be published in the next issue)
      encountered by the family of a critically ill child. Where possible easy
      reference tables have been included and the author hopes to introduce the package
      into the existing orientation programme for established staff and staff new to
      the unit in the hopes of decreasing the stress when a child is admitted.
      Paediatric resuscitation has not been covered intentionally, as the information
      on the physiological differences seemed to grow like 'Jack's beanstalk'.
      Therefore, a flow chart for basic and advanced life support is included as an
      appendix in Part I. It is hoped this will stimulate readers' interest for more in
      depth study.

PMID- 7772954
TI  - BACCN position statement: resourcing of intensive care services.

PMID- 7772953
TI  - Research and practice development.

PMID- 7772955
TI  - What of intensive care?

PMID- 7772956
TI  - Recognising post-traumatic stress in intensive care patients.
AB  - 'We may not be able to prevent stress or distress, but we can alter the intensity
      and duration of stress-related trauma by naming our demons, daring to struggle
      with them, and by creating healing communities.' (Chandler 1992, p 88) In order
      to create an environment in which the above process can take place it is
      incumbent upon nurses to assess patients in need and to institute appropriate
      intervention at an early stage. Critical care nurses have a particular
      responsibility to identify the seeds of post-traumatic stress and implement
      supportive and preventive strategies, primarily because of the numbers of
      traumatised victims passing through their care. Even so, there appears to be a
      dearth of critical care literature which addresses either assessment or
      intervention strategies relevant to this important aspect of practice. The
      purpose of this paper is to highlight aspects of assessment specific to post
      traumatic stress through a critical analysis and explanation of its theoretical
      base. This will act as a precursor to providing direction on possible practice
      developments.

PMID- 7772958
TI  - A rationale for mouth care: the integration of theory with practice.
AB  - Mouth care is a commonly performed nursing procedure in which the aim is to
      ensure that patients' mouths are cared for. However, there is evidence that
      unless dental plaque is removed from the tooth surfaces and the gingival margin,
      the mouth is in danger of becoming unhealthy and, therefore, uncared for. It
      appears from the dental literature that the use of a toothbrush is one of the
      best and most widely used tools in the Western world for removing dental plaque
      (Addy, Slayne & Wade 1992), other methods being ineffective, dangerous, or poorly
      researched (Trenter-Roth & Creason 1986). However, a review of the nursing
      literature indicates that toothbrushes are not the tools of choice for mouth care
      by nurses (Howarth 1977, Harris 1980). Thus, there appears to be a gulf between
      the knowledge base from the dental literature and the reality of nursing practice
      resulting in 'mouth care' becoming a misleading misnomer. The aim in this paper
      is to present a rationale for mouth care based upon the dental literature and to
      apply such knowledge to nursing practice, especially in intensive therapy units
      (ITUs), so that nurses may be in a better position to provide 'mouth care' which
      lives up to its name.

PMID- 7772957
TI  - A comparative descriptive study of patients admitted to a high dependency unit
      after major and non-major surgery.
AB  - Monash Medical Centre, a large major hospital in Melbourne Australia, recently
      opened a high dependency unit (HDU) at its Moorabbin campus. The present study
      was designed to examine two patient groups admitted to the unit after major and
      non-major surgical procedures. Another aim in the study was to describe the
      services required by these patients and to compare the two groups with regard to
      length of stay in the HDU, severity of illness, and pain control. The results of
      this study indicate that the HDU provided a valuable and needed service to a
      population of patients who have been identified as at risk of postoperative
      complications. The findings appear to agree with other research which suggests
      that nurses consistently rate patients' pain as less severe than patients' own
      ratings of pain indicate. Thus nurses appear to overestimate patients' perception
      of pain control. This study again indicates that even though it is generally
      recognised by nurses that patients are in pain the management of it is such that
      pain continues to be inadequately controlled.

PMID- 7772959
TI  - A qualitative study to establish the self-perceived needs of family members of
      patients in a general intensive care unit.
AB  - Admission to an intensive care unit (ICU) invariably causes a considerable degree
      of distress and anxiety to both patient and family. If we profess to deliver
      holistic care then it is essential that intensive care nurses are able to
      identify the specific needs of family members and provide appropriate supportive
      interventions. This small study was designed to gain the perspectives of the
      families. Through unstructured interviews participants were invited to discuss
      their experiences of visiting a critically ill relative, particularly in
      relationship to their own needs. Interviews were tape-recorded with permission
      and subsequently transcribed. Thematic content analysis adapted from Glaser &
      Strauss' 'grounded theory' approach (1967) by Burnard (1991) occurred, with
      formation of six categories, exemplified by verbatim quotations. The study may
      contribute towards a framework for preventative, supportive and therapeutic
      intervention with family members in the intensive care setting.

PMID- 7772960
TI  - Responsibility in intensive care: a critical analysis.
AB  - Nursing has undergone numerous aspects of change within the last 10 years,
      resulting in a blurring of roles and thus responsibilities. Responsibility in
      nursing is an enormous, vitally important and pertinent concept. In this paper
      the term 'responsibility' will be described, discussed and critiqued within the
      context of the management of care, research and education for nurses working in
      an intensive care environment.

PMID- 7772961
TI  - Education in critical care nursing: a new beginning.
AB  - The movement of nurse education to the tertiary sector is all but complete in
      Australia. Trends are changing as new partnerships are being forged and the focus
      of education is now reponsive to economic and political factors. These factors
      have resulted in the regionalisation of health care facilities and the de
      institutionalisation of health services in Queensland. Moreover, de
      institutionalisation of services coupled with economic rationalism has pre-empted
      the offering of post-graduate clinical courses by university nursing faculties.
      This paper addresses the process of developing the content of new courses under
      the umbrella of the Graduate Diploma/Masters in Critical Care Nursing offered at
      Griffith University Gold Coast. This initiative is the first in Queensland and
      has provided new vision in education for critical care nursing. This course
      includes a tapestry of theoretical knowledge enhancing clinical and factual
      subjects presented by experienced clinicians teaching with academics. The
      collaborative nature of nursing practice is reflected in academics and clinicians
      working jointly in course development, teaching and clinical placement.
      Strategies which were developed collaboratively addressed course content
      including logistics, time management, the critical selective selection of
      appropriate content, assessment critera, 'registerbility' within Queensland and
      other states, and clinical competence will be addressed. Moreover, this process
      of developing the course content utilised Australian National Registering
      Authority (ANRAC 1990) Competencies and Benners' (1984) use of the Dreyfus model
      to guide the expected knowledge level of the clinician at course completion. In
      particular this paper will not only address the blending of theory and practice
      to consolidate the relationship inherent between the clinician and education, but
      will establish the fact that no gap exists.

PMID- 7772962
TI  - Anesthesia for stereotactic radiosurgery in children.
AB  - The development of stereotactic radiosurgery has been a major advance in the
      treatment of intracranial lesions. By using a stereotactic head frame attached to
      the skull, large doses of radiation can be delivered precisely to the lesion
      while sparing surrounding tissues. Although adults can usually undergo this
      procedure with local anesthesia or conscious sedation alone, children frequently
      require general anesthesia. This report describes our experience with the
      anesthetic management of all children who have received this therapy at our
      institution since the inception of our stereotactic radiosurgery program in 1986
      through June 1993. Sixty-eight radiosurgery procedures were performed in 65
      patients. Anesthesia time averaged 9.2 h (range, 7-15). Twenty-two patients (ages
      11-17; mean 14.3) received local anesthesia alone, two patients (ages 11 and 15)
      received local anesthesia plus i.v. sedation, and 44 patients (ages 2-14; mean,
      7.3) received general anesthesia. Four potentially serious anesthesia-related
      events occurred; in one child (age 7) receiving general anesthesia, an
      endotracheal tube obstruction developed during radiosurgery requiring rapid
      reintubation while the child was still in the head frame; another (age 7) who was
      undergoing chemotherapy and had neutropenia and rhinitis had a lobar collapse
      while intubated, requiring mechanical ventilation and endotracheal tube
      suctioning for lung expansion. Another (age 5) with a recent upper respiratory
      tract infection had copious endotracheal secretions and sinusitis (ethmoid and
      maxillary) noted on initial computed tomography scanning and was given
      antibiotics and decongestants (following nasotracheal extubation), and another
      (age 15) receiving sedation without endotracheal intubation vomited an undigested
      meal midway through the procedure while her head was partially immobilized in the
      head frame.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772963
TI  - Regional cerebral metabolism of glucose in comatose and vegetative state
      patients.
AB  - Regional cerebral metabolism of glucose (rCMRglu) was evaluated in patients who
      were in a coma and vegetative state to determine the level of brain function
      during these conditions. rCMRglu was measured in 17 discrete brain regions with
      (/-) [18F] -fluoro-2-deoxy-D-glucose (FDG) and positrn emission tomography (PET)
      in 15 patients with ;brain pathology subsequent to cardiorespiratory arrest (CA),
      head trauma (HT), or brain ischemia (BI) resulting from cerebrovascular accident
      or brain surgery. Five comatose patients (Coma group, n = 5), and 10 vegetative
      state patients (VS, patients awake but not aware) were studied. The VA patients
      were subdivided, according to the length of their VS condition, into a VS group
      (n = 6, < 3 months if CA or BI patients, or < 12 months if HT patients) and a
      persistent vegetative state group (PVS, n = 4, > 3 months if CA or BI patients of
      > 12 months if HT patients.) Ten normal age-matched subjects served as control.
      Global CMRglu was 6.72 +/- 0.93 (+/-SD) mg/100 g/min in control subjects. It was
      significantly (p < - 0.001) reduced to 3.70 +/- 61 in coma, to 3.45 +/- in VS,
      and to 2.33 +/- 0.34 mg/100 g/min in PVS patients. rCMRglu was significantly
      reduced (p < - 01001) from control values in all the 17 structures surveyed in
      every patient. In the Coma and VS groups, there was an overlapping of rCMRglu in
      the majority of the brain structures. (ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772964
TI  - Indomethacin in controlling "normal perfusion pressure breakthrough" in a case of
      large cerebral arteriovenous malformation.
AB  - Control of "normal perfusion pressure breakthrough" is difficult and
      controversial. We describe a case in which indomethacin was used with success. We
      recommend extensive cerebral monitoring including regional cerebral oximetry when
      using indomethacin to detect impending cerebral ischemia.

PMID- 7772965
TI  - Perforation and partial obstruction of an armored endotracheal tube.
AB  - Armored endotracheal tubes are often used during cases in which there is a risk
      of compromise of a polyvinylchloride tube with positioning of a patient's head.
      The authors describe a case in which partial airway obstruction and perforation
      of such a tube occurred as a result of biting by a patient. Ways to avoid this
      complication are discussed.

PMID- 7772966
TI  - Preoperative evaluation for risk of venous air embolism in the sitting position.
AB  - We report a patient with meningioma and radiological findings of erosive bony
      change, who developed venous air embolism via the diploic vein in the eroded
      inner table of the skull during craniotomy in the sitting position. The findings
      in our case suggest that preoperative radiological imaging evaluation can
      increase an awareness of the possibility of venous air embolism.

PMID- 7772967
TI  - Control of outflow pressure provides spinal cord protection during resection of
      descending thoracic aortic aneurysms.

PMID- 7772968
TI  - Side effects of mild hypothermia.
AB  - Mild hypothermia is increasingly touted as a low risk clinical measure in brain
      protection. This article reviews potential adverse effects of mild hypothermia by
      organ system and suggests a risk assessment framework for clinical decision
      making.

PMID- 7772969
TI  - Inhibition of glutamate release: a possible mechanism of hypothermic
      neuroprotection.
AB  - The neuroprotective properties of hypothermia are well recognized. For many
      years, the ability of hypothermia to decrease the neurologic morbidity associated
      with episodes of ischemia has been ascribed to the reduction in metabolic rate
      that accompanies decreases in temperature. More recently, evidence has
      accumulated that hypothermia may exert some of its neuroprotective effects by
      reducing the ischemia-induced release of excitatory amino acids. This attenuated
      release occurs even with the mild degrees of hypothermia that can easily be
      produced in operating rooms and intensive care units. Preliminary data suggest
      that mild hypothermia may be of benefit in surgical patients at risk for
      intraoperative cerebral ischemia and patients who have suffered traumatic brain
      injury. Because of the minimal risk associated with lowering body temperature to
      34 degrees C, additional outcome studies are in progress to ascertain the
      potential benefits of this mode of therapy.

PMID- 7772970
TI  - Systemic hypothermia in treatment of severe brain injury.

PMID- 7772971
TI  - N2O: of questionable value.

PMID- 7772972
TI  - Nitrous oxide added to isoflurane increases brain artery blood flow and low
      frequency brain electrical activity.
AB  - Although changes in cerebral blood flow (CBF) and the electroencephalogram (EEG)
      have been reported with nitrous oxide (N2O) administration, the interaction of
      these parameters is unclear. The purpose of this study was to measure CBF and EEG
      during N2O administration in eight patients. A craniotomy was performed and CBF
      was measured in major brain arteries using a transit time Doppler flowmeter. EEG
      was recorded bilaterally from frontooccipital leads. Power spectrum analysis was
      performed on the EEG and power for delta, theta, alpha, and beta frequency bands
      analyzed over time. Arterial blood pressure was recorded continuously. N2O (66%)
      was added to the inspired gases during isoflurane anesthesia (0.8% end tidal)
      under hypocapnic (Paco2 = 29 mm Hg) and normocapnic conditions (Paco2 = 39 mm
      Hg). During hypocapnia, N2O administration decreased alpha EEG activity and
      increased delta activity but did not change CBF. During normacapnia, N2O produced
      similar but greater changes in EEG and increased CBF 39%. In three patients, the
      isoflurane concentration was increased to 1.6% end tidal during normocapnia. N2O
      administration in these patients also enhanced delta EEG activity and increased
      CBF. The slowing of EEG activity with N2O is temporally related to increases in
      CBF during normocapnia. Hypocapnia abolished the increase in CBF during N2O and
      attenuated the shift of EEG to delta activity.

PMID- 7772973
TI  - Nitrous oxide increases cerebral blood flow velocity during pharmacologically
      induced EEG silence in humans.
AB  - We examined the effect of nitrous oxide on cerebral blood flow velocity (Vmca),
      arteriovenous oxygen content difference and cerebral use of glucose during
      propofol-induced electrical silence of the electroencephalogram (EEG) in 10
      patients undergoing anesthesia for nonneurosurgical procedures. Anesthesia was
      induced with propofol 2.5 mg/kg, fentanyl 3 micrograms/kg (followed by an
      infusion of 2 micrograms/kg/h), vecuronium 0.1 mg/kg, and maintained with a
      propofol infusion (250-300 micrograms/kg/min) sufficient to induce EEG silence. A
      transcranial Doppler was used to measure the Vmca and a jugular bulb catheter was
      inserted for oxygen saturation and glucose use measurements. After a 15-period of
      isoelectric EEG and normocapnia (PaCO2 38 +/- 1 mm Hg), baseline arterial and
      jugular bulb venous blood gases were drawn, and mean arterial pressure (MAP),
      heart rate (HR), and Vmca were recorded. Nitrous oxide was then introduced and
      equilibrated to an end-tidal concentration of 70% for 15 min, after which MAP,
      HR, Vmca, arterial and jugular bulb venous blood gases were measured again.
      Nitrous oxide increased Vmca (29 +/- 4 to 35 +/- 4 cm/s, p < 0.01), cerebral use
      of oxygen (166 +/- 13 to 190 +/- 12 vol%-cm/s, p < 0.05) and glucose (245 +/- 38
      to 290 +/- 48 g%-cm/s, p < 0.05) by approximately 20%. Occasional bursts of EEG
      activity were observed in eight patients studied during the N2O stage. We
      conclude that in patients with propofol-induced isoelectric EEG, the increase
      seen in Vmca with the introduction of N2O is mainly due to cerebral stimulation
      and increase in cerebral metabolic rate.

PMID- 7772974
TI  - A comparison of anesthetic techniques for awake intubation in neurosurgical
      patients.
AB  - Two different methods of achieving upper airway anesthesia for awake fiberoptic
      intubation were prospectively compared in patients undergoing surgery for
      cervical spine instability. Forty patients were randomized to either topical
      anesthesia or nerve block groups. Topical anesthesia patients were administered
      nebulized 4% lidocaine (approximately 20 ml) via the oropharynx plus a
      transtracheal injection of 4% lidocaine (3 ml). Nerve block patients underwent
      bilateral glossopharyngeal and superior laryngeal nerve blocks with 2% lidocaine
      (0.5-2 ml per injection site) plus a transtracheal injection of 4% lidocaine (3
      ml). The quality of anesthesia for intubation was graded by observers blinded to
      group assignment. Mean arterial pressure, heart rate, Pao2, Paco2, pHa, SpO2, and
      plasma lidocaine concentrations were measured during the intubation sequence.
      Patient recall of intubation and discomfort were assessed during the
      postoperative period with visual analog scales. Time required for successful
      intubation and quality of intubation were not different between groups.
      Physiologic values for the two groups were similar. The mean total dose of
      lidocaine in the topical anesthesia group was approximately 2 times greater than
      that in the nerve block group (815 versus 349 mg; p < 0.0001). In contrast, mean
      plasma lidocaine concentration at initiation of intubation in the topical
      anesthesia group was half that of nerve block group (2.16 versus 4.23
      micrograms/ml; p < 0.0001). Ten minutes later there was no difference for plasma
      lidocaine concentration between groups. No patients had evidence of seizures or
      neurologic change during the procedure. There was no difference in patient
      perception of discomfort during the procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7772975
TI  - BMA reports on the declining standards in community care.

PMID- 7772976
TI  - Delivering quality infection control.

PMID- 7772977
TI  - Infection control and the bedside nurse.
AB  - Safe infection control practice implies that caregivers have an insight into the
      factors that contribute to hospital-acquired infections which enables them to
      provide informed care and examine patient treatment outcomes. However, results of
      recent studies suggest that this is far from the case. This article examines why
      this area of nursing knowledge and practice has remained unquestioned and urges
      for an examination of how nurses are prepared for safe, informed infection
      control practice.

PMID- 7772978
TI  - Breast cancer treatment.
AB  - This article reviews the developments in the management and prognosis of women
      with early breast cancer. Early diagnosis and the relevant therapies are examined
      and the value of good communication with breast cancer patients is explored.

PMID- 7772979
TI  - Nurse management of corneal abrasion.
AB  - Corneal abrasion is a commonly occurring eye injury accounting for approximately
      12.5% of clients seen in the Nottingham eye casualty department. This article
      describes the anatomy of the cornea and outlines the nurse management and
      treatment of traumatic corneal abrasion within a clinical setting.

PMID- 7772980
TI  - The role of learning disability nurses.

PMID- 7772982
TI  - Self-advocacy in learning disabilities.
AB  - This article examines the complexities of helping people with a learning
      disability to develop self-advocacy skills and accordingly proposes that self
      advocacy should take an explicit place in the RNMH curriculum.

PMID- 7772983
TI  - The experience of advocacy. 2: A group member's perspective.
AB  - This article examines advocacy and is written from a client's perspective. Hilary
      Drage is an experienced self-advocate and founder member of the Banbury Advocacy
      Group for Adults with a Learning Disability. Here she gives a personal account of
      the practice of self-advocacy and the functioning of a self-advocacy group. The
      article is based on an interview with Steve McNally.

PMID- 7772981
TI  - Empowering consumers: the caring challenge.
AB  - This article considers current issues relating to power relationships that exist
      between learning disability nurses and their clients. It examines the changing
      role of learning disability nurses and considers their influence on enhancing the
      quality of life for people with learning disabilities, whose autonomy and right
      to decision making has been consistently challenged throughout society.

PMID- 7772984
TI  - Staff stress and satisfaction in small staffed houses in the community: 1.
AB  - In this article, the first of two parts, the sources of stress and satisfaction
      experienced by nursing and social service staff working in group homes with young
      people with severe learning disabilities are investigated. It focuses on the
      stresses and satisfactions arising out of the performance of the direct care role
      for staff working in ordinary housing in the community.

PMID- 7772985
TI  - Should nurses be politically aware?
AB  - In the present atmosphere of change, nurses need to develop political awareness.
      This article reviews the many factors that have mitigated against such a
      development and examines how these have adversely affected the profession. It
      proposes that nurses must develop political awareness as only by becoming
      politically knowledgeable can they can control and shape their own destiny, and
      effectively contribute to the decisions that affect their patients.

PMID- 7772986
TI  - Protecting patient confidentiality.

PMID- 7772988
TI  - Reliability: consistency and accuracy in measurement.

PMID- 7772987
TI  - Advantages of primary nursing in geriatric day hospitals.
AB  - This article presents a rationale for the introduction of primary nursing as the
      most suitable method of organisation in geriatric day hospitals. Working
      conditions, the status of the nurse within the multidisciplinary team and the
      opportunities afforded by primary nursing for enhancing the nurse-patient
      relationship are examined.

PMID- 7772989
TI  - Law series: 7. Extended role of the nurse.

PMID- 7772990
TI  - Integrating nursing research and practice: Part I--A journey into the unknown.
AB  - We must all face the challenge of weaving together the art and science of
      nursing, of integrating nursing research and practice. In a two part article
      Northland nurses tell about their experiences with research and the study they
      carried out. Part one describes their beginning experiences with integrating
      research and practice.

PMID- 7772991
TI  - The diagnosis of schizophrenia and its impact on the primary caregiver.
AB  - This qualitative study investigates how the diagnosis of schizophrenia in a young
      adult impacts on the primary caregiver in the family. In this study all
      participants were mothers who had sons recently diagnosed with schizophrenia. An
      extensive literature review revealed a lack of research in this area. The
      research methodology is described. Data analysis determined themes or patterns of
      experience amongst participants in this study. From this small study it was seen
      that the impact on the participants was intensely traumatic and far reaching. Six
      themes emerged: trauma/distress, fear, uncertainty, relief, disruption and
      powerlessness. The results have major implications for nurses and other health
      professionals working in the Mental Health field.

PMID- 7772992
TI  - The knowing and doing of empowerment.

PMID- 7772993
TI  - Valuing students' experience in nursing education.

PMID- 7772994
TI  - The adventures of nursing practice through research. Report of International
      Nursing Research conference: Sydney Australia, July 1994.

PMID- 7772995
TI  - Advocacy in action.

PMID- 7772996
TI  - Did I do right?

PMID- 7772997
TI  - Care: a superior ideal for nursing?

PMID- 7772998
TI  - Neuromuscular development in Drosophila: insights from embryos and pupae.
AB  - During embryogenesis, Drosophila melanogaster generates a set of muscles and
      motoneurons that are restructured during pupal metamorphosis to give rise to an
      adult motor system. The study of neuromuscular development in embryos and pupae
      has recently revealed important insights into the cellular and molecular
      mechanisms controlling both muscle patterning and the establishment of synaptic
      connections.

PMID- 7772999
TI  - Activity-dependent remodeling of connections in the mammalian visual system.
AB  - The development of precise connections in the mammalian central nervous system
      requires neural activity. Synchronous patterns of afferent activity, and
      coincident afferent and target activity are required for specifying the neuronal
      connectivity that characterizes the adult visual pathway in mammals. During
      development, postsynaptic target neurons communicate with presynaptic afferents.
      Recent evidence suggests that the mechanisms that underlie activity-dependent
      development of connections in the visual system may share significant
      similarities with the mechanisms responsible for synaptic plasticity in the adult
      brain.

PMID- 7773000
TI  - Development.

PMID- 7773001
TI  - Intrinsic and extrinsic factors regulating vertebrate neurogenesis.
AB  - Recent studies of the factors regulating neurogenesis in vertebrates reveal three
      emerging themes. First, the number of cellular stages involved in this process
      may be greater than has previously been appreciated. Second, homologues of genes
      that regulate neurogenesis in invertebrates appear to play analogous roles in
      development of vertebrate nervous systems. Third, extrinsic factors can act to
      regulate neuron number during neurogenesis by controlling survival and
      differentiation, and not simply proliferation, of neural progenitor cells.

PMID- 7773003
TI  - Molecular genetics of neuronal adhesion.
AB  - Cell-cell and cell-matrix interactions are believed to play crucial roles in
      neural development. Cell adhesion molecules of the immunoglobulin and cadherin
      families, as well as integrin heterodimers and extracellular matrix
      glycoproteins, are widely expressed in the nervous system. The advent of gene
      targeting technology has heralded a new era for study of their function. Initial
      observations in 'knockout' mice have yielded some surprising results.

PMID- 7773002
TI  - Remodeling of the insect nervous system.
AB  - Our nervous systems and behavior are shaped by hormonally driven developmental
      changes that continue beyond the embryonic period. Key insights into this process
      have emerged from studies of the insect nervous system. During insect
      metamorphosis, the nervous system is remodeled through postembryonic
      neurogenesis, programmed cell death and the modification of persistent neurons.
      These changes are regulated to a large degree by gene cascades that are triggered
      by steroid hormones, the ecdysteroids. Current studies are attempting to reveal
      the molecular mechanisms involved in regulating these dramatic examples of
      developmental plasticity.

PMID- 7773005
TI  - Development of the zebrafish nervous system: genetic analysis and manipulation.
AB  - The accessibility and simplicity of the zebrafish embryo have led to fruitful
      examinations of how vertebrate embryos develop, at the cellular level. Recently,
      several groups have initiated large-scale mutagenesis in zebrafish and begun to
      generate transgenic zebrafish. The goals of these endeavors are to identify
      developmentally important genes and to delineate their in vivo function. If
      successful, the two approaches should significantly enhance our understanding of
      how genes control development in a vertebrate embryo.

PMID- 7773004
TI  - Molecular genetics of neuronal survival.
AB  - The past year has witnessed remarkable progress towards understanding the
      molecular genetics of neuronal survival. Gene-targeting experiments in mice have
      confirmed the long-standing idea that the nerve growth factor model of neuronal
      survival--that is, neuronal dependence on target-derived molecules during a
      critical period in development--is broadly applicable. Furthermore, a variety of
      biochemical and genetic techniques applied to both mammals and invertebrates have
      identified new genes involved in regulating cell survival during development.

PMID- 7773006
TI  - Targeting of mRNAs to subsynaptic microdomains in dendrites.
AB  - Recent studies have revealed that a heterogeneous population of mRNAs is present
      in neuronal dendrites (including mRNAs that encode proteins involved in
      intracellular signaling), that different types of neurons have different
      assortments of dendritic mRNAs, and that the levels of some dendritic mRNAs are
      up-regulated by activity. These findings reinforce and extend the hypothesis that
      the localization of mRNA in dendrites provides a means of synthesizing proteins
      locally that are important for synaptic function.

PMID- 7773007
TI  - Control of neuronal development in Caenorhabditis elegans.
AB  - Recent research into the development of the nervous system of the nematode
      Caenorhabditis elegans indicates the importance of multiple cell interactions and
      combinatorial gene expression. As many of the genes needed for C. elegans
      neuronal development have counterparts with similar activities in Drosophila
      melanogaster, the mechanisms of cell specification may be broadly conserved.

PMID- 7773008
TI  - Assembly of the postsynaptic apparatus.
AB  - Recent research has led to a clearer picture of the molecular organization of the
      postsynaptic apparatus at the developing neuromuscular junction. In addition, one
      link between the extracellular signaling molecule agrin and the intracellular
      events that mediate formation of acetylcholine receptor clusters has been
      established with the identification of an argin-binding protein.

PMID- 7773010
TI  - Guidance and induction of branch formation in developing axons by target-derived
      diffusible factors.
AB  - Developing axons appear to navigate to their targets partly in response to long
      range diffusible chemoattractants secreted by target cells. The past year has
      seen the identification of the first target-derived attractants for developing
      axons, the netrins. Target-derived diffusible factors have also been implicated
      in controlling the elaboration of axon collateral branches, and a recent study
      provides insight into the mechanism by which this is achieved. Evidence has also
      suggested neurotrophins and neurotransmitters as candidate branching and
      chemotropic factors.

PMID- 7773009
TI  - The sensory-motor role of growth cone filopodia.
AB  - Neuronal growth cones, the motile tips of elongating axons and dendrites, respond
      very precisely to cues encountered during pathfinding. During the past year, our
      knowledge about their sensory function, their integrative properties, and their
      motor function has advanced significantly. In particular, growth cone filopodia
      are currently being recognized for their prominent roles as sensors, transducers,
      and autonomous motor structures important for growth cone steering.

PMID- 7773011
TI  - Development of layers, maps and modules.
AB  - Developing neuronal cell sheets acquire position-specific features by mechanisms
      that differ in radial and tangential dimensions. These features include guiding
      cues for axonal growth and targeting that are used, for example, in map
      formation. Recent evidence supports the notion that graded distributions of
      molecules are involved in growth cone navigation and axonal branching. In
      addition, activity-dependent processes are important determinants of functional
      architecture, especially with respect to modular organization.

PMID- 7773012
TI  - Neuronal coupling and uncoupling in the developing nervous system.
AB  - Sensitive new tracers and imaging techniques have revealed that gap junction
      coupling during brain development is much more pronounced than previously
      believed. Recent results demonstrate that cell coupling can produce functional
      neuron assemblies characterized by synchronized fluctuations in the cytosolic
      Ca2+ concentration. Coupling is especially pronounced before and during the
      period of synapse formation and initial establishment of neuronal circuits. Thus,
      communication via gap junctions may generate coordinated electrical or
      biochemical activity before the onset of synaptic transmission, and thereby
      provide the outlines of functional architecture in the developing brain.

PMID- 7773013
TI  - The APETALA2 domain is related to a novel type of DNA binding domain.

PMID- 7773014
TI  - The tobacco homolog of mammalian calreticulin is present in protein complexes in
      vivo.
AB  - The analysis of protein sorting signals responsible for the retention of
      reticuloplasmins (RPLs), a group of soluble proteins that reside in the lumen of
      the endoplasmic reticulum (ER), has revealed a structural similarity between
      mammalian and plant ER retention signals. We present evidence that the
      corresponding epitope is conserved in a vast family of soluble ER resident
      proteins. Microsequences of RPL60 and RPL90, two abundant members of this family,
      show high sequence similarity with mammalian calreticulin and endoplasmin.
      RPL60/calreticulin cofractionates and costains with the lumenal binding protein
      (BiP). Both proteins were detected in the nuclear envelope and the ER, and in
      mitotic cells in association with the spindle apparatus and the phragmoplast.
      Immunoprecipitation of proteins from in vivo-labeled cells demonstrated that
      RPL60/calreticulin is associated with other polypeptides in a stress- and ATP
      dependent fashion. RPL60/calreticulin transcript levels increased rapidly in
      abundance during the proliferation of the secretory apparatus and the onset of
      hydrolase secretion in gibberellic acid-treated barley aleurone cells. This
      induction profile is identical to that of the well-characterized ER chaperones
      BiP and endoplasmin. However, expression patterns in response to different stress
      conditions as well as tissue-specific expression patterns indicate that these
      genes are differentially regulated and may not act in concert.

PMID- 7773015
TI  - The brown midrib3 (bm3) mutation in maize occurs in the gene encoding caffeic
      acid O-methyltransferase.
AB  - The brown midrib mutations are among the earliest described in maize. Plants
      containing a brown midrib mutation exhibit a reddish brown pigmentation of the
      leaf midrib starting when there are four to six leaves. These mutations are known
      to alter lignin composition and digestibility of plants and therefore constitute
      prime candidates in the breeding of silage maize. Here, we show that two
      independent brown midrib3 (bm3) mutations have resulted from structural changes
      in the COMT gene, which encodes the enzyme O-methyltransferase (COMT; EC
      2.1.1.6), involved in lignin biosynthesis. Our results indicate that the bm3-1
      allele (the reference mutant allele) has arisen from an insertional event
      producing a COMT mRNA altered in both size and amount. By sequencing a COMT cDNA
      clone obtained from bm3-1 maize, a retrotransposon with homology to the B5
      element has been found to be inserted near the junction of the 3' coding region
      of the COMT gene intron. The second bm3 allele, bm3-2, has resulted from a
      deletion of part of the COMT gene. These alterations of the COMT gene were
      confirmed by DNA gel blot and polymerase chain reaction amplification analyses.
      These results clearly demonstrate that mutations at the COMT gene give a brown
      midrib3 phenotype. Thus, the gene genetically recognized as bm3 is the same as
      the one coding for COMT.

PMID- 7773016
TI  - Characterization of the maize gene sugary1, a determinant of starch composition
      in kernels.
AB  - In maize kernels, mutations in the gene sugary1 (su1) result in (1) increased
      sucrose concentration; (2) decreased concentration of amylopectin, the branched
      component of starch; and (3) accumulation of the highly branched
      glucopolysaccharide phytoglycogen. To investigate further the mechanisms of
      storage carbohydrate synthesis in maize, part of the su1 gene locus and a cDNA
      copy of the su1 transcript were characterized. Five new su1 mutations were
      isolated in a Mutator background, and the mutant allele su1-R4582::Mu1 was
      isolated by transposon tagging. The identity of the cloned element as the su1
      gene locus was confirmed by the cosegregation of restriction fragment length
      polymorphisms in the same or nearby genomic intervals with three additional,
      independent su1 mutations. Pedigree analysis was also used to confirm the
      identity of su1. A 2.8-kb mRNA that is homologous to the cloned gene was detected
      in maize kernels, and a 2.7-kb cDNA clone was isolated based on hybridization to
      the genomic DNA. Specific portions of the cDNA hybridized with multiple segments
      of the maize genome, suggesting that su1 is part of a multigene family. The cDNA
      sequence specified a polypeptide of at least 742 amino acids, which is highly
      similar in amino acid sequence to bacterial enzymes that hydrolyze alpha-(1-->6)
      glucosyl linkages of starch. Therefore, debranching of glucopolysaccharides is
      seemingly part of the normal process of starch biosynthesis, and the final degree
      of branch linkages in starch most likely arises from the combined actions of
      branching and debranching enzymes.

PMID- 7773017
TI  - Arabidopsis phosphoribosylanthranilate isomerase: molecular genetic analysis of
      triplicate tryptophan pathway genes.
AB  - Phosphoribosylanthranilate isomerase (PAI) catalyzes the third step of the
      tryptophan biosynthetic pathway. Arabidopsis PAI cDNAs were cloned from a cDNA
      expression library by complementation of an Escherichia coli trpC- PAI deficiency
      mutation. Genomic DNA blot hybridization analysis detected three nonallelic genes
      encoding PAI in the Arabidopsis genome. DNA sequence analysis of cDNA and genomic
      clones indicated that the PAI1 and PAI2. All three PAI polypeptides possess an N
      terminal putative plastid target sequence, suggesting that these enzymes all
      function in plastids. The PAI1 gene is flanked by nearly identical direct repeats
      of approximately 350 nucleotides. Our results indicate that, in contrast to most
      microorganisms, the Arabidopsis PAI protein is not fused with indole-3
      glycerolphosphate synthase, which catalyzes the next step in the pathway. Yeast
      artificial chromosome hybridization studies indicated that the PAI2 gene is
      tightly linked to the anthranilate synthase alpha subunit 1 (ASA1) gene on
      chromosome 5. PAI1 was mapped to the top of chromosome 1 using recombinant inbred
      lines, and PAI3 is loosely linked to PAI1. cDNA restriction mapping and
      sequencing and RNA gel blot hybridization analysis indicated that all three genes
      are transcribed in wild-type plants. The expression of antisense PAI1 RNA
      significantly reduced the immunologically observable PAI protein and enzyme
      activity in transgenic plants. The plants expressing antisense RNA also showed
      two phenotypes consistent with a block early in the pathway: blue fluorescence
      under UV light and resistance to the anthranilate analog 6-methylanthranilate.
      The extreme nucleotide conservation between the unlinked PAI1 and PAI2 loci
      suggests that this gene family is actively evolving.

PMID- 7773018
TI  - Inhibition of the glycine decarboxylase multienzyme complex by the host-selective
      toxin victorin.
AB  - Victoria blight of oats is caused by the fungus Cochliobolus victoriae. This
      fungus is pathogenic due to its ability to produce the host-selective toxin
      victorin. We previously identified a 100-kD protein that binds victorin in vivo
      only in susceptible genotypes and a 15-kD protein that binds victorin in vivo in
      both susceptible and resistant genotypes. Recently, we determined that the oat
      100-kD victorin binding protein is the P protein of the glycine decarboxylase
      complex (GDC). In this study, we examined the effect of victorin on glycine
      decarboxylase activity (GDA). Victorin was a potent in vivo inhibitor of GDA.
      Leaf slices pretreated for 2 hr with victorin displayed an effective
      concentration for 50% inhibition (EC50) of 81 pM for GDA. Victorin inhibited the
      glycine-bicarbonate exchange reaction in vitro with an EC50 of 23 microM. We also
      identified a 15-kD mitochondrial protein that bound victorin in a ligand-specific
      manner. Based on amino acid sequence analysis, we concluded that the 15-kD
      mitochondrial protein is the H protein component of the GDC. Thus, victorin
      specifically binds to two components of the GDC. GDA in resistant tissue treated
      with 100 micrograms/mL victorin for 5 hr was inhibited 26%, presumably as a
      consequence of the interaction of victorin with the H protein. Victorin had no
      detectable effect on GDA in isolated mitochondria, apparently due to the
      inability of isolated mitochondria to import victorin. These results suggest that
      the interaction of victorin with the GDC is central to victorin's mode of action.

PMID- 7773020
TI  - Caring for the dying in Canada.

PMID- 7773019
TI  - Mutations in the NPH1 locus of Arabidopsis disrupt the perception of phototropic
      stimuli.
AB  - The phototropic response is an important component of seedling establishment in
      higher plants because it orients the young seedlings for maximal photosynthetic
      light capture. Despite their obvious importance, little is known about the
      mechanisms underlying the perception and transduction of the light signals that
      induce phototropic curvatures. Here, we report the isolation of eight mutants of
      Arabidopsis that lack or have severely impaired phototropic responses. These nph
      (for nonphototropic hypocotyl) mutants comprise four genetic loci: nph1, nph2,
      nph3, and nph4. Physiological and biochemical characterization of the nph1 allele
      series indicated that the NPH1 locus may encode the apoprotein for a dual
      chromophoric or multichromophoric holoprotein photoreceptor capable of absorbing
      UV-A, blue, and green light and that this photoreceptor regulates all the
      phototropic responses of Arabidopsis. It appears that the NPH1 protein is most
      likely a 120-kD plasma membrane-associated phosphoprotein because all of the nph1
      mutations negatively affected the abundance of this protein. In addition, the
      putative NPH1 photoreceptor protein is genetically and biochemically distinct
      from the HY4 protein, which most likely acts as a photoreceptor for blue light
      mediated hypocotyl growth inhibition. Furthermore, the NPH1 and HY4 proteins are
      not functionally redundant because mutations in either gene alone affect only one
      physiological response but not the other, thus providing strong support for the
      hypothesis that more than one blue light photoreceptor is required for the normal
      growth and development of a seedling.

PMID- 7773021
TI  - Specifics needed on safe dosage.

PMID- 7773022
TI  - Earlier postdischarge visits promote breastfeeding.

PMID- 7773023
TI  - Medical care of the dying. Where do family physicians fit in?

PMID- 7773024
TI  - Family physician hospital privileges. New approach.

PMID- 7773025
TI  - Dilemmas in care of the elderly.

PMID- 7773026
TI  - Do widowers use the health care system differently? Does intervention make a
      difference?
AB  - OBJECTIVE: To describe the health care use patterns of widowers who had
      participated in a randomized trial of mutual support, and of a matched cohort of
      married men DESIGN: Retrospective audit of Ministry of Health use data SETTING:
      The family practice unit in a general teaching hospital. PARTICIPANTS: The 113
      new widowers (61 treatment, 52 waiting-list controls) who participated in a
      randomized trial of mutual support, and 111 married men matched for age
      INTERVENTIONS: Mutual support program MAIN OUTCOME MEASURES: Monthly rates of
      visits to family physicians, psychiatrists, and all other specialists for the
      three cohorts RESULTS: Visit rates to family physicians and specialists (SPs) for
      the married men were stable for the 20 months of the study; rates for the
      widowers rose significantly from the time of loss to the end of the intervention
      (for FPs, f = 13.18, df = 2, P < .01; for SPs, f = 5.34, df = 2, P = .005). Rates
      for FPs declined after intervention for the treatment group, but kept rising
      among the controls (f = 4.17, df = 1, P = .044). CONCLUSIONS: The decreased
      physician visit rate among those taking part in the mutual support program
      suggests that this program met some of the widowers' social support needs that
      would otherwise have led to the use of health care resources.

PMID- 7773027
TI  - [Preliminary validation of instruments used to measure the psychotherapeutic
      knowledge, skills and attitudes of family physicians].
AB  - OBJECTIVE: To examine the validity and the reliability of three measurement
      instruments used to evaluate mental health training offered to residents in
      family medicine. DESIGN: Development and submission of three French-language
      instruments measuring knowledge, perceived skills, and attitudes of family
      physicians and residents. SETTING: Weekly psychotherapy workshop. PARTICIPANTS: A
      group of 90 family medicine residents and practising doctors were recruited by
      the authors and by teaching facilities. MAIN OUTCOME MEASURE: Reliability index
      KR20 and an evaluation of error in the instruments were used. RESULTS: The
      results satisfactory in terms of the measurement of perceived skills (KR20 =
      0.86) and the measurement of attitudes (KR20 = 0.96); the measurement of
      knowledge (KR20 = 0.70) was clearly unsatisfactory and the instrument will
      require upgrading. The measurement of perceived skills was the only one to reveal
      a distinction between the groups; practising doctors and those interested in
      psychotherapy believed their skills to be superior to those of residents in
      training (P = 0.005). CONCLUSION: Instruments measuring attitudes and perceived
      skills have excellent psychometric potential; however, it remains to be
      determined whether the measurement of perceived skills is valid and whether these
      instruments are useful for monitoring family medicine residents during their
      training or for assessing the impact of mental health training programs.

PMID- 7773028
TI  - [Hypercalcemia in cancer patients. Who, when and how to treat?].
AB  - The most frequent, potentially fatal, metabolic complication in cancer patients
      is hypercalcemia. After a discussion of cancer-associated hypercalcemia, we
      propose an individualized intervention model based on an analysis of the clinical
      situation, the prognosis, and available treatment options.

PMID- 7773029
TI  - Evaluating tall children.
AB  - The causes of tall stature are numerous; genetic tall stature and constitutional
      tall stature are the most common. Diagnosis can usually be established from the
      history and physical examination. An estimation of bone age can help to confirm
      diagnosis and to determine the child's growth potential. No treatment is usually
      necessary. Hormonal therapy can be considered for individuals for whom the
      predicted height is excessive if the psychosocial and medical advantages outweigh
      the risks of treatment.

PMID- 7773030
TI  - The rights of patients in research.

PMID- 7773031
TI  - Comparing treatments.

PMID- 7773032
TI  - Lower patients' cholesterol now.

PMID- 7773033
TI  - The importance of clinical skills.

PMID- 7773034
TI  - Diagnosing and managing occupational disease.

PMID- 7773035
TI  - Canada's health care system faces criticism.

PMID- 7773036
TI  - French to get hospital for Chinese medicine.

PMID- 7773037
TI  - Australian health insurance reforms face collapse.

PMID- 7773039
TI  - Barriers to health care in the single market.

PMID- 7773038
TI  - Survey highlights risk of foreign holidays.

PMID- 7773040
TI  - Contribution of dihydrotestosterone to male sexual behaviour.
AB  - OBJECTIVE: To document the relative importance of endogenous sex steroids in
      modulating the frequency of orgasms, the dominant aspect of sexual behaviour in
      healthy eugonadal men. DESIGN: Measurement of adrenal and testicular sex steroids
      in a sample of army recruits and study of their relation to frequency of orgasms
      ascertained by questionnaire after potential confounding variables were
      controlled for. SETTING: Military campus and military hospital laboratories in
      Athens, Greece. SUBJECTS: 92 consecutively enrolled healthy male recruits aged 18
      22 years. MAIN OUTCOME MEASURES: Weekly number of orgasms. Serum concentrations
      of testosterone, dehydroepiandrosterone sulphate, dihydrotestosterone,
      oestradiol, oestrone, delta-4-androstenedione, and sex hormone binding globulin.
      RESULTS: Serum dihydrotestosterone concentration was the only independent
      hormonal predictor of the frequency of orgasms; an increase in concentration of
      1.36 nmol/l (about 2 SD) corresponded to an average increase of one orgasm a
      week. CONCLUSIONS: Differences in concentrations of circulating
      dihydrotestosterone within the normal range may represent a major predictor of
      sexual activity in healthy young men.

PMID- 7773041
TI  - Prevalence of knee problems in the population aged 55 years and over: identifying
      the need for knee arthroplasty.
AB  - OBJECTIVE: To determine the prevalence of knee problems in people aged 55 years
      and over and identify those who should be considered for knee arthroplasty.
      DESIGN: Postal survey; questionnaires were sent to a multistage stratified
      probability sample of residents of North Yorkshire Health Authority aged 55 and
      over. SETTING: A health district with a population of 210,000 aged 55 and over.
      RESULTS: An initial four page postal questionnaire produced an 86% response rate
      among 18,827 eligible patients. A subsequent detailed questionnaire sent to 1277
      patients with knee problems (with a response rate of 78%) then determined the
      prevalence of severe pain and severe disability. Pain and disability consistent
      with the need to consider arthroplasty was found in 20.4/1000 (95% confidence
      interval 18.0 to 23.1); of these, 4.1 (2.7 to 5.8)/1000 had extreme disability.
      Age and sex specific rates in men who might benefit from arthroplasty were, in
      those aged 55-64, 12.9 (8.4 to 19.0)/1000; aged 65-74, 12.1 (7.4 to 18.4)/1000;
      aged 75 and over, 20.3 (12.9 to 30.5)/1000. In women aged 55-64 the rates were
      12.9 (8.6 to 18.7)/1000; aged 65-74, 19.6 (13.9 to 26.7)/1000; aged 75 years and
      over, 42.6 (34.3 to 52.4)/1000. CONCLUSIONS: Total knee replacement has until
      recently been considered unreliable and often seen as a last resort for many with
      severe knee problems. Advances in prosthesis design and surgical and anaesthetic
      techniques have transformed this procedure into a reliable option with a
      potential for reducing disability and dependency in a large number of people in
      the community. Understandably, the prevalence pool of those who may benefit is
      large; health authorities and, increasingly, general practitioners should
      consider purchasing more total knee replacement surgery to offer real choice to
      those in need.

PMID- 7773043
TI  - General practitioners' knowledge of notifiable, reportable, and prescribed
      diseases.

PMID- 7773042
TI  - Ten year cerebrovascular morbidity and mortality in 68 year old men with
      asymptomatic carotid stenosis.
AB  - OBJECTIVE: To study the natural course of carotid artery stenosis detected by
      ultrasonography. DESIGN: Prospective cohort study. Baseline examination in 1982-3
      included ultrasound examination of carotid arteries, measurement of ankle
      brachial blood pressure index, and detection of atrial fibrillation by 24 hour
      ambulatory electrocardiography. SETTING: Malmo, a city in southern Sweden with
      230,000 inhabitants. SUBJECTS: 470 men aged 68 years randomly selected from the
      population. MAIN OUTCOME MEASURES: Incidence of stroke and transient ischaemic
      attack and all cause mortality during 10 years of follow up in relation to
      carotid stenosis, leg artery disease (ankle-brachial blood pressure index below
      0.9), and atrial fibrillation. RESULTS: Fifty men had a stroke; six of these were
      haemorrhagic. Another 11 had a transient ischaemic attack. Eighteen of the men
      with carotid stenosis (21.6 events/1000 person years) and 43 of the men with
      normal carotid arteries (14.8 events/1000 person years) had a stroke or transient
      ischaemic attack (P = 0.188). Men with atrial fibrillation had an increased rate
      of cerebrovascular events (36.7/1000 person years (P = 0.048). The highest rate
      was found in men with asymptomatic disease of the leg arteries (38.6/1000 person
      years) (P < 0.001). The increased risk of stroke or transient ischaemic attack in
      this group remained after multivariate analysis (relative risk 2.0; 95%
      confidence interval 1.1 to 3.7). CONCLUSIONS: In this cohort carotid stenosis was
      not associated with an increased risk of stroke. Part of this lack of association
      was explained by the high mortality from ischaemic heart disease in men with
      severe stenosis. Twenty seven of the 61 cerebrovascular events, however, occurred
      in men who had normal carotid arteries, normal ankle pressure, and no atrial
      fibrillation.

PMID- 7773044
TI  - Industrial injury benefit for occupational asthma in north east of England.

PMID- 7773045
TI  - GPs in principle but not in practice: a study of vocationally trained doctors not
      currently working as principals.
AB  - OBJECTIVES: To identify doctors who are vocationally trained but not currently
      practising as principals in general practice; their reasons for not practising as
      principals; and whether the prospect of a re-entry course would appear to this
      group. DESIGN: Postal questionnaire survey based on semistructured interviews.
      SUBJECTS: Doctors who had been vocationally trained but were not currently
      practising as principals: 351 possible subjects identified by a process of
      "networking." SETTING: Trent Regional Health Authority. RESULTS: 166 of the
      doctors who replied fitted the criteria (100 women; 66 men). The out of hours
      commitment was ranked as the most important factor for not practising as a
      principal--95 women and 50 men rated it important--followed by difficulty in
      combining work with family commitments--84 women, 31 men. 82 respondents (49%)
      said they would be interested in a re-entry course if one were available.
      CONCLUSIONS: There is a pool of vocationally trained doctors in Trent region who
      are not practising as principals in general practice. More flexible working
      patterns and the availability of a re-entry course could make the post of
      principal in general practice a more attractive proposition to these doctors.

PMID- 7773046
TI  - Registration of drugs for treating cancer and HIV infection: a plea to carry out
      phase 3 trials before admission to the market.
AB  - Drugs for cancer and HIV infection tend to be admitted to the market on the basis
      of results from phase 2 trials. Assessing the benefit-risk balance with phase 2
      trials often is difficult--the effect of the drug is usually temporary; the
      correlation between response or improvement of clinical measurements and the
      patient's wellbeing is often poor; and the side effects of drugs for these fatal
      diseases are serious. Therefore, although sometimes difficult to conduct,
      comparative trials that use standard treatment, placebos, or best supportive care
      remain the cornerstone for reliably assessing the benefit-risk balance.

PMID- 7773047
TI  - New South Africa's doctors: a state of flux.

PMID- 7773048
TI  - China takes to the roads.
AB  - China is undergoing rapid motorisation--motor vehicle registrations are growing
      at a rate of 10%-20% a year. Road trauma is already a major public health
      problem, and road deaths, officially estimated to be around 50,000 a year, will
      almost certainly rise with increasing motorisation. China, with its millions of
      bicycles, currently has one of the most environmentally friendly transportation
      systems on the planet. However, as the trend towards car travel continues, the
      problems of congestion and environmental pollution so evident in the West will
      also become critical public health issues in China.

PMID- 7773049
TI  - Publication: an ethical imperative.
AB  - Publication of medical research is both a monitor of the researcher's ethics and
      an audit of the local or regional ethics committee that approved it. Selectivity
      of publication or of the intention to publish lessens this audit. Opinions differ
      about what is ethically allowable in clinical and benchtop medical research.
      Ethical permission and ethical monitoring of medical research are subject to a
      hierarchy of pyramidal controls, starting in hospital and ending with the local,
      institutional, or regional ethics committee. Currently, such committees function
      with widely varying degrees of efficiency and quality of output, and with
      differing viewpoints on many ethical issues. Without an a priori insistence by
      institutional ethics committees that there be an intention to publish all medical
      research involving human subjects, ethics committees cannot routinely be subject
      to the scrutiny or audit which they themselves demand of researchers.

PMID- 7773050
TI  - What do I want from health research and researchers when I am a patient?
AB  - I have attempted to adopt the perspective of a patient--albeit one with a rather
      atypical background--to explore what I want from health research and researchers.
      This has left me with the impression that health researchers could serve the
      interests of the public more effectively in a variety of ways, and that they
      would be helped to do so by greater lay involvement in planning and promoting
      health research.

PMID- 7773051
TI  - How can health service users contribute to the NHS research and development
      programme?
AB  - The National Childbirth Trust, along with other groups of health service users,
      is working with health professionals and researchers in planning clinical trials,
      setting priorities for research, systematically reviewing research reports, and
      getting research findings into practice. User groups may bridge the gap between
      the public and researchers by explaining research issues to a wide audience,
      presenting the needs and views of health service users to the research community,
      and suggesting how members of the public may be approached for their views
      directly. Service users recognise their need for training and support, and they
      call for development and evaluation of this work.

PMID- 7773052
TI  - ABC of rheumatology. Spondyloarthropathies.

PMID- 7773053
TI  - Accuracy of local data on skin cancer. Skin cancer registry data may greatly
      underestimate cases.

PMID- 7773054
TI  - People are overusing sunbeds.

PMID- 7773055
TI  - Accuracy of local data on skin cancer. Inaccurate data may lead to insufficient
      resources.

PMID- 7773056
TI  - Accuracy of local data on skin cancer. Computerised data collection systems have
      not improved data collection.

PMID- 7773057
TI  - Chemotherapy for solid tumours.

PMID- 7773058
TI  - Profiting from the NHS.

PMID- 7773059
TI  - Prophylaxis against malaria.

PMID- 7773060
TI  - Community psychiatric nurses and drug regimens.

PMID- 7773061
TI  - Cot death among Maori.

PMID- 7773062
TI  - GPs' attitudes to a self diagnosis of myalgic encephalomyelitis. Evidence
      supports presence of encephalitis.

PMID- 7773063
TI  - Mortality among twins.

PMID- 7773064
TI  - Temperature and cardiovascular mortality.

PMID- 7773065
TI  - Undernotification of whooping cough.

PMID- 7773066
TI  - Management of severe gastroparesis diabeticorum.

PMID- 7773067
TI  - Exercise and diverticular disease.

PMID- 7773068
TI  - Fitness programme for chronic low back pain. Details of the exercises are not
      given.

PMID- 7773069
TI  - Biological influences on criminal behaviour.

PMID- 7773070
TI  - Albumin in the nephrotic syndrome.

PMID- 7773072
TI  - Advance directives.

PMID- 7773071
TI  - Sedation in fibreoptic bronchoscopy.

PMID- 7773074
TI  - Measles campaign.

PMID- 7773073
TI  - Injury to child pedestrians.

PMID- 7773075
TI  - The Gulf War syndrome.

PMID- 7773076
TI  - Future of intensive care.

PMID- 7773077
TI  - Transferring the costs of expensive treatments. Guidelines may clarify
      responsibility for prescribing.

PMID- 7773078
TI  - [Acute drug poisonings].

PMID- 7773079
TI  - [The interaction of dopamine and opioid receptors in the re-establishing of an
      amnesic and forgotten memory trace by quinpirole].
AB  - The present study evaluated the contribution of delta and kappa opioid receptors
      to the dopamine-mediated reestablishment of an amnestic and forgotten memory
      trace. Using passive avoidance as a memory index, the pretraining injection of
      leukephalin was determined to enhance the efficiency of quinpirole, a selective
      dopamine D-2 receptor agonist, to reactivate the memory retrieval in amnesia and
      forgetfulness. In contrast, pretreatment with dynorphin attenuated the retrieval
      by enhancing the effect of the pretesting injection of quinpirole in amnesia.
      Quinpirole was found to be more effective in attenuating amnesia than
      forgetfulness.

PMID- 7773080
TI  - [The comparative characteristics of the spectrum of the pharmacological action of
      azaleptin and GCh-46].
AB  - Experiments on mice and rats were made to make a comparative evaluation of the
      psychotropic properties of asaleptin (leponex) and GCh-46. There were significant
      differences between the agents. Asaleptin, as a typical neuroleptic, had no
      anticonvulsant activity. But preserving some properties of asaleptin, GCh-46
      produced pronounced anticonvulsant effects comparable with those shown by
      traditional antiepileptic agents.

PMID- 7773081
TI  - [The genetic characteristics of the brain alpha 2-adrenergic and S2
      serotoninergic systems in the realization of the tail-jerk pain reflex and its
      morphine suppression in rats].
AB  - Experiments were conducted on two inbred rat strains--WAG/G and Fischer-344. The
      WAG/G rats were found to increase the density of brain cortical mu-opiate and
      alpha 2-adrenergic receptors, short latency of tail immersion from hot water,
      decreased analgesic action of 5 mg/kg of intraperitoneal morphine and pronounced
      analgesic action of 10 micrograms of intracerebral ventricular clonidine The
      Fischer-344 rats increased S2-receptor affinity, protracted pain latency,
      increased the analgesic action of morphine (5 mg/kg i.p.), serotonin (0.5
      microgram i.c.v.), and ketanserine (1 microgram i.c.v.). The intracerebral
      ventricular administration of clonidine, serotonin, yohimbine, and ketaserine
      significantly increased the analgesic action of morphine in the two strains. It
      is suggested that a prompt pain response and increased analgesic action of
      morphine in Fischer-344 rats may be determined by higher affinity of
      serotoninergic receptors, but a slow pain reflex and decreased morphine-induced
      analgesia of WAG/G rats may be caused by the high density of brain cortex alpha 2
      adrenergic receptors.

PMID- 7773082
TI  - [Individual sensitivity to the cerebrovascular antiserotonin action of
      propranolol and tolfenamic acid].
AB  - Experimentally, metisergide largely prevents and attenuates the development of
      cerebrovascular constrictive responses evoked by serotonin. Propranolol and
      tolphenamic acid alleviate decreases in the volumetric velocity of brain blood
      flow, which are induced by serotonin in half of the total number of experiments
      whereas in the other experiments these agents show no antiserotonin
      cerebrovascular properties.

PMID- 7773084
TI  - [The effect of antidepressants on the indices of the cardiointervalogram in
      intact rats and during the deprivation of paradoxical sleep].
AB  - The acute and chronic administration of antidepressants (amitriptyline,
      imipramine, befol) to rats led to the sympathetic influences of a
      cardiointervalogram as reduced cardiointervals and its increased amplitude and
      tension index. Imipramine was found to be effective in eliminating
      disadaptational abnormalities in cardiac performance, which promoted REM-sleep
      deprivation.

PMID- 7773083
TI  - [The effect of cerebrocrast on the microcirculation in acute transient cerebral
      ischemia].
AB  - In experiments on rats with cerebral ischemia (30-min occlusion of carotid
      arteries), the novel calcium antagonist Cerebrocrast (0.4 microgram.kg-1.min-1
      i.v. for 15 min) was found to provide the functional maintenance of the parietal
      cerebral bed in the postischemic period by improving cerebral hemodynamics,
      reducing the number of highly narrowed capillaries. The agent prevented the
      erythrocytic accumulation of lipid peroxidation (LPO) products (diene conjugates
      and Schiff bases) in the intra- and postischemic periods, promoted the
      maintenance of viscoelastic properties during LPO activation.

PMID- 7773085
TI  - [The clinical pharmacology of antianginal agents].
AB  - This paper provides the basic advances made in studying the clinical pharmacology
      of antianginal agents (AAs), demonstrates the contribution of current tools for
      evaluating their antianginal effects, namely pharmacodynamic studies using pair
      bicycle ergometry and repeated treadmill exercises, 24-hour ECG monitoring,
      pharmacokinetic studies. It shows that AAs can be chosen on an individual basis.
      The authors present pharmacodynamic characteristics of a number of new AAs from
      nitrates (trinitrolong, dinitrosorbilong, etc.), calcium antagonists, beta
      adrenoblockers (proxodolol, etc.). They have developed a method for assessing the
      biological equivalence of AAs. The paper discusses the tolerance that can be
      developed to nitrates and how it can be prevented. It first demonstrates that
      nifedipine tolerance can develop and that the withdrawal syndrome can occur if
      nitrates and calcium antagonists are discontinued. There are screening data on
      various combinations of AAs. A two-stage scheme for choosing an AA therapy is
      given.

PMID- 7773086
TI  - [The antihypertensive effect of the new cardioselective prolonged-action beta
      adrenoblocker bisoprolol compared with propranolol, metoprolol and placebo].
AB  - The antihypertensive effect of daily doses of three beta-adrenoblockers
      (Bisoprolol, 10 mg once a day, propranolol, 80 mg twice a day, and methoprolol,
      100 mg twice a day), and placebo was examined in 14 patients with persistent mild
      and moderate hypertension during a double blind cross-over study by using 24-hour
      monitoring of blood pressure and its routine measurements. The latter made by a
      mercury sphygmomanometer indicated that the antihypertensive and negative
      chronotropic effect of Bisoprolol in a dose of 10 mg remained 24 hours after its
      administration and it did not significantly differ from that of the two other
      agents given in the above doses. The application of 24-hour blood pressure
      monitoring allows a more pronounced antihypertensive effect of bisoprolol to be
      revealed during 24 hours than that displayed by the two agents. Bisoprolol is an
      effective and safe antihypertensive agent.

PMID- 7773087
TI  - [The pharmacokinetics and pharmacodynamics of prophylactic doses of aspirin in
      pregnant women from a group at risk for placental insufficiency].
AB  - The pharmacokinetics and pharmacodynamics of small-dose aspirin (60 mg/day) were
      studied during the second to the third trimesters in pregnant females at a high
      risk of placental insufficiency. In the group of pregnant women with
      uncomplicated pregnancies (n = 16), the aspirin kinetic changes which presented
      with a lower concentration-time index, higher total clearance and larger
      distribution volume were associated with the gestational age. Similar changes
      were revealed in the group of pregnant women (n = 4) with advanced placental
      insufficiency. The findings suggest that the optimal therapeutical aspirin doses
      should be chosen by the gestational age rather than by the severity of placental
      insufficiency.

PMID- 7773089
TI  - [The effect of succinate combined with cytochrome C on postischemic disorders in
      the skeletal muscle of the extremities].
AB  - A combination of succinic acid and cytochrome c was studied for effects on
      skeletal muscle carbohydrate metabolism in the extremities of rats with
      experimental arterial occlusion. The administration of the agents into the
      ischemic area allowed the stores of glycogen and ATP to be preserved, by lowering
      the activity of glucose-6-phosphate dehydrogenase and lactate dehydrogenase
      fraction V in the skeletal muscle of rats with extremity ischemia. The
      intraperitoneal administration of the agents produced no positive metabolic
      effect.

PMID- 7773088
TI  - [The possible glyciram stimulation of bone marrow hematopoiesis under cytostatic
      blood depression].
AB  - The present study was undertaken to examine whether glycyrram orally given can
      correct blood abnormalities caused by a single maximal tolerable dose of
      fluorouracil. Glycyrram was demonstrated to stimulate the recovery of
      granulocytic and erythroid populations of bone marrow hemopoiesis. The
      stimulating effect of glycyrram was associated with its activating action on the
      function of hemopoietic microenvironmental cells.

PMID- 7773090
TI  - [The immunomodulating action of energizing preparations under physical loading].
AB  - Riboxin produces a weak actoprotective effect during exercises, while glucose and
      benfotiamine enhance this effect of the former. Mildronate fails to affect the
      development of immune response and suppresses the physical fitness in swimming
      rats. Mildronate in combination with glucose and benfotiamine normalizes their
      immunological responsiveness and has no effects on the physical fitness.

PMID- 7773091
TI  - [The effect of Sandimmun on the rate of oxygen consumption by lymphocytes].
AB  - Experiments on male Wistar rat thymocytes have demonstrated that cyclosporin A,
      an active substance of the immunodepressive agent sandimmune given in
      concentrations of 1 to 10 micrograms/ml, has no effects on cellular oxygen
      consumption rates measured by the polarographic technique by using a Clarke
      electrode. At the same time cyclosporin A suppressed thymocyte respiration
      stimulated by the oxidative phosphorylation release 2,4-DNP (40 micrograms/M) by
      18 and 56% when given by concentrations of 2 and 10 micrograms/ml, respectively.
      The relationship between the adverse effects clinically observed and the findings
      was also examined.

PMID- 7773092
TI  - [The effect of antidote preparations on the immune reactions in acute dimethyl
      dichlorovinyl phosphate poisoning].
AB  - Experiments on CBA mice established that acute intoxication with
      dimethylchlorovinyl phosphate given in a single LD50 of 1.0 increased mice
      splenic colony-forming cells, decreased thymic T cells, delayed hypersensitivity,
      natural and antibody-dependent cellular cytotoxicities, sheep splenic red blood
      cells, thymus-independent Vi antigen antibody production. The antidote therapy
      with atropine (20 mg/kg) did not stop the main manifestations of posttoxication
      immunodeficiency and enhanced the suppression of a humoral immune response to
      sheep red blood cells. Dipyroxim (15 mg/kg) diminished manifestations of
      postintoxication immunodeficiency.

PMID- 7773093
TI  - [The effect of reaferon on the opioid systems of chronically alcoholized rats].
AB  - Chronic alcoholic intoxication is followed by a fall in 3H-(D-ala-2,D-leu-5)
      enkephalin affinity of mu-opioid receptors with their unchanged concentrations in
      the rat brain cortex, by reductions in the tissue and plasma levels of beta
      endorphine and met-enkephalin. A daily administration of reaferon in a dose of
      10,000 IU during two fortnights completely restored both the binding affinity of
      the receptors and the concentrations of the peptides tested: those of beta
      endorphine in the adenohypophysis and plasma and those of metenkephalin in the
      adrenals and plasma.

PMID- 7773094
TI  - [A multichannel unit for the search for tranquilizers and the study of the
      mechanisms of their action by the conflict situation method].
AB  - This paper outlines an installation for studying the mechanisms of action and
      searching for new tranquilizers by the conflict situation method. Unlike other
      such installations, this in question is multichannel, allowing the animals
      drinking motivation to be concurrently evaluated.

PMID- 7773095
TI  - [The computerized prediction of the spectrum of biological activity of chemical
      compounds by their structural formula: the PASS system. Prediction of Activity
      Spectra for Substance].

PMID- 7773096
TI  - [Natriuretic peptides--biologically active substances].

PMID- 7773097
TI  - [The pharmacological activity of carnosine].
AB  - The properties of the histidine-containing dipeptide carnosine (beta-alanyl-L
      histidine) and its possible biological role are considered. The agent is
      discussed in terms of its antioxidative and immunomodulating effects on the body.
      A history of its discovery and investigations of the therapeutical benefits are
      outlined. The data given indicate that there are great perspectives in
      expensively using carnosine as a drug.

PMID- 7773100
TI  - Isolation of bacteriophage infectious for Vibrio vulnificus.
AB  - Nine phage isolates infectious for Vibrio vulnificus and falling into four
      morphological groups were isolated from estuarine waters collected in Louisiana.
      Of the 60 V. vulnificus strains tested, 87% were susceptible to one or more of
      the isolates. With the exception of V. fluvialis, Vibrio species other than
      vulnificus were resistant to infection. A spectrum of enteric bacterial strains
      were similarly resistant. Susceptibility differences were seen between opaque
      (virulent) V. vulnificus strains and those with translucent (nonvirulent) colony
      types, with the former being more susceptible. Susceptibility patterns to
      infection by the nine phage isolates among the V. vulnificus test strains suggest
      that the latter may fall into several groups. Other aspects relating to the phage
      isolates are presented.

PMID- 7773099
TI  - [Immunomodulators--a new generation of antiviral agents].

PMID- 7773098
TI  - [The antianginal action of calcium antagonists: the results of instrumental
      examination and their clinical assessment].
AB  - In 88 patients with coronary heart disease and stable exercise-induced angina
      pectoris, the efficiency of calcium antagonists was examined by using myocardial
      Tl-199 scintigraphy and comparing its data with the parameters of angiography and
      their intracoronary injection. Three types of therapy-induced changes in
      myocardial perfusion were identified, which were as follows: 1) significant
      decreases in hypoperfusion area dimensions; 2) no changes in scintigraphic
      parameters, and 3) clinically asymptomatic increases in the number of
      hypoperfused sectors. There was a relationship between the therapy-induced
      changes and the number of sclerotic arteries though the ability of large coronary
      vessels to dilate was substantially decreased, as shown by angiopharmacological
      studies.

PMID- 7773102
TI  - Analysis of a gene region required for dihydrogen oxidation in Azotobacter
      vinelandii.
AB  - The putative products of six Azotobacter vinelandii chromosomal open reading
      frames (ORFs) were suggested to be involved in dihydrogen (H2) metabolism [Chen
      and Mortenson (1992) Biochim Biophys Acta 1131, 199-202]. A promoterless lacZ
      containing cassette was used to disrupt the ORFs. Qualitative analysis revealed
      that the lacZ genes were expressed only in those mutants where the directions of
      the inserted lacZ were identical to those of the ORFs, showing that the six ORFs
      were transcribed as predicted. Unlike wildtype (w.t.), none of the mutants could
      perform dioxygen (O2)-dependent H2-oxidation, even though Western immunoanalyses
      showed that the hydrogenase large subunit was present although in amounts less
      than in w.t. Only one of the mutants (a hypB mutant), grown in nickel-enriched
      media, showed meaningful restoration of the H2-oxidizing ability. From the above
      observations it is concluded that (a) the six-ORF region is transcriptionally
      active and involved in H2-oxidation, (b) the product of hypB is needed for nickel
      activation of hydrogenase, and (c) the six ORFs (genes) belong to two or more
      operons. Possible roles of the gene products for the assembly, modification, and
      processing of hydrogenase from its apoproteins and metal centers are discussed.

PMID- 7773101
TI  - A rapid dot immunoassay for detecting the Brazilian purpuric fever clone of
      Haemophilus influenzae biogroup aegyptius with a "flow through" device.
AB  - Brazilian purpuric fever (BPF) is a highly fatal pediatric disease that may
      follow an episode of purulent conjunctivitis caused by a virulent clone of
      Haemophilus influenzae biogroup aegyptius (Hae). Oral rifampin prophylaxis, by
      eliminating carriage of the BPF clone in children with conjunctivitis, may
      prevent onset of the systemic disease. A test to detect the BPF clone directly
      from eye swabs could identify those in need of prophylaxis. This is a preliminary
      report of a rapid dot immunoassay performed on a "flow-through" cartridge that
      was developed for use under field conditions. The test is based upon recognition
      of a unique epitope of the 25-kDa pilin protein on the surface of BPF clone cells
      by a monoclonal antibody. With 36 laboratory-maintained cultures of Hae (15 clone
      isolates and 21 others), sensitivity of the assay was 67% and specificity was
      95%. When fimbrial-enriched (25-kDa+) phenotypes of five false-negative clone
      strains were prepared for use as test antigens, sensitivity rose to 100%.
      Evaluation of the immunoassay under field conditions is necessary to prove its
      efficacy.

PMID- 7773103
TI  - A new alkaline serine protease from alkalophilic Bacillus sp.: cloning,
      sequencing, and characterization of an intracellular protease.
AB  - To obtain a new serine protease from alkalophilic Bacillus sp. NKS-21, shotgun
      cloning was carried out. As a result, a new protease gene was obtained. It
      encoded an intracellular serine protease (ISP-1) in which there was no signal
      sequence. The molecular weight was 34,624. The protease showed about 50% homology
      with those of intracellular serine proteases (ISP-1) from Bacillus subtilis, B.
      polymyxa, and alkalophilic Bacillus sp. No. 221. The amino acid residues that
      form the catalytic triad, Ser, His and Asp, were completely conserved in
      comparison with subtilisins (the extracellular proteases from Bacillus). The
      cloned intracellular protease was expressed in Escherichia coli, and its
      purification and characterization were carried out. The enzyme showed stability
      under alkaline condition at pH 10 and tolerance to surfactants. The cloned ISP-1
      digested well nucleoproteins, clupein and salmin, for the substrates.

PMID- 7773105
TI  - Alcohol in eastern Europe: market prospects, prevention puzzles.

PMID- 7773104
TI  - Glutamine synthetase/glutamate synthase ammonium-assimilating pathway in
      Schizosaccharomyces pombe.
AB  - Kinetic parameters of glutamine synthetase (GS) and glutamate synthase (glutamine
      oxoglutarate aminotransferase) (GOGAT) activities, including initial velocity,
      pH, and temperature optima, as well as Km values, were estimated in
      Schizosaccharomyces pombe crude cell-free extracts. Five glutamine auxotrophic
      mutants of S. pombe were isolated following MNNG treatment. These were designated
      gln1-1,2,3,4,5, and their growth could be repaired only by glutamine. Mutants
      gln1-1,2,3,4,5 were found to lack GS activity, but retained wild-type levels of
      NADP-glutamate dehydrogenase (GDH), NAD-GDH, and GOGAT. One further glutamine
      auxotrophic mutant, gln1-6, was isolated and found to lack both GS and GOGAT but
      retained wild-type levels of NADP-GDH and NAD-GDH activities. Fortuitously, this
      isolate was found to harbor an unlinked second mutation (designated gog1-1),
      which resulted in complete loss of GOGAT activity but retained wild-type GS
      activity. The growth phenotype of mutant gog1-1 (in the absence of the gln1-6
      mutation) was found to be indistinguishable from the wild type on various
      nitrogen sources, including ammonium as a sole nitrogen source. Double-mutant
      strains containing gog1-1 and gdh1-1 or gdh2-1 (mutations that result
      specifically in the abolition of NADP-GDH activity) result in a complete lack of
      growth on ammonium as sole nitrogen source in contrast to gdh or gog mutants
      alone.

PMID- 7773107
TI  - Alcohol consumption and all-cause mortality.

PMID- 7773106
TI  - Alcohol consumption and all-cause mortality.
AB  - Based on a large US representative cohort with detailed baseline interview and
      examination data, the relationship between alcohol consumption and all-cause
      mortality is examined over a period of 15 years follow-up. Results show a
      significant linear relationship for females and males under 60 years of age at
      baseline, and a non-significant U-shape for the older ones. Both results remain
      stable for different kinds of adjustment including adjustment for nutritional
      variables and smoking. Excluding people with heart disease history at baseline
      leads to an even more pronounced linear relationship for both males and females
      under 60 years of age. Furthermore, it is shown that the curvilinear relationship
      for men found in previous research is partly due to the age groups examined.

PMID- 7773108
TI  - Analyzing the balance of risk.

PMID- 7773109
TI  - Moderate drinking and health: being confounded by confounders.

PMID- 7773110
TI  - The "unhealthy abstainers" question is still important.

PMID- 7773111
TI  - The J-curve, causality and public health.

PMID- 7773112
TI  - Means, tails, and the wisdom of Geoffrey Rose.

PMID- 7773113
TI  - The risk of harm to oneself from drinking, Canada 1989.
AB  - In a national sample of 11,634 Canadians aged 15 years and above, risk curves for
      harm to six life-areas from one's own drinking and for assault by another drinker
      rose steadily with the respondent's volume of alcohol consumption. While drinking
      five or more drinks on an occasion at least once a month substantially raised the
      risk at a given volume of drinking, the risk rose with volume even among those
      not regularly drinking five or more drinks. These relationships remained in
      logistic regressions which controlled for gender, age and educational level.
      Younger respondents, those without higher education and men reported more harm
      for a given level of their own drinking although differences by gender
      disappeared above one-third of one drink per day. Three sets of guidelines for
      low-risk drinking--two from Canada, and one generally used in Britain--were
      compared in terms of the proportions of respondents reporting harm from their own
      drinking among those who had kept within the guideline in the previous 7 days'
      drinking. More restrictiveness in the guidelines was associated with substantial
      reductions in reported drinking-related harm.

PMID- 7773114
TI  - Prevention strategies and alcohol policy.
AB  - This paper addresses the potentials of high risk strategy and population strategy
      for preventing mortality from liver cirrhosis, accidents and suicide. The
      methodological approach is based on an integration of an empirical distribution
      of consumption and the risk functions of the damages at issue. According to the
      findings, the rate of alcohol-induced mortality from the three causes combined
      would be halved either by a 25 per cent decrease in overall consumption or a 36
      per cent decrease in the alcohol consumption of the heavy drinkers (the top 5 per
      cent). The high risk strategy is most efficient in preventing cirrhosis; however
      the effect of the population strategy is also quite substantial here. The
      comparative advantage of the population strategy is most marked in connection
      with accidents and suicide, but the high risk approach yields an appreciable
      impact in this context as well. That is, neither of the two strategies appears as
      clearly superior to the other in terms of efficiency. The high risk strategy thus
      seems to be a sensible complement to the population strategy, and should have the
      potential of yielding effects on the population level if implemented on a large
      scale.

PMID- 7773115
TI  - The costs of the detrimental effects of alcohol abuse have grown faster than
      alcohol consumption in Finland.
AB  - Between 1980 and 1990 alcohol consumption in Finland grew on average by 2.4% per
      year, and most of the detrimental effects of alcohol abuse grew faster. The real
      costs from nearly all alcohol-related detrimental effects grew during the 1980s
      on average by 1.7-2.4% annually, depending on the item. As a result of the volume
      and cost development the direct detrimental effects of alcohol abuse grew from
      FIM 1.0-1.3 billion in 1980 to FIM 2.8-3.7 billion in 1990: i.e. a real increase
      of 51-56% in the direct costs of detrimental effects. The indirect costs of
      detrimental effects (production losses, value of life lost through premature
      death), was FIM 9.9-18.1 billion in 1990. In 10 years the distribution of the
      costs of direct detrimental effects changed markedly, in particular regarding
      health and social costs: the share of health costs decreased 6 percentage points,
      while that of social costs increased 10 percentage points.

PMID- 7773116
TI  - The Svalbard study 1988-89: a unique setting for validation of self-reported
      alcohol consumption.
AB  - The Norwegian island of Spitzbergen, Svalbard offers a unique setting for
      validation studies on self-reported alcohol consumption. No counterfeit
      production or illegal import exists, thus making complete registration of all
      sources of alcohol possible. In this study we recorded sales from all agencies
      selling alcohol on Svalbard over a 2-month period in 1988. During the same period
      all adults living permanently on Svalbard were invited to take part in a health
      screening. As part of the screening a self-administered questionnaire on alcohol
      consumption was introduced to the participants. We found that the self-reported
      volume accounted for approximately 40 percent of the sales volume. Because of the
      unique situation applying to Svalbard, the estimate made in this study is
      believed to be more reliable compared to other studies using sales volume to
      validate self-reports.

PMID- 7773117
TI  - HIV risk-taking behaviour among injecting drug users currently, previously and
      never enrolled in methadone treatment.
AB  - This study compares the injecting and sexual risk-taking behaviour among
      injecting drug users (IDUs) currently, previously and never enrolled in methadone
      maintenance treatment (MMT). All subjects had injected during the 6 months prior
      to the day of interview. The current MMT group showed significantly lower
      injecting risk-taking behaviour subscale scores on the HIV Risk-taking Behaviour
      Scale (HRBS) of the Opiate Treatment Index than the previous MMT and non-MMT
      groups together. The current MMT group differed from the other two groups in the
      frequency of injecting and cleaning of injection equipment with bleach. There was
      no difference between the current MMT group and the other two groups combined in
      sexual risk-taking behaviour scores on the HRBS. There were no differences
      between the previous MMT and non-MMT groups in injecting and sexual risk-taking
      behaviour. HIV seroprevalence was low and there was no difference in
      seroprevalence between groups. Thus, IDUs currently enrolled in MMT are at
      reduced risk for HIV infection when compared with IDUs who have previously or
      never been enrolled in MMT. However, the absence of a difference between the
      current MMT and other two groups in frequency of sharing behaviours suggests the
      need for additional strategies among MMT clients to reduce needle-sharing.
      Possible strategies include the application of relapse prevention interventions
      and the availability of sterile injecting equipment in MMT clinics. Further
      research is needed to identify factors which increase attraction and retention of
      IDUs to MMT.

PMID- 7773118
TI  - Administration mode bias in a school survey on alcohol, tobacco and illicit drug
      use.
AB  - School surveys have become the most common method for determining the general
      level of tobacco, alcohol and illicit drug use among adolescents in a large
      number of countries. The two most commonly applied field procedures in school
      surveys are teachers' and researchers' administration of questionnaires. The
      impact of the difference between these two modes of administration has not been
      determined, although it has been argued that central involvement of teachers in
      data collection may decrease the perceived anonymity of the survey among
      students, and should thus be avoided. In a split-half random sample of 3017
      urban, Icelandic 16-20-year-old students, no statistically significant
      differences were found in reported use of licit or illicit drugs, nor in the
      stated willingness to be honest between these two modes of administration. These
      results suggest that when students return their responses in sealed envelopes,
      the two modes of administration produce equally valid results.

PMID- 7773119
TI  - Parental and peer influences on smoking among young adults: ten-year follow-up of
      the Oslo youth study participants.
AB  - This study was designed to investigate the impact of family and peer role models
      during the early adolescent years on smoking onset and on subsequent daily
      smoking among young adults. Baseline data were collected from a sample of 827
      students and their parents in 1979. Participating students were recruited among
      5th, 6th and 7th graders (11-14 years old) attending six schools in Oslo, Norway.
      The same students were invited to participate in a 2-year follow-up survey in
      1981 and in a 10-year follow-up survey in 1989 when their average age was 23.4
      years. Both at baseline and in 1981, smoking (experimental or regular) was
      strongly associated with smoking behaviour of friends and siblings. Parental
      smoking and parents' educational level were not significant predictors of their
      offspring's smoking in 1979. While friends' smoking in 1979 or 1981 remained a
      significant bivariate predictor of daily smoking in 1989, mother's baseline
      smoking emerged, in multivariate analysis, as the most important long-term
      predictor of daily smoking among young adults. These results point to the
      importance of including parents in smoking prevention efforts targeting
      adolescents.

PMID- 7773121
TI  - Comments on the European alcohol action plan.

PMID- 7773120
TI  - Tobacco smoking in young adults from 21 European countries: association with
      attitudes and risk awareness.
AB  - Information concerning tobacco smoking was obtained in a survey of 16,483
      students aged 18-30 years from 21 European countries. Belief in the benefits to
      health of not smoking were also assessed. Risk awareness was measured in terms of
      knowledge of the links between smoking and disease. The overall age-adjusted
      prevalence of smoking was 33.1% in men and 29.0% in women, but wide variations
      were observed across country samples. Significant sex differences were found in
      only a minority of cases. The inclusion of respondents who stated that they had
      sometimes smoked in the past substantially reduced variations in prevalence
      across country samples. Beliefs in the health benefits of not smoking were
      consistently associated with smoking behaviour. Awareness of the link between
      smoking and lung cancer was uniformly high, but awareness of the role of smoking
      in heart disease varied considerably across country samples, and averaged only
      64.4% in men and 62.9% in women. In the majority of countries, risk awareness was
      greater among smokers than non-smokers. The results suggest that in this selected
      sector of the population of young adults in Europe, sex differences in smoking
      are relatively minor, robust associations between attitudes and smoking behaviour
      can be identified, and there are major gaps in risk awareness.

PMID- 7773122
TI  - Radioautography in cellular and molecular biology.
AB  - A general survey is presented on the most important applications of radioactive
      compounds as well on fresh as on fixed tissues, with and without immunological
      reactions, at light and electron microscopic levels. Its goal is to show their
      flexibility and their extended applications, in comparison with the non
      radioactive methods. But radioautography applies as well to non-cellular aspects,
      such as electrophoretic and chromatographic techniques, permitting a
      complementary and even more detailed exploration of the molecules investigated at
      cellular levels. A rapid information is given on the exact denomination of the
      radioautographic methods, on hybridization in situ and in vitro, on the different
      blotting techniques used for DNA, RNA and proteins, on semi-quantitation and
      quantitation of DNA-RNA hybrids, on radioimmunodection by fluorography and on
      newer filmless radioautographic systems. The organ, body and pharmacological
      radioautographies belong to the nuclear medicine and have been evocated briefly.

PMID- 7773123
TI  - Proceedings of the 4th International Symposium on Radioautography, satellite
      symposium of the 25th annual meeting of the Clinical Electron Microscopy Society
      of Japan. Matsumoto, Japan, September 28-October 2, 1993.

PMID- 7773124
TI  - Incorporation of 3H-amino acids by endometrial stromal cells during
      decidualization in the mouse. A radioautographical study.
AB  - The incorporation of 3H-amino acids by endometrial stromal cells was analyzed by
      radioautography during decidualization in the mouse. 3H-proline was administered
      to 5- and 6-day pregnant mice and to virgin mice in estrus used as controls. 3H
      tryptophan was administered to 6-day pregnant mice. The animals were killed 30
      min. after the injection of the radioactive label. The quantitative analysis of
      the radioautograms showed that the concentration of silver grains per unit area
      due to 3H-proline incorporation was higher in decidual and predecidual cells on
      the fifth and sixth day of pregnancy than in fibroblasts of virgin mice.
      Considering the pregnant endometrium by itself, the incorporation of both 3H
      proline and 3H-tryptophan was higher in fully differentiated decidual cells and
      predecidual cells than in fibroblasts of the periphery of the endometrium and
      involuting decidual cells. These results show a clear correlation between
      different endometrial regions recognized by morphological criteria and their
      metabolic activity. The data also show that different cells of the pregnant
      endometrium have different metabolic activities, independently of the precursor
      that was used.

PMID- 7773125
TI  - Age-related changes of male mouse submandibular gland: a morphometric and
      radioautographic study.
AB  - The DNA synthesis and the changes of cell population kinetic of aging male mouse
      submandibular glands were studied by light and electron microscopic
      radioautography from embryonic day 19 to 21 months postnatal. At the embryonic
      day 19, the gland consisted of developing acinar cells (49%), intercalated duct
      (ICD) (37%), juxta-acinar (JA) (3%) and striated duct (SD) cells (11%). At birth,
      JA cells increased rapidly to 32%, thereafter decreased gradually. At 1 month of
      age, granular convoluted tubule cells appeared and increased rapidly in number
      with age. They reached a maximum at 6 month after birth. Then they appeared to
      decrease gradually from 6 to 21 months. The most conspicuous feature of the aged
      submandibular glands was the regressive changes of the granular ducts. The extent
      and height of the granular ducts as well as the content of mature secretory
      granules decreased. These changes may play an important role during the
      development of mice, because the granular duct synthesizes many biological
      factors. The 3H-thymidine labeling index of each cell type of male mouse
      submandibular glands reached a peak 1 day after birth and decreased with aging.
      The labeling index of intercalated duct cells was higher than the others and
      persisted for a long time. On the other hand, the labeling indices of the other
      cells were significantly depressed at one week after birth. From these
      observations on morphology, it was also shown that ICD cells were concerned with
      the generation of the other cell types.

PMID- 7773126
TI  - Uptake site of lansoprazole, a proton pump inhibitor, in human fundic mucosa:
      possible relevance with fibroblast and Helicobacter pylori.
AB  - To clarify the mechanism of the effect of lansoprazole in the healing of human
      gastric ulcer, the uptake sites of lansoprazole were studied using endoscopically
      biopsied specimens from the margin of the gastric ulcer. The specimens were
      incubated in a medium containing 3H-lansoprazole for 5 or 15 min., postfixed with
      1% osmic acid and embedded in Epon. The semithin or ultrathin sections were made
      and radioautographic emulsion films were applied by the wire-loop method. 30 days
      after the incubation, the sections were developed, fixed and observed by light
      and electron microscopy. As a result, the uptake sites of lansoprazole were
      accumulated on the fibroblasts located near the tip portion of the gastric mucosa
      and on the unmyelinated nerve fibers as well as on the parietal cells. Some of
      the uptake sites were also observed near the plasma membrane of the bacteria in
      the gastric lumen. From these observations, lansoprazole uptake sites were not
      only on the parietal cells but on the fibroblasts and the bacteria, suggesting
      that the effect of lansoprazole was exerted partly through the influence on the
      mesenchymal cells and Helicobacter pylori-related organisms.

PMID- 7773127
TI  - Use of confocal laser scanning microscopy in radioautographic study.
AB  - Confocal laser scanning microscopy was used to visualize the radioautograph at
      the light-microscope level. Confocal reflectance images from developed silver
      grains were overlaid with the differential interference contrast image of the
      tissue. With this technique, a well-focused radioautograph can be taken of both
      tissue sections and all of the silver grains dispersed in the thick emulsion
      layer. Further application of this microscopy is discussed.

PMID- 7773128
TI  - Heterogeneous distribution of 125I-insulin binding sites in the liver of fed and
      fasted mice.
AB  - A microradioautography made three min. after intravenous injection of 125I
      insulin was used to study the distribution of insulin binding sites in the liver
      of fed and fasted mice. A substantial specific binding of 125I-insulin to liver
      parenchymal cells could be seen in these mice, whereas radioautographs from
      animals injected with 125I-insulin plus an excess of unlabelled insulin showed
      only trace amounts of silver grains. In both fed and fasted mice, a density
      gradient of the binding from the periportal zone to the perivenous zone was
      evident, and the binding in each zone was significantly higher in the fasted mice
      than in the fed mice.

PMID- 7773129
TI  - Ultrastructural and radioautographic studies on DNA synthesis in Leydig cells on
      aging mouse testis.
AB  - A morphological observation and a radioautographic study were carried out to
      detect the ultrastructure and aging changes of DNA synthesis of the Leydig cells,
      whose structure has been observed and the area of the lipid droplets in the
      cytoplasm calculated. The observation by electron microscopy showed that Leydig
      cells contained abundant mitochondria and endoplasmic reticulum and that the area
      of the lipids in the cytoplasm changed with aging. Only little lipid droplets
      were found in embryonic and early postnatal stages, but they increased from
      postnatal two weeks onwards and no significant differences were found from 9
      months to 21 months. The DNA synthesis in these cells was not vigorous at
      embryonic day 19, explored by light microscopic radioautography 1 hr. following a
      single injection of 3H-thymidine. The labeling index increased slightly before
      six months of age and reached its peak at 9 months. There was no significant
      difference found in the number of labelled cells from that time on. A relatively
      high level was maintained at adult and senescent periods. Our results demonstrate
      that the generation of the Leydig cells contained plentiful lipid droplets was
      vigorous at adult and senescence.

PMID- 7773130
TI  - Brain activity of a rat reflects apparently the stimulation of acupuncture. A
      radioautography using 2-deoxyglucose.
AB  - To confirm a relationship between the central nervous system and the acupuncture,
      the response was examined in the rat brain using radioautography with tritiated 2
      deoxyglucose, after stimulation of some acupoints. Eight groups, of a total of 27
      rats were submitted to acupuncture at 6 different acupoints (Zusanli, Renzhong,
      Tianshu, Shenmen, Neiguan, Yongquan) and control, with or without electric pulses
      or with anesthesia respectively, prior to the injection with isotopic
      deoxyglucose. A hundred twenty cryosections were cut from a freshly frozen brain
      and exposed on single-coated X-ray films. The results showed that the acupuncture
      on the four acupoints of Zusanli, Tianshu, Shenmen and Neiguan enhanced the
      activity of the neocortex, the limbic cortex and the thalamic nuclei in
      comparison with the control group. The acupoints on Renzhong and Yongquan
      depressed the activity on the thalamic nuclei and the midbrain. The anesthesia
      with pentobarbital concealed the most activity on the whole area of the brain,
      which hardly responded to any stimulation of acupuncture. These results lead to
      the suggestion that the brain may reflect the signals by the stimulation of
      acupuncture and change the activity depending upon each acupoint.

PMID- 7773131
TI  - Study on nucleic acid synthesis in mouse retina and retinal pigment epithelium by
      radioautography.
AB  - The ocular tissues of ddY mice from embryonic 9 to postnatal day 14 were labelled
      in vitro with 3H-thymidine or 3H-uridine. After radioautography, the
      radioautographs were observed by light and electron microscopes. The labeling
      indices (L.I.) with 3H-thymidine or grain numbers with 3H-uridine were calculated
      and the area (microns 2) of cell organelles in both labelled and unlabelled
      retinal cell with 3H-thymidine were measured by image analysis. The L.I. of
      retinal cells were low in the beginning then increased and reached a peak at P3,
      while the L.I. of retinal pigment epithelium (RPE) increased and reached a peak
      at P7. The L.I. of both retinal and PE cells disappeared at P14. However, the
      L.I. of anterior region were more than those of equaterial and posterior regions
      in both retinal and PE cells. The results of the image analysis showed that the
      average area of cell organelles, both labelled and unlabelled retinal cells
      decreased from E9 to P14. The grain numbers of retina labelled with 3H-uridine
      increased until P1 then decreased, while the numbers of RPE increased and reached
      a peak at P3 whereafter they declined. No significant differences were detected
      among the three regions.

PMID- 7773132
TI  - Distribution of humanized MAb 425 (EMD 62,000) in rats and specific localization
      in tumor-bearing nude mice.
AB  - The murine MAb 425 (IgG2a) directed against human epidermal growth factor
      receptor is considered to have therapeutic potential in glioma patients. In order
      to circumvent immune response in clinical use, the MAb 425 was humanized by CDR
      grafting (IgG1). We have studied the distribution of reshaped MAb 425 (EMD
      62,000) in Wistar rats and the specific localization in female nude mice bearing
      human mamma carcinoma xenografts. The 125I-labelled MAb 425 was administered
      intravenously in a single dose (1 mg/kg) using unspecific human IgG1 antibody as
      control. The biodistribution was investigated both quantitatively and by whole
      body autoradiography. The autoradiographs showed a selective uptake of
      radioactivity by the tumour tissue. 15 days after administration, radioactivity
      was bound exclusively to the tumour. Similar results were obtained with the
      murine monoclonal antibody. Quantitative studies exhibited a tumour-blood ratio
      of about 5. The study demonstrates that the humanized MAb 425 is selectively
      localized in human mamma carcinoma xenografted to athymic mice.

PMID- 7773133
TI  - Zonal variations of types II, IX and XI collagen mRNAs in rat epiphyseal
      cartilage chondrocytes: quantitative evaluation of in situ hybridization by image
      analysis of radioautography.
AB  - The spatial-temporal distribution of the mRNAs for type IX and type XI collagens
      were compared to that of type II collagen mRNA in the tibial epiphyseal plate
      cartilage of normal growing rats. The mRNAs were detected by in situ
      hybridization with radio-labelled specific probes and visualized by
      radioautography. The areas covered by the resulting silver grains were quantified
      by computer assisted image analysis. The areas in chondrocytes of each zone of
      the epiphyseal plate cartilage, which correspond to the stages of chondrocyte
      development and function were determined. Types II, IX and XI mRNAs were present
      to some extent in chondrocytes of all zones. The distributions of type II and
      type IX collagen mRNAs were similar with the highest concentrations in the
      proliferative zone, and the lowest in the resting and calcifying zones
      chondrocytes. In contrast, type XI collagen mRNA had a different distribution,
      with the lowest concentration in the resting zone chondrocytes and a significant
      decrease in the calcifying zone chondrocytes. These patterns correlates with the
      changes in chondrocyte function, and may reflect the roles of the type IX and
      type XI collagens. The data show that computer assisted image analysis of in situ
      hybridization radioautographic images is a precise, rapid tool for analysing
      differences in gene expression.

PMID- 7773134
TI  - Light and electron microscopic radioautographic studies on macromolecular
      synthesis in digestive organs of aging mice.
AB  - For the purpose of analyzing the changes of macromolecular synthesis in aging
      animals, we have developed methodologies for quantitative light and electron
      microscopic radioautography. The methodologies were applied to DNA, RNA, protein,
      glucides and lipids syntheses of digestive organs, especially of the liver and
      the pancreas of aging strain ddY mice, demonstrating the incorporations of
      respective precursors, 3H-thymidine, 3H-uridine, 3H-leucine, 3H-glucosamine, 35S
      sulfuric acid and 3H-glycerol. Characteristic differences have been observed
      between the respective macromolecular syntheses in respective aging groups, from
      prenatal (embryonic day 19) to postnatal newborn period (postnatal day 1), from
      suckling (postnatal day 3) to weaning (postnatal day 14), juvenile (postnatal 1
      month), young adult (postnatal 2 month) and senescent periods (6 and 12 months up
      to 2 years). These results are extensively analyzed and reviewed.

PMID- 7773136
TI  - Distribution of [1,2-3H]taurine in the skin of adult and newborn mice studied by
      microradioautography.
AB  - In vivo light microscopic radioautography was used to demonstrate the
      distribution of taurine in adult and newborn mice at 30 min. and 3 hrs. after the
      injection of 3H-taurine. This study showed that the injected taurine was present
      in free form in the skin. Radioautographically, it was found that in the adult a
      very high density of taurine was found over the epidermis and external root
      sheaths near the opening of the hair follicles. The external root sheath just
      below the insertion of the sebaceous glands and the peripheral part of the
      sebaceous glands showed a high taurine distribution. Connective tissue in the
      dermis, however, showed low uptake of taurine. In the neonate mouse, the density
      of injected taurine in both the epidermis and the external root sheath was lower
      than that the density in the connective tissue in the dermis. We report these
      findings in detail and discuss some of the functional roles of taurine in the
      skin.

PMID- 7773135
TI  - Recent progress in whole-body radioautography.
AB  - We review whole-body radioautography for water-soluble substances and its
      applications studied to date in our laboratory. To transfer the whole-body
      section onto a glass slide, Japanese paper was inserted between frozen block and
      adhesive tape before sectioning. Then the section was dried together with the
      paper and adhesive tape in a cryotome and applied onto the glass slide coated
      with a mixture of egg-albumin and glycerin. The whole-body section was
      transferred to slide and contacted with the film in vacuum. By using these
      techniques, we review the glucose and taurine metabolism, the glucose-6
      phosphatase activity and the insulin receptor.

PMID- 7773137
TI  - Microchannel array detector for quantitative electronic radioautography.
AB  - The microchannel array detector provides direct electronic detection and real
      time imaging of radioactive tracers in samples that traditionally have been
      imaged by film radioautography. The technology of the detector is described, and
      the main benefits of this new technology, speed and precise quantitation, are
      illustrated with practical results. The instrument response to a 14C dilution
      series (range of 10(5)) was linear over the whole range. Results from the
      microchannel array detector are compared to results obtained with liquid
      scintillation counting (LSC) and densitometry of film radioautographs. Because
      the instrument response is linear and consistent from day to day, it is not
      necessary to routinely include calibration standards as is required for film. The
      14C counting efficiency was found to be essentially constant for different
      tissues in a whole body microtome section. As with LSC, results reported as
      counts per min. (CPM) are independent of counting time. Quantitative results were
      obtained with assays for chloramphenicol acetyl transferase in two min. and
      little as 0.2 DPM/mm2 of 32P was detected in seven min.

PMID- 7773138
TI  - Effect of biological response modifiers on growth and cell proliferation of human
      tumor xenografts in nude mice.
AB  - The effect of biological response modifiers on macroscopic tumor growth and on
      tumor cell proliferation of a human renal cell carcinoma and a squamous cell
      carcinoma (hypopharynx) in nude mice has been studied. Tumor necrosis factor
      alpha (TNF-alpha) and interferon alpha (IFN-alpha) as well as granulocyte
      macrophage colony-stimulating factor (GM-CSF) were applied either alone or in
      combination, and TNF-alpha was also combined with etoposide (ETP). TNF-alpha and
      IFN-alpha alone or in combination did not substantially affect the course of
      tumor growth, however, they did influence the pattern of tumor growth. There was
      also only a marginal effect on tumor cell proliferation. However, IFN-alpha
      protects the animals from tumor growth associated weight loss. ETP and ETP plus
      TNF-alpha leads to a deceleration of tumor growth, a decrease of the labeling
      index and to a significant decrease of the animal weight which indicates that the
      first two effects may be partly due to the toxicity of the treatment. GM-CSF
      modifies cell proliferation in a dose-dependent manner, i.e. stimulation at low
      doses and tendency to inhibition at higher doses. Although there is no
      substantial direct antineoplastic effect of the agents studied, the results make
      clear that indirect effects of therapeutic agents due to therapy induced cachexia
      should always be regarded. It is interesting that IFN-alpha has a protective
      effect against cachexia.

PMID- 7773140
TI  - Granulation in amine-storage organelles of mouse megakaryocytes: X-ray microprobe
      analysis and radioautography.
AB  - The mechanisms and the processes of the storage of bivalent cations, ATP and 5
      hydroxytryptamine (5HT) in the precursors of the amine-storage organelles of
      megakaryocytes were studied at the electron microscopic level. Although the
      precursors of the amine-storage organelles in the megakaryocytes fixed with
      glutaraldehyde and osmium tetroxide were empty, the electron opaque granules were
      observed in these organelles of the freeze-substituted megakaryocytes cut onto
      ethylene glycol. X-ray microprobe analysis demonstrated that they contained P, Mg
      and Ca. Quantitative differences in bivalent cations in the granules were not
      observed between megakaryocytes and blood platelets. Electron opaque uranaffin
      reaction products were observed in the precursors of the amine-storage organelles
      of the megakaryocytes after treatment with the uranaffin reaction for ATP.
      However, few chromaffin positive granules were observed in the precursors of the
      amine-storage organelles after the chromaffin reaction for monoamines.
      Radioautographic analysis demonstrated that blood platelets avidly took up 3H-5HT
      but megakaryocytes were not able to accumulate 3H-5HT in vivo. These results
      indicate that megakaryocytes do not yet acquire the well developed uptake system
      of 5HT in vivo, while they readily accumulate cations and ATP in the precursors
      of the amine-storage organelles.

PMID- 7773139
TI  - Localization of Na, K-ATPase isoforms in the hypothalamus of the rat.
AB  - In situ hybridization histochemistry with synthetic oligonucleotide probes was
      used to localize mRNAs encoding three isoforms of the catalytic (alpha) subunit
      and one isoform of the (beta) subunit of the Na, K-ATPase in rat hypothalamus
      using contact film radioautography. 3H-Ouabain binding to specific anatomical
      nuclei in the hypothalamus was determined using a quantitative radioautographic
      technique previously developed in our laboratory. Specific hybridization was
      found with oligonucleotide probes for mRNA encoding alpha 1, alpha 2, alpha 3,
      beta 1 isoforms of the Na, K-ATPase. High levels of hybridization signal for
      alpha 3 and beta 1 were found in ventromedial hypothalamus, supraoptic nucleus,
      paraventricular nucleus and the anterior hypothalamic area. Very low levels of
      hybridization for all isoforms were found in the optic chiasm. mRNAs encoding
      alpha 1 and alpha 2 isoforms were expressed at lower levels than alpha 3. The
      distribution of alpha 2 was consistent with expression in glial cells. Generally,
      levels of alpha 1 mRNA were higher in the arcuate nucleus than in other
      hypothalamic regions and very low levels were found in the anterior hypothalamic
      area. 3H-Ouabain binding was relatively diffuse, consistent with the localization
      of the synthesized Na, K-ATPase protein in cellular processes. The number of 3H
      ouabain binding sites in the paraventricular nucleus was significantly lower than
      other hypothalamic nuclei studied. The results suggest that Na, K-ATPase isoforms
      may be differentially expressed in hypothalamic nuclei.

PMID- 7773141
TI  - Biosynthesis of glycosaminoglycans in the endometrium during the initial stages
      of pregnancy of the mouse.
AB  - Significant changes in the synthesis of glycosaminoglycans occur during the
      transformation of stromal cells of the endometrium into decidual cells which
      takes place during the initial stages of pregnancy in mice. Hyaluronic acid,
      which is practically absent in the endometrium of virgin mice, increases
      dramatically on the fifth day of pregnancy, reaching its maximal concentration on
      day 6 followed by a 50% decrease on day 7. Changes in hyaluronic acid
      concentration also occur in pseudopregnant mice indicating that they are not
      related to the presence of the embryo in the uterus. The absolute concentration
      of the sulfated glycosaminoglycans, e.g., heparan sulfate, dermatan sulfate and
      chondroitin sulfate in the decidua did not change significantly. There was,
      however, a striking decrease of their biosynthesis in pregnant and pseudopregnant
      mice when compared to virgin mice, as shown by the use of radioactive inorganic
      sulfate as a precursor for the study of in vivo synthesis. A radioautographical
      analysis confirmed that the highest incorporation of radioactive sulfate was
      observed in virgin endometria when compared to pregnant ones. These studies also
      have shown a characteristic pattern of labeling in different regions of the
      endometrium that repeats itself during the different days of pregnancy.

PMID- 7773142
TI  - Improvements in bio-mechanical adhesion of screws used in medical field: first
      application in spinal surgery.
AB  - Metallic screws are becoming more and more useful to join bones or for prosthesis
      support in orthopaedic and dental surgery. High biocompatible materials such as
      titanium alloys and hydroxyapatite ceramics are making possible the realization
      of stable fixation devices utilizable in load-bearing applications. The
      mechanical and biological anchorage of metallic screws to the bone depends on
      many factors: mechanical screws-bone thread matching, use of cements between bone
      and screw, chemical-physical treatments of screw surface, use of screw coverage
      films based on osteointegrating ceramics or active bioglasses, use of porous
      coverage films to induce bone ingrowth into the pore, and so on. The first step
      of the research, the aim of the present paper, is the comparison among screws of
      different shapes and geometric characteristics in order to find the best
      macromechanical system versus the different load conditions. Static and dynamic
      tests are applied to the screws mounted on segments of pig spine, in order to
      measure the mechanical characteristics of the system under tension (pull-out),
      bending on the principal planes along the axis of the screw and fatigue loads.
      Physical analysis, obtained using energetic charged particles, such as SEM, RBS,
      and AES, are used to characterize the screw surface compositions and morphology.

PMID- 7773143
TI  - Valid method to evaluate the slope of Fourier transformed spectrum for the
      analysis of biological rhythm fluctuation.
AB  - Influences of lower frequency components of power spectrum calculated from
      biological rhythm data on the spectral slope were examined and the validity of
      conventional method to calculate the spectral slope was tested. Heart-beat-period
      data obtained from the electrocardiogram of rats were cut into two successive
      data sets, each of them was converted into power spectrum density by the fast
      Fourier transform, and the power spectra were compared with each other. The
      results showed that two spectra were overlapped only in the frequency range
      higher than a frequency about 15 times that of the dominant one, which means that
      the lower frequency components are not always the same and thus, the regression
      line by which the spectral slope is determined is considerably affected by the
      components. To evaluate the spectral slope, regression lines of spectra were
      obtained in three methods and their slopes were compared with each other. The
      methods were: "conventional" method, in which the weight of a frequency component
      was independent of the frequency (i.e., equal-weight = 1); "weight" method, in
      which the weight was the wave number included in the rhythm data; and "limited
      data" method, where the weight was 1 and lower-frequency components were
      excluded. The results showed that there was not a large difference between the
      slopes in cases where the spectrum looked rather linear. However, in cases of
      considerably curved spectra the difference was large and the "weight" method may
      be the most reasonable to use, and in cases of short data length the "limited
      data" method should be avoided.

PMID- 7773144
TI  - Reinforcement of bone cement around prostheses by pre-coated wire coil: a finite
      element model study.
AB  - The longevity of cemented total joint replacements, namely total hip arthroplasty
      (THA), depends on the integrity of the cement per se and interfaces of the
      metallic stem-cement and bone-cement, and stress/stress transmission and its
      distribution. A simple coil made of stainless steel wire was placed around a
      tapered stem in a simulated cement mantle to counteract the radial- and hoop
      stresses created by the stem loading. Two-dimensional axisymmetric finite element
      analysis was performed to elucidate the level of the stress and its distribution
      with and without the wire coil. The results suggest that the peak stresses
      distributed throughout the cement may be reduced by more than one half, via the
      incorporation of a wire coil, confirming the mechanical test results, which
      showed an average fracture load of 3.70 +/- 1.13 kN for pure bone cement control
      and 9.02 +/- 1.54 kN for the wire coil reinforced specimens. These results
      indicate that the reinforcement of the cement mantle with a wire coil in the
      distal end of the hip stem prosthesis could reduce the hoop-stresses, which may
      results in reduced stresses in the bone and cement interface. Consequently,
      loosening of the interfaces of the bone-cement and cement-stem could be reduced
      due to the enhanced fatigue life of the bone cement mantle with favorable stress
      distribution at the distal tip of the stem.

PMID- 7773145
TI  - The effect of two types of cross-linking on some mechanical properties of
      collagen.
AB  - Samples of collagen were cross-linked by two different methods: (a)
      glutaraldehyde and (b) a combination of dehydrothermal treatment and cyanamide.
      The elastic modulus, the ultimate tensile strength (fracture stress), strain to
      failure, work of fracture, and fracture toughness were measured before and after
      cross-linking in ambient laboratory conditions, and during immersion in water.
      These tests were all performed over a range of strain rates. For collagen tested
      in the wet condition, it was found that cross-linking increased the elastic
      modulus from approximately 25-30 MPa, to between 55 and 60 MPa, but there was
      little effect on fracture stress, and strain to failure was reduced. The work of
      fracture of the collagen decreased on cross-linking. Cross-linking had the same
      effect on the elastic modulus, fracture stress, and strain to failure of dry
      collagen, but the work of fracture was unaffected. In conclusion, cross-linking
      increased the elastic modulus, reduced the strain to failure, and had little
      effect on the fracture stress of collagen under the present experimental
      conditions.

PMID- 7773146
TI  - Direct or indirect skin lipid-ordering effect of pyrrolidone carboxylate sodium
      after topical treatment with penetration enhancers.
AB  - The structural changes in the lipid of the excised skin of nude mice and the
      porcine stratum corneum was investigated by in vitro treatment with vitamin C,
      oleic acid, or DMSO. The CH2 stretching vibrational peaks of lipid near 2920 cm-1
      (asymmetric) and 2850 cm-1 (symmetric) shifted to higher wavenumber due to the
      lipid-disorder after in vitro treatment with above enhancers. The spectral shift
      of the asymmetric CH2 band was more sensitive than that of the symmetric CH2
      band. The higher wavenumber of CH2 stretching bands decreased gradually to the
      lower region after co-treatment or posttreatment with pyrrolidone carboxylate
      sodium (PCA Na). Such a decrease was dependent on the PCA Na concentration and
      the time of treatment. The higher the concentration of PCA Na used, the lower
      value of the permeability coefficient of vitamin C through the excised skin and
      the downward spectral shift of asymmetric CH2 band were obtained. When PCA Na
      coexisted with vitamin C in the cell donor compartment, a competitive effect
      between PCA Na and vitamin C was found. The oleic acid was supposed to directly
      insert it into the lipid structure to form a rigid structure, leading to larger
      spectral shift of both stretching bands but lesser restoring ability after PCA Na
      treatment. However, DMSO only displaces water from the lipid head groups and
      protein domain of skin to indirectly loosen the lipid structure, resulting in
      lesser spectral shift of the CH2 stretching bands to higher region, which was
      easier and better restoration after PCA Na application. The PCA Na enabled to
      restore the disordered lipid structure to order state might be attributed to PCA
      Na previously penetrated into skin and then absorbed water to directly or
      indirectly rearrange the disordered lipid bilayer structure.

PMID- 7773147
TI  - Patterns of drug resistance parameters in adult leukemia.
AB  - P-glycoprotein (Pgp), Glutathione (GSH), Glutathione S-Transferase (GST), and O6
      Alkylguanine-DNA Alkyltransferase (ATase) were measured in parallel as putative
      indicators of drug resistance in adult leukemia. The patterns of resistance
      parameter expression of chronic and acute leukemia were different. In acute
      leukemia on average all parameters were increased as compared to normal bone
      marrow. In chronic leukemia GSH and GST were increased, whereas Atase, GPx and
      frequency of Pgp-expression were low. Treatment with cytostatic drugs did not
      influence median levels of expression/activity of the resistance parameters.
      Resistance parameter expression/activity of leukemic cells was also compared with
      various other tissue and tumor types. Generally the pattern of resistance
      parameter expression reflected the resistance status of the tissue,
      constitutively resistant tumor types and their corresponding normal tissue on
      average having higher levels than leukemic cells and other tissue and tumor types
      with acquired resistance. For individual patients with acute leukemia, however,
      none of the parameters was directly correlated with response to treatment.

PMID- 7773148
TI  - P-glycoprotein expression in acute myeloblastic leukemia analyzed by
      immunocytochemistry and flow cytometry.
AB  - Using the APAAP technique, we assessed the reactivity of five monoclonal
      antibodies, JSB1, C219, Mab 57, 2F8 and MRK16, to gp 170 in 60 cases of de novo
      acute myeloid leukemia (AML) and 13 relapses. Reactivity, varied between the five
      antibodies, and positivity was obtained with 2F8 > JSB1 > MRK16 > Mab57 > C219.
      Sixteen of the 60 cases were also studied by flow cytometry. In 10 cases, the
      results with the two techniques corresponded, in the other 6 cases, flow
      cytometry proved more sensitive than APAAP in detecting small amounts of gp170.
      In the flow cytometry analysis, the cells fixed in methanol and paraformaldehyde
      were more fluorescent than unfixed samples or those fixed in paraformaldehyde or
      methanol alone. Our results thus reveal that positivity for gp 170 depends on
      various factors, including the specificity of the monoclonal antibodies, the
      techniques used and the preservation of the samples. This suggests the need for a
      clear standardization of the methods to detect gp170.

PMID- 7773149
TI  - Comparative analysis of cytokines released by bone marrow stromal cells from
      normal donors and B-cell chronic lymphocytic leukemic patients.
AB  - We studied the production of cytokines (G-CSF, GM-CSF, IL-6, LIF and IL-10) by
      bone marrow stromal cells of five untreated patients with B-CLL, in Rai stage 0,
      I and II, and of 8 healthy subjects. The production of G-CSF, GM-CSF, LIF and IL
      10 did not differ significantly between controls and B-CLL patients. However, the
      ability of stromal cells to release IL-6 in response to LPS was decreased in all
      patients: 36 +/- 5 ng/ml versus 123 +/- 47 ng/ml for normal controls (p < 0.004).
      Moreover, a soluble activity that inhibited hematopoietic colony formation was
      detected in B-CLL stromal cell conditioned media. Some potential inhibitors were
      envisaged and the results indicated an increased production of TGF-beta by B-CLL
      stromal cells compared to normal stromal cells (respectively 53 +/- 10 versus 15
      +/- 4 ng/ml, p < 0.03). The reduced capacity of B-CLL stromal cells to produce IL
      6 was associated with this excessive release of TGF-beta; indeed, addition of
      anti-TGF-beta neutralizing antibody to B-CLL stromal cells, before LPS
      stimulation, totally normalized the production of IL-6. TGF-beta and IL-6 were
      also measured in serum samples from normal subjects and B-CLL patients. No
      significant difference was seen in the production of total TGF-beta (bioactive
      and latent forms) between normal and B-CLL sera but the mean level of bioactive
      protein in B-CLL sera was increased in comparison with normal sera (1.74 +/- 0.44
      versus 0.67 +/- 0.2 ng/ml, p < 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773150
TI  - Multiple patterns of MDM-2 deregulation in human leukemias: implications in
      leukemogenesis and prognosis.
AB  - The human analogue of the mouse double minute-2 (MDM-2) protein binds to p53
      protein and abrogates its tumor-suppressing activity. MDM-2 overexpression may
      represent an alternative mechanism to p53 mutation for escaping the p53-mediated
      growth control. Interestingly, multiple MDM-2 protein isoforms have been
      described and the possibility of functional differences between various isoforms
      has been raised. Previously, we demonstrated significant MDM-2 mRNA
      overexpression in human leukemias and suggested that MDM-2 overexpression may be
      a marker of aggressiveness of the disease. Polyclonal antibodies (Ab) have been
      generated to detect various isoforms of the MDM-2 protein. Using these Abs, we
      confirmed MDM-2 protein overexpression in leukemias. Furthermore, we observed
      heterogeneity in the isoforms expressed in various types of leukemias. In
      addition, we demonstrated that analysis by flow cytometry could be used as a
      diagnostic tool for detecting altered MDM-2 protein expression in leukemias. Here
      we review and expand our initial observations and confirm MDM-2 mRNA and protein
      overexpression by reverse transcription-polymerase chain reaction (RT-PCR), flow
      cytometry, and western blot analyses. Understanding the possible role of MDM-2
      oncogene expression in leukemias may establish the scientific basis for new
      therapeutic approaches.

PMID- 7773151
TI  - The role of decreased retinoblastoma protein expression in acute myelomonocytic
      and monoblastic leukemias.
AB  - The results of different investigators show that lack of p105 expression is
      relatively common in human myeloid leukemias, especially in monocytic leukemias.
      This suggests that loss of p105 expression could contribute to the altered growth
      control of these cells. So far no clear data exist which show that low p105
      levels in AML blasts predict a poor therapy outcome. Therefore it is not very
      likely that p105 expression will become a strong prognostic factor for the
      different treatment strategies in AML.

PMID- 7773153
TI  - Intestinal T-cell lymphoma with massive tissue and blood eosinophilia mediated by
      IL-5.
AB  - A case of enteropathy associated T-cell lymphoma (EATCL) in a 62-year-old female
      with a previous history of coeliac disease, complicated during the clinical
      course by massive blood and tissue eosinophilia is described. The patient's serum
      contained a factor capable of stimulating the in vitro growth of eosinophilic
      colonies (CFU-Eo), that was absent in the serum of normal donors. We suggest that
      such factor was Interleukin-5 (IL-5), as indicated by the presence in the
      monoclonal tumor T cells of IL-5 encoding mRNA, usually absent in the normal
      enterocytes of the jejunum.

PMID- 7773152
TI  - Chlorambucil, vincristine and cytarabine (COA) treatment of low grade lymphomas.
AB  - Forty-five patients with stage III-IV low grade non-Hodgkin's lymphoma (NHL) were
      treated with a non-intensive polychemotherapy regimen including chlorambucil
      vincristine and cytarabine (Ara-C), termed COA, for a total of 366 courses,
      beginning in June 1986. Grade 4 myelotoxicity occurred in only 4/45 patients. No
      treatment related death was observed. All patients were evaluable for response.
      Overall, 38 (84%) objective responses, including 31 (69%) complete responses
      (CR), were observed. At a median follow-up of 57 (21-84+) months, only 8 deaths
      occurred. Twenty-seven (60%) patients are still disease-free. All disease-free
      patients were in their first CR. The seven-year estimated survival is 71% and the
      estimated 7-year progression-free survival (PFS) was 48%. The estimated
      probability of complete responders to be disease-free at 6 years is 78%.
      Pretreatment laboratory parameters (serum levels of thymidine kinase, LDH and TNF
      alpha showed a good prognostic relevance at using univariate analysis. At
      multivariate analysis, only the pretreatment serum levels of TNF-alpha were
      significantly associated with a higher CR achievement probability (p = 0.02) and
      a longer PFS (p = 0.02). We established a risk model for clinical outcome based
      on these 3 parameters. Patients having all parameters within the normal range at
      diagnosis, showed a very good prognosis (100% 7-year PFS and survival), while
      patients with all parameters increased had a very poor prognosis (0% 7-year PFS
      and 22% 7-year survival). In conclusion, COA treatment appears to be a non-toxic
      and very effective treatment for low-grade non-Hodgkin's lymphomas.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7773154
TI  - Comparison of Epstein-Barr virus markers in Reed-Sternberg cells in adult
      Hodgkin's disease tissues from an industrialized and a developing country.
AB  - The link between Hodgkin's disease (HD) and Epstein-Barr virus (EBV) is well
      documented in childhood and here the same hypothesis has been examined in adults,
      by comparing cases from an industrialized and a developing country. In this study
      the prevalence of EBV markers in nodal lesions of adult HD were compared in 21
      patients from France (Fr) and 25 from Algeria (Al), all clinically staged during
      1990-1992. Median age was 29 years. Histologic subtypes included lymphocytic
      predominance (LP) Fr 1; nodular sclerosis (NS) Fr 16, Al 16; mixed cellularity
      (MC) Fr 4, Al 9. EBV markers examined included expression of latent membrane
      protein (LMP) in Reed-Sternberg and Hodgkin cells (RSC) by immunochemistry; EBV
      DNA and -RNA in situ hybridization (ISH); EBV-DNA by polymerase chain reaction
      (PCR). Results showed that RSC were LMP-positive in 4 (2 NS, 2 MC) French and 7
      (3 NS, 4 MC) Algerian. All LMP+ cases were also positive for EBV DNA-RNA ISH. ISH
      was positive in RSC of 33% of the French and 72% of Algerian patients (p < 0.02).
      The positivity was more frequent in MC (77%) than in other histologic types
      (45%). The EBV genome was detected by PCR on DNA extracted from frozen samples in
      84% of Fr and 95% of Al patients (100% of MC and 86% of other histologic types).
      Conclusion. The discrepancy between PCR and ISH results may be due to the lesser
      sensitivity of the ISH technique, or, alternatively, to the presence of EBV in
      the lymphoid cells surrounding RSC.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773155
TI  - Cytokine dysregulation in chronic graft versus host disease.
AB  - Cytokines play a key role in the pathogenesis of chronic Graft versus Host
      Disease (cGVHD) and various studies have shown abberant production of cytokines
      by immune cells from GVHD patients. Based on these findings and others showing
      that high TNF levels precede the development of GVHD, we evaluated inflammatory
      cytokine levels following BMT and during the development of cGVHD. In this study,
      patients undergoing bone marrow transplantation (BMT) who consequently developed
      chronic GVHD were analyzed as to their cytokine production during cGVHD and this
      was correlated with their clinical manifestations. A positive correlation was
      found between the severity as well as the number of major clinical complications
      and high levels of inflammatory cytokines (IL-1 beta IL-6 and TNF alpha) compared
      to control patients or to normal donors. Patients undergoing BMT who did not
      develop GVHD, did not produce high levels of IL-1 beta IL-6 or TNF. High levels
      of cytokines may be used as a tool for assessing novel therapeutic modalities and
      response to GVHD treatment.

PMID- 7773156
TI  - A retinoic acid resistant HL-60 cell clone sensitive to N-(4-hydroxyphenyl)
      retinamide-mediated clonal growth inhibition.
AB  - Among the Retinoic Acid (RA) derivatives, retinamides, and in particular N-(4
      hydroxyphenyl) retinamide (4-HPR), are currently being investigated in selected
      cases of cancer chemoprevention. The cellular target range, however, seems to be
      limited, as cells of hemopoietic origin are virtually incapable of terminal
      differentiation upon addition of the compound. We have reconsidered the effect of
      4-HPR on HL-60 cells by taking advantage of a mutant clone, generated in our
      laboratory, unresponsive to RA but highly responsive to dimethylsulfoxide (DMSO).
      We show here that this clone, upon addition of 4-HPR, although unable of
      undergoing full differentiation, shows considerable reduction of clonal growth.
      Moreover, the combination of 4-HPR and RA resulted in a much greater effect than
      the administration of 4-HPR alone. We suggest that 4-HPR and RA, at least in
      terms of mediating growth inhibition, may follow different metabolic pathways.

PMID- 7773157
TI  - A simplified method for cryopreservation of hematopoietic stem cells with -80
      degrees C mechanical freezer with dimethyl sulfoxide as the sole cryoprotectant.
AB  - A simplified method for cryopreservation was developed with 10% dimethylsulfoxide
      (DMSO) as the sole cryoprotectant without rate-controlled freezing. This method
      produced high recovery rate for mononucleated cells (87%) and elevated trypan
      blue viability (90%). Autologous peripheral blood stem cells (PBSCs) and bone
      marrow cells with plasma and 10% DMSO were frozen and stored in a -80 degrees C
      mechanical freezer. Eleven patients with solid and hematological malignancies
      were transplanted with autologous bone marrow or PBSCs. The median number of
      infused mononuclear cells (MNC) and CD34+ cells were 3.63 x 10(8)/Kg and 4.80 x
      10(6)/Kg, respectively. The median number of infused post-thawing CFU-GM was 20 x
      10(4)/Kg. All patients showed a rapid and sustained engraftment. The mean times
      to reach a neutrophil count of 0.5 x 10(9)/L and a platelet count of 50 x 10(9)/L
      were 11 and 13 days, respectively. All patients are alive and 10 in unmaintained
      complete remission for 3-9 months after transplantation. These results show the
      efficacy of this simplified cryopreservation technique that will be useful for
      institutions without rate-controlled freezing facilities.

PMID- 7773158
TI  - Polymyositis associated with Ki-1 lymphoma.
AB  - We report here a case of acute polymyositis associated with a Ki-1 non-Hodgkin's
      lymphoma (NHL). This anaplastic large cell malignant lymphoma was a primary T
      cell NHL lymphoma of the bone marrow. The malignant cells expressed the CD30 (Ki
      1), CD3, and CD4 antigens, the beta chain of the interleukin 2 receptor (CD25),
      and the betaF1 antigen (alpha/beta T-cell receptor). Chemotherapy and high dose
      methylprednisolone pulse therapy were initiated. However, no clinical improvement
      was noticed, because the patient rapidly died of an acute respiratory distress
      syndrome. To our best knowledge, this represents the first case of Ki-1 lymphoma
      associated with Polymyositis.

PMID- 7773160
TI  - c-mpl expression in hematologic disorders.
AB  - The c-mpl gene encodes a member of the hematopoietic cytokine receptor
      superfamily. This gene was discovered through the study of a murine retrovirus
      which induces an acute myeloproliferative syndrome in mice. MPLV (for
      myeloproliferative leukemia virus) has transduced a truncated and constitutively
      activated form of the c-mpl receptor chain. The c-mpl ligand is unknown, but
      recent data indicate that it could specifically regulate thrombocytopoiesis. This
      review focuses on the expression of the c-mpl gene in a large series of human
      hematopoietic pathologies by Northern blot analysis. Barely detectable transcript
      levels were detected in normal bone marrow (BM) and in BM samples from chronic
      myeloproliferative disorders, plasmocytoma, Burkitt lymphoma or acute lymphoid
      leukemia. In contrast, high levels of c-mpl expression were detected in 45% of
      acute myeloid leukemia (AML). No correlation was found between c-mpl expression
      and the French-American-British classification subtype of AML. However c-mpl
      expression correlated with CD34 expression, and unfavorable cytogenetic
      abnormalities, defining a subgroup of AML with a low rate of complete remission.
      In myelodysplasia, c-mpl expression was elevated in 44% of chronic myelomonocytic
      leukemia (CMML), 42% of refractory anemia with excess myeloblasts (RAEB), and
      RAEB in transformation to acute leukemia (RAEBt), but not in refractory anemia
      (RA) and RA with ringed sideroblasts (RARS). In CMML, there was no correlation
      between c-mpl expression and any prognostic factor tested, nor with the course of
      the disease. The biologic significance of c-mpl expression in RAEB and RAEBt is
      probably different.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773159
TI  - Legionnaires' disease during induction of remission chemotherapy for acute
      nonlymphocytic leukemia.
AB  - Two patients with acute nonlymphocytic leukemia (ANLL) who developed neutropenia,
      bilateral lung infiltrates, and did not respond to conventional antibiotic
      therapy nor amphotericin B are described. Clinical awareness and suspicion of
      Legionnaires' disease (LD) and early administration of erythromycin lead to their
      cure before the diagnosis of LD was confirmed.

PMID- 7773161
TI  - DNA fingerprint analysis in acute leukemias.
AB  - Restriction fragment length polymorphism (RFLP) analysis by Southern blotting or
      direct in-gel hybridization is a routine procedure in any genetic laboratory.
      Minisatellites and simple repeat probes for RFLP analysis have proved to be
      highly informative genetic markers, depending on their degree of homology and
      index of heterozygosity. Several of these probes have considerable
      individualization potential, thus yielding 'fingerprint' pattern. In the setting
      of acute leukemia DNA fingerprint (DNA-F) analysis is able to provide
      considerable information concerning the genetic instability of the leukemic
      clone. DNA-F is capable of detecting randomly occurring genetic alterations of
      unknown localization and to identify new hotspots of malignant transformation. As
      DNA-F analysis is not likely to be hampered by the effects of chemotherapy or DNA
      methylation, altered fingerprints may be regarded as characteristic of the
      leukemic clone. With the introduction of polymerase chain reaction (PCR) and
      increasing sensitivity, DNA-F analysis is likely to be of significant importance
      in monitoring minimal residual disease in human leukemia.

PMID- 7773162
TI  - p53 expression in non-Hodgkin's lymphomas: a marker of p53 inactivation?
AB  - The p53 gene located in the short arm of chromosome 17 at position 17p13, is
      involved in the negative regulation of cellular growth. p53 mutation seems to be
      the most frequent genetic alteration found in human cancer. Mutant conformation
      of the p53 gene is associated with cell proliferation and tumour progression, and
      in most cases implies p53 stabilization, which renders the p53 protein detectable
      through the use of immunohistochemical techniques. p53 expression is a frequent
      finding in high grade lymphomas of either B or T cell lineage, having been
      detected in 30% of cases in our series. The focal presence of p53+ cells was seen
      in a wide range of low and high grade lymphomas, including lymphadenitis and
      reactive tonsils. In 37.5% of cases this increased expression of p53 was
      secondary to mutation in highly conserved regions (exons 5-8). Unlike findings
      reported in other tumours, in lymphomas, p53 expression seems to be secondary to
      genetic alterations other than p53 mutation. Initial data suggest that the MDM2
      protein could be involved in inactivating p53 protein in most of these cases.
      Finally, p53 expression has been found to be a poor prognostic marker in high
      grade B-cell lymphomas in a large series of cases. High p53 expression was
      associated with a short survival, this relation being stronger in cases with
      simultaneous bcl2 expression.

PMID- 7773164
TI  - Chromosomal deletions in myelodysplasia.
AB  - There are two major classes of genes implicated in human tumorigenesis, the
      oncogenes and the tumour suppressor genes. In haematological malignancies most
      emphasis has been placed upon the recurring translocations in which the
      juxtaposition of two gene sequences has resulted in the activation of an
      oncogene. Chromosomal loss rather than translocation is the most frequent
      karyotypic abnormality in the myelodysplastic syndromes, a heterogeneous group of
      clonal malignant blood disorders characterised by dyshaematopoiesis and/or
      impaired maturation of haemopoietic cells with frequent evolution to acute
      leukaemia. Recent attention has focused on the loss of genetic material as a
      result of chromosomal monosomy or deletion in the myelodysplastic syndromes. The
      most frequently reported deletions in these myeloid syndromes are of chromosomes
      5, 20 and 7. Deletions of chromosomes 11, 12, and 13, although more rarely
      observed, are also characteristics of the myelodysplastic syndromes. It is
      probable that the deleted chromosomal bands give the location for as yet
      unidentified myeloid specific tumour suppressor loci and there is considerable
      interest in the cloning of these genes. This review discusses the three most
      frequently observed deletions in MDS; 7q deletion, 5q deletion and 20q deletion
      taking into account recent evidence on the respective critical regions of gene
      loss and the role of candidate genes.

PMID- 7773163
TI  - T cells in multiple myeloma: is this a reliable population to count on as
      antitumor effector cells?
AB  - Multiple Myeloma (MM) is still a long way from being cured. Disease evolution has
      been associated with a number of phenotypic and functional alterations in T
      cells, indicating that a progressive deterioration of cellular immunity might
      facilitate the negative outcome. Despite these correlations, specific
      interactions between tumor and T cells have been demonstrated indicating that a
      population liable to be exploited as antitumor effector cells exists in vivo.
      This review aims at recording some evidence obtained in our laboratory
      demonstrating that MM T cells, despite the variety of their alterations, can
      still generate potent antitumor activity. Adequate stimulation, however, is
      required to exploit this ability.

PMID- 7773165
TI  - The contribution of Auer rods to the classification and prognosis of
      myelodysplastic syndromes.
AB  - Auer rods were first recognized at the beginning of this century. Their presence
      soon became considered to be an unequivocal manifestation of a leukemic process.
      Possibly influenced by this long-held assumption, in 1982 the French-American
      British co-operative group (FAB) incorporated the presence of Auer rods into a
      classification system of the myelodysplastic syndromes that remains in widespread
      clinical usage today. Although unsubstantiated at the time, the presence of Auer
      rods was suggested to indicate a rapidly progressive disorder and a poor
      prognosis. In the absence of studies confirming the utility of Auer rods as a
      diagnostic criterion, the FAB classification system of myelodysplastic syndromes
      has been widely used to allocate therapy. In this review we examine the early
      descriptions of Auer rods and critically evaluate the studies examining the value
      their presence has in the classification and prognosis of patients with
      myelodysplastic syndromes.

PMID- 7773166
TI  - Monoclonal antibody-purged bone marrow transplantation therapy for multiple
      myeloma.
AB  - This report describes the clinical characteristics, treatment associated
      toxicity, and follow-up of fifty-eight patients with plasma cell--dyscrasias
      treated with high dose chemotherapy and total body irradiation (TBI) at a single
      institution. Following TBI, 36 patients received anti-B cell monoclonal antibody
      (MoAb)-treated autologous bone marrow, 21 patients received anti-CD6 cell MoAb
      treated allogeneic bone marrow to deplete T cells, and one patient received
      unpurged bone marrow from a syngeneic donor. Evaluation after high dose
      chemotherapy and bone marrow transplantation (BMT) demonstrated 26 complete
      responses (CR), 26 partial responses (PR), 2 non-responders, 1 not yet evaluated,
      and three toxic deaths. Fourteen of 36 patients who underwent autologous BMT are
      alive free from progression at 18 (range 5 to 68) months post transplant (post
      BMT); of these, 11 remain in continuous complete response at 16 (range 5 to 68)
      months post-BMT. Seven of 21 patients who underwent allogeneic BMT are alive free
      from progression at 30 (range 4 to 44) months post-BMT; of these, three patients
      remain in continuous complete response at 43 (range 33 to 45) months post-BMT.
      These data suggest that high dose chemotherapy with TBI followed by MoAb purged
      BM can be performed with acceptable toxicity and high tumor response rates.

PMID- 7773167
TI  - An update on allogeneic marrow transplantation for myelodysplastic syndrome.
AB  - Ninety-three patients with myelodysplastic syndrome with either excess blasts or
      life-threatening cytopenia received cyclophosphamide and total body irradiation
      (88 patients) or busulfan (5 patients) followed by allogeneic (90 patients) or
      syngeneic (3 patients) marrow infusion. Thirty-eight patients are disease-free
      survivors between 1.8 and 11.3 years (median 6.1 years) after transplantation.
      The median Karnofsky performance status of the survivors is 100%, and only 2 have
      a performance status of < 80%. Eighteen patients relapsed and the remaining 37
      died without evidence for relapse. The 5-year actuarial disease-free survival,
      relapse, and non-relapse mortality rates are 40%, 29%, and 44%, respectively. The
      actuarial relapse rate was higher among patients with excess blasts at the time
      of transplantation compared to those without excess blasts (49% vs. 4%, p =
      0.0001), resulting in a lower disease-free survival (31% vs. 54%, p = 0.07).
      Increasing age was associated with a lower disease-free survival (p = 0.02). In a
      multivariate analysis, younger age, shorter disease duration, and absence of
      excess blasts were associated with improved outcome. We recommend that patients
      with myelodysplasia with appropriate marrow donors, especially patients less than
      age 40, undergo marrow transplantation early during the disease course, before
      the disease progresses or life-threatening complications develop.

PMID- 7773168
TI  - A procedure for detecting structural domains in proteins.
AB  - A procedure is described for detecting domains in proteins of known structure.
      The method is based on the intuitively simple idea that each domain should
      contain an identifiable hydrophobic core. By applying the algorithm described in
      the companion paper (Swindells MB, 1995, Protein Sci 4:93-102) to identify
      distinct cores in multi-domain proteins, one can use this information to
      determine both the number and the location of the constituent domains. Tests have
      shown the procedure to be effective on a number of examples, even when the
      domains are discontinuous along the sequence. However, deficiencies also occur
      when hydrophobic cores from different domains continue through the interface
      region and join one another.

PMID- 7773169
TI  - Identification of a eukaryotic-like protein kinase gene in Archaebacteria.
AB  - Primary sequence patterns based on known conserved sites in eukaryotic protein
      kinases were used to search for eukaryotic-like protein kinase sequences in a six
      frame translation of the bacterial subsection of GenBank. This search identified
      a previously unrecognized eukaryotic-like protein kinase gene in three related
      methanogenic archaebacteria, Methanococcus vannielii, M. voltae, and M.
      thermolithotrophicus. The proposed coding sequences are located in orthologous
      open reading frames (ORFs): ORF547, ORF294, and ORF114, respectively. The C
      terminus of the ORFs contains 9 of the 11 subdomains characteristically conserved
      within the eukaryotic protein kinase catalytic domain. The N-terminus of the ORFs
      is similar to a putative glycoprotease in Pasteurella haemolytica and its
      homologue in Escherichia coli, the orfX gene. This is the first report of a
      eukaryotic-like protein kinase sequence observed in Archaebacteria.

PMID- 7773171
TI  - A brief and subjective history of contractility.

PMID- 7773173
TI  - Thermodynamics of heme-induced conformational changes in hemopexin: role of
      domain-domain interactions.
AB  - Hemopexin is a serum glycoprotein that binds heme with high affinity and delivers
      heme to the liver cells via receptor-mediated endocytosis. A hinge region
      connects the two non-disulfide-linked domains of hemopexin, a 35-kDa N-terminal
      domain (domain I) that binds heme, and a 25-kDa C-terminal domain (domain II).
      Although domain II does not bind heme, it assumes one structural state in apo
      hemopexin and another in heme-hemopexin, and this change is important in
      facilitating the association of heme-hemopexin with its receptor. In order to
      elucidate the structure and function of hemopexin, it is important to understand
      how structural information is transmitted to domain II when domain I binds heme.
      Here we report a study of the protein-protein interactions between domain I and
      domain II using analytical ultracentrifugation and isothermal titration
      calorimetry. Sedimentation equilibrium analysis showed that domain I associates
      with domain II both in the presence and absence of heme with Kd values of 0.8
      microM and 55 microM, respectively. The interaction between heme-domain I and
      domain II has a calorimetric enthalpy of +11 kcal/mol, a heat capacity (delta Cp)
      of -720 cal/mol.K, and a calculated entropy of +65 cal/mol.K. By varying the
      temperature of the centrifugation equilibrium runs, a van't Hoff plot with an
      apparent change in enthalpy (delta H) of -3.6 kcal/mol and change in entropy
      (delta S) of +8.1 cal/mol.K for the association of apo-domain I with domain II
      was obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773170
TI  - Differentiation of peptide molecular recognition by phospholipase C gamma-1 Src
      homology-2 domain and a mutant Tyr phosphatase PTP1bC215S.
AB  - Activated epidermal growth factor receptor (EGFR) undergoes autophosphorylation
      on several cytoplasmic tyrosine residues, which may then associate with the src
      homology-2 (SH2) domains of effector proteins such as phospholipase C gamma-1
      (PLC gamma-1). Specific phosphotyrosine (pTyr)-modified EGFR fragment peptides
      can inhibit this intermolecular binding between activated EGFR and a tandem amino
      and carboxy-terminal (N/C) SH2 protein construct derived from PLC gamma-1. In
      this study, we further explored the molecular recognition of phosphorylated
      EGFR988-998 (Asp-Ala-Asp-Glu-pTyr-Leu-Ile-Pro-Gln-Gln-Gly, I) by PLC gamma-1 N/C
      SH2 in terms of singular Ala substitutions for amino acid residues N- and C
      terminal to the pTyr (P site) of phosphopeptide I. Comparison of the extent to
      which these phosphopeptides inhibited binding of PLC gamma-1 N/C SH2 to activated
      EGFR showed the critical importance of amino acid side chains at positions P+2
      (Ile994), P+3 (Pro995), and P+4 (Gln996). Relative to phosphopeptide I, multiple
      Ala substitution throughout the N-terminal sequence, N-terminal sequence, N
      terminal truncation, or dephosphorylation of pTyr each resulted in significantly
      decreased binding to PLC gamma-1 N/C SH2. These structure-activity results were
      analyzed by molecular modeling studies of the predicted binding of phosphopeptide
      I to each the N- and C-terminal SH2 domains of PLC gamma-1.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7773172
TI  - A recombinant human hemoglobin with asparagine-102(beta) substituted by alanine
      has a limiting low oxygen affinity, reduced marginally by chloride.
AB  - A recombinant (r) mutant hemoglobin (Hb) with Asn-102(beta) replaced by an Ala
      (N102A(beta)) has been prepared by PCR amplification of a mutagenic DNA fragment
      and expression of the recombinant protein in yeast. The side chain of Asn
      102(beta) is part of an important region of the alpha 1 beta 2 interface that
      undergoes large structural changes in the transition between the deoxy and oxy
      conformations. Three natural mutant Hbs with neutral substitutions of Thr, Ser,
      or Tyr at this site have low oxygen affinities because a hydrogen bond between
      Asn-102(beta) and Asp-94(alpha) in normal HbA was considered to be absent in
      these mutants, thereby destabilizing the oxy conformation in favor of the deoxy
      conformation. This proposal has been tested by expression of an rHb containing
      alanine at position 102(beta); alanine was chosen because its methyl side chain
      cannot participate in hydrogen bond formation, yet it is small enough not to
      disrupt the subunit interface. The nature of the desired replacement was
      established by sequencing the entire mutated beta-globin gene as well as the
      tryptic peptide containing the substitution. Further characterization by SDS
      PAGE, isoelectric focusing, HPLC analysis, mass spectrometry, amino acid
      analysis, and sequencing of the mutant tryptic peptide confirmed the purity of
      the rHb. Its oxygen binding curve (2.4 mM in heme) in the absence of chloride
      showed that it had a very low oxygen affinity with a P50 of 42 mm Hg.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7773174
TI  - Interleukin-1 beta converting enzyme: a novel cysteine protease required for IL-1
      beta production and implicated in programmed cell death.
AB  - Interleukin-1 beta converting enzyme is the first member of a new class of
      cysteine proteases. The most distinguishing feature of this family is a nearly
      absolute specificity for cleavage at aspartic acid. This enzyme has been the
      subject of intense research because of its role in the production of IL-1 beta, a
      key mediator of inflammation. These studies have culminated in the design of
      potent inhibitors and determination of its crystal structure. The structure
      secures the relationship of the enzyme to CED-3, the product of a gene required
      for programmed cell death in Caenorhabditis elegans, suggesting that members of
      this family function in cell death in vertebrates.

PMID- 7773175
TI  - Conformational stability of HPr: the histidine-containing phosphocarrier protein
      from Bacillus subtilis.
AB  - The conformational stability of the histidine-containing phosphocarrier protein
      (HPr) from Bacillus subtilis has been determined using a combination of thermal
      unfolding and solvent denaturation experiments. The urea-induced denaturation of
      HPr was monitored spectroscopically at fixed temperatures and thermal unfolding
      was performed in the presence of fixed concentrations of urea. These data were
      analyzed in several different ways to afford a measure of the cardinal parameters
      (delta Hg, Tg, delta Sg, and delta Cp) that describe the thermodynamics of
      folding for HPr. The method of Pace and Laurents (Pace CN, Laurents DV, 1989,
      Biochemistry 28:2520-2525) was used to estimate delta Cp as was a global analysis
      of the thermal- and urea-induced unfolding data. Each method used to analyze the
      data gives a similar value for delta Cp (1,170 +/- 50 cal mol-1K-1). Despite the
      high melting temperature for HPr (Tg = 73.5 degrees C), the maximum stability of
      the protein, which occurs at 26 degrees C, is quite modest (delta Gs = 4.2 kcal
      mol-1). In the presence of moderate concentrations of urea, HPr exhibits cold
      denaturation, and thus a complete stability curve for HPr, including a measure of
      delta Cp, can be achieved using the method of Chen and Schellman (Chen B,
      Schellman JA, 1989, Biochemistry 28:685-691). A comparison of the different
      methods for the analysis of solvent denaturation curves is provided and the
      effects of urea on the thermal stability of this small globular protein are
      discussed. The methods presented will be of general utility in the
      characterization of the stability curve for many small proteins.

PMID- 7773176
TI  - Crystallographic study of the structure of colipase and of the interaction with
      pancreatic lipase.
AB  - Colipase (Mr 10 kDa) confers catalytic activity to pancreatic lipase under
      physiological conditions (high bile salt concentrations). Previously determined 3
      A-resolution X-ray structures of lipase-colipase complexes have shown that, in
      the absence of substrate, colipase binds to the noncatalytic C-terminal domain of
      pancreatic lipase (van Tilbeurgh H, Sarda L, Verger R, Cambillau C, 1992, Nature
      359:159-162; van Tilbeurgh et al., 1993a, Nature 362:814-820). Upon lipid
      binding, conformational changes at the active site of pancreatic lipase bring a
      surface loop (the lid) in contact with colipase, creating a second binding site
      for this cofactor. Covalent inhibition of the pancreatic lipase by a phosphonate
      inhibitor yields better diffracting crystals of the lipase-colipase complex. From
      the 2.4-A-resolution structure of this complex, we give an accurate description
      of the colipase. It confirms the previous proposed disulfide connections (van
      Tilbeurgh H, Sarda L, Verger R, Cambillau C, 1992, Nature 359:159-162; van
      Tilbeurgh et al., 1993a, Nature 362:814-820) that were in disagreement with the
      biochemical assignment (Chaillan C, Kerfelec B, Foglizzo E, Chapus C, 1992,
      Biochem Biophys Res Commun 184:206-211). Colipase lacks well-defined secondary
      structure elements. This small protein seems to be stabilized mainly by an
      extended network of five disulfide bridges that runs throughout the flatly shaped
      molecule, reticulating its four finger-like loops. The colipase surface can be
      divided into a rather hydrophilic part, interacting with lipase, and a more
      hydrophobic part, formed by the tips of the fingers. The interaction between
      colipase and the C-terminal domain of lipase is stabilized by eight hydrogen
      bonds and about 80 van der Waals contacts. Upon opening of the lid, three more
      hydrogen bonds and about 28 van der Waals contacts are added, explaining the
      higher apparent affinity in the presence of a lipid/water interface. The tips of
      the fingers are very mobile and constitute the lipid interaction surface. Two
      detergent molecules that interact with colipase were observed in the crystal,
      covering part of the hydrophobic surface.

PMID- 7773177
TI  - Mutations of surface residues in Anabaena vegetative and heterocyst ferredoxin
      that affect thermodynamic stability as determined by guanidine hydrochloride
      denaturation.
AB  - The stability properties of oxidized wild-type (wt) and site-directed mutants in
      surface residues of vegetative (Vfd) and heterocyst (Hfd) ferredoxins from
      Anabaena 7120 have been characterized by guanidine hydrochloride (Gdn-HCl)
      denaturation. For Vfd it was found that mutants E95K, E94Q, F65Y, F65W, and T48A
      are quite similar to wt in stability. E94K is somewhat less stable, whereas E94D,
      F65A, F65I, R42A, and R42H are substantially less stable than wt. R42H is a
      substitution found in all Hfds, and NMR comparison of the Anabaena 7120 Vfd and
      Hfd showed the latter to be much less stable on the basis of hydrogen exchange
      rates (Chae YK, Abildgaard F, Mooberry ES, Markley JL, 1994, Biochemistry 33:3287
      3295); we also find this to be true with respect to Gdn-HCl denaturation.
      Strikingly, the Hfd mutant H42R is more stable than the wt Hfd by precisely the
      amount of stability lost in Vfd upon mutating R42 to H (2.0 kcal/mol). On the
      basis of comparison of the X-ray crystal structures of wt Anabaena Vfd and Hfd,
      the decreased stabilities of F65A and F65I can be ascribed to increased solvent
      exposure of interior hydrophobic groups. In the case of Vfd mutants E94K and
      E94D, the decreased stabilities may result from disruption of a hydrogen bond
      between the E94 and S47 side chains. The instability of the R42 mutants is also
      most probably due to decreased hydrogen bonding capabilities.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7773178
TI  - Hydrogen bonding motifs of protein side chains: descriptions of binding of
      arginine and amide groups.
AB  - The modes of hydrogen bonding of arginine, asparagine, and glutamine side chains
      and of urea have been examined in small-molecule crystal structures in the
      Cambridge Structural Database and in crystal structures of protein-nucleic acid
      and protein-protein complexes. Analysis of the hydrogen bonding patterns of each
      by graph-set theory shows three patterns of rings (R) with one or two hydrogen
      bond acceptors and two donors and with eight, nine, or six atoms in the ring,
      designated R2(2)(8), R2(2)(9), and R1(2)(6). These three patterns are found for
      arginine-like groups and for urea, whereas only the first two patterns R2(2)(8)
      and R2(2)(9) are found for asparagine- and glutamine-like groups. In each case,
      the entire system is planar within 0.7 A or less. On the other hand, in
      macromolecular crystal structures, the hydrogen bonding patterns in protein
      nucleic acid complexes between the nucleic acid base and the protein are all
      R2(2)(9), whereas hydrogen bonding between Watson-Crick-like pairs of nucleic
      acid bases is R2(2)(8). These two hydrogen bonding arrangements [R2(2)(9)] and
      R2(2)(8)] are predetermined by the nature of the groups available for hydrogen
      bonding. The third motif identified, R1(2)(6), involves hydrogen bonds that are
      less linear than in the other two motifs and is found in proteins.

PMID- 7773179
TI  - A comparison of X-ray and NMR structures for human endothelin-1.
AB  - Direct comparisons between the recently solved X-ray and NMR structures of human
      endothelin-1 with respect to secondary structure, RMS deviations, surface
      accessibilities, and side-chain conformers indicate important differences in
      conformation, especially in the C-terminus, but also in the central loop region,
      that are important for defining the specificity of binding. These differences are
      larger than seen for other X-ray and NMR structures that have been compared.
      Comparisons between the X-ray structure and the NMR NOE constraints highlight the
      regions of flexibility and environment-induced diversity in the endothelin
      structures.

PMID- 7773180
TI  - Modeling substrate binding in Thermus thermophilus isopropylmalate dehydrogenase.
AB  - The Thermus thermophilus 3-isopropylmalate dehydrogenase (IPMDH) and Escherichia
      coli isocitrate dehydrogenase (ICDH) are two functionally and evolutionarily
      related enzymes with distinct substrate specificities. To understand the
      determinants of substrate specificities of the two proteins, the substrate and
      coenzyme in IPMDH were docked into their respective binding sites based on the
      published structure for apo IPMDH and its sequence and structural homology to
      ICDH. This modeling study suggests that (1) the substrate and coenzyme (NAD)
      binding modes of IPMDH are significantly different from those of ICDH, (2) the
      interactions between the substrates and coenzymes help explain the differences in
      substrate specificities of IPMDH and ICDH, and (3) binding of the substrate and
      coenzyme should induce a conformational change in the structure of IPMDH.

PMID- 7773181
TI  - A procedure for the automatic determination of hydrophobic cores in protein
      structures.
AB  - An algorithm is described for automatically detecting hydrophobic cores in
      proteins of known structure. Three pieces of information are considered in order
      to achieve this goal. These are: secondary structure, side-chain accessibility,
      and side-chain-side-chain contacts. Residues are considered to contribute to a
      core when they occur in regular secondary structure and have buried side chains
      that form predominantly nonpolar contacts with one another. This paper describes
      the algorithm's application to families of proteins with conserved topologies but
      low sequence similarities. The aim of this investigation is to determine the
      efficacy of the algorithm as well as to study the extent to which similar cores
      are identified within a common topology.

PMID- 7773182
TI  - A fast, economical and efficient method for DNA purification by use of a homemade
      bead column.
AB  - A fast, efficient and economical method for purification of DNA from various
      sources by the use of silica particles packed in homemade bead columns is
      described. The method is a further development of the method devised by Carter
      and Milton (1), improved by the introduction of a column operated with a vacuum
      system. The method is highly suitable for multiple sample handling in the
      preparation of DNA for sequencing and other purposes. Protocols are devised for
      plasmid minipreparation, gel elution and purification of DNA from solutions e.g.
      enzyme reactions.

PMID- 7773183
TI  - Susceptibility of Helicobacter pylori to antimicrobial agents: effect of
      sulglycotide.
AB  - H. pylori is regarded as a primary etiologic factor in gastric disease and the
      therapies now include a combination of antimicrobial agents with antiulcer drugs.
      Here, the effect of a new gastroprotective agent, sulglycotide, on the in vitro
      anti-H. pylori activity of metronidazole, erythromycin, tetracycline, and
      amoxycillin was assessed. The assays in the absence of sulglycotide gave MIC
      value 0.10mg/L for erythromycin, 0.12mg/L for amoxycillin, 0.15mg/L for
      tetracycline and 14mg/L for metronidazole, while sulglycotide alone gave MIC
      value of 20mg/L. The sulglycotide at its optimal dose (5mg/L) evoked a 4-fold
      enhancement in the MIC of amoxycillin, 5-fold in tetracycline, and 8.3-fold in
      erythromycin, while the MIC of metronidazole improved 3.5-fold at 10mg/L
      sulglycotide. The results point towards the advantage of combination therapy of
      sulglycotide and antibiotics for H. pylori eradication.

PMID- 7773184
TI  - Detection of M2 antibodies in patients with recurrent urinary tract infection
      using an ELISA and purified PBC specific antigens. Evidence for a molecular
      mimicry mechanism in the pathogenesis of primary biliary cirrhosis?
AB  - Primary Biliary Cirrhosis (PBC) is a chronic liver disease of unknown aetiology.
      The main characteristic feature of the disease is the presence of circulating
      antimitochondrial antibodies (AMA) to components (collectively named M2) of the
      mitochondrial 2-oxo-acid multienzyme complexes; pyruvate, oxoglutarate and
      branched chain oxo-acid dehydrogenase complexes. As these enzymes are
      phylogenetically conserved, AMA also exhibit reactivity against a range of
      microorganisms. PBC patients have an increased incidence of recurrent urinary
      tract infection (UTI) compared to other chronic liver disease controls.
      Interestingly, we have recently detected low titre AMA in patients with a history
      of recurrent UTI but normal liver function using crude bovine heart mitochondrial
      preparations and immunoblotting techniques. Here we confirm these findings using
      purified M2 antigens and ELISA. We found that 52% of "normal" subjects with a
      history of recurrent UTI had AMA specifically to M2 antigens. The percentage was
      significantly higher than that found for chronic liver disease (19%, p < 0.01)
      and normal controls (4%, p < 0.001). These results support our hypothesis for
      molecular mimicry in PBC. We propose that a bacterial trigger, possibly resulting
      from recurrent UTIs, is responsible for initiating an autoimmune response in a
      predisposed host because of a cross-reactivity between mitochondrial and
      bacterial antigens.

PMID- 7773185
TI  - Regression of LNCaP human prostate tumor xenografts in athymic nude mice by 13
      cis-retinoic acid and androgen ablation.
AB  - The present study was designed to investigate the effects of 13-cis-retinoic acid
      (13-cis-RA) (100 micrograms/mouse/day) and androgen ablation (castration) alone
      and in combination on growth of a human prostatic carcinoma line (LNCaP)
      transplanted to athymic nude mice as an experimental model. The results of these
      studies suggest that; (1) androgen ablation (castration) significantly decreased
      the size of LNCaP xenograft as compared to untreated animals; (2) when 13-cis-RA
      was administered to nude mice carrying established tumors (0.51 +/- 0.04 cm3),
      the tumor size was significantly reduced as compared to untreated controls (0.65
      +/- 0.06 cm3 versus 1.63 +/- 0.12 cm3). About 50% of the animals in this group
      showed xenografts necrosis followed by complete regression of tumors by five
      months; (3) the combination of androgen ablation and 13-cis-RA treatment to nude
      mice carrying tumors showed synergistic effect in decreasing the tumor size.
      These results indicate that combination therapies based on androgen ablation and
      retinoid administration may be a useful approach for the treatment of prostate
      cancer.

PMID- 7773186
TI  - Inhibition and kinetic alterations by excess free ATP and ADP of the ATP
      diphosphohydrolase activity (EC 3.6.1.5) from rat blood platelets.
AB  - ATP diphosphohydrolase (EC 3.6.1.5) catalyzes the hydrolysis of diphospho- and
      triphosphonucleosides and is activated by divalent cations. The enzyme described
      in rat blood platelets hydrolyzes Ca(2+)-ATP and Ca(2+)-ADP with a high affinity
      for these Ca(2+)-nucleotide complexes as substrates. In the present paper, we
      demonstrate that free ATP or free ADP induces inhibition and kinetic alterations
      of the enzyme from rat blood platelets. From these results, we draw conclusions
      about the binding of free nucleotides to the enzyme and their action as
      inhibitors with respect to calcium-nucleotide complex.

PMID- 7773187
TI  - Possible interaction of haemoglobin with a low Mr GTP-binding protein, ram p25.
AB  - Haemoblobin (Hb) was observed to inhibit the GDP/GTP exchange activity of a low
      M(r) GTP-binding protein, ram p25. Hb also inhibited the [32P]GTP-hydrolysis
      activity of ram p25. These inhibitory effects of Hb were lost after incubation of
      Hb at 80 degrees C for 3 min, indicating that the ternary tetrameric structure of
      Hb is essential for the inhibitory effects on ram p25 activities. Hb did not
      inhibit [35S]GTP gamma S-binding of nucleotide-free ram p25. Methaemoglobin
      (MetHb) also inhibited both [3H]GDP-dissociation and [32P]GTP-hydrolysis
      activities of ram p25 in a very similar manner to Hb. The results strongly
      suggest that Hb may suppress physiological function(s) of ram p25 in vivo by
      inhibiting both [32P]GTP-hydrolysis and [3H]GDP-dissociation of ram p25.

PMID- 7773190
TI  - Positive regulatory role of cAMP on alkaline phosphatase activity and
      proliferation of mitogen stimulated B lymphocytes.
AB  - Effect of dibutyryl cyclic adenosine monophosphate (dbt cAMP) on alkaline
      phosphatase (APase) of mitogen stimulated murine B lymphocytes was studied.
      Addition of dbtcAMP to lipopolysaccharide (LPS) stimulated B cells enhanced APase
      activity in a dose dependent and synergistic manner. dbtcAMP also stimulated the
      proliferative response of LPS treated B lymphocytes. On the other hand, when B
      lymphocytes stimulated with anti-immunoglobulin (anti-Ig) were treated with
      dbtcAMP neither DNA synthesis nor APase activity was enhanced. These results
      suggest that cAMP is a potent synergistic activator of APase in B lymphocytes
      committed to proliferation.

PMID- 7773188
TI  - Storage of rat liver for plasma membrane isolation.
AB  - We described a procedure for the preservation of rat liver which makes possible
      the isolation of plasma membranes after 10 days storage at -70 degrees C. The
      yield of plasma membranes obtained from the liver tissue kept at -70 degrees C
      for 10 days (3.43 +/- 0.08 mg protein/10 g wet liver) was not different
      statistically (P > 0.05) from the yield of freshly obtained plasma membranes
      (3.32 +/- 0.05 mg protein/10 g wet liver). However, a significantly low yield
      (2.65 +/- 0.08; P < 0.01) was obtained from 90 days stored rat liver when
      compared with the immediate isolation. Plasma membrane Na+, K+ ATPase and
      5'nucleotidase activities of the stored liver for 10 days were not different
      statistically (P > 0.05) from the enzyme activities of the freshly isolated
      membrane fractions. In contrast there was a significant decrease (p < 0.0001) in
      the activities of both plasma membrane Na+, K+ ATPase and 5'nucleotidase
      activities of 90 days stored rat liver at -70 degrees C when compared with
      immediate isolation. Considering the electron microscopic findings; we observed
      that the preservation of the integrity of the plasma membrane fractions obtained
      from fresh and frozen livers for 10 and 90 days seemed to be parallel to the
      biochemical results. Therefore we suggest that, storage of rat liver tissue for
      10 days make feasible to maintain the experimental design and give convenience
      for obtaining intact plasma membrane fractions.

PMID- 7773189
TI  - N-glycosylated polypeptides synthesized in the early phase of AcNPV infected
      insect cells.
AB  - Infected cell specific polypeptides (ICSP) in Autographa californica nuclear
      polyhedrosis virus (AcNPV) infected Spodoptera frugiperda cell line, Sf9, were
      radiolabelled with [14C] mannose and the labelled proteins were monitored at
      various time intervals. A major glycoprotein of molecular size of 64 kDa appears
      as early as 3h post infection (p.i.) which peaks at 12h p.i., but in presence of
      tunicamycin this protein is not labelled. Two other glycoproteins of molecular
      size 67 kDa and 63 kDa appear at 12h post infection. The glycosylation of these
      and eight other cellular proteins is also inhibited by tunicamycin. AcNPV
      propagated in tunicamycin treated Sf9 cells was found to cause delayed
      infectivity.

PMID- 7773191
TI  - Alteration of the microenvironment in plasma membranes of rat enterocytes after
      Escherichia coli heat stable enterotoxin treatment: effect on protein kinase C
      activity.
AB  - Plasma membranes isolated from Escherichia coli heat stable enterotoxin (STa)
      treated rat enterocytes were studied in respect to protein kinase C activity and
      fluidity change. Pretreatment of enterocytes with STa increased the membrane
      bound protein kinase C activity about 5 fold as compared to control. STa
      treatment made the membrane more fluid as evident from a higher
      phospholipid/cholesterol ratio and greater unsaturated fatty acid levels.
      Moreover, the phase transition temperature of the STa treated membrane appeared
      to be significantly lower than that of the corresponding control membrane,
      thereby further indicating a rise in fluidity of the membrane in the former case.
      Our results, therefore, suggested that following STa enterotoxin treatment an
      appropriate fluid environment in the rat intestinal cell membrane was essential
      for the activation of protein kinase C.

PMID- 7773192
TI  - Oxidative stress induced by ethanol in rat hepatocyte cultures.
AB  - Many controversies still exist with regard to the relationship between alcoholic
      intoxication and the occurrence of an oxidative stress. To attempt to resolve
      this question, first we investigated the induction by acute ethanol intoxication
      of lipid peroxidation in primary rat hepatocyte cultures using simultaneously two
      indices for each sample. When considering conjugated-diene indice, any lipid
      peroxidation elevation could be observed, whereas a net increase of extracellular
      free malondialdehyde was noted at 5 hours of incubation. These results led us to
      estimate the intracellular pool of low molecular weight iron which is known to be
      the iron species catalytically active in hydroperoxide degradation. An early
      enhancement of +20-30% of cellular low molecular weight iron was observed. Thus
      the discrepancy between conjugated dienes and malondialdehyde could be ascribed
      to an increase of hydroperoxide degradation into malondialdehyde by the transient
      cellular pool of low molecular weight iron. Lipid peroxidation and low molecular
      weight iron augmentation were linked to ethanol metabolism, since both were
      suppressed by the addition of 4-methylpyrazole, an alcohol dehydrogenase
      inhibitor. Superoxide dismutase activity was increased in the early incubation
      time (1 hour) and then markedly reduced. We conclude that ethanol metabolism can
      induce a lipid peroxidation accompanied by an elevation of intracellular pool of
      low molecular weight iron and a decrease of superoxide dismutase activity.

PMID- 7773193
TI  - Investigation of the effects of Zn2+ and Cu2+ on the K+ transport in yeast
      mitochondria. Evidences for the involvement of a Zn(2+)-binding protein in the
      K+/H+ exchange.
AB  - Effect of Zn2+ and Cu2+ were studied on the spontaneous swelling of yeast
      mitochondria in potassium acetate. (i) Whatever the pH, Cu2+ stimulated the
      swelling. (ii) Zn2+ inhibited or stimulated the swelling depending both on pH of
      the medium and of its concentration: it induced an inhibition of the K+/H+
      exchange at pH 6.8 and a stimulation at pH 7.7; at pH 7.4, Zn2+ inhibited the
      swelling at low concentration and stimulated the swelling at higher
      concentration. (iii) The thiol reagent mersalyl prevented the inhibition by Zn2+
      whereas N-ethylmaleimide and 5,5'-dithiobis(2-nitrobenzoate) prevented the
      stimulation by Zn2+: this allowed to hypothesize that two distinct Zn(2+)-binding
      sites were involved in the inhibition and in the stimulation of the swelling of
      yeast mitochondria suspended in potassium acetate.

PMID- 7773194
TI  - Nucleotides-induced cytosolic calcium transient and plasma membrane permeability
      in Chang human liver cells.
AB  - Extracellular nucleotides induce changes in cytosolic free Ca++ and also increase
      plasma membrane permeability to Ca++ ions in Chang human liver cells. Ca++
      permeability induced by nucleotides is reversible and inactivated immediately
      upon removal of agonist. Stimulated cells transferred into the fresh medium and
      re-exposed to nucleotides demonstrate reopening of Ca++ channel without
      stimulation of Ca++ transient. Relative potencies of nucleotides to induce
      membrane permeability and Ca++ transient were: UTP > ATP > gamma-S-ATP > ADP (non
      hydrolyzable ATP analogues and AMP had no effect). The permeability is not
      affected by specific inhibitors of voltage-operated calcium channels
      (verapamyl,cis-diltiazem and nifedipin). Nucleotides do not produce plasma
      membrane damages at concentrations up to 1 mM, as shown by exclusion of the
      propidium iodide. There are at least two types of nucleotides receptors in Chang
      cell membrane: P2y subtype receptors which is responsible for generation of the
      Ca++ transient, and P2x subtype receptors which lead to the opening of plasma
      membrane Ca++ channels upon activation.

PMID- 7773195
TI  - Complete nucleotide sequences of Marburg virus genes 5 and 6 encoding VP30 and
      VP24 proteins.
AB  - Nucleotide sequences of the genes 5 and 6 of the Marburg virus, Popp strain, were
      determined. ORFs encoding polypeptides VP30 (281 a.a., MW 32,640) and VP24 (253
      a.a., MW 28,621) were found. The putative transcription start and stop signals
      for viral RNA-dependent RNA polymerase were revealed for both genes. Overlapping
      of genes 5 and 6 was shown. The deduced amino acid sequences of VP30 and VP24
      proteins displayed significant homology with the analogous proteins of another
      filovirus, the Ebola virus (33% and 37%, respectively). The VP24 appeared to have
      a hydrophobic amino acid composition; content of hydrophobic amino acids was
      40.7%. Model of VP24 location in the virion was suggested.

PMID- 7773196
TI  - Coenzyme cycles and metabolic control analysis: the determination of the
      elasticity coefficients from the generalised connectivity theorem.
AB  - Metabolic control analysis allows one to express the elasticity coefficients
      (which describe the "local" kinetic features of enzymes) in terms of the control
      coefficients (quantitative indicators of the "global" control properties).
      However, when coenzymes (or metabolites linked by conservation constraints) are
      present in the pathway this procedure yields the "apparent" values of elasticity
      coefficients that correspond to the kinetic responses of the enzymes to such a
      simultaneous change of the coenzyme forms which leaves the total concentration of
      these forms unchanged (e.g., NAD+ + NADH in the glycolysis). We show that a
      generalised connectivity theorem (Kholodenko et al, Eur. J. Biochem. (1994) 225,
      179-186) makes it possible to express the elasticity coefficients with respect to
      every coenzyme form separately. Such expressions include (i) the control
      coefficients and (ii) the responses to changes in the total concentrations of the
      coenzymes.

PMID- 7773197
TI  - Identification of melatonin in plants and its effects on plasma melatonin levels
      and binding to melatonin receptors in vertebrates.
AB  - Twenty-four edible plants were investigated for the presence of melatonin,
      heretofore considered to be a molecule found only in the animal kingdom. The
      amount of melatonin in different plants varied greatly with highest melatonin
      being present in plants of the rice family. Melatonin was identified by
      radioimmunoassay and verified by high performance liquid chromatography with
      fluorescence detection. Feeding a diet containing plant products rich in
      melatonin to chicks increased radioimmunoassayable levels of melatonin in their
      blood. Likewise, melatonin extracted from plants inhibited binding of
      [125I]iodomelatonin to rabbit brain. Thus, melatonin ingested in foodstuffs
      enters the blood and is capable of binding to melatonin binding sites in the
      brain of mammals.

PMID- 7773198
TI  - An improved simple colorimetric method for quantitation of non-transferrin-bound
      iron in serum.
AB  - A simple method for direct quantitation of non-transferrin-bound iron (NTBI) in
      serum is introduced. NTBI was separated from serum by adding excess
      nitrilotriacetic acid disodium salt (NTA) to serum to form an Fe-NTA complex and
      then ultrafiltrated using a micro-filter. The NTBI in the ultrafiltrate was
      quantitated using a bathophenanthroline-based method. The optimal detection
      condition and several potential confounding factors were investigated. The actual
      measurements to samples in vivo and in vitro showed that this method is very
      practical.

PMID- 7773199
TI  - Specificity of inhibition of muscle glycogen phosphorylase b by flavins.
AB  - The inhibition of glycogen phosphorylase b from rabbit skeletal muscles by the
      derivatives of riboflavin, FMN, FAD, and 2', 3', 4', 5'-tetraacetylriboflavin
      substituted in positions 6 and 8 of the isoalloxazine part of the flavin molecule
      is found to be cooperative (the Hill coefficient, h, exceeds 1.0). The
      modification of the flavin molecule slightly changes the value of the Hill
      coefficient, but results in the increase of the "half-saturation" concentration
      [I]0.5.

PMID- 7773201
TI  - Polymorphism of the angiotensin I converting enzyme gene in essential
      hypertensive patients.
AB  - Insertion/deletion (I/D) polymorphism of the angiotensin I converting enzyme
      (ACE) gene has been associated with ischemic heart disease and hypertension. The
      D allele reportedly correlates with myocardial infarction and it has been
      suggested that it may serve as the basis of population-based risk assessment.
      Similarly, determining whether there is an ACE allele pattern associated with
      hypertension could be useful in developing screening strategies. Previous reports
      have not shown consistent findings in Caucasian and Japanese population groups,
      some having a predominance of the I allele. Although African Americans have the
      highest prevalence of hypertension in the world, their ACE gene polymorphism
      frequencies have not been clearly defined. We studied the allele and genotype
      frequencies in this group, consisting of 133 essential hypertensive subjects, and
      compared their findings with those reported from normotensive African Americans
      and from other racial groups. The black patients had a different allele
      distribution than the other populations in that the D was more common than the I
      allele, occurring at a rate of 59.7%. The most common genotype was DD and it was
      present in 42.5% of the hypertensive subjects in contrast to the ID genotype
      which was the most commonly reported genotype in normotensive individuals. The
      genotype pattern (frequencies of II, ID, DD) was significantly different (p <
      0.005, 2 df) from Japanese and Caucasian (Scotland and Australia) populations.
      There was no common allele or genotype distribution amongst these diverse
      hypertensive groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773200
TI  - Localized mitochondrial dysfunction in canine myocardial ischemia.
AB  - Effects of myocardial ischemia on mitochondrial enzymes and mitochondrial DNA
      (mtDNA) were examined using the model of Ameroid constriction of canine cardiac
      vessels. Endocardium supplied by constricted coronary arteries was found to have
      significantly lower citrate synthase and complex IV activities compared to values
      obtained from either epicardium supplied by constricted vessels or endocardium
      supplied by unconstricted coronary arteries. Neither significant differences in
      mtDNA copy number nor changes in respiratory complexes I, III and V were
      detected. These results suggest that highly localized, specific mitochondrial
      enzyme changes result from chronic myocardial ischemia.

PMID- 7773202
TI  - Purification and properties of 6-phosphogluconate dehydrogenase from beet leaves.
AB  - We have purified to homogeneity 6-Phosphogluconate dehydrogenase from leaves of
      silver beet (Beta vulgaris L.) by means of cation-exchange and affinity
      chromatography. The enzyme is a homodimer of 52 kDa subunits; it catalyzes NADP
      dependent oxidation of 6-P-gluconate with Michaelian substrate saturation. The
      activity is affected by some intermediates of carbohydrate metabolism,
      particularly erythrose-4-P. Subcellular fractionation studies indicate the
      cytosolic location of the enzyme.

PMID- 7773203
TI  - Significance of the N-terminal fragment of myosin regulatory light chain for
      myosin-actin interaction.
AB  - The influence of myosin regulatory light chains (LC2s) lacking the 2kD N-terminal
      portions of these chains, on internal organization of myosin heads and on actin
      myosin interaction was studied with limited proteolysis and polarized
      fluorescence methods. For these studies heavy meromyosin (HMM) preparations were
      used: HMM containing intact LC2s (phosphorylated or dephosphorylated) and HMM
      containing LC2s lacking the 2kD N-terminal portions (including serine which can
      be phosphorylated). It was found that the susceptibility of the heavy chain
      cleavage site to trypsin and the alkali light chain (LC1) site to papain of
      myosin containing shortened regulatory LC2s, is not dependent on saturation of
      LC2s with Ca2+ or Mg2+ ions. This is in contrast to the myosin containing intact
      LC2s where Ca2+ or Mg2+ ion saturation does demonstrate a dependence. Similarly,
      in spectroscopic experiments, dephosphorylated HMM containing intact LC2s causes
      decrease or increase of actin filament flexibility depending on whether Mg2+ or
      Ca2+ are bound to LC2s. Correspondingly, HMM with shortened LC2s induces only
      increase of actin flexibility despite cations being bound. We conclude that the N
      terminal fragment of LC2 is important for ensuring a proper Ca2+ dependent
      conformation of myosin head in the course of its actin-activated ATP hydrolysis.

PMID- 7773205
TI  - Role of tumour necrosis factor-alpha in dendritic cell-mediated primary mixed
      leucocyte reactions.
AB  - Tumour necrosis factor (TNF alpha) is a major inflammatory cytokine with
      potentiating effects on specific immune responses, including graft-versus-host
      disease. This study examined the contribution of TNF alpha to dendritic cell (DC)
      mediated primary allogeneic T lymphocyte responses. Purified blood DC were shown
      to produce minimal amounts of TNF alpha mRNA but no significant TNF biological
      activity or secreted TNF alpha as measured by ELISA. Amplification of DC mRNA by
      PCR using oligonucleotide primers to CD120a (TNFRI, p55) and CD120b (TNFRII, p75)
      and probing with specific internal oligonucleotides, suggested that DC express
      the CD120b but little if any CD120a. These results were confirmed using
      monoclonal antibodies to the TNF receptors. Polyclonal antiserum specific for TNF
      alpha blocked the blood DC-stimulated allogeneic mixed leucocyte reaction (MLR).
      The addition of TNF alpha to suboptimal MLRs (limited DC stimulators), increased
      the proliferation of responding T lymphocytes. Having confirmed that T
      lymphocytes produce TNF alpha and express CD120b after stimulation, we sought to
      clarify whether the contributing effect of TNF alpha to the allogeneic MLR
      resulted from a TNF alpha-mediated signal stimulating DC activity, or as a result
      of autocrine stimulation of T lymphocytes. Pre-incubation of DC with TNF alpha
      did not increase DC stimulatory capacity and late addition of anti-TNF serum (up
      to 72 h) still had a significant inhibitory effect on the MLR. We conclude that
      TNF alpha is probably not involved in the initial DC-T lymphocyte interaction,
      but acts as an autocrine growth factor for DC induced T lymphocyte proliferation.

PMID- 7773206
TI  - Changes in plasma transforming growth factor beta in response to high-dose
      chemotherapy for stage II breast cancer: possible implications for the prevention
      of hepatic veno-occlusive disease and pulmonary drug toxicity.
AB  - Veno-occlusive disease (VOD) of the liver and pulmonary drug toxicity (PDT) are
      two major complications of high-dose chemotherapy and autologous bone marrow
      transplantation (BMT) for solid tumors. We have previously demonstrated that an
      elevated plasma TGF-beta concentration before transplant predicts the later
      occurrence of these complications. In the present study, we used a simplified
      enzyme-linked immunosorbant assay (ELISA) to prospectively evaluate the kinetics
      of plasma TGF-beta concentrations of 45 patients with stage II breast cancer who
      underwent high-dose chemotherapy and autologous BMT. We demonstrated that, of the
      three TGF-beta isoforms, only TGF-beta 1 was present in the plasma. Pre
      transplant plasma TGF-beta 1 was significantly higher in patients with VOD and
      PDT compared with that in patients without these complications. The plasma TGF
      beta 1 level in patients who later developed VOD or PDT decreased to that of
      controls within 2 days of initiating high-dose chemotherapy; this decrease was
      not correlated with platelet concentration changes. These results suggest that
      interventions aimed at preventing the development at VOD or PDT must be given
      early in the course of high-dose chemotherapy.

PMID- 7773204
TI  - Nucleotide pool imbalances in the livers of patients with urea cycle disorders
      associated with increased levels of orotic aciduria.
AB  - Liver samples obtained at autopsy from patients with ornithine transcarbamylase
      (OTC) deficiency, a urea cycle disorder that is associated with high levels of
      orotic acid biosynthesis and excretion were analysed for nucleotide pools. As a
      control, liver samples from patients with a deficiency of mitochondrial carbamyl
      phosphate synthetase (CPS-I) which is not associated with increased levels of
      orotic acidurias were also analysed. The results show that liver tissue from OTC
      deficiency patients exhibited an increased ratio of uridine nucleotides to
      adenosine nucleotides, while in CPS-I deficiency patients, no such increase was
      noted. This study indicates that genetic disorders that are associated with
      increased loads of orotic acid exhibit abnormally high ratios of uridine to
      adenosine nucleotides in the liver. This type of imbalance is analogous to that
      seen in the liver of rats and mice exposed to an orotic acid supplemented or an
      arginine-deficient diet under liver tumor promoting conditions. It is likely that
      an imbalance in nucleotide pools may have a significant role in the
      pathophysiology associated with these disorders.

PMID- 7773207
TI  - Leukemia-specific allogeneic donor T cells: quantification by limiting dilution
      assay.
AB  - Allogeneic T cells are capable of discriminating between leukemia cells and non
      malignant hematopoetic cells. This has been concluded from clinical BMT data and
      demonstrated by in vitro experiments. We analyzed the frequency and specificity
      of leukemia-reactive T cells from syngeneic and allogeneic blood donors by
      limiting dilution assays for interleukin-2-producing (TH1) and cytotoxic (CTLp) T
      cells. Target cells were leukemia blasts obtained from a patient with common ALL.
      Control targets were generated by EBV transformation. Effector cells were
      generated from the peripheral blood of the patient in remission, from his
      syngeneic brother and from eight healthy, HLA-mismatched volunteers. The effector
      cells were stimulated with leukemia cells and interleukin-2. Neither the patient
      nor his brother were able to generate anti-leukemic CTLp or TH1. The HLA
      mismatched allogeneic donors displayed anti-leukemic CTLp frequencies with a
      range from 0 to 68 million. TH1 cells with anti-leukemic specificity were not
      detectable. We conclude that there are great inter-individual differences in the
      GVL potential of fully allogeneic peripheral T lymphocytes. It is possible to
      identify T cell lines with reactivity against leukemia blasts and non-reactivity
      against normal hematological cells from the same individual. These cell lines are
      potential effector cells for immunotherapy of human leukemia.

PMID- 7773208
TI  - Bispecific antibody-mediated cytotoxicity by CD4+ and CD8(+)-activated T cells
      generated from leukemia patients after allogeneic bone marrow transplantation.
AB  - The F(ab')2 bispecific antibody (BSAb) was prepared from anti-CD3 moAb and anti
      CD10 moAb. The BSAb could react with both CD3+ T cells and CD10+ leukemia cells
      and triggered T cell-mediated cytotoxicity. To apply the BSAb to prevention of
      leukemic relapse after BMT, we investigated the generation of both CD4+ and CD8+
      anti-tumor effector T cells from patient's PBMC 14 days after BMT. Neither CD4+ T
      cells nor CD8+ T cells, which were activated with immobilized anti-CD3 moAb plus
      IL-2, could lyse CD10+ leukemia cells by themselves, but they showed augmented
      cytotoxicity against CD10+ leukemia cells by targeting with anti-CD3 x anti-CD10
      BSAb. Moreover, the activated CD4+ T cells were demonstrated to produce IL-2 and
      IFN-gamma when they were cultured with CD10+ leukemia cells in the presence of
      the BSAb. The BSAb-mediated cytotoxicity of activated T cells was demonstrated
      not only against the recipient leukemia cells but also against third party
      leukemia cells. These results suggested that anti-CD3 x anti-CD10 BSAb might be a
      good tool to prevent relapse after BMT in combination with activated CD4+ T cells
      and CD8+ T cells.

PMID- 7773209
TI  - Interleukin-2 activation of chemotherapy and growth factor-mobilized peripheral
      blood stem cells for generation of cytotoxic effectors.
AB  - Based on our previous studies demonstrating marked anti-tumor activity of
      interleukin-2 (IL-2)-activated bone marrow in vitro and in vivo, we studied the
      generation of anti-tumor cytotoxic effectors from chemotherapy- and growth factor
      mobilized PBSC from 12 patients with different solid tumors. As chemotherapy and
      growth factor priming could lead to important qualitative and quantitative
      alterations of lymphoid cells, we also looked at the distribution of lymphoid
      cells contained in primed PBSC. In addition, different variables were defined for
      successful application of the technique to clinical protocols. The cells were
      placed in culture at varying cell densities in either serum-containing or serum
      free culture medium, supplemented with IL-2, 100 or 1000 Cetus units/ml at 37
      degrees C for 24 or 72 h, in flasks or in culture bags. Anti-tumor cytotoxicity
      was tested against A375 (melanoma), K562 (CML) and Daudi (Burkitt's lymphoma)
      cell lines in standard 4 h 51Cr release assay. Marked cytotoxicity was seen
      against all cell lines tested (A375: 32.7% +/- 5.2; K562: 52.8% +/- 4.8; Daudi:
      50.5% +/- 7.2). Cytotoxicity was comparable in serum-containing and serum-free
      culture conditions and in tissue culture flasks and bags. Cell density up to 10 x
      10(6)/ml was not associated with any significant decline in cytotoxicity. IL-2
      activation of PBSC after thawing led to the generation of cytotoxicity comparable
      to that obtained with fresh PBSC. On flow cytometric analysis, the proportion of
      CD8+ T cells and NK cells (CD56+) was found to be higher in primed PBSC than in
      control peripheral blood mononuclear cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773210
TI  - Influence of marrow CFU-GM content on engraftment and survival after allogeneic
      bone marrow transplantation.
AB  - The influence of the CFU-GM content of donor marrow on the outcome of allogeneic
      marrow transplantation (BMT) has been debated. We now report 38 patients (25
      acute leukemias, 10 chronic myeloid leukemias, two myeloma; 24 in first CR/CP and
      14 in more advanced phases of their disease) undergoing unmanipulated HLA
      identical sibling BMT following conditioning with cyclophosphamide and total body
      irradiation (TBI). The median number of nucleated cells infused was 4.3 x
      10(8)/kg (range 1.5-8.4); median CFU-GM numbers were 2.4 x 10(4)/kg (range 0.1
      46). End-points of the study were (1) speed of neutrophil and platelet
      engraftment; (2) quality of engraftment beyond day +50 after BMT; and (3)
      transplant-related mortality in patients stratified according to whether they had
      received less than (n = 18) or more than (n = 20) 2.4 x 10(4)/kg CFU-GM. These
      two groups were comparable for diagnosis, disease status, donor sex, donor age,
      recipient sex, recipient age, CVHD prophylaxis, number of cells infused and CMV
      serology. Neutrophil counts were comparable at all time intervals. There was also
      no difference in platelet counts on days +7 to +50. However, patients who had
      received higher CFU-GM numbers had significantly higher platelet counts on day
      +80 (149 vs. 75 x 10(9)/L; P = 0.002), day +100 (153 vs. 77 x 10(9)/L; P =
      0.0009) and day +150 (179 vs. 95 x 10(9)/L; P = 0.01). The 2-year actuarial
      transplant-related mortality was 5% vs. 53% (P = 0.007) in patients receiving
      high or low numbers of CFU-GM.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773211
TI  - Growth and endocrine function following bone marrow transplantation for
      thalassemia.
AB  - Twenty two patients with thalassemia major who received successful bone marrow
      transplantation (BMT) were followed to verify the impact of the transplant
      procedure on subsequent growth and development. The transplant preparative
      regimen consisted of busulphan and cyclophosphamide. Growth and endocrinological
      function were assessed during the first 4 years following BMT. At the time of
      transplant most patients showed growth retardation. The median difference between
      chronological age and bone age was -9.5 months for the boys and -8.5 months for
      the girls. Patients > 7 years old at the time of BMT showed a significant
      worsening of their growth delay at 48 months following BMT compared with 12
      months before transplantation. Patients < 7 years at the time of BMT had their
      growth retardation constant over time span after transplantation. Moreover six of
      11 younger patients showed an improvement of their growth delay compared with one
      of 11 older patients. The outcome of height standard deviation score at 24 and 48
      months following BMT was strictly correlated with the level of serum
      transaminases and ferritin. Sixteen patients had impaired growth hormone
      secretion after a provocative test evaluated at 24 months after transplant. At 48
      months there was no significant increase in the mean peak GH levels. This study
      confirms that the growth retardation of patients with thalassemia major is
      multifactorial.

PMID- 7773212
TI  - Low incidence of acute GVHD in patients transplanted with marrow from HLA-A,B,DR
      compatible unrelated donors among Japanese.
AB  - To prevent GVHD in BMT from unrelated donors, the matching of HLA between patient
      and donor is crucial. The appearance of acute GVHD was studied in 51 patients
      with hematological malignancies who were transplanted with non-T cell purged
      marrow from HLA-A,B and DR compatible unrelated donors with the assistance of the
      Tokai Marrow Donor Bank of Nagoya, Japan. Probability of grade II-IV acute GVHD
      was 32.0% and of grade III-IV acute GVHD was 17.0%. HLA-class II antigen
      compatibility showed a good correlation with the occurrence of acute GVHD. When
      the percentage relative response (RR) of MLC between patient and donor (GVHD
      vector) was < or = 5, grade II-IV acute GVHD was found in only 7.7% of patients
      (n = 16) and no severe grade III-IV GVHD occurred. Among patients with 6-10% RR
      (n = 10), 25.9% showed grade II-IV GVHD and 14.3% grade III-IV GVHD. Among
      patients with > or = 11% RR (n = 20), however, the incidence of grade II-IV acute
      GVHD reached 51.8% and that of grade III-IV acute GVHD 36.2%. These reactivities
      of MLC reflected the compatibility of HLA-DRB1 and DPB1. The fact that the
      incidence of acute GVHD in BMTs from HLA-A,B,DR compatible Japanese pairs was
      found to be lower than in the USA may be due to less diversity of the genetic
      background in Japan.

PMID- 7773213
TI  - Engraftment of patients with lymphoid malignancies transplanted with autologous
      bone marrow, peripheral blood stem cells or both.
AB  - Forty six patients with lymphoid malignancies receiving autologous transplants
      using three different sources of hematopoietic stem cells were compared for
      engraftment parameters. Thirteen patients (five with multiple myeloma, seven with
      non-Hodgkin's lymphoma and one with Hodgkin's lymphoma) received autologous
      marrow with post-transplant growth factors (group 1). During the same time
      interval, 14 patients (five with multiple myeloma, six with non-Hodgkin's
      lymphoma and three with Hodgkin's lymphoma) were transplanted with autologous
      marrow plus recombinant granulocyte colony-stimulating factor (rhG-CSF)-mobilized
      peripheral blood stem cells (PBSC) and post-transplant growth factors (group 2).
      Nineteen patients (seven with multiple myeloma and 12 with non-Hodgkin's
      lymphoma) received rhG-CSF mobilized PBSC and post-transplant growth factors
      (group 3). All PBSC were collected after G-CSF mobilization (16 micrograms/kg/day
      s.c. for 6 days) without prior chemotherapy. After high-dose myeloablative
      chemotherapy or chemoradiotherapy, the median days to recovery of neutrophils to
      levels of 0.5 and 1.0 x 10(9)/l were 12 vs. 9 vs. 9 days (P = 0.0003 (group 1 vs.
      group 2) and P = 0.53 (group 2 vs. group 3)) and 13 vs. 10 vs. 10 days (P =
      0.0003 (group 1 vs. group 2) and 0.92 (group 2 vs. group 3)) for groups 1, 2 and
      3, respectively. The median day to platelet transfusion independence was 22 vs.
      11 vs. 11 days (P = 0.001 (group 1 vs. group 2) and P = 0.50 (group 2 vs. group
      3)) for groups 1, 2 and 3, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773214
TI  - Bone marrow transplant-associated thrombotic microangiopathy: a case series.
AB  - Bone marrow transplant-associated thrombotic microangiopathy (BMT-TM) has been
      reported with widely varying frequencies and outcomes. Therefore a BMT-TM grading
      system (0-4) was developed based on the lactate dehydrogenase (LD) level and
      percentage (%) fragmented cells (FC) as follows: grade 0, normal or increases LD
      and FC < or = 1.2%; grade 1, normal LD and FC > or = 1.3%; grade 2, increases LD
      and FC = 1.3-4.8%; grade 3 increases LD and FC = 4.9-9.6%; and grade 4, increases
      LD and FC > or = 9.7%. Patients with grade 0 and grade 1 BMT-TM did not differ in
      clinical parameters. Twenty two patients had BMT-TM grade 2-4. These were
      observed for outcome. Seven of 10 with grade 2 BMT-TM had resolution of BMT-TM a
      median of 99 days (range 50-229 days) from diagnosis. This occurred spontaneously
      in five and following discontinuance of cyclosporine (CsA) in two. The remaining
      three had persistent BMT-TM at grade 2 (two patients) and grade 1 (one patient).
      In contrast, none with grade 3-4 BMT-TM had resolution. Seven with grades 3-4 BMT
      TM underwent a variety of plasma exchange procedures; six had partial hematologic
      responses. Patients with grades 3-4 BMT-TM had a poorer survival (median survival
      = 60 days) than those with grade 2 BMT-TM where the median survival has not been
      reached (P = 0.018). These results indicate that BMT-TM is common following
      allogeneic-BMT and the outcome is dependent on the grade. Those with grade 1-2
      BMT-TM generally do well.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773215
TI  - Case-control analysis of allogeneic bone marrow transplantation versus
      maintenance chemotherapy for relapsed ALL in children.
AB  - In a retrospective study, the results of maintenance chemotherapy and allogeneic
      bone marrow transplantation (BMT) for children who reached a second complete
      remission (CR2) of their acute lymphoblastic leukemia (ALL) were compared. Case
      control analysis was performed comparing 25 allogeneic transplant patients
      (cases) with 97 patients treated with maintenance chemotherapy (controls), who
      were matched for site of relapse, duration of CR1 and leukemia-free interval from
      onset of CR2. Until the first relapse, the children were treated according to
      standard protocols. The majority of patients suffered from a bone marrow relapse,
      mostly occurring more than 24 months after the onset of CR1. Remission
      reinduction treatment was heterogeneous. Patients treated with allogeneic BMT
      received high-dose chemotherapy and total body irradiation prior to BMT.
      Maintenance chemotherapy in controls was given for approximately 2 years.
      Following BMT, relapse rate was lower but the treatment-related mortality was
      higher compared with maintenance chemotherapy, resulting in leukemia-free
      survival rates at 4 years of 44% and 24%, respectively (not significant, NS).
      Case-control analysis of leukemia-free survival showed a hazard ratio of 0.756 in
      favor of BMT compared with chemotherapy (NS). If bone marrow relapses and central
      nervous system relapses were analyzed separately, a tendency to better leukemia
      free survival was present after BMT compared with maintenance chemotherapy for
      patients with a relapse in the central nervous system, but for an isolated bone
      marrow relapse, no differences in leukemia-free survival were seen between the
      two groups of patients.

PMID- 7773216
TI  - Effect of antimicrobial prophylaxis on hematopoietic recovery following
      autologous bone marrow transplantation: ciprofloxacin versus co-trimoxazole.
AB  - We evaluated the effect of oral ciprofloxacin on neutrophil recovery in 20
      consecutive patients undergoing autologous bone marrow transplantation (BMT) for
      malignant lymphoma and compared the results with a control group of 20 patients
      receiving co-trimoxazole and folinic acid. Both groups started the prophylactic
      antibiotic as well as granulocyte-macrophage colony-stimulating factor (GM-CSF)
      the day after marrow infusion and continued the former until the onset of febrile
      neutropenia (median duration of treatment 6 days for co-trimoxazole and 7 days
      for ciprofloxacin). The time of attain an absolute neutrophil count > or = 0.5 x
      10(9)/L was significantly shorter in patients receiving ciprofloxacin (16 days vs
      22 days; P = 0.006). There was no difference in time to attain a platelet count >
      or = 20 x 10(9)/L independent of transfusion or in time to the first febrile
      episode or incidence of bacteremia. We conclude that antibiotic prophylaxis with
      ciprofloxacin results in more rapid neutrophil recovery than prophylaxis with co
      trimoxazole. This may result from a myelosuppressive effect of co-trimoxazole or
      an enhancement of neutrophil recovery by ciprofloxacin, or both.

PMID- 7773218
TI  - HLA prediction model for extended family matches.
AB  - This article derives a probabilistic model for predicting HLA matches from a
      population of extended family members. (Extended family members are defined as
      either first cousins or blood-related aunts or uncles). The model uses family
      pedigree information and haplotype frequency data to estimate the likelihood of a
      match. Results are given for many ethnic groupings. A case study is also
      described. This technique is most applicable when all family members are of the
      same ethnic origin, which increases the likelihood of a match among a small
      number of family members, and the patient possesses a haplotype having a
      frequency exceeding 10%, within the patient's ethnic population. Under such
      conditions, an extended family search can frequently approximate the success rate
      of a single sibling search.

PMID- 7773217
TI  - Selective T cell depletion with CD8-conjugated magnetic beads in the prevention
      of graft-versus-host disease after allogeneic bone marrow transplantation.
AB  - The effects of a new immunomagnetic method of selectively depleting CD8+
      lymphocytes from donor bone marrow were studied in 29 patients undergoing
      transplantation from HLA-identical sibling (n = 20) or alternative (n = 9)
      donors. The direct immunomagnetic depletion method consistently removed > 95% of
      CD8+ cells and the non-specific loss of other cell subsets was only about 15%.
      Recovery of CFU-GM and BFU-e was on average > 100%. The final graft contained 0.9
      +/- 0.6 x 10(8)/kg nucleated cells and 1.4 +/- 2.7 x 10(5)/kg CD8+ cells.
      Patients also received cyclosporine starting day -1. Engraftment occurred in 28
      patients (97%), including three patients who received a non-TBI conditioning
      regimen. One patient receiving an unrelated transplant failed to engraft. Median
      time to ANC > 500 x 10(6)/L was 17 (12-23) days. Four of 20 patients receiving
      grafts from HLA-identical siblings (20%) developed acute GVHD grade > or = II.
      However, five of eight patients with grafts from alternative donors (63%) had
      grade > or = II GVHD. Nearly all patients developed fever around day 7,
      accompanied by fluid overload, mild skin rash and shortness of breath. This
      syndrome necessitated treatment with steroids. Immunomagnetic CD8 depletion is a
      simple and reproducible method of selective T cell depletion. In combination with
      cyclosporine it appears to be effective in the prevention of severe acute GVHD in
      HLA-identical sibling transplants, but not in transplants from less perfectly
      matched donors.

PMID- 7773220
TI  - Lupus inhibitors following bone marrow transplant.
AB  - Lupus inhibitors have been reported in a number of pathologic states in which
      there is a disruption of normal immunoregulation. We report here the development
      of new lupus inhibitors following bone marrow transplantation. Retrospective
      analysis of 1292 patients undergoing transplantation at the University of
      Minnesota over a 10 year period demonstrated newly recognized lupus inhibitors in
      3% of the patients. These inhibitors were usually detected in the first 1-2
      months after transplant. They occurred more frequently in children, with a
      particularly high incidence in patients with Hurler syndrome. The development of
      inhibitors was associated with the use of cyclosporine A (CsA) or T depletion for
      GVHD prophylaxis, with the use of busulfan/cytoxan as a preparative regimen
      (which includes phenytoin for seizure prophylaxis) and with the occurrence of
      viral infections. Lupus inhibitors were not associated with development of GVHD,
      or with any diagnosis other than Hurler syndrome. Thrombotic complications were
      rare as would be expected in this severely thrombocytopenic population. The
      incidence of lupus inhibitors that we recognized may substantially underestimate
      the true incidence as frequent routine coagulation studies were not performed in
      these patients. Prospective evaluation of lupus inhibitors during bone marrow
      transplant may provide insight into the pathogenesis of these inhibitors in other
      disease states.

PMID- 7773219
TI  - Reversible cyclosporine-induced cortical blindness in allogeneic bone marrow
      transplant recipients.
AB  - We report the occurrence of reversible cyclosporine-induced cortical blindness in
      three allogeneic bone marrow transplant recipients. Possible mechanisms involved
      in this rare complication, as well as the associated radiographic and pathologic
      findings, are discussed.

PMID- 7773221
TI  - Bone marrow transplantation for patients with Fanconi anemia: a study of 24 cases
      from a single institution.
AB  - Although bone marrow transplantation (BMT) can eliminate the hematologic
      manifestations of Fanconi anemia (FA), patients are unusually susceptible to
      complications associated with the use of cyclophosphamide (CY) in the
      conditioning regimen. To investigate modifications of the conditioning regimen,
      we reviewed the records of 24 patients with FA who received an allogeneic BMT.
      All patients presented with severe pancytopenia. One patient was transplanted
      with overt leukemia as well. Donors were HLA-identical siblings in 22 cases and 1
      and 2-antigen mismatched relatives in two cases, respectively. All conditioning
      regimens included CY 200 mg/kg in 10 patients; 140 mg/kg with or without
      antithymocyte globulin in 12 and 20 mg/kg with 400 cGy total body irradiation in
      two. GVHD prophylaxis comprised methotrexate and/or cyclosporine. Only one of 21
      evaluable patients did not show signs of engraftment. Toxicities included grade
      III/IV mucositis in 20 patients, severe dermatitis in four and veno-occlusive
      disease in four. Acute GVHD (> or = grade II) occurred in nine of 22 patients.
      Four patients developed chronic GVHD. With a median follow-up time of 24 months,
      14 of the 24 patients are alive with normal hematopoietic function. Eight of the
      10 patients with matched sibling donors who were conditioned with CY 140 mg/kg
      are alive and well. We conclude that BMT is an effective treatment for FA.
      Conditioning regimens using lower doses of CY are associated with manageable
      toxicity and can potentially increase the survival rate of patients with HLA
      matched donors.

PMID- 7773222
TI  - Allogeneic bone marrow transplantation for Hodgkin's and non-Hodgkin's lymphoma.
AB  - We studied 23 consecutive patients, median age 34 years, with relapsed or
      resistant aggressive lymphoma who underwent allogeneic BMT at the UCLA Medical
      Center Bone Marrow Transplantation Unit from 1 November 1984 to 30 March 1993.
      All patients were < 50 years of age and had sibling donors who were matched at
      the HLA-A, B and DR loci. Nine patients had Hodgkin's disease (HD) and 14 had non
      Hodgkin's lymphoma (NHL); three of these had low grade histology and 11 had
      intermediate or high grade lymphoma histology. After a median follow-up of 34
      months, eight patients are alive, seven without recurrent lymphoma. Five patients
      had early deaths. The disease-free survival for the entire group is 26% with an
      overall survival of 29%. There was no difference in survival rate on the basis of
      disease or histology. Comparing preparative regimens containing TBI to those
      without there was no difference in survival rate (P = 0.35). Neither age nor sex
      was a significant determinant of outcome (P = 0.63 and 0.36, respectively).
      Disease status at the time of transplantation proved to be the important
      determinant of outcome. Patients transplanted with chemotherapy sensitive disease
      (n = 9), defined as a partial or complete response to salvage chemotherapy, had a
      survival rate of 42%, which was significantly better than those who had
      refractory disease at transplantation (n = 14), who had a survival rate of 21% (P
      = 0.006). However, this small, but significant fraction of patients with
      refractory disease was curable. Thus, our data demonstrate that allogeneic bone
      marrow transplantation is an effective means of treatment for relapsed or
      aggressive Hodgkin's and non-Hodgkin's lymphoma.

PMID- 7773223
TI  - Accelerated hematopoietic recovery with the hemoregulatory peptide dimer SK&F
      107647 in bone marrow transplantation.
AB  - The effect of a novel hemoregulatory peptide SK&F107647 on recovery of
      hematopoiesis was studied in murine bone marrow transplantation (BMT) models. In
      the first model, lethally irradiated recipient mice were transplanted with 10(6)
      bone marrow cells from donors given a single injection of either SK&F107647 or
      PBS 2 days prior to transplantation. The femoral content of GM-CFC was shown to
      be almost twice as high in mice treated with SK&F107647 compared with controls.
      Both the marrow GM-CFC progenitor cell population and Mac-1 positive cells in
      blood were shown to recover faster in recipients of SK&F107647 treated donors.
      The use of SK&F107647 treated donors did not result in significantly faster blood
      cell count recovery in the recipient mice. In the second model, lethally
      irradiated recipients were transplanted with normal bone marrow cells (10(5)
      10(6) and then given daily injections of SK&F107647 for 10 days starting 1 day
      after transplantation. The results show significantly enhanced recovery of GM-CFC
      in spleen and bone marrow and enhanced numbers of mature Mac-1 positive cells in
      spleen and peripheral blood. In addition, Thy1.2 positive cells recovered faster
      in SK&F107647 treated animals compared with controls. The results from these
      models suggest a role for SK&F107647 in BMT either as a primer of the marrow
      before transplantation or as an enhancer of hematopoietic recovery when given
      therapeutically after transplantation.

PMID- 7773224
TI  - Delayed neutrophil recovery after BEAM chemotherapy and autologous bone marrow
      transplantation for lymphoma is not associated with increased mortality from
      infection.
AB  - Administration of high-dose cytotoxic therapy with autologous bone marrow
      transplantation (BMT) results in prolonged cytopenia and significant morbidity
      and mortality. Several groups have reported that the administration of
      recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF) to patients
      with delayed haematological recovery following autologous BMT may accelerate
      neutrophil recovery and decrease mortality. We have determined the prevalence and
      natural history of delayed neutrophil recovery following BEAM chemotherapy and
      autologous BMT for malignant lymphoma in 261 patients treated at a single
      institution without the use of haemopoietic growth factors. Forty of 261 (15%)
      patients took > 28 days to reach an absolute neutrophil count (ANC) > 0.5 x
      10(9)/L; 29 of these 40 (73%) with delayed engraftment reached an ANC > 0.5 x
      10(9)/L by day +42. Five patients with delayed engraftment died before day +100,
      two of progressive lymphoma, one from unirradiated blood product-related GVHD and
      two of interstitial pneumonitis (IP). The patients with IP had negative culture
      and bronchoscopic examinations and onset of assisted ventilation was day +15 and
      +18, respectively. These results show a high rate of relatively rapid spontaneous
      recovery in individuals with delayed neutrophil recovery after BEAM plus
      autologous BMT with a low incidence of death from infection.

PMID- 7773225
TI  - Treatment of leukemia relapse after bone marrow transplantation with interferon
      alpha and interleukin 2.
AB  - A 16-year-old girl with refractory AML received unmanipulated BMT from an
      unrelated donor. Leukemia relapse occurred 82 days later. The patient was then
      treated with IL-2 1.8 x 10(6) U/m2 for 5 days per week and 2.5 MU/m2 IFN-alpha
      three times per week. Toxicities included fever, skin rash, somnolence and a
      generalized seizure. Treatment was stopped after 2 weeks. Acute GVHD developed at
      the end of therapy and the patient's leukemia went into remission. She died of
      fungal pneumonia 30 days later. We conclude that a combination of cytokines may
      be useful in treating relapsed leukemia after BMT.

PMID- 7773226
TI  - High-dose melphalan allows durable engraftment of allogeneic bone marrow.
AB  - Conditioning regimens for allogeneic bone marrow transplantation are designed to
      eradicate malignant cells and to provide sufficient immunosuppression for
      engraftment of donor marrow. Total body irradiation and high-dose
      cyclophosphamide are the most established immunosuppressive agents used for this
      purpose. It is uncertain whether other alkylating agent-based conditioning
      regimens are sufficiently immunosuppressive to allow engraftment of allogeneic
      marrow. We report four patients who had prompt engraftment after conditioning
      with melphalan-based chemotherapy regimens (BEAM or busulfan/melphalan). Two
      patients survived without disease for a prolonged period, indicating that these
      melphalan regimens are sufficiently immunosuppressive to allow sustained
      engraftment and donor hematopoiesis.

PMID- 7773227
TI  - Does macrophage colony-stimulating factor have an effect on the mobilisation of
      peripheral blood stem cells?

PMID- 7773228
TI  - Rise in IgE levels during acute GVHD is a 'normal' response to increased gut
      permeability.

PMID- 7773230
TI  - Bone marrow transplantation for multiple myeloma: the Wayne State experience.

PMID- 7773229
TI  - Availability of Campath-1 antibodies for bone marrow transplantation.

PMID- 7773232
TI  - Notifiable diseases annual summary. 1993.

PMID- 7773231
TI  - Improved method for infusing cells.

PMID- 7773233
TI  - The immunopathology of chronic inflammatory periodontal disease.
AB  - Chronic inflammatory periodontal disease is known to be under the control of the
      immune response. However, the precise mechanism of the immunopathogenesis of this
      lesion has not yet been fully elucidated. In this review, the regulatory role of
      both lymphoid and non-lymphoid cells as well as cytokines and accessory molecules
      in the course of chronic inflammatory periodontal disease is discussed. Finally,
      based upon previous evidences, an attempt to establish a model of chronic
      inflammatory periodontal disease is made herein.

PMID- 7773234
TI  - Strong adjuvant action of Klebsiella O3 lipopolysaccharide and its inhibition of
      systemic anaphylaxis.
AB  - Immunization with lipopolysaccharide from Klebsiella O3 as an immunological
      adjuvant did not cause the death of mice in systemic anaphylaxis to bovine serum
      albumin. On the other hand, most mice immunized with lipopolysaccharide from
      Escherichia coli O111, Klebsiella O4 and Salmonella minnesota did die. Klebsiella
      O3 lipopolysaccharide enhanced IgM and IgG antibody response to BSA more markedly
      than Escherichia coli O111 lipopolysaccharide, while it affected the production
      of IgE antibody only slightly. therefore, it is suggested that the inhibition of
      systemic anaphylaxis by Klebsiella O3 lipopolysaccharide adjuvant might be
      related to its strong adjuvant action on IgM and IgG class antibody production,
      and that high levels of circulating IgM and IgG antibodies might act as blocking
      antibodies in the development of IgE-mediated systemic anaphylaxis.

PMID- 7773235
TI  - Epidemiological evaluation of Neisseria meningitidis serogroup B by pulsed-field
      gel electrophoresis.
AB  - Genomic DNA from 25 strains of serogroup B Neisseria meningitidis was subjected
      to pulsed-field gel electrophoresis (PFGE) after digestion with Spe I. N.
      meningitidis genomic DNA displayed considerable diversity. The diversity we
      observed among these strains was stable and included isolates from an outbreak
      that were phenotypically identical. This confirms the value of macrorestriction
      profiling and PFGE in providing epidemiologically stable strain markers for
      typing meningococci.

PMID- 7773236
TI  - Studies on adhesion, haemagglutination and other biological properties of Vibrio
      cholerae O139.
AB  - The adhesive capabilities of eight Vibrio cholerae O139 epidemic strains to
      isolated rabbit intestinal epithelial cells (RIEC) were observed to be high
      similar to those observed with a Vibrio cholerae O1 strain isolated from
      patients. Toxin production by the strains, measured by accumulation of fluid in
      rabbit ileal loop model, was high and the toxin was lethal as the animal expired
      within 6 h. Culture filtrates of the strains exhibited the presence of vascular
      permeability factor which produce induration and necrosis in the adult rabbit and
      guinea pig skin. All the strains showed high to moderate haemagglutinin titres
      against chicken erythrocytes and produced El Tor-like haemolysin. SDS-PAGE of the
      outer membrane preparation of the strains showed the presence of major protein
      component at 38 kDa region. The lethality of the toxin, high adhesive activity,
      shifting of the major outer membrane protein band and production of thermolabile
      haemolysin on Wagatsuma agar were the major variations of these epidemic strains
      from V. cholerae O1 and V. cholerae non-O1 strains isolated previously.

PMID- 7773237
TI  - Detection of attachment of enterotoxigenic Escherichia coli (ETEC) to human small
      intestinal cells by enzyme immunoassay.
AB  - Simple immunoassays were developed to study the binding between enterocytes of
      the small intestine and other cell types, and enterotoxigenic Escherichia coli
      (ETEC). CFA/I or CFA/II pilus protein or CFA-positive E. coli bacteria were
      immobilised in wells of microtitre plates and incubated with vesicles or crude
      mucus prepared from human brush border enterocytes. Binding of the cell
      preparations was detected by adding specific rabbit anti-brush border IgG
      followed by urease-labelled goat anti-rabbit IgG and urea substrate. The binding
      of purified CFA/I to human or rabbit small intestine, human oral epithelial cells
      or Caco-2 cells was detected with specific anti-CFA/I IgG. Both human brush
      border and mucus-derived preparations were able to attach to ETEC. The binding
      was CFA-specific and strong enough to withstand several washings. In contrast,
      CFA/I did not bind to small intestinal cells of non-human small intestinal
      origin, indicating that there may be important differences in affinity between
      receptors present on human small intestinal cells and cells of non-human small
      intestinal origin. Antibodies directed against human small intestinal and non
      small intestinal cells did not cross-react with either preparation, indicating
      that receptors between these different cell sources are different. The EIA proved
      useful during the identification of a newly-recognised 15 kDa bacterial surface
      component of ETEC strain H10407P, which may function as a putative attachment
      factor. The EIAs developed in this study were easy to perform and multiple tests
      could be performed on small samples, including biopsy samples obtained during
      endoscopy.

PMID- 7773238
TI  - Characterization of serogroup A Neisseria meningitidis strains by rRNA gene
      restriction patterns and PCR: correlation with the results of serotyping,
      subtyping and multilocus enzyme electrophoresis.
AB  - We studied 35 strains of Neisseria meningitidis serogroup A from different
      locations (France, Central African Republic, Sudan and Burkina Faso) using both
      ribotyping and a polymerase chain reaction (PCR). A non-radioactive probe label
      was used for ribotyping; detection consisted of an immunoenzymatic procedure
      using a bispecific antibody. The PCR was designed to amplify the 16S-23S rDNA
      internal transcribed spacer. These techniques were compared with other markers.
      The strains were identified as belonging to three clones (I, III-1, IV) by
      multilocus enzyme electrophoresis (MEE) and to three subtypes by serological
      methods. Ribotyping identified five groups and PCR identified four groups.
      Ribotyping gave more diversity between strains than either MEE or sero/subtyping,
      but confirmed the epidemiological data provided by the combination of these two
      techniques. The PCR provided a simple and convenient one-step procedure for the
      differentiation of strains of serogroup A.

PMID- 7773239
TI  - Immunosuppression induced by Salmonella infection is correlated with augmentation
      of interleukin-2 receptor alpha chain expression in murine splenic lymphocytes.
AB  - In a previous study, we observed that the suppression of T-cell proliferation
      induced by Salmonella cell-free extract was associated with augmentation of IL-2
      receptor (IL-2R) alpha chain expression. In this study, we also observed this
      kind of augmentation of IL-2R alpha in Salmonella-infected mice.
      Phytohaemagglutinin (PHA)-stimulated proliferation of murine spleen cells was
      significantly suppressed when the mice were infected with Salmonella typhimurium.
      However, expression of the alpha chain but not the beta chain of IL-2R in
      lymphocytes was augmented by the infection. Analysis of the IL-2R-positive cell
      population showed that the augmentation of IL-2R alpha was not specific to
      certain cell subpopulations. Furthermore, the inhibition of PHA-stimulated murine
      spleen cell proliferation and the augmentation of IL-2R alpha expression induced
      by the infection in lymphocytes was completely reversed by treatment with anti
      interferon-gamma monoclonal antibody (anti-IFN-gamma Ab). These results suggest
      that the suppression of T-cell proliferation induced by Salmonella infection was
      associated with augmentation of IL-2R alpha expression in an IFN-gamma production
      dependent manner in the same way as the suppression of T-cell proliferation
      induced by Salmonella cell-free extract.

PMID- 7773240
TI  - Enhanced cellular response in mice treated with a Brucella antigen-liposome
      mixture.
AB  - The capacity of liposomes constituted by dycetyl-phosphate (0.009 mM),
      cholesterol (0.017 mM), lecithin (0.003 mM), and myristic (0.1 mM), stearic (0.1
      mM), or oleic acid (0.1 mM) to modify the lymphocyte response to Brucella
      melitensis antigens in mice was studied. Mice treated with antigens mixed with
      liposomes containing myristic, stearic or oleic acid had higher antibody titres
      than mice given antigen suspended in a saline solution. Liposomes alone, without
      Brucella antigens, resulted in increased 3H-thymidine incorporation by
      lymphocytes both in vivo and in vitro. The addition of polyclonal activators (LPS
      and ConA) caused a further increase of 3H-thymidine uptake. Moreover, spleen
      lymphocytes from mice inoculated with Brucella antigens mixed with the liposomes
      had a significantly lower population of B lymphocytes (10%), and a notable
      increase in the Tc lymphocytes (20%). Autoradiography of sections of popliteal
      ganglia of treated mice showed that the radioactivity was concentrated mainly in
      the membrane structures of the cell.

PMID- 7773241
TI  - Rapid detection of Salmonella subspecies I by PCR combined with non-radioactive
      hybridisation using covalently immobilised oligonucleotide on a microplate.
AB  - A polymerase chain reaction (PCR)-based test was developed for the detection of
      Salmonella. One pair of oligonucleotide primers was designed to amplify a 93-bp
      fragment of a gene required for the invasion of HeLa cells by Salmonella ser
      Typhi strain Ty2. The amplified product was analysed by non-radioactive sandwich
      hybridisation in microtiter plates using two oligonucleotides. The capture
      oligonucleotide was covalently linked onto animated wells of microtiter plates.
      The detection oligonucleotide was labelled with biotine. The hybrid molecules
      were detected by avidine conjugated with alkaline phosphatase and chromogenic
      substrate. The described combination of microplate sandwich hybridisation and PCR
      seems to be a suitable method for rapid detection of Salmonella subspecies I. It
      only requires a thermal cycler and a conventional microtiter reader, and can be
      readily done on a large scale.

PMID- 7773242
TI  - Potential animal models of Helicobacter pylori infection in immunological and
      vaccine research.
AB  - Presence of Helicobacter pylori in the human gastric mucosa is associated with
      chronic gastritis and promotes the formation of peptic ulceration. Furthermore,
      long-term gastritis caused by the bacteria represents an increased risk of
      developing gastric cancer. Much controversy remains about the pathogenic
      mechanisms by which H. pylori can induce disease because of the limitations of
      animal models and the relevance of in vitro observations to the in vivo disease
      process. Studies of putative pathogenic factors such as induction of inflammatory
      mediators and immune evasion are required to understand how to design a vaccine
      against the infection. Vaccine adjuvants, delivery systems and therapeutic
      vaccination are likely to be the areas of major progress in the future. Data
      related to immunological aspects and vaccine development in potential animal
      models are reviewed.

PMID- 7773243
TI  - Cell surface characteristics of Helicobacter pylori.
AB  - Helicobacter pylori is an important gastroduodenal pathogen of humans.
      Immunological and structural studies have been performed on the phospholipids,
      lipopolysaccharides (LPS) and some surface proteins of H. pylori strains. H.
      pylori LPS has, in general, low immunological activity and this property may aid
      the survival of this chronic infection. Nevertheless, H. pylori LPS has been
      found to influence the quality of gastric mucin and to stimulate pepsinogen
      secretion, thereby contributing to gastric disease. A number of putative adhesins
      of the bacterium have been described. This multiplicity of adhesins may reflect
      that H. pylori adherence is a multi-step process involving different
      interactions, and that different adhesins may mediate adherence to various sites
      in gastric tissue.

PMID- 7773245
TI  - Isotypic analysis of specific antibody response in serum, saliva, gastric and
      rectal homogenates of Helicobacter pylori-infected patients.
AB  - The relationship between systemic and local humoral immune response to
      Helicobacter pylori is poorly understood. To further address this issue we
      measured, using ELISA, H. pylori-specific IgG and IgA antibodies in serum,
      saliva, gastric and rectal homogenates of H. pylori-infected patients. A total of
      107 patients who underwent upper GI endoscopy and/or sigmoidoscopy were studied.
      The isotypic pattern of H. pylori-specific antibodies appeared to differ at the
      serum, salivary, gastric and rectal mucosa level. Serum H. pylori IgG titers were
      higher than those of the serum-specific IgA. On the contrary, in saliva samples
      H. pylori IgA titers were higher than specific IgG titers. In gastric
      homogenates, specific IgG and IgA titers were similar. H. pylori-specific IgG
      were detectable in rectal homogenates but no or very low H. pylori-specific IgA
      were found in the same material. Furthermore, no difference was found in H.
      pylori IgG and IgA in serum, saliva and gastric homogenates between duodenal
      ulcer and non-ulcer dyspepsia patients. Data of the present study indicate that,
      in H. pylori-infected patients, the specific immune response is as follows: (1)
      it involves the secretory immune system; (2) it is paralleled by the specific
      salivary IgA; (3) it does not differentiate duodenal ulcer from non-ulcer
      dyspepsia patients; and (4) it does not take place in the large bowel.

PMID- 7773244
TI  - Salivary specific IgG is a sensitive indicator of the humoral immune response to
      Helicobacter pylori.
AB  - In humans, salivary antibodies are secreted during humoral immune response.
      Helicobacter pylori infection is associated with systemic humoral immune response
      reflected by raised serum levels of specific IgG. The present study was aimed at
      exploring whether salivary concentrations of specific H. pylori IgG are a
      reliable indicator of H. pylori infection. Serum and salivary samples were
      obtained from 291 subjects attending the GI clinic and tested for H. pylori
      specific IgG by a direct ELISA (94% sensitivity, 95% specificity for serum
      determinations) using a crude H. pylori sonicate as antigen. Data are given as
      optical density (mean +/- S.D.). Levels of salivary H. pylori IgG paralleled
      those of circulating specific IgG in the 291 subjects studied (0.981 +/- 0.431
      vs. 0.777 +/- 0.682, respectively). A significant positive correlation was found
      between specific H. pylori IgG in sera and saliva samples (r = 0.981, P <
      0.0001). An overall concordance between circulating and salivary H. pylori IgG
      was observed in 238 out of the 291 (81.7%) subjects. Salivary H. pylori IgG
      represent a sensitive marker of specific humoral immune response and they may
      substitute circulating H. pylori IgG measurement when sera samples are not
      available.

PMID- 7773246
TI  - Investigation of Helicobacter pylori ascorbic acid oxidating activity.
AB  - Helicobacter pylori sonicate was shown to oxidize ascorbic acid. Ascorbic acid
      oxidation was determined by chromatography combined with electrochemical
      detection. Water soluble ascorbic acid oxidase activity was rather independent of
      pH with a pH optimum around 2. By gel filtration the oxidizing activity co-eluted
      with an absorbency peak at 408 nm. The relative molecular mass (Mr) was
      approximately 14,000. It is suggested that this oxidating activity was caused by
      a cytochrome c-like molecule. Ascorbic acid oxidating activity could also be
      extracted from bacterial membranes by detergents. Gel filtration showed several
      forms, the major one with a Mr = 19,000. pH optimum was 6-7. Other oxidase
      positive bacterial strains like Campylobacter coli, Enterobacter cloacae and
      Pseudomonas aeruginosa could degrade ascorbic acid. Since ascorbic acid oxidation
      by Helicobacter pylori whole bacterial lysates has a pH optimum in the acidic
      range corresponding to pH in gastric fluid, the activity of the cytochrome c-like
      water soluble oxidant of Helicobacter pylori seems to be primarily important for
      the destruction of ascorbic acid in the gastric juice of infected patients.

PMID- 7773247
TI  - HLA-DR expression on CD8 lymphocytes from gastric mucosa in urease-positive and
      urease-negative gastritis.
AB  - We isolated lymphocytes from chronically inflamed gastric mucosa. We analysed the
      expression of IL-2 receptors (CD25), transferin receptors (CD71) and HLA-DR
      molecules on T lymphocytes by flow cytometric analysis in 16 patients with urease
      positive and in 7 patients with urease-negative chronic gastritis. In G0, G1 and
      G2 histological type (Sydney classification) of gastritis the number of
      lymphocytes obtained from the gastric mucosa biopsies was too low for the flow
      cytometric analysis. However, in G3 histological type of chronic gastritis we
      obtained enough cells for the flow cytometric analysis in 75%. We demonstrated a
      significant increase in HLA-DR expression on CD8 cells from patients with urease
      positive gastritis compared to urease-negative gastritis. We also observed a
      statistically non-significant increase in HLA-DR expression on CD3 cells, and in
      CD71 expression on both CD3 and CD8 cells in urease-positive gastritis. However,
      no difference in CD25 expression was found between the two types of gastritis.

PMID- 7773248
TI  - Attachment, ingestion and intracellular killing of Helicobacter pylori by human
      peripheral blood mononuclear leukocytes and mouse peritoneal inflammatory
      macrophages.
AB  - The different steps of phagocytosis, attachment, ingestion and intracellular
      killing of cells of Helicobacter pylori strain 17874 (expressing sialic acid
      specific haemagglutinin) and cells of H. pylori strain 17875 (expressing non
      sialic acid-specific haemagglutinin) have been studied. More cells of
      sialopositive H. pylori strain 17874 have been found attached to human peripheral
      blood mononuclear leukocytes (PBM) and mouse peritoneal inflammatory macrophages
      (PIM) than cells of sialonegative H. pylori strain 17875. Binding of cells of H.
      pylori strain 17874 has been significantly inhibited by treatment of phagocytes
      with neuraminidase. Inhibition of adhesion of these bacteria preincubated with
      foetuin to normal phagocytic cells has also been found. Well adhering cells of H.
      pylori strain 17874 were more resistant to killing mechanisms of human PBM and
      mouse PIM than cells of strain 17875. Good, probably sialic acid-specific
      haemagglutinin dependent, adhesion of H. pylori bacteria to phagocytes can be
      considered as an important virulence factor which facilitates the pathogen to
      avoid the defence mechanisms.

PMID- 7773249
TI  - Molecular analysis of Helicobacter pylori populations in antral biopsies from
      individual patients using randomly amplified polymorphic DNA (RAPD)
      fingerprinting.
AB  - In the present study, randomly amplified polymorphic DNA (RAPD) fingerprinting
      has been used to analyse multiple single colony isolates of Helicobacter pylori
      from antral biopsies in an attempt to ascertain whether or not multiple strains
      are present in individual patients using single biopsy samples. The RAPD
      fingerprints derived from single colonies obtained from the same biopsy specimen
      were in all cases indistinguishable. The previously noted heterogeneity between
      H. pylori strains from different individuals was confirmed. RAPD fingerprinting,
      combined with a simple method of template preparation, was shown to be an
      excellent method for H. pylori strain differentiation. The results of this study
      indicate that the H. pylori population is homogeneous in individual patients at a
      single gastric site.

PMID- 7773250
TI  - Development of a PCR-based technique for detection of Helicobacter pylori.
AB  - A primer-set was designed for specific detection of genes that encode for 16S
      rRNA of Helicobacter pylori, using direct polymerase chain reaction (PCR). The
      primers were selected in the hypervariable regions, derived from a complete small
      subunit 16S rRNA sequence of the reference strain H. pylori CCUG 17874. The
      primer-set amplified a 537 base pair (bp) sequence specifically from chromosomal
      H. pylori DNA. Amplification of purified chromosomal H. pylori DNA was achieved
      at concentrations as low as 1 femto gram (fg), equivalent to 5 bacteria.
      Furthermore, as few as 1 lysed H. pylori cell was detected by this PCR technique.
      The specificity of the primers was 100%, since purified chromosomal DNA was
      detected from all 32 various H. pylori isolates, whereas no other bacteria
      species were detected, whether related to Helicobacter or not. The 16S rDNA
      primers successfully detected H. pylori in antral biopsy specimens collected from
      infected patients.

PMID- 7773251
TI  - Gastric juice neopterin in Helicobacter pylori infection.
AB  - Neopterin, a pteridine compound produced by macrophages activated by interferon
      gamma, is widely used to assess the activation of cellular immunity. An elevation
      in serum or urinary neopterin reflects immune activation in many different
      disorders, including viral infections, cancer, autoimmune diseases or acute
      myocardial infarction, but less attention has been paid to neopterin
      concentration in other biological fluids. The aim of the present study was to
      examine neopterin concentration in gastric juice. An association with the
      presence of Helicobacter pylori, a bacterium linked to the most common disorders
      of upper digestive tract, was also investigated. Gastric juice was obtained at
      endoscopy from 61 patients. Neopterin was determined by a radioimmunoassay and
      the presence of H. pylori was examined by urease test. The macroscopic finding of
      bile in gastric juice was associated with significantly higher neopterin levels
      compared to patients where no bile was noted (15.5 +/- 15.6 vs. 2.1 +/- 3.0
      nmol/l, P < 0.001). However, similar concentrations were observed in the H.
      pylori positive and H. pylori negative patients (7.6 +/- 12.0 vs. 11.1 +/- 14.9
      nmol/l). Even in the absence of macroscopic bile contamination, no significant
      difference could be found between the infected and uninfected patients (2.3 +/-
      3.2 vs. 1.3 +/- 1.9 nmol/l), and the patients with duodenal ulcer and normal
      findings (3.8 +/- 4.6 vs 1.6 +/- 1.9 nmol/l). The contamination of gastric juice
      with bile represents the limitation for the use of neopterin as a marker of
      immune activation in the gastric mucosa. Rather than an index of immune
      activation, gastric juice neopterin concentration represents a marker of
      duodenogastric reflux.

PMID- 7773252
TI  - Glutathione S-transferases in housefly (Musca domestica): location of GST-1 and
      GST-2 families.
AB  - The two families of dipteran glutathione S-transferases (GST-1 and GST-2) were
      located separately by immunohistology on sections of adult houseflies. GST-1 was
      distributed in haemolymph cells, whereas GST-2 was found in the indirect flight
      muscles of the thorax and in the central nervous system. In the muscles, the
      distribution of GST-2 seemed to be uniform in cells, whereas in the brain and the
      thoracic ganglia GST-2 was found mainly in the cortical areas which are made up
      by cell bodies. Comparison of the GSTs' location between an insecticide
      susceptible strain of housefly and resistant ones indicated no variation due to
      resistance. Enzyme-linked immunosorbent assay tests were used to dose GST-2. In
      houseflies, there were 60 pmol of GST-2/fly, 80-90% being found in the thorax,
      about 10% in the head and the remainder in the abdomen. Furthermore, the roles of
      these GSTs are discussed in relation to their location and our knowledge on their
      catalytic activities or their transport ability in invertebrates and mammals.

PMID- 7773253
TI  - Primary structure of proteins from the wing cuticle of the migratory locust,
      Locusta migratoria.
AB  - Wing cuticle from pharate adult locusts, Locusta migratoria, contains several
      prominent proteins which occur as minor components or are completely absent in
      other cuticular regions. Six of the wing-specific proteins have been purified and
      their amino acid sequences determined by combined use of mass spectrometry and
      automated Edman degradation. During the sequence determination very long sequence
      runs (90-121 residues) were necessary in order to establish the primary
      structure. All the wing-specific cuticular proteins from locusts contain the
      repeated short sequence motif -Ala-Ala-Pro-Ala/Val-, which is common for all
      hitherto sequenced cuticular proteins from pharate locusts. Several of the wing
      specific proteins also possess an N-terminal region rich in glycine, tyrosine and
      leucine, characteristic for many locust cuticular proteins. Two of the analysed
      proteins have a conserved 61-residue sequence in common with a previously
      sequenced protein from locust wing cuticle and with two proteins from the pharate
      cuticle of adult Tenebrio molitor. Possible roles for the various sequence motifs
      are discussed.

PMID- 7773254
TI  - Characterization of a new class of transcribed repetitive DNA sequence which also
      exists as a hybrid with HP1 mRNA; potential for site-specific recombination in
      Drosophila melanogaster.
AB  - A new class of dispersed repetitive DNA designated as vivi-sequence (VS) has been
      identified in Drosophila. It is relatively AT rich and is transcribed. The VS
      transcription is developmentally regulated and generates multiple transcripts. A
      hybrid transcript, designated fl-cDNA, has been identified in which a small
      segment of the VS is fused to the 5' end of an unrelated structural gene
      transcript coding for the heterochromatin protein HP1. The VS has recombination
      signal sequences (RSS) characteristic of vertebrate immunoglobulin genes. Such
      sequences are also present in the HP1 DNA. In both cases the recombination signal
      sequences are found close to the junction between HP1 and the VS in fl-cDNA.
      There is additional sequence identity both 5' and 3' of the junction between HP1
      and the VS in fl-cDNA. We propose that (a) the HP1-VS composite transcript
      represented by the fl-cDNA may be the product of recombination between the two
      sequences, (b) that the process is mediated by the RSS and/or the DNA downstream
      of the junction between HP1 and the VS and (c) that the recombination event may
      lead to the inactivation of the HP1 gene in a cell and tissue specific manner.

PMID- 7773255
TI  - Expression cloning and characterization of a pupal cuticle protein cDNA of
      Galleria mellonella L.
AB  - Epidermal mRNA of freshly ecdysed pupae of Galleria mellonella was used to
      establish a cDNA library in phage lambda gt11. A cDNA clone was isolated by means
      of a pupal cuticle protein (PCP) specific antibody. Nucleic acid sequence data
      show an insert of 1212 bp with an open reading frame of 1062 bp. The presence of
      start, stop, and polyadenylation sites suggests, that this insert represents a
      full length transcript. Conceptual translation resulted in a protein of 353 amino
      acids including a signal peptide. The final processed protein product is rich in
      alanine and charged amino acids like glutamic acid. It has a calculated pI of
      4.19 and a molecular mass of 34.272 kDa. In hybrid selection/in vitro translation
      and in vitro transcription/translation experiments a translational product of 54
      kDa was synthesized. The difference between apparent and calculated molecular
      mass is thought to be due to the relatively high amount of glutamic acid residues
      clustered in two regions. The developmental profile of expression of the
      corresponding gene was analyzed by northern blot hybridization using a cDNA
      probe. The time course of expression is coincident with developmentally regulated
      metamorphic changes in the integument.

PMID- 7773256
TI  - Characterization of a Bombyx mori cDNA encoding a novel member of the attacin
      family of insect antibacterial proteins.
AB  - A Bombyx mori cDNA was cloned that hybridized with Hyalophora cecropia attacin
      probe and its nucleotide sequence was determined. This cDNA consisted of 846
      nucleotides and the deduced amino acid sequence showed that the cDNA encodes an
      attacin precursor protein. The putative mature protein of B. mori attacin had
      70.4, 68.3 and 18.8% identity in amino acid sequences with that of H. cecropia
      acidic and basic attacins and Sarcophaga peregrina sarcotoxin IIA, respectively.
      B. mori and H. cecropia attacins and S. peregrina sarcotoxin IIA had two
      subdomains in each G domain, suggesting that common amino acid residues in the
      subdomains are conserved during evolution and plays an important role in the
      activity of the antibacterial proteins. Expression of B. mori attacin gene was
      rapidly induced by the injection of Escherichia coli cells into B. mori larvae
      and continued at least for 48 h mainly in fat bodies and hemocytes.

PMID- 7773257
TI  - The B proteins secreted by the tubular accessory sex glands of the male mealworm
      beetle, Tenebrio molitor, have sequence similarity to moth pheromone-binding
      proteins.
AB  - B proteins represent one of the four major protein groups secreted by the tubular
      accessory glands of adult, male mealworm beetles. They are acidic proteins with
      an apparent molecular mass of 18.8 kDa. In this paper we present the deduced
      amino-acid sequences of two, almost identical B proteins, termed B1 and B2. The
      mature proteins are 118 amino acids long. They contain 11 (B2) or 12 (B1)
      possible phosphorylation sites and are rich in glutamic acid (16%). Lectin
      binding experiments indicate the presence of asparagine linked carbohydrate. The
      secondary structure of the B proteins is predicted to be almost completely alpha
      helical. The B proteins show significant sequence resemblance to a group of
      pheromone- and odorant-binding proteins in moths and Drosophila, suggesting a
      role as carrier proteins for lipids.

PMID- 7773258
TI  - Incidence of laxative abuse in community and bulimic populations: a descriptive
      review.
AB  - Estimates of the incidence of laxative abuse in bulimics and in the community-at
      large vary widely for various population samples. This review identified 73
      studies in which laxative abuse could be assessed in bulimics, nonbulimics, and
      the community-at-large. Relative risk values for laxative abuse among population
      subsamples were estimated by moment methods statistical procedure based on mixed
      model analysis. Results indicated that the lifetime occurrence for laxative abuse
      behavior in the community-at-large was 4.18%. Bulimic behavior increased the risk
      for laxative abuse 3.57-fold to 14.94%. Several methodologic and population
      parameter characteristics are examined for their select impact on laxative abuse.
      Review of medical nomenclature for classifying laxative substances, iatragenic
      effects of laxative abuse, and assessment recommendations are also included.

PMID- 7773259
TI  - The theme of death in the French and German literature on eating disorders.
AB  - It is not widely appreciated in the English-speaking world that a number of
      articles written in French and German do address the role played by death
      preoccupations and concerns in the development and maintenance of eating
      disorders, particularly anorexia nervosa. In previous published articles these
      important "hidden" threads have been highlighted in examining in some detail, the
      writings of the German authors Binswanger, Von Weizsacker, and Thoma. In this
      article, the writings of other German authors are also briefly reviewed as well
      as the French authors Bensoussan, Fouraste, Raimbault, and Thouzery-Loras.
      Implications and issues are posed for both the researchers and clinicians alike
      contributing to the literature in English on eating disorders, who do not
      necessarily embrace these themes in therapy and who may not reflect their
      significance to theory in the literature itself.

PMID- 7773260
TI  - Anorexia nervosa: directions for future research. Study Group on Anorexia
      Nervosa.
AB  - On September 27-29, 1993, the Study Group on Anorexia Nervosa (AN): Basic
      Mechanisms, Clinical Approaches and Treatment met in Geneva, Switzerland to
      discuss recent progress in research on anorexia nervosa, and to identify
      directions for future studies. Anorexia nervosa is a disorder of unknown
      etiology, without a specific curative treatment, affecting mostly individuals in
      adolescence and early adulthood, with significant morbidity and mortality, and
      having a major impact on psychosocial and vocational development. In anorexia
      nervosa there are severe disturbances in virtually every endocrine system, such
      as the hypothalamic-pituitary-adrenal (HPA) axis, the hypothalamic-pituitary
      gonadal (HPG) axis, the hypothalamic-pituitary-thyroid (HPT) axis, the growth
      hormone (GH)/somatomedin C (IGF-1) system, and the central and peripheral
      arginine vasopressin (AVP) systems. Furthermore, classical neurotransmitter
      systems, such as the cholinergic noradrenergic, and serotonergic systems, are
      abnormally regulated in anorexia nervosa. New research data is also emerging on
      the abnormal regulation of immune function in this disorder. The Study Group
      concluded that even though several biological systems are abnormally regulated in
      anorexia nervosa, there is no biological test which is specific enough to make
      the diagnosis of the disorder. New directions for research in anorexia nervosa
      are identified and discussed in this report. Finally, the Study Group proposed
      future meetings to bring together clinical and pre-clinical (pharmacological,
      biochemical, and molecular) scientists studying topics, such as neuroendocrine
      function, which are important in the biology of anorexia nervosa.

PMID- 7773261
TI  - Clinical characteristics of eating disorder patients who report sexual or
      physical abuse.
AB  - At initial contact in an eating disorders clinic, 712 female eating disorder
      patients were asked if they had been physically or sexually abused as children.
      They also completed a Beck Depression Inventory (BDI) and an Eating Disorders
      Inventory (EDI). Their eating disorder symptom frequency and severity was
      determined. They were asked if they had alcohol problems, had attempted suicide,
      or had shoplifting problems. Twenty-nine percent reported sexual abuse. Twenty
      five percent reported physical abuse. There was no correlation between reports of
      abuse and symptom frequency or severity. The abused subjects were more depressed
      on the BDI and showed more psychological disturbance on the EDI. Abused subjects
      were much more likely than nonabused subjects to report alcohol problems, suicide
      attempts, or shoplifting.

PMID- 7773262
TI  - Temperament in eating disorders.
AB  - This study examined dimensional personality and temperamental characteristics in
      women with eating disorders. Clinical symptoms, personality, and temperament were
      examined in 30 women with anorexia nervosa (AN), 32 women with bulimia nervosa
      with no history of anorexia nervosa (BN), and 20 women with comorbid anorexia and
      bulimia nervosa (AB). Temperament differed markedly across the groups on the
      Tridimensional Personality Questionnaire (TPQ) with AN women showing greater
      reward dependence, BN women scoring higher on novelty seeking subscales, and AB
      women showing high harm avoidance. The TPQ subscales also displayed higher
      classification accuracy than other personality and symptom measures.
      Temperamental features are distinct across eating disorder subtypes. Temperament
      could reflect differential vulnerabilities for the development of specific eating
      disorder symptom clusters.

PMID- 7773263
TI  - Psychological correlates of weight fluctuation.
AB  - This investigation attempted to determine psychological correlates of weight
      fluctuation in a sample of 497 normal weight and obese adults who were enrolled
      in a prospective, natural history study. Subjects were stratified by gender,
      obesity, and age and classified as weight maintainers, gainers, or losers based
      on their changes in weight over a 1-year period. Subjects were further classified
      as either weight fluctuators or nonfluctuators based on historical self-report.
      Nonfluctuators reported significantly higher general well-being, greater eating
      self-efficacy, and lower stress than weight fluctuators, regardless of body
      weight. Weight maintainers had more favorable eating self-efficacy related to
      negative affect than weight gainers. Results suggest that weight fluctuation is
      strongly associated with negative psychological attributes in both normal weight
      and obese individuals. Future research should focus on the assessment and
      treatment of weight fluctuation and on weight maintenance, irrespective of weight
      status.

PMID- 7773264
TI  - Developmental role of perceived parental control in the eating psychopathology of
      Asian and Caucasian schoolgirls.
AB  - It has been suggested that the relatively high levels of eating psychopathology
      among Asian schoolgirls living in the United Kingdom are due to "culture clash,"
      but this construct needs further definition. A recent study has shown that
      perceived control by family members is important in determining the relatively
      unhealthy eating attitudes of Asian adolescents. However, that study focused on
      older adolescents (aged 14-15 years). The present study examines the development
      of that effect in a sample of Asian and Caucasian adolescent girls with a broader
      range of ages (aged 12-16 years). Again, the unhealthy eating attitudes of Asian
      girls were partly explained by their high levels of perceived maternal control.
      However, this effect was particularly strong among the older girls, suggesting a
      developmental trend through adolescence. There might be clinical benefits of
      addressing perceived or actual maternal control in these girls.

PMID- 7773265
TI  - Female adolescents of alcohol misusers: disordered eating features.
AB  - Studies show that children of alcohol-abusing parents constitute an at-risk
      population. This study attempted to understand the impact of parental alcohol
      misuse on the disordered eating behaviors of their female adolescent children,
      based on a sample of 532 teenagers from alcohol-misusing parents in Minnesota.
      These female adolescents had significantly higher prevalence rates of all the
      seven eating disordered symptoms that were studied. The study also identified a
      few protective factors: Those who did not develop any of the disordered eating
      symptoms were more satisfied with their present weight. Further, they worried
      less about abuse from parents and perceived that their school personnel cared
      about them.

PMID- 7773267
TI  - In defense of psychosomatic theory: a critical analysis of Allison and Heshka's
      critical analysis.
AB  - This article analyses Allison and Heshka's (Internal Journal of Eating Disorders,
      13, 289-295, 1993.) critical analysis of studies supporting psychosomatic theory.
      Questionned first is, Allison and Heshka's contention that the obese overreport
      emotional eating as a result of effects of demand characteristics, social
      desirability, and interpersonal expectancies. These effects, however, indicate
      that a more plausible response would be an underreport of emotional eating. Also
      addressed is Allison and Heshka's (Eating Disorders: The Journal of Treatment and
      Prevention, 1, 31-38, 1993.) contention that a high correlation between a
      measurement instrument and a measure of social desirability invalidates that
      measurement instrument. Finally, in a rebuttal of Allison and Heshka's critical
      analysis of studies supporting psychosomatic theory, it is elaborated why
      emotional eating explains so little variance in weight gain and obesity.

PMID- 7773266
TI  - Premorbid onset of psychopathology in long-term recovered anorexia nervosa.
AB  - It is recognized that patients with anorexia nervosa commonly have other
      psychiatric illnesses. No study, to our knowledge, has determined whether these
      other psychiatric disorders occur prior to the age of onset of anorexia nervosa.
      We obtained a retrospective history from 24 subjects who were long term (more
      than 1 year) recovered from anorexia nervosa. We found that 58% reported that
      they had the onset of one or more childhood anxiety disorder diagnoses at the age
      of 10 +/- 5 years old. This was 5 years before the mean age of onset of anorexia
      nervosa. The onset of depression was about 1 year before the onset of anorexia
      nervosa in about one half the subjects. Alcohol and substance abuse/dependency
      tended to occur after the onset of anorexia nervosa and only occurred in anorexic
      subjects who binged and/or purged. The early and common onset of childhood
      anxiety disorders in a substantial percentage of anorexics raises the possibility
      that childhood anxiety disorders herald the first behavioral expression of a
      biologic vulnerability in some subjects who develop anorexia nervosa.

PMID- 7773268
TI  - Early trauma, dissociation, and late onset in the eating disorders.
AB  - Although the majority of patients with anorexia nervosa and bulimia nervosa
      develop these disorders in their teens and 20s, some patients develop an eating
      disorder in their 30s, 40s, or 50s. We present a subgroup of patients with the
      following pattern of symptoms and historical detail: (1) severe sexual and
      physical abuse by family members; (2) relatively good premorbid professional and
      marital adjustment (considering later difficulties) though characterized by (3)
      hypomania, binge eating, and morbid obesity. A pronounced shift in eating
      behaviors follows (4) medical trauma (e.g., injury, cancer, surgery) that occurs
      after age 30, interrupts previous hypomanic adaptation, and leads to severe
      restriction, purging, and dramatic weight loss (e.g., 100 lb). Although only one
      patient met full criteria for anorexia nervosa, weight loss and starvation were
      serious enough to provoke further medical crises in all patients. Finally, (5)
      during both weight loss and weight restoration patients demonstrated significant
      dissociative disturbance, including dissociated mood and personality states
      (i.e., multiple personality disorder), self-destructive behavioral episodes
      repeating early trauma, and avoidance of food as a way to manage PTSD symptoms.

PMID- 7773269
TI  - Pictorial adaptation of Stroop measures of body-related concerns in eating
      disorders.
AB  - Patients with eating disorders were asked to color-name pictures of a variety of
      body shapes. The time taken to color-name these stimuli was compared with the
      time taken to color-name a series of neutral visual stimuli. There was a
      significant delay in naming body shapes in comparison to neutral stimuli, and
      this delay was greater in anorexic and bulimic patients than in controls.
      Previous Stroop adaptations have used verbal stimuli to assess the intensity of
      weight and shape-related concerns. The possible advantages of pictorial stimuli
      are discussed.

PMID- 7773270
TI  - The effect of mobilization on cervical headaches.
AB  - Headaches of cervical origin are often treated with mobilization. Mobilization of
      the upper cervical spine, occiput-C3, and effect on frequency, duration, and
      intensity of cervical headaches were studied utilizing an A-B-A single case
      design. Ten subjects who met the operational criteria of cervical headaches
      completed the study. A headache log was used to document headache frequency,
      duration, and intensity throughout all three phases (A-B-A). The baseline phase
      (A) lasted approximately 1 month, and no intervention was performed. The
      intervention phase (B) consisted of 9-12 treatment sessions, two times per week
      for 3-4 weeks. Visual analysis of data plots revealed a decrease in headache
      frequency, duration, and intensity from the baseline phase to the treatment
      phase. This improvement continued through the second A phase for frequency but
      leveled off for both duration and intensity. A one-way analysis of variance
      supported the findings from the visual analysis. In these 10 subjects,
      mobilization had a therapeutic effect on cervical headaches.

PMID- 7773271
TI  - The ankle ligaments: consideration of syndesmotic injury and implications for
      rehabilitation.
AB  - Injury to the distal tibiofibular syndesmosis (DTFS) may be more common than
      previously reported. This injury is typically caused by external forces which
      produce sudden ankle dorsiflexion or plantar flexion in combination with external
      rotation of the foot. Common mechanisms include direct contact with another
      player or uneven physical terrain. Improper diagnosis of this injury may greatly
      delay the return to normal functional status and promote the development of
      chronic instability, degenerative joint changes, and pain. The purpose of this
      clinical commentary is to review the ligamentous anatomy of the ankle and the
      incidence of injury to the lateral ligaments of the ankle, with emphasis on DTFS
      injury. Special tests which enhance the recognition of DTFS injury, such as the
      external rotation stress test and the distal tibiofibular compression test, and a
      rehabilitation progression are presented.

PMID- 7773273
TI  - A modified internal rotation stretching technique for overhand and throwing
      athletes.
AB  - Strength, stretching, and rehabilitation methods for the shoulder have been
      previously described and have been universally applied; nevertheless, many
      throwing athletes continue to develop overuse injuries. The pitching process
      tends to increase external rotation and limit internal rotation of the shoulder
      joint. Our technique involves a modified stretching method of the posterior
      shoulder musculature. The athlete lies prone with the elbow flexed 90 degrees.
      With the shoulder abducted 90 degrees, in neutral flexion/extension, and 90
      degrees or more of internal rotation, the scapula protrudes posteriorly. By
      depressing the inferior angle of the scapula toward the thoracic wall, the
      infraspinatus muscle and posterior joint capsule are effectively isolated and
      stretched. Manual stabilization of the scapula onto the chest wall transfers the
      internal rotation movements to the glenohumeral joint, as opposed to sharing the
      movement with the scapulothoracic articulation. This method improves the efficacy
      of the internal rotation stretching exercise for the glenohumeral joint. Such an
      addition to traditional stretching methods may increase the efficiency of the
      least effective component. We conclude that this modification to traditional
      programs should be an integral part of the training and rehabilitation program of
      any athlete requiring near maximal performance of the shoulder.

PMID- 7773272
TI  - The contributions of proprioceptive deficits, muscle function, and anatomic
      laxity to functional instability of the ankle.
AB  - Functional instability is a common complication following an acute ankle sprain.
      Three potential contributing factors underlying the ankle which chronically gives
      way are proprioceptive deficits, muscle weakness, and ligamentous laxity. This
      study's purpose was to document the presence or absence of these concerns in a
      sample of subjects with unilateral functional ankle instability. Both ankles of
      42 subjects were randomly assessed for passive movement sense into inversion and
      generation of peak torque by the evertors isokinetically. Thirty-four subjects
      were available for documentation of talar tilt of both ankles through inversion
      stress radiographs. Analysis found significantly greater mean values for passive
      movement sense and talar tilt for the involved ankles compared with the
      uninvolved, while no significant strength differences in peak torque of the
      evertors were present. Fifty-eight percent of the sample demonstrated clinical
      impairments in at least one of these three categories. In conclusion, deficits in
      passive movement sense and anatomic stability are greater concerns than strength
      deficits when managing the ankle with functional instability.

PMID- 7773274
TI  - Shoulder kinesthesia in healthy unilateral athletes participating in upper
      extremity sports.
AB  - Shoulder kinesthesia has not been extensively studied in upper extremity
      athletes. The purpose of this study was to determine if there were differences in
      threshold to detection of passive motion between dominant and nondominant
      shoulders of healthy overhead athletes in two positions, 0 degrees and 75 degrees
      of external rotation. In addition, the study attempted to determine if there was
      a relationship between the range of external rotation (ER) and internal rotation
      (IR) and the threshold to detection of passive motion values. Shoulder
      kinesthesia was assessed in the dominant and nondominant shoulders of 20
      collegiate athletes participating in unilateral upper extremity sports. A
      proprioceptive testing device passively moved the shoulder into internal and
      external rotation. The dominant shoulder had a significantly greater difficulty
      detecting motion compared with the nondominant arm at both 0 degrees and 75
      degrees of external rotation. Both shoulders exhibited enhanced kinesthesia
      (lower threshold to detection of passive motion scores) at 75 degrees of external
      rotation compared with 0 degrees, where the glenohumeral joint capsule is
      relatively taut. The results of this study suggest that healthy upper extremity
      athletes may have kinesthetic deficits in their throwing shoulder compared with
      their nondominant shoulder.

PMID- 7773275
TI  - A comparison of torque production during dynamic strength testing of shoulder
      abduction in the coronal plane and the plane of the scapula.
AB  - Quantitative measurement of the shoulder abductors is important in a
      comprehensive assessment of shoulder muscle performance. Testing in traditionally
      accepted positions may be compromising to the glenohumeral static and dynamic
      stabilizers; therefore, there is a need to investigate testing in other planes of
      motion. The purpose of this study was to compare torque produced during
      isokinetic testing of shoulder abduction in the coronal plane and the scapular
      plane. Twenty female subjects with no previous shoulder pathology were tested at
      90 degrees/sec and 210 degrees/sec in the coronal and scapular planes using the
      Cybex II isokinetic dynamometer. Both peak torque and mean peak torque of three
      trials were recorded. A t test for related samples (p < .05) revealed no
      significant difference in the peak and mean peak torque produced at each speed.
      Using a two-way analysis of variance with repeated measures, no significant
      difference was found in the peak torque produced between the two planes. However,
      torque production at 90 degrees/sec in both test positions was significantly
      higher than torque production at 210 degrees/sec (F1,19 = 159.610, p < .001).
      Although anatomical, functional, and clinical reasons have been proposed for
      performing exercise and testing procedures of the shoulder abductors in the
      scapular plane, the results of this study indicate that in healthy young women,
      there is no difference in torque production between the two planes.

PMID- 7773277
TI  - Diabetes' sweet little mystery.

PMID- 7773276
TI  - Effect of running on anterior knee laxity in collegiate-level female athletes
      after anterior cruciate ligament reconstruction.
AB  - Agility running activities are commonly used in the latter stages of
      rehabilitation for anterior cruciate ligament (ACL) reconstruction. However, the
      effects of agility running on anterior knee laxity in these patients have not
      been examined. The purpose of this study was to examine changes in anterior knee
      laxity before and after 30 minutes of agility running exercise. Subjects (N = 9)
      were female athletes (mean age = 20.1 +/- 1.5 years; height = 171.7 +/- 10.4 cm;
      weight = 65.7 +/- 8.6 kg) with unilateral ACL reconstruction (central 1/3 patella
      tendon graft, postoperation range = 9-52 months, mean = 24.2 months).
      Measurements were made at 20 degrees and 90 degrees of knee flexion bilaterally
      with KT-1000 arthrometry (MEDmetric, San Diego, CA) and recorded in millimeters
      of displacement. Data were analyzed with an analysis of variance (ANOVA) with
      repeated measures (p < 0.05). Results showed no statistical differences between
      the ACL-reconstructed knee and the normal knee at 20 degrees and 90 degrees knee
      flexion. The authors conclude that the central 1/3 patella tendon graft performs
      comparable to the normal knee when stressed with agility running exercise;
      therefore, agility exercise is an appropriate, safe, short-term activity.

PMID- 7773278
TI  - The dominating effect of mutant p53.

PMID- 7773279
TI  - Probability and complex disease genes.

PMID- 7773280
TI  - "Take a break--have a quick map".

PMID- 7773281
TI  - Peaceful bombardment in the land of unrest.

PMID- 7773282
TI  - The question of heterogeneity in Marfan syndrome.

PMID- 7773283
TI  - Immune surveillance in colorectal carcinoma.

PMID- 7773284
TI  - Effect on splicing of a silent FGFR2 mutation in Crouzon syndrome.

PMID- 7773285
TI  - Genomic imprinting of Mash2, a mouse gene required for trophoblast development.
AB  - The mouse gene Mash2 encodes a transcription factor required for development of
      trophoblast progenitors. Mash2-homozygous mutant embryos die at 10 days
      postcoitum from placental failure. Here we show that Mash2 is genomically
      imprinted. First, Mash2+/- embryos inheriting a wild-type allele from their
      father die at the same stage as -/- embryos, with a similar placental phenotype.
      Second, the Mash2 paternal allele is initially expressed by groups of trophoblast
      cells at 6.5 and 7.5 days post-coitum, but appears almost completely repressed by
      8.5 days post-coitum. Finally, we have genetically and physically mapped Mash2 to
      the distal region of chromosome 7, within a cluster of imprinted genes, including
      insulin-2, insulin-like growth factor-2 and H19.

PMID- 7773286
TI  - Gene transfer and expression in progeny after intravenous DNA injection into
      pregnant mice.
AB  - Several methods that enable foreign genes to be transferred directly into germ
      cells and adult animals have been developed, which have stimulated great interest
      in manipulating genes in vivo. However, there have been no methods available for
      introducing genes into fetuses. We report here that a single intravenous
      injection of expression plasmid: lipopolyamine complexes into pregnant mice
      resulted in successful gene transfer into the embryos. The transgenes thus
      introduced were expressed in the fetuses and newborn progeny. This simple and new
      method of gene transfer into embryos will facilitate rapid analysis of transgene
      effects in the fetuses and will be useful for studying gene-deficient animal
      models to gain transgene functions at desired stages of embryogenesis.

PMID- 7773287
TI  - Mutation of the MXI1 gene in prostate cancer.
AB  - The Mxi1 protein negatively regulates Myc oncoprotein activity and thus
      potentially serves a tumour suppressor function. MXI1 maps to chromosome 10q24
      q25, a region that is deleted in some cases of prostate cancer. We have detected
      mutations in the retained MXI1 alleles in four primary prostate tumours with
      10q24-q25 deletions. Two tumours contained inactivating mutations, whereas two
      others contained the identical missense mutation. Fluorescence in situ
      hybridization also demonstrated loss of one MXI1 allele in an additional tumour
      lacking chromosome 10 abnormalities. MXI1 thus displays allelic loss and mutation
      in some cases of prostate cancer that may contribute to the pathogenesis or
      neoplastic evolution of this common malignancy.

PMID- 7773288
TI  - Transplantation to the rat brain of human neural progenitors that were
      genetically modified using adenoviruses.
AB  - Transplantations for neurological disorders are limited by the supply of human
      fetal tissue. To generate larger numbers of cells of appropriate phenotype, we
      investigated whether human neural progenitors expanded in vitro could be modified
      with recombinant adenoviruses. Strong expression of beta-galactosidase was
      obtained in vitro. Two or three weeks after transplantation of engineered cells
      to the rat brain, we observed a small percentage of surviving neuroblasts
      strongly expressing beta-galactosidase in four out of 13 rats. Thus human
      precursor cells that have been genetically modified using adenoviruses are a
      promising tool for ex vivo gene therapy of neurodegenerative diseases.

PMID- 7773289
TI  - A 2D crossover-based map of the human X chromosome as a model for map
      integration.
AB  - We have constructed a two-dimensional map of 243 markers on the X chromosome. The
      average distance between markers ordered by two recombinants is 5.4 centiMorgans
      (cM), which is reduced to 3.2 cM using a less stringent criterion of one
      recombinant. Map resolution is enhanced by replacing the usual reference marker
      format with a 2D format, and the two-recombinant rule is more conservative than
      the lod 3.0 criterion for order. Taken together, crossover mapping and the 2D
      format produces maps with greater reliability and higher resolution than maps
      constructed using currently accepted standards. This first high-density crossover
      based map of an entire human chromosome provides a model for integrating physical
      and genetic maps.

PMID- 7773290
TI  - Mutations in the gene for transglutaminase 1 in autosomal recessive lamellar
      ichthyosis.
AB  - We recently mapped the disease locus for severe autosomal recessive lamellar
      ichthyosis (LI) to chromosome 14q11 and showed complete linkage with TGM1, the
      gene encoding transglutaminase 1. We have now identified point mutations in TGM1
      in two of the multiplex LI families used in the linkage study. Each nucleotide
      change causes a non-conservative amino acid substitution of histidine for one of
      two adjacent arginine residues in exon 3 of the gene (Arg141His, Arg142His).
      Within the transglutaminase family, these arginines are invariant within a
      conserved region, distant from the catalytic site of the enzyme. We hypothesize
      that these mutations adversely affect formation of crosslinks essential in
      production of cornified cell envelopes and a normal stratum corneum layer of the
      skin.

PMID- 7773292
TI  - The minisatellite in the diabetes susceptibility locus IDDM2 regulates insulin
      transcription.
AB  - Genetic susceptibility to insulin-dependent diabetes mellitus (IDDM) is inherited
      as a polygenic trait. One of the loci implicated in IDDM is a polymorphic
      minisatellite 5' of the human insulin (INS) gene on chromosome 11. This insulin
      linked polymorphic region (ILPR) is composed of tandemly repeated sequences,
      which fall into three size classes: IDDM is strongly associated with short ILPR
      alleles. We now show that the ILPR is capable of transducing a transcriptional
      signal in pancreatic beta-cells, with a long ILPR possessing greater activity
      than a short ILPR. The ILPR contains numerous high-affinity binding sites for the
      transcription factor Pur-1, and transcriptional activation by Pur-1 is modulated
      by naturally occurring sequences in the ILPR. Our results demonstrate a possible
      function for this unique minisatellite, which may have implications for type 1
      diabetes.

PMID- 7773291
TI  - Susceptibility to human type 1 diabetes at IDDM2 is determined by tandem repeat
      variation at the insulin gene minisatellite locus.
AB  - The IDDM2 locus encoding susceptibility to type 1 diabetes was mapped previously
      to a 4.1-kb region spanning the insulin gene and a minisatellite or variable
      number of tandem repeats (VNTR) locus on human chromosome 11p15.5. By 'cross
      match' haplotype analysis and linkage disequilibrium mapping, we have mapped the
      mutation IDDM2 to within the VNTR itself. Other polymorphisms were systematically
      excluded as primary disease determinants. Transmission of IDDM2 may be influenced
      by parent-of-origin phenomena. Although we show that the insulin gene is
      expressed biallelically in the adult pancreas, we present preliminary evidence
      that the level of transcription in vivo is correlated with allelic variation
      within the VNTR. Allelic variation at VNTRs may play an important general role in
      human disease.

PMID- 7773293
TI  - A missense mutation in the glucagon receptor gene is associated with non-insulin
      dependent diabetes mellitus.
AB  - Non-insulin-dependent diabetes mellitus (NIDDM) affects about 5% of the world
      population. The disease presents a polygenic mode of inheritance, but mechanisms
      and genes involved in late-onset NIDDM are largely unknown. We report the
      association of a single heterozygous Gly to Ser missense mutation in the glucagon
      receptor gene with late-onset NIDDM. This mutation was highly associated with
      NIDDM in a pooled set of French and Sardinian patients (chi 2 = 14.4, P = 0.0001)
      and showed some evidence for linkage to diabetes in 18 sibships from 9 French
      pedigrees (chi 2 = 6.63, P < 0.01). Receptor binding studies using cultured cells
      expressing the Gly40Ser mutation demonstrate that this mutation results in a
      receptor which binds glucagon with a three-fold lower affinity compared to the
      wild type receptor.

PMID- 7773294
TI  - A mutant p53 transgene accelerates tumour development in heterozygous but not
      nullizygous p53-deficient mice.
AB  - To test the behaviour of a mutant form of p53 in the presence and absence of wild
      type p53 in vivo, we mated p53-deficient mice containing a p53 null allele to
      transgenic mice containing multiple copies of a mutant p53 gene (Val 135).
      Animals hemizygous for the endogenous wild-type p53 gene with the mutant
      transgene exhibited accelerated tumour development and an altered tumour spectrum
      compared to their non-transgenic counterparts. In contrast, transgenic and non
      transgenic animals nullizygous for endogenous p53 developed tumours at the same
      rate. Thus, the mutant Val-135 p53 allele may act in vivo in a dominant negative
      manner in the presence of wild-type p53 but does not display gain of function
      activity in the absence of wild-type p53.

PMID- 7773295
TI  - Gamete-specific methylation correlates with imprinting of the murine Xist gene.
AB  - We have investigated the potential role of DNA methylation as a regulator of
      imprinted Xist expression in mouse preimplantation embryos. The active paternal
      allele was found to be unmodified in sperm at CpG loci near the 5' end of the
      gene transcription unit. In contrast, on the inactive maternal allele, these same
      sites are initially methylated in the oocyte and then remain modified in the
      early embryo. In the male germ line, these methyl moieties are removed during
      spermatogenesis, and this occurs before the programmed reactivation of Xist in
      the testis. This represents a clear-cut example of a potential methylation
      imprinting signal that is reprogrammable and gamete derived.

PMID- 7773296
TI  - Methylation of the mouse Xist gene in sperm and eggs correlates with imprinted
      Xist expression and paternal X-inactivation.
AB  - Preferential paternal X-inactivation in the extra-embryonic tissues of the female
      mouse embryo is correlated with imprinted expression of the paternal allele of
      the Xist gene in pre-implantation development. Here we examine 11 CpG sites in
      Xist to determine whether differential methylation might be the molecular basis
      for imprinting. We find that three sites in the promoter region are methylated in
      eggs but not in sperm and that this differential methylation is maintained to the
      blastocyst stage when the paternal X-inactivation occurs. This is the first
      example of a primary gametic methylation imprint governing differential
      expression of parental alleles in pre-implantation embryos.

PMID- 7773297
TI  - Thanatophoric dysplasia (types I and II) caused by distinct mutations in
      fibroblast growth factor receptor 3.
AB  - Thanatophoric dysplasia (TD), the most common neonatal lethal skeletal dysplasia,
      affects one out of 20,000 live births. Affected individuals display features
      similar to those seen in homozygous achondroplasia. Mutations causing
      achondroplasia are in FGFR3, suggesting that mutations in this gene may cause TD.
      A sporadic mutation causing a Lys650Glu change in the tyrosine kinase domain of
      FGFR3 was found in 16 of 16 individuals with one type of TD. Of 39 individuals
      with a second type of TD, 22 had a mutation causing an Arg248Cys change and one
      had a Ser371Cys substitution, both in the extracellular region of the protein.
      None of these mutations were found in 50 controls showing that mutations
      affecting different functional domains of FGFR3 cause different forms of this
      lethal disorder.

PMID- 7773299
TI  - Limitations of probit plots in pharmacogenetics: requirement of genetic analyses
      to test hypotheses based on graphical methods.

PMID- 7773298
TI  - Nomenclature for N-acetyltransferases.
AB  - A consolidated classification system is described for prokaryotic and eukaryotic
      N-acetyltransferases in accordance with the international rules for gene
      nomenclature. The root symbol (NAT) specifically identifies the genes that code
      for the N-acetyltransferases, and NAT* loci encoding proteins with similar
      function are distinguished by Arabic numerals. Allele characters, denoted by
      Arabic numbers or by a combination of Arabic numbers and uppercase Latin letters,
      are separated from gene loci by an asterisk, and the entire gene-allele symbols
      are italicized. Alleles at the different NAT* loci have been numbered
      chronologically irrespective of the species of origin. For designation of
      genotypes at a single NAT* locus, a slash serves to separate the alleles; in
      phenotype designations, which are not italicized, alleles are separated by a
      comma.

PMID- 7773300
TI  - Modulation of xenobiotic-inducible cytochrome P450 gene expression by
      dexamethasone in primary rat hepatocytes.
AB  - Our previous studies (Sidhu JS et al. Arch Biochem Biophys 1993: 301, 103-113;
      Sidhu JS et al. In Vitro Toxicol 1994: 7, 225-242) demonstrated the importance of
      culturing primary rat hepatocytes with an overlay of extracellular matrix (ECM),
      together with optimal media formulations (Williams' E or Chee's), to efficiently
      maintain in vivo-like responsiveness of phenobarbital (PB)-inducible cytochrome
      P450 genes in vitro. In the present report, we have characterized culture
      conditions further by examining individual and interactive effects of
      dexamethasone (Dex) and PB on CYP2B1, CYP2B2, and CYP3A1 expression. Dex alone
      was not effective in enhancing CYP2B1 or CYP2B2 expression levels. However,
      together with PB, addition of low concentrations (10(-9)-10(-8) M) of Dex
      resulted in a marked potentiation of PB-inducible P450 gene expression. In
      contrast, at levels > 10(-7) M, Dex profoundly inhibited PB induction of the
      CYP2B1 and CYP2B2 genes. The overall stimulatory response to Dex was more
      dramatic in cells cultured in Williams' E than in Chee's medium. Similarly,
      concentrations of PB > 0.5 mM resulted in substantially reduced levels of CYP2B1
      and CYP2B2 induction than those attainable at lower PB concentrations. These
      results suggest that Dex and PB function cooperatively to regulate the CYP2B1 and
      CYP2B2 genes, and that composite interactions may either negatively or positively
      regulate expression, in a concentration-dependent manner. CYP3A1 was not
      regulated in a similar biphasic fashion, as this gene was fully responsive even
      at high dose levels of PB or Dex. With respect to other marker genes evaluated,
      high Dex concentrations (> 10(-7) M) were only marginally inhibitory to beta
      naphthoflavone-mediated induction of CYP1A1 and CYP1A2 mRNAs, and did not perturb
      expression of the liver-selective serum albumin gene. Addition of Dex was
      critical, however, to maintain glutathione S-transferase Pi expression, a marker
      of hepatocyte dedifferentiation, in the repressed state. Defining optimal culture
      conditions for maintaining hepatocyte differentiation in vitro are requisite for
      establishing primary culture models enabling investigation of the molecular
      mechanisms of PB-mediated gene regulation.

PMID- 7773301
TI  - Detection of CYP2C9 polymorphism based on the polymerase chain reaction in
      Chinese.
AB  - Cytochrome P450 (CYP) 2C9 catalyses the metabolism of a wide range of drugs.
      Previous studies have shown the differences in the amino acid composition among
      CYP2C9 variants at Cys144/Arg, Tyr358/Cys, Leu359/Ile, and Gly417/Asp. PCR
      endonuclease digestion methods have been developed to detect these four possible
      polymorphisms. The T416-->C mutation in exon 3 of CYP2C9 (Cys144-->Arg) creates
      an Ava II site. In the 135 subjects we tested, all leukocyte DNA samples showed a
      complete Ava II digestion indicating homozygous C416 (Arg144). A Tyr358-->Cys
      mutation will create a Nsi I site at codon 1057-1063 in exon 7. In 40 subjects
      tested, all samples showed negative results. DNA sequencing on a few samples
      showed Tyr358Ile359. A mismatched PCR primer pair was then designed to detect
      codon C1061-->A (Leu359-->Ile) mutation. In 115 subjects tested, 111 samples
      showed a complete Nsi I digestion (Ile359) and four samples showed heterozygous
      results. Another mismatched PCR primer pair was used to confirm the C1061 codon
      in heterozygous subjects. The four heterozygous subjects showed partial digestion
      with endonuclease Kpn I, which confirmed the heterozygous Ile/Leu at amino acid
      359. The G1236-->A mutation in exon 8 of CYP2C9 (Gly417-->Asp) creates a Hph I
      site. In all 46 subjects, homozygous G1236 (Gly417) was found. Most Chinese
      subjects actually have Arg144 Tyr358 Ile359 Gly417 in CYP2C9 as previously
      reported human-2. Furthermore, we found an A-->T (+12 position in intron 2)
      mutation in our CYP2C9 sequencing process. The mutation creates a NIa III
      site.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773302
TI  - (S)oxazepam glucuronidation is inhibited by ketoprofen and other substrates of
      UGT2B7.
AB  - 1,4-Benzodiazepine anxiolytics such as diazepam and halazepam are converted in
      vivo to oxazepam, an active metabolite with a hydroxyl group at the asymmetric C3
      position. D-glucuronic acid couples with the C3 hydroxyl group of oxazepam to
      form pharmacologically inactive diastereomeric glucuronide conjugates.
      Conjugation with glucuronic acid is catalysed by the microsomal UDP
      glucuronosyltransferase (UGT) enzyme system, which includes an undetermined
      number of isozymes. Although 1,4-benzodiazepines are ultimately cleared as
      oxazepam glucuronide, little is known about the particular UGT isozyme(s)
      responsible for the conjugation at the C3 position of these molecules. Microsomal
      preparations from three human livers were used to study the glucuronidation of
      (R,S)oxazepam in vitro. The predominant formation of the S- over the R
      glucuronide was reflected by the kinetic parameters: For (S)oxazepam glucuronide,
      the constants were Km = 0.18 +/- 0.02 mM and Vmax = 202.6 +/- 25.0 nmol min-1 per
      mg protein; for (R)oxazepam glucuronide, they were Km = 0.22 +/- 0.02 mM, Vmax =
      55.4 +/- 9.5 nmol min-1 per mg protein. Inhibition studies suggest that the two
      diastereomeric glucuronidations are catalysed by different UGT isozymes. That is,
      there was competitive inhibition of (S)oxazepam glucuronidation by non-steroidal
      anti-inflammatory drugs (NSAIDs), including ketoprofen while (R)oxazepam
      glucuronidation was not equally inhibited by these compounds. The order of
      potency of inhibitors of (S)oxazepam glucuronidation in this study was the same
      as the rank order of substrates conjugated by UGT2B7; hyodeoxycholic acid,
      estriol, (S)naproxen, ketoprofen, ibuprofen, fenoprofen, clofibric acid, and
      morphine (in descending order). The inhibition profile of (S)oxazepam
      glucuronidation suggests that UGT2B7 is the catalysing enzyme.

PMID- 7773304
TI  - Studies on interindividual variations of CYP2E1 using chlorzoxazone as an in vivo
      probe.

PMID- 7773303
TI  - Lack of a genetic polymorphism in the glucuronidation of fenofibric acid.

PMID- 7773305
TI  - Flavanone 3-hydroxylase transcripts and flavonol accumulation are temporally
      coordinate in maize anthers.
AB  - Flavanone 3-hydroxylase (F3H) activity is necessary for the production of both
      flavonols and anthocyanins. Flavonols are required for functional pollen in maize
      whereas anthocyanins are non-essential pigments. A cDNA for F3H was isolated from
      Zea mays using a heterologous sequence from Antirrhinum majus. Comparison of the
      deduced amino acid sequence of maize F3H with other F3H sequences confirmed that
      the protein is highly conserved among widely divergent plant species. The F3H
      gene is present in a single copy located at the tip of chromosome 2S. High levels
      of F3H gene expression were detected in pigmented husk and 26-day postpollination
      kernels; lower levels in 18-day postpollination kernels and in coleoptiles of
      germinating seedlings. Slot blot analysis showed that F3H transcript levels in
      young seedlings are increased by high fluence-rate white light treatment in the
      presence of the anthocyanin regulatory gene -r. HPLC analysis of extracts from
      developmentally staged anthers showed that flavonol accumulation begins at the
      uninucleate microspore stage, continues until maturity, and is not controlled by 
      r. When the expression pattern of several flavonoid biosynthetic genes was
      analyzed during microsporogenesis, only F3H transcript accumulation was
      coordinate with the appearance of flavonols in anthers.

PMID- 7773306
TI  - Correlation between the induction of a gene for delta 1-pyrroline-5-carboxylate
      synthetase and the accumulation of proline in Arabidopsis thaliana under osmotic
      stress.
AB  - The isolation and characterization is reported of a cDNA for delta 1-pyrroline-5
      carboxylate (P5C) synthetase (cAtP5CS), an enzyme involved in the biosynthesis of
      proline, from a cDNA library prepared from a dehydrated rosette plant of
      Arabidopsis thaliana. Southern blot analysis suggested that only one copy of the
      corresponding gene (AtP5CS) is present in A. thaliana. The deduced amino acid
      sequence of the P5CS protein (AtP5CS) from A. thaliana exhibited 74% homology to
      that of the P5CS from Vigna aconitifolia. Northern blot analysis revealed that
      the gene for P5CS was induced by dehydration, high salt and treatment with ABA,
      while it was not induced by heat or cold treatment. Moreover, the simultaneous
      accumulation of proline was observed as a result of the former treatments in A.
      thaliana. A cDNA for P5C reductase (cAtP5CR) was also isolated from A. thaliana
      and Northern blot analysis was performed. The AtP5CR gene was not induced to a
      significant extent by dehydration or high-salt stress. These observations suggest
      that the AtP5CS gene plays a principal role in the biosynthesis of proline in A.
      thaliana under osmotic stress.

PMID- 7773307
TI  - Functional expression of Saccharomyces cerevisiae CYP51A1 encoding lanosterol-14
      demethylase in tobacco results in bypass of endogenous sterol biosynthetic
      pathway and resistance to an obtusifoliol-14-demethylase herbicide inhibitor.
AB  - Nicotiana tabacum protoplasts have been transformed by Agrobacterium tumefaciens
      containing a T-DNA in which the gene CYP51A1 encoding lanosterol-14-demethylase
      (LAN14DM) from Saccharomyces cerevisiae is under the control of a cauliflower
      mosaic virus (CaMV) 35S promoter. Two transformants strongly expressed the
      LAN14DM as shown by Northern and Western experiments. These transgenic calli were
      killed by LAB 170250F (LAB) (a phytotoxic fungicide inhibiting both plant
      obtusifoliol-14-demethylase (OBT14DM) and LAN14DM) but were resistant to gamma
      ketotriazole (gamma-kt), a herbicide which has been shown to inhibit OBT14DM but
      not LAN14DM at a concentration that was lethal to control calli. However, these
      transgenic calli were killed by mixtures of gamma-kt plus fungicide inhibitors of
      LAN14DM such as ketoconazole, itraconazole or flusilazole which alone were not
      effective. Further analysis of the transgenic calli grown in the presence of
      gamma-kt showed that their delta 5-sterol content was close to that of untreated
      control calli obtained from protoplasts transformed with control plasmid; this is
      in agreement with evidence that the LAN14DM expressed from the transgene could
      bypass the blocked OBT14DM by using the plant substate obtusifoliol. In contrast,
      control calli when treated with gamma-kt, displayed a sterol content strongly
      enriched in 14 alpha-methyl sterols and depressed in physiological delta 5
      sterols. When the transgenic calli were cultured in mixtures of gamma-kt and
      LAN14DM inhibitors sterol compositions enriched in 14 alpha-methyl sterols were
      obtained, reflecting a strong inhibition of both 'endogenous' OBT14DM and
      'exogenous' LAN14DM. Taken together these results show that in tobacco calli
      transformed with CYP51A1, resistance to a triazole herbicide arises from
      expression of a functional LAN14DM enzyme; its activity in transgenic tissues
      creates a bypass of the sterol biosynthetic pathway at the 14-demethylase level
      when this latter is blocked by an OBT14DM herbicide inhibitor.

PMID- 7773308
TI  - Co-expression of native and introduced genes reveals cryptic regulation of HMG
      CoA reductase expression in Arabidopsis.
AB  - In eukaryotes, all isoprenoid compounds share a common precursor, mevalonic acid,
      whose synthesis is catalyzed by the enzyme 3-hydroxy-3-methylglutaryl coenzyme A
      (HMG CoA) reductase. As one step towards a better understanding of the role that
      this enzyme plays in coordinating isoprenoid biosynthesis in plants, Arabidopsis
      thaliana HMG CoA reductase was ectopically expressed in transgenic Arabidopsis
      plants. By using this molecular genetic approach, several novel and fundamental
      observations have been made regarding isoprenoid biosynthesis in Arabidopsis.
      First, it was demonstrated that the overexpression of authentic Arabidopsis HMG
      CoA reductase is not sufficient to alter the bulk synthesis and accumulation of
      the abundant end products of the plant isoprenoid pathway. Second, active
      transcription of the transgene appears to co-activate and deregulate expression
      of the native gene, resulting in a striking elevation of HMG CoA reductase mRNA
      levels. Finally, although very high levels of HMG CoA reductase mRNA were
      expressed in these transgenic plants, only modest increases in enzyme activity
      could be detected. Taken together, these data suggest that HMG CoA reductase
      expression is regulated at multiple levels in plants as well as animals, and they
      provide a foundation for elucidating the molecular mechanisms for mevalonate
      regulation in A. thaliana.

PMID- 7773309
TI  - An aldose reductase homologous gene from barley: regulation and function.
AB  - The expression of a barley gene homologous to aldose reductase and aldehyde
      reductase is restricted to the embryo and temporally correlated with its
      acquisition of desiccation tolerance. In the work presented, two aspects of this
      barley gene were investigated: its transcriptional regulation and the initial
      characterization of the enzymatic function. The transcriptional regulation of the
      gene was studied in transgenic tobacco by analysing the expression of chimeric
      genes containing 5' sequences of the barley gene transcriptionally fused to the
      GUS reporter gene. This functional analysis of the promoter revealed that a 1364
      bp 5' fragment confers the appropriate pattern of expression to the reporter gene
      in tobacco and that a short promoter fragment (-114 to +75) containing the
      sequence TACGTGGC, homologous to plant G-box elements, is sufficient for
      developmental expression during embryogenesis. To investigate the enzymatic
      properties of the gene product the wild-type protein and a mutant carrying a
      lysine 259 to methionine substitution were overexpressed in a procaryotic system
      and purified to homogeneity. The wild-type protein exhibits aldose reductase
      activity in the reduction of DL-glyceraldehyde and D-erythrose specifically using
      NADPH as co-factor whereas the mutant shows markedly reduced activity. However,
      the barley protein possesses some properties different to those of animal aldose
      and aldehyde reductases and its biological target still needs to be identified.

PMID- 7773311
TI  - Expression of a chimeric uidA gene indicates that polycistronic mRNAs are
      efficiently translated in tobacco plastids.
AB  - Polycistronic mRNAs are the predominant form of plastid primary transcripts. To
      determine if there is internal initiation of translation of promoter-distal open
      reading frames, a promoterless uidA reporter gene was integrated into the tobacco
      plastid genome downstream of the rbcL gene. Monocistronic uidA mRNA does not
      accumulate from the promoterless uidA construct. However, due to inefficient rbcL
      transcription termination, a polycistronic transcription unit is created that
      contains the uidA gene as the second cistron. Numerous stop codons in all three
      reading frames between the rbcL and uidA coding regions ensure that translation
      of uidA initiates only from the correct start codon. The encoded reporter gene
      product, beta-glucuronidase (GUS) accumulates to high levels in the
      transplastomic plants indicating that promoter-distal cistrons can be efficiently
      translated in plastids.

PMID- 7773310
TI  - A novel Arabidopsis type 1 protein phosphatase is highly expressed in male and
      female tissues and functionally complements a conditional cell cycle mutant of
      Aspergillus.
AB  - Type 1 protein phosphatases are very highly conserved throughout eukaryotes where
      they regulate a number of key metabolic and morphogenetic processes. A cDNA,
      AtPP1bg, representing a new member of the type 1 protein phosphatase gene family
      in Arabidopsis has been isolated on the basis of hybridization with the
      Aspergillus bimG protein phosphatase gene. The AtPP1bg gene potentially encodes a
      37 kDa protein very closely related to PP1 but with divergent N- and C-termini.
      The predicted amino acid sequence shows 71% identity to the ORF of the bimG gene.
      When expressed in Aspergillus under the alcA promoter, this phosphatase
      complements the temperature-sensitive bimG11 mutation allowing nearly normal
      vegetative growth at 37 degrees C (but not at 42 degrees C). Notably, the plant
      PP1 does not support morphogenesis (conidiation) at 37 degrees C. This may
      indicate that conidophore formation has particular phosphatase requirement(s)
      which the plant PP1 cannot supply. The pattern of expression of the AtPP1bg
      transcript has been studied during development of the plant. In situ
      hybridization of Arabidopsis with antisense probes shows that this phosphatase
      gene is expressed at a low level throughout the plant, but is strongly
      upregulated within developing flowers, especially in the tapetum, the developing
      and mature pollen and in the ovaries. This implies that the AtPP1bg either has a
      specialized role in the formation of these organs, or that there is an increased
      requirement for protein phosphatase 1 at these stages. It was found that the
      level of AtPP1bg transcript, as judged by the relative intensity of staining in
      different cells within the floral meristems, did not vary during the cell cycle.

PMID- 7773312
TI  - A novel Ti-plasmid-convertible lambda phage vector system suitable for gene
      isolation by genetic complementation of Arabidopsis thaliana mutants.
AB  - A new lambda phage vector system, lambda TI, has been constructed to facilitate
      genetic complementation of higher plant mutations. The lambda TI vectors are
      stable, and by using the Cre-lox site-specific recombination, are automatically
      convertible into Ti-plasmid binary vectors which are capable of expressing genes
      in higher plants. Two lambda TI vectors were constructed: (i) lambda TI1, which
      can generate a Ti-plasmid that contains the cauliflower mosaic virus (CaMV) 35S
      promoter and is suitable for the expression of cDNA in transformed plants and
      (ii) lambda TI2, which can generate a Ti-plasmid with the multicloning site
      (MCS). cDNA and genomic libraries, which were constructed from the cruciferous
      plant Arabidopsis thaliana in these lambda TI vectors, can be probed by large DNA
      fragments of more than 100 kb, such as yeast artificial chromosomes (YACs),
      enabling the direct screening of the clones in the chromosome region containing a
      specified genetic locus. These libraries will certainly become powerful tools for
      the genetic complementation of Arabidopsis mutant phenotypes by quickly providing
      transformation-competent clones.

PMID- 7773313
TI  - Three families of thiol peptides are induced by cadmium in maize.

PMID- 7773314
TI  - Uroflowmetry in elderly men.
AB  - In the evaluation of lower-urinary-tract symptoms, uroflowmetry has played a
      major role for decades due to its noninvasiveness and simplicity to perform.
      However, several pitfalls have to be taken into account as mentioned in this
      review. They include artifacts, circadian changes, observer variation, minimal
      volume, association with infravesical obstruction, relevant variables, reference
      values, and clinical applicability. Thus, uroflow should be interpreted with
      proper caution.

PMID- 7773315
TI  - Basics of pressure-flow studies.
AB  - Pressure-flow studies of voiding contain information about urethral resistance or
      obstruction and about the detrusor contraction or contractility. A fundamental
      problem, discussed in this paper, is how to disentangle these two. A second, more
      difficult, problem is how to evaluate them in a simple, clinically useful way.
      Plots of detrusor pressure against flow rate during the course of voiding offer a
      helpful adjunct to conventional urodynamic curves showing changes with time. Many
      ways of assessing urethral obstruction from these plots have been proposed that
      have somewhat differing aims but, in practice, produce rather similar results.
      Agreement on a standard method is needed to allow the comparison of results
      obtained in different centers. Detrusor contractility has been less extensively
      studied but methods for assessing it are available.

PMID- 7773317
TI  - Analysis of bladder-outlet function with the linearized passive urethral
      resistance relation, linPURR, and a disease-specific approach for grading
      obstruction: from complex to simple.
AB  - The concept of the passive urethral resistance relation (PURR) to quantify
      bladder outflow conditions in few parameters from the complex pressure/flow
      relation is generally accepted. The most simple, yet realistic, linearized format
      is the linear PURR (linPURR). This two-dimensional format allows clear
      identification of individual outflow conditions with distinction of different
      obstruction types. Unequivocal grading of obstruction, however, requires a one
      dimensional format. Theoretical considerations show that voiding function can be
      completely defined by a single parameter only when detrusor strength and
      obstruction type are uniform. This can be achieved with a disease-specific
      approach such as our pressure/flow diagram, which is specific for prostatic
      obstruction. It allows grading of obstruction stepwise for clinical decisions
      making or on a continuous scale for statistical applications using the maximal
      flow rate with related detrusor pressure as a single data point alone. Adding the
      actual linPURR to the diagram offers the unique feature of inherent conceptual
      quality control, relevant for individual assessment. The detrusor-adjusted mean
      PURR factor (DAMPF) is an alternative format of reducing the PURR to a single
      number, excluding at least the impact of variable detrusor strength, a conceptual
      advantage when the obstruction type is less uniform. The voiding pressure at
      maximal flow is a suitable parameter for most simple obstruction grading. Its
      validity can be significantly enhanced only when it is used in a disease-specific
      format, such as our pressure/flow diagram in combination with linPURR and DAMPF.
      Computerization does not improve the results of manual graphical analysis. Much
      more important is the clear conceptual definition and transparent application.
      More sophisticated computer-dependent methods such the original PURR/DURR and the
      three-parameter model can abstract more detailed information about outflow
      conditions, which requires expertise in their application and perfect data
      quality, but this does not result in better obstruction grading.

PMID- 7773316
TI  - Analysis of pressure-flow data in terms of computer-derived urethral resistance
      parameters.
AB  - The simultaneous measurement of detrusor pressure and flow rate during voiding is
      at present the only way to measure or grade infravesical obstruction objectively.
      Numerous methods have been introduced to analyze the resulting data. These
      methods differ in aim (measurement of urethral resistance and/or diagnosis of
      obstruction), method (manual versus computerized data processing), theory or
      model used, and resolution (continuously variable parameters or a limited number
      of classes, the so-called monogram). In this paper, some aspects of these
      fundamental differences are discussed and illustrated. Subsequently, the
      properties and clinical performance of two computer-based methods for deriving
      continuous urethral resistance parameters are treated.

PMID- 7773318
TI  - A clinical view of pressure-flow studies.
AB  - Lower-urinary-tract symptoms might be due to bladder dysfunction, infravesical
      obstruction, or both, and these conditions give rise to the same type of
      symptoms. Classification of symptomatic benign prostatic hyperplasia (BPH)
      patients into obstructed or unobstructed cases can be done only by pressure-flow
      studies. This classification has been demonstrated to be of predictive value for
      the outcome of surgical treatment, both symptomatically and urodynamically.
      Pressure-flow studies are therefore helpful in the pretreatment workup of
      patients in regard to both diagnosing the underlying pathophysiology and,
      consequently, stratifying patients for different treatments or watchful waiting.
      Different methods of interpreting pressure-flow investigations share the same
      theoretical foundation and therefore have only minor differences in classifying
      patients into obstructed or unobstructed cases. The more advanced methods make a
      more differentiated classification possible, but these are currently mostly of
      theoretical value in research.

PMID- 7773319
TI  - Is there a correlation between prostate size and bladder-outlet obstruction?
AB  - This retrospective study was conducted in 521 men with micturition complaints to
      determine the relationship between prostate size and bladder-outlet obstruction.
      Analysis showed a statistically significant correlation between bladder-outlet
      obstruction and prostate size. Urodynamic bladder-outlet obstruction was
      confirmed in 90% of the patients with a prostate size of more than 80 cm3. In 32%
      of the patients with a prostate smaller than 40 cm3, no urodynamic evidence of
      bladder-outlet obstruction was found. There was no correlation between symptom
      scores (Madsen and I-PSS) and the grade of bladder-outlet obstruction or prostate
      size. We conclude that precise determination of the prostate size and urodynamics
      investigations are important (complementary) parameters in the assessment of
      elderly men with micturition complaints.

PMID- 7773320
TI  - Joint Commission update: equipment management in the environment of care.

PMID- 7773321
TI  - Comparison of D10-value accuracy by the limited Spearman-Karber procedure (LSKP),
      the Stumbo-Murphy-Cochran procedure (SMCP), and the survival-curve method (EN).
AB  - The decimal reduction time (D10) may be determined by any of several methods,
      including the limited Spearman-Karber procedure (LSKP), the Stumbo-Murphy-Cochran
      procedure (SMCP), and the survival-curve method (EN). The International
      Organization for Standardization (ISO) endorses the LSKP and the EN. Most
      Japanese and German industries utilize the SMCP and the EN for calculation of the
      D value. A presentation at an ISO meeting suggested that the SMCP was less
      accurate than the LSKP, and the ISO recommended abandoning the SMCP. The paper
      concerning the accuracy comparison among these methods has not been published.
      Therefore, in order to examine whether the SMCP was truly inferior to the LSKP,
      the Japanese delegates to the ISO compared the accuracies of D10 values obtained
      with these methods by simulation and in experimental procedures using a
      biological indicator (BI) and a biological indicator evaluator resistometer
      (BIER) with ethylene oxide gas sterilization. The results indicate that the SMCP
      was not consistently less accurate than the LSKP in determining D10.

PMID- 7773322
TI  - Glucose biosensors with enzyme entrapped in polymer coating.
AB  - The pursuit of reliable biosensors for measuring glucose levels has been ongoing
      for decades. Their importance lies partly in the development of the implantable
      artificial pancrease, which can be used to deliver insulin to diabetics without
      the need to test glucose levels externally, with automatic delivery based on
      physiologic demand. Glucose sensors can also be used in short-term monitoring of
      glucose levels in hospitals and clinical laboratories. Three types of glucose
      biosensors were studied. All were based on a two-electrode system: an insulated
      platinum wire as a hydrogen peroxide electrode, and a silver wire twisted around
      the platinum wire as both a reference and a counter electrode. Each was coated
      with the enzyme glucose oxidase entrapped in a polymer matrix of cellulose
      acetate (CA) or poly 2-hydroxyethyl methacrylate (HEMA), then dip-coated by an
      additional polymer coating of polyvinylchloride (PVC), polyurethane (PU), or
      HEMA. The experiments were designed mainly to study the effectiveness of polymer
      coatings as diffusion-limiting membranes. The effect of each coating on the
      linear response to glucose concentration was examined. It was shown that
      additional (multiple) coatings can increase the linearity of the sensor response.
      The best results were obtained when the sensor was PVC-dip-coated three times.
      This preparation had a linear response up to 600 mg/DL glucose concentration. The
      sensors coated with PU and HEMA have linearity up to 280 and 240 mg/DL glucose
      concentrations, respectively. It was also shown that the coatings reduce
      interference from certain body chemicals.

PMID- 7773323
TI  - Clinical monitoring of inhaled nitric oxide: comparison of chemiluminescent and
      electrochemical sensors.
AB  - In view of the rapidly increasing use of inhaled nitric oxide for infants with
      potentially reversible pulmonary hypertension, the ability to accurately measure
      nitric oxide and its by-products is an increasingly important safety issue. The
      authors evaluated the abilities of two chemiluminescent analyzers and two
      electrochemical sensors to detect known concentrations of nitric oxide (NO) and
      nitrogen dioxide (NO2). A calibrated mass spectrometer was utilized to determine
      the reference levels of NO2. Mass flowmeters calibrated with bubble flowmeters
      and an audited cylinder of NO were utilized to determine the levels of NO. In a
      test laboratory environment, all sensors yielded reasonably accurate measurements
      of NO. It was observed, however, that the amounts of NO recorded by the candidate
      analyzers in an 82% oxygen environment were slightly low compared with reference
      methods. The chemiluminescent analyzers consistently underread the true amounts
      of NO2 in a high-oxygen environment, producing negative concentrations on one
      instrument. Some monitors that are being clinically utilized to measure NO were
      designed for industrial and environmental applications in which the ambient
      oxygen concentrations are less than 21%. In the presence of higher oxygen
      concentrations, such analyzers can significantly underread the amounts of NO2
      that are present, possibly because of reaction quenching or other effects.
      Measurements of NO and its by-products should be performed using analyzers that
      have been appropriately tested and calibrated with known concentrations of NO and
      NO2 prior to their clinical application.

PMID- 7773324
TI  - AAMI standards program annual report, 1994.

PMID- 7773325
TI  - Red blood cell physiology.

PMID- 7773326
TI  - Managing assertively: specific tactics for clinical engineering managers.

PMID- 7773327
TI  - Clinical information systems: considerations in selecting the hospital department
      with primary responsibility.

PMID- 7773328
TI  - Mitochondrial DNA variation in an experimental stock of gilthead sea bream
      (Sparus aurata).
AB  - We present a restriction site map for the mitochondrial DNA of the gilthead sea
      bream and the consensus sequence for a region of the mitochondrial cytochrome b
      gene. Restriction site and nucleotide sequence analysis was used to obtain
      individual mitotype profiles in a broodstock used for genetic studies. Eight
      mitotypes were detected among 33 animals assayed. In combination with
      hypervariable nuclear markers, this variation can be used to identify the parents
      of any offspring in mass matings and, also, to determine which of the two parents
      donated the egg and who donated the sperm. On the basis of restriction site
      variation, the Greek stock analyzed here is very similar to an Israeli stock
      described in an earlier publication. It is not known if this similarity will hold
      when the Israeli stock is examined for sequence variation.

PMID- 7773329
TI  - Somatolactin, a novel pituitary protein: isolation and characterization from
      Sparus aurata.
AB  - The complete amino acid sequence of somatolactin, a new pituitary protein
      belonging to the growth hormone/prolactin family, from the gilthead sea bream
      Sparus aurata has been determined. Somatolactin was isolated from the pituitary
      by alkaline extraction, gel filtration on a Sephadex G-100 column, and reversed
      phase high-performance liquid chromatography (rpHPLC) on a TSK gel ODS-120T
      column. The purified protein was confirmed to be somatolactin by immunoblotting
      using chum salmon somatolactin antisera. It was found that Sparus aurata
      somatolactin consists of two forms; one form (28 kD) is probably a glycosylated
      form, while the other (25 kD) is a simple protein form, as was found also in
      Atlantic cod. The somatolactin consists of 207 amino acids that show remarkable
      conservation among fish somatolactins.

PMID- 7773330
TI  - Rapid differentiation of hyperthermophilic Archaea by restriction mapping of the
      intergenic spacer regions of the ribosomal RNA operons.
AB  - We report a sensitive and convenient method for rapid differentiation of new
      isolates of hyperthermophilic Archaea. Polymerase chain reaction (PCR) was used
      to amplify the intergenic spacer regions of the ribosomal RNA operons of eight
      Archaea. Spacer regions from one Euryarcheote, Pyrococcus furiosus, and one
      Crenarcheote, Pyrodictium brockii, were sequenced completely. Restriction
      fragment length polymorphism (RFLP) analyses were performed on the spacer regions
      from eight hyperthermophilic Archaea, and the restriction patterns were used as
      fingerprints for six known strains and two isolates. The PCR-RFLP method used in
      this study allowed the differentiation of seven of the eight strains tested and
      could be generally applicable to all the Archaea.

PMID- 7773331
TI  - Genomic basis for antifreeze peptide heterogeneity and abundance in an Antarctic
      eel pout: gene structures and organization.
AB  - Type III antifreeze protein (AFP) in the Antarctic eel pout (Lycodichthys
      dearborni) occurs as a heterogeneous family of three major and at least five
      minor variants collectively maintained at high year-round blood levels (> 20
      mg/ml). Two major AFPs (RD1, RD2) are 7 kD in size, and the third (RD3) is 14 kD
      and is composed of two 7-kD AFP domains linked by a 9-residue connector. The
      genomic basis for the heterogeneity and abundance of these AFPs was investigated
      in this study. Genomic library screening statistics and restriction mapping
      analyses of 16 genomic clones together indicate an AFP gene family of over 40
      genes, which would provide a sizable gene dosage for high AFP output. Two genomic
      clones, each containing 2 AFP genes, were characterized in detail. Three of the
      genes, were characterized in detail. Three of the genes encode the 7-kD AFP RD2,
      and are arrayed in direct 8.3-kb tandem repeats. The three gene sequences are
      nearly 100% identical for a distance of over 3 kb (inclusive of 1.7-kb 5' and 1
      kb 3' flanking sequences), indicating strong selective pressure from the freezing
      Antarctic waters on maintaining functionality of AFP genes for producing adequate
      levels of AFPs for survival. The fourth AFP gene has multiple exons and
      translates into a multimeric AFP composed of at least six 7-kD AFP domains
      successively linked a 9-residue connector sequence similar to that of the dimeric
      14-kD AFP, RD3. The presence of an unusually large (2.7-kb) AFP messenger RNA
      beside two small ones (0.9 kb and 0.7 kb) in Northern blot of liver RNA is
      consistent with the presence of a large functional multiexon AFP gene.
      Substantial sequence identity (83%) between the 1.2-kb introns of the multiexon
      AFP gene and the intron and 5' flanking sequences of RD2 genes suggests that the
      former could arise from recombinant events that linked two adjacent 7-kD AFP
      genes in the 8.3-kb tandem repeats followed by duplication events to produce the
      multiple exons.

PMID- 7773332
TI  - Maternal and embryonic provenance of a sea urchin embryo transcription factor,
      SpZ12-1.
AB  - SpZ12-1 is a zinc-finger transcription factor. Previous work has indicated that
      this factor functions late in embryogenesis as a spatial transcriptional
      repressor. We show here that this factor is present in significant quantities
      even in unfertilized egg cytoplasm, and in similar quantities in mesenchyme
      blastula-stage embryo cytoplasm. Taken together with earlier measurements of
      Calzone and associates, our observations indicate that SpZ12-1 enters the
      embryonic nuclei between late cleavage and mesenchyme blastula stages. A low
      prevalence mRNA encoding SpZ12-1 is also present throughout development.
      Translation of this mRNA could, however, easily account for the complete
      complement of SpZ12-1 protein in the embryo, as estimated from its DNA binding
      activity. SpZ12-1 probably functions at several developmental stages and is
      evidently of both maternal and embryonic provenance.

PMID- 7773333
TI  - Development of a rainbow trout pituitary cell line that expresses growth hormone,
      prolactin, and somatolactin.
AB  - A cell line, RTP-2, has been developed from a normal-appearing pituitary of an
      adult rainbow trout. The cells grow in L-15 basal medium, supplemented with 2.5%
      to 10% fetal bovine serum, and have been passaged approximately 50 times over a 2
      year period. At low density the cells have a stellate shape, whereas at
      confluency islands of polygonal cells appear among a tangle of bipolar cells. At
      the ultrastructural level, most cells contain numerous lysosomes, autophagic
      vacuoles, and intermediate filaments, but no obvious secretory granules. Reverse
      transcription-polymerase chain reaction (RT-PCR) with oligonucleotides specific
      for growth hormone (GH), prolactin (PRL), and somatolactin (SL) as amplification
      primers and Southern blot hybridization of the PCR products with probes specific
      for GH, PRL, and SL demonstrate that this cell line expresses GH, PRL, and SL.
      Digestion of the GH product of RT-PCR with restriction endonuclease SalI or KpnI
      confirms that both rainbow trout growth hormone genes are expressed in this cell
      line.

PMID- 7773334
TI  - Two ferritin subunits of Atlantic salmon (Salmo salar): cloning of the liver
      cDNAs and antibody preparation.
AB  - The ferritin heavy (H) and middle (M) subunit cDNAs were isolated from the
      Atlantic salmon (Salmo salar) liver. Full-length clones encoding the ferritin M
      subunit of 176 residues were obtained by screening of a liver cDNA library. The
      evolutionary conserved iron-responsive element (IRE) was identified in the
      upstream untranslated region. Ferritin H cDNA was cloned by running reverse
      transcription-polymerase chain reaction (RT-PCR) on salmon liver mRNA. The salmon
      ferritin H subunit of 177 residues showed 67% sequence identity with the M
      subunit. Northern blot analysis revealed ferritin H mRNA in the liver, gonads,
      head kidney, heart, and spleen, whereas M subunit mRNA was found almost
      exclusively in the gonads. Polyclonal antibodies against both salmon ferritin H
      and M were raised in rabbits.

PMID- 7773335
TI  - Sequence analysis of a cDNA encoding an isotocin precursor and localization of
      the corresponding mRNA in the brain of the cartilaginous fish Torpedo marmorata.
AB  - The nucleotide sequence of a cDNA encoding an isotocin hormone precursor has been
      elucidated by analyzing a lambda ZAPII library constructed using poly(A)+ RNA
      from the brain of the cartilaginous fish Torpedo marmorata. The sequence predicts
      a precursor of 126 amino acid residues that consists of a signal peptide, the
      isotocin moiety, and a neurophysin carrier protein. In contrast to other known
      fish isotocin precursor sequences, the Torpedo neurophysin moiety is not extended
      at its carboxy-terminus by a copeptin-like sequence. The T. marmorata isotocin
      precursor exhibits highest amino acid sequence identity (61%) to the toad
      mesotocin precursor. As demonstrated by in situ hybridization, the isotocin mRNA
      is present in neurons of the preoptic area of the Torpedo brain.

PMID- 7773337
TI  - The changing and challenging ICU.

PMID- 7773336
TI  - A divergent cDNA homologue of the c-myc proto-oncogene in the eastern oyster
      Crassostrea virginica: implications for Myc evolution.
AB  - The polymerase chain reaction was used to identify myc-like cDNA fragments from
      several marine invertebrate phyla. A PCR clone produced from the eastern oyster
      Crassostrea virginica was subsequently used to screen a larval cDNA library, and
      a 1.9-kb cDNA clone was isolated and sequenced. The putative amino acid sequence
      encoded by this clone evidences a leucine zipper at its predicted carboxyl
      terminus and has an overall structural similarity to vertebrate c-myc proto
      oncogenes with several regions of high amino acid similarity. However, this
      oyster cDNA clone lacks the necessary amino acid conservation in the critical
      functional domains of Myc and thus is unlikely to function intracellularly in the
      oyster as a true homologue of vertebrate c-myc. We propose that the oyster cDNA
      clone described here represents a gene that has been derived from the same
      ancestral gene that eventually gave rise to vertebrate c-myc. Despite the
      apparent critical importance of the c-myc proto-oncogene in regulating cellular
      activities, these data suggest that the c-myc gene: (1) is unique to deuterostome
      phyla, and (2) assumed its critical role in regulating cell cycle activities at
      the divergence of the deuterostome ancestors from other protostomes during the
      Cambrian explosion. In support of these conclusions we present a functional model
      for the evolution of the Myc gene.

PMID- 7773339
TI  - Getting smarter--with a little help from the store.

PMID- 7773338
TI  - The impact of reengineering on inpatient nursing.

PMID- 7773340
TI  - Meeting the challenge of elder mistreatment.

PMID- 7773341
TI  - Establishment of primary epithelial cell culture from elutriated rat gastric
      mucosal cells.
AB  - Proliferating cells in the gastric mucosal epithelium were successfully enriched
      by counterflow elutriation in a medium-sized cell fraction. When inoculated on
      culture plates coated with E-C-L cell attachment matrix, these cells
      differentiated into mucus-producing cells after reaching confluence. Northern
      blot analysis did not detect any transcript of the proton pump, histidine
      decarboxylase, somatostatin, or pepsinogen I, indicating the absence of parietal,
      ECL, D, and chief cells in the confluent monolayer. These mucus-producing cell
      monolayers that respond to various growth factors may be a suitable model with
      which to investigate the function of gastric mucus cells in vitro.

PMID- 7773342
TI  - Effect of cold-restraint stress on immunoreactive thyrotropin-releasing hormone
      and immunoreactive somatostatin in the rat stomach.
AB  - The effects of cold-restraint stress on immunoreactive thyrotropin-releasing
      hormone (ir-TRH) and immunoreactive somatostatin (ir-SOM) concentrations in the
      rat stomach were investigated. Rats immobilized with a spring-loaded metallic
      plate were placed in a room maintained at 4 degrees C for 1-3 h and then
      decapitated serially for investigation. Gastric ir-TRH and ir-SOM concentrations
      were measured by individual radioimmunoassays. Cold-restraint stress induced
      gastric mucosal lesions as well as a decrease of the ir-TRH concentration in the
      glandular stomach, an increase of the ir-TRH concentration in the gastric juice,
      and a decrease in gastric pH. In contrast, this stress caused an increase of ir
      SOM in the glandular stomach and a decrease of ir-SOM in the gastric juice.
      However, cold or restraint stress alone did not induce gastric mucosal lesions or
      changes in gastric ir-TRH and ir-SOM concentrations or the gastric pH. To clarify
      the endocrine influence of peripheral TRH, pretreatment with thyroid hormone was
      performed to inhibit elevation of the serum TRH level during cold-restraint
      stress. Despite this pretreatment, cold-restraint stress still induced ulcer
      formation, along with changes in gastric ir-TRH and ir-SOM concentrations and
      gastric pH. These findings suggest that changes in gastric ir-TRH and ir-SOM
      concentrations may be closely related to ulcer formation due to cold-restraint,
      and that TRH may act in a paracrine manner in the stomach.

PMID- 7773343
TI  - Topographic study of Helicobacter pylori and HLA-DR antigen expression on gastric
      epithelium.
AB  - Helicobacter pylori and HLA-DR antigen expression on gastric epithelium,
      identified by an indirect immunoperoxidase staining method using monoclonal
      antibodies against H. pylori and HLA-DR antigens, were studied topographically.
      Fifty-nine biopsy specimens from 41 patients who had neither gastric cancer nor
      peptic ulcers were examined. H. pylori was observed predominantly over or on the
      surface epithelium, while HLA-DR antigens were frequently expressed on the
      epithelium of the isthmus region. These observations led to the conclusion that
      there was no direct topographic association between H. pylori and epithelial HLA
      DR expression. However, the frequency of HLA-DR expression in H. pylori-positive
      (28/29) specimens was significantly higher than that in H. pylori-negative
      (18/30) specimens (P < 0.01). Furthermore, a greater number of H. pylori was
      associated with a stronger expression of HLA-DR antigens (P < 0.001). We conclude
      that H. pylori is indirectly related to HLA-DR expression on gastric epithelium.
      H. pylori is the first microbial agent that has been suggested to be associated
      with epithelial HLA-DR expression in the human gastrointestinal tract.

PMID- 7773344
TI  - Diagnosis of gastric adenocarcinoma using a scoring system: combined assay of
      serological markers of Helicobacter pylori infection, pepsinogen I and gastrin.
AB  - This study was carried out to develop a scoring system for the diagnosis of
      gastric adenocarcinoma (GAC). A total of 686 subjects, 150 patients with GAC, 182
      with gastric ulcer, 127 with duodenal ulcer, and 227 subjects with negative
      findings, were enrolled. Analysis of the likelihood ratio (LR) showed that
      patients with advanced age, ulcer in the stomach, low serum levels of pepsinogen
      I (PGI), low PGI x gastrin values, and low PGI/gastrin ratio were likely to have
      GAC. Of these indicators, the serum PGI level had the greatest weight, with a LR
      of 7.59 for the group with a level < 30 ng/ml. A scoring system combining serum
      PGI level, Helicobacter pylori seropositivity, and gastric ulcer status was
      derived, using a logistic regression model. This scoring system was found to be
      better than any one-parameter criterion for diagnosing GAC after evaluation by
      the area under the receiver operating characteristic curve (0.84; 95% confidence
      interval, 0.81-0.88) or by specificity-fixed sensitivity (sensitivity 0.82 at
      specificity 0.72, sensitivity 0.87 at specificity 0.66, sensitivity 0.96 at
      specificity 0.44). This scoring system may be potentially useful as a new model
      for the noninvasive diagnosis of GAC in the future.

PMID- 7773345
TI  - Correlation of DNA content between endoscopic biopsy and surgically resected
      specimens in gastric and colorectal cancer.
AB  - To investigate DNA heterogeneity and the consistency of DNA content between
      endoscopic biopsy and the corresponding resected specimens, the DNA content of
      749 different samples from 30 gastric and 30 colorectal cancers was analyzed and
      the results were compared with those obtained from endoscopic biopsy specimens.
      The incidence of DNA heterogeneity was 33% in patients with gastric cancer and
      40% in those with colorectal cancer. Most of the cases of heterogeneity were
      caused by differences in DNA indices in aneuploidy. The consistency of DNA ploidy
      pattern between endoscopic biopsies and the corresponding resected specimens was
      100% in both gastric and colorectal cancer, while the consistency in the DNA
      index of aneuploid tumors was approximately 90%. From these results, it seems
      possible that analysis of the DNA content of a biopsy specimen could provide an
      adequate measure of the DNA content of the corresponding resected specimen.

PMID- 7773346
TI  - Epidermal growth factor enhances repair of rat intestinal mucosa damaged by oral
      administration of methotrexate.
AB  - To examine the trophic effect of epidermal growth factor on the rat small
      intestine, we measured diamine oxidase and ornithine decarboxylase activities in
      intestinal mucosa injured by methotrexate. Methotrexate was infused orally via a
      gastric tube at a dose of 10 mg/kg per day on 3 successive days (days 1-3).
      Epidermal growth factor was injected intraperitoneally at a dose of 40
      micrograms/kg per day on 4 successive days following methotrexate infusion (days
      4-7). Methotrexate caused a marked decrease in diamine oxidase activity; this
      decrease returned to a normal level on day 13 in controls. In rats injected with
      epidermal growth factor, diamine oxidase activity began to recover earlier than
      in the controls, and returned to a normal level on day 11. Epidermal growth
      factor enhanced the increase of ornithine decarboxylase activity in mucosa
      injured by methotrexate. When the increase of ornithine decarboxylase activity
      was suppressed by alpha-difluoromethylornithine, epidermal growth factor failed
      to facilitate the repair of intestinal mucosa. These results indicate that
      epidermal growth factor enhances intestinal repair following methotrexate
      infusion, and that this effect is mediated, at least in part, by ornithine
      decarboxylase. It is proposed that epidermal growth factor can be used clinically
      as a means to enhance mucosal repair of the intestine after chemotherapy with
      methotrexate.

PMID- 7773347
TI  - Significance of superoxide dismutase (SOD) in human colorectal cancer tissue:
      correlation with malignant intensity.
AB  - The significance of superoxide dismutase (SOD) activity in colorectal cancer
      tissue was determined from the aspect of the antioxidant defense system. SOD
      activity and thiobarbituric acid reactive substance were measured in the tumor,
      in tissues adjacent to the tumor, and in regions that appeared normal, and the
      results were analyzed in terms of various histopathological factors (stage of
      disease, depth of invasion, venous invasion, etc.). DNA ploidy pattern and cell
      proliferation in cancer tissue were also measured, and the results analyzed in
      relation to SOD activity. SOD activity in cancer tissue was higher than in the
      other two regions. SOD activity in cancer tissue increased with the progression
      of stage, and changed with the depth of invasion. There was a significant
      difference in SOD activity between patients with venous invasion and those in
      whom this was absent. Stepwise regression analysis suggested that venous invasion
      was the most significant factor influencing SOD activity. The proliferation index
      was high in cancer tissue with low SOD activity. The incidence of aneuploidy was
      high in cancer with high SOD activity, whereas the incidence of diploidy was high
      in cancer with low SOD activity. These results suggest that elucidation of the
      antioxidant system in cancer tissue can provide us with a better strategy for
      cancer treatment.

PMID- 7773348
TI  - Colonic mucosal hemodynamics and tissue oxygenation in patients with ulcerative
      colitis: investigation by organ reflectance spectrophotometry.
AB  - Colonic mucosal hemodynamics were investigated at the rectosigmoidal region of
      the colon in 46 patients with ulcerative colitis and in 18 normal subjects by
      organ reflectance spectrophotometry under colonoscopy. The value for the index of
      mucosal hemoglobin concentration (IHb) was significantly higher, and value for
      the index of mucosal hemoglobin oxygen saturation (ISO2) was significantly lower
      in patients with active ulcerative colitis than values in the normal controls or
      in patients with inactive ulcerative colitis. The results indicate mucosal
      congestion and hypoxemia in patients with active ulcerative colitis. The changes
      in IHb and ISO2 correlated well with the severity of ulcerative colitis scored by
      endoscopic findings and with the number of infiltrating inflammatory cells in the
      mucosa analyzed histologically in biopsy samples. In conclusion, the colonic
      mucosal microcirculation in patients with active ulcerative colitis was disturbed
      and showed congestion and hypoxemia. The analysis of hemodynamic changes may be
      helpful for assessing the activity of ulcerative colitis.

PMID- 7773350
TI  - Clinicopathologic studies of immunologic fecal occult blood test for colorectal
      cancer.
AB  - In our hospital, 83 patients with colorectal cancer underwent the immunologic
      fecal occult blood test (IFOBT). The positive rate for IFOBT in all patients was
      87%. Colon cancers more proximal than the transverse colon were 100% positive.
      Carcinomas of the ulcerative type showed a significantly higher positive rate
      than those of the non-ulcerative type (94% vs 73%). Carcinomas penetrating the
      muscularis or beyond showed a significantly higher positive rate, of 96% (52/54
      cases) compared to carcinomas confined to the mucosa or submucosa, which gave
      positive rates of 64% and 60%, respectively. In the investigation of the 7
      patients with colorectal cancer who showed negative results on the IFOBT, IFOBT
      had been performed only once in of these patients. Accordingly, it was considered
      necessary to perform IFOBT more than once. The cancers in 5 of these 7 patients
      were found to be carcinomas confined to the mucosa. This result suggests the
      advisability of annual IFOBTs. It is also considered necessary to manage patients
      who show undefinable but possibly positive (+/-) results with caution.

PMID- 7773349
TI  - A study of the histological criteria for ulcerative colitis: retrospective
      evaluation of multiple colonic biopsies.
AB  - It is clinically important to distinguish idiopathic inflammatory bowel disease
      (IBD) from other colitides, and ulcerative colitis (UC) from Crohn's disease
      (CD); however only a few histological criteria based on colonic biopsies have
      been established. We investigated 209 consecutive series of biopsies taken from
      38 patients with UC, 12 with CD, and 105 with other colitides, to evaluate
      whether combinations of histological features, selected on the basis of our
      experience, and listed below, could be useful criteria for the differential
      diagnosis of IBD, and, more specifically, of UC: (A) chronic inflammation with a
      predominant increase of plasma cells, (B) crypt distortion, (C) crypt atrophy,
      (D) diffuse chronic inflammation within a biopsy and between biopsies, and (E)
      diffuse mucin depletion within a biopsy and between biopsies. Findings that
      fulfilled all or two of A-C distinguished IBD from the other colitides with high
      sensitivity (94.3%) and specificity (95.8%). When the findings fulfilled the
      additional criteria of D and/or E, UC was differentiated from CD or the other
      colitides with high sensitivity (86.4%) and specificity (99.3%).

PMID- 7773351
TI  - Antibody-dependent cell-mediated cytotoxicity against cell lines generated by
      liver-specific idiotype-bearing antibody.
AB  - We produced a murine monoclonal antibody (mAb), designated H2-mAb, against a
      fractionated soluble phase of human liver homogenate which antibody reacted with
      human liver cells. A human antibody possessing the same idiotype as the H2-mAb,
      designated LSIA (liver-specific idiotype-bearing antibody), can be measured by a
      sandwich enzyme-linked immunosorbent assay, using the anti-H2 idiotype antibody.
      The serum level of LSIA in patients with histologically proven chronic hepatitis
      (CH) was significantly higher than that in healthy subjects and it was also
      higher than that in subjects with other diseases, including systemic lupus
      erythematosus. In a comparison between patients with CH type B and those with CH
      type C, there was no significant difference in serum levels of LSIA. It was
      possible to purify LSIA from the sera of patients with CH. The purified LSIA
      bound to the human cell lines Chang and HCC-M, derived from liver cells and a
      hepatoma respectively, but not to HeLa cells, a uterine carcinoma derivative. The
      reactivity of this mAb to HCC-M was weaker than that to Change. Moreover, the
      presence of LSIA caused an antibody-dependent cell-mediated cytotoxic challenge
      against Change cells in vitro.

PMID- 7773352
TI  - Genotype distribution in Nagoya and new genotype (genotype 3a) in Japanese
      patients with hepatitis C virus.
AB  - We evaluated hepatitis C virus (HCV) genotype distribution among Japanese
      patients in the city of Nagoya and the possible existence of any other genotype
      not determined by Okamoto's method. Eighty-five of 93 (91.4%) anti-HCV-positive
      patients had detectable HCV RNA. The genotype of the HCV isolate was determined
      in 84 of 85 (98.8%) of these HCV RNA-positive patients by Okamoto's method but
      determination was not possible in one (1.2%). Genotype 1b was detected in 58 of
      the 85 patients (68.2%), genotype 2a in 20 (23.5%), genotype 2b in 3 (3.5%), and
      genotype 1b + 2a in 3 (3.5%). In the remaining 1 patient in whom the genotype
      could not be determined, we determined the nucleotide sequence of the core region
      in HCV RNA extracted from this patient and evaluated it by molecular evolutionary
      analysis. This HCV isolate was then classified as genotype 3a. These results
      suggest that genotype 3a is rare among Japanese patients with HCV; thus, when
      classifying Japanese isolates, we should take more care because genotype 3a is
      not determined by current typing systems.

PMID- 7773353
TI  - Transcatheter arterial chemoembolization therapy with epirubicin hydrochloride,
      mitomycin C-iohexol-Lipiodol emulsion (EMILE) for hepatocellular carcinoma.
AB  - The efficacy of transcatheter arterial Lipiodol chemoembolization (TALCE) using
      epirubicin hydrochloride, mitomycin C-iohexol-Lipiodol emulsion (EMILE) for
      hepatocellular carcinoma (HCC) was assessed retrospectively. EMILE was confirmed
      to have characteristics of fair dispersibility, stability, and slow drug release
      in vitro prior to clinical administration. TALCE without EMILE (simple infusion
      of anticancer drugs and Lipiodol) and with EMILE were preoperatively performed in
      two groups of candidates for hepatectomy, consisting of 17 patients each (non
      EMILE and EMILE groups). Mean percentages of Lipiodol retention area to tumor
      area on computed tomographic (CT) scan following TALCE were 46.8 +/- 38.4% and
      91.5 +/- 13.2% (mean +/- SD), respectively (P = 0.0005). Mean percentages of
      necrotic area to tumor area determined on histologic study of specimens were 42.9
      +/- 43.8% and 63.2 +/- 44.0%, respectively (NS). In conclusion, TALCE with EMILE
      brought about longer retention of Lipiodol in HCC; however, gelatin sponge cubes
      and a higher dose of epirubicin hydrochloride were more significantly related to
      tumor necrosis than treatment with EMILE.

PMID- 7773354
TI  - Effects of cisapride on gallbladder emptying and pancreatic polypeptide and
      cholecystokinin release in humans.
AB  - We investigated the effects of cisapride on gallbladder motility and on the
      release of pancreatic polypeptide and cholecystokinin in the fasting and
      postprandial states. Cisapride (7.5 mg) and/or a test meal was administered
      intraduodenally to seven healthy volunteers with or without atropine pretreatment
      (0.5 mg, i.m.). In the fasting state, cisapride increased gallbladder volume to
      154% of the basal level, and significantly elevated plasma pancreatic polypeptide
      levels. The effects of cisapride were inhibited by atropine. In the postprandial
      state, integrated pancreatic polypeptide and cholecystokinin responses were
      increased by cisapride to 180% and 192%, respectively, of control values.
      Atropine inhibited the integrated gallbladder and pancreatic polypeptide response
      to about 60% of the control value, but did not affect the cholecystokinin
      response. These observations suggest that: (1) fasting gallbladder tone is
      influenced by cholinergic inhibitory mechanisms, (2) acetylcholine (ACh) is the
      final mediator for about 40% of the postprandial gallbladder emptying and
      pancreatic polypeptide response, and (3) coordination between the ACh-independent
      cholecystokinin response and ACh-dependent pancreatic polypeptide response may be
      important in the regulation of postprandial gallbladder emptying.

PMID- 7773355
TI  - Endoscopic injection sclerotherapy for esophageal variceal hemorrhage in
      myeloproliferative disorder: case report.
AB  - A 70-year-old woman with myeloproliferative disorder and massive splenomegaly
      presented with hematemesis. Emergency endoscopy demonstrated bleeding from
      esophageal varices. Management of variceal hemorrhage by endoscopic injection
      sclerotherapy, using 5% ethanolamine oleate, was successful. Following the
      control of variceal bleeding, she was treated with hydroxyurea, a
      myelosuppressive agent. The spleen size markedly decreased and she was discharged
      3 months later. Variceal hemorrhage in myeloproliferative disorder has been
      reported to be fatal on many occasions, despite different therapeutic approaches,
      including surgery. In this report, we demonstrated that endoscopic injection
      sclerotherapy followed by treatment with a myelosuppressive agent was effective
      in a patient with myeloproliferative disorder and variceal hemorrhage.

PMID- 7773356
TI  - A case of early gastric malignant lymphoma diagnosed and completely resected by
      strip biopsy.
AB  - A case of early gastric malignant lymphoma definitively diagnosed by strip biopsy
      is reported. The subsequent operation revealed that the strip biopsy had resulted
      in radical resection. A 55-year-old woman visited our hospital for detailed
      examination of a small gastric lesion. Histologic findings of the specimens
      obtained by conventional forceps biopsy indicated reactive lymphoid hyperplasia,
      although the possibility of malignant lymphoma was not completely ruled out.
      Strip biopsy was, therefore, performed to establish a definitive diagnosis.
      Histopathological examinations of the strip biopsy specimen revealed definitive
      findings of malignant lymphoma, which was B-cell phenotype immunocytochemically.
      The margin of the resected specimen was free of invasion by malignant lymphoma
      and no lymph node involvement was suggested by endoscopic ultrasonography,
      computed tomography, and gallium scintigram. Subtotal gastrectomy was
      subsequently performed to rule out the possibility of remaining malignant
      lymphoma cells. It was proven that the strip biopsy removed the lesion completely
      and no perigastric lymph nodes were involved. While is still controversial as to
      whether strip biopsy should be adopted for the radical resection of early gastric
      lymphoma, this procedure can definitely provide excellent specimens for the
      accurate diagnosis of gastric malignant lymphoma and probably for group III
      lesions in the stomach.

PMID- 7773357
TI  - A case of mesenteric venous thrombosis after endoscopic variceal band ligation.
AB  - A rare case of isolated superior mesenteric venous thrombosis (MVT) after
      endoscopic variceal band ligation (EVL) is reported. A 64-year-old woman with a
      history of idiopathic portal hypertension presented at the emergency room with
      vomiting, increasing cramping abdominal pain, and low-grade fever. She had
      undergone EVL for esophageal varices 4 months before and had had intermittent
      attacks of mild abdominal pain after the EVL. Ultrasonogram of the abdomen
      demonstrated marked concentric wall thickening of the ileal loop. Enhanced
      computed tomographic (CT) scan revealed a central lucency in the lumen of the
      superior mesenteric vein, surrounded by a high-density vein wall, corresponding
      to a thrombus. An isolated MVT and venous collateral network in the splanchnic
      area were confirmed by angiography. Supportive therapy, i.e., water and
      electrolyte replacement, and anticoagulation improved the clinical condition and
      radiologic status. This case of MVT after EVL suggests a possible relationship
      between EVL and MVT. It is necessary for clinicians to be aware of this
      relationship for the early diagnosis of MVT.

PMID- 7773358
TI  - DNA aneuploidy in a case of rectosigmoid adenocarcinoma complicated by ulcerative
      colitis.
AB  - A case of Borrmann type IV colorectal adenocarcinoma detected as a complication
      of long-standing ulcerative colitis is reported. Barium enema and colonoscopy
      disclosed a stenotic area associated with a tumoral mass and a flat elevated
      lesion in the rectosigmoid region and a submucosal tumor-like lesion in the
      rectum. Total colectomy was performed and histological studies demonstrated a
      moderately differentiated adenocarcinoma accompanied by high- and low-grade
      dysplasia. DNA ploidy pattern analysis showed aneuploidy in the adenocarcinoma
      and high-grade dysplasia, but diploidy in the normal and atrophic mucosa and in
      low-grade dysplasia. DNA aneuploid content was associated with the presence of
      colorectal carcinoma complicating ulcerative colitis, indicating that DNA content
      studies should be included in screening programs to detect early colorectal
      carcinoma following this disease, as a complementary study to histological
      assessment.

PMID- 7773359
TI  - A case of spindle cell sarcomatous change of hepatic ducts manifesting as
      obstructive jaundice.
AB  - Spindle cell carcinoma is a rare tumor commonly occurring in the upper
      aerodigestive tract. We report a 62-year-old male with spindle cell sarcomatous
      change located at the hepatic hilum, resulting in obstructive jaundice. The
      patient died after an extended resective operation. The rare disease and its
      histogenesis is discussed.

PMID- 7773360
TI  - A case of AIDS-related hepatic Kaposi's sarcoma.
AB  - In Japan, Kaposi's sarcoma (KS) is a very rare neoplasm. However, it does occur
      as one of the complications in patients with acquired immunodeficiency syndrome
      (AIDS). AIDS-related KS commonly involves the skin, lymph nodes, and
      gastrointestinal tract. Hepatic KS is sometimes observed in AIDS patients at
      autopsy, but it is very rarely diagnosed during life. We report a case of hepatic
      KS in an AIDS patient, detected by ultrasonography (US), computed tomography
      (CT), and magnetic resonance imaging (MRI) during life and proven at autopsy.
      Abdominal US revealed multiple hyperechoic tumors along the portal vein. CT scan
      showed low density and delayed enhancement by contrast material. These tumors
      were revealed as a low intensity area on a T1-weighted image of MRI and as a high
      intensity area on T2-weighted and proton density images. US, CT scan, and MRI
      revealed characteristic findings of hepatic KS. These procedures are very useful
      for the diagnosis of hepatic KS. To our knowledge, this is the first report of
      hepatic KS in Japan.

PMID- 7773361
TI  - The effect of E3330 on active oxygen generation by isolated hepatic macrophages
      in rats.

PMID- 7773363
TI  - Clinical applications of two-dimensional electrophoresis.
AB  - Two-dimensional electrophoresis is increasingly being used as an important tool
      for biological research although it continues to have few direct clinical
      applications. In the absence of simple systems to identify and quantify
      individual proteins or groups of proteins it is unlikely that clinical
      applications will increase. Measurement of some individual proteins, for example
      a single acute phase reactant, often yields as much clinically useful information
      as could be currently expected from quantitation of several proteins with the
      same physiological role. Cost-containment pressures within the clinical
      laboratory will prevent the technique from becoming widely used in the clinical
      laboratory until it can clearly demonstrate that it can produce clinically
      important and necessary information that can not be obtained by other means. We
      continue to believe that the technique's greatest potential lies in identifying a
      protein or proteins whose concentration can be correlated with a disease and
      whose concentration varies with the progress of the disease. Antibodies to such
      proteins can then be produced and used to quantify the disease-associated
      proteins by a simple procedure, such as nephelometry. In spite of our belief of
      the likely clinical application of the technique there appears to be no
      systematic use of two-dimensional electrophoresis for this purpose. With clinical
      specimens a few investigators still run gels of serum or urine from patients with
      apparently unusual disorders and compare them visually with gels from healthy
      individuals. Nevertheless, the technique continues to have considerable unmet
      promise for clinical applications.

PMID- 7773362
TI  - Role of endothelin in the development of hemorrhagic pancreatitis in rats.

PMID- 7773364
TI  - Protein mutations revealed by two-dimensional electrophoresis.
AB  - High-resolution two-dimensional electrophoresis (2DE) can resolve many hundreds
      of proteins present in complex mixtures depending on the method of detection.
      These proteins can be characterised qualitatively, with respect to their
      electrophoretic mobilities (i.e. charge and apparent molecular mass) and
      quantitatively, using densitometry, to determine their amounts. There has been a
      widespread application of 2DE in the analysis and characterisation of protein
      mutations for a range of organisms. This review presents examples of the use of
      2DE to study naturally occurring protein mutations and polymorphisms as well as
      the characterisation of induced protein mutations in prokaryotes and eukaryotes.
      Examples are presented to illustrate the use of 2DE to detect mutations affecting
      the electrophoretic mobility and biosynthesis of individual proteins as well as
      mutations leading to global alterations in cellular protein synthesis. The
      advantages and disadvantages of 2DE in the detection of protein mutations are
      discussed.

PMID- 7773365
TI  - Non-denaturing gel electrophoresis of biological nanoparticles: viruses.
AB  - Although gel electrophoresis is usually used for the fractionation of
      monomolecular particles, it is also applicable to the fractionation of the
      multimolecular complexes produced during both cellular metabolism and assembly of
      viruses in virus-infected cells. Gel electrophoretic procedures have been
      developed for determining both the size of a spherical particle and some aspects
      of the shape of a non-spherical particle. Capsids bound to DNA outside of the
      capsid can also be both fractionated and characterized. The procedures developed
      will be used for screening viral mutants; they also can potentially be used for
      diagnostic virology. Sensitivity of detection, the major current limitation, is
      being improved by use of both improved stains and scanning fluorimetry. The gels
      used for fractionation sometimes approximate random straight fiber gels, but
      become increasingly biphasic as the gel concentration is decreased.

PMID- 7773366
TI  - Polyacrylamide gel electrophoretic methods in the separation of structural muscle
      proteins.
AB  - Polyacrylamide gel electrophoresis plays a major role in analyzing the function
      of muscle structural proteins. This review describes one- and two-dimensional gel
      electrophoretic methods for qualitative and quantitative investigation of the
      muscle proteins, with special emphasis on determination of protein
      phosphorylation. The electrophoretic studies established the subunit structures
      of the muscle proteins, characterized their multiple forms, revealed changes in
      subunit composition or shifts in isoform distribution of specific proteins during
      development, upon stimulation or denervation of the muscle. Protein
      phosphorylation during muscle contraction is preferentially studied by two
      dimensional gel electrophoresis. The same method demonstrated protein alterations
      in human neuromuscular diseases.

PMID- 7773368
TI  - Protein separation techniques in the study of tissue regeneration.
AB  - The present report reviews the use of protein separation by means of two
      dimensional gel electrophoresis in the study of tissue regeneration. It is shown
      that such an approach can provide data on protein synthesis in different stages
      of limb regeneration or comparative data with other regenerative processes such
      as tail and lens regeneration. Such an approach is more realistic than other
      methods employing gene cloning or generation of antibodies and can lead to the
      actual identification and characterization of factors that are involved in these
      phenomena.

PMID- 7773367
TI  - Advances in agarose gel electrophoresis of serum lipoproteins.
AB  - Agarose gel electrophoresis has been extensively employed by researchers to gain
      a greater understanding of lipoprotein biology and its relationship to
      cardiovascular disease. Advances in this technique have been made in the
      visualization and quantitation of separated lipoproteins, in the use of agarose
      gel electrophoresis for detection and quantitation of apolipoproteins of the
      separated lipoproteins, and in the detection of lipoprotein heterogeneity.
      Agarose gel electrophoresis has been employed for two-dimensional electrophoretic
      analysis of lipoproteins as well as in several different methods which probe the
      immunological properties of lipoproteins. Agarose gel electrophoresis has thus
      become an important tool in the study of serum lipoproteins in both clinical and
      basic science laboratories.

PMID- 7773370
TI  - Education on abortion urged.

PMID- 7773369
TI  - Injection bias of DNA fragments in capillary electrophoresis with sieving.
AB  - The relative amounts of DNA fragments in a mixture injected into the capillary by
      electromigration or hydrodynamically by pressure were compared. Even if the
      electrophoretic mobilities of DNA fragments with different sizes are the same in
      a free solution in the sample vial, the size bias is brought about by the
      different mobilities in a sieving medium and by the electroosmosis. The
      experiments were performed in capillaries filled with a solution of liquified
      agarose, a replaceable sieving medium. The experimental results were compared
      with a theoretical model.

PMID- 7773371
TI  - Understanding rostering. Part 1. The rights & wrongs of rostering.

PMID- 7773372
TI  - The sun the moon & the stars.

PMID- 7773373
TI  - Competence is more than just standards.

PMID- 7773374
TI  - Sharing sorrow--a new beginning.

PMID- 7773375
TI  - The rise and fall of blood pressure measurements.

PMID- 7773379
TI  - Physiological roles of leupeptin and extracellular proteases in mycelium
      development of Streptomyces exfoliatus SMF13.
AB  - Streptomyces exfoliatus SMF13 produced leupeptin, chymotrypsin-like protease
      (CTP), metalloprotease, and trypsin-like protease (TLP) extracellularly. The
      activity of TLP was specifically inhibited by leupeptin. Production of leupeptin
      was closely associated with growth but leupeptin was inactivated by leupeptin
      inactivating protein (LIP) when growth reached the stationary phase in submerged
      cultures, or when aerial mycelia started to form on surface cultures. Autolysis
      of mycelia after the stationary phase in submerged cultures was apparently
      retarded by the addition of leupeptin; on surface cultures, aerial mycelium
      formation was clearly retarded by the addition of leupeptin. We propose that CTP
      participates primarily in utilization of a proteinaceous nitrogen source, that
      TLP functions as an essential enzyme involved in the metabolism of mycelial
      protein, that leupeptin inhibits the activity of TLP and that LIP inactivates
      leupeptin. The cascade of regulatory actions of the compounds, which are produced
      sequentially during mycelium development, may provide selective advantages in
      adverse culture conditions.

PMID- 7773378
TI  - Streptomyces peucetius daunorubicin biosynthesis gene, dnrF: sequence and
      heterologous expression.
AB  - The dnrF gene, responsible for conversion of aklavinone to epsilon-rhodomycinone
      via C-11 hydroxylation, was mapped in the daunorubicin (Dnr) gene cluster of
      Streptomyces peucetius ATCC 29050, close to drrAB, one of the anthracycline
      resistance genes. The dnrF gene was sequenced and should encode a protein of 489
      amino acids with a molecular mass of 52 kDa. The deduced DnrF protein shows
      significant similarities with bacterial FAD- and NADPH-dependent hydroxylases
      either required to introduce hydroxyl groups into polycyclic aromatic polyketide
      antibiotics or involved in catabolism of aromatic compounds. Heterologous
      expression of dnrF in Streptomyces lividans TK23 and in Escherichia coli
      demonstrated that the gene encodes a NADPH-dependent hydroxylase catalysing the
      hydroxylation of aklavinone to yield epsilon-rhodomycinone. The enzyme is
      inactive on anthracyclines glycosylated at position C-7 and its activity
      decreases to a different extent with other substrate modifications, indicating
      that DnrF has a significant substrate specificity.

PMID- 7773380
TI  - Lactococcus lactis glyceraldehyde-3-phosphate dehydrogenase gene, gap: further
      evidence for strongly biased codon usage in glycolytic pathway genes.
AB  - The gene gap, encoding glyceraldehyde-3-phosphate dehydrogenase (EC 1.2.1.12),
      was isolated from a genomic library of Lactococcus lactis LM0230 DNA. Plasmids
      containing the L. lactis gene were able to complement a gap mutant of Escherichia
      coli. The nucleotide sequence of gap predicted a polypeptide chain of 337 amino
      acids for the enzyme and a subunit molecular mass of 36,043. The codon usage in
      gap and four other glycolytic genes from L. lactis showed a high degree of bias,
      when compared with 84 other chromosomal genes. Northern blot analysis of total L.
      lactis RNA showed that gap hybridized strongly with a 1.3 kb transcript. The 5'
      end of the transcript was determined by primer extension analysis to be a C
      located 35 bp upstream from the gap start codon. These transcript analyses, and
      the orientation of the open reading frames in the DNA flanking gap, indicated
      that in L. lactis gap is expressed on a monocistronic transcript. Nucleotide
      sequencing indicated that the DNA adjacent to gap did not encode other glycolytic
      pathway enzymes. The DNA sequence flanking gap contained two open reading frames
      (ORF156 and ORF211) of unknown function. The 3' end of a clpA homologue was
      identified in the sequence upstream of ORF156. The location of gap on the L.
      lactis DL11 chromosome map was determined to be between map coordinates 0.530 and
      0.660.

PMID- 7773381
TI  - Biochemical genetics of a natural population of Escherichia coli: seasonal
      changes in alleles and haplotypes.
AB  - The level of diversity, degree of enzyme polymorphism, effective population size,
      and the relative roles of drift and selection were examined in a cross-section of
      a natural Escherichia coli population based on random samples of haplotypes of E.
      coli isolated from sewage. The population studied contained E. coli strains
      derived from a human population of approximately 16,000 individuals, as well as
      from other sources. Three sample sets were taken between May and August. Each set
      consisted of 100 E. coli clones. Six enzyme loci [GPI (5 alleles), GPD (5
      alleles), PGD (10 alleles), ADH (8 alleles), IDH (6 alleles), PGM (6 alleles)]
      were surveyed electrophoretically for each clone; 159 different haplotypes were
      obtained and it is likely that all possible combinations are present in the
      population sampled. The large numbers of different haplotypes observed were
      distributed as a series of four genetically similar families of clones. The large
      estimated effective population size (Ne = 10(10)) means that the observed large
      and highly significant changes in allele frequencies with time are not due to
      genetic drift. Selection, though not necessarily at the loci studied, is
      considered the only likely explanation.

PMID- 7773382
TI  - Mercury resistance as a selective marker for recombinant mycobacteria.
AB  - The use of antibiotic-resistance markers for the selection of recombinant
      mycobacteria is widespread but questionable considering the development of live
      recombinant BCG vaccines. In contrast, vector-encoded resistance to heavy metals
      such as mercury may represent an interesting alternative for the development of
      live vaccines compatible with use in humans and in animals. The mercury
      resistance genes (mer) from Pseudomonas aeruginosa and from Serratia marcescens
      were cloned into the Escherichia coli-Mycobacterium shuttle vector pRR3. The
      resulting vectors, designated pMR001 and pVN2, were introduced by electroporation
      into Mycobacterium smegmatis, Mycobacterium bovis BCG and Mycobacterium
      tuberculosis. The recombinant mycobacteria were stable in vitro and in vivo, and
      had high-level mercury resistance, thus indicating that the mer genes can be
      useful as selective markers in mycobacteria.

PMID- 7773383
TI  - Molecular biology of aflatoxin biosynthesis.

PMID- 7773384
TI  - Trichoderma harzianum genes induced during growth on Rhizoctonia solani cell
      walls.
AB  - Trichoderma harzianum is a biocontrol agent that attacks a range of economically
      important phytopathogenic fungi. In an attempt to identify genes specifically
      expressed by T. harzianum during growth on cell walls of Rhizoctonia solani, we
      carried out differential screening of an induced cDNA library. In this paper we
      report the analysis of the sequence and expression of two cDNA clones that encode
      putative mycoparasitism-related proteins of T. harzianum. One of these clones
      corresponds to a gene, inda1, that encodes a protein of 570 amino acids with a
      predicted molecular mass of 62,853 Da. The predicted amino acid sequence of inda1
      showed a high degree of similarity with amino acid permeases from several other
      organisms. The other cDNA clone corresponds to a gene, indc11, that encodes a
      novel protein of 340 amino acids with a predicted molecular mass of 37,010 Da.
      The use of this methodology should provide specific genetic markers to follow
      mycoparasitism by Trichoderma spp.

PMID- 7773385
TI  - A basic serine protease from Paecilomyces lilacinus with biological activity
      against Meloidogyne hapla eggs.
AB  - Scanning electron micrographs of the nematode-egg-parasitic fungus Paecilomyces
      lilacinus infecting eggs of the root-knot nematode Meloidogyne spp. suggested the
      involvement of lytic enzymes. When grown on a liquid mineral salts medium,
      supplemented with different substrates as the sole N- and C-source, the fungus
      produced an extracellular protease. Colloidal chitin, vitellin and intact eggs of
      the root-knot nematode Meloidogyne hapla induced proteolytic activity that was
      repressed by glucose. The protease was partially purified from the culture
      filtrate by affinity chromatography. It has a molecular mass of 33.5 kDa, a pH
      optimum of 10.3, a temperature optimum of 60 degrees C and an isoelectric point
      above pH 10.2. The enzyme was completely inhibited by PMSF. The amino acid
      sequence, as derived from the nucleotide sequence of a cDNA clone, had high
      homology with several subtilisin-like serine proteases. It was shown that the
      purified enzyme degrades vitellin. The protease quantitatively bound to nematode
      eggs, and eggs incubated with the purified protease eventually floated.
      Incubation of the purified protease with nematode eggs significantly influenced
      their development as demonstrated by time-lapse microscopy. Immature eggs were
      highly vulnerable to protease treatments, whereas those containing a juvenile
      were more resistant. In addition, hatched larvae were not visibly affected by the
      protease. It can be concluded that the serine protease might play a role in
      penetration of the fungus through the egg-shell of nematodes.

PMID- 7773387
TI  - Inducible expression of heterologous genes targeted to a chromosomal platform in
      the cyanobacterium Synechococcus sp. PCC 7942.
AB  - High-level, inducible expression of heterologous genes in the cyanobacterium
      Synechococcus sp. strain PCC 7942 was obtained using the Escherichia coli trc
      promoter and lacI repressor. The petE gene of Anabaena sp. strain PCC 7937
      encoding plastocyanin precursor protein and the E. coli uidA gene encoding beta
      glucuronidase were initially placed under the control of the trc promoter and
      lacI repressor by cloning into the E. coli pTrc99C expression vector and were
      introduced into the chromosomal platform for integration in metF (PIM) of the
      Synechococcus R2-PIM9 recipient strain. These pTrc99C-derived constructs often
      gave rise to transformants that did not contain a complete insert gene, probably
      because of gene conversion events. Selection of the desired Synechococcus R2-PIM9
      transformants was vastly improved using the new pTrcIS vector that contains the
      aadA gene encoding streptomycin resistance as an extra antibiotic resistance
      marker. The influence of IPTG concentration and induction time on gene expression
      with the E. coli trc/lacI system in Synechococcus was determined using beta
      glucuronidase as a reporter. The Anabaena PCC 7937 petE gene in Synechococcus was
      expressed to a high level upon induction with IPTG as shown by RNA and immunoblot
      analysis. The general usability of pTrcIS as a cloning vector for inducible
      heterologous gene expression in Synechococcus was confirmed by the introduction
      of several more genes.

PMID- 7773386
TI  - Characterization of npf mutants identifying developmental genes in Physarum.
AB  - In Physarum polycephalum, uninucleate haploid amoebae develop into macroscopic
      multinucleate plasmodia. Wild-type, sexual development is triggered when two
      amoebae carrying different alleles of matA fuse to form a zygote which develops
      into a diploid plasmodium. Mutations in the matA genetic region give rise to
      apogamic strains in which a single haploid amoeba can develop into a haploid
      plasmodium. An essential stage in both sexual and apogamic plasmodium formation
      is an extended cell cycle in uninucleate cells, which ends with the formation of
      a binucleate cell by mitosis without cytokinesis. Using a 'brute force' screening
      method, we have isolated mutants blocked in apogamic plasmodium development.
      Genetic analysis showed that the mutations we have identified were unlinked to
      matA, unlike mutations previously identified following an enrichment step. Most
      of the loci revealed by our screen were represented by only one allele,
      indicating that further screening should lead to the identification of additional
      genes required for plasmodium development. Phenotypic analysis showed that
      different mutants were blocked at different stages of plasmodium formation. Some
      of the mutations blocking apogamic development at an early stage, close to the
      start of the long cell cycle, failed to block sexual development in zygotes
      homozygous for the mutation. Since the two modes of plasmodium formation differ
      only in the initiation of development, these mutations presumably interfere with
      the initiation process. In the remaining mutants, in which both sexual and
      apogamic development were blocked, development first became abnormal towards the
      end of the long cell cycle. This suggested that the wild-type gene products were
      required by this time and was consistent with previous evidence that many changes
      in cellular organization and gene expression occur during the long cell cycle.
      Each of these mutants showed a different terminal phenotype and some aspects of
      plasmodium development occurred normally although others were blocked, suggesting
      that development involves multiple pathways rather than a dependent sequence of
      events. Phenotypic analysis of double mutants supported this conclusion and also
      revealed epistatic interactions, presumably due to blocks in the same pathway. In
      several of the mutants, terminally differentiated cells died by an apoptosis-like
      mechanism; since this was never observed in vegetative cells, it was presumably
      triggered by the failure of development. Phenotypic analyses of additional
      mutants will extend our understanding of the pathways involved in plasmodium
      development.

PMID- 7773388
TI  - IS292: a novel insertion element from Agrobacterium.
AB  - A new insertion sequence, IS292, located in the 6b gene of a nopaline-type
      Agrobacterium strain (X88-292) isolated from poplar was identified and sequenced.
      IS292 is 2494 bp long, has 21 bp inverted terminal repeats with two mismatches,
      and generates 10 bp direct repeats upon integration. No sequence similarity was
      found between IS292 and other insertion elements associated with Agrobacterium,
      but it shows strong similarity with ISR/1 from Rhizobium leguminosarum bv.
      viciae. The occurrence of IS292-like sequences in various Agrobacterium isolates,
      especially different Agrobacterium strains isolated from the same biotope, was
      demonstrated by DNA hybridization.

PMID- 7773389
TI  - Flavohaemoglobin HmpX: a new pathogenicity determinant in Erwinia chrysanthemi
      strain 3937.
AB  - Unlike wild-type Erwinia chrysanthemi strain 3937, which fully macerates
      inoculated Saintpaulia plants, HmpX- mutants produce necrotic lesions or no
      symptoms. The hmpX gene was sequenced and the corresponding protein sequence
      analysed. We show that HmpX belongs to a family of flavohaemoproteins (HMP),
      previously identified in two yeasts and in Escherichia coli. Comparisons of
      protein sequences at the secondary structure level by hydrophobic cluster
      analysis have shown that HmpX possesses two functional regions, a haemoglobin
      domain in its N-terminal part and a flavin reductase domain in its C-terminal
      part. In an HmpX- strain, the synthesis of pectate lyases, which are
      pathogenicity determinants in E. chrysanthemi, was reduced in conditions of low
      oxygen tension. Using gus fusion in hmpX, it was shown that hmpX transcription
      was induced in coculture with tobacco cells. A putative function for HmpX is
      discussed.

PMID- 7773390
TI  - Synergism between Erwinia pectate lyase isoenzymes that depolymerize both pectate
      and pectin.
AB  - Phytopathogenic Erwinia bacteria cause tissue maceration by secretion of
      pectinolytic enzymes such as pectate lyase (PL). Sequencing of overlapping
      genomic fragments from Erwinia carotovora subsp. atroseptica established the
      organization of a 7.5 kbp region encoding PL isoenzymes. Two intergenic regions
      of 656 and 645 bp separate three enzyme coding regions of 1125 bp exhibiting
      approximately 80% positional identity. The promoters of each of the three genes
      contain a segment with high homology to the binding sequence of the E.
      chrysanthemi KdgR transcription repressor, implying similar mechanisms of gene
      regulation in the two bacterial species. Separate expression of the pel genes in
      the Escherichia coli-pT7-7 system and purification of their products yielded PLs
      at 7-33 mg (I culture)-1 with greater than 95% purity. Availability of the
      recombinant enzymes allowed determination of the kinetic differences amongst the
      PL isoforms, PL1, PL2 and PL3. The results show that PL is not strictly confined
      to depolymerization of pectate since each isoenzyme more readily degrades 31%
      esterified pectin. Addition of isoenzyme combinations revealed no synergism with
      respect to degradation of pectate or 31% esterified pectin. However, addition of
      enzyme combinations containing PL3 enhanced the activity towards 68% esterified
      pectin, against which individual PL activities were low, by up to 64%. These data
      suggest that the combination of PL isoenzymes extends the range of pectic
      substrates which the bacterium can degrade.

PMID- 7773391
TI  - A temperature-compensated ultradian clock ticks in Schizosaccharomyces pombe.
AB  - An ultradian oscillation is described for Schizosaccharomyces pombe which meets
      the criteria for a cellular clock, i.e. timekeeping device. The rhythm can be
      induced by transfer from circadian conditions (stationary phase or very slow
      growth) to ultradian conditions (rapid growth). It can also be synchronized by
      ultradian temperature cycles of 6 degrees C difference. Released to constant
      temperature, the rhythm persists for 20 h without damping. The period of the free
      running rhythm is temperature-compensated and in no experiment did period length
      fall outside the narrow range between 40 and 44 min. The parameter observed is
      the septum index, i.e. the percentage of cells occupying the last stage of the
      cell cycle in wild-type cells before final division. The results suggest control
      of the cell division processes by the ultradian clock.

PMID- 7773392
TI  - Disruption of the actin cytoskeleton in budding yeast results in formation of an
      aberrant cell wall.
AB  - A temperature-sensitive, conditionally lethal actin mutant of Saccharomyces
      cerevisiae, DBY 1693, was used to study, using light and electron microscopy,
      dysfunction of the actin cytoskeleton in the morphogenesis of the cell wall.
      Cells of this mutant strain survived at least 24 h at the restrictive temperature
      (37 degrees C). These cells showed isodiametric growth. Mutant cells accumulated
      vesicles, probably as a consequence of chaotic secretory transport caused by loss
      of polarity. A conspicuous morphological response to the dysfunction of actin was
      the formation of an aberrant wall over the whole surface of the isodiametrically
      growing cell. This wall was of loose texture with protruding glucan microfibrils
      incompletely masked with amorphous matrix. It resembled the regenerating cell
      wall on the surfaces of yeast protoplasts. The localization of wall synthesis
      over the whole surface of temperature sensitive actin mutant cells was in
      accordance with an even distribution of submembranous actin in the form of
      patches (similarly to regenerating protoplasts). Delocalization of finger-like
      invaginations of the plasma membrane from the bud region to the whole surface of
      the growing cell was also found in mutant cells.

PMID- 7773393
TI  - Phylogenetic analysis of the ballistosporous anamorphic genera Udeniomyces and
      Bullera, and related basidiomycetous yeasts, based on 18S rDNA sequence.
AB  - The small subunit nuclear ribosomal DNA (18S rDNA) sequence was determined for
      twelve species of basidiomycetous anamorphic yeasts, i.e. three species of
      Udeniomyces, seven species of Bullera, Cryptococcus albidus and Phaffia
      rhodozyma. For phylogentic analysis, these sequences were aligned with published
      sequences for 36 other fungal species. Molecular phylogenetic analysis of maximum
      likelihood and parsimony showed that the 44 species of basidiomycetes analysed
      were divided into three major lineages. The ballistosporous yeast genera
      Udeniomyces and Bullera were clearly separated. On the phylogenetic tree,
      Udeniomyces megalosporus, U. puniceus and U. piricola showed a very close
      relationship with one another, and composed a lineage with Mrakia frigida, P.
      rhodozyma and Cystofilobasidium capitatum at high bootstrap confidence level. On
      the other hand, eight species of Bullera made lineages with selected species of
      Tremella (Tremellaceae), Filobasidium and Filobasidiella (Filobasidiaceae),
      Cryptococcus albidus and Trichosporon cutaneum. The molecular phylogeny deduced
      from the 18S rDNA sequence showed a possibility of heterogeneity among the
      species of Bullera at the generic level.

PMID- 7773394
TI  - Missense mutations that alter the DNA-binding domain of the MtrR protein occur
      frequently in rectal isolates of Neisseria gonorrhoeae that are resistant to
      faecal lipids.
AB  - Resistance of Neisseria gonorrhoeae to structurally diverse hydrophobic agents
      (HAs) has been associated with missense or deletion mutations in the mtrR
      (multiple transferable resistance Regulator) gene of laboratory-derived strains
      but their prevalence in clinical isolates was heretofore unknown. Since faecal
      lipids provide strong selective pressure for the emergence of variants resistant
      to HAs (HAR), the nucleotide sequence of the mtrR gene from rectal isolates of N.
      gonorrhoeae, which displayed different levels of HAR, was determined. Compared to
      the mtrR gene possessed by the HA-sensitive strain FA19, each clinical isolate
      contained mutations in the coding and/or promoter regions of their mtrR gene. A
      missense mutation in codon 45 (Gly-45 to Asp) was the most common mutation found
      in the strains studied and impacted the structure of the helix-turn-helix domain
      of the MtrR protein thought to be important in DNA-binding activity. Two clinical
      isolates bearing a missense mutation in codon 45 also contained a single basepair
      deletion in a 13 bp inverted sequence positioned within the mtrR promoter region.
      Introduction of mtrR sequences amplified from the clinical isolates into strain
      FA19 revealed that acquisition of the single basepair deletion was correlated
      with high level HAR while mutations in the mtrR-coding region provided for an
      intermediate level of HAR.

PMID- 7773395
TI  - Plasmids pIP419 and pIP421 from Bacteroides: 5-nitroimidazole resistance genes
      and their upstream insertion sequence elements.
AB  - The genetic organization of two different 5-nitroimidazole (5-Ni) resistance
      genes was investigated: nimC and nimD from Bacteroides plasmids pIP419 and
      pIP421, respectively. The nimC gene (492 bp) and the nimD gene (495 bp) directed
      the synthesis of polypeptides with deduced molecular masses of 18.37 kDa and
      18.48 kDa, respectively. The predicted proteins showed 67-83% identity and 78-91%
      similarity with the products of two other nimA and nimB genes previously
      described and could be derived from a common ancestral gene. An insertion
      sequence element (IS1170) was identified upstream of the nimC gene. IS1170 is
      1604 bp in length and is flanked by imperfect inverted repeats (15 bp). IS1170 is
      similar to the Bacteroides insertion sequence element IS942 with an identity of
      70% at the nucleotide level. The single copy of IS1170 present on plasmid pIP419
      is integrated 24 bp upstream of the initiation codon of nimC. Similar genetic
      organization was found on plasmid pIP421. One copy of another insertion sequence
      (IS1169) was found 4 bp upstream of the first ATG codon of the nimD gene. This
      element (1325 bp) shows a strong homology at the nucleotide level (70% identity)
      with IS1186 and IS1168 found to be associated with the Bacteroides carbapenem
      resistance gene cfiA, and the 5-Nirgenes nimA and nimB, respectively. There is
      strong evidence that, as in the case of the cfiA gene, the transcription of the
      four nim genes so far studied is directed by outward-oriented promoters, carried
      on the right ends of the different insertion sequence elements.

PMID- 7773396
TI  - Variation in the size of the repeat region of the fibrinogen receptor (clumping
      factor) of Staphylococcus aureus strains.
AB  - The ability of Staphylococcus aureus to bind to fibrinogen and fibrin is believed
      to be an important factor in the initiation of foreign body and wound infections.
      Recently, the gene encoding the fibrinogen receptor (clumping factor, ClfA) of S.
      aureus strain Newman was cloned and sequenced. The ClfA protein possesses a
      highly unusual 308 residue dipeptide repeat region composed predominantly of Asp
      and Ser. Polymerase chain reaction analysis of seven different strains showed
      that the size of the clfA repeat coding region varies from 580 bp to 1320 bp. In
      contrast, the clfA region A is the same size in each strain. The size of the clfA
      repeat region did not correlate with the ability of these strains to form clumps
      in a solution of fibrinogen. Indeed, the strain with the smallest repeat size of
      580 bp clumped almost as well as strain Newman. Each strain of S. aureus examined
      contained several high molecular mass proteins that reacted with anti-ClfA region
      A antibody. In some cases the molecular mass of the major protein varied in
      accordance with the length of the coding sequence for the repeat region R.

PMID- 7773397
TI  - Filling the gap between hns and adhE in Escherichia coli K12.
AB  - As a consequence of the absence of a general coordination process in the
      sequencing of the Escherichia coli K12 genome, to completely sequence the genome
      in a reasonable time it is important to fill in gaps between known regions. We
      report the sequence of the hns-adh region, at 27 min on the genome.

PMID- 7773398
TI  - Novel phosphotransferase system genes revealed by bacterial genome analysis--a
      gene cluster encoding a unique Enzyme I and the proteins of a fructose-like
      permease system.
AB  - Previous publications have demonstrated the presence of a cryptic gene encoding a
      novel Enzyme I of the phosphoenolpyruvate:sugar phosphotransferase system (PTS).
      Recent Escherichia coli genome sequencing revealed a gene (ptsA) encoding a new
      Enzyme I homologue in the 89.1-89.3 centisome region. We have analysed this
      region, and here describe and characterize open reading frames (ORFs) encoding
      (1) a fused PTS Enzyme I-IIAFru homologue, (2) a glycerol dehydrogenase, (3) a
      transaldolase homologue, (4) two PTS IIBFru homologues, (5) a PTS IICFru
      homologue, and (6) homologues of pyruvate formate-lyase and its activating
      enzyme. Binary comparison scores, multiple alignments and phylogenetic trees
      establish the families of proteins to which each of the relevant ORFs belong.
      Identification of the putative products of this gene cluster leads to the
      proposal that several of the proteins encoded in this region function in
      anaerobic carbon metabolism.

PMID- 7773399
TI  - The bceT gene of Bacillus cereus encodes an enterotoxic protein.
AB  - A toxin gene (bceT) on a 2.9 kb DNA fragment of Bacillus cereus B-4ac was cloned
      and expressed in Escherichia coli, and its nucleotide sequence determined. The
      DNA fragment contained an open reading frame capable of encoding a polypeptide of
      336 amino acids with a molecular mass of 41039 Da. The translated product in E.
      coli exhibited Vero cell cytotoxicity, and was positive in a vascular
      permeability assay. It also caused fluid accumulation in a ligated mouse ileal
      loop and was lethal to mice upon injection. These biological activities are
      considered characteristic of diarrhoeal enterotoxins. We therefore conclude that
      this gene, designated bceT, encodes one of the enterotoxic proteins of B. cereus
      which cause food-borne diarrhoea.

PMID- 7773400
TI  - The biosynthesis of periplasmic electron transport proteins in methylotrophic
      bacteria.

PMID- 7773401
TI  - Crystalline surface protein of Peptostreptococcus anaerobius.
AB  - The surface ultrastructure of three anaerobic Gram-positive cocci frequently
      encountered in oral infections, Peptostreptococcus micros, P. magnus and P.
      anaerobius, was studied. The type strains of P. micros (DSM 20468) and P.
      anaerobius (ATCC 27337), several clinical isolates of both species and the type
      strain of P. magnus (DSM 20470) were included. Thin-sectioned cells studied by
      electron microscopy revealed a homogeneous layer outside the peptidoglycan layer
      in P. anaerobius. In P. micros and P. magnus a more amorphous layer was present.
      No periodic structures were seen in negatively stained whole cells of these three
      species. However, in freeze-etched cells of P. anaerobius a crystalline surface
      protein layer (S-layer) was detected. No periodicity was seen in any of the P.
      micros strains or the P. magnus type strain by the methods used, but a periodic
      pattern was observed in negatively stained specimens of cell wall fragments of
      sonicated P. anaerobius cells. No capsular material was visible outside the S
      layer in P. anaerobius. The cells of the Peptostreptococcus spp. were extracted
      for 30 min with detergents and urea. One per cent SDS and M urea both extracted a
      major 78 kDa protein from all strains of P anaerobius. Extraction of P. micros
      and P. magnus cells did not reveal any major protein bands comparable to that of
      P. anaerobius. Surface biotinylation of cells followed by Western blotting and
      detection by alkaline-phosphatase-conjugated extravidin showed strong staining of
      the 78 kDa band in P. anaerobius, further indicating that this molecule is
      located on the surface of the cell and is the S-protein.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7773402
TI  - An inner cell wall protein (cwp1) from conidia of the entomopathogenic fungus
      Beauveria bassiana.
AB  - Following the removal of the rodlet layer from aerial or submerged conidia of the
      entomopathogenic deuteromycetous fungus Beauveria bassiana, SDS-insoluble, formic
      acid-extractable proteins were found in the residual cell wall material. Two
      major proteins (12.8 and 14.0 kDa) were extracted with formic acid from fractured
      aerial and submerged conidia but not from blastospores. Oxidation of the sample
      extracted by formic acid resulted in a single protein band (15.4 kDa) as judged
      by SDS-PAGE. Antibodies against this cell wall protein (cwp1) did not cross-react
      with cell wall extracts from the entomopathogenic deuteromycetous fungi
      Verticillium lecanii or Metarhizium anisopliae. Western blot analysis of two
      dimensional gels revealed at least three acidic isoforms (pI 4.0-4.8) of cwp1.
      Immunohistological studies revealed that the cwp1 was primarily localized in the
      cell wall of aerial and submerged conidia but not in blastospores.
      Immunolocalization was possible only if the conidia were previously boiled in 5%
      (v/v) beta-mercaptoethanol. The N-terminal sequence of cwp1 showed no
      similarities with other published sequences. Our results suggest that at least
      two major species of SDS-insoluble, formic-acid-extractable proteins exist in
      cell walls of B. bassiana aerial or submerged conidia; one is the hydrophobin
      which occurs in the outermost rodlet layer and the other, cwp1, occurs primarily
      next to the rodlet layer.

PMID- 7773403
TI  - Division-inhibition capacity of penicillin in Escherichia coli is growth-rate
      dependent.
AB  - Growing bacteria are sensitive to various beta-lactam derivatives due to their
      interference with peptidoglycan biosynthesis. At low concentrations, penicillin G
      (benzylpenicillin) blocks cell division without affecting mass growth rate. The
      MIC for division of Escherichia coli B/r (H266) was found to depend on the growth
      rate, which was modified by the nutritional conditions. Our hypothesis, that
      division sensitivity is proportional to the rate of peptidoglycan synthesis for
      septum formation, as well as to cell circumference, was thus confirmed.

PMID- 7773404
TI  - The signal transducer encoded by ampG is essential for induction of chromosomal
      AmpC beta-lactamase in Escherichia coli by beta-lactam antibiotics and
      'unspecific' inducers.
AB  - Chemical mutagenesis of the AmpC beta-lactamase-hyperinducible Escherichia coli
      strain SN0301/pNu305 carrying the cloned ampC and ampR genes from Citrobacter
      freundii OS60 gave four independent mutants in which beta-lactamase was no longer
      inducible, or was inducible only to a low level, by beta-lactam antibiotics. The
      genes ampC, ampR, ampD and ampE, which were essential for beta-lactamase
      induction, were functional in these mutants. In all four mutants, the sites of
      mutation were mapped to 9.9 min on the E. coli chromosome. Complementation with
      wild-type ampG restored inducibility of beta-lactamase to wild-type levels. The
      nucleotide sequence of all four mutant ampG alleles (ampG1, ampG3, ampG4 and
      ampG5) was determined. In three of the mutants, a single base exchange led to an
      amino acid change from glycine to aspartate at different sites in the deduced
      amino acid sequence. In the fourth mutant (ampG4), with low-level inducibility,
      the nucleotide sequence was identical to wild-type ampG. Spontaneous back
      mutation of the chromosomal ampG1 mutant resulted in restoration of wild-type
      inducibility and a return to the wild-type ampG sequence. Unspecific induction by
      components of the growth medium was also dependent on intact ampG function.

PMID- 7773405
TI  - Nitrogen-regulated transcription and enzyme activities in continuous cultures of
      Saccharomyces cerevisiae.
AB  - Variations in the transcription of nitrogen-regulated genes and in the activities
      of nitrogen-regulated enzymes of the yeast Saccharomyces cerevisiae were studied
      by changing the carbon and nitrogen fluxes. S. cerevisiae was grown in continuous
      culture at various dilution rates (D) under nitrogen limitation with NH4Cl as
      sole nitrogen source. With an increase in D from 0.05 to 0.29 h-1, both the
      glucose and the ammonia flux increased sixfold. The activities of the two ammonia
      incorporating enzymes, NADPH-dependent glutamate dehydrogenase (NADPH-GDH) and
      glutamine synthetase (GS), encoded by GDH1 and GLN1, respectively, increased with
      increasing D, while the activity of the glutamate-degrading enzyme, NAD-dependent
      glutamate dehydrogenase (NAD-GDH), decreased. Surprisingly, no changes were
      observed in the transcription of GDH1 and GLN1; however increased D was
      accompanied by an increase in GAP1 transcription. At the metabolite level, the
      increase in the glucose and nitrogen flux did not result in changes in the
      intracellular 2-oxoglutarate, glutamate or glutamine concentrations. It is shown
      that growth on ammonia alone is not sufficient to cause repression of GAP1 and
      GLN1 transcription and that the regulation of GAP1 transcription and both NADPH
      GDH and GS activity is not an on/off switch, but is gradually modulated in
      correlation with the ammonia concentration.

PMID- 7773407
TI  - Evidence for a developmentally regulated prespore-specific glutamine synthetase
      in the cellular slime mould Dictyostelium discoideum.
AB  - The enzyme glutamine synthetase (GS) is described for the first time in
      Dictyostelium discoideum. The appearance of this enzyme is developmentally
      regulated. The level of activity is low in vegetative cells and increases more
      than threefold during differentiation. Furthermore this enzyme is shown to be
      differentially localized in prespore cells, the specific activity being
      approximately fourfold higher than in prestalk cells. The enzyme has a pH optimum
      of 7.8 and 8.2 in the gamma-glutamyltransferase and gamma-glutamylsynthetase
      assays, respectively, and a temperature optimum of 45 degrees C. Kinetic studies
      of GS revealed apparent Km values of 5.9 mM, 0.009 mM and 8.6 mM for glutamine,
      ADP and NH2OH, respectively, in the gamma-glutamyltransferase assay, and of 2.2
      mM, 0.12 mM and 0.64 mM for glutamate, ATP and NH2OH, respectively, in the gamma
      glutamylsynthetase assay.

PMID- 7773406
TI  - Manipulation of intracellular glycerol and erythritol enhances germination of
      conidia at low water availability.
AB  - The insect pathogens Beauveria bassiana, Metarhizium anisopliae and Paecilomyces
      farinosus can be effective biocontrol agents when relative humidity (RH) is close
      to 100%. At reduced water availability, germination of propagules, and therefore
      host infection, cannot occur. Cultures of B. bassiana, M. anisopliae and P.
      farinosus were grown under different conditions to obtain conidia with a modified
      polyol and trehalose content. Conidia with higher intracellular concentrations of
      glycerol and erythritol germinated both more quickly and at lower water activity
      (aw) than those from other treatments. In contrast, conidia containing up to
      235.7 mg trehalose g-1 germinated significantly (P < 0.05) more slowly than those
      with an equivalent polyol content but less trehalose, regardless of water
      availability. Conidia from control treatments did not germinate below 0.951-0.935
      aw (identical to 95.1-93.5% RH). In contrast, conidia containing up to 164.6 mg
      glycerol plus erythritol g-1 germinated down to 0.887 aw (identical to 88.7% RH).
      These conidia germinated below the water availability at which mycelial growth
      ceases (0.930-0.920 aw). Germ tube extension rates reflected the percentage
      germination of conidia, so the most rapid germ tube growth occurred after
      treatments which produced conidia containing the most glycerol and erythritol.
      This study shows for the first time that manipulating polyol content can extend
      the range of water availability over which fungal propagules can germinate.
      Physiological manipulation of conidia may improve biological control of insect
      pests in the field.

PMID- 7773408
TI  - The tylosin producer, Streptomyces fradiae, contains a second valine
      dehydrogenase.
AB  - A second NAD-dependent valine dehydrogenase (VDH) of Streptomyces fradiae was
      detected and purified to homogeneity by affinity chromatography on Reactive-Blue
      2 Sepharose followed by gel filtration and Mono Q fast protein liquid
      chromatography. The relative molecular masses of the native enzyme and its
      subunits were determined to be 80,000 and 41,000, respectively, indicating that
      the enzyme is a homodimer. The enzyme was the only active VDH in S. fradiae; its
      activity was significantly induced by L-valine, but was repressed by ammonia.
      Among branched- and straight-chain amino acids that serve as enzyme substrates, L
      2-aminobutyrate and L-valine are preferred. Significant activities were found
      with deamino-NAD+ and 3-pyridinealdehyde-NAD+. The molecular and catalytic
      properties of the enzyme distinguish it from the enzyme previously purified, and
      thus indirectly indicate the existence of two VDHs in S. fradiae.

PMID- 7773409
TI  - Cloning of a Candida albicans peptide transport gene.
AB  - A Candida albicans peptide transport gene, CaPTR2, was cloned from a C. albicans
      genomic library by functional complementation of a peptide transport deficient
      mutant (strain ptr2-2) of Saccharomyces cerevisiae. CaPTR2 restored peptide
      transport to transformants as determined by uptake of radiolabelled dileucine,
      growth on dipeptides as sources of required amino acids, and restoration of
      growth inhibition by toxic peptides. Plasmid curing experiments demonstrated that
      the peptide transport phenotype was plasmid borne. CaPTR2 was localized to
      chromosome R of C. albicans by contour-clamped homologous electric field gel
      chromosome blots. Deletion subclones and frameshift mutagenesis were used to
      narrow the peptide transport complementing region to a 5.1 kb DNA fragment. DNA
      sequencing of the complementing region identified an ORF of 1869 bp containing an
      84 nucleotide intron. The deduced amino acid sequence predicts a protein of 70
      kDa consisting of 623 amino acids with 12 hydrophobic segments. A high level of
      identity was found between the predicted protein and peptide transport proteins
      of S. cerevisiae and Arabidopsis thaliana. This study represents the first steps
      in the genetic characterization of peptide transport in C. albicans and initiates
      a molecular approach for the study of drug delivery against this pathogen.

PMID- 7773410
TI  - Involvement of ArgR and PepA in the pairing of ColE1 dimer resolution sites.
AB  - Dimer formation and associated copy number depression is an important cause of
      multicopy plasmid instability. Natural multicopy plasmids employ site-specific
      recombination to convert dimers to monomers, thus maximizing the number of
      independently segregating molecules at cell division. Resolution of dimers of
      Escherichia coli plasmid ColE1 requires the plasmid cer site and at least four
      chromosome-encoded proteins: the XerC and XerD recombinases, and accessory
      factors ArgR and PepA. It has been suggested that ArgR has a role in the initial
      pairing of recombination sites and we describe here an attempt to detect this
      process in vivo. Our approach exploits a previous observation that a cer-like
      site known as the type II hybrid supports inter-molecular recombination and
      causes extensive multimerization of plasmids. We report that type-II-mediated
      multimerization can be repressed by a cer site in cis or in trans and propose
      that this is due to a physical interaction between the sites. If this hypothesis
      is correct, suppression of multimer formation provides an assay of site pairing.
      Our results demonstrate that the putative pairing interaction is independent of
      the topological relationship of the sites and that both PepA and ArgR are
      involved. Although most recombination-deficient mutant derivatives of ArgR are
      unable to pair recombination sites, we have found two (ArgR110 and ArgR115) which
      retain pairing activity. The validity of the pairing hypothesis is discussed in
      the light of alternative explanations for our data.

PMID- 7773411
TI  - Phage infection, transfection and transformation of Mycobacterium avium complex
      and Mycobacterium paratuberculosis.
AB  - Mycobacterium avium complex strains and Mycobacterium paratuberculosis are
      closely related intracellular pathogens affecting humans and animals. M. avium
      complex infections are a leading cause of morbidity and mortality in AIDS
      patients, and M. paratuberculosis is the agent of Johne's disease in ruminants.
      Genetic manipulation of these micro-organisms would facilitate the understanding
      of their pathogenesis, the construction of attenuated vaccine strains and the
      development of new drugs and treatment methods. This paper describes the
      replication of mycobacterial shuttle phasmids and plasmids, and the expression of
      the firefly luciferase reporter gene in M. avium complex and M. paratuberculosis.
      The mycobacteriophage TM4 propagated on M. smegmatis or M. paratuberculosis
      plaqued at the same efficiency on these two mycobacterial hosts. Screening of M.
      avium complex and M. paratuberculosis clinical isolates with TM4-derived
      luciferase reporter phages demonstrated that the majority of these isolates were
      susceptible to TM4. Conditions for introduction of DNA were determined by
      transfection of M. paratuberculosis with TM4 DNA and applied to isolate kanamycin
      resistant transformants of M. avium complex and M. paratuberculosis with
      Escherichia coli-Mycobacterium shuttle plasmids. Recombinant plasmids were
      recovered from transformants without apparent loss of DNA sequences. These
      results provide the basis for the genetic manipulation of these pathogenic
      mycobacterial species.

PMID- 7773412
TI  - Organization of carbamoyl-phosphate synthase genes in Neisseria gonorrhoeae
      includes a large, variable intergenic sequence which is also present in other
      Neisseria species.
AB  - The carbamoyl-phosphate synthase (CPS) enzyme in prokaryotes is a heterodimer,
      encoded by genes commonly called carA and carB. In most prokaryotes examined,
      these genes are separated by up to 24 bp and are cotranscribed. In Pseudomonas
      aeruginosa, carA and carB are also co-transcribed, but are separated by 682 bp.
      We have determined the complete DNA sequence of the carA and carB genes of
      Neisseria gonorrhoeae strain CH811. carA (1125 bp) and carB (3237 bp) are similar
      in size and sequence to other prokaryotic CPS genes, however they are separated
      by an intervening sequence of 3290 bp which has no similarity to the intervening
      sequence between other CPS genes; furthermore, putative transcription terminators
      are found downstream of both carA and carB. Several neisserial repetitive
      sequences were identified within the 9 kb sequenced, as well as novel 120 and 150
      bp repeats (designated RS6 and RS7, respectively) which were found within the
      intervening sequence between carA and carB. To determine whether the intervening
      sequence observed in N. gonorrhoeae CH811 was not unusual, the sequence between
      carA and carB was amplified by PCR from 30 isolates of N. gonorrhoeae. The
      intervening sequence was found to vary in size, from approximately 2.2 to 3.7 kb,
      although the carA and carB genes themselves did not vary in size in isolates with
      functional CPS enzyme. A similar large, variably sized intervening sequence was
      also found between the carA and carB genes of 12 isolates of N. meningitidis and
      18 commensal Neisseria isolates comprising nine species. This unexpected
      organization of the CPS genes in N. gonorrhoeae is therefore widespread
      throughout the genus Neisseria.

PMID- 7773413
TI  - Mutations in the glycerol kinase gene restore the ability of a ptsGHI mutant of
      Bacillus subtilis to grow on glycerol.
AB  - Although glycerol is not taken up via the phosphotransferase system (PTS) in
      Bacillus subtilis, some mutations that affect the general components of the PTS
      impair the ability of cells to grow on glycerol. Five revertants of a pts
      deletion mutant that grow on glycerol were analysed. They were shown to carry
      mutations in the glycerol kinase gene. These are missense mutations located in
      parts of the glpK gene that could encode regions important for the activity of
      glycerol kinase. The results strongly suggest that the main effect of the PTS on
      glycerol utilization in B. subtilis is mediated via glycerol kinase.

PMID- 7773414
TI  - The Bacillus subtilis dnaI gene is part of the dnaB operon.
AB  - The dnaI gene of Bacillus subtilis, previously identified through the isolation
      of the dnaI2 mutant, was found to be the second gene of the dnaB operon. The
      nucleotide substitution in the dnaI2 mutant gene was determined.

PMID- 7773415
TI  - Evolution of the korA-oriV segment of promiscuous IncP plasmids.
AB  - Plasmids belonging to Escherichia coli incompatibility group P are of particular
      interest because they can transfer between, and be stably maintained in, almost
      all Gram-negative bacterial species. The segment of the IncP alpha plasmid genome
      between the key regulatory gene korA and the vegetative replication origin, oriV,
      encodes a series of operons co-regulated with replication and transfer functions
      by the KorA protein. To determine which of these genes are likely to have an
      important role in IncP plasmid survival the equivalent region of the distantly
      related IncP beta plasmid R751 was sequenced. Sequence comparisons show that the
      kla operon (formerly the kilA locus, which is also responsible for a cryptic
      tellurite-resistance determinant) is completely absent from R751. Similarly in
      the kle region, which encodes genes associated with the KilE+ phenotype of
      unknown function, kleC and kleD, which we proposed arose by a duplication of kleA
      and kleB, are also completely absent. The genes that are conserved are klcA
      (formerly kilC, responsible for the KilC+, and recently proposed to be involved
      in overcoming restriction barriers during transfer), klcB (an ORF interrupted by
      Tn1 insertion in RK2), korC (a transcriptional repressor which controls the klcK
      and kle operons), and kleA, kleB, kleE and kleF. A striking feature of the
      organization in R751 is the lack of the strong transcriptional termination
      signals which are present in IncP alpha plasmids. The degree of divergence
      between the plasmids facilitates the identification of motifs of probable
      functional importance in the primary protein sequences.

PMID- 7773416
TI  - An operon encoding aspartokinase and purine phosphoribosyltransferase in Thermus
      flavus.
AB  - The nucleotide sequence of a 1.1 kb XhoI-HindIII fragment downstream of the
      malate dehydrogenase (mdh) gene of Thermus flavus revealed the presence of an ORF
      and an incomplete ORF lacking its NH2-terminal portion, in the opposite
      orientation to that of the mdh gene. These two genes overlapped with each other,
      sharing two base pairs, suggesting that these genes are co-transcribed in a
      single mRNA. One ORF (termed gpt) encoded a protein of 154 amino acids showing
      significant amino acid sequence similarity to purine phosphoribosyltransferases,
      such as xanthine-guanine phosphoribosyltransferase of Escherichia coli and human
      hypoxanthine phosphoribosyltransferase. Cloning and sequencing of the upstream
      region of the gpt gene, together with sequence comparison of the gene product
      encoded by the region upstream of gpt, suggested that the upstream ORF encoded
      two in-frame overlapping aspartokinase genes, askA, encoding the alpha-subunit of
      405 amino acids, and askB, encoding the beta-subunit of 161 amino acids, which
      was part of the 3' portion of askA. Consistent with the sequence data, the askAB
      and the gpt genes conferred the heat-stable enzyme activities of aspartokinase
      and phosphoribosyltransferase, respectively, on E. coli. Preliminary
      characterization of these enzymes produced in E. coli is described.

PMID- 7773417
TI  - The immunogenicity of recombinant Mycobacterium smegmatis bearing BCG genes.
AB  - Specific pathogen-free C57BL/6 mice infected with recombinant Mycobacterium
      smegmatis (rM. smegmatis) bearing BCG genes showed increased splenic survival
      compared to those receiving the vector control (plasmid DNA only). The mouse
      passaged rM. smegmatis (J3R) survived in peritoneal macrophages better than the
      vector control, regardless of whether the macrophages were infected in vivo or in
      vitro. When rM. smegmatis J3R was cultured in synthetic Proskauer-Beck-Tween
      medium, protein bands characteristic of BCG culture filtrates and not present in
      the vector control preparation were observed. Mice immunized with two doses of
      heat-killed J3R suspended in Freund's adjuvant were able to limit the growth of
      virulent Mycobacterium tuberculosis within the lung and spleen compared to that
      observed in control mice receiving adjuvanted vector control or Freund's adjuvant
      alone.

PMID- 7773418
TI  - pilO, a gene required for glycosylation of Pseudomonas aeruginosa 1244 pilin.
AB  - Nucleotide sequencing of a region downstream from the Pseudomonas aeruginosa 1244
      pilin structural gene, pilA, revealed an ORF potentially able to code for a
      protein of M(r) 50,862. This ORF, called pilO, was flanked by a tRNAthr gene,
      which was followed by a transcriptional termination sequence. The tRNAthr gene
      and the termination sequence were nearly identical to sequences found immediately
      adjacent to the pilA gene of several P. aeruginosa strains. A 2200 base mRNA
      strand, which contained both the pilO and pilA transcripts, was produced from
      this region, while a 650 base transcript containing only pilA was present in a
      100-fold excess over the longer transcript. Hyperexpression of the pilA gene in a
      PilO- strain resulted in normal pilus-specific phage sensitivity and twitching
      motility. The pilin produced by this strain had a lower apparent M(r) and a more
      neutral pl compared to that produced by a strain containing a functional pilO
      gene. This pilin failed to react with a sugar-specific reagent which recognized
      pilin produced by the strain containing a functional pilO gene.

PMID- 7773420
TI  - In situ probing of gram-positive bacteria with high DNA G+C content using 23S
      rRNA-targeted oligonucleotides.

PMID- 7773419
TI  - Typing of Staphylococcus aureus strains by PCR-amplification of variable-length
      16S-23S rDNA spacer regions: characterization of spacer sequences.
AB  - To develop a rapid and accurate method of typing large numbers of clinical
      isolates of Staphylococcus aureus, the spacer region C of the rRNA operon [1391
      507 (16S-23S)] was enzymically amplified from 322 strains. When the products were
      separated by denaturing PAGE, 15 variable-length rrn alleles were demonstrated,
      ranging in size from 906 to 1223 bp. The variable-length HpaII-digested region C
      [(region E; 1446-196 (16S-23S)] amplification products were cloned into M13mp18RF
      to sequence separate variable-length alleles. A total of 17 region E inserts were
      sequenced, aligned and divided into nine alleles by length (938-1174) and
      sequence properties. The 16S-23S spacer rDNA varied in length (303-551 bp) and in
      properties; three alleles contained a tRNAIle gene alone, two alleles contained a
      tRNAIle and a tRNAAla gene, and four alleles lacked tRNA genes. The sequences of
      two alleles showed less than 1% variation when isolated from two or three S.
      aureus strains. The 48 penicillin- and methicillin-sensitive strains were divided
      into 26 ribotypes; in contrast, the 274 methicillin-resistant S. aureus (MRSA)
      strains were divided into nine ribotypes (A-I) with 97% typing as either ribotype
      A or B (rrnL was missing in B). The sequence conservation of the rrn operons
      argues for the use of the 16S-23S spacer region as a stable and direct indicator
      of the evolutionary divergence of S. aureus strains.

PMID- 7773422
TI  - Stress, illness, and the physician.

PMID- 7773421
TI  - Bacillus thuringiensis protoxin: location of toxic border and requirement of non
      toxin domain for high-level in vivo production of active toxin.

PMID- 7773423
TI  - Alcohol and injuries. Time for action.

PMID- 7773424
TI  - Surrogate decision making. Only one piece of the puzzle.

PMID- 7773425
TI  - Alcohol and injury. A case-crossover study.
AB  - OBJECTIVE: To determine whether and to what extent alcohol consumption increases
      the risk of injury. DESIGN: The case-crossover study is a new research design for
      assessing rare acute events (such as trauma) in relation to intermittent
      exposures (such as alcohol use) that have transient effects. All interviewed
      patients serve as their own controls, and the study design compares exposure
      during a "case" period, such as the 6 hours prior to injury, with exposure during
      a "control" period, such as the same 6-hour window on the previous day. SETTING:
      Emergency centers of a university hospital and a private not-for-profit hospital
      in a small midwestern city. PATIENTS: Three hundred fifty adults who presented
      with an injury within 48 hours of the event. DATA COLLECTED: Retrospective self
      report of alcohol use in each of the 28 days and each of the 30 hours prior to
      injury, demographic variables, drug use prior to injury, patients' attributions
      regarding causes of their injury, and weather factors. RESULTS: Primary analysis
      was based on pairs of observations that were discordant for alcohol use in the 6
      hours prior to injury and the same 6-hour window on the previous day. The odds
      ratio for one or more standard drinks vs none was 2.5 (95% confidence interval,
      1.2 to 5.4); for four or more drinks vs three or fewer, 5.0 (95% confidence
      interval, 1.4 to 27). CONCLUSION: Alcohol use in the 6 hours prior to injury is
      associated with an increased risk of injury. The findings are consistent with a
      dose-response effect, but with this sample size no threshold of risk was found.

PMID- 7773426
TI  - Patients with dementia and their caregivers 3 years after diagnosis. A
      longitudinal study.
AB  - OBJECTIVES: To document caregivers' perceptions of the deterioration in
      functional ability of persons with dementia over time, to identify the most
      problematic behavior for caregivers at two stages of dementing illness, and to
      compare the perceived informational needs of caregivers at diagnosis and 3 years
      later. DESIGN: Single cohort. Surveys were mailed at time 1 and respondents were
      followed up after 3 years (time 2). SETTING: Midwestern hospital dementia
      assessment clinic with a family physician director. Continuing care was by
      community physicians. SUBJECTS: Thirty elderly patients with dementia who were
      evaluated at the dementia clinic. Data were provided by their caregivers.
      RESULTS: Patients' scores on the Activities of Daily Living section of the
      questionnaire declined (bathe self, P = .03; transfer from bed or chair, P = .03;
      and groom self, P = .06). Significant deterioration in behaviors over time was
      found in incontinence (P = .04). Fewer patients were depressed at time 2 (P =
      .02). The patient behaviors found most troublesome at time 1 were worrying about
      memory loss, losing or hiding things, feeling blue, experiencing restlessness,
      having difficulty calculating, experiencing a lack of interest, and having false
      ideas. At time 2, the greatest problems were having a short attention span,
      failing to recognize persons or things, experiencing a lack of interest,
      experiencing restlessness, repeating himself or herself, forgetting where he or
      she is, speaking incoherently, and being incontinent. Questions caregivers most
      wanted answered at time 1 concerned possible treatment, the future course of
      illness, and the cause of the symptoms. At time 2, the concerns were the future
      course of illness, possible treatment, and disease inheritance. There was
      significantly more interest in family agreement about care (P = .004) and the
      need for legal guardianship (P = .001) at time 2. CONCLUSIONS: Caregivers'
      perceptions of the most frequent and troublesome behaviors of patients with
      dementia were documented at different stages of the disease. The importance
      caregivers attached to their requests for information reflected changing but
      continuing needs for reassurance about the patient's diagnosis and treatment and
      for help with the psychosocial consequences of dementia. Physicians must be aware
      of caregivers' needs at different stages of the disease process and be equipped
      to help them appropriately.

PMID- 7773428
TI  - Delay of diagnosis and empiric treatment of angiotensin-converting enzyme
      inhibitor-induced cough in office practice.
AB  - OBJECTIVE: To evaluate the length of time taken to diagnose cough due to the use
      of an angiotensin-converting enzyme (ACE) inhibitor and the frequency of interim
      diagnoses and treatments given in an office practice. DESIGN: Retrospective case
      study. SETTING: Two academic group family practice offices. PATIENTS: Seventeen
      solicited cases of patients with suspected or known ACE inhibitor-induced cough
      over a 2-year period. MAIN OUTCOME MEASURES: Documentation in the patient chart
      of the nature and complaint of the cough; the time between initiation of therapy
      with the drug and complaint of the cough; the time between initiation of therapy
      with the drug and assessment of ACE inhibitor-induced cough or discontinuation of
      drug treatment; other diagnoses given to explain the cough; and other treatments
      given. RESULTS: There was an average of 14.5 weeks between the initiation of ACE
      inhibitor therapy and the first documentation of the complaint of cough, and an
      average of 24.0 weeks between the initiation of ACE inhibitor therapy and
      documentation of the cough side effect. Physicians made several interim diagnoses
      prior to recognizing cough as a side effect of ACE inhibitor therapy. Physicians
      prescribed 30 medications and took two chest radiographs on seven patients
      experiencing ACE inhibitor-induced cough prior to recognition of this side
      effect. CONCLUSIONS: The investigation found a significant delay in making the
      final diagnosis of ACE inhibitor-induced cough. Frequently, physicians gave other
      diagnoses, ordered unnecessary diagnostic tests, and ordered treatments other
      than the discontinuation of ACE inhibitor therapy. Earlier identification would
      be more cost-effective.

PMID- 7773427
TI  - Surrogates' predictions of seriously ill patients' resuscitation preferences.
AB  - BACKGROUND: Seriously or terminally ill patients are frequently incapacitated and
      unable to express their preferences regarding cardiopulmonary resuscitation
      (CPR). In this situation, family members or other surrogate decision makers are
      often asked whether they believe the patient would want to be resuscitated. We
      evaluated the concordance of patient CPR preferences and surrogate perceptions of
      the patient preferences in the Study to Understand Prognoses and Preferences for
      Outcomes and Risks of Treatments (SUPPORT), a large, multicenter study of
      seriously ill hospitalized patients. METHODS: We compared patient preferences and
      surrogate perceptions in 1226 pairings in which both patient and surrogate
      responded to CPR decision questions. We also examined factors that might
      influence patient-surrogate concordance. RESULTS: Twenty-nine percent of patients
      with paired data did not want to be resuscitated; 26% of surrogates did not
      believe the patient they represented would want to be resuscitated. Within pairs,
      the overall exact agreement with respect to CPR decisions was 74%. For patients
      favoring CPR, only 16% of the surrogates misconstrued the patient's wishes. For
      patients who did not want to be resuscitated, however, 50% of the surrogates did
      not reflect the patient's wishes. If patients reported telling surrogates their
      CPR preference, concordance was significantly improved if the surrogate believed
      the patient did not want to be resuscitated and was significantly worsened if the
      surrogate believed the patient wanted CPR. This finding is likely an artifact of
      patients being more likely to report their preference to surrogates if that
      preference was not to be resuscitated. CONCLUSIONS: Surrogates' perceptions of
      patient CPR preferences are often inaccurate, particularly for those patients who
      do not want to be resuscitated. Methods to improve communication between patients
      and surrogates on CPR preferences should be developed and evaluated.

PMID- 7773429
TI  - Factors associated with having eye examinations in persons with diabetes.
AB  - OBJECTIVES: To estimate compliance with guidelines on ocular examinations for
      diabetic persons, to examine factors that affect compliance, and to determine
      reasons for noncompliance. DESIGN: Cross-sectional population study. SETTING:
      Primary care setting. PATIENTS: The population is 765 diabetic persons with
      younger onset and 533 with older onset who participated in the 1990 to 1992
      follow-up examination of the Wisconsin Epidemiologic Study of Diabetic
      Retinopathy. MEASUREMENTS: A medical history was taken in which subjects were
      asked about eye examinations by ophthalmologists and optometrists. RESULTS: Sixty
      four percent of the younger-onset group and 62% of the older-onset group had had
      a dilated eye examination in the previous year. Persons in both groups were more
      likely to have had a dilated examination if they had a longer duration of
      diabetes, more severe retinopathy, a history of glaucoma or cataract, and health
      insurance that covered eye examinations. Persons with younger-onset diabetes were
      more likely to have had an examination if they were older, were visually
      impaired, and had more education or higher income. Persons in the older-onset
      group were more likely to have had an examination if they were female or taking
      insulin. In those not having an eye examination, 79% and 71% of the younger- and
      older-onset groups, respectively, reported not having had one because they had no
      problems with their eyes, and 31% and 35% reported not having been told they
      needed one. Thirty-two percent and 11% said they were too busy, and 30% and 12%
      said they could not afford an examination. CONCLUSIONS: Diabetic persons should
      be educated as to the need for eye care; the results show that barriers to eye
      care exist in the form of affordability and lack of time.

PMID- 7773430
TI  - Relationship between the family APGAR and behavioral problems in children.
AB  - OBJECTIVES: To assess the use of the Family APGAR instrument as a supplement to
      usual clinical methods for the detection of psychosocial problems in children and
      to evaluate the relationship between the Family APGAR and physician diagnosis and
      elevated Child Behavior Checklist (CBCL) scores. DESIGN: Cross-sectional.
      SETTING: Ambulatory care center of a community-based, university-affiliated
      family medicine training program. SUBJECTS: One hundred fifty-two parents of
      children aged 3 to 16 years. MAIN OUTCOME MEASURES: Family functioning was
      considered poor if Family APGAR scores were 5 or less. For the CBCL, sum total T
      scores greater than the 90th percentile for nonreferred children were considered
      clinically significant. Physicians used a checklist to indicate the presence of
      psychosocial problems or family dysfunction. RESULTS: Agreement between the
      Family APGAR scores and the physician's detection of child psychosocial problems
      was weak (kappa = 0.23). There was no relationship between the Family APGAR
      scores and physician perception of family dysfunction (kappa = -0.05). Although
      agreement between the Family APGAR and CBCL classifications was weak (kappa =
      0.20), families with low Family APGAR scores were more than twice as likely to
      have children with clinically significant CBCL scores than those with higher
      scores (risk ratio = 2.08; 95% confidence interval = 1.02 to 4.24). CONCLUSIONS:
      The relationships among the Family APGAR and CBCL scores and physician detection
      of child psychosocial problems were weak. Child psychosocial problems were more
      than twice as likely to be present when the Family APGAR score was low. These
      findings suggest that family functioning is related to child psychosocial
      problems, but that the Family APGAR may not improve screening for child
      psychosocial problems.

PMID- 7773431
TI  - Tuberculosis in the homeless.
AB  - The prevalence of tuberculosis in the homeless is on the rise. The presence of
      human immunodeficiency virus and multidrug-resistant tuberculosis in the homeless
      has contributed to this high prevalence. Several factors, including alcoholism,
      substance abuse, and psychiatric illness, combine to make it difficult to
      diagnose and treat tuberculosis in the homeless. Medical providers are likely to
      encounter homeless individuals in a number of settings, including emergency
      departments, community and free clinics, public hospitals, and health maintenance
      organizations. Appropriate screening, prevention, and treatment should be
      undertaken in collaboration with local health departments. The use of directly
      observed therapy and of the treatment regimens published by the Centers for
      Disease Control and Prevention improves treatment outcomes among the homeless.

PMID- 7773432
TI  - Interrater agreement in the interpretation of microscopic urinalysis.
AB  - To determine the reliability of specimen interpretation by outpatient
      laboratories, 150 consecutive specimens from three family practice centers were
      analyzed by either two laboratory technicians (n = 99) or two family physicians
      (n = 51). The results showed good to excellent agreement for contamination
      (defined as five or more epithelial cells per high-power field) or significant
      pyuria (five or more white blood cells per high-power field) or hematuria (five
      or more red blood cells per high-power field). Agreement between laboratory
      technicians did not differ significantly from agreement between physicians for
      the interpretation of contamination or pyuria, but for hematuria, agreement was
      higher between technicians (P = .02). These results suggest that outpatient
      interpretation of microscopic urine specimens shows levels of interrater
      agreement similar to or better than other tests that have been evaluated.

PMID- 7773433
TI  - Adherence to very-low-fat diet by a group of cardiac rehabilitation patients in
      the rural southeastern United States.
AB  - This 28-week observational study measured adherence to and acceptability of the
      diet and nutrition component of an Ornish-type program among patients in a rural
      southern setting. Ten volunteers followed a very-low-fat (10% of energy), total
      vegetarian diet and participated in a program of exercise, stress management, and
      group support. Patients made significant dietary changes and found the diet
      "acceptable." Three patients consumed less than 10% of energy from fat and two
      additional patients consumed less than 20% of energy from fat. Eighty-five
      percent of the patients' meals adhered to a near vegetarian diet. Weight loss
      ranged from 0.1 to 11.7 kg (0.25 to 26 lb). Lipid values were unchanged. At 12
      months, without the benefit of the structured program, one patient reported 100%,
      six reported 85%, and two reported 50% adherence to the dietary principles. We
      conclude that motivated patients with coronary artery disease can follow a very
      low-fat, near vegetarian diet but experience difficulty without a structured
      program.

PMID- 7773434
TI  - Uptake of acetylcholinesterase by neurons in the substantia nigra.
AB  - It is known that acetylcholinesterase is secreted by the dopaminergic neurons of
      the substantia nigra and has a subsequent action independent of cholinergic
      transmission. Although non-cholinergic actions of this protein have been
      demonstrated, the subsequent fate of acetylcholinesterase is unknown. One
      possibility is that acetylcholinesterase is taken up following secretion into the
      extracellular space. This hypothesis has been tested in vivo, in both conscious
      and anaesthetized guinea-pigs. Exogenous acetylcholinesterase (2-20 pM) was
      infused via a push-pull cannula implanted into either the substantia nigra or the
      surrounding extranigral regions: the amount subsequently recovered in the
      perfusate was then compared with control values. Only when the push-pull cannulae
      were implanted in the substantia nigra was there a marked decrease in the amount
      of acetylcholinesterase recovered; this selective retention was abolished when
      the perfusion medium was cooled to 4 degrees C or when the experiment was
      performed post mortem. Direct visualization of immunocytochemically identified
      nigral dopaminergic cells revealed co-localized deposits of labelled, exogenous
      acetylcholinesterase. Moreover, when exogenous acetylcholinesterase was boiled to
      prevent detection by the assay system and to eliminate any classical enzymatic
      action, an enhancement in perfusate levels of endogenous acetylcholinesterase was
      observed from nigral but not from extranigral sites, indicating that endogenous
      and exogenous acetylcholinesterases were in competition. These results suggest
      that, within the substantia nigra, secreted acetylcholinesterase may be subject
      to a temperature- and energy-dependent uptake mechanism.

PMID- 7773435
TI  - The effects of dopamine on the subthreshold electrophysiological responses of rat
      prefrontal cortex neurons in vitro.
AB  - The rat prefrontal cortex is densely innervated by dopaminergic fibres
      originating in the mesencephalic ventral tegmental area, and dopamine application
      in vivo has an inhibitory effect. We have studied the effects of dopamine on the
      persistent sodium current that is present in prefrontal cortex neurons and on the
      subthreshold electrophysiological responses generated by that current: a slow
      depolarization and a fast oscillatory activity. Experiments were made in coronal
      slices of rat frontal cortex (300-400 microns thickness) and intracellular
      recordings from regularly spiking cells were obtained with 3 M potassium acetate
      filled glass microelectrodes (80-150 M omega). Dopamine was applied dissolved in
      the extracellular medium and, in current-clamp recordings, reversibly inhibited
      the slow subthreshold depolarization. Dopamine was ineffective when applied after
      tetrodotoxin (1 microM) had blocked the action potentials. This inhibition was
      dose-dependent in the range of 0.1-10 microM). Dopamine, applied at 10 microM,
      decreased the steady-state firing frequency and also inhibited the subthreshold
      fast oscillatory activity. The currents activated in the subthreshold range were
      recorded with the single-electrode voltage-clamp technique and a clear
      persistent, tetrodotoxin-sensitive component was isolated. This component was
      inhibited by 50% in a reversible way by 20 microM dopamine. These results show
      that dopamine increases the threshold for spike firing and suggest a mechanism
      for the inhibitory action of this neurotransmitter in the prefrontal cortex.

PMID- 7773437
TI  - A minimal CGRP gene promoter is inducible by nerve growth factor in adult rat
      dorsal root ganglion neurons but not in PC12 phaeochromocytoma cells.
AB  - The calcitonin/CGRP gene is transcribed in thyroid C cells and some neuronal
      cells but not in other cell types. Although the promoter sequences mediating gene
      activity in thyroid C cells have been extensively studied, the elements
      responsible for promoter activity in neuronal cells and its stimulation by nerve
      growth factor (NGF) have not previously been defined. We report the first use of
      the calcium phosphate procedure to successfully transfect adult rat dorsal root
      ganglion neurons, which naturally express the calcitonin/calcitonin gene-related
      peptide (CGRP) in an NGF-inducible manner. This method was used to characterize
      the elements in the calcitonin/CGRP promoter which are responsible for its basal
      activity and NGF inducibility in DRG neurons and in PC12 cells, a neuronally
      derived cell line which does not naturally express the calcitonin/CGRP gene.
      Although the sequences required for basal activity are similar in each cell type,
      we show that a minimal calcitonin/CGRP promoter is NGF-responsive in dorsal root
      ganglion cells, but that upstream sequences are required for such inducibility in
      PC12 cells.

PMID- 7773436
TI  - Block of c-Fos and JunB expression by antisense oligonucleotides inhibits light
      induced phase shifts of the mammalian circadian clock.
AB  - Light-induced phase shifts of circadian rhythmic locomotor activity are
      associated with the expression of c-Jun, JunB, c-Fos and FosB transcription
      factors in the rat suprachiasmatic nucleus, as shown in the present study. In
      order to explore the importance of c-Fos and JunB, the predominantly expressed AP
      1 proteins for the phase-shifting effects of light, we blocked the expression of
      c-Fos and JunB in the suprachiasmatic nucleus of male rats, housed under constant
      darkness, by intracerebroventricular application of 2 microliters of 1 mM
      antisense phosphorothioate oligodeoxynucleotides (ASO) specifically directed
      against c-fos and junB mRNA. A light pulse (300 lux for 1 h) at circadian time 15
      induced a significant phase shift (by 125 +/- 15 min) of the circadian locomotor
      activity rhythm, whereas application of ASO 6 h before the light pulse completely
      prevented this phase shift. Application of control nonsense oligodeoxynucleotides
      had no effect. ASO strongly reduced the light-induced expression of c-Fos and
      JunB proteins. In contrast, light pulses with or without the control nonsense
      oligodeoxynucleotides evoked strong nuclear c-Fos and JunB immunoreactivity in
      the rat suprachiasmatic nucleus. These results demonstrate for the first time
      that inducible transcription factors such as c-Fos and JunB are an essential part
      of fundamental biological processes in the adult mammalian nervous system, e.g.
      of light-induced phase shifts of the circadian pacemaker.

PMID- 7773438
TI  - The effects of early postnatal modification of body shape on the somatosensory
      visual organization in mouse superior colliculus.
AB  - Different regions of the body of an animal have their own shape and location
      within visual space. Accordingly, in the superior colliculus there are
      somatosensory-visual bimodal neurons receiving tactile and visual input from the
      same region of space. In newborn mice, we changed the position of some body parts
      within visual space in order to see what happened to the alignment of the
      somatosensory and visual receptive fields of superior colliculus bimodal neurons.
      To do this, we modified the shape of the head by displacing the superior
      vibrissae and the ears, normally in the superior portion of visual space, into
      the inferior visual space. Analogously, we bent the inferior vibrissae into the
      superior visual space. At the sixth postnatal week we recorded from somatosensory
      visual bimodal neurons of the deep layers of the superior colliculus and found
      that the tactile and visual receptive fields were aligned. Neurons receiving
      tactile input from the downward-displaced superior vibrissae and ears showed
      visual receptive fields in the inferior portion of visual space, whereas neurons
      receiving input from the upward-displaced inferior vibrissae showed visual
      receptive fields in the superior visual space. These results show that an
      experience-dependent interaction between visual and somatosensory inputs occurs
      during development, and that early exposure to abnormal visual-somatosensory
      experience modifies the organization of multisensory neurons in the superior
      colliculus.

PMID- 7773439
TI  - Postnatal development of GABA neurons in the rat somatosensory barrel cortex: a
      quantitative study.
AB  - As an estimate of the numerical importance of GABA-containing neurons during
      development, their quantitative distribution was analysed in the primary
      somatosensory cortex of rats between postnatal days (P) 5 and 60, using the
      dissector method and GABA postembedding immunocytochemistry. In relation to the
      overall number of neurons in the barrel field cortex, the proportion of GABA
      neurons showed an early significant decrease between P5 and P10 from 14 to 11%,
      most likely due to termination of transient expression of GABA by some cells. It
      then remained stable until P20, after which it started slowly but steadily to
      increase, reaching 14% of the total at P60. The absolute number of GABA neurons
      also increased by nearly 50% during that period, whereas the number of all
      neurons remained constant. These changes are seemingly due to a subpopulation of
      neurons, shown to be of small size, which express GABA late in development. Thus,
      anatomical adjustments of the cortical GABA system may be observed at least until
      the end of the second postnatal month, reflecting both delayed maturation and
      adaptation of this inhibitory circuitry. We suggest the existence of three
      subpopulations of cortical GABA neurons depending on the time of onset and the
      regulation of their GABA expression: (i) neurons which express GABA before
      completion of migration and thus provide for its neurotrophic influence, (ii)
      neurons which express GABA immediately after completion of migration and build up
      the cortical inhibitory circuitry, and (iii) neurons which express GABA later in
      development and represent a substrate of experience-dependent plasticity.

PMID- 7773440
TI  - The classification and properties of nociceptive afferent units from the skin of
      the anaesthetized pig.
AB  - The afferent properties of nerve fibres innervating the hairy skin of the pig
      hind limb were investigated by recording from 142 single units from the saphenous
      nerve. Identified single units were isolated using maximal electrical stimulation
      of the nerve trunk. Afferent units were classified on the basis of their
      responses to a range of stimuli, both thermal (heating to 60 degrees C and
      cooling to 10 degrees C) and mechanical (air jet, von Frey type filaments with
      forces of 0.1-250 mN, and strong pressure with a blunt needle). A-fibre units
      (conduction velocity 6.3-64 m/s, n = 60) fell into categories that have been
      described in hairy skin in other mammalian species. Most were mechanoreceptors,
      although seven typical A-fibre mechanical nociceptors with large, multipoint
      fields were also isolated. No cutaneous receptive field could be found for 15% of
      A-fibre units. Out of 62 C-fibre units (conduction velocity 0.49-2 m/s) 40% had
      no cutaneous field for pressure, heat or cold. Of the C-fibre units with
      cutaneous fields, 42% were polymodal nociceptors, 38% were mechanoreceptors with
      a variety of properties, including some excited by noxious heat, and 19% were
      heat-only nociceptors. C-polymodal nociceptors had large receptive fields up to
      12.5 mm across and did not sensitize following strong heating. Twenty units
      conducted at 2-6.3 m/s, between the main C- and A-fibre bands, and were varied in
      their responses. Some had properties identical to C-fibre mechanoreceptors whilst
      four were sensitive cold thermoreceptors and one was a polymodal nociceptor. Two
      units were mechanical nociceptors with small receptive fields.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7773441
TI  - Temporal coding of amplitude and frequency modulation in the rat auditory cortex.
AB  - The rat primary auditory cortex was explored for neuronal responses to pure tones
      and sinusoidally amplitude-modulated (SAM) and frequency-modulated (SFM) stimuli.
      Units showed phase-locked responses to SAM stimulation (55%) and SFM stimulation
      (80%), with modulation frequencies up to 18 Hz. Tuning characteristics to the
      modulation frequency were mainly band-pass with best modulation frequencies
      (BMFs) between 4 and 15 Hz. Units with synchronized activity to SFM stimulation
      showed three response types with respect to the direction of the frequency
      modulation: 52% were selective to the upward direction, 30% to the downward
      direction, and 18% had no preference. Triangular frequency modulations were used
      to test if units were tuned to specific modulation frequencies or to specific
      rates of frequency change. In the vast majority of units tested the response
      characteristics were strongly influenced by varying the modulation frequency,
      whereas varying the rate of frequency change had little effect in the stimulus
      range used. Units that showed phase-locked responses to SAM and SFM stimulation
      had similar activity patterns in response to both types of stimuli. BMFs for SAM
      and SFM stimulation were significantly correlated. Intrinsic oscillations of up
      to 20 Hz could be seen in the spontaneous activity and after the stimuli
      independent of the stimulus type. Oscillation frequencies were significantly
      correlated with the BMFs of the respective units. The results are discussed in
      terms of a mechanism for periodicity detection based on a temporal code. This
      could be important for the recognition of complex acoustic signals.

PMID- 7773442
TI  - Homotypic and heterotypic coupling mediated by gap junctions during glial cell
      differentiation in vitro.
AB  - Intercellular communication mediated by gap junctions was investigated during
      oligodendrocyte differentiation in primary and secondary cell cultures from
      newborn and adult rats. Two types of communication were considered: ionic
      coupling and dye-coupling between similar oligodendrocytes selected at the same
      stage of differentiation (homotypic) and dye-coupling between oligodendrocytes
      and astrocytes (heterotypic). Intercellular diffusion of fluorescent probes and
      double whole-cell recordings were used to test the incidence of dye and ionic
      communication respectively. Progenitor cells, identified with A2B5 antibodies,
      were characterized by the absence of ionic and dye-coupling, whereas
      oligodendrocytes, identified with galactosylceramide antibodies, exhibited both
      types of communication. This homotypic coupling was inhibited by various
      uncoupling agents, but unaffected by treatments which increased the intracellular
      concentration of cAMP. In cocultures of astrocytes and oligodendrocytes, Lucifer
      yellow and sulphorhodamine B were exchanged in both directions. This heterotypic
      dye-coupling, which could be blocked by octanol, first appeared after 3 weeks in
      culture and increased to an incidence of 25% after 6 weeks, a developmental
      pattern comparable to homotypic dye-coupling between oligodendrocytes. In
      contrast, during the same period, progenitors and microglia were never observed
      to be dye-coupled with astrocytes.

PMID- 7773443
TI  - Properties of the hyperpolarization-activated cation current Ih in rat midbrain
      dopaminergic neurons.
AB  - Intracellular electrophysiological recordings in current- and voltage-clamp mode
      were obtained from dopaminergic neurons of the rat mesencephalon in an in vitro
      slice preparation. In current-clamp mode, a time-dependent anomalous
      rectification (TDR) of the membrane was observed in response to hyperpolarizing
      current pulses. In single-electrode voltage-clamp mode, a slowly developing
      inward current (Ih) underlying the TDR was studied by hyperpolarizing voltage
      commands from a holding potential of -50 to -60 mV. Ih started to be activated at
      approximately -69 mV, was fully activated at -129 to -141 mV, with half-maximal
      activation at -87 mV, and showed no inactivation with time. The time course of
      development of Ih followed a single exponential, and its time constant was
      voltage-dependent. At -81 mV, Ih activated with a time constant of 379 +/- 47.6
      ms, whereas at -129 mV Ih activated with a time constant of 65 +/- 2.2 ms. Its
      estimated reversal potential was -35 +/- 4 mV. Raising the extracellular
      concentration of K+ from 2.5 to 6.5 and to 12.5 mM increased the amplitude of Ih
      while reducing the extracellular concentration of Na+ from 153.2 to 27.2 mM
      caused a reduction in amplitude of Ih. Bath application of caesium (1-5 mM)
      reversibly reduced or blocked the TDR/Ih. Perfusion of tetrodotoxin (0.5-1
      microM), tetraethylammonium (10-20 mM) or barium (0.3-2 mM) did not significantly
      affect Ih. Ih was also present in cells impaled with CsCl-filled
      electrodes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773444
TI  - Nerve-dependent plasticity of the Golgi complex in skeletal muscle fibres:
      compartmentalization within the subneural sarcoplasm.
AB  - Several recent reports have highlighted the plasticity of the Golgi apparatus
      during myogenesis, yet the organization of this specialized organelle in
      innervated skeletal muscle fibres remains poorly understood. Using four bona fide
      anti-Golgi antibodies, directed against a 210 kDa protein, a 160 kDa
      sialoglycoprotein, the small GTP-binding protein rab6p, and TGN38, the
      localization of which covers the various compartments of the Golgi complex, we
      show by immunofluorescence microscopy that the Golgi complex undergoes
      considerable reorganization in the course of myogenic differentiation and motor
      endplate formation in the rat. Unlike the typical perinuclear distribution of the
      Golgi stacks associated with every nucleus in myotubes, a striking subneural
      compartmentalization is observed in adult innervated myofibres. In short-term
      denervated adult muscle fibres, we noticed the presence of the perinuclear Golgi
      apparatus in extrajunctional regions, a pattern reminiscent of that of developing
      myotubes. At variance with anti-Golgi antibodies, antibodies to the rough
      endoplasmic reticulum label structures dispersed throughout the entire
      sarcoplasm, hence suggesting that it is not the entire membrane/secretory protein
      synthesis machinery which is compartmentalized, but only the Golgi apparatus.
      Also, an unexpected lack of immunoreactivity with the TGN38 and alpha-mannosidase
      II antibodies points to biochemical differentiation of the subneural Golgi
      apparatus at the adult motor endplate. These new data extend our previous
      observations on the compartmentalization of the Golgi apparatus in the
      postsynaptic sarcoplasm of chick muscle fibres, and further illustrate the
      plasticity of the Golgi apparatus in muscle cells. The specialization of the
      Golgi apparatus within the subneural compartment provides this particular region
      with a compartmentalized secretory pathway, and these observations highlight the
      notion that the level of differentiation of this domain is not only maintained
      via transcriptional regulation but also by post-translational control mechanisms.

PMID- 7773445
TI  - Expression of the highly polysialylated neural cell adhesion molecule during
      postnatal myelination and following chemically induced demyelination of the adult
      mouse spinal cord.
AB  - We have investigated the expression of the highly polysialylated neural cell
      adhesion molecule in the mouse spinal cord during postnatal myelination and in
      the adult after chemically induced demyelination. By double immunohistochemistry,
      using a monoclonal antibody (anti-Men B) which specifically recognizes polysialic
      acid (PSA) units on neural cell adhesion molecule (N-CAM), and an anti-myelin
      basic protein, a caudorostral gradient of expression of PSA-NCAM was observed at
      postnatal day 1 (P1), which was inversely related to the gradient of myelination.
      At P7, PSA-NCAM labelling decreased relative to P1. In white matter, this
      decrease was correlated with the progression of myelination. PSA-NCAM
      immunoreactivity persisted in as yet unmyelinated structures, i.e. the
      corticospinal tract, the dorsomedial part of the ventral funiculus and the
      lateral funiculi, and decreased with the onset of myelination of these structures
      at P15. In the adult, PSA-NCAM expression remained in discrete structures, i.e.
      laminae I and II of the dorsal horn and lamina X around the central canal. The
      ependymal cells and the astrocyte endfeet under the meninges were also labelled.
      In addition, PSA-NCAM expression was reinduced on various cells and structures
      after lysolecithin-induced demyelination of the adult mouse spinal cord. At early
      times after demyelination, PSA-NCAM was expressed on glial cells around the
      lesion but also at a distance from this zone. Seven days after injection,
      cellular PSA-NCAM expression was found around but also within the lesion. This
      expression was totally abolished 15 days after injection. Double
      immunohistochemistry for PSA and cell-specific markers showed that the cells
      which expressed PSA-NCAM after demyelination were oligodendrocyte precursors,
      reactive astrocytes and Schwann cells. PSA-NCAM re-expression on all cell types
      was transient and ceased when myelin repair was accomplished. The spatial and
      temporal regulation of PSA-NCAM expression during development and after
      demyelination suggests a role for PSA-NCAM in glial plasticity during the
      myelination and remyelination processes.

PMID- 7773446
TI  - Receptor expression in olfactory neurons during rat development: in situ
      hybridization studies.
AB  - In situ hybridization approaches have been employed to explore the onset and time
      course of odorant receptor expression during the prenatal development of rats.
      The critical phase for the maturation of the olfactory system from embryonic day
      (E) 12 to E18 was analysed. The onset of expression of four receptor genes (OR5,
      OR14, OR37 and OR124) was found between day E12 and E14. In the early phase of
      development (E14) a distinct receptor subtype was expressed only in a few hundred
      neurons; the number increased about two-' to three-fold within a 2 day interval.
      From the very beginning, spatial segregation of receptor subtypes in distinct
      expression zones was observed.

PMID- 7773447
TI  - Increased beta-amyloid precursor protein expression in astrocytes in the gerbil
      hippocampus following ischaemia: association with proliferation of astrocytes.
AB  - Increases in beta-amyloid precursor proteins (APP), which include the beta
      amyloid senile plaque protein present in patients with Alzheimer's disease, have
      been shown to occur in models of neuronal damage and neurotoxic cell injury. This
      observation led us to examine the expression of these proteins after transient
      ischaemic episodes in the gerbil. Animals were killed 2-28 days after ischaemia
      and APP were detected by immunocytochemistry at the light and electron
      microscopic levels with an antibody raised against the C-terminal region of these
      proteins. The gliotic reaction was also examined using glial fibrillary acid
      protein (GFAP) immunoreactivity. Two days after ischaemia, neuronal cell death
      was observed in the hippocampal CA1 region accompanied by astrocyte hypertrophy.
      These hypertrophic astrocytes were found to be GFAP positive but stained weakly
      for APP. Seven days after ischaemia both astrocyte hypertrophia and hyperplasia,
      with identified mitotic figures, were observed. These hyperplasic astrocytes were
      intensely stained by the APP antibody, and were observed up to 28 days after
      ischaemia. This shows that neuronal cell death produced by transient ischaemia is
      followed by an increased APP expression which appears to be associated with the
      hyperplasic astrocytes but not with the initial hypertrophy of this cell
      population. These results, when taken together with those obtained in other
      models of neuronal damage or death, clearly suggest that APP expression follows
      neuronal death and is associated with astrocyte proliferation.

PMID- 7773448
TI  - Basic fibroblast growth factor opens calcium-permeable channels in quail
      mesencephalic neural crest neurons.
AB  - In order to investigate the action of basic fibroblast growth factor (bFGF) in
      the nervous system, we have studied the ionic signals elicited by this peptide in
      cultured quail mesencephalic neural crest neurons using patch-clamp and
      cytofluorimetric techniques. In this preparation stimulation with bFGF induced,
      with a delay of some tens of seconds, an inward cationic current. Single-channel
      experiments provided evidence for the activation of a calcium-permeable channel.
      In single-cell cytofluorimetric measurements, a sustained rise in [Ca2+]i was
      observed, which was dependent on the presence of external calcium. These events
      may play a role in the developmental effects of bFGF.

PMID- 7773449
TI  - Management of ductal carcinoma in situ.
AB  - Ductal carcinoma in situ (DCIS) is an early, localized stage of breast carcinoma
      that has an excellent prognosis when it is properly treated. The significant
      increase in the frequency of diagnosis of DCIS in recent years is the result of
      both better recognition of DCIS among pathologists and widespread use of
      screening mammography. Multicentricity, bilaterality and histologic subtype are
      important considerations in the management of this disease. The clinical
      presentation of DCIS is the presence of either a palpable mass or a mammographic
      abnormality, most frequently in the form of an area of microcalcifications. For
      several decades, total mastectomy was considered the appropriate treatment for
      DCIS, and it should still be considered the standard to which more conservative
      forms of treatment must be compared. Breast conservation surgery has been used
      with increasing frequency in the treatment of DCIS but the adequacy of this
      approach remains subject to controversy. Segmental mastectomy alone may be
      applied with caution in carefully selected patients, while the rest of the
      patients undergoing breast conservation surgery should be treated with breast
      irradiation. Axillary node dissection is generally considered unnecessary in the
      treatment of DCIS. There is no role for adjuvant chemotherapy in the management
      of this disease. The role of tamoxifen in the treatment of DCIS is not clearly
      defined and it should be given only to patients enrolled in clinical trials.
      Ongoing research should clarify the controversies surrounding DCIS and enable us
      to define the optimal management for this disease.

PMID- 7773450
TI  - Thick cutaneous melanoma of the trunk and extremities: an institutional review.
AB  - The objective of this study was to review our experience with thick cutaneous
      melanoma of the trunk and extremities and to identify subgroups of long-term
      survivors. Ninety-one patients admitted between the years 1977 and 1987, with
      cutaneous melanoma of the trunk or extremities, Breslow thickness > or = 4.0 mm,
      or a Clark's level V lesion form the basis of this review. Node positive clinical
      stage II patients had a 5-year survival rate of 32%. Five-year survival for node
      positive clinical stage III patients was 0% (P < 0.0001). Node negative clinical
      stage II patients, and those found to be histologically node positive, had no
      survival difference, P = 0.88. Sixty per cent of node negative patients with an
      extremity primary survived 5 years, while patients with a node positive truncal
      primary had a survival of 14%, P = 0.005. In conclusion, most patients present
      with local-regional disease. Patients with node negative extremity lesions have
      the best chance for cure.

PMID- 7773451
TI  - Prognostic value of ploidy of primary tumour and nodal secondaries in colorectal
      cancers.
AB  - Tumour ploidy is of prognostic value in colorectal cancer, DNA aneuploid tumours
      having a worse outlook. Nearly all studies have concentrated on the DNA content
      of the primary tumour. We have examined the ploidy of the primary tumour and its
      lymph node metastases in 71 cases of Dukes' stage C disease, to see whether this
      provides greater prognostic information than the primary alone. Analysis was
      performed using formalin-fixed, paraffin-embedded tumour sections. Ploidy of
      primary and metastases was different in 20 cases (28%), aneuploid nodes being
      seen with diploid primaries and vice versa. Ploidy of both the primary (chi 2 =
      4.86, P = 0.03) and secondary (chi 2 = 4.86, P = 0.03) tumours predicted survival
      in univariate analysis. Combining the ploidy of primary and nodes, three
      prognostic groups could be defined--diploid primaries with diploid metastases
      (hazard relative to both aneuploid, 0.36) had significantly better survival than
      cases where the ploidy of the primary and nodes were mixed (relative hazard 0.47
      0.56), which did better than cases with aneuploid primary and nodes. This study
      demonstrates that ploidy variation between primary and secondary tumours is
      common, and better prognostic information may be gained by studying both.

PMID- 7773452
TI  - Changes in serum sex steroid levels during megestrol acetate therapy.
AB  - We hypothesized that megestrol acetate (MA) may work on breast carcinoma by
      inducing changes in serum sex steroid levels. We prospectively measured levels of
      follicle-stimulating hormone (FSH), luteinizing hormone (LH),
      dehydroepiandrosterone (DHEA), estrone (E1), and estradiol (E2) in 18
      postmenopausal women before and during megestrol acetate therapy. MA
      significantly suppressed serum FSH, LH, DHEA and E1 levels. However, this was
      accompanied by a marked increase in serum E2 levels as measured by
      radioimmunoassay performed on whole serum. MA did not cross-react with the anti
      E2 antibodies used in the assay. Elevated E2 levels also occurred in
      oophorectomized and/or adrenalectomized patients indicating the ovary and adrenal
      are not the source of the elevated E2 levels. We conclude that MA may be
      metabolized to oestrogenic compounds that crossreact with antibodies to E2,
      explaining the elevated E2 levels observed. The effects of these oestrogenic
      metabolites on breast carcinoma are unknown.

PMID- 7773453
TI  - Carbon dioxide volume and intra-abdominal pressure determination before the
      creation of a pneumoperitoneum.
AB  - Laparoscopic surgery generally is regarded as a safe procedure when a preset
      pressure is used in the carbon dioxide insufflator. However, a fixed pressure
      setting is not appropriate when insufflating a very large or a very small
      abdomen. Presently, extrapolation from the commonly used 15 mm Hg to an
      appropriate and safe pressure cannot be easily determined except by a crude trial
      and error method. We developed an anthropometric formula to calculate the total
      abdominal cavity capacity and the corresponding pressure necessary to obtain safe
      pneumoperitoneum. This anthropometric formula calculates the total abdominal
      capacity by measuring one diameter from the symphysis pubis to the xyphoid bone,
      a second diameter as half the initial measurement, and a third diameter by
      dividing the waist measurement (minus an estimated percentage of body fat) and
      dividing that product by pi. The product of the three diameters is then
      multiplied by a constant (K = 0.5). We studied prospectively 20 patients whose
      indications for laparoscopic surgery necessitated creation of a pneumoperitoneum.
      The patients were divided into two groups: group A (n = 10), patients who were
      observed with the intra-abdominal pressure fixed at 15 mm Hg while recording the
      amount of distension produced in the abdominal cavity during creation of the
      pneumoperitoneum; and group B (n = 10) in whom pneumoperitoneum was obtained
      based on the initial volume of carbon dioxide-insufflation previously calculated
      using our formula. Based on our observations, we conclude that this
      anthropometric formula can be used successfully in predicting a safe level of
      insufflation in relation to the patient's size.

PMID- 7773454
TI  - Safe laparoscopic surgery: tubal ligation without prior pneumoperitoneum.
AB  - Twelve years of experience with tubal ligation by the laparoscopic route at two
      highly specialized centers of female sterilization are discussed; special
      attention is given to the technique and results achieved. The number of
      intraoperative and postoperative complications was very low compared with data
      reported elsewhere. This article attempts to present the knowledge gained by
      using the laparoscopic technique, at a time when the use of laparoscopic surgery
      is extending around the world. The direct insertion of trocars without prior
      pneumoperitoneum has proved to be safe, and the risks of intraabdominal (visceral
      or vascular) injuries are minimized by observing simple rules, such as clamping
      of the relaxed abdominal anterior wall with towel clips, maintaining sharpened
      trocars, and using the extended index finger as a limit to introduce only the tip
      of the trocars. We consider a medical history of previous laparotomy secondary to
      peritonitis and open abdominal treatment absolute contraindications for this
      technique.

PMID- 7773456
TI  - Endoscopic retrograde cholangiopancreatography and endobiliary stenting in the
      treatment of biliary injury resulting from liver trauma.
AB  - Two patients with the bile duct injury secondary to blunt liver trauma are
      presented. Endoscopic retrograde cholangiopancreatography (ERCP) proved to be a
      useful diagnostic and therapeutic modality in the treatment of these patients.
      This report advocates the use of ERCP and endobiliary stenting in the management
      of biliary injury resulting from liver trauma.

PMID- 7773455
TI  - Laparoscopic Nissen fundoplication--a curative, safe, and cost-effective
      procedure for complicated gastroesophageal reflux disease.
AB  - We prospectively evaluated the cases of 52 patients who underwent laparoscopic
      Nissen fundoplication from October 1992 to January 1994 for patient outcome,
      satisfaction, hospital stay, hospital cost, and disability. All cases were
      evaluated with historical findings, routine chemistry studies, upper
      gastrointestinal series, fluoroesophagography for esophageal motor function,
      gallbladder ultrasonography, and esophagogastroduodenoscopy. Six patients
      required esophageal manometry for diagnosis. All patients had refractory
      esophageal reflux disease or complications of chronic esophageal reflux. Forty
      nine (94%) of the 52 cases were completed laparoscopically. Ninety percent of
      those were cured of their symptoms and returned to a normal life-style. The
      percent had significant improvement, with rare episodes of reflux or dysphagia,
      and received antacids only occasionally. Hospital stay was reduced to 2.3 days,
      compared to 8.3 days for the open technique. Hospital cost was reduced to $6,870,
      compared to $11,990 for the open technique. Mean time until return to work was 15
      days in the laparoscopic group, compared to 42 days in the open Nissen group.
      There were two major complications (4%) and 12 minor complications (24%). There
      were no deaths. Fifty-one of 52 patients stated that they would recommend the
      procedure for others with the same problem. Laparoscopic Nissen fundoplication is
      a safe and effective treatment for refractory esophageal reflux and its
      complications and has the extra benefit of reduced hospital cost and stay and a
      more rapid return to work. Preoperative esophageal manometry and 24-h esophageal
      pH testing may be used selectively with excellent results.

PMID- 7773457
TI  - Feasibility of laparoscopic cholecystectomy for patients with a nonvisualized
      gallbladder on drip infusion cholangiography.
AB  - We report here the operative findings, the incidence of successful laparoscopic
      treatment, and the perioperative complications in patients with nonvisualized
      gallbladder on drip infusion cholangiography (DIC). Eighty-five patients with a
      nonvisualized gallbladder on DIC were entered into the study. None of the
      patients had a minimal adhesive gallbladder; 51 to 85 patients (60.0%) had
      moderate adhesive gallbladders, and 34 (40.0%) had severely adhesive ones. The
      rate of successful laparoscopic treatment, including laparoscopy-assisted
      abdominal surgery, was 97.6% (83 of 85 patients). Perioperative complications
      occurred in only three patients (3.5%), and there were no deaths related to the
      operation. Thus, when patients with a nonvisualized gallbladder on DIC undergo
      laparoscopic cholecystectomy, meticulous procedures must be carried out; however,
      as the rate of successful laparoscopic treatment is high, cholecystectomy under
      laparoscopy is feasible for experienced surgeons.

PMID- 7773458
TI  - Diagnostic laparoscopy in women with acute abdominal pain.
AB  - Nineteen women with acute lower abdominal pain of uncertain etiology underwent
      diagnostic laparoscopy during a 2-year period from August 1991 to August 1993 and
      were retrospectively reviewed. All patients, aged 12 to 44 years, were
      premenopausal. Laparoscopy provided definitive diagnosis in all 19 patients.
      Laparoscopic findings included appendicitis (11 cases), pelvic inflammatory
      disease (five cases), significant ovarian cysts (two cases), and ectopic
      pregnancy (one case). Successful laparoscopic procedures included appendectomy
      (five cases), and salpingo-oophorectomy (one case). Five patients required only
      diagnostic laparoscopy. Eight patients required conversion to an open procedure
      because of anatomical considerations (six cases) or equipment failure (two
      cases). Median operative time was 71 min, and median postoperative hospital stay
      was 2 days. Most diagnostic procedures were performed on the same day as
      admission, resulting in a median hospital stay of 3 days. Diagnostic laparoscopy
      performed in premenopausal female patients with acute lower abdominal pain of
      unknown etiology provides diagnostic accuracy as well as therapeutic capabilities
      and prevents unnecessary laparotomy.

PMID- 7773459
TI  - Laparoscopic restoration of intestinal continuity after Hartmann procedure.
AB  - Two cases of laparoscopic restoration of intestinal continuity are presented. The
      procedures were technically straightforward and both patients did well. These
      cases add to a small but growing literature documenting the technical feasibility
      of laparoscopic intestinal surgery. The potential risks and benefits of this
      minimally invasive technique are discussed.

PMID- 7773460
TI  - Laparoscopic partial splenic resection.
AB  - Twenty domestic pigs with an average weight of 30 kg were subjected to
      laparoscopic partial splenic resection with the aim of determining the
      feasibility, reliability, and safety of this procedure. Unlike the human spleen,
      the pig spleen is perpendicular to the body's long axis, and it is long and
      slender. The parenchyma was severed through the middle third, where the organ is
      thickest. An 18-mm trocar with a 60-mm Endopath linear cutter was used for the
      resection. The tissue was removed with a 33-mm trocar. The operation was
      successfully concluded in all animals. No capsule tears occurred as a result of
      applying the stapler. Optimal hemostasis was achieved on the resected edges in
      all animals. Although these findings cannot be extended to human surgery without
      reservations, we suggest that diagnostic partial resection and minor cyst
      resections are ideal initial indications for this minimally invasive approach.

PMID- 7773461
TI  - Laparoscopy-assisted colonoscopic polypectomy.
AB  - One of the most feared complications in the removal of moderate-sized or large
      sessile polyps is colonic perforation. Complete colonoscopic total excision of
      these kinds of polyps can be safely undertaken using laparoscopic assistance,
      which enables prompt diagnosis and treatment of perforation. Laparoscopy-assisted
      endoscopic polyp excision can be safely performed, avoiding critical septic
      complications and can also help in the selection of patients to appropriate
      colonic resection without increasing morbidity or mortality.

PMID- 7773462
TI  - Steam sterilization of laparoscopic instruments.
AB  - Because of the intricate internal parts of laparoscopic instruments, questions
      have been raised about the efficacy of cleaning and sterilization techniques. To
      assess these risks, hamburger meat was inoculated with high concentrations of
      vegetative pathogens and packed into laparoscopic cannulas. All openings of the
      cannulas were sealed during steam sterilization cycles ranging from 3 to 10 min
      in different experiments; cultures were obtained after cooling. Experiments were
      then performed using heat-resistant spore forms. Our studies showed that both the
      standard 10-min cycle and the 3-min "flash" were uniformly successful in killing
      all pathogenic microorganisms. A 7-min steam sterilization was necessary to kill
      spores within sealed cannulas. We conclude that a standard 10-min cycle within
      the steam autoclave provides complete sterilization of laparoscopic instruments;
      the 3-min "flash" sterilization is appropriate and safe for instruments that have
      been inadvertently contaminated or dropped during a surgical procedure.

PMID- 7773463
TI  - Videothoracoscopic resection of a posterior mediastinal tumor.
AB  - We report a complete videothoracoscopic resection of a posterior mediastinal
      tumor (neurilemmoma) in a 43-year-old man. The tumor was located in the right
      cupula of pleura and well demarcated. The tumor was mobilized under
      videothoracoscopic guidance and extracted from the thoracic cavity through a
      trocar site. The postoperative course was uneventful, and the postoperative pain
      could be reduced.

PMID- 7773464
TI  - Laparoscopic manipulation of a malfunctioning peritoneal dialysis catheter in a
      child.
AB  - A case of outflow obstruction of a peritoneal dialysis catheter in a 12-year-old
      boy is presented. The cause of obstruction was identified and remedied by
      laparoscopic means. Laparoscopy has important diagnostic and therapeutic roles in
      the evaluation of malfunctioning peritoneal dialysis catheters.

PMID- 7773465
TI  - Laparoscopic cholecystectomy in a 23-month-old infant.
AB  - We describe a laparoscopic cholecystectomy performed on a 23-month-old girl. The
      experience and the data in the literature indicate that this approach offers
      particular advantages for treatment of pediatric patients without increasing the
      operative risk.

PMID- 7773467
TI  - Exacerbation of groin hernias after laparoscopy.
AB  - The incidence of pneumoperitoneum-related complications of laparoscopy is quite
      low. The more common complications are due to improper placement of the needle
      during insufflation and those related to the cardiorespiratory system. We
      describe two cases who underwent prolonged laparoscopic surgery and presented
      postoperatively with hernia.

PMID- 7773466
TI  - Management of an abdominal cerebrospinal fluid pseudocyst using laparoscopic
      techniques.
AB  - Abdominal cerebrospinal fluid (CSF) pseudocysts are reported to occur in < 1% of
      ventriculoperitoneal shunts. Management options include various types of shunt
      revisions with or without aspiration or excision of the pseudocyst. We report a
      case in which laparoscopy was utilized in a 12-year-old boy to excise a portion
      of the pseudocyst, remove the shunt catheter tip from the residual pseudocyst,
      and reposition it in the peritoneal cavity. The patient experienced no
      complications from the procedure, and there has been no recurrence of the
      pseudocyst after 12 months of follow-up observation. This case report
      demonstrates a novel approach to the management of CSF pseudocysts that is
      minimally invasive, allows direct drainage of the pseudocyst, and permits
      manipulation and optimal repositioning of the shunt catheter.

PMID- 7773468
TI  - Benign cystic mesothelioma in a male patient: surgical treatment by the
      laparoscopic route.
AB  - We report a case of a benign cystic mesothelioma in a 44-year-old man. The
      patient was asymptomatic, and the cystic formation was discovered by chance in
      the course of ultrasonography for urological disorders. Benign cystic
      mesothelioma is a rare pathology, and only 19 cases have been described in male
      patients. The differential diagnosis versus other cystic diseases can only be
      defined histologically and is of critical importance to clinical management.
      Surgery is mandatory for both diagnosis and treatment. In the case reported here,
      a minimally invasive laparoscopic approach allowed not only histological
      diagnosis of benign cystic mesothelioma, but also its surgical treatment by the
      same route.

PMID- 7773470
TI  - Making loops in laparoscopic surgery: state of the art.

PMID- 7773469
TI  - Laparoscopic simple cystectomy in a man.
AB  - Laparoscopic surgery is rapidly being assimilated into the urologic
      armamentarium. Already many operations commonly done by an open approach are
      being performed laparoscopically. We report on the laparoscopic performance of a
      simple cystectomy in a spinal cord-injured male patient suffering from recurrent
      pyocystis. The procedure proved to be technically feasible, with the patient
      experiencing a short convalescence period.

PMID- 7773471
TI  - A technique for needle insufflation in obese patients.

PMID- 7773472
TI  - Transperitoneal laparoscopic approach to lumbar discectomy.
AB  - Recognition of the benefits derived from laparoscopic cholecystectomy led to the
      evaluation of a laparoscopic approach to the lumbar disc space. Goals included
      minimizing postoperative pain and disability while still achieving adequate
      access to the disc space, including adequate discectomy under direct
      visualization. Described herein are the methods used to develop the laparoscopic
      exposure necessary to allow anterior resection of the lumbar disc, as well as
      preliminary results of the first 15 patients to undergo laparoscopic discectomy.

PMID- 7773473
TI  - A comparative retrospective study of thoracoscopy versus thoracotomy for the
      treatment of spontaneous pneumothorax.
AB  - Thoracoscopic surgery has been claimed to reduce patient disability, recovery
      time, and hospital costs compared with open surgery. We analyzed 25 patients who
      had undergone thoracoscopic surgery and compared the outcome to 24 patients who
      had undergone conventional surgery for spontaneous pneumothorax. The
      thoracoscopic group was able to return to work and daily activities earlier and
      had less impairment of shoulder movement. There was a loss of sensation
      corresponding to the dermatomes where the thoracoscopic ports were placed, which
      could have resulted from compression of the intercostal nerves by the
      instruments. However, a similar loss of sensation was found in the thoracotomy
      group. We conclude that thoracoscopy may be the method of choice for the
      treatment of spontaneous pneumothorax, although further methodological
      development should be done.

PMID- 7773474
TI  - Videoendoscopic procedures in thoracic surgery: technical aspects and report of
      removal of a mediastinal cyst.
AB  - Current videoendoscopic technology and percutaneous techniques of exposure and
      dissection have been successfully applied to abdominal surgery with favorable
      results. Application of this technology to our practice of thoracic surgery is
      the basis of this report. Video-assisted thoracic surgery was performed in 36
      patients for the following indications: Raynaud's syndrome, undefined pulmonary
      nodule, persisting spontaneous pneumothorax, T1 bronchial carcinoma, and
      mediastinal cyst. Videoendoscopic surgical procedures were accomplished using
      double-lumen endotracheal anaesthesia and a percutaneous stapling device.
      Procedures performed using this technique include thoracic sympathectomy, wedge
      or keel excision, blebectomy, lung apex stapling, parietal pleurectomy, and
      dissection of the mediastinal cyst. Median operating time was 45 min (range, 15
      to 90 min). Tissue diagnosis was obtained in all patients. Median diameter of
      excised nodules was 10 mm (range, 7 to 70 mm). There were no operative deaths.
      The single complication was a prolonged air leak. This new method of thoracic
      surgery appears to benefit the patients. For us it proved a secure way to perform
      thoracic surgery. Our case of removal of a benign cyst in the posterior
      mediastinum shows that video-assisted thoracic surgery has expanding applications
      in the field of general thoracic surgery.

PMID- 7773475
TI  - Routine prophylactic vena cava filter insertion in severely injured trauma
      patients decreases the incidence of pulmonary embolism.
AB  - BACKGROUND: Trauma patients are at increased risk for venous thromboembolism
      despite routine prophylaxis. A five-year retrospective review of pulmonary
      embolism at the Medical Center Hospital of Vermont showed that four types of
      injuries (head injuries, spinal cord injuries, complex pelvic fractures, and hip
      fractures) accounted for 92 percent of pulmonary emboli in patients on the trauma
      service. STUDY DESIGN: Beginning July 1991, all patients who met criteria for a
      high-risk injury (excluding hip fractures) had prophylactic vena cava filters
      inserted percutaneously in the radiology suite. Weekly impedance plethysmography
      was performed for the detection of deep vein thrombosis. Following discharge,
      abdominal duplex ultrasound was performed at one month, six months, and yearly to
      check filter position and patency. RESULTS: To date, a total of 63 patients, or 2
      percent of the total trauma population, had prophylactic vena cava filters
      inserted. There were 19 (30 percent) deep vein thromboses in this population of
      patients and one patient had a pulmonary embolism (1.5 percent). Overall there
      was significant (chi-square, p < 0.00072) reduction of pulmonary embolism on the
      trauma service compared to the historical controls. Follow-up examination with
      abdominal duplex ultrasound showed a 30-day patency rate of 100 percent and a one
      and two-year patency rate of 96.1 +/- 3.8 percent by life-table analysis.
      CONCLUSIONS: We concluded that prophylactic vena cava filters are efficacious in
      decreasing the risk of pulmonary embolism in high-risk trauma patients.

PMID- 7773476
TI  - Isoperistaltic jejunal interposition for intractable postgastrectomy alkaline
      reflux gastritis.
AB  - BACKGROUND: The Roux-en-Y gastrojejunostomy is a popular method in the operative
      treatment of alkaline reflux gastritis and other postgastrectomy sequelae, but is
      associated with a high incidence of the so-called "Roux stasis syndrome." The
      Henley jejunal interposition has been used occasionally, albeit not widely, as an
      alternative to the Roux-en-Y reconstruction. STUDY DESIGN: Six patients underwent
      Henley gastrojejunoduodenostomy to treat severe (Visick grade IV) symptoms
      following Billroth I and II procedures for peptic ulcer disease. All interposed
      jejunal segments were 40 cm in length and isoperistaltic in orientation. All
      patients had follow-up examination and telephone interview (mean 4.3 years, range
      2.2 to 7.8 years). RESULTS: All patients noted dramatic improvement after
      remedial surgery in the first year of follow-up. After the first postoperative
      year, all patients remained virtually symptom-free (Visick grade I and II) with
      no complaints of gastrojejunal stasis or bile acid reflux. CONCLUSIONS: This
      experience suggests that the Henley jejunal interposition is our effective method
      of treating reflux gastritis and is not associated with the poor emptying
      frequently associated with the Roux-en-Y reconstruction.

PMID- 7773477
TI  - Highly selective vagotomy plus Jaboulay: a possible alternative in patients with
      benign stenosis secondary to duodenal ulceration.
AB  - BACKGROUND: The treatment of patients with duodenal ulcers has undergone radical
      changes in recent years. Symptomatic stenotic obstruction of the gastric outlet,
      however, has remained a specific indication for elective operation, with gastric
      resection (Billroth I or II) and vagotomy often used as options for intervention.
      STUDY DESIGN: The present report describes the results of highly selective
      vagotomy (HSV) in combination with lateral Jaboulay gastroduodenostomy in the
      treatment of patients with benign stenosis secondary to duodenal ulceration.
      Functionality of results and patient satisfaction have been focal aspects in our
      assessment. RESULTS: During a period of five years, HSV plus Jaboulay was
      performed upon 19 patients (14 men and five women, with an average age of 55
      years). No operative mortality was seen. The postoperative follow-up period
      ranged from 12 to 60 months. There were no ulcer recurrences, the functional
      results (roentgenographic double-contrast technique) were excellent, and patient
      satisfaction was high (Visick grade I, 67 percent; Visick grade II, 33 percent).
      CONCLUSIONS: As evidenced by the results, HSV plus Jaboulay seems to represent a
      convincing alternative to gastric resection in the treatment of patients with
      benign stenosis secondary to duodenal ulceration.

PMID- 7773479
TI  - Twenty-four hour monitoring of pH in the gastric tube replacing the resected
      esophagus.
AB  - BACKGROUND: Peptic ulcers in the gastric tube replacing the resected esophagus
      develop silently and cause serious problems. In this study, the acidity of the
      gastric tube was examined by 24-hour pH monitoring to determine if the acidity of
      the gastric tube was sufficient to cause peptic ulcers. STUDY DESIGN: The acidity
      of a gastric tube was evaluated by 24-hour pH monitoring of both the fundus and
      the antrum in 55 patients treated for carcinoma of the esophagus. The correlation
      between the fasting serum gastrin concentration and the intraluminal acidity of
      the completely vagotomized gastric tube was examined. RESULTS: In the patients
      with high postoperative acidity in the fundus or the antrum (46 percent of the 41
      patients examined), the intraluminal pH remained consistently low, even long
      after operative treatment. Significant correlations existed between the
      percentage of time that the pH remained below 3 preoperatively and
      postoperatively in both the fundus and the antrum (r = 0.4777, p = 0.0386, and r
      = 0.7597, p = 0.0002, respectively). The percentage did not decrease
      significantly postoperatively. A significantly negative correlation (r = 
      0.783401, p < 0.0001) was found between the fasting serum gastrin level and the
      proportion of time that the nocturnal pH in the antrum remained below 3.
      CONCLUSIONS: Even long after esophagectomy, the pH of the gastric tube is low
      enough to cause peptic ulcers, especially in patients with high preoperative
      acidity. In these patients, the intraluminal pH in the antrum of the gastric tube
      correlates inversely with the fasting serum gastrin level.

PMID- 7773478
TI  - Wound breaking strength and healing after suturing noninjured tissues.
AB  - BACKGROUND: Many operative procedures involve suturing healthy, previously
      nontraumatized tissues. The present study was done to investigate the wound
      breaking strength and healing after suturing noninjured tissues. STUDY DESIGN: A
      new experimental model of muscluloaponeurotic suture in the mouse is described
      and used to investigate the scar breaking strength, the concentration of 5
      hydroxyproline, the extrusion of suture material, and the histological
      characteristics of the repair process. Scar quality was compared at three weeks
      between a group of mice in which suture was done without prior tissue injury (n =
      24) and three groups of mice (n = 24 each) with prior tissue injury (tight
      ischemic suture, incision, and cautery). Silk (n = 8), polyglactin 910 (n = 8),
      and polypropylene (n = 8) sutures were used within each group. RESULTS: Scars
      resulting from the suturing of healthy tissues had less breaking strength than
      those with ischemic, incised, or cauterized wound edges (507 g compared to 590,
      730, and 732 g, respectively; p < 0.001) and had a lower 5-hydroxyproline
      concentration (5.1 ng/mg compared to 6.09, 6.77, and 7.49 ng/mg, respectively; p
      < 0.01). Polypropylene sutured scars had a higher breaking strength than silk
      (690 compared to 608 g, p < 0.01) or polyglactin 910 (690 compared to 626 g, p <
      0.01). Most of the stitches were extruded from the scar independent of the suture
      material. CONCLUSIONS: The quality of a scar does not seem to be as good when
      wound edges are healthy than when they have been previously injured.

PMID- 7773480
TI  - Evaluation of necrotizing pancreatitis in the opossum by dynamic contrast
      enhanced computed tomography: correlation between radiographic and morphologic
      changes.
AB  - BACKGROUND: The ability to quantitate the extent of acinar cell necrosis with
      contrast-enhanced computed tomography (CT) during acute pancreatitis is
      uncertain. STUDY DESIGN: Acute hemorrhagic necrotizing pancreatitis was induced
      in opossums by obstructing their biliopancreatic duct for up to seven days or by
      retrograde injection of a bile-trypsin taurocholate mixture into the opossum
      pancreatic duct. At selected times, groups of three animals each were examined by
      dynamic contrast-enhanced CT, and the abnormalities on the images were
      quantitated. Immediately following CT, the animals were sacrificed and the extent
      of necrosis was quantitated by morphometric analysis of tissue samples at the
      light microscope level. RESULTS: The CT severity score as well as the degree of
      nonenhancement on dynamic contrast-enhanced CT were both closely correlated with
      the extent of acinar cell necrosis (r = 0.91 and r = 0.97, respectively).
      CONCLUSIONS: The degree of pancreatic nonenhancement on dynamic contrast-enhanced
      CT can be used to quantitate the extent of pancreatic necrosis during acute
      necrotizing pancreatitis.

PMID- 7773481
TI  - Influence of local treatment on the recurrence rate of ductal carcinoma in situ.
AB  - BACKGROUND: Screening mammography has resulted in a significant increase in the
      diagnosis of ductal carcinoma in situ (DCIS). The role of breast conservation
      therapy and the long-term recurrence rate are still controversial. This article
      compares mastectomy, wide excision alone, and wide excision with radiation as
      treatments for DCIS. STUDY DESIGN: One hundred twenty-four cases of DCIS were
      retrospectively reviewed and were found to be pure DCIS by a senior pathologist.
      The mean age at diagnosis was 60 years (range, 33 to 81). Originally, 101
      patients (81 percent) presented with calcification on mammogram, and 23 (19
      percent) presented with a palpable mass. Histologic data showed that 54 (44
      percent) had noncomedo type lesions, 46 (37 percent) had comedo type, and 24 (19
      percent) had unknown type DCIS. RESULTS: Four of the 124 patients had a
      recurrence during a mean follow-up period of 43 months. Recurrence is defined as
      any development of DCIS or invasive carcinoma in the ipsilateral breast. There
      was one (1.3 percent) recurrence in the 75 patients treated with mastectomy (an
      adenocarcinoma of the chest wall), which occurred at 59 months. Treatment was
      5,750 cGy to the chest wall and the patient is free of disease 37 months
      postradiation. There were three (11 percent) recurrences at 14, 21, and 29
      months, respectively, in the 28 patients treated with wide excision alone. All
      three recurrences were found by calcifications on mammogram and all patients had
      comedo type original lesions. Two recurrences were pure DCIS of the breast. Both
      patients were treated with mastectomy and are free of disease at 33 and five
      months, respectively. The third recurrence was an invasive colloid carcinoma of
      the breast. Treatment was a modified radical mastectomy; the patient is free of
      disease after 62 months. There were no recurrences in the 21 patients who were
      treated with wide excision and radiation. Average total dose of radiation was
      5,835 cGy (range, 4,500 to 6,480). CONCLUSIONS: The results of this study
      indicate that both mastectomy and wide excision with radiation are associated
      with very low recurrence rates. Wide excision alone is associated with a higher
      recurrence rate. However, all recurrences were detected mammographically and all
      lesions were salvaged by mastectomy. Therefore, the ultimate local control and
      survival rates were similar for all three modalities.

PMID- 7773482
TI  - Understanding surgical knot security: a proposal to standardize the literature.
AB  - BACKGROUND: There is very little published data concerning the knot handling
      properties of suture materials. The few studies that are available on this
      subject contain discrepancies in nomenclature, testing methods, and in the type
      of data reported. To date, there has been no effort to present what is currently
      known concerning knot security in a unified format. STUDY DESIGN: A review of the
      literature was conducted to determine what is currently known concerning surgical
      knots, the efficiency of these knots, testing techniques, and nomenclature. The
      structures of common surgical knots were analyzed and their relationships
      determined. The results of the various studies were analyzed and a summary of
      existing data was prepared. RESULTS: Based on current literature and a thorough
      analysis of surgical knots, a standard method for testing knot efficiency and a
      standard nomenclature were proposed. Suture security has been shown to be
      strongly influenced by the type of knot used. Knots in which the second throw
      contains two turns are most efficient. CONCLUSIONS: Existing studies have
      demonstrated a strong variation in the efficiency of different surgical knots.
      Standards for testing and nomenclature have been presented. Effort now needs to
      be directed in three areas: simulating in vivo conditions, testing knots under
      these conditions, and determining the factors that make some suture materials
      more efficient in knot holding than others.

PMID- 7773483
TI  - Predicting axillary node positivity in patients with invasive carcinoma of the
      breast by using a combination of T category and palpability.
AB  - BACKGROUND: In spite of the development of numerous new tumor markers, axillary
      lymph node status continues to be the single most important prognostic variable
      regarding survival of patients with carcinoma of the breast. This study was
      undertaken to determine whether or not the combination of T category (TNM staging
      system) and palpability would be a better predictor of nodal positivity than T
      category alone. STUDY DESIGN: Clinical and pathologic data were analyzed for
      1,554 patients who underwent axillary lymph node dissection as part of their
      treatment for invasive carcinoma of the breast. Data were analyzed by the primary
      lesion's T category and whether or not the lesion was palpable. RESULTS: Five
      hundred fifty-one (35 percent) of 1,554 axillary node dissections contained
      metastases. The probability of nodal involvement was significantly higher and the
      average tumor diameter was slightly, but significantly, larger for palpable T1b,
      T1c, and T2 lesions when compared with nonpalpable lesions within the same T
      category (all p values less than or equal to 0.003). The probability of lymphatic
      tumor emboli or vascular invasion was generally higher for palpable lesions
      compared with nonpalpable lesions and increased as lesions got larger. The
      percentage of patients with low nuclear grade and favorable histology was
      generally lower for patients with palpable lesions compared with those having
      nonpalpable lesions and decreased as lesions got larger. CONCLUSIONS: Nodal
      positivity was significantly higher for palpable T1b, T1c, and T2 carcinoma of
      the breast when compared with nonpalpable carcinoma of the breast within the same
      T category. The combination of T category and palpability was a more accurate
      predictor of nodal positivity than T category alone.

PMID- 7773484
TI  - Survival impact of lymph node metastasis in TNM stage III carcinoma of the colon
      and rectum.
AB  - BACKGROUND: Node-positive (TNM stage III) adenocarcinoma of the colon and rectum
      consists of tumors with a widely variable prognosis. To predict the outcome of
      patients with stage III carcinoma, we assessed the survival impact of the number
      and level of lymph node metastasis and other clinicopathological variables. STUDY
      DESIGN: A retrospective study was performed on 538 patients with stage III
      carcinoma of the colon and rectum who underwent curative resection at Chang Gung
      Memorial Hospital between 1980 and 1989. Ten or more lymph nodes in each resected
      specimen were identified microscopically. Multivariate analysis was used to
      determine the independent variables. RESULTS: The relative survival rates at five
      and ten years were 52 and 42 percent, respectively. Tumor morphology, depth or
      tumor penetration, histologic grade, and the status (number and level) of nodal
      involvement were significant in the univariate analyses. Only grade and nodal
      status remained significant in the multivariate analysis. Based on the nodal
      status, these patients were separated into three groups: stage IIIA (one to three
      positive nodes and absence of pN3 metastasis), IIIB (four to nine nodes and
      absence of pN3), and IIIC (ten or more nodes or presence of pN3). The five-year
      survival rates for patients with stages IIIA, IIIB, and IIIC disease were 69, 44,
      and 29 percent, respectively. Compared with patients with stage IIIA disease, the
      odds of death for patients with stages IIIB and IIIC carcinoma were 2.1 (95
      percent confidence interval: 1.5 to 2.8, p = 0.0001) and 3.3 (95 percent
      confidence interval 2.4 to 4.5, p = 0.001), respectively. CONCLUSIONS: We suggest
      that stage III adenocarcinoma of the colon and rectum be divided into three
      substages: IIIA (one to three positive nodes and absence of pN3 metastasis), IIIB
      (four to nine nodes and absence of pN3), and IIIC (ten or more positive nodes or
      presence of pN3.

PMID- 7773485
TI  - Prostaglandin E1 attenuation of ischemic renal reperfusion injury in the rat.
AB  - BACKGROUND: Prostaglandin E1 (PGE1), a vasodilating prostaglandin, has been shown
      to protect against renal ischemic-reperfusion injury in acute experiments. The
      purpose of this study was to determine whether or not delayed administration of
      PGE1 would also be effective, as it has been suggested to be, in ischemic hepatic
      injury. STUDY DESIGN: In a chronic model, rats underwent 60 minutes of total
      renal ischemia followed by either NaCl or PGE1 therapy delivered at either time
      0, 30, or 60 minutes after reperfusion. Serum creatinine and renal histology were
      evaluated for seven days. In an isolated perfused kidney model, kidneys were
      similarly treated but were removed and perfused in order to measure renal
      vascular resistance (VR). RESULTS: Prostaglandin E1 administration at time 0
      resulted in lower creatinine values when compared with controls at both day 2
      (2.1 +/- 0.4 compared with 4.2 +/- 0.9 mg/dL) and day 7 (0.9 +/- 0.1 compared
      with 2.3 +/- 0.8 mg/dL). Conversely, no improvement was observed when PGE1 was
      delayed for either 30 or 60 minutes. Renal morphology at seven days was
      essentially intact in PGE1-treated rats (time 0) whereas changes characteristic
      of acute tubular necrosis were observed in control kidneys. Ischemia caused a
      twofold increase in VR compared with nonischemic controls (6.18 +/- 1.12 compared
      with 3.45 +/- 0.66 mm Hg/mL/min/g at 20 minutes of perfusion). Prostaglandin E1
      treated kidneys (time 0) had a VR that was unchanged from that calculated for
      nonischemic controls (3.28 +/- 0.63 compared with 3.45 +/- 0.66 mm Hg/mL/min/g at
      20 minutes). CONCLUSIONS: These data demonstrate that after total renal ischemia,
      PGE1 administration at reperfusion ameliorates the expected injury, whereas
      delayed treatment is ineffective. Decreased vascular resistance may be
      responsible for this protective effect.

PMID- 7773487
TI  - Venous thromboembolism in trauma patients.

PMID- 7773486
TI  - Levels of portal and systemic blood cytokines after colectomy in patients with
      carcinoma or Crohn's disease.
AB  - BACKGROUND: Cytokine overproduction has been observed in different
      pathophysiologic conditions, including sepsis, carcinoma, inflammatory disease,
      and tissue injury induced by operation. Colectomy is a procedure that may result
      in excessive cytokine release through the portal vein. The respective effects of
      an operative procedure, perioperative septic complications, and of the disease
      itself on cytokine production are still not known. STUDY DESIGN: This study was
      done to investigate the variations in the levels of interleukin-1 beta (IL-1),
      interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha) and C-reactive
      protein (CRP) in portal and systemic blood during and after colectomy in patients
      with malignancy or with Crohn's disease. Blood samples were collected
      intraoperatively from portal and systemic veins of 24 patients undergoing
      colectomy for either Crohn's disease (n = 13) or carcinoma (n = 11), and
      postoperatively (from days 1 to 5) from systemic veins. The changes in blood
      levels of cytokines and CRP in patients with an uneventful colectomy (n = 19)
      were compared to changes in patients whose colectomy was complicated by sepsis (n
      = 5). Similar changes in cytokines and CRP levels were compared between patients
      with malignancy and those with Crohn's disease. RESULTS: The portal and systemic
      blood levels of IL-1, IL-6, TNF-alpha, and CRP were significantly correlated
      before and after colectomy. In portal blood, the level of IL-6 was significantly
      higher after colectomy than before. In systemic blood, the levels of CRP, TNF
      alpha, and IL-6 before colectomy were significantly higher in patients with
      Crohn's disease than in patients with malignancy. After uneventful colectomy, a
      temporary increase in CRP, TNF-alpha, and IL-6 was noted in systemic blood,
      followed by a rapid decrease, although systemic blood cytokine levels remained
      significantly higher after colectomy complicated by sepsis. Interleukin-1 beta
      levels in both portal and systemic blood remained unchanged during and after
      colectomy, regardless of the indication for operation and its outcome.
      CONCLUSIONS: Colectomy causes acute release of cytokines and CRP in both the
      portal and systemic circulation. The increase in IL-6 observed after colectomy in
      portal blood and subsequently in systemic blood suggests local production from
      the resected specimen, or at least from the area of resection. Cytokine
      production, especially of IL-6, was modified not only by the underlying disease
      itself, as higher levels were observed in Crohn's disease before colectomy, but
      also by the presence of perioperative septic complications.

PMID- 7773488
TI  - Remedial operations for correction of bile reflex joints.

PMID- 7773489
TI  - Improvement of technique for adult orthotopic liver retransplantation.

PMID- 7773490
TI  - The paramedian approach to open laparoscopy.

PMID- 7773491
TI  - Expediting the open diagnostic peritoneal lavage.

PMID- 7773492
TI  - Distal pancreatectomy using the ultrasonic dissector.

PMID- 7773493
TI  - Perixiphoid extension of the midline incision.

PMID- 7773494
TI  - An alternative method to traditional pyloroplasty using a circular stapler.

PMID- 7773495
TI  - The abdominal compartment syndrome: the physiological and clinical consequences
      of elevated intra-abdominal pressure.

PMID- 7773496
TI  - Epidemiology, diagnosis, precautions, and policies of intraoperative anaphylaxis
      to latex.

PMID- 7773497
TI  - Cause and prevention of electrosurgical injuries in laparoscopy.

PMID- 7773498
TI  - Corrective treatment and anatomic considerations for laparoscopic cholecystectomy
      injuries.

PMID- 7773501
TI  - Immunohistochemical analysis of bcl-2 and p53 expression in breast carcinomas:
      their correlation with Ki-67 growth fraction.
AB  - We examined 59 breast cancers for p53 and bcl-2 protein expression by
      immunohistochemistry. The results were correlated with Ki-67 immunostaining. p53
      negativity was noted in 40 cases and the remaining 19 tumours were p53-positive.
      Thirty-six tumours showed strong expression of bcl-2 and in 23 no staining for
      this protein was observed. We found statistically significant reverse correlation
      between expression of p53 and bcl-2 in majority of carcinomas: 31 cases were bcl
      2 positive and p53-negative, and 14 tumours were bcl-2-negative and p53-positive.
      Six carcinomas showed no nuclear staining for Ki-67 and in the remaining 53 the
      percent of cancer cells positive for Ki-67 ranged from 1 to 60 (mean: 14.6). In
      these 53 cases we found that bcl-2-positive tumours were characterized by lower
      proliferation than bcl-2-negative tumours, the mean value of Ki-67 immunostaining
      being 10.7% and 23.0%, respectively. p53-negative tumours showed lower
      proliferation than p53-positive tumours: mean Ki-67 index was 10.2% and 23.9%,
      respectively. We conclude that immunohistochemically detected p53 and bcl-2
      proteins show a significant inverse relationship in majority of breast carcinomas
      and their expression correlates with tumour proliferation (Ki-67 immunostaining).

PMID- 7773500
TI  - Detection of microsatellite instability in human colorectal carcinomas using a
      non-radioactive PCR-based screening technique.
AB  - The aim of the present study was to establish a rapid, non-radioactive screening
      method for the detection of microsatellite instability (MIN). MIN is the primary
      characteristic of the mutator phenotype in tumours constituting hereditary non
      polyposis colon cancers (HNPCC). We investigated 30 patients suffering from
      colorectal cancer using a non-radioactive PCR-based technique. MIN was present in
      7 of 30 (23%) of the cases. There was a statistically significant correlation
      between MIN and localization of the tumour. Five of 7 (72%) tumours with MIN but
      only 4 of 23 (17%) tumours without MIN were localized in the proximal colon (P <
      0.01). There was a tendency to higher MIN frequency in tumours of patients with
      familial clustering of cancers. However, this was statistically not significant
      (P > 0.05). In addition, no correlation between MIN and tumour grade and stage
      was found. For the investigations in the present study we used a non-radioactive
      PCR-based method followed by denaturating polyacrylamide gel electrophoresis and
      silver staining. This method is highly sensitive and reproducible. Thus, PCR
      based analysis using a non-radioactive staining technique represents a
      comprehensive tool for MIN screening in diagnostic pathology.

PMID- 7773499
TI  - Microsatellite instability: new aspects in the carcinogenesis of colorectal
      carcinoma.
AB  - Very recently a new molecular mechanism in the tumorigenesis of colorectal
      carcinoma has been described which is closely linked to hereditary non-polyposis
      colonic cancer (HNPCC). Ubiquitous changes in the length of simple repetitive DNA
      sequences between constitutional and tumour DNA occur in about 90% of cases of
      HNPCC and in about 15% of cases of non-familial, sporadic colorectal carcinoma.
      Such microsatellite instabilities have been shown to be the phenotypical marker
      of mutations in the human homologues of prokaryotic mismatch repair genes (MutS,
      MutL, MutH). These data provide crucial new tools in the detection of patients at
      high risk of developing colon cancer and other HNPCC-related carcinomas. In
      addition, these developments provide new insights into a new, presumably primary
      event in oncogenesis, i.e. the occurrence of mutations in genomic stability genes
      leading to an increased cellular mutation rate ("mutator phenotype") and thus to
      cancer.

PMID- 7773502
TI  - Calcifying solitary bone cyst: morphological aspects and differential diagnosis
      of sclerotic bone tumours.
AB  - Fourteen solitary bone cysts (SBC) with large areas of calcification (7 in the
      femur, 4 in the humerus, and 1 each in the pelvis, the tibia and the scapula) and
      402 SBC from the Hamburg Bone Tumour Registry were reviewed in a retrospective
      study. The analysis was done with emphasis on the clinical, radiological and
      histological appearances. SBC are well known lesions, but calcifying SBC (CSBC)
      or extensive extragnathic cement-like bone productions are rare. The clinical and
      radiological differential diagnosis includes fibrous dysplasia, chondroma, low
      grade chondrosarcoma and osteosarcoma. Bits of this cement-like matrix are
      detectable within the wall of approximately 70% (278 of 402) of SBC from the
      registry. CSBC are changed SBC. The intraoperative confirmation of the diagnosis
      on a frozen section by the bone pathologist leads to curettage which is currently
      the most common therapy in this benign lesion.

PMID- 7773503
TI  - Immunohistochemical localization of cytochrome P450 2E1 in human pulmonary
      carcinoma and normal bronchial tissue.
AB  - Cytochrome P450 2E1 (CYP2E1) is a major xenobiotic-metabolizing enzyme but data
      concerning its extrahepatic expression are few. CYP2E1 can metabolically activate
      many procarcinogens and therefore its presence in the lung might play a role in
      bioactivation of procarcinogens, so we studied the expression and localization of
      CYP2E1 in primary pulmonary carcinomas and surrounding normal bronchial tissue
      from 28 patients. Seromucous glands showed expression of CYP2E1 in 19 and
      bronchial epithelium in 18 of the 28 samples of normal bronchial tissue. Thirteen
      of the corresponding cases of primary pulmonary carcinoma showed staining for
      CYP2E1. In 11 of these 13 cases, CYP2E1 was also present in normal bronchial
      tissue. There was no statistically significant difference in the expression of
      CYP2E1 between adenocarcinomas and squamous cell carcinomas. No association was
      observed between the expression of CYP2E1 in tumour tissue and normal bronchial
      tissue. However, there was a significant correlation between the expression of
      CYP2E1 in seromucous glands and bronchial epithelium (r = 0.61, P < 0.01) of
      normal tissue. We conclude that CYP2E1 can be present in both normal and
      neoplastic bronchial tissue.

PMID- 7773504
TI  - Intracellular localization, vesicular accumulation and kinetics of daunorubicin
      in sensitive and multidrug-resistant gastric carcinoma EPG85-257 cells.
AB  - In the human gastric carcinoma cell line EPG85-257P (parent) induction of
      resistance to daunorubicin (DAU) was achieved by selection with stepwise
      increased concentrations of the drug. The new variant was named EPG85-257DAU and
      was shown to overexpress the mdr1 gene product 170 kDa P-glycoprotein (P-Gp) as
      demonstrated by immunocytochemistry and mdr1-specific RT-PCR. To investigate the
      intracellular pathway of DAU the subcellular distribution of this autofluorescent
      drug was studied in the resistant cells and compared to its chemosensitive
      counterpart EPG85-257P. When sensitive cells were exposed to DAU the drug rapidly
      accumulated in the nucleus until cell death. No redistribution of DAU to the
      cytoplasm was observed. In resistant cells exposed to the drug DAU also
      accumulated in the nucleus but to a lesser extent than in parent cells. Following
      exposure, nuclear fluorescence was observed to decrease over a time period of up
      to 48 h. Six hours after DAU exposure formation of fluorescent vesicle formation
      started in the perinuclear region and increased continuously. After 48 h nuclear
      fluorescence was no longer detectable and DAU was located exclusively in
      vesicles. During this period the vesicles moved from the region of origin to the
      cell periphery. A pulse chase experiment showed, that vesicles may contain DAU
      derived from the nucleus. Treatment of EPG85-257DAU cells with DAU in conjunction
      with the chemosensitizer cyclosporin A (CsA) increased nuclear fluorescence
      without impairing vesicle formation. Disruption of microtubules by nocodazole led
      to an accumulation of vesicles in the perinuclear region indicating that
      microtubules are involved in vesicular transport. Treatment of EPG85-257DAU cells
      with the actin disruptor cytochalasin B led to accumulation of vesicles in the
      cell periphery indicating that actin may be involved in exocytosis. Uptake and
      efflux of DAU and rhodamin (RH) were determined in sensitive and resistant cells
      using a fluorescence activated cell sorter. Uptake of both compounds was
      distinctly lower in resistant than in sensitive cells. When resistant cells
      preloaded for 2 h with RH subsequently were incubated in drug free medium the
      substance was rapidly released indicating transmembrane transport by P-Gp. In
      contrast, despite expression of P-Gp in resistant cells no considerable release
      of DAU was observed for up to 2 h under the same experimental protocol. This
      indicates that in resistant cells intracellular DAU at least in part may be
      inaccessible for P-Gp and that vesicular drug transport appears to contribute to
      DAU resistance by removing intracellular DAU via exocytosis.

PMID- 7773505
TI  - Morphological modifications of apoptosis in HL-60 cells: effects of homocysteine
      and cytochalasins on apoptosis initiated by 3-deazaadenosine.
AB  - Using electron microscopy, confocal laser scanning microscopy and measurements of
      intact DNA we have studied the morphology and DNA degradation of human leukaemia
      HL-60 cells undergoing drug initiated apoptosis. Apoptosis was initiated by 100
      microM 3-deazaadenosine (c3Ado), 25 microM c3Ado plus 1 mM homocysteine
      thiolactone (Hcy) and 100 microM c3Ado plus 5 micrograms/ml cytochalasin B (CB).
      Two different phenotypes of apoptotic cells (APC), blebbed and non-blebbed, were
      present in the cultures. Blebbed APC dominated in cultures exposed to c3Ado,
      whereas most APC in cultures treated with c3Ado plus Hcy and all the APC in
      cultures treated with c3Ado plus CB displayed a non-blebbed phenotype. A more
      pronounced reduction of the chromatin/cytoplasm ratio, lower volume fractions of
      uncondensed chromatin and higher volume fractions of highly condensed chromatin
      (micronuclei) were found in cultures exposed to c3Ado and c3Ado plus Hcy when
      compared with cultures exposed to c3Ado plus CB. A partial inhibition of c3Ado
      apoptosis by CB was confirmed by measurements of intact DNA. The inhibitory
      effect of CB was not reproducible by CE, indicating that CB exerts its effect by
      an actin independent mechanism. Both blebbed and non-blebbed APC displayed
      nuclear fragmentation, segregation of organelles and cytoplasmic vesiculation,
      suggesting that the differences between the phenotypes were restricted to the
      cytoplasmic membrane. We were not able to demonstrate the presence of F-actin by
      fluorescein isothiocyanate-phalloidin staining in blebbed APC nor in non-blebbed
      APC in cultures treated with c3Ado plus Hcy. Non-blebbed APC in cultures treated
      with c3Ado plus CB displayed foci of F-actin at the internal part of the
      cytoplasmic membrane. This suggests that F-actin is preserved by the mechanism by
      which CB inhibits blebbing, and may indicate that blebbing of the cytoplasmic
      membrane during apoptosis is associated with F-actin deficiency rather than a
      result of actin-myosin interactions.

PMID- 7773506
TI  - Freeze-fracture immunocytochemistry for intracellular localization of serotonin
      in mast cells stimulated with compound 48/80.
AB  - Changes of intracellular localization of serotonin in rat mast cells were
      examined by freeze-fracture immunocytochemistry, to prevent the translocation of
      the serotonin antigen. Rat peritoneal cells including mast cells were stimulated
      in vitro with compound 48/80, at 17 degrees C for 0, 30 or 60 s for exocytosis to
      occur. The mast cells were fixed, quickly frozen and freeze-fractured to expose
      the antigen on the fractured surface. They were immunostained with serotonin
      antibody, and the immunoreactions on the fractured surface were examined on
      ultrathin sections by electron microscopy. Unstimulated mast cells exhibited
      serotonin localization mostly in each intragranular matrix. In contrast, mast
      cells stimulated for 30 s exhibited increased serotonin in their intergranular
      cytoplasm. Mast cells showed more distinct immunoreactions in the cytoplasm where
      degranulation would be promoted after 60 s. It is suggested that intracellular
      release of serotonin occurred in the stimulated mast cells.

PMID- 7773507
TI  - Mitochondrial abnormalities of muscle tissue in mice with juvenile visceral
      steatosis associated with systemic carnitine deficiency.
AB  - A mouse with juvenile visceral steatosis (the JVS mouse) has been recognized as a
      novel animal model for systemic carnitine deficiency. We examined cardiac,
      skeletal and smooth muscle cells in JVS and control mice by light and electron
      microscopy. Cardiac and skeletal muscle cells of these mice at 4 weeks of age
      exhibited a ragged-red appearance after trichrome staining. Electron microscopy,
      demonstrated increased numbers of mitochondria and lipid droplets in the cells.
      Compression or distortion of the myofibril bundles, primarily due to the
      increased number of mitochondria, suggests the possible existence of a functional
      disturbance of the cardiac and skeletal muscle. In the urinary bladder, only one
      or two large lipid droplets and slightly increased number of mitochondria were
      recognized in the perinuclear region of the smooth muscle cells. At 8 weeks of
      age, the mouse enzyme histochemistry specific for mitochondria, such as
      cytochrome c oxidase and succinic dehydrogenase, and oil red O staining,
      confirmed further increases in the number of mitochondria and lipid droplets in
      the heart. However, the accumulation of these organelles in the skeletal and
      smooth muscle cells was no greater than that noted in JVS mice at 4 weeks of age.
      In the cardiac muscle cells, autolysosomes or autophagic vacuoles containing
      electron-dense membranous, lamellar or whorled structures closely associated with
      mitochondria and pseudoinclusion bodies in the nucleus were recognized, and
      bundles of myofibrils were buried under numerous mitochondria, suggesting the
      existence of disturbed contractile function in the heart of JVS mice. These
      results indicate that this murine strain associated with systemic carnitine
      deficiency exhibits a generalized mitochondrial abnormality in the muscle system
      especially in the heart.

PMID- 7773508
TI  - Structural analysis of the formation of glomerular microaneurysms in the Habu
      venom model.
AB  - The goal of this study has been to characterize the process of glomerular
      microaneurysm formation and to separate it from capillary ballooning. In the Habu
      venom model glomerular capillary ballooning and glomerular microaneurysm
      formation are seen regularly. The sequence of glomerular lesions leading to a
      glomerular microaneurysm has been examined and it is clear that the process
      starts with local mesangiolysis. This may proceed to mesangial expansion and/or
      ballooning of glomerular capillaries but in contrast to ballooning the formation
      of a glomerular microaneurysm is based on endothelial defects. The process occurs
      as follows: once initiated by mesangial failure lesions extend along the
      mesangial axis. As long as the extension of the lesion encroaches on divergent
      capillary branches, capillary ballooning by "coalescence" is the result. This
      process comes to an end when convergent capillary branching is reached and two
      capillaries join. At this point endothelial disruptions occur, blood and
      mesangial spaces merge and a glomerular microaneurysm is established. Further
      growth of the microaneurysm occurs following damage spreading along the lobular
      axis. The entire process has been reconstructed and is presented in a three
      dimensional model.

PMID- 7773509
TI  - Nucleolar segregation as an early marker for DNA damage; an experimental study in
      rats treated with 4-hydroxyaminoquinoline 1-oxide.
AB  - Male 6-week-old Sprague Dawley rats were given a single intravenous injection of
      4-hydroxyaminoquinoline 1-oxide (4HAQO) at a dose of 20 mg/kg in order to produce
      ultrastructural changes as possible morphological biomarkers for toxicity.
      Immunohistochemically demonstrated formation of 4HAQO-DNA adduct was correlated
      with the changes found. Nucleolar alteration, demonstrable by electron microscopy
      as segregation of nucleolar components into granular and fibrillar compartments,
      was evident in cells of the target organs, exocrine pancreas and adrenocortex,
      but not of the non-target liver parenchyma. Sequential observation clarified that
      such alteration was highest in frequency 6 h and 4 h after 4HAQO administration
      in pancreatic acinar cells and adrenocortical cells respectively. Electron
      microscopically, apoptotic changes of acinar cells were evident 2 h after
      injection of 4HAQO. DNA adduct formation was consistently demonstrated in the
      same target organs showing nucleolar segregation, the highest frequency being
      noted 4 h after 4HAQO treatment in both pancreatic acinar cells and
      adrenocortical cells. Our results thus indicate an identity of the target cells
      for nucleolar segregation and 4HAQO-DNA adduct formation which correlates with
      4HAQO-toxicity. We suggest that nucleolar segregation occurs subsequent to the
      generation of DNA damage.

PMID- 7773510
TI  - Reaction of human lungs to aspirated animal fat (ghee): a clinicopathological
      study.
AB  - We report the clinical findings and pathological lung changes in four children
      following a cultural practice of forced feeding with animal fat (ghee) during
      infancy. The clinical presentation was of acute or chronic chest infection which
      failed to respond to antimicrobial therapy. The radiographic features ranged from
      extensive bronchopneumonia to collapse/consolidation and bronchiectasis. The
      light microscopy findings included diffuse mononuclear interstitial pneumonia,
      intraalveolar desquamation of pneumocytes, lipid granuloma formation, lung
      atelectasis and bronchiectasis. In the two children with longstanding reactions,
      the striking feature was the minimal lipid engulfment by the macrophages, the
      continuation of the mononuclear interstitial pneumonia, bronchiectasis and
      minimal lung fibrosis. In these two older children, the lung lymphatics were
      probably the main channels for drainage of the aspirated ghee.

PMID- 7773511
TI  - Participation of T lymphocytes in atherogenesis: sequential and quantitative
      observation of aortic lesions of rats with diet-induced hypercholesterolaemia
      using en face double immunostaining.
AB  - Using en face double immunostaining coupled with electron microscopy, we studied
      the temporal and spatial distribution of T lymphocytes and macrophages during the
      development of atherosclerosis in a diet-induced rat model fed an atherogenic
      diet for 2-40 weeks. T lymphocytes and macrophages adhered to the aortic surface
      by 2 weeks on the diet, with subsequent migration under the endothelium, and
      formed a fatty streak-like lesion. Analysis of the cellular components revealed
      that infiltration of T lymphocytes was most prominent in the incipient phase of
      lesion formation accounting for 60%, 29% and 34% of mononuclear cells appearing
      in 2-week lesions of the superior thoracic, inferior thoracic and abdominal
      segments of the aorta, respectively. After the incipient phase, the relative
      number of T lymphocytes in the three segments of the aorta showed a slow decline;
      the proportion of T lymphocytes to macrophages was approximately 1:3 to 1:4 in 10
      to 20-week lesions. An overall view of the lesional cells often demonstrated
      direct cellular contact between T lymphocytes and macrophages. Further, OX6/ED1
      double immunostaining demonstrated that Ia antigen was expressed on most
      macrophages. In later stages, breakdown of foamy macrophages occurred, and the
      extracellular accumulation of lipids and cell debris became prominent. The
      results demonstrated that in the diet-induced rat model, together with
      macrophages, large numbers of T lymphocytes participated in all stages of aortic
      lesions, initially adhering to the surface at prelesional stages and later as the
      principal component of the atherosclerotic lesion. It is possible that the method
      described here will provide a good tool for examining the role of T lymphocytes
      in atherogenesis.

PMID- 7773513
TI  - Congress on In Vitro Biology. Denver, Colorado, May 20-24, 1995. Abstracts.

PMID- 7773514
TI  - Empowerment in health care.

PMID- 7773512
TI  - Neural cell adhesion molecule immunoreactivity in Merkel cells and Merkel cell
      tumours.
AB  - We have analysed the expression of the neural cell adhesion molecule (NCAM) in
      normal Merkel cells of pig and human skin, and in nine neuroendocrine carcinomas
      of the skin (Merkel cell carcinomas). NCAM immunoreactivity was observed in
      virtually all Merkel cells, both in epidermis and vibrissae of pig snout skin and
      in human epidermis. Immunostaining surrounded the entire surface of Merkel cells
      and was not restricted to the contact areas between Merkel cells and nerve
      terminals. All Merkel cell carcinomas studied were also positive for NCAM. The
      immunostaining pattern of the tumour cells was similar to that observed in normal
      Merkel cells; the immunoreactivity was confined to the cell membranes. These
      results suggest that NCAM may be used as an immunohistochemical marker for both
      Merkel cells and Merkel cell tumours.

PMID- 7773515
TI  - Collaboration through project management.
AB  - This paper focuses on project management and examines its value for nurse
      managers. The paper explores the implementation of project management and its
      contribution to the collaboration between two Trusts in West Suffolk, UK. It
      argues that project management could serve the interest of nurse managers within
      the changing culture of the health service. The collaborative project was funded
      by the East Anglian Regional Audit Team.

PMID- 7773516
TI  - Clinical management: a special case*.
AB  - This paper briefly discusses the development of some of the principles of case
      management as they have been applied in the community. As a clinical management
      system we argue that the key elements of case management could and should be
      applied within institutional settings. We draw as an example Ashworth Special
      Hospital recently criticized for its lack of co-ordinated care by a Public
      Inquiry Committee. The resulting discussion focuses upon a rehabilitation
      framework which could be used to implement case management within such a setting;
      the implementation of such a framework and the benefits that would be gained.

PMID- 7773517
TI  - The management of professionals: the preferences of hospital sisters and charge
      nurses.
AB  - This analysis of the preferences of how sisters and charge nurses are managed is
      the result of a two centre descriptive study using theoretical models of
      professionalism, developing preferences and exercising situational leadership. It
      was conducted to determine if the management structure preferred by sisters and
      charge nurses, in a general acute hospital setting, supported the professionalism
      of nursing. The outcomes were intended to help develop a strategic plan for the
      future of nursing and the management of nurses. The research instruments were a
      self-completed questionnaire (19 were returned, a response rate of 31.1%) and
      four semi-structured interviews. The findings disclosed some dissatisfaction with
      the present management arrangements. The sisters and charge nurses felt that
      their priorities for practice and professional issues were better supported by
      clinically involved, ward-based senior nurses than by unit-based senior nurses
      with a general management function. However, sisters' and charge nurses'
      discussions with ward-based senior nurses were apparently less effective than
      discussions in peer groups which led to influential collegial autonomy. This
      preferred management style can be supported by the use of situational leadership
      theory which would enhance collegial autonomy and professional satisfaction.
      Recognition of the sisters and charge nurses preferences and adjustment of their
      management would therefore enable them to participate effectively in
      organizational decision-making.

PMID- 7773519
TI  - The developing role of the educational facilitator.
AB  - The National Health Service has undergone significant reforms in recent years. A
      consequence of these reforms has been to recast the relationship between service
      providers (Trusts) and educational providers (University Departments). This
      relationship is increasingly formalized through contractual processes and the
      ability of University Departments to respond promptly to identified needs within
      Trusts may become inhibited. As a Trust employee the Educational Facilitator can
      provide practice-led educational initiatives utilizing the resources found within
      the clinical environment. Such initiatives would be in accord with Trust
      objectives and be put into operation with ease. The current role of the
      educational facilitator is explored with key role components and functional areas
      identified. The paper concludes with a consideration of the role in the
      development of professional knowledge and strategies for knowledge development.

PMID- 7773518
TI  - Audit in the British National Health Service.
AB  - This paper is about audit as it exists inside the broader framework of quality
      control within the National Health Service. It will define medical audit briefly
      and examine its antecedents in exploring why it was introduced. The paper will
      proceed to analyse the underlying economic and political reasons for the
      Government's strategy for audit, and assesses its contribution to the debate
      about quality in health care. The paper concludes by considering the future
      direction of audit arising out of the recent emphasis placed on multi
      professional clinical audit.

PMID- 7773520
TI  - An analysis of case management--the efficient utility of human resources, but to
      what end?
AB  - Case management has been credited as a modality to reduce the lengths of hospital
      admission and to utilize human resources more effectively. The approach
      concentrates on the process of delivering care to constantly improve the
      productivity levels of health care practitioners. The United Kingdom government
      policy is certainly progressing towards cost-containment and cost-effective
      service delivery. However, it needs to be considered if the culture of nursing
      would be able to adopt the strategy. Firstly, it needs to be questioned if nurses
      have the managerial and financial acuity to successfully perform the role.
      Secondly, the adoption of case management may potentially negate the value of
      some aspects of professionally skilled nursing care which has little cost-benefit
      analysis but provides the true essence of nursing. With a further advancement of
      cost-centered care, case management may become the anti-thesis of an inherently
      caring profession.

PMID- 7773521
TI  - Looking back to the future.

PMID- 7773522
TI  - The health-care elective experience.

PMID- 7773523
TI  - The effectiveness of nursing: a review.
AB  - This paper describes the findings of a literature review of the effectiveness of
      nursing. Three journals were selected in which this type of study was most likely
      to be published. A diversity of attempts to measure nursing effectiveness with
      various types of patient was found. Generally, however, there was a lack of
      rigour in study design and sample sizes were too small to be able to draw
      conclusions. No studies were found which undertook a cost-effectiveness analysis
      of nursing interventions. Suggestions for the way forward in measuring nursing
      effectiveness are given, together with questions to be addressed by nursing
      research.

PMID- 7773525
TI  - The development of clinical leadership through supported reflective practice.
AB  - The notion of clinical leadership is significant in current nursing practice,
      particularly since recommendations made by the Department of Health in 'The
      Strategy for Nursing'. However, while it is a concept that many nurses aspire to
      implement, in reality the operationalizing of such a concept is fraught with
      difficulty. This paper aims to explore the issue of clinical leadership through a
      collegiate model developed in a particular practice area. The development of this
      collegiate relationship is articulated through the mediums of reflective practice
      and clinical supervision. A model of collegiality is offered as an approach to
      the integration of the spheres of clinical leadership. If reflective practice is
      to be a reality then it is essential that both clinical leaders and practitioners
      engage in such processes within a supportive culture.

PMID- 7773524
TI  - A critique of 'at risk' pressure sore assessment tools.
AB  - This paper critiques pressure sore risk assessment tools. No attempt is made to
      describe individual tools in detail as this literature is available elsewhere.
      The economic case for risk assessment is presented along with the criteria for an
      effective risk assessment instrument. Reliability and validity studies are
      reviewed in relation to three risk assessment tools: Norton, Waterlow and Braden.
      Finally a number of issues related to threshold scores, research design and the
      need to view pressure sores as a clinical problem rather than a nursing problem
      are discussed.

PMID- 7773526
TI  - Introduction of the use of structured pain assessment for post-operative patients
      in Kenya: implementing change using a research-based co-operative approach.
AB  - A research-based project was conducted to introduce structured pain assessment on
      a surgical ward at a general hospital in Kenya, East Africa. The aim was to
      improve pain control, and subsequently patients' recovery and satisfaction with
      care. It was agreed that the ultimate aim was to develop and use a common tool
      for pain assessment throughout the hospital, thereby reducing disparity in
      various clinical areas, and raising standards of patient care. The project was
      seen as a pilot, and planned introduction of the pain assessment took place over
      1 month. This paper describes the findings in relation to the patient sample, and
      perceptions of nurses taking part. It also contains reflections about action
      research, and how it may enter the scene as a way of understanding the whole
      picture retrospectively.

PMID- 7773527
TI  - What neurological patients regard as quality of life.
AB  - The aim of this study was to investigate how patients with progressive
      neurological disorders describe what they perceive as quality of life. The
      patients (n = 169) were interviewed while staying at a neurological
      rehabilitation centre by way of an open question, what 'quality of life'
      represented to them. Patients' statements were classified and a comparison was
      made with Kajandi's three levels of factors constituting quality of life. The
      categories that came forth were 'living in a sense of affinity', 'being
      independent', 'living on one's own terms' and 'feeling that life is meaningful'.
      The statements constituting the basis of the categories were impressive and
      illustrated wisdom. The results underline the uniqueness of each patient's
      situation, and how important it is that nursing and treatment are adjusted to the
      needs of the individual.

PMID- 7773528
TI  - Listening to the voices of older patients: an existential-phenomenological
      approach to quality assurance.
AB  - The motivation behind this study was a desire to gain access to the experiences
      of elderly people receiving nursing care in hospital. Previous experience with
      quantitative approaches to quality assurance had led to dissatisfaction with
      their neglect of the patient perspective or reliance on patient satisfaction
      questionnaires. An existential-phenomenological approach was used in an attempt
      to reconstruct patients' experiences as reported in their own words. Themes which
      emerged from the data and are reported here focus on 'routine geriatric care',
      'care deprivation', 'depersonalization', and 'geriatric segregation'. The
      findings are discussed against the background of literature about nursing care of
      elderly people. It is suggested that in the setting studied, limitations posed by
      past management deficiencies, under-staffing and poor physical environment
      contributed to the situation reported. Trained nurses felt they worked hard to
      give the best care they could but, with a high ratio of untrained staff and lack
      of continuing education, they were aware that their levels of achievement were
      far from ideal. The study demonstrates that, with an appropriate methodology, it
      is possible to gain access to how patients' experience their care and in this
      sense the attempt to 'listen to the voices of patients' was successful and gives
      pointers to developing more patient-sensitive quality-assurance processes.

PMID- 7773529
TI  - Using research to implement change: the introduction of group activities on a
      psychiatric unit.
AB  - Staff in a psychiatric unit of a general hospital proposed the introduction of a
      programme of structured group activities, based on their casual observation that
      patients were sometimes unoccupied and bored. It was decided to collect data
      systematically in order to inform the implementation of activities. An activities
      record sheet was developed to list all activities taking place over a 1-week
      period. Questionnaires were administered to patients (n = 23) and staff (n = 20)
      on the unit to seek their views on the value, type, timing, frequency and
      location of activities as well as on other related aspects. Overall, staff made
      practical and realistic suggestions regarding the implementation of structured
      group activities. The data collected, although useful in planning change, raised
      questions about the poor quality of patients' responses and the low response rate
      (50%) from staff. Implications of these and other issues are discussed.

PMID- 7773530
TI  - Colostomy irrigation--a safe practice?

PMID- 7773531
TI  - Respiratory effects of baclofen and 3-aminopropylphosphinic acid in guinea-pigs.
AB  - 1. The effects of the GABAB receptor agonists, baclofen and 3
      aminopropylphosphinic acid (3-APPi) given by the subcutaneous or
      intracerebroventricular (i.c.v.) route were examined on minute ventilation (V),
      tidal volume (VT) and respiratory rate (f) due to room air and carbon dioxide
      (CO2)-enriched gas hyperventilation in conscious guinea-pigs. 2. Baclofen (0.3-10
      mg kg-1, s.c.) produced a dose-dependent inhibition of V and f due to room air
      and CO2 inhalation. The maximum inhibition of room air breathing V was 85% +/- 3
      and f was 74% +/- 3 at 10 mg kg-1, s.c. The maximum effects on CO2-induced
      hyperventilation were 68% +/- 9 and 51% +/- 6, for V and f respectively. Only the
      highest dose of baclofen studied (10 mg kg-1) produced a significant inhibition
      of VT due to room air breathing (46% +/- 6) and CO2 breathing (38% +/- 11). 3. 3
      APPi (0.3-100 mg kg-1, s.c.) did not affect V, VT or f due to room air breathing
      or CO2 inhalation at any dose tested. Also, i.c.v. administration of 3-APPi (100
      micrograms) did not affect ventilatory responses due to room air breathing or CO2
      inhalation. 4. Pretreatment with the GABAB antagonist, CGP 35348 3-aminopropyl
      (diethoxymethyl) phosphinic acid (3-30 mg kg-1, s.c.) blocked the respiratory
      depressant effects of baclofen (3 mg kg-1, s.c.) in a dose-related fashion. 5.
      Intracerebroventricular (i.c.v.) administration of CGP 35348 (50 micrograms)
      blocked the respiratory depressant effects of baclofen. CGP 35348 given alone
      either i.c.v. or s.c. had no effects on respiration due to room air or CO2
      inhalation.6. Pretreatment with either the GABAA antagonist bicuculline (30 mg kg
      1, s.c.) or the opioid antagonist, naloxone (1 mg kg-1, s.c.) had no effect on
      the respiratory depressant action of baclofen(3 mg kg-1, s.c.).7. These results
      show that baclofen inhibits ventilation due to room air breathing, and attenuates
      the hyperventilation response to CO2 inhalation. The peripherally acting GABAB
      agonist, 3-APPi had no effect on ventilation. These findings demonstrate that the
      respiratory depressant effects of baclofen are due to activation of CNS GABAB
      receptors and indicates that only GABAB receptor agonists that penetrate into the
      CNS may cause respiratory depression.

PMID- 7773532
TI  - Unexpected prosecretory action component of loperamide at mu-opioid receptors in
      the guinea-pig colonic mucosa in vitro.
AB  - 1. In a voltage clamp setting (Ussing chamber), the antidiarrhoeal drug,
      loperamide (Lop) slightly augmented prostaglandin E1 (PGE1) plus theophylline
      stimulated net chloride secretion above control values at low concentrations (10(
      10) and 10(-9) M) but inhibited it at higher concentrations (10(-6) and 10(-5)
      M). The apparently weak prosecretory action component of Lop was turned into a
      clear cut antisecretory effect by pretreatment with 2 x 10(-7) M naloxonazine
      plus 10(-7) M CTOP-NH2 (D-Phe-Cys-Tyr-D-Trp-Orn-Thr-Pen-Thr-NH2), two selective
      mu opioid receptor antagonists. This indicates a prosecretory effect of
      loperamide at mu opioid receptors. The antisecretory effect of low Lop
      concentrations, uncovered by mu opioid receptor blockade, was prevented by
      additional blockade of kappa opioid receptors by 5 x 10(-9) M nor-binaltorphimine
      (nor-BNI). 2. The nonselective opioid antagonist, naloxone, at 10(-6) M did not
      significantly reduce either PGE1 plus theophylline-stimulated net chloride
      secretion in Lop-free controls or the antisecretory action of Lop. By contrast,
      the partial agonist ethylketocyclazocine (EKC), which activates kappa but blocks
      mu opioid receptors, concentration-dependently inhibited PGE1 plus theophylline
      stimulated net chloride secretion without any consistent prosecretory action
      component. Nor-BNI at 5 x 10(-8) M significantly blocked the antisecretory action
      of EKC. 3. It is concluded that, in the guinea-pig colonic mucosa under the
      present conditions, mu opioid receptors mediate enhancement and kappa opioid
      receptors inhibition of PGE1-stimulated net chloride secretion by low Lop
      concentrations. The two opposite actions are largely masked by superimposition.
      An opioid receptor-independent mechanism of action contributes to the
      antisecretory effect of Lop at high concentrations.

PMID- 7773533
TI  - Mediation of noradrenaline-induced contractions of rat aorta by the alpha 1B
      adrenoceptor subtype.
AB  - 1. The subtypes of alpha 1-adrenoceptor mediating contractions to exogenous
      noradrenaline (NA) in rat aorta have been examined in both biochemical and
      functional studies. 2. Incubation of rat aortic membranes with the irreversible
      alpha 1B-adrenoceptor antagonist, chloroethylclonidine (CEC: 10 microM) did not
      change the KD of [3H]-prazosin binding in comparison to untreated membranes, but
      reduced by 88% the total number of binding sites (Bmax). 3. Contractions of rat
      aortic strips to NA after CEC (50 microM for 30 min) incubation followed by
      repetitive washing, showed a marked shift in the potency of NA and a partial
      reduction in the maximum response. The residual contractions to NA after CEC
      incubation were not affected by prazosin (10 nM). 4. The competitive antagonists
      prazosin, terazosin, (R)-YM-12617, phentolamine, 5-methylurapidil and spiperone
      inhibited contractions to NA with estimated pA2 values of 9.85, 8.54, 9.34, 7.71,
      7.64 and 8.41, respectively. 5. The affinity of the same antagonists for the
      alpha 1A- and alpha 1B- adrenoceptors was evaluated by utilizing membranes from
      rat hippocampus pretreated with CEC, and rat liver, respectively. 5
      Methylurapidil and phentolamine were confirmed as selective for the alpha 1A
      adrenoceptors, whereas spiperone was alpha 1B-selective. 6. A significant
      correlation was found between the pA2 values of the alpha 1-adrenoceptor
      antagonists tested and their affinity for the alpha 1B-adrenoceptor subtype, but
      not for the alpha 1A-subtype. 7. In conclusion, these findings indicate that in
      rat aorta most of the contraction is mediated by alpha 1B-adrenoceptors, and that
      the potency (pA2) of an antagonist in this tissue should be related to its
      antagonistic effect on this subtype of the alpha 1-adrenoceptor population.

PMID- 7773534
TI  - Effects of the selective I1 imidazoline receptor agonist, moxonidine, on gastric
      secretion and gastric mucosal injury in rats.
AB  - 1. Previous reports of the effects of alpha 2-adrenoceptor stimulation on gastric
      secretion are inconsistent because it was not clear whether the compounds were
      activating alpha 2-adrenoceptors and/or newly described imidazoline receptors. In
      the present experiments, the effects of moxonidine, an I1-imidazoline receptor
      agonist and antihypertensive agent, on gastric secretion and on experimental
      gastric mucosal injury were examined. 2. Moxonidine (0.01, 0.1 and 1.0 mg kg-1,
      i.p.) potently inhibited basal (non-stimulated) gastric acid secretion in
      conscious rats with an ED50 of 0.04 mg kg-1. Two hours following administration
      of the highest dose of moxonidine (1.0 mg kg-1), gastric acid output was
      completely suppressed. Moxonidine also significantly increased intragastric pH,
      at the two highest doses. 3. The alpha 2-adrenoceptor agonist, clonidine (0.01,
      0.1 and 1.0 mg kg-1, i.p.) decreased basal acid secretion at the lowest dose
      (37%) and at the highest dose (46%), while the intermediate dose did not affect
      gastric acid output. 4. In an ethanol-induced model of gastric mucosal injury,
      moxonidine decreased the length of lesions at the lowest and highest doses (0.01
      and 1.0 mg kg-1) as well as the number of the lesions, at the highest dose (1.0
      mg kg-1). 5. In pylorus-ligated rats, moxonidine significantly decreased acid
      secretion (all doses), total secretory volume (1.0 mg kg-1) as well as pepsin
      output (1.0 mg kg-1). 6. In comparison to clonidine, moxonidine appears to be a
      more potent anti-secretory and gastric-protective compound. These data indicate a
      potential role for imidazoline receptor agonists in the management of
      gastroduodenal diseases associated with hypertension. The relative contribution
      of the central and peripheral effects of moxonidine to these gastrointestinal
      actions remains to be determined.

PMID- 7773535
TI  - Effects of Bordetella pertussis toxin pretreatment on the antiarrhythmic action
      of ischaemic preconditioning in anaesthetized rats.
AB  - 1. Bordetella pertussis toxin, which catalyses the ADP-ribosylation of certain
      guanine nucleotide binding proteins (G proteins), thus functionally uncoupling
      them from associated receptors, was examined to determine whether it modified the
      antiarrhythmic effect of ischaemic preconditioning in anaesthetized rats. 2.
      Pertussis toxin (25 micrograms kg-1, i.p., 48 h prior to heart isolation)
      attenuated the negative chronotropic effect of acetylcholine (ACh) in rat
      isolated Langendorff perfused hearts. ACh (10 microM) reduced heart rate by 4% in
      hearts taken from pertussis toxin-treated animals, compared to a reduction of 57%
      in hearts taken from animals treated only with vehicle. 3. In anaesthetized rats,
      ischaemic preconditioning (a single 3 min occlusion of the left main coronary
      artery followed by 10 min reperfusion) had a pronounced antiarrhythmic effect
      during a subsequent 30 min period of regional myocardial ischaemia. Compared to
      hearts receiving only a 30 min period of left coronary occlusion, there was a
      reduced mortality (67% and 0% for control and preconditioned groups,
      respectively; P < 0.01) and decreased incidences of ventricular tachycardia (VT)
      and ventricular fibrillation (VF). Pretreatment with pertussis toxin (25
      micrograms kg-1, i.p., 48 h previously) did not modify the arrhythmias associated
      with a 30 min period of regional myocardial ischaemia, neither did it modify the
      reduction in mortality (from 56% to 0%; P < 0.05) associated with
      preconditioning. Furthermore, the decrease in total ventricular premature beat
      count induced by preconditioning seen in controls (from 427 +/- 130 to 95 +/- 45)
      was also seen in pertussis toxin-treated rats (from 252 +/- 190 to 57 +/- 25). 4.
      These results suggest that receptor coupling to pertussis toxin-sensitive G
      proteins is not necessary for the antiarrhythmic effect of ischaemic
      preconditioning in this model.

PMID- 7773536
TI  - Pharmacokinetic modelling of the haemodynamic effects of the A2a adenosine
      receptor agonist CGS 21680C in conscious normotensive rats.
AB  - 1. The aim of the present investigation was to determine the relationship between
      the blood concentration and haemodynamic effects of the adenosine A2a receptor
      agonist, CGS 21680C (the sodium salt of 2-p-(2-carboxyethyl)phenylethylamino-5'-N
      ethylcarboxamidoadeno sin e) in conscious normotensive rats. 2. Chronically
      cannulated rats were randomly assigned to three groups which received 300, 1000
      or 3000 micrograms kg-1 (0.56, 1.9 or 5.6 mumol kg-1) of CGS 21680C intravenously
      over 15 min. The mean arterial blood pressure (MAP) and heart rate (HR) were
      monitored continuously during the experiment and serial arterial blood samples
      were taken for analysis of drug concentration. The ratio MAP/HR was also
      calculated, which may reflect changes in total peripheral resistance on the
      assumption that no changes in stroke volume occur. 3. For each individual rat the
      reduction in mean arterial pressure was related to the blood concentration
      according to the sigmoidal Emax model. The concentration-effect relationships
      were consistent for the different treatment groups. The potency based on free
      drug concentrations (EC50,u) was 5.8 ng ml-1 (11 nM) (mean +/- s.e.; n = 19) and
      correlated well with the reported adenosine A2a receptor affinity (Ki 19 nM). In
      comparison with the reduction in blood pressure, CGS 21680C exhibited a greater
      potency for the reduction of the ratio MAP/HR. 4. It is concluded that estimates
      can be obtained for the potency and intrinsic activity of adenosine A2a receptor
      agonists in vivo by pharmacokinetic-pharmacodynamic analysis of mean arterial
      pressure data in a rat model. In future studies, total peripheral resistance may
      also be useful as a pharmacodynamic parameter for A24 activation, provided that
      possible changes of the stroke volume are also assessed.

PMID- 7773537
TI  - Pertussis toxin-sensitive muscarinic relaxation in the rat iris dilator muscle.
AB  - 1. The effects of pertussis toxin (PTX) on contraction and/or relaxation induced
      by agonists or transmural nerve stimulation (TNS) were examined in the rat iris
      dilator and sphincter muscles. 2. TNS in the presence of phentolamine induced an
      atropine-sensitive biphasic response: initial contraction followed by relaxation
      in dilator muscles. Exogenously applied acetylcholine (ACh) elicited a large
      relaxation at low doses (3 microM or less) and a concentration at high doses. 3.
      Only the ACh-induced relaxation was affected by injection of PTX (10 ng) into the
      anterior eye chamber. Relaxation was decreased 12 h after injection and had
      completely disappeared after 24 h. Relaxation recovered in part 3 weeks and
      almost completely 8 weeks after PTX treatment. A gradual decrease in muscarinic
      relaxation in a dilator muscle was also observed in vitro after addition of PTX
      to the bathing solution. 4. The pA2 values of muscarinic blockers, pirenzepine,
      AF-DX 116, 4-DAMP, and himbacine for competitive antagonism to ACh-induced
      contraction were 7.14, 6.53, 9.03, and 6.80, respectively, in PTX-pretreated
      dilator muscles. These values are comparable to those obtained in
      parasympathectomized dilator muscles and may indicate involvement of M3 or M3
      like receptors in muscle contraction. 5. Pretreatment with PTX did not
      significantly affect contraction induced by noradrenaline or 5-hydroxytryptamine
      or the relaxation induced by isoprenaline in dilator muscles. 6. In conclusion,
      among several agonist-induced responses in the rat iris dilator and sphincter
      muscles, only muscarinic relaxation in dilator muscle occurs via activation of
      PTX-sensitive GTP binding proteins.

PMID- 7773538
TI  - Characterization of endothelin receptors in rat renal artery in vitro.
AB  - 1. The aim of this study was to investigate the function and characteristics of
      endothelin receptors in rat main branch renal artery in vitro. 2. Endothelin(ET)
      1 (mean EC50 = 9.8 nM) was approximately 12 fold more potent than ET-3 (mean EC50
      = 120 nM) as a contractile agonist and produced a greater maximum response. In
      contrast, neither of the ETB receptor-selective agonists, alanine[1,3,11,15]ET-1
      nor sarafotoxin S6c, (0.1 nM-1 microM), induced any contractile effect, or any
      relaxant effect in endothelium-intact preparations pre-contracted with the
      thromboxane A2 mimetic, U-46619. Sarafotoxin S6c (30 nM) also failed to induce
      any further contraction in tissues pre-contracted with an EC50 concentration of
      ET-1. 3. The ETA receptor-selective antagonist, BQ123, behaved as a weak and
      variable antagonist of the contractile effects of ET-1 (mean pA2 estimates in the
      range 5.8-6.3). In contrast, BQ123 antagonized ET-3 with a potency (mean pA2 =
      7.6) consistent with its affinity for ETA receptors. Co-incubation of BQ123 (3
      microM) with the putative ETB receptor-selective antagonist, IRL1038 (10 microM),
      produced no greater antagonism of ET-1 responses than was induced by BQ123 (3
      microM) alone. 4. In conclusion, ETB receptors do not appear to be present in rat
      main branch renal artery. The contractile effects of ET-3 in this tissue seem to
      be mediated by ETA receptors. While ETA receptors partly mediate the contractile
      effects of ET-1, these data raise the possibility that a population of novel
      BQ123-insensitive endothelin receptors may also contribute to this response.

PMID- 7773539
TI  - Effects of portal hypertension on responsiveness of rat mesenteric artery and
      aorta.
AB  - 1. We have examined the effects of pre-hepatic portal hypertension on the
      responsiveness of rat small mesenteric arteries and aorta. Rats were made portal
      hypertensive by creating a calibrated portal vein stenosis, or sham-operated. 2.
      In rat mesenteric arteries, there was no significant difference between portal
      hypertensive and sham-operated animals in the contractile potency of
      noradrenaline (NA), but the maximum contractile responses to NA, U46619 and KCl
      were significantly increased in vessels from portal hypertensive animals. This
      altered maximum contractile response was not due to alterations in smooth muscle
      mass. 3. In rat mesenteric arteries, there were no significant differences
      between portal hypertensive and sham-operated animals in endothelium-dependent
      relaxations to acetylcholine (ACh). The difference between portal hypertensive
      and sham-operated rats in the maximum response to U46619 was maintained following
      a combination of methylene blue (1 microM) and NG-monomethyl-L-arginine (100
      microM), suggesting that any differences in endothelial function do not explain
      differences in the response to vasoconstrictors. 4. In rat aorta, there were no
      significant differences between portal hypertensive and sham-operated animals in
      the contractile response to NA or KCl or in the endothelium-dependent relaxations
      to ACh. 5. In pithed rats, there was no difference between portal hypertensive
      and sham-operated animals in the pressor potency of NA. 6. It is concluded that
      portal hypertension produces an increase in the contractile response to the
      vasoconstrictors NA, U46619 and KCl in rat mesenteric arteries but not in the
      aorta. This suggests that the diminished responsiveness to vasoconstrictors
      reported in portal hypertensive rats in vivo is not due to a diminished
      responsiveness at the level of the vascular smooth muscle.

PMID- 7773540
TI  - Modulation of NMDA effects on agonist-stimulated phosphoinositide turnover by
      memantine in neonatal rat cerebral cortex.
AB  - 1. The ability of memantine (1-amino-3,5-dimethyladamantane) to antagonize the
      modulatory effects of N-methyl-D-aspartate (NMDA) on phosphoinositide turnover
      stimulated by muscarinic cholinoceptor- and metabotropic glutamate receptor
      agonists has been examined in neonatal rat cerebral cortex slices. 2. Memantine
      antagonized the inhibitory effect of NMDA (100 microM) on both total [3H]
      inositol phosphate ([3H]-InsPx) and inositol 1,4,5-trisphosphate (Ins(1,4,5)P3)
      mass accumulations stimulated by carbachol (1 mM) with EC50 values of 21 and 16
      microM respectively. 3. Memantine concentration-dependently antagonized (IC50 24
      microM) the ability of NMDA (10 microM) to potentiate [3H]-InsPx accumulation in
      response to a sub-maximal concentration of the metabotropic glutamate receptor
      agonist, 1S,3R-ACPD (10 microM). 4. The small (approx. 3 fold), concentration
      dependent increase in [3H]-InsPx accumulation stimulated by NMDA was completely
      antagonized by the prototypic NDMA receptor-channel blocker, MK-801 (1 microM) at
      all concentrations of NDMA studied (1-1000 microM). In contrast, antagonism by
      memantine (100 microM) was observed only at low concentrations of NMDA (1-10
      microM), whilst [3H]-InsPx accumulation stimulated by high concentrations of NMDA
      (300-1000 microM) was markedly enhanced by memantine. 5. Assessment of the
      incorporation of [3H]-inositol into inositol phospholipids revealed that
      memantine (100 microM) caused an approximate 2 fold increase in the labelling of
      phosphatidylinositol, phosphatidylinositol 4-phosphate and phosphatidylinositol
      4,5-bisphosphate. 6H.p.l.c. separation of [3H]-inositol (poly)phosphates
      demonstrated that whilst memantine (100 microM)alone had no significant effect on
      the accumulation of any isomer, it substantially altered the profile of
      accumulation stimulated by NMDA (1 mM), greatly facilitating accumulation of
      Ins(1,4,5)P3 and inositol 1,3,4,5-tetrakisphosphate (Ins(1,3,4,5)P4).7.These data
      provide evidence that memantine can antagonize the actions of NMDA in neonatal
      rat cerebral cortex slices in a manner consistent with this agent acting as a
      NMDA receptor-channel blocker. In addition, at least two further actions of
      memantine can be proposed. Memantine increases the rate of [3H]-inositol
      incorporation into the cellular inositol phospholipid fraction, without
      significantly stimulating phosphoinositide turnover. Furthermore, memantine can
      substantially alter patterns of inositol (poly)phosphates stimulated by NMDA,
      promoting the accumulation of the established and putative second messengers
      Ins(1,4,5)P3 and Ins(1,3,4,5)P4 which are not increased by NMDA in the absence of
      memantine. It is unknown whether these latter loci of memantine action contribute
      to known therapeutic actions of this agent.

PMID- 7773541
TI  - Effect of the vascular endothelium on noradrenaline-induced contractions in non
      pregnant and pregnant guinea-pig uterine arteries.
AB  - 1. The effect of pregnancy on noradrenaline-mediated contraction of guinea-pig
      uterine artery rings with both intact and denuded endothelium was investigated.
      2. Noradrenaline (25 nM-100 microM) induced concentration-dependent contraction
      of non-pregnant and pregnant guinea-pig uterine arterial rings with intact
      endothelium with similar pD2 and maximal response values (non-pregnant: pD2 =
      5.85 +/- 0.02, maximal response = 121 +/- 8.2%; pregnant: pD2 = 5.81 +/- 0.04,
      maximal response = 122 +/- 9.1%). Removal of endothelium did not affect
      noradrenaline-induced contractions in non-pregnant guinea-pig uterine artery (pD2
      = 5.97 +/- 0.02, maximal response = 119 +/- 8.6%). In contrast, in arteries from
      pregnant guinea-pigs, removal of endothelium shifted concentration-response curve
      for noradrenaline to the left, without affecting maximal response value (pD2 =
      6.36 +/- 0.03, maximal response = 120 +/- 9.0%). 3. The pKA values for
      noradrenaline were: 5.76 +/- 0.09 and 5.82 +/- 0.10 for non-pregnant guinea-pig
      uterine artery with intact and denuded endothelium, respectively and 5.74 +/-
      0.09 and 5.72 +/- 0.07 for pregnant guinea-pig uterine artery with intact and
      denuded endothelium, respectively. 4. The receptor occupancy-response
      relationship for noradrenaline was linear for all types of vessels, except for
      pregnant guinea-pig uterine artery with denuded endothelium, since half-maximal
      response to noradrenaline was obtained with 44.8 +/- 6.9% (non-pregnant guinea
      pig uterine artery with intact endothelium), 43.3 +/- 6.1% (non-pregnant guinea
      pig uterine artery with denuded endothelium) and 44.3 +/- 6.3% (pregnant guinea
      pig uterine artery with intact endothelium) receptor occupancy. In pregnant
      guinea-pig uterine artery with denuded endothelium, occupancy-response
      relationship for noradrenaline was non-linear since half-maximal response to
      noradrenaline was obtained with 19.7 +/- 3.3% receptor occupancy. 5. NG
      monomethyl-L-arginine (100 microM) and indomethacin (10 microM) did not affect
      concentration-response curve for noradrenaline in guinea-pig uterine arteries,
      regardless of pregnancy status or endothelial condition. 6. In quiescent
      preparations, the alpha-adrenoceptor antagonists, prazosin (5-50 nM) and
      yohimbine (1-10 microM) produced parallel rightward shifts of the curves for
      noradrenaline and the slopes of the Schild plots were not significantly different
      from unity. The plots constrained to a slope of unity gave the following - log Kb
      values: prazosin vs. yohimbine 8.78 +/- 0.03 vs. 6.41 +/- 0.02 for non-pregnant
      guinea pig uterine artery with intact endothelium, 8.95 +/- 0.03 vs. 6.34 +/-
      0.02 for non-pregnant guinea-pig uterine artery with denuded endothelium, 8.91 +/
      0.01 vs. 6.44 +/- 0.03 for pregnant guinea-pig uterine artery with intact
      endothelium and 9.07 +/- 0.01 vs. 6.52 +/- 0.03 for pregnant guinea-pig uterine
      artery with denuded endothelium.7. It is concluded that initially there is no
      difference in noradrenaline action between uterine arteries from non-pregnant and
      pregnant guinea-pigs, but after removal of the endothelium the pregnant guinea
      pig uterine artery is more sensitive to noradrenaline, which is related to
      increased receptor reserve for noradrenaline in this tissue. It is probable that
      relaxing factor derived from the endothelium mediates this effect, but it is
      unlikely to be nitric oxide or prostacyclin. Antagonist affinities and affinity
      of noradrenaline itself suggests that an identical subtype of alpha-adrenoceptor,
      probably the alpha 1 subtype, is involved in the noradrenaline-induced
      contraction of non-pregnant and pregnant guinea-pig uterine artery with or
      without endothelium.

PMID- 7773542
TI  - A new class of furoxan derivatives as NO donors: mechanism of action and
      biological activity.
AB  - 1. The mechanism of action and biological activity of a series of R-substituted
      and di-R-substituted phenylfuroxans is reported. 2. Maximal potency as
      vasodilators on rabbit aortic rings, precontracted with noradrenaline (1 microM),
      was shown by phenyl-cyano isomers and by the 3,4-dicyanofuroxan, characterized by
      a potency ratio 3-10 fold higher than glyceryl trinitrate (GTN). This effect was
      reduced upon coincubation with methylene blue or oxyhaemoglobin (10 microM). 3.
      The furoxan derivatives showing maximal potency as vasodilators were also able to
      inhibit collagen-induced platelet aggregation, with IC50 values in the sub
      micromolar range. 4. The furoxan derivatives were able to stimulate partially
      purified, rat lung soluble guanylate cyclase; among the most active compounds,
      the 3-R-substituted isomers displayed a higher level of stimulatory effect than
      the 4-R analogues. 5. Solutions (0.1 mM) of all the tested furoxans, prepared
      using 50 mM phosphate buffer, pH 7.4, (diluting 10 mM DMSO stock solutions) did
      not release nitric oxide (NO) spontaneously; however in presence of 5 mM L
      cysteine, a significant NO-releasing capacity was observed, which correlated
      significantly with their stimulation of the guanylate cyclase activity.

PMID- 7773543
TI  - The inhibition of CYP enzymes in mouse and human liver by pilocarpine.
AB  - 1. Pilocarpine is a cholinomimetic natural alkaloid. Its interactions with
      testosterone hydroxylations, coumarin 7-hydroxylase (COH), dimethylnitrosamine N
      demethylase (DMNA), pentoxyresorufin O-dealkylase (PROD) and 7-ethoxyresorufin O
      deethylase (EROD), which are indicative of the activities of cytochrome P4502A5
      (CYP2A5) or 6, 2E1, 2B, 1A, were examined in mouse and human liver microsomes. 2.
      In mouse liver microsomes the IC50 values of pilocarpine were 6 microM for COH
      and testosterone 15 alpha-hydroxylase (T15 alpha OH) activities, 4 microM for
      PROD, approximately 100 microM for DMNA and testosterone 6 beta-hydroxylase (T6
      beta OH) activities and > 1 mM for EROD activity. 3. In human liver microsomes,
      the IC50 value for COH was 6 microM and for DMNA 10 microM; T15 alpha OH and PROD
      activities were not detectable but T6 beta OH and testosterone 16 beta/2 beta
      hydroxylase activities were moderately inhibited (IC50 70 microM). 4. These
      results suggest that pilocarpine has (i) a high affinity towards phenobarbitone
      inducible CYP2A4/5 and CYP2B activities in mouse liver, (ii) a high affinity
      towards CYP2A6 in human liver microsomes and (iii) a moderate affinity towards
      CYP3A enzyme(s) in both microsomal preparations. 5. The low IC50 concentrations
      in vitro indicate potential metabolic interactions between pilocarpine and
      several P450 enzymes.

PMID- 7773544
TI  - The effects of phenelzine and other monoamine oxidase inhibitor antidepressants
      on brain and liver I2 imidazoline-preferring receptors.
AB  - 1. The binding of [3H]-idazoxan in the presence of 10(-6) M (-)-adrenaline was
      used to quantitate I2 imidazoline-preferring receptors in the rat brain and liver
      after chronic treatment with various irreversible and reversible monoamine
      oxidase (MAO) inhibitors. 2. Chronic treatment (7-14 days) with the irreversible
      MAO inhibitors, phenelzine (1-20 mg kg-1, i.p.), isocarboxazid (10 mg kg-1,
      i.p.), clorgyline (3 mg kg-1, i.p.) and tranylcypromine (10 mg kg-1, i.p.)
      markedly decreased (21-71%) the density of I2 imidazoline-preferring receptors in
      the rat brain and liver. In contrast, chronic treatment (7 days) with the
      reversible MAO-A inhibitors, moclobemide (1 and 10 mg kg-1, i.p.) or
      chlordimeform (10 mg kg-1, i.p.) or with the reversible MAO-B inhibitor Ro 16
      6491 (1 and 10 mg kg-1, i.p.) did not alter the density of I2 imidazoline
      preferring receptors in the rat brain and liver; except for the higher dose of Ro
      16-6491 which only decreased the density of these putative receptors in the liver
      (38%). 3. In vitro, phenelzine, clorgyline, 3-phenylpropargylamine,
      tranylcypromine and chlordimeform displaced the binding of [3H]-idazoxan to brain
      and liver I2 imidazoline-preferring receptors from two distinct binding sites.
      Phenelzine, 3-phenylpropargylamine and tranylcypromine displayed moderate
      affinity (KiH = 0.3-6 microM) for brain and liver I2 imidazoline-preferring
      receptors; whereas chlordimeform displayed high affinity (KiH = 6 nM) for these
      receptors in the two tissues studied, Clorgyline displayed very high affinity for
      rat brain (KiH = 40 pM) but not for rat liver I2 imidazoline-preferring receptors
      (KiH = 169 nM). 4. Preincubation of cortical or liver membranes with phenelzine
      (10-4 M for 30 min) did not alter the total density of I2 imidazoline-preferring
      receptors, indicating that this irreversible MAO inhibitor does not irreversibly
      bind to I2 imidazoline-preferring receptors. In contrast, preincubation with 10-6
      Mclorgyline reduced by 40% the Bmax of [3H]-idazoxan to brain and liver I2
      imidazoline-preferring receptors.5. Chronic treatment (7 days) with the inducers
      of cytochrome P-450 enzymes phenobarbitone (40 or 80 mg kg-1, i.p.), 3
      methylcholanthrene (20 mg kg-1, i.p.) or 2-methylimidazole (40 mg kg-1, i.p.) did
      not alter the binding parameters of [3H]-idazoxan to brain and liver 12
      imidazoline-preferring receptors.The compound SKF 525A, a potent inhibitor of
      cytochrome P-450 enzymes which forms a tight but reversible complex with the
      haemoprotein, completely displaced with moderate affinity (KiH = 2-10 microM)the
      specific binding of [3H]-idazoxan to brain and liver 12 imidazoline-preferring
      receptors. Preincubation of total liver homogenates with 3 x 10-4 M phenelzine in
      the presence of 10-3 M NADH, a treatment that irreversibly inactivates the haeme
      group of cytochrome P-450, did not reduce the density of liver I2 imidazoline
      preferring receptors. These results discounted a possible interaction of [3H]
      idazoxan with the haeme group of cytochrome P-450 enzymes.6. Together the results
      indicate that the down-regulation of I2 imidazoline-preferring receptors is
      associated with an irreversible inactivation of MAO (at least in the brain) that
      is not related either to the affinity of the MAO inhibitors for I2 imidazoline
      preferring receptors or to an irreversible binding to these putative receptors.
      These findings indicate a novel effect of irreversible MAO inhibitors in the
      brain and suggest a new target for these compounds that could be of relevance in
      the treatment of depression, a disease in which an increased density of brain I2
      imidazoline-preferring receptors has been reported.

PMID- 7773545
TI  - Interacting roles of nitric oxide and ATP in the pulmonary circulation of the
      rat.
AB  - 1. The potentiating effect of NG-nitro-L-arginine methyl ester, (L-NAME) a nitric
      oxide synthesis inhibitor, on responses of the rat pulmonary vascular pressure
      (PVP) to purinoceptor agonists was examined. 2. At a constant flow of 23 ml min-1
      the PVP was 22.4 +/- 2.5 mmHg (n = 15), and treatment with 100 microM L-NAME for
      15 min was without effect on the PVP. After the tone was raised with 28 nmol 9,11
      dideoxy-11 alpha, 9 alpha-epoxymethano-prostaglandin F2 alpha (U-46619), the PVP
      was 29.4 +/- 3.3 mmHg and treatment with 100 microM L-NAME was still without
      effect on the PVP. It appears that there is a graded release of nitric oxide in
      response to different levels of steady shear stress and in our experimental model
      the threshold for detection was not reached under basal conditions. 3. In
      contrast, when the circulation was challenged with 30 s step, additive increases
      in flow between 11 and 50 ml min-1 (n = 8), treatment with 100 microM L-NAME
      produced a significant (P < 0.05) increase in PVP suggesting that changes in flow
      derived forces evoke the release of nitric oxide. This was evident for flow rates
      above 30 ml min-1. 4. In preparations in which tone was raised with U-46619, a
      dose of 1 x 10(-8) mol ATP or 2-meSATP evoked a drop in PVP while alpha,beta
      meATP produced an increase in PVP under constant flow of 23 ml min-1. After
      treatment with 100 microM L-NAME, all three purinoceptor agonists evoked an
      increase in PVP. The increase in Pvp evoked by alpha, beta-meATP was not affected
      by L-NAME. These results suggest that P2Y-purinoceptor stimulation evokes the
      release of nitric oxide to produce vasodilatation.5. Under conditions of constant
      flow and basal pressure, 100 microM L-NAME significantly (P<0.05)potentiated the
      increase in Pvp evoked by 1 x 10-6 mol ATP, although the increase evoked by 1 x
      10-8 mol (alpha,beta-meATP, which was of similar magnitude, was not affected.
      These results indicate that a blockade of evoked nitric oxide release is
      responsible for the potentiation of the increase in Pvp evoked by ATP.6. This
      study shows that, while nitric oxide does not appear to be released in the
      pulmonary circulation of the rat under constant flow conditions, nitric oxide
      release evoked by purinoceptor agonists attenuates increases in pulmonary
      vascular pressure.

PMID- 7773547
TI  - Pharmacological characterization of RS 25259-197, a novel and selective 5-HT3
      receptor antagonist, in vivo.
AB  - 1. The pharmacological effects in vivo, of RS 25259-197, a selective 5-HT3
      receptor antagonist, have been investigated. 2. In anaesthetized rats, RS 25259
      197, administered by the intravenous, intraduodenal or transdermal route, dose
      dependently inhibited the von Bezold-Jarisch reflex induced by 2-methyl 5-HT
      (ID50 = 0.04 micrograms kg-1, i.v., 3.2 micrograms kg-1, i.d. and 32.8 micrograms
      per chamber, respectively). In this regard, when administered intraduodenally, RS
      25259-197 was more potent and exhibited a longer duration of action than either
      ondansetron or granisetron. 3. In conscious ferrets, RS 25259-197, administered
      intravenously or orally, dose-dependently inhibited emesis induced by cisplatin.
      The ID50 estimates of RS 25259-197 were 1.1 micrograms kg-1, i.v. and 3.2
      micrograms kg-1, p.o. In this respect, RS 25259-197 was more potent than
      ondansetron and equipotent with granisetron. 4. In conscious dogs, RS 25259-197,
      administered intravenously or orally, dose-dependently inhibited emesis induced
      by cisplatin (ID50 = 1.9 micrograms kg-1, i.v. and 8.5 micrograms kg-1, p.o.),
      dacarbazine (ID50 = 4.1 micrograms kg-1, i.v. and 9.7 micrograms kg-1, p.o.),
      actinomycin D (ID50 = 4.9 micrograms kg-1, i.v. and 2.5 micrograms kg-1, p.o.)
      and mechlorethamine (ID50 = 4.4 micrograms kg-1, i.v. and 3.0 micrograms kg-1,
      p.o.). Against each of the emetogenic agents, RS 25259-197 was very much more
      potent than ondansetron. When tested at equi-effective intravenous doses against
      cisplatin-induced emesis in dogs, RS 25259-197 had a longer duration of anti
      emetic activity (7 h) than ondansetron (4 h). At doses up to and including 1000
      microg kg-1, p.o., neither RS25259-197 nor ondansetron was capable of inhibiting
      apomorphine-induced emesis.5. At doses up to 1000 microg kg-1, i.v., RS 25259-197
      produced no meaningful haemodynamic changes in anaesthetized dogs.6. In summary,
      RS 25259-197 is a novel, highly potent and orally active 5-HT3 receptor
      antagonist in vivo. With respect to its anti-emetic activity, RS 25259-197
      appears to be a significant improvement over ondansetron in terms of potency and
      duration of action.

PMID- 7773546
TI  - The interaction of RS 25259-197, a potent and selective antagonist, with 5-HT3
      receptors, in vitro.
AB  - 1. A series of isoquinolines have been identified as 5-HT3 receptor antagonists.
      One of these, RS 25259-197 [(3aS)-2-[(S)-1-azabicyclo[2.2.2]oct-3-yl]
      2,3,3a,4,5,6-hexahydro- 1- oxo-1H-benzo[de]isoquinoline-hydrochloride], has two
      chiral centres. The remaining three enantiomers are denoted as RS 25259-198
      (R,R), RS 25233-197 (S,R) and RS 25233-198 (R,S). 2. At 5-HT3 receptors mediating
      contraction of guinea-pig isolated ileum, RS 25259-197 antagonized contractile
      responses to 5-HT in an unsurmountable fashion and the apparent affinity (pKB),
      estimated at 10 nM, was 8.8 +/- 0.2. In this tissue, the -log KB values for the
      other three enantiomers were 6.7 +/- 0.3 (R,R), 6.7 +/- 0.1 (S,R) and 7.4 +/- 0.1
      (R,S), respectively. The apparent affinities of RS 25259-197 and RS 25259-198, RS
      25233-197 and RS 25233-198 at 5-HT3 receptors in membranes from NG-108-15 cells
      were evaluated by a [3H]-quipazine binding assay. The -log Ki values were 10.5 +/
      0.2, 8.4 +/- 0.1, 8.6 +/- 0.1 and 9.5 +/- 0.1, respectively, with Hill
      coefficients not significantly different from unity. Thus, at these 5-HT3
      receptors, the rank order of apparent affinities was (S,S) > (R,S) > (S,R) =
      (R,R). 3. RS 25259-197 displaced the binding of the selective 5-HT3 receptor
      ligand, [3H]-RS 42358-197, in membranes from NG-108-15 cells, rat cerebral
      cortex, rabbit ileal myenteric plexus and guinea-pig ileal myenteric plexus, with
      affinity (pKi) values of 10.1 +/- 0.1, 10.2 +/- 0.1, 10.1 +/- 0.1 and 8.3 +/-
      0.2, respectively. In contrast, it exhibited low affinity (pKi <6.0) at 28 other
      receptors in binding assays, including adrenoceptors (alpha1A, alpha 1B, alpha2A,
      alpha 2B ,beta1, beta2), muscarinic (M1-M4), dopamine (D1, D2), opioid and other
      5-HT(5-HTlA, 5-HTlD, 5-HT2C, 5-HT4) receptors.4. RS 25259-197 was tritium
      labelled (specific activity: 70 Ci mmol-1) and evaluated in pharmacological
      studies. Saturation studies with [3H]-RS 25259-197 in membranes from NG-108-15
      and cloned homomeric a subunits of the 5-HT3 receptor from N1E-1 15 cells
      expressed in human kidney 293E1 cells,revealed an equilibrium dissociation
      constant (Kd) of 0.05 +/- 0.02 and 0.07 +/- 0.01 nM, and Bmax of610 +/- 60 and
      1068 +/- 88 fmol mg-1, respectively. Competition studies in NG-108-15 cells
      indicated a pharmacological specificity entirely consistent with labelling a 5
      HT3 receptor, i.e. RS 25259-197> granisetron> (S)-zacopride> tropisetron> (R)
      zacopride> ondansetron> MDL 72222.5. In contrast to the majority of radioligands
      available to label 5-HT3 receptors, [3H]-RS 25259-197 labelled a high affinity
      site in hippocampus from human post-mortem tissue with an equilibrium
      dissociation constant (Kd) of 0.15 +/- 0.07 nM and density (BmaX) of 6.8 +/- 2.4
      fmol mg-1 protein. Competition studies in this tissue indicated a pharmacological
      specificity consistent with labelling of a 5-HT3receptor.6. Quantitative
      autoradiographic studies in rat brain indicated a differential distribution of 5
      HT3receptor sites by [3H]-RS 25259-197. High densities of sites were seen in
      nuclear tractus solitaris and area postrema, a medium density in spinal
      trigeminal tract, ventral dentate gyrus and basal medial amygdala,and a low
      density of sites in hippocampal CAl, parietal cortex, medium raphe and
      cerebellum.7 In conclusion, the functional, binding and distribution studies
      undertaken with the radiolabelled and non-radiolabelled RS 25259-197 (S,S
      enantiomer) established the profile of a highly potent and selective5-HT3
      receptor antagonist.

PMID- 7773548
TI  - Rapid degradation of endothelin-1 by an enzyme released by the rat isolated
      perfused mesentery.
AB  - 1. In vivo the effects of endothelin-1 (ET-1) are limited by its rapid removal
      from the circulation and possibly by its metabolism by enzymes such as neutral
      endopeptidase 24.11, deamidase or carboxypeptidase A. Here, using as a model the
      isolated perfused mesenteric arterial bed of the rat, we have examined the
      involvements of these enzymatic activities in the vascular responses to ET-1. 2.
      Samples of Krebs buffer which had been recirculated through the mesenteric
      arterial bed for 30 min rapidly destroyed the activity of ET-1 as assessed either
      by bioassay on rings of rat thoracic aorta or by high performance liquid
      chromatography (h.p.l.c.). For instance, after 15 min incubation with the
      recirculated-Krebs solution (recirc-K) the contraction induced by 3 x 10(-9) M ET
      1 was reduced by more than 90%. Contractions induced by sarafotoxin 6b (3 x 10(
      9) M) were similarly suppressed by preincubation with recirc-K whereas those to
      Arg-vasopressin (3 x 10(-9) M) were unaffected. 3. The degradation of ET-1 by
      recirc-K was prevented by 1,10-phenanthroline (10(-3) M), abolished by heating
      the recirc-K solution to 90 degrees C for 15 min, and reduced by EGTA (5 x 10(-3)
      M) or ET-1(16-21) (10(-5) M). For instance, in the presence of ET-1(16-21) (n =
      6) the contraction induced by ET-1 was reduced by only 40% after 15 min
      incubation with recirc-K buffer. Leupeptin (3 x 10-4 M), dichloroisocoumarin(5 x
      10-5 M), phenylmethyl-sulphonyl fluoride (10-3 M), a combination of bacitracin
      (300 mg ml-1),bestatin (10-5 M), captopril (10-5 M), phosphoramidon (10-4 M) and
      thiorphan (10-4 M) or Polypep (aproprietary protein digest) did not inhibit the
      degradation of ET-1 by recirc-K.4. In experiments examining directly the vascular
      responses of the isolated perfused mesentery of the rat, the addition of
      cumulative concentrations of ET-1 to the recirculating Krebs solution caused
      small concentration-dependent increases in perfusion pressure. The inclusion of
      ET-1(16-2l), ET-1(17-21), or ET-1(18-21) (10-5M) greatly potentiated these
      responses, but not those to Arg-vasopressin or methoxamine.The effects of 1,10
      phenanthroline or EGTA could not be examined in this system because these agents
      both depressed non-specifically the vasoconstrictor responses of the mesenteric
      vascular bed.5. Thus, the rat mesentery releases an enzyme that very rapidly
      destroys ET-1 or the very closely related peptide, sarafotoxin 6b but not Arg
      vasopressin. This enzyme is most probably a metallopeptidase because of its
      sensitivity to inhibition by 1,10-phenanthroline or EGTA. It is particularly
      interesting that a simple vascular bed such as the mesentery produces such a
      powerful endothelin metabolising enzyme. It is tempting, therefore, to speculate
      that the endothelin degrading enzyme active at neutral pH that- we have found is
      important in the metabolism of ET-1 throughout the vasculature.

PMID- 7773549
TI  - Multiple effects and stimulation of insulin secretion by the tyrosine kinase
      inhibitor genistein in normal mouse islets.
AB  - 1. Islets from normal mice were used to test the acute effects of genistein, a
      potent tyrosine kinase inhibitor, on stimulus-secretion coupling in pancreatic
      beta-cells. 2. Genistein produced a concentration-dependent (10-100 microM),
      reversible, increase of insulin release. This effect was marginal on basal
      release or in the presence of non-metabolized secretagogues, and much larger in
      the presence of glucose or other nutrients. The increase in insulin release
      caused by 100 microM genistein was abolished by adrenaline or omission of
      extracellular Ca2+. It was not accompanied by any rise of cyclic AMP, inositol
      phosphate or adenine nucleotide levels. 3. Although genistein slightly inhibited
      ATP-sensitive K+ channels, as shown by 86Rb efflux and patch-clamp experiments,
      this effect could not explain the action of the drug on insulin release because
      the latter persisted when ATP-sensitive K+ channels were all blocked by maximally
      effective concentrations of glucose and tolbutamide. Genistein was also effective
      when ATP-sensitive K+ channels were opened by diazoxide and the beta-cell
      membrane depolarized by 30 mM K, but ineffective in the presence of diazoxide and
      normal extracellular K. 4. Genistein paradoxically decreased Ca2+ influx in beta
      cells, as shown by the inhibition of glucose-induced electrical activity, by the
      inhibition of Ca2+ currents (perforated patches) and by the lowering of cytosolic
      [Ca2+]i (fura-2 technique). Genistein thus increases insulin release in spite of
      a lowering of [Ca2+]i in beta-cells. 5. Daidzein, an analogue of genistein
      reported not to affect tyrosine kinases, was slightly less potent than genistein
      on K+ and Ca2+ channels, but increased insulin secretion in a similar way. Three
      other tyrosine kinase inhibitors, tyrphostin A47, herbimycin A and an analogue of
      erbstatin variably affected insulin secretion.6. Genistein exerts a number of
      heretofore unrecognized effects. The unusual mechanisms, by which genistein
      increases insulin release in spite of a decrease in beta-cell [Ca2+]i and without
      activating known signalling pathways, do not seem to result from an inhibition of
      tyrosine kinases.

PMID- 7773550
TI  - Dysfunction of muscarinic M2 receptors after the early allergic reaction:
      possible contribution to bronchial hyperresponsiveness in allergic guinea-pigs.
AB  - 1. Using a guinea-pig model of allergic asthma, in which the animals display
      early (0-5 h) and late phase (8-23 h after antigen challenge) bronchoconstrictor
      reactions, the function of prejunctional inhibitory M2 and postjunctional M3
      receptors in isolated tracheal preparations have been investigated. In addition,
      cardiac M2 receptor function in vitro and bronchial responsiveness to histamine
      in vivo were evaluated. 2. Sensitivity to inhaled histamine was increased 3.1
      fold and 1.6 fold after the early and late allergic reactions (i.e. at 5 h and 23
      h after a single ovalbumin challenge), respectively. At 23 h after the last of
      four allergen challenges, executed on four consecutive days, bronchial
      hyperresponsiveness to histamine was diminished to 1.3 fold. 3. After the early
      response, there was no change in cardiac muscarinic M2 receptor function, since
      in left atria pD2 (-log EC50) and Emax values of pilocarpine and pKB values of AQ
      RA 741, a selective M2 receptor antagonist, were not significantly different from
      controls (unchallenged sensitized animals), and this also applied to methacholine
      pD2 values for muscarinic M3 receptors in tracheal smooth muscle. 4.
      Prejunctional inhibitory muscarinic M2 autoreceptors in airway smooth muscle were
      markedly dysfunctional after the early allergic response, since potentiation of
      electrically evoked twitch contractions of tracheal preparations by low
      concentrations of the M2-selective muscarinic receptor antagonists, gallamine,
      methoctramine, AQ-RA 741 and AF-DX 116, which is the result of M2 receptor
      blockade, was clearly and significantly diminished compared to controls. However,
      after the late response, both in single and repeatedly challenged animals, twitch
      potentiation was not significantly different from and similar to controls,
      indicating restoration of M2 receptor function during the late allergic
      reaction.5. It is concluded that dysfunction of muscarinic M2 autoreceptors in
      the airways of sensitized and challenged guinea-pigs is already present after the
      early allergic reaction, and that it has recovered after the late response. Since
      histamine-induced bronchoconstriction involves vagal pathways, the present
      results suggest that bronchial hyperresponsiveness to histamine is partly due to
      M2 auto receptor dysfunction, leading to increased release of acetylcholine.

PMID- 7773551
TI  - Acute effects of the beta 3-adrenoceptor agonist, BRL 35135, on tissue glucose
      utilisation.
AB  - 1. The acute effects of BRL 35135 (BRL) on tissue glucose utilisation index (GUI)
      in vivo were investigated in anaesthetized rats by use of 2-deoxy-[3H]-glucose.
      2. Intravenous injection of BRL caused a dose-dependent increase in GUI in
      skeletal muscle, and white and brown adipose tissue; plasma insulin and fatty
      acid concentrations were also increased. Chronic treatment with BRL added to the
      diet caused a 34 fold increase in basal GUI of brown adipose tissue (BAT), but
      had no effect on GUI in other tissues. After chronic treatment, the acute tissue
      response to an intravenous maximal dose of BRL had disappeared completely in all
      tissues apart from the soleus muscle. 3. A high dose (20 mg kg-1) of the non
      selective beta-antagonist, propranolol, inhibited the acute effect of BRL on GUI
      in BAT, but failed to affect GUI in muscle. A lower dose (1 mg kg-1) of the
      antagonist also inhibited the BAT response, but had little or no effect on the
      response in Type I (working) muscles such as soleus and adductor longus (ADL),
      and potentiated the response in Type II (non-working) muscles such as tibialis
      and extensor digitorium longus (EDL). 4. A low dose (1 mg kg-1) of the selective
      beta 1-antagonist, atenolol, had no effect on the BRL response but the same dose
      of the selective beta 2-antagonist, ICI 118551, potentiated significantly the
      effect of BRL on GUI in most muscles without altering plasma insulin levels. 5.
      It is concluded that: (i) the heterogeneous tissue responses of different muscle
      fibre types in the presence of P-antagonists indicates that BRL affects muscle
      GUI directly, in addition to effects mediated by increases in plasma insulin
      concentration; (ii) the resistance of the BRL response to conventional P
      adrenoceptor antagonists implicates an atypical adrenoceptor mediating the GUI
      response in skeletal muscle, but this may not be identical to the adipose tissue
      P3-adrenoceptor; (iii) the potentiation of BRL responses by ICI 118551 indicates
      an inhibitory P2-adrenoceptor-mediated component in the muscle GUI response to
      BRL.

PMID- 7773554
TI  - Proceedings of the British Pharmacological Society meeting. 14-16 December 1994.
      Abstracts.

PMID- 7773553
TI  - Anaesthetic modulation of nicotinic ion channel kinetics in bovine chromaffin
      cells.
AB  - 1. We have investigated the action of the anaesthetics methoxyflurane,
      methohexitone and etomidate on the nicotinic acetylcholine receptor channel of
      bovine adrenal chromaffin cells using the whole cell patch clamp technique. 2.
      Spectral analysis of macroscopic currents evoked by 25 microM carbachol revealed
      that each of the agents tested reduced the lifetime of the channel open state in
      a dose-dependent manner. The whole cell current was inhibited in a concentration
      dependent fashion by each agent. 3. Channel gating parameters were calculated
      from single channel studies and the results used to test models explaining the
      modulation of nicotinic acetylcholine receptor channels by anaesthetics. 4. Each
      of the agents studied reduced the mean channel open time in a concentration
      dependent manner. Anaesthetic concentrations reducing mean open time by 50% were:
      370 microM methoxyflurane, 30 microM methohexitone or 23 microM etomidate. 5.
      Methohexitone and etomidate produced an increase in the number of brief closures
      within bursts, while no such increase was observed with methoxyflurane. Despite
      these inter-burst gaps, mean burst length was reduced by each of the agents
      tested. 6. It is concluded that a simple sequential blocking model fails to
      account for the action of these anaesthetics. An extended model, in which blocked
      channels can close, may be applicable.

PMID- 7773552
TI  - Role of endothelium in the human uterine arteries during normal menstrual cycle.
AB  - 1. The present experiments were designed to investigate the role of endothelium
      in the human uterine arteries during the normal menstrual cycle. 2. Acetylcholine
      (ACh) produced a concentration-dependent relaxation response during the higher
      level of plasma 17 beta-oestradiol (E2) (follicular and luteal phases, E2 = 131.9
      +/- 15.9 pg ml-1, n = 13; group I). However, the agent did not produce a definite
      relaxation, but produced a slight contraction during the ovulatory and
      menstruation phases (E2 = 19.8 +/- 2.9 pg mg-1, n = 5; group II). During the
      follicular and luteal phases (E2 = 181.1 +/- 9.0 pg ml-1, n = 6), ACh produced a
      slight contraction, but not relaxation in 6 cases (group III). Relaxation in
      response to A23187 in group II was not different from that in group I, while it
      was significantly (P < 0.05 and P < 0.005) reduced in group III. Sodium
      nitroprusside (SNP)-induced relaxation was similar in the three groups. 3.
      Correlation between the maximum response to ACh and the plasma E2 was highly
      significant (gamma = 0.8142, P < 0.001) in 18 cases of groups I and II, but not
      in all 24 cases including group III (gamma = 0.1183, NS). 4. Relaxations in
      response to ACh in group I or A23187 in all groups were abolished after removal
      of the endothelium. In group I, ACh- and A23187-induced relaxations were greatly
      inhibited by methylene blue or NG-nitro-L-arginine (L-NOARG) and partially
      inhibited by indomethacin. None of these treatments except for methylene blue
      modified the SNP-induced relaxation, which was significantly inhibited by
      methylene blue.5. The A23187-induced relaxation was hardly affected by methylene
      blue or L-NOARG in group III,but was partially inhibited by these agents in group
      II. The effect of indomethacin in inhibiting the A23187 induced-relaxation was
      most potent (58.9%) in group III and least (16.9%) in group I.6. There were no
      histological changes in 14 cases out of 18 (groups I and II), but very slight
      intimal thickening was observed in 4 cases in group I. On the other hand, severe
      intimal thickening was observed in all 6 cases in group III.7. These results
      indicate that, in human uterine artery strips, ACh and A23187 cause endothelium
      dependent relaxations, which are mediated mainly through EDRF/NO in group I,
      mainly prostacyclin(PGI2) in group III, or both in group II. It is suggested that
      lack of the production/release of EDRF/NO and/or of interaction between EDRF/NO
      and PGI2 might play a role in the formation of intimal thickening in human
      uterine arteries.

PMID- 7773555
TI  - Encapsulated PC12 cell transplants into hemiparkinsonian monkeys: a behavioral,
      neuroanatomical, and neurochemical analysis.
AB  - Four cynomolgus monkeys were trained on a hand reaching task and then rendered
      hemiparkinsonian with an intracarotid injection of n-methyl 4 phenyl 1,2,3,6,
      tetrahydropyridine (MPTP). Performance on this task with the limb contralateral
      to the MPTP injection was significantly impaired following the lesion. Three
      monkeys received implants of polymer-encapsulated containing PC12 cells into the
      caudate nucleus and putamen. One monkey received identical implants of empty
      capsules and served as a control. After a transient improvement, limb use in the
      control monkey dissipated and returned to post-MPTP disability. Two of the three
      PC12 cell grafted monkeys recovered performance on the hand reach task to near
      normal levels for up to 6.5 mo posttransplantation. Capsules retrieved from the
      monkeys who recovered limb function postimplantation contained numerous viable
      PC12 cells that continued to release levodopa, basal dopamine, and potassium
      evoked dopamine. In contrast, capsules retrieved from the PC12 cell-grafted
      monkey which did not recover limb use on the hand reach task contained few cells
      which secreted negligible or undetectable levels of levodopa and dopamine.
      Interestingly, functional disability was not reinstated following removal of the
      capsules. Neuroanatomical and neurochemical evaluation of the grafted striatum
      did not reveal a host-derived sprouting response of catecholaminergic or
      indolaminergic fibers. These data indicate that xenografts of PC12 cells can
      survive for up to 6.5 mo in nonimmunosuppressed monkeys when immunoisolated via
      polymer encapsulation. Moreover, these cells continue to secrete high levels of
      levodopa and dopamine and induce recovery of motor function in parkinsonian
      nonhuman primates.

PMID- 7773556
TI  - Synthetic vascular grafts seeded with genetically modified endothelium in the
      dog: evaluation of the effect of seeding technique and retroviral vector on cell
      persistence in vivo.
AB  - Unique characteristics of endothelium make it an attractive target cell for gene
      transfer. Genetically modified endothelial cells (ECs) seeded on synthetic
      vascular grafts offer the potential to control neointimal hyperplasia, decrease
      graft thrombogenicity and improve small diameter graft patency. This study
      addresses the issue of synthetic vascular graft colonization with endothelial
      cells transduced with noninducible retroviral marker genes in the dog. Autologous
      endothelial cells were enzymatically harvested and transduced with either the
      bacterial NeoR gene or human growth hormone gene using retroviral vectors. All
      transduced cells were positive by polymerase chain reaction (PCR) amplification
      for the transduced gene sequence prior to graft seeding. Transduced ECs were
      seeded on Dacron grafts (n = 3) preclotted with autologous blood. These grafts
      exhibited complete endothelialization at times from 250 to 360 days. Recovered
      DNA, however, was negative for the transduced gene sequence when analyzed by PCR
      and Southern blotting. Expanded polytetrafluoroethylene (ePTFE) was evaluated (n
      = 8) using several different cell seeding protocols. Grafts were seeded at 3
      densities (ranging from 6 x 10(3) to 1.5 x 10(5) cells/cm2) and 2 different
      adherence times. Seeding substrate was also evaluated. Grafts were either
      preclotted with whole blood or incubated with 20 or 120 micrograms/ml fibronectin
      for 60 min. Graft biopsies were evaluated from 2 to 52 wk. Limited
      endothelialization was present in 4 dogs as early as 2 wk, but never progressed
      to full luminal coverage. The remaining dogs failed to ever exhibit any luminal
      EC adherence. Two dogs with limited EC coverage had positive DNA by PCR for the
      NeoR gene sequence at 2 and 3 wk. In contrast to transduced EC's, nontransduced
      EC colonization of ePTFE was complete at 2 wk when seeded under conditions that
      transduced cells had failed to persist. Neither seeding density, adherence time,
      seeding substrate or retroviral vector used influenced the uniformly poor graft
      coverage seen with transduced cells. Results of this study indicate that despite
      successful gene transfer using 4 different retroviral vectors, transduced
      endothelial cells seeded under varying conditions appear altered in their ability
      to stably adhere and colonize synthetic vascular grafts in vivo.

PMID- 7773557
TI  - Repeated intraportal hepatocyte transplantation in analbuminemic rats.
AB  - The optimal site for implantation of isolated hepatocytes has not been
      established. We have developed a novel technique which allows repeated infusion
      of hepatocytes into the portal system via an indwelling catheter. Seven Nagase
      Analbuminemic rats (NAR) underwent single intraportal infusion of 2 x 10(7)
      isolated normal albumin-producing rat hepatocytes. Another seven NAR rats
      underwent placement of indwelling catheters into the portal venous system via the
      gastroduodenal vein. Each of them received six batches of 5 x 10(6) normal
      albumin producing hepatocytes. Seven control NAR rats were infused repeatedly
      (intraportally) with saline only. Plasma albumin (ELISA) showed significant
      increase in experimental animals and was more pronounced (p < 0.05) in rats
      transplanted repeatedly than in those given a single dose of cells.
      Immunohistochemical staining of the liver sections confirmed the presence of
      transplanted albumin producing hepatocytes. Rats transplanted with a single large
      batch of isolated hepatocytes showed liver tissue damage, whereas those subjected
      to repeated cell infusions had normal liver histology. We have developed a novel
      intraportal transplantation method which allows successful engraftment of a large
      number of isolated hepatocytes.

PMID- 7773558
TI  - Protective effect of glutathione (GSH) over glutathione monoethyl-ester (GSH-E)
      on cold preservation of isolated rat liver cells.
AB  - Hepatocyte suspensions provide a rapid method to determine how hypothermic
      storage affects liver cell metabolism and viability. We investigated whether
      reduced Glutathione (GSH) inclusion into a modified University of Wisconsin (UW)
      solution, has a protective effect over Glutathione derivatives, such as
      Glutathione-monoethylester (GSH-E), when suspensions of hepatocytes are cold
      stored for several days. Isolated rat liver cells were cold preserved 96 h in UW,
      UW plus 3 mM GSH and UW plus 3 mM GSH-E. During the cold storage, not significant
      changes in cell viability were observed, but the total Glutathione content was
      higher in systems with extracellular GSH over those with GSH-E or without. After
      cold storage, the liver cells were gently resuspended in Krebs-Henseleit-1%
      Albumin and used for 120 min of normothermic (37 degrees C) incubation. We
      evaluate the functional response of the cells measuring the exclusion of Trypan
      Blue (TBE). This response was clearly different in preserved cells in presence of
      GSH. These results indicate a protective role of extracellular Glutathione, due
      to an accumulation of it, rather than the derivative, for hepatic cell during the
      cold storage in UW solutions. And also, it is possible to extend experiments with
      hepatocytes from a single cell isolation over 4 or more consecutive days.

PMID- 7773560
TI  - Genetics and molecular biology.

PMID- 7773559
TI  - Porcine repeat element DNA: in situ detection of xenotransplanted cells.
AB  - Using a digoxygenin-labelled DNA probe derived from the porcine repeat element
      PRE-1, we have developed a protocol for the detection of transplanted porcine
      islets and hepatocytes against a background of murine host tissue. Analysis of
      this probe by Southern blotting indicated that PRE-1 hybridizes to pig genomic
      DNA but not to human or mouse DNA. On tissue sections, hybridizing probe was
      detected using alkaline phosphatase-conjugated antidigoxygenin antibody
      visualized with 5-bromo-4-chloro-3-indolyl-phosphate/4-nitro-blue tetrazolium
      chloride (BCIP/NBT) substrate. We have demonstrated sensitive and highly specific
      staining of porcine nuclei in fixed, paraffin embedded tissue sections, and have
      applied the technique to detect porcine pancreatic islets and hepatocytes
      transplanted into murine kidney and spleen. Application of this technique include
      detection of transplanted cells or organs across the variety of xenogeneic
      barriers.

PMID- 7773561
TI  - Nutrition.

PMID- 7773562
TI  - Genetics and molecular biology.

PMID- 7773563
TI  - Lipid metabolism.

PMID- 7773564
TI  - Hyperlipidaemia and cardiovascular disease.

PMID- 7773565
TI  - Atherosclerosis: cell biology and lipoproteins.

PMID- 7773566
TI  - Therapy and clinical trials.

PMID- 7773567
TI  - The VLDL receptor: wayward brother of the LDL receptor.
AB  - The VLDL receptor binds lipoproteins that contain apolipoprotein E and consists
      of five functional domains that resemble the LDL receptor. Although the LDL- and
      VLDL-receptor genes are located on different chromosomes, their gene structure
      and organization are almost the same. Despite the presence of sterol regulatory
      element-1-like sequences in the VLDL-receptor gene, the transcription of the gene
      is not down-regulated by sterols. The VLDL-receptor messenger RNA is highly
      expressed in tissues that actively metabolize fatty acids as their source of
      energy. The physiological role of the chicken cognate of the VLDL receptor has
      been revealed recently, but its function in mammals is still debatable.

PMID- 7773568
TI  - Bile acid transporters.
AB  - The sodium-dependent bile acid transporters and sodium-independent organic anion
      transporters are integral membrane glycoproteins that function in the
      enterohepatic circulation of bile acids. The recent cloning and expression of
      different classes of bile acid transporters have provided insights into their
      structure and molecular mechanism.

PMID- 7773569
TI  - Genetics and molecular biology.

PMID- 7773570
TI  - Apolipoprotein B messenger RNA editing: insights into the molecular regulation of
      post-transcriptional cytidine deamination.
AB  - A site-specific cytidine deamination (cytidine to uridine) in nuclear
      apolipoprotein B messenger RNA creates a translational stop codon that produces
      apolipoprotein B48. This process is mediated by an enzyme composed of distinct
      subunits, including apolipoprotein B messenger RNA editing enzyme catalytic
      polypeptide-1 and additional complementation factors. The apolipoprotein B
      messenger RNA editing enzyme catalytic polypeptide-1 is expressed ubiquitously in
      the rat, but is largely confined to the small intestine in humans and rabbits. By
      contrast, complementation activity is present in tissues that neither express nor
      edit apolipoprotein B messenger RNA.

PMID- 7773571
TI  - Biosynthesis and metabolism of lipoprotein (a).
AB  - Significant advances have been made over the past year toward understanding the
      pathways of lipoprotein (a) biosynthesis and metabolism. Transcriptional and post
      translational mechanisms have been identified as important determinants of plasma
      lipoprotein (a) levels. Assembly of lipoprotein (a) has been shown to be an
      extracellular event that occurs on the hepatocyte cell surface. The development
      of lipoprotein (a) transgenic mice has provided a valuable model to study the
      metabolism of lipoprotein (a).

PMID- 7773572
TI  - Transforming growth factor-beta: the key to understanding lipoprotein(a)?
AB  - Most large studies of the blood parameters that act as risk factors for
      myocardial infarction, stroke and atherosclerosis have identified elevated
      circulating levels of lipoprotein(a) as an important risk factor. Lipoprotein(a)
      consists of an LDL particle that is covalently bound to the distinguishing
      protein component apolipoprotein(a). Ever since apolipoprotein(a) was cloned in
      1987 and the marked sequence homology to plasminogen was noted, mechanisms for
      the atherogenic activity of lipoprotein(a), based on the competitive inhibition
      of plasminogen activity, have been proposed. However, with the availability of
      transgenic mice expressing both human apolipoprotein(a) and lipoprotein(a),
      recent studies have demonstrated that lipoprotein(a) acts to inhibit plasminogen
      activation in vivo. One consequence of this is reduced activation of the cytokine
      transforming growth factor-beta, an important regulator of vessel wall structure.

PMID- 7773573
TI  - Apolipoprotein E: impact of cytoskeletal stability in neurons and the
      relationship to Alzheimer's disease.
AB  - Apolipoproteins E3 and E4 exert differential effects on neuronal growth in vitro.
      Apolipoprotein E3 supports neurite extension, whereas apolipoprotein E4 does not.
      These isoform-specific effects may influence the stability of the cytoskeleton
      and may account for the association of the apolipoprotein E4 isoform with the
      pathogenesis of Alzheimer's disease.

PMID- 7773574
TI  - Yolk precursor transport in the laying hen.
AB  - The fully grown chicken oocyte, better known as the egg yolk, is a giant single
      cell that contains, besides bona fide cytoplasm, endocytosed, serum-derived
      lipoproteins and minor components that are essential for normal embryo
      development. The transport of bulk lipoproteins, micronutrients and morphogens to
      oocytes, in parallel with the maintenance of somatic homeostasis, is achieved by
      the cell-specific expression of receptors and subtle differences in the ligand
      structure that determine their target sites. Lipoprotein metabolism is the
      paradigm for these regulatory principles. In this review, the laying hen is
      described as a model system for intercellular transport that has uncovered new
      aspects of the biological rationale for the simultaneous expression of closely
      related genes in a single organism.

PMID- 7773575
TI  - Lipoprotein and receptor interactions in vivo.
AB  - A substantial number of animal models aimed at the genetic dissection of lipid
      metabolism have been generated recently. Transgenic and knockout mice, in which
      the receptors or apolipoproteins are overexpressed or destroyed, combined with
      virus-mediated gene transfer in vivo have advanced our understanding of the
      complex physiological and pathophysiological processes involved in lipid
      metabolism, including hepatic lipoprotein uptake and the formation of
      atherosclerotic lesions.

PMID- 7773576
TI  - The annual meeting and 35th symposia of the Japanese Society of Plant
      Physiologists. Matsue, Japan, March 28-30, 1995. Abstracts.

PMID- 7773577
TI  - Sepsis and septic shock. I. Definitions and pathophysiology.
AB  - Mortality from septic shock is considerable despite the advantages of
      cardiovascular support and antibiotic therapy. Understanding the pathophysiology
      of sepsis enables clinicians to institute rational intervention directed towards
      the pathophysiological mechanisms. This article reviews definitions of sepsis and
      offers a brief overview of ist pathophysiology. Current knowledge on the
      pathophysiological mechanism of cytokines and modulation of systemic cytokine
      levels during sepsis and septic shock is discussed. The important role of
      cytokines in sepsis and septic shock may require more detailed investigations of
      the cytokine pathophysiological network.

PMID- 7773579
TI  - Management of cancer anorexia/cachexia.
AB  - Cancer anorexia/cachexia is a common clinical problem that substantially impacts
      upon the quality of life and survival of affected patients. Extensive
      investigations have not supported the use of either enteral or paternal
      hyperalimentation for such patients. Despite positive pilot trial reports, large
      randomized studies have been unable to demonstrate a clinically defensible role
      for either pentoxifylline, cyproheptadine, or hydrazine sulfate for patients with
      anorexia. Multiple placebo-controlled, randomized, double-blind, clinical trials
      have demonstrated that corticosteroids do have appetite-enhancing properties in
      patients suffering from cancer anorexia/cachexia, but none of these studies has
      demonstrated weight gain. In comparison, multiple studies have demonstrated that
      the progestational agent, megestrol acetate, has both appetite-enhancing and
      weight-promoting properties.

PMID- 7773581
TI  - Intensive care in anticancer centres: an international inquiry.
AB  - Intensive care is increasingly frequently used in the management of cancer
      patients. In order to determine whether and how critical-care facilities are used
      specifically for these patients, we performed a world-wide inquiry in anticancer
      centres. We mailed a questionnaire to 141 centres and received 84 responses
      (57.5%). There was at least one oncological intensive care-unit (ICU) in 59
      hospitals (70%). The majority of the ICU were found in the European institutions.
      Data were obtained concerning the ICU organisation, the medical team, the nursing
      staff, the critical-care techniques and the anticancer treatments performed.
      Medical ICU appeared to be managed by physicians and nurses often qualified in
      both intensive care and oncology. These data suggest that oncological intensive
      care should be part of the training of oncologists and intensivists.

PMID- 7773578
TI  - Sepsis and septic shock. II. Treatment.
AB  - Mortality from septic shock is considerable despite the advantages of
      cardiovascular support and antibiotic therapy. This article reviews current
      therapy of septic shock including immunotherapy and further possibilities of
      septic shock treatment. The role of cytokines, their inhibitors and antibodies to
      endotoxin is mentioned. Although these treatments hold much promise for the
      future, careful evaluation of both the benefits and complications of therapy is
      needed before widespread clinical use can be recommended.

PMID- 7773580
TI  - The management of hypercalcemia of malignancy.
AB  - Hypercalcemia (HCM) occurs in 10-15% of all malignancies, predominantly in
      patients with solid tumors. This metabolic complication leads to significant
      morbidity and impairment of quality of life. Recent insights into the
      pathophysiology of HCM include an understanding of the role of parathyroid
      hormone-related peptide and several cytokines secreted by tumors. The osteoclast
      plays a central role as the final common pathway through which these hormones and
      cytokines act to cause bone lysis. These findings have led to the development of
      new treatment strategies. Foremost among these has been the introduction of
      agents such as the newer bisphosphonates and gallium nitrate, which are potent
      inhibitors of osteoclast-mediated bone resorption. The clinician can now choose
      from an array of therapeutic approaches based on a consideration of the
      mechanisms of action, individual clinical circumstances, efficacy, toxicities and
      costs of available agents. In addition to their use in the management of HCM, non
      toxic drugs that effectively inhibit osteoclast function, such as the
      bisphosphonates, are playing an emerging role in the palliative treatment of the
      more common clinical problems of painful lytic bone metastases and osteoporosis.

PMID- 7773582
TI  - Comparison of fluconazole with oral polyenes in the prevention of fungal
      infections in neutropenic patients. A prospective, randomized, single-center
      study.
AB  - The goal of this prospective randomized single-center study was the comparison of
      safety and efficacy of high-dose oral/intravenous fluconazole (400 mg daily)
      (group A) with oral nystatin plus miconazole inhalations (group B) in the
      prevention of fungal infections on a hemato-oncological isolation Ward. Of 157
      patients admitted to the isolation ward during the study period only 90 (57%)
      were eligible for randomization; 22 (14%) had a fungal infection at admission. Of
      the 90 randomized patients, 89 were evaluable, 43 in group A and 46 in group B.
      The age, sex, diagnosis, planned therapy and risk factors for fungal infections
      at admission as well as the duration of neutropenia were in the same proportions
      in both groups. Oral thrush and mucocutaneous candidiasis were prevented in all
      patients of both groups, and 29 patients (32%: 17 in group A, 12 in group B) were
      discharged after successful prophylaxis (NS). Empiric amphotericin B was given
      according to predetermined criteria to 45 patients (51%: 23 group A, 22 group B;
      NS). Fluconazole significantly delayed the time before the start of intravenous
      amphotericin B. It was begun after a median of 10 days (0-45 days, range) of
      neutropenia below 0.5 x 10(9) granulocytes/l in group A and 7.5 days (0-26,
      range) in group B (P < 0.05). The duration of successful prophylaxis was
      significantly longer in group A (26 days median) than in group B (21 days,
      median) (P < 0.05). Systematic fungal infection was documented in 3 patients (1
      group A, 2 group B; NS).

PMID- 7773583
TI  - Combined management in the treatment of epidoxorubicin extravasation. A case
      report.
AB  - Inadvertent extravasation during intravenous antitumor therapy is not an unusual
      complication and can cause damage ranging from minor erythema to severe local
      necrosis. The appropriate management of these iatrogenic accidents as a part of
      supportive care in oncology has been addressed by several experimental studies,
      but there has been little clinical study and no conclusive evidence on the best
      therapeutic strategies to adopt. The case reported here of a patient suffering
      from severe soft-tissue injury caused by extravasation of epidoxorubicin
      demonstrates the usefulness of a combined management (medical, surgical and
      rehabilitative) in the appropriate care of extravasation.

PMID- 7773585
TI  - Euthanasia not only for terminal illness.

PMID- 7773584
TI  - Intensive care support in oncology: a contradiction?

PMID- 7773587
TI  - Epstein-Barr virus immortalizing genes.
AB  - Epstein-Barr virus (EBV) is linked to several types of human cancer and
      immortalizes human B cells very efficiently; at least six viral genes are
      required for this. The mechanism by which EBV immortalizes cells is particularly
      interesting because its immortalization genes are not obvious homologues of those
      of other DNA tumour viruses.

PMID- 7773586
TI  - Intensive care and oncology.
AB  - Intensive care is increasingly used in the management of cancer patients. The
      main reasons for admitting a cancer patient to an intensive-care unit are
      postoperative recovery, critical complications of the cancer disease and its
      treatment, the administration and monitoring of intensive anticancer treatment,
      and acute disease unrelated to cancer or its treatment. The present review is
      focused on the prognosis of critically ill cancer patients, on the description of
      the types of complications requiring intensive care, on specific aspects of the
      application of critical-care techniques in cancer patients, on ethical
      considerations and on ICU organization in the context of oncology.

PMID- 7773588
TI  - Viral potentiation of bacterial superinfection of the respiratory tract.
AB  - Virus infections of the respiratory tract predispose it to bacterial
      superinfections. Epidemiological studies, clinical evidence of viral-bacterial co
      infection and animal models of such interactions suggest a time course of events
      and several mechanisms by which viral potentiation may occur. It appears that
      structural and functional disruption of the respiratory mucosal epithelium is a
      major contributor to the synergistic effects of superinfection.

PMID- 7773590
TI  - Intestinal epithelial cells as watchdogs for the natural immune system.
AB  - Intestinal epithelial cells secrete a spectrum of chemoattractant and
      proinflammatory cytokines after invasion by bacteria. We suggest the novel
      concept that epithelial cells not only act as a mechanical barrier to invasive
      bacteria, but that they also signal the presence of invasive pathogens to the
      mucosal immune and inflammatory cells.

PMID- 7773589
TI  - HIV retrotransposon activity and the immunopathogenesis of AIDS.
AB  - This article presents the new hypothesis that HIV retrotransposon insertional
      mutagenesis induces genomic effects that bring about immune dysfunction through
      disruption, deletion or rearrangement of the genome of the host. This activity
      may be augmented by the action of most, if not all, the cofactors of HIV-induced
      disease.

PMID- 7773591
TI  - The antiviral effects of nitric oxide.

PMID- 7773592
TI  - Identification of bacterial genes that contribute to survival and growth in an
      intracellular environment.

PMID- 7773593
TI  - Haemophilus ducreyi: pathogenesis and protective immunity.
AB  - Haemophilus ducreyi is the etiological agent of chancroid, a sexually transmitted
      disease that is common in developing countries and that has characteristic
      genital mucocutaneous lesions. The adherence and growth of bacteria on the
      surface of eukaryotic cells, and the production of cytotoxin(s) result in cell
      damage that may be responsible for the development of ulcers. The mechanisms for
      protective immunity in chancroid are unclear, but both humoral and cell-mediated
      mechanisms may be involved.

PMID- 7773594
TI  - Infection by bovine papillomavirus and prospects for vaccination.
AB  - Infection with bovine papillomavirus (BPV) results in the onset of benign
      proliferative lesions that usually regress spontaneously through a cell-mediated
      immune response. Occasionally, warts persist as benign tumours or progress to
      squamous-cell carcinomas. Vaccines that prevent or cure BPV infection provide a
      model for the formulation of vaccines against human papillomavirus.

PMID- 7773595
TI  - The fungal cell wall as a drug target.
AB  - Fungal infections are increasingly common and, in certain vulnerable patients,
      can be serious and even life threatening. The fungal cell wall, a structure with
      no mammalian counterpart, presents an attractive therapeutic target. Inhibitors
      of the synthesis of one cell-wall component, beta-(1,3)-glucan, are currently
      under development as antifungal and antipneumocystis agents.

PMID- 7773596
TI  - Stump the experts. Apocrine hidrocystoma.

PMID- 7773597
TI  - Soft tissue augmentation. A review.
AB  - BACKGROUND: Soft tissue augmentation is one of the most sought after cosmetic
      procedures around the world. It has been performed for centuries, but only in
      this decade or so have materials become available that allow effective therapy.
      OBJECTIVE: This review article discusses the use of materials for soft tissue
      augmentation as to where they fit into the overall scheme of treating the aging
      face, as well as the benefits and side effects of each, and how to maximize the
      use of these various materials. RESULTS: The materials reviewed with regard to
      both efficacy and safety of those currently on the market as well as those
      currently in research. CONCLUSION: With the understanding of the role of soft
      tissue augmentation in the overall treatment of the aging face as well as risk
      factors and ways to minimize the side effects, dermatologic surgeons can reach
      the goal of effectively treating patients with these materials.

PMID- 7773598
TI  - Postoperative wound infection rates in dermatologic surgery.
AB  - BACKGROUND: Multiple factors related to the nature of the surgical procedure can
      influence the risk of wound infection in dermatologic surgery. Despite that,
      wound infection rates in dermatologic surgical procedures are believed to be low.
      OBJECTIVE: This study was conducted: 1) to determine wound infection rates in
      Mohs and excisional surgery; and 2) to investigate if factors such as lesion
      type, anatomic location, postoperative defect size, number of Mohs stages
      required to achieve a tumor-free plane, and the type of reconstructive procedure
      influence the rate of surgical wound infections. RESULTS: Wound infection rate
      for 530 Mohs procedures and 517 excisions combined was 2.29%, falling within the
      predicted range for "clean" surgical procedures. In addition, Mohs procedures
      performed on the ear as well as large postoperative defects were found to have a
      higher rate of wound infections. CONCLUSION: Dermatologic surgery can be safely
      performed in an outpatient setting without a significant risk of infection.
      Certain anatomic sites, such as the ear, as well as size of postoperative defect,
      are important factors in predicting the risk of postoperative wound infection.

PMID- 7773599
TI  - Repetitive pulsed dye laser treatments improve persistent port-wine stains.
AB  - BACKGROUND: Approximately 50-75% lightening of port-wine stains is achieved
      within two to three treatments with pulsed dye laser therapy, but the incidence
      of complete clearing is variable. OBJECTIVE: This study was designed to: 1)
      assess the ability of continued repetitive pulsed dye laser treatments to further
      lighten persistent port-wine stains; 2) evaluate the factors contributing to the
      resistance of port-wine stains to laser therapy; and 3) determine the relative
      risk of adverse effects following repetitive treatments to the same area.
      METHODS: A retrospective photographic analysis was performed of 69 patients that
      failed to achieve greater than 75% lesional lightening within nine treatment
      sessions. The percentage improvement was assessed by comparing the degree of
      lightening at the last treatment to that of the midway point of treatment.
      RESULTS: Significant improvement in port-wine stain lightening, from the midway
      to last treatment, was seen in patients who had 10-25 repetitive treatments.
      CONCLUSION: Repetitive treatments with the pulsed dye laser can lead to
      improvement in the overall lightening of persistent port-wine stains without an
      increased risk of adverse effects.

PMID- 7773600
TI  - The isolated frontal forelock.
AB  - BACKGROUND: The progression and extent of male pattern baldness is statistically
      unpredictable. OBJECTIVE: An approach to the patient with male pattern baldness
      is suggested, which results in a product that changes appearance in a positive
      way, is natural, requires no maintenance, and does not deconstruct with
      progression of alopecia. METHODS AND RESULTS: A technique is described for
      transplantation of the frontal forelock allowing creation of a soft anterior zone
      and a dense posterior component. CONCLUSION: The utilization of donor hair to
      create a transplanted forelock will eventuate in a product that maintains
      naturalness regardless of the progression or extent of future hair loss.

PMID- 7773601
TI  - Aluminum oxide crystal microdermabrasion. A new technique for treating facial
      scarring.
AB  - BACKGROUND: Aluminum oxide crystal microdermabrasion, a newly developed
      technique, has the advantages of less bleeding, fewer complications, better
      compliance, and no need for local anesthesia or high surgical skill in comparison
      with traditional dermabrasion. OBJECTIVE: To demonstrate the effectiveness of
      this new technique in the treatment of facial scarring. METHODS: A total of 41
      patients were treated by this technique during the past 2 years (July 1992 to
      June 1994). RESULTS: All patients treated had good to excellent clinical
      improvement with 9.10 mean treatment sessions. CONCLUSION: From our experience
      and results, we think aluminum oxide crystal microdermabrasion is a safe surgical
      procedure and will be a good supplement to traditional dermabrasion especially in
      this era of HIV infection.

PMID- 7773602
TI  - Subcutaneous incisionless (subcision) surgery for the correction of depressed
      scars and wrinkles.
AB  - BACKGROUND: A new method of subcuticular underming for the treatment of depressed
      cutaneous scars and wrinkles is introduced. OBJECTIVE: To define the newly coined
      term "Subcision" and to describe this minor surgical procedure for treating
      depressed scars and wrinkles. METHODS: A tri-beveled hypodermic needle is
      inserted through a puncture in the skin surface (hence, "incisionless" surgery),
      and its sharp edges are maneuvered under the defect to make subcuticular cuts or
      "-cisions." RESULTS: The depression is lifted by the releasing action of the
      procedure, as well as from connective tissue that forms in the course of normal
      wound healing. CONCLUSION: This technique is useful in treating a variety of
      cutaneous depressions, including scars and wrinkles.

PMID- 7773603
TI  - Antibiotic prophylaxis in cutaneous surgery.
AB  - BACKGROUND: Postoperative wound infections, endocarditis, and late contamination
      of prosthetic implants are potential complications of cutaneous surgery.
      OBJECTIVE: To review current American Heart Association guidelines and their
      application to cutaneous surgery, and to determine how practicing physicians
      approach this problem. METHOD: Surveys were sent to dermatologists to determine
      what kind of preoperative screening was being done and how antibiotics were being
      used. RESULTS: The most common indications for prophylaxis were manipulation of
      infected tissue in patients undergoing any procedure, and any procedure in a
      patient with a prosthetic heart valve. Some respondents used antibiotic
      prophylaxis for all procedures, while others never used antibiotics in any
      surgical procedure. Cephalosporins and erythromycin were the most commonly used
      antibiotics and they were usually given orally, one dose before and one dose
      after surgery. CONCLUSION: Scientific literature supports the use of antibiotic
      prophylaxis for endocarditis in two situations: 1) surgical procedures on
      infected tissue in patients with a high risk cardiac lesion; and 2) any surgical
      procedure in a patient with a prosthetic heart valve. Our survey suggests that
      the majority of dermatologists obtain pertinent medical history and use
      appropriate antibiotic prophylaxis in these two situations. But the survey also
      suggests that antibiotic prophylaxis is used in a variety of situations where
      indications for use are not as clear, and sometimes prophylaxis is not used when
      it should be.

PMID- 7773604
TI  - Informed consent and informed refusal.
AB  - BACKGROUND: This article continues our medicolegal series that addresses issues
      affecting current dermatology practice. Informed consent and informed refusal
      have become cornerstones of modern American healthcare, and can serve to
      facilitate communication and trust between physician and patient. METHODS: A
      format with an initial discussion of legal concepts is followed by hypothetical
      problems and a review of actual cases to illustrate the principles of informed
      consent and informed refusal. RESULTS: A valid informed consent from a competent
      patient should be obtained before initiating most dermatologic treatment. When a
      competent patient refuses a recommended medical test or procedure, the physician
      should make sure the patient understands the potential negative consequences of
      refusal. Some form of written documentation in the medical record is advised in
      either situation. CONCLUSION: Failure to obtain a patient's informed consent
      prior to beginning treatment or failing to obtain an informed refusal before
      accepting a patient's decision to forego a test or procedure may subject the
      dermatologist to multiple later allegations, most commonly negligence.

PMID- 7773605
TI  - Closure of conchal defects. The hinged retroconchal island flap with overlying
      cutaneous transposition flap.
AB  - BACKGROUND: Conchal defects secondary to surgical procedures or trauma often
      cannot be closed primarily. OBJECTIVE: Tissue transfer for closure of defects
      must be tension free and not create a postauricular sulcus too shallow. METHODS:
      A retroconchal island flap provides such a closure. A rhomboid transposition flap
      used to provide closure of the donor site retains the depth of the posterior
      sulcus. RESULTS: The closure of the defect heals well within 4-6 weeks even in
      presence of scar tissue from multiple prior surgeries. CONCLUSION: The
      retronconchal island flap is a simple, reliable technique to close the defect of
      the concha without sacrificing the natural depth of the posterior sulcus.

PMID- 7773606
TI  - Bovine collagen products and gelatin sponges for hemostasis in punch biopsies of
      HIV-1+ patients.

PMID- 7773607
TI  - Laser hair transplantation.

PMID- 7773608
TI  - Carbamylation decreases the cytotoxicity but not the drug-carrier properties of
      polylysines.
AB  - The charge density of Poly(D-lysine) was reduced by the carbamylation of the
      lysyl residues with potassium cyanate. A decrease in the charge density of poly(D
      lysine) by 25% and 50% reduced the cytotoxicity of the ligand to cultured L929
      cells by a 5-, and a 20 to 25-fold level, respectively, as estimated by using
      either the viability or the protein assay. The uptake of cyanate-modified poly(D
      lysine) ligands in cultured L929 cells was not reduced, while the uptake of
      poly(D-lysine)/Heparin complex was reduced by 80%, as compared to that of
      unmodified poly(D-lysine). The in vivo biodistribution of cyanate-modified poly(D
      lysine) ligands in the lungs and the liver of mice was not altered in comparison
      to that of unmodified poly(D-lysine), whereas the poly(D-lysine)/Heparin complex
      was only accumulated in the liver but not in the lungs. The data in this paper
      indicate that a 50% decrease in the positive charge density of poly(D-lysine)
      reduces the toxicity, but not the carrier potential of this polycationic ligand.

PMID- 7773610
TI  - Effect of iontophoretic patterns on in vivo antidiuretic response to desmopressin
      acetate administered transdermally.
AB  - The effects of concentration, amperage and duration on the antidiuretic response
      induced by iontophoretic delivery of desmopressin acetate (DDAVP) were examined
      using a diabetes insipidus model in rats. A higher current density brought about
      a larger and longer antidiuretic response. Prolonged iontophoretic duration
      caused an overdose. Repeated short iontophoretic treatments with lower current
      density maintained a constant response with a short lag time and a rapid
      disappearance of pharmacological response immediately after cessation of the
      final treatment. This type of iontophoresis substantially reduced the inter
      subject variability of response as compared to the response using an intranasal
      route of administration.

PMID- 7773609
TI  - Cholesteryl-conjugated phosphorothioate oligodeoxynucleotides modulate CYP2B1
      expression in vivo.
AB  - 5' cholesteryl-conjugated phosphorothioate oligodeoxynucleotides with sequence
      complementary to the rat CYP2B1 mRNA were evaluated in adult male Sprague-Dawley
      rats for their pharmacokinetic properties, toxicity, and ability to modulate
      CYP2B1 expression in vivo. Following intraperitoneal administration of 35S
      labelled oligodeoxynucleotides, volume of distribution for the phosphorothioate
      was 0.33 l/kg while the 5' cholesteryl-conjugate oligodeoxynucleotide was 0.12
      l/kg. The elimination half-life was 23.2 and 55.4 hrs for cholesteryl-modified
      and unmodified oligodeoxynucleotides, respectively. Cholesteryl-conjugate
      oligodeoxynucleotide toxicity was detected at a dose of 1.0 mg/kg and consisted
      primarily of midzonal liver cell enlargement and increased total RNA.
      Hexobarbital sleep times, a measure of CYP2B1 enzyme activity in vivo, increased
      from 21.9 minutes in saline-treated animals to 29.5 minutes in cholesterol
      oligodeoxynucleotide-treated animals. A significant decrease in liver microsomal
      pentoxyresorufin O-dealkylase enzyme activity, a CYP2B1/2 specific assay, was
      observed but not a change in p-nitrophenol hydroxylase activity, a specific
      CYP2E1 assay. These data indicate that in vivo modulation of the CYP2B1 gene can
      be accomplished with synthetic phosphorothioate oligodeoxynucleotides in a
      sequence-specific manner. Further, cholesteryl conjugation to the 5' end of the
      oligodeoxynucleotide enhanced potency despite lesser bioavailability.

PMID- 7773611
TI  - Liposomal alpha-tocopherol alleviates the progression of paraquat-induced lung
      damage.
AB  - The present study was carried out to investigate the efficacy of liposome
      associated alpha-tocopherol in treating pulmonary damage caused by paraquat
      exposure. alpha-Tocopherol liposomes (8 mg alpha-tocopherol/kg body weight) or
      plain liposomes were intratracheally instilled into the lungs of rats 24 h after
      paraquat treatment (20 mg/kg, ip); treated animals were killed 8, 24 or 48 h
      after administration of the liposomal preparations. Lungs of animals exposed to
      paraquat were extensively damaged as evidenced by an increase in lung weight and
      decreases in pulmonary angiotensin converting enzyme and alkaline phosphatase
      activities. Also, paraquat treatment resulted in a significant reduction in
      glutathione (GSH) concentration in the lung and an elevation in microsomal lipid
      peroxidation levels, as measured by the formation of diene conjugates. Treatment
      of paraquat-injected rats with plain liposomes did not significantly alter
      paraquat-induced changes of all parameters examined. On the other hand, treatment
      of rats with alpha-tocopherol liposomes, 24 h after paraquat administration,
      resulted in a significant increase in pulmonary alpha-tocopherol concentrations
      as well as a reduction in paraquat-induced changes in lipid peroxidation, GSH
      concentration, and lung angiotensin converting enzyme and alkaline phosphatase
      activities. The results of the present study suggest that alpha-tocopherol,
      administered directly to the lung in a liposomal form, may serve as a potentially
      effective pharmacological agent in the treatment of paraquat-induced lung injury.

PMID- 7773612
TI  - Starch microspheres induce pulsatile delivery of drugs and peptides across the
      epithelial barrier by reversible separation of the tight junctions.
AB  - Non-parenteral administration of peptide drugs is prevented by the limited
      permeability of the epithelia lining the mucosal tissues. As a new approach to
      non-parenteral delivery, degradable starch microspheres (dsm) were coated with
      insulin and administered to the mucosal side of monolayers of human intestinal
      epithelial (Caco-2) cells in vitro. The microspheres induced a pulsed delivery of
      insulin across the epithelium that lasted for 1-2 h. The pulsed delivery
      correlated with a reversible appearance of focal dilatations in the tight
      junctions between the epithelial cells, indicating that dsm enhance the delivery
      of insulin by the paracellular route. These results provide an explanation for
      the previously observed absorption enhancing properties of dsm.

PMID- 7773613
TI  - Further studies on targeted DNA transfer to cells using a highly efficient
      delivery system of biotinylated transferrin and biotinylated polylysine complexed
      to streptavidin.
AB  - Conjugates consisting of biotinylated transferrin and biotinylated poly-L-lysine
      attached to streptavidin have been prepared and found to transfer luciferase
      plasmid DNA very efficiently to HeLa cells in the presence of chloroquine.
      Transfection was dependent on (i) use of biotinylated short chain polylysine
      containing 70 lysine residues, (ii) biotinylated transferrin containing 1-2
      biotin moieties, (iii) reaction of biotinylated transferrin with streptavidin
      followed by isolation of the resulting conjugate on Sephadex G-200 and (iv)
      interaction of streptavidin-biotinylated transferrin with biotinylated polylysine
      giving a complex suitable for DNA transfection. It was found that if the above
      sequence of steps resulting in the formation of streptavidin-biotinylated
      transferrin/biotinylated polylysine was followed without isolation of
      intermediate conjugates by Sephadex G-200 chromatography, pRSVL DNA transfer was
      still very efficient. Transfer of luciferase DNA by the streptavidin conjugates
      and subsequent expression of luciferase activity was almost completely inhibited
      by excess free transferrin, showing that gene transfer was through the
      transferrin receptor pathway via receptor-mediated endocytosis. The streptavidin
      (bio2-transferrin) bio10-pLys70 conjugate used in the present experiments was
      approximately one hundred times more efficient in pRSVL DNA transfection with the
      HeLa cells than the previously described avidin-pLys460 (bio-transferrin)
      complex.

PMID- 7773614
TI  - Synthesis and the stereoselective enzymatic hydrolysis of flurbiprofen-basic
      amino acid ethyl esters.
AB  - Ethyl esters of flurbiprofen L-arginine (FP-Arg-OH), flurbiprofen L-lysine (FP
      Lys-OH) and flurbiprofen p-guanidino-L-phenylalanine (FP-GPA-OH) were synthesized
      and then the release of flurbiprofen enantiomers from these derivatives in the
      presence of trypsin (Tp), carboxypeptidase B (CPB) and carboxypeptidase Y (CPY)
      were examined in order to evaluate their availability as prodrugs for
      flurbiprofen (FP). The ester bonds of the three racemic FP derivatives were
      hydrolyzed by Tp at about 3 to 20 times the rates of N-benzoyl-L-arginine ethyl
      ester (Bz-Arg-OEt), a specific substrate for Tp. (R)-FP was released faster than
      (S)-FP by either CPB or CPY from both FP-Arg-OH and FP-Lys-OH. On the other hand,
      FP-GPA-OH was not hydrolyzed at all by CPB and the hydrolysis rate of this
      compound by CPY was very slow. (S)-Flurbiprofen L-arginine ethyl ester ((S)-FP
      Arg-OEt) was separated from (R)-FP-Arg-OEt by high-performance liquid
      chromatography. A comparison of the kinetic parameters for the tryptic hydrolysis
      of the two optically active FP-Arg-OEt diastereomers and those of Bz-Arg-OEt
      suggested that the orientation of the scissile bond in each diastereomer to the
      catalytic center of Tp is more favorable than that of Bz-Arg-OEt. However, no
      significant difference was found between the kinetic parameters for the two
      diastereomers, suggesting that the orientational difference between (S)-FP and
      (R)-FP in the diastereomers does not have any effect on the tryptic hydrolysis of
      the ester bond.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773615
TI  - Chirality and drug targeting: pros and cons.
AB  - The theoretical basis of stereoselectivity in drug targeting in terms of eudismic
      ratio and quantitative structure-activity relationship has been presented.
      Specific examples of the advantages of using the correct stereoisomers (eutomers)
      rather than the distomers or racemic mixtures have been discussed. With the
      recent development of new methods of chiral synthesis and chiral analysis, it is
      not longer justifiable to continue to use racemic mixtures as therapeutic agents,
      unless it can be proven to be safe to do so. In the area of using peptides,
      proteins, glycoproteins and polysaccharides as therapeutic agents, mother nature
      has been very selective in choosing the optically active starting materials
      (Bradley, 1994), it is a necessity to design and test the proper optical isomer
      when a mimetic or antagonist compound is contemplated as a therapeutic agent.

PMID- 7773616
TI  - A non-ionic surfactant vesicle-in-water-in-oil (v/w/o) system: potential uses in
      drug and vaccine delivery.
AB  - An aqueous dispersion of niosomes (non-ionic surfactant vesicles) emulsified in
      an external oil phase forms the vesicle-in-water-in-oil (v/w/o) system described
      in this paper. The properties of the surfactant used to form the vesicles, the
      surfactant or surfactant mixture used to stabilize the emulsion and the nature of
      the oil phase can be changed to provide systems of different capacities for drug
      or antigen and different release characteristics. The same nonionic surfactant is
      used as the principle amphipile to form the niosomes and to stabilize the w/o
      emulsion, thus promoting stability by decreasing transfer of surfactant between
      the stabilizing monolayers and the vesicle bilayers. The in vitro release of
      carboxyfluoroscein and 5-fluorouracil encapsulated within the niosomes of the
      v/w/o system has been investigated, the nature of the oil phase and surfactant
      oil interactions being important in determining the rate of solute release.
      Initial studies of the system in vivo, as an adjuvant for tetanus toxoid, using
      cottonseed oil as the external oil phase, showed enhanced immunological activity
      over the free antigen or vesicles.

PMID- 7773617
TI  - Effect of calcium ions on the surface charge and aggregation of
      phosphatidylcholine liposomes.
AB  - The aggregation behaviour of multilamellar liposomes composed of egg
      phosphatidylcholine (EPC) and dipalmitoylphosphatidylcholine (DPPC) in the
      presence of varying concentrations of calcium ions has been studied by measuring
      changes in the particle size of liposome suspensions. Reversible aggregation
      occurred with both liposome preparations, showing a maximum rate at approximately
      0.9 to 1.8 mM calcium chloride. At higher or lower concentrations aggregation was
      inhibited in the case of EPC suspensions or, for DPPC systems, occurred only
      slowly. Furthermore, the EPC systems showed more marked increases in size when
      aggregation occurred. The zeta potentials of both systems were negative in water,
      becoming positive on increasing the concentration of calcium ions. A reasonable
      correlation was found between calcium concentration corresponding to the minimum
      in initial zeta potential and that producing the greatest aggregation rate.

PMID- 7773618
TI  - Biotransformations in the regioselective deacetylation of polyphenolic
      peracetates in organic solvents.
AB  - Regioselectivity has been observed in the deacetylation of peracetates of
      polyphenolic aromatic ketones by lipases from porcine pancreas (PPL) and Candida
      cyclindracea (CCL) suspended in organic solvents. The deacetylation of acetoxyl
      groups at positions para and meta to the carbonyl (ketonic) group is favoured
      over the one at the ortho position.

PMID- 7773619
TI  - The specific inhibition of crystal growth of monohydrogen potassium L-tartrate by
      d-catechin.
AB  - Crystal growth of monohydrogen potassium L-tartrate in an ethanolic aqueous
      solution was specifically inhibited by d-catechin, but not by either its epimeric
      isomer at C3, l-epicatechin or by gallic acid and caffeic acid. 3D-Structure
      similarity search of d-catechin with two molecules of the tartrate and docking
      study of d-catechin with the crystal model of the tartrate suggested that d
      catechin mimics a structure consisting of the two tartrate molecules in the
      inhibition. Differences in the conformation of the catechol moieties of d
      catechin and l-epicatechin may explain the distinct inhibitory effects of the
      epimeric isomers.

PMID- 7773620
TI  - Molecular determinants of recognition and activation at the cerebellar
      benzodiazepine receptor site.
AB  - Semiempirical quantum mechanical and molecular mechanics calculations were
      carried out to identify and characterize the steric and electronic properties
      that modulate ligand recognition and activation of the cerebellar
      GABAA/benzodiazepine (BDZ) receptor. For this hypothesis development, thirteen
      compounds belonging to structurally diverse chemical families were selected for
      study. Among the compounds selected were nine that bind and four that do not bind
      with appreciable affinity to this receptor and some that are known agonists,
      antagonists and inverse agonists, as measured by their modulation of GABA (gamma
      aminobutyric acid) enhanced chloride ion flux in cerebellum. The stereoelectronic
      requirements for recognition deduced from commonalities among the ligands are the
      presence of at least two of three hydrogen bonding centers, and a lipophilic
      aromatic ring, in a specific spatial relationship. The results suggest that the
      selectivity for the cerebellar or Type I subtype, demonstrated by some of these
      ligands, could be failure to meet the requirements for binding at other receptors
      because of the absence of one of the proton accepting centers or the larger
      surface area and volume of these ligands. The requirement for activation, deduced
      from comparisons of agonist, antagonist, and inverse agonist properties is the
      presence of an electron accepting aromatic ring in a specific geometric
      arrangement with respect to the components of recognition. The validity of the
      '3D-Pharmacophore' developed was probed by using it for predictions of the
      behavior of 11 additional compounds not used for its development.

PMID- 7773621
TI  - Suksdorfin: an anti-HIV principle from Lomatium suksdorfii, its structure
      activity correlation with related coumarins, and synergistic effects with anti
      AIDS nucleosides.
AB  - Suksdorfin (1), which is isolated from the fruit of Lomatium suksdorfii, was
      found to be able to inhibit HIV-1 replication in the T cell line, H9, with an
      average EC50 value of 2.6 +/- 2.1 microM. In addition, suksdorfin was also
      suppressive during acute HIV-1 infections of peripheral blood mononuclear cells,
      monocyte/macrophages and the promonocytic cell line, U937. Combinations of 1 and
      the anti-HIV nucleosides ddI and ddC demonstrated statistical synergy in
      inhibiting HIV-1 replication (ddC > ddI). However, the viral inhibition mediated
      by combining 1 with AZT was not statistically synergistic. Furthermore, the
      presence of suksdorfin did not antagonize the suppression mediated by the three
      nucleoside reverse transcriptase inhibitors. Comparison of the structure and
      activity of 1 with those of ten related compounds indicated that the
      dihydroseselin type of pyranocoumarin possessing a 4'-isovaleryl group is
      important to suksdorfin's enhanced anti-HIV activity.

PMID- 7773622
TI  - Potential radioprotective agents--V. Melatonin analogs. Oral activity of p
      aminopropiophenone and its ethylene ketal.
AB  - Seven new amides of 5-methoxytryptamine were synthesized and tested for
      radioprotective activity in mice. One of them, the heptafluorobutyramide 4, is
      moderately active (57% survivors), the rest demonstrate little or no activity. Of
      twelve compounds that had been found to exhibit high radioprotective activity by
      ip injection, only two [p-aminopropiophenone (9) and its ethylene ketal 8] retain
      that high activity (92-95% survivors) when administered orally. Three are
      moderately active: p-aminobenzonitrile (10, 55%), 5-methoxytryptamine octanoic
      amide (11, 50%), and p-aminobenzophenone (12, 48%).

PMID- 7773623
TI  - Dialkylaminoalkyl esters of 2,2-diphenyl-2-alkylthioacetic acids: a new class of
      potent and functionally selective muscarinic antagonists.
AB  - The synthesis and pharmacological activity as muscarinic antagonists of a number
      of 2-alkylthio-2,2-diphenylacetic acid esters are reported. The compounds studied
      are potent muscarinic antagonists and many of them show from moderate to high
      selectivity toward M2 or toward M1 and M2 receptors when tested on tissues but
      lack selectivity on five muscarinic human receptors (m1-m5) cloned and expressed
      in CHO-K1 cells. As a consequence, the compounds behave as functionally selective
      antagonists. Those showing M2 selectivity appear to be good drug candidates for
      the treatment of cognitive disorders connected with central cholinergic deficit.

PMID- 7773624
TI  - The synthesis of novel HIV-protease inhibitors.
AB  - The syntheses, enzyme inhibition and antiviral activity of potent HIV-protease
      inhibitors containing novel beta-hydroxy ether and thioethers based on the
      transition state mimetic concept are discussed.

PMID- 7773625
TI  - Alpha-ketoamide Phe-Pro isostere as a new core structure for the inhibition of
      HIV protease.
AB  - Studies on the inhibition of HIV-1 protease utilizing a core isostere with
      replacement of the scissle bond for an alpha-amino-ketone have resulted in the
      development of an alpha-keto-amide isosteric replacement of the Phe-Pro scissle
      amide bond. The simple dipeptide isostere was shown to be a promising new core
      structure for the development of the enzyme inhibitors. The Ki of this core
      structure was determined to be 6 microM, compared to 230 microM and > 50 microM
      for the corresponding phosphinic acid and hydroxyethylamine isosteres.

PMID- 7773626
TI  - Synthesis and anti-cancer activity of 2-alkylaminomethyl-5-(E)-alkylidene
      cyclopentanone hydrochlorides.
AB  - A series of 2-alkylaminomethyl-5-(E)-alkylidene cyclopentanone hydrochlorides
      (2), have been synthesized and evaluated as anti-cancer agents. These compounds
      were designed as masked alpha-methylenecyclopentanones, which appear in many
      cytotoxic or anti-cancer natural products. Most of the synthesized compounds were
      found to be active towards various human cancer cell lines and many showed
      significant subpanel selectivity. For compounds containing the same alkylidene
      moiety (from C3 to C9), the dimethylaminomethyl analogs were more active than
      structures possessing morpholino-, pyrrolidino-, or piperidino-methyl groups.
      Alteration of the alkylidene moiety had little effect on anti-cancer potency. The
      mass spectrum of a glutathione adduct of 2h indicated that the mechanism of
      action for these anti-cancer agents may be related to the attack at the
      aminomethyl carbon atom by biological nucleophilic thiols.

PMID- 7773627
TI  - A new class of compounds, peptide derivatives of adenosine 5'-carboxylic acid,
      includes inhibitors of ATP receptor-mediated responses.
AB  - A new type of ligand for the study of P2-purinergic receptor subtypes was
      synthesized by combining and modifying conventional nucleoside chemistry with
      Fmoc solid phase peptide synthesis techniques. The tri- and tetra-aspartic acid
      derivatives of adenosine-5'-carboxylic acid (AdoCAsp3 and AdoCAsp4) were found to
      act as weak agonists at P2-purinergic receptors, (activated by ATP and UTP
      respectively) present on C6 glioma cells. AdoCAsp4 induced inositol 1,4,5
      trisphosphate formation in the C6 cells with an EC50 of 73 microM. In addition,
      AdoCAsp4 was found to inhibit (IC50 approximately 80 microM) ATP-induced
      cytosolic [Ca2+] transients in these glioma cells. The glycine derivative,
      AdoCGly, increased evoked release of noradrenaline from mouse vas deferens
      slices, probably due to the blockade of presynaptic P2-autoreceptors. The
      possibility that aspartic, glutamic or gamma-carboxyglutamic residues may be used
      to replace phosphate groups on an ATP receptor ligand, opens up new ways in
      ligand design.

PMID- 7773628
TI  - Synthesis of 2-imidazolidinylidene propanedinitrile derivatives as stimulators of
      gastrointestinal motility--II.
AB  - In a previous paper, we reported that a novel ranitidine derivative 2 (fumarate:
      KW-5092), which had a 2-imidazolidinylidene propanedinitrile moiety (A), showed
      potent gastrointestinal motility enhancing activity. In order to obtain more
      potent gastrointestinal motility enhancing agents than compound 2 and to examine
      the effects of various substituents both at a nitrogen atom (B) in the 2
      imidazolidinylidene propanedinitrile moiety and a basic nitrogen atom (C),
      compounds 5-29 were synthesized and evaluated for acetylcholinesterase (AChE)
      inhibitory activity and potentiating action on electrically stimulated
      contractions of guinea pig ileum. Introduction of alkyl, benzyl, aryl or acyl
      groups to the nitrogen (B) or (C), remarkably influenced both activities. Among
      these, compounds 14 and 15 showed more potent AChE inhibitory activity (IC50 =
      6.7, 6.8 nM, respectively) than compound 2 and were active in potentiating action
      on the ileal contraction (EC30 = 9.5, 11 nM, respectively) together with a
      negligible histamine H2-receptor blocking property. Furthermore, these compounds
      were found to be more effective in the enhancement of gastrointestinal motility
      in anesthetized rabbits than compound 2.

PMID- 7773629
TI  - Neointimal fibrosis in vascular pathologies: role of growth factors and
      metalloproteinases in vascular smooth muscle proliferation.

PMID- 7773630
TI  - Collagen turnover in renal disease.

PMID- 7773631
TI  - Glomerular cell proteoglycans: their possible role in progressive glomerular
      disease.

PMID- 7773632
TI  - Human renal fibroblast cell lines (tFKIF and tNKF) are new tools to investigate
      pathophysiologic mechanisms of renal interstitial fibrosis.

PMID- 7773633
TI  - Myofibroblast differentiation during fibrosis.

PMID- 7773634
TI  - Integrin distribution in normal kidney and cultured human glomerular cells.

PMID- 7773635
TI  - Transforming growth factor beta (TGF-beta) regulates the matrix-associated
      plasminogen activator inhibitor 1 (PAI-1) in glomerular mesangial and epithelial
      cells.

PMID- 7773636
TI  - Increased fibronectin incorporation into extracellular matrix in response to
      platelet-derived growth factor is mediated by transforming growth factor beta.

PMID- 7773637
TI  - Opportunities for the discovery of novel therapies for fibrotic diseases.

PMID- 7773638
TI  - Renal scarring: a multi-organ approach to fibrosis.

PMID- 7773639
TI  - Pathways to renal fibrosis.

PMID- 7773640
TI  - Interstitial macrophages as mediators of renal fibrosis.

PMID- 7773641
TI  - Tissue inhibitor of the metalloproteinases and renal extracellular matrix
      accumulation.

PMID- 7773642
TI  - Role of the macrophage in the development of glomerulosclerosis.

PMID- 7773643
TI  - Matrix metalloproteinases and tissue inhibitor of matrix metalloproteinases
      expression by tubular epithelia and interstitial fibroblasts in the normal kidney
      and in fibrosis.

PMID- 7773644
TI  - Pathogenesis, experimental manipulation and treatment of liver fibrosis.

PMID- 7773645
TI  - Pathogenesis of lung fibrosis and potential new therapeutic strategies.

PMID- 7773646
TI  - Analytical expression for the magic-angle spinning nuclear magnetic resonance
      line shape in the presence of the second-order quadrupole interaction for the non
      zero asymmetry parameter and large sample rotation frequency.
AB  - An analytical expression for the magic-angle spinning nuclear magnetic resonance
      (MAS NMR) line shape function for the non-zero asymmetry parameter and large
      sample rotation frequency has been derived using the time-independent part of the
      quadrupole transition energy based on the stationary perturbation theory. The
      averaging over Euler angles in the case of a powdered sample is also done
      analytically, which is so far implemented in the literature by a numerical
      simulation procedure. While the peak positions obtained from analytical and
      numerical averaging procedures agree well, the peak heights are significantly
      different, showing the need for an analytical solution for the averaging over
      Euler angles, as this would otherwise lead to erroneous values for the quadrupole
      parameters. The MAS NMR line shape function derived in this paper can be compared
      directly with the experimental MAS NMR spectrum for the large sample rotation
      frequency, and the values of the quadrupole parameters can be obtained. We have
      also described a method of evaluating the quadrupole parameters for the small
      sample rotation frequency, using the peak heights and peak separation of the
      central band of the experimental MAS NMR spectrum and the MAS NMR line shape
      function derived in the present paper. As an example, the quadrupole parameters
      for vitreous B2O3 are computed.

PMID- 7773647
TI  - 13C solid-state nuclear magnetic resonance and Fourier transform infrared studies
      of the thermal decomposition of cork.
AB  - The thermal decomposition of cork has been studied by Fourier transform infrared
      (FTIR) spectroscopy and 13C solid-state nuclear magnetic resonance (NMR)
      spectroscopy with cross-polarization and magic-angle spinning (CP-MAS), high
      power 1H decoupling (HPDEC) and cross-polarization depolarization-polarization
      (CPDP). Waxes and other soluble components of cork begin to decompose at ca. 150
      degrees C. This is accompanied by partial decomposition of suberin, probably
      initiated at the points of attachment to the cell wall. The carbohydrates begin
      to decompose at ca. 200 degrees C. The decomposition of lignin begins at 250-300
      degrees C, while suberin undergoes further degradation. Significant amounts of
      coke are formed in the process. At 400 degrees C cork has been transformed into
      coke with traces of partially decomposed suberin. The thermal decomposition of
      cork is dependent on the calcination time, particularly in the 200-350 degrees C
      range.

PMID- 7773648
TI  - Anomalous proton relaxation, rotational tunnelling and barriers to methyl group
      rotation in solid acetyl halides.
AB  - Rotational excitations of methyl groups attached to carbonyl in solid acetic
      acid, acetyl fluoride, acetyl chloride and acetyl bromide have been investigated
      by 1H nuclear magnetic resonance (NMR) relaxation times and field-cycling
      measurements at two frequencies and various temperatures. The tunnel splittings
      have been found to occur between 3.3 and 0.08 mu eV making quantum effects
      important for the relaxation behaviour. For the acetyl halides, similar
      tunnelling and NMR frequencies lead to an anomalous-looking temperature
      dependence of the relaxation rates. A consistent description by Haupt's equation
      is possible. The rotational potentials have been derived from the data and
      compared with those obtained from microwave spectra of the corresponding isolated
      molecules. The hindering potential is purely three-fold and the barrier is
      dominated by the functional group.

PMID- 7773649
TI  - Determination of spin parameters reflected in the nuclear magnetic resonance
      powder patterns for two equivalent 31P nuclei in Lawesson's reagent.
AB  - The nuclear magnetic resonance (NMR) powder patterns observed for the 31P spin
      pair in Lawesson's reagent (1) were analyzed. Using an efficient procedure, wide
      ranges of the spin parameters were examined to determine whether they might
      reproduce the experimental one-dimensional (1D) spectrum of the present A2 spin
      system. It was demonstrated that the parameters were not uniquely determined from
      the 1D powder pattern only, but a significant reduction of their uncertainties
      was realized using the two-dimensional (2D) powder pattern. The molecular
      structure of 1 was discussed in terms of the refined spin parameters.

PMID- 7773650
TI  - Multifield magic-angle spinning and double-rotation nuclear magnetic resonance
      studies of a hydrated aluminophosphate molecular sieve: AlPO4-H2.
AB  - AlPO4-H2 is a microporous hydrated aluminophosphate, structurally related to VPI
      5, whose framework has highly elliptical 10-ring channels (2.9 x 7.6 A) parallel
      to the c crystallographic axis. To resolve a previously reported discrepancy
      between nuclear magnetic resonance (NMR) and X-ray diffraction (XRD) data a
      highly crystalline AlPO4-H2 has been further characterized with 27Al and 31P
      magic-angle spinning (MAS) NMR at 11.7 T and 27Al double-rotation (DOR) NMR at
      4.7 T. These present NMR data definitively show that the true space group
      symmetry of the AlPO4-H2 framework structure is triclinic rather than the higher
      orthorhombic symmetry proposed earlier from XRD studies.

PMID- 7773651
TI  - Solid-state 13C nuclear magnetic resonance spectra of 6-aminopenicillanic acid.

PMID- 7773652
TI  - Not just the bottom line.

PMID- 7773653
TI  - Osteonecrosis of the hip in sickle cell hemoglobinopathy.
AB  - Osteonecrosis secondary to sickle cell anemia and its genetic variants has many
      presentations depending on the age of onset and the extent of femoral head
      involvement. Total hip arthroplasty provides the greatest opportunity for
      clinical improvement of all treatment options, though early and late complication
      rates are high. Technical difficulties of total hip arthroplasty are related to
      marrow hyperplasia and the presence of sclerotic intramedullary bone. Surgical
      complications related to sickle cell hemoglobinopathy include vaso-occlusive
      crises, congestive heart failure, major transfusion reactions, intraoperative
      femoral fracture, femoral perforation, late aseptic loosening of acetabular and
      femoral components, and sepsis.

PMID- 7773654
TI  - The Peter Principle in orthopedics.
AB  - Original orthopedic devices that were developed, tested, and found useful, were
      subsequently modified and seemingly "improved" to a point of diminished
      usefulness--a manifestation of the Peter Principle applied to orthopedics. The
      authors describe seven examples: (1) the talar-tilt inversion apparatus; (2) the
      patellar-tendon-bearing, below-knee amputation prosthesis; (3) the patellar
      tendon-bearing orthosis; (4) the Veterans Administration Prosthetic Center's
      lumbosacral orthosis; (5) the partial-foot prosthesis; (6) the ankle-foot
      orthosis; and (7) the occipito-zygomatic cervical orthosis.

PMID- 7773655
TI  - Bone marrow/allograft component therapy. A clinical trial.
AB  - Bone graft is required in clinical orthopedic situations that involve a skeletal
      defect. Whether the defect is the result of trauma or surgery, autogenous iliac
      bone graft is the gold standard of therapy. The author used autogenous bone
      marrow/cancellous allograft as a bone graft substitute in 19 consecutive patients
      with a bony defect (synthetic bone substitutes were not available commercially
      when the series began). In this prospective study, both clinical and radiographic
      outcomes were followed. Of the patients, 100% were clinically healed at the site
      of grafting; 95% achieved radiographic union. No patients had surgical or
      postoperative complications. A bone marrow/allograft is a viable alternative to
      an iliac bone graft.

PMID- 7773656
TI  - Combined hip surgery in cerebral palsy patients.
AB  - Seventeen cases of dislocated/subluxated hips in 14 cerebral palsy patients that
      were relocated by the combined hip procedure were reviewed. The combined hip
      procedure includes varus derotation osteotomy, open reduction, innominate bone
      osteotomy, adductor releases, and iliopsoas recession, all done at one stage.
      Eleven patients were spastic quadriplegic, 1 was spastic diplegic; and 2 were
      spastic hemiplegic. Average age at operation was 10 years. Average follow-up was
      3 years. A total of 16 hips (94%) remained stable at follow-up with almost no
      change in center edge angle and the migration percentage, although the neck shaft
      angle remodeled over time. We conclude that the combined hip procedure is
      effective in maintaining hip reduction in cerebral palsy patients.

PMID- 7773657
TI  - Chondroblastoma of the patella presenting as knee pain in an adolescent.
AB  - We report a case of chondroblastoma of the patella, associated with an aneurysmal
      bone cyst and pathologic fracture, that presented as knee pain in a 13-year-old
      girl. This case is the fifth case in the literature that associates patellar
      chondroblastoma with fracture, which should probably be regarded as a significant
      feature of this lesion.

PMID- 7773658
TI  - Para-articular osteochondroma.
AB  - An unusual case of a para-articular osteochondroma in the vicinity of the knee is
      reported. Typical presentation and differential diagnosis of bone-forming lesions
      about the knee are discussed. Confirmed diagnosis should combine clinical
      presentation and appearance, laboratory data, radiographic evaluation, and
      possible biopsy of the lesion.

PMID- 7773659
TI  - Avascular necrosis of the medial femoral condyle in HIV-infected patients.
AB  - Avascular necrosis (AVN) of the femoral head has been described in the literature
      in patients infected with the human immunodeficiency virus. It has been
      associated with either a hypertriglyceridemic state or the presence of
      antiphospholipid antibodies. We describe a case of AVN of the medial femoral
      condyle in an HIV-infected patient associated with a hypertriglyceridemic state.

PMID- 7773660
TI  - Tee shirt management of nursemaid's elbow.
AB  - Subluxation of the radial head, or "nursemaid's elbow," is a common injury among
      children aged 1 to 4 years. The authors present a technique for flexed-elbow
      stabilization designed especially for very young children, which provides
      adequate immobilization without the use of a sling.

PMID- 7773661
TI  - A 9-year-old girl with swelling and pain in the leg.
AB  - The following case is presented to illustrate the roentgenographic and clinical
      findings of a condition of interest to the orthopedic surgeon. Initial history,
      physical findings, and roentgenographic examinations are presented on this page.
      The final clinical and roentgenographic differential diagnoses are presented on
      the following pages.

PMID- 7773662
TI  - Mediocrates: father of modern health care.

PMID- 7773663
TI  - Reflex sympathetic dystrophy.

PMID- 7773664
TI  - Comparing the efficacy of postoperative pain relief with the use of intra
      articular morphine versus Marcaine (bupivacaine) following arthroscopy of the
      knee.

PMID- 7773665
TI  - The versatility of the gastrocnemius muscle flap.
AB  - The gastrocnemius muscle rotation flap is a utilitarian procedure for management
      of soft-tissue defects about the knee. Ten patients underwent medial
      gastrocnemius muscle rotation flaps at our institution during a 24-month period.
      Four of the 10 patients underwent primary muscle rotation-plasty for
      reconstruction following tumor resection; 3 patients had soft-tissue defects
      following trauma; 2 patients had skin ischemia following total knee arthroplasty;
      and 1 patient had a soft-tissue defect from scar formation. All procedures were
      performed by an orthopaedic surgeon. At follow-up of 6 to 24 months, the soft
      tissue coverage was maintained in all patients. All of the muscle rotation flaps
      survived. The gastrocnemius rotation flap provides reliable anterior knee soft
      tissue coverage and can be performed by most orthopaedic surgeons.

PMID- 7773666
TI  - Scaphoid fractures and nonunions.
AB  - Fractures of the scaphoid are the most common of all fractures of the carpal
      bones. Scaphoid collapse and angular deformity may develop after fractures. The
      tenuous vascular anatomy of the scaphoid, the inherent biomechanical instability
      of scaphoid fractures, and the difficulty of radiographic diagnosis are the
      culprits of nonunion. The treatment of established scaphoid nonunion is
      difficult, and more so is the treatment of failed nonunion after grafting. One
      common method for treating scaphoid nonunion with angular deformity is length
      restoration using a wedge bone graft and Herbert screw fixation through a palmar
      approach. Attention to details of surgical technique are necessary for successful
      treatment outcome.

PMID- 7773667
TI  - Conservative options in the management of spinal disorders, Part II. Exercise,
      education, and manual therapies.
AB  - At this time, evidence supports exercise as an efficacious form of treatment for
      individuals suffering from back pain. The incorporation of education regarding
      posture, body mechanics, and ergonomics as part of a progressive exercise program
      appears justified. While there is empirical evidence available for the use of
      biofeedback, there are no specific studies supporting its efficacy in the
      treatment of the spine. Manual therapies such as mobilization and/or manipulation
      appear to shorten the course of subacute back pain, but do not alter the natural
      history and do not appear to be efficacious as monotherapy for chronic back pain.

PMID- 7773668
TI  - Analysis of the torque applied to bone screws by trauma surgeons. Comparisons
      based on years of experience and material of implant construction.
AB  - Stability of an internal fixation construct is dependent on the torque placed on
      the screws holding the plate, the number of screws in the construct, and the
      number of cortices purchased by each screw. This study addresses the ability of
      surgeons to apply uniform torque and the variability between stainless steel and
      titanium. A total of 630 measurements were made by trained orthopedists using a
      device to measure the torque applied to 3.5 mm screws when tightening them to a
      plate. Variations were found to be significant depending on the number of years
      the orthopedist was in practice and the type of construct material used. The
      average torque applied to a stainless steel construct is 5.82 in-lb, while the
      torque applied to titanium is 5.41 in-lb (P < 0.01). The longer an orthopedist is
      in practice, the more torque will be applied to the screw/plate construct.

PMID- 7773669
TI  - Assessment of eversion and plantar flexion strength after repair of Achilles
      tendon rupture using peroneus brevis tendon transfer.
AB  - Eight patients with Achilles tendon ruptures, one of which was a late discovery,
      underwent peroneus brevis tendon transfers to repair their injuries.
      Subsequently, both the repaired and normal extremities of all eight patients were
      tested for eversion and plantar flexion strength. The Cybex 340 isokinetic system
      (Lumex Corp, Bayshore, New York) was used at both 30 degrees per second and 120
      degrees per second. Patients' affected sides were then assessed subjectively for
      function compared with their opposite normal sides. Results for eversion strength
      showed a 17.4% deficit at 30 degrees per second and a 14.9% deficit at 120
      degrees per second on the repaired extremity. Only the group with the 14.9%
      deficit showed a statistically significant difference using the paired t test (P
      < 0.05). Results for plantar flexion strength showed a 1.5% difference at 30
      degrees per second and a 5.8% difference at 120 degrees per second. None of these
      differences were statistically significant. Subjective assessment showed no
      functional compromise in eversion strength, plantar flexion strength, activities
      of daily living, or ankle stability. Conclusions are that mild objective eversion
      weakness and no objective plantar flexion weakness can be expected after this
      procedure; however, subjective assessment reveals no functional compromise.

PMID- 7773670
TI  - A septic hip complicated by a ruptured appendix in an intravenous drug user.
AB  - This paper reports on a case of hip joint sepsis complicated by a ruptured
      appendix in an intravenous drug user. A 41-year-old woman underwent open
      irrigation and debridement of her right hip joint for a methicillin-sensitive
      Staphylococcus aureus infection. Five days later the patient developed an
      intraperitoneal mass, requiring laparotomy and debridement of a periappendiceal
      abscess. The organisms infecting the abscess were different from those infecting
      the patient's hip. The patient recovered satisfactorily after 6 weeks of
      intravenous antibiotic therapy.

PMID- 7773671
TI  - Beware of absent femoral pulse (or how to prevent major complications after minor
      procedures).
AB  - The following is presented to illustrate the importance of examining all
      peripheral pulses, especially the femoral pulse, before performing minor surgical
      procedures on the lower extremity, even limited toe amputation. This simple
      examination is a must in identifying patients at risk for severe peripheral
      arterial insufficiency, which can lead to major complications if underestimated
      or undiagnosed. We offer three examples to illustrate this point. All patients
      underwent successful revascularization and major lower limb amputation was
      avoided.

PMID- 7773672
TI  - A rare cause of low back pain.
AB  - An 18-year-old new army recruit had been treated by his medical officer for low
      back pain. The pain was not relieved by medication, and the soldier was referred
      to an orthopedic clinic. Muscle power, reflexes, and sensation were all normal
      for the lumbar and sacral nerves. Roentgenograms revealed a hemivertebra at the
      level of the first sacral segment. This is a very rare cause of backache in
      patients with intact and functioning lumbar and sacral nerves.

PMID- 7773673
TI  - A 55-year-old man with bilateral lower-limb numbness and weakness.
AB  - The following case is presented to illustrate the roentgenographic and clinical
      findings of a condition of interest to orthopedic surgeons. The initial history,
      physical findings, and roentgenographic examinations appear on this page. The
      clinical and roentgenographic diagnoses are presented on the following pages.

PMID- 7773674
TI  - Treatment of unstable intertrochanteric hip fractures associated with spinal
      fractures. A treatment dilemma.
AB  - Treatment approaches to a patient with polytrauma comprising combined spinal and
      hip fractures need more careful planning than those for a patient with an
      isolated spinal or hip fracture. The patient in this case presentation had
      multiple burst fractures of the spine, but was neurologically intact. The spinal
      injuries were treated conservatively. The patient also had concomitant unstable
      intertrochanteric fractures of the hip, which were treated surgically. The
      presence of a thoracic or lumbar fracture, in addition to a hip or femur
      fracture, may require an altered therapeutic approach. We present an approach to
      treating this complex problem without the use of a fracture table.

PMID- 7773675
TI  - Somatostatin in the prepacemaker nucleus of weakly electric fish, Apteronotus
      leptorhynchus: evidence for a nonsynaptic function.
AB  - Neuropeptides are widely distributed throughout the nervous system and exert a
      large number of heterogeneous functions. While they are synthesized in the soma,
      release is thought to take place in axonal terminals of neurons. A good model
      system to investigate the role of peptides in the nervous system is provided by
      the central posterior/prepacemaker nucleus (CP/PPn) of pacemaker nucleus (Pn), a
      medullary cell group controlling the electric organ discharge (EOD). Previous
      immunocytochemical and in situ-hybridization studies employing topographical
      criteria indicated that PPn neurons may express the neuropeptide somatostatin
      (SS). In the present study, we unambiguously identified PPn neurons by in vitro
      tract tracing. By combining this technique with SS immunocytochemistry, we found
      that a large portion of retrogradely labelled PPn neurons exhibited SS-like
      immunoreactivity (72-89%, n = 708 cells in 10 fish examined). Surprisingly,
      however, neither the proximal PPn axons nor anterogradely labelled terminals
      innervating the Pn displayed significant amounts of SS-like immunolabelling (n =
      10 fish examined in each experiment). These results and the lack of SS binding
      sites in the Pn [82] suggest that SS expressed by PPn cells is not synaptically
      released at the target site of their axons, the Pn, but acts via a nonsynaptic
      mechanism in the CP/PPn proper.

PMID- 7773676
TI  - Effects of in vitro ethanol and chronic ethanol consumption on the release of
      excitatory amino acids in the rat hippocampus.
AB  - In CA1-CA3 hippocampal slices, in vitro ethanol (EtOH) (10-100 mM) evoked, as a
      function of EtOH concentration, a differential release of aspartate (Asp) and
      glutamate (Glu). Omission of Ca2+ ions from the superfusion media completely
      abolished the EtOH-induced release of Asp but not that of Glu. In addition, at 20
      mM, EtOH enhanced K(+)-evoked release only of Asp. Finally, delayed changes were
      observed on NMDA-evoked release of [3H]noradrenaline (NA) in the dentate gyrus
      (DG) after withdrawal from EtOH for 30 days.

PMID- 7773677
TI  - Evidence that cholera toxin B subunit (CTb) can be avidly taken up and
      transported by fibers of passage.
AB  - It has been reported that cholera toxin B subunit (CTb) is a sensitive neuronal
      tracer with unique features. However, the possible uptake of CTb by non-terminal
      fibers passing through the injection site has not been examined thoroughly. In
      the present study, small iontophoretic injections (current = +2 microA) of CTb
      were made in the olivocerebellar pathway in the rat ventrolateral medulla. A
      large number of retrogradely labeled neurons were seen in the contralateral
      inferior olive. In addition, prominent anterogradely labeled climbing
      fibers/terminals were found in the cerebellum ipsilateral to the injection site.
      This study, in contrast to previous report(s), indicates that CTb can be taken up
      avidly by fibers of passage and transported both anterogradely and retrogradely.

PMID- 7773678
TI  - Regulation of proopiomelanocortin gene expression by neuropeptide Y in the rat
      arcuate nucleus.
AB  - In the arcuate nucleus which is richly innervated by both proopiomelanocortin
      (POMC) and neuropeptide Y (NPY) neurons, it has been shown that NPY fibers are in
      synaptic contact with POMC cell bodies. In order to determine whether NPY could
      influence POMC neuronal activity, we have studied the effects of NPY and some NPY
      analogs on POMC gene expression using quantitative in situ hybridization. The
      following peptides NPY, [Leu31,Pro34]-NPY (a Y1 receptor agonist), and NPY13-36
      (a Y2 receptor agonist) were injected into the left lateral cerebral ventricle of
      adult male rats 4 h before being perfused for histological procedures. The
      intracerebroventricular injection of NPY and NPY13-36 induced a significant
      decrease in the number of grains overlying the labelled neurons. On the other
      hand, the Y1 receptor agonist [Leu31,Pro34]-NPY did not modify POMC mRNA levels.
      These data then strongly suggest that NPY negatively regulates the genetic
      expression of POMC neurons via the Y2 NPY receptor subtype.

PMID- 7773679
TI  - Sulpiride increases and dopamine decreases intracranial temperature in rats when
      injected in the lateral hypothalamus: an animal model for the neuroleptic
      malignant syndrome?
AB  - Sulpiride in the perifornical lateral hypothalamus (pfLH) (4, 8 and 16
      micrograms/0.5 microliter) increased intracranial temperature (Tic). The
      hyperthermia started immediately after the injection, peaked 30 min later and
      lasted for more than 90 min. Sulpiride (12 micrograms) accelerated recovery from
      hypothermia in anesthetized animals. Forty-five min after sulpiride Tic raised
      1.17 +/- 0.06 degrees C. After a control injection the raise was only 0.5 +/-
      0.13 degrees C. Locally applied dopamine (DA) (5, 10 and 20 micrograms) 5 min
      before sulpiride (12 micrograms) attenuated sulpiride hyperthermia. The largest
      DA dose reduced Tic (-1.21 degrees C) when administered alone. These findings
      suggest the existence of D2 receptors in the LH involved in thermoregulation.
      Changes are that D2 receptors in the human LH could be responsible for the
      neuroleptic malignant syndrome (NMS), and that sulpiride injections in the rat LH
      could be used as a model for the study of the pathogenesis of this syndrome.

PMID- 7773680
TI  - Role of excitatory amino-acids in diethyldithiocarbamate-induced cell death in
      mesencephalic cultures.
AB  - The effects of diethyldithiocarbamate (DDC) and DDC plus glutamate on
      mesencephalic cell cultures were investigated. DDC 10 microM was toxic for cell
      cultures as assessed by observation under a phase-contrast microscope and the
      drop in [3H]dopamine uptake. Moreover, DDC 1 microM greatly potentiated cell
      death induced by glutamate 10 and 50 microM. (+)MK801, a selective non
      competitive antagonist of NMDA receptors, completely prevented the toxicity of
      the two neurotoxins.

PMID- 7773681
TI  - beta-Amyloid peptide decreases membrane fluidity.
AB  - The beta-amyloid peptide-25-35 (beta A25-35) decreases the fluidity of mouse
      brain membranes in a concentration-depending fashion. First effects were already
      seen at a beta A25-35 concentration of 100 nmol/1. beta-Amyloid peptide(1-40) was
      similarly active. beta A25-35 also decreases the fluidity of human lymphocyte
      membranes and of membranes from the cortex, hippocampus, striatum, and cerebellum
      of the rat, although the effects in the rat cerebellum are only weak. Scrambled
      beta A25-35 when investigated under similar conditions showed no effects on
      membrane fluidity. It is suggest that the effect on cellular calcium-signalling
      but also the neurotoxic properties of beta-amyloid might be the result of its
      concentration depending effects on membrane properties.

PMID- 7773682
TI  - Intracisternal injection of TRH antibody blocks gastric emptying stimulated by 2
      deoxy-D-glucose in rats.
AB  - We evaluated the effect of 2-deoxy-D-glucose (2-DG) on gastric emptying of a non
      nutrient solution in conscious rats using a Phenol red method. Intravenous
      injection of 2-deoxy-D-glucose dose-dependently increased the rate of gastric
      emptying. This stimulatory action of 2-DG was abolished by subdiaphragmatic
      vagotomy. Intracisternal injection of thyrotropin-releasing hormone (TRH)
      antibody blocked intracisternal TRH and intravenous 2-DG-induced enhancement of
      gastric emptying but not the stimulation of gastric emptying induced by
      intracisternal pancreatic polypeptide. The TRH antibody injected
      intraperitoneally had no effect. These results suggest that endogenous TRH in the
      brain is involved in vagal-dependent stimulation of gastric emptying by 2-DG.

PMID- 7773683
TI  - Spatial discrimination learning and choline acetyltransferase activity in
      streptozotocin-treated rats: effects of chronic treatment with acetyl-L
      carnitine.
AB  - Treatment of rats with i.c.v. injected streptozotocin (STREP) may provide a
      relevant model of neurodegeneration that is induced by a decrease in the central
      metabolism of glucose. Acetyl-L-carnitine (ALCAR) enhances the utilization of
      alternative energy sources and by such a mechanism of action ALCAR could
      antagonize the effects of STREP treatment. In this study the effects of chronic
      treatment with ALCAR were evaluated on spatial discrimination learning in the
      Morris task and choline acetyltransferase (ChAT) activity of middle-aged STREP
      treated rats. Chronic treatment with ALCAR attenuated both the STREP-induced
      impairment in spatial bias and the decrease in hippocampal ChAT activity. These
      findings indicate that ALCAR treatment has a neuroprotective effect, although
      further studies are needed to characterize the mechanism of action of ALCAR in
      this model.

PMID- 7773684
TI  - Tonotopic organization of responses reflecting stop consonant place of
      articulation in primary auditory cortex (A1) of the monkey.
AB  - Current source density and multiunit activity elicited by stop consonant-vowel
      syllables were examined in primary auditory cortex of an awake monkey. Relative
      amplitudes of the speech-evoked responses were determined by the onset spectra of
      the consonants and the tonotopic organization. This finding supports the
      psychoacoustic hypothesis that the onset spectra of stop consonants are important
      determinants for the discrimination of place of articulation.

PMID- 7773685
TI  - Immunocytochemical study with an anti-transferrin binding protein serum: a marker
      for avian oligodendrocytes.
AB  - We have investigated immunocytochemically the localization of a transferrin
      binding protein (TfBP) in adult CNS of avian and mammalian species using a
      polyclonal antibody raised against the protein purified from hen oviduct
      membranes (alpha OV-TfBP). TfBP has recently been shown to be HSP108. An overall
      strong immunoreactivity was revealed in most parts of the avian brains,
      especially in the white matter. The main immunoreactivity originated in small,
      intensely reacting cells interpreted as oligodendrocytes. The density of TfBP
      labeled oligodendrocytes of the avian brains was generally proportional to the
      degree of myelination. There were no marked differences in TfBP-immunostaining
      pattern between avian species (chick, pigeon and lovebird). On the other hand, in
      rat, rabbit and cat brains we could not find any TfBP-immunoreactivity.
      Immunoelectron microscopy has further revealed that TfBP is present in the light
      and medium types of oligodendrocytes which are known to have high metabolic
      activities. TfBP reaction product was homogeneously dispersed throughout the
      perinuclear cytoplasm and fine processes of oligodendrocytes. The
      intracytoplasmic organelles such as mitochondria and Golgi apparatus were devoid
      of reaction product. The presence of TfBP in oligodendrocytes implies that this
      protein may play an important role in transferrin-mediated iron metabolism in the
      CNS. The complete lack of cross-reactivity between alpha OV-TfBP and mammalian
      tissues suggests that there is species variability in TfBP structure. We conclude
      that this chick TfBP antiserum will prove useful in studies of oligodendrocytes
      and myelination in the avian CNS.

PMID- 7773686
TI  - Castration reduces vasopressin receptor binding in the hamster hypothalamus.
AB  - A recently developed ligand with very high affinity and selectivity for the
      vasopressin (AVP) V1a receptor subtype (i.e. [125I]Linear AVP antagonist ([125I]
      LinAntag) was used to describe the distribution of AVP binding sites in the
      hamster brain, and to determine whether AVP receptor binding was influenced by
      testicular hormones in sites involved in the regulation of steroid-dependent
      social behaviors. These studies demonstrated [125I]LinAntag binding in regions of
      the hamster brain which have not been previously identified with other AVP
      ligands. In addition, testicular hormones were found to alter [125I]LinAntag
      binding in two distinct regions, the posterior lateral preoptic-anterior lateral
      hypothalamic continuum and the posterior ventrolateral hypothalamic nucleus and
      adjacent tuberal area.

PMID- 7773687
TI  - High titer antibody to mammalian neuronal sodium channels produces sustained
      channel block.
AB  - Antibodies specific for neuronal sodium channels recognized the alpha and beta
      subunits of the voltage-gated sodium channel on immunoblots of crude rat and cat
      brain membranes and purified rat brain sodium channels. These antibodies did not
      recognize channels from rat cardiac or rabbit skeletal muscle. Antibody binding
      to blots of crude rat brain membranes was blocked by preabsorption of the
      antibody with purified rat brain sodium channels. Staining of the sodium channel
      alpha subunit on immunoblots of crude rat brain membranes was easily visualized
      at antibody dilutions of up to 1:150,000, which is at least 15-fold higher than
      that reported in previous studies. Addition of antibody produced in one chicken
      to the extracellular face of batrachotoxin-activated rat brain sodium channels in
      planar lipid bilayers produced a sustained block of the channel at either
      hyperpolarized (-65 to -45 mV) or depolarized potentials (+45 to +75 mV). This
      block was not produced when the antibody was added to the cytoplasmic face of the
      channel, or if preimmune antibody was added to the extracellular face of rat
      brain sodium channels.

PMID- 7773688
TI  - Dynamics of 5-hydroxytryptamine released from dopamine neurons in the caudate
      putamen of the rat.
AB  - Fast-scan cyclic voltammetry has been used for the detection of 5
      hydroxytryptamine (5-HT) in vivo. The applied potential waveform was previously
      optimized to maximize response times to concentration changes. This technique has
      been used to reinvestigate 5-HT release from striatal dopaminergic terminals
      after pharmacological pretreatment as reported by Stamford et al. [13]. Our
      results concur with those set forth by Stamford and further show that the
      dopamine transporter is responsible for 5-HT uptake in this experiment.

PMID- 7773689
TI  - Right vs. left sensorimotor cortex suction-ablation in the rat: no difference in
      beam-walking recovery.
AB  - The ability of rats to traverse a narrow elevated beam has been used to
      quantitate recovery of hindlimb motor function after unilateral injury to the
      sensorimotor cortex. We tested the hypothesis that the rate of spontaneous beam
      walking recovery varies with the side of the cortex lesion. Groups of rats that
      were trained at the beam-walking task underwent suction-ablation of either the
      right or left hindlimb sensorimotor cortex. There was no difference in hindlimb
      motor function between the groups on the first post-operative beam-waking trial
      carried out the day after cortex ablation and no difference between the groups in
      overall recovery rates over the next two weeks. Subsequent analyses of lesion
      surface parameters showed no differences in lesion size or extent. Regardless of
      the side of the lesion, there were also no differences between the right and left
      hemispheres in norepinephrine content of the lesioned or contralateral cortex. We
      conclude that the side of sensorimotor cortex ablation injury does not
      differentially affect the rate of spontaneous motor recovery as measured with the
      beam-walking task.

PMID- 7773690
TI  - Passage of peptides through the blood-brain barrier with colloidal polymer
      particles (nanoparticles).
AB  - Transport of the hexapeptide dalargin across the blood-brain barrier was
      accomplished using a nanoparticle formulation. The formulation consisted of
      dalargin bound to poly(butyl cyanoacrylate) nanoparticles by sorption, coated
      with polysorbate 80. Intravenous injection of this formulation to mice resulted
      in an analgesic effect. All controls, including a simple mixture of the three
      components (drugs, nanoparticles, and surfactant) mixed directly before i.v.
      injection, exhibited no effect. Analgesia was also prevented by pretreatment with
      naloxone. Fluorescent and electron microscopic studies indicated that the passage
      of the particle-bound drug occurred by phagocytic uptake of the polysorbate 80
      coated nanoparticles by the brain blood vessel endothelial cells.

PMID- 7773691
TI  - Localization of an isoform of carboxylesterase in rat brain differs from that in
      human brain.
AB  - Liver carboxylesterase (CE) is an enzyme capable of metabolizing drugs, and may
      also function as a regulator of lipid metabolism. We examined two isoforms of CE
      (RH1 and RL1) by immunohistochemistry in rat brain. The anti-RL1 antibody did not
      stain any brain structures. The anti-RH1 antibody, however, stained
      oligodendrocytes in all brain tissues and tanycytes, as well as some neurons in
      the deep cingulate gyrus, various hypothalamic nuclei and the spinal trigeminal
      nucleus. In the central nervous system, rat CE may function as a protective
      factor against foreign chemicals in these glial and neuronal cells. The
      distribution differed from that of the homologous human isoform which has been
      previously found only in endothelial cells in human brain. A possible relation
      between RH1 positive neurons and the medial pain system is discussed.

PMID- 7773692
TI  - A thermodynamic analysis of estrogen regulation of alpha 2-adrenoceptor binding.
AB  - We previously demonstrated that in vivo estradiol treatment markedly attenuates
      alpha 2-adrenoceptor function and coupling to G-proteins in the hypothalamus of
      female rats. Ligand binding studies indicated that 48 h exposure to estradiol
      decreases the number of alpha 2-adrenergic receptors in the agonist high affinity
      state. In the present studies, when [3H]RX821002 was used to label brain alpha 2
      adrenoceptors, the density of binding sites significantly increased in the
      hypothalamus and preoptic area 48 h after estrogen treatment. Moreover, the
      thermodynamics of ligand binding to alpha 2-adrenergic receptors in membranes of
      female rat hypothalamus were modified by the same estradiol treatments that
      reduce alpha 2-adrenoceptor function. In hypothalamic membranes from
      ovariectomized control rats, antagonist (RX821002)-receptor binding was primarily
      entropy-driven while agonist (oxymetazoline) binding had a higher enthalpy
      component. In membranes from estradiol-exposed animals, the entropic contribution
      to both agonist and antagonist bindings was markedly increased, and the enthalpy
      component was reduced. Since the thermodynamic characteristics of ligand-receptor
      binding are strongly correlated with efficacy in activating signal transduction
      [36], these data raise the intriguing possibility that steroids regulate
      transmembrane signaling by stabilization of a receptor conformation with reduced
      intrinsic efficacy.

PMID- 7773693
TI  - Multisensory convergence and integration in the neostriatum and globus pallidus
      of the rat.
AB  - The extracellular response properties of neurons in the caudate-putamen (CPu),
      globus pallidus (GP) and lateral amygdaloid nucleus (La) evoked by auditory and
      somatosensory stimuli were investigated. A total of 61 neurons in these areas
      responded either singly to somatosensory stimulation (unisensory), or to both
      somatosensory and auditory stimulation (multisensory). Higher rates of
      somatosensory stimulation reduced the response magnitude of CPu neurons more than
      that of GP neurons. In multisensory neurons, combined somatosensory and auditory
      stimulation compared to unisensory stimulation resulted in three characteristic
      response patterns: enhancement, depression or interaction. Temporal misalignment
      of the peak frequency latencies evoked by auditory and somatosensory stimulation
      altered the response magnitude in the majority of neurons. The response
      properties and anatomical connectivity of CPu and GP neurons suggest that the
      observed multisensory integrative effects may be used to facilitate motor
      responses to low intensity stimuli.

PMID- 7773694
TI  - Plasma hypernatremia induces c-fos activity in medullary catecholaminergic
      neurons.
AB  - Experiments were done in conscious rats to investigate the effect of intravenous
      infusion of hypertonic saline on the induction of the phosphoprotein Fos in
      brainstem catecholaminergic neurons. Fos induction, detected
      immunohistochemically, was used as a marker for neuronal activation. Infusions of
      165 mM or 1.4 M NaCl solutions into the jugular vein resulted in Fos-like
      immunoreactivity in approximately the caudal two thirds of nucleus of the
      solitary tract (NTS), the caudal and rostral ventrolateral medulla (VLM), and in
      the lateral aspects of the parabrachial nucleus (PBN). Within caudal NTS a small
      number (7.9 +/- 1.8%) of Fos labelled neurons were found also to contain tyrosine
      hydroxylase (TH) or dopamine beta-hydroxylase (DBH) immunoreactivity. In rostral
      NTS no Fos labelled cells were found to contain phenylethanolamine N
      methyltransferase (PNMT) immunoreactivity, although a few (8.5 +/- 2.3%) were
      immunoreactive to TH. Similarly, in VLM, most of the Fos labelled cells in caudal
      VLM (65.9 +/- 2.7%) contained either TH or DBH immunoreactivity, whereas in the
      rostral VLM, 32.2 +/- 4.6% of the Fos labelled cells were also immunoreactive to
      TH or DBH. However, no Fos cells were found in either the caudal or rostral VLM
      that were immunoreactive to PNMT. Little or no Fos-like immunoreactive neurons
      were detected in the brainstem after intravenous infusions of physiological (143
      mM) or hypotonic (106 mM) NaCl solutions. These data suggest that noradrenergic
      neurons of the caudal NTS and VLM are components of central circuits that are
      involved in osmoregulation and cardiovascular function.

PMID- 7773695
TI  - Long-term effect of HU-211, a novel non-competitive NMDA antagonist, on motor and
      memory functions after closed head injury in the rat.
AB  - HU-211 is a synthetic, non-psychotropic cannabinoid which acts as a non
      competitive NMDA antagonist and antioxidant. We studied the drug's therapeutic
      window as well as its long-term effect on cognitive and motor functions in a
      model of closed head injury (CHI) in the rat. A weight-drop device was used to
      induce CHI in either anesthetized male rats. HU-211 (5 mg/kg) was administered
      i.v. to the experimental groups. For the therapeutic window study, drug was
      injected at 4 or 6 h after CHI. Edema (water content) and clinical status
      (neurological severity score, NSS) were evaluated at 24 h. Reduction of edema was
      slight, whereas improvement of NSS was significant when the drug was administered
      at 4 or 6 h (P = 0.0023 and 0.059, respectively). To determine the drug's long
      term effect, it was administered 1 h after CHI and additional doses were later
      given. NSS was evaluated for a period of 30 d. A single dose of HU-211 given 1 h
      post-CHI improved the clinical outcome during the 30 d period (P < 0.01).
      Repetitive doses of HU-211 injected during the post traumatic period had similar
      effects. Cognitive functions were evaluated in the Morris water maze, with rats
      trained either before or after CHI. CHI resulted in a highly significant
      impairment of these abilities, whereas HU-211 treatment 1 h after CHI improved
      performance. Our results indicate that HU-211 is a potent cerebroprotective
      agent, with a therapeutic window of about 4 h.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773696
TI  - Chronic administration of (+)-amphetamine alters the reactivity of midbrain
      dopaminergic neurons to prefrontal cortex stimulation in the rat.
AB  - Repeated intermittent administration of (+)-amphetamine produces sensitisation to
      many of the behavioural effects of the drug. Evidence suggests that excitatory
      amino acidergic projections from the prefrontal cortex (PFC) to dopaminergic (DA)
      neurons in the ventral midbrain may be partly involved in the maintenance of
      sensitisation once induced. The present study was designed to investigate whether
      chronic amphetamine administration produces any alteration to this input, by
      assessing the impact of single pulse electrical stimulation of the PFC (0.25 and
      0.5 mA) on the extracellular activity of individual midbrain DA neurons in drug
      and vehicle treated rats. Animals were administered amphetamine according to a
      schedule known to produce sensitisation (2.5 mg/kg free base, once daily for 6
      days; s.c.), and the effect of PFC stimulation was assessed on withdrawal days 2
      and 10. In addition to single spike firing patterns, the ability of the
      stimulation to elicit stimulus bound (time-locked) burst events was also noted.
      In the majority of cases, the elicited responses could be broadly categorised
      into two types--ones characterised by an initial excitation (E responses) and
      ones characterised by excitation following an initial inhibition (IE responses).
      On withdrawal day 2, IE responses were affected such that, in those responses
      which contained time-locked bursts in their excitatory phases, the stimulus
      produced a time-locked burst on a greater percentage of trials. On withdrawal day
      10, the principal change was that E responses were more likely to occur in
      amphetamine-treated animals than controls (0.25 mA; 57.1% vs. 41.2% of responses,
      respectively; 0.5 mA; 36.7% vs. 23.5% of responses, respectively). It is argued
      that an increase in the proportion of excitatory responses in drug animals
      indicates a potentiation of the excitatory drive to the DA neurons. Insofar as
      sensitisation in the longer term relies upon an enhancement of amphetamine
      induced dopamine release in the forebrain, this may be one mechanism by which it
      is achieved.

PMID- 7773697
TI  - Delayed neuronal injury induced by sub-lethal NMDA exposure in the hippocampal
      slice.
AB  - Stroke produces neuronal death by two general processes which differ in their
      temporal course. Acute neuronal death occurs within minutes, while delayed
      neuronal death evolves within 24 h. To better examine mechanisms of delayed
      death, we developed a new in vitro model of delayed neuronal injury using
      extended electrophysiological recordings in paired hippocampal slices. We exposed
      one hippocampal slice of each pair to 10 microM N-methyl-D-aspartate (NMDA) until
      the orthodromic CA1 PS disappeared. Thereafter, NMDA-treated slices regained near
      full recovery of PS amplitude within one hour. However, 10 h later, NMDA-treated
      slices demonstrated a rapid decline in PS amplitude of 82% +/- 15. CA1
      orthodromic evoked PS was lost completely at an average 12.4 +/- 1.6 h after NMDA
      exposure. This sudden loss of response contrasted with paired, untreated slices,
      where CA1 PS could be elicited for 22.6 +/- 4.0 h (P < 0.05). Treatment with 10
      mM MgCl2 begun after NMDA exposure and continued for 35 min, prevented delayed
      loss of CA1 orthodromic PS, which then could be elicited for 20.3 +/- 2.1 h.
      These results indicate that delayed injury can be evaluated using the hippocampal
      slice. They also suggest that activation of NMDA receptors can induce delayed
      neuronal injury in CA1 neurons, and that magnesium treatment after NMDA can
      prevent this injury.

PMID- 7773698
TI  - Glutamate receptor subtype expression in human postmortem brain tissue from
      schizophrenics and alcohol abusers.
AB  - Antibodies to functional AMPA/kainate (GluR1, GluR2, GluR3), and kainate binding
      sites (GluR5-7) were used as probes to characterize and quantitate glutamatergic
      receptor subtypes in human post-mortem brain tissue from schizophrenic subjects
      and non-psychotic control subjects, which included normal controls and subjects
      with a previous history of alcohol abuse. Crude membrane fractions from human
      hippocampi and cingulate cortices were fractionated by SDS-PAGE,
      electrotransferred to nitrocellulose, and probed for the various glutamate
      receptor subtypes. Western blots were developed with chemiluminescence and the
      images analyzed by densitometry. Significant reductions were observed in the
      hippocampal immunoreactivity of both GluR2 and GluR3 AMPA/kainate receptor
      subtypes in schizophrenic subjects compared to the entire group of non-psychotic
      control subjects. No significant changes were observed in schizophrenic
      hippocampal GluR1 and GluR5 receptor subtypes or in levels of the structural
      control proteins, NCAM and tau. Significant increases were observed for GluR2 and
      GluR3 in the hippocampi of subjects with alcohol abuse histories when compared to
      the non-psychotic normal control group. When subjects with alcohol abuse
      histories were removed from the non-psychotic control pool, schizophrenics were
      no longer statistically different from the remaining normal controls. An analysis
      of GluR2 and GluR3 immunoreactivity in the cingulate cortex revealed no changes
      in these receptor subtypes among any of the groups. No alterations were observed
      in the immunoreactivity of these various proteins due to confounding factors such
      as age, sex, postmortem interval, or smoking history, except in the cingulate
      cortex were GluR3 receptor subtype levels were significantly reduced in the
      brains of smokers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773699
TI  - Increased NMDA-induced excitability during ethanol withdrawal: a behavioural and
      histological study.
AB  - Intrahippocampal injections of N-methyl-D-aspartic acid (NMDA) leads to
      neurodegeneration in a dose-dependent manner. Chronic administration of ethanol
      to animals leads to CNS tolerance and dependence. Hyperexcitability following
      ethanol withdrawal is thought to be related to increased sensitivity of the NMDA
      receptors. The purpose of this study was to investigate this predisposition to
      hyperexcitability by intrahippocampal injection of low dose of NMDA. Using
      control and ethanol-withdrawn male Wistar rats, behavioural indices were
      determined immediately after injection and morphological damage was assessed
      after a period of recovery. There was significantly increased hyperactivity in
      the ethanol-treated rats immediately after injection. Morphological damage
      resulting from 5 nmol of NMDA was significantly greater in the CA3 region of the
      hippocampus in these animals. These data support the hypothesis that ethanol
      dependence and subsequent withdrawal is associated with increased sensitivity to
      NMDA which may underlie ethanol withdrawal-associated brain damage.

PMID- 7773700
TI  - Staff perception of their roles during the transition of psychiatric care into
      the community.
AB  - The objective of this study was to investigate the staff's experiences involved
      in the processes of the transition of 20 non-demented long-stay psychiatric
      patients. Staff members expressed satisfaction from working outside the hospital.
      They believed that the patients' condition and their quality of life had improved
      and that they were likely to achieve successful resettlement after a lengthy
      process of rehabilitation. However, staff members considered that their roles
      were demanding and involved a lot of domestic activities. They recommended
      gradual and slow preparation for the patients, and an educational programme for
      the public as well as appropriate preparation and continuing professional support
      for staff.

PMID- 7773701
TI  - Formulation and testing of a nursing assessment form for mental patients as a
      basis for individualized nursing care.
AB  - The study described here was designed to develop and test a form of nursing
      assessment of mental patients for use as a basis for individualized holistic
      nursing care in any setting. Nursing assessment was made of 581 mental patients
      receiving care in either mental hospitals, psychiatric departments of general
      hospitals or in mental health centres. Subjects were observed, interviewed and
      asked to complete a structured assessment form. Major variables studied were
      physical nursing problems/needs with nine categories, psychosocial nursing
      problems/needs with nine categories, sex, age, and physical and psychiatric
      disorders. Data were analysed with frequency distribution and comparative
      techniques, correlational procedures, and the multiple linear regression
      statistical procedure. The frequency distribution of psychiatric diagnoses showed
      that schizophrenic disorders were the most frequent in the total sample. However,
      there were more depressive patients in the general hospital group. Physical
      nursing problems/needs were significantly related with psychosocial nursing
      problems/needs, affective-depressive disorders, sex and age as well as negatively
      related with psychotic and anxiety disorders. Psychosocial nursing problems/needs
      were significantly related with schizophrenic and psychotic disorders, physical
      disorders and with the younger age groups. It was concluded that the psychiatric
      nursing assessment should encompass the areas of personal characteristics, and
      physical and psychological problems of the patient, and thus lead to practicing
      psychiatric nursing, that is, holistic psychosomatic nursing.

PMID- 7773702
TI  - Evaluation of a transitional residential programme for homeless chronically
      mentally ill people.
AB  - This paper reports a successful transitional programme in the USA. The research
      programme evaluation covered 5.5 years and 228 severely and persistently mentally
      ill homeless clients who lived in a transitional residential centre. Forty-eight
      per cent of the residents achieved the Programme's goals of obtaining and
      maintaining permanent housing and a disability pension or a job. Achievement of
      client goals was positively related to length of stay of 3 months or more, to
      five or more previous psychiatric hospitalizations, and to participation in two
      or more ongoing activities whilst in the programme. Psychiatric diagnosis was not
      directly related to goal attainment in this programme.

PMID- 7773703
TI  - A stitch in time. Facilitating proactive interventions with dementia caregivers:
      the role of community practitioners.
AB  - The role of family caregivers in supporting people with dementia in the community
      is beyond question. Yet, all too often, the needs of such carers are overlooked
      by community practitioners. This paper describes the results of a study in Wales
      examining the experiences of dementia caregivers with Community Practitioners.
      Four themes are identified which encapsulate the various difficulties carers
      faced. These revolve around a lack of communication, information and support.
      Recommentations to improve the current situation are made.

PMID- 7773704
TI  - Mental health nursing: a global perspective.
AB  - This paper is based on a presentation by Dr Oguisso to the First Hamburg World
      Forum on Mental Health, 11 June 1994, for the Standing Committee of Presidents of
      International Non-Governmental Organizations Concerned with Mental Health Issues.
      Over recent years, the International Council of Nurses (ICN) has been concerned
      that health providers are sometimes not adequately prepared to give quality care
      and that resources are often well below those targeted for other sectors of the
      health care system. In 1991 the ICN chose 'Mental Health--Nurses in Action' as
      the theme for International Nurses Day on 12 May. With the help of the ICN
      provided educational kits, national nurses' associations updated nurses on the
      problems and informed the public that nurses as a group can provide many of the
      mental health services to people and answer their families needs.

PMID- 7773705
TI  - A study of the relationship between student nurses' and role models' empathy
      levels.

PMID- 7773706
TI  - Controlled comparison of three interventions with parents of children with
      learning disabilities exhibiting challenging behaviours.

PMID- 7773707
TI  - Development of a drop-in service in a small community team: continuing care to
      clients with long-term mental health problems.

PMID- 7773708
TI  - Survivor blaming.

PMID- 7773710
TI  - The Isle of Wight: emergency care during Cowes Week.

PMID- 7773709
TI  - Stress and the community mental health nurse: the development of a measure.
AB  - The issue of stress amongst health care professionals is currently a major
      concern within the British National Health Service. It is important for
      researchers to develop both reliable and valid psychometric measures to assess
      occupational stress. This paper outlines the development and piloting of a
      measure of professional stress for community mental health nurses, the CPN Stress
      Questionnaire (Revised). Data on the reliability and validity of this new measure
      are presented. It is concluded that this measure has good psychometric
      properties. A range of possible research applications is outlined.

PMID- 7773711
TI  - The health repercussions of government transport policies.

PMID- 7773712
TI  - The scope of professional practice and the accident and emergency nurse.

PMID- 7773713
TI  - Specialist units.

PMID- 7773714
TI  - Should relatives be present in the resuscitation room?
AB  - Many Accident & Emergency (A & E) nurses will be familiar with the situation of
      resuscitating an individual who may be, for example, a husband, father or son.
      When the severity of illness gives rise to question the probability of continuing
      life, what about the relatives - those people who hold most importance to that
      individual? The relatives are sometimes unaware of the sudden illness and can be
      left isolated in the realisation that their loved one has died, and they were not
      there. How often are relatives there when an individual dies suddenly in the A &
      E department? These emotive factors led to this discussion and study of the
      attitudes of hospital and ambulance staff towards permitting relatives to be
      present during a resuscitation.

PMID- 7773715
TI  - Use of video recorders in auditing initial assessment times.
AB  - The Patient's Charter (Department of Health 1992) states that patients attending
      Accident and Emergency departments will 'be seen immediately' and have 'their
      need for treatment assessed'. This paper describes a research project aimed at
      gathering accurate and reliable information regarding initial assessment times in
      a busy Emergency department. The use of closed circuit cameras and video
      recordings will be described. Ethical considerations will be highlighted along
      with the results of the study.

PMID- 7773716
TI  - Minor Injuries Unit: expanding the scope of accident and emergency provision.
AB  - The Minor Injuries Unit at St Charles Hospital, London, opened in early 1993. Its
      establishment is placed in the context of radical changes occurring in Accident
      and Emergency provision within the UK. The unit's success has exceeded initial
      expectations and mirrors the potential for such units detailed in recent studies.
      The use of treatment and prescription protocols are discussed. The effective
      utilisation of existing and potential nursing skills is demonstrated.

PMID- 7773717
TI  - Miscarriage counselling--an accident and emergency perspective.
AB  - Many women attend the Accident and Emergency department with vaginal bleeding as
      the first signs of a possible miscarriage. This study was undertaken to identify
      the views of Accident and Emergency nurses with regard to counselling these women
      in the Accident and Emergency department, and who should be undertaking the
      counselling. 50 questionnaires were distributed to 10 Accident and Emergency
      departments within the Yorkshire region, to qualified nurses of various grades
      and experience. 50% of the respondents said that counselling should be undertaken
      during the couple's stay in the department. This paper discusses where and when
      counselling should be undertaken, by whom and also focuses on the feelings,
      thoughts and needs of the couple.

PMID- 7773718
TI  - Violence in the accident and emergency department.
AB  - A survey of Accident and Emergency nurses was undertaken to study the prevalence,
      types and possible precipitating factors of violence in the workplace. Violence
      was sub-divided into physical and verbal. Verbal violence was more common than
      physical assault but often not reported. Often physical violence is under
      reported but in fact had affected one third of respondents. Associations with
      different types of violence are discussed. The need for further training in
      defusing violent situations and analysis of violent incidents is identified. Some
      suggestions for inclusion in a training programme are given.

PMID- 7773719
TI  - Children's experiences of pain in an accident and emergency department.
AB  - Controlling pain in sick or injured children continues to be a challenge,
      particularly for those working in Accident and Emergency departments. Empathising
      with the subjectivity of a child's experience, provides insight into the range of
      significant events that frequently exacerbate the quality and intensity of
      physical pain; the latter being compounded by the 'emotion' pain of fear,
      misunderstanding, separation or distress. This article stresses the importance of
      an holistic approach for effective pain management. The developmental aspects of
      the perceptual, interpretative and expressive components of pain will be explored
      and a range of pain assessment tools considered.

PMID- 7773720
TI  - HIV in the accident and emergency department.
AB  - This article is intended as an introduction to some of the issues which arise
      from the increasing incidence in the UK of human immunodeficiency virus (HIV) and
      acquired immune deficiency syndrome (AIDS). It is not possible fully to address,
      nor offer answers to, all of these issues. HIV and AIDS present many challenges
      to nurses. It tests not only our skills and methods of practice, but confronts
      our feelings about people whose lifestyles and behaviours may be different from
      our own (Lert & Marne 1992; McGrath et al 1993); it has also prompted us to alter
      our awareness and knowledge of medical, nursing and infection control issues.
      Hopefully this article will serve to stimulate reflection, thought and discussion
      as well as generating further, more specific papers of relevance to the Accident
      and Emergency nurse.

PMID- 7773721
TI  - Children in accident and emergency: parental perceptions of the quality of care.
      Part 2.

PMID- 7773722
TI  - Research based training for the nurse practitioner.
AB  - Exploration for oil and gas began in the North Sea in the mid 1960s. Since that
      time offshore medics have had the authority to diagnose and treat patients within
      a set of guidelines. As such they are one of the earliest groups of British nurse
      practitioners. Training for offshore medics in the UK sector of the North Sea is
      regulated by the Health and Safety Commission. In order to promote training based
      on research, a study was conducted to examine the pattern of referrals to the
      Accident and Emergency department of Aberdeen Royal Infirmary from offshore. This
      was done for a 9 year period. The purpose was to establish a reliable database of
      the most frequently occurring injury types and affected body parts, and to use
      this information to modify existing training courses for offshore medics. The
      total number of injury referrals during the study was 6270. The most common
      injury type was fracture/suspected fracture (mean = 50% +/- 3.2%) and the most
      common body part affected was the hand (mean = 37% +/- 3.7%). This paper
      indicates the changes which were made to an offshore medic training programme as
      a result of the research. It is suggested that unless such research is undertaken
      it is not possible to claim that the training of nurse practitioners, in this
      case offshore medics, is research based and therefore relevant to the needs of
      the community being served.

PMID- 7773723
TI  - Conflicts of practice confronting second line nurse managers in an accident and
      emergency department. Part I.
AB  - In recent times in Australia, there has been a proliferation of nursing career
      structures which aim to address the historical neglect of a career path for
      clinical nurses. Among these developments has been the formulation of a new and
      exciting nursing role, that of the second line nurse manager. This role was
      designed to give experienced nurses who traditionally worked 'in charge' formal
      recognition of their knowledge and skill, and sought to construct a role that
      encompassed both clinical and managerial responsibilities. However, the reality
      of these nurses' practice is fraught with problems and difficulties as they
      attempt to negotiate a new and uncharted domain. This paper recounts an action
      research study conducted by a group of second line nurse managers in an Accident
      and Emergency department, who sought to explore the dimensions of their practice.
      The study identifies problems with combining clinical and managerial
      responsibilities in the one role, within a context marked by a high level of
      unpredictability, and a culture which values clinical practice over other forms
      of nursing practice. The paper concludes with a number of recommendations to
      overcome these problems.

PMID- 7773724
TI  - Myocardial infarction and cardiovascular risk factors in Mexico City and San
      Antonio, Texas.
AB  - Because the epidemiology of cardiovascular disease in Mexico is largely unknown,
      we examined the prevalence of cardiovascular risk factors and myocardial
      infarction (MI) in adults from low-income colonias in Mexico City. Data were
      collected as part of the Mexico City Diabetes Study, a population-based survey of
      diabetes and cardiovascular disease conducted between 1987 and 1992. Results were
      compared with those obtained from a comparable survey conducted previously among
      low-income Mexican Americans in San Antonio, Tex. A total of 2271 individuals
      between the ages of 35 and 64 years from Mexico City and 1143 adults of the same
      age range from San Antonio were studied. Despite being leaner and having lower
      levels of total cholesterol, Mexicans in Mexico City had markedly higher levels
      of triglycerides (P < .001) and lower levels of HDL cholesterol (P < .001) than
      Mexican Americans in San Antonio. MI was assessed by Minnesota-coded
      electrocardiograms and by a self-reported history of physician-diagnosed heart
      attack. In men, the prevalence of self-reported heart attack was significantly
      higher in San Antonio than in Mexico City (odds ratio, 5.85; P < .001), and in
      women, the prevalence of electrocardiogram-documented MI was significantly higher
      in San Antonio than Mexico City (odds ratio, 2.51; P < .001). The apparent excess
      of MI in San Antonio relative to Mexico City could be due to higher case-fatality
      in Mexico City or to a higher incidence in San Antonio.

PMID- 7773725
TI  - Association between beta-carotene and acute myocardial infarction depends on
      polyunsaturated fatty acid status. The EURAMIC Study. European Study on
      Antioxidants, Myocardial Infarction, and Cancer of the Breast.
AB  - Because antioxidants may play a role in the prevention of coronary heart disease
      by inhibiting the peroxidation of polyunsaturated fatty acids (PUFAs), the
      combined association of diet-derived antioxidants and PUFAs with acute myocardial
      infarction (MI) was investigated. This multicenter case-control study included
      674 patients and 725 control subjects in eight European countries and Israel.
      Fatty acid composition and alpha-tocopherol and beta-carotene levels were
      determined in adipose tissue; selenium level was determined in toenails. For
      alpha-tocopherol no association with MI was observed at any PUFA level. The
      overall multivariate odds ratio (OR) for low (10th percentile) versus high (90th
      percentile) beta-carotene was 1.98 (95% confidence interval [CI], 1.39 to 2.82).
      The strength of this inverse association with MI was dependent on PUFA levels (in
      tertiles): for low PUFA, the OR for low versus high beta-carotene was 1.79 (95%
      CI, 0.98 to 3.25), for medium PUFA the OR was 1.76 (95% CI, 1.00 to 3.11), and
      for high PUFA 3.47 (95% CI, 1.93 to 6.24). For selenium increased risk was
      observed only at the lowest PUFA tertile (OR, 2.49; 95% CI, 1.22 to 5.09). This
      interaction between selenium and PUFAs was not significant and may at least
      partly be explained by a higher proportion of smokers at the low PUFA level.
      These findings support the hypothesis that beta-carotene plays a role in the
      protection of PUFAs against oxidation and subsequently in the protection against
      MI. No evidence was found that alpha-tocopherol or selenium may protect against
      MI at any level of PUFA intake.

PMID- 7773726
TI  - Oxidation-related analytes and lipid and lipoprotein concentrations in healthy
      subjects.
AB  - The relations between oxidation-related analytes and lipoprotein risk factors for
      coronary heart disease are poorly understood. To address this issue,
      ceruloplasmin, copper, iron, ferritin, cotinine, lipid peroxides, cholesterol,
      triglyceride, apoB, apoA-I, and lipoprotein(a) levels were measured in sera from
      apparently healthy subjects (51 men and 115 women). Pairwise comparisons revealed
      strong positive associations (P < .001) of copper and ceruloplasmin with lipid
      peroxides, total cholesterol, triglycerides and apoB, of transferrin with apoA-I
      and cholesterol, and of ferritin with triglycerides. Serum levels of oxidation
      related analytes did not differ between smokers and nonsmokers. In multivariate
      analysis, serum copper was the major independent determinant of serum lipid
      peroxide level, accounting for 15% of the variability in concentration (ferritin
      accounted for 1.6%). Copper and ceruloplasmin accounted for 20.5% of the
      variation in triglyceride levels; triglycerides and apoB accounted for 12% of the
      variability in ferritin levels; apoB and apoA-I accounted for 9% of the
      variability in transferrin levels. The data suggest that serum copper contributes
      to lipid peroxidation in vivo. There are significant associations between
      lipoprotein and transition metal-related analytes, and further work is needed to
      elucidate the physiological basis for these relations.

PMID- 7773727
TI  - Inhibition of the oxidative modification of LDL by nitecapone.
AB  - We studied in vitro the ability of nitecapone, 3-[(3,4-dihydroxy-5
      nitrophenyl)methylene]-2,4-pentanedione, a novel water-soluble compound with
      antioxidative properties, to inhibit the LDL oxidation promoted by copper ions,
      the aqueous free radical generator 2,2'-azobis(2-amidinopropane) hydrochloride
      (AAPH), and mouse peritoneal macrophages. In these three oxidation systems, the
      extent of LDL oxidation was determined by measuring the formation of conjugated
      dienes, the formation of thiobarbituric acid-reactive substances, the change in
      the electrophoretic mobility of LDL, and the uptake of LDL by macrophages. When
      LDL oxidation was promoted by copper ions, the reaction was found to be inhibited
      by nitecapone added in a three- to five-molar excess of the concentration of
      copper ions. The mechanism by which nitecapone exerted its antioxidative effect
      in copper-mediated LDL oxidation depended on binding and redox inactivation of
      the copper ions. Moreover, nitecapone released LDL-bound copper ions and so
      rendered the LDL particles more resistant to oxidation. In contrast to a water
      soluble alpha-tocopherol analogue that was rapidly consumed during the oxidative
      process, nitecapone retained its inhibitory effect for at least 2 days. Using
      immobilized metal ion affinity chromatography, we showed that nitecapone binds
      both copper and iron ions, whereas its affinity for zinc ions is low. Nitecapone
      also inhibited LDL oxidation in the free radical-mediated oxidation system
      (AAPH). In this system, nitecapone showed synergistic antioxidative action with
      ascorbic acid. Finally, nitecapone inhibited macrophage-mediated LDL oxidation.
      Accordingly, nitecapone appears to have a unique antioxidative profile in that it
      both selectively chelates pro-oxidative transition metals and scavenges free
      radicals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773728
TI  - Whole-blood platelet aggregation predicts in vitro and in vivo primary hemostatic
      function in the elderly.
AB  - Increased platelet aggregation is associated with higher coronary artery disease
      mortality. Enhanced platelet aggregation in platelet-rich plasma has also been
      described in the elderly. To define age-related changes in primary hemostasis, we
      studied 37 elderly and 31 young blood donors. There were no significant age
      related differences in whole-blood platelet aggregation, platelet adherence and
      thrombus formation on human umbilical artery segments, or bleeding time. Plasma
      fibrinogen was significantly higher in elderly men and women, whereas activated
      factor VII was elevated only in elderly women. Collagen-induced platelet
      aggregation was significantly correlated with platelet adherence to the
      subendothelium in elderly (r = .488, P = .002) but not in young donors.
      Accordingly, collagen-induced platelet aggregation showed a significant inverse
      correlation with bleeding time only in the elderly (r = -.401, P = .014).
      Arachidonic acid-induced platelet aggregation was significantly associated with
      platelet adherence to the subendothelium (r = .658, P = .003) and bleeding time
      (r = -.540, P = .021) only in elderly men. In young donors, ADP-induced platelet
      aggregation was significantly correlated with platelet adherence to the
      thrombogenic adventitial surface (r = .395, P = .031); in the elderly this
      association only approached significance (r = .315, P = .058). Whole-blood
      platelet aggregation in response to collagen and arachidonic acid may be more
      useful in predicting primary hemostatic function in the elderly than in the
      young. Furthermore, in the elderly, the correlation between platelet aggregation
      in whole blood and platelet-arterial wall interactions in vitro and in vivo may
      contribute to the ability of this test to predict coronary risk.

PMID- 7773729
TI  - Evidence that meizothrombin is an intermediate product in the clotting of whole
      blood.
AB  - Meizothrombin is an intermediate that is produced during the conversion of
      prothrombin to thrombin in systems composed of purified factor Xa and factor Va
      that are quantitatively assembled on an anionic phospholipid surface. The
      biological significance of this intermediate has recently been challenged by the
      apparent absence of meizothrombin during clotting of sodium citrate
      anticoagulated plasma. We analyzed the formation of thrombin during coagulation
      of nonanticoagulated, unchilled, minimally manipulated whole blood in glass
      tubes. The process was stopped at 0, 3, 5, and 7 minutes by the addition of
      biotinylated peptidyl chloromethyl-ketone active-site labeling reagents.
      Plasma/serum was separated by centrifugation, and labeled species were extracted
      by immunoadsorption with a polyclonal anti-prothrombin antibody. The purified
      prothrombin-derived species were separated by SDS-polyacrylamide gradient gel
      electrophoresis and visualized on a chemiluminescent avidin blot. Meizothrombin
      appeared as an intermediate product of this reaction and persisted with some
      increase through the 7-minute time point. We also observed incorporation of the
      active-site label into a species of lower molecular weight consistent with the B1
      chain of beta- and/or gamma-thrombin. These degraded forms of thrombin have not
      been previously demonstrated in a biologically relevant preparation. Our data
      clearly establish the generation of meizothrombin as an intermediate product of
      thrombin generation during whole-blood clotting. The data also represent the
      first experimental evidence for the generation of beta- and gamma-thrombin in a
      biologically relevant environment and time scale.

PMID- 7773730
TI  - Platelet cytosolic Ca2+ and membrane dynamics in patients with primary
      hypercholesterolemia. Effects of pravastatin.
AB  - This study was designed to evaluate the relationships between platelet cytosolic
      Ca2+ concentration ([Ca2+]i) and plasma lipids in patients with primary
      hypercholesterolemia. In a double-blind, placebo-controlled trial, we determined
      platelet [Ca2+]i in the presence and virtual absence of extracellular Ca2+ and
      the effects of prolonged treatment with pravastatin, a selective inhibitor of 3
      hydroxy-3-methylglutaryl coenzyme A reductase. Platelet [Ca2+]i and membrane
      microviscosity were determined in 22 normotensive hypercholesterolemic men.
      Platelet [Ca2+]i was observed to vary with in vivo plasma lipid characteristics:
      in untreated patients, [Ca2+]i determined at low extracellular Ca2+ concentration
      was significantly associated with plasma triacylglycerols (P = .008) and with the
      total cholesterol to HDL cholesterol ratio (P = .044). Triacylglycerol levels
      also correlated inversely with the external Ca(2+)-dependent [Ca2+]i rise.
      Pravastatin treatment reduced plasma total cholesterol (-20 +/- 3%), LDL
      cholesterol (-30 +/- 3%), triacylglycerols (-17 +/- 6%), and apoB levels (-25 +/-
      4%) and simultaneously decreased platelet [Ca2+]i measured in a low-Ca2+ medium
      by 14 +/- 6% (P = .03). However, [Ca2+]i values remained positively correlated
      with the total cholesterol to HDL cholesterol ratio (P = .04). Prvastatin
      treatment did not induce marked changes in membrane microviscosity, although the
      changes in trimethylaminodiphenylhexatriene anisotropy were inversely correlated
      with those of HDL cholesterol. These results indicate that plasma lipids can
      modulate cytosolic Ca2+ in platelets by affecting Ca2+ transport pathways that
      are dependent and independent of Ca2+ influx.

PMID- 7773731
TI  - FH Afrikaner-3 LDL receptor mutation results in defective LDL receptors and
      causes a mild form of familial hypercholesterolemia.
AB  - Three founder-related gene mutations (FH Afrikaner-1, -2, and -3) that affect the
      LDL receptor are responsible for 90% of the familial hypercholesterolemia (FH) in
      South African Afrikaners. Patients heterozygous for the FH Afrikaner-1 (FH1)
      mutation, which results in receptors having approximately 20% of normal receptor
      activity, have significantly lower plasma cholesterol levels and milder clinical
      symptoms than heterozygotes with the FH Afrikaner-2 mutation, which completely
      abolishes LDL receptor activity. In this study we re-created the FH3 mutation
      (Asp154-->Asn) in exon 4 by site-directed mutagenesis and analyzed the expression
      of the mutant receptors in Chinese hamster ovary cells. The mutation resulted in
      the formation of LDL receptors that are markedly defective in their ability to
      bind LDL, whereas binding of apoE-containing beta-VLDL is less affected. The
      mutant receptors are poorly expressed on the cell surface as a result of
      significant degradation of receptor precursors. The plasma cholesterol levels of
      31 FH3 heterozygotes were similar to FH1 heterozygotes but significantly lower
      than FH2 heterozygotes. The FH1 and FH3 heterozygotes also tended to be less
      severely affected clinically (by coronary heart disease and xanthomata) than FH2
      patients. This study demonstrates that mutational heterogeneity in the LDL
      receptor gene influences the phenotypic expression of heterozygous FH and that
      severity of expression correlates with the activity of the LDL receptor measured
      in vitro. The results further indicate that knowledge of the specific mutation
      underlying FH in heterozygotes is valuable in determining the potential risk of
      premature atherosclerosis and should influence the clinical management of FH
      patients.

PMID- 7773732
TI  - A novel variant of lysosomal acid lipase (Leu336-->Pro) associated with acid
      lipase deficiency and cholesterol ester storage disease.
AB  - Cholesterol ester storage disease (CESD) is associated with premature
      atherosclerosis, hepatomegaly, elevated LDL cholesterol levels, and in most
      cases, low HDL cholesterol levels. Previous studies have shown a G-->A mutation
      at the 3' splice junction of exon 8 (E8SJM) of the gene encoding lysosomal acid
      lipase (LAL) in two kindreds with CESD. In a Canadian-Norwegian kindred with this
      disease, we show this mutation in conjunction with an as yet unknown T-->C
      transition in exon 10 predicting a Leu336-->Pro (L336P) replacement and an A-->C
      transversion in exon 2 predicting a T-6P replacement in the prepeptide.
      Identification of the L336P rather than the T-6P replacement as the second defect
      underlying CESD in our patient is deduced from three lines of evidence. First,
      the E8SJM allele is located in cis with the mutation predicting the T-6P-encoding
      allele but in trans with the L336P-encoding allele; second, the L336P but not the
      T-6P replacement cosegregates with low LAL activity in the family; third, the T
      6P replacement was found in 6 of 28 alleles from subjects with normal lysosomal
      acid lipase activity, suggesting that this variant represents a frequent
      nonfunctional polymorphism. Since the residual LAL activity is higher and the
      clinical phenotype based on plasma lipid values and severity of
      hepatosplenomegaly is milder in this case than in a previously studied case who
      was homozygous for the E8SJM allele, we conclude that the L336P variant appears
      to be associated with a phenotypically mild form of CESD.

PMID- 7773733
TI  - Relations between deletion polymorphism of the angiotensin-converting enzyme gene
      and insulin resistance, glucose intolerance, hyperinsulinemia, and dyslipidemia.
AB  - Recent reports have shown that the frequency of the homozygous deletion genotype
      (DD) of the angiotensin-converting enzyme (ACE) gene is highly associated with
      myocardial infarction and cardiomyopathy, particularly in those considered to be
      at low risk for coronary heart disease (CHD) on the basis of their apoB or LDL
      cholesterol concentrations. The present study was initiated to extend this
      inquiry by exploring the possibility that the ACE/DD genotype might be associated
      with risk factors not evaluated in the initial reports. Consequently, we
      determined the ACE genotype in 181 subjects, 124 with normal glucose tolerance
      and 57 with noninsulin-dependent-diabetes mellitus (NIDDM), and compared various
      aspects of glucose, insulin, and lipoprotein metabolism in the three ACE
      genotypes. In general, normal subjects with the DD genotype had a lower body mass
      index, were more insulin sensitive (as assessed by the insulin suppression test),
      and had lower plasma glucose and insulin responses to oral glucose. In addition,
      plasma triglyceride and cholesterol concentrations were lowest and HDL
      cholesterol concentrations highest in the DD group. However, the only
      statistically significant differences were between the ID and DD groups; the
      latter had lower values for body mass index, was more insulin sensitive, and had
      a lower plasma insulin response to oral glucose. Similar but insignificant trends
      were noted in the patients with NIDDM. The present results show that subjects
      with the ACE/DD genotype are not at increased risk for CHD because of insulin
      resistance, relative hyperglycemia and hyperinsulinemia, or a dyslipidemia
      characterized by a high triglyceride and low HDL cholesterol
      concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773734
TI  - Factor V Leiden gene mutation and thrombin generation in relation to the
      development of acute stroke.
AB  - To determine the prevalence of the factor V Leiden gene mutation in relation to
      the phenotypes of cerebral infarction and cerebral hemorrhage, we studied 386
      randomly selected cases of acute stroke and 247 control subjects. Factor V
      genotype was determined by amplification of a 267-bp sequence of exon/intron 10
      of the factor V gene. Levels of prothrombin fragment F(1 + 2), a marker of
      thrombin generation, were determined in both acute and convalescent stroke and
      related to factor V genotype. Prothrombin fragment F(1 + 2) was assessed by using
      an enzyme-linked immunosorbent assay. Sixteen stroke cases (4.1%) were identified
      as having the mutation compared with 14 (5.6%) control subjects. Prothrombin
      fragment F(1 + 2) levels were estimated in 191 cases and found to be elevated
      both acutely and after 3 months, but they were not related to factor V genotype.
      Prothrombin fragment F(1 + 2) is elevated in acute stroke and requires further
      evaluation in relation to cerebrovascular disease. These results suggest that the
      factor V Leiden gene mutation is not a risk factor for arterial thrombosis
      causing stroke.

PMID- 7773735
TI  - Adsorption and coagulability of fibrinogen on atheromatous lipid surfaces.
AB  - Fibrinogen, the precursor of the blood clot matrix and a major constituent of
      atherosclerotic lesions, is shown to adsorb with high affinity to hydrophobic
      beads coated with cholesteryl oleate, cholesterol, or loosely packed lecithin.
      The quantity of fibrinogen that binds to cholesterol- or lecithin-coated beads
      decreases as the surface concentration of the lipid increases; densely packed
      films lecithin bind little,if any, if the protein. In sharp contrast, the
      appreciable quantity of fibrinogen that binds to cholesteryl oleate-coated beads
      is indifferent to the surface concentration of that lipid. Not unexpectedly, the
      quantity of fibrinogen that binds to beads coated with mixtures of cholesteryl
      oleate and lecithin increases with increasing concentration of the cholesteryl
      ester. When bound, fibrinogen can be converted by thrombin to fibrin and nucleate
      clot formation as manifested by the aggregation of stirred beads. These results
      indicate that hydrophobic, atheromatous lipid surfaces, particularly those rich
      in cholesteryl esters, may be predisposed to thrombosis by virtue of their
      inherent capacity to bind functional fibrinogen.

PMID- 7773736
TI  - Thrombotic thrombocytopenia induced in dogs and pigs. The role of plasma and
      platelet vWF in animal models of thrombotic thrombocytopenic purpura.
AB  - Thrombotic thrombocytopenia with severe depletion of plasma von Willebrand factor
      (vWF) was induced in normal large animals (5 dogs and 2 pigs) by botrocetin, a
      Bothrops factor requiring vWF for platelet agglutination. Botrocetin (90 to 100
      U/kg, 2.14 to 2.38 mg/kg, in a single i.v. injection) reduced plasma vWF activity
      to < 0.1 U/mL for 24 hours. During this period, multimeric analysis of plasma vWF
      antigen (Ag) revealed the loss of intermediate- and high-molecular-weight forms
      with a concomitant increase in lower molecular weight forms. A moderate reduction
      in factor VIII (FVIII) activity was observed. The vWF reduction was accompanied
      by transient thrombocytopenia and prolonged bleeding times during the deficiency
      state. Occlusive platelet thrombi were detected by transmission electron
      microscopy in the microcirculation of lung and spleen but not kidney or brain 30
      minutes after the botrocetin injection. Recovery of plasma vWF and platelet count
      occurred within 48 hours and was associated with the appearance in the plasma of
      unusually large forms of vWF:Ag multimers. The vWF:Ag multimer distribution was
      normal at 72 hours. The ultrastructural distribution of vWF in unstimulated
      normal porcine and canine platelets was examined by using immunogold staining.
      VWF was detected in the alpha-granules of normal pig platelets but was not
      observed in platelets from normal dogs. However, both animals developed
      thrombotic thrombocytopenia when injected with botrocetin. A second group of
      animals (2 dogs and 3 pigs) with von Willebrand disease (vWD) was given a single
      botrocetin injection (90 to 100 U/kg). No thrombocytopenia occurred.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7773737
TI  - Mast cell granule remnants carry LDL into smooth muscle cells of the synthetic
      phenotype and induce their conversion into foam cells.
AB  - We report the effect of mast cells on the uptake of LDL by smooth muscle cells
      (SMCs) and their conversion into foam cells in vitro. The mast cells were
      stimulated to exocytose their cytoplasmic secretory granules, and the granule
      remnants formed were recovered from the extracellular fluid and added to cultures
      of SMCs of either the synthetic or contractile phenotype in LDL-containing
      medium. In the presence but not in the absence of granule remnants, SMCs of the
      synthetic phenotype took up LDL with ensuing stimulation of intracellular
      cholesteryl ester synthesis and cytoplasmic accumulation of neutral lipid
      droplets. Using methylated LDL (mLDL), a modified species of LDL that binds to
      granule remnants but not to LDL receptors, we demonstrated that this uptake
      (leading to foam cell formation) occurred only when LDL was bound to granule
      remnants. After the addition of colloidal gold-LDL and granule remnants to the
      incubation system, electron microscopy revealed that within phagosomes of the
      SMCs there were granule remnants (diameter, 0.5 to 1 micron) coated with LDL,
      confirming that LDL had been carried into the cells with the remnants. SMCs of
      the contractile phenotype were less efficient than their synthetic counterparts
      at phagocytosing LDL-coated granule remnants and were not converted into foam
      cells. This difference in the rate of phagocytosis of granule remnants was
      present even in the absence of LDL, revealing that the more active phagocytosis
      by SMCs of the synthetic phenotype was not specifically related to uptake of
      lipids but rather reflected a general phenotype characteristic of these cells.
      These observations indicate a phagocytic mechanism by which SMCs of the synthetic
      phenotype are converted into cholesteryl ester-filled foam cells, and they also
      suggest that degranulation of mast cells plays a role in the development of fatty
      streak lesions.

PMID- 7773738
TI  - IgE-dependent generation of foam cells: an immune mechanism involving
      degranulation of sensitized mast cells with resultant uptake of LDL by
      macrophages.
AB  - Because a role has been suggested for IgE in cardiovascular diseases and for mast
      cells in cholesterol accumulation within the macrophages of atherosclerotic
      lesions, we examined mast cell-macrophage interactions in vitro by using rats
      with high serum levels of IgE antibodies. The rats were immunized with an antigen
      (ovalbumin) and adjuvant (Bordetella pertussis vaccine) to provoke synthesis of
      IgE and to sensitize their mast cells, ie, to allow the IgE to bind to the high
      affinity IgE receptors on the mast cell surfaces. On addition of the ovalbumin to
      suspensions of mast cells isolated from the peritoneal cavity of the immunized
      rats, the mast cells responded by exocytosing their heparin-proteoglycan-
      containing granules. When IgE-bearing peritoneal mast cells were cocultured with
      peritoneal macrophages (also from the immunized rats) in a medium enriched in
      LDL, addition of ovalbumin to the incubation medium triggered a dose-dependent
      release of granules and a dose-dependent increase in the rate of LDL uptake by
      the macrophages. In contrast, ovalbumin had no effect on LDL uptake if the
      cultures contained only macrophages or if the mast cells and macrophages were
      from nonimmunized rats. Thus, the sequence of events leading to enhanced uptake
      of LDL by macrophages depended wholly on IgE-dependent degranulation of the
      sensitized mast cells. With the aid of gold-labeled LDL we demonstrated that the
      exocytosed mast cell granules had bound LDL particles and carried them into the
      macrophages, with subsequent formation of foam cells. The current series of
      experiments delineates a novel immunologic mechanism for the formation of
      macrophage foam cells and assigns a potentially atherogenic role to mast cell
      bound IgE antibodies.

PMID- 7773739
TI  - Protein-peptide interactions.
AB  - Proteins can interact with short peptide sequences in a variety of ways that can
      be sequence dependent or independent. The bound peptides are frequently in an
      extended conformation but may also adopt beta-turns or alpha-helices as motifs
      for recognition. The peptides can be completely buried in cavities, bound in
      grooves or pockets, or form beta-strand type interactions at the protein surface.
      These various recognition motifs are illustrated by peptide interactions with
      antibodies, calmodulin, OppA periplasmic binding protein, PapD chaperone, MHC
      class I and class II molecules, and Src homology (SH) domains 2 and 3.

PMID- 7773740
TI  - Structure and function of restriction endonucleases.
AB  - Structures of two restriction endonucleases, BamHI and PvuII, were reported in
      the past year. This doubles the number of restriction endonuclease structures now
      known from two to four, and enables a comparative analysis of their structures
      and modes of DNA recognition. Despite a lack of sequence homology between the
      enzymes, BamHI turns out to resemble EcoRI, and PvuII turns out to resemble
      EcoRV. The active-site regions are structurally similar in all four enzymes, but
      their mechanisms of cleavage may differ.

PMID- 7773742
TI  - Protein-nucleic acid interactions.

PMID- 7773741
TI  - Four-helix bundle growth factors and their receptors: protein-protein
      interactions.
AB  - Many growth factors and cytokines promote receptor clustering on binding. At
      least three different protein-protein interaction sites are involved: cytokine
      receptor I, cytokine-receptor II and receptor I-receptor II. Although structural
      data on these complexes are limited, recent structural and mutagenesis studies of
      the four-helix bundle class of cytokines are clarifying the nature of the
      complexes formed.

PMID- 7773743
TI  - Folding and binding.

PMID- 7773744
TI  - DNA repair proteins.
AB  - DNA repair proteins act to correct mutagenic and toxic DNA damage, which can lead
      to cancer, aging and death. These proteins and their mechanisms of action have
      been found to be widely conserved between species, often from bacteria to man.
      Structural and biochemical studies on several bacterial enzymes involved in
      direct reversal and base excision repair have provided insights into the
      molecular basis of the recognition of damaged DNA and have also highlighted the
      novel roles that transition metals play in DNA repair.

PMID- 7773745
TI  - DNA topoisomerases.
AB  - In the past year, the atomic structures of three fragments of type I DNA
      topoisomerases were elucidated. Together with the atomic structure of a fragment
      of bacterial gyrase, this wealth of structural information is helping to further
      our understanding of the mechanism of action of topoisomerases.

PMID- 7773746
TI  - DNA modification by methyltransferases.
AB  - Enzymatic methylation of DNA plays important roles in both prokaryotes and
      eukaryotes. Structural study of the HhaI DNA methyltransferase has provided
      considerable insight into the chemistry of C5-cytosine methylation. The DNA
      protein complex reveals a substrate cytosine flipped out of the double helix
      during the reaction, and a novel two-loop DNA-binding motif used for both
      sequence recognition and flipping the base. Structural comparison of HhaI C5
      cytosine methyltransferase, TaqI N6-adenine methyltransferase, and catechol O
      methyltransferase reveals a common catalytic domain structure, which might be
      universal among S-adenosyl-L-methionine (SAM)-dependent methyltransferases.

PMID- 7773747
TI  - Aminoacyl-tRNA synthetases.
AB  - Detailed mechanisms for each step of the reaction catalyzed by both class I and
      class II aminoacyl-tRNA synthetases have been proposed on the basis of
      crystallographic data of aminoacyl-tRNA synthetases in complex with their
      different substrates. Despite the very different topologies of the two classes,
      there are striking and unanticipated chemical similarities between their active
      sites and proposed mechanisms.

PMID- 7773748
TI  - Theoretical studies of protein folding and unfolding.
AB  - The mechanism of protein folding is being investigated theoretically by the use
      of both simplified and all-atom models of the polypeptide chain. Lattice
      heteropolymer simulations of the folding process have led to proposals for the
      folding mechanism and for the resolution of the Levinthal paradox. Both stability
      and rapid folding have been shown in model studies to result from the presence of
      a pronounced global energy minimum corresponding to the native state.
      Concomitantly, molecular dynamics simulations with detailed atomic models have
      been used to analyze the initial stages of protein unfolding. Results concerning
      possible folding intermediates and the role of water in the unfolding process
      have been obtained. The two types of theoretical approaches are providing
      information essential for an understanding of the mechanism of protein folding
      and are useful for the design of experiments to study the mechanism in different
      proteins.

PMID- 7773749
TI  - Structures of folding intermediates.
AB  - The past year has yielded important results in the study of protein-folding
      intermediates. It has been shown that the equilibrium molten globule has a native
      like tertiary fold and is separated from the unfolded state by a first-order
      phase transition. New equilibrium intermediates have been revealed and
      substantial progress has been made in the understanding of two main barriers in
      protein folding.

PMID- 7773750
TI  - Characterizing transition states in protein folding: an essential step in the
      puzzle.
AB  - Transition states in protein folding are being analyzed experimentally and by
      computer simulation to reveal the sequence of events in the folding and unfolding
      of proteins at high resolution. Results of this analysis have enabled the
      reconstruction of folding pathways in vitro and open the prospect of analyzing
      pathways in vivo.

PMID- 7773751
TI  - The formation of protein disulphide bonds.
AB  - The past year has provided more detail on the formation of native disulphide
      bonds during protein folding at biosynthesis and has identified important
      cellular factors in the oxidative folding compartments, namely the eukaryotic
      endoplasmic reticulum and the bacterial periplasm. This information has enabled
      traditional in vitro refolding studies to be re-evaluated and their relevance as
      models for folding in the cell to be established.

PMID- 7773752
TI  - Molecular chaperones in cellular protein folding.
AB  - Protein folding in the cell requires molecular chaperones. The chaperone proteins
      of the hsp70 and hsp60 (chaperonin) classes stabilize unfolded or partially
      folded polypeptides, thereby preventing aggregation, and mediate folding to the
      native state in ATP-dependent reactions. Recent advances include a more detailed
      understanding of the mechanistic principles of hsp70 and hsp60 action, the
      solution of the crystal structure of the chaperonin GroEL, and the definition of
      pathways of chaperone-mediated protein folding.

PMID- 7773753
TI  - Amyloidosis.

PMID- 7773754
TI  - Skin fold dermatitis.

PMID- 7773755
TI  - Lumbosacral transitional vertebra and thoracic limb malformations in a Chihuahua
      puppy.
AB  - A three-month-old, male Chihuahua puppy with congenital absence of the distal 40%
      of the right thoracic limb was examined. The limb ended as a short, rounded, skin
      covered stump. Radiography revealed a 40% shortened humerus tapered to a blunt
      end without its distal extremity. Dissection of the left thoracic limb identified
      luxation of the elbow joint and absence of the fourth digital pad. Alizarin-red
      staining and clearing demonstrated syndactylous fourth and fifth digits in the
      left thoracic limb and an anomalous eighth lumbar vertebra. This additional
      vertebra was unilaterally sacralized and constituted a lumbosacral transitional
      vertebra.

PMID- 7773756
TI  - The canine cemented modular total hip prosthesis.
AB  - Total hip replacement (THR) is well established as a treatment modality for dogs
      with noninfectious, nonneoplastic, disabling conditions of the coxofemoral joint.
      Since the mid 1970s, a fixed-head prosthesis has been used in this procedure. A
      modular prosthesis, which is based on many of the technical advances found in
      human prostheses, now is available for use in veterinary medicine. The
      prosthesis, surgical instrumentation, surgical technique, and clinical results
      have been evaluated in a prospective study conducted at The Ohio State
      University's College of Veterinary Medicine. The modular prosthesis provides
      results equal to or better than the fixed-head prosthesis.

PMID- 7773757
TI  - Radiographic anatomy of the medial coronoid process of dogs.
AB  - Mediolateral, flexed mediolateral, mediocaudal-laterocranial 15 degrees oblique
      (extended and supinated mediolateral), and craniolateral-caudomedial 20 degrees
      to 30 degrees oblique radiographs of 16 elbow-joint specimens were produced to
      study the radiographic anatomy of the medial coronoid process. On the
      mediolateral view, the cranial point of the coronoid process was at the level of
      the distal one-third of the radial epiphysis. Degree of superimposition of the
      proximal radius and ulna determined how the medial coronoid process was projected
      on the radiographs. Mediocaudal-laterocranial oblique radiographs best showed the
      cranial outline of the medial coronoid process with moderate superimposition of
      the proximal radius and ulna.

PMID- 7773758
TI  - Fatal reexpansion pulmonary edema in a kitten following surgical correction of
      pectus excavatum.
AB  - Fulminant, fatal pulmonary edema developed in an eight-week-old kitten following
      external splint correction of severe pectus excavatum. History, signalment, onset
      of clinical signs, and gross pathological findings were most compatible with a
      diagnosis of reexpansion pulmonary edema (RPE). This report presents case
      findings and a literature review of RPE.

PMID- 7773759
TI  - A simplified method for stabilization of flail chest injuries in small animals.
AB  - Two dogs and one cat with flail chest injuries were treated by a new technique of
      external thoracic wall stabilization using a single circumcostal suture for each
      affected rib and a splint device. Application of the splint device was quick and
      required minimal manipulation of the patient. Stabilization of the flail chest
      resulted in improved respiration in each animal. The splint device was left in
      place in two of the animals as the sole means of rib fixation. No evidence of
      infection or other adverse effects were noted with this technique.

PMID- 7773760
TI  - Sacral fractures in dogs: a review of 32 cases.
AB  - Sacral fractures have not been described well in dogs. The records of 32 dogs
      diagnosed with sacral fractures were evaluated for neurologic deficits at
      presentation and discharge. Follow-up was in the form of telephone survey or
      physical examination at recheck. A score was assigned for each dog at
      presentation, discharge, and follow-up (0 for normal, 1 for minor deficits, and 2
      for major deficits). Fractures located lateral to the sacral foramina were called
      abaxial, and those medial to the sacral foramina were called axial. Axial
      fractures had significantly more severe deficits at presentation (p = 0.00017)
      and discharge (p = 0.03063), but not at follow-up. Neurologic status did not
      improve significantly during hospitalization in either fracture group, but had
      improved significantly at follow-up.

PMID- 7773761
TI  - Subcutaneous administration of desoxycorticosterone pivalate for the treatment of
      canine hypoadrenocorticism.
AB  - Twelve dogs with hypoadrenocorticism were treated with subcutaneous
      desoxycorticosterone pivalate (DOCP). Eight of these dogs were recently diagnosed
      and had not yet been treated. Four dogs previously had been diagnosed and treated
      (three with intramuscular DOCP, one with oral fludrocortisone acetate). History,
      physical examination, serum electrolytes, and blood urea nitrogen (BUN) were
      evaluated. Desoxycorticosterone pivalate (2.2 mg/kg body weight) was administered
      every 25 days. On day 0, recently diagnosed dogs had a median serum sodium
      concentration of 131.5 mEq/L, median serum potassium concentration of 6.6 mEq/L,
      and median BUN of 41.5 mg/dl. All subsequent median serum electrolyte and BUN
      concentrations were normal. All previously treated dogs had normal blood values
      which were maintained throughout the study.

PMID- 7773762
TI  - Diagnostic and therapeutic considerations in a hypercalcemic dog with multiple
      endocrine neoplasia.
AB  - Hypercalcemia was found in a dog examined for episodic weakness and
      disorientation. A right adrenal mass identified on abdominal ultrasonographic
      examination was diagnosed as a pheochromocytoma based on increased 1231
      metaiodobenzylguanidine uptake and characteristic histopathological features.
      Serum intact parathyroid hormone (iPTH), total serum calcium, and ionized serum
      calcium were increased prior to surgery. Although both total and ionized serum
      calcium concentrations decreased to within normal reference ranges following
      surgery through postoperative day 17, subsequent high concentrations with
      increased serum iPTH concentrations confirmed concurrent primary
      hyperparathyroidism. A right parathyroid tumor was suspected based on a
      technetium-99m-sestamibi (99mTc-sestamibi) scan.

PMID- 7773763
TI  - Hemobartonella felis infection with atypical hematological abnormalities.
AB  - Two cases of clinical feline hemobartonellosis with dramatic hematological
      changes are reported. One cat succumbed to an acute, severe hemolytic anemia
      accompanied by markedly increased numbers of nucleated erythrocytes. The second
      cat presented with a remarkably elevated leukocyte count and responded well to
      treatment with tetracycline. In both instances, the initial hematological data
      was very unusual for feline hemobartonellosis. These cases further exemplify the
      greatly variable and sometimes misleading hematological changes seen with
      Hemobartonella felis infection.

PMID- 7773764
TI  - Successful treatment of regional enteritis in a dog.
AB  - Regional enteritis was diagnosed in an 11-year-old, spayed female German shepherd
      dog with a history of intermittent vomiting and anorexia. Segmental, transmural
      granulomatous enteritis involved the pylorus, jejunum, and ileum. The jejunal
      lesions were excised. The remaining lesions completely resolved subsequent to
      long-term prednisone and sulfasalazine therapy.

PMID- 7773765
TI  - Canine neosporosis: a case report and literature review.
AB  - A three-year-old, intact female vizsla presented for signs of an acute-onset,
      progressive spinal cord disease. Postmortem examination revealed multifocal
      central nervous system (CNS) lesions, severe pneumonia with pulmonary edema, and
      congestion of the liver. Protozoal cysts were found in multiple spinal cord and
      brain stem sections. Immunohistochemical staining positively identified these
      cysts as Neospora caninum. A literature review of Neospora caninum infection in
      the dog with summary of the pathogenesis, clinical signs, diagnostic evaluation,
      treatment success, and pathology is presented to provide the clinician with an
      overview of this increasingly prevalent disease.

PMID- 7773766
TI  - That was the year that was.

PMID- 7773767
TI  - Backwards and forwards binding.

PMID- 7773768
TI  - How chaperones tell wrong from right.

PMID- 7773769
TI  - When lectin meets oligosaccharide.

PMID- 7773770
TI  - Ribozyme revealed.

PMID- 7773771
TI  - Snail and spider toxins share a similar tertiary structure and 'cystine motif'.

PMID- 7773772
TI  - Structure-activity relationships for P-type calcium channel-selective omega
      agatoxins.

PMID- 7773773
TI  - Picture story. Birds of a feather.

PMID- 7773774
TI  - De novo design of integral membrane proteins.
AB  - We have designed integral membrane proteins with one, two and four hydrophobic
      transmembrane segments of highly simplified amino acid composition and with
      appropriately placed positively charged lysine residues intended to control the
      overall membrane orientation. When expressed in Escherichia coli, these model
      proteins insert efficiently into the inner membrane and adopt the predicted
      topologies. This demonstrates the feasibility of de novo design of multi-spanning
      integral membrane proteins, and opens up new possibilities for membrane protein
      engineering.

PMID- 7773775
TI  - Crosslinking of mammalian lectin (galectin-1) by complex biantennary saccharides.
AB  - Galectins are beta-galactoside-binding proteins that occur intra- and
      extracellularly in many animal tissues. They have been proposed to form networks
      of glycoconjugates on the cell surface, where they may modulate various cell
      response pathways such as growth, activation and adhesion. The high resolution X
      ray crystallographic analyses of three crystal forms of bovine galectin-1 in
      complex with biantennary saccharides of N-acetyllactosamine type reveal infinite
      chains of lectin dimers cross-linked through N-acetyllactosamine units located at
      the end of the oligosaccharide antenna. The oligosaccharide adopts a different
      low energy conformation in each of the three crystal forms.

PMID- 7773776
TI  - Solution structure of the ets domain of Fli-1 when bound to DNA.
AB  - Members of the ets family of transcription factors share a conserved DNA-binding
      domain, the ets domain. By using multidimensional NMR, we have determined the
      structure of the ets domain of human Fli-1 in the DNA-bound form. It consists of
      three alpha-helices and a four-stranded beta-sheet, similar to structures of the
      class of helix-turn-helix DNA binding proteins first found in the catabolite
      activator protein of Escherichia coli. NMR and mutagenesis experiments suggest
      that in comparison to structurally related proteins, the ets domain uses a new
      variation of the helix-turn-helix motif for binding to DNA.

PMID- 7773777
TI  - Solution structure of the tetrameric minimum transforming domain of p53.
AB  - We report the solution structure of the minimum transforming domain (residues 303
      366) of human p53 (p53tet) determined by multidimensional NMR spectroscopy. This
      domain contains a number of important functions associated with p53 activity
      including transformation, oligomerization, nuclear localization and a
      phosphorylation site for p34/cdc2 kinase. p53tet forms a symmetric dimer of
      dimers that is significantly different from a recent structure reported for a
      shorter construct of this domain. Phosphorylation of Ser 315 has only minor
      structural consequences, as this region of the protein is unstructured. Modelling
      based on the p53tet structure suggests possible modes of interaction between
      adjacent domains in full-length p53 as well as modes of interaction with DNA.

PMID- 7773778
TI  - Structure of the N-terminal SH3 domain of GRB2 complexed with a peptide from the
      guanine nucleotide releasing factor Sos.
AB  - Src-homology 3 (SH3) domains mediate signal transduction by binding to proline
      rich motifs in target proteins. We have determined the high-resolution NMR
      structure of the complex between the amino-terminal SH3 domain of GRB2 and a ten
      amino acid peptide derived from the guanine nucleotide releasing factor Sos. The
      NMR data show that the peptide adopts the conformation of a left-handed
      polyproline type II helix and interacts with three major sites on the SH3 domain.
      The orientation of the bound peptide is opposite to that of proline-rich peptides
      bound to the SH3 domains of Abl, Fyn and p85.

PMID- 7773779
TI  - NMR structure of the N-terminal SH3 domain of GRB2 and its complex with a proline
      rich peptide from Sos.
AB  - GRB2 is a small adaptor protein of 217 amino acids comprising one SH2 domain
      surrounded by two SH3 domains. GRB2 couples receptor tyrosine kinase activation
      to Ras signalling by interacting, through its SH3 domains, to the carboxy
      terminal proline-rich regions of the guanine nucleotide exchange factor Sos. Here
      we report the synthesis and solution structure of the amino-terminal SH3 domain
      of GRB2 and of its more stable Ser 32 mutant. 1H NMR analysis of the complex
      between the Ser-32-GRB2-N-SH3 domain and the proline-rich peptide VPPPVPPRRR,
      derived from h-Sos, shows that relative to the SH3 peptide complexes described
      for PI3K, Fyn and Abl, the proline-rich peptide in this complex binds in the
      opposite orientation.

PMID- 7773780
TI  - Structure determination of racemic trichogin A IV using centrosymmetric crystals.
AB  - Direct methods of crystal structure solution are greatly facilitated in
      centrosymmetric space groups where the complexity of the phase-problem is
      reduced. For most peptides and proteins, crystallization in a centrosymmetric
      arrangement is precluded by an intrinsic dissymmetry due to the constituent
      chiral amino acid residues. The synthetic accessibility of peptide sequences
      containing amino acids of either chirality offers the possibility for co
      crystallization of racemic crystals. We report here the first use of such an
      approach for the de novo structure determination of a medium-sized molecule,
      trichogin A IV, which is a constituent of a fungal lipopeptaibol mixture
      possessing membrane-modifying properties of biological interest.

PMID- 7773781
TI  - Structural conservation of hypervariable regions in immunoglobulins evolution.
AB  - Analysis of human and mouse immunoglobulins has shown that five of six
      hypervariable regions that form the antigen binding site have a small repertoire
      of main chain conformations (canonical structures). Cartilaginous fishes are the
      most distantly related species to humans known to have an immune system, their
      evolutionary lines having diverged 450 million years ago. An analysis of VH and V
      kappa sequences from these fishes shows that all the main chain structures in
      their L1, L2, H1 and H2 hypervariable regions, and one of those in the L3 region,
      are the same as those most commonly found in human and mouse. This implies that
      the canonical structures occurring most commonly in hypervariable regions arose
      very early in the stages of the evolution of the immune system.

PMID- 7773782
TI  - Molecular geography.

PMID- 7773783
TI  - Integrin binding revealed.

PMID- 7773784
TI  - A gripping end to NF-kappa B.

PMID- 7773785
TI  - Re-orientation of retinal in the M-photointermediate of bacteriorhodopsin.

PMID- 7773786
TI  - Hormone binding site of corticosteroid binding globulin.

PMID- 7773787
TI  - Picture story. The inverse light-bulb.

PMID- 7773788
TI  - Conformational constraints in protein degradation by the 20S proteasome.
AB  - Conformationally stabilized peptides and unfolding intermediates of bovine alpha
      lactalbumin have been used to define the degree of unfolding required for
      degradation by 20S proteasomes. It appears that complete unfolding and the
      absence of disulphide bonds are prerequisites for degradation, suggesting that a
      relatively narrow opening controls access to the inner proteolytic compartment of
      the barrel-shaped proteasome. This is corroborated by electron microscopy studies
      showing that the insulin B-chain, which is otherwise easily degraded, cannot pass
      the orifice of this putative peptide channel when a Nanogold particle with a
      diameter of approximately 2 nm is covalently attached to it.

PMID- 7773789
TI  - Temperature-favoured assembly of collagen is driven by hydrophilic not
      hydrophobic interactions.
AB  - It has become almost axiomatic that protein folding and assembly are dominated by
      the hydrophobic effect. The contributions from this, and other, hydrophilic
      interactions can now be better distinguished by direct measurement of forces
      between proteins. Here we report the measurement of forces between triple helices
      of type I collagen at different temperatures, pH and solute concentrations. We
      separate repulsive and attractive components of the net force and analyze the
      origin of the attraction responsible for the collagen self-assembly. In this case
      the role of the hydrophobic effect appears to be negligible. Instead, water
      mediated hydrogen bonding between polar residues is the most consistent
      explanation.

PMID- 7773790
TI  - A novel variant of the catalytic triad in the Streptomyces scabies esterase.
AB  - The crystal structure of a novel esterase from Streptomyces scabies, a causal
      agent of the potato scab disease, was solved at 2.1 A resolution. The tertiary
      fold of the enzyme is substantially different from that of the alpha/beta
      hydrolase family and unique among all known hydrolases. The active site contains
      a dyad of Ser 14 and His 283, closely resembling two of the three components of
      typical Ser-His-Asp(Glu) triads from other serine hydrolases. Proper orientation
      of the active site imidazol is maintained by a hydrogen bond between the N delta
      H group and a main chain oxygen. Thus, the enzyme constitutes the first known
      natural variation of the chymotrypsin-like triad in which a carboxylic acid is
      replaced by a neutral hydrogen-bond acceptor.

PMID- 7773791
TI  - Implications for viral uncoating from the structure of bovine enterovirus.
AB  - We have determined the crystal structure of a bovine enterovirus, revealing that
      the topologies of the major capsid proteins and the overall architecture of the
      virion are similar to those of related picornaviruses. The external loops joining
      beta-strands are truncated and the canyon region is partially filled by an
      extension of the VP3 G-H loop giving the viral capsid a relatively smooth
      appearance. These changes may have implications for cell attachment. In spite of
      these differences the virus maintains a hydrophobic pocket within VP1, occupied
      by a specific 'pocket factor' which appears to be myristic acid. These
      observations support the proposal that a kinetic equilibrium exists between
      occupied and unoccupied pocket states, with occupation inhibiting uncoating.

PMID- 7773792
TI  - Structural basis of drug resistance for the V82A mutant of HIV-1 proteinase.
AB  - A major problem in the development of antiviral therapies for AIDS has been the
      emergence of drug resistance. We report an analysis of the structure of a Val 82
      to Ala mutant of HIV-1 proteinase complexed to A-77003, a C2 symmetry-based
      inhibitor. Modelling studies predicted that the V82A mutation would result in
      decreased van der Waals' interactions with the phenyl rings of A-77003 in both S1
      and S1' subsites. Unexpected rearrangements of the protein backbone, however,
      resulted in favourable re-packing of inhibitor and enzyme atoms in the S1 but not
      the S1' subsite. This analysis reveals the importance of enzyme flexibility in
      accommodating alternate packing arrangements, and can be applied to the re-design
      of inhibitors targeted to drug resistant variants which emerge in the clinic.

PMID- 7773793
TI  - Postinjury neutrophil priming and activation states: therapeutic challenges.
AB  - Both hyperactivity and hypoactivity of neutrophils (PMNs) have been implicated in
      the pathogenesis of postinjury multiple organ failure. In this paper, the
      cellular and molecular mechanisms involved in the regulation of PMN O2-
      production are reviewed. In addition, relevant research laboratory techniques for
      measuring both intracellular and extracellular O2- release are outlined. In a
      pilot study PMN O2- release in response to a battery of PMN agonists was
      determined, and four functional states of the NADPH were defined: resting,
      primed, activated, and unresponsive. PMNs from normal adult volunteers are in the
      resting state. In contrast, PMNs from patients with severe torso trauma are
      primed and activated in the first 24 h postinjury, but, after 48 h, become
      unresponsive to both receptor-dependent (platelet activating factor and N-formyl
      methyl-leucyl-phenylalanine) and receptor-independent (phorbol 12-myristate 13
      acetate) activation. The ability to identify at-risk patients and provide a
      rationale for ameliorating PMN-mediated tissue injury in patients with
      hyperinflammation syndromes are discussed. In addition, the importance of
      identifying patients with PMNs that are unresponsive, and the necessity for
      increasing PMN function in these patients in order to reduce the risk of sepsis,
      are also discussed.

PMID- 7773794
TI  - Optimal preoperative titrated dosage of hypertonic-hyperoncotic solutions in
      cardiac risk patients.
AB  - Hypertonic-iso/hyperoncotic solutions have been the subject of numerous studies,
      mostly used in a fixed dosage (4 mL/kg bw or 250 mL). Nearly no study exists to
      prove whether this is the appropriate dosage especially in cardiac risk patients
      with accompanying diseases. We have compared preoperative volume loading with
      either 10% hydroxyethyl-starch/7.5% NaCl (HHT-HES) or 10% hydroxyethyl-starch/.9%
      NaCl (HES) in 50 mL bolus infusions. Volume loading was done with either HES or
      HHT-HES in 2 x 20 patients before aortic aneurysmectomy. The endpoint of stepwise
      infusion represented the highest cardiac index (CI) at the lowest possible wedge
      pressure (PCWP) (turning point of each individual Frank Starling relation). 167.5
      mL (+/- 45.5 mL = 2.41 mL/kg bw) of HHT-HES and 440 mL (+/- 26.15 mL = 6.33 mL/kg
      bw) of HES were necessary. We observed a significant higher increase of the CI in
      the HHT-HES group. Significant increases of PCWP, pulmonary artery pressure, and
      central venous pressure occurred within the groups without any significant
      differences between the groups (p < .05). Results of the study showed: 1) The
      commonly used fixed dosage of 4 mL/kg bw of HHT-HES is too high in cardiac risk
      patients with slight hypovolemia. 2) HHT-HES should be given in an individual
      titration. 3) In the HHT-HES group we observed a positive inotropic effect
      (higher CI). 4) With the individual titration of HHT-HES no negative side effects
      occurred (especially no hypotension).

PMID- 7773795
TI  - Tumor necrosis factor antibody treatment of septic baboons reduces the production
      of sustained T-cell suppressive factors.
AB  - Post-traumatic septic complications result from impaired cell-mediated immune
      function, which is caused in part by circulating T-cell suppressive factors
      (TSFs). We examined whether tumor necrosis factor alpha (TNF-alpha) antibody
      treatment in a baboon sepsis model influences the production of TSFs, including
      interleukin-10 (IL-10) and transforming growth factor-beta (TGF-beta). Sepsis was
      induced in anesthetized baboons by Escherichia coli infusion, and caused an
      increase in plasma levels of TNF, TSF activity, IL-10, and active TGF-beta, as
      well as a decrease in latent TGF-beta. TNF antibody pretreatment reduced TNF
      levels by 98%. Transient TSF activity (0-4 h) was only marginally influenced,
      while sustained TSF activity (8-24 h) was markedly reduced. TSF activity at 24 h
      correlated with peak TNF levels. IL-10 levels, coinciding with early TSF
      activity, remained unchanged by anti-TNF treatment. Levels of active TGF-beta and
      the drop in latent TGF-beta were decreased. We conclude that anti-TNF treatment
      reduces sustained TSF activity and may partially restore impaired cell-mediated
      immune function.

PMID- 7773796
TI  - Injury to adult human dermal microvascular endothelial cells in vitro.
AB  - Adult human dermal microvascular endothelial cells maintained in culture for four
      to eight passages after isolation were injured by activated human neutrophils but
      were not injured by unstimulated cells. Injury was cytotoxic as indicated by
      release of 51Cr from prelabeled cells. Injury was partially inhibited with
      catalase, dimethylthiourea, and deferoxamine, but was not blocked by superoxide
      dismutase. Injury was enhanced following pretreatment with iron bound to the
      membrane-permeable chelator 8-hydroxyquinoline, while neither iron alone nor the
      chelator by itself enhanced injury. These data suggest that injury results from
      the generation of hydrogen peroxide by the activated neutrophils and its
      conversion to hydroxyl radical through an iron-dependent mechanism. These cells
      appear to be similar to human umbilical vein endothelial cells (HUVEC) in
      sensitivity to oxidant-induced injury. However, unlike HUVEC, these cells do not
      show the age-dependent decrease in sensitivity to killing by activated
      neutrophils that is a characteristic feature of HUVEC. Nor do they show the same
      increase in spontaneous lysis as a function of age that is characteristic of
      HUVEC.

PMID- 7773797
TI  - Acinar cell respiration in experimental acute pancreatitis.
AB  - The early pathogenetic steps that finally lead to acinar cell necrosis in acute
      pancreatitis have been characterized only scarcely as yet. Among a lot of
      hypotheses, one concept favors disturbances of cellular energy metabolism as a
      major factor that contributes to preterm cell decline. To investigate, whether an
      experimental acute pancreatitis alters cell respiration, the respiratory
      capacities of acinar cells isolated from rats with acute pancreatitis were
      measured. Acute pancreatitis was induced using Popper's model, i.e., a
      combination of duct obstruction, secretory stimulation, and mesenteric short-term
      ischemia with subsequent reperfusion. Acinar cells were isolated using a
      collagenase digestion technique. The respiratory rates of the isolated cells in
      suspension were measured at 37 degrees C in 100% oxygen-saturated N-(2
      hydroxyethyl)piperazine-N'-2-ethanesulfonic acid-buffered Eagle's-minimal
      essential medium. Resting respiration of the acinar cells uniformly amounted to
      about 60 pmol of O2/s x 10(6) cells in both the control and the pancreatitis
      group. Cellular respiration could significantly be stimulated by stepwise
      uncoupling of oxidative phosphorylation by means of 2,4-dinitrophenol in all cell
      suspensions investigated. The maximum rate of stimulated respiration was
      diminished in the cells isolated from rats with acute pancreatitis as compared
      with the controls (79.3 +/- 5.0 vs. 160.2 +/- 15.5 pmol of O2/s x 10(6) cells, p
      < .05), however. This reduced respiratory load capacity of the acinar cells in
      acute pancreatitis reflects the restricted ability of the cells to increase
      respiration on enhanced cellular demand. Since mitochondrial respiration is
      coupled to oxidative phosphorylation, an altered energy-transforming potential of
      the acinar cells in acute pancreatitis becomes evident.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7773798
TI  - Blood-to-tissue albumin transport in rats subjected to acute hemorrhage and
      resuscitation.
AB  - Hemorrhage induces a rapid redistribution of protein from extravascular spaces
      into the blood. We studied the effects of acute, nontraumatic hemorrhage on
      tracer-albumin clearances into individual tissues of rats to determine if reduced
      protein extravasation could account for intravascular protein gain. Three groups
      were studied: 1) HEM animals were anesthetized with pentobarbital sodium and bled
      to a mean arterial pressure of 50 mmHg for 90 min; 2) HEM-RS animals were treated
      identical to group 1 and then resuscitated with 5% bovine serum albumin (BSA)
      until baseline arterial pressures were regained; 3) SHAM animals served as time
      controls. Hemodynamic variables were measured periodically throughout hemorrhage
      and clearance periods, and plasma samples were collected prior to death for
      protein and hormone analysis. Plasma clearance of 131I-BSA into individual
      tissues was measured over the final 30 min of each protocol with a terminal
      injection of 125I-BSA used to correct for intravascular volume. Reduction of
      blood volume by 35% in HEM-treated animals resulted in a marked decrease in
      albumin transport relative to the SHAM group (p < or = .05) in the following
      tissues: skeletal muscle (-65%), skin (-49%), ileum (-75%), cecum (-66%), colon (
      67%), heart (-67%), and lung (-71%). Significant changes were not observed in the
      remaining tissues sampled: pancreas, kidney, and cerebrum. Albumin clearances in
      the HEM-RS group were slightly but not significantly lower than SHAM animals
      except for skeletal muscle, where transport remained depressed following
      resuscitation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773799
TI  - Lipopolysaccharide induces intracytoplasmic migration of the polymorphonuclear
      leukocyte CD11b/CD18 receptor.
AB  - We investigated the effects of lipopolysaccharide (LPS) on the subcellular
      location of the integrin receptor CD11b/CD18 (Mac-1). Cytoplast and subcellular
      fractionation experiments were performed to distinguish between receptor shedding
      and intracellular receptor transport as mechanisms involved for the effects of
      LPS on CD11b/CD18 expression. Cytoplast preparations demonstrated the same
      percentage of cell-associated receptors +/- LPS. Subcellular fractionation
      experiments demonstrated a shift from primarily plasma membrane fractions to
      azurophilic granules. Protein tyrosine kinase inhibition with genistein (50
      microM) inhibited the LPS-induced translocation of CD11b/CD18 receptors to
      azurophilic granules. The effects of LPS (10 ng/mL) alone were reproduced with
      LPS (.1 ng/mL) plus heat-inactivated pooled normal human serum. Preincubation of
      PMN with anti-CD14 monoclonal antibodies prevented the effects of LPS+serum on
      the translocation of CD11b/CD18 receptors. These results demonstrate that LPS
      regulates CD11b/CD18 expression by inducing intracytoplasmic translocation of
      this receptor to azurophilic granules. This process involves activation of
      protein tyrosine kinase, and endosomal acidification contributes to the
      degradation of these receptors within azurophilic granules.

PMID- 7773800
TI  - Reciprocal expression of phosphoenolpyruvate carboxykinase and acute phase genes
      during acute inflammation.
AB  - Part of the hepatic response to injury is mediated by the expression of a gene
      family known as acute phase genes. Expression of acute phase genes is induced by
      the presence of cytokines in the circulation such as tumor necrosis factor alpha,
      interferon gamma, and interleukins-1 and -6. Simultaneous with the transcription
      of acute phase genes, there is a decrease in the expression of other genes such
      as albumin. In the present study, we report the decrease in transcription of the
      gene coding for phosphoenolpyruvate carboxykinase (PEPCK), a key regulatory
      enzyme in the gluconeogenic pathway, in rat liver during an acute inflammatory
      state induced by bacterial endotoxin. Steady-state mRNA levels of PEPCK decrease
      3 h after endotoxin injection, returning to 70% of normal levels after 24 h. This
      decrease in PEPCK mRNA levels was due to a decline in the rate of transcription
      of the gene, most likely mediated by an increase in the circulating levels of
      insulin. However, expression of the PEPCK gene was not induced by an increase in
      the cellular levels of cAMP during inflammation. Such a lack of response to cAMP
      may be due to the inactivation of, or decrease in, the levels of the
      transcriptional factor(s) responsible for PEPCK transcription.

PMID- 7773801
TI  - Pentoxifylline improves survival and reduces tumor necrosis factor, interleukin
      6, and endothelin-1 in fulminant intra-abdominal sepsis in rats.
AB  - The influence of pentoxifylline (PTX) on mortality and some important mediators
      was studied in a model of cecal perforation with fulminant intra-abdominal sepsis
      in rats. Cumulative mortality was registered in three groups of animals:
      untreated sepsis (n = 36), sepsis + PTX 20 mg/kg/24 h (n = 24), and sepsis + PTX
      80 mg/kg/24 h (n = 24). PTX therapy was started at sepsis induction or after 4 h,
      and mortality was reduced from 89% in untreated sepsis to 60-66% in the PTX
      groups. Levels of sepsis mediators were studied in two groups: untreated sepsis
      and sepsis + PTX 40 mg/kg started 1 h after sepsis induction. In both groups 6-10
      animals were sacrificed at 4 and 8 h to measure blood levels of bacteria,
      endotoxin, tumor necrosis factor (TNF), interleukin-6 (IL-6), endothelin-1,
      lactate, neutrophils, and packed cell volume. Cecal perforation gave high levels
      of bacteria, endotoxin, TNF, IL-6, and endothelin-1, leading to dehydration,
      lactacidosis, neutropenia, and death. Treatment with PTX did not modify
      dehydration, neutropenia, or concentrations of bacteria and endotoxin. Release of
      endothelin-1 was delayed, TNF burst was nearly abolished, and levels of IL-6 and
      lactate were substantially suppressed. In summary, PTX improves survival and
      reduces blood concentrations of TNF, IL-6, lactate, and endothelin-1 in fulminant
      intra-abdominal sepsis in rats. The primary effect of PTX in this sequence is
      probably reduction of TNF.

PMID- 7773802
TI  - Lack of direct endotoxin-induced vasoactive effects on isolated skeletal muscle
      arterioles.
AB  - Septic shock continues to be a major cause of mortality in the intensive care
      unit. This study was conducted to determine if endotoxin exerts a direct effect
      on the major determinant of peripheral vascular resistance, skeletal muscle
      arterioles. First order cremasteric arterioles were isolated from male Sprague
      Dawley rats, cannulated with glass micropipettes, superfused in physiologic
      saline solution, and allowed to achieve spontaneous basal tone in the absence of
      intraluminal flow. Phenylephrine responsiveness was assessed before and after
      exposure to 2.5 micrograms/mL Salmonella enteritidis endotoxin (ET) for 1-2 h.
      There was no change in either basal diameter (91 +/- 5 microns before ET and 98
      +/- 5 microns after ET) or phenylephrine responsiveness. In vivo exposure to ET
      (15 mg/kg) resulted in no change in basal tone at 1 h, however increased tone was
      observed in arterioles harvested after 4 h of systemic ET (43 +/- 4% without ET
      and 57 +/- 3% with, p < .05). To determine if upstream conduit vessels released
      factors responsible for the vasodilation of skeletal muscle arterioles, isolated
      cannulated cremasteric arterioles were connected in series to a 1 cm segment of
      aorta and superfused without and with 2.5 micrograms/mL ET. An increase in basal
      diameter was observed in arterioles from 94 +/- 14 microns before ET to 120 +/-
      17 microns after ET (p < .05). These studies demonstrate that ET has no direct
      effect on isolated cannulated skeletal muscle arterioles, and that a vasodilating
      substance not consistent with nitric oxide is released from the upstream arterial
      bed.

PMID- 7773803
TI  - Amrinone combined with dobutamine improves hemodynamics and oxygen delivery
      without down-regulation of cardiac beta-adrenergic receptor density in porcine
      endotoxemia.
AB  - Effects of amrinone (AMR), a phosphodiesterase inhibitor, alone and in
      combination with dobutamine (DOB), on hemodynamics and O2 delivery were studied
      during porcine endotoxemia. Pentobarbital-anesthetized pigs were randomly
      administered either Escherichia coli lipopolysaccharide (endotoxin) or
      equivolumetric .9% NaCl (control) as a continuous infusion for 4 h. From 2 to 4 h
      (T = 120-240 min) of endotoxin infusion, pigs were randomly administered one of
      the following treatments; AMR infusion (40 micrograms/kg/min) (AMRlow); DOB (10
      micrograms/kg/min) (DOB); AMR infusion (40 micrograms/kg/min) + DOB (AMRlow+DOB);
      AMR bolus (.75 mg/kg) followed by AMR infusion (40 micrograms/kg/min) (AMRhigh);
      or AMR bolus (.75 mg/kg) followed by infusion (40 micrograms/kg/min) + DOB
      (AMRhigh+DOB). Myocardial samples were obtained at the end of the experiment and
      flash-frozen for beta-adrenergic receptor analysis. Endotoxin significantly (p <
      .05) decreased cardiac index, right ventricular ejection fraction, stroke volume
      index, maximum rate of rise of left ventricular pressure (dP/dtmax), mean
      arterial pressure, and O2 delivery, and increased pulmonary vascular resistance
      and mean pulmonary arterial pressure (p < .05). AMRlow+DOB significantly (p <
      .05) increased cardiac index, dP/dtmax, right ventricular ejection fraction,
      stroke volume index, O2 delivery and consumption, and decreased mean pulmonary
      arterial pressure, pulmonary vascular resistance, mean arterial pressure, and
      systemic vascular resistance. beta-Adrenergic receptor density (Bmax) and binding
      equilibrium dissociation constant (KD) for [3H]dihydroalprenolol were not
      affected by endotoxin or any treatment (p < .05). Endotoxin-induced hemodynamic
      deterioration and decreased O2 delivery was attenuated by AMRlow+DOB. Potential
      applications of this combination may exist in treatment of septic patients with
      inadequate myocardial performance and reduction in O2 delivery complicated by
      pulmonary hypertension.

PMID- 7773804
TI  - The 18th Annual Conference on Shock. Asheville, North Carolina, June 11-14, 1995.
      Abstracts.

PMID- 7773806
TI  - Development: on whose terms?

PMID- 7773805
TI  - Measurement methods to determine compliance with ambient air quality standards
      for suspended particles.
AB  - One of the most important parts of formulating a National Ambient Air Quality
      Standard is specifying the measurement methods for determining and attaining
      compliance. The samples taken for compliance are often pushed beyond their
      original purpose to identify sources, to evaluate the effectiveness of controls,
      and to determine relationships between pollution levels and public health. A full
      understanding of available sampling and analysis methods is needed, as well as an
      analysis of their costs, before acceptable monitoring approached can be
      specified. This review identifies issues related to measurement methods used to
      determine compliance with standards, describes current and future measurement
      methods and their limitations, and determines the extent to which existing
      technology can meet short-term and long-term needs for measuring compliance.

PMID- 7773807
TI  - AIDS in Manila, Philippines.

PMID- 7773808
TI  - After the storm: an American nurse visits Vietnam.

PMID- 7773809
TI  - Nursing education in Russia: visions and realities.

PMID- 7773810
TI  - Mission to Honduras.

PMID- 7773811
TI  - Self-care of older black adults in a South African community.

PMID- 7773812
TI  - Romania: a nursing journey.

PMID- 7773813
TI  - Latvia: nursing reborn.

PMID- 7773815
TI  - Continuous passive motion in rehabilitation after anterior cruciate ligament
      reconstruction.
AB  - In a prospective, randomized study, 34 patients (25 male, 9 female; mean age 27
      +/- 8 years) with unilateral anterior cruciate ligament ruptures and arthroscopic
      reconstruction with patellar tendon grafts were allocated at random to either
      early active motion only (AM; n = 17) or active motion in combination with
      continuous passive motion (CPM; n = 17). Range of motion was measured with a
      goniometer and joint swelling with a tape measure, preoperatively and at 6 weeks
      postoperatively. Neither associated injuries nor the age of the patients differed
      in the two groups. There was no difference in the range of motion between the two
      groups at 6 weeks' follow-up. Joint swelling was more pronounced in the AM group
      both preoperatively and at 6 weeks' follow-up. In this investigation the range of
      motion was not improved by CPM. The difference in joint swelling between the two
      groups may be explained by a persistent preoperative variation in joint effusion
      due to an imbalanced distribution of acute and chronic cases.

PMID- 7773814
TI  - Anterior cruciate ligament patellar tendon reconstruction: it is probably better
      to leave the tendon defect open!
AB  - The purpose of our prospective study was to establish whether or not in anterior
      cruciate ligament (ACL) patellar tendon reconstruction the tendon defect has to
      be closed. In 50 consecutive ACL patellar tendon reconstructions, the tendon
      defect was randomly closed (group I) or left open (group II). The following data
      were recorded from all patients on the 4th and 14th days post operation: range of
      motion (ROM), pain at rest, pain and validity at isometric contraction, ability
      of bent leg raising (at 4th day) and straight leg raising (at 14th day). All the
      patients underwent ultrasonographic examination after 3 months and X-ray scanning
      at 6 months post operation. Forty patients underwent a CT-scan examination at 6
      months. Thirty patients underwent isokinetic testing between 10 and 12 months
      post operation. Evaluating the immediate post operation data, no statistically
      significant differences emerged between the two groups. Ultrasonography showed in
      68% of the knees of group I (defect closed) a thickened patellar tendon (PT),
      while in 60% of group II it was of normal thickness. No patients of either group
      developed patella infera by X-ray evaluation 6 months post operation. CT scans at
      6 months showed that 100% of the knees of group I had a thickened PT in toto
      (nearly twice as thick as normal). Scar tissue was present not only in its
      central third but also in more than half of the cases in the medial and lateral
      third. In group II 75% of the patients had a normal thickness PT and 25%
      presented with only a minimal thickening. Scar tissue was distinguished only at
      its central third.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773816
TI  - A comparison of clinical and radiological parameters with two arthroscopic
      techniques for anterior cruciate ligament reconstruction.
AB  - We performed a comparative study of two series of 25 patellar tendon arthroscopic
      reconstructions of isolated chronic anterior cruciate ligament injuries,
      alternating between a double-incision (using a rear-entry guide) or single
      incision technique (using a transtibial approach). The patients were reviewed to
      assess the clinical, KT-2000 and radiological differences at an average follow-up
      of 14 months (range 8-18 months). For the clinical evaluation the International
      Knee Documentation Committee Form was used. The following radiographic parameters
      were measured: (1) the direction of the femoral and tibial tunnels in the antero
      posterior (AP) and lateral (LL) views; (2) the location of the anterior border of
      the intra-articular exit hole of the femoral tunnel in the LL radiologic view;
      (3) femoral interference screw divergence with the bone block. An extension loss
      < or = 5 degrees was detected in 40% of the double-incision and 36% of the single
      incision patients (NS). A flexion loss < or = 10 degrees was present in 8% of the
      double-incision and 16% of single-incision group (NS). There were no differences
      in terms of pivot shift test between the two groups (pivot glide in 12% of both
      groups). The average side-to-side KT-2000 differences at the manual maximum test
      were 1.98 mm in the double-incision and 2.64 mm in the single-incision group.
      With the double-incision technique the femoral and tibial tunnels were divergent
      in the AP plane and crossed the joint at an angle of 37 degrees and 72 degrees,
      respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773817
TI  - The double patella syndrome.
AB  - First described by A. Trillat, the double patella is an uncommon clinical feature
      following repetitive injuries of the extensor mechanism of the knee. The first
      injury is a tendo-periosteal avulsion of the suprapatellar or, less frequently,
      infrapatellar tendon from the corresponding patellar pole. Often these avulsions
      are misdiagnosed and therefore treated only with a cast or no immobilization at
      all. Subsequent giving-way episodes lead to extensive ossification which is
      adjacent to or separated from the patella. The peculiar shape of this
      ossification overriding or underlying the primary kneecap justifies the
      denomination of double patella. Surgical treatment consists of removal of the
      calcification and reattachment of the tendon to the patella by transosseous
      sutures.

PMID- 7773818
TI  - Validation and application of a subjective knee questionnaire.
AB  - Patients' complaints on limitations in activities of daily living (ADL) and
      sports are possible signs for various injuries of the knee joint. These
      complaints can be easily assessed by the patient using a questionnaire with
      visual analogue scale (VAS) responses. A German translation of the English
      questionnaire concerning knee complaints [4] has been validated and tested for
      clinical use. It consists of 28 questions. For the statistical analysis, an
      overall score (VAS score) of the questionnaire was determined. The validation
      included an expert evaluation on the content of the questionnaire, a test for the
      reliability, a comparison with subjective knee scoring systems (Cincinnati score,
      Lysholm score) and a test on VAS score results in patient groups with various
      knee injuries (discrimination of patients). For the evaluation of operative
      treatment results, the responsiveness of the questionnaire was tested in patients
      undergoing arthroscopic meniscus surgery and anterior cruciate ligament
      reconstruction. The investigation was conducted prior to the operation, 2, 6, 12
      and 24 weeks after surgery for both groups and also 36 weeks after surgery for
      the cruciate ligament patients. Interviews conducted with knee surgeons (so
      called knee experts) revealed that 85% judged the questionnaire as being
      acceptable for clinical use. The reliability of the VAS score for healthy
      individuals was r = 0.86. The reliability for patients in a postoperative
      rehabilitation programme was r = 0.92. By means of the VAS score we were able to
      assess the extent of limitations in knee function in various patient groups with
      meniscus lesions, insufficiency ot the anterior and posterior cruciate ligaments
      and chondromalacia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773819
TI  - Effect of fibrin glue and endothelial cell growth factor on the early healing
      response of the transplanted allogenic meniscus: a pilot study.
AB  - Twentyfour meniscal allotransplantations were conducted in 12 adult mongrel dogs.
      The medial meniscus was replaced using a deep-frozen meniscal allograft. The
      junction between the meniscus and capsule was treated in one of the three ways.
      In the control group, the meniscus was sutured only to the adjacent capsular
      tissue (group C). In the second group, fibrin glue was injected at the junction
      (group F), and in the third group, fibrin glue and endothelial cell growth factor
      (ECGF) were injected at the juncture between the transplanted meniscus and the
      adjacent capsule before the meniscus was sutured (group FE). Histological
      observation was performed to investigate the effect of fibrin glue and ECGF on
      the healing process of transplants at various intervals of 1, 4, 8 and 12 weeks.
      No immunological response was noted in any of the knees. The healing of the
      transplanted meniscus was first observed at the peripheral attachment. Also, the
      pannus-like tissue extended from the synovium to the surface of the meniscus. The
      healing rate in each group at 1 week and 12 weeks was 22% and 77% in group C, 52%
      and 80% in group F, and 64% and 80% in group FE, respectively. At 4 and 8 weeks,
      early cellular repopulation was found in group FE and the area which contained
      new cells was larger than the acellular central core at 8 weeks. However, there
      was no difference among the three groups at 12 weeks.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7773820
TI  - The influence of orthoses on the proprioception of the ankle joint.
AB  - The ankle joints of 14 healthy volunteers and 16 patients with unstable ankle
      joints were tested regarding their functional and proprioceptive capabilities.
      All of them were active athletes. Three tests were used of the study: single-leg
      stance test, single-leg jumping course test, angle-reproduction test. The
      influence of three stabilization devices (lace-on-brace/"Mikros", stirrup
      brace/"Aircast", taping) on the proprioceptivity of stable and unstable ankle
      joints was evaluated. The scores of the single-leg jumping course without any
      stabilizing device (category "standard") ranged between 8.06 and 13.68 (10.65 +/-
      1.29). In the categories "Mikros" (9.85 +/- 0.99), and "Aircast" (9.99 +/- 1.14)
      as well as with the tape bandage (10.27 +/- 0.81) better scores were achieved.
      The differences "standard vs. Mikros" and "standard vs. Aircast" revealed a
      significant reduction of the scores with orthoses (P < 0.01). The error rate in
      the single-leg stance test was within the range of 0-16 (5.12 +/- 2.85) for the
      category "standard". It was lower for the categories "Mikros" (3.65 +/- 2.65) and
      "Aircast" (4.17 +/- 2.59). The error rate was highest in the group with a tape
      bandage (5.79 +/- 3.53). The differences "standard vs Mikros" as well as
      "standard vs. Aircast" were significant (P < 0.01). There was also a significant
      difference between these categories regarding injured and not injured ankle
      joints (P < 0.01). The angle-reproduction-test showed higher values for the
      category "standard" (2.36 degrees +/- 0.97) in comparison to the categories
      "Mikros" (1.46 degrees +/- 0.72), "Aircast" (1.62 degrees +/- 0.91) and "taping"
      (1.84 degrees +/- 0.41).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773821
TI  - Tibial-talar dislocation without fracture: treatment principles and outcome.
AB  - The incidence of tibial-talar dislocations without fracture is unknown and has
      been sparsely reported in the literature. The diagnosis of the injury is
      straightforward with the appropriate examination and roentgenograms. Good to
      excellent results can be achieved with open or closed dislocations treated by
      closed reduction and immobilization for 4-6 weeks. Although open dislocations
      require irrigation, debridement, and possibly delayed closure, controversy exists
      with regard to acute ligament repair. Because good to excellent results are
      possible without acute ligament repair, and delayed repair on reconstruction can
      be accomplished with good outcomes, we recommend treating these injuries without
      ligament repair.

PMID- 7773822
TI  - Arthroscopic shoulder stabilization using Mitek anchors.
AB  - The purpose of this paper is to report our experience with an arthroscopic
      stabilization technique using bone anchors in the treatment of chronic
      unidirectional anterior-inferior shoulder instability. 30 of 32 patients (average
      age, 26 years) were followed for an average of 24 months (range 12 to 36). There
      were 28 patients with dislocations and four with subluxations. In the group of
      the dislocators five patients had more than 10 dislocations and 15 patients
      between one and seven (average three). In 68% a sport injury was the reason for
      the first dislocation. Due to the length of the labroligamentous detachment two
      to four anchors were used for stabilization. According to the criteria of Rowe,
      in the group of the subluxators (4) two had an excellent and two a good result.
      In the group of the dislocators (26) two patients dislocated their shoulder again
      after reconstruction without a new accident, one had a recurrent dislocation from
      significant trauma. Two of them had an open stabilization afterwards. Overall
      there were 53.9% excellent, 34.6% good and 11.5% poor results. In 50% there was
      no restriction of shoulder motion, 21% had a loss of external rotation of 5
      degrees and 29% of 10 degrees. Arthroscopic shoulder stabilization with help of
      Mitek anchors seems to be a good method for treatment of chronic unidirectional
      anterior-inferior instabilities with less than 10 dislocations preoperatively.
      All patients, who suffered a spontaneous recurrent dislocation, had more than 10
      dislocations before. In these cases this arthroscopic procedure is not suited to
      restore stability, even if a Bankart-lesion is present.

PMID- 7773823
TI  - Postoperative analgesic effects of intra-articular bupivacaine and morphine after
      arthroscopic cruciate ligament surgery.
AB  - Intra-articular administration of local anaesthetics such as bupivacaine can
      produce short-term postoperative analgesia in patients undergoing diagnostic
      arthroscopy or arthroscopic meniscectomy. A peripheral anti-nociceptive effect
      may also be induced by the administration of intra-articular opiates interacting
      with local opioid receptors in inflamed peripheral tissue. In the present study
      we aimed to study the analgesic effects of intra-articularly given bupivacaine
      and morphine sulphate (as well as the combination of both drugs) on postoperative
      pain. In a prospective, randomized, double-blind manner 40 patients received one
      of the following: (a) morphine (1 mg in 20 ml NaCl), (b) bupivacaine (20 ml,
      0.375%), (c) combination of both or (d) saline (20 ml, control group) intra
      articularly at the end of arthroscopic anterior cruciate ligament (ACL)
      reconstruction. The postoperative pain was assessed via a visual analogue scale
      (VAS) during the first 48 h after surgery, and supplemental analgesic
      requirements were noted. All comparisons were made versus the control group
      receiving saline. The pain scores were significantly lower in the morphine group
      at 24 and 48 h, and in the bupivacaine group at 2, 4 and 6 h after surgery. In
      the group that received a combination of both bupivacaine and morphine, the pain
      scores were significantly reduced throughout the whole postoperative observation
      period. No side-effects or complications from therapy were seen in any of the
      groups. The conclusion of this study is that intra-articular morphine is
      effective in the postoperative period after arthroscopic ACL
      reconstruction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7773824
TI  - Effect of knee flexion on the in situ force distribution in the human anterior
      cruciate ligament.
AB  - This study was conducted to evaluate the effect of applied load on the magnitude,
      direction, and point of tibial intersection of the in situ forces of the
      anteromedial (AM) and posterolateral (PL) bands of the human anterior cruciate
      ligament (ACL) at 30 degrees and 90 degrees of knee flexion. An Instron was used
      to apply a 100 N anterior shear force to 11 human cadaver knees, 6 at 30 degrees
      of knee flexion and 5 at 90 degrees of knee flexion. A Universal Force Sensor
      (UFS) recorded the resultant 6 degree-of freedom (DOF) forces/moments. Each
      specimen then underwent serial removal of the AM and PL bands. With the knee
      limited to 1 DOF (anteroposterior), tests were performed before and after each
      structure was removed. Because the path was identical in each test, the principle
      of superposition was applied. Thus, the difference between the resultant forces
      could be attributed to the force carried by the structure just removed. The
      magnitudes of force in the ACL at 30 degrees and 90 degrees of knee flexion were
      114.1 +/- 7.4 N and 90.8 +/- 8.3 N, respectively (P < 0.05). At 30 degrees, the
      AM and PL bundles carried 95% and 4% of the total ACL force, respectively. At 90
      degrees, the AM and PL bands carried 85% and 13%, respectively (P < 0.05). The
      direction of the in situ force in the whole ACL as well as its two bands
      correlated with the anatomic orientation of the ligament.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7773825
TI  - [Diagnostic house call within the scope of inpatient geriatric assessment].
AB  - The value of a diagnostic home visit as part of hospital-based geriatric
      assessment was examined in a prospective study. 141 subjects admitted from home
      to the geriatric hospital and showing functional decline with risk of nursing
      home placement underwent a comprehensive geriatric assessment and a diagnostic
      home visit. In 19.1% of the patients, the diagnostic visit resulted in a change
      of time, and in 14.9% in a change of location of discharge. Up to seven problems
      were newly discovered (mean 2.1). To maintain independence up to six technical
      aids were prescribed (mean 2.3). The most common recommendations were related to
      safety (59.2% of all cases). In 89.3% the diagnostic home visit was judged
      necessary by the home intervention team. A follow-up visit after 3 months
      revealed that about 80% of all recommendations were implemented and approximately
      the same amount of technical aids were still used. The diagnostic home visit
      allows individual prescription of technical aids, when necessary. It contributes
      meaningful information to the geriatric assessment process and helps to achieve
      successful in-hospital therapy and discharge planning. It can be recommended
      especially for elderly patients at risk for losing their independence.

PMID- 7773826
TI  - [Discharge from the geriatric clinic: factors predicting independent living at
      home].
AB  - This article presents the predictors for living at home 3 months, 6 months, 12
      months, and 24 months after hospitalization in a geriatric clinic. The
      multivariate regression analysis revealed the predictive factors for living at
      home after 3 months: Incontinence, functional status judged by the physician, and
      balance performance. For living at home at 6 months, balance performance,
      handgrip were predictive, and at 12 months, balance performance, physicians
      judgement of functional abilities and Barthel-Index had the most predictive
      value. The only factor that was recognized to be predictive for living at home at
      24 months was the physician's judgement of the functional abilities of the
      patient. It is concluded that the functional status measured by observation but
      preferably by performance is of predictive value for living at home from 6 months
      to 12 months after acute hospitalization.

PMID- 7773827
TI  - [Resident Assessment Instrument (RAI): a system for client evaluation and
      documentation in long-term care--an overview].
AB  - This article describes the interdisciplinary care planning system "Resident
      Assessment Instrument" (RAI) for nursing homes with its parts, the Health Care
      Financing Administration mandated "Minimum Data Set" (MDS) and the "Resident
      Assessment Protocols" (RAPs). The MDS-derived case mix system for resource
      allocation, the Resource Utilization Groups (RUGs), are mentioned. The
      prerequisites for an implementation of the F.R.G. are discussed.

PMID- 7773828
TI  - [The "Geriatric Assessment" Study Group (AGAST): recommendations for the use of
      assessment procedures].
AB  - This work presents preliminary recommendations for a three-step geriatric
      assessment approach developed by a newly created working group consisting of
      members from nine geriatric departments in Germany and Switzerland. The
      recommendations were based on a literature review, expert consultation, and a
      consensus meeting. As part of this effort, instruments and guidelines for
      selected geriatric assessment instruments were translated and will be tested in
      German language. Further research is planned for refining the recommended method.
      Currently, these recommendations might help to stimulate the spread of geriatric
      assessment method in German-speaking areas and facilitate joint research projects
      among geriatric institutions.

PMID- 7773829
TI  - [Geriatric assessment: possibilities and limits].
AB  - A recent meta-analysis has shown that comprehensive geriatric assessment can
      reduce mortality, increase survival at home, and improve functional status in
      elderly patients. Despite their high effectiveness, geriatric assessment programs
      have not yet been widely introduced into clinical practice. This review discusses
      the following four factors potentially explaining the limited spread of geriatric
      assessment programs. 1) There is a lack of accepted targeting criteria to select
      patients who need evaluation and management in costly in patient geriatric units.
      2) There are effectiveness gaps in current knowledge on modifiable disability
      risk factors. 3) Geriatric assessment programs have been insufficiently
      integrated into the continuity of primary care. 4) More data are needed for
      evaluating the cost of geriatric assessment. Interdisciplinary research might
      help to optimize geriatric assessment programs and, at the same time, might
      ensure access of elderly patients to appropriate geriatric assessment programs
      despite current restraints in health care costs.

PMID- 7773830
TI  - [Identification of functional deficits in the acute hospital by geriatric
      assessment].
AB  - Functional deficits of elderly patients are often not recognized during routine
      treatment in acute hospital care. In Germany, there are only limited experiences
      with the use of standardized assessment-scales in this health care setting. In
      this study, 112 patients were recruited for a very broad geriatric assessment
      focused on methodological and practical questions. There were 38.8% with deficits
      in the ADL and 12.6% with depressive symptoms. Many patients showed low
      motivational factors such as energy, efficacy and will. Geriatric syndromes such
      as malnutrition were also very common. In general, many patients in acute care
      hospitals have functional deficits which are not recognized by the physicians.
      For many patients, short instruments are sufficient for screening purposes. The
      effectiveness of a complete geriatric assessment depends mostly on the use of
      good selection criteria.

PMID- 7773831
TI  - [Diagnosis of depression in the elderly. The "Geriatric Depression Scale"].
AB  - Psychiatric diseases are very common among elderly people. Depressions rank
      before dementias in this age group. 2-2.5 million people aged over 65 years are
      suffering from symptoms of depression in Germany. Patients with Mayor Depression
      Disease (MDD) have a poor prognosis. MDD should therefore be recognized and
      treated in community dwelling elderly, in nursing homes and in hospitals.
      Underdiagnosis of MDD is well documented in the medical literature. Only a
      quarter of patients with a MDD are detected. By a short screening test for
      depression such as the Geriatric Depression Scale (GDS) depressed patients can be
      identified. With a sensitivity and specificity of about 70%. The time needed to
      perform the short form of the GDS is only 5-7 min. The GDS is an important part
      of many assessment programs in England and USA. It is also recommended in Germany
      by the "Geriatric Assessment" working group.

PMID- 7773832
TI  - Effectiveness of hospital-based geriatric evaluation and management and home
      intervention team (GEM-HIT). Rationale and design of a 5-year randomized trial.
AB  - In this ongoing randomized controlled trial the effectiveness of an
      interdisciplinary team implementing hospital-based comprehensive geriatric
      assessment (CGA) and home intervention is being studied. All patients admitted
      from home showing functional decline with impairment of any basic activity of
      daily living are randomly assigned to one of the following courses of treatment:
      CGA with in-hospital and post discharge management by a home intervention team
      (HIT), where necessary (group 1): CGA with recommendations and usual care at home
      (group 2); or usual hospital and home care (group 3). The HIT consists of 3
      nurses, 1 geriatrician, 1 physiotherapist, 1 occupational therapist, and 1 social
      worker. 540 patients will be recruited for the trial, which will assess the
      effects of GEM-HIT on the following outcomes: health status, functional status,
      survival, hospital readmission, nursing home placement and costs. The purpose of
      the GEM-HIT trial is to answer many of the current questions concerning treatment
      and health care delivery for frail older persons under the specific conditions
      found in Germany. The large sample size and the broad range of diagnoses included
      in the study will allow the evaluation of effects of GEM-HIT for subgroups and
      may help to identify the most effective assessment tools for use within our
      particular context.

PMID- 7773833
TI  - Comprehensive geriatric assessment and medication compliance.
AB  - Patient compliance is an essential therapeutic factor which is crucial to
      outcome. There is a recent surge of interest in compliance issues evoked by
      reliable and feasible measurement methods. In particular, data  on real-time
      dosing facilitate the interpretation of drug effects. This information can be
      used in patient counseling. Comprehensive geriatric assessment is likely to
      detect major reasons of non-intentional non-compliance. A medication review
      should include several questions on patient compliance behavior for which
      examples are proposed. Systematic geriatric assessment is likely to improve
      rational prescribing of pharmacotherapy in the elderly. This will also contribute
      to ensure patients compliance.

PMID- 7773834
TI  - Gender differences in age-related physiological changes and some diseases.
AB  - The clinical and laboratory data from a cross-sectional and a longitudinal study
      of healthy individuals between 50-89 years of age and that of centenarians were
      compared. The examination showed that in healthy elderly subjects and
      centenarians most of the clinical laboratory findings were in the normal range.
      However, age-related changes could be observed in erythrocyte sedimentation rate,
      in serum albumin level, and in the frequency of rheuma factor. Gender difference
      could be seen in the HDL-cholesterol level. Age and sex differences were observed
      in the hematocrit-, and hemoglobin-values, in serum creatinine-, total
      cholesterol-, serum IgG, IgA, IgM-levels, and in the frequency of the occurrence
      of antinuclear factor. The examinations demonstrated that lower hemoglobin and
      hematocrit values, elevated total-cholesterol level, the presence of antinuclear
      and rheuma factor, and elevated systolic blood pressure were more frequent in
      females than in males. It could be stated, however, that the mentioned changes
      did not prevent females from having a longer life span than males.

PMID- 7773835
TI  - [The main principles of the new nursing care insurance regulation].

PMID- 7773837
TI  - Collaboration in nursing: NOLF and NFSNO.

PMID- 7773836
TI  - [Method and organization of geriatric assessment].
AB  - The intention of a Geriatric Assessment (GA) is a more systematic and exact way
      to examine a wide range of activities of daily life. This can be achieved by the
      help of scientifically proved and standardized investigations which complete the
      medical judgment with objective and comparable results. This type of examination
      controls the selective observation of the investigator and makes reexamination
      easier. Moreover, this way of gaining information gives reliable hints about non
      apparent or difficult-to-estimate risks of a patient. The methods of GA have to
      be adapted to different qualities of resources which will be assessed: physical
      resources should be assessed by standardized ways of observation; the patient's
      subjective well-being should be examined by standardized interviews. The
      standardized instruments of measurement are fairly independent from personal
      qualifications of the investigator.

PMID- 7773838
TI  - Prevention works! With the nursing link.

PMID- 7773839
TI  - Salutogenesis: an organizing structure for addictions nursing.

PMID- 7773840
TI  - Dual specialization for addiction nurses.

PMID- 7773841
TI  - The role of the addictions nurse specialist in adult psychiatry.

PMID- 7773842
TI  - Survey of addiction education of Iowa nursing students.

PMID- 7773843
TI  - Creative sessions illustrate methods of prevention at 1994 conference.

PMID- 7773844
TI  - Certification update.

PMID- 7773845
TI  - Readiness for recovery.

PMID- 7773846
TI  - Comparison of outcomes between acute care general hospital transfers and direct
      admissions to a detoxification unit.

PMID- 7773847
TI  - Alcohol and drug problems in the elderly.

PMID- 7773848
TI  - Recommendations for fluoride.

PMID- 7773849
TI  - Immediate implant post-surgical complications.
AB  - Immediate surgical implants provide a convenient means of replacing missing teeth
      without requiring hard tissue reduction of restoration-free potential fixed
      partial denture abutments. Although the procedure is described as "predictable,"
      complications and failures do occur. This report presents four cases of immediate
      implant complications and their management, and discusses possible causes of the
      untoward results. Careful pre-operative planning, adequate surgical technique and
      post-surgical management, timely and suitable loading, and meticulous hygiene
      maintenance can serve to minimize implant complications and failures. The
      prospective immediate implant patient must be provided with sufficient
      information to allow informed consent to be given. Minimal requirements are a
      description of the procedures in terms the patient can understand, an explanation
      of potential risks and complications, and adequate disclosure of information
      about alternative therapies.

PMID- 7773850
TI  - Effectiveness of a topical antifungal regimen for the treatment of oral
      candidiasis in older, chronically ill, institutionalized, adults.
AB  - Because of predisposing systemic disease, the frequent administration of
      medication, and the use of a complete denture, oral candidiasis is a common
      problem among older, chronically ill, institutionalized adults. This randomized
      clinical trial was designed to evaluate the effectiveness of an antifungal
      denture soaking solution (48 mL nystatin liquid, 100,000 IU/mL, dissolved in 432
      mL of distilled water producing 10,000 IU nystatin mL solution), used as an
      adjunct to a nystatin vaginal lozenge (100,000 IU/g, dissolved in the mouth three
      times daily for seven days) in a group of older, chronically ill,
      institutionalized adults. Although the clinical signs and symptoms of oral
      candidiasis were resolved in all subjects following therapy, the presence of
      invasive Candida hyphae was detected in approximately 80 per cent of tissue
      and/or dentures. When compared to tap water, the use of an antifungal denture
      soaking solution produced no detectable difference in the presence of Candida
      albicans hyphae over a three-month period (M-H chi-square = 0.021, p = 0.886),
      but it did reduce the rate of recurrence of clinical signs and symptoms. The
      appropriateness of this regimen for the treatment of oral candidiasis in this
      type of patient is challenged.

PMID- 7773851
TI  - Submerged versus non-submerged dental implants: a comparison.

PMID- 7773852
TI  - Financially free and fifty something: pipe dream or possibility? (2).

PMID- 7773853
TI  - How successful is your dental practice?--10 performance criteria.

PMID- 7773854
TI  - Consent--is it informed and valid?

PMID- 7773855
TI  - Suicide--no margin for error.

PMID- 7773857
TI  - Patient education: the key to a successful practice in turbulent times.

PMID- 7773856
TI  - "Team dynamics 2000": patient care and practice management.

PMID- 7773858
TI  - Letters count.

PMID- 7773859
TI  - The future of third-party plans.

PMID- 7773860
TI  - To spit or expectorate?

PMID- 7773861
TI  - Informed consent.

PMID- 7773862
TI  - Making a good first--and lasting--impression.

PMID- 7773863
TI  - War is an atrocious thing.

PMID- 7773864
TI  - Ash Temple Limited--a century of service.

PMID- 7773865
TI  - Orthognathic surgery and the family dentist.
AB  - In general, orthognathic surgery is a reliable, appropriate and prudent treatment
      option to correct maxillofacial deformities that cannot be managed by nonsurgical
      means alone. Unfavorable outcomes are relatively rare, but the statistical
      frequency of these complications loses its meaning in those cases where they
      occur. If a complication happens to an individual patient, it represents a one
      hundred per cent incidence for that individual. For this reason, prior to the
      provision of treatment it is vitally important to obtain informed consent,
      ideally by establishing the widest possible information base on which meaningful
      communication can be built for the patient, the orthodontist, the surgeon, and
      the family dentist.

PMID- 7773866
TI  - Uncommon postoperative temporomandibular joint complications.

PMID- 7773867
TI  - Effects of home bleaching on the tissues of the oral cavity.
AB  - Eight subjects used a 10 per cent carbamide peroxide (Opalesence) home bleaching
      system in a mouthguard for 14 nights. Their periodontal health was assessed by
      measuring gingival crevicular fluid flow with a Periotron 6000, and subjects were
      given a questionnaire to assess the effects of the bleaching system. There was no
      significant change in the gingival crevicular fluid flow, recession, bleeding
      index or plaque index of any patient during the treatment phase. All treated
      teeth were lightened, and mild transient tooth sensitivity was common to all
      participants. One subject experienced internal tooth discoloration, possibly due
      to marginal leakage around an amalgam restoration.

PMID- 7773868
TI  - Dental amalgam: scientific consensus and CDA policy.

PMID- 7773869
TI  - Papillon-Lefevre syndrome associated early onset periodontitis: a review and case
      study.
AB  - A case of Papillon-Lefevre syndrome that has been managed successfully for six
      years is reported. Papillon-Lefevre syndrome is a rare form of early onset
      periodontitis that occurs at a rate of 1-3 per million. Diagnostic features
      include palmar-plantar hyperkeratosis and rapid periodontal destruction. Although
      the etiology of this syndrome is unknown, current theories on the nature of the
      underlying defect fall into three main categories: anatomical, bacterial and host
      response. Historically, Papillon-Lefevre syndrome was thought to lead to the
      inevitable loss of both the primary and permanent dentitions. However, a recently
      proposed treatment involving antibiotic coverage, extraction of the primary
      dentition and a period of edentulism has been shown to be effective in
      maintaining the permanent dentition. Since treatment may begin prior to the
      eruption of the permanent dentition, early recognition of Papillon-Lefevre
      syndrome is critical. Any young patient who exhibits palmar hyperkeratosis should
      be examined carefully for periodontal breakdown. Since the number of cases
      available for study is limited, referral of such individuals to University dental
      clinics may allow for a more specific analysis of immune or bacterial factors
      that may lead to a better understanding of this disease.

PMID- 7773870
TI  - Osteomyelitis of the jaws.
AB  - Osteomyelitis is described as an inflammation of bone and bone marrow that may
      develop in the jaws following a chronic odontogenic infection or for a variety of
      other reasons. This situation may be acute, sub-acute or chronic, resulting in a
      totally different clinical picture.

PMID- 7773871
TI  - MR demonstration of an anomalous muscle in a patient with coexistent carpal and
      ulnar tunnel syndrome. Case report and literature summary.
AB  - An aberrant muscle is demonstrated by magnetic resonance (MR) imaging in a
      patient presenting with focal wrist swelling and compression neuropathy of median
      and ulnar nerves following 4 months of carpentry work. The muscle originated from
      the palmaris longus tendon and ulnar antebrachial fascia at the lower half of the
      forearm as a single belly, then diverged medially from palmaris longus tendon and
      bifurcated. Both portions of the split muscle extended into the distal ulnar
      tunnel or Guyon's canal. One segment joined with the abductor digiti minimi
      muscle and the other with the flexor retinaculum. MR was able to clearly
      delineate this hypertrophied, symptomatic muscle anomaly. It may be helpful when
      mass effect is suspected in either tunnel, or in patients with atypical work
      related carpal tunnel syndrome with evidence of significant ulnar neuropathy for
      evaluation of underlying anomalous musculature. Normal MR images of the wrist are
      included for comparison and the literature is reviewed.

PMID- 7773872
TI  - Cat-scratch disease. Subtle vertebral bone marrow abnormalities demonstrated by
      MR imaging and radionuclide bone scan.
AB  - Cat-scratch disease (CSD) is a benign, self-limited cause of lymphadenitis
      occurring mainly in children and young adults. Its etiology is a delicate, small
      gram-negative pleomorphic bacillus. Less common manifestations of CSD are seen in
      5% of patients and include Parinaud's oculoglandular syndrome (with enlargement
      of the preauricular nodes), parotid gland enlargement, encephalitis,
      radiculopathy, pneumonitis, erythema nodosum, thrombocytopenia, and lytic bone
      lesions. We describe a patient in whom magnetic resonance imaging initially
      detected subtle vertebral bone marrow abnormalities that correlated with the site
      of abnormality on a subsequent radionuclide bone scan.

PMID- 7773873
TI  - MR characteristics of low-flow facial vascular malformations in children and
      young adults.
AB  - The purpose of this report is to describe the magnetic resonance (MR) imaging
      characteristics of low-flow vascular malformations of the face. We studied six
      patients ranging in age from 1 month to 20 years old, with surgically proven or
      clinically certain low-flow vascular malformations of the face. T1-weighted MR
      images of five lesions showed homogeneous intermediate to low signal intensity,
      similar to the signal intensity of muscle. T1-weighted images of one lesion
      showed mild high signal intensity and image of another demonstrated fatty
      infiltration. After contrast administration, images of four lesions showed
      moderate to marked enhancement, three diffused and one patchy. On T2-weighted
      sequences, five lesions were heterogeneously of high signal and one of low signal
      intensity. Three lesions exhibited low-signal septa, and two revealed low-signal
      vascular flow voids on both types of sequences. Satellite nodules were present in
      three instances. Low-flow vascular malformations involving the face in children
      and young adults have a heterogeneous and nonspecific appearance on MR images.
      They should be considered in the differential diagnosis of all facial masses
      presenting in children and young adults. Enhancement with contrast material is
      essential to localize the mass.

PMID- 7773875
TI  - Squamous cell carcinoma of the thymus with paraneoplastic hypercalcemia.
AB  - Primary thymic carcinoma is a rare neoplasm that in contradistinction to thymoma,
      is not supposed to be associated with a paraneoplastic syndrome. A 73-year-old
      man, with new onset of disorientation, was found to have an elevated serum
      calcium level as the cause. Computed tomography demonstrated a mediastinal mass,
      pericardial invasion, and metastases to the lung. Examination of a biopsy
      specimen revealed thymic squamous cell carcinoma. Thus, a paraneoplastic
      syndrome, in this case hypercalcemia, does not exclude primary carcinoma of the
      thymus.

PMID- 7773874
TI  - Cholelithoptysis: an unusual complication of laparoscopic cholecystectomy.
AB  - Laparoscopic cholecystectomy is emerging as a preferred surgical method in the
      treatment of cholecystitis. Decreased morbidity and mortality rates make this an
      attractive alternative to conventional cholecystectomy. Recently, specific
      complications including bile duct transection, biloma formation, and liver
      lacerations have been reported. We report here, however, an unusual case of
      intraoperative spillage of stones into the intraperitoneal cavity. Subsequent
      erosion through the diaphragm resulted in expectoration of stones, or
      cholelithoptysis.

PMID- 7773876
TI  - Pleurocutaneous fistula as a complication of oleothorax. CT findings in three
      patients.
AB  - The purpose of this study was to highlight pleurocutaneous fistula, documented on
      computed tomography (CT) scans, as a complication of oleothorax. CT images of the
      chest were evaluated retrospectively in three patients with pleurocutaneous
      fistula complicating oleothorax. The images documented oleothorax rupture in all
      three, with only one patient (case 2) showing concomitant surrounding chest wall
      and axillary inflammatory reaction. Surgery performed on one patient (case 1)
      confirmed the CT findings. While CT is invaluable in the demonstration of
      complications of oleothorax, to our knowledge CT depiction of oleothorax has not
      been reported in the literature. This complication may be more common than
      described in earlier literature, with the advent of cross-sectional imaging. In
      the right clinical setting, CT findings of inflammation or edema surrounding the
      oleothorax rupture may warrant surgical intervention.

PMID- 7773878
TI  - CT of secondary neoplasms. Unusual structural features--a pictorial essay.
AB  - The newer anticancer therapies, the routine employment of cross-sectional imaging
      modalities for staging and follow-up, and the increased survival rate of patients
      with neoplastic lesions have markedly widened the range of pathological and
      imaging features of secondary neoplasms. Moreover, the changes occurring in
      morphological and structural aspects of metastases may be the direct effect of
      the improved therapeutic tools, and in turn may offer revealing clues to the
      clinician regarding the outcome of therapy itself. The scope of this essay is to
      show the atypical computed tomographic (CT) aspects of a series of metastatic
      lesions. We selected the lesions on the basis of their unusual structural
      features, such as calcification; hemorrhage; superinfection; pseudocystic,
      cystic, and lipoid appearance; and hypervascularity. A highly detailed assessment
      of such changes is nowadays possible and appears mandatory.

PMID- 7773879
TI  - A 24-year-old man with diplopia and frontal headache.

PMID- 7773880
TI  - Radiological evaluation of the craniocervical junction in bone dysplasias and
      other related syndromes.
AB  - The craniocervical junction, a vital but anatomically complex region, presents
      additional interpretative challenges in patients with skeletal dysplasias and
      other syndromes involving the musculoskeletal apparatus. Our objective was to
      review the radiological evaluation used in such conditions; to do so, we
      identified retrospectively all of the occipitocervical studies done during the
      last 3 years at our institution on patients with skeletal dysplasias and related
      syndromes. The 28 cases thus found were reviewed and the different diagnostic
      modalities identified; the diagnostic findings were summarized and classified
      into osseous and soft tissue abnormalities. The standard criteria for cervical
      instability and cord compression were compared with measurements reported in our
      selected cases. The lateral radiograph of the cervical spine was the first
      diagnostic test, followed by additional flexion-extension views and sagittal spin
      echo magnetic resonance imaging; no conclusive diagnostic criteria for
      occipitoatlantal instability in children with bone dysplasias were identified.

PMID- 7773877
TI  - Emphysematous gastritis in an immunocompromised host.
AB  - Emphysematous gastritis is a rare, often lethal condition of gastric mural
      inflammation and gaseous dissection. Infection with gas-forming organisms is the
      most frequently cited cause. In all previously reported patients, the clinical
      presentation was dramatic. We report on an immunocompromised host who had a
      surprisingly subtle clinical presentation.

PMID- 7773881
TI  - Hypoplasia of the right hepatic lobe with ectopy of the gallbladder.
AB  - Two cases of hypoplasia of the right hepatic lobe with gallbladder ectopy, which
      were diagnosed by computed tomography, are reported here. In each patient, the
      left hepatic lobe was enlarged. The gallbladder was located in the inferior
      portion of the liver in one patient and immediately below the right hemidiaphragm
      in the other. No other anomalies complicated these two cases. It should be kept
      in mind that hepatic lobe anomalies may have associated ectopy of the
      gallbladder.

PMID- 7773882
TI  - Intrahepatic, extramedullary hematopoiesis mimicking hemangioma on technetium-99m
      red blood cell SPECT examination.
AB  - Cavernous hemangiomas are the most common lesion of the liver. Because of the
      risk of hemorrhage inherent in percutaneous biopsy of such lesions,
      noninterventional modalities (such as CT, ultrasound, MRI and Technetium-99m red
      blood cell imaging) have been utilized for differentiating them from other
      lesions. The sensitivities and specificities of these techniques vary greatly.
      Technetium-99m red blood cell imaging with planar and SPECT imaging has been
      shown to have an overall sensitivity of 89%, a specificity of 100%, and an
      overall accuracy of 92%. Despite its high accuracy, rare false positives have
      been reported with Technetium-99m red blood cell imaging with SPECT. Review of
      the literature indicates four cases of hepatocellular carcinoma, one case of
      hepatic angiosarcoma, and one case of hepatic metastases from colorectal
      carcinoma as having an appearance identical to hemangioma with this modality. We
      present an additional false positive of a focal region of intrahepatic
      extramedullary hematopoiesis in a patient with Gaucher's disease as having an
      appearance on Technetium-99m red blood cell imaging with SPECT identical to that
      of hemangioma.

PMID- 7773883
TI  - Sacral insufficiency fractures. Spectrum of radiological features.
AB  - Clinical and radiological features of 22 Chinese patients with sacral
      insufficiency fractures were reviewed. Twenty-one were postmenopausal women.
      Other risk factors were external pelvic radiotherapy (eight) and total hip
      replacement (two). Severe low back pain was the most common presenting complaint.
      Fractures initially were demonstrated by bone scintigraphy in 21 and computed
      tomography (CT) in seven patients. Concomitant parasymphyseal and pubic rami
      fractures were detected in 17 and 10 patients, respectively. Follow-up assessment
      by CT and bone scintigraphy in five patients showed various stages of fracture
      healing. Recognition of the radiological patterns of this entity is emphasized.

PMID- 7773884
TI  - Medical newsletters: funding and interests should be stated.

PMID- 7773885
TI  - Controversy over use of pregnant mare's urine.

PMID- 7773886
TI  - Controversy over use of pregnant mare's urine.

PMID- 7773887
TI  - Controversy over use of pregnant mare's urine.

PMID- 7773888
TI  - Government waste confuses physician.

PMID- 7773890
TI  - Trauma kits on trains lack equipment.

PMID- 7773889
TI  - Gun control.

PMID- 7773892
TI  - Financial assistance needed for Tanzanian medical student.

PMID- 7773891
TI  - Physician-assisted death: suicide prevention and patient autonomy.

PMID- 7773893
TI  - A global network for medical journal editors.

PMID- 7773895
TI  - Factors associated with the decision of family physicians to provide intrapartum
      care.
AB  - OBJECTIVE: To investigate which characteristics and beliefs of family physicians
      determine their decision to provide intrapartum care. DESIGN: Confidential survey
      questionnaire mailed in spring 1993. SETTING: Alberta and Ontario. SUBJECTS:
      Random selection of 207 physicians who had graduated from medical school between
      1953 and 1990 and were thought to be in family or general practice. Of 178
      eligible physicians, usable replies were received from 104 (58.4%). OUTCOME
      MEASURES: Beliefs (measured on a 7-point Likert scale) about the relevance of 16
      primary factors to the type of obstetric care provided; demographic, training and
      practice characteristics. RESULTS: The respondents who provided intrapartum care
      differed from those who did not in their beliefs about the availability of a
      local hospital suitable for intrapartum care (p < 0.001), their practice
      partners' views on the role of family physicians in providing obstetric care (p <
      0.002), their own concept of the role of family physicians in providing obstetric
      care (p < 0.001) and women's views on the type of obstetric care they want (p <
      0.002). They also differed, although less significantly, in their beliefs about
      the adequacy of their obstetric training before entering family practice (p <
      0.04), the expected effects of providing obstetric care on their free time (p <
      0.006), their fear of malpractice litigation (p < 0.028) and their perceived
      competence in performing practical obstetric procedures (p < 0.05). Logistic
      regression analysis revealed that certain secondary factors were particularly
      relevant to the respondents' provision of intrapartum care at present. These
      included the physician's perceived competence at managing postpartum maternal
      hemorrhage (odds ratio [OR] 48.90, 90% confidence interval [CI] 4.70 to 509), the
      belief that medical insurance premiums should not be affected by the type of
      obstetric care provided (OR 3.55, 90% CI 1.67 to 7.57]) and the number of
      practice partners who provided intrapartum care (OR 10.08, 90% CI 2.31 to 44.10).
      CONCLUSION: Several factors appear to influence family physicians in their
      decision to provide intrapartum care. This information will help to focus efforts
      to provide appropriate obstetric training for family practice residents and to
      retain involvement of family physicians in intrapartum care.

PMID- 7773896
TI  - Small-area variations in utilization of abortion services in Ontario from 1985 to
      1992.
AB  - OBJECTIVE: To assess interregional differences in the utilization of abortion
      services in Ontario from 1985 to 1992. DESIGN: Retrospective analysis of
      provincial therapeutic abortion database. SETTING: All hospitals conducting
      abortions between 1985 and 1992 and all free-standing abortion clinics conducting
      abortions between 1990 and 1992. POPULATION: All women in Ontario aged 15 to 44
      years who underwent a therapeutic abortion in Ontario during the study period.
      OUTCOME MEASURES: Utilization of abortion services by county and age-specific
      abortion rates by county of residence. RESULTS: From 1985 to 1989, when only
      hospital data were gathered, the mean therapeutic abortion rate increased by
      11.2%. From 1990 to 1992, when data from hospitals and free-standing clinics were
      collected, the mean rate increased by 26.5%. Logistic regression analysis showed
      significant variation in the age-standardized abortion rates between counties in
      each study year (p < 0.0001). The counties with age-standardized rates below the
      25th percentile had the highest proportions of women who sought abortion services
      outside their county of residence; in some of these counties no abortions were
      performed in local facilities. CONCLUSION: There are interregional variations in
      the utilization of abortion services in Ontario. These disparities raise
      questions about the accessibility of abortion services and need to be further
      investigated.

PMID- 7773898
TI  - Camphorated oil: still endangering the lives of Canadian children.
AB  - Camphor is a volatile, aromatic compound familiar to many people as a principal
      ingredient in topical home remedies for colds. It is highly toxic when ingested.
      Although camphorated oil in concentrations of 11% or greater is not longer sold
      in the United States, preparations containing concentrations of up to 20% are
      still sold over the counter in Canada. The authors describe two children who
      suffered severe poisoning after accidental ingestion of a small amount of
      camphorated oil. Both children exhibited generalized tonic-clonic seizures with
      subsequent respiratory depression. Treatment was symptomatic, consisting of
      seizure control and respiratory assistance. The authors argue that because
      camphorated oil is of questionable benefit and poses a danger to the public it
      should be removed from the market.

PMID- 7773897
TI  - Correlates of body mass index in the 1990 Ontario Health Survey.
AB  - OBJECTIVES: To determine the average body mass index (BMI) and the prevalence of
      overweight and obesity among people aged 20 to 64 years, to identify
      sociodemographic, lifestyle and health variables that correlate with overweight
      and obesity, and, through a comparison of the results with those from an earlier
      survey, to determine whether prevalence has changed over time. DESIGN: Cross
      sectional survey. SETTING: Ontario. PARTICIPANTS: The 1990 Ontario Health Survey
      surveyed 61,239 people representative of the Ontario population. The authors'
      analyses were restricted to those aged 20 to 64 years, excluding pregnant women.
      In the multivariate analyses they included only people with no missing values for
      any of the variables in the models (n = 26,306). OUTCOME MEASURES: BMI (weight in
      kilograms divided by height in metres squared) was used to measure healthy weight
      (BMI between 20 and 25), overweight (BMI greater than 25) and obesity (BMI
      greater than 27). RESULTS: The prevalence of obesity among men and women was
      33.6% and 22.8% respectively (adjusted odds ratio [OR] 1.78, 95% confidence
      interval [CI] 1.63 to 1.95). There was a positive relation with age (adjusted OR
      1.53 [95% CI 1.24 to 1.89] for age 25 to 29 years and 2.78 [95% CI 2.20 to 3.51]
      for age 50 to 54 years compared with age 20 to 24 years) and an inverse relation
      with education level (postsecondary education v. primary education: adjusted OR
      0.65 [95% CI 0.54 to 0.79]). Analysis of birthplace showed that the prevalence of
      obesity was lowest among those born in Asia (compared with Canadian born:
      adjusted OR 0.36 [95% CI 0.27 to 0.47]). The prevalence was higher among former
      smokers than among those who had never smoked (adjusted OR 1.20 [95% CI 1.18 to
      1.22]). People with more health problems and those who rated their health as fair
      or poor were more likely to be obese. The estimates of the prevalence of obesity
      were higher than those reported in the 1985 Health Promotion Survey for both
      sexes in all three age groups examined. CONCLUSIONS: These self-reported data
      indicate that overweight and obesity remain important health problems in Ontario,
      and the prevalence appears to be increasing.

PMID- 7773899
TI  - Statement on travellers and sexually transmitted diseases.

PMID- 7773894
TI  - Nutrient needs and feeding of premature infants. Nutrition Committee, Canadian
      Paediatric Society.
AB  - OBJECTIVE: To recommend appropriate intake of nutrients, food sources and feeding
      practices for premature infants. OPTIONS: Unfortified milk from the premature
      infant's own mother, fortified milk from the premature infant's own mother,
      formula designed for preterm infants and parenteral nutrition. OUTCOMES: From
      birth to 7 days, the minimum achievable goal is the provision of sufficient
      nutrients to prevent deficiencies and catabolism of nutrient substrate in
      premature infants; from 7 days to discharge from the neonatal intensive care
      unit, growth and nutrient retention at a rate similar to that which would have
      been achieved had the infant remained in utero; and for 1 year following
      discharge, nutrient intake to achieve catch-up growth. EVIDENCE: Few randomized
      clinical trials of feeding infants specific nutrients or of feeding choices have
      been conducted. On the basis of a MEDLINE search of the literature, committee
      members prepared reviews of the available information on each nutrient and
      feeding choice. The reviews were critically appraised by the committee.
      Recommendations were based on the consensus of the committee. VALUES: Whenever
      possible, the evidence was weighed in favour of randomized controlled trials. If
      such trials were unavailable, cohort studies were considered. If trials of either
      kind were unavailable, published data were reviewed and recommendations were
      based on consensus opinion. BENEFITS, HARMS AND COSTS: The advantages of feeding
      premature infants unfortified milk from their own mothers are psychologic
      benefits for the mother as well as anti-infective benefits and possibly improved
      intellectual development for the infant. However, unfortified milk from the
      infant's own mother is inadequate as a sole source of nutrients. The use of
      fortified milk from the mother results in faster growth as well as having the
      other benefits of mother's milk. When formulas designed for premature infants are
      given in adequate volumes, they provide an intake of nutrients that allows the
      infant to duplicate intrauterine growth without undue metabolic stress.
      RECOMMENDATIONS: The preferred food for premature infants is fortified milk from
      the infant's own mother or alternatively, formula designed for premature infants.
      This recommendation applies to infants with birth weights of a minimum of 500 g
      to a maximum of 1800 to 2000 g, or with a gestational age at birth of a minimum
      of 24 weeks to a maximum of 34 to 38 weeks (until the infant is able to nurse
      effectively). VALIDATION: These guidelines are in line with, but not identical
      to, recent guidelines by the Committee on Nutrition of the American Academy of
      Pediatrics and the Committee on Nutrition of the Preterm Infant of the European
      Society of Paediatric Gastroenterology and Nutrition. SPONSOR: The preparation of
      these guidelines was sponsored and funded by the Canadian Paediatric Society.

PMID- 7773900
TI  - New AIDS-treatment manual in BC.

PMID- 7773902
TI  - Murder-suicide involving BC doctor raises troubling questions about euthanasia.
AB  - The deaths last September of a British Columbia physician and his wife have
      raised troubling questions about euthanasia and Alzheimer's disease. Police
      described the deaths of Dr. Tom Powell and his wife Dr. Lorraine Miles, a retired
      dentist, as a murder-suicide. Friends of the couple wonder if more lenient laws
      concerning euthanasia and assisted suicide might have saved Miles' life.

PMID- 7773901
TI  - The Dutch experience with euthanasia: lessons for Canada?
AB  - Anne Mullens used a recent fellowship provided by the Atkinson Foundation to take
      an in-depth look at euthanasia in the Netherlands. During her time in Holland,
      she discussed the issue with doctors who support and oppose euthanasia. She
      accompanied a doctor as he visited a patient who was dying of cancer and was
      beginning to consider the possibility of euthanasia. She talked to a nonphysician
      who is adamantly opposed to euthanasia and carries a card stating that. She
      visited a hospital in Amsterdam that has received requests from foreigners
      seeking euthansia. Mullens offers a comprehensive look at an issue that continues
      to provoke strong feelings among Canadian physicians and patients.

PMID- 7773903
TI  - The message will be in the patient's receipt as New Brunswick prepares high-tech
      information system.
AB  - An effort to make the public appreciate the real cost of medical services has led
      to the development of an extensive medical-information and billing system in New
      Brunswick that uses a personal-information card. Likened to a credit card with
      unlimited credit, each has a magnetic strip with essential personal information
      with which to feed a province-wide computer system that eventually will link
      medicare, patients, doctors, prescription-drug programs and hospitals. The
      province hopes to have a pilot project running by year's end and then to
      introduce the system region by region.

PMID- 7773904
TI  - Health care reform comes to Alberta: "we're making this up as we go along".
AB  - Alberta left physicians out in the cold when Premier Ralph Klein's government
      began to slash the province's health care budget. Frustrated and angered at being
      excluded from the restructuring of the province's health care system, physicians
      rallied in protest, and now have some input into the new regional health
      authorities, at least in Edmonton and Calgary. Still, some physicians who feel
      the restructuring is an uncontrolled social experiment have opted to leave for
      positions in the US.

PMID- 7773905
TI  - "Why don't I send you and your wife two plane tickets..."?
AB  - Dr. James Hickey, who completed his residency in family medicine last year,
      reflects on medical practice and the negative impact of practice restrictions. At
      the same time the restrictions are appearing, he notes, recruiters from south of
      the border are conducting an aggressive campaign to convince Canadian family
      physicians to move to the US.

PMID- 7773906
TI  - I had an office to manage and patients to see.
AB  - An elderly woman seeks a physician's help because she has trouble sleeping and
      her doctor won't prescribe any more sleeping pills. The physician refuses to
      help, assuming that she is simply double doctoring. In the process, several
      doctors learn a lesson.

PMID- 7773907
TI  - Circumcision no longer a "routine" surgical procedure.
AB  - Nonmedical circumcision can no longer be considered routine in a new era of
      children's rights and more careful scrutiny of the medical necessity of surgical
      procedures. Although the minor procedure has been practised for centuries, custom
      and cultural factors may have had greater influence on the incidence of
      circumcision than the prevalence of problems such as penile cancer and urinary
      tract infection that it was thought to prevent.

PMID- 7773909
TI  - Homeopathy, other forms of alternative medicine sources of ongoing debate among
      physicians, patients.
AB  - Amy Rosen is the 1994 winner of the Amy Chouinard Memorial Essay Contest. Named
      in memory of longtime CMAJ and Canadian Journal of Surgery contributor Amy
      Chouinard, the competition is intended to stimulate interest in medical and
      health-related writing among journalism students. The winning essay examines the
      growing public interest in homeopathic medicine and physicians' opinions of the
      trend.

PMID- 7773908
TI  - The privatization of Canadian health care is moving into high gear.
AB  - The future of Canada's public health care system has been the source of much
      debate in the past year. Several signs, ranging from laser-surgery clinics in
      Ontario to the possible opening of a new private hospital in Toronto, indicate
      that the trend toward privatization is growing. Dr. Hugh Scully, former chair of
      a CMA working group that looked at the issue, expects the trend toward
      privatization to continue because "it simply isn't the case that the coverage
      people have come to expect will continue to be provided through the public
      purse." Dr. Jeffery Machat, a laser-surgery specialist from Windsor, Ont., thinks
      privatization brings needed investment to Canada's health care system.

PMID- 7773910
TI  - Looming public-service layoffs causing stress, other problems, Ottawa MDs report.
AB  - The federal government's attempts to curtail its deficit are going to cause
      thousands of layoffs in the Ottawa region, where the government is the main
      employer. The fear of being laid off is causing a great deal of stress among
      civil servants, and the signs of stress are being seen by the area's physicians.
      "We are seeing aggravated symptoms in people who have pre-existing psychiatric
      conditions," said Dr. Marvin Lange of the Royal Ottawa Hospital. "We are also
      seeing the emergence of new psychiatric symptoms in people who might not
      ordinarily have had them."

PMID- 7773911
TI  - Selection of students for veterinary medicine.

PMID- 7773912
TI  - Animals not abused by receiving somatotropin.

PMID- 7773913
TI  - Bovine somatotropin not abusive to cows.

PMID- 7773914
TI  - An ethicist's commentary of the case of a veterinarian utilizing homeopathic
      therapy.

PMID- 7773915
TI  - Therapy of gastrointestinal ulcers.

PMID- 7773916
TI  - Porcine colonic spirochetosis: a retrospective study of eleven cases.
AB  - This retrospective study of porcine colonic spirochetosis was done in order to
      characterize the clinical signs, the macroscopical and microscopical changes, and
      the bacteriological results of cases observed in Quebec. Necropsy records of all
      cases of colitis were reviewed. Eleven cases with filamentous bacteria colonizing
      the colonic epithelium were selected. This condition was only observed in weaned
      piglets, and was associated with mild persistent diarrhea and growth retardation.
      Macroscopic changes were generally limited to the presence of soft to liquid
      colonic contents. Adherence of filamentous helicoidal bacteria to the apical
      surface of the colonic epithelium and mild diffuse infiltration of the colonic
      lamina propria by mononuclear cells were the main histological findings. Weakly
      beta-hemolytic spirochetes were isolated in 6 cases. This condition seems to be
      underestimated for various reasons, and it is possible that some cases diagnosed
      as nonspecific colitis or superficial colitis, in fact, represent later stages of
      porcine colonic spirochetosis.

PMID- 7773917
TI  - The ecology of anthrax spores: tough but not invincible.
AB  - Bacillus anthracis is the causative agent of anthrax, a serious and often fatal
      disease of wild and domestic animals. Central to the persistence of anthrax in an
      area is the ability of B. anthracis to form long-lasting, highly resistant
      spores. Understanding the ecology of anthrax spores is essential if one hopes to
      control epidemics. Studies on the ecology of anthrax have found a correlation
      between the disease and specific soil factors, such as alkaline pH, high
      moisture, and high organic content. Researchers initially suggested that these
      factors influenced vegetative anthrax bacilli. However, subsequent research has
      shown that vegetative cells of B. anthracis have very specific nutrient and
      physiological requirements and are unlikely to survive outside a host. Review of
      the properties of spores of B. anthracis and other Bacillus species suggests that
      the specific soil factors linked to epidemic areas reflect important
      environmental conditions that aid the anthrax spores in causing epidemics.
      Specifically, high levels of calcium in the soil may help to maintain spore
      vitality for prolonged periods, thereby increasing the chance of spores
      encountering and infecting a new host. Cycles of runoff and evaporation may
      collect spores dispersed from previous epidemics into storage areas, thereby
      concentrating them. Uptake of large doses of viable spores from storage areas by
      susceptible animals, via altered feeding or breeding behavior, may then allow the
      bacterium to establish infection and cause a new epidemic. Literature search for
      this review was done by scanning the Life Sciences Collection 1982-1994 using the
      keywords "anthrax" and "calcium and spore."

PMID- 7773918
TI  - Immunoprophylaxis of bovine dermatophytosis.
AB  - The literature on immunoprophylaxis as control method for ringworm in cattle is
      reviewed. Scientific papers on immune response to dermatophyte antigens and
      vaccination against ringworm were obtained from personal files and computerized
      search in 4 relevant databases. Vaccines with antigens of Trichophyton verrucosum
      stimulate a humoral and cellular immune response. In animals vaccinated with
      inactivated vaccines, some protection is observed after challenge. However, the
      protective immunity is inadequate in most cases. Vaccination with live vaccines
      elicits an immune response that prevents the development of clinical disease. The
      protective immunity is based mainly on the cellular branch of the immune system.
      The efficacy and safety of live dermatophyte vaccines have been demonstrated in
      both challenge experiments and field trials from different countries. Effective
      control of ringworm in cattle has been achieved in regions implementing
      systematic vaccination.

PMID- 7773919
TI  - An outbreak of border disease in a sheep flock.

PMID- 7773920
TI  - Bovine spongiform encephalopathy in a Holstein cow born in the United Kingdom
      during September 1989.

PMID- 7773921
TI  - Arthrodesis of the scapulohumeral joint in a horse.

PMID- 7773922
TI  - Personnel points.

PMID- 7773923
TI  - Distribution of Streptococcus suis capsular types in 1994.

PMID- 7773924
TI  - [Cardiac dilatation in adult rabbits without evidence of relationship to the
      observed pathology].

PMID- 7773925
TI  - Eastern equine encephalitis in horses in Ontario in 1994.

PMID- 7773926
TI  - [Presumed drug adverse reactions reported to the Bureau of Veterinary Drugs].

PMID- 7773927
TI  - Joining a board of directors? Know your responsibilities.

PMID- 7773928
TI  - Serum anti-Helicobacter pylori antibody and gastric carcinoma among young adults.
      Research Group on Prevention of Gastric Carcinoma among Young Adults.
AB  - BACKGROUND: Helicobacter pylori is recognized as one of the possible causes of
      gastric carcinoma. There have been few studies on the relationship between H.
      pylori and gastric carcinoma in patients younger than 40 years. METHODS: Data and
      sera were collected from the cases (105 hospitalized patients younger than 40
      years with gastric carcinoma from 9 hospitals in the Kanto-Shin-Etsu Area in
      Japan) and controls (102 hospitalized control subjects and 101 screening control
      subjects) whose sex and age (within 4 years) were matched. The serum anti-H.
      pylori immunoglobulin G antibody was measured, and the odds ratio (OR) for the
      association between seropositivity and gastric carcinoma was calculated. RESULTS:
      The OR (95% confidence interval) was 13.3 (5.3-35.6). For women, the OR was 32.8,
      whereas for men it was 6.8. The OR for patients with early gastric carcinoma was
      20.8, and for patients with advanced disease, it was 10.8. The OR for intestinal
      type carcinoma was 18.0, and for diffuse-type carcinoma, it was 12.8. The OR for
      proximal carcinoma was 11.3, and for distal carcinoma it was 14.8. CONCLUSION:
      The OR for these young subjects was considerably larger than that for the older
      subjects in previously published studies. Among those younger than 40 years of
      age, early stage carcinoma has a stronger association with H. pylori than
      advanced carcinoma, and intestinal- and diffuse-type carcinomas have an
      association with H. pylori.

PMID- 7773929
TI  - Clinicopathologic significance of the K-ras gene codon 12 point mutation in
      stomach cancer. An analysis of 140 cases.
AB  - BACKGROUND: The frequency and clinicopathologic significance of the K-ras gene
      point mutation in stomach cancer remain to be defined. METHODS: The authors
      investigated the frequency of K-ras codon 12 point mutations in stomach cancer
      using a sensitive polymerase chain reaction (PCR)-based method in 140 samples and
      correlated the findings with various clinicopathologic characteristics of the
      patients. RESULTS: The overall frequency of K-ras codon 12 point mutations in
      stomach cancer was 7.9% (11/140). DNA sequencing of nine cases with K-ras codon
      12 point mutations identified seven cases with a single-base substitution of GGT
      to AGT (glycine to serine) and two with single-base substitution of GGT to AGT
      (aspartic acid). Tumors located in the upper third of the stomach had a
      significantly higher frequency of K-ras codon 12 mutations (3/8, 37.5%) compared
      with tumors located in the middle (4/29, 13.8%) or lower (3/99, 3.0%) thirds of
      the stomach (P = 0.001). No significant difference was observed in the frequency
      of K-ras codon 12 mutations in terms of other various clinicopathologic
      characteristics including tumor DNA ploidy and S-phase fraction. After a median
      follow-up of 26 months, disease free and overall survival were not significantly
      different between patients with stomach cancer with or without K-ras codon 12
      mutation. Among eight patients with stomach cancer located in the upper part of
      the stomach, none of the three patients with K-ras gene-mutated tumors died
      versus four of five with tumors without K-ras gene mutations (P = 0.064).
      CONCLUSIONS: K-ras codon 12 point mutations are uncommon in stomach cancer
      (7.9%). There was significant correlation between K-ras mutations and vertical
      tumor location in the stomach, suggesting that different mechanisms may play a
      role in the pathogenesis of stomach cancer according to the location of tumors in
      the stomach.

PMID- 7773930
TI  - Localization of oncofetal and normal fibronectin in colorectal cancer.
      Correlation with histologic grade, liver metastasis, and prognosis.
AB  - BACKGROUND: Expression of oncofetal fibronectin (oncFN) and normal fibronectin
      (norFN) in colorectal cancer specimens was examined to investigate the
      correlation between fibronectin localization and histologic grade, liver
      metastasis, and prognosis. METHODS: Immunohistochemical staining of oncFN and
      norFN was performed on 99 primary lesions and 12 liver metastases of colorectal
      cancer. The expression of norFN and oncFN was evaluated by grading the intensity
      of staining as negative, positive, or strongly positive. RESULTS: Positive
      staining for oncFN correlated positively with increasing stage. The rate of
      strongly positive staining for oncFN was 53% for primary lesions with liver
      metastasis, significantly higher than the oncFN-positive rate of 13% for
      metastasis free cases (P < 0.05). Liver lesions had an oncFN-positive rate of
      92%. The postoperative 5-year survival rate for 51 cases classified as Dukes
      Stage C was 77.8% for oncFN-negative cases, 36.5% for oncFN-positive cases, and
      22.2% for oncFN-strongly positive cases; these rates were significantly different
      (P < 0.01). Conversely, there was no correlation between norFN and any clinical
      variable. CONCLUSION: Expression of oncFN is correlated with a poor prognosis of
      Dukes C colorectal cancer and may serve as a useful postoperative prognostic
      sign.

PMID- 7773931
TI  - The significance of intraoperative periportal lymph node metastasis
      identification in patients with colorectal carcinoma.
AB  - BACKGROUND: Nine patients who underwent Radioimmunoguided Surgery (RIGS)
      (Neoprobe Corporation, Dublin, OH) procedures for colorectal cancer were found to
      have disease recurrence in the periportal area. This led to a retrospective study
      to determine whether periportal lymph node involvement could have been predicted
      intraoperatively for these patients. METHODS: One hundred twenty-four patients
      underwent second-look RIGS for recurrent colon and rectal cancer from 1986 to
      1992. The monoclonal antibody (MAb) B72.3 was administered as the carrier agent
      to 87 patients and the CC49 second-generation MAb was administered to 37
      patients. Both MAbs were radiolabeled with Iodine-125. RESULTS: Periportal lymph
      nodes with RIGS-positive tissue were found in 47 (38%) patients, hematoxylin and
      eosin-positive lymph nodes were found in 13 of 47, and in further
      immunohistochemical studies performed for 31 of the remaining 34 patients,
      positive lymph nodes were found in 8, resulting in an incidence of 48% (21/44). A
      critical review of the nine patients' charts who later presented with a tumor
      mass in the periportal area demonstrated intraoperative gamma-detecting probe
      counts in ratios three to five times that of the normal adjacent tissues in the
      periportal area at the time of first exploration. Probe-directed biopsy was
      reported to be histologically negative for tumor in these patients, and, thus,
      the surgeon proceeded assuming the periportal area to be negative. A
      retrospective study of the periportal lymph nodes of these patients using
      cytokeratin immunohistochemical analysis identified tumor in five (56%).
      CONCLUSIONS: These findings suggest that the RIGS system may be a valuable method
      of intraoperative prediction and detection of periportal lymph node metastasis.

PMID- 7773932
TI  - Expression of an endogenous galactose-binding lectin correlates with neoplastic
      progression in the colon.
AB  - BACKGROUND: Galectin-3 is an endogenous galactose-binding protein that is
      expressed in a wide range of normal and neoplastic tissues and is thought to be
      involved in cellular adhesion and growth regulation. Conflicting data have been
      reported regarding the expression of galectin-3 during carcinogenesis in the
      colon. METHODS: The authors studied the expression of galectin-3 in 153 tissue
      specimens, including 29 adenomas containing early cancer, 66 colon carcinomas of
      known Dukes' stage with available long term patient survival data, and 23
      additional primary carcinomas with 35 associated metastases. An
      immunohistochemical scoring system was used that considers tumor heterogeneity
      and yields an integrated numeric score subject to statistical analysis.
      Genetically related colon cancer cells with different metastatic capabilities
      also were compared by Western blot analysis. RESULTS: Galectin-3 expression was
      significantly higher in high grade dysplasia and early invasive cancers compared
      with the adenomatous tissue from which they evolved (mean staining score, 2.33
      vs. 1.15; P = 0.001). Galectin-3 expression in invasive cancers varied according
      to Dukes' stage, indicating a linear relationship with advancing stage (P =
      0.008). Enhanced expression correlated with decreased long term patient survival
      (P = 0.021). Metastases expressed a higher level of galectin-3 compared with the
      primary cancers from which they evolved (P < 0.005) as did cultured cells of high
      metastatic capability compared with their counterparts with low metastatic
      potential. CONCLUSION: Galectin-3 expression in colonic mucosa is related to
      neoplastic transformation and metastatic progression.

PMID- 7773933
TI  - Small adenocarcinoma of the lung. Histologic characteristics and prognosis.
AB  - BACKGROUND: Although there are many reported prognostic indicators for pulmonary
      adenocarcinoma, the clinicopathologic characteristics and prognostic factors of
      early stage adenocarcinoma have not been evaluated fully, except for several
      studies of nonmucinous and sclerosing bronchioloalveolar carcinoma. METHOD: Two
      hundred thirty-six surgically resected small peripheral adenocarcinomas measuring
      2 cm or less in greatest dimension were reviewed using a simple histologic
      classification of six types based on tumor growth patterns. RESULTS: Type A
      (localized bronchioloalveolar carcinoma [LBAC]) (n = 14) revealed replacement
      growth of alveolar-lining epithelial cells with a relatively thin stroma. In type
      B (LBAC with foci of structural collapse of alveoli) (n = 14), fibrotic foci due
      to alveolar collapse were observed in tumors of LBAC. Type C (LBAC with foci of
      active fibroblastic proliferation) (n = 141) was the largest group in this study,
      and foci of active fibroblastic proliferation were evident. Type D (poorly
      differentiated adenocarcinoma), type E (tubular adenocarcinoma) and type F
      (papillary adenocarcinoma with a compressive growth pattern) (n = 61) showed
      compressive and expanding growth. Types A and B showed no lymph node metastasis
      and the most favorable prognosis (100% 5-year survival) of the six types.
      CONCLUSION: Histologic types A and B are thought to be in situ peripheral
      adenocarcinoma, whereas type C appears to be an advanced stage of types A and B.
      Conversely, types D, E, and F are small advanced adenocarcinomas with a less
      favorable prognosis.

PMID- 7773934
TI  - Therapy program for patients with advanced stages of chronic lymphocytic
      leukemia. Chlorambucil, splenectomy, and total lymph node irradiation.
AB  - BACKGROUND: The clinical course of chronic lymphocytic leukemia (CLL) is
      variable. Staging systems define high risk groups, such as patients with Rai's
      Stage III and IV and Binet's stage C disease, as having a poor overall median
      survival. Most combination therapy programs have resulted in similar results.
      Chlorambucil remains the most commonly used drug, and new drugs, such as
      fludarabine, are promising. METHODS: Fifty-three patients with poor prognosis CLL
      (Stage III and IV) underwent chlorambucil treatment at a high intermittent dose.
      When Stage 0 was obtained, patients were considered responders and kept under
      surveillance. When the patients stopped responding after one or several courses
      of chlorambucil, further therapy was performed, including splenectomy (29
      patients) and total lymph node irradiation (9 of the 29 splenectomized patients).
      RESULTS: The overall median survival was 60 months. Thrombocytopenia and anemia
      were resolved in 55% and 82% of the patients, respectively, after chlorambucil
      therapy and in 85% and 100%, respectively, after splenectomy. Complications
      occurred in 34% of the splenectomized population. Total lymph node irradiation
      was poorly tolerated in 66% of the patients. When this analysis was performed, 24
      patients were classified as having Stage 0 disease with no disease progression
      for a mean of 21 months. CONCLUSIONS: Therapy programs allowing the selection of
      responders by the successive use of high intermittent dose chlorambucil and
      splenectomy may be beneficial in treating patients with advanced stage CLL.
      Because of its toxicity, total lymph node irradiation has no significant
      therapeutic effect.

PMID- 7773935
TI  - Use of immunohistochemical procedures in diagnosing angiosarcoma. Evaluation of
      98 cases.
AB  - BACKGROUND: Differential diagnosis of angiosarcoma, predominantly showing a non-
      or poorly vasoformative proliferation from other types of sarcomas, poorly
      differentiated carcinomas, and amelanotic melanoma, is often problematic.
      METHODS: The use of antibodies directed against Factor VIII-related antigen
      (FVIIIRA), Ulex europaeus lectin type 1 (UEA-1), CD31, and vascular endothelial
      growth factor (VEGF) in the diagnosis of angiosarcoma was examined in 98 cases of
      autopsy-proven angiosarcoma diagnosed during 1974-1990 in a survey of 178
      Japanese hospitals. Reactivity of angiosarcoma cells for epithelial membrane
      antigen, cytokeratin, and melanoma cell antigen (HMB45) also was examined.
      RESULTS: Histologic specimens were formed exclusively by vasoformative areas in
      32 cases and combined vasoformative and varying extents of non- or poorly
      vasoformative areas in another 66 cases. In vasoformative areas, the
      proliferating cells showed a diffuse positive reaction in the cytoplasm and/or
      cell surface for anti-FVII-IRA in 82 (84%) of 98 cases, for anti-CD31 in 78
      (80%), and for UEA-1 in 69 (70%). In non- or poorly vasoformative areas, the
      positivity rate for FVIIIRA, CD31, and UEA-1 was 29%, 62%, and 46%, respectively.
      A positive reaction was found for either one of three endothelial markers in the
      non- or poorly vasoformative areas of 57 cases (86%). Epithelial membrane antigen
      and anticytokeratin antibody were positive in 4 and 11 cases, respectively, in
      the vasoformative areas and in 3 and 14 cases, respectively, in non- or poorly
      vasoformative areas with a simultaneous positive reaction for either one of three
      endothelial cell markers. None of the proliferating cells showed a positive
      reactivity for HMB45. The positivity rates of the angiosarcoma cells for each
      marker were different according to the primary tumor sites. The angiosarcoma
      cells in non- or poorly vasoformative areas showed the lowest positivity rate for
      anti-FVIIIRA in the heart (9%) and for anti-CD31 in the extremities (17%) and the
      highest positivity rate for anticytokeratin in the trunk (60%). Ulex europaeus
      lectin type 1 had almost the same reactivity rate (30-56%) in every organ.
      Angiosarcoma cells in 13 (36%) of 36 biopsy specimens and 8 (14%) of 56 autopsy
      specimens were positive for the anti-VEGF antibody. CONCLUSION: These findings
      suggest that the combined use of endothelial cell markers including FVIIIRA, UEA
      1, and CD31 is useful in the diagnosis of angiosarcoma, especially in cases
      exclusively with a non- or poorly vasoformative pattern.

PMID- 7773936
TI  - Contralateral axillary lymph node metastasis as the first evidence of locally
      recurrent breast carcinoma.
AB  - BACKGROUND: Carcinoma of the breast infrequently presents initially as axillary
      adenopathy. In such cases, after biopsy proves the presence of metastatic
      carcinoma, the primary tumor generally is assumed to be in the ipsilateral
      breast, despite negative mammographic findings and the lack of a clinically
      palpable breast mass. METHODS: The authors recently studied a case of a 50-year
      old woman in whom recurrent neuroendocrine carcinoma of the breast presented as a
      contralateral axillary lymph node metastasis. After mastectomy ipsilateral to the
      metastasis proved negative for tumor, a histologic comparison of the previous
      contralateral tumor with that in the lymph node was performed, followed by biopsy
      of the clinically and mammographically negative original lumpectomy site.
      RESULTS: Histologic and immunohistochemical studies proved that the original,
      metastatic, and locally recurrent tumors were identical, sharing unusual
      neuroendocrine features. The patient is currently disease free after
      chemotherapy. CONCLUSION: Contralateral mammary carcinoma should be considered in
      the workup of a patient who presents with evidence of an axillary lymph node
      metastasis. Locally recurrent breast carcinoma may be clinically and
      mammographically occult. Histologic review of prior biopsy material and
      comparison with current tissue is essential in proper patient management.

PMID- 7773937
TI  - Multifocal vulvar intraepithelial neoplasia grade III and multicentric lower
      genital tract neoplasia is associated with transcriptionally active human
      papillomavirus.
AB  - BACKGROUND: The incidence of vulvar intraepithelial neoplasia Grade III (VIN III)
      is increasing and is diagnosed at a younger age than previously. VIN III is often
      multifocal and frequently coexists with multicentric dysplastic lesions in the
      cervix and vagina. Warty-type VIN III more often has been found to contain human
      papillomavirus (HPV) DNA than basaloid-type VIN III: The authors performed HPV
      DNA polymerase chain reaction (PCR) analysis in 48 VIN III biopsies and reverse
      transcriptase (RT)-PCR in 8 HPV-16 DNA-positive multifocal VIN III biopsies to
      detect E6/E7 transcripts. METHODS: Human papillomavirus DNA detection and
      histologic analysis were performed on alternating slides of paraffin embedded
      biopsies. Polymerase chain reaction was performed with consensus primers, and HPV
      typing was performed by direct sequencing. Total RNA was isolated from frozen
      biopsies by centrifuging a guanidinium thiocyanate (GTC) lysate through a cesium
      chloride (CsCl) cushion. The RT reaction was performed using a 3' primer, located
      just downstream of the E7 stop codon, and the PCR reaction was performed using
      the same 3' primer and a 5' primer located just downstream of the E6 start codon.
      RESULTS: The mean age of the 48 patients was 37.7 years. Eighty-one percent had
      multifocal VIN III: Sixty-six percent had multicentric neoplasia. Forty-six
      percent of the biopsies were warty-type, 17% basaloid-type, 35% mixed-type and 2%
      differentiated-type. Ninety-two percent were HPV-positive and 83% contained HPV
      16 DNA. Human papillomavirus DNA was more often present in multifocal VIN III
      lesions than in unifocal VIN III lesions and also more often in VIN III lesions
      coexisting with other dysplastic multicentric lesions than in unicentric VIN III
      lesions. Warty-type VIN III more often contained koilocytes than basaloid-type
      VIN III: A correlation between different morphologic forms of VIN III and the
      presence of HPV DNA was not found. Both types of VIN III often coexist in one
      lesion. In all the RT-PCRs, a 593-base-pair fragment was detected, corresponding
      to the expected length of the major E6*-E7 mRNA. CONCLUSIONS: The observed high
      prevalence of transcriptionally active HPV DNA associated with multifocal and
      multicentric dysplasia suggests a role of HPV in the pathogenesis of these
      lesions. A positive correlation between different morphologic forms of VIN III
      and the presence of HPV DNA was not found.

PMID- 7773938
TI  - Extracapsular growth of lymph node metastases in squamous cell carcinoma of the
      vulva. The impact on recurrence and survival.
AB  - BACKGROUND: Patients with squamous cell carcinoma of the vulva who present with
      multiple positive groin lymph nodes have poor survival. Growth of cancer through
      the capsule of the groin lymph nodes recently has been identified as an important
      prognostic factor for survival in that patient group. The objective of this study
      was to determine the influence of several clinicopathologic parameters on the
      pattern of recurrence and survival. METHODS: A review of 71 patients with
      squamous cell carcinoma of the vulva and positive lymph nodes was performed to
      assess the independent prognostic value of a number of variables for survival.
      Variables analyzed included tumor size, stage, number of positive lymph nodes,
      extracapsular growth of lymph node metastasis, the greatest dimension of tumor in
      the lymph nodes, the percentage of replacement of the lymph nodes by tumor,
      clinical lymph node status, and laterality of positive lymph nodes. RESULTS:
      Using the Mantel-Cox test, extracapsular growth of lymph node metastases (P =
      0.00), two or more positive lymph nodes (P = 0.02), and greater than 50%
      replacement of lymph nodes by tumor (P = 0.03) were predictors of poor survival.
      No difference was found between the groups with two positive lymph nodes and
      those with three or more. Extracapsular growth of lymph node metastases was the
      most significant independent predictor for survival. Distant metastases occurred
      in 7 of 15 patients (48%) who had a combination of extranodal spread, lymph node
      replacement greater than 50%, and three or more positive lymph nodes. CONCLUSION:
      Extracapsular growth of lymph node metastases in the groin is the most important
      predictor for poor survival in patients with squamous cell carcinoma of the
      vulva. Because of the predominant distant failure pattern in a subgroup of
      patients who have a combination of extranodal spread, multiple positive lymph
      nodes, and lymph nodes replaced by tumor greater than 50%, a future study of the
      effectiveness of systemic therapy for vulvar cancer must include these patients.

PMID- 7773939
TI  - c-erbB-2 and p53 expression in fallopian tube carcinoma.
AB  - BACKGROUND: Carcinoma of the fallopian tube is a rare gynecologic malignancy. Its
      histologic appearance and patterns of spread are similar to those of epithelial
      ovarian cancer. Alterations in the gene products of c-erbB-2 (HER-2/neu) and p53
      are found commonly in ovarian tumors and may have prognostic relevance. The
      authors sought to determine whether tubal cancers are biologically similar to
      ovarian cancer with respect to the expression of these two molecular markers.
      METHODS: A cohort of 43 patients with fallopian tube cancer was studied.
      Immunohistochemical staining for c-erbB-2 and p53 was performed on pretreatment
      tissue blocks. Clinical information was available for all patients, with a median
      follow-up of 9 years. Clinicopathologic correlations were made. RESULTS: Nine
      patients had Stage I disease, 11 had Stage II disease, 18 had Stage III disease,
      and 5 had Stage IV disease, with a median survival was 65 months. c-erbB-2
      overexpression was found in 11 cases (25.6%), and p53 positivity was noted in 26
      cases (60.5%). Log rank survival curves showed no association between staining
      for c-erbB-2 or p53 expression and clinical outcome. A multivariate analysis
      identified patient age older than 65 years (P = 0.05) and Stage III or IV disease
      (P = 0.0065) as the only variables that predicted poor outcome. CONCLUSIONS:
      Fallopian tube cancers are similar to ovarian cancer with respect to the
      proportion of tumors with abnormal expression of c-erbB-2 and p53. The authors
      could not demonstrate that these two molecular markers had prognostic relevance
      in this disease, but the size of their cohort was limited. However, the potential
      prognostic relevance of c-erbB-2 and p53 expression in tubal cancers should be
      pursued in a larger cohort.

PMID- 7773940
TI  - Cost and risk benefit in the management of clinical stage II nonseminomatous
      testicular tumors.
AB  - BACKGROUND: Two similarly effective treatment options exist for managing clinical
      low volume Stage II nonseminomatous germ cell testis tumors (NSGCT). Primary
      retroperitoneal lymph node dissection (RPLND) (with immediate adjuvant
      chemotherapy or chemotherapy at relapse) and primary chemotherapy have resulted
      in similar survival rates in large series. Because the chance for cure is similar
      with either approach, the cost and morbidity of therapy should be considered
      important discriminating factors in deciding which option to pursue for an
      individual patient. The purpose of this study was to undertake a cost/benefit and
      risk/benefit analysis of these two options using data and costs from the Indiana
      University experience. METHODS: The overall direct costs for 100 patients
      undergoing primary RPLND were compared with the total direct costs of 100
      patients receiving primary chemotherapy for low volume Stage II disease,
      including the costs of adjuvant chemotherapy, salvage chemotherapy in relapsing
      patients, and routine follow-up for a 5-year period. In addition, the two
      treatment options were analyzed relative to survival, late relapse, acute and
      chronic toxicity, (including fertility), and perioperative morbidity. RESULTS: In
      this analysis, the overall 5-year costs of RPLND were significantly less than the
      costs of primary chemotherapy. The two options did not differ significantly in
      terms of survival or quality of life. Patients receiving RPLND were found to have
      an advantage also in terms of fertility, toxicity, and late relapse. CONCLUSIONS:
      Treatment decisions for patients with clinical low volume Stage II NSGCT may be
      based on cost/benefit and risk/benefit considerations, including relative
      toxicity, long term cure rate, and individual patient preference. Patient
      compliance with follow-up, the specific expertise of the physicians, and the
      availability of specialized therapeutic care ultimately may influence such
      decisions.

PMID- 7773941
TI  - The in vitro motility of human gliomas increases with increasing grade of
      malignancy.
AB  - BACKGROUND: Malignant gliomas are a highly invasive disease with a dismal
      prognosis despite aggressive therapeutic interventions. METHODS: The authors
      tested the hypothesis that increasing in vitro motility of human glial tumors
      correlates with increasing grade of malignancy. A radial dish assay was used to
      quantitatively assess the brain tumor cell motility of 14 low passage cell lines
      derived from human glial tumors of varied malignancy, and 3 cell lines derived
      from human glia. The egress of cells from a central region of high tumor cell
      density to a region of lower tumor cell density was determined at various time
      points. A motility coefficient (MC), the slope of distance traveled against time,
      was generated by simple linear regression analysis. RESULTS: The MC increased
      with the increased histologic grade of malignancy. Generation of a t-statistic
      was used to determine the significance of differences in motility among 5
      histopathologic groups: 10 glioblastoma (World Health Organization Grade IV) cell
      lines (mean MC, 0.00396), 2 mixed anaplastic oligoastrocytoma (Grade III) cell
      lines (mean MC, 0.00382), 1 anaplastic astrocytoma (Grade III) cell line (mean
      MC, 0.00295), 1 Grade I glioma cell line (mean MC, 0.00206), and 3 human glial
      cell lines (mean MC, 0.00110). CONCLUSIONS: The radial dish assay provided a
      reproducible method for quantitatively assessing brain tumor cell motility. The
      higher MC observed with the malignant human glioma cell lines correlated with the
      tendency of these tumors to invade into adjacent brain tissue. The potential to
      inhibit glial tumor motility may provide an important therapeutic avenue in the
      future.

PMID- 7773942
TI  - Clinicopathologic features of primary and postirradiation cerebral gliosarcoma.
AB  - BACKGROUND: Gliosarcoma is an uncommon malignant brain tumor with mixed glial and
      mesenchymal elements. Experience is limited to case series, and pathologic data
      are disparate, leading to uncertainty about clinical features, management, and
      histogenesis. METHODS: A clinicopathologic review of 32 patients with survival
      analysis and immunohistochemical studies was performed including glial fibrillary
      acidic protein analysis, alpha-1-antitrypsin (alpha-1-AT) analysis, and smooth
      muscle actin (SMA) analysis. RESULTS: Twenty-five patients had primary
      gliosarcoma, whereas 7 developed gliosarcoma after irradiation for glioblastoma
      multiforme (GBM). Clinical features were similar to those of GBM. Most tumors
      were intraaxial and diffusely infiltrating by radiologic studies and at surgery.
      Median survival for primary gliosarcoma was 25 weeks overall, with patients who
      received irradiation surviving longer (46 vs. 13 weeks, P < 0.025). Gliosarcoma
      occurring after irradiation appeared hyperdense by computed tomography in five of
      seven cases, and median survival was 53 weeks. Primary gliosarcoma was a
      dimorphic tumor with malignant glial elements and features of malignant fibrous
      histiocytoma (MFH) or fibrosarcoma and one osteosarcoma. Smooth muscle actin
      labeled tumor vessels heavily, but in 15/25 primary cases, it extended to the
      surrounding spindle cells. The remaining cases appeared morphologically like MFH
      and tended to be positive for alpha-1-AT. Postirradiation gliosarcoma was
      fibrosarcomatous with positive SMA in 75% of the cases examined. CONCLUSIONS:
      Gliosarcoma behaves clinically like GBM, and survival may be improved by cranial
      irradiation of selected patients. Smooth muscle actin reactivity in sarcomatous
      areas suggests histogenesis in some tumors from the smooth muscle within GBM,
      whereas others may arise via different mechanisms including differentiation from
      a pluripotential precursor. Transformation of the smooth muscle within GBM may
      have therapeutic implications for antiangiogenesis agents.

PMID- 7773943
TI  - Diagnosis, management, and survival of patients with leptomeningeal cancer based
      on cerebrospinal fluid-flow status.
AB  - BACKGROUND: The authors assessed cerebrospinal fluid (CSF) flow in patients with
      carcinomatous meningitis using technetium-99m-DTPA (Tc-99) ventriculography to
      determine the frequency of flow abnormalities, their reversibility with
      treatment, and the implications for successful therapy and survival. METHODS:
      Technetium-99m-DTPA flow studies were performed in 31 patients after placement of
      Ommaya reservoirs (Baxter, McGaw Park, IL). Two millicuries of Tc-99 were
      injected into the reservoir. Planar images of the head and entire spine were
      obtained after 10 and 30 minutes and after 1, 4, 6, and 24 hours. Follow-up
      studies were performed for 12 patients whose initial studies were abnormal or who
      developed complications of therapy. RESULTS: In 19 of the 31 patients (61%),
      ventricular-outlet, spinal, or convexity blocks were identified. In 11 of these
      19 patients, focal radiotherapy to the site of the block restored normal flow.
      Survival among patients with initially normal, abnormal but correctable, and
      abnormal but uncorrectable CSF flow differed significantly (6.9, 13.0, and 0.7
      months respectively; P < 0.001). Some patients who were treated intrathecally
      despite abnormal CSF flow experienced drug-related toxicity. CONCLUSIONS:
      Cerebrospinal fluid-flow blocks are common in patients with carcinomatous
      meningitis and may occur at the skull base, in the spinal canal, and over the
      convexities. These flow abnormalities often can be corrected with appropriately
      directed radiotherapy. If untreated, CSF tumor progression (protected site
      effect), neurotoxicity (high concentration effect), and systemic toxicity
      (reservoir effect) can occur, resulting in shortened survival and treatment
      related morbidity. Therefore, intrathecal chemotherapy should be preceded by a
      radionuclide flow study and should be delayed if abnormal flow is documented
      until appropriate radiotherapy reestablishes normal flow.

PMID- 7773944
TI  - Phase I study of phenylacetate administered twice daily to patients with cancer.
AB  - BACKGROUND: The growth-inhibiting and differentiating effects of sodium
      phenylacetate against hematopoietic and solid tumor cell lines has aroused
      clinical interest in its use as an anticancer drug. In an earlier Phase I trial
      of phenylacetate aimed at maintaining serum drug concentrations in the range that
      proved active in vitro (> 250 micrograms/ml) for 2 consecutive weeks, infusion
      rates approached the maximum velocity of drug elimination and commonly resulted
      in drug accumulation and reversible dose-limiting neurologic toxicity. In this
      study, the authors described the nonlinear pharmacokinetics, metabolism,
      toxicity, and clinical activity of phenylacetate. METHODS: The treatment regimen
      of this Phase I study was designed to expose patients intermittently to drug
      concentrations exceeding 250 micrograms/ml and to allow time for drug elimination
      to occur between doses to minimize accumulation. Sodium phenylacetate was
      administered as a 1-hour infusion twice daily (8 a.m., 5 p.m.) at two dose levels
      of 125 and 150 mg/kg for a 2-week period. Therapy was repeated at 4-week
      intervals for patients who did not experience dose-limiting toxicity or disease
      progression. RESULTS: Eighteen patients (4 of whom previously were treated with
      phenylacetate by continuous intravenous infusion) received 27 cycles of therapy.
      Detailed pharmacokinetic studies for eight patients indicated that phenylacetate
      induced its own clearance by a factor of 27% in a 2-week period. Dose-limiting
      toxicity, consisting of reversible central nervous system depression, was
      observed for three patients at the second dose level. One patient with refractory
      malignant glioma had a partial response, and one with hormone-independent
      prostate cancer achieved a 50% decline in prostate specific antigen level, which
      was maintained for 1 month. CONCLUSIONS: Phenylacetate administered at a dose of
      125 mg/kg twice daily for 2 consecutive weeks is well tolerated. High grade
      gliomas and advanced prostate cancer are reasonable targets for Phase II clinical
      trials.

PMID- 7773945
TI  - Cancer incidence of Hispanics and non-Hispanic whites in Cook County, Illinois.
AB  - BACKGROUND: Variations in cancer incidence and mortality rates between Hispanics
      and non-Hispanic whites have been reported in several regions in the United
      States. This report describes the ethnic variation in selected cancer sites in
      Cook County, Illinois. METHODS: Cancer incidence, age-specific, and age
      standardized relative rates, and 95% confidence intervals were estimated among
      Hispanics and non-Hispanic whites in Cook County, Illinois, for 1986-1987.
      Hispanics were identified using surnames and maiden names with the Generally
      Useful Ethnic Search System (GUESS). RESULTS: Rates of lung cancer in Hispanics
      were approximately half of those observed for non-Hispanic whites. Hispanics also
      had lower rates of colon, breast, and bladder cancer. Hispanic females had rates
      of invasive cervical cancer that were approximately two times higher than those
      of non-Hispanic whites. CONCLUSIONS: These results are consistent with previous
      studies and suggest that Hispanics residing in the United States may retain some
      of the risk profile of those living in their home country.

PMID- 7773946
TI  - Socioeconomic variation in cancer survival in the southeastern Netherlands, 1980
      1989.
AB  - BACKGROUND: The survival rates of patients with cancer by socioeconomic status
      (SES) has never been investigated in the Netherlands, a country characterized by
      good general access to health care services. The association between
      socioeconomic status and survival from cancer of the lung (n = 4591), breast (n =
      3928), colorectum (n = 3558), prostate (n = 1484), and stomach (n = 1455) was
      studied, and the impact of some prognostic factors (stage at diagnosis,
      histologic type, and treatment) on this association was assessed. METHODS:
      Subjects were patients who were diagnosed from 1980 to 1989 and included in the
      population-based Eindhoven Cancer Registry in the Southeastern Netherlands. The
      patients were classified by socioeconomic status based on their postal code of
      residence at the time of diagnosis (3 or 5 categories). The follow-up ended July
      1, 1991, at which time relative survival rates and hazard ratios were calculated.
      RESULTS: A more favorable relative survival for patients living in high SES areas
      was found for those with cancer of the lung, breast, colorectum, and prostate,
      whereas for those with stomach cancer, lower survival was found for patients
      living in high SES areas. For cancer of the lung, colorectum, and prostate, the
      socioeconomic variation in survival could not be explained by the distribution of
      the prognostic factors stage, histologic type, and treatment. For patients with
      breast and stomach cancer, the socioeconomic variation in survival could be
      ascribed mainly to differences in the percentage of patients diagnosed with a
      metastasis. CONCLUSIONS: Socioeconomic variation in survival from a number of
      common cancer sites exists in the Netherlands, despite the fairly equal access to
      health care services for different socioeconomic groups. Most of the variation
      could not be explained by the differential distribution of stage, histologic
      type, and treatment across SES categories.

PMID- 7773947
TI  - Rheumatic manifestations of occult cancer.
AB  - BACKGROUND: The frequency with which rheumatic disorders occur when malignant
      neoplasms first present is unknown, and the significance of rheumatic conditions
      as cancer markers is unappreciated. METHODS: Patients admitted to a medical ward
      of a general hospital (Bnai Zion Medical Center, Haifa, Israel) during a 10-year
      period were surveyed. The frequency of the diagnostic evaluation of rheumatic
      disorders resulting in uncovering occult neoplasia at the time of index
      hospitalization and during the 2-year follow-up period was assessed. RESULTS: The
      incidence of occult cancer among patients admitted to a general medical ward with
      previously unclarified rheumatic disorders was 23.1%. Seventy-two percent of the
      group of patients with rheumatic diseases and occult cancer were male; 69% with
      rheumatic disease without cancer (control group) were female. The median age in
      the group with occult cancer was an average of 10 years older than the group
      without cancer, 67 versus 57 years (P < 0.001). Weight loss or anemia occurred in
      52% of the group with occult cancer and in 37.3% of the control cases (not
      significant). Typically, there were no distinguishing features of the rheumatic
      syndromes suggesting the coexistence of cancer. In 19 of 25 cases, the malignancy
      was uncovered by routine examinations. In four instances, neoplasia was not
      immediately apparent but was identified in a specific search. In two cases, no
      search for malignancy initially was undertaken, and Hodgkin's lymphoma was
      diagnosed 6 and 12 months later. In 9 of 25 cases, long term remission of
      neoplasia was achieved by cancer therapy with improvement of rheumatic
      manifestations coinciding with regression. CONCLUSIONS: A significant number of
      patients who are referred to a general medical ward for evaluation of previously
      unclassified rheumatic disorders may be found to have a previously undetected
      malignancy. For most patients, the symptoms of cancer are found by routine
      physical and laboratory examinations. The importance of the association of
      rheumatic disorders and malignancy requires greater awareness, appreciation, and
      clinical study.

PMID- 7773948
TI  - A phase II trial of human recombinant interleukin-2 administered as a 4-day
      continuous infusion for children with refractory neuroblastoma, non-Hodgkin's
      lymphoma, sarcoma, renal cell carcinoma, and malignant melanoma. A Childrens
      Cancer Group study.
AB  - BACKGROUND: Recombinant human Interleukin-2 (IL-2) has been effective at inducing
      measurable antitumor responses in adults with renal cell carcinoma and melanoma.
      It also is being tested as adjuvant therapy for patients with acute myeloid
      leukemia after autologous bone marrow transplantation. METHODS: The authors
      tested IL-2 in a pediatric Phase II trial using a regimen that has antitumor
      effects in adults and was proven to be tolerated acceptably in a prior Phase I
      pediatric trial. Thirty-eight patients were entered into this study of whom 36
      received IL-2 and were evaluable (20 with sarcoma, 9 with neuroblastoma, 5 with
      renal cell carcinoma, and 1 each with melanoma and lymphoma). RESULTS:
      Interleukin-2 dose modifications were based on tolerance and toxicity, such that
      46% of these patients received a 50% increase in IL-2 dose during the second
      week, and 81% of those receiving the elevated dose continued receiving this dose
      level during the third week of treatment. A single patient with renal cell
      carcinoma had a complete response that was maintained; the remaining 35 patients
      did not show objective evidence of tumor response sufficient to qualify as either
      a complete response or a partial response. CONCLUSIONS: Absolute lymphocyte
      counts were indicative of the immunostimulatory effect of this IL-2 regimen as
      observed for adults, with a median 7.2-fold increase. Nevertheless, despite
      immune activation, a sufficient number of patients were evaluated, indicating
      that IL-2 does not have measurable antitumor effects in children with large
      refractory sarcomas or neuroblastomas, whereas one of five children with renal
      cell carcinoma had a complete response, consistent with the 10-20% response rate
      observed in adults.

PMID- 7773949
TI  - Etoposide, ifosfamide, and cisplatin therapy for refractory childhood solid
      tumors. Response and toxicity.
AB  - BACKGROUND: Etoposide, ifosfamide, and cisplatin (VIP) are each active in
      treating pediatric solid tumors, and this combination has been shown to be
      effective in treating adult germ cell tumors. Etoposide, ifosfamide, and
      cisplatin therapy was used to treat 11 patients, with ages ranging from 14 months
      to 22 years, with relapsed sarcoma, Wilm's tumor, and hepatoblastoma. METHODS:
      Etoposide, ifosfamide, and cisplatin therapy was administered daily for 3 days in
      doses of cisplatin 20 mg/m2 with mannitol 10 g/m2 for 1 hour, etoposide 100
      mg/m2, and ifosfamide 1.5 g/m2 with MESNA 360 mg/m2 x 3 doses. A total of 65
      courses (range, 3-10/patient) were administered, with 86% of the courses
      administered at full dose. Hematopoietic growth factors were not used. RESULTS:
      All 10 evaluable patients responded. Six patients had a complete response (CR) by
      computed tomographic or magnetic resonance imaging scan after one to three
      courses. The remaining four patients had a partial response (PR) (> 50% decrease
      in disease). One PR was converted to a CR by resection of the residual lesions.
      The major toxicity was myelosuppression. The median nadirs after full doses were
      as follows: leukocyte count of 900/mm3, absolute neutrophil count (ANC) of
      156/mm3, platelet count of 61,000/mm3, and hemoglobin count of 8.6 g/dl; 75% of
      full dose courses led to an ANC of less than 500. Fever and neutropenia were
      observed after 8/55 (15%) full dose courses. Two episodes of bacteremia were
      noted, one with Staphylococcus epidermidis after full recovery of counts. The
      median time to hematologic recovery was 21 days (range, 14-29 days). No patient
      developed a decreased creatinine clearance level during therapy. Significant
      renal solute losses were observed in two patients, both of whom had been
      pretreated heavily with ifosfamide and had losses before VIP therapy.
      CONCLUSIONS: Etoposide, ifosfamide, and cisplatin appear to be active in treating
      childhood solid tumors. This therapy has predictable and tolerable myelotoxicity,
      and nephrotoxicity does not appear to be more severe than that observed after
      treatment with ifosfamide alone.

PMID- 7773950
TI  - Embryonal craniopharyngioma. Case report of the morphogenesis of a
      craniopharyngioma.
AB  - BACKGROUND: Ordinary craniopharyngiomas affecting sellar regions of children and
      preadolescents are composed of ameloblastomatous and/or squamous constituents.
      The authors encountered an autopsy case of a stillborn infant with a large
      craniopharyngioma with unusual manifestations. METHODS: The craniopharyngioma was
      analyzed using detailed histologic and immunohistochemical techniques. RESULTS:
      An autopsy revealed a large tumor arising from the pituitary gland with
      associated severe hydrocephalus. Histologically, the cells of the tumor showed
      features of ameloblastoma and organoid structures simulating tooth buds and
      adenohypophyseal primordia in the stage of organogenesis. Cells of the latter
      were shown to be immunoreactive for chromogranin A and six adenohypophyseal
      hormones. CONCLUSIONS: Because embryology of the adenohypophysis and the teeth
      indicated that all of the epithelia in this tumor emerged during the normal
      development of the stomodeum, it was believed that an "embryonal form of
      craniopharyngioma" would characterize this organoid neoplasm best. The possible
      morphogenesis of craniopharyngioma is also discussed.

PMID- 7773951
TI  - Characterization and chromosomal assignment of yeast artificial chromosomes
      containing human 3p13-p21-specific sequence tagged sites.
AB  - Human chromosomal region 3p12-p23 is proposed to harbor at least three tumor
      suppressor genes involved in the development of lung cancer, renal cell
      carcinoma, and other neoplasias. In order to identify one of these genes we
      defined sequence tagged sites (STSs) specific for 3p13-p24.2 by analyzing a
      chromosome 3p14 microdissection library. STSs were used for isolating yeast
      artificial chromosome (YAC) clones from the Centre d'Etude du Polymorphisme
      Humain (CEPH) YAC libraries. Thirty-eight YACs were assembled into a contig
      approximately 2.5 Mb in size spanning the t(3;8) and t(3;6) translocation
      breakpoints associated with hereditary renal cell carcinoma and hematologic
      malignancies, respectively. Chromosomal localization and chimeric status of 126
      YACs was analyzed by fluorescence in situ hybridization (FISH). The order of 17
      YACs determined by double-color FISH was in agreement with the STS-based
      arrangement of the YAC-contig.

PMID- 7773952
TI  - Appearance of isochromosome 18q can be associated with in vitro immortalization
      of human T lymphocytes.
AB  - T lymphocytes cultured from a skin biopsy specimen of a patient with atopic
      dermatitis developed isochromosome 18q concomitant to escape from replicative
      senescence. Furthermore, two T-cell lines established from patients with
      cutaneous T-cell lymphoma also developed isochromosome 18q during continuous
      growth. The results indicate that a pathway leading to immortalization of human T
      lymphocytes could involve genes located at chromosome 18.

PMID- 7773953
TI  - Cytogenetic study of a case of synchronous bilateral seminoma.
AB  - Cytogenetic analysis of a case of synchronous bilateral seminoma revealed, for
      each tumor, a chromosomal hypotetraploid mode with gain and loss of chromosomes
      and only one structural rearrangement, del(1p) and i(12p), which were secondary
      chromosomal events for the left and right tumors, respectively. This study
      allowed us to discriminate between a sole or independent origin for these two
      tumors.

PMID- 7773954
TI  - Clonal origin of Philadelphia chromosome negative cells with trisomy 8 appearing
      during the course of alpha-interferon therapy for Ph positive chronic myelocytic
      leukemia.
AB  - The transient appearance of a Philadelphia chromosome (Ph) negative clone with
      trisomy 8 was found in the bone marrow cells from a patient with Ph positive CML
      during the course of alpha-interferon (IFN) therapy. To determine whether this
      clone was derived from a Ph positive clone or from some other cell lineage, we
      performed molecular cytogenetic studies on bone marrow cells from the patient by
      fluorescence in situ hybridization (FISH). No fusion of BCR-ABL could be detected
      in cells with trisomy 8, clearly indicating that the Ph negative trisomy 8 clone
      was not derived from the Ph positive CML population.

PMID- 7773955
TI  - Translocation 11;14 in newly diagnosed chronic myelogenous leukemia.
AB  - In patients with chronic myelogenous leukemia (CML), the Philadelphia chromosome
      may be associated with a number of other cytogenetic lesions. However,
      t(11;14)(q13;q32), found mainly in B-cell lymphoproliferative disorders, has not
      been previously reported in Ph-positive CML. We describe a patient with
      hematologically typical chronic phase CML in whom both cytogenetic lesions were
      found at diagnosis.

PMID- 7773956
TI  - B-cell small lymphocytic lymphoma with circulating granular prolymphocytes and a
      novel trisomy 15 anomaly.
AB  - A 53-year-old man presented with cervical lymphadenopathy and massive
      splenomegaly. Peripheral blood examination showed many prolymphocytes with
      cytoplasmic azurophilic granules, giving an initial impression of large granular
      lymphocytosis. The lymph node biopsy and immunohistochemical study findings,
      however, were more compatible with a diagnosis of B-cell small lymphocytic
      lymphoma. The circulating prolymphocytes showed restricted kappa light chain
      expression similar to the lymphoid infiltrate in the lymph node. Karyotypic
      analysis revealed trisomy 15, a chromosomal abnormality that has rarely been
      described in small lymphocytic lymphoma or chronic lymphocytic leukemia.

PMID- 7773957
TI  - Translocation (9;22)(q22;q12). A recurrent chromosome abnormality in
      extraskeletal myxoid chondrosarcoma.
AB  - Cytogenetic analysis of a case of extraskeletal myxoid chondrosarcoma revealed a
      reciprocal translocation between 9q and 22q in almost all metaphases analyzed.
      Structural rearrangements involving 9q and 22q have been reported previously in
      three cases of extraskeletal myxoid chondrosarcoma. The breakpoints on
      chromosomes 9 and 22 in the present case were in regions 9q22-q31 and 22q11
      q12.2, respectively. The same breakpoints were present in all three previously
      reported cases. Thus, this recently identified rearrangement of 9q and 22q may
      serve as a critical cytogenetic parameter for the diagnosis and classification of
      extraskeletal myxoid chondrosarcoma, as well as being a primary chromosomal event
      in the course of development of this rare malignancy.

PMID- 7773958
TI  - Translocation (5;6) associated with spontaneously remitting congenital leukemia.
AB  - We describe a newborn with acute monocytic leukemia who underwent spontaneous
      remission. Chromosomal analysis of this patient's leukemic blasts identified a
      translocation between 5q31 and 6q21. Chromosome 5 has been implicated in adult
      leukemogenesis but only rarely in childhood leukemia. Several hematopoietic
      growth factors and growth factor receptors have been mapped to the long arm of
      chromosome 5. This report discusses the possible role of these gene products in
      inducing leukemia in our index case.

PMID- 7773960
TI  - Cytogenetic analysis of short-term cultured squamous cell carcinomas of the lung.
AB  - Cytogenetic analysis of 122 primary squamous cell carcinomas of the lung revealed
      clonal abnormalities in 56 tumors. Karyotypes with simple numerical changes were
      found in 32 tumors: 45,X,-Y in 28, 47,XY,+7/45,X-Y, in two, 47,XY,+Y/45,X,-Y and
      47,XY,+20/45,X,-Y in one tumor each. A super-numerary ring chromosome was the
      sole anomaly in two tumors. Complex structural changes were found in 22 tumors.
      The chromosomes most frequently involved in structural rearrangements were
      chromosomes 1 (15 tumors), 3, 7, and 11 (10 tumors each), 5 and 6 (nine tumors
      each), and 2, 8, and 12 (eight tumors each). The bands and regions most often
      affected were 1p11-13 and 5cen (six tumors each), 11p11, 14p11-13, 15cen, and
      17p11-12 (five tumors each), and 12p13 and 13cen (four tumors each). The only
      recurrent changes were the whole-arm rearrangements i(5)(p10) (five tumors) and
      i(6)(p10), der(9;15)(q10;q10), and der(13;15)(q10;q10) (two tumors each). The
      most prominent genomic imbalances were, apart from losses of the Y chromosome,
      losses from 1p, 3p, 5q, 6q, 8p, 13p, and 14p and gains from 1q and 5p.

PMID- 7773959
TI  - No association between HLA-DQ and -DR genotypes with nasopharyngeal carcinoma in
      southern Chinese.
AB  - The pathogenesis of nasopharyngeal carcinoma (NPC) is multifactorial.
      Associations have been reported between HLA and NPC. We studied the HLA-DR and 
      DQ regions on the molecular level in 136 persons (51 NPC patients and 85 healthy
      controls) from southern China, a particularly high-prevalence area for NPC.
      Restriction fragment-length polymorphism (RFLP) was used to genotype the MHC
      class II DR beta, DQ alpha, and DQ beta regions of the subjects. Polymerase chain
      reaction (PCR) using sequence-specific primer (SSP) for DQ beta genes was also
      performed. By RFLP, no significant difference was observed with respect to DRB,
      DQA, and DQB genes. By PCR SSP typing, we confirmed that there was no significant
      difference between NPC patients and controls with respect to DQ beta alleles. Our
      study suggests that HLA-DQ and -DR genes are not associated with NPC in southern
      Chinese and there may be other gene loci that predispose them to have such a high
      prevalence of the disease.

PMID- 7773961
TI  - Correlations of chromosome abnormalities with histologic and immunologic
      characteristics in 49 patients from Akita, Japan with non-Hodgkin lymphoma.
AB  - We have analyzed the chromosomes of 49 non-Hodgkin lymphoma patients from an area
      of Japan that is nonendemic for adult T-cell leukemia/lymphoma. Clonal chromosome
      abnormalities were found in the majority (88%) of the specimens examined. The
      most characteristic structural abnormalities were: t(14;18)(q32;q21),
      t(3;22)(q27;q11), t(11;14)(q13;32), idic(18)(p11.2), and the combination
      del(1)(p13) and del(1)(q11). The t(14;18) were found in four of five follicular
      lymphomas and in one diffuse lymphoma. The breaks at 3q27 included seven
      translocations and an inv(3)(q12q27). A t(3;22) was found in three patients, all
      B-cell type, two of whom had kappa phenotype and one of whom was negative for the
      surface Ig. Fifteen of 49 cases had deletion of 6q. The common deleted region was
      found only in the segment distal to 6q21. These findings indicate the high
      percentage of t(14;18) in follicular lymphomas, which is unusual in Japan, and
      the high incidence of 3q27 translocations.

PMID- 7773962
TI  - Cytogenetic report of a male breast cancer.
AB  - The cytogenetic findings on G-banding in an infiltrating ductal breast carcinoma
      in a 69-year-old man are reported. The main abnormalities observed were trisomy
      of chromosomes 8 and 9 and structural rearrangement in the long arm of chromosome
      17 (add(17)(q25)). Our results confirm the trisomy of chromosome 8 in the
      characterization of the subtype of ductal breast carcinomas and demonstrate that
      chromosome 17, which is frequently involved in female breast cancers, is also
      responsible for the development or progression of primary breast cancers in
      males.

PMID- 7773963
TI  - Renal cell carcinoma with translocation (X;1). Further evidence for a
      cytogenetically defined subtype.
AB  - A renal cell carcinoma from a 15-year-old male had a 49,Y,t(X;1)(p11.2;q21),
      +der(X)t(X;1) (p11.2;q21), +5, -16, +17, +18 karyotype. This is the third report
      of a translocation involving a breakpoint at Xp11.2 in a renal cell carcinoma in
      a child. A total of nine cases of renal cell carcinoma involving Xp11, including
      this case, have been reported. Of the eight cases for which there are genetics
      reports, all are male. Patients with renal cell carcinoma with abnormalities at
      Xp11 appear to be younger than renal cell carcinoma patients overall.

PMID- 7773964
TI  - RT/PCR detection of SIL-TAL-1 fusion mRNA in Chinese T-cell acute lymphoblastic
      leukemia (T-ALL).
AB  - The TAL-1 gene is located on chromosome 1p32. In about 20% of T-cell acute
      lymphoblastic leukemias (T-ALL), this gene is disrupted in its 5' portion by a
      site-specific 100-kg deletion and is fused with the 5' part of the SIL gene, to
      form SIL-TAL-1 chimeric gene. In this study, we established a "nested"
      retrotranscriptase/polymerase chain reaction (RT/PCR) technique which allows
      detection of the SIL-TAL-1 transcriptional expression. A chimeric mRNA was
      observed in four of 17 T-ALL cases and has been shown to result from the fusion
      between the exon 1 of SIL and exon 3 of TAL. A sensitivity test showed that this
      RT/PCR procedure could detect one leukemic cell among 10(6) normal cells. A
      positive RT/PCR result was obtained in two cases during clinical remission,
      suggesting the presence of minimal residual disease (MRD). One patient developed
      clinical relapse 3 months after PCR positivity. Moreover, analysis of the Tald
      rearrangement by DNA-based PCR in four patients with SIL-TAL-1 fusion revealed
      the type A (Tald1) rearrangement in all cases. Sequence analysis demonstrated the
      presence of N region and non-random "P" nucleotide, as well as base deletions at
      the genomic SIL-TAL-1 joining site. These data indicate that detection of TAL-1
      gene abnormality is important for diagnosis and monitoring of MRD in a subset of
      T-ALL.

PMID- 7773965
TI  - Characterization of a 14q+ marker chromosome in philadelphia chromosome positive
      acute lymphoblastic leukemia by DNA analysis and fluorescence in situ
      hybridization.
AB  - We report a case of precursor-B acute lymphoblastic leukemia (ALL) with the
      Philadelphia chromosome (Ph) and a 14q+ chromosome whose additional material was
      a part of the long arm of der(9)t(9;22). A minor population carrying the standard
      Ph translocation without the 14q+ was also observed at the first presentation.
      The translocation of the BCR gene from chromosome 22 to the subtelomeric region
      of the 14q+ was confirmed by fluorescence in situ hybridization (FISH) using a
      yeast artificial chromosome (YAC) clone containing the BCR gene. The breakpoint
      of chromosome 14 could not be determined exactly but probably was at 14q24 or
      14q32 by conventional chromosome analysis. Nevertheless, FISH using a YAC clone
      containing the human immunoglobulin heavy chain (IgH) gene locus, Southern blot,
      and pulsed-field gel electrophoresis (PFGE) analyses with IgJH probe, and loss of
      heterozygosity analysis at the alpha 1-antitrypsin (AT) gene locus showed lack of
      involvement of the IgH gene in the 14q+ and more centromeric breakage than the
      alpha 1-AT locus at 14q32.1. Thus, the formation of the 14q+ seemed to be a
      secondary genetic event after the Ph translocation and presumably played a minor
      role in the pathogenesis of B-cell malignancy in this case.

PMID- 7773966
TI  - Concomitant partial tetrasomy 3q and trisomy 18 in Waldenstrom macroglobulinemia.
AB  - We report a 54-year-old female patient with Waldenstrom macroglobulinemia who
      shows concomitant partial tetrasomy 3q in the form of an additional isochromosome
      3q, and trisomy 18. To our knowledge, isochromosome 3q has not been reported in
      chronic lymphoproliferative disorders. A review of the literature on karyotypic
      aberrations in Waldenstrom macroglobulinemia suggests that additional copies of
      the long arm of chromosome 3 and chromosome 18 may play a possible role in the
      pathogenesis of a subset of this disorder.

PMID- 7773967
TI  - Trisomy 8 in alveolar soft part sarcoma.
AB  - Cytogenetic studies were performed on an alveolar soft part sarcoma of a 6-year
      old boy. An extra chromosome 8 was present in 26 of 28 metaphases analyzed.

PMID- 7773968
TI  - Constitutional and acquired rearrangements of chromosome 7 in Wilms tumor.

PMID- 7773969
TI  - Deletion of both chromosome 7 homologues in leiomyoma.

PMID- 7773970
TI  - Timing of surgery in patients with infected spinal dermal sinuses: report of two
      cases.
AB  - In the past, if infection was present at the time a spinal dermal sinus was
      discovered, the sinus opening and cerebrospinal fluid were sterilized with a
      course of appropriate antibiotic therapy prior to the surgical intervention. The
      cases of two children with an infected spinal dermal sinus are reported here. One
      patient developed acute paraplegia during the initial stage of antibiotic
      therapy, and the second patient, who was admitted only with signs of fever and
      irritability, experienced after antibiotic therapy a complete myelographic
      blockade secondary to a large infected intradural dermoid tumor. The authors
      stress the importance of early neuroradiological and neurosurgical management of
      these lesions, even when an infection is present.

PMID- 7773971
TI  - Late thalamic atrophy in infarction of the middle cerebral artery territory in
      neonates. A prospective clinical and radiological study in four children.
AB  - We report four cases of progressive thalamic atrophy following ipsilateral
      cerebral infarction in the territory of the middle cerebral artery in neonates,
      with prospective radiological and clinical follow-up. This type of atrophy
      appears within 6 months after the onset of cerebral infarction. In the short
      term, this atrophy has no action on sensory and memory function and/or on sensory
      evoked potentials. This atrophy is not the result of secondary ischemic neuronal
      damage. Judging from several other experimental studies, thalamic atrophy may
      primarily result from retrograde degeneration. It would be interesting to observe
      the consequences of this atrophy on sensory and memory function over a long
      period.

PMID- 7773972
TI  - Pediatric cystic meningioma: report of three cases.
AB  - Three cases of pediatric cystic meningioma are reported. In a review of the
      literature the authors stress the importance and difficulty of accurate
      preoperative diagnosis. Cystic meningioma in pediatric patients differs from that
      in adults in the following respects: higher incidence, predilection for males,
      shorter clinical history, less specific neuroradiological diagnosis, frequent
      absence of a dural attachment, prevalence of Nauta type II cystic meningioma, and
      high incidence of the fibroblastic histotype.

PMID- 7773973
TI  - Calcified astrocytoma of the amygdalo-hippocampal region in children.
AB  - Three pediatric cases of temporal lobe seizure due to calcified glioma of
      amygdalo-hippocampal region are described. Computed tomography and magnetic
      resonance imaging showed dense calcification with no postcontrast enhancement in
      the amygdalo-hippocampal region. Positron emission tomography showed low oxygen
      metabolism, low glucose metabolism, hypermetabolism of amino acids, and low
      regional cerebral blood flow in the tumors. Single photon emission computed
      tomography showed a high accumulation of 201Tl chloride and 123I-isopropyl
      iodoamphetamine in one tumor, but otherwise low radioisotope uptake. These
      studies indicated low-grade malignancies. The patients were treated by partial
      tumor removal and radiotherapy. Histological examination of the tumor specimens
      showed astrocytoma with interstitial calcification. One patient died due to tumor
      recurrence, while the others are doing well with minimal seizure. We recommended
      temporal lobectomy in similar cases to achieve complete remission.

PMID- 7773974
TI  - Neurosurgical management of Walker-Warburg syndrome.
AB  - The Walker-Warburg syndrome (WWS) is a lethal complex of the central nervous
      system and the eyes. At present its cause is unknown, but clinical evidence
      strongly suggests that it is an autosomal-recessively inherited disorder. We
      report a series of nine children with WWS. The diagnosis was established by the
      detection of lissencephaly, hydrocephalus, and cerebellar malformation on
      computed tomography. All children exhibited profound psychomotor retardation and
      ocular abnormalities (in their anterior or posterior eye chambers). The existence
      of an occipital encephalocele in eight cases was the main diagnostic clue to WWS.
      Six patients were investigated for the presence for congenital muscular
      dystrophy, which was confirmed in only four of them. There were no patients with
      a cleft lip or palate. We studied the incidence of WWS in Spain and estimated it
      at 0.21 cases per 10,000 live-born children. In our series, WWS was prevalent in
      the Spanish gypsy population. Consanguinity was present in five of seven affected
      families. In a case of pregnancy with twins, one of the siblings was unaffected.
      Eight patients were treated with ventriculoperitoneal shunts and seven underwent
      encephalocele repair. Histological study of the excised encephaloceles
      demonstrated two different patterns. Interestingly, one of the infants showed
      coronal craniosynostosis. Finally, we include in the appendix, for completeness,
      a report of the case of the sibling of a WWS patient with acrania-exencephaly.

PMID- 7773975
TI  - SPECT and epilepsy with continuous spike waves during slow-wave sleep.
AB  - Ten cases of epilepsy with continuous spike waves in slow-wave sleep (CSWS) were
      evaluated using single photon emission computed tomography (SPECT); in eight
      patients the EEG paroxysmal abnormalities showed a predominant localization.
      SPECT carried out using 99mTc-HMPAO allows study of cerebral blood flow (CBF);
      the examination was performed during phases of drowsiness and the results
      compared to the EEG data. In four cases SPECT revealed areas of low CBF in sites
      corresponding to those of the prevalent EEG discharges; in two cases the areas of
      hypoperfusion did not correspond to those indicated by the EEG; lastly, in four
      cases SPECT results were negative. The areas of hypoperfusion were predominantly
      located in the frontal, temporal, and parietal regions. Furthermore, the
      percentage of positive SPECT results was significantly higher (five cases out of
      six) in the group in which the CSWS phase was prolonged for at least 1 year,
      compared to the group in which this phase lasted less than 1 year. Thus, in this
      type of epilepsy, SPECT reveals focal cortical areas of decreased CBF which
      correlated generally to the predominant sites of EEG abnormalities. A longer
      duration of the CSWS phase seems to be associated with a more significant
      cortical disorder, documented by the presence of areas of hypoperfusion.

PMID- 7773976
TI  - Residual spasticity after selective posterior rhizotomy.
AB  - The technique used in performing selective posterior rhizotomies to treat spastic
      cerebral palsy remains controversial. One hundred nine children who had undergone
      selective posterior rhizotomies were studied 6 months after their surgery. Their
      residual spasticity was correlated to the number of roots and whether or not
      abnormally responding roots were left, in order to validate the surgical
      technique used to treat spastic cerebral palsy at most neurosurgical centers in
      North America. The children were divided into three groups (group A: children who
      had their L2-S1 roots tested and selectively lesioned, n = 15; group B: children
      who had their L2-S2 roots tested and selectively lesioned, n = 62; group C:
      children who had their L2-S2 roots tested and whose lesioning was directed both
      by the response to the stimulation and mapping of the S1-S3 dorsal roots for
      afferent pudendal nerve activity, n = 32). Clinically significant residual
      spasticity was present in the gastrocnemius in 33% of the group A children, 11%
      of the group B children, and 6% of the group C children. We found that there was
      no significant increase in residual spasticity in the group C children when
      abnormally responding roots were not cut in order to preserve pudendal nerve
      activity. This study shows that the inclusion of the S2 roots decreases the
      amount of residual spasticity (P < 0.01). It also shows that leaving abnormally
      responding S2 roots to preserve pudendal nerve activity does not affect the
      incidence of postoperative spasticity (P > 0.1).

PMID- 7773977
TI  - Experiences with flow-regulated shunts (Orbis-Sigma valves) in cases of
      difficulty in managing hydrocephalus in children.
AB  - Due to an increasing number of shunt complications with conventional valves, we
      performed a study of 80 flow-regulated Orbis-Sigma valves implanted in 47
      children who had had repeated complications with conventional valves and 33
      children receiving their first shunt. The results were encouraging. During the
      first 5 years after implantation, the probability of absence of any kind of
      surgical intervention to the valve system was 57% and the probability
      satisfactory function of the valve itself was 70%. The most frequent complication
      was underdrainage of CSF, especially in children under the age of 1 year. No
      cases of CSF overdrainage occurred in this series. The Orbis-Sigma valve appears
      especially useful for patients unable to tolerate the anti-siphon device, and for
      patients over 1 year old receiving their first valve for hydrocephalus of non
      tumoral and non-haemorrhagic origin.

PMID- 7773978
TI  - Triventricular hydrocephalus: review of 71 cases evaluated at the Istituto
      Neurologico "C. Besta" Milan over the last 10 years.
AB  - The authors review 71 patients with triventricular hydrocephalus in whom a
      contrast-enhanced CT scan did not show any tumoral or vascular lesion that could
      have caused the hydrocephalus. The patients were subdivided into three age
      groups. The results of the neuroradiological examination, the surgical treatment,
      and the complications of the shunt procedure are analyzed, with special reference
      to the high number (13) of periaqueductal alterations of signal pattern found on
      MRI (interpreted as a "slow growing" neoplasm) and to the incidence and causes of
      shunt malfunction.

PMID- 7773979
TI  - Long-term follow-up in 233 patients with congenital hydrocephalus.
AB  - Data on 233 children with congenital hydrocephalus who were operated on in our
      department from 1964 to 1984 were analyzed. The study was started in January 1990
      and was based on questionnaire followed by a psychological examination. Thirty
      two patients (13.7%) died during the follow-up period. The average number of
      operations during the observation period was 2.7; in 166 patients (= 71.2%) the
      shunt had to be revised at least once. The reason for revision was a mechanical
      problem in 79.4% and infection in 15.5%. The psychological evaluation in 115
      patients showed a normal performance in 62.8%, while 29.8% had mild retardation,
      evident in speech impairment and/or impaired speech development, in memory and
      concentration, in poor intellectual performance and decreased performance in
      school. Severe retardation was seen in 7.4% of cases. Our results showed that the
      best outcome can be achieved with early shunt implantation. We did not, however,
      find any correlation between shunt revision rate and psychological results.

PMID- 7773980
TI  - Long-term results after ventriculo-atrial shunting in children.
AB  - A consecutive series of 120 patients with infantile hydrocephalus who were
      submitted to ventriculo-atrial shunting was studied. The average follow-up was 11
      years. There was no operative mortality; 7 patients died during the follow-up
      period, but only in 1 case was the cause of death a consequence of the shunt
      procedure. The incidence rates of infection and slit ventricle syndrome were 4.2%
      and 1.8%, respectively. Shunt revision was performed on 253 occasions yielding a
      revision rate of 2.2 per patient. Of these 253 revisions 167 (66%) took the form
      of elective lengthening of the atrial catheter. The number of reoperations to
      adjust the length of the atrial catheter or to revise the distal end of the
      shunting system is a major disadvantage, which actually favors ventriculo
      peritoneal shunting as the primary procedure for the treatment of pediatric
      hydrocephalus.

PMID- 7773981
TI  - Long-term outcome in aqueductal stenosis.
AB  - In this study, 78 patients with aqueductal stenosis were submitted to detailed
      neurodevelopmental assessment with a follow-up of 5-25 years. Sixty-eight percent
      of patients were categorized as normal; they either attended normal school
      courses or had regular jobs. Among these, 34% had some motor abnormalities
      (ataxia, mild hemiparesis, visual disturbances). Twenty-four percent (19 cases)
      were moderately disabled (trainable retardation) and 8% (6 cases) were severely
      handicapped. Epilepsy was observed in 13% of the cases. Incidence of recurrent
      and generalized seizures paralleled neurodevelopmental outcome (5% in normal, 16%
      in moderately disabled and 50% in severely disabled patients). Endocrine
      dysfunctions were evident in 28% of the cases and were characterized by
      precocious or delayed puberty, amenorrhea and somatic underdevelopment. No
      patient with ventricular enlargement and a cortical mantle width below 20 mm
      showed a good outcome. Large ventricles were compatible with normal mental
      development when compensated with a corresponding cranial vault enlargement. In
      patients with normal mental status and motor abnormalities, long-term CT scan
      findings revealed the presence of focal brain abnormalities (poroencephaly, brain
      atrophy, calcifications, extracerebral collections).

PMID- 7773983
TI  - Structural investigation on the carbohydrate backbone of the lipopolysaccharide
      from Klebsiella pneumoniae rough mutant R20/O1-.

PMID- 7773982
TI  - Malignant melanotic neuroectodermal tumor of infancy.
AB  - A 2-month-old boy underwent surgery for removal of a right temporal melanotic
      neuroectodermal tumor of infancy (MNTI). Histologically the tumor tissue showed
      signs of malignancy. The child was reexamined several times up to the age of 5
      years. Neuroradiological evaluation showed no evidence of tumor recurrence or
      metastases. No resulting handicap was observed during neurological and
      psychological follow-up examination at the age of 5 years. Our findings confirm
      that surgical removal as the therapy of choice provides an excellent prognosis
      for this kind of tumor in spite of its histologically malignant appearance.

PMID- 7773984
TI  - Authentic standards for the reductive-cleavage method. The positional isomers of
      partially methylated and acetylated or benzoylated 1,5-anhydro-D-galactitol.
AB  - Described herein is an efficient method for the synthesis of the sixteen
      positional isomers of methylated and acetylated or benzoylated 1,5-anhydro-D
      galactitol. The compounds are generated simultaneously by partial methylation of
      1,5-anhydro-D-galactitol and subsequent benzoylation, and the individual isomers
      are obtained in pure form by high-performance liquid chromatography.
      Debenzoylation and acetylation yielded the desired acetates. Reported herein are
      the 1H NMR spectra of the benzoates and the electron-ionization mass spectra of
      the acetates and the tetra-O-methyl derivative. Also reported for the acetates
      and the tetra-O-methyl derivative are their linear temperature-programmed gas
      liquid chromatography retention indices on three different capillary columns.

PMID- 7773985
TI  - TLC-LSIMS of neoglycolipids of glycosaminoglycan disaccharides and of
      oxymercuration cleavage products of heparin fragments that contain unsaturated
      uronic acid.
AB  - Heparin and chondroitin sulfate disaccharides have been investigated by high
      performance (HP) TLC and liquid secondary-ion mass spectrometry (LSIMS) after
      conversion to neoglycolipid derivatives by reductive-amination with an aminolipid
      (dihexadecyl phosphatidylethanolamine, DHPE). Mobility on HPTLC was largely
      determined by the number of sulfate groups present, but was also influenced by
      the position of sulfate, monosaccharide composition and linkage. The mass spectra
      acquired directly from the TLC plate provided quasimolecular and fragment ions
      from which composition, including sulfate content, and sequence information was
      obtained at high sensitivity. Lipid DHPE conjugation and TLC-LSIMS were performed
      to analyse products of the oxymercuration reaction used to cleave unsaturated
      uronic acid (delta UA) residues from glycosaminoglycan (GAG) fragments produced
      by enzymatic degradation with glycan lyases. Previously the identification of the
      product from delta UA and the integrity of the remaining structures from
      oligosaccharides larger than disaccharide have not been made. Multiple and
      characteristic products of the cleaved delta UA were detected and these can be
      used for identification of terminal delta UA and its sulfate content. It was
      established with several disaccharides and a tetrasaccharide that glycosidic
      linkages and O- and N-sulfate groups are preserved in the remaining structures
      after removal of delta UA. These results indicate that the oxymercuration
      reaction will be applicable to generating series of GAG fragments containing
      unmodified sequences for biological activity studies.

PMID- 7773986
TI  - Characterisation by LSI-MS and 1H NMR spectroscopy of tetra-, hexa-, and octa
      saccharides of porcine intestinal heparin.
AB  - The characterisation of oligosaccharide fragments isolated from enzymatically
      depolymerised porcine intestinal heparin is required in order to probe
      structure/function relationships of heparin in anticoagulation, antiangiogenesis
      and antiviral activity. We have used both LSI-MS and 600-MHz 1H NMR with chemical
      shift assignment by comprehensive 1H-1H TOCSY experiments to fully characterise
      the major oligosaccharide components including 4 tetrasaccharides, 3
      hexasaccharides, and 2 octasaccharides. One of the octasaccharides has not been
      identified previously and has the structure: delta UA(2S)-GlcNS(6S)-IdoA(2S)
      GlcNS(6S)-IdoA(2S)- GlcNS(6S)-GlcA-GlcNS(6S), where delta UA is 4,5-unsaturated
      uronic acid (4-deoxy-alpha-L-threo-hex-4-enopyranosyluronic acid), GlcN is --> 4)
      alpha-D-glucosamine, IdoA is --> 4)-alpha-L-iduronic acid, GlcA is --> 4)-beta-D
      glucuronic acid, and 2-O-, 6-O-, and 2-N-sulfate are abbreviated to 2S, 6S, and
      NS, respectively. Nearly complete NMR proton chemical shifts are reported for
      this data set. In addition a novel approach involving oxymercuration-lipid
      conjugation was used to independently assign sulfate substitution on the delta UA
      residues.

PMID- 7773987
TI  - Full assignment of the NMR spectrum of the capsular polysaccharide from
      Streptococcus pneumoniae serotype 10A.

PMID- 7773988
TI  - A new synthesis of 6-O-acylsucroses and of mixed 6,6'-di-O-acylsucroses.
AB  - Various 6-O-acylsucroses were synthesized in good yields from unprotected sucrose
      in N,N-dimethylformamide and the appropriate 3-acylthiazolidine-2-thiones 6 or 3
      acyl-5-methyl-1,3,4-thiadiazole-2(3H)-thiones 7. A selective ionization of the
      free sugar by sodium hydride or triethylamine, followed by acylation with 6, gave
      2-O-acylsucroses which were subjected in situ to intramolecular isomerizations
      using 1,8-diazabicyclo[5.4.0]undec-7-ene (DBU) or an aqueous solution of
      triethylamine to yield 6-O-acylsucroses. The later were otherwise obtained
      directly when sucrose was acylated with 6 or 7 in the presence of DBU. Moreover,
      mixed 6,6'-di-O-acylsucroses were readily obtained from 6'-monoacylates by using
      a Mitsunobu reaction without involving the concomitant formation of the 3',4'
      epoxide.

PMID- 7773989
TI  - Transjugular intrahepatic portosystemic shunt in portal vein thrombosis: role of
      the right gastric vein with anomalous insertion.
AB  - Transjugular intrahepatic portosystemic shunt (TIPS) was performed in two
      patients with portal vein thrombosis. In both patients, hepatopetal flow had been
      maintained by an anomalous insertion of the right gastric vein (RGV) into the
      portal vein bifurcation and into the left portal branch respectively. In one
      patient, the main portal trunk could not be recanalized and the RGV was used as
      an accessory portal vein to place one stent for TIPS. In the other case, access
      through the partial portal-vein occlusion was gained and three stents were placed
      from the hepatic vein to the main portal vein distal to the thrombus. In portal
      vein thrombosis, the aberrant insertion of the RGV into the left or right portal
      branches may maintain patency of the intrahepatic portal system and, in case of
      unsuccessful recanalization of the porta, may represent the sole pathway for
      placing a TIPS.

PMID- 7773990
TI  - Palmaz stent dislodgement into the left pulmonary artery complicating TIPS:
      percutaneous retrieval and extraction after venotomy.
AB  - A Palmaz stent had dislodged into the left pulmonary artery after TIPS. After
      transfemoral catheterization of the left pulmonary artery, the stent was
      retrieved into the right femoral vein employing an angioplastic balloon catheter
      and finally extracted after surgical venotomy.

PMID- 7773991
TI  - Intentional occlusion of a transjugular intrahepatic portosystemic shunt.
AB  - The transjugular intrahepatic portosystemic shunt (TIPS) procedure is a well
      described means of treating portal hypertension and its complications.
      Occasionally, the consequences of this shunt prompt the desire for its subsequent
      obliteration. We report one unsuccessful and one successful method of TIPS
      occlusion.

PMID- 7773992
TI  - Dissecting pseudoaneurysm of the hepatic artery: a delayed complication of
      angioplasty in a liver transplant.
AB  - We report a 59-year-old female with a dissecting pseudoaneurysm of the allograft
      hepatic artery, as a delayed complication of percutaneous transluminal
      angioplasty (PTA). PTA of a severe anastomotic stenosis was successful, but
      complicated by a dissection involving the allograft hepatic artery. A large
      dissecting pseudoaneurysm developed and was incidentally detected during routine
      sonographic evaluation 14 months after PTA. Because of the extent of the
      pseudoaneurysm, percutaneous repair or surgical reconstruction was considered
      impossible. The patient underwent successful retransplantation 1 week after
      diagnosis.

PMID- 7773993
TI  - Double aortic arch in d-transposition of the great arteries complicated by
      tracheobronchomalacia.
AB  - Simultaneous occurrence of d-transposition of the great arteries and aortic arch
      malformations is very rare. A case of this malformation, the fourth case reported
      in the literature, is described. Despite successful surgery,
      tracheobronchomalacia was fatal at the age of 7 months.

PMID- 7773994
TI  - Anomalous origin of the right pulmonary artery from the ascending aorta:
      diagnosis by magnetic resonance imaging.
AB  - Anomalous origin of the right pulmonary artery from the ascending aorta is a rare
      congenital anomaly. Magnetic resonance imaging (MRI) was performed on three
      patients with anomalous origin of the right pulmonary artery from the ascending
      aorta. ECG-gated, T1-weighted, spin-echo MRIs and cine MRIs were obtained. In one
      patient, postoperative MRI was also obtained. Echocardiography and cardiac
      catheterization were performed in three patients and angiocardiography was
      performed in two. MRI clearly showed anomalous origin of the right pulmonary
      artery from the posterior aspect of the ascending aorta, as well as combined
      anomalies including patent ductus arteriosus, aortopulmonary window, and
      interruption of the aortic arch in all three patients. Echocardiography missed
      this anomaly in all three. We suggest that MRI is an accurate imaging modality in
      diagnosing anomalous origin of the right pulmonary artery from the ascending
      aorta, obviating the need to perform angiocardiography.

PMID- 7773996
TI  - Crossover approach with a J-shaped sheath for angioplasty of iliofemoral artery
      stenoses and occlusions.
AB  - Thirty patients with atherosclerotic stenoses or occlusions of iliofemoral
      arteries were treated from the contralateral approach using a newly designed J
      shaped sheath. Seven patients with stenoses and one with an occlusion were
      successfully dilated with balloon angioplasty. Twenty-two patients with
      occlusions were treated with urokinase infusion, 16 of whom received coaxial
      infusion with the J-shaped sheath and catheter. Complete thrombolysis was
      achieved in 18 patients. The treatment success rate was 100% in the stenotic
      group and 83% in the occlusion group. Initially, J-shaped sheaths were useful for
      treatment of iliofemoral artery lesions from the contralateral femoral artery.

PMID- 7773997
TI  - Re: Histological analysis of atherectomy specimens: an opportunity neglected to
      guide therapy preventing restenosis.

PMID- 7773998
TI  - An introduction to the Food and Drug Administration and how it evaluates new
      devices: establishing safety and efficacy.
AB  - Most physicians, and certainly the lay public, have only limited knowledge of the
      responsibilities and limits of the Food and Drug Administration (FDA) of the
      United States of America. Although laws as early as 1902 protected the public
      from unrestricted sale of unsafe drugs, it was not until 1976 that devices came
      under regulation. An obvious difference existed between regulatory control of
      drugs vs devices. The drug-based approach for evaluation was rejected in favor of
      a new system based on device class and its degrees of risk. The premarket
      notification process (510K), and the premarket approval application (PMAA) became
      the regulatory pathway for device approval. The investigational device exemption
      (IDE) became the mechanism for established safety and efficacy. Occasionally
      conflicts exist between industry and the FDA. Submission of poorly planned
      studies wastes FDA resources whereas prolonged approval times can be devastating
      to the small single product business that creates the majority of our new
      devices. A compromise is obviously necessary if we are to maintain our premier
      identity as a new device entrepreneurial center and avoid industry's migration to
      countries where the regulatory standards might be less rigid.

PMID- 7773995
TI  - Localization of small pulmonary nodules for thoracoscopic resection: use of a
      newly developed hookwire system.
AB  - We developed a stainless steel spring hookwire, 0.28 mm in diameter and 10 mm in
      length, with a 30-cm-long, 5-0 nylon monofilament suture firmly attached to its
      funnel-shaped end. A 21-gauge, 10-cm-long cannula was used as an introducer, and
      a 24-gauge, 10-cm-long blunt-pointed needle as a pusher. The hookwire was
      successfully placed into the target pulmonary parenchyma under computed
      tomography guidance in two patients with a small pulmonary nodule. The attached
      string served as a clear guide at thoracoscopy. Flexibility of the exposed suture
      through the skin eased wire management after placement. No wire dislodgement
      occurred.

PMID- 7773999
TI  - Treatment of postoperative residual hepatolithiasis after progressive stenting of
      associated bile duct strictures through the T-tube tract.
AB  - PURPOSE: The authors report their experience with the treatment of intrahepatic
      bile duct strictures associated with hepatolithiasis. METHODS: Eighty patients
      had multiple postoperative retained intrahepatic duct stones trapped behind
      intrahepatic biliary strictures. Before stone extraction, the strictures were
      opened gradually by semirigid dilators, followed by stent placement to create
      enough patency for stone removal. All procedures were carried out through the T
      tube tracts and were aided by cholangioscopy and electrohydraulic lithotripsy.
      RESULTS: Complete clearance of stones was achieved in 69 patients. Failure to
      dilate the strictures was due to acute and multiple ductal angulations. These
      included the right posterior inferior intrahepatic duct at its junction with the
      left intrahepatic ducts when it was more than 2 cm distal to the hepatic
      bifurcation, when the angle between the T-tube tract and the common bile duct was
      smaller than 90 degrees, and when stones were located in peripheral intrahepatic
      ducts with more than five angulations. CONCLUSION: This technique is considered
      safe and effective for complicated hepatolithiasis with intrahepatic biliary
      strictures.

PMID- 7774001
TI  - The role of magnetic resonance angiography in the diagnosis of subclavian steal.
AB  - PURPOSE: To compare magnetic resonance angiography (MRA) with digital angiography
      for diagnosis of subclavian steal syndrome. METHODS: A comparison study between
      MRA and digital contrast arteriography was carried out in 10 patients with
      suspected subclavian steal syndrome. Two of these patients were studied by MRA
      before and after percutaneous transluminal angioplasty (PTA). MRA was obtained on
      a 1.5 tesla superconductive magnet with linear head coil using a fast low angle
      shot (FLASH 2D) sequence in the axial plane as well as a fast imaging with steady
      state precession (FISP 3D) with velocity compensation gradient echo sequence in
      the coronal plane. The coronal images were used as source data for the
      construction of projection images with the use of a maximum-intensity pixel
      algorithm. The images were rotated from -45 degrees to 45 degrees in 15 degrees
      steps. RESULTS: All 10 patients had evidence of proximal subclavian artery
      obstruction and flow reversal in the ipsilateral vertebral artery. On MRA,
      consistent visualization of the affected vertebral artery in the FLASH 2D
      sequences and nonvisualization in the FISP 3D sequences was interpreted as an
      indirect sign of subclavian steal. The subclavian artery obstruction could not be
      assessed due to field size limits of MRA. CONCLUSION: MRA allows determination of
      flow reversal in the diagnosis of subclavian steal.

PMID- 7774000
TI  - Hepatocellular carcinoma: efficacy of transcatheter oily chemoembolization in
      relation to macroscopic and microscopic patterns of tumor growth among 100
      patients with partial hepatectomy.
AB  - PURPOSE: To evaluate the efficacy of transcatheter oily chemoembolization (TOCE)
      for hepatocellular carcinoma (HCC) on the basis of microscopic and macroscopic
      findings postembolization. METHODS: HCCs ranging in size from 0.5 to 13 cm (mean
      3.6 cm) were obtained from partial hepatectomies of 100 consecutive patients who
      had undergone TOCE between 20 and 246 days (mean 59.5 days) prior to surgery. The
      efficacy of TOCE was assessed on the basis of the necrotic to live cell ratio of
      the tumors. The microscopic pattern of tumor growth was grouped into expanding
      type (complete capsule formation) and replacing type (incomplete or no capsule).
      There were five types of macroscopic groupings: single nodule, single nodule with
      extranodular growth (SNE), contiguous and noncontiguous multinodular, and massive
      growth type. RESULTS: Among 79 cases with the expanding type, 29 (37%) had 100%
      HCC necrosis, but none with 100% necrosis were in the replacing type. By
      macroscopic grouping, the efficacy of TOCE decreased from the single nodule type
      (50% of patients had 100% necrosis) to the SNE type (21%), and the other types
      (9%). CONCLUSION: TOCE appears to be most efficacious for HCC with the expanding
      growth pattern and HCC forming single nodules. Poor results are to be expected in
      HCC of replacing growth type and multinodular or massive growth types.

PMID- 7774002
TI  - Indirect portography enhanced by nicardipine versus prostaglandin E1.
AB  - PURPOSE: To compare nicardipine (NCR) and prostaglandin E1 (PGE1) for portal
      venous contrast enhancement on indirect portography in a retrospective study.
      METHODS: One milligram of NCR, a calcium antagonist, was injected into the
      superior mesenteric artery just prior to portography in 18 patients who had
      undergone otherwise identical portography using 20 micrograms PGE1 36-279 (mean
      133) days before. All 18 patients had liver tumors and showed no changes in
      portal vein status in the interim. RESULTS: Using conventional film/screen
      angiography, NCR provided equally good portograms as PGE1 with respect to image
      density and image contrast. Systemic effects on blood pressure and heart rate
      were minimal and no other side effects were observed with NCR. CONCLUSION: NCR is
      an inexpensive drug and is expected to provide well-contrasted, indirect
      portograms on conventional film/screen angiography.

PMID- 7774003
TI  - The protective effect of portoarterial shunts after experimental hepatic artery
      embolization in rats with liver cirrhosis.
AB  - PURPOSE: The role of the portal system after hepatic artery embolization (HAE)
      was examined. METHODS: Using a Wistar strain rat model of liver cirrhosis, the
      route and occurrence of portoarterial (PA) shunts before and after HAE by
      scanning electron microscopic (SEM) and histologic methods were evaluated. HAE
      was performed with iodized oil and gelatin sponge particles. RESULTS: In the SEM
      study, PA shunts did not develop in normal rats regardless of whether they did (n
      = 10) or did not have HAE (n = 5). The cirrhotic rat model showed PA shunts in
      both HAE (n = 5) and non-HAE (n = 5) animals. PA shunts were established via the
      peribiliary plexus and direct arterioportal anastomosis. In the histologic study,
      the occurrence of PA shunts in liver cirrhosis was significantly increased by HAE
      (HAE = 6, non-HAE = 6, p < 0.01). CONCLUSION: The development of PA shunts, which
      help perfuse liver parenchyma, may explain why HAE can be safely performed in
      patients with liver cirrhosis.

PMID- 7774004
TI  - Alphavirus and flavivirus glycoproteins: structures and functions.

PMID- 7774005
TI  - The price of repression.

PMID- 7774006
TI  - Signal transduction and membrane traffic: the PITP/phosphoinositide connection.

PMID- 7774007
TI  - The Gordon Conferences--R.I.P.?

PMID- 7774008
TI  - ORC and Cdc6p interact and determine the frequency of initiation of DNA
      replication in the genome.
AB  - The origin recognition complex (ORC) binds replicators in the yeast S. cerevisiae
      in a manner consistent with it being an initiator protein for DNA replication.
      Two-dimensional (2D) gel techniques were used to examine directly initiation of
      chromosomal DNA replication in temperature-sensitive orc mutants. Unlike in wild
      type cells, in orc2-1 and orc5-1 mutant cells, only a subset of replicators
      formed active origins of DNA replication at the permissive temperature. At the
      restrictive temperature, the number of active replicators was diminished further.
      Using a genetic screen, CDC6 was identified as a multicopy suppressor of orc5-1.
      2D gel and biochemical analyses demonstrated that Cdc6p interacted functionally
      and physically with ORC. We suggest that ORC and Cdc6p form a prereplication
      complex at individual replicators and therefore cooperate to determine the
      frequency of initiation of DNA replication in the genome.

PMID- 7774009
TI  - Purification of Tetrahymena telomerase and cloning of genes encoding the two
      protein components of the enzyme.
AB  - Telomerase is a ribonucleoprotein DNA polymerase that catalyzes the de novo
      synthesis of telomeric simple sequence repeats. We describe the purification of
      telomerase and the cloning of cDNAs encoding two protein subunits from the
      ciliate Tetrahymena. Two proteins of 80 and 95 kDa copurified and
      coimmunoprecipitated with telomerase activity and the previously identified
      Tetrahymena telomerase RNA. The p95 subunit specifically cross-linked to a
      radiolabeled telomeric DNA primer, while the p80 subunit specifically bound to
      radiolabeled telomerase RNA. At the primary sequence level, the two telomerase
      proteins share only limited homologies with other polymerases and polymerase
      accessory factors.

PMID- 7774010
TI  - Identification of a nuclear receptor that is activated by farnesol metabolites.
AB  - Nuclear hormone receptors comprise a superfamily of ligand-modulated
      transcription factors that mediate the transcriptional activities of steroids,
      retinoids, and thyroid hormones. A growing number of related proteins have been
      identified that possess the structural features of hormone receptors, but that
      lack known ligands. Known as orphan receptors, these proteins represent targets
      for novel signaling molecules. We have isolated a mammalian orphan receptor that
      forms a heterodimeric complex with the retinoid X receptor. A screen of candidate
      ligands identified farnesol and related metabolites as effective activators of
      this complex. Farnesol metabolites are generated intracellularly and are required
      for the synthesis of cholesterol, bile acids, steroids, retinoids, and
      farnesylated proteins. Intermediary metabolites have been recognized as
      transcriptional regulators in bacteria and yeast. Our results now suggest that
      metabolite-controlled intracellular signaling systems are utilized by higher
      organisms.

PMID- 7774011
TI  - Transcription factor NF-E2 is required for platelet formation independent of the
      actions of thrombopoietin/MGDF in megakaryocyte development.
AB  - Despite the importance of blood platelets in health and disease, the mechanisms
      regulating their formation within megakaryocytes are unknown. We generated mice
      lacking the hematopoietic subunit (p45) of the heterodimeric erythroid
      transcription factor NF-E2. Unexpectedly, NF-E2-/- mice lack circulating
      platelets and die of hemorrhage; their megakaryocytes show no cytoplasmic
      platelet formation. Though platelets are absent, serum levels of the growth
      factor thrombopoietin/MGDF are not elevated above controls. Nonetheless, NF-E2-/-
      megakaryocytes proliferate in vivo in response to thrombopoietin administration.
      Thus, as an essential factor for megakaryocyte maturation and platelet
      production, NF-E2 must regulate critical target genes independent of the action
      of thrombopoietin. These findings provide insight into the genetic analysis of
      megakaryocyte maturation and thrombopoiesis.

PMID- 7774012
TI  - Molecular basis of human 46X,Y sex reversal revealed from the three-dimensional
      solution structure of the human SRY-DNA complex.
AB  - The solution structure of the specific complex between the high mobility group
      (HMG) domain of SRY (hSRY-HMG), the protein encoded by the human testis
      determining gene, and its DNA target site in the promoter of the mullerian
      inhibitory substance gene has been determined by multidimensional NMR
      spectroscopy. hSRY-HMG has a twisted L shape that presents a concave surface
      (made up of three helices and the N- and C-terminal strands) to the DNA for
      sequence-specific recognition. Binding of hSRY-HMG to its specific target site
      occurs exclusively in the minor groove and induces a large conformational change
      in the DNA. The DNA in the complex has an overall 70 degrees-80 degrees bend and
      is helically unwound relative to classical A- and B-DNA. The structure of the
      complex reveals the origin of sequence-specific binding within the HMG-1/HMG-2
      family and provides a framework for understanding the effects of point mutations
      that cause 46X,Y sex reversal at the atomic level.

PMID- 7774013
TI  - Low pH induces swiveling of the glycoprotein heterodimers in the Semliki Forest
      virus spike complex.
AB  - Time-resolved cryoelectron microscopy reveals the first step in the
      conformational changes that enable membrane fusion in Semliki Forest virus. The
      neutral pH structure reveals a central cavity within the spike complex, plate
      like extensions forming a layer above the membrane, and the paths of the paired
      transmembrane domains connecting the trimeric spikes and pentamer-hexamer
      clustered capsid subunits. Low pH treatment results in centrifugal movement of
      E2, the receptor-binding subunit, centripetal movement of E1 to narrow the
      central cavity initiating the formation of an E1 trimer, and the extension of the
      E1 fusion sequence toward the target membrane.

PMID- 7774014
TI  - The protein kinase encoded by the Akt proto-oncogene is a target of the PDGF
      activated phosphatidylinositol 3-kinase.
AB  - The serine/threonine protein kinase encoded by the Akt proto-oncogene is
      catalytically inactive in serum-starved primary and immortalized fibroblasts.
      Here we show that Akt and the Akt-related kinase AKT2 are activated by PDGF. The
      activation was rapid and specific, and it was abrogated by mutations in the Akt
      Pleckstrin homology (PH) domain. The Akt activation was also shown to depend on
      PDGFR beta tyrosines Y740 and Y751, which bind phosphatidylinositol 3-kinase (PI
      3-kinase) upon phosphorylation. Moreover, Akt activation was blocked by the PI 3
      kinase-specific inhibitor wortmannin and the dominant inhibitory N17Ras.
      Conversely, Akt activity was induced following the addition of
      phosphatidylinositol-3-phosphate to Akt immunoprecipitates from serum-starved
      cells in vitro. These results identify Akt as a novel target of PI 3-kinase and
      suggest that the Akt PH domain may be a mediator of PI 3-kinase signaling.

PMID- 7774015
TI  - Serpentine cAMP receptors may act through a G protein-independent pathway to
      induce postaggregative development in Dictyostelium.
AB  - The transcription factor G box-binding factor (GBF) is required for the
      developmental switch between aggregative and postaggregative gene expression,
      cell-type differentiation, and morphogenesis. We show that constitutive
      expression of GBF allows ectopic expression of postaggregative genes, but only in
      response to exogenous cAMP. GBF activation requires the serpentine cAMP receptors
      required for aggregation, but not the coupled G alpha 2 or the G beta subunit,
      suggesting a novel signaling pathway. In response to high cAMP, g alpha 2-null
      cells can bypass the aggregation stage, expressing cell type-specific genes and
      forming fruiting bodies. Our results demonstrate that the same receptors regulate
      aggregation and cell-type differentiation, but via distinct pathways depending
      upon whether the receptor perceives a pulsatile or sustained signal.

PMID- 7774016
TI  - Sonic hedgehog induces the differentiation of ventral forebrain neurons: a common
      signal for ventral patterning within the neural tube.
AB  - The vertebrate hedgehog-related gene Sonic hedgehog (Shh) is expressed in ventral
      domains along the entire rostrocaudal length of the neural tube, including the
      forebrain. We show here that SHH induces the differentiation of ventral neuronal
      cell types in explants derived from prospective forebrain regions of the neural
      plate. Neurons induced in explants derived from both diencephalic and
      telencephalic levels of the neural plate express the LIM homeodomain protein Isl
      1, and these neurons possess distinct identities that match those of the ventral
      neurons generated in these two subdivisions of the forebrain in vivo. A single
      inducing molecule, SHH, therefore appears to mediate the induction of distinct
      ventral neuronal cell types along the entire rostrocaudal extent of the embryonic
      central nervous system.

PMID- 7774017
TI  - The Drosophila schnurri gene acts in the Dpp/TGF beta signaling pathway and
      encodes a transcription factor homologous to the human MBP family.
AB  - Decapentaplegic (dpp), a TGF beta-related ligand, plays a key role in Drosophila
      development. Although dpp receptors have been isolated, the downstream components
      of the signaling pathway remain to be identified. We have cloned the schnurri
      (shn) gene and show that it encodes a putative zinc finger transcription factor
      homologous to the human major histocompatibility complex-binding proteins 1 and
      2. Mutations in shn affect multiple events that require dpp signaling as well as
      the transcription of dpp-responsive genes. Genetic interactions and the
      strikingly similar phenotypes of mutations in shn and the dpp receptors encoded
      by thick veins and punt suggest that shn plays a downstream role in dpp
      signaling.

PMID- 7774018
TI  - Schnurri is required for Drosophila Dpp signaling and encodes a zinc finger
      protein similar to the mammalian transcription factor PRDII-BF1.
AB  - Cytokines of the TGF beta superfamily regulate many aspects of cellular function
      by activating receptor complexes consisting of two distantly related
      serine/threonine kinases. Previous studies have indicated that Drosophila dpp
      uses similar signaling complexes and strictly requires the punt and thick veins
      receptors to transduce the signal across the membrane. Here, we show that the
      schnurri (shn) gene is required for many aspects of dpp signaling. Genetic
      epistasis experiments indicate that shn functions downstream of the dpp signal
      and its receptors. The shn gene encodes a large protein similar to a family of
      mammalian zinc finger transcription factors. The shn protein might therefore act
      as a nuclear target in the dpp signaling pathway directly regulating the
      expression of dpp-responsive genes.

PMID- 7774020
TI  - Targeted disruption of the Huntington's disease gene results in embryonic
      lethality and behavioral and morphological changes in heterozygotes.
AB  - Huntington's disease (HD) is an incurable neuropsychiatric disease associated
      with CAG repeat expansion within a widely expressed gene that causes selective
      neuronal death. To understand its normal function, we have created a targeted
      disruption in exon 5 of Hdh (Hdhex5), the murine homolog of the HD gene.
      Homozygotes die before embryonic day 8.5, initiate gastrulation, but do not
      proceed to the formation of somites or to organogenesis. Mice heterozygous for
      the Hdhex5 mutation display increased motor activity and cognitive deficits.
      Neuropathological assessment of two heterozygous mice shows significant neuronal
      loss in the subthalamic nucleus. These studies show that the HD gene is essential
      for postimplantation development and that it may play an important role in normal
      functioning of the basal ganglia.

PMID- 7774019
TI  - Yama/CPP32 beta, a mammalian homolog of CED-3, is a CrmA-inhibitable protease
      that cleaves the death substrate poly(ADP-ribose) polymerase.
AB  - Although the mechanism of mammalian apoptosis has not been elucidated, a protease
      of the CED-3/ICE family is anticipated to be a component of the death machinery.
      Several lines of evidence predict that this protease cleaves the death substrate
      poly(ADP-ribose) polymerase (PARP) to a specific 85 kDa form observed during
      apoptosis, is inhibitable by the CrmA protein, and is distinct from ICE. We
      cloned a ced-3/ICE-related gene, designated Yama, that encodes a protein
      identical to CPP32 beta. Purified Yama was a zymogen that, when activated,
      cleaved PARP to generate the 85 kDa apoptotic fragment. Cleavage of PARP by Yama
      was inhibited by CrmA but not by an inactive point mutant of CrmA. Furthermore,
      CrmA blocked cleavage of PARP in cells undergoing apoptosis. We propose that Yama
      may represent an effector component of the mammalian cell death pathway and
      suggest that CrmA blocks apoptosis by inhibiting Yama.

PMID- 7774021
TI  - Micelle/water partition properties of phenols determined by liquid
      chromatographic method. Proposal for versatile measure of hydrophobicity.
AB  - Partition properties have been determined for 28 monosubstituted phenols in the
      sodium dodecylsulfate (SDS)/water system by micellar liquid chromatography (MLC),
      offering a useful and versatile method to estimate the hydrophobicity of
      compounds. The enthalpy and entropy terms of partition have also been determined
      from variable temperature experiments on MLC and are interpreted by such factors
      as molecular size and hydrogen-bond ability of the solute. The pi constants (pi,
      pi H and pi S) are determined from the experimental partition properties and
      applied to quantitative structure-activity relationships (QSAR) analysis, and
      their versatility supported.

PMID- 7774022
TI  - Duocarmycins, potent antitumor antibiotics produced by Streptomyces sp.
      structures and chemistry.
AB  - Seven novel potent antitumor antibiotics, duocarmycins A (1), C1 (2), C2 (3), D
      (4), B1 (5), B2 (6) and SA (7), were isolated from three independently collected
      Streptomyces sp. The complete structures, including absolute stereochemistry,
      were determined by spectral and chemical studies of those duocarmycins and
      several derivatives. Duocarmycins A (1) and SA (7) possess a 1,2,7,7a
      tetrahydrocycloprop[1,2-c]indol-4-one subunit, a common pharmacophore with that
      of CC-1065 (10) found from Streptomyces zelensis.

PMID- 7774023
TI  - Purines. LXX. An extension of the "phenacylamine route" to the syntheses of the 7
      N-oxides of 6-mercaptopurine and 6-methylthiopurine, and antileukemic activity of
      some purine N-oxides.
AB  - A full account is given of the first syntheses of 6-mercaptopurine 7-N-oxide (4)
      and 6-methylthiopurine 7-N-oxide (5). The synthesis of 4 followed a
      "phenacylamine route", which started from condensation of 4,6-dichloro-5
      nitropyrimidine (15) with N-(4-methoxybenzyl)phenacylamine to form the
      phenacylaminopyrimidine derivative (11) and proceeded through conversion into the
      mercapto derivative, intramolecular cyclization between the NO2 nitrogen atom and
      the phenacyl carbanion to give 6-mercapto-9-(4-methoxybenzyl)purine 7-N-oxide
      (12), and removal of the 4-methoxybenzyl group. S-Methylation of 12 and removal
      of the 4-methoxybenzyl group afforded 5. The location of the oxygen function in
      4,5, and 12 was confirmed by X-ray crystallographic analysis of 5.H2O, which was
      shown to exist in the N(7)-OH form (19). A UV spectroscopic approach suggested
      that the neutral species of 4 exists in H2O as the N(7)-OH tautomer (21), whereas
      that of 5 exists as an equilibrated mixture of the N(7)-oxide (5) and the N(7)-OH
      (19) tautomers. In the in vitro bioassay of antileukemic activity against murine
      L5178Y cells, the N-oxides 4 and 12 were found to be weakly cytotoxic.

PMID- 7774024
TI  - Disaccharides as endomannosidase inhibitors: syntheses of alpha
      homomannojirimycin and beta-homomannojirimycin linked to D-glucose and D-mannose.
AB  - 4-O-(alpha-D-Glucopyranosyl)-alphaHMJ (Glcalpha1,4HMJ), 4-O-(alpha
      mannopyranosyl)-alphaHMJ (Manalpha1,4alphaHMJ), 4-0-(alpha-glucopyranosyl)
      betaHMJ (Glcalpha1,4betaHMJ), and 4-0-(alpha-mannopyranosyl)-betaHMJ (Manalpha1,
      4betaHMJ) were synthesized as endomannosidase inhibitors which are potentially
      useful both for probing the pathways of N-linked glycoprotein processing and for
      the chemotherapy of some viral diseases.

PMID- 7774025
TI  - Synthetic study of 2-[(6,7,8,9-tetrahydro-5H-cyclohepta[b]pyridin-9- yl)
      sulfinyl]-1H-benzimidazole analogs and their biological properties as novel
      proton pump inhibitors.
AB  - A series of 2-[(cycloalka[b]pyridinyl)sulfinyl]-1H-benzimidazoles (11) was
      synthesized and tested for antisecretory activity against pentagastrin-induced
      gastric acid secretion in rats. A novel benzimidazole derivative containing a
      cyclohepta[b]pyridine moiety was found to be the most potent among the congeners,
      which included five- to eight-membered cycloalka[b]pyridine ring systems. Some 2
      [(6,7,8,9-tetrahydro-5H-cyclohepta[b]pyridin-9-yl)sulfinyl]-1H- benzimidazole
      analogs (14) with various substituents on the aromatic rings showed superior
      properties to omeprazole (1) in biological examinations in vivo. A
      diastereoisomer, TY-11345 (28Ba), was selected as a promising agent for further
      evaluation.

PMID- 7774026
TI  - Optically active antifungal azoles. IV. Synthesis and antifungal activity of
      (2R,3R)-3-azolyl-2-(substituted phenyl)-1-(1H-1,2,4-triazol-1-yl)-2-butanols.
AB  - (2R,3R)-3-Azolyl-2-(substituted phenyl)-1-(1H-1,2,4-triazol-1-yl)-2-butanols
      (III) were prepared from (2R,3S)-3-methyl-2-(substituted phenyl)-2-(1H-1,2,4
      triazol-1-yl)methyloxiranes (21a-f) by a ring-opening reaction with 1H-1,2,3
      triazole and 1H-tetrazole and evaluated for antifungal activity against Candida
      albicans in vitro and in vivo. The optically active oxiranes (21a--f) which serve
      as the key synthetic intermediates, were synthesized from 1-[(2R)-2-(3,4,5,6
      tetrahydro-2H-pyran-2-yl)oxypropanoyl]morpholin e (24) and substituted
      phenylmagnesium bromide (23) via six steps in a stereocontrolled manner. The 3
      (1H-1,2,3,-triazol-1-yl)-(IIIa) and 3-(2H-2-tetrazolyl)-2-butanol (IIId)
      derivatives showed strong protective effects against candidosis in mice.

PMID- 7774028
TI  - Synthesis and evaluation of novel nonpeptide angiotensin II receptor antagonists:
      imidazo[4,5-c]pyridine derivatives with an aromatic substituent.
AB  - Starting from recently reported nonpeptidic angiotensin II (AII) receptor
      antagonists, we have designed and prepared a new series of 6-arylimidazo[4,5
      c]pyridine derivatives. Variation of phenyl groups at the 4-, 6- or 7-position of
      imidazo[4,5-c]pyridine showed that substitution at the 6-position resulted in
      receptor-binding activity almost as potent as that of DuP 753. This led to
      synthesis and evaluation of an extensive series of 6-aryl-imidazo[4,5-c]pyridine
      derivatives. Some of them were 4-fold more potent in vitro than DuP 753, but only
      showed weak antihypertensive activity in vivo when given orally to rats.

PMID- 7774027
TI  - Optically active antifungal azoles. V. Synthesis and antifungal activity of
      stereoisomers of 3-azolyl-2-(substituted phenyl)-1-(1H-1,2,4-triazol-1-yl)-2-
      butanols.
AB  - The (2S,3S)-, (2R,3S)- and (2S,3R)-stereoisomers of (2R,3R)-3-azolyl-2
      (substituted phenyl)-1-(1H-1,2,4-triazol-1-yl)-2-butanols [(2R,3R)-1a--d] were
      prepared and evaluated for antifungal activity against Candida albicans in vitro
      and in vivo to clarify the relationships between stereochemistry and biological
      activities. The results revealed that the in vitro antifungal activity in each
      set of the four stereoisomers [(2R,3R)-, (2S,3S)-, (2R,3S)- and (2S,3R)-1a--d]
      definitely paralleled the in vivo antifungal activity against candidosis in mice,
      and the order of potency was (2R,3R) >> (2R,3S) > or = (2S,3S) > or = (2S,3R). In
      addition, the four stereoisomers in each set were assessed for sterol
      biosynthesis-inhibitory activities in C. albicans and rat liver. The (2R,3R)
      isomer was found to exert a strong and selective inhibitory effect on the sterol
      synthesis in C. albicans as compared with that in rat liver.

PMID- 7774029
TI  - Chemical and chemotaxonomical studies of ferns. LXXXVII. Constituents of
      Trichomanes reniforme.
AB  - Five new glycosides, 3,4-dihydroxyphenethyl alcohol 4-O-caffeoyl-beta-D
      allopyranoside, (6S,13S)-13-beta-D-fucopyranosyloxy-6-(beta-D-fucopyranosyl -(1-
      >2)-[beta-D-fucopyranosyl-(1-->4)-alpha-L-rhamnopyranosyloxy]) -cleroda-3,14
      diene, (6S,13S)-13-beta-D-fucopyranosyloxy-6-(beta-D-quinovopyranosyl  -(1-->2)
      [beta-D-fucopyranosyl-(1-->4)-alpha-L-rhamnopyranosyloxy  ])-cleroda-3,14-diene,
      (6S,13S)-13-alpha-L-arabinopyranosyloxy-6-(beta-D-fucopyranosyl-(1 -->2)-[beta-D
      fucopyranosyl-(1-->4)-alpha-L-rhamnopyranosyloxy])- cleroda-3,14-diene and
      (6S,13S)-13-alpha-L-arabinopyranosyloxy-6-(beta-D-quinovopyrano  syl-(1-->2)
      [beta-D-fucopyranosyl-(1-->4)-alpha-L-rhamnopy ranosyloxy])-cleroda-3,14-diene,
      were isolated, together with mangiferin and 6'-O-acetylmangiferin, from the
      fronds of a New Zealand fern, Trichomanes reniforme.

PMID- 7774031
TI  - Preliminary preformulation studies of a 2-(3,4-dimethoxyphenyl)ethylamine
      derivative for oral administration at an exploratory stage of new drug
      development.
AB  - Preliminary preformulation studies of a 2-(3,4-dimethoxyphenyl)ethylamine
      derivative were investigated. The hydrochloride form showed incompatibility with
      the excipients used for oral dosage forms. There were several crystal forms of
      the free base, namely, alpha-anhydrate, beta-anhydrate, monohydrate, and
      trihydrate. The trihydrate form was unstable. The degree of crystallinity of the
      beta-anhydrate form was difficult to control. The monohydrate form was difficult
      to manufacture with constant quality. The serum levels of the compounds in rats
      were almost related to the dissolution rates in the JP 1st disintegration medium
      from the discs. The serum level of alpha-anhydrate was the lowest. However, the
      dissolution rates from the formulations of alpha-anhydrate were improved. After
      oral administration of the improved formulation, the serum level of alpha
      anhydrate in beagle dogs was almost triple that after the oral administration of
      the capsule of the hydrochloride form.

PMID- 7774030
TI  - Six new presenegenin glycosides, reiniosides A--F, from Polygala reinii root.
AB  - Six new oleanane-type triterpene saponins, called reiniosides A-F, were isolated
      from the roots of Polygala reinii Fr. et Sav. and their structures were
      elucidated by spectroscopic and chemical means.

PMID- 7774032
TI  - Influence of formulation change on drug release kinetics from
      hydroxypropylmethylcellulose matrix tablets.
AB  - Examination was made of the release of indomethacin from
      hydroxypropylmethylcellulose (HPMC) matrices and the results were found to
      usually follow first order release kinetics. The release mechanism changed with
      formulation. HPMC content was the predominant controlling factor. As the HPMC
      content increased, drug release rate decreased, and the release mechanism
      gradually changed from Higuchi diffusion release to case II transport. Additives
      increased the release rate and enhanced Fickian diffusion. As drug content
      increased, release rate calculated from percent release data decreased while that
      calculated from mg release data increased. When indomethacin content was lower,
      drug release was diffusion controlled and when higher, non-Fickian transport or
      case II transport was apparent. Additive effects were also examined. Starch was
      found to most effectively maintain case II release. Complex additives containing
      starch were superior to any additive by itself. A multiple regression model was
      used to determine the relationship between response (release rate) and factors
      (content of HPMC and diluents), and on the basis of this model a formulation was
      established and found valid by agreement with data from the regression model.

PMID- 7774033
TI  - Heterocyclic betaines. XXII. Azinium(azolium) 4-nitrobenzimidazolate inner salts
      and their derivatives with several interannular spacers. Synthesis,
      characterization and antitrichomonal activity.
AB  - The synthesis of an ensemble of pyridinium(imidazolium) 4-nitrobenzimidazolate
      betaines and their derivatives with several interannular linkages has been
      explored. Their antiprotozoal activity has also been examined.

PMID- 7774034
TI  - Synthesis and antileukemic activity of chymotrypsin-activated derivatives of 3'
      amino-2',3'-dideoxycytidine. (Synthetic nucleosides and nucleotides. XXXIII.
AB  - 3'-Amino-2',3'-dideoxycytidine (8) was directly synthesized from 2'
      deoxycytidine. 2',3'-Dideoxy-3'-(N-acyl-L-phenylalanylamino)cytidines (acyl =
      butoxycarbonyl (9a), acetyl (9b), benzoyl (9c), and n-hexanoyl (9d)) were
      synthesized as chymotrypsin-activated prodrugs of 8. This N-protection was
      required for activation by chymotrypsin to 8. In vitro, compound 8 showed high
      cytotoxic activity against P388 cells, but the prodrugs 9a-d were ineffective. In
      vivo, however, these prodrugs showed much higher activity than 8 in mice bearing
      P388 cells.

PMID- 7774035
TI  - Controlled release by Ca(2+)-sensitive recombinant human tumor necrosis factor
      alpha liposomes.
AB  - Recombinant human tumor necrosis factor-alpha (rHuTNF) was entrapped in liposomes
      consisting of Egg phosphatidylcholine (EggPC) alone, EggPC-egg phosphatidic acid
      (EggPA) or EggPC-egg phosphatidylglycerol (EggPG). These liposomes, stored in
      vials, were stable for a month at 4 degrees C. The rHuTNF release from the
      liposomes were examined in rat plasma and phosphate buffered saline (PBS). rHuTNF
      was released from the liposomes containing EggPA in rat plasma. The release of
      rHuTNF was inhibited by EDTA and was induced in PBS containing CaCl2, indicating
      that this release is induced by Ca2+ ion in the plasma. The release of rHuTNF was
      promoted by an increase of the EggPA content. In conclusion, we could obtain
      stable liposomes in a vial and this liposome could immediately release rHuTNF in
      the rat plasma. Furthermore we were able to control the release rate of rHuTNF
      from these liposomes.

PMID- 7774036
TI  - Plasma lipids and lipoproteins response to a dietary challenge: analysis of four
      candidate genes.
AB  - The possible role of four candidate genes in lipid and lipoprotein response to
      diet was examined in 63 male students. Four site polymorphisms (signal peptide
      insertion/deletion, XbaI, MspI and EcoRI) of the apo B gene, three RFLPs (AvaII,
      StuI, and HincII) of the LDL receptor gene, two SSCPs of the cholesterol 7 alpha
      hydroxylase gene and the common apo E genotypes were determined. The average
      reductions induced by diet in participants homozygous for the absence of the XbaI
      restriction site (X-X-) of the apo B gene compared to those harboring this site
      (X+) were: 14.5 mg/dl and 9.4 mg/dl for total cholesterol (TC) (p < 0.09) and
      15.5 mg/dl and 7.9 mg/dl for LDL-C (p < 0.003), respectively. Differences in
      dietary responsiveness among the apo E, LDL receptor and the cholesterol 7 alpha
      hydroxylase genotypes were largely insignificant. Using the four apo B
      polymorphic sites, six unambiguous haplotypes were constructed and a model for
      their possible evolutionary relationship is presented. Genetic variation in the
      apo B gene region, as defined by haplotypes, accounted for 8.7% and 24.3% of the
      phenotypic variance in TC and LDL-C response to diet, respectively. Sequence
      analysis of a candidate locus, the putative LDL receptor binding region of apo B
      and its flanking sequences, was performed in two individuals, one homozygous for
      an apo B "hyper-responding" and another for the "lower-responding" haplotype, and
      no differences were found. In conclusion, haplotypes at the apo B gene locus are
      associated with dietary response of TC and LDL-C in young males. Yet, the
      sequence variation responsible for these differences is possibly located outside
      the putative LDL receptor binding domain.

PMID- 7774037
TI  - Risk estimates for developing motor neurone disease in first-degree relatives.
AB  - Patients with motor neurone disease resident in the three counties of South
      Glamorgan, Mid Glamorgan and Gwent (total population 1,394,400) from 1/11/91 to
      31/12/92, were ascertained through general practitioners and neurology department
      records: 62 out of 71 (51 male, 20 female) index cases ascertained agreed to be
      visited. These individuals were clinically reviewed, had a detailed family
      history taken and, after discussion, had a blood sample taken for testing for the
      X-linked bulbospinal muscular atrophy mutation. The period prevalence of motor
      neurone disease was 5.02/100,000 with a mean age of onset of 59.4 (S.D. 12.9)
      years. One 66-year-old male was found to have the X-linked bulbospinal muscular
      atrophy mutation. A single, definite first-degree relative pair was identified,
      of whom only one was included in the data. The index cases had a total of 131
      offspring and 173 siblings. The risk estimates, by current age, for these first
      degree relatives of patients with apparently sporadic motor neurone disease
      decreased from 1 in 85 at age 20 years to 1 in 1683 at age 80 years. These
      estimates require confirmation in an independent sample, as they are based on a
      single "event".

PMID- 7774038
TI  - Maternal 3;13 chromosome insertion, with severe pre-eclampsia.
AB  - A previously healthy young primigravida suffered very severe pre-eclampsia and
      was delivered at 32 weeks gestation. The baby was growth retarded with dysmorphic
      features, and died aged 4 days. Chromosome analysis of the baby revealed partial
      trisomy 13 resulting from recombination within a maternal insertion of part of
      13q into 3p. To date, the maternal insertion has been identified in a further
      three members of the family and may have contributed to a number of spontaneous
      abortions, stillbirths and neonatal deaths in other family members. The various
      possibilities for recombination and malsegregation are discussed. An association
      between pre-eclampsia and trisomy 13 has been reported previously. To our
      knowledge this present paper constitutes the first report of partial trisomy for
      13q occurring with pre-eclampsia.

PMID- 7774039
TI  - Increased frequency of the rare PstI allele (P2) in a population of CAD patients
      in northern Greece.
AB  - Restriction fragment length polymorphisms (RFLPs) at the apolipoprotein AI-CIII
      AIV gene cluster and their association with coronary artery disease (CAD) and
      lipid levels were studied in a Northern Greek population. Ninety-five patients
      with CAD and fifty-four normal controls, angiographically proven, were included
      in this study. Using genomic hybridization techniques, three polymorphic
      restriction sites were identified at this locus: the PstI at the 3' end of the
      apoAI gene, the SacI at the 3' non-coding region of the apoCIII gene and the
      PvuII at the intergenic region between the apoCIII-AIV genes. The rare allele
      (P2) arising from the absence of the PstI restriction site was observed with a
      significantly higher frequency (p < 0.01) in patients compared to normals (0.11
      vs 0.02). In contrast, the rare allele for the SacI polymorphic site had a
      similar distribution among patients and controls (0.12 vs 0.16). The same was
      observed for the PvuII RFLP (0.04 vs 0.05). Correlation of lipid and
      apolipoprotein AI levels with the three RFLPs revealed no significant
      association, although apo AI and HDL were lower in patients with the P2 allele.
      Thus, in this Greek population, only the PstI polymorphism, among the polymorphic
      restriction sites examined, appears to be associated with CAD.

PMID- 7774040
TI  - Charcot-Marie-Tooth disease: molecular characterization of patients from central
      and southern Italy.
AB  - The syndrome of peroneal muscular atrophy, or Charcot-Marie-Tooth (CMT), disease
      represents the most common inherited peripheral neuropathy, with a prevalence of
      about 1 per 2500. The disease is usually transmitted in an autosomal dominant
      fashion, although it can display all the mendelian patterns of inheritance. The
      chromosome 17-linked form (CMT1a) appears to be the most common form of the
      disease in all the ethnic groups studied so far, Italians included, and is due to
      a tandem duplication in 17p11.2. In order to study the distribution of CMT types
      and to establish a genotype-phenotype correlation in patients from Central and
      Southern Italy, we collected 19 CMT pedigrees diagnosed in the years 1992-1993.
      Simple tandem repeats (STR) polymorphism analysis with the marker RM11-GT and
      Southern blotting with the probes pVAW409R3 and pVAW412 were performed,
      demonstrating a high prevalence (about 60%) of 17p duplication in the families
      studied. No clinical or electrophysiological differences were noted between CMT1
      patients with or without 17p duplication, respectively. Two families affected by
      CMT2 showed no evidence of rearrangement at the D17S122 locus. These data are
      consistent with the hypothesis of a different molecular basis for CMT2.

PMID- 7774041
TI  - Familial microcephaly with severe neurological deficits: a description of five
      affected siblings.
AB  - Autosomal recessive microcephaly is usually characterized by normal developmental
      milestones and minor neurological deficits. In this report, we describe five
      siblings in one family with marked microcephaly, intractable seizures,
      quadriplegia and profound mental retardation. The recurrence risk of microcephaly
      when associated with devastating neurological deficits, as exemplified by this
      family, may be high and in such cases, the role of appropriate genetic counseling
      is of utmost importance.

PMID- 7774042
TI  - Dicentric chromosome Y associated with Leydig cell agenesis and sex reversal.
AB  - The nature of a non-mosaic marker Y chromosome observed in a pseudohermaphrodite
      patient with Leydig cell agenesis was investigated by high-resolution chromosome
      analysis and molecular probes from the Y chromosome. Cytogenetically, the marker
      chromosome appeared to be an isodicentric, with breakage in Yq11.21. Double
      copies of all Yp-specific loci tested, including SRY, were present. The most
      distal Yq portion detected in patient DNA was DXS278-C, which maps to interval D
      in the chromosome Yq deletion map. Fragment DXS278-B, which maps to deletion
      interval E, was absent. The possible relationship between this cytogenetic
      abnormality and Leydig cell agenesis, a finding never reported in association
      with Y chromosome rearrangements, is discussed.

PMID- 7774043
TI  - Sperm chromosome complements in a man heterozygous for a reciprocal translocation
      46,XY,t(9;13)(q21.1;q21.2) and a review of the literature.
AB  - Sperm chromosome complements were studied in a man heterozygous for a reciprocal
      translocation t(9;13)(q21.1;q21.2). A total of 89 spermatozoa were karyotyped
      after in vitro penetration of hamster eggs. The frequencies of alternate,
      adjacent 1 and adjacent 2 segregations were 46.9%, 35.8% and 17.3% respectively.
      For alternate segregation, the number of normal spermatozoa (21) was not
      significantly different from the number of spermatozoa carrying a balanced form
      of the translocation (17), as theoretically expected. The proportion of
      spermatozoa with an unbalanced form of the translocation was 53.1%. There was no
      evidence for an interchromosomal effect since the frequency of numerical
      abnormalities (unrelated to the translocation) was within the normal range of
      control donors. Data from a total of 31 reciprocal translocations studied by
      sperm chromosomal analysis were reviewed.

PMID- 7774044
TI  - Factors influencing whether or not couples seek genetic counselling: an
      explorative study in a paediatric surgical unit.
AB  - To investigate the factors influencing whether or not couples seek genetic
      counselling, the parents of 37 children with a major congenital anomaly were
      interviewed at home. All the children had been admitted to the Intensive Care
      Unit (ICU) of the Department of Paediatric Surgery. After physical examination of
      the child, the consultant clinical geneticist stated that genetic counselling was
      indicated for the parents. Whether they sought genetic counselling was left to
      the parents to decide. Eighteen of the 37 parents had sought genetic counselling.
      Assessment of the joint influence of a number of factors revealed that two
      factors were separately paramount in distinguishing between couples who did seek
      genetic counselling and those who did not: whether parents considered genetic
      counselling useful in their case shortly after the birth of their affected child,
      and whether the couple was clearly and correctly informed about the indication
      for genetic counselling. The intention to have a subsequent pregnancy was not
      associated with whether or not couples sought genetic counselling. Loss of
      information was observed: 1/3 of the referrals for genetic counselling mentioned
      on the written consultation forms were not stated in the discharge letters. This
      loss of information could have been reduced by a) routinely including the
      indication for genetic counselling in the discharge letter and b) appointing a
      coordinating physician to ensure that the parents were informed clearly about the
      availability of genetic counselling. Resistance to genetic counselling needs to
      be respected by the physician. Exploring its background might help to reduce this
      resistance.

PMID- 7774045
TI  - Antley-Bixler syndrome and esophageal atresia in a patient with trisomy 21.
AB  - The Antley-Bixler syndrome (ABS) is characterized by craniofacial, skeletal and
      urogenital anomalies. While most patients with ABS die of severe respiratory
      complications in their first months, long-term survivors have been reported. We
      report an infant girl, born to a consanguineous couple, with craniofacial and
      skeletal anomalies, consistent with ABS, in addition to atresia of the esophagus
      and trisomy 21.

PMID- 7774047
TI  - Occurrence of disseminated intravascular coagulation (DIC) in active systemic
      anaphylaxis: role of platelet-activating factor.
AB  - The possible occurrence of DIC in active systemic anaphylaxis was investigated in
      mice. Induction of active systemic anaphylaxis resulted in the development of DIC
      symptoms such as thrombocytopenia, prolongation of prothrombin time,
      hypofibrinogaemia, and elevated level of fibrinogen/fibrin degradation products.
      In addition, in histological examinations, massive congestion and cellular
      infiltration in pulmonary interstitia, and considerable haemorrhage in renal
      medullae were observed. All these changes were nearly completely prevented by
      pretreatment with platelet-activating factor (PAF) antagonist (BN 50739).
      Moreover, the same haematological and morphological changes were produced by a
      bolus injection of PAF. These data strongly suggest that DIC occurs in active
      systemic anaphylaxis and PAF plays a pivotal role in the development of DIC in
      anaphylaxis.

PMID- 7774048
TI  - Immune responsiveness to inhaled antigens: local antibody production in the
      respiratory tract in health and lung diseases.
AB  - The pulmonary defence mechanism in summer type hypersensitivity pneumonitis
      induced by Trichosporon cutaneum was investigated. We have studied the antibody
      response to fungal antigens in sera and bronchoalveolar lavage (BAL) fluids from
      patients with summer type hypersensitivity pneumonitis, bird fancier's lung,
      interstitial pneumonia associated with collagen vascular disease (INT-PNE), and
      from normal volunteers. Antigens extracted from fungi frequently isolated from
      home environments were used in ELISA to detect IgG and IgA antibodies in sera and
      BAL fluids. The results of the present study show that antibody titre in the
      respiratory tract to a variety of fungi from home environments is modulated by
      ongoing pulmonary inflammation, and that antibody production against inhaled
      antigens is altered by pulmonary inflammation resulting from diverse
      pathogenesis. This study concludes that the preexisting pulmonary inflammatory
      disease alters antibody production in the respiratory tract in response to
      inhaled fungi, and that the type of alteration depends in part on the etiology of
      the preexisting disease.

PMID- 7774046
TI  - Inhibition of gene expression by anti-sense oligodeoxynucleotides.

PMID- 7774049
TI  - Presence of mRNA for interferon-gamma (IFN-gamma) in blood mononuclear cells is
      associated with an active stage I sarcoidosis.
AB  - Peripheral blood mononuclear cells (PBMC) and bronchoalveolar lavage (BAL) cells
      obtained from sarcoidosis patients were investigated for the presence of mRNA for
      IFN-gamma. RNA was extracted from freshly obtained cells. In 12 cases PBMC were
      studied and in seven cases BAL cells were also available for concomitant
      investigation. In eight patients mRNA for IFN-gamma was present in blood and was
      significantly associated with stage I disease (P = 0.030). By comparison, BAL
      cells were less frequently positive for IFN-gamma transcripts (P = 0.039). Only
      one patient had simultaneous expression of IFN-gamma gene in blood and BAL cells.
      All other patients including four positive in blood were negative in BAL. The
      presence of IFN-gamma transcripts in PBMC was significantly associated with the
      capacity of these cells to generate IFN-gamma in unstimulated cultures. PBMC from
      patients showing IFN-gamma mRNA in blood were frequently high IFN-gamma producers
      in anti-CD3 MoAb-stimulated cultures.

PMID- 7774050
TI  - Two novel cationic staphylococcal proteins induce IL-2 secretion, proliferation
      and immunoglobulin synthesis in peripheral blood mononuclear cells (PBMC) of both
      healthy controls and patients with common variable immunodeficiency (CVID).
AB  - Two cationic proteins, a neutral phosphatase (NP-tase) and a 70-kD protein (p70)
      were isolated from Staphylococcus aureus by ion exchange chromatography. We
      compared their properties to those of the well established B cell mitogen of
      whole, fixed Staph. aureus strain Cowan I cells (SAC). Both purified proteins
      were able to induce immunoglobulin synthesis in PBMC cultures of healthy donors.
      NP-tase and p70 also induced immunoglobulin synthesis of PBMC from those patients
      with CVID who were also responsive to SAC plus IL-2 stimulation. Immunoglobulin
      synthesis in response to NP-tase and to p70 was time- and dose-dependent and
      could be inhibited by addition of specific antibodies against the proteins. In
      contrast to SAC, no addition of exogenous IL-2 was necessary to obtain maximal
      immunoglobulin synthesis induced by NP-tase or p70. However, neither protein was
      able to induce immunoglobulin synthesis in B cell-enriched cultures. High amounts
      of IL-2 were found in supernatants of PBMC from healthy donors following
      stimulation with low concentrations of NP-tase or p70, and this was associated
      with vigorous lymphocyte proliferation. Both proteins behave like typical
      antigens, and not like lectins or superantigens, since an NP-tase-stimulated T
      cell line showed an antigen-specific, MHC-restricted secondary response. In
      addition, no preferential T cell receptor V beta chain usage was found with eight
      V beta-specific MoAb. It is likely that the two proteins induce antigen-specific
      T cell activation, which is then followed by polyclonal activation of B cells via
      CD40 receptors and cytokine release.

PMID- 7774051
TI  - HIV-specific lymphoproliferative responses in asymptomatic HIV-infected
      individuals.
AB  - In vitro lymphoproliferative responses to HIV-1 recombinant antigens (gp160, p24,
      and Rev protein) were studied in 83 patients with asymptomatic HIV-1 infection
      (CDC groups II and III) and circulating CD4 lymphocyte numbers > 400/mm3.
      Significant response to at least one of the three antigens was detected in 52.4%
      of the subjects, but the responses were weak, and concordance of the response to
      the three antigens was rare, the frequency of individuals responding to each
      antigen not exceeding 22.4%. Increasing frequencies of response were observed
      when recall antigens (tetanus toxoid and Candida albicans glycomannoprotein)
      (65.5%) and anti-CD3 MoAb (76.6%) were used as stimuli. Although a significant
      association between lymphocyte response to p24, but not gp160, and steadiness of
      CD4 lymphocyte numbers before the assay was observed, no predictive value for
      lack of CD4 cell decrease was confirmed for either antigen, and fluctuation of
      the responses to HIV antigens was seen during subsequent follow up. The panel of
      T cell assays used could be regarded as appropriate for monitoring both HIV
      specific responses and T lymphocyte function during immunotherapy with soluble
      HIV antigens.

PMID- 7774052
TI  - The inhibitory effects of Mycobacterium tuberculosis on MHC class II expression
      by monocytes activated with riminophenazines and phagocyte stimulants.
AB  - The expression of MHC class II antigens by peripheral blood monocytes from normal
      individuals was investigated. Class II expression as determined by a cell ELISA
      was effectively induced by various phagocyte stimulants. A further aspect of our
      study investigated the effects of clofazimine, a riminophenazine antimicrobial
      agent and its analogue, B669, on class II expression. Both agents at
      concentrations attainable in vivo increased the expression of MHC class II
      antigens. A 25-kD glycolipoprotein derived from Mycobacterium tuberculosis that
      inhibits phagocyte functions has previously been described. This component
      significantly reduced the expression of MHC class II antigens induced by the
      riminophenazines, clofazimine and B669, interferon-gamma (IFN-gamma) or opsonised
      yeast when added at the initiation of experiments. The riminophenazines could not
      restore the decrease in class II antigen expression previously inhibited by the
      25-kD mycobacterial fraction. However, cultures prestimulated with the
      riminophenazines or phagocyte stimulants were unaffected by the 25-kD
      mycobacterial fraction. The results suggest the potential use of these agents as
      modulators of phagocyte function.

PMID- 7774053
TI  - Response of scid mice to establishment of Leishmania major infection.
AB  - The initiation of Leishmania major infection in susceptible BALB/c mice is
      regulated by interferon-gamma (IFN-gamma). To examine further the mechanisms of
      IFN-gamma-dependent regulation of the establishment of L. major, we studied the
      characteristics of the infection in severe combined immunodeficient (scid) mice.
      In the first 2 weeks of infection, we observed a delay in the development of the
      lesions in the footpads and lower numbers of parasites in scid compared with
      BALB/c mice. By week 5 after infection, the size of the leishmanial lesion was
      similar in both strains of mice, but the number of parasites in scid mice was 100
      fold higher than in BALB/c. Treatment with anti-IFN-gamma during the
      establishment of L. major did not alter the course of infection in scid mice,
      while it exacerbated lesion development in BALB/c mice. Macrophages from scid
      mice were unable to kill L. major when stimulated with IFN-gamma in vitro, and
      produced lower levels of nitric oxide compared with macrophages from susceptible
      BALB/c or the resistant C57Bl/6 mice. We examined whether delayed lesion
      development in scid mice was due to their inability to mount appropriate
      inflammatory responses. While significantly fewer nucleated cells were present in
      the footpads of scid mice compared with BALB/c, 2 and 3 weeks after infection, no
      difference in inflammatory response between scid and BALB/c mice was observed in
      response to L. major antigen in the footpads. In contrast, there was a dramatic
      increase in the number of cells in the popliteal lymph nodes of BALB/c mice.
      Decreased inflammatory responses of scid mice in the footpad (at the site of
      infection) may contribute to slower development of leishmanial lesions during the
      first 2 weeks of infection.

PMID- 7774054
TI  - The expression of IL-2, IL-4 and interferon-gamma (IFN-gamma) mRNA using liver
      biopsies at different phases of acute exacerbation of chronic hepatitis B.
AB  - To investigate the hypothesis that Th1 phenotype cytokines are associated with
      the increasing activity of hepatitis and Th2 phenotype cytokines with decreasing
      activity in the liver of chronic viral hepatitis, expressions of the mRNA of the
      cytokines IL-2, IFN-gamma and IL-4 in the liver of 23 patients with chronic
      hepatitis B were investigated by reverse transcription polymerase chain reaction.
      Patients were divided into three groups according to the phase of acute
      exacerbation of hepatitis as increasing (n = 9), decreasing (n = 8), and stable
      phase (n = 6). Both IL-2 and IFN-gamma mRNA were preferentially expressed in
      increasing phase than in decreasing phase (P < 0.01, P < 0.05, respectively) and
      associated with the high serum alanine aminotransferase (ALT) level. On the other
      hand, IL-4 mRNA was detected in decreasing phase with significant frequency
      compared with increasing phase (P < 0.05). However, expression of IL-4 mRNA was
      not associated with serum ALT level. Our results suggest that Th1 phenotype
      cytokines up-regulate and Th2 phenotype cytokines down-regulate the liver
      inflammation of chronic viral hepatitis.

PMID- 7774055
TI  - Circulating antiinflammatory cytokine IL-10 in patients with inflammatory bowel
      disease (IBD).
AB  - IBD is characterized by increased serum concentrations of different cytokines. IL
      10 inhibits the production of proinflammatory cytokines such as IL-1, tumour
      necrosis factor-alpha (TNF-a), interferon-gamma (IFN-gamma) and IL-6 through
      inhibitory action on Th1 cells and macrophages, and it is thought to be a
      suppressor type cytokine. In the present study we determined serum concentrations
      of IL-10 in patients with ulcerative colitis (UC) and Crohn's disease (CD). We
      measured human IL-10 by our own newly established ELISA system using PharMingen
      antibodies. Serum antibodies were assessed in 44 patients with UC, 40 patients
      with CD, and in 30 healthy controls. Human IL-10 serum levels were significantly
      increased in patients with active UC (144 +/- 34 pg/ml (mean +/- s.e.m.), P <
      0.001) and in active CD (132 +/- 32 pg/ml, P < 0.001) compared with healthy
      controls (44 +/- 9.5 pg/ml). Only patients with active CD and active UC presented
      with significantly increased IL-10 serum levels, while patients with inactive
      disease did not show any significant increase. There was no statistically
      significant difference between IL-10 serum levels in patients with CD or UC.
      Compared with clinical disease activity indices there was a significant
      correlation between IL-10 serum concentration and CDAI in patients with CD (r =
      0.45, P < 0.01) and CAI in UC patients (r = 0.39, P < 0.05). Comparing IL-10
      serum levels with serum concentrations of other proinflammatory cytokines there
      was a significant correlation to serum levels of sIL-2R (r = 0.417, P < 0.05) and
      IL-6 (r = 0.387, P < 0.05) in patients with CD. Serum cytokine levels in patients
      with UC did not show any significant correlation to IL-10 serum concentration. IL
      10 is elevated in serum of patients with active CD and UC, suggesting that IL-10
      acts as a naturally occurring damper in the acute inflammatory process of IBD.

PMID- 7774056
TI  - Expression of a unique protein on colon cancer cells that reacts with a novel
      monoclonal antibody and ulcerative colitis serum.
AB  - We earlier developed a MoAb, 7E12H12 (IgM isotype), against a protein present in
      normal colonic epithelial cells. To examine if 7E12H12-reactive protein is
      expressed in colon cancer cells and is recognized by ulcerative colitis (UC)
      associated autoantibody, we investigated several colon cancer cell lines. 7E12H12
      reactivity against the cells was examined by indirect immunofluorescence assay
      and whole cell ELISA against six colon cancer cell lines HT-29, LoVo, COLO 205,
      DLD-1, LS 180 and SW 1116. A competitive ELISA was developed using 7E12H12 MoAb
      and patients' serum to examine the cross-reactive antibodies in the serum. Among
      the six colon cancer cell lines only LS 180, DLD-1 and SW 1116 reacted with
      7E12H12 MoAb, while others did not. The mean (+/- s.e.m.) inhibition of the
      binding of 7E12H12 MoAb to LS 180 cells by UC serum (n = 51) was 42 +/- 2.1%,
      whereas in normal subjects (n = 17) it was 14 +/- 2.6%, in Crohn's disease (n =
      19) it was 15.3 +/- 2.5%, in infectious diarrhoea (n = 10) it was 11% +/- 3%, and
      in systemic lupus erythematosus (n = 10) it was 2% +/- 0.6%. The inhibition by
      the UC group was significantly (P < 0.001 - < 0.0001) higher than any of the non
      UC groups, and this inhibition was mainly by IgG1 antibody. The protein in the
      specific colon cancer cells recognized by the 7E12H12 MoAb cross-reacts with UC
      IgG1 antibody and may provide an in vitro system to examine the autoimmune
      mechanisms in UC.

PMID- 7774057
TI  - Molecular heterogeneity of antigen- or idiotype-induced anti-thyroglobulin
      monoclonal autoantibodies.
AB  - To define the molecular basis of the cognitive interaction in experimental
      autoimmune thyroiditis (EAT), we sequenced the variable regions of monoclonal
      autoantibodies to thyroglobulin (Tg), specific or not for the F40D peptide, a Tg
      peptide capable of inducing EAT in CBA/J mice. Three MoAbs were obtained by
      immunization with syngeneic Tg of CBA/J (3B8G9, 2F6F2) or C57Bl/6 (4D11F4) mice.
      3B8G9 was specific for F40D peptide, whereas 2F6F2 and 4D11F4 were not. Two
      others were raised in CBA/J mice by manipulation of idiotypic pathways: B12
      resulted from the immunization with one Ab2 beta, bearing the internal image of
      one F40D epitope, and TA2 from the immunization with F40D-specific cytotoxic HTC2
      T cells. B12 and TA2 were both specific for F40D. All hybridomas expressed
      different members of the J558 VH family, except 3B8G9 which expressed a Q52 VH
      gene segment. These data led us to hypothesize that regulatory anti-id
      autoantibodies used members of one VH family located in the 5'-end of the VH
      locus, whereas EAT-associated autoantibodies used a member of one of the most D
      proximal VH family. As expected, no homologies were found when anti-F40D
      monoclonal autoantibodies were compared with two other monoclonal autoantibodies
      displaying a different epitopic specificity. Among the anti-F40D monoclonal
      autoantibodies, one histidine residue located in position 35 of the CDR1 region
      was constantly found. Moreover, TA2 and B12 exhibited two common amino acids in
      their CDR3 regions, one glycine and one tyrosine, in positions 98 and 99,
      respectively. Striking homologies were found between TA2 and one anti-polyGAT
      MoAb, and between 3B8G9 and some anti-phenyloxazolone (phOx) monoclonal
      autoantibodies. Lastly, the VK sequence from 4D11F4 was identical at the amino
      acid level to the VK sequence from another monoclonal autoantibody, 81B1, which
      was previously raised towards syngeneic Tg in CBA/J mice. Our data imply that
      anti-idiotypic regulatory circuits in EAT might be generated by a heterogeneous
      population of B cells rather than obtained by a single dominant B cell
      population.

PMID- 7774058
TI  - Galactosylation of N- and O-linked carbohydrate moieties of IgA1 and IgG in IgA
      nephropathy.
AB  - The mechanism of IgA deposition in the kidneys in IgA nephropathy is unknown.
      Mesangial IgA is of the IgA1 subclass, and since no consistent antigenic target
      for the IgA1 has been described, we have investigated the glycosylation of the
      molecule, as a potential non-immunological abnormality which may contribute to
      its deposition. IgA1 is rich in carbohydrate, carrying N-linked moieties in
      common with IgG, but also O-linked sugars, which are rare in serum proteins, and
      not expressed by IgG or IgA2. Lectin binding assays were designed to examine the
      expression of terminal galactose on the N-linked carbohydrate chains of purified
      serum IgG and IgA1, and the O-linked sugars of IgA1 and C1 inhibitor (one of the
      very few other serum proteins with O-linked glycosylation). No evidence was found
      for abnormalities of N-linked glycosylation of either isotype in IgA nephropathy
      compared with matched controls. However, in IgA nephropathy, reduced terminal
      galactosylation of the hinge region O-linked moieties was demonstrated; this was
      not seen in C1 inhibitor, which showed normal or increased galactosylation of the
      O-linked sugars. This abnormality of IgA1 has considerable implications for the
      pathogenesis of IgA nephropathy, since the O-linked sugars lie in an important
      functional location within the IgA1 molecule, close to the ligand of Fc
      receptors. Changes in the carbohydrates in this site may therefore affect
      interactions with receptors and extracellular proteins, leading to anomalous
      handling of the IgA1 protein in this condition, including failure of normal
      clearance mechanisms, and mesangial deposition.

PMID- 7774059
TI  - Increased IL-2, IL-4 and interferon-gamma (IFN-gamma) in steroid-sensitive
      nephrotic syndrome.
AB  - We investigated the production of cytokines by peripheral blood mononuclear cells
      (PBMC) and serum cytokine concentrations in children with steroid-sensitive
      idiopathic nephrotic syndrome (SSNS). PBMC from patients off treatment were
      collected during remission and relapse and cultured in medium alone or stimulated
      with calcium ionophore plus phorbol myristate acetate. Control PBMC were taken
      from healthy age-matched children. IL-2 was measured by bioassay, IL-4 by
      immunoradiometric assay, and IL-8 and IFN-gamma by ELISA. After 24 h culture
      without stimulation, IL-2, IL-4 and IFN-gamma were not detectable in the
      supernatant in any of the children. After stimulation, the supernatant
      concentrations of IL-2 (median 172 U/ml at 24 h) and IL-4 (160 pg/ml at 24 h; 210
      pg/ml at 72 h) were significantly increased in relapse compared with remission
      (IL-2 37 U/ml; IL-4 65 pg/ml and 60 pg/ml) and controls (IL-2 69 U/ml; IL-4 40
      pg/ml and 40 pg/ml) (P < 0.05). The concentration of IFN-gamma was not
      significantly increased in relapse compared with remission and controls (600,
      325, and 145 U/ml, respectively, at 72 h). IL-8 concentrations were similar in
      relapse, remission and controls with stimulation (median 32, 40 and 40 ng/ml,
      respectively) and without (30, 17 and 10 ng/ml). IL-2 was not detectable in
      serum, but IL-4, IL-8 and IFN-gamma were measurable in about half the patients,
      both in relapse and remission, though were virtually undetectable in controls. We
      conclude that relapse of SSNS in children is associated with T lymphocyte
      activation with release of IL-2, IL-4 and IFN-gamma.

PMID- 7774060
TI  - Antibodies to small ribonucleoprotein and to 73-kD heat shock protein: two
      distinct markers of mixed connective tissue disease.
AB  - We set out to discover whether antibodies to small ribonucleoprotein antigens
      (RNP) and to 73-kD heat shock protein (hsp 73) which have been proposed as
      markers of mixed connective tissue disease (MCTD) recognize different epitopes.
      MCTD serum was immunoadsorbed on hsp 73-coupled Sepharose and the affinity
      retained, and non-retained fractions were checked by immunoblotting for
      recognition of either purified bovine hsp 73 or calf thymus extract RNPs. The hsp
      73 affinity-bound serum fraction recognized hsp 73 but not RNP antigens, the
      reverse being true for the non-retained fraction. We conclude that anti-hsp 73
      and anti-RNPs are distinct markers of MCTD.

PMID- 7774062
TI  - Autoantibody response to the Ro/La particle may predict outcome in neonatal lupus
      erythematosus.
AB  - This study was undertaken to determine the role of antibodies against both
      recombinant Ro (r-Ro) and La (r-La) proteins and polypeptides derived from the
      recombinant La protein in predicting fetal and neonatal outcome in children at
      risk to develop neonatal lupus erythematosus (NLE). All sera were obtained in the
      perinatal period and quantitative ELISA assays were used. We collected 41
      maternal sera within 2 months of delivery of a child with NLE (21 with congenital
      heart disease block (CHB) and 20 with dermatologic NLE) and 19 sera from anti-Ro
      and/or anti-La antibody-positive mothers with systemic lupus erythematosus (SLE)
      who delivered a child without NLE. All sera were tested for anti-r-La and anti-r
      Ro antibodies by ELISA, and most sera were tested for antibodies directed against
      La polypeptides by immunoblot. We found significantly higher anti-r-La antibody
      levels in the sera from mothers of children with NLE compared with sera from
      mothers of unaffected children (0.67 +/- 0.43 versus 0.14 +/- 0.30; P < 0.0001).
      There was a statistically significant difference in the mean anti-r-La levels
      between the sera of mothers of children with CHB compared with dermatologic NLE
      (0.51 +/- 0.45 versus 0.83 +/- 0.37 respectively; P = 0.0091). When we examined
      antibodies directed against the recombinant 52-kD Ro protein, there was a
      statistically significant elevation of titres in the sera of mothers of NLE
      children (0.77 +/- 0.35) compared with non-NLE mothers (0.29 +/- 0.39; P <
      0.0001). There was no difference in the r-Ro levels between mothers of children
      with dermatologic NLE compared with CHB (0.82 +/- 0.37 versus 0.71 +/- 0.74; P =
      0.32). When we examined polypeptides derived from the recombinant La protein, the
      mean number of polypeptides recognized by sera from mothers of children with NLE
      was significantly higher than the mean number of polypeptides recognized by sera
      from mothers of unaffected children (5.1 +/- 0.54 versus 2.3 +/- 0.54
      respectively; P < 0.001). More importantly, when we examined the individual
      polypeptides, we found that only sera from mothers of children with NLE and not
      from mothers of unaffected children recognized a polypeptide designated DD (30%
      versus 0%, respectively). These studies indicate that the autoantibody response
      to the Ro/La particle can differentiate sera from mothers of children with NLE
      and sera from mothers of unaffected children. Furthermore, there was a difference
      in the anti-La autoantibody response between mothers of children with CHB and
      dermatologic NLE.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7774061
TI  - Purification of antigenically intact Ro ribonucleoproteins; biochemical and
      immunological evidence that the 52-kD protein is not a Ro protein.
AB  - Anti-Ro sera immunoprecipitate Ro ribonucleoproteins (RNPs) from human cell
      extracts. Ro RNPs are biochemically heterogeneous particles whose functions are
      unknown and whose exact composition remains controversial. In addition to 60-kD
      Ro and to La proteins, a 52-kD polypeptide (p52) has been proposed to be a stable
      component of the Ro RNPs. To confirm the immunological studies supporting this
      hypothesis, we have biochemically purified Ro RNPs from HeLa cells using non
      denaturing conditions. Ro RNPs segregated into three distinct populations, one of
      which only contained hY5 RNA (RohY5 RNPs). No p52 co-purified with Ro RNPs.
      Despite the absence of p52, purified Ro RNPs had biochemical and immunological
      properties identical to those of unfractionated Ro RNPs. Many anti-Ro sera only
      recognize p52 in immunoblots, and are said to be monospecific anti-p52.
      Preincubation with purified RohY5 RNPs (free of p52) of all human anti-Ro
      (including so-called monospecific anti-p52) sera abolished their capacity to
      immunoprecipitate Ro RNPs from unfractionated HeLa cell extracts. Conversely,
      preincubation of anti-Ro sera with purified p52 protein specifically inhibited
      recognition of p52 in immunoblots, but did not interfere with immunoprecipitation
      of Ro RNPs. Our data demonstrate that anti-p52 antibodies do not target intact Ro
      RNPs, nor do they target the native 60-kD Ro protein. Contrary to previous
      reports, p52 protein is not a stable component of antigenically intact Ro RNPs.

PMID- 7774064
TI  - Composition and biological behaviour of immune complexes isolated from synovial
      fluid of patients with juvenile rheumatoid arthritis (JRA).
AB  - Data published from in vitro studies have shown that IgM-rheumatoid factor (RF)
      bearing immune complexes possess several biological features that may contribute
      to their pathogenicity. However, no studies have demonstrated that such complexes
      exist at sites of inflammation in children with rheumatoid disease. We used two
      methods of sequential column chromatography to purify immune complexes from
      synovial fluids of children with JRA. We demonstrate that high molecular weight
      complexes contain IgM-RF, have not bound C4 in vivo, but activate the classical
      pathway in vitro. In contrast, complexes which have bound C3 in vivo do not
      contain IgM-RF and are weak complement activators in vitro.

PMID- 7774063
TI  - Endothelial cell binding by human polyclonal anti-DNA antibodies: relationship to
      disease activity and endothelial functional alterations.
AB  - Polyclonal anti-dsDNA and anti-ssDNA antibodies (PoAb) that showed significant
      binding to human umbilical vein endothelial cells (HUVEC) were isolated from
      eight patients with systemic lupus erythematosus (SLE). Anti-dsDNA PoAbs from
      five patients and anti-ssDNA PoAbs from seven patients demonstrated enhanced
      binding to HUVEC during active disease, compared with PoAbs obtained from
      corresponding patients during remission. Reduction of the DNA content in the PoAb
      preparations by DNase treatment was associated with enhanced binding to HUVEC in
      20 of 32 PoAbs tested, which included 75% 'active disease' PoAbs, and with
      reduced binding to HUVEC in three of 32 PoAbs tested, all obtained during
      remission. Such altered endothelial cell binding was reversed with DNA
      reconstitution. Binding of the remaining nine PoAbs to HUVEC was not altered by
      variations in their DNA content. Induced plasma membrane expression of E
      selectin, but reduced expression of vascular cell adhesion molecule-1 (VCAM-1) by
      HUVEC, was observed following incubation of HUVEC with 'active disease' PoAbs
      from three and two of the eight patients, respectively. PoAbs and serum samples
      from two of the eight patients during active disease induced von Willebrand
      factor release from HUVEC, which was not observed during remission. We conclude
      that anti-DNA antibodies from selected patients with SLE can bind to endothelial
      cells. Correlation between cellular binding and disease activity suggests that
      such binding of anti-DNA antibodies to endothelial cells could be of pathogenic
      significance. Preliminary data also suggest that the expression of adhesion
      molecules and haemostatic factor(s) by endothelial cells may be modified
      following their binding by anti-DNA antibodies.

PMID- 7774066
TI  - Flow cytometric analysis of peripheral blood lymphocyte subset light scatter
      characteristics as a means of monitoring the development of rat small bowel
      allograft rejection.
AB  - This investigation used flow cytometry to monitor peripheral blood lymphocyte
      morphology after rat small bowel transplantation. Preliminary studies
      demonstrated that in vitro activated peripheral blood lymphocytes exhibited
      increased cell size and granularity as measured by flow cytometric analysis of
      forward (FSc) and side (SSc) light scatter characteristics. The formation of
      distinct 'activated' light scatter regions by such lymphoblastoid transformation
      occurred concomitantly with up-regulated p55IL-2R expression. Heterotopic small
      bowel transplantation was performed between PVG donor and DA recipient rats
      without immunosuppression. Animals receiving isografts served as controls.
      Peripheral blood lymphocyte subsets were identified using appropriate MoAbs, and
      the light scatter characteristics of each cell subset were determined by
      backgating strategies. Increased proportions of activated alpha/beta T cell
      receptor (TCR)-positive cells could be detected in allografted animals as early
      as day 2 post-transplantation. B cells showed peak activation by day 4, at which
      time the proportion of activated cells was over two-fold greater than that seen
      in untransplanted animals--few activated B cells were detected in isografted
      animals. Resting natural killer (NK) cell light scatter regions only partially
      overlap with those of resting T and B lymphocytes, but in allografted animals
      almost the entire NK population fell outside the resting lymphocyte gate by day 2
      post-transplantation, an activation state which was maintained until day 4. These
      findings associate peripheral blood cell subset lymphoblastoid transformation
      with developing small bowel allograft rejection. Importantly, changes were
      detected early and prior to the onset of overt rejection. These data suggest that
      analysis of peripheral blood lymphocyte light scatter properties may provide an
      insight into in vivo immune status after small bowel transplantation.

PMID- 7774067
TI  - Age-related changes in surface antigens on peripheral lymphocytes of healthy
      children.
AB  - The age-related changes in proportion of various subsets within lymphocytes were
      investigated in cord blood and peripheral blood from healthy children and adults.
      The percentages of T and B cells did not show age-related changes, whereas
      natural killer (NK) cells increased significantly with age. Within lymphocytes or
      the CD3+ T cell population the proportion of CD45RAbright+ lymphocytes decreased
      and that of CD45RO+ cells increased, while that of CD45RAdim+ cells showed no age
      related change. Within lymphocytes, the percentage of CD45RAbright+ CD4+ cells
      decreased, together with a decline of that of CD4+ cells. The proportions of
      CD45RAbright+ CD8+ cells and S6F1bright+ CD8+ cells increased with age, and the
      age-dependent increase of the proportion of CD8+ cells seems to be mainly
      attributable to the increases in these subsets. The CD45RAdim+ CD4+ and
      CD45RAdim+ CD8+ cells co-expressing CD45RO at a low level nevertheless showed no
      age-related changes. In gamma delta T cells, both delta TCS1+ and delta TCS1- T
      cells increased with age, but the delta TCS1- gamma delta T cells increased more
      than the delta TCS1+ subset. Among lymphocytes, the percentages of CD20+, CD21+
      and CD22+ cells remained similar, with no age-related changes, but the proportion
      of CD5+ cells within lymphocytes or B cells decreased. The proportions of CD16+
      NK cells among lymphocytes increased with age, and this change was attributable
      to the increase of CD56+ cells.

PMID- 7774065
TI  - Gamma delta T cell receptor gene expression by muscle-infiltrating lymphocytes in
      the idiopathic inflammatory myopathies.
AB  - Autoreactive alpha beta T cells have been implicated as playing a primary
      pathogenic role in a group of diseases characterized by chronic muscle
      inflammation known as the idiopathic inflammatory myopathies (IIM). gamma delta T
      cells, a distinct and enigmatic class of T cells, play a less certain role in a
      variety of human autoimmune diseases including the IIM. In an attempt to
      understand the significance of gamma delta T cells in the IIM, we utilized a
      sensitive polymerase chain reaction (PCR) technique to evaluate gamma delta T
      cell receptor (TCR) gene expression in 45 muscle biopsies obtained from 42 IIM
      patients (17 polymyositis, 12 dermatomyositis, and 13 inclusion body myositis).
      gamma delta TCR gene expression was not detected in 36 specimens, the majority of
      muscle biopsies surveyed. gamma delta TCR gene expression by muscle-infiltrating
      lymphocytes was detected among nine clinically heterogeneous patients. We further
      analysed the junctional sequence composition of the V gamma 3 and V delta 1
      transcripts, whose expression was prominent among gamma delta positive patients.
      DNA sequence analysis of V gamma 3 amplification products from two patients
      revealed the presence of several productively rearranged transcripts with amino
      acid sequence similarities within the V gamma 3-N-J gamma junctional domain. No
      amino acid sequence similarities were evident within the V delta-N-D delta-N-J
      delta region of V delta 1 transcripts amplified from four patients, although a
      distinct and dominant clonotype was detected from each patient. Our cumulative
      data suggest that unlike alpha beta T cells, gamma delta T cells do not play a
      prominent pathologic role in the IIM. In fact, the sporadic nature of gamma delta
      TCR gene expression detected among these patients implies that gamma delta T cell
      infiltration, when it occurs, is a secondary event perhaps resulting from non
      specific inflammatory processes.

PMID- 7774068
TI  - Incidence and outcome of pauci-immune necrotizing and crescentic
      glomerulonephritis in adults.
AB  - During a seven-year period (1986-1992) 719 adults (age > 16 years) underwent
      diagnostic renal biopsy in Stockholm (adult population 1.2 million). Seventy-one
      (10%) new cases of pauci-immune necrotizing and crescentic glomerulonephritis
      (NCGN) with or without systemic vasculitis were found: 39 females and 32 males
      (median age 67, range 20-84 years). The mean yearly incidence for the whole
      period was 0.8/100,000 population. The yearly incidence doubled from 0.6 before
      to 1.2/100,000 population after 1990. The incidence was highest among those > 65
      years of age. Age-corrected incidences for this age group increased from 1.4
      before to 3.9/100,000 after 1990. Anti-neutrophil cytoplasmic antibodies (ANCAs)
      tested in 60, showed antibodies against proteinase 3 (PR3) in 29 patients,
      against myeloperoxidase (MPO) in 26 and none in five patients. Mortality was
      highest in the early stages of the disease. From a total of 11 patients, 7 (15%)
      died within 2.5 months of diagnosis. Forty-six out of all 71 patients with NCGN
      belonged to the catchment area of our clinic and were studied in more detail.
      Twenty-six had microscopic polyangiitis (ANCAs were analyzed in 24, of these 16
      had anti-MPO, 6 anti-PR3, 2 had none), 13 had Wegener's granulomatosis (ANCAs
      were analyzed in all, of these 12 had anti-PR3, 1 anti-MPO) and seven had disease
      limited to the kidneys (ANCAs were analyzed in 6, 5 had anti-MPO, one was
      negative). At the time of diagnosis, 16 patients had s-creatinine < 300 mumol/l
      while 14 patients were dialysis-dependent (seven only temporarily). All patients
      received immunosuppressive therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7774069
TI  - Renal structure and function effects after low dose cyclosporine in psoriasis
      patients: a preliminary report.
AB  - Our studies on the treatment of psoriasis with cyclosporine A (CSA) have
      demonstrated efficacy at doses < 5 mg/kg/day. However, the nephrotoxicity of CSA
      at these low doses is not known and is the focus of this current study. Twenty
      nine patients prospectively had pretherapy assessment of renal function including
      serum creatinine and glomerular filtration rate (GFR). GFR was also measured
      while receiving CSA as well as posttherapy. These functional studies were
      compared with renal biopsies taken one month after discontinuing the drug.
      Pretherapy GFR values were normal in all of our subjects. However, by midstudy
      GFR values had dropped significantly in many patients. This trend continued so
      that at the end of the study mean GFR values had decreased by 12% with slightly
      over one quarter of the patients having reductions in GFR of at least 25%. Renal
      biopsy findings correlated well with the functional studies in particular the
      GFR, with those patients having the greatest reduction in GFR showing the most
      renal scarring. Thus, CSA at doses < 5 mg/kg/day induces variable chronic renal
      injury which correlates most closely with changes in the GFR.

PMID- 7774070
TI  - Efficacy of cyclosporin A (CyA) in psoriasis: an overview of dose/response,
      indications, contraindications and side-effects.
AB  - Since 1985, the efficacy of cyclosporin A (CyA) in severe psoriasis has been
      evaluated in a number of open and controlled studies, all of which have clearly
      established CyA as an effective antipsoriatic agent. The efficacy of CyA has also
      provided new insights into the pathophysiology of psoriasis. The effects of CyA
      treatment can be seen within weeks; they are dose-dependent and quickly
      reversible on stopping treatment. Hypertension and nephrotoxicity remain the
      greatest concerns associated with long-term use. In general, the incidence of
      hypertension is approximately 10%. A dosage of approximately 2.5-5 mg/kg/day of
      CyA induces a slight, but significant, dose-dependent increase in serum
      creatinine. Studies of pre- and post-treatment renal biopsies have also disclosed
      slight, but significant, increases in interstitial fibrous tissue which are
      negatively correlated to creatinine clearance. This review assesses the current
      knowledge of the prospects of CyA in the treatment of psoriasis with respect to
      dose/response, indications, contraindications and side-effects.

PMID- 7774071
TI  - A prospective study of cortical scarring in acute febrile pyelonephritis in
      adults: clinical and bacteriological characteristics.
AB  - Previous reports have demonstrated lesions on computerized axial tomography (CT),
      and nuclear scintigraphy (DMSA) in acute pyelonephritis (PN). We undertook a
      prospective study of all patients presenting to our hospital with PN over 40
      months. Patients who fulfilled diagnostic criteria, were treated with intravenous
      antibiotics. Excluding two who were pregnant, all patients had imaging by
      intravenous urography (IVU), CT and DMSA during their admission. Urine samples
      were collected prior to treatment. Patients without IVU evidence of cortical
      scarring but with parenchymal defects on CT and/or DMSA underwent a repeat DMSA
      three or more months after the acute episode. Of the 164 patients, 142 were
      female. E. coli was found in 116 patients. Forty-six patients had an abnormality
      on IVU. Of the 106 patients without IVU evidence of cortical scarring, 59 had a
      defect on CT and/or DMSA. Late DMSA scans in 35 of these 59 patients showed a
      persistent abnormality in 77%. E. coli characteristics such as P-fimbriae and
      Type 1 fimbriae were not predictive of acute imaging abnormalities. Inhibition of
      E. coli growth by the addition of EDTA was highly predictive of acute CT and DMSA
      abnormalities with a sensitivity of 83.3% and a specificity of 82.8%. Acute
      pyelonephritis is often associated with acute CT and/or DMSA abnormalities which
      may evolve into renal cortical scars. Acute scan abnormalities can be predicted
      by the presence of E. coli which were susceptible to EDTA in culture. Late
      scarring could not be predicted by clinical features, response to treatment or
      antibiotic used.

PMID- 7774072
TI  - Age-related differences in susceptibility of males and females to end-stage
      reflux nephropathy.
AB  - Age-specific rates for entry into Australian maintenance dialysis and
      transplantation programmes show that reflux nephropathy is equally common as a
      cause of end-stage renal failure in males and females from 5 to 24 years, and
      over 75 years of age, but between 35 and 64 years renal failure due to this
      disease is significantly more common in women than men.

PMID- 7774073
TI  - Evaluation of a rapid specific ward based assay for creatinine in blood.
AB  - We have evaluated a dry reagent stick test for the quantitation of creatinine in
      plasma employing a whole blood sample. The assay was found to be specific for
      creatinine and correlated well (r = 0.993) with an established laboratory
      procedure. The precision found indicated that the method was suitable for use in
      the diagnosis and monitoring of renal disease.

PMID- 7774074
TI  - Mortality in patients receiving renal replacement therapy, a single center study.
AB  - We studied all patients receiving renal replacement therapy (RRT) in the Kennemer
      Gasthuis Dialysis Centre (Haarlem) during the period January 1st 1986 to January
      1st 1991 in order to evaluate their mortality. Of the total number 205 patients,
      76 had died in this period, 82 were still receiving RRT on December 31st 1991 and
      47 had been transplanted. The most frequent cause of death was cardiovascular. Of
      the 76 patients who had died, 38 had requested cessation of dialysis. Of these,
      26% had also a malignancy and 29% had irreversible brain damage (CVA, dementia).
      Compared to the expected mortality rate in the general population of The
      Netherlands, dialysis patients have a Standardized Mortality Rate (SMR) of 6.91
      (95% Confidence Interval (CI) 4.72-9.54). Male patients had a SMR twice as high
      as females. Patients under age 50 had a SMR of 50.00 (95% CI 8.93-124.40) versus
      50 and older 7.19 (95% CI 4.26-8.91). The SMR was similar for patients with and
      without cardiovascular comorbidity before entering RRT. A Kaplan-Meier plot
      showed a significant difference for not transplantable versus transplanted or
      transplantable patients, however SMR for these 3 groups revealed no difference. A
      Kaplan-Meier plot of patient survival of patients starting RRT after January 1986
      (n = 114) showed a linear decrease of 20% yearly mortality. No gender difference
      was found. We conclude that 1. RRT is associated with high mortality, 2. SMR of
      young patients is higher than of the elderly and SMR of men is twice as high as
      SMR of women. Interestingly Kaplan-Meier survival plot did not reveal this
      difference.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7774075
TI  - Fibrillary glomerulonephritis and pulmonary hemorrhage in a patient with renal
      transplantation.
AB  - Fibrillary glomerulonephritis is an unusual kidney disease characterized by the
      deposition of immunoglobulins in a fibrillar pattern. Until recently it has been
      considered to involve the kidneys alone. We describe a patient who underwent
      renal transplantation and developed fibrillary glomerulonephritis with rapidly
      progressive renal failure and severe pulmonary hemorrhage two years and a half
      after transplantation. Nephropathy prior to transplantation was thought to be
      focal and segmental glomerulosclerosis. Diagnosis of fibrillary
      glomerulonephritis in renal allograft was confirmed by postmortem examination.
      50% of the glomeruli with extracapillary crescents were observed on light
      microscopy. By immunofluorescence main deposition of IgA was detected in the
      glomerular capillar walls and the mesangium. Electron microscopy showed fibrillo
      reticular deposits in the same place. Lung histology showed both old and recent
      areas of alveolar hemorrhage. Granular staining for IgA was observed in the
      alveolar walls by immunofluorescence. Ultrastructural analysis of the lung made
      evident fibrillo-reticulary deposits in the interstitium, similar than those
      observed in the glomeruli. The presence of these deposits in both renal and
      pulmonary tissues indicates the possibility of systemic involvement in fibrillary
      glomerulonephritis. In our case it could be related to the recurrence of this
      glomerulopathy in renal allograft.

PMID- 7774076
TI  - Effect of recombinant human erythropoietin on hospitalization of hemodialysis
      patients.
AB  - The effect of recombinant human erythropoietin (EPO) on hospitalization of
      patients with end-stage renal disease (ESRD) was evaluated in a controlled
      clinical trial. A cohort of 67 new hemodialysis patients prescribed EPO shortly
      after the clinical availability of EPO were the treatment group. The control
      group was a cohort of 67 new hemodialysis patients matched for clinical center,
      age, cardiovascular disease and transfusion history. These patients had not been
      prescribed EPO as they had started hemodialysis prior to the clinical
      availability of EPO. There were 21 pairs without hospitalization and 46 pairs
      with at least 1 member of the pair experiencing hospitalization. Among the latter
      group, the median follow-up was 174 and 184 days for the EPO and control patients
      respectively. For all hospitalizations, those treated with EPO were hospitalized
      15.3 days per year compared to 23.2 days for the control patients. The difference
      (EPO-control) was -7.9 days (95% CI: -21.0; 7.8) for all cause hospitalization.
      For hospitalizations due to cardiac, infectious disease and gastrointestinal
      disease, the differences were 1.6, 1.8 and 1.2 days favouring EPO treated
      patients. For hospitalizations related to vascular access complications, the
      difference was 0.9 days favoring the control group. All other causes favoured EPO
      treated patients by 4 days. There had been 58 hospitalizations in the EPO group
      compared to 97 in the control group. The mean duration of hospitalization was 8.0
      days for the EPO and 9.6 for the control group. The direction and magnitude of
      the change in all cause hospitalization represents an improvement in morbidity
      and an important decrease in health resource utilization.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7774077
TI  - Bone marrow findings before and after treatment with recombinant human
      erythropoietin in chronic hemodialyzed patients.
AB  - The stimulating effect of rHuEPO on erythropoiesis has been shown in several
      studies, using bone marrow cell culture or animal models. To investigate the
      effect of rHuEPO on bone marrow findings in vivo, we studied the bone marrow
      cellularity, the myeloid: erythroid (M:E) ratio, an estimate of the number of
      megakaryocytes, any cytomorphologic or maturation abnormalities, and an estimate
      of the storage iron before and after 3 months of treatment with rHuEPO in 10
      chronic hemodialyzed patients. Nine patients showed a slight or moderate decrease
      of erythropoiesis in bone marrow in comparison to normal bone marrow before
      rHuEPO treatment. The bone marrow cellularity was a mean of 28.5% and decreased
      in 8 out of 10 patients compared to normal values. However, megakaryopoiesis and
      granulopoiesis were normal. Three months of treatment with rHuEPO had increased
      erythropoiesis in all 10 patients, including one patient whose bone marrow proved
      to be normal erythropoiesis on baseline examination. The M:E ratio was
      significantly decreased from 4.0 +/- 1.2:1 to 2.4 +/- 1.1:1 (p < 0.005). The bone
      marrow cellularity was also increased in 9 patients, except in 1 patient whose
      specimen was inadequate for diagnosis, after 3 months of treatment with rHuEPO.
      On baseline examination of bone marrow, iron staining was undetectable in one,
      low in one, normal in 2 and high in 5 sections. According to grading, iron
      staining had decreased from 3.1 +/- 1.7 to 2.1 +/- 0.9 (p < 0.05).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7774078
TI  - Influence of recombinant human erythropoietin on hematological and hemostatic
      parameters with special reference to microhemolysis.
AB  - Twenty chronic hemodialysis patients with renal anemia (hematocrit < 25%)
      received recombinant human erythropoietin (40 IU/kg body weight 3 x weekly)
      intravenously after each dialysis. Prior to and at 4, 8 and 12 weeks after
      commencement of erythropoietin therapy, hematocrit together with hemostasis and
      microhemolysis parameters were determined. There were significant increases in
      hematocrit, platelet count and platelet retention, but a significant fall in the
      initial clearly prolonged bleeding time. Free plasma hemoglobin likewise
      increased. Conversely, lactate dehydrogenase, prothrombin time, fibrinogen,
      antithrombin III activity, protein C activity and protein S concentration were
      all unaltered. The positive effect on bleeding time and platelet retention is
      most probably caused by an increase in adenosine diphosphate due to the
      hematocrit-dependent rise in the blood shear stress via physiologic
      microhemolysis (raised free plasma hemoglobin).

PMID- 7774079
TI  - Glomerular filtration in patients suffering from reactive hypoglycemia.

PMID- 7774081
TI  - A case of unilateral renal cystic disease of a newborn.

PMID- 7774080
TI  - Gastric vascular ectasia in a chronic hemodialysis patient.

PMID- 7774082
TI  - Clinical and histological criteria defining the diagnosis of active chronic
      pyelonephritis in pregnancy.

PMID- 7774083
TI  - Patients with renal hypouricemia are prone to develop acute renal failure--why?

PMID- 7774084
TI  - Efficiency of hemodialysis therapy for a urea cycle defect in a neonate.

PMID- 7774086
TI  - From internal medicine to rheumatology and back: the example of mixed
      cryoglobulinemia.

PMID- 7774085
TI  - Pauci-immune crescentic glomerulonephritis and cutaneous vasculitis associated
      with anti-proteinase 3 antibody.

PMID- 7774087
TI  - Thrombocytopenia responsive to warfarin in a patient with systemic sclerosis-
      systemic lupus erythematosus overlap.
AB  - We report a patient with overlapping systemic sclerosis-systemic lupus
      erythematosus who developed refractory thrombocytopenia and recurrent thromboses.
      Coagulation and platelet labeling studies revealed that platelets were being
      consumed by the thrombus formation, and anticoagulation with warfarin
      dramatically increased the platelet count. This case report suggests that
      platelet consumption due to thrombus formation is one of the causes of
      thrombocytopenia in patients with rheumatic disease.

PMID- 7774088
TI  - Purine enzymes in rheumatoid arthritis. A clue to the prediction of the response
      to azathioprine? Review and hypothesis.
AB  - Azathioprine (AZA), a purine analog, is an effective agent in the treatment of
      rheumatoid arthritis (RA), but variability of response and sometimes life
      threatening side effects limit its use (1). The metabolism of AZA parallels the
      endogenous purine pathways. In this paper we review some general aspects of
      purine and thiopurine metabolism, their relation with various disease states and
      current knowledge of the influence of purine enzymes on the effects of AZA
      treatment. We suggest that intracellular purine enzyme activities determine the
      response to AZA treatment in patients with RA, and that a role for purine enzyme
      activities in the ethiopathogenesis of RA should be considered.

PMID- 7774089
TI  - Association of HLA-DR5 (DR11) with systemic sclerosis (scleroderma) in Mexican
      patients.
AB  - OBJECTIVE: To study the association between Major Histocompatibility Complex
      (MHC) haplotypes and systemic sclerosis (SSc) in Mexican mestizo patients.
      METHODS: Class I, II and III MHC antigens were determined in 41 Mexican mestizo
      patients with SSc, 113 of their first degree relatives, and 85 ethnically matched
      controls. The significance of differences between patients and controls was
      tested by chi-square analysis with Yates' correction. RESULTS: Frequencies of HLA
      DR5 and HLA-DRw52 were found to be higher in SSc patients compared to ethnically
      matched healthy controls (p = 0.007, RR = 3.31; 95% confidence interval: 1.3-8.3
      and p = 0.04, RR = 2.4; 95% confidence interval: 1.0-5.7, respectively). Sequence
      specific oligotyping in DR5 positive individuals showed that 10 out of 41
      patients had the DRB1*1104 subtype (24.3%) as compared to only 6 of the 85
      healthy controls (7.0%) (p = 0.01, RR = 4.25). Subdividing patients according to
      their clinical features showed a significant increase of HLA-DR5 in diffuse (p =
      0.013, RR = 3.89, 95% confidence interval: 1.27-12.0) and limited scleroderma (p
      = 0.0008), but not in the CREST syndrome. Segregation analysis obtained from the
      families showed that in the patients, DR5 was mostly part of the [HLAB35;DR5]
      haplotype as opposed to healthy controls. CONCLUSION: These data support the role
      of DR5 (DRB1*1104) in the genetic susceptibility to develop scleroderma in
      Mexican patients and also sustain the notion of genetically determined clinical
      subgroups of SSc.

PMID- 7774090
TI  - High dose methotrexate in the treatment of refractory juvenile rheumatoid
      arthritis.
AB  - OBJECTIVE: To assess the response to and safety of long term, high dose (> or = 1
      mg/kg/week or > or = 15 mg/m2/week) methotrexate (MTX) administration, in a
      cohort of 21 children with longstanding, severe juvenile rheumatoid arthritis
      (JRA). METHODS: Children received MTX at an average weekly dose of 27 mg for a
      mean of 15.2 months. Outcome was assessed using a disease activity score based on
      changes in concomitant therapy, laboratory parameters, physician's global
      assessment, and radiologic evaluation. RESULTS: Seven patients (33%) improved,
      including one child who achieved complete remission, while 14/21 children (67%)
      did not benefit from high dose MTX. Subsequently, 6/14 (43%) of the non
      responders discontinued high dose MTX and began cyclosporine. Radiologic
      progression, regardless of clinical outcome, was documented in 10/15 (67%) of the
      patients. The drug was well tolerated despite mild gastrointestinal symptoms and
      transient liver enzyme elevation. CONCLUSION: The results of this open
      retrospective pilot trial suggest that high dose MTX is well tolerated, but that
      its role in the treatment of children with refractory JRA may be limited.
      Radiologic progression, despite improvement in the clinical status or in the
      laboratory parameters, supports the hypothesis that MTX acts as a potent
      antiinflammatory agent.

PMID- 7774091
TI  - Juvenile chronic arthritis in Costa Rica. A pilot referral study.
AB  - In order to adequately care for patients with chronic disorders and to properly
      allocate resources, the epidemiology of the underlying disease must be know.
      Proper population based studies involve substantial planning and educational
      programs, however. To prepare for such a study of pediatric rheumatic disorders,
      we performed a referral-based pilot study. During an eleven-month period
      pediatricians all over Costa Rica were asked to refer to us all new cases of
      possible rheumatic disorders among children less than 16 years of age, using the
      EULAR criteria for juvenile chronic arthritis. The children were evaluated at the
      National Children's Hospital. An annual incidence of 5.9 cases of all types of
      pediatric rheumatic diseases per 100,000 was found. Incidences of 5.4 per 100,000
      children below 16 years of age and 6.1 for children below 12 years of age were
      observed for juvenile chronic arthritis (JCA). 77% of the JCA cases were of
      pauciarticular onset, and 23% were of polyarticular onset. No cases of systemic
      JCA were diagnosed. The female to male ratio was 3:2. Antinuclear antibodies were
      positive in 13% of the JCA cases, and IgM rheumatoid factor was found in 15% of
      the children. Chronic iritis was noted in only 2 cases; both were girls and both
      were ANA positive. The incidence found was low compared to population-based
      studies, but in the same range as hospital-based investigations.

PMID- 7774092
TI  - A possible linkage of HLA-DRB haplotypes with tiopronin intolerance in rheumatoid
      arthritis.

PMID- 7774094
TI  - Subcutaneous calcifications in diffuse idiopathic skeletal hyperostosis.

PMID- 7774093
TI  - Regression of amyloidosis with colchicine in familial Mediterranean fever in an
      Ashkenazi patient.

PMID- 7774095
TI  - Immunoglobulin production and eicosanoid precursors in patients with primary
      Sjogren's syndrome.

PMID- 7774096
TI  - On the utility of CD8 level assessment in the diagnosis of polymyalgia
      rheumatica/giant cell arteritis.

PMID- 7774097
TI  - Insufficiency fracture of the distal tibia mimicking arthritis in a rheumatoid
      arthritis patient. The possible role of methotrexate treatment.

PMID- 7774098
TI  - Elevated serum interleukin-6 levels associated with active disease in systemic
      connective tissue disorders.
AB  - OBJECTIVE: It is well established that connective tissue diseases such as
      systemic lupus erythematosus (SLE) are associated with a weak or absent acute
      phase response, although elevated serum interleukin 6 levels have been described.
      In this study, we have sought to correlate serum levels of IL-6 with standard
      laboratory and clinical assessments of disease activity in two connective tissue
      diseases, namely SLE and systemic sclerosis (SSc), and, for comparative purposes,
      rheumatoid arthritis (RA). METHODS: Serum IL-6 levels were determined by bioassay
      and also, in some sera, by immunoradiometric assay. They were compared with two
      inflammatory parameters, serum C-reactive protein (CRP) and plasma viscosity
      (PV), and with appropriate clinical measurements in the various patient groups,
      including BILAG in SLE, the skin score in SSc, and the Ritchie index in RA.
      RESULTS: Serum IL-6 (SeIL-6) levels were elevated in active SLE, SSc, and RA.
      This was poorly correlated with the acute phase response in SLE and SSc, but
      there was a strong relationship of SeIL-6 to disease activity in these
      conditions. In SLE, the BILAG disease activity index correlated best with SeIL-6
      levels while there was only a weak relationship between CRP and IL-6, and no
      relationship between CRP and disease activity. In SSc there was a relationship of
      disease activity to SeIL-6 but not between SeIL-6 and either CRP or PV. In a
      small RA group there was a much stronger relationship of SeIL-6 to CRP and PV, as
      has been previously described. CONCLUSION: The determination of SeIL-6 may be a
      useful indicator of disease activity in those patients groups, including SLE and
      SSc, in which a normal acute phase response by the liver is often lacking. The
      mechanism underlying this hepatic impairment requires further investigation, but
      is clearly not due to a failure to generate the appropriate cytokine signal.
      Excessive local or systemic production of IL-6 in connective tissue diseases
      could play an important pathogenic role in these conditions, for example through
      stimulating autoantibody synthesis.

PMID- 7774099
TI  - A prospective study of the long-term efficacy and toxicity of low-dose
      methotrexate in rheumatoid arthritis.
AB  - OBJECTIVE: To determine the long-term efficacy and safety of weekly low-dose
      methotrexate (MTX) in rheumatoid arthritis (RA). METHODS: Fifty-one patients
      receiving MTX for RA were prospectively studied over a mean treatment period of
      36 months. Standard clinical and laboratory measures of disease activity were
      assessed by the same investigator at baseline, and at 3, 6, 12, 24 and 36 months.
      RESULTS: The overall probability of continuing to take MTX was 80.3% at 12
      months, 74.5% at 24 months, and 70.5% at 36 months. Of the 36 patients who
      completed 36 months of therapy, a significant improvement was noted compared to
      baseline in all of the clinical disease variables and acute phase reactants, with
      a steroid-sparing effect. There were no significant differences in these
      parameters between the 36-month visit and the 24- or 12-month visit. Adverse
      events occurred frequently (80.3%), but only 15.6% of the patients discontinued
      MTX permanently. Four patients (7.9%) withdrew due to a lack of efficacy.
      CONCLUSION: Our findings indicate that MTX remains effective over 36 months of
      therapy, with an acceptable toxicity profile.

PMID- 7774100
TI  - Abnormal T cell receptor V beta gene expression in the peripheral blood and
      synovial fluid of rheumatoid arthritis patients.
AB  - OBJECTIVE: The aim of this study was to assess T cell receptor V beta-gene
      expression in the peripheral blood and synovial fluid of rheumatoid arthritis
      patients. METHODS: Cytometric analysis was performed on peripheral blood and
      synovial fluid lymphocytes from 12 patients using a restricted set of V beta
      specific monoclonal antibodies (to V beta 5.1-3, V beta 6.7 and V beta 8). In 5
      patients the expression of the V beta 1 through V beta 20 gene families was also
      analysed, using a recently described method based on a one-side-specificity
      polymerase chain reaction coupled to reverse dot hybridization. RESULTS:
      Cytometric analysis failed to show any consistent difference in the expression of
      V beta 5, 6 and 8 between the two compartments on the one hand, or between the
      peripheral blood of normal individuals and patients on the other hand. The
      PCR/dot hybridization method did not demonstrate a significant difference in the
      V beta repertoires between peripheral blood and synovial fluid samples from
      arthritis patients. However, in all patients the V beta 6, 13 and/or 14 families
      were expressed to a high level, so that these families frequently represented
      over 40% of the V beta 1-20 repertoire in both compartments, instead of the
      approximately 20% seen in normal peripheral blood samples. CONCLUSION: We
      conclude that V beta 6, 13 and 14 are overexpressed in both the peripheral blood
      and synovial fluid of rheumatoid arthritis patients compared to normal samples.

PMID- 7774101
TI  - Undifferentiated arthritis in an early synovitis out-patient clinic.
AB  - OBJECTIVE: To describe the features of undifferentiated arthritis in an early
      synovitis out-patient clinic. METHODS: In a two-year prospective cohort study 320
      patients with rheumatic symptoms of less than one year were investigated in an
      early synovitis out-patient clinic. Besides the clinical parameters, an intensive
      laboratory program was performed, including routine blood and serum parameters,
      immunological investigations (CRP, IgG,A,M,C3C4,RF,ANA, DNA, HLA B-27), and a
      microbiological program to search for reactive arthritis-inducing infections.
      RESULTS: 217 patients had inflammatory rheumatic diseases, of whom only 100 (46%)
      could be given a definite diagnosis, whereas 117 (54%) were considered as having
      undifferentiated arthritis (UA). Patients with UA had a mean age of 41 +/- 15
      years, the sex-ratio was 1.8:1.0 (f/m), joint manifestations were oligoarticular
      in 68%, monarticular in 14%, and polyarticular in 18%. Rheumatoid factor was
      positive in 17%, HLA-B27 was found in 27%, and 21% of the patients had a history
      of recent infection. Follow up over 26 (range 4-38) months of 28 (24%) patients
      with UA revealed complete remission in 15 patients (54%), while 10 patients (36%)
      had further UA with partial remission, unchanged activity or progressive disease,
      and only 2 (7%) developed rheumatoid arthritis (RA) and 1 (4%) was diagnosed as
      having ankylosing spondylitis. CONCLUSION: Most patients with early synovitis
      followed at our clinic remain unclassified with a good prognosis.

PMID- 7774102
TI  - Takayasu's arteritis in Italian patients.
AB  - OBJECTIVE: To evaluate the clinical features, angiographic findings and evolution
      of Takayasu's arteritis in Italian patients. METHODS: Retrospective analysis of
      the case records of 27 Italian patients with Takayasu's arteritis, all meeting
      the 1990 ACR criteria for classification of this vasculitis, with a median
      disease duration of 9.5 years. RESULTS: The patterns of arterial involvement and
      the frequencies of systemic and specific symptoms were similar, with some
      exceptions, to those reported in the literature. In our patients weight loss was
      rare, the incidence of respiratory symptoms and seizures was low, and no clinical
      manifestations of intestinal involvement were reported. All of the patients were
      treated with antiplatelet or anticoagulant medications, and 14 were also treated
      with corticosteroids and immunosuppressants; a stabilization of the vascular
      involvement was seen in most of them. Thirteen patients underwent surgery, and 5
      had percutaneous transluminal renal angioplasties. Five pregnancies were
      observed, without complications. Two patients died, one after an angiographic
      evaluation and one for reasons unrelated to the disease. CONCLUSIONS: Takayasu's
      arteritis is heterogeneous in presentation, evolution and response to therapy. In
      our series of patients the disease seems to have showed a more favorable course
      than that previously reported. This can be attributed to the effectiveness of
      therapy, but also, at least partially, to the better prognosis that the disease
      seems to have for Western than for Eastern subjects.

PMID- 7774103
TI  - Modified expression of c-Fos and c-Jun proteins and production of interleukin-1
      beta in patients with rheumatoid arthritis.
AB  - OBJECTIVE: To examine the relationship between the expression of c-Fos and c-Jun
      proteins and the METHODS: The expression of c-Fos and c-Jun proteins and the
      production of IL-1 beta in the PBMC of 11 patients with active RA was determine
      by Western blots and ELISA techniques, respectively. RESULTS: The spontaneous
      expression of c-Fos protein and the production of IL-1 beta was higher in RA
      patients. Under LPS treatment, the PBMC of both RA patients and healthy subjects
      produced similar high levels of IL-1 beta without any significant changes in the
      expression of c-Fos and c-Jun proteins. By contrast, PMA-induced production of IL
      1 beta was impaired in RA patients and was preceded by the disregulated
      expression of c-Fos and c-Jun proteins when compared with healthy donors.
      CONCLUSION: It can be postulated that in some RA patients the spontaneously high
      production of IL-1 beta may be associated with the up-regulated expression of c
      Fos protein in PBMC. On the other hand the impairment of IL-1 beta production in
      RA induced by the PKC-dependent pathway, may be related to disturbances in c-Fos
      and c-Jun protein expression. This dysfunction seems to be compensated by some
      unknown mechanisms implicated in LPS signalling, which is known to involve not
      only the PKC-mediated pathway.

PMID- 7774104
TI  - A longitudinal study of calprotectin as an inflammatory marker in patients with
      reactive arthritis.
AB  - OBJECTIVE: To examine the value of calprotectin, a major granulocyte protein with
      bactericide properties, as an inflammatory marker in patients with reactive
      arthritis. METHODS: Twenty-five patients with Chlamydia-induced and 27 patients
      with enterobacteria-induced reactive arthritis were analysed. At the first visit
      and after 3, 12, 24, 52 and 104 weeks, calprotectin concentrations were measured
      in plasma and when possible, in synovial fluid. C-reactive protein (CRP) and the
      erythrocyte sedimentation rate (ESR) were analysed and clinical assessments of
      disease activity were performed. RESULTS: Of the inflammatory markers, the plasma
      calprotectin concentrations were the first to normalize during recovery.
      Calprotectin concentrations in the plasma were highly correlated with CRP and
      ESR, and calprotectin was found to have high correlation coefficients with the
      clinical assessments of disease activity. High calprotectin concentrations were
      found in the synovial fluid. CONCLUSION: The high correlations between
      calprotectin in plasma and clinical and laboratory markers of inflammation, as
      well as the rapid normalization following clinical improvement, demonstrate that
      calprotectin may be used as an inflammatory marker in patients with reactive
      arthritis.

PMID- 7774105
TI  - Fetal outcome in women with primary Sjogren's syndrome. A retrospective case
      control study.
AB  - OBJECTIVE: To study fetal outcome in women with primary Sjogren's syndrome (SS)
      compared to that in women with systemic lupus erythematosus (SLE) and healthy
      women, and to study the possible association of fetal loss with anticardiolipin
      antibodies (aCL) and antibodies to SS-A/Ro and SS-B/La in women with primary SS.
      METHODS: A retrospective analysis of the fetal outcome in 55 pregnancies in 21
      patients with primary SS compared to that in 100 pregnancies in 42 patients with
      SLE and 94 pregnancies in 42 healthy women matched for age, parity and the onset
      of the autoimmune disease with respect to pregnancy. IgG-, IgM- and IgA-aCL were
      determined by a cofactor-dependent ELISA and antibodies to SS-A/Ro and SS-B/La by
      ELISA using human recombinant antigens and affinity-purified antigens. RESULTS:
      Of all the 55 pregnancies in patients with primary SS, 8 (15%) occurred after the
      onset of primary SS symptoms. Eleven (20%) of the 55 pregnancies ended in fetal
      loss. The relative risk (RR) for fetal loss in patients with primary SS was 2.7
      (95% CI 1.1-6.5; p = 0.023), and after the exclusion of the patient with four
      spontaneous abortions it was 2.0 (0.7-5.3; p = 0.18). In SLE the level of risk
      was 2.2 (0.9-5.0; p = 0.065). Fetal loss in patients with primary SS was not
      associated with elevated levels of anticardiolipin antibodies (aCL) or
      autoantibodies to SS-A/Ro or SS-B/La. Newborns of mothers with primary SS were
      not more premature or growth retarded than newborns of healthy women, but the
      absolute and the relative birth weights of the newborns of mothers with SLE was
      significantly lower than in healthy controls (P < 0.001 and P < 0.0001,
      respectively). CONCLUSION: We conclude that the majority of pregnancies in women
      with primary SS occur before the onset of the disease and that these women have
      an increased risk of fetal loss, which is not associated with elevated levels of
      ACL or antibodies to SS-A/Ro or SS-B/La. The risk of fetal loss in primary SS is
      similar to that in women with SLE, but fetal growth retardation appears to be
      more common in SLE than in primary SS.

PMID- 7774106
TI  - Induction of anti-DNA antibodies in non autoimmune mice by immunization with a
      DNA-DNAase I complex.
AB  - Recent studies suggest that anti-DNA antibodies may arise from the immune
      response to a complex of DNA and a DNA-binding protein. One of the protein
      targets frequently recognized by anti-DNA antibodies is the enzyme DNAase I. To
      investigate the possible role of DNAase I in the induction of anti-DNA
      antibodies, we immunized mice with a complex of DNA and DNAase I. Mammalian
      double strand DNA was crosslinked with DNAase I by ultraviolet light (UV)
      treatment and emulsified in complete Freund's adjuvant. BALB/c mice were
      immunized at the base of the tail with the DNA-DNAase complex, boosted after 2
      weeks with the immunogen in incomplete adjuvant and bled one week after the
      boost. Control mice received UV treated DNA in adjuvant. In one-third of the mice
      immunized with the DNA-DNAase complex, IgG anti-DNA antibodies were detectable in
      serum; the antibodies reacted with single and double strand DNA. No anti-DNA
      response was elicited by immunization with DNA alone. These data show that
      immunization with a DNA-DNAase complex can induce anti-DNA antibodies in non
      autoimmune mice strains and suggest that DNA-binding proteins may act as carriers
      in the immune response that leads to anti-DNA antibody production.

PMID- 7774107
TI  - The effect of sleep and nocturnal movement on stiffness, pain, and psychomotor
      performance in ankylosing spondylitis.
AB  - OBJECTIVE: This study was carried out in order to assess whether AS patients are
      adversely affected by a "good" night's sleep accompanied by little nocturnal
      movement. METHODS: Objective and subjective nocturnal movement, flexibility,
      stiffness, pain and psychomotor performance were measured in 22 subjects, 11 with
      ankylosing spondylitis and 11 controls. RESULTS: A better sleep integrity with
      little nocturnal movement was related to a decrease in lumbar flexibility.
      Difficulty in awakening and feeling tired and clumsy in the morning correlated
      with stiffness. Pain was correlated with a subjective difficulty in getting to
      sleep and a worse quality of sleep, but was also correlated with less objective
      sleep disruption. In the control group a better sleep integrity was correlated
      with an overnight decrease in psychomotor performance. In the spondylitic group a
      significant increase in performance occurred. Stiffness and pain did not
      correlate with performance. CONCLUSION: Sleep in ankylosing spondylitis differs
      from sleep in normals.

PMID- 7774108
TI  - Diverticulosis--a primary cause of life-threatening complications in rheumatoid
      arthritis.
AB  - OBJECTIVE: To assess the role of complicated diverticular disease as a cause of
      death in rheumatoid arthritis (RA). METHODS: In 1989 there were in Finland 1,666
      deaths in subjects entitled to specially reimbursed medication for RA under the
      nationwide sickness insurance scheme. A retrospective clinical study was
      performed on these cases. RESULTS: In 12 subjects, four males and eight females,
      the underlying cause of death was diverticular disease; the expected number was
      two. The mean age at death was 74 years in males and 80 years in females. The
      duration of RA ranged from 4 to 22 years (mean 13 years). In none of these cases
      was the death connected in the death certificate to RA or its treatment, yet all
      the subjects had been taking antirheumatic medication, usually two or three
      different drugs, at the time of death. CONCLUSION: Complicated diverticular
      disease, probably related to antirheumatic medication, is a more important cause
      of death in patients with RA than is generally recognized.

PMID- 7774109
TI  - Microvascular capillaroscopic abnormalities in rheumatoid arthritis patients.
AB  - Microvascular circulation was investigated by nailfold capillaroscopy in 32
      patients affected by rheumatoid arthritis (RA). In all the patients elongated and
      tiny capillaries as well as tortuousity were the main shape abnormalities of the
      capillary loops. Higher subpapilar venous plexus (SPVP) visibility was
      evidentiated in patients presenting antinuclear and anti-RANA antibodies. No
      differences in the capillaroscopic pattern were found between rheumatoid factor
      positive and rheumatoid factor negative patients. In conclusion, elongated and
      tortuous capillaries seem to be the main alterations in RA, although they are not
      specific to the disease and are not correlated with the presence of rheumatoid
      factor. Higher SPVP visibility may be an expression of the endothelial damage
      induced by antinuclear antibodies in vessel walls.

PMID- 7774110
TI  - Effects of fish oil on plasma fibrinolysis in patients with mild rheumatoid
      arthritis.
AB  - As rheumatoid arthritis (RA) patients have been shown to have impaired plasma
      fibrinolysis and fish oil has been suggested to be useful for RA, this study
      investigated the effects of fish oil on fibrinolytic parameters in patients with
      RA. Forty-five RA patients were randomised to receive either fish oil (1.7 gm
      eicosapentaenoic acid and 1.1 gm docosahexaenoic acid/day) or placebo treatment
      for at least 6 months. Plasma levels of fibrinogen, tissue-plasminogen activator
      (t-PA) and plasminogen activator inhibitor (PAI) activity were measured at 3
      month intervals. In the fish oil treatment group, plasma levels of fibrinogen and
      t-PA activity were reduced at 6 months when compared with baseline [fibrinogen:
      3.2 (2.85-3.53) milligrams vs 3.89 (3.56-4.22) milligrams, mean (95% confidence
      intervals for mean), p < 0.02; t-PA activity 1.4 (1.01-1.78) units/ml vs 1.94
      (1.55-2.33) units/ml, p < 0.01]. No significant changes in plasma PAI activity
      were seen during the treatment period in these patients. Placebo treatment did
      not significantly alter the plasma levels of fibrinogen or t-PA and PAI activity.
      In conclusion, fish oil supplementation does not appear to produce an improvement
      in plasma fibrinolysis. Indeed, plasma fibrinogen levels and t-PA activity were
      reduced. This could be due to an effect of fish oil on acute phase protein
      production. Alternatively, as t-PA is produced on an "on demand" basis, its
      reduction may be related to the lowering of fibrinogen levels following fish oil
      therapy.

PMID- 7774112
TI  - Schnitzler's syndrome (urticaria and macroglobulinemia) dramatically improved
      with corticosteroids.
AB  - The authors report the case of a 65-year-old man who had an evolving case of
      Schnitzler's syndrome with lytic bone lesions which was unresponsive to several
      drugs, and which dramatically improved with small quantities of corticosteroids.
      Schnitzler's syndrome, first described in 1974, is defined by chronic non
      pruritic urticaria, osteocondensation, and monoclonal IgM dysproteinemia without
      features of lymphoproliferative disease, and is associated with fever,
      deterioration of the general health and biological signs of inflammation. Only 22
      cases of Schnitzler's syndrome have been reported hitherto and there is no known
      effective treatment, H1 and H2 blockers, dapsone, colchicine, chloroquine,
      cyclophosphamide, chlorambucil and azathioprine having proven useless in the few
      patients treated. Corticosteroids may be effective, however, especially against
      the urticaria.

PMID- 7774111
TI  - Ectopic calcinosis possibly due to 1 alpha (OH) vitamin D3 in a patient with
      systemic lupus erythematosus.
AB  - A 30-year-old woman with systemic lupus erythematosus (SLE) developed ectopic
      calcinosis. She had been receiving prednisolone since 1980 with the addition of
      vitamin D3 in 1986. Despite this therapy, her renal function had gradually
      deteriorated. Right gonalgia was noted in September 1991. X-ray findings revealed
      calcinosis of the arteries of the femur, poplitea, cubitus, hands, and feet. Her
      finger pads and joint sacs were also involved. Calcinosis seen in SLE has only
      rarely been reported, and that observed in association with vitamin D
      intoxication or arteriosclerosis has a different distribution of calcium
      deposits. The use of vitamin D3 in our patient with renal disability may have
      induced calcinosis with a unique distribution.

PMID- 7774113
TI  - Severe lupus with infectious thyroiditis and lethal cardiomyopathy.
AB  - Clinical cardiomyopathy is an uncommon complication of systemic lupus
      erythematosus (SLE) and intracavitary thrombosis is rare. We describe a patient
      with active SLE who developed rapidly progressive cardiomyopathy, the fatal
      course of which was complicated by an intracavitary thrombus. Repeat cardiac
      echography studies and the endomyocardial biopsy proved to be helpful in
      diagnosing the lupus myocarditis and aided the regulation of therapy.
      Furthermore, the patient presented an acute suppurative thyroiditis never before
      described, to our knowledge, in SLE.

PMID- 7774114
TI  - [Causative factors and neurological diseases].
AB  - Considering the pathogenesis of neurological diseases, it is important to
      determine causative factors directly affecting the nervous system. We discussed
      here some neurological diseases induced by exogenous agents (thallium, organic
      phosphorus, organic solvents, acrylamide) and by "endogenous" agents (Krabbe
      disease, Alzheimer disease, familial amyloidotic polyneuropathy). In diseases by
      exogenous toxic agents, it is not very difficult to find the toxic factors.
      However, because a single agent can induce a variety of clinical symptoms, we
      should consider the dose of the agents, the toxic mechanisms and the
      susceptibility of tissues or organs. In endogenous diseases, causative agents are
      either toxic factors or the substances inducing mechanical injury. Endogenous
      toxic agents are usually produced by affected cells themselves. In the case of
      the substances inducing mechanical injury, the pathogenesis is more complex. The
      structure of the abnormal agents and tissue susceptibility should be considered.

PMID- 7774115
TI  - [The genetic manipulation and the brain research].

PMID- 7774116
TI  - [Molecular analysis and pathophysiology of genetic leukodystrophies].
AB  - The elucidation of the molecular genetics in genetic leukodystrophies is rapidly
      progressive. In 1993, genes responsible for adrenoleukodystrophy (ALD), globoid
      cell leukodystrophy and Canavan disease have been cloned. In this symposium, I
      will focus only on ALD because of the limitation of space. ALD is an X-linked
      recessive demyelinating disease of childhood. Adrenomyeloneuropathy (AMN) is a
      clinical variant of ALD. In both types of the disease, very long chain fatty
      acids accumulate in the body fluid and tissues of the patient. This finding
      suggests that there is a metabolic defect in the beta-oxidation in the
      peroxisome, but the primary defect has been unknown. In 1993, Mosser et al.
      reported a putative gene for ALD. According to the report, we obtained the cDNA
      from HeLa cells. Using the cDNA as the probe, we analyzed the expression of the
      gene in various samples of human and murine tissues. On northern blot analysis,
      mRNA of the gene was detected in all the tissues examined, and the amount and
      size of the mRNA were similar among all the tissues. We also examined the DNA and
      mRNA in 6 patients with ALD or AMN. On southern blot analysis, we could not
      detect large deletion in all the patients, while in northern blot analysis, mRNA
      was not detected in one patient (#163). The nucleotide sequence of mRNAs of the
      remaining 3 of 5 patients depicted different missense point mutations. The
      mutations were localized in the C-terminal regions of the gene, which are
      evolutionally conserved among ATP-binding protein superfamily, thereby suggesting
      that the mutations cause functional defect in the ALD protein.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7774117
TI  - [Molecular genetics in Creutzfeldt-Jakob disease].
AB  - Recent molecular genetic studies revealed that human prion protein (PrP) gene has
      a large repertoire of polymorphisms and mutations. Each variant PrP seems to
      correspond to the distinct type of prion diseases. We report herein that it is
      useful to classify prion diseases into Creutzfeldt-Jakob disease (CJD) type or
      Gerstmann-Straussler syndrome (GSS) type, based on the distribution of PrP in the
      central nervous system. The variant PrP including codon 102, codon 105, codon
      129, codon 145 and insertional mutations belong to the GSS type, while the wild
      type PrP and the variants including codon 180, codon 200, codon 210, and codon
      232 mutations belong to the CJD type. The CJD type prion diseases showed a
      rapidly progressive dementia, myoclonus, and periodic synchronous discharges in
      the electroencephalogram, and showed diffuse gray matter PrP accumulations
      including the synaptic structures in the pathological findings. The GSS type
      prion diseases showed a long clinical course without myoclonus and periodic
      synchronous discharges, and the major PrP accumulation sites were extracellular
      PrP plaques. The distribution of PrP deposit in the central nervous system
      influences the clinical and pathological aspects of prion diseases.

PMID- 7774118
TI  - [Expansion of triplet repeat and neurodegenerative disorders].
AB  - Recent studies on human genetic analysis have revealed that there is hitherto
      unknown category of genomic abnormality in human genetic diseases; an abnormal
      expansion of trinucleotide repeat. For example, Huntington's disease is caused by
      the CAG expansion to more than 40 in IT15 gene Up to the present, we have 7
      disorders which are revealed to be apparently caused by the triple repeat
      expansion: fragile X syndrome (two types), myotonic dystrophy, Huntington's
      disease, spinocerebellar atrophy type 1, dentatorubropallidoluysian atrophy and
      bulbo-spinal muscular atrophy. In this symposium, I would like to show first a
      clear inverse relationship between a length of CAG repeat and the age at onset in
      each Huntington's disease patient in Japan. Next, we would like to review and
      discuss on 1) the possible role of normal trinucleotide repeat in human gene, 2)
      the mechanisms for expansion of triplet repeat and for instability of the repeat
      length, and 3) the actual mechanism for neuronal cell death related to the
      expansion of triplet repeat.

PMID- 7774119
TI  - [Molecular basis of heterogeneities of clinical presentation of dentatorubral
      pallidoluysian atrophy (DRPLA)].
AB  - Dentatorubral-pallidoluysian atrophy (DRPLA) is an autosomal dominant
      neurodegenerative disorder affecting primarily dentatorubral as well as
      pallidoluysian atrophy. From a view point of clinical genetics, DRPLA is
      characterized by prominent anticipation and considerable heterogeneities in its
      clinical manifestations. Given the fact that unstable CAG repeat expansion is the
      causative genes for Huntington disease and spinocerebellar ataxia 1, in which
      anticipation and parental bias of transmission of the severest form are present,
      we hypothesized that DRPLA might be caused by unstable expansion of a gene
      containing a CAG repeat. By screening published genes containing CAG repeats,
      were able to identify the gene for DRPLA located on the chromosome 12. All the
      DRPLA patients had expanded CAG repeats, and furthermore, there is a good
      correlation between the degree of CAG repeat expansions and the ages of onset.
      There are also good correlation in the ages of onset of each of the neurological
      of manifestations including myoclonus, choreoathetosis, epilepsy, dementia, and
      psychiatric symptoms. We concluded that the unstable expansion of the CAG repeat
      in the DRPLA gene is intimately involved in the pathogenesis of DRPLA.

PMID- 7774120
TI  - [CTG-repeat in myotonin protein kinase].
AB  - Myotonic dystrophy (DM) is one of the most common inherited neuromuscular
      diseases in adults with a global incidence of 1 in 20,000 individuals. DM is an
      autosomal dominant disorder characterized primarily by myotonia and progressive
      muscle weakness. DM has unique genetic feature of anticipation, that is,
      increasing disease severity from generation to generation. DM candidate gene
      encodes a protein kinase (myotonin protein kinase; MtPK) expressed ubiquitously,
      and nearly all cases of DM displayed expansion (about 100 to 1,000) of the CTG
      repeat in the 3'-untranslated region, whose repeating number is in proportion to
      the severity of the condition. The physiological functions, however, of MtPK and
      the triplet repeat expansion are not yet clear. Thus, to elucidate the molecular
      mechanism of DM and for therapy of DM at last, we started biochemical analysis of
      MtPK and molecular biological study of CTG repeat. First of all, we have cloned a
      full length cDNA for MtPK, which encodes 625 amino acid residues and contains 5
      repeats of CTG. Detailed structural analysis of MtPK and expression study of MtPK
      using the cDNA were performed, and physiological function of MtPK is discussed
      based on the results.

PMID- 7774121
TI  - [Intractable epilepsy--neurophysiological evaluation and indication for surgical
      treatment].
AB  - Medically intractable epilepsy, defined as the clinical attacks occurring at
      least once a month in spite of appropriate antiepileptic drug treatments, is one
      of the commonest disorders in the clinical neurology. Since surgical treatment of
      epilepsy is successful in selected patients, it is most important to delineate
      the epileptogenic focus and functions of adjacent cortical areas as precisely as
      possible. Recent advances in electrophysiology, magnetoencephalography, magnetic
      resonance imaging (MRI), functional imaging techniques such as positron emission
      tomography (PET) and single photon emission computed tomography (SPECT) have
      enabled us to elucidate the epileptogenic focus noninvasively without involving
      the conventional invasive EEG recording techniques. We evaluated 37 patients with
      intractable partial seizures by using prolonged video/EEG monitoring with
      sphenoidal or T1/T2 electrodes. MRI, ictal and interictal SPECT for blood flow
      measurement and interictal FDG-PET for glucose metabolism. Among 20 patients with
      intractable epilepsy who had a single ictal focus, PET, ictal SPECT and MRI
      findings were correlated with the ictal EEG finding with the concordance rate of
      100, 86 and 75%, respectively. If all of those findings were convergent upon a
      single focus, then the surgical treatment with intraoperative corticography is
      most likely effective without employing any invasive recording. If those findings
      were divergent, then the invasive evaluation will be indicated.

PMID- 7774122
TI  - [Basic and clinical approaches for surgical treatment of intractable epilepsies].
AB  - Recent reports demonstrated that patients with medically intractable epilepsy
      were benefited with surgical treatments. Even in pediatric patients, early
      surgery is effective not only in seizure control but also in verbal, intelligent
      and social outcomes. In the present study, basic and clinical approaches in the
      treatment of intractable epilepsies were studied. In chronic cat model of
      intractable temporal lobe epilepsy induced by a microinjection of kainic acid,
      temporal cortical excision with amygdala focus resection or focus and hippocampal
      resections were examined by means of microsurgical technics. The cats with
      amygdala focus resection demonstrated spontaneous hippocampal seizures while cats
      with focus and hippocampal resection did not show seizures in the long time
      course after the surgery. In a cat model of cortical focal seizures, multiple
      subpial transection(MST) was examined. The cortical seizures, induced by a
      microinjection of kainic acid into unilateral sensori-motor cortex, were
      suppressed immediately after the MST. Postoperative course was uneventful and
      seizure was not recurred. However, pathological study demonstrated subpial scar
      formation at the site of MST in the sensori-motor cortex. In 38 patients with
      medically intractable epilepsies, surgical treatments were performed in the
      Department of Neurosurgery. Asahikawa Medical College. The site of the
      epileptogenic lesion was studied with Video-EEG longterm monitorings, Neuro
      imagings with CT, MRI, interictal SPECT and/or ictal SPECT. At the surgery,
      intraoperative electrocorticograms(ECoGs) were monitored under light
      neuroleptanalgesia in order to localize epileptic focus. Seizure free rate with
      or without postoperative medication was 72%. Remarkable improvement was observed
      in 7 patients (18%), but, 4 patients (10%) did not show any improvement.

PMID- 7774123
TI  - [Physiological bases of involuntary movement].
AB  - Recent physiological, anatomical and neurobiological works on the basal ganglia
      give us clues for our understanding of the mechanisms of generation of
      involuntary movement. These are characteristic neuron circuit of the basal
      ganglia and signal content of the information transferred through the basal
      ganglia circuit. Efferent signals mediated by the striatal projection neurons are
      fed to either the internal segment (GPi) or external segment (GPe) of the globus
      pallidus or substantia nigra pars reticulata (SNr). Projection neurons of the
      striatum, GPe, Gapital and SNr are all inhibitory in their action, while those of
      the subthalamic nucleus (STN) are excitatory. Therefore, projection from the
      striatum to the GPi or SNr (direct path), output nucleus of the basal ganglia,
      would produce facilitatory effects on the target of the basal ganglia output
      through disinhibition. On the other hand, projections of striatum-GPe-STN-GPi
      pathway (indirect path) would produce active inhibition of the target. GPi
      activity of monkey rendered Parkinsonism by MPTP is abnormally high and activity
      of GPe is lower than that before MPTP application, while the GPi activity of STN
      lesioned monkey showing limb dyskinesia (hemiballismus) is much lower than normal
      animal. These observations suggest it is essential to maintain adequate level of
      basal ganglia inhibitory output for proper muscle tone and stable performance of
      movement. Indirect pathway and STN system may play an essential role in the
      stabilization of output level of basal ganglia.

PMID- 7774124
TI  - [Involuntary movements mechanism by reference to stereotactic surgery].

PMID- 7774125
TI  - [Cervical myelopathy from an aspect of a neurological surgeon].
AB  - More than 65 per cent of intramedurally tumors and intradural extramedurally
      tumors were located in cervical region. They enact a cause of cervical
      myelopathy. A special attention should be paid to solitaly intramedurally
      vascular malformations, when the patients show an acute progressive myelopathy.
      In very rare cases of syringomyelia, intramedurally tumors such as
      hemangioblastoma or ependymoma could be found, so that enhanced MRI or
      angiography should be done if necessary. In cases of a herniated disc, cervical
      spondylosis and OPLL, the distance between articulo-pillar line and spinolaminal
      line must be measured. If the distance of both lines is near or the same, that
      means narrow cervical canal. In rare cases the form of the vertebral body is
      round. This is a rare cause of a type of narrow canal.

PMID- 7774126
TI  - [Visual information processing in humans].
AB  - Recent advances in parallel information processing of primates and humans have
      been reviewed. First, I review what is known about physiology and anatomy of the
      primate visual pathways. Several lines of evidence suggest that the primate
      visual system consists of the parvocellular (P) and the magnocellular (M)
      pathways. M-system originates from the A retinal ganglion cells that project to
      the visual cortex (V1) via the magnocellular layers of the lateral geniculate
      nucleus (LGN). This system plays an important role for motion and stereopsis. P
      system derives from the B retinal ganglion cells that project to V1 via the
      parvocellular layers of the LGN. This system shows selectivity for color vision
      and form perception. Second, I focus on the information processing of the human
      visual pathways. Psychophysical evidence suggests that there are also P and M
      systems in humans. However, there have been few electrophysiological studies
      which intend to separate the responses specific to P and M systems in human
      visual evoked potentials (VEPs). Based on the physiological distinctions between
      P and M systems, the use of isoluminant color patterns and apparent motion
      display allows us to evaluate P and M systems, respectively.

PMID- 7774127
TI  - [Magnetoencephalography (MEG) and functional brain mapping].

PMID- 7774128
TI  - [Evoked potentials].
AB  - Recent advances of evoked potentials, mainly pain-related somatosensory evoked
      potentials following CO2 laser stimulation (pain SEPs), were summarized. A small
      negative and a large positive potential, the N240-P340 and the N300-P400
      following the hand and the foot stimulation, were identified in normal subjects.
      Conduction velocity of the A delta fibers and the spinothalamic tract was
      approximately 10 m/sec. Pain SEPs were significantly decreased in amplitude and
      the marked pain relief was induced by vibration applied to the area where laser
      stimulation was applied. This finding was compatible with the gate control
      theory. Active and passive movements of the limbs remote from and adjacent to the
      stimulated area significantly decreased pain SEPs in amplitude. This indicated
      the particular interactions between pain perception and movement-related cortical
      activities taken place in some areas of the brain. The theory, diffuse noxious
      inhibitory controls (DNIC) proposed by Le Bars et al., was also confirmed by pain
      SEPs. Pain SEPs were useful in clinical testing. Pain SEP findings showed a
      significant correlation with the clinical impairment of pain sensation, and the
      subclinical lesions of the ascending pathways of the painful sensation were
      detected by pain SEPs.

PMID- 7774129
TI  - [Transcranial magnetic stimulation].
AB  - The technique of transcranial magnetic stimulation of the motor cortex is a new
      neurophysiological examination of the central motor pathways. In clinical
      application a reduced MEP/M wave amplitude ratio had a higher correlation with
      hyperreflexia than did a delayed MEP onset latency. The inhibitory period (IP)
      which is a transient suppression of muscle action potentials following motor
      evoked potentials (MEP) by magnetic cortical stimulation is caused primarily by
      inhibitory process in the motor cortex, because the duration of IP did not depend
      on the amplitude of MEPs, MEP distribution over the motor cortex or severity of
      voluntary contraction. Furthermore, the IP was shorter and the amplitude of MEP
      was increased when ipsilateral motor cortex stimulation to the thenar muscle
      preceded the contralateral cortex stimulation. C response in a patient with
      familial essential myoclonus was significantly suppressed by the magnetic
      stimulation of the sensory cortex locally and during the IP. The uncrossed
      pyramidal tract was proved by motor cortex stimulation in a patient with
      hemorrhage in the right thalamus and internal capsule who showed a right
      hemiparesis. The enhancement of cortical SEP amplitudes (P23 and N30) were noted
      when the median nerve was stimulated at 50 msec following magnetic stimulation
      over the sensory cortex locally. SEPs by twin coil stimulation at thoracic and
      lumbar root levels are useful in detecting the lesions of spinal cord or roots.
      Sympathetic skin responses and sudomotor potentials are recorded easily by the
      neck magnetic stimulation, and are useful method for evaluating sympathetic nerve
      function.

PMID- 7774130
TI  - [The nervous system involvement in human retroviral infection].
AB  - Human T-lymphotropic virus type I (HTLV-I) is a pathogenic retrovirus associated
      with a chronic progressive myelopathy, termed HTLV-I-associated myelopathy (HAM).
      A chronic inflammatory process has been implicated in HAM by a pathological
      study, but the exact mechanism still remains to be elucidated. Our quantitative
      polymerase chain reaction study indicated that the large increase in the HLTV-I
      proviral DNA in peripheral blood is associated with the development of HAM. The
      nucleotide sequence analysis of HTLV-I in central nervous system (CNS) tissue of
      HAM patients revealed that the sequences of HTLV-I genome were heterogenous in
      all cases, and that the pX-defective mutants were found frequently in the CNS.
      Thus, HTLV-I exists as quasispecies in vivo, as shown in the case of human
      immunodeficiency virus. It is possible that the HTLV-I pX microvariants
      contribute to the neural damage, since the pX gene products are essential for the
      transactivation of various cellular genes as well as for viral replication.

PMID- 7774131
TI  - [Free radicals and neural cell damage].
AB  - Free radicals are species containing unpaired electron, such as superoxide,
      hydroxyl radical and nitric oxide. The non-radical hydrogen peroxide is easily
      converted to the free radical during metabolism. These free radicals and hydrogen
      peroxide are constantly generated in the human and animal bodies and removed by
      antioxidant defences. Excessive production of free radicals can result in tissue
      damage, which mainly involves generation of hydroxyl radical and other oxidants
      in the presence of iron. The brain tissue contains large amount of unsaturated
      fatty acids and catecholamines, which are thought to be target molecules for free
      radical-induced peroxidation and neural cell damage, and such free radical
      induced cell damage appears to play a major role in the pathogenesis of many
      neurological diseases.

PMID- 7774132
TI  - [Superoxide formation and lipid peroxidation by the mitochondrial electron
      transfer chain].
AB  - Isolated mitochondria supplemented with succinate or NAD(+)-linked substrates
      generate hydrogen peroxide (H2O2) in State 4 and the generation is enhanced by
      antimycin A, an inhibitor of the respiratory chain. Superoxide is a
      stoichiometric precursor of mitochondrial H2O2 because the ratio of O2-/H2O2
      generation rates is close to 2.0 and is generated by an autoxidizable component
      in the NADH dehydrogenase and the ubiquinone-cytochrome b site. Lipid
      peroxidation is a free radical-mediated degradation of polyunsaturated fatty
      acids. Lipid-peroxidation reactions by bovine submitochondrial particles are
      supported by NADH or NADPH in the presence of ADP-Fe3+ chelate. Electrons from
      NADH are supplied to the reactions from a component between the substrate site
      and the rotenone-sensitive site of the NADH dehydrogenase. The peroxidation is
      dependent on the rate of electron input into the respiratory chain and on the
      concentration of reduced ubiquinone. Alteration of inner-membrane components and
      damage to electron-transfer activities of submitochondrial particles are induced
      by lipid peroxidation. 1-Melhyl-4-phenylpyridinium (MPP+), a metabolite of a
      parkinsonism-inducing drug, induces NADH-dependent superoxide formation and
      enhances NADH-dependent lipid peroxidation in submitochondrial particles,
      indicating that the oxidative stress induced by MPP+ may potentiate its toxicity
      in dopamine neurons.

PMID- 7774133
TI  - [Electrodiagnosis of neuromuscular diseases--a syndrome of monomelic amyotrophy
      with spinal hemiatrophy, anti-GM1 antibodies and abnormal F-waves (MASH)].
AB  - Electrodiagnosis rests upon sound anatomical and physiological bases of the
      peripheral nervous system, which are utilized for the dynamic process of
      differential diagnosis. If clinical and electrophysiological findings do not
      conform to any of the previously known diseases, there may be a chance of
      identifying a new entity. As an example, we report nine Japanese patients with
      unilateral atrophy of the distal upper limb and the cervical cord. Symptoms
      typically began insideously in young adulthood, progressed for a few years and
      then stabilized. Distribution of the muscle weakness usually corresponded to the
      territories of a few peripheral nerves, although not accompanied by sensory
      deficits. Serum anti-GM1 IgG antibodies were elevated in 6 out of 9 patients.
      Electrophysiological testings disclosed absent or delayed F-waves in the nerve
      involved. No long tract signs of the cord were demonstrated, although the spinal
      cord atrophy was extensive in some patients. Three showed partial clinical
      improvement after cyclophosphamide therapy or intravenous immunoglobulin. These
      findings may suggest that this entity is immune-mediated as in multifocal motor
      neuropathy, with its blunt of immune attack directed not only to peripheral motor
      nerves but also to spinal motor neurons.

PMID- 7774134
TI  - [Radiological imaging of the central nervous system].
AB  - The radiological evaluation of central nervous system has been dramatically
      altered by the advent of MR imaging. MR imaging is a versatile modality that has
      been applied in almost all kinds of disorders in the brain, spinal cord and the
      surrounding structures. However, there are some limitations, such as low
      detectability of subarachnoid hemorrhage or calcifications, difficulty in
      visualization of bony details, and various kinds of artifacts. On the other hand,
      there have also been considerable technical advances in other imaging modalities,
      such as spiral CT, doppler US, etc. With the continuous advance in each imaging
      modality, their roles and the strategy in the diagnosis of disorders in central
      nervous system will be changed. In this review, the present status and current
      roles of various imaging modalities, such as plain X-ray, CT, MR imaging, nuclear
      medicine, ultrasound, angiography and myelography, are discussed.

PMID- 7774135
TI  - [Muscle pathologic diagnosis--mechanism in muscle fiber degeneration].
AB  - In various neuromuscular diseases, the most significant muscle degeneration is
      muscle fiber necrosis as seen in Duchenne muscular dystrophy (DMD). A certain
      membrane instability is probably responsible for muscle fiber necrosis, because
      defects in membrane proteins have been proposed to associate with progressive
      muscular dystrophies including dystrophin in DMD, a 50 KD subunit of dystrophin
      associated glycoprotein (DAG) in severe childhood autosomal recessive muscular
      dystrophy (SCARMD), and subunit M of laminin (merosin) in congenital muscular
      dystrophy and dy mouse. The vulnerable muscle surface membrane may permit
      extracellular calcium influx into the sarcoplasm resulting in focal myofibrillar
      hypercontraction (opaque fiber) and activation of proteases such as calpain and
      cathepsins. The muscle fiber then undergoes necrosis and allows macrophage
      invasion, followed by muscle fiber regeneration. Focal myofibrillar degeneration
      involving rimmed vacuole (RV) formation is an another striking muscle fiber
      degeneration seen in various neuromuscular diseases including inclusion body
      myositis (IBM) and distal myopathy with rimmed vacuole formation (DMRV). Abnormal
      accumulation of ubiquitin, beta-amyloid protein precursor and tau protein has
      been described in IBM by Askanas et al. The similar findings are also
      recognizable in DMRV and in an experimentally induced myopathy after long-term
      chloroquin administration to rat. Therefore, if we clarify the pathomechanism of
      degenerative process involved in the rimmed vacuole formation, the results may
      provide some insights into the understanding the process involved in amyloid
      plaque formation in Alzheimer's disease.

PMID- 7774136
TI  - [Diagnostic neuropathology supported by immunohistochemistry].
AB  - There are various histological components in the central nervous system. When
      making a neuropathological diagnosis, it is difficult to identify each component.
      Recently, with the adoption of immunohistochemistry in diagnostic neuropathology,
      the identification of each component has become relatively easy.
      Immunohistochemistry is a useful method for staining objective tissues or cells
      employing the antigen-antibody reaction. Its specificity is very high. In the
      field of diagnostic neuropathology, immunohistochemical techniques have developed
      in the diagnosis of brain tumors. With the aid of immunohistochemistry, various
      findings have been obtained. At the present time, however, the number of
      available antibodies is rather restricted. As a result, accurate differentiation
      of microglia and brain macrophage is difficult, and the origin and definition of
      microglia and brain macrophages are controversial. In the near future, with
      further progress in immunohistochemical techniques, the number of antibodies will
      rapidly increase and their sensitivity should improve. When this is achieved, it
      will be possible to elucidate the pathophysiology of the central nervous system
      morphologically.

PMID- 7774137
TI  - Impact on empiric treatment of group A streptococcal pharyngitis using an optical
      immunoassay.
AB  - The potential impact of using a rapid diagnostic test (Strep A OIA) on detection
      and treatment of group A beta-hemolytic streptococcal (GABHS) pharyngitis in a
      large-volume pediatric and adolescent clinic was examined. Of 519 swabs processed
      for both culture and the OIA test, 114 were culture-positive for GABHS compared
      with 133 positive by the OIA test, for an agreement of 94%. OIA test sensitivity
      compared with culture was 96%, and specificity was 94%. Forty-seven percent of
      all study patients were empirically placed on antibiotics. In-clinic OIA testing
      could have reduced inappropriate therapy and been a cost-effective alternative to
      culture.

PMID- 7774138
TI  - Risk of lead poisoning in abused and neglected children.
AB  - This study examined the prevalence of lead poisoning in 746 abused and neglected
      children taken into protective custody by Cook County, Illinois, Child Protective
      Services, Department of Children and Family Services (DCFS). Most of these
      children had a history of neglect (62%) or dependency (23%); they were
      predominantly African-American (88%). Venous blood lead concentrations (PbB) were
      obtained on 589 children, ages 6 months to 6 years, between January 1, 1992, and
      December 31, 1992. Three hundred eighty-one (64.7%) children tested had a PbB >
      or = 10 micrograms/dL (0.48 mumol/L); the mean PbB was 12.23 micrograms/dL (0.587
      mumol/L). These data support a recommendation for lead screening in any child
      with a history of abuse or neglect if environmental risk factors cannot be
      assessed.

PMID- 7774139
TI  - Identification of sepsis in neonates following maternal antibiotic therapy.
AB  - To examine the value of current diagnostic tests identifying neonatal sepsis
      related to intrapartum treatment with antibiotics, we reviewed the charts of 219
      mother-infant pairs, of which 139 mothers received intrapartum antibiotics (group
      1) and 80 mothers did not (group 2). When compared with group 2 infants, group 1
      infants had fewer positive blood cultures (4.3% vs 20%, P < 0.003), blood
      cultures positive for group B streptococci (GBS) (P < 0.001), and positive urine
      GBS latex agglutination (LA) tests (P < 0.001). Although the sensitivity of the
      white blood cell count (WBC) was 81%, the specificity was < 60% in both groups.
      The specificity of the urine GBS LA test was 92%. These results suggest (1) the
      WBC will neither confirm nor rule out neonatal septicemia; (2) blood cultures are
      indicated in suspected neonatal sepsis even if there was maternal intrapartum
      treatment with antibiotics; and (3) a urine GBS LA test is a useful adjunct in
      the diagnosis of neonatal GBS septicemia.

PMID- 7774140
TI  - Failure to clinically predict NICU hearing loss.
AB  - Neonatal intensive care unit (NICU) survivors demonstrate handicapping
      sensorineural hearing loss up to 50 times more frequently than normal newborns,
      yet little is known about the etiology of the hearing loss. Theoretically,
      accurate identification and triage of a particular infant based on a clinical
      profile would be useful. Forty NICU graduates of The Massachusetts General
      Hospital were selected for a detailed retrospective chart review evaluating
      prenatal, perinatal, and NICU medical conditions and treatment. Twenty-three
      patients identified with hearing loss and 17 infants with normal hearing were
      compared clinically. Univariate and multivariate analysis was performed on a
      subpopulation of patients (20 with hearing loss and 16 with normal hearing). A
      history of ventilation was associated with hearing loss (P = .0023), but this
      factor was not absolute. No other clinical parameters were convincingly linked to
      hearing loss. We conclude that reliance on risk factors is an inadequate clinical
      method to select a patient for a hearing test and that each NICU survivor
      deserves audiometric evaluation.

PMID- 7774141
TI  - Moraxella (Branhamella) catarrhalis bacteremia in children. A report of two
      patients and review of the literature.
AB  - We report two cases of Moraxella catarrhalis (M. catarrhalis) bacteremia in
      apparently healthy children. One patient had bilateral otitis media and the other
      had pharyngitis and sinusitis; both patients had uncomplicated clinical courses.
      A literature review revealed 22 reported cases of M. catarrhalis bacteremia in
      children, 14 (63%) of which occurred in patients who had no identified underlying
      condition. Eight (36%) cases were seen in children who were immunocompromised.
      Nine (40%) patients presented with either purpura, petechia, or a maculopapular
      rash. M. catarrhalis is well known as a respiratory pathogen, but it has not been
      recognized as a common cause of unsuspected bacteremia in children.

PMID- 7774142
TI  - A subtle sign of spinal cord lipoma.

PMID- 7774143
TI  - Esophagitis as a cause of infant colic.

PMID- 7774144
TI  - Self-induced pneumoparotitis.

PMID- 7774145
TI  - Reversal of anorexia in a child with partial ornithine transcarbamylase
      deficiency by cyproheptadine therapy.

PMID- 7774146
TI  - Congenitally acquired chloroquine-resistant P. falciparum malaria in an infant
      born in the United States.

PMID- 7774147
TI  - A common factor for cardiac or respiratory failure in SIDS.

PMID- 7774148
TI  - Staphylococcus-induced toxic shock following balanitis.

PMID- 7774149
TI  - Perinatal intracranial hemorrhage due to maternal salicylate ingestion.

PMID- 7774150
TI  - Is treatment of AOM with once-a-day amoxicillin feasible?

PMID- 7774151
TI  - Intussusception following ingestion of broken glass.

PMID- 7774152
TI  - [Health and disease in the 18th century. Communications presented at the meeting
      of the Swiss Society of the study of the 18th century. Berne, 1-2 October 1993].

PMID- 7774153
TI  - [A Swiss medical periodical in the service of enlightenment: Johann Heinrich
      Rahn's Gazette de Sante].

PMID- 7774154
TI  - [Health in Diderot's Encyclopedia].

PMID- 7774155
TI  - [Illness as metaphor. New thoughts on an old dispute: Julien Offray de la Mettrie
      and Albrecht von Haller].

PMID- 7774157
TI  - [Dissemination of medical knowledge in Europe during the 18th century].

PMID- 7774156
TI  - [National pride and private health].

PMID- 7774158
TI  - [Arbitrary limit of the judge in evaluating a crime: forensic medicine in Geneva
      in the 18th century].

PMID- 7774159
TI  - [Isaak Iselin's medical history].

PMID- 7774160
TI  - [Johann Kaspar Lavater's physico-theological viewpoint of animal magnetism].

PMID- 7774161
TI  - ["Malgre vos defauts je vous aime a la rage". On Johannes von Muller's homoerotic
      preferences].

PMID- 7774162
TI  - [From Ulrich Braker's home pharmacy].

PMID- 7774164
TI  - [Death of the king and female disorders: the chief valet of the chamber of Louis
      XV consults Tissot about his young woman (May 1776)].

PMID- 7774163
TI  - ["Every pain is a reminder of our high rank." From the medical record of the
      young artist Ida Brun].

PMID- 7774165
TI  - ["Cette faiblesse originelle de nos nerfs". Intellectuality and the feminine
      constitution--Julia Bondeli's medical reports].

PMID- 7774166
TI  - [Ideals of health].

PMID- 7774167
TI  - [Health and illness: tools for satire by Jonathan Swift].

PMID- 7774168
TI  - [Medicine and essayistics. Typical poetologic reflections exemplified by the
      periodical Der Arzt].

PMID- 7774169
TI  - ["Der Pobel aber bleibt versaumt"--the calendar as a popular vehicle for public
      health education].

PMID- 7774170
TI  - Individualizing recall intervals in child dental care.
AB  - Individualizing and extending recall intervals for children have been recommended
      in Norway to target resources efficiently. Recall intervals were changed for
      children aged 3-18 years in Drammen from 1991. Clinical time spent by dentists
      and dental hygienists, dental health status and length of recall intervals were
      registered from 1990 to 1993. For the child population, the mean recall interval
      changed from 12.5 to 13.7 months and the annual time spent per child was reduced
      by 14% from 1990-91 to 1992-93. Adjusted for the decline in number of new decayed
      teeth, the reduction in time spent was 11%. Children with intervals of 17 to 20
      months had fewer new decayed teeth and their care required less personnel time
      than other children. For children with new decayed teeth, time spent for dental
      care was not associated with recall interval, while for children without new
      decayed teeth, longer recall intervals were associated with shorter time for
      dental care. The variation in number of decayed teeth and time spent for dental
      care was substantial at all intervals. Individualizing and extending recall
      intervals to some extent targeted resources at children with more dental disease.
      However, in the short run, inequality in dental health persisted. Limited
      extension of recall intervals did not interrupt the long-term trend toward better
      dental health in the children and substantial resources were saved in the dental
      services.

PMID- 7774171
TI  - Dentists' attitudes toward frustrating patient visits: relationship to
      satisfaction and malpractice complaints.
AB  - A 22-item questionnaire measuring physician frustration in communicating with
      patients was adapted to dentists, and its reliability and validity assessed, in a
      sample of 289 English dental surgeons in general practice in Greater Manchester.
      Subscales were derived assessing the concepts of unpleasant dentist feelings,
      lack of communication, patient non-compliance, patient control, and practice
      organization with Cronbach's alpha ranging from 0.59 to 0.77. Three of five
      subscale scores (unpleasant feelings, lack of communication, and practice
      organization) were significantly greater for dentists who had official
      malpractice complaints to insurers. Similarly, all five subscores were greater
      for dentists who reported larger numbers of unsatisfactory visits and expressed
      greater dissatisfaction with dental practice.

PMID- 7774172
TI  - Effects of lifelong consumption of fluoridated water or use of fluoride
      supplements on dental caries prevalence.
AB  - This study was undertaken to determine the prevalence of dental caries in
      children ages 6-14, from fluoridated and non-fluoridated areas in British
      Columbia, Canada, and the effects of receiving certain fluoride preventive
      procedures during childhood. Children from two communities were surveyed using a
      modified Decayed, Missing and Filled Tooth Surface Index (D1D2MFS).
      Questionnaires on the use of various fluoride preventive practices and residence
      histories during childhood were collected. Completed questionnaires were returned
      and exams were performed on 1131 children. Crude caries prevalence scores for the
      different fluoride exposure groups were tested for differences in dental age and
      the level of educational attainment of parents and/or guardians. No significant
      group differences were found. The 110 children with lifelong exposure only to
      fluoridated water had 35%, or 0.88 (S.D. = 2.91), fewer decayed or filled tooth
      surfaces per child (P < 0.07) than children with no reported exposure to systemic
      fluorides. For the 122 children who had taken fluoride supplements for 4 yr or
      more, 0.67 fewer decayed and filled tooth surfaces (26% reduction) were observed
      per child when compared to children with no exposure to fluoridated water or
      supplements. For children who used fluoride supplements for less than 4 yr, no
      significant benefits were observed. Approximately 75% of the caries prevalence
      for control and fluoride-exposed groups was on pit and fissured surfaces.
      Reductions by surface type showed savings on both smooth and pit and fissured
      surfaces.

PMID- 7774173
TI  - Effects of glass ionomer cement, resin-based pit and fissure sealant and HF
      applications on occlusal caries in a developing country field trial.
AB  - The aim of this community-oriented study was to evaluate different methods to
      prevent fissure caries. The following products and measures were tested: 1) glass
      ionomer cement (GIC) applied by dentist; 2) same material applied by short term
      (3 days) trained personnel (teachers); 3) application of a 0.5% HF solution three
      times; 4) an established autopolymerized resin based sealant (Delton). The study
      was performed in Bangkok, Thailand, a city in a developing country experiencing
      increasing caries prevalence. Children with at least three sound permanent molars
      from two age groups, 7-8 and 12-13-yr-olds respectively were chosen from very low
      to medium socioeconomic level families. 1264 children were systematically
      assigned to experiment or control groups based on school and DMFT. For the
      younger age group, the 2 yr mean DFS occlusal increment in the Control group was
      0.66 surfaces. Significantly lower increments were observed in the GIC
      experimental group: 0.17 surfaces applied by the teachers and 0.32 applied by
      dentist, corresponding to 74% and 52% reductions, respectively. The mean
      increment in the HF group was 0.44 surfaces, a 33% reduction in relation to the
      Control group. For the 12-13-yr-olds, the mean occlusal surface DF increment was
      0.70 surfaces in the Control group. Almost no occlusal increment was found in the
      Delton group, 0.05 DFS, a 93% reduction. In the GIC Dentist group, the DFS
      increment was 0.48 and in the Teacher group 0.56, corresponding to 31% and 20%
      reduction, respectively. A slight and nonsignificant increase of caries in
      relation to the Control group was observed in the HF group.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7774175
TI  - Pilot study comparing parents' and third-grade schoolchildren's attitudes toward
      braces and perceived need for braces.
AB  - An instrument developed for third-grade schoolchildren and their parents was
      pilot-tested for its ability to measure orthodontic attitudes and perception of
      the child's need for braces. Seventy-eight children and 54 parents were surveyed.
      Forty-six percent of the children wanted braces while 61% believed that they
      needed braces. Correlation between desire for braces and perceived need was 0.47,
      suggesting that desire and perceived need were only moderately correlated in
      children. Sixty-three percent of the parents believed that their child needed
      braces. Despite such proportions of children and parents perceiving a need for
      treatment, three-fourths of the children and two-thirds of the parents were
      satisfied with the appearance of the child's teeth. Attitude subscales, derived
      from the attitude survey, and clinical orthodontic parameters were used to model
      children's and parents' perceived need for braces in the child. No clinical
      parameter was a significant correlate in either children's or parents' model of
      perceived need. Neither race nor gender contributed significantly to either
      model. The subscales Concern for Appearance and Social Aspects of Braces were the
      strongest covariates of children's perceived need for braces. Concern for
      Appearance was the most important correlate in the parents' model. These data
      suggest that parents' perceived need for orthodontic treatment for their third
      grade children is determined primarily by a concern for appearance rather than
      clinical status. In third-graders, perceived aesthetics and social aspects
      apparently have more influence than clinical status in creating a perception of
      need for braces.

PMID- 7774174
TI  - Evaluation after 4 years of the combined use of fluoride and dental sealants.
AB  - This study evaluates the caries-preventive potential in permanent teeth of dental
      sealants when combined with an ongoing, school-based fluoride program. The
      investigation was designed as a sequential, cross-sectional comparison. Dental
      caries findings in 1987 for 416 children ages 7-11 and 14-17 who received dental
      sealants and fluorides were compared with corresponding data derived from 1983
      baseline examinations of children who received fluoride therapy only. In
      addition, sealant retention status was determined. Overall mean DMFS scores in
      1987 for children in two age groups combined were 51% lower than in 1983. Also, a
      surface-specific treatment effect was demonstrated in pit and fissures for both
      older and younger age groups. The overall proportion of sealants retained on
      occlusal surfaces of first molars after an average of 2 yr (92%) compared
      favorably with similar figures cited in the scientific literature. The results of
      this study suggest that pit and fissure sealants confer additional caries
      preventive benefits beyond those of fluoride therapy alone.

PMID- 7774176
TI  - Oral health in Danish hospitalized psychiatric patients.
AB  - The purpose of the present study was to describe oral health status in a group of
      hospitalized mental patients, and to study the association between dental caries
      and mental illness. A total of 278 psychiatric patients admitted to a regional
      Danish hospital were described with respect to the number of teeth present, DMFS,
      gingival and periodontal status and presence of removable dentures. The oral
      health status of the hospitalized mental patients was relatively poor compared
      with the general population of the area. For instance, actual decayed surfaces
      were found among 55% of the participants compared to the reference figure of 23%
      in the general population. A multiple regression analysis demonstrated that DMFS
      was related to duration of mental illness and to psychiatric diagnosis.
      Furthermore, a multiple logistic regression analysis revealed that the presence
      of actual decayed surfaces was associated with neglect of toothbrushing,
      subjective symptoms of xerostomia and participation in the hospital dental
      program. To conclude, variables of mental illness and psychiatric treatment and
      care were demonstrated to influence oral health. This underlines the need of
      special preventive programs aimed at hospitalized psychiatric patients.

PMID- 7774178
TI  - Preventive Care Advised (PCA)/Operative Care Advised (OCA)--categorising caries
      by the management option.
AB  - Currently a range of systems and classifications are used by clinicians,
      epidemiologists and clinical research workers to sub-divide carious lesions into
      different grades. These systems are based on the depth of the lesion and/or the
      presence/absence of macroscopic cavitation. In order to improve upon the
      meaningfulness and comparability of such systems in the light of increasing
      knowledge about the disease process, lesion behaviour and caries management
      options, the authors propose a new system of categorisation that differentiates
      between lesions which normally require operative intervention and those which do
      not. In future, it is proposed that in addition to existing conventional
      criteria, diagnostic systems should also allow results to be expressed in terms
      of 1) lesions for which appropriate non-invasive Preventive Care Is Advised (PCA
      lesions) and 2) lesions for which Operative Care Is Advised (OCA lesions).
      Locally acceptable sub-divisions may have to be developed and agreed for certain
      specific applications. The adoption of this additional nomenclature and approach
      in the future should aid communications between the different groups involved in
      caries diagnosis and research. It may facilitate the dissemination of research
      findings, as well as helping to "drive" researchers working on caries diagnostic
      methods to focus on techniques which will aid in the accurate assessment of
      lesion activity and behaviour. Such a focus should also increase our
      understanding of treatment decision making and promote the development of
      clinical guidelines. The facility to retain existing criteria in parallel, for
      local and other purposes, would preserve comparability with data collected
      previously.

PMID- 7774177
TI  - Prevalence study of oral mucosal lesions in a selected Cambodian population.
AB  - The aim of this study was to investigate the epidemiology of oral mucosal lesions
      in a selected Cambodian population to obtain pilot data useful in planning an
      oral health data base for the country. Due to unstable conditions in Cambodia,
      the validity of population data related to present census information is highly
      questionable. Therefore, prior to this investigation a census registration was
      carried out using local health workers as registrars in nine villages of a
      commune. In the period July 4-31, 1991, a total of 1319 individuals (953 women,
      366 men, 15-99 yr) were examined by one oral surgeon in the nine villages of Kok
      Trop Commune, Kandal Stung District, southwest of the capital Phnom Penh.
      Clinical diagnoses were based on WHO criteria. Information on smoking habits,
      betel nut chewing habits, and alcohol use was collected by 4 Khmer dental
      personnel. In total, 71 lesions were recorded in 64 (4.9%) individuals.
      Leukoplakia was found in 1.1%, lichen lesions in 1.8%, candidosis in 1.4%,
      submucous fibrosis in 0.2%, cancer in 0.1% and other diagnoses in 0.8%. The
      prevalence of leukoplakia was 2.2% and 0.6% among men and women respectively, a
      statistically significant difference (P < 0.05). There were significantly more
      smokers (P < 0.01) among subjects with leukoplakia (64.3%) than among those
      without this lesion (28.6%). All subjects with lichen lesions were women. The age
      adjusted relative risk for developing lichen among betel nut chewers as compared
      to non-chewers was 3.3.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7774179
TI  - Caries experience in urban and rural Chilean 3-year-olds.

PMID- 7774180
TI  - Need for orthodontic treatment in Northern Ireland.

PMID- 7774181
TI  - Recall intervals, dental hygienists and quality in child dental care.
AB  - Decline in dental disease and the need to provide dental care efficiently suggest
      changes in clinical and administrative routines in public dental care provision
      for children. A field project in Norway demonstrated productivity gains after the
      introduction of individualized recall intervals and using dental hygienists to
      conduct recall examinations. The purpose of the present study was to assess
      changes in the quality of dental health outcome and changes in the quality of the
      process of dental care provision. Recall intervals were increased from a target
      of 12 months to 16 and 18 months in two districts. Dental hygienists undertook
      all recall examinations and referred to dentists those patients who required
      operative care. Bitewing radiographs were inspected for all 18-yr-olds who were
      examined in 1989, 1990 and 1991 (n = 956) and for those who were examined before
      the changes were implemented in 1987 (n = 300). For each child, approximal caries
      on 24 surfaces was scored according to a 4-point severity scale. Clinical records
      were examined to determine what treatment had been provided. For each year after
      the changes were implemented, the quality of health outcome was assessed by
      comparing the radiographic caries prevalence and the number of sound surfaces
      with 1987 data. Quality in the process of care provision was indicated by the
      treatment decisions for approximal caries and by the proportion of
      uninterpretable surfaces on radiographs for each study year. The mean number of
      sound surfaces increased over time. A declining proportion of sound surfaces was
      restored over the study period, and almost all caries lesions extending deep into
      dentine were restored. Radiographic quality improved during the project
      period.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7774182
TI  - A critical commentary and updating of the guinea pig maximization test.
AB  - The guinea pig maximization test (GPMT) of Magnusson and Kligman was published in
      1969. Since then, a vast body of practical experience with the test has been
      accumulated. New information requires that certain aspects of the procedure be re
      evaluated, especially with regard to the interpretation of challenge results. In
      particular, awareness of the phenomenon of hyperirritable skin (the 'angry back'
      phenomenon) suggests that presently used controls are not always adequate and may
      overstate allergenicity owing to false-positive reactions. The control group
      should be exposed to a chemical insult at induction which provokes an
      inflammatory reaction comparable to the test substance. We present strategies to
      distinguish irritant from allergic responses. Allergic reactions should persist
      on rechallenge weeks later, while nonspecific irritant reactions generally fade
      and are irreproducible in particular animals. Finally, when a chemical is
      identified as a contact sensitizer in the GPMT, that result is simply a
      categorical statement of a theoretical hazard. An assessment of risk is necessary
      to estimate the relevance of the test result to usage in the real world.

PMID- 7774183
TI  - Patch test results with serial dilutions of nickel sulfate (with and without
      detergent), palladium chloride, and nickel and palladium metal plates.
AB  - Clinical experience suggests the existence of different degrees of sensitivity in
      nickel-allergic patients. For quantification of this phenomenon, 462 consecutive
      patients with previously diagnosed or strongly suspected nickel allergy were
      tested with serial dilution patch tests with 5 ppm to 5% nickel sulfate in pet.
      (Ni), and 5 ppm to 1% nickel sulfate in pet. with 1% detergent (Ni/D).
      Additionally, nickel and palladium metal plates were tested in 103, and cobalt
      salts, dichromate and palladium chloride (PdCl2) in most patients. 332 patients
      reacted positively to Ni or Ni/D. The influence of a concomitantly administered
      detergent was not significant. A significant correlation was found between
      positive reactions to low concentrations of Ni (or Ni/D), i.e., 0.1% or less (N =
      166), and concomitant reactions to nickel metal plates, cobalt salts and PdCl2
      and a history of ear piercing with metal intolerance. The clinical relevance of
      reactions to PdCl2 is at present not clear. A subgroup of nickel-allergic
      patients with "high sensitivity" can be defined. In future studies further
      addressing the clinical relevance of high versus low sensitivity, patch testing
      with 0.01, 0.1, 1.0 and 5% nickel sulfate in pet. is recommended instead of
      routine tests with 5% only.

PMID- 7774184
TI  - Contact allergy to gold sodium thiosulfate.
AB  - 278 consecutive patients with suspected contact dermatitis were patch tested with
      the European standard series and gold sodium thiosulfate (0.5% pet.): 13 patients
      (4.6%) had a positive allergic response to gold sodium thiosulfate (GST). All of
      these patients were female, with a mean age of 37 years. The most frequent site
      of eczema in these patients was the head and neck (62%). A seborrhoeic
      distribution of eczema was common. 46% had involvement of the limbs, 15% had a
      perianal or perivulval rash. The mean duration of eczema in this group of
      patients was 15.8 months. 54% of patients allergic to gold were also allergic to
      nickel. Biopsy of positive patch test reactions to GST were consistent with
      allergic contact dermatitis.

PMID- 7774185
TI  - Ear piercing, and nickel and cobalt sensitization, in 520 young Swedish men doing
      compulsory military service.
AB  - Piercing the earlobes has increased in popularity among males in recent years.
      This habit would be expected to increase the incidence of nickel and cobalt
      sensitization. Patch testing with nickel sulfate and cobalt chloride was
      performed in 520 young Swedish men doing compulsory military service. The overall
      frequency of nickel/cobalt positive tests was 4.2%. The prevalence of
      nickel/cobalt positive tests was significantly higher (p < 0.05) in 152 men with
      pierced earlobes (7.9%) than in those 368 with unpierced earlobes (2.7%). A
      history of hand eczema (7/152 = 4.6%) or other types of eczema (22/152 = 14.5%)
      in individuals with pierced earlobes was no more common than in those with
      unpierced earlobes: 24/368 = 6.5% and 51/386 = 13.9%, respectively (n.s.). Hand
      eczema was no more common in sensitized (1/22 = 4.5%) than in nonsensitized
      individuals (32/498 = 6.4%) (n.s.).

PMID- 7774186
TI  - Hand eczema in Finnish farmers. A questionnaire-based clinical study.
AB  - In a population of 2005 Finnish farmers, 172 (8.6%) reported hand or forearm
      dermatoses in a self-administered questionnaire. 138 (80%) of them attended a
      clinical examination. Skin prick tests (SPTs) were done to 80% and patch tests
      (PTs) to 77% of the examined farmers. 93% of hand dermatoses were eczema and 70%
      were considered work-related. Cow allergy was found in 41 of 104 prick- and patch
      tested farmers (39%). Immediate allergy to cow epithelium was encountered in a
      total of 28/41, in 20 with SPTs, and in 8 only with 20 min PTs. Delayed contact
      allergy to cow dander was found in 27/41. The result suggests that in addition to
      SPTs using commercial cow epithelium extract, PTs using fresh cow dander should
      also be done, and both immediate and delayed responses should be read.

PMID- 7774188
TI  - Allergic contact dermatitis from the newly introduced fungicide fluazinam.
AB  - In spring 1992, several farmers in the western part of The Netherlands developed
      dermatitis on their hands, forearms and face. In some, the legs, trunk and
      genitals were also affected. Complaints ranged from a mildly itchy, papular rash
      to a painful, weeping and blistering dermatitis. Medical aid was needed by 5/9 of
      them. Some of the farmers grew seed potatoes, the others cultivated lilies. All
      of them had in common that their complaints emerged after repeated application of
      a new fungicide over several weeks. The fungicide was Shirlan, with fluazinam as
      its active ingredient. 9 farmers were patch tested with a concentration range of
      the whole formulation (aq.) and of the active ingredient (pet.). In 7 of 9
      farmers, positive patch tests were scored with both the whole formulation (down
      to 0.01% aq.) and fluazinam itself (down to 0.1% pet.). Patch tests in
      consecutive control patients (n = 10) were all negative. As it was impossible to
      substitute fluazinam as the active ingredient, farmers are now supplied with
      detailed information as to how to avoid skin contact as much as feasible.

PMID- 7774187
TI  - Occupational allergic contact dermatitis from ethyl cyanoacrylate.
AB  - Glues based on cyanoacrylates are widely used as contact adhesives for metal,
      glass, rubber, plastics and textiles, as well for biological materials, including
      binding tissues and sealing wounds in surgery. In this paper, an apprentice
      cobbler with an occupational allergic contact dermatitis from an ethyl
      cyanoacrylate glue, in which the major monomer was shown to be the sensitizer, is
      reported. Initial patch testing with the cyanoacrylate glue dissolved in acetone
      with the Finn Chamber (aluminium) technique yielded false-negative reactions.
      Positive test reactions were obtained with the same preparations using Van der
      Bend chambers. With petrolatum as vehicle for the glue, there was no difference
      between Finn Chamber technique and Van der Bend chamber technique. The role of
      aluminium in the false-negative reactions is discussed.

PMID- 7774189
TI  - Irritant effects of a detergent in wash and chamber tests.
AB  - Irritant properties of detergents can be tested by using patch and chamber tests
      and various kinds of use tests. The aim of the present study was to compare the
      results of use and 12 mm Finn Chamber tests. Study subjects (10 atopic and 11 non
      atopic medical students) washed the outer aspect of 1 upper arm with liquid
      detergent for 1 minute 2 x daily for 1 week. 48-h chamber test with 5
      concentrations of the same detergent in water were concurrently applied to upper
      back skin. Transepidermal water loss (TEWL), electrical capacitance and skin
      blood flow were measured to quantify reactions on days 0, 2, 5 and 7. Irritant
      contact dermatitis developed equally in atopics and non-atopics in the wash test,
      whereas in the chamber test with a 10% aq. solution of the detergent, increase in
      TEWL was significantly higher in atopics than in non-atopics. The chamber test
      results thus predicted poorly the result of the wash test. This might indicate
      that the wash test and the chamber test measure different aspects of skin barrier
      function.

PMID- 7774190
TI  - The influence of patch tests with clobetasol propionate on adjacent patch test
      reactions.
AB  - Contact allergy to corticosteroids now seems frequent among patients being patch
      tested. As corticosteroids are intrinsically anti-inflammatory, we investigated
      whether patch tests with a potent corticosteroid might suppress simultaneous
      adjacent patch test reactions to another allergen. Nickel-sensitive subjects were
      patch tested with an aqueous dilution series of nickel in duplicate, adjacent to
      patch tests with clobetasol propionate 1% in ethanol and with ethanol,
      respectively. Statistical evaluation of the results obtained in 2 different
      centers, using their own patch test techniques, did not reveal any suppression of
      the positive nickel patch test reactions.

PMID- 7774191
TI  - Occupational sensitivity to rubber.

PMID- 7774192
TI  - Allergic contact dermatitis from tolnaftate.

PMID- 7774193
TI  - Contact urticaria from cucumber pickle and strawberry.

PMID- 7774194
TI  - Allergic contact dermatitis from epsilon-caprolactam.

PMID- 7774195
TI  - Contact sensitivity to cyanoacrylate nail-adhesive with dermatitis at remote
      sites.

PMID- 7774197
TI  - Latex allergy among hairdressers.

PMID- 7774196
TI  - Photoallergy to oxybenzone in cosmetic creams.

PMID- 7774198
TI  - Allergic contact dermatitis from a wart remover solution.

PMID- 7774199
TI  - An unusual complication of patch testing.

PMID- 7774200
TI  - Allergy to epoxy compounds over a decade.

PMID- 7774201
TI  - Allergic contact dermatitis due to piketoprofen.

PMID- 7774202
TI  - In vitro release of interferon-gamma by peripheral blood mononuclear cells of a
      patient with carbamazepine-induced allergic drug eruption in response to
      stimulation with carbamazepine.

PMID- 7774203
TI  - Allergic contact dermatitis from Rhus toxicodendron in a phytotherapeutic
      preparation.

PMID- 7774204
TI  - Contact dermatitis from tantalum.

PMID- 7774205
TI  - Environmental glass fibre counts and skin symptoms.

PMID- 7774206
TI  - Colophony in bindi adhesive.

PMID- 7774207
TI  - Allergic contact conjunctivitis and blepharitis from tobramycin.

PMID- 7774208
TI  - Contact dermatitis from clotrimazole.

PMID- 7774209
TI  - A simple method of determining TS-F-R in nail polish.

PMID- 7774210
TI  - Medical complications of aneurysmal subarachnoid hemorrhage: a report of the
      multicenter, cooperative aneurysm study. Participants of the Multicenter
      Cooperative Aneurysm Study.
AB  - OBJECTIVES: This report examines the frequency, type, and prognostic factors of
      medical (nonneurologic) complications after subarachnoid hemorrhage in a large,
      prospective study. The influences of contemporary neurosurgical, neurological,
      and critical care practice on mortality and morbidity rates after aneurysmal
      subarachnoid hemorrhage are evaluated. DESIGN: A study of medical complications
      observed in the placebo limb of a large, randomized, controlled trial of the
      calcium antagonist, nicardipine, after subarachnoid hemorrhage. SETTING: Patients
      were recruited from 50 hospitals in 41 neurosurgical centers in the United States
      and Canada. PATIENTS: A total of 457 patients with subarachnoid hemorrhage, > or
      = 18 yrs of age, were randomly assigned to the placebo group. All patients
      arrived at the participating center within 7 days (mean 1.0 +/- 1.8 [SD] days) of
      rupture of an angiographically documented saccular aneurysm. MEASUREMENTS AND
      MAIN RESULTS: The frequency rates of symptomatic vasospasm, rebleeding, and total
      mortality rate after subarachnoid hemorrhage at 3-month follow-up were 46%, 7%,
      and 19%, respectively. The frequency of having at least one severe (life
      threatening) medical complication was 40%. The proportion of deaths from medical
      complications was 23%. This value was comparable with the proportion of deaths
      attributed to the direct effects of the initial hemorrhage (19%), rebleeding
      (22%), and vasospasm (23%) after aneurysmal rupture. The frequency of life
      threatening cardiac arrhythmias was 5%; less ominous rhythm disturbances occurred
      in 30% of the patients. There was an increased frequency of cardiac arrhythmias
      on the day of, or day after, aneurysm surgery. Pulmonary edema occurred in 23% of
      the patients, with a 6% occurrence rate incidence of severe pulmonary edema.
      There was a wide variation from center to center, with the greatest frequency on
      days 3 through 7. There was a nonsignificant association of pulmonary edema with
      the use of hypertensive hypervolemic therapy (p = .10), and a significant
      association with the timing of surgery (p < .05). Some degree of hepatic
      dysfunction was noted in 24% of patients, the majority with only mild
      abnormalities of hepatic enzymes with no clinical accompaniment (4% frequency of
      severe hepatic dysfunction). Thrombocytopenia occurred in 4% of patients, usually
      in the setting of sepsis. Renal dysfunction was reported in 7% of the patients,
      with 15% of that figure deemed to be of life-threatening severity. There was an
      association (p = .001) with antibiotic therapy. CONCLUSIONS: Potentially
      preventable medical complications after ruptured cerebral aneurysm add to the
      total mortality rate of patients, and may increase length of hospital stay in the
      critical care setting. The proportion of deaths after subarachnoid hemorrhage
      from medical complications equals those deaths from either direct effects,
      rebleeding, or vasospasm individually. Pulmonary complications are the most
      common nonneurologic cause of death. Cardiac arrhythmia, although frequent, was
      not associated with significant mortality. The frequency of cardiac arrhythmia
      and pulmonary edema increased on the day of, or day after, aneurysm surgery.
      Renal and hepatic dysfunction, and blood dyscrasias, were also observed,
      underscoring the need for meticulous monitoring for metabolic and hematologic
      derangements.

PMID- 7774211
TI  - NG-methyl-L-arginine, an inhibitor of nitric oxide synthase, reverses interleukin
      2-induced hypotension.
AB  - OBJECTIVE: To evaluate the role of NG-methyl-L-arginine as a modulator of the
      hyperdynamic shock induced by the administration of interleukin-2 (IL-2). DESIGN:
      A prospective, pilot clinical study. SETTING: Intensive care unit of a tertiary
      care center. PATIENTS: Three sequential patients with metastatic renal cell
      carcinoma who developed hypotension during their first course of treatment with
      high-dose IL-2 (18 x 10(6) IU/m2/day by continuous infusion for 5 days).
      INTERVENTIONS: Upon developing hypotension during their subsequent therapy with
      IL-2, patients were administered 12 mg/kg of NG-methyl-L-arginine. Thereafter, a
      dose of 4 mg/kg was given every 4 hrs, as needed, to maintain the systolic blood
      pressure above 100 mm Hg. MEASUREMENTS AND MAIN RESULTS: Invasive hemodynamic
      monitoring was instituted before the initiation of treatment with IL-2.
      Differences noted before, and 15 mins after, the administration of NG-methyl-L
      arginine were analyzed using the paired t-test. NG-methyl-L-arginine (12 mg/kg)
      induced a significant antihypotensive effect (mean blood pressure increased from
      87 +/- 4 to 121 +/- 7 mm Hg), accompanied by an increase of the systemic vascular
      resistance (549 +/- 51 to 860 +/- 167 dyne.sec/cm5) and pulmonary vascular
      resistance (81 +/- 16 to 117 +/- 29 dyne.sec/cm5). A decrease in the cardiac
      index was also documented (4.5 +/- 0.5 to 3.6 +/- 0.3 L/min/m2). No significant
      changes in pulmonary artery occlusion and central venous pressures were observed.
      Maintenance doses of 4 mg/kg of NG-methyl-L-arginine induced similar hemodynamic
      results, although the duration of the antihypotensive effect of NG-methyl-L
      arginine decreased with sequential doses. CONCLUSIONS: The hemodynamic effects
      induced by IL-2 administration are reversed by NG-methyl-L-arginine, a nitric
      oxide synthesis inhibitor. These results provide evidence for the biological
      activity of NG-methyl-L-arginine when administered alone to hypotensive patients.
      While no adverse effects were observed in this preliminary study, issues of
      toxicity and effectiveness need to be defined further in formal clinical trials.
      NG-methyl-L-arginine may play a therapeutic role in the modulation of the extreme
      vasodilation induced by cytokine administration or in septic shock.

PMID- 7774212
TI  - Frequency of mortality and myocardial infarction during maximizing oxygen
      delivery: a prospective, randomized trial.
AB  - OBJECTIVES: To determine the frequency of myocardial infarction and mortality
      during treatment that increased oxygen delivery (DO2) to > or = 600 mL/min/m2. To
      define the characteristics of patients achieving a high DO2 without inotropes in
      order to guide future studies. DESIGN: A prospective, randomized, controlled
      trial. SETTING: Two surgical intensive care units at The Queen's Medical Center
      in the University of Hawaii Surgical Residency Program. PATIENTS: Eighty-nine
      surgical patients (> or = 18 yrs of age), who were admitted to a surgical
      intensive care unit and who required pulmonary artery catheter monitoring, were
      selected for the study. Diagnoses included sepsis, septic shock, adult
      respiratory distress syndrome, or hypovolemic shock. Patients facing imminent
      death were excluded from the study. INTERVENTIONS: The treatment group received
      fluid boluses, blood products, and inotropes, as needed, to achieve a DO2 of > or
      = 600 mL/min/m2 in the first 24 hrs. Using the same interventions, we treated the
      control group to reach a DO2 of 450 to 550 mL/min/m2. MEASUREMENTS AND MAIN
      RESULTS: Hemodynamic measurements were obtained every 4 hrs until the pulmonary
      artery catheter was removed. DO2 and oxygen consumption were calculated by
      standard formulas. Serial creatine kinase myocardial fraction and
      electrocardiograms were documented for the first 48 hrs after study entry and for
      any new onset of arrhythmia or increasing hemodynamic instability. The patients
      who generated a high DO2 (> or = 600 mL/min/m2) with only preload treatment were
      reflective of patients with better cardiac reserve and low mortality rates. These
      patients, from both treatment and control groups, were excluded in the final
      analysis. The treatment group who received inotropes to achieve the high DO2 had
      a 14% mortality rate. Those patients who failed to achieve the high DO2 had a 67%
      mortality rate, and the control group who achieved a normal DO2 had a 62%
      mortality rate (p = .005). The frequency of myocardial infarction after study
      entry was 5.6% (five of 89 patients). This rate was not higher among the groups
      who received inotropes. Logistic regression analysis showed that age of > or = 50
      yrs could be used to classify patients as not self-generating, with an 83% chance
      of being correct. CONCLUSIONS: The group that required catecholamines to achieve
      a DO2 of > or = 600 mL/min/m2 had a lower mortality rate, with no increase in the
      frequency of myocardial infarction. Future prospective, controlled trials
      examining select groups of patients (age > or = 50 yrs) may demonstrate a
      difference between control and treatment groups by eliminating the majority of
      patients who generate the high DO2 with only preload augmentation.

PMID- 7774213
TI  - Effect of the antiendotoxic agent, taurolidine, in the treatment of sepsis
      syndrome: a placebo-controlled, double-blind trial.
AB  - OBJECTIVE: To assess the benefit gained from administration of the antiendotoxic
      drug, taurolidine, on outcome in critically ill patients with sepsis syndrome.
      DESIGN: A prospective, randomized, double-blind trial. SETTING: The general
      intensive therapy unit in a university teaching hospital. PATIENTS: One hundred
      patients admitted with sepsis syndrome over a 2-yr period. INTERVENTIONS:
      Patients were randomized to receive the amino-acid derivative, taurolidine, or an
      identically presented placebo. MEASUREMENTS AND MAIN RESULTS: Acute Physiology
      and Chronic Health Evaluation II (APACHE II), sepsis, and organ failure scores
      were measured daily. Blood for culture and endotoxin assay (using the limulus
      amoebocyte lysate assay) was sampled every 12 hrs for up to 5 days. Hemodynamic
      variables were recorded every 4 hrs. Forty-nine patients received taurolidine and
      51 patients received placebo. There was no difference in APACHE II score, Sepsis
      Score, or presence of infections between the groups. The frequency of Gram
      negative bacteremia was low at 12%. There was no difference in endotoxin
      activity, clinical or bacteriologic outcome, resolution of organ failure, or
      mortality rate between groups. Predicted risk of death for patients receiving
      taurolidine was 45%, and the actual mortality rate was 44%. In the group that
      received placebo, the predicted mortality rate was 38% and the actual mortality
      rate was 39%. CONCLUSION: Taurolidine had no beneficial therapeutic effect on the
      outcome of patients admitted to the intensive therapy unit with sepsis syndrome,
      using clinical, bacteriologic outcomes, progression of endotoxemia, resolution of
      organ failure, and 28-day mortality rate as end points.

PMID- 7774214
TI  - Long-term survival after intensive care unit admission with sepsis.
AB  - OBJECTIVE: To evaluate the long-term survival of critically ill patients with
      sepsis and to assess the factors predictive of long-term survival (> 1 month
      after admission date). DESIGN: Prospective, cohort study. SETTING:
      Medical/surgical intensive care unit (ICU) in a multidisciplinary community
      hospital. PATIENTS: All patients admitted to the ICU from January 1, 1987 to
      March 31, 1991 who both demonstrated clinical evidence of the systemic
      inflammatory response syndrome and yielded blood cultures positive for a
      bacterium or fungus (n = 153). INTERVENTIONS: Random set of procedures normally
      performed in an ICU setting. MEASUREMENTS AND MAIN RESULTS: Patient
      characteristics, including age, blood culture results, comorbid conditions, and
      severity of illness as estimated by the Acute Physiology Score of the Acute
      Physiology and Chronic Health Evaluation II prognostic system were recorded.
      Follow-up evaluation utilizing the National Death Index provided survival outcome
      for all patients 1 yr after hospital discharge. The mortality rate at hospital
      discharge was 51.0%, and mortality rates at 1 month, 6 months, and 1 yr after
      admission date were 40.5%, 64.7%, and 71.9%, respectively. A total of 33 patients
      survived beyond the period of observation. The analyses demonstrated the
      following findings: a) the survival rate was negatively correlated with the Acute
      Physiology Score up to 1 month after hospital admission date, but uncorrelated
      thereafter; b) fungal infections, such as Candida, had the shortest survival
      prospects of any blood-borne infection; and c) both malignancy and human
      immunodeficiency virus infection contributed to poorer outcomes, but differed in
      their patterns of long-term survival. CONCLUSIONS: The most critical period for
      surveillance of bacteremic patients was in months 2 through 6 after discharge,
      during which time, the percentage of patients surviving decreased dramatically.
      The degree of physiologic derangement, as measured by the Acute Physiology Score,
      was a useful measure of prognosis within the first month after the score was
      assessed at ICU admission. However, beyond this period, prognostic utility
      decreased significantly. Healthcare providers should use caution concerning the
      expected survival of hospitalized patients with human immunodeficiency virus,
      based on experience with distinct conditions, such as malignancies.

PMID- 7774215
TI  - Triage considerations for patients with acute gastrointestinal hemorrhage
      admitted to a medical intensive care unit.
AB  - OBJECTIVE: To determine whether previously identified clinical criteria,
      available at the time of triage, can predict clinical outcomes for patients with
      acute gastrointestinal (GI) hemorrhage. DESIGN: An inception cohort study.
      SETTING: Barnes Hospital, an academic tertiary care center. PATIENTS: One hundred
      eight consecutive hospital admissions (103 patients) triaged to intensive care
      for GI hemorrhage. INTERVENTIONS: Prospective patient surveillance, data
      collection, and risk stratification using preselected clinical criteria and
      outcomes assessment. MEASUREMENTS AND MAIN RESULTS: Using clinical data available
      at the time of triage, 28 (25.9%) intensive care unit admissions were classified
      as low risk for having poor outcomes. There was no difference in the distribution
      of upper and lower GI tract sources of hemorrhage for the two risk groups (p =
      .310). Stigmata of recent hemorrhage were endoscopically identified for six
      (21.4%) of the low-risk patient admissions and for 16 (20.0%) of the high-risk
      patient admissions (p = .872). Patient admissions identified as low risk had
      significantly lower rates of recurrent GI hemorrhage (3.6% vs. 22.5%; p = .022),
      less acquired organ system derangements (1.0 +/- 0.3 vs. 1.5 +/- 1.0 organs; p <
      .001), shorter lengths of hospitalization (4.9 +/- 3.5 vs. 8.8 +/- 7.4 days; p <
      .001), required transfusion with fewer units of packed red blood cells (1.3 +/-
      1.2 vs. 6.2 +/- 4.7 units; p < .001), and had a lower overall hospital mortality
      rate (0.0% vs. 21.3%; p = .008) compared with patient admissions identified as
      being high risk. CONCLUSION: These data suggest that objective clinical criteria,
      available at the time of triage determination, can be utilized to identify a low
      risk group of patients with acute GI hemorrhage, having favorable outcomes and
      potentially no need for intensive care unit services.

PMID- 7774216
TI  - Enteral nutrition in the critically ill patient: a prospective survey.
AB  - OBJECTIVES: To describe current enteral nutrition-prescribing practices for
      critically ill patients, and to identify factors associated with initiation of,
      and tolerance to, enteral nutrition. DESIGN: A prospective, cohort study.
      SETTING: Two tertiary care medical-surgical intensive care units (ICU) in
      Ontario, Canada. PATIENTS: We enrolled 99 consecutive patients who were expected
      to stay in the ICU for > 3 days and who were unable to tolerate oral nutrition.
      We followed patients for 21 days or until they tolerated enteral nutrition,
      tolerated oral nutrition, were discharged from the ICU, or died. MEASUREMENTS AND
      MAIN RESULTS: We recorded time elapsed from ICU admission to initiation and
      tolerance of enteral feedings, and examined factors associated with these events.
      We defined tolerance as receiving 90% of estimated daily energy requirements for
      > 48 hrs without gastrointestinal dysfunction (i.e., high gastric residuals,
      vomiting, diarrhea, abdominal distention). Seventy-three (74%) of 99 patients
      were started on enteral feedings an average 3.1 days (range 1 to 18) after ICU
      admission. Of 26 patients never started on enteral nutrition, three (12.5%)
      patients eventually tolerated oral nutrition, 14 (54.0%) patients were discharged
      from the ICU, and seven (27.0%) patients died. Reasons for not initiating enteral
      nutrition included absence of bowel sounds (27.0%), high nasogastric drainage
      (16.9%), contraindication to enteral nutrition (16.7%), tolerance of oral
      nutrition (6.8%), and no apparent reason (5.1%). Abdominal surgery, use of
      vasoactive drugs, and admission to one hospital made initiation of enteral
      nutrition less likely, whereas presence of bowel sounds and admission to the
      other hospital made initiation of enteral nutrition more likely. Thirty-five
      (42.9%) of 73 patients started on enteral nutrition achieved tolerance of the
      regimen. The average time from ICU admission to tolerance of feedings was 5.8
      days (range 1 to 14). Once started on enteral nutrition, the most common reasons
      for decreasing or discontinuing feedings included high gastric residuals (51.0%),
      mechanical feeding tube problems (15.4%), medical or surgical procedures (5.4%),
      and vomiting (5.1%). Use of paralytic agents and the presence of high gastric
      residuals were associated with intolerance. Of 38 patients who did not achieve
      tolerance, 20 (52.6%) patients were discharged from the ICU, eight (21.0%)
      patients died, and eight (21.0%) patients eventually tolerated oral nutrition.
      CONCLUSIONS: Enteral nutrition is not started in all eligible ICU patients.
      Approximately half of those patients receiving enteral nutrition achieved
      tolerance of the regimen. Gastrointestinal dysfunction causing intolerance to
      enteral nutrition is a common reason for not starting, or discontinuing,
      feedings.

PMID- 7774218
TI  - Effect of computerized charting on nursing activity in intensive care.
AB  - OBJECTIVE: To measure the impact on nursing activity of introducing computerized
      medical records into intensive care units (ICUs). DESIGN: Prospective data
      collection monitoring the activity of ICU nurses before and after installation of
      a computerized charting system. SETTING: A six-bed coronary care unit and an
      eight-bed medical ICU at the Minneapolis VA Medical Center. SUBJECTS: Registered
      nurses providing intensive care services. INTERVENTIONS: Installation of a
      Clinical Information System that computerized the ICU medical records.
      MEASUREMENTS AND MAIN RESULTS: Before computer installation, nurses spent 24% of
      their time manipulating data (7% gathering and 17% charting). After installation,
      charting time decreased to 10%, and data gathering time decreased to 4%, while
      10% of time was spent at computer terminals entering or reviewing data. The total
      time manipulating data post-installation was thus 24% (i.e., unchanged from
      previous). Computerized charting did not alter time spent in patients' rooms (43%
      pre- and 43% postinstallation) compared with time spent at the central station
      (37% pre- and 36% post-installation) or elsewhere (20% pre- and 21%
      postinstallation). Relative time spent at various tasks varied between units and
      from shift to shift, but the net effect of computerized charting was that nurses
      had more time available at the central station for monitoring, and that the
      computer terminals were used primarily in the patient rooms. CONCLUSIONS:
      Computerized charting will not necessarily provide ICU nurses with a net excess
      of time for tasks unrelated to manipulating data.

PMID- 7774217
TI  - Chemical compatibility of inotropic and vasoactive agents delivered via a
      multiple line infusion system.
AB  - OBJECTIVES: To determine the chemical compatibility of three different triple
      drug admixtures diluted with either 5% dextrose in water or 0.9% NaCl solution
      when administered via a multiple line infusion system (Omni-Flow 4000, Abbott
      Laboratories, Abbott Park, IL). The triple drug admixtures were: a) dobutamine,
      dopamine, and norepinephrine; b) nitroglycerin, sodium nitroprusside, and
      dobutamine; and c) nitroglycerin, dopamine, and dobutamine. DESIGN: Two phase in
      vitro compatibility study. SETTING: Pharmaceutical laboratory. SUBJECTS: None.
      INTERVENTIONS: Phase I assessed chemical stability when the triple drug admixture
      was placed in a single container. In phase II, individual drug components of the
      admixtures were infused via the multiple line infusion system. Samples were
      collected at time 0, 1 hr, 2 hrs, 4 hrs, 12 hrs, and 24 hrs. All samples were
      frozen and stored at -70 degrees C until assayed. MEASUREMENTS AND MAIN RESULTS:
      Samples were assayed using stability-indicating high performance liquid
      chromatography. The triple drug admixtures were considered to be chemically
      stable if there was < or = 10% loss of stated potency over 24 hrs. In phase I,
      chemical stability was observed for all triple drug admixtures at 24 hrs. In
      phase II, dobutamine, dopamine, norepinephrine, and sodium nitroprusside showed
      chemical stability at 24 hrs. Nitroglycerin showed a two-fold increase in
      concentration at 24 hrs compared with the initial concentration through the test
      infusion system; however, this amount was still one third lower than originally
      anticipated. CONCLUSIONS: All triple drug admixtures were chemically stable when
      placed in single containers. Dobutamine, norepinephrine, and sodium nitroprusside
      showed chemical stability when delivered via a multiple line infusion system. The
      reduced recovery of nitroglycerin from the test infusion system may result from
      adsorption of the nitroglycerin to the polyvinyl chloride plastic cassette and
      tubing during infusion.

PMID- 7774219
TI  - Variability of intrinsic positive end-expiratory pressure in patients receiving
      mechanical ventilation.
AB  - OBJECTIVE: Since variations in breathing pattern may affect the level of
      intrinsic positive end-expiratory pressure (PEEP), breath-to-breath variation of
      intrinsic PEEP was assessed. DESIGN: Descriptive and prospective study. SETTING:
      Medical intensive care unit of a university teaching hospital. PATIENTS: Thirty
      four patients requiring mechanical ventilation for a period of time due to
      respiratory failure. MEASUREMENTS AND MAIN RESULTS: Intrinsic PEEP was determined
      using simultaneous recordings of the esophageal pressure and airflow. The breath
      to-breath intrinsic PEEP, respiratory rate, tidal volume, inspiratory time, and
      fractional inspiratory time were measured. Intrinsic PEEP was noted in 33 of 34
      patients. For all patients, the mean intrinsic PEEP was 3.59 cm H2O. The group
      mean standard deviation (SD) of the intrinsic PEEP over 35 breaths was 2.68 cm
      H2O. In 17 chronic obstructive pulmonary disease patients, the mean intrinsic
      PEEP was 4.69 cm H2O and the group mean SD of the intrinsic PEEP was 3.19 cm H2O.
      In the subgroup of patients with significant intrinsic PEEP, the mean intrinsic
      PEEP was 6.69 cm H2O and the group mean SD was 4.29 cm H2O. The group mean
      coefficient of variation of intrinsic PEEP for all 34 patients was 123%. Among
      the 15 patients with clinically significant intrinsic PEEP, the coefficient of
      variation was smaller (74%). We did not find significant correlation between the
      coefficients of variation of breathing pattern parameters and the coefficients of
      variation of intrinsic PEEP. CONCLUSIONS: We conclude that the occurrence rate of
      intrinsic PEEP in mechanically ventilated patients is high. The degree of
      variability in intrinsic PEEP on a breath-to-breath basis is also high. It may be
      difficult to find a specific level of intrinsic PEEP. Addition of external
      positive end-expiratory pressure without considering the breath-to-breath
      variability may lead to overdistention of the lung.

PMID- 7774220
TI  - Glycosylated recombinant human tumor necrosis factor binding protein-1 reduces
      mortality, shock, and production of tumor necrosis factor in rabbit Escherichia
      coli sepsis.
AB  - OBJECTIVE: To examine the effect of glycosylated recombinant human tumor necrosis
      factor binding protein-1 (r-hTNF binding protein-1), the extracellular domain of
      the tumor necrosis factor receptor p55 produced in mammalian cells, in a rabbit
      model of circulatory shock due to Escherichia coli. DESIGN: Prospective,
      randomized, controlled trial. SETTING: University hospital research laboratory.
      SUBJECTS: Eighteen female, New Zealand white rabbits. INTERVENTIONS: Anesthetized
      rabbits, infused with E. coli (10(9) organisms/kg), were pretreated with either r
      hTNF binding protein-1 or saline. Mean arterial pressure, central venous
      pressure, cardiac output, and heart rate were recorded every 20 mins for 1 hr
      before, and for 4 hrs after, the infusion of E. coli. Blood samples were obtained
      at 1-hr intervals for platelet count and white blood cell count, r-hTNF binding
      protein-1, and tumor necrosis factor (TNF) measurements. MEASUREMENTS AND MAIN
      RESULTS: Administration of r-hTNF binding protein-1 resulted in improvement of
      mean arterial pressure, cardiac output, and systemic vascular resistance, as
      compared with the vehicle-treated group (p < .05). Treatment with r-hTNF binding
      protein-1 was associated with 100% survival, as compared with 55.6% of the saline
      treated rabbits (p < .05). Approximately 85% of r-hTNF binding protein-1 was
      cleared from the circulation 1 hr after the bolus injection (from 171 +/- 27
      micrograms/mL at time = 0, to 27 +/- 4 micrograms/mL at 60 mins, decreasing to 6
      +/- 2 micrograms/mL for the next 3 hrs). The r-hTNF binding protein-1-treated
      rabbits had lower serum TNF bioactivity during the first 2 hrs (p < .01). The
      decreased bioactivity of TNF was confirmed by a specific radioimmunoassay for
      rabbit TNF. However, at 4 hrs, the vehicle-treated rabbits had lower serum
      bioactive TNF concentrations (p < .05). The decrease in TNF concentrations in the
      r-hTNF binding protein-1-treated rabbits resulted from decreased production and,
      in part, from carry-over of r-hTNF binding protein-1 into the bioassay.
      CONCLUSIONS: Treatment with r-hTNF binding protein-1 improved hemodynamic
      variables and survival of E. coli-challenged rabbits. Administration of r-hTNF
      binding protein-1 suppressed bioactivity of TNF in the circulation of these
      rabbits, and the production of TNF as well.

PMID- 7774221
TI  - Increasing organ blood flow during cardiopulmonary bypass in pigs: comparison of
      dopamine and perfusion pressure.
AB  - OBJECTIVE: To determine whether low-dose dopamine infusion (5 micrograms/kg/min)
      during cardiopulmonary bypass selectively increases perfusion to the kidney,
      splanchnic organs, and brain at low (45 mm Hg) as well as high (90 mm Hg)
      perfusion pressures. DESIGN: Randomized crossover trial. SETTING: Animal research
      laboratory in a university medical center. SUBJECTS: Ten female Yorkshire pigs
      (weight 29.9 +/- 1.2 kg). INTERVENTION: Anesthetized pigs were placed on
      normothermic cardiopulmonary bypass at a 100-mL/kg/min flow rate. After baseline
      measurements, the animal was subjected, in random sequence, to 15-min periods of
      low perfusion pressure (45 mm Hg), low perfusion pressure with dopamine (5
      micrograms/kg/min), high perfusion pressure (90 mm Hg), and high perfusion
      pressure with dopamine. Regional perfusion (radioactive microspheres) was
      measured in tissue samples (2 to 10 g) from the renal cortex (outer two-third and
      inner one-third segments), stomach, duodenum, jejunum, ileum, colon, pancreas,
      and cerebral hemispheres. MEASUREMENTS AND MAIN RESULTS: Systemic perfusion
      pressure was altered by adjusting pump flow rate (r2 = .61; p < .05). In the
      kidney, cortical perfusion pressure increased from 178 +/- 16 mL/min/100 g at the
      low perfusion pressure to 399 +/- 23 mL/min/100 g at the high perfusion pressure
      (p < .05). Perfusion pressure augmentation increased the ratio of outer/inner
      renal cortical blood flow from 0.9 +/- 0.1 to 1.2 +/- 0.1 (p < .05). At each
      perfusion pressure, low-dose dopamine had no beneficial effect on renal perfusion
      or flow distribution. Similar results were found in the splanchnic organs, where
      regional perfusion was altered by perfusion pressure but not by dopamine. In
      contrast, neither changing perfusion pressure nor adding low-dose dopamine
      altered blood flow to the cerebral cortex. CONCLUSIONS: These data indicate that
      the lower autoregulatory limits of perfusion to the kidneys and splanchnic organs
      differ from those limits to the brain during normothermic bypass. Selective
      vasodilation from low-dose dopamine was not found in renal, splanchnic, or
      cerebral vascular beds. Increasing the perfusion pressure by pump flow, rather
      than by the addition of low-dose dopamine, enhanced renal and splanchnic but not
      cerebral blood flows during cardiopulmonary bypass.

PMID- 7774222
TI  - Interleukin-1 receptor antagonist attenuates leukocyte-endothelial interactions
      in the liver after hemorrhagic shock in the rat.
AB  - OBJECTIVE: To evaluate the influence of interleukin-1 on leukocyte-endothelial
      cell interactions and the microcirculation in the liver after hemorrhagic shock
      by means of intravital microscopy using an interleukin-1 receptor antagonist (IL
      1ra). DESIGN: Prospective, randomized, blinded, controlled study. SETTING:
      University research laboratory. SUBJECTS: Anesthetized female Sprague Dawley rats
      weighing 200 to 230 g. INTERVENTIONS: Hypovolemic shock was induced and
      maintained for 1 hr (mean arterial pressure 40 mm Hg; cardiac output 50% of
      baseline). After adequate resuscitation and 5 hrs of reperfusion (mean arterial
      pressure > 100 mm Hg; cardiac output > 120% of baseline), the microcirculation in
      liver sinusoids was examined by intravital fluorescence microscopy. Continuous
      administration of IL-1ra (5 mg/kg/hr) was started at different times in a
      prospective, randomized, blinded fashion, either as pretreatment 5 mins before
      shock induction (n = 6), or as therapy at the time of resuscitation (n = 6). An
      additional bolus injection of 5 mg/kg of IL-1ra was given to the latter group.
      MEASUREMENTS AND MAIN RESULTS: Mean arterial pressure, cardiac output, heart
      rate, and blood gases were comparable in all shock groups during the experiments.
      The percentage of permanently adherent leukocytes (adhesion time of > 20 secs) in
      the pretreated group was significantly decreased in comparison with the control
      group (pretreatment group 16.9 +/- 1.9% vs. control group 42.1 +/- 5.4%; p < .001
      by analysis of variance; sham group 9.1 +/- 1.1%). Administration of IL-1ra at
      the time of resuscitation also reduced firm adhesion of leukocytes to sinusoidal
      endothelium (treated group 28.8 +/- 3.6%, p < .01). Temporary adhesion rates of
      leukocytes (adhesion time of < 20 secs) were unaffected by pretreatment or
      treatment with IL-1ra with respect to control values. Liver microcirculation was
      impaired after hemorrhagic shock but not improved by IL-1ra. CONCLUSIONS: The
      results show that adhesion of leukocytes to hepatic sinusoidal endothelium is at
      least partly regulated by interleukin-1. Adherence was attenuated by the
      application of IL-1ra, which might be due to diminished expression of adhesion
      receptors by endothelial cells or leukocytes. Even administration of IL-1ra at
      the time of resuscitation reduces the early inflammatory response in the liver
      after shock, thus offering a potentially important therapeutic approach.

PMID- 7774223
TI  - Methyl isobutyl amiloride delays normalization of brain intracellular pH after
      cardiac arrest in rats.
AB  - OBJECTIVE: The sodium/hydrogen ion (Na+/H+) antiporter system of brain cells is
      responsible for reducing intracellular acid loads and regulating cellular volume.
      Activation of this system during reperfusion following cardiac arrest may
      contribute to cerebral edema and subsequent brain damage. Therefore, we wished to
      determine whether administration of methyl isobutyl amiloride, a known inhibitor
      of the Na+/H+ antiporter system, would cross the blood brain barrier and delay
      the return of brain intracellular pH to normal values during reperfusion after
      cardiac arrest in rats. DESIGN: a) Prospective sequential evaluation of the
      regional brain blood flow and 3H-methyl isobutyl amiloride extraction fraction in
      rats; b) prospective sequential evaluation of brain intracellular pH in rats
      treated with methyl isobutyl amiloride compared with untreated control rats.
      SETTING: A research laboratory. SUBJECTS: Thirteen male Wistar rats: a) three
      rats to study regional brain blood flow and 3H-methyl isobutyl amiloride cerebral
      extraction; and b) ten rats to study the effect of methyl isobutyl amiloride on
      brain intracellular pH after cardiac arrest and reperfusion. INTERVENTIONS: a)
      Rats were injected with 14C iodoantipyrine and 3H-methyl isobutyl amiloride, and
      their brains were subsequently analyzed to determine regional cerebral blood flow
      and percent of cerebral extraction of methyl isobutyl amiloride. b) Cardiac
      arrest was induced with potassium chloride followed by resuscitation 7 mins later
      in untreated control rats and rats treated with methyl isobutyl amiloride.
      MEASUREMENTS AND MAIN RESULTS: a) Regional cerebral blood flow (mL/100 g/min)
      determined with 14C iodoantipyrine and percent of cerebral extraction of 3H
      methyl isobutyl amiloride were evaluated in various regions of the brain. Mean +/
      SD values were 167 +/- 15 and 7 +/- 1 for the frontal cerebral cortex; 159 +/-
      10 and 7 +/- 2 for the parietal cerebral cortex, 130 +/- 17 and 8 +/- 1 for the
      hippocampus, 154 +/- 33 and 13 +/- 4 for the cerebellum and 166 +/- 27 and 6 +/-
      1 for the striatum (mL/100 g/min). These values were determined by a dual label
      indicator fractionation method. b) Brain intracellular pH was measured by neutral
      red histophotometry after 15 mins of reperfusion following cardiac arrest. As
      compared with untreated control rats, methyl isobutyl amiloride-treated animals
      had significantly lower brain intracellular pH values after 15 mins of
      reperfusion. Mean +/- SD pH values were 6.78 +/- 0.18 for the rats treated with
      methyl isobutyl amiloride vs. normal intracellular pH of 7.11 +/- 0.07 for the
      untreated control rats. CONCLUSIONS: a) Methyl isobutyl amiloride crosses the
      blood brain barrier of rats. b) The Na+/H+ antiporter system is operative during
      reperfusion after cardiac arrest in rats.

PMID- 7774224
TI  - Serotonin receptors regulate canine regional vasodilator responses to burn.
AB  - OBJECTIVE: To determine which serotoninergic receptor subtype(s) mediates the
      regional vasodilator response to scald injury. DESIGN: Prospective, randomized
      trial. SETTING: Microcirculation research laboratory. SUBJECTS: Anesthetized
      dogs. INTERVENTIONS: Mechanically ventilated dogs underwent cannulation of a
      brachial artery and placement of an ultrasonic flow probe around one femoral
      artery. All animals received a 2% to 3% body surface area partial thickness scald
      injury by immersing the paw ipsilateral to the instrumented femoral artery into
      100 degrees C water for 5 secs. In one group of dogs, BMY 7378 (a
      serotoninergic1A receptor antagonist) was given by the peripheral intravenous
      route before burn. These results were compared with those findings obtained from
      a group of animals that received a burn only, and groups of animals given a
      peripheral intravenous injection of methysergide (a serotoninergic receptor
      antagonist) or ritanserin (a serotoninergic2 receptor blocking agent) before
      burn. Experiments were conducted for two postburn hours. MEASUREMENTS AND MAIN
      RESULTS: Burn injury caused a marked and persistent increase in regional (e.g.,
      femoral artery) blood flow, an effect that was significantly blunted by preburn
      administration of the serotoninergic receptor antagonist, methysergide. Preburn
      administration of BMY 7378 increased baseline femoral blood flow by 13%,
      reflecting its known serotonin agonist properties. However, when compared with
      the mean postscald increases in femoral blood flow over baseline seen in scald
      only dogs and in animals given the serotoninergic2 receptor blocking agent,
      ritanserin (before scald), the BMY 7378-treated group demonstrated a significant
      (p < .001 by analysis of variance) 2-hr-postscald blunting of this femoral
      vasodilator response. CONCLUSION: These data suggest that serotoninergic1A-like
      receptors play an integral, albeit not an exclusive, role in blood flow
      regulation to the site of burn injury.

PMID- 7774225
TI  - Simple method to measure total expiratory time constant based on the passive
      expiratory flow-volume curve.
AB  - OBJECTIVE: In intubated, mechanically ventilated patients, inspiration is forced
      by externally applied positive pressure. In contrast, exhalation is passive and
      depends on the time constant of the total respiratory system. The expiratory time
      constant is thus an important determinant of mechanical ventilation. The aim of
      this study was to evaluate a simple method for measuring the expiratory time
      constant in ventilated subjects. DESIGN: Prospective study using a lung simulator
      and ten dogs. SETTING: University hospital. SUBJECTS: Commercially available lung
      simulator and ten greyhound dogs. INTERVENTIONS: Different expiratory time
      constants were set on the lung simulator. In the dogs, the endotracheal tube was
      clamped to increase airways resistance by 22.5 cm H2O/(L/sec) and the lungs were
      injured with hydrochloric acid to decrease total respiratory compliance by 16
      mL/cm H2O. This procedure resulted in a wide range of expiratory time constants.
      MEASUREMENTS AND MAIN RESULTS: Pneumotachography was used to measure flow and
      volume. The ratio of exhaled volume and peak flow was calculated from these
      signals, corrected for the limited exhalation time yielding the "calculated
      expiratory time constant" and compared with the actual expiratory time constant.
      The typical error was +/- 0.19 sec for the lung simulator and +/- 0.15 sec for
      the dogs. CONCLUSIONS: The volume and peak flow corrected for limited exhalation
      time is a good estimate of the total expiratory time constant in passive subjects
      and may be useful for the titration of mechanical ventilation.

PMID- 7774226
TI  - Serial somatosensory and brainstem auditory evoked potentials in monitoring of
      acute supratentorial mass lesions.
AB  - OBJECTIVE: To determine the relevance of serial evoked potentials (brainstem
      auditory evoked potentials and somatosensory evoked potentials) and clinical
      parameters (pupillary response and intracranial pressure) in patients with acute
      supratentorial mass lesions. DESIGN: Prospective case series of comatose patients
      with acute supratentorial mass lesions. SETTING: Neurocritical care unit of a
      tertiary care center. PATIENTS: Thirty consecutive patients with the following
      study inclusion criteria: a) clinical and computed tomography evidence of an
      acute supratentorial mass lesion; b) implantation of an intracranial pressure
      monitoring device; and c) a persistent comatose state during the observation
      period. INTERVENTIONS: Brainstem auditory evoked potentials, somatosensory evoked
      potentials, intracranial pressure, and pupillary responses were recorded at the
      time of three particular events: a) immediately after implantation of an epidural
      intracranial pressure monitoring device; b) during intracranial pressure therapy;
      and c) at termination of intracranial pressure therapy. Evoked potential results
      were ranked into three categories: a) normal on both sides; b) abnormal or absent
      on one side; and c) evoked potentials on both sides abnormal or absent.
      Spearman's rank correlation was performed to analyze serial recordings. Cross
      tables were generated to determine the prognostic value of evoked potentials and
      clinical parameters. Fisher's exact test was applied to calculate statistical
      significance. MEASUREMENTS AND MAIN RESULTS: Intracranial pressure values
      correlated with pupillary responses and brainstem auditory evoked potentials
      during and at the termination of intracranial pressure therapy. Pupillary
      findings correlated with brainstem auditory evoked potentials only at the time of
      termination of intracranial pressure therapy. There was no correlation between
      somatosensory evoked potentials and clinical parameters. Pupillary responses
      indicated a good or poor recovery during and at the termination of intracranial
      pressure therapy. Brainstem auditory evoked potentials and intracranial pressure
      values distinguished between good and poor outcome only at termination of
      intracranial pressure therapy. Somatosensory evoked potential results did not
      predict outcome. CONCLUSIONS: Shortly after manifestation of supratentorial mass
      lesions, the results of evoked potentials and clinical parameters indicate
      increased intracranial pressure and incipient transtentorial herniation but do
      not predict sequelae. Our results indicate that after institution of effective
      therapy, pupillary abnormalities and brainstem auditory evoked potentials serve
      as valuable prognostic predictors. In contrast, somatosensory evoked potentials
      reflect neither therapeutic efficacy nor outcome in our patient population.

PMID- 7774227
TI  - Probability of survival after prolonged extracorporeal membrane oxygenation in
      pediatric patients with acute respiratory failure. Extracorporeal Life Support
      Organization.
AB  - OBJECTIVE: Extracorporeal membrane oxygenation (ECMO) has been used with
      increasing frequency for respiratory failure that is unresponsive to conventional
      therapy. We examined the relationship between duration of ECMO and outcome to
      understand whether prolonged ECMO (duration of the procedure for > 14 days) was
      more commonly associated with futile therapy or eventual recovery. DESIGN: A
      cohort study of all patients reported to the Pediatric ECMO Registry for Acute
      Respiratory Failure of the Extracorporeal Life Support Organization. SETTING:
      Tertiary hospitals (n = 83) capable of providing extracorporeal support for
      pediatric patients. PATIENTS: Children (n = 382) between the ages of 1 wk and 18
      yrs of age with severe respiratory failure. INTERVENTIONS: Extracorporeal
      membrane oxygenation. MEASUREMENTS AND MAIN RESULTS: The death or live hospital
      discharge of ECMO-treated patients, together with the post-ECMO mechanical
      ventilation course, were examined as a function of duration of ECMO and of pre
      ECMO respiratory status. The occurrence of complications and the causes of death
      were also noted. The criteria used to initiate ECMO, as well as the determination
      of the futility of further ECMO, were determined by local practice at individual
      centers. There were 382 patients treated with ECMO, of whom 184 (48%) survived.
      The proportional survival in the patients treated for the longest duration was
      similar to the overall group. The cause of death was given for 168 patients: 32
      neurologic deaths; nine deaths due to ECMO complications; and 30 deaths due to
      nonpulmonary organ failure. There were 97 deaths due to elective ECMO
      termination; 80 of these deaths occurred after the determination of the futility
      of anticipating pulmonary recovery. The latter deaths occurred at widely varying
      durations of ECMO, with a median of 282 hrs. However, at that same duration, 47
      eventual survivors (26% of all survivors) continued to receive ECMO. By
      discriminant analysis, the survival rate was independently related (r2 = .18; p <
      .0001) to peak ventilator inspiratory pressure before ECMO and duration of
      intubation before ECMO, patient age, and the occurrence of several complications.
      CONCLUSIONS: While the survival rate in pediatric patients receiving ECMO appears
      related to the severity of lung disease and to the occurrence of ECMO
      complications, the survival rate in patients treated with ECMO courses of > 2 wks
      was similar to the survival rate of patients treated for shorter periods of time.
      ECMO was terminated in some patients for pulmonary futility at durations of ECMO
      associated with survival in substantial numbers of patients in whom ECMO was
      continued.

PMID- 7774229
TI  - Coma and metabolic acidosis related to the use of muscle liniment.

PMID- 7774228
TI  - Noninvasive monitoring of end-tidal carbon dioxide tension via nasal cannulas in
      spontaneously breathing children with profound hypocarbia.
AB  - OBJECTIVE: To determine the correlation between end-tidal CO2 and PaCO2 measured
      via nasal cannulas in spontaneously breathing children with profound hypocarbia
      (PaCO2 < 30 torr [< 4.0 kPa]). DESIGN: Prospective evaluation. SETTING: Pediatric
      intensive care unit (ICU) in a tertiary care referral center. INTERVENTIONS:
      None. PATIENTS: Patients admitted to the ICU with a diagnosis of diabetic
      ketoacidosis in whom invasive arterial access was deemed necessary for clinical
      care. The patients were spontaneously breathing, without intubation. The study
      included nine patients, with an average age of 9.9 yrs (range 4 to 17) and weight
      of 38.7 kg (range 17 to 68). MEASUREMENTS AND MAIN RESULTS: End-tidal CO2 was
      sampled from nasal cannulas by a sidestream aspirator and estimated by infrared
      spectroscopy. The correlation between arterial and end-tidal CO2 was compared
      using linear regression analysis. A total of 65 arterial blood gases were
      obtained from the nine patients. The PaCO2 was < or = 30 torr (< or = 4.0 kPa) in
      38 of the samples. The PaCO2 to end-tidal CO2 gradient was < or = 4 torr (< or =
      0.5 kPa) in 64 of 65 samples and 4.8 torr (0.6 kPa) in one sample. Linear
      regression analysis of arterial vs. end-tidal CO2 yielded a slope of 0.99, an r2
      value of .97, and a p value of .0001. CONCLUSIONS: End-tidal CO2 measurement by
      infrared spectroscopy provides an accurate estimation of PaCO2, even during
      episodes of severe hypocarbia. Its use may limit the need for invasive monitoring
      and/or repeated arterial blood gas analyses.

PMID- 7774230
TI  - Clostridium difficile causing sepsis and an acute abdomen in critically ill
      patients.

PMID- 7774231
TI  - Lorazepam versus midazolam for sedation.

PMID- 7774232
TI  - Lorazepam versus midazolam for sedation.

PMID- 7774233
TI  - Regionalization of critical care medicine.

PMID- 7774234
TI  - Prolonged paralysis with atracurium infusion.

PMID- 7774235
TI  - Prolonged paralysis with atracurium infusion.

PMID- 7774236
TI  - Another negative clinical trial of a new agent for the treatment of sepsis:
      rethinking the process of developing adjuvant treatments for serious infections.

PMID- 7774237
TI  - Medical management of aneurysmal subarachnoid hemorrhage.

PMID- 7774239
TI  - Preserving preceptors: a valuable resource.

PMID- 7774238
TI  - A second large controlled clinical study of E5, a monoclonal antibody to
      endotoxin: results of a prospective, multicenter, randomized, controlled trial.
      The E5 Sepsis Study Group.
AB  - OBJECTIVE: To evaluate the safety and efficacy of E5, a murine, monoclonal
      antibody directed against endotoxin, in the treatment of patients with Gram
      negative sepsis. DESIGN: A multicenter, randomized, double-blind, placebo
      controlled trial. SETTING: Fifty-three hospitals across the United States,
      including university medical centers, Veterans Affairs Medical Centers, and
      community hospitals. PATIENTS: 847 patients were randomized into this study.
      Enrolled patients met criteria for three conditions: a) known or suspected Gram
      negative infection; b) clinical evidence of sepsis; and c) signs of end-organ
      dysfunction. Patients with refractory shock were excluded from the study.
      INTERVENTIONS: Two doses of E5 (2 mg/kg/day by intravenous infusion 24 hrs
      apart), or placebo that was identical in appearance were administered. In
      addition, all patients received standard supportive therapy and broad-spectrum
      antibiotics. MEASUREMENTS AND MAIN RESULTS: The primary end point was mortality
      over 30 days. Secondary outcome measures included the resolution and prevention
      of organ failure in the same two populations. Additionally, the safety of E5 was
      evaluated. There was no significant improvement in survival over 30 days among
      patients with Gram-negative sepsis who received E5 compared with those patients
      who received placebo (n = 530; p = .21). In addition, E5 did not improve survival
      for patients with Gram-negative sepsis and organ failure (n = 139; p = .3).
      However, a significantly greater percentage of patients with Gram-negative sepsis
      experienced resolution of major organ failure if they received E5, compared with
      those patients who received placebo (n = 139; 48% E5 vs. 25% placebo; p = .005).
      This result extended to all patients who entered the study with one or more major
      organ failures, regardless of the etiology of the infection (n = 225; 41% E5 vs.
      27% placebo; p = .024). E5 also provided protection against the development of
      some organ failures, but significant prevention was only observed for adult
      respiratory distress syndrome (p = .007) and central nervous system dysfunction
      (p = .050). Hypersensitivity reactions attributable to E5 occurred in 2.6% of
      patients. An asymptomatic antibody response occurred in 44% of the E5-treated
      patients and in 12% of the patients who received placebo. CONCLUSIONS: In this
      study, E5 did not reduce mortality in nonshock patients with Gram-negative sepsis
      whether or not those patients also had organ failure. However, E5 did result in
      greater resolution of organ failure in patients with Gram-negative sepsis. This
      benefit extended to those patients with suspected Gram-negative etiology. This
      finding is important because patients with suspected Gram-negative sepsis and
      organ failure can be identified without waiting for culture results. In addition,
      E5 resulted in the prevention of adult respiratory distress syndrome and central
      nervous system organ failure. However, more studies are needed to determine if
      this result can be extended to organ failure in general. E5 is safe as a
      treatment for patients with Gram-negative sepsis.

PMID- 7774240
TI  - The patient-driven system.

PMID- 7774241
TI  - Playing--and winning--the transitions game.

PMID- 7774242
TI  - Winners and losers in healthcare reform.

PMID- 7774244
TI  - Innovations in technology: continuous intra-arterial blood gas monitoring.

PMID- 7774243
TI  - Clarification sought for pharmacologic stress testing.

PMID- 7774245
TI  - Auto-PEEP: measurement issues and nursing interventions.

PMID- 7774246
TI  - Measles pneumonia in the critically ill child: application of alternative
      ventilation strategies.
AB  - Measles pneumonia is a life-threatening complication in children infected with
      the measles virus. The increased number of reported cases over the last several
      years suggests a need for heightened awareness of the complication among
      pediatric critical care nurses. Application of alternative ventilation strategies
      in the critical care setting continues to be explored in children with ARDS
      refractory to more conventional ventilation support, because the mortality and
      morbidity associated with ARDS in children remain high. Patients who present with
      diffuse, bilateral lung injury, such as in measles pneumonia, may be candidates
      for alternative ventilation strategies. Few investigators have studied
      alternative ventilation strategies in the pediatric ICU setting. Therefore,
      nursing research related to the impact of nursing interventions during
      alternative ventilation strategies is needed. Specifically, evaluation of ET
      suctioning practices and other interventions that influence oxygen delivery and
      consumption are necessary to plan effective care during alternative ventilation
      strategies and improve patient outcome. Prevention of measles pneumonia is
      clearly the preferred "treatment." Preventive healthcare is paramount in
      providing optimal care for children. However, until we can address the
      environmental factors that predispose children to communicable diseases such as
      measles, critical care nurses must be knowledgeable about the assessment and
      management of measles pneumonia.

PMID- 7774247
TI  - ECCO2R: an experimental approach to treating ARDS.

PMID- 7774248
TI  - Factors related to unplanned extubation of endotracheal tubes.

PMID- 7774249
TI  - Continuous airway pressure monitoring in the critical care setting.

PMID- 7774250
TI  - Critical care technicians: letting nurses be nurses. Interview by Michael
      Villaire.

PMID- 7774252
TI  - AACN believes in ... bridging the gap between research and practice.

PMID- 7774251
TI  - Critical care nursing in army field hospitals.

PMID- 7774253
TI  - AACN believes in ... partners in the community.

PMID- 7774254
TI  - AACN believes in ... helping people make care choices.

PMID- 7774255
TI  - AACN believes in ... helping nurses learn.

PMID- 7774256
TI  - AACN believes in ... programs driven by the needs of patients.

PMID- 7774257
TI  - Jill Ley: putting critical pathways on the map. Interview by Michael Villaire.

PMID- 7774258
TI  - Strategies for writing an effective resume.

PMID- 7774259
TI  - The supervisory status of nurses.

PMID- 7774260
TI  - Accreditation aches and pains.

PMID- 7774261
TI  - Care: an ethical foundation for critical care nursing.
AB  - Critical care nursing by definition focuses on human responses to life
      threatening problems. An increasing number of ethical dilemmas confronts the
      critical care nurse. A traditional principled orientation to ethical reasoning
      requires detachment that does not acknowledge the special nature of the nurse
      patient relationship and, by itself, does not give satisfactory direction in
      resolving ethical dilemmas. An ethic of care that acknowledges the special
      relationship and connection of one human being with another may provide the
      necessary guidance to assist the nurse in resolving these dilemmas. Critical care
      nursing practice based on an ethic of care acknowledges and legitimizes care for
      patients as well as oneself.

PMID- 7774262
TI  - The patient-driven system.

PMID- 7774263
TI  - A message to critical care nurses.

PMID- 7774264
TI  - A misconception in article on counting heart rate?

PMID- 7774265
TI  - Manipulating PA catheters carries responsibility.

PMID- 7774266
TI  - Coronary-subclavian steal after CABG surgery.
AB  - Patients who have undergone CABG surgery using the IMA are at risk for the
      development of coronary-subclavian steal. Therefore, recurrence of angina or ECG
      signs suggestive of myocardial ischemia after CABG with the IMA must be evaluated
      immediately. Recognition of the signs and symptoms with appropriate intervention
      is necessary to prevent the life-threatening consequences of reversed bloodflow
      from the myocardium. Routine assessment of bilateral blood pressure measurements
      may provide a critical clue in identifying this syndrome.

PMID- 7774267
TI  - Rupture of a splenic artery aneurysm in pregnancy.
AB  - Although ruptured splenic artery aneurysm in pregnancy is frequently fatal for
      mother and infant, prompt diagnosis and surgical treatment increase their chances
      for survival. Normal physiologic and hemodynamic changes of pregnancy may mask
      early symptoms of hypovolemic shock in pregnant women. The fetus is especially at
      risk, because maternal compensatory mechanisms activated during hemorrhage shunt
      blood from uteroplacental circulation to maternal central circulation.
      Collaboration between perinatal and critical care team members is essential.

PMID- 7774268
TI  - Acute methemoglobinemia: a nursing perspective.

PMID- 7774269
TI  - Is chest physiotherapy necessary after cardiac surgery?

PMID- 7774270
TI  - Genetic illness in the adult ICU: implications for nursing practice.

PMID- 7774271
TI  - Managing coronary atherectomy patients in a special procedure unit.

PMID- 7774272
TI  - Peripheral nerve stimulators in the critical care setting: a policy for
      monitoring neuromuscular blockade.

PMID- 7774273
TI  - Nursing care of patients undergoing dynamic cardiomyoplasty.

PMID- 7774274
TI  - What heals? What do nurses do that makes a difference?

PMID- 7774275
TI  - Gastroesophageal reflux: the use of pH monitoring.

PMID- 7774276
TI  - Perforin and granzymes: crucial effector molecules in cytolytic T lymphocyte and
      natural killer cell-mediated cytotoxicity.

PMID- 7774278
TI  - TIA-1: structural and functional studies on a new class of cytolytic effector
      molecule.

PMID- 7774277
TI  - Perforin, killer cells and gene transfer immunotherapy for cancer.

PMID- 7774279
TI  - Calreticulin: a granule-protein by default or design?

PMID- 7774280
TI  - A new function for an old enzyme: the role of DNase I in apoptosis.

PMID- 7774281
TI  - The ligands and receptors of the lymphotoxin system.

PMID- 7774283
TI  - The role of CD28 costimulation in the generation of cytotoxic T lymphocytes.

PMID- 7774282
TI  - Structure and biogenesis of lytic granules.
AB  - Lytic granules are specialized secretory organelles which appear after activation
      of CTLs and NK cells. The lytic granules contain a series of proteins that
      mediate target cell destruction after secretion from the cell. In addition, these
      organelles serve as the lysosomes of these lymphocytes. At the EM level three
      types of granules with distinct regions are distinguished. Intriguingly, lytic
      and lysosomal proteins are localized in distinct regions. This is particularly
      interesting because lysosomal and lytic proteins can use the same sorting
      mechanisms to be targeted to this compartment. We favor the idea that a
      combination of sorting mechanisms result in this final segregation: the MPR
      receptor sorts both lysosomal proteins and granzymes from the Golgi complex, but
      a second event, such as selective aggregation with proteoglycans, then results in
      the segregation of lytic and lysosomal proteins in the granule. Lytic granules
      provide a way to store and simultaneously secrete the lytic proteins in a highly
      specific fashion. The granules are able to move along microtubules using a
      kinesin-like motor, and thus can cluster at the site of membrane contact with a
      target cell. Once polarized, the granules exocytose their contents, using a
      molecular machinery that is as yet poorly defined. Understanding the machinery
      involved in both functions of the lytic granules will provide ways to control the
      action of cytotoxic lymphocytes, ultimately in clinical situations.

PMID- 7774284
TI  - Degranulating cytotoxic lymphocytes inflict multiple damage pathways on target
      cells.

PMID- 7774285
TI  - Granzymes and apoptosis: targeting the cell cycle.

PMID- 7774286
TI  - Effects of vasoactive intestinal polypeptide on the growth processes in rat
      thyroid lobes: studies ex vivo in vitro.
AB  - The effects of intravenous (i.v.) injections of vasoactive intestinal polypeptide
      (VIP) and intraperitoneal (i.p.) injections of thyroid-stimulating hormone (TSH,
      thyrotropin) on 3H-thymidine incorporation into the DNA of rat thyroid lobes
      incubated, after collecting, in vitro, were investigated. The animals of groups 1
      6 were injected with the following substances: group 1, 0.9% NaCl; group 2, 2 IU
      TSH (i.p.); group 3, 10(-12) mol VIP; group 4, 10(-10) mol VIP; group 5, 10(-8)
      mol VIP; and group 6, 10(-8) mol VIP + 2 IU TSH (i.p.). The rats of each group
      were divided into three subgroups, and sacrificed after 6, 12 or 24 h from the
      time of injection. For group 1, the additional control group zero was used, and
      these controls were sacrificed immediately after i.v. injections of 0.9% NaCl at
      zero time. After decapitation the thyroid lobes were collected and then incubated
      for 4 h in RPMI 1640 medium in the presence of 3H-thymidine, 15% FCS and Hepes
      buffer. In all groups and at all times an increase of 3H-thymidine incorporation
      occurred; the stimulatory effect of VIP (in all doses) was stronger than that of
      TSH; the rate of 3H-thymidine incorporation after injections of both VIP and TSH
      (group 6), was higher than the rates following injections of VIP alone (group 5)
      or TSH alone (group 2).

PMID- 7774287
TI  - Age-associated changes of neutrophil responsiveness in a human healthy elderly
      population.
AB  - Conflicting results have been reported on polymorphonuclear (PMN) cell
      responsiveness during senescence. Consequently, neutrophil absolute numbers and
      PMN-mediated chemotaxis, phagocytosis, killing and superoxide anion (O2-)
      generation in healthy aged volunteers divided into different groups according to
      increasing age criteria, were investigated and evaluated. Data provide evidence
      that absolute amounts of PMN cells declined in a significant manner in donors
      over 85 years old only when compared with young subjects. On the contrary,
      regardless of age, the aged individuals exhibited a significant impairment of PMN
      chemotactic, phagocytic and killing functional capacities. Finally, formyl
      methionyl-leucyl-phenylanaline (FMLP)-triggered O2- release was reduced in all
      elderly groups, while depression of O2- production was seen in subjects between
      the age of 86 and 104 years using phorbol 12-myristate 13-acetate (PMA) as
      agonist. These findings indicate that an imbalance in the PMN cell immune
      reactivity occurs throughout the senescence process.

PMID- 7774288
TI  - Transformation of diploid human lung fibroblasts with oncogene ras increases the
      frequency of abnormal mitoses.
AB  - The human oncogene ras p21 was transfected into human lung fibroblast WI-38
      diploid cells. All of the clones that were isolated (n = 36), exhibited rapid
      growth and transformed morphology which was ascertained by both transmission and
      scanning electron microscopy as extensive formations of microvilli on the plasma
      membrane, marked distortion of the nuclear membrane and increased number of
      pinocytotic vesicles in the cortical cytoplasm. The frequency of abnormal
      metaphases rose from 15% in parental WI-38 cells to 35.5-48.4% in all ten clones
      examined. Lagging chromosomes in prometaphase represented 42.1-69.4% of the total
      abnormal mitoses followed in frequency by 3-group metaphase and C-metaphase. All
      transformed cells were aneuploid. These data provide evidence for the association
      between cellular transformation with oncogenic ras and elevated abnormal mitoses
      in human cells.

PMID- 7774289
TI  - Localization of the Cu/Zn superoxide dismutase gene in the Drosophila willistoni
      species group by in situ hybridization.
AB  - Due to the physiological importance of its product, the Cu/Zn superoxide
      dismutase enzyme, the gene coding for this enzyme was mapped in five species of
      the Drosophila willistoni subgroup and in D. nebulosa by in situ hybridization
      using D. melanogaster as a control. The results indicate that this locus is
      located on the XR chromosomal arm of the five sibling species and on the XL
      chromosomal arm of D. nebulosa, suggesting the occurrence of a pericentric
      inversion before the separation of these entities.

PMID- 7774291
TI  - Accumulation of B-chromosomes in drosophila kikkawai Burla.
AB  - Drosophila kikkawai is a unique species in the genus, having two types of B
      chromosomes with distinct centromeres. Laboratory experiments pertaining to their
      accumulation were carried out, using continuous selection and inbreeding
      procedures. Karyotypes with B-chromosomes ranged from 1 to 4. A maximum of four B
      chromosomes in a culture were accumulated which seems to be the maximum tolerable
      limit in this species.

PMID- 7774290
TI  - Vitamin C mediated amelioration of pesticide genotoxicity in murine
      spermatocytes.
AB  - The effect of vitamin C on the genotoxicity of three pesticides (Endosulfan,
      Phosphamidon, Mancozeb) was monitored by screening meiotic (metaphase I)
      chromosomes in the primary spermatocytes of Swiss albino mice, Mus musculus. A
      dose-dependent amelioration by vitamin C was observed in the Phosphamidon-treated
      group where quadruple the therapeutic dose produced maximum amelioration. In
      Endosulfan- and Mancozeb-treated groups, no further amelioration was achieved
      beyond the double dose of vitamin C, and the damage frequency did not come down
      to the control level. The possible mechanism of this effect is discussed.

PMID- 7774292
TI  - Practicing medicine without a license.

PMID- 7774293
TI  - Beta 2-agonists and their antagonists.

PMID- 7774294
TI  - Is thoracic CT performed often enough?

PMID- 7774295
TI  - In search of the appropriate use of chest computed tomography.

PMID- 7774296
TI  - Is living kidney donation still justifiable?

PMID- 7774297
TI  - Aerosol therapy in mechanically ventilated patients.

PMID- 7774298
TI  - Nd-YAG laser pleurodesis via thoracoscopy. Endoscopic therapy in spontaneous
      pneumothorax Nd-YAG laser pleurodesis.
AB  - From January 1986 to February 1993, 85 patients with spontaneous pneumothorax
      were treated in our department by a new endoscopic procedure using an Nd-YAG
      laser beam via thoracoscopy to obtain permanent pleurodesis and to treat the lung
      lesion responsible for the air leak. The 55 men and 30 women ranged in age from
      16 to 51 years (mean age 26 years). Under general anesthesia the thoracoscope was
      introduced through a 1-cm incision in the anterior axillary line of the fourth
      intercostal space. In 68 patients small blebs (less than 2 cm in diameter) were
      detected and successfully resected with low power Nd-YAG laser pulses. In two
      patients found at thoracoscopy to have lesions larger than 2 cm, the Nd-YAG laser
      failed to seal the air leak and thoracotomy was performed. Air leaks were not
      detected at endoscopy in the remaining patients. After treatment of the lung
      lesions, the parietal pleura was abraded by using the laser energy. There were no
      side effects. Eighty patients were treated successfully without recurrence
      (maximum follow-up 86 months). Three other patients developed recurrence of
      pneumothorax after 5, 6, and 24 weeks, and surgery was considered mandatory in 2
      of them. At thoracotomy, in both patients, a small bleb was detected in the lower
      lobe and resected. The whole upper lobe was strongly adherent to the parietal
      pleura in the site of previous laser abrasion. The authors conclude that Nd-YAG
      laser via thoracoscopy should be considered as a viable therapeutic option in
      patients with spontaneous pneumothorax.

PMID- 7774299
TI  - Pleurodesis using talc slurry.
AB  - OBJECTIVE: To determine the efficacy and safety of talc slurry for pleurodesis.
      DESIGN: Retrospective. PARTICIPANTS: All patients who received talc slurry via
      tube thoracostomy at Memorial Sloan-Kettering Cancer Center from March 1991 to
      April 1992. RESULTS: Fifty-eight patients received talc slurry in 75 procedures;
      five patients had 2 unilateral procedures and 12 had bilateral procedures. Fifty
      two patients had malignant pleural effusions with the most common cell types
      being breast (23 of 52, 44 percent), lung (4 of 52, 8 percent), ovarian (4 of 52,
      8 percent), and endometrial (3 of 52, 6 percent). Four patients had benign
      conditions. The mean duration of follow-up was 171 days (range, 2 to 450 days).
      Success, defined as the absence of pleural fluid reaccumulation, was evaluable in
      47 of 73 (64 percent) procedures. Pleurodesis was successful in 38 of 47 (81
      percent). Adverse effects associated with pleurodesis included fever (46 of 73,
      63 percent), empyema (4 of 73, 5 percent), atrial arrhythmia (3 of 73, 4
      percent), hypotension (3 of 73, 4 percent), and hypoxemic respiratory failure (3
      of 73, 4 percent). There were no deaths attributable to the procedure.
      CONCLUSIONS: Talc slurry instilled through a chest tube is an effective bedside
      method of pleurodesis. Fever occurs frequently. Respiratory failure is a rare but
      potentially serious complication that deserves further investigation.

PMID- 7774300
TI  - Spontaneous pneumothorax. Long-term results with tetracycline pleurodesis.
AB  - The aim of this prospective study was to determine the rate of recurrence for
      spontaneous pneumothorax (SP) after tetracycline pleurodesis (TCP), using that of
      observation, tube thoracostomy alone, and thoracotomy as references. From 1985 to
      the end of 1991, 78 patients were treated with tetracycline pleurodesis and 135
      patients served as control subjects. Pleurodesis was induced by instillation of
      tetracycline and ascorbic acid through the pleural drain. The indication was any
      SP treated with tube thoracostomy, without active pulmonary infection. Follow-up
      period was from 13 to 95 months (mean, 45 months); follow-up rate was 94 percent.
      Post-therapy surgery was necessary for eight patients in whom pleurodesis failed
      due to presence of a persistent air leak. The ipsilateral recurrence rate of
      patients treated with TCP was 9 percent (6/66) and recurrence time ranged from 2
      days to 9 months. The recurrence rate for patients treated with observation was
      36 percent, 35 percent for those having chest tube alone, and none for those
      undergoing surgery. No death occurred as a direct result of this procedure and
      all patients could be released from the hospital. Eleven subjects died during the
      follow-up period; the mean follow-up until death was 37 months (range, 2 to 87
      months). Five deaths were due to respiratory causes and six were due to
      extrapulmonary causes. Tetracycline pleurodesis has been shown to be a good
      alternative for the prevention of recurrence of SP. Its recurrence rate is lower
      than that of tube drainage but higher than that of surgical treatment.

PMID- 7774301
TI  - Subclinical surface alterations of human pleura. A scanning electron microscopic
      study.
AB  - Pleuritis or pleural effusion frequently develops in patients with pneumonia or
      heart failure. Most of these pleural changes regress without intrapleural
      intervention. The detailed mechanisms of the regression of the pleural changes in
      humans are not well documented. We studied the parietal pleura of nine patients
      with lung cancer and two patients with coronary artery disease by scanning
      electron microscopy (SEM). All patients had neither radiographic nor gross
      evidence of pleural disease but all had mixed surface alterations by SEM. Focal
      denudation of mesothelial cells was common. Deeper injuries exposed thick and
      thin interweaving collagen bundles. Patchy depositions of amorphous or
      crystallized fibrin covered normal and damaged pleural surfaces, frequently
      admixed with macrophages, red blood cells, and tissue debris. Reactive
      mesothelial cells appeared to proliferate over the fibrin. Our findings suggest
      that subclinical pleural alterations occur often in patients with pulmonary or
      cardiac diseases and that an intact pleural surface in those patients is restored
      mainly by the proliferation of reactive mesothelial cells.

PMID- 7774302
TI  - Cardiopulmonary exercise testing. Determinants of dyspnea due to cardiac or
      pulmonary limitation.
AB  - The aim of this study was to bring to light new and simple criteria, obtained
      during cardiopulmonary exercise testing, in order to demonstrate in patients the
      cardiac or the pulmonary origin of a comparable exertional dyspnea. Forty male
      subjects were compared, who exercised with a 30-W/3-min protocol and were divided
      into three groups: the cardiac heart failure (CHF) group (n = 15), the chronic
      obstructive lung disease (COLD) group (n = 15), and the control group (n = 10).
      The two groups of patients differed totally from the control group concerning
      their spirometric values at rest and a clear inability during effort which was
      confirmed by all the studied cardiopulmonary parameters at maximal exercise. The
      CHF and COLD groups differed slightly concerning their maximum symptom-limited
      oxygen uptake, only when related to body mass (13.26 +/- 0.69 ml/kg/min in CHF
      group, 17.05 +/- 1.59 ml/kg/min in COLD group; p < 0.05), and concerning their
      maximum ventilatory equivalent for oxygen which tended to be higher in the CHF
      group in comparison with the COLD group (p = 0.082). Furthermore, and as
      foreseen, the two groups of patients clearly differed at maximum exercise
      concerning the ventilatory reserve respiratory parameter (49.73 +/- 3.18 percent
      in CHF group, 8.38 +/- 5.85 percent in COLD group; p < 0.01). On the other hand,
      they did not differ concerning cardiac parameters or those considered as such
      (maximum heart rate [HR], HR reserve, HR response, maximum O2 pulse measurement).
      While their maximum ventilation was similar in the CHF and COLD groups, a
      difference in adaptation during exercise was found by observing their breathing
      pattern. In the CHF group, this was demonstrated by a significantly lower
      breathing frequency at maximum exercise (31.24 +/- 1.53 beats/min vs 37.75 +/-
      2.24 beats/min; p < 0.05) and a tidal volume that tended to be higher at maximum
      exercise (p = 0.077) and significantly higher at 60-W work load (p < 0.05). This
      work shows that the study of ventilatory reserve and breathing pattern during
      exercise testing allows one to discriminate if dyspnea on exertion in patients is
      due to cardiac or respiratory disease.

PMID- 7774303
TI  - The effects of exercise testing on the prescription of oxygen therapy.
AB  - This study reviews the effects of using oxygen saturation measurements during
      exercise and the effects of the method of exercise testing on the prescription of
      oxygen therapy. Using cutaneous oximetry (designated A and B models) and co
      oximetry, 25 of 41 patients (model A), 30 of 39 patients (model B), and 28 of 42
      patients (co-oximetry) had an oxygen saturation measurement greater than 85
      percent at maximal incremental exercise despite an arterial oxygen tension less
      than 55 mm Hg. Also, in a group of patients who underwent incremental followed by
      constant work rate testing, 9 of 28 exhibited a fall in arterial oxygen tension
      to 55 mm Hg or below only during the constant work rate testing. Oxygen
      saturation measurements cannot reliably be used as a substitute for arterial
      oxygen tension measurements for the prescription of oxygen therapy. The type of
      exercise study performed may influence the outcome of such oxygen prescription.

PMID- 7774304
TI  - The relationship between oxygen consumption and work rate in patients with
      airflow obstruction.
AB  - The oxygen cost of augmented ventilation is increased in patients with chronic
      obstructive pulmonary disease, either at rest or during exercise. Thus, if
      excessive demands are placed on the respiratory muscles during exercise in these
      patients, we postulate that the total oxygen consumption (VO2) may increase
      relative to the work rate compared to control subjects. The aim of this study was
      to examine the relationship between VO2 and work rate during exercise in patients
      with airflow obstruction. A retrospective analysis of data collected over 7 years
      was conducted. Patients with airflow obstruction (n = 131) were compared and
      contrasted with those in whom pulmonary function studies (spirometry, lung
      volumes) were normal (n = 199). Severity of airflow obstruction (ie, mild
      moderate, severe) was determined, using the 95 percent confidence limits for the
      ratio of FEV1 to FVC. Incremental exercise studies were performed on a cycle
      ergometer. Resting VO2 was not significantly different across the groups with
      airflow obstruction measured either directly or normalized for body weight. The
      VO2max was significantly reduced in the patients with severe airflow obstruction,
      compared with the normal group, as well as the patients with mild and moderate
      airflow obstruction. No differences were noted in the slope of VO2 plotted
      against work rate in the patients with airflow obstruction (regardless of the
      severity of the obstruction) and individuals in whom results of pulmonary
      function tests were normal. In addition, when gender was taken into account,
      there was essentially no difference in the slopes for either male or female
      subjects across all groups. Stepwise, linear regression failed to demonstrate any
      variable or variables that were strongly related to slope. We postulate that the
      maintenance of a normal slope of VO2 on work rate in patients with airflow
      obstruction, in whom the oxygen cost and work of breathing is likely increased,
      may mask a significant reduction in nonrespiratory VO2 (for example, to
      exercising skeletal muscles).

PMID- 7774305
TI  - Role of myocarditis in athletes with minor arrhythmias and/or echocardiographic
      abnormalities.
AB  - We report the clinical and instrumental data, including the endomyocardial biopsy
      findings, of six young athletes presenting with minor arrhythmias and/or
      echocardiographic abnormalities. In one of them, a left ventricular dilation with
      moderate depression of the systolic function had been attributed to an athlete's
      heart. A diagnosis of arrhythmogenic right ventricular dysplasia had been made in
      three others, one with right ventricular dilation and apical hypokinesia, and two
      with ventricular arrhythmias with QRS morphology of left bundle branch block. A
      myocarditis could be unequivocally established in four athletes (two with and two
      without fibrosis). In the remaining two, with a clinical history strongly
      suggesting a previously acute myocarditis, the endomyocardial biopsy specimen
      revealed a nonspecific fibrosis compatible but not definitely pathognomonic of a
      healed myocarditis. Our report suggests that a myocarditis may be a cause of
      minor rhythm disturbances and/or echocardiographic abnormalities in athletes. A
      prevalent localization of the inflammatory process in the right ventricle with or
      without the occurrence of ventricular arrhythmias with left bundle branch block
      morphology can mimic an arrhythmogenic right ventricular dysplasia. An early
      diagnosis of myocarditis in athletes is useful to avoid the risk of fatal
      arrhythmias, also considering that rest still keeps on being one of the most
      effective strategies in myocarditis management.

PMID- 7774306
TI  - Chest radiographs fail to detect right ventricular enlargement and right atrial
      enlargement in patients with a pure restrictive ventilatory impairment.
AB  - The validity of measurements of the cardiac silhouette on chest radiographs for
      the evaluation of right ventricular enlargement and right atrial enlargement in
      patients with a pure restrictive ventilatory impairment was investigated in 19
      patients. The forced vital capacity (FVC) percent predicted in these patients was
      59 +/- 12 percent (mean +/- SD) (range, 29 to 79 percent). Right ventricular
      enlargement, by two-dimensional echocardiography, was defined as a right
      ventricular area > 20.4 cm2 and right atrial enlargement was defined as a right
      atrial area > 15.3 cm2. Chest radiographic measurements in the posteroanterior
      (PA) projection included distance from the midline to the farthest point of the
      right border of the cardiac silhouette, transverse cardiac diameter, and
      cardiothoracic ratio. Measurements in the lateral projection included the lateral
      horizontal transverse diameter, ventral portion of the lateral broad diameter,
      and obliteration of the retrosternal space. Neither the right ventricular area
      nor the right atrial area correlated with any of these radiographic measurements.
      There were no differences in these chest radiographic measurements among patients
      with normal right ventricular and right atrial dimensions, patients with right
      ventricular enlargement, and patients with right atrial enlargement. We conclude,
      therefore, that PA and lateral chest radiographs do not reliably detect right
      ventricular enlargement or right atrial enlargement in patients with a pure
      restrictive ventilatory impairment.

PMID- 7774307
TI  - Paradoxic pulmonary vasoconstriction in response to acetylcholine in patients
      with primary pulmonary hypertension.
AB  - Pulmonary vascular reactivity was assessed during diagnostic heart
      catheterization in two patients with pulmonary hypertension unexplained by
      pulmonary or cardiac disease and in five patients with atypical chest pain and
      normal coronary arteriograms. Acetylcholine, an endothelium-dependent vasodilator
      that also has a direct contracting effect on vascular smooth muscle cells, was
      infused in the right atrium in a step-wise increasing dose in order to obtain
      final blood concentrations in the pulmonary circulation ranging from 10(-6) mol/L
      to 10(-4) mol/L. In the five control patients, acetylcholine induced a dose
      related decrease of pulmonary vascular resistance (-52 percent +/- 9 percent). In
      the patients with primary pulmonary arterial hypertension, however, acetylcholine
      caused a paradoxic increase of pulmonary arterial pressure and of pulmonary
      vascular resistance. Thus, it appears that endothelium-dependent vasodilation is
      impaired in the pulmonary circulation of patients with primary pulmonary arterial
      hypertension. Endothelial dysfunction in the pulmonary circulation may play a
      role in the pathophysiology of this disease.

PMID- 7774308
TI  - Stacked inspiratory spirometry reduces pulmonary shunt in patients after coronary
      artery bypass.
AB  - Atelectasis is a major factor in postoperative morbidity for patients undergoing
      cardiopulmonary surgery. We evaluated the effectiveness of stacked inspiratory
      spirometry (STIS) in 17 patients status postcoronary artery bypass graft in a
      nonrandomized fashion. We measured pulmonary shunt as an endpoint, and compared
      the magnitudes before and after the STIS maneuver. Our results showed an 8.66
      percent reduction in pulmonary shunt (p < 0.05). The reduction in shunt was
      modest; however, repetitive maneuvers might result in greater improvement.

PMID- 7774309
TI  - Noninvasive predictors of systemic embolism in mitral stenosis. An
      echocardiographic and clinical study of 500 patients.
AB  - Few predictors of systemic embolism in patients with mitral stenosis have been
      identified by noninvasive methods. This study used the most powerful noninvasive
      diagnostic tool, transthoracic echocardiography, as well as other noninvasive
      clinical information to look for predictors. Five hundred consecutive patients
      with a mitral valve area of 2 cm2 or less were studied. They were divided into
      two groups: group 1 consisted of 143 patients with a history of systemic embolism
      and group 2 consisted of 357 patients with no history of systemic embolism. Using
      a stepwise logistic regression on a random subsample of 400 patients, 4
      independent predictors were found: the presence of atrial fibrillation (p =
      0.003, relative risk [RR] = 2.3, 95% CI = 1.3, 4.2), the absence of significant
      tricuspid regurgitation (p = 0.008, RR = 2.5, 95% CI = 1.3, 4.9), the absence of
      aortic regurgitation (p = 0.022, RR = 2.2, 95% CI = 1.1, 4.2), and the presence
      of left atrial smoky echoes (p = 0.039, RR = 1.7, 95% CI = 1.1, 3.0). When the
      above model, together with significant interaction terms, was applied to the
      remaining 100 patients, both the Hosmer-Lemeshow and Brown goodness-of-fit
      statistics were not significant (p = 0.888 and p = 0.248, respectively),
      indicating that the fit was adequate and the model was validated. Thus, important
      noninvasive predictors of systemic embolism in patients with mitral stenosis can
      easily be obtained. Subgroups of patients with high risk of systemic embolism can
      be identified. This may refine our therapeutic strategies to prevent the
      catastrophe of systemic embolism.

PMID- 7774310
TI  - Interleukin-2 and soluble interleukin-2 receptor in bronchoalveolar lavage fluid
      from patients with bronchial asthma.
AB  - To clarify the interrelation between interleukin-2 (IL-2) and soluble IL-2R
      receptor (sIL-2R), as products of T-cell activation in the bronchial tree of
      patients with bronchial asthma, we measured the concentration of IL-2, sIL-2R,
      and the cellular composition in bronchoalveolar lavage (BAL) fluid. We also
      measured physiologic parameters, including provocation concentration of histamine
      required to reduce the forced expiratory volume in 1 s by 20 percent of the
      prechallenge baseline (PC20). The concentrations of IL-2 and sIL-2R were higher
      in BAL fluid of symptomatic patients with bronchial asthma than those of normal
      subjects and asymptomatic patients. There was a significant correlation between
      IL-2 and sIL-2 concentrations in BAL fluid of the patients with bronchial asthma.
      Patients with other lung diseases had significantly higher concentration of IL-2
      than normal control; however, sIL-2R was not detected in their BAL fluids. The
      concentration of IL-2 inversely correlated with FEV1 in symptomatic bronchial
      asthma. Among the inflammatory cells in BAL fluid, percentages of eosinophils
      showed significant correlation with the concentrations of IL-2 and sIL-2R in BAL
      fluid of the patients with bronchial asthma. In conclusion, IL-2 within the
      bronchial tree appears to be associated with eosinophil infiltration. This leads
      to physiologic changes in symptomatic patients with bronchial asthma, which may
      be influenced by the presence of sIL-2R in BAL fluid.

PMID- 7774311
TI  - Interleukin-6, interferon-gamma, and phospholipid levels in the alveolar lining
      fluid of human lungs. Profiles in coal worker's pneumoconiosis and idiopathic
      pulmonary fibrosis.
AB  - Cytokines are widely involved in physiologic as well as immunoinflammatory and
      fibrosing processes of the lung. The aim of this work was to study, by
      bronchoalveolar lavage, two groups of human interstitial lung diseases (ILD) with
      fibrosing propensity (ie, idiopathic pulmonary fibrosis [IPF], n = 10; and coal
      worker's pneumoconiosis [CWP], n = 15). Patients were compared with nonsmoker
      control subjects (n = 20). Cellularity, proteins, and phospholipids were
      determined in the alveolar fluids. In addition, two cytokines (interleukin-6 [IL
      6] and interferon-gamma [IFN-gamma]), which are presumed to possess respective
      antifibrotic and profibrotic activities, were measured in the respiratory tract.
      Compared with control subjects, IPF and simple CWP showed alveolar
      hypercellularity (p < 0.05) and relative lymphocytosis (p < 0.05). Both exhibited
      increased alveolar permeability (ie, increased albumin/urea ratio, p < 0.05),
      with enhanced IL-6 and decreased IFN-gamma in the alveolar spaces (p < 0.05). On
      the other hand, IPF displayed an associated polymorphonuclear alveolitis,
      enhanced alveolar epithelial lining fluid (AELF) volume and low surfactant
      phospholipid levels (p < 0.05 vs control), whereas simple CWP shared an exclusive
      lymphocytosis, normal AELF volume, and a surfactant lipid overflow (p < 0.05 vs
      control). Relationships among all of these parameters were found only between
      alveolar cellularity, neutrophils and IL-6 levels in the AELF of IPF
      (respectively, r = 0.85, p = 0.0009, and r = 0.89, p = 0.0006). In summary,
      common alterations of cellular and cytokine turnover were observed in IPF and
      simple CWP and may reflect activity of the antifibrotic fight in these diseased
      lungs. Surfactant phospholipid levels are likely to represent a specific
      disturbance among IPF and CWP, but no clear relationship with respect to the
      other parameters could be established for explaining the difference in time
      course outcome.

PMID- 7774312
TI  - The role of two-segment bronchoalveolar lavage in the diagnosis of pulmonary
      infections.
AB  - STUDY OBJECTIVE: To determine if performing bronchoalveolar lavage (BAL) from
      more than one lung segment augments the diagnostic yield in patients with
      pulmonary infection. PATIENTS AND STUDY DESIGN: Seventy-six patients who
      underwent bisegmental BAL for the diagnosis or exclusion of pulmonary infection
      were studied prospectively. MAIN RESULTS: In patients with AIDS, the
      concentration of Pneumocystis carinii was higher in the upper lobes than in the
      middle lobes, regardless of whether the patients had been receiving pentamidine
      prophylaxis. In patients without HIV infection, the number of P carinii clusters
      was much lower. In 2 of 5 HIV-negative patients, P carinii organisms were
      detectable but in one of two lavage specimens, whereas in only 1 of 19 AIDS
      patients, P carinii organisms were not found in both lavaged segments. In
      bacterial pneumonia, BAL fluid from a segment of the radiologically most involved
      area had a much higher cell concentration, percentage of neutrophils, and
      concentration of bacteria than from the segment that was not or less severely
      involved on chest radiograph. In two of nine patients with AIDS and
      cytomegalovirus (CMV) pneumonia, cytopathogenic CMV effects were not found in
      both lavaged segments. In one of eight patients, mycobacteria could be cultured
      only from one of two radiologically involved segments. CONCLUSION: An increase in
      the diagnostic sensitivity by performing BAL in two lung segments is limited to
      cases where P carinii pneumonia is a relevant consideration in immunocompromised
      patients without HIV infection. In bacterial pneumonia, BAL can be performed in a
      single radiographically involved lung segment without a loss in diagnostic
      sensitivity. Since our study population of patients with CMV pneumonitis,
      mycobacterial infections, and fungal infections was small, no reliable
      conclusions are possible and BAL of more than one lung segment seems justified
      until more information is available.

PMID- 7774314
TI  - Respiratory care practitioners' attitudes toward patients with AIDS.
AB  - OBJECTIVE: To assess attitudes of respiratory care practitioners about AIDS and
      patients with AIDS. DESIGN: A questionnaire that explored attitudes about AIDS
      was disseminated throughout southern New Jersey. Identity of individual
      responders was protected carefully. RESULTS: One hundred fifty-nine responses
      were received. The majority of responders favored identification of patients with
      AIDS, segregation of those patients into AIDS wards, and then avoidance of the
      AIDS wards. There was some bias against patients with known high-risk behaviors
      (especially drug abuse), but once a patient had AIDS the fear of getting AIDS was
      the only factor that correlated (p = 0.001) with the desire to avoid AIDS
      patients. Thirty-nine percent of responders said that they used universal
      precautions less than 90 percent of the time, and no factor (including fear of
      AIDS and markers of education) predicted which therapists did not consistently
      use them. CONCLUSIONS: The desire to avoid AIDS represents a rational desire not
      to become infected with the HIV virus. This study documents an identify-and-avoid
      philosophy in lieu of careful use of universal precautions. Educational efforts
      need to emphasize that the use of precautions represents the only truly effective
      means of preventing infection with the AIDS virus and other communicable
      diseases.

PMID- 7774313
TI  - Bronchodilator pretreatment improves aerosol deposition uniformity in HIV
      positive patients who cough while inhaling aerosolized pentamidine.
AB  - OBJECTIVE: To determine the effect of bronchodilator pretreatment on deposition
      uniformity of aerosolized pentamidine (AP) in HIV-positive patients who coughed
      while inhaling AP. DESIGN: Nonrandomized control trial. SETTING: A university
      hospital. PATIENTS: Ten HIV-positive patients who were using AP prophylactically.
      INTERVENTION: Four patients who coughed during AP administration were pretreated
      with 10 mg metaproterenol aerosol prior to a second inhalation of AP.
      MEASUREMENTS: Skew, a measure of overall deposition symmetry, deposition in the
      apex vs the base of the right lung (A:B ratio), and percentage of change from
      baseline in peak expiratory flow rate (PEFR). RESULTS: At baseline, the average
      (+/- SD) skew value for four subjects who coughed (0.89 +/- 0.19) was
      significantly higher than for six control subjects (0.58 +/- 0.07) (p < 0.01),
      indicating enhanced nonuniformity of AP distribution. After bronchodilator, no
      one coughed and the average skew value was normalized to 0.57 +/- 0.13. The A:B
      ratios at baseline and after metaproterenol were not significantly different,
      suggesting that deposition of AP in the apex, relative to basal deposition, was
      not enhanced by bronchodilator treatment. When no bronchodilator was
      administered, average PEFR decreased to 330 +/- 162 from baseline (410 +/- 84).
      Average PEFR increased to 429 +/- 85 from baseline (395 +/- 116) after
      bronchodilator pretreatment. CONCLUSIONS: These results suggest that in addition
      to relieving cough in patients receiving AP prophylactically, pretreatment with
      metaproterenol enhances uniformity of distribution of AP and improves PEFR.

PMID- 7774315
TI  - Preventive therapy for contacts of multidrug-resistant tuberculosis. A Delphi
      survey.
AB  - OBJECTIVE: Several outbreaks of multidrug resistant tuberculosis (MDR-TB) have
      recently occurred in which healthcare workers and others have become infected.
      Given the lack of clinical data to guide preventive therapy for such contacts, a
      Delphi survey of a panel of 31 TB therapy experts was undertaken to identify a
      consensus regimen. DESIGN: An initial questionnaire presented three scenarios
      describing persons with significant exposure to MDR-TB and with new tuberculin
      skin test reactions > 15 mm (except one anergic patient) without evidence of
      disease. Panelists were asked to suggest possible preventive therapy regimens.
      METHODS: During a second round survey, the panel members were asked to review the
      suggested regimens provided for each scenario and to rank them from one to nine
      as extremely inappropriate to extremely appropriate. Results of this second
      survey were tabulated and shared with the members of the panel who were then
      asked to rerank each regimen in light of the previous cumulative panel responses.
      RESULTS: No specific regimen achieved initial positive consensus by predefined
      criteria. In two of the three scenarios the no treatment option, however, was
      deemed clearly inappropriate. The data were also analyzed by what percentage of
      respondents who ranked a regimen as at all appropriate (ie, six or more on the
      nine point scale). For scenarios involving a nurse, an HIV-positive tuberculin
      reactor, and a patient who was anergic HIV-positive, treatment with pyrazinamide
      1,500 mg daily with ciprofloxacin 750 mg twice a day for 4 months received a
      somewhat appropriate rating from more than 50 percent of respondents.
      CONCLUSIONS: The management of persons exposed to and infected by patients with
      MDR-TB has become a serious problem in the context of MDR-TB outbreaks. This
      panel of experts agreed that some form of preventive therapy was warranted;
      however, they were not able to reach defined consensus on what regimen should be
      used, although a regimen of pyrazinamide 1,500 mg daily with ciprofloxacin 750 mg
      twice a day for 4 months was considered somewhat appropriate. Clinical data on
      the efficacy of alternative preventive therapy regimens for such contacts are
      urgently needed.

PMID- 7774316
TI  - Mycobacterial infection in renal transplant recipients.
AB  - STUDY OBJECTIVE: To determine the prevalence and presentation of mycobacterial
      infection as well as the influence on outcome in graft function and patient
      survival in renal transplant recipients at our institution. DESIGN: A
      retrospective review of case records of all renal transplant recipients from 1980
      to 1992. SETTING: Groote Schuur Hospital, a large teaching hospital and regional
      tertiary referral center in Cape Town, South Africa. PATIENTS: During the period
      reviewed, 857 transplants were performed. The records of 487 patients who had
      remained in Cape Town were examined. RESULTS: There were 22 cases of
      mycobacterial infection (21 confirmed or presumed Mycobacterium tuberculosis and
      1 unidentified Mycobacterium other than tuberculosis). In seven cases,
      immunosuppression had been intensified within 3 months of diagnosis. The median
      time from transplantation to diagnosis was 14 months (range, 2 to 74). Chest
      radiograph findings included consolidation (14), miliary pattern (4), pleural
      effusion (3), tuberculoma (2), cavitation (2), and hilar lymphadenopathy (1).
      Diagnosis of tuberculosis was made on sputum smears (eight), pleural biopsy
      specimen (two), fine-needle aspiration (one), and fiberoptic bronchoscopy in ten
      cases (brushings, eight; transbronchial biopsy specimen, three). Extrapulmonary
      tuberculosis (in addition to pulmonary tuberculosis) occurred in five patients
      (tuberculous meningitis, one; renal tuberculosis, one; and dissemminated
      infection, four). Five of the seven patients in whom immunosuppression had been
      intensified had concurrent infections; two of these died and the remainder
      returned to dialysis within 6 months. All but one patient received three
      antituberculosis drugs, including rifampin and isoniazid, for between 6 and 18
      months. At the end of the period of review, 12 (59 percent) patients were alive,
      10 with functioning grafts and 2 receiving dialysis. Four patients died while
      receiving antituberculosis treatment, but death was only directly related to
      tuberculosis in one case. CONCLUSIONS: Tuberculosis is an important infection in
      renal transplant recipients in Cape Town, but disseminated disease is less common
      than reported elsewhere.

PMID- 7774317
TI  - Reduction of environmental tobacco smoke exposure among asthmatic children: a
      controlled trial.
AB  - STUDY OBJECTIVE: This randomized clinical trial tested a behavioral medicine
      program designed to reduce asthmatic children's exposure to environmental tobacco
      smoke (ETS) in the home. DESIGN: Families were randomly assigned to an
      experimental preventive medicine counseling group, a monitoring control group, or
      a usual treatment control group. Families were measured six times over 1 year.
      PARTICIPANTS: Ninety-one families were recruited from four allergy clinics.
      INTERVENTION: The experimental group received a 6-month series of counseling
      sessions designed to decrease ETS exposure. This group also monitored smoking,
      exposure, and children's asthma symptoms. The monitoring group did not receive
      counseling and the usual treatment control group received outcome measures only.
      MEASUREMENTS AND RESULTS: Parents reported the daily number of cigarettes
      children were exposed to during the week preceding interviews. A nicotine air
      monitor and construct validity analysis confirmed the validity of exposure
      reports. Exposure to the parent's cigarettes in the home decreased for all
      groups. The experimental group attained a 79 percent decrease in children's ETS
      exposure, compared with 42 percent for the monitoring control and 34 percent for
      the usual treatment control group. Repeated-measures analysis of variance
      resulted in a significant (F([10,350] = 1.92, p < 0.05) group by time effect. At
      the final 12-month visit, the experimental/counseling group sustained a 51%
      decrease in children's exposure to cigarettes in the home from all smokers, while
      the monitoring control group showed an 18% decrease and the usual treatment
      control group a 15% decrease from pre-intervention [corrected]. CONCLUSION: A
      behavioral medicine program was successful in reducing exposure to ETS in the
      home for these asthmatic children.

PMID- 7774318
TI  - Demographic influences on asthma hospital admission rates in New York City.
AB  - Surveillance reports describe an increase in asthma prevalence, and cite New York
      City as an area of excessive asthma mortality. To assess trends and the influence
      of geography, race, and ethnicity on hospital admission rates for asthma between
      1989 and 1991, data of all admissions for asthma to New York City hospitals were
      reviewed. The average citywide annual hospital admission rate was 681 per 100,000
      population, and the racial and ethnic distribution was 1,003 per 100,000 Hispanic
      patients, 810 per 100,000 for blacks, and 242 per 100,000 for whites (p <
      0.0001). Bronx and Manhattan had the highest admissions rates, and contained a
      few zip codes with very high rates. In these zip codes, admission rates were
      consistently highest among Hispanics, followed by blacks and whites. New York
      City asthma admission rates increased 12.7 percent during the study. Very high
      admission rates among Hispanic patients and high rates in blacks, in specific
      geographic areas, are responsible for this trend. Targeted education and
      treatment programs could reduce hospital admissions and mortality in small
      geographic areas with high asthma morbidity.

PMID- 7774319
TI  - Association between reported use of inhaled triamcinolone and differential short
      term responses to aerosolized albuterol in asthmatics in an emergency department
      setting.
AB  - Forty-four adult patients with acute asthma were treated with albuterol at a rate
      of 15 mg/h over 2 h. Analysis of covariance showed a significantly higher
      baseline adjusted mean for both percent predicted forced expiratory volume in 1 s
      (PFEV1) (p = 0.045) and percent predicted forced vital capacity (PFVC) (p =
      0.022) at 50 and 110 min for the patients who reported triamcinolone use.
      Although heart rates decreased overall during the first hour of albuterol
      treatment, a rise in mean heart rate occurred during the second hour of treatment
      only in patients reporting triamcinolone use (p = 0.005). After accounting for
      the effects of parenteral corticosteroids, the effect of reported triamcinolone
      use remained significant. These data suggest that use of inhaled corticosteroids
      in this context may be associated with enhanced local and systemic beta
      responsiveness, and if a causal relationship could be confirmed, this may
      constitute yet another advantage of early inhaled corticosteroid treatment in
      asthma. These data also suggest that chronotropic effects of high-dose albuterol
      should be monitored in patients using inhaled triamcinolone.

PMID- 7774320
TI  - Roxithromycin reduces the degree of bronchial hyperresponsiveness in children
      with asthma.
AB  - We evaluated the effects of a new semisynthetic macrolide antibiotic,
      roxithromycin, on the bronchial hyperresponsiveness to histamine in children with
      asthma. Twelve hospitalized asthmatic children, aged 11 to 15 years (mean age,
      12.9 years), were enrolled in this study. They were treated with 150 mg of
      roxithromycin once a day orally for 8 weeks without any side effects. The PC20
      value 4 or 8 weeks after the administration of roxithromycin increased
      significantly over the initial values (p < 0.05, p < 0.01, respectively). No
      significant change was observed in serum theophylline concentrations during this
      study. Serum cortisol level in the morning did not change after the
      administration of roxithromycin for 4 weeks. These results suggest that
      administration of roxithromycin may act favorably in the treatment of childhood
      asthma.

PMID- 7774321
TI  - Reduction in patient timing errors using a breath-activated metered dose inhaler.
AB  - Delivery of aerosol medication to the lower respiratory tract by metered dose
      inhaler (MDI) is often limited by the patient's inability to properly coordinate
      activation of the device with inspiration. This study evaluated a new breath
      activated MDI device, designed to minimize patient timing errors by sensing
      inspiratory flow and automatically activating to deliver aerosol medication.
      Twenty novice adult volunteers, previously naive to the technique of MDI use, and
      20 patients currently using MDIs were tested in their ability to coordinate MDI
      usage. Simultaneous recording of respiratory events and device activation allowed
      analysis of timing errors. With a conventional MDI, a 31.0 percent incidence of
      errors was seen in the novice group and a 21.5 percent incidence of errors was
      seen in the experienced group. These compared with error rates using the breath
      activated MDI of 6.5 percent and 5.0 percent in the two groups respectively (p =
      0.009, p = 0.04). The breath-activated inhaler was preferred by 35 of 40
      subjects. In conclusion, MDI technique timing errors were significantly less with
      this breath-activated MDI device in both novice and experienced subjects, and it
      was also preferred by both groups.

PMID- 7774322
TI  - Cardiac arrhythmias, snoring, and sleep apnea.
AB  - We investigated the frequency of cardiac arrhythmias in patients suspected of
      having sleep apnea, and related them to the severity of apnea, snoring, and
      nocturnal hypoxemia. We prospectively studied 458 patients who had nocturnal
      polysomnography which included objective measurement of snoring (quantified by
      the number of snores per hour of sleep [snoring index (SI)] and maximum nocturnal
      sound intensity [(dBmax)], as well as examination of the electrocardiogram
      (modified lead 2). We found 58 percent prevalence of arrhythmias in patients with
      sleep apnea (apnea/hypopnea index = AHI > 10), vs 42 percent in nonapneic
      controls (chi 2 = 16.7, p < 0.0001). Patients with arrhythmias had more severe
      apnea and nocturnal hypoxemia, but not snoring, than patients without
      arrhythmias. To examine separately the relationship between the prevalence of
      arrhythmias and snoring, nocturnal oxygenation, and apnea--we selected subgroups
      of patients "at the opposite ends of the spectrum" with respect to the severity
      of snoring, hypoxemia, and apnea. We found that 38 percent of light snorers had
      arrhythmias vs 39 percent of heavy snorers, 82 percent of patients with mean
      nocturnal oxygen saturation < 90 percent had arrhythmias vs 40 percent of
      patients with mean nocturnal oxygen saturation > 90 percent (chi 2 = 7.4, p =
      0.006), and 70 percent of patients with AHI > or = 40 had arrhythmias vs 42
      percent with AHI < or = (chi 2 = 9.2, p = 0.002). We conclude that patients with
      sleep apnea as a group have higher prevalence of cardiac arrhythmias than
      nonapneic patients and that snoring alone, without concomitant sleep apnea, is
      not associated with increased frequency of cardiac arrhythmias.

PMID- 7774323
TI  - Accuracy of end-tidal and transcutaneous PCO2 monitoring during sleep.
AB  - STUDY OBJECTIVE: Although it is intuitively desirable, the measurement of
      arterial carbon dioxide tension (PaCO2) during diagnostic polysomnography and
      nocturnal trials of positive pressure therapy is invasive and potentially
      expensive. The accuracy of end-tidal carbon dioxide tension (PETCO2) and
      transcutaneous carbon dioxide (tcPCO2) monitoring in these contexts has not been
      systematically evaluated. This investigation was undertaken to evaluate the
      accuracy of PETCO2 and tcPCO2 in patients undergoing polysomnography. METHODS AND
      PROCEDURES: Values of PETCO2 were compared with PaCO2 in 19 patients
      spontaneously breathing room air (condition 1), in 13 patients receiving
      supplemental oxygen via nasal cannula (condition 2), and in 22 patients receiving
      nocturnal positive pressure ventilatory assistance (all but one with continuous
      positive airway pressure or bilevel positive airway pressure) (condition 3). The
      accuracy of tcPCO2 monitoring during sleep was also examined by comparing tcPCO2
      values with simultaneously recorded PaCO2 values obtained during sleep in
      patients undergoing nocturnal polysomnography. Data were collected using three
      commercially available brands of tcPCO2 monitors (capnograph R, n = 17 patients;
      capnograph S, n = 17; and capnograph N, n = 15). RESULTS: Accuracy of PETCO2-
      There was significant scatter in the PaCO2 vs PETCO2 relationship such that only
      23 percent of the variability in PaCO2 was explained by variation of PETCO2
      during condition 1 and only 15 percent and 20 percent of the variability in PaCO2
      was explained by variation of PETCO2 during conditions 2 and 3, respectively.
      21.3 percent of patients had average PETCO2 values in error by > 10 mm Hg during
      condition 1, while during conditions 2 and 3, 46.2 and 63.7 percent of patients
      had average values in error by > 10 mm Hg, respectively. Accuracy of tcPCO2-
      While capnographs S and N generally overestimated PaCO2 with a wide scatter,
      capnograph R tended to have offsetting overestimations and underestimations of
      PaCO2 with a wide scatter. With each capnograph, a relatively small portion of
      the variability of the PaCO2 was explained by variability of the tcPCO2 (r2 =
      0.2, 0.45 and 0.64 for capnographs S, N, and R, respectively). Across the three
      capnographs, 43.1 to 66.7 percent of measurements were in error by > 10 mm Hg,
      and 5 to 20 percent of measurements reflected errors > 20 mm Hg. There was no
      consistent relationship between the tcPCO2 error and the level of PaCO2, nor was
      the tcPCO2 error consistent in individual patients. There was no relationship
      between tcPCO2 accuracy and body mass index. CONCLUSION: Neither PETCO2, measured
      within a face mask, nor tcPCO2 is a consistently accurate reflection of PaCO2.
      This limits the utility of these variables in monitoring patients during
      diagnostic and therapeutic sleep studies, and in particular, during trials of
      nocturnal ventilatory assistance where adequate levels of support are to be
      established and unacceptable hyperventilation and respiratory alkalosis must be
      recognized.

PMID- 7774324
TI  - The radiographic findings of fibrosing mediastinitis.
AB  - We retrospectively reviewed the radiographic findings of fibrosing mediastinitis
      (FM) in 33 patients. Imaging studies included chest radiographs, computed
      tomographic scans, magnetic resonance imaging examinations, esophograms,
      ventilation perfusion scans, angiograms, and venograms. Findings include
      bronchial narrowing in 11 patients (33 percent), pulmonary artery
      obstruction/narrowing in 6 patients (18 percent), esophageal narrowing in 3
      patients (9 percent), and superior vena cava obstruction/narrowing in 13 patients
      (39 percent). Two distinctly different radiographic patterns were identified: a
      localized pattern seen in 27 patients (82 percent) that frequently contained
      calcification and a diffuse pattern seen in 6 patients (18 percent) that did not
      contain calcification. The localized pattern is most likely due to histoplasmosis
      and does not show radiographic evidence of improvement with steroid therapy. The
      diffuse pattern may more likely be truly idiopathic or of a noninfectious
      etiology. Several patients with the diffuse pattern showed radiographic evidence
      of improvement with steroid therapy.

PMID- 7774325
TI  - Radiologic findings of adult primary immunodeficiency disorders. Contribution of
      CT.
AB  - STUDY OBJECTIVE: We wished to review the chest radiographic and computed
      tomographic (CT) findings in adults with primary immunodeficiency disorders, and
      to evaluate the influence of CT on the treatment of these patients. DESIGN:
      Retrospective blinded review of radiographs, CT scans, and clinical data.
      SETTING: National referral center for immunodeficiency disorders. PATIENTS: Forty
      six chest radiographs and 22 CT examinations of subjects with primary
      immunodeficiency disorders were independently scored. Nineteen of the subjects
      who had CT scans had B-cell deficiency, while 3 had T-cell deficiency. RESULTS:
      CT-detected bronchiectasis in 15 of 19 subjects with B-cell deficiency, compared
      with 7 cases detected on chest radiograph. Unsuspected upper lobe bronchiectasis
      was found on CT in 15 cases. Other CT findings in this group included small
      nodules in seven subjects, interstitial lines in four, air trapping in seven,
      ground glass or parenchymal consolidation in nine, evidence of small airways
      disease in nine, and mucus plugs in four. Two of the three subjects with T-cell
      disorders showed cavitation and two had unsuspected reactive mediastinal
      adenopathy. Clinical management appeared to be altered in five subjects with B
      cell deficiency by CT findings of severe focal or diffuse bronchiectasis or small
      airways disease. Additionally, CT localized the bleeding site in three subjects
      with hemoptysis. CONCLUSIONS: CT is valuable for detection of bronchiectasis in
      subjects with B-cell immunodeficiency and may alter treatment of these patients.

PMID- 7774326
TI  - Chemoprevention effects on bronchial squamous metaplasia by folate and vitamin
      B12 in heavy smokers.
AB  - The purpose of this study was to observe the effects of folate and vitamin B12 on
      bronchial squamous metaplasia with cellular atypia, known to be a precancerous
      change, in heavy smokers. Cases of squamous metaplasia were recognized on sputum
      cytologic study. The location of bronchial lesions was identified by
      bronchofiberoscopy in all cases. The grade of cellular atypia was evaluated on
      the basis of histologic specimens. Thirty-eight patients with squamous
      metaplasia, including 21 patients receiving folate and vitamin B12 and 17
      patients without any medication, were investigated prospectively for 1 year.
      Consecutive bronchofiberoscopic examinations were performed in each patient in 3
      to 4 months after the first examination in order to evaluate the lesions. Grades
      of cellular atypia were examined by histologic specimens using a scoring system
      from 0 to 3. There was no significant difference in mean scores at entry in the
      medication group (1.7) and control group (1.4). The medication group showed
      significant decrease in mean scores (0.4) while the control group had no change
      in mean scores (1.2) at termination. Plasma levels in the medication group were
      significantly increased at termination of the study while those of the control
      group showed a slight decrease. The results show that the cellular atypia
      squamous metaplasia in heavy smokers can be reduced by administration of folate
      and vitamin B12.

PMID- 7774327
TI  - Persistent respiratory health effects after a metam sodium pesticide spill.
AB  - STUDY OBJECTIVE: To report the occurrence of persistent respiratory disorders,
      including irritant-induced asthma, among adults living and working near an
      environmental spill of the pesticide, metam sodium, after the derailment of a
      tank car. DESIGN: Retrospective clinical case series. SETTING: California
      communities situated within one-half mile of the Sacramento River, from Mt.
      Shasta City to Shasta Lake. PATIENTS: 197 adults referred to a university
      occupational/environmental health clinic or to a private
      occupational/environmental health practitioner for evaluation of health problems
      potentially related to the spill. MEASUREMENTS AND RESULTS: History, physical
      examination, review of medical records, spirometry, and methacholine challenge
      testing revealed 20 cases of persistent irritant-induced asthma and 10 cases of
      persistent exacerbation of asthma. CONCLUSIONS: This is the first reported series
      of cases of persistent irritant-induced asthma involving both community residents
      and occupationally exposed individuals.

PMID- 7774328
TI  - Mortality due to farmer's lung in Finland.
AB  - Fatal cases of farmer's lung (FL) are rare. We found, based on death
      certificates, 13 cases of FL with a fatal outcome in Finland between 1980 and
      1990. Compared with incidence data from the years 1980 to 1982, the mortality was
      estimated as 0.7 percent. On average, death occurred 8 years after the diagnosis
      of FL. One patient died acutely after a heavy mold exposure. The other patients
      had chronic disease. Among them the immediate cause of death was pneumonia in
      seven patients, respiratory insufficiency in four, and pneumothorax in one
      patient. The majority of these patients with a fatal outcome had suffered from
      symptoms of FL for more than 1 year before the diagnosis was established and
      fibrotic changes were already visible in the chest radiograph at the time of the
      diagnosis.

PMID- 7774329
TI  - Immune responses to Aspergillus fumigatus and Pseudomonas aeruginosa antigens in
      cystic fibrosis and allergic bronchopulmonary aspergillosis.
AB  - Allergic bronchopulmonary aspergillosis (ABPA) in Cystic Fibrosis (CF) is well
      documented. Aspergillus fumigatus is the causative agent of ABPA, and Pseudomonas
      aeruginosa particularly the mucoid variety has been frequently isolated from the
      sputum of patients with CF. This study investigates the cellular and humoral
      immune response to both A fumigatus and P aeruginosa antigens in patients with CF
      and ABPA (CF/ABPA), CF only, and healthy controls. The A fumigatus and P
      aeruginosa antigen specific IgE and IgG in sera and peripheral blood mononuclear
      cell culture supernatants (PBMC sups), lymphoproliferation to antigens, and
      leukotriene B4 (LTB4) were measured. Results indicate significant elevated levels
      of A fumigatus specific IgG (A fumigatus-IgG) and Paeruginosa-IgE in serum.
      Significant Paeruginosa-IgG was measured in PBMC sups. The concanavalin A
      nonbinding A fumigatus antigen, previously shown to induce specific T-cell
      responses in vitro in patients with ABPA, elicited significant
      lymphoproliferative response in a greater proportion of patients with CF/ABPA and
      not in CF or controls, underlining the importance of this antigen in the
      diagnosis of ABPA. In contrast, a greater proportion of the CF group responded to
      P aeruginosa antigens compared with the controls and CF/ABPA. Hence, the CF and
      CF/ABPA groups respond to both P aeruginosa and A fumigatus antigens with the
      former group responding strongly to P aeruginosa and the latter to A fumigatus
      antigens.

PMID- 7774330
TI  - A simplified insertion technique for tracheobronchial silicone stents.
AB  - In many patients with central airway obstruction due to extrinsic compression or
      malacia, insertion of tracheobronchial stents can provide effective and permanent
      relief. Of the various types of prostheses described, the silicone Dumon-Artemis
      stents (Medicore, Brussels, Belgium) are probably the most efficient. The use of
      an elegant and safe specially designed stent introducer system combined with a
      special bronchoscope is proposed for insertion by Dumon. This combined stent
      insertion system, however, is relatively expensive and cumbersome, especially for
      centers where relatively limited numbers of patients are treated. We propose an
      alternative, simplified insertion technique of silicone Dumon-Artemis stents,
      which was proven safe and efficient in our series of patients.

PMID- 7774331
TI  - Quality of life after cardiopulmonary resuscitation.
AB  - OBJECTIVES: This study evaluates the influence of Cardiopulmonary Resuscitation
      (CPR) on the components of quality of life (QOL) of patients after discharge from
      the hospital. DESIGN: Extracted from a prospective national survey on Dutch
      intensive care units (ICUs). SETTING: Thirty-six ICUs of both university and
      nonuniversity hospitals, spread throughout the country. METHODS: For a period of
      6 months, 9,803 consecutive ICU admissions entered the study. Outcome in
      connection with in-hospital CPR was analyzed by comparing the CPR group (n = 477)
      with a standardized control group without CPR (n = 500). INTERVENTIONS:
      Activities of daily living were registered at the time of hospital admission. A
      record was kept of each patient for demographics, severity of illness, length of
      stay, daily use of manpower and ICU technology, and mortality. Six months after
      hospital discharge, the QOL of 69 patients in both the CPR and control groups was
      measured with the Sickness Impact Profile (SIP). RESULTS: CPR was performed in
      4.8 percent of the patients, mainly from the general ward. These patients were
      older, had a higher severity of illness, and a higher daily consumption of
      nursing resources. The QOL did not correlate with severity of illness on
      admission, length of stay, or consumption of resources in the ICU. On the whole,
      the SIP scores of both CPR and control groups did not differ much: 11.7 vs 10.7,
      and circulatory arrest did not appear to impair the self-sufficiency in the study
      group significantly in comparison with the controls. An increased dysfunction was
      found in the CPR group of patients concerning their work and their psychosocial
      functioning. CONCLUSION: Patients who have recovered from a circulatory arrest
      after CPR resuscitation find their capacity for resuming work diminished after
      discharge from the hospital, while they seem to experience a postponed negative
      effect on their mental functioning, especially the functions connected with the
      awareness of their environment.

PMID- 7774332
TI  - Tracheal aspirate correlates with protected specimen brush in long-term
      ventilated patients who have clinical pneumonia.
AB  - STUDY OBJECTIVE: This study was undertaken to determine whether tracheal aspirate
      cultures correlate with protected specimen brush (PSB) cultures in the diagnosis
      of probable ventilator-associated pneumonia (VAP). DESIGN: Retrospective
      evaluation of 52 episodes of clinical pneumonia in 38 patients who underwent
      bronchoscopy and PSB as well as tracheal aspirate cultures. SETTING: The study
      took place in long-term, acute care hospital associated with a university medical
      school. This hospital specializes in ventilator-assisted patients. PATIENTS: The
      patient population consisted of long-term ventilated patients (average
      ventilation time was 22 weeks; range, 4 weeks to 3 years) who presented with the
      clinical diagnosis of VAP (fever, increased white blood cell count, new
      infiltrate on chest radiograph, and bronchorrhea). No patient had received
      antibiotics for the preceding 5 days at the time of bronchoscopy or tracheal
      aspirate culture. MEASUREMENTS: The tracheal aspirate and PSB culture and
      sensitivities results. RESULTS: Identical organisms were recovered in both the
      tracheal aspirate and PSB cultures in 36 of 52 episodes of VAP (69 percent). No
      organism was recovered in either the tracheal aspirate or the PSB in 4 of 52
      suspected episodes (8 percent). Positive bacterial cultures in the tracheal
      aspirate but not the PSB were found in 8 of 52 (15 percent) episodes. In 3 of 52
      episodes (6 percent), 1 isolate of pathogenic bacteria was found on PSB and 2
      were found on tracheal aspirate cultures. However, all three isolates had the
      similar antibiotic sensitivities. In the final episode, the PSB culture grew an
      organism that was not present in the tracheal aspirate culture (2 percent). When
      comparing the tracheal aspirate with the PSB, the following were calculated:
      sensitivity = 97.7 percent; specificity = 50 percent; positive predictive value =
      91.3 percent; and negative predictive value = 80 percent. CONCLUSION: Tracheal
      aspirate cultures correlate with PSB cultures in patients receiving long-term
      ventilation who have clinical pneumonia, and they can be used to direct initial
      antibiotic therapy in this group of patients.

PMID- 7774333
TI  - Pulmonary endothelial permeability in patients with severe lung injury. Clinical
      correlates and natural history.
AB  - STUDY OBJECTIVE: To establish the natural history of lung injury in adult
      respiratory distress syndrome (ARDS) in terms of increased pulmonary vascular
      permeability. Secondly, to relate such changes to the number of neutrophils in
      bronchoalveolar lavage (BAL) and a clinical score of the severity of lung injury.
      DESIGN: Prospective, open. SETTING: Adult intensive care unit of a tertiary
      (national) referral hospital. PATIENTS: Fourteen patients meeting accepted
      diagnostic criteria for ARDS. INTERVENTIONS: Mechanical ventilatory support.
      Conventional intensive care and support for other failed organ systems as
      appropriate. MEASUREMENTS AND RESULTS: Pulmonary vascular permeability was
      estimated using a dual isotope technique (protein accumulation index [PAI]),
      neutrophil numbers by BAL and the severity of ARDS by the lung injury score
      (LIS). The PAI and LIS were measured simultaneously on three occasions as far
      apart as possible during the course of the illness. A single BAL was performed
      immediately after one of the three PAI/LIS measurements, the precise timing being
      dictated by the clinical stability of each patient. Fourteen patients (8 male;
      age range, 19 to 69 years) were studied, 1.40 +/- 0.16, 11.36 +/- 1.79, and 20.90
      +/- 2.30 days after the onset of ARDS (mean +/- SEM). Six patients died. The PAI
      (normal range, 0 to 1.0 x 10(-3)) was 2.81 +/- 0.39, 2.94 +/- 0.48, and 2.80 +/-
      0.87; and LIS (severe injury > or = 2.5) was 2.18 +/- 0.25, 2.48 +/- 0.14, and
      2.06 +/- 0.27, respectively. The BAL neutrophil content was 54.09 +/- 8.89. There
      were significant positive correlations between PAI and LIS (r = 0.73, p < 0.001)
      and PAI and BAL neutrophil content (r = 0.81, p < 0.001). CONCLUSIONS: These data
      suggest that increased pulmonary vascular permeability persists throughout the
      course of ARDS and is related to a clinical score of injury severity and BAL
      neutrophil content.

PMID- 7774334
TI  - Comparison of pressure and flow triggering systems during continuous positive
      airway pressure.
AB  - STUDY OBJECTIVE: Compare the inspiratory work of breathing (WOBI) during pressure
      triggering (PT), and flow triggering (FT) using two microprocessor ventilators.
      DESIGN: A randomized, crossover comparison of triggering strategies and
      ventilators used. SETTING: Surgical intensive care unit. PATIENTS: Ten patients
      recovering from acute respiratory failure (eight men, two women; mean age, 48 +/-
      12 years) breathing on continuous positive airway pressure (CPAP) of 5 cm H2O
      were studied. INTERVENTIONS: Patients were randomly assigned to either receive 5
      cm H2O CPAP via one of two units (Hamilton Veolar or Puritan Bennett 7200ae)
      using either PT or FT. Each patient had 30-min trials using the following: (1)
      Veolar FT; (2) Veolar PT; (3) 7200ae FT; and (4) 7200ae FT. MEASUREMENTS AND
      RESULTS: During each trial period, work of breathing (WOB) and pressure time
      product (PTP) were measured using a respiratory monitor (Bi-core CP-100). All
      patients were placed in semi-Fowler position and esophageal balloons were
      inserted and their position confirmed using the occlusion technique. Continuous
      measurements of peak negative pressure during inspiration, tidal volume (VT),
      minute ventilation (VE), respiratory frequency (f) were accomplished with a flow
      transducer at the proximal airway. FT with the 7200ae was superior to PT as
      measured by both the WOB (0.58 +/- 0.3 vs 0.84 +/- 0.2 J/L, p < 0.01) and PTP
      (148 +/- 50 vs 206 +/- 41 cm H2O/s/min, p, 0.05). FT with the Veolar was also
      superior to PT with respect to the WOB (0.53 +/- 0.2 vs 0.93 +/- 0.2 J/L, p <
      0.01) and PTP (140 +/- 39 vs 229 +/- 46 cm H2O/s/min, p < 0.05). CONCLUSION: FT
      reduces the WOB compared with PT, regardless of the ventilator used. The
      reduction in WOB during FT is related to improved responsiveness and changes in
      the posttrigger phase.

PMID- 7774335
TI  - Portable chest radiographs identify mechanical ventilator-associated
      hyperinflation.
AB  - OBJECTIVE: Portable chest radiographs (CRs) are obtained routinely in
      mechanically ventilated patients, but little is known about relationships between
      CR findings and ventilator parameters. It is unclear whether radiographically
      apparent hyperinflation correlates with tidal volume (VT), body weight (BW),
      VT/kg, or levels of peak airway pressure (PAP), positive end-expiratory pressure
      (PEEP), or pressure support (PS). DESIGN: Prospective comparison of CR and
      ventilator parameters in 62 mechanically ventilated patients in surgical and
      medical intensive care units of a university hospital. PATIENT SELECTION: All
      mechanically ventilated adults with portable CR on four separate dates. METHODS:
      Chest radiographs were classified by subjective assessments as hyperinflated (H+)
      or nonhyperinflated (H-), independent of knowledge of patients or their
      mechanical ventilation. Chest radiographs were reclassified independently as H+,
      H-, or indeterminate by a radiologist using objective criteria. Ventilator
      parameters recorded at the time of the CR were obtained and compared. RESULTS:
      Patients with CRs classified subjectively as H+ compared with patients with CRs
      classified as H- had a larger VT/kg (12.0 +/- 0.4 ml/kg [mean +/- SEM] vs 10.2 +/
      0.4; p = 0.004), lower BW (70.8 +/- 2.9 kg vs 81.5 +/- 3.8; p = 0.03), higher
      PEEP (6.5 +/- 0.5 cm H2O vs 5.0 +/- 0.4; p = 0.01), and higher PAP (38.2 +/- 2.1
      cm H2O vs. 33.4 +/- 1.8; p = 0.06). Using objective CR classifications, patients
      with H+ CRs had a VT/kg of 12.6 +/- 0.4, larger than in the indeterminate (11.1
      +/- 0.8) and H- (9.9 +/- 0.3) groups (p < 0.001). The BW differed among
      objectively classified groups (66.5 +/- 2.7 H+, 68.9 +/- 5.1 indeterminate, and
      85.2 +/- 3.7 H-; p < 0.001), but other ventilator parameters did not correlate
      univariately with the degree of inflation on CR. Multivariate analysis showed
      that higher VT was predictive of H+ after adjusting for BW in subjective (p =
      0.076) and objective (p = 0.017) classifications. PEEP (p = 0.004) and older age
      (p = 0.021) were also associated with H+ in multivariate analysis. Four of 25 (16
      percent) patients with objectively H+ CRs developed barotrauma, while no patient
      with H- CR had this complication (p = 0.037). CONCLUSIONS: In mechanically
      ventilated patients, hyperinflation seen on portable CR is associated with higher
      VT, VT/kg, and lower BW, and may help predict subsequent barotrauma.

PMID- 7774336
TI  - Regular beta-adrenergic agonists. Evidence, not reassurance, is what is needed.

PMID- 7774337
TI  - Administration of therapeutic aerosols to mechanically ventilated patients.

PMID- 7774338
TI  - An asymptomatic pleural mass in a 72-year-old man.

PMID- 7774339
TI  - Sternal mass.

PMID- 7774340
TI  - Comparison of the effectiveness of tetracycline and minocycline as pleural
      sclerosing agents in rabbits.
AB  - Parenteral tetracycline, one of the most commonly used agents for producing
      pleurodesis, is no longer available because of stricter regulations governing the
      manufacturing process. The objective of this project was to determine whether
      minocycline, a tetracycline derivative, is an effective sclerosant in an
      experimental model in rabbits. We also studied the relationship of the dose and
      the volume injected to the degree of pleurodesis. The following medications were
      instilled intrapleurally in anesthetized male rabbits: tetracycline, 35 mg/kg; or
      minocycline, 4, 7, 10, or 20 mg/kg, diluted to a total volume of 1 or 2 ml of
      bacteriostatic saline solution; or minocycline, 40 mg/kg, diluted to a total
      volume of 2 ml of the solution. Twenty-eight days after the instillation, the
      animals were killed. The pleural spaces were assessed grossly for evidence of
      pleurodesis and microscopically for evidence of fibrosis and inflammation. The
      degree of pleurodesis grossly and microscopically after the injection of 7, 10,
      20, or 40 mg/kg of minocycline was comparable to that after the injection of 35
      mg/kg of tetracycline, while the dose of 4 mg/kg was less effective. In the
      animals who received the higher doses of minocycline intrapleurally (ie > or = 20
      mg/kg), there was an excess mortality both early (chi 2 = 3.61, 0.05 < p < 0.10)
      and late (chi 2 = 11.0, p < 0.005) which appeared to be related to the
      development of hemothorax. The intrapleural injection of the tetracycline
      derivatives was significantly (p < 0.05) more effective when the total volume of
      the solution was 2 ml rather than 1 ml. The present study demonstrates that
      minocycline is an effective agent for producing pleurodesis in the rabbit.
      Minocycline given intrapleurally at doses of 7 mg/kg or above is comparable to
      tetracycline, 35 mg/kg. Higher doses of minocycline (> or = 20 mg/kg) produce a
      high mortality that seems to be related to hemothorax. Since, in humans, a large
      experience confirms only 20 mg/kg of tetracycline is needed to produce adequate
      pleurodesis safely, we recommend a dose of 4 mg/kg of minocycline for the
      production of pleurodesis.

PMID- 7774341
TI  - Effect of intratracheal dexamethasone on oleic acid-induced lung injury in the
      rat.
AB  - The therapeutic efficacy of single-dose intratracheal dexamethasone (2.5 mg/kg)
      in oleic acid-induced acute lung injury in the rat was established by showing
      significant improvement in bronchoalveolar lavage parameters and lung compliance
      at 24 h after oleic acid as compared with animals not treated with oleic acid. An
      equivalent dose of intraperitoneal dexamethasone demonstrated no therapeutic
      benefit at 24 h after oleic acid. The therapeutic effect of this single-dose
      intratracheal dexamethasone regimen was accompanied by recovery to normal
      bronchoalveolar parameters and lung compliance at 7 days, in contrast to previous
      observations made with high-dose sustained intraperitoneal dexamethasone (4 mg/kg
      for 7 days). This improved benefit:toxicity ratio of intratracheal dexamethasone
      compared with systemic dexamethasone may be due to enhanced topical anti
      inflammatory potency relative to systemic potency and toxicity.

PMID- 7774342
TI  - Staging of bronchogenic carcinoma by bronchoscopy.

PMID- 7774343
TI  - Cardiovascular manifestations of cocaine abuse. A case of recurrent dilated
      cardiomyopathy.
AB  - The medical complications of cocaine abuse are being encountered by clinicians
      with increasing frequency. The cardiovascular manifestations of cocaine abuse
      include chest pain, myocardial ischemia and infarction, congestive heart failure,
      arrhythmias, infective endocarditis, and aortic dissection. The pathogenesis of
      these cardiovascular complications has not been fully elucidated but may be
      related to a combination of the sympathomimetic and membrane anaesthetic effects
      of cocaine. We present these concepts in a case discussion format.

PMID- 7774344
TI  - Brain abscess caused by Blastomyces dermatitidis in a child with cystic fibrosis.
AB  - An 8-year-old girl with moderately severe cystic fibrosis and right upper lobe
      bronchiectasis developed a cerebellar abscess caused by Blastomyces dermatitidis.
      To our knowledge, this is the youngest child with cystic fibrosis and a brain
      abscess, and the first documented case caused by a fungus.

PMID- 7774345
TI  - Hepatic vein obstruction due to Swan-Ganz catheter placement.
AB  - Complications from Swan-Ganz catheters during insertion, long-term placement, or
      removal have been known since its development. I describe the unusual
      presentation of a pacing Swan-Ganz catheter mispositioned into the hepatic vein
      producing vascular obstruction, yet with adequate cardiac pacing.

PMID- 7774346
TI  - Miliary mesothelioma.
AB  - Metastases in pleural mesothelioma usually occur late in the disease process.
      Diffuse involvement of the lung parenchyma is rare. A patient with miliary
      pulmonary parenchymal involvement with malignant mesothelioma is described. To
      our knowledge, this represents the first such case reported.

PMID- 7774347
TI  - Round atelectasis as a complication of Legionnella pneumonia.
AB  - Round atelectasis is a rare lung pseudotumor that is most commonly associated
      with asbestos-related pleural disease but can result from a variety of chronic
      pleural diseases. We describe a patient who developed round atelectasis over a
      period of only several months following an acute pleuropulmonary illness caused
      by Legionnella pneumophila.

PMID- 7774348
TI  - Mirror-image tumors in mirror-image twins.
AB  - Genetic factors are known to play a role in causing lung cancer. Twin cases of
      bronchioloalveolar, squamous, and anaplastic bronchogenic carcinoma have been
      previously reported. We describe mirror-image twins with adenocarcinoma of the
      lung occurring in mirror-image locations. They shared smoking and an occupational
      risk, carpentry, in addition to identical genetic backgrounds.

PMID- 7774349
TI  - Hemodynamic compromise secondary to a mediastinal bronchogenic cyst.
AB  - Bronchogenic cysts are not commonly the cause of severe symptoms, and often
      present only as an abnormality on chest roentgenogram. We report an unusual
      patient with a mediastinal bronchogenic cyst associated with rapid hemodynamic
      deterioration secondary to compression of vital structures.

PMID- 7774350
TI  - Interferon-related bronchiolitis obliterans organizing pneumonia.
AB  - We present an unusual case of a patient with chronic hepatitis C who experienced
      dyspnea, fever, and cough after 2 1/2 months' treatment with interferon. His
      radiograph demonstrated diffuse pulmonary infiltrates and bronchoalveolar lavage
      fluid showed an increase in lymphocytes, especially CD8-positive cells. The lung
      biopsy findings were bronchiolitis obliterans organizing pneumonia (BOOP). The
      pulmonary symptoms disappeared and the chest radiograph became normal after
      interferon therapy was discontinued and corticosteroid therapy was given.
      Interferon is suspected to be responsible for the BOOP.

PMID- 7774351
TI  - Thoracoscopic retrieval of a fractured thoracentesis catheter.
AB  - With the resurgence of laparoscopic surgical procedures, thorascopic procedures
      have followed close behind. Many procedures which in the past have required
      formal thoracotomy may now be performed via less invasive methods. Presented
      herein is a report and description of thoracoscopic retrieval of a fractured
      thoracentesis catheter.

PMID- 7774352
TI  - Abnormal movement of the arytenoid region during exercise presenting as exercise
      induced asthma in an adolescent athlete.
AB  - A 16-year-old female basketball player presented with a 2 1/2-year history of
      exercise-induced severe dyspnea, stridor, and mild wheezing that did not respond
      to prophylactic treatment with beta-agonists and cromolyn. Spirometric data at
      rest were normal, but flow-volume loops during exercise suggested a variable
      extrathoracic obstruction. Laryngoscopic evaluation while the patient was riding
      an exercise bicycle demonstrated an abnormal motion of the arytenoid region
      causing obstruction of the airway during inspiration. The vocal cords moved
      normally. This patient demonstrates the capacity of supraglottic tissue to
      obstruct the airway during exercise as a cause for exercise-induced dyspnea and
      stridor. Patients with this disorder may be misdiagnosed as having exercise
      induced asthma.

PMID- 7774353
TI  - Microneurographic evidence of sudden sympathetic withdrawal in carotid sinus
      syncope; treatment with ergotamine.
AB  - A proportion of patients with carotid sinus syncope (CSS) remain symptomatic even
      after pacemaker implantation because of persistence of a vasodepressor component.
      We report a patient with CSS whose syncopal episodes could be reproduced by
      carotid sinus massage and were due to profound hypotension associated with sudden
      sympathetic withdrawal, based on direct measurements of sympathetic nerve
      traffic. A double-blind trial with inhaled ergotamine provided significant
      symptomatic relief.

PMID- 7774354
TI  - Metastatic pulmonary calcification mimicking air-space disease. Technetium-99m
      MDP SPECT imaging.
AB  - Metastatic pulmonary calcification (MPC), a complication of chronic renal
      failure, is uncommonly diagnosed antemortem, yet may be a significant etiology of
      pulmonary dysfunction in patients with renal failure. The degree of respiratory
      distress often does not correlate with the degree of macroscopic calcification.
      Patients with extensive calcification may be asymptomatic, while others with
      subtle calcification or normal chest radiographs may have severe respiratory
      compromise. Additionally, the findings on chest radiographs may be confused with
      air-space disease, including pulmonary edema and pneumonia. Radionuclide imaging
      may detect MPC in the setting of normal chest radiographs, and confirm the
      diagnosis when there are radiographic findings of air-space disease without
      macroscopic calcification. We present a patient with bilateral upper lobe disease
      suspected to represent edema or pneumonia, proven to represent MPC on 99mTc MDP
      scintigraphy with single photon emission computed tomography (SPECT), CT, and
      later at transbronchial biopsy.

PMID- 7774355
TI  - Mediastinitis with fistula formation to the left main bronchus. A complication of
      wisdom tooth extraction.
AB  - We describe a 23-year-old patient who after extraction of four wisdom teeth
      developed a descending necrotizing mediastinitis with a spontaneous fistula to
      the left main bronchus. Because of this fistula, treatment was limited to
      surgical drainage of the neck region and antibiotics. Recovery was uneventful.

PMID- 7774356
TI  - Rupture of thoracic aorta caused by penetrating aortic ulcer.
AB  - We present the findings in a 57-year-old man with a rupture of the thoracic aorta
      that originated in a penetrating atherosclerotic aortic ulcer. It formed a large
      hematoma that clinically mimicked a true saccular thoracic aneurysm. The
      possibility of penetrating aortic ulcer should be considered in the differential
      diagnosis of aortic aneurysm.

PMID- 7774357
TI  - Application of ultrafast computed tomography for diagnosis of perivalvular
      abscesses. Surgical implications.
AB  - The presence of a perivalvular abscess is associated with an increased risk of
      morbidity and mortality with valve replacement and can require extensive
      debridement and reconstructive procedures. An accurate noninvasive method for
      preoperative diagnosis may hasten operation and aid in preoperative and surgical
      management. Two cases are presented in which ultrafast computed tomography
      accurately identified perivalvular abscesses not detected on two-dimensional
      transthoracic echocardiography and guided operative intervention.

PMID- 7774358
TI  - In vivo diagnosis of pulmonary atherosclerosis. Role of intravascular ultrasound.
AB  - The application of intravascular ultrasound (IVUS) in diagnosing pulmonary artery
      atherosclerosis is described. To the best of our knowledge, this is the first
      description of the use of this technique in the recognition of pulmonary
      atherosclerosis. We describe a patient with long-standing primary pulmonary
      hypertension with evidence of pulmonary artery calcification seen on a chest x
      ray film. The IVUS imaging of the pulmonary arteries identified intimal
      disruption with complex atherosclerosis. Thus, IVUS can be a useful tool in the
      diagnosis of pulmonary artery atherosclerosis.

PMID- 7774359
TI  - Unusual presentation of gastric dilatation. Dramatic complete atrioventricular
      block.
AB  - We report a case of gastric dilatation in a ventilated 18-year-old woman, which
      was revealed by the acute onset of hypotension, sinus bradycardia, and complete
      atrioventricular block. Hypotension and cardiac rhythm disturbances resolved with
      intravenous injection of atropine, but recurred a few minutes later and required
      a second bolus of atropine, which had a transient beneficial effect. Only gastric
      decompression, as soon as gastric distention was recognized, was able to restore
      normal cardiac rhythm and adequate blood pressure. This case highlights the
      seriousness of gastric dilatation and argues for the vagal mechanism of cardiac
      rhythm and conduction troubles complicating gastric dilatation.

PMID- 7774360
TI  - Left pleural hemorrhagic effusion. A presenting sign of thoracic aortic
      dissecting aneurysm.
AB  - Left hemorrhagic pleural effusion was the presenting sign of painless aortic
      dissecting aneurysm in two elderly hypertensive patients. Computed tomography
      (CT) of the chest revealed the aneurysmal dilatation of the thoracic aorta and an
      intimal flap connecting its descending part with the left pleural space. The
      patients were treated conservatively with blood transfusions and drugs directed
      to control blood pressure. The first reported 71-year-old patient remains in
      stable condition for 16 months without evidence of recurrent active aortic
      dissection. The second 85-year-old patient remained in stable condition for 28
      days, but finally had a second fatal episode of dissection into the left pleural
      space. The differential diagnosis of nontraumatic left hemorrhagic pleural
      effusion in an elderly hypertensive patient should include dissecting aneurysm of
      the descending thoracic aorta and CT of the chest should be performed as the next
      preferable diagnostic procedure.

PMID- 7774361
TI  - Childhood pulmonary alveolar proteinosis. Extracorporeal membrane oxygenation
      with total cardiopulmonary support during bronchopulmonary lavage.
AB  - Partial cardiopulmonary bypass with extracorporeal membrane oxygenation to allow
      bilateral bronchopulmonary lavage in pulmonary alveolar proteinosis has been
      described. However, this technique is complicated by a very low arterial PO2 and
      cardiovascular embarrassment. Total cardiopulmonary support avoids these problems
      and was successfully used in a 2 1/2-year-old girl.

PMID- 7774362
TI  - Bronchogenic carcinoma in patients seropositive for human immunodeficiency virus.
AB  - The purpose of this report is to describe an association between bronchogenic
      carcinoma and HIV. Three HIV-seropositive patients are described who developed
      bronchogenic cancer (two large cell, one adenocarcinoma) before developing an
      AIDS-defining illness. A critical review of the literature revealed 22 other
      patients in which the association of HIV infection and lung cancer is reported.
      These patients are characterized by a relatively young age at diagnosis (median,
      43 years) and prevalence of the adenocarcinoma subtype (13 of 25 patients).
      Twenty of 21 patients had a history of smoking. Among 21 patients for whom data
      were available, 6 patients (28 percent) had AIDS at time of diagnosis of lung
      cancer while 11 patients (55 percent) did not have AIDS or AIDS-related complex
      at diagnosis.

PMID- 7774363
TI  - Performing thoracoscopy. The controversy continues.

PMID- 7774364
TI  - Mechanical ventilation for Pneumocystis carinii pneumonia in patients with the
      acquired immunodeficiency syndrome.

PMID- 7774365
TI  - Diagnosis of Pneumocystis carinii infection in HIV-seropositive patients by
      identification of P carinii in pleural fluid.

PMID- 7774366
TI  - Crossreactivity of Candida with pneumocystis.

PMID- 7774367
TI  - The upper airway resistance syndrome.

PMID- 7774368
TI  - Ventilator-associated pneumonia.

PMID- 7774369
TI  - Providing a comfortable fitted mask.

PMID- 7774370
TI  - Pressure control ventilation.

PMID- 7774371
TI  - Asbestos-related pleural plaques and lung cancer.

PMID- 7774372
TI  - Survival of patients undergoing Nd-YAG laser therapy compared with Nd-YAG laser
      therapy and brachytherapy for malignant airway disease.

PMID- 7774373
TI  - Needle aspiration biopsy and ultrasonic guidance.

PMID- 7774374
TI  - Failure to achieve adequate serum levels with monthly replacement therapy in
      alpha 1-antitrypsin deficiency.

PMID- 7774375
TI  - Monitoring hemodynamics and blood gases during fiberoptic bronchoscopy.

PMID- 7774376
TI  - Primary site of lung cancer with systemic metastasis.

PMID- 7774377
TI  - Hypoxic lactic acidosis.

PMID- 7774378
TI  - Aspirin-induced asthma and artificial flavors.

PMID- 7774380
TI  - Bayes theorem. Diagnostic testing for tuberculosis in children.

PMID- 7774379
TI  - Reduce sympathetic hyperreactivity.

PMID- 7774381
TI  - Waiting for a phone call.

PMID- 7774382
TI  - A specific protein found in human senescent fibroblasts.
AB  - The limited potential for proliferation of human fibroblasts in culture
      represents cell level senescence. Aging is a programmed process under genetic
      control, and at certain stage of the life-span of animal cells, some genes start
      to express. Studying the biomarkers of senescent cells is important to
      understanding the basic mechanism of aging which may be relevant to the normal
      cell growth control and tumor biology. A protein with 72,000 Dalton molecular
      weight was detected by the hybridoma method in our laboratory. The protein shows
      specificity to senescent or presenescent cells of several cell lines, including
      WI-38, K.D., U2OS, etc.

PMID- 7774383
TI  - Quadrilateral space syndrome.
AB  - We studied 4 cases of quadrilateral space syndrome. Though the syndrome is quite
      uncommon, it might be discovered by examination of the patient complaining of
      pain of neck and shoulder especially when the tenderness in the quadrilateral
      space. Early surgical decompression is indicated as soon as diagnosis is made.

PMID- 7774385
TI  - Magnetic resonance imaging and microsurgical treatment of intramedullary
      hemangioblastoma of the spinal cord.
AB  - Thirteen cases of intramedullary hemangioblastoma of the spinal cord were studied
      radiologically, especially with magnetic resonance imaging (MRI). Microsurgery
      was used to remove the tumors in all cases. Signs and symptoms were improved in
      84.6% of the cases after operation. The diagnosis and microsurgical techniques
      for excision of intramedullary hemangioblastoma of the spinal cord are discussed.
      This disease should be differentiated from hydromyelia, intramedullary
      ependymoma, and vascular malformation of the spinal cord. Total removal of the
      tumor is recommended.

PMID- 7774384
TI  - Experimental renal artery stenosis and angioplasty. The mechanism of the
      angioplasty.
AB  - The mechanism of percutaneous transluminal renal angioplasty (PTRA) was studied
      in 18 dogs. The dogs were divided into two groups. Seven dogs were in the early
      group and eleven were within 1-3 weeks after PTRA. A 4/0 resorbable chronic
      catgut was used to ligate subtotally the renal artery to create fibromuscular
      dysplasia. PTRA was performed after renal artery stenosis for 6-8 weeks. The
      changes of ultrastructure of renal artery were studied. A contrary orientation
      balance hypothesis was proposed to explain the mechanism of PTRA.

PMID- 7774386
TI  - Management of the orbital contents in radical surgery for squamous cell carcinoma
      of the maxillary sinus.
AB  - We reviewed retrospectively 139 patients with squamous cell carcinoma of the
      maxillary sinus who were treated with planned combinations of preoperative
      radiotherapy and maxillectomy between 1958 and 1987. The 5-year survival rate of
      these patients was 30%. In 111 patients who had tumor invasion of the orbital
      floor 88 underwent radical surgery with orbital exenteration and 23 had their
      orbital contents preserved. If orbital exenteration was performed, the 5-year
      survival rate was 27.3% (24/88) and the rate of recurrence within the orbit was
      12.5%. In patients with preservation of the orbital contents, the corresponding
      rates were 34.8% (8/23) and 8.6% respectively (P = 0.65). Histological study
      after maxillectomy with orbital exenteration showed that in 95% of 65 specimens
      (62/65) invasion of the orbit was limited. These tumors could be completely
      resected by total maxillectomy with limited removal of the periorbital tissues
      after preoperative radiotherapy. We conclude that after preoperative radiation,
      the eyeball could be safely preserved in most selected patients with maxillary
      sinus carcinoma invading the orbital floor.

PMID- 7774388
TI  - Quantitative study of AgNOR in differential diagnosis between non-Hodgkin's
      lymphoma and reactive hyperplasia.
AB  - The argyrophilic staining technique was used in differential diagnosis between
      non-Hodgkin's lymphoma (NHL) and reactive hyperplasia (RH) of lymphatic tissues
      in 30 cases of RH and 71 cases of NHL which were classified as low (11 cases),
      moderate (49 cases) and high malignant (11 cases) groups. The number and the area
      of Ag nucleolar organizer region (AgNORs) in 100 cells of each case were examined
      by both IBAS-200 cytoimage analyser and microscope. The results showed that there
      was significant difference in the number, but not in area, of AgNOR granules
      between RH and low malignant group of NHL (P < 0.001). In NHL, the significant
      differences in the number and area of AgNORs were found between each groups (P <
      0.05 or P < 0.001). It was also observed that in NHL, the number of AgNOR was
      negatively correlated with the area of the granules, and the shapes and
      distribution patterns of AgNOR were significantly different between each groups.
      Our results suggest that the quantitative study of AgNOR combining with the
      histological characteristics is very helpful in the differential diagnosis of RH
      and NHL and in the classification of NHL.

PMID- 7774387
TI  - Morphology and morphogenesis of hepatitis E virus (strain 87A).
AB  - The morphology and morphogenesis of isolated hepatitis E virus (HEV, strain 87A)
      were observed by electron microscopy (EM) and immune electron microscopy (IEM).
      Progressively developing local vesicles, virions accumulation in crystalline
      arrays and viroplasmic focus were seen in cytoplasm of infected cells.
      Replication and assembly of the new generation viruses were closely associated
      with rough endoplasmic reticulum (RER), inclusion body (IB) and microfibrils.
      Condensation and margination of chromatin, dispersion of nucleolar material,
      nuclear membrane alteration and masses of threads, granular material, and
      fibrillar component of the nucleus were frequently found. These changes revealed
      that this strain virus was confirmed as a RNA virus. The shape of the virus
      particles appeared approximately spherical whether the specimens were from the
      tissue culture crude suspension or purified highly concentrated preparations. The
      size of the virion was about 30 nm in diameter. The viral particles appeared
      unsmooth and irregular in outline. The spike-like structures may be occasionally
      observed on the surface of some viral capsides. The diameter of the strain 87 A
      virus is larger than the picornavirus and smaller than the calicivirus. This
      strain virus is different from classical calicivirus in without the cup-shaped
      surface depressions. The new genus, heparnavirus genus of caliciviridae family
      should be proposed for HEV.

PMID- 7774389
TI  - Rapid diagnosis and treatment of chlamydial conjunctivitis.
AB  - During December 1989 to December 1992, conjunctival specimens from 63 patients
      with severe trachoma and 30 with acute follicular conjunctivitis at the eye
      clinic of Tong Ren Hospital in Beijing, were tested by using direct
      immunofluorescent technique and amplified enzyme-linked immunoassay (Micro Trak
      and IDEIA) for chlamydial antigenicity. Trachoma accounted for 97.6% while acute
      follicular conjunctivitis accounted for 2.4% of the positive cases. Micro Trak
      and IDEIA tests proved advantageous over the culture method for the detection of
      Chlamydia trachomatis. In our study, Ofloxacin eye ointment has been proved to be
      an alternative drug for severe trachoma with better curative effectiveness.

PMID- 7774390
TI  - Applications of antisense RNA and DNA in cardiovascular research.

PMID- 7774391
TI  - Extrinsic compression of the lower ureter by a patent umbilical artery. Report of
      two cases.

PMID- 7774392
TI  - The national symposium on unstable angina pectoris. Classification,
      pathophysiology and management.

PMID- 7774393
TI  - Neurochemistry in China.

PMID- 7774394
TI  - Strive to prevent and control diabetes in China.

PMID- 7774395
TI  - Lymphocytic and erythrocytic k+, Na+, Ca++, Mg++ content in patients with
      congestive heart failure.
AB  - The content of lymphocytic and erythrocytic K+, Na+, Ca++, Mg++ changed in
      patients with congestive heart failure, related to clinical treatment and
      prognosis. The longer the course of disease, the more significant the changes,
      with no relation to the etiology of heart disease. The changes were partially
      improved after treatment of the heart failure. The content of electrolytes is not
      significantly different in patients in NYHA Class III, compared to those in NYHA
      Class IV. The metabolic changes of electrolytes occur on the myocardial cells,
      skeletal muscle cells and peripheral erythrocytes in patients with congestive
      heart failure. However, serum electrolyte content does not reflect precisely
      overall electrolyte metabolism in the body. Whether similar changes of
      electrolyte content occur in the peripheral lymphocytes is rarely reported. We
      studied the lymphocytic and erythrocytic electrolyte content in patients with
      congestive heart failure, to provide some reference in the clinical treatment and
      prognosis of congestive heart failure.

PMID- 7774396
TI  - Experiment study on the effect of Sheng-Mai injection on the contractivity of
      diaphragm and its mechanism.
AB  - In this study the effect of Sheng-Mai Injection i.e. Red Ginseng-Ophiopogon Root
      Injection (one kind of traditional Chinese medicines) on the contractivity of
      diaphragm was observed. The results confirmed that Sheng-Mai Injection increased
      Pdi of the fatigued diaphragm in rabbits and reduced the time needed for the
      recovery of Pdi of fatigued diaphragm to the normal value. These results suggest
      that Sheng-Mai Injection can increase the contractive force and promote the
      recovery of the fatigued diaphragm. The effect of Sheng-Mai Injection on the
      contractivity of the isolated diaphragmatic bundle of rats was also observed and
      the results confirmed that Sheng-Mai Injection increased the diaphragmatic
      contractive force directly. This effect of increasing the contractive force of
      diaphragm was attenuated by adding calcium channel blocker isoptin and
      disappeared when there was no calcium in the extracellular fluid. It is deduced,
      therefore, that the mechanism of the effect of Sheng-mai Injection is related to
      the increased influx of calcium from extracellular fluid into the cells.

PMID- 7774397
TI  - Platelet activation in patients with chronic pulmonary heart disease. Effect of
      dipyridamole treatment.
AB  - Plasma levels of beta-thromboglobulin (beta-TG), platelet factor 4(PF4) and
      platelet aggregation rate (PAR) were measured in remission phase of 15 patients
      affected with chronic pulmonary heart disease (CPHD). beta-TG, beta-TG/PF4, PF4
      and PAR were significantly higher in the patients than in controls (P < 0.01 and
      0.05, respectively). After 10 days of treatment with Dipyridamole 100mg tid, beta
      TG, beta-TG/PF4 and PF4 decreased significantly compared with pretreatment values
      (P < 0.01 and 0.05, respectively). The results suggest that in vivo platelet
      activation is indeed present in patients with CPHD and that dipyridamole can
      antagonize platelet activation in vivo.

PMID- 7774398
TI  - Therapeutic effects of photosensitizers in combination with laser and ACNU on an
      in vivo or in vitro model of cerebral glioma.
AB  - This study investigated the independent and combined effects of photodynamic
      therapy (PDT), laser photodynamic hyperthermia (LPDH) and 1-(4-amino-2-methyl-5
      pyrimidinyl) methyl-3-(2-chloroethyl) -3-nitrosourea hydrochloride (ACNU) in a
      rat 9L induced gliosarcoma model. The mortality rate (MR60), mean survival time
      (MST60), and increasing life span (ILS60) within 60 days were determined to
      evaluate the therapeutic effect in vivo. The MR60 and MST60 of the gliosarcoma
      tumor control were 100% and 16.2 days. The ILS60s of PDT and ACNU were 72.84% and
      49.81%, respectively, but MR60 of both were 86.72%. All combined treatments
      produced significantly prolonged survival (P < 0.01). The combined effects of
      LPDH and ACNU, MR60, MST60, and ILS60 were 60%, 43 days, and 165.4%,
      respectively. The ILS60 of PDT + ACNU (96.48%) and PDT + LPDH (98.58%) also
      indicated a synergistic or additive effect. The survival fraction and synthetic
      rate of DNA, RNA, and protein of glioma 9L tumor cells in vitro after single
      treatment of PDT or combined with antitumor drugs and laser showed that the
      cytotoxicity of PDT to 9L tumor cell was obvious by using Rh123, HPD, and Pf-II
      as photosensitizers. Combined treatments of PDT, antitumor drugs, and laser
      suppressed the synthesis of DNA, RNA, and protein more significantly than single
      treatment with PDT.

PMID- 7774399
TI  - [An experimental study on brain-gut peptide receptors in brains of rats with
      hepatic encephalopathy].
AB  - By means of radioligand binding assay, two brain-gut peptide, somatostatin (SS)
      and vasoactive intestinal peptide (VIP), receptors in crude synaptosomal
      membranes of brain were investigated in rats with hepatic encephalopathy (HE) and
      in controls. In HE rats and in controls, the maximal binding capacity (Bmax) were
      238.0 +/- 14.2 and 200.0 +/- 11.3 fmol/mg of protein, the dissociation constant
      (Kd) was 3.99 +/- 0.22 and 3.89 +/- 0.34 nM respectively for SS receptors. The
      Bmax values of VIP receptors in HE rats and in controls were 9.56 +/- 0.29 and
      10.92 +/- 0.44 fmol/mg of protein, the Kd values were 0.28 +/- 0.01 and 0.29 +/-
      0.02 nM, respectively. Increased Bmax values of SS receptors (P < 0.005) and
      decreased Bmax values of VIP receptors (P < 0.002) were observed in HE rats as
      compared with those in controls. The results suggest that changes of brain-gut
      peptide receptors in brains play a significant role in the pathogenesis of HE.

PMID- 7774400
TI  - [Hepatic hemodynamic changes in liver cancer patients during intrahepatic
      arterial angiotensin II infusion induced hypertension and chemoembolization].
AB  - In this report, hepatic hemodynamics were studied by pulsed ultrasound doppler
      during the process of intrahepatic arterial angiotensin II infusion induced
      hypertension and chemoembolization (IHCE) in 20 liver cancer patients. It was
      found that at 90 seconds after I-HCE, tumor blood supply increased by an average
      of 1.786 times while the blood flow of proper hepatic artery decreased to an
      average of 0.5665 times of its original level. At the same time patients'
      peripheral blood pressure increased by 3.7kPa. It is evidenced that angiotensin
      II infusion augments blood flow to tumor region while decreases blood supply in
      healthy tissues.

PMID- 7774401
TI  - [A measurement of liver volume and its changes in post-hepatitic cirrhosis].
AB  - By use of the computerized digital image processing system, the liver volume in
      vivo was successfully measured and the three dimensional image of the liver
      rebuilt in 62 cases of posthepatitic cirrhosis and 15 noncirrhotics. It was found
      (1) The liver volume of 474.64 +/- 115.28cm3/m2 in Chinese cirrhotics is
      significantly smaller than that of the control (P < 0.001); (2) In most cases,
      patients in class I of the liver function have a larger liver volume; (3)
      Patients with smaller liver volume have poor tolerance to surgery with a critical
      value of 400cm3/m2; (4) the liver volume considerably reduced after shunt plus
      devascularization but did not change after devascularization only.

PMID- 7774403
TI  - [The surgical treatment of gastric stump cancer: an analysis of 26 cases].
AB  - 26 patients with gastric stump cancer were treated by surgery plus chemotherapy
      or radiotherapy in our hospital from 1970 to 1992. 20 patients were qubiected to
      surgery plus chemotherapy 12 patients were operable six patients had simple
      radiotherapy. These patients were followed up to the end of 1992. Using Kaplan
      Meier method and log-rank test (P < 0.05), we analysed the factors effecting the
      survival rate and drew a conclusion that surgical treatment plus adjuvant
      chemotherapy is the treatment of choice, and if no-resection, we would treat it
      with chemotherapy rather than radiotherapy.

PMID- 7774402
TI  - [Portal vein embolization via a fine needle guided by angio-echography:
      experimental and clinical study].
AB  - This paper introduced a technique of portal vein embolization by injection of
      ethanol via fine needle under guidance of angio-echography. First introportal
      ethanol injection were done in 28 dogs to evaluate its embolic efficacy and
      safety. The result showed if a dose of injected ethanol was chosen properly,
      expected embolization could be obtained with slight toxicity to hepatic
      parenchyma and function. For clinical application, selective portal vein puncture
      was percutaneous transhepatic under echo guidance. Ultrasound angiography by
      injecting carbon dioxide (CO2) into portal vein was introduced initially. After
      confirmed that the injected branch was that supplied the tumor and there was no
      retrograde overflow of portal blood, ethanol was injected at a dose no more than
      10ml. Eighteen patients with hepatocellular carcinoma and underlying liver
      cirrhosis underwent the procedure preoperatively. Of 14 cases who received
      hepatectomies, portal vein embolization developed in 12. Since the procedure was
      guided by angio-echography it could be used for indicated cases with satisfactory
      embolic effect and not harmful to liver. The procedure had advantages of simple
      manipulation and made selective embolization easier compared to interventional
      transcatheter portal vein embolization.

PMID- 7774404
TI  - [Air plethysmography in the diagnosis of primary venous insufficiency of lower
      extremities].
AB  - Through the assessment 101 limbs of 77 subjects by air plethysmography (AP), we
      studied the method of AP test and the values of various indices in diagnosis of
      primary venous insufficiency (PVI). Venous filling index (VFI) was found valuable
      to quantitate the venous reflux with its value beyond the threshold of 5 ml/sec.
      It has a potential value to assess the effect of operations on PVI, such as
      valvuloplasty aiming to abolish venous reflux. Ejection fraction (EF) was found
      to be abnormal with its value less than 40%. It may be used to evaluate the
      function of calf pump quantitatively, predict the ulcer formation, and help make
      a decision of surgery timely. The comprehensive analysis of VFI, EF, RVF
      (residual volume fraction) and AVP (ambulatory venous pressure) indicated that
      there seems to be different types of PVI: type 1, low ejection (low EF) high
      venous reflux (high VFI); type 2, high ejection low venous reflux; type 3, low
      ejection low venous reflux. This new classification may impose some on the
      selection of adequate therapies, which will be further investigated.

PMID- 7774405
TI  - [Occult breast cancer: 9 cases report and review].
AB  - From 1977 to 1994, 9 breast cancer were treated. All patients presented axillary
      node enlargement as first sign. Six patients were treated by radical or modified
      radical mastectomy and 3 by axillary node excision. All patients received
      postoperative adjuvant radiotherapy and chemotherapy. Among the 6 patients
      treated by radical or modified radical mastectomy, 4 survived over 10 years after
      surgery, 1 died of heart disease at 8 years, and 1 on chemotherapy is for 4
      months. The three patients treated by axillary node excision, all died of the
      disease at 8-32 months. It is considered that radical or modified radical
      mastectomy with adjuvant radiotherapy and chemotherapy is a suitable treatment
      selection for occult breast cancer.

PMID- 7774406
TI  - [Study on the collagen of the different region of disc and different sigmental
      disc].
AB  - With the method of the collagen decomposition producting special hyoroxyprolines
      (HYP), the collagens of the different region of discs and different segmental
      discs were studied. The results were as follow: The fibrous annulus had a higher
      collagen content than did the nucleus pulposus (P < 0.001). In fibrous annulus,
      the inner region had a lower collagen content was found at the postolateral part
      of the fibrous annulus (P < 0.05), especially at the poster-lateral inner zone (P
      < 0.001). The local low-collagen content at the particular location may be one of
      the factors, which was clinically susceptible to a disc herniation at the part.
      An increasing graduation of collagen content was found from thoracic disc12 to
      lumbar disc 5. But, there was no statistically significant difference (P > 0.05).

PMID- 7774407
TI  - [Lumbosacral lipomas with spinal bifida].
AB  - Spinal dysraphism is usually accompanied with lumbosacral lipoma. The
      neurological deficits such as lower extremities sensorimotor disturbances, bowel
      and bladder dysfunction are produced by tethering, compression of lipoma and
      direct transmission of external force on the spinal cord during growth period. 25
      patients treated surgically at our hospital between May, 1985, and January, 1993,
      were reviewed. Surgical approach was designed for debulking the lipomatous mass,
      untethering and decompressing the cord, repairing the dural defect and paraspinal
      muscle cleft. 2-59 months (mean 37.5 mons) after operation the 2 patients whose
      neurological system were normal before operation remained intact. In other 23
      patients, bowel function recovered in 75%, active urination restored and improved
      in 66.2%. Motor dysfunction and paresthesia of the lower extremities alleviated
      in 78.3%. A case of mild uremia returned to normal and another moderate case
      improved. None was deteriorated by the operative procedure except one case in
      which a posterior nerve root was injured.

PMID- 7774408
TI  - [Video-assisted thoracoscopic surgery for pulmonary wedge resection].
AB  - Video-assisted thoracoscopic surgery (VATS) wedge resection of lung has largely
      become a practical surgical procedure because the development of instruments and
      surgical techniques. The safety and feasibility are more remarkable comparing
      with standard surgical procedure. From November, 1992 to March, 1994, twelve
      patients suffering from pulmonary mass were underwent VATS. VATS wedge resection
      in 10, VATS pulmonary mass biopsy in 2. No operative death and severe
      complications occurred in this group. We discussed the clinical classification,
      indication and the surgical technique in this paper.

PMID- 7774409
TI  - [Occlusion with interrupted titanium clips for ruptured bullae under video
      assisted thoracoscopic surgery].
AB  - Spontaneous pneumothorax is a common disease and as many as 20% of these patients
      should be operated because of a recurrent pneumothorax, persistent air leak, or
      failure to completely reexpand the lung. From January 1993 until March 1994, on
      the basis of experiment, we performed video-assisted thoracoscopic surgery (VATS)
      intervention and talc pleurodesis on 8 patients with spontaneous pneumothorax
      caused by ruptured bullae, and designed a new procedure of occluding the bullae
      with interruptured titanium clips. This procedure has some advantages of complete
      occlusion of lung tissue at the base of the bulla, minimal loss of lung tissue,
      effectively preventing leakage and recurrent pneumothoraces, and enough capacity
      of anti-tension while the lung expands. Also Authors have advocated giving a
      negative pressure suction to opsilateral lumen of the Carlen's tube interbation
      to visualize adequately the intrathoracic structures, while selective lung
      ventilation is performed. This method keeps hemodynamic stability and is
      performed more easily and safely than that of positive pressure insufflation is
      done. Postoperatively, complete lung expansion was obtained in all patients.
      There were no perioperative complications related to VATS, and no recurrences to
      date. These early results with thoracoscopic management of spontaneous
      pneumothorax caused by ruptured bullae have encouraging.

PMID- 7774410
TI  - [Video-assisted thoracoscopic surgery for chest disease].
AB  - Video-assisted thoracoscopic surgery was applied in a total of 20 patients, since
      Dec. 1992. There were 16 man and 4 woman whose ages ranged from 20 to 65 years.
      Three patient had a wedge resection for lung tumors, one a lobectomy for
      tracheaectasy, eleven with recurrent spontaneous pneumothorax were successfully
      treated, Pleural tumors (n = 1), pulmonary cyst (n = 1), Three biopsy of lung.
      The advantages of this for patients include cosmetic considerations, a shorter
      operation period, low pain, earlier postoperation mobilization.

PMID- 7774411
TI  - [Non-operative regions extradural hematoma: a review of 5 cases].
AB  - The authors report five patients who developed non-operative regions extradural
      hematoma following removal of intracranial tumors (3 cases) or cystiform diseases
      (2 cases). 3 cases developed on the left hemicerebrum. 2 cases formed on the
      bilateral. 4 cases were supratentorial operations, one inferior tentorial. The
      causative mechanisms of hematoma formation were attributed to a rapid fall in
      intracranial pressure, an increased blood velocity and the patient's position
      during the operation. Unexplained cerebral swelling during operation or delayed
      post-operative recovery should be intensely investigated by CT scanning. An
      emergency operation is indicated when the hematoma volume is more than 30ml.

PMID- 7774412
TI  - [Study of mechanism of selective head cooling-dehydration combined therapy for
      brain resuscitation: effect on function of brain cellular membrane].
AB  - We induced cerebral complete ischemia (CCI) by "four-vessel" model. The changes
      of Na+,K(+)-ATPase, Ca2+, Mg(2+)-ATPase, phospholipase A2 (PLA2), total
      phospholipids on brain cellular membrane (BCM) at 30, 180, 360 min of reperfusion
      following 30 min CCI were observed. The effects of selective head cooling (SHC,
      28C, surface cooling method), mannitol dehydration (MD), and selective head
      cooling-dehydration combined therapy (SHCDCT) on these changes were also
      investigated. Compared with non-ischemic, during reperfusion activities of Na+,
      K(+)-ATPase, Ca2+, Mg(2+)-ATPase decreased while PLA2 increased (P < 0.001),
      phospholipids decreased at 180 and 360 min of reperfusion (P < 0.01). SHC and
      SHCDCT blocked all above changes, MD had no effect. These results suggest that
      SHCDCT after starting reperfusion do promote recruitment of BCM function by
      blockade of the successive reperfusion damage on BCM.

PMID- 7774413
TI  - [The effects of injection salviae miltiorrhizae in preventing and treating fat
      embolism syndrome].
AB  - This study was to examine the effects and mechanisms of injectio salviae
      miltiorrhizae (ISM) in preventing and treating fat embolism syndrome (FES), which
      was simulated by intravenous injection of homologous bone marrow fat in 16 dogs.
      PaO2, free fatty acids (FFAs), TXA2/PGI2, SOD/MDA were measured in different
      times combined with X-ray, conjunctiva microcirculation observation, radioisotope
      scanning and histologic examination. It was found that in the control group there
      were a significant fall in PaO alpha and rise in FFAs and MDA; blood clot stained
      with oil red O showed many fat droplets; radioisotope scanning revealed mild
      hypoperfusion or perfusion defects. In the treatment group, arterial oxygen
      levels were maintained, serum level of FFAS and MDA was reduced significantly. It
      is concluded that there is damage induced by oxygen-derived radicals in FES, LSM
      is an effective therapy for the FES, and 99mTc radioisotope scanning is a
      promising technique for noninvasive identification of FES in the early stage.

PMID- 7774414
TI  - [Surgery of thymoma].

PMID- 7774415
TI  - [Expression of WT1mRNA: relation to histology in Wilm's tumor].
AB  - The mRNA expression of WT1 gene was examined by Northern blot and Dot blot
      hybridization in 13 Wilm's tumors of varying histology, 2 normal kidneys (1 and 5
      years of age) and 1 fetal kidney (5 months of gestation). RESULTS: (1) WT1 gene
      expression was much higher in fetal kidney than in normal kidney of children; (2)
      Wilm's tumors which were predominantly epithelial or blastemal expressed high
      amounts of WT1mRNA, whereas predominantly stromal tumors expressed low amounts (P
      < 0.01). The data suggests that (1) there is a relationship between WT1 gene
      expression and cellular differentiation in kidney development; (2) low level
      expression of WT1mRNA results in disruption of cell differentiation and
      development of Wilms' tumor which shows stromal-predominant histology.

PMID- 7774416
TI  - [Timing of radical operation on Hirschsprung's disease in newborns].
AB  - From June 1987 to June 1993, 42 neonates with Hirschsprung's disease (NHD) were
      treated with modified Duhamel's procedure. The follow-up from 2 months to 5 years
      (mean 30 mons) showed satisfactory results in all survivors. Comparing with 21
      infants with Hirschsprung's disease treated (IHD) with modified Swenson's method
      showed that: (1) The follow-up results of NHD were better than IHD; (2) The
      extent and degree of hypertrophy and dilatation of proximal and transitional
      segment were less serious in NHD and the length of resection was shorter than
      that of IHD (NHD: 14.5-24.1 cm, IHD: 33-40.5 cm); (3) The degree of pathological
      changes such as mucosal inflammation, ulcer formation, and degeneration of
      ganglion cells was related to the age, duration and the length of agangliosis.
      Hirschsprung's disease has a chronic progressive course. Early operation can
      decrease the secondary structural and functional damage to the intestine.

PMID- 7774417
TI  - [The shunt for portal hypertension in children].
AB  - Ten children with portal hypertension were treated with shunt operations. Among
      them, 9 were extrahepatic and one was intrahepatic lesion. The follow-up for 1-14
      years showed: (1) In the 3 patients treated with splenopneumopexy, hemorrhage
      from the esophageal varices were controlled and portopulmonary shunt was
      demonstrated by Doppler ultrasound and radionuclide; (2) In the 6 patients
      treated with mesocaval shunt, 3 were non-recurrent bleeding and 2 died of
      recurrent bleeding or other disease respectively; (3) In one child with hepatic
      cirrhosis (11 year old) treated by splenorenal shunt, non-recurrent bleeding
      occurred. The authors suggest the portopulmonary shunt by splenopneumopexy is
      safe and effective for the portal hypertension of children.

PMID- 7774418
TI  - [Treatment of pediatric late stage neuroblastoma].
AB  - From 1960 to 1992, 62 children with late stage neuroblastoma (stage III-IV) were
      admitted to our hospital. 24 (1960-1982) treated with operation and routine
      chemotherapy all died in 24 months after operation. And in 38 (1983-1993) treated
      with operation and high dose chemotherapy (including auto-bone-marrow
      transplantation + three times dose VM26 + routine chemotherapy in 3 cases, high
      dose chemotherapy + resection of tumor + high dose chemotherapy + routine
      chemotherapy for 4 years in 27, and dumbbell neuroblastoma in 8), 24 cases (63.%)
      still lived up to now. In which 11 cases (28.9%) lived more than 5 years and
      other 13 cases middle survival stage was 26.9 months. The high chemotherapy
      couldn't be instead of operation but it might produce a favourable condition to
      radical operation and thereby increase the effect of the operation.

PMID- 7774419
TI  - [A transposition of iliopsoas in replacement of pelvic floor for incontinence of
      urination and/or defecation in children].
AB  - Fourteen patients, the age ranged from 2 to 12 years, with fecal and/or urinary
      incontinence were treated between 1991 and 1993 using a transposition of
      iliopsoas in replacement or strengthening of pelvic floor. The results were
      encouraging. The evaluation of the function of pelvic floor was described.
      Levator plays an important role in normal mechanism of defecation as well as
      urination. Several types of incontinence develop while the disfunction of pelvic
      floor occur and some function of continence could be restored by an operation of
      transposition of iliopsoas.

PMID- 7774420
TI  - [Infantile indirect inguinal hernia treated with laparoscopy high ligation of
      hernial sac].
AB  - 22 cases of infantile indirect inguinal hernia were treated with laparoscopy high
      ligation of hernial sac. They were followed up for 9-18 months, the primary
      results were satisfactory and quite encouraging. The merits of this newly
      developed method are: The technique is relatively simple and less of
      postoperative complications. The technique and key point of the method were
      described in detail.

PMID- 7774421
TI  - [Surgical treatment thoracoabdominal aortic aneurysms with blocking of aorta at
      short intervals].
AB  - Visceral ischemia and deterioration in renal function is common cause of
      morbidity in patients with thoracoabdominal aortic aneurysm surgically treated.
      Two patients with huge thoracoabdominal aortic aneurysm were surgically treated
      by a new technique of shunting. The operation was performed by using a synthetic
      artificial graft, which was sutured to the iliac artery by end to side
      anastomosis, and the upper end of the graft was anastomosed to the cut end of the
      thoracic aorta by end-to-end method. Compared with the traditional temporary
      shunting, there are several advantages in using the improved shunting technique.
      First, by so doing the ischemic time of various viscera could be fractionated and
      shortened, just about 17 minutes. visceral ischemic complication can be avoided.
      Second the pseudoaneurysm produced by the traditional method of temporal shunting
      could be prevented by the improved method. Third, on account of the ischemic time
      of the viscera is decreased, operation could be done under normal temperature
      without need for hypothermia. In treating a case of huge thoracoabdominal aortic
      aneurysm, successful result could hardly be obtained without good
      prepostopoerative care. We should also emphasize that the improvement of some
      surgical technique is also important.

PMID- 7774422
TI  - [Surgical treatment of left ventricular aneurysm].
AB  - From April 1972 to Dec. 1993, 152 cases underwent operation for left ventricular
      aneurysm (LVA) in Fuwai hospital. There were 143 males and 9 females with mean
      age of 49 years. Patients underwent ECG, chest X-ray (C/T 0.42-0.71),
      echocardiogram (LVEDP 0.267-6.27 kPa and cardiocoronary angiography (LVEF13-69%).
      There were 58 cases (38%) in NYHA class II, 82 cases (54%) in class III and 58
      cases (7%) in class IV preoperatively. The total operative mortality was 9% with
      7% of the last six-year. The main cause of the death was refrectory low cardiac
      output syndrome. Univariate analysis showed that the operative risk factors
      included ventricular arrhythmias, preoperative congestive heart failure (< 1
      month), poor NYHA class, A-V condaction block. 138 discharged cases were followed
      up from 2-215 months (mean 36). There were 11 late deaths. The five-year and ten
      year survival was 90% and 55% respectively. At the latest follow-up 44 cases
      (35%) were in NYHA class I, 62 (49%) in class II, 6 (6%) in class III and 2 (2%)
      in class IV. Our report demonstrated CABG is an effective treatment with good
      early and late results for LVA.

PMID- 7774423
TI  - [Surgical treatment of constrictive pericarditis in 162 cases].
AB  - The authors reports the experience of surgical treatment of constrictive
      pericarditis in 162 cases. Age ranged from 6 to 66 years old. The cardiac
      function and circulatory dynamics were improved after decortication of the
      thickened pericardium in most of the patients. Overall surgical mortality was
      3.1%. The major cause of death was low cardiac output syndrome in the early
      postoperative period. The authors consider that the excision of the thickened
      pericardium is better to begin from the left to right and the good perioperative
      management particularly the rational agents is essential in the prevention of low
      cardiac output syndrome.

PMID- 7774424
TI  - [Surgical treatment of middle lobe carcinoma of the lung].
AB  - From February 1965 to April 1993, 88 patients with middle lobe carcinoma of the
      lung were treated surgically. It constituted 7.7% of the total patients of
      operated lung cancer in our hospital. Clinical symptoms were mainly fever, cough,
      bloody-sputum and chest pain. 84 of 88 patients were treated by wedge resection,
      lobectomy and pneumonectomy. Exploration was preformed in 4 patients. The 1, 3, 5
      and 10-year survival rates of the 78 patients followed up were 87.18%, 43.08%,
      38.18% and 24.13% respectively. It related to four clinical features of middle
      lobe cancer of the lung were treated surgically is discussed.

PMID- 7774425
TI  - [Further experience in the diagnosis and treatment of sphenoidal ridge
      meningioma].
AB  - 72 cases with sphenoidal ridge meningioma operated on in recent 12 years in our
      department were reported. In the microsurgical group and non-microsurgical group,
      the rate of total removal of medial tumors was 65% and 20% respectively (P <
      0.01); lateral tumors was 100% and 77% respectively (P > 0.05); the mortality was
      6.7% and 11.9% respectively (P > 0.05); the rate of neurological impaired was
      33.3% and 64.3% respectively (P < 0.001); good rate of following up for a long
      time was 87.5% and 16.7% in medial group respectively (P < 0.05); 66.7% and 75%
      in lateral group respectively (P > 0.05). It is believed that application of CT
      and angiography and microsurgical technique is helpful to the diagnosis and
      treatment of sphenoidal ridge meningioma.

PMID- 7774426
TI  - [Surgical treatment of pituitary adenoma].
AB  - Seventy-four patients with pituitary adenoma were treated by surgery, including
      51 transsphenoidal and 23 transcranial approaches, without death, postoperative
      leakage of CSF and early-period intracranial infection. Many patients had a
      transient diabetes insipidus after operation. In discussion we attended the
      difference of attacking age of pituitary adenoma between male and female, the
      significances of CT and MRI as well as the indication and the important points of
      various approaches.

PMID- 7774428
TI  - [Changes in gut hormones after Roux-en-Y cholangio-jejunostomy].
AB  - In order to explore the mechanism of secondary gastric acid hypersecretion after
      Roux-en-Y Cholangio-jejunostomy (CJR-Y), we studied the changes of gastric acid
      secretion and determined the levels of somatostatin (SS), gastrin (Gn),
      neurotensin (NT), beta-endorphin (beta-EP) in serum, gastric juice and pyloric
      antrum in patients with CJR-Y. The results showed that gastric hypersecretion
      developed, levels of SS in those specimens decreased significantly and the
      content of Gn increased obviously after CJR-Y; whereas the content of NT and beta
      EP did not change significantly. We concluded that the decreased level of SS
      plays a role in the mechanism.

PMID- 7774427
TI  - [Two-stage multivariant analyses for prediction of hepatic function reserve].
AB  - Eleven liver function tests were used for preoperative estimations of the hepatic
      function reserve in 103 patients with primary hepatocellular carcinoma (HCC) and
      underlying liver cirrhosis. Postoperatively, the patients' liver function could
      be classified as good recovering (Grade A, n = 38), functional damage (Grade B, n
      = 37) and liver failure (Grade C, n = 28). Single factor analyses showed 6 of
      those tests were significant indicators, including the ratio of blood glucose
      level at 120 minutes and 60 minutes by oral glucose tolerance test, total
      bilirubin, the ratio of albumin and globulin, prealbumin, prothrombin time and
      indocyanine green retention at 15 minutes. The correlations between 11
      preoperative parameters (xi) and postoperative course scored (Y) were analysed by
      Fisher's discriminant test. The multiple regression equation Y1 was obtained by
      comparing from groups of Grade A with B and formula Y2 from groups of Grade B
      with C. The predictive accuracy of both equations were 88.0%, 83.1%,
      respectively. To select adequate surgical procedures with the best therapeutic
      effect and minimal liver damage for the patients with HCC, we proposed a method
      of "two-stage predications" combining use of Y1 and Y2 for evaluation of liver
      function reserve.

PMID- 7774429
TI  - [Dilatation of stricture of anastomosis after reconstruction of esophagus].
AB  - This article reports the experience of the esophagus dilating technique in the
      treatment of 658 cases of postoperative anastomotic stricture for esophageal
      cancer and cardiac cancer during the period from May 1983 to May 1993, being
      delated add up to 3240 times with total effective rate 96.5%, among them 61.6% of
      the cases less than five, 84.5% of the cases less than ten. Of them, 27 cases
      (4.1%) had postoperative complications, of which the main ones were esophagus
      perforation 8 cases (1.2%), hemorrhage of anastomotic stoma 4 cases (0.6%),
      mediastinitis 1 case (0.2%) and loca trauma 14 cases (2.1%). The operative
      indication, surgical technique and complication were discussed.

PMID- 7774430
TI  - [Clinical application and technical problems of colonic interposition for
      esophageal substitution].
AB  - From Jan. 1980 to Jan. 1991, A total 41 patients, including 22 patients with
      corrosive stricture after esophageal chemical burns, 10 patients with cancer of
      the laryngopharynx, 7 patients with esophageal cancer and 1 case of cardiac
      carcinoma, underwent of colonic interposition for esophageal substitution. This
      accounted 0.7% of all of the esophageal reconstruction during the same period.
      There were 23 cases of retrosternal colonic bypass and 18 cases of trans-hiatal
      inversion-stripping esophagectomy without thoracotomy. The main postoperative
      complications were anastomotic leakage at the cervical region and incision
      infection, but no mortality. The indications, choice of the colonic segment and
      the technical problems of this operation were discussed.

PMID- 7774431
TI  - [The application radionuclide bone imaging in the treatment of hallux valgus].
AB  - Radionuclide bone imaging (RNBI) was performed by means of 99mTc-MDP on both 20
      health subjects (40 feet) and 20 patients with hallux valgus (26 feet). The
      results showed that radioactivity intake were increased in second (or third)
      metatarsal of 26 feet of hallux valgus. The ratio of radioactivity of the lesion
      and contralateral normal site (D/N) had statistical difference (P < 0.01). Both
      the patient and normal groups RNBI is a highly sensitive study and valuable for
      the classification of diagnosis. It help for selection of surgical treatment, as
      to evaluate the results of the treatment.

PMID- 7774432
TI  - [The compensatory changes of unstriped muscles of portal vein and superior
      mesenteric artery in rabbits infected with schistosomiasis].
AB  - We observed the changes of unstriped muscle of portal vein and superior
      mesenteric artery in rabbits infected with schistosomiasis in different stages
      with Masson trichrome stain. The results showed compensatory hypertrophy and
      hyperplasia of unstriped muscle of internal and medial layer of portal vein and
      superior mesenteric artery. It is concluded that the portal system is volume
      vessel as well as resistance vessel, which can counteract the intrahepatic
      resistance, maintaining the liver blood flow supply. The hyperdynamic circulation
      of viscera contributes to elevation of constrict power of the superior mesenteric
      artery, resulting in compensatory hypertrophy and hyperplasia of the unstriped
      muscle.

PMID- 7774433
TI  - [The experiment research of OB glue used in tracheoanastomosis].
AB  - Resect a segment of canine cervical trachea. The length of resected trachea is
      from 1-4cm and 5-8cm. In the first group, one dog was used for each length and
      two dogs were used for each length in the second group, therefore twelve were
      used in the experiment. The upper and lower ends were matched and seved by three
      stitches, and OB glue was used to coat in the anastomosis crevice, and at last
      the cre-vice was wrapped with a sheet of loose tracheal sheath. After the
      operation, irritating cough, barking, swallowing and free movement of neck didn't
      cause fistula. Nakedeyes and tissue examination showed that the healing of the
      anastomostic orifice was well and no stenosis was found. The glue membrane was
      absorbed completely within 1-2 months. Outside body anti-pulling force experiment
      (for 8 cases) showed that the anastomostic line can hold 100cm H2O stress and 2kg
      pulling strength if only OB glue was used to connect the resected ends. Hence,
      this experiment shows that the usage of OB glue for tracheal anastomosis is a
      safety, simple and convenient method.

PMID- 7774434
TI  - [The study of repairing ability of freeze-dried bone allograft].
AB  - There were many methods to preserve allogeneic bone allograft, however, a lot of
      studies have shown that the freeze-dried bone allograft banking is the best one.
      But it is not clear what temperature to lyophilize the allograft is better. In
      this experiment, we used method, in which the temperature of lyophilization was
      raising naturally and regularly, to lyophilize the allograft. The repairing
      ability of the freeze-dried allograft was studied in rabbits and comparison was
      made with that of autograft and fresh allograft. The results indicated that the
      repairing ability of bone defects was not significantly different between
      autograft and freeze-dried allograft. There was no significant difference between
      autograft and fresh allograft 3 weeks after transplantation, but significant
      difference was noted 8 weeks after grafting. It is suggested that this might be
      associated with the latent period before immunological rejection and the method
      itself, in which the temperature of lyophilization raising naturally is
      beneficial.

PMID- 7774435
TI  - [Progress in the preparation of bone allografts and their clinical uses].

PMID- 7774436
TI  - [Experimental and clinical studies of small bowel allotransplantation].
AB  - The pigs with allograft were divided into 5 groups according to the different
      immunosuppressive regimens. Acute rejection of allograft occurred in animals not
      treated with immunosuppressive agents or treated with low dose of cyclosporine
      (CsA). There was no rejection developed in the pigs treated with high dose CsA or
      low dose CsA and tripterygium wilfordii (TW). No evidence of chronic rejection
      was detected in animals with continued administration of TW after living longer
      than 100 days when the immunosuppressive treatment was discontinued. A woman with
      enterocolitis, ileus and short-gut syndrome received a complete cadaveric small
      bowel transplantation in march 12, 1994. The graft had 6 minutes for warm
      ischemia and 9 hours and 45 minutes for cold ischemia. The immunosuppressive
      therapy consisted of CsA, TW and methylprednisolone. The patient is alive and the
      function of graft is normal.

PMID- 7774437
TI  - [Application of gasless laparoscopic device in laparoscopic surgery].
AB  - The aim of this study was to evaluate the gasless laparoscopic device (GLD) in
      laparoscopic surgery. GLD, independently designed and manufactured by ourselves
      in 1993, incorporates a manipulator and laparoscopic abdominal retractor. From
      August to October 1993, we conducted an experimental study on gasless
      laparoscopic cholecysto-duodenostomy in 5 dogs. Four of them were completely
      successful and one was converted to open surgery due to gallbladder rupture. The
      result showed that GLD could maintain good exposure in laparoscopic surgery,
      laparoscopic suturing and knotting could become easier and operative cost could
      be reduced with conventional instruments. We also developed an intracorporeal
      "Chinese Knotting" and a self-designed push tube for extracorporeal knot tying.
      During April and August 1994, we successfully applied our modified GLD in gasless
      laparoscopic cholecystectomy, inguinal herniorrhaphy laparoscopic-assisted
      sigmoidectomy, abdomino-perineal resection of rectal carcinoma.

PMID- 7774439
TI  - [AgNOR, DNA ploidy and prognosis in colorectal cancer].
AB  - A follow-up study with special reference to nucleolarorganizer region-associated
      protein (AgNOR) and DNA ploidy was conducted in 83 consecutive cases of
      colorectal cancer patients who underwent radical surgery at the people's
      Hospital, Beijing, from 1982 through 1986. Counting on the mean number of AgNOR
      showed a predominant difference between the tumor tissue (9.796 +/- 3.670) and
      normal mucosa (2.937 +/- 0.812), (P < 0.001). With regard to the tumor
      differentiation, the number of AgNOR was paralleled with the degree of malignancy
      of the tumor, 8.178 +/- 2.864 for well differentiated tumors, 10.086 +/- 3.940
      for moderately differentiated tumors and 11.577 +/- 2.824 for poorly
      differentiated ones. Patients with lower AgNOR (< 10) tumor had a prominent
      survival advantage over those with AgNOR > or = 10 tumor. Particularly when
      combined with the factors of DNA ploidy and AgNOR, prognosis of patients with
      diploid tumor and AgNOR < 10 was more favorable than that of those with aneuploid
      and AgNOR > or = 10 tumor.

PMID- 7774438
TI  - [Effects of over feeding on the energy expenditure and substrates oxidative rate
      in surgical patients].
AB  - In this study, computerized indirect calorimetric measurements were made using a
      medical graphics critical care monitor (CCM) desktop analysis system in the
      observation of metabolic state of 20 patients complicated with external
      gastrointestinal fistula. While these malnourished patients were provided with
      1.5 x REE in total energy intake, the malnutrition state could be reversed. But
      with 1.75 or 2.0 x REE or up total energy intake, the general nutritional state
      could not be improved faster, the O2 consumption and CO2 production and energy
      expenditure increased, while the net glucose oxidation increased and net lipid
      oxidation decreased or net lipogenesis occurred simultaneously. We believed that
      superfluous energy intake is harmful to critically ill patients and may lead to
      cell injury and dysfunction.

PMID- 7774440
TI  - [Inhibition of antisense DNA and its derivative on gastric transformed cell
      carcinogenicity].
AB  - In this study, an antisense c-Ha-ras DNA was synthesized. It was a complementary
      oligonucleotide chain to the sequence of initiation position of c-Ha-ras gene
      transcription. We found that the antisense DNA blocked the gene expression at the
      level of transcription and translation and partially reverted the malignant
      phenotyped of gastric transformed cells, including their growth rate, colonies
      formation in soft agar, tumorigenicity in nude mice and different grade. When the
      5'-end of the antisense DNA was covalently linked with psoralen group, its
      biological effects were significantly enhanced. No effect of tumor inhibition was
      found in control oligonucleotide chains not complete complementary to the
      sequence of target gene. These results indicate that antisense DNA and its
      derivative are effective in tumor gene therapy.

PMID- 7774441
TI  - [Study and clinical application of tumor-infiltrating lymphocytes isolated from
      hepatocarcinoma].
AB  - Tumor-infiltrating lymphocytes isolated from freshly resected tumors of 12
      patients with hepatocarcinoma were propagated in vitro and infused to patients.
      The average weight of tumor for culture of TIL was 4.8g, number of cells 5.8 x
      10(7), time for in vitro expansion was 31.8 days. The maximal expansion achieved
      1000 fold, with a mean amplification rate of 198.5 fold. LAK cell culture
      supernatant stimulated TIL growth. 10 of 12 patients received clinical treatment,
      the number of cells infused reached 4 x 10(8)-1.1 x 10(10). TIL was infused by
      hepatic artery. TIL isolated from hepatocarcinoma demonstrated cytotoxic activity
      to tumor targets.

PMID- 7774442
TI  - [Evaluation of the prognosis of critically ill surgical patients by APACHE II
      score system].
AB  - A prospective trial was conducted in 386 critically ill surgical patients, the
      APACHE II score was used to quantify the severity of illness and to judge the
      outcome. Admission APACHE II score of these patients averaged 15.6 +/- 5.4, the
      mortality rates rose from 1.9% to 100% when the APACHE II score increased from 0
      to 38. The score was closely correlated with the subsequent risk of hospital
      death for these patients (r = 0.75 P < 0.001). Critically ill surgical patients
      would be well served by APACHE II for quality assurance or outcome.

PMID- 7774443
TI  - [The effects of combined hepatectomy and immuno-chemotherapy on postoperative
      recurrence rate of primary liver cancer].
AB  - 121 cases with primary liver cancer were divided into four groups: OP: resection
      only (30 cases); OC: combined operative resection and chemotherapy (27 cases);
      OI: combined operative resection and immunotherapy (31 cases); OI: combined
      operative resection and immuno-chemotherapy (33 cases). The results showed that
      one year recurrence rate was 56.7%, 40.7%, 32.3% and 27.3%, respectively. The
      recurrence rate of group OI and group OIC were significantly lower than that of
      group OP and group OC. It indicated that combined operation and immuno
      chemotherapy is useful in preventing post operative recurrence.

PMID- 7774445
TI  - [Dynamic cardiomyoplasty: first successful clinical case in China].
AB  - A 35-year-old man with chronic heart failure (NYHA Class III) caused by dilated
      cardiopathy was selected for dynamic cardiomyoplasty. The procedures were
      completed in one stage. The left latissimus dorsi muscle was mobilized and
      wrapped around the heart. A set of medtronic cardiomyostimulator system (A
      Medtronic Model SP 1005A Cardiomyostimulator, two Medtronic Model SP 5528
      intramuscular leads, and two medtronic Model 5701-35 Cardiac screw-in leads) was
      implanted. The postoperative sequential progressive skeletal muscle
      electrostimulation was started two weeks after cardiomyoplasty. The final
      electrostimulated parameters were: 6 pulses, amplitude 2.75 V, synchronization
      delay 75 ms, pulse width 210 us, synchronization delay 75 ms, pulse width 210 us,
      synchronization ratio 2:1, frequency 30 Hz, stimulation duration 185 ms. The
      patient recovered very well. After four months, patient's status improved to NYHA
      Class I. Echocardiography, MUGA, and catheterization studies showed a significant
      improvement in hemodynamic parameters (MUGA LVEF increased from 15% to 24%, SVI
      increased from 21.7 ml/beat/m2 to 50.6 ml/beat/m2: CI increased from 2.699
      L/min/m2 to 3.59 L/min/m2.

PMID- 7774444
TI  - [Predictors of hepatic functional reserve in cirrhotic patients].
AB  - We have determined the interstitial ratio, hepatocyte numerical density on area
      (NA) by the method of Luzex-F Image Analyser, and the level of serum prealbumin
      (PA), choline esterase activity (ChE) by agarose immunodiffusion and ratemetry in
      control group (14 cases) and 25 cirrhotic patients undergoing pericardial
      devascularization. The results were compared with traditional hepatic function
      grade (Child's Grade). We found that NA, PA, and ChE are independently useful in
      evaluating the hepatic functional reserve in cirrhotic patients.

PMID- 7774446
TI  - [Congenital kinking of the aorta: report of 5 cases].
AB  - 5 patients with congenital kinking of the aorta, one male and 4 females with a
      mean age of 29 years (age range, 10-37 years), underwent surgical-treatment.
      There was a systolic murmur at the left sternal border and the interscapular area
      and hypertension only in the right arm. A chest rentgenogram showed a widened
      left superior mediastinum. Angiograms showed elongation, kinking and aneurysm
      formation of the aortic arch and descending aorta and the aneurysm ruptured in
      one. Three patients were associated with coarctation of the aortic arch, one with
      coarctation of the upper descending aorta and another with interruption of the
      aortic arch. All the patients had an excellent results. The clinical features,
      morphology, surgical techniques and postoperative care were discussed.

PMID- 7774447
TI  - [Clinical fracture of joint prostheses].
AB  - Ten Ti6Al4V joint prostheses, including 8 hips and 2 knees, were fractured after
      1 to 13 years in vivo service following the primary arthroplasty. The
      metallographs and electronic microscopies, taken from the retrieved components,
      demonstrated that there are typical characteristics of stress corrosion fatigue.
      The excessive chemical content of raw material, the presence of interior defects,
      such as inclosures and porosities, incorrect design features, which violate
      biomechanic principles, the overheating and improper surface finishing of the
      parts, and the clinical varus positioning of the hip stem contribute to the
      device failure. Policies are proposed to overcome this problem. Among them are
      drawing national mandatory standards on surgical implants, taking strigent
      administration measures to ensure the quality of joint prostheses and the
      establishment of training centers for arthroplasty.

PMID- 7774448
TI  - [Absorbable SR-PGA implant in orthopaedics: preliminary results of treatment of
      fractures].
AB  - This article reports preliminary results of treatment in 33 patients with 36
      cancellous bone fractures using absorbable rods and screws of self-reinforced
      polyglycolide (SR-PGA). Plaster cast was used postoperatively for 3 weeks. All
      fractures but one lateral ankle fracture were fixed until healed without
      displacement. All of them healed at six weeks after trauma. No wound infection
      and fluid accumulation occurred. This new device is an ideal implant for fixation
      of cancellous bone fracture.

PMID- 7774449
TI  - [Anatomy and clinical application of transcervicothoracic polyphyletic blood
      supply skin flap].
AB  - Transcervicothoracic skin flap was used to repair the faciocervical scars left
      after burns in 56 cases. Anatomy and clinical application proved that the
      transverse cervical artery branches out a constant skin artery before it enters
      the trapezius muscle and this artery, after crossing the clavicle, is divided
      into two branches, one extending outwards, and the other downwards. The internal
      thoracic artery branched out an intercostal perforator on the spot 1 cm to the
      parasternum. The perforator extended along the intercostal plane and belonged to
      the direct skin artery. The rate for perforation between the second and third
      ribs was the highest and the diameter of the perforator the greatest. The
      thoracoacromial skin artery perforated through the medialsemis between the
      greater pectoral muscle and the deltoid muscle, and extended toward the shoulder,
      supplying the skin of the infraclavicular, deltoid and upper greater pectoral
      regions with blood. Anatomy and contrast examination showed that there are
      extensive anastomoses between the three groups of blood vessels. On the basis of
      these anastomotic branches, transregional skin flaps can be designed to repair
      faciocervical damages. These flaps were successfully used in the 56 cases, with
      32 cases having the the branch of cervical segment of the trasverse cervical
      artery as the pedicle, and 24, the second and third perforators of the internal
      thoracic artery as the pedicle. It was proved that the transregional flaps can be
      successfully transferred regardless of the sites of the pedicles.

PMID- 7774450
TI  - [Endodermal sinus tumor of the testis in children: report of 9 cases].
AB  - Nine children with endodermal sinus tumor of testis have been treated since 1982.
      Their age ranged from 7 months to 5 years. Radical inguinal orchiectomy was
      carried out in all the patients. Four patients have received irregular
      chemotherapy. The follow-up showed that 4 died of the metastasis within 5 years
      and 5 (stage I clinically) survived without evidence of the recurrence for 1.5-7
      years after operation. Serum AFP determination may give important information for
      the classification of the tumor and the evaluation of the follow-up results. For
      the cases of clinical stage I, radical orchiectomy, short course of chemotherapy,
      and frequent observations of AFP level are advocated.

PMID- 7774451
TI  - [A clinical study of inhibition of secondary cataract with heparin].
AB  - Extracapsular cataract extraction with posterior chamber lens implantation was
      performed on 47 eyes with senile cataract of which 25 eyes were in the control
      group and 22 eyes were irrigated with heparin solution (25U/ml) in the operation,
      the drug group. Postoperatively, 2 eyes with hyphema were found in the drug
      group, but the deposition of fibrin and cells on the anterior lenticular surface
      and the posterior capsular opacification were significantly less than those in
      the control group. 3 months after the operation, the mean visual acuity in the
      drug group was 0.70 +/- 0.26 markedly higher than that in the control group, 0.54
      +/- 0.28 (P < 0.05).

PMID- 7774453
TI  - [A clinical analysis of pupillary membrane formation after intraocular lens
      implantation].
AB  - In 540 cases having undertaken extracapsular cataract extraction and intraocular
      lens implantation, a pupillary membrane developed in 76 cases, the rate of
      occurrence being 14%. Generally, the membrane appears on the fifth post-operative
      day and corticosteroids are effective in its treatment. After treatment no
      significant sequela is left and the corrected postoperative visual acuity is not
      affected. The pathogenesis, treatment and prognosis of the pupillary membrane are
      briefly discussed in the report.

PMID- 7774452
TI  - [Cataract extraction and intraocular lens implantation in patients with uveitis].
AB  - Thirty two patients with uveitis had a posterior chamber intraocular lens
      implantation after extracapsular cataract extraction. After a mean follow-up
      period of 5.4 months (range 3 to 29 months), the corrected visual acuity in 93.7%
      of the patients reached to 0.5 or better. Postoperative complications included
      posterior capsule opacification and iris posterior synechiae. The results suggest
      that careful selection of candidates for IOL implantation be crucial for
      successful cataract surgery in uveitis patients.

PMID- 7774454
TI  - [Vitrectomy combined with posterior chamber intraocular lens implantation in
      complicated ocular injuries].
AB  - Posterior chamber intraocular lens implantation combined with lensectomy
      vitrectomy and/or removal of intraocular foreign bodies in one operation was
      performed on 12 patients with ocular injuries involving both anterior and
      posterior segments. There were 6 cases with intravitreal or intraretinal foreign
      bodies, 3 cases with lens dislocation in the vitreous by blunt trauma and 3 cases
      with vitreous hemorrhage and cataract. Pre-operatively, the visual acuities of
      all patients ranged from light perception to 0.02, while postoperatively, their
      visual acuities were 0.5-1.5 in 8 cases, 0.3 in 2 cases, finger counting and 0.05
      in other 2 cases which were related to optic nerve atrophy and retinal vein
      occlusion, respectively. The results suggest that the combined surgery benefit
      the fast visual rehabilitation in selected young patients with unilateral ocular
      injuries.

PMID- 7774456
TI  - [A clinical analysis of subclinical siderosis and secondary glaucoma].
AB  - In this study, we reported 6 cases of retained iron-containing intraocular
      foreign body with no signs of siderosis but manifestations of secondary open
      angle glaucoma. The clinical characteristics and the possible mechanism of this
      form of glaucoma were described. It is proposed to name this special and easily
      neglected glaucoma "subclinical siderosis secondary glaucoma".

PMID- 7774455
TI  - [Complicated cataract after vitrectomy and gas-liquid exchange].
AB  - Cases with complicated cataract occurring after vitrectomy and gas-liquid
      exchange were reported. In a consecutive series of 62 eyes having undertaken the
      operation, a transient cataract developed in 8 eyes and an irreversible cataract
      in 28 eyes. The manifestation of the transient cataract is the posterior
      subcapsular opacity, feathery or placoid vacuolar in clusters in appearance. It
      was found that if the amount of the residual vitreous at the retrolental space is
      great enough, the chance of occurrence of complicated cataract is less. That the
      direct contact of the gas with the lens affects the lens metabolism and nutrition
      is the chief cause of the development of the cataract. It is suggested that to
      prevent the development of cataract induced by the gas, besides selection of body
      posture, quiet stay in bed and proper selection of gas type, the vitreous at
      retrolental space be resected as little as possible.

PMID- 7774457
TI  - [Magnetic resonance imaging in 80 cases of orbital tumors].
AB  - Magnetic resonance imaging (MRI) is a new medical imaging technique which has
      been used in evaluating ocular and orbital diseases in recent years. Owing to the
      high resolution of soft tissues and lesions, it is superior to ultrasound and
      computed tomography in the localization and characterization of an orbital tumor
      in diagnosis. In this paper, we analysed 80 cases of MR images of orbital tumors
      by which all the lesions were detected. Benign or malignant disorders were
      recognized in 59 cases and complete tumors with accurate localization were shown
      in 79 cases. The principles of MRI, signal intensity of various tumors and the
      indications of MRI were discussed.

PMID- 7774458
TI  - [A study on risk factors of retinopathy of prematurity].
AB  - Ocular fundi of 54 premature infants (age of gestation < 37 weeks) and 5 full
      term babies with low body weight (< 2500 g) were examined at the forth week after
      birth. According to the international classification of retinopathy of
      prematurity, they were diagnosed as retinopathy of prematurity (ROP). The risk
      factors of the incidence of ROP were statistically analyzed, respectively. The
      results show that the lower the body weight, the shorter the gestation, the
      higher the oxygen concentration, the longer the oxygen administration, the higher
      the incidence of ROP. The incidences of ROP in the following baby groups, the
      body weight at birth < or = 1500 g, gestational weeks < or = 32 weeks, the oxygen
      concentration administered > 80%, and the duration of persistent oxygen
      administration > 5 days are significantly higher than those in the corresponding
      respective other groups. It is also demonstrated that the duration of the first
      time of oxygen administration and the complications of the newborn babies such as
      asphyxia, intracranial hemorrhage, anemia, pneumonia and blood transfusion have
      no effects on the incidence of ROP.

PMID- 7774459
TI  - [Treatment of myopic anisometropia by radial keratotomy].
AB  - 18 cases of myopic anisometropia were treated by radial keratotomy (RK). The
      preoperative myopia in eyes with higher degrees of refractive error ranged from 
      3.25 to -11.00D (mean = -6.53D), the anisometropia ranged from -2.50 to -11.00D
      (mean = 4.95D) and the visual acuities of the naked eyes were 0.02 to 0.15 (mean
      = 0.08). A half year after the operation, on the average, there was a 0.46
      increase in visual acuity, -4.57 D decrease in myopia and -3.60D decrease in
      anisometropia. Postoperatively, 14 cases had regained the binocular single vision
      and 6 cases had 60" stereoscopic vision which is in the normal range. Therefore,
      it is considered that RK operation not only can decrease myopic degree and
      increase visual acuity, but also can decrease or even eliminate anisometropia to
      facilitate the recovery of binocular single vision. In monocular or anisometropic
      myopia, if the corrected visual acuity of the myopic eye or the eye with higher
      degree of myopia in a case is not below 0.6, RK operation is indicated and if the
      anisometropia is lower than -9.00D, postoperatively, binocular single vision may
      be recovered. The preoperative examination of myopic anisometropia, the method of
      predicting prognosis and some attention points in the treatment are also
      mentioned in the paper.

PMID- 7774460
TI  - [A histopathologic study on lacrimal gland in Sjogren's syndrome].
AB  - Biopsy specimens of palpebral lacrimal glands from 15 cases of Sjogren's syndrome
      (SS) were studied by light and transmission electron microscopy. Six cases
      without any symptoms or signs of dry eyes were used as the control. The main
      changes of SS included: (1) massive infiltration of lymphocytes; (2) atrophy of
      lacrimal glandular follicles and ducts in various degrees; (3) degeneration and
      necrosis of glandular epithelium; and (4) proliferation of connective tissue.
      Lymphatic infiltration indicates that the damage of the glandular tissue might be
      related to autoimmune pathogenesis. According to the histopathologic findings,
      the authors divide SS into three stages which are basically consistent with their
      clinical presentations.

PMID- 7774462
TI  - [A study on histopathology of iris with Nd: YAG and/or argon laser iridotomy].
AB  - Laser iridotomy including Nd: YAG, argon and Nd: YAG combined with argon was
      performed on 42 eyes of 25 chinchilla rabbits. The postoperative follow-up was 8
      months. The histopathological changes of the irides at the sites of the various
      laser shots under light, transmission and scanning electron microscopic
      examinations were compared. The results show: (1) In regard to the Nd: YAG laser
      effect on the target tissue, the inherent elasticity of the tissue may play a
      more important role in curative effects of the therapy than the thickness of the
      tissue. (2) Every iris hole, < 200 microns in diameter, performed by Nd: YAG or <
      450 microns, by argon or argon combined with Nd: YAG was closed by the first
      postoperative week. The histopathological findings demonstrate that the pigment
      epithelial proliferation and migration are more marked in the irides with argon
      laser iridotomy. (3) An insufficient coagulative burn of the argon laser may
      cause congestion of iris blood vessels and possibly, result in more severe
      bleeding during succedent Nd: YAG laser shots.

PMID- 7774461
TI  - [Experimental studies on the changes of immunocytochemistry of gamma-aminobutyric
      acidergic neurons in the lateral geniculate nuclei of amblyopic kittens].
AB  - 14 kittens at 2-4 weeks of age were randomly divided into normal (N) and
      monocular deprived (MD) groups. Before the MD amblyopic models were made, pattern
      visual evoked potentials (PVEPs) were elicited from the experimental eyes. After
      the closure of 7 unilateral eyes (right 3, left 4) with operation, the two kitten
      groups were fed for 12 weeks under a same visual environment. At the end of 12
      weeks, PVEPs were re-examined and amblyopia was confirmed in the MD group. The
      gamma-aminobutyric acidergic (GABAergic) neurons in the layers A, A1 and C in the
      contralateral geniculate nucleus (CLGN) inputs from N and MD eyes were stained
      with antibiotin-peroxidase complex (ABC) method. The changes in number and grey
      degree of GABA immunopositive neurons in the layers A, A1 and C in CLGN inputs
      from N and MD eyes were analysed by a computer image analysis system. The results
      show that GABA immunopositive neurons are reduced in number and their grey degree
      is decreased in the layer inputs from MD eyes in the comparisons between the
      layers of inputs from MD and N eyes. The experiment indicates that (1) GABAergic
      neurons in the kitten lateral geniculate nucleus (LGN) are susceptible to visual
      deprivation during the postnatal critical period and their functions are
      dependent on the import of visual sense information and the retinal activity. (2)
      GABAergic neurons in the LGN act as regulators in dealing with and importing
      visual signal toward striate cortex.

PMID- 7774463
TI  - [Research on corneal thickness at multi-points in normal and myopic eyes].
AB  - The corneal thickness of the center and other 24 points were measured in 31
      normal eyes and 246 myopic eyes. The results show that the mean central corneal
      thickness of the normal eye is 541 +/- 45.29 microns and that of the myopic eye,
      544 +/- 35.01 microns. There are no significant differences in the central
      corneal thickness in comparisons between the left and right eye, between the male
      and female, among various age groups, and among various degrees of refractive
      error. However, with the increase of age and increase of myopic refractive error,
      the central corneal thickness gradually becomes thinner. There are differences in
      thickness among various directions, the superior direction being the thickest and
      the temporal inferior, the thinnest. From the center to the limbus, the thickness
      of the cornea gradually increases, but the values of the increase of the
      thickness are various in various directions, that should be paid attention to in
      radial keratotomy.

PMID- 7774465
TI  - Harry E. Bacon Oration. Comparison of the functional results of restorative
      proctocolectomy for ulcerative colitis between the J and W configuration ileal
      pouches with sutured ileoanal anastomosis.
AB  - PURPOSE: This study was designed to compare function of patients who had
      undergone reconstruction following proctocolectomy for ulcerative colitis using
      the J or W configuration ileoanal pouch. METHODS: Of 126 patients who underwent
      restorative proctocolectomy between January 1981 and March 1993, 101 had surgery
      for ulcerative colitis. Eighty-seven of these patients were available for review
      by personal or postal interview. All operative procedures were performed by one
      surgeon. The group comprised 35 W-pouches and 52 J-pouches. RESULTS: More
      patients with a J-pouch had a stool frequency of greater than 8 per 24 hours (P =
      0.044), and they were also more likely to use a perineal pad (P = 0.019). No
      difference in the rates of nocturnal stool frequency, fecal incontinence, or use
      of constipating agents between the two pouch designs was found. Significantly
      more patients with a J-pouch have had episodes of pouchitis (P = 0.001). Of the
      total patient group 91.9 percent felt that restorative proctocolectomy had
      improved their quality of life. CONCLUSION: Minor differences in the function of
      the W configuration ileoanal pouch and the J configuration ileoanal pouch are
      demonstrated in this study.

PMID- 7774464
TI  - [A method of measuring iris radius by computerized image analysis].
AB  - A new method of measuring the iris contour has been set up with a personal
      computer. The model of a parabolic curve, an approximate mimic iris contour
      curve, was traced to define the profile contour of the iris from a photograph. A
      radius measured from the apex of the curvature of the parabola, named iris radius
      (IR), was calculated by a computer to describe the degree of the curvature of the
      iris contour. The iris radius of 93 eyes of 68 cases with early pupillary block
      primary angle closure glaucoma were measured by this method. The results show
      that the mean iris radius of cases with glaucoma is shorter than that of the
      normal age matched controls (53 cases 106 eyes) and there is statistical
      significant difference (P < 0.01). This method of measurement can be an effective
      method to further study the early diagnosis and pathogenic mechanism of the
      pupillary block angle closure glaucoma.

PMID- 7774466
TI  - Barnett continent intestinal reservoir. Multicenter experience with an
      alternative to the Brooke ileostomy.
AB  - PURPOSE: Since 1988, surgeons at five hospitals have been performing the Barnett
      continent intestinal reservoir (BCIR). The BCIR includes modifications to the
      original Kock pouch, designed to reduce the incidence of valve slippage and
      fistula formation. Principle modifications include an intestinal collar, an
      isoperistaltic valve, and a lateral pouch design. METHOD: This unique
      collaborative study includes 510 ulcerative colitis or familial polyposis
      patients, with a follow-up time from one to five years postoperatively. RESULTS:
      Ninety-two percent still have functioning reservoirs. Six and one-half percent
      have had their pouches removed and replaced with conventional Brooke ileostomies.
      Reoperation rate for major pouch-related complications (other than pouch removal)
      was 12.8 percent. These complications included slipped valve (6.3 percent), valve
      fistulas (4.5 percent), and pouch fistulas (6.3 percent). Several questions were
      administered to patients whose responses revealed a significant improvement in
      general quality of life, state of mind, and overall health. CONCLUSIONS: The BCIR
      represents a successful alternative to patients with a conventional Brooke
      ileostomy or those who are not candidates for the ileal pouch-anal anastomosis.

PMID- 7774467
TI  - Perianal injection of autologous fat for treatment of sphincteric incontinence.
AB  - PURPOSE: The aim of this study was to evaluate the results of treatment of
      partial fecal incontinence with perianal injection of autologous fat. METHODS:
      The study comprised 14 patients with partial fecal incontinence (9 women and 5
      men). Ages ranged from 38 to 62 years. Fifty to 60 ml of fat were harvested from
      the abdominal wall and injected submucosally into the rectal neck at 3 and 9
      o'clock positions. Mean follow-up was 18.6 months. RESULTS: All patients were
      continent during the first two to three postinjection months. At the sixth month,
      patients were divided into three scores. Score 1 (complete continence) comprised
      three patients who are now continent for 9, 11, and 14 months postinjection, with
      normalization of their rectal neck pressure. Seven patients with Score 2 were
      incontinent to flatus and were reinjected; they are now continent (Score 1) for a
      mean of 13.8 months and have normal rectal neck pressure. Four patients had Score
      3 (no improvement), of whom two became continent after the second injection and
      two after the third. They are now continent (Score 1) 6 to 16 months
      postinjection. Factors that contributed to failure comprised injection of
      unwashed fat or wrong positioning of the needle. There was no fat migration or
      embolism. CONCLUSION: Perianal fat injection is effective in treatment of partial
      fecal incontinence. The technique is simple, easy, cost-effective, and performed
      on an outpatient basis.

PMID- 7774468
TI  - Frequency of hereditary nonpolyposis colorectal cancer. A prospective multicenter
      study in Finland.
AB  - PURPOSE: Hereditary nonpolyposis colorectal cancer (HNPCC) is an autosomal
      dominant cancer syndrome characterized by early onset of colorectal carcinomas
      (CRC). Recently, two HNPCC genes have been mapped and cloned, one in the short
      arm of chromosome 2 and another in the short arm of chromosome 3. There has been
      a major controversy about the frequency of HNPCC. The few estimates available
      have been based on series selected by age or series representing local area. The
      purpose of the present study was to design a nonselected, prospective,
      multicenter study, taking into account the family background and other risk
      factors of CRC. METHODS: The proportion of HNPCC of all (N = 406) CRC cases was
      evaluated in a prospective multicenter study. Family history and other risk
      factors were investigated over a 12-month period for all new CRC patients in ten
      hospitals. These cases constituted 23 percent of all CRCs diagnosed in Finland
      during the study period. RESULTS: Three (0.7 percent) cases of verified and seven
      (1.7 percent) cases of suspected HNPCC were identified, following the evaluation
      of all families with features indicative of susceptibility to cancer. The
      proportion of identifiable risk factors of CRC was 5.8-7.5 percent (HNPCC, 0.7
      2.4 percent; previous CRC, 3.4 percent; ulcerative colitis, 1.0 percent; familial
      adenomatous polyposis coli, 0.7 percent). CONCLUSION. This prospective
      multicenter study revealed that the frequency of hereditary colorectal cancer is
      lower than in some previous studies, when diagnosis is based on extensive
      pedigree analysis. This result with recent findings of common ancestral founding
      mutation in Finnish HNPCC families indicates that there may be geographic
      differences in the occurrence of HNPCC. However, this does not change the fact
      that identification of HNPCC--perhaps one of the most common inherited diseases
      identified in humans--has become a question of vital importance now when
      diagnosis of the syndrome and large-scale screening of gene carriers using
      specific tests are on the horizon.

PMID- 7774469
TI  - Colonoscopic bowel preparations--which one? A blinded, prospective, randomized
      trial.
AB  - For the past decade peroral, orthograde, polyethylene glycol-electrolyte lavage
      solutions (PEG-ELS) have been the preferred bowel-cleansing regimens before
      diagnostic and therapeutic procedures on the colon and rectum. The large volume
      and unpalatibility of these solutions may lead to troubling side effects and poor
      patient compliance. PURPOSE: This study was undertaken to determine which of
      various colon-cleansing methods before colonoscopy would provide greater patient
      acceptance while maintaining similar or improved effectiveness and safety.
      METHODS: Three hundred twenty-nine patients undergoing elective ambulatory
      colonoscopy were prospectively randomized to one of three bowel preparation
      regimens. Group 1 received 41 of PEG-ELS (n = 124). Group 2, in addition to PEG
      ELS, received oral metoclopramide (n = 99). Group 3 received oral sodium
      phosphate (n = 106). All groups were evenly matched according to age and sex.
      RESULTS: Ninety-one percent of all patients completed the preparation received.
      Sixteen percent of patients suffered significant sleep loss with a bowel
      preparation. When comparing the three groups, there was no difference in the
      assessment of nausea, vomiting, abdominal cramps, anal irritation, or quality of
      the preparation. Compared with other preparations, oral sodium phosphate was
      better tolerated. More patients completed the preparation (P < or = 0.001). Fewer
      patients complained of abdominal fullness (P < or = 0.001). More patients were
      willing to repeat their preparation (P < or = 0.02). Also, sodium phosphate was
      found to be four times less expensive than either of the PEG-ELS preparations.
      CONCLUSION: All regimens were found to be equally effective. Abdominal symptoms
      and bowel preparation were not influenced by the addition of metoclopramide. The
      oral sodium phosphate preparation was less expensive, better tolerated, and more
      likely to be completed than either of the other preparations.

PMID- 7774470
TI  - Laparoscopic-assisted colectomy learning curve.
AB  - PURPOSE: The purpose of this paper is to establish the number of cases necessary
      to master laparoscopic removal of the left or right colon. METHODS: Data were
      obtained by chart review and by individually completed questionnaires. RESULTS: A
      total of 144 laparoscopic-assisted or intracorporeal right or left
      hemicolectomies were completed by four surgeons at separate institutions.
      Questionnaires were completed by each surgeon for each sequential hemicolectomy,
      and data concerning the type of surgery and total operating time were recorded.
      Times were plotted to diagram individual learning curves for each surgeon, and
      data grouping methods were used to determine the curve for each surgeon as well
      as for the combined data base. Learning was said to have been completed when the
      surgeon's operative time reached a low point and subsequently did not vary by
      more than 30 minutes. A total of 78 right colectomies and 66 left colectomies
      were completed by the group. Respectively, each surgeon appeared to learn the
      procedure after 16, 21, 11, and 6 cases. When the entire database was analyzed as
      a whole, it was shown that between 11 and 15 completed colectomies were needed
      for learning, after which operative times remained relatively stable.
      CONCLUSIONS: This analysis, using total operative time as an indication of
      learning, shows that approximately 11 to 15 completed laparoscopic colectomies
      are needed to comfortably learn this procedure.

PMID- 7774471
TI  - Does the avoidance of nasogastric decompression following elective abdominal
      colorectal surgery affect the incidence of incisional hernia? Results of a
      prospective, randomized trial.
AB  - PURPOSE: In a previous, prospective, randomized study of the use of nasogastric
      tubes in patients undergoing elective abdominal colorectal surgery, we found that
      patients who did not have nasogastric (NG) decompression postoperatively had a
      significantly higher rate of abdominal distention, nausea, and vomiting. Patients
      from that study have now been followed for a median duration of 5.3 years to
      evaluate whether this elevation in perioperative intra-abdominal pressure would
      subsequently lead to an increased incidence of incisional hernia. RESULTS: Of the
      251 patients who received NG decompression, 8 (3.2 percent) developed incisional
      hernias compared with 15 (6.6 percent) of 229 patients who were not decompressed
      (P = 0.085). CONCLUSION: The increase in postoperative abdominal distention and
      vomiting that occurs in patients who do not receive NG decompression does not
      lead to a significantly increased incidence of incisional hernia. Furthermore, we
      continue to support avoidance of routine prophylactic postoperative nasogastric
      decompression in uncomplicated, elective abdominal colorectal surgery.

PMID- 7774472
TI  - Hyperbaric oxygenation in severe perineal Crohn's disease.
AB  - PURPOSE: Perineal involvement in Crohn's disease is a common and distressing
      condition, often refractory to medical or surgical treatments. Recent reports
      suggest the efficacy of hyperbaric oxygenation (HBO) in the healing of perineal
      lesions. We evaluated HBO in severe patients with perineal Crohn's disease.
      METHODS: Ten consecutive patients (8 women, 2 men; mean age, 30 years) were
      studied. There were four superficial fissures, four cavitating ulcers, six low or
      superficial fistulas, two high fistulas, and one irreversible anal stenosis. All
      patients had received one or more medical treatments without healing the perineal
      lesions, and all had had previous surgery for perineal lesions. RESULTS: Two
      patients discontinued HBO after a few sessions and did not complete treatment.
      Eight patients completed at least 30 HBO sessions and were evaluable. At the end
      of the procedure, six of eight patients treated were healed, three completely and
      three partially. All patients who healed completely received HBO as an additional
      treatment to local perineal surgery. CONCLUSION: HBO might be useful as a last
      resort treatment of chronic perineal Crohn's disease, resistant to other
      treatments or as a complement to surgery.

PMID- 7774473
TI  - Fluctuation of blood pressure and pulse rate during colostomy irrigation.
AB  - PURPOSE: The aim of this study was to determine the effects of colostomy
      irrigation on the vital signs of patients with left colostomy. METHODS: Twenty
      two consecutive patients who underwent abdominoperineal resection for cancer of
      the lower rectum and had left lower quadrant end colostomy were included in this
      study. Subjective symptoms, blood pressure, and pulse rate during the first
      irrigation were investigated. RESULTS: Fluctuation of blood pressure during
      instillation was 8.0/8.5 mmHg (average) and 25.0/17.9 mmHg during evacuation.
      Fluctuation of pulse rate was 5.5 per minute (average) during instillation and
      11.5 per minute during evacuation. The number of subjects who showed more than
      20% fluctuation of systolic pressure was 12 (54.5 percent) and that of diastolic
      pressure was 14 (63.6 percent). One of 22 patients complained of illness during
      irrigation. CONCLUSION: Although colostomy irrigation showed no significant
      effects on vital signs in the majority of patients, it caused a significant
      reduction in both blood pressure and pulse rate in a small number of patients.
      Careful attention should be paid to vital signs considering the possibility of
      such effects, especially on the initial irrigation.

PMID- 7774474
TI  - Follow-up after curative surgery for colorectal carcinoma. Randomized comparison
      with no follow-up.
AB  - PURPOSE: This study investigated the value of intense follow-up compared with no
      follow-up after curative surgery of cancer in the colon or rectum. METHODS: One
      hundred seven patients were randomized to no follow-up (control group; n = 54) or
      intense follow-up (follow-up group; n = 53) after surgery and early postoperative
      colonoscopy. Patients in the follow-up group were followed at frequent intervals
      with clinical examination, rigid proctosigmoidoscopy, colonoscopy, computed
      tomography of the pelvis (in patients operated with abdominoperineal resection),
      pulmonary x-ray, liver function tests, and determinations of carcinoembryonic
      antigen and fecal hemoglobin. Follow-up ranged from 5.5 to 8.8 years after
      primary surgery. RESULTS: Tumor recurred in 18 patients (33 percent) in the
      control group and in 17 patients (32 percent) in the follow-up group. Reresection
      with curative intent was performed in three patients in the control group and in
      five patients (four of whom were asymptomatic) in the follow-up group. In the
      follow-up group two asymptomatic patients with elevated carcinoembryonic antigen
      levels were disease-free three and five and one-half years after reresection and
      were the only patients apparently cured by reresection. No patient underwent
      surgery for metastatic disease in the liver or lungs. Symptomatic metachronous
      carcinoma was detected in one patient (control group) after three years. Five
      year survival rate was 67 percent in the control group and 75 percent in the
      follow-up group (P > 0.05); the corresponding cancer-specific survival rates were
      71 percent and 78 percent, respectively. CONCLUSION: Intense follow-up after
      resection of colorectal cancer did not prolong survival in this study.

PMID- 7774475
TI  - Long-term management of diverticulitis in young patients.
AB  - PURPOSE: This study was designed to determine the natural history of documented
      diverticulitis that resolves after treatment with intravenous antibiotics and
      bowel rest in patients under the age of 50. METHODS: Records of 40 patients aged
      50 or under who were hospitalized with the diagnosis of acute diverticulitis
      between 1980 and 1984 were reviewed to obtain data regarding how the diagnosis
      was made. Patients successfully treated with antibiotics were contacted five to
      nine years after their attack and surveyed via telephone questionnaire about
      symptoms, recurrent attacks, and surgical interventions. RESULTS: A total of 40
      patients were included in the study. Ten patients (25 percent) required surgery
      during initial admission, and 30 patients were discharged with resolution of
      their symptoms after treatment with intravenous antibiotics and bowel rest. A
      five-year to nine-year follow-up was obtained on patients treated medically, one
      third of whom underwent operation for diverticulitis during this period, and two
      thirds of whom did not require surgery during the follow-up period. All
      operations were elective with single-stage resections. CONCLUSION: Based on our
      data, we do not recommend surgery in this population after a single episode of
      diverticulitis that resolves after treatment with antibiotics.

PMID- 7774476
TI  - Pudendal neuropathy is not related to physiologic pelvic outlet obstruction.
AB  - Chronic straining because of pelvic outlet obstruction is hypothesized to cause
      pudendal neuropathy (PN) by stretch injury. PURPOSE: The aim of this study was to
      determine any association between PN and pelvic outlet obstruction. METHODS: One
      hundred forty-seven constipated patients were evaluated by cinedefecography and
      pudendal nerve terminal motor latency assessment. PN was defined as a latency
      longer than 2.2 ms. Pelvic outlet obstructive patterns of evacuation included
      paradoxic contraction, nonrelaxation of the puborectalis muscle, or failure of
      opening of the anal canal. RESULTS: Median length of constipation including
      straining during evacuation was eight (range, 1-47) years. Ninety-one (62
      percent) subjects had a normal pattern of evacuation, and 56 (38 percent) had an
      obstructed pattern. Both groups had a similar median age (68 vs. 69 years,
      respectively; P > 0.05) and same median length of symptoms. Overall incidence of
      PN was 23.8 percent (10.9 percent unilateral and 12.9 percent bilateral). There
      was no difference in the incidence of PN between patients with normal evacuation
      and patients with obstructed evacuation (24.2 percent vs. 23.2 percent,
      respectively; P > 0.05). Patients with PN had a similar incidence of physiologic
      pelvic outlet obstruction as did patients without PN. However, median age of
      patients with PN was higher than those without PN (73 vs. 66 years, respectively;
      P > 0.05). CONCLUSION: There was a difference in the incidence of PN between
      normal and obstructed patterns of evacuation. Therefore, the espoused theory that
      obstructed defecation causes PN appears flawed.

PMID- 7774477
TI  - Subtotal colectomy with Hartmann's pouch for inflammatory bowel disease.
AB  - PURPOSE: Fulminant or unremitting colitis caused by inflammatory bowel disease
      (IBD) is effectively managed by subtotal colectomy (STC) and standard ileostomy.
      However, controversy exists regarding the optimal management of the retained
      rectum. We reviewed our experience with intraperitoneal Hartmann's closure to
      determine whether this is an acceptable way to handle the rectal remnant.
      METHODS: We retrospectively reviewed hospital and office records of 114
      consecutive patients with IBD colitis who underwent STC with Hartmann's pouch
      since 1988. Patient demographic data, operative details, and postoperative
      complications were recorded. In patients who underwent subsequent surgery,
      technical difficulty and complications related to rectal dissection were
      documented. RESULTS: There were three instances of pelvic sepsis secondary to
      leakage from the Hartmann's pouch, an overall incidence of 2.6 percent. Two of
      these patients required exploratory surgery. The third patient responded
      dramatically to antibiotics and transanal catheter decompression of the
      Hartmann's pouch. Subsequent to this experience, patients undergoing STC and
      Hartmann's closure for IBD colitis had transanal catheter drainage of the rectal
      remnant as a routine part of their postoperative care. There were no instances of
      leakage among the 41 patients who underwent rectal decompression. There were two
      reports (3 percent) of technical difficulty in locating or mobilizing the
      intraperitoneal rectal remnant at 60 subsequent surgical procedures. CONCLUSION:
      Intraperitoneal Hartmann's closure of the rectum is the preferred management in
      patients with intractable IBD colitis requiring STC.

PMID- 7774478
TI  - Intestinal obstruction promotes gut translocation of bacteria.
AB  - PURPOSE: Translocation of enteric organisms has been implicated as a possible
      source of sepsis in susceptible patients. Animals studies have suggested that
      intestinal obstruction promotes bacterial translocation from the gut lumen. The
      aim of this study was to study the prevalence of bacterial translocation in
      patients with and without intestinal obstruction. METHODS: Serosal scrapings,
      mesenteric lymph nodes, and peripheral blood cultures were obtained from 254
      patients. Scrapings and nodes were homogenized and incubated aerobically and
      anaerobically. Full-thickness biopsies underwent villous height analysis. The
      clinical course was followed for at least six weeks. RESULTS: Bacterial
      translocation to mesenteric nodes occurred more frequently in patients with large
      bowel obstruction than in patients without obstruction (14 of 36 patients vs. 16
      of 218 patients; P < 0.001). Both aerobic and anaerobic bacteria were found to
      translocate. The more distal the obstruction, the more likely anaerobic bacteria
      were to be identified. Translocation of bacteria predisposed to postoperative
      septic complications (P < 0.05). Villous height was not related to bacterial
      translocation. CONCLUSIONS: Gut translocation of bacteria is more common in
      patients with intestinal obstruction, and its association with septic
      complications appears to be of clinical significance.

PMID- 7774479
TI  - Outcome of surgery for colorectal cancer in a defined population in Sweden from
      1984 to 1986.
AB  - PURPOSE: This study was designed to investigate incidence, treatment, and outcome
      for patients with colorectal cancer. METHODS: From 1984 to 1986 in Ostergotland,
      a county in Sweden with a defined population, a prospective registration using a
      computerized protocol was undertaken. RESULTS: In the surgical departments 596
      cases were diagnosed and 31 more cases were diagnosed in other departments,
      bringing the incidence to 53 cases per 100,000 inhabitants per year. Of the
      cases, 14 percent presented as emergencies. The resectability rate was 90
      percent, and the rate of curative operations was 74 percent. Postoperative
      mortality within 30 days was 2.9 percent. Crude five-year survival for all
      patients was 40 percent, and the corrected survival rate was 53 percent. After
      curative resection the crude five-year survival rate was 53 percent, and the
      corrected survival rate was 70 percent. Prognosis was better for colon than for
      rectal cancer, 76 percent vs. 59 percent corrected five-year survival rate. For
      rectal cancer the local recurrence rate was 20 percent after curative resection.
      CONCLUSIONS: The prognosis was improved compared with a previous study from the
      same area because of decreased postoperative mortality, increased rate of
      operations for cure, and an increased five-year corrected survival rate. Local
      recurrence after rectal cancer was still high but may be reduced with improved
      surgical technique.

PMID- 7774480
TI  - Expression of nm23-H1 predicts lymph node involvement in colorectal carcinoma.
AB  - PURPOSE: Reduced expression of the metastasis suppressor gene nm23-H1 has
      previously been correlated with high tumor metastatic potential and fatal
      clinical outcome in some tumors (e.g., breast). For colorectal carcinomas, the
      findings are equivocal. METHODS: We have used a monoclonal antibody against nm23
      H1 to investigate the expression in colorectal carcinomas at the time of primary
      curative surgery (R0 resection) to assess if there was any relation between nm23
      H1 expression and stage or histologic grade at the time of primary tumor removal.
      RESULTS: Of 100 colorectal carcinomas studied (Stages I, II, and III according
      UICC, all resected curatively), nm23-H1 immunoreactivity was weak in 41 (41
      percent), moderate in 24 (24 percent), and strong in 35 (35 percent) cases. The
      grade of positivity against nm23-H1 was significantly lower in advanced stages of
      the disease (Stages II or III) (P < 0.001, chi-squared = 52.8). In tumors with
      low or weak immunoreactivity against nm23-H1, frequency of lymph node metastases
      was significantly higher compared with those with moderate or strong staining (P
      < 0.001; chi-squared = 50.58). Therefore, with a sensitivity of 93 percent and a
      specificity of 58 percent, low nm23-H1 immunoreactivity of the primary tumor,
      assessed at the time of surgery, is an indicator of the presence of lymph node
      metastases. CONCLUSIONS: Immunohisto-chemical evaluation of nm23-H1 in the
      primary tumor or in a biopsy is a useful predictor of stage of disease and
      presence of lymph node metastases in colorectal carcinomas and may have clinical
      significance, e.g., in predicting optimal therapeutic regimes.

PMID- 7774482
TI  - Circular stapled rectal stricturoplasty with the Proximate intraluminal stapler.
AB  - PURPOSE: Benign rectal strictures arise from a variety of causes, and numerous
      techniques have been developed to deal with them. When even the most innovative
      methods of stricture treatment fail, major resection may be required. An
      alternative to resection is desirable. METHODS: A case is presented in which the
      Proximate curved intraluminal stapler was used to perform successful
      stricturoplasty of a low rectal stricture when other methods failed. RESULTS:
      Circular stapled rectal stricturoplasty provided a wide lumen, minimized
      perforation risk, and preserved continence. CONCLUSION: Circular stapled rectal
      stricturoplasty is an option to consider when other treatments for rectal
      stricture fail.

PMID- 7774481
TI  - Treatment of Hirschsprung's disease in the adult. Report of five cases.
AB  - PURPOSE: Between 1983 and 1991, five adult patients were diagnosed and treated
      for Hirschsprung's disease. Mean age was 37 (range, 13-45) years. Three patients
      had classic Hirschsprung's disease, and two had findings consistent with short
      segment disease. Each patient had a history of disabling, lifelong constipation.
      METHODS: Diagnosis was established with the aid of barium enema study, anorectal
      manometry, and tissue biopsy. RESULTS: Three patients with classic disease
      underwent resection of diseased bowel, rectal mucosectomy, and anastomosis
      between the ganglion-containing bowel and anus. All three patients had excellent
      functional improvement in the perioperative period. Two patients with findings
      consistent with short segment Hirschsprung's disease were treated by anorectal
      myectomy. Neither patient obtained lasting relief.

PMID- 7774483
TI  - Stapled stricturoplasty for Crohn's disease. A new technique.
AB  - PURPOSE: Stricturoplasty was originally used to treat multiple fibrotic
      strictures of tuberculosis. As the pendulum of treatment of Crohn's disease swung
      toward conservatism and bowel preservation, stricturoplasty was performed in
      Crohn's disease. Stricturoplasty can be used when there is limited, well
      localized disease and should be avoided in the presence of grossly inflamed or
      infected material. We describe a new technique of stricturoplasty. METHODS:
      Typically stricturoplasty is performed in a manner similar to a Heineke-Mikulicz
      pyloroplasty. A stapled stricturoplasty technique has been previously described,
      but in actuality these are more similar to a bypass procedure. Our technique uses
      a stapled, open technique similar to the triangulating method of bowel
      anastomosis. This was performed in one patient to correct six strictures.
      RESULTS: Our patient did well postoperatively and developed no significant
      complications. He has no evidence of recurrent strictures. CONCLUSION: We
      describe a stapled stricturoplasty technique that is truly a stricturoplasty
      because the bowel lumen is increased; it is similar to the triangulating method
      of end-to-end stapled bowel anastomosis. It is safe, efficient, and effective.
      Additionally, it allows radiographic location of the stricturoplasty site, thus
      allowing determination of effectiveness of the procedure as well as recurrence.

PMID- 7774484
TI  - Do nonsteroidal anti-inflammatory drugs prevent rectal carcinoma in familial
      adenomatous polyposis?

PMID- 7774485
TI  - Technical error caused by software.

PMID- 7774486
TI  - An unusual cutaneous presentation of metastatic colon carcinoma.

PMID- 7774487
TI  - Fine-needle aspiration cytopathology of soft tissue: chondromyxoid and myxoid
      lesions.
AB  - Soft-tissue lesions pose an intimidating challenge to diagnostic interpretation
      by fine-needle aspiration cytology. To better characterize such aspirates, we
      investigated a subgroup of lesions which yielded a large amount of chondromyxoid
      and myxoid stroma (CMS). Thirty-three cases (22 malignant lesions, 11 benign
      lesions) in which CMS was a prominent feature of the smears were studied. The
      most common malignant neoplasms were extraskeletal chondrosarcoma (6 cases),
      myxoid liposarcoma (6), and malignant fibrous histiocytoma (5). The benign
      entities consisted of ganglion cyst (4), myxoma (3), and neurofibroma (2). Of the
      aspirates from 22 malignant neoplasms, 15 (68%) contained opaque stroma, and in
      18 (81%) the stroma was distributed as discrete clumps or fragments; all
      extraskeletal chondrosarcomas and chordomas contained these features.
      Additionally, in five of six chondrosarcomas the matrix exhibited cells within
      lacunae. Except for a tracheal chondroma which extended into the adjacent soft
      tissue, no benign aspirates had all three of these cytologic features. Twenty
      three aspirates (70%) were moderately or highly cellular; all but two of these
      were malignant. Moderate to marked nuclear atypia occurred in 13/22 (59%)
      malignant and 1/11 (9.0%) benign aspirates. With a few exceptions, aspiration
      smears of benign lesions with abundant CMS were characterized by low cellularity,
      semitransparent amorphous stroma, and lack of nuclear irregularity. Recognition
      of variations in the character of the background material in addition to
      traditional cytologic criteria can aid in the diagnosis of benign and malignant
      chondromyxoid and myxoid aspirates of soft tissue.

PMID- 7774488
TI  - Transtracheal needle aspiration.
AB  - A series of 27 transtracheal needle aspiration biopsies performed on 25 patients
      were reviewed. A rigid bronchoscope and rigid needle were used. The biopsies were
      performed as staging procedures in patients with bronchogenic carcinoma, or to
      obtain diagnoses in patients with mediastinal adenopathy. A cytopathologist
      attended 11 biopsies and microscopically examined a direct smear to determine
      adequacy. Repeat biopsies were taken at the time if necessary. A diagnosis was
      obtained in 9/11 (81%) of these cases. Only 3/16 biopsies (18.8%) performed in
      the absence of a pathologist were diagnostic. All negative cases were
      subsequently found to have disease (2 sarcoidosis, 13 cancer) by other methods
      including mediastinoscopy in 5 cases. In the patient group sampled, the technique
      of rigid needle and rigid bronchoscope with a cytopathologist in attendance
      resulted in a much higher sensitivity for the test than has been previously
      reported.

PMID- 7774489
TI  - Mucinous cystic tumor of the pancreas: an analysis of FNA characteristics with an
      emphasis on the spectrum of malignancy associated features.
AB  - Previously, pancreatic mucinous cystic tumors were classified as either benign
      (cystadenoma) or malignant (cystadenocarcinoma). Descriptions of the fine-needle
      aspiration (FNA) findings of these neoplasms have heretofore emphasized malignant
      cytologic characteristics. In the following, we present a summary of a study of
      FNA characteristics from ten patients with cystic mucinous neoplasms, four of
      whom have correlating histologic material. In this study, we found a spectrum of
      cytologic features ranging from completely benign appearing to obviously
      malignant. We discuss cystic mucinous pancreatic tumors and the associated FNA
      findings helpful in diagnosis and categorization of these neoplasms. Also, we
      suggest the inclusion of a new entity in the mucinous neoplasm category.

PMID- 7774490
TI  - Comparative cytologic findings of in situ and invasive adenocarcinoma of the
      uterine cervix.
AB  - The cytologic findings in 13 cases of cervical adenocarcinoma in situ (mean age
      33.9 yr) were compared with those in 9 cases of cervical invasive adenocarcinoma
      (mean age 45.7 yr). All diagnoses were confirmed by biopsy. The major differences
      found were that a necrotic background (66% invasive vs. 0% in situ) and
      macronucleoli (77% invasive vs. 0% in situ) were more common in invasive cases,
      whereas associated squamous-cell dysplasia (69% in situ vs. 0% invasive) was more
      common in in situ cases. Other differences included syncytial tissue fragments
      with irregular cell borders, frequent cell drop-off, and markedly atypical single
      columnar cells (or markedly atypical naked nuclei) seen more commonly in invasive
      cases, whereas monolayer sheets and/or syncytial tissue fragments with smooth
      borders and rare cell drop-off were more common in in situ cases. Although none
      of these features is diagnostic individually, in combination they are helpful in
      distinguishing between in situ and invasive adenocarcinoma. Nine of 13 of the in
      situ cases showed associated squamous-cell dysplasia. In all nine of these cases,
      the glandular dysplasia was overlooked or underestimated in severity on original
      cytologic diagnosis. This suggests that the presence of a squamous lesion may
      lead to decreased detection of glandular lesions, perhaps because the features of
      squamous lesions are more well known; thus they are more easily recognized, at
      the expense of glandular lesions. All invasive adenocarcinomas were identified as
      carcinoma in the original diagnosis with seven specified as invasive
      adenocarcinomas.

PMID- 7774491
TI  - Benign spindle and inflammatory lesions of the breast: diagnosis by fine-needle
      aspiration.
AB  - We describe fine-needle aspiration (FNA) findings in 7 patients with breast
      masses showing numerous spindle cells in smear material. The benign nature of
      these lesions was confirmed by clinical follow-up (n = 4) or surgical excision
      with histologic examination (n = 3). The final diagnosis included one case each
      of myofibroblastoma, juvenile hypertrophy, post-FNA reactive stromal
      proliferation, stromal induction in proliferative fibrocystic disease, and
      subareolar abscess. There were two instances of granulation tissue. The case of
      stromal induction was initially felt to be suspicious for phyllodes tumor. The
      post-FNA stromal reaction was considered sufficiently atypical to warrant
      histologic investigation. The importance of historical and physical examination
      findings in accurate interpretation of these uncommon cases is emphasized. Some
      will require histologic assessment for final diagnosis.

PMID- 7774492
TI  - Subcutaneous masses of the scalp and forehead: diagnosis by fine-needle
      aspiration.
AB  - We report our cytologic findings and clinical correlations in benign (N = 2) and
      malignant (N = 16) subcutaneous masses of the scalp (N = 15) and forehead (N =
      3), studied by fine-needle aspiration (FNA). Diagnoses were divided in 3 groups:
      (1) Scalp plasmacytoma (as a manifestation of multiple myeloma) (6 cases) was the
      most frequent diagnosis. In one patient it was the presenting manifestation of
      the disease. (2) Miscellaneous malignancies included 8 carcinomas, 1 melanoma,
      and 1 malignant lymphoma. The scalp or forehead mass was the initial presentation
      and FNA was the initial diagnostic approach in five patients. (3) A single case
      each of pilar-type keratinous cyst and hematoma were the only benign masses
      encountered. In conclusion, a significant number of subcutaneous masses of the
      scalp or forehead represent metastatic or systemic malignancies, and they may be
      the initial manifestation of the disease. Rapid and accurate diagnosis by FNA
      provides guidelines for appropriate therapy, especially in those patients who
      present with advanced disease.

PMID- 7774493
TI  - High grade squamous cervical lesions following negative Papanicolaou smears:
      false-negative cervical cytology or rapid progression.
AB  - The cervical cytologic finding of a high grade squamous intraepithelial lesion
      (HGSIL) or carcinoma shortly following a negative smear is unusual. To determine
      if such cases are due to screening errors, inadequate sampling, or rapidly
      progressive lesions, a review of negative smears (immediately preceding a
      diagnosis of HGSIL or carcinoma by at most 2 yr) was performed on 17 patients
      (all such patients in our 1990-92 files, representing 6% (17/290) of such
      diagnoses). The time between negative smear and positive result averaged 9.3 mo.
      Eighty-eight percent of these patients had prior histories of a cytologic
      abnormality. Upon review, 16 of 17 "negative" smears contained a cytologic
      abnormality. Atypical immature squamous metaplastic type cells (AISMTs) were
      found in 11 of 16 cases, atypical squamous cells or slight dysplasia were found
      in 5 of 16, HGSIL was found in 5 of 16, and atypical cells of undetermined type
      and origin were noted in 1 of 16. Combinations of the above diagnoses were
      present in 6 of 16 cases. The number of abnormal cells per slide was estimated,
      with < 10 cells in 1 case, < 50 in 4 cases, 50-100 in 7 cases, 100-200 in 3
      cases, and > 200 in 1 case. In this study, screening and/or evaluation errors
      were the dominant cause of false-negative cytologic diagnoses, with AISMTs
      accounting for the most commonly missed or misinterpreted cells. These cells are
      small and have hyperchromatic nuclei with elevated nucleus to cytoplasmic ratio
      and nuclear irregularities.

PMID- 7774494
TI  - Comparison of immunoreactivity of neu oncoprotein in fine-needle aspirates and
      paraffin-embedded materials.
AB  - Expression of the neu oncogene has been extensively examined in frozen and
      paraffin section breast cancers; however, very few studies examine neu
      oncoprotein oncoprotein expression in fine-needle aspirates. To this effect, we
      compared the expression of neu oncoprotein in formalin-fixed paraffin-embedded
      breast cancers and the corresponding fine-needle aspirates of these cancers.
      There was 100% correlation between the expression of neu oncoprotein in the
      paraffin-embedded breast cancers and the fine-needle aspirates, indicating the
      suitability of fine-needle aspirates for the expression of neu oncoprotein in
      breast cancers.

PMID- 7774495
TI  - c-erbB-2 in retrospect: is it time for molecular cytology?

PMID- 7774496
TI  - Renal hydatid cyst: urinary cytological diagnosis.
AB  - Echinococcal disease is endemic in many areas of Asia, Europe, South America, the
      Near East, Australia, and New Zealand. Hepatic and pulmonary cysts are the most
      common presentation. Isolated renal hydatid cyst is an uncommon presentation of
      echinococcal disease, since renal involvement occurs in only 2-3% of cases. We
      present the case of a young man with renal colic, in whom the diagnosis of renal
      hydatid disease was established cytologically. Urine cytology, performed because
      of persistent hematuria, revealed scolices of Echinococcus granulosus and
      prompted further imaging investigation, and, ultimately, surgical treatment.

PMID- 7774497
TI  - Pilomatrixoma: a description of two cases diagnosed by fine-needle aspiration.
AB  - The present work reports on the findings obtained by fine-needle aspiration of
      two pilomatrixomas located on the upper limbs whose diagnosis was confirmed
      histologically. In both cases, the cytology disclosed a proliferation of small
      round basaloid cells that were dispersed and grouped in clusters together with
      squamous cells and abundant multinucleate giant cells. The differential diagnosis
      with other neoplasms is discussed.

PMID- 7774498
TI  - Neuroendocrine carcinoma of the thymus: aspiration biopsy, immunocytochemistry,
      and clinicopathologic correlates.
AB  - We report three cases of well-differentiated neuroendocrine carcinoma originating
      primarily in the anterior mediastinum which had been initially investigated by
      fine-needle aspiration cytology in conjunction with immunocytochemistry and
      subsequently recognized as thymic in origin. Aspirates consisted of loosely
      cohesive or aggregated medium sized elements with round to oval nuclei and scanty
      cytoplasm. In all cases the Romanowsky stain provided an excellent delineation of
      definite paranuclear inclusion-like structures having a semicircular or discoid
      appearance which appeared to contain cytokeratin by immunocytochemical studies
      and were very similar to the intermediate filament paranuclear "buttons" found in
      neuroendocrine Merkel cell carcinoma of the skin. This appears to be a novel
      cytologic observation for thymic neuroendocrine carcinoma. We discuss the
      significance of the above cytologic and immunocytochemical findings and their
      possible role in the diagnosis of thymic neuroendocrine carcinoma by fine-needle
      aspiration biopsy.

PMID- 7774499
TI  - Primary lymphoma of bone: diagnosis by fine-needle aspiration biopsy in a
      pediatric patient.
AB  - We present an unusual case of a child with an isolated lytic lesion in the L3
      vertebral body. Fine-needle aspiration biopsy showed a small, blue-cell neoplasm
      raising the differential diagnosis of Ewing's sarcoma and lymphoblastic lymphoma.
      Through a combination of morphologic and immunofluorescent findings we
      established a diagnosis of lymphoblastic lymphoma. This case further documents
      the utility of fine-needle aspiration biopsy in the diagnosis of pediatric
      tumors.

PMID- 7774501
TI  - Ultrasound guided fine-needle aspiration cytology: diagnosis of hydatid disease
      of the abdomen and thorax.
AB  - Eight cases of hydatid disease of the abdomen and thorax were diagnosed by fine
      needle aspiration (FNA) cytology under ultrasound guidance. The age of the
      patients ranged from 28 to 60 yr with a median of 34.5 yr; the male to female
      ratio was 2:6. None of the cases were diagnosed clinically as hydatid diseases
      but following ultrasonography suspicion of hydatid cyst was raised in two cases.
      The locations of cysts were the liver in six cases, the lung in one case, and the
      mediastinum in one case. FNA yielded clear fluid in five cases and turbid fluid
      in three cases. Laminated cyst wall, scolices, and hooklets were observed in one
      case, scolices and hooklets were present in two cases, and laminated cyst wall
      along with hooklets were seen in two cases. The remaining three cases showed only
      laminated cyst walls which yielded positive reaction with periodic acid-Schiff
      reaction. Inflammatory cell reaction in the form of neutrophils was observed in
      four cases, including the three cases where turbid fluid was aspirated.
      Epithelioid cell reaction was present in one case. None of our eight cases showed
      any untoward allergic reaction following FNA.

PMID- 7774500
TI  - Fine-needle aspiration cytology of adenoid (acantholytic) squamous-cell
      carcinoma.
AB  - Adenoid squamous-cell carcinoma (ASCCa) is an uncommon cancer which occurs most
      frequently in the skin of the head and neck region of elderly, sun-exposed
      individuals. Histologically, ASCCa is characterized by gland-like, "adenoid" cell
      groups with a central, detached acantholytic cellular component and an intact
      peripheral rim of cells. The cytological features of five fine-needle aspiration
      cytology (FNAC) samples from four patients with primary or metastatic ASCCa are
      presented. These were assessed for features which would allow distinction of this
      variant from conventional squamous carcinoma. The adenoid component was
      represented in FNAC by intact, sometimes three-dimensional cell groups simulating
      glandular structures. Also present were cells in short chains of two or three in
      single cell files and scattered, individual dyskeratotic cells. Individual cells
      had rounded, accentuated borders, cytoplasmic keratinization, and often pyknotic
      nuclei, representing acantholytic cells from the adenoid "lumens." Features of
      malignancy, including cellular atypia and increased mitotic rate, were present
      allowing for distinction between ASCCa and benign acantholytic processes such as
      pemphigus.

PMID- 7774502
TI  - Cytodiagnostic pitfalls in pulmonary coccidioidomycosis.
AB  - Two cases of pulmonary coccidioidomycosis which were initially misdiagnosed as
      carcinoma in cytologic examinations of material obtained by bronchoscopy or fine
      needle aspiration are reported. The cytodiagnostic pitfalls of misinterpreting
      reactive bronchial epithelial cells as carcinoma cells and of failing to
      recognize fungal organisms are discussed.

PMID- 7774503
TI  - Comparison of conventional and ThinPrep preparations of mucoid cytology samples.
AB  - Cytological specimens containing large amounts of mucus and/or blood are often a
      considerable problem as far as preparation and especially screening are
      concerned. The ThinPrep method, which uses a mucolytic and hemolysing solution
      and prepares slides automatically, eliminates difficulties in both areas.
      Comparing ThinPreps to conventionally prepared samples reveals equivalent or even
      superior cellular preservation. Cells are spread in a thin layer, mostly with
      only a minimal amount of residual mucus or blood. Screening is consequently much
      easier and faster. The time-saving effect does not compromise the diagnostic
      accuracy, as we could demonstrate with an 92% overall agreement in both
      procedures. The difference of 8% could possibly be attributed to inadequate
      splitting of the samples.

PMID- 7774504
TI  - The status of residency training in cytopathology.

PMID- 7774505
TI  - Cytological grading of breast carcinoma.

PMID- 7774506
TI  - Spindling artefact of urothelial cells.

PMID- 7774507
TI  - FNA lymphoproliferative diseases: myths and legends.

PMID- 7774508
TI  - Current management of acute myocardial infarction.
AB  - Acute myocardial infarction is a devastating cardiac clinical event, which is the
      result of progressive coronary arteriosclerosis. Coronary heart disease is a
      major health concern that accounts for a significant number of hospitalizations,
      health care expenditures, and deaths. Recent advancements in the nature and
      pathophysiology of progressive coronary disease and infarction have allowed us to
      curb the natural course of the disease, shorten hospital stays, and improve
      patient outcomes. Focused history taking and physical examination, with the
      assistance of the appropriate laboratory studies and an electrocardiogram,
      facilitate the rapid identification of a patient with myocardial infarction.
      Overall clinical results will be improved by minimizing the time from diagnosis
      to therapy. Several initial measures are readily available to the physician at
      the time of the patient's arrival in the hospital emergency room. Consideration
      regarding relief of pain, anticoagulation, and contraindications for thrombolytic
      therapy should accompany the initial evaluation. For patients in whom the
      diagnosis is in doubt, adjunctive confirmatory testing and imaging studies should
      be urgently sought. Elderly patients have a higher mortality rate from
      infarction, so an aggressive approach in this group of patients is warranted.
      Administration of thrombolytic therapy or primary angioplasty will be most
      efficacious in a majority of patients. The evolution of adjunctive medications
      will further improve efficacy and avoid reinfarction. Proper dosage and timing of
      adjunctive medications, along with dosage titration based on hemodynamic
      response, will facilitate the best possible results. Rapid restoration of flow
      down a suddenly occluded epicardial coronary vessel is the primary end point in
      therapy. With this in mind, there has been an increasing trend toward mechanical
      restoration of flow by means of primary angioplasty in centers where this
      technologic capability is available. Close attention to the patient's hemodynamic
      status along with rapid identification and therapy of peri-infarction arrhythmias
      will help to avoid clinical complications. When peripheral perfusion is
      compromised, hemodynamic monitoring, inotropic medications, and mechanical
      assistance may become necessary. Subsequent severe pump failure is usually the
      result of a devastating mechanical complication. Patients with mechanical
      complications have a high associated event-related mortality rate. Urgent
      identification of the nature of the complication with the use of invasive and
      noninvasive imaging studies, mechanical and inotropic assistance, and emergency
      surgical correction may be lifesaving.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7774509
TI  - Microelectronic systems for monitoring and enhancing patient compliance with
      medication regimens.

PMID- 7774511
TI  - Prospects for the use of antioxidant therapies.
AB  - Free radical oxidative stress has been implicated in the pathogenesis of a
      variety of human diseases. Natural antioxidant defences have been found to be
      defective in many of the same diseases. This has led to suggestions that
      oxidative damage and therefore disease progression may be retarded by
      supplementing natural antioxidant defences. Potential antioxidant therapy
      includes natural antioxidant enzymes and vitamins or synthetic agents with
      antioxidant activity. Diseases where antioxidant therapy may be beneficial
      include diabetes mellitus, reperfusion injury, inflammatory diseases and the
      prevention of chronic processes such as atherosclerosis and carcinogenesis.
      Further well controlled prospective clinical trials of antioxidants are required
      to establish the efficacy and tolerability of antioxidant therapy in the
      treatment of human diseases.

PMID- 7774512
TI  - Current concepts and controversies in the use of vitamin K.
AB  - Vitamin K is a fat-soluble vitamin crucial to the production of many proteins
      involved with the coagulation process. It is integral in the synthesis of
      coagulants (factors II, VII, IX and X) and anticoagulants (proteins C and S). It
      is generally recognised that routine administration of vitamin K (phytomenadione)
      shortly after birth will prevent major neonatal morbidity and mortality related
      to haemorrhage. Vitamin K supplementation during pregnancy is also recommended if
      mothers are on anticonvulsant therapy or prolonged treatment with certain
      antibiotics. These medications, if ingested by pregnant women, predispose the
      neonate to a bleeding tendency caused by vitamin K deficiency. Vitamin K
      treatment of pregnant mothers before premature delivery has also been suggested
      to reduce the incidence of severe intracranial haemorrhage (ICH) in premature
      neonates. Although further studies are pending, the data to date do not support
      using antenatal vitamin K for preventing ICH.

PMID- 7774510
TI  - Panic disorder. Pathophysiology and drug treatment.
AB  - Advances over the past 2 decades in our understanding of the biology of panic
      disorder have paralleled a remarkable increase in the development of new
      pharmacological agents with antipanic effects. Although we can not presently use
      biological tests to help with our choice of therapeutic agent for individual
      patients, we can use this biological understanding in the development of overall
      pharmaco-therapeutic strategies. Current evidence does not support the hypothesis
      that panic disorder is associated with a primary disorder in one neurotransmitter
      system. Rather, the data suggest that the biological aetiology of panic disorder
      is related to abnormalities in the function of a variety of neurotransmitters
      including serotonin (5-hydroxytyrptamine; 5-HT), noradrenaline (norepinephrine),
      gamma-aminobutyric acid (GABA), dopamine, and cholecystokinin. It is likely,
      however, that panic disorder is a biologically heterogeneous condition and that
      biological subtypes may exist in which the primary abnormality may involve one or
      a few neurotransmitter systems. Currently, the data best support the hypothesis
      that pharmacotherapeutic agents with primary action at sites within the GABA and
      serotonin systems are the most effective in the treatment of panic disorder.
      Nevertheless, some patients will respond well to drugs with predominant activity
      in other systems, or may require pharmacotherapy designed to affect the function
      of more than 1 neurotransmitter. As our understanding of the biological aetiology
      of panic disorder evolves, the pharmacotherapeutic agents and strategies used in
      the treatment of this disorder will continue to evolve as well.

PMID- 7774513
TI  - Enoxaparin. A reappraisal of its pharmacology and clinical applications in the
      prevention and treatment of thromboembolic disease.
AB  - Enoxaparin (enoxaparin sodium) is a low molecular weight derivative of
      unfractionated heparin which has been evaluated for the treatment and prevention
      of thromboembolic disease. Since a previous review in Drugs, well controlled
      clinical trials have confirmed the effectiveness of enoxaparin as prophylaxis in
      patients with a high risk for deep venous thrombosis (DVT), i.e. those undergoing
      hip or knee replacement surgery. Enoxaparin 30mg twice daily, initiated
      postoperatively, offers an overall balance of prophylactic efficacy and
      haemorrhagic tolerability which is superior to that of unfractionated heparin. In
      comparative clinical trials, this dosage demonstrated either improved efficacy
      and a similar haemorrhagic profile, or a similar degree of efficacy with a lower
      rate of haemorrhagic events, compared with unfractionated heparin 5000IU 3 times
      daily. Limited data indicate that an enoxaparin regimen of 40mg once daily,
      starting preoperatively, is more effective than unfractionated heparin in
      patients undergoing hip replacement and has a comparable haemorrhagic profile. In
      patients with a moderate risk for DVT, enoxaparin is similar to unfractionated
      heparin in both efficacy and haemorrhagic profile, while preliminary
      investigations have demonstrated the utility of enoxaparin in the prevention of
      DVT in elderly, nonsurgical patients. Enoxaparin may also be useful for the
      treatment of existing DVT and as an anticoagulant in haemodialysis. Thus,
      enoxaparin is an effective form of prophylaxis for thromboembolic disease in
      moderate to high risk surgical situations. Recent evidence for improved efficacy,
      together with a similar incidence of haemorrhagic complications in most
      situations, may lead to enoxaparin being preferred to unfractionated heparin for
      the routine prevention of DVT after high risk surgery. Although detailed
      comparisons with other low molecular weight heparins and antithrombotic agents
      are required before its relative clinical utility can be fully assessed,
      enoxaparin is likely to play a significant role in the prophylaxis of
      thromboembolic disorders.

PMID- 7774514
TI  - Tianeptine. A review of its pharmacodynamic and pharmacokinetic properties, and
      therapeutic efficacy in depression and coexisting anxiety and depression.
AB  - Tianeptine is a novel antidepressant agent, both structurally (modified
      tricyclic) and in terms of its pharmacodynamic profile. Unlike other
      antidepressant agents, tianeptine stimulates the uptake of serotonin (5
      hydroxytryptamine; 5-HT) in rat brain synaptosomes and rat and human platelets,
      increases 5-hydroxyindoleacetic acid (5-HIAA) levels in cerebral tissue and
      plasma, and reduces serotonergic-induced behaviour. Tianeptine reduces the
      hypothalamic-pituitary-adrenal response to stress, antagonises stress-induced
      behavioural deficits and prevents changes in cerebral morphology. The
      antidepressant efficacy of tianeptine, as shown in 2 trials of patients with
      major depression or depressed bipolar disorder with or without melancholia, is
      greater than that of placebo. In patients with major depression without
      melancholia or psychotic features, depressed bipolar disorder or dysthymic
      disorder, the antidepressant efficacy of short term (4 weeks to 3 months)
      tianeptine therapy appears to be similar to that of amitriptyline, imipramine and
      fluoxetine and may be superior to that of maprotiline in patients with coexisting
      depression and anxiety. However, submaximal dosages of amitriptyline and
      maprotiline were used in these studies. Preliminary evidence suggests that
      tianeptine may also be effective in patients with endogenous depression.
      Progressive therapeutic improvements have been observed with up to 1 year of
      tianeptine treatment, and long term therapy may reduce the rate of relapse or
      recurrence. Tianeptine is effective in the treatment of depression in elderly and
      post-alcohol-withdrawal patient subgroups. Tianeptine was more effective in
      reducing psychic anxiety than placebo in patients with major depression or
      depressed bipolar disorder with or without melancholia. The overall anxiolytic
      properties of tianeptine in patients with coexisting depression and anxiety
      appear to be similar to those of amitriptyline, imipramine and fluoxetine and may
      be superior to those of maprotiline, although submaximal dosages of amitriptyline
      and maprotiline were used. Studies of tianeptine in patients with primary anxiety
      have not been conducted. Tianeptine is well tolerated in the short (3 months) and
      long (up to 1 year) term. The incidence of dry mouth (38 vs 20%), constipation
      (19 vs 15%), dizziness/syncope (23 vs 13%), drowsiness (17 vs 10%) and postural
      hypotension (8 vs 3%) are greater with amitriptyline than with tianeptine.
      Insomnia and nightmares occur in more tianeptine than amitriptyline recipients
      (20 vs 7%). The relative lack of sedative, anticholinergic and cardiovascular
      adverse effects with tianeptine makes it particularly suitable for use in the
      elderly and in patients following alcohol withdrawal; these patients are known to
      have increased sensitivity to the adverse effects associated with psychotropic
      drugs.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7774517
TI  - Diurnal variations of EEG power in healthy adults.
AB  - EEG power variations were evaluated in 9 healthy young adults from 8.45 a.m. to 9
      p.m. and at 7 a.m. the next day. EEG signals were obtained from 16 electrodes in
      closed eyes and open eyes situations. Diurnal power variations were calculated
      for each frequency component, according to the recording situation (RS) and to
      the scalp site. Regarding values in the early morning on the first day, the power
      of almost all the frequency components showed an important diurnal increase. It
      came back close to initial values at 7 a.m. on the second day, which is in
      agreement with the existence of EEG circadian variations. Diurnal evolutions were
      dependent on the frequency components: the higher the frequency, the later was
      its diurnal maximum. For many frequency components, the diurnal variation was
      dependent on RS and the scalp topography. All these characteristics could be used
      to split the classical EEG bands, especially the delta and alpha bands and be
      useful for physiological and pharmacological research.

PMID- 7774516
TI  - Rifaximin. A review of its antibacterial activity, pharmacokinetic properties and
      therapeutic potential in conditions mediated by gastrointestinal bacteria.
AB  - Rifaximin is a derivative of rifamycin which acts by inhibiting bacterial
      ribonucleic acid (RNA) synthesis. It is virtually unabsorbed after oral
      administration; thus it is used primarily to treat local conditions within the
      gastrointestinal tract. In vitro data indicate rifaximin possesses good activity
      against species of Staphylococcus, Streptococcus and Enterococcus but lesser
      activity against species of Enterobacteriaceae. Bacterial resistance during
      exposure to rifaximin has been reported but its clinical importance remains to be
      fully defined. Results of comparative trials demonstrate that rifaximin is
      similar in efficacy to neomycin and lactulose in patients with hepatic
      encephalopathy and appears to be better tolerated. In 1 study, cyclical
      administration of rifaximin for 15 days per month was associated with progressive
      improvement over a 3-month period. In patients with infectious diarrhoea,
      rifaximin induces more rapid improvement in stool consistency and decreased
      frequency of faecal evacuations when compared with placebo, and is similar in
      efficacy to neomycin. Available data suggest rifaximin may be of some use in
      acute diverticulitis, but its use for the prevention of inflammatory
      complications or for control of common symptoms of diverticulosis requires
      further study. Preoperative treatment with rifaximin as antibacterial prophylaxis
      in colorectal surgery shows some potential but should be further investigated.
      Overall, rifaximin may be useful as an alternative therapy in hepatic
      encephalopathy but more data are needed to better define its clinical potential
      in infectious diarrhoea, diverticular disease and as antibacterial prophylaxis
      prior to colorectal surgery.

PMID- 7774518
TI  - EEG spectral analysis in vascular and Alzheimer dementia.
AB  - The role of EEG spectral analysis in the diagnosis of syndromes of dementia is
      still disputed. Since there have been few studies dealing with the profile of
      power spectra, the present investigation has focused on this aspect, constructing
      power spectra taken from 16 derivations and calculated by averaging twenty 2 sec
      epochs, using a serial array of frequencies from 1 to 32 Hz. The spectral
      analysis of the EEG, recorded under awake resting eyes closed (REC) and open
      (REO) conditions, was performed in 50 patients with Alzheimer's disease (AD), 37
      with vascular dementia (VaD) and 36 elderly controls. Three spectral profiles
      were found under REC: (i) type A, showing a dominant 6.5-12 Hz peak (44% AD,
      97.3% VaD), although lower than in controls; (ii) type B, lacking a dominant peak
      in the 6.5-12 Hz band, but characterised by high power in 1-6.5 Hz band (44% AD,
      2.7% VaD); (iii) type C, corresponding to a flat, low voltage, spectrum (12% AD).
      Unlike controls, demented patients showed an increased REO/REC power ratio in the
      6.5-12 Hz band, especially in those with type B spectra. AD patients with type B
      spectra had an earlier age of disease onset.

PMID- 7774519
TI  - Power spectrum and intracranial EEG patterns at seizure onset in partial
      epilepsy.
AB  - Intracranial electroencephalographic patterns of seizure onset during
      preoperative assessment with intracerebral and subdural electrodes have been
      correlated with surgical outcome in 15 patients with partial epilepsy assessed
      for surgery. The presence and topography of electrodecremental events, high
      frequency activity, irregular sharp waves intermixed with slow activity, spike
      wave activity and rhythmic ictal transformation at seizure onset were studied in
      a total of 78 complex partial seizures. Raw traces from intracerebral and
      subdural recordings were assessed visually in conjunction with changes in the
      following spectral variables (calculated for consecutive 1.28 sec epochs):
      amplitude (sum of amplitude of all components within a frequency band), activity,
      mobility, and complexity. The time course of these variables during preictal and
      ictal periods was displayed and assessed. This technique proved effective for
      detecting low-amplitude high-frequency activity and subtle electrodecremental
      events. It was concluded that: (a) most patients (12/15) showed early
      electrodecremental events, generalised or local, mainly involving frequencies
      below 40 Hz; (b) generalised electrodecremental events at onset did not imply
      poor outcome; (c) localised high-frequency activity, between 20 and 80 Hz, was
      associated with a good outcome.

PMID- 7774515
TI  - Ramipril. An updated review of its therapeutic use in essential hypertension and
      heart failure.
AB  - Ramipril is a second generation angiotensin converting enzyme (ACE) inhibitor.
      Like enalapril, it is a prodrug and is hydrolysed in vivo to release the active
      metabolite, ramiprilat, which has a long elimination half-life, permitting once
      daily administration. The antihypertensive efficacy of ramipril has been
      confirmed in large-scale noncomparative studies conducted in general practice as
      well as in more rigorously controlled clinical trials. In the former,
      approximately 85% of patients with mild to moderate essential hypertension have
      responded successfully to treatment with ramipril 2.5 or 5 mg/day, while
      comparative trials indicate that the antihypertensive efficacy of the drug is
      equivalent to that of other established ACE inhibitors and the beta-adrenoceptor
      antagonist atenolol. As expected, the response rate to ramipril monotherapy is
      lower in patients with severe hypertension (around 40%), although the blood
      pressure lowering effect can be enhanced with the addition of a diuretic such as
      hydrochlorothiazide or piretanide. The antihypertensive efficacy of ramipril is
      maintained in patients with diabetes mellitus and preliminary data indicate that
      the drug has the beneficial effect of decreasing urinary albumin excretion in
      diabetic patients with nephropathy. Ramipril is superior to atenolol in causing
      regression of left ventricular hypertrophy, although the clinical significance of
      this effect per se remains to be established. The large-scale Acute Infarction
      Ramipril Efficacy (AIRE) study demonstrated that ramipril 5 or 10 mg/day
      significantly decreased the risk of all-cause mortality by 27% in patients with
      clinical evidence of heart failure after acute myocardial infarction, even if
      transient. The beneficial effect of ramipril was apparent by 30 days of treatment
      and appeared to be greatest in patients with more severe ventricular damage after
      infarction. Ramipril is well tolerated in general practice, with 5% or fewer
      patients discontinuing therapy because of drug intolerance. The data available
      suggest that ramipril shares a similar tolerability profile to that of other
      established ACE inhibitors. Thus, clinical data confirm ramipril as a useful
      alternative ACE inhibitor for the treatment of patients with mild to moderate
      hypertension, and indicate a beneficial effect of the drug in patients with
      clinical evidence of heart failure after acute myocardial infarction. It is also
      reasonable to assume that ramipril will be of value in the treatment of patients
      with more established heart failure or asymptomatic left ventricular dysfunction.

PMID- 7774520
TI  - Propagation patterns of temporal spikes.
AB  - In standard EEG recordings, spikes appear as single events characterized mainly
      by the scalp location of the their peak voltage. The signal-to-noise ratio of raw
      EEG is usually too high to permit more detailed analysis. We used spike averaging
      to improve the resolution of interictal spikes in 40 patients with temporal lobe
      epilepsy. Spikes were identified visually in raw, digitally stored EEG. When
      multiple spike types were present in a patient, they were grouped separately.
      Spikes were synchronized for averaging by aligning their negative peaks in a
      designated channel. Sixteen patients demonstrated spike propagation from anterior
      temporal to posterior temporal electrode locations. Thirty-six patients
      demonstrated spread of spikes from anterior temporal to fronto-polar electrode
      sites. While anterior temporal and fronto-polar spikes were often synchronous,
      fronto-polar spikes followed anterior temporal discharges in 25% of cases and
      preceded them in 13%. Spike averaging revealed propagation patterns not apparent
      on visual inspection of raw EEG. We speculate that these patterns may reflect
      inherent physiological properties of temporal and frontal neuronal circuits,
      possibly utilized by the epileptogenic process.

PMID- 7774521
TI  - Topographic EEG changes due to hypobaric hypoxia at simulated high altitude.
AB  - Multichannel human EEG signals were studied topographically in subjects exposed
      to an atmosphere of reduced air pressure in a chamber in which high-altitude
      conditions were simulated. EEG signals from 16 electrodes placed on the scalp
      were recorded simultaneously with electrocardiography and vertical eye movement.
      Baseline records were first obtained at sea level (PRE 0 m), and then at reduced
      air pressures corresponding to the altitudes of 3000 m, 4000 m, and 6000 m,
      respectively, and after returning to sea level (POST 0 m). A complete set of EEG
      records under all 6 conditions was obtained in 5 of the 15 subjects, and under 5
      conditions (all except the 6000 m condition) in 3 other subjects. The spectral
      powers of 1 min epochs of the multichannel EEG signal under each altitude
      condition were compared to that at PRE 0 m using analysis of variance. Under the
      3000 m condition, the spectral power of the 10-11 Hz components was significantly
      decreased and, with increasing altitude, significant decrease of spectral power
      was observed in a wider range of the alpha frequency band. Under the 6000 m
      condition, the decrease of spectral power of the alpha band in the posterior
      brain areas was -7 dB compared to the baseline. In contrast, the spectral power
      of the theta frequency band in anterior brain areas increased significantly in
      the 5000 m and 6000 m conditions. At the POST 0 m condition after return from the
      5000 m condition (without exposure to the 6000 m condition), the EEG showed
      recovery to the level of the baseline PRE 0 m condition.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7774522
TI  - Electrocortical distinction of vocabulary types.
AB  - Psycholinguistic theories propose that words of the 2 major vocabulary classes,
      content (open-class) and function (closed-class) words, are computationally
      distinct and have different neuronal generators. This predicts distinct EEG
      patterns elicited by words of these 2 classes. To test this prediction, content
      and function words, together with matched pseudowords, were presented in a
      lexical decision task (where subjects had to decide whether stimuli were
      meaningful words or not). Evoked potentials were recorded from 17 electrodes 12
      of which were located in close vicinity of the perisylvian cortices. Already 160
      msec post stimulus onset, substantial differences in activity patterns
      distinguish the 2 vocabulary classes. A hemisphere by word class interaction
      revealed interhemispheric differences for function words but not for content
      words. Potentials evoked by function words were more negative over the left
      hemisphere compared to the right. These results evidence that brain mechanisms
      underlying function and content word processing are different. The following
      explanation of the data is proposed: content words correspond to neuronal
      assemblies equally distributed over both hemispheres, while assemblies
      corresponding to function words are strongly lateralized to the left hemisphere
      and primarily located in the perisylvian region.

PMID- 7774524
TI  - Discrimination between phase-locked and non-phase-locked event-related EEG
      activity.
AB  - Differentiation between phase-locked and non-phase-locked event-related EEG
      activity is an important task in the evaluation of event-related EEG activity.
      Event-related changes of EEG activity such as event-related desynchronization
      (ERD) or event-related synchronization (ERS) can be quantified by either
      instantaneous band power or intertrial variance calculations. In the former case
      the ERD or ERS can be masked by an event-related potential while in the latter it
      is not. Examples from sensory stimulation and movement experiments, where the ERD
      (ERS) is calculated by both methods, are shown and discussed.

PMID- 7774523
TI  - A spatial oculomotor memory-task performance produces a task-related slow shift
      in human electroencephalography.
AB  - Electroencephalographic (EEG) deflections in humans related to the performance of
      memory-guided saccades were studied in this work. The EEG deflections were
      recorded during 2 spatial oculomotor delayed response tasks in which the subject
      was instructed to make a saccade either to the right or to the left depending on
      the spatial location of the cue which had been shown in the beginning of the
      delay period. The EEG deflections were compared to those recorded during a
      control task in which the subject also made a saccade to the right or to the left
      after a delay but the requirement to keep spatial information actively in mind
      was minimized. A slow delay-related shift was recorded during all task
      conditions. The slow shift was positive in the most frontal and negative in the
      more posterior recording sites. The negative slow shift in the more posterior
      recording sites was larger in the memory tasks than in the control task. Since
      the memory and the control tasks differed mainly in their requirement to hold
      spatial information in mind it is suggested that the difference in the magnitude
      of slow shifts between the memory and the control tasks reflects neural activity
      related to spatial working memory. But although the oculomotor responses in all
      tasks were similar, the preparatory activities for the impending eye movements
      may not have been similar and in addition to working memory may have contributed
      to the observed differences in the slow shifts.

PMID- 7774525
TI  - Virus-induced increases in airway mast cells in brown Norway rats are associated
      with enhanced pulmonary viral replication and persisting lymphocytic
      infiltration.
AB  - Brown Norway (BN) rats are more susceptible than Fischer 344 (F344) rats to
      parainfluenza virus-induced lung injury and to bronchiolar mast cell increases
      that are associated with persistent airway hyperresponsiveness. In this study,
      pulmonary viral replication as well as immune, inflammatory, and airway mast cell
      responses to Sendai virus infection were compared between neonatal BN and F344
      rats. BN rats supported prolonged viral replication, and viral titers in BN rats
      were 5-fold higher (p < .05) than in F344 rats at 7 days after inoculation. F344
      rats had 18-fold higher (p < .06) numbers of lymphocytes in bronchoalveolar
      lavage fluid at 7 days after inoculation than did BN rats. Persisting bronchiolar
      aggregates of lymphocytes, plasma cells, and macrophages were more common, and
      increases in bronchiolar mast cells were greater in BN rats than in F344 rats. No
      strain differences were detected in bronchiolar intramural infiltrates of CD4 +
      or CD8 + cells. The greater susceptibility of BN rats to virus-induced increases
      in bronchiolar mast cells and airway responsiveness may be the result of their
      less efficient viral clearance mechanisms and more persistent bronchiole-centered
      inflammatory response.

PMID- 7774526
TI  - Hydrogen peroxide inhibits lung neutral endopeptidase.
AB  - Oxidants have been implicated in the pathogenesis of many inflammatory airway
      diseases. Neutral endopeptidase (also called enkephalinase, EC 3.4.24.11) is a
      peptidase that is involved in the degradation of several proinflammatory
      peptides, such as tachykinins and kinins. Indirect evidence suggests that airway
      neutral endopeptidase is inactivated by oxidants. To determine whether hydrogen
      peroxide inactivates neutral endopeptidase, we studied the activity of this
      peptidase in washed crude preparations of membranes from guinea pig lungs. Washed
      crude membrane preparations were exposed to increasing concentrations of hydrogen
      peroxide (1.25-25 mM) in the presence or absence of two different concentrations
      of catalase (300 and 700 U/mL). Neutral endopeptidase activity was inhibited by
      hydrogen peroxide in a concentration-dependent fashion (p = .0001). Addition of
      catalase prevented, in a concentration-dependent fashion, the inhibition of
      neutral endopeptidase induced by hydrogen peroxide (p = .0001). Mannitol (40 mM)
      and L-methionine (20 mM) did not prevent inhibition of neutral endopeptidase
      induced by hydrogen peroxide (2.5 mM). It can be concluded that neutral
      endopeptidase is inactivated by hydrogen peroxide, an effect that is prevented by
      catalase. Hydrogen peroxide-induced inactivation of neutral endopeptidase is not
      mediated by spontaneous generation of either hydroxyl radical or hypochlorous
      acid in the membrane preparation. Our results suggest that neutral endopeptidase
      inactivation may occur in airway diseases associated with exposure to or
      production of oxidants.

PMID- 7774527
TI  - Effect of IL-1 blockade on inflammatory manifestations of acute ventilator
      induced lung injury in a rabbit model.
AB  - Ventilator-induced lung injury in children and adults is characterized by an
      initial inflammatory phase. To investigate whether the inflammatory cytokine, IL
      1, plays a role in this process, a rabbit model of ventilator-induced injury was
      created. Animals maintained under pentobarbital anesthesia were primed for injury
      by undergoing lung lavage with 22 mL/kg of saline and then ventilated for 8 h
      with either FIO2 0.21 and normal pressures or FIO2 1.0 and high ventilator
      pressures. The animals exposed to hyperoxia/hyperventilation demonstrated a
      greater increase in lung lavage neutrophil counts and a higher histological
      injury score, as well as a faster decline in oxygenation compared to the control
      animals. A third group of rabbits received 800 micrograms of recombinant IL-1
      receptor antagonist after lung lavage and prior to the exposure to FIO2 1.0 and
      high ventilator pressures. These animals had significantly lower concentrations
      of albumin and elastase and lower neutrophil counts in their lungs after the 8-h
      ventilatory period compared to hyperoxia/hyperventilation rabbits. IL-1 blockade
      had no effect on the decline in dynamic compliance and oxygenation seen in saline
      treated hyperoxic/hyperventilated rabbits. IL-1 is a mediator of acute
      inflammation due to ventilator-induced lung injury.

PMID- 7774528
TI  - Emphysema as a result of involuntary exposure to tobacco smoke: morphometrical
      study of the rat.
AB  - Several attempts have been made to describe the relation that exists between
      tobacco smoke and emphysema, through different experimental models of the active
      smoker. Despite the negative effects that involuntarily inhaled tobacco smoke can
      have on the lung, no experimental model of the passive smoker has been proposed.
      In this study, an experimental model of the involuntary smoker is described and
      the following hypothesis proposed: Passive exposure to tobacco smoke produces
      morphological alterations in the rat lung, which are compatible with emphysema.
      Emphysema will be considered to have been caused when enlargement of the distal
      airspaces of the lung and lung tissue destruction are demonstrated. Sixty Wistar
      rats were used, divided into two groups: a control group and a group that was
      passively exposed to tobacco smoke for a period of 3 months. A morphometrical
      study of the lung was performed using a computerized system. To demonstrate
      enlargement of the distal airspaces of the lung, the following variables were
      quantified: alveolar chord and mean linear intercept index (Lm); tissue loss was
      demonstrated by means of the quantification of the variables: tissue density,
      internal alveolar perimeter (IAP), and wall thickness (WT). The elastic fiber was
      also quantified. The animals that were exposed to tobacco smoke displayed the
      following significant alterations (p < .05): an increase of the alveolar chord
      and of the Lm, a decrease of the IAP, WT, and tissue density, and a loss of the
      elastic component of the lung. On the basis of these findings, it is concluded
      that the rats that were exposed in a passive way to tobacco smoke display
      morphological pulmonary alterations that are compatible with the definition of
      emphysema.

PMID- 7774529
TI  - Urinary excretion of polyamines in the adult respiratory distress syndrome.
AB  - Polyamines are low molecular weight polycations that are critically important in
      cellular proliferation and differentiation. To investigate their potential role
      in acute lung injury, the polyamines spermidine, spermine, and putrescine were
      measured in 24-h urine collections from intubated patients with ARDS (n = 12) or
      congestive heart failure with cardiogenic pulmonary edema (CHF, n = 10) and in
      normal subjects (n = 10). Mean concentrations of putrescine were similar between
      groups, but spermidine concentrations in patients with ARDS (52.7 +/- 19.7
      nmol/mg creatinine) were significantly higher than in normal subjects (4.9 +/-
      0.7 nmol/mg), p < .05. Mean concentrations of spermine in ARDS (270.6 +/- 78.1
      nmol/mg) were higher than in CHF (1.0 +/- 0.5 nmol/mg), p < .05, and normal
      subjects (0.3 +/- 0.1 nmol/mg), p < .05. Concentrations of putrescine increased
      significantly during the first 7 days of ARDS (241.5 +/- 127.1% above baseline, n
      = 6), p < .05. Urinary polyamine excretion did not correlate with severity of gas
      exchange or death. These results are the first to suggest a potential role for
      polyamines in the pathophysiology of ARDS.

PMID- 7774530
TI  - Identification of IL-1 inhibitory activity as IL-1 receptor antagonist (IL-1ra)
      in vitro and kinetics of IL-1ra and IL-1 beta in experimental rabbit lung
      granuloma.
AB  - This study investigated whether interleukin-1 (IL-1) inhibitory activity in LPS
      stimulated culture supernatants of alveolar macrophages and epithelioid cells
      obtained from rabbit lung granulomas induced by complete Freund's adjuvant (CFA)
      was identical to IL-1 receptor antagonist (IL-1ra) and examined the changes of IL
      1ra and IL-1 beta levels in lung tissue during the natural course of
      granulomatous inflammation. In the thymocyte proliferation assay, prostaglandin
      E2 (PGE2)-free culture supernatants from each cell population revealed a bell
      shaped IL-1 titration curve with IL-1 activity suppressed at dilutions of 1:1 to
      1:2, and gel chromatography of serum-free culture supernatants showed an IL-1
      inhibitory peak at 21-25 kD. Suppression of IL-1 activity in the supernatants at
      lower dilutions and the gel-purified IL-1 inhibitory activity both almost
      disappeared after IL-1ra depletion with an anti-rabbit IL-1ra immunoaffinity
      column, indicating that IL-1ra was responsible for this in vitro IL-1 inhibitory
      activity. Pulmonary tissue levels of IL-1 beta pecked at 24 h (52.0 +/- 9.5
      pg/mg) after CFA injection, whereas IL-1ra levels peaked at 4 weeks (23.1 +/- 4.0
      ng/mg) when granuloma development was maximal, and the molar excess of IL-1ra to
      IL-1 beta peaked from 4 weeks onward at over 800-fold. These observations suggest
      that IL-1ra may be effective for IL-1 regulation, especially in the later stage
      of granulomatous responses. Immunohistochemical studies demonstrated that the
      cellular source of IL-1ra within the pulmonary granulomas was mainly epithelioid
      cells.

PMID- 7774531
TI  - Exercise potentiation of lung injury following inhalation of a pneumoedematogenic
      gas: perfluoroisobutylene.
AB  - Exercise performed after exposure to various pneumoedematogenic gases can
      increase the severity of pulmonary edema beyond that which occurs when exposure
      is followed by rest. The present study was performed to investigate the potential
      relationship between a preexisting breach in the lung's permeability status
      following exposure to an edematogenic gas (perfluoroisobutylene, PFIB) and the
      potentiating effects of postexposure exercise. Rats were exposed to a
      concentration of PFIB (100 mg/M3 for 10 min) that results in a unique
      postexposure latency period (approximately 8 h) prior to the occurrence of overt
      pulmonary edema. The study examined how exercise performed during and after the
      latency period affects the severity of the injurious response to this toxic gas.
      The initial results indicated that exercise performed during the post-PFIB
      exposure latency period does not potentiate the injurious response, as judged by
      conventional lung gravimetric and histopathological criteria, but when overt
      pulmonary edema was preexistent, exercise had a potentiating effect. Changes in
      lavageable protein were assessed as a more sensitive indicator of permeability
      changes that may occur during the latency period following PFIB exposure, and the
      study examined how exercise performed early during the latency period affects
      this index of pulmonary edema. The study also assessed whether PFIB-induced
      damage to lung cells is enhanced by exercise during the latency period by
      measuring lavageable lactate dehydrogenase activity. The results from these
      latter experiments suggest that a preexisting enhancement in lung permeability is
      not an absolute requirement for exercise to potentiate the pulmonary edematous
      response in lungs that are undergoing insidious injury, and that postexposure
      exercise does not enhance the cell-killing effects of PFIB as a mechanism
      underlying the exercise potentiating response. Conceivably, the ability of
      exercise to increase lavageable protein in the absence of a preexisting increase
      in lung permeability may be due to hyperventilation- and/or pulmonary
      hypertension-associated intercellular junctional changes that may occur during
      exercise. Additionally, it remains possible that exercise during PFIB-induced
      insideous lung injury results in an enhancement in the rate of transcellular
      transport of blood proteins onto the alveolar surface.

PMID- 7774532
TI  - Beta-carotene, vitamin E and vitamin C in different stages of experimental
      carcinogenesis.

PMID- 7774533
TI  - Supplementation with flaxseed oil versus sunflowerseed oil in healthy young men
      consuming a low fat diet: effects on platelet composition and function.
AB  - OBJECTIVE: To compare the effects of supplementing a low fat diet with an alpha
      linolenic acid-rich (C18:3 n-3) oil with a linoleic acid-rich (C18:2 n-6) oil on
      platelet composition and function. DESIGN: Prospective study with random
      allocation to one of the two oils. SETTING: Free-living study. SUBJECTS: Eleven
      healthy young males recruited from within the University. INTERVENTIONS: Subjects
      were allocated to consume 40 g of either flaxseed oil (n = 5) or sunflowerseed
      oil (n = 6) daily for 23 days. Fasting blood samples were collected at
      commencement and completion of supplementation for analysis of platelet fatty
      acids and platelet aggregation. RESULTS: The platelet eicosapentaenoic acid (EPA)
      more than doubled in the group taking flaxseed oil (P < 0.05) but was unchanged
      in the sunflowerseed group. As a result the platelet EPA:arachidonic acid ratio,
      considered a marker for thromboxane production and platelet aggregation
      potential, increased in the flaxseed group (P < 0.05). The aggregation response
      induced by 0.75 and 2 micrograms of collagen was decreased in those taking
      flaxseed oil (P < 0.05). CONCLUSION: This study provides further evidence that
      consumption of alpha-linolenic acid-rich oils may offer protective effects
      against cardiovascular disease over linoleic acid-rich oils via their ability to
      decrease the tendency of platelets to aggregate.

PMID- 7774534
TI  - Infant feeding and nutritional status: the dilemma of mothers in rural Senegal.
AB  - OBJECTIVE: To describe infant feeding practices in rural Senegal in relation to
      age and nutritional status. The main hypothesis to be tested was whether mothers
      modulate feeding in response to growth and nutritional status of their infants.
      DESIGN: A cross-sectional survey using qualitative 24-h recalls and lifetime
      recalls to assess feeding practices, and using weight and recumbent length
      measurements to assess nutritional status. SETTING: Three health clinics in the
      Fatick region, a rural area of Senegal, West Africa, covering a population of
      26,600. SUBJECTS: All 2-10-month-old infants attending four immunization sessions
      in 1991 (n = 1174; 80% of convoked infants). MAIN OUTCOME MEASURES: Prevalence of
      feeding with additional food (gruel, family diet and food of animal origin),
      weight-for-length and length-for-age. RESULTS: All infants were breastfed. A
      supplement had been given the day before the survey to 10% of infants aged 2-3.9
      months, 30% of infants aged 4-5.9 months and 45% of those aged 6-6.9 months. The
      main food items were watery millet gruel and family diet (millet or rice). Gruel
      was given in response to perceived breast-milk insufficiency. Animal products
      were seldom eaten at any age. Length-for-age and weight-for-length were
      significantly lower among infants supplemented with millet gruel, when adjusted
      for age; while no such relationship was found with family diet. CONCLUSION:
      Mothers preferentially fed gruel to small, thin infants.

PMID- 7774535
TI  - Metabolic responses to starch in oat and wheat products. On the importance of
      food structure, incomplete gelatinization or presence of viscous dietary fibre.
AB  - OBJECTIVE: Evaluate the importance of incomplete gelatinization, food structure
      and presence of viscous dietary fibre for the postprandial glycaemic and
      insulinaemic responses to oat and wheat products. DESIGN: Three common breakfast
      meals were tested, 'raw' rolled oats (muesli), boiled rolled oats (oat porridge)
      and white wheat bread. Boiled intact oat and wheat kernels (kernel porridges)
      were also included. For comparison, glycaemic indices (GIs) were calculated both
      from analysis of capillary and venous blood samples. SETTING: The study was
      performed at the research laboratory, Dalby Health Sciences Centre (primary
      care). SUBJECTS: Nine healthy male volunteers between 65 and 70 years of age
      participated in the study. RESULTS: The rolled oats and oat porridge elicited
      high metabolic responses. No differences in the glycaemic and insulinaemic
      indices (IIs) were seen between these products and white wheat bread. In
      contrast, the kernel porridges produced low glucose and insulin responses. No
      differences were obtained in GI values whether based on capillary or venous
      blood. However, with some products capillary blood allowed smaller differences to
      be detected. CONCLUSIONS: Neither incomplete gelatinization in rolled oats nor
      naturally occurring viscous dietary fibre in oats affect postprandial glycaemia,
      whereas enclosure of intact kernels significantly blunt metabolic responses.

PMID- 7774536
TI  - Iron balance in menstruating women.
AB  - OBJECTIVES: To study factors determining iron balance in menstruating women by
      examining the relationships between total iron requirements, based on menstrual
      iron losses and basal iron losses, and serum ferritin concentration, transferrin
      saturation, blood haemoglobin concentration, bone marrow haemosiderin and
      absorption of iron from a test dose of ferrous sulphate (0.56 mg Fe). SUBJECTS:
      The study was made in 203 women all aged 38 years, randomly selected from the
      census register of Goteborg. The study was originally made in 1968-69. Serum
      ferritin in frozen sera was first analysed in 1978. Reanalyses, calibrated to the
      International Standard 80/602, and studies on the effect of storage of sera, were
      made in 1992. This allowed a complete re-examination of the importance of
      different determinants of iron balance in women. RESULTS: With increasing iron
      requirements there was an increase in iron absorption, and a decrease in serum
      ferritin concentration and transferrin saturation. Above a certain level of iron
      requirement there was a rather sudden decrease in haemoglobin concentration and
      in stainable iron in bone marrow smears, indicating the critical level of iron
      requirements in these women that could be balanced by an increased iron
      absorption from the present diet. This level represents the maximal adaptation to
      maintain iron balance in an iron-replete state that can be achieved with this
      diet and corresponds to a prevalence of iron deficiency of about 25%.
      CONCLUSIONS: The continuous regulation of iron absorption from iron deficiency to
      iron repletion has a critical balance point determined by the properties of the
      diet.

PMID- 7774538
TI  - Is dietary underreporting macronutrient specific?

PMID- 7774537
TI  - Diet and vitamin D status among pregnant Pakistani women in Oslo.
AB  - OBJECTIVES: In the present study the diet and the nutritional status of pregnant
      Pakistani immigrant women have been compared with a group of Norwegian women.
      DESIGN: A cross-sectional survey of women in the 18th week of pregnancy. SETTING:
      Women referred to routine ultrasound examination at Aker and Ulleval Hospitals in
      Norway. SUBJECTS: All (58) healthy women of Pakistani origin referred from
      October of 1991 to January of 1992 were included, of whom 38 (66%) participated.
      Forty-five Norwegian women were randomly included in the same period and 38 (84%)
      of these women participated. RESULTS: The serum levels of 25-hydroxyvitamin D3
      were significantly lower in the Pakistanis compared with the Norwegians (median
      19 nmol/l vs 55 nmol/l, P < 0.001) and 83% of the Pakistani women had 25
      hydroxyvitamin D3 levels below the reference value (< 30 nmol/l). The Pakistanis
      had higher levels of serum parathyroid hormone (median 2.6 vs 1.6 pmol/l, P <
      0.001). The Pakistanis also had a lower dietary intake of vitamin D than that of
      the Norwegians (median 2.2 vs 3.3 micrograms/day, P < 0.05), and a lower total
      intake, including supplements (median 2.9 vs 7.0 micrograms/day, P < 0.001).
      Among the Pakistanis a correlation was found between the dietary intake of
      margarine, the main source of vitamin D in the diet, and the concentration of 25
      hydroxyvitamin D3 in serum, r = 0.48 (P = 0.01). In general, the Pakistanis
      avoided any direct sunshine exposure, and no relation between outdoor activity
      and serum level of 25-hydroxyvitamin D3 was found. The Pakistani women had a
      lower intake of calcium than the Norwegians (median 793 vs 1134 mg/day, P <
      0.001). CONCLUSION: This study has shown that Pakistani women living in Oslo are
      at great risk of developing vitamin D deficiency during pregnancy. The main
      reasons for this are avoidance of sun exposure, a low dietary intake of vitamin
      D, and no or little use of supplementation.

PMID- 7774539
TI  - Serum cholesterol and ischaemic heart disease.

PMID- 7774540
TI  - Infection of horses by Tyzzer's bacillus.

PMID- 7774542
TI  - Vertical tears of the cranial horn of the meniscus and its cranial ligament in
      the equine femorotibial joint: 7 cases and their treatment by arthroscopic
      surgery.
AB  - Five horses with a vertical tear in the cranial horn and cranial ligament of the
      medial meniscus and 2 horses with a similar injury in the lateral meniscus were
      diagnosed from a series of 126 horses which were examined arthroscopically for
      stifle lameness. All the lesions had similar characteristics. The tear was about
      1 cm from the axial border of the meniscus and its ligament and, in all but one
      case in which it was incomplete, much of the torn tissue was loosely attached in
      the axial part of the joint from where it was removed. The remaining meniscus,
      abaxial to the tear, was displaced cranially and abaxially and its torn edges
      were debrided. Radiographically, 6 cases had proliferative new bone on the
      cranial aspect of the intercondylar eminence of the tibia and 3 had calcified
      soft tissue densities in the cranial, medial or lateral femorotibial joint.
      Following surgery and a 6 month period of rest and controlled exercise, 3 horses
      returned to full competition work, one was usable for hacking, 2 are convalescing
      and one is lame after one year. It is postulated that this could be a
      characteristic meniscal injury in horses which can benefit from arthroscopic
      surgery. Better techniques for accessing the body and caudal pole of the menisci
      are needed if a more complete diagnosis and treatment of meniscal injuries are to
      be achieved.

PMID- 7774541
TI  - Absorption and dosage of theophylline in the horse after single and repeated
      administration of a microencapsulated preparation.
AB  - The kinetics of 2 formulations of theophylline were studied in horses. In an
      initial cross-over study (Phase I) serum concentration-time curves were
      determined for granulated and microencapsulated theophylline after a single oral
      administration (5 mg/kg bwt). In Phase II microencapsulated theophylline was
      administered at 5 mg/kg bwt/12 h for 10 days at feeding time, as in normal
      clinical practice. Although no significant differences between the 2 preparations
      were found with respect to the main kinetic parameters, the microencapsulated
      form was more evenly and completely absorbed from the digestive tract;
      furthermore, after the repeated treatment, its trough-peak serum concentrations
      were always within the therapeutic window and no toxic effects were observed in
      treated animals.

PMID- 7774544
TI  - How the horse moves: 1. Significance of graphical representations of equine
      forelimb kinematics.
AB  - The kinematics of 24 two-year-old Dutch Warmblood horses were recorded at the
      trot (4 m/s) on a high-speed treadmill to study the coordination of joints within
      the equine forelimb. Joint angle-time, angle-angle, stick, and marker diagrams
      were used to show forelimb motion graphically. Because the kinematic data
      referred to the joint angles of the horse standing squarely and were time
      standardised to the duration of the stride cycle, mean joint curves could be
      calculated for the total group. The motion of each segment in the equine forelimb
      during a complete stride is described and its function in intralimb coordination
      evaluated. It appeared that the rotation of the scapula and the cranio-caudal
      movement of the distal forelimb are synchronous and pendular. The carpal joint
      rapidly snaps into overextension at the beginning of the stance phase to enable
      the forelimb to work as a propulsive strut. The fetlock joint acts as an elastic
      spring, thereby conserving energy and, at the same time, absorbs oscillations
      generated by initial ground contact. Furthermore, the coordination between carpal
      and fetlock joints in the swing phase appears to be strongly influenced by
      inertia. Using the graphic tools evaluated in this paper, we were able to
      visualise the kinematics of the equine forelimb and relate these to specific
      functions of the forelimb in locomotion. This information can be used to select
      kinematic variables for clinical studies in which equine forelimb function has to
      be described and quantified.

PMID- 7774543
TI  - Effect of feeding state on the response of horses to repeated bouts of intense
      exercise.
AB  - Four mature Standardbred horses were used in a 2-period cross-over design
      experiment to evaluate the effect of feeding state (fed or fasted) on metabolic
      response to 2 repeated bouts of exercise. Horses were either fasted 15 to 16 h
      before exercise or fasted for 12 h and then fed 2 kg of whole corn 2.5 to 3 h
      before exercise. In the first period, 2 horses in each feeding state were
      exercised. In the second period, the treatments were switched. The exercise test
      consisted of 2 exercise bouts separated by a 90 min recovery period. Each
      exercise bout included a warm-up phase and a high intensity phase (1600 m at 11
      m/s on a 2% graded treadmill). Blood samples collected during the exercise test
      were analysed for glucose, non-esterified fatty acids (NEFA), insulin and lactate
      concentrations. Fasted horses had lower insulin concentrations and higher NEFA
      concentrations at the onset of exercise (P < 0.05). NEFA concentrations were
      consistently higher (P < 0.05) in the fasted horses until the high intensity
      phase of the second exercise bout. Feeding state did not affect heart rate or
      plasma lactate responses to exercise. Plasma glucose concentrations tended to
      decline in the fed horses during the first exercise bout. Neither a positive nor
      a negative effect of feeding state on horses performing repeated bouts of intense
      exercise were found.

PMID- 7774545
TI  - How the horse moves: 2. Significance of graphical representations of equine hind
      limb kinematics.
AB  - Kinematic data of the equine hind limb are presented graphically and related to
      functional aspects of the hind limb in locomotion. The trot of 24 two-year-old
      Dutch Warmblood horses was recorded at 4 m/s on a high-speed treadmill using
      kinematic analysis equipment. Joint angle-time, angle-angle, stick and marker
      diagrams were used to present graphically the data following standardised
      procedures. As the kinematic data were expressed with reference to the joint
      angles of the horse standing squarely and were time-standardised to the duration
      of the stride cycle, mean joint curves for the total group could be calculated
      and therefore describe the function of the different segments of the equine hind
      limb. The motion of the hind limb in the sagittal plane appeared to be pendular
      around a rotation point in the acetabulum. During the stance phase the extension
      of the fetlock joint and stance flexion of the stifle, tarsal and coffin joints
      illustrate the shock absorption of the hind limb. In the swing phase the
      reciprocal apparatus, which forms the coupling mechanism between stifle and
      tarsal joint, also influences the fetlock joint because synchronous flexion and
      extension between these 3 joints were demonstrated. By graphically presenting
      hind limb motion we were able to illustrate the relation between kinematics and
      function. This graphic analysis can be used in clinical studies involving
      quantification of equine hind limb coordination in the sagittal plane.

PMID- 7774546
TI  - Interstitial pneumonia in the horse: a fledgling morphological entity with
      mysterious causes.

PMID- 7774547
TI  - Autologous blood instillation alters respiratory mechanics in horses.
AB  - To investigate physiological consequences of autologous blood instillation in the
      lungs of healthy horses, respiratory mechanics and bronchial response to
      histamine were studied in 8 Thoroughbreds before and after introducing autologous
      blood (n = 5) and sterile saline solution (n = 3) into their lungs. Blood
      instillation resulted in a decrease in dynamic compliance (Cdyn) and increased
      respiratory resistance (R). Bronchial sensitivity and reactivity were unchanged
      after blood introduction. There were no significant changes in pulmonary
      mechanics or bronchial response after saline instillation.

PMID- 7774548
TI  - Effects of a 3 month endurance training programme on skeletal muscle
      histochemistry in Andalusian, Arabian and Anglo-Arabian horses.
AB  - Twenty adult (5 to 14 years old) sedentary stallions of several breeds (8
      Andalusians, 7 Arabians and 5 Anglo-Arabians) were endurance-trained for 3
      months. Duplicate biopsies from 2 different depths (20 mm, superficial sampling
      site; 60 mm, deep sampling site) of the gluteus medius muscle were collected
      before and after training and after 3 months of detraining. Few significant
      changes in muscle fibre type composition were recorded in response to training.
      The percentage of type I fibres in the deep sampling site of the muscle in
      Andalusian horses and of type IIB oxidative fibres in the superficial region in
      Anglo-Arabians had increased significantly (P < 0.05) after training. The mean
      type I and IIA cross-sectional area was increased significantly (range P < 0.05
      to P < 0.01) after 3 months' training in the deep site of the muscle in Arabian
      and Andalusian horses, but not in Anglo-Arabians. The changes seen in fibre sizes
      disappeared after the detraining period. The mean number of capillaries adjacent
      to type I fibres in the superficial sampling site of the muscle had increased
      significantly (P < 0.05) in response to training in Andalusian and Arabian
      horses. However, a significant decrease in the mean number of capillaries in
      contact with each fibre type relative to the mean area of that fibre type was
      observed associated with training in the deep region of the muscle for type I and
      IIA fibres in Arabians (P < 0.01) and for type I fibres in Andalusian horses (P <
      0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7774549
TI  - Meniscus lesions in man and horse.

PMID- 7774550
TI  - Sensory innervation of the navicular bone and bursa in the foal.
AB  - The sensory innervation of the navicular bone (os sesamoideum distale) and its
      suspensory ligaments [ligamenta sesamoidea collateralia (CSL) and ligamentum
      sesamoideum distale impar or distal sesamoidean impar (DS-impar) ligament] and
      the navicular bursa (podotrochlearis) was examined in the neonatal foal using
      immunocytochemistry. With antisera raised to substance P (SP) and human
      calcitonin gene-related peptide (CGRP), immunoreactive nerves were demonstrated
      to innervate the CSL and navicular bursa. Within CSL, and SP- and CGRP-like
      nerves were present in the synovial lining of the navicular bursa, appearing to
      reach the surface lining. These nerves appeared to enter the CSL and navicular
      bursa via the abaxial regions of the foot. Both peptides were present in the deep
      digital flexor tendon (DDf) along the palmar border of the navicular bursa, as
      well as in the DS-impar ligament. More nerve fibres were present in the dorsal
      part of CSL bordering the distal interphalangeal joint than was observed palmarly
      in CSL along the navicular bursa. Both peptides were observed to innervate the
      cartilage canals within the navicular bone. In terms of relative densities of
      immunoreactive SP- and CGRP-like peptides, the CSL dorsally and the DS-impar
      ligament had the highest relative densities of nerve fibres followed by the
      navicular bone, the palmar aspect of CSL and the DDf tendon bordering the
      navicular bursa. These results are discussed in relationship to local anaesthetic
      injections into the navicular bursa.

PMID- 7774551
TI  - Haematuria, pigmenturia and proteinuria in exercising horses.
AB  - The effects of exercise on urinary excretion of red blood cells, pigments
      (haemoglobin and myoglobin) and protein were studied in 8 mares performing
      treadmill exercise at speeds eliciting 40, 60 and 95% of the maximal oxygen
      consumption (VO2max). Gross haematuria and pigmenturia were observed in all
      horses during exercise at the 2 higher intensities, while these findings were
      detected in only one of 8 mares during exercise at 40% of the VO2max. For the
      remaining 7 mares exercised at 40% of the VO2max, increased urinary excretion of
      red blood cells (RBCs) and pigments was evident after centrifugation of urine
      samples and reagent strip analysis of the supernatant fractions. An increase in
      urine flow (UF) during exercise at 40% of the VO2max may have contributed to the
      infrequent observation of gross haematuria and pigmenturia during exercise at
      this intensity. A transient increase in UF following exercise at 60 and 95% of
      the VO2max resulted in rapid resolution of gross haematuria and pigmenturia, but
      increased urinary excretion of RBCs and pigments remained evident by reagent
      strip analysis for up to 60 min following exercise. Mean +/- s.e. urinary protein
      excretion increased from a resting value of 2.2 +/- 0.2 mg/min to 5.6 +/- 0.9,
      14.5 +/- 4.7 and 78.4 +/- 18.6 mg/min after exercise at 40, 60 and 95% of the
      VO2max, respectively. These results demonstrate that exercise induced haematuria
      and pigmenturia and post exercise proteinuria are common in horses. Their
      occurrence is transient and does not appear to be associated with any lasting
      changes in renal function.

PMID- 7774552
TI  - The effect of maternal age and parity on the racing performance of thoroughbred
      horses.

PMID- 7774553
TI  - Diffuse alveolar damage in the horse.

PMID- 7774554
TI  - Seroanalysis of Tyzzer's disease in horses: implications that multiple strains
      can infect Equidae.
AB  - A monoclonal antibody based competitive inhibition assay was used to detect
      antibodies in horse sera to purified flagellar antigens from distinct Clostridium
      piliforme isolates. Sequential absorption of hyperimmune rat serum to C.
      piliforme isolate E (horse-origin isolate), a positive C. piliforme-immune horse
      serum, and other suspected immune horse sera with unrelated bacteria or C.
      piliforme isolates E or isolate R1 (rat-origin isolate) alone demonstrated the
      specificity of this assay for C. piliforme. This specificity was associated with
      the inhibition of monoclonal antibody binding to C. piliforme flagella, rather
      than to C. piliforme somatic antigens, by horse immunoglobulins partially
      purified from serum. Thirty seven of 162 horse sera possessed large amounts of
      antibody to the flagella of C. piliforme isolate E and 23 of the 162 had large
      amounts of antibody to the flagella of C. piliforme isolate R1; 9 of the sera
      possessed large amounts of antibody to both flagellar antigens. Absorption of
      these sera with isolate E or R1 demonstrated that antibody reactivity to the 2 C.
      piliforme isolates was isolate-specific and not due to antibody cross-reactive
      with both isolates. These results suggest that infection of horses with C.
      piliforme may be relatively common; and that they are susceptible to at least 2
      distinct strains.

PMID- 7774555
TI  - One-dimensional genome scanning: identification of the basis of a mouse mutation
      and identification of genomic changes in ovarian carcinoma.
AB  - We have developed a simple one-dimensional electrophoretic method, genome
      scanning, that can be used to identify large-scale genomic differences between
      two or more DNA samples. Genome scanning is especially useful in the detection of
      genetic amplifications, deletions, and rearrangements. The assay is essentially a
      high-resolution Southern analysis, comparing equivalent amounts of genomic DNA
      samples that are variant for a given trait. The Southern blots are hybridized to
      a probe sequence derived from a medium copy number repetitive element (1000-2000
      copies per haploid genome) naturally dispersed throughout the genome. The
      hybridization pattern that results is complex and consists of hundreds of bands.
      If the DNA samples are otherwise equivalent, a net difference in hybridization
      intensity between homologous bands of different samples indicates a genetic
      change. In this report, we discuss the origin of the method, its premise, and
      review its application to mouse mutational analysis and to human cancer research
      (a more detailed discussion of the theory is presented elsewhere in this issue;
      Y. Gondo and M. H. Brilliant, Electrophoresis 1995, 16, 174-178).

PMID- 7774556
TI  - Size-selected genomic libraries: the distribution and size-fractionation of
      restricted genomic DNA fragments by gel electrophoresis.
AB  - By using one-dimensional genome scanning, it is possible to directly identify the
      restricted genomic DNA fragment that reflects the site of genetic change. The
      subsequent strategies to obtain the molecular clones of the corresponding
      restriction fragment are usually as follows: (i) the restriction of a mass
      quantity of an appropriate genomic DNA, (ii) the size-fractionation of the
      restricted DNA on a preparative electrophoresis gel in order to enrich the
      corresponding restriction fragment, (iii) the construction of the size-selected
      libraries from the fractionated genomic DNA, and (iv) the screening of the
      library to obtain an objective clone which is identified on the analytical genome
      scanning gel. A knowledge of the size distribution pattern of restriction
      fragments of the genomic DNA makes it possible to calculate the heterogeneity or
      complexity of the restriction fragment in each size-fraction. This manuscript
      first describes the distribution of the restriction fragments with respect to
      their length. Some examples of the practical application of this theory to genome
      scanning is then discussed using presumptive genome scanning gels. The way to
      calculate such DNA complexities in the prepared size-fractionated samples is also
      demonstrated. Such information should greatly facilitate the design of
      experimental strategies for the cloning of a certain size of genomic DNA after
      digestion with restriction enzyme(s) as is the case with genome scanning.

PMID- 7774557
TI  - Theoretical basis of one-dimensional genome scanning: a direct method to identify
      the site of a mutation.
AB  - Genome scanning is a technique designed to uncover a net genetic difference
      between otherwise identical DNA samples. As such, it can be used to directly
      identify the site of a gene mutation, facilitating the cloning of DNA fragments
      from that site. Unlike other conventional positional cloning methods, one
      dimensional genome scanning does not require prior knowledge of the location of
      the gene or mutation nor does it require closely linked markers. Rather, this
      method can directly identify the site of a net genomic change, such as a deletion
      or duplication caused by a mutation. Thus, the genome scanning method can be used
      in place of classic positional cloning strategies because prior positioning or
      mapping of the objective gene is unnecessary. By using this approach, we have
      identified and cloned a DNA fragment duplicated in the p(un) mutation of the
      mouse pink-eyed dilution locus (Brilliant et al., Science 1991, 252, 566-569).
      However, no other similar attempt using one-dimensional genome scanning has been
      reported so far, in spite of the simplicity of the procedure and its success in
      identifying and ultimately characterizing the pink-eyed dilution gene of the
      mouse. The lack of other reports of its success are perhaps not because of the
      practical difficulties of this method, but may be due to the false presumption
      that the probability for directly identifying the mutation site using genome
      scanning is extremely low. The theoretical probability was calculated and is
      presented here.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7774558
TI  - Multilocus genomic mapping with intracisternal A-particle proviral
      oligonucleotide probes hybridized to mouse DNA in dried agarose gels.
AB  - Recently, oligonucleotide probes that detect intracisternal A-particle (IAP) gene
      subfamilies with a limited number of proviral copies have been shown to be useful
      multilocus markers. A procedure for hybridization of these probes has been
      developed and is described. In summary, the main features of the method are the
      following: (i) A pulse controller is used during agarose gel electrophoresis to
      improve resolution of restriction fragments in genomic DNA. (ii) Hybridization is
      performed in a dried gel. (iii) The hybridized gel is washed in
      tetramethylammonium chloride to eliminate differences in oligonucleotide
      composition on hybrid stability. Use of the procedure is demonstrated by genomic
      mapping of IAP loci in the AXB BXA recombinant inbred mouse strains,
      identification of hypomethylated loci in tumor cells, and detection of a
      transposed IAP provirus previously identified as the basis for a mutation at the
      agouti locus.

PMID- 7774559
TI  - An expanded system of restriction landmark genomic scanning (RLGS Ver. 1.8).
AB  - The restriction landmark genomic scanning (RLGS) method is a high-speed genome
      scanning system which is based on the concept that restriction enzyme sites can
      be used as landmarks throughout the genome. It employs direct end-labeling of the
      genomic DNA digested with a rare-cutting restriction enzyme, followed by high
      resolutional two-dimensional electrophoresis. Recently, this system was further
      developed to lower cost and to simplify the procedure. This paper reviews the
      RLGS principle and the breakthroughs enabling its further development. Also
      presented is the precise protocol of the newest version (RLGS Ver. 1.8) that
      offers cost effectiveness and an expanded production system. Finally, the
      advantages of this new RLGS method and prospects for its widespread application
      are discussed.

PMID- 7774560
TI  - A spot cloning method for restriction landmark genomic scanning.
AB  - We introduce two new methods for target cloning of DNA fragments corresponding to
      spots on the two-dimensional profile of restriction landmark genomic scanning
      (RLGS). One is a restriction trapper-based method and the other is a polymerase
      chain reaction (PCR) mediated method. Both are designed to select the target DNA
      fragments from a large amount of unlabeled background DNA fragments in the RLGS
      gel which produce background clones. The restriction trapper method is simple,
      with a cloning efficiency that is not biased by the length of the target DNA nor
      by its GC content. On the other hand, the PCR-mediated method is efficient for
      cloning DNA fragments from a small amount of starting materials. These methods
      provide us with powerful tools for isolating DNA clones identified by the RLGS
      system as interesting spots. This paper reports the precise protocols of these
      methods and discusses their application and usefulness.

PMID- 7774561
TI  - The use of restriction landmark genomic scanning to scan the mouse genome for
      endogenous loci with imprinted patterns of methylation.
AB  - Restriction landmark genomic scanning (RLGS) has been used to screen endogenous
      loci for imprinted patterns of methylation. The screening method is based upon
      the identification of genetic variation in RLGS profiles between different
      strains and determining whether specific variant landmarks are transmitted
      equally to the progeny of reciprocal F1 matings. The RLGS profiles of C57BL/6
      (B6) and DBA/2 (D2) and their reciprocal hybrids were produced with two enzyme
      combinations that used NotI as the landmark enzyme and two combinations that used
      BssHII. An estimated 13% of the spots are either B5- or D2-specific in these
      tests, giving a total of nearly 1000 variant loci that were examined for
      imprinted methylation. Three candidate loci for imprinted regulation were
      identified in these analyses. We also used crosses of more genetically diverse
      parents to increase the number of variant loci screened. Interspecific crosses of
      B6 with the M. musculus strain PWK and intrasubspecific crosses between B6 and
      the M. molossinus strain MSM expanded the levels of variation between the
      parental strains in the cross to an estimated 31% and 26%, respectively. The RLGS
      patterns for one NotI combination and one BssHII profile were examined for each
      of these crosses, giving approximately 2000 additional loci that were screened
      for imprinted patterns of methylation. Eight loci with imprinted patterns of
      transmission were observed out of 3040 loci tested. The chromosomal locations for
      the three B6 and D2 specific loci, Irlgs 1-3, were identified using BXD
      recombinant inbred strain analysis. Irlgs 1 and 3 are B6- and D2-specific loci
      that had the same strain distribution pattern which mapped to the central region
      of chromosome 9.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7774562
TI  - Accessibility to tissue-specific genes from methylation profiles of mouse brain
      genomic DNA.
AB  - The DNA methylation status of a large number of genomic loci is visualized
      simultaneously and quantitatively as two-dimensional gel spots in the newly
      developed restriction landmark genomic scanning with a methylation-sensitive
      restriction enzyme (RLGS-M). Here, we demonstrate that RLGS-M using NorI as a
      methylation-sensitive enzyme could also scan gene loci of mammalian genomes,
      since almost all of the NotI loci corresponding to randomly chosen RLGS-M spots
      were located near or in transcriptional units (6 out of 7 NotI-linking clones)
      when mouse brain genomic DNA was used. This supports the previous prediction that
      most NotI sites are located in CpG islands (Lindsay and Bird, Nature 1987, 327,
      336-338). Furthermore, beginning with RLGS-M spots we examined how to approach
      their corresponding RNA messages, whose expression may be associated with
      methylation. We compared RLGS-M patterns among various developmental stages of
      the mouse brain from embryonic day 9.5 to postnatal 8 weeks or among in vitro
      cell lines, and detected alterations of RLGS-M spots which were due to
      methylation of NotI sites. Two experiments using NotI-linking clones or
      polymerase chain reaction (PCR) were carried out to approach to their
      corresponding RNA messages. Consequently, we isolated two PCR-amplified clones (#
      15 and # 91) which corresponded to methylatable loci and gave positive signals to
      mRNA from the adult brain. Furthermore, we identified two NotI-linking clones
      (C211 and C198) whose corresponding NotI loci localized near or at
      transcriptional units and were methylated in cell lines.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7774564
TI  - Genetic mapping of restriction landmark genomic scanning loci in the mouse.
AB  - Restriction landmark genomic scanning (RLGS) was originally proposed as a high
      speed method for surveying a large number of restriction landmarks in genomic
      DNA. The effort to apply this method to genetic analysis has been made, resulting
      in developing the new approach for the rapid construction of the genetic map of
      complex mammalian genomes (RLGS spot mapping). Especially, the use of NotI as the
      restriction landmark for genetic studies suggests that there is a high
      probability that a significant number of these RLGS loci will be associated with
      CpG islands of functional genes. Moreover, it is possible to use the RLGS spot
      mapping to analyze genetic map-poor species very rapidly for linkage of recessive
      mutations or segregating traits, because it does not rely upon cloned probes or
      sequences. In this paper, we summarize the progress that has been made in the
      practical application of the RLGS method to genetic analysis using congenic
      strains, recombinant inbred (RI) strains, and in interspecific backcrosses of
      mice.

PMID- 7774563
TI  - Demethylation of a repetitive DNA sequence in human cancers.
AB  - To detect DNA alterations in unknown regions in human cancers, we have performed
      restriction landmark genomic scanning (RLGS) analysis of DNA isolated from cancer
      and normal cells. One spot with a highly intensified signal was detected in DNA
      from all six malignant melanoma cell lines, two of five colon cancer cell lines
      and one of six pancreatic cancer cell lines analyzed. In DNA from normal cells,
      two placentas and seven cultured lymphocytes, the signal of this spot was not
      intense. The DNA fragment corresponding to the spot was cloned. By nucleotide
      sequence analysis, the DNA fragment was revealed to be a part of a repeating unit
      of a 13 kbp nucleotide sequence of which 200 copies were located in chromosome
      8q21. Southern blotting analysis using the cloned fragment as a probe
      demonstrated that the intensified signal for the DNA fragment observed in cancer
      cells was due to demethylation in the recognition sequence of the NotI
      restriction enzyme. The results suggest that marked demethylation in the
      repeating units might be associated with the genesis or progression of some types
      of cancers.

PMID- 7774565
TI  - Quantitative and qualitative genetic variation in two-dimensional DNA gels of
      human lymphocytoid cell lines.
AB  - There is a continuing need for more efficient methods to examine human (and
      other) populations for altered germinal and somatic cell mutation rates. To this
      end, we have explored the potential usefulness of two-dimensional (2-D)
      electrophoresis of human DNA fragments obtained from restriction-enzyme-digested
      genomic DNA, using samples from father/mother/child trios. On a single 2-D DNA
      preparation, approximately 2000 DNA fragments varying in size from 1.0 to 5.0 kbp
      in the first dimension and 0.3 to 2.0 kbp in the second dimension are visualized.
      To enter into a genetic analysis of quantitative variation, these fragments must
      exhibit positional and quantitative stability. With respect to the latter, if
      spots that are the product of two homologous DNA fragments are to be
      distinguished with the requisite accuracy from spots that are the product of only
      one fragment, the coefficient of variation of spot intensity should be
      approximately < or = 0.12. At present, 482 of the spots in our preparations meet
      these standards. In an examination of preparations based on three Japanese
      mother/father/child trios, 43 of these 482 spots were found to exhibit variations
      that segregated within families according to Mendelian principles. Additionally,
      of the 2000 spots, 1114 (of which the aforementioned 482 are a subset) were
      deemed appropriate for the study of qualitative variation. A total of 142
      variable spots were identified; the heterozygosity index for these DNA fragments
      was 4.4%. The genetic nature of the additional variants was again established by
      their segregation according to Mendelian principles. We have established the
      feasibility of cloning fragments from such gels and determining their nucleotide
      sequence. This technology should be highly efficient in monitoring for mutation
      resulting in loss/gain/rearrangement events in DNA fragments distributed
      throughout the genome.

PMID- 7774566
TI  - A single gel analysis of 575 dominant and codominant restriction landmark genomic
      scanning loci in mice interspecific backcross progeny.
AB  - We identified 575 new NotI landmarks of C57BL/6(B)- and M. spretus (S)-specific,
      dominant and codominant loci which were segregated in B x S interspecific
      backcrosses (BSS), using the restriction landmark genomic scanning (RLGS) spot
      mapping method. All of these loci were visualized on a single RLGS profile which
      was produced with NotI-PvuII-PstI. These landmarks include 250 newly identified S
      specific spots in addition to the previously reported 325 B-specific spots. The S
      specific spots were identified by reading full or half intensity, based on the
      property that the spot intensity of the autoradiographic signal reflected the
      copy number of an end-labeled restriction landmark. The cumulative map is 1341 cM
      and it is based upon 985 meiotic events in 72 backcross progeny. This map covers
      90% of the total estimated length of the mouse genetic map. This map provides a
      good tool for the high-speed genome scanning assay in the mouse genome by a
      single RLGS gel analysis.

PMID- 7774568
TI  - High resolution microscopic mapping of DNA using multi-color fluorescent
      hybridization.
AB  - We describe a procedure for microscopically mapping the relative positions of DNA
      probes along extended strands of DNA. The procedure referred to as direct visual
      hybridization (DIRVISH) DNA mapping involves the simultaneous hybridization of
      multiple probes and the fluorescent colors, red green and blue to produce images
      that convey high-resolution mapping information. The images appear as long
      strings of fluorescent signals positioned as they are in the genome. A visual
      multi-color map is generated within 2 days. Cosmid probes span a distance of 10
      microms or more and have been observed to contain patterns within the strings of
      signals. We have developed computer imaging programs to scan through the strings
      of signals and plot the intensities. Scans through multiple signal strings for
      one cosmid probe revealed consistent patterns. We have interpreted the patterns
      as the result of suppression of repetitive DNA sequence hybridization. These
      patterns may prove useful as fingerprints for regions of DNA.

PMID- 7774567
TI  - Application of fluorescence in situ hybridization in genome analysis of the
      mouse.
AB  - Fluorescence in situ hybridization (FISH) is an effective technique for
      localizing cloned DNA probes directly onto metaphase chromosomes. Human genome
      mapping using FISH has been significantly enhanced by the development of new
      techniques, especially high-resolution gene mapping with direct R-banding FISH
      and physical gene ordering with multi-color FISH. By contrast, FISH techniques
      have not been put to practical use for the analysis of the mouse genome compared
      with the human. We have developed and modified FISH techniques for use in mouse
      genome analysis. In this article we summarize and review our recent results with
      FISH analyses in the following studies: (i) high-resolution gene mapping with the
      direct R-banding FISH, (ii) analysis of chromosomal rearrangement with multi
      color FISH, (iii) establishment of centromere mapping with the major satellite
      DNA probe, (iv) analysis of chromatin structure in meiotic cells, and (v)
      application of FISH in cytogenetic studies of genetic variation in the mouse,
      showing that these applications of FISH are very useful for mouse genome
      analysis.

PMID- 7774570
TI  - Differential cloning using in-gel competitive reassociation.
AB  - We describe the principle and actual processes of a differential cloning
      procedure designed for cloning of anonymous restriction DNA fragments whose
      molecular sizes differ between two genomic DNA preparations from higher organisms
      as a result of DNA rearrangement, polymorphism, etc. The procedure, which was
      extensively modified from the original one and still employs in-gel competitive
      reassociation (IGCR) as the basic principle, aims for cloning of DNA fragments
      which exist in one copy or less per mammalian genome. The modified procedure
      consists of dissociation and reassociation of biotinylated restriction digests of
      target DNA fragments (from which clones are to be isolated) in the presence of a
      large excess of reference (competitor) DNA in gel after electrophoresis, which is
      followed by absorption of the target DNA fragments to streptavidin-coated tubes
      and solid-phase polymerase chain reaction. After repeating these steps we
      attained substantial enrichment of altered DNA fragments which were originally
      present in one copy or less per complex mammalian genome.

PMID- 7774569
TI  - Genomic mismatch scanning: current progress and potential applications.
AB  - Genomic mismatch scanning (GMS) is a new method of genetic mapping which attempts
      to purify and map the regions of identity between two complex genomes in a single
      test. Identical DNA fragments from two genomic sources are enriched in two steps:
      (i) after reannealing of the two genomes, heterohybrids are purified by using a
      combination of a restriction methylase and methylation-sensitive endonucleases,
      (ii) heterohybrids that contain mismatches are nicked in vitro by the E. coli
      MutHLS mismatch repair system and are eliminated subsequently from the pool,
      leaving only mismatch-free heterohybrids. The genomic origin of this selected
      pool of DNA fragments is then mapped in a single hybridization step onto
      metaphase chromosomes or ordered DNA arrays. The principal advantages of GMS are
      (i) it approaches the theoretical limit of mapping power and resolution offered
      by an arbitrarily dense set of completely informative polymorphic markers and
      (ii) it results in a great increase in the effective number of informative
      markers without a corresponding increase in the number of individual tests. Thus,
      it should provide an efficient method for affected-relative-pair linkage mapping
      and for linkage disequilibrium mapping. In addition, a variation of GMS may allow
      rapid genomic scanning for regions of homozygosity-by-descent or somatic loss-of
      heterozygosity. The feasibility of GMS has been validated in the 15 mb genome of
      Saccharomyces cerevisiae. This article discusses the principles of GMS, the
      application to more complex genomes, and the possible uses of GMS.

PMID- 7774571
TI  - Crystal structure of a theta-class glutathione transferase.
AB  - Glutathione S-transferases (GSTs) are a family of enzymes involved in the
      cellular detoxification of xenotoxins. Cytosolic GSTs have been grouped into four
      evolutionary classes for which there are representative crystal structures of
      three of them. Here we report the first crystal structure of a theta-class GST.
      So far, all available GST crystal structures suggest that a strictly conserved
      tyrosine near the N-terminus plays a critical role in the reaction mechanism and
      such a role has been convincingly demonstrated by site-directed mutagenesis.
      Surprisingly, the equivalent residue in the theta-class structure is not in the
      active site, but its role appears to have been replaced by either a nearby serine
      or by another tyrosine residue located in the C-terminal domain of the enzyme.

PMID- 7774572
TI  - Binding of syndecan-like cell surface proteoglycan receptors is required for
      Neisseria gonorrhoeae entry into human mucosal cells.
AB  - Bacterial invasion of human mucosal cells is considered to be a primary event in
      the pathogenesis of a gonococcal infection. Here we report that cell surface
      heparan sulfate proteoglycans may play a role in the establishment of an
      infection, by functioning as receptors for the invasion-promoting gonococcal
      opacity protein adhesin. Chemical modification and enzymatic removal of
      proteoglycan receptors from cultured epithelial cells abolished opacity protein
      associated gonococcal invasion, and mutant cell lines defective in proteoglycan
      synthesis were poor substrates for gonococcal attachment. The addition of
      purified receptor and receptor analogues totally blocked gonococcal entry into
      the cells. Heparin-affinity chromatography and receptor binding assays using
      recombinant bacteria producing defined opacity proteins and reconstituted
      receptor or purified receptor fragments as probes, identified one particular
      member of the opacity protein family (MS11-Opa30) as the primary ligand for this
      novel class of receptors for bacteria. Heparan sulfate proteoglycans with
      gonococcal binding activity were purified from various cell types derived from
      target tissues of gonococcal infection, including ME-180 endocervical cells and
      primary cultures of human corneal epithelium. The physico-chemical properties of
      the receptor indicate that it may belong to the syndecan proteoglycan family.

PMID- 7774573
TI  - Dominant mutants identify new roles for p34cdc2 in mitosis.
AB  - A large number of dominant mutants have been generated in the fission yeast cdc2
      gene, causing lethality when expressed in wild-type cells. The mutants interfere
      with distinct aspects of p34cdc2 function, producing one of four different
      phenotypes: mitotic arrest, multiple rounds of S phase in the absence of mitosis,
      premature mitosis or G2 arrest. The mitotic mutants DL41, DL45 and DL50 are
      characterized in this paper. Over-expression of DL41 or DL45 causes mitotic
      arrest, specifically interfering with sister chromatid separation, without
      preventing spindle elongation. This suggests a role for p34cdc2 in triggering
      sister chromatid separation at anaphase. DL41 and DL45 also cause abnormal septum
      formation, suggesting that p34cdc2 may also be involved in regulating this
      process in fission yeast. These mitotic aspects of p34cdc2 function may involve
      interaction with p13suc1, since increased expression of suc1 partially suppresses
      DL41 and DL45. Over-expression of DL50 causes premature mitotic entry in cells
      that have not completed S phase, resulting in lethality. DL41, DL45 and DL50
      correspond to mutation of p34cdc2 residues predicted to be on the surface of the
      protein, identifying potential sites of interaction with mitotic regulators of
      p3cdc2, and these residues are conserved amongst cdc2 proteins found in other
      eukaryotes.

PMID- 7774574
TI  - Cell cycle regulation of human WEE1.
AB  - WEE1 kinase negatively regulates entry into mitosis by catalyzing the inhibitory
      tyrosine phosphorylation of CDC2/cyclin B kinase. We report here an investigation
      of human WEE1. Endogenous WEE1 migrates as an approximately 94 kDa protein in SDS
      PAGE, substantially larger than the 49 kDa protein encoded by the original human
      WEE1 cDNA clone that was truncated at the 5'-end. Antibody depletion experiments
      demonstrate that WEE1 accounts for most of the activity that phosphorylates CDC2
      on Tyr15 in an in vitro assay of HeLa cell lysates, hence it is likely to have an
      important role in the mitotic control of human cells. WEE1 activity was not found
      to be elevated in HeLa cells arrested in S phase, suggesting that unreplicated
      DNA does not delay M phase by hyperactivating WEE1. WEE1 activity is strongly
      suppressed during M phase, suggesting that negative regulation of WEE1 could be
      part of the mechanism by which activation of CDC2/cyclin B kinase is promoted
      during the G2/M transition. M phase WEE1 is re-activated in samples prepared in
      the absence of protein phosphatase inhibitors, demonstrating that WEE1 is
      inhibited by a mechanism that requires protein phosphorylation.

PMID- 7774575
TI  - Tyr115 is the key residue for determining agonist selectivity in the V1a
      vasopressin receptor.
AB  - Using a three-dimensional model of G protein-coupled receptors (GPCR), we have
      previously succeeded in docking the neurohypophysial hormone arginine-vasopressin
      (AVP) into the V1a receptor. According to this model, the hormone is completely
      embedded in the transmembrane part of the receptor. Only the side chain of the
      Arg residue at position 8 projects outside the transmembrane core of the receptor
      and possibly interacts with a Tyr residue located in the first extracellular loop
      at position 115. Residue 8 varies in the two natural neurohypophysial hormones,
      AVP and oxytocin (OT); similarly, different residues are present at position 115
      in the different members of the AVP/OT receptor family. Here we show that Arg8 is
      crucial for high affinity binding of AVP to the rat V1a receptor. Moreover, when
      Tyr115 is replaced by an Asp and a Phe, the amino acids naturally occurring in
      the V2 and in the OT receptor subtypes, the agonist selectivity of the V1a
      receptor switches accordingly. Our results indicate that the interaction between
      peptide residue 8 and the receptor residue at position 115 is not only crucial
      for agonist high affinity binding but also for receptor selectivity.

PMID- 7774576
TI  - Heparin can activate a receptor tyrosine kinase.
AB  - Heparin, a densely sulfated glycosaminoglycan produced by mast cells, is best
      known for its inhibitory effects on the blood coagulation system. Heparin or
      heparan sulfate proteoglycans are also essential cofactors for the interaction of
      fibroblast growth factors (FGFs) with their receptor tyrosine kinases (FGFRs).
      Here we show that heparin is a growth factor-independent activating ligand for
      FGFR-4. Heparin stimulates FGFR-4 autophosphorylation on transfected myoblasts,
      fibroblasts and lymphoid cells, and is most potent on cells lacking surface
      heparan proteoglycan. Two functional analogs of heparin, fucoidan and dextran
      sulfate, are also activators of FGFR-4, while neither heparin nor its analogs can
      stimulate FGFR-1 in the absence of FGF. A mutation in the FGFR-4 ectodomain which
      impairs receptor activation by FGFs does not interfere with activation by
      heparin, demonstrating that receptor domains required for heparin or FGF
      activation are not identical. Heparin activation of FGFR-4 or of a chimeric
      receptor bearing FGFR-4 ectodomain and FGFR-1 cytodomain triggers downstream
      tyrosine phosphorylation of several signaling proteins, and induces proliferation
      of cells bearing the chimeric receptor. Consistent with these findings, a soluble
      FGFR-4 ectodomain has strong FGF-independent affinity for immobilized heparin
      resin, while soluble FGFR-1 requires FGF for stable heparin interaction. Heparin
      activation of FGFR-4 is the first example of a mammalian polysaccharide serving
      as a signaling ligand.

PMID- 7774578
TI  - GS domain mutations that constitutively activate T beta R-I, the downstream
      signaling component in the TGF-beta receptor complex.
AB  - The TGF-beta type II receptor (T beta R-II) is a transmembrane serine/threonine
      kinase that, upon ligand binding, recruits and phosphorylates a second
      transmembrane kinase, T beta R-I, as a requirement for signal transduction. T
      beta R-I is phosphorylated by T beta R-II in the GS domain, a 30 amino acid
      region preceding the kinase domain and conserved in type I receptors for other
      TGF-beta-related factors. The functional role of seven serines and threonines in
      the T beta R-I GS domain was investigated by mutational analysis. Five of these
      residues are clustered (TTSGSGSG) in the middle of the GS domain. Mutation of two
      or more of these residues impairs phosphorylation and signaling activity. Two
      additional threonines are located near the canonical start of the kinase domain,
      and their individual mutation to valine strongly inhibits receptor
      phosphorylation and signaling activity. Replacement of one of these residues,
      Thr204, with aspartic acid yields a product that has elevated in vitro kinase
      activity and signals anti-proliferative and transcriptional responses in the
      absence of ligand and T beta R-II. The identification of constitutively active T
      beta R-I forms confirms the hypothesis that this kinase acts as a down-stream
      signaling component in the TGF-beta receptor complex, and its activation by T
      beta R-II or by mutation is necessary and sufficient for propagation of anti
      proliferative and transcriptional responses.

PMID- 7774577
TI  - Affinity and specificity requirements for the first Src homology 3 domain of the
      Crk proteins.
AB  - The specificity of SH3 domain complex formation plays an important role in
      determining signal transduction events. We have previously identified a highly
      specific interaction between the first CrkSH3 domain [CrkSH3(1)] and proline-rich
      sequences in the guanine nucleotide exchange factor C3G. A 10 amino acid peptide
      derived from the first proline-rich sequence (P3P4P5A6L7P8P9K10K11R12) bound with
      a Kd of 1.89 +/- 0.06 microM and fully retained the high affinity and unique
      selectivity for the CrkSH3(1) domain. Mutational analysis showed that P5, P8, L7
      and K10 are critical for high affinity binding. A conservative mutation, K10R,
      significantly decreased the affinity for the CrkSH3(1) domain while increasing
      the affinity for Grb2. Comparative binding studies with the K10R and K10A mutant
      peptides to c-Crk and v-Crk further suggested that K10 binds via a charge
      dependent and a charge-independent interaction to the RT loop of the CrkSH3(1)
      domain. Besides determining important structural features necessary for high
      affinity and specificity binding to the CrkSH3(1) domain, our results also
      demonstrate that a conservative mutation in a single amino acid can significantly
      alter the specificity of an SH3 binding peptide.

PMID- 7774579
TI  - Energy-dependent chromatin accessibility and nucleosome mobility in a cell-free
      system.
AB  - Chromatin structure must be flexible to allow the binding of regulatory proteins
      and to accommodate different levels of gene activity. Chromatin assembled in a
      cell-free system derived from Drosophila embryos contains an activity that
      hydrolyses ATP to render entire nucleosome arrays mobile. Nucleosome movements,
      most likely their sliding, occurred even in the presence of the linker histone
      H1. The dynamic state of chromatin in the presence of the activity and ATP
      globally increased the accessibility of nucleosomal DNA to incoming proteins.
      This unprecedented demonstration of energy-dependent nucleosome mobility
      identifies a new principle which is likely to be fundamental to the mechanism of
      chromatin remodelling and the binding of regulatory proteins.

PMID- 7774580
TI  - A transition in transcriptional activation by the glucocorticoid and retinoic
      acid receptors at the tumor stage of dermal fibrosarcoma development.
AB  - In transgenic mice harboring the bovine papillomavirus genome, fibrosarcomas
      arise along an experimentally accessible pathway in which normal dermal
      fibroblasts progress through two pre-neoplastic stages, mild and aggressive
      fibromatosis, followed by a final transition to the tumor stage. We found that
      the glucocorticoid receptor (GR) displays only modest transcriptional regulatory
      activity in cells derived from the three non-tumor stages, whereas it is highly
      active in fibrosarcoma cells. Upon inoculation into mice, the aggressive
      fibromatosis cells progress to tumor cells that have high GR activity; thus, the
      increased transcriptional regulatory activity of GR correlates with the cellular
      transition to the tumor stage. The intracellular levels of GR, as well as its
      hormone-dependent nuclear translocation and specific DNA binding activities, are
      unaltered throughout the progression. Strikingly, the low GR activity observed in
      the pre-neoplastic stages cannot be overcome by exogenous GR introduced by co
      transfection. Moreover, comparisons of primary embryo fibroblasts and their
      transformed derivatives revealed a similar pattern--modest GR activity,
      unresponsive to overexpressed GR protein, in the normal cells was strongly
      increased in the transformed cells. Likewise, the retinoic acid receptor (RAR)
      displayed similar differential activity in the fibrosarcoma pathway. Thus, the
      oncogenic transformation of fibroblasts, and likely other cell types, is
      accompanied by a striking increase in the activities of transcriptional
      regulators such as GR and RAR. We suggest that normal primary cells have a
      heretofore unrecognized capability to limit the magnitude of induction of gene
      expression.

PMID- 7774581
TI  - Multiple modes of dorsal-bHLH transcriptional synergy in the Drosophila embryo.
AB  - Synergistic interactions between the maternal regulatory factor dorsal (dl) and
      basic helix-loop-helix (bHLH) activators are essential for initiating
      differentiation of the mesoderm and neuroectoderm in the early Drosophila embryo.
      Here we present evidence that dl-bHLH interactions mediating gene expression in
      the neuroectoderm and mesoderm are fundamentally distinct. Close proximity of dl
      and bHLH binding sites is essential for the synergistic activation of gene
      expression in the lateral neuroectoderm, where there are diminishing levels of
      the dl regulatory gradient. In contrast, sharp on/off patterns of gene expression
      in the presumptive mesoderm do not require linkage of these sites. Analysis of
      minimal and synthetic promoter elements suggests that dl and bHLH activators,
      such as twist, might interact with different rate-limiting components of the
      transcription complex. These results are consistent with two distinct modes of dl
      bHLH synergy: cooperative binding to DNA (requiring linkage of sites) and
      synergistic contact of basal transcription factors (not requiring linkage).
      Finally, the characterization of a 57 bp synthetic minimal stripe unit (MSU)
      provides evidence for a third tier of dl-bHLH synergy. Tandem copies of the MSU
      function as a bona fide enhancer and can mediate neuroectoderm expression in
      transgenic embryos even when placed 4.5 kb downstream of a test promoter.
      Multiple copies of the MSU function synergistically only when linked, but not
      when separated. We propose that this linkage requirement provides the basis for
      the evolution of modular promoters composed of discrete, non-overlapping
      enhancers.

PMID- 7774582
TI  - Mutations in GCD11, the structural gene for eIF-2 gamma in yeast, alter
      translational regulation of GCN4 and the selection of the start site for protein
      synthesis.
AB  - Translation initiation factor 2 (eIF-2) in eukaryotic organisms is composed of
      three non-identical subunits, alpha, beta and gamma. In a previous report, we
      identified GCD11 as an essential gene encoding the gamma subunit of eIF-2 in the
      yeast Saccharomyces cerevisiae. The predicted amino acid sequence of yeast eIF-2
      gamma displays remarkable similarity to bacterial elongation factor Tu, including
      the presence of sequence elements conserved in all known guanine nucleotide
      binding proteins. We have identified the molecular defects present in seven
      unique alleles of GCD11 characterized by a partial loss of function. Three of
      these mutations result in amino acid substitutions within the putative GTP
      binding domain of eIF-2 gamma. We show that the gcd11 mutations specifically
      alter regulation of GCN4 expression at the translational level, without altering
      the scanning mechanism for protein synthesis initiation. Six of the mutant
      alleles presumably alter the function of eIF-2 gamma, rather than its abundance.
      A single allele, gcd11-R510H, suppresses a mutant his4 allele that lacks a
      functional AUG start codon. The latter result indicates that the gamma subunit of
      eIF-2 participates in recognition of the start site for protein synthesis, a role
      previously demonstrated in yeast for eIF-2 alpha and eIF-2 beta.

PMID- 7774583
TI  - A novel endocytosis signal related to the KKXX ER-retrieval signal.
AB  - Membrane proteins often contain a sorting signal in their cytoplasmic tail that
      promotes their clustering into coated vesicles at a specific cellular site. ERGIC
      53 contains a cytoplasmic ER-retrieval signal, KKFF. However, overexpressed ERGIC
      53 is transported to the cell surface and rapidly endocytosed. Here we report
      that ERGIC-53 carries a previously undescribed endocytosis signal. Surprisingly,
      the signal was KKFF and like the ER-retrieval signal required a C-terminal
      position. In fact, the minimal consensus sequence determined by substitutional
      mutagenesis (K-K/R-F/Y-F/Y) was related to the ER-retrieval consensus (K-K-X-X).
      Furthermore, we provide evidence that internalization of VIP36, a protein that
      cycles between plasma membrane and Golgi, is mediated by a signal at its C
      terminus that matches the internalization consensus sequence. The relatedness of
      the two signals suggests that coatomer-mediated retrieval of proteins may be
      mechanistically more related to clathrin-dependent sorting than previously
      anticipated.

PMID- 7774584
TI  - A tyrosine-containing motif mediates ER retention of CD3-epsilon and adopts a
      helix-turn structure.
AB  - The CD3-epsilon endoplasmic reticulum (ER) retention motif has been characterized
      by mutagenesis and NMR spectroscopy. Tyr177, Leu180 and Arg183 are involved in ER
      retention. The motif forms an elongated alpha-helix in which the tyrosine and
      leucine residues are closely apposed, followed by a beta I' turn that places
      Arg183 in the vicinity of Leu180. The structure formed by Tyr177 and the leucine
      in position +3 is reminiscent of the beta-turn structure adopted by tyrosine
      containing endocytosis signals. Moreover, substitution of the transferrin
      receptor (TfR) internalization sequence by the CD3-epsilon motif still allowed
      the rapid internalization of the TfR and, conversely, the chimeric protein
      resulting from the substitution of the CD3-epsilon motif by the endocytosis
      signal of the low density lipoprotein receptor was ER located. These data support
      the idea of a functional homology between the two types of signal.

PMID- 7774585
TI  - 39 kDa receptor-associated protein is an ER resident protein and molecular
      chaperone for LDL receptor-related protein.
AB  - The low density lipoprotein receptor-related protein (LRP) is a multifunctional
      endocytic receptor with the ability to bind and endocytose several structurally
      and functionally distinct ligands. A 39 kDa receptor-associated protein (RAP)
      inhibits all ligand interactions with LRP in vitro. In the present study, we
      demonstrate that RAP is an endoplasmic reticulum (ER) resident protein. The
      tetrapepetide sequence HNEL at the C-terminus of RAP is both necessary and
      sufficient for RAP retention within the ER. Metabolic labeling combined with
      cross-linking studies show that RAP interacts with LRP in vivo. Pulse-chase
      analysis reveals that this association is transient early in the secretory
      pathway and coincides with LRP aggregation and reduced ligand binding activity.
      Both internal triplicated LRP binding domains on RAP and multiple RAP binding
      domains on LRP appear to contribute to the aggregation of LRP and RAP.
      Dissociation of RAP from LRP results from the lower pH encountered later in the
      secretory pathway and correlates with an increase in LRP ligand binding activity.
      Taken together, our results thus suggest that RAP functions intracellularly as a
      molecular chaperone for LRP and regulates its ligand binding activity along the
      secretory pathway.

PMID- 7774586
TI  - Identification of a regulatory motif in Hsp70 that affects ATPase activity,
      substrate binding and interaction with HDJ-1.
AB  - The Hsp70 family of molecular chaperones has an essential role in the synthesis,
      folding and translocation of the nascent peptide chain. While the general
      features of these activities are well documented, less is understood about the
      regulation of these activities. The ATPase rate is stimulated by non-native
      proteins, furthermore, interaction with ATP leads to the release of protein
      substrate concurrent with a conformational change in Hsp70. One interpretation of
      these data is that the two domains of Hsp70 interact. In the process of mapping
      the carboxyl-terminal boundary of the substrate binding domain for human Hsp70,
      we identified a regulatory motif, EEVD, which is conserved at the extreme
      carboxyl terminus among nearly all cloned cytosolic eukaryotic Hsp70s. Deletion
      or mutation of EEVD affects the ATPase activity, the ability to interact with
      substrates, and interferes with the ability of the mutant Hsp70 to interact with
      HDJ-1 in the refolding of denatured firefly luciferase. Examination of the
      biophysical properties of the mutant Hsp70s reveals a change in the overall shape
      and conformation of the protein consistent with reduced interactions between the
      two domains. These data suggest that the EEVD motif is involved in the
      intramolecular regulation of Hsp70 function and intermolecular interactions with
      HDJ-1.

PMID- 7774587
TI  - Dynamic interaction of the protein translocation systems in the inner and outer
      membranes of yeast mitochondria.
AB  - Mitochondria contain two distinct protein import systems, one in the outer and
      the other in the inner membrane. These systems can act independently of one
      another in submitochondrial fractions of if a protein is transported to the outer
      membrane or to the intermembrane space. It has been proposed that the two systems
      associate reversibly when a protein is transported across both membranes, but
      this hypothesis has remained unproven. In order to address this question, we have
      checked whether antibodies against a subunit of one system can co
      immunoprecipitate subunits of the other system. We find that the two systems
      associate stably if a matrix-targeted precursor is arrested during import; no
      association is seen in the absence of a stuck precursor. These experiments
      provide direct evidence that protein import into the mitochondrial matrix is
      mediated by the reversible interaction of the two translocation systems.

PMID- 7774588
TI  - Protein secretion by hybrid bacterial ABC-transporters: specific functions of the
      membrane ATPase and the membrane fusion protein.
AB  - The Erwinia chrysanthemi metalloprotease C and the Serratia marcescens haem
      acquisition protein HasA are both secreted from Gram-negative bacteria by a
      signal peptide-independent pathway which requires a C-terminal secretion signal
      and a specific ABC-transporter made up of three proteins: a membrane ATPase (the
      ABC-protein), a second inner membrane component belonging to the membrane fusion
      protein family and an outer membrane polypeptide. HasA and protease C
      transporters are homologous although the secreted polypeptides share no sequence
      homology. Whereas protease C can use both translocators, HasA is secreted only by
      its specific transporter. Functional analysis of protease C and HasA secretion
      through hybrid transporters obtained by combining components from each system
      demonstrates that the ABC-protein is responsible for the substrate specificity
      and that inhibition of protease C secretion in the presence of HasA results from
      a defective interaction between HasA and the ABC-protein. We also show that the
      outer membrane protein, TolC, can combine with the membrane fusion protein HasE
      in the presence of either ABC-protein to form a functional transporter but not
      with the membrane fusion protein, PrtE. This indicates a specific interaction
      between the outer membrane component and the membrane fusion protein.

PMID- 7774590
TI  - Disassembly of the reconstituted synaptic vesicle membrane fusion complex in
      vitro.
AB  - The interaction of the presynaptic membrane proteins SNAP-25 and syntaxin with
      the synaptic vesicle protein synaptobrevin (VAMP) plays a key role in the
      regulated exocytosis of neurotransmitters. Clostridial neurotoxins, which
      proteolyze these polypeptides, are potent inhibitors of neurotransmission. The
      cytoplasmic domains of the three membrane proteins join into a tight SDS
      resistant complex (Hayashi et al., 1994). Here, we show that this reconstituted
      complex, as well as heterodimers composed of syntaxin and SNAP-25, can be
      disassembled by the concerted action of the N-ethylmaleimide-sensitive factor,
      NSF, and the soluble NSF attachment protein, alpha-SNAP. alpha-SNAP binds to
      predicted alpha-helical coiled-coil regions of syntaxin and SNAP-25, shown
      previously to be engaged in their direct interaction. Synaptobrevin, although
      incapable of binding alpha-SNAP individually, induced a third alpha-SNAP binding
      site when associated with syntaxin and SNAP-25 into heterotrimers. NSF released
      prebound alpha-SNAP from full-length syntaxin but not from a syntaxin derivative
      truncated at the N-terminus. Disassembly of complexes containing this syntaxin
      mutant was impaired, indicating a critical role for the N-terminal domain in the
      alpha-SNAP/NSF-mediated dissociation process. Complexes containing C-terminally
      deleted SNAP-25 derivatives, as generated by botulinal toxins type A and E, were
      dissociated more efficiently. In contrast, the N-terminal fragment generated from
      synaptobrevin by botulinal toxin type F produced an SDS-sensitive complex that
      was poorly dissociated.

PMID- 7774589
TI  - Embryonic tissue differentiation in Caenorhabditis elegans requires dif-1, a gene
      homologous to mitochondrial solute carriers.
AB  - The dif-1 gene was identified in a general screen for maternal-effect embryonic
      lethal (Mel) mutants. dif-1 mutant embryos complete gastrulation and embryonic
      cell division normally, but then arrest development with only a small amount of
      tissue differentiation. Either maternal or zygotic dif-1 activity is sufficient
      for wild-type development. The temperature-sensitive period of a cold-sensitive
      dif-1 mutant shows that dif-1 activity is essential only for 3 h, corresponding
      to the major period of embryonic tissue differentiation, and is not required post
      embryonically. The results point to a role for dif-1 in the maintenance of tissue
      differentiation in the developing embryo, but not for its initiation. Cloning and
      sequencing of the dif-1 gene revealed that its product is homologous to proteins
      in the mitochondrial carrier family. Although dif-1 activity is required only
      during embryogenesis, dif-1 RNA is expressed at all stages of development. In
      situ hybridization to embryos showed that dif-1 RNA is initially present in all
      cells of the embryo; this most likely corresponds to maternal dif-1 RNA. Later,
      the presumable zygotic dif-1 RNA is found only in the gut and hypodermis of the
      embryo. This tissue-specific expression raises the possibility that the dif-1
      protein acts non-cell autonomously and that some communication or molecular
      transport dependent on DIF-1 takes place during embryonic tissue differentiation.
      dif-1 is the first mitochondrial carrier homologue known to be needed
      specifically for a developmental process.

PMID- 7774591
TI  - Retroviral sequences located within an intron of the dilute gene alter dilute
      expression in a tissue-specific manner.
AB  - The murine dilute coat color locus encodes an unconventional myosin heavy chain
      that is thought to be required for the elaboration or maintenance of dendrites or
      organelle transport in melanocytes and neurons. In previous studies we showed
      that the d mutation carried by many inbred strains of mice (now referred to as
      dilute viral, dv), is caused by the integration of an ecotropic murine leukemia
      virus (Emv-3) into the dilute gene and that phenotypic revertants of dv (termed
      d+) result from viral excision; a solo viral long terminal repeat (LTR) is all
      that remains in revertant DNA. In the studies described here we show that Emv-3
      sequences are located within an intron of the dilute gene in a region of the C
      terminal tail that is differentially spliced. We also show that these Emv-3
      sequences result in the production of shortened and abnormally spliced dilute
      transcripts and that the level of this effect varies among tissues. This tissue
      specific effect on dilute expression likely accounts for the absence of
      neurological abnormalities observed in dv mice. Surprisingly, we also found that
      the solo viral LTR present in revertant d+ DNA produces a tissue-specific effect
      on dilute expression, although this effect is less dramatic than with the full
      length provirus and produces no obvious mutant phenotype. These findings have
      important implications for understanding the effects of viral sequences on
      mammalian gene expression.

PMID- 7774593
TI  - Transposon-mediated chromosomal rearrangements and gene duplications in the
      formation of the maize R-r complex.
AB  - R-r controls the production of anthocyanin pigment in plant parts and the
      aleurone layer of seeds through the production of a family of related
      transcriptional activating proteins of the helix-loop-helix type. The R-r complex
      comprises a series of repeated, homologous components arranged in both direct and
      inverted orientations. These include the P component, a simple R gene that
      confers pigmentation of plant parts, and the S subcomplex that consists of a
      truncated inactive R gene called q, and two functional R genes, S1 and S2, that
      pigment the aleurone. The S genes are arranged in an unusual inverted head-to
      head orientation. The identity of each functional component was confirmed by
      microprojectile bombardment of intact maize tissues with cloned genomic DNA and
      by analysis of in vivo mRNA populations. Sequence analysis suggests that the S
      subcomplex was derived through the rearrangement of a simple P-like progenitor
      element. At the rearrangement breakpoints, features typical of the CACTA family
      of transposable elements were found. The location and arrangement of these CACTA
      element sequences implies that this element may have mediated the chromosomal
      rearrangements that led to the formation of the R-r complex. The unusual
      structure of R-r explains much of the meiotic instability of the complex.

PMID- 7774592
TI  - Loss of TAL-1 protein activity induces premature apoptosis of Jurkat leukemic T
      cells upon medium depletion.
AB  - Transcriptional activation of the tal-1 gene occurs in -30% of patients with T
      cell Acute Lymphoblastic Leukemia and is therefore likely to be involved in human
      T cell leukemogenesis. However, the TAL-1 protein functional properties involved
      in this process have not been assessed so far. We have derived a clonal subline
      of the Jurkat T cell line which produced solely a mutant truncated form of TAL-1
      protein. Sequencing of genomic DNA and cDNAs showed that the only transcribed tal
      1 allele of this mutant subline harbored a G nucleotide insertion at codon 270.
      The resulting frameshift modifies TAL-1 residues 272-278 and creates a stop at
      codon 279. Although the deletion of the 53 carboxy-terminal residues of the TAL-1
      protein did not directly affect the TAL-1 basic helix-loop-helix domain (residues
      185-243), it had drastic effects on TAL-1 functional properties, since the mutant
      subline exhibited a dramatic decrease of protein binding activity to the TAL-1
      DNA consensus sequence. Growth curves indicated that the mutant subline exhibited
      premature apoptosis upon medium depletion or serum reduction when compared with
      the parental cells. However, no difference between Jurkat and the mutant subline
      was observed in etoposide- or Fas/APO-1-triggered apoptosis. Stable expression of
      the mutant TAL-1 protein in Jurkat cells resulted in a phenotype that was similar
      to that of the mutant Jurkat subline, indicating that the TAL-1 mutant protein
      behaved like a dominant negative mutant and that the premature apoptosis of the
      mutant subline upon medium depletion was the consequence of the loss of TAL-1
      protein activity.

PMID- 7774594
TI  - RNA-mediated transposition of the tobacco retrotransposon Tnt1 in Arabidopsis
      thaliana.
AB  - The tobacco (Nicotiana tabacum) retrotransposon Tnt1 was introduced into
      Arabidopsis thaliana. In this heterologous host plant species, Tnt1 undergoes an
      RNA-mediated transposition and creates a 5 bp duplication at the insertion sites.
      This is the first report of transposition of a retrotransposon after introduction
      into a heterologous host species. Tnt1 transposed during in vitro regeneration of
      transformed A.thaliana, but no transposition event was detected as happening in
      T2 and T3 generation plants. Newly synthesized copies of Tnt1 can integrate into
      coding regions of the host DNA. Our results open up the possibility of using Tnt1
      as a new tool for insertional mutagenesis and functional analysis of plant
      genomes, in addition to the strategies of T-DNA and transposon tagging.

PMID- 7774595
TI  - A domain sharing model for active site assembly within the Mu A tetramer during
      transposition: the enhancer may specify domain contributions.
AB  - The functional configuration of Mu transposase (A protein) is its tetrameric
      form. We present here a model for the organization of a functional Mu A tetramer.
      Within the tetramer, assembly of each of the two active sites for Mu end cleavage
      requires amino acid contributions from the central and C-terminal domains
      (domains II and III respectively) of at least two Mu A monomers in a trans
      configuration. The Mu enhancer is likely to function in this assembly process by
      specifying the two monomers that provide their C-terminal domains for strand
      cleavage. The Mu B protein is not required in this step. Each of the two active
      sites for the strand transfer reaction is also organized by domain sharing (but
      in the reverse mode) between Mu A monomers; i.e. a donor of domain II (also the
      recipient of domain III) during cleavage is a recipient of domain II (and the
      donor of domain III) during strand transfer. The function of the Mu B protein
      (which is required at the strand transfer step) and that of the enhancer element
      may be analogous in that their interactions with Mu A (domain III and domain I
      alpha respectively) promote conformations of Mu A conducive to strand cleavage or
      strand transfer.

PMID- 7774597
TI  - A eukaryotic gene encoding an endonuclease that specifically repairs DNA damaged
      by ultraviolet light.
AB  - Many eukaryotic organisms, including humans, remove ultraviolet (UV) damage from
      their genomes by the nucleotide excision repair pathway, which requires more than
      10 separate protein factors. However, no nucleotide excision repair pathway has
      been found in the filamentous fungus Neurospora crassa. We have isolated a new
      eukaryotic DNA repair gene from N.crassa by its ability to complement UV
      sensitive Escherichia coli cells. The gene is altered in a N.crassa mus-18 mutant
      and responsible for the exclusive sensitivity to UV of the mutant. Introduction
      of the wild-type mus-18 gene complements not only the mus-18 DNA repair defect of
      N.crassa, but also confers UV-resistance on various DNA repair-deficient mutants
      of Saccharomyces cerevisiae and a human xeroderma pigmentosum cell line. The cDNA
      encodes a protein of 74 kDa with no sequence similarity to other known repair
      enzymes. Recombinant mus-18 protein was purified from E.coli and found to be an
      endonuclease for UV-irradiated DNA. Both cyclobutane pyrimidine dimers and (6
      4)photoproducts are cleaved at the sites immediately 5' to the damaged
      dipyrimidines in a magnesium-dependent, ATP-independent reaction. This mechanism,
      requiring a single polypeptide designated UV-induced dimer endonuclease for
      incision, is a substitute for the role of nucleotide excision repair of UV damage
      in N.crassa.

PMID- 7774598
TI  - Chimeric proteins containing the cytoplasmic domains of the mannose 6-phosphate
      receptors codistribute with the endogenous receptors.
AB  - We have constructed and transiently expressed in HeLa cells a series of hybrid
      proteins in which the cytoplasmic domain or both the transmembrane and the
      cytoplasmic domains of the mannose 6-phosphate/insulin-like growth factor II
      receptor were fused to the ectodomain of the hemagglutinin of the influenza virus
      (HA), a typical plasma membrane protein. In addition, we have expressed a hybrid
      protein containing the luminal domain of HA fused to the transmembrane and
      cytoplasmic tail of the cation-dependent mannose 6-phosphate receptor. These
      hybrids were transported through and sorted from the secretory pathway as shown
      by acquisition of endo-H resistant oligosaccharides and their ability to recruit
      the Golgi assembly proteins AP-1 on the Golgi membrane. Like the mannose 6
      phosphate receptors (MPRs), these hybrid proteins are also present in small
      amounts at the cell surface where they are likely to undergo endocytosis as
      disruption of the endocytosis signals contained in the MPR cytoplasmic domains
      induces their accumulation at the cell surface. Double immunofluorescence studies
      indicate that these chimeras codistribute with the endogenous MPRs at steady
      state. The results suggest that the cytoplasmic domains of the MPRs are
      sufficient to determine the steady-state distribution of the full-length
      proteins.

PMID- 7774596
TI  - Escherichia coli RecG and RecA proteins in R-loop formation.
AB  - Escherichia coli rnhA mutants devoid of RNase HI exhibit constitutive stable DNA
      replication, cSDR, which is thought to be initiated from R-loops stabilized in
      the absence of RNase HI. We found that a combination of an rnhA and a recG
      mutation is lethal to the cell. recG mutations that inactivate the helicase
      activity of RecG protein and inhibit reverse branch migration of Holliday
      junctions impart phenotypes resembling those of rnhA mutants. Thus, recG mutants
      display cSDR activity, and recG polA double mutants are inviable as are rnhA polA
      double mutants. These results suggest that the RecG helicase has a role in
      preventing R-loop formation. A model that R-loops are formed by assimilation of
      RNA transcripts into the duplex DNA is discussed. The model further postulates
      that RecA protein catalyzes this assimilation reaction and that RecG protein
      counteracts RecA in this reaction, resolves R-loops by its helicase activity, or
      does both.

PMID- 7774599
TI  - Role of free p70 (Ku) subunit in posttranslational stabilization of newly
      synthesized p80 during DNA-dependent protein kinase assembly.
AB  - The Ku antigen (p70/p80 heterodimer) is the DNA binding component of a DNA
      dependent serine/threonine kinase (DNA-PK), the catalytic activity of which is
      carried by a 350 kDa polypeptide (p350). In the present studies, the assembly of
      p70, p80, and p350 was investigated in human K562 (erythroleukemia) cells, and
      rabbit (RK13) or murine (L-929) cells infected with recombinant vaccinia viruses
      directing the synthesis of human p70 and p80. Pulse-chase analysis and density
      gradient centrifugation revealed a pool of free p70 subunits in K562 cells that
      dimerized within minutes with newly synthesized p80, whereas Ku became associated
      with newly synthesized p350 1 to 4 h after the onset of p70/p80 heterodimer
      assembly. A stable pool of free p80 subunits was not detected, and newly
      synthesized p80 was degraded rapidly (t1/2 < 1.5 h) unless it became incorporated
      into a p70/p80 dimer. The explanation for the absence of unassembled p80 subunits
      in K562 cells was investigated further by expressing human p70 and p80
      individually or together in Ku-deficient RK13 or L-929 cells infected with
      recombinant vaccinia viruses p70-vacc and/or p80-vacc. As in uninfected K562
      cells, the t1/2 of the free recombinant human p80 subunit expressed in RK13 cells
      was < 1.5 h unless it was "rescued" by dimerization with p70. The t1/2 of human
      p70 as well as p70/p80 heterodimers was > 16 h in RK13 cells.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7774600
TI  - Truncation mutagenesis of the non-alpha-helical carboxyterminal tail domain of
      vimentin reveals contributions to cellular localization but not to filament
      assembly.
AB  - We have investigated the effect of stepwise truncating the carboxyterminal domain
      ("tail") of the intermediate filament (IF) protein vimentin of the clawed toad,
      Xenopus laevis, on filament assembly in vitro and, using cell transfection, in
      vivo and also on the cellular topology of the structures formed. All truncations
      examined, except the minimal one missing the last 11 amino acids which made the
      protein more sensitive to changes of ionic strength, did not significantly alter
      IF assembly in vitro, as judged by electron microscopy, viscometry and
      determination of viscoelastic properties with a laser-operated torsion pendulum.
      Stable transfections of vimentin-free mammalian cells with cDNAs encoding these
      mutations resulted at 28 degrees C, i.e. the permissive temperature for assembly
      of Xenopus vimentin, in the formation of extended IF bundle arrays. At 37 degrees
      C, however, the mutants lacking more than the last 35 amino acids could leave the
      cytoplasm and accumulated in the nucleus, indicating a certain topogenic element
      is located in the tail and directs cytoplasmic restriction in the wild-type
      protein although this does not form IFs under these conditions. Transfer to the
      nucleus is, however, abolished if the IF-consensus motif at the end of the rod
      domain is removed, suggesting that this part of the molecule also contributes to
      nuclear location. Similar results were obtained with human vimentin: While the
      rod entered the nucleus, headless vimentin, unable to form IFs, remained
      restricted to the cytoplasm owing to its tail domain. In contrast, tailless human
      vimentin and tailless mouse desmin, which are fully assembly-competent in vitro,
      both formed extensive IF arrays in the cytoplasm but did not accumulate in the
      nucleus. We conclude that in class III IF proteins stepwise deletions in the
      tail, while not considerably altering IF assembly in vitro, can change the
      topogenesis of IF proteins and structures in the living cell.

PMID- 7774601
TI  - Actin filaments are involved in cellular graviperception of the basidiomycete
      Flammulina velutipes.
AB  - Inhibitor studies demonstrate a major role of the actin cytoskeleton in cellular
      graviperception of the basidiomycete Flammulina velutipes. Treatment of explanted
      fruiting body stipes with 10(-4) M of the actin filament-disrupting agent
      cytochalasin D causes specific suppression of gravitropic curvature to 21% of the
      control value. Elongation growth is depressed to 48%. In contrast, curvature and
      elongation remain almost unaffected by 10(-4) M of the microtubule inhibitor
      oryzalin. Immunohistochemical labeling of actin filaments in stipe hyphae of
      Flammulina reveals a close colocalization with the nuclei. The label pattern is
      destroyed upon 10(-4) M cytochalasin treatment. The role of the actin
      cytoskeleton in graviperception in Flammulina parallels aspects of gravisensing
      in Chara rhizoids and thus points at basic similarities between fungal and plant
      mechanisms of cellular gravity perception.

PMID- 7774602
TI  - Effects of cytochalasin D on shape and fluid pinocytosis in human neutrophils as
      related to cytoskeletal changes (actin, alpha-actinin and microtubules).
AB  - We report that cytochalasin D (CD) is not a reliable tool to inhibit all forms of
      cell motility and actin polymerization in neutrophil granulocytes. In addition to
      the well-established effects of CD such as altered localization of F-actin,
      inhibition of surface ruffling, fluid pinocytosis and actin polymerization in
      agonist-stimulated cells, we find that in human neutrophils CD can 1) induce
      another type of continuous shape changes (10(-6) M and 10(-5) M CD), 2) stimulate
      fluid pinocytosis (10(-5) M CD), 3) increase actin polymerization (10(-5) to 10(
      4) M CD) and alter the localization of F-actin and alpha-actinin (10(-6) to 10(
      4) M CD). At 10(-5) M CD F-actin and alpha-actinin are preferentially located in
      different areas of the cell. At 10(-4) M CD actin and alpha-actinin may
      colocalize at the membrane but not in cytoplasmic foci. Thus, stimulation of
      shape changes, pinocytosis, actin polymerization and differential reorganization
      of the cytoskeleton occur at CD concentrations which are widely used to inhibit
      cell motility. The results show that CD is not a reliable tool to inhibit all
      movements of cells and actin polymerization in general. Shape changes, but not
      fluid pinocytosis and the relative redistribution of F-actin and alpha-actinin
      induced by 10(-5) M cytochalasin D are suppressed by 10(-5) colchicine. This
      indicates that also microtubules can play a role in determining neutrophil shape
      and movements.

PMID- 7774603
TI  - The perinuclear centriole-containing centrosome is not the major microtubule
      organizing center in Sertoli cells.
AB  - Microtubules are abundant in Sertoli cells and are predominantly arranged
      parallel to the long axis of the cell. In addition, the centrioles occur in a
      perinuclear position in the basal one third of the cell. In this study we
      investigate the importance of the perinuclear centriole-containing centrosome as
      a microtubule organizing center (MTOC) in Sertoli cells. In all experiments, rat
      testes were perfusion fixed and then processed for electron and/or fluorescence
      microscopy. For fluorescence microscopy, fragments or dissected pieces of
      seminiferous epithelium were labeled for tubulin and actin. The three-dimensional
      pattern of microtubules in Sertoli cells was determined using data collected with
      a confocal microscope and analyzed using the NIH-Image program (written by Wayne
      Rasband at the NIH). The detailed arrangement of microtubules around, and the
      number of microtubule ends associated with, the centrosome were determined from
      composite projections constructed from serial thin sections. The nucleating
      potential of the perinuclear centrosome was determined by perfusing testes for 6
      h with 10 micrograms/ml nocodazole and then for up to 3 h with control buffer
      prior to fixation and analysis with confocal and standard fluorescence
      microscopy. Microtubules are not organized around a focal perinuclear site and
      few microtubule ends are associated with the centrosome. Moreover, in cells
      recovering from nocodazole treatment, microtubules first appear in apical
      (peripheral) processes. Our data indicate that the centriole-containing
      perinuclear centrosome is not a significant MTOC in Sertoli cells. Rather,
      microtubules are nucleated in peripheral regions and project basally. Based on
      the observations that microtubules appear to "cuff" the nucleus, intermediate
      filaments are concentrated around the nucleus, microtubules project into the
      perinuclear intermediate filament network, and microtubules and intermediate
      filaments are often coaligned, we suggest that microtubules are anchored into
      position at the base of the cell via linkages with the intermediate filament
      network. Our nucleation-anchorage model of microtubule organization in Sertoli
      cells may be applicable to other epithelial systems.

PMID- 7774605
TI  - Characterization of the binding of calmodulin to non-erythroid spectrin.
AB  - Both brain and erythrocyte spectrin bound calmodulin in a calcium-dependent
      manner when immobilized on a polyvinylidene difluoride (PVDF) membrane, though
      the affinity of the non-erythroid spectrin was much greater than that of the
      erythroid isoform. The interaction was characterized further using equilibrium
      partition. In the presence of calcium, the partition behavior of calmodulin was
      affected by both spectrins, though brain spectrin caused a much larger change in
      partition. However, in both cases it was evident that the observed partition
      behavior of calmodulin was due to complex formation with spectrin. Analysis of
      the equilibrium partition data indicated the presence of a high-affinity site
      characterized by a dissociation constant of about 0.3 microM and probably one or
      more much weaker sites (> 0.3 mM). The presence of at least two distinct binding
      sites was substantiated by the observation that truncated recombinant spectrin
      fusion proteins comprising either the middle part or the C-terminal of non
      erythroid alpha-spectrin bound calmodulin.

PMID- 7774604
TI  - Cell adhesion to the apical pole of epithelium: a function of cell polarity.
AB  - Human uterine epithelium displays a distinct polarized organization with apical,
      lateral, and basal plasma membrane domains. Although non-adhesive throughout most
      of the menstrual cycle, epithelial cells allow attachment of trophoblast cells to
      their apical pole during embryo implantation. A recent hypothesis postulates that
      epithelial cells turn off genes for apical-basal polarity and turn on genes for a
      more mesenchyme-like phenotype allowing cell-cell interaction with trophoblast.
      Using an in vitro assay human uterine cell lines (RL95-2, HEC-1-A, AN3-CA) were
      selected on the basis of adhesiveness for trophoblast-type cells (JAR).
      Subsequently, uterine cells were examined for epithelium-specific ultrastructure
      using transmission electron microscopy, and for the expression of E-cadherin,
      alpha 6-, beta 1-, beta 4-integrin subunits and cytokeratin using
      immunocytochemistry, confocal laser scanning microscopy, and surface replication
      technique. HEC-1-A monolayers are non-adhesive for JAR cells and appear highly
      polarized expressing E-cadherin, alpha 6-, beta 1-, beta 4-integrin subunits, and
      cytokeratin. Both, integrins and E-cadherin, are present at the lateral membrane.
      RL95-2 monolayers which are adhesive for JAR cells appear non-polarized. Like HEC
      1-A cells, RL95-2 cells express E-cadherin, alpha 6-, beta 1-, and beta 4
      integrin subunits, and cytokeratin. In contrast to HEC-1-A cells, integrins and E
      cadherin are distributed at the entire cell surface. AN3-CA monolayers are non
      adhesive for JAR cells and appear non-polarized. Cells lack epithelial-specific
      markers such as keratin and E-cadherin. They show only low expression of alpha 6
      , beta 1-integrin subunits and lack beta 4-integrin subunit. Conversely, they
      express vimentin. Thus, modulation of the epithelial phenotype of uterine cells,
      i.e. loss of apical-basal polarity, might prepare the apical cell pole for cell
      cell interaction with trophoblast. However, loss of cell polarity would not lead
      to enhancement of adhesiveness for trophoblast if accompanied by a loss of
      epithelium-specific adhesion molecules.

PMID- 7774606
TI  - Purification, partial characterization and immunolocalization of a
      proteophosphoglycan secreted by Leishmania mexicana amastigotes.
AB  - The intracellular amastigote form of the parasitic protozoon Leishmania mexicana
      expresses a high-molecular weight phosphoglycan, which is antigenically related
      to the surface glycolipid lipophosphoglycan and the secreted enzyme acid
      phosphatase of Leishmania promastigotes. This antigen was purified from a cell
      free homogenate of infected mouse tissue and from amastigotes. Compositional and
      immunological analysis of the purified components indicate a proteophosphoglycan
      structure consisting of serine-rich polypeptide chains and mild acid-labile
      phosphooligosaccharides capped by mannooligosaccharides. Immunofluorescence and
      immunoelectron microscopy of parasitized mouse peritoneal macrophages and
      infected mouse tissue suggest that the proteophosphoglycan is secreted in large
      amounts by amastigotes via their flagellar pockets into the parasitophorous
      vacuoles of host cells. In some infected macrophages proteophosphoglycan is also
      located in vesicles apparently originating from the parasitophorous vacuole,
      which demonstrates redistribution of a secreted amastigote antigen in parasitized
      host cells.

PMID- 7774607
TI  - Thyroid radioiodide transport: models, rate-limiting steps, and relation to
      formation of iodoprotein.

PMID- 7774608
TI  - Endocytosis of decorin by bovine aortic endothelial cells. off.
AB  - The small dermatan sulfate proteoglycan decorin is efficiently internalized by a
      variety of cells of mesenchymal origin. Decorin-binding receptor proteins of 51
      and 26 kDa are involved in this process. Uptake is modulated by highly sulfated
      heparan sulfate which interacts with the receptor proteins, too. Compared with
      cultured skin fibroblasts, bovine aortic endothelial cells have a lower capacity
      for decorin endocytosis whereas their apparent concentration of receptor proteins
      is even higher. The low internalization rate is attributed to the greater
      occupancy of receptor proteins by heparan sulfate of the plasma membrane and/or
      the extracellular matrix. Growth of endothelial cells on Falcon 3090 tissue
      culture inserts made possible to study decorin uptake from the apical and
      basolateral membrane, respectively. Decorin uptake was at the limit of detection
      when the proteoglycan was added to the basolateral compartment. Uptake via the
      apical membrane was at least as efficient as in monolayer cultures on plastic.
      The basolateral membrane, however, was enriched in receptor proteins, but also in
      heparan sulfate proteoglycans. It is, therefore, suggested that endothelial cells
      are especially involved in the clearance of decorin which is present in blood
      plasma.

PMID- 7774609
TI  - The microtubule cytoskeleton in human phagocytic leukocytes is a highly dynamic
      structure.
AB  - The microtubule cytoskeleton of human leukocytes has been difficult to study, in
      part, due to the lack of a reliable protocol for the indirect immunofluorescence
      staining of microtubules in these cells. We report here the development of a
      simple and reliable immunocytochemical labeling protocol for the examination of
      microtubules in leukocytes including monocytes, neutrophils, and eosinophils. The
      dynamic properties of microtubules in both monocytes and neutrophils were
      examined by indirect immunofluorescence staining of cells following exposure to
      nocodazole. Nocodazole-induced depolymerization is extremely rapid in both cell
      types, as is the regrowth of microtubules following removal of the nocodazole.
      Rapid reorganization of the microtubule cytoskeleton was also observed in
      neutrophils undergoing chemotactic stimulation. Bundling of microtubules was
      observed in both monocytes and neutrophils isolated from patients undergoing
      taxol infusion chemotherapy. The taxol-induced bundles were transient in nature
      as they were absent from samples collected 48 h following the completion of the
      taxol infusion. These results demonstrate the unique dynamic properties of
      leukocyte microtubules and indicate that they can be altered in vivo. The
      development of this staining protocol should allow for the further analysis of
      leukocyte microtubules as related to the normal functional response of these
      cells and form the basis for correlating alterations in microtubule dynamics with
      the effects of taxol on leukocyte function.

PMID- 7774610
TI  - A radioimmunoassay to monitor synaptic activity in hippocampal neurons in vitro.
AB  - Exocytosis of synaptic vesicles (SV) results in the surface exposure of lumenal
      epitopes of SV proteins. We have recently described the use of antibodies
      directed against the lumenal N-terminus of synaptotagmin I (Sytlum-Abs) to
      morphologically monitor exo-endocytic recycling of SVs. We report here that a
      radioimmunoassay based on these antibodies can be used to quantify levels of
      synaptic activity in primary neuronal cultures. High density cultures of
      hippocampal neurons grown in the absence of glia were used for these studies. A
      significant cell surface pool of synaptotagmin I immunoreactivity was detectable
      by Sytlum-Abs at steady state. The increase in the amount of Sytlum-Abs which
      became cell bound during a 3 min incubation at 37 degrees C over the Ab bound to
      this cell surface pool, was substantially higher in depolarizing media containing
      extracellular Ca2+ than in Ca(2+)-free media. Incubation of the cultures with
      Sytlum-Abs for longer time periods indicated a sustained increase in the rate of
      SV exocytosis in depolarizing media which lasted for at least 1 h. This increase
      was completely abolished by pretreating the neurons with tetanus toxin and this
      block correlated with a disappearance of synaptobrevin immunoreactivity. This
      radioimmunoassay therefore offers a new way to monitor SV exocytosis of neuronal
      populations in vitro irrespective of the type of neurotransmitter secreted and of
      postsynaptic effects.

PMID- 7774611
TI  - Basolateral but not apical application of protease results in a rapid rise of
      transepithelial electrical resistance and formation of aberrant tight junction
      strands in MDCK cells.
AB  - In the presence of Ca2+, application of trypsin to the basolateral surface of
      confluent MDCK cell monolayers with formed tight junctions (TJ), induces the
      formation of basolaterally oriented aberrant TJ strands. Induction of aberrant TJ
      strands is accompanied by an increase in transepithelial electrical resistance
      (TER), up to 90%, which upon addition of trypsin inhibitor is maintained for up
      to 1 h. Thereafter TER returns slowly to baseline values. Under similar
      conditions, application of trypsin to the apical surface has little or no effect
      on either TER or the number of aberrant TJ strands. Confocal microscopy of
      monolayers, immunostained for ZO-1, revealed that this TJ associated cytoplasmic
      protein, extended below the TJ along the basolateral surface following brief
      exposure to trypsin. Removing Ca2+ after treatment of the monolayer with
      basolaterally applied trypsin resulted, after 20 min, in the increased
      partitioning of TJ particles onto the E fracture face, of both normal and
      aberrant TJ strands. Like the TJ strands themselves, therefore, aberrant strands
      may be linked to cytoskeletal elements. Aberrant TJ strands do not form when
      monolayers, maintained in low Ca2+ medium, are exposed to trypsin, suggesting
      that under these conditions TJ precursors, and/or trypsin-sensitive proteins
      regulating TJ strand assembly, are sequestered in a vesicular compartment that is
      inaccessible to exogenous trypsin. Prolonged exposure of the apical surface of an
      established, polarized epithelium with intact TJ to trypsin, had little effect on
      TJ integrity and did not induce aberrant strands.

PMID- 7774612
TI  - Carbohydrate-deficient glycoprotein syndrome (CDGS)--glycosylation, folding and
      intracellular transport of newly synthesized glycoproteins.
AB  - Carbohydrate-deficient glycoprotein syndrome (CDGS) is a hereditary glycosylation
      disorder of unknown origin. In this study we used skin fibroblasts from patients
      with CDGS to study the glycosylation of three well characterized glycoproteins
      using gel mobility analysis, endoglycosidase treatments and protein folding
      studies. We show that glycoprotein transport along the secretory pathway was
      delayed. Dilation of the rough endoplasmic reticulum indicated a retention
      phenomenon for selected glycoproteins. However, for all examined glycoproteins
      cotranslational glycosylation in CDGS fibroblasts was normal.

PMID- 7774614
TI  - Glucose levels and succinate and lactate dehydrogenase activity in EMT6/Ro tumor
      spheroids.
AB  - To evaluate the effects of glucose on the development of cell heterogeneity and
      the occurrence of necrotic areas in the center of tumor spheroids, a procedure
      (combining microdissection of small tissue samples from frozen-dried cryosections
      and microchemical analysis) was developed to measure glucose in distinct,
      concentrically arranged, microregions of tumor spheroids: the outermost area of
      proliferating cells, the area of nonproliferating cells and 2 central "necrotic"
      areas, with either abundant or little intercellular space. Since glucose levels,
      for analytical reasons, had to be expressed on a dry weight basis, and because of
      the morphological heterogeneity of the microregions of tumor spheroids, it was
      necessary to measure and take into account the regional differences in cell
      density (water content), in order to obtain adequate estimates of the glucose
      levels in the various microregions. At glucose concentrations of 5.5 and 3.6 mM
      in the culture medium, the glucose levels varied between 3.5 and 1.4 mmoles/kg
      wet weight and were lowest in those central areas where the cell density was
      lowest. Histochemical demonstration of the distribution of lactate and succinate
      dehydrogenase activity indicates a considerably higher capacity of tumor cells
      for anaerobic than for aerobic energy production.

PMID- 7774613
TI  - Yeast Nop3p has structural and functional similarities to mammalian pre-mRNA
      binding proteins.
AB  - Indirect immunofluorescence shows the yeast protein Nop3p/Np13p/Mts1p to be
      localized both in the nucleoplasm and the nucleolus. Here we show that Nop3p can
      be efficiently UV cross-linked in vivo to poly(A)+ RNA. In higher eukaryotes it
      would therefore be classed as a heterogeneous nuclear ribonucleoprotein (hnRNP)
      component. As judged by immunofluorescence and in situ hybridization, a
      temperature-sensitive allele of nop3 leads to the accumulation of poly(A)+ RNA in
      the nucleus at non-permissive temperature. The sequence of Nop3p shows homology
      to the larger members of the SR protein family of splicing factors, particularly
      in the RRMH domain. We have, however, detected no splicing defects in strains
      genetically depleted to Nop3p or carrying a temperature-sensitive allele.

PMID- 7774615
TI  - International Congress on Sudden Infant Death Syndrome: The Role of Environmental
      Factors in Infant Morbidity and Mortality. Graz, Austria, 24-27 May 1995.
      Abstracts.

PMID- 7774616
TI  - 29th Annual meeting of the European Society for Clinical Investigation and the
      Medical Research Society of Great Britain. Cambridge, England, 2-5 April 1995.
      Abstracts.

PMID- 7774618
TI  - T cells made deficient in interleukin-2 production by exposure to staphylococcal
      enterotoxin B in vivo are primed for interferon-gamma and interleukin-10
      secretion.
AB  - The superantigen staphylococcal enterotoxin B (SEB) induces a defect in
      interleukin (IL)-2 production by T cells expressing specific T cell receptor V
      beta domains. The present study was undertaken to determine the capacity of T
      cells, made deficient in IL-2 production by exposure to SEB in vivo, to secrete
      interferon (IFN)-gamma and IL-10 and to induce pathology upon SEB rechallenge.
      For this purpose, BALB/c mice received two intraperitoneal injections of 100
      micrograms SEB with a 48-h interval. First, we compared peak serum levels of IL
      2, IFN-gamma and IL-10 after SEB rechallenge with those measured after a single
      SEB injection in control mice. The expected defect in IL-2 production in SEB
      pretreated mice was associated with a major increase in IL-10 and IFN-gamma
      levels which were about fivefold higher than in controls. Experiments in mice
      depleted of CD4+ or CD8+ cells as well as studies in which purified T cell
      populations were rechallenged with SEB in vitro indicated that both CD4+ and CD8+
      cells from SEB-pretreated mice were primed for IL-10 and IFN-gamma production.
      Furthermore, SEB-pretreated mice were sensitized to the toxic effects of the
      superantigen as indicated by a 30-70% lethality rate (vs. 0% in naive mice)
      within 48 h after SEB rechallenge. IFN-gamma was involved in the lethal syndrome
      as it could be prevented by injection of neutralizing anti-IFN-gamma monoclonal
      antibody. We conclude that SEB-reactive T cells made deficient for the production
      of IL-2 by exposure to SEB in vivo are primed for IFN-gamma and IL-10 production,
      and that IFN-gamma up-regulation is involved in the shock syndrome occurring upon
      SEB rechallenge.

PMID- 7774617
TI  - RAG1 and RAG2 expression in human intestinal epithelium: evidence of extrathymic
      T cell differentiation.
AB  - We examined the hypothesis that the adult human gastrointestinal tract is a site
      of extrathymic T cell differentiation. When T lymphocytes undergo gene
      rearrangement, the products of both RAG1 and RAG2 genes are expressed; RAG mRNA
      is present only in tissue governing lymphocyte maturation. In this study, reverse
      transcription polymerase chain reaction (RT-PCR) was used to detect RAG1-and RAG2
      specific mRNA. Total RNA was purified from small intestinal samples from five
      adults. Peripheral blood mRNA from the same patient was used as a negative
      control in two cases. Bone marrow RNA preparations from two healthy donors were
      used as positive controls. cDNA synthesis was carried out using random hexamers.
      Primers for first round and nested PCR of RAG1 and RAG2 were synthesized. RAG1
      and RAG2 mRNA was detected in all bone marrow preparations but was absent in all
      peripheral blood samples. RAG1 and RAG2 mRNA was detected in the small intestine
      of four of the five patients studied. RAG1 and RAG2 expression was localized in
      the epithelial layer and absent in the lamina propria. RAG1 and RAG2 expression
      in the epithelial layer is strong evidence that T cell differentiation occurs in
      the adult human intestine.

PMID- 7774619
TI  - Expression of heat-stable antigen on tumor cells provides co-stimulation for
      tumor-specific T cell proliferation and cytotoxicity in mice.
AB  - Heat-stable antigen (HSA/J11d/possibly homologous to CD24), a cell adhesion
      molecule capable of providing a co-stimulatory signal for T cell proliferation,
      is expressed on B cells, activated T cells, monocytes, granulocytes, Langerhans
      cells and thymocytes. Recent studies have demonstrated that co-stimulatory
      signals provided by cell adhesion molecules such as B7-1 play an essential role
      in generation of an anti-tumor immune response. To examine whether the co
      stimulatory signal provided by HSA can induce an anti-tumor immune response, we
      have transfected HSA cDNA into the murine melanoma cell line K1735M2, and
      examined the ability of this transfected cell line to induce tumor-specific T
      cell responses. The results demonstrate that spleen cells from mice immunized
      with HSA-transfected K1735M2 cells showed enhanced T cell proliferation in a
      mixed lymphocyte tumor reaction (MLTR) assay and also demonstrated a significant
      anti-tumor cytotoxicity to the parent tumor cell (K1735M2). This anti-tumor
      cytolytic activity could be abrogated by pretreatment of effector cells with anti
      mouse CD8 monoclonal antibody and complement. Under similar conditions, spleen
      cells from C3H mice immunized with vector-transfected K1735M2 cells neither
      actively proliferate in an MLTR assay, nor did they exert significant cytolytic
      activity against the respective tumor cells. In summary, our study demonstrated
      that HSA can provide a co-stimulatory signal for the T cell immune response
      against tumor cells in a murine model.

PMID- 7774620
TI  - Evidence for the stochastic acquisition of cytokine profile by CD4+ T cells
      activated in a T helper type 2-like response in vivo.
AB  - The diversity of cytokine production patterns displayed by T cells activated in
      vivo was investigated by analyzing short-term antigen-specific CD4+ T cell clones
      and single CD4+ T cells derived from draining lymph nodes of mice undergoing a T
      helper 2 (Th2)-like response to keyhole limpet hemocyanin (KLH). On average, 2.7%
      of CD4+ lymph node cells gave rise to clones in the presence of the immunizing
      antigen and, of these, about 90% secreted interleukin-4 (IL-4) and 20% secreted
      interferon-gamma (IFN-gamma) when restimulated after 2 weeks in vitro. Almost all
      IFN-gamma-producing clones co-produced IL-4. The definition of clones as positive
      or negative for cytokine synthesis depended on assay sensitivity, however, since
      their titers were distributed continuously from the threshold of detection over
      at least a 1000-fold range. Reverse-transcription polymerase chain reaction
      analysis of 59 clones revealed multiple patterns of co-expression of IL-2, IL-3,
      IL-4, IL-6, IFN-gamma and granulocyte-macrophage colony-stimulating factor (GM
      CSF) mRNA. Although most clones contained detectable IL-4 and IL-6 mRNA and a
      minority contained IFN-gamma mRNA, only 1 clone expressed the canonical Th2
      cytokine profile. The observed frequencies of mRNA co-expression for most of the
      six cytokines (including IL-4 with IFN-gamma), and the frequency of co-secretion
      of IL-4 and IFN-gamma, were not significantly different from those predicted for
      random association. Independent regulation of IL-4 and IFN-gamma mRNA expression
      was confirmed at the single-cell level in a polyclonal population of KLH-primed
      CD4+ cells, among which co-expression of these cytokines again occurred at the
      frequency predicted for a random event. The data suggest that the polarization of
      this immune response towards a Th2 cytokine profile is achieved by altering the
      probabilities of expression of the IL-4, IFN-gamma and other cytokine genes at
      the population level, rather than by selective expansion of a distinct T cell
      subset.

PMID- 7774621
TI  - Biphasic effect of interferon-gamma in murine collagen-induced arthritis.
AB  - Interferon-gamma (IFN-gamma) exerts both enhancing and suppressing influences on
      collagen-induced arthritis (CIA), depending on the route and protocol of
      administration. To study the role of IFN-gamma on the autoimmune process of CIA,
      we treated DBA/1 mice with two different rat monoclonal antibodies (mAb) to
      murine IFN-gamma. Treatments, given twice weekly for 4 weeks, consisted of
      intraperitoneal injections of either mAb. In early treatments, starting from the
      day of immunization with type II collagen (CII), the severity of arthritis was
      reduced in both groups of anti-IFN-gamma-treated mice compared with control
      groups. Moreover, anti-CII antibody levels decreased in the sera of these mice.
      CIA was also down-regulated in mice treated from days 14 or 28 post immunization.
      In contrast, late treatments with anti-IFN-gamma mAb either induced aggravating
      effects, or did not affect the course of the disease. On the other hand,
      administration of high doses (8 x 10(4) U three times/week) of rat recombinant
      IFN-gamma exerted a transient increase of CIA severity. These findings suggest
      that IFN-gamma may play a critical role during both the induction and the course
      of CIA, first enhancing the immune response, and then regulating the arthritis
      process.

PMID- 7774623
TI  - Interaction of B and T lymphocyte subsets with high endothelial venules in the
      rat: binding in vitro does not reflect homing in vivo.
AB  - Lymphocytes continuously migrate through the body, and their efficient
      extravasation from the blood via high endothelial venules (HEV) is essential for
      initiating an appropriate immune response. Most investigations have focused on
      the lymphocyte/HEV interaction in vitro. However, to what extent such systems
      reflect the situation in vivo is not known. It is also unclear whether lymphocyte
      subsets immigrate into the HEV in proportion to their presence in the blood, and
      whether import capacity is limited by the HEV. When rat mesenteric lymph node
      lymphocytes were incubated in vitro on cryostat sections, the well-known
      preferential binding of B lymphocytes to HEV of Peyer's patches (PP) and T cells
      to HEV of axillary lymph nodes (axLN) was observed (axLN vs. PP: B lymphocytes
      21.2 +/- 5.0% vs. 40.6 +/- 11.0%, T lymphocytes 84.6 +/- 6.3% vs. 56.5 +/-
      12.9%). However, when labeled mesenteric lymph node lymphocytes were injected and
      their location within the HEV was analyzed 15 min later, no preferential
      interaction was seen. After injection of labeled thoracic duct lymphocytes, the
      percentage of labeled cells among B and T lymphocytes in the blood was
      significantly different (4.4 +/- 0.9% vs. 8.9 +/- 3.6%), whereas that in HEV of
      axLN (19.0 +/- 6.4% vs. 16.6 +/- 6.0%) and PP (30.6 +/- 6.1% vs. 33.9 +/- 4.4%)
      was comparable. Although the number of injected lymphocytes was similar in
      magnitude to the total blood lymphocyte pool, after injection there was no
      increase in lymphocyte numbers in the HEV. Thus, the adhesion assay in vitro does
      not completely reflect immigration into HEV in vivo. In addition, our data
      suggest that both the availability of lymphocyte subsets in small venules and the
      immigration rate into HEV are actively regulated in vivo.

PMID- 7774622
TI  - Depletion of CD8+ T cells suppresses the development of experimental autoimmune
      myasthenia gravis in Lewis rats.
AB  - To understand the role of CD8+ T cells in experimental autoimmune myasthenia
      gravis (EAMG), CD8+ T cells were depleted by injecting a monoclonal anti-rat CD8
      antibody (OX8) into Lewis rats immunized with Torpedo acetylcholine receptor
      (AChR) in complete Freund's adjuvant (CFA). CD8-depleted EAMG rats showed
      strikingly less muscle weakness and lower anti-AChR IgG antibody levels compared
      to Hy2-15-injected control EAMG rats. Moreover, the numbers of AChR-specific IgG
      antibody-secreting cells, AChR-reactive interferon-gamma-secreting T helper type
      1-like cells and lymphocyte proliferation to AChR were lower in the CD8-depleted
      group than in control EAMG rats. These differences were significant among
      mononuclear cells from inguinal and popliteal lymph nodes, mesenteric lymph nodes
      and spleen, but not from thymus when examined 3, 5 and 7 weeks post-immunization.
      We suggest that CD8+ T cells are involved in the induction and persistance of
      EAMG by directly or indirectly affecting AChR-reactive T cells and anti-AChR IgG
      antibody-secreting cells.

PMID- 7774625
TI  - Substitutions at the Glu62 residue of human interleukin-2 differentially affect
      its binding to the alpha chain and the beta gamma complex of the interleukin-2
      receptor.
AB  - Human interleukin-2 (IL-2) alpha helix B is more conserved than the whole
      molecule, but has been less studied than other alpha helices of IL-2. Using site
      directed mutagenesis, several IL-2 mutants in this helix were obtained. We found
      that the IL-2 mutant containing Leu at position 62 (Leu62-IL-2) loses its ability
      to bind IL-2 receptor subunit alpha (IL-2R alpha), but retains binding affinity
      to IL-2R subunit beta gamma as well as some bioactivity; nevertheless, another
      substitution at the same residue, Arg62IL-2, loses its binding ability to both IL
      2R alpha and IL-2R beta gamma, and can no longer stimulate IL-2-dependent cell
      growth, showing that Glu62 not only takes part in IL-2R alpha binding, but can
      also affect IL-2 binding to IL-2R beta gamma. In this regard, Glu62 may be a key
      site in the IL-2/IL-2R alpha interaction, and can facilitate IL-2R ternary
      complex formation, leading to IL-2R alpha-mediated, IL-2-stimulated signal
      transduction.

PMID- 7774624
TI  - Generation of antigen-specific CD4+ T cell lines from naive precursors.
AB  - The conditions required for sensitizing naive T cells to nominal antigen are
      poorly understood. In this report we describe an in vitro system for generating
      antigen-specific CD4+ T cells from previously unprimed individuals. Freshly
      isolated CD4+ T cells were cultured with keyhole limpet hemocyanin (KLH), sperm
      whale myoglobin (SWM), or human immunodeficiency virus (HIV) gp160, antigens to
      which most persons have not been sensitized, in the presence of either dendritic
      cells (DC) or macrophages (M phi). In short-term (< 8 days) cultures, CD4+ T
      cells or their CD4+, CD45RA (naive) subpopulation mounted significant
      proliferative responses to KLH, SWM, and HIV gp160, but only if the antigens were
      presented by DC. In contrast, CD4+, CD45RO (memory) T cells responded poorly to
      these antigens, although they responded vigorously to tetanus toxoid, a recall
      antigen, presented by either DC or M phi. KLH- and SWM-specific CD4+ T cell lines
      were established from the starting population that had been sensitized in vitro,
      following repeated stimulation with antigen and M phi in medium supplemented with
      interleukin-2 and interleukin-4. Despite the continued presence of these
      cytokines during T cell expansion, the expanded lines retained their ability to
      respond to the priming antigen in the absence of exogenous cytokines. When the
      CD45RA and CD45RO subpopulations were sensitized and expanded separately, the
      CD45RA cells alone gave rise to antigen-specific T cell lines, while the CD45RO
      cells proliferated nonspecifically. These results demonstrate that human naive
      CD4+ T cells can be sensitized in vitro to nominal antigens presented by DC and
      that the sensitized cells can be expanded into long-term lines that retain their
      antigen specificity.

PMID- 7774626
TI  - Homotypic aggregation of murine B lymphocytes is independent of CD23.
AB  - CD23 is a low-affinity receptor for IgE (Fc epsilon RII). Functions attributed to
      CD23 not involving IgE suggest that it interacts with ligands other than IgE.
      CD21 has recently been described as a counter ligand for CD23. A number of lines
      of evidence have implicated CD23 as an adhesion molecule in human B cells. We
      have investigated the role of CD23 in homotypic B cell aggregation in the mouse,
      using lipopolysaccharide plus interleukin-4-induced aggregation as a model
      system. In this system high levels of aggregation are accompanied by a massive up
      regulation of CD23 expression. However, in contrast to what has been observed in
      human B cells, we find no evidence of a role for CD23 in homotypic adhesion of
      murine B cells.

PMID- 7774627
TI  - Alloreactive natural killer cells in the rat: complex genetics of major
      histocompatibility complex control.
AB  - A major role for the nonclassical major histocompatibility complex (MHC) class I
      region, i.e. RT1.C, in controlling rat natural killer (NK) cell alloreactivity
      has recently been established, and several findings suggested the existence of NK
      triggering alloantigens coded for by this region. Here, we have extended our
      studies on the MHC control of NK cell cytotoxicity against concanavalin A
      activated T cell blasts by comparing semi-syngeneic and fully allogeneic
      combinations, and we show the following: (a) The self MHC exerted a strong
      influence on the NK allorecognition repertoire. (b) When anti-F1 hybrid cytolytic
      activities of parental strain NK cells were measured, both recessively and non
      recessively inherited susceptibility patterns emerged. (c) In most combinations
      parental strain cells were lysed by F1 hybrid NK cells, thus resembling the
      hybrid resistance phenomenon described in mice. The cytotoxicity was lower in
      strain combinations where NK susceptibility was inherited non-recessively, i.e.
      when parent anti-F1 reactivity was detected, than in recessive combinations. (d)
      LEW.1LM1 (RT1lm1) target cells, with a deletion in the RT1.C region that includes
      expressed class I genes, were more sensitive to lysis by MHC matched NK cells
      (PVG.1L(LEW), RT1l) than were parental LEW (RT1l) cells. The effect of the
      deletion was the opposite when MHC allogeneic (RT1c, RT1u) as well as semi
      syngeneic (RT1l/c) NK cells were employed, i.e. sensitivity was decreased. We
      conclude that certain MHC-encoded antigens, depending on the haplotype
      combination of effector and target cells, may either trigger or inhibit rat NK
      cell cytotoxicity. Furthermore, the potential role of peptides bound to MHC class
      I molecules recognized by NK cells is discussed.

PMID- 7774628
TI  - Regulation of T cell receptor (TCR)-beta locus allelic exclusion and initiation
      of TCR-alpha locus rearrangement in immature thymocytes by signaling through the
      CD3 complex.
AB  - During thymocyte differentiation, the T cell receptor (TCR)-beta genes are
      rearranged before the TCR-alpha genes. Immature CD4-8- double-negative thymocytes
      with a productive rearrangement of the TCR-beta locus are selected to continue
      maturation to the CD4+8+ double-positive stage, driven by signals through the pre
      TCR. The signals through the pre-TCR can be synchronized by injection of mice
      with anti-CD3 epsilon monoclonal antibody. Using this approach, we demonstrated
      coordinated induction of a triad of responses in immature thymocytes: arrest of V
      to DJ rearrangement in the TCR-beta locus, transient down-regulation of
      rearrangement-activating gene (RAG)-1 and RAG-2 transcripts, and initiation of
      germ-line transcription of the TCR-alpha locus. These results suggest that the
      transition from TCR-beta to TCR-alpha locus rearrangement is controlled by signal
      transduction through the pre-TCR.

PMID- 7774629
TI  - Soluble mouse major histocompatibility complex class II molecules produced in
      Drosophila cells.
AB  - We have exploited Drosophila melanogaster Schneider cells and compatible
      inducible expression vectors to produce large amounts of secreted major
      histocompatibility complex (MHC) class II molecules (I-Ed). A simple two-step
      purification protocol was developed. In the first step, recombinant molecules
      were enriched using a monoclonal anti-class II antibody column followed by a
      nickel chelate column which further purified and concentrated the recombinant
      protein to several mg/ml. Characterization of the purified material indicates
      that the molecules are correctly assembled into alpha beta heterodimers. Further
      analysis shows that the recombinant MHC class II molecules are devoid of
      endogenous peptides and, therefore, homogeneous peptide/MHC complexes could be
      prepared by adding exogenous I-Ed-specific peptides at slightly acidic pH. Upon
      peptide addition, molecules underwent a conformational change into a more compact
      form revealed by gel filtration analysis. In addition, the peptide/MHC complexes
      were biologically active. As little as 10 ng of these complexes coated on plastic
      from a 100 ng/ml solution were sufficient to trigger antigen-specific T cell
      hybridomas. These MHC class II molecules, together with various forms of soluble
      T cell receptor (TcR) proteins, provide valuable tools to analyze the molecular
      details of TcR/antigen recognition.

PMID- 7774630
TI  - Selective induction of interleukin-1 receptor antagonist and interleukin-8 in
      human monocytes by normal polyspecific IgG (intravenous immunoglobulin).
AB  - We have investigated the effects of intravenous immunoglobulin (IVIg), a
      therapeutic preparation of normal human polyspecific IgG, on the synthesis and
      release of cytokines by peripheral blood monocytes. IVIg was found to selectively
      induce gene transcription and secretion of interleukin-1 receptor antagonist (IL
      1ra) and IL-8 in cultures of normal human monocytes. The addition of IVIg to
      cultures of purified monocytes induced a dose-dependent secretion of IL-1ra and
      IL-8 without stimulating the production of IL-1 alpha, IL-1 beta, tumor necrosis
      factor-alpha or IL-6. The effects of IVIg required both the Fc and F(ab')2
      portions of IgG. IVIg-induced production of IL-8 by monocytes was enhanced by
      lipopolysaccharide (LPS), although LPS inhibited the secretion of IL-1ra,
      suggesting that IVIg and LPS stimulate distinct intracellular pathways in
      monocytes. Induction of IL-1ra and IL-8 by IVIg was enhanced in the presence of
      autologous T lymphocytes. Our observations document the selectivity of the
      effects of IVIg on the synthesis of cytokines and cytokine antagonists by human
      monocytes. Induction of IL-1ra and IL-8 by IVIg may contribute to the anti
      inflammatory effects of immunoglobulin therapy in patients with autoimmune and
      systemic inflammatory disorders.

PMID- 7774631
TI  - Inhibition of natural killer cell-mediated bone marrow graft rejection by
      allogeneic major histocompatibility complex class I, but not class II molecules.
AB  - The role of major histocompatibility complex (MHC) class I and class II molecules
      in natural killer (NK) cell-mediated rejection of allogeneic, semisyngeneic and
      MHC-matched bone marrow grafts was investigated. The use of beta 2-microglobulin
      (beta 2m) -/- and beta 2m +/- mice as bone marrow donors to MHC-mismatched
      recipients allowed an analysis of whether the presence of semi-syngeneic and
      allogeneic MHC class I gene products would be triggering, protective or neutral,
      in relation to NK cell-mediated rejection. Loss of beta 2m did not allow H-2b
      bone marrow cells to escape from NK cell-mediated rejection in allogeneic
      (BALB/c) or semi-allogeneic (H-2Dd transgenic C57BL/6) mice. On the contrary, it
      led to stronger rejection, as reflected by the inability of a larger bone marrow
      cell inoculum to overcome rejection by the H-2-mismatched recipients. In H-2
      matched recipients, loss of beta 2m in the graft led to a switch from engraftment
      to rejection. At the recipient level, loss of beta 2m led to loss of the
      capability to reject H-2-matched beta 2m-deficient as well as allogeneic grafts.
      When MHC class II-deficient mice were used as donors, the response was the same
      as that against donors of normal MHC phenotype: allogeneic and semi-syngeneic
      grafts were rejected by NK cells, while syngeneic grafts were accepted. These
      data suggest a model in which allogeneic class I molecules on the target cell
      offer partial protection, while certain syngeneic class I molecules give full
      protection from NK cell-mediated rejection of bone marrow cells. There was no
      evidence for a role of MHC class II molecules in this system.

PMID- 7774632
TI  - Orally induced bystander suppression in experimental autoimmune uveoretinitis
      occurs only in the periphery and not in the eye.
AB  - Oral administration of retinal soluble antigen (S-Ag) suppresses the induction of
      S-Ag-mediated experimental autoimmune uveitis (EAU) in Lewis rats. EAU induced
      with interphotoreceptor retinoid-binding protein (IRBP), another retinal
      autoantigen, can also be suppressed by oral administration of IRBP. It has been
      speculated that feeding with one retinal autoantigen could suppress induction of
      uveitis with the other retinal protein by means of bystander suppression. Both
      uveitogenic effector and suppressor cells should find their antigens within the
      retina, where the suppressor cells would be expected to act on the effector
      cells. However, reciprocal combinations of antigens used for induction and
      suppression of uveitis failed to prevent onset of disease, demonstrating that
      bystander suppression obviously does not occur in the eye. To investigate further
      the localization of suppressor mechanisms, we fed Lewis rats either with retinal
      S-Ag or with ovalbumin (OVA) and then immunized the animals either with a mixture
      of S-Ag and OVA or with each antigen separately, injected into contralateral hind
      legs. Feeding of S-Ag prior to immunization led to suppression of uveitis,
      whereas feeding of OVA had no tolerizing effect when S-Ag and OVA were injected
      into different legs. Nevertheless, immunizing rats with a mixture of S-Ag and OVA
      after OVA feeding suppressed uveitis to a high degree. These findings suggest
      that orally induced bystander suppression might not occur in the target organ,
      but rather peripherally at the site of induction of the autoimmune T cells.

PMID- 7774633
TI  - Toxoplasma gondii-specific CD4+ T cell clones from healthy, latently infected
      humans display a Th0 profile of cytokine secretion.
AB  - Human Toxoplasma gondii (Tg)-specific T cell clones were raised by infecting
      peripheral blood mononuclear cells (MNC) from two healthy, latently infected
      individuals with Tg trophozoites. All of the clones had a CD4+ immunophenotype
      and produced simultaneously interleukin (IL)-2, interferon (IFN)-gamma, IL-4 and
      IL-5 upon mitogen or antigen stimulation. Tg-specific T cell clones were
      classified as T helper of type 0 (Th0) since most of them released roughly
      comparable amounts of IFN-gamma and IL-4. In some clones, a trend to an increased
      production of IFN-gamma following antigen-specific as compared to non-specific
      stimulation was observed. The Th0 phenotype was also expressed by T cell clones
      that had been raised from bulk cultures performed in the presence of IL-4 or IFN
      gamma. All of the Tg-specific T cell clones were cytolytic in a non-specific
      assay which involves the triggering of the CD3-T cell receptor (TcR) complex.
      Some clones specifically lysed an autologous lymphoblastoid cell line (LCL) that
      had been infected with Tg trophozoites. Finally, most of the Tg-specific T cell
      clones produced IL-10, irrespective of whether they had been raised from bulk
      cultures incubated in the presence or absence of IL-4 or IFN-gamma. Taken
      together, these findings suggest that Tg-specific Th0 helper cell clones from
      healthy, latently infected individuals, beside activating toxoplasmacidal
      mechanisms through IFN-gamma release, might limit the magnitude of the immune
      response of the parasite by killing Tg-infected antigen-presenting cells and by
      releasing IL-10.

PMID- 7774634
TI  - T lymphocyte development in p56lck deficient mice: allelic exclusion of the TcR
      beta locus is incomplete but thymocyte development is not restored by TcR beta or
      TcR alpha beta transgenes.
AB  - The protein tyrosine kinase, p56lck, is involved in signal transduction in mature
      T cells and in the molecular events controlling early thymocyte differentiation.
      Thymuses of mice deficient for p56lck expression (p56lck-/-) consist of immature
      CD4-CD8- double-negative (DN) and CD4+CD8+ double-positive (DP) thymocytes and
      are severely reduced in total cell number. In this report we have studied DN
      thymocytes from p56lck-/- mice and found an increase in the proportion of the
      CD44-CD25+ subset, suggesting that transit through this stage, which is known to
      require T cell receptor (TcR) beta expression, may be delayed in the absence of
      p56lck expression. In addition, the expression of a transgenic TcR beta chain or
      TcR alpha beta pair did not restore thymic development in p56lck-/- mice.
      However, in contrast to mice expressing a dominant negative isoform of p56lck in
      which DP thymocytes do not develop, DP thymocytes still develop in nontransgenic
      and TcR transgenic p56lck-/- mice. These results demonstrate that expansion of
      the DP subset is impaired in p56lck-/- mice. In contrast, allelic exclusion is
      not severely compromised. Although there was an increase in the number of
      peripheral T cells expressing more than one V beta chain in TcR transgenic p56lck
      /- mice, we found that inhibition of endogenous TcR beta gene rearrangement was
      almost complete in thymocytes of V beta transgenic p56lck-/- mice and we could
      not detect any peripheral T cells that expressed more than one V beta chain in
      non-transgenic p56lck-/- mice.

PMID- 7774635
TI  - Down-regulation of class II major histocompatibility complex molecules on antigen
      presenting cells after interaction with helper T cells.
AB  - The recognition of antigenic peptides by CD4+ helper T cells is demonstrated here
      to result in a dramatic (up to 90%) decrease in expression of major
      histocompatibility complex (MHC) class II molecules on the surface of antigen
      presenting cells (APC). The reduction is selective to the class II isotype
      presenting the antigen, but if affects both allelic forms of the same isotype in
      heterozygous APC. The observed MHC down-regulation requires a specific T cell
      receptor-peptide-class II interaction, a direct contact between T cell and APC,
      and the involvement of CD2 molecules. These findings have important implications
      for the regulation of immune response, self tolerance, and autoimmunity.

PMID- 7774636
TI  - An interleukin-6 transgene expressed in B lymphocyte lineage cells overcomes the
      T cell-dependent establishment of normal levels of switched immunoglobulin
      isotypes.
AB  - Long-term proliferating, stromal cell/interleukin (IL)-7-reactive precursor B
      cell lines established from fetal liver and bone marrow of human IL-6-transgenic
      B6Ld46 mice produce and secrete human IL-6. When transplanted into severe
      combined immunodeficient (SCID) or Rag2 knockout (Rag2-T) mice, these pre-B-cell
      lines establish a part of the B cell compartment but yield no T cells, as do pre
      B cell lines from genetically matched non-transgenic mice. Within 2 to 3 months
      after transplantation, the serum of mice transplanted with pre-B cells from
      normal mice contains normal levels of IgM (200-600 micrograms/ml) but 10-100-fold
      lower levels of the IgG subclasses and of IgA. In contrast, the sera of mice
      transplanted with IL-6 transgenic pre-B cells contain not only IgM, but also IgG
      and IgA at nearly normal levels. The results indicate that at least a part of the
      plasmacytosis and elevated IgG production observed previously in the IL-6
      transgenic mice appears to be due to a T cell-independent activation of IgG and
      IgA production by the IL-6-secreting pre-B cells and their differentiated progeny
      in the immunodeficient hosts.

PMID- 7774637
TI  - Signaling through murine CD38 is impaired in antigen receptor-unresponsive B
      cells.
AB  - CD38 is a 42-kDa membrane associated enzyme which converts NAD into cyclic ADP
      ribose (cADPR), a Ca(2+)-mobilizing second messenger, and ADP-ribose (ADPR).
      Agonistic antibodies to murine CD38 deliver a potent growth co-stimulus to mature
      splenic B lymphocytes. In this report we demonstrate a striking relationship
      between CD38-mediated mitogenesis and the ability of surface IgM to promote B
      cell proliferation. Tolerized B lymphocytes obtained from a double-transgenic
      mouse model of B cell tolerance do not proliferate in response to antigen
      stimulation through the Ig receptor or to agonistic anti-CD38 antibodies.
      Similarly, B-1 cells isolated from the peritoneal cavity of normal mice, and
      splenic B cells isolated from newborn mice were also unresponsive to both anti
      IgM and anti-CD38 stimulation. All of these CD38-unresponsive B cells expressed
      normal levels of cell surface CD38 and responded to numerous other stimuli. CD38
      immunoprecipitated from these B cell populations was normal in size and
      effectively hydrolyzed NAD, suggesting that the defect in CD38 signaling likely
      occurs downstream of CD38 itself. Signaling through CD38 and IgM does not always
      have identical effects on B cells since anti-CD38 cannot deliver inhibitory
      growth or differentiation signals to normal B cells or immature B cell lines.
      Nevertheless, the correlative data with these multiple B cell models of
      unresponsiveness suggests that the signaling pathway utilized by CD38 and IgM
      intersect, possibly sharing at least one of the crucial components of the Ig
      receptor signaling cascade.

PMID- 7774638
TI  - Increased dexamethasone sensitivity of neonatal leukocytes: different mechanisms
      of glucocorticoid inhibition of T cell proliferation in adult and neonatal cells.
AB  - Glucocorticoids (GC) are known to inhibit the proliferative response of
      leukocytes after mitogenic activation. Until now, the effects of GC on the immune
      system have been studied predominantly in adults. However, GC are frequently
      administered to human fetuses and newborns for the prevention and treatment of
      respiratory distress syndrome. The immune system of human newborns is still a
      functionally immature system. Therefore, we wondered whether the immaturity is
      also reflected by altered responses to hormonal signals such as glucocorticoids.
      We studied the effects of the GC dexamethasone (DEX) on the proliferation of
      peripheral blood mononuclear cells and T cells in vitro after stimulation with
      phytohemagglutinin, anti-CD3, anti-CD3/anti-CD28 or anti-CD2/anti-CD28. Our data
      demonstrate that neonatal cells are much more sensitive to inhibition of the
      proliferative response by DEX than adult cells (ED50 1 +/- 0.8 nM vs. 221 +/- 135
      nM). This difference in sensitivity is not related to differences in affinity and
      capacity of binding of [3H] DEX. Moreover, we show that the mechanisms of GC
      inhibition differ between adult and neonatal cells. In adult cells, addition of
      interleukin (IL)-2 does not restore DEX inhibition of the proliferative response.
      In contrast, the proliferative response of neonatal cells can be restored
      completely by the addition of IL-2. These data suggest that the primary target of
      GC in neonatal cells is inhibition of IL-2 production. In adult cells, other
      mechanisms are responsible for inhibition of T cell proliferation.

PMID- 7774639
TI  - Studies on the T cell dependence of natural IgM and IgG antibody repertoires in
      adult mice.
AB  - The present experiments address the thymic dependence of IgM and IgG natural
      antibody repertoires in adult euthymic and athymic BALB/c mice, as well as in
      athymic animals reconstituted with a fixed number of syngeneic T cells. Within 3
      weeks of the transfer of 10(7) syngeneic splenic T lymphocytes to athymic mice,
      the T cell compartment is essentially reconstituted in the peritoneal cavity (up
      to 80% of the numbers in euthymic animals), but is only 10-20% of controls in the
      spleen and lymph nodes. Early after transfer, there is an increase in the numbers
      of activated B cells and of immunoglobulin-secreting cells in the spleen, and
      within 1-2 weeks, the serum concentrations of IgG1 and IgG2a are fully
      reconstituted to control levels (30-40-fold increased). Multiparametric analyses
      of serum IgM and IgG repertoires revealed that euthymic and athymic mice share
      essentially all natural antibody reactivities towards syngeneic extracts of liver
      and muscle. When tested at the same immunoglobulin concentrations, however, nude
      sera consistently show higher values of reactivity in all detectable bands. The
      transfer of 10(7) splenic T cells into athymic mice results in a general decrease
      of serum IgM reactivities, some of which become undetectable, and in alterations
      of the serum IgG repertoire as early as 1 week, and for at least 4 weeks after
      transfer. T cell transfer, however, fails to restore the euthymic IgM and IgG
      repertoires within 4 weeks. The present observations demonstrate that, after
      limited T cell reconstitution of nude mice, there is a rapid and quantitatively
      important increase of serum IgG1 and IgG2a production; the serum IgM reactivity
      repertoire is qualitatively similar in euthymic and athymic animals, but is
      generally decreased by T cell activity; and the serum IgG repertoire, which is
      qualitatively similar in euthymic and athymic animals, is amplified by T cell
      activity and partially altered by T cell transfer into athymic animals. These
      results raise questions on the mechanisms of B cell activation and natural
      antibody repertoire selection in T cell-deficient adult individuals.

PMID- 7774640
TI  - Human eosinophil peroxidase enhances tumor necrosis factor and hydrogen peroxide
      release by human monocyte-derived macrophages.
AB  - Inhibition of growth or eradication of experimentally induced tumors has been
      shown to be accompanied by infiltration of eosinophils and macrophages into the
      tumor mass. Since macrophages are important mediators of host antitumor activity,
      the possibility arises that a collaboration may exist between these two cell
      types in the control of tumor growth. In this study, we report the effect of
      eosinophil peroxidase (EPO), a basic protein contained in eosinophils that binds
      to several cell types including macrophages, on tumor necrosis factor (TNF)
      production and hydrogen peroxide release by human monocyte-derived macrophages.
      After incubation with EPO, the macrophages produced large amounts of TNF and
      displayed an enhanced phorbol 12-myristate 13-acetate-triggered hydrogen peroxide
      release. These effects were accompanied by an increased cell protein content and
      by morphologic changes leading the large, round macrophages of the control
      cultures to become elongated, pear-like or spindle shaped cells after treatment
      with EPO. The stimulatory effect of EPO on hydrogen peroxide release was
      insensitive to addition of exogenous catalase, a H2O2-degrading enzyme,
      suggesting that an extracellular catalytic activity of EPO was not involved. In
      addition, myeloperoxidase, the homologous peroxidase of neutrophils with a
      catalytic activity similar to that of EPO, was ineffective. The EPO-induced
      effects differed in several aspects from the effects of lipopolysaccaride and
      interferon-gamma, two well-known macrophage activators. These findings provide
      supportive evidence for a functional interrelationship between eosinophils and
      macrophages that may be physiologically relevant in the tumoricidal activity of
      macrophages.

PMID- 7774641
TI  - Restoration of endogenous antigen processing in Burkitt's lymphoma cells by
      Epstein-Barr virus latent membrane protein-1: coordinate up-regulation of peptide
      transporters and HLA-class I antigen expression.
AB  - Group I Burkitt lymphoma (BL) lines retaining the original BL tumor cell
      phenotype are unable to present endogenously expressed antigens to HLA class I
      restricted cytotoxic T cells (CTL) but can be recognized if the relevant HLA
      class I/peptide epitope complex is reconstituted at the cell surface by exogenous
      addition of synthetic target peptide. Endogenous antigen-processing function is
      restored in BL lines that have undergone Epstein-Barr virus (EBV)-induced drift
      in culture to the group III phenotype typically displayed by EBV-transformed
      lymphoblastoid cell lines (LCL) of normal B cell origin. We compared group I
      versus group III cells for their expression of proteasome components, transporter
      proteins and HLA-class I antigens, all of which are thought to be involved in the
      endogenous antigen processing pathway. By Western blot analysis, there were not
      consistent differences in the low molecular mass protein subunits of proteasomes
      (lmp)-2, lmp-7 and delta, although the mb-1 proteasome subunit was regularly
      present at higher levels in group I BL lines relative to group III lines or LCL.
      By contrast there were marked differences in the expression of peptide
      transporter-associated proteins (Tap), with down-regulation of Tap-1 and Tap-2 in
      8/8 and 7/8 group I BL lines, respectively. Surface levels of HLA class I
      antigens were also consistently lower in group I cells; this was not associated
      with an intracellular accumulation of free HLA heavy chains, such as is seen in
      the Tap-deficient T2 processing-mutant line, but instead reflected a reduced rate
      of HLA class I synthesis in group I cells. Analysis of EBV gene transfectants of
      the B lymphoma lines BJAB and BL41 showed that the virus-encoded latent membrane
      protein-1 (LMP1), which is one of several EBV antigens expressed in group III but
      not in group I cells, was uniquely able to up-regulate expression both of the Tap
      proteins and HLA class I. Furthermore, this was accompanied by a restoration of
      antigen-processing function as measured by the ability of these cells to present
      an endogenously expressed viral antigen to CTL. These effects of LMP1 were
      similar to those induced in the same cell lines by interferon-gamma treatment.
      The results implicate both Tap and HLA class I expression as factors limiting the
      antigen-processing function of BL cells, and suggest that the accessibility of
      other EBV-associated malignancies to CTL surveillance may be critically dependent
      upon their LMP1 status.

PMID- 7774642
TI  - Oral tolerance to haptens: intestinal epithelial cells from 2,4
      dinitrochlorobenzene-fed mice inhibit hapten-specific T cell activation in vitro.
AB  - The mechanisms underlying the induction of immunological tolerance after feeding
      soluble exogenous antigens, including proteins and haptens, are still unclear.
      Using a model of oral tolerance to the contact-sensitizing hapten 2,4
      dinitrochlorobenzene (DNCB), we have compared the ability-of intestinal
      epithelial cells and of Peyer's patch APC to present DNCB in vitro or ex vivo
      after oral feeding, to specific peripheral lymph node T cells from DNCB
      sensitized mice. In contrast to Peyer's patch APC, which induce efficient hapten
      specific T cell activation upon exposure to the hapten either in vitro or in
      vivo, mature MHC class-II-positive intestinal epithelial cells were unable to
      induce T cell activation in either case. Interestingly, enterocytes from DNCB-fed
      mice exerted a dramatic inhibitory effect on the proliferative response of hapten
      primed T cells in response to dinitrobenzene sulfonate presented by syngeneic
      spleen cells. This inhibitory effect, which was also observed with supernatant of
      intestinal epithelial cells from DNCB-fed mice, could be reversed by neutralizing
      anti-transforming growth factor (TGF)-beta antibodies. In addition, pre
      incubation of hapten-sensitized T cells with enterocytes from DNCB-fed mice
      induced T cell anergy, which could be reversed by exogenous interleukin-2 or
      interleukin-4. These data demonstrate that intestinal epithelial cells activated
      in vivo by oral administration of DNCB are able to block proliferation of
      activated T cells through secretion of immunosuppressive cytokines such as TGF
      beta. It is proposed that intestinal epithelial cells may play a significant role
      in oral tolerance by limiting T cell-mediated hypersensitivity responses.

PMID- 7774643
TI  - Abnormal CD45RC expression and elevated CD45 protein tyrosine phosphatase
      activity in LEC rat peripheral CD4+ T cells.
AB  - LEC rats are known to show a maturational arrest in the development of CD4+8+ to
      CD4+8- cells in the thymus. Despite the blockade of maturation of CD4+8
      thymocytes, CD4+ T cells were observed in peripheral lymphoid organs, and these
      cells exhibit a defect in interleukin-2 (IL-2) production upon concanavalin A
      (Con A) stimulation. Although peripheral CD4+ cells in normal rat highly
      expressed CD45RC (CD45RChigh), the level of CD45RC expression was low (CD45RClow)
      in LEC rat peripheral CD4+ cells. However, CD4+ cells from both strains highly
      expressed CD45 when those cells were stained by pan-CD45 mAb, suggesting that LEC
      rat CD4+ cells are deficient in expression of the CD45RC isoform, but not of CD45
      molecules. When backcross rats from (F344 x LEC)F1 x LEC were examined, the
      phenotype for CD45 expression pattern in CD4+ cells was clearly correlated with
      IL-2 production level in response to Con A stimulation. Thus, CD45RClow cells
      exhibit a defect in IL-2 production, while CD45RChigh cells show normal IL-2
      production. Protein tyrosine phosphatase (PTPase) activity in the membrane
      fraction of LEC rat CD4+ cells was threefold higher than that of normal rat CD4+
      cells. Con A stimulation led to an increase in tyrosine phosphorylation levels,
      especially 100- and 40-kDa proteins, in normal rat CD4+ cells. In LEC rat CD4+
      cells, however, the level of tyrosine phosphorylation in those proteins were very
      low. These results suggest that an elevated CD45 PTPase activity is responsive
      for a defect in IL-2 production in LEC rat peripheral CD4+ T cells.

PMID- 7774644
TI  - T cell receptor iota an alternatively spliced product of the T cell receptor zeta
      gene.
AB  - It has been previously suggested that three alternative splicings of the murine T
      cell receptor (TCR) zeta gene are involved in the regulation of TCR/CD3
      transduction signals. We here describe a new alternative splicing of this gene
      (TCR iota), cloned by reverse transcriptase-polymerase chain reaction, that is
      encoded by exons 1-7 and 10. The protein putatively encoded by TCR iota mRNA
      differs in its carboxy terminus from that coded by TCR0 as a consequence of the
      reading frame shift of exon 10. The possible role of this new splicing in TCR
      modulation is briefly discussed.

PMID- 7774646
TI  - Antibody responses to Toxoplasma gondii antigen in human peripheral blood
      lymphocyte-reconstituted severe-combined immunodeficient mice reproduce the
      immunological status of the lymphocyte donor.
AB  - These studies describe the production of specific antibodies in human peripheral
      blood lymphocyte-reconstituted severe-combined immunodeficient (PBL-SCID) mice
      following vaccination with antigen from the protozoan parasite Toxoplasma gondii.
      To determine the effect of previous exposure of the lymphocyte donor to antigen,
      human-PBL-SCID animals were created by transferring peripheral blood lymphocytes
      from either a single T. gondii-seronegative or a single seropositive donor. These
      reconstituted animals were subsequently inoculated with T. gondii soluble
      tachyzoite antigen (STAg) entrapped within non-ionic surfactant vesicles as an
      immunological adjuvant. Animals were bled at pre-determined time points post
      vaccination and the expression of human anti-STAg antibodies in the plasma
      determined by enzyme-linked immunosorbent assay. Human antibodies specific for
      STAg were readily inducible in both groups of reconstituted animals, although the
      pattern of isotype production differed markedly between groups. The response in
      animals reconstituted with lymphocytes from the T. gondii-seronegative donor
      consisted primarily of IgM and subsequently of IgG (predominantly IgG1). In
      animals reconstituted with lymphocytes from the seropositive donor, no parasite
      specific IgM could be demonstrated. The detectable response to STAg consisted
      entirely of human antibodies of the IgG isotype (IgG1), indicative of a memory
      type response. These results mimicked exactly the antibody responses that would
      be expected had the lymphocyte donors been directly challenged with either the
      antigen or the live infectious agent, demonstrating that the immune system within
      these animals is functional and reproducible with regard to both the primary and
      secondary responses of the human donors.

PMID- 7774645
TI  - HIV-1 glycoprotein gp120 disrupts CD4-p56lck/CD3-T cell receptor interactions and
      inhibits CD3 signaling.
AB  - Using the CD4+ human T cell clone P28, we demonstrated that the HIV-1
      glycoprotein gp120 inhibited CD3-induced inositol trisphosphate production,
      calcium influx and T cell proliferation. Additionally, gp120 was shown to
      dissociate the tyrosine kinase p56lck from CD4 in CEM cells, with a concommittant
      inhibition of CD4-linked kinase activity. We have addressed the question whether
      disruption of CD4/p56lck or CD4/CD3-T cell receptor interactions, or both, could
      account for the inhibitory effect of gp120 in P28 cells. By comparing the effects
      of various anti-CD4 monoclonal antibodies (mAb) with those of gp120, we show that
      gp120 and IOT4a modulate CD4 expression, and decrease CD4-associated p56lck and
      CD4-linked kinase activity at the plasma membrane. In contrast, OKT4A and OKT4
      anti-CD4 mAb have no inhibitory effect. Interestingly, gp120 also inhibits CD3
      induced Lck activation and cellular tyrosine phosphorylation, particularly of
      phosphoinositide-specific phospholipase C-gamma-1. Kinetic experiments reveal
      that the inhibitory effect of gp120 on CD3-induced tyrosine phosphorylation
      appears as early as 30 min, but culminate when CD4-p56lck complexes disappear
      from the cell surface after 4 h. These results suggest that a negative signal is
      triggered by gp120 that results, after a few hours, in down-modulation of CD4
      p56lck complexes and the impairment of CD3 signaling. Supporting this hypothesis,
      gp120 inhibits CD3-linked kinase activity as shown by the inhibition of the
      phosphorylation of CD3 chains, leading to the inhibition of subsequent signal
      transduction.

PMID- 7774647
TI  - Characterization of the human interleukin-5 gene promoter: involvement of octamer
      binding sites in the gene promoter activity.
AB  - To investigate the human interleukin (IL)-5 gene promoter, we have constructed a
      plasmid with the firefly luciferase reporter gene linked to human IL-5 5'
      flanking sequence (nucleotides -507 to +44). We have used this plasmid to
      transfect the mouse EL4 T cell line, which can, under certain conditions, produce
      IL-5 transcripts. Phorbol 12-myristate 13-acetate, A23187 and N6, 2'-O-dibutyryl
      adenosine 3':5'-cyclic monophosphate co-stimulation of EL4 cells transfected with
      the human IL-5/luciferase reporter gene construct resulted in maximal induction
      of the luciferase gene. Deletion analysis of the IL-5 promoter revealed the
      presence of negative regulatory elements between nucleotides -404 and -312 and
      two regions, located between nucleotides -312 and -227 and between nucleotides 
      80 and -35, that are involved in the positive regulation of the IL-5 promoter.
      Using electrophoretic mobility shift assays, we show that the positive element
      located between nucleotides -312 and -227 involves the binding of factors
      antigenically related to Oct1, Oct2A and Oct2B, to a perfect octamer motif
      located at position -244/-237. Introduction of three point mutations in the
      octamer motif of the IL-5/luciferase reporter gene plasmid, which results in the
      loss of competition for the factors binding to the IL-5 promoter sequence,
      reduced the production of luciferase from stimulated, transfected EL4 cells, by
      90%. Octamer factors can also bind within the second positive regulatory region.

PMID- 7774648
TI  - Impaired survival of T cell receptor V gamma 3+ cells in interleukin-4 transgenic
      mice.
AB  - The mouse epidermis contains a network of Thy-1+ dendritic T cells. Most of these
      cells express a homogeneous T cell receptor (TCR) configuration (V gamma 3/V
      delta 1) with only negligible junctional diversity. Because fetal thymocytes are
      precursors of these dendritic epidermal T cells (DETC) and the addition of
      interleukin (IL)-4 to fetal thymic organ cultures causes an early arrest in
      thymopoiesis, we examined DETC development in transgenic (tg) mice expressing IL
      4 under the control of major histocompatibility complex class I regulatory
      sequences. Immunohistologic examination of epidermal sheets and polymerase chain
      reaction analysis of total skin RNA from IL-4 tg mice failed to reveal TCR V
      gamma 3+ DETC and V gamma 3 mRNA, respectively. In contrast, the sizes of TCR
      gamma delta subpopulations in lymphoid organs were unchanged in these mice.
      Although the numbers and staining intensities of TCR V gamma 3+ thymocytes in
      early fetal (days 14-17) IL-4 tg mice were similar to those of littermate
      controls, we observed a preferential death of these cells in thymic organ
      cultures from IL-4 tg mice. We observed further that epidermal sheets prepared
      from 9-day-old mice whose mothers had been treated with an IL-4-neutralizing
      antibody from day 12 to day 18 of pregnancy contained DETC numbers similar to
      those of controls. However, upon termination of the anti-IL-4 treatment, DETC
      ceased to expand. We conclude that IL-4 impairs the survival of TCR V gamma 3+
      cells.

PMID- 7774649
TI  - Antigen detection in vivo after immunization with different presentation forms of
      rabies virus antigen: involvement of marginal metallophilic macrophages in the
      uptake of immune-stimulating complexes.
AB  - Several mechanisms have been postulated to explain the relatively high
      immunogenicity of antigens presented in immune-stimulating complexes (iscom).
      Their potency can in part be explained by the specific targeting of these
      structures to cells presenting antigens to the immune system. However, until now
      no method for the subcellular detection of iscom in situ was available. In the
      present study, a novel, fast and simple method for the detection of iscoms in
      situ is demonstrated. By making use of the lipophilic fluorescent carbocyanine
      dyes, 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate (DiI)
      and 3,3'-dioctadecyloxacarbocyanine perchlorate (DiO), rabies virus antigen and
      iscom prepared with this antigen were visualized with fluorescence microscopy.
      The labeled antigen and iscoms were observed in macrophages of spleen and liver
      of mice within 1-2 h after intravenous administration. When administered
      intramuscularly or in the footpad, uptake in macrophages of draining lymph nodes
      could be demonstrated. In the spleen, labeled inactivated virus antigen localized
      preferentially in the marginal zone macrophages and to a lesser extent in the red
      pulp macrophages. In contrast, antigen presented in iscom was taken up mainly by
      the marginal metallophilic macrophages and to a much lesser extend by marginal
      zone macrophages or follicular-dendritic and -B cells. This method enables the
      detection of iscom and membrane viruses and allows the analysis of their relation
      to antigen-presenting cells in situ. Here, we demonstrate that iscom containing
      rabies virus antigen are taken up by a subset of macrophages in the spleen
      distinct from those that take up inactivated rabies virus antigen not presented
      in iscom, thereby possibly explaining the observed difference in immunogenicity
      of these antigen preparations. Furthermore, we show a lower efficiency on the
      induction of humoral and cellular responses after intravenous immunization for
      both types of antigen when compared with subcutaneous immunization.

PMID- 7774650
TI  - Developmentally regulated expression of P-glycoprotein (multidrug resistance)
      activity in mouse thymocytes.
AB  - P-glycoprotein (P-gly) is the transmembrane efflux pump responsible for multidrug
      resistance in tumor cells. The activity of P-gly in mature peripheral lymphocytes
      is lineage specific, with CD8+ T cells and natural killer (NK) cells expressing
      high levels as compared to CD4+ T cells and B cells. We have now investigated P
      gly activity in immature and mature subsets of mouse thymocytes. Our data
      indicate that P-gly activity is undetectable in immature CD4-8- and CD4+8+
      thymocyte subsets. Among mature thymocytes, P-gly activity is absent in the CD4+
      subset but present in the more mature (HSAlow) fraction of CD8+ cells.
      Furthermore, while thymic CD4-8- T cell receptor (TCR) gamma delta cells have
      little P-gly activity, a minor subset of CD4-8- or CD4+ TCR alpha beta +
      thymocytes bearing the NK1.1 surface marker expresses high levels of P-gly
      activity. Collectively, our results indicate that P-gly activity arises late
      during thymus development and is expressed in a lineage-specific fashion.

PMID- 7774651
TI  - A 17-kDa CD4-binding glycoprotein present in human seminal plasma and in breast
      tumor cells.
AB  - We previously isolated gp17, a human seminal plasma glycoprotein, which
      specifically interacts with the D1-D2 region of CD4, a T cell surface molecule
      involved in antigen recognition mediated by helper T cells also acting as a
      receptor for the human immunodeficiency virus. In this study we report that
      monoclonal antibodies (mAb) reacting with gp17 are able to inhibit the binding of
      gp17 to immobilized soluble CD4. An immunohistochemical analysis shows that gp17
      is also expressed in mammary tumor cells upon hormone treatment and in biopsies
      from breast cancer patients. A structural characterization of gp17, including
      amino acid sequencing, indicates that the protein has an extensive structural
      similarity with a glycoprotein designated as seminal actin-binding protein
      (SABP), also secreted by male sexual glands. SABP is in turn identical to gross
      cystic disease fluid protein-15 (GCDFP-15) or prolactin-inducible protein (PIP),
      a factor known as a highly specific and sensitive marker of primary and
      metastatic apocrine breast cancer. To establish further the correspondence of
      gp17 and GCDFP-15/PIP/SABP, the latter was expressed in bacteria from a cloned
      cDNA and purified by affinity chromatography to either anti-gp17 mAb-Sepharose or
      CD4-Sepharose. The purified recombinant protein is shown to inhibit the binding
      of labeled, pure g17 to immobilized soluble CD4. The finding that breast cancer
      cells express a protein able to interact with the CD4 domains involved in the
      recognition of class II major histocompatibility antigens suggests a possible
      mechanism by which a tumor may affect the activity of tumor-infiltrated CD4+ T
      cells.

PMID- 7774652
TI  - No role of interleukin-4 in CD23/IgE-mediated enhancement of the murine antibody
      response in vivo.
AB  - Antigen-specific IgE up-regulates the specific IgM, IgG1, IgG2a and IgE response
      in vivo when given to mice together with antigen. The enhancement is mediated by
      the low-affinity receptor for IgE, Fc epsilon RII or CD23, as demonstrated both
      in CD23-deficient mice and by blocking CD23 with anti-CD23 monoclonal antibodies.
      A possible mechanism behind the regulatory effects of CD23 is that the
      IgE/CD23/antigen complex is endocytosed by B cells, leading to increased antigen
      processing and presentation on major histocompatibility complex (MHC) class II
      molecules to T helper cells. In the present study we have found that the
      expression of CD23 is reduced fivefold on splenic B cells in mice genetically
      deficient for IL-4. When IL-4-deficient mice and normal littermates were
      immunized with 2,4,6-trinitrophenyl (TNP)-specific IgE followed by bovine serum
      albumin (BSA)-TNP or with BSA-TNP alone, the BSA-specific IgG1 and IgG2a
      responses were equally well augmented by IgE in all mice. In addition, a low but
      significant IgE response was seen even in the IL-4-deficient mice. Thus,
      enhancement of the antibody response through IgE and CD23 occur in the absence of
      IL-4 and is not dependent on CD23 up-regulation.

PMID- 7774653
TI  - CD38 ligation induces discrete cytokine mRNA expression in human cultured
      lymphocytes.
AB  - Human CD38 is a surface glycoprotein expressed by different immuno-competent
      cells such as immature and activated lymphocytes, plasma cells and natural killer
      cells. It has recently been reported that the CD38 molecule exerts adenosine
      diphosphate ribosyl cyclase activity and is associated with distinct
      transmembrane signaling molecules. This study reports that ligation of CD38 by
      specific monoclonal antibodies (mAb) induces multiple cytokine mRNA expression in
      cultured peripheral blood mononuclear cells (PBMC). The mRNA for tumor necrosis
      factor-alpha, interleukin (IL)-1 beta, IL-6, granulocyte-macrophage colony
      stimulating factor (GM-CSF) and IL-12 were always detected, whereas interferon
      gamma and IL-10 mRNA expression were seen in most, but not all PBMC cultures. Low
      levels of IL-2, IL-4 and IL-5 mRNA were also found. The key observation of this
      work is that CD38 ligation in PBMC induces a large spectrum of cytokines, many of
      which overlap with those induced via CD3 activation. The main differences between
      CD38 and CD3 activation are the low to undetectable levels of IL-2 mRNA, and the
      sustained IL-1 beta and IL-6 mRNA accumulation found in PBMC cultures following
      treatment with anti-CD38 mAb. Furthermore, PBMC proliferation was not found to be
      a prerequisite for CD38-mediated cytokine induction. Together, these results
      suggest that human CD38 activates a signaling pathway which leads to the
      induction of a discrete array of cytokines, and that this pathway only partially
      overlaps with that controlled by T cell receptor CD3.

PMID- 7774654
TI  - Covalent linkage of C3 to properdin during complement activation.
AB  - Activation of the alternative complement pathway of serum produces complexes of
      properdin (P) and C3 as measured in a double antibody enzyme-linked immunosorbent
      assay. When purified from serum, these complexes decrease factor B hemolytic
      activity in serum and do not restore the alternative pathway hemolytic activity
      of serum deficient in P. Sodium dodecylsulfate-polyacrylamide gel electrophoresis
      (SDS-PAGE) of activated serum containing biotinylated P, followed by blotting to
      nitrocellulose and development with streptavidin-alkaline phosphatase revealed a
      band at 53 kDa for monomeric P and an additional band at 160 kDa. P samples
      eluted from zymosan and purified from activated serum revealed a band at 116 kDa
      for C3 alpha and 74 kDa for C3 beta, and an additional band at 160 kDa when
      analyzed by SDS-PAGE, Western blotting and development with antibody to C3. The
      appearance of a 160 kDa band containing P and C3 indicates that these proteins
      are contained in a complex formed during activation of the alternative pathway.
      Activation of a purified reagent mixture containing factors B, D, and H, and 125I
      labeled P or 125I-labeled C3, followed by SDS-PAGE and autoradiography confirmed
      the presence of a 160-kDa band which disappeared following hydroxylamine
      treatment of the sample. These data are consistent with a covalent linkage of C3
      to P via the C3 alpha chain, producing the 160-kDa complex.

PMID- 7774655
TI  - Stimulation of rat striatal tyrosine hydroxylase activity following intranigral
      administration of sigma receptor ligands.
AB  - The effects of sigma ligands on turning behavior and striatal tyrosine
      hydroxylase activity were determined following microinjection of two chemically
      dissimilar sigma ligands into the rat substantia nigra. Striatal tyrosine
      hydroxylase activity was monitored by measuring the amount of 3,4
      dihydroxyphenylalanine (DOPA) formed following inhibition of DOPA decarboxylase
      activity with m-hydroxybenzylhydrazine (NSD-1015). The sigma ligands, 1,3-di-o
      tolylguanidine (DTG) and (-)-deoxy-N-benzylnormetazocine, produced a significant
      increase both in contralateral turning and in tyrosine hydroxylase activity. The
      DTG-induced increase in tyrosine hydroxylase activity was not antagonized by
      intranigral injection of the NMDA receptor antagonist, 3-(2-carboxypiperazine-4
      yl)-propyl-1-phosphonic acid (CPP). CPP alone produced significant contralateral
      turning that was not accompanied by an increase in striatal tyrosine hydroxylase
      activity, indicating that turning per se is not sufficient to activate striatal
      tyrosine hydroxylase. The DTG-induced increase in tyrosine hydroxylase activity
      was antagonized by general anesthetics such as halothane and chloral hydrate.
      These results indicate that occupancy of sigma receptors in the substantia nigra
      is associated with an activation of dopamine formation in dopaminergic terminals
      in the striatum and support the concept that sigma activity in the substantia
      nigra produces an activation of dopamine-mediated responses in the striatum.

PMID- 7774656
TI  - An antisense oligodeoxynucleotide to mu-opioid receptors inhibits mu-opioid
      receptor agonist-induced analgesia in rats.
AB  - We examined effects of an antisense oligodeoxynucleotide against the mu-opioid
      receptor on mu-opioid receptor agonist-induced antinociception in the cold water
      (-3 degrees C) tail-flick test in rats. Rats were injected
      intracerebroventricularly (i.c.v.) with an antisense, sense or missense
      oligodeoxynucleotide or artificial cerebrospinal fluid on days 1, 3 and 5. On day
      6, antinociceptive effects of opioid agonists were tested. Compared to the
      artificial cerebrospinal fluid treatment, the cumulative dose-effect curve for
      subcutaneous (s.c.) morphine was shifted to the right by the antisense
      oligodeoxynucleotide, but not by the missense oligodeoxynucleotide or the sense
      oligodeoxynucleotide treatment. Antisense oligodeoxynucleotide treatment reduced
      the analgesic effect of the mu-opioid receptor agonist PL017 ([N-MePhe3,D
      Pro4]morphiceptin), but not the delta-opioid receptor agonist BW373U86 ((+/-)-4
      ((a-R*)-a-((2S*,5R*)-4-allyl-2,5-dimethyl-1-piperazinyl)-3- hydroxybenzyl)-N,N
      diethyl-benzamide) or the kappa-opioid receptor agonist spiradoline ((+/-)
      (5a,7a,8b)-3,4-dichloro-N-methyl-N-[7-(1- pyrrolidinyl)-1-(oxaspiro-[4,5]dec-8
      yl]benzeneacetamide monohydrochloride). The drugs were given by i.c.v. injection.
      These findings indicate that i.c.v. administration of a mu antisense
      oligodeoxynucleotide specifically blocks mu-, but not delta- or kappa-opioid
      receptor-mediated analgesia in the rat cold water tail-flick test.

PMID- 7774657
TI  - Antinociceptive effect of dihydroetorphine in diabetic mice.
AB  - The antinociceptive potency of dihydroetorphine in diabetic mice was examined.
      Subcutaneous administration of dihydroetorphine produced a dose-dependent
      antinociception in both non-diabetic and diabetic mice. The antinociceptive
      potency of s.c. dihydroetorphine was less in diabetic mice than in non-diabetic
      mice. The antinociception induced by i.c.v. dihydroetorphine (0.02 microgram) was
      also significantly less in diabetic mice than in non-diabetic mice. The
      antinociceptive effects of dihydroetorphine (10 micrograms/kg i.p.) in both
      diabetic and non-diabetic mice were significantly antagonized by s.c.
      administration of beta-funaltrexamine, a selective mu-opioid receptor antagonist.
      Furthermore, the antinociceptive effect of dihydroetorphine (10 micrograms/kg
      i.p.) in non-diabetic mice, but not in diabetic mice, was also significantly
      antagonized by naloxonazine, a selective mu 1-opioid receptor antagonist. The
      time course and the potency of the antinociceptive effect of dihydroetorphine (10
      micrograms/kg i.p.) in diabetic mice were similar to those in naloxonazine
      treated non-diabetic mice. Naltrindole, a selective delta-opioid receptor
      antagonist, or nor-binaltorphimine, a selective kappa-opioid receptor antagonist,
      had no significant effect on the antinociceptive effect of dihydroetorphine (10
      micrograms/kg i.p.) in both diabetic and non-diabetic mice. These results suggest
      that dihydroetorphine produces an antinociceptive effect through the activation
      of both mu 1- and mu 2-opioid receptors in mice. Furthermore, the reduction in
      dihydroetorphine-induced antinociception in diabetic mice, as compared with non
      diabetic mice, may be due to the hyporesponsive to supraspinal mu 1-opioid
      receptor-mediated antinociception in diabetic mice.

PMID- 7774658
TI  - Effect of combination of a tissue-type plasminogen activator and an endothelin
      receptor antagonist, FR139317, in the rat cerebral infarction model.
AB  - We were interested to investigate if a combination of a modified tissue-type
      plasminogen activator, SUN9216, which is constructed by modifying a single amino
      acid (Asn117-Gln117) to yield a tissue-type plasminogen activator lacking finger
      and growth factor domains with a long half-life in blood, and an endothelin
      receptor antagonist, FR139317, (R)2-[(R)-2-[(S)-2[[1-(hexahydro-1H
      azepinyl)]carbonyl]amino-4- methyl-pentanoyl]amino-3-[3-(1-methyl-1H
      indolyl)]propionyl)amino-3- (2-pyridyl)propionic acid, has greater thrombolytic
      efficacy than a thrombolytic agent alone in reducing the size of cerebral
      infarction. The thrombotic occlusion of the rat middle cerebral artery was
      induced by a photochemical reaction between rose bengal and green light, which
      causes endothelial injury followed by platelet adhesion and formation of a
      platelet-rich thrombus. SUN9216 (1 mg/kg) was injected intravenously 30 min after
      the middle cerebral artery occlusion and the time for reopening of the middle
      cerebral artery by SUN9216 was monitored for a 60-min period under an operating
      microscope. In the rats in which thrombolysis was achieved with SUN9216, the size
      of the cerebral infarction was significantly (P < 0.05) reduced as compared with
      that in the rats treated with saline and was comparable to the reduction produced
      by the combination doses. It is concluded that, under the present experimental
      conditions, endothelin may not be involved in the impaired local cerebral blood
      flow after thrombolysis.

PMID- 7774659
TI  - The effects of adenosine A3 receptor stimulation on seizures in mice.
AB  - We have previously shown that acute preischemic adenosine A3 receptor stimulation
      results in an increased postischemic damage, while chronic stimulation of this
      receptor diminishes it. Since several pathophysiological phenomena are common for
      both ischemia and seizures, we have explored the effect of acute and chronic
      administration of the adenosine A3 receptor selective agonist IB-MECA (N6-(3
      iodobenzyl) adenosine-5'-N-methylcarboxamide) prior to seizures induced by N
      methyl-D-aspartate (NMDA), pentamethylenetetrazole, or electric shock. At 100
      micrograms/kg, acutely injected IB-MECA was protective in chemically but not
      electrically induced seizures. In chronic administration of IB-MECA, significant
      protection against chemically induced seizures was obtained in all studied
      measures, i.e., seizure latency, neurological impairment, and survival. Although
      threshold voltage was unchanged in electrically induced seizures, a chronic
      regimen of IB-MECA significantly reduced postepileptic mortality. Since the
      combination of an arteriole-constricting compound 48/80 and hypotension-inducing
      clonidine injected prior to NMDA results in a significant protection against
      seizures, and since acute stimulation of adenosine A3 receptor causes both
      arteriolar constriction and severe hypotension, there is a possibility that the
      protection obtained by the acutely administered drug may result from inadequate
      delivery of chemoconvulsants to the brain. It is, however, unknown whether the
      protective effect of chronically administered IB-MECA is related to the effect of
      the drug on blood flow, neuronal mechanisms, or both.

PMID- 7774660
TI  - Interleukin-1 receptor antagonist displays intrinsic agonist activity on rat
      gastric fundus motility in vitro.
AB  - It has been shown previously that both forms of interleukin-1, 1 alpha and 1
      beta, produce dose-dependent relaxation of the rat gastric fundus in vitro,
      accompanied by an increased production and release of eicosanoids. This effect
      appears to be mediated, at least in part, by leukotrienes, since the inhibition
      of 5-lipoxygenase by specific drugs counteracts interleukin-1-induced gastric
      relaxation. In the present study, we attempted to antagonize interleukin-1
      induced inhibition of gastric fundus motility with a interleukin-1 receptor
      antagonist. Surprisingly, the interleukin-1 receptor antagonist itself possessed
      interleukin-1-like agonist activity, since: (a) it produced rapid, dose-dependent
      relaxation of the rat gastric fundus, with an estimated EC50 of 70 pg/ml and a
      maximal effect at 10 ng/ml; (b) interleukin-1 receptor antagonist-induced
      relaxation was dose dependently inhibited by N-(3-phenoxycinnamyl)acetohydroxamic
      acid (BW A4c), a specific inhibitor of 5-lipoxygenase; (c) in the first 5 min
      after its addition to the bath solution, interleukin-1 receptor antagonist
      produced a significant increase in prostaglandin E2 release from the gastric
      strips. This evidence suggests that, shortly after receptor occupancy, in this
      experimental model interleukin-1 and interleukin-1 receptor antagonist share the
      same pattern of mechanical and biochemical activities.

PMID- 7774661
TI  - Developmental changes in response to endothelins and receptor subtypes of
      isolated rat duodenum.
AB  - The response of isolated duodenum to endothelin-1, -3 and IRL 1620 (Suc
      [Glu9,Ala11,15]endothelin-1 (8-21)), a selective endothelin ETB receptor agonist,
      was studied in both neonatal (1-week-old) and adult rats by recording mechanical
      activity isotonically. Endothelin-1, -3 and IRL 1620 (1-100 nM) elicited
      sustained contraction of neonatal duodenum, in a concentration-dependent manner,
      with a potency order of endothelin-1 = endothelin-3 > IRL 1620. The response to
      endothelin-1 and -3 (10-1000 nM) of adult duodenum was biphasic, i.e., transient
      relaxation followed by contraction, with a potency order of endothelin-1 >
      endothelin-3. The contractile response to endothelin-1 of adult but not neonatal
      duodenum was significantly antagonized by pretreatment with FR139317 (1 microM),
      an endothelin ETA receptor antagonist. An endothelin ETB receptor antagonist, RES
      701-1 (3 microM), weakly antagonized the IRL 1620-induced contraction of neonatal
      duodenum. However, RES-701-1 (10 microM) did not affect the response to
      endothelin-1 of either adult or neonatal duodenum. These results indicate that
      the duodenal response to endothelins changes from a sustained contraction in
      neonates to a biphasic response in adults. The contractile response to
      endothelins of neonatal duodenum is suggested to be mediated through endothelin
      ETB receptors or possibly RES-701-1-resistant ETB receptor subtypes and
      contraction of adult duodenum through endothelin ETA receptors. The mechanism of
      the endothelin-induced response of duodenum was also studied.

PMID- 7774662
TI  - Depletion of cortical cholecystokinin levels after excitotoxin injection into the
      nucleus basalis: sensitivity to MK-801.
AB  - The release of cholecystokinin (CCK) in vitro has been shown to be influenced by
      NMDA receptors. In this study we have investigated whether excitotoxin-induced
      seizure activity affects the release and tissue content of CCK. Excitotoxin
      injection caused a significant decrease in CCK in ipsilateral frontal, parietal
      and temporal cortex by (30-54%) at 8 h compared to contralateral cortex and sham
      operated controls and the effect was reversed by 24 h. No change was detected in
      occipital cortex, hippocampus and nucleus accumbens. The effect in frontal and
      temporal cortex was maximal at 8 h and could be completely prevented by treatment
      with MK-801(3 mg/kg i.p.). Anaesthesia (pentobarbital) alone or in combination
      with MK-801 did not affect peptide levels at 8 h. CCK mRNA levels were also
      studied quantitatively by slot-blot analysis but were unaffected at 6, 8 and 24 h
      after excitotoxin injection. The decrease in CCK tissue levels indicated that
      seizure activity stimulated CCK release which was confirmed in ex vivo
      experiments where K(+)-evoked (34 mM) CCK release was significantly enhanced in
      ipsilateral cerebral cortex at 6 h compared to contralateral cortex.

PMID- 7774663
TI  - The membranes of cultured rat brain astrocytes contain endothelin-converting
      enzyme activity.
AB  - Both endothelins and their big-endothelin precursors were found capable of
      inducing the release of arachidonic acid from purified cultures of rat
      astrocytes. Their order of potency was as follows: big-endothelin-3 < big
      endothelin-1 < endothelin-1 = endothelin-3. Mature endothelins induced the
      release of arachidonic acid in a rapid fashion. In contrast, much longer
      incubation times were required for big-endothelins to exert an effect, suggesting
      that their activity was dependent on their conversion. When big-endothelin-1 was
      added to the incubation medium of intact live astrocytes, it was converted into
      mature endothelin-1 in a time-dependent manner and the conversion was inhibited
      by phosphoramidon. This suggests that astrocytic endothelin-converting enzyme is
      (at least in part) an external membrane-bound metalloprotease. Some conversion of
      big-endothelin-3 into endothelin-3 also occurred. However, it was less efficient
      than the conversion of big-endothelin-1, which is compatible with the lower
      bioactivity of big-endothelin-3 vs. that of big-endothelin-1 in astrocytes.

PMID- 7774664
TI  - Effects of the dopamine autoreceptor antagonist (-)-DS121 on the discriminative
      stimulus properties of d-amphetamine and cocaine.
AB  - (-)-DS121 [S-(-)-3-(3-cyanophenyl)-N-n-propyl piperidine) is a recently
      synthesised phenylpiperidine derivative suggested to be a dopamine receptor
      antagonist acting preferentially at dopamine autoreceptors. The drug exerts
      'agonist-like' behavioural effects by enhancing dopamine release, but also shares
      properties in common with neuroleptics. The ability of (-)-DS121 to both
      generalise to and antagonise the stimulus effects of psychostimulants was
      determined in rats trained to discriminate d-amphetamine (0.5 mg/kg) or cocaine
      (5.0 mg/kg) from saline in a two-lever, food-reinforced, drug discrimination
      task. (-)-DS121 (3.5-14.0 mg/kg) produced small, but significant, increases in
      drug lever-appropriate responding in both d-amphetamine and cocaine-trained rats.
      However, there was no indication of a dose-dependent effect in either case. On
      the other hand, (-)-DS121 dose-dependently reduced response rate. Caffeine
      produced a higher level of drug lever-appropriate responding than (-)-DS121 in d
      amphetamine-trained rats. (-)-DS121 (7.0-14.0 mg/kg) also weakly antagonised the
      cueing properties of both d-amphetamine and cocaine. A marked response disruption
      with the drug combination precluded testing of higher doses of (-)-DS121. A
      combination of subthreshold doses of (-)-DS121 (3.5 mg/kg) and d-amphetamine
      (0.0625 mg/kg) produced a significant degree of drug lever-appropriate
      responding, suggesting a synergistic interaction between these drugs. However,
      such an interaction was not noted with a higher dose of (-)-DS121, or when this
      drug was administered with a low dose of cocaine (0.25 mg/kg).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7774665
TI  - Phosphodiesterase inhibitors reduce bronchial hyperreactivity and airway
      inflammation in unrestrained guinea pigs.
AB  - A new guinea pig model of allergic asthma was used to investigate the effects of
      low doses of the phosphodiesterase inhibitors, rolipram (phosphodiesterase IV
      selective), ORG 20241 (N-hydroxy-4-(3,4-dimethoxyphenyl)-thiazole-2
      carboximidamide; dual phosphodiesterase III/IV inhibitor with some selectivity
      for the phosphodiesterase IV isoenzyme), and of theophylline (non-selective) on
      allergen-induced early and late phase asthmatic reactions, bronchial
      hyperreactivity to histamine inhalation, and airway inflammation. Theophylline
      (25 mg/kg i.p.) and ORG 20241 (5 mg/kg i.p.) did not affect histamine-induced
      bronchoconstriction, whereas rolipram (75 micrograms/kg i.p.) only slightly
      reduced the response to histamine at 7 h after administration. However, bronchial
      hyperreactivity after the early and after the late reaction was significantly
      reduced by theophylline, rolipram and ORG 20241, while bronchoalveolar lavage
      studies revealed a selective inhibition of airway inflammation by the
      phosphodiesterase inhibitors. Theophylline significantly reduced the number of
      eosinophils, neutrophils and macrophages; rolipram reduced the number of
      neutrophils and lymphocytes, and ORG 20241, the number of eosinophils and
      macrophages. None of the compounds at the dosage indicated reduced the early and
      late reaction when administered i.p. 1 h before allergen exposure to defined dual
      responding animals. These results indicate that non-bronchodilator doses of these
      phosphodiesterase inhibitors markedly reduce the allergen-induced development of
      bronchial hyperreactivity as well as airway inflammation, presumably by
      selectively inhibiting cellular migration. The results suggest that an
      orchestrated series of cellular interactions is involved in the development of
      bronchial hyperreactivity. It is concluded that phosphodiesterase inhibitors may
      be very useful in the treatment of bronchial asthma.

PMID- 7774666
TI  - Naloxone reduces the neurochemical and behavioral effects of amphetamine but not
      those of cocaine.
AB  - The specific opioid receptor antagonist naloxone modifies the effects of
      amphetamine in a wide variety of behavioral paradigms. Naloxone also attenuates
      the amphetamine-induced increase in extracellular dopamine in the brain of rats.
      Therefore, these experiments were designed to replicate the neurochemical and
      behavioral interactions between naloxone and amphetamine, and to extend these
      observations to interactions between naloxone and cocaine. Microdialysis was
      performed on adult male rats of Sprague-Dawley descent. Rats were pretreated with
      a subcutaneous injection of 5.0 mg/kg naloxone or vehicle, which was followed 30
      min later by cumulative doses of subcutaneous d-amphetamine (0.0, 0.1, 0.4, 1.6,
      6.4 mg/kg) or intraperitoneal cocaine (0, 3, 10, 30, 56 mg/kg) at 30 min
      intervals. The microdialysis probes were perfused at a flow rate of 0.6
      microliter/min with artificial cerebrospinal fluid. Dialysate samples were
      collected every 10 min from either the nucleus accumbens or striatum and analyzed
      for dopamine content by high-performance liquid chromatography (HPLC). Locomotor
      activity (photobeam breaks) was monitored simultaneously with the collection of
      dialysate samples. Amphetamine and cocaine dose-dependently increased
      extracellular dopamine in both the nucleus accumbens and striatum. Naloxone
      pretreatment significantly reduced the amphetamine-induced increase in
      extracellular dopamine in both brain regions and also attenuated the increase in
      locomotor activity elicited by amphetamine. Naloxone pretreatment had no effect,
      however, on the cocaine-induced increase in extracellular dopamine or locomotor
      activity. These findings suggest that endogenous opioid systems play a role in
      mediating the neurochemical and behavioral effects of amphetamine, but not those
      of cocaine.

PMID- 7774668
TI  - Homologous and heterologous regulation of receptor-stimulated phosphoinositide
      hydrolysis.
AB  - Signal transduction at a diverse range of pharmacologically distinct receptors is
      effected by the enhanced turnover of inositol phospholipids, with the attendant
      formation of inositol 1,4,5-trisphosphate and diacylglycerol. Although
      considerable progress has been made in recent years towards the identification
      and characterization of the individual components of this pathway, much less is
      known of mechanisms that may underlie its regulation. In this review, evidence is
      presented for the potential regulation of inositol lipid turnover at the level of
      receptor, phosphoinositide-specific phospholipase C and substrate availability in
      response to either homologous or heterologous stimuli. Available data indicate
      that the extent of receptor-stimulated inositol lipid hydrolysis is regulated by
      multiple mechanisms that operate at different levels of the signal transduction
      pathway.

PMID- 7774667
TI  - Evidence for two different imidazoline sites on pancreatic B cells and vascular
      bed in rat.
AB  - The relative potencies of imidazoline compounds to induce insulin secretion and
      vascular resistance were compared in the isolated perfused rat pancreas. On
      insulin secretion, only the two imidazolines, antazoline and efaroxan, induced a
      concentration-dependent response, antazoline being 10 times more potent than
      efaroxan. In contrast, idazoxan, a blocker of imidazoline I1 sites, at
      concentrations up to 30 microM, antagonized the insulin response to 10 microM
      efaroxan (IC50 approximately equal to 14 +/- 2 microM) without affecting that to
      3 microM tolbutamide. On pancreatic vessels, not only antazoline and efaroxan but
      also idazoxan induced a concentration-dependent vasoconstriction; the rank order
      of agonist potency was antazoline > efaroxan > idazoxan. In addition, cimetidine,
      an imidazole known to bind imidazoline I1 sites, ineffective per se, partially
      reversed the insulin stimulatory effect of efaroxan without affecting its
      vasoconstrictor effect. This study demonstrates that the insulin secretory and
      vasoconstrictor actions of imidazolines involve different imidazoline sites in
      rat pancreas. The results provide evidence for an I1 type mediating insulin
      secretion on B cells and an I2 type mediating vasoconstriction in vessels.

PMID- 7774669
TI  - The function of a highly-conserved arginine residue in activation of the
      muscarinic M1 receptor.
AB  - Arg123 in the rat muscarinic M1 receptor is part of the highly conserved triad
      Asp-Arg-Tyr found at the junction of transmembrane helix 3 with the second
      intracellular loop. Mutation of Arg123 to Lys, Ala, Leu, Glu and Gln had no
      effect on levels of receptor expression in COS-7 cells, or on affinities for the
      antagonist N-methylscopolamine. Acetylcholine stimulation of the Lys123 receptor
      evoked the same maximum phosphoinositide response as the wild type, although the
      potency was reduced six-fold, but mutation to other residues strongly disrupted
      receptor function. Mutation of Arg123 always decreased the ratio of the high
      affinity to the low affinity agonist binding constant, but the absolute effect on
      the latter varied from a 4-fold increase for the Lys123 to a small decrease for
      the Leu123 mutation. These results suggest that a positive charge at position 123
      is central to the activation of G-proteins by the muscarinic M1 receptor.

PMID- 7774670
TI  - Pharmacological properties of two recombinant splice variants of the PACAP type I
      receptor, transfected and stably expressed in CHO cells.
AB  - Two splice variants of the pituitary adenylate cyclase activating polypeptide
      (PACAP) type I receptor (PACAP receptor and PACAP/HOP receptor isoform) were
      stably expressed in Chinese hamster ovary (CHO) cells that did not express
      constitutively receptors for this family of peptides. The PACAP/HOP receptor
      protein had a 28 amino acid extension in the C-terminal part of the third
      intracellular loop. The two cell lines studied, CHO 2-10 (PACAP receptor) and CHO
      4-12 (PACAP/HOP receptor) expressed a receptor density of 4.6 +/- 0.3 and 2.6 +/-
      0.2 pmol/mg protein, respectively, with corresponding Kd values of 14.2 +/- 2.0
      and 8.2 +/- 1.0 nM for [Ac-His1]PACAP-27 used as a tracer. Tracer binding was
      slightly decreased by GTP in both clones. The Kd values of PACAP-27, PACAP-38,
      vasoactive intestinal peptide (VIP), PACAP-27 fragments and analogues evaluated
      by binding competition curves, were higher in CHO 2-10 than in CHO 4-12, whereas
      the Kd for PACAP-38 fragments did not differ. The receptors were coupled to
      adenylate cyclase and the EC50 values were lower than the Kd values in both cell
      lines, suggesting an amplification process due to the existence of spare
      receptors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7774671
TI  - Polyclonal antibodies against human melanocortin MC1 receptor: preliminary
      immunohistochemical localisation of melanocortin MC1 receptor to malignant
      melanoma cells.
AB  - Peptides of 11 and 15 residue lengths were synthesised according to the sequence
      of the N-terminal region of the human MC1 melanocyte stimulating hormone
      receptor. The peptides were conjugated to thyroglobulin and used for preparation
      of antisera in the rabbit. Each of the conjugates raised antisera which showed
      high titre and specificity for its respective peptide antigen when evaluated in
      an ELISA test. Both types of antisera immunostained MC1 receptor expressing COS-7
      cells. By contrast, the sera did not stain control COS-7 cells not expressing the
      MC1 receptor. Moreover, preimmune sera or antiserum preadsorbed with its
      respective peptide did not stain the MC1 receptor expressing cells. The antisera
      were used to immunostain sections of normal human skin, as well as samples of
      cutaneous malignant melanoma tumours obtained from a patient. The cells of the
      melanoma tumours were very strongly immunostained with the MC1 receptor antisera.
      By contrast, melanocytes which were present in the normal skin could not be
      visualised with our antisera.

PMID- 7774673
TI  - Evidence that beta-endorphin is an agonist at bovine pineal delta-opioid
      receptors.
AB  - Since beta-endorphin is the putative endogenous ligand for epsilon-opioid
      receptors, the previous demonstration of saturable, high affinity beta-endorphin
      binding sites on bovine pineal membranes suggests the possible presence of
      epsilon-opioid receptors. To determine the identity of pineal beta-endorphin
      binding sites, the inhibition of [125I]beta-endorphin binding by ligands with
      varying affinities for epsilon-, mu-, delta- or kappa-opioid receptors was
      investigated. A high positive correlation was observed between the Ki values for
      these drugs to inhibit [125I]beta-endorphin binding to pineal membranes and for
      these drugs to bind to delta-opioid receptors but not to mu-, kappa- or epsilon
      opioid receptors, demonstrating that in the pineal beta-endorphin binds to delta
      opioid receptors. Both NaCl and a GTP analogue were potent inhibitors of
      [125I]beta-endorphin binding, providing evidence that beta-endorphin is an
      agonist at pineal delta-opioid receptors. These results suggest that endogenous
      bovine beta-endorphin may modulate pineal function.

PMID- 7774672
TI  - Structure-activity relationship of bromoeudistomin D, a powerful Ca2+ releaser in
      skeletal muscle sarcoplasmic reticulum.
AB  - Bromoeudistomin D and 9-methyl-7-bromoeudistomin D which have a beta-carboline
      skeleton are powerful Ca2+ releasers from skeletal muscle sarcoplasmic reticulum
      exhibiting caffeine-like properties. We examined the effects of bromoeudistomin D
      analogues on Ca(2+)-induced Ca2+ release from skeletal muscle sarcoplasmic
      reticulum. Among bromoeudistomin D analogues, the Ca(2+)-releasing activities of
      carboline derivatives were higher than those of carbazole derivatives, suggesting
      that a carboline skeleton is significantly important for the manifestation of
      Ca(2+)-releasing activity and Ca2+ sensitivity of Ca(2+)-induced Ca2+ release. On
      the contrary, the analogues which have a carbazole skeleton and bromine at C-6
      inhibit both Ca(2+)- and caffeine-induced Ca2+ release. 9-Methyl-substitution of
      the analogue elevated its Ca(2+)-releasing activity. Moreover, there is a close
      correlation between the enhancement of [3H]ryanodine binding to sarcoplasmic
      reticulum by the analogues and the activation of Ca2+ release by them.
      Bromoudistomin D analogues may provide valuable information about the structure
      function relationship of the ryanodine receptor/Ca2+ release channels in skeletal
      muscle sarcoplasmic reticulum.

PMID- 7774674
TI  - Effect of receptor density on the receptor-effector coupling: use of cloned and
      stably expressed alpha 1B-adrenoceptors in CHO cells.
AB  - Using Chinese hamster ovary cells stably expressing alpha 1B-adrenoceptor as a
      model, we investigated whether the changes in receptor density may influence the
      receptor-effector coupling relationship. Among the transfected cells, two clones
      which showed similar pharmacological properties but markedly differed in receptor
      density (Bmax were 1600 and 110,000 sites/cell, respectively), were examined. The
      phenoxybenzamine inactivation method showed that the alpha 1B-adrenoceptor
      occupancy and transients of cytosolic Ca2+ concentration ([Ca2+]i) response
      relationship was markedly nonlinear but similar in the two cell lines. The dose
      response relationship for norepinephrine-induced [Ca2+]i response showed an
      increase in maximum effect with no change in agonist potency, and the increase in
      maximum effect was disproportionate to the difference in receptor density. The
      results indicate that the classical model of drug-receptor action cannot
      appropriately describe the coupling of alpha 1B-adrenoceptor to [Ca2+]i response
      in the single receptor expressing system.

PMID- 7774676
TI  - Comparative effects of GLP-1-(7-36) amide, oxyntomodulin and glucagon on rabbit
      gastric parietal cell function.
AB  - We have investigated in vitro, the effects of glucagon-like peptide-1-(7-36)
      amide (GLP-1-(7-36) amide), oxyntomodulin and glucagon on two rabbit parietal
      cell-enriched fractions (F3, F3n), with parietal cell contents of 60% and 88%,
      respectively. Histamine (10(-5) M) stimulated [14C]aminopyrine accumulation to an
      amount of 850% in excess of the basal level, whereas GLP-1-(7-36) amide (10(-7)
      M) and oxyntomodulin (10(-6) M) induced increases of 50% and 30%, respectively.
      With a histamine concentration of 10(-6) M, [14C]aminopyrine accumulation was
      stimulated to 498% in excess of the basal level; GLP-1-(7-36) amide (10(-7) M)
      and oxyntomodulin (10(-7) M) induced increases of 18% and 15%, respectively. With
      these parameters, oxyntomodulin[19-37] and glucagon were without effect. Specific
      binding of [125I]GLP-1-(7-36) amide to parietal cell plasma membranes was
      inhibited dose-dependently by GLP-1-(7-36) amide, oxyntomodulin and glucagon with
      inhibitory concentrations of 0.25 nM, 65 nM and 800 nM, respectively. No specific
      binding of [125I]oxyntomodulin or [125I]glucagon was detectable. GLP-1-(7-36)
      amide receptor mRNA was only detected in parietal cell-enriched fractions. GLP-1
      (7-36) amide, oxyntomodulin and glucagon stimulated parietal cell cAMP production
      to similar maximal levels with median values close to 0.28 nM, 10.5 nM and 331.7
      nM, whereas oxyntomodulin[19-37] had no effect. The maximal cAMP production
      induced by GLP-1-(7-36) amide, oxyntomodulin or glucagon was additive to that
      induced by histamine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7774675
TI  - Characterisation of melanocortin receptor subtypes by radioligand binding
      analysis.
AB  - The DNAs encoding three melanocortin receptor subtypes (melanocortin MC1
      receptor, melanocortin MC3 receptor and melanocortin MC5 receptor) were expressed
      individually in COS (CV-1 Origin, SV40) cells to characterise their ligand
      binding properties. The results indicated that [125I][Nle4, D-Phe7]alpha-MSH
      (melanocyte stimulating hormone) bound to a single saturable site with Kd values
      of 85.1 +/- 8.0 pmol/l (mean +/- S.E.M), 396 +/- 65 pmol/l and 5.05 +/- 1.00
      nmol/l for melanocortin MC1 receptor, melanocortin MC3 receptor and melanocortin
      MC3 receptor, respectively. The melanocortin MC1 receptor and the melanocortin
      MC5 receptor showed a similar potency order to the melanocortic peptides examined
      which was markedly different from the potency order of the melanocortin MC3
      receptor. The melanocortin MC1 receptor and melanocortin MC5 receptor had a
      relatively higher affinity for alpha-MSH than gamma-MSH and beta-MSH, whereas the
      melanocortin MC3 receptor had higher affinity for desacetyl-alpha-MSH, gamma-MSH
      and beta-MSH compared to alpha-MSH. The inclusion of the endopeptidase inhibitor
      phosphoramidon to prevent the breakdown of ACTH-(1-39) (adrenocorticotrophic
      hormone) to alpha-MSH, decreased ACTH-(1-39) binding affinity showing that ACTH
      (1-39) had a much lower affinity for melanocortin MC1 receptor than reported
      earlier.

PMID- 7774677
TI  - Atrial natriuretic factor stimulates migration by human neutrophils.
AB  - Atrial natriuretic factor causes a strong stimulation of human neutrophil
      migration in the concentration range of 4 x 10(-9) and 10(-7) M. The effect,
      which depends on the presence of extracellular Mg2+ but not on extracellular
      Ca2+, is composed of a chemokinetic and a chemotactic component. Cyclic GMP level
      of neutrophils is enhanced by atrial natriuretic factor. Two inhibitors of
      soluble guanylate cyclase, 6-anilino-5,8-quinolinedione (LY 83583) and methylene
      blue, have no effect on stimulation of migration by atrial natriuretic factor.
      Atrial natriuretic factor-activated migration is inhibited by pertussis toxin.
      Migration by electroporated neutrophils is synergistically enhanced by guanosine
      5'-[gamma thio]triphosphate (GTP gamma[S]) and atrial natriuretic factor or by
      GTP gamma[S] and chemotactic peptide, while GTP gamma[S] and dioctanoyl glycerol
      give an additive effect. The results suggest that besides a modulation via cGMP a
      part of the effect of atrial natriuretic factor on migration is regulated via the
      ANF receptor-subtype that does not activate guanylate cyclase.

PMID- 7774679
TI  - Prolonged incubation with neuropeptide Y upregulates beta-adrenoceptors yet does
      not cause supersensitivity of beta-adrenoceptor signaling.
AB  - In neonatal rat ventricular myocytes prolonged incubation with 1 microM
      neuropeptide Y (2 h-48 h) increased beta-adrenoceptor density 16-24% (n = 4--8,
      all p < 0.05), an effect prevented by pertussis toxin pretreatment. Prolonged
      incubation with neuropeptide Y had no effect on adenylycylclase activity
      stimulated by 5'-guanylylimidodiphosphate or (-)-isoprenaline, probably because
      of a neuropeptide Y-induced decrease in affinity of the beta-adrenoceptor for
      agonist. Thus, chronic incubation with an inhibitory agonist does not inevitably
      lead to supersensitivity of the adenylylcyclase pathway.

PMID- 7774678
TI  - Daphnoretin-induced respiratory burst in rat neutrophils is, probably, mainly
      through protein kinase C activation.
AB  - Daphnoretin, a dicoumarin isolated from Wikstroemia indica C.A. Mey.
      (Thymelaceae), induced superoxide anion (O2-) formation in rat neutrophils in a
      concentration-dependent manner. Addition of staurosporine reduced daphnoretin
      induced respiratory burst. Removal of extracellular free Ca2+ by EGTA did not
      affect the respiratory burst of neutrophils in response to daphnoretin. Prior
      exposure of neutrophils to phorbol 12-myristate 13-acetate (PMA) or daphnoretin
      reduced the O2- formation caused by a subsequent challenge with PMA and
      daphnoretin, but potentiated the response caused by a subsequent addition of
      formyl-Met-Leu-Phe (fMLP). Like PMA, daphnoretin did not increase the [Ca2+]i
      during cell activation. In neutrophil suspension, daphnoretin increased the
      membrane associated protein kinase C activity. In the presence of Ca2+ and
      phosphatidyl-serine, daphnoretin also activated protein kinase C isolated from
      cytosolic fraction of resting neutrophils. Staurosporine inhibited the direct
      activation of protein kinase C caused by daphnoretin as well as by PMA.
      Daphnoretin reduced the [3H]Phorbol-12,13-dibutyrate ([3H]PDB) binding to the
      neutrophil cytosolic protein kinase C in a concentration-dependent manner with an
      IC50 value of 1.77 +/- 0.37 microM. These results indicate that daphnoretin, like
      PMA, may direct activation of protein kinase C which in turn activated NADPH
      oxidase and elicited respiratory burst.

PMID- 7774680
TI  - Inhibition of voltage-dependent Ca(2+)-current by alpha-adrenoceptor agonists in
      smooth muscle cells.
AB  - The cellular mechanisms underlying the inhibitory effects of phenylephrine on
      dihydropyridine-sensitive, voltage-dependent Ca2+ currents recorded from single
      smooth muscle cells dissociated from the rat anococcygeus muscle were examined.
      Phenylephrine (0.1-30 microM) produced a concentration-dependent inhibition of
      the Ca2+ current; the maximum response occurred at a concentration of 10 microM,
      which inhibited the peak inward current evoked at 0 mV by 57.7 +/- 4% (n = 8).
      The response to phenylephrine was reduced but not abolished in cells containing
      1,2-bis(2-aminophenoxy)ethane N,N,N',N'-tetraacetic acid (BAPTA; 10 mM), and it
      persisted in cells dialysed internally with heparin (5 mg.ml-1). This was despite
      the fact that both EGTA (5 mM) and heparin were able to block the phenylephrine
      induced, Ca(2+)-dependent chloride current recorded in the same cells. The
      inhibition of the Ca2+ current produced by phenylephrine was abolished in cells
      containing guanosine 5'-[beta-thio]diphosphate (GDP-beta-S) but persisted in
      cells pre-treated with pertussis toxin. Our results suggest that the inhibition
      of L-type Ca2+ current seen following alpha-adrenoceptor activation occurs by a
      mechanism independent from the inositol trisphosphate-mediated release of Ca2+
      from intracellular stores.

PMID- 7774681
TI  - Glucocorticoids regulate the expression of angiotensin AT1 receptors, in the
      human hepatoma cell line, PLC-PRF-5.
AB  - The effects of different steroids on the expression of angiotensin AT1 receptors
      by the human hepatoma cell line, PLC-PRF-5 was studied. Dexamethasone and
      aldosterone decreased the specific binding of [3H]angiotensin II to intact PLC
      PRF-5 cells by 57 +/- 4% and 54 +/- 2%, respectively, compared to control,
      untreated cells. EC50 values for dexamethasone, cortisol and aldosterone were 1.8
      +/- 0.6, 40 +/- 6, and 310 +/- 20 nM, respectively, suggesting that these effects
      were mediated via a glucocorticoid receptor. Scatchard analysis revealed that
      dexamethasone decreased the number of angiotensin AT1 receptors expressed (50 +/-
      4% relative to control) with no change in receptor affinity. Treating cells with
      dexamethasone in the presence of either an angiotensin converting enzyme
      inhibitor or an angiotensin II receptor antagonist did not prevent the reduction
      in angiotensin AT1 receptor expression, ruling out a mechanism involving a
      dexamethasone induced increase in endogenous angiotensin II production. A
      ribonuclease protection assay established that the steady state level of
      angiotensin AT1 receptor mRNA in dexamethasone treated cells was reduced to 34.7
      +/- 8.4% of untreated cells. The decrease in the number of angiotensin AT1
      receptors expressed on the cell surface after treatment with dexamethasone
      therefore seems likely to reflect the decreased steady state level of the mRNA
      coding for this receptor.

PMID- 7774682
TI  - Serotonin uptake inhibitors modulate intracellular Ca2+ mobilization in
      platelets.
AB  - The serotonin uptake inhibitors sertraline, paroxetine and fluoxetine were
      compared with imipramine and the calmodulin antagonists N-(6-aminohexyl)-5-chloro
      1-naphthalene-sulfonamide (W-7) and calmidazolium, for their effects on
      intracellular Ca2+ mobilization in human platelets. All serotonin uptake
      inhibitors and calmodulin antagonists augmented thrombin-mediated increases in
      intracellular Ca2+. Sertraline, calmidazolium and W-7 also caused large dose
      dependent increases in baseline levels of intracellular Ca2+. There was a rough
      correlation between the ability to elevate intracellular Ca2+ and potencies for
      inhibition of calmodulin. Neomycin, an inhibitor of inositol trisphosphate (IP3)
      generation, significantly inhibited the effects of sertaline. This is consistent
      with a role of IP3 and calmodulin in the effects of these drugs.

PMID- 7774683
TI  - Ouabain enhances nitric oxide synthesis in rat vascular smooth muscle cells
      induced by interleukin-1 beta.
AB  - Incubation of cultured rat vascular smooth muscle cells with interleukin-1 beta
      caused a significant increase in the production of nitrite, a stable metabolite
      of nitric oxide (NO), in time- and dose-dependent manners. Addition of ouabain to
      the culture further enhanced interleukin-1 beta-induced nitrite production.
      Similarly, interleukin-1 beta produced a significant increase in the cellular
      level of guanosine 3',5'-cyclic monophosphate, and the increase was significantly
      enhanced by coincubation with ouabain. The calcium ionophore ionomycin also
      significantly enhanced interleukin-1 beta-induced nitrite generation. These
      findings indicate that ouabain enhances NO synthesis in vascular smooth muscle
      cells induced by interleukin-1 beta, presumably through an increase in
      intracellular calcium ion concentrations.

PMID- 7774684
TI  - 5-HT1A receptor-mediated activation of high-affinity GTPase in rat hippocampal
      membranes.
AB  - GTP hydrolyzing activity was assayed by measuring the amount of 32P(i) released
      from 0.3 microM [gamma-32P]GTP in the membranes prepared from rat brain. 5
      Hydroxytryptamine (5-HT) stimulated the high-affinity GTPase activity in
      hippocampus, but not in striatum, in a concentration-dependent manner with an
      EC50 value of 18 nM and maximal percent stimulation of 13.9%. This response was
      mimicked by (+/-)-8-hydroxy-2-(di-n-propylamino)tetralin [(+/-)-8-OH-DPAT], but
      not by (+/-)-1-(2,5-dimethoxy-4-iodophyenyl)-2-aminopropane [(+/-)-DOI]. These
      results suggest that 5-HT-stimulated high-affinity GTPase activity of the GTP
      binding protein(s) is mediated via 5-HT1A receptor subtype in the rat
      hippocampus.

PMID- 7774685
TI  - Profiling of trans-azetidine-2,4-dicarboxylic acid at the human metabotropic
      glutamate receptors mGlu1b, -2, -4a and -5a.
AB  - We have tested the two enantiomers of trans-azetidine-2,4-dicarboxylic acid,
      (2S,4S)-azetidine-2,4-dicarboxylic acid ((2S,4S)-ADA) and (2R,4R)-azetidine-2,4
      dicarboxylic acid ((2R,4R)-ADA) for activity at the human metabotropic glutamate
      receptors mGlu1b, mGlu2, mGlu4a and mGlu5a expressed in mammalian cells. In
      Chinese hamster ovary (CHO) cells expressing human mGlu2 receptors, 500 microM
      (2S,4S)-ADA inhibited forskolin-stimulated cAMP accumulation by 33 +/- 3% while
      100 microM (1S,3R)-1-Aminocyclopentane-1,3-dicarboxylic acid induced an
      inhibition by 66 +/- 5%. The (2R,4R)-ADA enantiomer was inactive at human mGlu2
      receptors. In CHO cells expressing human mGlu4a receptors, 10 microM L-AP4
      inhibited forskolin-stimulated cAMP levels by 37 +/- 4% whereas both ADA
      enantiomers of trans-azetidine-2,4-dicarboxylic acid (500 microM) had no such
      effect. In CHO cells expressing human mGlu1b receptors and L cells expressing
      human mGlu5a receptors, both enantiomers, applied at 500 microM or 1 mM, were
      ineffective in stimulating inositolmonophosphate accumulation and did not affect
      quisqualate-stimulated inositolmonophosphate accumulation. We conclude that
      (2S,4S)-azetidine-2,4-dicarboxylic acid is a weak human mGlu2 receptor agonist
      and that (2R,4R)-azetidine-2,4-dicarboxylic acid is inactive at human mGlu2
      receptors. Trans-azetidine-2,4-dicarboxylic acid has no significant agonistic
      effect on human mGlu4a receptors and neither agonistic nor antagonistic effects
      on human mGlu1b and mGlu5a receptors.

PMID- 7774686
TI  - Activation of phospholipase C by G-protein beta gamma subunits in DDT1MF-2 cells.
AB  - Adenosine A1 receptors directly stimulate inositol phospholipid hydrolysis and
      Ca2+ mobilization through a pertussis toxin sensitive mechanism in DDT1MF-2
      cells. In the present study we have investigated whether G protein beta gamma
      subunits (G beta gamma) are capable of stimulating phospholipase C in DDT1MF-2
      cell membrane preparations using lipid vesicles containing
      [3H]phosphatidylinositol 4,5-bisphosphate. DDT1MF-2 cell membrane and soluble
      fractions were found to contain phospholipase C activity which was stimulated by
      increases in free Ca2+ ion concentration. G beta gamma purified from bovine
      retinal transducin produced significant increases in phospholipase C activity in
      DDT1MF-2 cell membranes. G beta gamma-dependent activation of phospholipase C,
      while virtually absent in the presence of low Ca2+ ion concentrations, increased
      markedly with increasing free Ca2+ ion concentration. These data suggest that
      membrane bound phospholipase C in DDT1MF-2 cells is sensitive to Ca2+, and may be
      stimulated conditionally by G beta gamma subunits, i.e. G beta gamma subunits
      activate the enzyme only in the presence of Ca2+. G beta gamma subunits also
      stimulated soluble phospholipase C in DDT1MF-2 cells. These findings support the
      hypothesis that Gi beta gamma subunits are involved in adenosine A1 receptor
      stimulated phospholipase C/Ca2+ signaling in DDT1MF-2 cells.

PMID- 7774687
TI  - Functional alpha 3-glycine receptors in rat adrenal.
AB  - The adrenal medulla contains high-affinity strychnine binding sites, presumed to
      be receptors for glycine. In this study, glycine injection (400 pmol) via a
      cannula attached to a microdialysis probe increased in vivo concentrations of
      catecholamines in the adrenal microdialysate in anesthetized rats. Strychnine
      perfusion (20 pmol/20 min) blocked these responses. To identify receptors
      potentially mediating this effect, we tested for RNA transcripts of the three
      known alpha subunits of strychnine binding site, using the reverse transcription
      polymerase chain reaction. Only mRNA encoding the alpha 3 isoform was found in
      the rat adrenal. The findings suggest that in the rat adrenal, glycine stimulates
      catecholamine release by binding to strychnine binding sites and that those sites
      probably contain the alpha 3 isoform.

PMID- 7774688
TI  - [An investigation of 4,125 cases of Kazak childhood strabismus and amblyopia].
AB  - An investigation was made on 4,125 Kazak pupils (aged from 4 to 14 years) with
      strabismus and amblyopia in 9 schools of 5 countries. Among the subjects
      examined, 48 cases (1.1%) were strabismus including 32 (66.67%) external and 16
      (33.33%) internal strabismus; 15 cases (31.25%) suffered from both strabismus and
      amblyopia and 33 (68.75%) were strabismus but had normal visual acuity; 139 cases
      (209 eyes) were amblyopia (morbidity rate: 3.37%) including 70 binocular and 69
      monocular amblyopia, 73 males and 66 females. Out of the 209 amblyopia eyes, 84
      (40.19%) were slight, 104 (49.76%) medium and 21 (10.05%) serious. Ametropia was
      also found to be in the majority in Kazak childhood amblyope. Only 106 of 209
      eyes were simple farsighted. To prevent the occurrence of amblyopia the writer
      suggests that efforts of finding and correcting ametropia at early stage should
      be made.

PMID- 7774690
TI  - [Primary epithelial lacrimal gland tumors: the pathologic classification of 272
      cases].
AB  - This paper reports the pathologic classification of 272 cases with primary
      epithelial lacrimal gland tumors in comparison with that of the salivary glands.
      The extensive series of lacrimal gland tumors accounts for 70% of the 390
      lacrimal fossa lesions and 18% of the 1,530 orbital tumors in one single
      hospital. Benign mixed tumors ranked the first (52%), adenocystic carcinomas the
      second (25%) and malignant mixed tumors (9%) the third. Among the other less
      common tumors the authors identified, for the first time, 3 polymorphous low
      grade adenocarcinomas, 2 spindle celled myoepitheliomas and 1 carcinosarcoma of
      the lacrimal gland. The diagnosis and differential diagnosis of polymorphous low
      grade adenocarcinoma and spindle cell myoepithelioma were discussed.

PMID- 7774689
TI  - [Observations on sensory heterotropia].
AB  - The authors analysed the records of 73 cases with sensory heterotropia, and
      discussed the correlation between the age of sensory obstacles in sensory
      heterotropia and the type of heterotropia, the restores of binocular vision after
      surgical correction and the reversion of eye position. The authors suggested that
      sensory heterotropia should be treated as early as possible so that binocular
      vision could be restored.

PMID- 7774691
TI  - [Eyelid reconstruction in primary position: a preliminary report of 30 cases].
AB  - We performed an operation of eyelid reconstruction in primary position on 30 eyes
      of eyelid defect caused by different reasons. Following up for 4-24 months, there
      was a good result on 28 cases (93.33%). Compared with the traditional methods,
      the method has the characteristics of simple technic and small tissue injury.

PMID- 7774694
TI  - [The observation of the bulbar conjunctival microcirculation in patients with
      retinitis pigmentosa].
AB  - The detection of the bulbar conjunctival microcirculation (BCM) of 73 cases (146
      eyes) with retinitis pigmentosa (RP) showed that there were some abnormal changes
      of BCM in the pathologic progress of RP. The older the patient, the longer the
      disease history and the more the loss of visual field, the more serious the
      abnormal changes of BCM. The disease in male patients was in general more serious
      than in female patients. Its characteristics were the followings: increase in the
      number of tortuous vessels; the different widths of vessels in a few cases;
      obvious increase of microangioma; abnormal proportion of artery to vein;
      decelerated blood flow and aggregated erythrocytes. Some abnormal changes in the
      nailfold microcirculation (left ring finger) were observed in the meantime, and
      compared with those in the BCM of 56 cases. It was found that they were
      positively interrelated (gamma's = 0.9965, P < 0.001).

PMID- 7774693
TI  - [Haemodynamic changes and clinic significance in primary pigmentary degeneration
      of retina].
AB  - In comparison with 40 healthy controls, the blood viscosity and erythrocystic
      agglutination index were predominantly higher in 44 cases with primary pigmentary
      degeneration. It is believed that the changes mentioned above may result in
      general and local circulatory disturbance, leading the tissue to ischeia, anoxia
      and a series of other pathological changes; and exacerbating the functional
      damage of retina. The author suggests that primary pigmentary degeneration of
      retina may be treated with the drugs which can lower the blood viscosity, the
      concentration of blood cholesterol and lipid, and increase blood-dynamics.

PMID- 7774692
TI  - [The complications of senile patients with diabetic retinopathy].
AB  - From December, 1990 to June, 1992, 114 patients with diabetic retinopathy were
      treated ambulatorally in our department. Among them 109 cases (42 males and 67
      females) were older than 45 years with 210 diseased eyes. 65 eyes suffered from
      simple diabetic retinopathy, 145 eyes proliferative one. The visual acuity of 105
      eyes (50%) was lower than 0.3, 65 eyes (30.95%) was lower than 0.05. 100 cases
      (91.74%) were complicated with cardiovascular diseases, 5 cases (4.5%) with
      cerebrovascular accident, 56 cases (51.40%) with hyperlipemia, 42 cases (61.76%)
      with high viscosity of the blood. Among the ophthalmic complications, macular
      disease occurred in 122 eyes, cataract in 88 eyes, central retinal vein
      obstruction in 15 eyes, neovascular glaucoma in 5 eyes.

PMID- 7774695
TI  - [Treatment with Western and Chinese medicine for retinal pigmentary
      degeneration].
AB  - The report presents 45 cases of retinal pigmentary degeneration treated by
      Western and Chinese medicine. Of them, 14 cases (31.11%) got significant
      therapeutical effectiveness; 18 cases (40%) favorite and 6 cases (13.33%) were
      improved. The general curative rate was 84.44%. After follow-up for 1 to 5 years,
      the vision and visual field in all the cases were improved to a certain extent.
      We used the dose of Chinese herbal medicine, the decoction of retinal pigmentary
      degeneration, in the treatment. The result showed it is a very beneficial method
      for retinal pigmentary degeneration.

PMID- 7774696
TI  - [Studies on MDA and MDA/MDAa in patients with retinitis pigmentosa].
AB  - With fluorimetry, the concentration of malondialdehyde (MDA) and the ratio of MDA
      before and after the blood platelets activated (MDA/MDAa) were determined in
      patients with retinitis pigmentosa (RP). The results showed the above two
      parameters were statistically higher than those of the normal controls, which
      indicated the superoxidation metabolism increased and the blood was in a state of
      hypercoagulation in RP patients. The reasons for the results and their roles in
      RP disease were discussed. Treatments with anti-lipid, and anti-coagulation drugs
      combined with Chinese medicines were suggested.

PMID- 7774697
TI  - [Argon laser photocoagulation in the treatment of central serous
      chorioretinopathy].
AB  - Thirty-six cases (41 eyes) with central serous chorioretinopathy were treated by
      using argon laser photocoagulation. The results showed that the number of eyes
      with vision equal to or more than 1.0 increased from 7 (17.1%) pre-laser to 26
      (63.4%) post-laser, while the number of eyes with vision less than 1.0 decreased
      from 25 (61%) pre-laser to 6 (14.6%) post-laser. The subretinal fluid was almost
      entirely absorbed from 1 week to 1 month after, and central fovea reflex could be
      seen in some cases. The results indicate that the vision prognosis is strongly
      related to the duration of the disease, but the direction of leakage to the
      fovea, the distance between the leakage and the fovea, and the dimension of
      sensory retina detachment are factors which weakly affect the post-laser vision.

PMID- 7774698
TI  - [The comparative study of pattern visual evoked potential in the normal infants
      and adults].
AB  - This paper presents the pattern visual evoked potential (PVEP) results and
      comparative study between the two groups of 65 normal infants at the age of 3, 6,
      9, 12 months and 18 normal adults. The different pattern spatial frequency
      stimulations (74', 25', 6') were given to the infants and adults. In the infant
      group, the latencies of P1 components of PVEP delayed significantly and
      amplitudes of PVEP decreased significantly between 74' and 6' spatial frequency
      with the spatial frequency of stimulation increasing. In the same spatial
      frequency stimulation, when 3 months infant group was compared with the 6, 9, 12
      months infant and adult groups, the latencies of N1 and P1 waves showed
      significant difference, but no difference was found in the amplitudes of P1 wave.
      Our results might indicate that the visual function expressed by low, medium, and
      high spatial frequency in infants from 6 to 12 months could reach the level in
      adults, and in 3 months infants, not maturely develop.

PMID- 7774699
TI  - [Study on soluble proteins in human fetal lens].
AB  - Soluble proteins from corter of human fetal clear lenses were separated by column
      chromatography with Sepharyl S-300 (superfine) and determined by disc-PAGE and
      SDS-PAGE. The results documented from 18W, 21W (2 cases) and 24W fetal lenses
      suggested that a negative correlation tended to be presented between the age of
      fetus and fraction of alpha, beta 1 crystallins (r = -0.9542; r = -0.9674) and a
      positive correlation between the age of fetus and fraction of beta 2, gamma
      crystallins (r = 0.9666; r = 0.9970). There was no change in the alpha, beta 1,
      beta 2 crystallins on disc-PAGE. Among the fetuses of different ages, the blurred
      band of gamma crystallin seen in 18W and 21W fetal lenses was thickened in the
      24W fetal lens. The SDS-PAGE showed that there was no significant difference
      among the polypeptides in each of alpha, beta 1, beta 2, gamma crystallins in the
      studied fetal lenses of different age groups. It is presumed that the normal lens
      is proportionally composed of four fractions of crystallin. This is
      hypothetically contributed to the maintenance of normal structure of the lens,
      why the proper proportion of four fractions of crystallins is depended either on
      proteins synthesis or on protein molecular assembly is not yet clear.

PMID- 7774700
TI  - [Bacteriological detection of anterior chamber aspirate after extracapsular
      cataract extraction with intraocular lens implantation].
AB  - We cultured the anterior chamber aspirates of 83 patients with extracapsular
      cataract extraction and IOL implantation. Of the 83 cases, 5 (6.1%) had positive
      aspirates including 3 cases of staphylococcus epidermidis and 2 cases of
      staphylococcus aureus. No eye in our study developed bacterial endophthalmitis.
      Our study suggests that the anterior chamber of human eyes is capable of clearing
      a low inoculum of bacteria after cataract surgery without the development of
      bacterial endophthalmitis.

PMID- 7774701
TI  - [Penetrating keratoplasty for bullous keratopathy].
AB  - A retrospective review for bullous keratopathy in our hospital from 1985 to 1992
      was studies. Among the cases with bullous keratopathy, 14 were performed with
      antiglaucoma operation and cataract extraction, 12 that experienced a contusion
      or penetrating trauma history underwent cataract operation. IOL implantation seen
      in 3 patients, 4 cases were associated with vitreous contact to cornea after
      cataract extraction, the other 4 cases had advanced glaucoma. Besides, there were
      1 case of Fuch's endothelium dystrophy, ICE syndrome and severe herpes simplex
      keratitis, respectively. The preoperation visual acuity of them was all less than
      finger count. The follow-up was 3 months to 5 years. The results showed the
      grafts of 28 cases (70%) were clear, 7 cases (17.5%) semi-clear, 5 cases (12.5%)
      opaque. Postoperatively, all of the patients escaped from the pain and 22 cases
      achieved a visual acuity of 0.02-0.7. Some good advice in treatment of bullous
      keratopathy were proposed.

PMID- 7774702
TI  - [Herpes zoster keratoendotheliitis].
AB  - Herpes zoster keratoendotheliitis is related to autoimmunity or herpes zoster
      virus infection. It is characterised by K.P. and interstitial edema. The disease
      responds well to the administration of steroids and a good result is often
      achieved.

PMID- 7774703
TI  - [The clinical observation of China-made ofloxacin eye drops in the treatment of
      bacterial infection of the external eye].
AB  - Ninety patients with extraocular infection were observed. After bacteriological
      examination on all of the patients, we found that staphylococcus epidermidis was
      the main pathogen and accounted for 43.3%. Next to it were staphylococcus aureus
      (31.1%), saprophytic staphylococcus was (5.6%), diplococcus catarrhus (3.3%) and
      moraxella sp. (2.2%). All the patients were treated with Ofloxacin eye drops
      produced in Guangzhou. The bacteriological examination showed negative in 98.9%
      of the patients, which proved this medicine has high antibiotic power.

PMID- 7774704
TI  - [Etiology of blindness in remote area: a clinic report].
AB  - This paper analyzes the cause for blindness in 408 patients of Xinfeng People's
      Hospital from 1977 to 1991. The results show that cataract is the major cause for
      blindness (32.84%). The others are eye injury in patients below age 46, cataract
      and glaucoma in patients above age 46. It is suggested that the stress of
      prevention and treatment for blindness should be put on the prevention of eye
      injury in juveniles and middle aged people, and the treatment for senile cataract
      in remote mountain areas.

PMID- 7774705
TI  - The voltage-gated Ca2+ release channel in the vacuolar membrane of sugar beet
      resides in two activity states.
AB  - The voltage-gated Ca2+ release channel in the vacuolar membrane of sugar beet tap
      roots resides in two states which show similar reversal potentials in biionic
      conditions but differ dramatically in their single channel current and open
      frequency. State I has a unitary Ca2+ conductance of 3.9 +/- 0.5 pS and channel
      openings are rare at vacuolar resting potentials. After spontaneous and
      reversible transition into State II the unitary Ca2+ conductance increases three
      fold, accompanied by a concomitant rise in channel activity over the
      physiological voltage range. The 15- to 19-fold increase in total Ca2+ current
      after the State I to State II transition could play an essential role in channel
      activation during signal transduction.

PMID- 7774706
TI  - Differential regulation of G protein alpha-subunit GTPase activity by peptides
      derived from the third cytoplasmic loop of the alpha 2-adrenergic receptor.
AB  - The effect of peptides homologous to segments of a G protein-coupled receptor on
      the GTPase activity of recombinant Go alpha (rGo alpha) and Gs alpha (rGs alpha)
      has been tested. These peptides contain overlapping sequences spanning from amino
      acid 212 of the putative fifth transmembrane domain to amino acid 229 of the
      third cytoplasmic loop of the alpha 2 adrenergic receptor. Interestingly, two
      peptides (comprising residues 212-227 and 214-227) strongly inhibit the basal
      GTPase activity of both rGo alpha and rGs alpha. Instead, a C-terminally extended
      peptide (residues 216-229) stimulates rGo alpha but slightly inhibits rGs alpha.
      Circular dichroism spectroscopy of the peptides reveals that an a helical
      structure is more easily inducible in the inhibitory ones. These findings
      constitute an example of peptides representing cytoplasmic receptor sequences
      that differentially modulate the GTPase activity of recombinant G protein alpha
      subunits.

PMID- 7774707
TI  - Amiloride and harmaline are potent inhibitors of NhaB, a Na+/H+ antiporter from
      Escherichia coli.
AB  - The diuretic drug amiloride is a specific inhibitor of sodium transporting
      proteins in several cell types. Attempts to inhibit this activity in membrane
      vesicles derived from various bacteria, did not yield clear results. Therefore,
      we tested the effect of amiloride and its derivatives on the purified Na+/H+
      antiporters of E. coli reconstituted in functional form in proteoliposomes.
      Whereas NhaA is not inhibited by amiloride, both amiloride and harmaline are
      potent inhibitors of NhaB with K0.5 of 6 and 15 microM, respectively. The pattern
      of inhibition by amiloride derivatives is different from that reported for
      mammalian antiporters but similar to that reported for the Na+/H+ antiporter of
      D. salina [Katz, A., Kleyman, T.R. and Pick, U. (1994) Biochemistry 33, 2389
      2393]. Clonidine is a poor inhibitor (K0.5 = 200 microM) while cimetidine had no
      effect on the antiporter up to concentration of 1 mM. These new potent inhibitors
      provide us with important tools for the study of the mechanism of action of NhaB.

PMID- 7774708
TI  - Lutein associated with a transthyretin indicates carotenoid derivation and novel
      multiplicity of transthyretin ligands.
AB  - Transthyretins isolated from different species bind hydrophobic compounds and are
      often obtained in a yellow form. Such a transthyretin from chicken serum was
      purified by chromatography using Sepharose-coupled human retinol-binding protein.
      The yellow chromophore was extracted with methanol and purified by reverse phase
      HPLC followed by normal-phase chromatography on a nitrile column. Ultraviolet
      visible absorbance and mass spectrometry identified the yellow compound as
      lutein, i.e. xanthophyll, (all-trans)-beta, epsilon-carotene-3,3'-diol, estimated
      to constitute 10-30% of associated colourless compounds. These components are
      different from the yellow component isolated from human transthyretin and
      establish that carotenoid-derived pigments can be associated with transthyretins.

PMID- 7774709
TI  - Phospholipid membrane permeability of peptide nucleic acid.
AB  - Phospholipid vesicles (liposomes) as membrane models have been used to study the
      penetration properties of peptide nucleic acid (PNA), a new DNA analog in which
      the nucleobases are attached to a pseudo-peptide backbone. The liposomes were
      characterised by carboxyfluorescein efflux, light-scattering and cryogenic
      transmission electron microscopy. The liposome structure was found not to be
      affected by the incorporation of PNA or an oligonucleotide. Two 10-mer
      fluorescein-labelled PNAs were found to have low efflux rates (half-times of 5.5
      and 11 days), comparable to a 10-mer oligonucleotide (half-time of 7 days). We
      conclude that passive diffusion of unmodified PNA is not an effective way of
      transport into biological cells.

PMID- 7774710
TI  - Two molecules of cytochrome c function as the electron donors to P840 in the
      reaction center complex isolated from a green sulfur bacterium, Chlorobium
      tepidum.
AB  - A photoactive reaction center complex was isolated from a thermophilic green
      sulfur bacterium, Chlorobium tepidum under anaerobic conditions. The electron
      transfer occurred from heme c to the photo-oxidized reaction center chlorophyll,
      P840+, with a half time (t1/2) of 110 or 340 microseconds at 24 or 12 degrees C,
      respectively. Optical measurements under multiflash excitations indicated that
      two hemes function as the immediate electron donors to P840+. SDS-PAGE analysis
      of the RC complex in combination with the N-terminal amino acid sequence analyses
      revealed five subunit bands; a core protein (65 kDa), the light harvesting
      bacteriochlorophyll alpha protein (41 kDa), a protein with 2[4Fe-4S] clusters (31
      kDa), monoheme cytochrome c (22 kDa), and a 18-kDa protein whose function is
      unknown. The reaction center complex, thus, contains two molecules of cytochrome
      c per P840.

PMID- 7774712
TI  - Stimulation of MAP kinase by v-raf transformation of fibroblasts fails to induce
      hyperphosphorylation of transfected tau.
AB  - A proportion of the microtubule-associated protein, tau, is in an elevated state
      of phosphorylation in foetal and adult brain whereas all of the tau in paired
      helical filaments, which are characteristic of Alzheimer's disease is
      hyperphosphorylated; it is important therefore to elucidate the mechanisms that
      regulate tau phosphorylation. Here we describe results that show that although
      MAP kinase can hyperphosphorylate tau in vitro, activation of MAP kinase in
      transformed fibroblasts does not result in hyperphosphorylation of transfected
      tau, whereas glycogen synthase kinase-3 beta (GSK-3 beta) when co-transfected
      with tau does result in tau hyperphosphorylation. The findings imply that GSK-3
      beta may be a stronger candidate than MAP kinase for inducing tau
      hyperphosphorylation in vivo.

PMID- 7774711
TI  - Complete 13C assignments for recombinant Cu(I) rusticyanin. Prediction of
      secondary structure from patterns of chemical shifts.
AB  - Complete resonance assignments for the 13C spectrum of reduced (Cu(I))
      rusticyanin have been made using 13C, 15N doubly labeled recombinant material.
      The reported assignments include those for the carboxyl and carbonyl carbon atoms
      and protonated aromatic ring carbons, and were obtained using a variety of 2- and
      3D inverse-detected NMR experiments, including 13C, 15N, 1H triple resonance
      experiments and HCCH-COSY and -TOCSY. Backbone carbonyl assignments were obtained
      using 3D HNCO and HCACO spectra, and modified versions of 2D H(CA)CO and HMBC
      spectra were used to obtain side-chain carboxyl carbon and methionine epsilon
      methyl carbon assignments, respectively. A comparison of the 13C alpha, 13C beta
      and 13CO chemical shifts with published 'random coil' values confirms the
      conclusion reached from a consideration of the 3JHN alpha coupling constants and
      the pattern of sequential NOEs, that the protein consists largely of beta
      structure.

PMID- 7774713
TI  - The amino acid sequence of eukaryotic translation initiation factor 1 and its
      similarity to yeast initiation factor SUI1.
AB  - Eukaryotic initiation factor eIF-1 was purified from rabbit reticulocytes. Amino
      acid sequence analysis revealed that the protein contained a blocked amino
      terminus. After cleavage with the endoproteinase Asp-N, three peptides were
      sequenced. The obtained partial sequences were identical to sequences of
      SUI1ISO1, the human homologue of the yeast translation initiation factor SUI1.
      The SUI1 gene product was identified as a protein involved in the recognition of
      the protein synthesis initiation codon. A similar mode of action has been
      suggested for eIF-1.

PMID- 7774714
TI  - Cell adhesion activity of the short cytoplasmic domain isoform of C-CAM (C-CAM2)
      in CHO cells.
AB  - C-CAM is a Ca(2+)-independent rat cell adhesion molecule belonging to the CEA
      gene family of the immunoglobulin superfamily. Two major isoforms that differ in
      the length of their cytoplasmic domains exist. In previous studies it has been
      reported that only the long isoform (C-CAM1) but not the short isoform (C-CAM2)
      can mediate adhesion. However, in the mouse, isoforms with both long and short
      cytoplasmic domains have been reported to have adhesive activity. In order to
      analyze this apparent conflict we transfected C-CAM1 or C-CAM2 into CHO Pro5
      cells and examined their adhesive phenotype in an aggregation assay. We found
      that in this cellular system both C-CAM1 and C-CAM2 could mediate cell-cell
      adhesion in a Ca(2+)-independent and temperature-independent way. The results
      suggest that the cellular environment is important for the activity of C-CAM
      isoforms.

PMID- 7774715
TI  - Structural determination of two N-linked glycans isolated from recombinant human
      lactoferrin expressed in BHK cells.
AB  - A full-length cDNA coding for human lactoferrin was isolated from a mammary gland
      library and the recombinant protein was expressed in BHK cells as described by
      Stowell K. M. et al. [1991, Biochem. J. 276, 349-355]. Two N-linked glycans from
      purified recombinant lactoferrin were released by hydrazinolysis and analyzed by
      400-MHz 1H-NMR spectroscopy. The identified structures corresponded to N
      acetyllactosaminic biantennary glycans and were alpha-2,3-disialylated forms
      (80%) or alpha-2,3-monosialylated (20%) forms. Moreover, 70% of total glycans
      were alpha-1,6-fucosylated at the GlcNAc residue linked to asparagine. In regard
      to its glycan moiety, the recombinant glycoprotein is close to native
      lactoferrins from milk or leucocytes but shows specific structural features which
      should be taken into account prior to in vivo and in vitro biological studies.

PMID- 7774716
TI  - Regulation of the human spermidine synthase mRNA translation by its 5'
      untranslated region.
AB  - An increased mRNA content of spermidine synthase was found in phytohemagglutinin
      stimulated human peripheral lymphocytes and in cultured human myeloma (Sultan)
      cells stimulated to grow by change of the culture medium. The many-fold increase
      in the amount of the message was accompanied by stimulation of the enzyme
      activity in activated lymphocytes, but not in stimulated myeloma cells. In the
      present study the effect of the 5'-untranslated region of spermidine synthase
      mRNA on the post-transcriptional control of its expression was studied both in
      vitro in rabbit reticulocyte system and in cultured mammalian cells. The results
      show that the GC-rich 5'-untranslated region of spermidine synthase mRNA has an
      inhibitory effect on its translation.

PMID- 7774717
TI  - Lipid hydroperoxide-induced apoptosis: lack of inhibition by Bcl-2 over
      expression.
AB  - Increased membrane lipid peroxidation has recently been implicated as being
      associated with apoptosis. In the present study the addition of 15
      hydroperoxyeicosatetraenoic acid (15-HPETE) or 13-hydroperoxydodecadienoic acid
      (13-HPODE) to A3.01 T cells is shown to induce marked chromatin condensation
      coincident with DNA fragmentation, indicative of apoptosis. 15-HPETE also evoked
      an immediate and sustained rise in cytoplasmic calcium which was required for the
      induction of apoptosis. A3.01 cells transfected with the bcl-2 proto-oncogene
      were 6- to 8-fold more resistant to apoptotic killing by tumor necrosis factor
      alpha, but only 0.4-fold more resistant to 15-HPETE. Thus, Bcl-2 is not capable
      of protecting cells from undergoing apoptosis following the direct addition of
      lipid hydroperoxides.

PMID- 7774718
TI  - Effect of 6-ketocholestanol on FCCP- and DNP-induced uncoupling in plant
      mitochondria.
AB  - Effect of 6-ketocholestanol on FCCP-induced and DNP-induced uncoupling in beef
      liver and pea stem mitochondria was studied, under experimental conditions at
      which this steroid abolished the effect of low concentrations of FCCP and other
      most potent uncouplers in rat mitochondria [Starkov et al. (1994) FEBS Lett.,
      355, 305-308]. It is shown that, in both types of mitochondria, 6-ketocholestanol
      prevents or reverses the uncoupling induced by low concentrations of FCCP, but
      not that caused by high concentrations of FCCP or by any concentration of DNP.
      Progesterone and male sex hormones, showing recoupling capability in animal
      mitochondria, appear to be ineffective in the plant system. Cholesterol does not
      recouple in both animal and plant mitochondria. Plant steroids, such as beta
      sitosterol and stigmasterol, are also without effect.

PMID- 7774719
TI  - Homologues of the engrailed gene from five molluscan classes.
AB  - We used the polymerase chain reaction (PCR) to amplify, clone, and sequence 10
      engrailed homeodomains from 8 species in the five major molluscan classes,
      including the serially organized chiton (Polyplacophora) lineage. The Drosophila
      melanogaster gene engrailed (en) is one of several genes involved in embryonic
      segment polarity determination. Studies of engrailed sequence and expression in
      molluscs are of interest due to questions regarding the evolution and homology of
      segmentation in these taxa. Nucleotide and deduced amino acid sequence
      comparisons reflect evolutionary conservation within helices of the en
      homeodomain and ancient divergences in the region 3' to the homeodomain.

PMID- 7774721
TI  - Wild type and constitutively activated forms of the Drosophila Toll receptor have
      different patterns of N-linked glycosylation.
AB  - Toll is a Drosophila membrane protein related in sequence to the mammalian
      platelet glycoprotein 1B and to the interleukin-1 receptor. It mediates a signal
      transduction pathway leading to the development of dorsoventral polarity in the
      Drosophila embryo. In this paper we show that a constitutively activated mutant
      receptor, Toll10B, is processed into a distinct isoform of slower electrophoretic
      mobility when compared with the wild type molecule in both cell lines and the
      embryo. The wild type protein can also be processed into this form if over
      expressed but in the embryo is present as the smaller species. We show that the
      decrease in the mobility of Toll10B and over-expressed wild type receptors is
      caused by altered patterns of N-linked glycosylation and that both forms are
      secreted to the cell surface. On the basis of these results, we propose that the
      Toll10B receptor is unable to associate with a limiting co-factor which when
      bound directly or indirectly masks supplementary N-linked glycosylation sites.

PMID- 7774720
TI  - Conversion of the sodium channel activator aconitine into a potent alpha 7
      selective nicotinic ligand.
AB  - Methyllycaconitine (MLA) is a competitive antagonist of nicotinic acetylcholine
      receptors, with a remarkable preference for neuronal [125I]alpha Bgt binding
      sites. We have begun to investigate the structural basis of its potency and
      subtype selectivity. MLA is a substituted norditerpenoid alkaloid linked to a 2
      (methylsuccinimido)benzoyl moiety. Hydrolysis of the ester bond in MLA to produce
      lycoctonine diminished affinity for rat brain [125I]alpha Bgt binding sites 2500
      fold and abolished affinity for [3H]nicotine and muscle [125I]alpha Bgt binding
      sites. The voltage-gated Na+ channel activator aconitine, also a norditerpenoid
      alkaloid, but with significant structural differences from lycoctonine, displayed
      comparable weak or absent nicotinic activity. Addition of a 2
      (methylsuccinimido)benzoyl sidechain to O-demethylated aconitine, to mimic MLA,
      abolished Na+ channel activation and conferred nanomolar affinity for brain
      [125I]alpha Bgt binding sites, comparable to that of MLA. We propose that the
      ester-linked 2-(methylsuccinimido)benzoyl group is necessary for nicotinic
      potency, but alpha 7 selectivity resides in the norditerpenoid core of the
      molecule.

PMID- 7774722
TI  - Interferon receptor recognition peptides enhance the biological potency of
      interferon alphas.
AB  - Based on our earlier studies that defined three strategic regions in the Type 1
      interferon (IFN) molecule associated with receptor interactions and biological
      activity, three IFN receptor recognition peptides (IRRP) were synthesized, with
      amino acid sequences CLKDRHD (IRRP1), ESLLEKFYTELYQQLND (IRRP2) and
      YFQRITLYLTEKKYSPCA (IRRP3) and examined for biological effectiveness. In cell
      surface receptor binding studies, the binding capacity of cells for IFN-alpha s
      was increased in the presence of the IRRPs. Increased receptor occupancy resulted
      in increased phosphorylation-activation of the transcription factor ISGF3 and
      enhanced antiviral activity. The potentiating effect on IFN-induced growth
      inhibition was less marked. These data suggest that the IRRPs may influence the
      biological potency of IFN-alpha by facilitating accessibility to cell surface
      receptor components. The IRRPs may function to increase the number of low
      affinity receptor-ligand interactions necessary to initiate receptor
      oligomerization, thereby catalysing the formation of high affinity IFN-receptor
      complexes.

PMID- 7774723
TI  - Introduction of a CuA site into the blue copper protein amicyanin from
      Thiobacillus versutus.
AB  - The C-terminal loop of the blue copper protein amicyanin, which contains three of
      the four active site ligands, has been replaced with a CuA binding loop. The
      purple protein produced has visible and EPR spectra identical to those of a CuA
      centre. Recent evidence strongly suggests that the CuA centre of cytochrome c
      oxidase and the A centre of nitrous oxide reductase are similar and are both
      binuclear. It therefore follows that the purple amicyanin mutant created here
      also possesses a binuclear CuA centre.

PMID- 7774724
TI  - Furin is important but not essential for the proteolytic maturation of gp160 of
      HIV-1.
AB  - The envelope glycoproteins of HIV are required for viral infectivity. Proteolysis
      of the precursor envelope glycoprotein gp160 results in the formation of gp120
      and gp41. Cleavage occurs after the sequence Arg-Glu-Lys-Arg. This sequence is
      expected to be a substrate for the cellular protease furin. We examined whether
      furin is responsible for cleavage of gp160 by using a furin-deficient CHO cell
      line and the same cell line transfected with furin cDNA. Data obtained from viral
      transmission assays suggested that furin increased viral infectivity but was not
      essential for the maturation of gp160, implying that other proprotein processing
      enzymes also recognize this putative furin cleavage site.

PMID- 7774725
TI  - Amylin and epinephrine have no direct effect on glucose transport in isolated rat
      soleus muscle.
AB  - Amylin and epinephrine did not significantly affect insulin stimulated, or basal,
      3-O-methylglucose transport in isolated rat soleus muscle, as measured by the
      release of 3-O-methylglucose from pre-loaded tissue. Both amylin and epinephrine
      inhibited insulin-stimulated 2-deoxyglucose uptake (by 25% and 38%, respectively)
      in soleus muscle from fed rats but not from fasted rats. The latter results are
      consistent with amylin and epinephrine stimulating glycogenolysis and inhibiting
      hexokinase activity by intracellular accumulation of glucose 6-phosphate. We
      conclude that amylin, like epinephrine, does not specifically inhibit glucose
      transporters in skeletal muscle.

PMID- 7774726
TI  - Estimates of early twentieth-century U.S. homicide rates: an econometric
      forecasting approach.
AB  - Bureau of the Census death registration records, as reported in Mortality
      Statistics, are a primary source for early twentieth-century U.S. homicide
      statistics. Those data appear to show a massive rise in homicide during the first
      decade of the century, with a continuing increase through 1933. This increase is
      quite at variance with the trend away from violence in other industrialized
      societies. During the first one-third of the century, however, death registration
      was incomplete; it occurred only in an expanding "registration area" that was
      composed, in the earlier years, primarily of states with typically low rates of
      homicide. Further, in the first decade of the century homicides within the
      registration area often were reported as accidental deaths. As a result, apparent
      increases in rates of homicide in the United States between 1900 and 1933 may be
      illusory. I use a two-step process to address these problems. Drawing on internal
      evidence and commentaries in early volumes of Mortality Statistics, I use GLS
      regression to estimate the prevalence of undercounts. Then I create a series of
      GLS models that use registration area data to estimate early twentieth-century
      national rates. These estimates call into question the extent of homicide change
      early in the century.

PMID- 7774727
TI  - Binary outcomes and endogenous explanatory variables: tests and solutions with an
      application to the demand for contraceptive use in Tunisia.
AB  - Many demographic studies examine discrete outcomes, and researchers often suspect
      that some of the explanatory variables may be influenced by the same unobserved
      factors that determine the discrete outcome under examination. In linear models,
      the standard solution to this potential endogeneity bias is an estimator such as
      two-stage least squares. These methods have been extended to models with limited
      dependent variables, but there is little information on the performance of the
      methods in the types of data sets typically used in demographic research. This
      paper helps to fill this gap. It describes a simple analytic framework for
      estimating the effects of explanatory variables on discrete outcomes, which
      controls for the potential endogeneity of explanatory variables. It also
      discusses tests for exogeneity and joint determination of the outcomes and the
      explanatory variables. It summarizes the results of a Monte Carlo study of the
      performance of these techniques and uses these results to suggest how researchers
      should approach these problems in practice. We apply these methods to the
      examination of the impact of fertility intentions on contraceptive use, based on
      data from the 1988 Tunisia Demographic and Health Survey.

PMID- 7774728
TI  - Echoes of the baby boom and bust: recent and prospective changes in living alone
      among elderly widows in the United States.
AB  - Today the great majority of noninstitutionalized elderly widows live alone, a
      striking increase from a quarter-century ago. A noticeable difference has
      occurred, however, in trends by age; the proportion of the young-old widows
      living alone is starting to decline, while that of the old-old continues to
      increase. We use a model suggested by earlier studies to explain the emergence of
      this difference, and assess the prospects of its continuing over the next three
      decades. We find that the recent differential change in the proportions of
      younger and older widows living alone is due primarily to a differential change
      in kin availability that has emerged as the baby boomers' parents have begun to
      reach retirement age. Over the next decade, the same type of differential change
      by age in kin availability will continue; living alone is likely to become less
      common among young-old than among old-old widows, in a reversal of the pattern of
      the last quarter-century. In the first two decades of the next century, as the
      baby boom affects kin availability among the old-old, and as the subsequent baby
      bust affects that among the young-old, the age pattern of living arrangements
      among elderly widows will reverse once again.

PMID- 7774729
TI  - Stability and change in temporal distance between the elderly and their children.
AB  - Drawing on a developmental model of late-life migration, this paper investigates
      how older people's health and social characteristics influence stability and
      change in their temporal distance from their children. Data from the Longitudinal
      Study of Aging are used to examine both discrete transitions and continuous
      change in distance over a four-year period. Decline in older parents' physical
      health increased the propensity of parents and children to become temporally
      closer to each other. Among those parent-child pairs who had become closer, the
      conjunction of declining health and widowhood increased both the degree of non
      coresident proximity and the likelihood of transition to coresidence. The
      findings portray a geographically resilient family that adjusts to the changing
      needs of its older members.

PMID- 7774730
TI  - The influence of nonmarital childbearing on the formation of first marriages.
AB  - We document a negative association between nonmarital childbearing and the
      subsequent likelihood of first marriage in the United States, controlling for a
      variety of potentially confounding influences. Nonmarital childbearing does not
      appear to be driven by low expectations of future marriage. Rather, it tends to
      be an unexpected and unwanted event, whose effects on a woman's subsequent
      likelihood of first marriage are negative on balance. We find that women who bear
      a child outside marriage and who receive welfare have a particularly low
      probability of marrying subsequently, although there is no evidence that AFDC
      recipients have lower expectations of marriage. In addition, we find no evidence
      that stigma associated with nonmarital childbearing plays an important role in
      this process or that the demands of children significantly reduce unmarried
      mothers' time for marriage market activities.

PMID- 7774731
TI  - The impact of "parent care" on female labor supply decisions.
AB  - Data from the 1986-1988 Survey of Income and Program Participation panels were
      used to analyze how informal caregiving of disabled elderly parents affected
      female labor supply. Instrumental variables analyses suggested that coresidence
      with a disabled parent leads to a large, significant reduction in work hours, due
      primarily to withdrawal from the labor force. Although the impact of nonhousehold
      member caregiving was insignificant, evidence of an effect was stronger when
      commitment of caregiving time was greater. Projections of female labor force
      participation rates should account for potential increases in caregiving demand
      due to the aging of the U.S. population.

PMID- 7774732
TI  - Measuring fertility demand.
AB  - We propose a multidimensional conceptualization of fertility demand and evaluate
      potential measures of each dimension, using data from a telephone survey of
      Wisconsin residents age 18-34. Most of the measures met tests for interval-level
      measurement; all produced high estimates of test-retest reliability. We found
      support for only two dimensions of demand, intensity and certainty; potential
      measures of centrality had relatively low associations with any of the latent
      dimensions. Demand certainty improved prediction of fertility expectations beyond
      a trichotomous (yes, no, don't know) measure, but demand intensity did not. We
      found mixed evidence for the conceptualization of fertility demand as a single
      continuum on which desire to avoid pregnancy is the opposite of desire to have a
      child.

PMID- 7774733
TI  - Redefining single-parent families: cohabitation and changing family reality.
AB  - This paper explores the implications, for the measured prevalence and duration of
      mother-only families, of marked changes in nonmarital fertility, unmarried
      cohabitation, and homeleaving and re-entry. Throughout, estimates are compared on
      the basis of marital definitions and definitions including cohabitation. The
      duration of the first single-parent spell appears to have increased under the
      marital definition, but declines substantially when cohabitations are taken into
      account. A substantial proportion of single mothers have spent some time as
      single parents while in their parents' household. Hence we argue that definitions
      of single-parent families must be based on living arrangements rather than on the
      parents' marital status.

PMID- 7774734
TI  - Adolescent gynecology and obstetrics.
AB  - Adolescent gynecology is a subspeciality of obstetrics and gynecology and not
      broadly known. It deals with many gynecological and obstetrical problems which
      may be seen during adolescence. The International Federation of Pediatric and
      Adolescent Gynecology is a branch of FIGO and promotes research and teaching
      programs on pediatric and adolescent gynecology. Health care professionals should
      address sex education programs providing accurate information to young people on
      sexual matters. Prevention of gynecological diseases, undesired pregnancies and
      sexually transmitted diseases are the goals of physicians working in adolescent
      gynecology.

PMID- 7774735
TI  - A randomized prospective trial comparing single dose prostaglandin E2 vaginal gel
      with forewater amniotomy for induction of labour.
AB  - A prospective randomized parallel-group study was carried out to compare the
      efficacy of a single dose vaginal prostaglandin E2 gel with forewater amniotomy
      for induction of labour at term in 260 parturients (110 primigravid and 150
      parous women) with low risk pregnancy and favourable cervix. In the prostaglandin
      E2 (PGE2) managed group, the primigravidae were treated with 2 mg PGE2 gel and
      parous patients with 1 mg PGE2 gel. Forewater amniotomy was performed 4 h later,
      or sooner if women requested analgesia. In the amniotomy group, artificial
      forewater amniotomy was carried out and a repeat cervical assessment done 4 h
      later, or sooner if women requested analgesia. In both groups, intravenous
      oxytocin was established if there was evidence of disordered uterine activity, 6
      h after the start of initial intervention. An assessment of consumers' views was
      carried out by using a standardized questionnaire completed 48 h after delivery.
      There was a significant reduction in the requirement for oxytocin augmentation in
      women treated with PGE2: primigravidae, odds ratio (OR), 0.27 and 95% confidence
      interval (CI), 0.12-0.61; multiparae, OR, 0.19 and 95% CI, 0.08-0.45. Fewer
      primigravidae managed with PGE2 gel required epidural analgesia (OR, 0.16; 95%
      CI, 0.06-1.00). Fewer parous women managed with PGE2 gel required parenteral
      opiates (OR, 0.44; 95% CI, 0.23-0.85) and more women required inhalation
      analgesia or no analgesia (OR, 2.22; 95% CI, 1.76-2.79). The intervention to
      delivery intervals were shortened in PGE2 groups independent of parity but the
      differences were not significant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7774737
TI  - Amniocentesis before 15 weeks' gestation: technical aspects and obstetric risks.
AB  - In a prospective case-control study, early amniocenteses (EAC, n = 242) at
      between 12 and 14 weeks gestation, were compared with standard amniocenteses
      (SAC, n = 242) performed at between 15 and 24 weeks gestation. The medical
      records of these 484 cases were reviewed for indications, success rate, color and
      volume of amniotic fluid, gestational age, number of needle insertions, location
      of the placenta, culture failure rate, obstetric complications and therapeutic
      abortion rate. There were no significant differences between the two groups in
      success rate, in culture success rate or in the outcome of the pregnancies. The
      volume of the sample taken was smaller in the EAC patients (P < 0.001), and
      therapeutic abortions were performed significantly earlier (P < 0.02.) Results
      show that EAC is feasible from 11 weeks' gestation, and can be performed for the
      usual indications as an alternative to chorionic villus sampling. In the near
      future, cytogenetic techniques will enable results to be obtained in less than a
      week.

PMID- 7774736
TI  - Induction of labour at term in primigravidae with low Bishop's score: a
      comparison of three methods.
AB  - OBJECTIVE: To determine which of three methods of induction of labour at term in
      primigravidae with a low Bishop's score is effective and safe. DESIGN: Random
      allocation to Prostin E2 and amniotomy later (Group A); low amniotomy and
      oxytocin titration (Group B); and intra-cervical Foley balloon overnight followed
      next morning by low amniotomy and oxytocin titration (Group C). SUBJECTS AND
      SETTING: Primigravidae (n = 90) in the University Hospitals, Benin City, Nigeria.
      MAIN OUTCOME MEASURE: (i) Time taken to achieve 3 uterine contractions in 10 min;
      (ii) induction-delivery interval. RESULTS: The mean time interval between
      intervention and regular uterine contractions was shortest in Group C (A vs. C, P
      < 0.02; A vs. B, P < 0.02). The mean induction-delivery interval was shortest in
      Group C (11.1 h) followed by Group B (13.9 h) and Group C (17.9 h) P < 0.05
      0.001. CONCLUSION: The induction-delivery interval was shortest when using a
      Foley catheter for cervical ripening followed by amniotomy and oxytocin
      titration.

PMID- 7774739
TI  - Obstetric and perinatal outcome in human immunodeficiency virus-infected pregnant
      women with and without opiate addiction.
AB  - This study was undertaken to assess the impact on gestation played by the simple
      human immunodeficiency virus (HIV)-seropositive status either alone or
      complicated by opiate abuse in the absence of other confounding variables. To
      this purpose the main obstetric complications and the perinatal outcome were
      prospectively evaluated in 38 simple HIV-infected women, 14 of whom were simple
      carriers and 24 under methadone treatment, and in 76 uninfected women, 16 of whom
      were methadone users and 60 controls. In simple HIV-carriers maternal weight gain
      (P < 0.001) and both 1- and 5-min Apgar scores (P < 0.005) were reduced whereas
      the incidence of miscarriage was increased (P < 0.05). Worse obstetric and
      perinatal outcomes were found in HIV-seropositive drug addicts, in which
      gestational length (P < 0.001), maternal weight gain (P < 0.001) and Apgar scores
      were lower (P < 0.005 and P < 0.001, respectively) and the rate of preterm
      labour, small for gestational age newborns, vaginal and urinary infections as
      well as of unexplained fever (P < 0.05) was higher. Outcomes were similar in HIV
      seropositive and seronegative drug addicts and in both groups a positive
      correlation (r = 0.62 P < 0.001, and r = 0.44, respectively) was found between
      the number of infectious episodes throughout pregnancy and the mean dose of
      opiate consumed daily. Our results suggest that HIV-seropositive condition might
      exert slight direct and indirect detrimental effects on pregnancy. Whatever the
      maternal serologic status, opiate intake not only causes a further worsening of
      gestational and perinatal outcomes, but also increases the susceptibility towards
      pathogens.

PMID- 7774738
TI  - Perinatal mortality in home births in rural Tanzania.
AB  - OBJECTIVE: To compare perinatal mortality, stratified for risk level, in home
      births attended by a relative or traditional birth attendant without formal
      training with births attended by trained personnel in a dispensary or hospital.
      STUDY DESIGN: A prospective community based study in five villages in
      Northwestern Tanzania during 1990, involving 222 women delivering at home and 199
      in a dispensary or hospital. RESULTS: Twenty-two of the 29 (76%) perinatal deaths
      occurred in home births. Perinatal mortality, stratified for risk level, was
      three times higher in home births than it was in births in dispensaries or in
      hospital (Mantel-Haenszel odds ratio, 3.29; 95% CI, 1.28-9.22). CONCLUSIONS: This
      study re-emphasises that all births should be attended by adequately trained
      personnel. More effective strategies are needed to convince women with high risk
      pregnancies to deliver in hospital. Emergency referral services are required to
      deal with unexpected complications arising in low risk births at home.

PMID- 7774740
TI  - Peripheral capillaroscopic findings and blood rheology during normal pregnancy.
AB  - Peripheral capillary microscopy and blood rheology where used to investigate
      circulatory changes during normal pregnancy. The first part of the investigation
      was designed as a cross-sectional study in which capillary morphology and blood
      flow in the first (n = 24) and third trimester (n = 15) of pregnancy was compared
      with non-pregnant controls (n = 15). In the second part a longitudinal comparison
      of capillaroscopic and hemorheological findings throughout pregnancy was
      performed in 12 women with four measurements at 10-week intervals. In addition,
      in this group hemorheological measurements were carried out. Both the cross
      sectional as well as the longitudinal group showed a significant increase in
      capillary blood flow velocity which was already present in the first trimester.
      Throughout pregnancy a gradual enlargement of the pericapillar papilla was seen,
      reflecting water retention in the interstitial tissue. At low shear rates a
      significant increase in viscosity was found at the end of pregnancy both in whole
      blood and at a standardized hematocrit of 45%. Capillaroscopy appears to be an
      appropriate method to study circulatory changes throughout pregnancy and its
      value as a diagnostic tool to detect early pathological developments is the
      objective of a future investigation.

PMID- 7774741
TI  - Abu Dhabi third stage trial: oxytocin versus Syntometrine in the active
      management of the third stage of labour.
AB  - OBJECTIVE: To compare the effect of oxytocin and Syntometrine when used as part
      of active management of third stage of labour on postpartum haemorrhage,
      hypertension, nausea/vomiting and retained placenta. STUDY DESIGN: A randomised
      double blind trial was conducted in the Obstetric Unit of Corniche Hospital, Abu
      Dhabi in the United Arab Emirates. Between 1 January 1991 and 30 June 1991, 2040
      women were randomly allocated either to the oxytocin (n = 1017) or the
      Syntometrine (n = 1023) group. Twelve patients had to be excluded from the trial
      (oxytocin, 5; Syntometrine, 7) after randomisation because they no longer
      fulfilled the inclusion criteria. All women in the trial received either oxytocin
      10 units or Syntometrine 1 ml (oxytocin 5 units+ergometrine (ergonovine) 0.5 mg)
      by intramuscular injection with delivery of the anterior shoulder of the baby.
      Relative risk with 95% confidence intervals was calculated for each variable.
      RESULTS: Oxytocin (10 units) alone was as effective as Syntometrine (1 ml) in
      preventing post-partum haemorrhage without an increase in the incidence of
      retained placenta. Median blood loss was similar in both groups. The incidences
      of nausea, vomiting and headache were significantly lower in the oxytocin group,
      as was the occurrence of a mean rise in diastolic and systolic blood pressures of
      20 and 30 mmHg or more, respectively. CONCLUSION: Prophylactic administration of
      oxytocin 10 U in the third stage of labour, as part of active management, reduces
      the incidence of maternal nausea, vomiting, headache and rise in blood pressure
      than does Syntometrine 1 ml without adversely affecting the rate of post partum
      haemorrhage.

PMID- 7774742
TI  - The karyotype of fetuses with anomalies detected by second trimester
      ultrasonography.
AB  - OBJECTIVE: To determine the incidence of abnormal karyotype among fetuses with
      anomalies detected by detailed second trimester ultrasonography. STUDY DESIGN: A
      total of 573 patients underwent amniocentesis following the detection of
      anomalies by detailed second trimester ultrasonography. RESULTS: Thirty-six
      (6.3%) fetuses with abnormal karyotype were detected. The most common abnormal
      karyotypes were: trisomy 18, 11 cases; trisomy 21, 8 cases; 45XO, 7 cases;
      trisomy 13, 3 cases; and triploidy, 2 cases. Abnormal karyotype was detected in
      20/111 (18%) fetuses with more than one anomaly, 15/182 (8.2%) with cystic
      hygroma, and 1/38 with nuchal thickening. No abnormal karyotype was detected
      among 108 fetuses with choroid plexus cyst, 58 with hydronephrosis, 25 with
      ventriculomegaly, 16 with a single umbilical artery, 18 with cardiac anomalies.
      CONCLUSIONS: (1) Half of the cases with abnormal karyotype occurred in fetuses
      with more than one anomaly. (2) Cystic hygroma was the isolated malformations
      most commonly associated with abnormal karyotype. (3) Isolated malformations such
      as choroid plexus cyst or hydronephrosis were not associated with abnormal
      karyotype.

PMID- 7774743
TI  - Successful external version of B-twin after the birth of A-twin for vertex--non
      vertex twins.
AB  - OBJECTIVE: To determine the optimal intrapartum management of twins, especially
      those in vertex--non-vertex presentation. STUDY DESIGN: The study population
      consisted of 408 sets of twins delivered between 1988 and 1992, weighing at birth
      over 1500 g. According to our protocol, vaginal delivery was attempted in the
      vertex-vertex presentations. If non-vertex presentation was first, we performed
      cesarean section. In vertex--non-vertex cases, the first was delivered vaginally
      and external cephalic version or breech delivery was performed on the second.
      Apgar scores were compared according to presentation and delivery mode. RESULTS:
      Vaginal delivery was accomplished in 122 (73%) of 169 vertex--vertex
      presentations, 96 (68%) of 142 vertex--non-vertex presentations, and 4 (5%) of 99
      non-vertex--other presentations. External cephalic version (ECV) of the second
      twin and subsequent vaginal delivery in vertex--non-vertex was successful in 75%
      of cases, and internal podalic version and assisted breech delivery were
      performed in 20 cases, and the remaining two were delivered by cesarean section.
      Apgar scores were not significantly different among the various groups, and no
      complications arose from external cephalic version performed on second non-vertex
      twins. CONCLUSIONS: External cephalic version was found safe for delivering
      second non-vertex twins in cases where the first twin is in vertex presentation.
      In our opinion routine cesarean section is thus no longer justified in such
      cases.

PMID- 7774744
TI  - Transvaginal sonography and endometrial thickness in patients with postmenopausal
      uterine bleeding.
AB  - The objective of the present study was to evaluate the usefulness of transvaginal
      ultrasonography in assessment of the endometrial thickness in patients with
      postmenopausal uterine bleeding in relation to the histopathological results of
      the endometrial biopsy. A total of 118 women with postmenopausal uterine bleeding
      were studied prospectively. Thirty postmenopausal women without vaginal bleeding
      and without gynaecological complaints served as a control group. In women with
      histopathological diagnosis of atrophic endometrium the mean endometrial
      thickness was 3.1 +/- 1.7 mm whereas the corresponding value for patients with
      endometrial carcinoma was 18.4 +/- 8.2 mm (P < 0.001). No endometrial carcinoma
      was diagnosed in endometrial thickness < or = 6 mm. The sensitivity was 100% and
      specificity 64% if a 6-mm cutoff limit was used. We consider that transvaginal
      ultrasonographic investigation for post-menopausal bleeding may provide useful
      information for selection of those patients who are under higher risk of
      endometrial abnormalities. When using vaginal sonography for measuring the
      endometrial thickness in women with postmenopausal bleeding, it is reasonable not
      to perform a dilatation and curettage if the endometrial thickness is < or = 6
      mm.

PMID- 7774745
TI  - The omentoplasty: a neglected ally in gynecologic surgery.
AB  - Although the omentum is extensively used in general, reconstructive and thoracic
      surgery as a pedicled omentoplasty, little information exists about the utility
      of such a procedure in general and radical gynecologic surgery. In this paper we
      review the properties of the omentum which may be useful in gynecologic surgery.
      The omentum is highly vasculated and rich in thromboplastin, an excellent
      property for treating difficult to handle abdominal or pelvic abscesses and for
      inducing hemostasis. Furthermore, it appears that the omentum has a trophical
      effect on the surrounding tissue, making it very useful in reconstruction
      procedures. Moreover, elevating the small intestines out of the true pelvis paves
      the way for high dose (brachy)radiotherapy with less radiation enteritis. The
      technique of the pedicled omentoplasty is straightforward and takes 20-30 min
      extra operating time. We use pedicled omentoplasty for covering large operating
      fields instead of reperitonealization, to prevent radiation enteritis, as a
      matrix for grafting, to treat serious intraperitoneal infections and to
      facilitate hemostasis. Our experience of 48 omentoplasty procedures in gynecology
      is described.

PMID- 7774746
TI  - Effect of some sex steroid hormones on human spermatozoa migration in vitro.
AB  - The potential chemotactic effect of sex steroid hormones on human spermatozoa was
      studied. In an in vitro model, the number of human sperm cells migrating to
      Biggers-Whitten-Whittingham (BWW) medium containing progesterone in
      concentrations from 1 microgram/ml to 100 micrograms/ml was significantly higher
      than the number migrating to control medium (pure BWW). The presence of
      testosterone in the incubation medium decreases the migration of spermatozoa, and
      estradiol and estriol did not cause any visible changes in their behaviour. This
      effect of changes in migration was interpreted as chemotaxis of spermatozoa.

PMID- 7774747
TI  - The effect of labetalol on maternal haemodynamics and placental perfusion in
      awake near term guinea pigs.
AB  - The effect of labetalol (20 micrograms/kg/min) on maternal haemodynamics in
      general, and absolute placental perfusion in particular, was studied in eight
      chronically instrumented hypertensive guinea pigs near term. One day before drug
      testing, all experimental animals were subjected to haemoconcentration
      (haematocrit was gradually raised from 35.9 +/- 2.9 to 49.4 +/- 5.6 vol%, mean +/
      S.D.) to establish a prolonged and stable state of hypertension. This procedure
      increased mean arterial pressure from 59.7 +/- 7.2 to 70.3 +/- 8.6 mmHg, and was
      paralleled by mild foreseeable systemic haemodynamic effects (redistribution of
      cardiac output away from intestines and brain), without consistent changes in the
      maternal placental blood flow. The hypotensive effect of labetalol was paralleled
      by a selective reduction in placental perfusion as reflected by a consistent fall
      in weight-specific cardiac output fraction (from 55.5 +/- 26.6 to 40.9 +/-
      12.5%/100 g, P < 0.05) and blood flow (from 155 +/- 76 to 112 +/- 44 ml/min/100
      g, P < 0.05) to the placentas. The concomitant placental resistance had increased
      consistently from 0.55 +/- 0.26 to 0.62 +/- 0.32 mmHg.min.100 g/ml, P < 0.05. We
      conclude that in awake late-pregnant hypertensive guinea pigs, labetalol reduces
      uteroplacental blood flow selectively. We speculate that the latter selective
      effect is secondary to the fall in blood pressure.

PMID- 7774748
TI  - Thoracic electrical bioimpedance: suitable for monitoring stroke volume during
      pregnancy?
AB  - To obtain normal values for maternal stroke volume and cardiac output during
      pregnancy, a non-invasive, accurate and reproducible method is required. The
      thoracic electrical bioimpedance (TEB) method may be suitable. However, this
      method is as yet only qualified for short-term trend recordings, since it assumes
      that body dimensions such as height, weight and thoracic circumference remain
      constant during the study. This may not be the case in long-term studies,
      especially during pregnancy. In this paper it is argued that changes in stroke
      volume (SV) during pregnancy are reflected most strongly when using the formula:
      SV = P VET (dZ/dt)max/Z0, where P is a personal factor to be determined at the
      beginning of pregnancy; VET the ventricular ejection time; (dZ/dt)max the maximum
      of the first derivative of the thoracic impedance during the cardiac cycle and Z0
      the time average of this impedance during the cardiac cycle. Indexed parameters
      should not be used as this reduces sensitivity. Commercial equipment, based upon
      other algorithms, can be used by feeding the right parameters for each series of
      measurements. This enables calculation, trends in stroke volume and cardiac
      output for longitudinal studies for instance during pregnancy.

PMID- 7774749
TI  - Prolongation and improvement of prostasome promotive effect on sperm forward
      motility.
AB  - Prostasomes isolated from human seminal plasma stimulated the forward motility of
      buffer-washed, and therewith immobilised, normal human spermatozoa in a dose- and
      time-related fashion. Albumin exhibited a similar capacity for stimulation.
      Combining prostasomes with 5 mmol/l of any of the hexoses fructose, glucose or
      mannose (but not galactose) resulted in a prolongation and improvement of the
      effect by prostasomes (or albumin) for the first 150 min. Hence, a dose-response
      effect at 60 and 120 min was obtained by prostasomes on sperm forward motility
      provided 5 mmol/l of fructose was present--otherwise not. Many substances besides
      the hexoses were examined for possible positive effects on sperm forward motility
      in concert with prostasomes with no additional effect. Enrichment of optimum
      concentrations of prostasomes and glucose with 2 mmol/l of adenine stimulated
      further the velocity parameters of the spermatozoa over time. The effect of
      adenosine was less evident under these conditions. Experiments carried out with
      prostasomes in the presence of divalent cations or chelators suggested that
      magnesium ions are essential for sperm forward motility. There appeared to be a
      safety margin concerning calcium ions, and zinc ions did not seem to be primarily
      involved in sperm forward motility in the presence of prostasomes.

PMID- 7774750
TI  - Endometriosis of the sciatic nerve: case report demonstrating the value of MR
      imaging.
AB  - Among the many causes of sciatica, endometriosis, a rare aetiology, should be
      considered in menstruating women in view of the diagnostic strategy and ensuing
      therapeutic implications. We report a case of sciatic nerve involvement with
      endometriosis in contact with the nerve in the left sciatic notch. Exploration by
      MRI was invaluable for the diagnosis, revealing a signal on the stem of the nerve
      suggestive of a lesion with haemorrhagic content.

PMID- 7774751
TI  - Pre-rupture diagnosis and management of rudimentary horn pregnancy in the first
      trimester.
AB  - A case of pregnancy in the rudimentary horn of a unicornuate uterus, suspected on
      routine pelvic examination and confirmed by sonography as early as at 8 weeks of
      gestation is presented. Ultrasonographic findings of the case and surgical
      management of ipsilateral adnexa at the time of excision of rudimentary horn are
      discussed.

PMID- 7774752
TI  - A case of tracheal agenesis delivered of a patient with mosaic Turner's syndrome.
AB  - We describe a female infant with tracheal agenesis associated with severe
      complicated malformations including the cardiovascular system. The patient was
      born of a mother with mosaic Turner's syndrome at 35 weeks of gestation after
      premature rupture of the membranes during treatment for polyhydramnios. The
      patient died 2 days after birth and the autopsy disclosed tracheal agenesis and
      associated multiple anomalies.

PMID- 7774753
TI  - Absence of electrical uterine activity after endoscopic access for fetal surgery
      in the rhesus monkey.

PMID- 7774754
TI  - Lipoperoxidation induced by hydrogen peroxide in human erythrocyte membranes. 1.
      Protective effect of Ginkgo biloba extract (EGb 761).
AB  - The antioxidant potential of Ginkgo biloba extract (EGb 761) on healthy human
      erythrocyte membranes was investigated. Lipoperoxidation was induced in
      erythrocyte suspensions using hydrogen peroxide, in the presence of EGb 761 at 37
      degrees C; malondialdehyde production was determined as the indicator of
      lipoperoxidation during the incubation period. The results for EGb 761 at
      concentrations of 0, 25, 50, 125, 250 and 500 micrograms/ml suggest that the
      antioxidant potential of EGb 761 in erythrocyte membranes increases with dose.
      Similarly, using different incubation periods (0, 15, 30, 45 or 60 min) indicated
      that the antioxidant effect of EGb 761 increased by the incubation time.

PMID- 7774755
TI  - Effect of nadifloxacin on neutrophil functions.
AB  - Recent reports indicate that nadifloxacin is an effective therapy for acne
      vulgaris and has a mechanism of action similar to that of the tetracyclines which
      act directly as antioxidants against infiltrated neutrophils. The effects of
      nadifloxacin on neutrophil functions, including the generation of reactive oxygen
      species, chemotaxis and phagocytosis were investigated. Nadifloxacin reduced the
      numbers of superoxide radical anions (O2-) and hydroxyl radicals (OH.) generated
      by neutrophils. The drug did not, however, significantly inhibit neutrophil
      chemotaxis and phagocytosis nor did it decrease the levels generated in a cell
      free, xanthine-xanthine oxidase system. These results indicate that the clinical
      effectiveness of nadifloxacin may be partly due to its inhibitory action on the
      generation of O2- and OH. by neutrophils leading to a reduction in oxidative
      tissue injury.

PMID- 7774756
TI  - Changes in plasma fatty acid profile in Japanese patients with chronic
      pancreatitis.
AB  - The serum zinc, prealbumin, retinol-binding protein and carotene concentrations
      and the plasma fatty acid composition were determined to assess the nutritional
      condition of 24 patients with chronic pancreatitis compared with that of 20
      healthy controls. The daily food intake and faecal fat excretion of the two
      groups were also measured. In the chronic pancreatitis group, the calorie and fat
      intakes were significantly lower than those of the controls. Serum levels of
      zinc, prealbumin and carotene were also significantly lower than those of the
      controls. Percentages of plasma linoleic and arachidonic acids were low, while
      percentages of palmitoleic acid, eicosapentaenoic acid and docosahexaenoic acid
      were high. Fish oil intake correlated negatively with plasma linoleic acid
      concentration (P < 0.05). The above results indicate that the relatively high
      intake of fish oil and the relatively low intake of dietary fat in Japanese
      patients with chronic pancreatitis with a mild degree of steatorrhoea results in
      an abnormally low plasma level of linoleic acid.

PMID- 7774757
TI  - Effects of pancreatic digestive enzymes, sodium bicarbonate, and a proton pump
      inhibitor on steatorrhoea caused by pancreatic diseases.
AB  - Forty-five patients with pancreatic steatorrhoea (27 with calcified pancreatitis,
      13 with non-calcified pancreatitis, two with pancreaticoduodenectomy, one with
      total pancreatectomy, and two with pancreatic cancer) were divided into four
      groups and given the following medication for 2 to 4 weeks: 4 to 6 g/day of
      sodium bicarbonate (group I); 9 g/day of high-lipase pancreatin (lipase, 56,600
      U/g, Federation Internationale Pharmaceutique (FIP); group II); 12 to 24 tablets
      or 9.0 g of commercial pancreatic enzyme preparations (group III); or 50 mg of
      omeprazole (group IV). Faecal fat excretion was evaluated before and after drug
      administration. Faecal fat excretion was reduced by 2.9 g (range, 1.7 to 5.0 g)
      in group I; 8.8 g (range, 2.9 to 39.9 g) in group II; 10.8 g (range, 2.3 to 21.8
      g) in group III; and 4.3 g (range, 3.6 to 5.6 g) in group IV. The pancreatic
      digestive enzyme preparation was more effective than sodium bicarbonate and
      agents that raise the pH of the upper small intestine (such as proton-pump
      inhibitors) in reducing faecal fat excretion. The results indicate that all of
      the preparations used are effective against mild pancreatic steatorrhoea. If the
      condition is more advanced, however, a massive dosage of pancreatic digestive
      enzyme and possibly the combined use of an agent to raise the pH of the upper
      small intestine are likely to be effective.

PMID- 7774758
TI  - Faecal triglycerides and fatty acids in the differential diagnosis of pancreatic
      insufficiency and intestinal malabsorption in patients with low fat intakes.
AB  - To investigate possible parameters for the differential diagnosis of steatorrhoea
      in patients with low fat intakes, faecal specimens were analysed from 15 patients
      with steatorrhoea due to chronic pancreatitis and seven patients with
      steatorrhoea due to intestinal malabsorption. The fat intakes of the patients
      ranged from 30.1 to 60 g, less than the average in American and European
      patients. The group with pancreatic steatorrhoea showed a significantly lower
      faecal output than the group with intestinal steatorrhoea but the two groups did
      not differ significantly in their total faecal fat excretion or concentration.
      The percentage triglycerides and the molecular ratio of triglycerides to fatty
      acids in the faeces were significantly higher (P < 0.01) in the group with
      pancreatic steatorrhoea than in those with intestinal steatorrhoea. The molecular
      percentage ratio of triglycerides to fatty acids was 6.8 +/- 2.2 for the chronic
      pancreatitis group and 2.4 +/- 1.0 for the intestinal malabsorption group; while
      the respective faecal hydroxy fatty acid contents were 3.1 +/- 3.6% and 10.1 +/-
      3.3% (means +/- SDs). These latter two parameters appeared to be the most
      valuable for distinguishing the two forms of steatorrhoea.

PMID- 7774759
TI  - Evaluation of anti-HTLV-1 antibody in primary glomerulonephritis.
AB  - Human T-cell leukaemia virus type-1 (HTLV-1) is known to cause adult T-cell
      leukaemia. The prevalence of anti-HTLV-1 antibody in haemodialysis patients has
      been reported to be higher than that in the general population. The anti-HTLV-1
      antibody-positive rate in patients with primary glomerulonephritis in the
      Nagasaki district, an endemic area of HTLV-1, was evaluated. The antibody
      positive rates in patients with primary glomerulonephritis (9.9%) and in
      haemodialysis patients (18.4%) were significantly higher than the rate in general
      blood donors (6.6%). Of 142 patients with primary glomerulonephritis, 14 (9.9%)
      were positive for the antibody; histological evaluation of these patients showed
      minor glomerular abnormality in one, mesangial proliferative glomerulonephritis
      in eight (IgA nephropathy in six and non-IgA nephropathy in two), membranous
      nephropathy in three, and crescentic glomerulonephritis in two. Evaluation of 10
      antibody-positive patients by immunofluorescent microscopy showed immunocomplex
      type nephritis in nine, suggesting the involvement of HTLV-1-associated antigen
      in the development and progression of glomerulonephritis.

PMID- 7774760
TI  - Zolpidem in insomnia: a 3-year post-marketing surveillance study in Switzerland.
AB  - A multicentre post-marketing surveillance study was conducted in Switzerland in
      routine practice and involved 1972 insomniac patients treated with zolpidem, an
      imidazopyridine hypnotic agent. The patients were representative of the general
      insomniac population (65% women; mean age 55 years; 29% over 65). Of the
      patients, 87% were treated with a zolpidem dosage of 10 mg/day and the median
      treatment duration was 30 days. All adverse events were collected through
      spontaneous reporting. A total of 175 patients (8.9%) reported 343 adverse
      events, and 102 (5.2%) of them discontinued treatment. CNS (central nervous
      system)-related adverse events accounted for 66% of the total, the most common
      events being residual daytime sedation and insufficient efficacy in 3.7% and
      1.6%, respectively; confusion, disorientation, nervousness, nightmares, amnesia,
      impaired concentration and anxiety were observed in a lower proportion. Gastro
      intestinal symptoms, headache and skin reactions were the most frequent non-CNS
      related effects. No serious adverse event was reported and no new risk factors or
      at-risk populations were identified. The safety profile of zolpidem is thus
      consistent with its known pharmacological properties, the results of previous
      clinical trials, and the cumulative international experience gained with this
      short-acting hypnotic drug.

PMID- 7774761
TI  - Friedreich's ataxia in the elderly.
AB  - Friedreich's ataxia is one of the best defined and most common forms of
      hereditary ataxia of unknown aetiology. It is transmitted in an autosomal
      recessive manner, appearing sporadically, usually in childhood or adolescence.
      The case of an elderly patient with a possible diagnosis of late-onset
      Friedreich's ataxia is reported; this is thought to be the only such case in the
      literature. The 91-year-old Anglo female presented with ataxia that had been
      progressive over the last 5 years. Magnetic resonance imaging scans of the head
      revealed mild peripheral cerebellar atrophy and moderate cerebral atrophy. The
      patient's parents were unaffected but two of her six siblings had had
      Friedreich's ataxia starting in childhood, and four of her grandfather's siblings
      had had an undiagnosed illness that left them in wheelchairs early in life.
      Friedreich's ataxia was diagnosed in view of the strong family history and non
      revealing magnetic resonance imaging of the brain.

PMID- 7774763
TI  - The neurophysiological evaluation of auditory discrimination.

PMID- 7774762
TI  - Lipoperoxidation induced by hydrogen peroxide in human erythrocyte membranes. 2.
      Comparison of the antioxidant effect of Ginkgo biloba extract (EGb 761) with
      those of water-soluble and lipid-soluble antioxidants.
AB  - An in vitro model using healthy human erythrocyte suspensions was used to compare
      the antioxidant effect of standardized Ginkgo biloba extract (EGb 761) with those
      of water-soluble (ascorbic acid, glutathione and uric acid) and lipid-soluble
      (alpha-tocopherol and retinol acetate) antioxidants. Lipid peroxidation was
      induced by hydrogen peroxide in the absence (control) and presence of
      antioxidants at low (25 micrograms/ml) and high (250 micrograms/ml)
      concentrations. Malondialdehyde production was determined as the indicator of
      lipid peroxidation during the incubation period. The results suggest that all of
      the antioxidants, except ascorbic acid, have antioxidant potential in this system
      in a concentration-dependent manner. When the antioxidants were compared, EGb 761
      was found to be more effective than water-soluble antioxidants, and as effective
      as lipid-soluble antioxidants. Among the lipid-soluble antioxidants there was no
      significant difference in potency between alpha-tocopherol and retinol acetate,
      but uric acid was the most potent of the water-soluble antioxidants. The
      antioxidant potency of EGb 761 appears to be comparable with that of the well
      known antioxidants alpha-tocopherol and retinol acetate.

PMID- 7774764
TI  - Developmental studies and clinical application of mismatch negativity: problems
      and prospects.
AB  - There is wide interest in the clinical application of mismatch negativity (MMN)
      to assess discriminative capabilities in individuals whose auditory capacities
      are difficult to determine, including infants, young children and those with
      severe cognitive impairment. Before MMN can be used as a clinical
      electrophysiologic measure, it is necessary to establish that it can be reliably
      elicited in normal individuals. This chapter describes a detailed analysis of MMN
      recorded in a group of healthy 8-yr-old children to assess intrasubject and
      intersubject reliability of the response. We conclude that although statistically
      reliable results can be obtained with group data, and perhaps even in individuals
      when large numbers of stimuli can be delivered, the unfavorable signal to noise
      ratio of individual MMN data currently limits its clinical applicability.
      Suggestions for approaches to surmount these difficulties are presented for its
      eventual clinical usefulness.

PMID- 7774765
TI  - Practical issues in the clinical application of mismatch negativity.
AB  - The mismatch negativity (MMN) recordings provide an objective measure of the
      preattentive, automatic auditory discrimination function. This article deals with
      issues central to the recording of the MMN and the interpretation of the results
      for clinical and electrodiagnostic purposes. The methods of acquiring as pure an
      MMN response as possible, i.e., one not contaminated by auditory cortical
      responses reflecting other functions, are discussed first. Second, other
      technical questions associated with the recording are reported on, e.g., what MMN
      parameters should be recorded and how, what is the smallest recordable MMN
      response, and what is the repeatability of the MMN recordings. Then, the effect
      of various physiological factors on the MMN (age, alertness, gender, topographic
      distribution of the MMN) is considered. The correlation between auditory
      discrimination performance and the MMN amplitude, observed in normal population,
      is dealt with. Finally, there is a short concluding overview on clinical findings
      of MMN recordings and discussion on their electrodiagnostic applications.

PMID- 7774766
TI  - The mismatch negativity in cochlear implant users.
AB  - For individuals with severe or profound hearing loss, electrical stimulation of
      surviving neural elements by a cochlear implant may partly restore a sensation of
      hearing. Determining the extent of restoration based on behavioral measures may
      be difficult, particularly when evaluating young children or individuals who have
      little or no experience with normal hearing. In normal-hearing individuals, an
      objective measure of sound discrimination may be obtained by studying the
      mismatch negativity (MMN) component of the auditory evoked potential. The MMN may
      be evoked by a number of physical differences in acoustic stimuli including
      duration and pitch. For cochlear implant users, analogous stimulus differences
      may be produced by changing the length of a stimulus pulse train or by changing
      the pair of activated electrodes along a multi-electrode implant array. This
      paper will provide an overview of our current results, comparing evoked response
      data recorded from both normal-hearing individuals and cochlear implant users. In
      both normal-hearing individuals and cochlear implant users, MMNs were evoked by
      differences in stimulus train duration and pitch (or electrode pair activation in
      cochlear implant users). These findings suggest that the MMN may be a useful
      method for assessing the discriminability of electrical stimulation patterns
      produced by a cochlear implant. Eventually, information gained by MMN testing may
      yield important information for developing rehabilitation programs for the
      individual user.

PMID- 7774767
TI  - Neurophysiologic bases of speech discrimination.
AB  - The mismatch negativity (MMN) is an automatic cortical evoked potential that
      signifies the brain's detection of acoustic change. In other words, the MMN
      reflects the neurophysiologic processes that underlie auditory discrimination. As
      such, the MMN provides an objective tool for evaluating central auditory
      mechanisms involved in speech perception. We are using the MMN to study the
      central auditory processes that encode acoustic changes important for speech
      perception in 1) normal-hearing adults and children, 2) individuals with impaired
      auditory systems (including persons with learning disabilities, attention deficit
      disorders, cochlear implants), and 3) an animal model. Specifically, we have
      demonstrated that the MMN provides information about the central processing of
      fine acoustic differences, the neuroanatomic pathways that encode acoustic
      change, central auditory processing in the presence of peripheral hearing
      deficits, and central auditory system plasticity. In addition, we have considered
      methodological challenges associated with measuring the MMN in individual
      subjects. Several methodological issues--including appropriate stimuli, stimulus
      presentation variables, the recording protocol and environment, and validation of
      the MMN in individuals--are discussed.

PMID- 7774768
TI  - Cerebral generators of mismatch negativity (MMN) and its magnetic counterpart
      (MMNm) elicited by sound changes.
AB  - Infrequent ("deviant") sounds occurring in a sequence of repetitive ("standard")
      sounds elicit an event-related brain potential (ERP) response called the mismatch
      negativity (MMN) even in the absence of attention to these sounds. MMN appears to
      be caused by a neuronal mismatch between the deviant auditory input and a sensory
      memory trace representing the standard stimuli. This automatic mismatch process
      has presumably a central role in discrimination of changes in the acoustic
      environment outside the focus of attention. Thus, localizing cerebral generators
      of MMN might help identify brain mechanisms of auditory sensory memory and
      involuntary attention. This review summarizes results from studies aimed at
      localizing MMN generators on the basis of (1) scalp-distribution, (2)
      magnetoencephalographic (MEG), (3) intracranial, and (4) brain-lesion data. These
      studies indicate that a major MMN source is located in the auditory cortex.
      However, the exact location of this MMN generator appears to depend on which
      feature of a sound is changed (e.g., frequency, intensity, or duration), as well
      as on the complexity of the sound (e.g., a simple tone versus complex sound).
      Consequently, memory traces for different acoustic features, as well as for
      sounds of different complexity, might be located in different regions of auditory
      cortex. However, MMN appears to have generators in other brain structures, too.
      There is some evidence for contribution of frontal-lobe activity to the MMN,
      which might be related to the involuntary switching of attention to a stimulus
      change occurring outside the focus of attention. In addition, intracranial MMN
      recordings in animals suggest that at least in some species, MMN subcomponents
      also may be generated in the thalamus and hippocampus.

PMID- 7774769
TI  - The mismatch negativity of event-related potentials as a probe of transient
      auditory memory: a review.
AB  - The use of the mismatch negativity as a probe to study the memory upon which it
      depends is reviewed. Topics about the memory include its duration, its capacity,
      the kind of information that can be stored in the memory, how the information is
      stored, whether the memory is accessed in parallel or in series, whether it is
      hard-wired or can be modified by experience, and its relationship to sensory
      memory.

PMID- 7774770
TI  - The mismatch negativity: a powerful tool for cognitive neuroscience.
AB  - This article reviews research on the relatively recently discovered event-related
      potential component, the mismatch negativity (MMN), which is of great potential
      interest for understanding central auditory function and various forms of its
      pathology. This change-specific response can serve as an accurate objective
      measure for central sound representations that form the basis, for instance, for
      correct hearing of speech. Deficiencies in the MMN may be related to different
      forms of deficits in central auditory processing.

PMID- 7774771
TI  - Event-related potentials and the categorical perception of speech sounds.
AB  - OBJECTIVE: To determine whether there are physiological correlates of categorical
      perception. DESIGN: Human evoked potentials were recorded in response to computer
      modified speech sounds from a nine-stimulus continuum between /ba/ and /da/. In
      the first experiment, subjects listened to trains composed of 52% /ba/ or /da/
      and 6% of each of the other eight stimuli and classified the stimuli as "ba" or
      "da." In the second experiment, subjects read a book and ignored trains
      containing a standard stimulus (p = 80%) and two deviant speech sounds (p = 10%
      each), one within the same category as the standard and the other across the
      category-boundary. The third experiment was similar to the first except that the
      subject was reading. The fourth experiment compared the responses to stimuli that
      deviated from standards in terms of their phonemic category or intensity.
      RESULTS: An N2-P3 complex was evoked by those stimuli in the more improbable
      category when the stimuli were attended to in the first experiment. In the second
      and third experiments, there was a clear mismatch negativity (MMN) for the across
      category deviant stimuli when the standard stimulus came from the /ba/ end of the
      continuum. However, when the standard stimulus came from the /da/ end of the
      continuum, there was no definite MMN. The overall frequency-content of our /da/
      stimulus was broader than that of the /ba/ stimulus. A deviant stimulus from the
      /da/ end of the continuum thus contained frequencies which were not present in
      the /ba/-standard stimuli and these frequencies could elicit a MMN. In the fourth
      experiment the MMN evoked by a small change in intensity was much larger than
      that evoked by a change in phonemic category. CONCLUSIONS: The N2-P3 complex
      accurately reflects the phonemic categorization of speech stimuli. The MMN evoked
      by changes in speech sounds may indicate the detection of acoustic rather than
      phonetic changes.

PMID- 7774773
TI  - There is a story to tell.

PMID- 7774772
TI  - On the origin and development of the mismatch negativity.
AB  - This review summarizes a number of findings related to the generation,
      development, and diagnostic value of mismatch negativity (MMN). The animal
      analogue of MMN to frequency contrast can be observed in the primary and
      secondary auditory cortical and also in the association cortical recordings. It
      is shown that subcortical sensory specific and archicortical structures may also
      contribute to the processes involved. The results are more complex than would be
      predicted by the notion that only the primary system plays an active role in the
      comparison processes reflected by the MMN that and the nonprimary pathway acts
      only as a modulating influence. The fundamental nature of the brain functions
      reflected by MMN is suggested by the demonstration of MMN in sleep and
      anesthesia, though in limited conditions. The postnatal development of automatic
      stimulus comparison, as indexed by MMN, presents an isochronicity, contrary to
      other evoked potential components whose development is not complete until
      puberty. Thus, the MMN provides a stable measure for electrophysiological
      assessment of auditory perception. This possible diagnostic value of the MMN is
      shown in studies of aphasics which emphasize the nature of perceptual deficits in
      the processing various speech and nonspeech stimuli.

PMID- 7774774
TI  - Medicaid free distribution programs and availability of childhood immunizations
      in rural practices.
AB  - BACKGROUND: The impact of a federal program that provides free childhood
      immunizations to private physicians for their Medicaid patients was examined. The
      aim of the study was to find out whether the program affected the availability of
      immunizations in rural and urban family physicians' practices. METHODS: A survey
      form about physician practice policies was sent to a stratified sample of 1,184
      urban and rural family physicians in six states. States that participated in the
      federal free vaccine program were matched with states in the same region that did
      not participate in this program. RESULTS: States with no free vaccine
      distribution program showed a significant difference in the availability of
      immunizations from rural family physicians, compared with urban physicians (52%
      vs 87%, P < .001). However, in states with free distribution programs, no
      difference was found between rural and urban physicians (90% vs 94%, P = .18). In
      states without free distribution programs, immunization availability showed a
      positive and significant correlation with the size of the community where the
      physician practiced (Pearson correlation coefficient = .48, P < .001), whereas no
      correlation between community size and immunization availability existed in
      states with a free distribution program (Pearson correlation coefficient = .04, P
      = .53). CONCLUSION: Federal programs that offer free childhood immunizations to
      physicians for use in Medicaid populations have a dramatic effect on increasing
      immunization availability in rural areas.

PMID- 7774775
TI  - Predictors of first-contact care in a poor urban community.
AB  - OBJECTIVE: The aim of the study was to identify predictors of first-contact care
      in a population of poor urban residents. METHODS: Information from a community
      health needs survey was used for the study. The sample included adult residents
      in five urban census tracts with a large proportion of Puerto Rican Hispanics.
      Potential predictors included social characteristics, source of health insurance,
      perceived health status, number of chronic diseases, use of alternatives to
      medical care, smoking status, and problems with alcohol use. RESULTS: A total of
      826 household interviews were completed for a participation rate of 78% among
      eligible households. Individuals with no health insurance were six times more
      likely to lack a source of first-contact care, compared with those who have
      traditional indemnity insurance. Those who only had Medicaid were four times more
      likely to lack a source of first-contact care. Respondents involved in Medicaid
      managed care programs had similar access to first-contact care as those with
      commercial insurance. Individuals who reported problems with alcohol were three
      times more likely to lack a source of first-contact care. CONCLUSIONS: Health
      insurance is an important predictor of access to first-contact care for poor
      urban residents. Those who identify problems with alcohol and African-Americans
      have additional difficulty with access to first-contact care.

PMID- 7774776
TI  - Depression in mothers of children with attention deficit hyperactivity disorder.
AB  - BACKGROUND AND OBJECTIVES: Does having a child with attention deficit
      hyperactivity disorder (ADHD) increase the risk of depression in the child's
      mother? The present study was initiated to explore this issue in a primary care
      setting and evaluate the need for routine screening of maternal depression in
      mothers of children with ADHD. METHODS: The subjects were 59 biological mothers
      of children with ADHD. All were patients in a rural, private, office-based family
      practice. Each subject was given a Zung Self-rating Depression Scale (SDS). After
      completion, the mothers were interviewed to confirm or exclude depression by
      Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria.
      RESULTS: Thirty-nine of the 59 mothers returned a completed Zung SDS. No
      statistically significant differences were noted between the respondents and
      nonrespondents, nor between ADHD children of respondents and nonrespondents.
      Twenty-one respondents had Zung scores in the depressive ranges. By DSM-III-R
      criteria, 15 were subsequently found to be depressed. None of the 18 mothers with
      normal scores on the Zung were found to be currently depressed. CONCLUSIONS: The
      incidence of major and minor depression in primary care outpatients is 4%-6% and
      6%-14%, respectively. However, the present study reveals an incidence of 17.9%
      for major depression and 20.5% for minor depression in mothers of children with
      ADHD, suggesting that routine screening for maternal depression needs to be
      considered when children are diagnosed with ADHD in primary care settings.

PMID- 7774777
TI  - Family medicine research: a matter of values and vision.

PMID- 7774778
TI  - Differences in labor and delivery experience in family physician- and
      obstetrician-supervised teaching services.
AB  - BACKGROUND: Other studies have shown that family physicians' pregnancy management
      styles are different from obstetricians' styles. This study examines whether
      these differences also exist in teaching services supervised by family physicians
      and obstetricians. METHODS: A retrospective study was done of deliveries
      performed by residents at five teaching hospitals in five states. A total of
      4,558 women were admitted to teaching services supervised by either family
      physicians (n = 1,754) or obstetricians (n = 2,804). Medical records for women
      whose labor and delivery were supervised by family physicians and obstetricians
      were reviewed and compared for demographics, pregnancy history, delivery
      management, and outcome variables. RESULTS: Women admitted to teaching services
      supervised by family physicians were more likely to be younger and have no
      insurance, compared with those on services supervised by obstetricians. Even
      after adjustment for pregnancy risk, obstetrician-supervised teaching services
      had an increased incidence of preterm labor, more frequent use of epidural
      anesthesia, and higher episiotomy and cesarean section rates than family practice
      teaching services. CONCLUSIONS: The demographic and clinical characteristics of
      family practice and obstetric teaching services differ. Patients on the services
      supervised by family physicians were more representative of the maternity
      practice of practicing family physicians.

PMID- 7774779
TI  - Factors associated with research productivity in family practice residencies.
AB  - BACKGROUND: Research productivity and the associated features of research
      productivity in family practice residencies have not been well described. The
      objectives of this study are to describe residency research productivity and
      identify the set of independent factors that best characterize programs at
      various levels of productivity. METHODS: A 23-item survey was mailed to 226
      randomly selected family practice residency directors. The survey included items
      on program demographics, mentoring, resident and faculty research activities, and
      program research resources. Factor and discriminant analyses were performed to
      identify the major independent factors associated with productivity. RESULTS: A
      total of 154 completed surveys were received for a response rate of 68%. Based on
      a cross tabulation of grants per program and publications per faculty, 22% of
      programs had high productivity, 46% had medium productivity, and 32% had low
      productivity. The significant factors of mentor support, amount of research
      activity, and program size contributed independently to the classification of
      programs by relative level of research productivity. These associations remained
      significant when university programs were excluded. CONCLUSIONS: Family practice
      residencies with relatively higher research productivity are more likely to have
      three characteristics than lower productivity programs: availability of a
      research mentor, more faculty research activities, and larger program size.

PMID- 7774780
TI  - Economic viability of a model rural family practice.
AB  - BACKGROUND AND OBJECTIVES: A model rural clinic was established by the Quincy
      Family Practice Residency Program with the financial support of sponsoring local
      hospitals. The purpose of the study was 1) to determine the financial viability
      of such a model practice and 2) to determine the practice's financial effect on
      the sponsoring hospitals. METHODS: The rural practice was established in a
      medically underserved area 30 miles from the sponsoring hospitals. A cost
      analysis of months 7-18 of operation was performed, including an analysis of
      charges generated at the sponsoring hospitals. Theoretical models of practice to
      enhance economic viability were explored. RESULTS: The 3,051 office visits fell
      short of expectations. These visits generated a net practice income of $18,596.
      Had the practice sought full payment for these visits instead of accepting
      Medicare assignments, the net income potential would have been $39,182. Growth of
      the practice until it reached the average size of a typical rural family practice
      (6,000 annual visits) would produce a net income of $67,113 with Medicare
      assignments and $103,578 if Medicare assignments were not accepted. Had the
      practice been a federally designated rural health clinic, a mid-level
      practitioner with physician supervision could have generated a net practice
      income of $53,640 for 3,051 visits or $138,863 for 6,000 visits. Referrals from
      the model clinic for laboratory work, radiology, and hospital admissions
      generated $9.17 in charges for the sponsoring hospitals for each dollar charged
      by the clinic. CONCLUSIONS: The financial viability of rural practices is
      adversely affected by the Medicare reimbursement system. Our model clinic had a
      positive economic effect on the sponsoring hospitals, suggesting that innovative
      collaborative sponsorship of such clinics may be mutually beneficial.

PMID- 7774781
TI  - A randomized, controlled trial of the influence of prenatal parenting education
      on postpartum anxiety and marital adjustment.
AB  - OBJECTIVE: The aim of this study was to measure the impact of two middle
      trimester parenting communication classes on postpartum anxiety, marital
      adjustment, and postpartum adjustment. METHODS: Seventy primiparous, low-risk
      couples enrolled in prenatal classes in a large urban hospital were randomized to
      experimental and control groups. An educational intervention consisting of two
      second-trimester classes was facilitated by two social workers. The classes were
      based on a previous assessment of the educational needs of postpartum couples and
      contained didactic sessions, role-playing sessions, and values clarification
      exercises. The Spielberger State-Trait Anxiety Inventory and the Dyadic
      Adjustment Scale were administered to both groups prenatally in the second
      trimester and at 6 weeks and 6 months postpartum. A modified version of the
      O'Hara Postpartum Adjustment Questionnaire was administered at 6 weeks and 6
      months postpartum. RESULTS: Both groups scored comparably in the prenatal period.
      The experimental group scored significantly lower on anxiety and higher on dyadic
      adjustment at both postpartum time periods than the control group. The
      experimental group also indicated a higher degree of postpartum adjustment.
      CONCLUSION: Prenatal parenting communication classes had a significant impact on
      postpartum anxiety, postpartum marital satisfaction, and postpartum adjustment.

PMID- 7774782
TI  - [Gastric schwannoma. Report of a case].
AB  - Gastric schwannoma is a rare and benign neurogenic tumor. Diagnosis of this
      entity is uncertain previous to surgery, being this tumor localized in the sub
      mucosa. Final diagnosis is achieved by surgical removal and histological
      examination.

PMID- 7774783
TI  - [Splenic pseudocystic. Report of a case].
AB  - Splenic pseudocysts represent 70 to 80% of the non parasitic cysts of this organ.
      Malaria, infectious mononucleosis, tuberculosis and t. pallidum infection are
      predisposing factors. Cystic characteristics are determined by CT-SCAN and
      ultrasound. Final diagnosis is achieved by hystological examination. This is a
      case report.

PMID- 7774784
TI  - [Abstracts of the XI Latin American Congress of Pediatric Gastroenterology and
      Nutrition, II Ibero Latin American Congress of Pediatric Gastroenterology and
      Nutrition, II Venezuelan Congress of Pediatric Gastroenterology].

PMID- 7774785
TI  - [Bacterial microflora and intestinal ecosystem. Physiopathology of the
      contaminated small bowel. Acute diarrhea. Environment in Spain].

PMID- 7774786
TI  - [Metabolic impact of acute diarrhea].

PMID- 7774787
TI  - [Nutritional factors affecting diarrhea susceptibility].

PMID- 7774788
TI  - [Economic significance of acute diarrhea].

PMID- 7774790
TI  - [The management of medical care provided to hospitalized patients].

PMID- 7774789
TI  - [What may be standardized about re-feeding in 1994?].

PMID- 7774792
TI  - [Early gastric cancer staging by radiology, endoscopy, trans-endoscopic
      ultrasonography and its anatomo-pathological correlation].
AB  - Early gastric cancer detection is still in its more elementary step in the
      western hemisphere, while in Japan gastric cancer is detected mainly in its early
      stage. The aim of this article is to analyze the Japanese method for early
      gastric cancer detection and staging, by sketch of certain morphologic criterions
      and a report of a typical case. In our case the lesion's staging was predicted as
      submucosal by means of endoscopy and double contrast roentgenography. Endoscopic
      ultrasonography complemented the analysis. The standard anatomopathological work
      up for early gastric cancer in Japan is also analysed. By this former method the
      accuracy of the initial staging by endoscopy, and radiologic means was ensured.
      By a correct early gastric cancer diagnosis and staging a better selection of the
      surgical strategy and survival can be achieved.

PMID- 7774791
TI  - [Gastric leiomyoblastoma. Histomorphologic and immunologic analysis of 3 cases].
AB  - We present three cases of Leiomioblastomas of stomach, diagnosed at the unit of
      Pathology of the Gastrointestinal Cancer Center "Dr Luis E. Anderson" -San
      Cristobal-Tachira State Venezuela. The lesions are analyzed from the clinical,
      morphological and immunohistological points of view, utilizing Queratine and
      Vimentin techniques. This neoplasm is not frequent but it is interesting because
      its biologic behavior not always correspond to its histology-pattern.

PMID- 7774793
TI  - BamHI and HindIII repetitive DNA families in the rice genome.
AB  - In this paper we describe a novel method of cloning representative members of
      different repetitive DNA families based on the screening of a rice (Oryza sativa)
      genomic library using DNA from different C0t fractions as probes. Two genomic
      clones, which represent two different repetitive DNA families in rice, were
      isolated by this method and have been characterized. Their nucleotide sequences,
      copy numbers, distributions in major rice genome types, methylation patterns, and
      chromosomal localizations were determined.

PMID- 7774794
TI  - Detection of genetic diversity in tea (Camellia sinensis) using RAPD markers.
AB  - Camellia sinensis is a beverage tree crop native to Southeast Asia and
      introductions have been made into several nonindigenous countries. No systematic
      assessment of genetic variability in tea has been done anywhere. In this study,
      random amplified polymorphic DNA (RAPD) analysis was used to estimate genetic
      diversity and taxonomic relationships in 38 clones belonging to the three tea
      varieties, assamica, sinensis, and assamica ssp. lasiocalyx. Extensive genetic
      variability was detected between species, which was partitioned into between and
      within population components. Seventy percent of the variation was detected
      within populations. Analyses based on band sharing separated the three
      populations in a manner consistent with both the present taxonomy of tea and with
      the known pedigrees of some clones. RAPD analysis also discriminated all of the
      38 commercial clones, even those which cannot be distinguished on the basis of
      morphological and phenotypic traits.

PMID- 7774795
TI  - Phylogenetic relationships of the monogenomic species of the wheat tribe,
      Triticeae (Poaceae), inferred from nuclear rDNA (internal transcribed spacer)
      sequences.
AB  - Phylogenetic relationships of 30 diploid species of Triticeae (Poaceae)
      representing 19 genomes were estimated from the sequences of the internal
      transcribed spacer (ITS) region of nuclear ribosomal DNA. The ITS sequence
      phylogeny indicated that: (i) each genome group of species is monophyletic,
      concordant with cytogenetic evidence; (ii) Hordeum (I) and Critesion (H) are
      basal; (iii) Australopyrum (W) is closely related to Agropyron (P); (iv)
      Peridictyon (G), Heteranthelium (Q), and Dasypyrum (V) are closely related to
      Pseudoroegneria (S); (v) most of the annuals, Triticum s.l. (A, B, D), Crithopsis
      (K), Taeniatherum (T), Eremopyrum (F), Henrardia (O), Secale (R), and two
      perennials, Thinopyrum (J) and Lophopyrum (E), all of Mediterranean origin, are a
      monophyletic group. However, phylogenetic trees based on morphology group these
      Mediteranean species with various perennial lineages of the Arctic-temperate
      region. The molecular data and biogeography of the tribe suggest that the
      Mediterranean lineage is derived from the Arctic-temperate lineage and that the
      two lineages have evolved in parallel. Extensive morphological parallelism
      apparently obscures the true genealogical history of the tribe when only
      morphology is considered.

PMID- 7774796
TI  - A survey of DNA polymorphism within the genus Capsicum and the fingerprinting of
      pepper cultivars.
AB  - Interspecific genetic variation was examined in the genus Capsicum based on
      shared restriction fragments in Southern analyses. Four distinct clusters were
      delineated among 21 accessions of cultivated and wild pepper (C. annuum, C.
      baccatum, C. chacoense, C. chinense, and C. frutescens). Three tight clusters
      comprised of accessions belonging to C. annuum, C. frutescens, and C. baccatum,
      respectively, were formed, along with a fourth cluster comprised of one accession
      each of C. chinense and C. chacoense. All accessions were differentiated by this
      technique, and the clusters corresponded closely to previous morphology-based
      classification. Sufficient DNA polymorphism exists among these accessions that
      segregating populations useful for restriction fragment length polymorphism
      (RFLP) mapping could be constructed using any two pepper accessions as parents.
      Regression analysis indicates that genetic distance is a good predictor (R2 =
      0.872) of the level of mappable DNA polymorphism in Capsicum. Intraspecific
      variability was examined among four C. annuum cultivars (NuMex R Naky, Jupiter,
      Perennial, and Criollo de Morelos 334) using both RFLPs and randomly amplified
      polymorphic DNA (RAPDs), allowing a comparative evaluation of the two techniques.
      Seventeen percent of the clones used singly in RFLP analyses were sufficient for
      the differentiation of these varieties, as were 12.5% of the RAPD PCR
      amplifications. Dendrograms constructed from RFLP and RAPD analyses of the
      intraspecific data are similar but not identical. Southern analysis and RAPD PCR
      should be useful for DNA fingerprinting and the discrimination of closely related
      C. annuum genotypes.

PMID- 7774797
TI  - Evolution of finger millet: evidence from random amplified polymorphic DNA.
AB  - Finger millet (Eleusine coracana ssp. coracana) is an annual tetraploid member of
      a predominantly African genus. The crop is believed to have been domesticated
      from the tetraploid E. coracana ssp. africana. Cytogenetic and isozyme data point
      to the allopolyploid nature of the species and molecular information has shown E.
      indica to be one of the genomic donors. A recent isozyme study questioned the
      proposed phylogenetic relationship between finger millet and its direct ancestor
      subspecies africana. An approach using random amplified polymorphic DNA (RAPD)
      was employed in this study to examine genetic diversity and to evaluate
      hypotheses concerning the evolution of domesticated and wild annual species of
      Eleusine. Unlike previous molecular approaches, the RAPD study revealed genetic
      diversity in the crop. The pattern of genetic variation was loosely correlated to
      geographic distribution. The allotetraploid nature of the crop was confirmed and
      molecular markers that can possibly identify the other genomic donor were
      proposed. Genotypes of subspecies africana did not group closely with those of
      the crop but showed higher affinities to E. indica, reflecting the pattern of
      similarity revealed by the isozyme study. The multiple origin of subspecies
      africana could explain the discrepancy between the isozyme-RAPD evidence and
      previous information. The RAPD study showed the close genetic affinity of E.
      tristachya to the E. coracana--E. indica group and understood the distinctness of
      E. multiflora.

PMID- 7774798
TI  - A transcript family from a long-range repeat cluster of the house mouse.
AB  - A family of closely related genes is a component of the polymorphic long-range
      repeat cluster D1Lub1 of the house mouse. Members of the gene family have
      diverged from one another by rearrangements and point mutations. D1Lub1 cluster
      have low (approximately 50) or high (> or = 500) copy numbers. In mice with high
      copy clusters five or six poly(A)+ RNAs are found, while in mice with low-copy
      clusters only a single member of the RNA family is detected. The RNA family is
      synthesized in a tissue-independent manner. Each member of the RNA family is
      defined by a set of DNA probes. Cross hybridization with the probes reveals
      common 5' regions and variable remaining parts. The RNA variants are probably
      transcribed from different gene copies.

PMID- 7774799
TI  - Amplification of Ac in tomato is correlated with high Ac transposition activity.
AB  - We have assayed the transposition activity of the maize transposable element Ac
      in transgenic tomato plants that had a single copy of Ac. We found that Ac
      elements were in either a high or low activity state and that an Ac insertion
      could cycle from low to high activity within a generation. The different
      transposition activities were not simply due to the chromosomal position of the
      element, because the same Ac insertion had different levels of activity in
      sibling plants. Transposition activity was measured by two methods, one genetic
      and one physical; both assays gave similar results for each plant studied.
      Notably, plants with active Ac elements had progeny with amplified Ac copy
      number, while no amplification was detected in lines containing Ac in a low
      activity state. Analysis of lines with amplified elements revealed that the
      elements could be either clustered or dispersed. Our results were consistent with
      amplification being the result of transposition.

PMID- 7774800
TI  - Molecular analysis of evolutionary patterns in U genome wild wheats.
AB  - The theory of pivotal-differential evolution states that one genome of polyploid
      wheats remains stable (i.e., pivotal) during evolution, while the other genome or
      genomes may become modified (i.e., differential). A proposed mechanism for
      apparent modification of the differential genome is that different polyploid
      species with only one genome in common may exchange genetic material. In this
      study, we analyzed a set of sympatric and allopatric accessions of tetraploid
      wheats with the genomic constitutions UM and UC. The U genome of these species is
      from Triticum umbellulatum and is considered to be the pivotal genome. The M and
      C genomes, from T. comosum and T. dichasians, respectively, are considered to be
      the differential genomes. Low copy DNA was analyzed using "sequence tagged site"
      primer sets in the polymerase chain reaction, followed by digestion with
      restriction enzymes. Genetic similarity matrices based on shared restriction
      fragments showed that sympatric accessions of different U genome tetraploid
      species did not tend to share more restriction fragments than did allopatric
      accessions. Thus, no evidence for introgression was found. Analysis of the
      diploid progenitor species showed that the U genome was less variable than the M
      and C genomes. Additionally, comparison of diploid and polyploid species using
      genome-specific primer sets suggests a possible polyphyletic origin for T.
      triunciale and T. machrochaetum. Thus, our results suggest that the differential
      nature of the M and C genomes may be the result of variability introduced by the
      diploid progenitors and not the result of frequent introgression events after
      formation of the polyploid.

PMID- 7774801
TI  - Molecular cloning of a bovine ornithine decarboxylase cDNA and its use in the
      detection of restriction fragment length polymorphisms in Holsteins.
AB  - A cDNA coding for ornithine decarboxylase (ODC) was isolated from a bovine liver
      cDNA library. The clone (1758 base pairs) consisted of 5'- and 3'-untranslated
      regions of 185 and 187 nucleotides, respectively, and an open reading frame of
      1383 nucleotides encoding an ODC protein (M(r) 51,342 daltons) of 461 amino
      acids. Comparison of the nucleotide and the predicted amino acid of the cDNA with
      other mammalian ODCs showed a very high degree of homology both at the DNA and
      protein levels. The bovine ODC mRNA was identified by northern blot to be a
      single species with a molecular size of 2.35 kilobase pairs. Primer extension
      analysis indicated that the 5'-untranslated region of the bovine ODC mRNA was 312
      nucleotides long. Southern blot analysis of bovine genomic DNA revealed
      restriction fragment length polymorphisms when cleaved with restriction enzymes
      PstI, MspI, TaqI, and Bg/I.

PMID- 7774802
TI  - An evaluation of sequence tagged microsatellite site markers for genetic analysis
      within Citrus and related species.
AB  - Microsatellites, also called sequence tagged microsatellite sites (STMSs), have
      become important markers for genome analysis but are currently little studied in
      plants. To assess the value of STMSs for analysis within the Citrus plant
      species, two example STMSs were isolated from an intergeneric cross between
      rangpur lime (Citrus x limonia Osbeck) and trifoliate orange (Poncirus trifoliata
      (L.) Raf.). Unique flanking primers were constructed for polymerase chain
      reaction amplification both within the test cross and across a broad range of
      citrus and related species. Both loci showed length variation between test cross
      parents with alleles segregating in a Mendelian fashion to progeny. Amplification
      across species showed the STMS flanking primers to be conserved in every genome
      tested. The traits of polymorphism, inheritance, and conservation across species
      mean that STMS markers are ideal for genome mapping within Citrus, which contains
      high levels of genetic variability.

PMID- 7774803
TI  - Analysis of annual Medicago species using RAPD markers.
AB  - Annual species of the genus Medicago have attracted interest as green manure and
      temporary forage crops. This study was conducted to determine if randomly
      amplified polymorphic DNA (RAPD) markers could be used to assess the variability
      within and among species. Several accessions of each six species (M. scutellata
      Mill., M. disciformis DC., M. murex Willd., M. truncatula Gaertn., M. polymorpha
      L., and M. rugosa Desr.) were studied. A phylogeny reconstructed with the
      computer program Phylogenetic Analysis Using Parsimony (PAUP) showed the same
      relationships as traditional taxonomy. Variation was present among accessions of
      all species. Several accessions were considerably different from others within
      the species (one of each M. scutellata and M. polymorpha) and four accessions of
      M. murex were differentiated by both morphology and RAPD banding patterns from
      the other accessions. These accessions may be useful to include in a core
      collection. Variation within accessions was present. Although the species are
      autogamous, the original seed collections may have been made from a number of
      plants in the same area. Also, some outcrossing or seed mixing may have occurred.
      Finally, at least 10 RAPD primers appear to be necessary in order to develop
      reliable estimates of relatedness among annual Medicago accessions.

PMID- 7774804
TI  - DNA-strand breaks in chromosomes of early mouse embryos as detected by in situ
      nick translation and gap filling.
AB  - The nick translation and gap filling procedures, without external addition of
      nicking enzymes, were performed in situ on fixed chromosomes of mouse
      preimplantation and postimplantation embryos and of bone marrow in order to
      detect possible DNA single-strand breaks (nicks and (or) gaps). All chromosome
      preparations were made using the same technique. Nick translation of chromosomal
      DNA with DNA polymerase I (Pol I) or gap filling with the Klenow fragment of Pol
      I in the presence of biotinylated-dUTP, demonstrated a regular absence of label
      on chromosomes of postimplantation embryos and bone marrow. No difference in
      sensitivity was found between the holoenzyme and the Klenow fragment. In
      preimplantation embryos, the chromosome reactivity in nick translation was
      highest at the blastocyst stage and varied according to cleavage divisions of the
      zygote.

PMID- 7774805
TI  - Association of RAPD marker with linolenic acid concentration in the seed oil of
      rapeseed (Brassica napus L.).
AB  - The F2 progeny (64 individuals) from the cross between oilseed rape (Brassica
      napus L.) cultivar Topas and R4 (a low linolenic mutation line) was analyzed with
      8 RFLPs and 34 RAPDs to discover a genetic tag for gene(s) affecting linolenic
      acid concentration. According to variance analysis (ANOVA), one RAPD marker (25a)
      was significantly associated with linolenic acid content; the linolenic acid
      concentration in the seeds of F2 individuals showing the marker (includes both
      homo- and hetero-zygotes) was 7.43 +/- 1.35% and in those lacking the marker was
      5.70 +/- 1.52%. Marker 25a may be used to facilitate selection for fatty acid
      composition in future breeding programs of oilseed rape.

PMID- 7774806
TI  - Detection of rye chromosome 2R using the polymerase chain reaction and sequence
      specific DNA primers.

PMID- 7774807
TI  - Tissue-specific regulation of the insulin gene by a novel basic helix-loop-helix
      transcription factor.
AB  - The insulin gene is one of the best paradigms of tissue-specific gene expression.
      It is developmentally regulated and is expressed exclusively in the pancreatic
      beta-cell. This restricted expression is directed by a tissue-specific enhancer,
      within the promoter, which contains an E-box sequence. The insulin E-box binds an
      islet-specific protein complex, termed 3a1. E-boxes bind proteins belonging to
      the basic helix-loop-helix (bHLH) family of transcription factors. The bHLH
      proteins function as potent transcriptional activators of tissue-specific genes
      by forming heterodimers between ubiquitous and cell-restricted family members. In
      addition, the cell-restricted bHLH members play an important role in specifying
      cell fate. To isolate the tissue-specific bHLH factor controlling insulin gene
      expression and study its role in islet cell differentiation, a modified yeast two
      hybrid system was utilized to clone a novel bHLH factor, BETA2 (beta-cell E-box
      trans-activator 2), from a hamster insulin tumor (HIT) cell cDNA library.
      Northern analysis demonstrates that high-level expression of the BETA2 gene is
      restricted to pancreatic alpha- and beta-cell lines. As expected of tissue
      specific bHLH members, BETA2 binds to the insulin E-box sequence with high
      affinity as a heterodimer with the ubiquitous bHLH factor E47. More importantly,
      antibody supershift experiments clearly show that BETA2 is a component of the
      native insulin E-box-binding complex. Transient transfection assays demonstrate
      that the BETA2/E47 heterodimer synergistically interacts with a neighboring beta
      cell-specific complex to activate an insulin enhancer. In contrast, other bHLH
      factors such as MyoD and E47, which can bind to the insulin E-box with high
      affinity, fail to do so. Thus, a unique, cooperative interaction is the basis by
      which the insulin E-box enhancer discriminates between various bHLH factors to
      achieve tissue-specific activation of the insulin gene.

PMID- 7774808
TI  - Association of an activator with an RNA polymerase II holoenzyme.
AB  - RNA polymerase II holoenzymes have been described that consist of RNA polymerase
      II, a subset of general transcription factors, and four SRB proteins. The SRB
      proteins, which were identified through a selection for genes involved in
      transcription initiation by RNA polymerase II in vivo, are a hallmark of the
      holoenzyme. We report here the isolation and characterization of additional SRB
      genes. We show that the products of all nine SRB genes identified thus far are
      components of the RNA polymerase II holoenzyme and are associated with a
      holoenzyme subcomplex termed the mediator of activation. The holoenzyme is
      capable of responding to a transcriptional activator, suggesting a model in which
      activators function, in part, through direct interactions with the holoenzyme.
      Immunoprecipitation experiments with anti-SRB5 antibodies demonstrate that the
      acidic activating domain of VP16 specifically binds to the holoenzyme.
      Furthermore, the holoenzyme and the mediator subcomplex bind to a VP16 affinity
      column. These results provide a more complete description of the RNA polymerase
      II holoenzyme and suggest that this form of the transcription apparatus can be
      recruited to promoters via direct interactions with activators.

PMID- 7774809
TI  - The origin recognition complex has essential functions in transcriptional
      silencing and chromosomal replication.
AB  - The role of the origin recognition complex (ORC) was investigated in replication
      initiation and in silencing. Temperature-sensitive mutations in ORC genes caused
      defects in replication initiation at chromosomal origins of replication, as
      measured by two-dimensional (2-D) origin-mapping gels, fork migration analysis,
      and plasmid replication studies. These data were consistent with ORC functioning
      as a eukaryotic replication initiator. Some origins displayed greater replication
      initiation deficiencies in orc mutants than did others, revealing functional
      differences between origins. Alleles of ORC5 were isolated that were defective
      for silencing but not replication, indicating that ORC's role in silencing could
      be separated from its role in replication. In temperature-sensitive orc mutants
      arrested in mitosis, temperature-shift experiments caused a loss of silencing,
      indicating both that ORC had functions outside of the S phase of the cell cycle
      and that ORC was required for the maintenance of the silenced state.

PMID- 7774810
TI  - Localization of RecA-like recombination proteins on chromosomes of the lily at
      various meiotic stages.
AB  - The Rad51 and Lim15 proteins of lily, which are homologs of the bacterial RecA
      protein, were found on chromosomes in various stages of meiotic prophase 1. The
      presence of both Rad51 and Lim15 proteins as discrete foci on leptotene and
      zygotene chromosomes and their colocalization suggest that meiotic recombination
      begins at the leptotene stage with the cooperation of these proteins and
      continues in zygotene. Localization of the foci on or adjacent to the chromosomes
      suggests that these proteins bind to the chromatin loops that extend from the
      axial cores. The proteins in these foci may participate in the searching and
      pairing of homologous DNA sequences, as the RecA protein does. The different
      pattern of localization of the Rad51 protein between the leptotene and pachytene
      stages and the absence of the Lim15 protein in the pachytene stage suggest that
      the Rad51 protein plays different roles in these stages.

PMID- 7774811
TI  - p53-dependent and independent expression of p21 during cell growth,
      differentiation, and DNA damage.
AB  - Expression of p21 has been shown to be up-regulated by the p53 tumor suppressor
      gene in vitro in response to DNA-damaging agents. However, p21 expression can be
      regulated independently of p53, and here we show that expression of p21 in
      various tissues during development and in the adult mouse occurs in the absence
      of p53 function. However, most tissues tested did require p53 for p21 induction
      following exposure of the whole animal to gamma irradiation. These results show
      that normal tissue expression of p21 to high levels is not dependent on p53 and
      confirm that induction of p21 by DNA-damaging agents does require p53. p21 is
      expressed upon differentiation of p53-deficient murine erythroleukemia (MEL)
      cells, and the kinetics of induction of p21 in this system suggest that it may be
      involved in the growth arrest that precedes terminal differentiation. The gene is
      up-regulated in mouse fibroblasts in response to serum restimulation but the
      kinetics and levels of induction differ between wild-type and mutant cells.
      Expression of p21 message following serum restimulation is superinducible by
      cycloheximide in wild-type but not in p53-deficient cells. The increases in p21
      mRNA are reflected in changes in p21 protein levels. p21 expression also appears
      to be regulated at the post-transcriptional level because moderate increases in
      mRNA expression, during differentiation of MEL cells and upon serum restimulation
      of fibroblasts, are followed by large increases in protein levels. Regulation of
      the mouse p21 promoter by p53 depends on two critical p53-binding sites located
      1.95 and 2.85 kb upstream from the transcriptional initiation site. The sequences
      mediating serum responsiveness of the promoter map to a region containing the
      proximal p53 site. p53 appears to play a critical role in p21 induction following
      DNA damage. Moreover, p21 can be regulated independently of p53 in several
      situations including during normal tissue development, following serum
      stimulation, and during cellular differentiation.

PMID- 7774812
TI  - Concerted action of TGF-beta 1 and its type II receptor in control of epidermal
      homeostasis in transgenic mice.
AB  - Transforming growth factor-beta 1 (TGF-beta 1) is a modulator of cellular
      proliferation, differentiation, and extracellular matrix deposition. It is a
      potent epithelial growth inhibitor and can alter the differentiative properties
      of keratinocytes, in vitro, but little is known about its normal physiological
      function in the epidermis in vivo. Transgenic mice were generated using a keratin
      10 (K10) gene promoter to drive constitutive expression of TGF-beta 1 in the
      suprabasal keratinocyte compartment. Surprisingly, these mice showed a two- to
      threefold increase in epidermal DNA labeling index over control mice, in the
      absence of hyperplasia. The transgene, however, acted in the expected fashion, as
      a negative regulator of cell growth, when hyperplasia was induced by treatment by
      12-tetradecanoyl-phorbol-13-acetate (TPA). Epidermal TGF-beta type I and II
      receptor (T beta RI and T beta RII) levels were examined in control and
      transgenic mice during induction of hyperplasia by TPA. Whereas T beta RI levels
      remained relatively constant, T beta RII expression was strongly induced in TPA
      treated skins, prior to the induction of the growth inhibitory response to TGF
      beta 1, and its level of expression correlated with growth sensitivity to TGF
      beta 1 in vivo and in vitro. These results suggest that TGF-beta 1 and its type
      II receptor are part of the endogenous homeostatic regulatory machinery of the
      epidermis.

PMID- 7774813
TI  - The bli-4 locus of Caenorhabditis elegans encodes structurally distinct
      kex2/subtilisin-like endoproteases essential for early development and adult
      morphology.
AB  - Many secreted proteins are excised from inactive proproteins by cleavage at pairs
      of basic residues. Recent studies have identified several serine endoproteases
      that catalyze this cleavage in the secretory pathways of yeast and metazoans.
      These enzymes belong to the kex2/subtilisin-like family of proprotein
      convertases. In this paper we describe the molecular characterization of the bli
      4 gene from Caenorhabditis elegans, which was shown previously by genetic
      analysis of lethal mutants to be essential for the normal development of this
      organism. Sequencing of cDNA and genomic clones has revealed that bli-4 encodes
      gene products related to the kex2/subtilisin-like family of proprotein
      convertases. Analysis of bli-4 cDNAs has predicted four protein products, which
      we have designated blisterases A, B, C, and D. These protein products share a
      common amino terminus, but differ at the carboxyl termini, and are most likely
      produced from alternatively spliced transcripts. We have determined the molecular
      lesions for three bli-4 alleles (h199, h1010, and q508) that result in
      developmental arrest during late embryogenesis. In each case, the molecular
      lesions are within exons common to all of the BLI-4 isoforms. The original
      defining allele of bli-4, e937, is completely viable yet exhibits blistering of
      the adult cuticle. Molecular analysis of this allele revealed a deletion that
      removes exon 13, which is unique to blisterase A. No RNA transcript corresponding
      to exon 13 is detectable in the blistered mutants. These findings suggest that
      blisterase A is required for the normal function of the adult cuticle.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7774814
TI  - Myxococcus xanthus, a gram-negative bacterium, contains a transmembrane protein
      serine/threonine kinase that blocks the secretion of beta-lactamase by
      phosphorylation.
AB  - A gene, pkn2, encoding a Myxococcus xanthus protein with significant similarities
      to eukaryotic protein serine/threonine kinases, was cloned using the polymerase
      chain reaction. The open reading frame for the protein, beginning with a GUG
      initiation codon, consists of 830 amino acids. The amino-terminal 279 residues
      show 37% identity to catalytic domain of Pkn1, another protein serine/threonine
      kinase expressed during the development at the onset of sporulation. The
      catalytic domain of Pkn2 contains 27% and 25% identity to rat Ca2+/calmodulin
      dependent protein kinase and Bos taurus rhodopsin kinase, respectively. In the
      middle of the carboxy-terminal regulatory domain, there is a typical
      transmembrane domain consisting of 18 hydrophobic residues. The gene product,
      Pkn2, produced in Escherichia coli under a T7 promoter was phosphorylated at both
      serine and threonine residues. TEM-beta-lactamase produced in E. coli was found
      to serve as an effective substrate for Pkn2, phosphorylated only at threonine
      residues, shifting its apparent molecular mass from 29 to 44 kD. The
      phosphorylated beta-lactamase was unable to be secreted into the periplasmic
      space and localized in the cytoplasmic and membrane fractions. Analysis of phoA
      fusions with pkn2 demonstrated that Pkn2 is a transmembrane protein with the
      kinase domain in the cytoplasm and the 207-residue carboxy-terminal domain
      outside the cytoplasmic membrane. Disruption of pkn2 showed no effect on
      vegetative growth but reduced the yield of myxospores by 30%-50%. On the basis of
      the present results, we propose that Pkn2 is a transmembrane protein
      serine/threonine kinase that regulates the activity of endogenous beta-lactamase
      or related enzymes in response to an external signal yet to be identified.

PMID- 7774815
TI  - A STAT protein domain that determines DNA sequence recognition suggests a novel
      DNA-binding domain.
AB  - Stat1 and Stat3 are two members of the ligand-activated transcription factor
      family that serve the dual functions of signal transducers and activators of
      transcription. Whereas the two proteins select very similar (not identical)
      optimum binding sites from random oligonucleotides, differences in their binding
      affinity were readily apparent with natural STAT-binding sites. To take advantage
      of these different affinities, chimeric Stat1:Stat3 molecules were used to locate
      the amino acids that could discriminate a general binding site from a specific
      binding site. The amino acids between residues approximately 400 and
      approximately 500 of these approximately 750-amino-acid-long proteins determine
      the DNA-binding site specificity. Mutations within this region result in Stat
      proteins that are activated normally by tyrosine phosphorylation and that
      dimerize but have greatly reduced DNA-binding affinities.

PMID- 7774817
TI  - Quality of life: what is it?

PMID- 7774816
TI  - Assembly and function of a TCR alpha enhancer complex is dependent on LEF-1
      induced DNA bending and multiple protein-protein interactions.
AB  - In this study we examine the molecular basis for the synergistic regulation of
      the minimal TCR alpha enhancer by multiple proteins. We find that reconstitution
      of TCR alpha enhancer function in nonlymphoid cells requires expression of the
      lymphoid-specific proteins LEF-1, Ets-1 and PEBP2 alpha (CBF alpha), and a
      specific arrangement of their binding sites in the enhancer. We show that Ets-1
      cooperates with PEBP2 alpha to bind adjacent sites at one end of the enhancer,
      forming a ternary complex that is unstable by itself. Stable occupancy of the Ets
      1- and PEBP2 alpha-binding sites in a DNase I protection assay was found to
      depend on both a specific helical phasing relationship with a nonadjacent
      ATF/CREB-binding site at the other end of the enhancer and on LEF-1. The HMG
      domain of LEF-1 was found previously to bend the DNA helix in the center of the
      TCR alpha enhancer. We now show that the HMG domain of the distantly related SRY
      protein, which also bends DNA, can partially replace LEF-1 in stimulating
      enhancer function in transfection assays. Taken together with the observation
      that Ets-1 and members of the ATF/CREB family have the potential to associate in
      vitro, these data suggest that LEF-1 can coordinate the assembly of a specific
      higher-order enhancer complex by facilitating interactions between proteins bound
      at nonadjacent sites.

PMID- 7774819
TI  - Efficacy of hand massage in decreasing agitation behaviors associated with care
      activities in persons with dementia.

PMID- 7774818
TI  - Forgetfulness in elders: strategies for protective caregiving.
AB  - Nurses working with elders know from experience that an elder being viewed as
      forgetful negatively affects both the quality and the quantity of elders' social
      relationships. Avoiding stigmatization, in the presence of increased forgetting,
      presents a challenge for elders and their caregivers. Gerontologic nurses can
      assist forgetful elders with their personal impression management. They can
      protect these elders from being labeled by their social group. However, in order
      to assist elders in maintaining acceptable social impressions, nurses need to
      understand the impression management process and effective strategies for
      assisting forgetful elders in social situations.

PMID- 7774821
TI  - The caregiver needs a day off.

PMID- 7774820
TI  - A hospital-based skilled nursing facility: a special place to care for the
      elderly.

PMID- 7774822
TI  - Untying the elderly: response to quality-of-life issues.

PMID- 7774823
TI  - Extracts from Gerry's journal.

PMID- 7774824
TI  - Music as a nursing intervention for residents with Alzheimer's disease in long
      term care.

PMID- 7774825
TI  - Managing the cardiac arrest in the long-term care and subacute medical facility.

PMID- 7774826
TI  - Quality-of-life issues in home care.
AB  - Quality-of-life issues in home care are complex. Nurses not only must help the
      family consider these factors for the patient at home, but also they must examine
      the effects of home care on the primary caregiver and the entire family. Nurses
      use a holistic view in assessment to diagnose the needs of the client and the
      caregiver. Physiologic, psychologic, cultural, spiritual, and sociologic aspects
      are all considered. Nurses have an important role in assisting clients and their
      families to maximize the benefits of home care. They can help them with the
      provision of care in the current situation and to plan for the future for
      appropriate levels of care as the client's condition changes. These actions will
      result in an optimum quality of life for the client and the client's family.

PMID- 7774827
TI  - Maximizing calcium intake.

PMID- 7774828
TI  - Medications and sexual functioning in older adults.

PMID- 7774829
TI  - High-dose chemotherapy with autologous bone marrow support in ovarian carcinoma:
      the bottom line, more or less.

PMID- 7774830
TI  - A phase II trial of high-dose mitoxantrone, carboplatin, and cyclophosphamide
      with autologous bone marrow rescue for recurrent epithelial ovarian carcinoma:
      analysis of risk factors for clinical outcome.
AB  - Despite high initial response rates to platinum-based chemotherapy, most patients
      with advanced ovarian carcinoma die of drug-resistant disease. Drug resistance
      can be overcome in the hematologic malignancies and lymphomas with high-dose
      therapy and bone marrow transplantation (BMT) when used early, suggesting that
      this therapy may also be of value in ovarian carcinoma. As a prelude to the use
      of high-dose chemotherapy with BMT early in the management of advanced ovarian
      carcinoma, we evaluated a new high-dose regimen in patients with
      relapsed/refractory ovarian carcinoma to define toxicities and responses. Thirty
      patients were treated, of whom 20 were platinum resistant and 22 had > 1 cm
      maximum diameter disease. They received mitoxantrone (75 mg/m2), carboplatin
      (1500 mg/m2), and cyclophosphamide (120 mg/kg), followed by an autologous BMT.
      Overall, 89% responded, with clinical complete responses seen in 88 vs 47% (P =
      0.06) of platinum-sensitive vs -resistant disease. There was only one early death
      (3.3%) due to Aspergillus pneumonia. Median survival for all 30 patients was 29
      months, and at 3 years 23% are alive without disease. There was a 10.1- vs 5.1
      month progression-free survival for patients with platinum-sensitive versus 
      resistant disease, and at a median follow-up of 12 months, 80% of the platinum
      sensitive patients are alive. This regimen is safe, and for platinum-sensitive
      disease appears superior to other salvage therapies. Its use should be explored
      earlier in the management of advanced ovarian carcinoma.

PMID- 7774831
TI  - Potential of cervical electrosurgical excision procedure for diagnosis and
      treatment of cervical intraepithelial neoplasia.
AB  - The aim of this study was to evaluate the diagnostic potential, treatment
      efficacy, specimen adequacy, and acute complication rate associated with
      electrosurgical excision procedure (EEP) of the cervix for the management of
      cervical intraepithelial neoplasia (CIN). Analysis was performed retrospectively
      on 153 consecutive patients who underwent EEP under colposcopic guidance.
      Patients with negative endocervical curettage (ECC), adequate colposcopy, and
      biopsy-proven CIN were considered candidates for therapeutic EEP, whereas
      patients with a positive ECC, inadequate colposcopy, or cytology two or more
      grades discordant from the biopsy results underwent diagnostic EEP.
      Histopathologic specimens were graded as adequate, suboptimal, or inadequate.
      Diagnostic EEP was performed in 85 cases, and the remaining 68 procedures were
      performed primarily for treatment. Specimens were graded as adequate in 83%,
      suboptimal in 13%, and inadequate in 4% of the diagnostic EEP's. Specimen
      adequacy correlated most strongly with operator experience (P < 0.05). Four
      patients were found to have microinvasive or invasive cervical carcinoma.
      Complications occurred in 7% of the EEPs performed. Most consisted of immediate
      or delayed hemorrhage. In conclusion, EEP is a safe, well-tolerated procedure
      which is acceptable as both a therapeutic and diagnostic tool in the management
      of CIN when performed by an experienced operator. We recommend that initial EEP
      procedures should be performed for therapeutic indications, since adequacy of EEP
      specimens correlated with the level of operator experience.

PMID- 7774833
TI  - Overexpression of the protein tyrosine phosphatase, nonreceptor type 6 (PTPN6),
      in human epithelial ovarian cancer.
AB  - Our current understanding of human ovarian tumorigenesis is limited by the lack
      of a discrete precursor lesion as well as a limited knowledge of the steps in
      tumor progression. Since the alterations in the regulation of the tyrosyl
      residues on various cellular proteins appear to be an important pathway in
      neoplastic transformation, it is possible that changes in the expression of the
      proteins that control tyrosine phosphorylation (i.e., tyrosine kinases and
      phosphatases) may play a role in ovarian cancer development. Protein tyrosine
      phosphatase, nonreceptor type 6 (PTPN6), contains two src homology 2 domains and
      is expressed primarily in hematopoietic and epithelial cells. Using Northern blot
      and immunoblotting analysis, we showed that both the PTPN6 transcripts and
      proteins were overexpressed two- to four-fold in 7 of the 8 ovarian epithelial
      carcinoma cell lines studied. In addition, we showed that there was also a two-
      to threefold increase in expression of the PTPN6 transcript in 10 of 11 (91%)
      invasive ovarian epithelial cancer tissues examined. These observations suggest
      that the PTPN6 gene is potentially of etiologic relevance to a majority of
      ovarian cancers.

PMID- 7774832
TI  - The subrenal capsule assay in selecting chemotherapy for ovarian cancer: a
      prospective randomized trial.
AB  - In order to find out whether the response rate and survival in epithelial ovarian
      cancer can be improved by aid of sensitivity testing with the subrenal capsule
      assay (SRCA), 196 patients with FIGO Stage II-IV epithelial ovarian cancer were
      randomized to be treated with either cyclophosphamide-doxorubicin-cisplatin (CAP)
      or SRCA-guided chemotherapy. The drug combinations tested with the SRCA were (1)
      cyclophosphamide-doxorubicin-carboplatin (CACAR), (2) CAP, (3) carboquone
      methotrexate-tegafur (CQ-MTX-TEG), (4) cisplatin-etoposide-hexamethyl-melamine (P
      VP-HXM), and (5) bleomycin-epirubicin-cisplatin (BEP). A total of 132 patients
      (CAP, 69; SRCA, 63) were eligible for efficacy analysis based on relaparotomy
      findings. The overall response rate was 59% in the CAP arm and 62% in the SRCA
      arm. In the SRCA arm, 16 patients were treated with CACAR, 24 with CAP, 10 with
      CQ-MTX-TEG, 11 with P-VP-HXM, and 2 with BEP. The response rate to CACAR was 63%
      and to SRCA-CAP was 75%. The number of complete responses was higher when CAP was
      given as guided by the assay than when given at random (14/24 vs 23/69; P = 0.03,
      Pearson chi 2). Survival curves as estimated by Kaplan-Meier method gave a median
      survival of 24 (SE = 4) months to the SRCA arm and 28 (SE = 5) for the CAP arm (P
      = 0.7; log-rank test). Because no survival benefit was achieved, the SRCA
      obviously needs further development before it can be routinely recommended in the
      choice of first-line chemotherapy for patients with ovarian cancer.

PMID- 7774834
TI  - Using a vaginal tube to exteriorize lymph nodes during a laparoscopic pelvic
      lymphadenectomy.
AB  - Laparoscopic pelvic lymphadenectomy for gynecological malignancy involves
      mobilizing and exteriorizing the lymph nodes. We removed the nodes by passing a 4
      to 5-cm-diameter tube through the vagina to the abdomen following the
      hysterectomy. The nodes were passed through the tube rather than pulled through
      the abdominal ports. The tube is easy to insert and is a valuable conduit for
      exteriorizing tissue during laparoscopic pelvic surgery for gynecological cancer.

PMID- 7774835
TI  - Results of postoperative radiation therapy for patients with carcinoma of the
      uterine cervix: evaluation of intravaginal cone boost with an electron beam.
AB  - Retrospective analysis was carried out from the records of 108 patients with
      carcinoma of the uterine cervix treated with postoperative external whole pelvic
      irradiation (EWPI) followed by intravaginal cone boost with an electron beam to
      the vaginal cuff (IVCB) to evaluate the efficacy of this method. The 5-year cause
      specific survival rates were 89% for 89 patients undergoing prophylactic
      radiation therapy and 56% for 19 patients undergoing salvage radiation therapy (P
      < 0.001). The 5-year survival rates were 62% for 11 patients with macroscopic
      residual tumors and 41% for 8 patients with microscopic residual tumors. Of the
      patients with pelvic lymph node (PLN) involvement, incidences of intrapelvic
      recurrence, extrapelvic recurrence, and distant metastases were 12, 9, and 3%,
      respectively. The prognosis for patients without PLN metastasis was significantly
      better than that for patients with PLN metastasis in the prophylactic radiation
      therapy group (P < 0.001). Recurrent tumors at the vaginal cuff were observed in
      only 2 patients in the prophylactic radiation therapy group. Vesicovaginal
      fistula was observed in 4 patients. Only 1 patient developed Grade 2 rectal
      complications. No other severe complications were observed. IVCB following EWPI
      is a safe and effective postoperative radiation therapy technique for patients
      with cervical cancer.

PMID- 7774836
TI  - The importance of the groin node status for the survival of T1 and T2 vulval
      carcinoma patients.
AB  - The purpose of this study was to analyze (1) the prognostic factors for survival
      of T1 and T2 carcinoma patients and (2) the impact of the initial groin node
      status for the time to recurrence and site of recurrence. We performed a follow
      up study on 190 women with a T1 or T2 squamous cell carcinoma of the vulva. Data
      were obtained on age and general medical condition, the clinical and histological
      characteristics of the primary tumor and the inguinofemoral lymph nodes,
      treatment, recurrences, and survival. The standard treatment was radical
      vulvectomy with bilateral inguinofemoral lymphadenectomy supplemented with
      postoperative radiotherapy to the primary site, groin, and pelvic side walls if
      groin metastases were present. Compared to patients without lymph node metastases
      in the groin, the relative risk of dying within a given time period was estimated
      to be 2.47 (limits of the 95% confidence interval: 1.24, 4.93) and 9.69 (3.90,
      24.03) for patients with unilateral and bilateral node metastases, respectively.
      The number of metastatic lymph nodes or their intra- or extranodal growth was not
      associated with survival. The relative risk of dying within a given time period
      was 2.71 (1.36, 5.40) for patients with a T2 tumor compared to those with a T1
      tumor and 2.37 (1.31, 4.31) for patients with vasoinvasive growth compared to
      those without capillary-lymphatic tumor infiltration. Tumor thickness,
      differentiation grade, and multifocal growth did not determine survival. In the
      multivariate Cox regression analysis, the presence of inguinofemoral lymph node
      metastases proved to be the most important prognostic factor for patients'
      survival. Of the 119 patients who underwent lymphadenectomy but in whom no groin
      node metastases were found, 6 (5%) patients manifested an early recurrence (i.e.,
      residual cancer or a recurrence within 2 years after the diagnosis). In contrast,
      of the 51 patients with histologically documented groin node metastases, 15
      (29.4%) manifested an early recurrence and these recurrences appeared equally
      distributed over the primary site and other sites.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 7774837
TI  - T2/3 vulva cancer: a case-control study of triple incision versus en bloc radical
      vulvectomy and inguinal lymphadenectomy.
AB  - The purpose of this case-control study was to compare outcome in T2/3 vulvar
      cancer patients treated with radical vulvectomy and inguinal lymphadenectomy
      using either a triple incision or en bloc technique. All T2/3 vulvar cancer
      patients treated by the triple incision technique were identified and compared to
      a control group consisting of similar T2/3 patients treated with an en bloc
      procedure at the same institution. Survival by surgical stage, lesion diameter,
      nodal status, and margin status was analyzed and compared between the two groups.
      Twenty-seven vulvar cancer patients with a T2/3 lesion underwent radical
      vulvectomy and inguinal lymphadenectomy using the triple incision technique; the
      control group consisted of 20 T2/3 vulvar cancer patients treated by en bloc
      resection. The two groups were matched for age, surgical stage, grade, lesion
      diameter, margin status, nodal status, and adjuvant treatment. The recurrence
      rate in the triple incision group was 37% compared to 35% in the en bloc group.
      (OR, 1.092, 95% CI, [0.327, 3.649], P = 0.9). There was no difference in the
      local recurrence rate between the two groups (80% in the triple incision group
      and 72% in the en bloc group) (P = 0.5). Five-year survival for the triple
      incision and the en bloc groups was similar, 64 and 82%, respectively (P = 0.15).
      Survival between the groups was not statistically different when analyzed
      according to surgical stage, lesion diameter, nodal status, and negative margin
      status. These data indicate that the triple incision technique provides survival
      outcomes similar to the standard en bloc radical vulvectomy in patients with T2/3
      vulva cancer. Due to the significant morbidity that has been associated with the
      en bloc radical vulvectomy and inguinal lymphadenectomy, the triple incision
      technique should be considered as the preferred method of treatment for most
      vulvar cancer patients.

PMID- 7774838
TI  - Gestational trophoblastic tumors of the uterus: MR imaging--pathologic
      correlation.
AB  - The purpose of this study is to evaluate the MR findings of gestational
      trophoblastic tumors (GTTs). Ten patients who confirmed the diagnosis (4
      choriocarcinomas and 6 invasive moles) constituted the basis of our study. The MR
      findings from these patients were prospectively correlated with the
      histopathology of resected tumor specimens. MR findings of 4 patients with
      choriocarcinomas were well-defined, hemorrhagic masses with central necrosis. In
      contrast, 6 patients with invasive moles showed ill-defined, permeative masses
      with densely enhanced solid components and tiny cystic lesions. The trophoblastic
      proliferation, coagulation necrosis, and molar villi had varying signal
      intensities on T1- and T2-weighted images. Our results suggest that MR imaging is
      a promising tool for noninvasive morphologic analysis of GTTs.

PMID- 7774839
TI  - The interaction between cytotrophoblasts and their derived tumor cells.
AB  - Previous experiments demonstrated that human cytotrophoblasts and cells of the
      choriocarcinoma cell line JAr interact in vitro. As a result of this interaction
      there is an increased synthesis of CG and hPL, probably as a result of the
      increased CG and hPL synthesis by the cytotrophoblasts. In the present
      investigation we studied this interaction in greater detail and found that both
      cytotrophoblasts and JAr cells undergo changes in their biological properties as
      a result of this interaction. JAr cells and cytotrophoblasts cocultured for 72 hr
      were fractionated according to their size by centrifugal elutriation. The number
      of cells in the fraction which contain the largest cells was very significantly
      increased as a result of the coculture. This increase was due to an increase in
      the number of cells of both cell types. This fraction was the most active one in
      the synthesis of CG and hPL. The synthesis of DNA by the JAr nuclei in this
      fraction of the cocultured cells was almost completely inhibited but in the
      parallel fraction of the JAr cells cultivated alone the level of DNA synthesis
      was equal to that of all other JAr cell fractions. Heterokaryons are formed in
      the coculture. In these heterokaryons a factor which inhibits DNA synthesis in
      the cytotrophoblasts may inhibit DNA synthesis in JAr nuclei and at least be
      partly responsible for the inhibition of DNA synthesis observed.

PMID- 7774840
TI  - Altered HLA expression by metastatic cervical carcinoma cells as a factor in
      impaired immune surveillance.
AB  - The altered expression of histocompatibility leukocyte antigens (HLA) in the
      development to cervical carcinoma suggests that tumor progression may be related
      to impaired recognition by host immune defense mechanisms. To investigate whether
      this phenomenon plays a role in the process of metastasis of cervical cancer, we
      analyzed and compared the HLA expression with the number of infiltrating immune
      cells in primary cervical carcinoma and related autologous metastases (n = 30) by
      staining serial paraffin and corresponding frozen sections with a panel of
      monoclonal antibodies. In 60% of the cervical metastases, compared to 21% of the
      primary tumors, a downregulation of monomorphic HLA class I antigens was
      observed, with frequent allele-specific alterations. In 50% the HLA class II
      expression was slightly increased on the metastatic tumor cells in comparison to
      the primary tumor. In addition, variability of alterations in HLA expression was
      observed between different metastases in the same patient. A minor infiltration
      of immune cells was present in cervical metastases compared to the primary
      tumors, especially in the HLA class I-downregulated metastases. Furthermore, loss
      of HLA class I expression on the metastatic tumor cells resulted in a significant
      decrease of tumor-infiltrating CD8+ T lymphocytes. These findings suggest that in
      cervical carcinoma loss of HLA class I expression plays a decisive role in the
      escape from immune surveillance leading to a greater metastatic potential of
      tumor cells.

PMID- 7774841
TI  - Phase II trial of mitomycin-C in squamous cell carcinoma of the uterine cervix: a
      Gynecologic Oncology Group study.
AB  - Fifty-six patients with advanced, persistent, or recurrent squamous cell
      carcinoma of the cervix not previously exposed to cytotoxic drugs, other than as
      radiosensitizers, were entered into a study of single-agent 20 mg/m2 mitomycin-C
      every 6 weeks. The overall response rate among the 52 patients evaluable for
      response was 12% (three complete and three partial responses). Median response
      duration was 7.3 months. For the entire population, median progression-free
      interval was 3.0 months, and median survival was 4.9 months. Among 27 patients
      with pelvic disease only in previously radiated fields, two responses were
      observed (7%), whereas four responses were observed among 25 patients with
      extrapelvic disease in nonradiated fields (16%). The most frequent and severe
      adverse effects were the result of myelosuppression. Based on the modest level of
      activity observed, no further study of mitomycin-C in squamous cell carcinoma of
      the cervix is planned.

PMID- 7774842
TI  - Urinary tract infection in patients of gynecological malignancies undergoing
      external pelvic radiotherapy.
AB  - A total of 216 midstream urine (MSU) samples from 36 patients with gynecological
      malignancies undergoing external pelvic radiotherapy (RT) were studied
      periodically every week for any evidence of urinary tract infection (UTI). UTI
      was detected in 33.3% patients of whom 8.3% had infection at the onset of RT and
      the rest developed UTI during the course of therapy. All three patients who had
      UTI at the onset of RT underwent cystoscopy as a part of routine pretreatment
      workup. A higher preponderance of UTI was observed in patients of stage III
      carcinoma cervix (33.3%) compared to stage II (16.7%) during the course of RT.
      Half of the patients with UTI had repeated episodes of infection despite
      appropriate antibiotic treatment. The study emphasizes the importance of
      conducting periodic MSU examination in patients with gynecological malignancies
      during RT and its treatment with appropriate antibiotics to minimize the risks of
      further injury to the already susceptible uroepithelium following radiotherapy.

PMID- 7774843
TI  - Induction of immunocellular resistance to IL-2-activated lymphocytes within
      ovarian carcinoma cells.
AB  - The development of resistance within ovarian carcinoma cells to activated
      cytotoxic lymphocytes was the objective of this study. Primary ovarian carcinoma
      cells were obtained from the ascites of a patient. These cells were cocultured
      with IL-2-activated autologous tumor-associated lymphocytes (TALs) for 1 week.
      The resulting selected cells underwent a second coculture for 3 days with IL-2
      activated autologous TALs or tumor-infiltrating lymphocytes (TILs). Phenotype
      analysis of the lymphocytes was performed prior to selection and 4-hr chromium
      release assays were used to detect resistance induction. Resistance to all
      effector cells could be demonstrated for the selected cells. However, selected
      cells maintained in culture demonstrated no difference in cytotoxic
      susceptibility from unselected cells. The following conclusions were made: (i)
      rapid immunoselection can occur for ovarian carcinoma in vitro; (ii) the
      resistance induced is not MHC-restricted; (iii) resistance induced by one type of
      cytotoxic cell results in general resistance to other types of cell from the same
      patient; and (iv) this resistance is not maintained during in vitro culture.
      These results may have direct implications on the future immunotherapy for this
      condition.

PMID- 7774844
TI  - Participation in transvaginal ovarian cancer screening: compliance, correlation
      factors, and costs.
AB  - The objective was to identify factors influencing participation in screening for
      ovarian cancer using transvaginal sonography in the free experimental program at
      the University of Kentucky over its 6+ year history. Database records for
      screenings, performed from 1987 to June 1994, were utilized. Computer sorts, 1990
      census information as predictors, and stepwise multiple regression analysis were
      employed. Participation in the model ovarian screening program took 3-4 years to
      approach > 300 screens/month, with repeat screenings exceeding new subject
      participation in this time period. A number of participants traveled > 200 miles
      for screening on both initial and repeat encounters. Analysis of distance to the
      screening site, median family income, county physician population, and education
      levels indicated that distance and then education correlated best with
      participation. Unit screening cost shrank from $45 to under $25 when maximal
      participation was achieved. Distance and education correlated with participation.
      Expenses compare favorably with diagnostic procedures for other diseases.

PMID- 7774845
TI  - Blood transfusion and the risk of recurrence in stage IB cervical cancer.
AB  - The objective of this study is to determine if perioperative blood transfusions
      increase the risk of recurrence in stage IB cervical cancer. Medical records from
      all patients with FIGO stage IB cervical cancer undergoing radical hysterectomy
      and pelvic lymphadenectomy (RH + PLND) at the University of Iowa and the
      University of Nebraska from 1978 to 1990 were retrospectively reviewed. Data
      collected included patient age, body mass index (BMI), tumor size, cell type,
      depth of cervical invasion (DOI), presence of capillary-lymphatic space
      involvement (CLSI), lymph node metastasis, operating time, estimated blood loss,
      transfusion, and follow-up data. Three hundred two patients underwent RH + PLND.
      Transfusions were given to 244 (81%), with a mean of 2.6 units (range 1-18
      units). Median follow-up was 49.5 months (range 9-190 months). Twenty patients
      (6.6%) had pelvic nodal metastasis. There were no periaortic nodal metastases in
      the 101 patients who had periaortic nodes dissected. There were no significant
      differences between the transfused and nontransfused groups, with respect to age,
      BMI, DOI, or pelvic node metastasis. Transfused patients differed significantly
      from the nontransfused in that they had larger tumors (P = 0.047), more frequent
      CLSI (P = 0.013), longer procedures (P = 0.02), and greater estimated blood loss
      (P < 0.0001). Recurrences developed in 29 patients (19 pelvic, 7 lung, 3 bone).
      There is no difference in disease-free survival (DFS) or calculated projected
      survival between the transfused and nontransfused groups. Pelvic node metastasis
      and tumor size were independent poor prognosticators. After controlling for these
      factors, the number of blood transfusions was not predictive of recurrence or
      survival. Perioperative transfusions do not increase the risk of recurrence in
      patients with cervical cancer.

PMID- 7774846
TI  - A phase II trial of piroxantrone in advanced ovarian carcinoma after failure of
      platinum-based chemotherapy: Southwest Oncology Group Study 8904.
AB  - A phase II trial of the new anthrapyrazole piroxantrone was conducted by the
      Southwest Oncology Group in advanced ovarian carcinoma. The objective were to
      evaluate its response rate and toxicity in patients who had disease persistence,
      progression, or recurrence either during or after platinum-containing
      chemotherapy. A two-stage statistical design targeted accrual to 15 eligible
      patients if no responses were observed. The piroxantrone starting dose was 120
      mg/m2, with the provision to escalate to 150 and 180 mg/m2. There were 16
      eligible patients, all of whom had received either one (12 patients) or two (4
      patients) prior platinum-containing regimens; one patient had received
      doxorubicin. Fourteen of the 16 patients were enrolled either at the time of
      disease persistence/progression during initial chemotherapy or with recurrence or
      progression within 6 months of the previous platinum-based remain. One to 5
      cycles of piroxantrone were given. Dose escalation was feasible in 7 patients but
      was prevented in the other 9 by neutropenia. Maximum toxicity for all cycles was
      none or grade 1 in 2 patients; grade 2, 5; grade 3, 8; and grade 4, 1. All but
      one of the grade 3 or 4 events was from myelosuppression; there were no adverse
      cardiac events. No responses were observed. Thus, piroxantrone appears inactive
      in patients with persistent, progressive, or recurrent ovarian cancer who
      recently had received a platinum-based regimen.

PMID- 7774848
TI  - Successful liver treatment of a juvenile granulosa cell tumor in a 4-year-old
      child by regional deep hyperthermia, systemic chemotherapy, and irradiation.
AB  - Juvenile granulosa cell tumors (JGCT) of the ovary are rare in children and
      adolescents. About 90% are diagnosed in early-stage FIGO I with favorable
      prognosis. More advanced stages (FIGO II-IV) have a poor clinical outcome and
      chemotherapy alone cannot avoid tumor progression. Regional deep hyperthermia
      (RHT) induced by microwave technique has been established as an additional
      modality for treatment of different tumors. However, in cases with liver
      involvement there are technical problems which have not yet been solved. We
      report on a 4-year-old child who suffered from diffuse liver metastases 10 months
      after JGCT of the left ovary. After chemotherapy including ifosfamide, etoposide,
      and carboplatin in combination with RHT and consolidation radiotherapy, the
      patient has been in complete remission for 1 year of follow-up. This Case Report
      indicates the feasibility of combining surgery, chemotherapy, hyperthermia, and
      radiation therapy (which can also be an effective treatment modality for advanced
      granulosa cell tumor) for the treatment of liver metastases of JGCT, but does not
      allow comparisons of these treatments.

PMID- 7774849
TI  - Dysgerminoma and gonadal dysgenesis in a 46,XX female with no evidence of Y
      chromosomal DNA.
AB  - The occurrence of dysgerminoma in dysgenetic gonads without Y chromosomal
      influence is exceptionally rare. We used Southern blot hybridization of Y-DNA
      probes to genomic DNA to search for any Y-related influence in a patient with a
      dysgerminoma, dysgenetic gonads, and a 46,XX karyotype. No Y-specific DNA was
      found at 11 loci representing the short arm, centromere, and long arm. This
      absence of any Y-DNA leaves open to question the absolute requirement of Y
      related influence in the development of dysgerminoma in dysgenetic gonads.

PMID- 7774847
TI  - Neoadjuvant chemotherapy with vincristine and cisplatin followed by radical
      hysterectomy and pelvic lymphadenectomy for FIGO stage IB bulky cervical cancer:
      a Gynecologic Oncology Group pilot study.
AB  - Thirty-five patients with bulky (designated as > or = 4 cm size) International
      Federation of Gynaecology and Obstetrics (FIGO) Stage IB cervical cancer were
      treated with cisplatin, 50 mg/m2, and vincristine, 1 mg/m2, administered
      intravenously at 10-day intervals for a total of three courses before planned
      radical hysterectomy. One patient died of unrelated cause following one course of
      chemotherapy and was not evaluated for response. Of the 34 evaluable patients who
      completed chemotherapy, a complete clinical response was noted in two patients
      (6%) and a partial response in 26 patients (76%). Five patients (15%) had stable
      disease and one patient (3%) had disease progression. All chemotherapy was
      completed within 4 weeks (range 17-28 days). There was no grade 4 toxicity noted.
      Only one case each of reversible grade 3 granulocytopenia and stomatitis and two
      cases of reversible grade 3 peripheral neuropathy were noted. Of the 34 patients
      who received chemotherapy, the only patient with disease progression received
      standard pelvic radiation therapy in lieu of radical surgery. A second patient
      with stable disease had unresectable pelvic lymph node metastases and underwent
      confirmatory lymph node biopsy only and received standard radiation therapy
      postoperatively. The remaining 32 patients underwent radical hysterectomy and
      pelvic lymphadenectomy from 12 to 49 days following chemotherapy. Surgery was
      performed without significant difficulty. Eight of these patients (25%) had
      pelvic node metastases and received postoperative pelvic radiation therapy.
      Twenty-four months following initiation of treatment, 25 (74%) were alive and
      presumed free of disease, 4 had died of cancer (12%), 1 was alive with recurrence
      (3%), and 4 patients (12%) were lost to follow-up. A prospective randomized study
      is needed to assess the value of this approach compared with standard management.

PMID- 7774850
TI  - Endometrial squamous cell carcinoma following whole pelvic radiation therapy:
      response to carboplatin.
AB  - A case of Stage IV endometrial squamous cell carcinoma occurring 8 years after a
      low anterior resection and whole pelvic radiation therapy for a Dukes D colon
      carcinoma is presented. Koilocytosis was present in the tumor. There was no
      evidence of human papillomavirus antigen or DNA in the tumor. The patient was
      treated with surgery followed by six cycles of carboplatin chemotherapy. At the
      completion of chemotherapy there was no clinical or radiological evidence of
      disease. The tumor recurred 9 months postchemotherapy and the patient died of
      disease 17 months postdiagnosis.

PMID- 7774851
TI  - Treatment-related myelodysplastic syndrome following abdominopelvic radiotherapy
      for endometrial cancer.
AB  - A patient with grade II endometrial adenocarcinoma underwent TAH/BSO. The tumor
      penetrated 50% of the myometrium. A lesion from the serosa of the sigmoid colon
      was removed and contained metastatic adenocarcinoma. Metastatic tumor was also
      found in the common iliac lymph nodes. Postoperatively the patient was treated
      with abdominopelvic radiotherapy to 30 Gy. The pelvis was boosted to a dose of
      46.2 Gy. The vaginal apex was then treated with three applications of high-dose
      rate brachytherapy to a total dose of 12 Gy. The patient was doing well with no
      evidence of recurrence 52 months following treatment when she was diagnosed with
      a myelodysplastic syndrome. Cytogenetic analysis revealed aberrations of
      chromosomes 5 and 7, which is highly suggestive of a treatment-related process.
      Myelodysplasia induced by radiotherapy alone is an unusual but recognized event.

PMID- 7774852
TI  - Extraovarian stage IV peritoneal serous papillary carcinoma presenting as an
      asymptomatic skin lesion--a case report and literature review.
AB  - An 81-year-old G2 P2 white female in good health with the exception of well
      controlled hypertension presented to her family physician with a newly discovered
      lesion in the skin of the abdominal left lower quadrant. Initially, this nodule
      was viewed as innocuous and was followed with the expectation that it would soon
      resolve. Three months later, the lesion was biopsied, revealing a pattern
      consistent with papillary serous carcinoma from a presumed ovarian primary. CT
      scan revealed a pelvic mass. Subsequent laparotomy revealed a benign tubal
      cystadenofibroma, but otherwise normal pelvic viscera. Additional findings,
      however, included multiple small parietal peritoneal nodules histopathologically
      diagnosed as extraovarian peritoneal serous papillary carcinoma similar to the
      skin lesion. All gross disease was extirpated. The patient received chemotherapy
      as for advanced ovarian cancer.

PMID- 7774853
TI  - Onycholysis of the finger and toenails following the application of high-dose
      oral etoposide (1250 mg/m2) given as 200- and 150-mg single doses from days 1-10
      every 3 weeks.

PMID- 7774855
TI  - Re: Uterine papillary serous carcinoma: patterns of metastatic spread.

PMID- 7774854
TI  - 12 cases of carcinoid tumors metastatic to the breast have been reported.

PMID- 7774856
TI  - [Determination of phosphatidylinositol turnover for pharmacological analysis].
AB  - The most popular method for determining phosphoinositide hydrolysis is the
      analysis of water-soluble materials in cells or tissues that have been labeled
      with [3H]inositol by separating them on anion exchange open columns or HPLC
      columns. Recently, a radioreceptor assay has become available for the analysis of
      inositol 1,4,5-trisphosphate (IP3) using IP3 receptors and [3H]IP3; this allows
      the analysis of IP3 in vivo. On the other hand, radiolabeled phosphoinositides
      are measured by thin layer chromatography to analyze the breakdown or synthesis
      of phosphoinositide in response to stimuli. The purified enzyme with phospholipid
      vesicles can be used to hydrolyze [3H]phosphatidylinositol 4,5-bisphosphate
      (PIP2) to [3H]IP3, which makes it possible to search for direct action of a drug
      on phospholipase C.

PMID- 7774857
TI  - [Hypocalcemic effect of elcatonin in mouse models for humoral hypercalcemia of
      malignancy].
AB  - To elucidate the effect of calcitonin on humoral hypercalcemia of malignancy
      (HHM), we studied the effect of elcatonin, a synthetic eel calcitonin analog, on
      plasma calcium concentration in hypercalcemic nude mice transplanted
      subcutaneously with FA-6 pancreas cancer cells and hypercalcemic mice produced by
      continuous infusion of parathyroid hormone-related peptide (PTHrP). Elcatonin
      proved to exert a potent hypocalcemic effect in either model for hypercalcemia.
      The effect reached peaks at 2 hr after its administration, and it was no longer
      detected at 24 hr. The dose-dependent effects of a single administration of
      elcatonin were studied in the FA-6 tumor-bearing mice: the hypocalcemic effect of
      elcatonin at 1-2 hr after administration was dose-relatedly augmented. The effect
      of daily administration of elcatonin was further studied in the FA-6 tumor
      bearing mice: 5-Day daily administration of elcatonin was not accompanied by
      reduction in its hypocalcemic effect. Moreover, it was suggested that higher the
      efficacy of elcatonin, the higher were the plasma calcium concentrations in the
      tumor-bearing mice. These results indicated that elcatonin exerts an immediate
      hypocalcemic effect even on models for acute and severe hypercalcemia such as FA
      6 tumor-bearing mice, that this hypocalcemic effect became more potent depending
      on their elevation of plasma calcium concentration, and that elcatonin exerts a
      hypocalcemic effect even on a model for hypercalcemia due to PTHrP, a presumable
      causative substance of HHM.

PMID- 7774858
TI  - [A study on the effect of cepharanthin, a biscoclaurine alkaloid, on enhancement
      of mitogen-induced histidine decarboxylase activity in mice spleens and the
      effect of histamine on the production of cytokines].
AB  - The effect of cepharanthin on the enhancement of mitogen-induced histidine
      decarboxylase (HDC) activity in mice spleens and the effect of histamine on the
      production of cytokines were investigated. Cepharanthin enhanced LPS-induced HDC
      activity in normal mice spleens and also enhanced it in genetically T cell
      deficient nude mice spleens and T and B cell-deficient scid mice spleens.
      Therefore, cepharanthin can exert its effect on macrophages without T cells or B
      cells. Cepharanthin enhanced LPS-induced cytokine production by macrophages.
      Histamine induced cytokine production and enhanced LPS-induced cytokines
      production by macrophages. However, diphenhydramine and cimetidine, histamine
      receptor antagonists, did not block this process. Alpha-fluoromethylhistidine, a
      suicide inhibitor of HDC, suppressed LPS-induced cytokine production. These
      results suggest that cytokine production by macrophages is regulated by both
      histamine added exogenously and histamine induced by macrophages themselves and
      that histamine participates in enhancement of cytokine production by
      cepharanthin.

PMID- 7774859
TI  - [Inhibitory effects of prostaglandin E1.alpha-cyclodextrin (PGE1.CD) on
      dimethylnitrosamine-induced acute liver damage in rats].
AB  - The effects of PGE1.CD on dimethylnitrosamine (DMN)-induced acute liver damage
      with intravascular coagulation in rats were biochemically and histopathologically
      investigated. PGE1.CD was administered i.v. from 30 min before to 24 hr after DMN
      intoxication (pretreatment) and from 30 min after or from 4 hr after to 24 hr
      after DMN-intoxication (post-treatment). Pretreatment with PGE1.CD (0.2-2
      micrograms/kg/min) dose-dependently suppressed the decrease of platelet counts
      and the elevation of blood biochemical parameters (PT, HPT, GOT, GPT, LDH, LAP, T
      Bil) caused by DMN-intoxication. PGE1.CD (0.5 microgram/kg/min and over)
      significantly suppressed the DMN-induced histopathological changes (occurrence of
      hemorrhage and necrosis). Post-treatment with PGE1.CD (2 micrograms/kg/min) also
      suppressed the liver damage. Furthermore, pretreatment with PGE1.CD (2
      micrograms/kg/min) not only suppressed the disruption of hepatocytes, but also
      prevented the damages of sinusoidal endothelial cells and lysosomal membrane, and
      it reduced the increase of lipid peroxidation. PGE1.CD (1 microgram/kg/min and
      over) significantly suppressed the decrease of hepatic tissue blood flow caused
      by DMN-intoxication. These results demonstrate that PGE1.CD has therapeutically
      efficacy against DMN-induced acute liver damage in rats; Therefore, it will be
      clinically useful for the treatment of severe hepatitis such as fulminant
      hepatitis with intravascular coagulation in the sinusoid.

PMID- 7774860
TI  - [Studies on histamine H2-receptor antagonistic property of FRG-8813, a novel anti
      ulcer drug].
AB  - The present study was conducted to investigate the histamine H2-receptor
      antagonistic property of FRG-8813 by using isolated guinea pig right atria,
      gastric cells and cerebral cortex preparations. FRG-8813 inhibited the histamine
      induced positive chronotropic response of the right atria and shifted the
      concentration-response curve of histamine to the right with suppression of the
      maximal response. Although the inhibitory effect of FRG-8813 was enhanced in a
      time-dependent manner and long-lasting, the antagonism was reversible. The
      potency of FRG-8813 was 2 times and 50 times greater than those of famotidine and
      cimetidine, respectively. FRG-8813 decreased the histamine-induced
      [14C]aminopyrine accumulation in gastric cells. Schild plot analysis showed that
      the slopes of FRG-8813, famotidine and cimetidine were 1.56, 1.40 and 1.07,
      respectively, suggesting that the mode of the antagonism of FRG-8813 is also
      unsurmountable in gastric cells. The lack of effect on dbcAMP- and bethanechol
      induced [14C]aminopyrine accumulations indicated the selectivity of FRG-8813 for
      histamine H2-receptor. As in the right atria, the potency of H2-antagonism was
      1.5 times and 40 times greater than those of famotidine and cimetidine,
      respectively. In the [3H]tiotidine binding study of the cerebral cortex
      preparation, the Ki values showed that the affinity of FRG-8813 was 2 times and
      80 times more potent than those of famotidine and cimetidine, respectively. In
      conclusion, FRG-8813 is an unsurmountable and selective histamine H2-receptor
      antagonist with 2 times greater potency than famotidine. The antagonistic
      activity is reversible in spite of the time-dependent increase of the antagonism.

PMID- 7774861
TI  - [Hemodynamic and neurohumoral effects of carperitide (alpha-human atrial
      natriuretic peptide) in dogs with low-output heart failure].
AB  - We examined the hemodynamic and neurohumoral effects of carperitide in dogs with
      low-output heart failure (LHF) produced by volume expansion, ligation of the left
      anterior descending coronary artery and methoxamine infusion. Carperitide (0.1
      approximately 1 micrograms/kg/min, i.v. infusion for 30 min) decreased pulmonary
      arterial pressure, right atrial pressure and systemic vascular resistance and
      increased cardiac output. These pharmacological activities were equivalent to
      those of nitroglycerin (NG, 3 micrograms/kg/min). Although most of the animals
      did not excrete urine after induction of LHF, carperitide, unlike NG, increased
      urine volume. The plasma level of cyclic GMP was elevated about three times by
      induction of LHF and further increased after treatment with carperitide (1
      microgram/kg/min). Carperitide had no effects on plasma renin activity, plasma
      aldosterone concentration and plasma noradrenaline. These results taken together
      indicate that carperitide reduces both preload and afterload in association with
      an increase in cyclic GMP production and improves the untoward hemodynamic
      alterations in LHF dogs.

PMID- 7774862
TI  - Interaction of cardiac myocytes and non-myocytes in mechanical stress-induced
      hypertrophy.
AB  - It is known that mechanical stress directly changes the conformation of the
      functional proteins, or directly activates enzymes such as phospholipase in the
      plasma membrane. The integrin-cytoskeleton complex may be an alternative
      candidate structure for a mechanoreceptor and a transducer. The cytoskeleton has
      been also shown to play an important role in secretion. Mechanical stress may
      stimulate the secretion of some cytokines or angiotensin II, which may generate
      multiple intracellular signals as a secondary event. External stimuli are
      generally transduced into the nucleus through the activation of protein kinase
      cascade. Stretching of cardiac myocytes stimulates the activity of PKC, Raf-1
      kinase, MAP kinase kinase. MAP kinase and S6 kinase. In cardiac myocytes,
      mechanical stress directly induces gene expression as well as protein synthesis.
      Immediate early genes are first induced, and then fetal-type genes are reinduced.
      Both in hypertrophied hearts and in the experimental model of cardiac hypertrophy
      induced by pressure overload. Ca(2+)-ATPase content of cardiac myocytes is
      depressed. Reduced function of sarcoplasmic reticulum causes insufficient
      decrease of intracellular calcium in diastole and induces slowing of ventricular
      relaxation. In the interstitium of pressure overloaded hearts, the accumulation
      of collagen fiber is increased. The abnormal deposit leads to increased chamber
      stiffness and diastolic dysfunction. Furthermore, TGF-beta and tissue renin
      angiotensin system are up-regulated in pressure overloaded hearts, both of which
      accelerate the interstitial fibrosis.

PMID- 7774863
TI  - Fibronectin expression in the cardiovascular system.
AB  - Fibronectin (FN) is a dimeric glycoprotein found in the extracellular matrix
      (ECM) of most tissues and serves as a bridge between cells and the interstitial
      collagen meshwork. It also influences diverse processes including cell growth,
      adhesion, migration, and wound repair. Multiple FN forms arise by the alternative
      splicing of a primary transcript originating from a single gene. The spatial and
      temporal alterations in FN expression in the cardiovascular system have been
      studied in vitro in cell culture and in vivo during fetal development,
      hypertrophy, infarction, arterial injury and aging. This review describes
      characteristics of FN expression in cardiovascular system: 1. the FN phenotype is
      regulated during development. A high FN mRNA level is related to an early cardiac
      organogenesis and a progressive decrease that begins at the fetal stage and
      continues through senescence. During cardiac ontogeny, there is a linear
      correlation between total FN mRNA accumulation and the relative amounts of FN
      EIIIA and EIIIB RNA. This correlation is absent during cardiac growth in the
      adult. 2. A differential reexpression of the FN isoforms is observed in both
      myocardium and aorta in different models of hypertension or infarction but with
      different threshold and time course. Changes in total FN mRNA levels in
      hypertensive models vary depending on the authors. Nevertheless the differences
      in the expression of the fetal forms of FN mRNA observed among the various models
      of hypertension-induced hypertrophy indicate that the process of FN pre-mRNA
      splicing in the adult myocardium is specifically regulated and depends on the
      pathological situations and the type of cell.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7774864
TI  - Pharmacological modulation of cardiac fibroblast function.
AB  - The cardiac interstitium is composed of nonmyocyte cells and a structural protein
      network which plays a dominant role in governing the structure, architecture, and
      mechanical behavior of the myocardium. The heterogeneity in myocardial structure,
      created by the altered behavior of nonmyocyte cells, particularly cardiac
      fibroblasts which are responsible for myocardial collagen metabolism and fibrous
      tissue accumulation, may largely explain the appearance of diastolic and/or
      systolic myocardial failure. Regulatory mechanisms that are related to the
      fibrous tissue response in various cardiovascular diseases, e.g., hypertensive
      heart disease, dilated cardiomyopathy or post myocardial infarction, are of
      primary clinical interest. A better understanding of the hitherto neglected role
      of cardiac fibroblasts in mediating an adverse structural remodeling of the
      myocardium will lead to specific pharmacologic agents that interfere with the
      fibrous tissue response. Several lines of evidence based on in vivo and in vitro
      studies suggest that circulating and tissue renin-angiotensin-aldosterone systems
      (RAAS) are involved in the structural remodeling of the nonmyocyte compartment,
      including the cardioprotective effects of angiotensin converting enzyme (ACE)
      inhibition or aldosterone receptor antagonism that was found to prevent
      myocardial fibrosis in the rat with renovascular or genetic hypertension. In
      cultured adult cardiac fibroblasts, an angiotensin (Ang)II- or aldosterone
      mediated dose-dependent increase in collagen synthesis could be completely
      abolished by the use of AngII type 1 or mineralocorticoid receptor antagonists,
      respectively. Likewise, the AngII-mediated decrease in the activity of matrix
      metalloproteinase 1, the key enzyme for interstitial collagen degradation, could
      be antagonized by AngII receptor blockade.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7774865
TI  - Morphoregulatory interactions of endocardial endothelium and extracellular
      material in the heart.
AB  - The endocardium forms the inner lining of the cavities of the heart. The luminal
      surface of the cardiac wall is subjected to considerable cyclical physico
      chemical forces. These forces can have structural and physiological consequences
      both for the endocardial endothelium and for the subjacent interstitial tissue.
      In the latter tissue space, the extracellular matrix (ECM) plays a dominant role
      during cardiogenesis. For example, this role becomes evident from the influence
      of fibronectin in the directional migration of proendocardial cells and in the
      formation of a trabeculated heart. In particular, the complex processes occurring
      in the valves of the developing heart illustrate a spatiotemporally regulated
      expression of ECM components and adhesion molecules. In the adult heart, the
      endocardial interstitial tissue consists of a thin basal lamina, a reticular
      lamina and a fibroelastic layer which contains some fibroblasts, smooth muscle
      cells and a heterogeneous population of nerve fibers. Unlike in arteries, elastic
      fiber in the fibroelastic layer of ventricular endocardium do not constitute an
      elastic lamina. Differences in thickness of the endocardium between atria and
      ventricles, as well as the diffuse and focal endocardial fibrosis during ageing
      have been related to mechanical stress and local turbulence of flow. Although
      endocardial fibrosis is a common pathological finding in various
      cardiomyopathies, our knowledge on the structural organization and on the
      pathogenetic role of ECM is very limited, mainly by the lack of suitable
      experimental models.

PMID- 7774866
TI  - [A new method for occlusion of persistent ductus arteriosus (Botalli)].

PMID- 7774867
TI  - [Measures of quality assurance in PTCA].

PMID- 7774868
TI  - Extracellular matrix and cardiac interstitium: restriction is not a restricted
      phenomenon.

PMID- 7774869
TI  - Local regulation of extracellular matrix structure.
AB  - The extracellular matrix (ECM) is composed of various collagens,
      glycosaminoglycans, and elastin bathed by a tissue fluid found throughout the
      interstitial space. It is this substratum in which fibroblasts and macrophages
      normally reside, where fibroblast phenotypic transformation occurs, and into
      which inflammatory cells migrate when called upon during tissue repair. Many
      diseases, expressed in an organ-specific manner, require organ-specific ECM
      remodeling. Regulation of fibrillary type I collagen synthesis, whose
      disproportionate (relative to degradation) accumulation is characteristic of the
      tissue fibrosis that adversely alters organ function, is therefore of
      considerable importance. Emerging evidence implicates angiotensin converting
      enzyme (ACE), found in fibroblast-like cells, and ACE-related peptides,
      angiotensin II and bradykinin, in serving important regulatory functions that
      influence wound healing and thereby ECM structure in health and disease. The
      heart and its collagen matrix have been targeted for discussion in this brief
      review.

PMID- 7774870
TI  - Collagen VI in the extracellular matrix of normal and failing human myocardium.
AB  - Our own previous studies of the composition of the extracellular matrix of human
      failing hearts showed that collagen VI seems to play a major role in the origin
      of cardiac fibrosis. Therefore, collagen VI was investigated in more detail in
      tissue samples taken from clinically normal left ventricle and from myocardium
      failing because of dilated cardiomyopathy. Tissue sections prepared with collagen
      VI antibodies were examined by fluorescence microscopy using conventional or
      confocal laser scanning microscopy. In normal myocardium, collagen VI was located
      in both, endomysium and perimysium, in blood vessels it surrounded closely
      individual myocytes. Failing myocardium showed enlargement of the extracellular
      space and collagen VI was abundant. The localisation was perivascular as well as
      interstitial in fine or thick bundles enclosing the myocytes completely. In
      hearts with far progressed failure areas of replacement fibrosis containing
      increased amounts of collagen VI were evident. Double-staining for vimentin and
      collagen VI revealed a close interaction with fibroblasts. Although the function
      of collagen VI is not yet entirely clear it seems obvious that collagen VI plays
      an important role in the development of fibrosis in the failing heart.

PMID- 7774871
TI  - [The extracellular matrix and cytoskeleton of the myocardium in cardiac
      inflammatory reaction].
AB  - The cardiac cytoskeleton and the extracellular matrix play an essential role for
      maintaining cellular integrity and function of the myocardium. The network of
      microtubules and intermediate filaments are disrupted by the inflammatory
      reaction which depends on resident cells (myocytes, fibroblasts, endothel cells)
      and on systemic cells (granulocytes, macrophages, monocytes, lymphocytes).
      Changes in the cardiac cytoskeleton and the extracellular matrix may affect
      contractile function, since the cytoskeleton organizes the intra- and
      intercellular architecture. The inflammation in heart disease and the induction
      of fibrosis are mediated by cytokines and growth factors derived from fibroblast
      activation and from the B- and T-cell activity. A possible connecting link for
      the induction of fibrosis is the presentation of the myocardial antigens to the
      immune system and its subsequent cellular and humoral autoreactive response
      (Figure 1). Different autoantibodies to sarcolemmal and myolemmal antigens, to
      laminin, to extracellular matrix proteins, to the collagens and to myofibrils
      were demonstrated both in endomyocardial biopsy and as circulating autoantibodies
      in the peripheral blood. The pathophysiological role of the cytoskeleton and the
      extracellular matrix are well defined for beta-tubulin, fibronectin, laminin,
      desmin, vimentin, vinculin and collagen: beta-tubulin is increased or altered in
      dilated cardiomyopathy (DCM). Fibronectin appears in irregular forms in DCM as
      well. Ultrastructural analysis showed an increased content of laminin in basement
      membranes. In addition anti-laminin antibodies were found in 73% of patients with
      myocarditis and in 78% of patients with DCM. Desmin (z-bands) are partly
      destroyed in DCM. Anti-desmin antibody titers as indicators of a possible
      secondary immune response are found high in patients with acute myocarditis
      declining during reconvalescence and are also elevated in DCM. The vimentin of
      the endothelial cells and the vinculin of the sarcolemmal membrane and the
      intercalated discs have been demonstrated to be irregularly shaped and increased
      in content in DCM whereas in myocarditis their appearance and content is still
      unknown. The intracellular content of collagen type 5 is increased in DCM and in
      myocarditis. The presence of autoantibodies to components of the cytoskeleton and
      the extracellular matrix in myocarditis and perimyocarditis is well-described.
      Antibodies to the myolemma and the sarcolemma are found in almost all patients
      with perimyocarditis in the serum or bound in the biopsy. Some of them have been
      known cytolytic in vitro to isolated heart cells. In pericarditis a shift to
      antibodies to the extracellular matrix, collagen and intermediate filaments is
      observed among the circulating antibodies.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7774872
TI  - [Present and future in organ transplantation].
AB  - Artificial organs and organ transplantation are the only way to replace the
      deteriorated function of damaged organs. However, complete replacement of the
      original functions of organs is not yet possible for artificial organs today, and
      organ transplantation faces severe scarcity of donor organs. Newly developed
      immunosuppressant, cyclosporin-A, has contributed to marked improvement in the
      results of organ transplantation, and organ transplantation is not any more in
      the stage of experimental therapeutic methods but becomes a choice of routine
      therapeutic modality for organ failure. The main reason for retarded development
      of organ transplantation in this country is that organ donation from heart
      beating cadavers is not yet allowed. However, it is reported that 50 to 60% of
      Japanese people are ready to accept brain death and organ donation from heart
      beating cadavers. According to the above described social circumstances, this
      symposium was organized to overview and discuss the present status and problems
      in organ, cell transplantation and embryo transfer. I hope that the fruitful
      results of this symposium will contribute to rapid social and institutional
      preparations for organ transplantation and to many patients.

PMID- 7774873
TI  - [Current state in heart transplantation].
AB  - The Registry of the International Society for Heart and Lung Transplantation
      reported that 31,157 transplantations were performed throughout the world until
      1993, including 26,704 heart transplantations, 1,567 heart-lung transplantations,
      1,943 single lung transplantations and 943 bilateral or double lung
      transplantations. Heart transplantations were carried out at two hundred fifty
      one institutes in the world and more than 3,000 patients received heart
      transplantations every year. The number of heart transplantations, however,
      became plateau in 1988 and since 1991 the number of operations rather decreased
      because of the shortage of donor hearts. Indications for adult heart
      transplantation include coronary artery disease in 47.2% and cardiomyopathy in
      43.5%, representing the most frequently reported indications. Retransplantations
      represent only 2.3% of the total heart transplantations. The results for heart
      transplantation reveal that the 1, 3, 5, and 12-year actuarial survival are 80%,
      72%, 64% and 40%, respectively. Comparing the data before and after 1982 when
      cyclopropane was introduced for transplantations, a substantial improvement in
      actuarial survival is obtained. For instance, 3-year actuarial survival before
      1981 was 40% whereas since 1982 3-year actuarial survival is improved up to 75%.
      However, the patients in the older age (more than 65 years old) and pediatric
      patients, particularly less than one year old, have a significant reduction in
      outcome compared with younger adult patients and the outcome of heart
      retransplantation was still poor. Because of the shortage of donor heart quite a
      large number of patients develop hemodynamic deteriorations before
      transplantation and mechanical assist device is one of strategies to treat these
      patients as bridge to heart transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7774874
TI  - [Hepatocyte transplantation].
AB  - Hepatocyte transplantation has been studied to treat patients with liver
      disorders which do not need total replacement of the liver. We found that
      intrasplenically transplanted hepatocytes recomposed liver tissues in the spleens
      of rats and that they revealed similar structure and function of the liver. We
      also successfully transplanted hepatocytes into the spleens of rats which were
      isolated from cirrhotic livers or were thawed after long term cryopreservation.
      We developed the method to isolate human hepatocytes from resected liver tissues
      and made clinical trials of intrasplenic hepatocyte transplantation for the
      patients with chronic liver disorders. We detected the survival of transplanted
      hepatocytes in the spleens of patients, however, further proliferation of them
      has not yet identified. Hepatocyte transplantation still has many unresolved
      problems before its clinical application, such as a method to stimulate the
      proliferation of transplanted hepatocytes enough to make functional support of
      the damaged livers. In this article, I will review the present status and future
      aspects of hepatocyte transplantation.

PMID- 7774875
TI  - [Kidney transplantation].
AB  - From March 1986 to August 1994, 110 living-related renal transplants were
      performed under the cyclosporine combination immunosuppression. Age of the
      recipients ranged from 4 to 48 years old (mean 29.3), and 81 patients were male
      and 29 were female. The mean duration on dialysis before the transplants were
      39.7 months (0 to 210), and the methods of dialysis were divided with
      hemodialysis in 94 patients, CAPD in 15 and no dialysis in 1. The donors
      consisted of 96 parents (87.3%), 66 mothers and 30 fathers, and 14 siblings
      (12.7%). Age of the donors ranged from 28 to 73 years old (mean 48.7). The number
      of patients with acute rejection episodes were 48 patients with once, 18 with
      twice, 10 with 3 times and 34 (30.9%) with no rejection. Patient survival rate
      was 99.0% after 1 year posttransplantation, 97.9% after 3 years and 95.7% after 5
      years. Graft survival rate was 91.5%, 85.1% and 77.8%, respectively. Twenty
      grafts were lost with the most common causes of graft loss being chronic
      rejection (55%), acute rejection (20%) and accelerated acute rejection (15%). In
      cadaveric renal transplants, because of very small number of informations for
      cadaver donor, only 13 cadaveric renal transplants were performed in Hokkaido,
      from 1984 to August 1994. There was no case over 5 years follow up
      postoperatively, so patient survival rate was 100% and 90% after 1 year and 3
      years posttransplantation, and graft survival rate was 84.6% and 74.0%,
      respectively. Two kidneys of 13 cadaveric renal transplants were never
      functioning grafts. We have to make more efforts for propagation of the donation
      system.

PMID- 7774877
TI  - [Assisted reproductive technology; IVF-ET].
AB  - To summarize the procedures and outcomes of assisted reproductive technology
      (ART). Novel and updated ART for the practical management of infertile couples
      are presented and compared with conventional modalities. The outcomes measured
      included clinical pregnancy, ectopic pregnancy, abortion, still birth and
      delivery. Of ART treatments, 19,319 cycles initiated was IVF with 12.7% clinical
      pregnancy per retrieval in the world in 1991. In Japan, pregnancy rate of 9,667
      cycles with IVF was 12.7% in 1991. 300 cycles initiated was IVF with 20%
      pregnancy rate at the Department of Obstetrics and Gynecology, Asahikawa Medical
      College in 1994. In 1995, there will be more program offering more treatments
      cycles of ART. Improvements in stimulation, the culture system for fertilization
      and embryo growth, cryopreservation and microinsemination are expected to enhance
      the rates of clinical pregnancy.

PMID- 7774876
TI  - [Hematopoietic stem cell transplantation].
AB  - Recent development of chemotherapy enabled us to cure patients with malignancies
      including leukemia, malignant lymphoma, choriocarcinoma, ovarian cancer, breast
      cancer and so on. In order to obtain the definite effect, the quantities of
      chemotherapeutic agents should be increased and the major lethal side effect
      caused by bone marrow failure should be avoided. For this purpose, hematopoietic
      stem cells derived from either bone marrow or peripheral blood can be used for
      the rapid recovery of neutropenia and thrombocytopenia. We prepared stem cells
      both from bone marrow and peripheral blood by anti-CD34 monoclonal antibody bound
      on magnetic beads column and administered into severe combined immunodeficiency
      (SCID) mouse. Four and 20 weeks after transplantation, mononuclear cells bearing
      human hematopoietic antigens and human immunoglobulin G were appeared in the
      circulation, suggesting that stem cells from peripheral blood also possess long
      standing capability of maturation as well as those from bone marrow. We next
      conducted clinical study of high dose chemotherapy combined with peripheral blood
      stem cell transplantation for patients with poor risk choriocarcioma. By this
      treatment, 4 complete response (CR) and 4 partial response (PR) were obtained,
      whereas 2 progressive disease (PD), 1 no change (NC) and 5 PR were obtained by
      the previous conventional chemotherapies. The results obtained were promising and
      this treatment regimen may become a good modality for the complete treatment of
      chemotherapy curable tumors.

PMID- 7774878
TI  - [Molecular cloning and functional expression of a mouse adrenocorticotropin
      receptor gene].
AB  - Human genes for an adrenocorticotropin (ACTH) receptor and a melanocyte
      stimulating hormone (MSH) receptor, and a mouse gene for a MSH receptor have been
      cloned recently. They constitute a family of receptors for peptides derived from
      proopiomelanocortin. The ACTH receptor mRNA and the MSH receptor mRNA were
      expressed only in the adrenal and melanocytes, respectively. Thereafter, three
      novel receptor genes for melanocortins were molecularly cloned and were expressed
      exclusively in the brain but not in the adrenal or melanocytes. It has remained
      unknown how these receptors are differentially expressed in specialized cell
      type. An adrenocortical cell line of mouse origin, Y-1, is to date the sole cell
      line which shows responsiveness to ACTH resulting in the induction of steroids.
      For analysis of the transcriptional regulation of ACTH receptor in Y-1 cells, I
      have isolated the mouse ACTH receptor gene. A 914 bp DNA fragment of the human
      ACTH receptor gene was amplified by polymerase chain reaction and used as a
      probe. Eight positive clones were obtained by screening 10(6) phage clones of a
      mouse genomic library under the condition of low stringency. One phage clone,
      lambda mCTR8 which gave the most intense hybridization signal was analyzed. It
      contained an approximately 12 kb insert. By comparing it with the previously
      reported human ACTH receptor gene and bovine ACTH receptor cDNA, the mouse
      homologue is intron-less in its coding region, and has a potential to encode for
      a 296-amino-acid polypeptide which possesses 88.9% and 78.7% identities to the
      human and bovine ACTH receptors, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7774879
TI  - [Antiproliferative effect of tumor necrosis factor-alpha on human glioblastoma
      cells].
AB  - Although tumor necrosis factor-alpha (TNF) has been applied to early clinical
      trials for patients with malignant glioma, majority of human glioma cells has
      been reported to be resistant to TNF cytocidal effect in vitro. This study
      investigated antiproliferative effect of the TNF associated with induction of
      differentiation and expression of two distinct TNF receptors on human
      glioblastoma cell lines. The expression of p55 and p75 TNF receptors on 12 human
      glioblastoma cell lines was assessed by polymerase chain reaction and flow
      cytometry. p55 TNF receptor was detected in all cell lines, and only 4 cell lines
      concomitantly expressed p75 TNF receptor. Twelve human glioblastoma cell lines
      were treated with low-dose TNF, up to 256 U/ml for 7 days. TNF did not exhibit
      its cytocidal effect, but showed antiproliferative effects with inhibition of DNA
      synthesis in majority of cell lines tested. Flow cytometry with the
      bromodeoxyuridine-propidium iodide dual staining technique demonstrated that this
      antiproliferative effect of TNF was attributed to accumulation of glioblastoma
      cells in G0/G1 phase, suppressing the proliferative pathway. Furthermore the TNF
      stimulation increased glial fibrillary acidic protein and production of bioactive
      molecules including interleukin(IL)-6, IL-8, granulocyte-macrophage colony
      stimulating factor, prostaglandin E2 and manganous superoxide dismutase. In
      conclusion, human glioblastoma cells had p55 TNF receptor as a functional
      receptor and well responded to low-dose TNF stimulation, but not susceptible TNF
      cytocydal effect. The effect of TNF on glioblastoma cells appeared to modulate
      cell differentiation. TNF may be utilized as an agent for a differentiation
      therapy for human glioblastomas.

PMID- 7774880
TI  - [Promiscuous T cell hybridoma derived from NOD mouse].
AB  - In previous studies of this laboratory, epitope (site contacts with TCR) and
      agretope (site contacts with MHC molecule) were determined on p43-58 peptide
      composed of residues 43 to 58 of pigeon cytochrome c. Position 50 was shown to be
      a major epitopic site. Positions 46 and 54 were agretopic sites and we could
      determine specific amino acids on the agretopic positions which bound to each
      relevant I-A or I-E molecule. Using NOD mice, amino acids on the agretopic
      positions bound to I-Ag7 molecules were analyzed. Arginine (R) at position 46 and
      alanine (A) at position 54 were shown to be an agretopic motif bound to I-Ag7
      molecules. I then established hybridomas specific for a p43-58 analogue,
      46R50E54A, which contains R, glutamic acid (E) and A at positions 46, 50 and 54,
      respectively. Among the 46R50E54A-specific T cell hybridomas, a highly
      promiscuous hybridoma, NOE33-1-2, which recognized 46R50E54A with a variety of I
      A molecules (I-Ad,s,u,v) as well as with I-Ag7 was obtained. Interestingly, NOE33
      1-2 cells exhibited almost same responding pattern to various 46R50E54A analogue
      peptides as bulk lymph node T cells from each I-A bearing mice immunized with a
      46R50E54A analogue did. Thus, the responding pattern of NOE33-1-2 appeared to be
      simply reflected by the binding affinity of the 46R50E54A analogues to the
      relevant I-A molecule. However, subsequent analysis with I-Ad and mutant I-Ad
      expressing antigen presenting cells (APC) showed that the floor part of beta
      chain of the I-Ad molecule was profoundly involved in interaction among TCR of
      NOE33-1-2, 46R50E54A and the I-Ad molecule. On the other hand, this part appeared
      not to be important in responses of all other 46R50E54A-specific and I-Ad
      restricted T cell hybridomas derived from I-Ad or I-Ab mice. No difference was
      shown in the expression of accessory molecules which might interpret the queer
      interaction between TCR of NOE33-1-2, antigenic peptide and MHC molecule. When
      NOE33-1-2 cells were competed with T cell hybridomas derived from I-Ad mice for I
      Ad plus peptide Ag, the TCR of NOE33-1-2 cells showed higher affinity to the
      stimulatory complexes than that of latter hybridoma cells. These findings suggest
      that NOE33-1-2 hybridoma cells are of peculiar characteristics which may be
      attributable to negative or positive selection under influence of I-Ag7
      molecules.

PMID- 7774881
TI  - [Studies on the regulation of glycolipid sulfotransferase activity in human renal
      cancer cells].
AB  - In the previous studies, epidermal growth factor (EGF) was found to elevate
      glycolipid sulfotransferase activity in a human renal cell carcinoma cell line,
      SMKT-R3. To elucidate whether Ras is involved in the signal transduction pathway
      from EGF to the expression of the sulfotransferase, effects of EGF and a tyrosine
      kinase inhibitor on the sulfotransferase activity were investigated in renal
      cancer cells stably expressing activated Ras. SMKT-R3 cells were transfected with
      a plasmid carrying v-H-ras (pv-H-ras). As a control, SMKT-R3 cells transfected
      with a mutant v-H-ras, in which glycine at position 15 was replaced by valine
      (pG15V), was used. The expression of v-H-ras in transfected cells was examined by
      RT-PCR analysis. Two clones transfected with pv-H-ras, named A1 and A6, and two
      clones transfected with pG15 V, termed B1 and B4, were found to express v-H-ras
      and G15V genes, respectively, and employed in the following experiments. Though
      EGF elevated the activity of glycolipid sulfotransferase in B1, B4 and SMKT-R3
      cells, it did not change the activity levels in A1 and A6 cells. This result
      suggested that since the signal from Ras was saturated in the cells expressing
      activated Ras, the cells did not respond to the stimulation by EGF. To know the
      association between tyrosine kinase of EGF receptor and Ras, the effect of
      Genistein, a specific inhibitor of tyrosine kinase, on the sulfotransferase
      activity was examined in these cell lines. Genistein reduced the activity of
      glycolipid sulfotransferase in B1, B4, and SMKT-R3 cells, whereas it hardly
      affected the sulfotransferase activity in A1 and A6 cells. This result indicated
      that the signal from tyrosine kinase was dissociated from the regulation of the
      sulfotransferase activity in the cells expressing activated Ras. These
      observations suggest that Ras is involved in the signal transduction from EGF to
      the expression of glycolipid sulfotransferase activity in SMKT-R3 cells and acts
      in the downstream of tyrosine kinase of EGF receptor.

PMID- 7774882
TI  - [Establishment and analysis of cell culture infected persistently with JC virus].
AB  - JC polyomavirus (JCV) is the causative agent of a demyelinating disease in the
      central nervous system, known as progressive multifocal leukoencephalopathy.
      Since it is difficult to propagate JCV in vitro, many laboratories have attempted
      to develop cell lines permissive for replication of JCV. It was recently reported
      that serial passage of JCV (strain Mad-1) in a human neuroblastoma cell line (IMR
      32 cells) generated JCV variants (M1-IMRa, -IMRb, -IMRc) adapted to the growth in
      IMR-32 cells. We obtained a persistently-infected cell culture, designated JCI
      cells, by continued subcultivation of IMR-32 cells which had been infected with
      these adapted variants. To understand the mechanism by which the carrier state
      was maintained, we molecularly cloned multiple JCV DNAs from JCI cells.
      Sequencing of the cloned DNAs revealed that a majority of the clones had the same
      altered regulatory sequence which was probably generated from M1-IMRa. A DNA
      transfection experiment using a chimeric JCV DNA, in which the regulatory region
      was derived from JCI and the other region from Mad-1, showed that the JCI
      regulatory region was less efficient in inducing virus production in IMR-32
      cells. Therefore, it could be concluded that the regulatory region is primarily
      important for maintaining the carrier state in JCI cells. Although JCI cells
      contained a significant amount of JCV, the yield of JCV could remarkably be
      increased by incubating a confluent JCI culture in a medium with a low serum
      concentration. Thus, JCI cells should greatly facilitate the production of JCV
      for future studies of the virus.

PMID- 7774883
TI  - [Epstein-Barr virus-specific immunity in asymptomatic carriers of human T-cell
      leukemia virus type 1].
AB  - Adult T-cell leukemia (ATL) patients are immunosuppressed as evidenced by anergy
      to recall antigens and the occurrence of opportunistic infections. The
      immunosuppression appears to be a critical factor or a predictive sign for the
      development of ATL in carriers of human T-cell leukemia virus type 1 (HTLV-1).
      This study was aimed at assessing the immune status of asymptomatic HTLV-1
      carriers with the immunity specific to Epstein-Barr virus (EBV), a ubiquitous
      human herpesvirus with oncogenic potential. Forty-three asymptomatic HTLV-I
      carriers were examined for their EBV serology and EBV-specific cytotoxic T-cell
      (EBV-CTL) activity, in comparison with 10 HTLV-I-non-infected normal controls.
      Both carriers and controls were all positive for EBV capsid antigen (VCA) IgG.
      Significantly elevated titer of VCAIgG and lower titer of EBV-determined nuclear
      antigen (EBNA) antibodies were observed in asymptomatic HTLV-I carriers,
      suggesting reactivation of EBV. Among the HTLV-I carriers, 9 (20.9%) had reduced
      activity of EBV-CTL as revealed by lower incidence of regression of in vitro EBV
      induced B-cell transformation. Accordingly, asymptomatic HTLV-I carriers were
      divided into three groups: the carriers with reduced EBV-specific cellular
      immunity (group I), the carriers showing normal cellular immunity but aberrant
      EBV-specific antibody titers (group II), and the carriers with normal EBV
      specific cellular immunity and serology (group III). Higher positive rate of anti
      HTLV-I Tax antibody was found in the former two groups (44.4% and 56.5%,
      respectively) compared with group III (18.2%). An immunosuppressive agent, 4
      deoxyphorbol ester induced a remarkable decrease of EBV-CTL activity in the
      carriers of group II and III at the concentration that affected none of the
      normal controls. These findings indicate that asymptomatic HTLV-I carriers suffer
      stepwise impairment of EBV-specific immunities, which may be caused by HTLV-I
      infection.

PMID- 7774884
TI  - [Determination of a peptide deduced from the influenza virus haemagglutinin that
      induces human class II-restricted T cell responses in DQ6 transgenic mice].
AB  - HLA-DQ6 (DQ6) transgenic mice were immunized with a set of peptides deduced from
      either a fragment of the haemagglutinin (HA) of influenza A/Aichi/2/68 virus
      (HA123-138) or pigeon cytochrome c 43-58 (p43-58) analogues. HA123-138 induced a
      moderate level of T cell responses in DQ6 transgenic mice. The T cell responses
      were shown to be restricted to either the DQ6 or I-Ab molecule. We then
      established T cell hybridomas specific for HA123-138 and restricted to DQ6 from
      DQ6 transgenic mice immunized with the HA123-138. These T cell hybridomas were
      activated by the stimulation with HA123-138 in the presence of an HLA-DQ6
      transfectant or a paraformaldehyde-fixed HLA-DQ6 positive EB cell line. Using one
      of these T cell hybridomas we searched for potent peptides which showed high
      antigenicity as compared with HA123-138. We found that a hybrid peptide antigen,
      46F/HA126-134/54A, which was composed of HA126-134 and the I-Ab binding component
      (46F/54A) previously determined on p43-58 analogues evoked considerable responses
      in the HA123-138 specific T cell hybridoma. Competitive inhibition assay with
      this T cell hybridoma and direct binding assay using a DQ6 positive EB cell line
      or DQ6-transfected L cells showed consistently that the agretopic position 46 of
      the p43-58 analogues and hybrid peptide antigens was preserved among DQ6
      restricted T cell responses and murine class II, I-A, restricted T cell
      responses. Phenylalanine (F) at the position 46 appeared to be a critical residue
      for binding to HLA-DQ6 as had been shown for binding to I-Ab.

PMID- 7774885
TI  - Pathobiological determinants of cocaine-associated cardiovascular syndromes.

PMID- 7774886
TI  - Tophaceous pseudogout (tumoral calcium pyrophosphate dihydrate crystal deposition
      disease).
AB  - Most cases of calcium deposition seen radiologically in soft tissues are caused
      by calcium hydroxyapatite and occur either as a complication of trauma with
      associated necrosis (eg, fat necrosis), generalized connective tissue diseases
      (eg, scleroderma), metabolic disturbances (eg, hyperparathyroidism, familial
      hyperphosphatemia), sarcoidosis, myeloma, or metastases. Hydroxyapatite deposits
      are seen at many soft tissue sites, including joint capsules, ligaments, blood
      vessels, dermis, etc. On the other hand, deposits of calcium pyrophosphate are
      seen typically in the meniscus, articular cartilage, ligamentum flavum, and
      intervertebral disc. They usually are punctate or linear in distribution within
      the meniscus or parallel to the subchondral bone end plate. We report seven cases
      of massive focal calcium pyrophosphate dihydrate (CPPD) crystal deposition
      disease (tophaceous pseudogout) that occurred in atypical locations for CPPD. The
      ages of the patients ranged from 31 to 86 years (average, 60.7 years). One
      patient was male and six were female. The temporomandibular joint was involved in
      three patients and the metatarsophalangeal joint of the great toe was involved in
      two patients. The hip joint and cervical spine were involved in one patient each.
      A mass or swelling with or without pain was a common symptom. None of the
      patients in our series had clinical or radiographic evidence of CPPD crystal
      deposition disease in any other joints. Roentgenograms showed calcified lesions
      with a granular or fluffy pattern. Histologically, the lesions showed small or
      large deposits of intensely basophilic calcified material containing needle
      shaped and rhomboid crystals with weakly positive birefringence characteristic of
      CPPD. Foreign body granulomatous reaction to the CPPD deposition was constantly
      found. Chondroid metaplasia around and in the areas of CPPD deposition was
      observed commonly. Some of the chondroid areas showed cellular atypia in
      chondrocytes suggestive of a malignant cartilage tumor. It is important to
      recognize this rare form of CPPD crystal deposition disease and to identify the
      CPPD crystals in the calcified deposits, thus avoiding the misdiagnosis of benign
      or malignant cartilaginous lesions.

PMID- 7774887
TI  - Pre-eclampsia is associated with an excess of proliferative immature intermediate
      trophoblast.
AB  - Pre-eclampsia/toxemia (PET) is an idiopathic hypertensive disorder of pregnancy
      elicited in susceptible mothers by exposure to placental trophoblast. Three facts
      regarding the placenta in PET are known: an association with large placentas
      (excessive trophoblast), a tendency for superficial implantation, and
      inappropriate trophoblastic immaturity, as assessed by ultrastructural and
      biochemical criteria. A unitary hypothesis is that PET is related to a maturation
      defect leading to excessive accumulation of inappropriately immature intermediate
      trophoblast in the placental implantation site. We studied the implantation site
      of PET and control placentas from three gestational age groups (25 to 30, 30 to
      35, and 36 to 40 weeks old [five per group]) by morphometry and
      immunohistochemistry using antibodies to three phenotypic markers (cytokeratin,
      human placental lactogen (HPL), and beta 2-microglobulin) and two markers of cell
      dynamics (proliferating cell nuclear antigen [PCNA] and bcl-2]). Implantation
      sites in the PET group had increased amounts of intermediate trophoblast (cell
      number and longitudinal extent) with an increased proliferative index (percentage
      of PCNA positive) and evidence of phenotypic immaturity (HPL negative).
      Intermediate trophoblast from both groups was uniformly bcl-2 negative and beta 2
      microglobulin positive. Based on these data and the findings of other
      investigators, we propose that the diagnostic term "atypical implantation site"
      be added to acute atherosis, villous infarction, and increased syncytial knotting
      as a characteristic of placentas from pre-eclamptic pregnancies.

PMID- 7774889
TI  - Nonfamilial tumoral calcinosis associated with chronic renal failure and
      secondary hyperparathyroidism: report of two cases with clinicopathological,
      immunohistochemical, and electron microscopic findings.
AB  - The clinical and pathological findings, including those of immunohistochemical
      and ultrastructural studies, of two cases of tumoral calcinosis-like lesion (TCL)
      are described. Both cases were associated with chronic renal failure and
      hyperparathyroidism. One case presented as a rapidly growing 20-cm
      multiloculated, cystic, calcific gluteal mass on the sacrum, which was not
      clinically suspected to be related to hyperparathyroidism. The other case
      presented as a 2.5-cm calcific mass on the right foot that recurred after
      surgical excision as a 7-cm mass, which was clinically presumed to be related to
      secondary hyperparathyroidism. Light microscopic and immunohistochemical studies
      on both cases and ultrastructural studies on one case indicated that the
      calcifying process involved histiocytes and osteoclast-like giant cells of
      histiocytic origin lining the cystic cavities. Hydroxyapatite crystal formation
      and calcification appeared to develop predominantly from intracytoplasmic
      membrane bound vesicles and also from mitochondria. These findings are similar to
      those recently reported for familial tumoral calcinosis, which support its having
      a mechanism of calcification comparable with that of a TCL.

PMID- 7774888
TI  - neu overexpression correlates with extent of disease in large cell ductal
      carcinoma in situ of the breast.
AB  - In a retrospective study of ductal carcinoma in situ (DCIS) of the breast, the
      expression of the neu oncogene was determined immunohistochemically in 76 women
      treated by local excision or mastectomy. The histopathological features,
      including the extent of the lesion, histological subtype, cell type, and number
      of mitoses, were related to neu overexpression. Immunopositivity was found only
      in DCIS of large cell type, where it correlated with extent of disease but not
      with mitotic rate. Our findings, together with previous experimental evidence,
      suggest that this relationship is a consequence of the effect of the neu protein
      on cell motility.

PMID- 7774890
TI  - CD30-positive anaplastic large cell lymphoma in a human T-cell lymphotropic virus
      I endemic area.
AB  - Clinicopathological and cytogenetic studies were performed on specimens from 43
      patients with CD30-positive anaplastic large cell lymphoma (ALCL). All patients
      were born and lived in a human T-cell lymphotropic virus (HTLV)-I endemic area.
      Twenty-one patients (48.8%) had serum anti-HTLV-I antibody suggesting the
      presence of adult T-cell leukemia/lymphoma (ATL). Seventeen of them showed a
      clonal integration of complete HTLV-I proviral DNA by the Southern blot
      hybridization method in materials obtained by biopsy. Their ages ranged from 37
      to 81 years (median, 67.0), and they frequently presented with lymphadenopathy
      (82.4%) and extranodal tumors with (76.5%) as well as with rare leukemic changes
      (5.9%). Immunohistologically the lymphoma cells in 15 ATL patients showed a T
      cell phenotype. In only one patient (5.9%) was there an expression of epithelial
      membrane antigen (EMA) in most of the lymphoma cells. Cytogenetically aberration
      of chromosome band 5q35 was not found in seven patients with HTLV-I proviral DNA.
      The overall median length of survival was 11.9 months for the patients with HTLV
      I proviral DNA, indicating a worse prognosis compared with that of the age
      matched patients with negative anti-HTLV-I antibody (P < .01). The specimens of
      the patients with HTLV-I proviral DNA had unique clinicopathological and
      cytogenetic features. These findings suggested that T-cell ALCL with HTLV-I
      proviral DNA should be considered to represent the lymphoma type of ATL.

PMID- 7774891
TI  - p53 expression and DNA ploidy of cartilage lesions.
AB  - The aim of this study was to investigate the expression of a tumor suppressor
      gene (p53) in cartilage lesions of bone and its relationship to their
      histological grade and DNA ploidy. An immunohistochemical assay for p53 and
      Feulgen-stained DNA preparations was subjected to computerized image analysis.
      Enchondromas, synovial chondromatosis, and low grade (grade I and II)
      chondrosarcomas were diploid. High grade (grade III) chondrosarcomas and high
      grade sarcomatous components of dedifferentiated chondrosarcomas were aneuploid.
      Well differentiated cartilaginous components of dedifferentiated chondrosarcomas
      were diploid. Microscopic examination showed weak focal positivity for p53 in one
      of 10 enchondromas one of six examples of synovial chondromatosis, and three of
      four low grade (grade I and II) chondrosarcomas. All three high grade (grade III)
      chondrosarcomas were strongly positive for p53. The high grade sarcomatous
      component of all four dedifferentiated chondrosarcomas was strongly positive for
      p53, whereas only focal weak positivity was noted in the well differentiated
      cartilaginous areas. These results were confirmed by quantitative computer
      assisted image analysis, which showed that high grade aneuploid cartilage tumors
      demonstrated strikingly higher levels of p53 than did diploid low grade malignant
      tumors or benign cartilage lesions.

PMID- 7774892
TI  - Nodal benign and malignant monocytoid B cells with and without follicular
      lymphomas: a comparative study of follicular colonization, light chain
      restriction, bcl-2, and t(14;18) in 39 cases.
AB  - As part of an effort to develop a better understanding of the relationship
      between nodal monocytoid B-cell lymphomas (MBCLs) and follicular lymphomas (FLs)
      when they coexist (MBCL + FL) and to assess the validity of the morphological
      criteria for the latter diagnosis, we evaluated follicular colonization, bcl-2
      reactivity, light chain restriction, and the presence of t(14;18) in 14 benign
      lymph node specimens containing benign monoclonal B cells (MBCs), in eight nodal
      specimens of pure MBCL, and in 17 nodal specimens of MBCL coexisting with FL
      (MBCL + FL). Follicular colonization by malignant MBCs was observed in six
      specimens of pure MBCL and in 13 specimens of MBCL + FL. Benign MBCs did not
      express bcl-2 by immunohistological methods in 11 of 12 benign specimens. In
      contrast, weak reactivity for bcl-2 was detected in malignant MBCs in four of
      five specimens of pure MBCL and in the MBCL component in 13 of 15 specimens from
      the MBCL + FL group. In the FL component of 13 specimens, the bcl-2 was strongly
      positive. Identical light chain restriction was detected by immunohistological
      methods in both the FL component and the MBCL component in 15 specimens of MBCL +
      FL. Polymerase chain reaction analysis did not detect the t(14;18) translocation
      in any of 10 benign specimens or any of six evaluable pure MBCL specimens. In
      contrast, the translocation was detected in whole sections from eight of 12
      specimens of MBCL + FL. Thus, on the one hand, the high incidences of follicular
      colonization and the coexistence of MBCL and FL as well as the identical light
      chain restriction in MBCL and FL components of MBCL + FL cases suggest that
      possibly these are related closely when they coexist. On the other hand, the bcl
      2 and t(14;18) data cannot be used as evidence in support of a close
      relationship.

PMID- 7774893
TI  - Vasculitis as the basis of cutaneous lesions in Reiter's disease.
AB  - The cutaneous lesions of Reiter's disease (RD) and pustular psoriasis (PP) are
      said to be histologically similar and often indistinguishable. We encountered
      three cases of RD in which biopsy specimens of lesions clinically compatible with
      keratoderma blenorrhagicum showed a pustular psoriasiform tissue reaction in
      conjunction with a subjacent superficial leukocytoclastic vasculitis (LCV). In an
      attempt to ascertain if these changes were distinctive and unique to cutaneous
      RD, the incidence of such changes in lesions of PP was examined using light
      microscopy and immunohistochemistry. The role of chlamydial infection in the
      pathogenesis of the observed vascular changes also was explored by assessing for
      the presence or absence of vascular deposition of chlamydial antigen in cutaneous
      RD compared with that in a control group that included cases of LCV and PP. In
      addition to conventional light microscopic analysis, immunoperoxidase studies to
      identify immunoglobulin deposition were performed on formalin-fixed, paraffin
      embedded tissue from two of three patients with RD and on skin biopsy specimens
      from 11 patients with PP. Direct immunofluorescence (DIF) studies with antibodies
      to immunoglobulin (Ig)G, IgM, IgA, C3, and chlamydial antigens were performed on
      frozen tissue from one patient with RD, two patients with PP, three patients with
      LCV, one patient with nonspecific dermatitis, and one patient with Behcet's
      disease, who had a high antichlamydia antibody titer. All three specimens of RD
      showed a pustular psoriasiform diathesis in conjunction with a subjacent
      superficial LCV that was of maximal intensity in the dermal papillae capillaries.
      Through an immunoperoxidase technique performed on formalin-fixed tissue, the RD
      cases for which tissue was available for study demonstrated Ig deposition in
      injured blood vessels; using the same technique one of 11 PP biopsy specimens
      showed vascular Ig deposition in concert with LCV. This patient's biopsy was from
      a lesion of drug-induced LCV. None of the other specimens showed either light
      microscopic or immunohistochemical evidence of vasculitis. In the one specimen of
      RD studied by DIF, vascular deposition of IgG, IgM, C3, chlamydia heat shock
      protein 60 (CHSP60), and chlamydia-specific lipopolysaccharide (LPS) was
      observed. In the two specimens of PP studied, vascular deposition of C3, fibrin,
      CHSP 60, and chlamydia-specific LPS was not observed. Two specimens of LCV and
      the one specimen of dermatitis with concomitant nonspecific vascular injury
      showed vascular Ig and C3 deposition; in contrast, no vascular deposition of CHSP
      60 or chlamydia-specific LPS was observed.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7774894
TI  - Is esthesioneuroblastoma a peripheral neuroectodermal tumor?
AB  - Esthesioneuroblastoma (ENB; olfactory neuroblastoma) is a rare, locally
      aggressive neoplasm of the sinonasal area and anterior cranial fossa. The
      histogenesis of the lesion is not clearly delineated, and the broad histological
      spectrum of ENB has confounded the issue. The location, histological features
      (neuropil, Homer Wright, and olfactory rosettes), and reported immunocytochemical
      reactions (neuron-specific enolase (NSE) and chromogranin (CHR) positivity)
      suggest that ENB may be a neural or neuroendocrine neoplasm derived from the
      olfactory membrane. Recent demonstration in two of three metastatic putative ENB
      cell lines of the 11;22 chromosomal translocation, seen in Ewing's sarcoma (ES)
      of bone and peripheral neuroectodermal tumors (PNET) of bone and soft tissue, has
      led to the conclusion that ENB may be closely related histogenetically to PNET.
      The overwhelming majority of cases of ES and PNET express the protein product of
      MIC-2, a gene located on the pseudoautosomal region of the X and Y chromosomes.
      This protein can be identified immunocytochemically by antibodies 12E7, HBA71,
      and ON13. We studied the expression of MIC-2 using the 12E7 antibody as well as
      multiple neural markers in 18 ENB samples obtained from the files of The Johns
      Hopkins Hospital. The patients ranged in age from 19 to 90 years (mean, 47.5;
      median, 47) and included five men and 13 women. None of the 18 specimens reacted
      with antibody 12E7, but 16 were positive for NSE, nine reacted to synaptophysin
      (SYN), and 13 showed antibodies to chromogranin (CHR). Our studies agree with the
      previous suggestions that ENB is a primitive neural tumor but fail to support the
      hypothesis that it is a member of the PNET family.

PMID- 7774895
TI  - Ductal carcinoma in situ treated with lumpectomy and irradiation:
      histopathological analysis of 49 specimens with emphasis on risk factors and long
      term results.
AB  - Forty-nine women with ductal carcinoma in situ (DCIS) treated with lumpectomy and
      irradiation were studied retrospectively. The median age was 50 years (range, 29
      to 73 years) and the median follow-up time from initiation of therapy was 86
      months (range, 17 to 230 months). Twelve patients presented with palpable masses
      (0.4 to 4 cm), three with breast thickening, and three with nipple discharge. In
      31 patients the tumors were detected by mammography. Intraoperatively, excision
      of lesions was confirmed by specimen x-ray (38 specimens) or gross inspection
      (five specimens) and was recorded to be complete. No record was available in the
      other six patients. Margins of excision free of DCIS were microscopically
      confirmed in 25 specimens. The size of impalpable DCIS lesions recorded in 25
      patients ranged from 0.4 to 5.0 cm (mean, 1.5 cm). Using Lagios' classification
      system, there were 18 classic comedocarcinomas, high nuclear grade (NG) with
      necrosis; seven cribriform/papillary, high NG with necrosis; 17
      cribriform/micropapillary, intermediate NG with or without necrosis; and seven
      cribriform/micropapillary, low NG without necrosis. In two patients residual
      malignant calcifications were present on the postoperative mammogram. Disease
      recurred in the treated breast at the site of incision in five patients at 18
      months and 8, 11, and 12 (two patients) years from initial therapy. The rate of
      local disease recurrence was 2% at 5 years and 6% at 10 years; three recurrences
      showed invasive ductal carcinoma and two were DCIS. To evaluate risk factors the
      following characteristics were considered: necrosis, NG, histological type,
      periductal fibrosis, periductal lymphoid infiltrate, margin status, age, and
      method of tumor detection. The end points chosen were recurrence and death from
      any cause (because only one patient died of disease). Although the recurrences
      were attributed to residual disease in two patients, of the clinical and
      pathological parameters evaluated, only periductal fibrosis showed a significant
      relationship with outcome, with a P value < or = .05 by the Wilcoxon test. On the
      other hand, using the proportional hazards model, necrosis was a significant
      predictor for recurrence (P = .02), as was the pair fibrosis and tumor detection
      when taken together (P = .05). Fibrosis significantly associated with high NG,
      Lagios' histological subtypes I and II, periductal lymphoid infiltrate, and
      necrosis (P < or = .0006).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7774896
TI  - Association of human papillomavirus with malignant and premalignant lesions of
      the uterine endometrium.
AB  - The possible association of human papillomavirus (HPV) with endometrial
      hyperplasia and endometrial adenocarcinoma was investigated. DNA from frozen
      tissues of 30 endometrioid carcinomas of Japanese patients was tested for HPV DNA
      by Southern blot hybridization analysis. Screening with HPV type 58 probe under
      low stringency conditions showed the presence of HPV DNA in two of 30
      endometrioid carcinomas. High stringency hybridization identified HPV type 16 in
      the two positive specimens. The presence of HPV was further analyzed by
      polymerase chain reaction (PCR)-Southern blot analysis of DNA from archival
      tissue blocks of the initial 30 endometrioid carcinomas as well as an additional
      17 endometrioid carcinomas and 13 atypical hyperplasias of the endometrium from
      Japan and 38 endometrioid carcinomas from the United States. Polymerase chain
      reaction amplification using type 16-specific HPV primers for a portion of the E6
      open reading frame was positive in six of 47 (13%) endometrioid carcinomas from
      Japan, including two in which HPV 16 was not detected by Southern blot analysis
      and two of 38 (5%) endometrioid carcinomas from the United States. Polymerase
      chain reaction amplification using L1 consensus sequence primers was positive for
      HPV in two of 13 (15%) endometrial hyperplasias, 13 of 47 (28%) endometrioid
      carcinomas from Japan, and six of 38 (16%) endometrioid carcinomas from the
      United States. Slot blot hybridization identified HPV type 16 in seven of the L1
      PCR products, including all but one specimen testing positive for HPV type, 16
      using E6 type specific primers. In situ hybridization was positive for HPVs 16/18
      in glandular epithelial tumor cells in six of the PCR-positive specimens. An
      additional specimen showed staining for HPVs 16/18 in acellular luminal debris in
      association with squamous metaplasia of the tumor, but staining was negative in
      the glandular cells of the tumor. Human papillomavirus was not detected by in
      situ hybridization in the remaining specimen, which was PCR positive for HPV 16.
      In situ hybridization was weakly positive for HPVs 31/33/35 in one specimen and
      was weakly positive for HPVs 6/11 in benign endometrial epithelial cells but not
      in tumor cells of another specimen that tested positive for HPV by L1 PCR. Two
      dimensional gel electrophoresis performed on two specimens showed that HPV DNAs
      were integrated into cellular DNA with no episomal coexistence. These findings
      suggest that HPV, especially HPV 16, may play an etiologic role in a fraction of
      endometrioid adenocarcinomas.

PMID- 7774897
TI  - Cocaine induced intracerebral hemorrhage: analysis of predisposing factors and
      mechanisms causing hemorrhagic strokes.
AB  - We analyzed 26 autopsy cases of cocaine induced intracerebral hemorrhage and
      compared those findings with those of 26 autopsy cases of cocaine induced
      cerebral aneurysm rupture. The incidence of hypertensive cardiovascular disease
      (HCVD) was significantly higher in persons with intracerebral hemorrhage than in
      those with aneurysm rupture. Our findings suggest that HCVD predisposes to
      cocaine induced intracerebral hemorrhage. We propose that the foregoing
      relationship results from a cocaine induced alteration of cerebral autoregulation
      in the context of increased cerebral blood flow.

PMID- 7774898
TI  - Nucleolar organizer regions as markers of endometrial proliferation: a study of
      normal, hyperplastic, and neoplastic tissue.
AB  - Nucleolar organizer regions (NORs) are loops of DNA that transcribe to ribosomal
      RNA. They can be visualized as intranuclear black dots by histochemical staining
      with a colloid silver solution. We applied this method to 78 sections of
      endometrial tissue obtained either from curettage or from hysterectomy specimens.
      The histological diagnoses were as follows: normal proliferative (N = 9) or
      secretory (N = 5) endometrium, simple hyperplasia (N = 10), complex hyperplasia
      (N = 18), atypical hyperplasia (N = 8), and adenocarcinoma (N = 28). Mean silver
      stained NOR (AgNOR) counts per cell were 3.2 (standard error of the mean [SEM],
      0.2) in normal proliferative and 2.7 (SEM, 0.2) in normal secretory epithelium,
      and increased to 4.1 (SEM, 0.3) in simple hyperplasia, to 5.4 (SEM, 0.4) in
      complex hyperplasia, to 8.1 (SEM, 0.7) in atypical hyperplasia, and finally to
      10.0 (SEM, 0.5) in endometrial carcinoma. The differences were significant (one
      factor analysis of variance [ANOVA], P < .001). A slight increase but no
      significant difference was seen between the mean AgNOR counts in endometrial
      carcinomas of different histological grades. Our study suggests that AgNOR counts
      are reliable markers of endometrial proliferation and allow a clear distinction
      between benign, premalignant, and malignant epithelial changes. Our AgNOR
      findings in endometrial hyperplasia support the concept of various degrees of
      hyperplasia that can be differentiated on morphological grounds.

PMID- 7774899
TI  - The histological spectrum of pulmonary graft-versus-host disease in bone marrow
      transplant recipients.
AB  - The histological changes in 17 biopsy specimens of the lung showing graft-versus
      host disease (GVHD) in bone marrow transplant (BMT) recipients were reviewed and
      correlated with the patients' clinical courses. These morphological changes fell
      into four transplant-related categories: diffuse alveolar damage, lymphocytic
      bronchitis/bronchiolitis with interstitial pneumonitis, bronchiolitis obliterans
      organizing pneumonia, and cicatricial bronchiolitis obliterans. Pulmonary disease
      correlated with the presence of GVHD at extrathoracic sites. Patients with active
      lymphocytic bronchitis/bronchiolitis, cicatricial bronchiolitis obliterans, and
      diffuse alveolar damage had particularly poor outcomes. A proposal is offered for
      the categorization of the pulmonary damage caused by GVHD in BMT recipients.

PMID- 7774900
TI  - Amplification of human papillomavirus types 16 and 18 in invasive cervical
      cancer.
AB  - The distribution and amplification patterns of human papillomavirus were studied
      in 15 human papillomavirus (HPV) 16- and six HPV18-positive cervical carcinomas
      by colorimetric in situ hybridization (ISH). The findings were correlated with
      the viral copy number and status of E1/E2 viral genes in the tumor DNA, as
      studied by dot blot analysis and the polymerase chain reaction, respectively. The
      tumors were classified according to the ISH signal into single dot, multidot,
      diffuse, and mixed patterns. The signal was homogeneously distributed only in
      single dot tumors and was clearly heterogeneous in tumors with mixed nuclear
      signal patterns, including both dot and diffuse signals. The single dot pattern
      predominated in HPV 18-positive tumors (83%), whereas the multidot pattern was
      most frequent in HPV 16-positive tumors (47%). Diffuse and mixed patterns were
      noted only in HPV 16-positive tumors (33%). The lowest mean copy of number per
      cell was observed in single dot tumors (25 +/- 15) with an ascendent trend toward
      the diffuse signal tumors (2832 +/- 2281). E1/E2 genes were disrupted in 75% of
      the single/multidot tumors and in none of the diffuse/mixed tumors. These data
      suggest diffuse signals originate by episomal amplification and dot signals
      originate by viral integration. Diffuse and dot patterns suggest different
      mechanisms of viral transformation.

PMID- 7774901
TI  - Colonic histiocytic neoplasm mimicking malignant histiocytosis and presenting as
      intussusception.
AB  - It is now apparent that distinction between the so-called malignant histiocytosis
      and lymphoma can be made using panels of established immunohistochemical markers
      and/or genotypic analysis. Many, if not all, of the previously diagnosed cases of
      malignant histiocytosis have been shown to be of lymphoid, rather than
      histiocytic, lineage. We report a rare case of colonic histiocytic neoplasm
      accompanied by a lymphoreticular dissemination that mimicked that of malignant
      histiocytosis. In addition, barium studies and computed axial tomography
      confirmed an intussusception that subsequently developed. The histiocytic nature
      of the neoplastic cells was supported by immunohistochemical, ultrastructural,
      and cytochemical studies. To our knowledge our case may represent the fifth
      documented case of a histiocytic malignancy reported in the literature. The
      relationship among the various cases will be discussed as well as the
      significance of the focal S-100 immunoreactivity observed in the present case.

PMID- 7774902
TI  - Acute neutrophilic myositis in Sweet's syndrome: late phase transformation into
      fibrosing myositis and panniculitis.
AB  - Early in the course of myeloblastic leukemia a patient concurrently developed
      febrile neutrophilic dermatosis and sterile acute myositis. The dermatitis and
      myositis were unresponsive to antibiotic therapy but remitted within a few days
      of institution of steroid treatment. The patient died of myocardial infarction.
      At autopsy the dermis was normal. Previously effected muscles were scarred. The
      overlying fascia and subcutaneous septa were fibrotically thickened. In addition,
      segmental acute aortitis was detected. Acute myositis and aortitis may reflect
      further organ manifestations of the Sweet's reactivity pattern. It is proposed
      that Sweet's myositis and dermatitis may evolve into a fibrosing myositis and
      panniculitis.

PMID- 7774903
TI  - Interpretation of artifactual vascular invasion in cervical squamous precursors
      due to lidocaine injection.

PMID- 7774904
TI  - Dormant cells in columnar cell carcinoma of the thyroid.

PMID- 7774905
TI  - The purported link between agent orange and cancer.

PMID- 7774906
TI  - MATS: a rapid and efficient method for the development of microsatellite markers
      from YACs.
AB  - In this report, we describe the successful application of a rapid and efficient
      procedure, based on subtractive hybridization and PCR amplification, for
      generating microsatellite-based markers directly from yeast artificial
      chromosomes (YACs). This strategy, termed MATS (marker addition through
      subtraction), exploits the fact that the only difference between a yeast host
      strain harboring a YAC and the host strain alone is the artificial chromosome.
      Given the low complexity of the yeast genome and relatively large target size
      presented by a YAC, only a single round of subtraction is required before
      amplification of the target sequences (YAC) and cloning into a plasmid vector for
      further analysis. Several key steps have been designed to achieve optimal
      subtraction and to obtain preferential amplification and recovery of the target
      sequences. Methods for efficient construction of small insert libraries and
      rapid, nonradioactive screening have also been integrated into the protocol.
      Using a 750-kb YAC as a target, we identified a minimum of 14 unique
      microsatellite containing clones, leading to the development of 12 polymorphic
      STSs (sequence-tagged sites). These new markers will facilitate the genetic
      localization of targeted locus and allow the accurate ordering by STS content
      mapping of a cloned contig spanning the interval. In addition to the utility of
      this approach in positional cloning, this strategy may provide an approach for
      filling gaps in the emerging genetic maps.

PMID- 7774907
TI  - Conservation and evolution of (CT)n/(GA)n microsatellite sequences at orthologous
      positions in diverse mammalian genomes.
AB  - The distribution and evolution of (CT)n microsatellites were examined in GenBank
      mammalian DNA sequences because these microsatellites are known to play important
      roles in the regulation of some genes in Drosophila melanogaster. A total of 236
      (CT)n microsatellite loci were found in GenBank mammalian gene sequences. To
      determine whether (CT)n microsatellite arrays were conserved at orthologous
      positions in distantly related mammalian sequences, we determined whether
      orthologous sequences existed in GenBank for each of the 236 loci. A total of 47
      sequence alignments could be made. For rodent x rodent comparisons, 7 of 8 (CT)n
      arrays were conserved at identical positions in each pair of orthologous
      sequences. Comparisons of orthologous sequences between different orders of
      mammals indicated that 11 of 39 (CT)n arrays occurred at orthologous positions or
      within 1 kb of orthologous positions in each pair of sequences. It appears that
      there is some level of conservation of (CT)n repeats in distantly related
      mammals. However, this level of conservation may not be greater than what might
      be expected to occur by chance. In 13 cases where (CT)n arrays were not conserved
      at orthologous positions, the lack of a (CT)n array in one sequence resulted from
      either nucleotide substitution within an array or nonexpansion of a shorter (CT)n
      element. In these cases, significant sequence identity could be detected
      throughout the entire region even though the repeat array was not detected in one
      of the sequences. In contrast, there was a disruption of sequence identity in the
      (CT)n microsatellite region that ranged from 24 to 1600 bp in 21 cases.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7774908
TI  - High-resolution cytogenetic mapping of the short arm of chromosome 1 with newly
      isolated 411 cosmid markers by fluorescence in situ hybridization: the precise
      order of 18 markers on 1p36.1 on prophase chromosomes and "stretched" DNAs.
AB  - A high-resolution cytogenetic map of the short arm of chromosome 1 with newly
      isolated 411 cosmid markers was constructed by fluorescence in situ hybridization
      (FISH). These markers were scattered throughout chromosome 1p, but they were
      preferentially concentrated on R-band dominant regions such as 1p36, 1p34, 1p32,
      1p22, and 1p13. Among these markers, 197 were localized on chromosome band 1p36,
      a region frequently deleted in neuroblastoma. Of these, 18 were precisely ordered
      on 1p36.1 by multicolor FISH of prophase chromosomes and "stretched" DNAs as
      follows: 1pter-163-41-11-1-226-586-568-614-631-665-451-199-190-561-241-74-1 76
      652-1cen. The high-density map of chromosome 1p constructed here can provide
      useful landmarks for constructing a contig map of the short arm of chromosome 1
      with YACs and cosmid clones and will expedite the identification of breakpoints
      and/or tumor suppressor gene(s) associated with several types of malignant tumors
      that frequently exhibit chromosomal aberrations or deletions of chromosome 1p.

PMID- 7774909
TI  - Regional assignment by hybrid mapping of 36 expressed sequence tags (ESTs) on
      human chromosome 6.
AB  - We have determined the regional chromosome assignment of 36 cDNAs from infant
      brain libraries by assessing the concordant segregation of PCR products using a
      human-rodent hybrid mapping panel that subdivides chromosome 6 into 15 regions.
      These mapped sequences serve as markers for the physical and expression maps of
      chromosome 6, as well as candidate genes for various disease loci. Sequence
      analysis has identified putative functions and motifs for some of these genes.

PMID- 7774911
TI  - Comparative mapping of 50 human chromosome 9 loci in the laboratory mouse.
AB  - We have set out to produce a comprehensive comparative map between human
      chromosome 9 (HSA9) and the laboratory mouse. The mouse homologues of 50 loci
      that were known to map to HSA9 were mapped by interspecific backcross linkage
      analysis. Ten loci from the short arm of HSA9 were mapped, and 40 from HSA9q,
      with 24 markers coming from the HSA9q33-q34 region--a part of the chromosome
      known to be very gene rich. Fifteen new assignments have been made--Ak3, Ctsl,
      Cntfr, C8g, D2H9S46E, Eng, Gcnt1, Irebp, Pappa, Ptgds, Snf212, Tal2, Tmod, Vav2,
      and Vldlr, the human homologues of which all map to HSA9. In addition, the
      assignment of Snf212 and Vldlr to MMU19 has defined a new region of synteny
      between the proximal portion of the short arm of HSA9 and the mouse.

PMID- 7774910
TI  - Amplification of the E2F1 transcription factor gene in the HEL erythroleukemia
      cell line.
AB  - The E2F transcription factor plays an important regulatory role in cell
      proliferation, mediating the expression of genes whose products are essential for
      inducing resting cells to enter the cell cycle and synthesize DNA. To investigate
      the possible involvement of E2F in hematopoietic malignancies, we isolated
      genomic clones encompassing the human E2F1 gene. We then used fluorescence in
      situ hybridization to localize E2F1 to human chromosome 20q11, telomeric to the
      p107 locus, a gene whose product is related to the retinoblastoma gene product
      (pRb). This finding contrasts with the 1p36 and 6q22 chromosomal locations
      previously assigned E2F2 and E2F3, two additional members of the E2F family.
      Although deletions or structural rearrangements of E2F1 were not detected in 14
      primary acute leukemia or myelodysplasia samples with structural abnormalities of
      chromosome 20q11, the gene was amplified and overexpressed in HEL erythroleukemia
      cells and translocated to other chromosomes in several established human leukemia
      cell lines. This study provides the first evidence of gene amplification
      involving a member of the E2F family of transcription factors. We propose that
      E2F1 overexpression in erythroid progenitors may stimulate abnormal cell
      proliferation by overriding negative regulatory signals mediated by tumor
      suppressor proteins such as pRb.

PMID- 7774912
TI  - Relative size and evolution of the germline repertoire of T-cell receptor beta
      chain gene segments in nonhuman primates.
AB  - The mammalian T-cell receptor (TCR) gene complexes exist as multiple tandemly
      arrayed gene segments that have apparently arisen by gene duplication mechanisms.
      A study of the number of TCR germline gene segments in several primate species
      might provide insight into the relative rate and patterns of gene duplication and
      deletion within these gene complexes. DNA probes from the TCR beta-chain variable
      (TCRBV) region gene segment subfamilies 1 through 25 and the constant region gene
      segment were sequentially hybridized under low stringency to Southern blots
      containing genomic DNA of human, gorilla, orangutan, and pig-tailed macaque. The
      number of gene members in each subfamily was estimated from the number of
      hybridizing DNA fragments. The results show apparent examples of both TCRB V gene
      duplication and deletion since speciation of the Hominoids from Cercopithecoid
      (Old World) primates. For one putative duplication/deletion event involving six
      TCRBV gene segments, derivation and comparison of germline DNA sequence from
      macaque and human as well as Southern blot analysis of additional primates
      demonstrated that this event was a duplication that occurred after the divergence
      of the family Pongidae (Greater Apes) from Hylobatidae (Lesser Apes). Southern
      blot analysis of multiple pig-tailed macaques and their offspring suggests a
      degree of DNA sequence variability in these gene segments similar to that
      observed in humans. An appreciation of the size and variability of each TCRBV
      subfamily will be useful when considering the DNA primers and probes necessary to
      measure the relative usage of these TCRBV genes as part of the immune response in
      these nonhuman primates.

PMID- 7774913
TI  - Genomic organization and chromosomal localization of the human and mouse genes
      encoding the alpha receptor component for ciliary neurotrophic factor.
AB  - Ciliary neurotrophic factor (CNTF) has recently been found to share receptor
      components with, and to be structurally related to, a family of broadly acting
      cytokines, including interleukin-6, leukemia inhibitory factor, and oncostatin M.
      However, the CNTF receptor complex also includes a CNTF-specific component known
      as CNTF receptor alpha (CNTFR alpha). Here we describe the molecular cloning of
      the human and mouse genes encoding CNTFR. We report that the human and mouse
      genes have an identical intron-exon structure that correlates well with the
      domain structure of CNTFR alpha. That is, the signal peptide and the
      immunoglobulin-like domain are each encoded by single exons, the cytokine
      receptor-like domain is distributed among 4 exons, and the C-terminal glycosyl
      phosphatidylinositol recognition domain is encoded by the final coding exon. The
      position of the introns within the cytokine receptor-like domain corresponds to
      those found in other members of the cytokine receptor superfamily. Confirming a
      recent study using radiation hybrids, we have also mapped the human CNTFR gene to
      chromosome band 9p13 and the mouse gene to a syntenic region of chromosome 4.

PMID- 7774914
TI  - A nonsense mutation in the 4-hydroxyphenylpyruvic acid dioxygenase gene (Hpd)
      causes skipping of the constitutive exon and hypertyrosinemia in mouse strain
      III.
AB  - 4-Hydroxyphenylpyruvic acid dioxygenase (HPD; EC 1.13.11.27) is an important
      enzyme in tyrosine catabolism in most organisms. Decreased activity of 4
      hydroxyphenylpyruvic acid dioxygenase in the liver of mouse strain III is
      associated with tyrosinemia. We report a nucleotide substitution that generates a
      termination codon in exon 7 of the 4-hydroxyphenylpyruvic acid dioxygenase gene
      in III mice. This mutation is associated with partial exon skipping, and most of
      the mRNA lacks sequences corresponding to exon 7. The partial exon skipping
      apparently is the result of a nonsense mutation in the exon. Mouse strain III is
      a model for human tyrosinemia type 3 (McKusick 276710), and this strain together
      with recently established models for tyrosinemia type 1 will facilitate studies
      of hereditary tyrosinemias.

PMID- 7774915
TI  - A human chromosome 7 yeast artificial chromosome (YAC) resource: construction,
      characterization, and screening.
AB  - The paradigm of sequence-tagged site (STS)-content mapping involves the
      systematic assignment of STSs to individual cloned DNA segments. To date, yeast
      artificial chromosomes (YACs) represent the most commonly employed cloning system
      for constructing STS maps of large genomic intervals, such as whole human
      chromosomes. For developing a complete YAC-based STS-content map of human
      chromosome 7, we wished to utilize a limited set of YAC clones that were highly
      enriched for chromosome 7 DNA. Toward that end, we have assembled a human
      chromosome 7 YAC resource that consists of three major components: (1) a newly
      constructed library derived from a human-hamster hybrid cell line containing
      chromosome 7 as its only human DNA; (2) a chromosome 7-enriched sublibrary
      derived from the CEPH mega-YAC collection by Alu-polymerase chain reaction (Alu
      PCR)-based hybridization; and (3) a set of YACs isolated from several total
      genomic libraries by screening for > 125 chromosome 7 STSs. In particular, the
      hybrid cell line-derived YACs, which comprise the majority of the clones in the
      resource, have a relatively low chimera frequency (10-20%) based on mapping
      isolated insert ends to panels of human-hamster hybrid cell lines and analyzing
      individual clones by fluorescence in situ hybridization. An efficient strategy
      for polymerase chain reaction (PCR)-based screening of this YAC resource, which
      totals 4190 clones, has been developed and utilized to identify corresponding
      YACs for > 600 STSs. The results of this initial screening effort indicate that
      the human chromosome 7 YAC resource provides an average of 6.9 positive clones
      per STS, a level of redundancy that should support the assembly of large YAC
      contigs and the construction of a high-resolution STS-content map of the
      chromosome.

PMID- 7774916
TI  - A boundary of long-range G + C% mosaic domains in the human MHC locus:
      pseudoautosomal boundary-like sequence exists near the boundary.
AB  - The human genome is composed of long-range G+C% (GC%) mosaic structures related
      to chromosome bands. We found the human MHC locus to be an example of megabase
      level GC% mosaic structures and predicted a possible boundary of the megabase
      level domains within an undercharacterized 450-kb region harboring the junction
      of MHC classes II and III. Chromosome walking of the 450-kb region and base
      compositional analysis precisely located the boundary of the mosaic domains,
      disclosing a sharp GC% transition. Near the transition point there was a 20-kb
      dense Alu cluster, a 30-kb dense LINE-1 cluster, and a sequence highly homologous
      with the pseudoautosomal boundary of the short arms of human sex chromosomes
      (PAB1X and PAB1Y); PAB1X and PAB1Y are the interface between sex-specific and
      pseudoautosomal regions. Many PAB1XY-like sequences (PABLs) were detected by
      hybridization against genomic DNA, and the new sequences defined the complete
      form of PABLs to be about 650 nt.

PMID- 7774917
TI  - YAC contigs covering an 8-megabase region of 3p deleted in the small-cell lung
      cancer cell line U2020.
AB  - Somatic deletions of chromosome 3p occur at high frequencies in cancers of
      kidney, breast, cervix, head and neck, nasopharynx, and lung. The frequency of 3p
      deletion in lung cancer approaches 100% among small cell lesions and 70 to 80% in
      non-small cell lesions. This evidence strongly implies that one or more tumor
      suppressor genes of potentially widespread significance reside within the deleted
      region(s). Precise definition of the deleted target region(s) has been difficult
      due to the extensive area(s) lost and use of markers with low informativeness.
      However, improved definition remains essential to permit isolation of putative
      tumor suppressor genes from 3p. The identification of several small, homozygous
      3p deletions in lung cancer cell lines has provided a critical resource that will
      assist this search. The U2020 cell line contains a small homozygous deletion that
      maps to a very proximal region of 3p and includes the marker D3S3. We previously
      identified a subset of DNA markers located within the deleted region and
      determined their relative order by pulsed-field gel mapping studies. In the
      present report, we describe the development of YAC contigs that span the majority
      of the deleted region and link up to flanking markers on both sides. The
      centromere proximal portion of the contig crosses the breakpoint from an X;3
      translocation located within 3p12 providing both location and orientation to the
      map. PCR-based (CA)n microsatellite polymorphisms have been localized within and
      flanking the deletion region. These markers should greatly facilitate loss-of
      heterozygosity studies of this region in human cancer. The contig provides a
      direct means for isolation of putative tumor suppressor genes from this segment
      of 3p.

PMID- 7774918
TI  - Cloning of the beta 3 chain gene (LAMB3) of human laminin 5, a candidate gene in
      junctional epidermolysis bullosa.
AB  - Laminin 5 consists of three polypeptides, alpha 3, beta 3, and gamma 2, encoded
      by the genes LAMA3, LAMB3, and LAMC2, respectively. In this study, we have
      elucidated the exon-intron organization of the human LAMB3 gene. Characterization
      of five overlapping lambda phage DNA clones revealed that the gene was
      approximately 29 kb in size. Subsequent sequence data revealed that the gene
      consisted of 23 exons that varied from 64 to 379 bp in size, accounting for the
      full-length cDNA with an open reading frame of 3516 bp encoding 1172 amino acids.
      Comparison of the LAMB3 gene structure with the previously characterized LAMB1
      gene revealed that LAMB3 was considerably more compact. Knowledge of the exon
      intron organization of the LAMB3 gene will facilitate elucidation of mutations in
      patients with the junctional forms of epidermolysis bullosa, some of which have
      been associated with mutations in the laminin 5 genes.

PMID- 7774919
TI  - The human and mouse homologs of the yeast RAD52 gene: cDNA cloning, sequence
      analysis, assignment to human chromosome 12p12.2-p13, and mRNA expression in
      mouse tissues.
AB  - The yeast Saccharomyces cerevisiae RAD52 gene is involved in DNA double-strand
      break repair and mitotic/meiotic recombination. The N-terminal amino acid
      sequence of yeast S. cerevisiae, Schizosaccharomyces pombe, and Kluyveromyces
      lactis and chicken is highly conserved. Using the technology of mixed
      oligonucleotide primed amplification of cDNA (MOPAC), two mouse RAD52 homologous
      cDNA fragments were amplified and sequenced. Subsequently, we have cloned the
      cDNA of the human and mouse homologs of yeast RAD52 gene by screening cDNA
      libraries using the identified mouse cDNA fragments. Sequence analysis of cDNA
      derived amino acid revealed a highly conserved N-terminus among human, mouse,
      chicken, and yeast RAD52 genes. The human RAD52 gene was assigned to chromosome
      12p12.2-p13 by fluorescence in situ hybridization, R-banding, and DNA analysis of
      somatic cell hybrids. Unlike chicken RAD52 and mouse RAD51, no significant
      difference in mouse RAD52 mRNA level was found among mouse heart, brain, spleen,
      lung, liver, skeletal muscle, kidney, and testis. In addition to an approximately
      1.9-kb RAD52 mRNA band that is present in all of the tested tissues, an extra
      mRNA species of approximately 0.85 kb was detectable in mouse testis.

PMID- 7774920
TI  - Genetic mapping of the mouse neuromuscular mutation kyphoscoliosis.
AB  - The ky mouse mutant, kyphoscoliosis, exhibits a degenerative muscle disease
      resulting in chronic deformation of the spinal column. Using an interspecific
      backcross segregating the ky mutation, we have mapped the ky locus to a small
      region of mouse chromosome 9. ky is nonrecombinant with the microsatellites
      D9Mit24 and D9Mit169 and lies in a conserved linkage group that encompasses human
      chromosome 3. s-Laminin (LAMS) and the gene for dystrophin-associated
      glycoprotein 1 (DAG1), which map to human chromosome 3, are both recombinant with
      ky, ruling them out as candidates.

PMID- 7774921
TI  - Conservation of the T-box gene family from Mus musculus to Caenorhabditis
      elegans.
AB  - Recently, a novel family of genes with a region of homology to the mouse T locus,
      which is known to play a crucial, and conserved, role in vertebrate development,
      has been discovered. The region of homology has been named the T-box. The T-box
      domain of the prototypical T locus product is associated with sequence-specific
      DNA binding activity. In this report, we have characterized four members of the T
      box gene family from the nematode Caenorhabditis elegans. All lie in close
      proximity to each other in the middle of chromosome III. Homology analysis among
      all completely sequenced T-box products indicates a larger size for the conserved
      T-box domain (166 to 203 residues) than previously reported. Phylogenetic
      analysis suggests that one C. elegans T-box gene may be a direct ortholog of the
      mouse Tbx2 and Drosophila omb genes. The accumulated data demonstrate the ancient
      nature of the T-box gene family and suggest the existence of at least three
      separate T-box-containing genes in a common early metazoan ancestor to nematodes
      and vertebrates.

PMID- 7774922
TI  - Sequence of human FEN-1, a structure-specific endonuclease, and chromosomal
      localization of the gene (FEN1) in mouse and human.
AB  - We recently purified and cloned the gene for a DNA structure-specific
      endonuclease, FEN-1, from murine cells. The murine protein recognizes 5' DNA flap
      structures that have been proposed in DNA replication, repair, and recombination.
      Here, we report the sequence of the human FEN1 gene. The translated sequence is
      identical to peptide sequence obtained from maturation factor-1, which is 1 of
      the 10 essential proteins for cell-free DNA replication. The human protein has
      the same structure-specific DNA endonuclease activity as the murine protein. Two
      human chromosomal hybridization signals, 11q12 and 1p22.2, were observed by FISH
      analysis using human genomic clones homologous to the mouse Fen-1 gene. The
      localization on human 11q12 was confirmed using radiation-reduced hybrids. The
      mouse Fen-1 gene is assigned to chromosome 19 based on somatic cell hybrids. The
      significance of these FEN1 gene localizations in human and mouse is discussed.

PMID- 7774923
TI  - Cloning mammary cell cDNAs from 17q12-q23 using interspecific somatic cell
      hybrids and subtractive hybridization.
AB  - We have cloned human genes that are encoded in the region 17q12-q23 and expressed
      in breast tissue using interspecific somatic cell hybrids and subtractive
      hybridization. Two mouse microcell hybrids containing fragments of human
      chromosome 17 with a nonoverlap region at 17q12-q23 were generated by microcell
      transfer. Radiolabeled cDNA was synthesized from the hybrid cell containing the
      17q12-q23 interval and was subtracted with an excess of RNA from the hybrid cell
      lacking the interval. Resulting cDNA probes enriched for sequences from 17q12-q23
      were used to screen a human premenopausal breast cDNA library, and 60 cDNAs were
      identified. Three of these cDNAs mapped to the hybrid cell nonoverlap region.
      These cDNAs were expressed in mammary epithelial cell hybrids, although none
      appeared to be breast-specific. Sequence analysis of the cDNAs revealed that
      clone 93A represents a previously unidentified gene, clone 98C has homology to an
      expressed sequence tag from goat mammary tissue, and clone 200A is identical to
      the human homologue of the Drosophila melanogaster flightless-I gene. These genes
      map outside a 1-cM region linked to early onset familial breast cancer but may be
      useful genetic markers in the 17q12-q23 region.

PMID- 7774924
TI  - Construction of a transcription map surrounding the BRCA1 locus of human
      chromosome 17.
AB  - We have used a combination of methods (exon amplification, direct selection,
      direct screening, evolutionary conservation, island rescue-PCR, and direct
      sequence analysis) to survey approximately 600 kb of genomic DNA surrounding the
      BRCA1 gene for transcribed sequences. We have cloned a set of fragments
      representing at least 26 genes. The DNA sequence of these clones reveals that 5
      are previously cloned genes; the precise chromosomal location of 2 was previously
      unknown, and 3 have been cloned and mapped by others to this interval. Three
      other genes, including BRCA1 itself, have recently been mapped independently to
      this region. Sequences from 11 genes are similar but not identical matches to
      known genes; 5 of these appear to be the human homologues of genes cloned from
      other species. Another 7 genes have no similarity with known genes. In addition,
      39 putative exons and 14 expressed sequence tags have been identified and mapped
      to individual cosmids. This transcript map provides a detailed description of
      gene organization for this region of the genome.

PMID- 7774925
TI  - Direct selection of expressed sequences within a 1-Mb region flanking BRCA1 on
      human chromosome 17q21.
AB  - Direct selection of genes within the interval of chromosome 17q21 containing
      BRCA1 was performed. YAC and cosmid contigs spanning the BRCA1 region were used
      to select cDNA clones from pools of cDNAs derived from human placenta, HeLa
      cells, activated T cells, and fetal head. A minimum set of 48 fragments of
      nonoverlapping cDNAs that unequivocally mapped within a 1-Mb region was
      identified, although it is not yet known how many of these are derived from the
      same transcript. DNA sequence analyses revealed that 4 of these cDNAs were
      derived from known genes (EDH17B2, glucose-6-phosphatase, IAI.3B, and E1AF), 1 is
      a member of a previously described gene family (HMG-17), and 7 share substantial
      identity with previously described genes from human or other species. The
      remainder showed no significant homology to known genes. Limited PCR-based
      expression profiles of a set of 13 of the genes were performed, and all gave
      positive results with at least some cDNA sources supporting the contention that
      they truly represent transcribed sequences. A comparison between genes obtained
      from this region by direct selection with those obtained by direct screening or
      exon trapping (see accompanying papers, this issue) revealed that over 90% of the
      genes identified by exon trapping were represented in the selected material and
      that at least two additional genes that appear to represent low abundance
      transcripts with restricted expression profiles were identified by selection but
      not by other means.

PMID- 7774926
TI  - 22 genes from chromosome 17q21: cloning, sequencing, and characterization of
      mutations in breast cancer families and tumors.
AB  - In our effort to identify BRCA1, 22 genes were cloned from a 1-Mb region of
      chromosome 17q21 defined by meiotic recombinants in families with inherited
      breast and/or ovarian cancer. Subsequent discovery of another meiotic recombinant
      narrowed the region to approximately 650 kb. Genes were cloned from fibroblast
      and ovarian cDNA libraries by direct screening with YACs and cosmids. The more
      than 400 cDNA clones so identified were mapped to cosmids, YACs, and P1 clones
      and to a chromosome 17 somatic panel informative for the BRCA1 region. Clones
      that mapped back to the region were hybridized to each other and consolidated
      into clusters reflecting 22 genes. Ten genes were known human genes, 5 were human
      homologs of known genes, and 7 were novel. Each gene was sequenced, compared to
      genes in the databases to find homologies, and analyzed for mutations in BRCA1
      linked families and tumors. Eight mutations were found in tumors or families and
      not in controls. In the gene encoding alpha-N-acetylglucosaminidase,
      approximately 100 kb proximal to the 650-kb linked region, somatic nonsense,
      missense, and splice junction mutations occurred in 3 breast tumors, but not in
      these patients' germline DNA nor in controls. In an ets-related oncogene in the
      linked region, a missense mutation cosegregated with breast cancer in one family
      and was not observed in controls. In a human homolog of a yeast pre-mRNA splicing
      factor, 3 different mutations cosegregated with breast cancer in 3 families and
      were not observed in controls. In these and the other genes in the region, 36
      polymorphic variants were observed in both cases and controls.

PMID- 7774927
TI  - A YAC-, P1-, and cosmid-based physical map of the BRCA1 region on chromosome
      17q21.
AB  - A familial early-onset breast cancer gene (BRCA1) has been localized to
      chromosome 17q21. To characterize this region and to aid in the identification of
      the BRCA1 gene, a physical map of a region of 1.0-1.5 Mb between the EDH17B1 and
      the PPY loci on chromosome 17q21 was generated. The physical map is composed of a
      yeast artificial chromosome (YAC) and P1 phage contig with one gap. The majority
      of the interval has also been converted to a cosmid contig. Twenty-three PCR
      based sequence-tagged sites (STSs) were mapped to these contigs, thereby
      confirming the order and overlap of individual clones. This complex physical map
      of the BRCA1 region was used to isolate genes by a number of gene identification
      techniques and to generate transcript maps of the region, as presented in the
      three accompanying manuscripts of Brody et al. (1995), Osborne-Lawrence et al.
      (1995), and Friedman et al. (1995).

PMID- 7774928
TI  - Assignment of the 36.5-kDa (RFC5), 37-kDa (RFC4), 38-kDa (RFC3), and 40-kDa
      (RFC2) subunit genes of human replication factor C to chromosome bands 12q24.2
      q24.3, 3q27, 13q12.3-q13, and 7q11.23.
AB  - Replication factor C is a multimeric primer-recognition protein consisting of
      five subunits (p145, p40, p38, p37, and p36.5) and is essential for the
      processive elongation of DNA chains catalyzed by DNA polymerase delta or epsilon
      in human cells. We have mapped the locations on human chromosomes of the genes
      coding for the four smaller subunits [p36.5 (RFC5), p37 (RFC4), p38 (RFC3), and
      p40 (RFC2)] using both PCR amplification from DNAs of a panel of somatic hybrids
      and fluorescence in situ hybridization to bands 12q24.2-q24.3, 3q27, 13q12.3-q13,
      and 7q11.23, respectively.

PMID- 7774929
TI  - Genetic and physical mapping of five novel microsatellite markers on human Xp21.1
      p11.22.
AB  - Five polymorphic CA-dinucleotide repeats, identified in cosmids from the short
      arm of the human X chromosome, have been characterized and localized to Xp21.1
      (DXS572), Xp11.4 (DXS556, DXS574), and Xp11.22-p11.23 (DXS722, DXS573). Genetic
      mapping with respect to five reference markers that include the gene for CGD
      (CYBB in Xp21.1), complemented by physical mapping information, has indicated the
      order tel-DXS572-CYBB-DXS1110-DXS556-DXS574-D XS7-DXS426-DXS722-DXS573-DXS255
      cen.

PMID- 7774930
TI  - Genomic organization and genetic mapping of the neuroimmune gene I2rf5 to mouse
      chromosome 4.
AB  - The nervous and immune systems share many functional and molecular similarities,
      including shared surface antigens, secretions of soluble factors, and cross
      modulatory effects. We have identified previously a novel mRNA termed F5, which
      is expressed only in activated T lymphocytes and mature, postmitotic neurons.
      Tissue specificity and sequence conservation suggest an important function for F5
      in T-lymphocyte proliferation and neuronal maturation. The F5 gene product is an
      evolutionarily conserved, cytoskeletal-associated phosphoprotein. A full-length
      mouse genomic clone has been isolated. The protein coding region of the F5 gene
      is approximately 16 kb in length and is composed of 13 coding exons. The gene
      encoding F5, termed I2rf5, was mapped using interspecies mouse crosses in close
      proximity to a number of genes associated with neuronal defects on distal
      chromosome 4.

PMID- 7774931
TI  - Physical and genetic localization of a Shab subfamily potassium channel (KCNB1)
      gene to chromosomal region 20q13.2.
AB  - A human delayed rectifier K+ channel gene has been localized to the long arm of
      human chromosome 20q13.2 by fluorescence in situ hybridization of genomic P1
      clones from this locus. A polymorphic (GA) microsatellite repeat was identified
      in one of the P1 clones. The new SSR marker (D20S436) was genotyped in four CEPH
      pedigrees. Two-point linkage analysis indicated linkage of this marker to a PCR
      marker, D20S109, with a maximum lod score of 9.32 at theta = 0.001. The
      assignment of this K+ channel gene to 20q13.2 eliminates it as a candidate for
      the gene associated with benign familial neonatal convulsions (BFNC), which has
      been localized to 20q13.3. Genetically, the K+ channel gene maps more than 30 cM
      proximal to the BFNC locus.

PMID- 7774932
TI  - Mapping of the human cone transducin alpha-subunit (GNAT2) gene to 1p13 and
      negative mutation analysis in patients with Stargardt disease.
AB  - We report localization of the human cone transducin (GNAT2) gene using
      fluorescence in situ hybridization on chromosome 1 in band p13. The recent
      assignment of a gene for Stargardt disease to the same chromosomal region by
      linkage analysis prompted us to investigate the possible role of GNAT2 in the
      pathogenesis of this disease. We investigated 66 unrelated patients for mutations
      in the coding region of the GNAT2 gene using polymerase chain reaction-single
      strand conformation polymorphism analysis (SSCP) and direct sequencing. No
      disease-specific mutations were found, indicating that GNAT2 is probably not
      involved in the pathogenesis of most cases of Stargardt disease.

PMID- 7774933
TI  - Phospholipase C gamma-2 (Plcg2) and phospholipase C gamma-1 (Plcg1) map to
      distinct regions in the human and mouse genomes.
AB  - The phospholipase C gamma-2 (Plcg2) gene encodes an enzyme that plays a crucial
      role in intracellular signal transduction pathways. This enzyme is important
      because of its role in the generation of second messengers following the
      hydrolysis of phosphatidylinositol 4,5-bisphosphate. We have now determined the
      chromosomal location of this gene in the mouse and human genomes. An
      interspecific backcross involving AEJ/Gn and Mus spretus mice was used to
      localize the gene in mouse. A rodent/human somatic cell hybrid panel was used to
      map PLCG2 in the human genome. Our results position Plcg2 in the central region
      of mouse chromosome 8. We also show that PLCG2 maps to the long arm of human
      chromosome 16, in the region q22-qter. Plcg2 does not map near its most closely
      related family member, Plcg1, in either genome, indicating that the mammalian
      Plcg genes belong to a dispersed family.

PMID- 7774934
TI  - The mouse Fau gene: genomic structure, chromosomal localization, and
      characterization of two retropseudogenes.
AB  - The Fau gene is the cellular homolog of the fox sequence of the Finkel-Biskis
      Reilly murine sarcoma virus (FBR-MuSV). FBR-MuSV acquired the Fau gene by
      transduction in a transcriptional orientation opposite to that of the genomic Fau
      gene. The genomic structure of the mouse Fau gene (MMFAU) and its upstream
      elements have been determined and are similar to those of the human FAU gene. The
      gene consists of five exons and is located on chromosome 19. The first exon is
      not translated. The promoter region has no well-defined TATA box but contains the
      polypyrimidine initiator flanked by regions of high GC content (65%) and shows
      all of the characteristics of a housekeeping gene. The 5' end of the mRNA
      transcript was determined by 5' RACE analysis and is located, as expected, in the
      polypyrimidine initiator site. Furthermore, the sequences of two retropseudogenes
      (Fau-ps1 and Fau-ps2) are reported. Both pseudogenes are approximately 75%
      identical to the Fau cDNA, but both are shorter due to a deletion at the 5' end
      and do not encode a functional protein. Fau-prs is interrupted by an AG-rich
      region of about 350 bp within the S30 region of the Fau cDNA. Fau-ps1 was
      localized on chromosome 1 and Fau-ps2 on chromosome 7.

PMID- 7774935
TI  - A physical map encompassing GP2B, EPB3, D17S183, D17S78, D17S1183, and D17S1184.
AB  - The q21 region of chromosome 17 contains the gene BRCA1, which is involved in
      familial early-onset breast and ovarian cancers. A physical map of a region that
      extends from a distal boundary of the BRCA1 region, D17S78, to GP2B has been
      constructed. The map consists of 30 STSs, including 2 new short tandem repeat
      polymorphic markers. The contig is composed of a mixture of 7 YACs, 5 P1
      plasmids, and 14 cosmids and was ordered by STS-content mapping.

PMID- 7774936
TI  - The structural genes, MEP1A and MEP1B, for the alpha and beta subunits of the
      metalloendopeptidase meprin map to human chromosomes 6p and 18q, respectively.
AB  - Meprins are cell membrane, oligomeric metalloendopeptidases composed of two
      distinct but evolutionarily related subunits, alpha and beta. The structural
      genes for the meprin subunits, Mep-1 alpha and Mep-1 beta, have been previously
      mapped to chromosomes 17 and 18, respectively, of the mouse genome. We now report
      the localization of MEP1A and MEP1B in the human genome. MEP1A mapped to the
      short arm of chromosome 6 by the use of radiation and somatic cell hybrids. More
      specifically, it is localized between the centromere and GSTA2 in 6p11-p12. MEP1B
      mapped to chromosome 18, by the use of somatic cell hybrids, in 18q12.2-q12.3,
      proximal to the TTR/PALB gene. As in the mouse genome, the two homologous human
      structural genes for alpha and beta (50% identical on the cDNA level) are
      unlinked. These new markers on human chromosomes 6 and 18 extend the region of
      known linkage homology with mouse chromosomes 17 and 18, respectively, and
      provide new molecular access to regions of the human genome.

PMID- 7774937
TI  - Physical analysis of the tuberous sclerosis region in 9q34.
AB  - We report the construction of a physical map based on cloned DNA within the
      candidate region for the tuberous sclerosis complex (TSC1) gene on chromosome
      9q34, between the markers D9S149 and D9S66. The DNA clones form three contigs
      consisting of 7 YACs, bridged by P1 and cosmid clones, and cover more than 950 kb
      of 9q34. Despite intensive screening of all available libraries, two gaps remain.
      A detailed physical map of much of this region was derived, and restriction
      mapping of the YAC, P1, and cosmid clones reveals novel CpG islands in this
      region. This set of genomic clones provides a resource for characterizing
      candidates for the TSC1 gene, guided by the location of CpG islands.

PMID- 7774938
TI  - Mapping of the NEP receptor tyrosine kinase gene to human chromosome 6p21.3 and
      mouse chromosome 17C.
AB  - The mouse receptor tyrosine kinase (RTK) NEP, also called Ptk-3, is widely
      expressed, with high levels in proliferating neuroepithelia of mouse embryos. The
      recently described human discoidin domain receptor (DDR) has a predicted amino
      acid sequence 93% identical to that of murine NEP and may be its human homologue.
      We have mapped the gene encoding NEP in human and mouse by fluorescence in situ
      hybridization using a mouse cDNA probe. The NEP/Nep gene maps to human chromosome
      6p21.3 and mouse chromosome 17C, respectively. This places the NEP/Nep gene at,
      or near, the major histocompatibility (MHC) locus--HLA in human and H2 in mouse,
      respectively. Based on its pattern of expression during development, NEP and Nep
      represent candidate genes for several MHC-linked developmental abnormalities in
      human and mouse.

PMID- 7774939
TI  - Structure of the mouse H2A.X gene and physical linkage to the UPS locus on
      chromosome 9: assignment of the human H2A.X gene to 11q23 by sequence analysis.
AB  - The H2A.X gene was cloned from the C3H mouse strain, and its structure was
      determined. Sequence analysis revealed that this gene is situated in close
      proximity to the porphobilinogen deaminase (PBGD) gene in the opposite
      orientation. The synteny is conserved in human. This permits us to assign the
      H2A.X gene to chromosome 9 and 11q23 in mouse and human, respectively.

PMID- 7774940
TI  - Mapping of the taurine transporter gene to mouse chromosome 6 and to the short
      arm of human chromosome 3.
AB  - Transport proteins have essential functions in the uptake of neurotransmitters
      and neuromodulators. We have mapped the gene encoding the taurine transporter,
      Taut, to the central region of mouse chromosome 6. Analysis of a cross
      segregating the neurological mutant mnd2 excluded Taut as a candidate gene for
      this closely linked mutation. To map the human taurine transporter gene, TAUT, a
      sequence-tagged site (STS) corresponding to the 3' untranslated region of the
      human cDNA was developed. TAUT was assigned to human chromosome 3 by typing this
      STS on a panel of somatic cell hybrids. Further analysis of a hybrid panel
      containing defined deletions of chromosome 3 suggested that TAUT maps to 3p21
      p25. These data extend a conserved linkage group on mouse chromosome 6 and human
      chromosome 3p. Deletion of TAUT might contribute to some phenotypic features of
      the 3p- syndrome.

PMID- 7774941
TI  - CEPH viewer: a client-server database to browse and manipulate CEPH physical
      mapping and linkage data.

PMID- 7774942
TI  - Assignment of the Waldner blood group locus (WD) to 17q12-q21.

PMID- 7774944
TI  - Assignment of ALDH3 to human chromosome 17p11.2 and ALDH5 to human chromosome
      9p13.

PMID- 7774943
TI  - A novel C2H2 zinc-finger protein gene (ZNF160) maps to human chromosome 19q13.3
      q13.4.

PMID- 7774946
TI  - Assignment of the human glypican gene (GPC1) to 2q35-q37 by fluorescence in situ
      hybridization.

PMID- 7774947
TI  - Integration of the 1993-94 Genethon genetic linkage map for chromosome 18 with
      the physical map using a somatic cell hybrid mapping panel.

PMID- 7774945
TI  - Mapping the human corticotropin releasing hormone binding protein gene (CRHBP) to
      the long arm of chromosome 5 (5q11.2-q13.3).

PMID- 7774948
TI  - Assignment of the human genes for desmocollin 3 (DSC3) and desmocollin 4 (DSC4)
      to chromosome 18q12.

PMID- 7774949
TI  - Assignment of the creatine transporter gene (SLC6A8) to human chromosome Xq28
      telomeric to G6PD.

PMID- 7774950
TI  - Assignment of the gene (EPLG2) encoding a high-affinity binding protein for the
      receptor tyrosine kinase elk to a 200-kilobasepair region in human chromosome
      Xq12.

PMID- 7774952
TI  - Mapping of the receptor protein-tyrosine kinase 10 to human chromosome 1q21-q23
      and mouse chromosome 1H1-5 by fluorescence in situ hybridization.

PMID- 7774951
TI  - The gene for fibroblast activation protein alpha (FAP), a putative cell surface
      bound serine protease expressed in cancer stroma and wound healing, maps to
      chromosome band 2q23.

PMID- 7774953
TI  - The mouse homologue of the tuberin gene (TSC2) maps to a conserved synteny group
      between mouse chromosome 17 and human 16p13.3.

PMID- 7774954
TI  - Structure, sequence, and chromosomal location of the gene for USF2 transcription
      factors in mouse.
AB  - The ubiquitously expressed upstream stimulatory factor (USF) involved in the
      transcription of a wide variety of cellular genes is defined as dimers of c-myc
      related proteins, composed of a basic helix-loop-helix/leucine zipper region. The
      USF family consists of different members that split into two groups: MLTF or USF1
      and USF2 or FIP. We present here evidence that USF1 and USF2 are distinct closely
      related genes in human, rat, and mouse. Based on the recent cloning of rat and
      human new cDNAs, we have isolated genomic clones encompassing the murine USF2
      gene, which consists of at least 10 exons spanning a minimum of 10 kb of genomic
      DNA. Unexpectedly, the organization of USF2 appears very split up by introns
      (0.08 to over 6 kb in size), compared to the myc gene structure. The entire gene
      (but the larger intron) and 1.6 kb of the 5' flanking region were sequenced. This
      5' flanking region is GC-rich, contains several putative transcription binding
      sites, and has no apparent TATA box. Gene mapping of murine USF2 and USF1 has
      been determined by in situ hybridization, indicating the localization of USF2 on
      chromosome 7 and of USF1 on chromosomes 1 and 11.

PMID- 7774955
TI  - The CEPH consortium linkage map of human chromosome 16.
AB  - A Centre d'Etude du Polymorphisme Humain (CEPH) consortium map of human
      chromosome 16 has been constructed. The map contains 158 loci defined by 191
      different probe/restriction enzyme combinations or primer pairs. The marker
      genotypes, contributed by 9 collaborating laboratories, originated from the CEPH
      families DNA. A total of 60 loci, with an average heterozygosity of 68%, have
      been placed on the framework genetic map. The genetic map contains 7 genes. The
      length of the sex-averaged map is 165 cM, with a mean genetic distance between
      loci of 2.8 cM; the median distance between markers is 2.0 cM. The male map
      length is 136 cM, and the female map length is 197 cM. The map covers virtually
      the entire chromosome, from D16S85, within 170 to 430 kb of the 16p telomere, to
      D16S303 at 16qter. The markers included in the linkage map have been physically
      mapped on a partial human chromosome 16 somatic cell hybrid panel, thus anchoring
      the genetic map to the cytogenetic-based physical map.

PMID- 7774956
TI  - A 500-kilobase region containing the tuberous sclerosis locus (TSC1) in a 1.7
      megabase YAC and cosmid contig.
AB  - A complete overlapping clone map of a 1.7-Mb region from DBH to D9S67 that
      includes the TSC1 candidate region has been constructed. The map includes YAC and
      cosmid clones, contains STS approximately every 50 kb on average, and establishes
      the order of five previously unordered loci. The overall physical length of this
      segment of chromosome 9q34 (1.7 Mb) is significantly less than expected compared
      to its estimated genetic length (approximately 10 cM). Consequently, the physical
      length of the TSC1 candidate region is substantially less than predicted by a
      genetic distance of approximately 2 cM.

PMID- 7774957
TI  - Genetic mapping in human and mouse of the locus encoding TRBP, a protein that
      binds the TAR region of the human immunodeficiency virus (HIV-1).
AB  - Productive infection with HIV-1, the virus responsible for AIDS, requires the
      involvement of host cell factors for completion of the replicative cycle, but the
      identification of these factors and elucidation of their specific functions has
      been difficult. A human cDNA, TRBP, was recently cloned and characterized as a
      positive regulator of gene expression that binds to the TAR region of the HIV-1
      genome. Here we demonstrate that this factor is encoded by a gene, TARBP2, that
      maps to human chromosome 12 and mouse chromosome 15, and we also identify and map
      one human pseudogene (TARBP2P) and two mouse TRBP-related sequences (Tarbp2-rs1,
      Tarbp2-rs2). The map location of the expressed gene identifies it as a candidate
      for the previously identified factor encoded on human chromosome 12 that has been
      shown to be important for expression of HIV-1 genes. Western blotting indicates
      that despite high sequence conservation in human and mouse, the TARBP2 protein
      differs in apparent size in primate and rodent cells.

PMID- 7774958
TI  - Cosmid assembly and anchoring to human chromosome 21.
AB  - A human chromosome 21-specific cosmid library from the Lawrence Livermore
      National Laboratory has been analyzed by two complementary methods,
      fingerprinting and hybridization; 40% coverage of the entire chromosome 21 has
      been achieved. To prepare a contig pool, approximately 9300 cosmid clones
      randomly selected from the library were fingerprinted and automatically assembled
      into 467 overlapping sets by the fluorescence-tagged restriction fragment method.
      The average size of the overlapping sets was 9.5 cosmids with minimal tiling
      paths consisting of 5.4 cosmids with a 10-kb extension each. However, as many as
      10% of overlaps within members were estimated to be false. For regional
      localization, we hybridized gridded arrays of cosmids with inter-Alu-PCR probes
      obtained from YAC clones and somatic cell hybrids and assigned 592 cosmids to 26
      subregions of 21q. Of these, 371 clones were incorporated into 139 contigs,
      anchoring the total 1864 cosmids to the subregion. The remaining 221 clones were
      mapped as orphans. To correlate the cytogenetic, YAC, and cosmid maps on 21q, the
      translocation breakpoints of the chromosomes contained in the somatic cell
      hybrids were mapped with respect to the STS content of the YACs. From the gene
      cluster regions, 176 ribosomal and 25 alphoid clones were isolated by
      hybridization. Together, these sets of anchored contigs and cosmids will provide
      a valuable resource for construction of a high-resolution map and for isolation
      of genes of interest from chromosome 21.

PMID- 7774959
TI  - Genomic organization of the mouse cyclin D1 gene (Cyl-1).
AB  - To determine the genomic organization of the mouse cyclin D1 locus (Cyl-1), a
      series of cosmids and cDNAs were recovered by hybridization with a genomic probe
      representing the 5' end of the homologous human gene, CCND1. Primer extension
      indicated that transcripts originate from one of three adjacent nucleotides at a
      single start site. Two overlapping cDNA clones that essentially accounted for the
      complete sequence of the larger 4.0-kb Cyl-1 transcript were characterized. A
      combination of RNase protection and sequencing across intron-exon boundaries
      established that the gene is organized into five coding exons with a long 3'
      untranslated region. Repeated attempts to isolate clones corresponding to the
      minor 3.5-kb RNA were compromised by the presence of an internal poly(A) domain.
      However, hybridization with specific probes revealed that the minor transcript
      lacks approximately 800 nucleotides from the 3' end of the major transcript and
      may be generated by a novel mechanism or by RNA processing.

PMID- 7774960
TI  - Genomic organization of the neurofibromatosis 1 gene (NF1).
AB  - Neurofibromatosis 1 maps to chromosome band 17q11.2, and the NF1 locus has been
      partially characterized. Even though the full-length NF1 cDNA has been sequenced,
      the complete genomic structure of the NF1 gene has not been elucidated. The 5'
      end of NF1 is embedded in a CpG island containing a NotI restriction site, and
      the remainder of the gene lies in the adjacent 350-kb NotI fragment. In our
      efforts to develop a comprehensive screen for NF1 mutations, we have isolated
      genomic DNA clones that together harbor the entire NF1 cDNA sequence. We have
      identified all intron-exon boundaries of the coding region and established that
      it is composed of 59 exons. Furthermore, we have defined the 3'-untranslated
      region (3'-UTR) of the NF1 gene; it spans approximately 3.5 kb of genomic DNA
      sequence and is continuous with the stop codon. Oligonucleotide primer pairs
      synthesized from exon-flanking DNA sequences were used in the polymerase chain
      reaction with cloned, chromosome 17-specific genomic DNA as template to amplify
      NF1 exons 1 through 27b and the exon containing the 3'-UTR separately. This
      information should be useful for implementing a comprehensive NF1 mutation screen
      using genomic DNA as template.

PMID- 7774962
TI  - Allergic bronchopulmonary aspergillosis: an emerging disease in India.

PMID- 7774961
TI  - Genomic organization of the human alpha-adducin gene and its alternately spliced
      isoforms.
AB  - The cDNA for the human alpha-adducin gene has been cloned, and different
      alternately spliced forms have been identified. We report the complete genomic
      organization of the human alpha-adducin gene and these alternately spliced forms.
      The human alpha-adducin gene, spanning approximately 85 kb, consists of 16 exons
      ranging in size from 34 to 1892 bp. One of the spliced forms of the human alpha
      adducin gene results from alternate use of the 5' splice donor site for exon 10,
      while another results in a truncated protein following insertion of 34 bp
      comprising exon 15, followed by a premature stop codon. This alternate spliced
      form of alpha-adducin is predicted to result in an altered carboxyl terminus that
      would eliminate a protein kinase and calmodulin binding site. Seven nucleotide
      substitutions and 4 insertion/deletions were also identified. The 5' region of
      the human alpha-adducin gene contains one Sp1 site, two AP2 sites, and two CAAT
      boxes. No TATA box was apparent, consistent with features of a housekeeping gene.
      We have mapped another cDNA within the first intron of the human alpha-adducin
      gene, suggesting overlapping genes in this 4p16.3 genomic region.

PMID- 7774964
TI  - Allergic bronchopulmonary aspergillosis: review of 20 cases.
AB  - An account of clinical, radiological and laboratory findings in 20 cases of
      allergic bronchopulmonary aspergillosis, seen over a period of 6 years is
      presented. All patients showed blood eosinophilia (with 30% having an absolute
      eosinophil count (AEC) of over 2000 mm3) and a positive immediate skin reaction.
      However, dual skin reaction with Aspergillus fumigatus antigen was observed in 7
      (35%) cases. Serum precipitins against A. fumigatus antigen was detected in all
      cases while culture of sputum yielded A. fumigatus in 15 (75%) cases. Areas of
      consolidations of various sizes, shapes and number (80%) and irregular
      infiltrations (60%), either shifting in nature (85%) or recurrent at same site
      (35%), were the main radiological findings.

PMID- 7774963
TI  - Allergic bronchopulmonary aspergillosis: a retrospective study of 35 cases.
AB  - Clinical profile of 35 patients with allergic bronchopulmonary aspergillosis
      (ABPA) was analysed. The disease was found to be more frequent among females.
      Constitutional symptoms, expectoration, increased breathless and poor control of
      asthma were the main presenting features. Skin reactivity against aspergillin and
      Candida was positive in 30 and 2 cases, respectively. Precipitating antibodies
      against Aspergillus species was positive in 28 cases, and against Candida
      albicans in 2 cases. Sputum grew either Aspergillus or C. albicans or both in 19
      patients. Absolute eosinophilia was observed only in one third of cases. Chest
      skiagram revealed characteristic central/proximal bronchiectasis and/or fleeting
      shadows in all cases. No specific pattern was observed on spirometry. There was
      no correlation between the duration of bronchial asthma, sputum culture and
      serology results. Most patients responded well to steroids. One striking feature
      of the study was that one third of the cases were misdiagnosed as pulmonary
      tuberculosis and were treated with antitubercular drugs for varying periods of
      time. A high index of clinical suspicion with appropriate laboratory tests are
      required to identify these cases.

PMID- 7774965
TI  - Correlative study of histopathology and bacteriology in patients of tubercular
      lymphadenitis.
AB  - Histopathology as well as bacteriology of lymph node specimen are useful
      diagnostic tools for tuberculous lymphadenitis. In the present study, a total of
      71 cases of lymphadenitis were selected for histopathological and bacteriological
      studies. Only 46 patients had caseating type and 4 had non-caseating type of
      tuberculous lymphadenitis while 21 patients revealed non-specific chronic
      lymphadenitis on histopathological examination. Only 6 lymph node smears were
      positive for acid fast bacilli (AFB), 19 cases were positive for mycobacterial
      culture growth. Thus, it is not necessary that the cases which are
      histopathologically positive will be positive for culture as well. Therefore,
      both bacteriology and histopathology are complimentary diagnostic tools for
      tuberculous lymphadenitis.

PMID- 7774966
TI  - Histoplasmosis in India: current status.

PMID- 7774967
TI  - Upper zone opacity mimicking lung cancer.

PMID- 7774968
TI  - Right axis deviation and right ventricular hypertrophy in constrictive
      pericarditis.

PMID- 7774969
TI  - Microfilaria in bronchial aspirate.
AB  - A 65-year-old female was evaluated for suspected bronchogenic carcinoma. The
      chest x-ray revealed a left parahilar opacity with a raised left dome of
      diaphragm. Fiberbronchoscopy showed an oedematous and hyperemic left main
      bronchus but no growth was visualised. Bronchial biopsy did not show any evidence
      of neoplasm. However, the bronchial aspirate smear examination showed one
      microfilaria. Post bronchoscopic roentgenogram done on the next day revealed
      clearing of left parahilar shadow and a normal diaphragm. The patient responded
      well to 300 mg of diethylcarbamazine given in divided doses for 3 weeks.

PMID- 7774970
TI  - Immunization coverage and the knowledge and practice of mothers regarding
      immunization in rural area.
AB  - One hundred and thirty mothers in the age group (15-44) years and 142 children
      aged (12-59) months were selected by cluster sampling method from nine villages
      in Wardha district. Out of this 100 mothers and 122 children could be contacted
      for evaluation of immunization coverage and assessing maternal knowledge and
      practice regarding immunization. 52.5% children were fully immunized and 45.1%
      were partially immunized. Vaccine coverage for B.C.G. and primary doses of
      DPT/OPV was 95.9% and above 85% respectively. It was 57.4% for measles and 63.04%
      for booster dose of DPT/OPV. Drop-out rate from second to third dose of DPT/OPV
      was 5.3% and from third to booster dose was 36.96%. Mothers had a fair knowledge
      regarding need for immunization but a poor knowledge regarding the diseases
      prevented and doses of the vaccines. Commonest side reactions reported were fever
      (36%) and pain at injection site (33%). Contraindications listed by mothers were
      mild cold (41%), mild fever (24%) or loose stools (14%). Health workers were the
      major source of information and 76% knew the use and maintenance of immunization
      cards.

PMID- 7774971
TI  - Prevalence of hepatitis B surface antigen and antibody among hospital admitted
      patients in Manipal.
AB  - 184 indoor patients suffering from various hepatic as well as non-hepatic
      disorders admitted in Kasturba Medical College & Hospital, Manipal during the
      year 1989 were studied for the presence of HBs Ag and anti HBs by ELISA. As viral
      hepatitis specially hepatitis B is a major public health problem in all parts of
      the world, this type of study will give an idea about the preponderance of
      hepatitis infection among hospital admitted patients.

PMID- 7774972
TI  - Nutritional status of under five children in an urban slum community of Calcutta.
AB  - Nutritional status particularly in relation to the possible risk of morbidity and
      mortality in children has long been recognised as a field of major concern. A
      cross-sectional study was undertaken with 1280 under five children in the urban
      slum community of Chetla, the field practice area of All India Institute of
      Hygiene & Public Health, Calcutta, during 1991 to identify their nutritional
      status. Wt/age being the most sensitive indicator was considered; and the
      children were graded using the Indian Academy of Pediatrics classification. It is
      evident from table 1, that more than half of the under five children were
      undernourished in the series, 27.7%, 16.8%, 5.3% and 1.8% being suffering from
      grade I, II, III and IV undernutrition respectively.

PMID- 7774973
TI  - A short communication on occurrence of rheumatic diseases attending hospital.
AB  - A total of 4800 patients suffering from rheumatic diseases, attending Department
      of Physical Medicine, Burdwan Medical College Hospital, West Bengal, during the
      period from January 1991 to June 1991, were studied. Out of these 4800 cases,
      soft tissue rheumatism cases were maximum (57%), followed by osteo-arthrosis
      cases (36%), rheumatoid arthritis (5.2%), rheumatic arthritis (0.4%), ankylosing
      spondylitis (0.6%), osteo-chondrosis (0.7%) and gouty arthritis (0.1). Soft
      tissue rheumatism cases were common (62.8) in age group 20-40 years, mainly
      (58.4%) in female and maximum (37%) of lumbosacral strain. Osteo-arthrosis cases
      were highest (53.9%) in 40-60 years of age with female preponderance (57.2%) and
      mainly (49%) of cervical spondylosis.

PMID- 7774974
TI  - Health financing in India.

PMID- 7774975
TI  - Evaluation of anthropometric indices of malnutrition in under five children.
AB  - Anthropometric indices in the assessment of malnutrition in under five children
      are being indiscriminately used especially when a community based survey is
      conducted and so the estimated prevalence of malnutrition varies in different
      methods. In this study a comparison of these common anthropometric measurements
      is done in order to find out the best method suitable for individual assessment
      of malnutrition. The evaluation technique discussed in this paper consists of
      comparison of the efficiency of various anthropometric measurements in detecting
      malnutrition and was judged in terms of specificity, sensitivity and predictive
      value. The test is most efficient when the sensitivity and specificity attain
      unity. In this study it is shown that weight for age and Body Mass Index (BMI)
      attain higher value of delta [delta = 1-(alpha + beta)], where - alpha is false
      positive value and beta is false negative value) and low value of delta standard
      error of which proves that the best method of assessing malnutrition using
      various anthropometric measurements is weight for age as against body mass index.

PMID- 7774976
TI  - Dietary cravings and aversions during pregnancy.
AB  - Although nausea and vomiting in early pregnancy has been studied in detail, there
      is little information available regarding dietary aversions and some cravings
      during pregnancy. To study the prevalence and factors associated with dietary
      aversions and cravings during pregnancy, a survey was carried out on 1000
      randomly selected pregnant women attending antenatal clinics in a district in
      southern Sri Lanka. In this group 473 (47.3%) had pregnancy cravings for wide
      variety of foods: sour food 65%, unripe fruits 40%, meat and fish 47%, ripe
      fruits 30%, food from alms giving 26% and jam and bread fruit 22%. Ninety nine
      per cent of those who had pregnancy cravings had made special attempt to obtain
      the food of their choice and all of them had their cravings satisfied by eating
      the food of their choice. Pregnancy cravings was significantly higher in women
      who married after a love affair's than in those who had on 'arranged' marriage (p
      < 0.05), in women who were superstitious (believed in devil dancing and gods)
      than in those who were not (p < 0.05), and in women with a family income of less
      than Rs. 2,500 than in those with an income of more than Rs. 2,500 (p < 0.05).

PMID- 7774977
TI  - Dietary patterns and selected anthropometric indices in reproductive age women of
      a slum in urban: Kurnool.
AB  - Dietary intake in pregnant, lactating and non-pregnant nonlactating women of an
      urban slum in Kurnool, A.P. are about 30% less than the ICMR recommended daily
      allowances. Heights and weights of the subjects are similar to the National
      Nutrition Monitoring Bureau's values for slum women and some inter-religious
      difference is observed in the anthropometry of the subjects.

PMID- 7774978
TI  - EEG predictability: adequacy of non-linear forecasting methods.
AB  - The predictive properties of EEG segments were analyzed. The sample included
      alpha, delta as well as spike and wave EEG activity recordings. Most of these
      segments are better described with non-linear autoregressive models, and a non
      linear forecasting algorithm is routinely required. In terms of their predictive
      properties, segments can be divided into unpredictable, predictable and very
      predictable, these three groups being similarly represented among the alpha
      activity EEG segments. In EEG segments with alpha activity, poor predictability
      is associated with poor organization of the rhythmic pattern. Concerning dynamic
      properties, it was found that cyclic skeletons were highly represented among the
      very predictable segments, which reflect a contribution of the deterministic
      component of the autoregressive model to the predictability of the segments.
      Notable contributions of the noise component may explain the properties of
      unpredictable segments. These results point to a great diversity of predictive
      patterns among EEG recordings. Other factors besides the existence of chaotic
      dynamics must be regarded.

PMID- 7774979
TI  - A fuzzy logic diagnosis system for classification of pharyngeal dysphagia.
AB  - Identification and classification of the dysphagic patient at risk of aspiration
      is important from a clinical point of view. Recently, we have developed
      techniques to quantify various biomechanical parameters that characterize the
      dysphagic patient, and have developed an expert system to classify patients based
      on these measurements. The purpose of the present investigation was to develop a
      fuzzy logic diagnosis system for classification of the patient with pharyngeal
      dysphagia into four categories of risk for aspiration. Non-invasive acceleration
      and swallow pressure measurements were obtained and five parameters were
      extracted from these measurements. A set of membership functions were defined for
      each parameter. The measured parameter values were fuzzified and fed to a rule
      base which provided a set of output membership values corresponding to each of
      the categories. The set of output values were defuzzified to obtain a continuous
      measure of classification. The fuzzy system was evaluated using the data obtained
      from 22 subjects. There was a complete agreement between the fuzzy system
      classification and the clinician's classification in 18 of the 22 patients. The
      fuzzy system overestimated the risk by half a category in two patients and
      underestimated by half a category in two patients. The fuzzy logic diagnosis
      system, together with the biomechanical measures, provides a tool for continued
      patient assessment on a daily basis to identify the patient who needs further
      videofluorography examination.

PMID- 7774980
TI  - PC program for assessing the effect of a treatment when subjects are growing:
      comparative studies.
AB  - We describe, illustrate, and make available a menu-driven PC program which can be
      used to assess the effect of a treatment on growth when random allocation of
      subjects to the treatment and control groups is not feasible. Three different
      estimators of, and confidence intervals for, this effect are computed, namely,
      the simple gains, standardized gains, and covariance adjusted estimators. It is
      shown by means of several examples that these estimators can differ
      substantially, and some guidelines for choosing between them in specific
      circumstances are provided.

PMID- 7774981
TI  - PC program for comparing two regression lines over a specified finite interval.
AB  - A method due to Tsutakawa and Hewett (Biometrics 34 (1978) 391-398) for comparing
      two regression lines over a specified, finite interval has been implemented. We
      describe and illustrate the procedure and program, and make the latter available
      to interested readers.

PMID- 7774982
TI  - PC program for determining the dose necessary to produce a given amount of
      change.
AB  - Given a simple linear regression equation of the form D = alpha + beta Z, it is
      well-known how to predict, and construct confidence intervals for, the value of D
      corresponding to a given Z. In this paper we describe, illustrate and make
      available a menu-driven PC program which can be used to solve the inverse
      problem, namely, to estimate and construct confidence intervals for the value of
      Z corresponding to a given value of D. We describe the procedure in the context
      of a dose-response relationship, where it is desired to estimate the dose (Z) to
      effect a given amount of change (D), but the method is more general than this. In
      particular, it may be usefully applied in calibration problems where one may wish
      to estimate the true value of a measurement given the value as read from a
      measuring device.

PMID- 7774983
TI  - PC program for simultaneously testing equality of means and variances for paired
      bivariate normal data.
AB  - A menu-driven PC program for simultaneously testing the equality of means and
      variances for paired bivariate normal data is described, illustrated and made
      available. While the corresponding tests for independent samples are well-known
      and widely implemented, in the paired situation only the test for no change in
      mean values (the paired t-test) has been similarly covered. Tests for no change
      in variability, while important, are less well-known and not implemented in most
      commercial statistical computing programs.

PMID- 7774984
TI  - PC program extending the Potthoff-Roy longitudinal data analysis model to allow
      missing data: Kleinbaum's method.
AB  - Potthoff and Roy (Biometrika, 51 (1964) 313-326) generalized the multivariate
      analysis of variance model into a form that is especially useful for the study of
      longitudinal growth curve data. Applications of this method have, however, been
      limited by the requirement that each case in the sample be measured at the same
      set of time points, i.e. there can be no missing data. In this paper we describe,
      illustrate, and make available a user-friendly, interactive PC program
      implementing Kleinbaum's (J Mult Anal, 3 (1973) 117-124) extension of the
      Potthoff-Roy model to allow incomplete measurement sequences. These missing data
      are permitted to arise either randomly or by design as in mixed longitudinal
      studies.

PMID- 7774985
TI  - A new model for blood flow through an artery with axisymmetric stenosis.
AB  - Presented herein are the studies on the flow behavior of a blood type suspension
      through a circular tube with an axisymmetric stenosis. The suspension of the
      cells in plasma is represented by a layered fluid model, with a marginal cell
      free layer of the suspending medium near the wall, a central core region and an
      annular layer of a biviscous fluid layer. It is understood that the proposed
      model may contribute to the inbuilt mechanism for drag reduction and prevention
      of the further development of the stenosis. The concept of lubricating pipe
      lining for transporting various industrial fluids is well represented through
      three-layered core-annular flows. The governing equations are solved numerically
      by using finite element method. The velocity fields, including separation and
      reattachment points, and the distribution of pressure and wall shear stresses
      have been brought out and discussed. The results of the analysis show that the
      presence of the marginal cell-free layer reduces the wall shear stresses and the
      length of the flow reversal zone. The non-Newtonian character of the suspension
      is helpful in reducing the abnormal effects of the stenosis. The model thus
      establishes the inbuilt character of blood for decreasing the stresses and this,
      in turn, reduces the load on the heart in propelling the blood.

PMID- 7774986
TI  - A computer program for the analysis of chromatograms used in pharmacokinetic
      studies.
AB  - An analog/digital (A/D) converter and software written in BASIC language have
      been developed for the analysis of chromatographic data which are needed for
      pharmacokinetic (PK) studies in humans and in experimental animals such as dogs
      and rats. Using an A/D converter, widely sold personal computers produced by NEC
      or EPSON are applicable to both high-performance liquid-chromatography (HPLC)
      data analysis and PK analysis. When chromatographic data is taken up by the
      computer and treated as a variable, a maximum of 12,000 data points are saved by
      the computer. As 10 digital data points are taken up by the computer per second
      through the A/D converter, the maximum run time of a chromatogram is 20 min. For
      the purpose of HPLC analysis, however, five digital data points per second are
      usually enough for routine analysis. In this software, the program is written to
      take and save five digital data points/s. Therefore, the maximum run time of this
      software increased to 40 min per chromatogram. All the digital data through the
      A/D converter are saved into the data file on a floppy disk or hard disk. For the
      chromatogram analysis, both automatic peak identification and manual peak
      identification, which must be selected with the use of the mouse driver, are
      available. All the data, peak area, peak height, etc. are also saved into the
      data file. After a calibration curve is produced, following the input of peak
      analysis data of known spiked samples, the drug concentration for each sample is
      estimated. These concentration-time data are also saved into the data
      file.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7774987
TI  - Automating the sleep laboratory: implementation and validation of digital
      recording and analysis.
AB  - OBJECTIVES: We report on the implementation of digital processing in a large
      clinical and research sleep laboratory. The system includes the digital
      collection, display, analysis, and repository of physiological signals collected
      during sleep. METHODS: After describing the original analog system, the computer
      equipment and software necessary for the digital implementation are presented and
      we explain our algorithms for rapid eye movement (REM) and delta-wave detection.
      Finally, we describe an experiment validating the digital system of display and
      analyses. CONCLUSIONS: The digital processing of sleep signals saves computer
      operator, polysomnographic technologist, and computer time. It also saves
      resources such as polysomnographic paper and FM tape. The digital signals lend
      themselves to a large array of analysis techniques and result in improved signal
      quality. Automated REM and delta-wave detection via digital processing correlate
      highly with visual counts of rapid eye movements and delta waves.

PMID- 7774988
TI  - Intracoronary stenting after unsuccessful PTCA. Early restenosis and explanation
      of stents during bypass surgery.
AB  - The case of a 63-year-old man is described, who received two intracoronary Palmaz
      Schatz-Stents after dissection and occlusion following PTCA of two segments of
      the left anterior descending branch of the left coronary artery. Because of
      recurrent angina caused by early restenosis in the 'unprotected' segment between
      the stents, surgical revascularisation was performed and the stents were removed.

PMID- 7774989
TI  - Effect of gemfibrozil versus lovastatin on increased serum lipoprotein(a) levels
      of patients with hypercholesterolemia.
AB  - The aim of this study was to determine the effect of gemfibrozil, compared with
      lovastatin, in patients with high levels of lipoprotein(a) and on plasma lipid
      profile. Twenty-seven nondiabetic patients with high levels of plasma lipids and
      lipoprotein(a), 19 male and eight female, aged 37-68 (mean +/- S.D. 54.2 +/- 7.5)
      years, were randomly assigned to 2 weeks of treatment with gemfibrozil 600 mg
      twice daily (14 pts.) or lovastatin 40-80 mg once daily (13 pts.). Patients had
      fasting plasma total cholesterol levels > or = 6.2 mmol/l, low-density
      lipoprotein > 4.14 mmol/l and lipoprotein(a) > 0.62 mmol/l. All patients but one
      had triglycerides > 2.82 mmol/l. There were no statistical differences between
      both groups in terms of age, sex, clinical diagnosis and previous medication.
      After 3 months of treatment, gemfibrozil reduced triglycerides (47.9% vs. 24.5%;
      P < 0.001), very low density lipoprotein (43.9% vs. 24.6%; P < 0.05),
      lipoprotein(a) (25.3% vs. 4.9%; P < 0.05) and increased high-density lipoprotein
      (34.4% vs. 11%; P < 0.01) more than lovastatin. Gemfibrozil and lovastatin
      reduced comparably total cholesterol (21.4% vs. 29.0%; P = NS) and low-density
      lipoprotein (26.5% vs. 37.3%; P = NS). The plasma levels of high-density
      lipoprotein and lipoprotein(a) were unchanged significantly by lovastatin. In
      conclusion, besides well-known efficacy in hyperlipidemia treatment, gemfibrozil
      also increased high-density lipoprotein and reduced lipoprotein(a), which may
      have important epidemiologic implications.

PMID- 7774990
TI  - Effect of aging on left ventricular filling in untreated hypertensive patients.
AB  - The aim of this study was to evaluate the influence of age and other clinical and
      echocardiographic parameters on left ventricular filling in a group of 174
      untreated patients with mild to moderate hypertension (aged 20-82 years; mean
      51.2 years) and in 189 age-matched normotensive subjects. All subjects underwent
      an echocardiographic study with pulsed Doppler evaluation of left ventricular
      filling. Left ventricular dimensions and indexes of systolic function were
      similar and within normal limits in both groups. Left ventricular filling was
      altered in hypertensive subjects < 65 years with a decrease of peak early
      velocity (peak E), an increase of peak atrial velocity (peak A) and a reduced E/A
      ratio. However in subjects > or = 65 years, we did not observe any differences in
      transmitral flow velocity pattern between hypertensive and normotensive subjects.
      The stepwise regression analysis showed that age alone explains up to 8% of peak
      E variance, 14% of peak A and 26% of E/A ratio in hypertensives, while in
      normotensives it explains up to 18% of peak E variance, 50% of peak A and 61% of
      E/A ratio. The other variables entered into the regression slightly improved the
      predictive power. In conclusion, age is the major independent factor affecting
      left ventricular filling in both groups, even if its predictive power was smaller
      in the hypertensive group. The similarity of diastolic filling pattern in elderly
      hypertensive and normotensive subjects suggests that the 'aging factor' plays an
      important role in influencing left ventricular filling pattern so as to mask the
      effect of hypertension in the elderly patients.

PMID- 7774991
TI  - Comparison of efficacy of nisoldipine, metoprolol, and isosorbide dinitrate in
      patients with stable exertional angina: a randomized, cross-over, placebo
      controlled study.
AB  - We evaluated the acute antianginal effect of oral nisoldipine (10 mg), metoprolol
      (40 mg), and long-acting isosorbide dinitrate (20 mg) in 15 patients with stable
      exertional angina. The patients performed symptom-limited treadmill exercise at 2
      h after the administration of placebo (Placebo stages 1 and 2) and each of the
      active drugs. After Placebo stage 1, the patients were randomized for cross-over
      evaluation of the acute effect of a single oral dose of placebo (Placebo stage
      2), nisoldipine, metoprolol, or long-acting isosorbide dinitrate. All 15 patients
      developed angina during all of exercise tests and their exercise tests were
      terminated at the onset of angina. The time until development of 0.1 mV ST
      segment depression was increased by all three drugs compared to placebo, and it
      was significantly longer with metoprolol than with isosorbide dinitrate.
      Similarly, the time to ceasing exercise because of angina was also prolonged by
      all three drugs. The exercise time was longer with nisoldipine and metoprolol
      compared to isosorbide dinitrate, but there was no significant difference between
      nisoldipine and metoprolol. In conclusion, metoprolol and nisoldipine more
      effectively prolonged exercise compared to long-acting isosorbide dinitrate in
      patients with stable exertional angina.

PMID- 7774992
TI  - Impaired cholinergic peripheral vasodilation and its relationship to hyperemic
      calf blood flow response and exercise intolerance in patients with chronic heart
      failure.
AB  - This study examined the peripheral endothelium-dependent vasodilatory response to
      acetylcholine and the endothelium-independent vasodilatory response to
      nitroprusside in 19 patients with chronic heart failure and eight controls. These
      peripheral blood flow responses were compared with hyperemic calf blood flow
      changes after maximum leg exercise and 5-min femoral occlusion. The peripheral
      blood flow response to forearm intra-arterial infusion of acetylcholine and
      sodium nitroprusside, and reactive hyperemic calf blood flow changes were
      measured by plethysmography. All peripheral blood flow responses were
      significantly reduced in patients with chronic heart failure (P < 0.05).
      Reduction of acetylcholine-mediated changes in peripheral blood flow was
      correlated with exercise-induced calf blood flow response (r = 0.51, P < 0.05),
      but not with occlusion-induced calf blood flow response (r = 0.02, NS). Sodium
      nitroprusside-mediated changes were not correlated with any reactive hyperemic
      blood flow responses (exercise: r = 0.27, NS; occlusion: r = 0.11, NS). When the
      patients were divided into two subgroups based on the median exercise-induced
      calf blood flow change, the subgroup with the lower calf blood flow response
      showed a reduction in exercise capacity (anaerobic threshold: 11.8 +/- 0.6 vs.
      14.6 +/- 1.0 ml/kg/min; P < 0.05). These findings suggest that endothelial
      dysfunction is related to a decrease in exercise-induced skeletal muscle blood
      flow and exercise capacity in patients with chronic heart failure.

PMID- 7774993
TI  - Silent myocardial ischemia in diabetics with normal autonomic function.
AB  - Twenty male diabetic patients (age range, 40-60 years) with normal autonomic
      function were studied to determine the prevalence of silent myocardial ischemia
      on exercise as well as ambulatory electrocardiography. The presence and extent of
      silent myocardial ischemia was also correlated with the severity of
      atherosclerotic coronary artery disease as determined by coronary angiography. A
      cohort of 20 matched non-diabetic patients were also included in the study.
      Silent myocardial ischemia was detected in 50% of the diabetic patients on
      exercise electrocardiography and in 35% on ambulatory electrocardiography
      compared with 10% and 5% in non-diabetics by the two methods, respectively (P <
      0.01 and P < 0.05, respectively). On exercise testing in diabetic patients,
      silent myocardial ischemia was detected in 64% of the patients with three-vessel
      disease, 50% of the patients with two-vessel disease and 20% of the patients with
      one-vessel disease whereas in non-diabetic patients silent myocardial ischemia
      was detected in only 18% of the patients with three-vessel disease (P < 0.05) and
      in none of the patients with two- or one-vessel disease. On ambulatory
      electrocardiography, only patients (both diabetic and non-diabetic) with three
      vessel disease manifested silent myocardial ischemia. Total ischemic burden was
      similar in both the diabetic and non-diabetic patients. We conclude that silent
      myocardial ischemia occurs in diabetic patients with coronary artery disease more
      frequently even in the absence of autonomic dysfunction and the prevalence of
      silent myocardial ischemia is higher in patients with severe degree of coronary
      artery disease.

PMID- 7774994
TI  - Use of electrophysiological studies in the diagnosis and treatment of cardiac
      patients with left ventricular dysfunction and high grade ventricular ectopy.
AB  - We studied the sudden death occurrence in 28 patients (23 males, age 59.2 +/-
      15.6 years) who had a documented cardiac disease with left ventricular
      dysfunction (ejection fraction < or = 0.4) and high grade ventricular ectopy.
      None had suffered from spontaneous sustained ventricular arrhythmia and/or
      syncope. Their diagnosis and treatment were guided by electrophysiological
      studies. Electrophysiological studies were performed in the antiarrhythmic drug
      free state. In cases when sustained ventricular arrhythmias could be induced,
      antiarrhythmic treatment was prescribed according to the results of the
      electrophysiological studies. In cases of non-inducibility, no antiarrhythmic
      treatment was prescribed. The patients were followed up for a period of 20.6 +/-
      11.2 months. The end points were occurrence of documented spontaneous sustained
      ventricular arrhythmia and sudden death. None of the 19 non-inducible patients
      experienced sudden death or spontaneous sustained ventricular arrhythmia. Two of
      the nine inducible patients died suddenly (P = 0.1). The 3-year sudden death
      mortality rate of the whole group was 7.5%. We conclude that when cardiac
      patients with high grade ventricular ectopy and left ventricular systolic
      dysfunction are treated according to the results of electrophysiological studies,
      it can be expected that their 3-year mortality rate will be low and significantly
      inferior to that reported for conventionally treated patients.

PMID- 7774996
TI  - Significance of ST segment depression during adenosine-induced coronary hyperemia
      in angina pectoris and correlation with angiographic, scintigraphic, hemodynamic,
      and echocardiographic variables.
AB  - Factors determining myocardial ischemia during adenosine-induced coronary
      vasodilation in patients with angina pectoris are not well defined. To evaluate
      the angiographic, scintigraphic, hemodynamic, and echocardiographic determinants
      of ST segment depression during adenosine infusion, 40 patients with angina
      pectoris underwent technetium-99m sestamibi single photon emission computed
      tomography and simultaneous two-dimensional echocardiography. Ischemic ST
      depression occurred in 18 patients (45%). Coronary angiography was performed in
      all patients and a coronary artery jeopardy score was determined. The
      sensitivity, specificity, and the predictive accuracy of adenosine-induced ST
      segment depression in detecting significant coronary artery disease were 53%,
      100%, and 60%, respectively, while the corresponding results for detecting
      reversible perfusion defects were 61%, 92%, and 70%, respectively. Univariate
      predictors of ST segment depression included the coronary artery jeopardy score,
      the presence and the extent of reversible perfusion defects, the presence of
      three-vessel and/or left main coronary artery disease, and diastolic blood
      pressure at peak adenosine infusion. There was a trend (P = 0.06) to a higher
      incidence of collateral vessels in patients developing ST segment depression. The
      coronary artery jeopardy score was found to be the only significant independent
      predictor of ST segment depression by stepwise multivariate logistic regression
      analysis. Thus, in patients with angina pectoris, the coronary artery jeopardy
      score, representing the extent of significant coronary artery disease, is the
      most important independent predictor of adenosine-induced ST segment depression.
      ST depression is unusual in the absence of reversible perfusion defects and is
      also associated with more extensive reversible defects.

PMID- 7774995
TI  - Plasma lipid profile and coronary artery disease in Brazilian hemodialysis
      patients.
AB  - We studied the prevalence of lipid disorders and of coronary artery disease and
      the main factors affecting plasma lipids in a cohort of Brazilian hemodialysis
      patients. The investigation comprised 75 adult hemodialysis patients and 200
      normal controls matched for age, sex, race and body mass index. Mean values for
      plasma lipids were within normal limits in the dialysis group. Total cholesterol
      (184 +/- 44 vs. 201 +/- 46 mg/dl), LDL (110 +/- 36 vs. 131 +/- 44 mg/dl) and HDL
      (40 +/- 13 vs. 47 +/- 12 mg/dl) were significantly lower in the dialysis patients
      (P < 0.01), whereas VLDL (32 +/- 14 vs. 21 +/- 12 mg/dl) and triglyceride (161 +/
      71 vs. 111 +/- 70 mg/dl) were increased (P < 0.01). Increased triglyceride was
      observed in 24% of the dialysis patients, a prevalence two to three times lower
      than that reported in the literature. In the dialysis group, the variables
      positively related to total cholesterol were hypertension (P < 0.05) and gender
      (female) (P < 0.05); to LDL and HDL, hypertension (P < 0.05 and P < 0.01,
      respectively); and to triglyceride, use of propranolol (P < 0.01). Age, race,
      duration of hemodialysis, body mass index and plasma creatinine did not affect
      plasma lipids. The prevalence of coronary artery disease, established by invasive
      and noninvasive methods, was 10.7% while in the literature 20-35% of the
      unselected hemodialysis patients present obstructive coronariopathy. We conclude
      that the plasma lipid profile of Brazilian hemodialysis patients is similar to
      those reported in American and European literature, whereas the prevalence of
      hypertriglyceridemia and of coronary artery disease appears to be reduced.

PMID- 7774997
TI  - Intracardiac varices of the right atrium: a case report and review of the
      literature.
AB  - Two broad-based masses arising along the right atrial septum in a 31-year-old man
      were detected by transesophageal echocardiography and were thought to represent
      partially calcified myxomas. However, at operation they were cystic structures
      filled with blood and calcific nodules. Microscopically, they represented varices
      with phleboliths. Angiography and ultrafast computed tomography may help
      distinguish this entity from myxomas and other right atrial intracavitary masses.

PMID- 7774998
TI  - Evaluation of left ventricular filling by echocardiographic atrioventricular
      plane displacement in patients with coronary artery disease.
AB  - Mean atrioventricular (AV) plane displacement which resulted from left atrial
      systole and its ratio to the total diastolic displacement, were determined by
      echocardiography in 101 patients with coronary artery disease. Ratio of motion of
      the AV plane caused by left atrial systole to the total diastolic displacement
      was correlated with late-to-early mitral flow peak velocity index (r = 0.7).
      Selecting a value of this ratio of the AV plane displacement > or = 44% to define
      Doppler characteristics indicating impaired left ventricular relaxation, resulted
      in a high sensitivity, specificity and predictive value. Its value was also
      validated in another prospectively examined group of coronary artery disease
      patients. In conclusion echocardiographic assessment of AV plane displacement can
      be used for the estimation of left ventricular filling in patients with coronary
      artery disease and particularly in detecting impaired left ventricular
      relaxation.

PMID- 7774999
TI  - Anomalous left circumflex in tetralogy of Fallot--a case report.
AB  - A case of anomalous left circumflex coronary artery coursing the right
      atrioventricular groove in a patient with the Tetralogy of Fallot is described, a
      pattern which, to the best of our knowledge, has not been reported earlier.

PMID- 7775000
TI  - Reversal of dilated cardiomyopathy after chronic tricyclic antidepressant drug
      withdrawal.
AB  - Two patients referred for heart transplantation for dilated cardiomyopathy on
      chronic tricyclic antidepressant treatment are described. Echocardiographic
      normalization of left ventricular diameters and function were evidenced after
      drug withdrawal, suggesting drug-induced toxic myocardial disease. The
      possibility of functional improvement after tricyclic antidepressant drug
      withdrawal should be kept in mind before including patients with dilated
      cardiomyopathy in a heart transplantation program.

PMID- 7775001
TI  - Spontaneous coronary artery dissection associated with oral contraceptive use.
AB  - A 39-year-old woman presented with acute myocardial infarction due to spontaneous
      dissection of the left anterior descending artery. This was treated
      conservatively. She had been on combined oral contraceptive pills from the age of
      22. Repeat coronary angiography 7 months later revealed spontaneous complete
      healing.

PMID- 7775002
TI  - The connection between lactose and coronary artery disease.

PMID- 7775004
TI  - Chemical shift differences between free and Fab-bound peptide correlate with a
      two-stage selection of peptide sequences from a random phage display library to
      delineate critical and non-critical residues for antibody recognition.
AB  - Epitope libraries provide a method to identify peptide ligands for antibodies,
      receptors or other binding proteins. As such, they provide a powerful tool to
      rapidly identify lead ligands in the drug discovery process. In an attempt to
      correlate structural information with the results from peptide screening, we have
      used NMR spectroscopy of peptide/antibody complexes to demonstrate that core
      residues identified through a two-stage selection process undergo a larger
      structural change upon binding antibody than do positions in the peptide amenable
      to a variety of side chains. The model system used was the M2 monoclonal
      antibody/Flag octapeptide epitope system. We have analyzed two peptides: Ac-Asp
      Tyr-Lys-Leu-Gly-Asp-Asp-Leu-NH2 (peptide 1), which contains several non-core
      positions randomized, and Ac-Asp-Tyr-Lys-Asp-Asp-Asp-Asp-Leu-NH2 (peptide 2),
      which closely corresponds to the original Flag sequence. Enrichment of the
      peptides with 15N facilitated the investigation by permitting spectral editing of
      the peptide resonances in the presence of antibody. For peptide 1 the absolute
      shifts for the free vs. Fab-bound peptide were found to be largest for the amide
      groups of Asp-1 and Asp-6, in agreement with classification of these residues as
      critical by the phage display library selection process. For peptide 2 the
      largest absolute shifts were observed for Asp-1 and Asp-4, with the other
      aspartic acid residues also showing significant but smaller changes.

PMID- 7775003
TI  - Stereoselective synthesis of Xaa psi[CH2CH(OH)]Yaa dipeptidomimetics and their
      inclusion in HIV-1 protease inhibitors.
AB  - Two stereoselective syntheses of a new pseudodipeptide isostere, the right-hand
      hydroxyethylene dipeptidomimetic (Xaa psi[CH2CH(OH)]Yaa), are presented. In one
      method readily available amino acids are used as starting materials for Evans
      chiral aldol condensation chemistry. The second method relies on the synthesis of
      an anti-aldol product for the hydroxyethylene isostere via an E-selective ethyl
      hydrocinnamate enolization, and thus allows for the synthesis of isosteres having
      side chains other than those available from amino acids. Both methods are
      illustrated by the chiral synthesis of Boc-Phe psi[CH2CH(OH)]Phe. Two
      diastereomers, (S,S,R) and (S,R,R), are incorporated into an HIV-1 protease
      inhibitor template which yields potent inhibitors of HIV-1 protease when the
      pseudodipeptide isostere is Phe psi[CH(OH)CH2]Phe or Phe psi[CH(OH)CH(OH)]Phe.
      The resulting Phe psi[CH2CH(OH)]Phe-containing inhibitors possess modest potency.

PMID- 7775005
TI  - Synthesis of a selenomethionine peptide and a preliminary study of transport into
      Escherichia coli monitored by high-performance liquid chromatography.
AB  - The tripeptide Gly-SeMet-Gly has been synthesized by a combination of solution
      and solid-phase methods. Increase in weight of the resin was very nearly
      theoretical, and purification was straightforward. Its absorption was compared to
      that of the corresponding peptide, Gly-Met-Gly, in E. coli using HPLC ion
      exchange separation and fluorometric determination of the disappearance of
      peptides in the culture medium and the appearance of methionine and
      selenomethionine in the same culture medium. As E. coli are not known to possess
      extracellular peptidases, and in fact have been shown to possess transport
      systems for peptides, this absorption is interpreted as transport of the peptide
      through the cell wall and membrane into the cytoplasm, endohydrolysis of the
      peptide, and efflux of the peptides' amino acids. Uptake of both peptides was
      approximately equal, but was slowed when both peptides were present
      simultaneously.

PMID- 7775006
TI  - Chemical phosphorylation of the peptides GGXA (X = S, T, Y): an evaluation of
      different chemical approaches.
AB  - An evaluation was made of the two methods most commonly used for phosphorylation
      of hydroxyamino acids in peptides, i.e. the tetrazole-catalysed phosphitylation
      by di-tert-butyl-N,N-diethylphosphoramidite followed by oxidation and the
      phosphorylation by dibenzylphosphochloridate. As model system the sequence GGXA
      (X = S, T, Y) was used which represents a random-coil sequence avoiding the
      influence on the reaction kinetics of secondary structure formation. In the case
      of serine- and threonine-containing peptides, both synthetic methods gave
      comparable yields of the desired phosphopeptides. The phosphorylation of tyrosine
      was achieved more favorably via the phosphoramidite method. However,
      phosphotyrosine peptides are most easily obtained by peptide synthesis using Fmoc
      Tyr(PO3Me2)OH as building block. The dibenzylphosphochloridate method yields the
      expected phosphopeptides as the only peptide derivative and in addition, a great
      number of unidentified by-products which can be removed by ion-exchange
      chromatography. The phosphoramidite method consistently resulted in three peptide
      derivatives, i.e. the desired phosphopeptide, the phosphitylated peptide and a
      bridged derivative with two GGXA fragments linked through a phosphodiester
      bridge. The derivatives were characterised by RP and ion-exchange chromatography,
      31P- and 1H-NMR spectroscopy, and ion-spray and electrospray mass spectrometry.
      Interestingly, even these mild ionisation techniques resulted in partial
      fragmentation. The observed fragmentation pathways seem to be a diagnostic tool
      for the identification of phosphorylation sites in peptides. Both the
      phosphorylated serine and threonine peptide lost phosphoric acid (98 mass units),
      the tyrosine peptide lost phenyl phosphate (174 mass units).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7775008
TI  - Designed polyanionic coiled-coil proteins: acceleration of heparin cofactor II
      inhibition of thrombin.
AB  - Novel polyanionic proteins were designed to increase the rate of heparin cofactor
      II (HC) inhibition of alpha-thrombin, an essential protease in the coagulation
      cascade. Two alpha-helical coiled-coil proteins, a 62-residue dimer containing 8
      Glu residues (E8C) and a 104-residue dimer containing 14 Glu residues (E14C),
      plus two 31-residue control peptides containing 8 Glu residues each (E8A and
      E8B), were chemically synthesized, structurally characterized and enzymatically
      assayed. Circular dichroic spectrophotometry indicated that both E8C and E14C
      formed stable two-chain alpha-helical coiled coils at pH 7 and 25 degrees C. The
      control peptides were only partially alpha-helical. E14C remained folded at 90
      degrees C but E8C was half unfolded at 49 degrees C. Coiled-coil proteins E8C and
      E14C maximally accelerated by 35- and 33-fold, respectively, the rate of HC
      inhibition of alpha-thrombin. None of these compounds accelerated antithrombin
      inhibition of alpha-thrombin, and neither control peptide accelerated HC
      inhibition of alpha-thrombin. Acceleration of the HC inhibition of alpha-thrombin
      showed bimodal dependence on the concentration of the polyanionic protein, which
      is consistent with formation of a HC-coiled-coil-thrombin ternary complex. The
      results suggest that antithrombotic polyanionic alpha-helical coiled-coil
      proteins can be designed and synthesized and that the occurrence of secondary
      structure can be correlated with biological activity.

PMID- 7775007
TI  - Solution structure of the hydrophilic region of HIV-1 encoded virus protein U
      (Vpu) by CD and 1H NMR spectroscopy.
AB  - The HIV-1 specific Vpu is a class I oligomeric membrane phosphoprotein of unknown
      structure and mechanism. The first experimental evidence for the position of
      secondary structural elements present in the hydrophilic C-terminal region of Vpu
      under various solution regimes is reported. CD data for nine overlapping 15 amino
      acid fragments and 3 longer fragments indicate the presence of only transitory
      amounts of stable structure in aqueous solution alone, while with increasing
      trifluoroethanol content limiting structures were found indicating two helical
      segments in the hydrophilic region of Vpu. These limiting structures were more
      precisely defined from a detailed study of Vpu41-58, Vpu52-74 and Vpu63-81, by a
      combination of 2D 1H NMR spectroscopy, distance geometry, and restrained
      molecular dynamics and energy minimization calculations. Sets of low-energy
      conformations compatible with the quantitative NOE data indicate that Vpu41-58
      has an alpha-helix from residues 42 to 50 while a second helix is found for Vpu52
      74 from residues 57 to 69. Vpu63-81 shows only the presence of a single reverse
      turn at residues 74 to 77, without any evidence of helix, under the same
      conditions. From CD measurements the first helix extends back to residue 30 and
      is connected to the N-terminal anchor of Vpu. Thus the hydrophilic region of Vpu
      consists of two alpha-helices joined by a flexible region of 6 or 7 residues,
      which contains the phosphoacceptor sites of Vpu at positions 52 and 56. The
      second helix is followed by a single reverse turn and a flexible C-terminus.

PMID- 7775009
TI  - Coupling in the absence of tertiary amines. V. Removal of the 2
      nitrobenzenesulfenyl (NPS) group with 1-hydroxybenzotriazole in the presence of
      aniline or N-methylaniline.
AB  - In a search for conditions of acidolytic removal of amine protecting groups
      leading to salts of the deblocked amine that can be acylated without addition of
      a tertiary amine, cleavage of the 2-nitrobenzenesulfenyl (Nps) group with
      hydroxybenzotriazole (HOBt) in 2,2,2-trifluoroethanol was attempted. The Nps
      group was smoothly removed, but the resulting salt of the amine component could
      not be acylated unless deprotonated with a tertiary base. A rationale is now
      proposed for this unsatisfactory outcome of the cleavage reaction and for the
      concomitant surprising reduction of HOBt to benzotriazole. Based on the proposed
      mechanism, a new approach was designed for the removal of the Nps group. It was
      cleaved with HOBt in the presence of weakly basic nucleophiles such as aniline, N
      methylaniline or 8-aminoquinoline. The protecting group was transferred smoothly
      to the amino group of the nucleophilic acceptor leaving the deblocked amine
      component in the form of its HOBt salt. This was then readily acylated without
      addition of a tertiary amine.

PMID- 7775010
TI  - The preferred solid-state conformation of (alpha Me)Trp peptides.
AB  - The two Z-L-Ala-DL-(alpha Me)Trp-NH2 diastereomeric dipeptides were synthesized
      from (Z-L-Ala)2(O) and H-DL-(alpha Me)Trp-NH2. The latter racemate, prepared by
      phase-transfer catalyzed alkylation of the N alpha-benzylidene derivative of
      alanine amide followed by acidic hydrolysis of the resulting Schiff base, was
      characterized by X-ray diffraction. The molecular and crystal structure of Z-L
      Ala-L-(alpha Me)Trp-NH2, separated from its diastereomer by silica-gel column
      chromatography, was determined by X-ray diffraction analysis. Both independent
      molecules in the asymmetric unit of the dipeptide adopt a type-II beta-bend
      conformation. However, only the more regularly folded conformation of molecule B
      is stabilized by a 1<--4 C = O...H--N intramolecular H bond. The present results
      indicate that: (i) the C alpha-methylated (alpha Me)Trp residue is a strong beta
      bend and helix former, and (ii) the relationship between (alpha Me)Trp chirality
      and helix screw sense tends to be opposite to that of protein amino acids. The
      implications for the use of the (alpha Me)Trp residue in designing
      conformationally restricted analogs of bioactive peptides are briefly discussed.

PMID- 7775011
TI  - Unprotected peptides as building blocks for branched peptides and peptide
      dendrimers.
AB  - We describe two new site-specific ligation methods for preparing branched peptide
      dendrimers such as multiple antigen peptide (MAP). Both methods are based on the
      general approach of exploiting the specific reaction between a weak base and an
      aldehyde under acidic conditions so that unprotected peptides can be used as
      building blocks. A weak base such as benzoyl hydrazine or 1,2-amino thiol of
      cysteine was attached to the N-terminal of an unprotected peptide as nucleophile
      to react with the alkyl aldehyde on the core matrix of MAP to form a stable
      hydrazone linkage or a five-membered thiazolidine ring, respectively. Two
      synthetic peptides rich in basic amino acids such as lysine and arginine were
      used as models in the ligation reactions in solution to give peptide dendrimers
      containing four or eight copies of peptide immunogens. The resulting
      macromolecules with the MW ranging from 5 to 16 kDa were unambiguously
      characterized by laser-desorption mass spectrometry. Furthermore, we also
      optimized the conditions of these ligation reactions using elevated temperature
      and a water-miscible organic co-solvent to give a combination of rate enhancement
      about 10 fold. These optimizations allowed the ligation reactions to be completed
      in < 4 h instead of 2-3 days. Our ligation approach also has the advantages of
      flexibility so that peptides can be attached through the amino or carboxyl
      terminus to the core matrix. The phenyl hydrazone linkage and the five-membered
      ring were found to be stable at physiological pH suitable for immunization. Thus
      our results provide two practical and useful methods for the synthesis of
      macromolecular peptide dendrimers for vaccines, artificial proteins, and enzymes.

PMID- 7775012
TI  - Structural characterizations of neuropeptide tyrosine (NPY) and its agonist
      analog [Ahx5-17]NPY by NMR and molecular modeling.
AB  - The structures of human NPY and of its centrally truncated agonist analog [Ahx5
      17]NPY have been investigated in DMSO-d6 by two-dimensional NMR and by molecular
      modeling. For both peptides, a complete resonance assignment was achieved and a
      large number (more than 200) of inter-residue NOE connectivities were observed,
      including long-range connectivities between the N- and C-terminal ends of the
      chain. Molecular models were calculated using NOE constraints by distance
      geometry, simulated annealing and conjugate gradient energy minimization. The
      results indicate that both peptides are folded in the center of their chain, NPY
      adopting the hairpin shape, whereas the central portion of [Ahx5-17]NPY is
      characterized by relatively large loops. In contrast to previous models,
      practically no alpha-helical structure exists for these peptides under our
      conditions, but two beta-turns are found in NPY and one in [Ahx5-17]NPY. The
      proximity of the terminal ends could be the determinant factor for their
      activity.

PMID- 7775014
TI  - Synthesis and separation of protected tripeptide epimers by RP-HPLC.
AB  - Twenty three epimeric pairs of protected tripeptides of the type Z-Ala-Xaa-Val
      OMe have been synthesized by conventional coupling procedures in solution.
      Optimal conditions for baseline separation of LLL/LDL epimers were found by high
      performance liquid chromatography on a RP-18 column with aqueous methanol as
      mobile phase. The hydrophobic parameters (log kw) were determined for all
      tripeptides.

PMID- 7775013
TI  - Specificity and formation of unusual amino acids of an amide ligation strategy
      for unprotected peptides.
AB  - An important step in the recently developed ligation strategy known as domain
      ligation strategy to link unprotected peptide segments without activation is the
      ring formation between the C-terminal ester aldehyde and the N-terminal amino
      acid bearing a beta-thiol or beta-hydroxide. A new method was developed to define
      the specificity of this reaction using a dye-labeled alanyl ester aldehyde to
      react with libraries of 400 dipeptides which contained all dipeptide combinations
      of the 20 genetically coded amino acids. Three different ester aldehydes of the
      dye-labeled alanine: alpha-formylmethyl (FM), beta-formylethyl (FE), and
      beta,beta,beta-dimethyl and formylethyl esters (DFE), were examined. The DFE
      ester was overly hindered and reacted with N-terminal Cys dipeptides (Cys-X).
      Interestingly, it also reacted slowly with the sequences of X-Gly where Gly was
      the second amino acid and the X-Gly amide bond participated in the ring
      formation. Although the FE ester reacted similarly as the FM ester in the ring
      formation, the subsequent O,N-acyl transfer was at least 30-fold slower than
      those of the FM-ester. The FM alpha-formyl methyl ester was the most suitable
      ester and was reactive with dipeptides of six N-terminal amino acids: Cys, Thr,
      Trp, Ser, His and Asn. The order and extent of their reactivity were highly
      dependent on pH, solvent and neighboring participation by the adjacent amino
      acid. In general, they could be divided into three categories. (1) N-Terminal Cys
      and Thr were the most reactive.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775015
TI  - Prediction of protein secondary structures from their hydrophobic
      characteristics.
AB  - Deciphering the native conformation of proteins from their amino acid sequences
      is one of the greatest challenges in the field of molecular biology. The
      successful prediction of structural class may help to improve the accuracy levels
      of structure (secondary and tertiary) predictive schemes in globular proteins. In
      our earlier works we developed a new surrounding hydrophobicity scale for the 20
      amino acid residues applicable for both globular and membrane proteins and used
      it successfully to predict the transmembrane helical and strand segments in
      membrane proteins. In this article we propose (i) rules to predict the structural
      class of proteins and (ii) a new predictive scheme for forecasting secondary
      structures of globular proteins, with the use of the new hydrophobicity scale.
      This scheme predicts the structural class and secondary structures of globular
      proteins to 92 and 82% levels of accuracy, respectively, far better than the
      levels from other existing methods.

PMID- 7775016
TI  - Efficient synthesis of metal binding peptides incorporating aminodiacetic acid
      based ligands.
AB  - New N alpha-Fmoc/Bu(t) protected amino acids bearing half-EDTA side chains
      (CH2)nN(Ada-O-Bu(t))2 n = 1 (5), n = 2 (24), n = 3 (10), n = 4 (15) were prepared
      in satisfactory yields. These derivatives can be conveniently used in a solid
      phase peptide synthesis as they are devoid of serious shortcomings of Boc/Bzl
      based syntheses of metallopeptides, such as preliminary peptide capping as well
      as undesired lactamization of 5 during the peptide synthesis. Munksgaard 1995.

PMID- 7775017
TI  - Simultaneous differential scanning calorimetry, X-ray diffraction and FTIR
      spectrometry in studies of ovalbumin denaturation.
AB  - The new application of differential scanning calorimetry (DSC) and the
      susceptibility of ovalbumin to alpha-chymotrypsin gave a quantitative estimation
      of protein denaturation in solid ovalbumin. Solid ovalbumin in granules with 11%
      of water was heated at 100 degrees C in closed and nonclosed ampules. In order to
      compare effects of size and crystal structure, two proteins (bovine albumin and
      gamma-globulin) were examined at similar conditions for the extent of
      denaturation. Ovalbumin and bovine albumin showed similar extents of
      denaturation, but gamma-globulin, with a very different molecular mass, showed
      the maximal conformational changes. The enthalpy of denaturation was measured to
      elucidate the conformational changes in solid proteins. Its value was used for
      calculation of the degree of denaturation. The thermodynamic data associated with
      transition were calculated and the number of bonds broken during denaturation was
      determined. Intrinsic fluorescence was utilized in order to compare these two
      methods. Moreover, X-ray diffraction and FTIR spectrometry were applied to native
      and denatured proteins.

PMID- 7775018
TI  - Synthesis of dipeptide 4-nitroanilides containing non-proteinogenic amino acids.
AB  - A series of tert-butyloxycarbonyl amino acid 4-nitroanilides, including N
      alkylated amino acids and (R)-thiazolidine-4-carboxylic acid, (S)-oxazolidine-4
      carboxylic acid. (4S,5S)-5-methyloxazolidine-4-carboxylic acid, (4S,5R)-5
      methyloxazolidine-4-carboxylic acid, (S)-azetidine-2-carboxylic acid, (S)
      pipecolic acid and (S)-3,4-dehydroproline, were prepared conveniently by the
      isocyanate method or the mixed anhydride procedure. The resulting amino acid 4
      nitroanilides were extended to corresponding dipeptide 4-nitroanilides with tert
      butyloxycarbonyl-(S)-alanine. In the case of sterically hindered amino acid 4
      nitroanilides the mixed anhydride procedure with diphenylphosphinyl chloride was
      successful.

PMID- 7775019
TI  - Amino-acid conjugates of the hapten 2-phenyl-4-ethoxymethylene-5(4H)-oxazolone.
      Synthesis and confirmation of structure.
AB  - 2-Phenyl-4-ethoxymethylene-5(4H)-oxazolone (PhOx = CHOEt) was reacted with
      methylamine, and 2-phenyloxazole-4-carboxylic acid was coupled with methylamine.
      The spectroscopic properties of the two products were compared in order to
      confirm that aminolysis of PhOx = CHOEt occurs by displacement of the ethoxy
      group to give 2-phenyl-4-(substituted-methylene)-5(4H)-oxazolones and not by
      attack at the oxazolone-carbonyl followed by rearrangement to give 2
      phenyloxazole-4-carboxamides. Ten crystalline conjugates were prepared and
      characterized by reacting PhOx = CHOEt with an excess of unprotected di- and
      trifunctional amino acid anions followed by purification by washing them with
      hydrochloric acid.

PMID- 7775020
TI  - The linked phi psi chain plot for visual comparison of the backbone conformation
      of peptides and proteins.
AB  - A new graphic method is described for presenting in two dimensions the phi and
      psi dihedral angles that describe the backbone conformation of a peptide or
      protein chain. For each residue in sequence, phi and psi are plotted as dots on
      the y-axis above the next two points on the x-axis representing the residue
      number. Each dot is linked to the next dot by a slanting line segment (link) and
      each cis-peptide bond (omega approximately 0 degrees) between residues X and Y is
      indicated by marking dots psi X and phi Y with a diamond. This linked phi psi
      chain plot is more useful than an unlinked phi psi chain plot for visually
      recognizing helices, sheets and turns and for graphically comparing several
      protein structures. Overlaying the linked phi psi chain plots for 15 beta
      hairpins classified as type-I' beta-turns revealed that three were significantly
      different from the rest. The dihedral angles (mean +/- standard deviation) of the
      loop residues (L1, L2) for a cluster of 12 beta-hairpins with an inverse-common,
      type-I' beta-turn (phi L1 = 52 +/- 7 degrees, psi L1 = 40 +/- 8 degrees, phi L2 =
      80 +/- 9 degrees, psi L2 = -1 +/- 13 degrees) are similar to the standard
      dihedral angles for the type-1' turn (60, 30, 90 and 0 degrees, respectively).

PMID- 7775021
TI  - Cyclic analogues of wasp kinins from Vespa analis and Vespa tropica.
AB  - Syntheses are described of two bradykinin-like kinins isolated from Vespa analis
      (G-R-P-P-G-F-S-P-F-R-V-I, VSK-A) and Vespa tropica (G-R-P-Hyp-G-F-S-P-F-R-V-V,
      VSK-T) and of their cyclic analogues. Linear dodecapeptides were prepared by the
      solid-phase procedure based on Fmoc-chemistry, and cyclization was carried out by
      the diphenyl-phosphorylazide method. Peptide were characterized by amino acid
      analysis, optical rotation, analytical HPLC and FAB-MS. The conformational
      features of the cyclic and linear kinins were determined by circular dichroism
      measurements in water, 95% trifluoroethanol and 8 M guanidinium chloride.
      Consistent with previous findings, preliminary pharmacological experiments on
      smooth muscle preparations showed that cyclic wasp kinins were 50-100 times less
      potent than their linear analogues. Moreover, cyclo-VSK-A and cyclo-VSK-T behave
      like kininase inhibitors by preventing the degradation of straight kinins.

PMID- 7775022
TI  - Engineering of five 88-residue receptor-adhesive modular proteins containing a
      parallel alpha-helical coiled coil and two RGD ligand sites.
AB  - Several 88-residue proteins were designed, synthesized and examined as receptor
      adhesive modular proteins (RAMPs). Three covalent and two noncovalent dimers were
      made from two 44-residue peptide chains containing three structural modules: RGD
      A23a (ligand-spacer-coil) and A9a-RGD (coil-spacer-ligand). The ligand module
      contained the tripeptide Arg-Gly-Asp (RGD). The coil modules A9a and A23a were
      five-heptad alpha-helices engineered by Hodges and co-workers [Int. J. Peptide
      Protein Res. (1992) 40, 171-179]. By circular dichroic spectroscopy, each of
      these five RAMPs contained an alpha-helical coiled coil. The disulfide-bridged
      dimer RGD-A23a/RGD-A23a and its reduced form (RGD-A23a)2 had two N-terminal RGD
      sites. The disulfide-bridged dimer A9a-RGD/A9a-RGD and its reduced form (A9a
      RGD)2 had two C-terminal RGD sites. However, the disulfide-bridged heterodimer
      RGD-A23a/A9a-RGD had one RGD site at each terminus with a 50 Angstrum coiled coil
      between them. The temperature at the midpoint of unfolding for each of the
      covalent homodimers RGD-A23a/RGD-A23a (67 degrees C) and A9a-RGD/A9a-RGD (69
      degrees C) was slightly higher than that of the corresponding noncovalent
      homodimer (RGD-A23a)2 (62 degrees C) or (A9a-RGD)2 (68 degrees C) but much lower
      than that of the covalent heterodimer RGD-A23a/A9a-RGD (79 degrees C). The
      enthalpy and entropy of thermal unfolding were also significantly greater for the
      heterodimer than for the four homodimers, consistent with the heterodimer having
      the most stable coiled coil. Although the distance between its RGD sites was at
      least 50 Angstrum greater than that for the homodimers, this heterodimeric RAMP
      was only as active as the homodimers A9a-RGD/A9a-RGD and (A9a-RGD)2 in inhibiting
      the adhesion of A2058 melanoma cells to extracellular matrix proteins.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7775023
TI  - A novel oxidation-labile linker for solid-phase peptide synthesis.

PMID- 7775024
TI  - Triangular space and the development of a working model in the analysis.
AB  - Two clinical examples are presented in order to demonstrate how the analyst uses
      what he perceives to be the patient's impact on his ability to think, in
      constructing an effective psychoanalytic working model. The two clinical cases,
      very different in character and in the countertransference difficulties they
      cause, lead to the construction of quite diverse working models, although an
      oedipal illusion plays a central role in both. The presentation is based on the
      premise that psychic space exists and that the shape of the psychic space of one
      individual affects by way of projection the shape of the psychic space of
      another. In the discussion the author traces Bion's concept of the working model
      and the abstractions which can be developed from it, as well as the use of Bion's
      theory in Britton's discovery of the effect that a patient's personal model of
      the oedipal situation can have on the mind of the analyst.

PMID- 7775025
TI  - 'No greater, richer, more mysterious subject [...] than the life of the mind'. An
      early exchange of letters between Freud and Einstein.
AB  - The exchange of letters between Freud and Einstein to which we owe 'Why war?' was
      preceded three years earlier, in 1929, by another, hitherto unknown, brief
      correspondence. It began with a rather peculiar congratulatory missive sent by
      Freud to Einstein on the occasion of the latter's fiftieth birthday, against
      which the recipient defended himself with jovial sarcasm. Freud explained his
      'transgression' in a long and illuminating letter, in which he characterised it
      as an expression of envy. In so doing he assigned an exceedingly benign quality
      to the affect of envy and suppressed the obvious admixture of aggression. The
      author shows in her interpretation that Freud's envy was directed chiefly towards
      the undisputed world renown of the much younger man, whose work had already been
      distinguished with the Nobel Prize. Freud may possibly have known that, not long
      before, Einstein had declined to second the nomination of the founder of
      psychoanalysis for a Nobel Prize; at any rate, his letter describes in telling
      images the particular difficulties and handicaps associated with the
      investigation of human mental life.

PMID- 7775027
TI  - Psychoanalysis in Britain: points of cultural access, 1893-1918.
AB  - An attempt is made here to organise a body of facts available in the published
      literature concerning who, when and why Freud and his ideas were first noticed
      during the early years of psychoanalysis. Specific citations and references
      mentioning Freud reveal a surprisingly wide range of different kinds of cultural
      interest. In fact, we can identify seven different cultural locations which
      adopted some element of the ideas of Freud for specific reasons: (i) the interest
      in the theory of hysteria, from the Society for Psychical Research, commencing in
      1893; (ii) the interest in the psychoanalytic theory of sexuality, from Havelock
      Ellis, from about 1895, in support of radical attitudes towards sexual freedom;
      (iii) as part of the reaction against the pessimistic attitude to treatment in
      British psychiatry, from around 1905 onwards; (iv) the endeavour of W. H. R.
      Rivers and others to create an empirical science of psychology embracing
      scientific psychoanalysis, around 1910-15; (v) the application of psychoanalysis
      to the psychological novel by writers and also to understanding the creative
      process, using Freud's theory of symbols, around 1913; (vi) the attraction of
      some progressive educationalists to Freud's outline of child development, from
      1913; and (vii) the struggle of philosophers, including Bertrand Russell, to
      comprehend the implications of the psychoanalytic view of the unconscious. It is
      claimed that the multivalent quality of Freud's ideas contributed to the success
      of psychoanalysis over the suggestive therapies, and in the conflicts with
      dissenters within the psychoanalytic movement.

PMID- 7775026
TI  - Jones on ice: psychoanalysis and figure skating.
AB  - This paper rescues Ernest Jones's largely-unknown book, 'The Elements of Figure
      Skating' (1931/1952), from relative obscurity and argues for its place in the
      psychoanalytic literature. In the first section, the authors situate Jones's
      passion for figure skating by turning to various historical and biographical
      sources, and to personal correspondence with Jones's son, Mervyn Jones. In the
      second section, they offer the first textual reading of Jones and skating within
      a psychoanalytic framework. This approach, they argue, is long overdue since
      Jones explicitly claimed that the 'Elements' was motivated by his interest in the
      'psychological' problems of the beginning skater, and with the task of
      instruction therein. The authors rely heavily on passages from the 'Elements', in
      part because the book is out-of-print and unavailable to most readers, but also
      because Jones's own words are an exemplary instance of his intense transference
      to psychoanalytic theory during his extra-professional time as a skater. They
      conclude the paper by arguing that Jones ultimately advocates a position beyond
      psychology when he idealistically embraces 'exact knowledge' as the royal road to
      masterful skating.

PMID- 7775028
TI  - Psychoanalytic realities and the analytic goal.

PMID- 7775029
TI  - Anna Freud's adult psychoanalytic technique: a defence of classical analysis.
AB  - The four parts of this paper try to give a picture of Anna Freud's views about
      adult psychoanalytic technique. In the first part, an historical review is given
      of the main points that Anna Freud made about the development of classical
      technique. In the second part, a clinical sketch is presented of the author's own
      personal training analysis with Anna Freud, as an illustration of her actual
      analytic approach in practice. The third part presents a very brief summary of
      the historical development of 'modern' psychoanalytic contributions and the
      controversies that resulted. Finally, the fourth part summarises several major
      areas of differences that Anna Freud believed had developed in recent decades
      between classical analysis and the more 'modern' varieties that focus
      predominantly on the transference and the 'here-and-now' interaction between
      patient and analyst. By outlining the many differences, the presentation attempts
      to convince some of the new generation of psychoanalysts in our pluralistic world
      of the continued value of the underlying principles behind classical technique.

PMID- 7775030
TI  - Psychic reality and unconscious belief.

PMID- 7775031
TI  - Psychic reality in psychoanalytic theory.

PMID- 7775032
TI  - Psychic reality or various realities.

PMID- 7775033
TI  - Psychic reality and clinical technique.

PMID- 7775034
TI  - Addressing the psychic reality of the borderline child.

PMID- 7775035
TI  - Playing with reality: the development of psychic reality and its malfunction in
      borderline personalities.

PMID- 7775036
TI  - Analysing children's dreams.

PMID- 7775037
TI  - Trauma and termination.
AB  - The author suggests a particular reading of the thesis put forward by Freud in
      'Analysis terminable and interminable' that an effective and more definitive
      conclusion may be expected in analyses of cases with traumatic aetiology. This
      reading shifts the emphasis from the patient's history to the possibility of its
      crystallising in focal nuclei emerging within the analytic relationship under the
      pressure of the termination. The revival of separation anxieties which cannot be
      worked through, and their crystallisation in precipitating traumatic events, may
      give rise to decisive psychic work allowing the analysis to be brought to a
      conclusion. Two case histories are presented to show how the end of the analysis
      assumes the form of a new trauma, which reactivates in the present, traumatic
      anxieties from the patient's own infantile history. In the first case a premature
      birth and in the second a miscarriage, originally experienced as isolated
      automatic events without time or history, are relived in the terminal phase as
      vicissitudes of the transference, so that new meaning can be assigned to them and
      they can be withdrawn from the somatic cycle of repetition. The powerful tendency
      to act out and the intense countertransference pressure on the analyst are
      discussed in the light of the specificities of this phase, which is crucial to
      the success of the analysis. This leads to a re-examination, in the concluding
      notes, of some theoretical questions inherent in the problem of the termination
      and, in particular, to a discussion of the ambiguous concept of a natural ending.

PMID- 7775038
TI  - Analytic listening and the experience of surprise.
AB  - The analyst's experience of surprise, its relation to different models of
      analytic listening and its function in the analytic process is illustrated and
      explored through a series of clinical vignettes. Surprise is a crucial affective
      ingredient of the analyst's attention and data-gathering. It is multiply
      determined and inevitably reflects some discovery or rediscovery on the part of
      the analyst about both the patient and the analyst. In the dynamic tension of the
      analyst's listening there is always an interplay between expectation and
      surprise, as each new facet of the patient's conflictual organisation is
      revealed. Evenly-hovering attention entails the setting aside of conscious
      expectation and so maximises the potential for curiosity, surprise and discovery.
      The author describes the relation of surprise to transient identifications with
      the patient and to the interventions that result, the relation of surprise to the
      sense of the uncanny, and the shifts in the analyst's defensive organisation that
      allow for the experience of surprise. Several vignettes illustrate the interplay
      of the analyst's and the patient's psychologies and the manner in which surprise
      may alert the analyst to mutually-created resistances and enactments, which may
      appear to be discrete phenomena, but are in fact continuous processes, intrinsic
      to the work.

PMID- 7775039
TI  - A silenced Indian: more on the secret fantasy of being an exception.
AB  - By means of some aspects of an analysis, the author shows how the fear of being
      murdered may form part of the secret fantasy of being an exception. This fantasy
      should offer protection against being helplessly at the mercy of intense feelings
      which cannot be integrated, and of an intolerable loss of the sense of self,
      which renders true separation impossible. During the course of development the
      fantasy gradually assumes its definitive form. One element of this definitive
      form is that the analysand exists in a state of adulthood as he imagined it as a
      child. Control and autonomy here seem guaranteed, and dependence, helplessness
      and ridiculousness have been overcome. For the creation of such a fantasy, the
      analysand makes 'a great leap forward' at one or more stages of his development.
      The author indicates how a leap of this kind could be imagined in intrapsychic
      terms.

PMID- 7775040
TI  - Misunderstanding and psychic truths.

PMID- 7775041
TI  - On the difficulty of making a mutative interpretation.
AB  - Beginning with Strachey's formulation of the mutative interpretation as the
      vehicle of the therapeutic action of psychoanalysis, the author considers what
      makes a mutative interpretation difficult for the analyst. He concludes that this
      difficulty stems from a relationship of mutual projective identification between
      patient and analyst, which produces an atmosphere antagonistic to analysis. By
      viewing the analytic dyad as a group of two, it is possible to relate this anti
      analytic atmosphere to Freud's and Bion's theories of group mentality. The author
      also concludes that Strachey's 'auxiliary superego' is indistinguishable in
      practice from the analyst's ego, since it is concerned only with 'real and
      contemporary' events, and suggests that our understanding of what is specific to
      the therapeutic action of psychoanalysis would be simplified and improved if we
      replaced Strachey's terms 'auxiliary superego' and 'mature superego' with 'ego'.
      A successful mutative interpretation is a victory of ego over superego; this
      process requires that the analyst free himself from the intellectual
      deterioration that the fusion of superegos has produced; and this accomplishes
      one of the purposes of analysis: to help the patient think and feel what is true.

PMID- 7775042
TI  - Special issue dedicated to M. Russell Harter.

PMID- 7775043
TI  - Locating VEP equivalent dipoles in magnetic resonance images.
AB  - Pattern-reversal and diffuse flash visual evoked potentials (VEPs) were obtained
      from 4 normal adults. A spatiotemporal dipole model was used to determine the
      location of the hypothetical equivalent dipoles consistent with the scalp
      distribution of the VEPs. Equivalent dipoles representing ERG and VEP activity
      were placed within 3-D magnetic resonance images of the brain. Most of the
      localization error appeared to be due to inadequate sampling of the potential
      field in frontal and occipital areas by the 10-20 system of electrode placement.
      Locating electrophysiologic dipoles within magnetic resonance images of brain
      structure allows evaluation of dipole localization techniques.

PMID- 7775044
TI  - Comparison of the smooth eye tracking disorder of schizophrenics with that of
      nonhuman primates with specific brain lesions.
AB  - The smooth pursuit eye tracking deficit (ETD) often associated with schizophrenia
      has generated enormous interest over the last 20 years. The deficit is observed
      in about 80% of schizophrenics and in half of their first degree relatives. It is
      not affected by neuroleptic medication and is not due to inattention. A review of
      52 studies (and actual records when available) on ETD in schizophrenia reveals
      that the deficit can consistently be described as low gain pursuit augmented with
      catch-up saccades and often peppered with intrusive saccades. A review of the
      brain areas that have been shown to be involved in pursuit provides the necessary
      background for the subsequent section which details the nature of the smooth
      tracking deficits following experimental lesions. This section reveals that the
      ETD following lesions of the frontal lobe is unique in that it closely resembles
      the ETD of schizophrenics. This finding lends further support for frontal lobe
      theories of schizophrenia.

PMID- 7775045
TI  - Reflections on visual evoked cortical potentials and selective attention:
      methodological and historical.
AB  - Details of research in which Russ Harter participated in his formative years are
      reviewed. Harter's participation in the early work on Visual Selective Attention
      (Eason, Harter & White, 1969) probably contributed most importantly to his
      career. While reviewing Russ's early experience with basic vision research and
      pioneer visual evoked potentials (VEPs), there is reference to extensive
      information regarding stimulus effects on VEPs (exogenous components of the ERP).
      There can be complex early and late waveforms and waveform changes with changes
      in certain stimulus conditions. There are critical peripheral vision effects at
      various loci over the visual field on VEP and reaction time. Special emphasis is
      given to effects of individual differences in training and skill of experienced
      subjects, as well differences in ability. These observations may suggest methods
      for optimizing sensitivity of ERPs and possibly some clues toward further
      understanding of ERPs.

PMID- 7775046
TI  - Spatial vision in adults and infants: a tribute to Russell Harter.
AB  - To be recognized, the retinal image of an object must first be segregated from
      the retinal image of its surroundings. Luminance contrast is only one way by
      which an object can be rendered visible. Motion contrast alone, texture contrast
      alone, colour contrast alone and disparity contrast alone can also render an
      object visible. This paper notes that psychophysical studies of patients with
      brain lesions show that motion-defined form and luminance-defined form are
      processed separately and describes how magnetic (MEG) or electrical (VEP)
      recording can be used to compare brain responses to luminance-defined form,
      motion-defined form, colour-defined form, texture-defined form and disparity
      defined form. At an early stage in visual processing, the retinal images of
      luminance-defined objects pass through neural filters, each of which is
      selectively sensitive to a limited range of orientations, spatial frequencies and
      temporal frequencies. The properties of individual filters can be isolated and
      quantified by means of the two-sinewave VEP approach. The two-sinewave method
      also allows binocular function to be tested objectively and its normality
      assessed quantitatively even when one or both eyes have low acuity. Evoked
      potential studies of visual development in human infants and studies of labile
      phenomena in adults are both facilitated by the speed of our VEP sweep method.

PMID- 7775047
TI  - Comparison of visual evoked potential and psychophysical contrast sensitivity.
AB  - We measured contrast processing as a function of spatial and temporal frequency
      using three measurement techniques: psychophysical thresholds, visual evoked
      potential (VEP) thresholds and VEP amplitudes. Measurements were made using the
      same stimulus parameters and on the same group of subjects. The agreement among
      these functions depended upon the particular spatio-temporal stimulus employed
      and in general, there were more differences than similarities among these
      measures. For example, VEP derived functions (both amplitude and threshold)
      peaked at 4 c/deg, whereas, the psychophysical functions peaked at 1 c/deg. VEP
      amplitude functions were maximum at > or = 3.5 Hz, whereas both psychophysical
      and VEP sensitivity were maximum at < or = 2.5 Hz. VEP thresholds were broad and
      low pass in shape and in contrast, the psychophysical and VEP amplitude functions
      were band pass. In summary, comparisons among these measures of contrast
      processing must be made with caution.

PMID- 7775048
TI  - Contrast-dependent responses in the human visual system: childhood through
      adulthood.
AB  - Visual evoked potentials (VEPs) to temporal modulation of spatial patterns,
      recorded from humans ranging in age from 4-42 years, demonstrated that contrast
      dependent responses exist in early childhood and change dramatically throughout
      childhood. Bright or dark isolated-check stimuli were used to emphasize
      contributions from ON or OFF pathways to the VEP. (ON and OFF pathways constitute
      one major pair of parallel subsystems, which process brightness [positive
      contrast] and darkness [negative-contrast] information, respectively.) The
      developmental effects observed for each pathway were similar in magnitude and
      time course, suggesting maturation of a common physiological mechanism dependent
      on spatial contrast. Children's responses were more variable and larger than
      those of adults, and exhibited a relative phase lag. In addition, we recorded
      transient VEPs to a conventional contrast-reversing checkerboard pattern. The
      latency of the major positive wave (P100) was found to decrease, while the
      latency of the initial positive wave (P60) was found to increase, with increasing
      age. We propose a vector-summation model, which posits a relative decrease in
      cortical excitation with increasing age, to explain our major findings.

PMID- 7775049
TI  - Infant visual development: an overview of studies using visual evoked potential
      measures from Harter to the present.
AB  - Studies of sensory and perceptual abilities in infants require creative,
      innovative techniques. Although the young infant's response repertoire may appear
      limited to the naive individual, a number of highly refined procedures have been
      developed and implemented with these non-verbal humans over the last twenty
      years. The most successful protocols for evaluating visual development rely
      either on behavioral responses or on electrophysiological recordings. The first
      published report using visual evoked potentials to study the development of
      pattern vision in human infants was presented by M. Russell Harter. This work
      provided the impetus for a wealth of studies exploring issues of visual
      information processing abilities in early infancy. The available range of data
      and experimental techniques are now sufficiently refined that many clinical
      issues are currently being addressed. The purpose of this review is to document
      the evolution of scientific studies since Harter's seminal work. The selection of
      protocols presented focuses on those with either current clinical applications or
      those which hold promise for future applications in the evaluation and treatment
      issues of abnormal visual development.

PMID- 7775050
TI  - The time-course of global precedence and consistency effects.
AB  - The global precedence effect refers to the finding that global aspects of a scene
      are processed more rapidly than local detail in the scene. In experiments with
      large Hs and Ss (global stimuli) made up of small Hs and Ss (local stimuli),
      choice reaction time (RT) to the global letters is shorter than RT to the local
      letters (global precedence effect). In addition, RT for local letters is shorter
      when the local letters are the same as the global letter (consistency effect). We
      sought to determine the time course of the global precedence and consistency
      effects by delaying the global information relative to the local information. In
      Experiment I, the middle cross-bar of the global letter (S or H) was presented
      followed by the rest of the global letter at delays of 0, 48, 80, 160, 320 and
      640 ms. The results indicated that the global precedence effect was obtained at
      delays < 48 ms and local precedence effects are obtained at delays > 80 ms.
      Consistency effects were found in the absence of global precedence effects, but
      only at delays of 48 and 80 ms. Experiment II was a replication with delays of
      16, 32, 48, 64, 80, and 96 ms. The results of this experiment were in agreement
      with those of Experiment I. These findings offer support for the notion that the
      consistency effect is mediated by a higher level process than is the global
      precedence effect.

PMID- 7775051
TI  - Discriminability of random-dot stereograms in three-dimensional space.
AB  - The discriminability of crossed-disparity (near) and uncrossed-disparity as a
      function of their location in the upper-left, upper-right, lower-left, and lower
      right quadrants of the visual field. Discriminability was assessed using choice
      reaction-time (RT) and accuracy measures. While near targets were recognized
      equally well in the upper and lower fields, far targets were perceived more
      easily in the upper visual field. The discriminability of far targets was
      particularly poor in the lower left quadrant. These results point to the
      existence of fundamental asymmetries in perceiving crossed and uncrossed
      disparities along the vertical and lateral axes.

PMID- 7775052
TI  - Models of binocular luminance interaction evaluated using visually evoked
      potential and psychophysical measures: a tribute to M. Russell Harter.
AB  - We determined subjects' responses to sine-wave modulated lights employing
      visually evoked potentials (VEPs) and psychophysical thresholds in a series of
      experiments. The stimuli had the same temporal frequency and mean luminance in
      each eye but the phase difference between the two eyes was varied so that phase
      was either the same (dioptic) or different (dichoptic) in the two eyes. The data
      were fit by a model which had two binocular pathways, one which summed monocular
      nonlinear elements and a second which had a nonlinearity following the
      combination of monocular linear elements. In the second channel the outputs of
      the monocular linear elements were summed at low luminance while at higher
      luminance levels they were subtracted. Based on variations in the threshold data
      with temporal frequency, the pathway which summed nonlinear monocular elements
      was identified with the magnocellular (M) pathway, and the pathway which combined
      monocular linear elements prior to a binocular nonlinear element was identified
      with the parvocellular (P) pathway.

PMID- 7775053
TI  - The role of attention in feature detection and conjunction discrimination: an
      electrophysiological analysis.
AB  - An electrophysiological probe technique was used to ascertain whether the same
      attentional mechanisms are employed for both the detection of simple visual
      features and the discrimination of conjunctions of features. Visual search arrays
      containing 14 grey items and 2 colored items were presented; one color was
      designated relevant for each trial block. Subjects were required to report the
      presence or absence of the relevant color (feature detection condition) or the
      shape of the relevantly-colored item (conjunction discrimination condition).
      Shortly after the onset of the search array, a task-irrelevant probe stimulus was
      flashed at the location of the relevant or irrelevant color and the event-related
      potential (ERP) produced by this stimulus was used to assess sensory processing
      at the probed location. Probes presented at the location of the relevant color
      were found to elicit enhanced ERP components and probes presented on the opposite
      side of the display from the relevant color elicited suppressed components. These
      effects were observed in both the detection and discrimination conditions,
      indicating that spatially restricted attentional processes are used for both the
      detection of simple features and the discrimination of conjunctions. However, one
      ERP component (the PI wave) exhibited these effects in the discrimination
      condition but not in the detection condition, indicating that conjunction
      discrimination utilizes additional attentional processes beyond those required
      for feature detection.

PMID- 7775054
TI  - Electrophysiological indicants of black-white discrimination performance for
      letter and non-letter patterns.
AB  - This study examined event-related potentials (ERPs) and behavioral measures,
      considered to be sensitive to the selective processing of black versus white
      letter and non-letter patterns, in a group of seventy-four randomly selected 6 to
      8 year old children. Results demonstrated faster and more accurate behavioral
      performance on the experimental task for the letter than for the non-letter
      patterns. The ERP measures provided complementary information regarding this
      letter facilitation effect, indicating that the selective neural processing of
      letter as compared to non-letter patterns was present in the electrophysiological
      waveform within the initial 100-140 ms after stimulus presentation. Later ERP
      measures (200-260 and 500-600 ms post-stimulus) in response to the letter stimuli
      showed greater differences as a function of task relevance over the left than
      over the right hemisphere. The results from the present study indicate a
      remarkably early facilitative influence of stimulus type (letter versus non
      letter patterns) on the luminance discrimination of these stimuli and are
      consistent with an overlap of linguistic and perceptual processing.

PMID- 7775055
TI  - Connectional specificity in the cat's retinogeniculate system.
AB  - The establishment of normal patterns of retinogeniculate projections in cats is
      the end-product of the operation of at least three guidance/recognition
      mechanisms. First, topographic order must be retained in the central maps of
      visual space. Second, inputs from the two eyes must segregate from each other and
      target their appropriate layers in the lateral geniculate nucleus. Finally,
      specific cell classes in the retina must stabilize contacts with functionally
      matched geniculate neurons. These processes are ordered temporally, and may
      permit the specification of accurate retinogeniculate connections using a minimum
      of molecular gradients and markers.

PMID- 7775056
TI  - Mismatch negativity--a unique measure of sensory processing in audition.
AB  - Physically deviant auditory stimuli occurring among frequent ("standard") stimuli
      (e.g., tones or phonetic stimuli) elicit the mismatch negativity (MMN) of the
      auditory event-related potential (ERP). The MMN is presumably generated by a
      mismatch process between the sensory input from a deviant stimulus and a neural
      sensory-memory trace representing the physical features of the standard stimulus.
      This process, as well as sensory analysis of auditory input and its encoding into
      the memory trace, appear to be automatic since the MMN is elicited even by
      changes in unattended auditory stimuli. Therefore the MMN indirectly provides a
      unique, objective measure of the central representation of a sound. This opens
      new possibilities for basic research as well as clinical and other applications.

PMID- 7775058
TI  - Shifting attention in visual space: the effects of peripheral cueing on brain
      cortical potentials.
AB  - The effects of attentional shifts following peripheral cues were studied in
      humans using event-related potentials (ERPs) and reaction times. Subjects
      released a key following the presentation of a target preceded by a predictive
      cue in the same (valid) or the opposite (invalid) visual field, or a bilateral,
      non-predictive cue. The stimulus onset asynchrony (SOA) separating cue and target
      was either 200 or 600 ms. Subjects were faster and more accurate when responding
      to validly cued targets. Attentional modulation of the ERP was manifested as an
      enhancement of P1-N1 amplitude at posterior electrode sites following a validly
      cued target. Furthermore, the latencies of P1, N1 and P3 were significantly
      shorter in valid trials than in invalid trials. These results only reached
      significance with the longer SOA, since ERP refractoriness distorted the response
      evoked by the target when the SOA was only 200 ms. The findings are discussed in
      the context of previous behavioral and ERP cueing studies.

PMID- 7775057
TI  - Event related potentials in adults diagnosed as reading disabled in childhood.
AB  - The purpose of this study was to identify electrophysiological correlates of
      reading disability (RD) in adults with psychometrically documented childhood
      reading histories. Specific a-priori hypotheses for these correlates were
      generated from the findings of Harter, Anllo-Vento, Wood & Schroeder (1988a);
      Harter, Diering & Wood (1988b). The subjects were 32 males with normal
      intelligence and no history of attention deficit disorder or current major
      psychopathology. Event related potentials were recorded over O1, O2, C3', C4',
      F3, and F4 to letter stimuli using an intralocation selective attention paradigm.
      Subjects with RD showed a general reduction in positivity starting at 150 ms and
      continuing up to 500 ms. The reduced positivity at left central P240 replicated
      the findings of Harter et al. (1988b) with children. However, adult RD was
      associated with more diffuse, bilateral reduction in electrophysiological
      response to all stimuli. A possible relationship between the bilaterality of the
      neural deficit and the severity of the dyslexia was proposed: that a bilateral
      deficit may be involved in severe cases.

PMID- 7775059
TI  - Event-related potential correlates of early processing in normal aging.
AB  - Auditory event-related potentials were recorded from normal elderly and young
      adult subjects during simple reaction time and discrimination conditions. In both
      response conditions, the stimuli were randomly presented, as in an auditory
      "oddball" paradigm. It was found that NA, an index of early information
      processing, was significantly delayed in the elderly. Although the latency of N1
      was not significantly different between the groups, the latencies of N2 and P3
      were significantly longer for the aged subjects. The amplitudes of N1, NA1, NA2
      and N2 showed no group differences. The raw amplitude of P3 showed a group
      difference in topography: Pz was greater than Fz for the young group, but not for
      the aged. When the amplitudes of NA1, NA2, and P3 were scaled, however, the
      topography of these components showed no significant group differences. These
      findings suggest that the age-related slowing of later ERP components and
      behavior may be partially accounted for by delays in early attention dependent
      perceptual processes, as indexed by NA.

PMID- 7775061
TI  - In memory of M. Russell Harter scientist, scholar, educator May 13, 1940-March
      24, 1990.

PMID- 7775060
TI  - Cellular bases for the control of retinogeniculate signal transmission.
AB  - The dorsal lateral geniculate nucleus (LGN) is the major thalamic relay for
      retinal signals en route to cortex. However, LGN cells operate as more than just
      a simple relay of their retinal inputs. Rather, they function as a variable gate,
      determining what, when, and how much retinal information gets passed to visual
      cortex. Two factors that are key to this control are the innervation patterns and
      electrophysiological membrane properties of geniculate cells. This paper
      discusses three active membrane properties and the manner in which they modulate
      the transfer of retinal signals to cortex. They are the low threshold calcium
      (Ca2+) conductance, a transient potassium (K+) conductance, and NMDA receptor
      mediated excitatory postsynaptic potentials (EPSPs). The low-threshold Ca2+
      conductance transforms a geniculate cell from a state of single spike activity to
      one of bursting discharge, the potassium current leads to a delay in membrane
      depolarization to reach spike threshold, and NMDA receptor activity modulates
      EPSP amplitude and duration near spike threshold. Additionally, we consider how
      nonretinal inputs, such as the ascending cholinergic pathway from the brainstem
      parabrachial region and the descending pathway from layer VI of visual cortex,
      influence the expression of these membrane properties through their control of
      membrane potential.

PMID- 7775062
TI  - Defining the neural bases of visual selective attention: conceptual and empirical
      issues.
AB  - This paper focuses on conceptual and empirical issues relevant to defining the
      neural bases of visual selective attention. At the most general level, it is held
      that the integration of human and monkey research is essential to developing a
      generally applicable, yet precise, understanding of attentional mechanisms. More
      specific issues that are considered here include: 1) the general definition of
      attention (as a process, state, etc.) and the operational definition of attention
      in experimental work, 2) the possibility that different forms of attention use
      distinctive neural circuits, 3) the levels of the system at which attention may
      modulate sensory inflow, 4) the degree to which circuits and levels addressed by
      attentional modulation depend on task (sensory and behavioral) variables and 5)
      the nature of cellular processes that may underlie attentional modulation. The
      available techniques for examining neural processes in humans and monkeys are
      considered in light of these issues and the need for direct comparability between
      human and monkey experiments.

PMID- 7775063
TI  - Temporal dynamics of visual-evoked neuromagnetic sources: effects of stimulus
      parameters and selective attention.
AB  - Results are reviewed from several neuromagnetic studies which characterize the
      temporal dynamics of neural sources contributing to the visual evoked response
      and effects of attention on these sources. Different types of pattern-onset
      stimuli (< or = 2 degrees) were presented sequentially to a number of field
      locations in the right visual field. Multiple dipole models were applied to a
      sequence of instantaneous field distributions constructed at 10 ms intervals.
      Best-fitting source parameters were superimposed on Magnetic Resonance images
      (MRI) of each subject to identify the anatomical structure(s) giving rise to the
      surface patterns. At least three sources, presumably corresponding to different
      visual areas, were routinely identified from 80-150 ms following the onset of
      visual stimulation. This observation was consistent across subjects and studies.
      The temporal sequence and strength of activation of these sources, however, were
      dependent upon the specific stimulus parameters used to evoke the response (e.g.,
      eccentricity) and on the relevance of the stimulus to the subject. In addition,
      our results provide evidence for the recurrence of activity in striate and
      extrastriate regions, following the initial cycle of responses.

PMID- 7775065
TI  - Circadian differences in hemisphere-linked spelling proficiencies.
AB  - Male and female adolescents (N = 113) were assigned randomly to spelling
      instruction in either morning or afternoon groups for a school year. A spelling
      list (100 words) was administered at the beginning of the school year to obtain a
      sample of error responses and estimate proficiency. Although equally proficient,
      subjects tested in the afternoon showed more phonetically inappropriate errors,
      while those tested in the morning showed more phonetically appropriate errors.
      This error pattern is viewed as support for a more engaged left hemisphere in the
      morning. There were no differences on two types of visual errors. Subjects then
      received instruction in spelling for nine months in either morning or afternoon
      settings. Time-of-day effects were not evident on the word list and there were
      too few errors to conduct a posttest error analysis. However, standardized test
      results for a subgroup revealed that subjects receiving morning instruction made
      greater gains on phonetically regular words compared to phonetically irregular
      words--an effect consistent with a circadian-linked higher level of left
      hemisphere engagement early in the day. The findings are of a pilot nature, but
      implications for education and further research are discussed.

PMID- 7775064
TI  - Sex differences in patterns of hemispheric cerebral metabolism: a multiple
      regression/discriminant analysis of positron emission tomographic data.
AB  - Sex differences in brain hemispheric structure and function have been reported,
      and sex-related differences in hemispheric interregional correlations were
      reported in a prior analysis of resting PET glucose metabolic (rCMRglc) data. To
      explore further the effect of sex on patterns of hemispheric brain functional
      interactions, we applied a multiple regression/discriminant analysis to resting
      rCMRglc PET data from young normal men and women to test two hypotheses: (1)
      women have stronger between-hemisphere functional interactions; (2) men have
      stronger within-hemisphere functional interactions. Two separate discriminant
      functions based on these hypotheses distinguished men and women: the first
      reflected rCMRglc interdependencies between hemispheres and correctly classified
      all women and 94% of the men; the second reflected rCMRglc interdependencies
      within the left hemisphere and correctly classified 82% of the women and 88% of
      the men. Because the discriminant functions successfully distinguished men and
      women, these results provide support for both hypotheses.

PMID- 7775066
TI  - Laser evoked brain potentials in response to painful trigeminal nerve activation.
AB  - Long latency brain potentials were evoked by infrared laser stimuli (LEPs)
      applied to the right forehead in order to activate the thinnest cutaneous A-delta
      afferents of the upper branch of the trigeminal nerve thus inducing a painful
      sensation. Ten healthy male subjects participated in 4 identical subsequent
      sessions, one week apart, receiving 4 blocks of 40 stimuli each. This way the
      individual trigeminal LEPs, as well as their inter- and intraindividual
      reliability were determined. Five major components could be identified, denoted
      by polarity and peak latencies: N150, P230, N300, P360, N480. The LEP waveforms
      were found to be highly stable within subjects, peak latencies varied by less
      than 5%. Great variation in waveform appeared amongst subjects, peak latencies
      varied by more than 15%. The last two components exhibited the largest
      variability and were not identified in all subjects.

PMID- 7775067
TI  - Conduction velocity groups in the retino-tectal and retino-thalamic visual
      pathways of the pigeon (Columbia livia).
AB  - The anatomical characteristics of the avian visual system are well known.
      However, there are wide gaps in our knowledge with respect to the physiological
      characteristics of their visual system. For example, we lack both an operational
      identification of the different ganglion cell types present in the retinae of
      birds, and a description of their presumptive differential central projections.
      The results presented here address this latter point by classifying the
      conduction velocity groups of fibers present in the optic tract of the pigeon. We
      report the existence of at least 5 groups of axons in the optic tract of the
      pigeon, with conduction velocities of 22-18 m/s, 12-10 m/s, 8 m/s, 6 m/s and less
      than 2.5 m/s. All five groups project to the tectum but only the four fastest
      groups project to the dorsal thalamic complex. The homologies with the
      populations of retinal axons found in cats are discussed.

PMID- 7775068
TI  - Chronic & infrequent opioid exposure suppresses IL-2R expression on rhesus monkey
      peripheral blood mononuclear cells following stimulation with pokeweed mitogen.
AB  - In the present investigation, infrequent and chronic (daily) exposure of rhesus
      monkeys to morphine was investigated for their effect on cytokine receptor
      expression, interleukin (IL)-2-production, and the nuclear factor kappa B (NF
      kappa B) levels following stimulation with PWM. In a time-dependent manner,
      peripheral blood mononuclear cells (PBMCs) from both infrequent- and daily
      morphine treated monkeys displayed significantly less (40 +/- 7%) IL-2 receptor
      compared to PBMCs from saline-treated controls. However, PBMCs from chronic
      opioid- and infrequent opioid-treated monkeys displayed similar levels of IL-4
      and IL-7 receptors compared to saline-treated animals. Following stimulation with
      PWM, PBMCs from chronic opioid-treated monkeys produced elevated levels of IL-2
      (870 +/- 94 pg/ml) compared to IL-2 levels (463 +/- 88 pg/ml) of PBMCs from
      saline-treated monkey. Likewise, PBMCs from chronic-morphine exposed monkeys had
      elevated levels (43%) of NF kappa B compared to PBMCs from saline-treated
      (control) monkeys following 72 hours in culture with PWM. Collectively, these
      observations suggest morphine regulates selective molecular events that manifest
      in biologically altered immune function including T cell activation and IL-2
      production.

PMID- 7775069
TI  - Embryonic cultures but not embryos transplanted to the mouse's brain grow rapidly
      without immunosuppression.
AB  - Embryos and embryocultures can be successfully transplanted into various bodily
      organs. However immunosuppression or homogenicity are required for the success of
      such experimental manipulation. Since the brain is considered immunologically
      privileged, we transplanted 2-4 cell embryos of C57BL x BALB/c, embryonic stem
      cells (ES) or embryoid bodies (EB) cultures into the hippocampus of the
      heterogeneous mouse stock HS/IBg. Both ES and EB cultures developed into an
      extensive growth, eventually larger than the brain itself, causing the death of
      the host in less than 29 days. The growth was identified as teratoma, mostly made
      of immature cells and tissues of diverse origin. Thus, the overall histological
      picture was that of a malignant teratoma. On the other hand, no embryos were
      found at any time after the transplantation; apparently, they could not survive
      in the host brain. The growth rate and the relative lack of rejection suggest
      that the brain offers a unique medium for ES and EB cultures but, not to embryos.

PMID- 7775070
TI  - Metabolic activity in rat visual system during exposure to high and low
      intensities of patterned and diffuse light.
AB  - An examination of rat visual system activity, during exposure to either "pattern"
      (black and white stripes) or "diffuse" (eye covered by white mask) visual
      stimulation at high or low illumination intensities (1600 and 1 lux at cornea,
      respectively), was carried out using the 2-deoxyglucose (2-DG) autoradiographic
      technique. Pattern elevated 2-DG uptake in the dorsal and ventral lateral
      geniculate nuclei, in the lateral posterior nucleus, and in area 17, but was less
      effective at the high than at the low light intensity. Diffuse light also
      elevated 2-DC uptake in the thalamic nuclei but the increase was less impressive
      and the same at both intensities. Diffuse light at either high or low intensity
      had no effect on cortex. Like thalamus and cortex, pattern was a less effective
      stimulus for the colliculus at the high than at the low intensity, but, in
      contrast to thalamus and cortex, high intensity diffuse light suppressed 2-DG
      uptake in the colliculus to a level below that produced by darkness; low
      intensity diffuse light had no effect. These 2-DG findings are discussed in terms
      of how forebrain and midbrain divisions of the rat's rod-dominated visual system
      maintained their respective spatial processing and change-detecting functions
      over a considerable range of illumination intensity.

PMID- 7775071
TI  - Utilization of maternal perinatal risk indicators in the differential diagnosis
      of ADHD and UADD children.
AB  - The purpose of this study was to differentiate between children diagnosed with
      Attention-Deficit Hyperactivity Disorder (ADHD), children with Undifferentiated
      Attention-Deficit Disorder (UADD) and a control group using maternal perinatal
      information. The sample consisted of 74 ADHD, 56 UADD, and 135 normal children
      between the ages of 6 years, 5 months and 13 years, 4 months. The results
      supported the use of maternal perinatal information in the diagnosis of attention
      disorders. More specifically, the greater the number of medical conditions prior
      or during their pregnancy the more likely a child was diagnosed with an attention
      deficit disorder. In addition, if the mother experienced moderate emotional
      stress or smoked cigarettes during pregnancy the child was more likely to be
      diagnosed with an attention deficit disorder.

PMID- 7775072
TI  - Weak electromagnetic fields reverse visuospatial hemi-inattention in Parkinson's
      disease.
AB  - Drawing tasks, both free and copied, have achieved a central position in
      neuropsychological testing of patients with unilateral cerebral dysfunction by
      virtue of their sensitivity to different kinds of organic brain disorders and
      their ability to provide information on lateralized brain damage. In the drawings
      of patients with right hemispheric damage, visuospatial neglect is revealed by
      the omission of details on the side of the drawing contralateral to the
      hemispheric lesion. Patients with unilateral cerebral damage, particularly those
      with left hemispheric damage, also demonstrate a tendency to place their drawings
      on the side of the page ipsilateral to the cerebral lesion, a phenomenon which
      has been termed visuospatial hemi-inattention. It has been reported previously
      that brief external application of alternating pulsed electromagnetic fields
      (EMFs) in the picotesla (pT) range intensity improved visuoperceptive and
      visuospatial functions and reversed neglect in Parkinsonian patients. The present
      communication concerns four fully medicated elderly nondemented Parkinsonian
      patients (mean age: 74.7 +/- 4.6 yrs; mean duration of illness: 7.7 +/- 5.2 yrs)
      in whom application of these EMFs produced reversal of visuospatial hemi
      inattention related to left hemispheric dysfunction. These findings support prior
      observations demonstrating that pT EMFs may bring about reversal of certain
      cognitive deficits in Parkinsonian patients.

PMID- 7775073
TI  - Improvement in short-term visual memory by weak electromagnetic fields in
      Parkinson's disease.
AB  - Neuropsychological studies have demonstrated that Parkinson's disease (PD) is
      associated with various cognitive deficits ultimately leading in about 30% of
      patients to the development of dementia. These studies have demonstrated also a
      greater decrement of right hemispheric functions with visuospatial deficits
      occurring in up to 90% of PD patients. The Rey-Osterrieth Complex Figure (ROCF)
      Test has been employed in the assessment of right hemispheric functions and
      particularly for the evaluation of visuoconstructive abilities and short-term
      visual memory. I have demonstrated recently that external application of
      electromagnetic fields (EMFs) in the picotesla (pT) range intensity is an
      effective nonpharmacological modality in the management of the motor and
      cognitive deficits of Parkinsonism. In the present communication I present 3
      fully medicated nondemented PD patients (mean age: 68 +/- 8.1 yrs; mean duration
      of illness: 9.0 +/- 4.0 yrs; mean disability on the Hoehn and Yahr scale: 3) who
      were tested on the ROCF Test before and after a series of treatments with EMFs.
      In response to the administration of EMFs the group demonstrated a mean of 23.1
      +/- 13.6% improved performance on copy of the ROCF and a 39.3 +/- 13.4%
      improvement of short-term recall of the ROCF. These findings demonstrate that
      treatment with pT EMFs improves deficits in visuospatial functions and visual
      memory in Parkinsonism which usually remain unaffected during standard treatment
      with dopaminergic pharmacotherapy.

PMID- 7775074
TI  - Parkinsonian micrographia reversed by treatment with weak electromagnetic fields.
AB  - Micrographia is one of the characteristic clinical signs of Parkinson's disease
      (PD) which is linked to striatal dopaminergic deficiency. It has been reported
      recently that external application of weak electromagnetic fields (EMFs) in the
      picotesla (pT) range and of low frequency produced dramatic improvements in motor
      symptoms in Parkinsonian patients indicating that a specific range of
      electromagnetic energy increases, among others, striatal dopaminergic
      neurotransmission. In the present communication, I present two fully mediated
      Parkinsonian patients who, prior to the application of EMFs, drew lilliputian
      sized figures reflecting the micrographia of the disease. In both patients a
      series of treatments with pT EMFs produced, in addition to improvement in motor
      symptoms, a dramatic increase in the size of their drawings with reversal of
      their micrographia. Since both patients were maintained on dopaminergic
      medications prior to and during treatment with EMFs it is suggested that
      Parkinsonian micrographia is related also to abnormalities of nondopaminergic
      systems which are affected by weak EMFs. This report corroborates previous
      observations demonstrating the powerful antiParkinsonian effect of pT range EMFs
      and highlights the unique efficacy of this treatment modality in Parkinsonism.

PMID- 7775076
TI  - [Clinical research in Germany].

PMID- 7775075
TI  - Cholinergic mechanisms in Gilles de la Tourette's syndrome.
AB  - Gilles de la Tourette syndrome (GTS), a chronic, familial, neuropsychiatric
      disorder of unknown etiology, is characterized clinically by the presence of
      motor and vocal tics that wax and wane in severity over time and by the
      occurrence of a variety of neurobehavioral disturbances including hyperactivity,
      self-mutilatory behavior, obsessive compulsive behavior, learning disabilities,
      and conduct disorder. Pharmacological studies suggest that the tics of GTS result
      from dysfunction of monoaminergic systems, more specifically from increased
      dopaminergic activity due to postsynaptic dopamine receptor supersensitivity.
      However, given that striatal dopaminergic and cholinergic systems exhibit
      reciprocal antagonism in other movement disorders such as Parkinsonism and
      chorea, it is conceivable that the cholinergic system is implicated in the
      disease. In the present communication it is proposed that: (a) the emergence of
      motor and vocal tics in GTS is associated with increased central cholinergic
      activity; (b) cholinergic overactivity is involved in the manifestation of other
      symptoms in GTS including depression, sleep disorders, motion sickness, pain,
      sensory tics, and the waxing and waning course of the disease; (c) abnormalities
      of the cholinergic system support previous evidence linking GTS with delayed
      cerebral maturation in a subset of young patients; and (d) drugs which stimulate
      cholinergic receptors may exacerbate symptoms of GTS, and as with dopamine
      agonists, should be avoided in patients with GTS.

PMID- 7775077
TI  - [Cellular interactions in the vascular wall and mechanisms of action of
      endothelial factors].

PMID- 7775079
TI  - [Molecular regulatory processes in glomerular cells of the kidney].

PMID- 7775080
TI  - [Immunology and genetics of rheumatoid arthritis].

PMID- 7775078
TI  - [Respiratory insufficiency].

PMID- 7775081
TI  - [Non-genomic aldosterone action. A new concept for the mechanism of action of
      steroids is developed].

PMID- 7775082
TI  - [Incretin research in the development of new strategies of diabetes therapy].

PMID- 7775083
TI  - [Clinical neuroendocrinology].

PMID- 7775084
TI  - [Hypertriglyceridemia and arteriosclerosis. Physiology and pathophysiology of
      chylomicron catabolism].

PMID- 7775085
TI  - [Mechanism of liver damage. Pathogenesis of primary hemochromatosis and auxiliary
      liver transplantation].

PMID- 7775087
TI  - [Molecular mechanisms of hematopoietic stem cell differentiation].

PMID- 7775088
TI  - [Cell differentiation and local regulatory systems].

PMID- 7775086
TI  - [Immune dysregulation and malignant lymphoma].

PMID- 7775090
TI  - [Male phenotype, female genotype. The role of SRY].

PMID- 7775089
TI  - [47-year-old patient with pulmonary hypertension, anemia and thrombocytopenia].

PMID- 7775091
TI  - [Organic nitrates. I. Mechanism of action and new therapeutic approaches in
      myocardial ischemia].

PMID- 7775092
TI  - [Organic nitrates. II. Dosage and clinical indications].

PMID- 7775093
TI  - [Physician practice limits and disposition. Reflections on moderation in
      determination of physician supply according to Section 102 SGB V].

PMID- 7775094
TI  - [Basically, is there a possibility for therapy with ovulation inhibitors in
      hepatitis C with virus persistence and in the acute stage?].

PMID- 7775095
TI  - [Manifestation of thrombocytopenia of 70,000/microliters in a 30-year-old patient
      with ankylosing spondylitis].

PMID- 7775096
TI  - [Paresthesia].

PMID- 7775097
TI  - Retinitis pigmentosa and allied diseases. Implications of genetic heterogeneity.

PMID- 7775098
TI  - The effect of oxygen on vasoformative cell division. Evidence that 'physiological
      hypoxia' is the stimulus for normal retinal vasculogenesis.
AB  - PURPOSE: To assess the role of oxygen in normal retinal vasculogenesis. METHODS:
      A new preparation for studying cytogenesis in retinal wholemounts was developed.
      Nuclei of dividing cells were labeled with a monoclonal antibody to
      bromodeoxyuridine (BrdU), and vascular cells were covisualized with Griffonia
      simplicifolia lectin. The topography and time course of vasculogenic cell
      division and vessel formation were determined in the kitten retina during normal
      development and under experimental hyperoxia and hypoxia. RESULTS: During normal
      development, vasculogenic cell division was maximal at the leading edge of the
      forming vessels. Normal vessel formation was initially proliferative, and cell
      division was high. However, after vessel formation occurred, which presumably
      relieved tissue hypoxia, the mitogenic process was markedly reduced, and many
      excess capillary segments underwent retraction. The rate of vasculogenic cell
      division and vessel formation increased when the inner layers of the retina were
      made avascular after exposure to hyperoxia, and it decreased when there was an
      increase in inspired oxygen. CONCLUSIONS: The authors have shown that between 17%
      and 45% oxygen, the extent of vasculogenic cell division is inversely
      proportional to the level of oxygen in the inspired gas mixture. They have
      further shown that dividing vascular cells have a peak density in a region
      proximal to the edge of the forming vasculature. The density is maximal between
      P7 and P8, a time when formation of photoreceptor outer segment begins, only a
      few days before the onset of retinal function. These results led the authors to
      conclude that the stimulus for normal vasculogenesis is a transient but
      physiological level of hypoxia induced by the increasing activity of retinal
      neurons.

PMID- 7775099
TI  - Supplemental oxygen therapy. Basis for noninvasive treatment of retinopathy of
      prematurity.
AB  - PURPOSE: To determine the effectiveness of supplemental oxygen therapy (SOT) in
      ameliorating the proliferative vasculopathy characteristic of the feline model of
      retinopathy of prematurity (ROP). METHODS: Kittens were exposed to high (70% to
      80%) oxygen for the first 4 days of life to induce obliteration of the retinal
      circulation. The level of inspired oxygen at successive stages after hyperoxia
      were varied systematically, and the retinas were examined for the extent of
      revascularization, astrocyte survival, intactness of the blood-retinal barrier,
      and extent of preretinal vessels. RESULTS: The level of inspired oxygen required
      to protect the retina from hypoxic damage and yet provide a stimulus for growth
      of the vasculature varied during a 6-week period. The rate of revascularization
      of the retina increased as the oxygen content of the inspired gas mixture
      decreased, with a consequential increase in the pathology observed. However, a
      regimen that produced a quicker rate of revascularization with a slightly higher
      level of pathology actually offered the retina greater protection in the long
      term. The formation of preretinal vessels was effectively prevented by SOT.
      Supplemental oxygen therapy could be terminated once a significant portion of the
      retina was revascularized. CONCLUSIONS: The proliferative vasculopathy of a
      kitten model of ROP can be significantly reduced by a regimen of SOT, which
      attempts to mimic physiological levels of hypoxia in the retina during its
      revascularization. Optimal revascularization requires a balance between the rate
      and quality of vessel growth. With further refinement of the protocol, SOT could
      provide noninvasive treatment of ROP in neonates.

PMID- 7775100
TI  - Effect of group B streptococcal meningitis on retinal and choroidal blood flow in
      newborn pigs.
AB  - PURPOSE: To assess the effect of group B streptococcal (GBS) meningitis on
      retinal blood flow (RetBF) and choroidal blood flow (ChBF) autoregulation in
      sedated newborn piglets (1 to 5 days of age). METHODS: Fourteen study animals
      injected with 0.5 ml heat-killed GBS (10(9)) were compared to 10 control animals
      injected with 0.5 ml saline. The site of injection for both groups was the
      cerebral lateral ventricles. RetBF and ChBF were measured by radioactive
      microspheres (141Ce, 51Cr, 113Sn, 85Sr, 95Nb, 46Sc) over a mean arterial blood
      pressure (MABP) range of 20 to 150 mm Hg. Hypertension and hypotension were
      induced 2 hours apart in random sequence on each animal by inflating balloon
      tipped catheters placed at the descending aorta and the aortic root,
      respectively. RetBF and ChBF were measured 15 minutes before and after injection
      of GBS or saline (baseline) and during hypotension or hypertension. RESULTS:
      Fifth-order polynomial regression analyses of RetBF and ChBF (ml/100 g per
      minute) versus MABP showed that in control animals, blood flows were constant at
      MABP of 60 to 110 mm Hg for RetBF and was pressure passive above and below these
      ranges. However, no autoregulation was observed for ChBF throughout the MABP
      range. In contrast, RetBF of GBS-treated animals increased with increasing blood
      pressure throughout range of MABP studied, and absence of autoregulation was
      maintained in the choroid. Vascular resistance (mm Hg/ml per minute/100 g)
      increased as MABP was raised to maintain constant flow and was correlated
      linearly with MABP at 60 to 110 mm Hg (r = 0.6682, P = 0.0003) in RetBF of
      control animals but not in GBS-treated animals (r = -0.291, P = NS). Vascular
      resistance did not change with MABP for ChBF of control animals (r = -0.264, P =
      NS) but decreased as MABP was raised in GBS-treated animals (r = -0.548, P <
      0.0001). GBS did not alter oxygen delivery, which varied directly with MABP in
      control animals (RetBF: r = 0.74, P < 0.001; ChBF: r = 0.68, P < 0.001) and in
      GBS-treated animals (RetBF: r = 0.55, P < 0.001; ChBF: r = 0.68, P < 0.001).
      CONCLUSION: Group B streptococcal meningitis significantly impairs eye blood flow
      autoregulation and may contribute to increased risk of retinal damage in infants
      with meningitis.

PMID- 7775101
TI  - Local response of the primate retinal microcirculation to increased metabolic
      demand induced by flicker.
AB  - PURPOSE: To study the response of the macular circulation to a local increase in
      metabolic demand created by a flickering source of illumination. METHODS: Laser
      targeted angiography (release of a fluorescent dye from heat-sensitive liposomes
      using a laser pulse) was used to study, in subhuman primates, changes in
      hemodynamic parameters of the retinal circulation that were induced by a
      flickering source of illumination. Changes in the macular macrocirculation were
      compared with those in the macular microcirculation and were evaluated at various
      distances from the foveola. RESULTS: In response to monochromatic light flicker,
      the blood flow in retinal arteries increased by 30%. The response of the
      microcirculation was not homogeneous. It showed a maximum increase in the mid
      perifoveal region where there is an increase in ganglion cells and nerve fibers.
      Interestingly, the maximum change in the index representing capillary blood flow
      exceeded the blood flow change in the artery (P < 0.08). CONCLUSIONS: A stimulus
      expected to cause increased metabolic demand results in a regulatory response by
      the retinal microcirculation. This response shows spatial variations that
      correspond with known variations in retinal anatomy. The authors propose that a
      redistribution of blood can occur between the capillary layers to fulfill high
      metabolic demands by neuronal tissue remote from the choroid.

PMID- 7775102
TI  - Variability in choriocapillaris blood flow distribution.
AB  - PURPOSE: To investigate variability of choriocapillaris blood flow patterns.
      METHODS: After the intravenous injection of indocyanine green, angiograms were
      recorded at 30 images per second in rhesus monkey eyes using a fundus camera
      equipped with a pulsed laser diode light source, synchronized with a gated (5
      msec), intensified charge-coupled device, or CCD, video camera. Images of
      choriocapillaris filling alone were extracted. Plastic corrosion casts were made
      of two of the monkey's choroidal vasculatures for subsequent scanning electron
      microscopy examination. RESULTS: Pulsed laser indocyanine green fluorescence
      excitation produced better definition of choriocapillaris filling than had been
      achieved using continuous illumination. No correlation was found between the
      choriocapillaris plexus architecture revealed by the plastic corrosion casts and
      the observed choriocapillaris lobular filling. Overall posterior pole
      choriocapillaris dye-filling patterns were relatively stable for periods of days,
      but they changed gradually for periods of weeks. Localized minor pattern changes
      occurred on a much shorter time scale. Choriocapillaris filling patterns were
      altered by acutely elevating intraocular pressure, by O2 and CO2 breathing, and
      by argon laser retinal photocoagulation of adjacent areas. CONCLUSIONS:
      Choriocapillaris filling patterns appear to be determined by the network of
      perfusion pressure gradients that exist among the interspersed feeding arterioles
      and draining venules connected to the choriocapillaris plexus. Changes in
      intraocular pressure and in blood PO2 and PCO2 levels can produce marked changes
      in the distribution of choriocapillaris blood flow. Retinal laser
      photocoagulation of adjacent fundus areas alters choriocapillaris blood flow to
      the extent that the altered flow might be an important factor in the beneficial
      results attributed to retinal laser treatment.

PMID- 7775103
TI  - Primate rod and cone photoreceptors may differ in glucose accessibility.
AB  - PURPOSE: Glucose is crucial for the function of retinal photoreceptors, other
      retinal neurons, and glial cells. Exogenous glucose can be extracted from the
      retinal and choroidal circulation, and endogenous glucose may be generated from
      breakdown of intracellular glycogen stores. Because glucose deprivation is a
      critical component of retinal ischemia, the authors sought to determine the sites
      of glucose entry into and generation within the retina. METHODS: The localization
      of the glucose transporter, GluT-1, and the brain and muscle isozymes of glycogen
      phosphorylase, GlyP, was studied by immunohistochemistry of adult human and
      monkey retinas. RESULTS: Brain glycogen phosphorylase (B-GlyP) immunoreactivity
      was found in cone, but not rod, photoreceptors. There was immunostaining of
      foveal and peripheral cones throughout the cytoplasm from the outer segment to
      the synaptic pedicle. Short wavelength ("blue") cones were positive for B-GlyP.
      Diffuse staining of the inner and outer plexiform and the nerve fiber layers did
      not resemble the distinct morphology of Muller cells. Immunoreactivity to muscle
      GlyP (M-GlyP) was confined to selected synaptic layers of the inner plexiform
      layer in monkey retina. Staining with antibody to GluT-1 demonstrated diffuse
      reactivity throughout the retina, including the blood-retinal barrier cells,
      retinal pigment epithelium, and vascular endothelium. Ultrastructural
      immunohistochemistry showed staining of rod and cone inner and outer segments.
      CONCLUSIONS: These immunohistochemical studies indicate that rod and cone
      photoreceptors have the biochemical capability to transport exogenous glucose
      from the circulation. Only cones appear capable of using endogenous glycogen
      stores. These findings imply that cones could be more resistant to acute
      reductions in circulating glucose during hypoglycemia. However, during hypoxic
      insult, glycogenolysis and anaerobic glycolysis could result in increased
      production of intracellular lactic acid, potentially predisposing the cone to
      acidotic damage.

PMID- 7775104
TI  - Phagocytosis and H2O2 induce catalase and metallothionein gene expression in
      human retinal pigment epithelial cells.
AB  - PURPOSE: Reactive oxygen intermediates have been implicated in the aging process
      and degenerative diseases of the eye, including retinopathy of prematurity,
      cataractogenesis, and macular degeneration. The purpose of this study was to
      investigate the effect of phagocytosis of photoreceptor outer segments and the
      addition of exogenous H2O2 on catalase and metallothionein expression in human
      retinal pigment epithelial cells. METHODS: Confluent RPE cells were treated with
      bovine photoreceptor outer segments or H2O2 for either 6 or 18 hours. Slot blot
      hybridization was used to assess catalase and metallothionein gene expression
      after 6 hours. Catalase enzyme activity and metallothionein content were measured
      after 18 hours. RESULTS: Phagocytosis or the addition of H2O2 increased catalase
      enzyme activity and metallothionein twofold above control levels. The addition of
      n-acetyl cysteine abrogated the inductive effect caused by either stress.
      Catalase and metallothionein gene expression, measured by slot blot
      hybridization, also were measurably induced by either stress. Phagocytosis of
      photoreceptor outer segments increased extracellular H2O2 concentration nine
      times above control. CONCLUSIONS: The response of the retinal pigment epithelial
      cells to phagocytosis was indistinguishable from the response observed after the
      addition of exogenous H2O2. The generation of H2O2 during phagocytosis may act as
      an intracellular signal in retinal pigment epithelial cells that leads to
      increased levels of key antioxidant enzymes and other proteins important for
      protecting the cells from oxidative damage.

PMID- 7775105
TI  - Regulation of proliferation and photoreceptor differentiation in fetal human
      retinal cell cultures.
AB  - PURPOSE: To examine whether fetal human retinal cells can be maintained in vitro
      over long time periods and to determine whether exogenous growth factors can be
      used to generate large numbers of photoreceptors within these cultures. METHODS:
      Fetal human retinas (6 to 13 weeks after conception) were dissected, dissociated,
      and plated into culture wells. Specific growth factors and steroid/thyroid
      hormones, which have been shown to influence retinal progenitor cell
      proliferation and differentiation in rats, were added to the culture medium to
      determine whether any of these factors had similar effects on human retinal
      cells. RESULTS: Fetal human retinal cells survived and continued to proliferate
      for up to 300 days in vitro. Under control conditions, 15 million cells were
      generated from an initial plating of 100,000 cells; however, the addition of
      either epidermal growth factor or basic fibroblast growth factor stimulated
      proliferation and resulted in the generation of more than 100 million cells. A
      percentage of these cells was induced to differentiate as photoreceptors by
      adding either retinoic acid or triiodo-thyronine to the culture medium.
      CONCLUSIONS: Fetal human retinal cells can be maintained and expanded in vitro,
      indicating that this technique may be useful for generating large numbers of
      retinal cells. The number and types of cells generated can be influenced by
      adding exogenous factors to the culture medium. The response of human retinal
      cells to growth factors and hormones is similar to the response of rodent retinal
      cells to the same factors, suggesting that the effects of these factors are
      conserved across species.

PMID- 7775106
TI  - Age-related variation in the hydraulic conductivity of Bruch's membrane.
AB  - PURPOSE: To determine whether alterations in local fluid dynamics are associated
      with aging of the Bruch's membrane-choroid complex. In the macula, such changes
      have been postulated as causative factors underlying some pathologic
      manifestations of age-related macular degeneration (AMD). METHODS: The pressure
      induced flow of physiological buffer through isolated human Bruch's membrane
      choroid complex was measured using a modified Ussing chamber. Values of flow
      facilitated the calculation of hydraulic conductivity (flow per unit pressure),
      for individual complexes, which subsequently allowed for the development of an
      age-related profile. RESULTS: In all specimens, flow across the Bruch's membrane
      choroid complex was found to be directly proportional to the applied pressure,
      whereas hydraulic conductivity was independent of pressure over the range
      studied. The hydraulic conductivity of the complex exhibited an exponential
      decrease with increasing age of donor, the most rapid decline occurring during
      the first four decades of life. The age-related change was most pronounced in the
      macula, where hydraulic conductivity halved every 9.5 years, compared to a t1/2
      for the periphery of 19 years. CONCLUSIONS: The decline in the hydraulic
      conductivity of the Bruch's membrane-choroid complex with age implies a decreased
      capacity for the exchange of fluid between the choroidal and retinal pigment
      epithelial compartments. The relevance of these findings to the development of
      AMD is discussed.

PMID- 7775107
TI  - Albumin movement out of the subretinal space after experimental retinal
      detachment.
AB  - PURPOSE: The subretinal fluid of serous retinal detachments contains protein, but
      little is known about its origin and fate. The authors designed experiments to
      study the rate and route of albumin movement out of the subretinal space.
      METHODS: Experimental retinal detachments were made in Dutch rabbits by injecting
      Hanks' balanced salt solution containing serum levels (approximately 30 mg/ml) of
      fluorescein isothiocyanate (FITC) albumin into the subretinal space through a
      micropipette. Subretinal, vitreous, and serum fluid samples were withdrawn 0 to 4
      hours later through a similar micropipette and were analyzed for osmolality, FITC
      albumin content (by fluorophotometry) and FITC+native albumin content (by gel
      electrophoresis). Sodium iodate was injected intravenously in some rabbits to
      damage the retinal pigment epithelium (RPE). RESULTS: Albumin injected into the
      subretinal fluid diffused steadily into the vitreous, and its concentration
      decreased by approximately 5% per hour. This rate was unaffected by RPE damage.
      Albumin did not move into the bloodstream unless the RPE was damaged with sodium
      iodate, and then it crossed the RPE at approximately 25% of the rate at which it
      moved into the vitreous. Subretinal fluid osmolality remained within the range of
      293 to 294 mOsm/kg despite protein movement and the continual absorption of fluid
      from the detachments. CONCLUSIONS: These results show that albumin in the
      subretinal space diffuses readily into the vitreous, and subretinal osmolality
      changes are rapidly equilibrated with the vitreous. Albumin does not cross normal
      RPE, and it crosses iodate-damaged RPE more slowly than it crosses retina. Thus,
      there must be a constant supply of albumin if high subretinal concentrations are
      to be sustained in clinical serous detachments.

PMID- 7775108
TI  - Identification and synthesis of chemotactic tripeptides from alkali-degraded
      whole cornea. A study of N-acetyl-proline-glycine-proline and N-methyl-proline
      glycine-proline.
AB  - PURPOSE: To identify and synthesize the polymorphonuclear leukocyte
      chemoattractant(s) released from alkali-degraded corneas. METHODS: Corneas were
      degraded in 1.0 N NaOH, neutralized, ultrafiltered, and dialyzed. The final
      active ultrafiltrate was subjected to high-performance liquid chromatography on a
      Protein PAK I-60 column. The most active fractions were further separated on a mu
      Bondapak-C18 and I-60 column in sequence. RESULTS: Fraction 38 from the final I
      60 column associated with a 210-nm absorption peak and elicited a polarization
      and chemotactic response from polymorphonuclear leukocytes. The loss of
      polarization activity in fraction 38 after exposure to prolidase suggests that
      this peptide contains a Pro-X (X = amino acid) peptide bond. The amino acid
      composition of fraction 38 was 35% glycine and 53% proline. Peptide sequence
      analysis was unable to establish a primary sequence even though Picotag analysis
      showed the presence of large amounts of the two amino acids. Mass spectrometry
      revealed only two molecular species of 312 MWt and 284 MWt. Tripeptides were
      synthesized using all possible amino acid permutations of 2 Pro and 1 Gly and
      tested in the polarization and chemotactic assays. These techniques demonstrated
      that n-acetyl-Pro-Gly-Pro, and to a lesser degree n-methyl-Pro-Gly-Pro, were the
      only synthetic tripeptides with activity similar to the purified chemoattractant.
      CONCLUSIONS: The data show that the chemotactic peptides, purified from alkali
      degraded whole cornea and confirmed with identical synthetic tripeptides, are N
      acetyl-Pro-Gly-Pro and N-methyl-Pro-Gly-Pro. Although a number of proteins
      contain the Pro-Gly-Pro sequence, large amounts of collagen in the cornea suggest
      this as a major source. The small size and hydrophilic nature of these
      chemoattractants are predictive of a high degree of diffusibility. These
      chemoattractants are likely to play a major role in the early neutrophil response
      after an alkali injury.

PMID- 7775109
TI  - NaK-ATPase pump sites in cultured bovine corneal endothelium of varying cell
      density at confluence.
AB  - PURPOSE: The driving force for ion and water flow necessary for efficient
      deturgesence of the corneal stroma resides in the ouabain-sensitive sodium (Na)
      pump of corneal endothelial cells. Using a cell culture model of corneal
      endothelial cell hypertrophy, the authors examined the expression of Na pumps at
      the cell surface to see how this central element of the endothelial pump changed
      as corneal endothelial cell density decreased to a level associated with corneal
      decompensation in vivo. METHODS: 3H-ouabain binding to NaK-ATPase at saturating
      conditions was used to quantitate the number of Na pump sites on cultured bovine
      corneal endothelial cells as the confluent density decreased from approximately
      2750 cells/mm2 to approximately 275 cells/mm2. RESULTS: The mean number of Na
      pump sites per cell at confluence (1.92 +/- 0.07 x 10(6)) did not change as the
      cell density decreased 2.7-fold from 2763 cells/mm2 to 1000 cells/mm2. However,
      pump site expression doubled to approximately 4 x 10(6) sites/cell as the cell
      density decreased from 1000 cells/mm2 to 275 cells/mm2. Despite the incremental
      increase in Na pump site expression that occurred as the cells hypertrophied
      below a density of 1000/mm2 to achieve confluence, this increase was insufficient
      to prevent a decrease in Na pump site density of the intact monolayer, expressed
      as pump sites/mm2. CONCLUSION: The confluent cell density of cultured bovine
      corneal endothelial cells can be varied from that found in the normal native
      cornea to that associated with corneal decompensation. In confluent cultures with
      cell densities ranging from 2750 cells/mm2 to 1000 cells/mm2, the number of pump
      sites per cell remains relatively unchanged. Below cell densities of 1000
      cells/mm2, the number of pump sites per cell progressively increases. The
      increased Na pump site abundance in markedly hypertrophied endothelial cells
      cannot adequately compensate for the progressive reduction in the number of
      transporting cells per unit area within the intact monolayer. Even when
      considered with the decrease in the size of the paracellular ion conductive
      pathway that is a consequence of progressive endothelial hypertrophy, the overall
      pumping capacity of the intact endothelial monolayer declines.

PMID- 7775110
TI  - Neural network classification of corneal topography. Preliminary demonstration.
AB  - PURPOSE: Videokeratography is a powerful tool for the diagnosis of corneal shape
      abnormalities. However, interpretation of the topographic map is sometimes
      difficult, especially when pathologies with similar topographic patterns are
      suspected. The neural networks model, an artificial intelligence approach, was
      applied for automated pattern interpretation in corneal topography, and its
      usefulness was assessed. METHODS: One hundred eighty-three topographic maps were
      selected and classified by human experts into seven categories: normal, with-the
      rule astigmatism, keratoconus (mild, moderate, advanced), postphotorefractive
      keratectomy, and postkeratoplasty. The maps were divided into a training set (108
      maps) and a test set (75 maps). For each map, 11 topography-characterizing
      indices calculated from the data provided by the TMS-1 videokeratoscope, plus the
      corresponding diagnosis category, were used to train a neural network. RESULTS:
      The correct classification was achieved by a trained neural network for all 108
      maps in the training set. In the test set, the neural network correctly
      classified 60 of 75 maps (80%). For every category, accuracy and specificity were
      greater than 90%, whereas sensitivity ranged from 44% to 100%. CONCLUSIONS: With
      further testing and refinement, the neural networks paradigm for computer
      assisted interpretation or objective classification of videokeratography may
      become a useful tool to aid the clinician in the diagnosis of corneal topographic
      abnormalities.

PMID- 7775111
TI  - Epithelial regeneration after limbus-to-limbus debridement. Expression of alpha
      enolase in stem and transient amplifying cells.
AB  - PURPOSE: To examine the expression of the glycolytic enzyme alpha-enolase after
      limbus-to-limbus epithelial debridement in the rabbit. METHODS: Corneas were
      debrided, leaving limbal epithelium intact, and were allowed to heal from 2 days
      to 8 weeks. Immunofluorescence microscopy was used to observe the expression of
      alpha-enolase. To quantitate changes in alpha-enolase levels 2 days to 4 weeks
      after wounding, epithelium was harvested, homogenized, and assayed using anti
      alpha-enolase in immunoslot blots. RESULTS: Expression of alpha-enolase appeared
      to increase in the limbus and the central cornea during epithelial migration (2
      day time point) with intense labeling of all basal cells. These levels were
      maintained until wound closure (1 week). By 2 weeks, expression in the limbal
      basal cells decreased to levels present in unwounded corneas. Expression in the
      corneal epithelium decreased after 2 weeks, progressing from central cornea to
      the periphery. At 4 weeks, antibody binding decreased concomitantly with a change
      in the shape of the basal cells from flattened or ovoid to columnar. At 8 weeks,
      expression of alpha-enolase was similar to that in control corneas. Immunoslot
      blot data indicated that alpha-enolase made up 0.28% of the total soluble protein
      in unwounded corneal epithelium and 0.73%, 1.22%, 0.96%, and 0.49% at 2 days, 1
      week, 2 weeks, and 4 weeks after debridement, respectively. CONCLUSIONS: These
      data indicate that expression of alpha-enolase is elevated during corneal
      epithelial migration initiating from the stem (limbal basal) cell population and
      that expression is linked to active migration. Furthermore, it appears that
      limbal basal cells are metabolically active during the period of epithelial sheet
      movement, whereas peripheral corneal basal cells remain activated as long as 4
      weeks after wounding.

PMID- 7775112
TI  - Systemic immunization with Hsp60 alters the development of chlamydial ocular
      disease.
AB  - PURPOSE: To determine whether immunization with recombinant Hsp60 would
      exacerbate ocular pathology on challenge with viable chlamydial elementary
      bodies. METHODS: Guinea pigs were immunized either subcutaneously with
      recombinant Hsp60 or both subcutaneously with recombinant Hsp60 and ocularly with
      attenuated Salmonella typhimurium expressing the guinea pig inclusion
      conjunctivitis (GPIC) Hsp60 antigen. All animals were challenged in the
      conjunctiva with the agent of GPIC, and the degree of gross ocular pathology was
      determined. Immunoglobulin G (IgG) and immunoglobulin A (IgA) antibody titers to
      Hsp60 were measured in ocular secretions as a measure of the degree of
      immunization. RESULTS: In primary and challenge GPIC infection, the degree of
      gross ocular pathology was lower in the immunized group. The presence of high IgA
      and IgG antibody titers to Hsp60 in tears suggested that the response may have
      been modified by the presence of blocking antibodies that either may have removed
      the antigen quickly or prevented interaction with sensitized T cells. In contrast
      to subcutaneous immunization, the combined immunization regimen, consisting of
      subcutaneous recombinant Hsp60 followed by ocular inoculation of the attenuated
      Salmonella, resulted in no difference in gross pathology after reinfection of
      guinea pigs with GPIC. CONCLUSIONS: These data indicated that the immunization
      with Hsp60 did not produce exacerbated disease on challenge with viable
      organisms; however, the data suggested that the route of administration, form of
      antigen, or both may be critical in the disease process.

PMID- 7775113
TI  - Protection against herpes simplex virus-induced eye disease after vaccination
      with seven individually expressed herpes simplex virus 1 glycoproteins.
AB  - PURPOSE: To compare the efficacy of each of seven expressed herpes simplex virus
      1 (HSV-1) glycoproteins as vaccines to protect against ocular disease after
      primary ocular HSV-1 infection. METHODS: Mice were vaccinated three times with
      equal amounts of each of seven individually expressed HSV-1 glycoproteins (gB,
      gC, gD, gE, gG, gH, and gI) and then ocularly challenged with McKrae, a corneal
      disease-producing strain of HSV-1. Viral clearance from the eye, blepharitis,
      keratitis, and neovascularization were determined at various times after
      infection. RESULTS: Mice vaccinated with gD or gB had the best protection against
      eye disease. Vaccination with gI, gC, or gE produced moderate protection against
      eye disease. Vaccination with gG produced less protection, and vaccination with
      gH produced no apparent protection against eye disease. CONCLUSIONS: These
      results suggest that when used as vaccines, different HSV-1 glycoproteins provide
      different levels of protection against HSV-1-induced eye disease. Based on
      comparison with the authors' previously published results, the ability of each
      glycoprotein to protect against eye disease correlated with the ability of the
      glycoprotein to induce high serum neutralizing antibody titers and killer cell
      activity. Results suggest that the effectiveness of these seven glycoproteins in
      protecting against eye disease can be ranked as follows: gD > gB > gI > (gC = gE)
      > gG > gH.

PMID- 7775114
TI  - Measurement of blood-retinal barrier breakdown in endotoxin-induced
      endophthalmitis.
AB  - PURPOSE: Endophthalmitis is a severe inflammatory disorder with profound visual
      consequences. Treatment of this disorder has been limited by the lack of
      quantitative information regarding retinal responses to severe inflammation. The
      purpose of this study was to measure the effect of endotoxin-induced
      endophthalmitis on blood-retinal barrier (BRB) function in vivo using contrast
      enhanced magnetic resonance imaging (MRI). METHODS: Endophthalmitis was produced
      by injecting Escherichia coli endotoxin into the midvitreous of pigmented
      rabbits. Contrast-enhanced MRI was performed at selected intervals thereafter. In
      all cases, a clinical grading system was used to assess the severity of
      inflammation before imaging. In a dose-response experiment, total vitreous
      protein was measured from vitreous specimens obtained 1 day after endotoxin
      injection and immediately after the imaging procedure. RESULTS: At 1 day after
      injection, endotoxin produced a selective breakdown of the inner BRB at all doses
      evaluated (0.01 microgram to 500 micrograms). Permeability-surface area product
      normalized to the area of leaky retina (PS') increased from 1.35 +/- 0.78 x 10(
      4) cm/minute (mean +/- SEM, n = 4 eyes) at a dose of 0.01 microgram to 8.15 +/-
      2.22 x 10(-4) cm/minute n = 4) eyes) at a dose of 10 micrograms. Inner BRB
      integrity was restored by day 28 after injection. In general, changes in PS',
      blood-aqueous barrier leakage, mean clinical score, and vitreous protein
      concentration were found, but the correlation between any two of these parameters
      was poor. CONCLUSION: Leakage of contrast appears early in the course of
      endotoxin-induced endophthalmitis and is a self-limited process. In future
      studies, these quantifiable changes in BRB permeability should prove useful in
      the assessment of various therapeutic interventions.

PMID- 7775115
TI  - In vivo bacterial protease production during Pseudomonas aeruginosa corneal
      infection.
AB  - PURPOSE: To establish if active pseudomonal proteases are present in vivo during
      corneal infection with Pseudomonas aeruginosa and to determine if the mouse
      strains used in these and previous studies have the ability to mount a nonocular
      antibody response to the purified proteases because antibodies to the bacterial
      proteases were not detected previously during in vivo ocular infection. METHODS:
      At certain times after corneal infection with P. aeruginosa, corneas were
      harvested and supernatants from the corneal homogenates were analyzed for
      proteolytic activity by zymography and immunoreactivity by immunoblotting. The
      efficiency of the extraction procedures used in these studies was determined by
      incubating uninfected corneal homogenates with the purified proteases. The
      resultant supernatants were analyzed for alkaline protease and elastase activity.
      Additionally, mice were immunized intraperitoneally with the purified proteases
      with and without adjuvant to determine if the animals could mount a nonocular
      antibody response. RESULTS: Corneas infected with P. aeruginosa demonstrated the
      presence of alkaline protease, but not elastase, by the two methods examined. The
      kinetics of the in vivo alkaline protease response closely parallels previously
      reported bacterial clearance studies in that peak alkaline protease activity was
      detected in corneal tissue when peak bacterial numbers also were observed in the
      eye, and it was absent when the eyes were sterile or nearly sterile. In addition,
      C57BL/6J mice were capable of mounting a nonocular antibody response to microgram
      quantities of both proteases only in the presence of adjuvant. CONCLUSIONS: In
      the model described, enzymatically active alkaline protease, but not elastase,
      was demonstrated in corneal tissues during in vivo infection. Concentrations of
      these proteases were much lower than those required to stimulate an antibody
      response.

PMID- 7775116
TI  - Freeze-fracture studies of interendothelial junctions in the angle of the human
      eye.
AB  - PURPOSE: The aim of this study was to determine the structure and complexity of
      the intercellular junctions between trabecular endothelial cells and Schlemm's
      canal endothelial (SCE) cells as they exist in the normal human eye. Despite the
      probable relevance of these junctions to aqueous outflow, examination of these
      junctions has been limited to monkey eyes. METHODS: Human eyes (< 24 hours after
      death) were fixed by immersion in modified Karnovsky's fluid. Radially oriented
      tissue-chopper sections (190 microns) were trimmed to contain only the trabecular
      meshwork, Schlemm's canal, and a narrow strip of the sclera. Specimens were
      processed for conventional electron microscopy and freeze-fracture. Replicas were
      produced in a freeze-fracture apparatus operated at -115 degrees C and 10(-7)
      torr. Thin sections were stained with uranyl acetate and lead citrate.
      Micrographs were taken on a transmission electron microscope. RESULTS: The
      trabecular endothelial cells were joined by gap junctions and short discontinuous
      junctional strands that partitioned predominantly with P-face. The strand pattern
      varied from short and isolated undulating strands to radiating arrays of short
      junctional strands. No continuous zonulae occludentes were observed. The SCE
      cells were joined by continuous tight junctions (tj) composed of discontinuous
      strands that rarely branched or anastomosed. The tj strands fractured
      preferentially with the E-face, where they were positioned at the bases of
      shallow valleys. On the P-face, a complementary system of shallow ridges was
      observed with few particles at their crests. Often, only a single continuous
      strand was present for long distances, with occasional short discontinuous
      strands running parallel to the single strand. Less often, short lengths of
      remarkably complex junctions, which occasionally branched or anastomosed, were
      also encountered. When more than one strand was present, numerous free endings
      and transjunctional pathways, described in monkey eyes as "slit-pores," were
      evident. CONCLUSION: The overall structure of the junctions between endothelial
      cells of Schlemm's canal in the human eye was more complex, and thus less
      permeable, than that reported in the monkey eye. The role of slit-pores and other
      junctions of SCE and trabecular endothelial cells will require further
      investigation under conditions of flow and in glaucoma to determine if these
      junctions change in a manner that might influence outflow resistance.

PMID- 7775117
TI  - Glaucomatous visual fields. FASTPAC versus full threshold strategy of the
      Humphrey Field Analyzer.
AB  - PURPOSE: This study examined how FASTPAC, a fast strategy for the Humphrey Field
      Analyzer (HFA), compares to the standard 4/2-dB full threshold strategy in
      patients with glaucoma. METHOD: The author tested one eye each of 50 patients
      with glaucoma (23 with only relative defects, 27 with at least one absolute
      defect; age range, 25 to 79 years; median age, 61.5 years) with both strategies
      using program 30-2 of the HFA (stimulus size III). Global visual field indices as
      calculated by Statpac, unweighted mean sensitivity, and examination time were
      compared. In addition, a point by point analysis of the sensitivity values was
      performed. RESULTS: Between the two strategies, no significant differences were
      found for indices directly related to the sensitivity values (mean sensitivity
      [MS], mean deviation [MD]) or for the actual thresholds. For the entire
      population, FASTPAC showed higher mean short-term fluctuation (SF; P = 0.018),
      lower mean pattern standard deviation (PSD; P = 0.006), and mean corrected PSD
      (CPSD; P < 0.001) values and a time reduction of more than 30% (P < 0.001)
      compared to the standard strategy. These differences between the strategies were
      found to be independent of the amount of field loss, except for PSD (P = 0.001).
      No age influence was present. Statistically significant linear regression (r >
      0.70, P < 0.001) was found between the FASTPAC values of MS, MD, PSD, CPSD, and
      the corresponding values determined with the standard strategy. No correlation
      exists for SF (r < 0.46, P > 0.030). CONCLUSIONS: FASTPAC provides a considerable
      time reduction at the cost of higher threshold fluctuation. This may lead to
      problems in detecting relative defects or changes in differential light threshold
      in follow-up examinations.

PMID- 7775118
TI  - The statistical interpretation of blue-on-yellow visual field loss.
AB  - PURPOSE: To evaluate short-wavelength-sensitive perimetry in the detection of
      glaucomatous field loss. METHODS: The sample consisted of 27 normal subjects, 24
      patients with primary open angle glaucoma (POAG), and 27 patients with ocular
      hypertension (OHT). Blue-on-yellow (B-Y) and standard (W-W) perimetry was
      undertaken with a modified Humphrey Field Analyzer 640 on one eye of each subject
      and patient. The B-Y data were corrected for individual ocular media absorption.
      Results were compared to an age-matched normal database of 50 subjects (age
      range, 60 to 82 years; mean age, 70.0 years; SD, 6.4 years). Visual field indices
      and total and pattern deviation probability maps were calculated for both W-W and
      B-Y fields. RESULTS: The B-Y normal database exhibited increased between-subject
      variability compared to the W-W normal database (P < 0.001). The greater
      variability increased with the increase in eccentricity (P < 0.001) and with the
      increase in age (P = 0.032). All patients with POAG exhibited B-Y field loss; 11
      demonstrated greater B-Y loss than the corresponding W-W field. In advanced POAG,
      the B-Y and the W-W fields were similar. Twenty-five of the 27 normal subjects
      exhibited normal B-Y fields. Five of the 27 patients with OHT manifested B-Y
      focal abnormality and a normal W-W field: in two, W-W focal loss subsequently
      developed. CONCLUSIONS: Short-wavelength-sensitive perimetry can identify visual
      field loss before that detected by W-W perimetry. However, the increased between
      subject variability necessitates stringent statistical analysis in the definition
      of abnormality.

PMID- 7775119
TI  - Transforming growth factor-beta induces plasminogen activator inhibitor type-1 in
      cultured human orbital fibroblasts.
AB  - PURPOSE: The level of constitutive plasminogen activator inhibitor type-1 (PAI-1)
      expression in cultured human orbital fibroblasts is considerably lower than that
      found in dermal fibroblasts. This divergence in PAI-1 expression implies
      differences in the pericellular proteolytic environment and, therefore, in the
      turnover of extracellular matrix. In this article, the authors examine the effect
      of transforming growth factor-beta (TGF-beta) on PAI-1 expression in orbital
      fibroblasts. METHODS: Human orbital and dermal fibroblasts were grown in culture.
      Confluent monolayers were treated with TGF-beta. PAI-1 in the extracellular
      matrix was quantitated by radiolabeling the cultures and electrophoresing the
      cellular material on SDS-PAGE. Medium content was determined by
      immunoprecipitation of [35S]PAI-1 with a rabbit, anti-human, polyclonal antibody.
      PAI-1 mRNA was determined by Northern hybridization. RESULTS: TGF-beta increased
      PAI-1 levels in orbital fibroblasts in a dose-dependent manner, up to 35-fold.
      The induction was maximal after 16 hours of treatment. The increases in
      extracellular matrix PAI-1 paralleled those observed in the medium. The steady
      state levels of the mRNA encoding the protein were upregulated by TGF-beta up to
      60-fold 8 hours after the addition of TGF-beta. The fractional increase in PAI-1
      expression in orbital fibroblasts was consistently greater than that observed in
      dermal strains. CONCLUSIONS: Exposure to TGF-beta consistently induces PAI-1
      expression in orbital fibroblasts, cells that do not express the polypeptide
      constitutively at high levels. The effects are mediated at the pretranslational
      level and involve the upregulation of PAI-1 mRNA. These results suggest that TGF
      beta may exert a profound regulatory influence on the pericellular proteolytic
      environment in orbital connective tissue.

PMID- 7775120
TI  - Modulation of cellular functions in retroorbital fibroblasts using antisense
      oligonucleotides targeting the c-myc protooncogene.
AB  - PURPOSE: To examine the signal transduction pathways involved in the activation
      of orbital fibroblast effector functions relevant to the pathogenesis of Graves'
      ophthalmopathy (GO). To determine, using antisense technology, whether the c-myc
      protooncogene is involved in cell proliferation and glycosaminoglycan (GAG)
      synthesis in cultured orbital fibroblasts (OF). METHODS: The effects of a 16-mer
      c-myc antisense phosphorothioate oligodeoxynucleotide (S-ODN) on OF monolayers
      derived from orbital connective tissue of patients with severe GO (n = 6) and
      healthy individuals (n = 3) were investigated. Quiescent OF monolayers were
      treated with serum or cytokines and were exposed to increasing concentrations of
      a c-myc antisense S-ODN and several control S-ODN. Cell proliferation was
      quantitated by direct cell counting and by immunocytochemistry for the nuclear Ki
      67 antigen. Glycosaminoglycan synthesis was examined by [3H] GAG analysis. The
      effects of the c-myc antisense S-ODN and control S-ODN on c-myc mRNA and protein
      product levels were analyzed using reverse-transcriptase polymerase chain
      reaction, immunocytochemistry, and immunoblotting, respectively. RESULTS:
      Transient suppression of c-myc mRNA and the c-myc protein product by a c-myc
      antisense S-ODN (2 to 8 microM) strongly inhibited cell proliferation and GAG
      synthesis in OF derived from patients with GO and healthy individuals. These
      effects occurred in a dose-dependent manner and were specific for the c-myc
      antisense S-ODN used. Cell morphology or viability were not affected.
      CONCLUSIONS: The c-myc protooncogene and its protein product are involved in the
      proliferative and metabolic activities of OF exposed to serum or cytokines in
      vitro. C-myc appears to be an essential component of at least two OF cellular
      activities likely to contribute to the orbital tissue alterations in GO.

PMID- 7775121
TI  - Cyclosporin protects the eyelid skin from injury after injection of doxorubicin.
AB  - PURPOSE: The myotoxic drug doxorubicin can treat blepharospasm and hemifacial
      spasm permanently when injected directly into the eyelid of patients. One side
      effect of this treatment is the dose-related occurrence of injury to the skin
      overlying the injection site. The purpose of this study was to determine if
      injection of the immunosuppressive agent cyclosporin into rabbit eyelids before
      doxorubicin treatment could reduce the occurrence of injury to the overlying skin
      and to determine the effect of cyclosporin pretreatment on doxorubicin-induced
      muscle fiber loss. METHODS: Anesthetized rabbits received injections of varying
      doses of cyclosporin 20 minutes before injection of either 0.5, 1, or 2 mg
      doxorubicin. The rabbits were examined daily, and epithelial changes were
      recorded as to duration, time of onset, and healing. When the skin was completely
      healed, the animals were killed and eyelid tissue was prepared for morphometric
      determination of muscle fiber number. Acute inflammation was quantitatively
      assessed using an Evans blue assay. RESULTS: At specified doses, cyclosporin
      improved the doxorubicin chemomyectomy protocol in three ways. It delayed the
      onset of skin injury at the higher doses of doxorubicin, and it markedly
      decreased the duration of skin injury. At some doses, cyclosporin completely
      prevented the formation of epithelial defects. The combination, however, did not
      increase muscle loss compared to doxorubicin alone; in fact, it had a slightly
      myoprotective effect. A dose range for cyclosporin administration was determined
      that resulted in a quantitative and dose-dependent reduction in inflammation at
      the injection site. CONCLUSIONS: The injection of cyclosporin into the eyelids
      before doxorubicin treatment delayed the onset, reduced the duration, and limited
      the extent of development of eyelid skin injury. Perhaps by limiting cytokine
      release, cyclosporin decreased the inflammatory reaction compared to that seen
      with doxorubicin alone. This combination has the potential to improve patient
      acceptance of doxorubicin chemomyectomy for the treatment of blepharospasm and
      hemifacial spasm.

PMID- 7775122
TI  - Transcranial magnetic stimulation of the posterior parietal cortex degrades
      accuracy of memory-guided saccades in humans.
AB  - PURPOSE: Previous neurophysiological studies in the monkey have shown that the
      posterior parietal cortex (PPC) is involved in the control of memory-guided
      saccades. In this study, the authors investigated the effect of focal
      transcranial magnetic stimulation (TMS) over the posterior parietal cortex on
      accuracy of memory-guided saccades in humans to clarify the cortical region
      related to controlling memory-guided saccades. METHODS: Single TMS pulses were
      applied systematically at various locations over the parietal cortex during
      memory-guided saccades in human subjects. Each subject was instructed to fixate
      on a central target until the target was extinguished. A lateral target was
      flashed for 100 msec with unpredictable direction and amplitude. The subject
      executed a saccade to the remembered position of the previously flashed target in
      total darkness when the central target was extinguished. Transcranial magnetic
      stimulation was applied after the extinction of the central target with various
      latencies. Stimulation sites were identified by three-dimensional magnetic
      resonance imaging (MRI). RESULTS: Transcranial magnetic stimulation of the right
      PPC degraded accuracy of rightward and leftward memory-guided saccades in all
      subjects, when TMS was applied 100 msec after the offset of the central target.
      On the other hand, TMS of the left PPC showed no effects on accuracy of memory
      guided saccades. Systematic error of saccade amplitude appeared as a hypometria
      for rightward saccades. Three-dimensional MRI revealed that the effective
      stimulation site was located over the posterior portion of the intraparietal
      sulcus and the superior part of the angular gyrus of the right hemisphere.
      CONCLUSIONS: These findings strongly suggest that the right PPC is involved in
      maintaining spatial accuracy of remembered target locations of memory-guided
      saccades in humans.

PMID- 7775123
TI  - Renin-containing Muller cells of the retina display endocrine features.
AB  - PURPOSE: An ocular renin-angiotensin system has been implicated in the
      proliferation of retinal blood vessels and blindness in diabetes mellitus. Its
      cellular basis has not been established. The objective was to identify sites of
      renin synthesis, secretion, and processing in eyes from humans, BALB/c mice,
      Sprague-Dawley rats, and a hypertensive transgenic rat model (mREN-2) that
      displays amplified extrarenal renin synthesis. METHODS: Paraffin sections of eyes
      were incubated with antisera to renin protein, prorenin, vimentin, and Muller
      cells. Enzyme kinetic renin assay was performed on extracts of whole eyes
      (excluding lens and vitreous) and comparisons made with adrenal glands and
      kidneys. For detection of renin mRNA, retinas were separately pooled from BALB/c
      and Swiss mice. RESULTS: In normal rodent and autopsy human eyes, labeling for
      renin, vimentin, and Muller cell protein was observed in the cytoplasm of all
      macroglial Muller cells, with renin labeling most obvious in endfeet closely
      apposed to retinal blood vessels. Prorenin labeling was not detected. Less
      intense renin labeling, again without prorenin, was seen in nonpigmented ciliary
      epithelium of rodents. In transgenic (mREN-2) rat eyes, renin and prorenin
      labeling of Muller cells and nonpigmented ciliary epithelium were intense.
      Prorenin was localized to the posterior region of Muller cells but only sparsely
      to endfeet in rodent retinas, and renin was present only in an active form in
      amounts one third that of one adrenal. Renin mRNA was readily detected. In human
      retina, renin was present in active and pro-forms, and the total amount was
      approximately one fiftieth that of adrenal. CONCLUSION: Renin is synthesized in
      the retina and is specifically localized to the macroglial Muller cells.
      Nonpigmented ciliary epithelium also contains renin. The presence of prorenin in
      the posterior part of the Muller cell, with active renin throughout but notably
      in endfeet in apposition to retinal capillaries, suggests directional processing
      of renin. These findings are consistent with earlier suggestions that retinal
      neovascularization may be associated with Muller cell dysfunction.

PMID- 7775124
TI  - Differential effects of aqueous and vitreous on fiber differentiation and
      extracellular matrix accumulation in lens epithelial explants.
AB  - PURPOSE: Results from this and other laboratories strongly suggest that
      differences in the properties of the ocular media that bathe cells in the
      anterior and posterior regions of the lens contribute to its normal growth
      patterns and polarity. The aim of this study was to compare the effects of
      aqueous and vitreous on the morphology of lens epithelial explants, with
      particular attention to changes associated with fiber differentiation. METHODS:
      Light and electron microscopy were used to assess rat lens epithelial explants
      cultured with bovine aqueous or vitreous. Immunohistochemistry was used to detect
      fiber-specific crystallins and extracellular matrix components, and synthesis of
      extracellular matrix was investigated by autoradiography. RESULTS: Vitreous, but
      not aqueous, induced morphologic changes characteristic of fiber differentiation,
      which included cell elongation, organelle loss, and the appearance of ball and
      socket junctions, as well as the accumulation of beta-crystallin. In addition,
      vitreous stimulated the synthesis and organization of a distinct basement
      membrane on explants that resembled the lens capsule, both structurally (regular
      layers of basal laminae) and immunologically (reactive for laminin and heparan
      sulphate proteoglycan). CONCLUSIONS: Only one of the ocular media, the
      posteriorly located vitreous, induced lens epithelial explants to undergo
      morphologic events characteristic of fiber differentiation. This provides further
      support for the hypothesis that anteroposterior patterns of cellular responses in
      the lens are caused by differences in the ocular media. The observation that
      vitreous also stimulated the synthesis and assembly of capsule-like extracellular
      matrix suggests that vitreous contains factors that may influence lens capsule
      formation in situ.

PMID- 7775126
TI  - Phase II evaluation of the AMAP, 773U82 mesylate, in pancreatic cancer.
AB  - Pancreatic cancer is the fifth leading cause in cancer related death among adults
      in the United States. Thirty-thousand new cases of pancreatic cancer are
      diagnosed each year, most are metastatic at diagnosis and no effective systemic
      therapy is available. 773U82 mesylate is one of a series of compounds
      (arylmethylaminopropanediols-AMAPS) which was synthesized at the Wellcome
      Research Laboratories. AMAPS bind to DNA, show evidence of topoisomerase 2
      inhibition and are active in a variety of murine and human preclinical screens.
      Based on these data a phase II trial of 773U82 mesylate administered at 800 mg/m2
      daily x 3 at a 4 h infusion repeated every three weeks was carried out. Patients
      eligible for these trials had histologic proof of adenocarcinoma, good
      performance status, and normal organ function. This was a multi-institutional
      trial. Nineteen patients were entered; 15 patients were fully eligible and 4 were
      ineligible, but were evaluated. Thirteen patients were fully evaluable for
      response and no response was seen. Median time to progressive disease among
      eligible patients was 56 days. Toxicity of 773U82 mesylate was myelosuppression
      which was not prohibitive. 773U82 mesylate is not active in pancreatic cancer.

PMID- 7775125
TI  - Intracameral injection of antigen potentiates the production of antigen-specific
      T cell proteins in serum after the induction of delayed-type hypersensitivity.
AB  - PURPOSE: To determine whether the introduction of antigen into the anterior
      chamber induces the production of extracellular antigen-specific T cell proteins
      (T cell antigen-binding molecules [TABM] specific for the antigen. METHODS:
      Balb/c mice received an intracameral or subconjunctival injection of
      trinitrophenylated spleen cells (TNP spleen cells) before skin sensitization and
      challenge with picrychloride. The production of TNP-specific TABM in serum was
      quantified by enzyme-linked immunosorbent assay-based antigen binding and
      immunoblotting using a rabbit antiserum raised against a monoclonal antigen
      specific T cell protein that induces suppressor T cells. RESULTS: Intracameral,
      but not subconjunctival, injection of TNP spleen cells before contact
      sensitization increased the level of TNP-specific TABM in serum. At 2 days, TABM
      levels began to rise and peaked at 5 days after contact sensitization. Anterior
      chamber injection of TNP spleen cells alone into nonimmunized mice did not induce
      a detectable increase of TNP-specific TABM in serum. Mice that did not receive an
      intracameral TNP spleen cell injection but were made contact sensitive to TNP
      showed a diminished TNP-specific TABM response. Specificity of the TABM induced
      by intracameral-injection and sensitization for the TNP hapten was documented by
      showing that the induced TABM binds TNP-bovine serum antigen (BSA) but does not
      bind either BSA alone or azobenzenearsonate-ovalbumin and that immune sera raised
      against ovalbumin did not contain an increase in TNP-specific TABM. TNP-specific
      TABM in the sera of mice receiving an intracameral injection of TNP spleen cells,
      followed by contact sensitization with picrylchloride (PCl), were purified by
      affinity for TNP and were resolved by polyacrylamide gel electrophoresis and
      immunoblotting as M(r) 110,000 polypeptides. CONCLUSIONS: Serum levels of TNP
      specific TABM induced by contact sensitization alone are enhanced fourfold to
      fivefold when sensitization is preceded by the intracameral, but not the
      subconjunctival, injection of TNP spleen cells. The authors propose that besides
      suppression of systemic delayed type hypersensitivity, the intracameral injection
      of antigen into nonimmune mice may prime an increased production of TABM, which
      may indicate systemic activation of the immunoregulatory T cell circuit.

PMID- 7775127
TI  - Phase I study of mitonafide with a 3-day administration schedule: early
      interruption due to severe central nervous system toxicity.
AB  - Eleven patients with solid tumors for whom effective therapy was not available
      entered a phase I study of mitonafide given as a short intravenous (i.v.)
      infusion daily for 3 consecutive days. The initial dose level was selected
      according to the experience from another phase I study using a 5-day
      administration schedule. Six patients entered the first dose level (180 mg/m2/day
      x 3 days) and 4 of them had grade 3-4 leukopenia. This level was considered to be
      the maximum tolerated dose (MTD) and no further dose escalations were attempted.
      The following 5 patients received a dose approximately 10% inferior to the
      previous one (160 mg/m2/day x 3 days). Three of them had grade 3-4 neutropenia.
      Three partial responses were observed in total. After inclusion of 11 patients,
      an unexpected toxicity, central nervous system (CNS) toxicity, consisting of
      severe loss of memory, temporospatial disorientation and high integrative
      function impairment was observed in 5 patients (46%). A median patients' follow
      up of 3 months after treatment discontinuation showed that these alterations were
      progressive and not reversible. This disabling toxicity prompted us to an early
      study interruption. In conclusion, mitonafide, when administered as a short 3-day
      i.v. infusion, can induce severe and irreversible CNS toxicity. Nevertheless,
      since antitumor activity has been observed, further development of the drug is
      recommended with different schedules of administration that have shown not to
      produce neurotoxicity, i.e., 5-day continuous infusion.

PMID- 7775128
TI  - Phase I/II trial of dipyridamole, 5-fluorouracil, leukovorin, and mitoxantrone in
      metastatic breast cancer.
AB  - Based upon the hypothesis that dipyridamole would potentiate the cytotoxicity of
      mitoxantrone and the combination of 5-fluorouracil (5-FU) and leukovorin, we
      performed a phase I/II trial of the combination of dipyridamole, 5-FU,
      leukovorin, and mitoxantrone in patients with metastatic breast cancer. The dose
      of dipyridamole was fixed at 175 mg/m2 by mouth every 6 h (700 mg/m2/day), based
      upon a previous phase I trial of oral dipyridamole with 5-FU and leukovorin.
      Dipyridamole therapy began 24 h prior to the first dose of chemotherapy and
      continued until 24 h after the last dose of chemotherapy for each course of
      treatment. At the initial dose level, leukovorin 200 mg/m2 was given
      intravenously immediately prior to 5-FU 375 mg/m2 intravenously on days 1-5.
      Mitoxantrone 6 mg/m2 was given as a single dose on day 3. Unacceptable toxicity
      was observed at this dose level, leading to successive dose decrements rather
      than dose increments. The maximum tolerated dose was leukovorin 200 mg/m2 days 1
      2, 5-FU 375 mg/m2 days 1-2, mitoxantrone 6 mg/m2 on day 2, and dipyridamole 175
      mg/m2 every 6 h on days 0-3. Two responses were produced in 15 patients. This
      regimen is not recommended for further investigation in the treatment of breast
      cancer.

PMID- 7775130
TI  - High-dose aminothiadiazole in advanced colorectal cancer. An Illinois Cancer
      Center phase II trial.
AB  - Thirty-three patients with advanced colorectal carcinoma were entered on a phase
      II trial of weekly IV aminothiadiazole (175 mg/m2 escalated to 200 mg/m2) with
      concomitant allopurinol and non-steroidal anti-inflammatory agents (NSAID's).
      Toxicity was predominantly GI, cutaneous, and chest pain/dyspnea. Twenty-five
      percent of patients had grade 3 or 4 toxicity. There were no responses in 27
      evaluable patients. Median survival was 12 months. Aminothiadiazole, at higher
      doses than used in previous reports, when given with NSAID's, had no significant
      activity against large bowel cancer.

PMID- 7775129
TI  - Postincubation with aclarubicin reverses topoisomerase II mediated DNA cleavage,
      strand breaks, and cytotoxicity induced by VP-16.
AB  - In previous studies, we found that VP-16 (etoposide) induced cytotoxicity and
      protein-concealed strand break formation was prevented in a small cell lung
      cancer (SCLC) cell line, when the cells were incubated with aclarubicin prior to
      treatment with VP-16. In the present work, we studied the effect of adding
      aclarubicin to the cell suspension after VP-16. In a clonogenic assay, we found
      that the cytotoxicity induced by VP-16 in SCLC cells was inhibited when cells
      were postincubated with aclarubicin. The addition of aclarubicin at any time in
      relation to VP-16 was able to stop further cytotoxicity induced by the
      topoisomerase II (topo-II) targeting drug. Aclarubicin was also found to
      antagonize the cytotoxicity induced by VM-26 (teniposide), and m-AMSA. With the
      alkaline elution technique we found that postincubating the cells with
      aclarubicin inhibited VP-16-induced DNA strand break formation. In an in vitro
      system with purified topo-II and naked DNA we likewise found, that postincubation
      with aclarubicin prevented VP-16 induced cleavage. In the same in vitro system,
      also baseline cleavage induced by topo-II was inhibited when aclarubicin was
      present. Importantly, aclarubicin exerted the antagonism to topo-II targeting
      drugs both when administered prior to and after the topo-II targeting agents.
      Thus, our data suggest that sequential rather than simultaneous administration of
      aclarubicin and topo-II targeting agents may be superior with respect to net
      cytotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775131
TI  - Pharmaceutical development of a parenteral formulation of the novel anti-tumor
      agent carzelesin (U-80,244).
AB  - The aim of this study was to design a parenteral dosage form for the
      investigational cytotoxic drug carzelesin. A stable formulation in PET
      (Polyethylene glycol 400/absolute ethanol/Tween 80, 6:3:1, v/v/v) was developed.
      The prototype, containing 0.50 mg carzelesin in 2.0 ml PET formulation, was found
      to be the optimal formulation in terms of solubility, stability and dosage
      requirements in phase I clinical trials. Quality control of the formulation
      showed that the pharmaceutical preparation of carzelesin in PET is not negatively
      influenced by the manufacturing process. Shelf life studies demonstrated that the
      formulation is stable for at least 1 year, when stored at -30 degrees C in the
      dark. In addition, the stability of carzelesin in the PET formulation is
      discussed as a function of temperature, additives and after dilution in infusion
      fluids.

PMID- 7775132
TI  - Phase II study of elsamitrucin in non-small cell lung cancer.
AB  - Elsamitrucin (BMY-28090) a novel fermentation product has demonstrated pre
      clinical anti-tumour activity against a number of cell lines. The dose limiting
      toxicity in phase I studies was a reversible increase in hepatic transaminase.
      This study was initiated to determine the activity of elsamitrucin in patients
      with previously untreated, bi-dimensionally measurable, cytologically or
      histologically proven, non-small cell lung cancer who were not curable by
      surgery. Elsamitrucin at a dose of 25 mg/m2 was administered intravenously over 5
      10 min weekly for a minimum of 6 weeks. Seventeen patients were entered on study,
      15 were evaluable for toxicity and 14 evaluable for response. No responses were
      documented in the 14 patients evaluable for response. Both hematological and non
      hematological toxicities were mild to moderate in severity. The commonest being
      nausea, vomiting, lethargy and local skin reactions at the site of the infusion.
      These results indicate that elsamitrucin when given in this dose and schedule to
      patients with surgically incurable non-small cell lung cancer has no activity.

PMID- 7775133
TI  - Phase II trial of PALA and 6-methylmercaptopurine riboside (MMPR) in combination
      with 5-fluorouracil in advanced pancreatic cancer.
AB  - The biochemical modulators PALA, an inhibitor of aspartate transcarbamylase which
      depletes uridine nucleotide pools, and 6-methylmercaptopurine riboside (MMPR)
      which inhibits purine metabolism, selectively potentiate the antitumor activity
      of 5-fluorouracil (5-FU) in preclinical models. Based on a phase I trial of this
      combination, we performed a phase II trial in patients with advanced pancreatic
      cancer. PALA 250 mg/m2 was administered i.v. on day 1, followed 24h later by MMPR
      150 mg/m2 as a bolus i.v. injection, and 5-FU 2300 mg/m2 by 24h infusion.
      Treatments were repeated weekly. Seventeen patients, all previously untreated
      with chemotherapy, were entered, of whom 14 are evaluable for response. Toxicity
      > or = grade 2 included nausea (6/17), vomiting (4/17), diarrhea (3/17),
      stomatitis (5/17), and neurotoxicity (2/17). Among 14 evaluable patients there
      were no partial responses, and two patients with stable disease. Pretreatment
      with PALA and MMPR is insufficient to enhance the activity of 5-FU in pancreatic
      cancer.

PMID- 7775134
TI  - Phase II trial of liposomal encapsulated doxorubicin in patients with advanced
      renal cell carcinoma.
AB  - Fourteen patients with advanced renal cell carcinoma were treated on a phase II
      trial with liposomal encapsulated doxorubicin (Lipodox, LED). None of the
      fourteen evaluable patients achieved a complete or partial response.
      Myelosuppression was the most common toxicity and no cardiac toxicity was
      evident. Seventy-nine percent (11 of 14) of patients experienced grade III or IV
      neutropenia. In summary, LED did not show antitumor activity in the treatment of
      advanced renal cell carcinoma.

PMID- 7775135
TI  - Phase II study of carboplatin and edatrexate (10-EdAM) with leucovorin rescue for
      patients with recurrent squamous cell carcinoma of the head and neck.
AB  - Recurrent squamous cell carcinoma of the head and neck is poorly responsive to
      chemotherapy in most patients; therefore, the development of new approaches is
      essential. Edatrexate is a new antifolate with improved preclinical antitumor
      activity when compared to methotrexate. The purpose of this study was to define
      the feasibility and efficacy of combining edatrexate with another active single
      agent, carboplatin in chemotherapy-naive recurrent disease. Carboplatin was given
      as an outpatient on day 1 at a dosage based on the formula: Dose (mg/m2) =
      (0.091) (creatinine clearance) (body surface area) (desired percentage change in
      platelet count) + 86. Edatrexate (80 mg/m2) was given on days 1, 8, and 15 of a
      21 day cycle. Calcium leucovorin 15 mg was given orally every 6 h for 4 doses
      after edatrexate. Of the 26 patients entered on the study, 1 was invaluable for
      toxicity or response and 3 patients were evaluable for toxicity only. Grade 3 or
      4 neutropenia occurred in 2 patients each, and grade 3 or 4 thrombocytopenia
      occurred in 2 and 4 patients, respectively. Grade 3 stomatitis occurred in only
      two patients. Overall, major responses occurred in 2 of 22 evaluable patients
      (9%). The combination of carboplatin and edatrexate was not superior to the
      results expected with either agent alone.

PMID- 7775136
TI  - Phase II trial of piroxantrone in metastatic breast cancer. A Southwest Oncology
      Group study.
AB  - Thirty-two eligible patients with advanced metastatic breast cancer who had
      received no more than 1 prior chemotherapy regimen for metastatic disease (16 had
      received prior doxorubicin) were treated with piroxantrone at a dose of 120 mg/m2
      intravenously every 21 days. In the twenty-seven patients evaluable for response,
      two partial responses were seen. Toxicities observed were primarily hematologic
      with grade 3 or greater granulocytopenia occurring in 34% of the patients. One
      patient developed symptomatic congestive heart failure at a total cumulative dose
      of 960 mg/m2. We conclude that piroxantrone given at this dose and schedule has
      minimal activity in patients with metastatic breast cancer.

PMID- 7775137
TI  - Hepatoma/merbarone. A Southwest Oncology Group study.
AB  - Sixteen eligible patients with hepatocellular carcinoma, previously untreated,
      received merbarone 1000 mg/m2/d for five consecutive days every 21 days. No
      complete or partial response to treatment was obtained. Seven patients had grade
      4 granulocytopenia. One patient died with renal failure. Merbarone in this dose
      and schedule was ineffective in the treatment of hepatocellular carcinoma.

PMID- 7775138
TI  - Phase II study of edatrexate in advanced head and neck cancer. A Southwest
      Oncology Group study.
AB  - Fifty-two patients with persistent, recurrent and/or metastatic squamous cell
      cancer of the head and neck were treated with weekly edatrexate, 80 mg/m2. Nine
      patients had received previous adjuvant or neoadjuvant chemotherapy. Of the 46
      eligible patients, two complete responses and one partial response were observed
      (6%, 95% confidence interval of 1-18%). The most common toxicities were
      myelosuppression and mucositis, but dermatologic toxicity was also observed in
      25% of patients. Edatrexate appears to have limited activity in advanced head and
      neck cancer.

PMID- 7775139
TI  - Phase II trial of 6-thioguanine in advanced renal cell carcinoma. An Illinois
      Cancer Center study.

PMID- 7775140
TI  - Anxiety disorders.

PMID- 7775141
TI  - Depression in adolescence.

PMID- 7775142
TI  - Chronic depression.

PMID- 7775144
TI  - Advances in understanding obsessive compulsive disorder.

PMID- 7775143
TI  - ACE inhibitors in the management and prevention of heart failure.

PMID- 7775145
TI  - Occupational disorders of the upper limb.

PMID- 7775146
TI  - Referrals to Irish accident and emergency departments.
AB  - A prospective survey of samples of thirty consecutive referrals from general
      practitioners in fifteen European Countries (the European study of Referrals from
      Primary Care), found that Irish doctors sent a higher proportion (20.6%) of
      referrals to Accident and Emergency (A&E) Departments than in any other country
      in the study. Further analysis of the Irish sample showed that 57% of these
      patients were referred to specialists other than Emergency and Trauma (E&T) (i.e.
      12.7% of all referrals). These referrals were mostly for acute medical or
      surgical conditions requiring inpatient treatment. More non-E&T referrals were
      sent by doctors closer than 10 km from hospital (26.8% of all their referrals),
      as compared with doctors 10 km or further from hospital (8.1% of all their
      referrals). Doctors older than 40 years sent more non-E&T referrals to A&E
      Departments (16.9% of all their referrals) as compared with those aged 40 years
      or younger (9.6% of all their referrals). In contrast, referrals to Emergency and
      Trauma specialists were associated with greater distance to hospital, as doctors
      closer than 10 km from hospital made only 1.6% of all referrals to the E&T
      specialty, while doctors 10 km or further from hospital made 12.5% of all
      referrals to E&T specialists. The author recommends that referrals to non-trauma
      specialists in the Republic of Ireland should go directly to these specialists,
      as in all other countries in Europe, thus freeing Emergency and Trauma
      specialists for their proper Accident and Emergency function.

PMID- 7775147
TI  - A comparison of attendance for drug misuse to Dublin accident & emergency
      departments 1985-1993.
AB  - We compared attendance by Drug Misusers to the Accident & Emergency Departments
      (A&E) in the greater Dublin area during September 1985 and April 1993. The study
      took the form of a questionnaire administered by the previously trained A&E staff
      to attenders who were currently (within the past six months): experimenting with
      drugs, abusing drugs or drug dependent. Seventy three drug misusers were
      identified in September 1985 and 68 in April 1993. Poly substance misuse was a
      major feature of the 1993 survey and Benzodiazepines replaced Heroin as the major
      drug of misuse. There was a significant increase in the misuse of prescribed
      opiates, in particular morphine sulphate, methadone and DF118. Physical problems
      associated with drug misuse were more common in 1993 because of the new trend of
      crushing and injecting the morphine sulphate tablet. Patients continue to inject
      drugs and are poor attenders at needle exchange programmes. We feel that all
      doctors should exercise caution in their prescribing habits in view of the
      alarming increase in the misuse of prescribed medication as indicated by our
      figures.

PMID- 7775148
TI  - Nonmelanoma skin cancer in an Irish population: an appraisal of risk factors.
AB  - Previous Irish studies have shown a high prevalence of nonmelanoma skin cancer
      (NMSC). However, unlike elsewhere where the generally quoted ratio of basal cell
      carcinoma (BCC):squamous cell carcinoma (SCC) is at least 4:1 the ratio in
      Ireland was found to be 1:1. We examined this ratio in patients attending the
      dermatology outpatients and determined risk factors for the development of NMSC
      within an Irish population where 75% of the population have been shown to have
      skin type 1 or 11. The study consisted of a retrospective 10 year review of
      biopsy proven cases of NMSC and a prospective case control study of NMSC which
      allowed examination of risk factors and comparison to a control group. The
      BCC:SCC ratio in the retrospective study was 3:1. In the prospective study the
      ratio of BCC:SCC was 4.4:1. Skin type 1 and numerous freckles were identified as
      risk factors in the NMSC group.

PMID- 7775150
TI  - Sneddon's syndrome--clinical course and out-come.
AB  - Five patients presented with Sneddon's syndrome characterised by cerebral
      infarction, livedo reticularis, hypertension, epilepsy and a progressive
      dementia. Two patients had raised anticardiolipin antibody titres. The clinical
      symptoms and immunological disturbance in Sneddon's syndrome and the
      antiphospholipid syndrome are similar, and may indicate the importance of immune
      mediated thrombosis in Sneddon's syndrome.

PMID- 7775149
TI  - Clinicopathologic observations in 100 consecutive patients with fatal head injury
      admitted to a neurosurgical unit.
AB  - A neuropathologic study of 100 patients with fatal head injuries admitted to a
      neurosurgical unit revealed hypoxic-ischaemic brain damage in 74% and diffuse
      axonal injury in 42% of patients respectively. Of the seven patients who died as
      a result of extracerebral injuries, there were four in whom death due to
      hypovolaemic shock, was considered potentially avoidable. This study indicates
      that there is scope for improvement in the management of patients with acute head
      injury, particularly in the prevention of secondary brain damage, and in the need
      to increase awareness of potentially life threatening extracerebral injuries as a
      cause of coma.

PMID- 7775151
TI  - Recurrent ovarian carcinoma: diagnosis and second-line therapy.
AB  - Approximately 10% of patients with ovarian cancer will develop a recurrence.
      Successful treatment of recurring disease has been documented, and recent
      developments in chemotherapy are encouraging. In our study, CA125 Tumour Marker
      was a useful marker to monitor the course of such disease, and detected recurring
      ovarian cancer at a sub-clinical level, leading to earlier diagnosis. This may
      have implications for outcome.

PMID- 7775152
TI  - A comparison of parenteral tenoxicam and diclofenac in the treatment of acute
      soft tissue injury of the lower limb.

PMID- 7775153
TI  - Psoriatic arthropathy.

PMID- 7775154
TI  - Alterations in the pulmonary and systemic immune response in rats exposed to coal
      fly ash.
AB  - The effect of intratracheally injected fly ash on the development of pulmonary
      and systemic immunity was studied in rats. Following intratracheal and
      intraperitoneal immunisation with sheep red blood cells (SRBC) there was an
      appearance of antibody forming cells (AFC) in lung associated lymph nodes (LALN)
      of animals exposed to either fly ash or physiological saline. Enumeration of AFC
      in LALN after immunisation by either of the routes, revealed a reduction in the
      number of AFC in LALN of fly ash exposed rats in comparison to saline exposed
      animals. The reduction in the number of AFC was more pronounced after exposure of
      Cd-coated fly ash. The AFC appeared in the spleen only after immunisation through
      intraperitoneal route and the number of AFC in spleen of the fly ash and saline
      exposed group of animals did not show any significant difference. These results
      demonstrate that fly ash burden of lungs results in an impairment of the local
      immune response of the lungs without an associated effect on the systemic
      immunity.

PMID- 7775155
TI  - Effects of an S-adenosyl-L-homocysteine hydrolase inhibitor on murine macrophage
      activation and function.
AB  - The S-adenosyl-L-homocysteine (AdoHcy) hydrolase inhibitor MDL 28,842 has been
      demonstrated to be a potent inhibitor of T-cell activation, both in vitro and in
      vivo. Although the inhibition of T cells in vitro was independent of macrophages,
      the direct effect of MDL 28,842 on macrophages is unknown. In this report the
      effects of MDL 28,842 on macrophage cytokine production, cell-surface antigen
      expression, and antigen processing and presentation were examined.
      Lipopolysaccharide (LPS) stimulation of IL-1 synthesis by peritoneal macrophages
      was not effected by MDL 28,842 using cells obtained from B10.A and B10.B mice and
      weakly inhibited using cells from BALB/C mice (IC50 > 10 microM). In contrast,
      TNF-alpha synthesis by BALB/C macrophages was inhibited by MDL 28,842 with an
      IC50 < 0.1 microM. B10.A and B10.B macrophages did not produce detectable TNF
      alpha in response to LPS in this system. Treatment with 1-10 microM MDL 28,842
      resulted in a modest decrease in major histocompatibility complex class II (MHC
      II) determinant expression by Interferon-gamma-activated macrophages. The
      expression of other cell-surface markers was not altered in the presence of MDL
      28,842. The processing of antigen and its presentation by MHC class-II-positive
      macrophages to a T-cell hybridoma was also not affected by incubation with MDL
      28,842.)

PMID- 7775157
TI  - Development of a binding assay for the B1 receptors for kinins.
AB  - A novel binding assay to kinin B1 receptors was developed, based on the design of
      a high-affinity agonist ligand, [125I]Tyr-Gly-Lys-Aca-Lys-des-Arg9-BK. Binding to
      rabbit aortic smooth muscle cells is highly temperature-dependent (optimal at 37
      degrees C); apparent binding equilibrium is reached within 30 min, and
      competition by kinin analogs reveals the expected correlation with the B1
      receptor pharmacology. The dissociation constant (Kd) of the labeled ligand is
      approx. 0.2 nM and this value does not change significantly as a function of
      cytokine pretreatment. However, the receptor abundance (Bmax) is significantly
      increased (1.5-fold) by pretreating the cells with interleukin-1 (IL-1), while
      oncostatin M (OSM) produces a marginal increase of the Bmax. This assay may be
      useful in documenting the regulation of B1 receptors in pathology.

PMID- 7775156
TI  - Pretreatment with beta-funaltrexamine blocks morphine-mediated suppression of CTL
      activity in alloimmunized mice.
AB  - The effect of prolonged exposure to morphine on cytotoxic T lymphocytes (CTL) and
      splenic natural killer (NK) activity was investigated. Daily administration of
      morphine (50.0 mg/kg, s.c.) to alloimmunized mice for 11 days resulted in a
      significant decrease (25-50%) in peritoneal and splenic CTL activity but not
      splenic NK activity. To identify the effector cell population mediating
      cytolysis, cell enrichment studies were carried out. The results of these studies
      indicated the CTLs are CD8+ CD4-. Chronic morphine treatment increased the
      percentage (25-30%) of CD3+ CD4+ and CD8+, but not Ig+ cells in the spleen
      relative to saline-treated controls. Pretreatment of mice with the mu-selective
      antagonist, beta-funaltrexamine blocked morphine-mediated suppression of splenic
      and peritoneal CTL activity as well as the increase in CD3+ CD4+ and CD8+ splenic
      lymphocytes. These results indicate the generation of CTLs in vivo is sensitive
      to chronic morphine exposure implicating opiates as important co-factors through
      modulation of cell-mediated immunity.

PMID- 7775158
TI  - Cell surface expression of heat shock proteins in dog neutrophils induced by
      mitochondrial benzodiazepine receptor ligands.
AB  - The effect of peripheral-type benzodiazepines on dog neutrophil stimulation was
      studied. Ro 5-4864 (a specific ligand of mitochondrial benzodiazepine receptor)
      and diazepam (which binds both to mitochondrial and central benzodiazepine
      receptors) did not show any direct toxic effect against neutrophils. PK 11195, a
      putative antagonist of the mitochondrial benzodiazepine receptor and an
      isoquinoline derivative, had a direct toxic effect at a concentration of 5 x 10(
      5) M (72% of cells were viable). Ro 5-4864 (10(-6)-10(-4) M) and diazepam (10(-6)
      2.5 x 10(-4) M) induced an intracellular oxidative stress in dog neutrophils.
      These compounds, in a micromolar range, also induced a concentration-dependent
      cell surface expression of heat shock protein (HSP) families. The percentages of
      positive cells that express these proteins were: 76.2% for HSP 27 kDa; 54.3% for
      HSP 72 kDa and 69.6% for HSP 90 kDa for Ro 5-4864 (10(-4) M), and 66.7% for HSP
      27 kDa; 45.4% for HSP 72 kDa and 78.3 for HSP 90 kDa for diazepam (2.5 x 10(-4)
      M). It appears that this HSP expression, induced by peripheral-type
      benzodiazepines could be mediated by an intracellular oxidative stress.

PMID- 7775160
TI  - Morphine inhibits the development of allogeneic immune responses in mouse lymph
      node.
AB  - Morphine and related opiates are often administered to relieve post-operative and
      chronic pain following transplantation surgery. Opiates have been shown to
      suppress a variety of immune parameters in both animal models and man. In the
      present study, we investigated whether morphine affects allogeneic immune
      responses by injecting C57BL/6 mice in the footpad with allogeneic spleen cells
      and examining changes in the draining popliteal lymph node (PLN). Morphine
      (administered as subcutaneous implants) had profound inhibitory effects on the
      development of alloreactivity manifested as a suppression of: (1) lymph node
      hyperplasia, (2) mixed lymphocyte reactivity (MLR) in PLN cells and (3) the
      number of CD4+ and Thy 1.2 lymphoid subsets. These inhibitory effects of morphine
      were abolished or dramatically reduced by co-administration of the opiate
      antagonist, naltrexone, indicating that suppression of allo-sensitization was
      opiate receptor mediated. In toto, these findings demonstrate that morphine
      administration interferes with the development of allogeneic immune response in
      mouse lymph node through an opiate receptor mediated mechanism.

PMID- 7775159
TI  - Involvement of histamine or tumor necrosis factor in early-type hypersensitivity.
AB  - A novel early-type hypersensitivity (ETH) reaction, manifested as capillary
      congestion, increase of vasopermeability, and plasma protein leakage, can be
      induced within 1 h after challenge of antigen-sensitized mice. The mediators
      involved in ETH varied among different strains of mice. The poly(Glu60Ala30Tyr10)
      (GAT)-induced ETH in BALB/c mice was blocked by diphenhydramine (histamine H1
      antagonist) and ketanserine (serotonin antagonist), but not by cimetidine
      (histamine H2 antagonist). These results indicate that both histamine and
      serotonin are involved, and that the histamine effect is mediated through a H1
      receptor. Meanwhile, GAT-induced ETH in B6 mice was inhibited by anti-TNF alpha
      antibody suggesting that TNF alpha is involved. The mice can be classified into
      either histamine or TNF alpha type based on the pattern of mediator involved in
      ETH. A/J and CBA strains as well as BALB/c mice were classified as histamine type
      while A. TL, B10.BR, and C3H/He in addition to B6 mice were TNF alpha type. The
      observation that GAT-induced ETH in (BALB/c x B6)F1 mice was inhibited by both
      diphenhydramine and anti-TNF alpha suggests that the mediation of the actions of
      histamine or TNF alpha by GAT was genetically controlled and inherited as the
      dominant trait in (BALB/c x B6)F1 mice. ETH could be passively transferred by
      heat (56 degrees C, 4 h)-treated anti-GAT sera. Sera derived from the histamine
      type transferred ETH across the type barrier and histamine was the mediator,
      irrespective of the type of the recipient. However, sera derived from TNF alpha
      type only transferred ETH to the mice of the same TNF alpha type and TNF alpha
      was the mediator.

PMID- 7775161
TI  - Corticosteroids class-dependently inhibit in vitro Th1- and Th2-type cytokine
      production.
AB  - Corticosteroids (CS) are very potent immunosuppressive agents and are widely used
      to treat inflammatory diseases. On the basis of their clinical efficacy and
      potency CS have been divided into different classes. In the present study we
      investigated whether the class-associated effects of CS are correlated with a
      differential in vitro effect on cytokine production by T lymphocytes. Therefore,
      we determined the in vitro effects of CS on the production of Th1- and Th2-type
      cytokines. The addition of CS, in the range of 10(-9) to 10(-4) M, resulted in a
      class- and dose-dependent inhibition of the production of both IFN-gamma and IL
      4. Notably, at the lowest doses tested, hydrocortisone and hydrocortisone 17
      butyrate had a stimulatory effect on IL-4 production. CS class-dependently
      inhibited the IL-2 production by T cells but did not affect IL-2R expression of
      the T cells. Addition of rIL-2 could not completely restore the inhibitory effect
      of the CS on proliferation and on IFN-gamma and IL-4 production, indicating that
      CS act only partially via inhibition of IL-2 production. The demonstrated
      positive correlation between the clinical efficacy and the in vitro effects of
      the different classes of CS strongly suggests that the effect of CS on T-cell
      mediated inflammation follows from inhibition of proliferation and cytokine
      production by T lymphocytes. The in vitro method used will be valuable for
      investigating and classifying new types of CS and other substances for
      applications in T-cell-mediated diseases.

PMID- 7775162
TI  - Development of the Nurse Information System (NIS): an update on progress.

PMID- 7775163
TI  - Progress report: nurse aide job analysis study.

PMID- 7775164
TI  - Writing CST default responses for pediatric and obstetrical nursing activity
      terms.

PMID- 7775165
TI  - External funding obtained to study the effectiveness of nurse disciplinary
      actions.

PMID- 7775166
TI  - Job analysis study of entry-level licensed practical/vocational nurses.

PMID- 7775167
TI  - National Council initiates study comparing the effectiveness of two approaches to
      the regulatory management of chemically impaired nurses.

PMID- 7775169
TI  - Computerized Clinical Simulation Testing (CST) update.

PMID- 7775168
TI  - Promoter Member Board participation in the Nurse Information System.

PMID- 7775171
TI  - Constructing the CST default client response database.

PMID- 7775170
TI  - Creating database links between nursing diagnoses and nursing activities.

PMID- 7775172
TI  - Efficacy, safety, and tolerability of dihydroergotamine nasal spray as
      monotherapy in the treatment of acute migraine. Dihydroergotamine Nasal Spray
      Multicenter Investigators.
AB  - Recently, a new nasal spray formulation of dihydroergotamine was developed which
      facilitates at-home treatment of migraine. We studied the efficacy, safety, and
      tolerability of dihydroergotamine nasal spray as monotherapy in the acute
      treatment of classic and common migraine in two, identical, double-blind,
      randomized, placebo-controlled trials. Of the 229 patients enrolled, 206 (102
      dihydroergotamine nasal spray, 104 placebo) were included in the intent-to-treat
      analyses; 182 treated two headaches and 24 treated one headache. Based on both
      the patients' and physicians' ratings, dihydroergotamine nasal spray was
      significantly superior to placebo for reducing the severity of headache pain in
      both studies, and in relieving nausea in Study 2. The onset of significant
      efficacy with dihydroergotamine nasal spray compared to that with placebo for
      both severity of headache pain and relief of nausea occurred at 1 hour in Study 2
      and at 3 hours in Study 1. Dihydroergotamine nasal spray was also significantly
      superior to placebo for the relief of headache pain in both studies. Based on the
      physicians' global evaluations of treatment efficacy for headache pain, 71% of
      the dihydroergotamine-treated patients in Study 2 and 59% of their counterparts
      in Study 1 were considered to be responders. The dihydroergotamine-treated
      patients had less newly-occurring vomiting than the placebo-treated patients. The
      majority of adverse events reported by the dihydroergotamine-treated patients
      were nasopharyngeal. The results demonstrate the efficacy, safety, and
      tolerability of dihydroergotamine nasal spray as monotherapy in the treatment of
      acute migraine attacks.

PMID- 7775173
TI  - Sinus headaches reconsidered: referred cephalgia of rhinologic origin
      masquerading as refractory primary headaches.
AB  - Headache associated with acute sinusitis is a well-recognized entity; the
      diagnosis is easily made due to the associated nasal and sinus symptoms. However,
      the phenomenon of referred headache from chronic sinusitis or intranasal
      abnormalities or both without upper respiratory symptoms is not well understood.
      Only recently have the nasal and sinus cavities been adequately visualized by
      both the human eye and radiographic techniques; a fact that may account for the
      historic neglect in considering this region a factor in headache etiology. Modern
      techniques employed in the workup of sinusitis, namely the use of rigid nasal
      endoscopes and coronal-plane CT scanning, have greatly enhanced the clinician's
      ability to evaluate and diagnose pathology in this area. This report describes a
      series of patients presenting with various primary headache syndromes without
      significant nasal or sinus symptoms who failed to respond to conventional
      antiheadache therapy. On nasal endoscopic and coronal CT examinations, various
      intranasal and sinus abnormalities were found (either anatomic variations or
      subclinical inflammation). Medical and/or surgical therapy addressing the
      sinonasal pathology resulted in improvement in every case, ranging from decreased
      severity of attacks to total resolution of headaches. A model explaining the
      possible mechanism of referred vascular-type headache from sinus and nasal origin
      is proposed.

PMID- 7775174
TI  - Long-term results of radiofrequency rhizotomy in the treatment of cluster
      headache.
AB  - Although the primary treatment of chronic cluster headache is medical, surgical
      treatment is sometimes used. The authors reviewed the charts of seven patients
      (ages 36 to 68 years) with chronic cluster headache to identify who responded
      best to percutaneous stereotactic radiofrequency rhizotomy after medical
      treatment failed. All patients had immediate pain relief after surgery. At follow
      up (median 5 years, range 2 to 20 years), two patients remained pain-free 7 and
      20 years later (excellent results); three patients had mild pain recurrence that
      was well controlled on medications (good results) 6 to 12 months after surgery;
      and two patients had major pain recurrence 4 days and 2 months after surgery
      (poor results). Six patients had relief of vasomotor symptoms. One patient had
      transient diplopia and keratitis without permanent sequelae. Both patients with
      excellent results had preoperative major pain around the eye; both patients with
      poor results had major pain around the temple, ear, and cheek; and the three
      patients with good results had pain equally severe in the eye, temple, and cheek.
      There was no association between patient age or sex, pain duration, preoperative
      response to lidocaine blockade, or previous surgery with pain relief. No
      differences occurred in pain relief between patients with dense hypalgesia and
      patients with analgesia. The authors conclude that (1) some patients with chronic
      cluster headache treated by percutaneous stereotactic radiofrequency rhizotomy
      achieve long-term pain relief, and (2) surgery on the trigeminovascular system
      alone may not cure the condition in patients with major pain around the temple,
      ear, and cheek.

PMID- 7775175
TI  - A preliminary report on hyperbaric oxygen in the relief of migraine headache.
AB  - Oxygen inhalation was early advocated as a treatment for migraine headache. It
      has been theorized that the efficacy of raising blood oxygen levels in vascular
      headache is mediated by vasoconstriction and metabolic effects. Hyperbaric oxygen
      can provide a much greater level of blood oxygenation than can provide a much
      greater level of blood oxygenation than normobaric oxygen, and in recent studies
      it has been used in the treatment of cluster headache. The purpose of this study
      was to compare the effects of hyperbaric oxygen and normobaric oxygen in
      migraine. Twenty migraineurs were divided randomly into two groups and studied in
      a hyperbaric chamber during a typical headache attack. Global headache severity
      was measured by a verbal descriptor scale before and after exposure to oxygen.
      One group received 100% oxygen at 1 atmosphere of pressure (normobaric) while the
      other received 100% oxygen at 2 atmospheres of pressure (hyperbaric). One of the
      10 patients in the normobaric group achieved significant relief of headache
      symptoms, while 9 of 10 in the hyperbaric group found relief. Based on a chi
      square test, this difference is significant at the P < .005 level. Those patients
      who did not find significant relief from normobaric oxygen were given hyperbaric
      oxygen as above. All nine found significant relief. The results suggest that
      hyperbaric (but not normobaric) oxygen may be useful in the abortive management
      of migraine headache. Possibilities for the mechanism of this effect, in addition
      to vasoconstriction, include an increase in the rate of energy-producing and
      neurotransmitter-related metabolic reactions in the brain which require molecular
      oxygen.

PMID- 7775176
TI  - The impact of migraine on health status.
AB  - PROBLEMS: What is the effect of migraine on health status, defined as the
      patient's physical, psychological, and social functioning? And, suppose that the
      health status of migraine sufferers appears to be impaired, to what extent is
      this a consequence of migraine-associated comorbidity rather than of migraine
      itself? METHODS: A group of 846 migraineurs, selected from the general population
      following IHS criteria, and a control group were surveyed with the Medical
      Outcomes Study 36-item Short-Form Health Survey, Nottingham Health Profile,
      EuroQol instrument, and the COOP/WONCA charts. Questions on demographic
      characteristics and comorbidity were included. RESULTS: The health status of
      migraineurs appeared to be significantly impaired in comparison to the control
      group. Because statistical significance is distinct from relevance, effect size
      estimators were employed. Although the direction of the differences indicated
      consistently a worse health status of the migraineurs, regardless of the
      instrument used, the sizes of the differences were small to medium. Self-reported
      comorbidity, especially depression, was more prevalent in the migraine group.
      However, this offered only a partial explanation for the impaired health status
      of the migraine group. CONCLUSIONS: Migraine has an independent moderately
      deteriorating effect on the daily functioning of individuals.

PMID- 7775177
TI  - Is abdominal pain a feature of adult migraine?
AB  - Recurrent abdominal pain in children, frequently diagnosed as "abdominal
      migraine," is thought to evolve into more typical migraine headache during the
      teens and twenties. If this transformation occurred, we would expect some adult
      migraineurs to retain abdominal pain; but we could not recall this symptom being
      mentioned by patients. However, without direct questioning the absence cannot be
      assumed. We, therefore, asked 100 migraineurs about abdominal symptoms during
      migraine attacks: only one experienced unexplained abdominal pain. We conclude
      that abdominal pain is not a feature in adult migraineurs, leading us to support
      the notions that: (1) recurrent abdominal pain of childhood has a number of
      causes; (2) abdominal migraine may be an incorrect attribution and is liable to
      be over diagnosed; (3) abdominal migraine requires more precise definition; (4)
      the transition from childhood abdominal migraine to adult migraine needs precise
      prospective study.

PMID- 7775178
TI  - The event-related potential P300 during headache-free period and spontaneous
      attack in adult headache sufferers.
AB  - The event-related potential P300 has been studied in 15 migraine without aura
      sufferers, and in 15 episodic tension-type headache sufferers, during pain-free
      periods and during spontaneous headache attacks. There were no variations of
      potential, either of P3 latency or N2-P3 amplitude, in either group during the
      interictal period. Similarly, there were no variations of the P300 parameters in
      the group of tension-type headache subjects during headache attacks; by contrast,
      a significant elongation of latency (P < 0.01) and an increment of N2-P3 wave
      amplitude (P < 0.002) was observed in the group of migraineurs. The authors
      discuss the data in accordance with the etiopathogenic theories of migraine and
      the hypothesis that acetylcholine and norepinephrine are the neurotransmitter
      able to affect the event-related potential P300, which reflects cerebral activity
      during sensory information processing and analysis.

PMID- 7775180
TI  - Toward a standard drug formulary for the treatment of headache.
AB  - The recent publication of drug formularies by third-party payers has serious
      implications for the practice of medicine. These formularies list the medications
      for which the consumer can be reimbursed by the third-party payer. The most
      restrictive of the five formularies I have received lists only two agents for the
      treatment of migraine headaches: Cafergot (at an incorrect dose of 1/100 mg) and
      Ergotrate which is no longer available. The most liberal of the formularies lists
      analgesics, Cafergot, Midrin, and Imitrex for the treatment of acute attacks, and
      as prophylactic agents, Inderal, Sansert, and analgesics (known to cause rebound
      headaches when used in this fashion in migraine patients). Abortive agents of
      proven value, such as DHE-45 and NSAIDs, and preventative medications, such as
      calcium channel blockers, tricyclic antidepressants, serotonin reuptake
      inhibitors, methylergonovine, and divalproex sodium, are not available. No one
      could quarrel with a goal of developing a cost-effective formulary. However, the
      authors of these formularies have clearly demonstrated their inability to provide
      even a current, accurate, and adequate formulary by existent standards of care in
      the treatment of migraine headache. While it is easy to criticize these
      formularies, it is more difficult to develop a comprehensive list that would
      satisfy the practitioners' need to provide relief for their patients with a
      minimum of side effects, and the needs of third-party payers (presumed) to
      provide quality care at the most economical level.

PMID- 7775179
TI  - Dopamine hypersensitivity in migraine: role in apomorphine syncope.
AB  - There is some evidence supporting a potential role of hypersensitivity of the
      dopaminergic system in the pathogenesis of migraine. In this case report, we
      describe a syncopal episode in a patient with migraine without aura after the
      administration of a very low dose of apomorphine, a classical agonist of
      dopaminergic receptors. The absence of cardiovascular risk factors in this
      patient suggests that the clinical event might have been caused by
      hypersensitivity of the dopaminergic system.

PMID- 7775181
TI  - Cost-effectiveness of computed tomography in the evaluation of patients with
      headache.
AB  - We report a retrospective study to determine the cost-effectiveness of cranial
      computed tomography in patients with headache without neurological finding. Five
      hundred ninety-two neurologically normal patients were examined between 1990 and
      1993 for the complaint of headache. Examination results were reevaluated from
      written report and image archive systems. Results were divided into three groups.
      In group P0, we included patients with normal cranial computed tomography
      findings. In group P1, patients showed some minor pathologies like ischemic or
      atrophic changes. These findings neither explained the reason for headache nor
      changed the clinical or therapeutic approach. The third group (P2) was to include
      patients with gross intracranial pathology like space-occupying lesions or
      bleeding. Five hundred forty-six of 592 patients were in the P0 group (92%), and
      the remaining 46 patients were in the P1 group (8%). No patient was found to have
      serious intracranial pathology detected by computed tomography. Cost of detection
      of a case with significant pathology was calculated. It is our opinion that
      computed tomography is an unrewarding technique in the evaluation of patients
      with chronic headache whose neurological examinations are normal.

PMID- 7775183
TI  - Chronic paroxysmal hemicrania in a child?

PMID- 7775182
TI  - Fluoxetine and migraine: comparison of double-blind trials.

PMID- 7775184
TI  - Standards of care.

PMID- 7775185
TI  - Headache and the human immunodeficiency virus type 1 infection.
AB  - This review focuses on the prevalence, causes, evaluation, and treatment of
      headache in individuals infected with human immunodeficiency virus type 1 (HIV
      1). Headaches, one of the commonest medical complaints in the general population,
      occur frequently in patients infected with the HIV-1. HIV-related headaches can
      occur at any time during the infection: at seroconversion, during the incubation
      period, in patients with symptomatic HIV-1 infection, or after an AIDS-defining
      illness. Causes of HIV-related headaches include HIV-1 itself, opportunistic
      conditions, or HIV-specific medications. Migraines, tension-type headaches,
      depression, and substance abuse enter into the differential diagnosis,
      particularly in the early stages of disease. The headaches seen in this
      population reflect a complex web of interactions imposed by immune competency,
      multiple etiologies, treatments, and premorbid conditions. Prompt recognition and
      early treatment of headache is essential since it may improve quality of life
      and, depending on the diagnosis, prolong survival. Physicians need to be alert
      and adaptable when assessing HIV-infected individuals with headache since
      multiple causes can exist in the same patient and new syndromes, complications,
      and investigational drugs are continually being identified.

PMID- 7775186
TI  - Comparison of dihydroergotamine with metoclopramide versus meperidine with
      promethazine in the treatment of acute migraine.
AB  - Migraineurs often seek office-based treatment for acute headache. To compare the
      efficacy and side effect profile, we entered 27 migraineurs into a prospective,
      randomized, double-blind study where each patient received either 75 mg
      meperidine with 25 mg promethazine IM or .5 mg dihydroergotamine with 10 mg
      metoclopramide IV. After 1 hour, pain relief was similar in the two groups, but
      side effects were significantly greater in the meperidine with promethazine
      regimen group. The dihydroergotamine with metoclopramide regimen is effective,
      and has minimal side effects, making it an attractive method for office-based
      treatment of acute migraine.

PMID- 7775188
TI  - Whiplash around the world.
AB  - The term "whiplash" was first used in 1928 by the American orthopedist Crowe,
      although the earliest use that I can find published was in 1945 by the American
      orthopedist Davis. Although widely used by the medical profession and public,
      many physicians find the term objectionable. However, when used appropriately to
      refer only to the mechanism of injury in a motor vehicle accident, the term can
      be worthwhile. In any case, "whiplash" is well-entrenched in usage and is here to
      stay. But what term is used in other languages? Is there a term similar to
      "whiplash?" To determine terms for whiplash injuries in other languages, members
      of the American Academy of Neurology living in non-English-speaking countries
      were contacted by mail. Terms used in 11 other languages are listed. Some
      comments about whiplash injuries by respondents are excerpted. Further cross
      cultural studies may be helpful in studying the influence of physician and
      popular attitudes, as well as litigation on persistent neck complaints and
      headaches after motor vehicle accidents.

PMID- 7775187
TI  - Preventive effects of hyperbaric oxygen in cluster headache.
AB  - The effect of a 2-week course of hyperbaric oxygen on both the duration and
      frequency of cluster headache attacks was tested in four patients suffering from
      chronic cluster headache with no clear response to pharmacological treatments.
      Two patients (two courses in one case) dramatically improved while on hyperbaric
      oxygen treatment, this positive response remaining for 2 and 31 days
      posttreatment. Case 3 only improved in frequency, while the remaining patient
      showed no benefit. These findings suggest that daily hyperbaric oxygen treatment
      can be used as a transient preventive treatment for desperate cluster headache
      sufferers.

PMID- 7775189
TI  - Magnetic resonance imaging in migraine and tension-type headache.
AB  - Cerebral magnetic resonance imaging was performed on 63 patients with chronic
      primary headache (28 with migraine with and without aura, 35 with tension-type
      headache). Fifty-four headache-free individuals of the same age range were used
      as controls. The headache sufferers showed an incidence of focal white matter
      abnormalities on T2-weighted magnetic resonance imaging significantly higher than
      the age-matched control group (33.3% vs 7.4%). The incidence of white matter
      abnormalities did not correlate with age (except for patients older than 60
      years), sex, headache history, headache status, or ergotamine consumption.
      Migraine (with and without aura) and tension-type headache patients had similar
      prevalence of white matter abnormalities (32.1% vs 34.3%). The lesions were
      predominantly distributed in the frontal region, independent of the side of usual
      aura or headache. Our findings indicate that both migraine and tension-type
      headache may be associated with early pathologic changes in the brain and may
      share, at least in part, common pathogenic pathways.

PMID- 7775191
TI  - Headache in a nonclinical population in Dar es Salaam, Tanzania. A community
      based study.
AB  - Headache is a common symptom that constitutes a major health problem to all
      countries in the world with a variable prevalence from about 20.2% in the African
      population to about 80% in populations of the civilized world. Community-based
      studies in African populations are still scanty, and the impact on health
      facility utilization and sickness absence from work is unknown. After a simple
      random selection, 1540 urban workers and students of higher education completed a
      standardized self-administered questionnaire on headache. A total of 815 (52%),
      (620 (51%) men, 195 (60%) women) admitted to having suffered a headache requiring
      medication or medical consultation in the last year. Of these, 366 (23.7%) had
      recurrent headache not attributable to systemic disease. Of the total with
      recurrent headache, there was a significant preponderance of women over men with
      sex prevalence of 28.9% and 22.4%, respectively (X2 P = 0.0001). Combined
      vascular-muscular-type of headache exceeded all types of headache, accounting for
      35.8% of cases, followed by migraine accounting for 30.8% of cases. Organic
      disease was rare, accounting for 8.5% of cases, and psychogenic causes of
      headache were even rarer at less than 1.2% of cases. Within 2 months of onset of
      recurrent headaches, over 32% of sufferers had utilized the health facility at
      their place of work or study. A significant number of cases (175) had an average
      of 11.3 lost work days per year in comparison to a control group of 154 persons
      with an average of 5.7 lost work days per year for reasons other than headache
      (X2 P = 0.0005).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775190
TI  - Improvement of decreased critical flicker frequency (CFF) in headache patients
      with drug abuse after successful withdrawal.
AB  - A considerable proportion of headache patients fulfill the criteria of "drug
      abuse" (definition according to the International Headache Society [IHS]
      criteria). These patients exhibit markedly reduced vigilance and continuous
      performance, as shown by the results of critical flicker frequency (CFF)
      analysis. The present study deals with the question whether this impairment of
      vigilance and continuous performance is reversible. Forty-eight headache patients
      with drug abuse were investigated three times by means of CFF analysis:
      immediately before (A), immediately after (B), and 3 weeks after having finished
      (C) inpatient drug withdrawal. Immediately after withdrawal, a significant
      decrease of headache intensity was observed. The CFF values, however, remained
      unchanged at a depressed level, probably due to withdrawal medication and the
      initial sedative side effects of thymoleptic agents (given as prophylaxis). Three
      weeks after withdrawal, however, the CFF values were significantly improved, and
      were now within a range not far from the normal values known from a healthy
      general population. Thus, even after many years of drug abuse, headache patients
      have a good chance to improve their vigilance and continuous performance and to
      reach normal or close to normal levels.

PMID- 7775192
TI  - Intranasal capsaicin for acute abortive treatment of migraine without aura.

PMID- 7775193
TI  - Postconcussion syndrome.

PMID- 7775195
TI  - Immunohistochemical profile of ovarian inclusion cysts in patients with and
      without ovarian carcinoma.
AB  - The expression of cytokeratin, epithelial membrane antigen, Leu-M1, B72.3,
      carcinoembryonic antigen, human placental lactogen, proliferating cell nuclear
      antigen, p53, and ovarian carcinoma-associated antigen OC-125 was evaluated in
      inclusion cysts in contralateral ovaries of patients with unilateral ovarian
      carcinoma. The findings were compared with the findings in inclusion cysts in
      ovaries of patients without ovarian carcinoma. Although there was more frequent
      expression of tumour markers B72.3 and CEA in patients with ovarian carcinoma,
      these differences did not reach statistical significance.

PMID- 7775197
TI  - Immunohistochemical demonstration of the carbonic anhydrase isoenzymes I and II
      in pancreatic tumours.
AB  - The location of carbonic anhydrase (CA) isoenzymes I, II and VI in normal and
      neoplastic pancreatic tissue was studied using polyclonal antisera and the
      immunoperoxidase technique. Samples were obtained from patients with well
      differentiated (n = 4), moderately differentiated (n = 1) and poorly
      differentiated (n = 4) ductal adenocarcinomas, cystadenocarcinoma (n = 2),
      adenosquamous carcinoma (n = 1), acinar adenocarcinoma (n = 1), gastrinoma (n =
      3), insulinoma (n = 3) and glucagonoma (n = 1). The control specimens were from a
      patient with traumatic laceration of the pancreas. The normal and malignant
      endocrine tissue showed intense positive staining for CA I localized in the cells
      expressing glucagon. In the exocrine pancreatic tissue, CA II was detected in the
      normal and neoplastic ductal epithelium. No specific staining was detected with
      anti-CA VI serum in either normal or malignant tissue.

PMID- 7775196
TI  - Distribution and quantification of alpha 1-integrin subunit in rat organs.
AB  - The alpha 1 beta 1-integrin is known to be a receptor for collagen and laminin
      mediating cell-matrix interactions. A monoclonal antibody, 33.4, which
      specifically inhibits the alpha 1-integrin-mediated in vitro cell-collagen
      binding of rat hepatocytes and hepatoma-derived A-cells (Loster et al., 1994),
      was used to purify by immunoaffinity chromatography the alpha 1-integrin subunit
      from rat liver in large quantities for inducing a polyclonal antiserum. In
      immunoblot analysis on membrane extracts of several rat organs this polyclonal
      antiserum recognized only a 190 kDa-band, suggesting that it is highly specific
      for the alpha 1-integrin subunit. A sandwich-ELISA with monoclonal antibody 33.4
      and the polyclonal antiserum against the alpha 1-integrin subunit, respectively,
      enabled the quantitative expression pattern of the alpha 1-integrin subunit to be
      studied in different rat organs. With the exceptions of brain (not detectable)
      and muscle (low concentration), the alpha 1-integrin subunit was detectable in
      almost all organs of the digestive, respiratory and urogenital system as well as
      in lymphatic organs. The highest relative concentrations of alpha 1-integrin
      subunit were found in uterus, lung and spleen, whereas in seminal vesicle,
      stomach, parotid gland, epididymis, kidney and liver only modest concentrations
      were evident. The organ distribution and localization of alpha 1-integrin subunit
      were studied by immunohistochemistry with monoclonal and polyclonal antibodies.
      Immunoreactivity was present in the plasma membranes of all smooth muscle cells,
      vascular endothelial cells of many organs and fibrocyte-fibroblast sheaths in the
      heart and kidney. Since these cells are in close contact with collagen-containing
      basal membranes as well as reticular fibrils, strong evidence exists that in rat
      tissues the alpha 1-integrin subunit is expressed at sites where collagen is
      present and might be involved in vivo in cell-collagen binding.

PMID- 7775194
TI  - Analysis of enzyme reactions in situ.
AB  - Estimations of metabolic rates in cells and tissues and their regulation on the
      basis of kinetic properties of enzymes in diluted solutions may not be applicable
      to intact living cells or tissues. Enzymes often behave differently in living
      cells because of the high cellular protein content that can lead to homologous
      and heterologous associations of protein molecules. These associations often
      change the kinetics of enzymes as part of post-translational regulation
      mechanisms. An overview is given of these interactions between enzyme molecules
      or between enzyme molecules and structural elements in the cell, such as the
      cytoskeleton. Biochemical and histochemical methods are discussed that have been
      developed for in vivo and in situ analyses of enzyme reactions, particularly for
      the study of effects of molecular interactions. Quantitative (histochemical)
      analysis of local enzyme reactions or fluxes of metabolites has become
      increasingly important. At present, it is possible to calculate local
      concentrations of substrates in cells or tissue compartments and to express local
      kinetic parameters in units that are directly comparable with those obtained by
      biochemical assays of enzymes in suspensions. In situ analysis of the activities
      of a number of enzymes have revealed variations in their kinetic properties (Km
      and Vmax) in different tissue compartments. This stresses the importance of in
      vivo or in situ analyses of cellular metabolism. Finally, histochemical
      determinations of enzyme activity in parallel with immunohistochemistry for the
      detection of the total number of enzyme molecules and in situ hybridization of
      its messenger RNA allow the analysis of regulation mechanisms at all levels
      between transcription of the gene and post-translational activity modulation.

PMID- 7775198
TI  - Histochemical differences of the lectin affinities of backbone polylactosamine
      structures carrying the ABO blood group antigens in papillary carcinoma and other
      types of thyroid neoplasm.
AB  - Endo-beta-galactosidase from Escherichia freundii cleaves linear polylactosamine
      structure as follows: R-GlcNAc-beta 1-3Gal-beta 1-4GlcNAc-beta 1-R' + H2O-->R
      GlcNAc-beta 1-3Gal + GlcNAc-beta 1-R'. Staining with Griffonia simplicifolia
      agglutinin II (GSA-II) following enzyme digestion reveals the distribution of R
      GlcNac-beta 1-3Gal-beta 1-4GlcNAc-beta 1-R' structures in tissue sections. In
      this study, the procedure was applied to formalin-fixed, paraffin-embedded tissue
      sections from 26 cases of papillary carcinomas including 2 follicular variants, 8
      follicular carcinomas, 7 adenomas, 1 anaplastic carcinoma and 1 medullary
      carcinoma in order to investigate whether different types of polyactosamine
      containing structure are produced in these thyroid neoplasms. Simultaneously, the
      susceptibility of the ABH antigens expressed in these neoplastic cells to endo
      beta-galactosidase digestion was examined. Most of the papillary carcinoma cells
      from all the individuals examined were strongly stained by GSA-II following
      enzyme digestion. Without enzyme digestion, little or no reactivity with GSA-II
      was observed. Among other types of neoplasms, only one case of follicular
      carcinoma exhibited reactivity with GSA-II following enzyme digestion. ABH
      antigens were expressed in 22 cases of papillary carcinomas, 2 adenomas, 5
      follicular carcinomas and 1 anaplastic carcinoma, and their expression was
      dependent on the ABO blood group of the patients. Endo-beta-galactosidase
      digestion resulted in the elimination of these antigens not only in papillary
      carcinomas but also in other neoplasms.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775199
TI  - Wet autoclave pretreatment for immunohistochemical demonstration of oestrogen
      receptors in routinely processed breast carcinoma tissue.
AB  - The immunohistochemical demonstration of oestrogen receptor (OR) was performed on
      32 randomly selected and routinely processed breast carcinomas after wet
      autoclave pretreatment of sections. The autoclave method was compared to the OR
      status found on frozen sections as well as to alternative pretreatment methods
      such as enzymatic predigestion and microwave irradiation. Using four different
      monoclonal antibody clones (H222, LH1, CC4-5, 1D5.26), the OR status was
      evaluated for each of the various pretreatment methods applied. All cases with a
      high OR content on frozen sections (n = 11) also showed a high OR status on wet
      autoclave-pretreated paraffin tissues using antibody clones 1D5.26 and CC4-5; in
      cases with low OR content on frozen sections, no false-negative cases were
      recorded using only the antibody 1D5.26 neither after wet autoclave nor microwave
      pretreatment. In addition, with this antibody, OR was detectable after autoclave
      pretreatment in two cases which were considered to be OR-negative even on frozen
      sections. When the primary antibody was omitted, no false-positive cases were
      observed after wet autoclave pretreatment. Thus, in our hands, wet autoclave
      pretreatment, in combination with the antibody 1D5.26, offers a highly sensitive
      method for the immunohistochemical demonstration of OR in routinely formalin
      fixed, paraffin-embedded sections of breast carcinomas.

PMID- 7775200
TI  - Immunohistochemical detection of oncoprotein 18 (Op18) in malignant lymphomas.
AB  - Expression of oncoprotein 18 (Op18), an intracellular phosphoprotein up-regulated
      in many malignant cell types, was evaluated in a series of normal lymphoid tissue
      and malignant lymphomas. In normal tonsils and reactive lymph nodes, the majority
      of Op18-positive cells were present in the germinal centres, whereas cells in the
      mantle zone were essentially negative and the interfollicular areas showed
      occasional positive cells. Double staining for PCNA and Op18 revealed that Op18
      expression only to some extent was correlated with cell proliferation, as
      determined by PCNA expression. Non-Hodgkin's lymphomas exhibited a variable Op18
      expression, and in Hodgkin's disease, Reed-Sternberg and Hodgkin cells frequently
      expressed Op18 with a strong staining intensity. Using Op18-PCNA double staining
      in malignant lymphomas, Op18 expression could also be partially dissociated from
      cell proliferation. By using confocal microscopy, the intracellular localization
      of Op18 was studied, demonstrating diffuse reactivity in the cytoplasm in
      interphase cells and during mitosis, whereas nuclei and condensed chromosomes
      were negative. In conclusion, Op18 was expressed at variable levels in most,
      perhaps all, proliferating lymphocytes in benign lymphoid tissue as well as in
      malignant lymphomas. However, the Op18 protein was also detected in a significant
      fraction of apparently non-cycling normal and neoplastic lymphocytes.

PMID- 7775202
TI  - Widowhood: a painful intrusion into the analytic space.

PMID- 7775201
TI  - Distribution of vasoactive intestinal peptide-like immunoreactivity in the taste
      organs of teleost fish and frog.
AB  - Using immunohistochemistry, vasoactive intestinal peptide (VIP) was visualized in
      taste bud cells of the carp, Cyprinus carpio, and the European catfish, Silurus
      glanis, by means of light and electron microscopy. Intracellular membrane
      systems, presumably smooth endoplasmic reticulum, of light (sensory) cells, but
      not of dark (supporting) cells and basal cells, were densely labelled with
      antibody. In the frog (four species: Rana temporaria, R. ridibunda, R. arvalis,
      R. pipiens), taste bud cells did not label. However, the dense basal nerve fibre
      plexus, some subepithelial ganglionic cells, but no ascending intragemmal fibres,
      were immunoreactive. In fish, the results support evidence that VIP is involved
      in the modulation of taste transduction at the level of receptor cells. In the
      frog, an indirect, possibly vasodilatatory effect on taste perception may be
      considered.

PMID- 7775203
TI  - Psychoanalytic theories of infant differentiation of self and other.
AB  - Traditional psychoanalytic theories of infancy were challenged a number of years
      ago by Peterfreund (1978) and Milton Klein (1980), but published debate on this
      issue has only recently begun to appear. The main purpose of this paper is to
      respond to Zuriff's (1992) argument that new data from recent observational
      research on infants fails to refute earlier theories of infancy. The following
      quote from Zuriff is a good introduction to the topic: "For many years, a
      frequent and consistent criticism of psychoanalytic theory is that it is not
      testable (Nagel, 1959; Popper, 1962). That is, no matter what the evidence,
      psychoanalytic theories can always be maintained because they are too vague,
      incomplete, and indeterminate to be falsified. Yet, in the area of contemporary
      psychoanalytic theory of infancy, we seem to have a counterexample to this
      criticism. Supporters of the new theories claim that the experimental evidence
      refutes older psychoanalytic notions of infancy, such as normal autism and
      symbiosis, and establishes a different model, that of the 'competent infant.'"
      (p. 19).

PMID- 7775204
TI  - The impact of psychoanalytic values on transference and countertransference: a
      study in transcultural psychotherapy.
AB  - In transcultural psychoanalytically oriented treatments, the therapist must
      consider differences between the cultures of origin of both patient and
      therapist. The therapist also must be aware of a third relevant culture that
      affects the patient-therapist dyad: the psychoanalytic culture. The effect of the
      psychoanalytic culture and its values on the development of transference and
      countertransference is illustrated in three clinical vignettes from transcultural
      treatments. The authors offer suggestions for dealing with problems that arise
      because of discrepancies between the psychoanalytic cultural values and the
      patient's cultural values.

PMID- 7775206
TI  - Leopold von Sacher-Masoch and masochism.

PMID- 7775205
TI  - Regression and reparation in religious experience and therapy.

PMID- 7775209
TI  - A view of the moral landscape of psychoanalysis.

PMID- 7775207
TI  - From the ecclesiastical to the profane: foot fetishism in Luis Bunuel and Alain
      Robbe-Grillet.

PMID- 7775208
TI  - Psychoanalysis and faith.

PMID- 7775210
TI  - The Oedipus complex: some observations and questions regarding its validity and
      universal existence.

PMID- 7775212
TI  - Special issue based on a symposium on Developmental Psychophysiology at the 7th
      International Congress of Psychophysiology of the International Organization of
      Psychophysiology. Porto Carras, Macedonia, Greece, 27 September-2 October 1994.

PMID- 7775211
TI  - Substance abuse: the role of depression and trauma--a case report.
AB  - Substance abuse is associated diagnostically with existing depression,
      pathological mourning of the traumatic event itself, with the inevitable
      experience of object loss, and loss of love. Inability to form object
      representation insures primitive lack of object constancy, resulting in pre
      oedipal longing and neediness and malignant affect. Ambivalence towards the
      sadistic love objective is recognized and allows for a healthier, more complete
      period of mourning (Freud, 1917). Indeed, depression is banished from family
      acknowledgement in the service of homeostatic denial. This only reinforces the
      identified patient's feeling of unreality, shame and guilt over verbalizing the
      depression and the frequent underlying traumatic history. The enormous role of
      socio-economic stress is pervasive, yet the focus here is on individuals with
      complex dynamic constellations which are often ignored in the face of external
      factors. Addiction as attempt to self-medicate depression and trauma remains the
      overarching theme.

PMID- 7775214
TI  - Syndromes of schizophrenia and schizotypy, hemispheric imbalance and sex
      differences: implications for developmental psychopathology.
AB  - Progress is reviewed on the elucidation of the neuro-psychophysiological basis of
      a three-syndrome model of symptom expression in schizophrenia (Active, Withdrawn,
      Unreality), the first two syndromes of which were associated with an imbalance in
      activity between the hemispheres (Gruzelier, 1984). Recent work has discovered a
      similar three-syndrome structure to schizotypy in the normal population, and in
      keeping with the activation connotations of the Active and Withdrawn syndromes
      differences on self-report arousal scales were found. The same syndromes in
      normals were also associated with handedness, unlike the third Unreality syndrome
      which cognitive measures have shown to be inconsistently lateralised. Gender is
      known to be of fundamental importance to the form and expression of
      schizophrenia. Here sex differences had an important bearing on the syndrome
      hemispheric imbalance relations which were stronger in males, while females had
      higher scores on the Unreality syndrome. Cognitive asymmetry patterns measured
      with recognition memory tests of lateralised temporoparietal functions disclosed
      a word > face cognitive asymmetry in females and a face > word asymmetry in
      males; asymmetries which were found to characterise androgynous individuals and
      feminine males. The results are in keeping with the relevance of the
      temporoparietal region to sexual dimorphism in brain structure and function, and
      by virtue of hippocampal connections, possible influences of hormones on brain
      development.

PMID- 7775215
TI  - Sex and occupation as markers for task performance in a dichotic measure of brain
      asymmetry.
AB  - The present experiment tested dichotic listening performance in four groups of
      subjects: males and females working in occupations carried out most commonly by
      males, and males and females working in occupations most commonly carried out by
      females. It was hypothesized that both males and females in male-typical
      occupations would produce a similar pattern of performance in a dichotic task,
      that is, they would produce a marked right ear advantage (REA), reflecting a more
      asymmetric hemisphere organisation, while males and females in female-typical
      occupations would show a reduced REA reflecting less asymmetrically distributed
      underlying neural structures. The experimental results supported the hypothesis
      and are interpreted as support for a dimensional view of neurological sexual
      differentiation.

PMID- 7775213
TI  - New directions in developmental psychopathology.

PMID- 7775216
TI  - The maturational theory of brain development and cerebral excitability in the
      multifactorially inherited manic-depressive psychosis and schizophrenia.
AB  - An association has been established between the multifactorially inherited rate
      of physical maturation and the final step in brain development, when some 40% of
      synapses are eliminated. This may imply that similarly to endocrine disease
      entities, we have cerebral disease entities at the extremes of the maturational
      rate continuum. The restriction of prepubertal pruning to excitatory synapses
      leaving the number of inhibitory ones fairly constant, implies changes in
      cerebral excitability as a function of rate of maturation (age at puberty). In
      early maturation there will be an excess in excitatory drive due to prematurely
      abridged pruning, which compounds a synchronization tendency inherent in
      excessive synaptic density. Lowering excitatory level with antiepileptics is
      hypothesized to be a logical treatment in this type of brain dysfunction. In late
      maturation, a deficit in excitatory drive due to failure to shut down the pruning
      process associated with a tendency to the breakdown of circuitry and
      desynchronization, adds to a similar adversity inherent in reduced synaptic
      density. Raising the excitatory level with convulsants is hypothesized to be the
      treatment for this type of CNS dysfunction. The maturational theory of
      Kraepelin's psychoses holds that they are naturally occurring contrasting
      chemical signaling disorders in the brain at the extremes of the maturational
      rate continuum: manic depressive psychosis is a disorder of the early maturer and
      comprises raised cerebral excitability and a raised density of synapses. This is
      successfully treated with anti-epileptics like sodium valproate and carbamazepin.
      Schizophrenia is a disorder in late maturation with reduced cerebral excitability
      and reduced synaptic density. This is accordingly treated with convulsants such
      as typical and atypical neuroleptics. However, the conventional effective
      treatments in both disorders act on inhibition only by either lowering or raising
      inhibitory level. While the neuroleptics drugs are superior anti-psychotics they
      nevertheless do not affect the deviation in cerebral excitability which would
      explain why they do not cure. Disturbed circadian rhythms which precede psychotic
      episodes in manic depressives accord with a primary dysfunction in the CNS, the
      suprachiasmatic nucleus of the hypothalamus via its direct input the
      glutamatergic retinohypothalamic tract. The residual deficits in schizophrenia
      accord with persistently disconnected circuitry and communication which is a
      consequence of reduced excitatory level and is manifested in insufficient
      motivation, a reduced drive associated hypofunction, and neuromuscular
      dysfunction.

PMID- 7775217
TI  - Deviation in cerebral excitability: possible clinical implications.
AB  - Schizophrenia, a chemical signaling disorder in the brain, is also a
      deteriorating neurological disorder. The deficit in cerebral excitability, and
      associated reduced synaptic density, imply a risk of cortical breakdown of
      circuitry accompanied by an insufficient fill-in mechanism, and persistent silent
      spots, but no total loss of function, only dysfunction. This is subjectively
      experienced as deficiencies of cognition, perception and sensorimotor phenomena
      depending upon localization and connections of the disconnected circuitry.
      Considering the adversity inherent in this neural network, both the fast Hebbian
      pre-post form of learning and the slow pre-modulatory coincidence form of
      learning are probably impaired. The use of Feed Back Loops which usually govern
      our behaviour might also be impaired. In addition, we have to consider the daily
      problem of insufficient drive and motivation. Manic depressive psychosis, a
      chemical signaling disorder in the brain, is a true functional psychosis. The
      raised excitatory drive and raised synaptic density imply raised risk of
      uncoupling of circadian rhythms via the direct glutamatergic input to the
      suprachiasmatic nucleus of hypothalamus (SCN). This episodic brain stem
      dysfunction illustrates how a deficit in inhibition renders the brain unstable.
      The requirements of the fast Hebbian form of learning should easily be met, and
      neither should the slow forms of learning present a problem in networks
      characterized by excessive density.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775218
TI  - Functional brain asymmetry, handedness and menarcheal age.
AB  - Functional brain asymmetry influences many functions of the organism; the
      neuroendocrine axis is one that has received insufficient attention. In this
      study we set us as the goal of studying the link between functional brain
      asymmetry and menarcheal age in females with left versus right manual dominance.
      The appearance of the first menarche was used as a natural model of functioning
      of the hypothalamic-pituitary-gonadal (HPG) axis. 1695 females, aged between 16
      and 25 years, were interviewed by questionnaire about manual dominance and
      menarcheal age. 182 women were selected and divided into 2 groups: all left
      handers (n = 91), and a control group of 91 right-handers. We found a
      significantly lower average age of menarcheal appearance in the left-handers' age
      of 12.09 +/- 0.16 years compared to the right-handers' age of 13.32 +/- 0.12
      years (p < 0.001). The earliest menarcheal age in left-handers was 8 years and
      the peak of appearance at age 13 (in 30.76% of the cases). In right-handers these
      values were 10 and 14 years (in 40.60% of the cases), respectively. The data
      allow us to accept the existence of a link between functional brain asymmetry and
      menarche, which causes earlier activation of the HPG axis in left-handed females.

PMID- 7775219
TI  - Patterns of cognitive asymmetry and psychosis proneness.
AB  - We previously reported evidence in university students of three syndromes of
      schizotypy which have strong affinities with three-syndrome models of
      schizophrenia. As in schizophrenia two of the syndromes were associated with
      opposite hemispheric asymmetry patterns: an Active syndrome with a left > right
      asymmetry, and a Withdrawn syndrome with a right > left asymmetry. The third
      Unreality syndrome bore no consistent relation to pattern of asymmetry. Cognitive
      asymmetry was measured by comparing recognition memory for words with memory for
      unfamiliar faces using a neuropsychological test which assesses temporoparietal
      functions. Here the same approach was extended to the broader concept of
      psychosis proneness with a new inventory with four subscales: Introvertive
      Anhedonia, Impulsive Nonconformity. Unusual Experiences, and Cognitive
      Disorganisation. In support of the relevance of an activation dimension to
      cognitive asymmetry, Impulsive Nonconformity was associated with word > face
      superiority, as was a self report measure of Energy. Introvertive Anhedonia was
      associated with face > word superiority. As in schizophrenia these predicted
      asymmetry relations were significant in males only. Neither the Unusual
      Experiences nor Cognitive Disorganisation subscales were associated with
      cognitive asymmetry.

PMID- 7775220
TI  - Visual processing, lateralization and syndromes of schizotypy.
AB  - There is an association between positive features of schizotypy and dyslexia,
      largely involving distortions of visual and auditory perception and associated
      cognitive anomalies. In dyslexia, there is strong evidence for a disorder of
      subcortical magnocellular pathways, which may underlie these perceptual
      aberrations. Here we investigated visual processing in relation to three
      syndromes of schizotypy-Active, Withdrawn and Unreality-in normal adults, using a
      "dot localization" test of visual direction sense on which dyslexics perform
      poorly, and which should be sensitive to magnocellular dysfunction. Results
      showed that increased error scores were associated with both the positive
      syndromes, Active and Unreality, which in this study were highly correlated.
      There were also interactions between each syndrome and the direction of errors,
      such that high scorers on the Unreality and Active syndromes made more errors on
      leftward trials, while high Withdrawn subjects made fewer left and more right
      errors. Mixed handers also showed poorer performance than consistent handers. The
      evidence of poor visual direction sense in relation to positive syndromes of
      schizotypy and mixed handedness is consistent with the previous results for
      dyslexics, who also show these features. The opposite lateralization of errors in
      the positive v negative syndromes of schizotypy is in keeping with the model of
      hemisphere imbalance and patterns of cognitive asymmetry which distinguish Active
      from Withdrawn syndromes. These results are considered in relation to the
      proposal that a disorder of magnocellular function may underlie the perceptual
      distortions which are common to dyslexia and positive syndromes of schizotypy.

PMID- 7775221
TI  - Developmental dyslexia, neural timing and hemispheric lateralisation.
AB  - Approximately 5% of 8-10-year-olds experience exceptional difficulties learning
      to read (developmental dyslexia). This usually has a congenital basis; it runs in
      families, and affects 4 times as many boys as girls. Dyslexics typically show
      impairment both in phonemic segmentation (the subdivision of speech beyond the
      natural syllabic level) and in sequencing small visual symbols. Both these skills
      draw upon the ability of the nervous system to time sensory events precisely. A
      specific magnocellular cell type which expresses a distinctive surface antigen
      plays a crucial role in these functions. The development of this cell line is
      probably congenitally impaired in dyslexics. Visually they have lowered flicker
      and motion sensitivity, and disorder of the magnocellular layers of the Lateral
      Geniculate Nucleus can be seen post mortem. Likewise they have lowered
      sensitivity to changes in frequency and amplitude of sounds, hence impaired
      discrimination of speech sounds. These disorders are associated with abnormal
      hemispheric lateralisation in these subjects, e.g. dyslexics show reduction or
      reversal of the usual left > right asymmetry of the planum temporale. Many of
      these characteristics of impaired magnocellular function and reversed hemispheric
      asymmetry are found not only in dyslexic children but also in developmental
      dysphasics, autistics, high schizotypes and schizophrenics. I will speculate
      therefore that normal magnocellular development promotes normal hemispheric
      asymmetry and that impaired magnocellular development is responsible for a
      spectrum of problems associated with impaired hemispheric specialisation, ranging
      from the mildest, dyslexia, to the most severe, schizophrenia.

PMID- 7775222
TI  - Dyslexia, handedness and syndromes of psychosis-proneness.
AB  - In an earlier study, adult dyslexia was found to be strongly associated with
      positive schizotypal traits, and particularly with unusual perceptual
      experiences. However, recent evidence suggests that the structure of psychosis
      proneness in normals may involve three or four distinct yet related dimensions.
      Therefore a further study was conducted, using a wider range of measures, to
      explore associations between dyslexia and these different syndromes of psychosis
      proneness. Relationships with handedness were also investigated. If three
      syndromes of psychosis-proneness were delineated, broadly corresponding to
      "Active", "Withdrawn" and "Schneiderian/Unreality" syndromes of schizophrenia,
      dyslexics showed elevations on both positive syndromes (Active and Unreality),
      but not on the negative, Withdrawn syndrome. With a four-factor model only one
      dimension, perceptual/cognitive anomalies, distinguished dyslexics from controls.
      These findings confirm an association between dyslexia and positive, but not
      negative, schizotypal traits. Mixed-handedness was strongly associated with
      dyslexia, and in controls with those measures of psychosis-proneness involving
      unusual perceptual experiences. This suggests that reduced lateralization may be
      a feature common to both dyslexia and the Unreality syndrome of schizotypy, which
      may help to account for the strong relationship between them.

PMID- 7775223
TI  - Auditory event-related potentials, dichotic listening performance and handedness
      as indices of lateralisation in dyslexic and normal readers.
AB  - Evidence suggests that children with developmental dyslexia have poor
      phonological processing skills, are less likely to show lateralised activation
      during the processing of verbal information than children with normal reading
      ability and tend towards the left of the handedness continuum. The present study
      investigated this relationship between cerebral lateralisation and reading
      ability in children with and without dyslexia, directly using a dichotic
      listening paradigm with contemporaneous recording of auditory evoked potentials
      and indirectly using measures of hand preference and hand skill. The two groups
      were significantly different on a phonemic awareness task, particularly with
      reference to rime rather than phoneme onset. The two groups performed equally
      well on the dichotic listening task. However, normal readers produced
      significantly greater N100 amplitudes in the left temporal region during dichotic
      listening than the dyslexics who displayed approximately equivalent levels of
      amplitude bilaterally. In terms of hand preference the dyslexics were
      significantly less right-hand preferent than the controls, although the groups
      did not differ on a measure of right/left hand skill. The AEP lateralisation
      indices and the hand preference scores were significantly related to phonemic
      awareness performance. The different patterns of AEP activity produced by the two
      groups of children during the dichotic listening task and the differences in hand
      preference may be related to abnormal cerebral lateralisation of language
      functions. The failure of the dichotic listening task to discriminate between the
      two groups in spite of evidence of differences in cortical activation suggests
      that the processing difficulties which may be indexed by these differences in
      cortical activation affect the reading process at a later stage than that tapped
      by dichotic listening.

PMID- 7775224
TI  - Humankind's uses of animals.

PMID- 7775225
TI  - Food safety considerations.

PMID- 7775226
TI  - Vagal indigestion.

PMID- 7775227
TI  - Earth Day participants slap the hand that feeds them.

PMID- 7775228
TI  - The ethics and etiquette of good gossip.

PMID- 7775229
TI  - What is your diagnosis? Rodenticide toxicosis causing soft tissue swelling
      ventral to the hyoid bones and larynx.

PMID- 7775230
TI  - Trends in veterinarians' professional income, 1983 to 1993.

PMID- 7775232
TI  - Results of surgery and doxorubicin chemotherapy in dogs with osteosarcoma.
AB  - Thirty-five dogs with appendicular osteosarcoma were treated with 5 doses of
      doxorubicin (30 mg/m2 of body surface, i.v., every 2 weeks). Surgical excision of
      the primary tumor was performed 13 days after the second (n = 18) or third (n =
      17) treatment, and the subsequent doxorubicin treatment was given the day
      following surgery. Resected tumors were evaluated histologically to determine
      response to preoperative chemotherapy (ie, percentage of the tumor that was
      necrotic). Survival data for the 35 dogs were compared with survival data for a
      historical control group, consisting of 162 dogs with appendicular osteosarcoma
      treated by amputation alone. Administration of doxorubicin at 2 week intervals
      was well tolerated. Three dogs were alive and did not have evidence of disease at
      the time of reporting. Of the remaining 32 dogs, 3 died or were euthanatized
      because of cardiomyopathy presumably caused by doxorubicin; 1 died suddenly 116
      weeks after initiation of treatment; and the remaining 28 were euthanatized
      because of problems documented to be related to distant metastases. Thirteen dogs
      (40.6%) were euthanatized because of pulmonary metastases, 10 dogs (31.3%) were
      euthanatized because of bone metastases, and 5 dogs (15.6%) were euthanatized
      because of metastases in other sites. The proportion of dogs euthanatized because
      of bone metastases was significantly (P < 0.001) higher for the study group than
      for the control group. Median survival time for the 35 dogs that received
      doxorubicin was estimated to be 52.3 weeks, and 1- and 2-year survival rates were
      estimated to be 50.5 and 9.7%, respectively. Survival time was significantly (P <
      0.0001) longer for these dogs than for control dogs.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7775231
TI  - Efficacy of, and toxicoses associated with, oral idarubicin administration in
      cats with neoplasia.
AB  - Idarubicin, a new synthetic anthracycline analogue, was administered orally to 34
      cats with spontaneous tumors. The maximum tolerated dosage was determined to be 2
      mg/cat/d given for 3 consecutive days every 3 weeks. Anorexia and leukopenia were
      found to be dose limiting in cats receiving the drug at a higher dosage. The most
      common toxicoses seen at the maximum tolerated dosage were leukopenia, anorexia,
      and vomiting; however, development of toxicoses was not found to be associated
      with sex, FeLV test result, tumor type, dosage, age, or weight. Idarubicin (2
      mg/cat/d for 3 days, q 3 wks) was used to treat 18 cats with lymphoma in which
      complete remission had been achieved by administration of other chemotherapeutic
      agents. Median remission duration for these cats was comparable to that reported
      for cats treated with other protocols. We concluded that orally administered
      idarubicin would be useful in the treatment of cats with lymphoma.

PMID- 7775233
TI  - Chylothorax associated with constrictive pericarditis in a dog.
AB  - Chylothorax was associated with constrictive pericarditis in a 6-year-old mixed
      breed dog. Clinical signs included hepatomegaly, bilateral jugular pulses,
      muffled heart sounds, and dyspnea. Pleural effusion was identified on thoracic
      radiographs. Thoracentesis yielded 3 L of chylous effusion, confirmed by the
      cholesterol/triglyceride ratio (0.14). Echocardiography revealed a thickened
      pericardium, with numerous fibrin tags, which was suggestive of constrictive
      pericarditis. Central venous, right atrial, and right ventricular pressures were
      high and on right ventricular diastolic pressure tracings, the square-root sign,
      which is indicative of constrictive pericarditis, was evident. Exploratory
      thoracotomy and pericardiectomy were performed. Histopathologic findings were
      consistent with chronic non-suppurative pericarditis. The dog's condition
      improved after surgery. On reevaluation 11 months later, central venous pressure
      and results of physical examination and thoracic radiography were normal. On the
      basis of these findings, we concluded that chylothorax was caused by constrictive
      pericarditis in this dog. Chylothorax is often associated with disorders that
      have a poor prognosis, but if constrictive pericarditis can be identified as the
      cause of the chylothorax, exploratory thoracotomy and pericardiectomy can provide
      a cure.

PMID- 7775234
TI  - Hyperkalemia associated with potassium chloride administration in a cat.
AB  - Addition of appropriate amounts of potassium chloride solution to fluid
      administered i.v. resulted in hyperkalemia in a cat. To evaluate whether
      incomplete mixing of potassium chloride in the fluid might have resulted in the
      observed hyperkalemia, 40 mEq (20 ml) of potassium chloride solution was injected
      into each of three 1-L vinyl bags of 5% dextrose in water, with or without
      attempting to mix the additive with the fluid in the bag. Measurement of
      potassium concentrations in the bags revealed that injecting potassium chloride
      solution into a bag of fluid while that fluid is being administered can result in
      incomplete mixing and discharge of concentrated potassium chloride from the
      administration set. The greatest potassium concentration measured in fluid
      sampled from the administration set was 194 mEq/L.

PMID- 7775236
TI  - Glioma in a goat.
AB  - An adult goat was examined because of behavioral changes and circling. Results of
      neurologic examination, CSF analysis, hematologic evaluation, and computed
      tomography of the brain were suggestive of an intra-axial mass. The goat was
      euthanatized because of worsening neurologic condition and poor prognosis.
      Necropsy revealed a large mass in the right cerebral hemisphere and caudal brain
      herniation through the foramen magnum. The mass was diagnosed as a glioma, with
      oligodendrocyte differentiation. Results of immunohistochemical evaluation were
      compatible with a malignant, poorly differentiated tumor.

PMID- 7775235
TI  - Use of mesenteric lymphangiography in a calf with chylothorax and
      chyloperitoneum.
AB  - Lymphatic abnormalities resulting in chylous effusion into a body cavity are
      uncommon in domestic animals. In a 6-day-old calf admitted to our hospital
      because of failure to suckle and abdominal distention, however, mesenteric
      lymphangiography revealed an obstruction of lymphatic flow. Laparoscopic
      examination of the abdomen was unsuccessful. Fluid accumulation was resolved in
      this calf by drainage. In cattle with chylothorax and concurrent chyloperitoneum
      in which a traumatic lesion of the thoracic duct is possible, conservative
      management, with drainage and supportive treatment, should be attempted prior to
      considering surgical intervention.

PMID- 7775237
TI  - Effect of surgical removal of subcutaneous tumors on survival of rats.
AB  - Mammary and other subcutaneous tumors were surgically removed from aged Sprague
      Dawley rats in an attempt to extend survival. The surgical technique was
      straightforward, and survival following mastectomy was good (17/21). The number
      of mammary and pituitary tumors in sexually intact rats and those that had
      previously undergone ovariectomy were compared. The frequency of mammary tumors
      was significantly lower in ovariectomized vs sexually intact rats (2/47 vs
      24/49), as was the frequency of pituitary adenomas (2/46 vs 27/41). Survival to
      630 days of age was higher in ovariectomized than in sexually intact rats (42/47
      vs 29/49), although tumors did not contribute significantly to mortality.

PMID- 7775238
TI  - Uveal malignant melanoma in a duck.
AB  - An adult male Muscovy (Cairina moschata) X Peking (Anas platyrhynchos) duck had a
      primary malignant uveal melanoma with periocular extension involving the left
      eye. The periocular mass displaced the globe 1.5 cm laterally. Thoracic
      metastasis of the ocular neoplasm infiltrated the pectoral muscles, rib cage, and
      cranial lung lobe on the left side, causing diminished voluntary motion of the
      left wing. The left orbit was exenterated, but tumor regrowth was evident within
      2 weeks. This case was unusual because melanocytic neoplasms are rare in birds.

PMID- 7775239
TI  - Escherichia coli O157:H7.

PMID- 7775241
TI  - Chronicles of a feisty public health veterinarian.

PMID- 7775240
TI  - More information on hematologic characteristics of greyhounds.

PMID- 7775242
TI  - Pathogenesis of bluetongue virus infection of cattle.

PMID- 7775243
TI  - What is your diagnosis? Intracranial cavitary lesion.

PMID- 7775244
TI  - What is your neurologic diagnosis? An atypical case of diskspondylitis caused by
      Aspergillus spp.

PMID- 7775245
TI  - The limits of confidentiality: a veterinarian's duty to report disease, cruelty,
      and theft.

PMID- 7775246
TI  - Plasmid profiles and resistance to antimicrobial agents among Salmonella
      enteritidis isolates from human beings and poultry in the midwestern United
      States.
AB  - In the study reported here, 121 Salmonella enteritidis isolates from human beings
      and 467 isolates from nonhuman sources were analyzed for plasmid pattern and
      susceptibility to a panel of antimicrobial agents commonly used as biologic
      markers. A significant (P < 0.05) number of isolates from nonhuman sources were
      resistant to beta-lactam antibiotics and tetracycline. Resistance to
      aminoglycosides, quinolones, and trimethoprim/sulfamethoxazole was uncommon. Of
      the 588 isolates, 445 (76%) were resistant to 2 or more antimicrobial agents.
      Sixty of 121 (50%) S enteritidis isolates from human beings were susceptible to
      all 12 antimicrobial agents, but 425 of 467 (91%) S enteritidis isolates from
      nonhuman sources expressed resistance to 1 or more of the antimicrobial agents
      used in the study. Analysis of plasmid profiles revealed that significantly (P <
      0.05) more isolates from nonhuman sources had high molecular weight plasmids than
      did isolates from human beings. Isolates from ceca of chickens were associated
      with patterns of low molecular weight plasmids. Analysis of results of the study
      revealed similarities among S enteritidis from human beings and eggs, as
      determined on the basis of plasmid profiles and antibiotic susceptibility
      patterns, which may implicate eggs as one of the potential sources for infection
      of human beings. In addition, periodic monitoring of a substantial number of
      Salmonella isolates to detect drug resistance may be a prudent practice for use
      in revising the list of antimicrobial agents commonly used in human beings and
      other animals.

PMID- 7775247
TI  - Evaluation of results of preoperative urodynamic measurements in nine dogs with
      ectopic ureters.
AB  - Cytometrographic studies and urethral pressure profiles were performed to
      objectively assess the functional status of the urinary bladder and urethra in 9
      dogs with congenital ectopic ureters. Functional abnormalities of the urinary
      bladder or urethra were detected in 8 of 9 (89%) dogs. Cystometrographic evidence
      of reduced bladder capacity was detected in 4 (44%) dogs, and abnormalities in
      urethral pressure profiles were consistent with urethral incompetence in 6 (67%)
      dogs. Dogs with urethral pressure profile abnormalities were treated with
      phenylpropanolamine hydrochloride, and the urethral pressure profile was
      reevaluated. Urethral pressure measurements obtained before surgery (3 dogs) and
      after phenylpropanolamine (6 dogs) were used to predict the likelihood of
      continence after surgery. Predicted outcomes included continence maintained
      without medication (3 dogs), continence maintained with phenylpropanolamine (2
      dogs), and persistent incontinence despite phenylpropanolamine administration (4
      dogs). After surgical repair of ectopic ureters, 2 of 9 (22%) dogs were continent
      without medication, and 2 (22%) maintained continence with phenylpropanolamine
      treatment. Various degrees of incontinence persisted in 5 of 9 (56%) dogs, 4 of
      which had urethral incompetence that had been documented as poorly responsive to
      phenylpropanolamine administration prior to surgery. Predicted outcomes were
      consistent with actual outcomes in 8 of 9 (89%) dogs, with predictions of
      incontinence proving accurate in 4 of 4 (100%) dogs and predictions of continence
      proving accurate in 4 of 5 (80%) dogs. Urodynamic assessment of dogs with ectopic
      ureters appears to be valuable for identifying concurrent functional
      abnormalities of the urinary bladder and urethra and for predicting postoperative
      outcome.

PMID- 7775248
TI  - An acute hemolytic transfusion reaction caused by dog erythrocyte antigen 1.1
      incompatibility in a previously sensitized dog.
AB  - An acute hemolytic transfusion reaction resulting from dog erythrocyte antigen
      (DEA) 1.1 incompatibility developed in a dog previously sensitized to DEA 1.1 by
      a transfusion 3 years earlier. The dog developed fever, pigmenturia, and
      lethargy, and its PCV did not rise as expected. The donor blood was type DEA 1.1
      positive, whereas the recipient's blood was type DEA 1.1, DEA 1.2, and DEA 7
      negative. A major crossmatch was later found to be strongly incompatible. Studies
      of the recipient's plasma revealed a specific anti-DEA 1.1 alloantibody of the
      IgG class with high hemolysin and agglutinin activity. Such acute hemolytic
      transfusion reactions can be avoided by crossmatching previously transfused dogs
      and by using dogs that are type DEA 1.1 negative (and preferably also type DEA
      1.2 and DEA 7 negative) as blood donors.

PMID- 7775249
TI  - Survival of a domestic cat with naturally acquired cytauxzoonosis.
AB  - A cat with acute onset of febrile systemic illness was determined to be infected
      with Cytauxzoon felis. The diagnosis was made on the basis of cytologic
      morphology of erythroparasites seen in blood smears and results of
      microfluorometric immunoassay for serum antibody directed against C felis
      parasitized RBC. Treatment consisted of parenteral administration of fluids and
      antibiotics. The cat recovered within 2 weeks. Circulating erythroparasites were
      not detected on blood smears from samples collected during follow-up
      examinations. However, high serum antibody titer persisted for at least 15 weeks
      after infection. The cat continued to be free of clinical disease 2.5 years after
      the initial diagnosis. Whether C felis infection persists in this cat has yet to
      be determined. This case indicates that some domestic cats can recover from
      naturally acquired cytauxzoonosis.

PMID- 7775250
TI  - Streptococcal fibrinous pericarditis and peritonitis in a Vietnamese pot-bellied
      pig.
AB  - An 8-month-old female Vietnamese pot-bellied pig was examined because of a 48
      hour history of anorexia and signs of depression. Hypothermia, dehydration,
      pronounced respiratory effort, and muffled heart sounds were detected. Abdominal
      ultrasonography revealed ascites and hepatic congestion. Echocardiography
      revealed pericardial effusion and fibrinous pericarditis. Ultrasound-guided
      pericardiocentesis was diagnostic and therapeutic. Cytologic examination of
      pericardial and peritoneal fluid revealed degenerated neutrophils and intra-and
      extracellular gram-positive cocci. On microbial culture of pericardial and
      peritoneal fluid specimens, moderate growth of a beta-hemolytic Streptococcus sp
      of group G was observed. After initial treatment corrected hypothermia and
      dehydration, the pig was treated with sulfadiazine/sulfamerazine/sulfamethazine
      and oxytetracycline for 30 days. Echocardiographic examination 3 months after the
      initial examination revealed resolution of the pericardial effusion and fibrinous
      pericarditis.

PMID- 7775251
TI  - Factors affecting serum selenium and vitamin E concentrations in dairy cows.
AB  - Supplementation of selenium and vitamin E to enhance disease resistance in dairy
      cattle has become common, particularly to prevent periparturient reproductive
      disorders and mastitis. To establish reference values for serum vitamin E and
      selenium concentrations in postparturient dairy cattle and to determine whether
      serum concentrations of these micronutrients varied with season and stage of
      lactation, cows from a stratified random sample of 50 herds were studied for 1
      year. Blood samples were collected from each of the 50 study herds twice, from
      the 10 most recently parturient cows or from 10% of the herd, whichever was
      greatest. Mean concentration of vitamin E and selenium was 2.55 micrograms/ml and
      78.12 ng/ml, respectively. Vitamin E concentrations were significantly (P < 0.05)
      higher during the summer and fall than during the winter and spring. Selenium
      concentrations were significantly (P < 0.05) lower during the summer and fall
      than during the winter and spring. Herd, season of blood sample collection, and
      time since parturition were significant (P < 0.02) in explaining variation in
      vitamin E and selenium concentrations.

PMID- 7775253
TI  - In vitro cell monolayer invasion assay.

PMID- 7775252
TI  - Comparison of methods for measuring serum immunoglobulin concentrations in
      neonatal llamas.
AB  - Blood samples were collected from 25 neonatal llamas before suckling and at 24,
      48, 72, 96, and 120 hours of age. Nine tests for determining serum immunoglobulin
      concentrations were performed on each sample, to compare within-test variation
      and correlations among tests. The single radial immunodiffusion assay was the
      only quantitative test and therefore, was judged the most accurate test for
      determining the status of passive transfer of immunoglobulins in neonatal llamas.
      Measurement of globulin concentration and total serum protein, and the sodium
      sulfite precipitation test were accurate when compared with radial
      immunodiffusion assay results. Measurements of total serum solids by use of a
      hand-held refractometer and of albumin concentration, and the zinc sulfate
      turbidity and 10% glutaraldehyde coagulation tests were not reliable for
      detecting failure of passive transfer in neonatal llamas. Ten of 25 neonatal
      llamas were suspected of having partial to complete failure of passive transfer
      on the basis of results of the single radial immunodiffusion assay. The other
      tests used in this study identified between 4 and 7 of these 10 llamas at 24
      hours of age. On follow-up communication 4 to 6 months after the last-blood
      sample collection, none of the 25 llamas were identified as having been
      clinically ill or had received any treatments for illness associated with low
      immunoglobulin concentrations.

PMID- 7775254
TI  - Loss of heterozygosity on the short arm of chromosome 9 without p16 gene mutation
      in gastric carcinomas.
AB  - A putative tumor suppressor gene, p16 (MST1; multiple tumor suppressor 1/CDK4I;
      cyclin-dependent kinase 4 inhibitor), was isolated and mapped on the short arm of
      chromosome 9 (9p). The significance of p16 mutations in gastric tumorigenesis was
      examined by assessing p16 mutations as well as loss of heterozygosity (LOH) on 9p
      in 13 gastric adenomas and 45 adenocarcinomas. LOH on 9p (IFNA; alpha-interferon
      locus) was detected in 22% (5/23 informative cases) of differentiated
      adenocarcinomas, 10% (1/10) of undifferentiated carcinomas and none (0/6) of the
      adenomas. Although we found a sequence polymorphism at the second position of
      codon 99 (CGC/CAC) of the p16 in one gastric adenoma patient, no somatic
      mutations were detected in any of the gastric adenomas or adenocarcinomas. These
      results suggest that p16 mutations probably do not contribute to gastric
      tumorigenesis. However, these data suggest that another tumor suppressor gene on
      9p (near the IFNA locus) may contribute to the progression of differentiated
      adenocarcinoma of the stomach.

PMID- 7775255
TI  - Frequent loss of the cyclin-dependent kinase-4 inhibitor gene in human gliomas.
AB  - Studies have shown that homozygous deletion of the cyclin-dependent kinase-4
      inhibitor (CDK4I) gene, which is mapped to chromosome 9p21, is frequently
      observed in various types of human cancers. Here we report that the CDK4I gene
      was deleted in gliomas. Eight cell lines derived from glioblastomas and samples
      from 14 patients with various grades of gliomas were examined by Southern blot
      analysis. We found that the CDK4I gene was deleted in 7 of 8 (87.5%) cell lines
      and 7 of 9 (78%) samples from high-grade glioma patients, whereas it was deleted
      in 1 of 5 (20%) low-grade glioma samples. These results suggested that
      inactivation of the CDK4I gene may play an important role in the progression of
      human glioma.

PMID- 7775256
TI  - A radiation-induced murine ovarian granulosa cell tumor line: introduction of v
      ras gene potentiates a high metastatic ability.
AB  - A non-metastatic epithelial tumor cell line, OV3121, was established from ovarian
      granulosa cell tumor in B6C3F1 mouse irradiated with 60Co-gamma rays. OV3121
      cells showed an epithelial morphology and grew in monolayer with a population
      doubling time of 28-30 h. The production of estradiol and the expression of
      cytokeratin confirmed the epithelial origin of the line. No pulmonary metastasis
      was observed from solid tumors after subcutaneous (s.c.) injection or after
      intravenous (i.v.) injection of a clonal subline, OV3121-1 cells. We examined the
      experimental metastasis of individual clones of OV3121-1 cells, containing
      various introduced viral oncogenes: v-Ha-ras, v-Ki-ras, v-fms, v-mos, v-raf, v
      src, v-sis, v-fos and v-myc. Among them, only OV3121-1 cells with v-Ha-MuSV or v
      Ki-MuSV produced lung colonies at high frequencies. In a more detailed analysis,
      the v-Ha-ras transfectants OV-ras4 and OV-ras7 were found to form colonies in
      various organs by metastasis from tumors after s.c. injection, as well as lung
      colonies after i.v. injection. Moderately metastatic OV-ras7 cells showed high
      gelatinolytic activity at 72 kDa (MMP-2) and 92 kDa (MMP-9) as compared with the
      parental OV3121-1 and OV-Neo control cells by zymographic analysis. However, more
      metastatic OV-ras4 cells produced progressively weaker bands of 72 kDa
      gelatinolytic activity. No gross alterations in the expression of MMP-1, MMP-3,
      TIMP-1 and TIMP-2 transcripts were detected in these cell lines. These results
      suggest that this ovarian granulosa cell tumor line may provide a useful system
      for understanding the mechanisms by which oncogenes influence the occurrence of
      metastasis.

PMID- 7775257
TI  - Frequent genetic instability in small intestinal carcinomas.
AB  - To determine whether genetic instability plays a part in the development of
      digestive tract carcinomas, we analyzed 3 microsatellite loci isolated from
      tumors and surrounding normal tissue samples obtained during surgery. The
      polymerase chain reaction (PCR) technique was used to assess differences between
      tumor and matched normal DNAs. Replication errors (RERs) were observed in 3 of
      the 29 cases (10%) of gastric carcinoma and in 11 of the 72 cases (15%) of
      colorectal carcinoma. None of the 13 (0%) esophageal carcinoma cases showed any
      RER, but 5 of the 11 cases of small intestinal carcinoma (45%) had RERs, a
      significantly frequent finding. These results suggest that genetic instability
      plays an important role in the pathogenesis of small intestinal carcinomas.

PMID- 7775258
TI  - Enzymatic basis for the accumulation of Lewis(b) antigen in uterine endometrial
      cancer.
AB  - In order to clarify the mechanism of the abnormal expression of Lewis(b) antigen,
      which was specific for uterine endometrial cancer tissue, the activities of alpha
      1-->2fucosyltransferase, alpha 1-->3fucosyltransferase, and alpha 1-
      >4fucosyltransferase in normal endometrial tissues and uterine endometrial cancer
      tissues were determined. Further, an immunocytochemical study of the expression
      of blood group-related carbohydrate antigens in 6 cultured cell lines derived
      from various gynecologic malignant tumors was performed and the alpha 1-
      >2fucosyltransferase, alpha 1-->3fucosyltransferase, and alpha 1-
      >4fucosyltransferase activities of these cell lines were determined. Compared
      with normal endometrium, uterine endometrial cancer tissues showed significantly
      higher values of alpha 1-->2fucosyltransferase, alpha 1-->3fucosyltransferase,
      and alpha 1-->4fucosyltransferase activities. The specifically strong expression
      of type I carbohydrate chains, particularly the Lewis(b) antigen, was recognized
      in cultured cell lines derived from uterine endometrial cancer. Compared with
      those cell lines derived from uterine cervical cancer and ovarian cancer, the
      cultured cell lines derived from uterine endometrial cancer showed higher
      activities of alpha 1-->2fucosyltransferase and alpha 1-->4fucosyltransferase,
      which are enzymes related to the synthesis of Lewis(b) antigen. The cell lines
      derived from uterine endometrial cancer showed specifically high values of alpha
      1-->4fucosyltransferase activity. These results suggest that the alpha 1-
      >2fucosyltransferase and alpha 1-->4fucosyltransferase activities, especially the
      alpha 1-->4fucosyltransferase activity, contribute to the abnormal expression of
      the Lewisb antigen in uterine endometrial cancer.

PMID- 7775259
TI  - Ubenimex activates the E-cadherin-mediated adhesion of a breast cancer cell line
      YMB-S.
AB  - It has been reported that ubenimex, a biological response modifier, has a direct
      anti-tumor effect. To clarify the mechanism involved, we examined the effects of
      ubenimex on the growth and adhesive property of a breast cancer cell line YMB-S.
      The cells proliferate in a floating manner without aggregation in normal complete
      medium. Ubenimex induced cell-cell and cell-surface adhesion of the cells
      accompanied with growth suppression. E-Cadherin localized at cell-cell contact
      sites of adhered cells, and anti-E-cadherin antibody inhibited the adhesion. Both
      Western blot analysis and binding assay disclosed that there was no apparent
      difference between E-cadherin levels of the cells before and after the treatment
      with ubenimex. These results indicate that ubenimex inhibits the proliferation of
      YMB-S cells and augments cell-to-cell adhesion through the induction of E
      cadherin-mediated adhesion resulting from the functional activation of pre
      expressed but inefficient E-cadherin.

PMID- 7775261
TI  - Reversal of tumor necrosis factor resistance in tumor cells by adriamycin via
      suppression of intracellular resistance factors.
AB  - Tumor necrosis factor (TNF) and various chemotherapeutic drugs show synergistic
      antitumor effects in vitro and in vivo, though the mechanism is not clear. Based
      on our previous finding that endogenous TNF (enTNF) acts as an intracellular
      resistance factor against exogenous TNF by scavenging oxygen free radicals (OFR)
      with induced manganous superoxide dismutase (MnSOD), we examined the suppression
      of these resistance factors by chemotherapeutic drugs and the resulting increase
      in TNF cytotoxicity. Pretreatment of HeLa cells, which produce an appreciable
      amount of enTNF and show apparent TNF resistance, with TNF followed by adriamycin
      (ADM) resulted in an additive effect, whereas pretreatment with ADM followed by
      TNF resulted in a synergistic effect. After treatment of HeLa cells with ADM, the
      expression of enTNF was remarkably suppressed and MnSOD activity was decreased by
      one-half. These results indicate that suppression of the intracellular resistance
      factors, i.e., enTNF and MnSOD, by ADM plays an important role in the mechanism
      of the synergistic antitumor effect of TNF in combination with ADM.

PMID- 7775262
TI  - Pharmacokinetics of all-trans retinoic acid in pediatric patients with leukemia.
AB  - Since all-trans retinoic acid (ATRA) induces complete remission in a high
      proportion of patients with acute promyelocytic leukemia (APL), and its
      effectiveness appears to be related to the plasma or serum level, a
      pharmacokinetic study of ATRA was undertaken in nine patients with various
      leukemias. After oral administration at a dose of 30 mg/m2, the time required to
      reach the peak plasma level of ATRA (20-1198 ng/ml) was between 120 and 240 min
      and the apparent plasma elimination half life was 21-51 min. In addition, 13-cis
      retinoic acid was detected in the plasma of seven patients, indicating the
      occurrence of ATRA isomerization in vivo. ATRA therapy did not induce complete
      remission in all patients, even when high plasma levels were achieved. Among the
      six APL patients given ATRA therapy, one who failed to respond had a very low
      plasma ATRA level. These findings suggest that it may be useful to monitor plasma
      levels during oral ATRA therapy in order to achieve an appropriate treatment
      regimen.

PMID- 7775260
TI  - Do structural changes of T cell receptor complex occur in tumor-bearing state?
AB  - T cells in tumor-bearing mice and cancer patients were recently shown to be
      devoid of CD3-zeta chain, a signal-transducing invariant chain in T cell receptor
      (TCR) complex, and p56lck tyrosine kinase. In the present study, we investigated
      the structure and function of TCR complex in T cells from BALB/c mice bearing
      CSA1M fibrosarcoma. The expressions of TCR chains and p56lck in a T cell-enriched
      population from spleen were analyzed. Almost complete loss of CD3-zeta and p56lck
      was observed in the preparation from tumor-bearing mice as assessed by
      immunoblotting analysis using whole cell lysates, whereas the amounts of other
      TCR chains were relatively unchanged. However, these changes were due to the
      increase of contaminating Mac-1+ cells in the spleen of tumor-bearing mice
      because: 1) the removal of Mac-1+ cells led to the restoration of CD3-zeta and
      p56lck; and 2) CD3-zeta was clearly present when the preparation was solubilized
      with ionic detergent. Fc receptor gamma chain detected in the preparation from
      tumor-bearing mice disappeared along with the removal of Mac-1+ cells. These
      observations were further supported by the finding that addition of Mac-1+ cells
      from tumor-bearing mice to normal T cells resulted in loss of CD3-zeta, leaving
      CD3-epsilon largely intact. When T cells from tumor-bearing mice were highly
      purified by depletion of Mac-1+ cells, these T cells contained normal amounts of
      CD3-zeta at mRNA, protein, and surface levels, and expressed the properly
      assembled TCR complex on their cell surface. Moreover, stimulation of the TCR in
      these T cells by anti-TCR antibodies resulted in a comparable Ca2+ mobilization
      to that observed in normal T cells. These results suggest that no structural
      changes occur in TCR complex in our tumor-bearing mice, and that complete
      depletion of Mac-1+ cells in important to assess the structure of TCR complex.

PMID- 7775264
TI  - RS-22A, B and C: new macrolide antibiotics from Streptomyces violaceusniger. I.
      Taxonomy, fermentation, isolation and biological activities.
AB  - Three novel 36-membered macrolide antibiotics, RS-22A, B and C produced by
      Streptomyces violaceusniger have been isolated. These antibiotics were purified
      from an acetone extract of the mycelia followed by butanol extraction,
      centrifugal partition chromatography and HPLC. RS-22A, B, C showed antimicrobial
      activity against fungi and Gram-positive bacteria.

PMID- 7775263
TI  - Relationship between the pharmacokinetics of irinotecan and diarrhea during
      combination chemotherapy with cisplatin.
AB  - Two phase I trials of irinotecan (CPT-11) in combination with cisplatin were
      conducted. In both cases, the dose-limiting toxicities were leukopenia and/or
      diarrhea. During these trials the pharmacokinetics of CPT-11 and its active
      metabolite, 7-ethyl-10-hydroxycamptothecin (SN-38), were investigated to evaluate
      the relationship between pharmacokinetic parameters and diarrhea, since this is
      an unpredictable and severe toxicity of combination chemotherapy using CPT-11 and
      cisplatin. Twenty-three previously untreated patients with advanced lung cancer
      were evaluated in the pharmacokinetic study. Ten patients received CPT-11 at 80
      or 90 mg/m2 plus cisplatin at 60 mg/m2. The other 13 patients received CPT-11 at
      80 or 90 mg/m2 plus cisplatin at 80 mg/m2 with the granulocyte colony-stimulating
      factor support (2 micrograms/kg x 16 days). CPT-11 was given as a 90-min
      intravenous infusion on days 1, 8, and 15. Cisplatin was given on day 1. The
      pharmacokinetics of CPT-11 and SN-38 were analyzed on day 8 during the first
      course of treatment. The maximum tolerated dose of CPT-11 was 90 mg/m2 in both
      phase I trials. The severity of diarrhea was best correlated with the peak plasma
      concentration of SN-38 among the pharmacokinetic parameters tested. In addition,
      patients with a plasma SN-38 level > 12.4 ng/ml at 1.75 h after the start of CPT
      11 infusion had a higher incidence of Eastern Cooperative Oncology Group grade 3
      4 diarrhea than those with a lower SN-38 level (P = 0.0003). Stepwise logistic
      regression analysis identified the SN-38 concentration as a significant
      contributor to the development of diarrhea (P = 0.0021). We conclude that there
      is a clear relationship between the SN-38 concentration and diarrhea during
      chemotherapy with CPT-11 plus cisplatin.

PMID- 7775265
TI  - RS-22A, B and C: new macrolide antibiotics from Streptomyces violaceusniger. II.
      Physico-chemical properties and structure elucidation.
AB  - RS-22A, B and C are novel 36-membered macrolide antibiotics produced by
      Streptomyces violaceusniger. The structures of these antibiotics were
      unambiguously determined by 1D and 2D NMR and tandem-mass analysis of the
      oxidative derivative of RS-22C.

PMID- 7775266
TI  - 3'-Demethoxy-3'-hydroxystaurosporine, a novel staurosporine analogue produced by
      a blocked mutant.
AB  - 3'-Demethoxy-3'-hydroxystaurosporine, 1 (CGP 58,546), a novel staurosporine
      analogue, was isolated from a mutant of Streptomyces longisporoflavus R19 blocked
      in the last step of the biosynthetic pathway. CGP 58,546 was less potent than
      staurosporine, but it showed a more selective inhibition pattern against various
      subtypes of protein kinase C.

PMID- 7775267
TI  - A whole-cell Candida albicans assay for the detection of inhibitors towards
      fungal cell wall synthesis and assembly.
AB  - A whole-cell C. albicans screen was designed to identify novel inhibitors
      interacting with the synthesis, assembly and regulation of the fungal cell wall.
      C. albicans was grown in a paired broth assay in 96-well plates with natural
      product extracts or pure chemical compounds in the presence and absence of the
      osmotic stabilizer, sorbitol. Growth was visually examined over a 7-day period
      and scored into different growth categories. Positives from the sorbitol rescue
      were then examined under the microscope for morphological alterations and grouped
      into several morphological classes. Sorbitol protection and cell morphology were
      indicators of novel antifungal agents from natural product extracts and pure
      compounds.

PMID- 7775268
TI  - Novel squalestatins produced by biotransformation.
AB  - Microorganisms were screened for the ability to modify the squalene synthase
      inhibitor squalestatin 1. Biotransformation of 1 by two actinomycetes, S15106 and
      S15138, yielded three products hydroxylated on the 4,6-dimethyl-oct-2-enoyl side
      chain either at the 6 position (5) or 7 position (4 two diastereoisomers), and
      lacking the acetyl ester from the C-1 side chain. Many strains were found to
      hydrolyse the 4,6-dimethyl-oct-2-enoyl or acetyl esters to yield squalestatins 2
      or 3. The 3-methyl ester (6) of 1 was obtained using Fusarium sp. F13945. This
      fungus also produced a farnesoic acid derivative, possibly in response to
      inhibition of its squalene synthase by 1. The biotransformation products of 1 all
      retained potent squalene synthase inhibitory activity.

PMID- 7775269
TI  - Action of cytogenin on lymphoid cells and their cytokine production.
AB  - Action of cytogenin on macrophages and T cells was investigated. Phagocytosis of
      yeast and production of PMA-elicited superoxide anion by macrophages taken from
      mice given cytogenin po were augmented. Cytogenin enhanced productions of IL-1
      alpha by macrophages and IFN gamma and GM-CSF by spleen cells although it did not
      enhanced production of TNF alpha by macrophages and IL-6 by macrophages and
      spleen cells. Macrophages stimulated with cytogenin caused to stimulate
      proliferation of purified T cells in Intercell cultures in which each cell
      population was cultured without contact. Results suggest that cytogenin primarily
      activates macrophages to produce monokines such as IL-1 alpha and it causes to
      stimulate proliferation and differentiation of T cells resulting in production of
      lymphokines such as IFN gamma and GM-CSF.

PMID- 7775270
TI  - Modulation of macrophage activity in tumor bearing mice by cytogenin.
AB  - Cytogenin recovered the reduced mitogenic response to Con A of spleen cells of
      tumor bearing mice in vitro. The suppressive factor(s) was detected in adherent
      cell population in spleen cells. The reduced antitumor effector activity of
      spleen cells taken from tumor bearing mice was also augmented by the treatment
      with cytogenin in vitro. The effect of cytogenin was neutralized by the treatment
      with anti-Mac 1 serum. Administration of cytogenin inhibited the production of
      nitric oxide by macrophages which is known as one of suppressor factors. Results
      indicate that one possible action of cytogenin exhibiting antitumor activity in
      tumor bearing mice may be due to modulation of Mac 1 positive cells.

PMID- 7775271
TI  - Isolation and structural elucidation of antioxidative substances,
      carbazoquinocins A to F.

PMID- 7775272
TI  - Sch 50673 and Sch 50676, two novel antitumor fungal metabolites.

PMID- 7775273
TI  - GE20372 factor A and B. New HIV-1 protease inhibitors, produced by Streptomyces
      sp. ATCC 55925.

PMID- 7775274
TI  - Ochracenomicins A, B and C, new benz[a]anthraquinone antibiotics from
      Amicolatopsis sp.

PMID- 7775275
TI  - Isolation and identification of a new cephem compound from Penicillium
      chrysogenum strains expressing deacetoxycephalosporin C synthase activity.

PMID- 7775276
TI  - Synthesis and biological activity of derivatives of the herbicidal metabolite
      CL22T (phthoxazolin).

PMID- 7775277
TI  - The neuritogenesis inducer lactacystin arrests cell cycle at both G0/G1 and G2
      phases in neuro 2a cells.

PMID- 7775278
TI  - Biosynthesis of armentomycin: a chlorinated nonprotein amino acid.

PMID- 7775280
TI  - Neural tuning characteristics of auditory primary afferents in the chicken
      embryo.
AB  - Primary afferent activity was recorded from the cochlear ganglion in chicken
      embryos (Gallus domesticus) at 19 days of incubation (E19). The ganglion was
      accessed via the recessus scala tympani and impaled with glass micropipettes.
      Frequency tuning curves were obtained using a computerized threshold tracking
      procedure. Tuning curves were evaluated to determine characteristics frequencies
      (CFs), CF thresholds, slopes of low and high frequency flanks, and tip sharpness
      (Q10dB). The majority of tuning curves exhibited the typical 'V' shape described
      for older birds and, on average, appeared relatively mature based on mean values
      for CF thresholds (59.6 +/- 20.3 dBSPL) and tip sharpness (Q10dB = 5.2 +/- 3).
      The mean slopes of low (61.9 +/- 37 dB/octave) and high (64.6 +/- 33 dB/octave)
      frequency flanks although comparable were somewhat less than those reported for
      21-day-old chickens. Approximately 14% of the tuning curves displayed an unusual
      'saw-tooth' pattern. CFs ranged from 188 to 1623 Hz. The highest CF was well
      below those reported for post-hatch birds. In addition, a broader range of Q10dB
      values (1.2 to 16.9) may related to a greater variability in embryonic tuning
      curves. Overall, these data suggest that an impressive functional maturity exists
      in the embryo at E19. The most significant sign of immaturity was the limited
      expression of high frequencies. It is argued that the limited high CF in part may
      be due to the developing middle ear transfer function and/or to a functionally
      immature cochlear base.

PMID- 7775281
TI  - The tonotopic map in the embryonic chicken cochlea.
AB  - The purpose of the present study was to determine the tonotopic map in the
      chicken cochlea at 19 days of incubation (E19) by obtaining characteristic
      frequencies (CFs) for primary afferents, labeling the characterized neurons, and
      documenting their projections to the papilla. The lowest and highest CFs recorded
      were 188 and 1623 Hz respectively. The embryonic tonotopic map coincided with
      maps reported for post-hatch chicks. There were no evidence that neurons
      selective to low frequencies project inappropriately to more basal locations of
      the embryonic papilla. Linear regression was used to estimate the frequency
      gradient (b = 0.037 +/- 0.012 In Hz/% [b +/- SEb]) and intercept (In C, where C =
      111 Hz) of the semilog plot of frequency versus cochlear position (in % distance
      from apex). From these estimates the octave distribution was calculated to be
      18.7%/octave or 0.58 mm/octave. These quantities were not significantly different
      from those found in post hatch chickens. We conclude that the tonotopic map of
      the avian cochlea for CFs between 100 and 1700 Hz is stable and relatively mature
      from age E19 to post-hatch day 21 (P21). The most striking sign of immaturity in
      the E19 embryo is the limited range of high CFs. We offer the hypothesis that,
      between the ages of E19 and P21, improvements in middle ear admittance alone or
      in combination with functional maturation of the cochlear base may be the
      principal factors responsible for the appearance of adult-like high CF limits and
      not an apically shifting tonotopic map.

PMID- 7775279
TI  - Effect of stress on cochlear glucocorticoid protein: acoustic stress.
AB  - Levels of glucocorticoid (GR) receptor protein were determined by a quantitative
      enzyme-linked immunosorbent assay (ELISA) technique in inner ear tissue of rats
      exposed daily to 85 dB SPL white noise for 4 hours on 3 consecutive days. GR
      levels in spiral ligament and organ of Corti tissues were detected using a
      monoclonal antibody to the GR receptor, BuGR2. A non-significant 13% decrease in
      GR levels of spiral ligament tissues was observed in the noise exposed animals
      relative to untreated animals. A statistically significant decrease of 27% in GR
      protein levels was seen in the organ of Corti region (P < 0.03), however. There
      was a concomitant increase of serum corticosterone levels (P < 0.03) in noise
      exposed animals as opposed to those of controls. These results indicate a tissue
      specific response of GR receptor to acoustic stress. Inner ear GR protein
      therefore may be a useful marker in determining the effect of stress on the inner
      ear. Finally, such data may be applicable to support the hypothesis that stress
      is an etiological agent in Meniere's disease.

PMID- 7775282
TI  - Salicylate-induced abnormal activity in the inferior colliculus of rats.
AB  - The evaluation of the spontaneous activity of 471 units from the external nucleus
      of the IC revealed that salicylate induces an increase of the spontaneous
      activity and the emergence of a bursting type of activity longer than 4 spikes.
      For sharply tuned units, the affected cells were from the frequency range of 10
      16 kHz, which corresponds to the behaviorally measured pitch of salicylate
      induced tinnitus in rats. An exogenous calcium supplement, provided under the
      conditions shown to attenuate the behavioral manifestation of salicylate-induced
      tinnitus, abolished the modification of the spontaneous activity induced by
      salicylate. Finally, profound changes of activity were observed for cells not
      responding to contralateral sound. We propose that the observed long bursts of
      discharges represent tinnitus-related neuronal activity. The results are
      consistent with the hypothesis that GABA-mediated disinhibition is involved in
      the processing of tinnitus-related neuronal activity.

PMID- 7775283
TI  - Uptake of amikacin by hair cells of the guinea pig cochlea and vestibule and
      ototoxicity: comparison with gentamicin.
AB  - The distribution of amikacin (AK), an exclusive cochleo-toxic aminoglycosidic
      antibiotic (AA), and of gentamicin (GM), which is both cochleo- and vestibulo
      toxic, has been studied in cochlear and vestibular hair cells. Guinea pigs were
      treated during six days with one daily injection of AK (450 mg/kg/day) or GM (60
      mg/kg/day). AAs were detected, using immunocytochemical technique with scanning
      laser confocal microscopy, in isolated cells from guinea pigs sacrificed from 2
      to 30 days after the end of the treatments. Results demonstrate a rapid uptake
      (as soon as after 2-day treatment) of both AAs by cochlear and vestibular hair
      cells and a very slow clearance. Particularly GM and AK are detected in type I
      and type II hair cells of the utricles and cristae ampullaris. The presence of
      these two molecules with different toxic potentialities towards cochlear and
      vestibular hair cells indicates that the selective ototoxicity of aminoglycosides
      cannot be explained simply on the basis of particular uptake and accumulation in
      the different sensory hair cells.

PMID- 7775284
TI  - Shape and displacement patterns of the gerbil tympanic membrane in experimental
      otitis media with effusion.
AB  - This study assesses the visco-elastic properties of the tympanic membrane (TM) in
      isolated gerbilline temporal bones as a function of time after inducing
      experimental otitis media with effusion (OME). To do this we measured the TM
      displacements produced by application of sequences of static pressures across the
      TM, with a high resolution, real-time, differential moire interferometer, and the
      results were compared with measurements on healthy ears. Two methods of producing
      OME were used: in one group tubal plugging was performed to produce mild OME (the
      'TP group'); in the other group electro-cauterization of the nasopharyngeal
      orifice of the Eustachian tube was used to cause a severe form of OME (the 'EC
      group'). The measurements were performed from one day up to ten weeks after
      surgery. In the TP group the displacement fringe patterns were normal, i.e.
      qualitatively they resembled the patterns of the control group. Quantitatively
      there was a significant decrease of displacement for a given pressure on the
      first day after surgery, followed by a trend of increase with time; after seven
      to ten days the displacement was larger than in the control group. In the EC
      group the displacement was significantly reduced after half a week, followed by a
      trend of increase with time, similar to what was found in the TP group; at one
      week the displacement was larger than in the control group, and at ten weeks the
      largest displacement was recorded. In the EC group the displacement patterns were
      often irregular; in some cases with changes suggesting the presence of weak spots
      in the TM where retraction pockets most likely could develop. OME seems to affect
      the stiffness of the TM promptly so that it is a potential parameter for early
      diagnosis. The stiffness changes may, if measurable in the clinical situation,
      become prognostic parameters in the treatment of OME.

PMID- 7775285
TI  - The effects of exposure to intense sound on the DC endocochlear potential in the
      chick.
AB  - Chicks were exposed to an intense pure tone (0.9 kHz, 120 dB SPL) for 48 h. The
      DC endocochlear potential was measured with a microelectrode inserted into scala
      media in six separate groups of animals between 0 and 12 days post exposure.
      Similar data were obtained from seven groups of unexposed control chicks between
      2 and 15 days of age. One to nine animals were tested in each control or exposed
      group. The results in the control chicks revealed that the EP at 2 days of age
      (6.7 mV) was 36% of the mature value (15.2 mV) noted at 6 days of age. In the
      exposed animals, at 0-days recovery, the EP showed a 63% reduction relative to
      that measured in age matched control chicks. The level of EP in the exposed
      animals quickly recovered, and by 3 and 6 days post exposure exhibited a loss of
      only 7 and 3 percent relative to the age-matched controls. The recovery of EP was
      plotted against the recovery of evoked potential thresholds reported by others,
      and the time-course of the recovery functions were very similar. This
      relationship suggested that recovery of auditory function in the chick was highly
      correlated with the restoration of the EP. Damage to the tegmentum vasculosum and
      its capacity to secrete potassium, as well as the shunting of current through the
      damaged basilar papilla, are considered as mechanisms for the reduction of EP
      loss in the exposed ear.

PMID- 7775286
TI  - Three-channel Lissajous' trajectory of the binaural interaction components of
      human auditory middle-latency evoked potentials.
AB  - Three-channel Lissajous' trajectories (3-CLTs) of the binaural interaction
      component (BI) of auditory middle latency evoked potentials (AMLEPs) were derived
      from 14 normally hearing adults by subtracting the response to binaural clicks
      from the algebraic sum of monaural responses. AMLEPs were recorded in response to
      65 dB nHL, rarefaction clicks, presented at a rate of 3.3/s. A normative set of
      BI 3-CLT measures was calculated and compared with the corresponding measures of
      simultaneously recorded, single-channel vertex-left mastoid and vertex-neck
      derivations of BI and of AMLEP to binaural stimulation (B). 3-CLT measures
      included: apex latency, amplitude and orientation, as well as planar segment
      duration, orientation, size and shape. The results showed seven main apices and
      associated planar segments ('Be', 'Bf', 'Bg', 'Bh', 'Bi1', 'Bi2' and 'Bj') in the
      3-CLT of BI. Apex latencies of the BI 3-CLT were comparable to peak latencies of
      the vertex-left mastoid and vertex-neck AMLEP and BI records, both in their
      absolute values and in intersubject variability. Durations of BI planar segments
      were approximately 5.0 ms. Apex amplitudes of BI 3-CLT were larger than the
      respective peak amplitudes of the vertex-mastoid and vertex-neck BI records,
      while their intersubject variabilities were comparable. The lateralization of BI
      components may indicate asymmetric processing of binaural auditory input, or may
      be connected with anatomical asymmetry such as skull thickness. Preliminary
      analyses did not reveal a clear correlation between the lateralization of the BI
      component 'Bi2' and the handedness of the subject. We suggest that BI components
      of AMLEP may be associated with the primary auditory cortex and subcortical
      ascending structures.

PMID- 7775287
TI  - Possible origins of the non-monotonic intensity discrimination function in
      forward masking.
AB  - A non-monotonic intensity discrimination function in forward masking has been
      recently reported [Zeng et al. (1991) Hear. Res. 55, 223-230; Zeng and Turner
      (1992) J. Acoust Soc. Am. 92, 782-787] in which just-noticeable-differences
      (jnds) in intensity are largest for midlevel tones and smaller for soft and loud
      tones following an intense narrow-band noise. One hypothesis was that this
      midlevel hump reflects the contribution of low-spontaneous rate (SR) neurons to
      intensity coding, based on the differential recovery from forward masking of low
      SR and high-SR neurons [Relkin and Doucet (1991) Hear. Res. 55, 215-222]. The
      present study conducted three experiments stimulating different stages of the
      auditory system in an attempt to determine the peripheral and central origins of
      the midlevel hump. First, in two cochlear implant (CI) listeners, the forward
      masker produced a midlevel hump on the intensity discrimination function,
      suggesting that the synapses between the hair cell and the eighth nerve are
      probably not responsible for the hump, as they are bypassed and the eighth nerve
      is stimulated directly. Second, in auditory brainstem implant (ABI) listeners,
      the forward masker produced no midlevel hump, but the masked jnds were larger
      than those without a masker. The absence of the midlevel hump in the ABI
      listeners suggests that the occurrence of the hump requires physiological
      mechanisms in the auditory nerve transmission, or the intrinsic processing
      circuits of the cochlear nuclei, or both. Third, in normal-hearing listeners, an
      ipsilateral, 90 dB SPL, pure-tone forward masker produced a midlevel hump, which
      is similar to that using a narrow-band noise masker; whereas a contralateral
      forward masker produced essentially no midlevel hump, suggesting that binaural
      interactions at superior olivary complex and more central sites are probably not
      responsible.

PMID- 7775288
TI  - Nonlinear mechanics at the apex of the guinea-pig cochlea.
AB  - A heterodyne laser interferometer was used to observe the sound-evoked
      displacement patterns of Reissner's membrane and various other structures in the
      apical turn of the guinea-pig cochlea. Most structures (including the basilar
      membrane) were similarly tuned, and had best frequencies in the 200-350Hz range.
      A distinct notch was usually observed approximately 0.7 octaves above the best
      frequency, and amplitude- and phase-plateaus were observed at higher frequencies.
      In most other respects, however, the mechanical tuning resembled the frequency
      threshold curves of low frequency cochlear nerve fibers. In five reasonably
      intact, in vivo preparations, the frequency of the mechanical sensitivity notch
      was intensity-dependent: Compressive nonlinearities were observed above
      approximately 80 dB SPL on the low-frequency side of the notch, with
      antagonistically expansive nonlinearities on the high-frequency side. Two-tone
      suppression was observed in one of these preparations. Stimulus-related baseline
      position shifts were observed in another in vivo preparation. No such
      nonlinearities were observed in structurally damaged and/or > 1 hour post-mortem
      preparations. However, more robust nonlinearities were observed in all
      preparations at higher levels of stimulation (e.g. > 100-110 dB SPL). These high
      level nonlinearities diminished only slowly after death, and gave rise to various
      effects, including time-dependent (i.e. adapting) and severely distorted (e.g.
      peak-split and/or dc-shifted) responses.

PMID- 7775289
TI  - Processing of modulation frequency in the dorsal cochlear nucleus of the guinea
      pig: amplitude modulated tones.
AB  - The modulation frequency (Fm), particularly high Fm (> 200 Hz), in amplitude
      modulated (AM) tones can elicit the perception of the periodicity pitch (Langner,
      1992). In this study, single unit responses to the Fms of the sinusoidal AM tones
      were investigated at 50 to 90 dB SPL. The recordings were made from the dorsal
      cochlear nucleus (DCN) of neuroleptic anesthetized guinea pigs with an intact
      cerebellum. The DCN units show a good capability of phase-locking to Fm at 400
      1200 Hz. On-S-type II and Pauser/Buildup (P/B) units have a high modulation gain
      (7.2-8.3 dB). P/B units can preserve the high modulation gain (5-9 dB) up to 90
      dB SPL. The modulation gain exponentially increases with decreasing modulation
      depth (Dm) and the phase-locking is detectable even at the Dm as low as 2-5%. The
      'central skipping' of the phase-locking peak has been found at deep Dms in a few
      cases. The synchronization is independent of the discharge rate and can remain
      high even when the responses to AM tones are inhibited below the spontaneous
      activity. Such encoding behaviors over the unit's response area show that the Fm
      phase-locking is strong near or at its characteristic frequency (CF). The
      synchronization index (SI) versus carrier frequency (Fc) curve is similar to the
      inverse shape of tuning curve but more narrowly tuned than the iso-intensity
      function of pure tones at moderate to high intensity levels. The phase-locking is
      related to the unit's spontaneous rate (SR). The average modulation gain of the
      lower SR (< or = 2 spikes/s) units is 5 dB higher than that of the higher SR (> 2
      spikes/s) units (8.16 and 2.92 dB, respectively) at 70 dB SPL. These results
      suggest that AM information is temporally encoded over broad ranges of modulation
      parameters in the DCN and is conveyed by the Fc channel. Such a timing mechanism
      can play an important role in processing of complex sounds under normal acoustic
      conditions.

PMID- 7775290
TI  - The auditory neurobiology of marsupials: a review.
AB  - The marsupials, the large group of mammals which develop during fetal life in an
      externalized pouch, have been given little attention by auditory neurobiologists.
      In this review the structure of the auditory systems of the handful of marsupials
      which have been studied is described, the course of auditory development mapped,
      and the behavioral and electrophysiological manifestations of hearing examined.
      It is argued that research on the highly accessible developing marsupial will
      provide information about the development of hearing difficult to obtain from,
      but applicable to all, mammalian species.

PMID- 7775291
TI  - Regenerated hair cells in the European starling: are they more resistant to
      kanamycin ototoxicity than original hair cells?
AB  - Previous work from our laboratory [Marean et al. (1993) Hear. Res. 71, 125-136]
      has shown that a 10 day dose of 200 mg/kg/day kanamycin produced damage to the
      basal 34% of the starling basilar papilla. We also observed that repeating the
      dosing schedule following a 4 month survival period resulted in significantly
      less damage to the regenerated auditory epithelium. The present study
      investigated whether or not this apparent resistance was the result of a tendency
      for regenerated hair cells to be less susceptible to kanamycin ototoxicity, or if
      other, systemic factors may be involved. Eight European starlings were given
      subcutaneous injections of 200 mg/kg/day kanamycin for 10 days. Serum levels of
      kanamycin were measured at the time of sacrifice for all birds, and the basilar
      papillae of all birds were examined by scanning electron microscopy (SEM). Two of
      these birds (Group 1) were sacrificed immediately following the dosing period.
      Two of the birds were allowed to survive for 60 days (Group 2). Two of the birds
      were redosed with 200 mg/kg/day for 10 days after 60 days survival (Group 3).
      Finally, two birds were redosed with 250 mg/kg/day until serum levels of
      kanamycin were the same as Group 1 when sacrificed (> 9 micrograms/ml). The SEM
      results showed that the regenerated auditory epithelium of the birds dosed a
      second time sustained less damage compared to previously untreated ears, even
      though the dosing regimen was the same (Group 3 versus Group 1). The regenerated
      auditory epithelium of birds dosed a second time sustained the same damage as
      previously untreated animals when the dosage was increased to attain similar
      serum levels (Group 4 versus Group 1). These results suggest metabolic changes
      occur in the starling in response to the initial dose of kanamycin which do not
      necessarily involve changes in hair cell resistance to ototoxicity.

PMID- 7775292
TI  - Estimation of the pulmonary capillary transport function in isolated rabbit
      lungs.
AB  - Recently, we presented a method for estimating the pulmonary capillary volume and
      transport function based on the use of a reference indicator and two or more
      indicators that rapidly equilibrate (radially) with the tissue (i.e., the
      concentrations in the vascular and extravascular spaces at a given axial location
      are in equilibrium) during transit through the capillaries in a bolus-injection
      indicator dilution method (S. H. Audi, G. S. Krenz, J. H. Linehan, D. A. Rickaby,
      and C. A. Dawson. J. Appl. Physiol. 77:332-351, 1994). The objectives of the
      present study were 1) to determine whether [14C]diazepam and [3H]alfentanil
      equilibrate sufficiently rapidly between the vascular space and tissue and with
      sufficiently different pulmonary extra-vascular mean residence times to be used
      in a single bolus to estimate the pulmonary capillary volume and transport
      function using this method and 2) to estimate the pulmonary capillary volume and
      transit time distribution in isolated perfused rabbit lungs. Both [14C]diazepam
      and [3H]alfentanil were found to be rapidly equilibrating indicators by the
      criteria that, over a wide range of flow rates, their respective venous effluent
      concentration curves were nearly congruent on a time scale normalized to the lung
      mean transit time for the reference indicator (fluorescein isothiocyanate
      dextran). In addition, at a given plasma albumin concentration, [14C]diazepam had
      a significantly longer extravascular mean residence time than [3H]alfentanil,
      e.g., at 6% plasma albumin concentration, the extravascular mean residence time
      of [14C]diazepam was more than twice that of [3H]alfentanil. On average, the
      estimated pulmonary capillary volume for a 2.7-kg was approximately 4.2 ml or
      approximately 44% of the total pulmonary vascular volume (9.5 ml). The relative
      dispersion of the pulmonary capillary transport function of the rabbit was
      approximately 90%.

PMID- 7775293
TI  - Ozone-induced airway hyperresponsiveness: role of superoxide anions, NEP, and BK
      receptors.
AB  - We investigated the role of reactive oxygen species in ozone-induced airway
      hyperresponsiveness (AHR) in Brown Norway rats. Airway responsiveness to inhaled
      acetylcholine (ACh) and bradykinin (BK) and inflammatory cell recruitment in
      bronchoalveolar lavage fluid (BALF) were measured in vivo. Neutral endopeptidase
      (NEP) activity assay and measurement of BK-receptor binding sites in Brown Norway
      rat lungs were carried out in vitro. Apocynin (5 mg/kg), an inhibitor of
      superoxide anion-generating NADPH oxidase, was administered perorally 30 min
      before a 3- or 6-h exposure to 3 ppm of ozone, and the animals were studied 18-24
      h postexposure. Ozone induced increases in airway responsiveness to ACh and BK
      and in neutrophil counts in BALF. Apocynin inhibited the increase in airway
      responsiveness to BK but not to ACh without affecting the neutrophil counts in
      BALF. The antioxidants allopurinol and deferoxamine prevented ozone-induced AHR
      to both ACh and BK but did not reduce neutrophil counts. To further examine the
      mechanisms of ozone-induced AHR to BK, we measured NEP activity and the density
      of BK receptors in vitro after ozone exposure. Ozone exposure had no significant
      effect either on NEP activity or on the affinity and the number of BK receptors
      in lungs from rats treated with or without apocynin. We conclude that superoxide
      anions released from inflammatory cells in the airway may be involved in ozone
      induced AHR. Inactivation of NEP or upregulation of BK receptors do not appear to
      be involved, but the possibility of localized changes cannot be excluded.

PMID- 7775294
TI  - Catecholaminergic effects of prolonged head-down bed rest.
AB  - Prolonged head-down bed rest (HDBR) provides a model for examining responses to
      chronic weightlessness in humans. Eight healthy volunteers underwent HDBR for 2
      wk. Antecubital venous blood was sampled for plasma levels of catechols
      [norepinephrine (NE), epinephrine, dopamine, dihydroxyphenylalanine,
      dihydroxyphenylglycol, and dihydroxyphenylacetic acid] after supine rest on a
      control (C) day and after 4 h and 7 and 14 days of HDBR. Urine was collected
      after 2 h of supine rest during day C, 2 h before HDBR, and during the intervals
      1-4, 4-24, 144-168 (day 7), and 312-336 h (day 14) of HDBR. All subjects had
      decreased plasma and blood volumes (mean 16%), atriopeptin levels (31%), and
      peripheral venous pressure (26%) after HDBR. NE excretion on day 14 of HDBR was
      decreased by 35% from that on day C, without further trends as HDBR continued,
      whereas plasma levels were only variably and nonsignificantly decreased.
      Excretion rates of dihydroxyphenylglycol and dihydroxyphenylalanine decreased
      slightly during HDBR; excretion rates of epinephrine, dopamine, and
      dihydroxyphenylacetic acid and plasma levels of catechols were unchanged. The
      results suggest that HDBR produces sustained inhibition of sympathoneural
      release, turnover, and synthesis of NE without affecting adrenomedullary
      secretion or renal dopamine production. Concurrent hypovolemia probably
      interferes with detection of sympathoinhibition by plasma levels of NE and other
      catechols in this setting. Sympathoinhibition, despite decreased blood volume,
      may help to explain orthostatic intolerance in astronauts returning from
      spaceflights.

PMID- 7775295
TI  - Diaphragm thickness heterogeneity at functional residual capacity and total lung
      capacity.
AB  - One of the determinants of muscular force is the number of myofibrils in
      parallel, which is approximated by thickness. To better understand the
      heterogeneity of diaphragm thickness, we quantified the interregional and radial
      patterns of thickness of nine canine diaphragms rapidly perfusion fixed in situ
      with glutaraldehyde at functional residual capacity (FRC) (n = 6) and total lung
      capacity (TLC) (n = 3). Thickness was determined gravimetrically from punch
      biopsies radiating from the central tendon to rib cage insertion in ventral,
      middle, and dorsal costal and crural regions. For comparison, the contralateral
      unfixed hemidiaphragm was sampled in the same fashion. The findings of this
      investigation include the following. 1) The costal diaphragm exhibits the same
      pattern of interregional heterogeneity at FRC, TLC, and in the freshly excised
      state. 2) The costal diaphragm is significantly thinner at FRC in situ (0.17 +/-
      0.01 cm) than is the freshly excised contralateral diaphragm (0.21 +/- 0.01 cm; P
      < 0.05), whereas there is no significant difference between thickness at TLC and
      the freshly excised state. 3) There is significant, previously underscribed,
      radial tapering from the rib cage attachment (0.24 +/- 0.02) to the central
      tendon insertion (0.15 +/- 0.01 cm; P < 0.05) that is exaggerated at TLC. 4) With
      passive inflation from FRC to TLC, the greatest increase in thickness occurs
      close to the rib cage attachment for the ventral and medial costal regions but
      close to the central tendon in the dorsal and crural regions. We conclude that
      the diaphragm at FRC and TLC exhibits radial thickness heterogeneity that cannot
      be predicted from dimensions of the freshly excised diaphragm.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7775296
TI  - Fluid changes during pregnancy: use of bioimpedance spectroscopy.
AB  - The increase in body water during pregnancy is responsible for the largest
      portion of weight gain and is of interest of clinical practitioners. However,
      assessing changes in body fluids is not easily accomplished during pregnancy. The
      purpose of this study was to examine the accuracy of bioelectrical impedance
      spectroscopy for estimating fluid volumes before, during, and after pregnancy.
      Ten healthy adult women were recruited for the study. Total body water (TBW) and
      extracellular fluid (ECF) volume were measured at baseline (preconception); 8-10,
      24-26, and 34-36 wk of gestation; and 4-6 wk postpartum by deuterium oxide and
      NaBr dilution, respectively. Estimates of TBW and ECF were also obtained by
      bioimpedance spectroscopy (BIS). At baseline, mean values for dilution and BIS
      estimates of TBW and ECF were 33.2 +/- 4.6 (SD) vs. 31.6 +/- 6.2 liters and 15.2
      +/- 1.3 vs. 16.9 +/- 2.3 liters, respectively. TBW and ECF estimated by BIS were
      not significantly different from the dilution values at any time point. These
      results suggest that BIS may be useful in estimating volumes of ECF and TBW
      during pregnancy.

PMID- 7775297
TI  - Hyperpnea with dry air causes time-dependent alterations in mucosal morphology
      and bronchovascular permeability.
AB  - This study examines the morphological and physiological changes that occur in
      canine peripheral airways after hyperpnea with dry air. Peripheral airways were
      exposed to a 5-min 2,000 ml/min dry air challenge (DAC) at 24, 6, 2, or 1 h
      before or 60 s after (0 h) the injection of colloidal carbon. After recording the
      dry air-induced increase in peripheral airway resistance, the lungs were removed
      and prepared for morphometric analysis (n = 5). Light microscopy revealed that
      50% of the airway perimeter appeared damaged at 0, 1, and 2 h after DAC, and
      repair was evident 6-24 h after the challenge. The average goblet-to-ciliated
      cell ratio decreased from 0.34 before DAC to 0.15 after DAC and recovered within
      24 h. Dry air-induced bronchovascular leakage occurred immediately after DAC and
      persisted for > or = 24 h. DAC decreased mast cell number only in regions where
      the mucosa was damaged, and this decrease was inversely correlated with
      bronchovascular leakage. Finally, leukocyte infiltration was evident 1-2 h after
      DAC and continued throughout the 24-h period. We conclude that hyperpnea with dry
      air causes mucosal injury, inflammation, and microvascular leakage and that these
      dry air-induced effects persist for > or = 24 h after DAC.

PMID- 7775298
TI  - Estimation of dynamic chemoresponsiveness in wakefulness and non-rapid-eye
      movement sleep.
AB  - We developed a method for quantifying dynamic chemoresponsiveness on the basis of
      the ventilatory response to pseudorandom binary CO2 stimulation. The dynamic
      chemoreflex gain (GD) and effective time delay (TDeff) relating breath-to-breath
      fluctuations in alveolar PCO2 to ventilation were evaluated at frequencies
      between 0 and 0.05 Hz. Application of the method to simulated "data" showed that
      estimation errors in GD and TDeff were most likely to be minimized in the range
      of 0.01-0.03 Hz, corresponding to periodicities of 30-100 s. Estimation of TDeff
      was generally more susceptible to error than that of GD because of the limited
      time resolution of the breath-by-breath measurements. In eight awake normal
      adults, we compared estimates of GD derived from the pseudorandom binary CO2
      stimulation test with peripheral and central hypercapnic sensitivities deduced
      from single-breath and Read rebreathing measurements in the same subject. GD at
      0.02 Hz was highly correlated with peripheral hypercapnic sensitivity but poorly
      correlated with central hypercapnic sensitivity, underscoring the importance of
      the peripheral chemoreflexes in mediating ventilatory responses to phasic
      stimuli. Application of the procedure to a different group of 10 healthy
      volunteers during wakefulness and stage 2 sleep showed decreases in GD in 8
      subjects but increases in 2 subjects. However, for the group as a whole, GD and
      TDeff did not change significantly between wakefulness and sleep. The proposed
      method may provide information more pertinent to periodic breathing than
      traditional CO2 response tests do, since the chemoreflex responses to phasic
      variations in blood gases are likely to be important in determining ventilatory
      control during sleep.

PMID- 7775299
TI  - Alterations in intramuscular connective tissue after limb casting affect
      contraction-induced muscle injury.
AB  - This study examined the effect of alterations in rat intramuscular connective
      tissue (CT), secondary to limb immobilization, on the muscle's susceptibility to
      contraction-induced injury. Hindlimbs were casted for 3 wk with the extensor
      digitorum longus muscle fixed in a shortened (IM-SP) or lengthened position (IM
      LP). An age-matched control group remained uncasted. Extensor digitorum longus
      muscles were injured in vivo by using a motorized foot pedal that repeatedly
      flexed and extended the foot while the muscle was electrically stimulated during
      plantar flexion. Four hours postinjury, maximum isometric tetanic force (Po) was
      measured in vitro and was used as a functional index of muscle injury. Muscles
      were fixed, sectioned, and stained for later analysis. Intramuscular CT
      concentration, expressed as the ratio of CT area to muscle fiber area, was
      significantly higher in both IM-SP (0.153 +/- 0.003) and IM-LP (0.174 +/- 0.003)
      groups compared with controls (0.104 +/- 0.003). Po values of injured muscles
      both IM-LP and IM-SP were higher than the injured controls' Po of 9.41 +/- 0.63
      N/cm2 (P < 0.05). Injured IM-LP muscle forces were significantly higher than
      those of IM-SP. This study demonstrated that limb immobilization increases
      intramuscular CT concentration, which is accompanied by attenuation of muscle
      injury. We conclude that remodeling of intramuscular CT affects the muscle's
      resistance to contraction-induced injury.

PMID- 7775300
TI  - Visualization of airway obstruction in vivo during pulmonary vascular engorgement
      and edema.
AB  - Although pulmonary vascular engorgement has often been hypothesized to decrease
      airway caliber, leading to airway obstruction in asthma, direct evidence for this
      hypothesis is lacking. In the present study, we used high-resolution computed
      tomography to directly measure the changes in the caliber and wall thickness of
      conducting airways after volume loading with normal saline (NS) and homologous
      blood. Five anesthetized dogs received 0.2 mg/kg of atropine followed by either
      three sequential fluid challenges of 50 ml/kg of NS or two sequential challenges
      of 25 ml/kg of blood. Several weeks later, the same dogs received the other fluid
      challenge. Volume loading with 150 ml/kg of NS decreased the average airway
      luminal area to 68 +/- 3% (+/- SE) of baseline. Concomitantly, airway wall
      thickness increased to 150 +/- 6% of baseline. Volume loading with 50 ml/kg of
      blood decreased the average airway luminal area to 81 +/- 2% of baseline.
      Concomitantly, airway wall thickness increased to 108 +/- 2% of baseline.
      Therefore, for comparable changes in pulmonary vascular pressure, an infusion of
      NS caused a significantly greater decrease in airway luminal area and a larger
      increase in airway wall thickness than an infusion of blood. This suggests that
      the presence of edema fluid in or immediately surrounding the airway wall acts to
      decrease the airway lumen. However, since the degree of airway narrowing was only
      moderate, even with a most extreme fluid load, it seems unlikely that airway wall
      thickening or edema could be a primary cause of conducting airway obstruction in
      patients with asthma or impaired left ventricular function.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7775301
TI  - Exercise training alters the Ca2+ and contractile responses of coronary arteries
      to endothelin.
AB  - We tested the hypothesis that alterations in myoplasmic free Ca2+ (Ca(m))
      regulation in coronary smooth muscle after exercise training (Ex) underlie
      changes in vasomotor function. Yucatan miniature pigs were endurance trained by
      treadmill running for 16-20 wk. Simultaneous determination of Ca(m) (fura-2
      microfluorometry) and contraction during endothelin exposure in coronary arteries
      were then performed. Endothelin (10(-9) to 10(-7) M) was administered either
      cumulatively or as a single concentration. Ex significantly attenuated the Ca(m)
      response to 10(-9) and 10(-8) M endothelin. Developed tension was significantly
      diminished at 10(-8) M endothelin in Ex pigs, producing a rightward shift in the
      concentration-developed tension response. Attenuated Ca(m) and contractile
      response to 10(-8) M endothelin were present after Ex whether endothelin was
      applied cumulatively or as a single concentration. The developed tension-Ca(m)
      relationship showed an increased Ca(m) sensitivity of contraction with Ex.
      Endothelin (10(-8) M)-induced Ca2+ influx, estimated by Ba2+ influx in low-Na+
      solution, was increased threefold in coronary arteries from Ex pigs. The
      decreased Ca(m) in the presence of increased divalent cation (i.e., Ca2+) influx
      during 10(-8) M endothelin suggests a greatly enhanced sarcolemmal Ca2+ cycling
      in coronary arteries from Ex pigs.

PMID- 7775302
TI  - Chamber for controlling end-tidal gas tensions over sustained periods in humans.
AB  - Although techniques for the short-term control of end-tidal gases exist, the lack
      of a satisfactory technique for longer-term control of the end-tidal gases has
      limited protracted physiological experiments of this nature. We have constructed
      a chamber in which subjects can be comfortable for many hours while having their
      end-tidal gas composition monitored and controlled. The system for controlling
      the end-tidal gas composition is based on a principle described by Swanson and
      Bellville (J. Appl. Physiol. 39: 377-385, 1975) in which end-tidal PO2 (PETO2)
      and PCO2 (PETCO2) are monitored and deviations of the actual PETO2 and PETCO2
      (PETCO2) are monitored and deviations of the actual PETO2 and PETCO2 from the
      desired values are corrected by a feedback mechanism that adjusts the inspired
      gas composition accordingly. End-tidal and inspired gas tensions are measured via
      a nasal catheter connected to a mass spectrometer. A computer averages the end
      tidal and inspired gas tensions and, at 5-min intervals, adjusts the gas
      composition inside the chamber. During 8 h of isocapnic hypoxia, the system held
      the 5-min average value for PETO2 within 2 Torr of the desired value (55 Torr)
      and the value for PETCO2 within 0.35 Torr of the desired value (the resting value
      for each subject) in four subjects.

PMID- 7775303
TI  - Ventilatory response to 8 h of isocapnic and poikilocapnic hypoxia in humans.
AB  - Almost all studies of the effects of prolonged hypoxia on ventilation (VE) in
      humans have been performed with the end-tidal PCO2 (PETCO2) left uncontrolled.
      The purpose of this study was to compare the effects of 8 h of hypoxia with
      PETCO2 held constant with 8 h of hypoxia with PETCO2 left uncontrolled. Ten
      subjects completed the study. Each was seated inside a chamber in which the
      inspired gas could be controlled so as to maintain the desired partial pressures
      of end-tidal gases (sampled via nasal catheter) constant (see L.S.G.E. Howard et
      al. J. Appl. Physiol. 78:1088-1091, 1995.). Three 8-h protocols were employed: 1)
      isocapnic hypoxia, at an end-tidal PO2 of 55 Torr with PETCO2 held at the
      subject's resting value; 2) poikilocapnic hypoxia, at the same end-tidal PO2; and
      3) control, where the inspired gas was air. VE was measured (over 3 min) at 0 and
      20 min and at hourly intervals between 1.5 and 7.5 h. There was a rise in VE
      during isocapnic hypoxia [from an initial VE of 16.2 +/- 1.3 (SE) l/min to a
      final VE of 24.8 +/- 1.6 l/min], which was significant compared with
      poikilocapnic hypoxia and control values (P < 0.001, analysis of variance). There
      was no significant progressive rise in VE during poikilocapnic hypoxia compared
      with control values. These results show that isocapnic hypoxia produces a
      progressive increase in VE when sustained over an 8-h period. The onset of this
      response is faster than has been noted in studies of the progressive rise in VE
      associated with the poikilocapnic hypoxia of altitude.

PMID- 7775304
TI  - Alterations in respiratory control during 8 h of isocapnic and poikilocapnic
      hypoxia in humans.
AB  - In the preceding companion paper (L. S. G. E. Howard and P.A. Robbins, J. Appl.
      Physiol. 78: 1092-1097, 1995), we showed that ventilation rises during 8 h of
      isocapnic hypoxia. In the present study we report the changes that occur in the
      ventilatory response to acute hypoxia (AHVR) over 8 h of both isocapnic and
      poikilocapnic hypoxia. Ten subjects completed the study. Each was seated inside a
      chamber in which the inspired gas could be controlled so as to maintain the
      desired end-tidal gases (sampled via nasal catheter) constant. Three 8-h
      protocols were compared: 1) isocapnic hypoxia, at an end-tidal PO2 of 55 Torr
      with the end-tidal PCO2 held at the subject's resting value; 2) poikilocapnic
      hypoxia, at the same end-tidal PO2; and 3) control, where the inspired gas was
      air. AHVR was measured before and at 20 min and 4 and 8 h after the start of the
      experiment. A sequence of hypoxic square waves and sawtooth inputs was imposed by
      an end-tidal forcing system, with the subject breathing through a mouthpiece. End
      tidal PCO2 was held constant at 1-1.5 Torr above resting. Values for hypoxic
      sensitivity (Gp; 1.min-1.%-1) and hypoxia-independent ventilation (Vc; l/min)
      were calculated for each test of AHVR. Both Gp and Vc increased significantly
      during both hypoxic exposures in relation to control (P < 0.001, analysis of
      variance). Over the 8-h period, increases in Gp were 87% in isocapnic hypoxia and
      44% in poikilocapnic hypoxia, and increases in Vc were 89% in isocapnic hypoxia
      and 84% in poikilocapnic hypoxia. There were no significant differences between
      the isocapnic and poikilocapnic exposures. We conclude that Gp and Vc rise mainly
      as result of hypoxia per se and not the associated alkalosis.

PMID- 7775305
TI  - Ozone toxicity in the rat. I. Effect of changes in ambient temperature on
      extrapulmonary physiological parameters.
AB  - These studies examined the effects of exposure to near environmental levels of
      ozone (O3) on the unanesthetized unrestrained rat as well as the influence of
      changes in ambient temperature (Ta) on the observed responses. Male Fischer 344
      rats were implanted with radiotelemetry transmitters that permitted continuous
      monitoring of electrocardiogram, heart rate, core body temperature (Tco), and
      activity. Telemetry animals (n = 4-5/group) were combined with nontelemetry
      animals to produce nine treatment groups (n = 44-50/group) composed of
      combinations of one of three O3 exposure regimens (0.0 ppm x 24 h/day, 0.5 ppm x
      6 h/day, or 0.5 ppm x 23 h/day) paired with one of three Ta levels (10, 22, or 34
      degrees C). The experimental protocol consisted of a Control Period (filtered
      air; 1 day), Treatment Period (O3; 5 days), and Recovery Period (filtered air; 7
      days). At specific intervals during the experiment, subgroups (n = 6) of
      nontelemetry animals were randomly selected from each treatment group,
      anesthetized with urethan, and intubated, and their lungs were lavaged with warm
      saline. In general, results from the bronchoalveolar lavage procedure indicated
      that toxicity increased in magnitude and duration as the length of time of O3
      exposure increased and the Ta decreased. Similarly, whereas minimal
      extrapulmonary effects were observed at an Ta of 34 degrees C, O3 exposures at Ta
      levels of 22 and 10 degrees C produced significant decreases in heart rate (160
      and 210 beats/min, respectively), Tco (2.0 and 3.5 degrees C, respectively), and
      body weight (15 and 40 g, respectively). Decreases in these functional parameters
      reached their maxima over the first 2 exposure days and returned to control
      levels after the 3rd day of exposure. These data demonstrate the profound impact
      of Ta on Tco and other extrapulmonary parameters in the conscious unrestrained
      rat exposed to O3. Furthermore, these results suggest an integral role for both
      Tco and Ta in determination of the uptake of inhaled pollutants and modulation of
      the subsequent toxic effects and may have important implications with respect to
      the assessment of toxic risk.

PMID- 7775306
TI  - Acute lung injury in endotoxemic pigs: role of leukotriene B4.
AB  - The role of leukotriene B4 (LTB4) in the pathogenesis of acute lung injury was
      examined in endotoxemic pigs. In a preliminary study, the activity and
      specificity of an LTB4-receptor antagonist, LY-306669, were evaluated. In vitro,
      LY-306669 completely blocked the functional upregulation of phagocyte opsonin
      receptors induced by LTB4 but had a much smaller effect on opsonin receptor
      upregulation induced by platelet-activating factor. In pigs treatment with LY
      306669 prevented leukopenia induced by injection of authentic LTB4 but had no
      effect on the hematologic or hemodynamic effects of PAF or U-48816, a thromboxane
      A2 mimetic. In a second study, pigs received an intravenous priming dose of
      lipopolysaccharide (LPS) at time (t) = -18 h and were randomized to receive 1) no
      further treatment (n = 5), 2) LPS (250 micrograms/kg over 1 h beginning at t = 0
      h) and LY-306669 (10 mg/kg bolus and 3 mg.kg-1.h-1 infusion beginning at t = -15
      min) (n = 7), or 3) LPS and vehicle (n = 6). Treatment with LY-306669
      significantly ameliorated LPS-induced hypoxemia, pulmonary edema, and alveolitis.
      These data suggest that LTB4 is an important mediator of pulmonary dysfunction
      and transendothelial migration of neutrophils in LPS-induced acute lung injury.

PMID- 7775307
TI  - Structure of the latissimus dorsi muscle and respiratory function.
AB  - The aim of this study was to evaluate whether respiratory function influences the
      structure of the latissimus dorsi muscle (LD). Twelve patients (58 +/- 10 yr)
      undergoing thoracotomy were studied. Lung and respiratory muscle function were
      evaluated before surgery. Patients showed a forced expired volume in 1 s (FEV1)
      of 67 +/- 16% of the reference value, an FEV1-forced vital capacity ratio of 69
      +/- 9%, a maximal inspiratory pressure of 101 +/- 21% of the reference value, and
      a tension-time index of the diaphragm (TTdi) of 0.04 +/- 0.02. When patients were
      exposed to 8% CO2 breathing, TTdi increased to 0.06 +/- 0.03 (P < 0.05). The
      structural analysis of LD showed that 51 +/- 5% of the fibers were type I. The
      diameter was 56 +/- 9 microns for type I fibers and 61 +/- 9 microns for type II
      fibers, whereas the hypertrophy factor was 87 +/- 94 and 172 +/- 208 for type I
      and II fibers, respectively. Interestingly, the histogram distribution of the LD
      fibers was unimodal in two of the three individuals with normal lung function and
      bimodal (additional mode of hypertrophic fibers) in seven of the nine patients
      with chronic obstructive pulmonary disease. An inverse relationship was found
      between the %FEV1-forced vital capacity ratio and both the diameter of the fibers
      (type I: r = -0.773, P < 0.005; type II: r = -0.590, P < 0.05) and the
      hypertrophy factors (type I: r = -0.647, P < 0.05; type II: r = -0.575, P =
      0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775308
TI  - Complement activation in divers after repeated air/heliox dives and its possible
      relevance to DCS.
AB  - Plasma levels of the anaphylatoxin C5a were measured in 19 divers performing
      repeated air dives. Blood samples were collected immediately before the first
      dive and 2 h after the first and the second or third dive. Serum obtained at the
      same times was subjected to complement activation in vitro by air bubbles. Six
      divers developed symptoms of decompression sickness (DCS). Most intravascular
      bubbles were observed in divers with the lowest plasma levels of C5a. Postdive
      plasma levels of C5a did not increase compared with predive levels, nor were
      postdive levels significantly different after two or three dives compared with
      the first dive. Repeated dives did not influence the amounts of C5a generated in
      vitro. Neither plasma levels of C5a nor C5a generated in vitro were significantly
      different in divers who experienced symptoms of DCS vs. divers without symptoms
      of DCS. We conclude that plasma level of C5a and measurement of C5a generation in
      vitro cannot be used to predict DCS.

PMID- 7775309
TI  - Pulmonary venous congestion augments respiratory motoneuronal responses to
      cigarette smoke in rabbit.
AB  - We examined the effects of cigarette smoke inhaled during subthreshold pulmonary
      venous congestion (sPVC) on phrenic nerve (PN) and unit activity in the ventral
      respiratory group in rabbits. sPVC was achieved by inflating a balloon in the
      left atrium. Inhalation of low-nicotine cigarette smoke produced initial
      prolonged bursts in 34 (19 bulbospinal) out of 43 inspiratory (I) cells and in
      PN. Smoke decreased the activity of 29 out of 36 expiratory (E) cells (27 of 32
      early E and 2 of 4 late E). The prolonged PN bursts occasionally progressed to
      doublets superimposed over regularly occurring PN bursts. sPVC augmented the
      smoke effects: I cells displayed greater increases in spikes/burst (27 vs. 12%; P
      = 0.02) and burst duration (42 vs. 20%; P = 0.02) and greater decreases in
      interburst interval (34 vs. 10%; P < 0.02); PN displayed greater increases in I
      time (40 vs. 27%; P < 0.05), greater decreases in E time (18 vs. 26%; P < 0.05),
      and a greater incidence and duration of time of PN doublets (29 +/- 9 vs. 9 +/- 4
      s; P < 0.03); E cells displayed greater decreases in spikes/burst (43 vs. 29%; P
      = 0.01) and burst durations (35 vs. 18%; P < 0.01). Smoke-induced respiratory
      changes may be exaggerated during sPVC.

PMID- 7775310
TI  - In vivo measurements of pulmonary angiotensin-converting enzyme kinetics. I.
      Theory and error analysis.
AB  - We developed a procedure for measuring pulmonary angiotensin-converting enzyme
      kinetics with fluorine-18 fluorocaptopril and positron emission tomography (PET).
      The method is based on the application of a compartmental receptor model that
      represents the kinetics of two species of ligand, presumably the trans and cis
      conformers of captopril. The input function was characterized and includes
      corrections for the labeled metabolites of fluorocaptopril. Application of the
      procedure to lung time-activity data obtained with PET produced estimates of
      kinetic parameters demonstrating fast kinetics for one conformer and slower
      kinetics for the other. Simulation studies were performed to evaluate the
      sensitivity of the estimated parameters to errors in the model assumptions and in
      measured values for variables required for analysis of the PET data. Estimates
      for two of the kinetic parameters, the amount of perfused unbound functional
      enzyme normalized to regional lung volume and the association rate constant for
      the trans conformer, were relatively stable even with large errors in the input
      data, varying < 30% from true values for all perturbations. Thus, the procedure
      produces reliable estimates of the kinetics of the trans conformer of captopril
      as well as theoretical curves that are close to the observed data.

PMID- 7775311
TI  - In vivo measurements of pulmonary angiotensin-converting enzyme kinetics. II.
      Implementation and application.
AB  - We measured pulmonary angiotensin-converting enzyme (ACE) kinetics with fluorine
      18 captopril and positron emission tomographic (PET) imaging in five control dogs
      and in five dogs after 20-30 min of left caudal lobe (LCL) hypoxic ventilation.
      Time-activity data obtained with PET were interpreted with a compartmental
      receptor model relating changes in tissue and blood activity to one another
      within the region. In control dogs, the mean ratio of regional blood flow
      (measured by PET) between left and right dorsal lung regions was 0.90 +/- 0.16
      (SD) vs. 0.54 +/- 0.24 (P < 0.05) in LCL hypoxic dogs. In control dogs, the
      amount of perfused unbound enzyme normalized to regional extravascular water
      concentration (Bmax/EVLW) averaged 13.3 +/- 8.9 x 10(-6) mmol ACE/ml EVLW; the
      ratio of regional values between the left and right sides was 1.02 +/- 0.18. In
      the LCL hypoxic dogs, Bmax/EVLW was 9.7 +/- 11.3 x 10(-6) mmol/ml hypoxic lung
      region and the ratio was 0.47 +/- 0.31 (P < 0.05). In control dogs, the
      coefficient of variation for Bmax/EVLW among regions was only 19 +/- 10%,
      although the between-dog variation was greater (64 +/- 4%). We conclude that this
      completely noninvasive method appears to be a promising approach for evaluating
      the expression of pulmonary ACE in vivo.

PMID- 7775312
TI  - Effects of high pressures of various gas mixtures on rat striatal dopamine
      detected in vivo by voltammetry.
AB  - This work was performed to study the effect of pressure of various gas breathing
      mixtures on dopaminergic activity in the striatum by in vivo differential pulse
      voltammetry using carbon multifiber electrodes chronically implanted in 23 freely
      moving rats. Compression (0.5 bar/min) in a helium-oxygen mixture induced an
      increase in striatal extracellular dopamine (DA) beginning at 10-20 bars and
      reaching 32% above precompression levels when arriving at 90 bars (n = 9). To
      demonstrate that this increase is dopaminergic, nine rats with right
      nigrostriatal pathway 6-hydroxydopamine lesions were compressed in the same
      conditions. In this case, the increase in DA did not occur in the right caudate
      nucleus but was recorded in the intact left caudate nucleus. To study the effects
      on DA increase of narcotic gases, which are known to reduce some high-pressure
      nervous syndrome symptoms, eight and six rats were compressed in helium-nitrogen
      oxygen and hydrogen-helium-oxygen mixtures, respectively. They produced similar
      changes in striatal DA level in the same pressure range (23 and 20% increase,
      respectively, at the end of the compression). Consequently, the increase in
      striatal DA seems independent of the nature of the breathing mixture and seems
      related to the increase of pressure. The origin of this increase could be a
      pressure effect at the pre- or postsynaptic level.

PMID- 7775313
TI  - Multiparametric monitoring of the awake brain exposed to carbon monoxide.
AB  - We have applied in vivo real-time techniques to monitor the physiological changes
      associated with exposure to a pattern of carbon monoxide (CO) known to cause
      brain oxidative stress. Using a multiparametric monitoring device connected to
      the brain, we exposed unanesthetized rats to two levels of CO, 0.1 and 0.3% in
      air. Energy metabolism was evaluated by the optical monitoring of relative
      cerebral blood flow (CBF) and intramitochondrial redox state. Ionic homeostasis
      was assessed by measurements of K+,Ca2+, and H+ or Na+ levels in the
      extracellular space. The electrical parameters monitored were the
      electrocorticogram and direct current steady potential. Under 1,000 ppm of CO,
      the CBF was increased significantly without any measurable change in the NADH
      redox state, suggesting that the cause for the increased CBF was not hypoxia.
      Exposing the awake rat to 1,000 ppm of CO (40 min) followed by 3,000 ppm of CO
      (20 min) led to an increase in CBF followed by episodes of spontaneous brain
      depolarizations characterized by changes in ionic homeostasis and blood flow.
      These changes were similar to those recorded under cortical spreading depression.
      In most animals exposed to 3,000 ppm of CO, spontaneous oscillations in CBF and
      NADH redox state that were negatively correlated were recorded. The results
      indicate that an inspired CO level of 0.1% had effects largely restricted to
      blood flow, whereas at a higher CO level an additional impairment in energy
      supply resulted in a complex pattern of effects similar to that caused by brain
      ischemia.

PMID- 7775314
TI  - Glucose kinetics during high-intensity exercise in endurance-trained and
      untrained humans.
AB  - In humans, endurance training reduces the rates of glucose production and
      utilization during moderate-intensity exercise. It is uncertain, however, whether
      this is also true during high-intensity exercise. Accordingly, we studied eight
      endurance-trained cyclists and eight untrained subjects during 30 min of cycling
      at approximately 80% of maximal oxygen uptake (VO2max). Rates of glucose
      appearance (Ra) and disappearance (Rd) were determined using a primed, continuous
      infusion of [6,6-2H]glucose. Average glucose Ra during exercise did not differ in
      the trained and untrained subjects (34.3 +/- 3.6 vs. 36.0 +/- 1.7 mumol.min-1.kg
      1; mean +/- SE; P, not significant). Plasma insulin, glucagon, norepinephrine,
      and epinephrine concentrations were also similar in the two groups. In contrast,
      glucose Rd during exercise was 19% lower in the trained compared with the
      untrained subjects (27.0 +/- 2.6 vs. 33.2 +/- 1.5 mumol.min-1.kg-1; P < 0.001).
      Consequently, during exercise, plasma glucose concentration rose significantly (P
      < 0.05) in the trained subjects but did not change in the untrained subjects. We
      conclude that utilization of plasma glucose is lower in trained subjects during
      high-intensity exercise, even when the exercise is performed at the same relative
      (and therefore a higher absolute) intensity as in the untrained state.
      Hyperglycemia in trained subjects during intense exercise appears to be due to
      this lower rate of glucose utilization rather than a higher rate of glucose
      production.

PMID- 7775315
TI  - Comments on "Airway reopening pressure in isolated rat lungs".

PMID- 7775316
TI  - Invited editorial on "Effect of RBC shape and deformability on pulmonary O2
      diffusing capacity and resistance to flow in rabbit lungs".

PMID- 7775317
TI  - K+ and Lac- distribution in humans during and after high-intensity exercise: role
      in muscle fatigue attenuation?
AB  - This review describes processes for the distribution of K+ ([K+]) and lactate
      concentrations ([Lac-]) that are released from contracting muscle at high rates
      during high-intensity exercise. This results in increased interstitial and venous
      [K+] and [Lac-] in contracting muscle. Large and rapid increases in plasma [K+]
      and [Lac-] result in the transport of these ions into red blood cells (RBCs).
      These ions are distributed to noncontracting tissues within both the plasma and
      RBC compartments of blood. The extraction of K+ and Lac- from the circulation by
      noncontracting tissue serves to markedly attenuate exercise-induced increases in
      plasma [K+] and [Lac-]. This apparent regulation of the plasma compartment by
      noncontracting tissues helps to maintain favorable concentration gradients for
      the net movement of [K+] and [Lac-] into the venous side of the microcirculation
      from interstitial fluids of contracting muscle. This provides conditions that 1)
      reduce the increase in interstitial [K+], thereby decreasing the magnitude and
      rate of sarcolemmal depolarization, and 2) favor the sarcolemmal transport of Lac
      from within contracting muscle cells, thereby regulating intracellular
      osmolality and H+ concentration. On cessation of exercise, net K+ uptake by
      recovering muscle is rapid, with 90-95% recovery of intracellular [K+] within 3.5
      min, indicating a very high rate of Na+-K+ pump activity. The K+ extracted by
      noncontracting tissues during exercise may be slowly released during recovery.
      During the initial minutes of recovery, recovering muscle continues to release
      Lac- into the circulation, and noncontracting tissues continue to extract Lac-
      for up to 30 min. The uptake of Lac- by noncontracting tissues results in
      elevated intracellular [Lac-]. There is no evidence that Lac- extracted by
      noncontracting tissues is subsequently released; it is probably metabolized
      within these cells. We conclude that the uptake of K+ and Lac- by RBCs and
      noncontracting tissues regulates ion homeostasis within plasma and the
      interstitial and intracellular compartments of contracting muscle. The regulatory
      processes help to maintain the function of active muscles by delaying the onset
      of fatigue during exercise and to restore homeostasis during recovery.

PMID- 7775318
TI  - Effect of RBC shape and deformability on pulmonary O2 diffusing capacity and
      resistance to flow in rabbit lungs.
AB  - Isolated rabbit lungs were perfused with washed and resuspended human red blood
      cells (RBCs) in the presence of drugs known to change the shape and deformability
      of RBCs. With sodium salicylate (0.5-2 g/l), which causes echinocytosis and
      increases RBC deformability, lung diffusing capacity for O2 (DLO2) increased by
      21%. When chlorpromazine, which induces stomatocytosis and stiffens RBCs, was
      given (50 mg/l), DLO2 decreased by 18%. With sodium salicylate, the mean
      pulmonary artery pressure dropped by 14% from control values, whereas it
      increased by 18% under chlorpromazine. Comparative experiments with hemoglobin
      solutions did not reveal any effect of those two drugs either on DLO2 or on
      pulmonary arterial pressure, which indicates that the effects of sodium
      salicylate and chlorpromazine were due to changes in RBC shape and deformability.
      It is concluded that RBC shape and deformability affect pulmonary artery pressure
      and oxygen diffusing capacity, which may have an influence on oxygen transfer to
      tissue and hence be of clinical relevance.

PMID- 7775319
TI  - Effects of endotoxin on isolated porcine liver: pressure-flow analysis.
AB  - The peripheral vascular response to sepsis is characterized by a vasodilatation
      of the systemic arterial vessels. Pulmonary hypertension with an increase in
      resistance and back pressure to flow defined by pressure-flow (P-Q) relationships
      has been reported in experimental sepsis. We hypothesized that endotoxin can
      induce differential alterations in resistance and back pressure to flow in the
      liver venous and arterial beds. Ninety minutes after endotoxin administration in
      intact anesthetized pigs (n = 8), the liver was vascularly isolated and perfused.
      Steady-state P-Q relationships in both the portal vein (PV) and hepatic artery
      (HA) were generated at multiple outflow pressures (Pout; 0, 5, 10, and 15 mmHg)
      and compared with those obtained in control livers (n = 6). Extrapolated zero
      flow pressure intercepts (Pback) and slopes of the P-Q relationships were
      obtained by least squares linear regression analysis. Endotoxemia increased PV
      Pback (P < 0.05), and Pback always exceeded Pout (P < 0.05) when the latter was
      raised. In contrast, in controls, no difference was observed between Pback and
      Pout when the latter was raised. Endotoxemia also increased the PV slope compared
      with control. Raising Pout from 0 to 15 mmHg decreased PV slope in the endotoxin
      group to a greater degree than in controls (P < 0.05). In the HA, endotoxin
      caused a decrease in slope but did not alter Pback. The simultaneous increase in
      the PV Pback and slope that occurs with endotoxemia decreases splanchnic venous
      return, pooling blood in the splanchnic compartment for a given total blood
      volume.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775320
TI  - Metabolic and thermal adaptations from endurance training in hot or cold water.
AB  - Metabolic and thermal adaptations resulting from endurance training in hot vs.
      cold water were compared. It was hypothesized that training in hot water would
      have greater effects on muscle glycogen use and blood lactate accumulation during
      exercise than training in cold water. Eighteen men exercised at 60% of maximal
      oxygen uptake while immersed in hot (n = 9) or cold water (n = 9) for 1 h, 5
      days/wk, for 8 wk. Training in hot water (35 degrees C) potentiated body
      temperature increases during exercise, and training in cold water (20 degrees C)
      blunted body temperature increases during exercise. Before and after training,
      cardiorespiratory and thermoregulatory responses and muscle glycogen and blood
      lactate changes were assessed during a 1-h exercise trial in hot water and, on a
      separate day using the same intensity, in cold water. Oxygen uptake was similar
      for all trials, averaging 2.0 +/- 0.1 l/min. It was observed that 1) training
      reduced glycogen use and lactate accumulation during exercise, with no difference
      between cold and hot water training groups in the magnitude of this effect; 2)
      lactate accumulation during exercise was the same in hot water as in cold water;
      and 3) skin temperature decreased more rapidly during cold-water exercise after
      than before training, with no difference between cold and hot water training
      groups in the magnitude of this effect. Thus, exercise-induced body temperature
      increases are not an important stimulus for glycogen-sparing effects and blunted
      lactate accumulation associated with endurance training.

PMID- 7775321
TI  - Sympathetic nervous system activity, body fatness, and body fat distribution in
      younger and older males.
AB  - It was hypothesized that an increase in total and central body fatness is related
      to higher sympathetic nervous system activity (SNSA) in older men. Resting SNSA
      was measured from norepinephrine (NE) kinetics in 69 younger (18-36 yr) and 69
      healthy older men (55-80 yr). Body fat distribution was estimated from the waist
      circumference, body composition from underwater weighing, peak oxygen consumption
      from a treadmill test to exhaustion, and dietary intake from food diaries. Plasma
      NE concentrations were 41% higher (P < 0.001) in older men due to a 27% increase
      (P < 0.001) in NE appearance rate and a tendency for a lower NE clearance rate (P
      = 0.08). NE appearance rate was higher in individuals of both age groups who
      exhibited a greater waist circumference and body fatness (range of r values 0.49
      0.69; P < 0.01). The waist circumference, and not age, was the strongest
      predictor of the increase in NE appearance rate in older men. Statistically
      controlling for the waist circumference or body fatness diminished age-related
      differences in NE concentrations and in NE appearance rate. These findings
      suggest that an accumulation of total and central body fat is associated with
      higher levels of SNSA in older males.

PMID- 7775322
TI  - Relationship between MRI relaxation time and muscle fiber composition.
AB  - The relationship between nuclear magnetic resonance relaxation time obtained with
      magnetic resonance imaging (MRI) and muscle fiber composition of the lateral
      gastrocnemius was examined in 13 men. There was a positive correlation (r = 0.80,
      P < or = 0.001) between longitudinal relaxation time and the relative percentage
      of slow-twitch muscle fibers (type I). There was no relationship between
      transverse relaxation time and type I percentage (r = 0.17, P = 0.57). These
      results suggest that MRI longitudinal relaxation time can be used for the
      noninvasive estimation of muscle fiber composition in humans.

PMID- 7775323
TI  - Influence of spaceflight on the production of interleukin-3 and interleukin-6 by
      rat spleen and thymus cells.
AB  - Six adult male Sprague-Dawley rats were flown on the 7-day US space shuttle
      mission STS-54. After flight, the spleen and thymus from each animal were assayed
      for the capacity to secrete the cytokines interleukin-3 (IL-3) and IL-6. Spleen
      and thymus cells (5 x 10(6)/ml) were incubated for 48 h in the presence of 5
      micrograms/ml of concanavalin A or 2 micrograms/ml of bacterial
      lipopolysaccharide to stimulate the production of IL-3 and IL-6. IL-3 activity
      was measured using the IL-3/colony-stimulating-factor-dependent cell line 32D. IL
      6 activity was measured using the IL-6-dependent cell line 7TD1. Spleen and
      thymus cells harvested from flown rats secreted significantly higher titers of
      biologically active IL-3 compared with ground control rats. Spaceflight
      significantly enhanced IL-6 production by thymus, but not spleen, cells. The
      results of this study demonstrate that spaceflight can enhance the production of
      certain cytokines by cells of the immune system.

PMID- 7775324
TI  - Influence of isometric loading on biceps EMG dynamics as assessed by linear and
      nonlinear tools.
AB  - The summed electrical discharges generated by a contracting skeletal muscle
      constitute a dynamic system conveying electromyographic (EMG) information
      indicative of muscle physiological status. "Steady states" of activity can be
      achieved with light loads, but with heavy loads the dynamic system experiences
      continuous status transitions that culminate in task failure. The present study
      was designed to assess the applicability of two mathematical tools, one linear
      and the other nonlinear, in addressing the time course of EMG alterations under
      different loading challenges. Surface EMGs of the biceps brachii muscle were
      recorded from 14 healthy human volunteers during light and heavy loadings, and
      task failure occurred at varying times among the subjects. Digitized EMG signals
      were analyzed by linear spectral analysis (fast Fourier transform) and nonlinear
      recurrence-plot analysis. With light loading, computed variables from both
      analyses gave "quasi-steady-state" values over time, with recurrence-plot
      analysis having the higher variance. With heavy loading, the nonlinear variable
      (%determinism) increased sooner and exhibited larger changes from control values
      than decreases in the linear variable (spectral center frequency). Experimental
      results support the conclusion that both analyses can be combined to give a
      fuller assessment of the biceps EMG during light or heavy loading. Implications
      for the detection of muscular fatigue are discussed.

PMID- 7775325
TI  - Skeletal muscle characteristics among distance runners: a 20-yr follow-up study.
AB  - The purpose of this investigation was to examine the histochemical and enzymatic
      characteristics of skeletal muscle after 20 yr of distance running training.
      Twenty-eight men were first studied between 1966 and 1974 when they were all
      highly trained distance runners. On the basis of their training regimens in the
      interim between testing, subjects were described as highly trained (HI; n = 11),
      fitness trained (FIT; n = 10), or untrained (UT; n = 7). Gastrocnemius muscle
      biopsy samples revealed a mean increase (P < 0.05) in the proportion of type I
      fibers of the FIT and UT groups, whereas the HI group, which was initially
      characterized by a high percentage (> 70%) of type I fibers, was unchanged.
      Although the mean fiber type change of the HI group was similar between
      evaluations, 6 of the 11 subjects did elicit an increase in the percentage of
      type I fibers. A subgroup of elite distance runners who had continued to train
      for competition experienced an approximately 25% reduction (P > 0.05) in muscle
      succinate dehydrogenase activity and decreases (P > 0.05) in types I and II
      muscle fiber areas. On the average, in 1993 the HI group had higher (P < 0.05)
      succinate dehydrogenase and citrate synthase activities than the FIT and UT
      groups, whereas phosphorylase activity did not differ among the three groups.
      These data suggest that the middle-aged men in this study had a significantly
      greater proportion of type I muscle fibers than when they were 20 yr
      younger.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775327
TI  - Regional pulmonary blood flow during rest, tilt, and exercise in unanesthetized
      dogs.
AB  - We assessed the heterogeneity of regional pulmonary blood flow (PBFr), using
      radioactive microspheres in five unanesthetized dogs standing at rest (Rest),
      standing at a 45 degrees upward tilt (Tilt), and during moderate treadmill
      exercise (Exer). The excised lungs were cut into 1-cm3 pieces along transverse,
      horizontal, and longitudinal planes. Mean PBFr increased from 23.3 ml.min-1.g-1
      at Rest to 57.4 ml.min-1.g-1 during Exer, but the relative dispersions were not
      statistically different between states (47.3-51.9%). A small but significant
      gravity-dependent gradient in PBFr of < or = 4.7%/cm (r2 < or = 0.118) as well as
      a PBFr decreasing radial gradient from the lung midpoint of < or = 7.2%/cm (r2 <
      or = 0.108) were present in all states. PBFr at Rest was highly correlated with
      those at Tilt (r2 = 0.773) and Exer (r2 = 0.888), and a variable PBFr gradient of
      < or = 2.5%/cm from base to apex was observed. Fractal dimensions calculated
      using relative dispersion as a function of aggregated sample size were not
      significantly different between states and were 1.132 (r2 = 0.987) at Rest, 1.121
      (r2 = 0.973) at Tilt, and 1.149 (r2 = 0.986) during Exer. Thus, gravity and
      centripetal gradients consistently accounted for a maximal difference of only
      about twofold in PBFr and < 11% of overall PBFr heterogeneity in 1-cm3 samples.
      Recursive anatomic branching of pulmonary arteries and local mechanical factors
      apparently account for most of the blood flow heterogeneity in small pieces of
      lung.

PMID- 7775326
TI  - Electrochemical detection of rapid DA release kinetics during hypoxia in perfused
      superfused cat CB.
AB  - The hypothesis that hypoxic excitation is coupled to dopamine (DA) secretion was
      tested in perfused-superfused cat carotid bodies (CB). DA was electrochemically
      detected by an amperometric method (constant applied potential +150 mV) with
      Nafion polymer-coated recessed gold microsensors (tip diameter 3-8 microns) in 10
      cat CBs. Neural discharge (ND) from the whole sinus nerve was measured
      simultaneously with DA changes during interruption of perfusate flow and during
      hypoxic perfusion (5% O2). A computer-controlled instrument using a
      chronoamperometric technique (+550-mV pulses) with a Nafion-coated carbon fiber
      microelectrode (tip diameter 35 microns) was used to detect DA changes in two CBs
      during similar hypoxic stimuli. Rapid DA release kinetics were measured during
      flow interruption with an initial rate of 1.05 +/- 0.15 (SE) microM/s within the
      first 10-15 s. At most measurement sites, the increase in DA preceded the rise in
      ND. After the initial increase, DA release slowed to 0.16 +/- 0.02 microM/s,
      reaching a maximum DA concentration of 20.7 +/- 2.6 microM above baseline after
      90 s of flow interruption. Nicotine (10-micrograms bolus) caused a large increase
      in ND without a proportional increase in DA release. Spatially detailed time
      resolved electrochemical measurements were able to discriminate between DA
      release during hypoxia and chemoexcitatory responses that do not involve DA
      release.

PMID- 7775328
TI  - Short-term immobilization has a minimal effect on the strength and fatigability
      of a human hand muscle.
AB  - The purpose of this study was to determine the association between reduced
      fatigability typically observed in disused muscle and an improved resistance to
      the impairment of neuromuscular propagation. Endurance time of an isometric
      contraction sustained at 35% of maximum voluntary contraction (MVC) force and the
      fatigue-induced change in the evoked compound muscle action potential (M wave)
      were measured in the first dorsal interosseus muscle of human subjects before,
      during, and after 3 (n = 9) or 5 wk (n = 2) of immobilization. The immobilization
      procedure caused a substantial decline in the chronic electromyographic (EMG)
      activity (to 4% of control value) of the first dorsal interosseus muscle.
      Endurance time was found to be significantly correlated to the maintenance of M
      wave amplitude during the fatigue task. However, neither of these variables was
      significantly affected by immobilization. Also, immobilization had no significant
      effect on the prefatigue values of MVC force and EMG or twitch contraction time
      or on the postfatigue changes in MVC force and EMG, M wave duration, twitch
      amplitude, and contraction time. In the unfatigued muscle, immobilization did
      cause an increase in twitch force (153%) and a decrease in M-wave amplitude
      (67%). It appears, therefore, that a healthy first dorsal interosseus muscle is
      generally resistant to adaptation when its use has been reduced for 3-5 wk by
      immobilization.

PMID- 7775329
TI  - Activity of respiratory neurons during hypoxia in the chemodenervated cat.
AB  - Exposure of anesthetized paralyzed vagotomized peripherally chemodenervated cats
      to hypoxia results in initial depression and subsequent loss of the phrenic
      neurogram. To determine whether hypoxic respiratory depression results from the
      inhibition of respiratory premotor neurons by bulbospinal neurons of the
      Botzinger complex (Bot-E neurons), extracellular recordings were made of dorsal
      and ventral respiratory group bulbospinal inspiratory neurons and Bot-E neurons
      during acute hypoxic hypoxia. All neurons recorded decreased firing rate during
      hypoxia. Bot-E neurons became silent before the loss of phasic phrenic activity
      during hypoxia and commenced firing before or coincident with the return of the
      phrenic neurogram during reoxygenation. Inspiratory neurons ceased firing
      coincident with phrenic silence. Dorsal respiratory group and ventral respiratory
      group neurons that had a late onset of firing with respect to the phrenic
      neurogram during normoxia fired progressively earlier in inspiration during
      hypoxia, an effect that was reversed during reoxygenation. These data are
      consistent with inhibition and/or disfacilitation as the mechanism of hypoxic
      respiratory depression but suggest that Bot-E neurons are not the source of this
      inhibition.

PMID- 7775330
TI  - Fractal analysis of surfactant deposition in rabbit lungs.
AB  - The effect of exogenous surfactant in the treatment of acute lung injury may
      depend on homogeneity of distribution of the material delivered. Analyses of
      distribution rely on sectioning the lung, determining surfactant concentration
      for each piece, and describing the variation in that value. Results of such
      analyses are influenced by how finely the lung is sectioned. We have reanalyzed
      data from prior experiments to determine whether the distribution of administered
      surfactant is fractal, that is, is independent of the scale of measurement. Lungs
      from animals receiving surfactant radiolabeled with
      [3H]dipalmitoylphosphatidylcholine were cut into 108 pieces, and the normalized
      radioactivity in each piece was determined. Sectioning of the lungs into
      different numbers of pieces (n = 2, 6, 12, 18, 36, 54, or 108) was simulated, and
      corresponding radioactivity contents were calculated. The coefficient of
      variation (CV) of these normalized values was then calculated for each scale of
      measurement (expressed as relative piece volume), and ln(CV) was plotted as a
      function of the logarithm of relative piece volume. These relationships were
      linear (average correlation coefficient = 0.96) for all animals, consistent with
      CV being a fractal property. We conclude that the intrapulmonary distribution of
      surfactant may be fractal and is therefore a property of the lung. This study
      demonstrates the utility of fractal analysis in describing the pulmonary
      distribution of substances introduced via the airway.

PMID- 7775331
TI  - Metabolic, catecholamine, and exercise performance responses to various doses of
      caffeine.
AB  - This study examined the exercise responses of well-trained endurance athletes to
      various doses of caffeine to evaluate the impact of the drug on exercise
      metabolism and endurance capacity. Subjects (n = 8) withdrew from all dietary
      sources of caffeine for 48 h before each of four tests. One hour before exercise
      they ingested capsules of placebo or caffeine (3, 6, or 9 mg/kg), rested quietly,
      and then ran at 85% of maximal O2 consumption to voluntary exhaustion. Blood
      samples for methylxanthine, catecholamine, glucose, lactate, free fatty acid, and
      glycerol analyses were taken every 15 min. Plasma caffeine concentration
      increased with each dose (P < 0.05). Its major metabolite, paraxanthine, did not
      increase between the 6 and 9 mg/kg doses, suggesting that hepatic caffeine
      metabolism was saturated. Endurance was enhanced with both 3 and 6 mg/kg of
      caffeine (increases of 22 +/- 9 and 22 +/- 7%, respectively; both P < 0.05) over
      the placebo time of 49.4 +/- 4.2 min, whereas there was no significant effect
      with 9 mg/kg of caffeine. In contrast, plasma epinephrine was not increased with
      3 mg/kg of caffeine but was greater with the higher doses (P < 0.05). Similarly
      only the highest dose of caffeine resulted in increases in glycerol and free
      fatty acids (P < 0.05). Thus the highest dose had the greatest effect on
      epinephrine and blood-borne metabolites yet had the least effect on performance.
      The lowest dose had little or no effect on epinephrine and metabolites but did
      have an ergogenic effect. These results are not compatible with the traditional
      theory that caffeine mediates its ergogenic effect via enhanced catecholamines.

PMID- 7775332
TI  - Changes in regional lung impedance after intravenous histamine bolus in dogs:
      effects of lung volume.
AB  - We measured the effect of lung volume on the time course of regional lung input
      impedance (ZA) after bolus intravenous administration of 2 mg of histamine in
      seven open-chest dogs using alveolar capsule oscillators. ZA (24-200 Hz) was
      obtained during apnea at constant lung volume every 2 s for 80 s at lung
      inflation pressures of 0.1, 0.2, 0.3, 0.5, 0.7, and 1.0 kPa. Local airway
      resistance (RA) and elastance of the local lung region were calculated by fitting
      a four-parameter model to the measured ZA. Total lung resistance and lung
      elastance were also calculated from tracheal pressure and flow measured during
      mechanical ventilation (0.3 Hz) just before and after each set of ZA
      measurements. We found the histamine-induced changes in both lung resistance and
      lung elastance to decrease with increasing lung volume. RA also showed a large
      negative dependency on lung volume, and the variation between different RA
      measurements became markedly increased as lung volume decreased. In contrast,
      local airway elastance was essentially unaffected by lung volume. These results
      support the idea that parenchymal tethering of the very distal airways impedes
      their narrowing during bronchoconstriction. They also indicate that reduced
      parenchymal tethering causes airway narrowing to become markedly more
      inhomogeneous.

PMID- 7775333
TI  - Sympathetic nerve responses to hyperthermia in the anesthetized rat.
AB  - The aim of the present study was to characterize the sympathetic nerve responses
      to hyperthermia in chloralose-anesthetized rats. Discharges were recorded from
      the renal, lumbar, and splanchnic sympathetic nerves. Mean arterial pressure,
      heart rate, and sympathetic nerve discharge (SND) were recorded continuously
      during progressive increases in core body temperature (Tc) from 38.0 to 41.0
      degrees C. The following observations were made: 1) significant increases in
      renal, lumbar, and splanchnic SND were observed during hyperthermia; 2)
      autospectral analysis of renal and lumbar SND revealed that the frequency
      distribution of SND can be altered during progressive increases in Tc; and 3)
      increases in splanchnic SND to acute heating were similar in baroreceptor
      innervated and -denervated rats. We conclude that 1) hyperthermia is a potent
      stimulus to the sympathetic nervous system and increases the activity in three
      sympathetic nerves that innervate different regional arterial beds, 2) acute
      heating influences the neural circuits involved in generating SND as evidenced by
      changes in the basic pattern of renal and lumbar SND, and 3) the increase in
      splanchnic SND during hyperthermia is not opposed by the arterial and
      cardiopulmonary baroreceptors.

PMID- 7775334
TI  - Impact of age on the cardiovascular response to dynamic upright exercise in
      healthy men and women.
AB  - To examine whether age differentially modifies the physiological response to
      exercise in men and women, we performed gated radionuclide ventriculography with
      measurement of left ventricular volumes at rest and during peak upright cycle
      exercise in 200 rigorously screened healthy sedentary volunteers (121 men and 79
      women) aged 22-86 yr from the Baltimore Longitudinal Study of Aging. At rest in
      the sitting position, age-associated declines in heart rate (HR) and increases in
      systolic blood pressure occurred in both sexes. Whereas resting cardiac index
      (CI) and total systemic vascular resistance (TSVR) in men did not vary with age,
      in women resting CI decreased 16% and TSVR increased 46% over the six-decade age
      span. Men, but not women, demonstrated an age-associated increase of
      approximately 20% in sitting end-diastolic volume index (EDVI), end-systolic
      volume index (ESVI), and stroke volume index over this age span. Peak cycle work
      rate declined with age approximately 40% in both sexes, but at any age it was
      greater in men than in women even after normalization for body weight. At peak
      effort, ejection fraction (EF), HR, and CI were reduced similarly with age while
      ESVI and TSVR were increased in both sexes; EDVI increased 35% with age and
      stroke work index (SWI) rose 19% in men, but neither was related to age in women;
      and stroke volume index did not vary with age in either sex. When hemodynamics
      were expressed as the change from rest to peak effort as an index of
      cardiovascular reserve function, both sexes demonstrated age-associated increases
      in EDVI and ESVI and reductions in EF, HR, and CI. However, the exercise-induced
      reduction in ESVI and the increases in EF, CI, and SWI from rest were greater in
      men than in women. Thus, age and gender each have a significant impact on the
      cardiac response to exhaustive upright cycle exercise.

PMID- 7775336
TI  - Flow pulsatility does not increase mean microvascular pressure or filtration in
      zone 3 rabbit lungs.
AB  - We previously reported that mean pulmonary arterial pressure (Ppa) during
      pulsatile flow exceeded that for steady flow when flow was greater than the
      normal resting value and speculated that this was due to irregularities of the
      flow profiles in precapillary vessels, mainly the larger arteries. From this we
      hypothesized that neither mean microvascular pressure nor the rate of fluid
      filtration would be affected by flow pulsatility. We therefore compared the
      effects of steady vs. pulsatile flow on the double-occlusion pressure (Pdo) and
      on edema formation (rate of weight gain) in zone 3 rabbit lungs. Excised left
      lungs (n = 19) were perfused with Tyrode solution and ventilated with an end
      expiratory pressure of 2.5 cmH2O. A diaphragm pump generated pulsatile flow with
      a stroke volume of 1.0 ml (approximately 0.8 the normal resting value for rabbit
      left lung). Nonpulsatile flow was generated by raising an arterial reservoir.
      Flow rate was set at 100 or 400 ml/min (approximately 0.4 or 1.6 x the normal
      resting cardiac output, respectively). Vascular pressures (referenced to the
      bottom of the lung) were measured after ventilation, at end expiration, was
      interrupted. Pdo values were obtained in random order at 15 time points that were
      evenly distributed within the pulse cycle, averaged across pulses to obtain the
      mean capillary pressure profile, and then averaged over time. At the lower flow
      of 100 ml/min, mean Ppa and Pdo were slightly lower (3-4%) during pulsatile
      compared with nonpulsatile conditions. At the higher flow of 400 ml/min, mean Ppa
      was higher under pulsatile conditions (13%), whereas downstream the mean Pdo
      values were equal.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775335
TI  - Reduced motor unit activation of muscle spindles and tendon organs in the
      immobilized cat hindlimb.
AB  - Six weeks of limb immobilization of a healthy muscle (cat tibialis posterior) at
      a short length resulted in a significant reduction of mean fiber area for all
      fiber types (I, 71% of control; IIa, 77% of control; IIb, 79% of control),
      whereas fiber type proportions were unchanged. For motor units, there was a
      reduction in peak tetanic force (type slow > fast fatigue resistant > fast
      fatigable); an increase in the twitch-to-tetanus ratio for fast fatigue-resistant
      and slow units; and no effect on the twitch force, twitch time course, or
      fatigability. The reduction in peak force was greater than expected because of
      fiber atrophy in slow units. Immobilization had a minimal effect on muscle
      spindle afferent (Ia and spindle group II) responses to a ramp-and-hold stretch
      of the passive muscle. Tendon organ (Ib) afferents had an increased
      responsiveness to stretch after immobilization but only when the muscle was
      stretched from a short resting length. However, immobilization reduced the
      modulation of muscle afferent discharge in response to tetanic contractions of
      single motor units. The decline in responsiveness of spindles was a result of the
      reduced tetanic force of motor units. In contrast, tendon organs in immobilized
      muscle were twice as likely to convey no information on the contraction of a
      single motor unit and were more likely to be unloaded, suggesting that
      immobilization caused the functional denervation of some muscle fibers. Thus the
      responses of muscle spindles and tendon organs in immobilized muscle reflected
      atrophic changes in extrafusal fibers but did not provide evidence for
      substantial disturbance of receptor function.

PMID- 7775337
TI  - Role of neutral endopeptidase in bronchial hyperresponsiveness to bradykinin
      induced by IL-1 beta.
AB  - Interleukin-1 beta (IL-1 beta) induces bronchial hyperresponsiveness (BHR) to
      bradykinin but not to acetylcholine. We examined whether this was mediated
      through the inhibition of neutral endopeptidase (NEP) activity and/or through the
      enhancement of airway microvascular leakage (AML) by IL-1 beta. We administered
      human recombinant IL-1 beta (500 U) or saline intratracheally and 24 h later
      measured the airway responses to bradykinin (1 mM; 45 breaths). IL-1 beta-treated
      rats showed a decrease of 18.5 and 21.1% of NEP activity in the lungs and
      tracheobronchial tree, respectively (P < 0.05), associated with an augmented
      response in total lung resistance to bradykinin but with no increase in Evans
      blue dye extravasation used as a marker of AML. Phosphoramidon (0.1 and 1 mM; 90
      breaths), an NEP inhibitor, induced a dose-dependent increase in lung resistance
      to bradykinin without further enhancing BHR induced by IL-1 beta. Bradykinin
      induced AML was not enhanced by phosphoramidon in either saline- or IL-1 beta
      treated rats. Similarly, after captopril (1 mM; 90 breaths), an inhibitor of
      angiotensin-converting enzyme, there was no further enhancement of BHR to
      bradykinin induced by IL-1 beta. BHR to bradykinin induced by IL-1 beta may
      result from an inhibition of peptidase activity, such as NEP and angiotensin
      converting enzyme, and is not associated with an enhancement of AML.

PMID- 7775338
TI  - Gas density does not affect pulmonary acoustic transmission in normal men.
AB  - Fremitus, the transmission of sound and vibration from the mouth to the chest
      wall, has long been used clinically to examine the pulmonary system. Recently,
      modern technology has become available to measure the acoustic transfer function
      (TF) and transit times (TT) of the pulmonary system. Because sound speed is
      inversely proportional to the square root of gas density in free gas, but not in
      porous media, we measured the effect of air and Heliox (80% He-20% O2) breathing
      on pulmonary sound transmission in six healthy subjects to investigate the
      mechanism of sound transmission. Wide-band noise (75-2,000 Hz) was "injected"
      into the mouth and picked up over the trachea and chest wall. The averaged power
      spectra, TF, phase, and coherence were calculated using a fast Fourier transform
      based algorithm. The phase data were used to calculate TT as a function of
      frequency. TF was found to consist of a low-pass filter property with essentially
      flat transmitted energy to 300 Hz and exponential decline to 600 Hz at the
      anterior right upper lobe (CR) and flat transmission to 100 Hz with exponential
      decline to 150 Hz at the right posterior base (BR). TF was not affected by
      breathing Heliox. The average TT values, calculated from the slopes of the
      averaged phase, were 1.5 +/- 0.5 ms for trachea to CR and 5.2 +/- 0.5 ms for
      trachea to BR transmission during air breathing. During Heliox breathing, the
      values of TT were 1.5 +/- 0.5 ms and 4.9 +/- 0.5 ms from the trachea to CR and
      from the trachea to BR locations, respectively. These results suggest that sound
      transmission in the respiratory system is dominated by wave propagation through
      the parenchymal porous structure.

PMID- 7775339
TI  - T model partition of lung and respiratory system impedances.
AB  - The aim of this work was to demonstrate that the three compartments of the lung T
      network and the chest wall impedance (Zcw) can be identified from input and
      transfer impedances of the respiratory system if the pleural pressure is recorded
      during the measurements. The method was tested in six healthy volunteers in the
      range of 8-32 Hz. The impedances resulting from the decomposition confirm the
      adequacy of the monoalveolar structure commonly used in healthy subjects. Indeed,
      the T shunt impedance is well modeled by a purely compliant element, the mean
      compliance [0.038 +/- 0.081 (SD) l/kPa], which coincides within 9.5 +/- 6.3% of
      the alveolar gas compressibility derived from thoracic gas volume (0.036 +/-
      0.011 l/kPa). The results obtained provide experimental evidence that the
      alveolar gas compression is predominantly isothermal and that lung tissue
      impedance is negligible throughout the whole frequency range. The shape of Zcw is
      consistent with a low compliance-low inertance pathway in parallel with a high
      compliance-high inertance pathway. We conclude that the proposed method is able
      to reliably identify the T network featuring the lung and Zcw.

PMID- 7775340
TI  - Skin of the dorsal aspect of human hands and fingers possesses an active
      vasodilator system.
AB  - To test for an active vasodilator system in human hand and finger skin, seven
      subjects had a small area of dorsal hand, palm, or dorsal finger pretreated with
      bretylium (BT) to block adrenergic vasoconstriction. Skin blood flow was
      monitored at a BT-treated site, a comparable untreated site, and the forearm by
      laser-Doppler flowmetry. Cutaneous vascular conductance (CVC) was evaluated from
      the ratio of blood flow to arterial pressure. Body cooling, to evaluate
      vasoconstrictor system blockade, caused CVC at untreated sites of forearm, palm,
      dorsal hand, and dorsal finger to fall by 45 +/- 4, 85 +/- 5, 51 +/- 9, and 63 +/
      7%, respectively (all P < 0.05). At BT-treated sites of palm, dorsal hand, and
      dorsal finger, reductions in CVC were only 13 +/- 3, 2 +/- 18, and 13 +/- 4%,
      respectively (dorsal hand not significant, others P < 0.05). With body heating,
      increases in CVC at untreated sites of forearm, palm, dorsal hand, and dorsal
      finger were 881 +/- 165, 779 +/- 368, 423 +/- 115, and 1,430 +/- 716%,
      respectively (all P < 0.05). At BT-treated sites of palm, dorsal hand, and dorsal
      finger, increases were 35 +/- 15, 342 +/- 107, and 343 +/- 34%, respectively
      (palm not significant, others P < 0.05). Increased CVC at the palm began after
      1.2 +/- 0.2 min of heating, significantly earlier than forearm (11.8 +/- 2.5
      min), dorsal hand (16.4 +/- 3.4 min), or dorsal finger (15.6 +/- 3.6 min), which
      did not differ significantly from one another.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775341
TI  - Exogenous surfactant function in very preterm lambs with and without fetal
      corticosteroid treatment.
AB  - We have asked whether the function of a bovine source surfactant frequently used
      clinically (Survanta) could be enhanced after exposure to the very preterm lung
      when the surfactant was subsequently tested in vivo in preterm surfactant
      deficient rabbits. We also evaluated whether there would be effects resulting
      from fetal treatment with 0.5 mg/kg betamethasone given 48 h before delivery of
      lambs at 121 days gestational age. The fetal corticosteroid treatment
      significantly improved gas exchange, increased compliance, increased functional
      residual capacity, decreased vascular-to-alveolar protein leak, and increased
      static lung volumes. However, surfactant from both groups of lambs, recovered by
      alveolar wash and subsequently fractionated to recover the large-aggregate
      functional surfactant, was equivalent in function to the Survants given to the
      lambs when tested in preterm surfactant-deficient rabbits. Addition of plasma to
      Survanta resulted in high minimum surface tensions in vitro, and this inhibition
      could be prevented by supplementation of the Survanta with 5 or 10% sheep
      surfactant. No activation occurred with treatment of the very preterm lung, a
      result consistent with the lung being too immature to contribute components to
      the surfactant used for treatment. Fetal corticosteroid treatment had no effect
      on surfactant function at this gestational age.

PMID- 7775342
TI  - Performance and excitability of mdx mouse muscle at 2, 5, and 13 wk of age.
AB  - Dystrophin is a 427-kDa protein localized adjacent to the sarcolemma in skeletal
      muscle. Its physiological role remains uncertain, although its absence is known
      to cause muscular dystrophy. In this study, the function of dystrophin was
      investigated using the dystrophin-deficient mdx mouse. Control and mdx animals at
      2, 5, and 13 wk of age (n = 8-11/age) were compared to evaluate in situ
      gastrocnemius-plantaris-soleus muscle contractile, endurance, and excitability
      properties at nondegenerated, degenerated, and regenerated stages, respectively.
      Twitch and tetanic tensions expressed per gram of muscle mass were lower in mdx
      muscle only at 5 wk. Fatigue produced during successive contractions at 2, 10,
      and 20 Hz did not differ between the two groups at 2 and 5 wk but was lower in
      mdx muscle at 13 wk. This was not attributed to differences in mitochondria,
      since cytochrome-c oxidase activity was similar in mdx and control muscle.
      Contractile properties of control and mdx muscle became faster with age, and at
      13 wk the time to peak twitch tension was shorter in mdx muscle relative to
      control, whereas the half-relaxation times did not differ. Mass action potential
      area (M wave), an index of muscle excitability, was not significantly different
      between mdx and control muscle at 2 or 5 wk but was greater in mdx muscle at 13
      wk. Thus, in this weight-bearing muscle group, the lack of dystrophin has only a
      moderate impact in modifying muscle function relative to contractile properties,
      fatigability, or excitability.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775343
TI  - The effects of rM-CSF and rIL-6 therapy on immunosuppressed antiorthostatically
      suspended mice.
AB  - Antiorthostatically suspended mice had suppressed macrophage development in both
      unloaded and loaded bones, indicating a systemic effect. Bone marrow cells from
      those mice secreted less macrophage colony-stimulating factor (M-CSF) and
      interleukin-6 (IL-6) than did control mice. Because M-CSF and IL-6 are important
      to bone marrow macrophage maturation, we formulated the hypothesis that
      suppressed macrophage development occurred as a result of the depressed levels of
      either M-CSF or IL-6. To test the hypothesis, mice were administered recombinant
      M-CSF or IL-6 intraperitoneally. We showed that recombinant M-CSF therapy, but
      not recombinant IL-6 therapy, reversed the suppressive effects of antiorthostatic
      suspension on macrophage development. These data suggest that bone marrow cells
      that produce M-CSF are affected by antiorthostatic suspension and may contribute
      to the inhibited maturation of bone marrow macrophage progenitors.

PMID- 7775344
TI  - Compatibility of high-intensity strength and endurance training on hormonal and
      skeletal muscle adaptations.
AB  - Thirty-five healthy men were matched and randomly assigned to one of four
      training groups that performed high-intensity strength and endurance training (C;
      n = 9), upper body only high-intensity strength and endurance training (UC; n =
      9), high-intensity endurance training (E; n = 8), or high-intensity strength
      training (ST; n = 9). The C and ST groups significantly increased one-repetition
      maximum strength for all exercises (P < 0.05). Only the C, UC, and E groups
      demonstrated significant increases in treadmill maximal oxygen consumption. The
      ST group showed significant increases in power output. Hormonal responses to
      treadmill exercise demonstrated a differential response to the different training
      programs, indicating that the underlying physiological milieu differed with the
      training program. Significant changes in muscle fiber areas were as follows:
      types I, IIa, and IIc increased in the ST group; types I and IIc decreased in the
      E group; type IIa increased in the C group; and there were no changes in the UC
      group. Significant shifts in percentage from type IIb to type IIa were observed
      in all training groups, with the greatest shift in the groups in which resistance
      trained the thigh musculature. This investigation indicates that the combination
      of strength and endurance training results in an attenuation of the performance
      improvements and physiological adaptations typical of single-mode training.

PMID- 7775345
TI  - Adenosine A2 receptors reverse ischemia-reperfusion lung injury independent of
      beta-receptors.
AB  - To evaluate the adenosine systems ability to reverse the endothelial damage
      produced by ischemia and reperfusion (I/R), we studied several different
      selective adenosine-receptor agonists and antagonists, a protein kinase A
      inhibitor, and a beta-adrenoreceptor antagonist in isolated buffer-perfused rat
      lungs. I/R (45 min/105 min) produced a sixfold increase in endothelial
      permeability as measured by the capillary filtration coefficient. Both a
      selective A2-receptor agonist (CGS-21680, 300 nM) and a beta-receptor agonist
      (isoproterenol, 10 microM) reversed the increased microvascular permeability. A
      nonselective adenosine-receptor antagonist (SPT, 20 microM) and a selective A1
      receptor antagonist (DPCPX, 10 nM) had no effect on increased microvascular
      permeability. Also, isoproterenol and CGS-21680 reversed the damage being
      introduced after a selective A1-receptor agonist (CCPA, 100 nM). The nonspecific
      adenosine A1- and A2-receptor agonist NECA (12 nM) appeared to desensitize the A2
      receptors and a protein kinase A inhibitor, adenosine-3',5'-cyclic
      monophosphothioate (Rp-cAMPS, 100 microM), blocked the reversal of endothelial
      damage by isoproterenol or A2-receptor agonist. Propranolol (100 microM) blocked
      the effect of isoproterenol but not the effect of CGS-21680. From this study we
      conclude that A2-receptor activation reverses endothelial damage associated with
      I/R by a mechanism independent of beta-receptors or Gi protein. However, a
      protein kinase A-3',5',-cyclic adenosine monophosphate pathway is activated by
      both the adenosine systems and beta-receptor activation.

PMID- 7775347
TI  - Testosterone and aggression.

PMID- 7775348
TI  - Of norms and cutoffs.

PMID- 7775346
TI  - Effects of increased +Gz on chest wall mechanics in humans.
AB  - We studied the effects of head-to-foot acceleration (+Gz) on chest wall mechanics
      in five normal subjects seated in a human centrifuge. Results were compared with
      those previously obtained in the same subjects in microgravity during parabolic
      flights. In all subjects, end-expiratory abdominal pressure (Pga) and volume
      (Vab) increased with Gz. On average, end-expiratory Pga increased from 7.4 +/-
      1.7 cmH2O at + 1 Gz to 14.9 +/- 2.8 cmH2O at + 3 Gz and end-expiratory Vab
      increased by 0.32 +/- 0.06 liter between + 1 and + 3 Gz. On the other hand, the
      abdominal contribution to tidal volume (Vab/VT) and abdominal compliance
      decreased from 34.7 +/- 5.9% and 52 +/- 6 ml/cmH2O at + 1 Gz to 29.3 +/- 5.1% and
      26 +/- 4 ml/cmH2O at + 3 Gz, respectively. Changes in end-expiratory Pga were
      linear between 0 and + 3 Gz, but changes in end-expiratory Vab, Vab/VT, and
      abdominal compliance were greater in microgravity than in hypergravity. In
      contrast to weightlessness, which did not alter minute ventilation and tidal
      changes in Pga and transdiaphragmatic pressure, these variables increased with
      increasing Gz. These results indicate that, although changes in Gz have a linear
      effect on abdominal transmural pressure, hypergravity and weightlessness do not
      have symmetrical effects on chest wall mechanics.

PMID- 7775349
TI  - Comorbid Capgras' syndrome.

PMID- 7775350
TI  - PDD and Prader-Willi syndrome.

PMID- 7775351
TI  - A developmental psychopathology perspective on child abuse and neglect.
AB  - OBJECTIVE: The purpose of this review is to conceptualize child abuse and neglect
      within a developmental psychopathology perspective. Toward this end, issues of
      definition and epidemiology, etiology, and sequelae are addressed. METHOD:
      Research and theory on child abuse and neglect with relevance to a developmental
      perspective is reviewed. RESULTS: Considerable progress has been made in our
      understanding of the etiology and consequences of child abuse and neglect. Less
      progress has been made in utilizing this knowledge to inform treatment efforts.
      CONCLUSIONS: Incorporation of a developmental psychopathology perspective into
      efforts to understand and ameliorate the adverse effects of child abuse and
      neglect holds considerable promise for advancing research and intervention in the
      area of child maltreatment. The importance of providing comprehensive and
      coordinated services that incorporate knowledge of how maltreated youngsters
      negotiate stage-salient issues of development is stressed. The provision of child
      focused treatment, parent-based models of intervention, and ecologically driven
      approaches to prevention all can benefit from an understanding of the adverse
      effects that maltreatment exerts on the process of development.

PMID- 7775352
TI  - Unipolar depression in adolescents: clinical outcome in adulthood.
AB  - OBJECTIVE: This study examined the longitudinal clinical course and adult
      sequelae of adolescent unipolar major depressive disorder (MDD) using a
      controlled longitudinal design. METHOD: Subjects were 28 adolescents (15.4 +/-
      1.3 years) with systematically diagnosed unipolar MDD and 35 group-matched
      control subjects who participated in a cross-sectional electroencephalogram sleep
      and neuroendocrine study. Using standardized instruments, interviewers who were
      blind to subjects' initial diagnoses conducted follow-up clinical assessments 7.0
      +/- 0.5 years later in 94% of the original cohort. RESULTS: The depressed group
      showed high rates of recurrence of MDD episodes during the interval period (69%).
      They also had elevated rates of new-onset bipolar disorder (19%). Twenty-three
      percent of subjects with an initial diagnosis of MDD had no additional depressive
      episodes after the index assessment. The rate of new onset of depression in the
      controls was 21%. Low socioeconomic status predicted recurrence of depressive
      episodes in the MDD group. MDD subjects with recurrence(s) and controls with new
      onset of depression during the follow-up period had significant psychosocial
      morbidity, as evidenced by disruption in interpersonal relationships and
      dissatisfaction with life and decrease in global functioning, compared with both
      MDD subjects with no further episodes and control subjects who had never been
      psychiatrically ill. These psychosocial deficits persisted remission from
      depressive episode(s). CONCLUSIONS: Adolescent unipolar MDD predicts continued
      risk for recurrences with persistence of depressive episodes and psychosocial
      morbidity into adulthood. A sizable minority, however, have sustained periods of
      remission associated with good social adjustment.

PMID- 7775353
TI  - Psychiatric comorbidity among referred juveniles with major depression: fact or
      artifact?
AB  - OBJECTIVE: The high levels of psychiatric comorbidity reported in juveniles
      meeting operational definitions of depressive disorders raise both substantive
      and methodological concerns about whether depression with comorbid disorders
      should be classified as two disorders or as different manifestations of the same
      condition. Our purpose was to clarify issues of diagnostic heterogeneity and
      diagnostic overlap in juvenile depression. METHOD: The sample consisted of
      consecutively referred children and adolescents (N = 424) comprehensively
      evaluated with structured diagnostic interviews and psychosocial assessments.
      RESULTS: A clinical picture compatible with the diagnosis of major depression was
      identified in 40% of these referred youths. Children meeting criteria for major
      depression had prototypical symptoms of the disorder, a chronic course, and
      severe psychosocial dysfunction. In addition, they frequently met criteria for
      attention-deficit hyperactivity disorder, conduct disorder, and anxiety
      disorders. These comorbidity findings were not due to symptom overlap among major
      depression and the co-occurring disorders. For the most part, comorbid disorders
      preceded the onset of major depression by several years. CONCLUSIONS: Juvenile
      depression has a chronic course, severe dysfunction, and high levels of
      psychiatric comorbidity. Despite symptom overlap, our work suggests that major
      depression and other conditions may represent different disorders.

PMID- 7775354
TI  - Stressful life events in depressed adolescents: the role of dependent events
      during the depressive episode.
AB  - OBJECTIVE: To examine the relationship between stressful life events and major
      depressive disorder (MDD) in adolescents. METHOD: Adolescents (aged 12 to 18
      years) with a current episode of MDD based on Research Diagnostic Criteria (n =
      39) and normal controls free of any Axis I lifetime psychiatric disorder (n = 35)
      were assessed using the Life Events Record. RESULTS: MDD and normal control
      adolescents had similar rates of total stressful life events in the year before
      being interviewed. Stressful life events were dichotomized into those that were
      most likely either independent of or dependent on the adolescent's
      influence/behavior. Depressed adolescents had significantly more dependent
      stressful life events during the previous year than did the normal controls.
      Further analyses showed that depressed adolescents with dependent stressful life
      events scored lower on symptom clusters and accordingly were less severely
      depressed than depressed adolescents without dependent life events. CONCLUSIONS:
      The results of this study indicate that depressed adolescents have an increased
      risk for experiencing dependent life events. Furthermore, these data suggest that
      dependent life events in depressed adolescents are differentially associated with
      the type and severity of symptom presentation. The temporal occurrence, severity,
      and type of stressful life events as they relate to the onset, phenotypic
      expression, and maintenance of depression in adolescents need to be more fully
      understood.

PMID- 7775355
TI  - Early psychosocial risks for adolescent suicidal ideation and attempts.
AB  - OBJECTIVE: An ongoing, 14-year, longitudinal community study examined
      psychosocial risks for adolescent suicidal ideation and attempts, as well as the
      link between earlier suicidal behavior and later functioning. METHOD: Nearly 400
      youths were followed between the ages of 5 and 18 years. Suicidal ideation was
      assessed at age 15 and lifetime suicide attempts were determined at age 18. Risk
      factors covered developmental periods from birth to age 15, and most were
      measured prospectively using multiple informants. Late-adolescent functioning (at
      age 18) was based on both self-reports and school records. RESULTS: For both
      genders, the early onset (by age 14) of psychiatric disorders significantly
      increased the risk for suicidal ideation at age 15 and suicide attempts by age
      18. Early gender-specific risks for suicidal ideation included preschool
      behaviors that are counter to typical gender norms, such as aggressive behavior
      in females and dependence in males. Suicidal ideation at age 15 and suicide
      attempts were both associated with deficits in later adolescence (at age 18) in
      behavioral and social-emotional functioning. CONCLUSIONS: Suicidal ideation at
      age 15 was a marker of distress with long-term implications for later
      functioning. The early gender-specific risk factors for suicidal behavior
      identified in this study can aid in developing strategies for prevention and
      early intervention.

PMID- 7775357
TI  - Adolescents' image of their suicide attempt.
AB  - OBJECTIVE: To inventory the reasons adolescents give for their perceptions of
      events, thoughts, and feelings in the last days and hours before and during the
      attempt. METHOD: A semistructured interview also included the administration of
      an instrument that contained the formulation of reasons. RESULTS: The most
      frequently mentioned reasons for attempting suicide concerned the cessation of
      (an unbearable) consciousness. The motivation most frequently named for "crossing
      the bridge" between thinking about and attempting suicide involved an escalation
      of frustration and tension. CONCLUSIONS: Special emphasis should be given to
      family relationships, relationships with peers and friends, frustration
      tolerance, and the way in which adolescents handle their problems.

PMID- 7775358
TI  - Comparison of diagnostic criteria for attention deficit disorders in a German
      elementary school sample.
AB  - OBJECTIVE: This study compares teacher-reported prevalence rates for disruptive
      behavior disorders using DSM-IV, DSM-III-R, and DSM-III criteria within the same
      population of elementary school students and examines the relationships between
      DSM "subtypes" and academic performance, perceived behavior problems, and
      demographic variables. METHOD: Teacher rating scales were obtained on 1,077
      students in five rural and five urban public schools in Regensburg, Germany.
      Rating scales included DSM-III-R items (attention-deficit hyperactivity disorder,
      oppositional defiant disorder, conduct disorder), DSM-IV items (attention
      deficit/hyperactivity disorders [AD/HDs], oppositional defiant disorder), and DSM
      III items (attention deficit disorder, with and without hyperactivity). Factor
      analyses of significance were performed. RESULTS: Overall prevalence for
      attention deficit disorders increased from 9.6% (DSM-III) to 17.8% (DSM-IV)
      primarily because of new cases identified as AD/HD-AD (inattentive type) and to a
      lesser degree, AD/HD-HI (hyperactive-impulsive type). Inattention in any subtype
      was associated with academic problems, and perceived behavior problems were
      associated with more than 80% of the cases that included hyperactivity
      impulsivity. DSM-IV AD/HD subtypes showed significant behavioral, academic, and
      demographic differences. CONCLUSION: Application of DSM-IV criteria increased
      total AD/HD prevalence rates by 64% and identified the majority of children with
      academic and/or behavioral dysfunction. The data show significant heterogeneity
      between the subtypes and imply that many children screened into these subtypes
      require further evaluation to ensure appropriate management.

PMID- 7775356
TI  - Childhood circumstances, adolescent adjustment, and suicide attempts in a New
      Zealand birth cohort.
AB  - OBJECTIVE: To estimate the prevalence of attempted suicide during adolescence in
      a birth cohort of New Zealand children studied to the age of 16 years and to
      examine the relationships among adolescent problems of adjustment,
      psychopathology, childhood circumstances, and risks of adolescent suicide
      attempts. METHOD: Attempted suicide, adolescent problems of adjustment,
      psychopathology, and childhood circumstances were assessed as part of a
      longitudinal study of a birth cohort of 954 New Zealand children studied at
      annual intervals to the age of 16 years. RESULTS: By 16 years, 3.0% of the sample
      (4.2% of girls and 1.9% of boys) reported having made a suicide attempt. There
      were strong associations between attempted suicide and rates of adolescent
      problem behaviors or psychopathology; teenagers having problems of adjustment or
      psychiatric disorders were up to 22 times more likely to attempt suicide. Risks
      of attempted suicide were also higher among children from disadvantaged or
      dysfunctional family backgrounds. A loglinear model fitted to the measures of
      attempted suicide, adolescent psychopathology, problems of adjustment, and
      childhood circumstances suggested the presence of a causal chain process in which
      childhood problems were significantly (p < .005) related to increased risks of
      later psychopathology and problems of personal adjustment which were, in turn,
      related to significantly (p < .05) increased rates of attempted suicide.
      CONCLUSIONS: A common pathway that leads to increased vulnerability to suicidal
      behavior involves early disadvantageous childhood and family circumstances, which
      lead to increased risks of adolescent psychopathology and problems of adjustment,
      which lead to increased risks and vulnerability to adolescent suicidal behaviors.

PMID- 7775359
TI  - Test of four hypotheses for the comorbidity of attention-deficit hyperactivity
      disorder and conduct disorder.
AB  - OBJECTIVE: To study the basis of the comorbidity of two common psychiatric
      disorders of childhood: attention-deficit hyperactivity disorder (ADHD) and
      conduct disorder (CD). METHOD: Subjects were 45 boys (aged 7 to 11 years) with
      either ADHD, CD, or ADHD + CD and 16 normal control children (NC) studied by
      means of a 2 (ADHD versus no ADHD) x 2 (CD versus no CD) design. We (1) tested
      whether similar or different patterns of cognitive, developmental risk, and
      psychosocial factors characterize the "pure" forms of the two disorders (i.e.,
      ADHD and CD), and (2) compared the profile of the comorbid group (ADHD + CD) with
      those of the two pure groups. RESULTS: The ADHD group was significantly impaired
      on cognitive measures (inhibitory control and response alteration) and had
      greater delay in development and greater reading problems compared with CD and NC
      children; the CD group was exposed to significantly greater environmental
      adversity and had more severe problems in arithmetic than the ADHD and NC groups.
      The ADHD+CD group was similar to the ADHD group on cognitive, developmental, and
      reading measures and similar to the CD group on psychosocial and arithmetic
      measures. CONCLUSIONS: These results support the distinctiveness of ADHD and CD
      and the hypothesis that the comorbid condition of ADHD + CD is a hybrid of pure
      ADHD and pure CD.

PMID- 7775361
TI  - Six-year predictors of problems in a national sample: III. Transitions to young
      adult syndromes.
AB  - OBJECTIVE: To test developmental paths from adolescent syndromes and other
      candidate predictors to young adult syndromes. METHOD: A national sample assessed
      at ages 13 through 16 and 16 through 19 years was reassessed at 19 through 22
      years in terms of six syndromes derived empirically from parent and self-reports,
      two syndromes derived only from parent reports, and one derived from self
      reports. RESULTS: Several young adult syndromes were similar to adolescent
      syndromes and were strongly predicted by these syndromes. A new syndrome
      designated as Shows Off and an adult Aggressive Behavior syndrome were both
      predicted by the adolescent Aggressive Behavior syndrome. This indicates a
      developmental transition away from overt aggression among some aggressive youths
      but not others. A syndrome designated as Irresponsible was predicted by the
      adolescent Attention Problems syndrome and may be an adult phenotype of attention
      deficit disorder. Surprisingly, attention problems were associated with more
      diverse problems among females than males. CONCLUSIONS: There are strong
      predictive relations from adolescent to adult syndromes. Sex differences in
      predictive paths argue against basing assumptions about both sexes on findings
      for one sex.

PMID- 7775360
TI  - Bupropion versus methylphenidate in the treatment of attention-deficit
      hyperactivity disorder.
AB  - OBJECTIVE: In the treatment of attention-deficit hyperactivity disorder (ADHD),
      the efficacy of the tricyclic antidepressants and monoamine oxidase inhibitor
      antidepressants has been compared with that of both placebo and the stimulants
      (methylphenidate and/or dextroamphetamine). However, the effectiveness of
      bupropion has been contrasted only with placebo. The primary aim of this study
      was to contrast the efficacy of bupropion with that of methylphenidate in the
      treatment of ADHD. METHOD: A double-blind, crossover design was used in this
      study. After a 14-day medication washout period, 15 ADHD subjects (7 to 17 years
      old) were randomized to either methylphenidate or bupropion for 6 weeks, washed
      out for an additional 2 weeks, and then "crossed over" to the other drug.
      Methylphenidate was titrated to the maximum effective dose of 0.4 to 1.3 mg/kg
      per day (mean 0.7 mg/kg per day) and bupropion was titrated to an effective dose
      ranging from 1.4 to 5.7 mg/kg per day (mean 3.3 mg/kg per day). RESULTS: Both
      methylphenidate and bupropion produced significantly greater (p < .001) and
      equivalent improvement on the Iowa-Conners Teacher's Rating Scale according to
      both the subjects' parents and teachers. The same pattern of improvement was also
      noted for improvement on the Clinical Global Impression Scale, Kagan's Matching
      Familiar Figures Test, Continuous Performance Test, Children's Depression
      Inventory, Children's Manifest Anxiety Scale, and Rey Auditory-Verbal Learning
      Test. CONCLUSIONS: In this double-blind, crossover trial, bupropion and
      methylphenidate were both effective and did not differ in their overall efficacy
      as treatments for ADHD.

PMID- 7775362
TI  - Models of adolescent psychopathology: childhood risk and the transition to
      adulthood.
AB  - OBJECTIVE: To examine the relationship between DSM-III disorder in adolescence
      (age 15 years) and DSM-III-R disorder in early adulthood (age 18 years), in
      relation to a history of behavior problems or disorder, other family and
      individual characteristics, and events commonly associated with the transition to
      adulthood. METHOD: The sample came from a New Zealand birth cohort selected from
      the general population. Data were obtained from ages 3 to 18 years for 890 of
      those enrolled. RESULTS: For both males and females, disorder at age 15 was
      strongly predicted by histories of early mental health problems. However, neither
      those histories, background characteristics, nor the experience of adolescent
      transition events modified the strength of association between disorder at ages
      15 and 18 years. In childhood, after adjusting for histories of behavior
      problems, parental separations and (for boys) poor social competence remained
      independent predictors of disorder at age 15. Overall, boys appeared more
      vulnerable and those from socially disadvantaged backgrounds in early childhood
      had an elevated risk of disorder at age 18. After adjusting for disorder at age
      15, adolescent unemployment remained an independent predictor of disorder at age
      18 for both males and females. CONCLUSIONS: This study modeled the continuity of
      disorder across the adolescent transition period and, after taking earlier
      disorder into account, identified clear predictors of later disorder. This is the
      first step in the process of developing more effective interventions to reduce
      the risk of mental health disorders.

PMID- 7775363
TI  - Continuity and change of self-reported problem behaviors from adolescence into
      young adulthood.
AB  - OBJECTIVE: To investigate the 4-year course of behavioral and emotional problems
      from adolescence into young adulthood in a general population sample. METHOD: The
      population consisted of 364 individuals, aged 15 to 18 years at the beginning of
      the study. Subjects filled out the Youth Self-Report at the first time of
      assessment. At follow-up, 2 and 4 years later, subjects aged 19 or older
      completed the Young Adult Self-Report, which was derived from the Youth Self
      Report. RESULTS: Almost 40% of the adolescents who were classified as deviant
      initially were still deviant 4 years later. There was no significant difference
      in the continuity of internalizing problems versus externalizing problems in this
      sample. CONCLUSIONS: All types of problems tended to persist to a similar degree.
      This holds also for problems that are often regarded as typical childhood
      problems, such as attention problems and hyperactivity. Because adolescent
      problems are likely to continue, we need more knowledge on the efficacy of
      interventions.

PMID- 7775364
TI  - A double-blind multicenter trial comparing sertraline and fluoxetine in
      outpatients with major depression.
AB  - BACKGROUND: Sertraline and fluoxetine have pharmacokinetic and pharmacologic
      differences, which may be of clinical relevance. METHOD: A randomized, double
      blind, parallel-group study of 6 weeks' duration comparing the efficacy and
      safety of sertraline (50-100 mg/day) with those of fluoxetine (20-40 mg/day) was
      conducted in 286 psychiatric outpatients with DSM-III-R major depression or
      bipolar disorder (depressed). Primary efficacy measurements consisted of the 17
      item Hamilton Rating Scale for Depression (HAM-D) and the Clinical Global
      Impressions (CGI) scale. Secondary measurements included the Hamilton Rating
      Scale for Anxiety (HAM-A), the Raskin Depression Scale, the Covi Anxiety Scale,
      and the Leeds Sleep Questionnaire. Additionally, scores for two items and five
      factors from the HAM-D were analyzed. RESULTS: Efficacy was based on 124
      evaluable patients in each treatment group. As measured by HAM-D and CGI-Severity
      scores, there was a significant (p < .001) improvement from baseline to each
      follow-up visit in both treatment groups with no statistically significant
      difference between groups. There was also no significant difference in the
      proportion of responders in each group. CGI-Improvement responder rates were 69%
      for sertraline and 67% for fluoxetine. Results of secondary efficacy measurements
      followed the same trend, although from the second week of treatment there was a
      numerical advantage (not statistically significant) for sertraline over
      fluoxetine in improving anxiety symptoms as measured by the total HAM-A score.
      Headache and nausea were the most frequently reported events for both drugs. The
      incidence of early patient withdrawals due to treatment-emergent adverse events
      was 14% for sertraline and 13% for fluoxetine. The starting dosage (sertraline 50
      mg/day, fluoxetine 20 mg/day) was the final dosage in 76% of patients in both
      treatment groups. CONCLUSION: Sertraline and fluoxetine were equally effective
      and well tolerated in patients with major depression and associated anxiety.

PMID- 7775365
TI  - A double-blind comparison of clomipramine and desipramine in the treatment of
      developmental stuttering.
AB  - BACKGROUND: Clomipramine, a serotonin reuptake blocker that has been shown to be
      effective in treating obsessive-compulsive disorder and other unwanted
      repetitive, ritualized behaviors, was hypothesized to be superior to desipramine,
      a tricyclic antidepressant with selective noradrenergic effects, for
      developmental stuttering. METHOD: Seventeen psychiatrically normal subjects, aged
      14-61 years, with developmental stuttering completed a 10-week double-blind
      crossover trial of clomipramine and desipramine after a 2-week single-blind
      placebo phase. RESULTS: Clomipramine was superior to desipramine (two-tailed, p <
      .05) for 5 of 10 self-report ratings including stuttering severity on two scales,
      degree of preoccupation with stuttering and resistance to stuttering on a visual
      analog scale, and "expectancy" of stuttering on the Perceptions of Stuttering
      Inventory. CONCLUSION: Clomipramine may be clinically useful for some patients
      with developmental stuttering. Biological links between developmental stuttering
      and other repetitive motor patterns that are selectively responsive to
      serotonergic agents should be explored.

PMID- 7775366
TI  - Breastfeeding and sertraline: a 24-hour analysis.
AB  - BACKGROUND: Few reports exist on the levels of antidepressants in breast milk or
      on observed behavioral effects, if any, of neonates who are breast-fed. Thus, a
      dilemma exists for women who would like to breast-feed but require psychotropic
      medications. METHOD: Analysis of sertraline levels was performed on eight samples
      of breast milk obtained over a 24-hour period, after 3 weeks of breastfeeding,
      from a lactating patient taking sertraline and nortriptyline. During this same 24
      hour period, two serum samples each were taken from mother and child for analysis
      of sertraline and nortriptyline levels. After 7 weeks of exclusive breastfeeding,
      an additional serum sample was obtained from mother and child for analysis of
      sertraline levels. Drug metabolites were not measured. RESULTS: Breast milk
      levels of sertraline were lowest 1 hour before the ingestion of sertraline and
      highest 5 to 9 hours after ingestion of the drug. The infant's serum sertraline
      and nortriptyline levels were nondetectable. CONCLUSION: These data indicate that
      sertraline levels in breast milk vary substantially over 24 hours and appear to
      be lowest within the 2 hours before and 1 hour after ingestion of the medication,
      with the peak probably occurring between Hours 1 and 9 postingestion. However,
      the absence of detectable serum sertraline and nortriptyline levels in the infant
      suggests that if either medication is present in infant serum, its concentration
      would be extremely low. No abnormal occurrences have been noted in the
      development of the infant. It would be important in future studies to measure
      metabolites in addition to medication levels since the former have been
      associated with untoward events in an infant.

PMID- 7775367
TI  - Phenomenology of intentional repetitive behaviors in obsessive-compulsive
      disorder and Tourette's disorder.
AB  - BACKGROUND: Recent evidence suggests that obsessive-compulsive disorder (OCD) and
      Tourette's disorder are related and have overlapping clinical features. The
      purpose of this study was to test the following hypotheses regarding intentional
      repetitive behaviors in these two disorders: (1) In OCD without comorbid
      Tourette's, they are preceded by cognitive phenomena and autonomic anxiety, but
      not sensory phenomena, and (2) in Tourette's without comorbid OCD, they are
      preceded by sensory phenomena, but not cognitive phenomena nor autonomic anxiety.
      METHOD: Fifteen adult OCD outpatients without tics and 17 adult Tourette's
      outpatients without OCD were evaluated with a structured interview. Questions
      assessed cognitive, sensory, and affective experiences related to intentional
      repetitive behaviors. RESULTS: Five of 17 Tourette's subjects were excluded
      because they had only unintentional or occasionally intentional tics. All OCD
      patients reported some cognitions preceding their intentional repetitive
      behaviors, whereas only 2 of 12 Tourette's patients reported cognitions. In
      comparison, all Tourette's patients reported sensory phenomena preceding
      repetitive behaviors, and none of the OCD patients reported such sensations. In
      addition, 13 OCD patients reported at least mild autonomic anxiety associated
      with their repetitive behaviors, whereas no Tourette's patients reported such
      symptoms. CONCLUSION: Intentional repetitive behaviors in OCD differ from those
      in Tourette's and are associated with cognitive and autonomic phenomena. Sensory
      phenomena preceded intentional repetitive behaviors in Tourette's but not in OCD
      patients. The dimensions examined in this study (cognition, sensory phenomena,
      and autonomic anxiety) may represent valid clinical factors for characterization
      of repetitive behaviors in OCD and Tourette's.

PMID- 7775369
TI  - Obsessive-compulsive spectrum disorders.

PMID- 7775368
TI  - Prescribing trends of antidepressants in bipolar depression.
AB  - BACKGROUND: This study utilizing pharmacoepidemiologic methods was undertaken to
      determine the prescribing patterns of antidepressants particularly in bipolar
      depression. METHOD: From pharmacy records of the McLean Hospital, the number of
      patients receiving antidepressants and given electroconvulsive therapy (ECT) from
      June 1, 1987, to May 8, 1993, was determined. We later linked these data bases
      with patients who were diagnosed with DSM-III-R bipolar depression (296.5) during
      the same period of time. RESULTS: During the 6-year period, it was determined
      that 3829 inpatients had received tricyclic antidepressants (TCAs), 2981
      fluoxetine, 2603 trazodone, 809 bupropion, 743 monoamine oxidase inhibitors
      (MAOIs), 592 stimulants, 588 sertraline, 48 paroxetine, and 894 ECT. There were
      significant increases over time in prescriptions of MAOIs compared with
      fluoxetine (chi 2 = 14.36, p = .006), and bupropion compared with TCAs (chi 2 =
      6.45, p = .04). There was a trend for bupropion to be prescribed more over time
      compared with fluoxetine (chi 2 = 5.09, p = .08). There were no significant
      changes in the prescribing of other antidepressants or in the use of ECT.
      CONCLUSION: At our center, prescribing of bupropion and MAOIs in bipolar
      depression has increased significantly. This may be related to the reports in the
      literature of the low switch rates to mania with the use of these drugs.

PMID- 7775370
TI  - Depressive personality disorder.

PMID- 7775371
TI  - Current concepts in schizophrenia: international symposia report new standards
      for assessment and treatment. Part II: Treatment issues and broadening options.

PMID- 7775372
TI  - Birth of the sliding filament concept in muscle contraction.
AB  - Why were the two classical papers by A.F. Huxley and R. Niedergerke and by H.E.
      Huxley and J. Hanson on the sliding filament concept in muscle contraction
      published in the same issue (May 22, 1954) of Nature? This historical survey
      reveals the background of the two groups' monumental work.

PMID- 7775373
TI  - Expression and characterization of Met92Gln mutant plastocyanin from Silene
      pratensis.
AB  - To investigate the role of the copper-ligand Met92 in the structural and
      functional properties of silene plastocyanin (PC), Met92 was replaced with Gln,
      which is the purposed fourth copper-ligand in another blue copper protein,
      stellacyanin. By use of the recently developed expression system [Hibino et al.
      (1994) J. Biochem. 116, 826-832], the Met92Gln mutant of intermediate precursor
      plastocyanin was successfully expressed in Escherichia coli and accumulated in
      the periplasmic space as a mature protein. In contrast to the wild type, most of
      the Met92Gln mutant PC accumulated as an apoprotein. After purification, mutant
      apoprotein could incorporate copper ions, although less efficiently than the wild
      type apoprotein. The absorption peak of Met92Gln mutant PC was blue-shifted from
      597 nm in the wild type to 591 nm. The rhombic type EPR spectrum was obtained for
      the mutant in place of the axial spectrum in the wild type. Compared with that of
      the wild-type PC, the oxidation-reduction potentials of the Met92Gln mutant PC
      were lower by about 35 mV over the whole pH range examined. These results
      indicate that the Met92Gln mutant exhibited "stellacyanin-like" spectroscopic
      properties. Interestingly, the electron-transfer activities of the mutant PC with
      the physiological electron donor (cytochrome f) and acceptor (Photosystem I) were
      similar to that of the wild-type PC. Since Met92 is conserved in all the
      plastocyanins whose primary structures are known, we propose that the primarily
      function of Met as a copper-ligand is in the uptake of copper ions during folding
      rather than in electron-transfer activities.

PMID- 7775374
TI  - Determination of amounts of polyamines excreted in urine: demonstration of N1,N8
      diacetylspermidine and N1,N12-diacetylspermine as components commonly occurring
      in normal human urine.
AB  - An analytical system developed for fractionating free and monoacetylated
      polyamines [Hiramatsu, K. et al. (1994) J. Biochem. 115, 584-589] was proved
      useful also in detecting diacetylpolyamines, namely N1,N8-diacetylspermidine
      (diAcSpd) and N1,N12-diacetylspermine (diAcSpm). Detection limits were 0.9 and
      0.6 pmol (S/N = 5) for diAcSpd and diAcSpm, respectively. Analytical recovery and
      within-run variation were also satisfactory. Human urine samples were found to
      contain diAcSpd and diAcSpm. These polyamines were identified on the basis of the
      following observations: (i) their retention times were coincident with those of
      authentic samples; (ii) they were deacetylated to N8-acetylspermidine and
      monoacetyl- and free spermine, respectively, by acetylpolyamine amidohydrolase;
      and (iii) they were practically inert to direct oxidation by bacterial polyamine
      oxidase as were authentic samples. The amounts of eleven polyamine species
      including diAcSpd and diAcSpm in urine samples from 52 healthy persons were
      determined. Mean values for the major polyamine components were consistent with
      those reported by others. Although the amounts of diAcSpd and diAcSpm were very
      small, comprising only 1.4 and 0.46% of total polyamines, respectively, these two
      compounds were found to be always present in healthy human urine as regular
      constituents. Moreover, variation in their content among individuals was small,
      suggesting that excretion of these components in urine is strictly regulated.

PMID- 7775375
TI  - Geranylgeraniol is a potent inducer of apoptosis in tumor cells.
AB  - We screened various isoprenoids to find inducers of apoptosis for human leukemia
      HL-60 cells, and found that GGO (geranylgeraniol) had the most potent apoptosis
      inducing activity, as judged from DNA fragmentation in HL-60 cells. The apoptosis
      inducing activity of GGO is concentration- and time-dependent. DNA synthesis by
      HL-60 cells was selectively inhibited on treatment with GGO. Besides HL-60 cells,
      apoptosis was induced by GGO in various tumor cell lines, including human myeloid
      multipotential leukemia K562, lymphoblastic leukemia Molt3, and colon
      adenocarcinoma COLO320 DM.

PMID- 7775376
TI  - ATP-hydrolyzing excitation state of the reconstituted alpha 3 beta 3 complex of
      ATP synthase from the thermophilic bacterium PS3: structural characteristics
      shown by time-resolved small-angle X-ray scattering with synchrotron radiation.
AB  - The ATP-hydrolyzing excitation state of the alpha 3 beta 3 complex of the ATP
      synthase from the thermophilic bacterium PS3 was investigated using time-resolved
      small-angle X-ray scattering with synchrotron radiation. The results showed the
      presence of the alpha 3 beta 3 complex at a steady state during ATP hydrolysis
      when the alpha 3 beta 3 hexamer reacted with Mg-ATP. The radius of gyration of
      the complex in the steady state was significantly larger than that of the Mg-AMP
      PNP-hexamer complex, indicating a conformational change to an expanded structure
      during catalysis. This alpha 3 beta 3 complex dissociated into alpha 1 beta 1
      heterodimers with apparent first-order reaction kinetics after all the ATPs were
      converted to ADPs. In contrast, when the alpha 3 beta 3 complex reacted with Mg
      ADP, the complex dissociated into dimers with apparent first-order reaction
      kinetics without showing the steady state of the complex. The dimers, however, re
      associated into the hexamer when Mg-ATP was added. The results were well
      explained by a computer simulation based on non-linear chemical dynamics, in
      which a reaction mechanism that incorporates the dynamic structure of the hexamer
      in the steady state was considered.

PMID- 7775377
TI  - Purification and properties of L-galactono-gamma-lactone dehydrogenase, a key
      enzyme for ascorbic acid biosynthesis, from sweet potato roots.
AB  - L-Galactono-gamma-lactone dehydrogenase (L-galactono-gamma
      lactone:ferricytochrome c oxidoreductase [EC 1.3.2.3], GLDHase) which catalyzes
      the terminal step in the biosynthesis of L-ascorbic acid (AsA) has been purified
      from roots of sweet potato (Ipomoea batatas L., cv. Kintoki). Highly purified
      preparation of the GLDHase was obtained by three column chromatography steps with
      a recovery of ca. 1%, after solubilization from mitochondria in sweet potato
      roots. SDS-PAGE exhibited a single band at 56 kDa. In the native state, the
      apparent molecular mass of the enzyme was 56 kDa, based on a Sephadex G-100 gel
      filtration. The pI and optimum pH values were 5.8 and 7.9, respectively. The Km
      value for L-galactono-gamma-lactone was 0.12 mM. Substrate inhibition was
      obtained at concentrations greater than 4.2 mM. The enzyme was inhibited by p
      chloromercuribenzoate (PCMB) and acriflavine, and the inhibition of acriflavine
      was diminished by the addition of FAD or FMN. The only effective substrate for
      the GLDHase was L-galactono-gamma-lactone.

PMID- 7775378
TI  - Enzyme properties of Aplysia ADP-ribosyl cyclase: comparison with NAD
      glycohydrolase of CD38 antigen.
AB  - An ecto-enzyme of NAD glycohydrolase (NADase) induced by retinoic acid in HL-60
      cells is attributed to the molecule of CD38 antigen [Kontani, K., Nishina, H.,
      Ohoka, Y., Takahashi, K., and Katada, T. (1993) J. Biol. Chem. 268, 16895-16898].
      CD38 antigen has an amino acid sequence homologous to Aplysia ADP-ribosyl cyclase
      which generates cyclic adenosine diphosphoribose (cADPR) and nicotinamide (NA)
      from beta-NAD+. On the basis of this sequence homology, we compared enzyme
      properties between CD38 NADase expressed as a fusion protein in Escherichia coli
      and ADP-ribosyl cyclase purified from the ovotestis of Aplysia kurodai. 1) beta
      NAD+ analogs, nicotinamide 1, N6-ethenoadenine dinucleotide, and nicotinamide
      hypoxanthine dinucleotide, did not serve as good substrates for the ADP-ribosyl
      cyclase, suggesting that the intact adenine ring of beta-NAD+ was required for
      the cyclase-catalyzed reaction. On the other hand, CD38 NADase utilized the NAD
      analogs to form ADP-ribose and NA. 2) Kinetic analyses of the ADP-ribosyl cyclase
      reaction revealed that NA was first released from the substrate (beta-NAD+)
      enzyme complex, followed by the release of another product, cADPR, which was
      capable of interacting with the free enzyme. 3) The enzyme reaction catalyzed by
      the ADP-ribosyl cyclase was fully reversible; beta-NAD+ could be formed from
      cADPR and NA with a velocity similar to that observed in the degradation of beta
      NAD+. However, CD38 NADase did not catalyze the reverse reaction to form beta
      NAD+ from ADP-ribopase and NA. 4) The CD38 NADase activity was, but the ADP
      ribosyl cyclase activity was not, inhibited by dithiothreitol.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7775379
TI  - Modulations of elastin expression and cell proliferation by retinoids in cultured
      vascular smooth muscle cells.
AB  - Effects of retinoid derivatives (retinol, retinal, retinoic acid, and etretinate)
      on elastin expression and cell proliferation in chick embryonic vascular smooth
      muscle cells were compared. Retinoic acid and etretinate inhibited cell
      proliferation to a greater extent than retinol and retinal. Retinol showed no
      significant effect on cell proliferation or elastin synthesis. Retinoic acid
      exhibited the most pronounced stimulatory effect on elastin synthesis with a
      maximum stimulation of 2.8-fold at the concentration of 10(-6) M for 24-48 h
      treatment. A comparable increase in elastin mRNA level was observed in the case
      of retinoic acid treatment. When the cells were serially passaged to the third
      subcultivation, elastin synthesis declined with increasing number of cell
      passages. Retinoic acid reversed this decline of elastin synthesis. The results
      indicate that retinoic acid was potentially active and retinol was inactive for
      both inhibition of cell proliferation and stimulation of elastin synthesis. The
      inhibitory activities of the four compounds for cell proliferation appear to
      parallel the stimulatory activities for elastin synthesis. The stimulation of
      elastin expression by retinoids may thus be closely related to the inhibition of
      cell proliferation.

PMID- 7775380
TI  - The mRNA for alpha 1(XIX) collagen chain, a new member of FACITs, contains a long
      unusual 3' untranslated region and displays many unique splicing variants.
AB  - We have isolated cDNAs and completed for the first time the primary structure for
      a novel collagenous chain that was partially characterized earlier and named
      alpha 1(Y) chain [Yoshioka, H. et al. (1992) Genomics 13, 884-886]. The size of
      the coding region was unexpectedly small compared with the length of the mRNA (>
      10 kb), owing to the presence of a long 3' untranslated region (> 5 kb). The
      predicted polypeptide contained 1,142 amino acid residues with a 23-residue
      signal peptide consisting of 5 collagenous domains of 70-224 residues in length,
      interspersed and flanked with 6 noncollagenous (NC) domains. The primary
      structure is distinct from those of the 32 known collagen alpha-chains of types I
      through XVIII. Therefore, we designate this newly discovered collagen chain the
      alpha 1 chain of type XIX collagen. Sequence analysis suggested that this chain
      belongs to the recently discovered group of collagens known as FACITs (fibril
      associated collagens with interrupted triple-helices). Northern blotting analysis
      demonstrated hybridization of the cDNA to a large mRNA species (> 10 kb)
      extracted from a rhabdomyosarcoma cell line (CCL 136). We also isolated numerous
      truncated cDNA clones of which the 3' parts were different from the "proto" type
      of the mRNA of > 10-kb size. Sequence comparison between cDNAs and corresponding
      genomic DNA fragments indicated that unusual splicing events occurred through
      insufficient recognition at acceptor sites. Expression of the gene was extremely
      infrequent in the rhabdomyosarcoma cell line; it could be restricted to certain
      animal tissues both temporally and spatially during early development.

PMID- 7775382
TI  - Site-specific glycosylation of bovine butyrophilin.
AB  - Our previous studies showed that the N-linked sugar chains of most bovine
      glycoproteins from milk fat globule membranes (MFGM) contain the GalNAc beta 1-
      >4GlcNAc group [Sato et al. (1993) J. Biochem. 114, 890-900]. Since expression of
      the disaccharide structure is influenced by peptide sequences near the
      glycosylation sites [Smith and Baenziger (1992) Proc. Natl. Acad. Sci. USA 89,
      329-333], the site-specificity of the N-acetylgalactosaminylated sugar chains was
      investigated using bovine butyrophilin, a major MFGM glycoprotein with known
      primary structure. Two glycopeptide fragments which contained the N-linked sugar
      chains linked to either Asn-55 or Asn-215 residue were obtained by digestion of
      the protein with Achromobacter protease I. The sugar chains released from each
      glycopeptide by hydrazinolysis were reduced with NaB3H4. Structural analyses of
      the oligosaccharides by sequential exoglycosidase digestion and methylation
      analysis revealed that only complex-type sugar chains with the GalNAc beta 1-
      >4GlcNAc structure are included in Asn-55-linked oligosaccharides, while only
      novel hybrid-type sugar chains detected previously in bovine MFGM glycoproteins
      are included in Asn-215-linked oligosaccharides. The results show that the
      glycosylation of butyrophilin occurs in a site-specific manner.

PMID- 7775383
TI  - Amino acid sequence of C-terminal 17 kDa CNBr-fragment of Akazara scallop
      troponin-I.
AB  - The M(r) 52,000 subunit of Akazara scallop striated muscle troponin, which was
      tentatively identified as troponin I, was cleaved into two major fragments with
      CNBr: C-terminal 17 kDa fragment (CN17K) and N-terminal 35 kDa fragment (CN35K)
      [J. Biochem. 108, 519-521 (1990)]. CN17K inhibits rabbit reconstituted actomyosin
      Mg-ATPase activity, weakly in the absence of troponin T but strongly in its
      presence, together with Akazara tropomyosin. CN35K, however, hardly shows such
      inhibition. Thus, the amino acid sequence of the CN17K was determined by the
      Edman method. CN17K comprises 135 amino acid residues and its calculated
      molecular mass is 15,732 Da. A computer search of the SWISS-PROT data base
      revealed the TnIs of crayfish tail muscle, rabbit skeletal muscle, and bovine
      cardiac muscle to be homologous proteins with total sequence homologies of 39,
      30, and 30%, respectively, to CN17K. Significantly high homology was observed
      among these TnIs in the regions around residues 75-95, 99-114, and 135-151 of the
      rabbit TnI. From these facts, we conclude that the 52K subunit is a TnI.

PMID- 7775381
TI  - Cloning and characterization of cDNA for inter-alpha-trypsin inhibitor family
      heavy chain-related protein (IHRP), a novel human plasma glycoprotein.
AB  - The cDNA encoding inter-alpha-trypsin inhibitor family heavy chain-related
      protein (IHRP) was cloned from human liver cDNA libraries. Oligonucleotide
      primers of human liver cDNA for PCR were constructed from internal amino acid
      sequences obtained with proteolytic fragments of IHRP. The amplified cDNA served
      as a hybridization probe for the screening of human liver cDNA libraries. The
      cDNA of 2,977 bp contained an entire reading frame coding 930 amino acids. The N
      terminal 28 residues corresponded to a signal peptide for secretion. The N
      terminal 600 residues of the mature form exhibited considerable homology to those
      of ITI heavy chains, while the C-terminal 300 residues showed no homology with
      the heavy chains and low homology with ATP-dependent proteases. IHRP was readily
      cleaved into 85- and 35-kDa fragments when plasma was incubated at 37 degrees C.
      The cleaved site, Arg-Arg-Leu, was within a proline-rich region. Northern blot
      analysis of poly(A) RNAs from various human tissues only showed hybridization to
      liver RNA.

PMID- 7775384
TI  - Isolation and identification of adenosine triphosphoribosyl nicotinamide adenine
      dinucleotidephosphate from Azotobacter vinelandii.
AB  - A novel type of pyridine nucleotide, containing two adenosine triphosphate ribose
      residues rather than one, was isolated from Azotobacter vinelandii strain O. The
      nucleotide was shown to be 2"- or 3"-(2'-phosphoadenosine-5'
      diphosphoribosyl)nicotinamide adenine dinucleotide phosphate, in which 2'-phospho
      5'-diphosphoadenosylribose was glycosidically linked to the NADP at position 2'
      or 3' of the nicotinamide mononucleotide moiety. The ATPribosylNADP did not show
      coenzyme activity for yeast glucose 6-phosphate dehydrogenase, nor was it cleaved
      by Neurospora crassa NAD(P) glycohydrolase, indicating that the biological
      properties conferred on the beta-NADP molecule were largely modified by the
      attachment of the ATP-ribose group.

PMID- 7775385
TI  - A 6-kb upstream region of the human transthyretin gene can direct developmental,
      tissue-specific, and quantitatively normal expression in transgenic mouse.
AB  - To ascertain whether a 6-kb upstream region of the human transthyretin (TTR) gene
      contains the cis-element(s) required for proper specificity and level of
      expression, transgenic mice carrying the human mutant TTR gene containing either
      6-kb (6.0-hMet30) or 0.6-kb (0.6-hMet30) of the upstream region were produced and
      studied. The 6.0-hMet30 gene was expressed in the yolk sac, liver, and choroid
      plexus, where the mouse endogenous TTR gene is also expressed. In contrast,
      expression of the 0.6-hMet30 gene was restricted to the yolk sac and liver. The
      expression levels of the 6.0-hMet30 gene in the liver and serum were similar to
      those of the mouse TTR gene, and about 10-fold those of the 0.6-hMet30 gene.
      Before birth, the developmental profiles of the expression of both transgenes in
      each tissue were similar to those of the mouse TTR gene. However, the expression
      levels of the 6.0-hMet30 gene in the liver and serum increased after birth to
      reach adult levels at an age of 4 weeks, while expression of the 0.6-hMet30 gene
      remained at a low level after birth. These results suggest that the 6-kb upstream
      sequence contains the cis-elements required for developmental, tissue-specific,
      and quantitatively normal expression.

PMID- 7775387
TI  - The G-protein G(o) in mammalian cardiac muscle: localization and coupling to A1
      adenosine receptors.
AB  - To investigate the functional relevance of the G-protein G(o) to adenosine
      induced effects in the heart, we studied the localization of G(o) and its
      interaction with A1 adenosine receptors. Concentrations of G(o) in various
      mammalian hearts differed markedly between the atrial and the ventricular muscle,
      as well as among species. In most species examined, the concentration of G(o) was
      much higher in the atrium than in the ventricle. The highest levels of G(o) in
      atria and ventricles were found in the ferret heart. An immunohistochemical study
      of the ferret heart with G(o) alpha-specific antibodies showed that G(o) was
      localized throughout the membranes of cardiac myocytes, including the
      intercalated disks. In addition, G(o) was densely distributed in the nerve fibers
      and Purkinje fibers. Analyses of G(o) alpha subtypes showed that bovine atrium
      mainly contained G(o)A alpha, while bovine ventricle contained only G(o)B alpha.
      By contrast, ferret ventricle contained both subtypes of G(o) alpha. To study the
      coupling of G(o) to A1 adenosine receptors, receptors in ventricular membranes of
      ferrets, which had been pretreated with pertussis toxin, or purified receptors
      were reconstituted with purified G(o)A and G(o)B. The reconstitution experiments
      indicated that both subtypes of G(o) coupled with A1 adenosine receptors. These
      results suggest that the effect of adenosine is mediated by both G(o)A and G(o)B
      in membranes of ferret cardiac myocytes.

PMID- 7775386
TI  - Binding mode of phospholipase A2 with a new type of phospholipid analog having an
      oxazolidinone ring.
AB  - Inhibition of phospholipases A2 (PLA2s) by a new type of monodispersed
      phospholipid analog, 3-dodecanoyl-4-phosphatidylcholinohydroxymethyl-2
      oxazolidinone (oxazolidinone-PC), was investigated by the pH stat assay method
      using monodispersed 1,2-dihexanoyl-sn-glycero-3-phosphorylcholine (diC6PC) as the
      substrate. The PLA2s used were those from bovine pancreas and cobra (Naja naja
      atra) venom (Group I) and from Japanese mamushi (Agkistrodon halys blomhoffii)
      venom (Group II). This new-type substrate analog was shown to inhibit
      competitively both types of venom and bovine pancreatic enzymes by binding to the
      active site in a similar manner to the carboxamide-type analog 2-dodecanoyl-amino
      1-hexanol-phosphocholine (amide-PC). The binding of a stereoisomer, (R)-amide-PC,
      to N. naja atra (Group I) and A. halys blomhoffii (Group II) PLA2s was
      facilitated by the binding of Ca2+ to the enzymes. On the other hand, the binding
      of (R)-oxazolidinone-PC to the N. naja atra (Group I) enzyme was found to be
      independent of Ca2+ binding, while its binding to the A. halys blomhoffii (Group
      II) enzyme was markedly facilitated by the binding of Ca2+ to the enzyme. The
      binding of (R)-amide-PC to N. naja atra PLA2 (Group I) was markedly influenced by
      the ionization state of the catalytic residue His 48, whereas the binding of (R)
      oxazolidinone-PC was found to be practically independent of the ionization state
      of this residue.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775388
TI  - Clustering of Sp1 sites near the promoter region of ICP34.5 in herpes simplex
      virus type 1.
AB  - We report that a host nuclear protein of approximately 100 kDa binds to the
      tandemly reiterated DR2 sequence of herpes simplex virus type 1 (HSV-1). The DR2
      sequence is a repeated component in the "a" sequence, which defines the signals
      for cleavage and encapsidation of viral DNA; the "a" sequence also contains the
      promoter regulatory signals for the gene encoding the viral neurovirulence
      factor, ICP34.5. Characterization of the host binding protein by means of gel
      shifts and DNase I footprinting revealed this protein is the eukaryotic
      transcription factor, Sp1. Furthermore, as judged from the sequence homology, the
      DR2 region contains clustered matches to the consensus binding site for Sp1.
      Comparison of the host factor and purified Sp1 (by means of gel shifts and
      footprinting) confirmed these findings. Since clustered DNA recognition elements
      represent unusually high affinity binding sites, these repeated Sp1 motifs
      proximal to the ICP34.5 gene suggest that this region may be a major Sp1 binding
      site in the viral genome.

PMID- 7775389
TI  - Involvement of pertussis toxin-sensitive mechanism in retinoic acid-induced
      differentiation of human leukemic HL-60 cells.
AB  - Retinoic acid-induced differentiation of human leukemic HL-60 cells is
      accompanied with the early induction of an ecto-enzyme of NAD+ glycohydrolase
      (NADase), which has recently been identified as human leukocyte cell surface
      antigen CD38 [Kontani, K. et al. (1993) J. Biol. Chem. 268, 16895-16898]. The
      terminal cell differentiation attendant upon the cell growth arrest was, but the
      early induction of CD38 NADase activity was not, inhibited by prior treatment of
      HL-60 cells with pertussis toxin, which catalyzed ADP-ribosylation of the
      membrane-bound alpha beta gamma-trimeric GTP-binding proteins. The prior
      treatment was, however, not essential for the toxin-induced inhibition of the
      cell differentiation; the inhibition by the addition of pertussis toxin was still
      observed even after retinoic acid-induced expression of CD38 antigen. This
      suggested that a pertussis toxin-sensitive mechanism was involved in a late
      process of cell differentiation. Indeed, HL-60 cells appeared to secrete a
      differentiation-supporting factor in response to retinoic acid, since the cell
      differentiation was accelerated and potentiated upon culture of the cells in a
      conditioned medium prepared from retinoic acid-treated cells. The action of the
      differentiation-supporting factor was destroyed by heating and markedly
      attenuated in pertussis toxin-pretreated HL-60 cells. Thus, the whole process of
      the retinoic acid-induced cell differentiation appeared to consist of two
      distinguishable periods in terms of sensitivity to pertussis toxin; the toxin
      insensitive early period characterized by the induction of CD38 NADase activity
      and the toxin-sensitive late period in which the secretion of a differentiation
      supporting factor might be involved.

PMID- 7775390
TI  - Localization of three fragments of connectin in chicken breast muscle sarcomeres.
AB  - Connectin (titin) links the Z line to the myosin filament in sarcomeres of
      vertebrate skeletal muscle. An 800 kDa fragment of alpha-connectin runs from the
      Z line up to the N2 line region in the I band, and the following beta-connectin
      portion runs up to the edge of the M line on the myosin filament in chicken
      breast muscle sarcomeres. Immunoelectron microscopy showed that a 400 kDa
      fragment following the 800 kDa fragment reaches the edge of the myosin filament
      and, thereafter a 1,700 kDa fragment runs to the M line on the myosin filament in
      chicken breast muscle sarcomeres. When stretched, the epitopes to anti-400 kDa
      fragment antibodies outside the myosin filament moved toward the inside of the I
      band.

PMID- 7775391
TI  - Purification and characterization of protein disulfide isomerase from soybean.
AB  - Protein disulfide isomerase (PDI), which catalyses the folding of newly
      synthesized or denatured proteins through correct disulfide formation, was
      purified from soybean (Glycine max). The enzyme was purified 12,000-fold over
      crude extracts to apparent homogeneity in six purification steps: 60-70% ammonium
      sulfate fractionation, and chromatography on DEAE Toyopearl 650M, Q-Sepharose
      Fast Flow, Hiload Superdex 200 pg, Phenyl Sepharose HP, and TSK G-3000 SW. The
      native enzyme had a molecular weight of 120 kDa on gel filtration. Subunit
      molecular weight was estimated as 63 kDa by sodium dodecyl sulfate polyacrylamide
      gel electrophoresis, thus indicating the enzyme to be comprised of two identical
      subunits. The enzyme pH optimum was 8.0 with reactivation of scrambled RNase, and
      the pI 7.65. The N-terminal amino acid sequence of soybean PDI was homologous to
      that of mature alfalfa as deduced from the cDNA sequence. Two identical active
      site sequences, APWCGHCK, were obtained from different proteolytic peptide
      fragments of soybean PDI. Soybean PDI facilitated reactivation not only of
      scrambled RNase, but denatured and reduced lysozyme and the Bowman Birk soybean
      trypsin inhibitor as well. This is the first report to appear on the the
      purification, characterization and amino acid sequence analysis of the active
      site of a plant PDI.

PMID- 7775393
TI  - Protein kinase C phosphorylates p50 LSP1 and induces translocation of p50 LSP1 in
      T lymphocytes.
AB  - A lymphocyte-specific protein, p50, is phosphorylated on Ser and Thr residues in
      mitogen-activated T cells, suggesting that this molecule plays some role in the T
      cell activation cascade. p50 was identified as lymphocyte specific protein 1
      (LSP1), which is a putative calcium-binding protein. In the present study, to
      clarify the role of p50 protein in the cascade, in vivo and in vitro
      phosphorylation of this molecule, and the effect of the phosphorylation on its
      distribution in activated T cells were examined. First, to obtain a sufficient
      amount of p50 as a phosphorylation substrate, p50 cDNA, which encodes a protein
      of 330 amino acid residues with a molecular mass of 36,728 Da, was cloned from an
      ICR mouse thymocyte cDNA library and expressed in Escherichia coli. When the
      putative coding region of p50 cDNA was expressed in E. coli, the product showed
      an apparent molecular mass of 50 kDa on SDS-PAGE. The recombinant p50 was
      phosphorylated in vitro by rabbit protein kinase C (PKC) and by murine cytosolic
      protein kinase, that was activated by a combination of phosphatidylserine and
      diacylglycerol. Furthermore, p50 was shown to be phosphorylated on the same sites
      in T cells upon stimulation with Con A as when phosphorylated in vitro by rabbit
      PKC, indicating that p50 is phosphorylated by PKC in Con A-stimulated T cells. On
      subcellular fractionation followed by immunoblotting analysis, membrane-bound p50
      was shown to be released from the membrane following activation of PKC in T
      cells. These results and the recent finding that p50 binds to actin fibers raise
      the possibility that p50 controls the binding of actin fibers to the plasma
      membrane under regulation by PKC in T cells.

PMID- 7775392
TI  - Mouse macrophage metalloelastase expressed in bacteria absolutely requires zinc
      for activity.
AB  - Mouse macrophage metalloelastase was expressed in Escherichia coli. This
      recombinant enzyme (rMME) was present in the inclusion bodies that were
      solubilized in 7 M guanidine HCl. After removal of guanidine HCl, rMME was
      purified with a Q-Sepharose column. Degradation of [3H]elastin by rMME absolutely
      required Ca2+; the optimal Ca2+ concentration was 5 mM. NaCl stimulated the
      enzyme activity; maximal stimulation was obtained at 400 mM. The rMME activity
      was inhibited by metalloprotease inhibitors, but not by serine, aspartyl, or
      thiol protease inhibitors. Among the divalent cations tested, only Ba2+ and Sr2+
      exhibited marginal stimulation of rMME activity in the absence of Ca2+. Cu2+,
      Zn2+, or Cd2+ strongly inhibited rMME activity with IC50 values between 68 and
      180 microM, while Mg2+, Ba2+, Mn2+, Co2+, and Sr2+ had no effect. The requirement
      of Zn2+ for rMME activity was determined. Significant enzyme activity was present
      in rMME treated with EDTA followed by Q-Sepharose column chromatography. Only
      when the inclusion bodies were solubilized in the presence of 20 mM EDTA, did an
      enzyme preparation which was absolutely dependent on exogenous Zn2+ for activity
      result. The optimal Zn2+ concentration for rMME activation was 100 microM. These
      results indicate that Zn2+ is tightly bound to rMME.

PMID- 7775394
TI  - Specific aminoacylation of C4N hairpin RNAs with the cognate aminoacyl-adenylates
      in the presence of a dipeptide: origin of the genetic code.
AB  - A series of C4N hairpin RNAs bearing anticodon nucleotides at the 5' ends and a
      discriminator base and the sequence CCA at the 3' ends was constructed by an in
      vitro transcription system using T7 RNA polymerase. These RNAs were aminoacylated
      specifically with their cognate amino acids by reaction with aminoacyl-adenylates
      in the presence of a dipeptide, valyl-aspartic acid, suggesting that such hairpin
      RNAs are able to play the role of the present-day tRNA and that valyl-aspartic
      acid can perform the function of the present-day aminoacyl-tRNA synthetase as a
      catalyst in the aminoacylation reaction. These results should provide a useful
      clue to elucidating the origin of the genetic code.

PMID- 7775395
TI  - Role of Lys108 in the enzymatic activity of RNase Rh from Rhizopus niveus.
AB  - In order to elucidate on the mechanism of action of RNase Rh from Rhizopus
      niveus, we investigated the role of Lys108, which is conserved among the RNase T2
      family RNases except for two cases. The RNase activities of Lys108 mutant RNases,
      RNase RNAP K108R and K108L, are about 33.5 and 3.1% of that of the wild type
      enzyme, respectively. The relative rates of cleavage of dinucleoside phosphates
      by these two mutant enzymes were comparable to those with RNA as a substrate. The
      kinetic parameters of RNases RNAP K108R and K108L towards XpGs (where X is one of
      A, G, U, and C) were measured. The data indicated that the Km values of the two
      mutant enzymes are similar to those of the wild-type enzyme. The rates of release
      of the four nucleotides from RNA by digestion with the mutant enzymes were in the
      order A > G > U > C, which is qualitatively the same as that of the wild-type
      enzyme. From these data, we concluded that the Lys108 residue participates in the
      catalytic process, but not in the binding, and the positive charge of Lys108 is
      indispensable for the catalytic process, that is, the positive charge of Lys108
      may stabilize the pentacoordinated intermediate in the transition state as
      proposed in the case of Lys41 in RNase A, or may polarize the phosphate moiety of
      the substrate.

PMID- 7775396
TI  - Kinetic analysis of endocytosis and intracellular fate of liposomes in single
      macrophages.
AB  - Endocytosis and the intracellular fate of liposomes in single mouse peritoneal
      macrophages were examined kinetically by fluorescence microphotometry. Liposomes
      labeled with N-(7-nitro-2,1,3-benzoxadiazol-4-yl)phosphatidylethanolamine or
      containing 8-amino-naphthalene-1,3,6-trisulfonate were promptly incorporated into
      macrophages on incubation at 37 degrees C, but fluorescence increase caused by
      hydrolysis of 4-methylumbelliferyl-beta-D-glucoside encapsulated in the liposomes
      was observed after 30 min of incubation. The fluorescences of calcein and 8
      hydroxy-1,3,6-pyrenetrisulfonate (HPTS) in liposomes, which were respectively
      quenched statically due to high concentration and dynamically by a co-entrapped
      fluorescence quencher, p-xylene-bis-pyridinium bromide, also increased from 30
      min after the start of liposome incorporation, indicating that macrophages
      require this period for intracellular delivery of liposomes from the cell surface
      to lysosomes. Measurement of the intraendosomal pH change in a single macrophage
      at 37 degrees C with liposomes containing a pH-sensitive fluorescent marker,
      HPTS, showed that the pH value decreased continuously to a constant value of 5.5
      in 30-40 min after endocytosis, and this decrease was reversed on addition of
      NH4Cl, suggesting that acidification of endosomes is not a stepwise reaction and
      is coupled with delivery of liposomes. These fluorescence microphotometric
      systems using liposomes containing different fluorescent dyes should be useful
      for kinetic analyses of the endocytosis and intracellular fate of liposomes in
      various phagocytes.

PMID- 7775398
TI  - Purification and molecular shape of a 144 kDa protein bearing N-acetylglucosamine
      residues from rat liver nuclear envelopes.
AB  - A 144 kDa protein was purified from the WGA-Sepharose bound fraction of a rat
      liver nuclear envelope salt-extract by hydroxyapatite HPLC (HAP HPLC). Two other,
      120 and 86 kDa, proteins were also partially purified from the fraction by a
      combination of DEAE- and HAP-HPLCs. It was suggested that the 144, 120, and 86
      kDa proteins bear GlcNAc residues, and are nucleoporins, because they were
      purified from nuclear envelopes, reacted with WGA-HRP, and cross-reacted with an
      antibody against p62 nucleoporin complexes. The sedimentation coefficients and
      Stokes' radii of these GlcNAc-bearing proteins were determined by glycerol
      density gradient centrifugation and gel filtration in the presence of 500 mM
      NaCl. The molecular masses calculated from these values suggested that these
      three proteins each exist as a monomer under the conditions employed. The axial
      ratios of the purified 144, 120, and 86 kDa GlcNAc-proteins were estimated to be
      35, 31, and 31, respectively. These values suggested that they are rod-shaped
      molecules. The axial ratio of a purified nucleoporin-complex consisting of 62,
      60, and 54 kDa components bearing GlcNAc was shown to be 20. This nucleoporin
      complex seems to be a rod-shaped complex. From these results, a rod shape is
      proposed to be a common characteristic of GlcNAc-proteins in nuclear envelopes.

PMID- 7775397
TI  - Apparent antibacterial activity of catalase: role of lipid hydroperoxide
      contamination.
AB  - Escherichia coli was killed by catalase in dose-, time-, and pH-dependent
      manners. Dialyzed catalase had bactericidal activity, but enzyme which had been
      heat-denatured or inactivated by pretreatment with 3-aminotriazole plus hydrogen
      peroxide did not. Cytochrome c and hemoglobin also had bactericidal activity.
      Thiobarbituric acid-reactive substances were detected in commercial hemoproteins
      except for horseradish peroxidase and the relationship between the contents of
      these substances and bactericidal activity was demonstrated. Without the addition
      of hydroperoxide, hemoproteins except for horseradish peroxidase initiated the
      oxidation of 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) (ABTS) and
      catalase caused the peroxidation of linoleic acid. The pH patterns of
      bactericidal activity, lipid peroxidation, and the oxidation of ABTS were
      similar. The results indicate that hemoprotein preparations are contaminated with
      lipid hydroperoxides and it is the decomposition of these contaminants catalyzed
      by the hemoprotein into alkoxyl/peroxyl radicals that causes bacterial killing.

PMID- 7775399
TI  - Palmitoyl lysozyme-induced stabilization of PE (phosphatidylethanolamine)
      liposomes and their interaction with Candida albicans.
AB  - The interaction with fungal cells of dioleoylphosphatidylethanolamine liposomes
      coated with palmitoyl lysozyme was investigated using lysozyme as a stabilizer
      for an unstable bilayer as well as a recognizer for a specific target cell.
      Lysozyme, which interacts with chitin in the fungal cell wall, lyses chitin and
      kills the cells, was acylated with N-hydroxysuccinimide ester of palmitic acid
      (NHSP) and incorporated into the lipid bilayer. Lysozyme was optimally modified
      when the ratio of NHSP to lysozyme was 15 at pH 8.0. Modification of lysozyme was
      detected by SDS-PAGE, and its molecular weight was about 1,500 greater than that
      of the intact lysozyme at the optimal ratio of NHSP to lysozyme. The activity of
      palmitoyl lysozyme toward glycolchitin was reduced to 35% of that of intact
      lysozyme. Both lysozyme and palmitoyl lysozyme had antifungal activities, but
      palmitoyl lysozyme was more effective than intact lysozyme against Candida
      albicans. The minimal molar ratio of palmitoyl lysozyme to
      phosphatidylethanolamine required to form stable liposomes was 2.4 x 10(-4), and
      the optimal ratio was about 2.4 x 10(-3). The percentage survival of cells
      treated with the inserted palmitoyl lysozyme was lower than that of cells treated
      with free palmitoyl lysozyme. These findings suggest that palmitoyl lysozyme
      incorporated liposomal membrane is more effectively adsorbed by Candida albicans
      than free palmitoyl lysozyme is.

PMID- 7775400
TI  - Role of the C-terminal region of beta-amylase from barley.
AB  - To investigate the role of the C-terminal region of barley beta-amylase, plasmid
      delta 54 was constructed with an expression vector (pBETA92) of barley beta
      amylase by site-directed mutagenesis. Escherichia coli JM109 harboring plasmid
      delta 54 was expected to express delta 54 beta-amylase in which 54 amino acid
      residues were deleted from the C-terminus. The enzyme production started in the
      logarithmic phase, increased linearly, and reached a maximum after 12 h. delta 54
      beta-amylase gave a single activity band on isoelectric focusing (pI 6.85). delta
      54 beta-amylase was purified from the cells by consecutive alpha
      cyclodextrin/Sepharose 6B column chromatography. A comparison of the properties
      of the mutant enzyme with those of the original recombinant beta-amylase [Biosci.
      Biotech. Biochem. (1994) 58, 1080-1086] revealed two major differences. First,
      the original recombinant beta-amylase showed heterogeneity on isoelectric
      focusing, but delta 54 beta-amylase gave a single main band of protein (pI 6.85).
      Therefore, the isoelectrophoretic heterogeneity of the original recombinant beta
      amylase was apparently due to its C-terminal region. Secondly, delta 54 beta
      amylase lacked thermostability. Therefore, it was concluded that the C-terminal
      region was significantly involved in the thermostability of beta-amylase.

PMID- 7775401
TI  - A novel proteinase, glucagon-degrading enzyme, secreted by a human pancreatic
      cancer cell line, HPC-YO.
AB  - Sixty-four kinds of cell lines were examined as to their ability to degrade
      glucagon using conditioned-media obtained from their protein-free cultures. Two
      human tumor cell lines were shown to produce this activity, and the cell line,
      HPC-YO, established from a human pancreatic carcinoma was shown to produce the
      highest level of activity. The glucagon-degrading enzyme (GDE) was purified from
      HPC-YO conditioned-medium by a combination of ion-exchange, gel filtration, and
      hydroxylapatite column chromatographies. The purified GDE also degraded
      vasoactive intestinal polypeptide (VIP) and secretin, however, it did not cleave
      EGF, gastrin, insulin, somatostatin, substance P, neurotensin, or growth hormone.
      The molecular weight of GDE is 83,000, as determined on SDS-polyacrylamide gel
      electrophoresis. The N-terminal amino acid sequence of GDE was blocked, and the
      five partial amino acid sequences obtained on lysyl-endopeptidase digestion were
      determined to be N-L-T-E-E-Y-D-V-S-D-G-E-I-E-L-L-Y-E-K, V-E-T-Y-Y-D-L-L-F-E-K, L
      Y-W-F-L-D-E-A-K, S-N-S-T-S-Y-V-K, and Y-Y-A-S-T-S-Y-D-D-T-Y-K. The same or
      homologous amino acid sequences have not been found in known proteins,
      demonstrating that GDE is a novel peptidase that degrades the secretin family:
      glucagon, VIP, and secretin.

PMID- 7775402
TI  - Expression of differentiation-related phenotypes and apoptosis are independently
      regulated during myeloid cell differentiation.
AB  - When human promyelocytic leukemia cell line HL-60 was treated with various
      differentiation-inducers, apoptosis always occurred after the full appearance of
      differentiation-related phenotypes. However, the two phenomena could be
      dissociated when HL-60 cells were treated with PDBu. When HL-60 cells were
      cultured with PDBu for more than 36 h, apoptosis was induced following
      differentiation. Apoptosis was not, however, observed when PDBu was removed
      within 24 h, even though induction of differentiation-related phenotypes, such as
      NBT-reducing ability and surface marker expression, was the same as that in the
      control. Northern blot analysis revealed that bcl-2 mRNA was rapidly down
      regulated within 6 h of the treatment with PDBu. The amount of bcl-2 mRNA
      recovered to that of undifferentiated HL-60 cells when PDBu was washed out within
      24 h. In contrast, the recovery of bcl-2 was incomplete when the cells were
      treated with PDBu for more than 36 h, suggesting that bcl-2 is also a critical
      regulator of the cell fate during myeloid differentiation. This hypothesis was
      confirmed by experiments using antisense oligonucleotides, i.e., blocking the
      recovery of bcl-2 mRNA by antisense oligonucleotides could result in the
      induction of apoptosis in HL-60 cells from which PDBu was removed within 24 h.
      Moreover, overexpression of BCL-2 in HL-60 cells could block apoptosis during
      differentiation without any significant effect on differentiation itself. These
      results strongly suggest that apoptosis is not a simple consequence of
      differentiation-induction, and that apoptosis and differentiation are regulated
      independently in myeloid cells.

PMID- 7775403
TI  - Preparation and characterization of calmodulin-dependent protein kinase IV (CaM
      kinase IV) free of CaM-kinase IV kinase from rat cerebral cortex.
AB  - Our earlier finding [Kameshita, I. and Fujisawa, H. (1993) J. Biochem. 113, 583
      590] that calmodulin-dependent protein kinase IV (CaM-kinase IV) from rat
      cerebral cortex is markedly activated through autophosphorylation was reexamined
      in the light of a more recent study [Okuno, S. and Fujisawa, H. (1993) J.
      Biochem. 114, 167-170] suggesting the involvement of Ca2+/calmodulin-dependent
      CaM-kinase IV kinase in the activation of CaM-kinase IV in rat brain. Further
      purification of the previous CaM-kinase IV preparation by HPLC on a DEAE-NPR
      column abolished its marked activation on incubation under Ca2+/calmodulin
      dependent phosphorylation conditions, and the marked activation was restored by
      the addition of the fraction separated on a DEAE-NPR column, suggesting that CaM
      kinase IV was separated from CaM-kinase IV kinase involved in its activation by
      HPLC on DEAE-NPR. The HPLC-purified CaM-kinase IV still underwent a slow
      autophosphorylation, which was an intramolecular reaction. Some kinetic
      properties of CaM-kinase IV before and after autophosphorylation were examined
      for comparison. In addition, the purification by HPLC on DEAE-NPR revealed that a
      novel Ca(2+)-dependent calmodulin-binding protein, designated as CaMBP64, is
      present as a major contaminant in the previous purified CaM-kinase IV
      preparation.

PMID- 7775404
TI  - Analysis of functional domains of a GC box-binding protein, BTEB.
AB  - BTEB is a small GC box-binding protein containing three contiguous zinc finger
      structures in the C-terminal region of the molecule, and activates or represses
      the transcription of genes with the GC box sequence in the promoter, depending on
      the repetitiveness of the GC box sequence [Imataka et al. (1992) EMBO J. 11, 3663
      3671]. We have analyzed functional domains of BTEB in a transient expression
      system using Y-1 cells (a mouse adrenal cortex cell line). BTEB contained two
      regions responsible for the transcriptional activation. These regions showed a
      sequence similarity to each other and appeared to enhance the transcription
      independently. The two sequences were rich in hydrophobic amino acids and showed
      no similarity to the sequences of transactivation domains so far elucidated. The
      DNA-binding properties of BTEB were also analyzed by means of the gel mobility
      shift assay. Three contiguous zinc finger motifs were needed for the binding
      activity. Furthermore, it was revealed that a short basic region immediately N
      terminal to the zinc finger motifs was required for the DNA binding.

PMID- 7775405
TI  - Chronic administration of beta-adrenergic agonists can mimic the stimulative
      effect of cold exposure on protein synthesis in rat brown adipose tissue.
AB  - When mammals are exposed to a cold environment for a long time, the capacity of
      nonshivering thermogenesis by brown adipose tissue (BAT) increases in association
      with the stimulation of synthesis of some specific proteins and tissue
      hyperplasia, which are totally dependent on sympathetic innervation to this
      tissue. To clarify the roles of the adrenergic mechanisms for the cold-induced
      protein synthesis and hyperplasia in BAT, in this study, the effects of chronic
      treatment with adrenergic agonists using an osmotic mini-pump were examined in
      rats. Continuous administration of noradrenaline or isoproterenol (beta-agonist)
      for 10 days resulted in increased synthesis of the mitochondrial uncoupling
      protein and an isoform of glucose transporter (GLUT4), and tissue hyperplasia, in
      the same way as after cold exposure of the same duration. Phenylephrine (alpha
      agonist) administration did not have any significant effect. Surgical sympathetic
      denervation completely abolished the effects of cold exposure, whereas it did not
      influence those of adrenergic agonists at all. These results indicate that the
      stimulative effects of cold exposure on protein synthesis and hyperplasia of BAT
      are attributable solely to the beta-adrenergic action of noradrenaline secreted
      from the sympathetic nerves in this tissue.

PMID- 7775406
TI  - Oligonucleotides as research, diagnostic, and therapeutic agents.

PMID- 7775407
TI  - Inhibition of MAP kinase kinase blocks the differentiation of PC-12 cells induced
      by nerve growth factor.
AB  - The mitogen-activated protein kinase (MAP kinase) pathway is thought to play an
      important role in the actions of neurotrophins. A small molecule inhibitor of the
      upstream kinase activator of MAP kinase, MAP kinase kinase (MEK) was examined for
      its effect on the cellular action of nerve growth factor (NGF) in PC-12
      pheochromocytoma cells. PD98059 selectively blocks the activity of MEK,
      inhibiting both the phosphorylation and activation of MAP kinases in vitro.
      Pretreatment of PC-12 cells with the compound completely blocked the 4-fold
      increase in MAP kinase activity produced by NGF. Half-maximal inhibition was
      observed at 2 microM PD98059, with maximal effects at 10-100 microM. The tyrosine
      phosphorylation of immunoprecipitated MAP kinase was also completely blocked by
      the compound. In contrast, the compound was without effect on NGF-dependent
      tyrosine phosphorylation of the pp140trk receptor or its substrate Shc and did
      not block NGF-dependent activation of phosphatidylinositol 3'-kinase. However,
      PD98059 completely blocked NGF-induced neurite formation in these cells without
      altering cell viability. These data indicate that the MAP kinase pathway is
      absolutely required for NGF-induced neuronal differentiation in PC-12 cells.

PMID- 7775408
TI  - DNA enzymology above 100 degrees C. Topoisomerase V unlinks circular DNA at 80
      122 degrees C.
AB  - The widespread application of polymerase chain reaction and related techniques in
      biology and medicine has led to a heightened interest in thermophilic enzymes of
      DNA metabolism. Some of these enzymes are stable for hours at 100 degrees C, but
      no enzymatic activity on duplex DNA at temperatures above 100 degrees C has so
      far been demonstrated. Recently, we isolated topoisomerase V from the
      hyperthermophile Methanopyrus kandleri, which grows up to 110 degrees C. This
      novel enzyme is similar to eukaryotic topoisomerase I and acts on duplex DNA
      regions. We now show that topoisomerase V catalyzes the unlinking of double
      stranded circular DNA at temperatures up to 122 degrees C. In this in vitro
      system, maximal DNA unlinking occurs at 108 degrees C and corresponds to
      complementary strands being linked at most once. These results further imply that
      in the presence of sufficient positive supercoiling DNA can exist as a double
      helix even at 122 degrees C.

PMID- 7775409
TI  - Primary structure and functional expression of a cDNA encoding the bile
      canalicular, purine-specific Na(+)-nucleoside cotransporter.
AB  - We previously characterized a purine-specific Na(+)-nucleoside cotransport system
      in bile canalicular membrane. The function of this transport system may be
      related to conserving nucleosides and preventing cholestasis. We report here the
      isolation of a cDNA encoding a Na(+)-dependent nucleoside transporter from rat
      liver using an expression cloning strategy. The substrate specificities and
      kinetic characteristics of the cloned cotransporter are consistent with the
      properties of the Na(+)-dependent, purine-selective nucleoside transporter in
      bile canalicular membranes. The nucleotide sequence predicts a protein of 659
      amino acids (72 kDa) with 14 putative membrane-spanning domains. Northern blot
      analysis showed that the transcripts are present in liver and several other
      tissues. Data base searches indicate significant sequence similarity to the
      pyrimidine-selective nucleoside transporter (cNT1) of rat jejunum. Although these
      two subtypes of Na(+)-nucleoside cotransporter have different substrate
      specificities and tissue localizations, they are members of a single gene family.

PMID- 7775410
TI  - Evidence for involvement of phosphatidylcholine-phospholipase C and protein
      kinase C in transforming growth factor-beta signaling.
AB  - Transforming growth factor-beta (TGF-beta) is a multifunctional peptide that
      elicits a wide variety of responses in cells. TGF-beta binds to cell surface
      receptors that contain cytoplasmic serine/threonine kinase domains. Here we
      provide evidence that both phospholipase C and protein kinase C (PKC) are
      involved in the TGF-beta activation of transcription and luciferase expression
      from the p3TP-Lux plasmid. Down-regulation of PKC prevents TGF-beta 1 induction
      of luciferase expression. Staurosporin and Calphostin C, inhibitors of PKC, block
      the ability of TGF-beta 1 to initiate transcription of the luciferase gene.
      Further, D609, an inhibitor of phosphatidylcholine-phospholipase C (PC-PLC), and
      secondarily PKC also blocks TGF-beta 1-induced transcription of the transgene in
      A549 cells while the phosphatidylinositol-PLC pathway inhibitor U73122 is without
      effect. TGF-beta elevates steady-state mRNA levels for the endogenous PAI-1 and
      fibronectin genes. Treatment of cells with calphostin C or D609 prevents the TGF
      beta-induced increase in these mRNAs. Together, these results suggest that PC-PLC
      and PKC are in a TGF-beta signaling pathway that results in elevated gene
      expression.

PMID- 7775412
TI  - Cloning and expression of an evolutionary conserved single-domain angiotensin
      converting enzyme from Drosophila melanogaster.
AB  - Mammalian somatic angiotensin converting enzyme (EC 3.4.15.1, ACE) consists of
      two highly homologous (N- and C-) domains encoded by a duplicated gene. We have
      identified an apparent single-domain (67 kDa) insect angiotensin converting
      enzyme (AnCE) in embryos of Drosophila melanogaster which converts angiotensin I
      to angiotensin II (Km, 365 microM), removes Phe-Arg from the C terminus of
      bradykinin (Km, 22 microM), and is inhibited by ACE inhibitors, captopril (IC50 =
      1.1 x 10(-9) M) and trandolaprilat (IC50 = 1.6 x 10(-8) M). We also report the
      cloning and expression of a Drosophila AnCE cDNA which codes for a single-domain
      615-amino acid protein with a predicted 17-amino acid signal peptide and regions
      with high levels of homology to both the N- and C-domains of mammalian somatic
      ACE, especially around the active site consensus sequence. Northern analysis
      identified a single 2.1-kilobase mRNA in Drosophila embryos, and Southern
      analysis of Drosophila genomic DNA indicates that the insect gene is not
      duplicated. When expressed in COS-7 cells, the AnCE protein is a secreted enzyme,
      which converts angiotensin I to angiotensin II and is inhibited by captopril
      (IC50 = 5.6 x 10(-9) M) and trandolaprilat (IC50 = 2 x 10(-8) M). The
      evolutionary significance of these results is discussed.

PMID- 7775411
TI  - A spectroelectrochemical method for differentiation of steric and electronic
      effects in hemoglobins and myoglobins.
AB  - Spectroelectrochemical techniques are described which enable us to compare anion
      effects on redox curves of structurally distinct hemoglobins with oxygenation
      curves obtained under equivalent conditions. Nernst plots for tetrameric
      vertebrate Hbs show evidence of cooperativity, with the T state conformation more
      resistant to oxidation than the R state. Anions shift the conformation toward the
      T state and decrease the ease of oxidation, with variations in anion sensitivity
      similar to those observed in oxygen equilibria. Oxygen binding, unlike electron
      exchange, is known to be subject to steric constraints that vary considerably in
      natural and engineered hemoglobins that have differences in the distal residues
      of the heme pocket. Since oxidation curves are not subject to steric hindrance,
      anion-induced differences between the oxidation and oxygenation curves can be
      indicative of anion-induced alterations in the stereochemistry of the heme pocket
      that alters the ease of ligand entry or exit. Addition of inositol hexaphosphate
      to solutions of Hb A in 0.2 M nitrate generates such differences: the ease of
      electron abstraction from deoxy (T state) Hb A is unaffected, while, as
      previously reported, the oxygenation of deoxy (T state) Hb A is greatly hindered.
      The difference between inositol hexaphosphate effects on initial stages of
      oxidation and oxygenation indicates that the explanation for "multiple T states"
      in oxygen binding lies in the ability of the polyanion to greatly increase steric
      hindrance to ligand entry, without appreciable changes in the electronic features
      of the heme environment.

PMID- 7775414
TI  - Triacylglycerol synthesis by purified triacylglycerol synthetase of rat
      intestinal mucosa. Role of acyl-CoA acyltransferase.
AB  - The activities of the proposed triacylglycerol synthetase complex, acyl-CoA
      ligase, acyl-CoA acyltransferase (AAT), monoacylglycerol acyltransferase (MGAT),
      and diacylglycerol acyltransferase (DGAT), coeluted upon Cibacron blue 3GA
      agarose affinity chromatography of detergent-solubilized rat intestinal
      microsomes. The AAT activity is associated with a 54-kDa protein, that binds
      covalently an acyl group from acyl-CoA via a thiol ester linkage (Lehner, R. and
      Kuksis, A. (1993) J. Biol. Chem. 268, 24726-24733). Reagents that prevent the
      acyl-AAT formation inhibit triacylglycerol synthesis as does the removal of AAT
      from the complex by immunoprecipitation. In the absence of mono- and
      diacylglycerol acceptors, the acyl group is transferred to water. It is proposed
      that triacylglycerol synthesis proceeds via a sequential transfer of acyl groups
      from acyl-CoA ligase to the AAT, from which they are passed to the mono- and
      diacylglycerol acyltransferases for incorporation into the di- and
      triacylglycerols depending on the availability of the acyl acceptors.

PMID- 7775413
TI  - Implication of mammalian ribosomal protein S3 in the processing of DNA damage.
AB  - A human apurinic/apyrimidinic endonuclease activity, called AP endonuclease I, is
      missing from or altered specifically in cells cultured from Xeroderma pigmentosum
      group-D individuals (XP-D cells) (Kuhnlein, U., Lee, B., Penhoet, E. E., and
      Linn, S. (1978) Nucleic Acids Res. 5,951-960). We have now observed that another
      nuclease activity, UV endonuclease III, is similarly not detected in XP-D cells
      and is inseparable from the AP endonuclease I activity. This activity
      preferentially cleaves the phosphodiester backbone of heavily ultraviolet
      irradiated DNA at unknown lesions as well as at one of the phosphodiester bonds
      within a cyclobutane pyrimidine dimer. The nuclease activities have been purified
      from mouse cells to yield a peptide of M(r) = 32,000, whose sequence indicates
      identity with ribosomal protein S3. The nuclease activities all cross-react with
      immunopurified antibody directed against authentic rat ribosomal protein S3, and,
      upon expression in Escherichia coli of a cloned rat cDNA for ribosomal protein
      S3, each of the activities was recovered and was indistinguishable from those of
      the mammalian UV endonuclease III. Moreover, the protein expressed in E. coli and
      its activities cross-react with the rat protein antibody. Ribosomal protein S3
      contains a potential nuclear localization signal, and the protein isolated as a
      nuclease also has a glycosylation pattern consistent with a nuclear localization
      as determined by lectin binding. The unexpected role of a ribosomal protein in
      DNA damage processing and the unexplained inability to detect the nuclease
      activities in extracts from XP-D cells are discussed.

PMID- 7775415
TI  - The Moloney leukemia retroviral long terminal repeat trans-activates AP-1
      inducible genes and AP-1 transcription factor binding.
AB  - Moloney murine leukemia virus (Mo-MuLV) is a thymotropic and leukemogenic
      retrovirus which causes T lymphomas. The long terminal repeat (LTR) of Mo-MuLV
      affects the regulation of a number of cellular genes, including collagenase IV,
      monocyte chemoattractant protein-1, and c-jun genes, all of which contain 12-O
      tetradecanoylphorbol-13-acetate-responsive element consensus sites within their
      promoters. We report here that Mo-MuLV stimulates the collagenase IV gene through
      transcription factor AP-1, and that the expression of a subgenomic portion of Mo
      MuLV LTR alone is sufficient for this effect. Transient or stable expression of
      the viral LTR increases cellular AP-1 DNA binding activity. The collagenase IV 12
      O-tetradecanoylphorbol-13-acetate-responsive element consensus sequence was shown
      to be required for this trans-activation. Deletions or mutations of this
      consensus site which abolished AP-1 binding also abolished trans-activation by
      the LTR. Transient or stable transfection of the viral LTR into cells stimulated
      c-jun gene expression, suggesting one mechanism whereby the viral LTR may induce
      cellular AP-1 activity. Thus, the Mo-MuLV LTR, through activation of the
      transcription factor AP-1, is capable of regulating cellular gene expression,
      including the induction of proto-oncogenes. This activity may be relevant to the
      mechanisms whereby retroviruses which do not contain oncogenes induce neoplasia.

PMID- 7775417
TI  - Synthesis of a photoaffinity analog of 3'-azidothymidine, 5-azido-3'-azido-2',3'
      dideoxyuridine. Interactions with herpesvirus thymidine kinase and cellular
      enzymes.
AB  - Long term administration of 3'-azidothymidine (AZT) for the treatment of AIDS has
      led to detrimental clinical side effects in some patients, the biochemical causes
      of which are still being delineated. Base-substituted, azido-nucleotide
      photoaffinity analogs have routinely proven to be effective tools for identifying
      and characterizing nucleotide-utilizing enzymes. Therefore, we have synthesized 5
      azido-3'-azido-2',3'-dideoxyuridine, which is a potential photoaffinity analog of
      two human immunodeficiency virus drugs, AZT and 3'azido-2',3'-dideoxyuridine. A
      partially purified herpes simplex virus type 1 thymidine kinase and [gamma
      32P]ATP were used to make an AZT monophosphate analog, [32P]5-azido-3'-azido
      2',3'-dideoxyuridine monophosphate. The photoaffinity properties of this analog
      were initially tested with herpes simplex virus type 1 thymidine kinase.
      Photoaffinity labeling of this enzyme was saturable (half-maximal, 30 microM) and
      could be specifically inhibited by AZT, AZT monophosphate, thymidine, and
      thymidine monophosphate. Photolabeling of rat liver microsomal membranes was also
      done, and several membrane proteins that interact with AZT monophosphate were
      identified. The antiviral and cytotoxic activities of 5-azido-3'-azido-2',3'
      dideoxyuridine were determined using human immunodeficiency virus, type 1 strain
      IIIB and an AZT drug-resistant strain in human T lymphocyte H9 cells.

PMID- 7775416
TI  - Thermal stability and domain-domain interactions in natural and recombinant
      protein C.
AB  - Scanning microcalorimetry and spectrofluorimetry were applied to a study of the
      thermal stability and interaction of the modules within natural human protein C
      (PC) and recombinant protein C (rPC), a potential therapeutic anticoagulant
      expressed in transgenic pigs. Upon heating in the presence of 2 mM EDTA, pH 8.5,
      each protein exhibited a similar heat absorption peak with a Tm of approximately
      62 degrees C corresponding to the melting of the serine protease (SP) module.
      Deconvolution of this peak indicated that the SP module consists of two domains
      that unfold independently. At pH below 3.8, a second peak appeared at extremely
      high temperature corresponding to the unfolding of the two interacting epidermal
      growth factor-like (EGF) domains. This second peak occurred at a temperature
      about 20 degrees C lower in rPC than in PC indicating that the EGF domains in the
      recombinant protein are less stable. The isolated 6-kDa gamma-carboxyglutamic
      acid-rich (Gla) fragment as well as a 25-kDa Gla-(EGF)2 fragment both exhibited a
      sigmoidal fluorescence-detected denaturation transition in the same temperature
      region as the SP domains, but only in the presence of Ca2+. In 2 mM Ca2+, the
      first heat absorption peak in both intact proteins became biphasic, indicating
      Ca(2+)-induced structural changes. By contrast, Ca2+ had very little effect on
      the melting of Gla-domain-less protein C. This indicates that not Ca2+ itself but
      the Ca(2+)-loaded Gla domain is responsible for conformational changes in the SP
      domain of the parent protein. Detailed analysis of the shape of the endotherms
      obtained in Ca2+ and EDTA suggests that Ca2+ induces compact structure in the Gla
      domain which appears to interact strongly with the SP domain(s) of protein C.

PMID- 7775419
TI  - Promoter-dependent photocross-linking of the acidic transcriptional activator E2F
      1 to the TATA-binding protein.
AB  - Sequence-specific transcriptional activators, such as the human factor E2F-1,
      increase the rate of initiation of transcription by RNA polymerase II, possibly
      by contacting one or more of the RNA polymerase II-associated general initiation
      factors. One candidate target of transactivators is the TATA-binding protein
      (TBP), which, when bound to a promoter, nucleates the formation of a
      preinitiation complex. Previous studies using affinity chromatography techniques
      have shown that the activation domains of certain activators, including the
      acidic activation domain of E2F-1, can interact with TBP in the absence of DNA.
      Using a site-directed photoaffinity cross-linking approach, we demonstrate here
      that the activation domain of the chimeric activator LexA-E2F-1 can be cross
      linked to TBP when both factors are bound to a transcriptionally responsive RNA
      polymerase II promoter. Mutations within the activation domain of LexA-E2F-1 that
      impaired its ability to activate transcription in vitro were found to reduce
      cross-linking of LexA-E2F-1 to TBP. The association of initiation factor TFIIB
      with the TBP-promoter complex did not preclude this promoter-dependent cross
      linking to LexA-E2F-1; however, this cross-linking was promoter-independent. In
      contrast, TFIIA strongly inhibited the promoter-dependent cross-linking of LexA
      E2F-1 to TBP. These results directly demonstrate that acidic activators such as
      E2F-1 can interact with TBP during the earliest stages in the assembly of an RNA
      polymerase II preinitiation complex.

PMID- 7775420
TI  - Metabolic sources of hydrogen peroxide in aerobically growing Escherichia coli.
AB  - Exposure of cells to hydrogen peroxide (H2O2) mediates adaptive responses or
      oxidative damage, depending on the magnitude of the challenge. Determining the
      threshold for peroxide-mediated oxidative stress thus requires quantitation of
      the changes in endogenous H2O2 production. The intracellular steady-state
      concentrations of H2O2 were measured in intact Escherichia coli under different
      conditions. Compounds that block electron transport at NADH dehydrogenase
      (rotenone) or between ubiquinone and cytochrome b (antimycin) showed that
      univalent reduction of O2 can occur at these sites in vivo to form superoxide
      anion (O2-), in agreement with reports for mammalian mitochondria. Mutational
      inactivation of different components of the respiratory chain showed that H2O2
      production also depended on the energy status of the cell and on the arrangement
      of respiratory chain components corresponding to particular growth conditions.
      Production rates for O2- and H2O2 were linearly related to the number of active
      respiratory chains that reached maximal values during exponential growth. In the
      strains defective in respiratory chain components, catalase activity was
      regulated to compensate for changes in the H2O2 production rates, which
      maintained intracellular H2O2 at 0.1-0.2 microM during aerobic growth over a wide
      range of cell densities. The expression of a katG'::lacZ fusion (reporting
      transcriptional control of the catalase-hydroperoxidase I gene) was increased by
      H2O2 given either as a pulse or as a steady production. This response not only
      depended on the type and severity of the stimulus but was also strongly
      influenced by the growth phase of the cells.

PMID- 7775421
TI  - Expression of the leukocyte-associated sialoglycoprotein CD43 by a colon
      carcinoma cell line.
AB  - The colon adenocarcinoma cell line COLO 205 secretes L-CanAg, a mucin-like
      glycoprotein carrying the carcinoma-associated sialyl-Lewis a carbohydrate
      epitope. In an attempt to identify its apoprotein, an NH2-terminal peptide
      sequence was obtained from purified L-CanAg. In all interpretable positions, this
      sequence showed 100% identity to the NH2-terminal of human CD43 (leukosialin,
      sialophorin), a plasma membrane-bound sialoglycoprotein hitherto only identified
      in leukocytes and other hematopoietic cells. An antiserum against deglycosylated
      L-CanAg and an anti-CD43 antiserum both immunoprecipitated a 61-kDa band,
      interpreted as the CD43 precursor, from COLO 205 cells as well as from the known
      CD43-expressing cell line HL-60. Results from immunoprecipitations following
      pulse-chase experiments and tunicamycin treatments were in agreement with earlier
      studies on the CD43 precursor. RNA blot analysis confirmed the expression of CD43
      by the COLO 205 cell line, whereas three other colon carcinoma cell lines were
      negative. The glycosylation-dependent monoclonal antibody Leu-22, which
      recognizes leukocyte CD43, failed to bind L-CanAg, probably due to its much more
      extensive glycosylation. We conclude that L-CanAg is the secreted extracellular
      domain of a novel glycoform of CD43 and that CD43, if expressed in other
      carcinoma cells, may have escaped notice in studies relying on glycosylation
      dependent monoclonal antibodies against leukocyte CD43.

PMID- 7775418
TI  - Characterization of a mucin cDNA clone isolated from HT-29 mucus-secreting cells.
      The 3' end of MUC5AC?
AB  - HT-29 cells resistant to 10(-6) M methotrexate (HT29-MTX) secrete mucins with
      gastric immunoreactivity (Lesuffleur, T., Barbat, A., Dussaulx, E., and Zweibaum,
      A. (1990) Cancer Res. 50, 6334-6343). A 3310-base pair mucin cDNA clone (L31) was
      isolated from an HT29-MTX expression library using a polyclonal serum specific
      for normal gastric mucosa. It shows a high level of identity (98.6%) to clone
      NP3a isolated from a nasal polyp cDNA library (Meerzaman, D., Charles, P.,
      Daskal, E., Polymeropoulos, M. H., Martin, B. M., and Rose, M. C. (1994) J. Biol.
      Chem. 269, 12932-12939). However, as a result of changes in reading frame, the
      1042-amino acid deduced peptide contains four regions of a low similarity to the
      NP3a peptide. The amino acid sequence shows 36.3% similarity to part of the
      carboxyl-terminal sequence of MUC2 including the so-called D4 domain and 21.3% to
      the pro von Willebrand factor. A short amino acid sequence is similar to cysteine
      rich sequences repeated in tracheobronchial, gastric, and colonic mucin cDNAs.
      The gene corresponding to L31 is located in the mucin gene cluster on chromosome
      11p15.5. The patterns of mRNA expression were indistinguishable from those
      revealed with the JER58 probe (MUC5AC). Southern blot analysis indicates that the
      L31 and JER 58 sequences are within 20 kilobase pairs of each other. Together,
      these results suggest that L31 clone is the 3' end of MUC5AC.

PMID- 7775422
TI  - Cytosolic ADP-ribosylation factors are not required for endosome-endosome fusion
      but are necessary for GTP gamma S inhibition of fusion.
AB  - A specific role for ADP-ribosylation factors (ARFs) in in vitro endosome-endosome
      fusion has been proposed (Lenhard, J. M., Kahn, R. A., and Stahl, P. D. (1992) J.
      Biol. Chem. 267, 13047-13052). However, in vivo studies have failed to support a
      function for ARFs in the endocytic pathway, since an antagonist of ARF
      activities, brefeldin A, does not interfere with receptor internalization
      (Schonhorn, J. E., and Wessling-Resnick, M. (1994) Mol. Cell. Biochem. 135, 159
      164). This controversy surrounding the exact function of ARF in endocytic vesicle
      traffic prompted us to critically re-examine the involvement of ARFs in cell-free
      endosome fusion. Cytosol depleted of ARF activity was capable of supporting in
      vitro endocytic vesicle fusion but failed to support inhibition of this reaction
      in the presence of guanosine 5'-3-O-(thio)triphosphate (GTP gamma S). Addition of
      purified ARF1 restored the ability of the ARF-depleted cytosol to inhibit
      endosome fusion when incubated with GTP gamma S. Both endocytic vesicle fusion
      and the GTP gamma S-mediated inhibition of vesicle fusion were unaffected by
      brefeldin A. Moreover, the ATP requirement and kinetics of cell-free fusion are
      not altered by brefeldin A or depletion of cytosolic ARFs. These results suggest
      that cytosolic ARFs are not necessary for endosomal vesicle fusion in vitro but
      are responsible for inhibition of fusion in the presence of GTP gamma S and
      cytosolic factors in a brefeldin A-resistant manner.

PMID- 7775423
TI  - Overproduction and one-step purification of Escherichia coli 3-deoxy-D-manno
      octulosonic acid 8-phosphate synthase and oxygen transfer studies during
      catalysis using isotopic-shifted heteronuclear NMR.
AB  - The enzyme 3-deoxy-D-manno-octulosonic acid 8-phosphate synthase catalyzes the
      condensation of D-arabinose 5-phosphate with phosphoenolpyruvate to give the
      unique 8-carbon acidic sugar 3-deoxy-D-manno-octulosonic acid 8-phosphate (KDO 8
      P) found only in Gram-negative bacteria and required for lipid A maturation and
      cellular growth. The Escherichia coli gene kdsA that encodes KDO 8-P synthase has
      been amplified by polymerase chain reaction methodologies and subcloned into the
      expression vector, pT7-7. A simple one-step purification yields 200 mg of
      homogeneous KDO 8-P synthase per liter of cell culture. [2
      13C,18O]Phosphoenolpyruvate (PEP) was prepared by first, exchange of [2-13C]-3
      bromopyruvate with 2H2 18O followed by reaction of the labeled bromopyruvate with
      trimethylphosphite. The fate of the enolic oxygen in this multilabeled PEP,
      during the course of the KDO 8-P synthase-catalyzed reaction with D-arabinose 5
      phosphate, was monitored by 13C and 31P NMR spectroscopy. The inorganic phosphate
      formed during the reaction was further analyzed via mass spectral analysis of its
      trimethyl ester derivative. The 13C NMR spectrum of an incubation mixture of [2
      13C]PEP and D-arabinose 5-phosphate in 2H2 18O in the presence of KDO 8-P
      synthase was also recorded. [2-13C]KDO 8-P was utilized to determine the extent
      of nonenzymatic incorporation of 18O into the C-2 position of KDO 8-P. The
      results indicate that the enolic oxygen of the PEP is recovered with the
      inorganic phosphate, and the C-2 oxygen of KDO 8-P originates from the solvent,
      H2O.

PMID- 7775424
TI  - Targeted disruption of a B2 bradykinin receptor gene in mice eliminates
      bradykinin action in smooth muscle and neurons.
AB  - Mice that are homozygous for the targeted disruption of the gene encoding the B2
      bradykinin receptor have been generated. The gene disruption results in a
      deletion of the entire coding sequence for the B2 receptor. The disruption of the
      B2 receptor gene has been confirmed by genetic, biochemical, and pharmacological
      analyses. Mice that are homozygous for the disruption of the B2 receptor gene are
      fertile and indistinguishable from their littermates by visual inspection.
      Bradykinin fails to produce responses in pharmacological preparations from ileum,
      uterus, and the superior cervical ganglia from these mice. Therefore, expression
      of a single gene appears to be responsible for conferring responsiveness to
      bradykinin in these tissues.

PMID- 7775425
TI  - Identification of a sixth promoter that directs the transcription of gamma
      glutamyl transpeptidase type III RNA in mouse.
AB  - We have previously identified five promoters in the 5'-flanking region of the
      mouse gamma-glutamyl transpeptidase (gamma GT) gene. We now report the
      localization of a sixth promoter that supports the transcription of type III RNA,
      the major gamma GT RNA in fetal liver. We made a fetal liver cDNA library
      enriched for gamma GT RNA and obtained 12 gamma GT type III-specific clones. The
      longest clone is consistent with a transcription start site for type III RNA at a
      position 5' to the type IV promoter and about 5 kilobase(s) (kb) 5' to the first
      coding exon. We estimated by ribonuclease protection assay that about 80% of the
      gamma GT mRNA in fetal liver was type III. Primer extension and nuclease
      protection analyses mapped the 5' end of type III mRNA in fetal liver and kidney
      to a single cluster of potential major and minor transcription start sites.
      Deletion analysis using transient expression of chloramphenicol acetyltransferase
      constructs of the type III promoter region revealed the greatest activity with a
      1-kb 5'-flanking fragment in mouse kidney proximal tubular cells and no
      detectable activity in NIH-3T3 fibroblasts. These studies demonstrate that the
      type III 5' region of the mouse gamma GT gene is organized into two distinct
      exons (IIIa and IIIb) and that type III RNA is expressed under the control of its
      own promoter.

PMID- 7775426
TI  - Separate C-terminal domains of the epithelial specific brush border Na+/H+
      exchanger isoform NHE3 are involved in stimulation and inhibition by protein
      kinases/growth factors.
AB  - NHE3, a cloned intestinal and renal brush border Na+/H+ exchanger, has previously
      been shown to be both stimulated and inhibited by different protein
      kinases/growth factors. For instance, NHE3 is stimulated by serum and fibroblast
      growth factor (FGF) and inhibited by protein kinase C. In the present study, we
      used a series of NHE3 C terminus truncation mutants to identify separate regions
      of the C-terminal cytoplasmic tail responsible for stimulation and inhibition by
      protein kinases/growth factors. Five NHE3 C terminus truncation mutant stable
      cell lines were generated by stably transfecting NHE3 deletion cDNAs into PS120
      fibroblasts, which lack any endogenous Na+/H+ exchanger. Using fluorometric
      techniques, the effects of the calcium/calmodulin (CaM) inhibitor W13,
      calcium/CaM kinase inhibitor KN-62, phorbol myristate acetate, okadaic acid, FGF,
      and fetal bovine serum on Na+/H+ exchange were studied in these transfected
      cells. Inhibition of basal activity of full-length NHE3 is mediated by CaM at a
      site C-terminal to amino acid 756; this CaM effect occurs through both kinase
      dependent and independent mechanisms. There is another independent inhibitory
      domain for protein kinase C between amino acids 585 and 689. In addition, there
      are at least three stimulatory regions in the C-terminal domain of NHE3,
      corresponding to amino acids 509-543 for okadaic acid, 475-509 for FGF, and a
      region N-terminal to amino acid 475 for fetal bovine serum. We conclude that
      separate regions of the C terminus of NHE3 are involved with stimulation or
      inhibition of Na+/H+ exchange activity, with both stimulatory and inhibitory
      domains having several discrete subdomains. A conservative model to explain the
      way these multiple domains in the C terminus of NHE3 regulate Na+/H+ exchange is
      via an effect on associated regulatory proteins.

PMID- 7775428
TI  - Splicing isoforms of rat Ash/Grb2. Isolation and characterization of the cDNA and
      genomic DNA clones and implications for the physiological roles of the isoforms.
AB  - We obtained three types of cDNA clones homologous to Ash/Grb2(Ash-l) cDNA from
      rats. One of these clones, Ash-psi, was an unusual transcribed gene having 93%
      identity in the nucleotide sequence to Ash-l. The other two clones, Ash-m and -s,
      had nucleotide sequences identical with Ash-l cDNA in the amino-terminal region.
      The coding sequence of Ash-m cDNA is 42 nucleotides shorter than that of Ash-l
      cDNA. The defective region of Ash-m cDNA encodes 14 amino acid residues (157 to
      170 of Ash-l), which comprise the most conserved region of the second SH3 domain.
      On the other hand, the coding sequence of Ash-s terminated at the end of the
      first SH3 domain due to a stop codon at the boundary of the sequence, thereby
      differing from Ash-l cDNA. Cloning of the genomic DNA of the Ash-l-encoding gene,
      determination of the gene organization, and nucleotide sequencing revealed that
      the two isoforms, as well as Ash-l, are generated from a single gene by unusual
      alternative splicings. The gene spans more than 16 kilobases and contains 6 exons
      and 5 introns. Ash-m and Ash-s mRNAs were detected in various tissues by reverse
      transcribed polymerase chain reaction. Ash-m physically associated with dynamin,
      but the association with Sos was less effective than that of Ash-l in rat
      pheochromocytoma PC12 cell lysates, irrespective of treatment with nerve growth
      factor. In contrast, Ash-s formed a complex with dynamin and Sos in cell lysates.
      Moreover, the newly formed carboxyl-terminal SH3 of Ash-m by splicing bound
      different proteins from those bound to the carboxyl-terminal SH3 domain of Ash-l,
      suggesting that Ash-m generates different signals. Microinjection of Ash-m or Ash
      s into Balb/c 3T3 cells inhibited DNA synthesis induced by platelet-derived
      growth factor. These results show that these isoforms act as dominant negative
      regulators of mitogenic signals by Ash-l.

PMID- 7775427
TI  - The Saccharomyces cerevisiae VMA10 is an intron-containing gene encoding a novel
      13-kDa subunit of vacuolar H(+)-ATPase.
AB  - The vacuolar H(+)-ATPase (V-ATPase) functions as a primary proton pump that
      generates an electrochemical gradient of protons across the membranes of several
      internal organelles. It is composed of distinct catalytic and membrane sectors,
      each containing several subunits. We identified a protein (M16) that copurifies
      with the V-ATPase complex from Saccharomyces cerevisiae and appears to be present
      at multiple copies/enzyme. Amino acid sequencing of its proteolytic products
      yielded three nonoverlapping peptide sequences matching an unidentified reading
      frame located on chromosome VIII. Sequence analysis of cDNA encoding M16 revealed
      that the gene encoding this protein (VMA10) is interrupted by a 162-nucleotide
      intron that begins after the ATG codon of the initiator methionine. The cDNA
      encodes an hydrophilic protein of 12,713 Da with a basic isoelectric point of pH
      9. A delta vma10::URA3 null mutant exhibited growth characteristics typical of
      other vma disruptant mutants in genes encoding subunits of V-ATPase. The null
      mutant does not grow on medium buffered at pH 7.5. It fails to accumulate
      quinacrine into its vacuole, and subunits of the catalytic sector are not
      assembled onto the vacuolar membrane in the absence of M16. A cold inactivation
      experiment demonstrated that M16 is a subunit of the membrane sector of V-ATPase.
      M16 exhibits a significant sequence homology with subunit b of F-ATPase membrane
      sector.

PMID- 7775429
TI  - Spectral characterization and chemical modification of catalase-peroxidase from
      Streptomyces sp.
AB  - Catalase-peroxidase was purified to near homogeneity from Streptomyces sp. The
      enzyme was composed of two subunits with a molecular mass of 78 kDa and contained
      1.05 mol of protoporphyrin IX/mol of dimeric protein. The absorption and
      resonance Raman spectra of the native and its cyano-enzyme were closely similar
      to those of other heme proteins with a histidine as the fifth ligand. However,
      the peak from tyrosine ring at approximately 1612 cm-1, which is unique in
      catalases, was not found in resonance Raman spectra of catalase-peroxidase. The
      electron paramagnetic resonance spectrum of the native enzyme revealed uniquely
      two sets of rhombic signals, which were converted to a single high spin,
      hexacoordinate species after the addition of sodium formate. Cyanide bound to the
      sixth coordination position of the heme iron, thereby converting the enzyme to a
      low spin, hexacoordinate species. The time-dependent inactivation of the enzyme
      with diethyl pyrocarbonate and its kinetic analysis strongly suggested the
      occurrence of histidine residue. From the above-mentioned spectroscopic results
      and chemical modification, it was deduced that the native enzyme is predominantly
      in the high spin, ferric form and has a histidine as the fifth ligand.

PMID- 7775430
TI  - Chimeric muscle and brain glycogen phosphorylases define protein domains
      governing isozyme-specific responses to allosteric activation.
AB  - Muscle and brain glycogen phosphorylases differ in their responses to activation
      by phosphorylation and AMP. The muscle isozyme is potently activated by either
      phosphorylation or AMP. In contrast, the brain isozyme is poorly activated by
      phosphorylation and its phosphorylated a form is more sensitive to AMP activation
      when enzyme activity is measured in substrate concentrations and temperatures
      encountered in the brain. The nonphosphorylated b form of the brain isozyme also
      differs from the muscle isozyme b form in its stronger affinity and lack of
      cooperativity for AMP. To identify the structural determinants involved, six
      enzyme forms, including four chimeric enzymes containing exchanges in amino acid
      residues 1-88, 89-499, and 500-842 (C terminus), were constructed from rabbit
      muscle and human brain phosphorylase cDNAs, expressed in Escherichia coli, and
      purified. Kinetic analysis of the b forms indicated that the brain isozyme amino
      acid 1-88 and 89-499 regions each contribute in an additive fashion to the
      formation of an AMP site with higher intrinsic affinity but weakened
      cooperativity, while the same regions of the muscle isozyme each contribute to
      greater allosteric coupling but weaker AMP affinity. Kinetic analysis of the a
      forms indicated that the amino acid 89-499 region correlated with the reduced
      response of the brain isozyme to activation by phosphorylation and the resultant
      increased sensitivity of the a form to activation by saturating levels of AMP.
      This isozyme-specific response also correlated with the glycogen affinity of the
      a forms. Enzymes containing the brain isozyme amino acid 89-499 region exhibited
      markedly reduced glycogen affinities in the absence of AMP compared to enzymes
      containing the corresponding muscle isozyme region. Additionally, AMP led to
      greater increases in glycogen affinity of the former set of enzymes. In contrast,
      phosphate affinities of all a forms were similar in the absence of AMP and
      increased approximately the same extent in AMP. The potential importance of a
      number of isozyme-specific substitutions in these sequence regions is discussed.

PMID- 7775432
TI  - Structural requirement for cell adhesion to kalinin (laminin-5).
AB  - Laminin-5 (kalinin) was purified from spent cell culture media (SCC25 cells) by
      affinity chromatography on monoclonal antibody BM165. The protein was recovered
      as a mixture of the typical polypeptides of 165-155, 140, and 105 kDa as judged b
      SDS-polyacrylamide gel electrophoresis analysis under reducing conditions. The
      amino acid composition of purified laminin-5 was in agreement with that compiled
      from the recently published cDNA sequences of the alpha 3-, beta 3-, and gamma 2
      laminin chains. Moreover, the content of half-cystine residues in laminin-5 was
      about two-thirds that in laminin-1, which confirms the prediction of a smaller
      number of epidermal growth factor-like repeats in the amino-terminal portion of
      the three chains. The content of coiled-coil alpha-helices (27%) determined by CD
      spectroscopy was comparable to that reported for laminin-1, which indicates that
      the long arm portion of laminin-5 is equivalent to that of other laminin
      isoforms. The melting temperature was recorded at 72 degrees C by CD monitoring
      of unfolding and refolding of the coiled-coil structures during thermal
      denaturation and renaturation, respectively. The thermal stability of laminin-5
      is therefore significantly higher than that of laminin-1 or alpha 2-chain
      containing laminins, which suggests higher ionic interactions between the three
      polypeptide chains of laminin-5. Cell adhesion-promoting activity of laminin-5
      was found to be strictly and entirely dependent on the presence of coiled-coil
      structures. It decreased gradually after heat denaturation of the protein above
      65 degrees C and was totally abrogated at 75 degrees C. This is in contrast to
      laminin-1, which contains both conformation-dependent and -independent cell
      binding sites on the long and short arm domains, respectively.

PMID- 7775431
TI  - Molecular cloning and characterization of a second subunit of the interleukin 1
      receptor complex.
AB  - A monoclonal antibody (mAb) was isolated that blocked the binding and bioactivity
      of both human and murine interleukin 1 beta (IL-1 beta) on murine IL-1 receptor
      bearing cells. This mAb recognized a protein that was distinct from the Type I
      and Type II IL-1 receptors, suggesting that an additional protein exists that is
      involved in IL-1 biological responses. By expression cloning in COS-7 cells, we
      have isolated a cDNA from mouse 3T3-LI cells encoding this putative auxiliary
      molecule, which we term the IL-1 receptor accessory protein (IL-1R AcP). Sequence
      analysis of the cDNA predicts an open reading frame that encodes a 570-amino acid
      protein with a molecular mass of approximately 66 kDa. The IL-1R AcP is a member
      of the Ig superfamily by analysis of its putative extracellular domain and also
      bears limited homology throughout the protein to both Type I and Type II IL-1
      receptors. Northern analysis reveals that murine IL-1R AcP mRNA is expressed in
      many tissues and appears to be regulated by IL-1. In mammalian cells expressing
      natural or recombinant Type I IL-1R and IL-1R AcP, the accessory protein forms a
      complex with the Type I IL-1R and either IL-1 alpha or IL-1 beta but not IL-1ra.
      The recombinant accessory protein also increases the binding affinity of the
      recombinant Type I IL-1R for IL-1 beta when the two receptor proteins are
      coexpressed. Therefore, the functional IL-1 receptor appears to be a complex
      composed of at least two subunits.

PMID- 7775433
TI  - Double bond removal from odd-numbered carbons during peroxisomal beta-oxidation
      of arachidonic acid requires both 2,4-dienoyl-CoA reductase and delta 3,5,delta
      2,4-dienoyl-CoA isomerase.
AB  - The pathway for the peroxisomal beta-oxidation of arachidonic acid (5,8,11,14
      20:4) was elucidated by comparing its metabolism with 4,7,10-hexadecatrienoic
      acid (4,7,10-16:3) and 5,8-tetradecadienoic acid (5,8-14:2) which are formed,
      respectively, after two and three cycles of arachidonic acid degradation. When [1
      14C]4,7,10-16:3 was incubated with peroxisomes in the presence of NAD+ and NADPH,
      it resulted in a time-dependent increase in the production of acid-soluble
      radioactivity which was accompanied by the synthesis of 2-trans-4,7,10
      hexadecatetraenoic acid and two 3,5,7,10-hexadecatetraenoic acid isomers. The
      formation of conjugated trienoic acids suggests that peroxisomes contain delta
      3,5,delta 2,4-dienoyl-CoA isomerase with the ability to convert 2-trans-4,7,10
      hexadecatetraenoic acid to 3,5,7,10-hexadecatetraenoic acid. When 1-14C-labeled
      6,9,12-octadecatrienoic acid or 7,10,13,16-docosatetraenoic acid was incubated
      without nucleotides, the 3-hydroxy metabolites accumulated, since further
      degradation requires NAD(+)-dependent 3-hydroxyacyl-CoA dehydrogenase. When [1
      14C]5,8,11,14-20:4 was incubated under identical conditions, no polar metabolite
      was detected, but 2-trans-4,8,11,14-eicosapentaenoic acid accumulated. When NADPH
      was added to incubations, 3-hydroxy-8,11,14-eicosatrienoic, 2-trans-4,8,11,14
      eicosapentaenoic, 2-trans-8,11,14-eicosatetraenoic, and 8,11,14-eicosatrienoic
      acids were produced. Analogous compounds were formed from [1-14C]5,8-14:2. Our
      results show that the removal of double bonds from odd-numbered carbons in
      arachidonic acid thus requires both NADPH-dependent 2,4-dienoyl-CoA reductase and
      delta 3,5,delta 2,4-dienoyl-CoA isomerase. One complete cycle of 5,8-14:2 and
      5,8,11,14-20:4 beta-oxidation yields, respectively, 6-dodecenoic and 6,9,12
      octadecatrienoic acids.

PMID- 7775434
TI  - Coupled reactions in hemoglobin. Heme-globin and dimer-dimer association.
AB  - Five different human hemoglobins were used to test the postulate that
      dissociation of hemoglobin (Hb) tetramers into alpha beta dimers and dissociation
      of heme from globin are linked reactions. Spectrophotometric measurements of the
      initial rate of heme transfer from Hb to serum albumin were made over a 3000-fold
      range of Hb concentration and yielded the heme-globin dissociation rate constant
      for tetramers and that for dimers. The tetramer-dimer dissociation constant
      (K4,2) could then be calculated from the rate constant at intermediate
      concentrations. The values obtained for the five hemoglobins, spanning a 250-fold
      range in K4,2, were in good agreement with those found by direct methods. The
      relation between this new linkage reaction of hemoglobin and the classical ones,
      such as the reciprocal relation between the binding of oxygen and protons, is
      discussed briefly.

PMID- 7775435
TI  - The nuclear pore complex protein p62 is one of several sialic acid-containing
      proteins of the nuclear envelope.
AB  - While investigating the glycosylation of nuclear envelope proteins of
      neuroblastoma cells, we found several proteins that bound the sialic acid
      specific Sambucus nigra agglutinin. The strongest signals were obtained for
      proteins with apparent molecular masses of 66 and 180 kDa. The specificity of the
      lectin binding was checked by acylneuraminyl hydrolase treatment of nuclear
      envelope proteins, which prohibited S. nigra agglutinin binding. Digestion of
      nuclear envelope proteins with the N-glycosidase F revealed that sialic acid was
      N-glycosidically linked to the 180-kDa protein and very probably O-glycosidically
      linked to the 66-kDa protein. Upon extraction, the latter behaved like the
      nucleoporin p62 in that it was partly extracted by high ionic strength buffers,
      could not be solubilized by nonionic detergent, and was completely removed from
      the nuclear envelope with urea. Two-dimensional gel electrophoretic comparison
      showed that the S. nigra agglutinin-binding protein and p62 have an identical
      isoelectric point of about 5.0 and an identical apparent molecular mass of 66
      kDa. This, together with the binding of the anti-nucleoporin antibody,
      demonstrated the identity of the 66-kDa sialoprotein and p62. S. nigra agglutinin
      inhibits nuclear protein transport in neuroblastoma cells, strongly suggesting a
      functional significance of sialylation of p62.

PMID- 7775436
TI  - Mutations affecting the glycine receptor agonist transduction mechanism convert
      the competitive antagonist, picrotoxin, into an allosteric potentiator.
AB  - Contrary to its effects on the gamma-aminobutyric acid type A receptor,
      picrotoxin antagonism of the alpha 1 subunit of the human glycine receptor is
      shown to be competitive, not use-dependent, and nonselective between the
      picrotoxin components, picrotin, and picrotoxinin. Competitive antagonism and non
      use dependence are consistent with picrotoxin binding to a site in the
      extracellular domain. The mutations Arg-->Leu or Arg-->Gln at residue 271 of the
      glycine receptor alpha 1 subunit, which are both associated with human startle
      disease, have previously been demonstrated to disrupt the transduction process
      between agonist binding and channel activation. We show here that these mutations
      also transform picrotoxin from an allosterically acting competitive antagonist to
      an allosteric potentiator at low (0.01-3 microM) concentrations and to a
      noncompetitive antagonist at higher (> or = 3 microM) concentrations. This
      demonstrates that arginine 271 is involved in the transduction process between
      picrotoxin binding and its mechanism of action. Thus, the allosteric transduction
      pathways of both agonists and antagonists converge at a common residue prior to
      the activation gate of the channel, suggesting that this residue may act as an
      integration point for information from various extracellular ligand binding
      sites.

PMID- 7775437
TI  - Purification of a variant-specific surface protein of Giardia lamblia and
      characterization of its metal-binding properties.
AB  - Giardia lamblia, an intestinal parasite of humans and other vertebrates,
      undergoes surface antigenic variation by modulating the expression of different
      variant-specific surface proteins (VSP). VSPs are cysteine-rich surface proteins
      that bind zinc and other heavy metals in vitro. We developed an immunoaffinity
      chromatographic method to purify a VSP in order to determine its biochemical
      properties. The sequences of two different proteolytic fragments agreed with the
      sequence deduced from the cloned gene, and amino-terminal sequence indicated the
      removal of a 14-residue signal peptide, consistent with the transport of VSP to
      the cell surface. The protein is not glycosylated and has an isoelectric point of
      5.3. X-ray microanalyses indicated that the major metals in Giardia trophozoites,
      as well as purified VSP, are zinc and iron. The zinc concentration in Giardia
      cells was found to be 0.43 mM and the iron concentration 0.80 mM when compared
      with standard samples (zinc) or calculated from a known physical constants
      (iron). We propose that metal coordination stabilizes VSPs, rendering them
      resistant to proteolytic attack in the upper small intestine. Moreover, the
      ability to bind ions by Giardia may play a role in nutritional deficiency and/or
      malabsorption in heavily infected persons.

PMID- 7775438
TI  - The amino-terminal portion of the JAK2 protein kinase is necessary for binding
      and phosphorylation of the granulocyte-macrophage colony-stimulating factor
      receptor beta c chain.
AB  - The binding of granulocyte-macrophage colony stimulating factor (GM-CSF) to its
      receptor stimulates JAK2 protein kinase activation, protein phosphorylation, and
      JAK2 association with the beta c chain of the GM-CSF receptor. To better
      understand how different domains of the JAK2 function to regulate association and
      phosphorylation of the beta c receptor, the minimal portion of the beta c
      receptor necessary for JAK2 binding has been determined. Using glutathione S
      transferase (GST) fusion proteins expressing different portions of the membrane
      proximal domain of the beta c chain, we demonstrate that JAK2 binds to amino
      acids 458-495, but showed little binding to fusion proteins containing amino
      acids 483-559, 483-530, or 458-484. The GST-beta c 458-495 bound equally well to
      the wild type (WT) JAK2, a carboxyl-terminal deletion of JAK2 removing the
      protein kinase domain (amino acids 1000-1129), and a deletion of the kinase-like
      domain (amino acids 523-746). However, an amino-terminal JAK2 deletion (amino
      acids 2-239) markedly reduced binding to this GST-beta c. Far Western blotting
      demonstrated that a GST fusion protein containing amino acids 1-294 of JAK2, but
      not fusion proteins containing amino acids 295-522, 523-746, or 747-1127, bound
      GST-beta c 458-559. When the JAK2 WT and deletions were transiently expressed
      along with the alpha and beta c subunits of the GM-CSF receptor and the cells
      were treated with GM-CSF, the following results were obtained: 1) WT JAK2
      phosphorylated the beta c subunit in a GM-CSF-dependent manner, 2) the kinase
      like domain deletion phosphorylated the beta c subunit, and 3) both the kinase
      domain deletion and the amino-terminal deletion failed to stimulate
      phosphorylation of the beta c subunit. Therefore, phosphorylation of the beta c
      subunit requires the binding of JAK2 through its amino terminus.

PMID- 7775439
TI  - Pentobarbital-induced changes in Drosophila glutathione S-transferase D21 mRNA
      stability.
AB  - The Drosophila glutathione S-transferase (gstD) genes are a family of divergently
      transcribed, intronless genes and pseudogenes. Under control conditions, the
      steady-state level of gstD1 mRNA is 20-fold higher than that of the gstD21 mRNA
      despite a lower transcription rate of the gstD1 gene. The GST D1 protein level is
      four times as abundant as the GST D21 protein. The gstD1 and gstD21 genes
      responded rapidly to pentobarbital (PB) as changes in mRNA levels were detectable
      within 30 min of treatment. Maximal induction of gstD1 and gstD21 resulted in 3
      fold and 20-fold elevation of their respective mRNA levels. The major mechanism
      for the increase in gstD1 mRNAs appears to be transcriptional activation. The 2
      fold increase in the rate of gstD21 transcription, however, cannot fully account
      for the 20-fold increase in the steady-state level of gstD21 mRNA. Therefore,
      post-transcriptional mechanism(s) should also be responsible for the increase of
      gstD21 mRNA by PB. Because the gstD21 mRNA is relatively unstable under control
      conditions, induction of the intronless gstD21 mRNA by PB occurs mainly at the
      level of enhanced mRNA stability. The GST D1 protein level in adult Drosophila
      was increased approximately 2-fold after PB treatment, whereas the GST D21 level
      remained relatively the same. Thus, an increase in gstD21 mRNA stability by PB
      treatment is probably coupled to a regulatory effect at the translational level.

PMID- 7775440
TI  - A mechanism for inhibition of factor VIII binding to phospholipid by von
      Willebrand factor.
AB  - von Willebrand factor (vWf) acts as a carrier for blood coagulation factor VIII
      (fVIII) in the circulation. The amino-terminal 272 residues of mature vWf contain
      a high affinity fVIII binding site. Upon thrombin activation, fVIII is released
      from vWf, thereby allowing its binding to phospholipid which is required for its
      procoagulant activity. Although phospholipid and vWf compete for fVIII binding,
      it was previously suggested that their binding sites are not closely juxtaposed
      within the fVIII protein because only amino-terminal vWf proteolytic fragments
      larger than SPIII-T4 (1-272) were able to block the binding of fVIII to
      phospholipid. We have demonstrated, however, that SPIII-T4 is able to inhibit
      fVIII binding to phosphatidylserine (PS) in a dose-dependent fashion, but only at
      concentrations higher than those used in previous experiments. Our demonstration
      that the Kd values for vWf and SPIII-T4 for fVIII are 0.52 nM and 48 nM,
      respectively, explain this discrepancy. Inhibition (> 95%) of SPIII-T4 binding to
      fVIII by a purified recombinant fVIII C2 domain polypeptide demonstrated that
      SPIII-T4 binds directly to C2, as we had previously shown for vWf. The similarity
      of the C2 binding sites for vWf and SPIII-T4 was further confirmed by the
      identical inhibitory effects of synthetic peptides and monoclonal antibodies
      (mAbs) on vWf-fVIII or SPIII-T4 fVIII binding. In both cases, binding was
      inhibited by synthetic peptide 2303-2332, containing a PS binding site, and by
      mAb NMC-VIII/5 Fab' (epitope within C2 residues 2170-2327). We propose that vWf,
      via residues 1-272, and PS compete for fVIII binding because they recognize
      overlapping sites within fVIII C2 domain residues 2303-2332.

PMID- 7775441
TI  - Sphingolipid biosynthesis de novo by rat hepatocytes in culture. Ceramide and
      sphingomyelin are associated with, but not required for, very low density
      lipoprotein secretion.
AB  - Sphingolipids are constituents of liver and lipoproteins, but relatively little
      is known about their synthesis and secretion. Incubation of rat hepatocytes with
      [14C]- or [3H]serine labeled the long-chain base backbones of mainly ceramide and
      sphingomyelin. Most of the labeled sphingolipids were associated with the cells;
      however, 1-5% (the majority of which was ceramide) was released into the medium
      as part of very low density lipoproteins (VLDL). Since this is the first report
      that lipoproteins contain ceramide, lipoproteins were isolated from rat plasma,
      and the ceramide contents were (per mg of protein): 6.5 nmol for VLDL (d <
      1.018), 0.6 nmol for low density lipoproteins (1.018 < d < 1.063), 0.2 nmol for
      high density lipoproteins (1.063 < d < 1.18), and 0.1 nmol for the albumin
      fraction; the lipoproteins also contained 0.1-0.4 nmol of free sphingosine/mg of
      protein. A number of factors affected the secretion of radiolabeled
      sphingolipids: 1) addition of palmitic acid, but not stearic or oleic acid,
      enhanced secretion due to an increase in long-chain base synthesis de novo. 2)
      Choline deficiency caused a 42% reduction in the secretion of radiolabeled
      sphingomyelin, but this was due to an effect on VLDL secretion rather than a
      decrease in sphingolipid synthesis. Removal of choline was examined because
      previous studies (Yao, Z. M., and Vance, D. E. (1988) J. Biol. Chem. 263, 2998
      3004) have shown that choline deficiencies depress phosphatidylcholine synthesis
      and lipoprotein secretion. 3) Incubation of the cells with fumonisin B1, a
      mycotoxin inhibitor of sphinganine (sphingosine) N-acyltransferase, reduced
      overall sphingolipid synthesis and secretion by 90%, but had no effect on the
      secretion of apoB, phosphatidylcholine, or cholesterol. All together, these
      findings demonstrate that rat hepatocytes synthesize ceramide and sphingomyelin
      de novo and incorporate them into both cellular membranes and secreted VLDL, but
      normal sphingolipid synthesis is not required for lipoprotein secretion.

PMID- 7775442
TI  - Dimerization of the TATA binding protein.
AB  - The TATA binding protein (TBP) is a central component of all eukaryotic
      transcription machineries. The recruitment of TBP to the promoter is slow and
      possibly rate limiting in transcription complex assembly. In an effort to
      understand the nature of this potential rate-limiting step, we have investigated
      the physical state of TBP prior to DNA binding. By chemical cross-linking, gel
      filtration chromatography, and protein affinity chromatography, we find that the
      conserved carboxyl-terminal DNA binding domain of human TBP dimerizes when not
      bound to DNA. The data completely support the proposed dimeric structure of plant
      TBP, previously determined by x-ray crystallography. TBP dimers are quite stable,
      having an approximate equilibrium dissociation constant (KD) in the low nanomolar
      range. The dimerization interface appears to be dominated by hydrophobic forces,
      as predicted by the crystal structure. TBP dimers do not bind DNA, but they must
      dissociate into monomers before stably binding to the TATA box. Dissociation of
      TBP dimers appears to be relatively slow, and as such has the potential to
      dictate the kinetics of DNA binding.

PMID- 7775443
TI  - Evidence for functional binding and stable sliding of the TATA binding protein on
      nonspecific DNA.
AB  - The TATA binding protein (TBP) is required at RNA polymerase I, II, and III
      promoters that either contain or lack a TATA box. In an effort to understand how
      TBP might function at such a wide variety of promoters, we have investigated the
      specific and nonspecific DNA binding properties of human TBP. We show that TBP
      has less than a 10(3)-fold preference for binding a TATA box (TATAAAAG) than for
      an average nonspecific site. In contrast to TBP, which binds to the minor groove
      of DNA, major groove binding proteins typically display binding specificities in
      the range of 10(6). Once TBP is bound to DNA, whether it be a TATA box or
      nonspecific DNA, binding is quite stable with a t1/2 of dissociation in the range
      of 20-60 min for a 300-base pair DNA fragment. In this binding state, TBP appears
      to be capable of stable one-dimensional sliding along the DNA. Sequence-specific
      binding can be accounted for, in part, by different rates of sliding. Additional
      findings demonstrate that specific and nonspecific DNA impart upon TBP an
      enormous and equivalent degree of thermal stability, suggesting that the TBP-DNA
      interface on non-specific DNA is not radically different from that on TATA.
      Consistent with this notion, we find that nonspecifically bound TBP is competent
      in establishing pol II transcription complexes on DNA. Together, these finding
      provide a plausible mechanistic explanation for the ability of TBP to function at
      TATA-containing and TATA-less promoters.

PMID- 7775444
TI  - The role of water in retinal complexation to bacterio-opsin.
AB  - A system is described that allows for the delineation of the factors that effect
      the complexation of retinal to the apoprotein of bacteriorhodopsin. This
      complexation is investigated in various states of hydration, in H2O and D2O, at a
      variety of pH levels, with mutant membranes and labeled retinals. The
      complexation reaction was also investigated using absorption spectroscopy and
      vibrational spectra using difference Fourier transform infrared spectroscopy. The
      results demonstrate the crucial role of water in controlling the protein
      conformations that lead to protein/ligand binding reactions and begin to shed new
      light on the protein control of a reaction that normally cannot take place in an
      aqueous medium.

PMID- 7775445
TI  - The primary binding subunit of the human interleukin-4 receptor is also a
      component of the interleukin-13 receptor.
AB  - Interleukin (IL)-13 elicits a subset of the biological activities of the related
      IL-4. The basis of this functional similarity is that their specific cell-surface
      receptors (called IL-13R and IL-4R) are distinct, yet are complex and share a
      common subunit(s). The IL-4R primary binding subunit (called IL-4R alpha) does
      not by itself bind IL-13. We show that the ability of IL-13 to partially compete
      for IL-4 binding to some human cell types depended on co-expression of IL-4R and
      IL-13R. However, IL-13 binding was always associated with IL-4 binding. Hyper
      expression of IL-4R alpha on cells expressing both IL-4R and IL-13R decreased
      their binding affinity for IL-4, abrogated the ability of IL-13 to compete for IL
      4 binding, and yet had no effect on IL-13R properties. Anti-human IL-4R alpha
      monoclonal antibodies which blocked the biological function and binding of IL-4
      also blocked the function and binding of IL-13. These data show that IL-4R alpha
      is a secondary component of IL-13R.

PMID- 7775446
TI  - Isolation and characterization of guamerin, a new human leukocyte elastase
      inhibitor from Hirudo nipponia.
AB  - A new human leukocyte elastase inhibitor was extracted and purified from a Korean
      native leech Hirudo nipponia. The inhibitor, called guamerin, has a molecular
      weight of 6,110 and shows inhibition constant (Ki) of 8.1 x 10(-14) M. It is
      stable at a wide range of pH from 1 to 11 and heat-stable up to 90 degrees C. The
      complete amino acid sequence of guamerin reveals a cysteine-rich polypeptide of
      57 amino acid residues that shows no similarity to any known elastase inhibitors
      but has 51% sequence homology with hirustasin. Guamerin has identical spacing of
      10 cysteine residues as antistasin-type serine proteinase inhibitors, but the P1
      reactive site residue is Met36 instead of Arg. The neighboring sequence of the
      reactive site consists primarily of hydrophobic amino acid residues. Based on
      examinations of the target proteinases and the reactive site specificity,
      guamerin is a new low molecular weight protein that inhibits elastases.

PMID- 7775447
TI  - Participation and strength of interaction of lysine 95(beta) in the
      polymerization of hemoglobin S as determined by its site-directed substitution by
      isoleucine.
AB  - The role of Lys-95(beta), which is on the exterior of the hemoglobin (HbS)
      tetramer, in the aggregation process has been addressed because there is a lack
      of agreement on its importance. The early studies on the aggregation of HbS in
      the presence of other mutant hemoglobins are consistent with the subsequent
      electron microscopic studies in demonstrating the participation of Lys-95(beta)
      in gelation; the results of the crystal structure do not agree with these
      conclusions. Therefore, with the objective of clarifying its role we have carried
      out site-directed substitution of Lys-95(beta) to an isoleucine residue. The
      mutation was introduced by polymerase chain reaction recombination methodology,
      and the absence of other mutations in the beta-globin gene was established by
      sequencing the gene in its entirety. The recombinant mutant hemoglobin was
      expressed in yeast and characterized by peptide mapping and sequencing, which
      demonstrated that the only different tryptic peptide had the Ile substitution at
      position 95(beta). The recombinant hemoglobin had the correct amino acid
      composition and molecular weight by mass spectrometric analysis. It was also pure
      as judged by isoelectric focusing. It was fully functional because it had an
      average Hill coefficient of 3.1 and responded normally to the allosteric
      regulators, chloride, 2,3-diphosphoglycerate, and inositol hexaphosphate. Of
      particular interest was the finding that this hemoglobin mutant aggregated at a
      concentration of about 40 g/dl, nearly twice that at which HbS itself aggregated
      (24 g/dl). Therefore, Lys-95(beta) has a very important role in the aggregation
      process and is a good candidate site for the design of a therapeutic agent for
      sickle cell anemia.

PMID- 7775448
TI  - Temporal differences in the phosphorylation state of pre- and postsynaptic
      protein kinase C substrates B-50/GAP-43 and neurogranin during long-term
      potentiation.
AB  - The phosphorylation state of two identified neuralspecific protein kinase C
      substrates (the presynaptic protein B-50 and the postsynaptic protein
      neurogranin) was monitored after the induction of long term potentiation in the
      CA1 field of rat hippocampus slices by quantitative immunoprecipitation following
      32Pi labeling in the recording chamber. B-50 phosphorylation was increased from
      10 to 60 min, but no longer at 90 min after long term potentiation had been
      induced, neurogranin phosphorylation only at 60 min. Increased phosphorylation
      was not found when long term potentiation was blocked with the N-methyl-D
      aspartate receptor antagonist D-2-amino-5-phosphonovalerate, when only low
      frequency stimulation was applied or tetanic stimulation failed to induce long
      term-potentiation. Our data show that both B-50 and neurogranin phosphorylation
      are increased following the induction of long term potentiation, thus providing
      strong evidence for pre- and postsynaptic protein kinase C activation during
      narrow, partially overlapping, time windows after the induction of long term
      potentiation.

PMID- 7775449
TI  - Ligand-dependent antagonism by retinoid X receptors of inhibitory thyroid hormone
      response elements.
AB  - The role of retinoid X receptors (RXRs) on negative thyroid hormone response
      elements (nTREs) is not well understood. In this report, we demonstrate that an
      orientation-specific monomeric thyroid hormone receptor (T3R) DNA-binding site
      mediates thyroid hormone inhibition in the thyrotropin beta subunit gene (TSH
      beta) from human and murine species. Unlike positive TREs, addition of the ligand
      9-cis retinoic acid (9-cis RA) to cells transfected with a T3R beta 1 expression
      vector significantly reduces thyroid hormone inhibition of the TSH-beta gene,
      indicating that endogenous retinoid receptors antagonize T3R function.
      Cotransfection of an RXR-alpha but not a retinoic acid receptor-alpha expression
      vector further antagonizes thyroid hormone inhibition, but only in the presence
      of 9-cis RA. Antagonism by RXR requires both an intact DNA- and ligand-binding
      domain. Removal of monomeric T3R binding to the TSH-beta nTRE also requires both
      RXR domains. A model is proposed whereby monomeric T3R is removed from a nTRE by
      RXR occupied by its ligand 9-cis RA. This is the first report of 9-cis RA
      dependent antagonism of thyroid hormone inhibition via negative TREs.

PMID- 7775450
TI  - Involvement of a protein distinct from transcription enhancer factor-1 (TEF-1) in
      mediating human chorionic somatomammotropin gene enhancer function through the GT
      IIC enhanson in choriocarcinoma and COS cells.
AB  - Previous studies suggested that transcription enhancer factor-1 (TEF-1) was
      involved in mediating the human chorionic somatomammotropin (hCS) gene enhancer
      (CSEn) function (Jiang, S.-W., and Eberhardt, N. L. (1994) J. Biol. Chem. 269,
      10384-10392). We now show that an unrelated protein (CSEF-1) found in BeWo and
      COS-1 cells binds to the GT-IIC enhanson in CSEn and is correlated with CSEn
      activity in these cells. TEF-1 and CSEF-1 were distinguished by differential
      migration as GT-IIC complexes, thermal stability, molecular mass, and cross
      reactivity with chicken TEF-1 antibodies. TEF-1 and CSEF-1 bound to the GT-IIC
      and Sph-I/Sph-II enhansons with identical binding properties, and in vitro
      generated TEF-1 competed with CSEF-1 binding to the GT-IIC motif, suggesting that
      their actions might be mutually exclusive. Up- and down-regulation of TEF-1
      levels by expression systems and antisense oligonucleotides demonstrated that TEF
      1 inhibited the hCS promoter in a manner independent of the enhancer or a known
      TEF-1 DNA binding site. The data suggest that TEF-1 may provide a counter
      regulatory stimulus to the actions of CSEF-1, which may be involved in mediating
      enhancer stimulatory activity.

PMID- 7775451
TI  - Reduced chaperone-like activity of alpha A(ins)-crystallin, an alternative
      splicing product containing a large insert peptide.
AB  - alpha-Crystallin is a multimeric protein complex which is constitutively
      expressed at high levels in the vertebrate eye lens, where it serves a structural
      role, and at low levels in several non-lenticular tissues. Like other members of
      the small heat shock protein family, alpha-crystallin has a chaperone-like
      activity in suppressing nonspecific aggregation of denaturing proteins in vitro.
      Apart from the major alpha A- and alpha B-subunits, alpha-crystallin of rodents
      contains an additional minor subunit resulting from alternative splicing, alpha
      A(ins)-crystallin. This polypeptide is identical to normal alpha A-crystallin
      except for an insert peptide of 23 residues. To explore the structural and
      functional consequences of this insertion, we have expressed rat alpha A- and
      alpha A(ins)-crystallin in Escherichia coli. The multimeric particles formed by
      alpha A(ins) are larger and more disperse than those of alpha A, but they are
      native-like and display a similar thermostability and morphology, as revealed by
      gel permeation chromatography, tryptophan fluorescence measurements, and electron
      microscopy. However, as compared with alpha A, the alpha A(ins)-particles display
      a diminished chaperone-like activity in the protection of heat-induced
      aggregation of beta low-crystallin. Our experiments indicate that alpha A(ins)
      multimers have a 3-4-fold reduced substrate binding capacity, which might be
      correlated to their increased particle size and to a shielding of binding sites
      by the insert peptides. The structure-function relationship of the natural mutant
      alpha A(ins)-crystallin may shed light on the mechanism of chaperone-like
      activity displayed by all small heat shock proteins.

PMID- 7775452
TI  - New thermodynamic studies on ribonuclease A at low pH.
AB  - The Planck-Benzinger thermal work function, delta W zero(T), represents the heat
      flux term which is responsible for breaking or forming the noncovalent bonds in
      macro-molecular interactions, while the temperature-invariant chemical bond
      energy, delta H zero(T zero), gives molecules the cohesiveness to form
      macromolecular structures. A method is described for evaluating delta H zero(T
      zero) at different temperatures for ribonuclease A at low pH in the standard
      state, in order to determine the effect of pH on the thermodynamic stability of
      this protein. Ribonuclease A at pH 1.13 has a delta H zero(T zero) value of 58
      kcal mol-1; at pH 2.50, delta H zero(T zero) is 58, at pH 2.77, 59, and at pH
      3.15, 60 kcal mol-1. In the conformational thermal transition of ribonuclease A
      at pH 2.8, the compensatory temperature ranges from 50 to 320 K, and delta H
      zero(T zero) is approximately 5-6 kcal mol-1. This widening temperature range is
      typical of the unfolding process. Such differences in the magnitude of the
      temperature-invariant chemical bond energy can be attributed to specific changes
      in the solvent ordering in the immediate domain of ribonuclease A.

PMID- 7775453
TI  - The enterotoxin from Clostridium difficile (ToxA) monoglucosylates the Rho
      proteins.
AB  - The enterotoxin from Clostridium difficile (ToxA) is one of the causative agents
      of the antibiotic-associated pseudomembranous colitis. In cultured monolayer
      cells ToxA exhibits cytotoxic activity to induce disassembly of the actin
      cytoskeleton, which is accompanied by morphological changes. ToxA-induced
      depolymerization of actin filaments is correlated with a decrease in the ADP
      ribosylation of the low molecular mass GTP-binding Rho proteins (Just, I.,
      Selzer, J., von Eichel-Streiber, C., and Aktories, K. (1995) J. Clin. Invest. 95,
      1026-1031). Here we report on the identification of the ToxA-induced modification
      of Rho. Applying electrospray mass spectrometry, the mass of the modification was
      determined as 162 Da, which is consistent with the incorporation of a hexose into
      Rho. From several hexoses tested UDP-glucose selectively served as cosubstrate
      for ToxA-catalyzed modification. The acceptor amino acid of glucosylation was
      identified from a Lys-C-generated peptide by tandem mass spectrometry as Thr-37.
      Mutation of Thr-37 to Ala completely abolished glucosylation. The members of the
      Rho family (RhoA, Rac1, and Cdc42Hs) were substrates for ToxA, whereas H-Ras,
      Rab5, and Arf1 were not glucosylated. ToxA-catalyzed glucosylation of lysates
      from ToxA-pretreated rat basophilic leukemia (RBL) cells resulted in a decreased
      incorporation of [14C]glucose, indicating previous glucosylation in the intact
      cell. Glucosylation of the Rho subtype proteins appears to be the molecular
      mechanism by which C. difficile ToxA mediates its cytotoxic effects on cells.

PMID- 7775454
TI  - The influence of beta subunit structure on the interaction of Na+/K(+)-ATPase
      complexes with Na+. A chimeric beta subunit reduces the Na+ dependence of
      phosphoenzyme formation from ATP.
AB  - High-affinity ouabain binding to Na+/K(+)-ATPase (sodium- and potassium-transport
      adenosine triphosphatase (EC 3.6.1.37)) requires phosphorylation of the alpha
      subunit of the enzyme either by ATP or by inorganic phosphate. For the native
      enzyme (alpha/beta 1), the ATP-dependent reaction proceeds about 4-fold more
      slowly in the absence of Na+ than when saturating concentrations of Na+ are
      present. Hybrid pumps were formed from either the alpha 1 or the alpha 3 subunit
      isoforms of Na+/K(+)-ATPase and a chimeric beta subunit containing the
      transmembrane segment of the Na+/K(+)-ATPase beta 1 isoform and the external
      domain of the gastric H+/K(+)-ATPase beta subunit (alpha/NH beta 1 complexes). In
      the absence of Na+, these complexes show a rate of ATP-dependent ouabain binding
      from approximately 75-100% of the rate seen in the presence of Na+ depending on
      buffer conditions. Nonhydrolyzable nucleotides or treatment of ATP with apyrase
      abolishes ouabain binding, demonstrating that ouabain binding to alpha/NH beta 1
      complexes requires phosphorylation of the protein. Buffer ions inhibit ouabain
      binding by alpha/NH beta 1 in the absence of Na+ rather than promote ouabain
      binding, indicating that they are not substituting for sodium ions in the
      phosphorylation reaction. The pH dependence of ATP-dependent ouabain binding in
      the presence or absence of Na+ is similar, suggesting that protons are probably
      not substituting for Na+. Hybrid alpha/NH beta 1 pumps also show slightly higher
      apparent affinities (2-3-fold) for ATP, Na+, and ouabain; however, these are not
      sufficient to account for the increase in ouabain binding in the absence of Na+.
      In contrast to phosphoenzyme formation and ouabain binding by alpha/NH beta 1
      complexes in the absence of Na+, ATPase activity, measured as release of
      phosphate from ATP, requires Na+. These data suggest that the transition from E1P
      to E2P during the catalytic cycle does not occur when the sodium binding sites
      are not occupied. Thus, the chimeric beta subunit reduces or eliminates the role
      of Na+ in phosphoenzyme formation from ATP, but Na+ binding or release by the
      enzyme is still required for ATP hydrolysis and release of phosphate.

PMID- 7775455
TI  - Tepoxalin, a novel dual inhibitor of the prostaglandin-H synthase cyclooxygenase
      and peroxidase activities.
AB  - Prostaglandin-H synthase-1, the rate-limiting enzyme in prostaglandin synthesis,
      has both cyclooxygenase (CO) and peroxidase (PO) activities. While most
      nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit only the CO activity, we
      describe an inhibitor, tepoxalin, that inhibits both the CO (IC50 = 0.1 microM)
      and the PO (IC50 = 4 microM) activities. Unlike many NSAIDs which are competitive
      inhibitors of CO, tepoxalin is a noncompetitive inhibitor of CO and its
      inhibitory effect on PO but not CO is reversed by excess heme. Moreover,
      inhibition of the PO activity by tepoxalin is not dependent on the enzymatic
      turnover of the CO activity. The hydroxamic acid of tepoxalin is responsible for
      the PO inhibition since a carboxylic acid derivative of tepoxalin retains full CO
      but not PO inhibition. We postulated that the hydroxamic group might confer the
      ability to inhibit PO on conventional CO inhibitors. This idea was supported by
      the observation that naproxen hydroxamic acid, but not naproxen showed PO
      inhibition. Furthermore, tepoxalin's carboxylic acid analogue and naproxen each
      competitively relieved PO inhibition by their respective hydroxamic acids. The
      intracellular activity of PO as monitored by the release of reactive oxygen
      species was also inhibited by both tepoxalin and naproxen hydroxamic acid. These
      observations suggest a strategy for design of novel compounds to inhibit
      prostaglandin synthase PO. The therapeutic implications of these novel PO
      inhibitors are discussed.

PMID- 7775456
TI  - A mutant at position 87 of the GroEL chaperonin is affected in protein binding
      and ATP hydrolysis.
AB  - The highly conserved aspartic acid residue at position 87 of the Escherichia coli
      chaperonin GroEL was mutated to glutamic acid. When expressed in an E. coli groEL
      mutant strain deficient for phage morphogenesis, plasmid-encoded GroEL mutant
      D87E restored T4 phage morphogenesis. It did not, however, reactivate the
      transcription of a recombinant luciferase operon from Vibrio fischeri. In vitro,
      GroEL mutant D87E was found to be impaired in the ability to bind nonnative
      proteins and to hydrolyze ATP, resulting in less efficient refolding of urea
      denatured ribulose-1,5-bisphosphate carboxylase/oxygenase. Mutant oligomer D87E
      GroEL14 was able to bind GroES7 as efficiently as wild-type GroEL14. The
      conserved aspartic acid residue at position 87 located in the equatorial domain
      of GroEL (Braig, K., Otwinowski, Z., Hegde, R., Boisvert, D.C., Joachimiak, A.,
      Horwich, A.L., and Sigler, P.B. (1994) Nature 371, 578-586) is thus inferred to
      have a dual effect on the binding of nonnative proteins to the GroEL14 core
      chaperonin and on ATP hydrolysis.

PMID- 7775457
TI  - Characterization of chitin synthase 2 of Saccharomyces cerevisiae. Implication of
      two highly conserved domains as possible catalytic sites.
AB  - Chitin synthase 2 of Saccharomyces cerevisiae was characterized by means of site
      directed mutagenesis and subsequent expression of the mutant enzymes in yeast
      cells. Chitin synthase 2 shares a region whose sequence is highly conserved in
      all chitin synthases. Substitutions of conserved amino acids in this region with
      alanine (alanine scanning) identified two domains in which any conserved amino
      acid could not be replaced by alanine to retain enzyme activity. These two
      domains contained unique sequences, Glu561-Asp562-Arg563 and Gln601-Arg602-Arg603
      Arg604-Trp605, that were conserved in all types of chitin synthases. Glu561 or
      arginine at 563, 602, and 603 could be substituted by glutamic acid and lysine,
      respectively, without significant loss of enzyme activity. However, even
      conservative substitutions of Asp562 with glutamic acid, Gln601 with asparagine,
      Arg604 with lysine, or Trp605 with tyrosine drastically decreased the activity,
      but did not affect apparent Km values for the substrate significantly. In
      addition to these amino acids, Asp441 was also found in all chitin synthase. The
      mutant harboring a glutamic acid substitution for Asp441 severely lost activity,
      but it showed a similar apparent Km value for the substrate. Amounts of the
      mutant enzymes in total membranes were more or less the same as found in the wild
      type. Furthermore, Asp441, Asp562, Gln601, Arg604, and Trp605 are completely
      conserved in other proteins possessing N-acetylglucosaminyltransferase activity
      such as NodC proteins of Rhizobium bacterias. These results suggest that Asp441,
      Asp562, Gln601, Arg604, and Trp605 are located in the active pocket and that they
      function as the catalytic residues of the enzyme.

PMID- 7775458
TI  - Constitutive function of the basic helix-loop-helix/PAS factor Arnt. Regulation
      of target promoters via the E box motif.
AB  - Arnt is a nuclear basic helix-loop-helix (bHLH) transcription factor that,
      contiguous with the bHLH motif, contains a region of homology (PAS) with the
      Drosophila factors Per and Sim. Arnt dimerizes in a ligand-dependent manner with
      the bHLH dioxin receptor, a process that enables the dioxin-(2,3,7,8
      tetrachlorodibenzo-p-dioxin)-activated Arnt-dioxin receptor complex to recognize
      dioxin response elements of target promoters. In the absence of dioxin, Arnt does
      not bind to this target sequence motif. The constitutive function of Arnt is
      presently not understood. Here we demonstrate that Arnt constitutively bound the
      E box motif CACGTG that is also recognized by a number of distinct bHLH factors,
      including USF and Max. Importantly, amino acids that have been identified to be
      critical for E box recognition by Max and USF are conserved in Arnt. Consistent
      with these observations, full-length Arnt, but not an Arnt deletion mutant
      lacking its potent C-terminal transactivation domain, constitutively activated
      CACGTG E box-driven reporter genes in vivo. These results indicate a role of Arnt
      in regulation of a network of target genes that is distinct from that regulated
      by the Arnt-dioxin receptor complex in dioxin-stimulated cells.

PMID- 7775459
TI  - Stimulation of cannabinoid receptor CB1 induces krox-24 expression in human
      astrocytoma cells.
AB  - The recent isolation and cloning of the G protein-coupled central cannabinoid
      receptor (CB1) from brain tissue has provided a molecular basis to elucidate how
      cannabinoid compounds may mediate their psychoactive effects. Here we report the
      high expression of cannabinoid receptors in human astrocytoma tumors of different
      grades, in the astrocytoma cell lines U373 MG and GL-15, as well as in normal
      astrocytes. From an analysis of the coupling mechanisms of functional CB1
      receptors in U373 MG, we show that, in addition to the inhibition of adenylyl
      cyclase, activation by the cannabinoid agonist CP-55940 induces the expression of
      the immediate-early gene krox-24, also known as NGFI-A, zif/268, egr-1, and TIS8.
      The amount of Krox-24 protein and the level of Krox-24 DNA binding activity, as
      measured by Western blot and electrophoretic mobility shift assay, respectively,
      were also increased by the addition of CP-55940. These effects were blocked by
      incubation with pertussis toxin but not by treatment with hydrolysis-resistant
      cAMP analogues, suggesting that the transduction pathway between the cannabinoid
      receptor and krox-24 involves a pertussis toxin-sensitive GTP-binding protein and
      is independent of cAMP metabolism. The specific involvement of CB1 in Krox-24
      induction was demonstrated in Chinese hamster ovary cells transfected with the
      human CB1 receptor and also in experiments using the CB1-selective cannabinoid
      antagonist SR 141716A.

PMID- 7775460
TI  - Site-directed mutagenesis identifies residues involved in ligand recognition in
      the human A2a adenosine receptor.
AB  - The A2a adenosine receptor is a member of the G-protein coupled receptor family,
      and its activation stimulates cyclic AMP production. To determine the residues
      which are involved in ligand binding, several residues in transmembrane domains 5
      7 were individually replaced with alanine and other amino acids. The binding
      properties of the resultant mutant receptors were determined in transfected COS-7
      cells. To study the expression levels in COS-7 cells, mutant receptors were
      tagged at their amino terminus with a hemagglutinin epitope, which allowed their
      immunological detection in the plasma membrane by the monoclonal antibody 12CA5.
      The functional properties of mutant receptors were determined by measuring
      stimulation of adenylate cyclase. Specific binding of [3H]CGS 21680 (15 nM) and
      [3H]XAC (4 nM), an A2a agonist and antagonist, respectively, was absent in the
      following Ala mutants: F182A, H250A, N253A, I274A, H278A, and S281A, although
      they were well expressed in the plasma membrane. The hydroxy group of Ser-277 is
      required for high affinity binding of agonists, but not antagonists. An N181S
      mutant lost affinity for adenosine agonists substituted at N6 or C-2, but not at
      C-5'. The mutant receptors I274A, S277A, and H278A showed full stimulation of
      adenylate cyclase at high concentrations of CGS 21680. The functional agonist
      potencies at mutant receptors that lacked radioligand binding were > 30-fold less
      than those at the wild type receptor. His-250 appears to be a required component
      of a hydrophobic pocket, and H-bonding to this residue is not essential. On the
      other hand, replacement of His-278 with other aromatic residues was not tolerated
      in ligand binding. Thus, some of the residues targeted in this study may be
      involved in the direct interaction with ligands in the human A2a adenosine
      receptor. A molecular model based on the structure of rhodopsin, in which the 5'
      NH in NECA is hydrogen bonded to Ser-277 and His-278, was developed in order to
      visualize the environment of the ligand binding site.

PMID- 7775461
TI  - Neolactoglycosphingolipids, potential mediators of corneal epithelial cell
      migration.
AB  - Cell migration is a fundamental process of wound repair in biological systems. In
      an attempt to identify plasma membrane glycoconjugates which mediate cell
      migration, migrating and nonmigrating rabbit corneal epithelia were analyzed for
      reactivity with monoclonal antibodies (mAbs) specific for unsubstituted N-acetyl
      lactosamine (mAb 1B2), Le(x) (mAbs 7A and MMA), and sialyl Le(x) (mAb CSLEX1)
      carbohydrate chains of neolactoglycoconjugates. Immunohistochemical analysis
      indicated that regardless of whether the epithelia analyzed were from corneas of
      animals in vivo, corneas in organ culture, or cells in tissue culture, migrating
      cells stained intensely with mAb 1B2, whereas nonmigrating cells either did not
      stain or stained only weakly. mAbs MMA and 7A stained migrating epithelium as
      well as basal and middle cell layers of normal, nonmigrating epithelium. mAb
      CSLEX1 did not stain wounded corneas but stained the superficial cell layer of
      normal corneal epithelium. Biochemical analyses by TLC immunostaining revealed
      the presence of three mAb 1B2-reactive glycosphingolipids (GSL),
      neolactotetraosyl-(nLc4, paragloboside), neolactohexaosyl- (nLc6), and neolacto
      octaosylceramide (nLc8) in migrating epithelia. In contrast, nonmigrating
      epithelia contained only trace amounts of these glycolipids. Exogenous addition
      of nLc4, but not various other GSLs including a Le(x)-GSL (SSEA-1), stimulated re
      epithelialization of wounds in an experimental model of corneal epithelial wound
      healing. Moreover, re-epithelialization of wounds was significantly inhibited by
      mAb 1B2 but not by mAb MMA. The data suggest that neolacto-GSLs of corneal
      epithelium may be among the molecules which mediate healing of corneal epithelial
      wounds by influencing cell migration.

PMID- 7775462
TI  - Mutagenesis and the molecular modeling of the rat angiotensin II receptor (AT1).
AB  - The molecular interaction involved in the ligand binding of the rat angiotensin
      II receptor (AT1A) was studied by site-directed mutagenesis and receptor model
      building. The three-dimensional structure of AT1A was constructed on the basis of
      a multiple amino acid sequence alignment of seven transmembrane domain receptors
      and angiotensin II receptors and after the beta 2 adrenergic receptor model built
      on the template of the bacteriorhodopsin structure. These data indicated that
      there are conserved residues that are actively involved in the receptor-ligand
      interaction. Eleven conserved residues in AT1, His166, Arg167, Glu173, His183,
      Glu185, Lys199, Trp253, His256, Phe259, Thr260, and Asp263, were targeted
      individually for site-directed mutation to Ala. Using COS-7 cells transiently
      expressing these mutated receptors, we found that the binding of angiotensin II
      was not affected in three of the mutations in the second extracellular loop,
      whereas the ligand binding affinity was greatly reduced in mutants Lys199-->Ala,
      Trp253-->Ala, Phe259-->Ala, Asp263-->Ala, and Arg167-->Ala. These amino acid
      residues appeared to provide binding sites for Ang II. The molecular modeling
      provided useful structural information for the peptide hormone receptor AT1A.
      Binding of EXP985, a nonpeptide angiotensin II antagonist, was found to be
      involved with Arg167 but not Lys199.

PMID- 7775463
TI  - Glutathionylspermidine metabolism in Escherichia coli. Purification, cloning,
      overproduction, and characterization of a bifunctional glutathionylspermidine
      synthetase/amidase.
AB  - Glutathionylspermidine (GSP) synthetases of Trypanosomatidae and Escherichia coli
      couple hydrolysis of ATP (to ADP and Pi) with formation of an amide bond between
      spermidine (N-(3-aminopropyl)-1,4-diaminobutane) and the glycine carboxylate of
      glutathione (gamma-Glu-Cys-Gly). In the pathogenic trypanosomatids, this reaction
      is the penultimate step in the biosynthesis of the antioxidant metabolite,
      trypanothione (N1,N8-bis-(glutathionyl)spermidine), and is a target for drug
      design. In this study, GSP synthetase was purified to near homogeneity from E.
      coli B, the gene encoding it was isolated and sequenced, the enzyme was
      overexpressed and purified in quantity, and the recombinant enzyme was
      characterized. The 70-kDa protein was found to have an unexpected second
      catalytic activity, glutathionylspermidine amide bond hydrolysis. Thus, the
      bifunctional GSP synthetase/amidase catalyzes opposing amide bond-forming and 
      cleaving reactions, with net hydrolysis of ATP. The synthetase activity is
      selectively abrogated by proteolytic cleavage 81 residues from the C terminus,
      suggesting that the two activities reside in distinct domains (N-terminal amidase
      and C-terminal synthetase). Proteolysis at this site is facile in the absence of
      substrates, but is inhibited in the presence of ATP, glutathione, and Mg2+. A
      series of analogs was used to probe the spermidine-binding site of the synthetase
      activity. The activity of diaminopropane as a substrate, inactivity of the C4-C8
      diaminoalkanes, and greater loss of specificity for analogs modified in the 3
      aminopropyl moiety than for those modified in the 4-aminobutyl moiety indicate
      that the enzyme recognizes predominantly the diaminopropane portion of spermidine
      and corroborate N-1 (the aminopropyl N) as the site of glutathione linkage
      (Tabor, H. and Tabor, C. W. (1975) J. Biol. Chem. 250, 2648-2654). Trends in Km
      and kcat for a set of difluorosubstituted spermidine derivatives suggest that the
      enzyme may bind the minor, deprotonated form of the amine nucleophile.

PMID- 7775464
TI  - The ATP synthase gamma subunit. Suppressor mutagenesis reveals three helical
      regions involved in energy coupling.
AB  - A role in coupling proton transport to catalysis of ATP synthesis has been
      demonstrated for the Escherichia coli F0F1 ATP synthase gamma subunit.
      Previously, functional interactions between the terminal regions that were
      important for coupling were shown by finding several mutations in the carboxyl
      terminal region of the gamma subunit (involving residues at positions 242 and 269
      280) that restored efficient coupling to the mutation, gamma Met-23-->Lys
      (Nakamoto, R. K., Maeda, M., and Futai, M. (1993) J. Biol. Chem. 268, 867-872).
      In this study, we used suppressor mutagenesis to establish that the terminal
      regions can be separated into three interacting segments. Second-site mutations
      that cause pseudo reversion of the primary mutations, gamma Gln-269-->Glu or
      gamma Thr-273-->Val, map to an amino-terminal segment with changes at residues
      18, 34, and 35, and to a segment near the carboxyl terminus with changes at
      residues 236, 238, 242, and 246. Each second-site mutation suppressed the effects
      of both gamma Gln-269-->Glu and gamma Thr-273-->Val, and restored efficient
      coupling to enzyme complexes containing either of the primary mutations. Mapping
      of these residues in the recently reported x-ray crystallographic structure of
      the F1 complex (Abrahams, J. P., Leslie, A. G., Lutter, R., and Walker, J. E.
      (1994) Nature 370, 621-628), reveals that the second-site mutations do not
      directly interact with gamma Gln-269 and gamma Thr-273 and that the effect of
      suppression occurs at a distance. We propose that the three gamma subunit
      segments defined by suppressor mutagenesis, residues gamma 18-35, gamma 236-246,
      and gamma 269-280, constitute a domain that is critical for both catalytic
      function and energy coupling.

PMID- 7775465
TI  - Analysis of LE-ACS3, a 1-aminocyclopropane-1-carboxylic acid synthase gene
      expressed during flooding in the roots of tomato plants.
AB  - The plant hormone ethylene is produced in response to a variety of environmental
      stresses. Previous work has shown that flooding or anaerobic stress in the roots
      of tomato plants caused an increase in the production of the ethylene precursor 1
      aminocyclopropane-1-carboxylate (ACC) in the roots, due to flooding-induced
      activity of ACC synthase (EC 4.4.1.14). RNA was extracted from roots and leaves
      of tomato plants flooded over a period of 48 h. Blot analysis of these RNAs
      hybridized with probes for four different ACC synthases revealed that the ACC
      synthase gene LE-ACS3 is rapidly induced in roots. LE-ACS2 is also induced, but
      at later times. The genomic clone for LE-ACS3 was isolated and sequenced. At all
      time points, the probe from the LE-ACS3 coding region hybridized to two bands in
      the RNA blots. Hybridization using the first and third introns of LE-ACS3
      separately as probes indicate that flooding may inhibit processing of the LE-ACS3
      transcript. Sequence homology analysis identified three putative cis-acting
      response elements in the promoter region, corresponding to the anaerobic response
      element from the maize adh1 promoter, the root-specific expression element from
      the cauliflower mosaic virus 35S promoter and a recognition element for
      chloroplast DNA binding factor I from the maize chloroplast ATP synthase
      promoter.

PMID- 7775466
TI  - Mutational analysis of Ca(2+)-independent autophosphorylation of
      calcium/calmodulin-dependent protein kinase II.
AB  - Previous studies with synthetic peptides indicate that residues 290-309,
      corresponding to the calmodulin (CaM)-binding domain of Ca2+/CaM-dependent
      protein kinase II interact with the catalytic core of the enzyme as a
      pseudosubstrate (Colbran, R. J., Smith, M. K., Schworer, C. M., Fong, Y. L., and
      Soderling, T. R. (1989) J. Biol. Chem. 264, 4800-4804). In the present study, we
      attempted to locate the pseudosubstrate motif by generation or removal of
      potential substrate recognition sequences (RXXS/T) at selected positions using
      site-directed mutagenesis. Based on previous results, Arg297, Thr305/306, and
      Ser314 were selected as key residues. Single mutations such as N294S, K300S,
      A302R, A309R, and R311A were expressed, purified, and characterized. Several of
      the mutants exhibited decreased binding of and activation by CaM, not surprising
      since the mutations were within the CaM-binding domain. None of the mutants
      exhibited enhanced Ca(2+)-independent kinase activity toward exogenous substrate,
      but the K300S and N294S mutants showed a significant enhancement in the rate and
      stoichiometry of 32P incorporation during Ca(2+)-independent autophosphorylation.
      Using two-dimensional peptide mapping and phosphoamino acid analyses, enhanced
      phosphorylation of the introduced Ser residue was demonstrated in the K300S
      mutant but not in the N294S mutant. This specific Ca(2+)-independent
      autophosphorylation of Ser300 is consistent with the hypothesis that Arg297 may
      occupy the P (-3) position in a pseudosubstrate autoinhibitory interaction with
      the catalytic core in the nonactivated state of the kinase.

PMID- 7775467
TI  - An unusually stable purine(purine-pyrimidine) short triplex. The third strand
      stabilizes double-stranded DNA.
AB  - Classical models for DNA triple helix formation assume the stabilization of these
      structures through the formation of Hoogsteen hydrogen bonds. This assumes that G
      rich duplex DNA is more stable than triplex DNA. We report the results of co
      migration assay, dimethyl sulfate footprint, and UV spectroscopic melting studies
      that reveal that at least in some cases of short (13-mer) purine(purine
      pyrimidine) triplex the stability of double-stranded DNA is increased by the
      binding of the third strand. Under conditions which are usually considered as
      physiological (10 mM MgCl2, 150 mM Na+ or K+) and with a rate of heating/cooling
      of 1 degrees C/min, there is a good reversibility of the melting profiles which
      is consistent with a high rate of triplex formation. Other factors than Hoogsteen
      hydrogen bonds should therefore be involved in triplex stabilization. We suggest
      that oligonucleotides with similar properties could be efficient agents for
      artificial gene regulation.

PMID- 7775468
TI  - Structural basis for species-specific differences in the phosphorylation of Na,K
      ATPase by protein kinase C.
AB  - There is considerable evidence that protein kinases play a role in regulation of
      the activity of the Na,K-ATPase, but the characteristics of direct kinase
      phosphorylation of Na,K-ATPase subunits are still not well understood. There are
      36 sites that could qualify as protein kinase C motifs in rat alpha 1. Here we
      have used protein fragmentation with trypsin to localize the site of
      phosphorylation of the rat Na,K-ATPase alpha 1 subunit to within the first 32
      amino acids of the N terminus and then used direct sequencing of the
      phosphorylated protein to determine which of two candidate serine residues was
      modified. The result was that at most 25% of the 32P was found on Ser-11, a site
      that is well conserved in Na,K-ATPase alpha 1 subunits. The remaining 75% or more
      of the 32P was found on Ser-18, a site that is absent in many Na,K-ATPase alpha
      subunit sequences. This accounts for the observation that dog and pig alpha 1
      subunits can be phosphorylated by protein kinase C only to much lower levels than
      can rat alpha 1. It is also likely to be relevant to other known species-specific
      effects of protein kinase C on Na,K-ATPase.

PMID- 7775469
TI  - Cell type-specific secretion of parathyroid hormone-related protein via the
      regulated versus the constitutive secretory pathway.
AB  - Parathyroid hormone-related protein (PTHrP) is endoproteolytically processed to
      yield a family of mature secretory forms. These include an amino-terminal, a mid
      region, and a carboxyl-terminal form. Prior studies suggested that the mid-region
      form is secreted via the regulated secretory pathway, whereas the amino- and
      carboxyl-terminal forms are secreted via the constitutive pathway. Further, PTHrP
      is unusual in that it is produced under normal circumstances by neuroendocrine
      cell types as well as by prototypical constitutively secreting cell types. The
      potential for cell-specific secretory pathway use by PTHrP has not been explored.
      Using immunohistochemical and perifusion techniques, we demonstrate that all
      three PTHrP daughter peptides are secreted via the regulated pathway in
      neuroendocrine cells. In contrast, all three daughter peptides are secreted in a
      constitutive fashion by non-neuroendocrine cells. Thus, the secretion of PTHrP is
      unique in that it appears to be cell-specific. When it is expressed in
      neuroendocrine cells that contain the regulated pathway, it is secreted in a
      regulated fashion; when it is expressed in non-neuroendocrine cells, it defaults
      to the constitutive pathway. This phenomenon has not previously been described
      for a polypeptide hormone in naturally occurring cells.

PMID- 7775470
TI  - Cloning, overexpression, purification, and characterization of the carboxyl
      terminal nucleotide binding domain of P-glycoprotein.
AB  - Multidrug-resistant tumor cells overexpress P-glycoprotein (170 kDa), a member of
      the ABC (ATP Binding Cassette)-transporter superfamily. P-glycoprotein has been
      implicated in transport of a broad range of amphiphilic, hydrophobic drugs from
      tumor cells. The sequence and structural organization of P-glycoprotein, which
      consists of 12 transmembrane helices and two cytoplasmic nucleotide binding
      domains, is similar to other ABC-transporters. It is believed that the nucleotide
      binding domains of various ABC transporters, which have 30-50% sequence identity,
      play an important role in coupling ATP hydrolysis to the transport process. To
      allow structure-function studies of the nucleotide binding domains, the carboxyl
      terminal nucleotide binding domain (NBD) of Chinese hamster P-glycoprotein has
      been cloned, overexpressed, and purified both by itself and as a fusion with
      maltose-binding protein. It has been demonstrated that the carboxyl-terminal NBD,
      when overexpressed in Escherichia coli in the absence of transmembrane helices,
      has very low ATPase activity. This suggests that the amino-terminal nucleotide
      binding domain and possibly interaction with the transmembrane domains may be
      required for full ATPase activity. It is also consistent with the idea that the
      ATPase activity of P-glycoprotein is stimulated in the presence of drugs.
      Circular dichroism spectral analysis and the ability of carboxyl-terminal NBD,
      both by itself and as a fusion with maltose-binding protein, to bind ATP-agarose
      beads and P-glycoprotein specific monoclonal antibodies suggests that the
      polypeptide folds into a functional domain. Gel filtration chromatography and
      cross-linking studies indicate that the carboxyl-terminal NBD has a tendency to
      self-associate to form oligomers. It is speculated that the carboxyl-terminal NBD
      may play a role in self-association of P-glycoprotein molecules in the plasma
      membrane.

PMID- 7775471
TI  - Differential expression and regulation of hsp70 and hsp90 by phorbol esters and
      heat shock.
AB  - Human peripheral blood monocytes (PBM) produce superoxide anions (O2-.) by a
      process involving electron transfer from NADPH to O2, catalyzed by the
      respiratory burst enzyme NADPH oxidase. We have previously shown that
      phagocytosis, while activating NADPH oxidase, induced in PBM the synthesis of
      heat shock (HS) proteins (HSP). The present study was undertaken to establish
      whether this increase in HSP expression was related to O2-. and/or to classical
      second messengers such as protein kinase C (PKC). Thus, the effects of the PKC
      activator phorbol 12-myristate 13-acetate (PMA) were compared with those of heat
      shock on the expression, in PBM, of the major HSP, hsp70 and hsp90, using
      biometabolic labeling, Western and Northern blotting, and gel mobility shift
      assays. PMA induced the accumulation of mRNA and an increased expression of hsp90
      and, to a lesser extent, hsp/hsc70 (hsc is the cognate, constitutive form). This
      induction was also observed in PBM from patients with chronic granulomatous
      disease, a genetic defect in NADPH oxidase, and was abolished by the PKC
      inhibitors staurosporine and H-7. PMA did not cause activation of the HS factor,
      and the PMA-induced overexpression expression of HSP was not blocked by the
      transcriptional inhibitor actinomycin D. HSP-specific mRNA stability was
      increased after PMA exposure as compared with heat shock. These results suggest
      that O2-. is not involved in the PMA-mediated induction of hsp70 and hsp90 and
      that, in contrast to HS, PMA increases the expression of HSP as a result of PKC
      induced mRNA stabilization rather than of transcriptional activation of HS genes.

PMID- 7775472
TI  - Artificial transmembrane segments. Requirements for stop transfer and polypeptide
      orientation.
AB  - Transmembrane segments of proteins generally consist of a long stretch of
      hydrophobic amino acids, which can function to initiate membrane insertion (start
      stop sequences), initiate translocation (signal-anchor sequences), or stop
      further translocation of the following polypeptide chain (stop-transfer
      sequences). In this study, we have taken Escherichia coli alkaline phosphatase, a
      transported and water-soluble protein, and examined the requirements for
      converting it into a transmembrane protein with particular orientation. Since the
      wild type enzyme is transported, there is no predisposition against membrane
      translocation, yet it is not a membrane protein, so it does not possess any
      intrinsic membrane topogenic preferences. A series of potential transmembrane
      segments was introduced into an internal position of the enzyme to test the
      ability of each to initiate translocation, stop translocation, and adopt a
      particular orientation. For this purpose, cassette mutagenesis was used to
      incorporate new structural segments composed of polymers of alanines and
      leucines. The threshold value of hydrophobicity required to function as a stop
      transfer sequence was determined. For a transmembrane segment of typical length
      (21 residues), this value is equivalent to the hydrophobicity of 16 alanines and
      5 leucines. Interestingly, much shorter segments will also suffice to stop
      translocation, but these must be composed of more highly hydrophobic residues
      (e.g. 11 leucines). When the wild type amino-terminal signal peptide is deleted
      or made dysfunctional, sufficiently hydrophobic internal segments can initiate
      translocation of the following polypeptide and function as a signal anchor.
      Furthermore, in so doing, the orientation of the protein is changed from N(out)
      C(in) to N(in)-C(out).

PMID- 7775474
TI  - Nucleotide sequence and tissue-specific expression of the multifunctional protein
      carbamoyl-phosphate synthetase-aspartate transcarbamoylase-dihydroorotase (CAD)
      mRNA in Squalus acanthias.
AB  - Carbamoyl-phosphate synthetase II (CPSase II), aspartate transcarbamoylase
      (ATCase), and dihydroorotase (DHOase) catalyze the first three steps of de novo
      pyrimidine nucleotide biosynthesis, respectively. In mammalian species, these
      three enzyme activities exist in the cytosol in liver and other tissues as a
      multifunctional complex on a single polypeptide called carbamoyl-phosphate
      synthetase-aspartate transcarbamoylase-dihydroorotase (CAD) in the order of NH2
      CPSase II-DHOase-ATCase-COOH. Previous studies provided evidence that in Squalus
      acanthias (spiny dogfish) these enzymes are not expressed in liver and that they
      exist as separate entities in the cytosol of extra-hepatic tissues such as testes
      and spleen (Anderson, P. M. (1989) Biochem. J. 261, 523-529). Here we report that
      the genes for these three enzymes are expressed in testes as a single transcript
      analogous to CAD in mammalian species and that these genes are not expressed in
      liver at levels that can be detected by Northern blots or by the polymerase chain
      reaction. The absence of the pyrimidine pathway in the liver may be related to
      the exclusive localization of glutamine synthetase in the mitochondrial matrix
      which provides for efficient assimilation of ammonia as glutamine for urea
      synthesis in these ureoosmotic species; thus glutamine may not be available for
      CPSase II or other amidotransferase activities in the cytosol. The amino acid
      sequence deduced from the nucleotide sequence of the shark CAD cDNA reported here
      is very similar to CAD from other species; alignment with the hamster CAD
      sequence shows 77% identical residues.

PMID- 7775473
TI  - Functional characterization of the promoter region of the platelet-activating
      factor receptor gene. Identification of an initiator element essential for gene
      expression in myeloid cells.
AB  - To understand the molecular mechanisms that direct the expression of the gene
      encoding the platelet-activating factor (PAF) receptor, the 5'-flanking region of
      the human PAF receptor gene was cloned, and its promoter activity in myeloid cell
      lines was characterized. By the 5'-rapid amplification of cDNA ends method and
      primer extension, the transcription initiation site was mapped to an adenosine
      residue 137 bases upstream of the ATG translation initiation codon. The promoter
      region lacks a typical TATA or CCAAT box. However, the sequence encompassing the
      transcription initiation site shows high homology to the initiator (Inr)
      sequence. Transfection of promonocytic U937 cells with recombinant plasmids
      containing a series of truncated segments of the 5'-flanking region linked to the
      luciferase reporter gene revealed that the sequence from nucleotides -44 to +27
      relative to the transcription initiation site was sufficient to promote a high
      level of gene expression. The promoter activity was much lower in nonexpressing
      HeLa cells and promyelocytic HL-60 cells, which express relatively low levels of
      the PAF receptor. Gel mobility shift analysis demonstrated the binding of nuclear
      factors extracted from myelocytic cells to the -16/+18 sequence containing the
      Inr element. No binding activity was detected using the nuclear extracts from the
      nonmyelocytic HeLa cells. The DNA-protein complexes were sequence-specific since
      the binding was not significantly affected by the mutated Inr sequences or the
      Inr sequence of the terminal deoxynucleotidyltransferase gene. Furthermore, point
      mutations in the Inr element significantly reduced promoter activity in both U937
      and THP-1 cell lines. When Me2SO or retinoic acid was used to induce granulocytic
      differentiation of HL-60 cells, a distinct Inr-protein complex was induced
      concurrently, but the complex was not observed in 12-O-tetradecanoylphorbol-13
      acetate-induced monocytic differentiated HL-60 cells or Me2SO-induced
      differentiated U937 cells, indicating that the inducible Inr binding activity is
      granulocyte-specific. These results suggest that distinct nuclear factors
      interact with the unique Inr element and play a role in the transcriptional
      regulation of the PAF receptor in various myeloid cells.

PMID- 7775475
TI  - Proteolytic processing of Alzheimer's disease beta A4 amyloid precursor protein
      in human platelets.
AB  - The processing of amyloid precursor protein (APP) and production of beta A4
      amyloid are events likely to influence the development and progression of
      Alzheimer's disease, since beta A4 is the major constituent of amyloid deposited
      in this disorder. Our previous studies showed that human platelets contain full
      length APP (APPFL) and are a suitable substrate to study normal APP processing.
      In the present study, we show that a 22-kDa beta A4-containing carboxyl-terminal
      fragment (22-CTF) of APP is present in unstimulated platelets. Both APPFL and 22
      CTF are proteolytically degraded when platelets are activated with thrombin,
      collagen, or calcium ionophore A23187. Complete cleavage of APPFL and 22-CTF
      require the presence of extracellular calcium. Following stimulation in the
      presence of calcium, a new CTF of 17 kDa is generated, and the NH2-terminal
      epitope of beta A4 amyloid is lost. Preincubation of platelets with the cell
      permeable cysteine protease inhibitors calpeptin, (2S,3S)-trans-epoxysuccinyl-L
      leucyl-amido-3-methylbutane ethyl ester (E64d), Na alpha-p-tosyl-L-lysine
      chloromethyl ketone, or calcium chelator EGTA before platelet stimulation
      inhibits the degradation of both APPFL and 22-CTF. Divalent metal ions including
      zinc, copper, and cobalt inhibit the degradation of APPFL and 22-CTF. This study
      suggests that a calcium-dependent neutral cysteine protease is involved in the
      proteolytic processing of an amyloidogenic species of APP in human platelets.

PMID- 7775476
TI  - Identification of the primase active site of the herpes simplex virus type 1
      helicase-primase.
AB  - Herpes simplex virus type 1 (HSV-1) encodes a heterotrimeric helicase-primase
      composed of the products of the three DNA replication-specific genes UL5, UL8,
      and UL52 (Crute, J. J., and Lehman, I. R. (1991) J. Biol. Chem. 266, 4484-4488).
      The UL5 and UL52 products constitute a heterodimeric subassembly of the
      holoenzyme that contains both helicase and primase activities (Calder, J. M., and
      Stow, N. D. (1990) Nucleic Acids Res. 18, 3573-3578; Dodson, M. S., and Lehman,
      I. R. (1991) Proc. Natl. Acad. Sci. U. S. A. 88, 1105-1109). The role of the UL52
      product in the active HSV-1 helicase-primase was examined. A sequence located
      between residues 610 and 636 on the UL52 protein was found to be conserved among
      the UL52 homologues of eight herpesviruses. The carboxyl-terminal portion of this
      conserved sequence consisted of two Asp residues separated by a variable
      hydrophobic amino acid residue and is analogous to the divalent metal-binding
      site of DNA polymerases and several DNA primases. This motif has been designated
      the herpesvirus primase DXD motif. To study the role of the HSV-1 primase DXD
      motif in primase action, three site-directed changes were introduced into the
      UL52 gene. The helicase activity of the recombinant holoenzymes was unaffected by
      any of the introduced changes. Changing either of the two Asp residues that
      constitute the divalent metal-binding site (Asp628 or Asp630) to Ala dramatically
      reduced the primase activity of the HSV-1 helicase-primase holoenzyme in vitro,
      whereas alteration of the nearby conserved residue Asn624 to Gly had minimal
      effect. Therefore, in the three-subunit HSV-1 helicase-primase, the UL52 product
      provides at least a part of the primase catalytic site.

PMID- 7775477
TI  - The responsiveness of a tetracycline-sensitive expression system differs in
      different cell lines.
AB  - A tetracycline-sensitive inducible expression system was used to regulate the
      expression of neurotransmitter receptor genes in two mammalian cell lines. The
      dopamine D3-receptor was stably expressed in GH3 cells, and GluR6 (a glutamate
      receptor subunit) was stably expressed in human embryonic kidney (HEK 293) cells.
      Three striking differences were found. 1) In the inactive state, virtually no D3
      receptor expression was found in GH3 cells, whereas substantial levels of GluR6
      expression were found in HEK 293 cells. 2) The induction of expression obtained
      upon removal of tetracycline was robust in GH3 cells but only modest in HEK 293
      cells. 3) Whereas in each clonal cell line, the expression of a co-transfected
      hybrid transactivator is clearly regulated in a tetracycline-responsive manner,
      in the induced state, its mRNA levels were found to be very low in GH3 cells and
      very high in HEK 293 cells. The results indicate that, in contrast to GH3 cells,
      HEK 293 cells do not provide a cellular environment in which the expression of a
      heterologous gene can be tightly controlled in a tetracycline-responsive manner.

PMID- 7775478
TI  - G2/M transition requires multisite phosphorylation of oncoprotein 18 by two
      distinct protein kinase systems.
AB  - Oncoprotein 18 (Op18) is a conserved cytosolic protein that is a target for both
      cell cycle and cell surface receptor-regulated phosphorylation events. The four
      residues Ser16, Ser25, Ser38, and Ser63 are all subject to cell cycle-regulated
      phosphorylation. Ser25 and Ser38 are targets for cyclin dependent kinases (CDKs),
      while Ser16 and Ser63 are phosphorylated by an unidentified protein kinase. We
      have recently shown that induced expression of a CDK target site-deficient
      mutant, Op18-S25A,S38A, blocks human cell lines during G2/M transition. In the
      present report we show that mitosis is associated with complete phosphorylation
      of the two Op18 CDK target sites Ser25 and Ser38 and that Ser16 and Ser63 are
      also phosphorylated to a high stoichiometry. To evaluate the function of
      multisite phosphorylation of Op18, we expressed and analyzed the cell cycle
      phenotype of different kinase target site-deficient mutants. The data showed that
      induced expression of the S16A,S63A, S25A,S38A, and S16A,S25A,S38A,S63A mutants
      all resulted in an indistinguishable phenotype, i.e. immediate G2/M block and
      subsequent endoreduplication, a given fraction of G2 versus M-phase blocked
      cells, and a characteristic nuclear morphology of M-blocked cells. This result
      was unexpected; however, a likely explanation was provided by analysis of Op18
      phosphoisomers, which revealed that mutations of the CDK sites interfere with
      phosphorylation of Ser16 and Ser63. The simplest interpretation of our results is
      that phosphorylation of Ser16 and Ser63 is essential during G2/M transition and
      that the phenotype of the S25A,S38A mutant is mediated by the observed block of
      Ser16/Ser63 phosphorylation.

PMID- 7775479
TI  - Cloning of a novel phosphoprotein regulated by colony-stimulating factor 1 shares
      a domain with the Drosophila disabled gene product.
AB  - A unique protein with an apparent molecular mass of 96 kilodaltons (p96) was
      detected in the murine macrophage cell line, BAC1.2F5. The murine cDNA encoding
      p96 was cloned and sequenced, along with cDNAs representing two alternatively
      spliced forms of the protein. All three proteins possessed identical amino
      terminal domains with significant similarity to the amino-terminal domain of the
      Drosophila disabled gene product and carboxyl-terminal domains containing proline
      rich sequences characteristic of src homology region (domain 3) binding regions.
      BAC1.2F5 cells predominantly expressed the p96 protein, although mRNA and protein
      corresponding to the p67 splice variant were also detected. Electrophoretic gel
      retardation of p96 in response to stimulation of the cells with colony
      stimulating factor 1 was noticeable within 5 min after growth factor addition and
      reached a maximum at 60 min. Metabolic labeling experiments showed that the gel
      retardation of p96 was associated with increased phosphorylation of the protein
      exclusively on serine residues. These data identify a novel protein that is
      phosphorylated in response to mitogenic growth factor stimulation.

PMID- 7775480
TI  - The BM88 antigen, a novel neuron-specific molecule, enhances the differentiation
      of mouse neuroblastoma cells.
AB  - The BM88 antigen is a neuron-specific molecule widely distributed in the
      mammalian nervous system. It is a 22-kDa, apparently not glycosylated, integral
      membrane protein, which appears early during brain development and remains at
      high levels in the mature animal. Here, we describe the cDNA cloning of the
      porcine BM88 antigen and present evidence that this protein is involved in
      neuroblastoma cell differentiation. The deduced protein is a novel molecule
      consisting of 140 amino acids and bears a putative transmembrane domain at the
      COOH-terminal region. The mRNA of this protein is expressed only in neural
      tissues, where it is restricted to neurons. Stably transfected Neuro-2a cells
      overexpressing the BM88 antigen exhibited a significant change in morphology,
      reflected by enhanced process outgrowth, and a slower rate of division. Moreover,
      in the presence of differentiation agents, such as sucrose and retinoic acid, an
      accelerated differentiation of the transfected Neuro-2a cells was observed.
      Especially in the presence of sucrose, the consequent overexpression of the BM88
      antigen in the transfected cells resulted in their enhanced morphological
      differentiation accompanied by the induction of neurofilament protein expression.
      Our results suggest that the BM88 antigen plays a role in the differentiation of
      neuroblastoma cells.

PMID- 7775481
TI  - Nup358, a cytoplasmically exposed nucleoporin with peptide repeats, Ran-GTP
      binding sites, zinc fingers, a cyclophilin A homologous domain, and a leucine
      rich region.
AB  - The Ras-related nuclear protein, Ran, has been implicated in nuclear transport.
      By screening a HeLa cell lambda expression library with Ran-GTP and sequencing
      overlapping cDNA clones, we have obtained the derived primary structure of a
      protein with a calculated molecular mass of 358 kDa. Using antibodies raised
      against an expressed segment of this protein, we obtained punctate nuclear
      surface staining by immunofluorescence microscopy that is characteristic for
      nucleoporins. Electron microscopy of immunogold-decorated rat liver nuclear
      envelopes sublocalized the 358-kDa protein at (or near) the tip of the
      cytoplasmic fibers of the nuclear pore complex (NPC). In agreement with current
      convention, this protein was therefore termed Nup358 (for nucleoporin of 358
      kDa). Nup358 contains a leucine-rich region, four potential Ran binding sites
      (i.e. Ran binding protein 1 homologous domains) flanked by nucleoporin
      characteristic FXFG or FG repeats, eight zinc finger motifs, and a C-terminal
      cyclophilin A homologous domain. Consistent with the location of Nup358 at the
      cytoplasmic fibers of the NPC, we found decoration with Ran-gold at only the
      cytoplasmic side of the NPC. Thus, Nup358 is the first nucleoporin shown to
      contain binding sites for two of three soluble nuclear transport factors so far
      isolated, namely karyopherin and Ran-GTP.

PMID- 7775482
TI  - Induction and stabilization of I kappa B alpha by nitric oxide mediates
      inhibition of NF-kappa B.
AB  - To determine the mechanism(s) by which the endogenous mediator nitric oxide (NO)
      inhibits the activation of transcription factor NF-kappa B, we stimulated human
      vascular endothelial cells with tumor necrosis factor-alpha in the presence of
      two NO donors, sodium nitroprusside and S-nitrosoglutathione. Electrophoretic
      mobility shift assays demonstrated that both NO donors inhibited NF-kappa B
      activation by tumor necrosis factor-alpha. This effect was not mediated by
      guanylyl cyclase activation since the cGMP analogue 8-bromo-cGMP had no similar
      effect. Inhibition of endogenous constitutive NO production by L-N
      monomethylarginine, however, activated NF-kappa B, suggesting tonic inhibition of
      NF-kappa B under basal conditions. NO had little or no effects on other nuclear
      binding proteins such as AP-1 and GATA. Immunoprecipitation studies showed that
      NO stabilized the NF-kappa B inhibitor, I kappa B alpha, by preventing its
      degradation from NF-kappa B. NO also increased the mRNA expression of I kappa B
      alpha, but not NF-kappa B subunits, p65 or p50, and transfection experiments with
      a chloramphenicol acetyltransferase reporter gene linked to the I kappa B alpha
      promoter suggested transcriptional induction of I kappa B alpha by NO. We propose
      that the induction and stabilization of I kappa B alpha by NO are important
      mechanisms by which NO inhibits NF-kappa B and attenuate atherogenesis.

PMID- 7775484
TI  - Human dual specificity phosphatase VHR activates maturation promotion factor and
      triggers meiotic maturation in Xenopus oocytes.
AB  - Bacterially expressed, dual specificity phosphatase VHR protein induced germinal
      vesicle breakdown (GVBD) when microinjected into Xenopus oocytes, albeit with
      slower kinetics than that observed in progesterone- or insulin-induced
      maturation. A mutant VHR protein missing an essential cysteine residue for its in
      vitro phosphatase activity completely lacked activity in injected oocytes. VHR
      injection done in conjunction with progesterone or insulin treatment resulted in
      highly synergized GVBD responses showing much faster kinetics than that produced
      by VHR or either hormone alone. The delayed kinetics of VHR-induced GVBD and the
      synergistic responses obtained in the presence of hormones suggested that this
      protein may be promoting G2/M transition by weakly mimicking the action of cdc25,
      the dual specificity phosphatase that physiologically activates the maturation
      promotion factor. Various experimental observations are consistent with such a
      role for the injected VHR in oocytes: 1) as opposed to hormone-treated oocytes,
      histone H1 kinase activation is not preceded by MAPK activation in the process of
      GVBD in VHR-injected oocytes; 2) incubation of purified VHR with highly
      concentrated cell-free extracts of untreated oocytes resulted in activation of
      histone H1 kinase activity in the lysates; 3) coinjection of VHR with activated
      Ras proteins resulted in synergized responses, faster than those produced by
      either protein alone; 4) coinjection of VHR with the purified amino-terminal SH2
      domain of the p85 subunit of phosphatidylinositol 3-kinase (which blocks insulin
      induced GVBD) does not affect VHR-induced maturation. The biological actions of
      VHR in oocytes clearly distinguish it from other dual specificity phosphatases,
      which have shown inhibitory effects when tested in oocytes. We speculate that VHR
      may represent a dual specificity phosphatase responsible for activation of cdk
      cyclin complex(es) at a still undetermined stage of the cell cycle.

PMID- 7775483
TI  - Production of human secretory component with dimeric IgA binding capacity using
      viral expression systems.
AB  - The cDNA encoding the NH2-terminal 589 amino acids of the extracellular domain of
      the human polymeric immunoglobulin receptor was inserted into transfer vectors to
      generate recombinant baculo- and vaccinia viruses. Following infection of insect
      and mammalian cells, respectively, the resulting truncated protein corresponding
      to human secretory component (hSC) was secreted with high efficiency into serum
      free culture medium. The Sf9 insect cell/baculovirus system yielded as much as 50
      mg of hSC/liter of culture, while the mammalian cells/vaccinia virus system
      produced up to 10 mg of protein/liter. The M(r) of recombinant hSC varied
      depending on the cell line in which it was expressed (70,000 in Sf9 cells and 85
      95,000 in CV-1, TK- 143B and HeLa). These variations in M(r) resulted from
      different glycosylation patterns, as evidenced by endoglycosidase digestion.
      Efficient single-step purification of the recombinant protein was achieved either
      by concanavalin A affinity chromatography or by Ni(2+)-chelate affinity
      chromatography, when a 6xHis tag was engineered to the carboxyl terminus of hSC.
      Recombinant hSC retained the capacity to specifically reassociate with dimeric
      IgA purified from hybridoma cells.

PMID- 7775486
TI  - A dynamic shoulder model: reliability testing and muscle force study.
AB  - This study introduces a dynamic shoulder model, where forces were applied to
      individual muscles in ten cadaveric specimens. The model provided reproducible
      glenohumeral joint motion and thereby allowed the investigation of active,
      glenohumeral joint mechanics. Forces were created by servo-actuated hydrodynamic
      cylinders and applied to the deltoid muscle and to the rotator cuff through wire
      cables. Computerized regulation initiated precise, time controlled cycles of
      glenohumeral joint motion. The position of the glenohumeral joint in all spatial
      orientations was measured and recorded using an ultrasonic sensor device.
      Reproducibility of glenohumeral joint motion was demonstrated on the basis of
      five cycles of glenohumeral joint elevation. Repeatability variance of position
      measurements for five cycles of elevation averaged 0.80 degrees for abduction,
      0.75 degrees for anteflexion and 1.36 degrees for internal rotation. Arm weight
      and force distribution at the shoulder musculature were estimated according to
      the literature. In comparison to estimated physiologic conditions, a one third
      increase of arm weight led to a significant (p < 0.05) decrease of elevation of
      20%, a one third decrease of arm weight to an average increase of elevation of
      18% (p < 0.05). Exclusion of the supraspinatus muscle caused a significant (p <
      0.05) 6% decrease of elevation of the glenohumeral joint. Without force applied
      to the subscapularis and infraspinatus/teres minor muscles, elevation decreased
      16% (p < 0.05). A decrease of glenohumeral joint elevation of 25% resulted when
      force was applied to the deltoid muscle alone (p < 0.05).

PMID- 7775485
TI  - Differential regulation of a multipromoter gene. Selective 12-O
      tetradecanoylphorbol-13-acetate induction of a single transcription start site in
      the HMG-I/Y gene.
AB  - The human HMG-I/Y gene, encoding the non-histone "high mobility group" proteins
      HMG-I and HMG-Y, is transcriptionally activated in human K562 erythroleukemia
      cells by treatment with 12-O-tetradecanoylphorbol-13-acetate (TPA). TPA treatment
      induces differentiation of K562 cells within 2-4 days after treatment. In this
      report, we show that transcriptional activation of the HMG-I/Y gene is dependent
      on protein synthesis and is an early event (2 h after induction) in the TPA
      mediated differentiation process. Of the four functional transcription start
      sites present in the gene, only one (start site 2) is preferentially induced upon
      TPA treatment. This is the first report, to our knowledge, of the preferential
      utilization of a specific transcription start site in response to a particular
      stimulus in a gene that contains multiple promoters. This indicates that each
      start site in the gene has the potential to be independently regulated instead of
      being coordinately controlled as shown in a number of other genes. In addition,
      sequences upstream of the inducible start site, which contains a TPA-responsive
      element, mediates TPA inducibility through AP1 (or an AP1-like) transcription
      factor. The HMG-I/Y proteins function as key regulators of gene expression and
      play a significant role in chromatin structural changes as well. The cloning and
      sequence analyses previously reported indicated the structure of the HMG-I/Y gene
      to be highly complex and predicted its expression to be tightly regulated. The
      results presented here confirm and extend these earlier findings.

PMID- 7775487
TI  - Identification of elastic properties of homogeneous, orthotropic vascular
      segments in distension.
AB  - Characterization of the constitutive behavior of normal and pathological blood
      vessel segments could provide the clinician with a means to predict the onset and
      assess the severity of certain vascular maladies. Many of the constitutive models
      that have been proposed to date either fail to properly consider certain features
      of the anatomic structure and function of vascular tissue or are so
      mathematically complex that their utilization is intractable. We have developed a
      material identification technique that first required the adaptation and
      validation of a constitutive law describing the nonlinear, three-dimensional
      behavior of orthotropic, compressible, hyperelastic vascular segments. By
      coupling a nonlinear finite element program and experimental data with a robust
      nonlinear least-squares regression algorithm, a set of elastic parameters
      (moduli) is obtained. Regressions on data for a canine carotid artery and rabbit
      infrarenal aorta yielded coefficients of variation of 0.21 and 0.08,
      respectively. The estimated moduli demonstrated certain trends found by other
      investigators: both the canine carotid artery and rabbit aorta were found to be
      stiffer radially than circumferentially, and the former was found to be stiffer
      circumferentially than longitudinally. Using these material constants and
      measured arterial pressures, the stress distribution was computed for each
      specimen. The predicted radial stress was consistent with a transmural variation
      of approximately--p (applied luminal pressure) to approximately zero in both
      specimens, while the circumferential stresses ranged from 2.2p to 0.7p for the
      canine carotid, and from 6.4p to 3.7p for the rabbit aorta. The stress
      distributions qualitatively agreed with those reported in previous
      investigations, as well as with certain physiologic observations. Based on the
      results of our two sample cases, we believe that our technique could be
      beneficial to the assessment of the three-dimensional, anisotropic behavior of
      vascular tissue.

PMID- 7775488
TI  - Variation of muscle moment arms with elbow and forearm position.
AB  - We hypothesized that the moment arms of muscles crossing the elbow vary
      substantially with forearm and elbow position and that these variations could be
      represented using a three-dimensional computer model. Flexion/extension and
      pronation/supination moment arms of the brachioradialis, biceps, brachialis,
      pronator teres, and triceps were calculated from measurements of tendon
      displacement and joint angle in two anatomic specimens and were estimated using a
      computer model of the elbow joint. The anatomical measurements revealed that the
      flexion/extension moment arms varied by at least 30% over a 95 degrees range of
      motion. The changes in flexion/extension moment arm magnitudes with elbow flexion
      angle were represented well by the computer model. The anatomical studies and the
      computer model demonstrate that the biceps flexion moment arm peaks in a more
      extended elbow position and has a larger peak when the forearm is supinated.
      Also, the peak biceps supination moment arm decreases as the elbow is extended.
      These results emphasize the need to account for the variation of muscle moment
      arms with elbow flexion and forearm position.

PMID- 7775489
TI  - The effect of strict muscle stress limits on abdominal muscle force predictions
      for combined torsion and extension loadings.
AB  - The objective of this study was to determine to what extent the central nervous
      system activates torso muscles so as to equalize the largest muscle stresses. Two
      optimization models that treat large muscle stresses differently were formulated.
      One model minimized spinal compression force subject to the lowest possible
      muscle stress limit, and the other model minimized the sum of cubed muscle
      stresses. Experimental conditions were determined for which the two models made
      different muscle force predictions. Specifically, the models predicted different
      rectus abdominis activity levels for tasks involving torsion and extension moment
      loadings. Surface electromyography was used to evaluate the model predictions.
      Applied loads were chosen to assure that the rectus abdominis EMG exceeded 30%
      MVC. Analysis of variance indicated that rectus abdominis activity was not
      affected by torsion loading at the p < 0.05 level of significance in a
      statistical design having 90% power, which was consistent with the predictions of
      the model that minimized the sum of cubed muscle stresses. Thus, it was concluded
      that equalization of the largest muscles stress was not the paramount objective
      of the central nervous system in the tasks studied.

PMID- 7775490
TI  - Is staircase walking a risk for the fixation of hip implants?
AB  - Considerable forces and moments act at hip prostheses during most kinds of
      physical activities. High torque around the stem axis may contribute to implant
      loosening. With instrumented hip prostheses the joint force and its direction,
      the bending moment in the frontal plane and the torque were measured in two
      patients during upstairs, downstairs and level walking. The data give information
      on whether or not stairclimbing causes a more severe loading situation for the
      implants than walking. While going upstairs at normal speed the joint force is
      10% higher than during walking at 3 km h-1. Downstairs it increases by 20%. The
      bending moments change by nearly the same amounts. Upstairs the torsional moment
      is about twice as high as during slow walking. But walking at 5 km h-1 or slow
      jogging causes forces and moments of similar magnitudes. Even higher loads were
      observed when the patients stumbled without falling. Although torque during
      staircase walking is high, extreme values exclusively during stairclimbing are
      not confirmed by our data. The torsional moments now observed in vivo are close
      to or even exceed the experimentally determined limits of the torsional strength
      of implant fixations, found in the literature. Obviously, torsional moments play
      an important role for the potential loosening of hip prostheses.

PMID- 7775492
TI  - Mechanics of wave reflections in a coronary bypass loop model: the possibility of
      partial flow cut-off.
AB  - Local hemodynamics in a bypass loop model with dimensions typical of those in the
      human coronary circulation are studied, particularly with regards to the effects
      of wave reflections. While in a single vessel of such dimensions and a single
      source of wave reflections the effects would be insignificant, in a bypass loop
      the combination of a narrowed vessel with a converging junction and several
      reflection sites may produce wave reflections with significant effects on the
      pressure and flow distributions within the vessels forming the loop. Calculations
      to test this possibility were performed, based on D'Alembert's solutions of the
      wave equation and with a proposed matching scheme to deal with the converging
      junction. The results indicate that there are very large wave reflection effects
      at a frequency of 10 Hz, smaller but significant effects at 5 Hz, and some
      insignificant effects at 1 Hz. The results also indicate that partial flow cut
      off may occur within the loop under some singular circumstances, whereby certain
      harmonic components of the incident wave are totally reflected. In the clinical
      setting these effects would detract from the efficiency of the bypass as a
      conduit, to a degree dependent on the degree of occlusion of the bypassed vessel.
      The choice of a larger diameter for the bypass appears to diminish this
      dependence and is thus on the whole favorable despite the contribution it makes
      to impedance mismatch at the junction.

PMID- 7775491
TI  - Load-sharing patterns in the shoulder during isometric flexion tasks.
AB  - Patterns of load-sharing between the shoulder muscles during isometric flexion
      tasks were studied by using both a biomechanical shoulder model and
      electromyographic (EMG) recordings of ten subjects. The effect of changes in
      several model parameters and shoulder stiffness constraints on the predicted load
      sharing patterns were studied, while the arm position, hand load and precision
      requirements of the tasks were varied. The results calculated using the model
      were, when compared to the EMG recordings, plausible predicting a high level of
      synergistic contraction of muscles of the shoulder muscles during flexion tasks.
      The trends of the model-predicted muscle forces corresponded well to the EMG
      recordings. At low hand load levels the increasing of the shoulder stiffness
      strongly increased the muscle force levels, thus increasing also the level of
      synergistic contraction of muscles. At higher load levels the increase in the
      muscle forces was not so high, because the model predicted a high level of
      simultaneous contraction of muscles already at a low level of shoulder stiffness.
      Cluster analysis of the EMG recordings revealed large inter-individual
      differences in the load distribution patterns during flexion tasks. The
      constraint angle of the glenohumeral joint contact force direction was found to
      be an important model parameter affecting both the predicted forces and the
      maximum force production ability of the shoulder.

PMID- 7775493
TI  - Stress protection due to external fixation.
AB  - Bone is sensitive to mechanical influences. The presence of an orthopaedic device
      will impose constraints on the mechanical environment that may influence
      subsequent remodelling and repair. An Oxford External Fixator was applied to six
      intact ovine tibiae. The strains engendered during normal walking were then
      recorded from strain gauges applied to the mid-shaft of the bone. The fixator
      configuration was then altered such that the intact fixator bar connecting the
      pins was replaced with a sectioned version that did not permit load transfer
      through the fixator, and the strain environment re-recorded. The peak strains
      recorded with the intact bar were significantly lower than those recorded with
      the sectioned bar. This showed that the use of a fixator with an intact bar
      resulted in significant stress protection of the underlying bone. A fixator was
      then applied to both the right and left tibiae of a further six animals and the
      resulting strain environment and corresponding remodelling response was observed
      over 16 weeks. In each case one fixator was configured with an intact bar (the
      stress protected limb), whilst the other utilised a sectioned bar (the
      unprotected limb). The results showed that over this period the bone mineral
      content fell by 9% in the stress protected limb compared to the unprotected limp.
      Quantitative assessment of the bones showed that this bone loss occurred as a
      direct consequence of resorption on the periosteal and endosteal surfaces. In
      addition, strain recordings at week 16 showed that the fixator was still stress
      protecting the tibia.

PMID- 7775495
TI  - Time-frequency analysis of postural sway.
AB  - Postural sway during quiet stance has been used to characterize the postural
      control system. Most studies have used center of pressure (COP) measurements and
      have assumed stationarity, however, recent research has indicated that COP is not
      stationary. The purpose of this study is to introduce and demonstrate a
      nonstationary spectral estimation technique to examine the time-varying nature of
      postural sway. Data from two experiments were used to verify the usefulness of
      the spectral estimator for the analysis of COP. The first data set contains COP
      recorded from normal subjects swaying about their ankles in response to a
      metronome as it was gradually changed from 2 to 1 Hz. The time-frequency
      distribution reveals time-varying spectral changes corresponding to frequency
      changes made by the subjects. The second set consists of COP from normal subjects
      and vestibularly impaired patients standing quietly on a force plate with eyes
      closed for 100 s. The time-frequency distributions for the COP were estimated for
      both sets of data. The COP's appear to be nonstationary with the energies at a
      given frequency modulating through time.

PMID- 7775494
TI  - Force and pressure transmission through the normal wrist. A theoretical two
      dimensional study in the posteroanterior plane.
AB  - Force transmission through the wrist in the normal population was investigated
      using the rigid body spring modeling (RBSM) technique (assuming carpal bones are
      rigid bodies interposed by series of springs simulating articulating cartilage
      and constraining ligaments). One-hundred and twenty normal wrist posteroanterior
      X-rays of adults (evenly divided to represent both genders and two age groups)
      provided the anatomical data. Reaction forces between the carpal bones were
      modeled using a system of compression linear springs, representing cartilage and
      subchondral bone, and of tensile linear springs, representing ligaments. The
      spring constants were determined based on the material properties of wrist
      cartilage and ligaments. Assumed axial loads were applied along the metacarpals
      to simulate a grasp strength of 10 N with active stabilization of the wrist in
      neutral position. The force transmission ratio at the radio-ulno-carpal joint was
      55% through the radio-scaphoid and 35% through the radio-lunate joints. The
      remaining 10% of the load was passing through the triangular fibrocartilage with
      minor differences between genders. Among the intercarpal joints, a large
      percentage of the load of the wrist was transmitted to the scaphoid. The peak
      pressure was highest at the proximal pole of the radio-scaphoid, with a radio
      scaphoid versus radio-lunate peak pressure ratio of 1.6. The most important
      ligaments in terms of load transmission were those opposing ulnar translation of
      the carpus. The wrist morphology had little influence on the magnitude and
      pattern of load distribution. There was no effect of age on wrist force
      distribution.

PMID- 7775496
TI  - Use of the boundary element method for biological morphometrics.
AB  - Tensorial morphometric assessments of form difference can aid in the
      understanding of the cause of the form difference by providing reference frame
      independent, anisotropic, non-homogenous descriptions. The majority of biological
      and prosthetic structures cannot be adequately analyzed by current methods due to
      the paucity of anatomical landmarks and methodological requirements of
      subdivision through the domain. Internal subdivisions can be eliminated with the
      boundary element method (BEM). A non-landmark (NL) method can be developed by the
      combination of elliptical Fourier analysis (EFA) and BEM. The appropriateness of
      NL and BEM was investigated. The growth of the female rat neural skull from 7 to
      14 postnatal days was calculated with respect to increase in area. Linear and
      quadratic BEM landmark analysis were made using 10 and 5 elements, respectively.
      Five hundred linear BEM elements were constructed from the EFA equations for NL.
      The form change tensors were obtained by the solution of the Laplace equation
      using boundary displacements as the essential boundary conditions. For
      comparison, simplex triangular finite element analysis (FEA), quadrilateral FEA
      and macroelement analysis were made on the same structure. Results correspond
      well to the two major growth process in this time period; (1) high cerebellar
      growth, and (2) relatively higher facial versus neural growth. The results in
      other regions are close to the biologically observed 36% increase in area. The
      average difference between BEM, NL versus FEA is 1.9 and 2.8%. Trends in results
      with position are almost identical for BEM, NL, MEM and quadrilateral FEA. The
      morphometric landmark BEM technique requires an additional numerical scheme to
      eliminate the singularities near the boundary.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775497
TI  - Influence of thigh muscles on the axial strains in a proximal femur during early
      stance in gait.
AB  - This work is focused on the in vitro simulation of the loads occurring in the
      femur during early stance in gait, for hip prosthesis stress shielding test
      purposes. Ten thigh muscles (the three gluteal muscles, the three vasti, rectus
      femoris, adductor longus and magnus, biceps femoris), simulated by nylon straps,
      were tested in order to establish their influence on the strains in the proximal
      femur. Axial and hoop strains were recorded from 16 strain gauges for the effect
      of each muscle and compared to the strains recorded as a result of the hip joint
      reaction force only (i.e. without muscle simulation). It appears that the three
      glutei are the principal muscles in determining the vertical strains, however the
      rectus femoris, biceps femoris and the adductors were also seen to significantly
      affect the strain pattern. The inadequacy of increasing the adduction angle and
      applying the resultant force at the hip joint to simulate the abductors was also
      confirmed.

PMID- 7775498
TI  - Resonant frequency of a pin-accelerometer system mounted in bone.
AB  - Invasive measurements of spinal motion using intraosseous metal pins have become
      common. For this reason, the resonant frequency of intraosseous pins attached
      with accelerometers was determined using two different methods. It was concluded
      that plucking the pin is a reliable method for determining the resonant frequency
      and, in order to accurately measure bone movement at frequencies up to 32 Hz, the
      pin diameter should be 2.0 mm or more. With a mass of the accelerometer assembly
      equal to 27 g, the total pin length should not exceed 80 mm with a bone
      accelerometer distance of 25 mm and a pin diameter of 2.4 mm.

PMID- 7775499
TI  - Freeze clamping musculo-tendinous junctions for in vitro simulation of joint
      mechanics.
AB  - Incorporation of physiologic muscle tensions to simulate normal in vivo joint
      loading in cadaveric biomechanical studies has been a challenging problem,
      especially about the knee, foot, and shoulder. Simulation of muscle contraction
      requires attachment of tension producing devices to musculotendinous units. To
      this end, we modified the 'cryo-jaw' device, first described by Riemersma and
      Schamhardt (1982, J. Biomechanics 15, 619-620) to couple linear actuators to
      fresh cadaver tendons. These clamps were used in the simulation of 11 different
      muscles in laboratory investigations of shoulder, elbow, knee, and foot function.
      The clamps were able to transmit repetitively 3500 N of quadriceps force in eight
      knees and 2000 N of Achilles force in 11 feet. Overall success rate was 95%.

PMID- 7775500
TI  - Longitudinal strain of canine and porcine aortas.
AB  - The in situ longitudinal strain of canine and porcine aortas was investigated.
      Marks of black water-resistant ink were placed on the aortas and the axial
      lengths between the marks were measured in situ and in vitro. When the aortas
      were cut, the retraction was measured and described by the stretch ratio, which
      is defined as the length of a segment in situ divided by the length at no-load
      state. Results show that the stretch ratios of both porcine and canine aortas
      increase monotonically from 1.2 in the descending region to about 1.5 in
      abdominal region. Species differences are seen in the middle region. In both
      animals, the stretch ratio is correlated to the cross-sectional area of the
      vessel wall.

PMID- 7775501
TI  - Comments on 'Relationship between ankle muscle and joint kinetics during the
      stance phase of locomotion in the cat'.

PMID- 7775502
TI  - Increased lipid peroxidation and decreased antioxidant activity correspond with
      death after smoke exposure in the rat.
AB  - Oxidants are released directly from smoke and also as a result of the airways
      inflammation that occurs after smoke injury. We determined the relation between
      the degree of tissue oxidant change with the use of malondialdehyde content to
      measure lipid peroxidation and the degree of lung and systemic organ damage and
      resulting damage mortality 24 hours after a controlled smoke exposure in a rat
      model. We also monitored changes in the key tissue antioxidant catalase. We found
      that the degree of lung lipid peroxidation and the decrease in catalase activity
      directly correlated with mortality caused by respiratory failure and with the
      degree of lung inflammation but that they did not correlate with the peak
      carboxyhemoglobin level, a marker of smoke gas phase exposure. The lung oxidant
      changes also directly correlated with increased systemic lipid peroxidation and
      decreased catalase in liver and kidney tissue. We conclude that the initial smoke
      insult causes lung and in turn systemic inflammation with resulting release of
      oxidants, which leads to tissue oxidant injury. The degree of lung oxidant change
      significantly correlates with the degree of lung tissue injury, respiratory
      failure, and mortality, and the major source of the oxidant changes is tissue
      inflammation rather than oxidants in the smoke itself.

PMID- 7775503
TI  - Superoxide dismutase and leupeptin prevent delayed reperfusion injury in the rat
      small intestine during burn shock.
AB  - Delayed fluid resuscitation during burn shock is thought to compromise the
      integrity of gut mucosa and allow enteric bacteria to cross the luminal wall and
      infect other sterile organ systems. Superoxide dismutase, a free-oxygen radical
      scavenger; leupeptin, a protease inhibitor; and verapamil, a calcium channel
      blocker, were studied to evaluate their efficacy in maintaining cellular
      integrity in the gut of thermally burned rats whose fluid resuscitation had been
      delayed. Fifty male rats weighting 280 to 320 gm were given a full-thickness
      scald burn covering 50% total body surface area. Ten received early fluid
      resuscitation beginning half an hour after burn, and 40 received fluid
      resuscitation delayed by 6 hours. Those receiving delayed resuscitation were
      given superoxide dismutase (n = 10), leupeptin (n = 10), verapamil (n = 10), or a
      placebo of normal saline solution (n = 10) at the time of fluid resuscitation.
      Ileal mucosa samples were harvested, and adenosine triphosphate, diphosphate, and
      monophosphate were measured. Adenosine triphosphate, total nucleotides, and
      energy charge potential were significantly lower in the placebo group without
      therapy compared with those of the early resuscitation group. Superoxide
      dismutase and leupeptin therapy prevented this drop in cellular energy. Total
      water content was significantly increased in the placebo group compared with that
      of the early resuscitation group; superoxide dismutase was able to prevent this
      increase. Data indicate that intestinal reperfusion injury in burned rats can be
      effectively modulated with superoxide dismutase or leupeptin therapy.

PMID- 7775505
TI  - Translocation and survival of Bacteroides fragilis after thermal injury.
AB  - B. fragilis and E. coli were labeled with tritiated (3H) thymidine, and 10(10) of
      each were given separately by gavage in Balb/c mice immediately before a 20% burn
      injury was inflicted. Control groups received gavage with 3H-B. fragilis or 3H-E.
      coli without burn. Four hours after burn or gavage was administered, the animals
      were killed, and the radionuclide and colony counts were determined in the
      mesenteric lymph nodes, liver, and spleen. Additional groups of mice receiving
      gavage (B. fragilis or E. coli) and burn were observed for 10 days to study
      survival. The results showed that 3H-B. fragilis translocated to a greater extent
      than 3H-E. coli but that fewer B. fragilis than E. coli survived in tissues.
      Survival was 86% for animals challenged with B. fragilis versus 53% for animals
      challenged with E. coli. It is concluded that in this model B. fragilis
      translocates extensively after burn injury and that survival is closely related
      to the destruction of translocated bacteria.

PMID- 7775504
TI  - A quasi-experimental, dual-center study of morphine efficacy in patients with
      burns.
AB  - The efficacy of morphine sulfate for the relief of pain and anxiety in patients
      with burns was investigated in a quasiexperimental, dual-center study. More than
      100 patients at two burn centers in Iowa were studied. One of the units used no
      morphine or morphine derivatives for the control of pain (the no-morphine unit),
      and the other used moderate to high doses of morphine for the relief of pain (the
      morphine unit). Patients were asked to rate their pain and anxiety after
      hydrotherapy and at rest in the afternoon on a daily basis throughout their
      stays. Side effects were also measured, and nurses made ratings of the patients'
      pain and anxiety during morning hydrotherapy. Results indicated that pain and
      anxiety decreased significantly from hydrotherapy to afternoon assessments and
      decreased significantly during the patient's hospital stay. Unexpectedly,
      however, patients at the no-morphine unit consistently reported lower levels of
      pain and anxiety than did patients at the morphine unit. These results could not
      be explained by differences in burn size or number of surgeries across units.
      Other possible explanations are offered.

PMID- 7775506
TI  - Acute pseudo-obstruction in critically ill patients with burns.
AB  - Acute pseudo-obstruction of the colon (Ogilvie's syndrome) is a rare but
      potentially morbid complication of burn injury. Two thousand seven hundred three
      consecutive critically ill patients with burns were reviewed for findings
      consistent with pseudo-obstruction. Eight (0.29%) patients were identified. Mean
      age was 63.5 years, and mean burn size was 24.6% total body surface area. All
      patients were undergoing mechanical ventilation at the time of diagnosis. Six had
      a previous cardiac condition or complication, and five were on digoxin. Diagnosis
      was suspected in seven patients before colonoscopy or surgery. Six patients were
      treated with colonoscopy alone with one treatment failure. Two deaths occurred
      during hospitalization. Two late deaths were due to underlying cardiac
      conditions. The preferred treatment of Ogilvie's syndrome is nasogastric suction,
      colonic decompression, and close observation with surgery reserved for treatment
      failures or when diagnosis is in doubt. The incidence of Ogilvie's syndrome in
      patients with burns appears to be related to nonburn medical conditions,
      especially cardiopulmonary complications and age, rather than to the burn itself.

PMID- 7775507
TI  - A comparison of Xeroform and SkinTemp dressings in the healing of skin graft
      donor sites.
AB  - The best donor site dressing would minimize pain while it increased the rate of
      healing. This study compares a standard fine-mesh gauze dressing, Xeroform
      (Sherwood Medical Industries Ltd., Markham, Ontario, Canada), to a new collagen
      based dressing, SkinTemp (BioCore Inc., Topeka, Kan.). Eight patients requiring
      two donor sites of equal size received Xeroform gauze on one site and SkinTemp on
      the other. The Xeroform was covered for 24 hours and was then allowed to air-dry.
      Healing was determined to be complete once the gauze peeled off and complete
      epithelialization was observed. The SkinTemp was covered for 7 days and inspected
      on days 3, 5, and 7. Pain was measured daily with a standard visual analog scale.
      Mean Xeroform donor site size was 224.75 cm2, and SkinTemp size was 319.87 cm2.
      Donor site thickness was 0.012 to 0.014 inches for both. Mean length of healing
      was 10.62 days for Xeroform and 7.75 days for SkinTemp. Mean pain rating was
      22.28 mm for Xeroform and 15.29 mm for SkinTemp. The overall preference of the
      eight subjects yielded five choosing SkinTemp and three choosing Xeroform, and
      seven reported SkinTemp as less painful. SkinTemp dressing appears to be less
      painful and has a better healing rate compared with Xeroform.

PMID- 7775508
TI  - An unusual mechanism of electrocution via a spray of aluminum paint.

PMID- 7775509
TI  - Clinical experience with the use of biodegradable tacks in pediatric patients
      with burns.
AB  - Stainless steel staples are very popular for securing grafts and dressings on
      patients with burns because of the speed and security with which they can be
      applied and the fact that stainless steel is nonreactive. In patients with large
      burns hundreds of staples are used and can be difficult to visualize and remove;
      they are therefore retained. Although stainless steel does not cause local tissue
      reaction, its presence can confuse the later evaluation of local pain. A new
      biodegradable tack has been developed. We describe an initial experience with
      this device in pediatric patients with burns and make suggestions regarding their
      use.

PMID- 7775512
TI  - Use of burn intensive care unit gymnasium as an adjunct to therapy.
AB  - One primary goal for patients with burns is to prevent loss in range of motion
      and function in the involved extremities. Because therapies were provided only on
      weekdays at our facility, the burn team designed a gymnasium that was built in
      the burn unit where patients can carry out their exercise programs after hours
      and on weekends. Patients assume responsibility to complete their occupational
      and physical therapy assignments, in addition to their other scheduled therapy
      sessions. The development of the burn intensive care unit gymnasium has increased
      the opportunity for patients to improve their range of motion and overall
      functional status. We have also noted that patients feel a greater sense of
      motivation and accomplishment when they are invited to take more control of their
      recovery. Assuming responsibility for their programs enables patients to achieve
      their goals, thus increasing their self-esteem after what is often a very
      devastating injury.

PMID- 7775513
TI  - Pain and anxiety during burn dressing changes: concordance between patients' and
      nurses' ratings and relation to medication administration and patient variables.
AB  - Few studies have examined the various factors related to pain during burn
      dressing changes. Patients' and nurses' ratings of pain and tension were obtained
      during 107 burn dressing changes among 11 burned patients. As found in previous
      studies, there was little concordance between nurses' and patients' ratings. Both
      nurses' and patients' ratings of pain were positively related to amount of
      analgesic medications administered, whereas amounts were inversely related to
      patients' reports of pain in a subsample of dressing changes in which anxiolytics
      were administered. However, these relationships failed to reach statistical
      significance. Multiple regression analyses revealed that ratings of tension
      during the procedure were significantly related to overall and worst pain,
      whereas amount of analgesics and anxiolytics given, postburn day, and total body
      surface area were not. Exploratory correlations suggested that ability to
      accurately discriminate between painful episodes, social desirability, and trait
      anxiety may be factors that significantly influence self-report of pain and might
      be worthwhile to study more systematically in the future. Implications for burn
      pain control and suggestions for future research are presented.

PMID- 7775510
TI  - Recent advances in absorbent products for the incontinent patient with burns.
AB  - The purpose of this study is to describe the physical configuration of disposable
      and reusable absorbent products and relate composition and construction to
      efficacy in the management of urinary incontinence in patients with burn
      injuries. The basic structure of a wearable absorbent product consists of three
      layers: a fluid-impermeable backing sheet, a fluid-pervious coverstock on the
      body-contacting surface, and an interposed absorbent core. The biomechanical
      performance of these absorbent products was determined by measuring the total
      absorbent capacity, defined as the maximum amount of liquid held by the product
      as a whole. On the basis of the results of this study, absorbent products are
      recommended for the incontinent patient with burns.

PMID- 7775511
TI  - A survey of the prevalence and application of chest physical therapy in U.S. burn
      centers.
AB  - The purpose of this study was to determine the prevalence and application of
      chest physical therapy (CPT) in burn centers. Respiratory therapists primarily
      administered CPT, and suctioning and coughing were the most frequently used
      modalities. Further study of the efficacy of treatment techniques is needed to
      develop congruous standards for CPT after a burn injury.

PMID- 7775515
TI  - School reintegration.
AB  - School reintegration programs have been developed to enhance a positive sense of
      self-worth in a child who has been burned. The premise of these programs is that
      cognitive and affective education about children with burns will diminish the
      anxiety of the patient with burns, the patient's family, faculty and staff of the
      school, and the students. Five principles guide school reentry programs: (1)
      preparation begins as soon as possible; (2) planning includes the patient and
      family; (3) each program is individualized; (4) each patient is encouraged to
      return to school quickly after hospital discharge; and (5) burn team
      professionals remain available for consultation to the school. Reintegration
      programs can vary in format depending on patient and/or family need and
      capability of the burn team, thus allowing flexibility in assisting every child
      with burns make the transition from hospital patient to normal living.

PMID- 7775514
TI  - Effects of supplemented omega-3 and omega-6 fatty acid rich oils on the
      cardiovascular system of thermally injured rabbits: changes in plasma and
      platelet fatty acids.
AB  - The effects of omega-3 fatty acid rich oil (MaxEPA oil), omega-6 fatty acid rich
      oil (soybean oil), and a combination of omega-3 and omega-6 oils (MaxEPA oil +
      soybean oil) on cardiovascular health-related parameters of thermally injured and
      control (sham) rabbits were determined. Plasma and platelet analyses of burned
      rabbits fed with MaxEPA oil revealed significantly higher concentrations of
      eicosapentaenoic acid and docosahexaenoic acid + myristic acid. Linolenic acid
      concentrations declined in animals supplemented with soybean oil + MaxEPA oil. At
      the end of this study the lowest concentrations of linoleic acid and arachidonic
      acid were found in the sham and burned groups supplemented with soybean oil +
      MaxEPA oil. Overall, favorable significant differences in plasma and platelet
      fatty acids concentrations were found in burned or sham groups supplemented with
      MaxEPA when compared with those of groups supplemented with soybean oil. These
      favorable changes in plasma and platelet lipids may have an impact on the risk of
      cardiovascular disease in thermally injured patients.

PMID- 7775516
TI  - Recipe for postgraft antimicrobial wound cover.

PMID- 7775517
TI  - Cytotoxicity testing of topical antimicrobial agents on human keratinocytes and
      fibroblasts for cultured skin grafts.
AB  - Cultured epidermal skin has become an adjunctive therapy for treatment of major
      burn injuries, but its effectiveness is greatly limited because of destruction by
      microbial contamination. To evaluate candidate antimicrobial agents for use with
      cultured skin, a combined cytotoxicity-antimicrobial assay system was developed
      for determination of toxicity to cultured human keratinocytes and fibroblasts and
      for determination of susceptibility or resistance of common burn wound organisms.
      Candidate agents including chlorhexidine gluconate, polymyxin B, mupirocin,
      sparfloxacin, or nitrofurazone were tested separately for inhibition of growth of
      human cells and for inhibitory activity to microorganisms with the wet disk
      assay. The data showed that (1) chlorhexidine gluconate (0.05%) was uniformly
      toxic to both cultured human cells and microorganisms; (2) nitrofurazone (0.02%)
      had dose-dependent toxicity to human cells and limited effectiveness against gram
      negative microorganisms; (3) sparfloxacin (30 micrograms/ml) had low toxicity to
      human cells and retained antimicrobial activity against both gram-positive and
      gram-negative bacteria; (4) polymyxin B (400 U/ml) was not toxic to human cells
      and had intermediate effectiveness on gram-negative bacteria; and (5) mupirocin
      (48 micrograms/ml) had no toxicity to skin cells and had uniform effectiveness
      against Staphylococcus aureus including methicillin-resistant Staphylococcus
      aureus. Selection of topical antimicrobial drugs by these assays may improve
      effectiveness of cultured skin for burns and may be used to control other
      surgical wound infections.

PMID- 7775518
TI  - The changing image in cardiac surgery.

PMID- 7775519
TI  - Sternal wound infection: our experience with 200 cases.
AB  - More than 200 patients with sternal wound infections have been treated in the
      Plastic Surgery Department of our Medical Center over the years 1984-1993. Most
      of these were referrals from other hospitals. In recent years, the cases have
      become more severe, partially due to the fact that cardiac surgeons tend to
      operate older and sicker patients more readily than they previously did. 80% of
      these were post coronary bypass surgery, and the others heart and heart-lung
      transplants, repair of congenital heart anomalies, valve replacements etc.
      Several of the cases were cardiac surgery re-do's. Risk factors for developing
      this complication, such as diabetes, obesity, technical errors of sternal
      incision, prolonged intubation, the use of aortic balloon, etc. will be
      discussed. Many of our earlier patients had chronic fistulae following
      conservative therapy with old treatment modalities. In recent years, patients are
      usually referred at the acute stage. Most patients undergo removal of sternum and
      ribs. Previously, reconstruction included mainly transfer of the rectus ahdominis
      muscle, whereas lately the pectoralis muscles is utilized. Omentum was used in
      only one case. The importance of pre-operative imaging procedures has been
      thoroughly studied in our series. Especially important is the definition of the
      extent of the infection, and localization of foreign bodies causing chronic
      infections, such as suture material, epicardial electrodes etc. A change in
      infectants has also been noticed. In the first half of the study period,
      Pseudomonas aeruginosa comprised at least 40%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775520
TI  - Stentless porcine bioprosthesis for aortic valve replacement.
AB  - We report herein our experience with the Toronto Stentless Porcine Valve (Toronto
      SPV, manufactured by St. Jude Medical Inc., Minneapolis, MN, USA) for aortic
      valve replacement (AVR). To date 146 SPV valves have been implanted, 29 in an
      initial clinical trial (from October 1987 to April 1987) and 117 in the current
      FDA trial (September 1991 to January 1994). In the current trial the majority of
      patients were male (76%), aortic stenosis was the dominant lesion (73%) and 68%
      of the patients received a valve size 27 mm or greater. The mean age was 61.3 +/-
      12.0 years. For the entire group there has been no hospital death and no patient
      has required a pacemaker. Perioperative complications were myocardial infarction
      in three patients and suspect subacute bacterial endocarditis (medically treated)
      in three patients. There have been two late deaths (2%), two patients have had
      transient ischemic attacks (2%), and one patient suffered stroke with complete
      neurological recovery (1%). To date there has been no case of primary valve
      failure. Echocardiographic assessment of the SPV valve has demonstrated excellent
      effective valve orifice areas with very low transvalvular gradients and 95% of
      the patients had either 0 or 1+ insufficiency. These results are encouraging and
      justify the continued use of this valve in clinical trials. Further follow-up is
      required to determine its durability.

PMID- 7775521
TI  - Safety, feasibility and long term follow-up of a non-thoracotomy defibrillation
      system in patients with inducible sustained ventricular tachycardia/fibrillation.
AB  - A non-thoracotomy lead system CPI-ENDOTAK, a transvenous lead used alone or
      combined with a subcutaneous patch (SQ-P), was evaluated as an alternative to
      epicardial patches/electrodes in patients at high risk for sudden cardiac death
      undergoing implantable cardioverter-defibrillator (ICD) surgery. Fifty nine
      patients, 62 +/- 11.4 years with CAD (83.0%) cardiomyopathy (11.9%) other (5.1%),
      mean ejection fraction 31.8 +/- 14%, with inducible sustained VT/VF underwent
      testing of either lead alone or lead/SQ-P. Four configurations of NTL were
      tested. Fifty one patients had NTL implanted (lead alone = 60.8% and lead/SQ-P =
      39.2%). Eight patients required non-NTL approaches, due to high DFT (7) or
      anatomic anomaly (1). DFT's were 19.1J (lead alone) and 20.8J (lead/SQ-P). Acute
      complications: pulmonary embolism 1, lead dislodgement 3, sensing malfunction 1.
      [table: see text] CONCLUSION: A NTL system using either a single transvenous lead
      alone or combined with SQ-P can be implanted successfully in high risk patients
      with a low incidence of acute complications. Non-arrhythmic survival is lowest in
      patients receiving defibrillation shocks. Arrhythmic survival is high in all
      patients.

PMID- 7775522
TI  - Mid-term results of heart transplantation in diabetic patients.
AB  - BACKGROUND: Diabetes mellitus (DM) has been considered a relative
      contraindication to heart transplantation (HTx) because of possible increased
      infection rates and worsening DM with prednisone immunosuppression. The
      introduction of cyclosporine has allowed us to reduce the dosage of oral steroids
      and to accept DM patients (pts) for HTx. We reviewed the mid-term outcome of our
      DM pts who had undergone HTx. MATERIALS AND METHODS: Out of 257 HTx recipients,
      19 males and 3 females, aged 53 +/- 8 years, were diabetic. Prior to HTx, DM was
      controlled with insulin in 5, with oral hypoglycemic agents in 7 and with diet in
      the remaining patients. Immunosuppression consisted of cyclosporine and
      azathioprine; low-dose prednisone was added in 10 patients because of repeated
      rejections. RESULTS: All patients survived HTx and were followed 2 to 75 (mean 38
      +/- 21) months. There were 4 late deaths, with actuarial survival of 84% at 5
      years. DM was more difficult to control after HTx (12 patients requiring insulin
      vs 5 pre-HTx), but comparison of diabetic vs non diabetic patients following HTx
      showed no significant difference in frequency of rejection or infection during
      the 1st year (2.6 +/- 1.6 vs 2.1 +/- 1.5; 0.5 +/- 0.4 vs 0.4 +/- 0.3
      episode/patient respectively) and in 5-year actuarial survival (84% vs 77%).
      Renal function is preserved in all DM patients, hypertension has developed in
      11/18 (61%); annual post-HTx cardiac catheterisation has shown normal graft
      function and coronary arteries in all but 2 patients. CONCLUSIONS: Mid-term
      results indicate that HTx can be safely performed in diabetic patients; a longer
      follow-up is required to determine whether DM is no longer a contraindication to
      HTx.

PMID- 7775523
TI  - Warm continuous antegrade blood cardioplegia: applications in congenital heart
      disease.
AB  - Continuous warm blood cardioplegia is utilized by many surgeons as their method
      of choice for myocardial protection during operations for acquired heart disease.
      OBJECTIVE: this study was performed to determine the feasibility and safety of
      this method for intracardiac procedures through the right atrium and in
      particular, total cavopulmonary connection. MATERIALS AND METHODS: procedures
      included closure of an atrial septal defect (23), atrial septectomy (2) and total
      cavopulmonary connection (4). Antegrade blood cardioplegia was delivered
      continuously for an average of 27 +/- 21 minutes at an average flow of 130 +/- 60
      cc/min to maintain the aortic root pressure between 60 and 80 mmHg (mean 74 +/- 5
      mmHg). Perfusion with regular blood commenced in the last 2 to 8 minutes and
      complete de-airing procedure was performed on the beating heart before removal of
      the aortic cross-clamp. RESULTS: all patients resumed sinus rhythm and all but
      one had normal cardiac output postoperatively. In one patient after cavopulmonary
      connection the inferior vena-cava to pulmonary-artery connection was taken down
      because of increased pulmonary vascular resistance resulting in low output state.
      All patients made an uneventful recovery without neurological complications.
      CONCLUSIONS: this initial experience suggests that normothermic aerobic arrest
      can be used safely in the repair of congenital defects and may provide superior
      myocardial protection for complex procedures such as the Fontan procedure.

PMID- 7775524
TI  - Long-term results of plastic reconstructions in acquired aortic valvular disease.
AB  - Plastic surgery in acquired aortic valvular disease was performed in 164
      patients. Among them, 9 had the isolated aortic valvular injury; 130 mitral
      aortic defects; and 25 three-valve injuries. The restoration of the injured valve
      function was achieved, as a rule, using a combination of surgical methods:
      commissurotomy or wedge resection of the fibrous tissue in the commissurial area;
      parietal resection; the aortic root frame plasty; perforation hole plasty; the
      allogenic valvuloaortic complex sector transplantation; and wedge resection or
      isometric cusp plication in the commissurial area. Calcinosis was not a
      contraindication to surgery, if it could be removed completely without the cusp
      closing function disturbances. The hospital mortality rate was 8%. After hospital
      treatment all the patients were followed-up: 108 for over 1 year, and the maximum
      term of the follow-up was 7 years. From 1 to 4 years postoperatively, 4 patients
      were reoperated due to the appearance of aortic insufficiency. The causes of
      relapse were: infectious endocarditis (3 patients); active rheumatic process (1
      patient); and progressive dilatation of the fibrous ring (1 patient). During the
      follow-up 8 patients died: 6 of infectious endocarditis with mitral prosthetic
      injury; and in 2 the cause of death was not clear. The study of immediate and
      long-term aortic valvuloplasty results based on the clinical experience of 164
      operations allows to recommend the elaborated principles of the aortic valve
      surgical reconstruction for a wide application in cardiac surgery.

PMID- 7775525
TI  - Management of hypoplastic aortic arch associated with neonatal coarctation.
AB  - Controversy still exists as to whether hypoplastic aortic arch frequently
      associated with neonatal coarctation, should be enlarged at the time of
      coarctation repair. To determine the indications for and the outcome of repair of
      hypoplastic aortic arch, pre- and postoperative angiograms/echocardigraphy of 77
      cases with isolated (n = 25, Group 1) or complex (n = 52, Group 2) neonatal
      coarctation operated upon between 1/80 and 12/89 were reviewed. Age was 5-14 days
      (mean 8 +/- 1.6). Aortic arch/ascending aorta diameter ratio (AR/AA) as a measure
      of the degree of aortic arch hypoplasia was 0.39-0.64 (0.52 +/- 0.04) in isolated
      and 0.15-0.47 (0.34 +/- 0.06) in complex coarctation (p < 0.05). Left subclavian
      flap aortoplasty was used in 72 patients; alone in 25, in combination with
      pulmonary artery banding in 43 patients, and simultaneously with intracardiac
      repair in 4 patients. Extensive reconstruction of aortic arch and coarctation
      with synthetic patch was performed in the remaining 5 patients (AR/AO = 0.16 +/-
      0.03) using cardiopulmonary by-pass at the time of intracardiac repair. Operative
      mortality was 2/76 (2.5%). Follow-up is 6.6 +/- 1.4 years. Recoarctation occurred
      in 3 patients (4%). AR/AA increased to 0.86 +/- 0.1 in isolated (p < 0.05 vs
      preoperative) and to 0.7 +/- 0.1 in complex coarctation (p < 0.05 vs
      preoperative). In the majority of cases, hypoplastic aortic arch associated with
      coarctation grows satisfactorily following simple repair of coarctation with no
      significant residual narrowing.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775526
TI  - Survival following resection of clinically occult N2 non small cell lung cancer.
AB  - BACKGROUND: The role of resection in Stage IIIA (N2) non-small cell lung cancer
      (NSCLC) remains controversial despite reported survival rates of 25-40%. This
      study was undertaken to identify factors associated with a high risk of treatment
      failure after resection of clinically occult Stage IIIA (N2) NSCLC: Such
      prognostic factors may identify high risk patients as candidates for future
      clinical trials of multimodality lung cancer treatment and be important
      stratification factors in such trials. METHODS: The clinical and pathological
      records of 32 patients with clinical NO pathologic N2 NSCLC who underwent
      lobectomy (n = 17), pneumonectomy (n = 12), or bilobectomy (n = 3) and complete
      mediastinal lymph node dissection at Fox Chase Cancer Center from 1987 to 1991
      were reviewed. A multivariate analysis of clinical and pathologic variables was
      performed. RESULTS: Median follow-up was 15 months (range 5-55). Fifty-nine
      percent have recurred and 44% have died. Median disease free and overall survival
      were 16 and 19 months, respectively. Two year disease free and overall survival
      were 24% and 43%, respectively. No patient with more than one level of
      mediastinal lymph node metastases survived two years free of disease. Univariate
      and multivariate analysis revealed a longer disease free survival for those
      receiving adjuvant radiation therapy (19 vs 5 months) but no increase in overall
      survival. CONCLUSIONS: This experience with clinically occult Stage IIIA (N2)
      NSCLC suggests that multiple levels of mediastinal lymph node metastases predict
      treatment failure in patients following resection and that adjuvant mediastinal
      radiation improves disease free but not overall survival.

PMID- 7775527
TI  - Surgery in the management of mediastinal carcinoid.
AB  - Primary carcinoid tumors of the mediastinum were described for the first time in
      1972 as thymic carcinoids. Our experience with 16 patients who underwent
      diagnostic and surgical procedures at the Mayo Clinic is presented. All of these
      patients had mediastinal carcinoid. The surgical procedures included node biopsy,
      anterior mediastinotomy (Chamberlain), median sternotomy and posterior lateral
      thoracotomy. Complete resection was possible in 9 (56.3%) patients, 3 (18.7%) had
      partial removal (debulking), and 4 (25%) had diagnostic biopsies only. The
      operative morbidity was 25%. There were no postoperative deaths. In resectable
      patients, the average disease free interval was 45.7 months. Five year and ten
      year survival was 47% and 22%, respectively. Local or distant metastatic spread
      developed in all patients (100%). Mediastinal carcinoids are a separate entity
      from other thymic and mediastinal neoplasms. (We suggest that) Surgical excision
      may be possible earlier in the disease and radiation and chemotherapy are of
      doubtful value.

PMID- 7775528
TI  - Balancing the circulation in hypoplastic left heart syndrome.
AB  - A mathematical model based on oxygen flow was developed to study the effects of
      pulmonary to systemic flow ratios (QP/QS) on systemic oxygen availability. The
      model suggests that QP/QS = 1 is the safest ratio that would provide the largest
      safety margin in either low cardiac output or low pulmonary oxygenation
      conditions. The optimal value of QP/QS that will result in maximum oxygen
      availability is smaller than unity and depends on several circulatory parameters
      such as cardiac output, maximal oxygen capacity, level of pulmonary oxygenation,
      and oxygen consumption. The values of these parameters also dictate the
      permissible range of QP/QS beyond which abrupt oxygen deficiency ensues.
      Decreased pulmonary resistance resulting in increased pulmonary flow may
      eventually result in QP/QS that is beyond the vital range.

PMID- 7775529
TI  - Follow-up of infants after systemic-pulmonary shunts, performed with fresh frozen
      vein homografts. Postoperative angiographic assessment.
AB  - Ten of twenty-six modified Blalock-Taussig shunts performed with fresh frozen
      vein homograft were studied angiographically. In two of them the shunt was
      stenosed. The remaining eight shunts were satisfactory. Among them in four
      irregularities of the inner surface and in four spindle shape of the shunt were
      observed. The diameter ratio between subclavian artery and homograft at the time
      of operation and later as seen on the angiograms did not change. This suggests
      that spindle shape of homograft is caused by growth rather than by aneurysm
      formation.

PMID- 7775530
TI  - Some questions about Eurocollins solution used for lung preservation.
AB  - Currently, Eurocollins' (EC) solution (high-potassium concentration) is the most
      widely clinically used pulmonary perfusate. However, recently, experimental
      studies have reported an increase of the lung ischemic period using low-potassium
      solutions. The purpose of our study, is to investigate the influence of the EC
      ionic composition and the effect of hyperosmolarity due to the glucose
      concentration on isolated alveolar type II epithelial cells. Pneumocytes type II
      were isolated from pathogen free Wistar rats using the modified Dobbs' method.
      Cells were incubated for 6 hours at 4 degrees C in EC, Collins (CL) and Ringer
      Lactate (RL) solutions. After that, cellular viability was evaluated by analysis
      of the protein synthesis assay by measuring the 35 S methionine uptake during an
      incorporation period of one hour at 37 degrees C (picomol 35 S met/mg
      proteins/h). Mean +/- standard deviation and Student "t"-test were used for data
      presentation and results comparison. Cellular viability at time 0 (control)
      before cellular incubation was 3.93 +/- 0.38. After 6 hours at 4 degrees C the
      results were respectively as follows: EC = 2.16 +/- 0.13; CL = 2.63 +/- 0; RL =
      3.21 +/- 0.04. Our results suggest that the low-potassium extracellular type
      solution (RL) shows a protection on isolated type II epithelial cells
      statistically significant (p < 0.05) if compared with EC solution. Moreover CL
      solution, that has the same ionic composition EC but without glucose, presents a
      less cytotoxic effects on incubated cells than EC, confirming a deleterious
      influence of solution hyperosmolarity.

PMID- 7775531
TI  - Cardiomyoplasty review: physiological principles and characteristics of
      electrically stimulated skeletal muscle. II. A therapeutic option.
AB  - Chronic heart failure continues unsolved as ever despite recent advances in
      cardiac surgery and pharmacological new armamentarium and remains a significant
      cause of death, regardless of etiology. Cardiomyoplasty (CMP), a new form of
      biomechanical ventricular support, has given new life to the field of mechanical
      circulatory support, providing a "bridge" to transplantation and serving as a
      possible alternative to surgical treatment. The geographic distribution of world
      experience in 401 patients shows that 80% were centralized in Europe (50%) and
      South America (30%). This review of the data analysis, documented improved
      changes in patients clinical status, further clarifies and appropriate patients
      population indications for DCMP as well as that more than 80% survival
      probability for NYHA class II & III and an early procedure related mortality of 8
      to 10%.

PMID- 7775532
TI  - Chronic post thoracotomy pain.
AB  - Chronic post-thoracotomy pain (CPP) is a vexing clinical problem whose management
      has received scant attention. In order to identify the risk factors associated
      with CPP and determine the optimal treatment, the records of 238 consecutive
      patients who underwent thoracotomy were reviewed. CPP was defined as discomfort
      requiring the regular administration of analgesics that continued more than three
      months following surgery. CPP was present in 25 (11%) patients: 10/20 (50%) chest
      wall resections, 5/25 (20%) pleurectomies, 10/193 (5%) pulmonary resections.
      Among the 23 patients who required preoperative narcotics, 12 (52%) developed
      CPP. Improved pain control and decreased narcotic use was achieved via the
      administration of nonsteroidal anti-inflammatory medication and tricyclic anti
      depressants. In addition, 10/25 patients required 11 pain procedures: trigger
      point injection, intercostal blocks, injections of epidural steroids, stellate
      ganglion block. Recurrent pain occurred in 20 patients following initial control.
      All were found to have tumor regrowth. We conclude that CPP occurs more commonly
      following chest-wall resection and pleurectomy, and that preoperative narcotic
      use is a predictor of CPP. Worsening pain following initial relief should prompt
      a vigorous search for recurrent cancer.

PMID- 7775535
TI  - The role of pleuroscopy in the management of resistant empyema.

PMID- 7775533
TI  - The first step of experimental study on hybrid trachea: use of cultured
      fibroblasts with artificial matrix.
AB  - Anastomotic stenosis secondary to developing granulation tissue prevents an
      artificial trachea of non-porous type model from a safe practical use. Taira
      reported that a non-porous artificial trachea having soft ends for anastomosis
      works better in this regards apparently by cushioning mechanical stimulations
      repeatedly applied to the anastomotic rings than most models ever studied have
      done. We hypothesized that hybridization of soft anastomotic ends of nonporous
      artificial trachea may further prevent granulation tissue at the anastomoses
      hopefully by leading epithelial growth earlier onto the inner surface of graft's
      ends. The graft of our use was made of a 5-cm-long knitted dacron tube with inner
      coating with silicone rubber covering the entire length but for a 5 mm segment at
      each end. To date six mongrel dogs have been subjected to test this hypothesis. A
      piece of subcutaneous tissue was obtained from each dog and prepared for culture
      of fibroblasts in MEM. These fibroblasts were then suspended in 0.1% collagen
      with MEM in a container, in which a graft was placed for further culture.
      Following some 3 weeks of this preparation each graft was implanted to replace a
      10-cartilage-ring-long defect of the mediastinal trachea of each donor dog. One
      dog is enjoying active life 11 months postop, and another 3 months. Four dogs
      died from anastomotic stenosis 2 to 3 months. Being encouraged by the fact that
      the anastomotic rings of the long term survivors show bronchoscopically patency
      more than 40% of cut surface area, and some portion with possible
      epithelialization without granulation, we will report our further results, along
      with histological study.

PMID- 7775534
TI  - Video assisted thoracic surgery: our experience with 102 patients.
AB  - Recent advances in optics, video systems and endoscopic operating instruments
      have made thoracoscopy easier and more accurate. From May 1992 until December
      1993 we performed 102 Video Assisted Thoracic Surgical Procedure (VATS) for
      diagnosis and treatment. Twenty patients underwent thoracoscopy, twelve had
      pleurodesis. Seventy operative thoracoscopies included pulmonary wedge resection,
      dorsal sympathectomy, management of empyema, pleural tumor, bullectomy,
      pericardial window, anterior release for kyphoscoliosis and resection of
      posterior mediastinal cyst. In most cases of parenchyma resection, it was
      necessary to use three ports: one for video-endoscopy and two for preparation
      instruments and stapler. The average operation time was 58 minutes and average
      hospital stay was 3.5 days. Four patients died within 30 days after the procedure
      due to multi-organ failure, end-stage malignant disease and post pneumonectomy
      pulmonary edema, unrelated to the VATS itself. One patient had thoracotomy due to
      uncontrolled bleeding. No wound infection or other postoperative complication
      except intercostal neuralgia after dorsal sympathectomy was noticed. Localization
      of the target lesion deep within the parenchyma of the lung still poses a
      problem. We used a small incision (2 cm long), placing a finger to directly
      palpate the lung and locate the lesion, or made a mini thoracotomy. Conversion to
      thoracotomy was performed when malignancy was demonstrated at frozen section.
      CONCLUSIONS: 1) Thoracoscopy is a minimally invasive surgical technique causing a
      low morbidity rate and attaining a high diagnostic accuracy. 2) Postoperative
      recovery is brief and uneventful. New techniques of imaging are needed to locate
      the target lesion.

PMID- 7775536
TI  - Intermittent antegrade cardioplegia: warm blood vs cold crystalloid. A clinical
      study.
AB  - Intermittent antegrade warm blood cardioplegia (IAWBC) is a not usual technique
      of myocardial protection. We propose a delivery protocol that standardizes the
      length of ischemic intervals, duration of each cardioplegic dose and K+ amount.
      Cardioplegia is represented by blood, taken from the oxygenator and injected
      directly into the aortic root, and K+, added by means of a syringe pump. We
      reviewed the first 300 patients who underwent elective or urgent coronary artery
      by-pass procedures (group A) and compared them with the last 300 patients
      operated on with intermittent antegrade cold crystalloid cardioplegia (group B).
      The overall mortality in group A was lower than in group B (0.7 vs 3.0, p <
      0.05); there was no in-hospital death in patients with poor left ventricle (LVEF
      < 35%) in group A (0/64 vs 3/39, p < 0.025). Reduction of mortality was due to a
      drastic fall of morbidity. In group A no patients needed circulatory assistance
      (13 in group B, p < 0.0005) or intraaortic balloon pumping (9 in group B, p <
      0.005) in operating room or in intensive care unit (ICU); only 1 patient had
      inotropic drug (29 in group B, p < 0.0005) and only 6 needed lignocaine infusion
      (27 in group B, p < 0.0005). Incidence of postoperative myocardial infarction was
      lower in group A (4 vs 9 in group B) as well cerebrovascular accidents (4 vs 10
      in group B), but difference was not statistically significant.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7775537
TI  - The mitral valve replacement by the new-type bioprostheses (features of design
      and long-term results).
AB  - The BAKS bioprostheses were created in our centre and they have the following
      features: (1) to reduce immunogenicity they underwent a combined fermentochemical
      treatment which resulted in the native xenovalve consisting of collagen and
      elastic fibres only; (2) in cutting out the valve the natural aortic sinuses were
      preserved; and (3) the xenovalve was fixed on a functional frame of an original
      design. From 1979, BAKS have been implanted in 243 patients with the isolated
      mitral valve reumatic injury. The patients age varied from 11 to 59 years; 91
      patients (37.5%) were under 35 years. The 12-year survival rate (without hospital
      lethality) was 65.5 +/- 5.3%. The most serious longterm complications were:
      infectious endocarditis (3.14 patients/years); spontaneous degeneration of
      bioprosthetic cusps (2.24% patients/years); thromboembolism (0.6%
      patients/years). The morphological examination of bioprostheses removed in
      reoperations from 10 days to 10 years after implantation was performed in 51
      cases. Most often, collagen degeneration occurred in patients under 35. The
      pathologic structural changes originated because of the localized saturation of
      bioprosthetic cusps with the recipient plasma proteins, gradual disintegration of
      collagen fibres, and further calcification of that area. The indications to the
      mitral valve replacement by BAKS were: the left atrium thrombosis,
      thromboembolytic syndrome, contraindications to anticoagulation therapy, and the
      age over 35 years.

PMID- 7775538
TI  - T-graft: a new method of coronary arterial revascularization.
AB  - We present early results in 486 patients undergoing total coronary artery
      revascularization using a T-graft constructed from the attached left internal
      thoracic artery (LITA) and the free right internal thoracic artery (RITA). The
      anterior and anterolateral areas of the heart are by-passed with the LITA and the
      inferolateral, inferior and posterior areas are by-passed with the RITA. These
      patients received an average of 4.34 distal anastomoses with as many as four from
      each of the limbs of the T-graft. Ages ranged from 29 to 89 years and ejection
      fractions from 15 to 79%. Sixty-six patients were undergoing first reoperations
      and 6 received T-grafts at their second reoperation. The mortality at 30 days was
      2.3%. Two of 92 women and 9 of 394 men expired. The perioperative infarction rate
      was 1.2%. Postoperative angiography in 34 patients showed 98.3% of LITA and 86.5%
      of RITA anastomoses to be patent. There was a slightly higher patency observed in
      women. The T-graft technique can be applied to nearly all patients with 3 vessel
      coronary artery disease with low operative mortality. Precise technique with high
      power magnification is crucial. This procedure has the potential of avoiding
      further invasive procedures due to graft deterioration in many patients with 3
      vessel coronary artery disease.

PMID- 7775539
TI  - Results of mitral valve reconstruction in mitral valve insufficiency.
AB  - In the last three years forty mitral valve reconstruction (MR) procedures were
      performed in case of mitral insufficiency (MI). In three cases, anatomical
      changes made reconstruction impossible for us. One patient had to be re-operated
      because of unsatisfactory valve function. There was no operative mortality. In
      twelve of the patients, mitral insufficiency was the only problem, while in
      twenty eight others additional cardiac procedures (CABG, AVR) were performed. The
      patients' age ranged from 17 to 77 years. The aortic cross-clamping time for
      mitral reconstruction without additional cardiac procedures ranged from 35 to 134
      minutes. With one exception, the post-operative TEE indicated no, or very little,
      insufficiency. We concluded that the mitral valve insufficiency can be corrected
      with very good results and with a very low rate of complications. Such
      corrections ought therefore be taken into consideration before valve replacement.

PMID- 7775540
TI  - Single centre experience with the Jyros bileaflet rotating pyrolitic carbon
      valve.

PMID- 7775541
TI  - Sorin Bicarbon heart valve: early experience.

PMID- 7775542
TI  - Cardiac surgery in octogenarians.
AB  - Age as an important risk factor in surgery has always been debatable. Between
      January 1991 and December 1992, 35 consecutive octogenarian patients (23 males
      and 12 females; average age 82.3 years) were retrospectively evaluated. Twenty
      five patients had only coronary artery by-pass graft operations (CABG), five had
      aortic valve replacements (AVR) and five had combined AVR-CABG operations. Twenty
      five of the 30 patients (83%) who underwent CABG alone or a combined procedure
      had suffered from unstable angina. The mean ejection fraction was 40% in this
      group. An average of 2.8 grafts per patient was performed. The left internal
      mammary artery (LIMA) was-used in nine patients (30%). The average
      hospitalization period was 11.5 days. Operative mortality (within 30 days) was
      zero. Patients who underwent AVR only were hospitalized for an average of 17.6
      days and there were two cases (6%) of mortality in this group. All patients who
      underwent AVR and CABG were discharged within 14 days. Overall complications
      occurred in nine patients (25.7%); cardiac arrythmias, (4) neurological deficits
      (2), severe wound infections (2), and adult respiratory distress syndrome (1).
      The use of the LIMA was not associated with an increased incidence of bleeding or
      sternal infection. The low rates of mortality and major complications lead us to
      conclude that, when indicated, surgical treatment including the use of LIMA in
      selected cases, should be offered to this group of patients, even in the presence
      of moderate LV dysfunction.

PMID- 7775544
TI  - The management of soft tissue complications related to pacemaker implantations.
AB  - During the last six years (1988-1993) we have treated 15 patients suffering from
      soft tissue problems related to pacemaker implantations which included: skin
      erosions (2 patients), impending extrusion of the pacemaker pulse generator due
      to capsular contracture (4 patients), exposed pacemaker generator (6 patients),
      and exposed electrode (3 patients). This article describes a conservative
      approach to the treatment of these complications. Skin erosions are treated
      topically with antibacterial creams or solutions. Local infection is controlled
      by the administration of systemic antibiotics according to the antibiogram, as
      well as with local antibacterial dressings. Impending extrusion or exposure of
      the pacing system are treated by subcapsular relocation of the pacemaker
      generator or vertical-to-horizontal transposition of the exteriorized lead. These
      restricted local surgical interventions are designed to overcome the vertical
      force which tends to cause the extrusion of pacing hardware without using another
      implantation site which are already limited in number. This approach, which can
      be repeated, prevents the reintroduction of a new pacing system. The pre
      operative evaluation, surgical techniques and a long term follow-up are
      presented.

PMID- 7775543
TI  - Transvenous implantable cardiovascular defibrillator lead system: experience in
      28 patients.
AB  - Morbidity and mortality following Automatic Implantable Cardioverter
      Defibrillation (AICD) is mostly related to thoracotomy performed during placement
      of epicardial leads. From July 1991 to January 1994, a transvenous lead system
      (TLS) (Endotak C; CPI) was implanted in 28 patients (24 males, 4 females, age 15
      76 years) who suffered from life threatening ventricular tachyarrhythmias. Twenty
      four patients had a previous MI, mean LVEF was 26% (14-65%), two had mitral valve
      prolapse (one with prolonged QT), one had hypertrophic and another had dilated
      cardiomyopathy. The implantation procedure was performed in the operating room (n
      = 26) or in the Cath lab. (n = 2). Nineteen (out of the 28) patients were treated
      with Amiodarome before implantation (5 out of 7 had LVEF < 30%). A satisfactory
      defibrillation threshold (DFT) was achieved using Endotak lead alone in 22 (79%)
      patients. These patients had LVEF between 10% to 65% (less than 30% in three
      patients). In six patients the DFT was measured as lower than 20 J, and a
      subcutaneous patch was added (LVEF 12-38%, 4 patients with Amiodarome therapy).
      The implanted devices were all from CPI: 1600 (n = 5), PRX (n = 7), P2 (n = 15),
      PRX II (n = 1). During a 1-32 months of follow-up one patient died from severe
      CHF. The implanted device operated in 9/28 patients. The only complication
      related to implantation was infection at the pocket site (n = 2), which responded
      to antibiotic therapy in one patient, but required device explantation in another
      patient. The device was reimplanted in that patient three month later, with no
      further complications.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775545
TI  - Ruptured aneurysm of the sinus of Valsalva. Clinical review, treatment results.
AB  - Five patients were operated on because of ruptured aneurysm of the sinus of
      Valsalva. In the cases with no concomitant VSD the surgical access from the aorta
      was used. The aorta was opened and the Fogarty catheter was introduced to the
      fistula. The "wind sock" of the aneurysm was pulled back to the aorta and
      excised. The opening was closed with double-line pledgetted polypropylene
      sutures. In severe aortic incompetence mechanical prostheses were implanted. One
      patient had bacterial endocarditis with reopening of the fistula and aortic valve
      incompetence that required reoperation. All patients are in a good clinical
      state. We recommend the use of Dacron patches even in small aneurysms to avoid re
      opening of the fistula.

PMID- 7775546
TI  - Cryopreservation of veins as an alternative to autografts in coronary by-pass
      grafting.
AB  - Cryopreserved venous segments could be used as allografts in coronary by-pass
      surgery in patients with limited availability of venous or arterial conduits for
      autologous grafting. After primarily disappointing clinical results it was the
      aim of these experiments to improve freezing procedure and incubation media in
      order to maintain most of the functional integrity of the biological material
      after cryopreservation, and thus to contribute to the essential prerequisites for
      a successful implantation. Freshly prepared segments of human saphenous vein were
      cryopreserved: 1) using various computer-assisted freezing programs with definite
      cooling rates and seeding temperatures; 2) after incubation in media consisting
      of RPMI 1640 and cryoprotective agents in different combinations and
      concentrations. The veins were stored at -196 degrees C, thawed quickly and
      analyzed in an in vitro perfusion system. The degree of vitality of the vein
      segments was assessed by measuring vasoconstriction after application of
      Norepinephrine and Serotonine and vasodilatation following release of endothelium
      derived relaxing factor (EDRF) after perfusion with Acetylcholine. Our results
      show that the preservation of vascular smooth muscle can be maintained only by:
      1) equilibrating the vein in RPMI 1640 with 2.2 M Glycerol and 1.6 M Ethylene
      Glycol and 2) preventing an increase of temperature during the crystallization in
      the cooling process. The results clearly demonstrate the maintainance of vitality
      in vein segments after an appropriate freezing and equilibration process with
      specific cryoprotective agents. The data obtained in the study could serve as the
      basis for a better longterm prognosis of transplanted cryopreserved venous
      allografts.

PMID- 7775547
TI  - Coronary artery by-pass without cardiopulmonary by-pass for patients with severe
      left ventricular dysfunction.
AB  - OBJECTIVES: To evaluate results of coronary artery bypass grafting (CABG) without
      cardiopulmonary by-pass (CPB) for patients with severe left ventricular
      dysfunction. MATERIALS AND METHODS: Fifty-three patients with severe LV
      dysfunction (EF < 35%) underwent CABG without cardiopulmonary by-pass (CPB)
      between December 1991 and December 1993. They comprise 22% of 242 patients
      operated on without CPB by one of the authors (RM) in this period. There were 45
      (85%) males and eight (15%) females. Twelve (23%) patients were over 70 years.
      Nine (17%) were re-do CABG. Ten (19%) were referred for operation within the
      first 24 hours of evolving MI, and 13 (25%) up to two weeks after acute MI. Nine
      (17%) had preoperative EF < 20%, and six patients (11%) were in cardiogenic
      shock. Mean number of grafts/pt was 1.8 and IMA was used in 41 (77%). Only 14
      patients (26%) received a graft to a circumflex marginal artery. Ischemic time
      was 8 +/- 4 min/graft (mean +/- SD) when anastomosed to the LAD or RCA, and 14 +/
      7 min/graft when anastomosed to a marginal branch. RESULTS: One patient (1.9%)
      died perioperatively, and two (3.7%) suffered a non-fatal MI. At two-year follow
      up there were three late deaths, one of them from cancer. Three patients had
      return of angina, two of them were reoperated upon. CONCLUSIONS: These results
      suggest that CABG without CPB may be advantageous for patients with severe LV
      dysfunction.

PMID- 7775548
TI  - Perioperative infusion of nifedipine and metoprolol provides antiischemic and
      antiarrhythmic protection in patients undergoing elective aortocoronary by-pass
      surgery.
AB  - A randomised study was performed on 70 patients undergoing elective coronary by
      pass procedure to examine whether the combined, perioperative, 24-hour infusion
      of nifedipine and metoprolol reduces the incidence of perioperative myocardial
      ischemia and arrhythmias. The control group received nifedipine only. Repeated
      assessments of serum enzyme levels and 12-lead-ECG together with a 3-channel
      Holter monitoring over 48h were used to classify perioperative myocardial
      ischemia and supraventricular and ventricular arrhythmias. The two groups did not
      differ with respect to their demographic data, extracorporeal circulation, aortic
      cross-clamping time, or number of distal anastomosis. No perioperative myocardial
      infarction in either group was detected. However, a significantly lower incidence
      of transient ischemic event was observed in the NM group as compared transient
      ischemic events was observed in the NM group as compared to the N group. In
      addition, there was a tendency towards lower CK-MB-level and peak-values of CK-
      and CK-MB-enzymes in the NM group. With regard to perioperative dysrhythmias,
      there was a significantly lower incidence of sinus tachycardia and atrial
      flutter/fibrillation in the NM group as compared to the N group. In addition,
      postoperative heart rate was lower in the NM group starting from the 6th hour
      after opening the aortic cross-clamp. In conclusion, the combined perioperative
      infusion of nifedipine and metoprolol is superior in preventing perioperative
      myocardial ischemia and decreasing the incidence of supraventricular arrhythmias
      as compared to a single-drug regimen with nifedipine.

PMID- 7775549
TI  - Total preservation of chordae tendinae in mitral valve replacement (MVR).
AB  - Chordal papillary integrity is crucial for a good left ventricular performance
      following mitral valve surgery. From June 1991-July 1993 (2 years), 200 mitral
      surgeries were performed by the authors out of which MVR were done by preserving
      all chordae tendineae in 36 patients (18%), ages 11-64 years (mean 36 +/- 13.2
      SD), female to male ratio 3:1, New York Heart Association (NYHA) functional class
      III-IV. Preoperative workup revealed pure mitral stenosis (MS) in 12 patients
      (33%), mitral regurgitation (MR) in 16 (44%), MS + MR in 7 (19%), MS + aortic
      regurgitation (AR) in 4 (11%), MR + secundum atrial septal defect (ASD) in 2
      (6%), MR + primum ASD in 1, MR + coronary artery disease (CAD) in 1 (3%) and
      moderate to severe pulmonary hypertension in all. Twenty-two patients (61%) had
      MVR only, 4 (11%) had MVR + aortic valve replacement (AVR), 10 (29%) had MVR +
      tricuspid annuloplasty (TVA), MVR + secundum ASD closure in 2 (6%), MVR+primum
      ASD closure in 1 (3%) and MVR + coronary artery bypass grafting (CABG) in 1 (3%).
      Bioprosthesis used were: St. Vincents 17 (47%) and Carpentier Edwards 2 (6%).
      Mechanical valves used were: St. Jude's 1 (3%), Bjork-Shiley 2 (6%), St. Vincents
      5 (14%), CarboMedics 9 (25%). Success of the procedure were accomplished in all
      (100%) and was judged by extubation period of 6-18 hours, decreased pulmonary
      artery pressure, good prosthetic function and adequate ventricular performance by
      subsequent echocardiographic assessments. There were no early (< 30 days)
      mortality. All patients showed NYHA functional class I-II except in one with
      Marfan syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775550
TI  - Thoraco-abdominal aneurysm resection. Determinants of survival in a community
      hospital.
AB  - Twenty-five patients who underwent resection of a thoraco-abdominal aneurysm
      between 1985-1993 were reviewed to study determinants of survival in patients
      undergoing the procedure in a community hospital. Twelve procedures were
      performed electively, six urgently and seven emergently. Type I aneurysm was
      present in one patient (n = 1), Type II n = 7; Type III n = 5 and Type IV = 12.
      Hypertension (n = 17), cardiac disease (n = 10) and renal insufficiency (n = 4)
      were most common risk factors. Aneurysms were repaired using inclusion method
      without special techniques for renal or spinal cord preservation. Eighteen
      patients survived and were discharged; four patients died 30 days and three
      patients died 30 days. Causes of death were multisystem failure (n = 3), acute
      myocardial infarction (n = 2) coagulopathy (n = 1) and bowel infarction (n = 1).
      Major complications included renal failure (n = 2) myocardial infarction (n = 3),
      bleeding (n = 3), paraplegia (n = 1). Statistical significance was determined
      using Fisher's exact test-2 tail. Risk factors for death and complication
      included emergency or urgent surgery (4 deaths-emergent, 2 deaths-urgent) and
      preoperative renal insufficiency (2 deaths; 1 dialysis) 52% of patients in a
      community hospital setting underwent emergent or urgent operation and this
      accounted for 87% of deaths and most morbidity. Mortality in elective procedures
      was 8%. Based on this data, we believe that thoracoabdominal aneurysm resection
      can be reasonably undertaken in a community-type hospital.

PMID- 7775551
TI  - A half century of cardiovascular surgery: reflections.

PMID- 7775552
TI  - Porcine stentless aortic heart valve substitute mid-term clinical follow-up.
AB  - From May 1990 to January 1994, 120 patients underwent aortic valve replacement
      with the use of the Biocor porcine aortic stentless heart valve (BPASHV). There
      were 83 male and 3 female patients. The age ranged from 11 seventy-six (76) years
      with a mean of 36. Eighty-five patients were under 40 years of age. Sixty-four
      patients underwent their first aortic valve replacement due to rheumatic heart
      disease, 30 because of prosthetic valve failure and of those: 20 were due to
      primary tissue failure and in 10 due to prosthetic endocarditis, native aortic
      bicuspid valve in 11 and senile calcificant aortic valve disease in four. Thirty
      three patients had aortic annular related pathology. Their preoperative
      functional class revealed 61 patients in class III and 59 in class IV. The
      longest follow-up in this aortic group was 42 months with a mean of 26. The
      surgical technique used rendered consistent and reproducible results. There was a
      hospital mortality of six patients (5%). The mortality was not valve related. The
      hospital morbidity in 14 revealed full recovery of all patients. There were four
      late reoperations, in two due to recurrent endocarditis and in the last two
      because of paravalvar leak. There was a late mortality of four patients (non
      valve related). The follow-up of these patients revealed full competent aortic
      stentless valve in 97 patients and only minor jet in nine. Most patients are in
      functional class I and II. The Aortic stentless concept has proven to be
      outstanding with the use of the Biocor Aortic stentless valve throughout the
      current follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775553
TI  - Allograft aortic valve replacement. A comparison of the free-hand technique
      versus aortic root replacement.
AB  - OBJECTIVE: Comparing the results of aortic valve replacement (AVR) with
      cryopreserved allografts using two operative techniques: the free-hand and aortic
      root replacement. DESIGN AND SETTING: A cohort study in a tertiary care center.
      PATIENTS: Fifty eight patients underwent allograft AVR during the years 1987
      1994. The free-hand technique was used in 40 patients (group A) and aortic root
      replacement in 18 (group B). OUTCOME MEASURES: Perioperative morbidity,
      mortality, blood transfusion requirement and length of hospital stay. Mid-term
      survival, functional class and valve related complications. RESULTS: Early
      mortality-2 patients (11%) in group B, none in group A (p = 0.09). Patients in
      group B received more donor exposure from blood products than group A (28.4 +/-
      29.8 donors versus 3.8 +/- 6.1 donors, p < 0.00001). Perioperative complications
      occurred more often in group B (p = 0.042). However, the length of hospital stay
      was similar. Long-term follow-up ranged from 1 to 73 months (median 43 months).
      There was one non-valve related late death. No recurrence of endocarditis, or
      thromboembolic events were observed. 96% of the patients were in NYHA class I or
      II. Of these, echocardiogram showed trace or no aortic regurgitation (AR) in 96%.
      In group A one allograft was rereplaced with a mechanical valve for a technical
      failure, and mild and moderate AR were documented in two patients. This was not
      significantly different from group B. CONCLUSIONS: Aortic allograft durability at
      6 years is excellent and the overall valve-related complication rate is extremely
      low. The differences between the two groups were too small to demonstrate a clear
      cut superiority to any of the techniques. However, our results suggest that
      aortic root replacement is associated with increased early morbidity and
      mortality when used for more complex aortic valve and aortic root pathology,
      whereas the free-hand technique may be associated with more mid-term valvular
      insufficiency.

PMID- 7775554
TI  - Porcine stentless mitral heart valve substitute: short term clinical data.
AB  - Beginning March 1992 to February 1994, 65 patients were submitted to mitral valve
      replacement using the porcine mitral stentless heart valve. This group took in 65
      patients, their age ranged from four to 65 with a mean of 26 years. Forty
      patients were below years of age. The major indication was rheumatic heart
      disease sequelae in 50 patients, mitral valve endocarditis in six, myomatous
      degeneration in four and in five previous mitral prosthetic valve was replaced
      due to tissue failure. The preoperative functional class revealed 35 patients in
      class III and 30 in class IV. The longest follow-up was 23 months with a mean of
      12. The surgical technique used rendered consistent and reproducible results.
      There was a hospital mortality of two patients or 3.1%. The hospital morbidity
      revealed full recovery of all patients. There were three patients reoperated
      because of valve endocarditis in two and in one due to partial dehiscence of the
      suture at the annular level. All three patients had full recovery after a
      reoperation. There was a late mortality of two patients, non valve related. The
      follow-up of these patients revealed full competent stentless mitral valve in 50
      patients and in nine minor to mild jets were encountered by color echo-Doppler.
      Most patients are in functional class I and II. The stenless concept has prove to
      be outstanding in the mitral position throughout the current follow-up of close
      to 2 years.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775555
TI  - Optimal approach for mitral valve surgery.
AB  - It seems that mitral valve (MV) replacement technique is already standardized but
      still under discussion is the surgical approach. At Heart Surgery Clinic of
      Vilnius University MV replacement was started in 1970 (our total experience in
      valve surgery is 4396 operations). The most popular surgical approach was through
      left atrium (LA) from the right side. In cases with small atrium we used right
      atrial and transseptal and transverse transeptal biatrial (TTBA) approach. Left
      atrium approach is quite useful in many cases except those with small LA, LV
      hypertrophy and heart rotation when it can result a greater trauma for the heart,
      extended time of operation and, possibly, reduced performance after it. From
      September 1992 till May 1993 we used extended vertical transseptal (EVT) approach
      in 18 patients for MV replacement or repair, mitral and aortic valve replacement
      was performed for 5 patients, mitral valve replacement and tricuspid
      valvuloplasty for 13 patients, 5 patients had mitral valve reoperations and for 3
      patients aortocoronary by-pass performed additionally. The technique used was
      exactly as proposed by O. Alfieri et al, and incorporated bicaval cannulation and
      vertical transseptal incision extended into the roof of LA. From the first
      operation it became clear that this approach was superior to all others we had
      used during 20 years, since it gives perfect visibility of mitral valve, does not
      require retractors (only traction sutures are applied) and allows even to very
      easily use the continuous suture for valve fixation. Size of LA is no longer
      important.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775556
TI  - Early multicentre experience with the Jyros Bileaflet solid pyrolitic carbon
      rotating valve.

PMID- 7775557
TI  - Mechanical assistance as a bridge to transplantation different indications for
      different devices.

PMID- 7775558
TI  - Coronary by-pass reoperations without cardiopulmonary by-pass: the Israeli
      experience.
AB  - OBJECTIVES: To evaluate results of coronary artery by-pass grafting (CABG)
      reoperations without cardiopulmonary by-pass (CPB). MATERIALS AND METHODS: Thirty
      two patients underwent CABG reoperation with CPB between December 1991 and
      December 1993. There were 29 (91%) males, and 3 (9%) females. Mean age was 62 +/-
      7 years. Five (16%) were operated on emergently, two (6%) of them during
      cardiogenic shock. Three (9%) were referred for operation up to two weeks
      following acute MI. Six (19%) had preoperative EF < 35%. Significant associated
      systemic diseases included previous CVA in two patients (6%), calcified aorta in
      two (6%), peripheral vascular disease in six (19%), renal failure in one (3%),
      and severe COPD in one (3%). Mean number of grafts/pt was 1.5 (range 1-3), and
      IMA was used in 26 (81%) of patients. Only nine patients (28%) received a graft
      to a circumflex marginal artery, six (66%) of whom were operated on through left
      thoracotomy. RESULTS: Only two patients (6%) had low output syndrome
      postoperatively; one was supported with catecholamines, and the other with
      intraaortic balloon pump. Hospital stay was 6.1 +/- 1.5 days (mean +/- SD). Early
      unfavorable outcome included operative death in one patient (3.1%), non-fatal MI
      in two (6%), and sternal infection in one (3%). Follow-up (10 +/- 5 months, mean
      +/- SD) showed two late deaths (one cardiac, and one carcinoma), one (3%) non
      fatal MI, and return of angina in three (9%) patients. CONCLUSIONS: CABG
      reoperations without CPB should be considered, particularly for revascularization
      of the LAD and RCA systems. Left thoracotomy is optional for patients with
      disease confined to circumflex and LAD systems.

PMID- 7775559
TI  - Therapy and results of surgery: requiring infarction complications. An 8-year
      experience.
AB  - Among myocardial infarction (MI) secondary complications requiring surgical
      intervention, the primary sequel is the left ventricular aneurysm (LVA), as a
      matter of fact, the ventricle septum rupture (VSR) and the moderate to severe
      ischemic mitral valve regurgitation (IMR) are common as secondary or third follow
      ones. Between June 1985 and June 1993 in our department, we performed 6418
      operations with the support of the heart-lung-machine. This number includes 74
      (1.15%) operations of MI complications; 38 interventions because of LVA, 18
      operations because of IMR and 18 surgical corrections of VSR. In the great
      majority of cases a myocardial revascularization was performed simultaneously.
      Preoperatively the distribution of the whole patient population according to the
      functional NYHA classification was as follows: NYHA class I: 0, class II: 0,
      class III: 36 (48.6%), class IV: 27 patients (36.5%) and cardiogenic shock: 11
      patients (14.9%). LVA surgery consists in aneurysmectomy and linear closure or
      endoventricular patch reconstruction, VSR was closed with synthetic patch
      material and the correction of IMR was performed mainly through partial resection
      and replacement with a prosthetic valve. Our early mortality was 13.1% for the
      LVA, 38.8% for the VSR and 11.1% for the IMR patient population, which was
      congruent with the rates quoted in current literature. The patient follow-up was
      done within a period of 6 to 90 months after discharge and the available results
      are very good. Late mortality was 15%. The actuarial survival rat after 7 years
      was 85% for the LVA, 82% for the VSR and 87% for the IMR patient
      population.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775560
TI  - Airway obstruction in neonates and children: surgical treatment.
AB  - OBJECTIVE: This review of 54 infants and children with airway obstruction who
      were treated surgically emphasizes the importance of the surgical indications
      with respect to various anomalies causing airway obstruction and the surgical
      approach to their management. PATIENTS: There were 4 etiologic groups of airway
      obstruction. Group A comprised 12 infants with subglottic stenosis; Group B--20
      infants with tracheomalacia; 21 patients (Group C) with anatomic narrowing of the
      trachea; and 1 infant (Group D) with laceration of a main bronchus. METHODS: The
      surgical procedures performed included anterior laryngotracheal decompression in
      12 infants, aortopexy in 19; 1 pulmonary arteriopexy; tracheal stenting with an
      autologous rib graft in 3 and with Marlex mesh in 1. Tracheal widening, using a
      free tibia autologous graft, was performed in 3 patients; transbronchoscopic
      excision in 12; anterior tracheal wedge resection in 4, and segmental tracheal
      resection and anastomosis in 1 patient. The lacerated bronchus was repaired with
      fine Dexon sutures. RESULTS: There were no operative deaths. With respect to the
      original indications for surgery, there were 3 failures--2 in Group A and 1 in
      Group C. Two patients died from causes unrelated to the procedures--one 10 days
      postoperatively, and the other 3 months after surgery. CONCLUSIONS: The surgical
      approach to tracheal obstruction in infants and children offers effective
      treatment, with no operative mortality, a low complication rate, and good long
      term survival.

PMID- 7775561
TI  - Geometric reconstruction in left ventricular aneurysm. Surgical aspects and early
      results.
AB  - The early results of 79 patients who underwent left ventricular aneurysmectomy
      with geometric and circular reconstruction in a seven-year experience are
      analyzed. The most common indication for operation was congestive heart failure
      (78.4%), either isolated (25.3%) or with angina (53.1%). Sixty patients (76%)
      were in NYHA class III and 10 (12.6%) in NYHA class IV at the time of surgery.
      Fifty-eight (73.4%) underwent coronary artery by-pass graft surgery. Hospital
      mortality was 5.1%, in patients older than 60 (12%), in NYHA class IV (20%), with
      poor left ventricular function (EF < 0.30-20% and LVED > 25) (14%), and with
      extensive coronary artery disease (10%) were under increased risk. Low cardiac
      output and use of intra-aortic balloon pump were also associated risk factors.
      Other risk factors mentioned in the literature are discussed. There were no
      deaths from isolated left ventricular aneurysmectomy. The early results of this
      study and the early and late results of others using the same technique are
      better than the results obtained in previous studies of different types of
      correction, suggesting that this is the procedure of choice for treating left
      ventricular aneurysm.

PMID- 7775562
TI  - Value of dobutamine/nitrate radionuclide angiography in predicting
      revascularization effects on ventricular function.
AB  - OBJECTIVE: Dobutamine and Nitrate Radionuclide Angiography (RNA) may help to
      distinguish viable from nonviable myocardium and to predict revascularization
      effects on LV function. SETTING: Ambulatory. EXPERIMENTAL DESIGN: Prospective.
      PATIENTS AND METHODS: We studied 12 patients (11 male, 1 female; mean age 56 +/-
      10 years) with three-vessel disease, severe LV dysfunction, and prior MI for a
      mean follow-up time of 10 +/- 3.4 months. Thallium-201 scintigraphy favored
      potential viability in all patients: inducible ischemia with satisfactory
      perfusion in more than one coronary arterial territory. Global and regional
      LVEF's were calculated from preoperative RNA (baseline rest study and with
      continuous dobutamine infusion with gradual rate increase plus oral nitrates) and
      postoperative RNA at 1 and 6 months. RESULTS: There was no operative mortality,
      but two late deaths occurred. Symptomatically, most patients showed improvement.
      Global LVEF increased during dobutamine and nitrates preoperatively (p < 0.01),
      but not at 1 and 6 months postoperatively (without pharmacological intervention).
      Mean LVED volume was not significantly changed postoperatively. Regional EF
      improvement was found in 4 out of 9 LV wall segments under dobutamine and
      nitrates, and this increase persisted postoperatively at 1 and 6 months.
      CONCLUSIONS: Mild but significant increase in global LVEF during dobutamine and
      nitrates administration is not predictive of postoperative LVEF improvement.
      However, regional EF improvement appears to be predictive of post
      revascularization LV functional improvement.

PMID- 7775563
TI  - Crystalloid versus blood cardioplegia in coronary by-pass surgery. A prospective,
      randomized, controlled study in 100 consecutive adults.
AB  - In a prospective randomized trial we investigated the benefit of blood versus
      asanguinous cardioplegia in routine coronary by-pass grafting. One hundred
      consecutive adult patients were randomly assigned to two groups: Group A (53
      patients) received cold blood cardioplegia and group B (47 patients) had standard
      St. Thomas solution. In all patients we combined ante- and retrograde
      administration, in group A warm reperfusion was carried out before aortic
      declamping. Aortic cross clamp times, amount of cardioplegic solution and blood
      potassium levels at the end of cardio-pulmonary by-pass were higher in group A
      than in group B. The need for inotropic support at the end of the operation as
      well as in the postoperative period was more frequent in the crystalloid
      cardioplegia group. The occurrence of atrial fibrillation showed no clear
      correlation to the kind of cardioplegia used. Perioperative infarction was less
      frequent in the blood cardioplegia group (3.7% vs 6.3%; p < 0.01) and 30-day
      mortality was nil (0% vs 3.2%; p < 0.01). Hospital stay did not differ between
      the two groups. In this clinical trial we could demonstrate the superiority of
      blood versus crystalloid cardioplegia in routine coronary by-pass grafting. Ante-
      and retrograde delivery of cold blood cardioplegia followed by warm reperfusion
      is a safe and simple method yielding satisfactory results.

PMID- 7775564
TI  - Arterial revascularisation with the conjoined double internal mammary artery
      grafting.
AB  - A free graft Internal Mammary Artery (IMA) was proximally connected end-to-side
      to an in-situ IMA in 6 patients, a method we have named: "The conjoined double
      IMA". This alternative surgical technique was applied in patients where important
      vessels had to be grafted in presence of diseased aortic wall, insufficient
      supply of adequate veins, or a mammary not long enough, thus precluding the
      performance of other, more conventional methods for Double IMA grafting. Early
      clinical and angiographic follow-up demonstrate the feasibility of this technique
      in selected patients.

PMID- 7775565
TI  - The effects on blood flows of coronary artery by-pass grafts during intra-aortic
      balloon pumping.
AB  - The internal thoracic artery (ITA), as well as aorto-coronary by-pass grafts, has
      been used for widely coronary artery by-pass grafting. Intra-aortic balloon
      pumping (IABP) is the first choice for left ventricular support when low output
      syndrome occurs during coronary artery by-pass surgery. However, the effect of
      diastolic augmentation by IABP may vary to the type of grafts. Graft flow with
      and without IABP support were measured in six patients undergoing elective
      coronary artery bypass surgery requiring IABP at Kanazawa National Hospital. The
      patients ranged in age from 59 to 67 years, with a mean age of 63 years, and
      included one woman and five men. In all cases, the left ITA was dissected from
      the thoracic wall as pedicle, and anastomosed in situ to the left anterior
      descending artery. Saphenous vein grafts (SVGs) were used for aortocoronary by
      pass to the obtuse marginal branches, the first diagonal branches, the left
      circumflex branches, and/or the right coronary artery. Blood flow in 6 ITAs, 11
      SVGs to the left coronary artery systems, and three SVGs to the right coronary
      artery was measured by ultrasound transit-time flowmeter simultaneously with the
      electrocardiogram. Blood flows in ITA grafts and SVGs were measured during IABP
      assist and unassisting under hemodynamically stable conditions after
      discontinuing cardiopulmonary by-pass. The systolic and diastolic flows of each
      graft were measured using the peak of the R wave and the end of T wave on the
      electrocardiogram as the references for systole. Systolic flow during IABP were
      similar to unassisted flow in both ITA and SVGs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775566
TI  - The many faces of hepatocyte growth factor: from hepatopoiesis to hematopoiesis.

PMID- 7775567
TI  - Microinjection of mitotic cells with the 3F3/2 anti-phosphoepitope antibody
      delays the onset of anaphase.
AB  - The transition from metaphase to anaphase is regulated by a checkpoint system
      that prevents chromosome segregation in anaphase until all the chromosomes have
      aligned at the metaphase plate. We provide evidence indicating that a kinetochore
      phosphoepitope plays a role in this checkpoint pathway. The 3F3/2 monoclonal
      antibody recognizes a kinetochore phosphoepitope in mammalian cells that is
      expressed on chromosomes before their congression to the metaphase plate. Once
      chromosomes are aligned, expression is lost and cells enter anaphase shortly
      thereafter. When microinjected into prophase cells, the 3F3/2 antibody caused a
      concentration-dependent delay in the onset of anaphase. Injected antibody
      inhibited the normal dephosphorylation of the 3F3/2 phosphoepitope at
      kinetochores. Microinjection of the antibody eliminated the asymmetric expression
      of the phosphoepitope normally seen on sister kinetochores of chromosomes during
      their movement to the metaphase plate. Chromosome movement to the metaphase plate
      appeared unaffected in cells injected with the antibody suggesting that
      asymmetric expression of the phosphoepitope on sister kinetochores is not
      required for chromosome congression to the metaphase plate. In antibody-injected
      cells, the epitope remained expressed at kinetochores throughout the prolonged
      metaphase, but had disappeared by the onset of anaphase. When normal cells in
      metaphase, lacking the epitope at kinetochores, were treated with agents that
      perturb microtubules, the 3F3/2 phosphoepitope quickly reappeared at
      kinetochores. Immunoelectron microscopy revealed that the 3F3/2 epitope is
      concentrated in the middle electronlucent layer of the trilaminar kinetochore
      structure. We propose that the 3F3/2 kinetochore phosphoepitope is involved in
      detecting stable kinetochore-microtubule attachment or is a signaling component
      of the checkpoint pathway regulating the metaphase to anaphase transition.

PMID- 7775568
TI  - Structural interaction between the nuclear pore complex and a specific
      translocating RNP particle.
AB  - The transport of Balbiani ring (BR) premessenger RNP particles in the larval
      salivary gland cells of the dipteran Chironomus tentans can be followed using
      electron microscopy. A BR RNP particle consists of an RNP ribbon bent into a
      ringlike structure. Upon translocation through the nuclear pore complex (NPC),
      the ribbon is straightened and enters the central channel of the NPC with the 5'
      end of the transcript in the lead. The translocating ribbon is likely to interact
      with the central channel but, in addition, the remaining portion of the ribbon
      ring makes contact with the periphery of the NPC. To determine the nature of this
      latter interaction, we have now studied the connections between the RNP particle
      and the border of the NPC during different stages of translocation using electron
      microscope tomography. It was observed that the 3' terminal domain of the ribbon
      always touches the nuclear ring of the NPC, but the precise area of contact is
      variable. Sometimes also a region on the opposite side of the ribbon ring reaches
      the nuclear ring. The pattern of contacts could be correlated to the stage of
      translocation, and it was concluded that the particle-nuclear ring interactions
      reflect a rotation of the ribbon ring in front of the central channel, the
      rotation being secondary to the successive translocation of the ribbon through
      the channel. The particle's mode of interaction with the NPC suggests that the
      initial contact between the 5' end domain of the ribbon and the entrance to the
      central channel is probably crucial to accomplish the ordered translocation of
      the premessenger RNP particle through the NPC.

PMID- 7775569
TI  - Efficient endosomal localization of major histocompatibility complex class II
      invariant chain complexes requires multimerization of the invariant chain
      targeting sequence.
AB  - During biosynthesis, MHC class II-invariant chain complexes are transported into
      endosomal compartments where invariant chain (Ii) is degraded and class II
      encounters antigenic peptides. One of the signals that determines this
      intracellular transport route has been localized to the cytosolic domain of Ii.
      Deletion of this signal disrupts endosomal targeting and results in the stable
      expression of class II-Ii complexes at the surface. In this paper we have
      examined the role of Ii trimerization on the generation of this endosomal
      localization signal. In L cell transfectants expressing class II and both wild
      type Ii and a truncated form of Ii that lacks this endosomal localization signal,
      Ii was found to form multimers which could contain both wild type and truncated
      Ii. The multimers were not large aggregates but were found to be discrete
      complexes, probably the nine molecule class II-Ii complex that has been observed
      in human B cells. The co-expression of truncated Ii allowed for cell surface
      expression of a subset of wild type Ii. This surface-expressed wild type Ii
      associated with truncated Ii in multimers at a 2:1 ratio, indicating that these
      trimers contain two truncated and one wild type Ii molecule. These data suggest a
      division in trafficking of Ii trimers: if two wild type Ii molecules are present,
      the complex is transported to and rapidly degraded in endosomes, whereas the
      presence of only one wild type Ii results in trafficking and expression of the
      heterotrimer on the cell surface. Following surface arrival, complexes containing
      only a single wild type Ii molecule are internalized more rapidly and have a
      shorter half-life than complexes containing only truncated Ii molecules. These
      data suggest that although a single Ii cytosolic domain can function as a plasma
      membrane internalization signal, multimerization of Ii is required for efficient
      Golgi complex to endosome targeting of class II-Ii complexes.

PMID- 7775570
TI  - "Synchronized" endocytosis and intracellular sorting in alveolar macrophages: the
      early sorting endosome is a transient organelle.
AB  - Incubation of alveolar macrophages in hypoosmotic K(+)-containing buffers results
      in persistent cell swelling and an inability to undergo regulatory volume
      decrease. We demonstrate that cells incubated in hypo-K+ show an inhibition of
      endocytosis without any observed alteration in recycling. The inhibition of
      endocytosis affected all forms of membrane internalization, receptor and fluid
      phase. Both increased cell volume and the inhibition of endocytosis could be
      released upon return of cells to iso-Na+ buffers. The ability to synchronize the
      endocytic apparatus allowed us to examine hypotheses regarding the origin and
      maturation of endocytic vesicles. Incubation in hypo-K+ buffers had no effect on
      the delivery of ligands to degradative compartments or on the return of
      previously internalized receptors to the cell surface. Thus, membrane recycling
      and movement of internalized components to lysosomes occurred in the absence of
      continued membrane influx. We also demonstrate that fluorescent lipids, that had
      been incorporated into early endosomes, returned to the cell surface upon
      exposure of cells to hypo-K+ buffers. These results indicate that the early
      sorting endosome is a transient structure, whose existence depends upon continued
      membrane internalization. Our data supports the hypothesis that the transfer of
      material to lysosomes can best be explained by the continuous maturation of
      endosomes.

PMID- 7775571
TI  - Apical and basolateral coated pits of MDCK cells differ in their rates of
      maturation into coated vesicles, but not in the ability to distinguish between
      mutant hemagglutinin proteins with different internalization signals.
AB  - In polarized epithelial MDCK cells, all known endogenous endocytic receptors are
      found on the basolateral domain. The influenza virus hemagglutinin (HA) which is
      normally sorted to the apical plasma membrane, can be converted to a basolateral
      protein by specific mutations in its short cytoplasmic domain that also create
      internalization signals. For some of these mutations, sorting to the basolateral
      surface is incomplete, allowing internalization of two proteins that differ by a
      single amino acid of the internalization signal to be compared at both the apical
      and basolateral surfaces of MDCK cells. The rates of internalization of HA-Y543
      and HA-Y543,R546 from the basolateral surface of polarized MDCK cells resembled
      those in nonpolarized cells, whereas their rates of internalization from the
      apical cell surface were fivefold slower. However, HA-Y543,R546 was internalized
      approximately threefold faster than HA-Y543 at both membrane domains, indicating
      that apical endocytic pits in polarized MDCK cells retained the ability to
      discriminate between different internalization signals. Slower internalization
      from the apical surface could not be explained by a limiting number of coated
      pits: apical membrane contained 0.7 as many coated pits per cell cross-section as
      did basolateral membranes. 10-14% of HA-Y543 at the apical surface of polarized
      MDCK cells was found in coated pits, a percentage not significantly different
      from that observed in apical coated pits of nonpolarized MDCK cells, where
      internalization was fivefold faster. Thus, there was no lack of binding sites for
      HA-Y543 in apical coated pits of polarized cells. However, at the apical surface
      many more shallow pits, and fewer deep, mature pits, were observed than were seen
      at the basolateral. These results suggest that the slower internalization at the
      apical surface is due to slower maturation of coated pits, and not to a
      difference in recognition of internalization signals.

PMID- 7775572
TI  - A density-sensing factor regulates signal transduction in Dictyostelium.
AB  - Dictyostelium discoideum initiates development when cells overgrow their
      bacterial food source and starve. To coordinate development, the cells monitor
      the extracellular level of a protein, conditioned medium factor (CMF), secreted
      by starved cells. When a majority of the cells in a given area have starved, as
      signaled by CMF secretion, the extracellular level of CMF rises above a threshold
      value and permits aggregation of the starved cells. The cells aggregate using
      relayed pulses of cAMP as the chemoattractant. Cells in which CMF accumulation
      has been blocked by antisense do not aggregate except in the presence of
      exogenous CMF. We find that these cells are viable but do not chemotax towards
      cAMP. Videomicroscopy indicates that the inability of CMF antisense cells to
      chemotax is not due to a gross defect in motility, although both video and
      scanning electron microscopy indicate that CMF increases the frequency of
      pseudopod formation. The activations of Ca2+ influx, adenylyl cyclase, and
      guanylyl cyclase in response to a pulse of cAMP are strongly inhibited in cells
      lacking CMF, but are rescued by as little as 10 s exposure of cells to CMF. The
      activation of phospholipase C by cAMP is not affected by CMF. Northern blots
      indicate normal levels of the cAMP receptor mRNA in CMF antisense cells during
      development, while cAMP binding assays and Scatchard plots indicate that CMF
      antisense cells contain normal levels of the cAMP receptor. In Dictyostelium,
      both adenylyl and guanylyl cyclases are activated via G proteins. We find that
      the interaction of the cAMP receptor with G proteins in vitro is not measurably
      affected by CMF, whereas the activation of adenylyl cyclase by G proteins
      requires cells to have been exposed to CMF. CMF thus appears to regulate
      aggregation by regulating an early step of cAMP signal transduction.

PMID- 7775574
TI  - Actin filament organization in the fish keratocyte lamellipodium.
AB  - From recent studies of locomoting fish keratocytes it was proposed that the
      dynamic turnover of actin filaments takes place by a nucleation-release
      mechanism, which predicts the existence of short (less than 0.5 microns)
      filaments throughout the lamellipodium (Theriot, J. A., and T. J. Mitchison.
      1991. Nature (Lond.). 352:126-131). We have tested this model by investigating
      the structure of whole mount keratocyte cytoskeletons in the electron microscope
      and phalloidin-labeled cells, after various fixations, in the light microscope.
      Micrographs of negatively stained keratocyte cytoskeletons produced by Triton
      extraction showed that the actin filaments of the lamellipodium are organized to
      a first approximation in a two-dimensional orthogonal network with the filaments
      subtending an angle of around 45 degrees to the cell front. Actin filament
      fringes grown onto the front edge of keratocyte cytoskeletons by the addition of
      exogenous actin showed a uniform polarity when decorated with myosin subfragment
      1, consistent with the fast growing ends of the actin filaments abutting the
      anterior edge. A steady drop in filament density was observed from the mid-region
      of the lamellipodium to the perinuclear zone and in images of the more posterior
      regions of lower filament density many of the actin filaments could be seen to be
      at least several microns in length. Quantitative analysis of the intensity
      distribution of fluorescent phalloidin staining across the lamellipodium revealed
      that the gradient of filament density as well as the absolute content of F-actin
      was dependent on the fixation method. In cells first fixed and then extracted
      with Triton, a steep gradient of phalloidin staining was observed from the front
      to the rear of the lamellipodium. With the protocol required to obtain the
      electron microscope images, namely Triton extraction followed by fixation,
      phalloidin staining was, significantly and preferentially reduced in the anterior
      part of the lamellipodium. This resulted in a lower gradient of filament density,
      consistent with that seen in the electron microscope, and indicated a loss of
      around 45% of the filamentous actin during Triton extraction. We conclude, first
      that the filament organization and length distribution does not support a
      nucleation release model, but is more consistent with a treadmilling-type
      mechanism of locomotion featuring actin filaments of graded length. Second, we
      suggest that two layers of filaments make up the lamellipodium; a lower,
      stabilized layer associated with the ventral membrane and an upper layer
      associated with the dorsal membrane that is composed of filaments of a shorter
      range of lengths than the lower layer and which is mainly lost in Triton.

PMID- 7775573
TI  - A trypanosome-soluble factor induces IP3 formation, intracellular Ca2+
      mobilization and microfilament rearrangement in host cells.
AB  - Lysosomes are recruited to the invasion site during host cell entry by
      Trypanosoma cruzi, an unusual process suggestive of the triggering of signal
      transduction mechanisms. Previous studies showed that trypomastigotes, but not
      the noninfective epimastigotes, contain a proteolytically generated
      trypomastigote factor (PGTF) that induces intracellular free Ca2+ transients in
      several mammalian cell types. Using confocal time-lapse imaging of normal rat
      kidney (NRK) fibroblasts loaded with the Ca(2+)-sensitive dye fluo-3, we show
      that the initial intracellular free Ca(2+) concentration ([Ca2+]i) transient
      detected a few seconds after exposure to trypomastigote extracts is a result of
      Ca2+ release from intracellular stores. Removal of Ca2+ from the extracellular
      medium or inhibition of Ca2+ channels with NiCl2 did not affect the response to
      PGTF, while depletion of intracellular stores with thapsigargin abolished it.
      [Ca2+]i transients induced by PGTF were shown to be coupled to the activity of
      phospholipase C (PLC), since the specific inhibitor U73122 completely blocked the
      response, while its inactive analogue U73343 had no effect. In addition,
      polyphosphoinositide hydrolysis and inositol 1,4,5-trisphosphate (IP3) were
      detected upon cell stimulation with PGTF, suggesting the participation of IP3
      sensitive intracellular Ca2+ channels. An immediate effect of the signaling
      induced by PGTF and live trypomastigotes was a rapid and transient reorganization
      of host cell microfilaments. The redistribution of F-actin appeared to be a
      direct consequence of increased [Ca2+]i, since thrombin and the Ca2+ ionophore
      ionomycin produced a similar effect, with a time course that corresponded to the
      kinetics of the elevation in [Ca2+]i. These observations support the hypothesis
      that PGTF-induced disassembly of the cortical actin cytoskeleton may play a role
      in T. cruzi invasion, by facilitating lysosome access to the invasion site. Taken
      together, our findings suggest that the proteolytically generated trypomastigote
      factor PGTF is a novel agonist that acts through the PLC/phosphoinositide
      signaling pathway of mammalian cells.

PMID- 7775575
TI  - The impact of chromosomes and centrosomes on spindle assembly as observed in
      living cells.
AB  - We analyzed the role that chromosomes, kinetochores, and centrosomes play in
      spindle assembly in living grasshopper spermatocytes by reconstructing spindles
      lacking certain components. We used video-enhanced, polarization microscopy to
      distinguish the effect of each component on spindle microtubule dynamics and we
      discovered that both chromosomes and centrosomes make potent and very different
      contributions to the organization of the spindle. Remarkably, the position of a
      single chromosome can markedly affect the distribution of microtubules within a
      spindle or even alter the fate of spindle assembly. In an experimentally
      constructed spindle having only one chromosome, moving the chromosome to one of
      the two poles induces a dramatic assembly of microtubules at the nearer pole and
      a concomitant disassembly at the farther pole. So long as a spindle carries a
      single chromosome it will persist normally. A spindle will also persist even when
      all chromosomes are detached and then removed from the cell. If, however, a
      single chromosome remains in the cell but is detached from the spindle and kept
      in the cytoplasm, the spindle disassembles. One might expect the effect of
      chromosomes on spindle assembly to relate to a property of a specific site on
      each chromosome, perhaps the kinetochore. We have ruled out that possibility by
      showing that it is the size of chromosomes rather than the number of kinetochores
      that matters. Although chromosomes affect spindle assembly, they cannot organize
      a spindle in the absence of centrosomes. In contrast, centrosomes can organize a
      functional bipolar spindle in the absence of chromosomes. If both centrosomes and
      chromosomes are removed from the cell, the spindle quickly disappears.

PMID- 7775576
TI  - Acetylation of lysine 40 in alpha-tubulin is not essential in Tetrahymena
      thermophila.
AB  - In Tetrahymena, at least 17 distinct microtubule structures are assembled from a
      single primary sequence type of alpha- and beta-tubulin heterodimer, precluding
      distinctions among microtubular systems based on tubulin primary sequence
      isotypes. Tetrahymena tubulins also are modified by several types of
      posttranslational reactions including acetylation of alpha-tubulin at lysine 40,
      a modification found in most eukaryotes. In Tetrahymena, axonemal alpha-tubulin
      and numerous other microtubules are acetylated. We completely replaced the single
      type of alpha-tubulin gene in the macronucleus with a version encoding arginine
      instead of lysine 40 and therefore cannot be acetylated at this position. No
      acetylated tubulin was detectable in these transformants using a monoclonal
      antibody specific for acetylated lysine 40. Surprisingly, mutants lacking
      detectable acetylated tubulin are indistinguishable from wild-type cells. Thus,
      acetylation of alpha-tubulin at lysine 40 is non-essential in Tetrahymena. In
      addition, isoelectric focusing gel analysis of axonemal tubulin from cells unable
      to acetylate alpha-tubulin leads us to conclude that: (a) most or all ciliary
      alpha-tubulin is acetylated, (b) other lysines cannot be acetylated to compensate
      for loss of acetylation at lysine 40, and (c) acetylated alpha-tubulin molecules
      in wild-type cells contain one or more additional charge-altering modifications.

PMID- 7775577
TI  - Structure of growing microtubule ends: two-dimensional sheets close into tubes at
      variable rates.
AB  - Observation of microtubule growth at different rates by cryo-electron microscopy
      reveals that the ends range from blunt to long, gently curved sheets. The mean
      sheet length increases with the growth rate while the width of the distributions
      increases with the extent of assembly. The combination of a concentration
      dependent growth rate of the tubulin sheet with a variable closure rate of the
      microtubule cylinder, results in a model in which stochastic fluctuations in
      sheet length and tubulin conformation confine GTP-tubulins to microtubule ends.
      We propose that the variability of microtubule growth rate observed by video
      microscopy (Gildersleeve, R. F., A. R. Cross, K. E. Cullen, A. P. Fagen, and R.
      C. Williams. 1992. J. Biol. Chem. 267: 7995-8006, and this study) is due to the
      variation in the rate of cylinder closure. The curvature of the sheets at the end
      of growing microtubules and the small oligomeric structures observed at the end
      of disassembling microtubules, indicate that tubulin molecules undergo
      conformational changes both during assembly and disassembly.

PMID- 7775578
TI  - Regulation of a muscle-specific transgene by retinoic acid.
AB  - Retinoic acid (RA) has been shown to have variable effects on myogenic
      differentiation in cell culture. The application of RA on primary cultures of
      embryonic somites, limb buds, and neonatal limbs inhibited myogenic
      differentiation in a dose-dependent way as indicated by the repression of: (a)
      myotube formation, (b) myosin heavy chain protein accumulation, (c) myosin light
      chain (MLC) 1/3, alpha sk-actin and myogenic factor transcript expression.
      Expression of retinoic acid receptors (RAR) was also affected by RA treatment,
      specifically RAR gamma transcripts were induced. To further understand the
      pleiotropic action of RA on myogenesis, we took advantage of two muscle-specific
      transgene markers which consisted of CAT reporter genes driven by regulatory
      elements either from the myosin light chain 1/3 locus (MLC-CAT) or the alpha
      skeletal actin gene (alpha sk actin-CAT). RA inhibited MLC-CAT transgene but not
      alpha sk actin-CAT transgene expression in primary cultures from these mice.
      Analysis of MLC-CAT expression in transgenic mouse primary cultures and in stably
      transfected C2C12 cells demonstrated that repression of MLC-CAT activity by RA
      was dependent upon diffusible factors in chick embryo extract. We hypothesize
      that during development, the pleiotropic effects of RA on myogenesis do not
      depend solely on the distribution and concentration of RA itself, but are also
      influenced by extracellular signals in the embryonic environment.

PMID- 7775579
TI  - Calsensin: a novel calcium-binding protein expressed in a subset of peripheral
      leech neurons fasciculating in a single axon tract.
AB  - The mAb lan3-6 recognizes a cytosolic antigen which is selectively expressed in
      the growth cones and axons of a small subset of peripheral sensory neurons
      fasciculating in a single tract common to all hirudinid leeches. We have used
      this antibody to clone a novel EF-hand calcium-binding protein, calsensin, by
      screening an expression vector library. A full-length clone of 1.1 kb identified
      by the antibody was isolated and sequenced. In situ hybridizations with calsensin
      probes and antibody staining using new polyclonal antisera generated against
      calsensin sequence demonstrate that calsensin indeed corresponds to the lan3-6
      antigen. Calsensin consists of 83 residues with a calculated molecular mass of
      9.1 kD that contains two helix-loop-helix domains. The calcium-binding domains
      are likely to be functional in vivo since a fusion protein derived from the
      calsensin clone binds 45Ca2+ in vitro. Immunoaffinity purification experiments
      with the lan3-6 antibody shows that a large 200,000 M(r) protein selectively
      copurifies with calsensin in two different leech species. These results suggest
      that calsensin may be functioning as a trigger protein which interacts with the
      larger protein. These data are consistent with the hypothesis that calsensin may
      mediate calcium-dependent signal transduction events in the growth cones and
      axons of this small group of sensory neurons which fasciculate in a single axon
      tract.

PMID- 7775580
TI  - bcl-2 overexpression inhibits cell death and promotes the morphogenesis, but not
      tumorigenesis of human mammary epithelial cells.
AB  - Overexpression of the B cell leukemia/lymphoma-2 (bcl-2) gene has been shown to
      confer a survival advantage on cells by inhibiting apoptosis. In epithelia, the
      bcl-2 gene is also related to development and differentiation, and the protein is
      strongly expressed in the embryo in the epithelial cells of the developing
      mammary gland. To investigate directly the effect of bcl-2 on human epithelial
      cells, we used an amphotropic recombinant retrovirus to introduce the gene into
      nontumorigenic cell lines developed from luminal epithelial cells cultured from
      milk. Here we demonstrate that while bcl-2 overexpression does not directly
      induce the tumorigenic phenotype, it provides a survival advantage to the mammary
      epithelial cells by inhibiting cell death at confluence or under conditions of
      serum starvation, bcl-2 can also affect the phenotype of the original epithelial
      cells, and promote epithelial-mesenchymal conversion, accompanied by loss of the
      cell adhesion molecules E-cadherin and alpha 2 beta 1 integrin. The extent of the
      epithelial-mesenchymal conversion varies with small differences in the phenotype
      of the parental line and with the level of expression of Bcl-2 and in some cases
      cell lines emerge with a mixed phenotype. The increased survival of Bcl-2
      expressing cells at confluence results in multilayering, and the development of
      three- dimensional structures. Where a mixed phenotype is observed these
      structures consist of an outer layer of polarized epithelial cells separated by a
      basement membrane-like layer from an inner mass of fibroblastoid cells. Branching
      morphogenesis of bcl-2 transfectants is also observed in collagen gels (in the
      absence of fibroblast growth factors). The results strongly indicate that by
      increasing their survival under restrictive growth conditions, and by modifying
      the epithelial phenotype, bcl-2 can influence the specific morphogenetic behavior
      of mammary epithelial cells.

PMID- 7775581
TI  - The cadherin-binding specificities of B-cadherin and LCAM.
AB  - The cadherin family of calcium-dependent cell adhesion molecules plays an
      important part in the organization of cell adhesion and tissue segregation during
      development. The expression pattern and the binding specificity of each cadherin
      are of principal importance for its role in morphogenesis. B-Cadherin and LCAM,
      two chicken cadherins, have similar, but not identical, spatial and temporal
      patterns of expression. To examine the possibility that they might bind to one
      another in a heterophilic manner, we generated, by cDNA transfection, L-cell
      lines that express LCAM or B-cadherin. We then examined the abilities of these
      cells to coaggregate with each other and with other cadherin-expressing cells in
      short-term aggregation assays. The B-cadherin- and the LCAM-expressing cell lines
      segregate from P-, N-, or R-cadherin-expressing cells. B-cadherin- and LCAM
      expressing cell lines, however, appear to be completely miscible, forming large
      mixed aggregates. Chick B-cadherin and murine E-cadherin also form mixed
      aggregates, indistinguishable from homophilic aggregates. Murine E-cadherin and
      chick LCAM coaggregate less completely, suggesting that the heterophilic
      interactions of these two cell lines are weak relative to homophilic
      interactions. These data suggest that heterophilic interactions between B
      cadherin and LCAM are important during avian morphogenesis and help identify the
      amino acids in the binding domain that determine cadherin specificity.

PMID- 7775582
TI  - The interaction of the retina cell surface N
      acetylgalactosaminylphosphotransferase with an endogenous proteoglycan ligand
      results in inhibition of cadherin-mediated adhesion.
AB  - We have previously shown that the binding to cells of a monoclonal antibody
      directed against the chick neural retina N-acetylgalactosaminylphosphotransferase
      (GalNAcPTase) results in inhibition of cadherin-mediated adhesion and neurite
      outgrowth. We hypothesized that the antibody mimics the action of an endogenous
      ligand. Chondroitin sulfate proteoglycans (CSPGs) are potential ligands because
      they inhibit adhesion and neurite outgrowth and are present in situ at barriers
      to neuronal growth. We therefore assayed purified CSPGs for their ability to
      inhibit homophilic cadherin-mediated adhesion and neurite outgrowth, as well as
      their ability to bind directly to the GalNAcPTase. A proteoglycan with a 250-kD
      core protein following removal of chondroitin sulfate chains (250-kD PG) inhibits
      cadherin-mediated adhesion and neurite outgrowth whether presented as the core
      protein or as a proteoglycan monomer bearing chondroitin sulfate. A proteoglycan
      with a 400-kD core protein is not inhibitory in either core protein or monomer
      form. Treatment of cells with phosphatidylinositol-specific phospholipase C,
      which removes cell surface GalNAcPTase, abolishes this inhibitory effect. Binding
      of the 250-kD core protein to cells is competed by the anti-GalNAcPTase antibody
      1B11, suggesting that 1B11 and the 250-kD core protein bind to the same site or
      in close proximity. Moreover, soluble GalNAcPTase binds to the immobilized 250-kD
      core protein but not to the immobilized 400-kD core protein. Concomitant with
      inhibition of cadherin mediated adhesion, binding of the 250-kD core protein to
      the GalNAcPTase on cells results in the enhanced tyrosine phosphorylation of beta
      catenin and the uncoupling of N-cadherin from its association with the
      cytoskeleton. Moreover, the 250-kD PG is present in embryonic chick retina and
      brain and is associated with the GalNAcPTase in situ. We conclude that the 250-kD
      PG is an endogenous ligand for the GalNAcPTase. Binding of the 250-kD PG to the
      GalNAcPTase initiates a signal cascade, involving the tyrosine phosphorylation of
      beta-catenin, which alters the association of cadherin with the actin-containing
      cytoskeleton and thereby inhibits adhesion and neurite outgrowth. Regulation of
      the temporal and spatial expression patterns of each member of the
      GalNacPTase/250-kD PG interactive pair may create opportunities for interaction
      that influence the course of development through effects on cadherin-based
      morphogenetic processes.

PMID- 7775584
TI  - Hepatocyte growth factor/scatter factor modulates cell motility, proliferation,
      and proteoglycan synthesis of chondrocytes.
AB  - Hepatocyte growth factor/scatter factor (HGF/SF) is a multifunctional growth
      factor that promotes proliferation, motility, and morphogenesis in epithelial
      cells. Recently the HGF receptor, c-met protooncogene product, has been shown to
      be expressed in developing limb buds (Sonnenberg, E., D. Meyer, M. Weidner, and
      C. Birchmeiyer, 1993. J. Cell Biol. 123: 223-235), suggesting that some
      populations of mesenchymal cells in limb buds respond to HGF/SF. To test the
      possibility that HGF/SF is involved in regulation of cartilage development, we
      isolated chondrocytes from knee joints and costal cartilages of 23-d embryonic
      and 4-wk-old rabbits, and analyzed the effects of HGF/SF on migration and
      proliferation of these cells. We found that HGF/SF stimulated migration of
      cultured articular chondrocytes but did not scatter limb mesenchymal fibroblasts
      or synovial fibroblasts in culture. HGF/SF also stimulated proliferation of
      chondrocytes; a maximum three-fold stimulation in DNA synthesis was observed at
      the concentration of 3 ng/ml of HGF/SF. Moreover, HGF/SF had the ability to
      enhance proteoglycan synthesis in chondrocytes. The responsiveness of
      chondrocytes to HGF/SF was also supported by the observation that they expressed
      the HGF/SF receptor. Addition of the neutralizing antibody to rat HGF/SF affected
      neither DNA synthesis nor proteoglycan synthesis in rat chondrocytes, suggesting
      a paracine mechanism of action of HGF/SF on these cells. In situ hybridization
      analysis showed that HGF/SF mRNA was restrictively expressed in the areas of
      future joint regions in developing limb buds and in the intercostal spaces of
      developing costal cartilages. These findings suggest that HGF/SF plays important
      roles in cartilage development through its multiple activities.

PMID- 7775585
TI  - Separate cis-acting DNA elements of the mouse pro-alpha 1(I) collagen promoter
      direct expression of reporter genes to different type I collagen-producing cells
      in transgenic mice.
AB  - The genes coding for the two type I collagen chains, which are active selectively
      in osteoblasts, odontoblasts, fibroblasts, and some mesenchymal cells, constitute
      good models for studying the mechanisms responsible for the cell-specific
      activity of genes which are expressed in a small number of discrete cell types.
      To test whether separate genetic elements could direct the activity of the mouse
      pro-alpha 1(I) collagen gene to different cell types in which it is expressed,
      transgenic mice were generated harboring various fragments of the proximal
      promoter of this gene cloned upstream of the Escherichia coli beta-galactosidase
      gene. During embryonic development, X-gal staining allows for the precise
      identification of the different cell types in which the beta-galactosidase gene
      is active. Transgenic mice harboring 900 bp of the pro-alpha 1(I) proximal
      promoter expressed the transgene at relatively low levels almost exclusively in
      skin. In mice containing 2.3 kb of this proximal promoter, the transgene was also
      expressed at high levels in osteoblasts and odontoblasts, but not in other type I
      collagen-producing cells. Transgenic mice harboring 3.2 kb of the proximal
      promoter showed an additional high level expression of the transgene in tendon
      and fascia fibroblasts. The pattern of expression of the lacZ transgene directed
      by the 0.9- and 2.3-kb pro-alpha 1(I) proximal promoters was confirmed by using
      the firefly luciferase gene as a reporter gene. The pattern of expression of this
      transgene, which can be detected even when it is active at very low levels,
      paralleled that of the beta-galactosidase gene. These data strongly suggest a
      modular arrangement of separate cell-specific cis-acting elements that can
      activate the mouse pro-alpha(I) collagen gene in different type I collagen
      producing cells. At least three different types of cell-specific elements would
      be located in the first 3.2 kb of the promoter: (a) an element that confers low
      level expression in dermal fibroblasts; (b) a second that mediates high level
      expression in osteoblasts and odontoblasts; and (c) one responsible for high
      level expression in tendon and fascia fibroblasts. Our data also imply that other
      cis-acting cell-specific elements which direct activity of the gene to still
      other type I collagen-producing cells remain to be identified.

PMID- 7775583
TI  - Identification of the low density lipoprotein receptor-related protein (LRP) as
      an endocytic receptor for thrombospondin-1.
AB  - Thrombospondin-1 (TSP1) has potent biological effects on vasculature smooth
      muscle cells (SMCs) and endothelial cells. The regulation of extracellular
      accumulation of TSP1 is mediated by a previously obscure process of endocytosis
      which leads to its lysosomal degradation. Since members of the low density
      lipoprotein receptor (LDLR) family have been found to mediate endocytosis which
      leads to degradation of a diverse array of ligands, we evaluated their possible
      role in the uptake and degradation of TSP1 by vascular SMCs, endothelial-cells
      and fibroblasts. 125I-TSP1 was found to be internalized and degraded lysosomally
      by all these cell types. Both the internalization and degradation of 125I-TSP1
      could be inhibited by a specific antagonist of the LDLR family, the 39-kD
      receptor-associated protein (RAP). Antibodies to the LDLR-related protein (LRP)
      completely blocked the uptake and degradation of 125I-TSP1 in SMCs and
      fibroblasts but not endothelial cells. Solid-phase binding assays confirmed that
      LRP bound to TSP1 and that the interaction was of high affinity (Kd = 5 nM).
      Neither RAP nor LRP antibodies inhibited the binding of 125I-TSP1 to surfaces of
      SMCs. However, cell surface binding, as well as, endocytosis and degradation
      could be blocked by heparin or by pre-treatment of the cells with either
      heparitinase, chondroitinase or beta-D-xyloside. The data indicates that cell
      surface proteoglycans are involved in the LRP-mediated clearance of TSP1. A model
      for the clearance of TSP1 by these cells is that TSP1 bound to proteoglycans is
      presented to LRP for endocytosis. In endothelial cells, however, the
      internalization of TSP1 was not mediated by LRP but since RAP inhibited TSP1
      uptake and degradation, we postulate that another member of the LDLR family is
      likely to be involved.

PMID- 7775587
TI  - Effect of lysophospholipids on signaling in the human Jurkat T cell line.
AB  - Lysophospholipids have recently been demonstrated to induce activation and
      proliferation of fibroblasts and other cell lineages by interacting with high
      affinity cell surface receptors leading to specific intracellular signaling
      events. Platelet activation, likely at the site of injury or inflammation,
      results in increased production of lysophospholipids suggesting a possible source
      of lysophospholipids. We have recently demonstrated that high concentrations of
      lysophospholipids are present in ascites and plasma from ovarian cancer patients,
      suggesting that physiologically produced lysophospholipids could interact with
      cells present in these fluids, including lymphocytes, and alter their function.
      We demonstrate herein that lysophosphatidic acid (LPA), lysophosphatidylserine
      (LPS), and sphingosylphosphorylcholine (SPC) activate the Jurkat T cell line.
      Each of the lysophospholipids induced a transient increase in cytosolic free
      calcium ([Ca2+]i) in Jurkat cells. Increases in [Ca2+]i were cross-desensitized
      by LPA, LPS and SPC, suggesting that the lysophospholipids share the same
      receptor(s) or that their downstream signaling pathways converge or interact.
      Lysophosphatidylglycerol (LPG), a competitive inhibitor of the putative LPA
      receptor, inhibited the calcium releasing activity of LPA, but not that of LPS
      and SPC, suggesting that these lysophospholipids interact with different
      receptors and that desensitization is due to interactions in downstream signaling
      pathways. The ability of the lysophospholipids to induce increases in [Ca2+]i was
      attenuated, but not completely blocked, by increases in [Ca2+]i induced by
      activation of the thrombin receptor. In contrast, increases in [Ca2+]i induced by
      the lysophospholipids and cross-linking the CD3 component of the T cell receptor
      complex with the UCHT1 antibody did not undergo heterologous desensitization.
      Strikingly, LPA is sufficient to stimulate proliferation of Jurkat cells in serum
      free medium or in synergy with low concentrations of fetal bovine serum. In
      addition, LPA also increased the production of the T cell growth factor,
      interleukin 2 (IL-2), by Jurkat cells treated with phorbol esters. LPS, in
      contrast, inhibited Jurkat proliferation while increasing IL-2 production and SPC
      inhibited both processes. Thus, although all three lysophospholipids were
      sufficient to induce a transient increase in [Ca2+]i in Jurkat cells, they
      induced markedly different physiological consequences.

PMID- 7775586
TI  - Patterns of cyclic AMP-dependent protein kinase gene expression during ontogeny
      of the murine palate.
AB  - Normal growth and differentiation of embryonic palatal tissue depends on
      regulated levels of intracellular cAMP. Cyclic AMP-dependent protein kinases
      (PKA) act to mediate the biological activities of cAMP. PKA isozyme protein
      profiles demonstrate a clear pattern of temporal alterations in embryonic palatal
      tissue during its development. In order to ascertain the molecular basis for
      changing PKA isozyme profiles during palatal ontogeny, the spatial and temporal
      expression of mRNAs for regulatory (RI alpha, RII alpha, and RII beta) and
      catalytic (C alpha) subunits of PKA was examined. RNA extracted from murine
      embryonic palatal tissue (days 12-14 of gestation) was examined by Northern blot
      analysis. Significant levels of constitutively expressed RI alpha and C alpha
      mRNA were seen on all days of gestation examined. RI alpha transcripts were
      substantially less abundant in palate mesenchymal cells in vitro than in palatal
      tissue in vivo. Levels of RII alpha and RII beta mRNA were highest on gestational
      day (GD) 12, a period characterized by pronounced palatal tissue growth. In
      addition, patterns of tissue distribution of RII beta, not previously described,
      were examined in the developing embryonic palate. A dramatic developmental shift
      in tissue distribution of RII beta was seen. The isozyme was evenly distributed
      between palatal epithelial and mesenchymal cells on GD 12 but by GD 14, RII beta
      was predominantly localized to palatal epithelial cells. Direct activation of
      adenylate cyclase with forskolin in murine embryonic palate mesenchymal (MEPM)
      cells resulted in an increase in RII alpha mRNA levels but had no effect on
      steady state levels of RII beta or C alpha mRNA. In addition, elevation of
      intracellular levels of cAMP resulted in a shift in the transcriptional profile
      of RI alpha mRNAs. Results of this study document specific patterns of expression
      for the genes encoding the various cAMP-dependent protein kinase regulatory and C
      alpha subunits in murine embryonic palatal tissue. In addition, we have
      demonstrated adaptational changes of this kinase in MEPM cells in response to
      conditions of increased intracellular levels of cAMP.

PMID- 7775588
TI  - Matrix protein synthesis by glomerular mesangial cells in culture: effects of
      transforming growth factor beta (TGF beta) and platelet-derived growth factor
      (PDGF) on fibronectin and collagen type IV mRNA.
AB  - The pathogenesis of glomerular scarring is multifactional; recent evidence
      suggests that transforming growth factor beta (TGF beta), a pleiotropic
      cicatricial mediator, may promote mesangial sclerosis by enhancing the production
      of extracellular matrix proteins. We studied the effect of TGF beta 1 and TFG
      beta 2 on collagen type IV and fibronectin (FN) synthesis in human glomerular
      mesangial cells in culture (GMC). Two hours after addition of TGF beta, an up to
      twofold increase in abundance of collagen type IV mRNA was found, which further
      increased up to fivefold within 24 h. Addition of cycloheximide did not inhibit
      the TGF beta effect, but caused by itself an up to twofold increase in the
      abundance of collagen type IV mRNA after 2 h. Together with collagen mRNA, the
      mRNA for FN and for platelet-derived growth factor (PDGF) was also enhanced. PDGF
      was found to enhance abundance of the collagen type IV and fibronectin mRNA in
      GMC. A neutralizing antibody to PDGF or a PDGF-antisense oligonucleotide partly
      inhibited the TGF beta-induced increase of collagen type IV mRNA, suggesting that
      TGF beta can affect the collagen type IV synthesis not only directly but also
      indirectly via the synthesis of PDGF.

PMID- 7775589
TI  - Effects of the overexpression of the small heat shock protein, HSP27, on the
      sensitivity of human fibroblast cells exposed to oxidative stress.
AB  - The role of the human small heat shock protein (HSP27) in oxidative stress was
      examined using stable transformants of an immortalized human fibroblast cell line
      (KMST-6) isolated by transfection of HSP27 expression vectors. Several stable
      transformants that expressed high or low levels of HSP27 protein were obtained.
      Clones expressing high levels of HSP27 were more sensitive to growth inhibition
      by a low dose of hydrogen peroxide (0.1 mM) than those expressing low levels.
      Clones expressing high levels of HSP27 did not acquire obvious resistance to
      hyperthermy and cytotoxic agents, except for one (#13), in which resistance to
      cytotoxic agents was increased. The level of phosphorylated HSP27 in clones
      expressing high levels of this protein increased at 30 min and was sustained even
      4 hours after exposing the cells to 0.1 mM of hydrogen peroxide. On the other
      hand, the levels in clones expressing low levels of HSP27 were reduced within 4
      hours after exposure to hydrogen peroxide. Furthermore, overexpression of
      nonphosphorylatable mutant HSP27 did not affect sensitivity to oxidative stress.
      These results suggested that constitutively high expression of HSP27 in KMST-6
      cells make them susceptible to oxidative stress resulting in growth arrest, and
      this mechanism could involve the phosphorylation of HSP27.

PMID- 7775591
TI  - Iron and copper requirements for proliferation and differentiation of a human
      promyelocytic leukemia cell line (HL-60).
AB  - Trace mineral deficiencies tend to have profound effects on the integrity of
      formed blood elements. Anemia and neutropenia are commonly seen in copper (Cu)
      deficiency. We therefore developed a serum-free medium to examine the trace
      mineral requirements, in particular iron and Cu, for proliferation and retinoic
      acid (RA)-induced differentiation of HL-60 cells. This defined medium (DFM) was
      composed of Iscove's Modified Dulbecco's Medium (IMDM) supplemented with insulin
      and human apo-transferrin (each at 5 micrograms/ml) and 1.4 microM FeSO4. The
      iron concentration range for optimal cellular proliferation was narrow (2-3
      microM). HL-60 cells could be maintained in DFM for 15 passages with a doubling
      time of 38-40 hr. The Cu content of IMDM was very low. Thus, by the fourth
      passage in DFM, the activity of cuproenzymes (cytochrome c oxidase, CCO; and
      copper-zinc superoxide dismutase, CuZnSOD) began to decline. Supplementation of
      DFM with CuSO4 (50 nM) restored enzyme activities. Treatment of cells with a Cu
      chelator (tetrathiomolybdate, 1 microM) rapidly reduced the activities of both
      CCO and CuZnSOD. Over the Cu concentration range examined (5-350 nM), Cu
      supplementation had little effect on HL-60 proliferation. Cell retained the
      ability to differentiate along the granulocytic pathway when treated with RA, but
      seemed to be less sensitive to the inducing agent except at the highest
      concentration tested (1 microM). This decreased sensitivity to RA did not seem to
      be related to the Cu status of the cells but rather to the absence of a component
      of serum. Indeed, cells grown in DFM regained their sensitivity to RA when
      allowed to differentiate in IMDM with 5% serum. These data indicate that the
      processes of growth and terminal differentiation in HL-60 cells are not greatly
      influenced by Cu. Thus, it seems likely that the insult resulting in neutropenia
      which is associated with Cu deficiency may occur earlier than the promyelocytic
      stage. However, the possibility that the mechanisms contributing to neutropenia
      may be unrelated to primary defects in the biochemistry of neutrophil maturation
      cannot be ruled out.

PMID- 7775590
TI  - Evidence that cell survival is controlled by interleukin-3 independently of cell
      proliferation.
AB  - Hemopoietic cell proliferation is controlled by a set of polypeptide growth
      factors and regulatory molecules that bind to cell surface receptors inducing
      cellular responses. Maintenance of a viable state, cell growth, DNA synthesis and
      mitosis are basic properties of proliferating cells, but links between growth
      factor receptors and each of these cellular outcomes are poorly understood. Most
      studies have monitored DNA synthesis as a measure of progression through the cell
      cycle or directly measured viable cell numbers, but cell survival per se as an
      output of receptor activation by ligand, has received little attention. In this
      study we have used a bone marrow-derived murine cell line that is dependent on
      interleukin-3 for growth, to investigate the relationship between DNA synthesis
      and a biochemical marker of cell survival, reduction of the tetrazolium salt,
      MTT. We show that at times up to 6 hr, continued DNA synthesis, RNA synthesis,
      protein synthesis, and mitochondrial respiration are not necessary for background
      or IL-3-stimulated MTT reduction. Furthermore, dibutyryl cyclic AMP promoted
      background and IL-3-dependent MTT reduction while simultaneously inhibiting DNA
      synthesis. These results provide evidence that IL-3 controls events involved in
      MTT reduction and cell survival independently of DNA synthesis.

PMID- 7775592
TI  - Immunochemical characterisation of megakaryocyte potentiator activity from mouse
      bone marrow.
AB  - Megakaryocyte potentiator derived from mouse bone marrow has been shown to be
      immunologically similar to Interleukin-6 (IL-6). In this study the activity has
      been characterised by biochemical and immunochemical techniques. The activity is
      described as a O-linked glycosylated molecule with an apparent MW of 15 Kd and pl
      of the range pH 5.9-6.35. The data show that mouse bone marrow potentiator
      activity is a variant of IL-6 and with the potential to enhance megakaryocyte
      growth.

PMID- 7775593
TI  - RB phosphorylation in sodium butyrate-resistant HL-60 cells: cross-resistance to
      retinoic acid but not vitamin D3.
AB  - To examine the potential coupling between inducible cellular changes in RB
      (retinoblastoma) tumor suppressor protein phosphorylation and ability to G0
      growth arrest and differentiate, HL-60 promyelocytic leukemia cells were cultured
      in incremental sodium butyrate (NaB) concentrations and thereby made resistant to
      the growth inhibitory effects of sodium butyrate, which normally induces G0
      arrest and monocytic differentiation in wild type HL-60 cells. The resistant
      cells were also unable to differentiate in response to NaB, indicating that a
      regulatory function controlling both G0 growth arrest and differentiation had
      been affected. The induced resistance was not genetic in origin since the cells
      regained the ability to G0 arrest and differentiate after being recultured in
      medium free of sodium butyrate for only three days. The resistant cells had
      similar cell cycle phase durations as the original wild type cells. The resistant
      cells retained the ability to both G0 arrest and differentiate in response to
      1,25-dihydroxy vitamin D3 (VD3), normally an inducer of G0 arrest and monocytic
      differentiation in wild type cells. However, they were cross-resistant to
      retinoic acid (RA), another ligand for the same steroid thyroid hormone receptor
      family, which induces G0 arrest and myeloid differentiation in wild type cells.
      The ability to G0 arrest and phenotypically differentiate in response to RA were
      both grossly impaired. Unlike wild type cells which undergo early down-regulation
      and then hypophosphorylation of the RB protein when induced to differentiate, in
      resistant cells, hypophosphorylation of RB in response to NaB was grossly
      retarded. These changes in RB protein occurred faster when the cells were treated
      with VD3. In contrast, the changes in RB phosphorylation occurred significantly
      slower when the cells were treated with RA. The results suggest a coupling
      between the ability to G0 growth arrest and phenotypically convert and the
      ability to hypophosphorylate RB.

PMID- 7775594
TI  - Regulation of endothelial cell gap formation and barrier dysfunction: role of
      myosin light chain phosphorylation.
AB  - Endothelial cell (EC) contraction results in intercellular gap formation and loss
      of the selective vascular barrier to circulating macromolecules. We tested the
      hypothesis that phosphorylation of regulatory myosin light chains (MLC) by
      Ca2+/calmodulin-dependent myosin light chain kinase (MLCK) is critical to EC
      barrier dysfunction elicited by thrombin. Thrombin stimulated a rapid (< 15 sec)
      increase in [Ca2+]i which preceded maximal MLC phosphorylation (60 sec) with a 6
      to 8-fold increase above constitutive levels of phosphorylated MLC. Dramatic
      cellular shape changes indicative of contraction and gap formation were observed
      at 5 min with maximal increases in albumin permeability occurring by 10 min.
      Neither the Ca2+ ionophore, A23187, nor phorbol myristate acetate (PMA), a direct
      activator of protein kinase C (PKC), alone or in combination, produced MLC
      phosphorylation. The combination was synergistic, however, in stimulating EC
      contraction/gap formation and barrier dysfunction (3 to 4-fold increase). Down
      regulation or inhibition of PKC activity attenuated thrombin-induced MLC
      phosphorylation (approximately 40% inhibition) and both thrombin- and PMA-induced
      albumin clearance (approximately 50% inhibition). Agents which augmented [cAMP]i
      partially blocked thrombin-induced MLC phosphorylation (approximately 50%) and
      completely inhibited both thrombin- and PMA-induced EC permeability (100%
      inhibition). Furthermore, cAMP produced significant reduction in the basal levels
      of constitutive MLC phosphorylation. Finally, MLCK inhibition (with either ML-7
      or KT 5926) or Ca2+/calmodulin antagonism (with either trifluoperazine or W-7)
      attenuated thrombin-induced MLC phosphorylation and barrier dysfunction. These
      results suggest a model wherein EC contractile events, gap formation and barrier
      dysfunction occur via MLCK-dependent and independent mechanisms and are
      significantly modulated by both PKC and cAMP-dependent protein kinase A
      activities.

PMID- 7775596
TI  - Growth of mouse hepatocytes is stimulated by gastrin.
AB  - Hepatocyte growth is regulated by various growth factors, including epidermal
      growth factor (EGF) and insulin. Recently, several additional peptide hormones
      have been shown to stimulate growth of hepatocyte only in the presence of EGF or
      insulin and are thus termed secondary mitogens. Gastrin regulates growth of
      normal and neoplastic gastrointestinal tissues, but the effect on growth of
      hepatocyte is unknown. We examined the effect of gastrin on growth of a normal
      mouse hepatocyte (NMH) line established in our laboratory. Effect of gastrin-17
      (G-17) (10(-8) to 10(-6) M) on growth of NHM cells was examined in either the
      presence or absence of EGF in the culture medium. Growth of NMH cells was
      evaluated by incorporation of either bromodeoxyuridine (BrdU) or 3H-thymidine and
      by counting cells. Presence of a cell-surface receptor for G-17 was determined by
      Scatchard analysis using 125I-G-17. In the presence of EGF, gastrin stimulated
      growth of NMH cells; in the absence of EGF, gastrin did not affect growth. The
      stimulatory effect of gastrin on NMH cells was blocked by JMV 320, a CCK-B type
      receptor antagonist. NMH cells possess a single, high affinity binding site for
      gastrin (Kd = 1.2 nM); EGF increased the gastrin binding capacity compared to non
      treated cells (3.5 +/- 0.4 vs. 2.2 +/- 0.6 fmol/10(6) cells). G-17 stimulated
      growth of NMH cells through a single high affinity receptor for G-17 which
      pharmcologically appears to be the CCK-B type only in the presence of EGF and
      thus can be considered a secondary mitogen.

PMID- 7775595
TI  - Inhibition of N-linked glycosylation induces early apoptosis in human
      promyelocytic HL-60 cells.
AB  - Inhibition of protein N-glycosylation by tunicamycin induced morphological
      changes characteristic of apoptosis in human promyelocytic HL-60 cells.
      Internucleosomal DNA fragmentation could be detected after short-time incubation
      (between 6 and 9 h) of HL-60 cells with low doses of tunicamycin (0.05
      micrograms/ml). Under these conditions the synthesis of glycoproteins was reduced
      to 17% of control values, while no significant changes in the rates of total
      protein synthesis could be observed. Tunicamycin ability to induce DNA
      fragmentation was in good correlation with its potency as glycosylation inhibitor
      in several myeloid cell lines. Tunicamycin-induced apoptosis was potentiated by
      activation of protein kinease C (PKC) by phorbol esters and partially prevented
      by the PKC inhibitor staurosporine. Inhibitors of RNA and protein synthesis
      displayed a protective effect. Treatment of HL-60 cells with tunicamycin did not
      elicit the expression of cell surface differentiation antigens or their ability
      to generate superoxide anion. In contrast, tunicamycin significantly inhibited
      these processes during dimethyl sulfoxide (DMSO)-induced myeloid differentiation.
      These observations indicate that the main effect of tunicamycin in HL-60 cells is
      the induction of apoptosis.

PMID- 7775597
TI  - P-glycoprotein stability is affected by serum deprivation and high cell density
      in multidrug-resistant cells.
AB  - The control of P-glycoprotein (Pgp) expression in multidrug-resistant cells (MDR)
      is complex and may be regulated at different levels. We have investigated Pgp
      stability in four different human and hamster MDR cell lines. Using a pulse-chase
      procedure we show that Pgp half-life is between 14 and 17 h in all these cell
      lines when they are growing exponentially. However, in the presence of a low
      level of serum, Pgp half-life is increased four to sixfold. A similar effect is
      observed when the cell cultures are maintained in high cell density. The
      increased Pgp stability appears to be differently regulated as serum deprivation
      results in a general enhanced degradation of total cytoplasmic and membrane
      proteins. Moreover, the observed serum effect suggests the involvement of growth
      factors in the control of Pgp stability. These findings suggest that protein
      stability may be an important factor in the regulation of Pgp expression.

PMID- 7775598
TI  - Multifunctional phosphatidic acid signaling in mammary epithelial cells:
      stimulation of phosphoinositide hydrolysis and conversion to diglyceride.
AB  - We have shown previously that phosphatidic acid esterified to polyunsaturated
      fatty acids is mitogenic for primary cultures of mouse mammary epithelial cells
      embedded within collagen gels. We hypothesized that this mitogenic competence
      resulted from the ability of this phospholipid to activate multiple signal
      transduction pathways in mammary epithelium. A closer examination of this
      hypothesis was undertaken by examining the effect of exogenous phosphatidic acid
      on phosphoinositide (PI) hydrolysis and its intracellular metabolism to
      diglyceride, an activator of protein kinase C. For assays of phosphoinositide
      specific phospholipase C activation, mammary epithelial cells from virgin Balb/c
      mice were isolated by collagenase dissociation of mammary glands and cultured on
      the surface of Type I collagen-coated culture dishes. Phosphatidic acid (PA)
      stimulated a sustained increase in inositol phosphates and caused inositol
      phospholipid depletion when added to cells in which inositol phospholipids were
      prelabeled with 3H-myoinositol. This effect was specific for PA among
      phospholipids tested. Neither lineoleic acid, that can be released from PA, nor
      prostaglandin E2 affected PI hydrolysis. When mammary epithelial cells were
      cultured inside collagen gels in the presence of exogenous PA or
      phosphatidylcholine (PC) radiolabeled with 3H-glycerol, PA was found to persist
      intracellularly and be dephosphorylated to diglyceride (an activator of protein
      kinase C) to a greater extent than PC, a nonmitogenic phospholipid. In contrast
      to PA, epidermal growth factor (EGF) only slightly stimulated PI hydrolysis,
      showing that these two different growth-promoting factors do not actively couple
      to the same signal transduction pathways in mammary epithelial cells. These
      results show that PA may activate multiple pathways in mammary epithelial cells
      either directly or via its metabolism to diglyceride.

PMID- 7775599
TI  - Multiple pathways are involved in protection of MCF-7 cells against death due to
      protein synthesis inhibition.
AB  - Previously we have shown that IGF-I protected MCF-7 cells against death induced
      by the protein synthesis inhibitor cycloheximide (CHX). In the present study we
      investigated the ability of protein kinase C activator 12-0-tetradecanoyl-phorbol
      13-acetate (TPA), the protein kinase A activator 8-bromoadenosine 3'5'-cyclic
      monophosphate (Br-cAMP), and the enzyme inhibitor aurintricarboxylic acid (ATA)
      to protect MCF-7 cells against death, due to a continuous presence of CHX. Cell
      death was evaluated after 48 h of incubation by several techniques (trypan blue
      staining, release of lactic dehydrogenase, cellular ATP content, transmission
      electron microscopy, and DNA fragmentation). Apoptosis which terminates in
      necrosis, characterized this mode of cell death. TPA and ATA at optimal
      concentrations of 40 ng/ml and 100 micrograms/ml, respectively, reduced cell
      death to the control level (without CHX), while Br-cAMP at an optimal
      concentration of 650 micrograms/ml reduced cell death only partially. IGF-1, TPA,
      and ATA, which stimulated protein synthesis in the control MCF-7 cells, had no
      effect on protein synthesis in the CHX-treated cells, indicating that the
      survival effect is not due to new protein synthesis. The protein kinase C
      inhibitor staurosporine blocked the survival effect of TPA and IGF-1 in a dose
      dependent manner, however did not affect the survival effect of ATA. The tyrosine
      kinase inhibitor genistein blocked the survival effect of IGF-1, but not that of
      TPA and ATA. Our results provide evidence for several distinctive pathways, the
      activation of which protects MCF-7 cells against death, due to protein synthesis
      inhibition.

PMID- 7775600
TI  - Cell cycle reentry of mammalian fibroblasts is accompanied by the sustained
      activation of p44mapk and p42mapk isoforms in the G1 phase and their inactivation
      at the G1/S transition.
AB  - Mitogen-activated protein (MAP) kinases are serine/threonine kinases that are
      rapidly activated in response to mitogenic stimuli. Here we examined the
      enzymatic activity and phosphorylation state of the individual p44mapk and
      p42mapk isoforms during early G1 and late G1 phase of the mammalian cell cycle.
      Release of fibroblast cells from early G1 block was accompanied by a rapid rise
      in the myelin basic protein (MBP) kinase activity of p44mapk and p42mapk, which
      declined slowly over several hours to reach negligible values as cells enter S
      phase. When cells were released from late G1 block, the activity of p44mapk and
      p42mapk increased transiently, and then rapidly declined to baseline values
      during G1 to S phase transition. Cells released at the G1/S boundary in a medium
      lacking growth factors entered S phase in the complete absence of MAP kinase
      activity. Unlike MAP kinases, the histone H1 kinase activity of p33cdk2 was
      elevated in late G1 arrested cells and continued to increase during S phase
      entry. The enzymatic activation of p44mapk and p42mapk in both early G1 and late
      G1 phase was accompanied by an increase in the phosphothreonine and
      phosphotyrosine content of the proteins. These findings suggest that the
      sustained activation of MAP kinases during G1 progression and their inactivation
      at the G1/S transition are two regulatory processes involved in the mitogenic
      response to growth factors.

PMID- 7775601
TI  - Mitogenic activity of neu differentiation factor/heregulin mimics that of
      epidermal growth factor and insulin-like growth factor-I in human mammary
      epithelial cells.
AB  - Recently, a family of growth factors has been described that activates erbB-2
      receptors. These factors, known as the neu differentiation factors (NDF) or
      heregulins (HRG), induce tyrosine phosphorylation of erbB-2 receptors as a result
      of their direct interaction with either erbB-3 or erbB-4 receptors. Although it
      is known that expression of erbB-2 receptors has relevance in human breast cancer
      progression, how erbB-2, -3 and -4 receptors regulate mammary epithelial cell
      proliferation is not known. Therefore, experiments were carried out to study the
      mitogenic activity of NDF/HRG on the human mammary epithelial cell line MCF-10A
      which can be cultured continuously under serum-free conditions. MCF-10A cells,
      like primary cultures of normal human mammary epithelial cells, express an
      absolute requirement for exogenous epidermal growth factor (EGF) and insulinlike
      growth factor I (IGF-I) for growth. The results of these experiments indicate
      that NDF/HRG can induce tyrosine phosphorylation of p185erbB-2 in MCF-10A cells
      and is mitogenic for these cells. This is consistent with the coexpression of
      erbB-2 and erbB-3 mRNA that we have observed in MCF-10A cells. In addition, we
      found that NDF/HRG can substitute for either EGF or IGF-I to stimulate
      proliferation of these cells. The ability to substitute for both EGF and IGF-I is
      a unique property of NDF/HRG and is not shared by other members of the EGF or IGF
      family of growth factors, nor by other factors that we have studied. A striking
      isoform specificity was also observed which indicated that the beta-isoforms of
      NDF/HRG were greater than ten times more mitogenic than the alpha-isoforms. We
      also examined the mitogenic activity of NDF/HRG on MCF-10A cells that overexpress
      the erbB-2 receptor as a result of infection with a retroviral vector containing
      the human c-erbB-2 gene (MCF-10AerbB-2 cells). These studies indicated that MCF
      10AerbB-2 cells have increased sensitivity to the mitogenic effects of NDF/HRG
      and that these cells are responsive to the alpha-isoforms of NDF/HRG at
      physiological concentrations. Thus, NDF/HRG is a dual specificity growth factor
      for human mammary epithelial cells, and the responsiveness of the cells to
      NDF/HRG is influenced by the level of expression of erbB-2 receptors.

PMID- 7775602
TI  - Correlation between the number of melanosomes, tyrosinase mRNA levels, and
      tyrosinase activity in cultured murine melanoma cells in response to various
      melanogenesis regulatory agents.
AB  - Tyrosinase is the rate limiting enzyme critically associated with melanin
      synthesis. The melanosomes are specialized membrane-bound organelles within
      melanocytic cells in which melanin polymers are ultimately deposited. To
      determine whether tyrosinase correlates with the number of melanosomes, we
      examined the relationship between tyrosinase activity, tyrosinase mRNA levels,
      and the number of melanosomes in B16 murine melanoma cells, using melanogenesis
      regulatory agents. 12-O-Tetradecanoylphorbol-13-acetate (TPA) or linoleic acid
      decreased tyrosinase activity, while dibutyryl cyclic adenosine monophosphate
      (dbcAMP) or palmitic acid increased it. The tyrosinase mRNA levels were not
      always correlated with tyrosinase activity, i.e., TPA down-regulated, dbcAMP
      upregulated, while linoleic acid or palmitic acid did not alter the message
      levels, indicating that fatty acid regulation of melanogenesis was due to post
      transcriptional events. The number of melanosomes changed when agents which
      modulate the tyrosinase gene expression were added, since TPA decreased, dbcAMP
      increased, and linoleic acid or palmitic acid did not alter their number. These
      results suggest that the number of melanosomes changed in relation to tyrosinase
      mRNA level but not to tyrosinase activity in response to melanogenesis regulatory
      agents.

PMID- 7775603
TI  - Differential effects of glucocorticoids on insulin-like growth factor I action in
      cultured human fibroblasts.
AB  - Glucocorticoids act synergistically with insulin-like growth factor I (IGF-I) to
      stimulate DNA synthesis and replication of cultured human fibroblasts. In the
      present study, we further define glucocorticoid and IGF-I interactive effects on
      human fibroblast metabolism and growth. IGF-I stimulated dose-dependent increases
      in early metabolic events. Half-maximal effectiveness was seen at 5-8 ng/ml IGF
      I, with mean maximal responses of 1.5-, 2-, and 6-fold for [3H]2-deoxyglucose
      uptake, [14C]glucose incorporation, and [14C]aminoisobutyric acid (AIB) uptake,
      respectively. A 48-hour preincubation with 10(-7) M dexamethasone markedly
      enhanced both the sensitivity and maximal effectiveness of IGF-I stimulation of
      AIB uptake. In contrast, dexamethasone had no effect on IGF-I-stimulated glucose
      uptake and utilization. Maximum specific binding of [125I]IGF-I to fibroblast
      monolayers was identical in ethanol control and glucocorticoid-treated cells,
      with 50% displacement at approximately 5 ng/ml IGF-I. In addition to its
      synergism with IGF-I, preincubation with dexamethasone augmented insulin and
      epidermal growth factor (EGF) stimulation of [3H]thymidine incorporation;
      dexamethasone had no effect on platelet-derived growth factor or fibroblast
      growth factor action. Two-dimensional gel electrophoresis identified two specific
      glucocorticoid-induced proteins in human fibroblast cell extracts with molecular
      weights of 45K and 53K and pIs of 6.8 and 6.3, respectively. These data indicate
      that IGF-I receptor-mediated actions in human fibroblasts are differentially
      modulated by glucocorticoids. Glucocorticoids are synergistic with IGF-I in
      stimulating mitogenesis and amino acid uptake, without having any apparent effect
      on IGF-I-stimulating glucose metabolism. Glucocorticoid enhancement of growth
      factor bioactivity may involve modulation of a regulatory event in the mitogenic
      signaling pathway subsequent to cell surface receptor activation.

PMID- 7775604
TI  - Activation of junB and c-myc primary response genes by interleukin 9 in a human
      factor-dependent cell line.
AB  - Interleukin 9 (IL-9) stimulates the proliferation of various hematopoietic cell
      types. To elucidate the molecular mechanisms underlying the cell proliferation
      action, immediate-early gene expression elicited by IL-9 in a human factor
      dependent cell line, MO7e, was studied. IL-9 stimulation resulted in a rapid and
      transient elevation of primary response genes including junB and c-myc. The
      differential effects of protein kinase inhibitors, herbimycin A, genistein, and H
      7 on the steady-state mRNA level and the transcription rate of junB and c-myc
      genes triggered by IL-9 were also investigated. Herbimycin A, but not genistein,
      specifically inhibited the expression of junB steady-state mRNA and the in vitro
      transcription of the junB gene. IL-9-enhanced c-myc gene expression was
      completely inhibited by both herbimycin A and genistein at the level of
      transcriptional initiation. H-7 failed to inhibit c-myc, but partially abolished
      junB mRNA induction. The role of protein kinase C in IL-9-mediated junB induction
      was also examined. The different responses of junB and c-myc messages to protein
      kinase inhibitors suggested that more than one pathway may be involved in IL-9
      mediated signal transduction which leads to the expression of junB and c-myc
      genes.

PMID- 7775605
TI  - Isolation of nonsedimentable lipid-protein particles from insect intestine.
AB  - Nonsedimentable lipid-protein particles have been isolated from intestinal tissue
      of the American cockroach, Periplaneta americana. Most of the particles were
      within the range 30-50 nm in diameter and appear to originate from larger
      structures. Lipid analysis of the particles showed them to be enriched in neutral
      lipid components relative to microsomal membranes. Specifically, there is a
      decline in the amounts of phosphatidylcholine and phosphatidylethanolamine in the
      nonsedimentable particles compared with the microsomal membranes. Also, in
      contrast to microsomal membranes, the particles have a higher content of
      phosphatidic acid along with 1,2- and 1,3-diacyglycerols, free fatty acids and an
      unidentified lipid that co-migrates with sterol ester, wax ester and hydrocarbon
      standards in thin layer chromatograms. The cytosol, separated from the particles
      by ultrafiltration, contained phosphatidic acid, free fatty acids and the
      unidentified lipid. By contrast, the composition of neutral lipids in the cytosol
      resembles that of the particles. SDS-PAGE analysis of microsomal membranes, the
      particles and particle free cytosol shows an enrichment of low molecular weight
      proteins in the particles and cytosol. The particles and cytosol appear to
      possess proteolytic activity that is distinguishable from that of corresponding
      microsomal membranes since the incubation of these components with BSA resulted
      in the formation of distinct polypeptides. Many characteristics of these
      particles resemble those of the deteriosomes that have been isolated from plant
      tissue.

PMID- 7775606
TI  - Analysis of sequence-specific binding activity of cis-elements in human thymidine
      kinase gene promoter during G1/S phase transition.
AB  - Expression of thymidine kinase (TK) gene in normal human diploid, cells is both
      cell cycle and age dependent and appears to be transcriptionally regulated.
      Several studies have indicated that the G1/S control sequence may reside within
      the region of about 130 bp upstream of the transcription initiation site. We have
      previously shown that a trans-acting factor, CBP/tk (CCAAT binding protein for TK
      gene), binds to either one of the two inverted CCAAT boxes in a cell cycle- and
      age-dependent manner (Pang and Chen, 1993, J. Biol. Chem., 268:2909-2916). An
      upstream 25 bp fragment (-109/-84), containing both Yi-like and E2F-like binding
      sites, has recently been proposed to be essential for the G1/S regulation of
      human TK gene. To assess the contribution of various cis-elements in human TK
      promoter to the G1/S regulation, we have examined the binding activity of these
      cis-elements in the nuclear extracts derived from human IMR-90 cells at low
      passage number. Our results indicated that no binding activity could be detected
      using either the 25 bp fragment (-109/-94) or the authentic Yi sequence. However,
      Yi binding activity was observed in SV-40 transformed IMR-90 cells. In contrast,
      the 28 bp fragment (-91/-64) that contains the distal inverted CCAAT box
      exhibited a strong binding in serum-stimulated young IMR-90 cells. The binding of
      CBP/tk to the 28 bp fragment was abolished by a single base mutation in the CCAAT
      box. The CBP/tk binding of the 28 bp fragment could not be displaced by either
      the 25 bp fragment or the authentic Yi element. A deletion of the 5'-flanking
      region of the 28 bp fragment up to 5 bases also abolished the binding activity.
      The CBP/tk binding in IMR-90 cells was supershifted by antiserum against NF-Ya,
      but not by antiserum made against p107, pRb, cyclin A, p33cdk2, or p34cdc2. Taken
      together, our results suggest that the G1/S regulatory cis-element in human TK
      promoter may be confined only to CBP/tk binding sites.

PMID- 7775607
TI  - XVII international Symposium on Cerebral Blood Flow and Metabolism. Cologne,
      Germany, 2-6 July 1995. Abstracts.

PMID- 7775608
TI  - Medicine as an agency of social control: Part Three.

PMID- 7775609
TI  - Effects of water deprivation for 48 hours on the pharmacokinetics and
      pharmacodynamics of furosemide in rats.
AB  - The effects of water deprivation for 48 h on the pharmacokinetics and
      pharmacodynamics of furosemide were examined after intravenous, 8 mg/kg body
      weight, and oral administration, 16 mg/kg body weight, of furosemide to control
      and water deprived rats. After i.v. administration, the total body and nonrenal
      clearances decreased significantly in water-deprived rats. The urine output,
      urinary excretion of sodium, potassium and chloride based on grams of kidney
      weight, and the diuretic, natriuretic and chloruretic efficiencies decreased
      significantly in water-deprived rats after both intravenous and oral
      administration of furosemide, suggesting that the dose of furosemide for water
      deprived patients may require modification.

PMID- 7775610
TI  - Caffeine test assessment for measuring liver function in critically ill patients.
AB  - Caffeine elimination was studied in 73 patients admitted to an intensive care
      unit, 33 of whom had liver disease. Mean plasma clearance of caffeine in patients
      with no liver disease (1.30 +/- 0.79 ml/kg/min) was significantly higher than in
      patients with liver disease (0.39 +/- 0.23 ml/kg/min). Mean half-life of caffeine
      in patients with liver disease (23.96 +/- 12.19 h) was significantly higher than
      in patients with no liver disease (7.25 +/- 3.04 h). No significant differences
      in distribution volumes were found. Receptor-operator curves (ROC) for plasma
      clearance and the half-life of elimination of caffeine showed a high diagnostic
      value. Therefore, the parameters for caffeine biotransformation, i.e. Cl and
      t1/2, are useful for assessing liver function in the population studied.

PMID- 7775612
TI  - Patient information leaflets on over-the-counter (OTC) medicines: the
      manufacturer's perspective.
AB  - A survey was undertaken to assess the views of the manufacturers of over-the
      counter (OTC) products about (i) the value of patient information leaflets
      (PILs), (ii) the recent European Community directive relating to PILs and (iii)
      the procedures which are in place for producing and testing PILs. Although
      approximately half (15/31) of the respondents (response rate 31/58) thought that
      PILs were more important for OTC than prescription only medicines, this view was
      not unanimous. A majority (18/28) thought that the new EC directive would provide
      too much information to patients although only a small number (2/27) thought that
      the regulations were unnecessary. Indication for the product was thought to be
      the most important information for the immediate outer packaging. Only about one
      third (35%) of patients are thought to read PILs, in contrast to the majority who
      read the outer packaging. A wide variety of departments contribute to preparing
      PILs. The marketing department had a major input particularly with respect to
      layout and testing of leaflets. On the whole the design and production of PILs
      involves considerable effort but their testing appears less structured and
      thorough.

PMID- 7775611
TI  - The medical and surgical management of trigeminal neuralgia.
AB  - Trigeminal neuralgia is a paroxysmal and severely disabling facial pain. The
      diagnosis is usually made on the basis of a typical history and the exclusion of
      secondary causes. Initial management of the pain is medical. Carbamazepine is the
      drug of choice although some patients respond to other drugs including phenytoin,
      baclofen, sodium valproate and clonazepam. Surgical therapy should be considered
      if medical treatment fails or cannot be tolerated. Surgical options include
      peripheral or central (intracranial) procedures. Central procedures have greater
      morbidity and a significant mortality rate (approximately 1%) but the success
      rates are much greater. Physicians should be aware of the potential benefits of
      surgery but all patients should be advised carefully about the risks before
      informed consent is given.

PMID- 7775614
TI  - Prolonged bleeding time during ciprofloxacin therapy.
AB  - Ciprofloxacin is a broad spectum quinolone antibiotic. Side effects reported
      include nausea and other gastrointestinal symptoms; skin and musculoskeletal side
      effects may also occur. No bleeding abnormalities or alteration in coagulation
      have been documented. We report a case where ciprofloxacin appeared to contribute
      to an idiosyncratic prolongation of bleeding time although a rechallenge 8 months
      later did not reproduce the effect. Moreover, subsequent investigation of the
      influence of ciprofloxacin on bleeding parameters in 10 healthy volunteers
      demonstrated no alterations in bleeding parameters.

PMID- 7775613
TI  - Shelf-life determination of prostaglandin E1 injections.
AB  - A rapid stability indicating assay for the determination of prostaglandin E1
      (PGE1) in pharmaceuticals was developed using High Pressure Liquid Chromatography
      (HPLC). A solution of 20 micrograms/ml PGE1 in 4% alcohol and 0.9% saline has an
      activation energy of 18,683 cal/mol and the predicted shelf-lives were: at 4
      degrees C t95 = 51.8 days and t90 = 106.5 days and at 25 degrees C t95 = 4.8 days
      and t90 = 9.8 days.

PMID- 7775615
TI  - Teicoplanin or vancomycin in the treatment of gram-positive infections?
AB  - The glycopeptide antibiotics vancomycin and teicoplanin have similar mechanisms
      of action on bacterial cell wall synthesis. Their spectra of activity are limited
      to Gram-positive bacteria, with the degree of bactericidal activity depending on
      the species of micro-organism. Staphylococcus aureus, Staphylococcus epidermis,
      enterococci and Clostridium difficile are generally sensitive, including
      methicillin-resistant strains of S. aureus and S. epidermidis. Glycopeptide
      resistance has recently emerged in staphylococci and enterococci. Vancomycin has
      a shorter half-life than teicoplanin and requires multiple dosing to maintain
      adequate serum levels. It can only be given by prolonged intravenous infusion
      over 1 h. In contrast, the pharmacokinetics of teicoplanin allow for once-daily
      dosing, either by rapid intravenous infusion or by the intramuscular route. The
      latter offers reliable absorption for patients with limited venous access and is
      also of benefit for out-patient therapy. Teicoplanin is a safer drug than
      vancomycin. It is associated with a lower incidence of nephrotoxicity or
      ototoxicity. Compared to vancomycin, the availability of the intramuscular route
      and the absence of a requirement for routine serum monitoring, together with the
      reduced need to treat drug-related side-effects make teicoplanin more cost
      effective. It is as effective as vancomycin for most indications, is safe, easy
      to administer and an important agent for treating Gram-positive infections. Its
      role in hospitals is likely to increase if the price of drug acquisition is kept
      low.

PMID- 7775617
TI  - Clinical review 70: Approaches to the prevention of breast cancer.
AB  - In the face of an apparently increasing incidence of postmenopausal breast
      cancer, and with frustratingly limited gains in treatment, significant
      possibilities for widespread prevention of breast cancer must be vigorously
      explored. However, progress with this approach has been painfully slow, and the
      multifactorial etiology of breast cancer development is most responsible for this
      delay. The challenges in our approaches are to recognize the major differences
      between treatment and prevention and to demand a comprehensive biological
      rationale, an absence of serious toxic effects and likely long-term acceptability
      to women of interventions coming to definitive clinical trial.

PMID- 7775616
TI  - Immunocytochemical analyses of dehydroepiandrosterone sulfotransferase in
      cultured human fetal adrenal cells.
AB  - Dehydroepiandrosterone sulfate is the major steroid secretory product of the
      human fetal adrenal gland. Several factors have been shown to modulate the
      secretion of this steroid by cultured fetal adrenal cells. In addition to the
      cytochrome P450 enzymes that are important in steroid biosynthesis,
      dehydroepiandrosterone sulfotransferase (DST) is likely to be a key regulated
      enzyme in the formation of sulfated steroids, which are characteristic of the
      human adrenal cortex, particularly that of the fetus and the adult zona
      reticularis. In the present investigation, we sought to evaluate the cellular
      localization of DST in cultures derived from the fetal zone, neocortex, and
      adrenal capsule and to determine the effects of ACTH and other agonists of the
      protein kinase-A pathway on the abundance of DST in such cells. Cells derived
      from the fetal zone, neocortex, and adrenal capsule were either precultured for 3
      13 days in plastic flasks followed by culture on coverslips or were cultured
      directly on coverslips in control medium (McCoy's 5A medium that contained 5%
      fetal bovine serum) or control medium plus ACTH, forskolin, or dibutyryl cAMP for
      1-4 days. Cells were fixed in buffered formalin and then immunostained for DST by
      use of a rabbit polyclonal antiserum prepared against human liver DST. DST
      immunoreactivity was abundant in freshly isolated cortical cells derived from
      fetal zone and neocortex. DST immunoreactivity was still observable in fetal zone
      and neocortex cells as well as in cells prepared from enzymatic digests of
      adrenal capsule after scraping off adherent neocortex cells following culture for
      9-14 days in control medium. Adrenal fibroblasts were negative for DST. DST
      abundance in cortical cells was increased in cultures supplemented with ACTH,
      forskolin, or dibutyryl cAMP compared to that in cultures grown in control medium
      alone. The results of Western blot analyses of DST in these cells were consistent
      with the immunocytochemical data. These results suggest that DST is present in
      both fetal zone and neocortex cells of the human fetal adrenal at midgestation
      and that the production of DST is stimulated by ACTH and agonists of the protein
      kinase-A signal transduction pathway in the human fetal adrenal gland.

PMID- 7775618
TI  - Body composition and skeletal density--mechanical loading or something more?

PMID- 7775619
TI  - Regular exercise dissociates fat mass and bone density in premenopausal women.
AB  - Body weight is one of the principal determinants of bone density and fracture
      frequency, but there is significant disagreement in the literature regarding the
      relative contributions of the lean and fat components of body weight to this
      relationship. As previous studies have not considered the possible role of
      exercise in soft tissue-bone density interrelationships, we measured areal bone
      mineral density (BMD), fat mass, and lean mass in eumenorrheic premenopausal
      women and determined whether the interrelationships of these variables are
      influenced by the subject's exercise status. Subjects with mean activity levels
      of more than 140 kilojoules/kg.day (equivalent to undertaking vigorous physical
      activity for > 1.5 h/week) were classified as exercisers. In the nonexercising
      subjects (n = 36; age, 36 +/- 8 yr), BMD was markedly weight dependent (0.45 < r
      < 0.62), and this was contributed to by both fat and lean tissue. Because this
      finding may have arisen from the mutual dependence of soft tissue mass and areal
      BMD on body size, fat and lean masses were reexpressed as a percentage of body
      weight. The percent fat tended to be positively related to areal BMD (0.23 < r <
      0.35), whereas the percent lean was inversely related to this index. A second way
      of obviating the mutual dependence of soft tissue mass and areal BMD on body size
      is to derive BMD/height as an index of volumetric bone density. This parameter
      was only related to lean mass in the femur, whereas the correlations with fat
      mass were little changed. The percent fat was positively (0.29 < r < 0.43) and
      the percent lean was negatively (-0.43 < r < -0.29) related to BMD/height
      throughout the skeleton, including the femur. In the exercising subjects (n = 63;
      age, 33 +/- 8 yr), fat mass and lean mass were unrelated to BMD/height (r <
      0.23). However, the percent lean was positively correlated with BMD and
      BMD/height in the femoral neck (r = 0.28 and r = 0.31, respectively). It is
      concluded that bone density is only associated with fat mass in sedentary women.
      In exercisers, femoral neck density is related to lean mass, possibly through the
      effects of weight-bearing exercise on both of these variables.

PMID- 7775620
TI  - Clinical case seminar: Hypokalemia in a 52-year-old woman with non-small cell
      lung cancer.

PMID- 7775621
TI  - Extrasellar, intracavernous sinus adrenocorticotropin-releasing adenoma causing
      Cushing's disease.
AB  - This report describes a patient with pituitary-dependent Cushing's disease who
      had a preoperative ACTH gradient to the left at the level of the cavernous sinus.
      Intraoperatively, an adenoma was found entirely within the left cavernous sinus,
      with no direct connection to the pituitary gland. To our knowledge, such a tumor
      has not been reported previously. This case has implications for the diagnosis,
      treatment, and follow-up of patients with pituitary-dependent Cushing's disease.
      The presence of an entirely extrasellar ACTH-releasing adenoma in the cavernous
      sinus could explain why pituitary-dependent Cushing's disease may persist
      postoperatively, even after total hypophysectomy. The diagnosis of an
      intracavernous tumor can be established by cavernous sinus venography. An
      extrasellar intracavernous adenoma can be diagnosed intraoperatively after
      careful negative exploration of the sellar contents followed by incision of the
      cavernous sinus on the side of the ACTH gradient established by venous sampling.

PMID- 7775622
TI  - Glucose modulation of insulin and glucagon secretion is altered in impaired
      glucose tolerance.
AB  - Insulin and glucagon secretion was compared in women with impaired glucose
      tolerance (IGT; n = 19, age 58.4 +/- 0.3 yr; mean +/- SD) and women with normal
      glucose tolerance (NGT; n = 40, age 58.4 +/- 0.3 yr). Fasting plasma insulin
      levels were higher in IGT than in NGT (P = 0.026), whereas fasting glucose and
      glucagon levels were not different. Arginine was injected intravenously (5 g),
      which rapidly stimulated insulin and glucagon secretion in all subjects. Raising
      the blood glucose (BG) to 14 and 28 mmol/L potentiated insulin secretion and
      inhibited glucagon secretion. The acute insulin response to arginine (AIR = 2-5
      min postload increase) at BG 14 mmol/L, but not at fasting BG or BG 28 mmol/L,
      was lower in IGT than in NGT (P = 0.033), as was the glucose potentiation of AIR
      (slopeAIR) (P = 0.020). The acute glucagon response (AGR) was higher in IGT than
      in NGT at BG 14 mmol/L (P = 0.016). SlopeAGR (glucose inhibition of AGR) was
      reduced in IGT (P = 0.001). In NGT, there was a significant inverse correlation
      between slopeAIR and slopeAGR (P = 0.002) not seen in IGT. We conclude that in
      IGT with normal fasting BG, the glucose modulation of islet function is impaired,
      indicating that islet dysfunction is an early lesion during the development of
      noninsulin-dependent diabetes mellitus.

PMID- 7775623
TI  - A comparison of the effects of oral and transdermal estrogen replacement on
      insulin sensitivity in postmenopausal women.
AB  - Previous studies have shown that oral, but not transdermal, administration of
      estrogen stimulates GH secretion in postmenopausal women. Because GH impairs
      insulin action, the impact of estrogen replacement therapy on carbohydrate
      metabolism may be influenced by the route of administration. The aim of this
      study was to prospectively compare the effects of oral and transdermal estrogen
      replacement on glucose tolerance and insulin sensitivity in postmenopausal women.
      In an open label, randomized, cross-over study, nine postmenopausal women were
      randomized to transdermal estrogen patches (Estraderm-TTS 100) or oral conjugated
      estrogen (Premarin, 1.25 mg) daily for 12 weeks and then crossed over to receive
      the alternative treatment for a further 12 weeks. An oral glucose tolerance test
      and hyperinsulinemic euglycemic clamp (HEC) were performed before treatment and
      at the end of 10 weeks of treatment. Oral and transdermal estrogen both
      significantly reduced LH to the same degree. Mean GH did not significantly change
      with transdermal estrogen, but rose significantly during oral estrogen therapy.
      Peak and mean glucose and insulin levels during the oral glucose tolerance test
      were not altered by estrogen therapy and were not significantly different between
      treatments. Mean glucose and insulin levels were maintained at an identical level
      during the HEC performed at pretreatment and during estrogen therapy. The mean
      glucose infusion rate required to maintain euglycemia during the HEC (mean +/-
      SEM, pretreatment, 40.4 +/- 4.8 mumol/kg.min) was unaltered by oral (39.8 +/- 4.6
      mumol/kg.min) or transdermal estrogen treatment (42.1 +/- 4.2 mumol/kg.min).
      However, during the transdermal estrogen phase (60 +/- 10 mumol/L), the mean
      nonesterified free fatty acid concentration was suppressed to a significantly
      lower level during the HEC than during the oral estrogen phase (120 +/- 20
      mumol/L; P < 0.05). We conclude that compared to the oral route, transdermal
      estrogen therapy is associated with a slight, but significant, improvement of
      insulin action on lipid metabolism. However, in the short term, the route of
      estrogen replacement therapy does not have a major impact on glucose metabolism
      in postmenopausal women.

PMID- 7775624
TI  - Somatostatin enhances insulin-stimulated glucose uptake in the perfused human
      forearm.
AB  - Somatostatin is widely used in experimental metabolic studies to control hormone
      actions. It has also been suggested that, in addition to its well known
      suppressive effects, somatostatin per se may increase insulin sensitivity. In
      order to examine this suggestion, we gave six healthy male volunteers (age 33 +/-
      1 yr, mean +/- SEM; body mass index, 24.1 +/- 0.6 kg/m2) either a local
      intraarterial (brachial artery) or a systemic venous infusion of 25 micrograms/h
      somatostatin twice. The study consisted of a 1-h basal period and a 2-h systemic
      hyperinsulinemic (0.4 mU/kg.min) euglycemic clamp. Compared with the systemic
      control infusion, local forearm perfusion with somatostatin caused a 55% increase
      in insulin-stimulated forearm glucose uptake (0.74 +/- 0.18 vs. 0.47 +/- 0.19
      mmol/L, P < 0.05). Intraarterial somatostatin perfusion did not alter basal
      forearm glucose uptake (0.14 +/- 0.07 vs. 0.17 +/- 0.12 mmol/L), the amount of
      glucose administered during the clamp (M-value, 3.2 +/- 0.5 vs. 3.0 +/- 0.6
      mg/kg.min), or the levels of insulin, C-peptide, glucagon, or GH. Intermediary
      metabolite exchange across the forearm, total forearm blood flow, and oxygen
      saturations also remained stable. Glucose concentrations were slightly higher
      (0.06 +/- 0.01 mmol/L) in arterial than in arterialized blood, whereas lactate
      concentrations were comparatively decreased (108 +/- 51 mumol/L) in arterial
      blood. Our data suggest that somatostatin increases insulin-stimulated muscle
      utilization of glucose through local mechanisms. Although the nature of this
      increase remains to be established, it should be taken into consideration in
      metabolic studies using somatostatin.

PMID- 7775625
TI  - Relationships of plasminogen activator inhibitor activity and lipoprotein(a) with
      insulin, testosterone, 17 beta-estradiol, and testosterone binding globulin in
      myocardial infarction patients and healthy controls.
AB  - The relationships between plasminogen activator inhibitor (PAi) activity and
      lipoprotein(a) [Lp(a)] and insulin, testosterone, 17 beta-estradiol, and
      testosterone binding globulin (TEBG) were assessed in 42 myocardial infarction
      male patients and 74 healthy controls. Patients had higher levels of insulin than
      did controls (87 +/- 30 vs. 75 +/- 28 pmol/L, respectively; P < 0.04), and no
      differences were found in levels of PAi activity, testosterone, 17 beta
      estradiol, and TEBG. Lp(a) levels greater than 0.3 g/L were more frequent in
      patients than in controls (P < 0.002). In all subjects, PAi activity levels were
      significantly and positively correlated with body mass index (r = 0.20, P <
      0.05), triglycerides (r = 0.38, P < 0.0001), and insulin (r = 0.27, P < 0.005)
      and were negatively correlated with testosterone (r = -0.28, P < 0.005) and TEBG
      (r = -0.42, P < 0.001). Stepwise multiple regression analysis showed
      triglyceride, insulin, and TEBG levels to be significantly related to PAi
      activity. No significant correlations were found between Lp(a) levels and all
      hormonal variables studied and between Lp(a) and PAi activity (r = -0.06, P <
      0.58). These results suggest that TEBG is significantly and independently related
      to PAi levels.

PMID- 7775626
TI  - Differential adaptation of glucocorticoid sensitivity of peripheral blood
      mononuclear leukocytes in patients with sepsis or septic shock.
AB  - In view of the immunosuppressive action of glucocorticoids (GCs), the activation
      of the hypothalamo-pituitary-adrenal axis in patients with sepsis or septic shock
      is paradoxical. At the same time, administration of GCs to these patients is not
      clearly beneficial. We investigated the role of GCs in severe illness by
      measuring the sensitivity of peripheral blood mononuclear leukocytes to GCs in a
      mitogen-stimulated lymphocyte proliferation assay. In addition, we studied the
      role of interleukin-2 and several other cytokines in this system. Cells from
      patients with sepsis or septic shock (n = 15) were more sensitive to the
      antiproliferative action of GCs than were cells from normal controls (IC50 6.7 +/
      2.1 nmol/L for patients vs. 19.5 +/- 2.5 nmol/L for controls; P < 0.01). This
      increased sensitivity of the peripheral mononuclear cells to dexamethasone during
      the period of sepsis normalized during the ensuing period of clinical recovery of
      these patients. Dexamethasone inhibited the production of interleukin-2 in the
      mitogen-stimulated cells. Addition of interleukin-2 antagonized the suppressive
      effects of dexamethasone in a dose-dependent manner, both in cells from controls
      and in cells from patients with sepsis. To a lesser extent, the combination of
      interleukin-1, interleukin-6, and tumor necrosis factor-alpha also counteracted
      the effects of dexamethasone. In conclusion, our results suggest that not only
      the activity of the hypothalamo-pituitary-adrenal axis but also the sensitivity
      to GCs is regulated during sepsis and septic shock. Generally there is an
      increased sensitivity to GCs, which might help to protect the organism as a whole
      through supportive effects on metabolism and vasculature. This hypersensitivity
      is counteracted, possibly at the site of inflammation, by high local
      concentrations of cytokines. This would enable an adequate local response of the
      immune system in the presence of elevated cortisol levels. In view of the
      increased sensitivity of peripheral leukocytes to GCs, treatment of these
      patients with high doses of GCs may not be beneficial or may even be harmful.

PMID- 7775627
TI  - Glucocorticoids, sympathetic activity, and presynaptic alpha 2-adrenoceptor
      function in humans.
AB  - The sympathetic nervous system and the pituitary-adrenocortical system are two of
      the body's main stress effector systems. Animal studies have indicated that
      exogenously administered glucocorticoids inhibit sympathetic outflows and
      interfere with the function of presynaptic alpha 2-adrenoceptors modulating
      neuronal norepinephrine (NE) release. The present study tested whether
      glucocorticoids produce similar effects in humans. In a randomized, double-blind,
      placebo-controlled cross-over experiment, 15 healthy subjects took 20 mg
      prednisone or placebo orally daily each morning for 1 week, followed by the other
      drug after a 1-week washout. On the last day of each treatment week, blood
      samples were drawn for assays of plasma levels of catechols and ACTH before and
      after iv infusion of the alpha 2-adrenoceptor antagonist yohimbine (YOH) (0.125
      mg/kg bolus, 0.001 mg.kg-1.min-1 infusion). In 7 subjects, directly recorded
      peroneal skeletal muscle sympathetic nerve activity (MSNA) was also measured at
      baseline and after YOH infusion at the end of both treatment weeks. Prednisone
      decreased plasma NE levels and MSNA compared with levels after placebo (1.09 +/-
      0.11 nmol/L vs. 1.40 +/- 0.13 nmol/L, P < 0.01; 30 +/- 4 bursts/min vs. 36 +/- 3
      bursts/min, P < 0.05) without affecting blood pressure or pulse rate. YOH
      increased mean arterial blood pressure by 12% (P < 0.001) and heart rate by 7% (P
      < 0.05); prednisone did not alter these effects of YOH. YOH-induced proportionate
      increments in plasma NE levels averaged about 10 times those in MSNA. Prednisone
      did not affect the YOH-induced proportionate increments in plasma NE levels
      (placebo, 243%; prednisone, 237%) or MSNA (placebo, 22%; prednisone, 23%). The
      decrements in MSNA and plasma NE levels after prednisone treatment indicate that
      glucocorticoids inhibit sympathoneural outflows in humans. The 10-fold larger NE
      than MSNA response to YOH confirms substantial inhibitory modulation of NE
      release by alpha 2-adrenoceptors on noradrenergic terminals, and the similarity
      of responses to YOH after prednisone or placebo suggests that glucocorticoid
      induced sympathoinhibition occurs independently of altered modulatory function of
      alpha 2-adrenoceptors on noradrenergic terminals.

PMID- 7775628
TI  - Stimulation of intracellular calcium concentration by adenosine triphosphate and
      uridine 5'-triphosphate in human term placental cells: evidence for purinergic
      receptors.
AB  - Recent data suggest an important role for calcium (Ca2+) in human placental
      endocrinology. Thus, the regulation of Ca2+ influx seems to be implicated in the
      modulation of human placental lactogen and hCG release. A possible mechanism of
      influx regulation is through receptor-operated channels. One of the most
      characterized receptor gating Ca2+ channels, the ATP receptor, stimulates the
      intracellular calcium concentration ([Ca2+]i) in various tissues. The aim of this
      study was to determine whether ATP receptors gating Ca2+ channels are also
      present in placental cells. We thus determined the effect of ATP on [Ca2+]i in
      human term trophoblastic cells loaded with the Ca(2+)-responsive fluorescent dye
      fura-2. ATP stimulated a 4.3 +/- 0.4 (+/- SE)-fold increase in [Ca2+]i, with a
      half-maximal effective concentration (EC50) of 1.5 mumol/L. The pharmacological
      activation profile suggests the presence of purinergic P2u receptors (nucleotide
      receptors), because uridine 5'-triphosphate (UTP) also stimulated [Ca2+]i (4.0
      fold increase, with an EC50 of 10 mumol/L). The ATP-stimulated [Ca2+]i was partly
      sensitive to pertussis toxin; we observed a 58% inhibition of ATP-induced [Ca2+]i
      with the toxin without effect on basal [Ca2+]i. The ATP- and UTP-stimulated
      [Ca2+]i declined with time in the presence of ATP (or UTP). The rate of
      deactivation was rapid (t1/2, < 60 s with 10(-5) mol/L ATP) and concentration
      dependent. The deactivation occurring during one application of ATP or UTP
      resulted in a diminution of subsequent responses. The recovery was incomplete
      even with long waiting times (up to 30 min). ATP and UTP also stimulated inositol
      phosphate production with EC50 values of 11 and 15 mumol/L, respectively, but not
      human placental lactogen or hCG release in experiments in which known
      secretagogues were effective. The results suggest the presence in human term
      placental cells of P2u receptors pharmacologically similar to those observed in
      other tissues, especially in the pituitary and amnion. The physiological
      significance of this stimulation of [Ca2+]i by ATP and UTP in the human placenta
      remains to be investigated.

PMID- 7775629
TI  - Effects of a new oral contraceptive containing an antimineralocorticoid
      progestogen, drospirenone, on the renin-aldosterone system, body weight, blood
      pressure, glucose tolerance, and lipid metabolism.
AB  - Combined hormonal oral contraceptives (OCs) may lead to a mild rise in blood
      pressure and body weight. In rare instances, large increments in blood pressure
      are measured. We investigated the effect of a combination of ethinyl estradiol
      (EE) plus a progestogen with antimineralocorticoid, i.e. natriuretic, properties
      [Drospirenone (DRSP)] on body weight, blood pressure, the renin-aldosterone
      system, atrial natriuretic factor, plasma lipids, and glucose tolerance. It is
      anticipated that this will lead to the development of an OC that does not raise
      body weight or blood pressure. Four groups of 20 women each received 30
      micrograms EE plus 3 mg DRSP (group A), 20 micrograms EE plus 3 mg DRSP (group
      B), 15 micrograms EE plus 3 mg DRSP (group C), and, as a control OC, 30
      micrograms EE plus 150 micrograms levonorgestrel (Microgynon, Schering; group D)
      for 6 months. During the OC-free control cycles before and after treatment and
      throughout treatment, the target parameters were measured. Between the
      pretreatment cycle and the sixth treatment cycle, mean body weight fell by 0.8 to
      1.7 kg in groups A, B, and C (P < 0.05 vs. D), whereas it rose by 0.7 kg in group
      D. Systolic and diastolic blood pressures fell by 1-4 mm Hg in groups A, B, and C
      (significant for A and C vs. D) and increased by 1-2 mm Hg in group D. Renin
      substrate rose equally in all groups (P < 0.05), whereas PRA and plasma
      aldosterone rose significantly only in the DRSP groups, presumably due to sodium
      loss. In the DRSP groups, high density lipoprotein cholesterol rose (P < 0.05),
      in contrast to group D. Low density lipoprotein cholesterol fell slightly (P >
      0.05), whereas triglyceride levels showed a stronger increase in the DRSP groups
      (P < 0.05) than in group D. All groups attained good cycle control; group A had
      the best. Side-effects were minimal. To our knowledge, this is the first report
      on a combined OC that leads to a small decrease in body weight and blood
      pressure. It may be especially beneficial for women susceptible for a gain in
      weight and a rise in blood pressure.

PMID- 7775630
TI  - 17 beta-estradiol stimulates prostacyclin, but not endothelin-1, production in
      human vascular endothelial cells.
AB  - The exact mechanisms by which estrogens protect against occlusive vascular
      disorders are not known. One possibility could be an effect on vascular
      endothelial vasoactive compounds, such as vasodilatory prostacyclin (PGI2) and
      vasoconstrictory endothelin (ET-1). Here we report on the effect of 17 beta
      estradiol on the synthesis of PGI2 and ET-1 in cultured human umbilical vein
      endothelial cells. These cells were incubated in the absence (control) and
      presence of 17 beta-estradiol (0.001-1 mumol/L) for 3-24 h with serum (10%) or
      without serum. The release of PGI2, as assessed by its metabolite 6-keto
      prostaglandin F1 alpha, and that of ET-1, were assessed by RIA. 17 beta-Estradiol
      (0.01-0.1 mumol/L) predissolved in ethanol (final concentration, 0.01%) increased
      PGI2 production by 26-30% in endothelial cells incubated without serum. This
      increase in PGI2 production was enhanced up to 66% when 17 beta-estradiol (1
      mumol/L) was encapsulated within beta-cyclodextrin. The stimulation of PGI2
      production was detectable after 12 h of incubation. The 17 beta-estradiol-induced
      stimulation of PGI2 production was blocked in dose-dependent manner by
      antiestrogenic tamoxifen. 17 beta-Estradiol failed to affect the production of
      PGI2 if the endothelial cells were incubated with serum and had no effect on ET-1
      production under any conditions. 17 beta-Estradiol-induced stimulation of
      vasodilatory and antiaggregatory PGI2 production without a concomitant change in
      vasoconstrictory ET-1 production may provide one explanation for the ability of
      estradiol to maintain vascular health and protect against vascular disorders.

PMID- 7775632
TI  - Localization and quantification of vascular endothelial growth factor messenger
      ribonucleic acid in human myometrium and leiomyomata.
AB  - Vascular endothelial growth factor (VEGF) messenger RNA (mRNA) and VEGF peptide
      were studied in human myometrium and leiomyomata. Amplification of complementary
      DNA from myometrium and leiomyomata by the polymerase chain reaction revealed
      three species of mRNA encoding VEGF: VEGF189, VEGF165, and VEGF121. In situ
      hybridization demonstrated VEGF mRNA expression throughout the smooth muscle
      cells of myometrium and leiomyomata. VEGF-like immunoreactivity was also detected
      in these tissues by immunocytochemistry. Quantification of VEGF mRNA using an
      RNAse protection assay demonstrated that in normal myometrium, levels of VEGF
      mRNA are significantly higher in the secretory phase than in the proliferative
      phase of the cycle. Leiomyomata did not have significantly different levels of
      VEGF mRNA compared with normal myometrium. In untreated leiomyomata, there was no
      significant difference between VEGF mRNA levels in the proliferative and
      secretory phases of the cycle. Leiomyomata from women treated with a GnRH anlog
      did not have significantly different levels of VEGF mRNA from untreated
      leiomyomata.

PMID- 7775631
TI  - Molecular and pharmacological characterization of somatostatin receptor subtypes
      in adrenal, extraadrenal, and malignant pheochromocytomas.
AB  - SRIH receptors were quantified by radioautography in 33 pheochromocytomas and 5
      normal adrenals. Binding was evenly distributed over the tumors, whereas it was
      more intense in adrenal medulla than cortex. Binding levels were significantly
      higher in tumoral than in normal tissue, but did not differ among tumors. At 100
      nmol/L, SRIH-14 and octreotide (or BIM23014 in cross-linking experiments to a 57
      kilodalton component) comparably displaced SRIH binding, BIM23042 and BIM23052
      were less potent, and BIM23056 was inefficient. In increasing doses, the rank
      order of potency was SRIH-14 > SRIH-28 > octreotide > BIM23052 >> BIM23042 >> >
      BIM23056. All five species of SRIH receptor (SSTR1-5) messenger ribonucleic acids
      (mRNAs) were measurable in pheochromocytomas and normal adrenals, SSTR2 and SSTR4
      mRNA were the most expressed moieties. The proportion of SSTR5 mRNA species was
      higher in normal adrenals (21%) than in pheochromocytomas (6%). In the presence
      of guanylylimidodiphosphate, SRIH binding was reduced by 83%. However, SRIH did
      not alter basal or forskolin-stimulated adenylyl cyclase activity. Taken
      together, these pharmacological and molecular data indicate that SRIH binding on
      pheochromocytomas depends on a mixed population of receptors, mainly of the SSTR2
      and SSTR4 subtypes, efficiently coupled to G proteins, but not to adenylyl
      cyclase inhibition.

PMID- 7775634
TI  - Degree of activation of the pituitary-testicular axis in early pubertal boys with
      constitutional delay of growth and puberty determines the growth response to
      treatment with testosterone or oxandrolone.
AB  - Early pubertal boys (testicular volume, 4-6 mL) with constitutionally delayed
      growth and puberty were randomized to 3 months of treatment after a baseline 12-h
      overnight hormone profile: group 1 (n = 5), daily placebo; group 2 (n = 5), 2.5
      mg oxandrolone daily; or group 3 (n = 6), 50-mg testosterone monthly im
      injections. LH and GH profiles (15-min samples) were analyzed by peak detection
      (Pulsar), Fourier transformation, and autocorrelation. FSH and testosterone
      levels were measured hourly, and insulin, sex hormone-binding globulin, insulin
      like growth factor-I, and insulin-like growth factor-binding protein-3 levels
      were determined at 0800 h. Multiple regression was used to analyze the response
      to treatment (growth) with respect to baseline features. Endocrine variability
      was marked. Profiles ranged from unreactive to well established LH pulsatility
      and adult testosterone levels. The areas under the curve (AUC) for LH, FSH, and
      testosterone ranged 10-fold (4.4-46.3 IU/L.h), 8-fold (7.9-63.4 IU/L.h), and 45
      fold (3.6-161.7 nmol/L.h), respectively. The growth response was individually
      varied, but significantly increased 0-6 months in the active treatment groups.
      Age, testicular volume, and LH AUC interacted significantly (r2 = 0.95; P <
      0.05). Allowance for these produced a highly significant treatment effect (P =
      0.006). Age, testicular volume, LH AUC, and testosterone AUC, but not treatment,
      significantly increased growth by 0-12 months (r2 = 0.88; P < 0.05). We
      demonstrate a spectrum of activation of the reproductive axis despite tight
      clinical staging. This, and not GH status at treatment commencement, influenced
      the growth response.

PMID- 7775633
TI  - Antiovulatory actions of RU 486: the pituitary is not the primary site of action
      in vivo.
AB  - Continuous administration of RU 486 impairs follicular development and inhibits
      ovulation in women. Yet, the mechanism of ovulation inhibition remains unknown.
      To characterize the mechanism(s) of ovulation inhibition, we studied six
      regularly menstruating cynomolgus monkeys for three consecutive (control-rest
      treatment) cycles. Monkeys received 1 mg/kg.day RU 486 in between cycle days 2
      22. Basal and GnRH-stimulated (1 and 50 micrograms GnRH, iv, 2 h apart) secretion
      of LH and FSH was assessed using serial blood samples (every 15 min for 12 h)
      collected on cycle day 10. Serum levels of estradiol (E2), progesterone (P4), RU
      486, cortisol, LH, FSH, and PRL were analyzed by RIAs, the bioactivity of LH was
      assessed using a mouse Leydig cell assay. The mean cycle length was prolonged by
      RU 486 treatment from 31.8 to 69.8 days (P = 0.008). During RU 486 treatment,
      patterns of E2 secretion varied considerably; the mean +/- SD E2 level was 204 +/
      139 pmol/L. LH peaks and P4 profiles compatible with luteal function were seen
      only before resumption of menstruation. However, one monkey had an increase in P4
      after the GnRH challenge-induced LH secretion. Basal levels of LH varied between
      suppressed and apparently normal values, whereas basal FSH seemed little affected
      by RU 486 treatment. In two monkeys with E2 secretion indicative of normal
      follicular development, minor peaks of LH, but no rises in serum P4, were seen.
      The ratio of bioactive/immunoactive LH was reduced in these monkeys during RU 486
      treatment compared to that during the washout period of the treatment cycle.
      Surprisingly, the pituitary responsiveness to acute GnRH challenge was not
      affected by RU 486 administration. The individual levels of RU 486 were similar
      during the treatment period (mean, 40 nmol/L). A resumption of ovulatory cycles
      occurred when RU 486 concentrations were below 2.5 nmol/L. We conclude that in
      cynomolgus monkeys, inhibition of ovulation by RU 486 occurs mainly at the level
      of the hypothalamus, with possible additional effects on the granulosa cell
      function and alterations of LH bioactivity.

PMID- 7775635
TI  - Estrogen receptor gene expression in human uterine leiomyomata.
AB  - Estrogen and progestin are believed to be important physiological regulators of
      uterine leiomyoma growth. We recently showed that progesterone receptor messenger
      ribonucleic acid (mRNA) and protein levels are increased in human uterine
      leiomyomas compared with those in myometrial biopsy tissue obtained from the same
      patient. To further characterize the molecular mechanisms underlying abnormal
      growth of uterine leiomyomas, we analyzed biopsy samples of tumor and adjacent
      normal myometrium for estrogen receptor (ER) gene expression. Northern analysis
      indicated that ER mRNA levels were increased 1.4-to 12.6-fold in leiomyoma
      compared with myometrium in all patients examined (n = 11), whereas beta-actin
      mRNA was not different between the two groups. The size of the primary ER mRNA
      transcript was 6.2 kilobases in both leiomyoma and myometrium, indicating no
      gross mutation of the ER gene. An ER protein of 66 kilodaltons was detected by
      Western blot analysis, and quantitative immunoassay of ER revealed 9448 +/- 1955
      fmol/mg DNA in leiomyoma compared to 2827 +/- 979 fmol/mg DNA in myometrial
      tissue. Scatchard analysis of 17 beta-estradiol binding to cell-free extracts
      revealed enhanced binding capacity (per mg DNA) in leiomyoma tissue (n = 6) of
      about 6-fold, whereas ER binding affinity was not substantially different between
      the leiomyoma and adjacent myometrial tissues. We propose that increased
      expression of progesterone receptor in leiomyoma is most likely a consequence of
      overexpression of functional ER that results in increased end-organ sensitivity
      to estradiol.

PMID- 7775636
TI  - Analysis of the insulin receptor gene in noninsulin-dependent diabetes mellitus
      by denaturing gradient gel blots: a clinical research center study.
AB  - We have used a new technique of denaturing gradient gel blotting to determine the
      prevalence of alterations in the intracellular domain of the insulin receptor in
      normal individuals and subjects with non-insulin-dependent diabetes mellitus
      (NIDDM). This method detects DNA sequence differences as restriction fragment
      melting polymorphisms (RFMP) and is sensitive to changes in sequence at both
      restriction sites and within the fragments themselves. Using restriction digests
      with AluI, HaeIII, HinfI, RsaI, Sau3A, and Sau96, 12 RFMPs were found to localize
      to the region of the beta-subunit of the insulin receptor gene. Using exon
      specific probes, these RFMPs could be localized to specific regions surrounding
      individual exons, including exons 14, 15, 17, 19, 20, and 22. In general, linkage
      disequilibrium between polymorphisms was inversely related to their distance in
      the gene structure, although there was a "hot spot" for recombination between
      exons 19 and 20. No difference in melting temperatures or allele frequency was
      observed between NIDDM patients and controls. These data indicate that the region
      of the insulin receptor gene coding for the intracellular portion of the beta
      subunit is highly polymorphic and that polymorphisms surrounding specific exons
      can be identified by denaturing gradient gel blotting, but there is no evidence
      that variation at this locus contributes to NIDDM susceptibility in most
      individuals.

PMID- 7775637
TI  - Trophoblast and placental villous core production of lipid peroxides,
      thromboxane, and prostacyclin in preeclampsia.
AB  - Placentas obtained from women with preeclampsia produce more lipid peroxides and
      more thromboxane, but less prostacyclin, than normal. The tissue compartments
      within the placenta that are responsible for this are not known. The placenta is
      a heterogeneous tissue compartmentalized into trophoblast cells and villous core
      tissue that is comprised of stromal and vascular tissue. In this study we
      determined the placental compartments responsible for increased production of
      lipid peroxides and thromboxane in preeclampsia. Placentas were obtained from six
      normally pregnant women and seven women with preeclampsia. Trophoblast cells and
      villous core tissues were isolated and incubated in Dulbecco's Modified Eagle's
      Medium for 48 h. Samples were collected at 0, 2, 6, 16, 28, and 48 h of
      incubation and analyzed spectrophotometrically for lipid peroxides by a peroxide
      equivalent assay and for thromboxane and prostacyclin by RIA of their stable
      metabolites, thromboxane-B2 and 6-keto-prostaglandin-F1 alpha. Trophoblast cells
      isolated from preeclamptic placentas produced significantly more lipid peroxides
      (1972 +/- 502 vs. 1102 +/- 335 pmol/micrograms protein after 48 h of incubation),
      more thromboxane (328 +/- 57 vs. 153 +/- 53 pg/microgram at 48 h), and more
      prostacyclin (50 +/- 11 vs. 13 +/- 3 pg/microgram at 48 h, respectively) than
      trophoblast cells isolated from normal placentas. Villous core tissue isolated
      from preeclamptic placentas produced significantly more lipid peroxides (455 +/-
      107 vs. 241 +/- 34 pmol/microgram) and more thromboxane (148 +/- 51 vs. 76 +/- 14
      pg/microgram) than normal villous core tissue, but there was no difference in
      prostacyclin production (36 +/- 11 vs. 40 +/- 9 pg/microgram). Because of the
      increase in thromboxane production, the ratio of thromboxane to prostacyclin was
      higher in preeclamptic than normal villous core tissue (6.29 vs. 2.17).
      Comparison of production by different compartments within the placenta
      demonstrated that lipid peroxides and thromboxane were primarily produced by the
      trophoblast cells and stromal tissue, whereas prostacyclin was primarily produced
      by the vascular tissue. We conclude that increased placental production of lipid
      peroxides and thromboxane in preeclampsia originates from both the trophoblast
      cell and the villous core compartments. As the placenta secretes lipid peroxides,
      the trophoblast cells could be a source of increased lipid peroxides in the
      maternal circulation of women with preeclampsia. The increased ratio of
      thromboxane to prostacyclin in the villous core could be responsible for
      increased placental vasoconstriction.

PMID- 7775638
TI  - Insulin-mediated increase in blood flow is impaired in the elderly.
AB  - It has recently been recognized that the ability of insulin to augment blood flow
      is reduced in insulin-resistant conditions such as obesity and noninsulin
      dependent diabetes mellitus. Normal aging is characterized by resistance to
      insulin-mediated glucose uptake. We undertook the following studies with the
      hypothesis that the resistance to insulin-mediated glucose uptake that occurs
      with aging is caused in part by a reduction in insulin-mediated blood flow. These
      experiments were conducted on healthy young (n = 13; age, 24 +/- 1 yr; body mass
      index: 22.2 +/- 0.6 kg/m2) and old (n = 13; age, 77 +/- 1 yr; body mass index:
      24.2 +/- 0.5 kg/m2) subjects. Each subject underwent two studies. In the control
      study, saline was infused for 4 h. In the euglycemic clamp study, insulin was
      infused for 4 h at a rate of 40 mU/m2.min in the young subjects and 34 mU/m2.min
      in the old subjects. Blood samples were taken, and calf blood flow was measured
      using venous occlusion plethysmography at regular intervals in each study. Basal
      calf blood flow was lower in the elderly (young subjects: 1.51 +/- .08 mL/100 mL
      tissue per min; old subjects: 1.15 +/- 0.07 mL/100 mL tissue per min, P < 0.002).
      During the euglycemic clamp studies, steady-state insulin and glucose values were
      similar in the two age groups. Glucose disposal rates were significantly higher
      in the young subjects (P = 0.01 by analysis of variance). Mean arterial pressure
      values were significantly higher in the elderly (P < 0.001 by analysis of
      variance) throughout the clamp, but there was no significant change over time in
      either age group. The mean incremental blood flow rate at steady-state (180-240
      min) was significantly higher in the young subjects (0.76 +/- 0.23 mL/100 mL
      tissue per min) than in the old subjects (0.05 +/- 0.09 mL/100 mL tissue per min,
      P < 0.01). There was a significant correlation between steady-state glucose
      disposal rate values and incremental blood flow rates in the young subjects (r =
      0.59, P < 0.05) but not in the old subjects (r = 0.21, P = NS). We conclude that
      normal aging is characterized by an impairment in the ability of insulin to
      modulate blood flow, which may contribute in part to the insulin resistance of
      aging.

PMID- 7775639
TI  - Human T-lymphotropic virus type I-associated uveitis in patients with Graves'
      disease treated with methylmercaptoimidazole.
AB  - Human T-lymphotropic virus type I (HTLV-I) is responsible for a certain form of
      uveitis [HTLV-I-associated uveitis (HAU)]. A previous history of Graves' disease
      has been reported in 9-17% of the patients with HAU. In this study, the
      prevalence of patients with either HTLV-I antibody or uveitis was evaluated in
      819 consecutive patients with thyroid disorders between 1991 and 1992. Serum HTLV
      I antibody was found in 25 of 392 patients with Graves' disease, 19 of 257 with
      chronic thyroiditis, and 3 of 170 with nodular goiter. Five of 25 HTLV-I-positive
      patients with Graves' disease developed HAU. All of these 5 patients had been
      treated with methylmercaptoimidazole (MMI). Within a few months before the onset
      of uveitis, 3 patients were hyperthyroid, and 2 were hypothyroid. In 2 of 5
      patients, an exacerbation of uveitis occurred soon after the readministration of
      MMI for the relapse of hyperthyroidism. None of the 367 HTLV-I negative patients
      with Graves' disease nor 22 HTLV-I-positive patients with chronic thyroiditis or
      nodular goiter developed uveitis. It was therefore suggested that Graves'
      disease, thyroid dysfunction and/or MMI administration might be related to the
      development of HAU.

PMID- 7775640
TI  - Modulation of leukemia inhibitory factor gene expression and protein biosynthesis
      in human endometrium.
AB  - Implantation is the process by which the blastocyst becomes intimately connected
      with the maternal endometrium/decidua. The independently developing
      preimplantation blastocyst then becomes dependent on the maternal environment for
      its continued development. Although the factors involved in the regulation of
      blastocyst implantation are incompletely understood, recent studies strongly
      suggest a critical role for leukemia inhibitory factor (LIF) in mice. We showed
      previously that LIF acts on human trophoblasts to shift their differentiation
      toward the anchoring phenotype by increasing the synthesis of fibronectin. In the
      present study, we first evaluated the temporal expression of LIF in the human
      endometrium in order to gain further insights into the role of LIF in human
      implantation. We established the LIF is expressed in the endometrium in a
      menstrual cycle-dependent manner. The most abundant LIF messenger ribonucleic
      acid (mRNA) levels are observed in the mid- and late-luteal phase samples. LIF
      mRNA was also present in decidual tissues of first trimester of pregnancy, but
      levels were lower than those found in the midluteal endometrium. We then
      investigated the regulation of LIF expression in human endometrial cells in
      culture by cytokines, steroid hormones, and growth factors. We could not show any
      direct stimulatory evidence of steroid hormones (estradiol and progestins) on LIF
      mRNA expression or protein production by endometrial cells in culture. On the
      other hand, we showed that interleukin-1, tumor necrosis factor-alpha, platelet
      derived growth factor, epidermal growth factor, and transforming growth factor
      beta are potent inducers of LIF expression in endometrial stromal cells in
      culture in a concentration- and time-dependent manner. Interferon-gamma acted to
      inhibit LIF expression induced by these cytokines. In contrast, we found high
      constitutive and relatively less regulated levels of LIF mRNA in the endometrial
      gland cells. The timing of the expression of LIF in the endometrium suggests a
      potential role in the implantation. The regulation of the expression of LIF may
      have an important role in the physiological and pathological processes involving
      human implantation.

PMID- 7775641
TI  - Renal mass and serum calcitriol in male idiopathic calcium renal stone formers:
      role of protein intake.
AB  - To determine whether chronic overconsumption of protein might increase renal mass
      and cause up-regulation of 1,25-dihydroxyvitamin D3 [1,25-(OH)2D] production, 57
      male recurrent idiopathic calcium stone formers (RCSF), 29 with hypercalciuria
      (HCSF; urinary calcium x V, > 7.50 mmol/day) and 28 with normocalciuria (NCSF),
      were compared with 15 healthy male controls (C) while consuming a free choice
      diet. Renal mass in RCSF was measured by the sum of the surface areas of right
      and left kidneys (square centimeters) on plain films of the abdomen by a computer
      assisted sonic stylus; in C, renal mass was assessed sonographically. Serum
      intact PTH and 1,25-(OH)2D were measured radioimmunometrically. In HCSF, urinary
      phosphate x V (35.9 +/- 1.2 mmol/day) was higher than that in NCSF (29.3 +/- 1.3
      mmol/day; P = 0.0009) or C (28.7 +/- 1.8 mmol/day; P = 0.005); urinary creatinine
      x V (16.5 +/- 0.5 mmol/day) was also higher in HCSF than in NCSF (15.0 +/- 0.5
      mmol/day; P = 0.024) or C (13.8 +/- 0.6 mmol/day; P = 0.002). For identical blood
      levels of ionized calcium and phosphate, the 1,25-(OH)2D/PTH concentration ratio
      (an index of regulation of 1,25-(OH)2D production) was higher in HCSF (6.5 +/-
      1.0) than in NCSF (4.0 +/- 0.3; P = 0.005). In addition, the sum of the surface
      areas of right and left kidneys was increased in HCSF (163.4 +/- 2.9 cm2)
      compared with that in NCSF (140.5 +/- 3.1 cm2; P = 0.0001), and it positively
      correlated with urinary phosphate x V (r = 0.429; P = 0.001) as well as with
      urinary creatinine x V (r = 0.294; P = 0.026); no such correlation was noted in
      C. Calcitriol levels were positively related to renal mass in RCSF (r = 0.316; P
      = 0.018), but not in C. Finally, urinary calcium x V positively correlated with
      the serum calcitriol/PTH concentration ratio only in RCSF (r = 0.388; P = 0.003).
      These findings suggest that protein overconsumption may cause an increase in
      renal mass and up-regulate calcitriol production in some male RCSF, an effect
      that would subsequently cause "idiopathic" hypercalciuria.

PMID- 7775642
TI  - Urinary pyridinoline and deoxypyridinoline in healthy children and in children
      with growth hormone deficiency.
AB  - To assess the bone growth status in healthy children, urinary pyridinoline (PYR)
      and deoxypyridinoline (DPYR) levels, which are specific bone resorption markers,
      were studied in 192 healthy children, aged 3-14 yr. In healthy children ages 3-5
      yr, the urinary PYR level was about 10 times higher than that in healthy adults
      (238.3 +/- 22.7 pmol/mumol Cr in boys and 261.8 +/- 14.2 pmol/mumol Cr in girls;
      mean +/- SE, and the level declined gradually with age. In boys, the urinary PYR
      level began to rise at about 10 yr of age and peaked 2 yr later, declining
      thereafter. In girls, urinary PYR level declined rapidly after 11 yr. The age
      related changes in urinary DPYR levels closely resembled those in urinary PYR
      levels. We further studied PYR and DPYR levels in 17 GH-deficient children who
      were beginning treatment with GH. After 2-3 months of GH therapy, 1.3-fold
      significant increases in urinary PYR and DPYR levels were observed. These results
      indicate that the bone resorption in children is increased relative to that in
      adults, that urinary PYR and DPYR levels are increased during puberty when the
      growth rate is markedly elevated, and that bone resorption in children is
      accelerated by GH therapy.

PMID- 7775643
TI  - 3-Monoglucuronyl-glycyrrhetinic acid is a major metabolite that causes licorice
      induced pseudoaldosteronism.
AB  - 18 beta-Glycyrrhetinic acid (GA) has been thought to be one of the major
      metabolites that causes licorice-induced pseudoaldosteronism. However, we found
      no difference in the blood level of GA between the patients with and without
      pseudoaldosteronism. We measured the blood concentration of 3 beta-D
      (monoglucuronyl)18 beta-glycyrrhetinic acid (3MGA), another metabolite of 3 beta
      D-diglucuronyl-18 beta-glycyrrhetinic acid (glycyrrhizin), by high performance
      liquid chromatography and found an increased concentration of 3MGA in 10 patients
      with licorice-induced pseudoaldosteronism, but not in 11 patients without
      pseudoaldosteronism. To investigate whether 3MGA can inhibit 11 beta
      hydroxysteroid dehydrogenase, we incubated rat renal microsome with or without
      3MGA and measured the conversion rate of [3H]cortisol to [3H]cortisone. 3MGA was
      found to be a potent inhibitor of 11 beta-hydroxysteroid dehydrogenase, allowing
      cortisol to exert its full mineralocorticoid effects. These results suggest that
      licorice-induced pseudoaldosteronism is due to an increased concentration of
      3MGA, but not GA, in the circulating blood of these patients.

PMID- 7775644
TI  - Inhibition of steroid 5 alpha-reductase with finasteride: sleep-related
      erections, potency, and libido in healthy men.
AB  - To objectively measure the effects of a 5 alpha-reductase inhibitor on erectile
      function, we studied 20 sexually active men (aged 41-64 yr) during double blind,
      randomized administration of 5 mg/day finasteride (F) or placebo (P). Serum
      testosterone and dihydrotestosterone (DHT) were measured every 4 weeks. Sleep
      related erections were assessed with comprehensive polysomnography for 2 nights
      before randomization (session 1) and at week 12 (session 2). Sexual function
      questionnaires were administered weekly. Serum DHT levels at week 0 were 1.47 +/-
      0.11 and 1.16 +/- 0.27 nmol/L (P > 0.05) in the P and F groups, respectively. F
      group levels fell to 31% and 28% of control values at week 4 and 12. Penile tip
      peak tumescence time increased on second nights more in the P than the F group at
      12 weeks, producing a session main effect (P < 0.02) and a group X session
      interaction (P < 0.05). No significant group X session interactions were found
      for any sleep erection measures in a best night analysis or for self-reported
      sexual activity. Thus, F did not consistently suppress sleep-related erections
      compared to P. F primarily inhibits type 2 5 alpha-reductase activity; however,
      type 1 5 alpha-reductase is the major enzyme in the central nervous system.
      Therefore, DHT involvement in the maintenance of libido and potency is not
      excluded. Nonetheless, these data support the feasibility of using a type 2
      inhibitor to treat benign prostatic hyperplasia without impairing erectile
      function.

PMID- 7775645
TI  - Priming of human polymorphonuclear neutrophilic leukocytes by insulin-like growth
      factor I: increased phagocytic capacity, complement receptor expression,
      degranulation, and oxidative burst.
AB  - Insulin-like growth factor I (IGF-I) is a GH-dependent peptide regulating
      mammalian growth that seems to be of importance for the normal development and
      function of the immune system. Polymorphonuclear neutrophilic leukocytes (PMNLs)
      are terminally differentiated phagocytes essential for host defense, and in the
      present study, recombinant human IGF-I was shown to be a powerful primer of
      mature human PMNLs. IGF-I augmented the PMNL phagocytosis of both immunoglobulin
      G-opsonized Staphylococcus aureus and complement-opsonized Candida albicans. In
      addition, the growth factor increased PMNL complement receptor expression
      [complement receptors 1 (CD35) and 3 (CD11b)] and primed the cells to stronger f
      met-leu-phe-induced degranulation of both specific and azurophilic granules
      [markers: CD11b, CD35 and CD67 (specific granules); CD63 (azurophilic granules)].
      In contrast, IGF-I did not alter the PMNL surface expression of Fc gamma RI
      (CD64), Fc gamma RII (CDw32), or Fc gamma RIII (CD16). PMNLs exposed to IGF-I
      increased their f-met-leu-phe and phorbol myristate acetate-induced oxidative
      burst, as evaluated by hydrogen peroxide production, whereas IGF-I did not
      influence PMNL actin polymerization. The priming of PMNLs by IGF-I was dependent
      on time and concentration, and saturating amounts of a monoclonal antibody to the
      IGF-I receptor blocked the priming of PMNLs by this peptide. These experiments
      demonstrate that IGF-I can selectively stimulate mature PMNL functions, providing
      further evidence for the interaction between the immune and the endocrine
      systems.

PMID- 7775646
TI  - The human adrenal microsomal glucose-6-phosphatase system.
AB  - Microsomal glucose-6-phosphatase (EC 3.1.3.9) is a multicomponent enzyme system
      traditionally thought only to be present in gluconeogenic tissues. The enzyme is
      associated with transport systems, for its substrate glucose-6-phosphate, and its
      products phosphate and glucose. It has been shown, using immunohistochemical
      methods and monospecific antibodies, that the component proteins of the enzyme
      system are present in human embryonic and fetal adrenal gland and are
      predominantly located in the fetal zone with lesser reactivities in the
      definitive zone. In addition, specific glucose-6-phosphatase activity was shown,
      and the rates of entry of glucose-6-phosphate, phosphate, and glucose into
      microsomes isolated from human fetal adrenals were measured. Although the
      complete enzyme system is present, the ratio of the component activities and
      comparison with human fetal and adult liver indicate that the regulation of the
      adrenal and liver glucose-6-phosphatase systems is different. In the human
      postnatal adrenal, immunoreactivies to the protein components decrease
      dramatically and are confined predominantly to the zona reticularis, suggesting a
      specialized role for adrenal glucose-6-phosphatase in fetal life.

PMID- 7775647
TI  - Human chorionic gonadotropin-dependent expression of vascular endothelial growth
      factor/vascular permeability factor in human granulosa cells: importance in
      ovarian hyperstimulation syndrome.
AB  - Ovarian hyperstimulation syndrome (OHSS) is a severe complication arising from
      controlled ovarian stimulation treatment. This iatrogenic condition is
      potentially lethal and occurs in 0.3-5% of stimulated ovarian cycles. hCG
      exacerbates OHSS. The pathophysiology of OHSS is still unknown; therefore,
      treatment regimens are aimed at ameliorating symptoms. Prominent features of OHSS
      are an elevated risk of thromboembolism due to enhanced production of von
      Willebrand factor by endothelial cells and ascites, or pulmonary edema due to
      increased vascular permeability followed by third space fluid accumulation. Both
      of these sequelae can be evoked by vascular endothelial growth factor (VEGF),
      also known as vascular permeability factor (VPF). High concentrations of VEGF/VPF
      have been demonstrated in ascitic fluid from patients with OHSS, but the source
      of VEGF/VPF in these patients remained unidentified. Here we report that the
      messenger ribonucleic acid expression of VEGF/VPF in human luteinized granulosa
      cells (GCs) is dose and time dependently enhanced by hCG in vitro. Furthermore,
      VEGF/VPF proteins are produced by GCs. Our results suggest that the effects of
      hCG on the development and course of OHSS may be mediated by the production of
      VEGF/VPF by GCs.

PMID- 7775648
TI  - Role of the serotonin receptor subtype 5-HT1D on basal and stimulated growth
      hormone secretion.
AB  - At present, four main types of serotonin (5-HT) receptors have been identified in
      the brain (5-HT1, 5-HT2, 5-HT3, and 5-HT4). In addition, the 5-HT1 have been
      further subclassified. We have taken advantage of a new selective 5-HT1D receptor
      agonist 3-[2-(dimethylamino)ethyl]-N-methyl-1H-indole-5-methanesulfonamide
      succinate, Sumatriptan, to evaluate the role of 5-HT1D receptors on GH secretion.
      To this end, several tests with or without sumatriptan were undertaken in normal
      prepubertal children. Furthermore, we assessed the effect of Sumatriptan on basal
      GH secretion and the GH response to GHRH in obese children. In normal children,
      Sumatriptan administration (3 mg, sc) resulted in an increase in basal GH levels
      at 30 min (7.7 +/- 1.5 micrograms/L; P < 0.05) and increased GH responses to GHRH
      (47.3 +/- 6.4 vs. 29.6 +/- 9.7 micrograms/L; P < 0.05). The Sumatriptan-induced
      increase in GH responses to GHRH was dependent on the stimulus tested.
      Pretreatment with Sumatriptan did not modify the GH response to clonidine or
      pyridostigmine, as assessed by the peak GH response and the area under the curve.
      In contrast, it increased the GH response to arginine. In the obese subjects, the
      GH response to GHRH was reduced (7.3 +/- 1.0 vs. 29.6 +/- 9.7 micrograms/L at 30
      min) compared to that in control children (P < 0.05). Sumatriptan administration
      did not alter the basal GH value (peak GH, 1.7 +/- 0.3 micrograms/L at 30 min).
      However, Sumatriptan administration clearly increased the effect of GHRH,
      resulting in a GH peak of 14.6 +/- 3.1 micrograms/L at 30 min (P < 0.01). To
      assess the specificity of Sumatriptan on anterior pituitary hormone secretion, we
      studied its effect on TSH and PRL responses to TRH as well as LH-releasing
      hormone-induced LH and FSH secretion. Administration of Sumatriptan did not alter
      the response of any of these hormones. Our results indicate that 5-HT1D receptors
      have a stimulatory effect on GH secretion, possibly by inhibiting hypothalamic
      somatostatin release.

PMID- 7775649
TI  - Growth hormone insensitivity syndrome due to point deletion and frame shift in
      the growth hormone receptor.
AB  - By direct amplification and sequencing of genomic DNA by the polymerase chain
      reaction, we have identified a unique 2-base deletion in the growth hormone
      receptor gene of a patient with extreme short stature and growth hormone
      insensitivity (Laron) syndrome. We found a deletion of bases 118-119 in exon 4,
      which corresponds to the extracellular domain of the growth hormone receptor.
      Since this mutation encodes a frameshift in the amino acid sequence and a stop
      codon relatively early in the translation of the growth hormone receptor, we
      conclude that this deletion caused the growth hormone insensitivity in this
      patient.

PMID- 7775650
TI  - [A molecular pathological study on the localization of the human papillomavirus
      using nested PCR and in situ hybridization methods in paraffin embedded tissues].
AB  - This study was designed to use nested polymerase chain reaction (nested PCR), in
      situ hybridization (ISH) and immunohistochemical techniques to identify human
      papillomavirus (HPV) in tissues fixed in formalin and embedded in paraffin.
      Eighty cases including 17 cases of condyloma acuminatum, 10 cases of cervical
      dysplasia, 6 cases of carcinoma in situ, 16 cases of squamous cell carcinoma of
      the uterine cervix, 14 cases of nasal and paranasal papilloma, 1 case of
      transitional cell papilloma and 16 cases of esophageal squamous cell carcinoma
      were examined. With the nested PCR method, the positive reaction rate of HPV was
      higher than with the single step PCR method. The detection rate was about ten
      fold higher in condyloma acuminatum and two times higher in cervical dysplasia
      with the nested PCR method. In four cases of condyloma acuminatum, ISH was
      positive. Three of those cases were type 18 HPV and the another was type 11 HPV.
      Immunohistochemically, HPV was detected only in the cases of condyloma
      acuminatum. The nuclei of superficial epithelial cells, especially kilocytes
      reacted positively both by ISH and immunohistochemical methods. Nested PCR is not
      a very complicated technique, and the detection rate is higher than that of
      commonly used pathological techniques. These results suggest that nested PCR will
      be a useful test for HPV routine pathological diagnosis.

PMID- 7775651
TI  - [Effect of newly developed analogue of growth hormone releasing peptide [D-Ala-D
      beta Nal-Ala-Trp-D-Phe-Lys-NH2 (KP-102)] on growth hormone secretion in adult
      male rats].
AB  - The effect of a newly developed hexapeptide; D-Ala-D-beta Nal-Ala-Trp-D-Phe-Lys
      NH2 (KP-102) on GH secretion was studied in adult male rats. KP-102 induced a
      large plasma GH response at a dose of 0.5 micrograms/kg BW in conscious rats,
      although GH-releasing abilities of KP-102 varied markedly depending on the phase
      of GH secretion. Among urethan-anesthetized rats, KP-102 alone exerted a small
      influence on GH secretion, but it produced a large plasma GH response in the
      presence of exogenous GH-releasing factor (GRF). The rest of studies were
      performed on urethan anesthetized rats. During intermittent administration of
      GRF, the somatotropes became refractory to a large bolus dose of GRF, but KP-102
      induced a marked increase of plasma GH. The GH response to KP-102 alone or KP-102
      with GRF was significantly augmented when cysteamine HCl was previously
      administered. Although KP-102 and GRF acted synergistically on GH secretion in
      control animals, they acted additively in cysteamine-administered rats. Taken
      together, these findings suggest that the KP-102-induced GH secretion largely
      depends on GRF and the secretagogue potentiates the GRF effect by antagonizing
      the SS action at the level of somatotropes. It is concluded that KP-102 alone or
      in combination with GRF provides a means of stimulating GH secretion in the face
      of elevated inhibitory tone mediated by SS.

PMID- 7775652
TI  - [Endotoxin-induced lung injury. The roles of leukocytes and oxidants, and the
      efficacies of steroids and antioxidants].
AB  - Previous work in our laboratory has shown the relation between leukocytes (WBC)
      and the generation of oxidants in endotoxin (LPS) shock. The purpose of this
      study was to find out if WBC-derived oxidants can produce acute lung injury in
      guinea pigs given LPS. We alos evaluated the efficacies of steroids and
      antioxidants against the initial changes in LPS-induced lung injury. One group of
      guinea pigs (200-250 g, male) received 0.7 mg/kg (LD50, 24 hrs.) of E. coli LPS
      in the peritoneal cavity (group I). The animals in group II received 30 mg/kg of
      methylprednisolone (MP), followed by intraperitoneal LPS. The animals in group
      III were given 30 mg/kg of 2-aminomethyl-4-tert-butyl-6-propionylphenol
      hydrochloride (ONO-3144), a known as antioxidant (OH radical scavenger), and then
      an injection of LPS. The animals were killed at following time course: 30, 60 or
      180 minutes after the LPS injection. Hematological examinations (WBC counts),
      total cell counts and differential counts in bronchoalveolar lavage (BAL) fluid
      were done along with light microscopic studies. Superoxide dismutase (SOD)
      activity, catalase activity and malonaldehyde (MDA) produced as a result of lipid
      peroxidation in the lung were measured and correlated with histological changes.
      Survival ratios of the three groups were compared. The results obtained were: 1)
      Significant leukopenia occurred in all groups. 2) In group I, WBC, especially
      eosinophils, were recovered by BAL and the total cell number of the BAL fluid had
      increased by 180 minutes after LPS injection, but MP or ONO-3144 treatment
      inhibited the migration of WBC (eosinophils and neutrophils) into alveolar lumen
      after LPS injection. 3) Histologic examinations revealed diffuse edema,
      hemorrhage, and marked leukocyte infiltration in the alveoli in group I, but not
      in group II or III. 4) SOD activity in all group diminished below the control
      level. Catalase activity had significantly increased by 180 minutes after LPS
      injection in group I, but not in group II or III. MDA had increased remarkably by
      60 minutes after injection of LPS in group I, but MP or ONO-3144 treatment
      prevented such increases. 5) Animals in group II and III survived significantly
      longer than those in the other group. In conclusion, these findings suggest that
      LPS provokes WBC-mediated vascular damage in the lung and steroids or
      antioxidants can minimize the injury and prevent edema formation. Steroids might
      be useful for achieving quantifiable changes in LPS-induced WBC chemotaxis to the
      lung and for decreasing oxidant-induced lung injury.

PMID- 7775653
TI  - [Scanning electron microscopic study of the development of crystalline lens
      fiber].
AB  - To elucidate the 3-dimensional structural development of the albino rabbit lens
      fiber, and to study how cataracts affect these fibers, the lenses from rabbits 1,
      2, 4, and 8 weeks old, and from 8 week old rabbits with cataracts caused by
      naphthalene were examined with a scanning electron microscope. The results were:
      1) Normal rabbit: The ratio of the length of the anterior suture line to the
      diameter of the lens gradually rose from 1 to 4 weeks and then reached a plateau.
      The ratio of the length of the posterior suture line was constant from the first
      week on. Fibers were wider in lenses from older rabbits, except for those in the
      middle of the suture line. Ball-and-socket junctions were common on the anterior
      side and were concentrated in the area of the paraanterior suture line of lenses
      from older animals. The lateral large processes were only noted near the anterior
      suture line, and in extended direction from its end. The likelihood of finding
      edge processes, especially in the area of middle anterior and posterior sections,
      rose with age. 2) Rabbit exposed to Naphthalene: The rate of increase of the
      length of the anterior suture line and the diameter of the lens were both low,
      but their ratio did not differ from that of a normal rabbit's lens. On the
      contrary, the growth rate of the posterior suture line was much greater than that
      of the diameter. The peculiarity of distribution of edge processes and width
      found in normal lens fibers was not found in naphthalene-affected fibers.

PMID- 7775655
TI  - [Treatment of so-called keloid with excision and postoperative electron
      irradiation].
AB  - Between 1988 and 1994, 110 patients with 139 so-called keloids site, which had
      been treated with conservative therapy were treated with excision, suture, and
      postoperative irradiation with a 4 MeV electron beam. They were irradiated within
      one or two days after surgery, for three consecutive days. The total doses were
      15 Gy or 18 Gy per fractions for the most part. Control rates of true keloids and
      hypertrophic scars were 76.0% (57/75) and 93.8% (60/64), respectively, and the
      overall effectiveness rate was 84.2%. No remarkable side effects were observed.
      Transient hyperpigmentation was found in 44.6%. No carcinogenesis have been found
      in our series of patients. Considering the possibility of recurrence, side
      effects, and carcinogenesis, the indication of our treatment was decided. The
      result of our treatment using a low-megavolt electron beam was similar to that of
      published series using a low-energy X-ray. The advantages of the use of electron
      beam are that the peak of dose is the layer of the occurrence of keloid, and that
      the depth of penetration of radiation is limited without appreciable effect on
      the deeper structures. At present, the equipments of low-energy X-ray have been
      disposed. Our treatment using a electron beam will be an effective treatment.

PMID- 7775654
TI  - [EEG power and coherence in presenile and senile depression. Characteristic
      findings related to differences between anxiety type and retardation type].
AB  - Quantitative EEG analysis was done on 29 medicated right-handed depressive
      patients at age over 45 and age and sex matched right-handed 20 normal controls.
      The patients were all diagnosed as major depression with melancholia by DSM-III-R
      and were divided into anxiety type (n = 17) and retardation type (n = 12)
      evaluated with the Hamilton rating scale for depression. Eye closed resting EEGs
      were recorded on a data recorder from the 16 electrode leads (10-20 system).
      Artifact rejected 3 minutes EEGs were analyzed by off-line with Fast Fourier
      Transform from the bilateral frontal (F3, F4), parietal (P3, P4) and occipital
      (O1, O2) regions. The mean values of absolute amplitude power (microV) and the
      mean Z scores of inter-, and intrahemispheric coherence were obtained in theta 1
      (4.0-6.0 Hz), theta 2 (6.0-8.0 Hz), alpha 1 (8.0-10.5 Hz), alpha 2 (10.5-13.0
      Hz), beta 1 (13.0-20.0 Hz), and beta 2 (20.0-40.0 Hz) frequency bands
      respectively. The main findings were: 1) Beta 1 and beta 2 power were greater in
      patients with anxiety type depression than in normal controls, and the
      differences were statistically significant over the parietal and occipital
      regions in beta 1 and the frontal region in beta 2. The anxiety type was
      distinguished from the retardation type with the increase of beta 2 power. The
      retardation type showed higher alpha 1 power over the frontal region and lower
      alpha 2 power over the occipital region than normal controls. 2) Both types
      showed greater frontal predominant ratio to the parietal in beta 2 power than did
      normal controls. The retardation type was distinguished from the anxiety type
      with the right predominance in beta 1 power over the frontal region. 3) Both
      groups of patients showed lower frontal interhemispheric coherences than normal
      controls in each band. In particular, the anxiety type showed significantly lower
      alpha 2 band and lower beta 1 and beta 2 bands. The parietal interhemispheric
      coherence was lower in the anxiety type but higher in the retardation type than
      in normal controls in each band, and this difference was prominent in theta 2
      band. 4) The two groups of patients showed higher fronto-parietal
      intrahemispheric coherences in both hemispheres than the normal controls in each
      band. Especially, the anxiety type showed higher in theta two and alpha 1
      bands.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7775656
TI  - [Serosal smear cytology in operation for gastric and colonic cancers].

PMID- 7775657
TI  - [A case of streptococcal toxic shock syndrome (severe group A streptococcal
      infections) caused by arthritis].

PMID- 7775658
TI  - [Recent advances in esophageal cancer treatment].

PMID- 7775659
TI  - Effect of immunization with lutropin-receptor on the ovarian function of rabbits.
AB  - Three New Zealand white adult female rabbits, designated as A, B, and C, were
      immunized to produce lutropin receptor antibodies. Antisera inhibited the binding
      of 125I-hCG to the lutropin receptor and the production of testosterone by hCG
      stimulated rat Leydig cells. During the study period of, approximately 10 months
      after the last immunization, rabbits did not ovulate in response to an injection
      of 75 IU of human chorionic gonadotropin or mating as revealed by laparotomy. As
      the antibody titers declined, induction of ovulation and laparotomy revealed
      restoration of ovulation and corpus luteum formation. However, no pregnancy
      occurred when rabbits A and B were mated and artificially inseminated. These
      observations indicate that lutropin receptor antibodies can cause infertility in
      female rabbits.

PMID- 7775660
TI  - The specificity and affinity of polyclonal antibodies raised in rabbits against a
      hapten conjugated to rabbit serum albumin.
AB  - In this study, rabbit antisera to hapten-rabbit serum albumin conjugates were
      investigated regarding antibody titer, affinity, specificity, and affinity
      distribution. Methyl phosphonic acid p-amino-phenyl 1,2,2-trimethylpropyldiester
      (MATP) served as model hapten. Four MATP-rabbit serum albumin conjugates with
      various hapten densities (with and without spacer) were synthesized and used for
      immunization of rabbits. Antisera were collected over a 130 day-period and
      characterized with different ELISA methods. We found that immunogens with rabbit
      serum albumin gave antisera with lower titers, but similar affinity as compared
      to polyclonal or monoclonal antibodies obtained with non-rabbit protein as
      carrier protein. Immunogens with a low hapten density led to higher final titers
      without affecting antibody affinity or specificity. Immunogens containing a
      bridging group resulted in higher antibody affinity with a changed specificity.
      The pattern of antibody affinity distribution differed considerably among
      individual rabbits and showed a non-Gaussian subpopulation distribution.

PMID- 7775661
TI  - A non-isotopic immunoassay for guanosine 3':5'-cyclic monophosphate using a
      cyclic GMP-biotin conjugate as tracer.
AB  - 2'-O-monosuccinylguanosine 3':5'-cyclic monophosphate was coupled to N-biotinyl
      1,8-diamino-3,6-dioxaoctane after converting succinyl-cGMP into its N
      hydroxysuccinimide active ester. Isolation and purification of the succinyl-cGMP
      biotin conjugate was performed with FPLC using reversed phase chromatography. The
      synthesis described yielded a conjugate suitable for use as tracer in
      immunoassays for the cGMP measurement in plasma and urine samples. Employing
      biotin as the primary probe in a competitive solid phase immunoassay allows for
      flexible end point determination by means of commercially available labeled
      streptavidin derivatives. Streptavidin-europium was used in conjunction with the
      DELFIA-system for time-resolved fluorometric end point measurement (TR-FIA),
      streptavidin-horseradish peroxidase was used for colorimetric end point
      determination (EIA). Both non radioactive immunoassay systems showed excellent
      correlation with the reference radioimmunoassay, good sensitivity and
      reproducibility. The succinyl-cGMP-biotin conjugate was shown to be stable for
      more than two years without any apparent loss of chemical stability or
      immunological reactivity.

PMID- 7775662
TI  - Enzyme linked immunosorbent assay for the neurohypophyseal hormones arginine
      vasotocin and isotocin.
AB  - A competitive enzyme linked immunosorbent assay (ELISA) using new polyclonal
      antibodies was developed for the first time for each of two neurohypophyseal
      hormones: arginine vasotocin (AVT, ubiquitous in vertebrates) and isotocin (IT,
      restricted to teleost fish). The antibodies obtained were highly specific, showed
      no cross-reaction between the two peptides and were able to suppress the activity
      of the peptides in in vitro bioassays. An original feature of the assays was the
      covalent binding of the peptidic antigen to Covalink microplates. Competition was
      thereafter made between this bound antigen and the antigen in samples, for a
      fixed amount of the relevant antibody. Revelation used peroxidase-labeled
      antibodies. These ELISAs were sensitive enough to detect 1 ng/ml and 0.1 ng/ml
      for AVT and IT respectively. Moreover, for the first time, the two hormones were
      measured separately, each in the presence of the other, and shown to exist as
      circulating hormones in fish.

PMID- 7775663
TI  - A noncompetitive enzyme immunoassay for rat prolactin.
AB  - A sensitive and specific noncompetitive rat prolactin (rPRL) enzyme immunoassay
      (EIA) is described. In this assay, the same rabbit anti-rPRL antibody is both
      adsorbed to a solid-phase support, i.e. 96-well microtiter plates and conjugated
      covalently to peroxidase as a tracer. PRL being sandwiched between antibody
      molecules, the enzymatic activity is thus proportional to the amount of rPRL
      concentration. This assay was found highly specific for rat PRL and displayed a
      sensitivity of 12.5 pg/well (0.125 ng/ml) of NIH-RP2 equivalents. The intra-assay
      and inter-assay coefficients of variation were less than 10% over a wide range of
      rPRL concentration (0.25-40 ng/ml). This rPRL-EIA permits to quantify PRL in
      culture media or biological samples containing up to 25% of plasma. Comparison
      with a radioimmunoassay revealed a good correlation (r = 0.984, the slope =
      1.04). This EIA is rapid, results being obtained within 4h30 or 18h30 depending
      on the nature of the biological samples. The tracer, easily performed with a low
      cost enzyme, can be stored for very long durations. Thus, this sensitive and
      rapid assay provides a valuable method for measuring rPRL.

PMID- 7775664
TI  - Detection of soluble T cell receptor-releasing cells by ELISPOT assay.
AB  - A specific and sensitive enzyme-linked immunospot (ELISPOT) assay has been
      developed for the detection and enumeration of soluble T cell receptor (TCR)
      releasing cells. Using this method, we readily detected at the single cell level
      the release of soluble TCR by living T lymphoma cells (MT-2 and HSB-2) but not by
      human B lymphoma cells (DAKIKI), mouse hepatoma cells (MH134) and dead MT-2.
      Furthermore, distinct spots in MT-2 cell culture were not visualized using
      several monoclonal antibodies against antigens unrelated to TCRs as a primary
      antibody. The specific and quantitative detection of soluble TCR-releasing cells
      using ELISPOT assay will certainly provide a valuable tool to better characterize
      soluble TCRs and their relationship to immune regulation and a number of
      diseases.

PMID- 7775665
TI  - Doxycycline inhibits neutrophil (PMN)-type matrix metalloproteinases in human
      adult periodontitis gingiva.
AB  - We previously reported that low-dose doxycycline (DOXY) therapy reduces host
      derived collagenase activity in gingival tissue of adult periodontitis (AP)
      patients. However, it was not clear whether this in vivo effect was direct or
      indirect. In the present study, inflamed human gingival tissue, obtained from AP
      patients during periodontal surgery, was extracted and the extracts partially
      purified by (NH4)2SO4 precipitation. The extracts were then analyzed for
      collagenase activity using SDS-PAGE/fluorography/laser densitometry, and for
      gelatinase activity using type I gelatin zymography as well as a new quantitative
      assay using biotinylated type I gelatin as substrate. DOXY was added to the
      incubation mixture at a final concentration of 0-1000 microM. The concentration
      of DOXY required to inhibit 50% of the gingival tissue collagenase (IC50) was
      found to be 16-18 microM in the presence or absence of 1.2 mM APMA (an optimal
      organomercurial activator of latent procollagenases); this IC50 for DOXY was
      similar to that exhibited for collagenase or matrix metalloproteinase (MMP)-8
      from polymorphonuclear leukocytes (PMNs) and from gingival crevicular fluid (GCF)
      of AP patients. Of interest, Porphyromonas gingivalis collagenase was also
      inhibited by similar DOXY levels (IC50 = 15 microM), however the collagenase
      activity observed in the gingival tissue extracts was found to be of mammalian
      not bacterial origin based on the production of the specific alpha A (3/4) and
      alpha B (1/4) collagen degradation fragments. In contrast, the inhibition of
      collagenase purified from culture media of human gingival fibroblasts (MMP-1)
      required much greater DOXY levels (IC50 = 280 microM). The predominant molecular
      forms of gelatinolytic activity presented in the AP patients gingival tissue
      extracts were found to closely correspond to the 92 kD PMN-type gelatinase (MMP
      9) although small quantities of 72 kD fibroblast-type gelatinase (MMP-2), and
      some other low molecular weight gelatinases, were also detected. The IC50 of DOXY
      versus gingival tissue gelatinolytic activity was estimated at 30-50 microM
      measure using either type I gelatin zymography or the biotinylated type I gelatin
      assay. We conclude that MMPS in inflamed gingival tissue of AP patients, like
      those in GCF, originate primarily from infiltrating PMNs rather than resident
      gingival cells (fibroblasts and epithelial cells) or monocyte/macrophages, and
      that their pathologically-elevated tissue-degrading activities can be directly
      inhibited by pharmacologic levels of doxycycline.

PMID- 7775666
TI  - Ex vivo studies of polymorphonuclear neutrophils from patients with early-onset
      periodontitis (III). CR3 and LFA-1 expression by peripheral blood and gingival
      crevicular polymorphonuclear neutrophils.
AB  - In this study, we assessed the LFA-1 (CD18/CD11a) and CR3 (CD18/CD11b) expression
      on peripheral polymorphonuclear leukocytes (PB-PMN) and crevicular fluid
      polymorphonuclear leukocytes (CF-PMN), by subjects with a healthy periodontium (n
      = 7), gingivitis (n = 8), early-onset periodontitis (n = 17) and adult
      periodontitis (n = 8). Using flow cytometry analysis, the %s of CD18, CD11a and
      CD11b positive cells and the absolute numbers of fluorescent molecules were
      determined. No significant difference could be found among the 4 groups, for
      these 2 kinds of parameters, in PB-PMN or CF-PMN. However, a great difference
      could be noted between the results obtained from PB-PMN and those obtained from
      CF-PMN. The %s of positive CF-PMN were significantly lower than those of PB-PMN
      for the 3 sub-units (p < 0.001). The levels of CD18 and CD11b expressed by CF-PMN
      were higher than those expressed by PB-PMN and the difference was significant for
      CD11b (p < 0.001). On the contrary, the level of CD11a expressed on CF-PMN was
      significantly lower than that expressed by PB-PMN (p < 0.001). Hence, our current
      results show that early-onset periodontitis PMN can be quite normal and this fact
      is not surprising insofar as, in our study, these cells were perfectly functional
      and all the subjects were in good health. We concluded that the analysis of the
      leukocyte adhesion receptors expression on PB-PMN does not appear useful for
      helping to establish a differential diagnosis between the different forms of
      periodontitis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775667
TI  - Periodontal disease and type I diabetes mellitus in children and adolescents.
AB  - This study compared the periodontal status of a juvenile diabetic study group
      with that of a non-diabetic control group similar in age and sex. The study group
      consisted of 26 type I diabetic patients with an average age of 13.42 years and
      24 control subjects of similar age. The diabetic subjects were evaluated with
      glycosylated hemoglobin (GHb) to obtain a measure of diabetic control. Clinical
      periodontal evaluations were performed for all teeth in each subject, and
      consisted of the plaque index, gingival fluid flow, gingival index, probing
      depths, clinical attachment levels, recession, and bleeding on probing. Analysis
      of the data demonstrated no statistically significant differences in the overall
      means for the 2 groups for average attachment loss, probing depths, recession,
      gingival index, plaque index, gingival fluid flow, or bleeding on probing. There
      was no significant association between the level of control of diabetes (GHb) and
      clinical variables. However, comparisons based on site-specific measurements
      showed the gingival index to be somewhat higher among the diabetics (p = 0.0002),
      and examination of interaction effect plots showed the diabetic group to have
      higher average gingival index for most teeth and higher or the same plaque index
      levels on all teeth relative to controls. Thus, a young study population with
      type I diabetes mellitus was found to have significantly increased severity of
      inflammatory gingival disease compared to controls of similar age.

PMID- 7775668
TI  - The microbiota of osseointegrated implants in patients with a history of
      periodontal disease.
AB  - The purpose of this study was to determine the presence of suspected periodontal
      pathogens in the peri-implant microflora of osseointegrated implants exposed 3
      and 6 months to the oral environment of patients previously treated for
      periodontal disease. Subgingival microbial samples were taken in the deepest
      residual pocket of each quadrant in 10 patients before placement of ITI implants
      and in 10 patients before abutment connection of Branemark implants. The samples
      were cultured using continuous anaerobic techniques. 4 patients were positive for
      P. gingivalis, 13 for P. intermedia, 2 for A. actinomycetemcomitans, 16 for
      Fusobacterium, 7 for C. rectus and 12 showed microscopic evidence of spirochetes.
      After 3 and 6 months exposure of the implants to the oral environment, one sample
      was obtained from the peri-implant sulcus in each patient. P. gingivalis was
      found in 2 patients in the peri-implant samples after 3 and 6 months. 6 peri
      implant samples were positive for P. intermedia after 3 months, 7 after 6 months.
      Fusobacterium was present in 13 peri-implant samples after 3, and in 12 samples
      after 6 months. 4 patients showed evidence of for C. rectus after 3 months, 2
      after 6 months. Spirochetes were seen in 3 peri-implant samples after 3 and in 5
      after 6 months. None of the implants were found to be colonized by A.
      actinomycetemcomitans, although the organism was detected on teeth in 1
      individual. Similar distribution patterns were noted for ITI and Branemark type
      implants.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775669
TI  - A comparison of partial and full mouth scoring of plaque and gingivitis in oral
      hygiene studies.
AB  - The clinical testing necessary to demonstrate the safety and efficacy of new
      toothbrushes is complex and expensive. Any modification of methodology that could
      reduce complexity and cost without compromising quality would benefit both
      investigators and the public. Results from an 8-week toothbrush study were
      assessed for the use of partial as compared to full-mouth evaluations. The
      potential utility of an objective, minimally-invasive bleeding index for the
      evaluation of gingivitis was also tested. 2 partial evaluations, half-mouth and
      molar/anteriors, revealed decrements in modified gingival index (MGI), bleeding
      index and plaque index that were statistically significant and similar in
      magnitude to those derived from full-mouth examinations. % decrements in MGI and
      bleeding index based on the Ramfjord teeth were not significant statistically.
      Results for the new sulcular bleeding index were essentially similar to those for
      the MGI. However, the bleeding index offered the advantage of improved
      objectivity for use in both white and non-white subjects. These results suggest
      that partial evaluations and the new bleeding index may be useful elements in the
      design of toothbrush efficacy studies.

PMID- 7775670
TI  - Personal risk factors for generalized periodontitis.
AB  - Periodontitis is generally considered to be a consequence of an unfavourable host
      parasite interaction in which bacteria are the determinants of disease. An
      intense search continues for the bacteria, specific or non-specific, that are
      responsible for periodontitis and various forms of the periodontal diseases have
      been associated with, and are widely believed to be caused by, specific bacterial
      groups. However, the distribution of periodontopathic bacteria is far wider than
      the distribution of periodontitis, indicating that the association between
      bacteria and periodontitis is weak. This paper proposes a paradigm for the
      etiology of generalized periodontitis in which 'host' factors are not only those
      triggered by bacteria (the agent) but are also those personal factors that
      influence the outcome of the host/parasite relationship. The personal factors
      that diminish the efficiency of host defense may include psycho-social stress
      from the social environment, factors from the lifestyle such as diet, smoking and
      alcoholism and systemic factors such as intercurrent disease or deficiencies
      within the immune/inflammatory system. A model is described in which the
      interaction of personal factors with the social environment provides the
      potential for the initiation of periodontitis. Biological variation is
      significant and the combination of factors that cause generalized periodontitis
      or any other chronic disease in one individual may not result in dental or any
      other chronic disease in another.

PMID- 7775671
TI  - Relationship between CPITN and periodontal attachment loss findings in an adult
      population.
AB  - This study investigates the relationship between CPITN findings and the
      prevalence and severity of periodontal attachment loss in a rural Kenyan
      population comprising 1131 persons aged 15-65 years. All persons were examined
      for calculus, gingival bleeding, pocket depths and attachment loss levels on 4
      sites of each tooth present. Recordings of bleeding, calculus and pocket depths
      were used to compute CPITN scores based on the 10 index teeth originally
      proposed, and these CPITN scores were subsequently related to the attachment loss
      findings derived from the full-mouth assessment. In most cases, persons with a
      CPITN score < or = 1 did not have attachment loss > or = 4 mm. However, among 40+
      year-old persons with CPITN score 2 over 90% had attachment loss > or = 4 mm and
      over 50% of the 50+ year-olds with CPITN score 3 had attachment loss > or = 6 mm.
      Less than 20% of the 15-29 year-olds with CPITN score 3 had attachment loss > or
      = 6 mm, and usually the attachment loss levels ranged between 0 and 3 mm. Beyond
      the age of 35 years over 10% of the sextants with CPITN score 0 had attachment
      loss > or = 4 mm. Below the age of 35 years more than one third of all sextants
      with CPITN score 3 had attachment loss levels < or = 3 mm. Thus, the CPITN
      findings overestimate both prevalence and severity of periodontal attachment loss
      among the younger age groups and underestimate these parameters among elderly
      subject.

PMID- 7775672
TI  - Prognostic criteria for the efficiency of non-surgical periodontal therapy in
      advanced periodontitis.
AB  - The aim of the study was to find out which clinical, radiographic and
      microbiological variables can be used as prognostic criteria for the efficiency
      of the commonly used initial treatment protocol comprising scaling, root planning
      and instruction on oral hygiene in advanced adult periodontitis. 46 patients
      (mean age 48 years) with untreated, advanced periodontitis volunteered for the
      study. The clinical examination included recordings of plaque, gingival and
      calculus indices, probing pocket depths, bleeding and suppuration after probing,
      probing attachment levels and furcation involvements. Infrabony and furcation
      lesions were assessed from panoramic radiographs. Actinobacillus
      actinomycetemcomitans and Porphyromonas gingivalis were cultured from the
      deepest, most inflamed periodontal Pockets, from surface of the tongue and from
      saliva. 3 months after the completion of non-surgical treatment comprising
      meticulous scaling and root planing and instruction on oral hygiene, the healing
      was assessed clinically, and 13 patients were assigned to a maintenance care
      programme (MC) and 33 to further treatment procedures (FT). Evaluation of the
      baseline clinical and radiographic data showed a significantly higher %s of > or
      = 6 mm deep periodontal pockets, surfaces with suppuration, and sites with
      subgingival calculus, as well as higher numbers of infrabony lesions, in FT
      patients than in MC-patients. Subgingival A. actinomycetemcomitans was isolated
      at baseline in 55% of the FT-patients and in 38% of the MC-patients, and P.
      gingivalis in 27% and 23%, respectively. A. actinomycetemcomitans was eradicated
      by non-surgical treatment from only one patient. P. gingivalis was detected in
      15% of the patients in both groups after treatment.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7775673
TI  - Crevicular interleukin-1 beta in moderate and severe periodontitis patients and
      the effect of phase I periodontal treatment.
AB  - Interleukin-1 beta (IL-1 beta), a potent stimulator of bone resorption, has been
      implicated in the pathogenesis of periodontal destruction. However, the
      relationship between cytokines and periodontal disease has not been studied
      sufficiently to allow definitive conclusions. The aims of this study are to
      investigate crevicular IL-1 beta and the clinical status of patients with
      periodontitis and the effect of phase I periodontal therapy on levels of IL-1
      beta. For this study, 130 gingival crevicular fluid (GCF) samples were harvested
      from non-inflamed (15) and diseased sites (115) in 11 patients with
      periodontitis. The gingival index (GI) and probing depth (PD) of each site was
      recorded initially and one month after treatment. The amount of IL-1 beta in the
      GCF was measured by enzyme-linked immunosorbent assay (ELISA) using an antibody
      specific for this cytokine. Before treatment, IL-1 beta was found in 12 of 15 non
      inflamed gingival crevices and in 112 of 115 diseased pockets. The amount of IL-1
      beta varied from 4.03 to 511.12 pg/site. The average amount of IL-1 beta from
      diseased sites was 3-fold greater than that from non-inflamed sites. Both total
      amount of IL-1 beta and the GCF volume, but not IL-1 beta concentration, were
      found to be correlated, positively, with GI score and PD. After therapy, 63 sites
      from 7 patients were re-examined, and the amount of IL-1 beta in 49 of 63 sites
      was found to have declined. These data suggest that the amount of crevicular IL-1
      beta is closely associated with periodontal status. This relationship may be
      valuable in monitoring periodontal disease activity.

PMID- 7775674
TI  - Observations of root surfaces from patients with early-onset periodontitis and
      leukocyte adhesion deficiency.
AB  - The purpose of this investigation was to report observations of the root surfaces
      of teeth from 2 siblings with leukocyte adhesion deficiency (LAD). In previous
      publications, the clinical, radiographic and immunologic findings in the family
      were presented. 38 permanent teeth from the 2 siblings were prepared for
      microscopic examination, 11 for light microscopy (LM), and 27 for scanning
      electron microscopy (SEM). In addition, 8 healthy teeth obtained from 2 patients
      requiring extractions for orthodontic treatment served as controls. LM
      observations on healthy teeth revealed cementum with normal structural appearance
      which exhibited a mosaic or mogul-like pattern with SEM. In LAD specimens,
      cementum apical to the dentogingival junction exhibited resorption lacunae and
      areas of poor structural definition characterized by aplasia and hypoplasia
      (hypomineralization). Areas of hypoplasia presented as distinct irregular
      surfaces with a pebbly or globular-like appearance. Alteration in cementum
      formation and maturation may play a role in the etiology of early-onset
      periodontitis.

PMID- 7775675
TI  - The effectiveness of an electronic toothbrush in the removal of established
      plaque and treatment of gingivitis.
AB  - The purpose of the present study was to evaluate the effect of an electronic
      toothbrush on established plaque and gingivitis in a 5-month clinical trial. This
      electronic toothbrush sends approximately a 0.15 mA current through the brushhead
      which presumedly enhances the efficacy of the brush in plaque elimination. For
      this study, 80 volunteers (non-dental University students) were selected on the
      basis of having moderate gingival inflammation. At baseline, plaque and bleeding
      upon probing were assessed on the vestibular, mesio-vestibular, distovestibular
      and lingual surfaces using the 'half-mouth' design. After 2-months and 5-months,
      these clinical indices were again recorded. At each assessment, the participants
      received a new brushhead. All baseline indices appeared to be well-balanced. A
      mean Silness and Loe plaque score of 1.70 and 1.64 were found in the control and
      test groups, respectively. Little change was observed from baseline to 5-months.
      The Quigley and Hein plaque index behaved comparably. The mean bleeding upon
      probing score at baseline was 1.43 and 1.39 for the control and test group,
      respectively. Little to no improvement was observed in the course of this study.
      No beneficial effect could be shown for this 'electronic' design of manual
      toothbrush.

PMID- 7775676
TI  - Periodontal findings in spouses. A clinical, radiographic and microbiological
      study.
AB  - Clinical, radiographic and microbiological examination of periodontal conditions
      was carried out in 2 groups of married couples to assess similarities between
      husband and wife. The diseased probands (n = 10) exhibited advanced periodontitis
      and the healthy ones (n = 10) were periodontally normal. The clinical examination
      comprised the assessment of plaque, probing pocket depths, gingival bleeding on
      probing, suppuration, supragingival and subgingival calculus. The extent and type
      of alveolar bone loss was determined from panoramic radiographs. Bacterial
      samples were taken from the 6 deepest and most inflamed periodontal pockets and
      from stimulated saliva. The samples were cultured for Actinobacillus
      actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia,
      Campylobacter rectus and Peptostreptococcus micros. The mean detection frequency
      of moderately deep pockets (4-5 mm) and deep pockets (> or = 6 mm) was
      significantly higher in the diseased probands than in their spouses. The mean
      detection frequency of moderately deep pockets was significantly higher in the
      spouses of the diseased probands than in the spouses of the healthy ones. Deep
      pockets were found in 6 spouses of the diseased probands, whereas only in 2
      spouses of the healthy ones. Both diseased proband and his/her spouse harbored A.
      actinomycetemcomitans, P. gingivalis, P. intermedia, C. rectus and P. micros in
      4, 6, 9, 9 and 4 couples, respectively. Both healthy proband and his/her spouse
      harbored the pathogens in 0, 1, 9, 5 and 3 couples, respectively. P. gingivalis
      was found in 7 spouses of the diseased probands, but only in 2 spouses of the
      healthy ones.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775677
TI  - The young mind.

PMID- 7775678
TI  - Class II Vitremer restoration of primary molars.
AB  - Several resin-modified, glass-ionomer cements have proved successful when used in
      Class III and Class V cavities in primary teeth. One of them, Vitremer, is
      proving to be very durable when used in Class I and Class II cavities in primary
      teeth. The material is handled as quickly and easily as silver amalgam. The
      components of the Vitremer Tri-Cure System are: Primer, Glass powder, Liquid, and
      Resin gloss. In addition to a light-curing mechanism, Vitremer hardens by the
      acid base, glass-ionomer reaction, and a chemical "dark cure", catalyzed by a
      reduction/oxidation reaction. Over 600 Class II Vitremer restorations have been
      placed and over 250 have been in the teeth long enough (12 to 18 months) to be
      observed regularly.

PMID- 7775679
TI  - Polycarboxylate cement as a cavity-sealing material for the calcium hydroxide
      pulpotomy: a retrospective study.
AB  - Polycarboxylate cement was evaluated as a cavity-sealing material in calcium
      hydroxide pulpotomies of primary molars. The lifespan of these teeth (N = 55)
      were compared with that of the corresponding teeth on the contralateral sides.
      The success rate for the treatment was 75.5 percent after one year and at least
      61.9 percent after two years. Significant shorter life-spans were found in
      primary teeth with pulpotomy than in those without it. However, polycarboxylate
      cement can be a suitable alternative for zinc oxide-eugenol as a cavity sealing
      material in calcium hydroxide pulpotomies.

PMID- 7775680
TI  - Orthodontic diagnosis and treatment planning in the primary dentition.
AB  - Early recognition of malocclusions is in the hands of the primary care providers.
      Pediatric and general dentists should be familiar with conditions that are known
      to interfere with growth and development of a child. Conditions such as early
      loss of primary teeth, anterior and posterior crossbites, and some Class III
      skeletal problems can be treated in the primary dentition to facilitate normal
      growth and development and offered some benefit to the patients. On the other
      hand, aggressive arch length modulation, Class II correction and intervention for
      vertical problems, including non-nutritive sucking habits, is largely
      unwarranted.

PMID- 7775681
TI  - A longitudinal assessment of predictive value of a caries activity test in young
      children.
AB  - A longitudinal study was conducted in Okayama, Japan to investigate the
      predictive value of a caries activity test (Cariostat). The subjects were 100
      children who participated in routine dental examinations at 18, 24 and 36 months.
      Results indicated caries prevalence of 9% at 18 months, 21 percent at 24 months
      and 70 percent at 36 months. Cariostat scores at each age were correlated with
      dmft at 36 months and with whether or not child was caries-free at 36 months.
      Cariostat scores at each age showed good validity (sensitivity + specificity) for
      whether or not child was caries-free at 36 months. These results indicated that
      caries activity test, Cariostat, was effective for predicting caries occurrence
      in young children.

PMID- 7775682
TI  - How important are techniques? The empathic approach to working with children.
AB  - The author presents behavior management as essentially anxiety management, not
      alone in the child but in ourselves as well. Behaviorist and humanist
      psychologies are discussed. The author is critical of the teaching that behavior
      management can be taught as a technique: if a specific management technique is
      used, the child will behave in a certain way. Several techniques are discussed.
      Voice control and facial expression are discussed. Physical restraints are
      considered and their use discussed, along with their long-term effects. Empathy
      is discussed at length.

PMID- 7775683
TI  - Anxiety reduction with nitrous oxide: a permanent solution?
AB  - Anxiety scores of highly fearful children were registered during a control period
      after their curative treatment. The average length of the control period was
      seventy-two weeks. The anxiety scores of the children who were treated curatively
      with the aid of nitrous oxide were significantly lower than those of children
      from a behavioral management group. All the semiannual check-ups were performed
      without the use of nitrous oxide. Anxiety scores of all the children during the
      control period correlated closely with the anxiety scores of the curative
      treatment before and after the control period. It was concluded that nitrous
      oxide helps children to lower their anxiety levels during a long period after
      treatment. Influencing anxiety in highly anxious children might be characterized
      as a long-term process.

PMID- 7775684
TI  - Transcutaneous electrical nerve stimulation (TENS) for pain management during
      cavity preparations in pediatric patients.
AB  - The purpose of this study was to evaluate the effectiveness of Transcutaneous
      Electrical Nerve Stimulation (TENS) in pain reduction during cavity preparations
      in pediatric patients. Twenty patients, ages eight to fourteen years, were
      treated for Class I amalgam restorations in mandibular first permanent molars
      using TENS in a double blind protocol. Randomized assignments were made for ten
      experimental and ten control patients. Using the visual analogue scale, the ANOVA
      test indicated a significant decrease (p < 0.01) in patient ratings between the
      TENS experimental and the control group. It can be concluded there was a
      statistically significant decrease in the pain perceptions of pediatric patients
      during Class I amalgam cavity preparations in mandibular first permanent molars.

PMID- 7775685
TI  - Child abuse education: do not overlook dental professionals.
AB  - Dental professionals are mandated by law to report suspicions of child abuse and
      neglect (CAN), but surveys show dentists do not fulfill their obligation to
      report. Even though more than 50 percent of physical abuse occurs to the head and
      facial area, and more than 70 percent of child abuse and neglect fatalities are
      caused by injuries to the head and neck, dental professionals are often
      overlooked in efforts to educate the public on the problem. Pre-program
      questionnaires completed by dental professionals attending an educational program
      on identifying and reporting child abuse indicated that 70 percent had no
      previous training in identifying and reporting child abuse, 65 percent had
      suspected child abuse in their patients, but only 19 percent reported the abuse.
      As a result of this educational program, it is expected that some children in the
      state of Indiana will receive improved assessments by dentists and suspected
      child abuse and neglect will be reported to the proper agencies when identified.

PMID- 7775686
TI  - Your pediatric patients may be moving away from your practice.
AB  - A review is provided of general population movements to different places of
      residence. Emphasis is placed on the need for practitioners to consider the
      impact on young children as they leave familiar surroundings and enter the world
      of a new residence.

PMID- 7775687
TI  - Turner's syndrome in association with hemangioma of the parotid gland: report of
      case.
AB  - We report a case of Turner's syndrome with hemangioma of the parotid gland. The
      symptom complex of this syndrome are infantilism, pterygium colli and unusual
      carrying angle of the elbow. Orodental alterations and multisystem afflictions
      have been reported in these patients. Diagnosis is based on a combination of the
      clinical features, buccal smear finding of the absence of barr body and confirmed
      by karyotyping which can detect mosaic cell lines of the X chromosome.

PMID- 7775688
TI  - Calcifying odontogenic cyst in infancy: report of case associated with compound
      odontoma.
AB  - A case of calcifying odontogenic cyst associated with compound odontoma in an
      unerupted primary tooth in a three-year-old patient is reported. Some
      considerations regarding the age of the patient, differential diagnosis and
      treatment are discussed. Although the cyst can occur at any age, the majority of
      cases appear before the fourth decade of life. This malady represents less than 2
      percent of all odontogenic tumors and cysts.

PMID- 7775689
TI  - Fluid management in ARDS: "keep them dry" or does it matter?

PMID- 7775690
TI  - Treatment of surgical and non-surgical septic multiorgan failure with bicarbonate
      hemodialysis and sequential hemofiltration.
AB  - OBJECTIVE: Hospital mortality of patients with septic multiorgan failure (MOF) is
      still around 95%. The present study investigates whether this high mortality
      could be significantly reduced by the addition of sequential hemofiltration (SH)
      with bicarbonate hemodialysis (HD) to the currently used life supportive
      measures. DESIGN: 35 (18 surgical and 17 nonsurgical) patients, with 3 or more
      organ failures, had daily sessions of zero balance SH, for periods ranging from 2
      22 days. MEASUREMENTS AND RESULTS: SH induced significant improvement of PaO2/100
      FIO2, Apache II score, MAP, as well as blood chemistry in survivors. Dying
      patients had less marked improvement of blood oxygenation, non-significant
      changes in other variables, in addition to low MAP before and after SH, as well
      as marked hemodynamic unstability during the procedure. The observed hospital
      mortality was 38% for the surgical group, and 35.3% for the medical patients
      (n.s.). CONCLUSIONS: Mortality observed in this retrospective, uncontrolled study
      was significantly lower than that currently observed with conventional supportive
      therapy, with or without the addition of other forms of blood purification, e.g.
      CAVH and CAVHD. This improvement in results appears to be related to the property
      of SH to completely clear 90% of the blood from mediators of inflammation in only
      one passage through the hemofilter, and to better tolerance of HD done using
      bicarbonate buffer. A definite evaluation of this technique will be eventually
      reached by a programmed, appropriate sample size study, which is out of reach for
      one individual ICU.

PMID- 7775691
TI  - Autonomic control of the heart and peripheral vessels in human septic shock.
AB  - OBJECTIVE: Circulating endotoxin impairs the sympathetic regulation of the
      cardiovascular system in animals. We studied the changes in the autonomic control
      of the heart and circulation during septic shock in humans. DESIGN: 12 patients
      (age 43.0 +/- 6, 17-83 years) were investigated during septic shock (mean
      duration: 3.5 +/- 0.5 days) and during recovery, fluctuations in R-R interval,
      invasive arterial pressure (AP) and peripheral arteriolar circulation (PC,
      photoplethysmography) were evaluated by spectral analysis as a validated
      noninvasive measure of sympathovagal tone. Apache II score was adopted as the
      disease severity index. Low frequency components (0.03-0.15 Hz) of the frequency
      spectra were expressed as relative to the overall variability (LFnu) for each
      cardiovascular variable. RESULTS: LFnu were low or absent during shock but, in
      the 10 patients who recovered, increased by the time of discharge (post-shock). R
      R LFnu increased from 17 +/- 6 to 47 +/- 9 (p < 0.03), AP LFnu from 6 +/- 3 to 35
      +/- 4 (p < 0.02) and PC LFnu from 18 +/- 3 to 66 +/- 4 (p < 0.001). Apache II
      fell from 23.1 +/- 1, at admission, to 14.8 +/- 1.8 at discharge (p < 0.005). Two
      patients died showing no LFnu increase. CONCLUSION: Reduced LF components of the
      variability of cardiovascular signals are characteristic of septic shock,
      confirming the presence of abnormal autonomic control. Restored sympathetic (LF)
      modulation seems to be associated with a favourable prognosis.

PMID- 7775692
TI  - Use of morphine cholescintigraphy in the diagnosis of acute cholecystitis in
      critically ill patients.
AB  - OBJECTIVE: To determine the efficacy of morphine enhanced radionuclide
      cholescintigraphy (MC) in the diagnosis of acute cholecystitis (AC) in critically
      ill patients. DESIGN: Retrospective chart review. SETTING: 2 university
      hospitals. PATIENTS AND METHODS: Records of all ICU patients who underwent MC as
      part of an evaluation for AC over an 8 year period were reviewed (n = 45). All
      patients initially had standard radionuclide cholescintigraphy (RC) performed
      which showed nonvisualization of the gallbladder (GB) and were then given
      morphine sulfate (0.05-0.1 mg/kg i.v.). RESULTS: The mean age was 54 years (range
      18-84 years). Risk factors for AC included fasting in 41 patients (mean 12.4
      days) and total parenteral nutrition in 32 patients. Signs of biliary sepsis
      included temperature > 100 degrees F in 38 patients, WBC > 10,000/ml3 in 40
      patients, abdominal pain in 29 patients, and abnormal liver function tests in 42
      patients. 23 patients had GB ultrasonography, with 7 showing stones. MC was
      positive (non-visualization) in 16 patients and negative (GB visualized) in 29,
      including 4 with gallstones. All patients in whom the GB was visualized did so
      within 1 h. There were 13 patients with positive MC who underwent operation; 12
      had AC (9 acalculous, 3 calculous). Three patients were treated medically and
      recovered (false positive). All 29 patients with negative MC were true negatives.
      Overall, MC had an accuracy of 91%, sensitivity of 100%, specificity of 88%,
      positive predictive value of 75%, and negative predictive value of 100%.
      CONCLUSION: MC is a useful test in the evaluation of critically ill patients for
      suspected AC, particularly in patients with known risk factors or documented
      gallstones.

PMID- 7775693
TI  - Predictive value of tetrapolar body impedance measurements for hydration status
      in critically ill patients.
AB  - OBJECTIVE: To design and evaluate a simple and rapid method to predict body
      hydration status in critically ill patients. DESIGN: Prospective, consecutive
      sample. SETTING: Medical intensive care unit of a university hospital. PATIENTS:
      31 consecutive patients. METHODS: All patients were classified daily for
      hydration status by the attending physician based on clinical impression, weight
      changes and laboratory measurements. The hydration status was scored as
      'dehydrated', 'euvolemic' or 'edematous'. The total body impedance was measured
      daily by a tetrapolar impedance technique. RESULTS: Resistances > 700 omega were
      found in dehydrated subjects and resistances of < 400 omega in edematous
      patients. Weight gain was observed in dehydrated and weight loss in edematous
      patients. A discriminant analysis was used to create a predictive model for
      hydration using the daily impedance and weight measurements. If a cutoff point of
      60% for the predicted classification was used to categorize the patient's
      hydration as dehydrated, euvolemic and edematous, no false positive predictions
      were observed for the dehydrated or the edematous state. CONCLUSION: Impedance
      measurements are in close agreement with the clinical impression of hydration of
      critically ill patients. Future investigations must elucidate the clinical
      importance.

PMID- 7775694
TI  - No-reflow after cardiac arrest.
AB  - OBJECTIVE: Successful resuscitation of the brain requires unimpaired blood
      recirculation. The study addresses the question of the severity and reversibility
      of no-reflow after cardiac arrest. DESIGN: Adult normothermic cats were submitted
      to 5, 15 and 30 min cardiac arrest by ventricular fibrillation. The extent of no
      reflow was assessed in each cardiac arrest group after 5 min closed chest cardiac
      massage in combination with 0.2 mg/kg epinephrine or after successful
      resuscitation followed by 30 min recirculation. MEASUREMENTS AND RESULTS:
      Reperfusion of the brain was visualized by labelling the circulating blood with
      FITC-Albumin. Areas of no-reflow, defined as absence of microvascular filling,
      were identified by fluorescence microscopy at 8 standard coronal levels of
      forebrain, and expressed as percent of total sectional area. During cardiac
      massage, no-reflow affected 21 +/- 5%, 42 +/- 38% and 70 +/- 27% of forebrain
      after 5, 15 and 30 min cardiac arrest, respectively. After 30 min spontaneous
      recirculation following successful resuscitation of the heart, no-reflow
      significantly declined to 7 +/- 11% after 5 min cardiac arrest (p < 0.05) but
      persisted in 30 +/- 11% and 65 +/- 21% of forebrain after 15 and 30 min cardiac
      arrest, respectively (n.s.). CONCLUSION: Our observations demonstrate that
      resuscitation of the heart by closed chest massage causes severe (and after
      prolonged cardiac arrest irreversible) no-reflow of the brain. This suggests that
      no-reflow is an important cause of post-resuscitation brain pathology.

PMID- 7775695
TI  - An experimental set-up to test heat-moisture exchangers.
AB  - OBJECTIVES: The purpose of this study was to build an experimental set-up to
      assess continuously the humidification, heating and resistance properties of heat
      moisture exchangers (HMEs) under clinical conditions. DESIGN: The experimental
      set-up consists of a patient model, measurement systems and a ventilator.
      SETTING: Surgical ICU, University Hospital of Rotterdam. MATERIALS: A clinically
      used HME. MEASUREMENTS AND RESULTS: The air flow, pressure in the ventilation
      circuit, pressure difference over the HME, and partial water vapour pressure and
      temperature at each side of the HME were measured. The resistance, absolute
      humidity, humidification efficiency and temperature difference at the patient
      side of the HME were calculated. Measurements were performed during 24 h. The
      temperature output, humidity output and lung mechanics of the patient model were
      similar to values found in mechanically ventilated patients. The measurement
      system was in agreement with the ISO draft standard and was capable of measuring
      dynamic variation of water and heat exchange over the range of a clinically used
      ventilator setting. CONCLUSION: The experimental set-up described is reliable for
      evaluating HMEs and can also be used for future clinical evaluation of HMEs. The
      main advantages of this set-up over those described previously are: (i)
      measurements of dynamic variations of water and heat exchange; (ii) on-line
      measurements of expiratory, as well as inspiratory resistance.

PMID- 7775696
TI  - Clinical validation of the Deltatrac monitoring system in mechanically ventilated
      patients.
AB  - OBJECTIVE: To evaluate a monitor of pulmonary gas exchange (Deltatrac, Datex) in
      a clinical setting. DESIGN: After in vitro evaluation, comparison over 2 min
      between VO2 and VCO2 values measured by the Deltatrac and the Douglas bag
      technique. Comparisons were also achieved over 8 h periods between the Deltatrac
      and a system using a mass-spectrometer. SETTING: Polyvalent intensive care unit
      (ICU 15 beds) in a 1200 bed general hospital. PATIENTS: Comparison with the
      Douglas bag technique in 10 patients undergoing controlled ventilation.
      Comparison with the mass-spectrometer system in 25 other patients undergoing
      controlled or pressure support ventilation. MEASUREMENTS AND RESULTS: Compared to
      the results obtained by the Douglas bag technique, the bias (+/- 2 SD) for VO2
      and VCO2 was -3.5 +/- 26.6 and 6.1 +/- 12.7 ml.min-1, respectively. By comparison
      with the mass-spectrometer system, the bias for VO2 and RQ was -5.8 +/- 16.0
      ml.min-1 and 0.018 +/- 0.048, respectively. No drift between the two systems was
      observed over time. CONCLUSIONS: The Deltatrac appears suitable for VO2 and VCO2
      measurements in ventilated patients and equivalent to a mass-spectrometer system
      for long term measurements.

PMID- 7775697
TI  - Cardiac output measurement by the thermodilution method: an in vitro test of
      accuracy of three commercially available automatic cardiac output computers.
AB  - OBJECTIVE: To describe the accuracy and the reproducibility of the thermodilution
      flow measurements obtained using 3 commercially available cardiac output
      computers commonly used in intensive care units. DESIGN: An experimental "in
      vitro" study. Twelve different values of control flow (Qctr) were measured (Qmsr)
      using 3 different cardiac output computers (Abbott Critical Care System,
      Oximetrix 3 SvO2/CO Computer, Baxter Oximeter/Cardiac Output Computer SAT-1;
      American Edwards Laboratories, 9520 A Cardiac Output Computer). Standard
      equipment and techniques were employed, taking account of the specific weight and
      heat of warm water relative to blood. In addition, separate sets of measurements
      were performed in order to investigate the effect on Qmsr of some variables which
      may influence the "indicator" loss (time for injection, depth of immersion of the
      catheter, temperature of the injected fluid). SETTING: Our laboratory, inside the
      intensive care unit. MEASUREMENTS AND RESULTS: The analysis of the linear
      regression of Qmsr versus Qctr (r values between 0.992 and 0.984; residual
      standard deviation values comprised between 0.24 and 0.49 l/min; intercepts and
      slopes not significantly different from identity line), the values of the
      percentage errors (PE = [Qctr-Qmsr].100/Qctr; PE mean values 7.9, 5.0 and 13.1),
      and those of the coefficients of variability (CV = standard deviation mean value,
      %; CV mean values 5.4, 5.8 and 4.6), show a good level of accuracy and
      reproducibility of the measurements. Our data confirm previously reported
      results. Furthermore, the cumulative effect of variables capable of influencing
      the "indicator" loss, even if corrected according to the "calculation constant"
      the manufacturers provide, was found to result in statistically significant
      changes of Qmsr. CONCLUSION: The accuracy and reproducibility of the automatic
      cardiac computers tested is sufficient for practical clinical purpose. It may
      also depend on the modality of injection of the cooling bolus, which may
      significantly influence the effective "indicator" losses.

PMID- 7775698
TI  - Characteristics of the ventilator pressure- and flow-trigger variables.
AB  - Pressure- and flow-triggering are available in the Puritan Bennett 7200ae and
      Siemens SV 300. Using a mechanical lung model, we described the characteristics
      of the pressure- and flow-triggered continuous positive airway pressure (CPAP) of
      both ventilators. In the Puritan Bennett 7200ae, the pressure-triggered CPAP is
      characterized by the relatively insufficient flow delivery after the triggering,
      resulting in a greater lung pressure-time product (total PTP) than the flow
      triggered CPAP. Pressure support of 5 cmH2O results in total PTP less than that
      with flow-triggered CPAP. In the Siemens SV 300, total PTP with pressure- or flow
      triggered CPAP is comparable. Total PTP is less with pressure- or flow-triggered
      CPAP of the Siemens SV 300 than that of the Puritan Bennett 7200ae, respectively.
      The application of small pressure- or flow-triggered pressure support in the
      Puritan Bennett 7200ae eliminates the difference. The impact of these differences
      on patient inspiratory muscle work remains to be determined.

PMID- 7775701
TI  - Round table conference on clinical trials for the treatment of sepsis. Brussels,
      March 12-14, 1994.

PMID- 7775699
TI  - Removal of pro-inflammatory cytokines with renal replacement therapy: sense or
      nonsense?

PMID- 7775703
TI  - External high-frequency ventilation in patients with respiratory failure
      (external ventilation)

PMID- 7775702
TI  - Withdrawal syndrome following midazolam infusion.

PMID- 7775704
TI  - Catheter breaking and embolization after right heart catheterization.

PMID- 7775700
TI  - Central venous catheter infections: concepts and controversies.
AB  - Central venous catheters (CVCs) are widely used in critically ill patients in
      intensive care units. However, infectious complications are common and may limit
      their utility. We critically review the literature to determine the impact of CVC
      design and composition, insertion site selection, insertion procedures, care and
      removal of temporary CVCs on infectious complications. Relevant articles were
      identified and selected for review using a database search (Medline and manual of
      the English language literature) based upon study design and sample size with an
      emphasis on prospective randomized trials. To minimize infectious complications
      and maintain a reasonable cost-benefit ratio, we recommend: i) use a single lumen
      catheter unless clear indications for a multi-lumen catheter exist; ii) insert
      the catheter via the subclavian vein if no relative contraindication exists
      (bleeding diathesis, positive pressure ventilation); iii) disinfect the insertion
      site employing sterile technique; iv) apply a dry, sterile dressing and change
      the dressing every other day; v) inspect the insertion site for signs of
      infection and remove the catheter if pus is present; vi) if a catheter-related
      infection is suspected, change the catheter over a guidewire and culture the
      distal segment. The replacement catheter should be removed if an original
      catheter segment culture is positive.

PMID- 7775705
TI  - Systemic air embolism after laser resection of a tracheal tumor.

PMID- 7775706
TI  - Clostridium septicum primary myonecrosis related to cecal neoplasia.

PMID- 7775707
TI  - Restoration of anterograde flow in acute myocardial infarction: the first 15
      years.

PMID- 7775708
TI  - Lessons we have learned from the GUSTO trial. Global Utilization of Streptokinase
      and Tissue Plasminogen Activator for Occluded Arteries.
AB  - Thrombolytic therapy remains a mainstay for the treatment of patients with acute
      myocardial infarction. This therapy has been the subject of intense investigation
      and multiple studies as well as substantial controversy. Controversial issues
      include, among others, the specific drug, need for heparin, the relation between
      time to treatment and outcome and risk/benefit considerations. The Global
      Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded
      Coronary Arteries (GUSTO) trial of 41,021 patients addressed many of these
      issues. The results of the main trial were conclusive--treatment with accelerated
      tissue-type plasminogen activator (t-PA) resulted in a decreased mortality rate
      with a 15% reduction (95% confidence interval 5.9 to 21.3) compared with the two
      streptokinase monotherapy strategies (p = 0.001). Virtually all subgroup
      analyses, including age, nonanterior infarction location, patients undergoing
      bypass graft surgery and hypertensive patients, showed remarkable consistency
      with improved outcome with accelerated t-PA. This reduction in all-cause
      mortality with accelerated t-PA was associated with a small (absolute 0.2%) but
      significant increase in hemorrhagic stroke (p = 0.03). A combined end point of
      death or disabling stroke, or both, was still decreased in the accelerated t-PA
      group compared with the streptokinase group (p = 0.006). The angiographic
      substudy evaluated the mechanism of improved outcome and documented that
      reperfusion therapy works by restoring Thrombolysis in Myocardial Infarction
      (TIMI) grade 3 flow early, improving left ventricular function and improving
      mortality. The most favorable outcome seen with t-PA was related to the finding
      that it resulted in improved TIMI grade 3 flow compared with that for
      streptokinase.

PMID- 7775709
TI  - Current issues concerning thrombolytic therapy for acute myocardial infarction.
AB  - Data are now available from three large-scale randomized trials that directly
      compare the risks and benefits of thrombolytic agents in acute myocardial
      infarction. In the interpretation of results from the Gruppo Italiano per lo
      Studio della Sopravvivenza nell'Infarto Miocardico (GISSI-2) trial and its
      International Extension, the Third International Study of Infarct Survival (ISIS
      3), and the Global Utilization of Streptokinase and Tissue Plasminogen Activator
      for Occluded Coronary Arteries (GUSTO-1) trial, there are areas of both agreement
      and controversy. It is generally agreed that the agents most commonly used in the
      United States--tissue-type plasminogen activator (t-PA), streptokinase and
      anisoylated plasminogen streptokinase activator complex (APSAC)--all reduce
      mortality when given to patients with acute evolving myocardial infarction.
      Further, it is clear that thrombolytic therapy given to such patients presenting
      up to 12 h after onset of symptoms reduces the mortality rate by approximately
      20%, that aspirin therapy for patients presenting up to 24 h reduces the
      mortality rate by approximately 23% and that the benefits of thrombolytic therapy
      and aspirin are additive. Finally, and of most importance, the earlier
      administration as well as the more widespread use of thrombolytic therapy and
      aspirin would save many more lives. The totality of evidence clearly indicates
      that streptokinase produces significantly fewer strokes and cerebral hemorrhages
      than either t-PA or APSAC. Whether or not accelerated t-PA has a small advantage
      for mortality is less conclusive.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775710
TI  - Antithrombotic therapy for acute myocardial infarction.
AB  - Antithrombotic therapy is clearly beneficial in the treatment of acute myocardial
      infarction, but the optimal regimen is controversial. Treatment with aspirin
      leads to substantial and significant reductions in rates of mortality,
      reinfarction and stroke in patients with acute myocardial infarction, and the
      benefits are additive with those of thrombolytic therapy. It is unclear whether
      heparin confers additional net benefits over aspirin alone. In patients receiving
      aspirin and thrombolytic therapy, there is no mortality benefit from adding
      delayed subcutaneous heparin, no consistent patency benefit from adding immediate
      intravenous heparin and no reduction in mortality from adding immediate
      intravenous heparin, at least for patients treated with streptokinase. However,
      heparin is consistently associated with increased rates of intracranial and other
      serious bleeding events when used with both aspirin and thrombolytic therapy.
      Existing data support the need for further large-scale trials of current and
      newer antithrombotic regimens in acute myocardial infarction to assess the
      balance of benefits and risks of these regimens compared with that for aspirin
      alone. In patients not receiving thrombolytic therapy, randomized trial data are
      currently insufficient to adequately compare the benefits and risks of adding
      heparin to aspirin alone. The First American Study of Infarct Survival (ASIS-1)
      will directly compare the balance of risks and benefits of aspirin alone, aspirin
      plus intravenous heparin and aspirin plus intravenous hirudin in patients with
      acute myocardial infarction not receiving thrombolytic therapy.

PMID- 7775711
TI  - Time to thrombolytic treatment: factors affecting delay and their influence on
      outcome.
AB  - One of the major limitations to realizing the full potential of the lifesaving
      effects of thrombolytic therapy has been the failure to initiate treatment in the
      first 1 to 1.5 h after symptom onset. The barriers to early treatment include the
      following: 1) Most patients fail to react rapidly and appropriately to symptoms.
      2) Few emergency medical/paramedic systems have established effective triage
      systems for patients with chest pain or have implemented prehospital
      electrocardiography to better manage patients with possible acute myocardial
      infarction. 3) Time to treatment after hospital arrival currently averages 1 to
      1.5 h-two to three times longer than what should be necessary to initiate therapy
      in the patient with typical electrocardiographic and clinical findings and co
      morbid risk factors. Trials evaluating the effects of prehospital-initiated
      therapy have all shown trends toward a reduction in mortality (18%) associated
      with early treatment; however, none has been large enough in and of itself to be
      conclusive. The goal in the coming years will be to decrease each of these
      components of delay by developing effective education programs for the lay
      public, speeding and improving prehospital care by the routine use of
      electrocardiography and reducing hospital treatment times to < or = 30 min in the
      "uncomplicated" patient.

PMID- 7775712
TI  - Hirudin: initial results in acute myocardial infarction, unstable angina and
      angioplasty.
AB  - The central role of thrombosis in the pathogenesis of acute myocardial
      infarction, unstable angina and complications after angioplasty has led to
      intense interest in developing more effective antithrombotic agents for these
      disorders. Hirudin, a direct thrombin inhibitor, has undergone extensive testing
      in experimental models and has recently been evaluated in patients in several
      pilot trials. Across these three indications, hirudin has been found to achieve a
      more consistent level of anticoagulation than heparin, as gauged by the activated
      parital thromboplastin time. Similarly, as an adjunct to thrombolytic therapy in
      acute myocardial infarction, in the treatment of unstable angina and in support
      of angioplasty, hirudin appeared to improve indexes of coronary reperfusion and
      patency. Initial results with clinical end points, including death or myocardial
      infarction, appeared to favor hirudin over heparin. In several large phase III
      trials, hirudin is being compared with heparin for all three indications. In the
      first phases of these trials, the rate of hemorrhagic events, including
      intracranial hemorrhage, was higher than expected in both the hirudin and heparin
      arms, which demonstrated that a safety ceiling had been reached. The reformulated
      Thrombolysis in Myocardial Infarction (TIMI) 9 and Second Global Use of
      Strategies to Open Occluded Coronary Arteries (GUSTO II) trials are using lower
      doses of hirudin and heparin, which should allow testing of whether the initial
      favorable results observed in pilot trials will translate into improved clinical
      outcome, with an acceptable safety profile, for patients with acute myocardial
      infarction or unstable angina or those undergoing angioplasty.

PMID- 7775713
TI  - Cost and quality of life: thrombolysis and primary angioplasty.
AB  - In an era of limited health care resources, analyses of the cost-effectiveness of
      cardiac interventions are becoming increasingly important. By generally accepted
      cost-effectiveness methodologies, the incremental cost for thrombolysis with
      streptokinase in patients with acute myocardial infarction ranges from
      approximately $3,500 to approximately $21,000/year of life saved. The estimated
      incremental cost-effectiveness of tissue-type plasminogen activator (t-PA)
      compared with streptokinase ranges from approximately $16,000 to $60,000/year of
      life saved. Pooled results of three randomized trials suggest that primary
      angioplasty can reduce mortality by as much as 63% without any increase in cost.
      This potential benefit is substantially greater than the 10% to 15% relative
      mortality rate reduction for each hour earlier that thrombolytic therapy is
      administered or the 12% relative benefit suggested for accelerated t-PA compared
      with that for streptokinase. Large-scale randomized trials are encouraged to
      determine whether the cost and mortality of population-based strategies using
      primary angioplasty are better than strategies that rely on intravenous
      thrombolysis.

PMID- 7775714
TI  - Angiotensin-converting enzyme inhibitors after myocardial infarction: indications
      and timing.
AB  - A number of major studies have examined the impact of angiotensin-converting
      enzyme inhibitors on mortality in patients with ischemic heart disease. However,
      in these studies, selection of patients, choice of agent and timing of treatment
      after myocardial infarction have differed. In the Second Cooperative North
      Scandinavian Enalapril Survival Study (CONSENSUS II), all patients, unless
      hypotensive, were treated immediately after thrombolysis with placebo or
      intravenous enalaprilat followed by oral therapy. In contrast, in the Survival
      and Ventricular Enlargement (SAVE) study, patients were selected with a reduced
      radionuclide ejection fraction and without overt ongoing ischemia. Despite these
      different approaches, both studies were based on the rationale that angiotensin
      converting enzyme inhibition would beneficially affect infarct expansion and
      subsequent remodeling. The SAVE study reported a significant reduction in
      mortality rate (19% risk reduction, 95% confidence interval [CI] 3% to 32%) over
      an average follow-up period of 42 months, but with no observable impact on
      mortality rate until almost 1 year into treatment. The CONSENSUS II trial closed
      prematurely, with no benefit (a 10% increase in risk, 95% CI 7% reduction to 29%
      increase) apparent from enalapril after 6 months of follow-up. The recently
      reported but unpublished findings of Gruppo Italiano per lo Studio della
      Sopravvivenza nell'Infarto Miocardico (GISSI-3) and the Fourth International
      Study of Infarct Survival (ISIS-4) indicate a small benefit from early (within 24
      h) short-term (4 to 6 weeks) treatment of all patients, unless hypotensive, after
      a myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775715
TI  - Indications for immediate angiotensin-converting enzyme inhibition in patients
      with acute myocardial infarction.
AB  - When initiated a few days after myocardial infarction, angiotensin-converting
      enzyme inhibition exerts beneficial effects on survival and morbidity in patients
      with asymptomatic left ventricular systolic dysfunction or symptomatic heart
      failure. During the acute phase of a myocardial infarction, angiotensin
      converting enzyme inhibition appears to be well tolerated, to prevent the
      development of heart failure in patients with asymptomatic left ventricular
      systolic dysfunction and to improve the hemodynamic and clinical variables of
      heart failure when present. Accordingly, early angiotensin-converting enzyme
      inhibition is clearly indicated in patients with acute myocardial infarction
      associated with asymptomatic left ventricular dysfunction or clinical evidence of
      heart failure. Angiotensin-converting enzyme inhibition may also be beneficial
      when thrombolytic agents fail to restore coronary patency in patients with acute
      myocardial infarction.

PMID- 7775716
TI  - Assessing risk for the onset of functional dependence among older adults: the
      role of physical performance.
AB  - BACKGROUND: Approximately 10% of nondisabled, community-dwelling adults aged 75
      years and older lose independence in basic activities of daily living (ADLs) each
      year. The purpose of this study was to evaluate whether simple tests of physical
      performance could identify older adults, independent in their basic ADLs, who
      were at increased risk for the onset of functional dependence. METHODS: Among a
      representative cohort of 1103 community-dwelling adults aged 72 years and older,
      we evaluated the 664 subjects who were cognitively intact and independent in
      their basic ADLs at the baseline interview. All cohort members had undergone a
      comprehensive assessment, including a battery of qualitative and timed
      performance tests. The main outcome event was the onset of functional dependence,
      defined as a new disability in one or more of the seven basic ADLs at the 1-year
      follow-up. RESULTS: Functional dependence developed in 53 (9%) of the 563
      subjects who had complete data at the 1-year follow-up. Eight of the 12
      qualitative tests and all six of the timed tests were significantly associated (P
      < .05) with the onset of functional dependence. Both qualitative and timed
      performance tests demarcated subjects into groups at low and high risk for
      functional dependence. Four timed tests--chair stands, rapid gait, 360 degrees
      turn, and bending over--showed a threshold phenomenon, where the rate of new
      dependence increased slowly with worsening performance until a critical point (or
      threshold) was reached, and the rate of dependence increased substantially. For
      timed chair stands, for example, the rates of functional dependence within
      quarters of worsening performance were 5.3%, 6.3%, 6.7%, and 16%. The risk of
      functional dependence was markedly elevated (30%-50%) for subjects who were
      unable to perform the timed tests. CONCLUSIONS: Several simple tests of physical
      performance were strongly associated with the onset of functional dependence.
      These results support the potential use of physical performance tests to develop
      a risk assessment strategy that could identify subgroups of older persons,
      independent in all ADLs, who are at increased risk for functional dependence.

PMID- 7775717
TI  - Does oxybutynin add to the effectiveness of prompted voiding for urinary
      incontinence among nursing home residents? A placebo-controlled trial.
AB  - OBJECTIVE: To determine if oxybutynin, a bladder relaxant medication, adds to the
      effectiveness of prompted voiding (PV) in the management of urinary incontinence
      among nursing home residents. DESIGN: Randomized, placebo-controlled, double
      blinded, dose-adjusted, crossover trial of oxybutynin added along with PV.
      SETTING: Seven nursing homes in Los Angeles County, California. PARTICIPANTS:
      Seventy-five nursing home residents with predominantly urge incontinence, whose
      incontinence did not respond well to a trial of PV. MAIN OUTCOME MEASURES: The
      frequency of incontinence, measured as the percentage of hourly (7 AM to 7 PM)
      physical checks over a 3-day period at which the resident was found wet. RESULTS:
      Sixty-three (84%) of the residents completed the study. Among those completing
      the trial, the percent of checks wet went from 26.5% to 23.7% on placebo to 20.2%
      on active drug. These changes were statistically significant but not clinically
      meaningful. A clinically significant decrease in the frequency of incontinence,
      which we defined as a relative reduction in the percent of checks wet of > 33%,
      occurred in 20 subjects (32%) while on active drug and in 12 subjects (19%) while
      on placebo (P = .48 by chi-square). Twenty-five subjects (40%) met our
      "continence criteria" of an average of one or less wet per day while on active
      drug, and 11 subjects (18%) achieved this goal on placebo (P = .005 by chi
      square). CONCLUSION: Oxybutynin does not add to the clinical effectiveness of PV
      in the majority of nursing home residents with urge type urinary incontinence.
      Selected residents may, however, become more responsive to PV while on
      oxybutynin. Our data are consistent with other studies of bladder relaxant
      medications in functionally impaired populations. New drugs and/or other
      interventions are needed for the large number of incontinent nursing home
      residents who do not respond well to PV.

PMID- 7775718
TI  - Epidemiologic and diagnostic aspects of bacteriuria: a longitudinal study in
      older women.
AB  - OBJECTIVE: To examine month-by-month variability of bacteriuria in a cohort of
      older women and to evaluate the performance of rapid diagnostic tests commonly
      used to indicate the presence of significant bacteriuria. DESIGN: Prospective,
      observational study. SETTING: Community housing sites and a long-term care
      institution. PARTICIPANTS: Sixty-one women, mean age 77.6, took part in the
      study. MEASUREMENTS: Midstream clean-catch urine samples and medical information
      on subjects were collected at baseline, and then monthly for 6 months. RESULTS:
      Bacteriuria alone (> or = 10(5) organisms per mL) occurred in 17% of all urine
      samples (28% of patients), bacteriuria with pyuria in 15% (26% of patients), and
      bacteriuria with symptoms in 3% (10% of patients). Spontaneous clearance of
      bacteriuria with pyuria was common (P = .30), as were new occurrences (P = .12)
      over 6 months of follow-up. For the outcome of bacteriuria with symptoms,
      sensitivity of urinary diagnostic tests such as bacteria and pyuria on
      microscopic analysis, and leukocyte esterase on dipstick testing, ranged from 79
      to 93%. Negative predictive values of these tests approached 100%. CONCLUSIONS:
      Bacteriuria was a very common event, occurring in almost one-fifth of all urine
      samples and one-third of all subjects during 6 months of follow-up. Month-by
      month follow-up indicates that the natural history of bacteriuria is marked by
      frequent spontaneous alternation between positive and negative events. The high
      negative predictive value of many simple diagnostic tests commonly used for
      urinary tract disease suggests that they can quickly and cost-effectively rule
      out bacteriuria in the older female patient.

PMID- 7775719
TI  - Factors influencing users' return home on discharge from a geriatric intermediate
      care facility in Japan.
AB  - OBJECTIVES: To determine the factors that influence users' destinations on
      discharge from Geriatric Intermediate Care Facilities (GICFs), which were
      established in Japan in 1987 to help hospitalized older people return home.
      DESIGN: Retrospective chart review. SETTING: A 94-bed GICF attached to Saku
      Central Hospital in Japan. SUBJECTS: Charts of all users (N = 437) aged 65 years
      and older, discharged from the GICF between July 1987 and February 1991, were
      reviewed. MEASUREMENTS: The independent variables, obtained from users' admission
      records, were age, sex, place of residence before admission, length of stay,
      intellectual impairment (assessed by Karasawa's diagnostic criteria for senile
      dementia), ability to perform activities of daily living (ADLs), and living
      arrangement of users in the GICF. The dependent variable was destination after
      discharge from the GICF. MAIN RESULTS: Multiple logistic regression analyses
      revealed that, compared with users who were able to successfully return home,
      users with little ability to perform ADLs, male users, and those admitted from
      other institutions were more likely to be hospitalized. Such analyses also
      revealed that users who came from institutions, had low ability to perform ADLs,
      and lived alone were more likely to be institutionalized in nursing homes.
      CONCLUSIONS: Evaluating a user's physical, mental, and socioeconomic conditions
      at an early stage of admission to a GICF may allow us to predict whether the user
      can be successfully discharged to his or her home or will have to remain in the
      GICF for an extended period.

PMID- 7775720
TI  - Age-related differences in the utilization of therapies post acute myocardial
      infarction.
AB  - OBJECTIVE: To describe the effect of age on the care of patients hospitalized
      with acute myocardial infarction (MI). DESIGN: Retrospective chart review of all
      cases with a primary or secondary discharge diagnosis of acute MI. SETTING: Two
      large community hospitals in Milwaukee, Wisconsin, from July 1, 1990 to June 30,
      1991. PATIENTS: There were 771 charts reviewed, of which, 149 cases were aged 54
      years or younger, 203 were 55 to 64 years, 224 were 65 to 74 years, and 195 were
      aged 75 years or older. MEASUREMENTS: Hospital charts were examined for use of
      diagnostic and therapeutic interventions, including medications and procedures,
      as well as length of stay and in-hospital mortality. RESULTS: Older patients were
      more likely to be female (18%, 20%, 38%, and 56% for the four age groups,
      respectively, P < .001 chi-square for linear trend), more likely to present with
      congestive heart failure (31%, 39%, 51%, and 72%, P < .001), and had a higher in
      hospital mortality rate (5%, 7%, 10%, and 18%, P < .001). Older patients had a
      longer length of stay in the hospital. The use of cardiac catheterization in
      these post-MI patients was high and did not decrease until after age 75 (85%,
      88%, 88%, and 47%, P < .001). The percentage of patients receiving balloon
      angioplasty decreased with age (51%, 51%, 43%, and 20%, P < .001), whereas the
      percentage of patients receiving myocardial revascularization did not
      significantly differ with age (15%, 22%, 25%, and 19%, P = .46). Aspirin was less
      likely to be prescribed to older patients at discharge (79%, 82%, 70%, and 62%, P
      < .001). CONCLUSION: A surprisingly high percentage of those older than age 65
      received invasive tests and interventions. This high utilization rate coexists
      with our continued ignorance about the efficacy of these tests and interventions
      in older adults.

PMID- 7775721
TI  - Age as a determinant of cardiopulmonary resuscitation outcome in the coronary
      care unit.
AB  - OBJECTIVE: To determine whether age is associated with the outcome of
      cardiopulmonary resuscitation (CPR) in the coronary care unit (CCU). DESIGN:
      Retrospective chart review. SETTING: The coronary care units of two Canadian
      tertiary care teaching hospitals. PATIENTS: Two hundred sixty-four coronary care
      unit patients undergoing cardiopulmonary resuscitation between January 1, 1985
      and June 30, 1992. RESULTS: There was no significant difference in survival to
      discharge after CPR between patients less than 70 years of age (17.0%) and
      patients 70 years of age and older (17.2%) (odds ratio = 0.99; 95% confidence
      interval = 0.46, 1.80). Patients 70 years of age and older who survived to
      discharge after CPR had significantly greater lengths of stay (28.1 vs 19.3 days,
      P = .008). CONCLUSIONS: Age was not associated with a difference in survival to
      discharge after CPR in the CCU, although a clinically significant difference
      could not be excluded because of limited power.

PMID- 7775722
TI  - Posturography and balance problems in older people.
AB  - OBJECTIVE: To determine which measurements and test conditions on posturography
      are most useful for identifying balance problems in older people. SUBJECTS: Two
      samples of 70 community-dwelling older subjects (> 75 years). One group
      (controls) considered their balance normal for their age, and the other
      (patients) complained of imbalance. MEASUREMENTS: Velocity of sway on static
      (with and without foam) and dynamic posturography, Tinetti gait and balance
      score, self-reported fear of falling, and number and circumstances of falls.
      RESULTS: Mean sway velocity was significantly increased in patients compared with
      controls. The greatest difference between patients and controls occurred with
      measures of anterior-posterior sway velocity during angular tilt of the platform.
      Sway velocity was not significantly increased in patients or controls who
      reported falls compared with those who did not report falls. Even when comparing
      those who fell as a result of loss of balance with those who fell because of
      trips or slips, there was no significant difference in sway velocity. By
      contrast, those who reported fear of falling (patients and controls) had
      significantly increased sway velocity compared with those who did not report fear
      of falling. CONCLUSION: On average, velocity of sway (particularly in the
      anterior-posterior direction) is higher in older subjects who complain of
      imbalance compared with age-matched controls, and the difference is greater with
      dynamic posturography than with static posturography. However, the posturography
      data provided little information about the cause of the imbalance and did not
      correlate with the frequency of reported falls.

PMID- 7775724
TI  - Contractures and loss of function in patients with Alzheimer's disease.
AB  - OBJECTIVE: To investigate the prevalence of contractures in patients with
      Alzheimer's disease and to assess possible associations between contractures and
      cognitive and functional decline in Alzheimer's disease. DESIGN: Case series.
      SETTING: Subjects from an outpatient, university-based, dementia research center,
      followed, when necessary, into residential home and nursing home settings.
      PATIENTS: A consecutive sample of 161 patients (48 men, 113 women; mean age 75.3
      +/- 8.6 years) with a clinical diagnosis of probable Alzheimer's disease and with
      deficits in basic activities of daily living or more severe functional
      impairment. MAIN OUTCOME MEASURES: For cognition, the Mini-Mental State
      Examination (MMSE); for functioning, the Functional Assessment Staging Scale
      (FAST); contracture is defined as a decrease of 50% or more of the normal passive
      range of motion of the joint. RESULTS: Prevalence of contractures was correlated
      highly with degree of functional impairment (r = .70, P < .001). More than three
      quarters of patients who had lost the ability to walk manifested contractures;
      however, contractures were found in fewer than 11% of all ambulatory patients
      examined. When present, contractures involved more than one extremity in 97% of
      cases and involved all four extremities in more than two-thirds of patients.
      CONCLUSION: Joint contractures are very common in the severe stages of
      Alzheimer's disease. More than a quarter of a million institutionalized residents
      in US nursing homes are likely to be afflicted by this potentially painful and
      disfiguring condition. Possible pathophysiology and contributing factors and
      possible means of intervention for this major source of disability are discussed.

PMID- 7775723
TI  - Older community-dwelling adults' attitudes toward and practices of health
      promotion and advance planning activities.
AB  - OBJECTIVE: To describe the attitudes toward and practice of health prevention and
      advance planning measures by a group of community-dwelling older adults and to
      examine the effect of age on these practices. DESIGN: A descriptive study
      performed by mail survey. PARTICIPANTS: Members of a research registry who were
      65 years of age or older. MEASUREMENTS: By means of a written questionnaire, we
      asked about knowledge of various health prevention and advance planning topics,
      including exercise, cholesterol screening, rectal examination, influenza
      vaccination, sigmoidoscopy, mammography, prostate cancer screening, organ
      donation, autopsy, health care proxy, and advance directives. Of those who knew
      about the topic, we asked if the respondent had discussed it with a physician,
      who initiated the conversation, and if the respondent participated in the
      activity. We also asked how important the topic was to the respondent. RESULTS:
      We received 598 completed surveys, a response rate of 83%. Respondents had a mean
      age of 74 years, were predominately white (96%), and were well educated, with 44%
      having completed college. The respondents were all knowledgeable about the
      topics, and, with the exception of sigmoidoscopy, organ donation, and autopsy,
      more than 70% thought these topics were important. In the case of health
      screening and prevention activities, a large percentage of respondents reported
      having discussed the topic with a physician, and a slightly smaller percentage
      reported regular participation. In the case of health care proxies and advance
      directives, however, only about one-half of those who had made these arrangements
      said they had discussed them with a physician. When discussion did occur, it was
      much more likely to have been initiated by the respondent. Controlling for level
      of education, age was inversely associated with the likelihood of a woman
      reporting she had undergone mammography (P < .05). Age, however, was not
      associated with decreased frequency of undergoing other screening tests.
      CONCLUSIONS: Among a group of well educated older adults, reported interest in
      and compliance with health screening, health promotion, and advance planning
      activities were high. However, sigmoidoscopy, a relatively more invasive
      procedure that is generally recommended as a screening tool, is reported less
      likely to be practiced than prostate cancer screening, a less invasive procedure
      without such recommendation. Older adults state they are pursuing health care
      proxies and advance directives, often without the involvement of their
      physicians. Of the screening tests about which we asked, age was associated only
      with less frequent practice of mammography.

PMID- 7775725
TI  - A low, 'normal' score on the Mini-Mental State Examination predicts development
      of dementia after three years.
AB  - OBJECTIVES: To study whether a low, "normal" sumscore (i.e., 24 or higher) on the
      Mini-Mental Status Examination (MMSE) near the cutpoint usually employed for
      identifying persons with cognitive impairment predicts later development of
      dementia. DESIGN: A prospective study of a random sample of nondemented persons
      aged 75 years and older, according to DSM-III criteria, with follow-ups after 3
      and 6 years. PARTICIPANTS: The subjects were 215 persons living at home, mean age
      81 years, 81% women. Their mean MMSE sumscore at the start of the study (T0) was
      27.9 (range 24-30). MAIN RESULTS: A low MMSE sumscore at T0 was identified as a
      statistically strongly significant predictor of dementia after 3 years (P <
      .001), when more than 40% of those with a sumscore of 24 or 25 at T0 had become
      demented. A similar, although weaker and statistically nonsignificant, trend was
      observed for the risk after 6 years in relation to MMSE scoring at baseline.
      CONCLUSION: Persons with a sumscore of 24 or 25 and classified as not suffering
      from dementia according to the DSM-III criteria are at high risk of developing
      dementia within 3 years.

PMID- 7775726
TI  - Effect of hormone replacement therapy for menopause on the mechanical properties
      of skin.
AB  - OBJECTIVE: To evaluate the effect of hormone replacement therapy (HRT) for
      menopause on the mechanical properties of the skin in healthy women. DESIGN: A
      group of 114 women, including 43 nonmenopausal controls, 46 menopausal women with
      HRT and 25 menopausal women without HRT, participated in the study. Mechanical
      properties of the skin were measured on the volar forearm using a computerized
      suction device. SETTING: University medical center. Research laboratory in
      bioengineering and biometrology. RESULTS: Computerized measurements of skin
      deformability and viscoelasticity revealed differences between the three groups
      of women. A steep increase in skin extensibility was evidenced during the
      perimenopause in untreated women. HRT appeared to limit the age-related increase
      in cutaneous extensibility, thereby exerting a preventive effect on skin
      slackness. No effect of HRT was found on other parameters of skin
      viscoelasticity. CONCLUSION: HRT has a beneficial effect on some mechanical
      properties of skin and thus may slow the progress of intrinsic cutaneous aging.

PMID- 7775727
TI  - Mechanisms of constipation in older persons and effects of fiber compared with
      placebo.
AB  - OBJECTIVE: To investigate the mechanisms of constipation and the effect of fiber
      supplementation on physiology, mechanisms, stool parameters, and colonic transit
      times in a group of constipated older patients. DESIGN: Single-blind, randomized,
      placebo-controlled fiber intervention with crossover. SETTING: A university-based
      outpatient center. PATIENTS: Ten community-living older men and women, healthy
      except for chronic constipation. INTERVENTIONS: Patients were given either 24 g
      psyllium fiber or placebo fiber daily for 1 month, then crossed over to the other
      arm for an additional month. Structured testing, including total gut transit time
      and rectal and colonic manometry, was performed at the end of each intervention
      month. Patients recorded stool frequency, consistency, and weights daily.
      RESULTS: The predominant mechanism for constipation in these patients was outlet
      delay caused by pelvic dyssynergia. Fiber decreased total gut transit time from
      53.9 hours (placebo condition) to 30.0 hours (P < .05). Stool weights and
      consistency were not significantly improved by fiber, though there was a trend
      toward an increase in stool frequency (1.3 vs 0.8 bowel movements per day.)
      Pelvic floor dyssynergia was not remedied by fiber, even when constipation was
      clinically improved. CONCLUSIONS: Fiber supplementation appeared to benefit
      constipated older patients clinically, and it improved colonic transit time, but
      it did not rectify the most frequent underlying abnormality, pelvic floor
      dyssynergia.

PMID- 7775728
TI  - Thyroid autoantibodies in hospitalized chronic geriatric patients: prevalence,
      effects of age, nonthyroidal clinical state, and thyroid function.
AB  - OBJECTIVE: To investigate the effect of age, clinical condition, and thyroid
      function on the prevalence of thyroid autoantibody positivity in hospitalized
      chronic geriatric patients. DESIGN: A screening study of hospitalized chronic
      geriatric patients. PARTICIPANTS: 249 non-selected, hospitalized, chronic
      geriatric patients more than 60 years of age and 81 20 to 40-year-old healthy
      persons. MEASUREMENTS: Thyrotropin (TSH); thyroxine (T4) and free thyroxine
      (FT4); and triiodothyronine (T3), thyroglobulin (Tg), antibodies against thyroid
      peroxidase (AbTPO) and antibodies against thyroglobulin (AbTg) estimation in a
      screening study. RESULTS: AbTPO positivity (AbTPO+) was found more often than
      AbTg positivity (AbTg+) (15.3% vs 9.2%, P = .04), one being positive (Ab+) in
      19.3%. The occurrence was higher in females than males (Ab+:27.1% vs 7.1%, P <
      .001; AbTPO+:21.9% vs 5.1%, P < .001; AbTg+:13.2% vs 3.1%, P = .0052). Among the
      Ab+ patients, AbTPO was more often positive than AbTg (40/48 vs 21/48, P < .001).
      The sensitivity, specificity, and positive predictive value of Ab positivity to
      detect a thyroid disorder were 0.35, 0.85 and 0.38, respectively. Within the
      population of euthyroid geriatric patients, the occurrence of AbTg+ (chi 2(2) =
      8.65, P = .013) and Ab+ (chi 2(2) = 8.02, P = .018) correlated positively with
      the age of the patients, and there was also a female predominance (AbTPO+ 18% vs
      3.7% in the males; AbTg+ 13% vs 2.4%; Ab+ 25.8% vs 6.1%). When compared with 20
      to 40-year-old subjects, only the euthyroid > or = 80-year-old patients showed a
      significantly higher occurrence of Ab+ (26.2% vs 9.9% chi 2(1) = 5.64, P = .017).
      In the euthyroid > or = 80-year-old females, AbTPO+ was 25%, AbTg:22.2%, and Ab+:
      36.1%!. The nonthyroidal clinical state of the euthyroid patients did not
      correlate with the antibody prevalence. CONCLUSIONS: In hospitalized chronic
      geriatric patients, AbTg and especially AbTPO positivity is frequent, even in
      euthyroid patients without goiter. This aspecific Ab positivity in the euthyroid
      state correlates to the age, but not to the severity of the nonthyroidal clinical
      condition of the patients and explains why the Ab positivity is not predictive
      enough for thyroid dysfunction in this subpopulation. Thus, in hospitalized
      chronic geriatric patients the AbTg and AbTPO titers should be examined only in
      cases where thyroid screening (TSH) reveals abnormal results.

PMID- 7775729
TI  - The reliability and validity of the Geriatric Depression Rating Scale
      administered by telephone.
AB  - OBJECTIVE: To evaluate prospectively the reliability and validity of the
      Geriatric Depression Scale administered by telephone (T-GDS) in patients
      undergoing outpatient comprehensive geriatric assessment. SUBJECTS: A total of
      101 geriatric patients were evaluated in a 1-year period at the outpatient
      Geriatric Assessment Center of the University of Nebraska Medical Center.
      METHODS: The 30-item GDS was completed by all patients on three occasions: by
      telephone several days before their assessment, face-to-face during their
      assessment visit, and several days later, again by phone. During their
      assessment, all patients were evaluated by one of three geriatric psychiatrists
      who were blind to all GDS results. The test-retest reliability of the T-GDS was
      measured by comparing the results of the two phone interviews. The construct
      validity of the T-GDS was estimated by comparing the results of the initial T-GDS
      to the GDS obtained during the comprehensive assessment. The criterion validity
      of the T-GDS was estimated by comparing the results of the T-GDS with the
      clinical diagnosis of depression assigned by the psychiatrists. RESULTS: The
      individual items of the initial T-GDS showed substantial concordance with the
      second T-GDS (kappa range 0.35-0.75, mean = 0.52), and with the assessment GDS
      (kappa range 0.29-0.75, mean = 0.52). One item showed evidence of bias when
      comparing the two T-GDSs, and two items when comparing the initial T-GDS to the
      GDS done during the assessment. The mean number of symptomatic responses was not
      significantly different for the T-GDS versus assessment administration but did
      decline slightly when comparing the two T-GDSs. ROC curve analyses showed good
      agreement between the clinical diagnosis and the T-GDS. CONCLUSION: The GDS
      appears to maintain its reliability and validity when administered via telephone
      and thus may be useful for a variety of epidemiological and clinical purposes.

PMID- 7775730
TI  - Concurrent validity of administering the Geriatric Depression Scale and the
      physical functioning dimension of the SIP by telephone.

PMID- 7775731
TI  - Reliability of screening for sensory impairment in depressed versus nondepressed
      older adults.

PMID- 7775733
TI  - Health care reform and the care of older adults.

PMID- 7775732
TI  - Are acting and omitting morally equivalent? A reappraisal.

PMID- 7775734
TI  - The healthcare revolution: change and impact on geriatric medicine.

PMID- 7775735
TI  - Report on public policy: whatever happened to comprehensive health care reform?

PMID- 7775737
TI  - Withdrawing versus withholding therapy: still a pernicious distinction.

PMID- 7775736
TI  - International common denominators in geriatric rehabilitation and long-term care.

PMID- 7775739
TI  - Letter from Toronto.

PMID- 7775740
TI  - Pneumoperitoneum in an older patient.

PMID- 7775738
TI  - Healthcare reform: benefits or hazards for the frail and their doctors.

PMID- 7775741
TI  - Falls Handicap Inventory (FHI)--an instrument to measure handicaps associated
      with repeated falls.

PMID- 7775742
TI  - The evolution of nursing homes.

PMID- 7775743
TI  - Postprandial hypotension.

PMID- 7775744
TI  - Physician assessment of patient competence.

PMID- 7775745
TI  - Physician assessment of patient competence.

PMID- 7775746
TI  - Endoscopic carpal tunnel release: a prospective study of complications and
      surgical experience.
AB  - A 63-center prospective study of endoscopic carpal tunnel release using the Agee
      Carpal Tunnel Release System was conducted in 1049 procedures in 988 patients.
      Prior experience with endoscopic release varied significantly among surgeon
      participants. Surgeons evaluated the newly redesigned system for blade
      visibility, blade height, and mechanical function. Data on patient complications
      were collected at the time of surgery and 3-4 weeks postoperative. The results
      indicated minimal complications and no confirmed injuries to vessels or nerves;
      the symptoms from one possible digital nerve injury eventually resolved
      completely. Surgeons were able to observe the point of entry of the blade into
      the transverse carpal ligament in 97.5% of procedures. Introduction of the blade
      assembly into the carpal tunnel was rated easy or adequate in 90.6% of
      procedures, and blade height was rated adequate in 97.4% of procedures.

PMID- 7775747
TI  - Biomechanical changes after carpal tunnel release: a cadaveric model for
      comparing open, endoscopic, and step-cut lengthening techniques.
AB  - We used a previously described cadaveric model for evaluating changes in flexor
      tendon biomechanics after open carpal tunnel release to evaluate endoscopic and
      step-cut lengthening techniques. A 26% and 18% increase in tendon excursion
      consumed by wrist motion was demonstrated for flexor digitorum profundus and
      flexor digitorum superficialis tendons respectively after open transection of the
      transverse carpal ligament. A 21% and 15% increase in tendon excursion was
      demonstrated after endoscopic carpal tunnel release and a 21% and 16% increase
      after step-cut lengthening of the transverse carpal ligament. Increased excursion
      was noted after 20-30 degrees of wrist flexion as tendon bowstringing occurred.
      Although division of the transverse carpal ligament by all methods resulted in a
      significant increase in tendon excursion, the differences between methods of
      carpal tunnel release were not significant. This cadaveric study evaluates one
      potential cause for weakness after carpal tunnel release, palmar displacement of
      the flexor tendons, which results in increased flexor tendon excursion consumed
      by wrist motion.

PMID- 7775748
TI  - Externally applied forces to the palm increase carpal tunnel pressure.
AB  - Change in carpal tunnel pressures that result from externally applied forces to
      the palm of the hand were assessed in five cadaveric specimens. MIKRO-TIP
      transducers were percutaneously placed into the carpal tunnel at the level of the
      hook of the hamate. A 1 kg force was applied to the palm of the hand in 16
      separate locations. Significant elevations in carpal tunnel pressure were
      observed for external forces applied over the flexor retinaculum (103 mm Hg) and
      also for the hypothenar (37 mm Hg) and thenar (75 mm Hg) areas adjacent to the
      distal aspect of the carpal tunnel. These data demonstrate that the application
      of external forces on the palm of cadaver hands increases carpal tunnel pressure
      and the magnitude of the pressure change in the carpal tunnel depends on the
      location of the applied force.

PMID- 7775749
TI  - Effect of lumbrical muscle incursion within the carpal tunnel on carpal tunnel
      pressure: a cadaveric study.
AB  - Lumbrical muscle incursion within the carpal tunnel has been implicated as a
      possible cause of carpal tunnel syndrome. During finger flexion, surgeons have
      observed the presence of lumbrical muscles in the carpal tunnel. However, the
      significance of this incursion has not been evaluated. To evaluate the effect of
      lumbrical muscle incursion within the carpal tunnel as a cause of carpal tunnel
      syndrome, carpal canal pressures were measured in cadaver hands at the level of
      the hamate hook for four finger positions: (1) 100% finger flexion; (2) 75%
      finger flexion; (3) 50% finger flexion; and (4) full extension. After measuring
      carpal tunnel pressures for each position, the lumbrical muscles were excised and
      the pressures were again recorded. A progressive increase in carpal tunnel
      pressure was noted for each degree of finger flexion in the group with intact
      lumbricals. This is in sharp contrast to a relatively stable carpal tunnel
      pressure during finger flexion for the group without lumbrical muscles. Two-way
      repeated measures analysis of variance revealed a significant difference in
      carpal tunnel pressure for both variables, lumbrical muscles and finger position.
      One-way repeated measures analysis of variance for carpal tunnel pressures
      demonstrated that the effect of finger position was significant for the group
      with intact lumbricals but not for the group with lumbricals removed. We conclude
      that lumbrical muscle incursion into the carpal tunnel can result in elevation of
      carpal tunnel pressure in cadaver hands and could be a variable in the cause of
      work-related carpal tunnel syndrome.

PMID- 7775751
TI  - Neurologic and ischemic complications of upper extremity vascular access for
      dialysis.
AB  - This study reviews the clinical course of 22 patients with chronic renal failure
      on hemodialysis with ischemic or neurologic problems in the upper extremity
      distal to an arteriovenous fistula. Two distinct presentations were observed.
      Twelve patients developed significant motor and/or sensory impairment immediately
      following surgical construction of the fistula. Ten patients presented with upper
      extremity ischemia, established or impending tissue loss, or nonhealing wounds
      distal to a dialysis fistula. Seventeen of the 22 patients were diabetic. Nerve
      conduction studies, noninvasive vascular studies, and arteriography were used to
      confirm the diagnosis. Sixteen of the 22 patients had ligation or revision of the
      fistula. Five patients underwent amputations at the metacarpal or phalangeal
      level, and one patient underwent below-elbow amputation.

PMID- 7775752
TI  - Hemodynamic variations between end-to-side and end-organ flap systems.
AB  - This study aimed to evaluate microcirculatory differences between anatomic
      arrangements of the intact side flow and the end flow systems. The cremaster
      muscle tube-flap model was employed. Fifty male Sprague-Dawley rats were studied
      in two experimental groups of 25 animals each. The end-to-side vascular system
      was compared with end-organ flaps during acute (6 hours) and chronic (1, 3, 7,
      and 14 days) observation periods. Standard microcirculatory measurements were
      taken in all groups including vessel diameters, red blood cell velocities, and
      capillary densities. End-to-side flaps presented with stable flow hemodynamics
      over a 14-day period. In end-organ flaps we found acute venous congestion,
      alterations in arterial and venous flow velocities, and a significant decline in
      capillary perfusion.

PMID- 7775750
TI  - Pressure dynamics of the carpal tunnel and flexor compartment of the forearm.
AB  - Although carpal tunnel pressures have been observed to increase as a result of
      repetitive flexion and extension of the wrist, and forearm compartment pressures
      have been shown to rise during and after muscle activity, the relationship
      between those two observations has not been studied. The flexor compartments of
      five cadavers were perfused with saline to determine whether elevated pressure in
      the flexor compartment of the forearm is transmitted to the carpal tunnel. The
      pressure in the carpal tunnel after the infusion was significantly different from
      the pressure in the flexor compartment of the forearm. Furthermore, pressures
      recorded in the carpal tunnel at the conclusion of the study were not
      statistically different from the preinfusion pressures. While the carpal tunnel
      may appear to be an open compartment anatomically, it functions as a relatively
      closed compartment with respect to transfer of pressure from the flexor
      compartment of the forearm under conditions that mimic elevated tissue pressure.

PMID- 7775753
TI  - Toe-to-finger transfer combined with wrap-around flap: a new technique for four
      finger amputation.
AB  - A surgical technique for reconstruction of four-finger amputation, toe-to-finger
      transfer combined with wrap-around flap procedure, is described. Opposable ulnar
      fingers, reconstructed using the second and third toe, provide sufficient grip
      function. The long finger, reconstructed with the wrap-around flap using the
      lateral aspect of the great toe, provides pinch function. Improving the hand
      function is worthwhile despite morbidity from losing two toes.

PMID- 7775754
TI  - Arborization of the distal posterior interosseous nerve.
AB  - The distal posterior interosseous nerve was dissected in 41 cadaveric specimens.
      Intraarticular branches were tagged with radioopaque markers and verified by
      fluoroscopy. The nerve averaged 1.3 mm in diameter and was located on the radial
      side of the fourth dorsal compartment encased in thickened fascia. Six of the
      specimens had a branch to the distal radioulnar joint, which originated 5 cm
      proximal to the joint. Distally, the nerve coursed with terminal branches of the
      interosseous artery. Innervations were categorized according to level:
      radiocarpal, midcarpal, and terminal. Fourteen had innervations to all three
      levels, and there were radiocarpal branches in 27 specimens, midcarpal branches
      in 35, and terminal branches in 29. Varying combinations of innervations were
      seen.

PMID- 7775756
TI  - Difference in sensibility between the dominant and nondominant index finger as
      tested using the Semmes-Weinstein monofilaments pressure aesthesiometer.
AB  - In 130 active subjects aged 7 to 76 years, sensibility of both index fingers were
      tested using Semmes-Weinstein monofilaments. Subsequently, subjects were asked to
      indicate their dominant side. The gathered data was analysed statistically to try
      and find a possible difference in sensibility between the dominant and
      nondominant side. No difference was found in the majority of our series (76). The
      index at the nondominant side was found to have superior sensibility in 35 out of
      130 subjects, while the reverse was true in the remaining subjects (19). In case
      there is a difference in sensibility between the two hands, the less sensitive
      side shows 'normal' distribution of light touch thresholds, whereas at the more
      sensitive side these thresholds usually scored one nylon rod marker lower.

PMID- 7775757
TI  - Neuroendocrine carcinoma of the finger: a case report.

PMID- 7775758
TI  - Hypertrophic neuropathy presenting with ulnar nerve compression: a case report.

PMID- 7775755
TI  - Subjective outcome following surgical management of upper extremity neuromas.
AB  - Our study used a telephone survey to evaluate long-term subjective outcome of 70
      patients with 112 upper extremity neuromas treated surgically. The mean
      postinjury time before surgery was 9 years. The mean postsurgical followup was 5
      years. Fifty-one of the patients were involved with workers' compensation (WC).
      Forty-five patients reported good relief of pain. Preoperatively, 46 patients
      were unemployed because of pain; following surgery 18 of these patients returned
      to work. Of the 54 patients taking analgesic medication preoperatively, 19
      reported less and 10 reported no postoperative analgesic use. No significant
      difference was found in gender, postinjury time, postsurgical followup time,
      number of previous surgeries for pain relief, or site of nerve injury between
      patients who reported improvement versus no symptomatic improvement. Poor
      subjective outcome occurred in patients (p < .03), with 16 out of 19 of those not
      involved with WC reporting good pain relief as compared to 29 out of 51 of WC
      patients.

PMID- 7775759
TI  - Scaphoid nonunion: treatment by open reduction, bone graft, and staple fixation.
AB  - Thirty-eight scaphoid nonunions were treated by iliac crest bone grafting and
      staple fixation. A distractor was inserted through an anterior incision and the
      scaphoid was distracted to restore its original length. The nonunion was then
      grafted and held with a staple. Consolidation was achieved in 36 cases despite 6
      cases of partial avascular necrosis. Pain at the graft site, which was usually
      transient, was the only complication. Wrist extension was significantly improved.
      The main indication for this procedure is pseudarthrosis of the middle third of
      the scaphoid.

PMID- 7775760
TI  - Refracture of a proximal pole scaphoid fracture: a case report.

PMID- 7775761
TI  - Scaphoid nonunion in a child: a case report.

PMID- 7775762
TI  - Type III-A hypoplastic thumb.
AB  - Thirteen type III-A hypoplastic thumbs were reviewed. The abnormalities included
      those found in type II hypoplasia (narrow thumb-index web space, hypoplastic
      thenar muscles, unstable metacarpophalangeal joint, as well as extrinsic tendon
      abnormalities); all had stable carpometacarpal joints. They are differentiated
      from type III-B hypoplastic thumbs, which have an unstable carpometacarpal joint
      due to a deficient base of the metacarpal. The extrinsic tendon abnormalities
      included absent extensor pollicis longus tendon, absent or aberrant flexor
      pollicis longus tendon, and a tendon interconnection between the flexor pollicis
      longus and extensor aponeurosis. Twelve of the thumbs had surgical
      reconstruction. None was treated with ablation and index pollicization.

PMID- 7775763
TI  - Flexor tenolysis in children.
AB  - This study aimed to determine whether there is an age below which flexor
      tenolysis may not be beneficial and whether there is any detriment to waiting for
      a more appropriate age. In this study, patients in their first decade had minimal
      improvement in their active flexion after flexor tenolysis. Six patients were
      tenolysed more than 1 year after their original operation and none appeared to
      have been compromised by the prolonged interval between injury repair and
      tenolysis. Significant improvement in active flexion after tenolysis can be
      confidently expected only in children over 11 years old.

PMID- 7775764
TI  - Correction of an angular deformity of the thumb in a juvenile by epiphyseal
      distraction.

PMID- 7775765
TI  - Biomechanical and clinical evaluation of the epitenon-first technique of flexor
      tendon repair.
AB  - Thirteen matched pairs of canine flexor tendons were repaired using both the
      Epitenon-first and the modified Kessler with an epitendinous running suture.
      These were then tested to failure with a longitudinal force in an Instron test
      machine. Human cadaver flexor digitorum profundus tendons were used to determine
      the cross sectional area of the tendon that is displaced by suture material of
      the Kessler repair and Epitenon-first core suture. Results of biomechanical
      testing revealed the epitenon-first technique to be 22% stronger than the
      modified Kessler technique. Comparison of tendon repair cross sectional contact
      areas by digital scanning of surface photomicrographs demonstrated 20% of the
      surface area of the repair is occupied by the knot of the modified Kessler
      technique, while the core suture of the epitenon-first repair consumed only 2.6%
      of the cross sectional area. These findings correlate with our clinical results
      of 26 zone II flexor tendon repairs in 18 patients repaired with the epitenon
      first technique over a 4-year period. Of these, there has been one rupture and no
      repeat operations for lysis of adhesions.

PMID- 7775766
TI  - Augmented Becker versus modified Kessler tenorrhaphy in monkeys: dynamic
      mechanical analysis.
AB  - The strength and gliding efficiency of an augmented Becker and Kessler tendon
      repair techniques were compared in fresh cadaver macaque monkey hands. Gliding
      efficiency was determined by comparing tendon work and load measurements made
      during tendon excursion to full fist with the same measurements made after tendon
      repair. Repair strength was then determined by tendon distraction to complete
      repair rupture. Data were gathered by computer controlled tensiometer and
      analyzed by factorial and repeated measures ANOVA. The augmented Becker repairs
      were significantly stronger than Kessler repairs. Repaired tendons required more
      load and work to bring the fingers into full fist; both repair types resulted in
      gliding efficiencies of 30% compared to intact controls. The augmented Becker
      repair is significantly stronger in situ than the modified Kessler and is
      recommended when early postoperative motion regimens are planned.

PMID- 7775767
TI  - Clinical management of partially lacerated digital flexor tendons: a survey
      [corrected] of hand surgeons.
AB  - A survey was taken of one thousand members of the American Society for Surgery of
      the Hand to determine the methods by which clinicians currently treat partial
      lacerations of flexor tendons. Results from 591 respondents show that most
      surgeons use a modified Kessler technique and begin protected mobilization within
      the first 48 hours.

PMID- 7775768
TI  - Flexor pollicis longus rupture in a trigger thumb: a case report.

PMID- 7775769
TI  - Endoscopic retrieval of severed flexor tendons.

PMID- 7775770
TI  - Safety and efficacy of percutaneous trigger finger release.
AB  - Twenty-five A1 pulleys in 5 fresh cadaveric hands and 13 trigger fingers in 11
      patients were released percutaneously with a 19 gauge needle, as described by
      Eastwood et al., to determine the efficacy and safety of the technique. Over 90%
      of the length of each individual finger and thumb A1 pulley were successfully
      released in the cadaveric digits with no injuries to the A2 pulley, nerves, or
      vessels. Superficial abrasions were noted in four superficialis tendons. In our
      surgical series, complete clinical release (eradication of triggering) was
      achieved in each digit. In 8 of 13 digits, the A1 pulley was found to be
      completely divided on open exploration. In five digits, while triggering was
      eliminated, some of the A1 pulley remained intact. There were no complications.
      Because of the proximity of digital nerves, we do not perform percutaneous
      release in the index finger or thumb.

PMID- 7775771
TI  - Functional reconstruction of the shoulder with a latissimus dorsi pedicle flap
      and a hemiarthroplasty: a case report.

PMID- 7775772
TI  - Functional range of motion of the elbow.
AB  - One hundred normal upper extremities in 50 adults were sequentially studied in a
      Bledsoe brace, which limited elbow motion. The amount of flexion and extension of
      the elbow was serially limited by 15 degree increments. At each setting, the
      subjects were asked to perform 12 activities of daily living. The percentage of
      subjects who completed each task with the specified range of motion was
      determined. Overall, 49 of the subjects performed all of the tasks with extension
      limited at 75 degrees and flexion limited at 120 degrees. By isolating the
      allowable range of motion of the elbow and allowing for compensatory motions and
      strategies of the normal adjacent joints, the functional elbow range of motion is
      established as 75 degrees-120 degrees flexion. Thus, the functional status of a
      patient with a specific elbow range of motion can be predicted more accurately.

PMID- 7775773
TI  - Grip strength testing using the BTE work simulator and the Jamar dynamometer: a
      comparative study. Baltimore Therapeutic Equipment.
AB  - This study compared the results obtained from testing grip strength using the
      hydraulic Jamar dynamometer and the BTE Work Simulator. The grip strength of 14
      adults was assessed with the Jamar at 90 degrees elbow flexion, Jamar at 45
      degrees elbow flexion, and the BTE using the manufacturers recommended position.
      Greater strength measurements were generated with the elbow at 90 degrees rather
      than 45 degrees on the Jamar. The Jamar measurements at 90 degrees of elbow
      flexion were not significantly different from the BTE work simulator values.
      Intraclass correlation coefficients between the Jamar at 90 degrees and the BTE
      work simulator values were excellent. This study demonstrated that the results
      obtained from the BTE work simulator and the Jamar dynamometer are comparable.
      These findings validate the use of the BTE work simulator for grip strength
      testing.

PMID- 7775774
TI  - Ligamentous and tendinous support of the pisiform, anatomic and biomechanical
      study.
AB  - Twenty-five formalin preserved cadaveric wrists were dissected and the
      relationship of the piso-triquetral joint and its surrounding soft tissue
      structures were defined. An additional 4 fresh frozen wrists were examined in
      longitudinal and transverse sections. These anatomical studies showed the
      extensor retinaculum to have a complex insertion into the pisiform, flexor carpi
      ulnaris, fifth metacarpal, piso-metacarpal ligament, and the abductor digit
      minimi muscle. A capsulo-ligamentous structure on the medial aspect of the piso
      triquetral joint was also identified. Bio-mechanical testing was performed on 12
      fresh cadaver wrists and the results were compared to the anatomical findings to
      determine the contribution of surrounding soft tissue structures to piso
      triquetral joint stability. Mechanical testing showed the soft tissues around the
      piso-triquetral joint to be strongest proximally and distally and weakest
      medially. Transection of the transverse carpal ligament resulted in increased
      lateral motion of the pisiform, but there was no significant decrease in
      stiffness. This study provides insight into the etiology of piso-triquetral joint
      instability and dysfunction.

PMID- 7775776
TI  - Extrinsic wrist ligaments in the pathomechanics of ulnar translation instability.
AB  - A description of the various combinations of ligament disruptions necessary for
      ulnar translation instability is presented based on a series of cadaver
      dissections and load studies. Dissections and load studies demonstrated that
      major ligament disruption, even to the extent that only the dorsal ulnolunate,
      the palmar ulnolunate or the radioscaphocapitate, and the long radiolunate
      ligaments were left intact, failed to result in meaningful ulnar translation of
      the carpus. The radioscaphocapitate ligament alone could not prevent significant
      ulnar translation. Palmar translation instability was evident with less ligament
      disruption than that needed for ulnar translation and was always evident if there
      was ulnar translation. These studies imply that ulnar translation represents a
      much more global ligament disruption and instability than previously suggested in
      the literature.

PMID- 7775775
TI  - Rotational stability of the carpus relative to the forearm.
AB  - To perform rotational tasks adequately, the rotational laxity between the radius
      and the carpus must be constrained within a certain limit. The contribution of
      nine individual capsuloligamentous structures to the rotational stability of the
      radiocarpal joint was studied using 14 fresh-frozen human cadaveric specimens.
      Torque-rotation curves, with sequential section of the soft-tissue structures,
      were used to calculate the percentage contribution of each individual structure.
      The primary pronation constraint was the palmar radioscaphocapitate ligament. The
      contributions to supination constraint were more complex; the dorsal
      radiotriquetral ligament was dominant, assisted by the palmar ulnolunate
      ligament. Structures originating from the ulna changed their major constraint
      contribution with forearm orientation, whereas those with a radial origin had a
      constant contribution independent of forearm rotation. Injury of these structures
      may lead to rotational instability at the radiocarpal level and should be
      considered when treating carpal instabilities.

PMID- 7775777
TI  - Treatment of acute injuries of the triangular fibrocartilage complex associated
      with distal radioulnar joint instability.
AB  - One hundred thirty patients who had an injury of the triangular fibrocartilage
      complex (TFCC) with distal radioulnar joint (DRU) instability were treated
      operatively. The TFCC injury with DRUJ instability occurred as an isolated lesion
      in 20. After appropriate fracture stabilization, 86 patients were treated with
      closed reduction of the DRUJ and radioulnar transfixation with one to two
      Kirschner wires with the forearm in neutral rotation. In 19 patients the avulsed
      ulnar styloid was internally fixed, and the DRUJ supplemented with radioulnar
      transfixation. In 13 patients the ulnar styloid was internally fixed. In 12
      patients with radial avulsion fractures the displaced bony fragment was
      percutaneously fixed with a Kirschner-wire. Postoperatively all the patients were
      immobilized in a long arm cast in neutral rotation for 6 weeks. The results were
      excellent in 95%, fair in 30, and poor in 5.

PMID- 7775778
TI  - Lasso stabilization of the distal ulna after tumor resection: a report of two
      cases.
AB  - Two patients with complicated giant cell tumors of the distal ulna were treated
      by resection of 7.5 and 5.5 cm of the ulna, respectively. The proximal ulnar
      stump was stabilized with a lasso tendon graft, which allowed the patients to
      return to presurgery activities. The technique described is a modification of a
      tendon loop reconstruction used by Bunnell.

PMID- 7775779
TI  - Intra-articular impaction fractures of the phalanges.
AB  - Six patients with acute impacted fractures of the base of the proximal or middle
      phalanges were treated with open reduction and internal fixation. Two of three
      patients who presented with chronic injuries also underwent surgical
      reconstruction. Contiguous 1.5-mm sagittal computed tomographic imaging was
      performed on each proximal interphalangeal joint fracture; the imaging documented
      an average impaction of 30% of the articular surface area. Metaphyseal bone
      grafting was necessary to support the articular surface in three acute and both
      late patients. Rigid internal fixation, most frequently employing a composite
      wire tension band technique, allowed immediate postoperative range of motion
      exercises. At an average follow-up period of 21 months, all six acute patients
      had restoration of an excellent painless range of motion. There was no loss of
      articular congruency on final x-ray films. Late or conservative treatment of
      these injuries was uniformly less successful.

PMID- 7775781
TI  - Complications following AO/ASIF wrist arthrodesis.
AB  - Seventy-three wrist arthrodeses (71 patients) using AO/ASIF dorsal plate fixation
      and iliac crest bone graft were retrospectively reviewed to assess complications
      of this technique. There were 82 complications in 50 wrists. Nonunion of the
      radius to the carpus did not occur. Forty-five of the complications were related
      to the soft tissues; 29 were bone or articular complications. Chronic unexplained
      pain represented 8 of the complications. Overall, 63 of the 82 complications
      resolved. Nineteen wrists required additional surgery, most frequently for plate
      removal. Eighteen wrists were left with one or more residual difficulties after
      fusion. Thus, 55 of the wrist arthrodeses ultimately resulted in a stable, pain
      free wrist.

PMID- 7775780
TI  - Sesamoid arthrodesis for hyperextension of the thumb metacarpophalangeal joint.
AB  - Forty-two sesamoid arthrodeses performed since 1986 were reviewed. Thirty-seven
      cases were considered successful. Hypertension recurred in 3 of the 20 procedures
      performed for cerebral palsy and 1 of the 21 performed in association with basal
      joint arthroplasty for arthritic conditions. The single post trauma case was
      successful. Flexion was preserved. Prevention of hyperextension of the
      metacarpophalangeal joint assists in reducing metacarpal adduction in cerebral
      palsy and has a stabilizing effect in basal joint arthroplasty.

PMID- 7775782
TI  - An epidemiologic study of carpal tunnel syndrome and hand-arm vibration syndrome
      in relation to vibration exposure.

PMID- 7775783
TI  - How emergency physicians approach low back pain: choosing costly options.
AB  - To determine ways in which emergency physicians approach the diagnosis and
      treatment of the common presenting complaint of low back pain, responses of
      emergency physicians to a questionnaire dealing with three hypothetical patients
      with different types of low back pain were taken from a stratified national
      random sample of eight medical specialties. For severe acute (with and without
      sciatica) or chronic low back pain, physicians were asked which tests and
      consultants they would use in pursuit of the diagnosis, and which treatments and
      specialty referrals they would recommend in each of the three scenarios. For
      diagnosis in the acute cases (pain less than 1 week), up to 22% of emergency
      physicians recommended computed tomography (CT scan) and 36% recommended magnetic
      resonance imaging (MRI). Specialist consultation would be sought for 61% of the
      acute sciatica patients, 32% of the acute nonsciatica patients, and 47% of the
      chronic patients. In approaching treatment, over 75% of emergency physicians
      would advise bedrest for an average of 3.5 to 4.5 days. Between 16% and 40%
      suggested physical therapy for the acute patients. Referrals to surgical
      specialists (orthopedist or neurosurgeon) were highest (81%) for acute sciatica,
      compared with 52% for chronic low back pain, and 41% for acute nonsciatic low
      back pain. In conclusion, given that most cases of acute low back pain resolve
      with minimal intervention, diagnostic imaging, laboratory testing, and early
      specialist consultation favored by many emergency physicians would add little
      except expense to understanding its etiology. For treatment, emergency physician
      recommendations for bedrest were longer than necessary and, for physical therapy,
      of no proven benefit.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775784
TI  - Does the substitution of a resident for a flight nurse alter scene time?
AB  - The purpose of this study was to compare the performance of a nurse resident crew
      (N/R) to that of the usual nurse/nurse (N/N) crew in a helicopter transport
      service using scene time as a measure of overall teamwork. It was designed as a
      retrospective case control study carried out by a university-based helicopter
      emergency transport service. Emergency Medicine second-year residents who
      volunteered to be assigned to the helicopter transport service for 1 month
      rotations flew with an experienced flight nurse. This nurse/resident (N/R) team
      was compared to the usual nurse/nurse (N/N) team in scene trauma flights. The
      average ground time for the N/N crew (10.5 minutes, n = 43) was not significantly
      different from that of the N/R crew (10.3 minutes, n = 43). This study suggests
      that an emergency medicine resident can be incorporated into a flight crew
      without adversely affecting scene time.

PMID- 7775785
TI  - Prehospital needle aspiration and tube thoracostomy in trauma victims: a six-year
      experience with aeromedical crews.
AB  - The use of prehospital tube thoracostomy (TT) for the treatment of suspected
      tension pneumothorax (TPtx) in trauma patients is controversial. A study is
      presented that reviews a 6-year experience with the use of needle catheter
      aspiration (NA) and chest tubes performed in the field by air medical personnel.
      Prehospital flight charts and hospital records from 207 trauma patients who
      underwent one or both of these procedures in the field were retrospectively
      reviewed. The clinical indications used to determine treatment are presented for
      both procedures. Improvement in clinical status of patients observed by flight
      personnel were similar for both treatment groups (54% for NA, 61% for TT). Thirty
      two (38%) of the TT patients had failed NA attempts prior to chest tube
      placement. Average time on scene (T.O.S.) was significantly greater for the TT
      group (25.7 min versus 20.3 min for NA group). Fewer patients were pronounced
      dead on arrival (D.O.A.) with TT treatment compared to NA alone (7% versus 19%,
      respectively). Injury severity scores, number of hospital complications, length
      of stay (L.O.S.), and total hospital costs were not different between the two
      groups. There were no cases of lung damage or empyema formation associated with
      prehospital TT treatment. Overall mortality was similar for both groups. From
      these data, we conclude that NA is a relatively rapid intervention in the
      treatment of suspected TPtx in the prehospital setting; however, TT is an
      effective adjunct for definitive care without increasing morbidity or mortality.
      A better understanding of the physiology of intrapleural air masses is needed to
      determine the most effective decompression requirements prior to aeromedical
      transport.

PMID- 7775786
TI  - Traumatic retropharyngeal hematoma--a cause of acute airway obstruction.
AB  - Blunt trauma causing a retropharyngeal hematoma without an associated cervical
      fracture is a relatively rare occurrence. This article presents the case of a
      patient with airway compromise from a retropharyngeal hematoma, and discusses the
      diagnosis, airway management, and treatment of this condition.

PMID- 7775787
TI  - Traumatic bilateral carotid dissection.
AB  - Traumatic dissection of the carotid artery is an infrequent but serious
      complication of blunt cranial-cervical injury. The typical patient presents with
      deficits attributable to cerebral ischemia in the distribution of the affected
      vascular supply. Key considerations in the clinical picture are a delay in
      symptom presentation, normal initial computed tomography scans, and potential for
      concomitant cerebral or visceral injury. Because the initial clinical and
      diagnostic picture may be normal, it is crucial for emergency physicians to
      aggressively search for this injury in the presence of blunt cranial trauma. We
      present an unusual case of bilateral high extracranial carotid dissection
      secondary to blunt trauma. The pathophysiology of carotid artery trauma,
      treatment options, and key acute care issues are discussed.

PMID- 7775788
TI  - Missed slipped capital femoral epiphysis: illustrative cases and a review.
AB  - Slipped capital femoral epiphysis (SCFE) is a fairly common condition affecting
      older children and adolescents, and has the potential for long-term, crippling
      sequelae. Early recognition is the single most important controllable factor, but
      the diagnosis is often missed or delayed, resulting in progression of the slip. A
      SCFE should be suspected and promptly evaluated in any older child or adolescent
      presenting with a limp or complaints of hip, groin, thigh, or knee pain,
      especially if the patient is overweight. The diagnosis is usually made by
      anteroposterior and frog-leg lateral radiographs of the hips. Common errors at
      initial presentation include: not obtaining hip radiographs (due to either no hip
      pain or the lack of an impressive history and physical findings); misreading hip
      radiographs (the findings can be subtle); and lack of timely referral. Early
      involvement of and treatment by an orthopedic surgeon can greatly reduce the
      potential complications. We present three cases of SCFE that highlight common
      errors made at initial presentation, and a discussion that includes the
      differential diagnosis of an older child or adolescent with a painful limp.

PMID- 7775789
TI  - Magnetic resonance evaluation of brainstem dysfunction in eclampsia and the HELLP
      syndrome.
AB  - An unusual case of a 40-year-old woman with eclampsia and the HELLP syndrome
      associated with brainstem dysfunction is presented. The patient made a
      progressive neurological recovery. A follow-up magnetic resonance image (MRI)
      demonstrated complete resolution of the multiple foci. The MRI of the brainstem
      was found to correlate far more closely with neurological findings than with
      computed tomography (CT scan).

PMID- 7775790
TI  - Abdominal gestation.
AB  - Abdominal pregnancy is such an unusual form of ectopic gestation that the
      diagnosis is often missed or delayed. We report three cases, each with a
      different clinical presentation. A careful history and evaluation in the
      Emergency Department (ED), along with liberal and timely use of ultrasonography,
      are critical for prompt diagnosis and treatment. Features such as abdominal pain
      inconsistent with a previous presumptive diagnosis, or repeated ED visits, in a
      patient with a positive beta-HCG test, are suggestive of this diagnosis.

PMID- 7775791
TI  - Clozapine overdose, a case report.
AB  - Clozapine, an atypical antipsychotic agent with few of the extrapyramidal side
      effects of other antipsychotic agents, was approved for use in the United States
      in 1989. Because of drug-induced agranulocytosis, it is dispensed only under
      rigid guidelines. Overdose has been rare. Presented here is a case of clozapine
      overdose treated successfully with supportive care in which agranulocytosis did
      not develop.

PMID- 7775793
TI  - An introduction to disaster medicine in Europe.
AB  - Disaster medicine, which is based primarily on military and emergency medicine,
      is a young branch on the old tree of medicine. It touches on various disciplines
      within and outside the medical field. The subject is being taught on the academic
      and postacademic levels at many universities throughout Europe. The first chair
      in disaster medicine was established in Linkoping, Sweden; the second is now in
      Amsterdam, The Netherlands. Some aspects of disaster medicine specifically
      oriented toward Europe are presented.

PMID- 7775792
TI  - Comparison of three methods of gut decontamination in tricyclic antidepressant
      overdose.
AB  - The purpose of this study was to prospectively compare the effectiveness of three
      different gut decontamination methods in 51 patients presenting to an emergency
      department with tricyclic antidepressant overdose. Patients were randomized to
      three treatments; Group 1 received activated charcoal, Group 2 received saline
      lavage followed by activated charcoal, and Group 3 received activated charcoal
      followed by saline lavage followed by activated charcoal. Baseline
      characteristics of the three groups did not differ, including Glasgow Coma
      Scores, age, and mean tricyclic antidepressant levels. Average length of stay in
      admitted patients was 93.3 hours in Group 1, 107.2 hours in Group 2, and 66.7
      hours in Group 3. Of those admitted to an ICU, average ICU time was 66.9 hours in
      Group 1, 54.1 hours in Group 2, and 34.4 hours in Group 3. Average duration of
      sinus tachycardia was 20.8 hours in Group 1, 30.8 hours in Group 2, and 32.2
      hours in Group 3. Of those requiring mechanical ventilation, average ventilator
      time was 43.4 hours in Group 1, 24.1 hours in Group 2, and 17.8 hours in Group 3.
      No statistically significant difference could be shown with respect to the
      clinical endpoints noted. There were no deaths in any of the groups. All three
      methods of gut decontamination had similar clinical outcomes.

PMID- 7775794
TI  - Ligamentous injuries of the wrist.
AB  - Wrist injuries occur commonly. Significant wrist injuries such as perilunate
      dislocation and scapholunate dissociation may occur without carpal bone fracture.
      The emergency physician can recognize these ligamentous wrist injuries by noting
      abnormalities of the shapes, joint spaces, and alignments of the carpal bones.
      Early diagnosis allows for prompt referral and optimal outcome.

PMID- 7775795
TI  - Selection criteria utilized for hyperbaric oxygen treatment of carbon monoxide
      poisoning.
AB  - Medical directors of North American hyperbaric oxygen (HBO) facilities were
      surveyed to assess selection criteria applied for treatment of acute carbon
      monoxide (CO) poisoning within the hyperbaric medicine community. Responses were
      received from 85% of the 208 facilities in the United States and Canada. Among
      responders, 89 monoplace and 58 multiplace chamber facilities treat acute CO
      poisoning, managing a total of 2,636 patients in 1992. A significant majority of
      facilities treat CO-exposed patients with coma (98%), transient loss of
      consciousness (LOC) (77%), ischemic changes on electrocardiogram (91%), focal
      neurologic deficits (94%), or abnormal psychometric testing (91%), regardless of
      carboxyhemoglobin (COHb) level. Although 92% would use HBO for a patient
      presenting with headache, nausea, and COHb 40%, only 62% of facilities utilize a
      specified minimum COHb level as the sole criterion for HBO therapy of an
      asymptomatic patient. When COHb is used as an independent criterion to determine
      HBO treatment, the level utilized varies widely between institutions. Half of
      responding facilities place limits on the delay to treatment for patients with
      only transient LOC. Time limits are applied less often in cases with persistent
      neurologic deficits. While variability exists, majority opinions can be derived
      for many patient selection criteria regarding the use of HBO in acute CO
      poisoning.

PMID- 7775796
TI  - Retinal hemorrhage in the young child: a review of etiology, predisposed
      conditions, and clinical implications.
AB  - Retinal hemorrhage is a frequent finding in child abuse, but may also be
      associated with cardiopulmonary resuscitation, accidental trauma, and a variety
      of illnesses such as blood dyscrasias and infections. Although it is imperative
      that child abuse be considered in all children who present with retinal
      hemorrhages, whether retinal hemorrhages can be attributed to cardiopulmonary
      resuscitation in suspected cases of abuse poses a dilemma. The etiologies of
      retinal hemorrhage as well as the literature presently available to support or
      refute the various diagnoses are discussed. Guidelines for funduscopic
      examination in the Emergency Department as well as a clinical classification of
      retinal hemorrhage are provided. In addition, guidelines are suggested for the
      appropriate clinical investigations in children with retinal hemorrhages.

PMID- 7775797
TI  - A case of peri-lunate dislocation.

PMID- 7775798
TI  - Airway management for a retropharyngeal hematoma.

PMID- 7775799
TI  - Isolated bladder rupture after minor trauma in a patient with alcohol
      intoxication.

PMID- 7775800
TI  - "Impending death" and sertraline.

PMID- 7775801
TI  - Objectives to direct the training of emergency medicine residents on off-service
      rotations: traumatology, Part 2.
AB  - This is the 31st article in a continuing series of objectives to direct emergency
      medicine resident experiences on off-service rotations. Neck and torso trauma
      accounts for a large portion of injuries, and its management is an essential part
      of training in emergency medicine. Due to the often life-threatening
      presentations of trauma victims, resident instruction may be conducted at the
      bedside in difficult and demanding situations. Therefore, it is essential for
      residents to have specific goals and objectives to guide their acquisition of
      knowledge required to make critical decisions for patients with major trauma.

PMID- 7775802
TI  - Correlation between urinalysis and intravenous pyelography in pediatric abdominal
      trauma.
AB  - Controversy exists surrounding the appropriate indications for intravenous
      pyelography (IVP) in assessing blunt renal injuries in children. Forty-one
      consecutive cases of suspected blunt renal injuries, who had an IVP performed
      between January 1988 and December 1990 at The Children's Hospital of Eastern
      Ontario, were examined by a retrospective chart review. Eighty percent of the
      IVPs were normal. Of the eight abnormal IVPs, four were contusions, two
      lacerations, and two nontraumatic abnormalities. There was no hemodynamic
      compromise, no requirement for surgical intervention, and no deaths in the study
      population. In the absence of significant hematuria (> or = 100 rbc/hpf), the
      probability of detecting a traumatic abnormality on IVP is low (4%). There was no
      correlation between the mechanism of injury and the IVP findings. We conclude
      that intravenous pyelography has a low yield in the absence of significant
      hematuria (> or = 100 rbc/hpf).

PMID- 7775803
TI  - Emergency department use and misuse.
AB  - We conducted a 14-day survey of the emergency department (ED) at a university
      tertiary care teaching hospital to examine appropriate and inappropriate use of
      the ED. The results are based on a convenience sample of 849 patients, selected
      to represent a 1-week period. Three categories (CAT) of patients were defined.
      CAT I: patients had a medical condition that could only be assessed in the ED.
      CAT II: patients had a medical condition that required evaluation either in the
      ED or elsewhere within 6 hours of triage. CAT III: patients could wait to be
      evaluated 6 or more hours from time of triage. Patients in CAT II were matched
      with outpatient facilities (OPF), based on the time of presentation, the
      presenting complaint, investigative tests, and treatments required. Overall, it
      was found that 69% of the patients were appropriate users and could have been
      seen only in the ED. Fifteen percent of the patients were classified as
      inappropriate users and should have been seen at an OPF. The remaining 15.8%
      represented "gray zone" cases. An interview conducted on a subset of ambulatory
      patients revealed the main reasons for choosing to visit the ED were lack of
      awareness of other facilities, perceived seriousness of condition, trust in the
      ED staff, or proximity of the ED. It was concluded that misusers represent a
      small portion of our ED caseload.

PMID- 7775805
TI  - Immunotherapeutic strategies targeting rheumatoid synovial T-cell receptors by
      DNA inoculation.
AB  - Immunotherapy against autoreactive T-cell receptors (TCRs) has been reported to
      have promise in several animal models of autoimmune diseases. Facilitated DNA
      inoculation has many potential advantages as a modality for development of
      specific immune responses. Specifically, this technology is able to deliver
      exogenous antigens for processing via both the endogenous pathway, with
      subsequent presentation by class-I major histocompatibility (MHC) antigens, and
      the exogenous pathway, with subsequent presentation by class-II MHC antigens.
      This allows for induction of both arms of the cellular immune system. These
      cellular immune responses may be particularly important in targeting and
      controlling pathogenic cell populations. The application of this technology to
      the treatment of human autoimmune diseases depends on the availability of readily
      manipulated systems for the evaluation of specific interventions. Here we report
      the full length cloning and expression of TCRs from rheumatoid arthritis synovial
      tissue. These were developed by recombinant polymerase chain reaction, cloning
      and retroviral transduction into a TCR-alpha/beta-negative murine T-cell
      hybridoma. Reconstitution of CD3 expression was confirmed by flow cytometry.
      Similar constructs have been developed for TCR-based immunotherapy by facilitated
      inoculation of DNA intramuscularly. Preliminary analysis of immune responses in
      mice indicates that these constructs elicit anti-TCR responses. These studies
      indicate the ability to reconstitute expression of potentially autoreactive human
      TCRs in a model system wherein specific immune responses elicited against these
      TCRs by various immunogens can be evaluated.

PMID- 7775806
TI  - DNA inoculation as a novel vaccination method against human retroviruses with
      rheumatic disease associations.
AB  - There are a number of rheumatologic manifestations of human retroviral infections
      associated with human immunodeficiency virus type I (HIV-I) and the human T-cell
      leukemia virus type I (HTLV-I) including arthritis, Sjogren's syndrome-like
      symptoms as well as other varied autoimmune phenomena. Infection with HTLV-1 may
      be directly involved in the etiology and/or pathogenesis of an arthritic
      condition similar to rheumatoid arthritis. We have been characterizing a new
      vaccination strategy against human retroviral infections, designated DNA
      inoculation. This procedure involves the intramuscular injection of DNA plasmids
      which express specific human retroviral antigens. This technique results in the
      development of humoral and cellular immune responses against these proteins.
      Specifically, this method has been successfully used to develop immune responses
      against HIV-I and HTLV-I. The availability of rat and rabbit infection models for
      HTLV-I, coupled with the successful development of immune responses in these
      animals after DNA inoculation with an HTLV-I envelope expressing plasmid, will
      allow the efficacy of this vaccination technique to be evaluated with protection
      against in vivo viral challenge as an endpoint.

PMID- 7775804
TI  - T-cell antigen receptors in rheumatoid arthritis.
AB  - Rheumatoid arthritis (RA) is a systemic disease of unknown etiology characterized
      by chronic inflammation mainly in the joints. Several lines of evidence suggest
      that T cells are involved in the pathogenesis of the disease. RA is associated
      with certain HLA-DR alleles. Studies analyzing T-cell receptor transcripts in RA
      have found biased or preferential usage of certain V alpha and/or V beta gene
      segments by T cells infiltrating the synovial membrane or extravasating into the
      synovial fluid compared to peripheral blood. In certain patients few T-cell
      antigen receptor (TCR) clones dominated the infiltrating T cells, suggesting that
      T cells from the synovial membrane or the synovial fluid comprise oligoclonal
      populations of T cells. However, other studies have found a polyclonal population
      of T cells. In interpreting these results the phase of the disease (early vs.
      late RA), the source of T cells and the limitations of the methods used in these
      studies should be taken into consideration. However, it appears that synovial T
      cells comprise oligoclonal populations of T cells and that there is a bias
      towards particular TCR gene segments, although a specific TCR gene segment in RA
      has not emerged.

PMID- 7775807
TI  - Intracellular location of inapparently infecting Chlamydia in synovial tissue
      from patients with Reiter's syndrome.
AB  - Culture of Chlamydia trachomatis from synovial tissues/fluids from Reiter's
      syndrome (RS) patients frequently yields negative results. However, we have
      identified chlamydial RNA at that site in such patients, suggesting that viable
      organisms may be present. Here we define the cellular location of chlamydia
      within the synovium via in situ hybridization. Using a chlamydial ribosomal RNA
      directed probe, we show that synovial tissue from culture-negative RS patients
      gives strong hybridization which is often localized to a subsynovial cell layer,
      rather than to the synovial lining; in some cases, hybridizing cells are
      dispersed through the synovium. All hybridization signal is located within host
      cells, indicating that infectious extracellular elementary bodies are rare or
      absent. These data confirm the extensive intracellular presence of inapparent
      chlamydia in the synovia of RS patients and provide some insight into the usual
      culture negativity of synovial tissues for the organism.

PMID- 7775808
TI  - Structural properties of a subset of nephritogenic anti-DNA antibodies.
AB  - Structural analysis of lupus autoantibodies is beginning to provide clues to the
      molecular basis for antigenic specificity and pathogenicity. The present analysis
      indicates that multiple light and heavy chains contain residues which can
      facilitate DNA binding, reaffirming the notion that there are multiple ways that
      different amino acids combine to form an antigen-binding pocket with affinity for
      dsDNA and ssDNA. Furthermore, this analysis suggests that these conformations and
      contact residues are intrinsic to germline sequences, although amino acid changes
      at critical locations (somatically introduced) modulate antigen binding, and
      appear to influence the capacity of individual immunoglobulin to form immune
      deposits. Analysis of additional individual immunoglobulins with closely related
      V-region sequences and differing pathogenic properties will be required to
      resolve the contribution of specific motifs to pathogenecity.

PMID- 7775810
TI  - Molecular Aspects of the Rheumatic Diseases. Proceedings of the 2nd symposium.
      Philadelphia, Pennsylvania, June 9-10, 1994.

PMID- 7775811
TI  - Zyn-Linker delivery of antirheumatic agents.
AB  - Despite our increasing ability to manage rheumatoid arthritis through systemic
      medication, refractory joints require local administration of more aggressive
      therapy in a substantial number of patients. These studies tested whether a new
      class of molecules designated Zyn-Linkers could deliver and retain therapeutics
      in a joint. Zyn-Linkers are synthetic lipid-like molecules designed to insert
      into cell membranes and enhance drug delivery to cells. After intra-articular
      injection into the knee of NZW rabbits, Zyn-Linkers bound rapidly and
      homogenously to synovial lining cells. Chelating Zyn-Linkers which contained Re
      186 or Y-90 were synthesized to evaluate localization and retention after intra
      articular injection. Initial studies using Re-186 Zyn-Linker gave excellent
      localization as evaluated by whole-body imaging: counts in the knee region
      represented > 90% of counts present in the whole body for at least 4-6 days
      postinjection. Similar results were obtained using a Y-90 Zyn-Linker and this
      agent was used for biodistribution studies due to its greater stability and ease
      of preparation. Efficacy and safety of Y-90 Zyn-Linker as a potential radiation
      synovectomy agent were estimated by extrapolation of biodistribution data to
      humans. A therapeutically effective dose of 8,000 cGy to synovium was calculated
      to require intra-articular injection of 3.4 mCi Y-90 Zyn-Linker, a value less
      than or equal to doses of particulate Y-90 agents used clinically in Europe. The
      predicted safety profile for Y-90 Zyn-Linker was excellent, with estimated doses
      to nontarget organs and tissues falling well within FDA-recommended safety levels
      for research-only radiopharmaceuticals. In addition to exhibiting desirable
      localization and retention properties, Zyn-Linkers may also be synthesized to
      release antirheumatic drugs such as methotrexate at controlled rates. This
      suggests substantial potential for these drug delivery molecules as chemical
      synovectomy agents which may be used concurrently with systemic chemotherapy to
      improve management of refractory joints.

PMID- 7775809
TI  - Molecular and structural analysis of nuclear localizing anti-DNA lupus
      antibodies.
AB  - To determine the structure of three nuclear localizing lupus anti-DNA
      immunoglobulins (Igs) and to search for clues to mechanisms of cellular and/or
      nuclear access, their H- and L-chain variable region sequences were determined
      and subjected to three-dimensional modeling. Although the results indicate
      heterogeneity in their primary structures, the H chains are encoded by 3 members
      of the J558 VH gene family with a common tertiary conformation that is not shared
      by a J558-encoded nonnuclear localizing anti-DNA control Ig. Furthermore, at
      least two of the Igs share a conformational motif in the H-chain CDR3, and all
      three Igs contain multiple positively charged amino acids in their CDRs,
      resembling nuclear localization signals that direct protein nuclear import.
      Notably, each VH and VK gene is also found recurrently among previously described
      autoantibodies. Molecular analysis further indicates that both germline-encoded
      and significantly mutated V genes can generate nuclear localizing anti-DNA Ig.

PMID- 7775813
TI  - [The relation between delivery method and prognosis for very low birth weight
      infants].
AB  - To further understand the relationship between perinatal factors and prognosis
      (neonatal and infantile death and major handicaps), we retrospectively studied
      128 singletons weighing less than 1,500g (very low birth weight; VLBW) infants,
      without maternal complications, IUGR or major congenital anomalies. The
      gestational age (mean +/- SD) at delivery and the birth weight (mean +/- SD) of
      subjects were 27.1 +/- 2.0 weeks and 1,041.1 +/- 264.1g, respectively. The
      results of the current study were as follows: 1) Malpresentation, low Apgar score
      (APS) and Respiratory distress syndrome (RDS) were observed more frequently in
      non-intact survivors than in intact survivors with statistical significance.
      Although the occurrence of fetal distress was correlated with low pH in the
      umbilical artery, no significant correlation was evident between the prognosis
      and either of the two above mentioned factors. The intact survivors had a
      significantly high frequency of PROM despite no correlation with signs of
      infection (WBC, CRP). 2) As to delivery methods in terms of prognosis, a cephalic
      vaginal group had the best prognosis and a breech-vaginal group had the worst,
      with statistical significance. A higher frequency of poor prognosis for infants
      was found in a malpresentation group with cesarean delivery and cervical dilation
      of more than 4cm. Thus, vaginal delivery is a possible option in case of cephalic
      VLBW infants.

PMID- 7775814
TI  - [Expression of epidermal growth factor, transforming growth factor-alpha and
      epidermal growth factor receptor messenger RNA in human endometrium and
      endometrial carcinoma].
AB  - To study the regulation of c-erbB, EFG and TGF-alpha in endometrium, we examined
      the expression of their mRNA in 5 normal endometrial and 5 endometrial carcinoma
      tissues by Northern blot and reverse transcription-polymerase chain reaction (RT
      PCR). By Northern blot with 10 micrograms of total RNA, c-erbB mRNA was not
      detected in the normal endometrium, but it was detected in 3 samples of
      endometrial carcinoma tissues. On the other hand RT-PCR identified c-erbB mRNA in
      all the normal endometrium and endometrial carcinoma tissues by amplifying cDNA
      derived from c-erbB mRNA. EGF mRNA was detected by RT-PCR in normal endometrium
      except in the early follicular phase. It was detected in all cases of endometrial
      carcinoma tissues. TGF-alpha mRNA was also detected in all the normal and
      endometrial carcinoma tissues by RT-PCR. Our study suggests that an
      autocrine/paracrine mechanism of EGF may regulate the endometrial cycle. Because
      some endometrial carcinoma tissues express the c-erbB mRNA much more than normal
      endometrium, disruption of the autocrine/paracrine mechanism may trigger
      subsequent endometrial carcinogenesis.

PMID- 7775812
TI  - [Changes in natural killer (NK) activity and fertility during the establishment
      of experimental endometriosis in the rat].
AB  - We examined the effect of experimental endometriosis (EE) on natural killer (NK)
      activities and fertilizability in the rat. EE was induced by autotransplantation
      of an endometrial fragment to the peritoneal wall. As a sham, abdominal fat
      tissue was implanted in the same way. NK activities of spleen cells were measured
      by means of a 4-hr 51Cr-release assay. RESULTS: (1) NK activities were
      significantly lower in EE than those in the sham (p < 0.001). (2) NK activity was
      recovered by surgical excision of the endometrial implant, but not increased by
      the administration of Danazol (100 mg/kg/day) or Buserelin (25 micrograms/kg/day)
      for 4 weeks. (3) The supernatant of endometriotic tissue cultures markedly
      suppressed NK activity. (4) The number of pups with EE was significantly smaller
      than in the controls (p < 0.05), but no difference between the two groups was
      observed in the number of oocytes in the Fallopian tube. CONCLUSION: (1) Splenic
      NK activity decreases at the time of the establishment of EE. (2) NK activity
      recovers after the removal of the implanted tissue. (3) Danazol and Buserelin
      have no effect on the NK activity in EE. (4) EE reveals some adverse effects on
      the postovulatory phase of fertility.

PMID- 7775815
TI  - [Estramustine phosphate, estrogen conjugated with nitrogen mustard inhibits the
      growth of endometrial cancer cells in vitro].
AB  - Estra-1,3,5 (10)-triene-3,17-diol (17 beta)-, 3-[bis(2-chloroethyl) carbamate]
      (Estramustine EM) was tested for its anticancer effect on human endometrial
      cancer cell lines: Ishikawa and its estrogen (E) independent sub-clone EIIL
      (Estrogen Independent Ishikawa Line). The results showed: (1) EM inhibited growth
      of both cell lines in a dose dependent manner giving ID50 for Ishikawa as 12
      microM and for EIIL as 65 microM. (2) The addition of EM to the culture medium
      caused cell detachment and death associated with a breakdown of DNA to
      approximately 90 base pair fragments. (3) Reverse transcription-polymerase chain
      reaction to examine expressions of c-erbB-2, nidogen and fas showed that EM
      completely abolished fas expression and resulted in a 40% decrease in nidogen
      expression in Ishikawa but not in EIIL. No change was seen in c-erbB-2
      expression. The present data indicate that the E component of EM does not
      stimulate the growth of Ishikawa or EIIL. Since the growth of both cell lines was
      inhibited but apparently in an E receptor (ER) dependent manner, EM may be of
      value in an adjuvant therapy for endometrial cancer, especially an ER positive
      one.

PMID- 7775816
TI  - [Usefulness of the combined transfusion of autologous blood as pre-deposited and
      preoperatively diluted in gynecological surgery].
AB  - To eliminate the risks involved in homologous blood transfusion in gynecological
      surgery, we studied the effect of the combined transfusion of autologous blood as
      predeposited and preoperatively diluted. Thirty-nine cases were operated on and
      studied. In 27 cases, a total of 695 ml/person of autoblood was taken during the
      15 preoperative days. In 39 cases, an average of 1,038 ml/person of autoblood was
      collected at the beginning of surgery. In 37 out of 39 cases, we were able to
      avoid homologous blood transfusion. In the remaining two cases with homologous
      blood transfusion, although more than 3,000 ml of operative blood loss was
      observed, only about 700 ml of homologous blood was needed. We did not find any
      serious side effect with autoblood transfusion. These results demonstrate the
      usefulness of the combined transfusion of autologous blood as predeposited and
      preoperatively diluted in gynecological surgery.

PMID- 7775818
TI  - [Association of pregnancy-induced hypertension with a molecular variant of
      angiotensinogen gene].

PMID- 7775817
TI  - [Expression of MMP-3 and TIMP-1 in the endometriosis and the influence of
      danazol].

PMID- 7775820
TI  - [A case of pregnancy complicated with virus-associated hemophagocytic syndrome].

PMID- 7775819
TI  - [Uterine artery Doppler flow velocimetry in patients with recurrent intrauterine
      fetal death treated with anticoagulant heparin therapy].

PMID- 7775821
TI  - [A case of hydatidiform mole with coexistent normal fetus probably in twin
      pregnancy].

PMID- 7775822
TI  - [A case of ovarian mucinous cystadenocarcinoma in a young woman after treatment
      of dysgerminoma on opposite side].

PMID- 7775823
TI  - [Efficacy of one week-treatment of antibiotics for Chlamydia trachomatis
      infection].

PMID- 7775824
TI  - Repair of UV-induced pyrimidine(6-4)pyrimidone photoproducts is selectively
      inhibited in transcriptionally active genes after heat treatment of human
      fibroblasts.
AB  - In normal human fibroblasts, repair of (6-4)PP in the active adenosine deaminase
      (ADA) gene occurs with similar rate in the transcribed and non-transcribed strand
      of the ADA gene, and removal of (6-4)PP from the active ADA gene is faster than
      from the inactive X-chromosomal 754 locus. Heat shock decreased the rate of
      repair of the active ADA gene down to the level of inactive genes, whereas the
      rate of repair of the inactive 754 locus was not affected.

PMID- 7775825
TI  - DNA damage and repair after low doses of UV-C radiation; comparable rates of
      repair in rodent and human cells.
AB  - The UV endonuclease assay for cyclobutane pyrimidine dimers in the DNA of UV-C
      irradiated mammalian cells has been modified by replacing alkaline sucrose
      sedimentation with alkaline unwinding and hydroxylapatite chromatography to
      determine the number of DNA breaks introduced by the endonuclease. Dimers induced
      by doses as low as 0.25 Jm-2 can be detected and the assay has been used to
      examine the capacity of human, hamster and mouse cells to remove damage inflicted
      by sublethal doses of UV-C. In addition, incision activity has been measured by
      incubating cells with DNA synthesis inhibitors after irradiation with UV-C. In
      rodent and human cells, given a dose of UV-C of 1 Jm-2 about half of the
      endonuclease-sensitive sites are lost in 5-6 h. The incision capacity of these
      cells corresponds well with the extent of removal of dimers. Thus, although
      rodent cells are normally considered to be relatively deficient in nucleotide
      excision repair, we find that rodent and human cells have comparable capacities
      to deal with low levels of UV-C-induced damage.

PMID- 7775826
TI  - Dependence of fluorodeoxyuridine-mediated radiosensitization on S phase
      progression.
AB  - Recent evidence casts doubt on the hypotheses that fluoropyrimidine-mediated
      radiosensitization is related to cytotoxicity or to cell cycle redistribution
      into the G1/S boundary. We hypothesized that cells that are capable of
      progressing into S phase in the presence of fluorodeoxyuridine may also be more
      susceptible to radiation-induced damage. To test this hypothesis,
      fluorodeoxyuridine (FdUrd)-treated HT29 human colon cancer cells were separated
      by centrifugal elutriation into four fractions (1-4) containing a range of cells
      from those at the G1/S boundary (fraction 1) to those which had progressed
      approximately 11% into S phase (fraction 4). We found that fraction 4 cells
      showed significantly greater radiosensitization than fraction 1 cells. We also
      compared the effects of fluorodeoxyuridine on HT29 and SW620 human colon cancer
      cells. We found that, in contrast with HT29 cells, SW620 cells arrested at the
      G1/S boundary and were minimally radiosensitized. Finally, we found that an
      increase in sensitivity was correlated with a decrease in the rate of repair of
      DNA double-strand and single-strand breaks (assessed by asymmetric field
      inversion gel electrophoresis and alkaline elution respectively). These findings
      are consistent with the hypothesis that fluorodeoxyuridine-mediated
      radiosensitization depends on S phase progression and a decreased ability to
      repair radiation-induced DNA damage.

PMID- 7775827
TI  - Abnormal radiosensitivity of lymphocytes from breast cancer patients with
      excessive normal tissue damage after radiotherapy: chromosome aberrations after
      low dose-rate irradiation.
AB  - There is a need for a simple, rapid assay for predicting normal tissue reactions
      in radiotherapy patients to reduce morbidity in sensitive patients and to allow
      dose escalation in resistant cases. Towards this goal we have investigated the
      gamma-ray sensitivity of lymphocytes from 16 breast cancer patients who had shown
      an exaggerated acute or late radiation reaction ('overreaction') of normal
      tissues after radiotherapy, using chromosome damage (dicentrics) as the endpoint
      because of its close relationship with cell killing. The use of a low dose-rate
      (LDR; 0.31 cGy min-1) was found to be better than a high dose-rate (170 cGy min
      1) in discriminating between over-reactors and controls, as predicted (and here
      confirmed) from previous studies on ataxia-telangiectasia (A-T) homozygotes and
      heterozygotes. Five of seven patients with excessive early skin reactions (e.g.
      erythema, moist desquamation) showed abnormal radiosensitivity, manifested either
      as aberration yields above the control range after LDR exposure or as less
      sparing than controls. The average LDR yield for early over-reactions was
      significantly higher than for controls (p = 0.009) and average sparing was less
      (p = 0.0002). Two of 10 patients with late complications (fibrosis,
      telangiectasia) had LDR yields above the control range, but the average yield for
      late over-reactors was not significantly above that of controls. Unexpectedly,
      two patients (one early, one late reaction) had LDR aberration yields below the
      control range. Quantitatively our results are consistent with the notion that
      over-reacting breast cancer patients are carriers of the A-T gene. Pilot studies
      on controls showed that the sparing effect of LDR irradiation was increased by
      lowering the dose-rate to 0.13 cGy min-1 and by using micronuclei rather than
      metaphase damage as the endpoint. These modifications to the protocol will be
      used in a large-scale prospective study.

PMID- 7775828
TI  - Micronucleus induction in peripheral blood lymphocytes of patients under
      radiotherapy treatment for cervical cancer or Hodgkin's disease.
AB  - The genetic damage present in peripheral blood lymphocytes of patients treated
      with fractionated partial-body radiation therapy for cervical cancer or Hodgkin's
      disease was followed during treatment by means of the cytokinesis-block
      micronucleus assay. For each patient a dose-response relationship with respect to
      the number of micronuclei after in vitro irradiation of blood samples
      pretreatment was also determined. Comparing the individual in vivo-in vitro data,
      the micronucleus yields after the equivalent whole-body dose during radiotherapy
      were found to differ substantially from the in vitro dose-response. Contrary to
      the linear-quadratic dose dependence after in vitro irradiation the initial
      increase in the micronucleus yield during radiotherapy levelled off at elevated
      doses. The observed differences cannot be attributed only to the effects of
      interphase death and the partial irradiation of the lymphocyte pool. The
      correlation between the micronucleus yield and the equivalent whole-body dose for
      values up to 2 Gy, observed for the pooled data of the first part of the
      radiotherapy treatment, demonstrates the suitability of the cytokinesis-block
      micronucleus assay as a biological dosemeter after accidents involving partial
      body irradiation.

PMID- 7775829
TI  - Quantifying intracellular radioresponse diversity in irradiated sandwich cultures
      via micronucleus expression.
AB  - Determining the degree of diversity in therapeutic sensitivity exhibited by a
      tumour population is of considerable clinical importance. In addition to being a
      contributor to radiation resistance, diversity is the basis for variation in
      sensitivity over the course of treatment. To study intrapopulation diversity in
      radiosensitivity following gamma-irradiation (2 Gy), distributions of the number
      of micronuclei/binucleate cell were obtained for human cervix carcinoma sandwich
      populations. Cell-to-cell diversity in radioresponse (micronucleus expression)
      was quantified using the overdispersion index ((variance/mean)--1). As measured
      by this index, the radioresponse diversity of sandwich cultures sharply increased
      after introduction of oxygen/nutrients to the cultures, mimicking tumour
      reperfusion. In addition, a strong correlation was found between this measure of
      diversity and the extent to which the fraction of cells without micronuclei
      exceeds that expected from a Poisson distribution. This correlation indicates
      that for a diverse population there can be a significant departure of the
      aggregate population sensitivity (determined, for instance, by log-survival in a
      clonogenic assay) from that inferable from simply averaging per-cell
      sensitivities (reflected, e.g. by mean number of chromosome aberrations/cell).
      Our experimental results suggest a model attributing diversity in a population to
      its being a mixture of distinct subpopulations, each biologically homogeneous
      with respect to micronucleus expression, and each contributing an individual
      Poisson-distributed micronucleus response. We demonstrate how such radiodiversity
      may be quantified and show that reoxygenation of a microenvironmentally
      heterogeneous population leads to an increase in its radiobiological diversity.

PMID- 7775830
TI  - X-ray-induced chromosomal aberrations and cell killing in somatic and germ cells
      of the scid mouse.
AB  - To characterize further the radiosensitivity of severe combined immunodeficiency
      (scid) mice, the induction of micronuclei (MN) in polychromatic erythrocytes as
      well as cell killing and translocation induction in stem cell spermatogonia was
      studied. Scid mice turned out to be clearly hypersensitive for X-ray-induced cell
      killing of both bonemarrow cells and spermatogonial stem cells. The frequencies
      of recorded micronuclei in polychromatic erythrocytes were comparable with that
      reported for the normal mouse, whereas the recovery of translocations was
      extremely low in the scid mouse. The dose-response relationship for induced
      translocations was bell shaped with a maximum of about 0.5% around doses of 0.5
      1.5 Gy X-rays.

PMID- 7775831
TI  - Effect of gamma-irradiation on the effector function of T lymphocytes in
      microbial control.
AB  - A chlamydial-specific T cell clone, capable of inhibiting the growth of
      infectious Chlamydia in vivo and in vitro, was employed to investigate the effect
      of gamma-irradiation on the ability of effector T cells to control infections.
      Clone 2.14-0 (CD4+), specific for the Chlamydia trachomatis biovar agent of mouse
      pneumonitis (MoPn), was irradiated with varying doses (0, 2.5, 5.0, 10.0, 20.0
      and 40.0 Gy) and its biological functions and ability to inhibit the
      intraepithelial growth of MoPn were assessed. The results revealed that although
      gamma-irradiation drastically reduced the proliferative response of the clone to
      antigen, it did not affect the phenotype and the effector function of inhibiting
      chlamydial growth. The preservation of anti-chlamydial function after gamma
      irradiation correlated with the retention of IFN-gamma and TNF-alpha secretion in
      response to antigenic stimulation. We conclude that the biologic functions of T
      cells requiring proliferation and differentiation are more likely to be adversely
      affected by gamma-irradiation on the short-term, but the effector functions,
      possibly associated with cytokines and cytolysis, may be preserved among
      persisting effector T cells in an irradiated individual.

PMID- 7775832
TI  - Time evolution of the number of functional murine eccrine sweat glands after
      irradiation: a quantitative analysis of experimental data using a model of
      proliferative and functional organization.
AB  - The function of eccrine sweat glands in the beta-pad of the mouse foot after
      irradiation was followed over time. Graded doses of X-rays were given to the
      foot, either as single doses or in two equal fractions separated by a 24-h
      interval. A quantitative, non-invasive, functional assay was used allowing
      repeated evaluation of the animals. Sweat gland function was assessed once a week
      for the first 6 weeks, and at 8, 10, 14, 18, 28, 38 and 45 weeks after
      irradiation. The beta-pad of the unirradiated foot was used as a control. The
      function dropped to a nadir within 8-10 weeks after irradiation, whereafter it
      gradually recovered, reaching a stable level 20-25 weeks after irradiation. These
      data were analyzed using a mathematical model of proliferative and functional
      organization of the sweat pore. The model provides a description of the time
      evolution of pore function, and its basic features were as follows. The
      functional subunit is a single sweat pore, which will be assayed as functional
      provided that it contains a number of functional cells above a critical
      threshold. The functional cells are capable of self renewal (a so-called
      'flexible' tissue), and the proportion of proliferating cells is subject to
      homeostatic control. Irradiation is assumed to transfer a certain fraction of the
      cells into a state with a limited probability of successful division. This
      fraction is assumed to have a linear-quadratic dependence on dose. The values of
      all free model parameters were optimized by a maximum-likelihood fit to the
      experimental data. With optimized parameter values, the initial decrease, nadir,
      and long-term level of tissue function estimated from the model were in close
      agreement with the experimental observations for all the 28 dose groups. Some of
      the estimated model parameters are: growth fraction 4.2 +/- 0.2%; cell cycle
      time, 0.95 +/- 0.04 days; number of functional cells in a single pore in the
      unirradiated animal, 9.9 +/- 0.5; and alpha/beta ratio, 4.3 Gy (95% confidence
      interval 3.1-5.0 Gy). It is concluded that the present model, despite its
      relative mathematical simplicity, provides a close description of the
      postirradiation kinetics of functional cells in the mouse sweat gland.

PMID- 7775833
TI  - Effect of changing weekly dose on accelerated repopulation during fractionated
      irradiation of mouse tongue mucosa.
AB  - The effect on accelerated repopulation of fractionated radiotherapy with changing
      weekly dose was studied in mouse oral mucosa. The basic conventional treatment
      protocol comprised five daily fractions per week, 3 Gy per fraction, given over 3
      weeks. In dynamic treatment schedules the same total dose was delivered by giving
      5 x 2, 5 x 3 and 5 x 4 Gy, or the reverse sequence. In concomitant boost
      experiments five additional daily doses of 1 or 2 Gy respectively were applied
      either during the first or last week of the conventional treatment. Graded
      terminating test doses were given in order to establish dose-effect curves for
      complete mucosal denudation. Higher initial doses consistently resulted in longer
      latent times between top-up irradiation and complete epithelial denudation,
      corresponding to significantly higher cell densities at the time of test
      irradiation. The top-up ED50's served as a measure of repopulation efficacy. The
      difference in repopulated dose between schedules with initial or terminal dose
      concentration was 10% for dynamic fractionation (p = 0.02) and about 7% in the 2
      Gy boost protocol (p = 0.13), and no difference was observed with boost doses of
      5 x 1 Gy. In conclusion, a clear though moderate increase in both cell density
      and residual tissue tolerance can be achieved by protocols with substantially
      higher doses in the first treatment week.

PMID- 7775834
TI  - Amelioration of radiation nephropathy by acetylsalicylic acid.
AB  - This investigation was carried out to assess the amelioration by two
      antithrombotic drugs of radiation nephropathy in mice. Mouse kidneys were given
      split-dose irradiation to total doses between 17 and 22 Gy. A first group of
      animals was given acetylsalicylic acid (ASA) in drinking water, a second received
      daltroban, a thromboxane A2/prostaglandin H2 receptor antagonist, and a third
      received normal tap water, serving as a control. Both antithrombotic drugs were
      started 1 week prior to the irradiation and were given throughout the whole
      follow-up period. Renal function was assessed every 4 weeks from 18 weeks after
      the start of irradiation onwards by measuring the [51Cr] EDTA retention and
      haematocrit. The dose of ASA (600 mg/kg/day) caused an inhibition of thromboxane
      A2 and prostacyclin biosynthesis to 19 +/- 10 (mean +/- SEM) and 85 +/- 22%,
      respectively, as assessed by the excretion of their urinary metabolites. A
      significant sparing effect on the renal function after irradiation was observed
      in the ASA-treated animals. Using the latency time to reach 4% residual plasma
      activity of [51Cr] EDTA, a dose-modifying factor of 1.19 was calculated. No
      effect was seen with daltroban (10 mg/kg/day). Histopathological analysis of the
      kidneys at 12 months after irradiation demonstrated a substantially lower level
      of damage in the ASA-treated mice compared with daltroban-treated and radiation
      only animals. These data indicate that long-term treatment with ASA is effective
      in reducing renal functional impairment after irradiation.

PMID- 7775835
TI  - Tumour oxygenation, radiosensitivity, and necrosis before and/or after
      nicotinamide, carbogen and perflubron emulsion administration.
AB  - Hypoxia is one of the factors involved in tumour resistance to radiotherapy. One
      way to improve tumour oxygenation is to use oxygen carriers such as perflubron
      emulsion plus carbogen or vasoactive drugs such as nicotinamide. The perflubron
      emulsion and carbogen act mainly on hypoxia caused by limited diffusion of
      oxygen; nicotinamide acts mainly on acute hypoxia. The aim was to correlate
      radiosensitivity and pO2 measurements (computerized pO2 histograph) after
      nicotinamide, perflubron emulsion and carbogen administration, and to determine
      the role of necrosis in this correlation. Two human tumour xenografts (HRT18,
      Na11 +) and one rodent tumour (EMT6) were used. Clonogenic assays and pO2
      measurements were performed under similar conditions. The radiosensitization and
      oxygenation levels increased with all treatments. The maximal effects were found
      with the combination of nicotinamide (1 g/kg), perflubron emulsion and carbogen.
      A correlation between the radiosensitization and the pO2 measurements was found
      for the three cell lines with a cut-off point of 10 mmHg. The presence of
      necrosis could explain the low pO2 (< 2 mmHg) found even when complete
      radiosensitization was observed.

PMID- 7775836
TI  - Investigation of lung tumour induction in BALB/cJ mice following paternal X
      irradiation.
AB  - Evidence of an enhanced incidence of lung tumours (benign adenomas and
      adenocarcinomas) was sought in the BALB/cJ mouse following paternal germ cell X
      irradiation. In a series of replicate studies spanning approximately 1 year,
      males were exposed to single, acute X-ray doses of 0, 250 and 500 cGy. In each of
      the 2 consecutive weeks immediately thereafter they were placed with two females
      to generate progeny that were derived from irradiated post-meiotic cells
      (spermatozoa to late spermatids). These animals were then examined at 8 or 12
      months for lung tumours. While the proportion of fertile females and mean litter
      size was affected by the radiation, showing a dose-dependent, dominant lethal
      response, and while cases of mutant offspring were detected, the paternal
      radiation did not affect lung tumour incidence in the offspring. The incidence
      did not vary significantly between germ cell stages irradiated (week of mating),
      sex of offspring, or radiation dose. However, significant differences between
      lung tumour incidence (mostly representing benign adenomas) were found between
      different replicates, these being high at the start of the study, declining and
      then rising to yet higher levels at its close. The finding that lung tumour
      incidence in BALB/cJ mice is not affected by paternal germ cell irradiation does
      not accord with Nomura's reports using other strains of mice. This, in turn,
      weakens biological support for a causal association between the raised incidence
      of childhood leukaemia and non-Hodgkin lymphoma near Sellafield and the father's
      recorded radiation exposure during employment by the nuclear industry.

PMID- 7775837
TI  - ECG of The Month. Recycling problem. Atrial tachycardia.

PMID- 7775839
TI  - Gastric carcinoma: recent issues in prognostic factors.
AB  - The prognosis of gastric carcinoma remains unfavorable despite a greater
      understanding of its molecular pathology. This retrospective study of primary
      gastric carcinomas was collected from one of the highest risk regions of China
      and examined for the oncogenetic expression of p53, c-erbB-2, and PCNA using
      immunohistochemistry and DNA contents by flow cytometry and image analysis. These
      products are reported to influence the tumor behavior. The p53 nuclear and c-erbB
      2 membrane-bound stainings were seen in 58% and 34% of cases, respectively. A
      high PCNA index was found in 90% of the tumors. The p53 expression did not
      correlate with the histological differentiation, gross morphology, and depth of
      tumor invasion. Additionally, p53 and c-erbB-2 reactivity did not correlate with
      the proliferative index (PI) or S-phase DNA content. However, the mutant p53
      expression was detected in the dysplastic cells adjacent to the tumor, suggesting
      a possible role of the oncogene in tumor pathogenesis. Mutant p53 expression can
      also be helpful in early detection of cases with dysplasia in well-differentiated
      adenocarcinomas.

PMID- 7775840
TI  - Cancer. A potentially preventable disease.
AB  - Current epidemiologic and carcinogenesis data are lending credence to the
      hypothesis that individual cancers have specific causes. Because of this, most
      cancers are at least potentially preventable. Primary prevention, with removal of
      specific etiological agents, is the best means of prevention, such as elimination
      of tobacco smoke. Short of knowing the specific etiology, new chemo-prevention
      techniques are now being studied evaluating hormonal agents, anti-inflammatory
      drugs, and the structural analogs of vitamin A.

PMID- 7775838
TI  - Otoacoustic emissions: an emerging diagnostic tool.
AB  - Otoacoustic emissions are acoustic signals detectable in the external auditory
      canal that reflect the state of health of the cochlea. Transiently-evoked
      otoacoustic emissions and distortion-project otoacoustic emissions are two types
      of otoacoustic emissions currently under investigation as well as in limited
      clinical use. These objective tests of cochlear function add significantly to the
      armamentarium currently in place for the evaluation of hearing. The clinical use
      of these diagnostic tools will likely increase dramatically in the coming years.
      The following review provides a basis for understanding the nature and clinical
      utility of otoacoustic emissions.

PMID- 7775841
TI  - Women's health. Part II: Individual, environmental and economic factors affecting
      adherence to recommended screening practices for breast cancer.
AB  - In order for cancer mortality rates to be sufficiently reduced to meet the goals
      set by the National Cancer Institute, it is imperative that we broaden our
      understanding of the factors which affect participation in preventive health
      practices. Early detection and diagnosis of breast cancer are associated with
      participation in mammography, breast self-examination, and seeking medical care.
      A stratified random sample of women residing in Orleans Parish (40 to 65 years of
      age; annual family incomes < $40,000) were surveyed by telephone. Results of the
      survey were examined to determine the impact of individual, environmental, and
      economic factors on adherence to recommended screening practices for breast
      cancer. Results indicate a significant proportion of women are not adhering to
      recommended practices. Preventive health practices were positively related to
      physician recommendation of a mammogram and how the physician communicated with
      the patient; patient's income; belief in Powerful Others Locus of Control; and
      beliefs about the efficacy of early diagnosis and treatment. Fear of breast
      cancer was negatively related to preventive health practices. Findings highlight
      the utility of an ecological perspective in the development of secondary
      prevention strategies for breast cancer.

PMID- 7775842
TI  - Cancer information service. The National Cancer Institute's link to the
      community.

PMID- 7775844
TI  - The Orleans Parish Medical Society's "doctors in the schools" anti-tobacco
      education program.

PMID- 7775843
TI  - Historical profiles of toxic chemicals in urban and rural Louisiana lake
      sediments: epidemiological significance.
AB  - Sediment cores collected from lakes in rural and urban/industrial areas of
      Louisiana were dated using 137Cs, sectioned, and analyzed for a wide range of
      pollutant chemicals deposited during the period 1950 to 1991. Mutagenicity
      testing also was performed on extracts from the cores. Statistical and other
      comparisons of chemical data indicated that annual loadings of polycyclic
      aromatic hydrocarbons (PAHs), chlorinated chemicals, and toxic trace metals were
      not significantly different in the urban lake versus the rural lake over the
      historical period compared. Mutagenic activity was detected in both lakes,
      primarily in sediments deposited between 1955 and 1980, with minimal activity
      before and after that period. This was a time of widespread industrial and
      agricultural activity in Louisiana, before restrictions on chemical releases to
      the environment were instituted and enforced.

PMID- 7775845
TI  - From product to process in curriculum planning: a view from Britain.
AB  - I visited California in 1989 in order to meet Mary Poplin at the Claremont
      Graduate School. I had been deeply impressed by her two articles that had
      appeared the previous year in the Journal of Learning Disabilities (Poplin,
      1988a, 1988b). It is always such a pleasure to meet someone of like mind. (The
      meeting seemed particularly poignant in light of the fact that at that time, back
      in Britain, the National Curriculum was rearing its ugly head.) The work of Lous
      Heshusius (1982, 1989, 1991, 1992) and Richard Iano (1986, 1989, 1990) has also
      given me much encouragement. All three writers rightly reject "reductionism" in
      special education and support an alternative world view: holism. I am very
      concerned about the way that Individualized Education Programs (IEPs) dominate
      special education in both North America and Britain. The purposes of this article
      are to sketch an account of the rise of IEPs in Britain, to expose some problems
      presented by the behavioral objectives model and its associated IEPs, to
      introduce an alternative model--the process model--and to show the shift from a
      product to a process approach in curriculum planning.

PMID- 7775846
TI  - Responsible inclusion for students with learning disabilities.
AB  - The purpose of this article is to contrast responsible with irresponsible
      inclusion practices for students with learning disabilities. Guidelines for
      responsible inclusion are that the student and family are considered first,
      teachers choose to participate in inclusion classrooms, adequate resources are
      provided for inclusion classrooms, models are developed and implemented at the
      school-based level, a continuum of services is maintained, the service delivery
      model is evaluated continuously, and ongoing professional development is
      provided.

PMID- 7775848
TI  - Homework practices of students with and without learning disabilities: a
      comparison.
AB  - This article describes a study examining the homework practices of 48 students
      with learning disabilities and a matched sample of 48 nondisabled students.
      Students ranged in age from 11 to 15 years and attended Grades 6 through 8.
      Students in both groups completed the Student Survey of Homework Practices, a 27
      item, Likert-type questionnaire examining students' homework practices and
      attitudes toward homework. Results indicated that although there were some
      similarities in the homework practices of both groups, the students with learning
      disabilities engaged to a significantly greater extent in practices that
      interfered with homework completion. Suggestions for increasing the homework
      completion rates of students with learning disabilities are provided.

PMID- 7775847
TI  - Verbal and visual problems in reading disability.
AB  - Most individuals interested in reading disability favor the view that disordered
      language processing is the main cause of children's reading problems and that
      visual problems are seldom, if ever, responsible. Nevertheless, in a preliminary
      study (Eden, Stein, & Wood, 1993) we showed that visuospatial and oculomotor
      tests can be used to differentiate children with reading disabilities from
      nondisabled children. In the present study we investigated a larger sample of
      children to see if these findings held true. Using 93 children from the Bowman
      Gray Learning Disability Project (mean age = 11.3 years; 54 boys, 39 girls), we
      compared the phonological and visuospatial abilities of nondisabled children
      (children whose reading at fifth grade rated a Woodcock-Johnson reading
      standardized score between 85 and 115), and children with reading disability
      (whose reading standardized score was below 85 on the Woodcock-Johnson). In
      addition to performing poorly on verbal tests, the children with reading
      disability were significantly worse than nondisabled children at many visual and
      eye-movement tasks. A high proportion of the variance (68%) in reading ability of
      both the nondisabled children and those with reading disability could be
      predicted by combining visual and phonological scores in a multiple regression.
      These results provide further support for the hypothesis that reading disability
      may, to some extent, result from dysfunction of the visual and oculomotor
      systems.

PMID- 7775849
TI  - Impaired recognition of traffic signs in adults with dyslexia.
AB  - Ten adults with dyslexia (4 women and 6 men, mean age: 26.8 years, range: 19-43
      years) and 11 controls (5 women and 6 men, mean age: 20.5 years, range: 18-29
      years) were tested on their ability to differentiate between real and false
      traffic signs. The stimuli, computer-presented color pictures, were chosen to
      minimize the applicability of verbal or written linguistic skills to the task.
      The adults with dyslexia recognized the traffic signs significantly less well
      than did the controls. Furthermore, whereas for the controls there was a
      significant correlation between traffic sign recognition and driving experience,
      no such correlation was found for the adults with dyslexia. The results are
      interpreted in terms of a deficit in implicit learning.

PMID- 7775851
TI  - Subtle symptoms associated with self-reported mild head injury.
AB  - We conducted a survey on the relationship between mild head injury incidence and
      a variety of psychological and educational symptoms in a sample of 1,345 high
      school and 2,321 university students. Once figures were adjusted to represent a
      50:50 gender ratio, 30% to 37% of subjects reported having experienced a head
      injury incident, with 12% to 15% of the total group of subjects reporting such an
      incident with loss of consciousness. We found significant relationships between
      the incidence of such mild head injury and gender, sleep difficulties, social
      difficulties, handedness pattern, and diagnoses of attention deficit, depression,
      and speech, language, and reading disorders.

PMID- 7775850
TI  - Fable comprehension by children with learning disabilities.
AB  - Seven fables were read to 14 average learners and 14 children with learning
      disabilities, all of whom ranged in age from 10 to 13 years. They were presented
      with four possible moral choices: one correct, one related, and two incorrect.
      They were instructed to select the correct moral choice and were asked to explain
      their choice. The average learners' ability to select the correct moral was
      significantly better than that of the children with learning disabilities. In
      addition, even when they chose correct morals, the children with learning
      disabilities were less capable of explaining their choice.

PMID- 7775853
TI  - Polarized secretion of apoA-I and apoA-II by transfected MDCK cells.
AB  - Apolipoproteins (apo) are secreted preferentially from the basolateral surface of
      hepatocytes and enterocytes. The polarized secretion of proteins is either
      mediated by a protein-dependent sorting signal or by a cell-dependent default
      pathway. In order to determine the mechanism for the polarized secretion of
      apolipoproteins, we examined the secretion of apoA-I and apoA-II in transfected
      Madin-Darby canine kidney (MDCK) cells. Transfected MDCK cells and Caco-2 cells
      were grown as a polarized monolayer on tissue culture inserts, which separate an
      upper apical compartment from the lower basolateral compartment, and the
      secretion of apoA-I and apoA-II into the apical and basolateral compartments was
      quantitated by immunoprecipitation. Caco-2 cells almost exclusively secreted apoA
      I and apoA-II basolaterally, with an apical to basolateral ratio of 18:82 for
      apoA-I, and 11:89 for apoA-II. In contrast, transfected MDCK cells secreted
      significant amounts of apoA-I and apoA-II into both compartments, but with a bias
      toward apical secretion and an apical to basolateral ratio of 66:34 and 68:32,
      respectively. The polarized secretion of MDCK cells was not due to transcytosis,
      diffusion, or differential recovery. As assessed by density gradient
      ultracentrifugation, apoA-I and apoA-II secreted from either the apical or
      basolateral surface were relatively lipid-poor. Overall, these results suggest
      that the polarized secretion of apoA-I and apoA-II does not occur by a protein
      dependent sorting signal, but by a cell-dependent default pathway that leads to
      preferential basolateral secretion by Caco-2 cells and both apical and
      basolateral secretion in MDCK cells, but with a bias toward apical secretion.

PMID- 7775852
TI  - Assembly of very low density lipoproteins in rat liver: a study of nascent
      particles recovered from the rough endoplasmic reticulum.
AB  - To investigate the assembly pathway for hepatic very low density lipoproteins
      (VLDL), nascent lipoproteins were recovered from a purified, intact rough
      endoplasmic reticulum (ER) fraction isolated from rat liver. Two fractions were
      recovered by ultracentrifugation. Particles isolated at d 1.006 g/ml were
      triglyceride-rich particles containing apolipoprotein (apo)B-100 or apoB-48, and
      apoE with very small amounts of apoA-I. Compared with VLDL recovered from the
      Golgi apparatus, the particles from the rough ER had less triglyceride, but more
      cholesteryl ester and phospholipid. The second class of particles isolated
      between d 1.006 and 1.210 g/ml were phospholipid-rich and contained apoB-48,
      apoE, and apoA-I. ApoB-100 was a minor component. Radioisotope incorporation
      studies utilizing [3H]leucine revealed differential rates of labeling of the
      apoproteins in these two lipoprotein fractions. ApoB-100 and apoE followed
      similar patterns in both fractions with peak incorporation occurring within 15
      min of isotope injection. Incorporation of [3H]leucine into apoB-48 in the dense
      fraction peaked within 15 min of isotope administration, but peak incorporation
      in the d 1.006 g/ml fraction did not occur until approximately 30 min after
      injection. We propose that the two lipoprotein fractions recovered from the rough
      ER are intermediates in the assembly of VLDL by the liver. Comparison of the
      composition of these two particles with that of Golgi VLDL supports the
      sequential assembly of VLDL by the liver. Furthermore, we propose that the
      initial steps in the assembly of apoB-100- and apoB-48-containing lipoproteins
      are different with nascent apoB-100-containing particles being formed through the
      cotranslational association of this apoprotein with lipid while nascent apoB-48
      containing VLDL are formed in the rough ER through a two-step process.

PMID- 7775854
TI  - Tissue-specific, developmental and nutritional regulation of the gene encoding
      the catalytic subunit of the rat apolipoprotein B mRNA editing enzyme: functional
      role in the modulation of apoB mRNA editing.
AB  - Apolipoprotein B (apoB) mRNA editing, a posttranscriptional site-specific
      cytidine deamination reaction, is mediated by a protein complex of which the
      catalytic component (REPR) has recently been cloned. REPR mRNA was demonstrated
      by RNase protection at highest abundance in small intestine and colon but the
      transcript was detectable in all tissues examined including kidney, spleen, lung,
      liver, and ovary. ApoB mRNA was found predominantly in the liver and small
      intestine but low levels were detected in all adult tissues examined and found to
      be variably (29-86% TAA) edited. In addition, S100 extracts prepared from spleen
      and kidney were competent to edit an apoB RNA template in vitro, suggesting that
      the entire apoB mRNA editing complex is present and functionally active in these
      tissues. In situ hybridization demonstrated REPR mRNA to be distributed along the
      entire villus-crypt axis, while apoB mRNA distribution did not extend into the
      crypts. In the liver, both apoB and REPR mRNA were detected in all cells of the
      hepatic lobule without an apparent gradient of expression. REPR mRNA was found in
      the red pulp of the spleen and in the superficial crypt cells of the colon. This
      distribution of REPR mRNA was recapitulated by immunocytochemical localization of
      the protein within these tissues. Finally, the developmental and nutritional
      modulation of REPR was examined in relation to endogenous apoB mRNA editing.
      Small intestinal apoB mRNA editing was found to undergo a developmentally
      regulated increase beginning at gestational day 20, preceding a developmental
      increase in REPR mRNA abundance. Additionally, hepatic and kidney apoB mRNA
      editing both revealed a temporal dissociation from alterations in REPR mRNA
      abundance. By contrast, adult rats subjected to fasting and refeeding a high
      carbohydrate diet, demonstrated concordant modulation of endogenous apoB mRNA
      editing and REPR mRNA abundance (r = 0.92, P < 0.001). Taken together, the data
      demonstrate that REPR and other components of the rat apoB mRNA editing complex
      are widely distributed and undergo distinct developmental and metabolic
      regulation that interact to regulate apoB mRNA editing in a tissue-specific
      manner.

PMID- 7775855
TI  - Structural basis of the phospholipid acyltransferase enzyme substrate
      specificity: a computer modeling study of the phospholipid acceptor molecule.
AB  - The activity of the 1-acyl-sn-glycero-3-phosphocholine acyltransferase enzyme
      (E.C. 2.3.1.??) was measured with three radically different acceptor substrates:
      1-palmitoyl-sn-glycero-3-phosphocholine (P-sn-G3PC), 1-palmitoyl-sn-glycero-2
      phosphocholine (P-sn-G2PC), and 1-hexadecyl-sn-glycero-3-phosphocholine (He-sn
      G3PC). It was found that the enzyme had similar activity with P-sn-G3PC, the
      natural acceptor substrate, and with P-sn-G2PC. The enzyme showed no detectable
      activity toward He-sn-G3PC. These results are much different than would be
      expected from simple examination of the structures. Computer-assisted molecular
      modeling was done to study the geometrical configurations and to focus upon the
      similarities and differences of the three substrate acceptor molecules. Three
      bond distances were selected as important for enzyme recognition: the distance
      between the oxygen of the acceptor hydroxyl group and 1) the phosphorus; 2) the
      nitrogen; and 3) the oxygen bridge to the hydrocarbon chain. There were striking
      similarities for the bond distances of two of the three acceptor substrates, P-sn
      G3PC and P-sn-G2PC. These were the two molecules that were shown to have activity
      with the enzyme. The bond distances found for the enzymically inactive acceptor
      substrate, He-sn-G3PC, differed significantly from P-sn-G3PC and P-sn-G2PC.
      Therefore, this latter molecule probably does not fit into the active site of the
      enzyme. The modeling data are also consistent with the experimental observation
      that He-sn-G3PC is not an inhibitor.

PMID- 7775856
TI  - Coenzyme A-dependent modification of fatty acyl chains of rat liver membrane
      phospholipids: possible involvement of ATP-independent acyl-CoA synthesis.
AB  - Certain species of fatty acyl chains of microsomal lipids from rat hepatocytes
      underwent desaturation when the microsomal fraction was incubated with CoA and
      NADH. For instance, 18:0, 18:2(n-6), and 20:3(n-6) incorporated into membrane
      lipids were gradually converted to 18:1(n-9), 18:3(n-6), and 20:4(n-6),
      respectively. Further, 20:5(n-3) and 18:3(n-6) were metabolized to 22:5(n-3) and
      20:4(n-6) respectively, through chain elongation or chain elongation plus
      subsequent desaturation when malonyl-CoA was present. In contrast to esterified
      fatty acids, negligible change was observed for fre fatty acids under the same
      experimental conditions. It is apparent that ATP-independent acyl-CoA synthesis
      is implicated in such enzymatic modification of fatty acyl chains. The presence
      of either gel-filtered cytosol or bovine serum albumin markedly potentiated the
      reaction. However, the addition of ATP and Mg2+ did not accelerate the overall
      reaction induced in the presence of CoA alone. These results suggest that the
      pathway of CoA-dependent/ATP-independent modification of fatty acyl chains is
      sufficiently active to account for the desaturation and chain elongation of fatty
      acids esterified in membrane lipids, especially phospholipids, of living cells.

PMID- 7775857
TI  - Control of lipolysis in intra-abdominal fat cells of nonhuman primates:
      comparison with humans.
AB  - The mechanisms that control lipolysis in intra-abdominal fat cells from various
      primate species, the marmoset (Callithrix jacchus), the baboon (Papio papio), and
      the macaque (Macaca fascicularis), were compared to those of human intraabdominal
      fat cells. Selective beta 1- or beta 2-adrenoceptor agonists induced lipolysis in
      all species. Selective beta 3-agonists (BRL 37344, CL 316243, and SR 58611) acted
      as partial agonists in marmoset but were inefficient in other primates, including
      humans. alpha 2-Adrenoceptor number ([3H]RX 8210002 binding) equalized (baboon)
      or exceeded (other primates) beta 1/beta 2-adrenoceptors ([3H]CGP 12177 binding).
      Baboon fat cell membranes expressed similar amounts of coupled beta- and alpha 2
      adrenoceptors. In all species, norepinephrine- or epinephrine-induced lipolysis
      did not reach the lipolytic effect of isoproterenol but their effects were
      enhanced after alpha 2-adrenoceptor blockade. N6-phenylisopropyladenosine (PIA)
      induced a full antilipolytic effect in baboon, macaque, and human adipocytes
      through adenosine receptors ([3H]DPCPX binding). Peptide YY (PYY) weakly
      inhibited lipolysis in baboon. Adrenocorticotropic hormone (ACTH) was inactive
      whereas parathyroid hormone (PTH) partially stimulated lipolysis in primates.
      Histamine was partially lipolytic in marmoset only. This study emphasizes the
      similarities of the mechanisms controlling the lipolysis in nonhuman primate and
      in human adipocytes and suggests that the baboon and the macaque should provide
      unique models for the study of the regulation of lipolysis.

PMID- 7775858
TI  - Associations of hepatic and lipoprotein lipase activities with changes in dietary
      composition and low density lipoprotein subclasses.
AB  - To test whether lipoprotein lipase or hepatic lipase activities are associated
      with lipoprotein subclasses, and to assess the effects of dietary manipulations
      on these associations, enzyme activities were measured in postheparin plasma (75
      U heparin/kg) from 43 healthy men who were randomly allocated to a low-fat (24%
      fat, 60% carbohydrate) and a high-fat (46% fat, 38% carbohydrate) diet for 6
      weeks each in a cross-over design. The high-fat diet significantly increased both
      lipoprotein lipase (+20%, P = 0.02) and hepatic lipase (+8%, P = 0.007)
      activities. On both diets, hepatic lipase activity was significantly positively
      correlated (P < 0.01) with plasma apolipoprotein (apo)B concentrations, and with
      levels of small dense low density lipoprotein (LDL) III, measured by analytic
      ultracentrifugation as mass of lipoproteins of flotation rate (Sof) 3-5, while
      lipoprotein lipase activity was inversely associated with levels of LDL III (P <
      0.05). Despite the cross-sectional correlations, increased hepatic lipase
      activity was not significantly correlated with the reduction in LDL III mass
      observed on the high-fat diet. Rather, changes in hepatic lipase were correlated
      inversely with changes in small very low density lipoproteins (VLDL) of Sof 20
      40, and small intermediate density lipoproteins (VLDL) of Sof 10-16. Moreover,
      changes in lipoprotein lipase activity were not significantly correlated with
      changes in small LDL, but were positively associated with changes in small IDL of
      Sof 10-14, and large LDL I of Sof 7-10. Thus, while increased levels of small
      dense LDL are associated with a metabolic state characterized by relatively
      increased hepatic lipase and decreased lipoprotein lipase activity, changes in
      these enzymes do not appear to be primary determinants of diet-induced changes in
      levels of this LDL subfraction. On the other hand, increased lipoprotein lipase
      activity induced by high-fat feeding may contribute to the accumulation in plasma
      of both large LDL I and small IDL, whereas increased hepatic lipase may promote
      catabolism or clearance of triglyceride-rich lipoprotein remnants.

PMID- 7775859
TI  - Effects of fish oil fatty acids on low density lipoprotein size, oxidizability,
      and uptake by macrophages.
AB  - The effect of fish oil and corn oil supplementation on plasma lipids and
      lipoproteins and on low density lipoprotein (LDL) oxidation was examined in 20
      treated hypertensive subjects. The randomized double-blind crossover study
      consisted of two 6-week interventions with 4 g/day of a highly purified fish oil
      or corn oil. Fish oil significantly (-24%, P < 0.01) reduced plasma triglyceride,
      and increased LDL-cholesterol (+6%, P < 0.01 compared to corn oil). LDL particles
      were larger (P < 0.01) after fish oil compared to baseline and LDL size was
      inversely correlated with plasma triglyceride (P < 0.001) both before and after
      fish oil supplementation, and positively correlated with high density lipoprotein
      cholesterol (P < 0.01). Fish oil reduced lag time before onset of copper-induced
      LDL oxidation (-25%, P < 0.001) and significantly increased production of
      thiobarbituric acid-reactive substances (TBARS) during oxidation, compared with
      corn oil. Corn oil had no significant effect on lag time and oxidation rate. Fish
      oil increased macrophage uptake of copper-oxidized LDL and of macrophage-modified
      LDL. Corn oil was without effect. Additionally, macrophages that were
      supplemented with fish oil fatty acids in vitro displayed a significantly (P <
      0.001) higher capacity to oxidize LDL than either control cells or cells
      supplemented with corn oil fatty acids. We conclude that from the standpoint of
      atherosclerosis, fish oil fatty acids adversely raise the susceptibility of LDL
      to copper-induced and macrophage-mediated oxidation but that the increase in
      plasma LDL cholesterol concentration reflects an increase in size that may be
      favorable.

PMID- 7775861
TI  - Characterization of stratum corneum structure in reconstructed epidermis by X-ray
      diffraction.
AB  - The intercellular lipid regions in the stratum corneum (SC), the outermost layer
      of the skin, form the major barrier for diffusion of substances through the skin.
      The barrier function of in vitro reconstructed epidermis is still impaired. With
      respect to further optimization of the model, it is necessary to characterize its
      stratum corneum lipid structure. In this study, small and wide angle X-ray
      diffraction were used to characterize the lipid organization in stratum corneum
      isolated from 14-day-old reconstructed epidermis. The measurements were carried
      out at room temperature, and subsequently as a function of temperature between 25
      degrees C and 109 degrees C, followed by measurements after cooling to room
      temperature. The results of the X-ray diffraction measurements revealed the
      following in reconstructed epidermis. 1) The lamellar ordering of stratum corneum
      lipids was much lower than that observed in native stratum corneum. 2)
      Crystalline anhydrous cholesterol was present. 3) Orthorhombic packing was
      present, but the corresponding reflections were very weak. The orthorhombic
      packing disappeared between 30 degrees C and 45 degrees C. 4) A hexagonal packing
      was present and disappeared between 60 degrees C and 75 degrees C. 5) Soft
      keratin is present. 6) A higher extent of lamellar ordering could be achieved by
      heating to 109 degrees C and cooling down to room temperature. Analysis of SC
      lipids revealed the presence of high amounts of triglycerides, the level of which
      could be decreased by lowering the glucose content. However, modulation of
      culture medium composition did not significantly affect lipid lamellae structures
      or hydrocarbon chain packing.

PMID- 7775860
TI  - Plasma lipid transport in the hedgehog: partial characterization of structure and
      function of apolipoprotein A-I.
AB  - Apart from exhibiting the presence of lipoprotein [a] in its plasma, another
      interest of the European hedgehog in lipoprotein research lies in the
      quantitative prominence of a complex spectrum of high density lipoproteins (HDL)
      and very high density lipoproteins (VHDL) as cholesterol transporters in plasma
      (Laplaud, P. M. et al. 1989. Biochim. Biophys. Acta. 1005: 143-156). We,
      therefore, initiated studies in the field of reverse cholesterol transport in the
      hedgehog. As a first step, we characterized apolipoprotein A-I (apoA-I), the main
      protein component of hedgehog HDL and VHDL. Proteolytic cleavage of apoA-I (M(r)
      approx. 27 kDa) using two different enzymes resulted in two sets of peptides that
      were subsequently purified by high performance liquid chromatography, and that
      allowed us determination of the complete protein sequence. Hedgehog apoA-I thus
      consists of 241 amino acid residues and exhibits an overall 58% homology to its
      human counterpart, i.e., the lowest value observed to date among mammalian
      species. However, it retained the general organization common to all known apoA
      Is, i.e., a series of amphipathic helical segments punctuated by proline
      residues. Circular dichroism experiments indicated a helical content of approx.
      45%, increasing to approx. 58% in the presence of lecithin unilamellar liposomes.
      Apart from other differences, amino acid composition analysis shows that hedgehog
      apoA-I contains four isoleucine residues, while this amino acid is totally absent
      from the corresponding protein in higher mammals. Polyclonal antibodies raised
      against hedgehog apoA-I failed to detect any cross-reactivity between the animal
      and human proteins, although comparative prediction of the respective antigenic
      structures using the Hopp-Woods algorithm indicated that several potentially
      antigenic sites may occur in similar regions of the protein. Finally, hedgehog
      apoA-I was shown to be able to activate lecithin:cholesterol acyl transferase,
      although it was 4 to 5 times less efficient in this respect than the human
      protein.

PMID- 7775862
TI  - Inhibition of cellular cholesterol efflux by 25-hydroxycholesterol.
AB  - The effect of oxysterols on efflux of cholesterol from mouse L-cell fibroblasts,
      rat Fu5AH hepatoma cells, J774 macrophages, and human EA.hy 926 endothelial cells
      was studied. Cells were preincubated with 25-hydroxycholesterol (25-OHC) either
      during labeling of the cells with [3H]cholesterol or during equilibration after
      labeling. Subsequently, the release of [3H]cholesterol into medium containing 0.2
      mg HDL3/ml was measured and the fractional release of cellular [3H]cholesterol
      was calculated. Pretreatment with 25-OHC (1 microgram/ml) caused a 30% reduction
      in [3H]cholesterol efflux from L-cells during 8 h of incubation with HDL3. 25-OHC
      also inhibited cholesterol efflux from Fu5AH and J774 cells, but the effect was
      less marked. There was only a small, nonsignificant reduction of efflux from
      EA.hy 926 cells. The mechanisms of 25-OHC-induced inhibition of cellular
      cholesterol efflux was further studied in L-cells, because of their sensitivity
      to 25-OHC treatment. The effect of 25-OHC on cholesterol efflux was dose
      dependent, with significant effects seen at 25-OHC concentrations as low as 50
      ng/ml. The half-time for cholesterol efflux from 25-OHC-treated cells (5
      micrograms/ml) was 13.0 +/- 3.3 h compared to 5.7 +/- 1.0 in control cells,
      corresponding to a 55% reduction in the rate of cholesterol release. Other
      oxysterols, including 7-ketocholesterol, 7 alpha- and 7 beta-hydroxycholesterol,
      and 22(S)-hydroxycholesterol also inhibited [3H]cholesterol efflux from L-cells
      significantly, but to a lesser degree. 25-Hydroxycholesterol (5 micrograms/ml)
      reduced efflux from both normal and cholesterol-enriched cells by 31 and 14%,
      respectively. Inhibition of efflux was similar when reconstituted HDL3
      apolipoprotein/phosphatidylcholine particles or small unilamellar
      phosphatidylcholine vesicles were used as cholesterol acceptors instead of HDL3.
      The content of phospholipids, cholesterol and the FC/PL ratio of intact cells and
      from isolated plasma membrane vesicles were the same for control and 25-OHC
      treated cells. Efflux of [3H]cholesterol from plasma membranes isolated from 25
      OHC-treated cells was 20% less than efflux from membranes from control cells. The
      difference in efflux observed in intact cells is partially explained by the
      reduction in efflux from the plasma membrane. In conclusion, our studies suggest
      that oxysterols, especially 25-hydroxycholesterol, can reduce cellular
      cholesterol efflux in vitro. Therefore oxysterols, either endogenous or derived
      from the diet, may influence cellular cholesterol efflux in vivo, the first step
      in reverse cholesterol transport.

PMID- 7775863
TI  - Apolipoprotein E isoforms and rare mutations: parallel reduction in binding to
      cells and to heparin reflects severity of associated type III
      hyperlipoproteinemia.
AB  - The LDL receptor-independent binding of human apolipoprotein E isoforms and rare
      apoE mutations were studied on LDL receptor-deficient human fibroblasts using
      chemical cross-linking and cell binding studies. The cross-linking experiments
      demonstrated that all apoE variants bind to the low density lipoprotein receptor
      related protein, a potential receptor for remnant lipoproteins. In cell binding
      studies, the effect of the apoE variants on binding of beta-VLDL was
      investigated. Addition of normal apoE-3 to the binding assay resulted in a 12
      fold increase of beta-VLDL particle binding, whereas this effect was reduced in
      the clinically defective variants: apoE-2, (Arg158-->Cys), 24.4% of apoE-3; apoE
      1, (Gly127-->Asp, Arg158-->Cys), 49.2% of apoE-3; apoE-1(Lys146-->Glu), 18.2% of
      apoE-3. Heparin binding studies with the same variants showed a parallel
      reduction in proteoglycan binding (apoE-2(158), 58.2% of apoE-3; apoE-1(127,158),
      37.9%; apoE-1(146), 20.6%). We conclude that LDL receptor-independent mechanisms
      contribute to remnant clearance. The functionally dominant mutation apoE-1(146)
      was most defective in heparin binding studies in vitro. In cell binding studies,
      apoE-1(146) did mediate lipoprotein binding only 18% compared to apoE-3. This
      indicates the important role of the apoE interaction with proteoglycans in vivo
      and could explain the development of type III hyperlipoproteinemia in patients
      with such apoE variants.

PMID- 7775864
TI  - Characterization of constitutive human serum amyloid A protein (SAA4) as an
      apolipoprotein.
AB  - Serum amyloid A proteins (SAAs), a family of homologous molecules, are
      apolipoproteins of high density lipoprotein (HDL). They can be divided into two
      groups. The first group comprises the well-characterized acute phase SAAs that
      associate with HDL during inflammation, thereby remodeling the HDL particle by
      displacing apolipoprotein (apo)A-I. The second group consists of the recently
      discovered constitutive SAAs, mouse SAA5 and human SAA4. They exist as minor
      apolipoproteins on HDL but constitute more than 90% of the total SAA during
      homeostasis. We have characterized human SAA4 as an apolipoprotein. During
      homeostasis, SAA4 is synthesized only in the liver. Purification of SAA4 has been
      described and its plasma concentration has been established at 55 +/- 13
      micrograms/ml in 26 healthy individuals. It was present on all HDL density
      classes and very low density lipoprotein (VLDL) but was absent from low density
      lipoprotein (LDL). Using two-dimensional electrophoresis and phosphorimaging,
      SAA4 was found to be associated with a specific subpopulation of only three HDL
      particles, not involved in the initial cholesterol transfer from cells.

PMID- 7775865
TI  - Tetradecylthioacetic acid (a 3-thia fatty acid) decreases triacylglycerol
      secretion in CaCo-2 cells.
AB  - The effects of the hypolipidemic fatty acid analogue tetradecylthioacetic acid
      (TTA) on synthesis and secretion of lipoproteins in CaCo-2 cells were studied.
      Radiolabeled tetradecylthioacetic acid was absorbed and metabolized as
      efficiently as oleic acid, although a discrepancy in the metabolic fate was
      evident. Whereas tetradecylthioacetic acid was incorporated into cell-associated
      triacylglycerol to the same extent as normal fatty acids (e.g., oleic acid and
      palmitic acid), the amount of triacylglycerol secreted from cells incubated with
      tetradecylthioacetic acid was 8 to 10 times lower than the amount secreted from
      cells incubated with palmitic acid and oleic acid, respectively. On the other
      hand, there was an enhanced incorporation of tetradecylthioacetic acid into cell
      associated and secreted phospholipids. Despite incorporation of
      tetradecylthioacetic acid into cellular triacylglycerol, unlike oleic acid,
      tetradecylthioacetic acid did not stimulate production of triacylglycerol-rich
      particles. Ultracentrifugation of basolateral media from cells incubated with
      tetradecylthioacetic acid revealed low amounts of triacylglycerol in the
      triacylglycerol-rich fraction (p < 1.006 g/ml), suggesting secretion of
      lipoproteins with a higher density than chylomicrons. However, the present study
      shows that the stimulated triacylglycerol secretion caused by oleic acid was
      inhibited in the presence of TTA. The decreased rate of triacylglycerol secretion
      from these cells was not accompanied by a stimulation of fatty acid oxidation.
      Based on these findings, we therefore suggest that tetradecylthioacetic acid
      mainly affects secretion of lipoproteins in CaCo-2 cells.

PMID- 7775866
TI  - Progesterone blocks intracellular translocation of free cholesterol derived from
      cholesteryl ester in macrophages.
AB  - Macrophage foam cells must accommodate continuing fluxes of free cholesterol in
      spite of a greatly expanded store of cholesteryl ester. Though endogenous free
      cholesterol synthesis is suppressed, free cholesterol continues to enter the cell
      via endocytosis of oxidized/modified lipoproteins. It has been shown previously
      that this free cholesterol is released into the lysosomal compartment and rapidly
      transported to the plasma membrane prior to its esterification. A substantial
      amount of free cholesterol is also presented via the continuous hydrolysis of
      cholesteryl ester during the cholesteryl ester cycle. We addressed the question
      of whether the intracellular free cholesterol derived from the hydrolysis of
      cholesteryl ester formed a protected pool for rapid re-esterification. Incubation
      of macrophage foam cells with cyclic AMP to enhance cholesteryl ester hydrolysis,
      and with S58035 to inhibit acyl-CoA:cholesterol acyltransferase (ACAT) activity,
      led to conversion of cellular cholesteryl ester to free cholesterol and transport
      of this free cholesterol to the plasma membrane. Addition of progesterone,
      previously demonstrated to be an inhibitor of free cholesterol transport in other
      cell types, also led to conversion of cholesteryl ester to free cholesterol even
      though progesterone was only a weak inhibitor of ACAT activity. Free cholesterol
      in the plasma membrane was an important source of ACAT substrate to balance the
      constitutive hydrolysis of cholesteryl ester in cholesterol-loaded macrophages.
      Treatment of cells with progesterone, however, prevented free cholesterol derived
      from cholesteryl ester hydrolysis from moving to the plasma membrane. The
      sequestration of free cholesterol by progesterone could be reversed by incubation
      with human HDL3.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775867
TI  - Modulation in delta 9, delta 6, and delta 5 fatty acid desaturase activity in the
      human intestinal CaCo-2 cell line.
AB  - We report the influence of media lipids, growth in lipid-poor medium, and cell
      differentiation on delta 9, delta 6, and delta 5 desaturase activity in the human
      CaCo-2 enterocyte cell line. We also describe the level of incorporation of
      palmitic (16:0), linoleic (18:2n-6), and eicosapentaenoic (EPA) acids (20:5n-3)
      and their higher homologues into cytosolic and membrane lipids during long-term
      (10 days) medium supplementation in fully differentiated 16- to 18-day-old
      cultures. CaCo-2 monolayers reached confluency by day 6 with subsequent
      development of microvilli and maximal expression of microvillus membrane sucrose,
      alkaline phosphatase, and gamma-glutamyltransaminase occurring between days 16
      and 23 after plating. There was evidence of the presence and modulation of delta
      9, delta 6, and delta 5 desaturase activity (delta 9 > delta 6 > delta 5). delta
      6 Desaturase activity decreased approximately 2-fold between days 6 and 24 of
      culture and when the fetal bovine serum concentration was increased from 0.5% to
      25%; in contrast, when cells were starved for 72 h, activity increased 5.4-fold.
      When the media was supplemented with either linoleic acid and/or EPA, both delta
      6 and delta 5 desaturase activities were inhibited, the greatest reduction of
      delta 5 desaturase activity occurring with EPA. Incorporation of media fatty
      acids plus their desaturase and elongase products was highly dependent on medium
      composition with the homologues of delta 9 > delta 6 > delta 5. Supplementation
      of cellular media with 100 microM EPA for 10 days decreased membrane
      phosphatidylethanolamine arachidonic acid level from 13.2 to 8.9%. From these
      results we conclude that enterocyte membrane fatty acid composition and
      desaturase enzyme activity are regulated by both dietary fat intake and cell
      maturation. The clinical relevance of these observations on lipid dietary
      modification for the management of chronic inflammatory bowel disease is still
      uncertain but these observations suggest that the beneficial effects of EPA
      supplements on human ulcerative colitis may be due to a reduction in enterocyte
      arachidonic acid content by down-regulation of delta 6 and delta 5 desaturase
      activity.

PMID- 7775868
TI  - Distribution of exogenously added gangliosides in serum proteins depends on the
      relative affinity of albumin and lipoproteins.
AB  - Gangliosides in normal serum are found only in lipoproteins and the relative
      content of the three major lipoprotein fractions is low density lipoprotein >
      high density lipoprotein > very low density lipoprotein (LDL > HDL > VLDL). Upon
      in vitro incubation of labeled gangliosides with human serum, about 15% of the
      exogenous gangliosides became associated with the albumin fraction and 85% were
      distributed on the lipoproteins in the order HDL > LDL > VLDL. To compare the
      relative affinities of serum proteins for gangliosides, the levels of exchange of
      exogenous gangliosides between preloaded serum proteins were determined. Although
      albumin had the highest binding capacity for gangliosides, 85% of the albumin
      loaded gangliosides were transferred to the total lipoprotein fraction and this
      exchange was reversible. The transfer rate from albumin to isolated lipoproteins
      was higher to LDL (90%) and HDL (85%) whereas only 55% of albumin-loaded
      gangliosides were transferred to VLDL. The study of exchanges of preloaded
      gangliosides between isolated lipoproteins showed that the extent of transfer of
      gangliosides from a given lipoprotein fraction onto other lipoproteins was
      inversely correlated with its endogenous ganglioside content. Moreover, in the
      absence of albumin from the incubation medium, the final lipoprotein distribution
      of remaining exogenous gangliosides was similar to the normal distribution of
      endogenous gangliosides in serum lipoproteins. The formation of unexchangeable
      complexes between albumin and micellar exogenous gangliosides could be a possible
      explanation for the observed differences in the distribution of exogenous and
      endogenous gangliosides in serum proteins.

PMID- 7775869
TI  - High density lipoprotein subfractions in non-insulin-dependent diabetes mellitus
      and coronary artery disease.
AB  - High density lipoprotein (HDL) subfractions (2b, 2a, 3a, 3b, and 3c) separated by
      gradient gel electrophoresis (GGE) and defined by Gaussian summation analysis,
      and the compositions of HDL2 and HDL3, separated by preparative
      ultracentrifugation, were studied in four groups of men with or without non
      insulin-dependent diabetes mellitus (NIDDM) and coronary artery disease (CAD):
      group 1 (DM+CAD+, n = 50); group 2 (DM-CAD+, n = 50); group 3 (DM+CAD-, n = 50);
      and group 4 (DM-CAD-, n = 31). HDL GGE subfraction distributions, available in
      125 subjects, were not significantly different among the groups. In contrast,
      dividing the whole study population into quartiles of serum triglyceride (TG)
      concentration showed that high TG levels were significantly associated with low
      HDL2b and high HDL3b concentrations. In a multivariate linear regression model,
      postheparin plasma hepatic lipase (HL) activity, and fasting serum insulin and TG
      concentrations were all associated independently and inversely with low HDL2b,
      but lipoprotein lipase or cholesteryl ester transfer protein activities were not
      correlated with HDL2b concentrations. Group 1 tended to have the smallest mean
      particle sizes in the HDL subfractions, significantly (P < 0.03, CAD vs. non-CAD)
      for HDL2b and for HDL2a. These differences were independent of TG, insulin and
      HL, but lost their significance when adjusted for beta-blocker therapy. Both HDL2
      and HDL3 particles in group 1 were significantly depleted of unesterified
      cholesterol, and their HDL2 was TG-enriched (P = 0.053). A high HL activity,
      hyperinsulinemia and hypertriglyceridemia are independently associated with low
      levels of HDL2b and generally small HDL particle size. HDL particles in subjects
      with NIDDM and CAD are small-sized and have a low free cholesterol content. Both
      these characteristics may be markers of impaired reverse cholesterol transport.

PMID- 7775870
TI  - Selective uptake of HDL cholesteryl esters is active in transgenic mice
      expressing human apolipoprotein A-I.
AB  - The direct non-endocytotic uptake of cholesteryl esters (CE) from high density
      lipoprotein (HDL) plays a major role in HDL CE metabolism in rats and rabbits. In
      vitro evidence indicates it may also play such a role in humans. However, a study
      in mice (tracing the CE and apoA-I moieties of HDL) concluded that, while
      selective uptake played a role in normal animals, it did not in transgenic mice
      which express predominantly human apoA-I (Chajek-Shaul et al., 1991. Proc. Natl.
      Acad. Sci. USA. 88: 6731-6735);thus human apoA-I was apparently unable to support
      selective uptake. These conclusions rested on plasma decay data that represent a
      composite of all tissue and which may obscure tissue-specific factors. Thus we
      reexamined the matter by measuring the rates of uptake of HDL components by
      individual tissues using intracellularly trapped tracers. Plasma decay data were
      much as reported in the referenced study. Nonetheless the fractional rate of
      uptake of HDL CE was greater than that of apoA-I in adrenal gland and liver,
      indicating selective uptake. Kidney took up apoA-I tracer at a greater fractional
      rate than CE tracer, apparently by filtration and reabsorption of free apoA-I,
      and this uptake was at a greater fractional rate in the transgenic mice than in
      normal mice. Thus, the lack of evidence for selective uptake in the plasma decay
      data of the transgenic mice was explained by a higher rate of renal uptake of
      apoA-I and not by a diminished rate of selective uptake in other
      tissues.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775871
TI  - Chicken yolk contains bona fide high density lipoprotein particles.
AB  - Lipoproteins, the major nutrient source for developing embryos in egg-laying
      species, are thought to be transported from the circulation of the hen to the
      yolk of growing oocytes. In order to fully understand the contribution of the
      different lipoprotein species to oocyte growth, yolk formation, and embryo
      development, we have started to elucidate the relationships between the high
      density lipoproteins (HDL) in serum with the hitherto uncharacterized yolk HDL
      fraction. Immunoblotting with antibodies against apolipoprotein (apo) A-I, the
      major protein moiety of circulating HDL, revealed, for the first time,
      significant amounts of this protein in yolk. Importantly, yolk apoA-I was an
      integral component of bona fide lipoprotein particles: i) the apoA-I-containing
      particles could be purified by ultracentrifugal flotation and immunoaffinity
      chromatography on immobilized anti-apoA-I IgG; ii) the particles resembled serum
      HDL in ultrastructural, chemical, and biochemical aspects; and iii) in
      particular, these particles contained another major apolipoprotein, apo II. To
      date, apo II has been assumed to be unique to the very low density lipoprotein
      (VLDL) and HDL fractions of laying hen serum. Its residence on yolk HDL
      particles, together with the other results, strongly implies that yolk HDL, at
      least to a large part, is derived from serum. This implication is supported by
      the presence of apoA-I in oocytic coated vesicles. However, an oocyte plasma
      membrane receptor for the transport of HDL could not be identified; furthermore,
      immunoelectron microscopy demonstrated that yolk HDL particles do not colocalize
      with VLDL, known to be endocytosed via a specific receptor. Thus, these studies
      have revealed that HDL particles are taken up into the oocyte from the serum of
      the laying hen, and are deposited into the yolk by a mechanism distinct from that
      involved in the uptake of other yolk lipoproteins.

PMID- 7775872
TI  - Structural and stereochemical studies of potent inhibitors of glucosylceramide
      synthase and tumor cell growth.
AB  - Analogs and homologs of PDMP were synthesized, based on its structure (D-threo-1
      phenyl-2-decanoylamino-3-morpholino-1-propanol). This compound had previously
      been found to block the synthesis of GlcCer (glucosylceramide). Increasing the
      acyl chain length from 10 to 16 carbon atoms greatly enhanced the efficacy of the
      enzyme inhibitor, as did the use of a less polar cyclic amine, especially a
      pyrrolidine instead of a morpholine ring. Replacement of the phenyl ring by a
      chain corresponding to sphingosine also yielded a strongly inhibitory material.
      By using a chiral synthetic route, we showed that the isomers active against
      GlcCer synthase had the R,R-(D-threo)-configuration. However, strong inhibition
      of the growth of human cancer cells in plastico was produced by both the threo
      and erythro racemic compounds, showing involvement of an additional factor
      (beyond simple depletion of cell glycosphingolipids by blockage of GlcCer
      synthesis). The growth arresting effects could be correlated with increases in
      cellular ceramide and diglyceride levels. The aliphatic pyrrolidino compound was
      strongly inhibitory toward the glucosyltransferase and produced almost complete
      depletion of glycolipids, but did not inhibit growth or cause an accumulation of
      ceramide. Attempts were made to see whether the differences in growth effects
      could be attributed to the influence of the inhibitors on related enzymes
      (ceramide and sphingomyelin synthase and ceramidase and sphingomyelinase). While
      some stimulation of enzyme activity was noted, particularly at high inhibitor
      concentrations (50 microM), these findings did not explain the differing effects
      of the different inhibitors. The best inhibitors of GlcCer synthase compared
      favorably in efficacy with some cancer chemotherapeutic drugs in current use when
      tested with a battery of human cancer cells.

PMID- 7775873
TI  - A novel assay for cytosolic 3-hydroxy-3-methylglutaryl-coenzyme A synthase
      activity using reversed-phase ion-pair chromatography: demonstration that
      Lifibrol (K12.148) modulates the enzyme activity.
AB  - Cytosolic HMG-CoA synthase and microsomal 3-hydroxy-3-methylglutaryl-CoA (HMG
      CoA) reductase catalyze two sequential steps in the mevalonate pathway. Both
      enzymes are negatively regulated by cholesterol. Cytosolic HMG-CoA synthase is
      responsible for the generation of HMG-CoA from acetyl-CoA and acetoacetyl-CoA).
      We have developed a new method to determine HMG-CoA synthase activity. In this
      assay, HMG-CoA is formed from acetoacetyl-CoA and labeled acetyl-CoA. The HMG-CoA
      product is isolated from the reaction mixture by means of reversed-phase ion-pair
      chromatography. The recovery of the product was always greater than 90%. The
      average within-batch coefficient of variation for HMG-CoA synthase activity was
      5.1%. Using the new assay, we demonstrate that Lifibrol (K12.148), a new
      hypolipidemic compound, inhibits HMG-CoA synthase. Because our assay is accurate
      and precise it may become useful in future studies on the regulation and the
      pharmacological modulation of cytosolic HMG-CoA synthase.

PMID- 7775874
TI  - Potential bile acid metabolites. 23. Syntheses of 3-glucosides of nonamidated and
      glycine- and taurine-amidated bile acids.
AB  - The 3-glucosides of nonamidated lithocholic, chenodeoxycholic, ursodeoxycholic,
      deoxycholic, and cholic acids, and their double conjugate forms with glycine and
      taurine were synthesized. The key reactions used were 1) beta-D- glucosidation at
      C-3 by the Koenigs-Knorr condensation reaction of 3 alpha-hydroxylated bile acid
      methyl (or p-nitrophenyl) esters with 1 alpha-bromo-1-deoxy-2, 3, 4, 6-tetra-O
      acetyl-D-glucopyranose in the presence of cadmium carbonate in refluxing benzene;
      2) indirect and direct amidations at C-24 by the activated p-nitrophenyl ester
      and by the diethylphosphorylcyanide methods, respectively, using glycinate ester
      and taurine as coupling agents; and 3) simultaneous alkaline hydrolysis of the
      hydroxyl-protecting and ester groups in both the sugar and aglycone moieties.

PMID- 7775875
TI  - Evaluation of the efficacy of routine BCG vaccination: a case-control study.
AB  - A case-control study was conducted in a metropolitan region of Cairo, Egypt to
      determine the protective efficacy of routine BCG Vaccination of infants against
      childhood pulmonary tuberculosis. A total of 175 cases of children suffering from
      pulmonary tuberculosis were obtained over 8 months period from hospitals likely
      to admit such cases in Cairo. Each case was matched to two controls for the
      district of residence. Vaccination status of cases and controls was ascertained
      by asking the mothers and confirmed by examination of the left arm of the study
      children for the scar of BCG vaccination. The overall crude efficacy of BCG
      vaccination was found to be 53% (CL: 68%, 31%), dropping to 49% (CL: 57%, 25%)
      after controlling for the confounding effect of crowding index. Potential biases
      in the study design and their role in over or underestimation of the vaccine
      efficacy were discussed.

PMID- 7775876
TI  - Integration of hepatitis B immunization in the Expanded Program on Immunization
      of the Child Survival Project.
AB  - The Expanded Program on Immunization (EPI) is a component of the Child Survival
      Project (CSP) whose objectives are to reduce the incidence rates of six childhood
      diseases (Measles, Diphtheria, Pertussis, Tetanus, Tuberculosis, Poliomyelitis)
      and to reduce the number of infant deaths from those diseases by increasing
      effective vaccination coverage. In 1991, the CSP/EPI developed a national plan to
      introduce national immunization of infants against hepatitis B in an attempt to
      control the magnitude and seriousness of the damage which viral hepatitis causes
      in terms of morbidity, mortality and serious sequelae as hepatitis B is an
      endemic disease in Egypt causing an important public health problem which
      requires urgent control. This presentation will discuss the integrated effort
      undertaken to plan and implement the program, the different challenges it faces,
      control studies being performed as well as the proposed objectives of the
      hepatitis B vaccination program.

PMID- 7775877
TI  - Bacteriology of chronic secretory otitis media in children.
AB  - One hundred and four effusions from 66 children with CSOM were cultured for
      aerobic and anaerobic bacteria. Fifty percent of all effusions yielded bacterial
      growth and Gram negative organisms constituted 69.2% of those isolates. H.
      influenza was the most commonly isolated organism (36.5%) followed by B.
      catarrhalis and Str. pneumoniae. All B. catarrhalis, Staph. aureus and
      pseudomonas isolates were resistant to ampicillin while cefotaxime was active
      against all the isolated Gram positive and Gram negative bacteria. Considering B
      lactamase production, all the isolated Staph. aureus were BLPs while in case of
      Gram negative bacteria, not all the ampicillin resistant strains were BLPs.

PMID- 7775878
TI  - Study of workload of general medicine specialists working in the health insurance
      clinics.
AB  - This study was conducted at 4 of the H.I.O. polyclinics in Alex. with the
      objective of examining the change in visit rate per 1000 beneficiaries for
      general medicine specialty at H.I.O. clinics during a 4-year period (1985-1988)
      and to detect any trends that may have a bearing on the H.I.O. standards for
      supply of specialists. Data were collected from H.I.O. statistics department,
      H.I.O. regulations, and also through researcher's observation and specialists'
      interview. The collected data was used to describe the workload in terms of
      annual visit rate, actual number of working hours, the specialists' average
      production hours per day, the specialists' average idle time per day, the
      estimated number of required specialist working hours per day, and the
      specialists' recommended working hours per day. The results revealed a rising
      trend in the rate of use of general medicine specialist services and a definite
      shortage of supply of general medicine specialists was found in all clinics
      compared to H.I.O. standards. On the other hand, recommended supply based on
      specialist opinion was less than the H.I.O. standards but more than the current
      supply. Accordingly H.I.O. should re-estimate the specialist population standard
      and should seek the commitment of specialists to the revised standards.

PMID- 7775879
TI  - Effect of nickel sulfate alone and with ultraviolet light on micronuclei
      frequency in cultured human lymphocytes.
AB  - Comutagenic or cocarcinogenic activities have been reported between nickel
      compounds and UV light. The presence of micronuclei in a binucleated lymphocyte
      is regarded as an alternative to classical cytogenic methods for monitoring
      chromosomal damage. The present study aimed to detect this comutagenicity as
      regards micronuclei induction. Human peripheral lymphocytes were treated with
      different concentrations of nickel sulfate and/or with UV light at 200 and 1000
      ergs/mm2. Cells have been cultured and 100 binucleated cells were counted and the
      micronuclei frequency recorded. The observed values for all concentrations of
      nickel sulfate combined with UV were less than expected for an additive response
      of two agents computed as the combined increase over the values of the control
      for the metal and UV alone. Caution is advised when interpreting cytogenic values
      in multiple exposures.

PMID- 7775880
TI  - Assessment of knowledge, attitudes and practices of expectant mothers in relation
      to antenatal care in Assiut governorate.
AB  - This study aims to assess knowledge, attitudes and practices of expectant mothers
      in relation to ante-natal care in Assiut and to find out factors affecting their
      knowledge. Attitudes and practices. The present study was carried out in the ante
      natal clinic at Assiut General Hospital and three Maternal and Child Health
      Centers in Assiut. Fifty women were selected from each of the previously
      mentioned settings. A specially designed interview sheet was used to collect the
      necessary data. It was consisted of four parts. The first part included questions
      related to individual features of women, the second part included questions
      related to their family features, the third part concerned with previous
      obstetrical history of women and their acceptance of pregnancy and the fourth
      part included questions related to knowledge, attitudes and practices of
      expectant mother in relation to ante-natal care. The findings of the present
      study revealed that one quarter of the study sample (25.5%) lacked basic and
      essential knowledge about ante-natal care, most of older women (88.2%) were more
      likely to have poor knowledge in relation to ante-natal care, the higher educated
      women (66.7%) were more likely to have good knowledge about ante-natal care
      compared to 33.5% of lower educated women. It was also observed that the majority
      of working women (90%) were more likely to have good ante-natal care knowledge
      compared to housewives (10%). Most of the primigravida women (88.2%) were more
      likely to have poor knowledge in relation to ante-natal care compared to 11.8% of
      women whose gravidity was less than 5.

PMID- 7775881
TI  - Knowledge and practices of pregnant women in relation to the intake of drugs
      during pregnancy.
AB  - The present study was done to assess Knowledge and practices of expectant women
      regarding drug intake during pregnancy. To achieve this aim, a simple random
      sample of 400 pregnant women during their last trimester of pregnancy were
      selected. A specially designed interview schedule was developed and used to
      collect the necessary data about the study subjects. The interview schedule
      consisted of four main parts to cover the following: 1. General characteristics
      of the sample. 2. Obstetrical characteristics of the sample 3. Knowledge about
      drug intake during pregnancy. 4. Practices of the study subjects in relation to
      drug intake during pregnancy. 5. Factors affecting their knowledge regarding drug
      intake during pregnancy. The main findings of the study were: 1. In general, the
      study sample lacked the essential knowledge regarding drug intake during
      pregnancy especially in relation to the risk time for taking drugs in which
      nearly one-fifth of the sample (19.5%) did not know that it is risky to take
      drugs during pregnancy without doctor's order. 2. Regarding the practices of the
      study subjects in relation to drug intake during pregnancy, it was observed that
      the majority of the sample (86%) took drugs without prescription such as vitamins
      and general tonics, antacids, analgesics, anti-emetics, sedatives and antibiotics
      to treat their minor or major complaints during pregnancy. 3. In this study, it
      was also found that certain factors seemed to affect women's knowledge regarding
      drug intake during pregnancy. It was more obvious to observe that nearly two
      thirds (60.8%) of women whose age was less than 30 years were more likely to have
      inadequate and poor knowledge in this respect. It was observed that the majority
      (81.9%) of illiterate women were more likely to have inadequate and poor
      knowledge about drug intake during pregnancy. It was also found that nearly three
      quarters (72.3%) of housewives were more likely to have poor and inadequate
      knowledge. It was also noticed that the majority (81.5%) of the primigravidae
      women were more likely to have poor and inadequate knowledge. It was also noted
      that the majority of women (87.1%) who had previous abortions were more likely to
      have poor and inadequate knowledge.

PMID- 7775882
TI  - Phosphorus-nitrogen loading and trend of fish catch as index of lake Mariut
      eutrophication.
AB  - Lake Mariut was considered in the past to represent an important source of fish
      production in Alexandria especially during the periods which were characterized
      by low catch from its marine fisheries. The growing population in Alexandria and
      the expanding industries around the lake were accompanied with increased
      quantities of domestic and industrial wastes discharged annually into the lake
      proper. These quantities were increased from 192 million cubic meters in 1974 to
      about 300 million cubic meters in 1992. Consequently, the water quality in this
      basin was highly deteriorated and changed to become markedly eutrophic. High
      input of nutrients through sewage and industrial wastes has considerably
      increased the phosphorus and nitrogen load in the lake proper. Phosphorus and
      nitrogen loading in this basin were estimated in 1992 to be 60.2 gm/m3 P/y and
      79.8 gm/m3 N/y. According to the nutrient concept given by Vollenweider (1974),
      these two figures have provided an evidence that the lake proper was strongly
      changed from oligotrophic to polytrophic phase. The trend of its total fish catch
      as well as the trend of different fish categories catch during the period 1970
      1992 also confirms its eutrophication. This is in addition to bad changes that
      took place with respect to environmental conditions due to the continuous inflow
      of domestic and industrial wastes from different sources into this part of Mariut
      lake. Marginal increments of the lake proper total catch were decreased from
      20.6% in 1970 to -28.8% in 1992, while the marginal increments of Tilapia sp.,
      Clarias sp, Anguilla sp. and Mugil sp. were decreased from 21.4%, 14.3%, 29.8%,
      and 28.9% respectively in 1970 to -29.1%, -25.3%, -43.0%, and -36.8% in 1992.
      Based on these two indices of the lake proper eutrophication, the expected
      improvement of its environmental conditions will take several years after
      treating all inland discharges flowing into the lake and/or diverting all
      relevant outfalls away from this basin.

PMID- 7775884
TI  - A prospective study of postoperative fever--a clinical epidemiologic study.
AB  - During a 12 months period 693 patients undergoing surgical procedures were
      prospectively studied to investigate the etiology of postoperative fever. The
      overall rate of fever was similar for the three categories of surgical procedures
      studied. No cause of fever was found in 5%, 2.7% and 1.7% of patients who
      underwent clean, clean contaminated and contaminated surgical procedures.

PMID- 7775885
TI  - Measurement of non-specific antibodies in renal transplant patients and the
      incidence of certain postoperative viral infections.
AB  - In this study we assess the level and incidence of panel reactive antibodies
      which are the main cause of hyperacute rejection in renal transplant. The
      patients sera were tested against the lymphocytes of standard individuals. The
      lymphocyte panel had adequate representation of most of known antigens. 11 out of
      20 patients (55%) gave positive standard panel test utilizing the
      microlymphocytotoxic assay. The positivity was recorded at 20 degrees C
      suggesting that those patients were sensitized. When the recipient sera were
      treated with Dithiothreitol (DTT) 2 cases showed false cytotoxic antibodies as
      shown in the negative panel obtained after the DTT treatment. The other nine
      positive cases showed true cytotoxic by not reacting with DTT. 80% of active CMV
      infections occurred concomitantly to acute rejection episodes and/or its
      treatment, suggest a chronologic, possibly causal link between rejection and CMV
      infection.

PMID- 7775883
TI  - Epidemiological evaluation of oral polio vaccine efficacy in Cairo.
AB  - A case-control study was conducted between November 1992 and May, 1993 to assess
      the effectiveness of routine oral polio vaccine (OPV) immunization against
      paralytic poliomyelitis among children aged 1-5 years in Cairo city. Cases of
      paralytic poliomyelitis at Imbaba Institute of poliomyelitis and Ain-Shams
      Pediatric Hospital fulfilling the study criteria were obtained. The diagnosis of
      cases was based on clinical grounds. Age and sex-matched controls were recruited
      concurrently from patients admitted for reasons other than poliomyelitis. There
      were 55 cases of poliomyelitis. Vaccination status of cases and controls was
      ascertained by asking the mothers through interviewing using a questionnaire that
      had been developed for the purpose of the study. Vaccine efficacy (VE) was 86%
      (95% CI: 39-97%) and 92% (95% CI: 64-98%) for 3 and 4 doses of OPV respectively.
      For a vaccine like OPV with the potential of near 100% VE after 3 doses, the
      estimated level of protection (86%) is considered low especially when we realize
      the enormous efforts carried out by Ministry of Health and UNICEF in Egypt for
      upgrading the cold-chain. Higher figures of VE are supposed to be achieved if we
      are going to meet the challenge of poliomyelitis eradication by the year 1994.
      Potential biases in study design were also discussed.

PMID- 7775886
TI  - Study of behavioral pattern among preschoolers in Alexandria.
AB  - A cross sectional study was done on (178) preschooler selected in a cluster
      technique. Matthews Youth Test of Health was completed by teachers for
      measurement of (type A) behavior pattern. (BCL) was chosen to assess behavioral
      problems among preschoolers. (type A) children in the study constituted 43.82%
      and those having behavioral problems were 29.21%. Boys were significantly more of
      (type A) and had more behavioral problems than girls (X2 = 4.9012 and 6.1730
      respectively). Professional parents had children significantly more of (type A).
      Single children were significantly more of (type B). Children tended to be
      significantly more (type A) when their both parents were (type A).

PMID- 7775887
TI  - Influence of different means of washing and processing on removing of Actellic
      residue from spinach and eggplant and its in-vivo action on mice hepatic
      biochemical targets.
AB  - This study was carried out to investigate the effect of different washing
      solutions on the removal of Actellic residue from fresh and processed vegetables,
      namely; spinach and eggplant. Also, to identify the effect of Actellic residue on
      the health status of mice when fed these contaminated vegetables. The amount of
      insecticide residue detected using GLC indicated that, tap water, sodium
      hydroxide solution and potassium permanganate solution gave high percent removal.
      However, processing did not remove more than 45% except for grilling of eggplant
      which removed 88.17%. Meanwhile, changes in some hepatic biological parameters
      were well recognized in the groups of mice fed contaminated- unwashed either
      processed or unprocessed vegetables.

PMID- 7775888
TI  - A method for adjusting the international growth curves for local use in the
      assessment of nutritional status of Saudi pre-school children.
AB  - The aim of this study is to illustrate a method for adjusting the internationally
      used National Center for Health Statistics (NCHS) growth curves for local use in
      the assessment of nutritional status of Saudi children. All children 1-60 months
      in three semiurban-rural communities in Asir region, Saudi Arabia (N = 1168) were
      subjected to weight and height (or length) measurements. These measurements were
      individually compared with those of the NCHS reference population. The
      distribution of the study population was found to be significantly shifted to the
      left of the normal distribution for reference population on the percentile growth
      curves (P < 0.001). This denoted the inappropriateness of the NCHS reference
      standards for local use. Accordingly, the lower limits for the expected normal on
      the growth curves has been shifted from the 3rd percentile line to -3 standard
      deviation line, to be suitable for the Saudi children. This led to 70% & 56%
      reductions in the estimation of undernutrition, based on wt/age and ht/age
      indicators respectively. It is recommended that this adjustment be supported by
      other studies locally and in other developing countries.

PMID- 7775889
TI  - Hearing impairment: is it a public health problem among primary school pupils in
      Alexandria?
AB  - A hearing screening survey was conducted among the primary school students in
      Alexandria. It aimed at measuring the prevalence of hearing impairment among
      students and studying the predisposing factors of hearing problems. The schools
      of the middle educational region were selected to carry out the study. Hearing
      tests; audiometry and tympanometry, were used to screen 196 students from
      different types of schools (113, 55 and 28 students from governmental, language
      and private schools respectively). A questionnaire was introduced to a subsample
      of those students (n = 141) including some predisposing factors of hearing
      problems and answered by parents. The physical environment of schools was studied
      including noise level, ventilation and crowding. The obtained results showed that
      the prevalence of failed students in audiometry and tympanometry was 24.49 % and
      36.22 % respectively. Moreover, the prevalence of pupils who failed in both tests
      was 7.65 %. Boys were more likely to have hearing impairments than girls.
      Positive family history of deafness early in life and the continuous complaining
      of nasal obstruction were significantly related to hearing impairments among
      students. A very small percentage of parents (4.17 %) were aware of the presence
      of a hearing problem in their children. Furthermore, 48 % of failed students in
      audiometry were poor achievers in schools as stated by their teachers. The study
      of physical environment in schools revealed noise levels (inside and outside
      classes) above the acceptable but still within the permissible level. On the
      other hand, crowding at schools, as measured by the per capita space area, showed
      a significant association with the hearing problems in students. It is
      recommended to improve awareness of parents and teachers through health education
      programs. Screening questionnaire can develop an at risk concept for children, as
      the use of specialist otologists for screening is likely to be very expensive and
      they must be considered as first point of referral after screening.

PMID- 7775892
TI  - Prevalence of amblyopia among schoolboys in Abha city, Asir Region, Saudi Arabia.
AB  - The aim of this study is to estimate the prevalence of amblyopia among schoolboys
      in Abha City and to examine its relations with anisometropia and strabismus. A
      total of 971 male school children were selected randomly from the elementary
      schools for male in the city. Using the criterion of a visual acuity of 6/9 or
      worse, with no obvious structural disease of the eye, to define amblyopia, 18
      cases have been found to have the condition, with a prevalence of 1.85%. Those
      cases consisted of 7(47%) with anisometropic amblyopia and strabismus, and 2(13%)
      with deprivation amblyopia. Amblyopia showed a prevalence equal to 27% and 31%
      among children with anisometropia and those with strabismus respectively. An
      effective screening program for early detection of amblyopia through the well
      baby clinics is recommended.

PMID- 7775890
TI  - An audit of caesarean section among Saudi females in Jeddah, Saudi Arabia.
AB  - In this study the case records of 1414 patients who delivered at Alshaty hospital
      within one year were examined and some important variables related to caesarean
      section cases and their outcome were discussed. The caesarean section rate was
      found to be 9.9%. The high number of grand multigravida and primigravida among
      these Saudi mothers have contributed to this high caesarean section rate. The
      high emergencies in these sections (73.6%) have resulted in higher incidence of
      maternal and fetal morbidity namely postoperative pyrexia (37%), maternal anemia
      (20%) and extensive neonatal resuscitation (34%). The main indications of
      caesarean section in this hospital were repeated caesarean section (34.3%),
      failure of progress (19.3%) and fetal distress 12.9%. The relation and
      interaction between the three groups were thoroughly discussed based on the
      mechanisms of these indications. It is concluded that the changing trend of
      indications of caesarean section was mostly related to the change in departmental
      management rather than change in the characteristics of the patients.

PMID- 7775891
TI  - Study of the knowledge, attitude of Egyptian health care workers towards
      occupational HIV infection.
AB  - Acquired immuno-deficiency syndrome (AIDS) was reported for the first time in
      Egypt in 1986. Up to March 1993, 60 cases were notified to the Ministry of Health
      and 359 were detected to be infected with human immunodeficiency virus (HIV).
      Most cases had acquired infection abroad through blood, blood products or sexual
      contact. The number of cases is continuously increasing. Fear and ignorance about
      HIV infection causes panic among health care workers (HCWs) whenever a case is
      discovered and needs medical care. We assessed the knowledge and attitude of 346
      HCWs towards the probability of occupational HIV infection using a self
      administered questionnaire. The sample included physicians, surgeons, nurses,
      laboratory technicians and ambulance workers. 72.8% of HCWs believed that they
      are in "great" danger of acquiring AIDS through occupational exposure, whereas
      0.6% thought that there was no danger. 67% of HCWs had wrong ideas about
      transmission of HIV (toilet seats, droplet infection, touching patients). 83.5%
      mentioned that AIDS patients should be isolated in quarantine. The main source of
      information about AIDS was the television, radio and ordinary press. 44.8% got
      their information from textbooks or scientific literature. 95.4% felt the need
      for more information about infection and disease. The results show an urgent need
      to start a program of education of HCWs concerning the risk of occupational HIV
      infection and the measures of its prevention.

PMID- 7775893
TI  - The evaluation of an Arabic version of Rose questionnaire.
AB  - An Arabic version of Rose questionnaire was tested to establish its credibility
      as an epidemiological tool for screening purposes. The study showed that the
      criteria used in defining CHD determinants were still applicable today and in
      Arabic. The Arabic version maintained similar, if not better, sensitivity and
      specificity results than its original counterpart. The study pointed out,
      however, to several limitations that should be kept in mind during the
      interpretation of the questionnaire results.

PMID- 7775894
TI  - Anticardiolipin antibodies in rheumatoid arthritis.
AB  - The presence of anticardiolipin antibodies (aCL IgM & IgG), rheumatoid factor
      (RF) C-reactive protein (CRP) and antinuclear antibodies (ANA) were evaluated in
      26 patients with rheumatoid arthritis (RA) disease [12 patients with acute
      disease (gr 1), 14 patients with chronic disease (gr 2) and 10 normal subjects as
      control (gr 3)]. aCL IgM was significantly increased in gr 1 & gr 2 when compared
      with gr 3 (P < 0.001 & P < 0.010 respectively). aCL IgG was non significantly
      increased in gr 1 & gr 2 when compared with gr 3 (P < 0.076 & P < 0.022
      respectively). In group 1 75% of the patients were positive for a CLIgM, 25%
      positive for a CLIgG, 75% for RF, 58.3% for CRP, 25% positive for ANA Shaggy
      pattern and 33.3% positive for ANA speckled pattern. In group 2, the percent of
      positive cases were 42.85% for a CLIgM, 14.28% for a CLIgG, 42.8% for RF, 57.14%
      for CRP, 14.25% for ANA shaggy pattern and 28.57% for ANA speckled pattern. In
      the control group, all antibodies proved to be negative in every case. There was
      positive correlation between a CL IgM & aCLIgG and duration of disease in gr 1 &
      gr 2. There was positive correlation between a CLIgM and ESR in gr 1. There was
      negative correlation between a CLIgG and ESR in gr 1. There was negative
      correlation between a CLILgM & ESR in gr 2. There was positive correlation
      between a CLIgG & ESR in gr 2. We conclude that the presence of a CL antibodies
      (IgM & IgG) correlate well with the activity of disease, so this draw our
      attention to the importance of a CL antibodies as a parameter for prognosis of
      the disease.

PMID- 7775895
TI  - Referral system in the Asir Region, Saudi Arabia: knowledge, attitude, and
      practice of physicians working in urban areas--a comparative study of
      governmental and private health sectors.
AB  - A comparative study of knowledge, attitude and practice regarding referral system
      was undertaken among all governmental primary health care and private dispensary
      physicians (56 and 50 respectively) in Abha and Kamis, Asir Region. Results show
      that knowledge about referral is adequate in both groups, but the attitudes and
      practice of both groups need to be positively modified specially among the
      private sector physicians. The paper recommends more orientation programs for
      both groups of physicians and urges the private sector physicians to be more
      involved in Ministry of Health training programs and activities. Cooperation in
      referral between the private sector and government hospitals is seen as one way
      of improving health care in Saudi Arabia.

PMID- 7775896
TI  - Prevalence of antibodies to Toxoplasma gondii among blood donors in Abha, Asir
      Region, south-western Saudi Arabia.
AB  - One thousand samples of sera from healthy blood donors in the Asir Central
      Hospital, a tertiary facility in the Southwestern part of Saudi Arabia, were
      screened for Toxoplasma gondii IgG antibodies by the Indirect Haemagglutination
      Antibody (IHA) test. A prevalence of 52.1% was found. Seropositivity increased
      with age. The Geometric Mean Titre (GMT) of IHA antibodies was 596.7. While the
      prevalence increased with age, the GMT declined in the higher age groups. Three
      hundred sixty six of these sera were also tested for specific IgM titres by micro
      ELISA technique and 4.1% were found positive, indicating possible acute or recent
      infection. These serological studies indicate a higher prevalence of
      toxoplasmosis among healthy blood donors in the Asir region compared to earlier
      seroprevalence studies in other areas of Saudi Arabia. The high frequency in
      antibody titres might be due to differences in climatic conditions, culinary
      habits and exposure to the sources of infection. In view of these findings, it is
      felt that when considering blood transfusion for a special group of patients
      (i.e. immunocompromised or immunosuppressed), it would be wise to exclude those
      with evidence of previous exposure to T. gondii.

PMID- 7775897
TI  - Study of referral process between general practitioners and specialists in health
      insurance clinics in Alexandria.
AB  - The present study was designed to investigate the reasons for which patients are
      referred by G.Ps to G.M. specialists, and to assess the extent to which referred
      cases need specialist care. The study sample included specialists of general
      medicine working at 4 of the H.I.O. polyclinics and all G.Ps who referred cases
      that were considered as inappropriate referrals by the study specialists, as well
      as 20% of Patients referred to G.M. specialists by G.Ps. were systematically
      randomly selected during a period of 10 consecutive days. The results indicated
      that the rate of inappropriate referral to G.M. specialists was high, the rate of
      discrepancy between G.P. and specialist diagnoses was generally high, there was a
      high discrepancy between G.Ps and specialists regarding the reason for
      inappropriate referral, and there was poor communication from the lower (G.P.) to
      the higher (specialists) levels in the referral process. Reasons for referral to
      specialists were not recorded by G.Ps in 100% of cases. To overcome these
      problems H.I.O. should place special emphasis on the professional training and
      continuing education of G.Ps, with special attention to the few common conditions
      that were responsible for the greater proportion of referral problems. At the
      same time, H.I.O. should strengthen the technical and administrative control over
      G.P. referral behavior.

PMID- 7775898
TI  - Alternative therapies.

PMID- 7775899
TI  - Screening flexible sigmoidoscopy and insurance reimbursement.

PMID- 7775900
TI  - Nebulized saline and bronchitis.

PMID- 7775901
TI  - Specialty choice by medical students.

PMID- 7775902
TI  - Revolution in the American medical system.

PMID- 7775903
TI  - Promotes diazepam as safe, effective.

PMID- 7775906
TI  - More medical malapropisms.

PMID- 7775905
TI  - Drug interaction induces hypoglycemia.

PMID- 7775904
TI  - Semen responsible for fishy vaginal odor.

PMID- 7775907
TI  - The complete annual physical examination refuses to die.

PMID- 7775908
TI  - Periodic health evaluation of adults: a survey of family physicians.
AB  - BACKGROUND: The routine periodic health evaluation (PHE) is a popular format in
      primary care practice for the delivery of clinical preventive services to adults,
      but knowledge of the current pattern of use and of the content of the PHE is
      limited. METHODS: We surveyed a random sample of 567 family physicians (response
      rate, 60.1%) in New England regarding their approach to and attitudes about the
      PHE of adults. RESULTS: Family physicians reported spending a mean of 35.2% (11.6
      hours per week) of their total ambulatory care time on adult PHEs, which were
      usually scheduled for 20 to 30 minutes each. All respondents recommended a PHE to
      men > or = 50 years old and to women > or = 40 years old, and more than 90%
      recommended a PHE to younger patients. Most physicians (80.7%) reported that the
      PHE is their primary mechanism for delivering preventive services, and 90.6%
      believed that the PHE should include a comprehensive physical examination. The
      mean number of physical examination items performed during the PHE was 11.6 to
      13.9, depending on patient age and sex. As part of the PHE, most physicians
      (71.6% to 90.7%, depending on patient age and sex) ordered one or more screening
      laboratory tests not recommended by the US Preventive Services Task Force.
      Utilization of fewer laboratory tests was associated with residency training,
      employment in a health maintenance organization (HMO), and limited concern about
      malpractice suits. CONCLUSIONS: Family physicians reported spending a substantial
      amount of time on the PHE of adults, performing extensive screening physical
      examinations and many screening laboratory tests of unknown effectiveness. Among
      family physicians, there is considerable unexplained variation in the form and
      content of the PHE.

PMID- 7775909
TI  - Including smoking status as a new vital sign: it works!
AB  - BACKGROUND: Despite the adverse health consequences of smoking, many physicians
      still neglect to counsel smokers to quit. This study evaluated the effect of
      including smoking status as a vital sign on the frequency of physician
      discussions with patients about smoking and physician advice to quit smoking.
      METHODS: A consecutive sample of adult ambulatory patients in our metropolitan
      family practice residency program completed exit surveys on physician and nurse
      counseling about smoking. Control group data were collected for 1 month before
      the change was made to include smoking status as a vital sign on patient charts.
      Charts were then marked with a stamp as a chart prompt in the vital signs
      section. Data were collected for 2 months after smoking status was added to the
      stamp. RESULTS: There were 637 individuals surveyed, of whom 179 were current
      smokers; 95 in the "prestamp" group and 84 in the "poststamp" group. The
      percentage of patient-physician encounters during which smoking was discussed
      increased from 47% to 86% (P < .001). Physician advice to quit increased from 50%
      to 80% (P < .001). Physician discussion of smoking with patients increased across
      all of the five stages of change but most dramatically (53% to 95%) in the
      "preparation" stage. Physicians were much less likely to counsel patients in the
      "precontemplation" stage to quit smoking. CONCLUSIONS: Including smoking as a new
      vital sign significantly increased the likelihood of smoking-related discussions
      between patients and their physicians. The stamp is inexpensive and easy to use,
      and because it is a one-time office system change, it is more likely to be
      implemented and maintained in busy practices.

PMID- 7775910
TI  - Counseling patients for smoking cessation.

PMID- 7775911
TI  - Effect of race on survival following in-hospital cardiopulmonary resuscitation.
AB  - BACKGROUND: Race has been shown to be a significant predictive factor in a number
      of treatment decisions and outcomes, including survival following out-of-hospital
      cardiopulmonary resuscitation (CPR). The goal of this study was to determine
      whether race is associated with the rate of survival to discharge following in
      hospital CPR. METHODS: Consecutive adult patients undergoing attempted CPR at
      three teaching hospitals were identified. Demographic, clinical, and laboratory
      data from the time of admission, information about the resuscitation attempt, and
      the outcome of CPR were recorded for each patient. The characteristics of black
      and non-black patients were compared. Logistic regression was used to determine
      whether race was a significant independent predictor of CPR outcome. RESULTS: A
      total of 656 patients were identified. Black patients had a higher mean severity
      of illness as measured by the Acute Physiology and Chronic Health Evaluation
      (APACHE) III score, were more likely to have an initial rhythm of
      electromechanical dissociation or asystole, were less likely to have an admitting
      diagnosis of myocardial infarction or a history of coronary artery disease, and
      had a higher serum creatinine level, lower serum albumin value, and lower 24-hour
      urine output for the first 24 hours. There was no difference between black and
      nonblack patients regarding the rate of survival of the resuscitative effort
      itself. However, black patients were significantly less likely than nonblack
      patients to survive to discharge following resuscitation (Mantel-Haenszel odds
      ratio, 0.31; 95% confidence interval, 0.15 to 0.68). This relationship persisted
      after adjusting for potential confounders such as age, sex, initial cardiac
      rhythm, diagnosis of pneumonia, serum creatinine level, hospital, and APACHE III
      score. CONCLUSIONS: Black race is significantly associated with a lower rate of
      survival to discharge following in-hospital CPR. Further work is needed to
      explore this association in other settings; to examine the effect of other
      possible confounding variables, such as tobacco use, socioeconomic status, and
      marital status; and to further study the determinants of physician decision
      making about resuscitation.

PMID- 7775913
TI  - Laparoscopic general surgery: state of the art.
AB  - The rapid acceptance of laparoscopic cholecystectomy into surgical practice has
      been followed by the extension of laparoscopic treatment to many other surgical
      problems. While the role of laparoscopic surgery for some conditions is now well
      established, its applicability in other situations requires further evaluation.
      This review summarizes our current understanding of the laparoscopic management
      of common surgical disorders involving the gallbladder and bile ducts, groin
      hernias, appendix, colon, stomach, and esophagus.

PMID- 7775914
TI  - A case report of disseminated blastomycosis and adult respiratory distress
      syndrome.
AB  - Blastomycosis is a fungal disease endemic to the midwestern and southeastern
      United States. This is a case report of a 29-year-old woman who presented with
      weight loss, fever, fatigue, and pneumonia. She developed disseminated
      blastomycosis, adult respiratory distress syndrome (ARDS), and ulcerative skin
      lesions, requiring mechanical ventilation, amphotericin B, and multiple
      surgeries. Blastomycosis is endemic to a large portion of the United States.
      Family physicians should consider fungal infection in the differential diagnosis
      of an unresolving pneumonia.

PMID- 7775912
TI  - Effect of terbutaline tocolysis on infant birthweight.
AB  - BACKGROUND: Previous research has suggested that terbutaline sulfate increases
      serum glucose in pregnant women. Increases in serum glucose in women who have
      gestational diabetes mellitus often lead to the birth of larger infants. This
      study examines the effect on infant birthweight of terbutaline used as a
      tocolytic agent in otherwise normal term pregnancies. METHODS: An historical
      cohort study was conducted of all births in a 12-month period at a US Army
      community hospital. There were 1376 deliveries of all types; 481 of the patients
      were excluded for variables that influence gestational duration or fetal weight,
      and 5 patients' records were lost. Birthweights relative to gestational age were
      compared. RESULTS: The two groups (women who were treated with terbutaline, n =
      94; control group, n = 796) differed with respect to age (terbutaline group, 1.6
      years younger, P = .002); pregravid weight (terbutaline group, 10.3 lb lighter, P
      < .001); and total weight gain (terbutaline group, 3.2 lb less, P = .001). The
      groups were comparable in all other variables studied (P > .05). Women receiving
      terbutaline therapy (average length of therapy, 4.7 weeks) gave birth an average
      of 1 week earlier than those not treated with terbutaline (39.09 weeks and 40.09
      weeks, respectively, P < .001). The mean absolute birthweight of infants exposed
      to terbutaline in utero was less than that of infants from the control group (P <
      .001), but this difference (191.6 g) can be accounted for by the difference in
      average gestational age between the terbutaline group and the control group.
      There was no difference in birthweight (P > .05) when birthweight relative to
      gestational age was compared between the two groups. CONCLUSIONS: Women in this
      study who were treated with terbutaline did not give birth to larger infants. The
      previously noted hyperglycemia in women receiving terbutaline may not have been
      present in this study population or may not have been significant enough to
      affect birthweight.

PMID- 7775915
TI  - Urinalysis to diagnose UTI.

PMID- 7775916
TI  - Efficacy of screening mammography.

PMID- 7775917
TI  - Use of the periodic health evaluation by family physicians.

PMID- 7775918
TI  - A feel for the water.

PMID- 7775919
TI  - Competing in the managed care milieu.

PMID- 7775920
TI  - Above the law.

PMID- 7775921
TI  - The medical examiner. When to report and help with death certificates.
AB  - Medical examiners perform autopsies on victims of criminal violence and such
      deaths must be reported to the medical examiner. Because few medical personnel
      are cognizant of the full extent of the types of deaths which must be reported
      and of the substantial noncriminal aspects of medical examiner services, this
      description of the Florida Medical Examiner System emphasizes these areas and
      deaths due to late sequelae of violence. Proper death certification is one aspect
      of medical practice in which most physicians receive absolutely no training;
      therefore the essential elements are briefly outlined.

PMID- 7775922
TI  - Rupture of symphysis pubis caused by forceful and excessive abduction of the
      thighs with labor epidural anesthesia.
AB  - Only a few cases of rupture of the symphysis pubis have been reported but the
      condition could become more frequent with epidural anesthesia. Conservative
      management is emphasized. Rupture is caused by desensitization to the labor
      process due to epidural anesthesia and excessive abduction of the thighs to
      increase anterior-posterior diameter during the birth process. Greater use of
      labor epidural anesthesia could increase the frequency of this event.

PMID- 7775923
TI  - Physician issues and Florida health care reform.
AB  - Data are presented from a mail survey of Florida physicians one year after
      passage of the Florida Health Care Insurance and Reform Act. Respondents rated
      the importance of various issues and reported their perceptions of physician
      input, knowledge and support for health-care reform legislation. Issues
      considered important included tort reform, physician autonomy, consumer choice of
      providers, and freedom from insurance hassles along with reduced paperwork.
      Ratings were low for input and health-care reform support. Issues of importance
      to physicians were not addressed by previous legislation; therefore, they must
      take the lead in focusing new legislation in conjunction with their professional
      organizations.

PMID- 7775924
TI  - Cyber documentation.

PMID- 7775925
TI  - Power of negative thinking.

PMID- 7775926
TI  - Resisting the reality of the HIV/AIDS epidemic.

PMID- 7775927
TI  - The FMA's on-line system.

PMID- 7775928
TI  - Differentiation of vaccine and wild mumps viruses by polymerase chain reaction
      and nucleotide sequencing of the SH gene: brief report.
AB  - The nucleotide sequences of the SH gene and its F gene flanking region were
      determined over a range of 322 nucleotides for two live vaccines, two vaccine
      associated isolates, six wild mumps viruses, and an attenuated mumps virus and
      compared to other sequences already published. Comparison revealed that the
      vaccine strains were clearly different from each other and the postvaccination
      isolates were different from the vaccines used. The viruses were assigned to
      three known cocirculating viral lineages. The attenuated mumps virus possesses
      nucleotide sequences identical to those of its progenitor strain.

PMID- 7775929
TI  - Adenovirus genome types isolated from stools of children with gastroenteritis in
      Sao Paulo, Brazil.
AB  - In a prospective one-year study of acute gastroenteritis in hospitalized children
      less than 2 years of age, in Sao Paulo (Brazil), adenoviruses were detected by
      specific enzyme immunoassay (El-ARA) in 7 of 67 (10%) ill children and in 9 of 79
      (11.4%) controls. They were the sole recognizable agent of diarrhea in 6 ill
      children. In another child these viruses were detected in a dual infection with
      astrovirus. Enteric adenoviruses (Ad40/41) were the most common serotypes
      detected in children with diarrhea (3/7) and Ad7 the serotype most detected in
      the controls (5/9), associated with lower respiratory tract infection. Thirteen
      adenovirus strains, isolated in HEp2 or HEK-293 cells, were characterized by
      seroneutralization and restriction enzyme analysis. The established adenoviruses
      were typed as AV-7-D5 (five associated to lower respiratory tract infection and
      one to diarrhea), AV-1-D10 (one diarrhea case), AV-31-D2 (two controls with
      respiratory infection), and two isolates as AV-12-D7, a new genome type. One
      subgenus D isolate, serotype 28, with restriction patterns different from those
      of the prototype, remained untyped. Only one enteric adenovirus could be typed.
      The restriction patterns of this isolated were similar to those of the prototype
      AV-41-D1. The genome type of the other three enteric adenoviruses could not be
      determined.

PMID- 7775930
TI  - Detection and characterisation of bisegmented double-stranded RNA viruses
      (picobirnaviruses) in human faecal specimens.
AB  - The prevalence of picobirnaviruses (PBVs) in human stools was investigated by
      polyacrylamide gel electrophoresis (PAGE) analysis of 832 faecal specimens
      collected between 1982 and 1993 from patients in various clinical groups. Similar
      prevalences (9-13%) were detected in patients with or without gastroenteritis and
      throughout the age range of 3 to > 65 years. Two methods for the extraction of
      nucleic acid, a phenol/chloroform method and a guanidinium thiocynate
      (GTC)/silica method, were compared. Detection of PBVs by PAGE was three times
      more sensitive following RNA extraction by the GTC/silica method.
      Characterisation of three strains was carried out. Segment sizes ranged from
      1.625 to 1.95 kilo base pairs (Kbp) and 2.2 to 2.5 Kbp for the fast and slow
      migrating bands, respectively. The nuclic acid was shown to be double-stranded
      RNA (dsRNA) by nuclease digestion. PBV-like particles were detected by electron
      microscopy in two PAGE-positive stools. Virion diameters ranged from 35 to 41 nm
      and a buoyant density of 1.38-1.4 g/ml in caesium chloride (CsCl) was
      demonstrated. These findings suggest that PBVs are widespread in humans in the
      United Kingdom. However, no disease association could be demonstrated.

PMID- 7775931
TI  - Hepatitis C virus RNA in plasma and blood mononuclear cells in patients with
      chronic hepatitis C treated with alpha-interferon.
AB  - Hepatitis C virus (HCV), a positive stranded RNA virus, is the main causative
      agent of post-transfusion and sporadic non-A non-B hepatitis worldwide. Paired
      samples of plasma and peripheral blood mononuclear cells (PBMC) from 11 patients
      with chronic hepatitis C treated with alpha-interferon (IFN) were tested, using a
      single step polymerase chain reaction (PCR), for the presence of HCV RNA. Before
      treatment, the viral genome was detected in all the plasma samples and 81.8% of
      PBMC. After 3 months of treatment, HCV RNA was still present in 63.6% of plasma
      samples but in only 27.3% of PBMC. A good correlation was observed between serum
      alanine aminotransferase level normalisation and disappearance of the viral
      genome in plasma. Among the six responder patients, five relapsed shortly after
      IFN withdrawal; HCV RNA became detectable again, especially in PBMC. These
      results show the presence of HCV in PBMC from most patients infected chronically.
      IFN therapy had an inhibitory effect on viral replication in lymphoid cells, but
      frequent relapses observed after cessation of treatment with IFN suggested
      persistence of HCV in these cells.

PMID- 7775932
TI  - Comparison of the kinetics of Puumala virus specific IgM and IgG antibody
      responses in nephropathia epidemica as measured by a recombinant antigen-based
      enzyme-linked immunosorbent assay and an immunofluorescence test.
AB  - Immunoglobulin M and G (IgM and IgG) responses were followed up to 6 months in
      patients with nephropathia epidemica (NE) by an enzyme-linked immunosorbent assay
      (ELISA) using a recombinant Puumala virus (PUU) nucleocapsid protein as antigen
      and an immunofluorescence test (IF) using PUU infected, acetone-treated cells as
      antigen. The recombinant protein was produced by cloning and expressing the
      nucleocapsid encoding gene of PUU as a polyhistidine fusion protein in
      Escherichia coli. The product was purified over a metal chelating ion affinity
      column. On admission, all 17 patients had an IgM response by both methods. The
      IgM titers decreased significantly by both methods 3 months after onset (ELISA P
      < 0.05 and IF P < 0.05). Four of six still had detectable IgM, however at low
      levels, after 6 months. Presence of specific IgG differed significantly on
      admission between the two methods: by ELISA 8 of 17 had detectable specific IgG,
      whereas by IF 15 of 17 had specific IgG (P < 0.02). There were 10 significant
      titer rises between acute and convalescent serum samples in the same patients by
      both methods. It is concluded that the IgG antibody response differs in the early
      phase of NE as measured by a method using a recombinant PUU nucleocapsid protein
      and a method using PUU infected acetone-treated cells as antigens. Furthermore,
      the results suggest that it is of importance to rely on specific IgM for
      serodiagnosis of NE during the acute phase.

PMID- 7775933
TI  - Single-step nested polymerase chain reaction for detection of different genotypes
      of hepatitis C virus.
AB  - Hepatitis C virus (HCV) exhibits considerable sequence variability and circulates
      in the blood at extremely low levels. Current methods for detecting HCV RNA are
      based mostly on nested polymerase chain reaction (PCR), in which part of the
      first amplification product is reamplified in the second tube by an internal
      primer pair. A novel nested PCR method was developed in which the two successive
      amplification processes are carried out in the same tube with a single step of
      physical manipulation. Careful selection of highly conserved sequences of the 5'
      noncoding region as primers enabled successful detection of all three major
      genotypes circulating in France, including the one with variation in this region.
      Retaining high sensitivity of the conventional nested PCR, the novel method
      reduced greatly the risk of carry-over contaminations. It was also cost- and time
      saving. The one-step nested PCR method is especially suitable for routine
      diagnosis of HCV infection in clinical laboratories.

PMID- 7775934
TI  - Detection of enterovirus-specific RNA in serum: the relationship to chronic
      fatigue.
AB  - The serum of 88 chronic fatigue patients was screened for enteroviral specific
      sequences by polymerase chain reaction (PCR) assay. The PCR method used was
      "nested" PCR targetting the 5' nontranslated region of the enteroviral genome
      which yielded a final fragment length of 264 base pairs. Samples were obtained
      from patients during 1990-1991. In addition, buffy coat specimens and stool
      specimens were examined in some patients. Samples from two cohorts of comparison
      individuals were also obtained. The comparison groups were firstly, acutely ill
      individuals with symptoms consistent with a presumed enteroviral infection
      (matched by age, sex, and date of receipt of specimen) and secondly, healthy
      individuals (matched by age and date of receipt of specimen). Enteroviral
      specific sequences were detected in 36 of 88 serum samples from chronic fatigue
      patients, 22 of 82 acutely ill individuals, and 3 of 126 healthy individuals. The
      enteroviral PCR positivity did not correlate with any one particular feature of
      chronic fatigue nor did it reflect any history of illness at onset of fatigue,
      duration of fatigue, or age of patient. These results provide new evidence for
      the presence of enteroviral specific sequences in serum, buffy coat, and stool
      samples in many patients with chronic fatigue. This may reflect a persistent
      enterovirus infection in a proportion of chronic fatigue patients.

PMID- 7775935
TI  - Seroprevalence of hepatitis C virus infection and its genotype in Lanzhou,
      western China.
AB  - The seroprevalence of hepatitis C virus (HCV) infection in Lanzhou, Western China
      was studied. HCV genotypes in 20 patients with HCV infection was determined by
      genotype-specific primer for polymerase chain reaction (PCR) based on HCV core
      region and compared with the genotype assigned by sequence comparison and
      molecular evolutionary analysis based on the same region. Antibody to HCV (anti
      HCV) was present in 2.5% of volunteer blood donors and in 35.0% of paid blood
      donors (P < 0.01). HCV infection is uncommon in patients with liver disease who
      attended liver clinics in this locality; 4.0% with acute hepatitis and 4.0% with
      chronic hepatitis, 10.0% with liver cirrhosis, and none with hepatocellular
      carcinoma were seropositive for anti-HCV. Genotype 1b and 2a were both found to
      be prevalent. Together, they accounted for 19 of 20 (95%) patients with HCV
      infection. Sequencing of the HCV core region from two patients showed that the
      assignment of HCV genotype by genotype-specific primers for PCR matched well with
      the genotyping results based on sequence comparison and molecular evolutionary
      analysis. These data showed that HCV is present in Western China, HCV infection
      is more common in paid blood donors, and HCV genotypes 1b and 2a are both
      prevalent in Western China.

PMID- 7775936
TI  - Cytomegalovirus infection and viral shedding in the genital tract of infertile
      couples.
AB  - The prevalence of cytomegalovirus (CMV) infection and viral shedding in infertile
      couples in Taiwan and its role in infertility were studied. Two hundred fifty
      couples were enrolled in this study. Anti-CMV IgG was measured in serum samples
      from these infertile couples. Viral shedding examined by DNA hybridization was
      detected in semen from the husband and cervical mucus from the wife. Anti-CMV IgG
      was detected in 249 (99.6%) of the 250 male serum samples and in 247 (98.9%) of
      the 250 female serum samples. Viral shedding was detectable in 83 (33.5%) of 248
      semen samples and 83 (33.7%) of 246 cervical mucus samples by dot-blot DNA
      hybridization assay. Semen quality was not apparently affected by the existence
      of viral shedding. The co-shedding rate in semen and cervical mucus was high
      (15.9%). It is concluded that the seroprevalence and genital tract viral shedding
      were relatively high in infertile couples in Taiwan. Viral shedding did not
      affect the semen quality. Nevertheless, screening of donor semen is recommended.

PMID- 7775937
TI  - Geographic sequence variation of latent membrane protein 1 gene of Epstein-Barr
      virus in Hodgkin's lymphomas.
AB  - To assess the role of the Epstein-Barr virus (EBV) latent membrane protein 1
      (LMP1) gene in the development of Hodgkin's lymphoma (HL), the polymorphism of
      this gene in EBV isolates from different geographic locations was analyzed. A 497
      bp fragment spanning LMP1 gene exons 1 and 2 was amplified by polymerase chain
      reaction (PCR), using a primer pair bracketing a Xhol restriction site. PCR
      products were subjected to Xhol digestion and to DNA sequencing analysis. Twenty
      five HL biopsy specimens from the United States and five HL and four non
      Hodgkin's lymphoma (NHL) biopsy specimens from Italy were examined. Eighty
      percent of LMP1-positive samples (12 of 15) from the United States maintained the
      Xhol restriction site and the remaining 20% partially lost the Xhol site. One of
      four EBV-positive HL and one of the three EBV-positive NHL specimens from Italy
      lost the restriction site. The other three EBV-positive HL DNAs were partially
      cut by Xhol. Direct DNA sequencing analysis revealed that those Italian samples
      not digested by Xhol were due to a G to C transversion at the first base of codon
      18, resulting in the change of glycine to arginine. Those DNA samples partially
      cut by Xhol were due to a mixture of G/C at the same location. In contrast, those
      partially digested American HL DNAs had a mixture of G/T at the second base of
      codon 17.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775938
TI  - Renal failure due to BK virus infection in an immunodeficient child.
AB  - We report a child with cartilage-hair hypoplasia and Hodgkin's disease who
      developed progressive renal failure and died following infection with a
      polyomavirus, BK virus. Renal biopsy showed interstitial inflammation, tubular
      atrophy, and intranuclear inclusions in tubular epithelium, with large numbers of
      papovavirus particles within the cells. BK virus infection was confirmed by
      polymerase chain reaction on renal biopsy material and in urine and the
      demonstration of a high titre of haemagglutination inhibition (HI) and IgM
      antibody to the virus in the patient's serum. This case emphasises the need to
      study in depth any unusual clinical manifestation in immunocompromised patients
      to delineate better the full clinical impact of less well-established pathogens
      such as BK virus.

PMID- 7775939
TI  - Polymerase chain reaction detection of small round-structured viruses from two
      related hospital outbreaks of gastroenteritis using inosine-containing primers.
AB  - Two outbreaks of gastroenteritis in the UK which occurred nine days apart at
      Lymington and Southampton hospitals were investigated. The clinical and
      epidemiological features of both outbreaks were characteristic of small round
      structured virus (SRSV) infection with rapid onset of diarrhoea and/or nausea and
      vomiting and propagation of the outbreaks by secondary spread. SRSV particles
      were observed by immune electron microscopy (EM) in 60% of faecal samples from
      both outbreaks and no other pathogens were detected. The index case for the
      second outbreak was a patient who was admitted with diarrhoea and vomiting after
      being discharged from Lymington hospital during the first outbreak. The
      possibility that the two outbreaks were caused by the same strain of SRSV was
      investigated by the polymerase chain reaction (PCR). New inosine-containing PCR
      primers were designed to amplify the RNA polymerase region of SRSV cDNA from
      genetic groups I and II. The PCR using the group II primers achieved a higher
      detection rate for SRSVs in faecal samples (68% of samples positive from both
      outbreaks) than immune EM. SRSVs were not detected using the group I primers or
      using conventional degenerate PCR primers. The nucleotide sequences of PCR
      amplicons from both outbreaks were identical providing molecular epidemiological
      evidence for the involvement of a single SRSV strain. Comparison of the RNA
      polymerase region of this virus with the equivalent regions of genetic group I
      (69.4-75.0% amino acid identify) and genetic group II (88.9-100% amino acid and
      77.1-88.1% nucleotide identity) SRSVs revealed that the causative SRSV was a
      distinct member of genetic group II.

PMID- 7775941
TI  - Hepatitis C virus genotypes in Belgian hemophiliacs.
AB  - Hemophiliacs who have been exposed to unheated and/or dry heated pooled clotting
      factor concentrates are at a high risk of chronic hepatitis C. Serum HCV-RNA was
      measured by reverse transcriptase-polymerase chain reaction (RT-PCR) technique in
      58 hemophiliacs positive for anti-HCV antibodies, HCV-RNA was detected in 55
      patients. Based on the results of PCR positivity, HCV genotyping was carried out
      using genotype specific probes and the dot blot hybridization assay: 2 patients
      were found to be infected with type 1a (3.6%), 31 patients with type 1b (56.4%),
      8 patients with type 2 (14.6%), 6 patients with type 3 (10.9%), 1 patient with
      type 4, and 7 patients with double infection (12.7%). As compared to a control
      group of 105 nonhemophilia patients with chronic hepatitis C, HCV genotype 1b was
      found predominant in both groups. However, double infection with two HCV types as
      well as a relatively high prevalence of infection with type 2 and type 3 were
      found in hemophiliacs.

PMID- 7775940
TI  - Prognostic value of adenosine deaminase compared to other markers for progression
      to acquired immunodeficiency syndrome among intravenous drug users.
AB  - This study was designed to determine the prognostic value of erythrocyte
      adenosine deaminase (ADA) as a possible indicator of progression to AIDS, and
      compare this with other known cellular and serological markers. At the end of a 3
      year study, a cohort of 114 human immunodeficiency virus-1 (HIV-1) seropositive
      intravenous drug users (IVDUs) from the five different Center for Disease Control
      (CDC) groups was examined in order to estimate the prognostic relevance with
      respect to the progression to acquired immunodeficiency syndrome (AIDS) of each
      of the following markers at baseline value: number and percentage of CD4+ T
      cells, number of CD8+ T cells, CD4+/CD8+ ratio, IgA and beta 2 microglobulin and
      ADA levels, and the presence of HIV antigens. Moreover, 57 IVDUs belonging to II
      and III CDC groups were analyzed in a follow-up study at 6-month intervals, in
      order to evaluate and compare the behavior of each marker over time. The
      prognostic significance of each marker was assessed by computing the survival
      distribution and the Cox analysis in a multivariate model providing the set of
      markers with greatest predictive value. The levels of ADA and the CD4+/CD8+ ratio
      showed a linear association with disease staging, whereas beta 2 microglobulin
      and CD4+/CD8+ ratio were the best predictors for AIDS progression. A highly
      significant increase in ADA and beta 2 microglobulin was observed during follow
      up. The results obtained among HIV-positive IVDUs clearly indicate that the
      erythrocyte ADA may be considered a reliable marker of the development of HIV
      infection from the intermediate stages of the disease onwards.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7775943
TI  - Detection of hepatitis C virus RNA in the cell fraction of saliva before and
      after oral surgery.
AB  - The presence of hepatitis C virus (HCV) RNA in serum, whole saliva, and saliva
      from the submaxillary glands was investigated before and after oral surgery. The
      presence of HCV RNA (positive and negative-strand RNA) was determined in serum
      and saliva by a nested polymerase chain reaction in 26 anti-HCV positive
      patients, of whom 11 were coinfected with human immunodeficiency virus-1. Oral
      surgery was carried out on five occasions on four of the patients. HCV RNA was
      detected in the sera of 23 of 26 (88%) patients, and in the saliva of 4 of the 23
      (17%) of the viremic patients. In all four cases, HCV RNA was detected only in
      the cell fraction derived from centrifugation of whole saliva. Negative-stranded
      HCV RNA was not detected. At one of five occasions of oral surgery, HCV RNA was
      detected in saliva sampled immediately after surgery, but not before or 24 hours
      after surgery. The results suggest that HCV is present in saliva in less than 25%
      of HCV viremic persons. The presence of the virus in saliva is restricted to the
      cell fraction. Thus, saliva may serve as a possible, but low, nonparenteral
      transmission route of HCV. Contamination of saliva by blood during and after oral
      surgery may result in an increased risk of viral exposure. Except for trauma
      caused by sharp instruments during surgery, this might contribute to the higher
      HCV seropositivity found among dentists.

PMID- 7775942
TI  - Molecular characterization of a human calicivirus with sequence relationships
      closer to animal caliciviruses than other known human caliciviruses.
AB  - cDNA clones were produced from a morphologically typical human calicivirus (HuCV)
      in stool specimens collected in 1982 during an outbreak of gastroenteritis in
      Sapporo, Japan. The cDNA clones were generated separately in two laboratories by
      reverse transcriptase-polymerase chain reaction (RT-PCR) using primers 35 and 36
      derived from Norwalk virus. The RT-PCR product from six specimens was of the
      predicted size, had a continuous protein encoding frame on the positive strand,
      and contained GLPS and YGDD amino acid motifs at the predicted distance from the
      primers. RT-PCR amplification with primer 35 and a HuCV/Sapporo-specific primer
      36 of four HuCV/Sapporo-positive stool specimens from a 1986 Houston day care
      center outbreak yielded products with 93% nucleotide and 99% predicted amino acid
      sequence identity with the HuCV/Sapporo strain from the 1982 outbreak. The
      HuCV/Sapporo strains are genetically distinct from previously characterized HuCVs
      and more closely related to known animal CVs than other known HuCVs.

PMID- 7775944
TI  - Measles antibodies in women and infants in the vaccine era.
AB  - The present investigation was done to determine whether measles enzyme immune
      assay (EIA) absorbency values were lower in women born in the vaccine era after
      1963 and their infants in an upstate New York metropolitan area, an area of low
      measles incidence during the past 10 years compared with women born before the
      measles vaccine era who had natural measles. Aliquots of 202 sera from mother
      infant pairs collected for other purposes from November 1990 to June 1991 at
      Albany Medical Center Hospital were tested by EIA. The demographic data available
      for analysis were maternal age and infant gestational age. Measles mean
      absorbency values were analyzed according to maternal age. Of 202 mother-infant
      pairs, 30% of mothers and 17% of their infants were seronegative (EIA < 0.16).
      Mothers born before 1963 and their infants had significantly higher mean EIA
      absorbency values than mothers born after 1963 and their infants (P < 0.002). The
      percent seropositive for measles antibodies by EIA for mothers born before 1963
      and their infants, 87% and 94%, respectively, was significantly higher than the
      percent seropositive for mothers born after 1963 and their infants, 61% and 69%,
      respectively (P = 0.0001). Since the mean measles antibodies as measured by EIA
      absorbency were significantly lower in the mothers born after 1963 and their
      infants compared with women born before the vaccine era, the strategy for measles
      control in the future may have to include lowering the age of infant
      immunization.

PMID- 7775945
TI  - Successful treatment of a squamous papilloma of the hypopharynx-esophagus by
      local injections of (S)-1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine.
AB  - Human papillomaviruses (HPV) are associated with benign lesions and show
      specificity towards the location or tissues that they infect. HPVs are
      responsible for warts. Among more than 60 different HPV types known to occur in
      humans, a strong association has been found between types 16 and 18 and cervical
      cancer, and such an association is also suspected for types 31, 33, 35, 45, 51,
      52, and 56. We describe the effects of (S)-1-(3-hydroxy-2-phosphonyl
      methoxypropyl)cytosine (HPMPC), following local intratumoral injection, in a 69
      year-old woman with hypopharyngeal and esophageal papillomatous lesions,
      polymerase chain reaction (PCR) positive for HPV types 16 and 18, that relapsed
      after surgery and that also failed to respond to Nd-Yag laser photocoagulation
      and alpha-interferon treatment (6 x 10(6) U five times a week for 4 weeks
      followed by three times a week for 2 months). HPMPC was given at 1.25 mg/kg, with
      a sclerosing needle, through the biopsy channel of a video-endoscope, directly
      into the tumor, from March until July 1993 at seven different occasions. The
      first four injections were given at an interval of 1 week at the level of the
      hypopharynx. The next three injections were given at an interval of 3 to 5 weeks.
      During the fourth to the seventh session, half of the dose was injected into the
      hypopharyngeal and the other half into the esophageal tumor. Three further
      injections of HPMPC were administered at the level of the esophageal tumor in
      September 1993 with 2-week intervals. After HPMPC treatment, the lesions became
      smaller and flat until they completely disappeared.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7775946
TI  - Complete nucleotide sequences and the characteristics of two hepatitis B virus
      mutants causing serologically negative acute or chronic hepatitis B.
AB  - Hepatitis B virus (HBV) DNA was amplified by the polymerase chain reaction from
      the sera of a patient with acute hepatitis and a patient with chronic hepatitis.
      Both patients were negative for serum hepatitis B surface antigen and hepatitis B
      core antibodies and had been previously diagnosed as non-A, non-B, non-C, non-D,
      non-E hepatitis. The nucleotide sequence revealed an 8-nucleotide deletion in the
      X-gene coding region creating a C-terminally truncated X protein, and probable
      mutation of the enhancer II/core promoter element. In addition, DR2 showed a T-to
      C mutation at the extreme 5'-terminus. These mutations within the X-gene coding
      region must suppress replication and expression of HBV DNA, and this seems to be
      responsible for absence of serological markers despite the presence of HBV
      infection.

PMID- 7775947
TI  - Analysis of genomic polymorphism among herpes simplex virus type 2 isolates from
      four areas of Japan and three other countries.
AB  - Genomic polymorphism of 307 epidemiologically unrelated strains of herpes simplex
      virus type 2 (HSV-2) from four areas of Japan and three other countries (Korea,
      Sweden and the U.S.A.) was analysed by using 16 variable markers selected from 97
      restriction endonuclease (RE) sites with five REs. In addition to the 16 markers,
      26 rare variable RE sites were found in 307 isolates. Five and four of 16 markers
      (RE sites) were found to differ in the frequency of isolates with the markers
      between isolates from Japan and Sweden and between those from Japan and the
      U.S.A., respectively, suggesting that they are genomically different from each
      other. In this manner, 307 HSV-2 isolates from four countries could be classified
      into 68 different genotypes (no. of isolates/no. of genotypes = 4.5). Some
      isolates from one country or more than two countries at times were classified
      into the same genotypes, which were referred to as predominant genotypes. The
      most predominant genotypes for isolates from Japan, Sweden and the U.S.A. were
      genotypes 30, 26 (32) and 3, respectively, indicating that they are different by
      the country. In genotypes 1 and 6, the frequency of isolates was found to be
      significantly different between Japan and Sweden and between Japan and the
      U.S.A., respectively. Nine out of 16 markers differed in the most genomically
      distant isolates, each of which was obtained in Sweden and Japan. In addition,
      high correlation coefficients (r) in the Japanese isolates were detected in
      different pairs of markers from those in the Swedish isolates, suggesting that
      isolates from these two countries are evolutionarily distant.

PMID- 7775948
TI  - Isolation of human herpesvirus 7 from an infant with febrile syndrome.
AB  - A viral isolate obtained from peripheral blood lymphocytes of an infant with a
      nonspecific febrile syndrome was identified as human herpesvirus 7 (HHV-7) on the
      basis of PCR analysis of its DNA with one set of primers specific for HHV-7. The
      correlation of HHV-7 with the febrile episode affecting the infant is suggested.

PMID- 7775949
TI  - Hepatitis C genotypes in haemophilic patients treated with alpha-interferon.
AB  - The effect of alpha-interferon on the hepatitis C genotypes was examined in 25
      anti-HCV-positive haemophilic patients. The rate of multiple HCV genotypes in
      patients who are likely to have mixed infections was also studied. Pretreatment
      results showed that 3/25 (12%) patients had a change in genotypes, whereas
      posttreatment this rose to 10/25 (40%). Seven of 10 (70%) patients who showed a
      change in genotype had a clinical response to alpha-interferon. Six of 25 (24%)
      patients showed a complete clinical response to alpha-interferon, and the
      majority of these were either type 2 or 3. This study supports previous evidence
      that type 1 is less likely to respond to alpha-interferon, and that alpha
      interferon may alter the concentrations of the various circulating genotypes
      present in multiply-infected patients. There are many difficulties in studying
      hepatitis C in haemophilic patients due to the sequence heterogeneity within each
      individual, and this study has shown that no ideal method exists as yet for
      looking at HCV genotypes in multiply-infected individuals.

PMID- 7775950
TI  - Fulminant human herpesvirus six encephalitis in a human immunodeficiency virus
      infected infant.
AB  - Self-limited involvement of the central nervous system (CNS) is a relatively
      common complication of primary infection with human herpesvirus six (HHV-6) in
      normal children. We describe an HIV-infected infant who developed fulminant
      encephalitis as a complication of HHV-6 infection. Immunohistochemical staining
      of CNS tissue demonstrated productive infection of all CNS cell-types. Analysis
      of the infected brain tissue by the polymerase chain reaction (PCR) confirmed the
      presence of a dense HHV-6 infection in the tissue, and demonstrated that the
      virus present in the CNS tissue was predominantly the A variant of HHV-6. This is
      the first demonstration of invasive tissue disease caused by HHV-6 in an HIV
      infected infant.

PMID- 7775951
TI  - Detection and typing of human papillomaviruses by in situ hybridization with
      biotinylated oligonucleotide mixtures.
AB  - The value of biotinylated oligonucleotide probes for screening and typing by in
      situ hybridization of the most frequent genital human papillomavirus infections
      (HPVs 6, 11, 16, 18, 31, and 33) was assessed. Optimal hybridization conditions
      were defined on a panel of paraffin-embedded tissue sections previously
      characterized with HPV full genome probes. Mixtures of oligonucleotides rather
      than single oligonucleotides were used to improve sensitivity and specificity.
      All HPV-positive specimens were detected by the screening mixture with a
      sensitivity and specificity similar to that of full genome probes. Typing
      mixtures were highly specific for each HPV type. This study confirms the
      potential of oligonucleotide probes for detecting and typing HPV infections.

PMID- 7775952
TI  - Detection of acute measles infections by indirect and mu-capture enzyme
      immunoassays for immunoglobulin M antibodies and measles immunoglobulin G
      antibody avidity enzyme immunoassay.
AB  - An avidity test for measles IgG was developed and applied to the study of IgG
      immunoglobulin maturation kinetics in follow-up sera from 12 patients with known
      acute primary and convalescent measles and sera from blood donors. The avidity of
      the IgG anti-measles responses was measured using the 8 M urea elution technique,
      the results being expressed as the percentage ratio between the test readings for
      eluted and noneluted samples. The IgG avidity results were compared with those of
      indirect and mu-capture IgM enzyme immunoassays. This test was capable of
      detecting low-avidity antibodies at the acute phase of measles up to 7 weeks, and
      increasing avidity through immunosaturation during the convalescent phase. The
      avidity in these samples did not reach the level found in the samples of the
      blood donors under the follow-up time. Although a limited number of serum samples
      was examined, the results suggest that the measles IgG avidity test is a powerful
      tool for differentiating primary measles infection from the convalescent phase.

PMID- 7775953
TI  - Seroepidemiological study of hepatitis delta virus infection in Okinawa, Japan.
AB  - A seroepidemiological study on hepatitis delta virus (HDV) infection was
      conducted in the Okinawan islands, the area of Japan where hepatitis B virus
      infection is most prevalent. The subjects of this study included 116 asymptomatic
      hepatitis B surface antigen (HBsAg) carriers, 48 patients with chronic hepatitis
      (CH), 19 with liver cirrhosis (LC), and 11 with hepatocellular carcinoma (HCC).
      Among the 194 serum samples examined, a total of 10 (5.2%) were anti-HDV
      seropositive. Anti-HDV was detected in 2 (1.7%) of the 116 asymptomatic HBsAg
      carriers, in 3 (6.3%) of the 48 patients with CH, and in 5 (26.3%) of the 19 with
      LC. However, none of the patients with HCC had detectable anti-HDV. Eight of the
      10 were born in the Miyako island group and the remaining 2 on the main island of
      Okinawa. Since the subjects included 34 individuals who were living and/or born
      in the Miyako islands, the positive rate of anti-HDV in the islands was 23.5%.
      This study demonstrates the existence of an endemic area of HDV infection in
      Japan.

PMID- 7775954
TI  - Serological evidence for hepatitis E virus infection in Israel.
AB  - Israel is suspected to be endemic for hepatitis E virus (HEV) because of its
      geographic location and the large-scale immigration from endemic countries.
      Although no cases of local HEV infection have been diagnosed, a serological
      survey would provide indirect evidence for such infection. We examined sera from
      1,416 healthy subjects, including 1,139 Jews from various regions of Israel and
      277 Arabs, most of whom reside in the West Bank of the Jordan River. In addition,
      we tested 13 non-A, non-B, and non-C viral hepatitis patients. Sera were screened
      for antibody to hepatitis E virus (anti-HEV) by a newly developed enzyme
      immunoassay (EIA) and by immunoblots for both IgG and IgM anti-HEV activity.
      Positive samples were confirmed by neutralization. The seroprevalence found by
      EIA was 2.81% and 1.81% in the Jewish and Arab populations, respectively. More
      than a 2-fold higher prevalence in males compared to females and an increase with
      age were found in both populations. However, these differences were
      nonsignificant. The geographical distribution was even throughout the country,
      except for two clusters of 3 and 4 seropositive individuals possibly reflecting
      past foci of infection. Eight of 37 EIA-positive sera were positive for IgG, and
      3 were positive for IgM by the immunoblot assay. Among hepatitis patients (9
      acute and 4 chronic), one patient with chronic hepatitis was positive for both
      IgG and IgM. Our study provides indirect evidence that Israel is endemic for
      HEV.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775955
TI  - Precore and core mutations in HBV from individuals in India with chronic
      infection.
AB  - Ten hepatitis B surface antigen seropositive carriers (5 asymptomatic and 5 with
      chronic liver disease) were tested for HBeAg/anti-HBe and for HBV-DNA using the
      polymerase chain reaction. Five were DNA-positive, 2 with HBeAg and 3 with anti
      HBe. Nucleotide sequences were determined for these 5 cases. Hepatitis B virus
      DNA from one cirrhotic carrier with anti-HBe had a mutation in the precore region
      (nucleotide position 1862) which may affect signal peptide cleavage and HBeAg
      synthesis. In the other 2 anti-HBe- and DNA-positive cases, a cirrhotic carrier
      and an asymptomatic case, there was a mutation at nucleotide position 1896
      leading to a termination codon in the precore region. In all 5 patients, except
      for one or two missense mutations, there was no significant variation in the core
      region.

PMID- 7775956
TI  - Seroepidemiology of hepatitis E in selected Australian populations.
AB  - The presence of hepatitis E virus-specific antibodies (anti-HEV) was determined
      in selected Australian groups. Anti-HEV was detected initially using a
      recombinant antigen-based enzyme immunoassay (EIA). It was found that 1 of 279
      (0.4%) blood donors, 14 of 182 (7.7%) Indochinese refugees, 2 of 89 (2.2%) sera
      submitted for amoebic serology (generally people who had visited developing
      countries), 1 of 13 (7.7%) patients with non-A, non-B hepatitis, none of 7 (0%)
      patients with fulminant non-A, non-B hepatitis, and none of 33 (0%) control sera
      were repeatedly reactive by the HEV EIA. The positive sera were subjected to
      further testing using a supplemental immunoblot. Preliminary data suggest that
      while potentially large numbers of people infected with HEV are entering
      Australia, no compulsive evidence was found in these particular groups for
      endemic HEV infection in Australia. This is the first seroepidemiological survey
      of HEV in Australia.

PMID- 7775957
TI  - Local succession of adenovirus strains in pediatric gastroenteritis.
AB  - Assessment of the current incidence of different adenovirus types in local
      gastroenteritis involved the examination of over 1,000 stool specimens annually
      from 1988-1992. Adenoviruses were detected by electron microscopy and/or cell
      culture in 32% of the specimens in which a viral pathogen was detected. The
      identification of every adenovirus isolate to type by neutralization with
      specific antisera against the first 6 types and by restriction analysis of
      nonneutralized isolates was started in 1990. Samples from 1988 and 1989 were
      examined retrospectively. Adenovirus strains were compared to those isolated in a
      study between 1980-1983. Enumeration of individual adenovirus types revealed a
      number of trends, demonstrating that rapid changes in the local incidence of
      several strains were occurring in Manitoba. The incidence of adenovirus type 40
      (Ad40) as a cause of gastroenteritis was found to have fallen dramatically in
      recent years. The predominant cause of gastroenteritis in Manitoba is a variant
      strain of Ad41, increasing in predominance each year and now responsible for over
      a third of the symptomatic cases examined since 1990. The majority of restriction
      site differences of the Ad41 variant strain from the prototype strain Tak were
      mapped to the hexon and fiber genes, both of which code for the neutralizable
      external viral epitopes. The probability of the observed pattern of mutations
      occurring by chance was calculated as P < 0.0005, indicating a strong pressure
      for selection of these immunologically significant alterations to the viral
      proteins responsible for cell attachment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775960
TI  - Analysis of clinical and virological factors associated with response to alpha
      interferon therapy in chronic hepatitis C.
AB  - Interferon alpha (IFN-alpha) therapy is currently the treatment of choice for
      chronic hepatitis C (HCV) infection, but it fails to achieve a sustained response
      in approximately 75% of those treated. The factors which determine whether or not
      an individual will respond to IFN-alpha are uncertain, although a number of
      potentially predictive factors have been proposed. In this study a wide range of
      clinical, demographic, and virological parameters were evaluated in relation to
      therapeutic outcome in a group of 30 Italian patients with chronic hepatitis C.
      All patients received 3 MU leukocyte-derived IFN-alpha three times a week for 6
      months and were then followed prospectively for at least 12 months. 53% of
      patients responded initially, but a sustained response was observed in only 17%.
      Responders were found to be significantly younger than nonresponders (45.6 +/-
      3.1 vs. 55.4 +/- 2.7), and less frequently cirrhotic (2/16 vs. 7/14). Sustained
      responders had a mean pretreatment HCV-RNA titer approximately tenfold lower than
      that of those who did not have a sustained response, but the difference was not
      statistically significant. HCV genotype was found to be significantly associated
      with both initial and sustained response. Patients infected with HCV-2a were more
      likely to respond (89%) than those who were infected with HCV-1b (37%), and they
      were also more likely to sustain that response (33% vs. 6%).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7775959
TI  - Follow-up of antibody responses to human papillomavirus type 16 E7 in patients
      treated for cervical carcinoma.
AB  - A synthetic peptide comprising amino acids 6-35 of HPV-16 E7 was used in an ELISA
      to screen sera taken from 31 cervical carcinoma patients. Sera obtained before
      and during treatment, and in follow-up, were tested for the presence of
      antibodies to this peptide. Sixteen patients with negative pretreatment serum
      determination remained negative during treatment and follow-up. Of the 15
      patients with positive pretreatment sera, 12 showed a decrease in anti-E7 6-35
      antibody level during treatment. During follow-up an increase in anti-E7/6-35
      antibody level was observed in 6 out of 7 patients with progressive or recurrent
      disease, whereas all patients who remained in complete remission showed stable or
      further decreasing antibody levels. During the course of disease of the 15
      seropositive patients, serum anti-E7/6-35 antibody levels were compared with
      serum squamous cell carcinoma antigen (SCC-Ag) profiles, a clinically useful
      tumor marker in the management of cervical cancer patients. Similar patterns were
      observed in 10 out of 15 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7775958
TI  - Hepatitis B vaccination in infants of mothers infected with human
      immunodeficiency virus.
AB  - A study was conducted to investigate the immunogenicity of a recombinant DNA
      hepatitis B vaccine in neonates and children of HIV-infected women. Immunization
      against hepatitis B consisted of three 10 micrograms doses of the vaccine
      administered on a 0-, 1- and 6-month schedule. The children were followed up for
      an average of 11 months. Of the 118 HIV-positive neonates who participated in the
      study, 95 lost their HIV antibodies during the follow-up period. Most (94.2%) of
      the latter who completed the study responded to the vaccine. Of the 23 who
      remained HIV-positive, 17 completed the study and 7 produced hepatitis B
      antibodies.

PMID- 7775961
TI  - Evaluation of the polymerase chain reaction for the detection of human
      papillomavirus from urine.
AB  - The ability to detect the presence of human papillomavirus (HPV)-DNA sequences in
      urine was evaluated using polymerase chain reaction (PCR). DNA was purified and
      extracted from urine samples, and subjected to 40 cycles of amplification using
      the consensus primer pair MY11 and MY09. Coamplification using the beta-globin
      primers, GH20 and PC04, was performed as an internal reaction control. Following
      assay optimization, urine samples from 22 women undergoing examination for
      cervical dysplasia were tested for the presence of HPV-DNA. PCR assay results
      were correlated with cytologic and histologic findings as well as ViraType assay
      results. Overall, HPV was detected by PCR in 16 (76%) of the interpretable
      samples. HPV sequences were detected in 13 (87%) of the 15 specimens from women
      showing evidence of condylomata, dysplasia, or invasive carcinoma. HPV was
      detected in 3 (50%) of the women whose cytologic or histologic results were
      either negative or showed benign atypia. Although the sample size in this study
      is small, our results show that HPV can be detected by PCR in a majority of
      individuals showing evidence of HPV infection. The method described provides a
      means for the clinical laboratory to detect a broad range of HPV types from using
      a sample obtained by noninvasive techniques. The ability to easily obtain urine
      would allow for increased numbers of individuals to be tested, and thus, aid in
      our understanding of HPV.

PMID- 7775962
TI  - Activity-Dependent Forms of Plasticity. Proceedings of a symposium. Paris,
      France, 1-3 February 1994.

PMID- 7775963
TI  - Activity-dependent forms of plasticity.

PMID- 7775964
TI  - The role of receptor/channel activity in neuronal cell migration.
AB  - Confocal laser microscopy, in conjunction with carbocyanine dyes and calcium
      sensitive fluorescent indicators, was used in slices and explant cultures of
      developing cerebellum to study cellular mechanisms underlying a motility of
      neuronal cell migration. The results indicate that a combination of voltage- and
      ligand-activated ion channels cooperatively regulates Ca2+ influx into the
      migrating cells. We suggest that molecules, present in the local cellular milieu,
      affect cell motility by activating specific ion channels and second messengers
      that influence polymerization of stiff and contractile cytoskeletal proteins.
      This early interaction between postmitotic neurons and surrounding cells controls
      the rate of their movements, sculpts their shapes, establishes their positions,
      and, therefore, indirectly determines their identities to prior formation of
      synaptic connections.

PMID- 7775965
TI  - Spontaneous calcium transients regulate neuronal plasticity in developing
      neurons.
AB  - Calcium ions play critical roles in neuronal differentiation. We have recorded
      transient, repeated elevations of calcium in embryonic Xenopus spinal neurons
      over periods of 1 h in vitro and in vivo, confocally imaging fluo 3-loaded cells
      at 5 s intervals. Calcium spikes and calcium waves are found both in neurons in
      culture and in the intact spinal cord. Spikes rise rapidly to approximately 400%
      of baseline fluorescence and have a double exponential decay, whereas waves rise
      slowly to approximately 200% of baseline fluorescence and decay slowly as well.
      Imaging of fura 2-loaded neurons indicates that intracellular calcium increases
      from 50 to 500 nM during spikes. Both spikes and waves are abolished by removal
      of extracellular calcium. Developmentally, the incidence and frequency of spikes
      decrease, whereas the incidence and frequency of waves are constant. Spikes are
      generated by spontaneous calcium-dependent action potentials and also utilize
      intracellular calcium stores. Waves are produced by a mechanism that does not
      involve classic voltage-dependent calcium channels. Spikes are required for
      expression of the transmitter GABA and for potassium channel modulation. Waves in
      growth cones are likely to regulate neurite extension. The results demonstrate
      the roles of a novel signaling system in regulating neuronal plasticity, that
      operates on a time scale 10(4) times slower than that of action potentials.

PMID- 7775967
TI  - Postnatal maturation of gamma-aminobutyric acidA and B-mediated inhibition in the
      CA3 hippocampal region of the rat.
AB  - In the adult central nervous system, GABAergic synaptic inhibition is known to
      play a crucial role in preventing the spread of excitatory glutamatergic
      activity. This inhibition is achieved by a membrane hyperpolarization through the
      activation of postsynaptic gamma-aminobutyric acidA (GABAA) and GABAB receptors.
      In addition, GABA also depress transmitter release acting through presynaptic
      GABAB receptors. Despite the wealth of data regarding the role of GABA in
      regulating the degree of synchronous activity in the adult, little is known about
      GABA transmission during early stages of development. In the following we report
      that GABA mediates most of the excitatory drive at early stages of development in
      the hippocampal CA3 region. Activation of GABAA receptors induces a
      depolarization and excitation of immature CA3 pyramidal neurons and increases
      intracellular Ca2+ ([Ca2+]i)] during the first postnatal week of life. During the
      same developmental period, the postsynaptic GABAB-mediated inhibition is poorly
      developed. In contrast, the presynaptic GABAB-mediated inhibition is well
      developed at birth and plays a crucial role in modulating the postsynaptic
      activity by depressing transmitter release at early postnatal stages. We have
      also shown that GABA plays a trophic role in the neuritic outgrowth of cultured
      hippocampal neurons.

PMID- 7775966
TI  - The Ca2+ influx induced by beta-amyloid peptide 25-35 in cultured hippocampal
      neurons results from network excitation.
AB  - Although a neurotoxic role has been postulated for the beta-amyloid protein (beta
      AP), which accumulates in brain tissues in Alzheimer's disease, a precise
      mechanism underlying this toxicity has not been identified. The peptide fragment
      consisting of amino acid residues 25 through 35 (beta AP25-35), in particular,
      has been reported to be toxic in cultured neurons. We report that beta AP25-35,
      applied to rat hippocampal neurons in culture, caused reversible and repeatable
      increases in the intracellular Ca2+ concentration ([Ca2+]i), as measured by fura
      2 fluorimetry. Furthermore, beta AP25-35 induced bursts of excitatory potentials
      and action potential firing in individual neurons studied with whole cell current
      clamp recordings. The beta AP25-35-induced [Ca2+]i elevations and electrical
      activity were enhanced by removal of extracellular Mg2+, and they could be
      blocked by tetrodotoxin, by non-N-methyl-D-aspartate (NMDA) and NMDA glutamate
      receptor antagonists, and by the L-type Ca2+ channel antagonist nimodipine.
      Similar responses of bursts of action potentials and [Ca2+]i increases were
      evoked by beta AP1-40. Responses to beta AP25-35 were not prevented by
      pretreatment with pertussis toxin. Excitatory responses and [Ca2+]i elevations
      were not observed in cerebellar neuron cultures in which inhibitory synapses
      predominate. Although the effects of beta AP25-35 depended on the activation of
      glutamatergic synapses, there was no enhancement of kainate- or NMDA-induced
      currents by beta AP25-35 in voltage-clamp studies. We conclude that beta AP25-35
      enhances excitatory activity in glutamatergic synaptic networks, causing
      excitatory potentials and Ca2+ influx. This property may explain the toxicity of
      beta AP25-35.

PMID- 7775968
TI  - Lamina-specific synaptic connections of hippocampal neurons in vitro.
AB  - By using slice cultures as a model, we demonstrate here that different target
      selectivities exist among the various afferent fibers to the hippocampus. As in
      intact animals, septohippocampal cholinergic fibers, provided by a slice culture
      of septum, innervate a co-cultured slice of hippocampus diffusely, that is,
      without forming distinct layers of termination. As in vivo, the septal
      cholinergic fibers establish synapses with a variety of target cells. Conversely,
      fibers from an entorhinal slice co-cultured to a hippocampal slice display their
      normal laminar specificity. They preferentially terminate in the outer molecular
      layer of the fascia dentata, thereby selectively contacting peripheral dendrites
      of the granule cells. This preferential termination on peripheral dendritic
      segments is remarkable, since these fibers do not have to compete with
      commissural fibers, hypothalamic fibers, and septal afferents for dendritic space
      under these culture conditions. Moreover, in triplet cultures in which first two
      hippocampal slices were co-cultured and then, with a delay of 5 days, an
      entorhinal slice was added, the fibers from the entorhinal slice and those from
      the hippocampal culture terminated in their appropriate layers in the hippocampal
      target culture. However, in this approach the normal sequence of ingrowth of
      these two afferents was reversed. In normal ontogenetic development, entorhinal
      afferents arrive in the hippocampus before the commissural fibers. The results
      show that there are different degrees of target selectivity of hippocampal
      afferents and that the characteristic lamination of certain afferent fibers in
      the hippocampus is not determined by their sequential ingrowth during
      development.

PMID- 7775969
TI  - Multiple forms of long-term potentiation and multiple regulatory sites of N
      methyl-D-aspartate receptors: role of the redox site.
AB  - Long-term potentiation (LTP) is a form of synaptic plasticity thought to be
      involved in learning and memory. Although extensively studied, mainly in the CA1
      region of the hippocampus, the mechanisms underlying the induction and expression
      of LTP are poorly elucidated. This is probably due to the fact that LTP is not a
      unique process and indeed recent studies have shown that several forms of LTP
      could be generated depending on the experimental conditions. Furthermore, LTP is
      generally associated with a long-lasting increase of the synaptic efficacy of
      AMPA receptors but an increasing number of data also suggested that NMDA
      receptors could be potentiated as well. NMDA receptor responses are modulated by
      a large number of extracellular and intracellular events, providing additional
      possibilities for the generation of LTP. The role of these different modulatory
      sites of the NMDA receptor and their relation with LTP are reviewed with a
      particular attention to the redox site which seems to be a selective target to
      distinguish between AMPA and NMDA-LTP.

PMID- 7775970
TI  - Posttetanic potentiation and presynaptically induced long-term potentiation at
      the mossy fiber synapse in rat hippocampus.
AB  - A form of long-term potentiation (LTP) is induced at the mossy fiber (MF) synapse
      in the hippocampus by high-frequency presynaptic stimulation (HFS). It is
      generally accepted that induction of this form of LTP (MF LTP) does not depend on
      postsynaptic Ca2+ current gated by N-methyl-D-aspartate receptors, but it has
      remained controversial whether induction depends on postsynaptic depolarization
      and voltage-gated entry of Ca2+. There are also contradictory data on the time
      course of both LTP and post-tetanic potentiation (PTP), a shorter duration form
      of potentiation observed at MF synapses immediately following HFS. It has been
      proposed that some of these differences in results may have arisen because of
      difficulties in isolating monosynaptic responses to MF input. In the present
      study, whole cell recording was used to observe excitatory postsynaptic currents
      (EPSCs) elicited in CA3 pyramidal cells by input from MFs. Postsynaptic cells
      were dialyzed with 1,2-bis(o-aminophenoxy)-ethane-N,N,N',N'-tetraacetic acid
      (BAPTA) and F- to inhibit postsynaptic mechanisms that required Ca2+, cells were
      under voltage clamp during HFS, and conditions were selected to minimize the
      likelihood of polysynaptic contamination. Under these conditions, HFS
      nevertheless induced robust LTP (mean magnitude, 62%). The possibility that EPSCs
      were contaminated by polysynaptic components was investigated by exposing the
      slices to a suppressing medium (one that partially blocked neurotransmission).
      EPSC waveforms did not change shape during suppression, indicating that
      contamination was absent. The LTP observed always was accompanied by prominent
      PTP that lasted through the first 5 to 15 min following HFS (mean decay time
      constant, 3.2 min). Induction of this LTP was not cooperative; there was no
      relationship between the size of responses and the magnitude of the LTP induced.
      LTP magnitude also was unrelated to the extent to which postsynaptic cells
      depolarized during HFS. These results show that high rates of presynaptic MF
      activity elicit robust LTP whether or not there is accompanying postsynaptic
      depolarization or increase in the concentration of postsynaptic Ca2+. High
      frequency MF activity also results in a PTP that is unusually large and long.

PMID- 7775971
TI  - Fast and slow excitation of inhibitory cells in the CA3 region of the
      hippocampus.
AB  - Pyramidal cells form excitatory synaptic connections with local inhibitory
      neurons in the hippocampus. This recurrent synapse plays a crucial stabilizing
      role in the control of hippocampal activity, since it transforms pyramidal cell
      activity into inhibition of the same pyramidal cell population. Using a
      combination of dual recording from presynaptic and postsynaptic cells and
      anatomical techniques, we show that these synaptic connections often comprise a
      single site for liberation of excitatory transmitter. The resulting excitatory
      postsynaptic potentials (EPSCs) have a fast time course and a similar amplitude
      to miniature EPSCs recorded in tetrodotoxin and cobalt. In contrast, activation
      of metabotropic glutamate receptors (mGluRs) by transmitter liberated during
      repetitive activation of these synapses produces an excitation with a much slower
      time course. In addition to somatodendritic mGluRs, which excite inhibitory
      cells, a different species of mGluR is present on inhibitory cell terminals. This
      mGluR is activated by higher concentrations of the agonist t-1-amino-cyclopentyl
      1,3-decarboxylate and acts to reduce gamma-aminobutyric acid release. mGluRs,
      thus, have a dual action to enhance and to depress synaptic inhibition in the
      hippocampus.

PMID- 7775972
TI  - Possible strategies for finding the substrate for learning-induced changes in the
      hippocampal cortex.
AB  - For long-lasting memory traces, structural synaptic changes remain a probable
      mechanism. However, in higher animals it has proved difficult to provide positive
      evidence for this notion. The main reason may be that the changes are subtle and
      are to be found in a relatively small subset of synapses and in a distributed
      manner in the cellular network in question. Here, we discuss possible strategies
      for finding structural changes in the hippocampus associated with spatial
      learning, an activity for which this structure is important. Spatial learning may
      induce new excitatory synapses in a small subset of hippocampal CA1 neurons
      because we observe a higher spine density without alteration in dendritic length
      or branching. The dendritic synapses are regularly spaced, irrespective of spine
      density, suggesting the operation of an intersynaptic dispersing force.

PMID- 7775973
TI  - Fos: an immediate-early transcription factor in neurons.
AB  - In the past several years a great deal of evidence has accumulated linking
      neuronal activation events to the regulation of gene expression. We have pursued
      an analysis of c-fos regulation in the nervous system to elucidate the molecular
      mechanisms involved in stimulus-transcription coupling. The c-fos gene can be
      viewed as an archetype of the set of cellular immediate-early genes encoding
      transcription factors. These genes are believed to function in coupling short
      term signals elicited by extracellular to long-term changes in cellular phenotype
      by orchestrating alterations in target gene expression. Several animal seizure
      models have been used to demonstrate the activation of gene expression in
      specific populations of neurons. Using a transgenic mouse approach, based on a
      foslacZ fusion gene, we now demonstrate an association between c-fos expression
      and cell death in the nervous system. A delayed and protracted induction was
      observed following surgical lesion and in response to neurotoxin exposure. This
      system allows us to determine, for the first time, the DNA regulatory sequences
      that are responsible for the induction of gene expression in neurons in vivo.
      Furthermore, foslacZ transgenic mice provide a unique resource for identifying
      cell populations that respond to specific stimuli or that are susceptible to
      particular toxins.

PMID- 7775974
TI  - Cell death, gliosis, and synaptic remodeling in the hippocampus of epileptic
      rats.
AB  - Seizures set in motion complex molecular and morphological changes in vulnerable
      structures, such as the hippocampal complex. A number of these changes are
      responsible for neuronal death of CA3 and hilar cells, which involves necrotic
      and apoptotic mechanisms. In surviving dentate granule cells seizures induce an
      increased expression of tubulin subunits and microtubule-associated proteins,
      suggesting that an overproduction of tubulin polymers would lead to a remodeling
      of mossy fibers (the axons of granule cells). In fact, these fibers sprout in the
      dentate gyrus to innervate granule cell dendrites, creating recurrent excitatory
      circuits. In contrast, terminal mossy fibers do not sprout in the CA3 field.
      Navigation of mossy fiber's growth cones may be facilitated by astrocytes, which
      would exert differential effects by producing and excreting cell adhesion and
      substrate molecules. In the light of the results discussed here, we suggest that
      in adult brain activated-resident astrocytes (nonproliferating, tenascin
      negative, neuronal cell-adhesion molecule-positive astrocytes) could contribute
      to the process of axonal outgrowth and synaptogenesis in the dentate gyrus, while
      proliferating astrocytes, tenascin-positive, could impede any axonal
      rearrangement in CA3.

PMID- 7775975
TI  - Molecular correlates between reactive and developmental plasticity in the rat
      hippocampus.
AB  - Area CA3 of the hippocampus is the most epileptogenic structure of the brain.
      Various studies have shown that kainate-induced experimental epilepsy in rats and
      human cases of epilepsy are associated with sprouting of the mossy fibers of the
      dentate granule neurons and selective loss of pyramidal neurons, notably in the
      CA3-CA4 areas of Ammon's horn. In experimental models of epilepsy, brief seizure
      activity initiates a cascade of molecular alterations that will contribute to
      changes in the expression of numerous genes, which can last several weeks. The
      products of some of these genes will contribute to the permanent state of
      enhanced synaptic efficiency, to the sprouting and formation of novel excitatory
      synapses, and possibly to neuronal cell loss. The expression of genes encoding
      transcription factors and numerous growth factors is rapidly altered following
      seizure episodes. Based on observations in vivo and in vitro in cultured
      hippocampal neurons, it is hypothesized that an interplay between transcription
      and growth factors, because of their pleiotropic effects on the regulation of
      effector genes, may be instrumental in coupling transient extracellular stimuli
      to irreversible cellular alterations.

PMID- 7775977
TI  - mRNA distribution within dendrites: relationship to afferent innervation.
AB  - The majority of neuronal mRNAs are confined to cell bodies, but a few mRNAs are
      present at high levels in dendrites. Here we report an initial analysis of the
      relationship between afferent innervation and the distribution of mRNA within
      dendritic fields. In situ hybridization techniques were used to compare the
      subcellular distribution of dendritic mRNAs in principal neurons of the
      hippocampal formation in vivo. The mRNA encoding the alpha subunit of
      calcium/calmodulin dependent protein kinase II (CAMII kinase) was present at high
      levels throughout the layers that contain the dendrites of hippocampal pyramidal
      cells and dentate granule cells. In contrast, the mRNA encoding the high
      molecular weight microtubule-associated protein MAP2 had a more limited
      distribution. In the dentate gyrus, labeling for MAP2 was present in a discrete
      band in the lamina containing proximal dendrites and decreased to low levels in
      laminae containing distal dendrites. This laminar pattern resembles the distinct
      terminations of the commissural/associational projection (high MAP2 labeling) and
      the entorhinal projection (lower MAP2 labeling) upon dendrites of granule cells.
      To determine if the differential distribution of dendritic mRNAs was regulated by
      either the presence or activity of afferents, we evaluated mRNA distribution in
      the dentate molecular layer following (1) removal of the entorhinal input by
      lesions of the entorhinal cortex or (2) prolonged delivery of potentiating
      stimulation to entorhinal afferents. Denervation led to modest decreases in the
      levels of mRNAs for both CAMII and MAP2 but did not lead to detectable
      alterations in mRNA distribution. Also, prolonged stimulation did not lead to
      detectable alterations in MAP2 or CAMII mRNA distribution although such
      stimulation clearly elevated the expression of mRNA for glial fibrillary acidic
      protein (GFAP).

PMID- 7775978
TI  - Cu(II) binding by angiotensin II fragments: Asp-Arg-Val-Tyr-Ile-His and Arg-Val
      Tyr-Ile-His. Competition between amino group and imidazole nitrogens in anchoring
      of metal ions.
AB  - Potentiometric and spectroscopic (absorption, circular dichroism and electron
      paramagnetic resonance) study on the coordination of two angiotensin II fragments
      (Asp-Arg-Val-Tyr-Ile-His and Arg-Val-Tyr-Ile-His) to Cu(II) ions has shown that
      competition between amino and imidazole nitrogens to anchor metal ions is a
      complicated process and may lead to formation of macrochelate rings. The
      important factor that influences this competition is the distance between
      competing His and N-terminal residues (number of spacer residues in a peptide
      sequence).

PMID- 7775976
TI  - The neural cell adhesion molecule and synaptic plasticity.
AB  - Highly stereotyped patterns of neuronal connections are laid down during the
      development of the nervous system via a range of activity independent and
      activity dependent mechanisms. Whereas the coarse hard-wiring of the nervous
      system appears to rely on molecular recognition events between the neuron, its
      pathway, and its target, the establishment of precisely patterned functional
      circuits is thought to be driven by neuronal activity. In this review we discuss
      the role that the neuronal cell adhesion molecule (NCAM) plays in morphological
      plasticity. Recent studies on NCAM and its probable species homologue in Aplysia
      (apCAM) suggests that an individual CAM can function to both promote synaptic
      plasticity and maintain the structure of the synapse. In the adult brain, changes
      between stability and plasticity are likely to underlie dynamic morphological
      changes in synaptic structures associated with learning and memory. In this
      review we use NCAM as an example to illustrate mechanisms that can change the
      function of an individual CAM from a molecule that promotes plasticity to one
      that does not. We also discuss evidence that NCAM promotes plasticity by
      activating a conventional signal transduction cascade, rather than by modulating
      adhesion per se. Finally, we consider the evidence that supports a role for NCAM
      in learning and memory.

PMID- 7775979
TI  - Photoaquation of cis-dichlorobis-(1,10-phenanthroline)chromium(III) and the
      photochemical and thermal reactions of this complex with native calf-thymus DNA.
AB  - The photoaquation of the title compound [cis-Cr(phen)2CL+2] has been studied
      using high performance liquid chromatography. Both monoaquo [cis
      Cr(phen)2Cl(OH2)2+2] and diaquo [cis-Cr(phen)2(OH2)3+2] products are formed, and
      the quantum efficiency for the loss of starting material in Tris buffer (pH 7)
      under argon and oxygen is 0.010 +/- 0.001 and 0.0026 +/- 0.0002, respectively.
      The presence of deoxyguanosine (dG) increases the rate of loss, as much as
      twofold under argon, but only the rate of diaquo product formation is enhanced by
      the nucleoside. The dG effect is attributed to reductive quenching of the cis
      Cr(phen)2Cl+2 excited state by the base. Equilibrium dialysis studies indicate
      that both cis-Cr(phen)2Cl+2 and cis-Cr(phen)2(OH2)3+2 minimally associate with
      calf-thymus DNA. However, photolyses of cis-Cr(phen)2Cl+2 with the nucleic acid
      yield a mixture of unidentified covalent adducts. The diaquo complex also forms
      covalent adducts with DNA in the absence of light. Photolyses of the cis
      Cr(phen)2Cl+2 with polyribonucleotides indicate a clear preference for covalent
      binding to the purines.

PMID- 7775981
TI  - Comparison of polysaccharide iron complexes used as iron supplements.
AB  - An oral hematinic marketed as "water soluble polysaccharide iron complex"
      (Vitaline Formulas) has been characterized using x-ray powder diffraction and
      Mossbauer spectroscopy. Another polysaccharide iron complex marketed as Niferex
      (Central Pharmaceuticals) has been previously studied by us and found to have a
      core similar to ferrihydrite, but with some long-range order of the mineral
      akaganeite, beta-FeOOH. The latter is seen in other ferric carbohydrate complexes
      synthesized by the hydrolysis of FeCl3. This commercial product, however, is very
      different and has a mixture of iron components including hematite (alpha-Fe2O3)
      magnetite (Fe3O4), goethite (alpha-FeOOH), iron metal, and a ferrous salt.

PMID- 7775980
TI  - Cobalt(III)-ligated peptides as acyl acceptors in peptide synthesis catalyzed by
      chymotrypsin.
AB  - The efficiency of cobalt(III)-ligated peptides as acceptor nucleophiles in acyl
      transfer reactions catalyzed by alpha-chymotrypsin was examined. A series of
      metallopeptides with the general formula [H-(Gly)n-OCo(NH3)5]2+ (1 < or = n < or
      = 4) was tested. The aminolysis rate of acyl-chymotrypsin was measured
      spectrophotometrically by monitoring the concentration of unreacted nucleophile.
      The rate of the competing hydrolysis of acyl-chymotrypsin was obtained by
      automatic titration with base, using a pH-stat. The main result was that the
      positively charged metallopeptides, in general, were more efficient nucleophiles
      than the corresponding amides and free peptides that were examined for
      comparison. A binding model that rationalizes the findings is given.

PMID- 7775982
TI  - Preferential interactions in the H2O/lysozyme/AlCl3 system.
AB  - The preferential interactions of lysozyme with solvent components is studied in
      aqueous solutions of AlCl3. The interaction parameter is negative at large salt
      concentrations, indicating that the interaction process of both salt and protein
      is thermodynamically favorable. The transfer free-energy parameter and the
      solubility data show that aluminum chloride is a salting-in agent for lysozyme.
      Moreover, these preferential interactions also are correlated with both protein
      solubility in the solvent medium and the influence of salt on the lysozyme
      structure. Viscometric and refractometric studies show that lysozyme can undergo
      a conformational change at 1 mM of salt, and spectrophotometric studies indicate
      a protein activity of approximately 75% at 10 mM of salt. Therefore, neither the
      interaction of AlCl3 with the lysozyme nor the conformational change undergone
      directly affect the catalytic amino acid residues of the active site.

PMID- 7775983
TI  - In vitro anticomplementary activity of constituents from Morinda morindoides.
AB  - In a screening program for complement classical pathway modulation, an 80% MeOH
      extract of the leaves of Morinda morindoides showed potent dose-dependent
      anticomplementary activity. Bioassay-guided chromatographic separation of the
      active constituents led to the isolation of ten flavonoids of which two were
      aglycones. The compounds were tested in vitro for their putative complement
      inhibiting properties on the classical (CP) and the alternative (AP) pathways of
      the complement system. The results indicated that quercetin [1], quercetin 3-O
      rhamnoside (quercitrin) [5], and quercetin 3-O-rutinoside (rutin) [7] showed
      similar anticomplementary activities (inhibition) on the CP of complement. A
      mixture of two kaempferol triglycosides isolated and denoted as M(015), also had
      a good inhibitory effect. The effects of these compounds were dose-dependent for
      this pathway. On the AP of complement, quercetin [1] and M(015) had,
      respectively, more pronounced inhibitory and activatory effects than the other
      tested flavonoids, but their effects were not dose-dependent for this pathway.
      The other isolated flavonoids showed weak effects or were inactive for both
      pathways.

PMID- 7775984
TI  - Anti-AIDS agents, 18. Sodium and potassium salts of caffeic acid tetramers from
      Arnebia euchroma as anti-HIV agents.
AB  - Monosodium and monopotassium salts [2-4] of isomeric caffeic acid tetramers were
      isolated from Arnebia euchroma as anti-HIV agents. Mixtures of dipotassium and
      disodium salts [1] of a caffeic acid tetramer and dipotassium and potassium
      sodium salts [5] of a caffeic acid tetramer glucoside were also isolated from the
      active fraction. The structures of 1-5 were characterized by chemical and
      spectral evidence. Compounds 2-4 demonstrated potent anti-HIV activity with EC50
      values of 2.8, 4.0, and 1.5 micrograms/ml, respectively. Treatment of 1-4 with
      dilute HCl yielded known caffeic acid tetramers [8 and 9], which were found to be
      less active, indicating the importance of the sodium and potassium salts to the
      enhanced anti-HIV activity.

PMID- 7775985
TI  - New myrsinol-related polyfunctional pentacyclic diterpene esters from roots of
      Euphorbia prolifera.
AB  - Five Euphorbia substances, SPr1-SPr5, were isolated from the roots of Euphorbia
      prolifera. They were found to have similar structures but were inactive in a
      mouse ear inflammation assay. By nmr analysis and after single-crystal X-ray
      crystallography the structure of SPr5 was established as a hexaester
      (tetraacetate-benzoate-propionate) of a hitherto unknown polyfunctional
      pentacyclic diterpene parent alcohol, structurally related to myrsinol. As judged
      from its nmr spectra, SPr4 is an analogue of SPr5, carrying an isobutyrate
      substituent in place of a benzoate ester functionality. SPr1-SPr3 were partially
      characterized by their mass spectra as esters of diterpene parent alcohols
      possibly related to the myrsinol structure. SPr1-SPr5 may represent one of the
      product lines branching off the proposed main route of biogenesis of the
      oligocyclic diterpenoid skin irritants and tumor promoters occurring in many, but
      not all, of the species in the plant families Thymelaeaceae and Euphorbiaceae.

PMID- 7775986
TI  - Triterpenoid saponins from Ilex paraguariensis.
AB  - The leaves of Ilex paraguariensis have yielded three new saponins named
      matesaponins 2, 3, and 4 [1-3], which have been characterized by chemical and nmr
      methods as ursolic acid 3-O-[beta-D-glucopyranosyl-(1-->3)-[alpha-L
      rhamnopyranosyl- (1-->2)]]-alpha-L-arabinopyranosyl]-(28-->1)-beta-D
      glucopyranosyl ester, ursolic acid 3-O-[beta-D-glucopyranosyl-(1-->3)-alpha-L
      arabinopyranosyl]-(28-- >1)- [beta-D-glucopyranosyl-(1-->6)-beta-D
      glucopyranosyl]ester, and ursolic acid 3-O-[beta-D-glucopyranosyl-(1-->3)-[alpha
      L- rhamnopyranosyl-(1-->2)]]-alpha-L-arabinopyranosyl]-(28-->1)-[beta -D-
      glucopyranosyl-(1-->6)-beta-D-glucopyranosyl]ester, respectively.

PMID- 7775987
TI  - Bipolal: anti-microalgal compound isolated as a candidate for marine antifouling
      produced by Bipolaris sp. F5206.
AB  - Bipolal [1], a new compound with marine antifouling potential, was isolated from
      the culture broth of Bipolaris sp. The structure was determined to be an
      eremophilane derivative on the basis of 2D nmr spectroscopy and chemical
      transformations.

PMID- 7775988
TI  - Measuring activities in clinical trials using random work sampling: implications
      for cost-effectiveness analysis and measurement of the intervention.
AB  - Determining research-related costs from intervention-related costs is important
      for both clinical and health services research. Often this task involves
      estimating what proportion of the workday personnel spend on a variety of
      activities. We used a portable random reminder beeper to measure the daily work
      activities and contacts of study nurses within the context of a multi-site
      randomized trial designed to assess the effectiveness of primary care. Nurses
      recorded 4920 work activities over 140 consecutive workdays. Research-related
      activities consumed the largest proportion of the workday, 42.5% (95% CI, 38.1
      46.7) followed by patient care, 28.8% (24.1-33.2), personal time 16.4% (12.0
      20.7), and time spent in transit 12.5% (9.1-15.9). Because this research-related
      time is spent performing tasks specific to the enrollment of patients and
      measurement of outcome variables, we will use an adjusted annual salary for these
      nurses (from $56,392-$32,425) when attributing costs of the intervention in cost
      effectiveness analyses and for future management projections. Work sampling is a
      flexible, inexpensive method that was well accepted by the nurses in this study.
      Our results provide important insights into the costs analysis of complex
      interventions involving health professionals and may allow us to explore why the
      intervention worked or did not work at individual sites.

PMID- 7775989
TI  - Selecting control groups for studies of familial aggregation of disease.
AB  - In genetic-epidemiologic studies to determine the association between the disease
      status of family members, this association is measured by comparing rates of the
      disease in relatives of probands (index cases) with the disease, with the rates
      of the disease among individuals in a control group. Either of two types of
      control groups are generally used: (1) a control group consisting of a random
      sample from the population or the entire population if available or (2) a control
      group consisting of relatives of individuals without the disease under study. We
      examine the advantages and disadvantages of using these different types of
      control groups. We show two major results for family studies: (1) when there are
      no other factors associated with the disease status of an individual other than
      the disease status of a family member, both types of control groups will give a
      valid test of the null hypothesis of no familial aggregation. However, tests
      using a population control group will always be less efficient statistically,
      than those performed with a control group of relatives of probands without the
      disease under study, the degree of efficiency decreasing with increasing
      population prevalence of the disease. (2) When factors other than the disease
      status of a family member are also associated with the disease status of an
      individual, if this factor is a proband characteristic (which is not shared by
      relatives) population control groups cannot be adjusted to eliminate possible
      bias due to the potential confounding effect of this factor (unlike control
      groups consisting of relatives of probands without the disorder).

PMID- 7775990
TI  - Autoperception and satisfaction with health: two medical care markers in elderly
      hospitalized patients. Quality of life as an outcome estimate of clinical
      practice.
AB  - This paper reports a prospective study, carried out in elderly patients
      hospitalized for acute illness, designed to evaluate the effectiveness of medical
      treatment from the point of view of quality of life (QoL). Patient's
      autoperception and satisfaction with health, the most relevant subjective
      estimates of QoL, were assessed on admission to hospital and at check-up after
      discharge. A comprehensive functional evaluation of the patients was made. The
      results indicated an improvement in health autoperception coherent with the
      professional view. However, health satisfaction was not modified in any way after
      medical treatment. This dissonance could be explained because the predictors of
      satisfaction, age, sex, functional status and comorbidity, are the factors least
      modified by treatment. Satisfaction with ones own health could be a crucial
      marker of QoL especially for chronic diseases, but not appropriate for monitoring
      treatment effectiveness of acute illness. Health autoperception seems to be more
      desirable as an outcome estimate for this purpose.

PMID- 7775991
TI  - Gender differences in cystic fibrosis: Pseudomonas aeruginosa infection.
AB  - The median survival age for females with cystic fibrosis (CF) is approximately 3
      years younger than for males. We tested whether earlier acquisition of
      Pseudomonas aeruginosa (PA) by female CF patients or the greater impact of this
      organism on their lung disease, or both, contribute to their poorer survival. PA
      infection status, survival, pulmonary function tests, and chest X-ray scores from
      patients who were followed at our center for at least 2 years with a minimum of
      three respiratory cultures per year were analyzed (n = 848). The median age of
      chronic infection with mucoid PA was 1.7 years earlier in females than in males.
      Patients infected with mucoid PA had poorer survival, chest X-ray scores, and
      pulmonary function tests than patients who had either no Pseudomonas species or
      only the nonmucoid phenotype. Acquisition of mucoid PA was associated with an
      accelerated rate of decline in pulmonary function. However, the rate of change of
      pulmonary function after mucoid PA infection was similar for males and females.
      Moreover, even among patients who had only the mucoid form or only the nonmucoid
      form, males had better percent predicted forced expiratory volume in 1 sec and
      better survival. Therefore, factors in addition to earlier acquisition of mucoid
      PA may contribute to the poorer survival of female CF patients.

PMID- 7775992
TI  - Validation of a French-language version of the MOS 36-Item Short Form Health
      Survey (SF-36) in young healthy adults.
AB  - The MOS 36-Item Short Form Health Survey (SF-36) is designed to measure 8
      dimensions of health in clinical and general population settings. The main aim of
      this paper was to examine the reliability and validity of this instrument in
      young adults. A secondary aim was to document the results of a rapid translation
      procedure of the instrument, to be compared later to the more thorough official
      French adaptation. The translated survey was answered in 1992 by 1007 residents
      of Geneva, Switzerland, 18-44 years old, identified from health insurance rolls
      (82% response rate). Completion rate for all 8 dimensions of health was 95.5%.
      The instrument demonstrated excellent covergent (100%) and discriminant (98%)
      validity against pre-set criteria. Interval scaling of responses could be
      verified in some, but not all, items. Cronbach alpha (reliability) coefficients
      ranged from 0.76 to 0.92. Factorial analysis yielded 2 principal components,
      corresponding to mental and physical health. Thirteen of 16 correlations between
      health dimensions and principal components were within a pre-established range.
      Validation by independent clinical variables was also, with few exceptions,
      consistent with theory. Thus the SF-36 retained excellent psychometric properties
      even when used in a generally very healthy group. The careful but rapid
      translation procedure used in this study may be an effective alternative to full
      scale cultural adaptations when resources are limited.

PMID- 7775993
TI  - Can drug treatment be improved by feedback on prescribing profiles combined with
      therapeutic recommendations? A prospective, controlled trial in general practice.
AB  - We have carried out a prospective, controlled trial to ascertain whether mailed
      feedback on general practitioners' (GPs) own prescribing combined with relevant
      recommendations on drug treatment, can improve the prescribing. The GPs in the
      Norwegian county of More and Romsdal recorded all their contacts with patients
      and prescriptions during two periods. After the first period the GPs in Romsdal
      only (intervention group) received a mailed report giving their prescribing
      profiles as well as treatment recommendations for insomnia and acute cystitis.
      The total number of contacts with patients was 68,625 in which 55,747 items were
      prescribed. The GPs in the intervention group changed their prescribing in
      accordance with the intervention: they prescribed significantly less sleeping
      pills for each patient, preferred short- to long-acting benzodiazepine hypnotics
      and tranquilizers, and they chose trimethoprim as a first line treatment for
      acute cystitis. We conclude that it is possible to improve the GPs' prescribing
      through mailed feedback.

PMID- 7775995
TI  - Stability of blood (pro)vitamins during four years of storage at -20 degrees C:
      consequences for epidemiologic research.
AB  - We studied the effects of frozen storage on (pro)vitamin concentrations in EDTA
      plasma and whole blood. Aliquots from 55 samples were analyzed before storage and
      after 3, 6, 12, 24, 36 and 48 months at -20 degrees C. Dramatic decreases
      occurred for EDTA-plasma concentrations of vitamin E between 6 and 12 months,
      vitamin A, total carotenoids and beta-carotene after 1 year, and whole blood
      niacin. A smaller decrease was observed for folic acid at 1 year of storage, but
      the level remained constant thereafter. The vitamins D, B6, B12 (EDTA-plasma), B1
      and B2 (whole blood) showed no decline during 4 years of storage. With the
      exception of folic acid, the observed decreases varied considerably among
      subjects. Therefore using EDTA-plasma stored longer than 1 year at -20 degrees C
      will result in highly attenuated odds ratios when assessing the relationship
      between vitamin A, carotenoids, or vitamin E with a given disease. Attenuation
      will also occur when using niacin concentrations in whole blood stored for 4
      years at -20 degrees C.

PMID- 7775994
TI  - Population-based registries using multidisciplinary reporters: a method for the
      study of pediatric neurologic disorders.
AB  - Few registries are available for evaluating population differences for rare,
      newly, or ill-defined pediatric neurologic disorders. The purpose of this article
      is to present standard methodologies for establishing a population-based registry
      and evaluating the completeness of a registry's case ascertainment. The Texas
      Rett Syndrome Registry (TRSR) is used as a model. The combination of health care
      and education resources has identified approx. 89-100% of the Rett syndrome cases
      in Texas. Cases reported by non-physician sources, although older on average
      (10.7 vs 7.7 years of age), did not differ by other demographic characteristics
      from those reported by physicians. Non-physician health and education
      professionals participated with the TRSR at a significantly higher rate than
      physicians, 89 and 37% (p < 0.05), respectively. Capture-recapture techniques,
      both two-sample and log-linear modeling, were used to quantitatively evaluate
      case ascertainment. Standardized national and international population-based
      registries could be the basis of an initiative to identify the etiology and
      perhaps preventive measures for pediatric neurologic disorders.

PMID- 7775996
TI  - Competing mortality risks and differential survival.

PMID- 7775997
TI  - The etymology and pathogenesis of "wonk".

PMID- 7775998
TI  - Vulvo-vaginal candidiasis associated with acitretin.
AB  - The aim of this study was to estimate the risk of vulvo-vaginal candidiasis among
      the users of acitretin. The incidence rate ratio of vulvo-vaginal candidiasis was
      estimated in a cohort of acitretin users by using prescription sequence analysis.
      Study subjects were 196 women between 15 and 45 years of age, exposed to
      acitretin in 1990. Prescriptions of drugs for treatment of vulvo-vaginal
      candidiasis were used as proxy for the occurrence of vulvo-vaginal candidiasis.
      Validation of the proxy drug was performed by record linkage of pharmacy and
      medical records. In addition to the risk estimation by incidence rate ratios a
      case-crossover study with patient-stratified logistic regression analysis was
      performed to control for distortion due to individual differences in contribution
      of exposure time. The positive predictive value of the proxy drug for vulvo
      vaginal candidiasis ranged between 57 and 100%, the sensitivity was 87% and the
      specificity estimated 99%. The crude incidence rate ratio for vulvo-vaginal
      candidiasis following acitretin exposure was 2.8 (CI95%: 1.1-7.1). The pooled
      Mantel-Haenszel incidence rate ratio was 3.3 (CI95%: 1.1-9.6) after
      stratification for accumulated level of exposure. Patient-stratified analysis on
      the subgroup of cases (n = 15) revealed an odds ratio of 6.5 (CI95%: 2.3-18.2).
      This study strongly suggests that the higher occurrence of vulvo-vaginal
      candidiasis during acitretin exposure is attributable to the drug.

PMID- 7776000
TI  - The use of unlicensed assistive personnel. When to support, oppose, or be
      neutral.

PMID- 7775999
TI  - The use of prescription claims databases in pharmacoepidemiological research: the
      accuracy and comprehensiveness of the prescription claims database in Quebec.
AB  - Despite the potential benefits of using prescription claims databases for
      pharmacoepidemiological research, little work has been reported on the nature of
      available information or its accuracy. The purpose of this study was to describe
      information contained within the prescription claims database in Quebec, and to
      assess the accuracy of drug information that might be used to monitor drug
      exposure and physician prescribing. The comprehensiveness of the prescriptions
      claims database was assessed by examining 1,917,214 records of dispensed
      prescriptions for a regionally stratified random sample of 65,349 Quebec elderly
      in 1990. We found that values in key fields (individual identifiers, drug,
      quantity, date dispensed and duration) were missing or out of range in 0-0.4% of
      records. The accuracy of data were examined in 723 prescriptions filled by 306
      elderly patients attending one internal medicine clinic. Of these prescriptions,
      83% were filled by the patient and correctly identified the patient and drug and
      in 89% of these 599 records, the prescribing physician was correctly identified.
      The quantity and duration of the prescriptions were accurate in 69.1% and 72.1%
      of records, respectively. We conclude that the prescription claims database in
      Quebec may represent one of the most accurate means of determining drugs
      dispensed to individuals. There may be limitations in using this database for
      dosing information.

PMID- 7776001
TI  - The nurse entrepreneur. Legal aspects of owning a business.
AB  - For those nurse executives and managers with an innovative flair and a desire for
      increased personal and professional autonomy and flexibility, becoming an
      entrepreneur holds promise of potential financial and personal rewards. The
      freedom associated with flexible hours and job setting enables many nurses to
      balance work, family, or school commitments. Along with these rewards come the
      legal responsibilities of owning and managing a business--something many nurse
      entrepreneurs believe is well worth the investment.

PMID- 7776002
TI  - Healthcare in transition. Labor law impact on nurse-supervisor roles.
AB  - The United States Supreme Court has issued a new decision concerning the
      representation rights of nurses who exercise supervisory authority on behalf of
      their employers. However, the holding of the decision may reflect a view of labor
      management relations that is outdated, given the massive changes that healthcare
      is going through in the 1990s.

PMID- 7776003
TI  - The impact of a wireless telecommunication system on time efficiency.
AB  - With the increased acuity of patients and the resultant complexity of care
      required, effective and efficient communication among patients, nurses, and
      physicians is a critical variable in patient outcomes. In recognition of the need
      for rapid communication between health professionals, University Hospital in
      Denver, Colorado, instituted a wireless telecommunication system on two medical
      surgical nursing units. Evaluation research of this innovation in practice
      revealed a significant time savings by both nurses and clerical staff members.
      This time savings translates into improved patient care because skilled personnel
      have more time available for direct patient care.

PMID- 7776004
TI  - Expanding services through student placements: Strategies for the home health
      administrator.
AB  - As home healthcare becomes increasingly "high-tech," home health administrators
      struggle to provide nursing students with traditional community health nursing
      experiences. The gap between education and service widens as university faculty
      turn to other community health agencies, including academic nursing centers, for
      clinical placements. Strategies that administrators and faculty can use to modify
      current clinical experiences in ways that expand agency services while meeting
      the educational goals are presented.

PMID- 7776005
TI  - Home Care Steps protocols: Home care's answer to changes in reimbursement.
AB  - Home care agencies must plan for increasing demands from managed-care
      organizations; federal, state, and local governments; and consumers to provide
      appropriate, timely, high-quality, and cost-effective home healthcare services.
      Providers of home care services need a methodology to appropriately manage and
      control their service delivery. The Home Care Steps protocols discussed in this
      article provide such a methodology.

PMID- 7776006
TI  - The proactive management of rumor and gossip.
AB  - Gossip and rumor are common forms of communication in the workplace.
      Consequently, nursing administrators are challenged to find ways to manage these
      grapevine activities. The authors present an analysis of gossip and rumor and
      discuss strategies for their prevention and control.

PMID- 7776007
TI  - Pulling the plug.

PMID- 7776008
TI  - Supplemental staffing. Nurse manager views of costs, benefits, and quality of
      care.
AB  - The authors identified nurse managers' perceptions of supplemental staffing
      costs, benefits, and quality of care related to patient care delivery and
      knowledge of the setting. Qualitative responses related to perceptions of costs
      and benefits were analyzed. Perceptions of quality of care were more positive
      when related to actual patient care delivery, but relatively negative for items
      relating to knowledge of policies, procedures, and care delivery setting.

PMID- 7776009
TI  - Dealing with inappropriate behavior on a multidisciplinary level: A policy is
      formed.
AB  - Rapid changes due to healthcare reform have impacted the patient care setting,
      demanding that care is provided in an efficient manner--a team working in harmony
      to meet patient care needs. However, inappropriate behavior at the work site
      continues to rob healthcare providers of valuable time as they stop to regroup
      from its effects on staff and organizations. A search in the Dixie Regional
      Medical Center in St. George, Utah, to solve this age-old dilemma led to the
      formation of a policy to guide staff members in a positive direction when
      resolving conflict issues. This article addresses these efforts.

PMID- 7776010
TI  - Nurses' retirement preparation.
AB  - Nurses expect that professional achievement and dedication to society will reward
      them with economic security in their later years. Such rewards may not be theirs
      without deliberate and careful attention to early preparation. This study showed
      that although nurses expect an adequate income during retirement, their current
      pension, benefit, and savings status suggests otherwise. Nurses who do not
      actively manage personal finances or attend to details of employment benefit
      packages place themselves at distinct risk for economic crisis during their
      decades of retirement.

PMID- 7776011
TI  - Identifying the best in nurse executive leadership: Part 1, Questionnaire
      results.
AB  - Further analysis of a previously reported transformational leadership study
      indicated that the study's 81 excellent nurse executives can be further
      delineated into four groups based on the difference between the scores of nurse
      executives and staff for transformational and transactional leadership. Part 1
      reports questionnaire results, indicating that staff identify two groups as more
      highly transformational. Part 2 will identify further characteristics of these
      groups based on interview data results.

PMID- 7776012
TI  - One fellow's perspective. Reflections on the J & J Wharton Fellows Program for
      nurse executives.

PMID- 7776013
TI  - Primary care for women. Comprehensive sexual health assessment.
AB  - This article discusses the fundamentals of sexual functioning and describes the
      elements of a comprehensive, developmentally relevant sexual health assessment.
      Personal barriers that may prevent clinicians from comfortably addressing sexual
      issues are discussed, and useful strategies for facilitating effective,
      reciprocal communication during a sexual health history are presented. A
      therapeutic intervention model for counseling, referral, and sexual health
      assessment of women in the primary care setting is also included.

PMID- 7776014
TI  - Primary care for women. Assessment of hematologic disorders.
AB  - This article reviews hematopoiesis, the pathophysiology of selected hematological
      disorders, and the components of the health history and physical exam that are
      needed to make a complete assessment of women with a variety of hematological
      disorders. The laboratory testing and interpretation of tests that augment the
      assessment of women with signs and symptoms of hematological disorders are also
      included.

PMID- 7776015
TI  - Primary care for women. Comprehensive cardiovascular assessment.
AB  - This article identifies the tools necessary for basic primary care assessment and
      evaluation of the cardiovascular system in women. Risk factors and abnormalities
      associated with cardiovascular problems are discussed. Guidelines are presented
      that will enable the primary care clinician to determine normal cardiovascular
      function in women, identify risk factors that indicate the need for preventive
      care, and discover abnormalities that may require referral and intervention.

PMID- 7776016
TI  - Primary care for women. Comprehensive assessment of the respiratory system.
AB  - This article reviews the anatomy and physiology of the respiratory system and
      provides techniques for the physical assessment and data collection for common
      respiratory complaints in women. The pertinent historical, physical examination,
      and laboratory data for asthma, pneumonia, bronchitis, cough, and tuberculosis
      are also presented. This article is the first of two articles on primary care for
      women with respiratory complaints; the subsequent article will address primary
      care management of common respiratory conditions.

PMID- 7776017
TI  - Primary care for women. Comprehensive assessment of the neurologic system.
AB  - This article reviews the essential neuroanatomy and neurophysiology, and
      summarizes the components of the health history, physical exam, and laboratory
      tests required for an assessment of the neurologic system within the primary care
      setting. Brief case studies illustrate the wide range of symptoms associated with
      neurologic disorders in women and the manner in which the pattern of symptoms can
      be used to locate the site of pathology and indicate the need for referral and
      follow-up.

PMID- 7776018
TI  - Primary care for women. Comprehensive dermatologic assessment.
AB  - This article identifies the components necessary for comprehensive dermatologic
      assessment, including the pertinent anatomy and physiology, appropriate health
      history, and physical examination strategies. An overview of common dermatologic
      conditions in women is presented, and the identification of and action needed for
      life-threatening dermatologic conditions are reviewed. This article is the first
      of two articles on primary care for women with dermatological complaints; the
      subsequent article will address primary care management of common dermatologic
      conditions.

PMID- 7776019
TI  - Primary care for women. Comprehensive assessment of the head and neck.
AB  - This article reviews the pertinent anatomy of each body system involved in the
      assessment of the head and neck (including the eyes, ears, nose, and throat) and
      describes the basic elements of the comprehensive health assessment. Frequently
      encountered chief complaints are discussed. Aspects of the health assessment that
      will assist the primary care provider in making a differential diagnosis and
      determining the need for referral are presented. This article is the first of two
      articles on this topic; the subsequent article will address primary care
      management of common conditions of the head and neck.

PMID- 7776020
TI  - Primary care for women. Comprehensive assessment of common musculoskeletal
      disorders.
AB  - This article reviews the common musculoskeletal disorders that are likely to be
      encountered in the women's primary care setting. Basic anatomy and physiology of
      the musculoskeletal system are reviewed, and the assessment and treatment of
      complaints of strains, sprains, low back pain, chest pain, carpal tunnel
      syndrome, musculoskeletal pain syndrome, fibromyalgia, osteoporosis, and
      osteoarthritis are discussed. Examples of low-technology treatment strategies are
      included.

PMID- 7776021
TI  - Primary care for women. Comprehensive assessment of gastrointestinal disorders.
AB  - This article summarizes the anatomy and physiology of the gastrointestinal
      system, reviews physiologic changes that occur with normal development, and
      discusses considerations for the primary care provider in gathering health
      history information and conducting the physical exam. The use of diagnostic
      testing during the evaluation of women with gastrointestinal complaints is
      reviewed. A case study is used to illustrate an integrated approach to diagnosis
      and management of gastrointestinal disorders of women in the primary care
      setting.

PMID- 7776023
TI  - Primary care for women. The nurse-midwifery legacy.

PMID- 7776022
TI  - Primary care for women. Assessment and management of genitourinary tract
      disorders.
AB  - This article reviews the basic anatomy and physiology of the genitourinary system
      and disorders commonly encountered in the primary care setting. The role of the
      nurse-midwife in the assessment and treatment or referral of complaints of
      dysuria, hematuria, and incontinence is discussed. The treatment of nonpregnant
      women with cystitis is addressed; symptoms associated with pelvic relaxation are
      discussed, and a management scheme for teaching effective pelvic floor exercises
      is presented.

PMID- 7776024
TI  - Primary care for women. An overview of the role of the nurse-midwife.
AB  - The nurse-midwife's past, present, and future roles in the primary care of women
      are explored using a recent Institute of Medicine report on primary care as a
      framework for discussion. Primary care, the scope of services, and the role of
      the primary care clinician are described, and specific strategies for a primary
      care emphasis in basic nurse-midwifery education are addressed. The nurse
      midwife's future roles in collaborative practice for the primary care of women
      and the need for continuing education opportunities in primary care are also
      discussed.

PMID- 7776026
TI  - Primary care for women. Environmental assessment of the home, community, and
      workplace.
AB  - This article presents the primary health care provider with an overview of basic
      environmental health issues, discusses symptoms related to environmental
      exposures, and provides a review of the steps involved in comprehensive
      environmental assessment. Guidelines for assessing women within the context of
      the home, community, and workplace are provided.

PMID- 7776027
TI  - Primary care for women. The art of interviewing.
AB  - This article focuses on the skills, attitudes, and goals required for effective
      history-taking during comprehensive health assessment in the primary care
      setting. The approach presented is characterized as "patient-centered" in that
      the woman is engaged in the problem-solving process. Specific communication
      skills are discussed, and attitudes and goals that enable primary care providers
      to adopt a patient-centered approach to relationship-centered care are included.

PMID- 7776025
TI  - Primary care for women. Screening tests and preventive services recommendations.
AB  - This article reviews public health prevention principles and screening test
      requirements and discusses current guidelines that underlie widely used
      preventive services recommendations. The reasons and rationales that govern the
      screening of healthy asymptomatic women for certain diseases are reviewed. This
      update will prepare nurse-midwives for enhanced roles in health promotion, an
      important aspect of the scope of primary care services for women.

PMID- 7776028
TI  - Internal fixation of calcaneus fractures: an anatomical study of structures at
      risk.
AB  - This study examines the risk of injury to medial soft-tissue structures during
      the fixation of calcaneal fractures performed through a lateral approach. An L
      shaped lateral incision was performed on 10 fresh cadaver feet. The calcaneus was
      divided into three zones for study. Ten K-wires were inserted in a standard
      configuration from a lateral starting point extending through the medial cortex.
      The feet were dissected medially to measure the distance from each exiting K-wire
      to the medial and lateral plantar vessels, the calcaneal branch of the posterior
      tibial nerve, and the tendons of the flexor hallucis longus, flexor digitorum
      longus, and posterior tibialis. The mean risk of injury to these medial
      structures was calculated for each lateral insertion site. Wires placed in the
      subchondral bone of the posterior facet or anterior to the critical angle of
      Gissane were determined to be at high risk of injury to the medial soft tissues.
      Structures at risk included the medial and lateral plantar nerves and vessels and
      the flexor hallucis longus tendon. Caution should be exercised when inserting K
      wires, drills, and screws into high-risk areas to avoid iatrogenic injury to the
      medial structures.

PMID- 7776029
TI  - Hematoma block for ankle fractures: a safe and efficacious technique for
      manipulations.
AB  - The purpose of this study was to examine the safety and efficacy of the hematoma
      block technique for closed ankle fracture manipulation. Twenty-three patients
      received a hematoma block with or without supplemental analgesia and/or sedation
      for the manipulative reduction of an ankle fracture, and 37 patients received
      parenteral agents alone. At an average of 12 months post-reduction, patients were
      administered a questionnaire concerning their level of discomfort surrounding the
      manipulation of their acute injury. Their experienced level of pain was recorded
      on a pain analog scale at the time of injury, at the time of reduction, and at
      the time of the questionnaire. Other queries were made regarding their recall of
      other aspects of their acute care treatment. The hematoma block group noted their
      pain differential to be 3.4 less during reduction compared with the time of
      injury. In the 17% subgroup of hematoma block patients who received no
      supplemental parenteral analgesia, the pain differential was noted to be 4.5 less
      during reduction. This was in contrast to the non-hematoma block group, which
      rated their pain differential to be 0.6 between injury and reduction. In
      addition, the hematoma block procedure resulted in no associated complications.
      The results of this study led us to conclude that the hematoma block with or
      without supplemental analgesia for the manipulation of ankle fractures was safe
      and effective and is a useful technique. This is particularly true in those
      patients in whom an adequate dosage of parenteral medication is contraindicated
      or unsafe.

PMID- 7776030
TI  - Management protocol for unreamed interlocking tibial nails for open tibial
      fractures.
AB  - Over a 15-month period, 41 open grade I-IIIA tibia fractures were treated with
      unreamed interlocking nails. A protocol previously established by the authors to
      enhance fracture union was followed. The purpose of the study was to determine if
      union rate for the comminuted statically locked fracture could be reduced through
      early dynamization, bone grafting, or a combination of both. Of the 41 patients,
      15 had grade I wounds, 12 had grade II wounds, and 14 had grade IIIA wounds.
      Fracture classification using the Orthopaedic Trauma Association Classification
      showed 19 42A fractures, 15 42B fractures, and seven 42C fractures. Fifteen of
      the 41 fractures required dynamization for rotational and axial stabilization. Of
      these 15 patients, five subsequently underwent dynamization only, six underwent
      autogenous bone grafting, and three underwent both dynamization and bone
      grafting, one of which also underwent exchange rodding. One patient underwent
      bone grafting and exchange rodding. Comparing the fractures of these 15 patients
      to similar fractures previously reported, union rate was reduced from 37 to 24
      weeks. This was statistically significant to 0.002. It is the authors'
      recommendation that statically locked unreamed tibial nails be dynamized and/or
      bone grafted at 6-8 weeks postinjury to enhance union and reduce the time of
      fracture healing.

PMID- 7776031
TI  - Osteomyelitis in grade II and III open tibia fractures with late debridement.
AB  - The purpose of this study was to compare the incidence of infection in grade II
      and III open tibia fractures with respect to early and late debridement. All
      grade II and III tibia fractures treated between January 1988 and January 1992
      were reviewed. Forty-seven fractures (25 grade II and 22 grade III) in 46
      patients were eligible for entry into the study. In all grade II and III
      fractures, one of 15 fractures (7%) debrided in < or = 5 h became infected.
      Twelve of 32 fractures (38%) debrided > 5 h after injury became infected (p <
      0.03). Overt manifestations of infection did not appear until an average of 4.8
      months from the time of injury, and the infecting organisms correlated with the
      initial cultures in only 25% of the cases. Negative postdebridement cultures did
      not preclude subsequent infection. The Injury Severity Score did not appear to
      correlate with increased risk of subsequent osteomyelitis.

PMID- 7776033
TI  - Open dislocation of the knee.
AB  - Traumatic open dislocation of the knee is an infrequent, severe injury associated
      with extensive ligamentous damage and a high incidence of vascular and neurologic
      involvement. Eighteen patients with 19 open knee dislocations were treated at the
      affiliated hospitals of the University of Pennsylvania and Louisiana State
      University Medical Center during an 18-year period. Final results included three
      above-knee amputations, one knee fusion, and one total knee arthroplasty. The 14
      knees salvaged had only fair to poor function according to the Hospital for
      Special Surgery Knee Injury Score at an average follow-up of 36 months after the
      injury (average score = 29, range - 17 to 37). Nine patients (47%) had
      concomitant neurologic or vascular injury, and eight patients (42%) had wound
      healing difficulties. Five complete disruptions of the popliteal artery or
      posterior tibial artery underwent emergent revascularization, successful in three
      of the extremities, with the remaining two extremities requiring above-knee
      amputations. These massive injuries are often limb-threatening despite prompt
      surgical intervention and early antibiotic therapy. There is a very high
      incidence of infection and neurologic injury with a guarded prognosis for limb
      survival and satisfactory function.

PMID- 7776032
TI  - Intramedullary nailing of aseptic tibial nonunions without the use of the
      fracture table.
AB  - Twenty-seven patients with 28 aseptic nonunions were treated with reamed
      intramedullary (IM) nailing of the tibia and were followed for at least 1 year
      postoperatively. The management protocol called for a radiolucent operating room
      table with the limb draped free and manual manipulation of the nonunion with a
      preference for closed nailing. Nail interlocking was used when residual axial or
      rotational instability was observed after nail insertion. Iliac crest bone
      grafting was performed on all patients requiring open nailing. Closed nailing,
      using the described technique, was accomplished in 20 cases; open nailing was
      necessary in eight. Although operative time and total blood loss were
      significantly increased with open nailing, time to union was similar in the two
      groups. Twenty-seven nonunions healed. The lone persistent nonunion responded to
      bone grafting, leaving the nail in situ. One infection occurred, which responded
      to debridement, drainage, and long-term antibiotic therapy without requiring nail
      removal. Acceptable bony alignment was attained in all patients. Functional
      results were excellent. This method is recommended for all tibial nonunions
      amenable to IM nail stabilization. A history of prior acute infection and/or
      excessive shortening due to bone loss constitute the relative contraindications.

PMID- 7776034
TI  - Response of the lateral meniscus of the dog to wide incision and repair of the
      meniscotibial ligament.
AB  - The effects of extensive incision and reattachment of the coronary ligaments on
      meniscal healing in the canine were examined. Through an extensile exposure to
      the lateral tibial plateau, nine mongrel dogs underwent wide incision,
      reflection, and subsequent reattachment of their meniscotibial ligaments. At
      intervals of 3, 6, and 9 weeks, three dogs were killed and a gross and
      microscopic evaluation of their menisci and perimeniscal tissues was performed.
      At 3 weeks, a small region of the central meniscal periphery was found to be
      devoid of a vascular network. By 6 weeks, the entire peripheral vasculature had
      reconstituted. No specimen demonstrated histologic evidence of meniscal necrosis
      or degeneration. Healing occurred by fibrovascular scar.

PMID- 7776035
TI  - Distal femur as a donor site of autogenous cancellous bone graft.
AB  - We performed a prospective clinical study and a cadaveric study to evaluate the
      morbidity associated with harvesting cancellous bone from the distal femoral
      metaphysis for use in the lower extremity. Thirty patients underwent harvest of
      distal femoral cancellous bone: 13 for acute trauma and 17 for reconstructive
      procedures. The distal femoral condyle is approached through a 6-cm midlateral,
      longitudinal incision. A small cortical window is created, bone graft is
      harvested, and the cortical window is replaced. All patients were kept nonweight
      bearing on the extremity for a minimum of 6 weeks. Patients were followed for an
      average of 10 months (range 3-32 months) and no patient was lost to follow-up
      before allowing full weight bearing. There were no donor site would or
      neurovascular problems and no femur fractures. A cadaveric study was also
      performed in which bone was harvested from the distal femur, the bone was
      quantified, and the knees were tested in compression (axial loading). The bone
      harvested knees failed in the same load range as the contralateral control knees
      did. The distal femoral metaphysis has many advantages compared with the iliac
      crest in cases when cancellous bone is needed for the lower extremity. Harvesting
      distal femoral bone is associated with little morbidity if performed correctly,
      and if the patient remains nonweight bearing for 6 weeks.

PMID- 7776036
TI  - Mechanics of retrograde nail versus plate fixation for supracondylar femur
      fractures.
AB  - Two common types of internal fixations for the supracondylar femur fractures--the
      retrograde intramedullary nail and the 95 degrees sideplate and screw--were
      mechanically tested in synthetic composite femur bones to determine the
      quantitative differences in their inherent rigidity. The medial and lateral
      femoral condyles were separated by a sagittal osteotomy, and a standardized
      medial segmental shaft defect was created at the distal shaft. The osteotomized
      specimens were stabilized using one of the two implants and were tested in
      different modes of loading. The bending stiffness of both constructs were not
      significantly different in varus compression, medial bending (pure varus), and
      bending in flexion. The plate and screw implant was three times stiffer in
      lateral bending (pure valgus) and 1.2 times stiffer in valgus compression than
      the retrograde supracondylar nail (p < 0.01). The torsional stiffness of the
      plate and screw implant was significantly higher, 1.6 times that of the nail.
      Clinically, the most important and common cause of implant failure is varus
      loadings due to loss of medial cortical contact. Although the retrograde nail was
      less rigid in other physiologically less critical modes of loading, it had a
      rigidity comparable to that of the plate in varus loading. Therefore, a
      supracondylar nail may be considered a mechanically possible alternative to plate
      fixation.

PMID- 7776037
TI  - Sural nerve grafting for lower extremity nerve injuries.
AB  - Fourteen consecutive patients who had sural nerve grafts to reconstruct the
      sciatic or peroneal nerve were retrospectively evaluated to determine the
      functional return of reinnervation. A standardized functional evaluation to
      assess motor and sensory return of the injured compared with the contralateral
      side was employed as a means of normalizing the data. The dorsiflexion and
      plantar flexion strength were quantitatively measured to determine the recovery
      of muscle strength, and recorded as a percentage of the strength of the
      contralateral extremity as well as by assigning a motor grade. Sensory recovery
      was evaluated by sensory grade, two-point discrimination, and response to Semmes
      Weinstein monofilaments. The average age of these 14 patients was 20 years (range
      8-63 years). All but one of the patients regained protective sensation and five
      patients regained useful motor function. Four of the five patients regaining
      useful function were pediatric patients. Improved functional outcome was
      correlated to the nerve injured, patient age, mechanism of injury, length of
      graft, and the delay to grafting. The return of lower extremity function,
      obviating the need for bracing, can occur in children but is a rare occurrence in
      the adult patient although protective sensation is routinely gained and disabling
      paresthesias from neuromas are avoided.

PMID- 7776038
TI  - Effects of supine positioning and fracture post placement on the perineal
      countertraction force in awake volunteers.
AB  - An instrumented traction post was used to determine the magnitude and direction
      of the countertraction force applied to the perineum of 15 awake volunteers for a
      series of 12 positions used in fracture surgery and compared with their
      corresponding neutral position controls. The results demonstrated that adduction
      of the affected limb and abduction of the contralateral limb applied the greatest
      force to the perineum with ipsilateral and contralateral placement of the
      fracture post. These two maneuvers increased the perineal countertraction force
      80% above their respective neutral readings. Abduction of the affected limb
      reduced the traction force by 50% with ipsilateral and contralateral placement of
      the fracture post. Flexion-abduction-external rotation of the contralateral leg
      reduced the forces applied to the perineum by 60% when the fracture post was
      placed contralateral to the affected limb. Contralateral placement of the post
      decreased the perineal countertraction force 46% below the value for ipsilateral
      post placement for this maneuver. Internal and external rotation of the affected
      limb had no effect on the perineal countertraction force for either placement of
      the post. There was a significant decrease in the perineal forces for the neutral
      positions after adduction of the affected limb and abduction of the contralateral
      limb with ipsilateral placement of the post, indicating that the volunteers
      shifted on the fracture table in response to pain. There was no significant
      difference in the direction of the countertraction force for the various
      positions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7776039
TI  - Treatment of fracture blisters: a prospective study of 53 cases.
AB  - From June 1987 to January 1993, 53 fractures complicated by overlying blisters
      were identified and prospectively followed. Data concerning the mechanism of
      injury, time course in the development of the fracture blisters, clinical
      characteristics of the blister, fracture type and management, and soft-tissue
      treatment and outcome were collected. Clinically, two types of blisters were
      identified: clear fluid filled and blood filled. Methods used to treat the skin
      blister were: aspiration of the blister, deroofing of the blister with subsequent
      application of Silvadene cream or coverage with a nonadherent dressing, and
      leaving the blister intact and covered by a loose gauze or exposed to the air. No
      significant difference was found in the outcome of the skin injury treated with
      the various modalities. Nineteen patients underwent early open reduction and
      internal fixation in the presence of intact fracture blisters. In 17 cases the
      incision healed within 3 days, sealing off the deeper structures, and
      reepithelialization of the blister bed then occurred at a later date. Two of the
      patients who had incisions pass through blood-filled blisters developed wound
      healing complications. Although there was no significant difference in the
      outcome of the soft-tissue treatment techniques, our present practice is to leave
      all fracture blisters intact. If the blisters rupture spontaneously, they are
      deroofed and covered with a nonadherent dressing. Early surgery is contemplated
      in patients with intact blisters and without severe swelling.

PMID- 7776040
TI  - Marginal mandibular nerve palsy due to compression by a cervical hard collar.
AB  - A case history of a trauma patient who developed a palsy of the marginal
      mandibular nerve from compression by a cervical spine hard collar is presented.
      After clinical and radiographic screening found no evidence of occult cervical
      spine pathology, the collar was removed; the palsy resolved uneventfully during
      the next 2 days.

PMID- 7776042
TI  - The unstable shoulder girdle: early functional treatment utilizing open reduction
      and internal fixation.
AB  - The unstable shoulder girdle--a combination of a scapular neck fracture with a
      clavicular fracture, acromioclavicular dislocation, or sternoclavicular
      dislocation--represents a rare and often underestimated injury. Sufficient
      treatment to permit early function is necessary to avoid a frozen shoulder as
      well as to treat concomitant thoracic injuries. This is possible only by open
      reduction and internal fixation. In most cases this can be achieved by a sole
      osteosynthesis of the clavicular injury. We retrospectively analyzed 12 cases and
      classified the results according to the Constant Score. This analysis showed
      excellent functional results in nearly all cases.

PMID- 7776043
TI  - The use of sonography for evaluation of the integrity and healing process of the
      tibiofibular interosseous membrane in ankle fractures.
AB  - This study evaluates the value of sonography in the diagnosis of the rupture and
      healing process of the interosseous membrane in Weber type B and C ankle
      fractures. In 90 such fractures a rupture of the interosseous membrane was
      intraoperatively observed in 35 cases (38.8%). All Weber type C fractures showed
      a rupture of the interosseous membrane, whereas only 23% of the Weber type B
      fractures were associated with a rupture of the interosseous membrane (p <
      0.001). In the vast majority of the cases (77%), particularly in all Weber type B
      fractures (p < 0.01), the rupture of the interosseous membrane extended above the
      proximal fracture line of the fibula. By means of sonography, in the acute
      posttrauma period a rupture of the interosseous membrane was found in 37.4% of
      the cases. Thus, in our series the results of sonography and the operative
      findings coincided in 88.6% of the cases concerning location, type, and extent.
      Sonography was performed by three unbiased observers, and the results were
      compared with the intraoperative findings. Thus, the sensitivity of the
      sonography in the diagnosis of the rupture of the interosseous membrane was
      88.8%, the diagnostic value of the method 92.2%, and specificity 94.5%. The
      sonographic findings of the healing process of the interosseous membrane were in
      absolute (100%) agreement with the intraoperative observations at the time of
      removal of the osteosynthesis material. Complete healing occurred within 3-5
      months after trauma in 70% of the cases of ruptured interosseous
      membrane.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7776044
TI  - Profiting from managed care.

PMID- 7776041
TI  - Traumatic dislocation of the lateral sesamoid of the great toe: nonoperative
      management.
AB  - A case of traumatic dislocation of the lateral sesamoid of flexor hallucis brevis
      tendon associated with metatarsal neck fractures due to a crush injury is
      reported. This patient was treated nonoperatively by elevation, application of
      plaster, and then free mobilisation. The patient has now fully recovered and
      remains completely asymptomatic despite residual sesamoid dislocation 1 year
      after the injury. The nonoperative management of this injury has not, to our
      knowledge, been reported previously.

PMID- 7776045
TI  - Evaluation of osseointegration of endosseous implants in radiated, vascularized
      fibula flaps to the mandible: a pilot study.
AB  - PURPOSE: This study clinically evaluated the osseointegration of implants placed
      into vascularized fibula flaps used in mandibular reconstruction of cancer
      patients following radiation treatment and subsequent hyperbaric oxygen (HBO)
      therapy. MATERIALS AND METHODS: Five head and neck cancer patients had mandibular
      resection and immediate reconstruction with a vascularized fibula flap.
      Subsequent therapy included greater than 50 Gy of radiation to the fibula flap
      over a 6 to 8-week period. Two to 6 weeks following radiation therapy each
      patient received 20 90-minute daily sessions of HBO at 2.4 atmosphere pressure.
      Stage 1 implant surgery was performed placing two to six implants (15 mm in
      length and 3.75 to 4.0 mm in width) into each fibula flap. This was followed by
      10 postoperative HBO sessions using the previously mentioned protocol. The stage
      2 procedure was performed 6 months after the stage 1 procedure. Osseointegration
      was assessed clinically using manual force and an electronic device at the time
      the implants were uncovered and monthly over a 6-month period. RESULTS: All 20
      implants placed in the fibula flaps were osseointegrated clinically at the time
      the implants were uncovered and during the 6-month follow-up. CONCLUSION: In this
      pilot study, mandibular reconstruction with a vascularized fibula flap and
      endosseous osseointegrated implants, following radiation of the fibula, was
      successful. It was concluded that factors such as the graft having its own blood
      supply and the use of HBO contributed to the successful osseointegration of these
      implants.

PMID- 7776046
TI  - Are mandibular third molars a risk factor for angle fractures? A retrospective
      cohort study.
AB  - PURPOSE: Anecodotal reports suggest that the presence of mandibular third molars
      predispose the mandible to angle fractures. The purpose of this study was to
      evaluate mandibular third molars as risk factors for angle fractures in a patient
      sample with fractured mandibles. MATERIALS AND METHODS: The medical records and
      panoramic radiographs of a patient cohort with mandible fractures was
      retrospectively reviewed. Data were collected for the following variables: age,
      sex, race, mechanism of injury, number and location of mandible fractures, and
      the presence and position of the mandibular third molars. RESULTS: Of the 73
      patients with mandibular third molars, 30 (41.1%) had angle fractures. Of the 28
      patients without mandibular third molars, 3 (10.7%) had angle fractures (P =
      .004). CONCLUSION: The results of this study demonstrate that patients with
      fractured mandibles and mandibular third molars are 3.8 times more likely to have
      an angle fracture than patients without mandibular third molars.

PMID- 7776047
TI  - An evaluation of velopharyngeal ring ligation in cleft palate repair.
AB  - PURPOSE: This article describes the details of the velopharyngeal ring ligation
      procedure (VPRL) and compares the results with those achieved with the von
      Langenbeck (VL) and pharyngeal flap procedures (PFP). PATIENTS AND METHODS: A
      random sample of 52 patients was evaluated postoperatively by phonation tests,
      measurement of oral pressure, pharyngeal fluoroscopy, and cineradiography.
      RESULTS: The results showed that the speech of the VPRL group was significantly
      better than that of the VL group. The velopharyngeal competence rate, the
      anteroposterior nasopharyngeal minimal diameter, the left-right nasopharyngeal
      minimal diameter (both in repose and on phonation), and the length of the soft
      palate were significantly different between VPRL and VL, and between VPRL and
      PFP. Differences in the velar angle were significant between VPRL and PFP and
      between PFP and VL, but there was no significant difference between VPRL and VL.
      CONCLUSIONS: VPRL is a better method for cleft palate repair than the VL or PFP
      procedures. It can reduce the nasopharyngeal space circumferentially, thus
      improving the patient's speech.

PMID- 7776048
TI  - Maxillary sinus aspergillosis: diagnosis and differentiation of the pathogenesis
      based on computed tomography densitometry of sinus concretions.
AB  - PURPOSE: The efficacy of preoperative computed tomography (CT) densitometry in
      evaluating the origin of sinus concretions (SC) in sinus aspergillosis (SA) and
      its value for differentiation between a dental (endodontic) and an aerogenic
      pathogenesis were examined. PATIENTS AND METHODS: Thirty-two patients who
      demonstrated radiodense maxillary sinus concretions in standard radiography
      underwent an additional preoperative CT examination of the maxillary sinus and
      the SC. The density of the SC and the root canal filling materials was assessed.
      The SC were subdivided into organic (< 1,500 HU) and inorganic (> 1,500 HU)
      masses; this classification was useful in the differentiation between a dental
      and an aerogenic pathogenesis of SA. RESULTS: SA was diagnosed in 22 patients
      (68.8%). The SC of SA patients had a density of 2,566.5 +/- 713.6 HU, whereas
      those of patients without SA had a density of 1,159.9 +/- 1,008.4 HU (P < .01). A
      correlation between the density of inorganic SC and that of root filling
      materials was found (r = .78, P < .01). CONCLUSION: CT densitometry allows a
      classification of SC into two subgroups. The correlation between the density of
      root filling materials and that of radiodense sinus concretions seems to point to
      a "dental" origin of some concretions in SA. However, "organic" masses found in
      CT densitomentric examinations represent endogenous fungal products, which
      indicate an aerogenic pathogenesis of SA. Additional CT examinations of
      radiodense sinus concretions may thus be of some value for diagnosing SA and
      differentiating their pathogenesis.

PMID- 7776049
TI  - Use of TiNiCo shape-memory clamps in the surgical treatment of mandibular
      fractures.
AB  - PURPOSE: This study tested the clinical application of shape-memory clamps for
      fixation of mandibular fractures using transoral access. MATERIALS AND METHODS:
      Clamps made of Ti50Ni48.7Co1.3 alloy were used to fix mandible fractures. These
      clamps automatically recovered their programmed shape at body temperature. The
      clamps were used to treat all types of fractures occurring between the mandibular
      angles. Postoperative maxillomandibular fixation was not required. Clamps were
      removed after a period of at least 6 weeks, and tissue samples were taken for
      microscopic examination. RESULTS: Seventy-seven patients with mandibular
      fractures were treated using the shape-memory clamps. There were 19 women and 58
      men, from 17 to 74 years old. Altogether 93 fractures were treated, involving 124
      clamps. There were 56 cases of single fractures and 21 cases of multiple
      fractures. In 72 patients the treatment progressed satisfactorily; in five cases
      infections occurred. Histologic examination of tissue taken from 58 patients
      after removal of the clamps did not indicate any atypical tissue reactions or
      signs of disturbed cell maturation. CONCLUSIONS: The application of shape-memory
      clamps for surgical treatment of mandible fractures facilitates treatment while
      ensuring stable fixation of the bone fragments. No pathologic tissue reactions to
      the implants were observed in either animals or humans.

PMID- 7776051
TI  - Intraoral defect coverage with muscle flaps.
AB  - PURPOSE: This study investigated whether wound healing after the use of purely
      muscular flaps for intraoral defect coverage is negatively influenced by
      insipient muscular atrophy and the absence of a covering layer. MATERIALS AND
      METHODS: In an experimental study, microsurgical transplantation of muscle flaps
      from the anterior abdominal wall was carried out in 18 Lewis rats. A nerve
      anastomosis for motor reinnervation was not performed. Atrophy of the muscle
      flaps was determined by measuring the reduction of their size and weight after 3,
      8, and 20 weeks. In the clinical part of the study, free muscle transplants from
      different donor regions (vastus lateralis, pectoralis major, internal oblique,
      and temporalis muscles) were used for defect coverage in various areas of the
      oral cavity. To study epithelization, punch biopsy specimens from the muscle
      surface were taken at periods of 2 to 4 weeks up to 6 months for histologic
      evaluation. Final evaluation of reconstruction results with special regard to
      speech, tongue mobility, mouth opening, chewing, and swallowing took place after
      6 months. RESULTS: In the experimental study, average weight loss of the muscle
      flaps was 67% after 20 weeks, and the remaining surface area was 71%. The number
      of myocytes was only about 30% compared with control muscles, and parts of the
      flap appeared as a thin fibrous membrane. Clinically, this atrophy led to
      restricted mobility in such areas as the floor of the mouth, the buccal plane,
      and the tongue. Muscle flaps covering solid structures such as bones or
      reconstruction plates adapted well to the transplant bed, and the atrophy of the
      muscle led to no constriction of the surrounding tissue. Atrophy also did not
      have a negative effect when muscle flaps were placed in the region of the
      pharyngeal wall. Epithelization started from the edges after 2 weeks and was
      concluded after 8 weeks in all transplants if no additional radiation was
      performed. The muscle tissue was sufficiently resistant so that infection,
      fistulization, and necrosis did not occur. CONCLUSIONS: Muscle flaps undergo
      considerable atrophy with a cicatricial transformation and reduction of
      flexibility. Despite these disadvantages they can be used in the hard palate, the
      alveolar crest, and in the pharyngeal wall without causing functional
      restriction. Because of constriction of the surrounding tissues, mobile areas
      such as the buccal plane, the floor of the mouth, and the tongue are not suitable
      as sites for muscle transplants.

PMID- 7776050
TI  - The effects of orthodontic treatment on isometric bite forces and mandibular
      motion in patients before orthognathic surgery.
AB  - PURPOSE: Little is known about the effects of orthodontic treatment on oral motor
      function. The objective of this report is to evaluate changes in mandibular
      motion and maximum bite force that occur between the initiation of presurgical
      orthodontics and its completion before surgery. PATIENTS AND METHODS: Fifteen
      patients (9 women, 6 men) with a variety of dentofacial deformities were examined
      before and after presurgical orthodontics. Mechanical advantage of the muscles
      and bite points, mandibular range of motion, maximum isometric bite force, and
      levels of electromyographic (EMG) activity in the anterior and posterior
      temporalis and masseter muscles during isometric bites were recorded on all
      subjects over time. Data obtained before and after completion of presurgical
      orthodontics were statistically compared. RESULTS: Presurgical orthodontics
      reduced mandibular mobility somewhat, but the amount was not significant.
      Statistically significant reductions in bite force were noted after orthodontics
      for incisor, canine, premolar, and molar bite positions. No significant
      difference in the EMG/bite force slopes was obtained, nor was there any
      difference in the moment arms of the bite points or the muscles of mastication
      from orthodontics. CONCLUSIONS: This study showed significant changes in measures
      of oral motor function resulting from orthodontic treatment. A larger study is
      needed to confirm that these results will be similar in all orthodontic patients.
      There is no indication that these changes are the result of physiologic
      alterations of the muscles of mastication. The best current explanation is that
      these changes result from the pain and discomfort of the orthodontic appliances
      and the induced malocclusion.

PMID- 7776053
TI  - Bilateral pseudogout of the temporomandibular joint: report of case and review of
      literature.

PMID- 7776052
TI  - Early carcinoma of the oral cavity: a conservative approach with radiation
      therapy.

PMID- 7776054
TI  - Giant peripheral ossifying fibroma of the maxilla: report of a case.

PMID- 7776056
TI  - Actinomycosis presenting as a midline palatal defect.

PMID- 7776055
TI  - Leiomyosarcoma of the tongue: a case report.

PMID- 7776057
TI  - Mandibular hemangiopericytoma: report of a case and review of the literature.

PMID- 7776058
TI  - Multiple granular cell tumors of the oral cavity: report of a case and review of
      the literature.

PMID- 7776059
TI  - Singultus: a distressing postsurgical complication.

PMID- 7776060
TI  - Adenomatoid odontogenic tumor: report of an unusually large lesion in the
      mandible.

PMID- 7776061
TI  - Use of pharyngoplasty to improve resonance in adult closed-head injury patients:
      report of cases.

PMID- 7776062
TI  - Severe cutaneous foreign body giant cell reaction after temporomandibular joint
      reconstruction with Proplast-Teflon.

PMID- 7776063
TI  - The use of an orthodontic appliance to stabilize a temporomandibular joint-
      continuous passive motion machine.

PMID- 7776064
TI  - Avoiding problems when switching an endotracheal tube.

PMID- 7776065
TI  - Untoward events associated with use of midterm i.v. devices.
AB  - The placement of a peripheral i.v. device causes increased stress for many
      individuals, sometimes causing temporary and self-limiting responses, described
      as vasovagal reactions. Report monitoring has identified adverse experiences that
      exceed anticipated reactions to stress and that may be life threatening. Untoward
      events have been reported during or immediately after insertion of midterm
      peripheral i.v. devices made of an elastomer/hydrogel polymer. Although the cause
      of these reactions remains unclear, it is a reminder that to identify and
      evaluate device-related issues, untoward events must be assessed, treated,
      evaluated, documented, and reported.

PMID- 7776066
TI  - Polyurethane and silicone: myths and misconceptions.
AB  - Silicone elastomer has been the standard by which other catheter materials have
      been judged. In the past ten years, technical advances in polymer research have
      provided the medical manufacturer with a wide variety of new materials for
      catheter manufacture. Thermoplastic polyurethane has shown great promise as an
      alternative to silicone for vascular catheters. This article examines the basic
      properties of the two materials and describes the findings in the literature that
      show comparable biocompatibility properties for both materials.

PMID- 7776067
TI  - Pulsatile i.v. insulin therapy for severely out of control diabetes.
AB  - A recently published National Institutes of Health study shows that tight blood
      glucose control is critical to averting diabetic complications. However, a small
      fraction of patients with diabetes cannot safely achieve tight blood glucose
      control even under the regimen employed in the study. Pulsatile i.v. insulin
      therapy (PIVIT) can help these severely ill patients gain control of their
      diabetes. After more than a decade of research, PIVIT is now in routine clinical
      use for severely out of control diabetes. PIVIT is performed on an outpatient
      basis at a number of hospitals and clinics around the United States. The clinical
      availability of PIVIT for severely out of control diabetes offers an important
      alternative for the approximately 1% of patients who are unable to attain the
      benefits of tight control through conventional means.

PMID- 7776068
TI  - The role of the i.v. specialist in health care reform.
AB  - IV nurses must have a better understanding of health care reform to understand
      why hospitals are decreasing nursing positions in general and why administrators
      always seem to cut i.v. nursing positions first. It is also important to learn
      strategies that i.v. teams can adopt to demonstrate their contribution to quality
      patient care so they are less likely to be eliminated.

PMID- 7776069
TI  - Abnormal tympanography after supine bottle feeding.
AB  - OBJECTIVE: To determine whether bottle feeding with the infant in the supine
      position is related to entry of milk into the middle ear, thereby predisposing
      the infant to otitis media. STUDY DESIGN: Ninety children, aged 7 to 24 months,
      who were free of respiratory infection and had normal tympanograms initially,
      were bottle fed in either the supine or the semiupright position, and
      tympanography was repeated immediately afterward. RESULTS: Thirty-four (59.6%) of
      the 57 infants fed in the supine position had abnormal postfeeding tympanographic
      results compared with only five (15%) of the 33 infants fed in the semiupright
      position (p < 0.005). In addition, when the infants with abnormal tympanograms
      were placed in semiupright or prone positions for 15 minutes after feeding, the
      majority of tympanograms returned to normal. CONCLUSION: These data suggest that
      supine bottle feeding has a significant effect on middle-ear pressure dynamics,
      probably caused by the aspiration of milk into the ear. The results also suggest
      that repositioning infants after feeding may mitigate the effects of supine
      feeding, at least in healthy children. Although this study did not demonstrate
      that tympanographic abnormality definitely predisposes to otitis media, it
      provides more evidence to encourage the practice of feeding infants in a
      semiupright position.

PMID- 7776070
TI  - The clinician's role in teaching proper infant feeding techniques.
AB  - The species-specific advantages and significant nutritional and health benefits
      of breast-feeding are widely acknowledged. Less recognized are the advantages of
      the process of breast-feeding itself. Adherence to the natural mechanics of
      breast-feeding will preclude many of the problems associated with improper bottle
      feeding. For example, the semiupright position of the infant during breast
      feeding helps eliminate the entry of milk into the middle ear and reduces choking
      and regurgitation. The action of suckling during breast-feeding minimizes the
      intake of air. In addition, the direct eye contact that is natural to breast
      feeding fosters bonding, and the close body contact promotes a sense of security
      in the child. These advantages, so natural to breast-feeding, are likely to be
      absent from bottle feeding unless some of the natural techniques associated with
      breast-feeding are adopted. This article describes various aspects of the breast
      feeding process with the goal of urging practitioners to instruct patients to
      transfer these techniques to bottle feeding. In so doing, clinicians may help
      their patients avoid the hazards of improper bottle feeding.

PMID- 7776071
TI  - Quantitative and qualitative video analysis of infants feeding: angled- and
      straight-bottle feeding systems.
AB  - OBJECTIVE: To determine whether an angled-bottle feeding system is more effective
      than a straight-bottle feeding system in facilitating the medically recommended
      semiupright infant posture and to determine whether an angled bottle promotes
      improved ergonomic alignment and comfort for the feeder. STUDY DESIGN: On two
      consecutive days, 23 pairs of parent-infant teams, seated in an ergonomic chair,
      were videotaped at the same time of day, during which infants were fed by their
      parents with either an angled or a straight bottle (presented in balanced order)
      fitted with the infants' regular nipple. Infants were given their regular type
      and amount of formula. RESULTS: The angled bottle provided a higher level of
      satisfaction compared with the straight bottle. Less gastric discomfort occurred
      with the angled bottle versus the straight bottle when each was compared with the
      bottle used at home. In addition, feeders assumed ergonomically sound positions.
      CONCLUSION: This study indicates that an angled bottle is preferable to a
      straight bottle because it encourages more physiologic positioning of the infant,
      improves the comfort level of the feeder, improves ergonomic feeding performance,
      and decreases the need for burping.

PMID- 7776072
TI  - Nipple confusion: toward a formal definition.
AB  - The purposes of this article are to introduce a formal definition of nipple
      confusion and to propose various hypotheses concerning its cause. The term nipple
      confusion refers to an infant's difficulty in achieving the correct oral
      configuration, latching technique, and suckling pattern necessary for successful
      breast-feeding after bottle feeding or other exposure to an artificial nipple.
      Many early breast-feeding failures are attributed to nipple confusion, although
      scientific data are lacking to document its prevalence, the mechanisms involved,
      or various factors that predispose an infant to this phenomenon. Two
      classifications of nipple confusion are recommended to distinguish the impact of
      artificial nipples during the newborn period from their influence after breast
      feeding is well established. Maternal and infant risk factors making an infant
      more susceptible to nipple confusion are discussed. Future studies are planned to
      help elucidate the nature of nipple confusion and identify the circumstances
      under which infants are most vulnerable to this phenomenon. Meanwhile, it would
      seem prudent for clinicians to identify newborns at risk for nipple confusion and
      to minimize the use of bottle feedings in such babies. Medically indicated
      supplements in the early days of life could be provided by alternative methods,
      such as cup, spoon, or dropper feeding, until breast-feeding can be established.

PMID- 7776073
TI  - Imaging evaluation of breast-feeding and bottle-feeding systems.
AB  - OBJECTIVE: To compare infant sucking and swallowing patterns during feeding with
      a new artificial nipple and during breast-feeding. METHODS: Fifteen healthy, term
      infants were fed successfully for 1 week with use of the new tricut nipple; then
      each infant's oral cavity was examined during feeding by using real-time
      ultrasonography. Measurements of nipple length and compression were made,
      together with observations concerning the integrity of the seal formed by the
      infant's mouth around the nipple. These data were compared with similar data from
      previous studies of 16 breast-fed infants. RESULTS: Although no artificial
      feeding system exactly simulates breast-feeding, the new tricut nipple was sucked
      in a manner similar to the way the human nipple is sucked and delivered milk
      posteriorly to the foramen cecum region of the tongue, just as the breast does.
      CONCLUSION: Although further studies are necessary, to evaluate other
      characteristics of the new tricut nipple, the measurements from this
      investigation are useful additions to the ultrasound data these investigators
      have accumulated on various artificial feeding systems. These data may also prove
      helpful in determining the most appropriate nipples for infants with various
      feeding disorders.

PMID- 7776074
TI  - Comparative safety and efficacy of two immune globulin products in Kawasaki
      disease.
AB  - OBJECTIVE: To compare the safety and efficacy of various intravenously
      administered immune globulin (IVGG) products in patients with Kawasaki disease.
      METHODS: We performed a retrospective matched-pair study of 45 pairs of patients,
      matched by age, gender, hospital, and illness day when IVGG therapy was
      initiated. All patients received aspirin, 80 to 100 mg/kg per day; one of each
      pair received Venoglobulin, 2 gm/kg (product A), and the other received Iveegam,
      2 gm/kg (product B). Safety was assessed during and after IVGG infusion by
      recording rigors, pruritus, hypotension, urticaria, and nausea. Treatment
      efficacy was evaluated by posttreatment height and duration of fever, and
      subsequent echocardiographic changes. RESULTS: Untoward reactions during
      infusions occurred more often with product A (25%) than with product B (2%) (p <
      0.025); most reactions were rigors (18% vs 2%) (p < 0.05). Therapy was completed
      in all patients. Height of fever and proportion of patients febrile each day
      after product A or B did not differ significantly. No differences were found in
      the frequency of coronary artery abnormalities 1 year after illness. CONCLUSIONS:
      No significant differences in efficacy appeared between the two IVGG products,
      but they differed significantly in non-life-threatening adverse reactions,
      especially infusion-related rigors. Other IVGG products should be evaluated in a
      similar fashion.

PMID- 7776075
TI  - A randomized trial comparing the efficacy of epinephrine with salbutamol in the
      treatment of acute bronchiolitis.
AB  - This randomized, double-blind trial compared the efficacy of nebulized
      epinephrine with salbutamol in the treatment of infants with acute bronchiolitis.
      The mean percent oxygen saturation at 60 minutes was significantly higher in the
      epinephrine group. Thirty-three percent of the patients in epinephrine group were
      admitted to the hospital compared with 81% of the salbutamol group (p = 0.003).
      We conclude that nebulized epinephrine is more efficacious than salbutamol for
      infants with acute bronchiolitis seen in an emergency department.

PMID- 7776076
TI  - Antibiotic-associated hemorrhagic colitis without Clostridium difficile toxin in
      children.
AB  - We describe nine children with antibiotic-associated hemorrhagic colitis without
      Clostridium difficile toxin. The onset was usually sudden, with severe
      hematochezia and abdominal cramps. The illness quickly resolved and required no
      specific treatment except discontinuation of the implicated antibiotic. Early
      proctosigmoidoscopy was a useful diagnostic adjunct. It appears that antibiotic
      associated hemorrhagic colitis is a distinct entity rather than a variant of
      antibiotic-associated colitis in children.

PMID- 7776078
TI  - Discordance for hyperinsulinemic hypoglycemia in monozygotic twins.

PMID- 7776079
TI  - Comparison of fiberoptic and conventional phototherapy for neonatal
      hyperbilirubinemia.

PMID- 7776077
TI  - Abnormalities in control of ventilation in newborn infants with myelomeningocele.
AB  - OBJECTIVE: The objective of this study was to assess respiratory responses of
      newborn infants with myelomeningocele through pneumograms and carbon dioxide
      challenge, and to evaluate the possibility of predicting which patients with
      myelomeningocele acquired respiratory symptoms related to the Arnold-Chiari
      deformity and brain-stem dysfunction. METHODS: All surviving infants with spina
      bifida who were born at the University of Iowa Hospitals and Clinics (UIHC) or
      were transferred there on the first day of life between January 1987 and January
      1991 were assessed with a pneumogram and CO2 challenge once they were medically
      stable, and were followed for a mean of 30 months (10 to 53 months). RESULTS:
      Thirty patients met the inclusion criteria for this study; four died before being
      studied. Of the 26 remaining patients, 12 were born at the UIHC and 14 were
      transferred to the UIHC on the first day of life. Of the 26 infants studied, 12
      (46%) had abnormalities on the pneumogram, including 2 with significant periodic
      breathing and 10 with episodes of desaturation below 87%. Of the 26 infants
      studied, 4 had no detectable response to an increasing fraction of CO2 in
      inspired air on the CO2 challenge and 12 had an increase in exhaled minute
      ventilation per increase in the alveolar fraction of CO2 in exhaled air more than
      2 SD below the mean. Only 10 patients (38.5%) had normal ventilatory responses to
      the increasing fraction of CO2 in inspired air. On follow-up, only one study
      patient had symptoms related to Arnold-Chiari deformity and brain-stem
      dysfunction (bilateral vocal cord paralysis). His neonatal CO2 challenge results
      and his pneumogram were normal. CONCLUSION: We conclude that these two tests are
      not useful in predicting which patients will have symptoms related to Arnold
      Chiari deformity. Specificity for the pneumogram and the CO2 challenge was 0.52
      and 0.36, respectively. Sensitivity was zero for both tests, although this result
      is limited by the low incidence of symptomatic Arnold-Chiari deformity in this
      sample. As previous investigators have found, a significant number of patients
      with meningomyelocele had abnormal ventilatory patterns. These ventilatory
      abnormalities indicate that even in the absence of severe symptoms, the control
      of the ventilatory response is somewhat impaired in many patients with
      meningomyelocele. This alteration in ventilatory control is probably related to
      abnormalities in the development of the brain stem.

PMID- 7776081
TI  - Hemoglobin A1c levels in young patients with diabetes beyond the "honeymoon"
      period.

PMID- 7776080
TI  - Single-day therapy for rickets.

PMID- 7776082
TI  - Lactic acidosis in a patient with acute lymphoblastic leukemia.

PMID- 7776083
TI  - True hermaphroditism with 46,XY karyotype and a point mutation in the SRY gene.

PMID- 7776084
TI  - Recent developments in the pathophysiology and treatment of persistent pulmonary
      hypertension of the newborn.
AB  - Successful management of severe PPHN depends on the application of appropriate
      strategies to manage the cardiopulmonary interactions that characterize this
      syndrome. Manifestations of PPHN often involve dysfunctional pulmonary
      vasoregulation, with suprasystemic pulmonary vascular resistance causing
      extrapulmonary shunting, pulmonary parenchymal disease causing intrapulmonary
      shunting, and systemic hemodynamic deterioration. Inhaled NO can cause marked
      improvement in oxygenation when optimal lung inflation is achieved and systemic
      blood volume and vascular resistance are adequate. Although concern has been
      expressed regarding potential increases in costs associated with this new
      therapy, we have found that the successful application of inhaled NO in PPHN has
      reduced costs of hospitalization and duration of hospital stay by approximately
      50% and 40%, respectively. However, inhaled NO alone is unlikely to cause
      sustained improvement in oxygenation in neonatal hypoxemic respiratory failure
      associated with severe parenchymal lung disease without extrapulmonary shunting.
      Inhaled NO may be an important tool in the management of severe PPHN when its
      application is limited to patients with severe extrapulmonary shunting and
      vigilant attention is given to changes in the clinical course.

PMID- 7776085
TI  - Vertical transmission of human immunodeficiency virus type 1: autologous
      neutralizing antibody, virus load, and virus phenotype.
AB  - OBJECTIVE: To evaluate immunologic and virologic correlates of vertical
      transmission of human immunodeficiency virus type 1 (HIV-1). DESIGN: Case-control
      study. PATIENTS: Women who were prospectively enrolled in a natural history study
      of HIV-1 infection in women and infants. Sixteen HIV-1-infected women whose
      infants became infected were matched by CD4+ cell percentage and use of
      zidovudine during pregnancy with women whose infants did not become infected.
      MEASUREMENTS: Maternal autologous neutralizing antibody, virus load determined by
      RNA-polymerase chain reaction (RNA-PCR), and virus phenotype. RESULTS: Most women
      in both groups had low titers of autologous neutralizing antibody, and no
      difference in neutralizing titers was observed (range, < 4 to 181 in both
      groups). The HIV-1 copy number in maternal plasma was not significantly different
      in the two groups but was inversely correlated with maternal CD4+ cell percentage
      (p < 0.005). Five women in the transmitting group and four in the non
      transmitting group had syncytium-inducing (SI) phenotype virus. Two infected
      infants had SI phenotype virus. The SI phenotype virus was associated with a
      greater HIV-1 copy number in maternal plasma (p < 0.05) and an increase in the
      mortality rate for the infants (p < 0.01). CONCLUSIONS: In women matched for CD4+
      cell percentage, low titers of autologous neutralizing antibody, high virus load,
      and SI phenotype virus were not associated with an increased risk of transmission
      of HIV-1 to their infants.

PMID- 7776086
TI  - Cytokine elevations in infants with bacterial and aseptic meningitis.
AB  - We sought to determine whether the detection of cytokines, produced during the
      inflammatory response, would aid in the diagnosis of meningitis in young infants.
      We measured cerebrospinal fluid (CSF) and plasma levels of interleukin-6 (IL-6)
      and tumor necrosis factor (TNF) in 62 infants less than 6 months of age whose
      condition was evaluated for meningitis. Twenty infants had culture-proved
      meningitis, 22 had aseptic meningitis, and 20 control infants had no evidence of
      meningitis. The CSF IL-6 levels were elevated in all 20 infants with bacterial
      meningitis and in 9 of 22 infants with aseptic meningitis but were undetectable
      in all control subjects. Furthermore, CSF IL-6 levels were 10 times greater in
      infants with bacterial versus aseptic meningitis (p < 0.001). Levels of TNF in
      CSF were detected in 12 of 20 infants with bacterial meningitis and were
      undetectable in infants with aseptic meningitis and in control infants (p <
      0.02). Plasma IL-6 and TNF levels were unreliable for the detection of meningitis
      in this patient population. We conclude that the presence of IL-6 in the CSF
      reliably identifies infants with meningitis and that the presence of CSF TNF is a
      highly specific indicator of bacterial meningeal inflammation.

PMID- 7776087
TI  - Efficacy of an observation scale in detecting bacteremia in febrile children
      three to thirty-six months of age, treated as outpatients. Occult Bacteremia
      Study Group.
AB  - OBJECTIVE: To assess the efficacy of the Yale Observation Scale (YOS) in
      detecting occult bacteremia in febrile, ambulatory pediatric patients with no
      apparent signs or symptoms of severe infection and with no focal infection.
      DESIGN: YOS scores were assigned as part of a prospective, multicenter,
      randomized, interventional trial of oral and intramuscular antibiotics in
      preventing the complications of occult bacteremia in febrile children. SETTING:
      Pediatric emergency departments at eight urban medical centers. PARTICIPANTS:
      Children, 3 to 36 months of age with a temperature at least 39.0 degrees C, a
      nonfocal, non-toxic-appearing illness (or uncomplicated otitis media), treated as
      outpatients. INTERVENTIONS: None. RESULTS: There were 6611 assessable patients,
      who had both a blood culture result and a YOS score assigned. The median YOS
      score for both patients with bacteremia (n = 192) and patients without bacteremia
      (n = 6419) was 6, but the mean rank among patients with bacteremia was
      significantly higher (p < 0.0001). The sensitivity, specificity, and positive and
      negative predictive values for a YOS score greater than 10 were 5.2%, 96.7%,
      4.5%, and 97.1%, respectively. CONCLUSIONS: The YOS scores are higher among
      patients with bacteremia than among patients without bacteremia, but the
      difference is not clinically useful in detecting occult bacteremia in febrile
      children, with nonfocal, apparently nontoxic infection, treated as outpatients in
      this age group.

PMID- 7776088
TI  - Clinical characteristics and risk factors for Vibrio cholerae infection in
      children.
AB  - Surveillance was conducted during February and March 1991 in the pediatric
      emergency department of Cayetano Heredia Hospital, Lima, Peru, to contrast the
      characteristics of children with epidemic cholera with those of children with
      noncholera-associated diarrhea. Among 626 patients 14 years of age or younger,
      Vibrio cholerae O1 was isolated from stool specimens of 310 patients (49%), more
      commonly from children older than 24 months of age (66%; p < 0.0001) than from
      younger children. Cholera was clinically characterized by a more sudden onset;
      watery diarrhea; and associated abdominal pain, muscle cramps, and vomiting,
      which led to more severe dehydration and hospitalization more often than in
      noncholera cases. Only one patient with cholera died, for a case-fatality rate of
      3.2 deaths per 1000 persons. Nonpotable water and uncooked foods were identified
      as probable vehicles for V. cholerae. The frequency of diarrhea among relatives
      of patients with cholera suggested intrafamily transmission. This study of
      epidemic cholera describes the clinical features and the risk factors for
      acquisition of the infection, and points out the low case-fatality rate with
      prompt and appropriate treatment.

PMID- 7776089
TI  - A reexamination of the risk factors for the sudden infant death syndrome.
AB  - OBJECTIVE: To determine which risk factors are specific for the sudden infant
      death syndrome (SIDS) rather than characteristic of postneonatal deaths in
      general. STUDY POPULATION: The live births and infant death cohorts of the 1988
      National Maternal and Infant Health Survey. METHODS: Information on live births,
      deaths from SIDS, and postneonatal deaths from other causes was abstracted from
      the National Maternal and Infant Health Survey. To account for oversampling of
      certain populations, the data were weighted to reflect national counts. Risk
      factors were defined as black race, birth weight less than 1500 gm, birth weight
      less than 2500 gm, gestational age at birth less than 37 weeks, 5-minute Apgar
      score less than 7, male gender, more than two previous pregnancies, maternal age
      less than 20 years, maternal education level less than 12 years, multiple births,
      and maternal smoking during pregnancy. Odds ratios (ORs) and 95% confidence
      intervals (Cls) were calculated to compare the SIDS with the live births cohort,
      infants who died of other causes with the live births cohort, and SIDS with non
      SIDS deaths. The population-attributable risk percentage was computed for risk
      factors independently associated with SIDS when compared with other postneonatal
      deaths. RESULTS: For all characteristics other than a 5-minute Apgar score less
      than 7, the ORs comparing infants who died of SIDS with the live births cohort
      were significantly greater than 1.0. Similarly, ORs comparing infants who died of
      other causes with the live births cohort were also greater than 1.0, except for
      male gender. When the two infant death cohorts were compared, only maternal
      smoking during pregnancy and low maternal education level were significantly more
      common among the SIDS group. After we controlled for cigarette smoking, the
      adjusted OR for low maternal education level was not significantly greater than
      1.0. However, even after control for low maternal education level, prenatal
      exposure to tobacco was significantly more common among the SIDS group than in
      infants dying of other causes (OR = 1.97; 95% Cl, 1.59 to 2.45). On the basis of
      an adjusted OR of 2.92 when the SIDS group was compared with the live births
      cohort, the population-attributable risk percentage for maternal smoking as a
      risk factor for SIDS was 30%. CONCLUSION: Among characteristics generally thought
      to be risk factors, only maternal smoking during pregnancy was independently
      associated with SIDS. Data from this nationally representative sample indicate
      that if women refrained from smoking while pregnant, up to 30% of SIDS might be
      prevented.

PMID- 7776090
TI  - Economic comparison of a tissue adhesive and suturing in the repair of pediatric
      facial lacerations.
AB  - OBJECTIVE: To determine, from the societal perspective, the most cost efficient
      of the three methods commonly used to repair pediatric facial lacerations:
      nondissolving sutures, dissolving sutures, or a tissue adhesive (Histoacryl
      blue). DESIGN: Cost-minimization analysis and willingness-to-pay survey. SETTING:
      Tertiary-care pediatric emergency department. METHODS: All differential costs
      relevant to equipment utilization, pharmaceutical use, health care worker time,
      and parental loss of income for follow-up visits were calculated for each method.
      On the basis of previous research, our model assumes equal cosmetic outcome for
      the three methods. In addition, a convenience sample of 30 parents were surveyed
      in the emergency department to rank their preferences and willingness to pay for
      the three methods of wound closure. RESULTS: The reduction in cost (in Canadian
      dollars) per patient of switching from the standard nondissolving sutures was
      $49.60 for switching to tissue adhesive and $37.90 for dissolving sutures.
      Sensitivity analyses performed on key variables did not significantly alter our
      conclusions. Of those parents surveyed; 90% (95% confidence interval, 74% to 98%)
      chose tissue adhesive and 10% (95% confidence interval, 2% to 26%) chose
      dissolving sutures as their first choice for wound closure. Nondissolving sutures
      were ranked third by 29 of 30 parents. Parents were willing to pay a median (25th
      to 75th percentile) of $40 ($25 to $100) for tissue adhesive and $25 ($10 to $56)
      for dissolving sutures if only nondissolving sutures provided by the health care
      system (p = 0.1). CONCLUSIONS: Tissue adhesive is the preferred method of closure
      of pediatric facial lacerations because it results in the most efficient use of
      resources and is preferred by the majority of parents.

PMID- 7776092
TI  - Coagulation factor deficiencies during initiation of extracorporeal membrane
      oxygenation.
AB  - OBJECTIVE: We examined the hypothesis that critically ill patients receiving
      extracorporeal membrane oxygenation (ECMO) have reduced clotting factor levels,
      which may contribute to the risk of hemorrhagic complications. METHODS: Blood
      samples were collected from 19 patients before and 1 hour after initiation of
      ECMO. Heparin present in samples was removed by ECTEOLA (epichlorohydrin
      triethanolamine) cellulose resin adsorption, and coagulation factors were assayed
      by automated techniques. Factor deficiency was defined as levels at least 2 SD
      less than published age-adjusted reference values. RESULTS: Thirteen patients
      (68%) had deficiencies of two or more factors before ECMO. Despite inclusion of
      factor-containing blood products in the ECMO priming solution, 10 patients (53%)
      had deficiencies of two or more factors after initiation of ECMO. Four patients
      had intracranial hemorrhages and were found to be deficient in five or more
      factors at the time of cannulation. CONCLUSIONS: Severe coagulation factor
      deficiencies are often present in patients requiring ECMO, and coagulation
      factors provided through the circuit prime are insufficient to ensure correction
      of these deficiencies. Deficiency of multiple coagulation factors may contribute
      to the risk of intracranial hemorrhage during ECMO; the practice of excluding
      factor-containing solutions from the circuit prime should be examined
      prospectively.

PMID- 7776091
TI  - Risk of recurrent stroke in patients with sickle cell disease treated with
      erythrocyte transfusions.
AB  - OBJECTIVE: To determine the effect of a transfusion program on risk of stroke
      recurrence in children with sickle cell disease. DESIGN: The clinical course and
      experience with transfusion therapy at eight centers were reviewed for subjects
      whose initial stroke occurred after January 1988. RESULTS: Sixty subjects were
      observed for 191.7 patient-years. Eight had a single recurrent stroke (two
      intracranial hemorrhages and six infarctions) for a prevalence of 13.3%, or one
      recurrence for each 24 patient-years of observation. Thirteen subjects had 15
      transient neurologic events; two of these had subsequent strokes, but the overall
      risk was similar for those who did and those did not have transient events.
      Hemoglobin S levels were greater than the desired maximum of 30% at the time of 7
      of 16 transient events and five of six recurrent infarctions. The stroke
      recurrence rate was similar to those in previous reports of children receiving
      long-term transfusion therapy but significantly less than that reported for
      children who did not receive transfusions (p < 0.001). CONCLUSIONS: We conclude
      that maintenance of hemoglobin S at a level less than 30% appears to be effective
      in reducing the rate of recurrent infarction but does not prevent transient
      neurologic events. Transient neurologic events are common but do not appear to be
      related to recurrent stroke.

PMID- 7776093
TI  - Prediction of the outcome of growth hormone therapy in children with idiopathic
      short stature. A multivariate discriminant analysis.
AB  - OBJECTIVE: To identify, with the use of pretreatment clinical data, the children
      with idiopathic short stature responsive to treatment with growth hormone (GH).
      DESIGN: Open, prospective study in a university hospital. SUBJECTS: Patients
      admitted to the study met the following criteria: birth weight at least 2.5 kg,
      no sign of dysmorphic disease, stature less than the 3rd percentile for
      chronologic age (CA), linear growth velocity (GV) less than the 25th percentile
      for bone age (BA), no sign of puberty, maximal GH response to pharmacologic
      stimulation greater than 10 micrograms/L, no evidence of organic disease,
      treatment with daily subcutaneous administration of GH at a dose of 12 to 16
      IU/m2 per week. MAIN OUTCOME MEASURES: Eight pretreatment growth variables and
      the increase of GV after 6 months of therapy were measured. Children with a
      change in GV that was greater than 2.5 cm/yr after 6 months of GH therapy were
      considered responders to GH. RESULTS: We studied 67 patients (44 boys). Forty
      patients (60%) were responders. With univariate analysis the variables found to
      have predictive value were GV (z score for gender and CA), bone age (z score for
      gender and CA), and percentage of ideal body weight. These variables were
      employed in a multivariate discriminant analysis. Growth velocity and BA showed
      the best independent discriminant analysis. Growth velocity and BA showed the
      best independent discriminant significance in predicting responsiveness to the
      initial 6 months of GH therapy. The obtained equation was as follows: Score = 
      0.40 + 0.92X1 - 0.87X2, where X1 is the GV z value for CA and X2 is the BA z
      value for CA). Using this scoring system, we obtained a specificity of 96.3% and
      a sensitivity of 92.5% in predicting responsiveness to GH (chi-square with Yates
      correction, 48.2; p < 0.001). CONCLUSIONS: Discriminant analysis may permit the
      pretreatment prediction of responsiveness to the initial 6 months of GH therapy
      in short children without GH deficiency.

PMID- 7776094
TI  - Clinical and biochemical characterization of short-chain acyl-coenzyme A
      dehydrogenase deficiency.
AB  - OBJECTIVE: We identified two additional patients with short-chain acyl-coenzyme A
      (CoA), further characterized the clinical and biochemical features of this
      defect, and compared it with other fatty acid oxidation defects. DESIGN: We have
      measured the in vitro short-chain acyl-coenzyme A dehydrogenase (SCAD) activity
      in six affected persons with the electron-transfer flavoprotein-linked assay in
      the presence and absence of anti-medium-chain acyl-CoA dehydrogenase antibody.
      Urine organic acids, acylglycines, acylcarnitines, and radiolabeled substrate
      catabolism by skin fibroblasts were also examined. RESULTS: All patients had some
      neurologic abnormalities, including hypotonia, hypertonia, or seizures. None of
      the patients had episodes of hypoglycemia; in the only patient tested, fasting
      ketogenesis was not impaired. Four patients were initially seen in the neonatal
      period, two with profound metabolic acidosis and two with mild acidemia; the
      other two cases were recognized in infancy. Enzymatic analysis of cultured skin
      fibroblasts demonstrated approximately 10% activity of SCAD when compared with
      control fibroblasts. Gas chromatography and mass spectrometry of urine revealed
      that ethylmalonic acid was present in all samples but not always at elevated
      concentrations; methylsuccinic acid and butyrylglycine were sporadically
      elevated. n-Butyrylcarnitine was often found in urine and plasma. Radiolabeled
      substrate metabolism was reduced to 40% to 60% of control values. CONCLUSIONS:
      Because affected persons do not consistently excrete characteristic metabolites,
      the diagnosis of this enzymatic deficiency is difficult. It is necessary to
      collect and analyze several urine and plasma specimens when the diagnosis is
      being considered in patients with neurologic abnormalities suggestive of this
      disorder.

PMID- 7776095
TI  - Prolonged dysphagia caused by congenital pharyngeal dysfunction.
AB  - We describe two patients with severe, isolated, congenital dysphagia caused by
      paralysis of the pharyngeal muscles, who recovered at the ages of 40 months and
      20 months, respectively. No other evidence of neurologic or muscular dysfunction
      was present except for a transient paralysis of the adductors of the vocal cords
      in one child. Radiocinematographic studies showed paralysis of the pharyngeal
      stage of swallowing, with minimal involvement of the oral stage. One child
      refused oral feeding for several months after apparent radiologic recovery. Two
      other patients with a similar disorder died of tracheal aspiration at the ages of
      8 months and 4 months, respectively. Autopsies showed no abnormality of the
      central nervous system, and the cranial nerves involved in swallowing were
      normal. Only five other well-studied cases of this syndrome have been reported.
      These observations demonstrate the existence of a type of severe, idiopathic,
      congenital dysphagia related to paralysis of the constrictor muscles of the
      pharynx, with a propensity to recover after several months or years if properly
      managed. The cause of the disorder is obscure, but it is probably related to a
      dysfunction of the central nervous system.

PMID- 7776096
TI  - Prevention of recurrent febrile seizures.

PMID- 7776097
TI  - Comparison of an optical immunoassay technique with two culture methods for the
      detection of group A streptococci in a pediatric office.
AB  - For detecting group A beta-hemolytic streptococci in an office setting, an
      optical immunoassay method was compared with two culture methods. The sensitivity
      and specificity of OIA as compared with 5% sheep blood agar cultures were 91.4%
      and 95.6%, and as compared with a Todd-Hewitt broth method were 90.4% and 94.1%,
      respectively.

PMID- 7776098
TI  - Diagnosis of group A streptococcal pharyngitis in a private clinic: comparative
      evaluation of an optical immunoassay method and culture.
AB  - We compared the sensitivity and specificity of the Strep A Optical ImmunoAssay
      (OIA) method with our routine trypticase soy agar with 5% sheep blood (TSA)
      culture technique and with a broth-enhanced culture in the diagnosis of group A
      beta-hemolytic streptococcal infection. Compared with broth-enhanced culture, the
      Strep A OIA had a sensitivity and specificity of 94.8% and 98.8%, respectively;
      TSA culture had a sensitivity and specificity of 92.5% and 99.4%, respectively.
      The Strep A OIA, which takes 10 minutes to perform, offered sensitivity and
      specificity equivalent to that of TSA culture in the diagnosis of group A beta
      hemolytic streptococcal pharyngitis.

PMID- 7776099
TI  - Relationship between parental occupation and children's oropharyngeal
      colonization with Neisseria meningitidis.
AB  - We explored, during an outbreak of meningococcal disease, whether children of
      parents with workplace exposure to children were at increased risk of
      oropharyngeal colonization with Neisseria meningitidis. In comparison with
      children of parents without workplace exposure to children, the risk of
      colonization was not increased (odds ratio = 1.62; 95% confidence interval, 0.56
      to 4.72). Therefore a parent's occupation does not appear to increase the risk of
      their children's colonization with N. meningitidis.

PMID- 7776100
TI  - Consumption of soft drinks with phosphoric acid as a risk factor for the
      development of hypocalcemia in children: a case-control study.
AB  - A comparison of 57 cases (in children with serum calcium concentration < 2.2
      mmol/L) and 171 controls (in children with serum calcium level > or = 2.2 mmol/L)
      was carried out to assess whether the intake of at least 1.5 L/wk of soft drinks
      containing phosphoric acid is a risk factor for the development of hypocalcemia.
      A significant association was found: odds ratio = 5.27; 95% confidence interval,
      3.17 to 8.75; p < 0.001. The hypothesis of a causal relationship between intake
      of phosphoric acid-containing soft drinks and hypocalcemia warrants further
      investigation.

PMID- 7776101
TI  - Cerebral artery stenoses in Williams syndrome cause strokes in childhood.
AB  - Extensive narrowing of lumens of many cerebral arteries caused strokes with brain
      damage and chronic hemipareses in two children with Williams syndrome. Increased
      irritability, loss of consciousness, and seizures were initial signs. Arterial
      stenoses are not limited to the supravalvular aorta and pulmonary arteries in
      patients with Williams syndrome.

PMID- 7776102
TI  - Ischemic stroke and intracranial multifocal cerebral arteriopathy in Williams
      syndrome.
AB  - We describe an otherwise healthy 2-year-old patient with Williams syndrome who
      had a stroke as a result of intracranial multivessel focal and segmental stenotic
      disease. The diagnosis of Williams syndrome was confirmed by elastin gene
      deletion testing. Combined magnetic resonance imaging and magnetic resonance
      angiography, and transcranial Doppler flow studies, were used in diagnosing and
      monitoring the course of the disease.

PMID- 7776103
TI  - Pancreatic glucagon levels in infants and children with hyperinsulinemia.
AB  - Serum concentrations of pancreatic glucagon were measured in 40 patients with
      hyperinsulinemic hypoglycemia. In infants with severe disease the glucagon levels
      were markedly elevated; lower levels were observed in children with episodic
      hypoglycemia. During diazoxide treatment and after pancreatectomy, the glucagon
      levels decreased proportionally to suppression of the insulin secretion. Thus the
      secretion of glucagon seems to be retained in hyperinsulinism in proportion to
      the insulin hypersecretion, and an increased glucagon level indicates long during
      and severity of hyperinsulinemic hypoglycemia.

PMID- 7776104
TI  - Chronic pancreatitis in a patient with cystic fibrosis and clinical pancreatic
      insufficiency.
AB  - Pancreatitis occurs in up to 15% of patients with cystic fibrosis and pancreatic
      sufficiency, but the possibility of its occurrence in patients with pancreatic
      insufficiency has not been recognized. We describe a patient with homozygous
      delta F508 cystic fibrosis and typical symptoms of pancreatic insufficiency
      (greasy, fatty stools) in whom pancreatitis developed.

PMID- 7776106
TI  - Bayley-Pinneau method of height prediction in girls with central precocious
      puberty: correlation with adult height.
AB  - One of the sequelae of idiopathic central precocious puberty (ICPP) can be short
      adult stature. In this retrospective study adult height was normal in 90% of
      girls with untreated ICPP (mean, 161.4 +/- 7.7 cm). The height prediction made at
      the time of initial examination and the height age correlated with adult height.
      Therefore the initial height prediction can be useful in identifying those girls
      with ICPP at risk for short stature.

PMID- 7776105
TI  - Beneficial effect of growth hormone on atherogenic risk in children with growth
      hormone deficiency.
AB  - We studied changes in the atherogenic index (total cholesterol divided by high
      density lipoprotein cholesterol) in 12 prepubertal boys with growth hormone (GH)
      deficiency during 9 months of GH treatment. High-density lipoprotein cholesterol
      level increased until 5 months without significant changes in total cholesterol
      level; thus GH therapy may be beneficial in reducing the atherogenic index in
      boys with GH deficiency.

PMID- 7776107
TI  - Acquired platelet dysfunction with eosinophilia in white children.
AB  - Acquired platelet dysfunction associated with eosinophilia has been described
      mainly in indigenous Southeast Asian and East Indian children. We describe two
      white boys in whom this disorder developed after they had lived in Malaysia for
      12 to 18 months. Acquired platelet dysfunction associated with eosinophilia
      should therefore be considered in children who, after a visit to this region,
      have easy bruising and esoinophilia.

PMID- 7776108
TI  - Effect of airway pressure on inferior vena cava pressure as a measure of central
      venous pressure in children.
AB  - We evaluated the effect of elevated airway pressure on the validity of
      intravascular pressure obtained in the distal inferior vena cava (IVC) as a
      measure of central venous pressure (CVP) in a group of children receiving
      mechanical ventilation. The IVC pressure correlated well with CVP in the patients
      without abdominal distention, but the disparity was wider in those with abdominal
      distention. Elevated mean airway pressure or positive end-expiratory pressure had
      no effect on the relationship of IVC to CVP.

PMID- 7776109
TI  - Peutz-Jeghers syndrome in a neonate.
AB  - A 15-day-old girl was found to have generalized gastrointestinal polyposis
      resulting from Peutz-Jeghers syndrome. Her manifestations included abdominal
      distention, hematemesis, bloody diarrhea, and edema. She died at 1 year of age of
      multiple complications of her disease.

PMID- 7776110
TI  - Double-blind, randomized trial of one versus three prophylactic doses of
      synthetic surfactant in 826 neonates weighing 700 to 1100 grams: effects on
      mortality rate. American Exosurf Neonatal Study Groups I and IIa.
AB  - At 33 hospitals in the United States, a double-blind, randomized clinical trial
      was performed to compare one versus three prophylactic doses of synthetic
      surfactant in 700 to 1100 gm inborn infants. All 826 infants received an initial
      prophylactic dose of surfactant within 30 minutes of birth. Subsequently 410
      infants received two doses of placebo (air) 12 and 24 hours later, and 416
      infants received two additional doses of surfactant. By the age of 28 days, 70
      infants who received one dose of surfactant and 40 infants who received three
      doses were dead, a 43% relative reduction in the mortality rate (30 fewer deaths;
      p = 0.002). By the age of 1 year after term, 87 infants who received one dose and
      62 infants who received three doses were dead: a 29% relative reduction in the
      mortality rate (25 fewer deaths; p = 0.027). Infants who received three doses of
      surfactant required significantly less oxygen and less mean airway pressure for
      the first week of life. Necrotizing enterocolitis (9 vs 25 infants; p = 0.005),
      and use of high-frequency ventilation (13 vs 26 infants; p = 0.037); pancuronium
      (43 vs 62 infants; p = 0.045); and leukocyte transfusions (0 vs 4 infants; p =
      0.042) were less frequent in the three-dose group, but air leak, bronchopulmonary
      dysplasia, intraventricular hemorrhage, patent ductus arteriosus, pulmonary
      hemorrhage, and infections were not different. These results indicate that
      physiologic findings, mortality rates, and probably morbidity rates are improved
      by two additional prophylactic doses of synthetic surfactant.

PMID- 7776111
TI  - Effects of central apnea on cerebral blood flow velocity in healthy term infants.
AB  - We evaluated a new method of monitoring cerebral blood flow velocity (CBFV) and
      described changes in CBFV in relation to central apnea in 17 healthy term
      infants. The area under the velocity curve during apnea did not change, whereas
      area under the velocity curve per the waveform showed a significant difference,
      suggesting that stability is maintained through an increase in CBFV with each
      heartbeat. The maintenance of cerebral hemodynamics during isolated central apnea
      supports the assumption that these episodes are benign.

PMID- 7776112
TI  - Soluble interleukin-2 receptor as a predictor of neonatal sepsis.
AB  - We prospectively measured soluble interleukin-2 receptor levels in 56 premature
      infants with suspected sepsis and demonstrated significant differences between
      those with positive results on blood, urine, or cerebrospinal fluid cultures, and
      those with negative results. Soluble interleukin-2 receptor levels can be used to
      facilitate the diagnosis of sepsis in premature infants with negative blood
      culture results.

PMID- 7776113
TI  - Reference ranges for serum cortisol and 17-hydroxyprogesterone levels in preterm
      infants.

PMID- 7776114
TI  - Conjugated hyperbilirubinemia in a newborn infant after maternal (transplacental)
      treatment with flecainide acetate for fetal tachycardia and fetal hydrops.
AB  - An infant with intrauterine supraventricular tachycardia and fetal hydrops,
      successfully treated with administration of flecainide acetate to the mother had
      conjugated hyperbilirubinemia shortly after birth. An extensive evaluation failed
      to disclose a known cause. We believe that in utero exposure to flecainide
      acetate resulted in conjugated hyperbilirubinemia in this infant.

PMID- 7776115
TI  - Effect of acetaminophen and of low intermittent doses of diazepam on prevention
      of recurrences of febrile seizures.
AB  - Acetaminophen and low doses of diazepam were evaluated for the prevention of
      recurrences of febrile seizures in a placebo-controlled, double-blind trial.
      Children after their first febrile seizure were assigned to receive either one
      dose of rectally administered diazepam, and then, after 6 hours, oral doses of
      0.2 mg/kg three times a day for the first 2 days if the fever stayed greater than
      38.5 degrees C, or a placebo similarly during forthcoming febrile episodes. In
      addition, each febrile episode was randomly assigned to be treated with
      acetaminophen or the placebo. Thus four groups were examined for 2 years:
      patients receiving two kinds of placebo, patients receiving diazepam and a
      placebo, patients receiving acetaminophen and a placebo, and patients receiving
      both diazepam and acetaminophen. Of a total of 180 patients (102 boys), 161 were
      followed for the 2-year period and 157 were seen at the last outpatient
      examination: 80 in the diazepam group and 77 in the placebo group. The final
      analysis of the efficacy of the drugs was made on the basis of the data from 153
      patients who had had at least one febrile episode during follow-up. There were
      641 fever events during this period, and 38 children (21.1%) had 55 recurrences
      of febrile seizures. Acetaminophen had no effect on the recurrence rate. Seizures
      recurred at least once in 21 patients (28.4%) receiving diazepam and 17 (21.5%)
      receiving a placebo (p = 0.4138, log-rank test). The combination of antipyretic
      agents with anticonvulsant medication did not reduce the recurrence of febrile
      seizures. Our results show that low doses of acetaminophen or diazepam or both
      are ineffective for preventing febrile seizures.

PMID- 7776116
TI  - Benign intracranial hypertension in children with growth hormone deficiency
      treated with growth hormone.
AB  - We report 13 cases of benign intracranial hypertension (IH) in children with
      growth hormone (GH) deficiency treated with GH in the United States. The group
      consisted of eight boys and five girls, 3 to 16 years of age (median, 9 years).
      The interval from starting GH therapy to diagnosis of IH was 2 weeks or less in
      six patients, between 2 and 12 weeks in four, 8 months in one, 5 years in one,
      and unknown in one. Seven patients were not known to have previously described IH
      risk factors; the other six had at least one factor each. All patients but one
      had headache, nausea, vomiting, and visual changes. All had papilledema, and
      cerebrospinal fluid pressures were elevated (> 250 mm H2O) in all nine patients
      tested. The GH dosage range was 0.17 to 0.35 mg per kilogram body weight per week
      (median, 0.30 mg/kg per week) for the 11 patients with dosage data. After
      discontinuation of GH and treatment with lumbar punctures and/or medications,
      signs and symptoms resolved in eight children; in two of these children signs and
      symptoms reappeared when GH therapy was restarted. In four patients signs and
      symptoms resolved while GH therapy was continued; one child was treated with a
      ventriculoperitoneal shunt because of an arachnoid cyst, after which GH was
      restarted without subsequent IH. In the 12 patients with idiopathic GH deficiency
      the course of IH was benign, with complete resolution of all signs and symptoms.
      Because doses and scheduling of GH administration have changed since the
      introduction of recombinant GH, higher doses and increased frequency of
      administration may be contributing to the development of IH in some patients. We
      suggest beginning therapy at the lowest recommended dose, with gradual titration
      to higher doses, and the performance of routine funduscopic examinations during
      initiation of GH therapy and whenever signs or symptoms of IH develop.

PMID- 7776118
TI  - Acid phosphatase in midgut digestive cells in partially fed females of the cattle
      tick Boophilus microplus.
AB  - Enzyme cytochemistry was used to identify vesicles containing acid phosphatase in
      the midgut digestive cells of partially fed females of the cattle tick Boophilus
      microplus. The vesicles were elongated or tubular in shape and appeared to be
      involved with the digestion of host bloodmeal. In mature cells, they were
      sometimes in close contact with large endosomes, which contained host blood. The
      vesicles were identified as tubular lysosomes because their morphological and
      cytochemical characteristics were analogous to similar structures described in
      mammalian cells. This is the first report of such lysosomes in tick gut cells and
      suggests some parallels with the intracellular structures involved in the
      digestion process of mammalian cells. Acid phosphatase in tick gut was also
      assayed biochemically and was shown to be inhibited with 10 mM sodium fluoride.
      Cytochemistry showed that this inhibitor blocked activity within the cell and on
      the lumenal cell membrane.

PMID- 7776117
TI  - Glycerophosphorylcholine, a component of both Ascaris suum muscle and
      Caenorhabditis elegans.
AB  - Studies of the muscle phospholipid metabolism of Ascaris suum suggest an effect
      of cholinergic drugs on the turnover of phosphatidylcholine and the generation of
      glycerophosphorylcholine (GPC). 31P-nuclear magnetic resonance (NMR) studies of
      helminths revealed the presence of a major peak that was assigned to GPC. The
      primary effect of the cholinergic drugs on the parasites' phosphate profile
      appeared to be on the level of GPC. In in vivo studies, decreases in internal GPC
      concentrations occurred prior to any decrease in the concentration of ATP. The
      importance of these studies relies on the correct identity of this major 31P-NMR
      resonance. More recently, the identity of this resonance as GPC was questioned by
      experimental data obtained from C. elegans dauer larvae using the NMR technique.
      Because studies from our laboratory suggested that phospholipid metabolism may be
      intimately connected with the parasite's responses to drugs, the identity of the
      assigned resonance in the 31P-NMR spectrum as GPC in Ascaris suum was reexamined
      and found to be correct. Similar studies with C. elegans indicate the presence of
      both GPC and GPE.

PMID- 7776120
TI  - The effects of culture-site, depth, season, and stock source on the prevalence of
      Marteilia refringens in cultured mussels (Mytilus galloprovincialis Lmk.) from
      Galicia, Spain.
AB  - Samples of a marteiliad parasite in Mytilus galloprovincialis Lmk. from NW Spain
      were identified as Marteilia refringens, using light and electron microscopy. The
      most important lesions in the mussel tissues were found in the digestive tubules
      at the moment of the release of the sporangia, resulting in a breakage of the
      epithelial cells of the digestive tubules. The plasmodia of a Marteilia-like
      organism were also found in the gills, accompanied by a severe host reaction in 1
      of the 4,200 examined mussels. The prevalence of the M. refringens parasite was
      monitored for 4 yr and correlation was found with prevalence, site, and depth of
      mussel culture. No correlation was found with geographical origin of the mussels.
      Mussels collected from the inner part of the Ria de Vigo were more frequently
      infected (38.5%) than those from the middle (29.0%) and outer parts (5.5%).
      Mussels from 2-m samples showed a higher mean prevalence of M. refringens than
      those from the 5-m samples (13.3 and 8.3%, respectively).

PMID- 7776119
TI  - Mitochondrial NADH-->NAD transhydrogenation in adult Hymenolepis diminuta.
AB  - Adult Hymenolepis diminuta mitochondria catalyze a transhydrogenation reaction
      between NADPH and NAD and between NADH and NAD. The NADPH-->NAD reaction is
      catalyzed by an inner membrane-associated pyridine nucleotide transhydrogenase,
      whereas the NADH-->NAD reaction is ostensibly catalyzed by another system(s). The
      source(s) of NADH-->NAD activity was evaluated by assessments of its
      intramitochondrial distribution and thermal lability and by comparisons with the
      distribution/thermal lability of NADH dehydrogenase, lipoamide dehydrogenase, and
      NADPH-->NAD transhydrogenase. The occurrence of NADH and lipoamide dehydrogenase
      components was readily demonstrable. Like NADPH-->NAD transhydrogenase, NADH
      dehydrogenase was essentially membrane bound. Lipoamide dehydrogenase and NADH-
      >NAD activities were, at different levels, in the membrane and soluble fractions.
      Based on thermal profiles, NADH and lipoamide dehydrogenase differed from each
      other and from NADPH-->NAD transhydrogenase. Although the NADH-->NAD profile
      closely paralleled that for lipoamide dehydrogenase, it also was similar to the
      NADH dehydrogenase profile. Collectively, these data are consistent with the
      supposition that the H. diminuta mitochondrial NADH-->NAD transhydrogenation
      reaction is catalyzed by lipoamide dehydrogenase and possibly by NADH
      dehydrogenase rather than by an independent transhydrogenase system.

PMID- 7776121
TI  - Secular and seasonal trends of Neospora abortion in California dairy cows.
AB  - This study was undertaken to determine if the proportion of dairy cow abortions
      attributable to Neospora sp. infection increased or occurred in a seasonal cycle
      during a 6-yr period. Abortions caused by Neospora sp. were tallied for all
      fetuses submitted to the Tulare branch of the California Veterinary Diagnostic
      Laboratory between January 1985 and December 1990. Regression analysis of 221
      cases of Neospora among 762 fetuses submitted showed a weak increasing secular
      trend (P = 0.053, r2 = 0.05), with predicted monthly proportions at the beginning
      and end of the 6 yr of 0.16 and 0.33, respectively. Using a Kolmogorov-Smirnov
      type statistic, comparison of the 12-mo distribution of Neospora sp. cases and a
      hypothetical distribution of cows at risk of aborting found about 16% of
      variation in cases was attributable to season (P < 0.01). More cases were found
      in winter than in summer and early fall. Results indicate that Neospora sp.
      abortion in California dairy cows is not new or recently emerging and that
      seasonally related factors influence some of the risk of abortion. Results
      suggest that Neospora sp. has contributed to the high dairy cow abortion rate for
      many years, and that seasonally varying exposures may predispose to transmission
      or recrudescence of infection.

PMID- 7776122
TI  - Genetic characterization of isolates of Giardia duodenalis by enzyme
      electrophoresis: implications for reproductive biology, population structure,
      taxonomy, and epidemiology.
AB  - The nature and extent of genetic variation in Giardia was used to infer its mode
      of reproduction, population structure, taxonomy, and zoonotic potential. Ninety
      seven isolates of Giardia duodenalis, from a defined area in Western Australia
      and throughout Australia and overseas, were obtained from humans, cats, cattle,
      sheep, dogs, goat, beaver, and rats. Enzyme electrophoresis revealed extensive
      genetic variation with 47 different zymodemes. The widespread occurrence of
      certain zymodemes and the similarity of relationships among isolates inferred
      from independent genetic markers suggests a clonal population structure for G.
      duodenalis, although occasional bouts of genetic exchange may occur. The 47
      zymodemes clustered similarly in phenetic (UPGMA) and phylogenetic (Fitch
      Margoliash) analyses. The level of genetic diversity in isolates from a defined
      geographical area in Western Australia was similar to the level of diversity in
      isolates from throughout Australia. These data suggest that clonal lineages
      within G. duodenalis are evolutionarily independent. Although there was a
      significant overall correlation between genetic distance separating zymodemes and
      occurrence in different host species, we found genetically identical isolates
      from humans and other animals and extensive genetic diversity between isolates
      from humans. We interpret this as evidence for zoonotic transmission of the
      parasite.

PMID- 7776123
TI  - Genetic structure of midwestern Ascaris suum populations: a comparison of
      isoenzyme and RAPD markers.
AB  - Isoenzyme and random amplified polymorphic DNA (RAPD) markers were used to
      characterize the genetics of geographic variation among population samples of
      Ascaris suum from midwestern localities. Independent estimates of fixation
      indices (FST) based on isoenzyme and RAPD markers showed the same general
      patterns of differentiation and substantial statistical correlation (r = 0.70).
      Of the total estimated gene diversity, 9.4% (isoenzyme) and 9.2% (RAPD) was
      distributed among infrapopulations. Geographic localities accounted for 7.8%
      (isoenzyme) and 6.2% (RAPD) of the total gene diversity. Only infrapopulations
      from a single farm were characterized by low fixation indices (isoenzyme and RAPD
      FST < 0.05). Isoenzyme and RAPD markers revealed moderate genetic differentiation
      among infrapopulations and localities, which indicates significant population
      subdivision among A. suum from farms within geographic regions. Departures from
      random mating were revealed by deficiencies of heterozygotes within
      infrapopulations and by high positive values of FIS among and between
      infrapopulations. The average inbreeding (FIS) coefficient among all
      infrapopulations was 0.22. Thus, the genetic composition of these A. suum
      infrapopulations, whether from a general geographic region of a single farm, was
      not consistent with a model of random recruitment from a larger panmictic pool of
      parasite life cycle stages.

PMID- 7776124
TI  - Microevolution and the genetic structure of parasite populations.
AB  - The development of polymerase chain reaction-based methods for assessing the
      genotypes of small individual organisms will promote groundbreaking
      investigations of the genetic architecture of parasite populations. Both
      quantitative genetic models and general knowledge of parasite natural history are
      useful for making general predictions about the distribution of genetic variation
      over geographic space. However, designing experimental studies to assess
      relationships between specific life history variables and patterns of genetic
      structure in natural populations will be challenging. Traditional biochemical
      genetic methods have already been used to study a limited number of parasite
      populations, and inferred patterns of genetic structure are distinctly different
      between certain species. Some of these differences in genetic architecture may be
      explained by parasite or host factors that either promote or retard the
      dissemination of life cycle stages over geographic space. Many additional
      empirical studies are needed to characterize basic features of parasite
      populations, including the spatial distribution and group size of random mating
      populations and levels of gene flow among parasite subpopulations.

PMID- 7776125
TI  - A new method for evaluating experimental cryptosporidial parasite loads using
      immunofluorescent flow cytometry.
AB  - A flow cytometric method for the quantification of Cryptosporidium parvum oocysts
      in stool specimens was developed to replace conventional microscopic
      immunofluorescent assays. Fecal pellets were collected from control (uninfected)
      severe combined immune-deficient mice, suspended in 2.5% potassium dichromate at
      a ratio of 400 microliter per pellet, and homogenized by vortexing. Purified
      oocytes were added to the samples (10(5), 10(4), 10(3), and 10(2)/ml). Aliquots
      (200 microliters) of the vortexed samples were centrifuged over microscale
      discontinuous sucrose gradients. The oocyst-containing fractions were collected,
      washed, and incubated with an oocyst-specific monoclonal antibody (labeled with
      fluorescein isothiocyanate) for 30 min at 37 degrees C. Sample volumes were
      adjusted to 600 microliters with phosphate-buffered saline and assayed by using
      logical gating of forward/side scatter and fluorescence signal on a flow
      cytometer. Seeded samples showed a linear correlation with the number of oocysts
      recovered from the gradients. Analyses of stool samples from chronically infected
      mice demonstrated that the flow cytometry method was approximately 10 times more
      sensitive than conventional immunofluorescent assays.

PMID- 7776126
TI  - Duration of immunity to shedding of Toxoplasma gondii oocysts by cats.
AB  - Cats that have shed Toxoplasma gondii oocysts are considered to be immune to
      reshedding of oocysts. To investigate if this immunity persists in cats for 6 yr,
      12 4-6-mo-old cats without T. gondii antibodies were inoculated orally with
      tissue cysts of the ME-49 strain (6 cats) and the TS-2 strain (6 cats) of T.
      gondii. All of them shed > or = 20 million oocysts between 4 and 13 days after
      feeding tissue cysts. Two cats became ill between 11 and 13 days after primary
      infection; 1 died on the 13th day, and the other had to be killed on the 11th day
      because of generalized acute toxoplasmosis. Toxoplasma gondii oocysts were not
      found on the hair of 10 cats examined 7 days after cats had shed millions of
      oocysts. On day 39 after primary infection, 5 cats (2 infected with the ME-49
      strain and 3 infected with the TS-2 strain) were challenged orally with tissue
      cysts of the ME-49 strain. None of the challenged cats shed oocysts. One cat died
      due to causes unrelated to toxoplasmosis. Seventy-seven months after primary
      infection, the remaining 9 cats were challenged orally with tissue cysts of the
      P89 strain of T. gondii. Four of these 9 cats re-shed T. gondii oocysts; 3 of
      them had been challenged also at 39 days after primary infection. Two control
      cats housed together with chronically infected cats for 6 yr remained
      seronegative for T. gondii; both of these shed oocysts after challenge with the
      P89 strain.

PMID- 7776127
TI  - Detection by ELISA of circulating anti-blood fluke (Carettacola, Hapalotrema, and
      Learedius) immunoglobulins in Hawaiian green turtles (Chelonia mydas).
AB  - An enzyme-linked immunosorbent assay (ELISA) is described utilizing the surface
      glycocalyx crude antigen of adult blood trematodes Learedius learedi, Hapalotrema
      dorsopora, and Carettacola hawaiiensis, for the detection of circulating
      antibodies (Ab) in Hawaiian green turtles (Chelonia mydas) naturally infected
      with the parasites and with or without green turtle fibropapillomatosis (GTFP). A
      concentration of 10.0 micrograms/ml of antigen was optimal in terms of test
      specificity and sensitivity. A direct ELISA with anti-reptilian/amphibian
      phosphatase-labeled IgG identified C. mydas Ab at a dilution of 1/12,800.
      Utilizing indirect ELISA, it was possible to detect Ab to blood flukes at a
      dilution of 1/3,200. The gross lesions and histopathology were typical for
      cardiovascular spirorchidiasis in C. mydas. No significant relationship was found
      between the size of turtles and the degree of GTFP severity. Forty-seven of 59
      (80%) samples, from 5 sites, gave a positive ELISA reaction; 6 of the 47 (13%)
      specimens gave significantly (P < 0.001) higher absorbance values, with 5 from
      the same location. All 12 (20%) ELISA-negative turtles originated from 1 site,
      and the absorbance values of the 41 animals from this location were significantly
      lower (P < 0.015) when compared with the other 4 sites. The proposed assay is
      fast, has the feature of visual scoring, and can be used for determination of
      exposure of C. mydas to the spirorchid trematodes.

PMID- 7776128
TI  - A defined antigen for the serodiagnosis of Taenia ovis infections in dogs.
AB  - The evaginated scolex of Taenia ovis secretes an antigen complex into defined
      culture medium that has been used to develop a cestode-specific enzyme-linked
      immunosorbent assay (ELISA). We now describe an immunoblot test for antibodies to
      T. ovis based on the recognition of a 94-kDa antigen band in the sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis profile of T. ovis scolex secretions.
      The test was specific for cestode infections in dogs and was 82% sensitive for
      the recognition of T. ovis infections. Affinity-purified antibody uniquely
      recognizing this 94-kDa band was used to screen a cDNA expression library
      constructed utilizing mRNA from newly evaginated T. ovis scoleces. The cDNA from
      putative positive bacteriophage were subcloned into the plasmid pGEX and
      expressed as fusion proteins with schistosome glutathione-S-transferase (GST).
      The expressed fusion proteins were purified using glutathione-agarose beads. The
      recombinant parasite antigen was either eluted as a fusion protein with GST or
      cleaved from GST using a restriction protease. Some dog sera reacted with the GST
      molecule. However, the recombinant cleaved antigen from 1 clone, T. ovis 40,
      showed 42% sensitivity and 100% specificity for cestodes in an ELISA using test
      sera from dogs monospecifically infected with T. ovis and preabsorbed with
      bacteria. Some sera from dogs monospecifically infected with other cestode
      species (Taenia pisiformis, 30%; Taenia hydatigena, 30%; Echinococcus granulosus,
      20%) reacted with the cloned antigen.

PMID- 7776130
TI  - High energy phosphate metabolites observed by NMR in infective larvae of
      Haemonchus contortus.
AB  - Phosphorus resonances consistent with phosphoarginine and ATP were observed in
      the in vivo 31P-nuclear magnetic resonance (NMR) spectra of infective larvae of
      Haemonchus contortus. The level of phosphoarginine quickly declined when nematode
      suspensions were purged with nitrogen and was restored upon return to aerobic
      conditions. Saturation transfer NMR demonstrated forward and reverse exchange of
      phosphorus between phosphoarginine and ATP.

PMID- 7776129
TI  - Effects of dehydroepiandrosterone in immunosuppressed adult mice infected with
      Cryptosporidium parvum.
AB  - Cryptosporidiosis is a diarrheal disease in humans and other animals caused by
      the coccidian parasite, Cryptosporidium parvum. This study was undertaken to
      determine the effectiveness of dehydroepiandrosterone (DHEA) in reducing C.
      parvum infections in immunosuppressed adult C57BL/6N mice and to identify the
      immunomodulatory effects of DHEA that result in increased resistance to
      cryptosporidiosis. Dexamethasone-immunosuppressed mice were readily infected with
      C. parvum following orogastric intubation with 10(6) oocysts/mouse. DHEA
      treatment of these mice significantly reduced (P < 0.01) both fecal oocyst
      shedding and parasite colonization of the ilea. Immunosuppressed mice treated
      with DHEA had more splenic total T cells, CD4+ T cells, and CD8+ T cells than
      immunosuppressed mice that were not treated, but the differences were not always
      significant. Moreover, nonimmunosuppressed mice treated with DHEA had
      significantly more (P < 0.05) splenic total T cells, CD4+ T cells, and total B
      cells than nonimmunosuppressed mice that did not receive DHEA. Of particular
      interest was the significantly larger (P < 0.05) number of CD8+ T cells in
      immunosuppressed, C. parvum-infected, DHEA-treated mice compared with the same
      mice that were not treated. Up-regulation of the immune system by exogenous DHEA
      may be useful in the treatment and palliation of cryptosporidiosis.

PMID- 7776131
TI  - Taxonomy of Heterocotyle dasyatis n. comb. (syn. Diploheterocotyla dasyatis)
      (Monogenea: Monocotylidae).
AB  - The monotypic genus Diploheteocotyla Yamaguti, 1965, parasitic on the gills of a
      dasyatidid ray collected off Hawaii, is synonymized with Heterocotyle Scott,
      1904. Its type species, D. dasyatis Yamaguti, 1965, is redescribed, illustrated,
      and transferred to Heterocotyle as H. dasyatis (Yamaguti, 1965) n. comb.
      Heterocotyle dasyatis is distinguished from the 9 known species of the genus by
      the morphology of the male copulatory organ, by the accessory piece, which is
      composed of 10 sclerotized strands, and by the presence of a complex sclerite in
      the proximal portion of the vagina. The apparent presence of spermatophores is
      recorded for the first time in this genus.

PMID- 7776133
TI  - Myxobolus cultus n. sp. (Myxosporea: Myxobolidae) in the goldfish Carassius
      auratus transformed from the actinosporean stage in the oligochaete Branchiura
      sowerbyi.
AB  - A new myxosporean Myxobolus cultus n. sp. was found in experimentally infected
      goldfish Carassius auratus exposed to actinosporean spores from the oligochaete
      Branchiura sowerbyi (Tubificidae). At 2-4 mo following initial exposure, spores
      of M. cultus were observed in the cartilage of goldfish. A lymphocytic infiltrate
      surrounded the pseudocysts. Some pseudocysts were destroyed and spores had been
      engulfed by phagocytes. Phagocytized spores were also found in the epidermis of
      skin and within melanomacrophage centers in the kidney.

PMID- 7776132
TI  - Proterometra autraini n. sp. (Digenea: Azygiidae) from Michigan's upper peninsula
      and a key to species of Proterometra.
AB  - Life stages of Proterometra autraini n. sp. (Digenea: Azygiidae) from the Au
      Train River, Au Train, Michigan are described, with emphasis on the cercarial
      stage. Progenetic cercariae develop in rediae in the snail Elimia livescens and
      emerge seasonally from mid-summer to mid-autumn. Cercariae emerge naturally
      between 1000 and 2100 hr EDT. Adults were retrieved from several naturally
      infected fish species. Specimens of Cottus bairdi (n = 16) displayed the greatest
      prevalence (75%), mean intensity (7.1), and abundance (5.3) of infection.
      Experimental infections were successful in C. bairdi, Lepomis macrochirus, and
      Perca flavescens. The geographical range of this parasite is limited to the
      portion of the Au Train River between Au Train Lake and Lake Superior.

PMID- 7776134
TI  - Inhibitory activity of the anti-malarial atovaquone (566C80) against ookinetes,
      oocysts, and sporozoites of Plasmodium berghei.
AB  - Ookinete formation from mature Plasmodium berghei gametocytes in vitro was
      partially inhibited by 0.05-0.1 microM atovaquone and almost totally blocked at a
      concentration of 0.25 microM. Microgametocyte exflagellation was not affected by
      atovaquone at concentrations up to 300 microM. Ookinete formation was also
      inhibited in culture when addition of 0.20 microM atovaquone was delayed by 4 hr,
      by which time DNA replication was likely to have been completed. Inhibition of
      ookinete formation by atovaquone was not reversed by orotic acid. Plasmodium
      berghei-infected Anopheles stephensi mosquitoes were fed a second blood meal 4,
      7, 14, and 20 days postinfection (p.i.) from mice that had been treated with
      atovaquone or control diluent 8 hr previously. Atovaquone blood feeds on day 4
      reduced oocyst numbers on days 6-12, although sporozoite numbers in the thorax
      and abdomen on day 20 were not significantly reduced. Blood feeds on day 7 slowed
      oocyst growth, blood feeds on day 14 did not significantly reduce sporozoite
      numbers, and feeds to mosquitoes on day 20 p.i. had no effect on transmission to
      naive mice. Sporozoite invasion of human hepatoma cells was unaffected by the
      presence of atovaquone.

PMID- 7776135
TI  - Ultrastructural effects of diclazuril against Toxoplasma gondii and investigation
      of a diclazuril-resistant mutant.
AB  - Diclazuril is an anticoccidial that inhibits tachyzoite production of the RH
      strain of Toxoplasma gondii by > 97% at a concentration of 0.005 micrograms/ml.
      The effects of 1.0 microgram/ml diclazuril on the development of 3 strains (RH
      and 2 tissue cyst formers, GT-1, and WTD-3) of T. gondii in vitro was examined
      using transmission electron microscopy. The effects of diclazuril were not noted
      until 2 days after treatment. Treatment with diclazuril interfered with
      endodyogeny and resulted in the production of multinucleate (> 2 nuclei) meront
      stages. Up to 12 nuclei were observed in some meronts. Tachyzoites attempted to
      bud from the surfaces of these stages but division was apparently blocked by the
      action of diclazuril. The parasitophorous vacuole (PV) enclosing developing
      stages became hypertrophic. As the meront stages degenerated the PV became filled
      with membranous material and the cytoplasmic contents of lysed stages. Formation
      of tissue cysts by the GT-1 and WTD-3 strains of T. gondii was not prevented by
      treatment with diclazuril. A mutant of the RH strain that was resistant to 1.0
      microgram/ml diclazuril was selected by progressive culture in permissive levels
      of the agent. This DicR-1 mutant produced significantly fewer tachyzoites (P <
      0.05) in vitro than its parent strain. Resistance to diclazuril appears to be
      stable because reversion to sensitivity to the agent did not occur after 50
      passages in the absence of drug pressure. The DicR-1 mutant was somewhat less
      pathogenic for mice (70% mortality) than its parent RH strain (100% mortality)
      and persisted as tissue cysts in the brains of mice.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7776136
TI  - Scanning electron microscopy of adult Wuchereria bancrofti (Nematoda:
      Filarioidea).
AB  - Despite the great importance of Wuchereria bancrofti in causing human lymphatic
      filariasis, only conventional morphological studies have been completed with
      adult forms of this filaria. No ultrastructural studies have been carried out,
      mainly due to the difficulty in obtaining viable parasites from human tissues and
      the lack of a suitable experimental model or in vitro cultivation. With the
      recent success in using ultrasound to localize adult worms in living tissues and
      their surgical recovery from human lymphatic vessels, we show in the present
      paper the first ultrastructural observations of this filarial form. The cuticle
      surface analyzed by scanning electron microscopy showed a transversal striated
      aspect with periodic annulations and many small protuberances irregularly
      distributed along the filaria. The adults present a specialized cephalic area,
      with the oral opening surrounded by a circular mouth, papillae, and amphidial
      opening. Other structures, for example the anal, vulvar, and cloacal opening and
      spicules, were also observed and are described herein.

PMID- 7776137
TI  - Comparative morphology of the scolices and microtriches among five species of
      Tetrabothrius (Eucestoda: Tetrabothriidae).
AB  - The structure of the scolex, neck, and adjacent strobila of 5 species of
      Tetrabothrius was evaluated using low to high magnification scanning electron
      microscopy. Species-specific patterns and morphotypes (spiniform, papilliform,
      and filiform) of microtriches were found on the scolices and strobilar tegument
      of Tetrabothrius (Oriana) affinis, Tetrabothrius (Oriana) filiformis, and
      Tetrabothrius (Culmenamniculus) laccocephalus; microtriches were absent in
      Tetrabothrius (Culmenamniculus) cylindraceus and Tetrabothrius (Tetrabothrius)
      sp. The presence, distribution, and form of microtriches may not be correlated
      with the subgeneric divisions of Tetrabothrius or the host taxon. Unique patterns
      do not appear to be shared with other groups of cestodes, particularly other
      tetraphyllideans. We suggest that the spiniform, filiform, and papilliform types
      of microtriches may be symplesiomorphic for the Eucestoda.

PMID- 7776138
TI  - Multiple heterogenous isolates of Cryptosporidium serpentis from captive snakes
      are not transmissible to neonatal BALB/c mice (Mus musculus).
AB  - Oral inoculations of 9 litter-groups of 3 5-day-old suckling BALB/c mouse pups
      (Mus musculus) with 6.7 x 10(3) to 1.2 x 10(5) per pup of viable, Cryptosporidium
      serpentis oocysts from snakes resulted in no transmission. Mice showed normal
      development; the litter-group weight gain was not altered significantly (P >
      0.05) relative to the total number of C. serpentis oocysts inoculated or to the
      initial group weight (P > 0.05). Histological sections of stomach, duodenum,
      jejunum, ileum, cecum, and colon 4 days postinoculation did not contain life
      cycle stages of Cryptosporidium in any inoculated mice. Because these neonatal,
      C. parvum-susceptible BALB/c mice were resistant to infection it is unlikely that
      C. serpentis transmission to the snakes "via infected prey" results when captive
      snakes are maintained on a diet of BALB/c mice.

PMID- 7776139
TI  - New host records for Myxidium serotinum (Protozoa: Myxosporea) from North
      American amphibians.
AB  - Three hundred twenty-five amphibians (80 salamanders, 245 frogs and toads) from
      Arkansas and Texas, representing 28 species within 9 families (Ambystomatidae,
      Plethodontidae, Salamandridae, Sirenidae, Bufonidae, Hylidae, Leptodacytlidae,
      Microhylidae, Ranidae) were examined for gall bladder myxosporeans. Of these, 32
      (10%) were found to harbor Myxidium serotinum Kudo and Sprague, 1940, including 3
      (4%) of the salamanders and 29 (12%) of the frogs and toads. This report
      documents 6 new host records for M. serotinum in Ambystoma opacum, Bufo
      americanus charlesmithi, Bufo speciosus, Acris crepitans blanchardi, Gastrophryne
      olivacea, and Pseudacris streckeri illinoensis. In addition, the Great Plains
      narrowmouth toad G. olivacea represents the first microhylid host of Myxidium
      spp. worldwide.

PMID- 7776140
TI  - Rhabdochona cotti (Nematoda: Rhabdochonidae) in mottled sculpins, Cottus bairdi,
      from the Ford River, Michigan.
AB  - A total of 933 mottled sculpins, Cottus bairdi Girard (Cottidae), was examined
      for Rhabdochona cotti from April 1983 through November 1986 from 3 localities (up
      river, middle, down-river) in the Ford River in Michigan's Upper Peninsula. The
      prevalence and mean intensity of R. cotti were highest in sculpins from the
      middle (37%) and up-river localities (2.0), respectively. The intensity of R.
      cotti significantly increased with host length at the middle and down-river
      localities. Rhabdochona cotti did not exhibit consistent seasonal infection
      patterns at each location when the data were analyzed seasonally within and
      between years. Gravid R. cotti infected sculpins in most seasons of each year at
      the up-river and middle localities. The limited occurrence of R. cotti in
      sculpins in North America is summarized and discussed.

PMID- 7776141
TI  - B lymphocytes are not required for murine resistance to the human filarial
      parasite, Brugia malayi.
AB  - Immunocompetent mice are resistant to the growth and development of human
      lymphatic filarial parasites, including the aperiodic strain of Brugia malayi. We
      have recently established that mice homozygous for the severe combined
      immunodeficiency (scid) mutation, and therefore deficient in both T and B
      lymphocytes, are permissive for infection. This observation suggests that
      components of the adaptive (antigen-specific) immune system are obligate
      requirements for murine resistance to B. malayi. In order to determine more
      precisely the component of the immune system that mediates murine resistance to
      B. malayi, we have used mouse strains in which individual genes involved in the
      maturation of specific components of the immune system have been disrupted by
      homologous recombination. In previous studies, we demonstrated that mice that
      lack either major histocompatibility (MHC) class I restricted, CD8+ T lymphocytes
      (beta 2-microglobulin knockout mice; beta 2M-/-) or CD4+ T lymphocytes (CD4
      knockout mice; CD4-/-) are as resistant to B. malayi as intact mice. In the
      current study, we have used mice in which the membrane exon of the immunoglobulin
      (Ig) mu (heavy chain) constant region gene segment has been disrupted by
      homologous recombination. These mice cannot develop mature B lymphocytes and lack
      serum Ig. We demonstrate that such "B-less" mice are completely resistant to B.
      malayi. These data, taken in combination with the observation that T-cell
      deficient athymic mice homozygous for the nu (nude) mutation are fully permissive
      for infection, suggest that B lymphocytes and their products are neither required
      nor sufficient to mediate resistance to B. malayi.

PMID- 7776142
TI  - Intracapsular asexual proliferation of Mesocestoides sp. tetrathyridia in the
      gastrointestinal tract and mesenteries of the prairie rattlesnake (Crotalus
      viridis viridis).
AB  - Nonproliferous and proliferous tetrathyridia (Mesocestoides sp.) have been
      reported from natural and experimental infections in reptiles and rodents.
      Multiple tetrathyridia (1+) in individual capsules (host-derived) were observed
      for both types of tetrathyridia and in both types of animals. To determine
      whether proliferous tetrathyridia in this genus could replicate in host capsules
      of the prairie rattlesnake (Crotalus viridis viridis), 11 snakes were inoculated
      and maintained in 2 environmental chambers (25 C and 30 C). One snake at each
      temperature was removed at 4-wk intervals and killed. Sections of the
      gastrointestinal tract and adjacent mesenteries were histologically examined. The
      increase in the numbers of tetrathyridia per capsule was significant at both 25 C
      (P = 0.007) and 30 C (P < 0.001). Identification of 7 intracapsular tetrathyridia
      with binary scoleces served as collaborative evidence. This paper presents the
      first significant evidence for asexual replication of the proliferous
      tetrathyridia (Mesocestoides sp.) in a reptilian host.

PMID- 7776143
TI  - Andracantha tunitae (Acanthocephala) in the shag (Phalacrocorax aristotelis) from
      Shetland, Scotland.
AB  - Following the wreck of the oil tanker Braer on the coast of Shetland, Scotland,
      in January 1993, many shags (Phalacrocorax aristotelis) were killed. Sixty-nine
      per cent of these birds were found to harbor a sexually mature acanthocephalan (5
      +/- 4.3 [SE] worms per infected bird) in their small intestines. The
      acanthocephalan has been identified as Andracantha tunitae (= Corynosoma tunitae)
      on the basis of its characteristic fields of trunk spines and their distribution
      in the region of the genital aperture.

PMID- 7776144
TI  - Distribution of Myxobolus scleroperca (Myxobolidae: Myxosporea) in yellow perch
      (Perca flavescens) in the Great Lakes.
AB  - Myxobolus scleroperca infected the sclerotic cartilage of 26 of 100 yellow perch
      (Perca flavescens) examined in August-September 1991 from the Indiana waters of
      southern Lake Michigan. The mean lengths of infected and uninfected fish were 171
      mm and 148 mm, respectively. A significantly higher percentage of female fish
      were infected than male because more larger females were examined than males.
      Perch less than 94 mm were not infected, indicating that the parasite is not
      evenly distributed in the host population, preferring larger (older) fish. An
      alternative explanation that should be considered is that young fish die from
      this infection. Yellow perch collected from eastern Lake Michigan in 1990 and
      from Saginaw Bay, Lake Huron in 1991 were not infected with M. scleroperca,
      indicating that the parasite has a patchy distribution among perch populations of
      the Great Lakes.

PMID- 7776145
TI  - Family beliefs among adolescents at risk for substance abuse.
AB  - This study investigates the extent to which adolescents identified as at-risk for
      substance abuse express different beliefs about the importance of family,
      religiosity, education, and work in comparison to their own parents and to
      adolescents and parents in control group. It was hypothesized that the success of
      parents in communicating such values to their children could be a significant
      variable in risk of substance abuse. We found that parents of at-risk adolescents
      did not hold significantly different beliefs than parents in the control group.
      Beliefs of the at-risk adolescents were significantly different from other
      adolescents and both parent groups. We also found that the absolute difference in
      age between parent and adolescent significantly smaller in the at-risk group as
      compared to the control group.

PMID- 7776146
TI  - Impact of contextual variables on adolescent situational expectation of substance
      use.
AB  - The relationship between contextual variables and situational expectation of drug
      and alcohol use at the school level suggested by Interactive theory was
      investigated [1, 2]. A canonical correlation analysis supported a significant
      relationship between situational expectation of drug and alcohol use and several
      contextual variables including Students' Perceptions of What Teachers Expect of
      Them Academically, Percentage of White Students, and the Prosperity of the
      School. The results indicated that the more prosperous the school and the greater
      the students' perceptions of what teachers expect of them academically, the lower
      the situational expectation of smoking cigarettes or taking depressants and the
      higher the percentage of white students the higher the situational expectation of
      drinking beer and liquor. Implications for prevention programs and school
      environment are discussed.

PMID- 7776147
TI  - The relationship of self-perception and stress in adult children of alcoholics
      and their peers.
AB  - Woititz identified thirteen generalizations which she asserts characterize adult
      children of alcoholics (ACOAs) [1]. Her work, however, was based upon clinical
      populations and may not be generalizable to a non-clinical population. Using 442
      undergraduate students, 2 x 3 multivariate analysis of variance (parental
      alcoholism by level of childhood stress) on students' perceptions of the
      applicability of Woititz's variables to them was conducted. No significant
      effects were found even though ACOAs experienced more childhood stress than their
      peers. Results do not support the generalization of Woitiz's model to a non
      clinical sample.

PMID- 7776148
TI  - Effects of normative feedback on consumption among heavy drinking college
      students.
AB  - College students, particularly those who drink heavily, tend to overestimate the
      prevalence of heavy drinking among their peers. A self-regulation model predicts
      that feedback of undesirable deviation from normative standards would result in
      correction of behavior toward perceived norms. From a screening of 568 college
      students, sixty-four heavy drinkers were identified and offered the opportunity
      to participate in a survey study of drinking. Of these, twenty-six accepted and
      returned questionnaires with detailed information regarding their drinking
      practices. These were randomized to receive or not receive, by return mail,
      personal feedback of their drinking relative to population norms. At an
      independent follow-up interview, feedback subjects showed greater reduction in
      weekly consumption and typical intoxication levels, relative to controls. This
      simple feedback intervention, requiring no personal contact, may be a cost
      effective strategy for reducing risky drinking.

PMID- 7776149
TI  - Adolescent drinking and driving: etiology and interpretation.
AB  - In the adolescent population, drinking and driving is an important cause of
      injury, disability and premature death. A literature review of the demographics
      and etiology of drinking and drinking/driving reveals: 1) which subgroups of the
      adolescent population are more likely to drink and drink/drive; 2) where and why
      adolescents drink and drink/drive; 3) peer and family issues associated with
      adolescent drinking and drinking/driving; and 4) adolescent expectancies and
      perceived efficacies associated with drinking and drinking/driving. A discussion
      of the role of theory and the use of etiologic data in intervention research
      precedes an overview of several types of school-based alcohol-prevention programs
      and recommendations for more theory based interventions.

PMID- 7776150
TI  - Patterns of drug use among white institutionalized delinquents in Georgia:
      evidence from a latent class analysis.
AB  - Previous research by Kandel [1] and others indicates that adolescent drug use
      follows a progression from legal drugs, through marijuana, to hard drugs. In this
      study of drug use patterns, institutionalized delinquents were found to follow a
      similar progression of drug use. Unlike previous studies which used "rule of
      thumb" methods of model assessment, this study uses probabilistic assessment of
      the models. Importantly, the present study supports a modified gate-way sequence,
      where cocaine use appears as an intermediate step between marijuana use and use
      of other hard drugs. It is suggested that widespread availability of cocaine in
      the late 1980's may have resulted in a new "step" in the drug use sequence.

PMID- 7776151
TI  - Reading abilities of drug users in Anchorage, Alaska.
AB  - Evaluated the reading abilities of 122 male and fifty-nine female intravenous and
      other drug users in Anchorage, Alaska. Reading abilities were assessed through
      the Reading subtest of the Wide Range Achievement Test-Revised and the short Form
      of the Woodcock Reading Mastery Test-Revised. Results indicated that men and
      Black subjects reported the highest levels of schooling completed. However, no
      differences were revealed across gender and ethnicity in actual reading levels.
      Among all subjects, the average reading ability was between 8.5 and 8.7 grade
      level. These scores place the average subject reading at a level lower than
      approximately 76 percent of the general population. Implications are provided for
      development of educational materials accessible for this population.

PMID- 7776152
TI  - Ultrastructural localization of glycosaminoglycans in human gingival connective
      tissue using cupromeronic blue.
AB  - Human gingiva was stained with cupromeronic blue according to Scott's critical
      electrolyte concentration technique in order to localize glycosaminoglycans (GAG)
      in the electron microscope. Identification was performed by digestion with
      chondroitinase AC, ABC and heparinase. The GAG were localized in three
      compartments of the connective tissue: the supra-alveolar fiber apparatus, the
      loose connective tissue and the basement membranes. In the supra-alveolar fiber
      apparatus, consisting mainly of densely packed parallel collagen fibrils,
      dermatan sulfate GAG are regularly attached to the d-band of the collagen
      fibrils. The precipitates (6-7 nm in diameter) aggregate to thicker precipitates
      (up to 16 nm), thus possibly providing stability to the fiber system. In the
      loose connective tissue with sparse collagen fibrils dermatan and chondroitin
      sulfate GAG form very large precipitates (up to 30 nm in diameter and 400 nm
      length) which interconnect the few collagen fibrils. The basement membranes of
      the epithelium and capillary endothelium contain heparan sulfate GAG as fine
      precipitates (4-6 nm in diameter) which form a meshwork. These findings are
      consistent with the Scott model (1) for the interactions among glycans and
      glycans and collagen fibrils in connective tissues.

PMID- 7776153
TI  - Bacterial steroidogenesis by periodontal pathogens and the effect of bacterial
      enzymes on steroid conversions by human gingival fibroblasts in culture.
AB  - Studies were performed to investigate the effect of microbial culture
      supernatants of periodontal pathogens on the metabolism of radiolabelled
      testosterone in the presence or absence of human gingival fibroblasts.
      Subgingival plaque samples were obtained on paper points from 3 sites with
      probing depth values of 6-8 mm. Samples were incubated with 14C-testosterone for
      24 h in brain heart infusion (BHI) broth. Similar incubations were also carried
      out with strains of A. actinomycetemcomitans, P. Intermedius and P. gingivalis to
      study the metabolism of radiolabelled testosterone by these periodontal
      pathogens. At the end of a 24 h incubation period with fibroblasts and
      supernatants or sonicates, the radioactive metabolites were extracted with ethyl
      acetate, evaporated and subjected to thin layer chromatography. The separated
      metabolites were quantified by scanning the radioactive plates using a Berthold
      linear analyser. When three sub-gingival plaque samples were incubated with
      radiolabelled testosterone there were 50-fold, 10-12-fold and 15-17-fold
      increases in 5 alpha-dihydrotestosterone (DHT) synthesis over 4-androstenedione
      production in these mixed microbial cultures. The two strains of P. intermedius
      produced 3- and 20-fold increases in 4-androstenedione production and DHT
      synthesis respectively. Both strains of A. actinomycetemcomitans and P.
      gingivalis showed 3-4-fold and 12-28-fold increases respectively in 4
      androstenedione synthesis over that of DHT. Culture supernatants of P.
      intermedius and P. gingivalis caused 3-fold and 2-fold increases in DHT synthesis
      by fibroblasts over controls. There was little change in the case of the third
      pathogen. Since DHT has implications on matrix synthesis by fibroblasts in the
      environment of plaque associated inflammatory periodontal disease, bacterial
      metabolism and the effect of bacterial supernatants on human gingival fibroblasts
      can influence the degree of inflammatory repair.

PMID- 7776154
TI  - Effect of Campylobacter rectus LPS on plasminogen activator-plasmin system in
      human gingival fibroblast cells.
AB  - The plasminogen activator (PA)-plasmin system is implicated in the degradation of
      the extracellular matrix in inflammation through activation of metalloproteases
      and prekallikrein. We examined the activation of the PA-plasmin system in human
      gingival fibroblast cells (Gin-1 cells) following treatment with
      lipopolysaccharide (LPS) from Campylobacter rectus, which is frequently detected
      at sites of periodontal disease. The C. rectus LPS stimulated the plasmin
      activity in the conditioned medium of Gin-1 cells in a time- and dose-dependent
      manner, and C. rectus LPS also stimulated the PA activity in the conditioned
      medium. The PA produced by Gin-1 cells was determined to be urokinase PA (uPA),
      as preincubation of Gin-1 conditioned medium with anti-uPA antiserum completely
      inhibited the PA activity while that with anti-tPA antiserum had no inhibitory
      effect. The concentration of PA inhibitor-1 (PAI-1) in the conditioned medium was
      decreased by the addition of C. rectus LPS. Therefore, the enhancement of plasmin
      activity in the conditioned medium was dependent on increased uPA activity via
      the decrease of the PAI-1 level of Gin-1 cells treated with C. rectus LPS.
      Furthermore, the conditioned medium of Gin-1 cells treated with C. rectus LPS
      showed significantly increased kallikrein activity, indicating the conversion of
      prekallikrein to kallikrein, which converts kininogen into kinin. These findings
      suggest that C. rectus LPS is a potent stimulator of inflammation of gingival
      tissue which acts through stimulation of the PA-plasmin system.

PMID- 7776156
TI  - Determination of small sample volumes in the analysis of drugs at specific sites
      in the oral cavity.
AB  - Two methods for the determination of sample volumes between 0.2 and 0.6
      microliters were compared by preparing standard curves for volumes over this
      range. The first method used a Periotron and the second the sample mass. A linear
      model was fitted and 95% confidence limits for volumes estimated by each method
      were calculated. This showed that use of either the maximum Periotron reading or
      the sample mass allowed estimation of volumes to within +/- 0.056 microliter and
      +/- 0.047 microliter respectively. It is proposed that measurement of sample mass
      provides a simple and accurate method to determine sample volume when analysing
      drug concentrations at specific sites in the oral cavity.

PMID- 7776155
TI  - Cytotoxic effect of vesicles produced by Porphyromonas gingivalis on fibroblasts
      in culture.
AB  - It has been shown that the vesicles produced by Porphyromonas gingivalis under
      certain growth conditions contribute to its pathogenicity. In this study, we
      demonstrate the cytotoxic effect of the vesicles using two methods: one
      quantitative (the colorimetric cytotoxicity test using sulforhodamine B) and the
      other qualitative (flow cytometry).

PMID- 7776157
TI  - Detection of periodontal probing change by analysis of distribution mean and
      skew.
AB  - A problem associated with probing measurement is that important site-specific
      change may be obscured by measurement variability. Furthermore, if many sites are
      monitored there is an increasing likelihood that any particular "detected change"
      might be the result of this measurement error. Since error and multiplicity
      effects would tend to increase mouth-wise false positive rate, demanding decision
      thresholds are often set. However, imposition of difficult criteria, increases
      site-wise false negative rate and therefore reduces utility in the clinical
      setting. Evaluation of mean change might sometimes be a useful alternative, but
      also problematic as a few dramatic site-level losses can be inconsequential among
      many stable or improving sites. A strategy is proposed for evaluating probing
      changes in a single patient, which is based on the statistical evaluation of two
      attributes of the change distribution. (1) Disease progression is concluded when
      mean probing loss increases over time, and (2) a clinically relevant asymmetry is
      concluded when the distribution tail corresponding to loss is skewed.
      Computerized simulation was used to determine alpha-error for tests of mean and
      skew, for three different distributions of probing change. Actual alpha-error was
      shown to be near nominal levels. Power was estimated as a function of the number
      and magnitude of sites with probing loss and as a function of whether there was
      change in both mean and skew or in skew alone. Under most conditions studied,
      simultaneous tests for skew and mean provided enhanced power relative to a test
      for loss alone and would appear to offer the clinician an additional statistical
      context for appraising disease status.

PMID- 7776158
TI  - Succession of putative peri-implant pathogens after root-form and plate-form
      implant placement in partially dentate adult monkeys.
AB  - This report describes the succession of putative peri-implant pathogens in
      partially dentate monkeys after dental implantation and prosthetic
      reconstruction. Tooth and implant (6 root-end form, 4 blade-vent implants) sites
      in eight monkeys were monitored microbiologically and clinically during the pre
      implant stage, abutment connection stage, bridge placement stage, and three and
      six months after the bridge placement stage. Tooth and implant sites were cleaned
      monthly post-extraction. Microbiological studies included dark field microscopy,
      selective and non-selective culture, and primary phenotypic characterization of
      culture isolates. After implant surgery, the median proportion of several
      putative peri-implant pathogens studied were significantly elevated. Following
      fixture placement, P. intermedia replaced P. melaninogenica as the predominant
      Black Pigmented Anaerobic Bacilli (BPAB) in the mouth. After abutment connection
      stage, levels of P. intermedia, A. actinomycetemcomitans, F. nucleatun,
      Haemophilus sp. and spirochetes were significantly elevated at implant and tooth
      sites. Three months after bridge installations, P. intermedia and A.
      actinomycetemcomitans remained significantly elevated at implant sites. At six
      months after bridge installation, levels of P. intermedia, F. nucleatum and A.
      actinomycetemcomitans declined significantly relative to levels at three months.
      Porphyromonas sp. and spirochetes were not significantly elevated although their
      levels correlated with gingival redness. P. intermedia, Porphyromonas sp. and
      spirochetes levels correlated significantly with probing depth. Correlation was
      detected between P. gingivalis and spirochetes; and between A.
      actinomycetemcomitans and F. nucleatum. Our studies show a transitional increase
      in levels of several organisms resembling putative pathogens of human peri
      implant infection, associated with implant placements in partially edentulous
      mouths and supports early prophylactic interventions to control their levels.

PMID- 7776159
TI  - Assessment of periodontal tissues damping characteristics: current concepts and
      clinical trials.
AB  - The reproducibility of an electronic device for the assessment of periodontal
      tissues damping characteristics was judged by evaluating the inter-examiner,
      inter-device and day to day variations of the measurements (PTVs). Nine young
      periodontally healthy volunteers were examined by two examiners (EX-1 and EX-2)
      and two devices (D-1 and D-2) in the following sequence: EX-1 D-1, EX-2 D-1, EX-1
      D-2, and EX-2 D-2. PTVs were obtained at 5 different occasions during the same
      day. In some instances examiner 2 measured higher scores than examiner 1 with
      both devices. This difference was statistically significant (P = 0.05), if the
      total of 900 measurements was considered. The measurements of device 2 were
      approximately 0.5 PTV units higher, also reaching a statistical significance (P =
      0.05). This difference is of limited clinical significance. The day to day
      variation was evaluated by comparing the scores obtained at 8 a.m. with the ones
      at the four other periods. The lowest scores were measured at 8 a.m. Only the 11
      a.m. and the 2 p.m. measurements differed significantly. The effect of hormonal
      changes during the menstrual cycle and of smoking habits on PTVs were also
      evaluated. Ten female periodontally healthy volunteers were examined three times
      a week, during a period of two menstrual cycles. No significant PTV changes were
      found during the menstrual cycle. The effect of the smoking habit on PTVs was
      tested on 23 periodontally healthy patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7776160
TI  - An evaluation of laser Doppler readings obtained from human gingival sulci.
AB  - A small laser doppler probe with an outside diameter comparable to a conventional
      periodontal probe (0.5 mm) was developed. The objectives of this investigation
      were to determine if intrasulcular laser doppler readings (LDR): 1) are
      reproducible; 2) can detect vascular changes associated with trauma from probe
      placement; 3) were reproducible when obtained with a stabilizing stent or without
      a stent; and 4) could detect vascular changes following the injection of a local
      anesthetic with vasoconstrictor. Nine adult volunteers with clinically healthy
      gingiva were evaluated for 30 second intervals at 5 sites. Baseline LDR were
      obtained twice at each site utilizing an acrylic stent to stabilize the probe and
      once without the stent (trial 1). All LDR were repeated at one month (trial 2)
      and again two months (trial 3) after baseline. One additional reading per subject
      was obtained following the administration of a local anesthetic with a
      vasoconstrictor during the second trial. Inter-trial comparisons found no
      significant difference in mean LDR between any of the three observation times.
      However, intra-trial comparison between the first and second LDR revealed an
      increase of approximately 50% in mean LDR. A 3-fold reduction in mean LDR (P <
      0.001) was noted following the administration of a local anesthetic with
      vasoconstrictor. Intra-class correlation coefficients for stent stabilized LDR
      were 0.51 (P < 0.01) and 0.63 (P < 0.01) while intra-class correlation for hand
      held LDR was 0.40 (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7776161
TI  - The effects of smokeless tobacco on clinical parameters of inflammation and
      gingival crevicular fluid prostaglandin E2, interleukin-1 alpha, and interleukin
      1 beta.
AB  - The purpose of this study was to examine the effect of smokeless tobacco (ST) on
      gingival inflammation as assessed clinically and biochemically by gingival
      crevicular fluid (GCF) levels of PGE2, IL-1 alpha, and IL-1 beta. These
      parameters were compared in ST users (n = 12) and control, non-tobacco using
      subjects (n = 8) matched for plaque and probing depth levels. Both GI and GCF
      PGE2 concentration were significantly (P < 0.05) elevated at ST placement sites
      compared to sites in control subjects. A short-term longitudinal trial spanning 7
      days also was undertaken within ST users (n = 18) to study the dynamics of
      gingival inflammation when ST is moved to a new site. At day 0 habitual ST
      placement sites exhibited a significantly (P < 0.05) higher GI compared to non
      tobacco placement sites. Following transfer of ST to a new placement site, 48
      hour GI scores were increased (P < 0.05) at this region. Although GCF parameters
      were not significantly altered, over 80% of the subjects developed dramatic
      inflammatory reactions in the alveolar mucosa, ranging from erythema to
      ulceration, at the new site of placement. This observation of a more severe
      response in alveolar mucosa compared to gingiva may be related to the physical
      location of ST or differences in tissue characteristics.

PMID- 7776162
TI  - Histological location of a standardized periodontal probe in man.
AB  - The purpose of this study was to locate the position of the periodontal probe tip
      using a pressure of 126 N/cm2 (force of 0.30N using a round periodontal probe tip
      with a diameter of 0.55 mm). The influence of gingival inflammation on this
      position was also studied. Subjects with three levels of periodontal health and
      disease were entered into the study and each contributed one experimental tooth.
      At each site a standardized probing system was used to place a probe into a
      clinical pocket. The probe tip was luted to the test tooth surface. The tooth
      with its gingival tissue and probe tip was extracted, fixed, and processed for
      histological measurements. Distances in mm were obtained from the cemento-enamel
      junction (CEJ) to the probe tip, to the base of the crevice/pocket, and to the
      most coronal connective tissue attachment. Analysis of the data indicated that
      clinical inflammation was not a factor in the placement of the probe tip at
      crevice/pocket's landmarks relative to the CEJ; however variability of probing
      may have caused the non-significance. The probing system placed the probe tip
      0.66 mm apical to the base of the crevice/pocket and 0.06 mm coronal to the most
      coronal connective tissue attachment. These conclusions corroborated the results
      of the previous study in dogs which predicted probe placement of 0.44 mm apical
      to the base of the crevice using the standardized pressure of this probing
      system.

PMID- 7776163
TI  - Removal of interproximal subgingival plaque by hand and automatic toothbrushes.
AB  - Subgingival plaque removal at interproximal sites by automatic and hand
      toothbrushes was compared with control sites at which cleansing was not
      performed. There were 58 patients, 35 to 63 years of age, each with one hopeless
      tooth requiring extraction. Each patient was randomly assigned to one of four
      test groups: hand brush; automatic toothbrush 1; automatic toothbrush 2; and no
      brushing. The brushing instructions as stated by the manufacturers were
      demonstrated and the patient brushed the sextant containing the test tooth for 20
      seconds. The level of the gingival margin was marked at each interproximal test
      site. The teeth were extracted and processed for SEM, and subgingival plaque was
      viewed at X100 and X2000 magnifications. A montage of photomicrographs of the
      gingival groove to the occlusal margin of the bacterial plaque at X100
      magnification was made and the distance from the groove to the margin was
      measured. An ANOVA was performed using P = 0.05 level for significance. Due to
      processing difficulties, only 33 specimens were available for analysis. The
      average distances from the groove to the subgingival plaque front for the four
      test groups were 0.514, 0.132, 0.163, and 0.111 mm respectively. The maximum
      distance (1.5 mm) of plaque removal was greatest for the hand toothbrush. Due to
      the large standard deviation (0.636 compared to 0.146, 0.250, and 0.124
      respectively), the hand brushing group was excluded from ANOVA. There were no
      statistically significant differences among the automatic toothbrushes and the no
      brushing control (P = 0.8393). It was concluded that a single session of oral
      hygiene instruction with an automatic toothbrush did not result in subgingival
      interproximal plaque cleansing.

PMID- 7776165
TI  - Vascular changes following mucoperiosteal flap surgery: a fluorescein angiography
      study in dogs.
AB  - This study was undertaken to determine the vascular changes which occur following
      mucoperiosteal flap surgery where two different suturing techniques were
      employed. In four healthy adult mongrel dogs, buccal and lingual full-thickness
      envelope flaps were reflected in the mandibular quadrants following intravicular
      incisions from the first premolar to the first molar. The flaps were immediately
      readapted and primary closure was achieved by the horizontal mattress suturing
      technique in one quadrant and the direct interrupted suturing technique in the
      contralateral quadrant of each dog. A simple photographic system was developed
      for recording the in vivo gingival circulation depicted by fluorescein
      angiography just prior to surgery and then after surgery on days 1, 3, 7, 10, 14,
      and 21. The flaps were divided into three interproximal and two mid-buccal sites
      for analysis and the intracapillary and diffusion extent of dye fluorescence was
      accurately quantified by computerized planimetry. As healing progressed,
      longitudinal changes relative to presurgical baseline were analyzed by paired t
      test. Cross-sectional comparisons utilizing Student t-test allowed for evaluating
      differences between the two suturing techniques as well as differences between
      interproximal versus mid-buccal sites at each postsurgical day. It was found that
      the simple act of raising a mucoperiosteal envelope flap initiates significant
      vascular trauma. Statistically significant reductions in flap circulation
      relative to presurgical baseline lasted for at least 3 days but persisted for 7
      days at the interproximal sites. Flap diffusion (extravascular leakage) recovered
      sooner and extended over a significantly greater area of the flap than did
      intracapillary flap circulation during the early period of healing.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7776164
TI  - Use of the carbon dioxide laser in retarding epithelial migration: a pilot
      histological human study utilizing case reports.
AB  - Predictable regeneration of tooth-supporting tissues lost to periodontal disease
      is the aim of periodontal therapy. Often the result of conventional treatment is
      healing with a long junctional epithelium along the root surface and little
      regeneration of the complete attachment apparatus. The purpose of this pilot
      study was to evaluate whether de-epithelialization with a CO2 laser at the time
      of flap surgery and at 10-day intervals over the first 30 days of healing has the
      potential to enhance the formation of a connective tissue attachment. Six
      mandibular incisors in two patients were selected for the study. Each patient
      received oral hygiene instruction and initial therapy prior to surgery. The teeth
      were splinted together, open flap debridement was performed on all teeth, a notch
      was placed on the roots at the height of the crest of the alveolar bone, and the
      flaps were sutured in place. The test side received controlled de
      epithelialization of the outer (oral) gingiva with the carbon dioxide laser, and
      the inner gingival flap. The de-epithelialization was repeated on the test side
      at 10, 20, and 30 days postsurgically. Controls received open debridement only.
      Block sections were taken at 90 days and processed for histologic analysis. The
      results showed that for both patients, junctional epithelium (JE) was formed on
      both test and control teeth. In all control teeth, the JE extended the entire
      length of the root to the base of the reference notch.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7776166
TI  - Alendronate treatment of naturally-occurring periodontitis in beagle dogs.
AB  - The treatment of periodontal disease has been largely directed at the
      microbiological etiology. The prevention of bone loss by modulating the host
      response to the bacteria may be a useful adjunctive method in the management of
      periodontitis. Alendronate, an amino bisphosphonate, may inhibit bone loss in
      osteolytic diseases by altering osteoclast activity. The objective of this double
      blind study was to evaluate alendronate inhibition of alveolar bone loss in the
      naturally occurring beagle dog model of periodontitis. Sixteen 7 to 9 year old
      beagles with moderate-to-severe periodontitis were studied for 6 months. The dogs
      were stratified into two groups based on initial periodontal severity. One group
      received 3.0 mg/kg alendronate weekly orally and the other group received a
      placebo. Silk ligatures were placed on the study teeth for the first 3 months of
      the study to exacerbate the periodontal destruction. Clinical data were collected
      for attachment level, gingival index, plaque index, and mobility at baseline and
      one-month intervals. Intraoral radiographs were made at baseline and at 3 and 6
      months. The mandibles were processed for histology at month 6. The radiographs
      were analyzed by digital image analysis of the subtracted images. A statistically
      significant difference in bone mass (P < 0.001) was observed between the
      alendronate and placebo groups. The bisphosphonate had no effect on the clinical
      parameters of gingival inflammation or plaque. A trend toward decreased
      attachment loss and mobility was observed in favor of the alendronate
      group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7776167
TI  - The effectiveness of a disposable tooth cleansing device on plaque.
AB  - A disposable polyester foam sponge on a stick, impregnated with a non-foaming
      dentifrice, has been widely dispensed to hospitalized and nursing home patients
      for intraoral cleansing and refreshing. Since no information was found relative
      to tooth cleansing capabilities, we have evaluated its effectiveness in the
      removal of accumulated plaque and also in prevention of plaque accumulation.
      Removal of 72 hours of accumulated plaque was assessed in a cross-over design
      study comparing the device with a commercially-available toothbrush by two
      different groups of 13 and 29 adult, healthy subjects who used each instrument
      for 1 and 3 minutes respectively. No significant differences were found between
      mean scores assessed by Turesky's modification of the Quigley-Hein plaque index
      by either group using either instrument at either time period (P > 0.05).
      Prevention of plaque accumulation was assessed in a third group of 25 subjects
      who used each instrument an average of 3 times a day for 1 week in a cross-over
      study. While the toothbrush was found significantly more effective in retarding
      the accumulation of plaque from a plaque-free baseline on both facial and lingual
      surfaces (P < 0.02), the tooth cleansing device still retained plaque-preventive
      capabilities by maintaining plaque formation below 2 mm at the cervical margin of
      the tooth. Results of this study indicate the tooth cleansing device may be a
      viable alternative to conventional toothbrushes.

PMID- 7776168
TI  - Prostaglandin E2 regulates gingival mononuclear cell immunoglobulin production.
AB  - Histological studies have revealed elevated levels of T and B lymphocytes in
      inflamed gingival tissue. Functional analysis of these B cells has determined
      that they are spontaneously secreting large amounts of immunoglobulin. Several
      components of bacterial plaque which accumulate during the onset of periodontal
      disease induce polyclonal B cell activation, and are most likely responsible for
      the "hyperactive" state of these gingival B lymphocytes. In addition to this
      exaggerated humoral response, increased levels of inflammatory mediators, such as
      prostaglandin (PG) E2, have been implicated in the pathogenesis of disease.
      Therefore, the purpose of this study was to determine if PGE2 could regulate
      immunoglobulin production within inflamed gingival tissue. Specimens were
      harvested during routine surgery of patients with chronic adult periodontitis.
      Utilizing an ELISA, elevated levels of IgG were detected in the supernatant of
      cultured gingival mononuclear cells. Inclusion of indomethacin, which inhibits
      arachidonic acid metabolites such as PGE2, caused a decrease in IgG levels. PGE2
      exerted a biphasic effect upon IgG production, with high doses diminishing and
      low doses increasing IgG levels. From a clinical perspective, these results
      suggest that elevated levels of PGE2 associated with inflammation will attenuate
      an IgG response and, as PGE2 production wanes, the local humoral response will
      rebound. Interestingly, the combination of low dose PGE2 and IL-4 induced a
      synergistic rise in IgG production. These findings support the theory that local
      PGE2 levels can regulate immunoglobulin production and potentiate cytokine
      induced class switching within gingival tissue.

PMID- 7776169
TI  - The effects of scaling procedures on epithelial cell growth on titanium surfaces.
AB  - This study examined in vitro epithelial cell growth on titanium surfaces which
      had been instrumented by 3 types of periodontal curets. Commercially pure
      titanium discs were uniformly scaled using plastic, stainless steel, or gold
      coated curets and then seeded with a microdot (50,000 cells per 10 microliters)
      of rat gingival epithelial cells. After 5 days of growth, epithelial cell surface
      area (mm2) coverage was measured on photographed specimens using a computer
      digitizing system. Scanning electron microscopic evaluation showed a denser
      central core of cellular growth on the stainless steel-treated surfaces as
      compared to the other surface treatments. Epithelial surface area coverage on the
      stainless steel, plastic, and control groups did not vary significantly among
      groups. However the gold-coated curet exposed surfaces supported significantly
      less epithelial growth than the stainless steel and control surfaces. A better
      understanding of in vitro epithelial cell responses to different titanium surface
      characteristics will assist in designing implant scaling procedures which allow
      maintenance of the implant perimucosal seal.

PMID- 7776170
TI  - Short-term effects of phase I therapy on crevicular cell populations.
AB  - The purpose of the present study was to use a novel intracrevicular lavage
      technique to evaluate short-term effects of phase I therapy on crevicular cell
      populations. Nineteen patients with untreated advanced adult periodontitis were
      selected for phase I therapy. One side of the dentition was treated with
      ultrasonic curets (U), the other side with manual curets (M). Nine months before
      (-9), immediately prior to (0), and 1 month after treatment (+1) gingival index
      (GI), plaque index (PI), bleeding index (BI), bleeding on probing (BOP), probing
      depth (PD), and probing attachment levels (PAL) were measured at all sites in the
      dentition. Crevicular lavages were obtained from 3 to 4 selected sites per
      patient at the same time points. Crevicular leukocytes were vital stained with
      ethydium bromide-fluorescein-diacetate (EB-FDA). The total number of cells and
      the percentage of vital cells (%) were calculated for each sample. Clinical and
      lavage parameters obtained from the selected sites were compared between U and M
      sites, and between pre- and post-treatment values. The results showed that
      without treatment PAL remained at the same level at both pretreatment time points
      -9 and -0 (control). At 1 month after treatment there were statistically
      significant reductions in GI, PI, BOP, and PD (P < 0.001 for each comparison),
      and a statistically significant gain in PAL from 4.9 to 4.1 mm (P = 0.014). The
      total number of leukocytes per sample was similar at both pretreatment time
      points, but numerically reduced at 1 month after treatment. The percent of vital
      leukocytes was above 74% at both pretreatment time points (control). After
      treatment these values were below 70%. This reduction was statistically
      significant (P < 0.002). These results suggest that periodontal phase I therapy
      leads to shifts in crevicular cell populations.

PMID- 7776171
TI  - Factitious injury of the oral mucosa: a case series.
AB  - Gingival and oral mucosal tissues can be the site of a number of mucocutaneous
      and ulcerative conditions. Generally, these are not difficult to identify on the
      basis of clinical characteristics, and diagnosis can be aided by the use of
      routine histopathological and immunopathological techniques as well as other
      laboratory investigations. Self-induced or factitious injury (FI) of the oral
      mucosal tissues may present a confusing clinical picture, and be diagnosed
      erroneously as a mucocutaneous disorder in spite of the absence of appropriate
      pathological and immunopathological findings, or a failure to respond to routine
      treatment. A case series is presented here outlining 4 cases of FI which
      presented initially as mucocutaneous disease. These cases were investigated to
      rule out systemic or local causes, in order to establish a diagnosis of FI.
      Treatment of these conditions was facilitated with placebo or sham procedures
      which were designed primarily to cover the lesions. In most cases, the self
      injurious behavior could be linked to secondary gain.

PMID- 7776172
TI  - Re: A 6-month multi-center evaluation of adjunctive tetracycline fiber therapy
      used in conjunction with scaling and root planing in maintenance patients (J
      Periodontal 1993;64:685-691)

PMID- 7776173
TI  - A review of the evidence supporting melatonin's role as an antioxidant.
AB  - This survey summarizes the findings, accumulated within the last 2 years,
      concerning melatonin's role in defending against toxic free radicals. Free
      radicals are chemical constituents that have an unpaired electron in their outer
      orbital and, because of this feature, are highly reactive. Inspired oxygen, which
      sustains life, also is harmful because up to 5% of the oxygen (O2) taken in is
      converted to oxygen-free radicals. The addition of a single electron to O2
      produces the superoxide anion radical (O2-.); O2-. is catalytic-reduced by
      superoxide dismutase, to hydrogen peroxide (H2O2). Although H2O2 is not itself a
      free radical, it can be toxic at high concentrations and, more importantly, it
      can be reduced to the hydroxyl radical (.OH). The .OH is the most toxic of the
      oxygen-based radicals and it wreaks havoc within cells, particularly with
      macromolecules. In recent in vitro studies, melatonin was shown to be a very
      efficient neutralizer of the .OH; indeed, in the system used to test its free
      radical scavenging ability it was found to be significantly more effective than
      the well known antioxidant, glutathione (GSH), in doing so. Likewise, melatonin
      has been shown to stimulate glutathione peroxidase (GSH-Px) activity in neural
      tissue; GSH-PX metabolizes reduced glutathione to its oxidized form and in doing
      so it converts H2O2 to H2O, thereby reducing generation of the .OH by eliminating
      its precursor. More recent studies have shown that melatonin is also a more
      efficient scavenger of the peroxyl radical than is vitamin E. The peroxyl radical
      is generated during lipid peroxidation and propagates the chain reaction that
      leads to massive lipid destruction in cell membranes. In vivo studies have
      demonstrated that melatonin is remarkably potent in protecting against free
      radical damage induced by a variety of means. Thus, DNA damage resulting from
      either the exposure of animals to the chemical carcinogen safrole or to ionizing
      radiation is markedly reduced when melatonin is co-administered. Likewise, the
      induction of cataracts, generally accepted as being a consequence of free radical
      attack on lenticular macromolecules, in newborn rats injected with a GSH
      depleting drug are prevented when the animals are given daily melatonin
      injections. Also, paraquat-induced lipid peroxidation in the lungs of rats is
      overcome when they also receive melatonin during the exposure period. Paraquat is
      a highly toxic herbicide that inflicts at least part of its damage by generating
      free radicals.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7776174
TI  - Age-related differences in the structure of human pineal calcium deposits:
      results of transmission electron microscopy and mineralographic microanalysis.
AB  - Pineal tissue calcifications (male, ages 14, 47, 62, 82), which were
      metallographically embedded and polished at controlled levels and studied by
      transmission electron microscopy and microanalytic spectroscopy, showed age
      related differences. Results show that concentrically arranged crescent-shaped
      lamellae increase in number and decrease in width with age. Calcium (Ca) and
      phosphorus (P) per point measurements in dark and light lamellae at various
      distances from the core show Ca/P molar ratios between 1.49-1.62 in the 82-year
      old specimen as compared to 1.26 to 1.41 in the younger specimens. The 62-year
      old specimens show a decrease in P and an increase in Ca from periphery to
      center. These data and other descriptive details suggest that the sum of these
      changes represent remodelling of the mineralogical structure within the same
      calcification throughout the life span.

PMID- 7776175
TI  - Effects of a one-hour light pulse on the timing of the circadian rhythm in
      melatonin secretion in rams.
AB  - The effects of a 1-hr light pulse on the timing of the circadian rhythm in the
      blood plasma concentration of melatonin were documented in Soay rams. Groups of 5
      to 6 animals were transferred from short days (LD 8:16) to constant dim red light
      (DD) for 6 days, and were exposed to a 1-hr light pulse at one of 16 different
      times throughout 24 hr on day 3. Blood samples were collected hourly for 30 hr
      before (day 2-3) and after the light pulse (day 5-6), and the plasma
      concentrations of melatonin were measured by radioimmunoassay. The animals were
      allocated to experimental groups based on the circadian time (CT) when the light
      pulse was given using two hourly blocks through the circadian day; the onset of
      enhanced melatonin secretion (melatonin peak) was designated as CT 12. Under DD
      there was a clearly defined plasma melatonin rhythm in all animals. The mean
      duration of the melatonin peak was 13.24 +/- 0.16 hr (n = 91) and the mean period
      between the onset of successive melatonin peaks was 23.55 +/- 0.10 hr (n = 21).
      The effect of the 1-hr light pulse on the time of onset of the melatonin peak
      varied significantly with the circadian time when the light pulse was given
      (ANOVA, P = 0.031).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7776176
TI  - Melatonin in edible plants identified by radioimmunoassay and by high performance
      liquid chromatography-mass spectrometry.
AB  - Melatonin, the chief hormone of the pineal gland in vertebrates, is widely
      distributed in the animal kingdom. Among many functions, melatonin synchronizes
      circadian and circannual rhythms, stimulates immune function, may increase life
      span, inhibits growth of cancer cells in vitro and cancer progression and
      promotion in vivo, and was recently shown to be a potent hydroxyl radical
      scavenger and antioxidant. Hydroxyl radicals are highly toxic by-products of
      oxygen metabolism that damage cellular DNA and other macromolecules. Herein we
      report that melatonin, in varying concentrations, is also found in a variety of
      plants. Melatonin concentrations, measured in nine different plants by
      radioimmunoassay, ranged from 0 to 862 pg melatonin/mg protein. The presence of
      melatonin was verified by gas chromatography/mass spectrometry. Our findings
      suggest that the consumption of plant materials that contain high levels of
      melatonin could alter blood melatonin levels of the indole as well as provide
      protection of macromolecules against oxidative damage.

PMID- 7776177
TI  - The pineal gland of the aging rat: calcium localization and variation in the
      number of pinealocytes.
AB  - In the present study, we investigated the population of pinealocytes in the
      pineal gland of aging rats. Dark and light pinealocytes were analyzed as to their
      calcium content. Calcium localization was realized in dark and light cells by
      means of cytochemistry and X-ray microanalysis. Calcium was mainly localized in
      dark pinealocytes characterized by many ultrastructural signs of degeneration.
      The number of pinealocytes per square surface of aged rats (28 months) was
      compared to young ones (3-4 months). While there is a significant increase in the
      number of dark pinealocytes there is a decrease in the total number of
      pinealocytes in aged rats. This age-related loss of pinealocytes may explain the
      age-related functional decline of the pineal gland activity (e.g., the decrease
      of the nocturnal melatonin production).

PMID- 7776178
TI  - Circadian and ultradian variations of pituitary and pineal hormones in normal
      men: evidence for a link between melatonin, gonadotropin, and prolactin
      secretion.
AB  - The study was performed to investigate the physiological relationship between the
      pineal hormone melatonin and pituitary functions in normal men. Series of blood
      samples were obtained at 10-min intervals for 24-hr periods from 10 male
      volunteers (age 19-25 years). Samplings were repeated after 2 weeks and 3 months.
      Serum levels of melatonin, follicle-stimulating hormone (FSH), luteinizing
      hormone (LH), prolactin (PRL), and testosterone (T) were estimated by immunoassay
      methods (LH, PRL, every sample; melatonin, every 30 min; T, every 4 hrs; FSH once
      for each session). Diurnal characteristics of PRL and melatonin profiles were
      estimated by complex cosinor analysis, while short-term pulsatility of LH and PRL
      secretion was analyzed by the PULSAR algorithm. Data were correlated by linear
      regression analysis. The combined information of all three sampling sessions
      revealed significant negative correlations between the following parameters (N =
      10): Amplitude (Ampl) melatonin and Ampl PRL: r = -0.727, P < 0.02; Ampl
      melatonin and maximal (Max) PRL values: r = -0.73, P < 0.02; Max melatonin and
      Max PRL: r = -0.725, P < 0.02; area under the curve (AUC) melatonin and Ampl PRL:
      r = -0.637, P < 0.05; AUC melatonin and Max PRL: r = -0.640; P < 0.05; duration
      (Dur) of melatonin synthesis and Ampl PRL: r = -0.685, P < 0.03; Dur melatonin
      and Max PRL: r = -0.676, P < 0.04; Dur melatonin and FSH levels: r = -0.663, P <
      0.04; AUC melatonin and LH mean concentration: r = -0.732, P < 0.02; Max
      melatonin and LH mean concentration: r = -0.657, P < 0.04.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7776179
TI  - The enzymatic basis for the rat liver 6-hydroxymelatonin sulfotransferase
      activity.
AB  - Understanding 6-hydroxymelatonin (6HM) sulfation is deemed important to
      explaining normal and oncostatic actions of the pineal gland. Here we identify
      the enzymatic basis for this sulfation in rats. First, a quantitative assay was
      designed for measuring hepatic 6HM sulfotransferase (6HMST) activity. The assay
      was then used to identify a male dominant sexual dimorphism wherein liver from
      males contains double the 6HMST per g or per 100 g body weight seen in females.
      Examination of other rat tissues showed that most in vivo 6HM sulfation was
      likely to occur in liver. In addition, DEAE-Sephadex chromatography of liver
      cytosol indicated that 80-90% of the 6HMST activity in both sexes was due to an
      enzyme we named 6HMST II. A minor 6HM sulfotransferase (6HMST I) eluted from the
      columns prior to the main enzyme. 6HMST II, purified additionally, was shown to
      convert 6HM to a product that appeared to be 6HM sulfate (6-sulfa-toxymelatonin).
      The enzyme was inhibited by Na+, K+, Zn2+, and Cd2+. Its pH optimum was 7.80 +/-
      0.30. Comparisons are made between 6HMST II, dopamine sulfotransferase II, and
      aryl sulfotransferase IV.

PMID- 7776181
TI  - Attractiveness of the underling: an automatic power --> sex association and its
      consequences for sexual harassment and aggression.
AB  - One characteristic of men who sexually harass is that they are not aware that
      their actions are inappropriate or a misuse of their power (L. F. Fitzgerald,
      1993a). We investigated the existence and automaticity of a mental association
      between the concepts of power and sex, and its consequences for sexual harassment
      tendencies. Using a subliminal priming paradigm, Experiment 1 demonstrated an
      automatic link between power and sex, and only for men high in the likelihood to
      sexually harass or aggress. In Experiment 2, male participants were unobtrusively
      primed with either power-related or neutral stimuli. For men likely to sexually
      aggress, but not other participants, attraction ratings of a female confederate
      were significantly higher in the power priming than the neutral priming
      condition.

PMID- 7776180
TI  - When combining intrinsic motivations undermines interest: a test of activity
      engagement theory.
AB  - Three studies with elementary school children demonstrated that combining reading
      with coloring pictures can undermine children's later interest in reading, while
      also reducing their interest in coloring. Undermining is maximized when an
      activity is identified as secondary during the initial engagement, but other
      conditions must also be met as specified by activity engagement theory (Higgins &
      Trope, 1990): (a) the multiple input activities must be separately identified and
      considered simultaneously as alternatives, (b) the activity identified as primary
      during initial engagement must not be perceived as very attractive, and (c) the
      responses connected to an identified activity during the initial engagement must
      be activated subsequently. Conditions for enhancing interest in an activity are
      also considered.

PMID- 7776182
TI  - Fanning old flames: emotional and cognitive effects of suppressing thoughts of a
      past relationship.
AB  - Cognitive and electrodermal effects of suppressing thoughts of an old flame were
      examined in 2 experiments. Participants were asked to think aloud about an old
      flame--a past close relationship that either was or was not still desired--as
      their skin conductance level (SCL) was measured. Participants continued to think
      aloud as they were instructed either not to think about their old flame or to
      perform a comparison task. Participants were then asked to think about the old
      flame again. Participants who had suppressed thoughts of a no-longer-desired
      relationship were inclined to think aloud more about it afterward whereas those
      who suppressed thoughts of a still-desired relationship did not show such a
      rebound but evidenced increased SCL.

PMID- 7776183
TI  - Empathic accuracy in a clinically relevant setting.
AB  - This study addressed 3 questions regarding empathic accuracy in a clinically
      relevant setting. First, does the empathic accuracy of a perceiver improve with
      increased exposure to a target individual? Second, can empathic accuracy be
      enhanced by providing the perceiver with feedback about the target's actual
      thoughts and feelings? Third, are there stable individual differences in empathic
      accuracy that generalize across different targets? The results indicated that
      although absolute performance levels varied from 1 target to another, empathic
      accuracy generally improved with increased exposure to the target. In addition,
      feedback concerning the target's actual thoughts and feelings accelerated the
      rate at which the perceivers' empathic accuracy improved. Finally, cross-target
      consistency in responding (alpha = .86) revealed stable individual differences in
      the perceivers' empathic ability. Implications of these findings for clinical
      training and practice are discussed.

PMID- 7776185
TI  - Rigor, but not rigor mortis, in depression research.
AB  - With reference to the depression research methods review of H. Tennen, J.A. Hall,
      and G. Affleck (1995) and the earlier recommendations of P. C. Kendall, S. D.
      Hollon, A. T. Beck, C. L. Hammen, and R. E. Ingram (1987), the present discussion
      considers and then reaffirms selected methods. Discussion includes issues such as
      the use of analogue vs. clinical samples, single vs. multiple assessments, self
      report vs. structured diagnostic interviews, and the use of multiple gaiting and
      analyses of symptom clusters.

PMID- 7776184
TI  - Depression research methodologies in the Journal of Personality and Social
      Psychology: a review and critique.
AB  - Personality and social psychological studies of depression and depressive
      phenomena have become more methodologically sophisticated in recent years. In
      response to earlier problems in this literature, investigators have formulated
      sound suggestions for research designs. Studies of depression published in the
      Journal of Personality and Social Psychology (JPSP) between 1988 and 1993 were
      reviewed to evaluate how well these recommendations have been followed. Forty-one
      articles were examined for adherence to 3 suggestions appearing consistently in
      the literature: (a) multiple assessment periods, (b) multiple assessment methods,
      and (c) appropriate comparison groups. The studies published in JPSP have not
      adhered well to these standards. The authors recommend resetting minimum
      methodological criteria for studies of depression published in the premier
      journal in personality and social psychology.

PMID- 7776186
TI  - Activity and mood temperament as predictors of adolescent substance use: test of
      a self-regulation mediational model.
AB  - The authors tested a mediational model of temperament dimensions and substance
      use with a sample of 1,826 urban adolescents, M age 12.3 years. Five scales from
      the Revised Dimensions of Temperament Survey (DOTS-R) were administered together
      with measures of substance (tobacco, alcohol, marijuana) use and measures of
      related variables derived from a self-regulation model. Unique contributions to
      substance use were found for DOTS-R dimensions of high activity level (positively
      related) and positive mood (inversely related). High activity level and low
      positive mood were also related to lower levels of parental support. Analyses,
      including multiple regression and structural modeling, identified generalized
      self-control, maladaptive coping (anger and helplessness), novelty seeking, and
      affiliation with peer substance users as mediating the effect of temperament on
      substance use, with control for effects of parental support. Parental support was
      inversely related to substance use through several pathways. Implications for the
      theory of vulnerability are discussed.

PMID- 7776187
TI  - Attachment styles and repressive defensiveness: the accessibility and
      architecture of affective memories.
AB  - One hundred and twenty Israeli students were classified into secure, avoidant,
      and anxious-ambivalent attachment groups. They completed scales that tap the
      construct of repressive defensiveness and recalled early personal experiences of
      anger, anxiety, sadness, and happiness. Secure people reported moderate
      defensiveness and low anxiety and had easy access to negative memories without
      being overwhelmed by the spreading of the dominant emotional tone to nondominant
      emotions. Anxious-ambivalent people were unable to repress negative affects,
      reported high anxiety, had easy access to negative memories, and could not
      inhibit emotional spreading. Avoidant people reported high levels of
      defensiveness and anxiety and showed low accessibility to negative memories. The
      discussion emphasizes the parallel between a person's interaction with the social
      world and the makeup of his or her inner world.

PMID- 7776188
TI  - Resources, personal strivings, and subjective well-being: a nomothetic and
      idiographic approach.
AB  - The covariation of resources such as money, family support, social skills, and
      intelligence with subjective well-being (SWB) was assessed in 195 college
      students. Informant ratings provided an index of resources. Self-reports, daily
      experience sampling, and informant reports were used to measure SWB. The authors
      concluded that resources taken together are moderately strong predictors of SWB.
      This conclusion, however, was qualified by the fact that life satisfaction was
      more closely related to resources than was affective well-being and that social
      and personal resources were in general more strongly related to SWB than were
      material resources. The findings also supported the hypothesis that resources
      correlate more strongly with SWB when they are relevant to an individual's
      idiographic personal strivings. A tendency was found for people to choose
      personal strivings for which they have relevant resources, and the degree of
      congruence of individuals' goals with resources was predictive of SWB.

PMID- 7776189
TI  - Idiosyncratic trait definitions: implications for self-description and social
      judgment.
AB  - Descriptions of self (e.g., "I am dominant") may reflect not only a person's
      behavioral tendencies but also idiosyncratic definitions of the social concepts
      and categories being considered. Five studies revealed that participants who
      differed in their self-ratings along trait dimensions also tended to associate
      different behaviors and performances with those traits. For example, participants
      who described themselves as dominant tended to emphasize desirable over
      undesirable behaviors and characteristics in their definitions of the trait,
      whereas self-described nondominants highlighted the opposite. Participants' self
      ratings on dominance were also influenced by making positive or negative examples
      of dominant behavior salient to them. Moreover, when participants were induced to
      shift self-descriptions in self-serving ways, they tended to do so by revising
      their prototype of the trait in question. Discussion centers on the implications
      of these findings for the prediction of behavior and the interpretation of some
      social science results.

PMID- 7776190
TI  - Emotional conflict and well-being: relation to perceived availability, daily
      utilization, and observer reports of social support.
AB  - The link between emotional conflict and the perceived availability and use of
      social support was examined. One hundred and five undergraduate students
      completed measures of ambivalence over expressing emotion, repressive
      defensiveness, fear of intimacy, social support, and well-being. Self-reports,
      observer reports, and daily reports of social support during the previous month
      were collected. Both ambivalence and fear of intimacy were negatively related to
      self-report and daily measures of social support and to well-being. Repressive
      defensiveness was unrelated to the social support measures. Perceived social
      support mediated the relation between emotional conflict and well-being. Results
      suggest the presence of a negative bias toward the use of social resources by
      conflicted individuals.

PMID- 7776191
TI  - [Fatty acid metabolism in patients with idiopathic dilated cardiomyopathy:
      characteristics and prognostic implications].
AB  - The characteristics of myocardial fatty acid metabolism in patients with
      idiopathic dilated cardiomyopathy (DCM) were investigated by myocardial imaging
      with beta-methyl-p-[123I]iodophenyl-pentadecanoic acid (BMIPP) in 16 patients
      with DCM, 8 patients with hypertensive heart failure (HHF), and 11 normal
      subjects. Rest myocardial imaging with BMIPP and 201Tl was performed on another
      day. The index of myocardial BMIPP uptake, or uptake ratio, was calculated from
      the percentage uptakes of BMIPP and 201Tl. The index of inhomogeneity of
      intramyocardial isotope distribution was calculated as the coefficient of
      variation of BMIPP and 201Tl. The uptake ratio was significantly lower in DCM and
      HHF patients than in normal subjects (p < 0.01). Uptake ratio correlated well
      with fractional shortening (r = 0.76, p < 0.01), and left ventricular ejection
      fraction (r = 0.58, p < 0.01). Although uptake ratio was not different between
      DCM and HHF patients, defects in BMIPP imaging appeared more frequently in DCM
      (69%) than in HHF (38%) patients. Furthermore, the extent of the defect in BMIPP
      imaging in DCM patients was larger than that in 201Tl imaging (p < 0.05), but in
      HHF patients the extent of the defects in both methods was similar. The
      coefficient of variation of BMIPP in DCM patients was greater than those in HHF
      patients and in normal subjects, but those of 201Tl were not different between
      the three groups. The coefficient of variation of BMIPP in DCM patients
      correlated well with serum norepinephrine level (r = 0.57, p < 0.01) and atrial
      natriuretic peptide (r = 0.77, p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7776192
TI  - [Change in the treatment procedures for mitral valve disease].
AB  - This study investigated the changes in treatment procedures for mitral stenosis
      (MS) and mitral regurgitation (MR) against the background of a decrease in the
      incidence of rheumatic valvular disease. The study included 3,955 patients with
      MS undergoing closed mitral commissurotomy (CMC), open mitral commissurotomy
      (OMC), mitral valve replacement (MVR), or percutaneous transvenous mitral
      commissurotomy (PTMC) between 1952 and 1991, and 478 patients with MR undergoing
      MVR or mitral valvuloplasty in the Heart Institute of Japan, Tokyo Women's
      Medical College. The number of patients with MS undergoing surgical or catheter
      interventions has decreased and is now about 80 per year, a half of that
      experienced in the 1960s. CMC and OMC have been replaced by PTMC since the 1990s.
      The most popular treatment procedure is now MVR. The number of patients with MR
      undergoing surgery has increased to about 30 per year. Eighty percent of
      operations for MR are MVR and the others are mitral valvoplasty. Survey of the
      etiology of MR shows decreased rheumatic disease and increased degenerative
      disease. The incidence of MR due to ischemic heart disease and hypertrophic
      obstructive cardiomyopathy has slightly increased.

PMID- 7776193
TI  - [Mitral valve repair for infectious endocarditis].
AB  - Fourteen patients with mitral regurgitation resulting from infectious
      endocarditis underwent mitral valve repair between December 1988 and July 1994.
      There were nine males and five females aged from 14 to 70 years (mean 40.2 +/-
      19.7 years). Three patients had active endocarditis. Time between the onset of
      endocarditis symptoms and surgery ranged from 1 to 24 months (mean 8.3 months).
      Bacterial findings were Streptococcus in eight patients, Staphylococcus in one,
      and unknown in five. All macroscopically infected tissue was excised in patients
      with active endocarditis. Carpentier's reconstructive techniques were mainly
      used. There were no hospital deaths. Mean follow-up was 29 months and complete.
      Thirteen patients were in New York Heart Association functional class I and one
      in class II. There were no late deaths, reoperations, recurrent endocarditis,
      thromboembolic events, or other valve-related morbidity. We conclude that mitral
      valve repair is an attractive procedure in patients with mitral regurgitation
      resulting from infectious endocarditis.

PMID- 7776195
TI  - [The influence of electrical time interval indices and aging on the left atrial
      systolic time intervals].
AB  - The influence of aging and heart rate on left ventricular systolic time intervals
      is well known, but the effects on left atrial systolic time intervals, a new
      index of left atrial function, remain unknown. The influence of aging and heart
      rate on left atrial systolic time intervals was investigated in 43 normal
      subjects (13-72 years of age) by Doppler echocardiography. Atrial pre-ejection
      period, atrial ejection time, and corrected atrial pre-ejection period were
      obtained by transmitral Doppler echocardiography. Simple regression analysis
      showed atrial pre-ejection period significantly correlated with P wave duration
      (PP; r = 0.78), and PR interval (PR; r = 0.60), but not with RR interval (RR).
      However, multiple regression analysis showed atrial pre-ejection period
      significantly correlated only with PP. Simple regression analysis found atrial
      ejection time significantly correlated with PP (r = 0.38), and PR (r = 0.39), but
      not with RR. However, multiple regression analysis found atrial ejection time did
      not correlate with any factor significantly. Aging was significantly correlated
      with corrected atrial pre-ejection period (r = -0.37), but not with corrected
      atrial ejection time and atrial pre-ejection period. Atrial ejection time
      significantly correlated with corrected atrial pre-ejection period (r = -0.37),
      but not with atrial pre-ejection period. Corrected atrial pre-ejection period is
      a clinically useful index of left atrial systolic function.

PMID- 7776194
TI  - [Clinical evaluation of 123I-metaiodobenzylguanidine myocardial scintigram in
      patients with valvular heart disease].
AB  - Myocardial sympathetic nerve function can be evaluated by 123I
      metaiodobenzylguanidine (MIBG) scintigraphy. Congestive heart failure is closely
      related to myocardial sympathetic nerve function. This study evaluated the
      severity of congestive heart failure in 30 patients with valvular heart disease
      [aortic regurgitation (AR): n = 20, mean age = 70 +/- 13 years; mitral
      regurgitation (MR): n = 10, mean age = 61 +/- 18 years], who had chronic heart
      failure by MIBG myocardial scintigraphy. Single photon emission computed
      tomography (SPECT) and anterior planar myocardial images were obtained 15 minutes
      (initial images) and 4 hours (delayed images) after injection of MIBG (111MBq).
      Defect score was determined by the delayed SPECT images visually as a semi
      quantitative index. Myocardial MIBG uptake was quantified by the heart to upper
      mediastinum uptake ratio on the delayed anterior planar images (H/M) and mean
      cardiac MIBG washout rate during 4 hours was calculated from the bull's eye
      display data (clearance). These indices were compared with the NYHA class and
      echocardiographic findings of the patients. MIBG regional defect in the delayed
      image was most frequently seen in the inferoposterior wall, and defect score and
      clearance were significantly higher and the H/M ratio was significantly lower in
      NYHA class III patients than in class II patients. In patients with AR, clearance
      significantly correlated with left ventricular end-systolic dimension. In
      patients with MR, both the H/M ratio and clearance significantly correlated with
      left atrial dimension. Defect score, H/M, and clearance were closely related to
      the severity of AR and MR. These results indicate that MIBG scan can be used to
      assess the severity of valvular heart disease.

PMID- 7776196
TI  - [Right-sided infectious endocarditis due to methicillin-resistant Staphylococcus
      aureus resulting in ruptured abscess of the ventricular septum and sinus of
      Valsalva].
AB  - A 24-year-old woman presented with right-sided infectious endocarditis due to
      methicillin-resistant Staphylococcus aureus (MRSA). This is the first report of
      right-sided infectious endocarditis caused by MRSA in Japan. The patient was
      admitted to the Jichi Medical School Hospital because of fever of unknown origin
      and disturbance of consciousness. Several months before, she had discontinued
      treatment for hyperthyroidism. Antibiotics effective against MRSA, vancomycin and
      flomoxef, were given intravenously, but a new heart murmur was detected.
      Echocardiographic study revealed vegetations attached to the tricuspid valve and
      abscess formation on the ventricular septum. The vancomycin dosage was increased
      and arbekacin sulfate was also given from the sixth hospital day. However, these
      antibiotics had very little effect and the abscess rapidly increased in size.
      Color flow mapping finally demonstrated intracardiac shunt flow through the
      ruptured abscess of the ventricular septum and sinus of Valsalva. She died
      suddenly, probably from heart failure. The prognosis of infectious endocarditis
      due to MRSA is poor and drug therapy often fails. Thus, surgery should be
      considered in the early stage.

PMID- 7776197
TI  - [Instrumental problems with the apex cardiogram].

PMID- 7776198
TI  - Acronyms of clinical trials in cardiology--1995.

PMID- 7776200
TI  - "I did so!" But can you prove it? Avoiding claims through documentation.
AB  - The author explains the need to document medical records to provide protection in
      litigation and to enhance medical care. Practical tips to make documentation
      easier and more efficient are given.

PMID- 7776199
TI  - Podiatric malpractice litigation. What to do and what to expect.
AB  - Many podiatric physicians will never be sued during their careers, but if a suit
      happens, it can be one of the most stressful times in their lives. After
      contacting the insurance carrier, the podiatric physician must then wait as the
      case develops through the legal system. The deposition is when the podiatric
      physician will be asked questions about the case. It is important to remember to
      carefully answer the questions asked. Once in the trial stage, the appearance and
      testimony of the podiatric physician will be important in the jury's eyes. If a
      decision is not in your favor, you may be able to appeal the case to a higher
      court. Some cases may not go to trial as they could be settled or arbitrated
      along the way. By listening to your attorney and following the attorney's advice
      and recommendations, the legal process will be easier to manage and understand.

PMID- 7776201
TI  - Informed consent. Legal requirements for surgical procedures.

PMID- 7776202
TI  - Tips for testifying.
AB  - The author offers practical suggestions for the witness to help improve
      effectiveness without compromising truthfulness when testifying in depositions
      and trial. The guidelines are designed to reduce the podiatrist's apprehension
      when venturing into the legal arena and to serve as resource material.

PMID- 7776203
TI  - Problems with procedures.
AB  - The author evaluated over 2,000 nationwide claims in 14 years of podiatric
      malpractice suits. Surgical results are reviewed along with primary areas that
      generate claims. Suggestions are given on the impending claims and
      recommendations for abatement.

PMID- 7776204
TI  - Performing a workers' compensation medicolegal evaluation.
AB  - The purpose of this article is to familiarize the reader with the elements and
      parameters of a worker's compensation medicolegal evaluation. Physicians play a
      critical role in the determination of whether an alleged injury warrants
      compensation and vocational training. The author provides information that will
      assist the physician who is called on to make such a judgment.

PMID- 7776206
TI  - Fatal pontine hemorrhage after podiatric surgery. A case report.
AB  - The authors present a case of massive fatal pontine hemorrhage as a complication
      of hypertension in a patient treated for an infected diabetic ulcer. The
      podiatric physician must be aware of the risks associated with concomitant
      medical problems such as hypertension and ensure that proper therapeutic measures
      are taken to avoid the potential for catastrophic complications.

PMID- 7776205
TI  - Scope of practice in podiatric sports medicine.
AB  - The author discusses the issue of scope of practice in podiatric sports medicine
      and cases involving this area of practice, as well as the attendant
      ramifications. By gaining insight into this tissue, it is hoped the importance of
      practicing within the specific state scope of practice laws will be recognized.

PMID- 7776207
TI  - Scintigraphic detection of sequential symmetrical metatarsal stress fractures.
AB  - A patient with complaints of right foot pain and previous normal radiographs had
      an abnormal three-phase bone scan consistent with a second metatarsal stress
      fracture. Subsequent radiographs confirmed this diagnosis. Two months later, the
      patient developed pain in his left foot, and again initial radiographs were
      noncontributory. A later bone scan revealed a left second metatarsal stress
      fracture. The results in this case reemphasize the value of bone scintigraphy in
      patients with foot pain and no bone abnormalities on plain radiographs.

PMID- 7776208
TI  - Fracture of the fifth digit. An atypical presentation.
AB  - Digital fractures are a common injury in the forefoot. Most fractures, however,
      do not present relatively free of pain. When they present without pain or with
      few symptoms, they may be overlooked or misdiagnosed. The following is a case
      presentation of a patient who presented to Franklin Delano Roosevelt Hospital
      after trauma to the right fifth toe. The case was atypical in that the patient
      was asymptomatic despite the recent injury. Rapid conservative intervention by
      the patient at home, coupled with sensory neuropathy secondary to diabetes, can
      alter the clinical presentation as witnessed in this case. An appropriate history
      and physical examination combined with radiographs were essential to an otherwise
      ordinary clinical presentation.

PMID- 7776209
TI  - Bullosis diabeticorum.
AB  - The authors present a case of bullous dermatosis in a diabetic patient. The
      lesions were drained and deroofed, and at 1-year follow-up, the patient related
      no problems. Proper diagnosis and treatment of these lesions will avoid infection
      and ulceration.

PMID- 7776210
TI  - Total contact casting.
AB  - The treatment of diabetic foot ulcerations has been a difficult task for
      podiatrists. Numerous methods and materials have been used in an attempt to
      alleviate this frustrating and complex treatment dilemma. However, there is one
      treatment method that has been used successfully for decades on plantar
      ulcerations of the neuropathic foot. Total contact casting has been an easily
      applicable and effective treatment modality for neuropathic ulcerations of the
      diabetic foot.

PMID- 7776211
TI  - Patient education for diabetic patients. An integral part of quality health care.
AB  - The diabetic patient is at high risk for developing long-term medical
      complications including serious foot problems with potential loss of limb. With
      today's growing awareness of the importance of curtailing overall health care
      costs, the importance of comprehensive diabetic patient education programs is
      academic. It is demonstrated that a multidisciplinary approach to diabetic care
      management, with foot care assessment encompassing early preventive measures, can
      serve as a model for other Veterans Affairs Medical Centers to follow. Foot
      screenings can individualize specific foot problems and provide an understanding
      of risk factors to prevent complications. Patients with diabetes or peripheral
      vascular disease and, especially those individuals at risk of foot ulceration,
      are referred to the appropriate clinic for ongoing management to prevent
      amputation. Patient education is considered most effective when it is encouraged
      throughout a diabetic patient's medical care, and it becomes a part of lifestyle
      habits.

PMID- 7776212
TI  - Comparison of rearfoot motion in overground versus treadmill walking.
AB  - The purpose of this study was to determine whether walking on a treadmill is a
      valid simulator of overground walking with respect to rearfoot motion. The
      tibial, calcaneal, and rearfoot motions of 10 subjects (2 males, 8 females) were
      videotaped while they walked on a treadmill and overground. The results of a
      series of t-tests showed that there was no statistically significant difference
      between the two conditions on any of the variables measured.

PMID- 7776213
TI  - Shortening Z-osteotomy for the proximal phalanx of the hallux using axial guides.
AB  - The shortening Z-osteotomy of the proximal phalanx of the hallux has been
      presented as an alternative to the Regnauld enclavement procedure for patients
      with the appropriate indications. In addition to sharing the same positive
      characteristics as the Regnauld procedure, the Z-osteotomy has technical and
      physiologic advantages. The advantages of the Z-osteotomy over the Regnauld
      include maintenance of the intrinsic attachments at the base of the proximal
      phalanx, less risk of avascular necrosis, less technical difficulty, and absence
      of complications associated with an autogenous bone graft. Also, it does not
      affect the sesamoid apparatus. Research and extended follow-up studies will
      continue at Lakewood Regional Medical Center. In the last year, one author has
      completed approximately 13 of these procedures. The postoperative results have
      been encouraging and successful with one exception. In one case, the increase of
      the hallux interphalangeal angle was probably caused by excessive tightening of
      the distal screw compared with the proximal screw.

PMID- 7776214
TI  - Conservative podiatric medicine and disability in elderly people.
AB  - A survey was conducted of 248 noninstitutionalized people aged 75 years and
      older, residing in a designated geographical area. The effect of dependency and
      physical disability on the receipt of conservative podiatric medicine was
      examined, and, in addition, the prevalence of medical and podiatric conditions
      was determined.

PMID- 7776215
TI  - Chromoblastomycosis. A fungal infection primarily observed in the lower
      extremity.
AB  - Chromoblastomycosis is a cutaneous-subcutaneous fungal infection that is being
      seen more frequently in patients living in the US. The disease normally occurs in
      patients living in tropical and subtropical regions, but as the number of
      immigrants into the US increases, podiatrists must be able to recognize the
      manifestations of chromoblastomycosis. The most common sight involved is the
      lower extremity where it easily can be confused with other diseases such as
      tertiary syphilis, phaeohyphomycosis, and cutaneous tuberculosis, among others.
      Small lesions should be excised, while antifungal drugs, such as itraconazole,
      should be used when more tissue is involved.

PMID- 7776216
TI  - Elephantiasis nostras verrucosa. A case report.

PMID- 7776217
TI  - Chronic elephantiasis. A case report.
AB  - The authors presented a rare case study of a patient with chronic elephantiasis
      involving the lower extremities. The patient had contracted lymphatic filariasis
      while serving in the armed forces during World War II. The patient was followed
      regularly for local wound care by the Veterans Affairs podiatry department.
      However, he died from congestive heart failure and pneumonia in May of 1993.

PMID- 7776218
TI  - Verrucous carcinoma with a dorsal sinus tract.
AB  - A verrucous carcinoma of the right foot was presented. A unique finding, a dorsal
      sinus tract at the base of the fourth toe, was found on examination, which
      communicated with the tumor. Other reports of a sinus tract extending to the
      dorsal surface of the foot could not be found in the literature.

PMID- 7776219
TI  - Presentation of an intermetatarsal ganglion.
AB  - Ganglia have occurred in almost all areas of the foot, but most often associated
      with capsular or tendinous structures. They are fluid-filled masses which often
      present themselves radiographically as increases in soft tissue density. Ganglia
      exhibit high intensity magnetic resonance imaging and must be clinically and
      pathologically differentiated from other masses, such as, but not limited to,
      neuromas, granulomas, and neurilemomas. The authors present a rare occurrence of
      an intermetatarsal ganglionic cyst associated with the third dorsal interossei
      muscle, which was large enough to cause bony deformation of the adjacent
      metatarsals. It is unusual for ganglia to cause alterations in bone unless they
      are intraosseus in nature. Bone deformation and invasion are usually associated
      with aggressive tumors.

PMID- 7776220
TI  - Articular cartilage. Part I. The normal joint.
AB  - Articular hyaline cartilage is of interest to both the clinician and the basic
      scientist because of its unique physical and chemical properties which are a
      consequence of its biochemical composition. Although it is a tissue which is
      hypocellular, avascular, and also lacks nerves and lymphatics, it is active in
      synthesis and degradation. Articular cartilage responds to the forces to which it
      is subjected and, in this way, maintains its integrity as long as those forces do
      not exceed the tissue's capacity for repair or permanently change the biologic
      response of the cells.

PMID- 7776221
TI  - Articular cartilage. Part II. The osteoarthritic joint.
AB  - Articular hyaline cartilage, though a metabolically active tissue, has limited
      capacity for repair. Though the integrity of the cartilage is dependent upon a
      certain level of force placed upon it, excessive force leads to damage. It is
      when the breakdown of the cartilage exceeds the capacity of the cartilage for
      repair that osteoarthritis results. At present, pharmacologic treatment of
      osteoarthritis is focused toward the control of pain and stiffness. This
      treatment, however, masks the symptoms of the disease and effectively allows the
      patient to do further damage to the joint.

PMID- 7776222
TI  - Nonskid socks.
AB  - For children with normal anatomy, nonskid socks may be safe for indoor wear.
      However, they lack some protection capacity, and are not biomechanically helpful.
      Little scientific data exist to guide physicians on what children should wear on
      their feet. Dogma and prejudice may taint the advice physicians give. Perhaps
      this type of project will spur further investigation.

PMID- 7776223
TI  - Reversal of somatic neuropathy in a diabetic patient treated with pancreas-kidney
      transplantation.

PMID- 7776224
TI  - Who treats feet?

PMID- 7776225
TI  - A sustained inward current activated at the diastolic potential range in rabbit
      sino-atrial node cells.
AB  - 1. After blocking both the hyperpolarization-activated current and the membrane
      K+ conductance, depolarizations from -80 mV to between -70 and -50 mV induced a
      sustained current in sino-atrial node cells. We have tentatively designated this
      current Ist. 2. Ist was blocked by both organic and inorganic Ca2+ channel
      blockers, but was insensitive to tetrodotoxin (30 microM). Isoprenaline increased
      Ist. 3. The peak of Ist (at about -50 mV) was increased to 149 +/- 13% (n = 8, P
      < 0.01) by lowering the external Ca2+ concentration ([Ca2+]o) from 1.8 to 0.1 mM,
      in contrast to the marked depression of the L-type Ca2+ current. In 0.1 mM
      [Ca2+]o solution, the nicardipine-sensitive current-voltage relation showed the
      peak amplitude at about -50 mV and a reversal potential of +37.4 +/- 4.4 mV (n =
      5). The isoprenaline-sensitive component also showed a reversal potential of
      about +30 mV. 4. Reducing [Na+]o from 140 to 70 mM in 0.1 mM [Ca2+]o decreased
      Ist to 53 +/- 5% (n = 7, P < 0.01). Increasing [Ca2+]o or [Mg2+]o decreased the
      amplitude of Ist. The half-maximum concentration of Mg2+ inhibition was 2.2 mM.
      5. At 1.8 mM [Ca2+]o, Ist was inactivated by clamping for 5s at -10 mV, and
      gradually recovered after repolarization to -80 mV with a half-time of 1.36 +/-
      0.4 s (n = 6). 6. The transitional sino-atrial node cell had minimal amplitude of
      Ist. 7. These characteristics of Ist are qualitatively comparable to those of the
      monovalent cation conductance of the L-type Ca2+ channel induced by depleting
      external divalent cations to the micromolar range. We conclude that Ist is
      generated by a novel subtype of L-type Ca2+ channel.

PMID- 7776226
TI  - Expression and distribution of sodium channels in short- and long-term denervated
      rodent skeletal muscles.
AB  - 1. Loose-patch voltage-clamp recordings were made from rat and mouse skeletal
      muscle fibres denervated for up to 6 weeks. Innervated muscles possessed a Na+
      current density of 107 +/- 3.3 mA cm-2 in endplate membrane, and 6.3 +/- 0.6 mA
      cm-2 in extrajunctional membrane. This high concentration of Na+ channels at the
      endplate was gradually reduced following denervation. After 6 weeks of
      denervation, the endplate Na+ channel concentration was reduced by 40-50%, and
      the density of Na+ channels in extrajunctional membrane was increased by about
      30%. 2. The tetrodotoxin (TTX)-resistant form of the Na+ channel appeared after 3
      days of denervation and comprised approximately 43% of the endplate Na+ channels
      5-6 days after denervation. Subsequently, TTX-resistant Na+ channels were reduced
      in density to approximately 25% of the postjunctional Na+ channels and remained
      at this level up to 6 weeks after denervation. 3. RNase protection analysis
      showed that mRNA encoding the TTX-resistant Na+ channel was virtually absent in
      innervated muscle, rose > 50-fold after 3 days of denervation, then decreased by
      95% 6 weeks after denervation. The density of TTX-resistant Na+ channels
      correlated qualitatively with changes in mRNA levels. 4. These results suggest
      that the density of Na+ channels at neuromuscular junctions is maintained by two
      mechanisms, one influenced by the nerve terminal and the other independent of
      innervation.

PMID- 7776228
TI  - Effects of testosterone on synaptic efficacy at neuromuscular junctions in a
      sexually dimorphic muscle of male frogs.
AB  - 1. The effects of testosterone on synaptic efficacy were studied in the flexor
      carpi radialis, a sexually dimorphic forelimb muscle involved in frog clasping
      behaviour. Male Xenopus laevis frogs were castrated and then given either
      testosterone-filled implants (CT frogs) or empty implants (C frogs) for 2, 8 or
      16 weeks. 2. Intracellular recordings were made from fibres in the shoulder
      region and in a region midway between the elbow and wrist. These regions are
      mainly innervated by spinal nerve 2 (SN2) and spinal nerve 3 (SN3), respectively.
      3. In CT muscles, the percentage of fibres that failed to generate an action
      potential in response to a single nerve stimulus was greater than in C muscles.
      The percentage of such fibres was greater among SN2 fibres than among SN3 fibres.
      4. The input resistance and membrane time constant were lower in CT muscles than
      in C muscles for SN2 fibres but not for SN3 fibres. The action potential
      threshold was lower in CT muscles than in C muscles. In SN2 fibres, the action
      potential threshold was higher than in SN3 fibres. 5. Quantal content with 1 Hz
      nerve stimulation and miniature endplate potential (MEPP) frequency did not
      differ between CT and C junctions. However, both parameters were lower at SN2
      junctions than at SN3 junctions. The amplitude of MEPPs was lower in CT muscles
      than in C muscles only for SN2 junctions. 6. Facilitation of transmitter release
      with 70 or 10 Hz nerve stimulation was greater at CT junctions than at C
      junctions. Also, SN2 junctions showed greater facilitation than SN3 junctions. 7.
      We hypothesize that the more androgen-sensitive SN2 junctions, which have lower
      quantal content and greater facilitation, belong to motor units that are
      tonically active, fatigue resistant, and contract more slowly. The less androgen
      sensitive SN3 junctions, which have higher quantal content and less facilitation,
      may belong to motor units that are phasically active, fatigable and contract more
      rapidly. Testosterone enhances these differences such that flexor carpi radialis
      junctions are better adapted to the functional demands of clasping.

PMID- 7776227
TI  - Length dependence of Ca2+ sensitivity of tension in mouse cardiac myocytes
      expressing skeletal troponin C.
AB  - 1. Beat-to-beat performance of myocardium is highly dependent on sarcomere
      length. The physiological basis for this effect is not well understood but
      presumably includes alterations in the extent of overlap between thick and thin
      filaments. Sarcomere length dependence of activation also appears to be involved
      since length-tension relationships in cardiac muscle are usually steeper than
      those in skeletal muscle. 2. An explanation recently proposed to account for the
      difference between length-tension relationships is that the cardiac isoform of
      troponin C (cTnC) has intrinsic properties that confer greater length-dependent
      changes in the Ca2+ sensitivity of tension than does skeletal troponin C (sTnC),
      presumably due to greater length-dependent changes in the Ca(2+)-binding affinity
      of cTnC. To test this hypothesis, transgenic mice were developed in which fast
      sTnC was expressed ectopically in the heart. This allowed a comparison of the
      length dependence of the Ca2+ sensitivity of tension between myocytes having thin
      filaments that contained either endogenous cTnC or primarily sTnC. 3. In myocytes
      from both transgenic and normal mice, the Ca2+ sensitivity of tension increased
      similarly when mean sarcomere length was increased from approximately 1.83 to
      2.23 microns. In both cases, the mid-point (pCa50) of the tension-pCa (i.e. 
      log[Ca2+]) relationship shifted 0.12 +/- 0.01 pCa units (mean +/- S.E.M.) in the
      direction of lower Ca2+. 4. We conclude that the Ca2+ sensitivity of tension in
      myocytes changes as a function of sarcomere length but is independent of the
      isoform of troponin C present in the thin filaments.

PMID- 7776230
TI  - Cellular basis of temporal synaptic signalling: an in vitro electrophysiological
      study in rat auditory thalamus.
AB  - 1. The cellular mechanisms underlying temporal synaptic signalling of
      tectothalamic pathways were investigated in rat medial geniculate body (MGB)
      maintained in vitro. Stimulation of the brachium of the inferior colliculus
      elicited either a short latency, single- (or dual-) spike or a long latency (10
      80 ms) burst in MGB neurones. The delayed burst response was found in most non
      lemniscal or caudodorsal MGB (MGd) neurones, whereas single-spike units were
      mainly seen in the lemniscal ventral MGB (MGv). Population latency analysis
      revealed that the overall relay time of tectothalamic transmission is
      approximately 50 ms, with at least two excitation peaks occurring around 8 and 15
      ms, respectively. 2. Intracellular recordings showed that the delayed burst
      responses in MGd neurones were mediated by an EPSP-triggered low threshold spike
      (LTS). Small variations in either the membrane voltage or in EPSP amplitude
      induced significant shifts of LTS latency. 3. Compared with MGv cells, MGd
      neurones exhibited a more negative resting membrane potential and a prolonged
      EPSP; they lacked an apparent hyperpolarization-activated inward rectifier (Ih).
      These factors seem to lead collectively to a dominant occurrence of long latency
      burst response in the MGd. In the majority of single-spiking MGv cells that
      expressed a clear Ih, application of Cs+ consistently hyperpolarized the cell,
      which transformed a single-spike synaptic response into an EPSP-LTS burst or a
      subthreshold EPSP. 4. Taken together, these data suggest that the monosynaptic
      tectothalamic pathways are capable of introducing a ventrodorsal gradient in
      auditory response time. This synaptic activity pattern is probably dominantly
      regulated by a set of membrane conductances expressed endogenously in
      thalamocortical neurones.

PMID- 7776229
TI  - Effects of creatine phosphate and inorganic phosphate on the sarcoplasmic
      reticulum of saponin-treated rat heart.
AB  - 1. Ventricular trabeculae from rat heart were permeabilized by treatment with
      saponin. In the presence of 150 nM Ca2+, application of 20 mM caffeine released
      Ca2+ from the sarcoplasmic reticulum (SR), resulting in a transient contracture.
      Ca2+ released from the SR was detected using fura-2 fluorescence. The amplitudes
      of the caffeine-induced Ca2+ transients were used to assess SR Ca2+ content. 2.
      In the absence of creatine phosphate (CP), introduction of 5-30 mM inorganic
      phosphate (Pi) caused a net release of Ca2+ from the SR. Subsequent caffeine
      induced Ca2+ and tension transients were smaller in the presence of Pi. Under
      these conditions, 30 mM Pi decreased the caffeine-induced Ca2+ transients by 45
      +/- 3.1% (mean +/- S.D., n = 14). On removal of Pi, the [Ca2+] transiently
      decreased and the caffeine-induced Ca2+ transients returned to control levels
      over 4-6 min. 3. In the presence of CP (5-15 mM), the Ca2+ transients were
      unaffected by the introduction of Pi (5-30 mM) or slightly increased in
      amplitude. Pi (30 mM) significantly increased the caffeine-induced Ca2+
      transients by 7 +/- 8.8% (mean +/- S.D., n = 19, P < 0.05) in the presence of 15
      mM CP. The release of Ca2+ on addition of Pi and decrease in [Ca2+] on Pi
      withdrawal was less pronounced or absent completely in the presence of CP. The
      inhibitory effects of Pi on caffeine-induced Ca2+ release became apparent as the
      [CP] was decreased from 5 to 0 mM. 4. In the presence of the creatine
      phosphokinase inhibitor dinitro-fluorobenzene (DNFB) the effects of Pi (in the
      presence of CP) were qualitatively similar to the results obtained in the absence
      of CP, although the decrease in caffeine-induced Ca2+ release was less
      pronounced. 5. These results suggest that the rise in [Pi]i during ischaemia or
      anoxia will have little effect on the regulation of Ca2+ by the SR while the
      [CP]i remains above 5 mM. However, as the [CP] decreases below 5 mM, the
      accumulation of Pi within the cytosol will progressively reduce the SR Ca2+
      content. CP may act in conjunction with endogenous creatine phosphokinase to
      modify the response of the SR to Pi, and possible mechanisms are considered.

PMID- 7776231
TI  - Synaptic integration in layer IV of the ferret striate cortex.
AB  - 1. Whole-cell patch recording were made with dye-filled electrodes from layer IV
      in slices of the ferret striate cortex. Projections from the thalamus and layer
      VI provide most of the extralaminar input to layer IV. Interactions between these
      two pathways are thought to play a role in the generation of suppressive non
      linearities such as end-inhibition. Thus, synaptic responses evoked by
      stimulating each pathway individually were compared with those produced by
      activating both projections together. 2. Spiny stellate cells are the majority
      population in layer IV and were the most frequently patched neurons (n = 23); all
      fired adapting trains of large, fast action potentials. About half of those
      tested (n = 13) were progressively inhibited by strengthening the stimulus to
      layer VI, while the rest became more excited. For the former, the response evoked
      by stimulating both pathways in coincidence was often more hyperpolarizing than
      would have been predicted by summing the responses to either projection alone (n
      = 4). Hence, the inputs from the thalamus and layer VI are integrated by circuits
      that can produce strong and non-linear inhibition. 3. Recordings from various
      basket cells, which are inhibitory, have provided a first view of the suppressive
      circuits in layer IV (n = 5). Two cells were excited by stimulation of both
      pathways. The remaining three cells were mainly excited by activation of thalamic
      afferents but were largely inhibited by stimulation of layer VI. Thus, inhibition
      seen at the level of the spiny stellate cells could result from two mechanisms
      operating via presynaptic smooth cells: convergent excitation provided by both
      ascending pathways on the one hand, and a push-pull relationship between pathways
      on the other.

PMID- 7776232
TI  - Regulation of granule size in human and horse eosinophils by number of fusion
      events among unit granules.
AB  - 1. We have investigated the granule size distributions in human and horse
      eosinophils by time-resolved patch-clamp capacitance measurements. 2. During
      exocytosis of single granules the electrical capacitance of the plasma membrane
      increases in discrete steps. The steps in horse cells are about six times larger
      than those in human cells in accordance with the difference in granule size. 3.
      In both species a multimodal capacitance step size distribution is observed with
      a first peak at 6-7 fF corresponding to granules with a diameter of about 450-500
      nm and a surface area of about 0.7 microns2, which we call the unit granule. The
      other peaks in the distributions correspond to multiples of the surface area of
      these units. 4. These results show that the larger granules are formed by fusion
      of several unit granules and the final size of mature granules is determined by
      the number of units allowed to fuse with each other. Whereas in human eosinophils
      most granules consist of one or two units, most granules of horse eosinophils are
      formed by fusion of seven to fifteen units. 5. The intracellular fusion events
      associated with vesicular traffic are believed to occur constitutively. In
      contrast, our results indicate that a cellular mechanism exists which regulates
      the size of the mature granules by determining the number of units allowed to
      fuse with each other. In view of our recent report that granule-granule fusion
      can be activated by GTP gamma S, this regulation may possibly involve GTP-binding
      proteins.

PMID- 7776233
TI  - Central inhibitory effects of muscimol and bicuculline on the milk ejection
      reflex in the anaesthetized rat.
AB  - 1. In order to determine whether GABAergic mechanisms are involved in the control
      of the milk ejection reflex in the rat, we examined the effects of central
      administration of a GABAA receptor agonist (muscimol) and antagonist
      (bicuculline) on the milk ejection reflex in the urethane-anaesthetized rat. 2.
      Intracerebroventricular (i.c.v.) injection of both muscimol (n = 17), at doses of
      5, 10 and 20 ng, and bicuculline (n = 15), at doses of 0.01, 0.1 and 0.3
      microgram, inhibited the milk ejection reflex in a dose-dependent manner. The
      bicuculline-induced inhibition was accompanied by desynchronization of the
      electroencephalogram and, at the highest dose, by alteration in the sensitivity
      of the mammary gland to oxytocin. No significant effect on the milk ejection
      reflex was seen with i.c.v. isotonic saline (n = 5). 3. Injection of 20 (n = 5)
      or 40 ng (n = 2) muscimol or 0.1 microgram bicuculline (n = 5) i.c.v. did not
      significantly alter the rise in intramammary pressure evoked by electrical
      stimulation of the neurohypophysis. 4. Bilateral 400 nl microinfusions directly
      into the supraoptic nuclei of either muscimol (20-100 ng microliter(-1); n = 10)
      or bicuculline (0.15 micrograms microliter(-1); n = 5) [corrected] resulted in an
      inhibition of the milk ejection reflex, which was not accompanied by
      desynchronization of the electroencephalogram. 5. The effects of i.c.v.
      injections of muscimol (15 and 20 ng) and bicuculline (0.01, 0.12 and 0.3
      microgram) on the electrical activity of twenty-seven antidromically identified
      supraoptic magnocellular neurones were examined. Both compounds resulted in an
      inhibition of the background firing of oxytocinergic and vasopressinergic cells,
      and delayed the occurrence of high frequency bursts in oxytocin neurones. In five
      supraoptic neurones, bicuculline induced a transient activation before
      inhibition. 6. The powerful inhibitory action on the milk ejection reflex of both
      muscimol and bicuculline provides evidence for the importance of GABA neurones in
      maintaining the functional integrity of the mechanisms which allow the
      intermittent and pulsatile release of oxytocin during suckling.

PMID- 7776235
TI  - Inhibitory effect of sympathetic stimulation on activities of masseter muscle
      spindles and the jaw jerk reflex in rats.
AB  - 1. To evaluate sympathetic effects on jaw muscles, the discharges of masseter
      muscle spindle afferents, jaw muscle electromyographic (EMG) activities and blood
      flow changes were compared in anaesthetized decerebrate rats before and during
      electrical stimulation of the cervical sympathetic trunk. 2. To eliminate the
      possibility of efferent control from the trigeminal motoneurones, muscle spindle
      activity was recorded from the cut peripheral end of the masseter nerve. The
      absence of a sympathetic component in the masseter nerve was confirmed by the
      horseradish peroxidase method. 3. Electrical stimulation of the sympathetic nerve
      at frequencies within the physiological range reduced muscle spindle afferent
      discharges evoked by passive jaw opening. 4. Sympathetic stimulation also reduced
      the EMG activity evoked by the jaw jerk reflex, which may reflect a sympathetic
      effect on spindle afferents. After cessation of stimulation, a transient increase
      in EMG activity was observed, which may be due to efferent supply from the
      trigeminal motoneurones. During rhythmical jaw movements, no sympathetic effect
      on EMG activity was detected. 5. The above sympathetic effect on muscle spindle
      afferents and EMG activity was independent of blood flow changes.

PMID- 7776234
TI  - Role of nitric oxide in non-adrenergic, non-cholinergic relaxation and modulation
      of excitatory neuroeffector transmission in the cat airway.
AB  - 1. The effects of nitrosocysteine (cys-NO), L-N omega-nitroarginine (L-NNA) and L
      N omega-nitro-L-arginine methylester (L-NAME), oxyhaemoglobin and Methylene Blue
      were observed on the resting membrane potential, muscle tone and excitatory
      junction potentials (EJPs) of cat tracheal smooth muscle tissue. 2. Cys-NO (10(
      9) to 10(-6) M) showed no effect on the resting membrane potential of smooth
      muscle cells of the cat trachea but it dose-dependently relaxed the tracheal
      tissue in the presence of 5-HT, atropine and guanethidine. 3. Electrical field
      stimulation (EFS) applied during contraction evoked by 5-HT in the presence of
      atropine and guanethidine evoked non-adrenergic, non-cholinergic (NANC) muscle
      relaxation. L-NNA (10(-4) M) and L-NAME (10(-4) M) completely suppressed the
      relaxation when single or short repetitive stimuli were applied, but suppression
      was incomplete with repetitive stimuli of 4 ms pulse duration applied at 20 Hz. A
      substantial part of the L-NNA- or L-NAME-insensitive relaxation was abolished by
      tetrodotoxin. 4. Cys-NO dose-dependently suppressed the EJPs without changing the
      resting membrane potential, and L-NNA, L-NAME, Methylene Blue and oxyhaemoglobin
      enhanced the amplitude of the EJP to 1.2-1.5 times the control value. 5. EJPs
      showed some summation when repetitive field stimulation was applied at 20 Hz. L
      NNA or L-NAME enhanced the summation, and the mean slopes were increased from
      0.61 +/- 0.22 to 2.0 +/- 0.3, or 1.9 +/- 0.2 mV per stimulus. Vasoactive
      intestinal polypeptide (VIP) antiserum and VIP antagonists further enhanced the
      summation in the presence of L-NNA. 6. These results indicate that NANC
      relaxation can be classified into two different components according to the
      threshold for activation, and nitric oxide is involved in one. The present
      results also suggest that endogenous or exogenous nitric oxide has a
      prejunctional action in inhibiting excitatory neuroeffector transmission in
      addition to a direct action on the smooth muscle cells, presumably by suppressing
      transmitter release from the vagus nerve.

PMID- 7776236
TI  - Responses of human masseter motor units to stretch.
AB  - 1. The reflex responses to stretch were studied in single motor units and the
      surface electromyogram in human masseter. 2. Controlled stretches of the
      isometrically contracting jaw-closing muscles evoked short-latency (10-15 ms) and
      long-latency (35-70 ms) excitatory reflex responses in the masseter surface
      electromyogram. 3. The majority (65%) of tonically active masseter motor units
      were excited in both short- and long-latency phases of the reflex. The timing of
      the stimulus determined whether the unit discharged in the short- or long-latency
      phase. If a non-tonically active motor unit was recruited by the stimulus, it
      invariably discharged in the long-latency phase. 4. Although short-latency
      responses were strongly time-locked to the stimulus, there was very little
      shortening of interspike intervals (ISIs) in this phase of the reflex. The
      shortening of ISIs was more prominent and prolonged during the long-latency
      phase, which explains why this phase produces most of the reflex force changes
      following the stretch. 5. Within pairs of concurrently active motor units there
      was a tenfold range in the size of the short-latency response to the same
      stretch. 6. A substantial proportion (35%) of the twenty-two masseter motor units
      tested had no statistically significant short-latency reflex response. 7. In
      contrast to other human muscles, there was no functional connection between a
      population of Ia afferents and some masseter motoneurons. There are two possible
      explanations for this result. The short-latency, presumably monosynaptic, Ia
      afferent inputs may not be uniformly distributed to human masseter motoneurons.
      Alternatively, these inputs may be subject to tonic presynaptic inhibition that
      is not uniformly distributed throughout the masseter motoneuron pool.

PMID- 7776237
TI  - Glycogen resynthesis in human muscle fibre types following exercise-induced
      glycogen depletion.
AB  - 1. Studies investigating muscle glycogen resynthesis in man have usually examined
      mixed-fibred biopsies or have used histochemical methods to estimate single fibre
      resynthesis. Since the accuracy of the latter is open to debate, this study
      investigated glycogen resynthesis in type I and II fibres using biochemical
      methods of analysis. 2. Seven subjects performed one-legged cycling exercise to
      exhaustion. During the initial 2 h of recovery, subjects consumed 3 g of glucose
      (kg body mass (BM))-1, and a high carbohydrate diet thereafter. Muscle biopsy
      samples were obtained from both legs at exhaustion, and from the exercised leg
      after 3, 10 and 24 h of recovery. 3. In the initial 3 h of recovery, there was a
      25 +/- 8% higher rate of resynthesis in type I compared with type II fibres (41
      +/- 3 and 31 +/- 4 mmol glucosyl units (kg dry mass (DM))-1 h-1, respectively; P
      < 0.05). Between 3 and 10 h of recovery, resynthesis in type I fibres declined by
      60 +/- 13% to 15 +/- 4 mmol glucosyl units (kg DM)-1 h-1 (P < 0.01), whilst the
      rate in type II fibres was maintained. Good agreement was found when relating the
      mixed-fibred muscle glycogen concentration to the mean concentration found in
      type I and type II fibres (r = 0.96). 4. A discrepancy was found to exist with
      histochemically derived data reported in the literature. The higher initial
      glycogen resynthesis rate in type I fibres may be attributable to fibre-type
      differences in glucose uptake and disposal.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7776238
TI  - Respiratory phase resetting and airflow changes induced by swallowing in humans.
AB  - 1. Relationships between the timing of respiration and deglutition were studied
      in thirty awake healthy subjects at rest. Deglutition was monitored by submental
      electromyography, pharyngeal manometry and videofluoroscopy. Respiration was
      recorded by measurement of oronasal airflow and chest wall movement. Three types
      of deglutition were studied: injected bolus swallows, spontaneous swallows, and
      visually cued swallows of boluses previously placed in the mouth. 2. The effect
      of each swallow on respiratory rhythm was characterized by measurement of
      cophase, defined as the interval between the onset of deglutitive submental EMG
      activity to the onset of subsequent rescheduled inspirations. Cophase was
      determined for swallows initiated at different phases of the respiratory cycle.
      In all subjects deglutition caused phase resetting of respiratory rhythm. Cophase
      was largest for swallows initiated near the the inspiratory-expiratory (E-I)
      transition and smallest for swallows initiated near the expiratory-inspiratory (E
      I) transition. The pattern of respiratory resetting by deglutition was
      topologically classified as type 0. This pattern was shown for swallows induced
      by bolus injection or visual cue, and for spontaneous swallows. 3. The incidence
      of spontaneous deglutition was influenced by the position of the swallow in the
      respiratory cycle. Few spontaneous swallows were initiated near the E-I
      transition whereas most occurred from late inspiration to mid-expiration. 4.
      Deglutition caused an abrupt decrease in airflow leading to an interval of
      apnoea, followed by a period of expiration. The duration of deglutition apnoea
      for spontaneous swallows was shorter than that for 5 ml bolus swallows, and was
      unaffected by the respiratory phase of swallow initiation. The period of
      expiration after swallowing was longest for swallows initiated at the I-E
      transition, and shortest for E-I swallows. 5. The intervals between bolus
      injection and the onset of deglutition apnoea, and the timing of swallowing
      events, were not significantly altered by the phase in the respiratory cycle at
      which swallowing was exhibited. 6. To quantify the relationship between bolus
      flow and respiration, we determined the latencies between cessation of
      inspiratory airflow and arrival of the bolus at the larynx (alpha), and between
      laryngeal bolus departure and resumption of inspiratory airflow (delta). Both
      values were dependent upon the respiratory phase of swallowing. The lowest values
      for alpha and delta were found for early-inspiratory and late-expiratory
      swallows, respectively. 7. We conclude that swallowing causes respiratory phase
      resetting with a pattern that is characteristic of the strong perturbations of an
      attractor-cycle oscillator.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7776239
TI  - 'Non-hypotensive' hypovolaemia reduces ascending aortic dimensions in humans.
AB  - 1. The notion that small, 'non-hypotensive' reductions of effective blood volume
      alter neither arterial pressure nor arterial baroreceptor activity is pervasive
      in the experimental literature. We tested two hypotheses: (a) that minute
      arterial pressure and cardiac autonomic outflow changes during hypovolaemia
      induced by lower body suction in humans are masked by alterations in breathing,
      and (b) that evidence for arterial baroreflex engagement might be obtained from
      measurements of thoracic aorta dimensions. 2. In two studies, responses to graded
      lower body suction at 0 (control), 5, 10, 15, 20 and 40 mmHg were examined in
      twelve and ten healthy young men, respectively. In the first, arterial pressure
      (photoplethysmograph), R-R interval, and respiratory sinus arrhythmia amplitude
      (complex demodulation) were measured during uncontrolled and controlled breathing
      (constant breathing frequency and tidal volume). In the second, cross-sectional
      areas of the ascending thoracic aorta were calculated from nuclear magnetic
      resonance images. 3. Lower body suction with controlled breathing resulted in an
      increased arterial pulse pressure at mild levels (5-20 mmHg; ANOVA, P < 0.05) and
      a decreased arterial pulse pressure at moderate levels (40 mmHg; ANOVA, P <
      0.05). Both R-R intervals and respiratory sinus arrhythmia were negatively
      related to lower body suction level, whether group averages (general linear
      regression, r > 0.92) or individual subjects (orthogonal polynomials, 12 of 12
      subjects) were assessed. 4. Aortic pulse area decreased progressively and
      significantly during mild lower body suction, with 47% of the total decline
      occurring by 5 mmHg. 5. These results suggest that small reductions of effective
      blood volume reduce aortic baroreceptive areas and trigger haemodynamic
      adjustments which are so efficient that alterations in arterial pressure escape
      detection by conventional means.

PMID- 7776240
TI  - Activation of P2-purinoreceptors triggered Ca2+ release from InsP3-sensitive
      internal stores in mammalian oligodendrocytes.
AB  - 1. The subcellular characteristics of an ATP-induced elevation of the cytoplasmic
      free calcium concentration ([Ca2+]i) were studied in cultured cells of the
      oligodendrocyte lineage obtained from mouse cortex and rabbit retina, as well as
      in oligodendrocytes from mouse corpus callosum slices, using laser scanning
      confocal microfluorometry. 2. With the stage- and lineage-specific antibodies O4
      and O10, three developmental stages within the oligodendrocyte lineage were
      distinguished prior to Ca2+ recording. 3. Bath application of 1-100 microM ATP
      induced a transient increase of [Ca2+]i in late precursors and oligodendrocytes
      but not in early glial precursor cells from retinal and cortical cultures and
      from corpus callosum slices. This effect of ATP was observed in Ca(2+)-free
      extracellular solution, suggesting that the ATP-mediated elevation of [Ca2+]i is
      due to a Ca2+ liberation from intracellular stores. 4. In both late precursors
      and oligodendrocytes from retina, the amplitude of ATP-induced [Ca2+]i transients
      was significantly higher in processes as compared with the soma; in cortical
      cultures such an uneven response was only observed in oligodendrocytes, while in
      immature cells responses in soma and processes were of similar amplitude. 5. The
      rank order of potency for the purine and pyrimidine nucleotides was UTP > or =
      ATP > ADP >> AMP = adenosine = Me-ATP for retinal oligodendrocytes, and ADP > or
      = ATP >> UTP = AMP = adenosine = Me-ATP for cortical oligodendrocytes. The
      response to ATP and related nucleotides was blocked by suramin, indicating the
      involvement of a P2-purinoreceptor in the ATP-mediated [Ca2+]i response. 6. ATP
      induced elevation of the cytosolic Ca2+ concentration was inhibited by incubating
      cells with thapsigargin (10 microM) and by intracellular administration of
      heparin (1 microM). These findings indicate that ATP triggers a release of Ca2+
      ions from InsP3-sensitive internal stores. 7. The ATP receptors may play a role
      in neuron-glial signal transfer; ATP is released as neurotransmitter, but also
      under pathological conditions from damaged cells.

PMID- 7776242
TI  - Activation of calcium current in voltage-clamped rat glomerulosa cells by
      potassium ions.
AB  - 1. We examined Ca2+ influx mechanisms using the whole-cell patch-clamp technique
      in primary cultures of rat glomerulosa cells. 2. Depolarization of the plasma
      membrane, as studied by a stepwise or ramp depolarization technique, activated
      low-threshold, transient (T-type) and high-threshold, long-lasting (L-type)
      voltage-dependent calcium channels (VDCCs). 3. Extracellular K+ activated an
      inward current (Ig1), even in voltage-clamped cells. This phenomenon was observed
      within the physiological concentration range, beginning at 4.6 mM K+o (as opposed
      to the control level of 3.6 mM K+o). Increased cell conductance and increased
      background noise indicated that Ig1 is evoked by enhanced channel activity.
      Potassium induced no outward current in the voltage range examined (-120 to +60
      mV). 4. When non-permeable anions were present only in the pipette and Na+ and
      Mg2+ were omitted from the bath, K+ still activated the current. Ig1 was blocked
      by 100 microM cadmium but was insensitive to 2 microM nifedipine or to 300 microM
      Ni2+. 5. In fluorimetric studies elevation of the cytoplasmic Ca2+ concentration
      in response to K+ (5.6-13.6 mM) was reduced only partially when VDCCs were
      blocked with Ni2+ (200 microM) and nifedipine (2 microM). 6. Elevation of the K+
      concentration shifted the threshold potential of the T-type calcium channel in
      the negative direction. 7. In summary, K+ as a ligand activates Ca(2+)-permeable
      channels in rat glomerulosa cells. This current may contribute to the development
      of Ca2+ signals in response to stimulation with K+ in the physiological range.
      The reduction of the activation threshold of the T-type current by K+ may also be
      of physiological significance.

PMID- 7776241
TI  - Immunoglobulin E receptor-activated calcium conductance in rat mast cells.
AB  - 1. The nystatin perforated-patch method was used to record macroscopic currents
      from anti-trinitrophenyl (TNP) immunoglobulin E (IgE)-sensitized rat basophilic
      leukaemia (RBL-2H3) cells at 37 degrees C. 2. An inwardly rectifying Ca2+ current
      (ICa) was activated upon stimulation with the multivalent antigen
      trinitrophenylated bovine serum albumin (TNP-BSA). Induction of ICa was not
      observed at room temperature. ICa was reversed and reinduced upon cyclical
      addition of the monovalent hapten dinitrophenyl (DNP)-lysine and multivalent
      antigen, indicating that a specific interaction of antigen with IgE was required
      to elicit ICa. 3. The antigen-induced current was also carried by Ba2+ or Sr2+,
      and to a lesser extent by Na+, in the nominal absence of Ca2+. ICa did not
      exhibit time-dependent opening (< or = 1 ms) in response to hyperpolarizing
      voltage steps to -100 mV, although it did accumulate steady-state inactivation of
      approximately 40-50% over 100 ms. 4. Two inorganic blockers of antigen-stimulated
      45Ca2+ influx and secretion, La3+ and Zn2+, inhibited ICa by approximately 50% at
      concentrations known to produce 50% block of 45Ca2+ influx. In contrast, cromolyn
      sodium (0.5 mM) and the L-type Ca2+ channel antagonist nitrendipine (5 microM)
      had no effect on ICa. 5. ICa also was induced by the intracellular Ca2+ mobilizer
      thapsigargin. Because the actions of thapsigargin and antigen were not additive,
      IgE receptor cross-linkage appears to activate the recently described
      capacitative Ca2+ entry channels.

PMID- 7776243
TI  - Dopamine D1 receptor modulates the voltage-gated sodium current in rat striatal
      neurones through a protein kinase A.
AB  - 1. Whole-cell recordings were made from striatal neurones obtained from neonatal
      rats and maintained in primary cultures. The effects of dopamine D1 receptor
      activation were studied on the voltage-gated sodium current. 2. Bath application
      of a specific D1 agonist, SKF38393 (1 microM), reduced the neuronal excitability
      recorded in current-clamp by increasing the threshold for generation of action
      potentials. 3. In voltage-clamp recordings, SKF38393 (1 microM) reversibly
      reduced the peak amplitude of the sodium current by 37.8 +/- 4.95%. This effect
      was reversed by the D1 antagonist SCH23390 and was blocked by the intracellular
      loading of GDP-beta-S (2 mM) suggesting GTP-binding protein involvement. 4. The
      D1 agonist reduced the peak amplitude of the sodium current without significantly
      affecting (i) the voltage dependence of the current-voltage relationship, (ii)
      the voltage dependence of the steady-state activation and inactivation, (iii) the
      kinetics of the time-dependent inactivation, and (iv) the kinetics of recovery
      from inactivation. 5. The peak amplitude of the sodium current was progressively
      reduced by intracellular loading of cyclic AMP-dependent protein kinase (100 U ml
      1). 6. Diffusion of a specific peptide inhibitor of the cyclic AMP-dependent
      protein kinase (PKI; 10 microM) into the cytosol of neurones blocked the effect
      of the D1 agonist on the sodium current amplitude. 7. These results demonstrate
      that dopamine acting at the D1 receptor reduces the amplitude of the sodium
      current without modifying its voltage- and time-dependent properties. This effect
      involves activation of the cyclic AMP-dependent protein kinase and results in a
      depression of the striatal neuronal excitability by increasing the threshold for
      generation of action potentials.

PMID- 7776244
TI  - Cation regulation of anion current activated by cell swelling in two types of
      human epithelial cancer cells.
AB  - 1. In epithelial cells, hyposmotic stress induces visible cell swelling and large
      Cl- currents, which deactivate on return to isotonic solutions and are abolished
      by 0.1-0.5 mM DIDS (4,4'-diisothiocyanatostilbene-2,2'-disulphonic acid). During
      depolarizing voltage clamp pulses, the currents activate rapidly and show time
      dependent relaxation with associated tail currents on return to negative
      potentials. 2. We used whole-cell and outside-out patch recording to study volume
      activation of Cl- currents in the epithelial cancer cell lines H69AR and HeLa S5.
      In a 210 or 160 mosmol l-1 hyposmotic bathing solution containing 90 mM NaCl, 1
      mM Ca2+ and 1 mM Mg2+, current relaxation was rapid, occurred positive to the Cl-
      reversal potential and reduced current to < 30% of its peak level at +100 mV. 3.
      Replacement of most bath inorganic cations by N-methyl-D-glucamine (NMDG) at
      constant Cl- concentration and osmolarity eliminated most of the current
      relaxation and caused an increase in steady-state current levels. Steady-state
      current was 85 +/- 6% of peak current at +100 mV in NMDG-Cl bath solution. This
      ratio fell to 55 +/- 2% (n = 5) when 1 mM Mg2+ was re-added to the bath. 4. Re
      addition of Mg2+ or other Group II metals (Ca2+, Sr2+, Ba2+) induced immediate
      changes in current relaxation in a dose- and species-dependent manner.
      Concentrations of Mg2+ as low as 0.1 mM were effective in causing Cl- current
      relaxation. The IC50 for steady-state current block by external Mg2+ was 1.75
      mM.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7776245
TI  - GABAA receptor activation and the excitability of nerve terminals in the rat
      posterior pituitary.
AB  - 1. The activation of GABAA receptors in nerve terminal membranes gates a Cl-
      channel. Experiments were conducted to determine how the activation of this
      receptor influences membrane potentials, action potentials and voltage-activated
      Na+ and K+ channels. 2. When activation of the GABAA receptor produced only
      conductance changes and no voltage changes, action potentials changed only
      slightly. The threshold for action potential generation increased by 15%. GABA
      reduced the broadening of action potentials caused by high frequency stimulation
      by only 7%. These results indicate that membrane shunting by GABA-gated Cl-
      channels plays a relatively minor role. 3. By recording changes in the current
      through K+ channels in cell-attached patches, the activation of GABAA receptors
      was shown to depolarize the nerve terminal membrane from rest by 14 mV. The GABAB
      receptor agonist baclofen produced no change in resting membrane potential as
      measured by this same technique. 4. In whole-terminal recordings under current
      clamp, with pipettes containing various Cl- concentrations, the GABA-induced
      depolarization increased with Ecl. The variation with Ecl provided a basis for
      evaluating the contributions of leak and K+ current in the balance of currents
      that determines the magnitude of the GABA-induced depolarization. 5. Based on the
      GABA-induced voltage change and an evaluation of the other currents of
      significance in the relevant voltage range, an estimate was obtained for ECl of 
      48 mV to give an estimate for the intracellular Cl- ion concentration of 20 mM.
      6. Under conditions allowing both conductance and voltage to change during Cl-
      channel gating, GABA prevented action potential responses to current injection.
      Comparable depolarizations produced by adjusting a steady holding current also
      blocked action potential responses. 7. A depolarization from -60 to -45 mV under
      voltage clamp inactivated approximately 90% of the Na+ channels and activated a
      small amount of K+ current. This suggests that inactivation of Na+ channels makes
      a major contribution to the inhibition of action potentials by GABA. 8. These
      results are consistent with the hypothesis that GABA inhibits neurosecretion by
      retarding impulse propagation into the terminal arborization. These results
      support a depolarization block mechanism for the inhibition of secretion, in
      which depolarization inactivates Na+ channels sufficiently to block action
      potentials.

PMID- 7776246
TI  - Action potential propagation and propagation block by GABA in rat posterior
      pituitary nerve terminals.
AB  - 1. A theoretical model was developed to investigate action potential propagation
      in posterior pituitary nerve terminals. This model was then used to evaluate the
      efficacy of depolarizing and shunting GABA responses on action potential
      propagation. 2. Experimental data obtained from the posterior pituitary with
      patch clamp techniques were used to derive empirical expressions for the voltage
      and time dependence of the nerve terminal Na+ and K+ channels. The essential
      structure employed here was based on anatomical and cable data from the posterior
      pituitary, and consisted of a long cylindrical axon (diameter, 0.5 mm) with a
      large spherical swelling (diameter, 4-21 mm) in the middle. 3. In the absence of
      an inhibitory conductance, simulated action potentials propagated with high
      fidelity through the nerve terminal. Swellings could block propagation, but only
      when sizes exceeded those observed in the posterior pituitary. Adding axonal
      branches reduced the critical size only slightly. These results suggested that
      action potentials invade the entire posterior pituitary nerve terminal in the
      absence of inhibition or depression. 4. The addition of inhibitory conductance to
      a swelling caused simulated action potentials to fail at the swelling.
      Depolarizing inhibitory conductances were 1.6 times more effective than shunting
      inhibitory conductances in blocking propagation. 5. Inhibitory conductances
      within the range of experimentally observed magnitudes and localized to swellings
      in the observed range of sizes were too weak to block simulated action
      potentials. However, twofold enhancement of GABA responses by neurosteroid
      resulted in currents strong enough to block propagation in realistic swelling
      sizes. 6. GABA could block simulated propagation without neurosteroid enhancement
      provided that GABA was present throughout a region in the order of a few hundred
      micrometres. For this widespread inhibition depolarizing conductance was 2.2
      times more effective than shunting conductance. 7. These results imply two modes
      of propagation block, one resulting from highly localized release of inhibitory
      transmitter under conditions potentiating GABA responses, and the other resulting
      from widespread release of GABA in the absence of receptor potentiation. 8. The
      Na+ channels of the posterior pituitary nerve terminal have a unique voltage
      dependence that allows small depolarizations to inactivate without causing
      activation. The voltage dependence of this Na+ channel may serve as a specialized
      adaptation that facilitates in allowing small depolarizing conductances to block
      action potential propagation.

PMID- 7776247
TI  - Modulation by zinc ions of native rat and recombinant human inhibitory glycine
      receptors.
AB  - 1. The effect of the divalent cation Zn2+ on inhibitory glycine receptor (GlyR)
      currents was investigated in rat embryonic spinal cord neurons and Xenopus
      oocytes expressing recombinant GlyRs. 2. In cultured spinal neurons, Zn2+
      potentiated glycine-induced whole-cell currents about 3-fold when applied
      extracellularly at concentrations of 0.5-10 microM. In contrast, higher
      concentrations (> 100 microM) of Zn2+ decreased the glycine response. 3. A
      similar biphasic modulation of glycine-induced currents by Zn2+ was also found
      with recombinant homo- and hetero-oligomeric GlyRs generated in Xenopus oocytes.
      Dose-response analysis showed that both the potentiating and inhibitory effects
      of Zn2+ result from changes in apparent agonist affinity. 4. Analysis of chimeric
      constructs of the GlyR alpha 1- and beta-subunits revealed that the positive and
      negative modulatory effects of Zn2+ are mediated by different regions of the
      alpha 1-subunit. 5. Our data indicate the existence of distinct high- and low
      affinity Zn2+ binding sites on the ligand-binding alpha-subunits of the GlyR.
      These sites may be implicated in the regulation of synaptic efficacy within
      glycinergic pathways.

PMID- 7776248
TI  - Subthreshold oscillations and resonant frequency in guinea-pig cortical neurons:
      physiology and modelling.
AB  - 1. Intracellular recordings were made from neurons in slices from guinea-pig
      frontal cortex. In 50% of the cells, sustained subthreshold voltage oscillations
      were evoked by long (> 6 s) depolarizing pulses. The peak-to-peak amplitude of
      these oscillations was less than 5 mV and the frequency was voltage dependent,
      increasing with depolarization from 4 (near rest) to 20 Hz (at 30 mV
      depolarization). 2. The impedance-frequency relationship of both oscillating and
      non-oscillating cells was studied by intracellular injection of sinusoidal
      current with linearly changing frequency. In most cells, a peak in the impedance
      magnitude (resonant behaviour) was observed at depolarized levels. The frequency
      of the peak impedance (peak frequency) increased with depolarization from 3 (near
      rest) to 15 Hz (at 30 mV depolarization). 3. Application of TTX (10(-6) M)
      significantly decreased the impedance magnitude near the peak frequency. The
      subthreshold oscillations, however, as well as the action potentials, were fully
      blocked by TTX. On the other hand, TEA (15 mM) and Cs+ (5 mM) abolished both the
      subthreshold oscillations and the resonant behaviour. Replacing Ca2+ with Co2+ (5
      mM) or Ni2+ (1 mM) did not abolish the subthreshold oscillations. The peak in the
      frequency-response curve was only slightly reduced. 4. An isopotential membrane
      model, consisting of a leak current, a fast persistent sodium current, a slow non
      inactivating potassium current (with the kinetics of the M-current) and membrane
      capacitance, is sufficient to produce both voltage oscillations and resonant
      behaviour. The kinetics of the K+ current by itself is sufficient to produce
      resonance behaviour. The Na+ current amplifies the peak impedance magnitude and
      is essential for the generation of subthreshold oscillation. The model correctly
      predicted the behaviour of the frequency response before and after TTX and TEA
      application, as well as the relation between the expected passive impedance and
      the experimental impedance. 5. We speculate that the tendency of the neurons to
      generate voltage signals at a certain frequency (as a result of the subthreshold
      oscillations) and to preferentially respond to inputs arriving at the same
      frequency (the resonance behaviour) promotes population activity at that
      preferred frequency.

PMID- 7776249
TI  - Synaptic and membrane mechanisms underlying synchronized oscillations in the
      ferret lateral geniculate nucleus in vitro.
AB  - 1. The cellular basis for generation of spindle waves and a slower synchronized
      oscillation resembling absence seizures was investigated with extracellular and
      intracellular recording techniques in slices of ferret dorsal lateral geniculate
      nucleus (LGNd) maintained in vitro. 2. Intracellular recording from LGNd relay
      cells in vitro revealed that spindle waves occurred once every 3-30 s and were
      associated with barrages of inhibitory postsynaptic potentials (IPSPs) occurring
      at a frequency of 6-10 Hz. These IPSPs resulted in the generation of rebound low
      threshold Ca2+ spikes at 2-4 Hz, owing to the intrinsic propensity of LGNd relay
      cells to generate oscillatory burst firing in this frequency range. These rebound
      bursts of action potentials were highly synchronized with local multiunit and
      single unit activity. 3. The spindle wave-associated IPSPs in LGNd relay cells
      exhibited a mean reversal potential of -86 mV. This reversal potential was
      shifted to more depolarized membrane potentials with the intracellular injection
      of Cl- through the use of KCl-filled microelectrodes. Simultaneous recording from
      the perigeniculate nucleus (PGN) and LGNd revealed the IPSPs to be synchronous
      with the occurrence of burst firing in the PGN. Excitation of PGN neurons with
      local electrical stimulation after pharmacological block of excitatory amino acid
      transmission resulted in bicuculline-sensitive IPSPs in relay neurons similar in
      amplitude and time course to those occurring during spindle waves. 4. Application
      of (-)-bicuculline methiodide resulted in the abolition of spindle wave
      associated IPSPs or in the slowing of the rate of rise, an increase in amplitude
      and a prolongation of these IPSPs; this resulted in a synchronized 2-4 Hz
      oscillation, in which each relay cell strongly burst on nearly every cycle, thus
      forming a paroxysmal event. Bath application of the GABAB receptor antagonist 2
      OH-saclofen blocked these slowed oscillations, indicating that they are mediated
      by the activation of GABAB receptors. In contrast, pharmacological antagonism of
      GABAB receptors did not block the generation of normal spindle waves. 5. These
      and other results indicate that spindle waves are generated in the ferret LGNd in
      vitro as a network phenomenon occurring through an interaction between the relay
      cells of the LGNd and the GABAergic neurons of the PGN. We propose that burst
      firing in PGN cells hyperpolarizes relay neurons through activation of GABAA
      receptors. These IPSPs result in rebound burst firing in LGNd cells, which then
      excite PGN neurons.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7776251
TI  - Step phase-related excitability changes in spino-olivocerebellar paths to the c1
      and c3 zones in cat cerebellum.
AB  - 1. Chronically implanted microwires were used to record extracellular field
      potentials generated in the c1 and c3 zones in the cortex of lobules V and VI of
      the cerebellum by non-noxious stimuli delivered to the superficial radial nerve
      in the ipsilateral forelimb. Responses due to input via climbing fibre afferents
      were studied; their latency and other characteristics identified them as mediated
      mainly via the dorsal funiculus spino-olivocerebellar path (DF-SOCP). 2.
      Responses at individual sites were studied repeatedly with a range of stimulus
      intensities and during two different behaviours: quiet rest and steady walking on
      an exercise belt. For responses during walking, step histograms were constructed
      showing response mean size during different tenths of the step cycle in the
      ipsilateral forelimb, both in absolute terms and relative to mean size during
      rest. 3. Step histograms for the same site on different days or different
      stimulus intensities varied appreciably in form but in both cases the timing of
      the largest response was usually the same or shifted by only one step tenth. 4.
      In both zones the largest responses during walking occurred overwhelmingly during
      the E1 step phase when the limb is extended forwards and down to establish
      footfall. Least responses were much less uniform in timing but were mostly during
      stance, particularly its early (E2) part. 5. In many histograms the smallest
      responses were smaller in mean size than the responses during rest while the
      largest were larger. These changes were not paralleled by changes in nerve volley
      size, so presumably reflect step-related central changes in pathway excitability.
      Facilitations and depressions were differently affected by stimulus intensity and
      sometimes occurred independently, suggesting generation by separate mechanisms.
      6. In both zones there were differences between recording sites which suggests
      that different DF-SOCP subcomponents innervate different parts of the zones.
      However, no systematic differences could be firmly established between the medial
      and lateral subzones of the c1 zone. 7. The results are discussed in relation to
      the hypothesis that the DF-SOCP constitutes the afferent limb of a
      transcerebellar mechanism involved in adapting the evolving step.

PMID- 7776250
TI  - Role of the ferret perigeniculate nucleus in the generation of synchronized
      oscillations in vitro.
AB  - 1. The cellular mechanisms by which neurons of the ferret perigeniculate nucleus
      (PGN) participate in the generation of spindle waves and slowed absence seizure
      like oscillations were investigated with intracellular and extracellular
      recording techniques in geniculate slices maintained in vitro. 2. During spindle
      wave generation, PGN neurons generated repetitive (2-9 Hz) high frequency (up to
      500 Hz) burst discharges mediated by the activation of a low threshold Ca2+ spike
      by the arrival of barrages of excitatory postsynaptic potentials (EPSPs). In most
      PGN cells at resting membrane potentials (-60 to -70 mV) spindle waves were
      associated with a progressive hyperpolarization that persisted as a prolonged
      after-hyperpolarization. 3. The EPSPs occurring in PGN cells were highly
      synchronized with burst firing in the neighbouring portion of the dorsal lateral
      geniculate nucleus (LGNd) and were intermixed with short duration inhibitory
      postsynaptic potentials (IPSPs). After block of GABAergic receptors, the EPSPs
      occurring during the generation of spindle waves reversed polarity at around 0
      mV. In addition, these EPSPs were completely blocked with the bath application of
      the non-NMDA receptor antagonist 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX), as
      was spindle wave generation in both the PGN and LGNd. 4. Slowing the intraspindle
      frequency to 2-4 Hz with pharmacological block of GABAA receptors resulted in a
      marked increase in the intensity of burst firing by PGN cells such that the
      number of action potentials per burst increased from a maximum of thirteen to a
      maximum of sixty. Block of GABAA receptors also resulted in a marked increase in
      the amplitude and duration of the EPSP barrages arriving from the relay laminae
      during generation of the slowed oscillation. 5. These findings indicate that
      spindle waves are generated in the ferret LGNd in vitro through an interaction
      between the GABAergic neurons of the PGN and relay neurons, such that burst
      firing in relay neurons activates a barrage of EPSPs and a subsequent low
      threshold Ca2+ spike in PGN cells. This activation of PGN neurons inhibits a
      substantial number of relay cells, a few of which rebound burst after this IPSP,
      thus starting the cycle again. Block of GABAA receptors results in a marked
      enhancement of activity in PGN cells through increased excitation from relay
      cells and disinhibition from neighbouring PGN cells. This increased activity in
      PGN neurons results in a markedly enhanced activation of GABAB receptors in relay
      neurons and the subsequent generation of paroxysmal activity that is similar to
      that associated with absence seizures.

PMID- 7776252
TI  - Pivotal role of phosphate chain length in vasoconstrictor versus vasodilator
      actions of adenine dinucleotides in rat mesenteric arteries.
AB  - 1. The isolated perfused rat mesenteric arterial bed was used to examine the
      activity of the adenine dinucleotides: beta-nicotinamide adenine dinucleotide
      (NAD); beta-nicotinamide adenine dinucleotide phosphate (NADP); flavin adenine
      dinucleotide (FAD); and of the alpha,omega-diadenosine polyphosphates: adenylyl
      adenosine (AP1A); P1,P2-diadenosine pyrophosphate (AP2A); P1,P3-diadenosine
      triphosphate (AP3A); P1,P4-diadenosine tetraphosphate (AP4A); P1,P5-diadenosine
      pentaphosphate (AP5A); P1,P6-diadenosine hexaphosphate (AP6A). Responses were
      compared with those of ADP, ATP, 2-methylthio-ATP (2-meSATP) and alpha,beta
      methylene ATP (alpha,beta-meATP). 2. In basal tone preparations mono- and
      dinucleotides elicited vasoconstriction with the order of potency: alpha,beta
      meATP > or = AP5A > or = AP6A > or = AP4A > or = 2-meSATP >> ATP >> ADP. The
      dinucleotides NAD, NADP, FAD, AP1A, AP2A and AP3A had no effect. 3. The P2X
      purinoceptor antagonist pyridoxalphosphate-6-azophenyl-2',4'-disulphonic acid (30
      microM) virtually abolished vasoconstrictor responses to AP4A, AP5A and AP6A. 4.
      Auto- and cross-desensitization of vasoconstrictor responses to AP4A, AP5A, AP6A,
      ATP and alpha,beta-meATP were observed. 5. In raised tone preparations
      nucleotides elicited endothelium-dependent vasodilatation with the order of
      potency: 2-meSATP = ADP > ATP > AP3A > AP2A > AP1A = NADP = FAD > NAD. The
      nucleotides AP4A, AP5A, AP6A and alpha,beta-meATP had no vasodilator effects. 6.
      It is concluded that the alpha,omega-adenine dinucleotides AP4A, AP5A and AP6A
      elicit vasoconstriction, but not vasodilatation, in the rat mesenteric arterial
      bed via P2x-purinoceptors. In contrast, the dinucleotides NADP, FAD, AP1A, AP2A
      and AP3A elicit vasodilatation, but not vasoconstriction, via endothelial P2Y
      purinoceptors. 7. It is suggested that there is a crucial relationship between
      the structure of the alpha,omega-diadenosine polyphosphates and their activity at
      P2X- and P2Y-purinoceptors with a pivotal role played by the polyphosphate chain.
      Molecules with four or more phosphates are vasoconstrictors, while those with
      three or less phosphates are vasodilators.

PMID- 7776253
TI  - Flow-dependent regulation of arteriolar diameter in rat skeletal muscle in situ:
      role of endothelium-derived relaxing factor and prostanoids.
AB  - 1. Arteriolar diameter in the resting rat spinotrapezius muscle was studied by
      intravital video microscopy before and after blockade of the L-arginine-EDRF (NG
      nitro-L-arginine, L-NNA) or the cyclo-oxygenase-prostacyclin (indomethacin)
      pathway. Blockade of either pathway leads to a decrease of arteriolar diameter of
      25-40%, while the combined blockade of both results in vasoconstriction of 50
      60%. 2. Alteration of blood flow velocity elicited by partial micropipette
      occlusion induces corresponding changes of vessel diameter. The flow-dependent
      diameter response is reduced by about 80% by L-NNA. By contrast, blockade of
      prostanoid production shows no significant influence on vessel response to blood
      flow alteration in the range tested. 3. Transient overshooting vasodilatation is
      seen for about 1 min following the sudden restoration of flow velocity subsequent
      to occlusion. In contrast to the initial phase of this response, the late phase
      is blocked by L-NNA. 4. The findings suggest that basal release of endothelium
      derived relaxing factor (EDRF) and prostanoids leads to additive and independent
      dilator effects, and that flow-dependent diameter changes are primarily mediated
      by EDRF. 5. If present data are compared with literature reports, it appears that
      arterial flow sensitivity is most pronounced in the smallest vessels. In such
      vessels, flow-dependent dilatation will amplify even small changes of volume flow
      by more than four times.

PMID- 7776254
TI  - Prevention of the excitatory actions of bradykinin by inhibition of PGI2
      formation in nodose neurones of the guinea-pig.
AB  - 1. Intracellular recordings were made from neurones in intact guinea-pig nodose
      ganglia in vitro and from acutely isolated adult guinea-pig and rabbit nodose
      neurons to study a bradykinin (BK)-mediated block of a slow spike after
      hyperpolarization (AHPslow) that is prominent in 30-40% of these neurones. 2. BK
      (100 nM) reversibly blocked the AHPslow, resulting in an ablation of the spike
      accommodative properties of these neurones. The B1 BK receptor agonist [des-Arg9]
      BK did not mimic or prevent the actions of BK. In contrast, the B2 BK receptor
      antagonist D-Arg-[Hyp3,Thi5,D-Tic7,Oic8]-BK (HOE 140) prevented BK-induced block
      of the AHPslow and the effect of BK on spike frequency adaptation. 3. The BK
      block of the AHPslow in acutely dissociated neurones was prevented by
      indomethacin, indicating that this BK effect was dependent upon a cyclo-oxygenase
      metabolite intrinsic to these neurones. 4. One to twenty femtomoles of the
      prostanoids PGE2, PGD2, 9 alpha, 11 beta-PGF2 (a metabolite of PGD2), PGF2 alpha,
      TxB2 and PGI2 were released spontaneously from a nodose ganglion in 15 min. BK
      (100 nM) selectively increased PGI2 release 2.8-fold without affecting the
      release of the other prostanoids. Treatment with 10 microM tranylcypromine (TCP),
      a putative PGI2 synthase inhibitor, completely prevented the BK-induced release
      of PGI2. 5. In the presence of 10 microM TCP, BK no longer produced significant
      effects on the AHPslow. In contrast, 10 microM TCP did not prevent PGI2 from
      blocking the AHPslow. 6. These results suggest that vagal afferents that exhibit
      AHPslow also possess the B2 type of BK receptor. Activation of these BK receptors
      results in the production of PGI2, which in turn controls spike frequency
      adaptation by affecting the amplitude of the AHPslow.

PMID- 7776255
TI  - Evidence for two different heat transduction mechanisms in nociceptive primary
      afferents innervating monkey skin.
AB  - 1. Mechano- and heat-sensitive A fibre nociceptors (AMHs) and C fibre nociceptors
      (CMHs) in hairy skin (forty-six AMHs and twenty-one CMHs) and in glabrous skin
      (fifty-nine AMHs and ten CMHs) of anaesthetized monkeys were tested with a 30 s,
      53 degrees C heat stimulus, delivered by a laser thermal stimulator (0.1 s rise
      time, 7.5 mm diameter). 2. Two types of heat response were observed in hairy skin
      AMHs. Type I AMHs had a peak discharge towards the end of the stimulus, response
      latencies to heat of up to several seconds, a median heat threshold greater than
      53 degrees C, and a mean conduction velocity of 25 m s-1 (n = 33). Type II AMHs
      had a peak discharge within 1-3 s, a mean response latency of 120 ms, a median
      heat threshold of 46 degrees C, and a mean conduction velocity of 15 m s-1 (n =
      13). Type I AMH fibres were sensitized to heat, whereas heat responses of type II
      AMHs were suppressed following the intense heat stimulus. 3. In glabrous skin,
      only type I AMHs were found. The absence of type II AMHs is consistent with the
      absence of first pain to heat in glabrous skin. 4. C fibre nociceptors in hairy
      skin had a peak discharge near stimulus onset, a mean response latency of 100 ms
      and a median heat threshold of 41 degrees C. Heat responses of CMHs in glabrous
      skin were not significantly different from those in hairy skin. 5. Only type II
      AMHs had response latencies that were short enough to explain first pain to heat.
      Heat thresholds of type II AMHs were significantly higher than those of CMHs. 6.
      These results suggest two different heat transduction mechanisms in nociceptive
      afferents. For one, heat energy is quickly transduced into action potentials, and
      the peak discharge is reached soon after stimulus onset. For the other, the
      transduction of heat is distinctly slower, and the peak discharge occurs near the
      end of the stimulus. Chemically mediated sensitization may be involved in the
      second transduction mechanism.

PMID- 7776256
TI  - Functional classification of afferent phrenic nerve fibres and diaphragmatic
      receptors in cats.
AB  - 1. Single afferent fibres with receptive fields in the diaphragm (272 units)
      dissected from the right phrenic nerve were classified according to the following
      properties: reaction to contraction of the diaphragm, resting activity,
      conduction velocity, location and properties of receptive fields, and reaction to
      injection of bradykinin and lactic acid into the internal thoracic artery. Nine
      additional fibres dissected from the phrenic nerve had receptive fields outside
      the diaphragm. The experiments were performed on chloralose-anaesthetized cats.
      2. Ninety-six fibres (36%) had high resting activity when unloaded by contraction
      of the diaphragm, had low-threshold receptive fields in the muscle and were
      mostly group II and III fibres. They probably innervated muscle spindles. 3.
      Eighty-eight fibres (32%) were vigorously activated by contraction of the
      diaphragm. They had low-threshold receptive fields located in the
      musculotendinous border and central tendon. Their conduction velocity was in the
      range for group II and III fibres. We infer that they may innervate tendon
      organs. 4. Eighty-eight fibres (32%) were slightly affected or not affected by
      diaphragmatic contraction. They had low- and high-threshold receptive fields
      located mostly in the muscular part of the diaphragm, and negligible resting
      activity. Most of them were group III and IV afferent fibres and were activated
      when bradykinin and lactic acid were applied to their receptive fields. Possibly
      these low- and high-threshold receptors innervated diaphragmatic ergo- and
      nociceptors, respectively. 5. Sensory outflow from the diaphragm was found to be
      somatotopically organized, so that fibres with receptive fields in the
      sternocostal portion were predominantly located in the upper phrenic nerve root,
      and those with lumbar receptive fields were in the lower root. 6. It is concluded
      that the phrenic nerve contains fibres from several distinct classes of sensory
      receptors: muscle spindles, tendon organs, ergoceptors and nociceptors. The
      sensory diaphragmatic outflow to the spinal cord is somatotopically organized.

PMID- 7776257
TI  - Adenosinergic modulation of respiratory neurones and hypoxic responses in the
      anaesthetized cat.
AB  - 1. The modulatory effects of intracellularly injected adenosine on membrane
      potential, input resistance and spontaneous or evoked synaptic activity were
      determined in respiratory neurones of the ventral respiratory group. 2. The
      membrane potential hyperpolarized and sometimes reached values which were beyond
      the equilibrium potential of Cl(-)-dependent IPSPs. At the same time, neuronal
      input resistance decreased. 3. Spontaneous and stimulus-evoked postsynaptic
      activities were decreased, as were mean respiratory drive potentials. 4. Systemic
      injection of the A1 adenosine receptor antagonist 8-cyclopentyl-1,3
      dipropylxanthine (DPCPX; 0.01-0.05 mg kg-1) resulted in an increase in mean peak
      phrenic nerve activity when arterial chemoreceptors were denervated. In contrast,
      phrenic nerve activity decreased when arterial chemoreceptors were left intact.
      5. The depressant effect of adenosine on synaptic activity was abolished after
      systemic DPCPX administration. DPCPX caused an increase in respiratory drive
      potentials, increased the amplitude of stimulus-evoked IPSPs, and hyperpolarized
      membrane potential. 6. Administration of DPCPX blocked the early hypoxic
      depression of stimulus-evoked IPSPs, doubled the delay of onset of hypoxic apnoea
      and shortened the time necessary for recovery of the respiratory rhythm. 7. The
      data indicate that adenosine acts on pre- and postsynaptic A1 receptors resulting
      in postsynaptic membrane hyperpolarization and depression of synaptic
      transmission. Blockade of A1 receptors increases respiratory activity, indicating
      that adenosine A1 receptors are tonically activated under control conditions.
      Further activation contributes to the hypoxic depression of synaptic transmission
      in the respiratory network.

PMID- 7776258
TI  - Receptive field characteristics of tactile units with myelinated afferents in
      hairy skin of human subjects.
AB  - 1. Impulses in single nerve fibres from the lateral antebrachial cutaneous nerve
      were recorded using the microneurography technique in human subjects. 2. In a
      sample of fifty-five mechanoreceptive units with fast-conducting nerve fibres,
      five types were identified, i.e. SAI (slowly adapting type I, Merkel), SAII
      (slowly adapting type II, Ruffini), hair units, field units and Pacinian-type
      units. The latter three unit types were all rapidly adapting. 3. The detailed
      structure of thirty-five receptive fields of SAI, SAII, hair and field units was
      explored with a method which was objective and independent of the experimenter's
      skill and experience. A lightweight probe was used to scan the receptive field
      area in a series of tracks 0.23 mm apart while single-unit activity was recorded.
      4. SAI fields were small and composed of two to four well-separated high
      sensitivity spots and often, in addition, one minor spot of lower sensitivity.
      SAII units typically fired spontaneously at a low and regular rate. Most fields
      consisted of one single spot of high sensitivity with diffuse borders. The hair
      units innervated ten to thirty-three (or more) hairs, which were evenly
      distributed over a large area. The field units were characterized by a number of
      small and closely packed high-sensitivity spots with diffuse borders. A
      conservative estimate indicated eleven spots per unit. 5. The findings indicate
      that the sheet of mechanoreceptors on the skin of the forearm is distinctly
      different from that on the dorsum of the hand and in the face. It seems
      reasonable to assume that the former is more representative for the hairy skin
      covering the main parts of the body.

PMID- 7776259
TI  - Human perceptual learning in identifying the oblique orientation: retinotopy,
      orientation specificity and monocularity.
AB  - 1. Human perceptual learning in discrimination of the oblique orientation was
      studied using psychophysical methods. Subjects were trained daily to improve
      their ability to identify the orientation of a circular 2.5 deg diameter
      unidimensional noise field. Dramatic improvements in sensitivity to contour
      orientation occurred over a period of 15-20 days. The improved performance
      persisted for several months. Improvement was more evident between daily sessions
      than within sessions. This was partly due to fatigue interfering with the
      learning effect. Moreover, a consolidation period seemed to be required. 2.
      Improvement was restricted to the position of the stimulus being trained. This
      position dependency of the learning effect proved very precise. After training at
      a specific stimulus position, merely displacing the stimulus to an adjacent
      position caused a marked increase in thresholds. 3. No transfer of the training
      effect was observed between orientations. Following a shift of 90 deg away from
      the trained orientation, performance fell, even below the initial level. 4. We
      observed complete to almost complete transfer between the two eyes. 5. Our
      results suggest plastic changes at a level of the visual processing stream where
      input from both eyes has come together, but where generalization for spatial
      localization and orientation has not yet occurred.

PMID- 7776260
TI  - Distribution of p21ras during primary palate formation of non-cleft and cleft
      strains of mice.
AB  - Cleft lip, with or without cleft palate, is one of the most common defects in
      craniofacial formation. The primary palatogenesis of mice is similar to that of
      humans and spontaneous cleft lip is associated with genotype in both mice and
      humans. To investigate the temporal and spatial expression of ras genes in cleft
      (A/WySn) and non-cleft strains of mice (BALB/cBy), a broad spectrum ras antibody
      was used. Positive staining was found in ectodermal, mesenchymal, and
      neuroepithelial cells of facial prominences before the primary palate formation
      stage (10 d 20 hr) in both strains. During the primary palate formation stage (11
      d 20 hr), positive staining was found in the ectodermal and mesenchymal cells of
      the facial prominences of the non-cleft strain but not in those of the cleft
      strain. These results suggest ras genes may play a role in the primary
      palatogenesis of mice. Cleft lip could be associated with the deficiency of ras
      gene expression during primary palate formation of mice.

PMID- 7776261
TI  - Detection of Epstein-Barr virus DNA in tongue tissues from AIDS autopsies without
      clinical evidence of oral hairy leukoplakia.
AB  - Epstein-Barr virus (EBV) DNA was detected by in situ hybridization at 3 sites of
      30 samples taken from clinically normal lateral border of tongue mucosa from 15
      AIDS autopsies and in none of 20 samples from 10 controls. The first positive
      case showed a thin layer of parakeratosis correlated with positive signals for
      EBV in one area and an adjacent area without obvious parakeratosis was also
      positive for EBV. These findings were present on both sides of the tongue. The
      second case was unilaterally positive for EBV and parakeratosis was absent. The
      hybridization signals were localised to koilocyte-like cells in the stratum
      spinosum, as in oral hairy leukoplakia (OHL). These observations suggest that the
      in situ hybridization technique can detect very early or subclinical OHL, and
      supports the role of EBV in the pathogenesis of this lesion.

PMID- 7776262
TI  - Proteoglycan changes in carcinogen (4NQO)-treated rat tongue mucosa.
AB  - The purpose of this study was to undertake preliminary analyses of the
      extracellular proteoglycans in carcinogen [4-nitroquinoline N-oxide (4NQO)]
      treated rat tongue mucosa. Experimental rats were exposed to twice-weekly
      applications of 4NQO in propylene glycol for six months, after which the animals
      were killed. Control and 4NQO-treated tissues were subjected to sequential
      aqueous extractions of proteoglycans under associative and dissociative
      conditions, followed by alkaline cleavage of protein-glycosaminoglycan linkages
      to yield a glycosaminoglycan residue. Tissues subjected to 4NQO applications
      contained smaller proportions of proteoglycans which were readily soluble under
      associative and dissociative conditions. Proportionately more proteoglycan
      remained strongly associated with other intercellular tissue components, being
      released only by alkaline cleavage. These biochemical alterations in preinvasive
      4NQO-treated epithelium and connective tissues, together with an observed
      associated change in water retention by the connective tissue, occurred prior to
      actual neoplastic invasion and suggest differences in macromolecular conformation
      and orderliness. We hypothesize that these changes are related to the phenomenon
      of neoplastic epithelial invasion.

PMID- 7776263
TI  - Induction of carcinomas and sarcomas by 9,10-dimethyl-1,2-benzanthracene
      administration into the hamster maxillary sinus.
AB  - To determine whether the local administration of 9,10-dimethyl-1,2-benzanthracene
      (DMBA) into the hamster maxillary sinus induced carcinoma at the injected site,
      hamsters were injected with 30 microliters of 0.5% solution of DMBA in dimethyl
      sulfoxide (DMSO) through the infraorbital foramen into the maxillary sinus once
      weekly for 10 weeks (Group 2). Another group of hamsters (Group 1) received
      similar injections of 30 microliters of DMSO only. In a third group of animals
      (Group 3), a roll of oxycellulose was inserted into the maxillary sinus and 40
      microliters of a 2% solution of DMBA in DMSO was injected once. Sinonasal
      carcinomas were demonstrated in 73% (8/11) of the hamsters in Group 2 and
      sarcomas were shown in 73% (8/11) of the hamsters in Group 3, as well as some
      carcinomas. No tumors were seen in the Group 1 hamsters. Histologic examination
      revealed squamous cell carcinomas arising from the surface epithelium and
      submucous glands of the nasal cavity and maxillary sinus. These findings indicate
      that the intrasinal administration of a 0.5% solution of DMBA in DMSO is a
      reliable method for inducing maxillary sinus cancer.

PMID- 7776264
TI  - Ultrastructural finding of vascular degeneration in fibrodysplasia ossificans
      progressiva (FOP).
AB  - The masseter and temporalis muscles were investigated ultrastructurally in 2
      patients having fibrodysplasia ossificans progressiva (FOP). Results showed
      atrophy and necrosis of muscle fibres. Both cases contained cartilage which was
      calcified in the second case and was associated with degenerating chondrocytes.
      The blood vessels showed various changes, with haematoma formation and large
      fibrin deposits. Some of the fibrin deposits seen in the second case were
      surrounded with cartilage. This suggests that the cartilage probably forms as a
      reaction to an old haemorrhage. It is possible that the effect of the mutant gene
      found in FOP is on blood vessels rather than the normal regulatory mechanisms of
      the inducible osteogenic precursor cells. These degenerating blood vessels often
      result in haemorrhage and fibrin deposits; the fibrosis, cartilage or bone
      formation are probably secondary changes. Amianthoid fibres found in the tendon
      of the temporalis muscles of the second case, together with the other changes of
      fibrosis and cartilage formation, account for the severe restricted mouth opening
      suffered by these patients.

PMID- 7776265
TI  - Histochemical study of lectin binding in the human fetal minor salivary glands.
AB  - The emerging synthesis of glycoconjugates containing specific oligosaccharides in
      developing human fetal labial and lingual salivary glands has been investigated
      by lectin histochemistry. An avidin-biotin technique was used to study the
      binding of lectins from Ulex europeus I (UEA-I), Dolichos biflorus (DBA), Glycine
      maximus (SBA), Helix pomatia (HPA), Arachis hypogaea (PNA) and Triticum vulgare
      (WGA) to specific sugars on sections of tissue from labial glands, glands of
      Blandin and Nuhn, glands of von Ebner and the dorsoposterior lingual salivary
      glands. Incipient synthesis of glycoconjugates in early glands and their presence
      in the cells and ducts of the later glands was shown. The study also showed a
      time-related increase in both staining intensity and binding sites of serous
      acinar cells from all glands and for all lectins used. For mucous cells, peak
      intensity of staining was reached by the middle phase of development. During
      later gland development this intensity was maintained in dorsoposterior lingual
      glands but tended to decline in labial glands. The various lectins showed
      different degrees of binding but UEA-I lectin generally bound the L-fucose sugar
      group in all salivary glands at all gestational ages. The results showed that
      lectins appear to bind to the oligosaccharides on epithelial cell surfaces of
      fetal salivary glands at all stages of development. The degree of change depends
      upon the stage of differentiation and maturation of the glands.

PMID- 7776266
TI  - Oral manifestations in glycogen storage disease type 1b.
AB  - Glycogen storage disease type 1b is a rare metabolic disorder which affects the
      transport system of glucose-6-phosphatase metabolism. As a result, hepatomegaly,
      failure to thrive, renal dysfunction and recurrent infections occur in affected
      patients. In this paper, the oral complications in three children with glycogen
      storage disease type 1b are discussed. Oral ulcers were a common finding,
      probably due to severe neutropenia and impaired neutrophil migration which
      characterises the onset of this rare disorder.

PMID- 7776267
TI  - Parallel pathways coordinate crawling in the medicinal leech, Hirudo medicinalis.
AB  - Changes in the behavior of crawling leeches were investigated after various kinds
      of manipulations, including selective transection or inactivation of body parts,
      as well as partial or complete transection of the central nerve cord, using a
      frame-by-frame analysis of video tapes of the crawling animals. From these
      studies, we found that: 1. Leeches made rhythmic crawling cycles even after their
      suckers were prevented from contacting the substrate by covering them over with
      glue. Hence, engagement and disengagement of the suckers are not necessary links
      in the crawling cycle. 2. Cutting the small, medial connective (Faivre's nerve)
      had no influence on crawling, but contraction during the whole-body shortening
      reflex was interrupted. Thus two behaviors which use the same motor output (i.e.,
      whole-body shortening and the contraction phase of crawling) are mediated by two
      different pathways. 3. Cutting all the connectives between two ganglia in the
      middle of the leech resulted in a loss of coordination between the parts of the
      animal on either side of the cut. Therefore, temporally coordinated sucker
      activity must be mediated through these connectives. 4. Pieces of leech bodies
      produced by complete transection produced rhythmic crawling cycles as long as the
      pieces included the head or tail plus 2-4 adjacent midbody segments. In all
      cases, the crawling movements progressed without delays as the movements reached
      the cut ends. Pieces of animals that included only midbody segments did not
      produce crawling movements. 5. These results can be explained by a model composed
      of intersegmental pathways for both elongation and contraction, circuits in the
      head and tail brains that switch between elongation and contraction, and both
      ascending and descending inhibitory influences that determine when the cycle
      switches from elongation to contraction and back again.

PMID- 7776268
TI  - Stiffness changes in chick hair bundles following in vitro overstimulation.
AB  - 1. The in vitro effect of intense stimulation on the micromechanical stiffness of
      hair cell sensory hair bundles was studied at three locations on the chick
      basilar papilla. Threshold levels of hair bundle motion, produced by a water jet
      stimulus, were examined before and after exposure to a 300 Hz water jet stimulus
      set at 25 dB above the pre-exposure threshold level. 2. Threshold levels of
      motion were systematically examined in 8 unexposed control cells. The level of
      water jet stimulus needed to achieve the detection threshold of motion remained
      constant in these cells when periodically tested over a 36.5-min interval. 3.
      Post-exposure changes in the motion detection threshold of hair bundles were
      examined in 82 hair bundles, and a number of effects were identified: 2.4% of the
      hair bundles showed no threshold changes; 31.7% of the hair bundles had threshold
      shifts which indicated an increase in stiffness; 18.3% exhibited a threshold
      shift that indicated a decrease in hair bundle stiffness, but with no recovery;
      and 47.6% had thresholds that indicated a decrease in hair bundle stiffness with
      recovery to pre-exposure levels within 16-18 min. 4. The results suggest that
      chick hair bundles exhibit complex and varied responses to overstimulation which
      are very different from that seen in the mammal.

PMID- 7776269
TI  - Acoustic response properties of single neurons in the central posterior nucleus
      of the thalamus of the goldfish, Carassius auratus.
AB  - Acoustic responses were recorded extracellularly from single neurons in the
      thalamic central posterior nucleus (CP). Spontaneous activity, best sensitivity,
      and sharpness of tuning (Q10dB) of CP neurons ranged from 0 to 36 spikes/s, -40
      to 5 dB re: 1 dyne/cm2, and 0.18 to 1.80, respectively. The distribution of
      characteristic frequency (CF) was nonuniform with a mode at 195 Hz. Temporal
      response patterns of CP neurons (N = 60) were categorized into three groups:
      phasic (25%), tonic chopper-like (22%), and tonic nonchopper-like (53%) on the
      basis of peri-stimulus time and inter-spike interval histograms. Most CP neurons
      (90%) did not phase-lock to tones, and none phase-locked strongly. The properties
      of CP neurons are similar to those of the midbrain torus semicircularis neurons
      in spontaneous rates, best sensitivities, nonuniform CF distributions, and in
      exhibiting level-independent best frequencies. Both CP and toral neurons show a
      diversity of response patterns resembling those found in the mammalian central
      auditory system. However, CP neurons have broader tuning and less phase-locking
      than toral neurons, suggesting different roles in auditory processing. While
      peripheral frequency analysis is enhanced at the midbrain level, the integration
      of frequency-selective channels in the thalamus may function in the processing of
      wideband spectra characteristic of natural sound sources.

PMID- 7776270
TI  - Current blood transfusion practice in aortic aneurysm surgery in Scotland. The
      Scottish Vascular Audit Group.
AB  - A questionnaire on current practice in blood transfusion during aortic aneurysm
      repair was sent to all consultant surgeons with a vascular interest practising in
      Scotland. Replies were received from 31 surgeons. A blood ordering schedule was
      operated by 29 surgeons for elective operations and 26 surgeons for emergency
      operations. The mean number of units of red cell concentrate ordered was 4.7
      units for elective operations (range 3-8 units) and 8 units for emergency
      operations (range 6-12 units). The time estimated to obtain red cell concentrate
      was 38.2 min (range 15-90 min) for a new request and 8.8 min (range 2-30 min) to
      obtain further blood in a patient already crossmatched. Blood conservation
      techniques employed included the use of low porosity or sealed grafts by 86% of
      surgeons. Autotransfusion was used by six surgeons, but only regularly by three
      surgeons. One surgeon used pre-deposit autologous transfusion and one used
      preoperative haemodilution. Intravenous heparin was used by 90% of surgeons
      during elective operations and by 16% of surgeons during emergency operations.
      Most surgeons used a standard dose of 5000 units of heparin.

PMID- 7776271
TI  - Non-specific abdominal pain: a safe diagnosis?
AB  - Non-specific abdominal pain (NSAP) is a benign condition with low morbidity. This
      follow-up study of 82 patients discharged from an emergency department after
      presenting with abdominal pain, during 1 calendar month, has shown that only 9.6%
      were diagnosed as having NSAP. It has been shown previously that 34.9% to 45.6%
      of patients presenting to an emergency department with abdominal pain will have
      NSAP. One large study showed that 88% of NSAP had improved or resolved at 2-3
      weeks without specific treatment and few required subsequent hospitalization. In
      this study a number of patients were given diagnoses which could not be supported
      from the history or investigations. This is a potentially dangerous practice.
      NSAP is a diagnosis of exclusion and the patient may be reassured that the
      condition is most likely benign or self limiting and allowed home.

PMID- 7776272
TI  - Mesenteric ischaemia: prognostic factors and influence of delay upon outcome.
AB  - The case records of 43 patients with acute mesenteric ischaemia who presented to
      the Professorial Surgical Unit, Aberdeen Royal Infirmary between January 1982 and
      December 1992 were examined. Principal presenting clinical symptoms were acute
      abdominal pain (100%) with diarrhoea in 44% of patients. Abdominal examination
      revealed diffuse non-specific tenderness in 48%, with signs of peritonitis in 52%
      of patients. In 22 of the 43 (51%) patients there was a delay in diagnosis
      (greater than 12 h from the onset of pain). The overall mortality was 70%, and
      three significant prognostic factors were identified--surviving patients had a
      delay in diagnosis of less than 12 h, a normal chest radiograph and a higher
      arterial paO2, (10.0 +/- 1.0 vs 7.7 +/- 1.2, P < 0.05, vs non-survivors), on
      admission to the surgical unit. Twenty-five of the 29 non-surviving patients had
      extensive infarction of small and large intestine, compared with only 1 of the 14
      surviving patients (P < 0.05).

PMID- 7776273
TI  - Open versus laparoscopic cholecystectomy: a comparison of postoperative
      temperature.
AB  - Laparoscopic cholecystectomy has been shown to allow better postoperative
      pulmonary function than open cholecystectomy, with less incidence of lung
      atelectasis. As atelectasis following abdominal surgery is responsible for most
      febrile episodes in the first 48 h, it was postulated that with minimally
      invasive surgery there may be a parallel improvement in the incidence of
      postoperative fever. This study was designed to evaluate this hypothesis. Seventy
      eight patients were randomly divided into two groups. Thirty-eight had an open
      cholecystectomy and 40 underwent the laparoscopic approach. Twenty-one of the 38
      patients (55%) following open cholecystectomy had early febrile episodes compared
      with only 6 of the 40 (15%) in the laparoscopic cholecystectomy group. We
      concluded that there was a lower incidence of febrile episodes following
      laparoscopic cholecystectomy and suggest that this was related to improved
      pulmonary function and minimal surgical trauma.

PMID- 7776274
TI  - Large bowel herniation after laparoscopic cholecystectomy.

PMID- 7776275
TI  - Ergonomics, engineering and surgery of endosurgical dissection.
AB  - Ergonomic analysis of the tasks of endosurgery helps in the design of instruments
      and tasks, and in decreasing the mismatch between human capacities and
      technology. It requires the study of the constraints of working through narrow
      fixed ports and an understanding of how the processes of gripping and dividing
      tissue are determined by its mechanical properties. This formal approach may
      offer more than trial-and-error evolution and haphazard solutions to problems by
      quicker general answers, with shorter learning curves, greater productivity and
      fewer errors, and decreased operator frustration. The first and ultimate benefit
      is for patients undergoing endosurgery.

PMID- 7776276
TI  - Distal first metatarsal osteotomy and adductor release as a treatment of hallux
      valgus.
AB  - A combined bony and soft tissue procedure is reported as a treatment of hallux
      valgus. Satisfactory subjective and objective results were obtained at an average
      follow-up of 49.6 months. There was a 21% incidence of avascular necrosis of the
      first metatarsal head, four out of the 38 patients (10.5%) having developed a
      varus deformity at follow-up.

PMID- 7776278
TI  - The crushed foot.
AB  - Crush-type injuries are potentially serious, and the foot is particularly
      vulnerable. Despite this, they are often inappropriately dismissed as trivial
      when first seen. This tendency to underestimate the severity of the injury is
      reinforced by unimpressive radiographic findings. Poor initial management may
      have significant physical and medicolegal implications. Four recently treated
      cases illustrate the covert severity of crush injuries to the foot.

PMID- 7776277
TI  - A prospective audit of knee arthroscopy: a study of the accuracy of clinical
      diagnosis and therapeutic value of 325 knee arthroscopies.
AB  - A prospective audit of 321 patients (325 knees) placed on the waiting list for
      arthroscopy revealed an accuracy of the preoperative diagnosis of 57%. The
      accuracy of consultants was 71% and the other grades of staff was 49%. The
      operation treated a pathological lesion and was considered to be therapeutic in
      154 knees (47%); an operation was more likely to be therapeutic when the
      preoperative diagnosis was correct (132 knees) than when the diagnosis was
      incorrect (22 knees). Attention to establishing an accurate preoperative
      diagnosis and close supervision of the waiting lists by consultants will reduce
      the number of non-therapeutic arthroscopies.

PMID- 7776279
TI  - Lap seat-belts: still trouble after all these years.
AB  - A series of three cases of severe injury caused by involvement in an accident
      while wearing lap seat-belts is presented. More than 30 years after the term
      'seat-belt syndrome' was coined, attention still requires to be drawn to the
      likely combination of severe spinal and intra-abdominal injuries in such
      patients.

PMID- 7776280
TI  - Rembrandt and medicine.

PMID- 7776281
TI  - Neonatal surgery.
AB  - Advances in the sophistication of operative and anaesthetic techniques and
      progress in pre- and postoperative care have contributed to the improved survival
      of infants undergoing surgery in the neonatal period. Neonatal surgery must be
      concentrated in designated regional centres where expertise of the full range of
      paediatric specialties is available to promote research and development of the
      specialty and to train future generations of paediatric surgeons.

PMID- 7776282
TI  - Results of 3 cm excision margin for melanoma of the scalp.
AB  - Local recurrence and survival were evaluated in 19 patients with melanoma of the
      scalp after conservative local treatment using a standard protocol of 3 cm
      excision margins and split skin grafting. Sixteen men and three women had a mean
      age of 46 years. 12 presented with stage I disease, one with stage II, five with
      stage III, and one with stage IV disease. Nodular melanoma was present in 16
      patients. 17 patients had either Clark level IV or V lesions and mean Breslow
      depth was 3.4 mm (range 0.9-25). Local recurrence occurred in only one patient
      who had an excision biopsy performed. Six of 12 patients with stage I disease
      developed regional adenopathy and only 2 are alive after therapeutic block
      dissection. All patients with stage III and stage IV disease have died. Excision
      using 3 cm margin is adequate to control local disease. Scalp melanoma is a
      specific anatomical subsite associated with a high incidence of regional disease
      and has a poor prognosis. This high risk group of patients may benefit from
      elective lymph node dissection.

PMID- 7776283
TI  - Assessment of a specimen mount for biopsy of impalpable breast lesions.
AB  - Biopsy of the impalpable breast lesion is an increasing part of the surgical
      workload as a result of the National Breast Cancer Screening Programme. A
      specimen mount card has been described to orientate such specimens in three
      dimensions prior to radiological and pathological examination. Experience with
      243 biopsies in this unit has shown it to be a useful aid in determining
      completeness of excision. It may also be used as a guide to further surgery when
      excision is incomplete and breast conservation is the treatment option of choice.

PMID- 7776284
TI  - A multivariate analysis of childhood abdominal pain in Trinidad.
AB  - This is a multivariate analysis of the data recorded in assessing 1158
      consecutive admissions presenting to a children's surgical ward with acute
      abdominal pain. There were 56 binary variables available for entry into the
      analysis. A statistical software package was used to perform a stepwise
      discriminant analysis on the data. The program selected 18 variables as having
      discriminating power in assigning patients to the six diagnostic groups. In order
      of discriminating power these were, mainly, a positive urine culture, the bowel
      history, the findings on rectal examination, the location of abdominal
      tenderness, the presence of a mass, and the white cell count. Lesser
      discriminating potential was assigned to the presence of dehydration; fluid
      levels on erect abdominal films, a rise in temperature, an increased pulse rate,
      the presence of urinary symptoms, and the general appearance of the child. Use of
      these data led to an overall correct classification of 80.7% of cases. It is
      concluded that these variables should be included in the assessment of children
      with acute abdominal pain.

PMID- 7776285
TI  - Preventive behaviors as correlates of periodontal health status.
AB  - OBJECTIVES: This investigation examined current practices of brushing, flossing,
      and periodic dental visits and their association with periodontal health status.
      METHODS: Data were collected using face-to-face interviews and 40-minute in-home
      dental examinations with a probability sample of adults 18 years of age or older,
      having at least one tooth, and living in housing units in the Detroit tricounty
      area. Complete examinations were performed on 319 individuals. RESULTS: On
      average, subjects reported brushing their teeth about twice a day. About one
      third of the population reported flossing at least once a day. Loss of
      periodontal attachment was related to frequency of brushing while subjects who
      exhibited acceptable flossing ability had less plaque and calculus, shallower
      pocket depths, and less attachment loss. Subjects reporting a periodic dental
      visit at least once a year had less plaque, gingivitis, and calculus than
      subjects reporting less frequent visits. In regression analyses, brushing
      thoroughness, flossing ability and frequency, and dental visit frequency were
      predictors of lower plaque, gingivitis, and calculus scores. In turn, these
      scores were predictors of shallower pocket depths and less attachment loss.
      CONCLUSIONS: Brushing, flossing, and periodic dental visits were correlated with
      better periodontal health. The behaviors appeared to be indirectly related to
      pocket depth and attachment loss through their associations with plaque,
      gingivitis, and calculus levels.

PMID- 7776286
TI  - Differences in judgments of persuasive argument quality by three population
      groups in Iowa.
AB  - OBJECTIVES: This study describes a method for studying the perceived
      persuasiveness of rationales for adopting preventive health behaviors. METHODS:
      Using the Elaboration Likelihood Model, we surveyed 156 individuals as to the
      level of persuasiveness that each of several categories of reason presented in
      adopting target "prevention" behaviors such as eliminating the use of smokeless
      tobacco or seeking regular dental care. RESULTS: Significant differences between
      what the public reported as persuasive reasons and those selected by future
      dental practitioners were found. Patients saw potential cost savings, elimination
      of future pain, and being told by an authority person to adopt a behavior as
      highly persuasive reasons to adopt a target behavior. Nonwhite patients gave
      significantly higher scores than did white patients to arguments centering on
      social/aesthetic appeal. On the negative side, episodic care seekers felt
      significantly more strongly than regular care seekers that their practicing
      dental prevention activities (e.g., regular checkups, brushing, and flossing)
      benefited someone other than themselves (dental profession and dental
      manufacturers). CONCLUSIONS: Results of this study suggest that one way to
      improve persuasive public health preventive messages is to consider whether the
      fundamental arguments on which preventive health campaigns are built have broad
      patient appeal.

PMID- 7776287
TI  - Relationships of personality traits and stress to gingival status or soft-tissue
      oral pathology: an exploratory study.
AB  - OBJECTIVES: The purpose of this study was to examine the relationships of
      personality traits and stress with gingival inflammation and with soft-tissue
      oral pathology. METHODS: Personality traits of psychoticism (P), extroversion and
      introversion (E), and neuroticism (N) were measured with Eysenck's personality
      questionnaire (EPQ). Stress was measured with a modified organizational and
      individual assessment survey (OIAS) developed by Hendrix. Military recruits from
      Ft. Leonard Wood, Missouri, were examined for soft-tissue oral pathology and
      gingival status at weeks one (n = 241) and six (n = 61) of basic combat training
      (BCT). The EPQ and OIAS were administered to 217 recruits during week six of BCT.
      A discriminant analysis was used to determine correlations among study variables.
      RESULTS: Significant correlations (P < .05) were found between personality traits
      and various measures of tolerance of stress. Little variance was found between
      groups originally presenting with or without disease. Only physical stress (P <
      .005) was shown to affect soft-tissue pathology, while gingival inflammation
      correlated significantly to E scores (P < .02), tolerance to change (P < .02),
      and anxiety (P < .05). CONCLUSIONS: Data support a possible relationship among
      certain personality traits, stress variables, and gingival inflammation or soft
      tissue pathology in recruits with extreme personality characteristics or
      perception of high physical stress levels in basic combat training.

PMID- 7776288
TI  - Considerations in establishing a dental program for the homeless.
AB  - The homeless are a diverse group who present the dental profession with a number
      of difficult challenges in the delivery of oral health services. Utilization of
      dental services by the homeless is low when provided in traditional settings and
      access is limited. The purpose of this case study is to review program planning
      issues focusing on the unique aspects of establishing dental programs for the
      shelter-based homeless. This paper is based on experiences in developing a dental
      program for homeless persons in Boston. The establishment of a portable dental
      program in 1988 for persons residing in shelters in the greater Boston area
      involved many administrative and clinical considerations. These factors included
      determination of needs and barriers to dental care, resource identification and
      development, program planning and implementation, evaluation, and the development
      of constituency support. The diversity of the homeless population in combination
      with the variation of space and medical resources at different shelter sites
      dictates flexibility in the development of programs to address the oral health
      needs of the homeless.

PMID- 7776289
TI  - A new era for community water fluoridation? Achievements after one-half century
      and challenges ahead.

PMID- 7776290
TI  - Dental caries in homeless adults in Boston.
AB  - OBJECTIVES: Information about the oral health status of the homeless is limited.
      The purpose of this study is to characterize the dental caries status among users
      of a dental treatment and referral program at homeless shelters in Boston, MA.
      METHODS: Persons attending the program during a one-year period were assessed for
      evidence of dental caries experience by a single examiner. DMFT counts were
      abstracted from patient records. RESULTS: The population examined (n = 73) was 66
      percent male with a mean age of 36 years. The racial composition was 51 percent
      African-American, 34 percent Caucasian, and 14 percent Hispanic. The 70 dentate
      people examined had a mean DFT of 11.1 (SD = 6.1). The mean percent of DFT that
      was DT per person was 55.7 percent. Untreated caries was detected in 91.4 percent
      of those examined. CONCLUSIONS: These findings show evidence of previous dental
      services utilization by these homeless individuals, but demonstrate a high need
      for preventive and restorative dental therapy.

PMID- 7776291
TI  - Fluoride--how much of a good thing? Introduction to the symposium.
AB  - January 25, 1995, is the 50th anniversary of the first controlled addition of
      fluoride to a public water supply. Those 50 years have seen extraordinary
      advances in oral health and consequent quality of life, for which fluoride use is
      generally considered the primary reason. More extensive exposure to fluoride in
      the modern era, however, has led to both a continuing decline in caries
      experience and an increased prevalence of dental fluorosis in children. At the
      other end of life, fluoride's role in bone strength among older people is not
      well defined. This symposium examines several aspects of fluoride use in the
      United States today, and has the purpose of helping to define the balance between
      maximizing the benefits of fluoride while minimizing its undesirable side
      effects.

PMID- 7776292
TI  - Sources of fluoride intake in children.
AB  - Wide variations in fluoride intake among children make estimating fluoride intake
      difficult. This paper discusses the various sources of fluoride intake among
      children, beginning with a review of the fluoride concentrations of water and
      other beverages, foods, and therapeutic fluoride products. A review of previous
      studies' estimates of fluoride intake from diet, dentifrice, fluoride
      supplements, fluoride mouthrinses, and gels, as well as total fluoride intake
      also is presented. Then, estimates of fluoride intake among young children of
      different age groups are summarized, and examples demonstrating the high level of
      variability of fluoride intake, both from individual sources and in total, are
      presented. Lastly, this paper discusses the implications of our current level of
      knowledge of children's fluoride intake, and presents recommendations for the use
      of fluoride for children in light of this current knowledge. The major
      recommendations are that: (1) the fluoride content of foods and beverages,
      particularly infant formulas and water used in their reconstitution, should
      continue to be monitored closely in an effort to limit excessive fluoride intake;
      (2) ingestion of fluoride from dentifrice by young children should be controlled,
      and the use of only small quantities of dentifrice by young children should be
      emphasized; and (3) dietary fluoride supplements should be considered a targeted
      preventive regimen only for those children at higher risk for dental caries and
      with low levels of ingested fluoride from other sources.

PMID- 7776294
TI  - Commentary on and recommendations for the proper uses of fluoride.
AB  - Fluorosis has been associated with the fluoride concentration of drinking water,
      use of dietary fluoride supplements, early use of dentifrices, and prolonged use
      of infant formula. The literature, however, does not show associations between
      fluorosis and use of fluoride mouthrinses, professionally applied fluorides,
      bottled waters, carbonated beverages, and juices. It is unwise to issue laundry
      lists of items that may be implicated as problem-causing when, in fact, they may
      not be. Although usually classified without fluorosis, children in Dean's
      "questionable" category would be classified with the condition if the TFI or TSIF
      were used. Accordingly, Dean, in 1942, really reported only 52.8 percent of
      children without fluorosis in Kewanee, a community with 0.9 ppm fluoride in
      drinking water. Because the morbidity and sequelae of dental caries have
      declined, undue emphasis has been placed recently on the risks of using fluoride
      rather than on its profound beneficial effects. Although of paramount importance,
      conclusions cannot be drawn on whether fluoride protects against, contributes to,
      or has no effect on bone fractures or is valuable in treating osteoporosis.
      Careful thought is required before making recommendations that may reduce health
      benefits because of unfounded concerns about perceived risks. There should be
      greater regulation of extraneous fluoride sources, rather than reliance on
      educational efforts or recommendations to eliminate use of highly effective
      preventive regimens.

PMID- 7776293
TI  - Fluoride and bone health.
AB  - This paper reviews some of the studies related to the effect of fluoride on the
      skeletal system of humans and outlines the knowns and unknowns of fluoride and
      bone health. Current research indicates that, in large enough doses, fluoride
      stimulates bone formation by osteoblastic stimulation, increases bone formation
      earlier and to a larger extent in trabecular bone compared to cortical bone, and
      increases spinal bone density. There is controversy, however, concerning the
      efficacy of fluoride as a therapeutic agent in the treatment of osteoporosis.
      Some clinical studies have found a reduction in vertebral fracture rates while
      others have not. To date, only ecologic studies have been conducted on the
      association between water fluoridation and hip fractures. The inability of
      ecologic studies to control for confounding variables makes their interpretation
      difficult. Based on the literature presented, it is concluded that there are more
      unknowns than knowns in terms of fluoride's effect on bone, osteoporosis, and
      fractures. One of the major unknowns in the relationship between fluoride and
      bone health is dose and duration. Two studies are underway that attempt to
      describe the dose-response relationship between waterborne fluoride and
      osteoporosis. These studies will be completed in the near future and their
      results, while providing new insight into fluoride's effects on bone, will by no
      means answer all the questions raised on this issue.

PMID- 7776295
TI  - The weight of scientific evidence: introducing the brief communication for the
      JPHD.

PMID- 7776297
TI  - Colposcopically directed biopsy and loop excision of the transformation zone.
      Comparison of histologic findings.
AB  - We performed a retrospective comparison between the findings from colposcopically
      directed biopsies and those from loop excision of the transformation zone (LETZ)
      specimens. The correlation was satisfactory. When a low grade squamous
      intraepithelial lesion (SIL) was predicted on a cytologic smear and biopsy
      specimen, no cases of invasive carcinoma were found. In two (0.8%) cases in which
      a high grade SIL was predicted on the cervical smear and biopsy, microinvasive
      carcinoma was found in the LETZ specimen.

PMID- 7776296
TI  - Oral health: an essential service for the homeless.

PMID- 7776298
TI  - Development of wound infection or separation after cesarean delivery. Prospective
      evaluation of 2,431 cases.
AB  - Wound infections are a common surgical complication, often requiring a prolonged
      hospital stay and leading to increased costs. Over a one-year period, 2,431
      patients were followed after cesarean delivery with prompt evaluation and culture
      of all suspicious wounds. Seventy subjects (2.8%) developed confirmed wound
      infection, and 42 (1.7%) developed noninfected open surgical wounds. Seven (0.3%)
      fascial dehiscences were diagnosed, requiring surgical repair. Forty of 63 (64%)
      infected wounds had positive bacterial cultures, with Staphylococcus epidermidis
      (29%), Enterococcus faecalis (17%), Staphylococcus aureus (17%), Escherichia coli
      (11%) and Proteus mirabilis (10%) the most frequent isolates. Only 7 of 42 (17%)
      noninfected wounds had positive cultures, with only S aureus, S epidermidis and
      Corynebacterium species isolated. Ninety-five percent of the noninfected wounds
      had blood or serous collections present. Rupture of membranes lasting longer than
      six hours, emergency cesarean delivery and morbid obesity were associated with a
      statistically increased likelihood of the development of infected wounds.
      Emergency cesarean delivery and morbid obesity, but not prolonged rupture of
      membranes, were associated with an increased likelihood of the development of
      noninfected wounds. Therefore, it appears that at least two mechanisms are
      responsible for the development of postcesarean open wounds: (1) increased
      amniotic fluid and wound colonization due to prolonged rupture of membranes,
      resulting in a wound infection containing one or more bacterial species derived
      from the cervicovaginal flora, and (2) increased exogenous bacterial
      contamination and flora consistent with skin species or breaks in sterile
      technique, often accompanying difficult or emergency surgery.

PMID- 7776299
TI  - Mass antimicrobial treatment in pregnancy. A randomized, placebo-controlled trial
      in a population with high rates of sexually transmitted diseases.
AB  - Sexually transmitted diseases (STDs) are highly prevalent in pregnant women in
      many developing countries and have been associated with poor obstetric outcomes.
      Case detection and treatment of STDs in women is problematic and expensive,
      underscoring the need for other strategies. To explore the potential benefits of
      routine antimicrobial therapy on pregnancy outcome, we carried out a randomized,
      double-blind, clinical trial in one of the antenatal clinics in Nairobi, Kenya.
      Four hundred pregnant women between 28 and 32 weeks' gestation were given a
      single dose of 250 mg ceftriaxone intramuscularly or a placebo. There was a
      significant difference between ceftriaxone and placebo-treated women in infant
      birth weight (3,209 versus 3,056 g, P = .01). In addition, there was a trend
      toward lower rates of birth weight < 2,500 g (4.0% versus 9.2%, P = .08) and
      postpartum endometritis (3.8% versus 10.4%, P = .05) in the intervention than in
      the placebo group. Neisseria gonorrhoeae was isolated from the cervixes of
      postpartum women in 1.8% of the intervention group as compared to 4.2% of the
      control group. These data suggest a beneficial effect of antimicrobial
      prophylaxis on pregnancy outcome. Larger studies should be carried out to examine
      the public health impact of this intervention.

PMID- 7776300
TI  - Transvestibular retropubic bladder neck suspension. A pilot study.
AB  - A pilot study was conducted assessing the operative feasibility, complications
      and results of a retropubic bladder neck suspension performed through a
      transvestibular approach. This study extended from July 1, 1990, to June 30,
      1991, and included patients who planned to undergo primary surgical correction of
      stress urinary incontinence. Through a transvestibular incision, a bladder neck
      suspension was performed by suturing the adjacent area of the vagina to the back
      of the pubic symphysis or the puborectalis muscle near the pubic bone. Ten women
      were entered into the study. There was one notable complication, a hematoma in
      the space of Retzius. One patient described worsening of her incontinence and
      underwent a Marshall-Marchetti-Krantz procedure three months postoperatively. The
      mean follow-up for the remaining nine patients was 27 months (range, 13-31). At
      this writing, 6 patients were completely continent, 1 was improved, and 2 had
      some degree of bladder instability with associated incontinence. Overall, the
      transvestibular procedure was thought to be technically difficult. Based on very
      limited data, the results of the study have discouraged our continued use of this
      procedure. The transvestibular approach may be applicable occasionally on
      selected patients.

PMID- 7776301
TI  - Off-label drug prescribing on a state university obstetric service.
AB  - Off-label drug use occurs when physicians prescribe a drug recommended for
      indications other than those listed on the prescription labeling. The purpose of
      the present investigation was to describe patterns of off-label drug use during
      pregnancy, including the types of drugs and their timing of use. All study
      pregnancies had to receive prenatal care at our state university clinics before
      14 weeks' gestation and deliver at our institution during a five-month period.
      Prenatal records were reviewed, and subjects were interviewed after delivery. A
      total of 165 (22.6%) of the 731 eligible subjects took > or = 1 (average 1.7, 95%
      confidence interval 1.3-3.8) drugs for off-label indications. Nearly all drugs
      were taken for a short term during the third trimester. The primary purposes were
      to avoid an obstetric complication (premature labor and delivery,
      preeclampsia/eclampsia) or improve the capacity for eventual postnatal
      adaptation. Despite discussions with patients, on no occasion was it recorded on
      the chart that the patient was informed that the drug was recommended for an off
      label indication. Results from this study should help drug manufacturers,
      insurance companies and federal regulatory agencies understand the common use of
      recommending certain drugs for off-label indications during pregnancy.

PMID- 7776302
TI  - Uterine artery ligation in the control of postcesarean hemorrhage.
AB  - The technique is described for devascularizing the post-cesarean section uterus
      with bilateral mass ligation of the ascending branches of the uterine arteries
      and veins. This 30-year clinical experience with 265 patients includes the
      results and complications. Ten patients required additional therapy. The
      effectiveness of this technique makes it a reasonable alternative to hypogastric
      artery ligation and reduces the need for hysterectomy.

PMID- 7776303
TI  - Palpable uterine artery pulsation as a clinical indicator of early pregnancy.
AB  - The objective of this study was to determine if palpable uterine artery pulsation
      is a reliable clinical indicator of pregnancy at less than six weeks' gestation.
      A preliminary, nonblind study involved 299 women. Of 31 women who were at less
      than six weeks' gestation, 24 had definite uterine artery pulsations, and 7 did
      not. Of 268 nonpregnant women, 256 did not have pulsation, while 12 did (P <
      .001). Because other clinical parameters could bias the interpretation of uterine
      artery pulsation, a second, blind study was undertaken. During it, 155 patients
      underwent bimanual examination only, and no other clinical information was
      available to the examiner. Of 25 women at less than six weeks' gestation, 19 had
      definite uterine artery pulsation, while 6 did not. Of 130 nonpregnant patients,
      121 did not have uterine artery pulsation, while 9 did (P < .001). Palpable
      uterine artery pulsation seems to be associated with early pregnancy, and
      physicians should add evaluation of pulsation to their clinical armamentarium.

PMID- 7776304
TI  - Cocaine use in pregnancy and the risk of intraamniotic infection.
AB  - A retrospective, case-control study was performed to determine whether pregnant
      women using cocaine had an increase in maternal infectious morbidity. Seventy-six
      women with urine drug screens positive for cocaine on admission to the labor and
      delivery unit were compared to 134 women who had negative urine drug screens.
      Patients were matched for risk factors associated with the development of
      intraamniotic infection and endometritis, such as parity, length of labor and
      length of membrane rupture. There was no significant difference in the incidence
      of intraamniotic infection or endometritis between the two groups. Thus, cocaine
      does not appear to increase the risk of peripartum infectious morbidity after
      controlling for well-established risk factors.

PMID- 7776305
TI  - Ionized serum magnesium and potassium levels in pregnant women with preeclampsia
      and eclampsia.
AB  - A prospective, cross-sectional study was performed to determine whether patients
      with preeclampsia or eclampsia had difficult serum levels or fractions of the
      active, ionized form of magnesium (IMg2+) as compared to normal, pregnant women.
      Using a novel ion selective electrode, we determined the IMg2+ levels and
      fractions as well as ionized calcium, sodium and potassium (K) in venous serum
      drawn on admission from 33 normal, pregnant women; 12 women with preeclampsia;
      and 2 women with postpartum eclampsia. Levels in 42 nonpregnant, age-matched,
      healthy women were also measured. We found that in normal pregnancy, levels and
      fractions of IMg2+ were significantly decreased as compared to levels and
      fractions in nonpregnant women (0.48 +/- 0.01 [SE] versus 0.60 +/- 0.005 mmol/L,
      and 63.2 +/- 1.0% versus 71.6 +/- 0.6%; P < .001 for both), but the levels and
      fractions in preeclamptics (0.48 +/- 0.01 mmol/L and 64.2 +/- 1.7%) were not
      significantly different (P > .05) from those in normal, pregnant women.
      Similarly, the levels and fractions of IMg2+ in the two eclamptic patients were
      within the ranges of normal and preeclamptic pregnancies. When the other cations
      were analyzed, a highly significant elevation (P < .001) in the mean K+ level and
      the K+/IMg2+ ratio in the preeclamptic patients was noted. Thus, it appears that
      serum IMg2+ levels are maintained in preeclampsia and eclampsia, but disturbances
      in K homeostasis and in the interrelationships between K and IMg2+ may occur.

PMID- 7776307
TI  - Laparoscopic resection of a noncommunicating rudimentary uterine horn. A case
      report.
AB  - Patients who have a unicornuate uterus with a noncommunicating rudimentary horn
      that contains an endometrial cavity are at risk for endometriosis and obstetric
      complications. As in this case, resection of the rudimentary horn can be
      performed laparoscopically without increased risk to the patient and with some
      potential benefit.

PMID- 7776306
TI  - Serum parathyroid hormone-related protein levels during lactation.
AB  - We measured parathyroid hormone-related protein (PTHrP) in the serum of 15
      healthy women within three days of beginning breast-feeding and within one hour
      of completing nursing. A sensitive immunoradiometric assay that measures N
      terminal PTHrP containing at least the first 74 amino acids was used. We found
      normal PTHrP values in all patients. Values one day before and two days after
      delivery in a hypoparathyroid woman who chose not to breast-feed were also
      normal. Since N-terminal PTHrP fragments of 1-36 amino acids or more are
      biologically active, we believe additional studies using sensitive PTHrP assays
      that measure smaller fragments and investigations performed under other
      conditions of breast-feeding are necessary before concluding that PTHrP does not
      have a role in calcium homeostasis in nursing mothers. Furthermore, additional
      studies in hypoparathyroid nursing mothers should be performed.

PMID- 7776308
TI  - Vesicouterine fistula after cesarean section. A case report.
AB  - A 27-year-old woman, gravida 3, para 2002, underwent repeat cesarean section and
      inadvertent cystotomy, with subsequent development of a vesicouterine fistula.
      The fistula did not resolve with prolonged bladder catheterization and required
      total abdominal hysterectomy with resection of the fistula tract and primary
      closure for definitive treatment.

PMID- 7776309
TI  - Tuboovarian abscess associated with Candida glabrata in a woman with an
      intrauterine device. A case report.
AB  - Candidal infection has been associated extensively with serious infections. Its
      role in genital tract infections has consisted largely of vulvovaginitis, with
      serious upper genital tract infection a rarity. A 47-year-old woman with an
      intrauterine device had Candida glabrata in a large tuboovarian abscess and
      recovered only after removal of the abscess and treatment with amphotericin B.

PMID- 7776310
TI  - Sciatic nerve endometriosis treated with a gonadotropin releasing hormone
      agonist. A case report.
AB  - Sciatic nerve endometriosis was previously treated primarily with surgery. Most
      commonly hysterectomy and bilateral salpingo-oophorectomy have been used;
      however, two reports also describe successful conservative surgery with resection
      of the endometriosis from the sciatic nerve. Only one case of sciatic nerve
      endometriosis has been reported to have responded to medical management. This
      report details the rapid and complete resolution of sciatica secondary to
      endometriosis after medical treatment with the gonadotropin releasing hormone
      analog leuprolide acetate for depot suspension.

PMID- 7776311
TI  - Leiomyoma of the female urethra. A report of two cases.
AB  - Leiomyoma of the female urethra is rare; only 34 cases have been reported in the
      medical literature in English. We report two additional cases in which hormonal
      factors appeared to play an important role.

PMID- 7776312
TI  - Extrapulmonary tuberculosis as a cause of unexplained postpartum fever. A case
      report.

PMID- 7776313
TI  - Garrulitas vulvae. A report of six cases.

PMID- 7776314
TI  - Pregnancy after endometrial ablation. A case report.
AB  - Pregnancy is a known but rare complication of endometrial ablation. In this case
      it ended in spontaneous abortion, but full-term pregnancy has been reported.

PMID- 7776316
TI  - Laparoscopic cholecystectomy in pregnancy. A case report.
AB  - Laparoscopic cholecystectomy was performed on a pregnant woman at 18 weeks of
      gestation without complications. Considering the risk/benefit ratio, laparoscopic
      cholecystectomy in pregnant women is preferable to conventional cholecystectomy.

PMID- 7776315
TI  - Pregnancy complicated by the Klippel-Trenaunay syndrome. A case report.
AB  - A primigravida with the Klippel-Trenaunay syndrome was admitted to the hospital
      at 34 weeks' gestation with a complaint of right calf pain. Superficial
      thrombophlebitis was diagnosed, and she was treated with compresses and
      analgesia. Speculum examination failed to reveal the presence of lower
      genitourinary tract arteriovenous malformations. Color flow mapping of the uterus
      did not identify any arteriovenous malformations. The patient delivered vaginally
      at term, and the postpartum course was unremarkable. Pregnancies complicated by
      the Klippel-Trenaunay syndrome are at increased risk of adverse perinatal
      outcomes, related primarily to the increased risk of hemorrhagic diathesis. The
      mode of delivery should be considered carefully in an attempt to minimize the
      risk to both mother and fetus.

PMID- 7776317
TI  - Conflict of interests: an introduction.
AB  - In earlier times, clinical researchers published the results of their studies as
      seemed most appropriate to them. In an increasingly computerized and
      communicative environment this is no longer satisfactory, since now there are a
      number of other groups whose interests need to be taken into account. These
      include patients, medical journals, the Stock Exchange, the media and the law.
      This supplement arises out of a meeting established to describe the methods used
      to communicate clinical research results, the timing and the needs of other
      groups in an attempt to improve understanding and to identify preferred practice.
      Avoidance by clinical investigators of conflict of interest and accusations of
      improper practice clearly merit discussion.

PMID- 7776318
TI  - Pressure on communication of results of clinical research: potential for improper
      practice. Proceedings of a meeting. London, October 13, 1993.
AB  - In earlier times, clinical researchers published the results of their studies as
      seemed most appropriate to them. In an increasingly computerized and
      communicative environment this is no longer satisfactory, since now there are a
      number of other groups whose interests need to be taken into account. These
      include patients, medical journals, the Stock Exchange, the media and the law.
      This supplement arises out of a meeting established to describe the methods used
      to communicate clinical research results, the timing and the needs of other
      groups in an attempt to improve understanding and to identify preferred practice.
      Avoidance by clinical investigators of conflict of interest and accusations of
      improper practice clearly merit discussion.

PMID- 7776319
TI  - Insider dealing rules: legal aspects.

PMID- 7776320
TI  - Publication of clinical trial results: a clinician's view.

PMID- 7776321
TI  - Publication of clinical trial results: a clinical investigator's view.

PMID- 7776322
TI  - Insider dealing rules: a financial analyst's view.

PMID- 7776323
TI  - Abdominal radiology in cystic fibrosis.

PMID- 7776324
TI  - Human recombinant DNase in cystic fibrosis.

PMID- 7776325
TI  - Colonic strictures in cystic fibrosis.

PMID- 7776327
TI  - Post heart/lung transplantation management.
AB  - Patients with cystic fibrosis present a challenge to management post
      transplantation but the results are comparable with those obtained in patients
      with other conditions. The increasing population of cystic fibrosis patients who
      have undergone transplantation will require joint management of such patients by
      cystic fibrosis specialists and pulmonary transplant specialists. The follow-up
      of patients with cystic fibrosis following pulmonary transplantation potentially
      affords us an exciting opportunity to study the natural history of this disease
      as it affects the extra pulmonary organs.

PMID- 7776326
TI  - Exercise and cystic fibrosis.

PMID- 7776330
TI  - Dermoid sinus in a Boerboel bitch.

PMID- 7776331
TI  - Equine viral arteritis in donkeys in South Africa.

PMID- 7776329
TI  - Abdominal pain in cystic fibrosis.

PMID- 7776328
TI  - Allergic and invasive aspergillosis.

PMID- 7776333
TI  - An assessment of the toxicity of parenteral treatment with copper EDTA and copper
      heptonate in sheep.
AB  - The toxicity of 2 parenteral copper (Cu) supplements was investigated. Di-sodium
      copper ethylene diamino tetra acetate (Cu EDTA) and Cu heptonate were
      administered to sheep (n = 9) by a single subcutaneous injection at a
      concentration of 0,2, 1 and 2 mg Cu/kg each (Trial 1.) Nine sheep were untreated
      and served as controls. The same treatments were applied to 2 sheep each (Trial
      2) with the addition of 3 mg Cu/kg live body mass as Cu heptonate, and Cu
      heptonate administered intravenously at rates of 0,2, 0,4 and 0,6 mg Cu/kg live
      body mass. In Trial 1, 67% of the sheep treated with Cu EDTA at 2 mg Cu/kg live
      body mass died within 3 to 17 d after treatment, while no mortalities occurred in
      sheep where Cu heptonate was administered at the same dosage rate and even at 3
      mg Cu/kg live body mass (P < or = 0,01). Post-mortem examination suggested acute
      Cu toxicity in all cases. Liver Cu concentrations were markedly increased (P < or
      = 0,05) by both supplements in groups of 3 treated sheep slaughtered over a 3
      month period compared to control animals. The liver Cu concentrations of sheep
      that succumbed to Cu toxicity were within the normal range of 100 to 450 mg/kg
      DM. Results from Trial 2 suggested that the 2 sheep treated with 2 mg Cu/kg live
      body mass as Cu EDTA, experienced a haemolytic crisis between 5 and 11 d after
      treatment, resulting in the death of one of these sheep. The haemolytic crisis
      was characterised by a severe decrease in haemoglobin concentration and
      haematocrit.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7776334
TI  - Production responses of sheep supplemented with copper, cobalt and selenium on
      kikuyu ryegrass pastures.
AB  - The copper (Cu) and selenium (Se) status of SA Mutton Merino ewes grazing kikuyu
      ryegrass pastures was investigated by analysing blood and liver samples. The
      response of ewes to oral supplementation with Cu, Cobalt (Co) and Se as single
      elements, or in 4 combinations were simultaneously assessed in a 2 x 2 x 2
      factorial experiment. Pastures grazed were low in Cu (less than 5 mg Cu/kg DM)
      except for the summer months, while pasture Se concentrations remained at
      concentrations less than 0,03 mg Se/kg DM for almost the entire period. Plasma Cu
      concentrations remained in excess of 80 micrograms/dl until pasture Cu
      concentrations decreased below 5 mg/kg DM. Blood Se concentrations generally
      reflected liver Se concentrations. Supplementation of ewes with 5 g Cu oxide
      needles (Embamin Copper LA, Rhone Poulenc) markedly increased (P < or = 0,01)
      hepatic Cu and plasma Cu concentrations. The monthly drenching of ewes with 5 mg
      Se as sodium selenite elevated blood Se concentrations to normal levels in excess
      of 100 ng/ml while ewes not supplemented with Se had blood Se concentrations
      indicative of a deficiency (50-100 ng/ml). Supplementation of ewes with Cu and Se
      elevated (P < or = 0,05) concentrations of these trace elements in the plasma and
      blood of their progeny. Supplementation of ewes with Cu and Se resulted in
      respective improvements (P < or = 0,05) of 5,3 and 4,8% in live mass during
      lactation, compared to contemporaries which did not receive either Cu or
      Se.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7776332
TI  - Factors which affect blood variables of slaughtered cattle.
AB  - Blood was obtained at an abattoir from 4 groups of cattle. The first group was
      slaughtered in a conventional way, the second and third were subjected to
      shechita slaughter with or without the application of the captive bolt
      immediately after the cutting of the throat, and the fourth group of cattle was
      subjected to a period of recumbency prior to conventional slaughter. Blood
      samples were analysed for concentrations of catecholamines, cortisol, glucose,
      lactate and total lipids. The haematocrit and osmolarity was also determined.
      There were no major differences in the blood variables of cattle subjected to
      conventional slaughter and those of cattle which had been subjected to a period
      of recumbency prior to conventional slaughter. Plasma catecholamine
      concentrations in cattle subjected to shechita slaughter without the application
      of a stun, were significantly elevated when compared to any of the other groups.
      It was concluded that postural changes have very little effect on the blood
      variables, but that the application of a stun after the throat has been cut in
      shechita slaughter abolishes the increases in blood variables associated with
      shechita in the absence of stunning.

PMID- 7776335
TI  - The effectiveness of using supplementary zinc and molybdenum to reduce the copper
      content in the liver of hypercuprotic sheep.
AB  - Two trials were conducted to evaluate the effectiveness of different methods of
      reducing the liver copper (Cu) concentration of sheep whose livers had been
      loaded with Cu, in order to protect the sheep from Cu toxicity, after dietary Cu
      had been withdrawn. In the first trial 0, 75, 150 and 300 mg zinc (Zn) kg-1 feed
      were added to a basic diet low in Cu and fed to hypercuprotic sheep (n = 32) for
      88 d. At the end of the trial, liver Cu concentrations (c 800 mg Cu kg-1 DM) in
      all 4 treatments did not differ significantly from the Cu concentrations of the
      liver biopsy samples taken at the onset of the trial. From other measurements
      taken, none of the sheep appeared to be close to the haemolytic phase of chronic
      Cu toxicity. In the second trial, lasting 79 d, 40 hypercuprotic sheep were
      allocated to 4 treatments, viz. a control, a group receiving a parenteral
      treatment of Zn, amounting to approximately 7 mg Zn d-1 and 2 further groups
      receiving molybdenum (Mo) (15 and 30 mg Mo sheep-1 d-1), added to the basic diet
      high in sulphur (4,06 g kg-1 DM). The parenteral Zn treatment did not change
      liver Cu concentrations. The 15 mg and 30 mg Mo treatments reduced the Cu in the
      livers significantly by 24% and 42% respectively. It is suggested that both oral
      and parenteral Zn supplementation are ineffective in reducing liver Cu
      concentration once dietary Cu has been withdrawn from the diet.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7776336
TI  - Serological relationship between a donkey alphaherpesvirus (isolate M7/91) and
      equid herpesvirus type 1 and 4.
AB  - Rabbit hyperimmune serum prepared against a donkey alphaherpesvirus isolate
      (M7/91), and against EHV-1 and EHV-4 was used to characterise the antigenic
      relationship between these 3 viruses. Serum from immunised rabbits was always
      more specific for homologous virus and showed different cross reactivity for
      heterologous virus. It was concluded that the immunologic relationship between
      the M7/91 isolate and EHV-1, was closer than that between this isolate and EHV-4.
      A serological survey of donkeys (n = 116) and horses (n = 57) revealed evidence
      of the presence of neutralising antibody to M7/91 in their sera. The titres of
      antibody to M7/91 in donkeys, ranged from 1:32-1 > or = 256 and was significantly
      higher than antibody titres to EHV-1 and EHV-4, while in horses, titres were
      lower but comparable to equine herpesvirus 1 and 4.

PMID- 7776337
TI  - Demographics of companion animals in South Africa.
AB  - A survey conducted in 1992, using a standardised, stratified sample was used to
      determine companion animal numbers in South Africa as a single geographical
      entity. The results indicated that there were 3.93 million dogs, 0.97 million
      cats, 0.98 million birds, 0.22 million other companion animals and 0.1 million
      horses in South African households. Thirty-seven per cent of households keeping
      companion animals, kept dogs; cats (13.4%); birds (4.8%); other companion animals
      (1.1%) and horses (2%). These results may provide information about possible
      markets in terms of numbers of species kept.

PMID- 7776338
TI  - Congenital skeletal malformations in Holstein calves associated with putative
      manganese deficiency.
AB  - Holstein calves (n = 47) with a dwarf-like appearance, joint laxity, superior
      brachygnathism and domed foreheads were born to heifers on natural grazing on the
      same farm. Six calves, between one week and 3 months of age, were euthanased.
      Marginally low concentrations of manganese were found in the livers, while high
      strontium concentrations were confirmed in soil, plants and grass specimens from
      the pasture, as well as in the bone ash of the ribs of 2 calves. Microscopical
      lesions in growth plates included irregularly aligned and shorter columns of
      chondrocytes and a reduction in width of the zone of hypertrophy when compared to
      a normal calf. This syndrome closely resembled a previously described
      chondrodystrophy in neonatal calves, attributed to a maternal manganese
      deficiency. Seepage from sea water evaporation pans on an adjacent farm was
      believed to have resulted in leaching of manganese from the soil and to be the
      source of the high levels of strontium. The cause of the skeletal defects is
      believed to be maternal manganese deficiency, complicated by an unknown factor.

PMID- 7776339
TI  - Advanced tuberculosis in an African buffalo (Syncerus caffer Sparrman).
AB  - A necropsy conducted on an emaciated 8-year-old female African buffalo (Syncerus
      caffer) in the Kruger National Park, revealed gross pathological changes
      compatible with generalised bovine tuberculosis. Macroscopic lesions in the lungs
      and associated lymph nodes were of a caseous necrotic nature with liquefied foci.
      Mycobacterium bovis was cultured from pulmonary lesions. The distribution and the
      characteristics of the lesions are described and the conclusion is made that the
      initial route of infection was aerogenous with secondary bacterial metastasis to
      the intestine. It would also appear that the spread of infection within the
      animal was extremely rapid. The conjecture is made that due to the cavernous
      state of the pulmonary lesions, the animal was probably highly infective at the
      time of death. Environmental factors that may have had an influence on the
      pathogenesis of the disease are seasonal rainfall fluctuations, extreme
      temperature variations and harsh ultra-violet exposure.

PMID- 7776340
TI  - Suspected chronic fluorosis in a sheep flock.
AB  - An estimated average daily intake of 107 g of a lick containing 3.4% of a
      commercial non-defluorinated rockphosphate, which has an average fluoride content
      of 2.5% m/m, caused an outbreak of suspected chronic fluorosis in a Dohne Merino
      sheep flock in the eastern Cape. Thirty seven per cent of the commercial 4-tooth
      animals were affected, whereas only 17% of the stud component of the same age
      group, which were in a better nutritional condition, showed clinical signs of
      fluorosis. Twenty per cent and 33.3% of the 6-tooth wethers and ewes
      respectively, were affected. Younger sheep and sheep in a relatively poor body
      condition, were more affected than older sheep and those in a relatively better
      condition. Non-defluorinated non-registered mineral sources should not be
      included in supplementary rations for sheep.

PMID- 7776341
TI  - A Dutch report on the ethics of neonatal care.
AB  - The Dutch Paediatric Association reports consensus among its members regarding
      the necessity to take the future quality of life into account when reaching
      decisions regarding the continuation or dis-continuation of life-prolonging
      treatment. The paramount importance of the discussion with the parents is
      stressed. Dissension exists regarding active euthanasia in the newborn, both
      opinions being respected. If dissension exists within the profession parents
      should be informed and if necessary referred to a doctor who shares their moral
      views.

PMID- 7776343
TI  - Ultimate justification: Wittgenstein and medical ethics.
AB  - Decisions must be justified. In medical ethics various grounds are given to
      justify decisions, but ultimate justification seems illusory and little
      considered. The philosopher Wittgenstein discusses the problem of ultimate
      justification in the context of general philosophy. His comments, nevertheless,
      are pertinent to ethics. From a discussion of Wittgensteinian notions, such as
      'bedrock', the idea that 'ultimate' justification is grounded in human nature as
      such is derived. This discussion is relevant to medical ethics in at least five
      ways: it shows generally what type of certainty there is in practical ethics; it
      seems to imply some objective foundation to our ethical judgements; it squares
      with our experience of making ethical decisions; it shows something of the nature
      of moral arguments; and, finally, it has implications for teaching medicine and
      ethics.

PMID- 7776342
TI  - Can there be an ethics of care?
AB  - There is a growing body of writing, for instance from the nursing profession,
      espousing an approach to ethics based on care. I suggest that this approach is
      hopelessly vague and that the vagueness is due to an inadequate analysis of the
      concept of care. An analysis of 'care' and related terms suggests that care is
      morally neutral. Caring is not good in itself, but only when it is for the right
      things and expressed in the right way. 'Caring' ethics assumes wrongly that
      caring is good, thus it can tell us neither what constitutes those right things,
      nor what constitutes the right way.

PMID- 7776344
TI  - Twenty years of the JME--reflections. Journal of Medical Ethics.

PMID- 7776345
TI  - Enhancing humanistic skills: an experiential approach to learning about ethical
      issues in health care.
AB  - An outstanding feature of the study of nursing ethics is that it raises questions
      concerning moral virtue, conscience, consistency and character. A considerable
      section of the literature is devoted to ideas of how best to teach ethics to
      health professionals. It has been shown that when faced with ethical dilemmas
      nurses tended to rely on intuition and instinct to resolve them, with little
      systematic analysis to help the process. Nurses who have been in practice for a
      number of years may experience particular difficulties in resolving ethical
      dilemmas, for although they may be able easily to identify ethical problems they
      may feel powerless to behave appropriately through lack of theoretical background
      and/or confidence in participating in informed debate. An educational programme
      was designed to meet the needs of mature registered nurses who were undertaking a
      post-qualification part-time honours degree in nursing studies. A variety of
      teaching methods were employed in teaching the nurses. These included discussion,
      student-led seminars, structured debate and role play. A session which dealt with
      sudden death and organ donation is described in some detail. Because the topic
      involved communication between professionals and patients and/or relatives and
      was linked with ethics, role play was used to explore the dynamics in these
      areas. The participants were invited to act out the situation as they felt it
      might occur. Role play highlighted the stress and shock attached to such an
      experience. Before working through the dynamics of a situation the nurses were
      conscious of being part of decision-making 'in the cold' and 'in isolation'. As a
      result of the experiential learning they felt more able to reflect analytically
      and to participate in discussions in an informed and articulate way.

PMID- 7776346
TI  - Peter Singer and 'lives not worth living'--comments on a flawed argument from
      analogy.
AB  - The Australian bioethicist Peter Singer has presented an intriguing argument for
      the opinion that it is quite proper (morally) to deem the lives of certain
      individuals not worth living and so to kill them. The argument is based on the
      alleged analogy between the ordinary clinical judgement that a life with a broken
      leg is worse than a life with an intact leg (other things being equal), and that
      the broken leg therefore ought to be mended, on the one hand, and the judgement
      that the lives of some individuals, for example, severely disabled infants, are
      not worth living and therefore ought to be terminated, on the other. In the
      present article it is argued that Singer's argument is flawed, intellectually
      and/or ethically.

PMID- 7776348
TI  - What I actually said about medical ethics: a brief response to Toon.
AB  - It has been said that I am against medical philosophy. This is a
      misrepresentation of my position. I am against conventional medical ethics
      teaching as it has to be done in medical schools, but very much in favour of
      philosophy in medicine.

PMID- 7776347
TI  - Cardiopulmonary resuscitation in the elderly: patients' and relatives' views.
AB  - One hundred inpatients on an acute hospital elderly care unit and 43 of their
      relatives were interviewed shortly before hospital discharge. Eighty per cent of
      elderly patients and their relatives were aware of cardiopulmonary resuscitation
      (CPR). Television drama was their main source of information. Patients and
      relatives overestimated the effectiveness of CPR. Eighty-six per cent of patients
      were willing to be routinely consulted by doctors about their own CPR status, but
      relatives were less enthusiastic about routine consultation. Patients' and
      relatives' views about the appropriateness of CPR did not differ significantly.
      Seventeen percent of patients did not desire CPR. However, 64 per cent of
      patients were ultimately willing to follow their doctor's advice about the
      appropriateness of CPR. The conclusion reached is that mentally competent,
      elderly patients but not their relatives should be routinely consulted about
      their own desire for CPR in order to avoid resuscitating patients against their
      wishes. Further research is required to find out how patients would feel about
      resuscitation if they were terminally ill or chronically confused, and how carers
      would feel about resuscitating such patients.

PMID- 7776349
TI  - Professed religious affiliation and the practice of euthanasia.
AB  - Attitudes towards active voluntary euthanasia (AVE) and physician-assisted
      suicide (PAS) among 1,238 doctors on the medical register of New South Wales
      varied significantly with self-identified religious affiliation. More doctors
      without formal religious affiliation ('non-theists') were sympathetic to AVE, and
      acknowledged that they had practised AVE, than were doctors who gave any
      religious affiliation ('theists'). Of those identifying with a religion, those
      who reported a Protestant affiliation were intermediate in their attitudes and
      practices between the agnostic/atheist and the Catholic groups. Catholics
      recorded attitudes most opposed to AVE, but even so, 18 per cent of Catholic
      medical respondents who had been so requested, recorded that they had taken
      active steps to bring about the death of patients.

PMID- 7776350
TI  - Patients' rights--why the Australian courts have rejected 'Bolam'.
AB  - This point of view compares the issue of informed patient consent primarily as it
      operates in Australia and the United Kingdom. It affords an overview, also, of
      the applicable law in the United States and Canada. It particularly focuses on
      the legal test to be applied to patient consent as established in the Bolam case
      in the United Kingdom. The case, following its approval by the House of Lords,
      holds that the negligent standard in patient consent situations is to be
      determined, in cases of dispute, in accordance with standards as viewed by a
      proper body of competent medical practitioners. By contrast, the law in the
      United States is premised on the notion of the fundamental right of patients to
      determine what should or should not be done with their own bodies. In Australia
      the Bolam test has been rejected by the High Court of Australia following earlier
      decisions in the State Supreme Courts. The Australian courts did not accept that
      the setting of standards by the medical profession was an acceptable way of
      determining the entitlements of a patient who has suffered harm. The author
      places this discussion in the context of greater community awareness of medical
      procedures, the heightened accountability of professionals and the increasing
      practice of having a substantial patient input into medical decisions. He also
      suggests that the differing social and professional attitudes to authority and
      fundamental rights to be found between Australia and the United Kingdom have
      influenced the outcome of the cases in the higher courts of both countries. He
      suggests that the Bolam test is an illustration of the tendency of authority in
      the United Kingdom to believe that 'Nanny know best'.

PMID- 7776351
TI  - Nutrition, dehydration and the terminally ill.

PMID- 7776352
TI  - Developing countries: whose views?

PMID- 7776353
TI  - The ethics of ignorance.

PMID- 7776354
TI  - The Institute of Medical Ethics: working parties and medical groups.

PMID- 7776356
TI  - Continuous measurement of blood gases using a combined electrochemical and
      spectrophotometric sensor.
AB  - The use of a combined electrochemical and fibreoptic continuous intra-arterial
      blood gas sensor is described. The purpose of the study was to evaluate the
      performance of the sensor in 10 patients in the intensive therapy unit following
      insertion through a femoral arterial cannula. To our knowledge this is the first
      published study on the valuation of an intravascular blood gas sensor through a
      femoral arterial cannula. A total of 71 sets of data comparing the sensor with
      the blood gas analyser were obtained. The bias and precision for pH, PCO2 and PO2
      were 0.006 and 0.07 pH units, 0.2 and 1.65 kPa (4.6% and 29%) and 0.8 and 2.7 kPa
      (5.1% and 14.3%) respectively. There was a degree of imprecision of the PCO2
      sensor, the reasons for which are discussed. In summary, the intra-arterial
      sensor functioned well when inserted into the femoral artery in post
      cardiopulmonary bypass patients. There were no complications attributable to
      sensor placement.

PMID- 7776355
TI  - The investigation of life-threatening child abuse and Munchausen syndrome by
      proxy.
AB  - The use of covert video surveillance in the investigation of suspected life
      threatening child abuse and Munchausen syndrome by proxy raises important ethical
      questions. That the recently reported provision of this facility in North
      Staffordshire was not presented to a Local Research Ethics Committee (LREC) for
      approval as a research exercise raises important questions about the ethical
      review of research and practice. The case made for avoiding such review is first
      set out and then examined. The three main premisses which form the basis of the
      view that LREC approval is not required are identified and tested in turn. The
      conclusion is that there is an undeniable element of research involved in the
      procedure and that the welfare of all those subjected to the surveillance would
      be best protected by the submission of the protocol to an independent committee
      for ethical assessment.

PMID- 7776357
TI  - HYOMEX: a miniature universal testing machine for in vivo biomechanical studies.
AB  - A miniaturized universal testing machine, HYOMEX, designed for biomechanically
      testing spinal structures of an anaesthetized research animal, such as a pig, is
      presented. A variety of mechanical applications such as static and dynamic tests,
      creep and relaxation tests, and fatigue tests with frequencies up to 20 Hz are
      possible. The system permits force control as well as displacement control.
      Continuous surveillance is made possible through interfacing the system to a
      computer. An application is presented where the viscoelastic behaviour in a
      porcine lumbar spine was measured.

PMID- 7776358
TI  - Waveform generator for electrical impedance tomography (EIT) using linear
      interpolation with multiplying D/A converters.
AB  - This paper describes the implementation of a multiplying digital-to-analogue
      (D/A) converter as a programmable waveform generator to be used in an electrical
      impedance tomography (EIT) system. Different digital techniques of generation
      waveforms are considered and the advantages and disadvantages of the chosen slope
      plus-pedestal technique are presented. A wire-wrapped prototype system has been
      designed, and from measured frequency spectra the total harmonic distortion can
      be calculated to values between 1.1 and 2.9% depending on frequency.

PMID- 7776360
TI  - Case records of the Department of Medicine University of Mississippi Medical
      Center. Sarcoidosis.

PMID- 7776359
TI  - Comparison of oscillometric and intra-arterial blood pressure and pulse
      measurement.
AB  - Non-invasive oscillometric blood pressure and pulse measured by an Omron HEM
      703CP monitor were compared with arterial values obtained from direct
      measurements of the radial artery. An excellent correlation and agreement was
      found between the two methods (systolic r = 0.99; diastolic r = 0.97; pulse r =
      0.99), although there was some variability among individual subjects. The range
      of difference between them was 0 to 10 mmHg for systolic and -6 to +5 mmHg for
      diastolic pressures. When tested on the bench using the Metron QA-1280 non
      invasive blood pressure analyser the HEM-703CP monitor rarely exhibited errors
      exceeding 2-3 mmHg over a measurement range of 50-200 mmHg.

PMID- 7776361
TI  - An ethical dilemma.

PMID- 7776362
TI  - Researchers develop ceramic drug delivery system.

PMID- 7776363
TI  - Nutritional support of the hospitalized patient: a team approach.
AB  - Nutritional deficits have long been recognized as contributing factors to
      morbidity and mortality of hospitalized patients. A multi-disciplinary team
      approach to nutritional support has been shown to be superior to non-team
      approaches. A formal consultive nutritional support team has been active at St.
      Dominic Hospital since 1991. The benefits of our nutritional support team at St.
      Dominic Hospital are described. Acquisition of an Indirect calorimeter has
      improved measurements of caloric and substrate requirements. Individualized
      nutritional prescriptions more closely meet assessed patient needs. Utilization
      of less expensive, more physiologic enteral feeding routes have increased. Also,
      the number of total parenteral nutrition (TPN) bags admixed and wasted have
      decreased, despite an increase in the percent of patients with moderate to severe
      nutritional risk. The nutritional support service at St. Dominic Hospital has
      improved patient care while reducing cost to both the institutional and patient.

PMID- 7776364
TI  - Mapping important nucleotides in the peptidyl transferase centre of 23 S rRNA
      using a random mutagenesis approach.
AB  - Random mutations were generated in the lower half of the peptidyl transferase
      loop in domain V of 23 S rRNA from Escherichia coli using a polymerase chain
      reaction (PCR) approach, a rapid procedure for identifying mutants and a plasmid
      based expression system. The effects of 21 single-site mutations, at 18 different
      positions, on cell growth, mutant rRNA incorporation into ribosomes and peptidyl
      transferase activity of the mutant ribosomes were analysed. The general
      importance of the whole region for the peptidyl transferase centre was emphasized
      by the finding that 14 of the mutants were sick, or very sick, when ribosomes
      containing chromosomal-encoded 23 S rRNA were inhibited by erythromycin, and all
      except one of these exhibited low levels of peptidyl transferase activity in
      their mutated ribosomes. Two mutations, psi 2580-->C and U2584-->G that both
      yielded inactive ribosomes were assigned to the donor substrate binding site and
      a possible base-pairing interaction between the 3'-terminal sequence of the
      peptidyl-tRNA and the sequence psi/U-G-G2582, that is conserved in all the non
      mitochondrial 23 S-like rRNA sequences, is proposed. Three sites that have been
      implicated in aminoacyl-tRNA binding were mutated: mutant m6A2503G yielded
      inactive ribosomes, while ribosomes from mutants Um2552A/C and U2555C yielded low
      and normal activities, respectively. Three mutants, U2528C, G2550A and A2565U,
      provide evidence for conformational rearrangements occurring in the peptidyl
      transferase centre which may be affected by the subunit-subunit interaction.
      Other mutants which yielded ribosomes that were seriously defective in peptidyl
      transferase activity were U2493A, U2493C, A2497G, A2530G, G2557A and A2589G.

PMID- 7776366
TI  - Defects in the Drosophila myosin rod permit sarcomere assembly but cause flight
      muscle degeneration.
AB  - We have determined the molecular and ultrastructural defects associated with
      three homozygous-viable myosin heavy chain mutations of Drosophila melanogaster.
      These mutations cause a dominant flightless phenotype but allow relatively normal
      assembly of indirect flight muscle myofibrils. As adults age, the contents of the
      indirect flight muscle myofibers are pulled to one end of the thorax. This
      apparently results from myofibril "hyper-contraction", and leads to sarcomere
      rupture and random myofilament orientation. All three mutations cause single
      amino acid changes in the light meromyosin region of the myosin rod. Two change
      the same glutamic acid to a lysine residue and the third affects an amino acid
      five residues away, substituting histidine for arginine. Both affected residues
      are conserved in muscle myosins, cytoplasmic myosins and paramyosins. The
      mutations are associated with age-dependent, site-specific degradation of myosin
      heavy chain and failure to accumulate phosphorylated forms of flightin, an
      indirect flight muscle-specific protein previously localized to the thick
      filament. Given the repeating nature of the hydrophobic and charged amino acid
      residues of the myosin rod and the near-normal assembly of myofibrils in the
      indirect flight muscle of these mutants, it is remarkable that single amino acid
      changes in the rod cause such severe defects. It is also interesting that these
      severe defects are not apparent in other muscles. These phenomena likely arise
      from the highly organized nature and rigorous performance requirements of
      indirect flight muscle, and perhaps from the interaction of myosin with flightin,
      a protein specific to this muscle type.

PMID- 7776365
TI  - Addition of a 29 residue carboxyl-terminal tail converts a simple HMG box
      containing protein into a transcriptional activator.
AB  - Human mitochondrial transcription factor A (h-mtTFA) is essential for initiation
      of transcription from the two promoters located in the displacement-loop region
      of human mitochondrial DNA. This 25 kDa protein contains two tandem, HMG box DNA
      binding domains separated by a 27 amino acid residue linker region and followed
      by a 25 residue carboxyl-terminal tail; both the linker and tail are rich in
      basic amino acid residues. Mutational analysis of h-mtTFA revealed that the tail
      region is important for specific DNA recognition and essential for
      transcriptional activation. The critical role of the human tail in transcription
      was confirmed by constructing chimeric proteins that exchanged similar regions
      between h-mtTFA and its Saccharomyces cerevisiae homolog, sc-mtTFA. Wild-type sc
      mtTFA is unable to activate transcription from the human mitochondrial light
      strand promoter (LSP). Addition of the human tail region to sc-mtTFA conferred
      LSP-specific promoter activation. In all of the different h-mtTFA mutations
      tested, transcriptional activation was correlated with specific DNA-binding
      activity, suggesting that these two functions may be inseparable, a situation
      entirely consistent with previous mutational analyses of human mitochondrial
      promoters.

PMID- 7776367
TI  - The role of ATP in the functional cycle of the DnaK chaperone system.
AB  - Hsp70 chaperons interact with protein substrates in an ATP-dependent manner to
      prevent aggregation and promote protein folding. For the Escherichia coli homolog
      DnaK, we have characterized the ATP hydrolysis cycle as well as the effects of
      the DnaJ and GrpE cofactors on substrate interaction to reach conclusions on the
      functional cycle. DnaK ATPase was stimulated by substrates (ninefold) and DnaJ
      (13-fold) through stimulation of the rate limiting step, gamma-phosphate cleavage
      (approximately tenfold slower than ADP release). Substrates stimulate ATPase
      after binding with high affinity (KA < 10 microM) to preformed DnaK-ATP
      complexes. The rapid binding kinetics lead to the conclusion that ATP-bound DnaK
      is the primary form initiating interaction with substrates for chaperone
      activity. The resulting DnaK-ATP-substrate complexes, however, are also
      characterized by rapid dissociation of bound substrate, but can be stabilized by
      hydrolysis of ATP (stimulated either by the substrate itself or DnaJ through
      their effects on the rate-limiting step). Stimulation of the gamma-phosphate
      cleavage reaction by DnaJ is much more efficient (complete conversion of bound
      ATP to ADP within five seconds) than that by substrates, indicating the special
      and important role for DnaJ in stabilization of DnaK-substrate interactions.

PMID- 7776368
TI  - The origins and consequences of asymmetry in the chaperonin reaction cycle.
AB  - The binding of nucleotides and chaperonin-10 (cpn10) to the Escherichia coli
      chaperonin-60 (cpn60) and their effect upon the molecular symmetry has been
      examined both kinetically and at equilibrium. ATP binds tightly and is hydrolysed
      on only one heptameric ring of the cpn60 tetradecamer at a time, thus inducing
      asymmetry in the cpn60 oligomer even in the absence of cpn10. In the absence of
      cpn10 these seven ATP molecules hydrolyse to form a cpn60:ADP7 complex in which
      ADP is tightly bound (Kd = 2-7 microM); further ADP binding to form a cpn60:ADP14
      complex is weak (K1/2 = 2.3 mM). We conclude that symmetrical nucleotide
      complexes (with 14 ATP or 14 ADPs) are unstable, demonstrating negative co
      operativity between the rings. When cpn60 is mixed with cpn10 and ATP the
      resultant cpn60:ATP7:cpn10 complex is formed rapidly (the rate constant for cpn10
      association is > 4 x 10(7) M-1 s-1) and before ATP is hydrolysed (k = 0.12 s-1
      per active subunit) to produce an extremely stable cpn60:ADP7:cpn10 complex. This
      allows ATP association on the unoccupied ring and nucleotide asymmetry in the
      double toroid is preserved. In "trapping" experiments, where the cpn60:ADP7:cpn10
      is challenged with ATP, cpn10 was observed to dissociate at a rate identical to
      that of steady-state ATP hydrolysis in the presence of cpn10 (k = 0.042 s-1 per
      active subunit). The spontaneous decay of cpn60:ADP7:cpn10 and any of the major
      steady-state complexes, under conditions where free nucleotides had been removed,
      occurred at a rate tenfold lower than ATP hydrolysis. Since the binding of the
      non-hydrolysable analogue AMP-PNP was unable to induce dissociation of the co
      chaperonin it was concluded that a transient state following ATP hydrolysis is
      necessary for the rapid dissociation of cpn10, which occurs once in every cycle.
      Trapping experiments using sub-stoichiometric concentrations of cpn10, relative
      to cpn60, show an unchanged rate of cpn10 exchange upon ATP hydrolysis,
      indicating that the formation of a symmetric, "football"-shaped complex in which
      two molecules of the co-chaperonin are bound to cpn60, is not an obligatory
      intermediate in the exchange process.

PMID- 7776369
TI  - Towards structure-based drug design: crystal structure of a multisubstrate adduct
      complex of glycinamide ribonucleotide transformylase at 1.96 A resolution.
AB  - An inhibitor complex structure of glycinamide ribonucleotide transformylase (GAR
      Tfase; EC 2.1.2.2) from Escherichia coli has been determined with a
      multisubstrate adduct BW1476U89 to an R-value of 19.1% at 1.96 A resolution. The
      structure was determined by a combination of molecular and single isomorphous
      replacement using data from two different monoclinic crystal lattices and
      collecting data from crystals soaked in 20% (w/v) methyl-pentanediol as
      cryoprotectant for shock-freezing at -150 degrees C. The multisubstrate adduct is
      bound in an extended crevice at the interface between the two functional domains
      of the enzyme. This inhibitor is positioned in the binding site by three sets of
      tight interactions with its phosphate, glutamate and pyrimidone ring moieties,
      while its interventing linker atoms are more flexible and adopt two distinct sets
      of conformations. The highly conserved Arg103, His108 and Gln170 residues that
      are key in ligand binding and catalysis (His108), have compensatory
      conformational variation that gives some clues as to their role in substrate
      specificity and in the formyl transfer. The molecular design of 1476U89 as a
      multisubstrate adduct inhibitor (Ki approximately 100 pM at pH 8.5), is confirmed
      as it closely mimics the shape, molecular interaction and combined binding
      constants of the natural 10-formyltetrahydrofolate (10-CHO-H4F; Km approximately
      77.4 microM at pH 8.5) and glycinamide-ribonucleotide (GAR; Km approximately 8.1
      microM at pH 8.5) substrates. The stereochemistry of this ligand complex suggests
      that His108 may act as an electrophile stabilizing the oxyanion of the
      tetrahedral intermediate that is formed as a result of the direct attack on the
      10-CHO-H4F by the amino group of GAR. Structural comparison of the folate binding
      modes among GAR-Tfase, dihydrofolate reductase and thymidylate synthase reveals
      that folate derivates bound to GAR-Tfase differentially adopt the trans
      conformation for the dihedral angle between atoms C-6 and C-9 providing a handle
      for targeting specific folate-dependent enzymes. The structural information
      derived from two different discrete conformations of the ligand in the binding
      site also suggests several leads for the de novo design of inhibitors of GAR
      Tfase that may develop into useful chemotherapeutic agents.

PMID- 7776370
TI  - Headful packaging revisited: the packaging of more than one DNA molecule into a
      bacteriophage P1 head.
AB  - Like a variety of other bacteriophages, such as T4 and P22, bacteriophage P1
      packages DNA by a "headful" mechanism in which the capacity of the viral capsid
      determines the size of the single DNA molecule that is packaged. Because of the
      long-standing and general acceptance of this packaging mechanism, we were
      surprised to discover that some of our observations, using the in vitro P1
      packaging system, could be explained by the packaging of less than headful-sized
      (< 110 kb) DNA molecules into a P1 capsid. To account for these observations, we
      describe results that support a model of in vitro P1 packaging in which multiple
      less than headful-sized DNA molecules are taken into a P1 head until that head
      has been filled. The results further suggest that the phage so generated can
      occasionally inject more than one DNA molecule into a cell upon viral infection.
      The data that supports these conclusions are: (1) the DNAs of the circular P1
      cloning vectors pAd10sacBII (32 kb) and pNS358 (14 kb) are packaged in vitro with
      an efficiency of about 6 to 12% of that of longer concatemers of these DNAs. (2)
      The in vitro packaging of two differentially marked, less than 18 kb plasmid DNAs
      in the same reaction results in the production of a phage that can occasionally
      inject both DNAs into the same cell upon infection. (3) Virus particles generated
      by the packaging of either pAd10sacBII plasmid DNA or the two differently marked
      plasmids have a density in CsCl equilibrium gradients that is the same as P1
      plaque-forming phage, suggesting that the former phage contain a headful of DNA.
      These results cannot be explained by Cre-mediated site-specific recombination
      between plasmids in the P1 packaging extracts. Finally, we present in vivo
      experiments that are also consistent with the headful packaging of multiple DNAs
      into a P1 head.

PMID- 7776371
TI  - Mutations that stabilize folding intermediates of phage P22 tailspike protein:
      folding in vivo and in vitro, stability, and structural context.
AB  - The folding of the trimeric phage P22 tailspike protein is affected by single
      amino acid substitutions designated temperature-sensitive folding (tsf)
      mutations. Their phenotypes are alleviated by two repeatedly isolated global
      suppressor (su) mutations (su V331A and su A334V) and by two additional
      substitutions (su V331G and su A334I), accessible through site-directed
      mutagenesis. We investigated the influence of the suppressor mutations on
      tailspike refolding in vitro, on its maturation at high expression levels in
      vivo, and on the rates of thermal unfolding of the native protein. All su
      mutations improved the folding efficiency in vitro and in vivo, but the relative
      effects of substitutions at position 334 were more pronounced in vivo, whereas
      the 331 substitutions were more effective in vitro. V331G caused the strongest
      increase in refolding yields of any single mutation, and was as effective as the
      V331A/A334V double mutation, where the two single mutations exhibited an additive
      effect. Both V331A and V331G retarded thermal denaturation, while A334V did not
      affect, and A334I accelerated unfolding. A334I is the first mutation found to
      affect the folding of the tailspike and the thermal stability of the native
      protein in opposite directions. The observed effects can be rationalized on the
      basis of the recently determined crystal structure of an N-terminally shortened
      tailspike. As the backbone dihedral angles of Val331 (phi = -119 degrees, psi = 
      142 degrees) are unusual for non-glycine residues, V331G and V331A may remove
      steric strain and thereby stabilize folding intermediates and the native protein.
      The beta-branched side-chains of Val and Ile substituted for Ala334 in the
      interior of the protein may improve a hydrophobic stack of residues in the large
      parallel beta-helix. This is likely important in loosely structured early folding
      intermediates, but not in the very rigid native structure, where the side-chain
      of Ile can hardly be accommodated.

PMID- 7776372
TI  - Structural refinement of the non-fluorescent flavoprotein from Photobacterium
      leiognathi at 1.60 A resolution.
AB  - The crystallographically-determined structure of the non-fluorescent flavoprotein
      (NFP) from Photobacterium leiognathi, a homolog of the bacterial luciferase
      subunits, has been refined to a conventional R-factor [formula: see text] of
      0.175 using synchrotron data between 10.0 and 1.60 A resolution. The molecular
      structure is a homodimer of beta/alpha domains, the monomer having structural
      similarities to (beta alpha)8 barrel proteins. However, one beta-strand and three
      alpha-helices of a typical (beta alpha)8 domain are not present in the NFP
      structure. The refined structure of NFP consists of the 228 amino acid
      polypeptide, 191 water molecules, a sulfate ion, and two flavin mononucleotides
      (FMNs) each with a covalently-attached myristate (C14 fatty acid). Both flavin
      adducts are well-ordered and have exceptional electron density for both the FMN
      and the myristate moieties. Each flavin mononucleotide-myristate adduct is
      characterized by a stereospecific linkage (the S enantiomer) between C-6 of the
      flavin isoalloxazine ring and the C-3' atom of the fatty acyl chain. The
      stereospecific nature of this flavin-fatty acid linkage suggests that it is the
      result of an enzyme-catalyzed reaction, most likely the bioluminescence reaction
      itself. The myristate chains are buried from solvent in hydrophobic pockets in
      the interior of the protein. Four amino acid side-chains of the NFP polypeptide
      have been modeled with alternate conformations. Five of the protein's seven alpha
      helices have classical C-capping boxes. NFP is dimeric and many of the extensive
      contacts at the dimer interface are mediated by hydrogen-bonded water molecules
      as well as by hydrophobic interactions. One of the myristate acyl chains sits
      between NFP monomers and contributes a significant portion of the hydrophobic
      interactions at the NFP dimer interface.

PMID- 7776373
TI  - Structural characterization of the molten globule and native states of
      apomyoglobin by solution X-ray scattering.
AB  - Compactness and shape are two of the critical properties that describe the degree
      of protein folding. Solution X-ray scattering is an effective technique for
      measuring these properties quantitatively. Structural characteristics of various
      conformational states of horse myoglobin were studied in terms of size and shape
      by solution X-ray scattering. The radius of gyration for native holomyoglobin was
      17.5 A, while that of the apomyoglobin native state was 19.7 A. Corresponding to
      the increase in the radius of gyration, the largest dimension of the molecule
      also increased from 47.5 A to 62.5 A. Both states are globular in shape. The
      scattering profiles in the high angle region suggest that the apomyoglobin native
      state has a distinct tertiary structure, and that packing of alpha-helices in the
      apomyoglobin native state would be looser than that of holomyoglobin. These
      observations indicate that the native state of apomyoglobin is expanded from that
      of holomyoglobin, and that the conformations of the two are not identical. The
      radii of gyration for the acid-unfolded state and the denaturant-unfolded state
      were 30 A and 35 A, respectively. Both unfolded states have chain-like
      conformations without any tertiary structures. The radius of gyration and the
      largest dimension of the molten globule stabilized by trichloroacetate were 23.1
      A and 72.5 A, respectively. The molten globule is expanded from the native state
      although it is globular, and is much more compact than the unfolded state. The
      bimodal distance distribution function and scattering profile at high-angle
      region suggest that the structure of the apomyoglobin molten globule contains a
      core comprising a cluster of multiple alpha-helices and flaring tail(s), which
      would be a common structural property of the compact denatured state appearing
      during the folding process. The compactness of each conformational state is
      highly correlated with the extent of formation of the alpha-helix.

PMID- 7776374
TI  - Functional characterization of the RNA-binding domain and motif of the double
      stranded RNA-dependent protein kinase DAI (PKR).
AB  - The double-stranded (ds) RNA-activated protein kinase, DAI (also known as PKR),
      contains an RNA-binding domain comprising two tandem repeats of a motif, the
      dsRBM, which is shared with a number of other proteins that interact with
      structured RNAs. We have expressed the entire domain and the first copy of the
      motif in Escherichia coli and purified the two proteins, p20 and p10, to apparent
      homogeneity in order to study their interactions with RNA and with the intact
      kinase enzyme. Both p20 and p10 bound preferentially to structured RNA molecules.
      Competition assays showed that in both cases the order of affinity is dsRNA > VA
      RNA > tRNA, but the isolated motif bound much less tightly than the entire
      domain. Measurement of the dissociation constants for dsRNA by quantitative gel
      mobility shift analysis gave apparent Kd values of 4 x 10(-9) M and 3.8 x 10(-7)
      M for p20 and p10, respectively. The binding of p20 molecules to dsRNA appeared
      to be cooperative. Multiple complexes were formed between the intact domain and
      dsRNA, saturating at a density of about one p20 molecule/11.25 base-pairs (or one
      turn) of duplex, whereas p10 achieved only about half of this packing density.
      The apparent Kd for the p20-VA RNA interaction was estimated as 3.5 x 10(-7) M
      and at least three complexes were detected, but no distinct complexes were
      visualized for the interaction between p10 and VA RNA. Both p20 and p10 inhibited
      autophosphorylation of intact DAI, probably by binding the dsRNA activator. Once
      activated, DAI could phosphorylate both p10 and p20, suggesting that
      intermolecular phosphorylation can occur.

PMID- 7776375
TI  - The presence of a D-stem but not a T-stem is essential for triggering
      aminoacylation upon anticodon binding in yeast methionine tRNA.
AB  - Dissection of the yeast cytoplasmic initiator tRNA(Met) into two helical domains,
      the T psi C acceptor and anticodon minihelices, failed to show anminoacylation
      and binding of the acceptor minihelix by the yeast methionyl-tRNA synthetase
      (MetRS) even in the presence of the anticodon minihelix. In contrast, based on
      the measure of the inhibition constant Ki, the anticodon minihelix carrying the
      methionine anticodon CAU is specifically bound to the synthetase and with an
      affinity comparable to that of the full-length tRNA. The yeast tRNA(Met) acceptor
      and anticodon minihelices were covalently linked using the central core sequences
      of either bovine mitochondrial tRNA(Ser) (AGY) lacking a D-stem or initiator
      tRNA(Met) from Caenorhabditis elegans lacking a T-stem. Based on modeling studies
      of analogous constructs performed by others, we assume that the folding and
      distance between the anticodon and acceptor ends of these hybrid tRNAs are
      identical to that of canonical tRNA. The three-quarter molecule, which includes
      the T-stem, has aminoacylation activity significantly more than an acceptor
      minihelix, while the acceptor stem/anticodon-D stem biloop has near wild-type
      aminoacylation activity. These results suggest that the high selectivity of the
      anticodon bases in tRNA(Met) depends upon the tRNA L-shape conformation and the
      presence of a D-arm. Protein contacts with the D-arm phosphate backbone are
      required for connecting anticodon recognition with the active site. These
      interactions probably contribute to fine tune the position of the acceptor end in
      the active site, allowing entry into the transition state of aminoacylation upon
      anticodon binding. The importance of an L structure for recognition of tRNA(Met)
      by yeast MetRS was also deduced from mutations of tertiary interactions known to
      play a general role in tRNA folding.

PMID- 7776376
TI  - Pseudoknot in domain II of 23 S rRNA is essential for ribosome function.
AB  - The structure of domain II in all 23 S (and 23 S-like) rRNAs is constrained by a
      pseudoknot formed between nucleotides 1005 and 1138, and between 1006 and 1137
      (Escherichia coli numbering). These nucleotides are exclusively conserved as
      1005C.1138G and 1006C.1137G pairs in all Bacteria, Archaea and chloroplasts,
      whereas 1005G.1138C and 1006U.1137A pairs occur in Eukarya. We have mutagenized
      nucleotides 1005C-->G, 1006C-->U, 1137G-->A and 1138G-->C, both individually and
      in combinations, in a 23 S rRNA gene from the bacterium E. coli. The ability of
      23 S rRNA to support cell growth is reduced when either of these base-pairs is
      disrupted, and it is completely abolished upon disruption of both base-pairs.
      Each mutant 23 S rRNA is assembled into 50 S subunits, but the mutant subunits do
      not stably interact with 30 S to engage in protein synthesis. Enzymatic and
      chemical probing of ribosomal particles reveals increased accessibility in the
      rRNA structure close to the sites of the mutations. The degree to which the
      mutations increase rRNA accessibility correlates with the severity of their
      phenotypic effects. Nucleotide 1131G is extremely reactive to dimethyl sulphate
      modification in wild-type subunits and ribosomes, but is rendered unreactive when
      either the pseudoknot is broken or when the r-proteins are removed. The structure
      of the pseudoknot region is possibly influenced by interaction of an r-protein at
      or close to the pseudoknot. Re-establishing the pseudoknot Watson-Crick
      interactions with one "eukaryal" (1005G.1138C or 1006U.1137A) pair and one
      "bacterial" C.G pair largely restores the structure and function of the rRNA.
      Bacterial ribosomes containing both these eukaryal pairs also participate in
      protein synthesis, although at much reduced efficiency, and the structure of
      their pseudoknot region is partially open and accessible.

PMID- 7776377
TI  - The structure of the R-type straight flagellar filament of Salmonella at 9 A
      resolution by electron cryomicroscopy.
AB  - The supercoiled forms of the flagellar filaments are thought to be constructed
      from a mixture of two distinct subunit conformations arranged in a regular
      manner. We analyzed the structure of one of the two straight flagellar filaments,
      each of which is built up with all its subunits in one of the two conformations.
      The filament we studied was isolated from the strain SJW1655 of Salmonella
      typhimurium and had a right-handed helical symmetry. With recent advancements in
      electron cryomicroscopy, such as a liquid helium temperature stage for frozen
      hydrated specimens and a stable field emission source, and also by averaging high
      resolution data with a proper correction of the contrast transfer function, the
      density distribution map of this straight flagellar filament was generated in far
      more detail than before by including data up to 9 A resolution. The structure
      shows a densely packed core region from about 15 to 55 A in radius, where a pair
      of concentric tubular features of high density is present without well-defined
      subunit boundaries, and an outer part from 55 to 115 A, where the subunits are
      mostly well separated from each other. The outer tube in the core region, from 35
      to 55 A in radius, contains many rod-like features with near-axial orientation
      and closest lateral distances of around 10 A, which are most likely to represent
      the alpha-helical bundles that were predicted in our previous report. In the
      inner tube, from 15 to 30 A in radius, the rod-like features are less clear.
      Between the inner and outer tubes are the short spoke-like densities, which are
      radially tilted and are connecting the two tubes. The outer part, from 55 to 115
      A, contains an axially elongated column density and a slewed projection with a
      narrow neck region. When compared with the other straight filament having left
      handed helical symmetry, this outer part does not show any significant changes in
      orientation, suggesting that the switch in the subunit conformation and packing
      involved in the polymorphic transitions is quite subtle and only occurs within
      the core region. Reassignment of each structural domain to the amino acid
      sequence is suggested, based on the volume of each domain, which was determined
      rather precisely by a proper correction of the contrast transfer function for
      both amplitudes and phases.

PMID- 7776379
TI  - Preconditioning stimuli and inadvertent preconditioning.
AB  - There are several factors besides brief episodes of total coronary occlusion
      which can provide sufficient stress to result in a preconditioning-like effect on
      the size of a myocardial infarction. Partial coronary artery stenosis, hypoxia,
      stretch, catecholamines, rapid pacing, and certain pharmacologic therapies may
      provide preconditioning stimuli. These same factors as well as mechanical
      complications in which a coronary artery is briefly occluded or stenosed prior to
      a subsequent coronary occlusion may lead to inadvertent preconditioning and
      confound the results of experimental cardiology studies.

PMID- 7776378
TI  - Structure of bacterial flagellar filaments at 11 A resolution: packing of the
      alpha-helices.
AB  - Recent advances in the analysis of electron micrographs of frozen, hydrated
      bacterial filaments have allowed us to average data from more than 150 images and
      to reconstruct the bacterial flagellar filament of Salmonella typhimurium at a
      resolution of approximately 11 A. In addition to the outermost features seen in
      earlier lower resolution maps of the filament, we find a pair of concentric tubes
      which surround a approximately A diameter channel at the center of the structure.
      The walls of these tubes are composed of rod-like features which we have
      interpreted as columns of individual alpha-helices stacked end-to-end. Each
      column runs approximately parallel to the helix axis. The wall of the innermost
      tube, at a radius of approximately 20 A, is formed from 11 such columns. The wall
      of the second tube is formed from 22 columns which occur alternately at radii of
      approximately 43 and approximately 47 A. The two concentric tubes are held apart
      by spacers. These are short, rod-like features, which run approximately parallel
      to the helix axis. We have interpreted these as additional alpha-helices. By
      symmetry, each flagellin monomer contributes an alpha-helix to the inner tube,
      two alpha-helices to the outer tube and a fourth alpha-helix to the spacer. We
      have tentatively assigned one type of alpha-helix in the outer tube to the
      approximately 30 C-terminal residues of flagellin while the remaining three alpha
      helices are assigned to the approximately 70 N-terminal residues. This
      interpretation of the reconstruction is consistent with available biochemical,
      biophysical and amino acid sequence information. We also present details of
      improved methodology to extract and evaluate the original data and also to assess
      the statistical significance of features in the three-dimensional map.

PMID- 7776380
TI  - Organization and function of sarcolemmal phospholipids in control and
      ischemic/reperfused cardiomyocytes.
AB  - The topic of this review is the lipidic part of the sarcolemma, the plasma
      membrane of the myocardial cell, and its role in (dis)function of the
      cardiomyocyte. First the isolation of the sarcolemma and its lipid composition
      are discussed. These phospholipids are not randomly distributed over the two
      monolayers of the lipid bilayer and negatively charged phospholipids are
      exclusively present in the cytoplasmic leaflet of the sarcolemma, which also
      contains the majority of phosphatidylethanolamine. This distribution is most
      likely caused by an active transport of these lipids and by an interaction of the
      headgroup of these lipids with the cytoskeleton. Subsequently the physicochemical
      properties of sarcolemmal phospholipids are discussed, where it is shown that
      certain phospholipids prefer non-bilayer phases, and the effects of sarcolemmal
      phospholipids on trans-sarcolemmal ion fluxes and calcium compartmentation are
      discussed. In the second part the effect of ischemia on sarcolemmal phospholipids
      is discussed with regard to: transbilayer distribution, hydrolysis, lateral
      distribution and sarcolemmal bilayer stability. In our view, onset of ischemia
      initiates a sequence of events leading to a loss of normal sarcolemmal
      phospholipid distribution with an outward migration of phosphatidylethanolamine.
      There follows, as ischemia progresses, loss of sarcolemmal bilayer stability due
      to the expression of the non-bilayer behavior of phosphatidylethanolamine,
      leading to irreversible disruption of the sarcolemma and cell death.

PMID- 7776382
TI  - Pancreastatin stimulates secretion from neonatal rat atrial cells.
AB  - Atrial myocardial cells store atrial natriuretic factor and secrete the peptide
      in response to extracellular stimulation. Ventricular myocardial cells also
      exhibit stimulated secretion of atrial natriuretic factor but with little or no
      intracellular storage. The stimulated secretion of other proteins from these
      cells is poorly characterized. In the present study the secretion of sulfated
      macromolecules from Na2(35)SO4 labeled atrial and ventricular myocardial cells
      was quantitated. Both cell types secreted a chondroitin sulfate proteoglycan, as
      evidenced by glycanase digestion. Endothelin-1, a known stimulator of ANF
      secretion, stimulated secretion from atrial cells about 70% but had no effect on
      ventricular cell secretion. The differential stimulation of atrial and
      ventricular cell secretion was not due to the absence of a regulated secretory
      pathway in the latter cell type since phorbol ester stimulated secretion from
      both cell types. This result indicates that differences exist in the early steps
      of signal transduction between atrial and ventricular cells. Pancreastatin, a
      regulatory peptide derived from chromogranin A, stimulated atrial cell secretion
      90%. This result suggests that chromogranin A, which has been identified in
      atrial secretory granules, may play an autoregulatory role in atrial secretion.

PMID- 7776384
TI  - Myocardial buffering capacity in ischemia preconditioned rat hearts.

PMID- 7776383
TI  - Ventricular myocytes isolated from rejecting cardiac allografts exhibit a reduced
      beta-adrenergic contractile response.
AB  - Previous experiments using multicellular preparations from rejecting transplanted
      animal hearts have indicated that a decrease in the contractile response to beta
      adrenergic stimulation accompanies acute rejection. The precise mechanism of this
      decreased beta-adrenergic response, which may limit the inotropic reserve in
      human transplant patients during rejection, is currently unknown. In order to
      determine whether the decreased beta-adrenergic response is an intrinsic property
      of the cardiac myocytes from rejecting hearts, we examined the effects of beta
      adrenergic stimulation (isoproterenol, 10(-8) and 10(-6) M) on the cell
      shortening of single myocytes isolated from native rat hearts (untransplanted
      Lewis strain), non-rejecting isografts (Lewis to Lewis heterotopic transplant),
      and rejecting allografts (Lewis to ACI transplant). The myocytes from isografts
      demonstrated a significantly increased contractile response to isoproterenol
      compared to native myocytes (presumably due to denervation supersensitivity),
      whereas the myocytes from allografts demonstrated a greatly decreased response to
      isoproterenol compared to both native and isograft myocytes. These results
      demonstrate that the decreased beta-adrenergic contractile response is an
      intrinsic property of the rejecting cardiac myocyte.

PMID- 7776381
TI  - Endothelin-1 contributes to ischemia/reperfusion injury in isolated rat heart
      attenuation of ischemic injury by the endothelin-1 antagonists BQ123 and BQ610.
AB  - A potential detrimental role of endothelin-1 in myocardial ischemia/reperfusion
      injury was studied by use of the endothelin-1 antagonists BQ123 and BQ610.
      Isolated isovolumetric rat hearts were perfused at constant pressure. BQ123 (7
      micrograms/min) and BQ610 (1.75 micrograms/min) did not alter mechanical function
      or coronary flow and shifted dose-response curves for endothelin-1 significantly
      to the right. In rats subjected to 30 min of no-flow ischemia, the increase of
      left ventricular resting pressure was significantly delayed by BQ123 and BQ610
      compared to control (BQ123: 20 +/- 2* mmHg, BQ610: 19 +/- 2* mmHg, control: 44 +/
      4 mmHg at 15 min of ischemia, respectively, *P < 0.05 v control). With
      reperfusion after 30 min of ischemia, recovery of left ventricular developed
      pressure was not significantly affected but tended to be better with endothelin-1
      antagonist pretreatment (BQ123: 20 +/- 3 mmHg; BQ610: 19 +/- 3 mmHg, control 12
      +/- 3 mmHg). However, in hearts subjected to 15 min of ischemia followed by
      reperfusion, recovery of left ventricular developed pressure was improved by
      BQ610 pretreatment (BQ610: 52 +/- 8* mmHg, control: 24 +/- 6 mmHg). We conclude:
      BQ123 and BQ610 effectively antagonize the coronary constrictive effect of
      endothelin-1. BQ123 and BQ610 delay the development of contracture during
      ischemia and may improve functional recovery during reperfusion. Our findings
      suggest that endogenous endothelin-1 may contribute to ischemia/reperfusion
      injury.

PMID- 7776385
TI  - Alterations of excitation-contraction coupling in stunned myocardium and in
      failing myocardium.
AB  - Although both myocardial stunning and chronic heart failure are characterized by
      contractile dysfunction, there are profound differences in their underlying
      mechanisms. Changes in cardiac contractile force can be effected by modulation of
      intracellular [Ca2+] or by alteration of the contractile protein response to
      intracellular Ca2+. New evidence suggests that the principal lesion in the
      stunned myocardium resides at the level of the contractile proteins, which may be
      injured by proteases activated early during reperfusion. In contrast, failing
      myocardium is known to display abnormal intracellular Ca2+ handling, indicative
      of dysfunction of the sarcoplasmic reticulum. Alterations of gene expression and
      isoform switching of the myofilaments also occur in failing myocardium,
      consistent with an observed shift of the kinetics of crossbridge cycling. In
      conclusion, changes in both intracellular Ca2+ homeostasis and myofilament
      function occur in failing myocardium, while stunned myocardium primarily reflects
      an uncoupling between Ca2+ and contractile force.

PMID- 7776387
TI  - Autoinduction of mRNA and protein expression for transforming growth factor-beta
      S in cultured cardiac cells.
AB  - Although transforming growth factor-beta s (TGF-beta s) are expressed widely in
      both adult and embryonic rat heart, both mRNA and protein expression increase
      following ischemic injury. Furthermore, exogenous administration of TGF-beta
      decreases cardiac damage following ischemia-reperfusion in rats. We have found
      that treatment of primary cultures of neonatal rat cardiomyocytes or cardiac
      fibroblasts with TGF-beta 1, 2, or 3 results in increased expression of TGF-beta
      1, 2, and 3 mRNA. TGF-beta 2 was generally the least effective isoform in
      inducing TGF-beta expression. In cardiac fibroblasts mRNA expression of all TGF
      beta s increased 2-3-fold following 1 h of treatment and decreased to control
      levels by 8 h which was accompanied by a 2.5- and 2.3-fold increase in TGF-beta 1
      and 2 protein secretion, respectively. By 48 h of treatment mRNA levels for TGF
      beta s 2 and 3 were less than 10% of control levels. In cardiomyocytes two-five
      fold increases in mRNA levels were observed following 1-24 h of TGF-beta 1
      treatment, but TGF-beta 1 and 3 mRNA levels returned to control values by 48 h
      while TGF-beta 2 mRNA expression remained elevated. TGF-beta 1 and 2 protein
      secreted by the cardiac myocytes was increased 2.9- and 1.7-fold, respectively.
      Autoinduction of TGF-beta s may play a beneficial role in cardiac wound healing
      by sustaining transient increases in TGF-beta levels from either endogenous
      synthesis or exogenous application.

PMID- 7776386
TI  - Intracellular compartmentation of troponin T: release kinetics after global
      ischemia and calcium paradox in the isolated perfused rat heart.
AB  - The marked differences in troponin T serum concentrations observed in patients
      with reperfused and non-reperfused myocardial infarction may be due to a
      perfusion dependent wash-out of an unbound fraction of cardiac troponin T. To
      test the release kinetics of troponin T experimentally, the isolated rat heart
      (Langendorff preparation) was damaged either by the calcium paradox or by no-flow
      ischemia. Following membrane damage by the calcium paradox troponin T (TNT)
      showed the same release kinetics in the coronary effluent as the cytosolic
      markers creatine kinase (CK) or lactate dehydrogenase (LDH). Peak levels of
      troponin T (282 +/- 58 micrograms/l), CK (6754 +/- 1642 U/l), and LDH (5817 +/-
      1730 U/l) occurred 5 min after onset of reperfusion with calcium containing
      buffers and returned to 9.9%, 1.3%, and 1% of their respective peak levels within
      55 min of reperfusion. During reperfusion after no-flow ischemia different
      release kinetics were found for cytosolic enzymes and troponin T. After 60 min of
      ischemia, troponin T levels in the coronary effluent increased over the entire
      reperfusion period of 55 min, almost doubling the 5 min value (191%). In
      contrast, cardiac enzymes rapidly declined to 18% (CK) and 23% (LDH) of their
      respective 5 min values at the end of reperfusion. Light microscopy after
      reperfusion with carbon black revealed a complete and homogeneous reperfusion of
      Langendorff hearts after no-flow ischemia. Immunoblot analysis confirmed the
      release of an undegraded 39 kDa troponin T molecule, both after global ischemia
      and the calcium paradox. These data indicate that prolonged ischemia induces a
      continuous liberation of cardiac troponin T, most probably from disintegrating
      myofibres, whereas membrane damage leads almost exclusively to leakage of a
      functionally unbound troponin T pool. These findings may explain the biphasic
      serum concentration changes of cardiac troponin T in patients with reperfused
      myocardial infarction.

PMID- 7776388
TI  - Bradykinin receptor and tissue ACE binding in myocardial fibrosis: response to
      chronic angiotensin II or aldosterone administration in rats.
AB  - High density angiotensin converting enzyme (ACE) binding is present in the
      perivascular fibrosis involving intramyocardial coronary arteries and the
      microscopic scarring of the myocardium that accompanies chronic elevations in
      circulating angiotensin II (AngII) and/or aldosterone (ALDO). As a kininase II,
      ACE degrades bradykinin. Herein we sought to determine whether bradykinin (BK)
      receptor binding was associated with ACE binding in each of these experimental
      models. BK receptor binding was localized and quantified by in vitro quantitative
      autoradiography, using [125I-Tyr8]BK. In serial sections of the same heart
      hematoxylin and eosin (H&E) and picrosirius red (PSR) staining were utilized to
      address cardiac myocyte injury and fibrosis, respectively. Four experimental
      groups were examined: unoperated, untreated, age/sex matched controls: age/sex
      matched uninephrectomized control rats receiving a high sodium diet; animals that
      received AngII (9 micrograms/h sc) for 2, 4 or 6 weeks; and uninephrectomized
      rats on a high sodium diet that received ALDO (0.75 micrograms/h sc) for similar
      periods of time. We found: (a) myocardial fibrosis, including perivascular
      fibrosis and microscopic scarring, at week 2 of AngII, but not until week 4 or
      more of ALDO treatment; (b) low BK receptor binding in normal ventricles that was
      increased in scars and markedly increased in perivascular fibrosis at week 2 of
      AngII and each increased further at week 4 and 6 of AngII: (c) low BK receptor
      binding at week 2 and 4 weeks of ALDO treatment which became markedly increased
      at fibrous tissue sites at week 6. BK receptor and ACE binding were anatomically
      coincident and localized to each site of fibrosis in both models. The co-location
      of BK receptor and ACE binding in these models raises the prospect that fibrous
      tissue ACE may utilize BK as substrate and BK, in turn, may play a role in
      fibrous tissue formation.

PMID- 7776389
TI  - Stable expression and functional characterization of a human cardiac Na+ channel
      gene in mammalian cells.
AB  - In order to develop mammalian cell lines expressing a functional human heart Na+
      channel gene (hH1), Chinese hamster ovary (CHO-K1) cells and HeLa cells were
      transfected with the hH1 gene and the bacterial neomycin (neo) resistance gene.
      In CHO-K1 cells, direct screening for hH1-positive, G418-resistant colonies by
      functional patch clamp analysis was complicated due to low-level endogenous
      expression of a brain-type Na+ channel. Therefore, we developed a stepwise
      strategy for isolation of cell lines expressing functional hH1 Na+ channels: G418
      resistant colonies were sequentially analysed for (1) chromosomal integration of
      hH1 DNA by PCR, (2) specific hH1 mRNA expression by RT-PCR, (3) hH1 protein
      production by immunoprecipitation with hH1-specific antisera, and (4) hH1 Na+
      channel function by patch-clamp analysis. Using this strategy we obtained two CHO
      K1 cell lines which express functional human heart Na+ channels. However, using
      the same strategy, we were unsuccessful in obtaining functional, hH1-positive
      HeLa cell lines, even though hH1 mRNA and protein was produced in these cells.
      The two CHO-K1 cell lines stably express human cardiac Na+ channels which retain
      normal electrophysiological characteristics with respect to activation and
      inactivation. In addition, the Na+ channels expressed in these cells are blocked
      by tetrodotoxin with an IC50 value of 2.5 microM; consistent with known cardiac
      Na+ channel pharmacology. The density of channels is high enough to permit
      recording of pseudomacroscopic currents in excised outside-out patches of
      membrane.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7776390
TI  - An analysis of lidocaine block of sodium current in isolated human atrial and
      ventricular myocytes.
AB  - Lidocaine is a Na+ channel blocker that is highly effective for the treatment of
      ventricular tachyarrhythmias, but is largely ineffective against atrial
      arrhythmias. If is not known if this differential efficacy is the result of
      differences in lidocaine inhibition of atrial v ventricular Na+ channels. The
      purpose of the present study was to characterize lidocaine block of Na+ channels
      in human atrium and ventricle. We used the whole cell voltage clamp technique
      with low external and internal Na+ concentrations (5 mM) to study the Na+ current
      (INa) in single human atrial and ventricular cells isolated enzymatically from
      specimens obtained during surgery. We found that tonic block of peak INa by
      lidocaine (200 microM, holding potential = -140 mV, 0.1 Hz, at 17 degrees C) was
      not voltage dependent in either cell type. Reduction of maximal peak Na+
      conductance in 41 atrial cells (19.8 +/- 2.7%) and nine ventricular cells (22.6
      +/- 1.7%) was virtually identical. The rate of onset of block development was
      determined during depolarization to either -80 mV or -20 mV. The time course of
      onset of block was described by a single exponential at -80 mV and by a double
      exponential at -20 mV. When the rate of block onset during a single conditioning
      depolarization was compared to that which developed during conditioning by a
      train of brief pulses (3 ms, 30 Hz), onset was faster during the pulse train. The
      results were nearly identical for atrial and ventricular INa. The time constants
      of recovery from block following either single pulse or multiple-pulse
      conditioning did not differ. These data suggest that lidocaine binds to both the
      activated and inactivated states of the human cardiac Na+ channel. Using an
      analytical method based upon the Guarded Receptor Hypothesis, we calculated
      apparent rate constants describing lidocaine's interaction with the three primary
      states of the human Na+ channel (resting, activated and inactivated). Rate
      constants were similar to those reported for other mammalian species. Our results
      demonstrate that lidocaine block of INa is virtually identical for human atrial
      and ventricular cells; thus additional mechanisms must be invoked to explain the
      differential efficacy of lidocaine against ventricular as compared to atrial
      dysrhythmias.

PMID- 7776391
TI  - Caretaker compliance with different antibiotic formulations for treatment of
      childhood pneumonia.
AB  - To determine the effect of antibiotic formulations on compliance, 400 children,
      aged 2 months to 5 years, with a presumptive diagnosis of pneumonia, were
      randomly assigned to receive one of the following formulations of cotrimoxazole:
      1. syrup accompanied by a 10-ml measuring cup; 2. syrup accompanied by a 5-ml
      measuring spoon; 3. tablets; 4. single-dose sachets of antibiotic powder. A
      research assistant visited the childs' home on the fourth day of therapy, asked
      the care-giver about compliance, and observed the care-giver prepare a dose of
      the medication. The remaining amount of medicine was measured, and when possible
      (n = 151), a urine specimen was tested for the presence of sulphamethoxazole. All
      of the care-givers reported giving at least one dose on the first day of therapy.
      By the fourth day, 82 per cent of those receiving syrup were still taking their
      medication compared to 71 and 55 per cent of those receiving sachets or tablets,
      respectively (P < 0.01). Of those who received syrup accompanied by a spoon, 38
      per cent under-dosed the medicine by at least 30 per cent. Overall, compliance
      was highly correlated with the care-giver's report of difficulty in administering
      the medication. Additional research is needed to understand the obstacles
      encountered by care-givers in administering sachets and tablets. Meanwhile, the
      use of antibiotic syrup, accompanied by an appropriately sized measuring cup,
      appears to offer the greatest probability of medication compliance in the
      treatment of Egyptian children with pneumonia.

PMID- 7776392
TI  - Neonatal meningitis: a 3-year retrospective study at the Mount Hope Women's
      Hospital, Trinidad, West Indies.
AB  - The objective of this 3-year (1988-1990) retrospective study was to report the
      experience with neonatal meningitis at the Neonatal Intensive Care Unit, Mount
      Hope Women's Hospital, Trinidad, West Indies. Neonates were included in the study
      if organisms were cultured from the cerebrospinal fluid (CSF) and/or if there was
      a pleocytosis (> or = 100/mm3) in the CSF. There were 49 neonates with meningitis
      out of a total of 17,048 live born (LB) infants during the 3-year period to give
      an overall incidence of 2.87/1000 LB. This was five times higher than the
      incidence reported in the literature. There were an additional five who were
      outborns to give a total of 54 cases. There were 34 males (63 per cent) with a
      mean birth weight of 2389 g. Antenatal risk factors included preterm delivery (50
      per cent), prolonged rupture of the amniotic membranes (37 per cent). Associated
      maternal conditions included hypertension and antepartum haemorrhage (9 per
      cent). In contrast to other reported studies, there was early onset of the
      condition (mean age at presentation was 4 days) and the commonest organism found
      was Group B streptococcus while the least common were the Gram-negative
      organisms. Also different in the present study was the high percentage (56 per
      cent) of meningitis associated with Group B septicaemia, the low mortality rate
      (13) and the low rate of neurological sequelae (40 per cent).

PMID- 7776393
TI  - Chronic malnutrition and Trypanosoma cruzi infection in children.
AB  - The distribution of T. cruzi infection overlaps regions with high prevalence of
      child malnutrition. We examined the possible association between T. cruzi
      infection and chronic malnutrition. In a cross-sectional survey conducted among
      1900 7-12 year-old schoolchildren in 60 village schools in central Brazil,
      anthropometric measurements (NCHS) taken from 153 children with at least two
      positive serological tests for antibodies against T. cruzi (IIF, ELISA, IHA) were
      compared to two age and sex seronegative matched classmates. Information on
      children's medical history and socio-economic status (SES) were collected from
      parents of the participants. Seropositive children had a 2.4-fold risk (95% CI
      1.4-4.0) of being stunted (z-score < 2.0 of height-for-age) when compared to
      uninfected children even after adjusting for confounding variables. Being
      underweight (z-score < -2.0 of weight-for-age) was also statistically associated
      with seropositivity to T. cruzi (OR = 2.8, 95% CI 1.4-5.6). No statistical
      evidence of multiplicative interaction between nutritional status and SES was
      detected. Further studies on nutrition and metabolism are required to look into a
      possible physiopathological mechanism for this association.

PMID- 7776395
TI  - Bejel in Malatya, Turkey.
AB  - Bejel is a form of endemic syphilis which is transmitted by non-venereal route.
      According to our knowledge, no cases of bejel have been reported from Turkey for
      more than 30 years. In this report, three children and their father who suffer
      from bejel are presented. The history, physical findings, laboratory
      investigations, treatment and results of the cases are reviewed, and the related
      literature is discussed.

PMID- 7776394
TI  - Loss of maternally-acquired measles antibody during infancy in Ilorin, Nigeria.
AB  - In a study of the prevalence of measles antibody in infants aged 1-9 months
      detectable antibody was present in 32 per cent. Prevalence was highest in the 4-7
      week age group and dropped rapidly with increasing age. In infants 28-35 weeks
      old, only 7 per cent had detectable antibody. Logistic regression analysis showed
      that by the end of the seventh month of life only 10 per cent would carry
      antibody against measles.

PMID- 7776396
TI  - An investigation into feeding errors of 0-4-month-old infants.
AB  - This study was carried out on 206 infants seen consecutively at the Pediatric
      Clinic of our hospital. The feeding errors investigated were: the proportion of
      infants not exclusively breast-fed, incorrect dilution of formula milk, incorrect
      dilution of cow's milk, rice flour feed prepared with water, and the use of rice
      water as a feed. The feeding methods of the infants were compared with their
      weight for height. Of those infants exclusively breastfed 83 per cent were found
      to be above 100 per cent as regards weight-for-height. In those receiving
      supplementary feeds this ratio was significantly lower (P < 0.05). In 20 per cent
      of cases where the infant had received formula milk and in 14 per cent of cases
      where the infant had received cow's milk, the milk was found to be overdiluted by
      more than 40 per cent.

PMID- 7776397
TI  - Integrated Child Development Services Scheme and nutritional status of Indian
      children.
AB  - The Integrated Child Development Services (ICDS) Scheme is one of the major
      National Human Resource Development Programmes of the Government of India. The
      programme completed 18 years of its effective operational duration on 2 October
      1993. During this period we have conducted various baseline surveys, multicentre
      longitudinal and periodic studies, and unicentre special study projects to
      determine the impact of the programme on the nutritional status of children aged
      0 to < 6 years and evaluate the coverage of the scheme. The children with normal
      nutrition in ICDS blocks constituted 50 per cent of the surveyed population in
      1976 in comparison to 75 per cent observed in baseline data of 1990 survey. There
      was a highly significant decrease in severely malnourished children from 21 per
      cent in 1976 to 7 per cent in 1990. The benefit of the programme was evident in
      all sections of the society including Scheduled Castes, Scheduled Tribes,
      Backward and Minority communities. The nutritional services (supplementary
      nutrition, Vit. A, Iron, and Folic Acid) coverage of the children increased from
      25 per cent in 1976 to 53 per cent in 1985 in ICDS blocks in comparison to 42 per
      cent in non-ICDS blocks, while that for pregnant and lactating women increased
      from 17 per cent and 14 per cent in 1976 to 25 per cent and 26 per cent 1985,
      respectively.

PMID- 7776398
TI  - Applications of molecular biology in parasitic diseases.

PMID- 7776399
TI  - Cranial sonography in pyogenic meningitis in neonates and infants.
AB  - Cranial sonography was performed in 34 infants with proven meningitis and with
      clinical suspicion of its complications, utilizing the patent anterior
      fontanelle. Twenty-five patients showed various sonographic findings which
      included ventriculomegaly, echogenic sulci, subdural effusion, ventriculitis,
      infarction/cerebritis, cerebral oedema, porencephalic cyst, etc. Sonography is
      safe and cost-effective in diagnosis of complications, and management of pyogenic
      meningitis in infants.

PMID- 7776400
TI  - The echocardiographic findings in kwashiorkor.
AB  - Echocardiography (ECHO), electrocardiography (ECG), and chest radiography (CXR)
      were performed in 44 children with kwashiorkor, and 44 age- and sex-matched
      controls. In patients with kwashiorkor, mean values obtained for end diastolic
      dimension (29.2 +/- 3.8 mm), end systolic dimension (20.9 +/- 2.8 mm), posterior
      ventricular wall thickness (5.42 +/- 0.57 mm), and shortening fraction (28.2 +/-
      4.3%) were significantly smaller than the corresponding values obtained in the
      controls -38.0 +/- 5.8 mm (P < 0.001), 27.6 +/- 4.5 mm (P < 0.001), 7.07 +/- 0.71
      mm (P < 0.001) and 31.4 +/- 4.5% (P < 0.05), respectively. Similarly, mean
      cardiothoracic ratio (48.6 +/- 3.4%) and QRS amplitude (13.20 +/- 4.85 mm) were
      significantly (P < 0.001) smaller in subjects than controls, corresponding values
      being 54 +/- 3.2 per cent and 20.18 +/- 5.12 mm, respectively. In the subjects,
      there was very good correlation between posterior ventricular wall thickness and
      cardiothoracic ratio (r = 0.93; P < 0.001) and also between the estimated left
      ventricular mass and S1 + R6 amplitude (r = 0.89; P < 0.001).

PMID- 7776401
TI  - Cytogenetic analysis of children suspected of chromosomal abnormalities.
AB  - Karyotypes were examined in 122 Omani children suspected of having chromosomal
      abnormalities. A total of 50 (41 per cent) had an abnormal karyotype: 38 (31 per
      cent) were Down's syndrome whilst a further 12 (10 per cent) had other types of
      chromosomal abnormalities. These findings suggest that cytogenetic analysis is
      useful in the investigations of children with congenital anomalies of unknown
      origin; to confirm clinical diagnosis in children with known cytogenetic
      syndromes and for genetic counselling.

PMID- 7776402
TI  - A 4-year study of neonatal meningitis: clinical and microbiological findings.
AB  - The clinical and microbiological data of 60 neonates, 23 from the Neonatal Unit
      (Group I) and 37 (Group II) from the General Paediatric Wards with meningitis are
      presented. The overall prevalence/1000 was significantly lower in Group I (0.36)
      than in Group II (1.11; P < 0.0001). This low incidence follows the introduction
      of amikacin for the treatment of the ill neonate in 1986. Streptococcus
      agalactiae 21 (35 per cent), Klebsiella pneumoniae 17 (28 per cent) and E. coli
      10 (17 per cent) were the commonest pathogens accounting for 80 per cent of the
      cases. Streptococcus agalactiae isolates were uniformly susceptible to penicillin
      and chloramphenicol. Gram negative isolates showed resistance to ampicillin,
      chloramphenicol and sulphamethoxazole-trimethoprim. In addition K. pneumoniae
      isolates showed resistance to gentamycin and amikacin. All isolates were fully
      susceptible to cefotaxime. Recently, four of six cases of K. pneumoniae in the
      Neonatal Unit were resistant to amikacin. Low birth weight, additional clinical
      problems, and ultrasound changes on cranial scanning carried a poor prognosis.
      Emphasis should be placed on close collaboration between clinicians and
      microbiologists in the choice of antimicrobial agents and aseptic techniques for
      the care of neonates.

PMID- 7776403
TI  - Mid-thigh circumference--role in assessing the nutritional status of children
      between 6 years and 12 years of age.
AB  - Children between 6 and 12 years form a group at risk for nutritional lag. It has
      been seen that their growth and nutritional status can be satisfactorily assessed
      by measuring the mid-thigh circumference, using a fibreglass measuring tape.

PMID- 7776405
TI  - Reasons for admission, causes of death and costs of admission to a tertiary
      referral neonatal unit in India.
AB  - The aim of this study was to determine the reasons for admission, charges made,
      and causes of death in a tertiary referral neonatal unit in India. Records of the
      Christian Medical College Hospital, Vellore, Tamil Nadu, India, were reviewed for
      the period 1 January-31 December 1992. The principal cause of death was
      ascertained with reference to predetermined diagnostic criteria. There were 5592
      livebirths, 138 stillbirths and 1809 admissions to the nurseries (1603 inborn,
      206 outborn). Suspected sepsis accounted for 24 per cent of admissions, 14 per
      cent required preterm care, 13 per cent phototherapy and 8 per cent were full
      term low birth weight babies admitted for observation. There were 87 early
      neonatal deaths, 4 per cent (49) of inborn admissions and 18 per cent (38) of
      outborn admissions. A further 11 babies were discharged to receive terminal care
      at home and nine were discharged, critically ill, against medical advice. Causes
      of death were respiratory problems of prematurity (49 per cent), lethal
      congenital malformations (22 per cent), complications of asphyxia (20 per cent)
      and sepsis (5 per cent). The median duration of nursery care was 2 days (range 1
      21) and the median charge made Rs 714 (range 122-5036). Although the pattern of
      admissions and deaths still reflects the substantial problems of suspected
      sepsis, asphyxia, and congenital malformations, problems of immaturity may be on
      the increase. We caution against hospital-based statistics that fail to take
      account of babies who are discharged alive in the knowledge that death is
      imminent. Considered strategies for the provision or selective provision, of
      neonatal care in India, are called for.

PMID- 7776404
TI  - Determinants of nutritional status in south-west Uganda.
AB  - In a cross-sectional survey carried out of 4320 children 0-59 months old in South
      west Uganda various socio-economic and environmental factors were related to poor
      nutritional status. Diarrhoea was strongly associated with all the anthropometric
      parameters examined, suggesting a bidirectional influence of diarrhoea on
      malnutrition and of malnutrition on diarrhoea. The other most important variables
      independently associated with one or more anthropometric parameters were:
      distance from a health unit, living in a household not able to hire labour, and
      whose members worked on other people's land, religion, parental education,
      crowding conditions, sanitation, acreage, ownership of cow, father's occupation,
      birth order, ethnicity, and prolonged breastfeeding. This data indicates that a
      range of specific interventions are likely to be necessary for the improvement of
      nutrition in this community.

PMID- 7776406
TI  - Randomized double-blind study comparing the efficacy of terazosin versus placebo
      in women with prostatism-like symptoms.
AB  - PURPOSE: We attempt to determine whether terazosin is effective therapy for the
      treatment of prostatism-like symptoms in women. MATERIALS AND METHODS: A total of
      29 women 47 to 79 years old with prostatism-like symptoms entered a randomized
      double-blind study comparing terazosin (14) versus placebo (15). The salient
      inclusion and exclusion criteria consisted of an American Urological Association
      (AUA) symptom score of 8 or more, post-void residual volume less than 300 ml. and
      absence of stress urinary incontinence. RESULTS: The baseline and final visit AUA
      symptom scores were 12.7 and 10.7 respectively, in the placebo group, and 16.4
      and 13.6, respectively, in the terazosin group. The differences between the
      change in AUA symptom score in the placebo and terazosin groups were not
      clinically or statistically significant. CONCLUSIONS: Our study demonstrates that
      terazosin is not effective for the treatment of prostatism-like symptoms in aging
      women.

PMID- 7776407
TI  - Symptoms of the transurethral resection syndrome using glycine as the irrigant.
AB  - We evaluated signs and symptoms of the transurethral resection syndrome recorded
      during and after 273 transurethral prostatic resections performed at 2 hospitals
      between 1984 and 1993. Glycine solution was used as the irrigant and ethanol
      served as a tracer for fluid absorption. The incidence and severity of symptoms
      that could possibly be related to the syndrome increased progressively as more
      glycine solution was absorbed. Patients who absorbed 0 to 300 ml. of glycine
      solution had an average of 1.3 such symptoms. This number increased to 2.3 when
      1,001 to 2,000 ml. were absorbed, 3.1 when 2,001 to 3,000 ml. were absorbed and
      5.8 for volumes greater than 3,000 ml. Nausea and vomiting occurred significantly
      more often when 1,001 to 2,000 ml. were absorbed compared to no absorption.
      Confusion and arterial hypotension were other prominent signs of fluid
      absorption, whereas hypertension was not. The severity of symptoms was markedly
      aggravated when more than 3,000 ml. were absorbed. Extravasation resulted in
      higher risks of bradycardia, hypotension and failed spontaneous diuresis
      postoperatively than absorption by the intravascular route.

PMID- 7776408
TI  - Impact of physician awareness on hospital charges for radical retropubic
      prostatectomy.
AB  - PURPOSE: We determine if physician awareness of hospital costs for radical
      retropubic prostatectomy affects physician practice patterns. MATERIALS AND
      METHODS: We reviewed 256 consecutive radical retropubic prostatectomies performed
      by 14 urologists during 4 years at a community hospital. After 2 years the
      physicians were provided information on factors that may decrease charges.
      RESULTS: Charges decreased significantly following intervention, from +f417,134
      within the initial 2 years to +f413,826 within the last 2 years (p < 0.005).
      Significant decreases were noted for length of stay, need for intensive care,
      operating time and blood loss. CONCLUSIONS: Traditional methods of physician
      education can impact practice patterns to decrease hospital charges for radical
      retropubic prostatectomy.

PMID- 7776409
TI  - Nerve sparing radical prostatectomy: a different view.
AB  - Erectile dysfunction was evaluated in 459 men with prostate cancer before and
      after radical prostatectomy. Potency was defined as the ability to achieve
      unassisted intercourse with vaginal penetration. Of the patients 51 were potent
      postoperatively, including 2 of 187 (1.1%) undergoing surgery without nerve
      sparing, and 27 of 203 (13.3%) undergoing unilateral and 22 of 69 (31.9%)
      undergoing bilateral nerve sparing prostatectomy. Less than half of the patients
      who were sexually active postoperatively were satisfied with the erections or
      achieved intercourse at least once a month. Postoperative potency was
      statistically related to the number of neurovascular bundles spared, frequency of
      intercourse preoperatively, absence of seminal vesicle or lymph node involvement
      with cancer, absence of postoperative incontinence or strictures, patient age and
      cancer volume.

PMID- 7776410
TI  - Radical retropubic prostatectomy: the influence of accessory pudendal arteries on
      the recovery of sexual function.
AB  - Arterial insufficiency is a major factor responsible for impotence in men
      following nerve sparing radical prostatectomy. Previously, accessory internal
      pudendal arteries have been identified traveling over the anterolateral surface
      of the prostate. Based on this observation, during the last 7 years we have
      consistently looked for the presence of these arteries and have developed a
      surgical technique for their preservation. Between 1987 and 1994, 835 potent men
      underwent radical prostatectomy and accessory pudendal arteries were identified
      in 33 (4%). Following the development of the surgical technique, it was possible
      to preserve arteries in 19 of 24 patients (79%). Followup evaluation of 1 year or
      longer was available for 22 men who did not undergo wide excision of a
      neurovascular bundle. Recovery of erection sufficient for unassisted intromission
      and orgasm occurred in 8 of 12 patients (67%) in whom the arteries were preserved
      and in 5 of 10 (50%) in whom the arteries were sacrificed. We conclude that 1)
      the presence of accessory internal pudendal arteries is rare (4%); 2) although
      these arteries were preserved in 79% of the patients, dissection of these
      arteries from the dorsal vein complex may be associated with excessive bleeding,
      and 3) because potency rates are similar in men with or without preservation of
      accessory arteries, routine preservation may not be productive.

PMID- 7776411
TI  - A worse prognosis for smokers with prostate cancer.
AB  - To identify phenomena that might explain a higher mortality-to-incidence ratio
      for prostate cancer among smokers, 359 patients with newly diagnosed tumors at a
      community hospital were analyzed by tumor stage and grade, host age, obesity,
      smoking habits and survival. Among the 235 men with nonstage A tumors, stage D
      disease was independently related to host smoking (odds ratio 2.1, 95% confidence
      interval 1.3 to 4.3, p = 0.015), as well as to higher tumor grade, younger host
      age and lack of obesity. Stage D disease was present in 69% of 16 heavy smokers,
      41% of 44 other smokers and 31% of nonsmokers. The 5-year tumor-specific
      mortality rate was greater among smokers than nonsmokers with stage D2 disease
      (88% versus 63%, p < 0.05) or with nonstage A disease (39% versus 17%, p <
      0.001). These observations are compatible with earlier metastasis and more
      aggressive subsequent tumor advancement in smokers, and indicate that smoking
      habits may contribute to differences in prostate cancer prognosis between
      populations.

PMID- 7776412
TI  - Prostate cancer--neurovascular preservation; smoking cessation may enhance
      prognosis?

PMID- 7776413
TI  - Incontinence after radical prostatectomy: detrusor or sphincter causes.
AB  - PURPOSE: Prospective studies have shown a high prevalence of decreased compliance
      immediately after radical prostatectomy, which may be a temporary phenomenon in
      men in whom incontinence persists for more than 1 year. We examined the video
      urodynamic records of 74 consecutive men referred to our urodynamic laboratory
      with incontinence as the predominant symptom following radical prostatectomy to
      evaluate voiding parameters and bladder function. MATERIALS AND METHODS: The
      urodynamic assessment was made an average of 3.8 years postoperatively. All men
      presented with persistent post-prostatectomy incontinence, and 64 underwent
      radical retropubic and 10 radical perineal prostatectomy. RESULTS: A total of 42
      men (57%) had sphincter weakness alone, 29 (39%) had detrusor instability and/or
      decreased compliance combined with sphincter weakness and only 3 (4%) had
      detrusor instability alone. Of 29 men with a combination of factors 8 had
      decreased compliance, with 3 also having detrusor instability. Anastomotic
      strictures occurred in 24% of the patients. A total of 31 patients voided by
      straining without demonstrable detrusor contraction (42% overall). CONCLUSIONS:
      Decreased compliance is an infrequent finding after radical prostatectomy.
      Detrusor abnormalities in general are rarely the sole cause of incontinence, with
      sphincter weakness being present in the majority of patients.

PMID- 7776414
TI  - Predisposing factors of systemic fungal infections of the genitourinary tract.
AB  - We reviewed 50 patients with genitourinary fungal infections between 1982 and
      1992. Infections were classified as simple--localized to the bladder and complex-
      demonstrated evidence of upper tract and/or systemic infection. Predisposing
      factors of fungal infections, including diabetes mellitus, prolonged Foley
      catheter drainage and corticosteroid use, were not significantly different. The
      incidence of obstructive uropathy (88% versus 20%), malnutrition (88% versus
      48%), neoplasia (56% versus 16%), renal failure (24% versus 8%) and prolonged
      antibiotic use (60% versus 32%) were significantly greater in patients with
      complex infections. The incidence of fungemia in patients with complex infections
      was 81% with an associated mortality rate of 36%. Of the patients with complex
      infections 56% required urological intervention. Given the high incidence of
      obstructive uropathy with complex fungal infections, upper tract imaging is
      essential.

PMID- 7776416
TI  - Snail-headed catheter retriever: a simple way to remove catheters from female
      patients.
AB  - A snail-headed catheter retriever was designed to remove the Double-J* catheter
      from female patients. The catheter can be removed within a few minutes using
      topical anesthesia at the outpatient department without endoscopic
      instrumentation and lithotomy position. No infection or bleeding developed
      following the procedure and all patients tolerated it well. The cost-effective
      retriever can be used as a convenient alternative for Double-J catheter removal
      from female patients.

PMID- 7776415
TI  - Clinical effect of captopril on the formation and growth of cystine calculi.
AB  - We determined the clinical efficacy of captopril for the prevention of new or
      stone growth in patients with homozygous cystinuria. Nine patients with a history
      of multiple cystine stones despite standard fluid and alkalization therapy
      received 50 mg. captopril, 3 times daily in addition to the standard therapy.
      Before treatment the rate of new stone formation or stone growth ranged from 0.7
      to 2.0 events (mean 1.2) per patient-year for 1 to 3 years of observation (mean
      1.9). During treatment the rate ranged from 0 to 3.0 events (mean 1.03) per
      patient-year for 0.5 to 6 years (mean 2.9). Although statistical significance was
      not evident for the group as a whole (p = 0.35), our findings suggest that
      captopril may be clinically efficacious in at least some patients with difficult
      to control cystinuria. Recommendations regarding its indications in this setting
      are made.

PMID- 7776417
TI  - Simplified surgical approach to bladder outlet obstruction following pubovaginal
      sling.
AB  - We report a new technique of vaginal patch interposition to relieve bladder
      outlet obstruction after a suburethral sling procedure when the obstruction is
      caused by over correction of the urethrovesical angle. In this technique the
      sling is incised longitudinally in the midline and dissected laterally. A vaginal
      patch is obtained from the vaginal mucosa, then interposed and sutured between
      the 2 cut edges of the sling. This method is characterized by simplicity and low
      morbidity, while preserving the integrity of the suburethral sling to maintain
      continence.

PMID- 7776418
TI  - The urologist as a discriminating diagnostician and surgeon.

PMID- 7776419
TI  - Functional bladder neck obstruction: a rare cause of renal failure.
AB  - We studied 7 men and 6 women (average age 33 years) who presented in renal
      failure with obstructive voiding symptoms or retention. Of these patients 11 had
      a dilated upper tract and 2 had shrunken kidneys. Mean serum creatinine at
      presentation was 7.0 mg./dl. No abnormality was noted on cysto-panendoscopy,
      retrograde urethrography and voiding cystourethrography. The patients were
      initially treated with clean intermittent self-catheterization following 7 to 10
      days of indwelling catheterization. The majority of patients had low pressure and
      low flow rate at initial presentation but high end filling pressure (mean 35.3
      cm. water), high voiding pressure (mean 118.9 cm. water), high opening pressure
      (mean 95.3 cm. water) and low peak flow (mean 5.7 ml. per second) on video
      pressure flow electromyography. The external sphincter was relaxed during voiding
      but the bladder neck opened intermittently or inadequately. No proper funneling
      of the bladder neck was seen. Thus, functional bladder neck obstruction was
      considered to be responsible for obstructive voiding in these patients. Of the
      patients 3 void to completion with the help of alpha blockers alone, 5 underwent
      bladder neck incision and are voiding well, and 5 were practicing clean
      intermittent self-catheterization at last followup. Serum creatinine returned to
      near normal in 10 patients. End stage renal failure persisted in 2 patients, 1 of
      whom underwent renal transplantation and is voiding well but the other died
      without having undergone renal replacement therapy. In the remaining patient
      serum creatinine was stable at 3.2 mg./dl. Mean serum creatinine at 6 months of
      followup was 2.33 mg.%. Bladder neck obstruction is a rare cause of renal failure
      which can be corrected if treated appropriately.

PMID- 7776420
TI  - Rufloxacin once daily versus ciprofloxacin twice daily in the treatment of
      patients with acute uncomplicated pyelonephritis.
AB  - PURPOSE: We compare the bacteriological and clinical efficacy of rufloxacin and
      ciprofloxacin in patients with acute uncomplicated pyelonephritis. MATERIALS AND
      METHODS: A total of 110 outpatients was enrolled in a randomized, double-blind
      multicenter study and treated for 10 days with 200 mg. rufloxacin daily (after a
      loading dose of 400 mg. on day 1) or 500 mg. ciprofloxacin twice daily.
      Bacteriological and clinical efficacy was based on the accumulated outcomes
      assessed at the end of treatment, and at 2 and 4 to 6 weeks. RESULTS: The
      bacteriological and clinical success rates of rufloxacin and ciprofloxacin were
      comparable: 55.6% versus 58.8% and 74% versus 71%, respectively (95% confidence
      interval -28% to +22% and -20% to +25%, respectively). Both study medications
      were well tolerated. CONCLUSIONS: Rufloxacin once daily is a good alternative in
      the outpatient treatment of acute uncomplicated pyelonephritis.

PMID- 7776421
TI  - Dependence of male voiding efficiency on age, bladder contractility and urethral
      resistance: development of a voiding efficiency nomogram.
AB  - The influence of age, urethral resistance and bladder contractility on voiding
      efficiency was evaluated by pressure-flow studies in 138 men of a mean age of 60
      years (range 18 to 86). From these studies the urethral resistance parameter was
      calculated and the maximum bladder contraction strength was determined. Premature
      fading of the bladder contraction was quantified by a bladder contraction
      strength decay factor. Voiding efficiency was expressed by the parameter of post
      void residual urine volume as a percentage of the initial bladder volume.
      Multiple regression analysis showed that voiding efficiency depended
      significantly in descending order of importance on urethral resistance, maximum
      bladder contraction strength and bladder contraction strength decay factor.
      Patient age was not an independent factor. Maximum bladder contraction strength
      and bladder contraction strength decay factor were not correlated, suggesting
      that maximum bladder contraction strength and its decay constitute different
      properties of bladder contractile function. A voiding efficiency nomogram is
      proposed, making use of the values for maximum bladder contraction strength and
      urethral resistance in individual patients. Such a nomogram may have predictive
      value for the occurrence of acute retention but it must be tested prospectively.

PMID- 7776422
TI  - Anuria due to intrarenal blood clots in solitary kidney after change of ureteral
      stent: resolution with minimally invasive evacuation.

PMID- 7776423
TI  - Ureterocystoplasty: importance of the proximal blood supply.

PMID- 7776424
TI  - Neuropathic bladder in setting of severe vitamin B12 deficiency: a case report.

PMID- 7776425
TI  - Commentary on ESWL and blood pressure.

PMID- 7776426
TI  - False aneurysm of the common iliac artery after pelvic lymphadenectomy:
      management of an unusual complication.

PMID- 7776427
TI  - Prostate cancer: unusual metastases 20 years after 125iodine brachytherapy.

PMID- 7776429
TI  - Re: A new use of ureteroscopy.

PMID- 7776428
TI  - New sexually transmitted diseases treatment guidelines.

PMID- 7776430
TI  - Re: Endo-ureteroplasty with a free urothelial graft.

PMID- 7776431
TI  - Re: Nitrofurantoin-induced pulmonary hemorrhage in a renal transplant recipient
      receiving immunosuppressive therapy: case report and review of the literature.

PMID- 7776432
TI  - Re: Eversion of the tunica vaginalis for prophylaxis of testicular torsion
      recurrence.

PMID- 7776434
TI  - Intraluminal wire retrieval of a proximally migrated pediatric Double-J ureteral
      stent.

PMID- 7776433
TI  - Pyeloplasty improves renal function and somatic growth in children with
      ureteropelvic junction obstruction.
AB  - We studied the systemic effects of pyeloplasty in 38 children with unilateral
      ureteropelvic junction obstruction. Mean patient age at surgery was 2.5 years and
      22 patients were age 1 year or younger. Mean followup was 18 months. We recorded
      serum creatinine levels, glomerular filtration rate calculated by the Schwartz
      formula body growth, the degree of dilatation and the excretory curve of the
      diuresis renogram. Pyeloplasty was effective in decreasing the degree of
      ultrasonographic dilatation and the excretory curve of the renogram in 36 cases.
      Two patients required reoperation. Individual renal function improved
      significantly in children younger than 1 year with preoperative differential
      function less than 45% but not in older children. Serum creatinine level
      decreased significantly after pyeloplasty in all children. Likewise, glomerular
      filtration rate improved significantly in all children. Preoperatively, 72% of
      children younger than 1 year were below the 50th percentile in height. The
      distribution of heights became normal after surgery. Overall, percentile rank for
      height increased in a significant number of patients of all ages. We conclude
      that unilateral hydronephrosis systemically affects body growth and overall renal
      function, the salutary effect of pyeloplasty goes beyond the affected kidney and
      pyeloplasty may be of greater benefit when performed in infancy. These parameters
      must be considered in protocols designed to compare outcomes in children with
      hydronephrosis treated surgically with those who are simply observed.

PMID- 7776435
TI  - Intraoperative spermatic venography reconsidered.
AB  - We review our most recent experience with varicocelectomy and post-ligation
      venography in 58 adolescents as followup to our previously reported series. A
      single injection venogram confirmed the completeness of varicocele ligation in
      82% of cases while 2 or more injections were required in the remainder.
      Venography was not performed in 8 cases because of technical difficulties in 5 or
      surgeon choice in 3. The recurrence rate was 8.6% and was not statistically
      significant whether or not venography was performed (p = 0.86). Although
      intraoperative spermatic venography is technically simple and safe, in our series
      its efficacy in diminishing the recurrence rate after varicocelectomy was
      unproved.

PMID- 7776436
TI  - Extracorporeal shock wave treatment raises blood pressure in borderline
      hypertensive rats.
AB  - The long-term sequelae on kidney function and blood pressure of renal shock wave
      treatment were studied in normotensive Wistar rats, contralaterally
      nephrectomized Wistar rats and borderline hypertensive F1-hybrids bred from
      stroke-prone spontaneously hypertensive rats and Wistar-Kyoto rats. Renal shock
      wave treatment raised arterial blood pressure in borderline hypertensive, but not
      in normotensive, rats. A concomitant impairment of ipsilateral renal function or
      perfusion was not seen despite macroscopic and microscopic evidence of a loss of
      functioning parenchyma. We conclude that extracorporeal shock wave treatment, by
      way of its detrimental effects on the kidney, has the potential to provoke
      arterial hypertension in rats, provided that a genetic predisposition exists.

PMID- 7776437
TI  - An immunohistochemical and prognostic evaluation of cathepsin D expression in 105
      bladder carcinomas.
AB  - Cathepsin D is a widely expressed aspartyl lysosomal protease. Clinical studies
      in several tumor types have shown a strong correlation between cathepsin D
      expression and tumor progression. In breast carcinoma, its expression is an
      independent prognostic factor associated with an increased risk of death.
      However, there have been no studies evaluating cathepsin D in bladder tumors.
      Therefore, the aim of this study was to determine the pattern of expression of
      cathepsin D in a large series of bladder carcinomas and assess its role as a
      prognostic factor against established variables. The tumors from 105 patients
      (median age 73) (median follow-up 26 months) with transitional cell carcinoma of
      bladder were examined. Forty-nine patients had superficial tumors (16 pTa; 33
      pT1), 56 had invasive tumors (14 pT2; 42 pT3); there were 35 grade 1/2 tumors and
      70 grade 3 tumors. These were stained by a standard immunohistochemical technique
      with an anti-cathepsin D monoclonal antibody. All 4 normal bladder specimens were
      positive for cathepsin D. Fifty-four tumors (51%) were positive for cathepsin D
      and 51 (49%) were negative. Chi square analysis showed a significant positive
      relationship between negative cathepsin D expression and stage (p < 0.0005),
      grade (p < 0.0001) and tumor morphology (p = 0.001). There was no relationship
      between cathepsin D expression and tumor ploidy (p > 0.1) or patient age (p =
      0.09). Univariate analysis of disease-free and overall survival showed that
      negative cathepsin D expression (p = 0.01 and p = 0.0003 respectively), stage (p
      = 0.004 and p < 0.005 respectively) and grade (p = 0.02 and p = 0.0007
      respectively) were associated with significantly worse prognosis. However, in a
      multivariate analysis of age, stage, grade and cathepsin D expression, only stage
      remained significant for overall survival (p < 0.005). The observed result for
      cathepsin D in the univariate analysis is probably due to its strong association
      with grade and stage. Nevertheless, cathepsin D status was able to provide
      additional prognostic information for overall survival in invasive tumors when
      stratifying for grade (p = 0.047), which suggests that it might provide
      additional prognostic data within particular tumor stages.

PMID- 7776438
TI  - Expression of cell growth regulated genes in the fetal kidney: relevance to in
      utero obstruction.
AB  - Previous studies of fetal urinary tract obstruction (bladder outlet obstruction
      and ureteral obstruction) in lambs have shown that obstructions created
      relatively early in gestation (4/10 to 6/10 term) can significantly affect growth
      of the developing kidney. This suggests that urinary tract obstruction in utero
      can alter normal mechanisms of kidney growth. However, a mechanism for these
      effects has not yet been proposed. In this study we have used mRNA expression
      analysis to characterize the temporal sequence of expression of several growth
      regulated genes during normal ovine kidney development. The purpose of this study
      was to test the hypothesis that early obstructions, such as those believed to
      arise in congenital obstructive uropathy in humans, might have a disproportionate
      effect on hyperplastic growth if the cellular growth fraction (percent of cells
      in the organ undergoing DNA synthesis) was greater in the second trimester than
      in the last. Northern blot analysis of the cell cycle-dependent genes histone H3,
      c-myc and ornithine decarboxylase (ODC) indicated a progressive, gradual decline
      in cellular proliferation in the kidney from approximately 60 to 135 days (4/10
      term to term) gestation, as evidenced by decreases in the respective mRNA levels.
      The greatest levels of cell proliferation occurred near the midpoint of
      gestation. This indirect measurement of decline in cellular growth fraction was
      reflected in direct measurements of change in relative kidney weight. To test
      whether this decline in mRNA levels occurs widely among genes expressed in the
      fetal kidney during this period, relative expression levels of more than 300
      anonymous mRNA transcripts were evaluated by differential display analysis. This
      method showed that genes whose expression patterns resembled the growth-regulated
      genes constituted less than 5% of the expressed mRNAs identified. These data
      indicate that intrauterine urinary tract obstructions that arise at or near the
      midpoint of gestation coincide with the highest rates of cell proliferation
      occurring in the second and third trimesters and, therefore, might adversely
      affect mechanisms of cell proliferation.

PMID- 7776439
TI  - Growth-inhibitory effects of serotonin uptake inhibitors on human prostate
      carcinoma cell lines.
AB  - Growth stimulation of a variety of cell types by the neurotransmitter serotonin
      has been reported. We have examined the effects of three serotonin-uptake
      inhibitors, 6-nitroquipazine, zimelidine and fluoxetine (Prozac, Eli Lilly Co.,
      Indianapolis, Indiana) on human prostate carcinoma cell lines. In vitro, all 3 of
      these compounds inhibited the proliferation of PC-3, DU-145 and LNCaP cells in a
      dose-dependent manner. Also, all 3 compounds blocked the uptake of a radiolabeled
      analog of serotonin by the prostate carcinoma cell lines. The order of potency
      for inhibition of growth as well as for serotonin uptake was fluoxetine >
      zimelidine > 6-nitroquipazine. The growth of subcutaneous, PC-3 xenografts in
      athymic nude mice was significantly inhibited by fluoxetine. These results
      implicate biogenic amines such as serotonin in the growth of prostate carcinoma
      cells and indicate the potential use of serotonin-uptake inhibitors for the
      treatment of prostate cancer.

PMID- 7776440
TI  - Treatment of renal hydatid disease by pedicled omentoplasty.
AB  - Renal hydatid disease is uncommon and accounts for only 2 to 3% of all hydatid
      diseases. The treatment of choice is surgical. Medical therapy is not always
      satisfactory and radical cure depends mostly on removal of all affected tissue.
      There is controversy concerning the treatment of residual cavity after evacuation
      of the cyst. For this problem we performed the pedicled omentoplasty in 4
      patients with renal hydatid disease. To our knowledge, this method has not been
      described previously for renal hydatid disease. Cystectomy with pedicled
      omentoplasty appears to be safe and effective in the management of renal hydatid
      disease.

PMID- 7776441
TI  - Three-dimensional arrangement of collagen and elastin fibers in the human urinary
      bladder: a scanning electron microscopic study.
AB  - To clarify the arrangements of collagen and elastin fibers of the urinary
      bladder, we examined 9 human (male, aged 42 to 72) urinary bladders by scanning
      electron microscopy with chemical digestion methods. The mucosal layer was
      divided into 3 portions according to the collagen arrangement: the superficial
      portion interwoven densely by collagen fibrils, the middle portion layered by
      flat bundles of collagen fibrils and the deep portion made of a loose network of
      twisted collagen bundles. In the muscular layer, the smooth muscle fascicles were
      firmly covered with collagen sheets, while each muscle cell in a fascicle was
      accommodated by a thin sheath of collagen fibrils. The serosal layer consists of
      wavy collagen bundles piled up in a sheet, which was intercalated by clusters of
      adipose cells. Elastic fibers were, on the other hand, sparse throughout the
      bladder wall, except for denser networks around the blood vessels and muscle
      fascicles and beneath the peritoneal mesothelium. The arrangements of these
      components were discussed in relation to the mechanical function and compliance
      of the urinary bladder.

PMID- 7776442
TI  - Regional differences in the innervation of the human ureterovesical junction by
      tyrosine hydroxylase-, vasoactive intestinal peptide- and neuropeptide Y-like
      immunoreactive nerves.
AB  - We have used double-label immunohistochemistry to examine the presence and
      pattern of colocalization of vasoactive intestinal peptide (VIP), neuropeptide Y
      (NPY), tyrosine hydroxylase (TH) and protein gene product (PGP) in nerve fibers
      supplying the human ureterovesical junction (UVJ). Several populations of nerve
      fibers within the UVJ region were identified according to their expression of
      potential transmitter substances. Presumptive noradrenergic axons containing TH-
      and NPY-like immunoreactivity (LIR) and non-noradrenergic fibers containing VIP-
      and NPY-LIR accounted for most of the total (PGP-LIR) innervation and supplied
      all regions of the UVJ. The distal ureter, Waldeyer's sheath and the trigone were
      supplied by predominantly noradrenergic TH/NPY-LIR nerve fibers, whereas the
      majority of fibers supplying the detrusor muscle were non-noradrenergic VIP/NPY
      LIR axons. The similarity in innervation of Waldeyer's sheath, ureter and trigone
      is consistent with the notion that these structures are all derived from a common
      mesodermal origin. Regional differences in innervation were also noted within the
      musculature of the distal ureter: TH/NPY-LIR fibers were localized to the outer
      part of the ureter, while VIP/NPY-LIR fibers supplied the inner part. This
      finding suggests that the different layers of the ureter may be independently
      controlled by different populations of nerves. The findings of this study support
      the view that noradrenergic nerves are important in maintaining the tone of the
      UVJ, but indicate that other neurotransmitters or neuromodulators may also be
      involved in the control of this region.

PMID- 7776443
TI  - LAK cell mediated apoptosis of human bladder cancer cells involves a pH-dependent
      endonuclease system in the cancer cell: possible mechanism of BCG therapy.
AB  - Intravesical bacillus Calmette-Guerin (BCG) is an effective treatment for
      superficial bladder cancer. However, its mechanism has been only partially
      elucidated. We studied whether LAK cell killing of human bladder cancer cells
      occurs via apoptosis (programmed cell death) or necrosis. Fluorescent dye labeled
      T24 cells were observed to undergo morphologic changes associated with apoptosis
      in the presence of LAK cells when analyzed under a fluorescence microscope.
      Furthermore, analysis of the DNA isolated from the cytotoxic assay confirmed that
      the LAK cell induced death of the T24 cells occurred via apoptosis. By
      pretreating the LAK cells with antifibronectin antibodies, we were able to
      significantly inhibit the LAK cell killing of the T24 cells. The percentage of
      cytotoxicity was reduced from 50% to 13% (p = 0.001), and the apoptotic pattern
      seen on agarose gel electrophoresis was significantly diminished. There was no
      significant change in the viability of the LAK cells following treatment with the
      antibodies. Endonuclease isolation from human bladder cancer T24 cells
      demonstrated that these cells express a pH-dependent and not a Ca++/Mg++
      dependent endonuclease. Significant degradation of a target DNA was observed only
      in pH 4 to pH 5.6 buffers containing endonuclease from T24 cells and not in pH 6
      to pH 8 buffers containing endonuclease from T24 cells. The presence or absence
      of Ca++/Mg++ in the various pH buffers did not alter the endonuclease activity.
      Finally, we demonstrated that death of T24 cells can be induced by altering the
      intracellular pH of the cells to 5.6 or lower with the proton ionophore
      nigericin. We conclude that LAK cells induce T24 cells to undergo apoptosis and
      that this process involves the fibronectin molecule present on the LAK cell
      membrane. Furthermore, the cleavage postulate that, in vivo, LAK cells activated
      by IL-2 produced by BCG activated CD4+ cells may induce bladder cancer cells to
      undergo apoptosis. This may partially explain the mechanism whereby BCG achieves
      its therapeutic effect.

PMID- 7776444
TI  - Distinct glycoforms of a tumor specific glycoprotein, gp200, in human testis and
      testicular tumors.
AB  - We recently purified a 200 kD peanut agglutinin-binding glycoprotein from the
      embryonal carcinoma cell line HT-E (833K) that is expressed selectively in
      nonseminomatous germ cell tumors. We now further characterize gp200 using Western
      blot analysis to compare normal and malignant testicular germ cells for
      reactivity to peanut agglutinin, a plant lectin that recognizes terminal D
      galactosyl residues, and GCTM-2, a monoclonal antibody that recognizes a 200 kD
      keratan-sulfate proteoglycan on human embryonal carcinoma. The results indicate
      that normal germ cells express gp200 as a membrane-bound 230 kD glycoform that
      expresses terminal galactose residues. This 230 kD glycoprotein is absent on
      spermatozoa but present on seminomatous germ cell tumors and somatic tissue and
      does not express terminal galactose on its carbohydrate side chains. In contrast,
      nonseminomatous germ cell tumors express a heavily sialylated glycoform of gp200
      that does express terminal galactose residues. These results describe a
      glycoprotein that exists in several glycoforms in normal and malignant testicular
      germ cells. The differential expression of these glycoforms may help in
      understanding the ontogeny of germ cell tumors.

PMID- 7776445
TI  - Expression of nm23 in cell lines derived from patients with metastatic renal cell
      carcinoma.
AB  - Reduced expression of nm23 has been associated with increased metastases and
      decreased survival in a variety of malignancies. In the present study, the
      expression of nm23 was examined by Northern and Western blot analyses in a series
      of cell lines derived from patients with metastatic renal cell carcinoma. Two of
      twelve (17%) informative cell lines derived from 9 patients had loss of
      heterozygosity at Nm23-H1. Twenty-two renal cancer cell lines derived from
      primary tumors, 5 cell lines derived from metastatic tumors and 4 short-term
      cultures of normal proximal renal tubular cells all expressed Nm23 mRNA in
      varying amounts. On average, the level of expression of Nm23 mRNA in short-term
      cultures of benign proximal renal tubular cells was found to be similar to the
      level seen in renal cancer cell lines. Twenty-eight cell lines derived from renal
      primary tumors and 8 cell lines derived from metastatic tumors expressed both the
      Nm23-H1 and Nm23-H2 proteins. High or low relative expression of nm23 at the mRNA
      or protein level did not correlate with survival. The absence of any anomalous
      pattern of expression of the nm23 genes and the lack of correlation of expression
      with survival suggests that nm23 does not play a central role in the progression
      of this tumor type.

PMID- 7776446
TI  - A new protocol for the followup of renal cell carcinoma based on pathological
      stage.
AB  - There is no consensus concerning which laboratory and imaging studies should be
      obtained to assess patients after radical nephrectomy for renal cell carcinoma.
      We retrospectively reviewed 158 patients who underwent radical nephrectomy with a
      final pathological diagnosis of renal cell carcinoma. Of the patients 21 had node
      positive or metastatic disease and 137 had no evidence of metastases at
      diagnosis. Of the latter group 19 had pathological stage T1N0M0, 82 stage T2N0M0
      and 36 stage T3N0M0 (18 stage T3a, 10 stage T3b and 8 stages T3a and b) tumor.
      Disease recurred in 0%, 14.6% and 52.8% (50%, 44.4% and 75%) of the patients,
      respectively. The average interval to recurrence was 29.5 months (range 3.5 to
      88.8) for patients with stage T2 carcinoma and 22 months (range 3 to 138) for
      those with stage T3 disease. Based upon our data, followup studies should include
      a symptom history, serum liver function studies and chest x-rays at defined
      intervals. Routine use of bone scans and computerized tomography does not appear
      to be necessary.

PMID- 7776450
TI  - Autoaugmentation gastrocystoplasty: early clinical results.

PMID- 7776447
TI  - The ontogeny of bladder function in the fetal calf.
AB  - Although numerous experimental studies have addressed urinary bladder physiology
      and pharmacology, little information is available concerning the ontogeny of
      bladder function. The present in vitro study describes the developmental aspects
      of bladder compliance, pressure generation and emptying in bovine fetuses from
      early second trimester to term (280 days). The results can be summarized as
      follows: 1) bladder compliance increased 3-fold between early second trimester
      and term; 2) sustained contractile response to bethanechol was present in all
      bladders; 3) field stimulation produced a submaximal, nonsustained contraction
      and an active relaxation when the field stimulus was turned off; 4) bladder
      emptying in response to bethanechol was nearly 100% in mid- and late-gestational
      bladders but was only 50% at early gestation; 5) bladder emptying in response to
      field stimulation was 20% to 40% for all gestational age groups; 6) field
      stimulated relaxation was observed only in the fetal bladder. These studies
      demonstrate that bladder physiology in utero is different from postnatal bladder
      function. The presence of a relaxant response during the fetal period may reflect
      a unique and significant role of the in utero bladder in protecting the upper
      urinary tracts from sustained increased pressure.

PMID- 7776448
TI  - Reactivities of mouse monoclonal antibody K2.7 to renal cancers in complement
      dependent cytotoxicity and antibody dependent cell-mediated cytotoxicity.
AB  - Immunohistochemical analysis by indirect immunoperoxidase staining demonstrated
      that monoclonal antibody (mAb) K2.7, derived from a mouse immunized with a renal
      cell carcinoma (RCC) cell line OS-RC-2, reacted with 89 of 95 renal cancer
      tissues (94%). Only 1 gastric and uterine cancer tissue showed positive staining
      among 87 cancer specimens from 9 different organs. Among normal human tissues,
      the renal tubule, testis, epithelium of the uterine endometrial gland and
      Fallopian tube, grey matter of cerebrum and cerebellum, and foreskin showed
      positive staining. Serological analysis by protein A mixed hemadsorption (PA)
      assay demonstrated that mAb K2.7 reacted with 25 of 31 RCC cell lines (81%), but
      with only 2 of 50 other cell lines from different organs. The specific antitumor
      activities of mAb K2.7 against RCC cell lines were investigated in vitro by
      complement dependent cytotoxicity (CDC) and antibody dependent cell-mediated
      cytotoxicity (ADCC) assays. In the CDC assay, all of the 9 RCC cell lines
      reactive serologically with mAb K2.7 were killed by mAb K2.7 with normal human
      serum, and the killing activity of mAb K2.7 correlated well with the reactivity
      of mAb K2.7 in the PA assay. mAb K2.7 showed the same killing activity against
      each of 3 RCC cell lines with sera from 9 patients with low and high stage renal
      cancers, as well as with normal human serum. In the ADCC assay, mAb K2.7 with
      peripheral blood leukocytes (PBLs) from 4 healthy donors showed cytotoxic
      activity against RCC cell lines. Peripheral blood leukocytes from the same 9
      renal cancer patients also showed significant killing activity against the 3 RCC
      cell lines. These findings suggest the potential utility of mAb K2.7 for specific
      immunotherapy of renal cancer.

PMID- 7776449
TI  - Cytoreductive surgery for stage IV renal cell carcinoma.
AB  - To facilitate the regression of extra renal disease in response to systemic
      therapy, cytoreductive surgery has been advocated as step 1 in the treatment of
      stage IV renal cell carcinoma. To determine the effect of surgery on subsequent
      clinical course, we reviewed the treatment records of 30 patients with known
      stage IV carcinoma of the kidney who underwent nephrectomy or additional
      procedures in preparation for systemic therapy. Of 30 patients only 7 (23%)
      underwent systemic therapy postoperatively. Progression of the disease, surgical
      morbidity and mortality were the factors preventing 77% of our patients from
      continuing with treatment. Since regression of extra renal lesions is the goal of
      systemic therapy, our data suggest that nephrectomy and most other cytoreductive
      operations in preparation for systemic therapy are not efficient treatment
      strategies.

PMID- 7776451
TI  - Renin in Wilms' tumor: prorenin as an indicator.

PMID- 7776452
TI  - A perspective on renal cell carcinoma.

PMID- 7776453
TI  - Transurethral resection of the intramural ureter as the first step of
      nephroureterectomy.
AB  - Nephroureterectomy is the standard surgical approach for upper urinary tract
      carcinoma. In 1952 a modified technique was described based on a prior endoscopic
      disconnection of the intramural ureter as an initial step for subsequent
      nephroureterectomy via a single lumbar incision. Since October 1989 we performed
      31 nephroureterectomies with this technique in 26 men and 5 women (average age
      64.5 years). Of the patients 9 had prior bladder carcinoma. The predominant
      pathological diagnosis of the nephroureterectomy specimens was high grade
      infiltrating tumor. There were no intraoperative complications except for 1 case
      of intra-abdominal extravasation detected in the immediate postoperative period
      and treated conservatively. With an average followup of 20 months, tumor has not
      recurred at either the resected trigonal area or the retroperitoneum. We believe
      that our experience assesses the feasibility of this technique to improve and
      simplify nephroureterectomy, thus, decreasing the morbidity rate and operating
      time while maintaining the same oncological radicality.

PMID- 7776454
TI  - Further experience with the modified ileal ureter.
AB  - A total of 50 patients for whom an ileal ureter was indicated was prospectively
      randomized between 2 treatment groups according to the surgical technique used.
      In group 1 the standard ileal ureter procedure was performed, while in group 2 a
      tailored and valved (modified) ileal ureter was fashioned. Of the patients 19 in
      group 1 and 23 in group 2 were available for followup of 69 +/- 5.8 months (range
      60 to 80). Among the 23 patients in group 2, 5 (22%) experienced reflux due to
      dessusception of the nipple valve and 4 (17%) had bladder stones. Metabolic
      acidosis was observed in 9 patients in group 1 (47%) and 4 in group 2 (17%).
      Urinary outflow obstruction occurred in 5 patients in group 1 and 1 in group 2.
      Although renal function was comparable among patients in both treatment groups,
      comparison between patients in group 1 and those without reflux in group 2 showed
      better renal function in the latter group. We conclude that reflux prevention is
      of central importance in preservation of renal function in patients with an ileal
      ureter. A distal nipple valve at the ileovesical anastomosis is associated with
      significant problems. These observations would urge urologists to search for a
      more suitable procedure that provides an efficient antireflux principle with
      minimal adverse sequelae.

PMID- 7776455
TI  - Experience in 100 patients with an ileal low pressure bladder substitute combined
      with an afferent tubular isoperistaltic segment.
AB  - Between April 1985 and April 1993, 100 consecutive men underwent lower urinary
      tract reconstruction after cystectomy. An ileal low pressure reservoir using the
      Goodwin cup-patch principle was combined with an afferent ileal tubular segment.
      The early complication rate was 11%, including 2 postoperative deaths due to
      septicemia. After a median followup of 27 months (range 3 to 96) 14 patients
      required surgery for late complications (intestinal obstruction, urethral
      stricture or tumor recurrence, hernia or ureteral stenosis). A total of 32
      patients died of metastatic bladder cancer and 7 died of other causes. The
      functional capacity of the bladder substitute was increased to the desired 450 to
      500 ml. after 3 to 12 months, which was paralleled by improving urinary
      continence. After 1 year 92% of the patients were continent by day and after 2
      years 80% were continent at night. Upper tract surveillance with excretory
      urography, renal ultrasound and serum creatinine estimation has shown 4 left
      ureteral strictures but not significant upper tract deterioration or ureteral
      recurrence. Significant reflux was not observed during video urodynamics unless
      the reservoir was overfilled. During voiding, by outlet relaxation and straining
      if necessary, the intra-abdominal pressure increase with straining acted equally
      on the reservoir and ureters. Therefore, unlike voiding with a normal bladder, no
      isolated intravesical pressure increase occurred and, thus, there was no reflux
      from the reservoir. The combination of an ileal low pressure reservoir with an
      afferent isoperistaltic ileal segment and an open end-to-side ureteroileal
      anastomosis allows for radical cancer surgery with resection of the ureters where
      they cross the iliac vessels and minimizes the risk of ureteral stenosis. The
      unidirectional peristalsis of the ureters and the afferent tubular ileal segment
      seem to protect the upper urinary tract sufficiently. The surgical technique is
      straightforward and allows for later conversion to an ileal conduit if necessary.
      The functional results of the bladder substitute are comparable to other similar
      reservoir techniques, provided that the patients are carefully selected, well
      rehabilitated and meticulously followed.

PMID- 7776457
TI  - The vesical blood-urine barrier: a relevant and dynamic interface between renal
      function and nervous bladder control.

PMID- 7776456
TI  - Hematuria home screening: repeat testing results.
AB  - To determine at what interval screening should be repeated to detect bladder
      cancer before it becomes muscle invasive 856 men who had 14 negative daily home
      tests for hematuria with a chemical reagent strip 9 months previously performed
      repeat tests. Of these men 50 (5.8%) had at least 1 positive test during the
      second 14-day screening period and 38 were evaluated, 15 of whom (39.5%) had
      significant urological pathological conditions, including 8 with malignancies.
      Bladder cancer was noted in 7 men, with no tumor invading the muscularis propria.
      The finding of 7 bladder cancers in 856 men (0.82%) who had a negative test 9
      months previously indicates that bladder cancer has a brief preclinical duration
      and that testing must be repeated at least annually for screening to detect
      bladder cancer consistently before invasion occurs.

PMID- 7776458
TI  - Intravesical recombinant tumor necrosis factor in the treatment of superficial
      bladder cancer: an Eastern Cooperative Oncology Group study.
AB  - We tested and proved the safety of recombinant human tumor necrosis factor given
      intravesically weekly for 11 weeks (dwell time 2 hours) for the treatment of
      superficial bladder cancer in 8 men and 1 woman 46 to 87 years old (mean age 69
      years). Cohorts of 3 patients received 200, 400 and 1,000 micrograms. recombinant
      human tumor necrosis factor. The maximal tolerated dose was not achieved. There
      were 9 episodes of urological symptoms, 8 of flu-like symptoms, 4 of headache and
      3 of chest tightness. Hematological and gastrointestinal toxicities were minor,
      and no renal toxicity was encountered. Recombinant human tumor necrosis factor
      was safe to administer at doses up to 1,000 micrograms. We hope that recombinant
      human tumor necrosis factor in conjunction with other antitumor agents will lead
      to a new, effective treatment for superficial bladder cancer.

PMID- 7776459
TI  - Sono-urethrography in the evaluation of anterior urethral strictures.
AB  - During a 7-year period 123 paired urethrographic and sono-urethrographic studies
      were performed on 101 patients with 110 urethral strictures. In all but 3 cases
      the urethra was subsequently evaluated either cystoscopically or at open
      operation. Sono-urethrography readily identified urethral calculi, diverticula
      and false passages. It correctly identified the stricture and its site in every
      case. There was a significant difference between stricture length as measured by
      urethrography compared to that measured by sono-urethrography (p < 0.003).
      However, if the strictures were grouped based on anatomical location, there was
      good correlation and no significant difference in the penile urethra (correlation
      coefficient = 0.94, p = 0.74) but poor correlation and the significant difference
      remained in the urethral bulb (correlation coefficient = 0.64, p < 0.007).
      Similarly, when urethrographic and sono-urethrographic stricture lengths were
      compared with operative lengths, in the penile urethra the correlation
      coefficients were close (correlation coefficient = 0.91 versus 0.98) but in the
      urethral bulb the poor correlation persisted (correlation coefficient = 0.69
      versus 0.89). Although sono-urethrography certainly identifies periurethral
      tissue, it was unreliable in predicting the depth of spongiofibrosis when
      compared with full depth biopsies in 36 patients with histopathological
      correlation. Finally, in 16% of the patients sono-urethrography correctly
      indicated a reconstructive procedure different from that originally suggested by
      conventional urethrography. Sono-urethrography is a dynamic 3-dimensional study
      that accurately identifies stricture site, number and caliber. Compared with
      conventional urethrography, it more accurately measures stricture length and
      diameter, and identifies periurethral tissue, making it a valuable adjunct in the
      evaluation of patients with suspected anterior urethral strictures.

PMID- 7776460
TI  - Incidence of penile pain after injection of a new formulation of prostaglandin
      E1.
AB  - PURPOSE: We determined the incidence of pain with injection of a new formulation
      of prostaglandin E1. MATERIALS AND METHODS: A total of 63 subjects with erectile
      dysfunction underwent treatment with the new formulation of prostaglandin E1.
      Evidence of pain associated with injection was obtained by questionnaire and
      through questioning. RESULTS: A total of 451 injections was given to 63 subjects
      in the office, with 16 episodes (3.5%) of pain in 10 (15.9%). Then, 680
      injections were performed by 38 subjects at home, with 15 episodes (2.2%) of pain
      in 8 (21%). Pain was not dose related. CONCLUSIONS: The new formulation of
      prostaglandin E1 is less likely to be associated with pain compared with alcohol
      based formulations.

PMID- 7776461
TI  - Penile prosthesis insertion with corporeal reconstruction with synthetic vascular
      graft material.
AB  - Difficulty with penile prosthesis insertion may be encountered in patients with
      severe cavernous scarring or tunica albuginea deficiencies. Eleven patients who
      underwent penile prosthesis implantation required simultaneous corporeal
      reconstruction due to prior prosthesis infection and/or erosion in 6, priapism in
      2 and Peyronie's disease in 1. One patient underwent prior neophallus
      construction with a tubularized abdominal wall flap for gender reassignment and 1
      had congenitally deficient corporeal bodies. In 4 patients previous additional
      attempts at prosthesis replacement were unsuccessful. The reconstruction
      techniques included exposure of the corpora usually through a ventral midline
      incision and repair with synthetic vascular graft material. Accessory sub-coronal
      incisions were used when the disease was localized to the distal corpora. Six
      patients required reconstruction of more than half of the corporeal lengths
      bilaterally and in 5 smaller portions were repaired. Two patients received a
      semirigid and 9 an inflatable implant. Mean followup was 46 months (range 5 to
      81). One patient required early reexploration for separation of the graft from
      the tunica and 2 required late surgical revision for distal tip divergence.
      Healing has been excellent and prosthesis function satisfactory in all patients.
      Infection, erosion and mechanical failure have not occurred. Penile prosthesis
      insertion with corporeal reconstruction using synthetic graft material is
      possible in these cases with acceptable morbidity rates and satisfactory erectile
      function.

PMID- 7776462
TI  - Impotence.

PMID- 7776463
TI  - Optimum abstinence time for cryopreservation of semen in cancer patients.
AB  - Although an abstinence period of 48 to 72 hours is the most commonly prescribed
      interval for diagnostic semen analysis, to our knowledge the association between
      the abstinence period and sperm quality after cryopreservation has not been
      identified. Patients with a malignant disease who are consulting for semen
      banking most often require urgent therapy. Consequently, defining the shortest
      abstinence period that allows for frequent semen collection within a limited
      interval and the best post-thaw sperm quality is necessary. We investigated the
      relationship between abstinence period, and the pre-freeze and post-thaw motility
      variables in semen specimens obtained from cancer patients for sperm banking.
      Samples collected from 95 patients were divided according to abstinence period:
      group 1-15 patients at 24 to less than 48 hours, group 2-53 at 48 to less than 72
      hours and group 3-27 at more than 72 hours. Pre-freeze and post-thaw motile sperm
      count and motion variables (motility, velocity, linearity, amplitude of lateral
      head movement and motility index), and percentage decrease in sperm variables
      after cryopreservation were analyzed. Semen volume, the pre-freeze and post-thaw
      motile sperm count, motion parameters and the percentage decrease in semen
      variables did not differ significantly among the groups. We conclude that semen
      collection for cryopreservation after 24 to less than 48 hours of abstinence
      results in post-thaw quality comparable to that after an abstinence of 48 to less
      than 72 hours or longer. Thus, an abstinence period of 24 to less than 48 hours
      can be recommended for sperm banking in cancer patients.

PMID- 7776465
TI  - Management of the epididymal tubule during an end-to-side vasoepididymostomy.
AB  - Microsurgical repairs of epididymal obstruction have improved because of specific
      tubule anastomoses. However, these techniques require considerable microsurgical
      skills and any modifications to organize and simplify these procedures seem
      desirable. Four modifications are described for the management of the epididymal
      tubule during end-to-side vasoepididymostomy, including closed tubule fixation,
      micro-tubulotomy, micro-suction and placement of double-armed sutures through the
      epididymal tubule before attachment of the vas. These procedures have been
      performed on 51 patients. "Mixed procedures," or a modified vasoepididymostomy on
      1 side and a vasovasostomy on the other, were done in 32 cases and "pure
      procedures," which included bilateral modified end-to-side vasoepididymostomy
      (16) and unilateral procedures (3), were done in 19. The semen and pregnancy data
      for the 19 cases of pure procedures were patency rate 58% in 11 and pregnancy
      rate 42% in 8. These modifications appeared to be helpful to organize and
      simplify several aspects of the procedure, and the results were improved compared
      to other techniques.

PMID- 7776464
TI  - Outcome prediction in patients with Fournier's gangrene.
AB  - We treated 30 patients with Fournier's gangrene during a 15-year period. Data
      were collected on demographics, medical history, admission signs and symptoms,
      physical examination, admission laboratory studies and bacteriology. The timing
      and degree of surgical debridement as well as antibiotic therapy were also
      reviewed. The extent of disease was calculated from body surface area nomograms.
      Data were stratified according to the outcomes of death (13 patients) or survival
      (17). Patients who survived were significantly younger (53 years old, range 23 to
      90) than those who died (71 years old, range 53 to 83, p = 0.004). Admission
      laboratory parameters that were statistically related to outcome included
      hematocrit, blood urea nitrogen, calcium, albumin, alkaline phosphatase and
      cholesterol levels. White blood count, platelets, potassium, bicarbonate, blood
      urea nitrogen, total protein, albumin and lactic dehydrogenase levels 1 week
      following hospitalization were also associated with outcome. The greater mean
      extent of body surface area involved among patients who died was not
      statistically different from that of those who lived (7.16 and 4.32%,
      respectively, p = 0.1). The number of surgical debridements did not seem to
      influence outcome. To assess better the physiological profile of the patients in
      both outcome categories, the acute physiology and chronic health evaluation II
      severity score was modified to create a Fournier's gangrene severity index. The
      mean Fournier's gangrene severity index for survivors was 6.9 +/- 0.9 compared to
      13.5 +/- 1.5 for nonsurvivors. Regression analysis demonstrated a strong
      correlation between Fournier's gangrene severity index and death rate
      (correlation coefficient = 0.934, p = 0.005). Using a Fournier's gangrene
      severity index threshold value of 9, there was a 75% probability of death with a
      score greater than 9, while a score of 9 or less was associated with a 78%
      probability of survival (p = 0.008). In conclusion, Fournier's gangrene is an
      infectious disease affecting an ever aging population of patients. Deviation from
      homeostasis is the most important parameter predictive of outcome and not the
      extent of disease or performance of surgical debridement. The Fournier's gangrene
      severity index is an objective and simple method to quantify the extent of
      metabolic aberration that may be used to predict outcome. We recommend the use of
      the Fournier's gangrene severity index when evaluating therapeutic options and
      reporting results.

PMID- 7776466
TI  - Femorotibial bypass for claudication: do results justify an aggressive approach?
AB  - PURPOSE: The role of infrainguinal arterial reconstructive surgery for
      claudication is controversial. We reviewed the results of femorotibial bypass
      procedures performed in a select group of patients with disabling claudication in
      an attempt to define a role for this aggressive approach. METHODS: Data were
      retrieved from the vascular registry, and hospital records were obtained for all
      patients undergoing femorotibial reconstruction for disabling claudication during
      the past 16 years at Brigham and Women's Hospital. Follow-up interviews were
      obtained to assess overall health, walking impairment, functional status, and
      patient satisfaction. RESULTS: During a 16-year period a total of 57 tibial
      reconstructions were performed in 53 patients for claudication (5% of all
      infrainguinal vein reconstructions). Autogenous vein conduit was used in all
      cases, most of which (70%) involved the greater saphenous vein in situ. Distal
      anastamoses were to the tibioperoneal trunk (12%), anterior tibial (18%),
      posterior tibial (47%), and peroneal (23%) arteries. Major complications occurred
      in 9%, and no perioperative deaths occurred. Overall 5-year survival was 54% +/-
      15%, and no major amputations were performed. Cumulative primary and secondary
      graft patency at 5 years were 81% +/- 6% and 86% +/- 5%, respectively. Patency
      rates were significantly better than those achieved in a concurrent series of
      tibial bypasses for limb salvage and were equivalent to those achieved with
      femoropopliteal bypass for claudication. Interviewed patients reported improved
      walking distance, reduced claudication, and a high degree of overall satisfaction
      with their operation. CONCLUSION: Results obtained with femorotibial bypass
      performed for claudication were superior to those obtained for limb salvage and
      were equivalent to those obtained with femoropopliteal bypass for claudication.
      The results obtained in this highly selected cohort suggest that patients at low
      risk with significant functional impairment from claudication, available
      autogenous vein, and suitable tibial outflow to the ischemic muscular bed can be
      offered revascularization with the expectation of durable long-term results.

PMID- 7776468
TI  - Magnetic resonance angiography in the preoperative evaluation of abdominal aortic
      aneurysms.
AB  - PURPOSE: Contrast arteriography (CA) is a useful but invasive technique for the
      preoperative evaluation of patients with abdominal aortic aneurysms (AAA). To
      evaluate the use of magnetic resonance arteriography (MRA) as a preoperative
      study we prospectively studied 38 patients undergoing AAA repair. METHODS: All
      patients underwent biplane CA and MRA with use of a gadolinium-enhanced
      technique. Radiographic studies were then independently evaluated by blinded
      radiologists for anatomic findings with CA used as the standard. Studies were
      then independently evaluated by blinded vascular surgeons, and a surgical plan
      was made. RESULTS: With CA and intraoperative findings as the standards, MRA
      proved highly accurate in the determination of multiple key anatomic elements.
      The proximal extent of aneurysmal disease was correctly predicted in 87% (33/38)
      patients. Significant iliofemoral occlusive disease was identified with a
      sensitivity of 83% (5/6). Iliac or femoral aneurysms were detected with a
      sensitivity of 79% (22/28) and specificity of 86% (41/48). Significant renal
      artery stenosis was detected with a sensitivity of 71% (12/17) and a specificity
      of 99% (72/73). Accessory renal arteries were correctly identified in 71%
      (12/17). Surgeon evaluators correctly predicted the proximal cross-clamp site in
      87% (33/38) of patients with use of MRA as compared with the actual operative
      conduct. Proximal anastomotic sites were correctly predicted in 95% (36/38) with
      MRA and 97% (37/38) with CA. Renal revascularization was predicted by MRA with a
      sensitivity of 91% (10/11) and specificity of 100% (65/65). The use of bifurcated
      aortic prostheses was correctly predicted by MRA in 75% (12/16), which was
      similar to that predicted by CA (81%, 13/16). CONCLUSIONS: MRA can provide
      preoperative anatomic information that is equivalent to CA for surgical planning.
      Because of favorable cost and patient safety considerations MRA will assume
      increasing importance in the preoperative evaluation of AAA.

PMID- 7776467
TI  - Photodynamic therapy of vein grafts: suppression of intimal hyperplasia of the
      vein graft but not the anastomosis.
AB  - PURPOSE: There is no clinically useful therapy for the suppression of vein bypass
      graft intimal hyperplasia (IH). Photodynamic therapy (PDT), a technique that uses
      light to activate otherwise biologically inert photosensitizers to produce
      cytotoxic effects, has been demonstrated to successfully inhibit experimental IH
      in balloon-injured arteries. The purpose of this study was to investigate the
      efficacy of PDT as a method to reduce vein graft IH. METHODS: Reversed external
      jugular vein bypass grafts of the common carotid artery were performed in 28 male
      Sprague-Dawley rats. The animals received either chloroaluminum sulfonated
      phthalocyanine (2.5 mg/kg intravenously) 24 hours before the ex vivo irradiation
      of the vein grafts (VG) with 100 joule/cm2 at 675 nm (PDT VG) or saline solution
      as control (CON VG). Preharvest bromodeoxyuridine was administered to label
      proliferating cells. All vein grafts were perfusion fixed within 96 hours for a
      pilot study or at 2 and 4 weeks for the main study. Histology,
      immunohistochemistry, and morphometric analysis were performed. RESULTS: There
      was no acute thrombus formation in the hypocellular PDT VG with occasional
      platelets but no leukocytes adherent to the luminal surface. Intimal areas of the
      PDT VG were 18% at 2 weeks and 53% at 4 weeks of the CON VGs (p < 0.05). Medial
      areas and percent of stenoses were also significantly less in PDT than in CON VG.
      However, intimal hyperplasia noted in the longitudinal sections within 2 mm of
      the anastomoses did not demonstrate a difference between PDT and CON VG. Intimal
      hyperplasia of both PDT and CON VG consisted of smooth muscle cells, verified by
      immunohistochemistry. Bromodeoxyuridine-labeled cells were more abundant in 2
      week than in 4-week specimens, were found most frequently in the intimal areas of
      the CON VG body, and were equivalent in the anastomoses of PDT VG and CON VG.
      CONCLUSIONS: These data suggest that PDT of vein grafts suppresses the
      development of IH in the body of the vein graft but does not affect IH adjacent
      to the anastomoses. The artery may be the source of proliferating smooth muscle
      cells that contribute to the anastomotic vein graft IH.

PMID- 7776469
TI  - Effect of intravenous glucagon on intestinal viability after segmental mesenteric
      ischemia.
AB  - PURPOSE: We have previously shown that intravenous glucagon significantly
      improves rat survival if given after release of superior mesenteric artery
      occlusion. The purpose of this study was to isolate the effects of glucagon on
      the intestine by creating a rat model of segmental mesenteric ischemia that
      avoids the systemic shock associated with total superior mesenteric artery
      occlusion and reperfusion. METHODS: In 18 anesthetized Sprague-Dawley rats, an 8
      cm segment of midileum was made totally ischemic for 110 minutes by occluding its
      vascular arcades and the bowel ends with microvascular clamps. Control animals (n
      = 8) received normal saline solution (10 ml/kg/hr intravenously) during ischemia
      and for 2 hours after declamping. Ten animals also received glucagon (1
      microgram/kg/min intravenously) during 2 hours after declamping. After a 24-hour
      recovery, the ischemic bowel segment, plus nonischemic proximal ileum, was
      examined histologically by computerized planimetry to measure wall thickness
      (muscularis, mucosa, and transmural), percent epithelial coverage, and villar
      surface ratio (villar surface length/bowel circumference). All observations were
      blinded. Comparisons were made by Student's t test. RESULTS: Compared with
      nonischemic ileum, the ischemic segment in control animals showed severe mucosal
      injury with a reduction in mucosal thickness to 25%, epithelial coverage to 23%,
      and villar surface ratio to 33% of that seen in nonischemic ileum (p < 0.01).
      Substantial preservation of ileal mucosal viability was seen in glucagon-treated
      animals. Mucosal thickness and epithelial coverage were twice as well preserved
      in glucagon-treated rats compared with control rats (p < 0.05), and villar
      surface ratio was also increased significantly (p < 0.05). The muscularis was not
      significantly injured in this model. CONCLUSIONS: By use of quantitative
      histologic measurements, we found that intravenous glucagon significantly
      improved ileal mucosal viability when given early during reperfusion after
      segmental ischemia. The mechanism of this effect and its potential clinical
      application merit further study.

PMID- 7776470
TI  - Should percutaneous transluminal renal artery angioplasty be applied to ostial
      renal artery atherosclerosis?
AB  - PURPOSE: The purpose of this study was to review the results of percutaneous
      transluminal renal artery angioplasty (PTRA) in patients with atherosclerosis to
      assess safety, anatomic and functional outcome, and differences in outcome
      between ostial and nonostial lesions. METHODS: We used retrospective review of 52
      consecutive patients who had undergone attempted PTRA for renal artery
      atherosclerosis during the calendar years 1987 to 1992. RESULTS: Fifty-two
      patients had 60 renal arteries on whom PTRA was attempted. The mean age was 68
      years. Atherosclerosis was generalized in 81% of the patients. The indication for
      angioplasty was salvage of functioning renal parenchyma in 81% of patients. Eight
      patients were undergoing dialysis at the time of attempted PTRA. Five arteries
      (8%) could not be dilated. There were one cardiac death and two arterial
      complications requiring surgery within 30 days. Thirty-five percent of patients
      with available angiograms had an anatomic improvement above a threshold of one
      stenotic group (30% to 40% diameter improvement), with residual stenosis of less
      than 50%. Half of patients treated for hypertension had improvement in their
      hypertension. Overall, there was no change in creatinine levels before and after
      the procedure. Four of eight patients undergoing dialysis at the time of PTRA
      were able to discontinue dialysis during follow-up. Four patients (11%) required
      surgical bypass and five patients (14%) required chronic dialysis during follow
      up. CONCLUSIONS: Modest success at low risk can be expected from PTRA in a group
      of patients with severe atherosclerosis. No significant difference in results
      between ostial and nonostial lesions was noted.

PMID- 7776471
TI  - Simultaneous aortic and renal artery reconstruction: evolution of an eighteen
      year experience.
AB  - PURPOSE: We reviewed an 18-year experience with combined abdominal aortic and
      renal artery reconstruction (AOR) with a particular focus on patients' clinical
      risk profile and surgical results in contemporary practice as compared with
      earlier experience. METHODS: One hundred seventy patients underwent AOR during
      the interval January 1, 1976 to June 30, 1994. To examine parameters
      representative of current practice, the cohort was divided into group I patients
      (n = 110) treated before 1990 and group II (n = 60) treated between 1990 and
      1994. Median follow-up duration for the entire cohort was 8.4 +/- 0.6 years.
      Renal artery reconstruction patency and patient survival rates were calculated by
      life-table methods. Logistic and Cox regression analysis were used to determine
      predictors of perioperative and long-term morbidity/mortality rates. RESULTS:
      Although demographic features changed little over the review period, the
      detection (56% vs 73%, p = 0.03) and treatment with percutaneous transluminal
      coronary angioplasty/coronary artery bypass grafting (11% vs 40%, p = 0.0001) of
      associated coronary artery disease were more frequent in group I patients. The
      operative mortality rate for the entire cohort was 6.5% (group I = 9% vs group II
      = 2%, p = 0.06). Changing trends of surgical techniques over the review period
      included (group I vs II, respectively) increased use of bilateral simultaneous
      renal artery repair (12% vs 25%, p < 0.005) and transaortic endarterectomy as the
      renal artery reconstruction technique (3% vs 25%, p < 0.0001). Favorable response
      in blood pressure control was noted in 68% of group II patients. The cumulative 5
      year survival rate for all patients was 75% with an initial serum creatinine of
      2.0 mg/dl or greater being the only negative predictor of late survival after
      regression analysis. CONCLUSION: The current operative mortality rate for AOR is
      in the range anticipated for aortic surgery alone, and this appears to be related
      to improved detection and treatment of associated coronary artery disease and
      intervention before major deterioration in renal function. These findings coupled
      with currently available natural history data relative to renovascular disease
      justify an aggressive approach with AOR when significant renal artery stenosis is
      detected during evaluation of aortic disease.

PMID- 7776472
TI  - Safety and efficacy of transaortic renal endarterectomy as an adjunct to aortic
      surgery.
AB  - PURPOSE: A study was undertaken to assess the safety and efficacy of transaortic
      endarterectomy for orificial atherosclerotic renovascular disease (ASRD),
      particularly in conjunction with surgery for concomitant aortic disease. METHODS:
      Forty-three consecutive patients with ASRD treated with transaortic orificial
      eversion endarterectomy were studied retrospectively to identify surgical
      indications, technical features, operative morbidity and mortality rates, and
      efficacy. RESULTS: A total of 76 renal arteries underwent transaortic
      endarterectomy for hypertension (88% of patients) or serum creatinine of 1.5
      mg/dl or greater (65% of patients), including two patients undergoing dialysis.
      Concomitant aortic surgery was performed in 39 patients for aneurysmal (n = 30)
      or occlusive (n = 9) disease. Two (2.6%) of 76 renal endarterectomies required
      intraoperative conversion to bypass because of poor flow, and three arteries
      (3.9%) were reimplanted or bypassed because of fragility of the renal orifice
      after endarterectomy. Thirty-day operative death occurred in two patients (4.7%),
      and major morbidity occurred in six (14.0%). Hypertension was cured or improved
      in 83% of patients with hypertension. Among patients with preoperative renal
      insufficiency, function was improved in 19%, with dialysis discontinued in one of
      two patients receiving dialysis, and function was worse in 23%, with one patient
      dependent on dialysis. CONCLUSION: Transaortic renal endarterectomy is an
      acceptably safe and effective adjunctive technique in selected patients with
      combined aortic disease and ASRD.

PMID- 7776473
TI  - Comparative early and late cardiac morbidity among patients requiring different
      vascular surgery procedures.
AB  - PURPOSE: The evaluation of coronary artery disease (CAD) in patients undergoing
      vascular surgery can provide information with respect to perioperative and long
      term risk for CAD-related events. However, the extent to which the required
      surgical procedure itself imparts additional risk beyond that dictated by the
      presence of CAD determinants remains in question. The purpose of this study was
      to quantify the relative contributions of specific vascular procedures and CAD
      markers on perioperative and long-term cardiac risk. METHODS: The study cohort
      comprised 547 patients undergoing vascular surgery from two medical centers who
      underwent clinical evaluation, dipyridamole thallium testing, and either aortic
      (n = 321), infrainguinal (n = 177), or carotid (n = 49) vascular surgery between
      1984 and 1991. Perioperative and late cardiac risk of fatal or nonfatal
      myocardial infarction (MI) was compared for the three procedures before and after
      adjustment for the influence of comorbid factors. These adjusted estimates may be
      regarded as the component of risk because of type of surgery. RESULTS:
      Perioperative MI occurred in 6% of patients undergoing aortic and carotid artery
      surgery, and in 13% of patients undergoing infrainguinal procedures (p = 0.019).
      Significant (p < 0.05) predictors of MI were history of angina, fixed and
      reversible dipyridamole thallium defects, and ischemic ST depression during
      testing. Although patients undergoing infrainguinal procedures exhibited more
      than twice the risk for perioperative MI compared with patients undergoing aortic
      surgery (relative risk: 2.4[1.2 to 4.5, p = 0.008]), this value was reduced to
      insignificant levels (1.6[0.8 to 3.2, p = 0.189]) after adjustment for comorbid
      factors. There was little change in comparative risk between carotid artery and
      aortic procedures before (1.0[0.3 to 3.6, p = 0.95]) or after (0.6[0.2 to 2.3, p
      = 0.4]) covariate adjustment. The 4-year cumulative event-free survival rate was
      90% +/- 2% for aortic, 74% +/- 5% for infrainguinal, and 78% +/- 7% for carotid
      artery procedures (p = 0.0001). Predictors of late MI included history of angina,
      congestive heart failure, diabetes, fixed dipyridamole thallium defects, and
      perioperative MI. Patients undergoing infrainguinal procedures exhibited a
      threefold greater risk for late events compared with patients undergoing aortic
      procedures (relative risk: 3.0[1.8 to 5.1, p = 0.005]), but this value was
      reduced to 1.3(0.8 to 2.3, p = 0.32) after adjustment. Long-term risk among
      patients undergoing carotid artery surgery was less dramatically altered by risk
      factor adjustment. CONCLUSION: In current practice, among patients referred for
      dipyridamole testing before operation, observed differences in cardiac risk of
      vascular surgery procedures may be primarily attributable to readily identifiable
      CAD risk factors rather than to the specific type of vascular surgery. Thus the
      cardiac and diabetic status of patients should be given careful consideration
      whenever possible, regardless of surgical procedure to be performed.

PMID- 7776474
TI  - Variability in measurement of abdominal aortic aneurysms. Abdominal Aortic
      Aneurysm Detection and Management Veterans Administration Cooperative Study
      Group.
AB  - PURPOSE: The purpose of this study was to report interobserver and intraobserver
      variability of computed tomography (CT) measurements of abdominal aortic aneurysm
      (AAA) diameter and agreement between CT and ultrasonography observed in the
      course of a large, multicenter, randomized trial on the management of small AAAs.
      METHODS: CT measurements of AAA diameter from participating centers were compared
      with measurements made from the same scan by a central laboratory. Blinded
      central remeasurement of a randomly selected subset of these CT scans was used to
      assess intraobserver variability. Agreement between AAA measurements by CT and
      ultrasonography done within 30 days of each other was also assessed. RESULTS: For
      interobserver pairs of local and central CT measurements of AAA diameter (n =
      806), the difference was 0.2 cm or less in 65% of pairs, but 17% differed by at
      least 0.5 cm. For intraobserver pairs of central CT remeasurements (n = 70), 90%
      differed by 0.2 cm or less, 70% were within 0.1 cm, and only one differed by 0.5
      cm. Of 258 ultrasound-measured and central CT pairs, the difference was 0.2 cm or
      less in 44% and at least 0.5 cm in 33%. Ultrasound measurements were smaller than
      central CT measurements by an average of 0.27 cm (p < 0.0001). Local CT and
      ultrasound measurements showed a marked preference for recording by half
      centimeter. CONCLUSIONS: A high degree of precision is possible in CT measurement
      of AAA diameter, but this precision may not be obtained in practice because of
      differences in measurement techniques. Differences between imaging modalities
      increase variability further. Variations in AAA measurement of 0.5 cm or more are
      not uncommon, and this should be taken into account in management decisions.
      Efforts to reduce variation in measurement are warranted and might include (1)
      seeking agreement between surgeons and radiologists on a precise definition of
      AAA diameter, (2) limiting the number of radiologists who measure AAAs, and (3)
      use of calipers and magnifying glass for CT measurements.

PMID- 7776475
TI  - Retroviral vector-mediated transfer and expression of human tissue plasminogen
      activator gene in human endothelial and vascular smooth muscle cells.
AB  - PURPOSE: Enhancement of the fibrinolytic activity of vascular cells by tissue
      plasminogen activator (tPA) gene transfer has considerable clinical potential.
      However, it is unknown whether greater constitutive expression of the tPA gene
      might increase plasminogen activator inhibitor-1 (PAI-1) secretion, which could
      negate expected increases in fibrinolytic activity that accompany greater tPA
      protein production. The objective of this investigation was to determine whether
      transduction of human endothelial cells (EC) and vascular smooth muscle cells
      (SMC) with a retroviral vector containing the human tPA gene would increase tPA
      production and what effect this would have on endogenous PAI-1 secretion and
      subsequent fibrinolytic activity. METHODS: Cultivated human EC and SMC either
      were transduced with a murine leukemia retroviral vector (MFG) containing the
      human tPA gene and, in the case of controls, the lacZ gene, or they were exposed
      to media alone. On days 14 and 28 after transduction, supernatent tPA antigen and
      PAI-1 antigen levels were measured by ELISA, and supernatent tPA activity was
      quantitated with a spectrolyse tPA/PAI assay. RESULTS: Southern and Northern blot
      analyses documented integration and transcription of the tPA gene in both EC and
      SMC. Greater tPA antigen production occurred in MFG-tPA-transduced EC and SMC
      compared with nontransduced or MFG-lac Z-transduced cells (p < 0.05). The tPA
      activity increased in transduced human saphenous vein EC (up to 5.1-fold) and
      human iliac artery EC (up to 4.7-fold), but no increased tPA activity occurred in
      transduced SMC, compared with nontransduced or MFG-lac Z-transduced cells (p <
      0.05). PAI-1 antigen was unchanged in transduced SMC but decreased in MFG-tPA
      transduced EC (p < 0.05). PAI-1 mRNA was unchanged in the transduced EC and SMC
      compared with nontransduced cells, suggesting that posttranslational events may
      have caused the changes in EC PAI-1. CONCLUSIONS: This investigation demonstrated
      that MFG-mediated tPA gene transfer into human EC resulted in a significant
      increase in tPA activity. Enhancement of adult human EC fibrinolytic activity by
      transfer of the human tPA gene has not been previously reported and represents a
      necessary finding in the development of this gene therapy technology for the
      prevention of thrombotic complications of vascular disease.

PMID- 7776476
TI  - The significance of microemboli detection by means of transcranial Doppler
      ultrasonography monitoring in carotid endarterectomy.
AB  - PURPOSE: Carotid endarterectomy (CEA) performed with continuous transcranial
      Doppler monitoring provides a unique opportunity to determine the number of
      cerebral microemboli and to relate their occurrence to the surgical technique.
      The purpose of this study was to assess in CEA the impact of cerebral
      microembolism on clinical outcome and brain architecture. We also evaluated the
      influence of the audible transcranial Doppler signal on the surgeon and his or
      her technique. METHODS: In a prospective series of 301 patients, CEA was
      monitored with electroencephalography and transcranial Doppler ultrasonography of
      the ipsilateral middle cerebral artery. Preoperative and intraoperative risk
      factors were entered in a logistic regression analysis program to assess their
      correlation with cerebral outcome. To evaluate the impact of cerebral
      microembolism on brain architecture, we compared preoperative and postoperative
      computed tomography scans or magnetic resonance images of the brain in two
      subgroups of 58 and 40 patients, respectively. RESULTS: Seven (2.3%) patients had
      intraoperative transient ischemic symptoms, three (1%) had intraoperative
      strokes, 1 (0.3%) had transient ischemic symptoms after operation, and 10 (3.3%)
      had postoperative strokes. Four (1.3%) patients died. Microemboli (> 10) noticed
      during dissection were related to both intraoperative (p < 0.002) and
      postoperative (p < 0.02) cerebral complications. Microemboli that occurred during
      shunting were also related to intraoperative complications (p < 0.007).
      Microembolism never resulted in new morphologic changes on postoperative computed
      tomography scans. On the contrary, the phenomenon of more than 10 microemboli
      during dissection was significantly (p < 0.005) related to new hyperintense
      lesions on postoperative T2-weighted magnetic resonance images. CONCLUSIONS:
      During CEA the presence of microembolism (> 10 microemboli) during dissection
      shows a statistically significant relationship with perioperative cerebral
      complications and with new ischemic lesions on magnetic resonance images of the
      brain. Moreover, microembolism during shunting is also related to intraoperative
      complications. Surgeons can be guided by the audio Doppler and emboli signals by
      changing their technique. This change may result in a decrease of microembolism
      and consequently in a decline of the intraoperative stroke rate.

PMID- 7776477
TI  - Spinal cord protection during thoracoabdominal aortic aneurysm repair: results of
      selective reconstruction of the critical segmental arteries guided by evoked
      spinal cord potential monitoring.
AB  - PURPOSE: The purpose of this study is to evaluate the results of spinal cord
      protection based on selective reconstruction of the segmental arteries. METHODS:
      Twenty-one patients who underwent repair of aneurysms (nine descending thoracic
      and 12 thoracoabdominal: three type I, six type II, and three type III) were
      analyzed. Ten patients had postdissection aneurysms. Operative techniques
      consisted of evoked spinal cord potential (ESP-dsc) monitoring and femorofemoral
      bypass in all cases, segmental resection in 12, and mild systemic hypothermia in
      eight. Arteries critical for cord blood flow were selectively reconstructed; if
      ESP-dsc showed change after resection of an aortic segment, arteries originating
      from this segment were reconstructed. RESULTS: ESP-dsc change was observed in 12
      patients. Arteries found to be critical were at the T8-L1 level in all but three
      cases. Selective reconstruction was performed in 10 of these 12 patients. ESP-dsc
      change could be reversed before reconstruction in four cases, three by control of
      back-bleeding critical arteries. Selective reconstruction resulted in return of
      ESP-dsc in seven other patients. Spinal cord injury occurred in five patients,
      two of whom did not undergo selective reconstruction. CONCLUSION: These results
      suggest that our current technique allows determination of critical arteries but
      does not completely prevent injury.

PMID- 7776479
TI  - Ruptured thoracic aortic aneurysms: a study of incidence and mortality rates.
AB  - PURPOSE: The purpose of this study was to determine the incidence and mortality
      rate of ruptured thoracic aortic aneurysm (TAA) in a well-defined population.
      METHODS: Retrospective analysis of complied data from multiple registries in
      Stockholm, Sweden was performed. RESULTS: Eighty-two and 76 cases were identified
      from 1980 and 1989, respectively, for an equal incidence of 5 per 100,000. Forty
      one percent of the patients were alive on arrival at an emergency hospital, but
      the overall mortality rate was 97% to 100%. CONCLUSIONS: The mortality rate of
      ruptured TAA is high. To decrease this high mortality rate, efficient screening
      methods for the diagnosis of TAA must be worked out, characteristics indicating
      high risk of rupture must be identified, and efforts should be made to increase
      the number of operations for ruptured TAA.

PMID- 7776478
TI  - Determining the acuteness and stability of deep venous thrombosis by ultrasonic
      tissue characterization.
AB  - PURPOSE: The intent of the study was to determine whether ultrasonic tissue
      characterization (UTC) could indicate acuteness and stability of deep venous
      thrombosis (DVT) of the lower extremities. METHODS: Thrombi presenting as filling
      defects on color Doppler imaging in the common or superficial femoral or
      popliteal veins in 50 extremities in 45 patients with DVT were studied. Acute DVT
      was less than 4 days duration, and chronic DVT was greater than 21 days duration.
      UTC analysis of parameters from the normalized power spectrum of backscattered
      ultrasound signals from venous filling defects was performed. This spectrum
      approaches a straight line, and its basic parameters, slope, and Y-intercept are
      related to scatterer size, concentration, and the square of the scatterer-to
      medium acoustic impedances. Ten of the DVT extremities were reexamined at 1 week
      to assess UTC changes that would indicate thrombus instability. RESULTS: Acute
      DVT (19 of the 50 extremities) could be distinguished from chronic DVT, mainly on
      the basis of significantly higher intercept values for the acute group, which
      were 11.6 relative decibels (dBr) higher than those of the chronic DVT group.
      Discriminant linear analysis of the two parameters indicated a sensitivity of
      94.7% and specificity of 90.3% in correctly diagnosing acute DVT. In a small
      sample of 10 extremities reexamined at 1 week, acute DVT extremities showed a
      mean 9.4 dBr decrease in intercept values with no significant change in slope.
      CONCLUSIONS: UTC distinguished clinically defined acute from chronic DVT. In a
      small series of extremities, UTC revealed significant instability of acute
      thrombi in a selected patient population.

PMID- 7776480
TI  - Screening for asymptomatic internal carotid artery stenosis: duplex criteria for
      discriminating 60% to 99% stenosis.
AB  - PURPOSE: The Asymptomatic Carotid Atherosclerosis Study (ACAS) showed that
      carotid endarterectomy reduces stroke risk in symptom-free patients with 60% or
      greater internal carotid artery (ICA) stenosis. This will surely lead to the
      performance of an increased number of screening duplex examinations. Assuming
      that positive study results will lead to arteriography or endarterectomy and
      keeping in mind the modest benefit for prophylactic endarterectomy demonstrated
      by ACAS (absolute risk reduction for ipsilateral stroke of 5.8% at 5 years),
      duplex criteria for 60% or greater ICA stenosis must have high positive
      predictive values (PPV). Determining criteria for 60% or greater stenosis, which
      emphasized high accuracy and PPV, forms the basis for this study. METHODS:
      Stenoses detected by angiography in 352 ICAs were blindly compared with those
      detected by duplex scanning. Duplex criteria were determined for highest overall
      accuracy in detection of 60% or greater ICA stenosis and for 95% or greater PPV.
      RESULTS: Maximal accuracy for detection of 60% or greater stenosis was 90%. This
      was achieved by the combination of a peak systolic velocity of 260 cm/sec or
      greater and an end diastolic velocity of 70 cm/sec or greater (sensitivity 84%,
      specificity 94%, PPV 92%). The 95% PPV for 60% or greater stenosis results from
      combining peak systolic velocity of 290 cm/sec or greater and end diastolic
      velocity of 80 cm/sec or greater. CONCLUSIONS: With use of these criteria duplex
      scanning accurately detects with high PPVs the threshold level of ICA stenosis
      defined in ACAS as receiving stroke reduction benefit from prophylactic carotid
      endarterectomy. These criteria should be useful for carotid artery screening and
      minimizing unneeded intervention.

PMID- 7776481
TI  - Endovascular arterial intervention: expression of concern.

PMID- 7776482
TI  - Treatment options for phlegmasia cerulea dolens.

PMID- 7776483
TI  - A case report of inflammatory aneurysm of the thoracic aorta.

PMID- 7776484
TI  - A piece of my mind. A trial for my life.

PMID- 7776485
TI  - Terms of engraftment: umbilical cord blood transplants arouse enthusiasm.

PMID- 7776486
TI  - FDA pushes for prescription drug information.

PMID- 7776487
TI  - From the Veterans Health Administration.

PMID- 7776488
TI  - From the Centers for Disease Control and Prevention. Update: trends in AIDS among
      men who have sex with men--United States, 1989-1994.

PMID- 7776489
TI  - From the Centers for Disease Control and Prevention. Prevalence and impact of
      arthritis among women--United States, 1989-1991.

PMID- 7776490
TI  - From the Centers for Disease Control and Prevention. Cholera associated with food
      transported from El Salvador--Indiana, 1994.

PMID- 7776491
TI  - Diagnostic and therapeutic technology assessment. Transjugular intrahepatic
      portosystemic shunt (TIPS).
AB  - OBJECTIVE: To provide clinicians with a technology assessment of the safety and
      effectiveness of the use of a transjugular intrahepatic portosystemic shunt
      (TIPS) for reducing portal hypertension and its associated complications of
      esophageal varices and ascites. PARTICIPANTS: A literature review and a
      Diagnostic and Therapeutic Technology Assessment (DATTA) survey questionnaire
      were mailed to 72 physicians with expertise in gastrointestinal or abdominal
      surgery or interventional radiology and a special interest in liver disease or
      esophageal varices. These panelists had been nominated to the DATTA panel by
      appropriate specialty societies and medical schools. A total of 54 panelists
      (75%) responded. EVIDENCE: Assessment was based on the expert opinion of the
      panelists, as well as on published scientific literature (available as of January
      2, 1995). Published studies were identified by a MEDLINE search using the terms
      transjugular intrahepatic portosystemic shunt, TIPS, and transjugular and by
      review of the references cited in these primary sources. CONSENSUS PROCESS: The
      respondents completed a DATTA survey questionnaire; the survey results were
      tabulated, analyzed, and interpreted by an American Medical Association staff
      physician. CONCLUSIONS: The safety of TIPS was considered to be established in
      the acute control of bleeding from esophageal varices in patients who had failed
      sclerotherapy. The safety of TIPS was considered to be promising for long-term
      control of bleeding from esophageal varices. In patients with end-stage liver
      disease and esophageal varices who are liver transplant candidates, the use of
      TIPS was considered to be an established therapy. The effectiveness of TIPS was
      considered to be (1) established in the acute control of bleeding in patients who
      failed sclerotherapy; (2) promising for long-term control of bleeding from
      esophageal varices; and (3) established in patients with end-stage liver disease
      and esophageal varices who are candidates for liver transplants.

PMID- 7776492
TI  - Captopril and diabetic nephropathy.

PMID- 7776493
TI  - HIV incidence among injection drug users enrolled in a Los Angeles methadone
      program.

PMID- 7776494
TI  - In the wake of Hurricane Andrew.

PMID- 7776495
TI  - Cost-effective treatment of depression.

PMID- 7776496
TI  - Dietary carotenoids, vitamins A, C, and E, and macular degeneration.

PMID- 7776497
TI  - Intramuscular vs intradermal hepatitis B vaccination: a 6-year follow-up.

PMID- 7776498
TI  - Lipoproteins, coagulation states, and risk of thrombotic events.

PMID- 7776499
TI  - Cost of patient follow-up after potentially curative colorectal cancer treatment.
AB  - OBJECTIVE: To estimate the cost of follow-up among colorectal cancer patients
      treated with curative intent based on the broad spectrum of surveillance
      strategies suggested in the literature. DESIGN: Economic analysis of the costs
      associated with 11 separate surveillance strategies. Charge data were obtained
      from the Part B Medicare Annual Data file and the Hospital Outpatient Bill file.
      SETTING: Ambulatory care. MAIN OUTCOME MEASURES: Medicare-allowed charges and an
      actual-charge proxy for 5 years of follow-up after treatment for colorectal
      cancer patients on a nationwide basis. RESULTS: Medicare-allowed charges varied
      widely for the 5 years of posttreatment follow-up from a low of $561 to a high of
      $16,492. When Medicare-allowed charges were converted to a proxy for actual
      charges using a conversion ratio of 1.62, the range was $910 to $26,717, a 28
      fold difference in charges. CONCLUSIONS: Charges vary extensively across follow
      up strategies, with no indication that higher-cost strategies increase survival
      or quality of life.

PMID- 7776500
TI  - Identification of comatose patients at high risk for death or severe disability.
      SUPPORT Investigators. Understand Prognoses and Preferences for Outcomes and
      Risks of Treatments.
AB  - OBJECTIVE: To develop and validate a simple prognostic scoring system to identify
      patients in nontraumatic coma at high risk for poor outcomes using data available
      early in the hospital course. DESIGN: Prospective cohort study. SETTING: Five
      geographically diverse academic medical centers. PATIENTS: A total of 596
      patients in nontraumatic coma enrolled in the Study to Understand Prognoses and
      Preferences for Outcomes and Risks of Treatments (SUPPORT), including 247 in the
      model derivation set and 349 in the model validation set. MAIN OUTCOME MEASURES:
      Death and severe disability by 2 months. MAIN RESULTS: For the 596 patients
      studied (median age, 67 years; 52% female), the primary cause of coma was cardiac
      arrest in 31% and cerebral infarction or intracerebral hemorrhage in 36%. At 2
      months 69% had died, 20% had survived with known severe disability, 8% were known
      to have survived without severe disability, and 3% survived with unknown
      functional status. Five clinical variables available on day 3 after enrollment
      were associated independently with 2-month mortality: abnormal brain stem
      response (adjusted odds ratio [OR] = 3.2; 95% confidence interval [CI], 1.3 to
      8.1), absent verbal response (OR = 4.6; 95% CI, 1.8 to 11.7), absent withdrawal
      response to pain (OR = 4.3; 95% CI, 1.7 to 10.8), creatinine level greater than
      or equal to 132.6 mumol/L (1.5 mg/dL) (OR = 4.5; 95% CI, 1.8 to 11.0), and age of
      70 years or older (OR = 5.1; 95% CI, 2.2 to 12.2). Mortality at 2 months for
      patients with four or five of these risk factors was 97% (58/60; 95% CI, 88% to
      100%) in the validation set. Brain stem and motor responses best predicted death
      or severe disability by 2 months. For patients with either an abnormal brain stem
      response or absent motor response to pain, the rate of death or severe disability
      at 2 months was 96% (185/193; 95% CI, 92% to 98%) in the validation set.
      CONCLUSIONS: Five readily available clinical variables identify a large subgroup
      of patients in nontraumatic coma at high risk for poor outcomes. This risk
      stratification approach offers physicians, patients, and patients' families
      information that may prove useful in patient care decisions and resource
      allocation.

PMID- 7776501
TI  - Serial coronary angiographic evidence that antioxidant vitamin intake reduces
      progression of coronary artery atherosclerosis.
AB  - OBJECTIVE: To explore the association of supplementary and dietary vitamin E and
      C intake with the progression of coronary artery disease. DESIGN: A subgroup
      analysis of the on-trial antioxidant vitamin intake database acquired in the
      Cholesterol Lowering Atherosclerosis Study, a randomized, placebo-controlled,
      serial angiographic clinical trial evaluating the risk and benefit of colestipol
      niacin on coronary artery disease progression. SETTING: Community- and university
      based cardiac catheterization laboratories. SUBJECTS: A total of 156 men aged 40
      to 59 years with previous coronary artery bypass graft surgery. INTERVENTION:
      Supplementary and dietary vitamin E and C intake (nonrandomized) in association
      with cholesterol-lowering diet and either colestipol-niacin or placebo
      (randomized). OUTCOME: Change per subject in the percentage of vessel diameter
      obstructed because of stenosis (%S) determined by quantitative coronary
      angiography after 2 years of randomized therapy on all lesions, mild/moderate
      lesions (< 50%S), and severe lesions (> or = 50%S). RESULTS: Overall, subjects
      with supplementary vitamin E intake of 100 IU per day or greater demonstrated
      less coronary artery lesion progression than did subjects with supplementary
      vitamin E intake less than 100 IU per day for all lesions (P = .04) and for
      mild/moderate lesions (P = .01). Within the drug group, benefit of supplementary
      vitamin E intake was found for all lesions (P = .02) and mild/moderate lesions (P
      = .01). Within the placebo group, benefit of supplementary vitamin E intake was
      not found. No benefit was found for use of supplementary vitamin C exclusively or
      in conjunction with supplementary vitamin E, use of multivitamins, or increased
      dietary intake of vitamin E or vitamin C. CONCLUSIONS: These results indicate an
      association between supplementary vitamin E intake and angiographically
      demonstrated reduction in coronary artery lesion progression. Verification from
      carefully designed, randomized, serial arterial imaging end point trials is
      needed.

PMID- 7776503
TI  - Bloodstream infections associated with a needleless intravenous infusion system
      in patients receiving home infusion therapy.
AB  - OBJECTIVE: To determine risk factors for bloodstream infections (BSIs) in an
      outbreak among patients receiving home intravenous infusion therapy. DESIGN: Case
      control and retrospective cohort studies. SETTING: Home health agency. PATIENTS:
      Patients receiving home intravenous infusion therapy from Rhode Island Home
      Therapeutics (RIHT) from January through December 1993. MAIN OUTCOME MEASURE:
      Development of primary BSI. METHODS: We compared patients with BSI (ie, case
      patients) with randomly selected noninfected RIHT patients receiving intravenous
      therapy, conducted a cohort study of all RIHT patients receiving intravenous
      therapy via a central venous catheter (CVC), and conducted a culture survey of
      injection cap luminal fluid. RESULTS: Case patients were more likely than
      controls to have had therapy via a CVC (11/11 vs 14/32; odds ratio [OR]
      undefined; P < .001) or total parenteral nutrition and intralipid therapy
      (TPN/IL) (9/11 vs 3/32; OR, 43.5; 95% confidence interval [CI], 4.9 to 510.0).
      Among RIHT patients with CVCs, risk factors for BSI were receipt of TPN/IL (9/35
      vs 2/67; rate ratio [RR], 8.6; 95% CI, 2.0 to 37.7) or use of a needleless
      infusion system (10/41 vs 1/61; RR, 14.9; 95% CI, 2.0 to 111.8). Only the
      combination of both exposures was significantly associated with development of a
      BSI (P < .001). Luminal fluid from injection caps of needleless devices was
      significantly more likely to be culture positive than fluid from protected-needle
      devices (5/23 vs 0/18; RR undefined; P = .04). CONCLUSIONS: Our data suggest that
      a needleless device used for TPN/IL was associated with increased risk of BSI
      when injection caps were changed every 7 days.

PMID- 7776504
TI  - Recommendations for off-label use of intravenously administered immunoglobulin
      preparations. University Hospital Consortium Expert Panel for Off-Label Use of
      Polyvalent Intravenously Administered Immunoglobulin Preparations.
AB  - OBJECTIVE: To summarize consensus recommendations for off-label uses of standard
      intravenous immunoglobulin (IVIG), as developed by a University Hospital
      Consortium (UHC) Expert Panel. These findings are intended to help guide
      clinicians in the appropriate and efficient use of IVIG. PARTICIPANTS: The UHC
      sponsored panel included eight physicians (board certified in critical care,
      hematology, immunology, neurology, oncology, pediatrics, or rheumatology) and two
      hospital pharmacists. EVIDENCE: MEDLINE and EMBASE were searched to identify all
      English-language review articles (n = 201) and original reports (n = 1904) on
      IVIG (human use only, excluding editorials, letters, and comments) published
      between January 1982 and March 1994. Relevant original reports (250) and review
      articles (87) were evaluated by the first author (T.A.R.). Extracted data
      included laboratory and clinical findings, objective measures, or clinical
      impressions. The evidence quality was graded by study design according to the US
      Preventive Services Task Force. CONSENSUS PROCESS: Before the panel meeting, a
      draft literature review and recommendations were produced by one of the authors
      (T.A.R.). The recommendations herein represent consensus (100% agreement) based
      on the published evidence. CONCLUSIONS: The UHC Expert Panel made specific
      recommendations for 53 off-label indications and the following general
      recommendations: (1) Usually IVIG is indicated only if standard approaches have
      failed, become intolerable, or are contraindicated; (2) IVIG products should be
      considered therapeutically equivalent and interchangeable; (3) interproduct
      pharmaceutical differences should be considered with the patient's clinical and
      physiological status when selecting an IVIG product; and (4) currently, IVIG
      manufacturers cannot guarantee freedom from viral contamination in the finished
      product.

PMID- 7776502
TI  - Pancreatic beta-cell dysfunction as the primary genetic lesion in NIDDM. Evidence
      from studies in normal glucose-tolerant individuals with a first-degree NIDDM
      relative.
AB  - OBJECTIVE: To test the hypothesis that insulin resistance precedes impaired
      insulin secretion in individuals genetically predisposed to non-insulin-dependent
      diabetes mellitus (NIDDM). DESIGN: Case-control study. SETTING: Outpatient
      facility of clinical research center. PARTICIPANTS: One hundred volunteers of
      European ancestry having normal glucose tolerance, 50 with and 50 without a first
      degree NIDDM relative, matched for age, sex, and degree of obesity. MAIN OUTCOME
      MEASURES: Insulin secretion and insulin sensitivity assessed by hyperglycemic (N
      = 100) and euglycemic-hyperinsulinemic (N = 62) clamp experiments. RESULTS: The
      individuals with a first-degree NIDDM relative had reduced first- and second
      phase insulin responses (mean +/- SEM, 939 +/- 68 vs 1209 +/- 82 pmol/L, and 322
      +/- 19 vs 407 +/- 24 pmol/L, respectively, P = .001 and .01), but their insulin
      sensitivity (148 +/- 6 and 92 +/- 6 nmol.kg-1.min-1/pmol.L-1 in hyperglycemic and
      euglycemic clamp studies) did not differ from that of the control group (126 +/-
      5 and 81 +/- 7 nmol.kg-1.min-1/pmol.L-1, in hyperglycemic and euglycemic clamp
      studies, P = .07 and .24, respectively). In some individuals only first- or only
      second-phase insulin responses were reduced. CONCLUSION: In this study
      population, heterogeneous defects in insulin secretion were demonstrated, while
      defects in insulin sensitivity were not evident. We therefore conclude that since
      the earliest defects identified in a group genetically at high risk to develop
      NIDDM are those related to insulin secretion, defects in insulin secretion rather
      than insulin sensitivity are likely the major genetic factor predisposing to
      development of NIDDM.

PMID- 7776505
TI  - Attention-deficit disorder. Born to be hyperactive?

PMID- 7776507
TI  - Follow-up testing for curatively treated cancer survivors. What to do?

PMID- 7776508
TI  - Which comes first in non-insulin-dependent diabetes mellitus: insulin resistance
      or beta-cell failure? Both come first.

PMID- 7776506
TI  - Marihuana as medicine. A plea for reconsideration.

PMID- 7776509
TI  - [Is there a receptor for volatile anesthetics?].
AB  - Because of the presence of inequality of the effect of volatile anesthetics on
      various neurotransmission systems, a specific receptor is proposed. Nonetheless,
      the differences are only of the magnitude, and almost all synapses are equally
      affected. The outstanding features of the action of volatile anesthetics are this
      wide range of the target, and the steep dose-response curve. The steep dose
      response curve indicates that various synapses respond to anesthetics with high
      cooperativity. When a string of amino acids folds into biologically meaningful
      structure by enclosing hydrophobic areas inside, some hydrophobic parts are left
      at the protein-water interface. These hydrophobic patches become the binding site
      for anesthetics. Because of the wide difference in the structures of anesthetics,
      it is difficult to assume a specific binding site of lock-and-key type for all
      anesthetics with all synaptic proteins. Presumably volatile anesthetics bind most
      hydrophobic patches nonselectively. The affinity to each patch may differ, and
      the relative specificity to each synapse may ensue. To define these areas as a
      receptor is a matter of opinion.

PMID- 7776510
TI  - [Continuous epidural buprenorphine for postoperative pain relief after
      thoracotomy].
AB  - To evaluate postoperative analgesia and side effects of epidural buprenorphine,
      60 patients after thoracotomy were divided into 6 groups. All patients received a
      bolus epidural administration of buprenorphine 0.1 mg in 8 ml of 0.25%
      bupivacaine. Following this epidural bolus, 10 patients in each group were given
      0.25% bupivacaine alone (group A), buprenorphine 5 micrograms in 1 ml of 0.25%
      bupivacaine (group B), buprenorphine 8 micrograms in 1 ml of 0.25% bupivacaine
      (group C), buprenorphine 12 micrograms in 1 ml of 0.25% bupivacaine (group D),
      buprenorphine 15 micrograms in 1 ml of 0.25% bupivacaine (group E) or
      buprenorphine 18 micrograms in 1 ml of 0.25% bupivacaine (group F) with a
      portable disposable device at a rate of 1 ml.h-1 for 48 h. The percentages of
      patients who did not need additional narcotics for the first 24 hours
      postoperatively in group A, B, C, D, E, and F were 20%, 40%, 30%, 50%, 60%, and
      70%, respectively. Those for the second 24 hours postoperatively in each group
      were 40%, 50%, 70%, 60%, 90%, and 90%, respectively. No significant difference in
      the incidence of side-effect was found among 6 groups. We concluded that optimal
      epidural doses of buprenorphine for post-thoracotomy pain relief are 15 and 18
      micrograms.h-1 in the first and second 24 hours postoperatively, respectively.

PMID- 7776511
TI  - [Postoperative analgesia service by continuous epidural infusion with
      buprenorphine].
AB  - We examined the analgesic efficacy and side effects of continuous epidural
      infusion with buprenorphine in 340 surgical patients. The patients received
      epidural injection of 0.1 mg of buprenorphine in 8 ml of 0.25% bupivacaine
      immediately after surgery. The patients who underwent thoracotomy or
      intraabdominal surgery were subsequently infused with buprenorphine 15 micrograms
      in 1 ml of 0.25% buprenorphine at a rate of 1 ml.h-1 for 48 h. In the other kinds
      of surgery, patients were infused with buprenorphine 8 micrograms in 1 ml of
      0.25% buprenorphine at a rate of 1 ml.h-1 for 48 h. The patients who did not need
      additional narcotics were 68% and 83% on the postoperative day 1 and 2,
      respectively. Visual analogue scale (VAS) was 22 +/- 2 mm at rest and 43 +/- 2 mm
      at movement on the postoperative day 1. Corresponding values on the postoperative
      day 2 were 16 +/- 2 mm and 37 +/- 2 mm, respectively. Nausea and vomiting were
      found in 12.4% of the patients.

PMID- 7776512
TI  - [Neonatal apnea after general anesthesia--effects of intraoperative
      hyperventilation and serum ionized Ca concentration].
AB  - The relationship between neonatal apnea following general anesthesia and serum
      ionized calcium (Ca2+) concentration was examined in 13 neonates who had received
      intraoperative hyperventilation. In all cases, preoperative serum Ca2+
      concentration was within normal limits. The anesthesia was maintained by nitrous
      oxide and oxygen. At the end of anesthesia, the incidence of abnormal breathing
      such as apnea, periodic breathing or subcostal retraction and their activity were
      investigated. Five minutes after intravenous administration of 2% CaCl2 solution
      (16 mg.kg-1), the same parameters were compared with the values before CaCl2
      administration. As we used only Ca2+ free solution for fluid therapy during
      operation, serum Ca2+ concentration decreased gradually under general anesthesia,
      but after CaCl2 administration, it increased and the incidence of abnormal
      breathing decreased. To determine the relationship between hyperventilation and
      the incidence of abnormal breathing, the data were analyzed by dividing the
      patients into two groups based on PaCO2 level, a lower PaCO2 group
      (intraoperative PaCO2 < 30 mmHg, n = 5) and a higher PaCO2 group (PaCO2 > or = 30
      mmHg, n = 8). But there was no significant relationship between them. In
      conclusion, this study demonstrates that the Ca administration has a favorable
      effect on respiratory system and motor activity, but we cannot relate the
      incidence of postoperative abnormal breathing to the degree of hyperventilation.

PMID- 7776513
TI  - [Diltiazem potentiates the neuromuscular blockade by vecuronium in humans].
AB  - We investigated interaction of diltiazem with vecuronium using constant infusion
      technique in 24 ASA class I or II elective surgical patients with no preoperative
      administration of Ca antagonists. Neuromuscular blockade was evaluated with
      accelerometry, which measured single twitch height of adductor pollicis muscle.
      After tracheal intubation under isoflurane anesthesia, patients received either
      no diltiazem (control group, n = 8)m, 5 mg (bolus) + 2 mcg.kg-1.min-1 constant
      infusion (2 mcg group, n = 8) or 5 mg (bolus) + 4 mcg.kg-1.min-1 constant
      infusion (4 mcg group, n = 8). When single twitch height returned to 10% of
      control value, infusion of vecuronium was started and the infusion rate was
      adjusted to maintain twitch height at 10% of the control value. After 30 minutes
      of stable twitch height, the vecuronium infusion rate and plasma diltiazem
      concentrations were measured. Diltiazem infusion of 4 mcg.kg-1.min-1 decreased
      the vecuronium infusion rate by 45% compared with 2 other groups. Plasma
      diltiazem concentrations in patients receiving 4 mcg.kg-1.min-1 were
      significantly higher than those receiving 2 mcg.kg-1.min-1. In conclusion
      diltiazem 4 mcg.kg-1.min-1 potentiates the neuromuscular blockade of vecuronium
      and it relates with the plasma diltiazem concentration.

PMID- 7776515
TI  - [Effects of trimetaphan on hemodynamics and pulmonary gas exchange--a comparison
      with those of nitroglycerin and prostaglandin E1].
AB  - In recent studies, the changes in arterial and end-tidal carbon dioxide tensions
      have been shown to correlate linearly with changes in cardiac output during the
      constant minute ventilation. High and low ventilation to perfusion ratios can
      also be estimated from blood and expiratory gas analysis. In the present study,
      the effects of trimetaphan (29 +/- 3 micrograms.kg-1.min-1) on hemodynamics and
      pulmonary gas exchanges were studied by analyzing these gas tensions in nine
      sevoflurane/nitrous oxide anesthetized patients, and were compared with those of
      nitroglycerin (5 micrograms.kg-1.min-1) and prostaglandin E1 (100 ng.kg-1.min-1)
      which had been reported in the previous study. During trimetaphan administration,
      arterial pressure decreased. The decreases in both systolic and diastolic
      arterial pressures were greater than those during nitroglycerin or prostaglandin
      E1 administration. PaCO2 decreased significantly, whereas it did not change in
      fixed direction with nitroglycerin infusion and increased with prostaglandin E1
      infusion. The magnification of both alveolar-arterial oxygen tension difference
      and arterial-end-tidal carbon dioxide tension difference during trimetaphan
      administration was equal to that during prostaglandin E1 administration and
      smaller than that during nitroglycerin administration. Therefore, it seems that
      trimetaphan as well as nitroglycerin decreases cardiac output but prostaglandin
      E1 increases or maintains it in patients under sevoflurane/nitrous oxide
      anesthesia, that trimetaphan reduces vascular resistance most weakly of the three
      (trimetaphan < nitroglycerin < prostaglandin E1), and that trimetaphan as well as
      prostaglandin E1 does not influence pulmonary blood distribution as strongly as
      nitroglycerin.

PMID- 7776514
TI  - [Estimation of respiratory functions by analysis of expired gas and blood gas
      during artificial ventilation and general anesthesia].
AB  - One-hundred and seven patients undergoing elective surgery were studied to
      analyze the correlations between preoperative spirometric values and respiratory
      parameters during general anesthesia. They were grouped according to 3
      criterions; preoperative %VC of less than 80%, FEV1.0% of less than 70%, V50/V25
      exceeding 4.0. Following the induction of general anesthesia and of mechanical
      ventilation, expiratory flow (VE), FECO2, PaCO2 and PaO2 were measured to
      calculate respiratory parameters including VCO2-SR, VD/VT-Bohr, VD/VT
      physiological (phys), a-ETDCO2, Volume Pressure Index (VPI) and A-aDO2. Six
      respiratory parameters were compared between the groups, and correlations between
      preoperative spirometric values were studied. Those with lower %VC had higher
      values in VCO2-SR and in VPI, and those with lower FEV1.0% had higher values in
      VCO2-SR, in VD/VT-phys and in a-ETDCO2. Significant correlations were also
      observed between these parameters. Preoperative V50/V25 and A-aDO2 during general
      anesthesia did not correlate with any of the parameters studied. We conclude that
      VCO2-SR, VD/VT-phys, a-ETDCO2 and VPI during general anesthesia are useful to
      detect the patients with restrictive and/or obstructive lung dysfunction,
      although they are not sensitive enough to detect those with small airway disease.

PMID- 7776516
TI  - [The comparison of hypnotic potency of nitrous oxide with that of sevoflurane:
      evaluation by the middle latency auditory evoked response].
AB  - In 10 consented patients (ASA I-II) we quantitated the hypnotic potencies of 0.7
      MAC nitrous oxide and 0.7 MAC sevoflurane by measuring auditory evoked response
      (AER), and compared the hypnotic potency of nitrous oxide with that of
      sevoflurane at the same MAC. In each patient, measurements of AER waves were
      performed in the following three stages, 0.7 MAC nitrous oxide, 0.7 MAC
      sevoflurane and 0.7 MAC nitrous oxide after induction of anesthesia. Analysis of
      variance was used to compare the hypnotic potencies between two inhaled
      anesthetics. Pa and Nb latencies with sevoflurane were longer than those with
      nitrous oxide, and Pa and Nb amplitudes with sevoflurane were greater than those
      with nitrous oxide. However, we found that there were no statistical
      significances in our results. In conclusion, nitrous oxide exerts as much
      hypnotic effect as sevoflurane.

PMID- 7776517
TI  - [The evaluation of cuff-occluded rate of rise of peripheral venous pressure
      (CORRP) for monitoring blood volume status].
AB  - Cuff-occluded rate of rise of peripheral venous pressure (CORRP) was evaluated
      for perioperative monitoring. We investigated the CORRP in 6 patients undergoing
      open laparotomy. These patients were given general anesthesia, and monitoring
      lines were inserted. Heart rate, blood pressure (BP), right atrial pressure
      (RAP), pulmonary capillary wedge pressure (PCWP), pulmonary artery pressure
      (PAP), cardiac output (CO) and CORRP were monitored. CORRP is defined as the
      average rate (in millimeters of mercury per minute) of rise of peripheral venous
      pressure after proximal occlusion of that vein by a tourniquet (select pressure:
      50 mmHg). In the actual measurement of CORRP, only the first 90% of the curve
      after occlusion of the tourniquet is used. CORRP correlated with RAP (r = 0.69 +/
      0.10), and PCWP (r = 0.79 +/- 0.07). On the other hand, there was no significant
      correlation between CORRP and BP, or PAP and CO. Snyder et al. described that
      CORRP seems to be an excellent indicator of acute volume change in the hyper- and
      hypovolemic canine model. We conclude that in these laparotomy patients, CORRP
      appears to be a sensitive and minimally invasive method of assessing volume
      status.

PMID- 7776518
TI  - [Endocrine effects of nicardipine on intraoperative hypertension under droperidol
      fentanyl-ketamine (DFK) anesthesia].
AB  - Effects of nicardipine on endocrine functions were evaluated in 10 surgical
      patients who received surgeries under total intravenous anesthesia with
      droperidol, fentanyl and ketamine (DFK). Plasma levels of norepinephrine (NE),
      epinephrine (E), plasma renin activity (PRA), aldosterone and atrial natriuretic
      peptide (hANP) were measured following nicardipine injection during 30 minutes of
      intraoperative hypertension. When the systemic blood pressure exceeded 160 mmHg
      systolic and 95 mmHg diastolic for five minutes, 0.5 mg approximately 10 mg of
      nicardipine was administered for 30 minutes to maintain the systolic blood
      pressure below 160 mmHg. Following the injection of nicardipine a significant
      reduction by 20% in the mean systolic and diastolic pressure was observed. Mean
      heart rate increased by 5%, but the increase was not significant. Plasma NE
      increased significantly 1.7 time from the control level at 15 minute following
      the injection. Plasma levels of E, PRA, aldosterone and hANP showed no
      significant changes.

PMID- 7776519
TI  - [The intrapulmonary metabolism of prostaglandin E1 in patients with pulmonary
      hypertension].
AB  - We investigated the intrapulmonary metabolism of prostaglandin E1 (PGE1),
      hemodynamics, oxygenation indexes (OI) and intrapulmonary shunt ratios (QS/QT) in
      patients with pulmonary hypertension (PH group, n = 7) and those with normal
      pulmonary artery pressure (N group, n = 5). PGE1 at a concentration of 20
      approximately 60 ng.kg-1.min-1 was continuously administered intravenously to the
      patients in both groups for treatment. The intrapulmonary metabolism of PGE1 was
      calculated as 100 x (1--the concentration ratio of PGE1 in radial/pulmonary
      artery) %. The concentrations of PGE1 were measured by radioimmunoassay (DCC
      method) with the specific anti-PGE1 antibodies supplied by Ono Pharmaceutical Co.
      Hemodynamics were measured using a Swan-Ganz catheter, and OI and QS/QT were
      calculated from blood gas analyses. In the PH group, the intrapulmonary
      metabolisms of PGE1 decreased significantly compared with the N group. In
      addition, mPAP/mSAP in the PH group increased significantly compared with the N
      group regardless of PGE1 administration. There were no significant differences in
      OI and QS/QT between the two groups in spite of PGE1 administration. We concluded
      that the intrapulmonary metabolisms of PGE1 in patients with pulmonary
      hypertension were significantly decreased compared to the patients with normal
      pulmonary artery pressure. For this reason, it is important to monitor
      hypotension more carefully whenever we administer PGE1 to patients for the
      treatment of pulmonary hypertension.

PMID- 7776520
TI  - [Effect of halothane on the energy metabolism of isolated perfused rat kidney as
      analysed by 31P-NMR].
AB  - The effects of halothane on energy metabolism of isolated perfused rat kidney
      were studied by 31P-NMR spectroscopy. Rat kidney was perfused by physiological
      medium containing halothane. Perfusion was carried out continuously in addition
      to ischemic period of 30 or 10 minutes. In continuous perfusion study, halothane
      concentration below 4% did not affect renal ATP level but halothane above 6%
      decreased ATP level significantly. In ischemic study, changes of renal energy
      metabolism were not influenced by halothane below 4% throughout the experiment,
      but halothane above 6% decreased ATP levels significantly after reperfusion. From
      the viewpoint of energy metabolism, it can be said that a low concentration of
      halothane does not damage renal cells but a high concentration of halothane has
      possibility to damage them. During and after ischemic insult, halothane does not
      diminish renal damage, but on the contrary a high concentration of halothane
      reversely worsens it.

PMID- 7776521
TI  - [Pediatric anesthesia and stress response].
AB  - The hyperglycemic and adrenocortical responses to upper and lower abdominal
      surgery were studied in four groups of children. In F group, lower abdominal
      surgery was performed under light general anesthesia (halothane 0.3-0.5% plus
      nitrous oxide and oxygen) combined with intravenous injections of fentanyl 10-13
      micrograms.kg-1. In L-E group, lower abdominal surgery was performed under light
      general anesthesia combined with lumbar epidural anesthesia (intermittent
      injections of 1.0% lidocaine). In T-E group, upper abdominal surgery was
      performed under light general anesthesia combined with thoracic epidural
      anesthesia (intermittent injections of 1.0% lidocaine). In H group, lower
      abdominal surgery was performed under general anesthesia (halothane 1.0-1.5% plus
      nitrous oxide and oxygen). The hyperglycemic and adrenocortical responses were
      inhibited in F group, suggesting that intravenous injections of fentanyl 10-13
      micrograms.kg-1 prevented the endocrine-metabolic response. On the other hand, in
      other three groups, those responses were not inhibited. Therefore we must
      consider the concentration and the volume of lidocaine in epidural groups. But
      general anesthesia combined with epidural anesthesia had a excellent effect on
      the postoperative pain management.

PMID- 7776522
TI  - [Anesthesia for a patient with Creutzfeldt-Jakob disease].
AB  - We reported anesthetic as well as perioperative management for a patient with
      Creutzfeldt-Jakob disease, a very rare transmissible neuropathy. A 51 year-old
      woman was scheduled for extirpation of recurrence of acoustic neurinoma. Three
      months before the operation, she had complained vertigo. After admission to our
      hospital, she had become progressively dementiated and developed disturbed
      consciousness. Anesthesia was induced with thiamylal and maintained with 0.7-1.5%
      isoflurane, nitrous oxide and oxygen. The anesthetic course was uneventful and
      the recovery from anesthesia was smooth. Postoperatively dementia progressed and
      myoclonus of extremeties appeared sixth weeks after the operation. Two months
      after the operation, a diagnosis of Creutzfeldt-Jakob disease was established by
      characteristic EEG and clinical course. Anesthesia for a patient with dementia
      was discussed.

PMID- 7776524
TI  - [Spinal anesthesia for an emergency surgery in a patient with right sided heart
      failure].
AB  - A 79-year-old female with a pace maker implanted because of complete A-V block
      associated with right sided heart failure was scheduled for the emergency repair
      of incarcerated abdominal wall hernia. Spinal anesthesia for the surgery and
      epidural catheterization for postoperative pain control were performed.
      Anesthesia and postoperative course were uneventful. The effects of spinal
      anesthesia on cardiovascular system are the result of preganglionic sympathetic
      block produced by the local anesthetic agent injected in the subarachnoid space.
      It is, therefore, desirable to consider the cardiovascular effects of spinal
      anesthesia (reduction of afterload and preload) on a patient who has right sided
      heart failure. Post operative pain control by PCA pump is also a basic method for
      a patient with right sided heart failure.

PMID- 7776523
TI  - [Spinal anesthesia for oophorectomy in a patient with pulmonary
      lymphangiomyomatosis accompanied by hypochondriasis].
AB  - A 41-year-old woman with pulmonary lymphangiomyomatosis had been scheduled for
      bilateral oophorectomy which led to amelioration of the pulmonary pathology. The
      discrepancy between her dyspnea on exertion and lung function tests suggested
      that she had a marked tendency toward hypochondria. Therefore, we chose spinal
      anesthesia because of its technical simplicity, rapid onset, and effectiveness of
      some sedatives used perioperatively. Surgery was performed uneventfully. The
      anesthetic method mentioned above did not worsen respiratory function
      perioperatively. Spinal anesthesia is thought to be appropriate anesthesia for
      patients with pulmonary lymphangiomyomatosis, if feasible.

PMID- 7776525
TI  - [The support of postoperative renal function by ulinastatin in patients with
      preoperative renal dysfunction].
AB  - The principal perioperative management of patients with renal dysfunction is to
      prevent postoperative acute renal failure. Therefore, it is crucial to do all
      possible therapies by which its occurrence is prevented. We experienced three
      cases in which ulinastatin may have been beneficial to maintain postoperative
      renal function. The patients had preoperative renal dysfunction with serum Cr
      between 1.5 and 2.0 mg.dl-1. During the operation and for the three postoperative
      days, 300,000 units.day-1 of ulinastatin were administered intravenously. After
      the operation, serum Cr level was not elevated. Urine output and creatinine
      clearance increased. These three clinical cases suggest that ulinastatin may
      prevent the deterioration of postoperative renal function in patient with
      preoperative renal dysfunction.

PMID- 7776526
TI  - [Anesthetic management using percutaneous cardiopulmonary support for cesarean
      section in a patient with severe pulmonary hypertension].
AB  - A 27-year-old female with severe pulmonary hypertension was scheduled to undergo
      an elective cesarean section at the 32-week gestational age. Since the
      preoperative assessment revealed that the patient could not tolerate the
      hemodynamic changes during the operation under general anesthesia without any
      cardiopulmonary support, the percutaneous cardiopulmonary support (PCPS) with a
      centrifugal pump was applied for the anesthetic management of the patient during
      the operation. After the induction of anesthesia, percutaneous cannulation was
      performed via the femoral artery and vein, and the PCPS was started with an
      assisted flow ranged 1.5-2.0 l.min-1. Then, the operation was performed, during
      which the cardiopulmonary function of the patient was well maintained with the
      aid of the PCPS. The operation was finished uneventfully, and the patient could
      successfully emerge from the PCPS immediately after the operation. The PCPS is
      thought to be very useful for the anesthetic management of the patients with poor
      cardiopulmonary tolerance.

PMID- 7776527
TI  - [Lack of effect of i.v. lidocaine on cardiovascular responses to laryngoscopy and
      intubation].
AB  - A randomized open study was carried out on 36, ASA I-II adult surgical patients
      to assess the effect of intravenous lidocaine and fentanyl on circulatory
      responses to laryngoscopy and intubation. The three treatment groups include:
      group L, intravenous lidocaine 1.5 mg.kg-1 2 minutes before laryngoscopy, group
      F, intravenous fentanyl 4 micrograms.kg-1, and group C, no treatment. Induction,
      preceded by preoxygenation was performed by intravenous vecuronium for
      precurarisation, followed by thiopental 4-5 micrograms.kg-1 and succinylcholine
      1.5 mg.kg-1. Before induction of anesthesia, there were no significant
      differences among the three groups in mean arterial pressure (MAP), heart rate
      (HR) and rate pressure product (RPP). After laryngoscopy and intubation, the
      three hemodynamic variables increased significantly from control values in group
      L and group C. The maximum values attained after intubation did not differ
      significantly between the two groups for any of the variables. In group F, these
      hemodynamic variables showed no significant changes after laryngoscopy and
      intubation and were significantly less than those in group F and group C.
      Intubating conditions were better in the fentanyl group than in the lidocaine
      group.

PMID- 7776528
TI  - [Use of ketamine combined with local anesthetics in epidural anesthesia].
AB  - Postoperative pain relief and sedation with epidural ketamine were studied.
      Twenty-four patients for elective upper abdominal surgery were divided into 4
      groups. Epidural catheter was inserted into thoracic epidural space before
      induction of general anesthesia. In each group, either 0.25% bupivacaine 5 ml
      only, ketamine 0.1 mg.kg-1 + bupivacaine 5 ml, or ketamine 0.3 mg.kg-1 +
      bupivacaine 5 ml, or ketamine 0.5 mg.kg-1 + bupivacaine 5 ml was injected into
      epidural catheter for complaint of pain in recovery room. In ketamine injected
      groups, blood pressure and heart were unchanged, but respiration rate increased
      significantly. Patients in ketamine 0.3 or 0.5 mg.kg-1 injected groups, pain
      relief and sedation score were significantly intensified, but patients in
      ketamine 0.5 mg.kg-1 injected group, incidence of pain in the back during
      injection and headache was high. We conclude that epidural ketamine is useful for
      postoperative pain relief, and the superior dose of epidural ketamine is 0.3
      mg.kg-1.

PMID- 7776530
TI  - [Clinical evaluation of prophylactic nitroglycerin infusion during coronary
      artery bypass grafting].
AB  - We evaluated retrospectively the benefit of prophylactic nitroglycerin (TNG)
      infusions during elective coronary artery bypass grafting (CABG) in 73 patients.
      In all patients anesthesia was maintained with high dose fentanyl. Thirty-seven
      patients were infused TNG 0.3 microgram.kg-1.min-1 during surgery and 36 patients
      were not. The TNG-infused patients demonstrated lower perfusion pressure during
      cardiopulmonary bypass (CPB) and higher incidence of inotropic administrations
      than the uninfused patients. Serum myocardial creatine phosphokinase (CPK-MB)
      levels of TNG-infused patients were higher than those of TNG-uninfused patients
      on the first postoperative day. We speculate that inotropic administrations under
      low myocardial perfusion pressure at the time of weaning from CPB induces
      myocardial ischemia which in turn causes an increase in serum CPK-MB level. We
      conclude that prophylactic administration of TNG does not prevent perioperative
      ischemia during CABG.

PMID- 7776531
TI  - [Experience of the great earthquake of Kobe Osaka area--role of
      anesthesiologists].

PMID- 7776529
TI  - [Perioperative management of dialysed patients for orthopedic surgery].
AB  - Recently, renal osteodystrophy is a remarkable problem in patients on long-term
      hemodialysis (HD). In this retrospective study, we evaluated the perioperative
      management of 21 patients receiving orthopedic surgery between January 1990 and
      December 1992. These patients had been maintained on HD for an average of 8.6
      years (range, 18 months-20 years). The primary causes of orthopedic surgery were
      amyloidosis, diabetic gangrene, rheumatoid arthritis and fractures. Laminectomy,
      replacement of arthropathy, osteosynthesis and amputation of the lower extremity
      were undertaken. General anesthesia was performed on six patients. Vecuronium was
      given to all of these patients. Isoflurane was used in 5 patients and sevoflurane
      in 1 patient. Regional anesthesia was used in 15 patients. During anesthesia, the
      average infusion rate of intravenous fluids was 2.7 ml.kg-1.h-1, and the
      intraoperative complications included hypertension in 16, hypotension in 12,
      arrhythmia in 4 and prolonged sedation in 2 patients. Postoperative complications
      included hyperkalemia in 2, pneumonia in 2, psychological disorder in 3, clotting
      fistula in 1 and delayed wound healing in 7 patients. One early death in a
      diabetic patient following amputation occurred on the 13th postoperative day.
      Preoperative HD was performed within 24 hours and postoperative HD within 72
      hours of the operation. Nafamostat mesilate was used as an anticoagulant.
      Excessive removal of potassium must be avoided during preoperative HD to prevent
      arrhythmia. The well-managed elective patients gave a good result. However,
      extreme care in nutrition and infection control should be taken, especially in
      diabetic patients.

PMID- 7776532
TI  - [An analysis of 41 elderly patients with urosepsis].
AB  - We performed a clinical evaluation in 41 patients with urosepsis at Tokyo
      Metropolitan Geriatric Hospital from July 1992 through March 1993. The most
      common organism isolated from the patients was Escherichia coli (46.3%), followed
      by Pseudomonas aeruginosa (9.8%), Methicillin-resistant staphylococcus aureus
      (7.3%), and mycetes (7.3%). The most frequent underlying disease was
      cerebrovascular disease (34.1%) and malignancies were observed 29.2% of all
      cases. Twenty-six patients (63.4%) had indwelling urethral catheters. Indwelling
      catheters were suspected to be related to the onset of urosepsis in 16 cases.
      Total mortality of urosepsis was 4.9% (2/41) in this study. We speculate that the
      main cause of urosepsis is a long-term use of urethral catheterization,
      especially in elderly patients with severe complications who are vulnerable to
      infections. It is important to assess and correct the conditions of dysuria of
      individual patients before placing indwelling urethral catheters.

PMID- 7776533
TI  - [Factors influencing users' destination upon discharge from a geriatric
      intermediate care facility in an urban area].
AB  - Geriatric Intermediate Care Facilities (GICF) have been established to help the
      hospitalized elderly return home. Users of the GICF are elderly persons who do
      not need hospitalization, but are mentally or physically impaired. To determine
      what factors influence users' destinations upon discharge from GICF, we analyzed
      various characteristics such as age, sex, place of residence before admission,
      length of stay, intellectual impairment, ability to perform activities of daily
      living (ADL) among users (N = 389) in a GICF in Chiba City. Multiple logistic
      regression analyses revealed that, compared with the users who were hospitalized,
      users who were male, admitted for home, stayed for long periods, and had a high
      ability to perform ADL were more likely to return home. The analyses also
      revealed that, compared with the users who were institutionalized, users who came
      from home, stayed for short periods, and had a high ability to perform ADL were
      more likely to return home. Evaluating a user's physical, mental, and
      socioeconomical conditions at an early stage of admission to a GICF may allow us
      to predict whether the user can be successfully discharged to his or her home or
      will have to remain at the GICF for an extended period.

PMID- 7776534
TI  - [Familial Alzheimer's disease in Japanese population].
AB  - We ascertained 56 related cases with early onset familial Alzheimer's disease
      (EOFAD; mean age of onset < 65 years) and 10 related cases with late onset
      familial Alzheimer's disease (LOFAD; mean age of onset > or = 65 years) through a
      questionnaire administered to neuro-psychiatric and medical school hospitals in
      Japan and through a review of cases in Japanese literature. Mean age of onset and
      death (+/- S.D.) of EOFAD were 43.4 +/- 8.6 years (n = 94) and 51.1 +/- 10.5
      years (n = 85), respectively. Distributions of the age-onset were relatively
      constant within a family but significantly different between families. Our result
      may suggest that clinical differences between families represent genetic
      heterogeneity at the molecular level. Six out of 32 related cases of with EOFAD
      showed the 717 Val-->Ile mutation of beta/A4 amyloid precursor protein (APP)
      gene. This result suggests that the frequency of this mutation in Japanese
      population is higher than in Caucasian and allelic the existenced heterogeneity,
      in Japanese EOFAD.

PMID- 7776535
TI  - [An 80-year-old female with pneumopericardium due to gastric perforation].
AB  - An 80-year-old woman was admitted to our hospital because of chest oppression and
      general malaise. On admission, auscultation of the heart revealed friction rub,
      so-called water-wheel like murmur. Chest X-ray film and computed tomography
      showed cardiomegaly and free air in the pericardium. Electrocardiogram showed low
      voltage with ST elevation in II, III, aVF and V1-V4. These findings suggested
      that the patient had pneumopericardium with pericarditis. Wenchebach type A-V
      block and atrial bradycardia appeared. Thus, the ventricular pacing was
      performed. However, patient died of multiple organ failure. The
      postmortempericardiography showed the gastro-pericardial fistula with hiatus
      hernia.

PMID- 7776536
TI  - [A case of angiosarcoma with renal failure caused by recombinant interleukin-2
      (rIL-2) and non-steroid anti-inflammatory drug (NSAID)].
AB  - A 77-year-old man was diagnosed to have diabetes. He was hospitalized for
      appetite loss, weight loss (6 kg/3 months) and right femoral pain. An abnormal
      shadow was noted on chest X-P. On admission, he was alert and there were no
      abnormal physical findings except limitation in the range of motion in the right
      lower extremity. His femoral pain was treated by a non-steroid anti-inflammatory
      drug (NSAID). Right femoral bone biopsy revealed angiosarcoma and staining for
      factor VIII, with negative staining for epithelial membrane antigen on enzyme
      assay. Therefore, he received systemic administration of recombinant interleukin
      2 (rIL-2). rIL-2 was administered intravenously twice daily at a dose of 40 x
      10(4) JRU. The total dosage of rIL-2 amounted to 1200 x 10(4) JRU, but renal
      failure deteriorated and he died on the 50th hospital day of his second
      admission. Combination of rIL-2 and NSAID may cause progression of nephropathy.

PMID- 7776537
TI  - [Apolipoprotein E allele of demented and non-demented centenarians: complete
      survey of centenarians in Yamanashi Prefecture].

PMID- 7776538
TI  - [Home oxygen therapy in elderly patients].

PMID- 7776539
TI  - [Management of methicillin resistant Staphylococcus aureus in the elderly].

PMID- 7776540
TI  - [The reliability and validity of a new self-completed questionnaire (QUIK)].
AB  - In order to evaluate the reliability and validity of a self-completed
      questionnaire (QUIK), devised to measured QOL, we examined the QUIK scores of
      elderly who visited the Kumamoto Health Administrative Center for a medical check
      up in March 1994. The QUIK questionnaire, which is a close-ended and disease non
      specific questionnaire, covered four domains such as physical functioning,
      emotional adjustment, interpersonal relationships, and attitudes toward life,
      interacting reciprocally. The mean and standard deviation on QUIK were much
      better in terms of total score (5.1 +/- 5.4), for each domain score in comparison
      with the patient group, and even in comparison with the non-patient group. The
      distribution of total scores on QUIK were as follows: excellent 15%, good 35%,
      fair 36%, poor 11%, very poor 2% and grossly impaired 0% according to a six
      tiered rating scale. The internal consistency in terms of total score was alpha =
      0.86. Very close correlation were seen among score, each domain score and
      satisfaction, being healthy and present state of feeling. If the cut-off points
      of total score were set between 9 and 10, the sensitivity were 0.65, specificity
      was 0.65 for the age index, sensitivity 1.00, validity 0.29 for the satisfaction
      index, while, sensitivity was 0.85 and validity 0.48, for the feeling index.
      There was a very close reciprocal correlation among the four domains, except for
      the relation between physical functioning and interpersonal relationship using
      multiple regression analysis. Further, significant correlations were obtained
      between the score in each domain and the score based on subtracting each domain
      score from the total score.

PMID- 7776541
TI  - [Value of 123I-BMIPP scintigraphy in patients with ischemic heart disease:
      comparison with exercise 201Tl SPECT].
AB  - To evaluate 123I labeled beta-methyl-branched fatty acid (BMIPP) myocardial
      uptake at rest in the segment with and without stress induced ischemia in
      patients with coronary artery disease, 123I-beta-methyl-branched fatty acid
      myocardial scintigraphy was performed at rest and was compared with the findings
      of stress-reinjection 201Tl myocardial scintigraphy in 31 patients with coronary
      artery disease. In 159 ischemic myocardial segments, equally decreased uptake on
      both reinjection 201Tl and fatty acid images was observed in 64 segments, more
      severely decreased uptake of fatty acid in 76 segments, and more severely
      decreased uptake of reinjection thallium in 19 segments. On the other hand, in 53
      non-reversible defects, each patterns was observed in 41, 3, and 9 segments
      respectively. When comparing the ischemic segments with more reduced uptake of
      fatty acid than reinjection thallium (Group 1) and the ischemic segments with
      equally or less reduced fatty acid uptake than reinjection thallium (Group 2),
      wall motion was more severely impaired in Group 1 than in Group 2 (severe hypo-
      to dyskinesis was present in 32 of 54 segments in group 1 and in 21 of 75
      segments in group 2, p < 0.005). In conclusion, in patients with coronary artery
      disease, resting fatty acid uptake was frequently more reduced than reinjection
      201Tl in the segments with stress induced ischemia and wall motion was more
      impaired in these segments. BMIPP myocardial imaging may provide information on
      metabolic alterations at rest independent of perfusion abnormalities in patients
      with coronary artery disease.

PMID- 7776542
TI  - [Assessment of 201Tl myocardial SPECT reinjected at 24 hours after stress
      imaging].
AB  - To improve the quality of 24 hours delayed images (24 DL) of stress thallium-201
      myocardial SPECT, reinjection was performed at 24 hours later (24 RI), and the
      results were compared with those of 24 DL. A total of 45 patients were studied,
      including 18 patients in 24 DL, 27 patients in 24 RI. All of them showed
      persistent defect or incomplete redistribution on the routine stress and 3 hours
      delayed SPECT scans. In 24 RI, 37 MBq of thallium-201 was reinjected at 24 hours
      later. Myocardial count of 24 DL was about 1/4 of stress image, while 24 RI was
      about 1/2. Quality of 24 RI image was nearly equal to 3 hours delayed image. Of
      regions without redistribution at 3 hours delayed image, 5 (36%) regions showed
      new redistribution at 24 RI. Of regions incomplete redistribution, 6 (25%)
      regions showed further redistribution. Compared with 24 DL, the frequency of
      redistribution tended to be higher in this protocol than that of the 24 DL (11%,
      17% respectively). In conclusion, the reinjection at 24 hours delayed imaging was
      considered to be useful to evaluate viability of myocardium in patient with CAD.

PMID- 7776543
TI  - [Identification of viable myocardium using 99mTc-tetrofosmin scintigraphy-
      comparison with 201Tl redistribution-reinjection images].
AB  - The purpose of this study was to clarify the diagnostic value of identifying
      viable myocardium using 99mTc-Tetrofosmin scintigraphy. Twenty-one patients with
      chronic coronary artery disease were studied using 201Tl exercise myocardial
      scintigraphy with reinjection and 99mTc-Tetrofosmin exercise myocardial
      scintigraphy. All patients had a history of old myocardial infarction. For 99mTc
      Tetrofosmin scintigraphy, 222 MBq of 99mTc-Tetrofosmin was injected during
      exercise, and exercise images were obtained 20 min thereafter. There hours later,
      666 MBq of 99mTc-Tetrofosmin was injected at rest, and images were obtained 40
      min and 220 min later. Myocardial viability in the 99mTc-Tetrofosmin scintigraphy
      was estimated as fill-in findings (FF) or over 50% of %RI uptake (%TF) in the
      rest image. Myocardial viability in the 201Tl scintigraphy was estimated as
      redistribution (RD), fill-in findings in the reinjection image (FR) or over 50%
      of %RI uptake in the reinjection image (% TL). Sixteen of the 21 patients (76%)
      who underwent 201Tl scintigraphy (RD 10, FR 3, %TL 3 cases) and 15 of the 21
      patients (71%) who underwent 99mTc-Tetrofosmin scintigraphy (FF 11, %TF 4 cases)
      had viable myocardium in the infarcted area. A comparison between the 99mTc
      Tetrofosmin rest images obtained 40 min after the injection and that of 220 min
      revealed no redistribution findings. The %RI uptake of the infarcted area in the
      resting 99mTc-Tetrofosmin image (47 +/- 16%) was slightly lower than that in the
      201Tl reinjection image (52 +/- 16%). In conclusion, viable myocardium was as
      clearly identified by 99mTc-Tetrofosmin, as by 201Tl scintigraphy.

PMID- 7776544
TI  - [The characteristic feature of myocardial imaging with 123I-labeled 15-(p
      iodophenyl)-3R,S-methylpentadecanoic acid in hypertrophic cardiomyopathy with
      asymmetric septal hypertrophy].
AB  - The aim of this study was to elucidate the characteristic feature of myocardial
      imaging with 123I-labeled 15-(p-iodophenyl)-3R,S-methylpentadecanoic acid (BMIPP)
      in the patients with hypertrophic cardiomyopathy (HCM). In 26 patients with
      asymmetric septal hypertrophy (ASH), the imaging data were acquired for 15
      minutes after the injection of 123I-BMIPP by the emission computed tomography
      (ECT). ECT image was divided into 17 segments to score the severity of the defect
      in each segment using a 5-point grading system from score 3 to score -1; score 3
      = severely decreased tracer uptake, score 2 = moderately decreased tracer uptake,
      score 1 = mildly decreased tracer uptake, score 0 = normal and score -1 =
      increased tracer uptake. Reduced uptake (Defect Score > or = 2) was frequently
      observed in septal portion of anterior wall (65%), septal portion of posterior
      wall (62%) and apical wall (73%). Defect score was higher in septal portion of
      anterior wall (p < 0.001), septal portion of posterior wall (p < 0.01) and apical
      wall (p < 0.01) than in the ventricular septum. This result indicates that in
      hearts with ASH, 123I-BMIPP image reveals severely impaired fatty acid metabolism
      in these regions. With the reference of the previous report about histologic
      features in necropsy hearts with HCM, myocardial fatty acid metabolic disorder
      shown by reduced 123I-BMIPP uptake is closely related to the histological
      abnormalities in hearts with HCM.

PMID- 7776546
TI  - [Restoration filtering based on projection power spectrum for single-photon
      emission computed tomography].
AB  - To improve the quality of single-photon emission computed tomographic (SPECT)
      images, a restoration filter has been developed. This filter was designed
      according to practical "least squares filter" theory. It is necessary to know the
      object power spectrum and the noise power spectrum. The power spectrum is
      estimated from the power spectrum of a projection, when the high-frequency power
      spectrum of a projection is adequately approximated as a polynomial exponential
      expression. A study of the restoration with the filter based on a projection
      power spectrum was conducted, and compared with that of the "Butterworth"
      filtering method (cut-off frequency of 0.15 cycles/pixel), and "Wiener" filtering
      (signal-to-noise power spectrum ratio was a constant). Normalized mean-squared
      errors (NMSE) of the phantom, two line sources located in a 99mTc filled
      cylinder, were used. NMSE of the "Butterworth" filter, "Wiener" filter, and
      filtering based on a power spectrum were 0.77, 0.83, and 0.76 respectively.
      Clinically, brain SPECT images utilizing this new restoration filter improved the
      contrast. Thus, this filter may be useful in diagnosis of SPECT images.

PMID- 7776545
TI  - [The role of gallium-67 citrate scintigraphy in Crohn's disease].
AB  - We investigated the usefulness of gallium scintigraphy and its importance in the
      choice of a treatment method for Crohn's disease. The subjects for the study were
      30 patients diagnosed as Crohn's disease. After intravenous injections of 67Ga
      citrate 111 MBq, planar and SPECT images were taken at 48 and 72 hrs. The overall
      positive rate was 42.1%, and among the positive cases, 78.6% required surgical
      treatment. On the other hand, surgical treatment was only performed in 18.8% of
      the negative cases, which was significantly low percentage. However, since 75% of
      the cases, in whom surgical treatment was performed, showed preoperative positive
      67Ga results, positive cases detected by 67Ga scintigraphy were considered to be
      high-risk cases requiring surgical treatment.

PMID- 7776548
TI  - [Serial assessment of MIBG scintigraphy in a case of DCM with heart failure
      improved by beta-blocker therapy].
AB  - We experienced a case of DCM (62-year-old man) improved by beta-blocker
      (Metoprolol) therapy and studied time course of MIBG scintigraphy. We measured
      cardiac functions by UCG and 99mTc cardiac pool imaging, and MIBG scintigraphy
      during 12 months of beta-blocker therapy. In planar images we measured washout
      rate (WR) in total myocardium and regional washout rate (rWR) in 6 segments of
      myocardium. Cardiac function improved after 3 months of therapy. The WR did not
      improve until 6 months, but improved after 9 months (Before: 35.1%, 3 months
      after: 34.6%, 6 months after: 33.6%, 9 months after: 27.6%, 12 months after:
      25.4%). rWR in inferoapical segment first improved at 3 months (Before: 40.1%, 3
      months after: 35.1%), whereas rWR in antero-apical segment improved after 6
      months and that in anterior segment improved after 9 months. These results
      suggest that the improvement of cardiac sympathetic nerve function in DCM treated
      with beta-blocker was not identical in each myocardium region.

PMID- 7776547
TI  - [A study of rCBF measurement with autoradiography (ARG) method using N-isopropyl
      p-[123I]iodoamphetamine (IMP) and SPECT--comparison of rCBF values between look
      up table (TLU) and ARG methods, and evaluation of venous blood samplings as a
      substitute for arterial blood sampling].
AB  - Regional cerebral blood flow (rCBF) values obtained by the TLU method with two
      123I-IMP SPECT scans and one point arterial blood sampling and rCBF obtained by
      the ARG method with one 123I-IMP SPECT scan and fixed distribution volume (Vd)
      values were compared in 17 cases. A case with post ischemic hyperperfusion or
      luxury perfusion was not observed in our cases. The correlation coefficients
      between rCBF values and Vd values obtained by the TLU method were 0.49 (p <
      0.001) in 184 ROI without hypoactive areas on the early image, and 0.61 (p <
      0.001) in 207 ROI with hypoactive areas, respectively. A high rCBF value with a
      low Vd value was not observed in any region. Mean Vd value was 44.0 +/- 7.0 (mean
      +/- SD) in all regions. The correlation coefficients between rCBF values using
      the TLU method and those using the ARG method with Vd fixed at 44 and 50 were
      also 0.98. Error of the rCBF value was larger in the region of high rCBF,
      however, noticeable error of the rCBF value was not observed in the ARG method.
      The ARG method is more convenient for quantifying rCBF. Venous blood
      radioactivity at 10 min after 123I-IMP infusion was smaller than arterial blood
      radioactivity, and the blood activity in the distal vein was larger than that in
      the proximal vein. The ratio of venous blood activity to arterial blood activity
      was 0.92 +/- 0.04 (mean +/- SD) at the back of the hand, however, the ratio was a
      variant in each case. Arterial sampling was thought to be a reliable method to
      obtain more stable and precise rCBF.

PMID- 7776549
TI  - [Changes of liver function measured by 99mTc-GSA scintigraphy after hepatectomy].
AB  - In 14 patients with hepatic tumors, liver volume and liver function indices were
      studied by 99mTc-GSA liver scintigraphy before and after hepatectomy. The liver
      volume measured by 99mTc-GSA SPECT was significantly decreased after surgery in
      all 14 patients (p < 0.001). Postsurgically, 7 patients showed an increase of
      greater than 10% in the LU15 value, while 3 showed a decrease of 10% in the LU15
      value, while 3 showed a decrease of 10%. Two patients showed a decrease of
      greater than 10% in the HH15 value after surgery. The changes in LU15 after
      surgery were inversely correlated with those in HH15. The present findings
      clarified that in several cases of surgically treated hepatic tumors, 99mTc-GSA
      indices of liver function generally thought to indicate the size of the
      functioning liver cell mass were distinctly improved after surgery in comparison
      with those before surgery, despite the postoperative decrease in the liver
      volume. Furthermore, the results of a 99mTc-GSA SPECT study separately measuring
      the volume of the unilateral hepatic lobe and its radioactivity uptake, indicated
      that regeneration of the functioning liver cells often occurred in the entire
      liver. 99mTc-GSA scintigraphy appears to be a valuable method for evaluating
      changes in both the liver volume and the liver function indices after
      hepatectomy.

PMID- 7776550
TI  - [Quantitative analysis of individual renal function using 99mTc-DMSA scintigram-
      comparison with 131I-OIH renogram].
AB  - 99mTc-2,3-di-mercapto-succinic acid (DMSA) is able to be used for the
      quantitative analysis of individual renal function by calculating the uptake
      ratio. The purpose of this study is to assess the clinical feasibility of DMSA
      uptake ratio as compared with 131I-ortho-iodo-hippuran (OIH) renogram pattern.
      Two hundred eleven cases (191 patients, 1 to 87 years old) with renal disorders
      and 4 normal volunteers (27.8 +/- 2.4 years old) were studied. Just prior to the
      DMSA study in the same day, OIH renogram was carried out. They were divided into
      6 types by OIH renogram patterns. In 24 cases of normal renogram pattern and
      normal blood data who were defined as the normal group and 4 normal volunteers,
      DMSA uptake ratio showed negative correlation with increasing age (r = 0.61, p <
      0.05). Patients of the severe impaired functioning and the non functioning
      patterns showed significantly decreased DMSA uptake ratios as compared with the
      normal pattern. There was also a significant difference in DMSA uptake between
      impaired functioning patterns. Compensative hemi-hypertrophy kidneys showed
      significantly higher DMSA uptake ratios than those of atrophic kidneys. The
      possibility of the quantitative analysis of the functional compensation was
      presumed. In conclusion, quantitative analysis of individual renal function using
      DMSA uptake ratio is considered to be useful to evaluate the renal functional
      reserve.

PMID- 7776551
TI  - [Renovascular hypertension and captopril-enhanced renal scintigraphy].
AB  - Renovascular hypertension (RVH) is a secondary hypertension that is caused by the
      renal artery stenosis and is curable by surgical treatment. Sensitivity and
      specificity of CRS for RVH have been reported to be in exceed of 90%. Captopril
      enhanced renal scintigraphy (CRS) has become an important tool in the diagnosis
      of RVH. In addition, the recent reports indicate that CRS is a promising means of
      prognostic evaluation in re-vascularization of RVH. In this report,
      pathophysiological considerations, methods, diagnostic criteria, diagnostic
      efficacy and consideration for clinical application are reviewed.

PMID- 7776552
TI  - [Evaluation and management of children with neurogenic bladder].

PMID- 7776553
TI  - [Usefulness of fine needle aspiration cytology in the diagnosis of prostate
      cancer].
AB  - The efficacy of aspiration cytology, using Franzen method and echo-guided
      aspiration for prostate cancer was examined to 102 patients under saddle-block
      anesthesia in urological clinic of Chiba University Hospital. Between 1990 and
      1993, 77 cases out of 102 patients were diagnosed histologically as prostate
      cancer by needle biopsy and 90% of them were coincidental with findings of
      aspiration cytology. Looking at histological grades, well differenciated cancer
      was shown to yield low positivity compared with moderately and poorly
      differentiated cancer. Positive rate showed similar when grade of specimens from
      needle biopsy was classified with Gleason pattern. Neither T category nor method
      of aspiration between Franzen and echo-guided methods influenced positive rate of
      aspiration cytology. On aspiration cytology, its grading revealed 60% of
      coincidence with that obtained by histological method. When counting more than
      300 scattered cells, 90% of coincidence was achieved with histological grading.
      It is concluded that aspiration cytology is efficient for diagnosis of prostate
      cancer.

PMID- 7776554
TI  - [Evaluation of renal graft function with radionuclide dynamic images--with
      special reference to the application of the modified Rutland's analytical
      method].
AB  - In calculation of an uptake coefficient (UC), proportional to the glomerular
      filtration rate for renal dynamic images with 99mTc diethyl triamine pentaacetate
      (DTPA), by the graphic method proposed by Rutland. We developed a new method of
      estimating input and output functions, by applying a factor analysis method to
      the renal dynamic images. The purposes of this paper are to describe the results
      obtained through phantom experiments and its clinical application. In the phantom
      experiments, a hemofilter was used as a method for real kidney and the filtration
      rate was changed to estimate the reproducibility of UCs. the UCs were estimated
      by trying different input functions; abdominal aorta curve, renal artery curve
      and intrarenal artery curve. The UCs estimated by using the intrarenal artery
      curve as an input function showed the best correlation with the pre-determined
      filtration rate. In clinical applications 8 normal subjects, 3 patients with
      acute renal failure, 11 donors and 22 recipients were studied. The USs obtained
      were compared with clinical data of renal function. A group of subjects having
      with both kidneys in the normal body space were classified as Cluster 1, another
      group of transplant recipients were classified as Cluster 2. In Cluster 1 the UCs
      showed a good correlation with Ccr (r = 0.909), and effective renal plasma flow
      (r = 0.798), and an inverse correlation between UCs and serum creatinine values
      (r = 0.747). The median value of UCs in 11 donors at pretransplantation were
      0.30, which increased to 0.46 at 3 weeks after transplantation. Cluster 2 has
      many risk factors (to be abnormal space, rejection, toxicity of Cyclosporin and
      immuno suppression) compared to Cluster 1, but in Cluster 2 the UCs showed a good
      correlation with Ccr (r = 0.955), and effective renal plasma flow (r = 0.653),
      and an inverse correlation between UCs and serum creatinine values (r = 0.857).
      Cluster 1 and Cluster 2 showed the same correlations with Ccr and UCs. But
      Cluster 1 is a different group from Cluster 2. The results of the study showed
      that the modified Rutland's analy analytical method can estimate the renal
      filtration rate accurately, evaluate the residual renal function in donors
      quantitatively and be a useful parameter for monitoring renal graft function.

PMID- 7776556
TI  - [Kinetic study of local relapse in prostatic cancer].
AB  - The change of both prostatic volume and bone metastasis was observed from the
      period of castration to death in 23 cases of prostatic cancer. As for the change
      of prostatic volume, they were classified into two groups. One group was called
      "local progressive type". In this group, prostatic volume reduced exponentially
      after the treatment of castration, then increased exponentially after a transient
      period. Another group was called "metastatic progressive type". In this group,
      prostatic volume did not change after the treatment of castration although the
      degree of bone metastasis advanced severely. The regression speed after
      castration (tau) was faster in local progressive type than in metastatic
      progressive type. This tau had a close relationship to the prognosis of each
      case. In local progressive type, doubling time (DT) during relapsed period was
      calculated in 13 cases. An inverse correlation was found between tau and DT. This
      correlation might be able to lead the conclusion that the ratio between residual
      androgen sensitive cancerous tissue and residual androgen insensitive cancerous
      tissue related to the local progression in relapsed prostatic cancer.

PMID- 7776555
TI  - [A pathological comparison of primary and metastatic lesions as a prognostic
      indicator for renal cell carcinoma].
AB  - The purpose of this study is clarify the changes in histological grade between
      primary and metastatic lesions in renal cell carcinoma. A tota of 100 cases of
      renal cell carcinoma and their metastases were compared respectively. In 31 (31%)
      of the cases observed, metastatic lesions were observed to have higher grade of
      malignancy when compared to primary lesions. In 59 (59%) of the cases, metastatic
      lesions had the same grade of malignancy and in 10 (10%) of the cases, metastatic
      lesions had a lower grade of malignancy when compared to primary lesions. The
      frequency of upgrading cases in young patients (i.e. less than 40 years old)
      occurred with less frequency when compared to elderly patients. Additionally, the
      frequency of upgrading cases involving female patients was lower when compared to
      male patients. The one year survival rates in patients, who received nephrectomy,
      having grade 1 to 4 lesions following metastases were 100%, 65%, 71%, and 27%
      respectively. From these percentages, a statistically significant difference
      exists in one year survival rates between patients with grade 2 and 4 metastatic
      lesions (p < 0.005), and grade 3 and 4 metastatic lesions (p < 0.01).
      Histological grade of metastatic lesions is an important prognostic indicator for
      determining the outcome of renal cell carcinoma following metastases. Thus it is
      important that the prognosis of renal cell carcinoma be based on the histological
      grade of metastatic lesions as well as primary lesions.

PMID- 7776557
TI  - [The efficacy of endopyeloureterotomy via a transpelvic extraureteral approach].
AB  - To evaluate the efficacy of endopyeloureterotomy via a transpelvic extraureteral
      approach for the treatment of ureteropelvic junction obstruction or upper
      ureteric stenosis, we analysed the results of 85 patients treated with this
      procedure between Aug. 1988 and June 1993. Eighty-five patients underwent 87
      procedures. Each patient has been followed-up more than 6 months postoperatively.
      Of 87 procedures, 71 were performed in patients with ureteropelvic junction
      obstruction and 16 were in patients with stenosis of the upper third ureter.
      Primary disease was 59 and secondary disease was 28. Twenty-one procedures were
      performed in patients with the stenotic segment over 2 cm. The operative
      procedure was performed by first incising with a 22 Fr. urethrotome (ACMI Co.);
      the dilated renal pelvic or ureteral wall posterolaterally as long as 1-1.5 cm
      junction from the stenotic segment toward ureteropelvic junction, then bringing
      the urethrotome out retroperitoneally through the incision and finally incising
      the stenotic segment with the cold knife under direct vision. A 12-16 Fr. PTCS
      tube (Sumitomo Behkuraito Co.) was left in place for 3 weeks as a stent. Mean
      operative time was 101 min and average length of incised segment was 3.7 cm.
      Complication included pneumothorax (1 case), pseudo ureter (1 case) and renal
      arterial anexryma (1 case). Followed-up period ranged from 6 to 64 months with
      the average being 26 months. Of 87 procedures, 80 (92%) achieved a disappearance
      or improvement of the obstructive change and 7 failed.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7776558
TI  - [Effect of caffeine and pentoxifylline on human sperm motility after one week
      storage at 3 degrees C].
AB  - The effect of caffeine (C) and pentoxifylline (P) on the sperm motility was
      examined after a 3 degrees C storage in a TEST yolk buffer for one week. Thus
      stored 24 semen samples from infertile patients were incubated with or without C
      or P at 37 degrees C. The motility was analysed for up to 240 minutes. The
      poststorage addition of C (1 mM) and P (1 mM) significantly increased the serum
      motility rate (p < 0.01). The stimulant effect of C and P was rather transient
      lasting no more than 2 hours. The prestorage addition of C and P in a preservant
      TEST yolk buffer was less effective than the poststorage administration.
      According to the time-related profiles of the sperm motility, 24 cases were
      divided into three groups. In group A (11 cases), the sperm motility rate
      increased from 30 to 90 minutes even without C or P. This group was responder of
      C and P. In group B (8 cases), the motility rate increased only in response to C
      and P and, in group C (5 cases), no such responses were observed. The prestorage
      semen qualities in terms of the sperm concentration, the motility rate, the
      velocity, the linearity, and the amplitude of the lateral head displacement were
      compared in these three groups. There was a significant difference between these
      3 groups (p < 0.05) on the parameters in terms of the sperm concentration,
      motility rate and velocity. It was suggested that these prestorage parameters
      predict the sperm activity in response to C and P after a one week 3 degrees C
      storage.

PMID- 7776559
TI  - [Carcinoma of the renal pelvis and ureter following bladder carcinoma].
AB  - We followed 135 primary bladder carcinoma patients for at least 3 years.
      Subsequent carcinomas of the upper urinary tract were found in 5 patients (3.7
      per cent) an average of 67 months after an initial treatment of the bladder
      tumors. Two patients underwent radical cystectomy and the remaining 3 patients
      received transurethral resections or partial cystectomy five to seven times for
      bladder lesions. Primary bladder tumor was multiple in all and one of them was
      accompanied by carcinoma in situ in the bladder and urethra. Except for one
      patient who presented with gross hematuria, four patients had no symptoms
      referable to the upper urinary tract tumor. However two of them had high stage
      disease. Positive urinary cytology was observed in only one patient. All patients
      underwent nephroureterectomy and the four got well but one died of acute heart
      failure. Regular urinary cytology and IVP should be done for an extended period
      of time for early detection of renal pelvic and ureter cancers in patients who
      had multiple and recurrent bladder cancers.

PMID- 7776560
TI  - [Evaluation of the efficacy of recombinant human erythropoietin (rHuEPO)
      administration on penile erection in males undergoing hemodialysis and effect on
      pituitary-gonadal function].
AB  - Recombinant human erythropoietin (rHuEPO) was administered to males undergoing
      hemodialysis, and its effects on penile erection and hypothalamus-pituitary
      gonadal hormone levels were studied. The subject consisted of 18 males undergoing
      hemodialysis ranging in age from 22 to 58 years (mean 45.3 years). Chronic
      glomerulonephritis was present in 16, and diabetic nephropathy in 2, as
      underlying disease. rHuEPO was administered intravenously at 1,500 U 3 times a
      week with a target to increase the Ht value to 25% or above. Penile erection was
      evaluated subjectively by a questionnaire based on a visual analogue scale and
      objectively by semi quantitative measurement of nocturnal penile tumescence (NPT)
      using an erectometer. Of the 18 patients, subjective improvements in penile
      erection were observed in 13 (72%), and objective improvements in NPT were
      observed in 10 (56%). The administration of rHuEPO may alleviate
      hyperprolactinemia but was found to have no effect on the FSH, LH, Zn, or HS-PTH
      level. rHuEPO was suggested to be fairly effective for the treatment of sexual
      disorders.

PMID- 7776561
TI  - [Pelvic lymph node involvement in primary bladder cancer. A clinicopathological
      study of radical cystectomies].
AB  - Between 1984 and 1992, 131 patients with bladder cancer underwent radical
      cystectomy and pelvic lymph node dissection with urinary diversion. There were
      110 male and 21 female patients, aged between 35 and 86 with a mean of 64 years.
      The follow-up period ranged from 1 month to 113 months, with a median of 34
      months. The five-year survival estimated by the Kaplan-Meier method was 66.9%
      over all 131 patients. The five-year survival rates were 83.3% for stage pTis
      patients, 66.7% for stage pTa, 97.0% for pT1, 70.7% for pT2, 47.9% for pT3a,
      26.2% for pT3b, and four-year survival was 25% for pT4 disease. Under the grading
      system, the five-year survival was 80.0% for cases of grade 2 disease and 63.6%
      for grade 3. There were two grade 1 patients who died of other diseases 15 and 16
      months after surgery. Of all 131 patients, 22 (16.8%) had lymph node involvement.
      The five-year survival was 34.5% for patients with positive lymph nodes in
      comparison with 73.8% for those without lymph node involvement. The frequency of
      lymph node involvement was 26.1% in the non TCC group and 14.8% in the TCC group
      including 23.7% of the grade 3 and 4.3% of the grade 2 cases. Pathologically, the
      patients with higher stages had a higher frequency of lymph node involvement, and
      there was a significant difference in the frequency between pT3a (14.3%) and pT3b
      (47.8%) disease. The five-year survival of patients with positive lymph nodes was
      40.0% for pN1, 32.1% for pN2 disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7776562
TI  - [The role of the vertebral veins in the dissemination of prostate carcinoma].
AB  - A total of 75 prostate cancer and 67 lung cancer patients with positive bone
      scintigrams were studied. The patterns of spread of tumors to various bones were
      different between the 2 groups. The differences in the distribution of bony
      metastases between the prostate and lung are explained by the role of Batson's
      vertebral venous plexus.

PMID- 7776563
TI  - [Evaluation of advanced bladder tumor].
AB  - Ninety-two cases of advanced bladder tumor treated at the University of Tokyo and
      branch hospital from January 1977 to December 1992 were analyzed. The advanced
      bladder tumor was defined as that of higher than pT2 (according to the General
      Rule for Clinical and Pathological Studies on Bladder Cancer) or that with
      distant metastases. The following variants were evaluated, the therapeutic
      methods, the histological type, grade, stage, type of infiltration. The evidence
      of lymphatic infiltration, vessel infiltration, and lymph node metastases were
      also reviewed. The survival rate was calculated using Kaplan-Meier's method. In
      the cases with lymph node metastases, the survival rate was significantly lower
      than in the cases without metastases (p < 0.01), while no other factors affected
      the survival rate.

PMID- 7776564
TI  - [A study on intratesticular aromatase activity in male infertility].
AB  - We report here the influence of intratesticular aromatase activity and
      intratesticular estrogen concentration on spermatogenesis. In the present study,
      we measured the levels of aromatase activity and the concentrations of
      intratesticular testosterone (T) and estradiol (E2) in 21 testicular tissues from
      biopsy of 20 idiopathic male infertility patients, 5 testicular tissues from
      castration of 4 prostatic cancer patients and a testicular tissue from an
      autopsy. Serum T, Free T, E2, LH and FSH were also measured if possible.
      Aromatase activity in the testis were assayed by measuring the amount of 3H2O
      formed during the conversion of [1 beta-3H] androstenedione to estrogen.
      Histological evaluation of the testes were performed using the Johnsen's score
      count (JSC) method. The rate of aromatase activity was linear in regard to time
      and amount of tissue. The production of 3H2O was inhibited by 4
      hydroxyandrostenedione. The apparent Km (Michaelis constant) of the reaction was
      23.2 nM. The rate of aromatase activity increased linearly as JSC level decreased
      (r = 0.67). Also, it significantly correlated with intratesticular T (r = 0.69),
      E2 (r = 0.88) and T/E2 ratio (r = -0.85), whereas it was not correlated with
      serum T, free T, E2, T/E2 ratio and free T/E2 ratio. Therefore, our results
      suggest the possibility that the increase in the rate of aromatase activity and
      the concentration of E2 may influence spermatogenesis.

PMID- 7776565
TI  - [Uretero-aortic fistula: a case report of a serious complication of indwelling
      ureteral catheter].
AB  - We present a case of a uretero-aortic fistula assumed to be caused by an
      indwelling ureteral catheter. A 65-year-old male who underwent cystectomy and
      ureterocutaneostomy with bilateral ureteral stents had been well until gross
      hematuria from the left catheter developed. In spite of a through radiological
      examination of the left kidney, no abnormal findings were noted. However, massive
      hemorrhage was encountered on catheter exchange, prompting us to suspect a
      formation of a uretero-arterial fistula. CT scan was performed again,
      demonstrating severe adhesion between the left ureter and the aorta at the
      crossing point. At exploration, a fistula of about 7 mm between the left ureter
      and anterior surface of the aorta was recognized. Left nephro-ureterectomy and
      closure of the aortic fistula with a rectus muscle fascia wrapping was
      successfully performed. His postoperative course was uneventful. Because the
      continued increase in the utilization of ureteral catheters could cause frequent
      occurrence of this condition, urologists should be aware of a uretero-arterial
      fistula as possible serious complication of indwelling ureteral catheters.

PMID- 7776566
TI  - [Extracorporeal shock wave lithotripsy for urinary calculi in an ileal reservoir
      following reconstruction of the urinary bladder].
AB  - A new method for reconstruction of the urinary bladder was introduced by Taguchi
      in 1977. It consisted of two components; making of pseudo-urethra and the
      reconstruction of urinary reservoir in the pelvis. The latter was made of the
      ileum and the peritoneum with temporary use of Japanese paper. This operative
      method was applied to a 28-year-old female patient when she had cystectomy and
      bilateral ureterostomy. Thereafter she had has no trouble for 13 years. However,
      her recent rentogenogram showed urinary tract calculi in the reservoir.
      Endoscopic treatment was not indicated because of the deformed reservoir and the
      inflexible pseudourethra. Thus, extracorporeal shock wave lithotripsy (ESWL) was
      applied to the case with successful results. We herrin reported the case and
      discussed the usefulness of ESWL for urinali calculi in the ileal reservoir.

PMID- 7776568
TI  - President's message: the best of times ... the worst of times.

PMID- 7776567
TI  - [Deoxycorticosterone-producing adrenocortical carcinoma--a case report].
AB  - A 39-year-old male presented with gross hematuria and left lower abdominal
      discomfort. Excretory urography showed a left ureteral stone and hydronephrosis.
      CT scans and magnetic resonance imaging showed a solid mass at the upper pole of
      the left kidney. Angiography revealed a hypervascular lesion at this area. The
      laboratory data showed a slightly decreased serum potassium level. In the
      endocrinological study, the serum deoxycorticosterone (DOC) level was markedly
      elevated. There was, however, no evidence of hypertension. The operation was
      performed on November 13, 1992. The tumor was almost separated from the left
      kidney, but an aberrant artery which divided from the renal artery and penetrated
      the renal parenchyma was found. Therefore, we had to carry out en bloc removal of
      the tumor together with the left kidney and the ureter which contained the
      ureteral stone. Pathological diagnosis was adrenocortical carcinoma. After the
      operation, hypokalemia and the serum concentration of DOC returned to normal
      range. Therefore, the tumor was diagnosed as DOC producing adrenocortical
      carcinoma. The patient was discharged 30 days after the operation with uneventful
      postoperative course. He received 2.5 g of op'-DDD a day. There was no evidence
      of distant metastasis or local recurrence 12 months after the operation. Nineteen
      cases of DOC producing adrenocortical tumor have been reported in the world
      literature. A case and a review of the literature are herein reported.

PMID- 7776569
TI  - Patterns of injury in pediatric patients in one Florida community and
      implications for prevention programs.
AB  - OBJECTIVES: To meet community needs, injury prevention programs for children
      should be based on an understanding of the patterns of different mechanisms of
      injury. This study was conducted by the staff of a level II pediatric trauma
      center to describe the patterns of injury in pediatric patients with traumatic
      injuries. METHODS: We conducted a retrospective review of medical records of all
      184 pediatric "trauma alert" patients seen during a 1-year period. The trauma
      alert status is assigned to children with serious injuries or when the mechanism
      of injury is severe. Data analysis used descriptive statistics. RESULTS:
      Pedestrian-versus-automobile injuries were the most common and most severe
      injuries, followed in frequency by falls, motor vehicle occupant, and bicycle
      versus-automobile injuries. Younger children tended to have injuries as a result
      of falls; school-age children were involved more often in pedestrian and bicycle
      injuries, and adolescents had more motor vehicle occupant injuries. Failure to
      use safety devices, such as helmets and seat belts, was a common finding.
      DISCUSSION: Patterns of injury were similar to those described in national
      studies. An extensive helmet campaign directed at child bicyclists was developed
      as a result of the priorities generated from the study. Other community programs
      included bicycle rodeos and a mix-off of nonalcoholic beverages.

PMID- 7776571
TI  - Planning and moving to a new emergency department: one hospital's experience.

PMID- 7776570
TI  - Emergency department patient liaison volunteers: a cost containment and visitor
      satisfaction strategy.
AB  - We have saved a minimum of $17,064 in personnel salaries of a patient
      representative (based on minimum wage and no paid benefits) during the past year.
      Although our liaison program was initially started as a cost-saving measure, the
      benefits of the program cannot be measured in monetary terms. Although this
      venture was our first attempt with a program of this nature, and we are still
      developing the program, we believe the development of the ED liaison volunteer
      program has been a major accomplishment for the emergency department and has also
      increased community support. Many of the liaisons were totally unaware of the
      activities in an emergency department. They now have a greater appreciation for
      the process of emergency care, and can relate that understanding to patients and
      families.

PMID- 7776572
TI  - Adverse effects of epinephrine when given to patients taking propranolol
      (inderal).

PMID- 7776573
TI  - Case studies in work redesign: cost considerations in a work redesign project.
AB  - Regardless of the limitations and comprehensiveness of plans for redesign, at
      least one common consideration prevails. Decisions to redesign should be well
      planned with specific attention to the details of the costs involved. As the
      unique needs of the institution are incorporated into the plan, a thorough cost
      benefit analysis should be used to determine final decisions. Without specific
      attention to a number of factors, including those noted above, the restructuring
      project may fall short of the intended goals of reducing costs and may actually
      increase costs.

PMID- 7776574
TI  - The road from Goma to Kigali: caring for refugees in Rwanda.

PMID- 7776575
TI  - Infectious disease screening and isolation for pediatric patients in an emergency
      department.

PMID- 7776576
TI  - A look at our new emergency department: Memorial Hospital, Colorado Springs,
      Colorado.

PMID- 7776577
TI  - "It's not a testing station!".

PMID- 7776578
TI  - Assault support team.

PMID- 7776579
TI  - The daughter that was nurse.

PMID- 7776580
TI  - Intravenous magnesium sulfate for acute asthma.

PMID- 7776581
TI  - The evolving change in paradigm from quality assurance to continuous quality
      improvement in prehospital care.

PMID- 7776582
TI  - Violence against nurses: is it a felony or not?

PMID- 7776583
TI  - A "liberation management" (shared-governance) model for a flight program.

PMID- 7776584
TI  - ED chest pain triage, TPA, and streptokinase checklists.

PMID- 7776585
TI  - Self-scheduling in the emergency department.
AB  - The primary steps to accomplish successful self-scheduling programs are as
      follows: 1. An appropriate amount of time must be committed for a trial period; a
      minimum of 6 months is recommended. In the initial phases of the program, it is
      important that the manager refrain from intervening in conflict resolution or
      allowing the staff members to abdicate decision making to management when
      problems arise. Changes in staff attitudes to assume responsibility for unit
      coverage emerge, in part, as a result of observing the consequences when it is
      not done. 2. At least 1 year, and often almost 2 years, are required to achieve
      smooth-flowing systems. 3. Time is needed for the staff members to become
      proficient in negotiation. The key to mutual cooperation is that everyone
      eventually experiences a need for a change in his or her particular schedule. The
      staff may need assistance in learning how to perceive possible changes or how to
      approach others. 4. Problems are usually resolved by staff-suggested rule
      additions or modifications. Rules can be used to help enforce consideration and
      fairness, but a noncompliant person may need individual attention.

PMID- 7776586
TI  - On-line charging = increased revenue.
AB  - Although the new ED charge system is not perfect, it has resulted in improved
      charging for services delivered; this increase in correct charges has more than
      offset the resources to develop the entire tracking system project within 1 year.
      This is one example in which computerization paid for itself, which should help
      ED managers justify computerization of their departments. It is hoped that more
      effective charge systems will occur as a component of the computerized patient
      record in which the patient charge is calculated on the basis of preset formulas
      for the amount of resources utilized, thus eliminating subjectivity in charging.
      With the capture of all services rendered, evaluation of practice patterns and
      outcomes would allow the ED staff to identify effective treatment regimens.
      Hopefully, unnecessary tests or treatments can be eliminated to promote a
      decrease in resource utilization and costs without compromising quality patient
      care.

PMID- 7776587
TI  - Triage protocols.

PMID- 7776589
TI  - Trauma resource nurse orientation program.

PMID- 7776588
TI  - Human immunodeficiency virus and acquired immunodeficiency syndrome: updating the
      MMWR file.

PMID- 7776590
TI  - Mobitz I versus Mobitz II: learning through storytelling.

PMID- 7776591
TI  - Autoerotic asphyxia in adolescents.
AB  - The death of a child or young adult is always tragic, regardless of the cause.
      Cases of autoerotic asphyxia are often labeled as suicide, or are underreported
      because of embarrassment of relatives or misidentification of the initial
      clinical manifestations. It may be that autoerotic asphyxial death is far more
      common than realized. Many emergency nurses and physicians lack adequate
      knowledge about this phenomenon to make an accurate diagnosis. Family members are
      often reluctant or unwilling to provide enough data surrounding the circumstances
      in which the patient was found, and the cause of death is mislabeled as suicide.
      Autoerotic asphyxia is frequently labeled as a sexual aberrancy and an act that
      society would rather not acknowledge. But there are a number of implications for
      emergency nurses, such as prevention and sensitive support of family in the
      emergency department, that demand our attention.

PMID- 7776592
TI  - Automobile air bag-mediated injury: a case presentation.
AB  - Because of the growing number of automobiles equipped with air bags, it is
      virtually certain that patients will seek treatment in the emergency department
      for air bag-mediated injury. The emergency nurse must be aware of air bag
      mediated injury patterns and prepared for triage and management of any of the
      potential concurrent injuries caused by air-bag deployment.

PMID- 7776593
TI  - A 42-year-old woman with unexplained swelling of the hand and forearm.

PMID- 7776594
TI  - A tribute to Barb Fassbinder.

PMID- 7776595
TI  - Jeremy.

PMID- 7776596
TI  - Acute iron ingestion in a 2-year-old child.

PMID- 7776597
TI  - "Please keep his hands warm".

PMID- 7776598
TI  - "Triaging out" children with minor illnesses from an emergency department by a
      triage nurse: where do they go?
AB  - OBJECTIVE: To determine whether parents of children with minor illnesses actually
      seek care after they receive advice and are referred from an emergency department
      by an ED triage nurse. DESIGN: Descriptive study of 100 parents with children who
      were given advice and referred from an urban, pediatric tertiary care center by
      an ED triage nurse. METHODS: A 10-item telephone survey was designed to determine
      whether parents took their children to the primary health care provider to whom
      they were likely to be referred. Parental perceptions of the severity of the
      child's medical problem, of the nurse's understanding of the problem, and of the
      satisfaction with the referral process were analyzed with Fisher's exact test.
      RESULTS: Most (79%) of the subjects did not seek care with a primary health care
      provider per referral. However, 81% of parents believed the triage nurse
      understood the child's problem (rated 4 or 5 on a 5-point Likert scale in which 5
      meant "completely understood" the child's problem) and 79% were satisfied with
      being referred from the emergency department (rated 4 or 5 on a 5-point Likert
      scale in which 5 meant "most satisfied" with being "triaged out"). CONCLUSION:
      Parental perceptions of the ED triage nurse's understanding of the child's
      complaint has a significant positive relationship on the parent's satisfaction
      with the advice and referral directives given by the nurse for the health care
      needs of the child. No children in this study experienced a worsening in their
      condition. Hence the ED triage nurse can be a valuable resource in educating and
      fostering primary health care practices within the community.

PMID- 7776599
TI  - Cocaine-induced myocardial infarction: treatment with thrombolytic therapy.
AB  - Patients with cocaine-induced AMI may be added to the expanding list of eligible
      candidates for thrombolytic therapy. ED nurses are in key positions to identify
      patients for thrombolysis, evaluate patients' responses, and minimize
      complications. With the rising use of cocaine, increased consideration should be
      given to any relatively young patient with unexplained cardiovascular symptoms
      and history of cocaine use.

PMID- 7776600
TI  - Markers of reperfusion after thrombolytic therapy for acute myocardial
      infarction.

PMID- 7776602
TI  - Syncope: categories and considerations for practice.
AB  - Cardiogenic and orthostatic syncope can be diagnosed in the majority of cases in
      the ED setting. Neurogenic causes of syncope may require more extensive testing
      and a longer in-hospital stay to determine the underlying cause. However, with
      the advent of more definitive laboratory tests such as CK determination,
      neurologic syncope may be more easily diagnosed in the emergency department. It
      is hoped that the morbidity and mortality rate related to syncope (falls, motor
      vehicle accidents) will decline with patient education, early diagnosis, and
      treatment. Cognizance of the various types and categories of syncope can assist
      the emergency nurse in triage, as well as enhance the differential diagnosis and
      treatment of the patient with syncope.

PMID- 7776601
TI  - Ketamine: the dissociative anesthetic and the development of a policy for its
      safe administration in the pediatric emergency department.

PMID- 7776603
TI  - Economical citywide tabletop disaster preparedness drill.

PMID- 7776604
TI  - Torsades de pointes: success equals recognition.

PMID- 7776605
TI  - The surprise gift.

PMID- 7776606
TI  - The evolution of air medical transport.

PMID- 7776608
TI  - Telephone consultation for a "managed care" population.

PMID- 7776607
TI  - Emergency care flow sheet.

PMID- 7776610
TI  - Nurses and the Internet.

PMID- 7776609
TI  - Providing educational information.

PMID- 7776611
TI  - Phone consultations with the ED physician: is there nursing liability?

PMID- 7776612
TI  - ACLS rapid rate conversion drugs.

PMID- 7776613
TI  - Pediatric quality improvement in the emergency department.

PMID- 7776614
TI  - ENA's new course in advanced trauma nursing: a conceptual approach.

PMID- 7776615
TI  - A 74-year-old woman with dizziness, lower extremity weakness, and slurred speech.

PMID- 7776616
TI  - The making of ENA's anniversary quilt.

PMID- 7776618
TI  - A look at our new emergency department: Waynesboro Hospital, Waynesboro,
      Pennsylvania.

PMID- 7776617
TI  - Emergency nurse encounters man with seizure at 20,000 feet.

PMID- 7776619
TI  - Pay and benefits of Canadian emergency nurses.

PMID- 7776620
TI  - President's message: archiving our organization.

PMID- 7776621
TI  - A research report card.

PMID- 7776622
TI  - Reuse of eye medication in the emergency department.

PMID- 7776623
TI  - Dopamine not effective for treatment of hypotension in chlorpromazine overdose:
      first case report.
AB  - Dopamine is a popular and effective vasopressor agent. However, in the event of
      overdose with a potent alpha 1-receptor blocker, dopamine may not be effective in
      treatment of hypotension. A vasopressor that stimulates only alpha-receptors,
      such as norepinephrine or phenylephrine, may be more appropriate. In our case,
      dopamine was clearly ineffective, whereas norepinephrine worked well. Our case
      also demonstrates the importance of carefully monitoring the effectiveness of any
      vasopressor therapy.

PMID- 7776625
TI  - Human ehrlichiosis: a case report from the South Carolina lowcountry.

PMID- 7776624
TI  - The MUSC lung transplantation program: the first year's experience.

PMID- 7776626
TI  - Selective spinal injections.

PMID- 7776627
TI  - Applications of small wire external fixation.

PMID- 7776628
TI  - Ehrlichiosis: more tick-borne terrorism?

PMID- 7776629
TI  - What is professionalism and can it be measured?

PMID- 7776630
TI  - 15 characteristics of personal maturity.

PMID- 7776631
TI  - The Nebraska "Network of Drug-Free Youth" program.
AB  - This paper describes Nebraska's six-year experience with a successful prevention
      program to form and maintain local drug-free youth groups. More than 4,500 youth
      were involved at the time of a six-year evaluation survey. Nearly 91% of group
      members who responded reported being alcohol-free in the previous 30 days and
      almost all (97%) reported being tobacco-free. Thirty-eight percent of members met
      one or more of the federal criteria for "high-risk" youth. Sixty-eight percent of
      responding high-risk youth who previously used alcohol credited group membership
      with helping them quit or reduce use. The program appears to assist in delaying
      onset of alcohol, tobacco, and other drug use for youth in the program, and to
      assist in decreasing or eliminating use of alcohol and tobacco by adolescents who
      used before participating.

PMID- 7776633
TI  - The Delaware School Health Advisory Committee.
AB  - For nearly 40 years, the Delaware School Health Advisory Committee (SHAC) has
      been improving school health education and school health services in the state.
      The SHAC has recommended policies to the Delaware Board of Education and the
      state legislature, conducted conferences and workshops, and published brochures,
      studies, resource guides, curricula, and pamphlets. The key to SHAC success has
      been its diverse membership and the cooperation it engendered in the state.

PMID- 7776632
TI  - A comprehensive approach to school health program needs assessments.
AB  - An assessment of health promotion needs represents a fundamental step for
      developing comprehensive school health programs. This project developed and
      tested an approach for school districts to use when conducting a district-wide
      needs assessment of school health programs. The approach assumes a needs
      assessment should be multidimensional and comprehensive. Seven priority health
      related behaviors were included as well as eight components of a school health
      program identified by Kolbe. This paper describes each aspect of the needs
      assessment, discusses the importance of perspectives provided by each component,
      and provides recommendations for districts interested in conducting an
      assessment.

PMID- 7776635
TI  - A letter to my principal: why is it always health education?

PMID- 7776634
TI  - School-level application of a social bonding model to adolescent risk-taking
      behavior.
AB  - Adolescent bonding--attachment to, commitment to, and involvement in conventional
      social activities-decreases the likelihood of engaging in some risk-taking
      behaviors. The extent to which bonding opportunities in the school environment
      affect individual's bonding and risk-taking behaviors is less explored. This
      study tested a model that includes individual and environmental indicators of
      bonding to predict cigarette smoking, drinking, drug use, and sexual activity
      among ninth grade students. Survey data representing students in 20 schools in
      seven western states are reported. Twelfth grade students' bonding and other
      demographic variables aggregated by school served as environmental indicators of
      bonding opportunities to predict ninth grade students' bonding and risk-taking
      behavior. Path analyses indicate the school environment has a direct influence on
      ninth grade students' bonding and, in turn, on the likelihood they will engage in
      risky behavior. Implications of these findings for future research directions and
      intervention design are discussed.

PMID- 7776636
TI  - Age preferences for same- and opposite-sex partners.
AB  - Preferences for age of partners of heterosexual and homosexual men and women were
      investigated. Personal advertisements were collected from newspapers in the
      United States and analyzed for the difference between the age of the advertiser
      and the age of the preferred partner. Heterosexual men tended to seek women
      younger than themselves, whereas women sought partners near their own age or
      older. The preferences of homosexual men and women were similar to those of
      heterosexuals, although more homosexuals stated a preference for a partner
      younger than themselves.

PMID- 7776637
TI  - Self-perception changes among sports camp participants.
AB  - The relationship between sports camp participation and changes in self-perception
      was assessed. The participants were 42 boys and 32 girls participating in a 5
      week summer sports camp for economically disadvantaged children in the United
      States. Self-concept was measured at the beginning and end of the camp with
      Harter's (1985) Self-Perception Profile (SPP) for Children. At the beginning of
      the camp the girls scored higher than the boys on overall SPP scores and three of
      six subscales. After 5 weeks, the girls' scores were higher on only one subscale
      and on adult group leaders' ratings. The decline in the girls' scores was
      attributed to the stress of competition or to initial overly positive self
      perceptions.

PMID- 7776638
TI  - Gender differences in job satisfaction.
AB  - The competing hypotheses of socialization, structural, and social role theories
      were used to investigate the possible existence of gender differences in job
      satisfaction. The hypotheses were tested in a sample of over 13,000 U.S.
      employees from approximately 130 organizations and divisions across a variety of
      industries. The organizations were clients of a North American-based management
      consulting company. T tests and effect sizes were calculated to test for the
      possible existence of group differences in job satisfaction between women and men
      in both clerical and managerial positions. The results indicate support for
      structural theory, some support for social role theory, and a lack of support for
      socialization theory. An important finding is that U.S. women and men in
      management apparently did not differ from one another in their sources of
      satisfaction at work.

PMID- 7776639
TI  - The effect of physical attractiveness comparison on choice of partners.
AB  - The roles of several presumed factors in the choice of partners during a first
      group encounter were examined, when the only available information was a ranking
      of group members' physical attractiveness. After they had received bogus feedback
      about their own attractiveness rank in a newly formed group, 99 Japanese students
      were asked to choose a partner for a task. The results indicated that feedback
      about one's own attractiveness was the primary factor that determined choice of
      others and that susceptibility to this type of feedback was characterized by a
      notable gender difference. These findings suggest that when the only information
      available about others concerns their physical appearance, the choice of partner
      or competitor, even for appearance-irrelevant tasks, is partially dependent on
      others' rankings of one's own physical attractiveness.

PMID- 7776640
TI  - Perception of the combined effect of smoking and alcohol on health.
AB  - Because smoking is significantly associated with drinking, the consumption of
      alcohol can be associated with indirect consumption of tobacco (passive smoking),
      and alcohol and tobacco can have synergetic effects, the ways people perceive
      their combined effects were investigated. Information integration theory was
      applied, and the results showed that rather than representing the combined
      effects of tobacco consumption and alcohol consumption in a synergetic or
      summative way, the sample of 40 French adults apparently considered that
      indulging in only one of these two behaviors results almost unilaterally in
      maximal alteration of health. The two effects were seen to combine disjunctively,
      a way of perceiving the combined effects of the two substances that runs counter
      to current medical data on the subject.

PMID- 7776641
TI  - Coping and depressive symptoms among Iranian students.
AB  - Five hundred sixty-eight junior and senior high school students in Tehran, Iran,
      completed measures of depressive symptoms and coping styles with regard to a
      difficult academic event. On average, the Iranian students reported more
      depressive symptoms than the U.S. adolescents did. Consistent with the results of
      studies with U.S. samples, the students who had an active coping style reported
      fewer depressive symptoms than the students who had a passive coping style did.
      These findings suggest that the Western construct of personal control functioned
      somewhat similarly in this non-Western sample.

PMID- 7776642
TI  - Stoicism: its relation to gender, attitudes toward poverty, and reactions to
      emotive material.
AB  - A scale was developed to test the hypotheses that stoicism would be more
      prevalent in British men (n = 30) than in British women (n = 32) and that
      stoicism would be related to negative attitudes toward the poor. It was also
      hypothesized that stoics would exhibit a weaker emotional reaction to stories
      that had emotive content. All three hypotheses were supported. There was evidence
      that the Stoicism Scale had internal consistency and some external validity.

PMID- 7776643
TI  - Life events, social support, and depression among Taiwanese female homemakers.
AB  - Eighty-five female homemakers in a Taiwanese city were surveyed. Multiple
      regression analysis indicated that age, life events, and social support were
      related to depression symptomatology. Younger homemakers reported more depressive
      symptoms than their older counterparts did. Life events were related to
      depression, and social support acted as a buffer against depression.

PMID- 7776644
TI  - The relationship between team friendships and burnout among residential
      counselors.
AB  - The relationship between team friendships and burnout was investigated. The
      participants were counselors from 16 work teams in a short-term residential
      facility for emotionally disturbed children and adolescents that was located in
      the United States. The burnout dimensions were lack of personal accomplishment,
      emotional exhaustion, and depersonalization (Maslach & Jackson, 1986). Reciprocal
      nominations between team members were used as a measure of team friendships.
      Friendship between members of the same team was positively related to personal
      accomplishment and inversely related to emotional exhaustion. The frequency of
      three aspects of team friendships was also examined: personal discussions, work
      discussions, and having fun. Having fun with a team friend was positively related
      to personal accomplishment, and having work discussions with a team friend was
      inversely related to depersonalization. The women reported more frequent contact
      with team friends than the men did.

PMID- 7776645
TI  - Predicting retirement anxiety: the roles of parental socialization and personal
      planning.
AB  - It was proposed that anxiety about retirement begins long before retirement, and
      that perceptions on one's parents' socialization into retirement and one's own
      planning for retirement are associated with retirement anxiety. Data from 213
      Canadian respondents (mean age = 44 years) were analyzed. Path analysis indicated
      that both parental socialization and own planfulness affect retirement anxiety.

PMID- 7776646
TI  - Gender role identity and perceptions of Ismaili Muslim men and women.
AB  - Gender roles in the Ismaili Muslim community were examined. Eighty-one Shia Imami
      Nizari Ismaili Muslims living in Ontario, Canada, provided demographic data and
      completed the Bem Sex-Role Inventory (BSRI; Bem, 1981) and the Attitudes Toward
      Women Scale (AWS; Spence, Helmreich, & Stapp, 1973). The results indicated that,
      although the Muslim women had more liberal views about gender roles than the
      Muslim men did, both the men and the women reported views that were liberal and
      comparable to those that have been reported by other Canadian samples.

PMID- 7776647
TI  - The effect of self-serving attribution on attraction in additive- and conjunctive
      task groups.
AB  - The prediction that the effect of self-serving attribution on personal attraction
      will vary according to task type was tested. Twenty-four groups of Turkish
      students, each consisting of 1 participant and 3 confederates, received success
      feedback after having performed either an additive or a conjunctive task. Two of
      the confederates made either self-serving or group-serving attributions, whereas
      the 3rd confederate attributed success to the collective efforts of all group
      members. Following these attributions, the participants filled out a form to
      indicate the degree to which they preferred each member as a friend and a work
      mate. Self-serving attributors in the conjunctive-task condition were less
      preferred as friends than the self-serving attributors in the additive-task
      condition. Also, the additive-task participants' ratings for other group members
      were systematically higher than those of the conjunctive-task participants. Thus,
      there was a main effect of task type for both friends and workmates.

PMID- 7776648
TI  - Perception of crowding among children and adolescents.
AB  - The effects of spatial orientation (closed vs. open) and furniture arrangement
      (side vs. central) on Indian children's (6 to 8 years) and adolescents' (16 to 18
      years) perceptions of crowding were studied, using Desor's (1972) Crowding
      Perception Test. The results indicated that spatial orientation and furniture
      arrangement had different effects on children's and adolescents' perceptions of
      crowding. The children perceived less crowding than the adolescents did, and
      central furniture arrangement was perceived as more crowded than side furniture
      arrangement was.

PMID- 7776649
TI  - Flow cytometric analysis of the DNA content in primary and metastatic lesions of
      colorectal cancer.
AB  - We investigated and compared the DNA content between primary and metastatic
      lesions from 30 colorectal cancer cases. The findings were only diploid in 2
      cases (6.7%) and only aneuploid in 18 cases (60.0%). On the whole, the DNA ploidy
      agreed in 20 cases (66.7%) between both lesions. In the 18 cases with only
      aneuploid tumors in both lesions, the DNA index tended to be larger in the
      metastatic lesions than in the primary lesions. In contrast, a variation in the
      DNA ploidy was observed in 10 cases (33.3%). These findings show that DNA ploidy
      tends to remain stable during metastasis in many cases of colorectal cancer,
      although the DNA index did tend to be larger in metastatic lesions than in
      primary lesions. The existence of intertumoral heterogeneity in the DNA ploidy
      also shows that specimens should be investigated from both lesions in order to
      obtain more accurate information on the tumor and its biological behavior.

PMID- 7776650
TI  - Growth inhibition of intracerebral rat glioma by transfection-induced human
      interferon-beta.
AB  - In our previous study on liposome-mediated transfection of the human interferon
      beta (HuIFN-beta) gene into subcutaneously implanted human gliomas in nude mice,
      we found that HuIFN-beta was produced and secreted by the tumor cells and that
      the growth of solid tumors was completely inhibited. The present study
      investigated the growth-inhibitory effect of liposomes containing the HuIFN-beta
      gene inserted into a vector (pSV2IFN-beta) on T9 rat glioma implanted into the
      brains of rats. Tumor cells and liposomes containing pSV2IFN-beta or other
      additives were simultaneously injected into the brains of rats. HuIFN-beta was
      detected in solid gliomas growing in the brains of rats injected with liposomes
      and magnetic resonance imaging (MRI) showed that tumor growth was inhibited. In
      addition, the latent period until the appearance of neurological symptoms was
      significantly prolonged in rats treated with liposomes containing pSV2IFN-beta.
      However, the survival time of the treated rats was not significantly increased.

PMID- 7776651
TI  - Pulmonary metastasectomy for soft tissue sarcomas: is it justified?
AB  - The role of pulmonary metastasectomy for metastatic soft tissue sarcomas is
      examined by reviewing the recent (1978-1994) English language literature. There
      are no prospective studies that contain an appropriate control group, and only
      one retrospective study contains a matched control group. In those few studies
      that provide greater than 5-year survival data, the survival curve still has a
      steep slope and few patients are alive at 7 years. In most studies only one or
      two patients are at risk at 5 years or more. Projected survival is therefore
      statistically questionable. It is currently impossible to know what is the impact
      of the surgical procedure over and above the natural history (biology) of the
      tumor. A randomized, prospective study, as suggested a decade ago, is still
      needed. While there may be some merit to pulmonary metastasectomy in highly
      selected patients, aggressive pulmonary metastasectomy does not seem justified by
      the available data.

PMID- 7776654
TI  - Lectin histochemical study of cholangiocarcinoma arising from stone-bearing
      intrahepatic bile duct.
AB  - With the purpose of studying changes in the expression of glycoconjugate
      structures in cholangiocarcinoma and the nonneoplastic epithelium of stone
      bearing intrahepatic bile ducts, a panel of 12 biotinylated lectins were used on
      formalin-fixed, paraffin-embedded tissue sections from 13 patients who had
      undergone surgical resection of cholangiocarcinoma and on nonneoplastic stone
      bearing intrahepatic bile ducts from 10 patients. Of the 13 patients with
      cholangiocarcinoma 10 had hepatolithiasis and 3 did not. Among the 12 lectins,
      only wheat germ agglutinin (WGA) stained the cholangiocarcinoma and nonneoplastic
      epithelium of the stone-bearing intrahepatic bile duct. All nonneoplastic
      epithelia of stone-bearing intrahepatic bile ducts were stained heavily and
      homogeneously by WGA, the GlcNAC-specific lectin. The high columnar epithelium of
      both intramural and extramural glands was stained in the supranuclear region,
      while the low columnar epithelium of serous acini was stained in the whole
      cytoplasm. cytoplasm. In the well-differentiated cholangiocarcinoma, the WGA
      weakly stained the neoplastic cells in the supranuclear region, while it stained
      the luminal cytoplasmic membrane heavily. In the poorly-differentiated
      cholangiocarcinoma, about 50% of cancer cells were stained with WGA. The
      carcinoma was moderately stained in the cytoplasm. Less reactivity and a lower
      percentage of cells stained with lectin were found in cholangiocarcinomas when
      compared to nonneoplastic epithelia. This led us to conclude that there is a
      dramatic decrease in lectin-binding carbohydrate structures associated with
      cholangiocarcinoma progression.

PMID- 7776653
TI  - Endoscopic injection sclerotherapy for esophageal varices associated with
      concomitant portal venous thrombus of hepatocellular carcinoma.
AB  - Between 1983 and 1994, we treated 51 patients with esophageal varices and portal
      trunk and main branch invasion of hepatocellular carcinoma, using endoscopic
      injection sclerotherapy. Variceal bleeding was controlled in 28 of 29 patients
      (96.6%), esophageal varices were completely eradicated in 28 (54.9%), and only 2
      of 28 (7.1%) bled from small, dilated, venous vessels after eradication. The
      cumulative nonbleeding rate at 3 years was 87.5%. Death caused by hepatocellular
      carcinoma accounted for 89.4% of the patients, whereas the rate of bleeding from
      esophageal varices was 4.3%. Variables significantly associated with the duration
      of survival were Okuda's clinical stage, alpha-fetoprotein, eradication of
      esophageal varices by sclerotherapy, and treatment of hepatocellular carcinoma,
      as determined in a univariate analysis. Multivariate analysis showed that
      eradication of esophageal varices by sclerotherapy, Okuda's clinical stage, and
      age were independent factors which significantly influenced survival time. We
      propose that complete eradication of esophageal varices and close follow-up using
      endoscopy may lead to a reduction in bleeding from esophageal varices, and hence
      may reduce mortality rates related to this bleeding.

PMID- 7776652
TI  - Establishment and characterization of human gastric and colonic xenograft lines
      resistant to CPT-11 (a new derivative of camptothecin).
AB  - CPT-11-resistant human gastric and colonic xenograft lines were established by
      direct intratumoral injection of CPT-11 into subcutaneous SC-1-NU and CC-2-NU
      tumors in nude mice once a week for 10 months. The resistance of these xenograft
      lines to CPT-11 was confirmed by growth inhibition rate, to be 36.3% and 45.4%,
      respectively, compared to each parent cell line. DNA topoisomerase I activity of
      the nuclear extracts of SC-1-NU/CPT-11 and CC-2-NU/CPT-11, as assayed by
      relaxation of supercoiled DNA Col-E1, was significantly less than those of the
      parent lines. The cellular levels of topoisomerase I in those resistant lines
      measured by Western blot analysis were 0.57- and 0.79-fold lower than those of
      the parental lines, respectively. However, the activity of DNA topoisomerase II
      of those resistant cell lines assayed by decatenation of kinetoplast DNA was
      higher than that of the parental lines and the cellular levels of topoisomerase
      II in the resistant lines measured by Western blot analysis were 10.8- and 8.1
      fold higher than those of the parent lines. Intracellular accumulation of CPT-11
      in CPT-11-resistant tumors was not changed as compared to that of the parental
      lines, but hydrolysis of CPT-11 to more active SN-38 was reduced in the resistant
      tumors.

PMID- 7776655
TI  - Concomitant sclerosing mesenteritis and inflammatory pseudotumor simulating
      gastric lymphoma or linitis plastica.
AB  - Both inflammatory pseudotumors and sclerosing (retractile) mesenteritis are
      uncommon conditions of unknown origin. A number of authors have reported patients
      presenting with complaints that were attributed to one or the other of these
      entities. In our review of the literature, we were unable to find a single case
      report of mixed abdominal findings that could be explained by the presence of
      both conditions. We report a case of the patient presenting with abdominal mass
      that was identified as having features of both sclerosing mesenteritis and
      inflammatory pseudotumor on pathologic diagnosis.

PMID- 7776656
TI  - Spindle cell tumor of the portal vein.
AB  - The authors describe the first reported case of spindle cell tumor of the portal
      vein (SCTPV) surgically excised in a 28-year-old woman. The tumor had caused
      portal vein obstruction with extensive collaterals. A side-to-side mesocaval
      shunt was created to reduce portal hypertension. Six months later the SCTPV could
      be excised. Radiation therapy (4,500 cGY) was given 2 months later. Although the
      tumor recurred in the liver 4 years later, the patient is alive and free of
      symptoms 6 years after the initial diagnosis.

PMID- 7776657
TI  - Synchronous, bilateral mastectomy.
AB  - Sixty-four patients (mean age, 51 years) had mastectomies which were synchronous
      and bilateral. Sixty-one premastectomy biopsies (bilateral, 34 and unilateral,
      27) demonstrated the following: invasive carcinoma, 17; noninvasive carcinoma,
      24; combination of above, 10; and benign disease, 10. Twenty-two patients had
      bilateral mastectomy because of bilateral positive biopsy. Twenty-nine patients
      with unilateral carcinoma on biopsy had bilateral mastectomy. Thirteen patients
      had bilateral mastectomy despite benign disease only on biopsy (10) or no biopsy
      (3). Ten unexpected carcinomas (34%) were found in the contralateral breast in
      the 29 patients with carcinoma diagnosed on unilateral biopsy. The biopsy
      pathology of these 10 specimens was invasive ductal carcinoma in 1 and
      multifocal, noninvasive carcinoma (ductal, 3 and lobular, 6) in 9. An unexpected
      carcinoma may be found in the contralateral breast in a significant number of
      patients who are selected for bilateral mastectomy, particularly if the selection
      is on the basis of a noninvasive, lobular histology. Bilateral mastectomy may be
      appropriate for such patients, particularly when complicated by a strong family
      history and breasts which are difficult to assess by physical or mammographic
      examination.

PMID- 7776658
TI  - Studies of rhodamine-123: effect on rat prostate cancer and human prostate cancer
      cells in vitro.
AB  - The effect of the lipophilic, cationic dye, Rhodamine-123 (Rh-123), on prostate
      cancer in rats, and on three tumor cell lines in vitro is reported here. The
      general toxicity of Rh-123 in mice has been found to be minimal. Lobund-Wistar (L
      W) rats with the autochthonous prostate cancer of Pollard were treated for six
      doses with Rh-123 at a dose of 15 mg/kg subcutaneously every other day.
      Microscopic examination of the tumors revealed cellular and acinar destruction.
      The effectiveness of Rh-123 as a cytotoxic agent was tested by clonogenic and
      viability assays in vitro with three human prostate cancer cell lines. Severe (60
      95%) growth inhibition was observed following Rh-123 exposure for 2-5 days at
      doses as low as 1.6 micrograms/ml in all three prostate cancer cell lines.

PMID- 7776659
TI  - Renal cell carcinoma extending to the renal vein and inferior vena cava: results
      of surgical treatment and prognostic factors.
AB  - Forty-seven patients with renal cell carcinoma with tumor thrombus extension to
      the renal vein or inferior vena cava (IVC) were treated surgically over a 10-year
      period. There were 41 males and 6 females with a mean age of 45.7 years. Thirty
      three patients had right-sided and 14 had left-sided tumors. Patients with renal
      vein or infrahepatic IVC thrombus were treated with radical nephrectomy with
      tumor thrombus excision after achieving conventional vascular control over the
      IVC and the opposite renal vein. Four patients with retrohepatic IVC thrombus
      were treated with venacavotomy and thrombectomy after achieving vascular control
      above the thrombus but below the hepatic veins while two other patients with
      retrohepatic and one with suprahepatic thrombus required a bifemoroatrial partial
      venous bypass prior to tumor thrombectomy. There was one postoperative death due
      to pulmonary embolism. The actuarial 5-year survival for all patients with venous
      extension was 50% and the median survival was 4.35 years. Perinephric spread and
      lymph node metastases were significant prognostic factors affecting survival.
      This suggests that it is the locoregional spread of renal cell carcinoma rather
      than the level of the thrombus which governs the prognosis of patients with tumor
      thrombus extension to the renal vein or IVC.

PMID- 7776660
TI  - The evaluation of hepatoprotective effects of Taiwan folk medicine 'teng-khia-u'.
AB  - 'Teng-khia-u' is a folk medicine of Taiwan, derived from the entire plants of
      Elephantopus scaber L., E. mollis H.B.K. and Pseudoelephantopus spicatus (Juss.)
      Rohr. The hepatoprotective effects of water extracts of these three plants
      against beta-D-galactosamine (D-GalN)- and acetaminophen (APAP)-induced acute
      hepatic damage were determined in rats. The results indicated that the serum
      glutamate-oxalate-transaminase (sGOT) and the serum glutamate-pyruvate
      transaminase (sGPT) levels caused by D-GalN and APAP decreased after treatment
      with crude extracts of 'teng-khia-u' (P < 0.005). The pathological changes of
      hepatic lesions, caused by D-GalN and APAP, improved following treatment with the
      drug extracts mentioned above.

PMID- 7776661
TI  - Analgesic effect of Irvingia gabonensis stem bark extract.
AB  - Irvingia gabonensis is used medicinally in most parts of tropical Africa for the
      treatment of a number of ailments. In West Africa the Mende tribe of Sierra Leone
      uses the stem bark to relieve pain. In order to establish a pharmacological
      rationale for the traditional use of this plant as a remedy for pain, the water
      and ethanol extracts of the powdered stem bark were screened for analgesic
      activity and compared with standard analgesic drugs. The water extract and
      morphine protected the mice from heat-induced pain. In contrast, the ethanol
      extract and metamizole sodium showed very low level of analgesic activity in this
      test. However, using tail pressure as a source of pain, the water and ethanol
      extracts, metamizole sodium and morphine offered protection to the mice against
      pain stimuli. Morphine and the water extract were more potent as analgesic agents
      in heat than non-heat pain test. The analgesic effects of the water extract and
      morphine were blocked by a non-selective opioid receptor antagonist, naloxone in
      both tests, whereas the analgesic effects of the ethanol extract and metamizole
      sodium were not antagonized by the same dose of the opioid antagonist. The data
      presented in this study suggest that the active principle(s) in the water extract
      has analgesic profile similar to that of the narcotic analgesic and the ethanol
      extract might contain compound(s) that behave like non-narcotic analgesic agent.
      These findings provide for the first time the pharmacological basis for the
      folkloric use of Irvingia gabonensis in the relief of pain.

PMID- 7776662
TI  - Effects of stilbenes isolated from medicinal plants on arachidonate metabolism
      and degranulation in human polymorphonuclear leukocytes.
AB  - Studies were made on the effects of stilbene derivatives isolated from medicinal
      plants on arachidonate metabolism and degranulation in human polymorphonuclear
      leukocytes (PMN-L). Resveratrol (3,4',5-trihydroxystilbene) isolated from the
      roots of Reynoutria japonica was found to inhibit the 5-lipoxygenase products 5
      hydroxy-6,8,11,14-eicosatetraenoic acid (5-HETE), 5,12-dihydroxy-6,8,10,14
      eicosatetraenoic acid (5,12-diHETE) and leukotriene C4(LTC4); its concentrations
      for 50% inhibition (IC50) were 8.90 x 10(-6) M, 6.70 x 10(-6) M and 1.37 x 10(-6)
      M, respectively. The IC50 of 5-HETE, 5,12-diHETE and LTC4 formations of synthetic
      3,3',4-trihydroxystilbene were 5.90 x 10(-6) M, 6.30 x 10(-7) M and 8.80 x 10(-7)
      M, respectively. Moreover, they inhibited the release of lysosomal enzyme such as
      lysozyme and beta-glucuronidase induced by calcium ionophore A 23187 from human
      PMN-L at 10(-3)-10(-4) M.

PMID- 7776663
TI  - Prophylactic therapy of Salmonella typhi septicemia in mice with a traditionally
      prescribed crude drug formulation.
AB  - A crude drug formulation comprised of eight medicinal herb extracts was studied
      for in vitro and in vivo effect against Salmonella typhi. The formulation
      displayed inhibitory action against the test organism in vitro. Subsequently mice
      were challenged with a virulent strain of Salmonella typhi (Ty2) and the
      protective effect of the formulation was evaluated with post-infective, pre
      infective, single and multiple dose schedules, administered either orally or
      subcutaneously. A schedule that included multiple divided doses prophylactically
      administered had a significant therapeutic effect.

PMID- 7776664
TI  - Medicinal plants from Riau province, Sumatra, Indonesia. Part 1: Uses.
AB  - One hundred and fourteen species of flowering plants, claimed to have medicinal
      uses, were recorded from a previously uninvestigated area of Sumatra. Of the
      specimens, which belonged to 51 families, 50% were used to combat fever, 33% for
      diarrhoea and 31% for other gastrointestinal problems. External applications were
      often used to treat internal conditions, particularly fever. Species new to the
      ethnomedical literature are Garcinia parvifolia, Scleria purpurescens, Galearia
      filiformis, Litsea elliptica, Litsea robusta, Barringtonia lanceolata, Sesbania
      aculeata, Mimosa pigra, Abelmoschus ficulneus, Hedyotis leucocarpa, Pavetta
      multiflora, Symplocos cochinchinensis and Trema tomentosa. Hanguana (as H.
      malayana) represents a new genus of medicinal plants.

PMID- 7776666
TI  - Tricuspid valve replacement. Fifteen years of experience with mechanical
      prostheses and bioprostheses.
AB  - Tricuspid valve replacement is not a common operation. The purpose of this study
      was to examine the early and late results in 60 patients who underwent 28 (47%)
      bioprosthetic and 32 (53%) mechanical tricuspid valve replacements. All
      operations took place between January 1978 and June 1993 during which period a
      total of 4741 patients underwent valve replacement operation. Mean patient age
      was 50 +/- 15 (18 to 75) years. Forty-one patients (68%) were female and 19
      patients (32%) were male. Forty-nine patients (82%) were in New York Heart
      Association class III or IV before operation. Forty-five patients (75%) were
      undergoing repeat cardiac valve operation. Seventeen patients (28%) had complex
      congenital cardiac problems. Operation was urgent in 15 patients (25%). The
      hospital mortality rate was 27% (16 patients). All patients with hospital death
      were in New York Heart Association class III or IV, were having repeat
      operations, or had complex congenital disease. Low output syndrome was observed
      in 21 patients (35%). Reoperation because of bleeding was required in seven
      patients (12%). Thirteen patients (22%) required permanent (epicardial lead)
      pacemaker implantation. Mean follow-up is 75 +/- 45 months (maximum 173 months)
      and 100% complete for the 44 patients who left the hospital. There have been 14
      deaths (32%). Nine of these patients (64%) had mechanical valves and five (36%)
      had bioprostheses. Of the 11 cardiac deaths, three were valve related
      (bioprostheses). Three patients (10%) required reoperation because of tricuspid
      valve prosthetic failure (1 thrombosed mechanical valve, 2 failed porcine
      valves). Of the remaining 30 patients, 20 (67%) are in New York Heart Association
      class I or II. Seventeen patients have mechanical valves and 13 have
      bioprostheses. Twenty-six patients (90%) are receiving warfarin. Thromboembolism
      (transient ischemic attack) has occurred in one patient with a mechanical valve
      who also had a previous cerebrovascular accident. In this group there has been no
      hemorrhage, endocarditis, or new pacemaker requirement. Actuarial survival for
      the whole series is 37% +/- 9% and for the hospital survivors is 50% +/- 12% at
      15 years. Linearized rates of valve-related complications are not different
      between groups. Tricuspid valve replacement is a beneficial procedure for
      patients with structural tricuspid valve disease, many of whom have other
      valvular or congenital disease. Contemporary mechanical prostheses and
      bioprostheses are equally effective in the tricuspid position. Mechanical valves
      should be considered for tricuspid replacement in young patients and in patients
      with mechanical valves implanted in the left side of the heart.

PMID- 7776665
TI  - Medicinal plants from Riau province, Sumatra, Indonesia. Part 2: Antibacterial
      and antifungal activity.
AB  - Antibacterial assays of 114 species listed in Part 1 showed that 82% of the
      extracts tested were active against Staphylococcus aureus, while 35% were active
      against Escherichia coli. Antifungal activity was less dramatic: 19% of the
      extracts inhibited Saccharomyces cerevisiae, while 20% inhibited Fusarium
      oxysporum. Our survey of relevant literature indicates that less than 30% of
      these Angiosperm species have previously been assayed for any form of
      antimicrobial activity.

PMID- 7776667
TI  - Reimplantation of the right internal thoracic artery as a free graft into the
      left in situ internal thoracic artery (Y procedure). One-year angiographic
      results.
AB  - Reimplantation of the right internal thoracic artery, as a free graft, into the
      left in situ internal thoracic artery (Y procedure) has enabled us to bypass more
      distant marginal vessels, which was not possible by the bilateral technique
      alone. This prospective study was aimed at evaluating the clinical state of the
      patients and the degree of patency of grafts within 16 months of follow-up. All
      80 patients who underwent the Y procedure between January 1988 and January 1992
      were included. This group represented 10% of the 840 patients having coronary
      bypass during the same period. A total of 202 coronary anastomoses were performed
      in this series. Early postoperative (30 days) complications included three deaths
      (3.75%), eight myocardial infarctions (10%), one case of phrenic nerve paralysis
      (1.25%), two cases of respiratory failure (2.5%), and six wound infections
      (7.5%). At 3 months' follow-up, 96% of patients were free of symptoms. During the
      follow-up period, four patients died of noncardiac causes (lung, pancreatic, and
      brain cancer and rupture of an abdominal aortic aneurysm). At 1 year, 71 patients
      were free of symptoms (97%). Sixty-one patients underwent coronary angiography
      between 12 and 24 months. Six patients with peripheral arterial disease were not
      suitable for coronary angiography, and six refused to be tested. These 12
      patients had normal thallium test results in the bypassed area (stress or
      dipyridamole test). The patency rate of the left internal thoracic artery was
      98.3% (n = 60), occlusion rate 1.6% (n = 1), and incidence of threadlike arteries
      4.9% (n = 3). Thus the rate of perfect patency was 93.4%. The patency rate of the
      right internal thoracic artery as a free graft was 93.4% (n = 57), occlusion rate
      6.5% (n = 4), and the incidence of threadlike arteries 8% (n = 5). Thus the rate
      of perfect patency was 85.2%. A total of 169 anastomoses were studied. The rate
      of patency of the anastomoses to the left anterior descending coronary artery was
      96% (n = 58) and the occlusion rate, 4% (n = 2). The patency rate of sequential
      anastomoses (side to side) to diagonal arteries was 100% (n = 16). Patency rate
      of anastomoses to obtuse marginal arteries was 95% (n = 58) and the rate of
      occlusion, 4.9% (n = 3). The patency rate of anastomoses to the posterior
      descending artery or distal branches of the right coronary artery was 80% (n =
      4/5).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7776668
TI  - Modified conduit preparation creates a pseudosinus in an aortic valve-sparing
      procedure for aneurysm of the ascending aorta.
AB  - Mechanical valved conduit replacement of the aortic root is a durable and
      appropriate procedure for many diseases of the ascending aorta, but may sacrifice
      an anatomically salvageable aortic valve. For young active patients and for
      patients with "systemic" arterial disease (atherosclerosis, Marfan's syndrome)
      who may require future operations, life-long anticoagulation with its attendant
      thromboembolic versus hemorrhagic risks is not ideal. Several techniques have
      been suggested as aortic valve-sparing options. Recently, a procedure was
      described that combines the freehand homograft techniques with the standard
      Bentall techniques (David procedure). This innovative technique replaces the
      ascending aorta with a Dacron cylinder, spares the aortic valve, and restores
      competence and thus offers an excellent alternative. The durability of this
      procedure that places the aortic valve inside a cylindrical conduit without
      sinuses of Valsalva is unknown. In selected patients, we have used this technique
      to spare the aortic valve. On the basis of experimental data and preliminary
      computer modeling, with the hope of improving the durability, we have modified
      the conduit to create a "pseudosinus" in our most recent nine patients. We have
      done the David procedure in 10 patients. The pseudosinus modification was done in
      the most recent nine patients. Patients' ages ranged from 37 to 71 years (mean
      49.9 years). There were five female and five male patients. Five patients had
      Marfan's syndrome and five patients had annuloaortic ectasia. There has been no
      mortality and all patients have had both early and late follow-up
      echocardiography. Five patients have zero to trace aortic insufficiency, four
      patients have trace to mild aortic insufficiency, and one patient has mild or
      "1+" aortic insufficiency. Aortic insufficiency has not progressed in any patient
      during the 18 months of follow-up. The patient with 1+ aortic insufficiency has
      no activity limits, good ventricular function, and no evidence of congestive
      symptoms. One patient who had extensive thoracoabdominal aneurysmal disease has
      undergone subsequent replacement of the descending aorta to the level of the
      renal arteries and has done well. Aortic valve-sparing replacement of the aortic
      root is an excellent procedure for any patient with an ascending aortic aneurysm
      and an anatomically salvageable valve. We believe that by modifying the proximal
      conduit and creating a "pseudosinus" into which the leaflets can retract without
      contact of the cylindrical conduit we may increase the longevity of the native
      aortic valve in this procedure.

PMID- 7776669
TI  - Growth and fibrinolytic parameters of human umbilical vein endothelial cells
      seeded onto cardiovascular grafts.
AB  - It was the aim of this study to investigate possible effects of biomaterials used
      to produce vascular grafts on the fibrinolytic system of endothelial cells.
      Therefore growth conditions for human umbilical vein endothelial cells on
      polytetrafluoroethylene and on polyurethane were optimized. Tissue culture
      polystyrene was used as a control material. We could demonstrate that precoating
      of the materials with fibronectin significantly increased the growth rate of
      human umbilical vein endothelial cells on these materials. Furthermore, we showed
      that human umbilical vein endothelial cells grown on polytetrafluoroethylene or
      polyurethane released more plasminogen activator inhibitor-1 and tissue type
      plasminogen activator into the conditioned media than did human umbilical vein
      endothelial cells grown on tissue culture polystyrene. Human umbilical vein
      endothelial cells cultured on polytetrafluoroethylene also deposited more
      plasminogen activator inhibitor-1 into the extracellular matrix than did control
      cells grown on tissue culture polystyrene. Our results give evidence that human
      umbilical vein endothelial cells grown on two biomaterials used to construct
      vascular grafts, namely polytetrafluoroethylene and polyurethane, produce tissue
      type plasminogen activator as well as plasminogen activator inhibitor-1, two
      major components of the fibrinolytic system also expressed by endothelial cells
      in vivo. In conclusion, our data suggest that endothelial cells grown on vascular
      grafts show functional integrity concerning their fibrinolytic system, which in
      turn might contribute to reduce the thrombogenic properties of the graft
      material.

PMID- 7776670
TI  - Transvenous versus transthoracic cardioverter-defibrillator implantation. A
      comparative analysis of morbidity, mortality, and survival.
AB  - The hypothesis that transvenous implantation of a cardioverter-defibrillator is
      associated with less morbidity than use of a transthoracic approach was
      investigated in a retrospective series of 146 patients. None of these patients
      had concomitant heart procedures, and the preoperative characteristics of the two
      groups were similar. When analyzed by actual technique used (transvenous, 57
      patients; transthoracic, 89 patients) and by the intention-to-treat method
      (transvenous, 65 patients, 8 of whom actually underwent thoracotomy; thoracotomy,
      81 patients), transvenous implantation was associated with a lower incidence of
      postoperative respiratory complications and atrial fibrillation. Total cardiac
      mortality and freedom from sudden cardiac death in the transvenous and
      transthoracic groups were comparable at 2 years.

PMID- 7776671
TI  - Successful outcome of lung transplantation is not compromised by the use of
      marginal donor lungs.
AB  - Lung transplantation is limited by a shortage of suitable donors. To address this
      shortage, we have begun using donor lungs that do not meet all of our previous
      rigorous donor criteria. Of 133 consecutive lung transplants done between June
      1991 and March 1994, 89 donors were considered ideal because they satisfied all
      of the following accepted donor criteria (group I): age younger than 55 years,
      smoking less than 20 pack-years, arterial oxygen tension greater than 300 mm Hg
      (using inspired oxygen fraction of 1.0 and positive end-expiratory pressure 5 cm
      H2O), and chest radiograph negative for infiltrate or trauma (contusion or
      pneumothorax). Thirty-seven donors failed to satisfy one of these criteria and
      seven donors failed to satisfy two of them, yielding 51 criteria denoting
      marginal status in the 44 donors in the marginal group (group II) as follows: age
      older than 55 years, 2; smoking history 20 or more pack-years, 9; unsatisfactory
      chest radiograph, 34; and arterial oxygen tension less than 300 mm Hg, 6. Sixty
      three single lung transplants were done (group I, 44 versus group II, 19)
      compared with 70 bilateral sequential transplants (group I, 45 versus group II,
      25). In 24 cases in group II, at least one of the lungs actually being implanted
      contained contusion or infiltrate. Evaluation of recipients from the two groups
      showed no significant difference in median duration of postoperative mechanical
      ventilation (3 days in both group I and group II) nor in alveolar-arterial oxygen
      gradient immediately after transplantation (group I, 304 +/- 14 mm Hg versus
      group II, 275 +/- 22 mm Hg; p = 0.266) or at 24 hours (group I, 125 +/- 12 mm Hg
      versus group II, 122 +/- 18 mm Hg; p = 0.933) (all values represent mean plus or
      minus the standard error). However, cardiopulmonary bypass was required to
      facilitate second graft insertion in bilateral sequential transplants more often
      in the marginal group (5 of 25, 20%) than in group I (6 of 45, 13%). There were
      three deaths within 30 days in group I (operative mortality, 3.4%) and none in
      group II. Currently, 74 (83.2%) of 89 remain alive in group I compared with 38
      (86.4%) of 44 in group II. On the basis of these data, we conclude that
      successful outcome of lung transplantation can be achieved with the use of
      marginal donor lungs.

PMID- 7776672
TI  - Cardiac transplant coronary artery disease. A multivariable analysis of
      pretransplantation risk factors for disease development and morbid events.
AB  - Coronary artery disease after cardiac transplantation is a major obstacle to long
      term survival. The development and progression of coronary artery disease after
      cardiac transplantation was analyzed in 217 consecutive patients undergoing
      transplantation. The actuarial freedom from any coronary artery disease (by
      angiography or autopsy) was 81% at 2 years and 20% at 8 years after
      transplantation. Coronary artery disease was more prevalent in male than female
      patients (30% versus 50% free of coronary artery disease at 5 years, p = 0.01).
      By multivariable analysis, pretransplantation risk factors identified for
      coronary artery disease included pretransplantation positive cytomegalovirus
      serologic status of the recipient (p = 0.002) and older donor age (p = 0.07).
      Progression of coronary artery disease was variable in both time of onset and
      rate. Earlier detection did not result in more rapid progression. Coronary events
      severe enough for retransplantation (n = 8) and/or death from coronary artery
      disease (n = 9) occurred in 15 patients, of whom four underwent
      retransplantation. The actuarial freedom from coronary events was 88% at 5 years
      and 79% at 8 years. By multivariable analysis, only male recipient (p = 0.05) was
      a risk factor for coronary events. Seven of the 15 patients (47%) with coronary
      events died suddenly of coronary artery disease without prior angiographic
      evidence of severe coronary disease. Coronary artery disease is progressive.
      Improved surveillance methods are required to detect the disease and institute
      timely intervention to prevent the occurrence of unanticipated death.

PMID- 7776674
TI  - Successful survival of primates receiving transplantation with "dead," nonbeating
      donor hearts.
AB  - A paucity of donor organs is the principal limitation in human heart
      transplantation. Prompted by our short-term studies of reanimating "dead" donor
      hearts in sheep, we applied the same reperfusion modifications in juvenile
      baboons to determine human applications in an anoxic arrest model (as occurs when
      non-brain-dead patients are extubated and allowed to die). Ten juvenile baboons
      (mean weight 3.6 kg) were studied. Five baboons were used as donors. After being
      anesthetized, donors were pretreated with methylprednisolone (Solu-Medrol), 50%
      dextrose, nifedipine, and prostaglandin E1 and then paralyzed and extubated.
      Donors became pulseless at 7 +/- 1 minutes and had electric arrest 9 to 18
      minutes after paralysis. The five donors were left undisturbed and warm for 15,
      22, 30, 30, and 31 minutes, respectively, after asystole. They were then given
      250 ml of 4 degrees C Roe's crystalloid cardioplegic solution via the aortic root
      and the hearts were explanted into iced Euro-Collins solution. Five baboons
      served as recipients. After donor harvest, recipients were placed on
      cardiopulmonary bypass, given prostaglandin E1, and cooled to 18 degrees C;
      circulatory arrest was instituted and the recipient's heart excised. The donor
      heart was transplanted in an orthotopic position. Before reinstitution of bypass,
      250 ml of terminal leukocyte-depleted blood cardioplegic solution was given, then
      bypass was restarted and the hearts were reperfused for 60 minutes. All animals
      were weaned from bypass without the use of inotropic agents. All animals were
      extubated within 2 to 4 hours after bypass and received standard
      immunosuppression. Peak creatine kinase MB/total creatine kinase ratio was 0.2%
      +/- 0.2%. Postoperative ejection fractions by echocardiography were 75% to 80%
      (mean 76%). Animals survived 1, 9, 13, 16, and 34 days, with three deaths caused
      by acute rejection and one each by stroke and diarrhea/dehydration. Pathologic
      findings showed no areas of fibrosis or ischemic damage. We conclude that
      successful reanimation and engraftment can be achieved with the use of the
      asystolic primate heart; this work suggests that human application is realistic
      and could greatly expand the donor pool.

PMID- 7776673
TI  - Impact of initial flush potassium concentration on the adequacy of lung
      preservation.
AB  - The effects of initial lung flushing with intracellular and extracellular fluid
      type solutions were studied in lungs stored with the University of Wisconsin
      solution. Excised Sprague-Dawley rat lungs (n = 39) were flushed first with one
      of the following solutions: (1) the University of Wisconsin solution (K+ = 140
      mmol/L), (2) modified (low potassium) University of Wisconsin solution (K+ = 20
      mmol/L), (3) phosphate buffered saline solution (K+ = 3.9 mmol/L), (4) modified
      low-potassium phosphate-buffered saline solution (K+ = 20 mmol/L), (5) modified
      high-potassium phosphate-buffered saline solution (K+ = 40 mmol/L), and (6) Euro
      Collins solution (K+ = 115 mmol/L) followed by secondary flush with storage
      solution and cold (4 degrees C) storage in University of Wisconsin solution for
      24 hours. The lungs were then reperfused in the isolated, pulsatile, blood
      perfused working lung system for 2 hours or until lung failure. Blood gas
      analysis and shunt fraction, aerodynamic parameters (airway resistance, lung
      compliance, elastic work, and flow resistive work), and total pulmonary vascular
      resistance were measured throughout the perfusion period. The mean oxygen
      tensions (in millimeters of mercury) at 30 minutes after the onset of reperfusion
      for University of Wisconsin solution, modified University of Wisconsin solution,
      phosphate-buffered saline solution, modified phosphate-buffered saline solutions
      (20 and 40 mmol/L), and Euro-Collins solution were 56.1 +/- 4.2, 72.7 +/- 9.1,
      87.7 +/- 6.9 (p < 0.01 versus University of Wisconsin solution; p < 0.01 versus
      Euro-Collins solution), 86.0 +/- 9.6 (p < 0.01 versus University of Wisconsin
      solution; p < 0.01 versus Euro-Collins solution), 87.9 +/- 7.7 (p < 0.01 versus
      University of Wisconsin solution; p < 0.01 versus Euro-Collins solution), and
      53.5 +/- 6.0, respectively. All aerodynamic parameters in the lungs flushed with
      extracellular fluid type solutions were superior to those flushed with
      intracellular fluid type solutions. We conclude that the efficacy of initial
      flushing was essential for successful lung preservation and that extracellular
      fluid type solutions were superior to intracellular fluid type solutions, at
      least for flushing the lung before storage with University of Wisconsin solution.
      Potassium concentration in flushing solution should be 20 mmol/L or less to
      obtain appropriate flushing and subsequent adequate distribution of the storage
      solution.

PMID- 7776675
TI  - Characteristics of patients surviving more than ten years after cardiac
      transplantation.
AB  - The clinical status and quality of life of 40 patients who lived or are still
      alive more than 10 years after transplantation at our institution were reviewed
      with the use of our transplant database, prospective patient examinations,
      cardiac catheterization, and exercise testing. Patient-perceived health status
      was determined with use of the Nottingham Health Profile and General Well Being
      examinations. Factors associated with longevity were determined by a Cox
      proportional hazards model. Twenty-six patients are alive and 14 have died. The
      mean age at transplant was 32.4 +/- 12 years and the current age (or age at
      death) is 46.1 +/- 12.8 years. Actuarial freedom from rejection was similar to
      that of patients surviving less than 10 years (p = 0.8), but freedom from all
      types of infection was less (p = 0.005). Immunosuppressive drugs include
      cyclosporine (11/26 patients), azathioprine (24/26), and prednisone (26/26, mean
      dose 12.7 mg/day). Catheterization hemodynamic data show well-preserved graft
      function at a mean follow-up of 11.7 +/- 3.3 years. Graft coronary artery disease
      prevalence is 51.0% +/- 8%. Exercise test results are as follows: duration 8.7 +/
      3.5 minutes (range 2 to 16 minutes), maximum heart rate/expected rate 77.3% +/-
      11% (50% to 92%), maximum systolic blood pressure 171 +/- 23 mm Hg (140 to 208 mm
      Hg), and metabolic equivalents 9.2 +/- 2.3 units (5.5 to 12.9 units), or about
      84% of predicted. Mean score on the General Well Being examination was 75.3 +/-
      21.6 (normal). Nottingham Health Profile scores were nearly normal, except for in
      the 50- to 64-year-old age group in categories of mobility, pain, sleep quality,
      and energy level. Causes of death were coronary artery disease in 7 of 14,
      infection in 4 of 14, lymphoma in 1 of 14, and nonlymphoid cancer in 2 of 14. In
      the Cox regression, variables most associated with survival (t > 2.0,
      multivariate p = 0.0005) were age at transplantation (t = 3.26), preoperative
      duration of illness (t = 3.57), postoperative cytomegalovirus infection (t =
      2.16), and ejection fraction at 12 months after operation (t = -2.62). We
      conclude that cardiac transplantation can provide patients with end-stage cardiac
      failure an acceptable general medical condition, functional status, and perceived
      quality of life well into the second decade after operation.

PMID- 7776677
TI  - The pumping and left ventricular unloading capabilities of the ventricular
      synchronous skeletal-muscle ventricle.
AB  - The pumping and left ventricular unloading capabilities of the left ventricular,
      ventricular synchronous skeletal-muscle ventricle were determined in nine
      anesthetized dogs ranging in weight from 20.7 to 31.8 kg. The ventricular
      synchronous skeletal-muscle ventricle consists of the left rectus abdominis
      muscle wrapped around a 4-mil-thick polyethylene pouch (wrapped volume 80 to 100
      ml) connected to the left ventricular apex with no valve and to the aorta via a
      prosthetic heart valve. The rectus muscle is timed to contract tetanically and
      relax during left ventricular ejection. This arrangement provides a high
      precontraction pressure for the rectus muscle and a high muscle capillary blood
      flow during skeletal muscle relaxation. The timing signal for initiation of the
      train of stimulating pulses (40/sec) was derived from the ventricular
      electrogram. The delay for the stimulus train determines the preload for the
      rectus muscle and along with the stimulus train duration determines ventricular
      synchronous skeletal-muscle ventricle stroke volume, which was measured by
      electric impedance. With unconditioned rectus muscles (70 to 120 gm) and with a
      pumping ratio of 1:3, ventricular synchronous skeletal-muscle ventricle stroke
      volume average 26.1 ml, which provided an average output of 876 ml/min. The
      normalized ventricular synchronous skeletal-muscle ventricle output was 35.6
      ml/min per kilogram of body weight. In a typical resting dog (and man), the
      normalized cardiac output is 70 ml/min per kilogram. Therefore the ventricular
      synchronous skeletal-muscle ventricle is capable of pumping 52% of the cardiac
      output (with a pumping ratio of 1:3). The optimum train delay from the apex of
      the ventricular electrogram ranged from 10 to 100 msec. The left ventricular
      ejection period averaged 309 msec, and this determines the time available for the
      rectus muscle to contract and relax. Evidence for unloading the left ventricle is
      shown by the reduced left ventricular diastolic pressure and stroke volume for
      the postassisted beats.

PMID- 7776676
TI  - Retrograde cardioplegia does not adequately perfuse the right ventricle.
AB  - Surgeons often rely primarily on retrograde cardioplegia for myocardial
      protection, because it provides adequate left ventricular perfusion even in the
      presence of coronary artery disease. Clinically, however, adequate right
      ventricular perfusion by retrograde delivery has not been demonstrated. Using
      intraoperative transesophageal echocardiography, we examined retrograde delivery
      of cardioplegic solutions by contrast echocardiography, which directly assesses
      myocardial perfusion. In 15 patients (seven having coronary bypass and eight
      having valve operations), 4 ml of sonicated Isovue medium was injected retrograde
      via a coronary sinus catheter. Myocardial perfusion was assessed quantitatively
      by visual inspection and back-ground-subtracted videodensitometric analysis. In
      five patients undergoing aortic valve replacement, right and left coronary ostial
      drainage was estimated during retrograde infusion. Before the aortic crossclamp
      was removed, myocardial oxygen extraction was calculated in all 15 patients by
      first delivering warm blood cardioplegic solution for 2 minutes in a retrograde
      fashion and then taking samples from the cardioplegia line and aortic root. This
      determined the oxygen extraction ratio across the myocardium at the end of
      retrograde delivery. Warm blood cardioplegic solution was next given antegrade,
      and 15 seconds later samples were taken from the cardioplegia line and a right
      ventricular (acute marginal) vein to determine the oxygen extraction ratio across
      the right ventricle. As assessed by contrast echocardiography, retrograde
      infusion resulted in almost four times more perfusion to the left ventricular
      free wall and septum than to the right ventricular free wall (74 +/- 2 versus 69
      +/- 2 versus 20 +/- 2, p < 0.05). In those five patients with an aortotomy the
      right ostial drainage was less than 5 ml/min whereas left ostial drainage was
      estimated at 80 ml/min during retrograde administration. Oxygen extraction across
      the myocardium supplied by retrograde infusion was low after 2 minutes.
      Conversely, when antegrade cardioplegia was started, right ventricular oxygen
      extraction rose fourfold (42% +/- 5% versus 11% +/- 1%, p < 0.05), demonstrating
      that retrograde cardioplegia had not adequately perfused the right ventricular
      myocardium. CONCLUSIONS: 1. Retrograde cardioplegia provides poor right
      ventricular myocardial perfusion as assessed by contrast echocardiography and
      coronary ostial drainage. (2) This poor perfusion is inadequate to meet
      myocardial demands as demonstrated by the high right ventricular oxygen
      extraction after a prolonged retrograde infusion. (3) Therefore surgeons must not
      rely solely on retrograde cardioplegia for right ventricular myocardial
      protection. This concept is especially important if continuous warm blood
      cardioplegia is used, because myocardial requirements are then higher.

PMID- 7776678
TI  - The influence of leukocyte filtration during cardiopulmonary bypass on
      postoperative lung function. A clinical study.
AB  - The accumulation of activated leukocytes in the pulmonary circulation plays an
      important role in the pathogenesis of lung dysfunction associated with
      cardiopulmonary bypass. Animal studies have demonstrated that the elimination of
      leukocytes from the circulation reduces postoperative lung injury and improves
      postoperative pulmonary function. We conducted a prospective randomized clinical
      study to evaluate whether postoperative lung function could be improved by use of
      a leukocyte filter during cardiopulmonary bypass. Elective coronary artery bypass
      grafting was done with a leukocyte-depleting arterial blood filter incorporated
      in the extracorporeal circuit (14 patients, leukocyte filter group) or without
      the filter (18 patients, control group). Blood samples collected at intervals
      before, during, and after operation were used for analysis of blood cell counts,
      elastase concentrations, and arterial blood gases. The use of the leukocyte
      filter caused no significant reduction in leukocyte count (p = 0.86). There were
      no differences in postoperative lung function between the groups, as assessed
      through (1) oxygenation index (290 for leukocyte filter group compared with 329
      for control group, 95% confidence interval, 286 to 372, p = 0.21), (2) pulmonary
      vascular resistance (p = 0.10), and (3) intubation time (16.6 hours for leukocyte
      filter group versus 15.7 hours for control group, 95% confidence interval, 12.1
      to 19.1 hours, p = 0.72). The levels of neutrophil elastase were significantly
      higher at the end of cardiopulmonary bypass in the leukocyte filter group (460
      microgram/L in leukocyte filter group versus 230 microgram/L in control group,
      95% confidence interval, 101 to 359 microgram/L, p = 0.003). We conclude that the
      clinical use of the present form of leukocyte-depleting filter did not improve
      any of the postoperative lung function parameters analyzed in this study.

PMID- 7776679
TI  - Blood cardioplegia enhanced with nitric oxide donor SPM-5185 counteracts
      postischemic endothelial and ventricular dysfunction.
AB  - This study tested the hypothesis that enhancement of blood cardioplegia with the
      nitric oxide donor agent SPM-5185 inhibits postischemic left ventricular and
      coronary endothelial dysfunction. Eighteen anesthetized dogs supported by total
      vented bypass were subjected to 30 minutes of normothermic ischemia followed by 4
      degrees C multidose blood cardioplegia. Hearts received either standard blood
      cardioplegia (vehicle group; n = 6), blood cardioplegia with 1 mumol/L SPM-5185
      (low-dose group; n = 6), or 10 mumol/L SPM-5185 (high-dose group; n = 6). After
      60 minutes of cardioplegic arrest, the heart was reperfused for a total of 60
      minutes, first in the beating empty state for 30 minutes and then after
      discontinuation of bypass for 30 minutes. Baseline and postischemic left
      ventricular function was assessed by the slope of the end-systolic pressure
      volume (impedance catheter) relation. Postischemic end-systolic pressure-volume
      relation was depressed by 53.7% of preischemic values in the vehicle group (from
      8.2 +/- 1.0 to 3.8 +/- 0.3 mm Hg/ml) and by 33.7% (from 9.2 +/- 1.1 to 6.1 +/-
      0.5 mm Hg/ml) in the low-dose group. In contrast, there was complete postischemic
      functional recovery in the high-dose group (from 7.6 +/- 1.1 to 7.2 +/- 1.2 mm
      Hg/ml). In coronary arteries isolated from these hearts, endothelium-dependent
      maximal relaxation to acetylcholine was impaired by 27% in the vehicle group and
      by 18% in the low-dose group, whereas the high-dose group showed complete
      endothelium-dependent relaxation. Myeloperoxidase activity, an index of
      neutrophil accumulation in postischemic myocardium, was elevated in the vehicle
      and low-dose groups (3.36 +/- 0.58 and 2.56 +/- 0.68 U/100 mg tissue) but was
      significantly reduced in the high-dose group to 1.27 +/- 0.45 U/100 mg tissue. We
      conclude that inclusion of 10 mumol/L nitric oxide donor SPM-5185 in blood
      cardioplegia improves postischemic ventricular performance and endothelial
      function in ischemically injured hearts, possibly via inhibition of neutrophil
      mediated damage.

PMID- 7776680
TI  - A 31P-nuclear magnetic resonance study of intermittent warm blood cardioplegia.
AB  - This study was designed to assess the effects of intermittent warm blood
      cardioplegia on myocardial energy metabolites, intracellular pH, and contractile
      function. The isolated blood-perfused pig hearts were divided into three groups.
      After 30 minutes of control perfusion, the hearts in group 1 (n = 10) received 90
      minutes of continuous warm (37 degrees C) blood cardioplegia; the hearts in group
      2 (n = 9) received six 5-minute periods of warm blood cardioplegia, interrupted
      by six 10-minute episodes of ischemia (37 degrees C). The hearts were then
      reperfused for 30 minutes. The hearts in group 3 underwent 150 minutes of control
      perfusion without cardioplegia or ischemic episodes. Phosphorus 31-nuclear
      magnetic resonance spectra showed that a 10-minute interruption of warm blood
      cardioplegia decreased phosphocreatine levels and intracellular pH by
      approximately 47% (p < 0.01) and 0.12 unit (p < 0.05), respectively, and
      increased inorganic phosphate levels by approximately 87%, whereas resumption of
      cardioplegia for 5 minutes resulted in almost 100% recovery of phosphocreatine
      and inorganic phosphate levels and intracellular pH. More important, subsequent
      interruptions did not result in any cumulative changes in phosphocreatine level,
      inorganic phosphate level, or intracellular pH beyond those changes observed
      after the initial cardioplegic interruption. Moreover, during reperfusion there
      were no significant differences in adenosine triphosphate and phosphocreatine
      levels among the three groups of hearts. Furthermore, hearts from groups 1 and 2
      showed comparable recovery of contractile function. These results indicate that
      six 10-minute interruptions and six 5-minute restorations of warm blood
      cardioplegia caused only mild and reversible changes in myocardial energy
      metabolites and intracellular pH and these changes were not cumulative. This
      study suggests that antegrade intermittent warm blood cardioplegia may provide as
      much myocardial protection as does antegrade continuous warm blood cardioplegia
      in the normal heart.

PMID- 7776681
TI  - Pharmacologic intervention for ischemic brain edema after retrograde cerebral
      perfusion.
AB  - Retrograde cerebral perfusion has recently been the focus of interest as a simple
      new technique of brain protection during aortic arch operations. We undertook the
      experimental protocol of 120 minutes of retrograde cerebral perfusion followed by
      antegrade reperfusion. Eighteen mongrel dogs were used. Retrograde cerebral
      perfusion was maintained at a flow rate of 150 to 250 ml/min to keep the
      perfusion pressure from 15 to 25 mm Hg. Animals were divided into three groups as
      follows: in group I, no treatment was received during and after retrograde
      cerebral perfusion; in group II, mannitol (2 gm/kg) was administered before
      cardiopulmonary bypass was restarted; and in group III, antivasospastic substance
      (1,2-bis nicotinamido]-propane) was continuously injected during and after
      retrograde cerebral perfusion (1 mg/kg per minute). Cerebral blood flow decreased
      during retrograde cerebral perfusion in all three groups. Cerebrovascular
      resistance showed marked increases 30 and 60 minutes after cardiopulmonary bypass
      was restarted in group I compared with the values in groups II and III (group I:
      3.35 +/- 0.73 and 5.00 +/- 1.57 mm Hg/ml per 100 gm per minute; group II: 1.30 +/
      0.33 and 1.03 +/- 0.17 mm Hg/ml per 100 gm per minute; group III: 1.24 +/- 0.41
      and 0.98 +/- 0.24 mm Hg/ml per 100 gm per minute). The oxygen extraction level
      was reduced by cooling, but it rose to a higher level as a result of significant
      desaturation of returned blood even in deep hypothermia during retrograde
      cerebral perfusion. Both cerebral metabolic rate of oxygen and cerebral metabolic
      rate of glucose remained at low levels during retrograde cerebral perfusion.
      Ratios of cerebral blood flow to cerebral metabolic rate of oxygen and cerebral
      blood flow to cerebral metabolic rate of glucose were markedly reduced during
      retrograde cerebral perfusion. Intracranial pressure showed significant increases
      30 and 60 minutes after cardiopulmonary bypass was restarted in group I compared
      with values in group II or group III (group I: 22.7 +/- 2.8 and 20.6 +/- 5.1 mm
      Hg; group II: 6.3 +/- 1.8 and 5.3 +/- 1.3 mm Hg; group III: 4.2 +/- 1.7 and 7.7
      +/- 2.8 mm Hg). Water content of the brain tissue in group I (77.54% +/- 0.29%)
      was significantly higher than that in group II (74.71% +/- 0.76%) or group III
      (74.14% +/- 0.48%). These data suggest that the supply of oxygen or glucose by
      retrograde cerebral perfusion is not enough to maintain sufficient cerebral
      metabolism, which may cause brain edema during antegrade reperfusion.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 7776682
TI  - Pulmonary resection for invasive Aspergillus infections in immunocompromised
      patients.
AB  - Standard antifungal medical therapy of invasive pulmonary aspergillosis that
      occurs in immunocompromised patients with hematologic diseases with neutropenia
      or in liver transplant recipients results in less than a 5% survival. In view of
      these dismal mortality rates, we adopted an aggressive approach with resection of
      the involved area of lung along with systemic antifungal therapy when localized
      invasive pulmonary aspergillosis developed in these patients. Between January
      1987 and December 1993, 14 patients with hematologic diseases and 2 liver
      transplant recipients underwent resection of acute localized pulmonary masses
      suggestive of invasive pulmonary aspergillosis a median of 7.5 days (range 1 to
      45 days) after the diagnosis was clinically suggested and confirmed by chest
      computed tomographic scans. Operative procedures done included two
      pneumonectomies, one bilobectomy with limited thoracoplasty, nine lobectomies,
      and five wedge resections (one patient with hematologic disease had two
      procedures). All patients were treated before and after the operation with
      antifungal agents. Nine (64%) of 14 patients with hematologic disease and 2
      (100%) of 2 liver transplant recipients survived the hospitalization with no
      evidence of recurrent Aspergillus infection after a median 8 months of follow-up
      (range 3 to 82 months). The five hospital deaths (all patients with hematologic
      diseases) occurred a median of 20 days after operation from diffuse alveolar
      hemorrhage in three, graft-versus-host disease in one, and multiple organ system
      failure with presumed disseminated Aspergillus infection in one. Four of the five
      deaths were in patients with allogeneic bone marrow transplants. Two of the three
      patients requiring resection of multiple foci of infection died, as did the only
      patient who was preoperatively ventilator dependent. In immunocompromised
      patients with hematologic diseases or liver transplantation with invasive
      pulmonary aspergillosis, early pulmonary resection should be strongly considered
      when the characteristic clinical and radiographic pictures appear.

PMID- 7776683
TI  - Safety and efficacy of video-assisted thoracic surgical techniques for the
      treatment of spontaneous pneumothorax.
AB  - Video-assisted thoracic surgery has been widely used in the treatment of
      spontaneous pneumothorax despite a paucity of data regarding the relative safety
      and long-term efficacy for this procedure. We reviewed 113 consecutive patients
      (68 male and 45 female patients, aged 15 to 92 years, mean 35.1) who underwent
      121 video-assisted thoracic surgical procedures during 119 hospitalizations from
      1991 through 1993. Recurrent ipsilateral pneumothorax was the most frequent
      indication for surgery and occurred in 77 patients (65%). The most common method
      of management was stapling of an identified bleb in the lung, which was
      undertaken in 105 (87%) patients. No operative deaths occurred. Complications
      included an air leak lasting longer than 5 days in 10 (8%) patients, two of whom
      required second procedures for definitive management. No episodes of
      postoperative bleeding or empyema occurred. The postoperative stay ranged from 1
      day to 39 days (median 3 days, average 4.3 days) and 99 patients (84%) were
      discharged within 5 days. Mean follow-up was 13.1 months and ranged from 1 to 34
      months. Eleven patients (10%) were lost to follow-up. Ipsilateral pneumothorax
      recurred after five of 121 procedures (4.1%). Twelve perioperative parameters
      (age, gender, race, smoking history, site of pneumothorax, severity of
      pneumothorax, operative indications, number of blebs, site of blebs, bleb
      ablation, method of pleurodesis, and prolonged postoperative air leak) were
      entered into univariate and multivariate analysis to identify significant
      independent predictors of recurrence. The only independent predictor of
      recurrence was the failure to identify and ablate a bleb at operation, which
      resulted in a 23% recurrence rate versus a 1.8% rate in those with ablated blebs
      (p < 0.001). These data suggest that video-assisted thoracic surgery is a viable
      alternative to thoracotomy for the treatment of recurrent spontaneous
      pneumothorax. It results in a short hospital stay, low morbidity, high patient
      acceptance, and a low rate of recurrence.

PMID- 7776684
TI  - Immunohistochemical detection of P53 protein is not associated with a poor
      prognosis in non-small-cell lung cancer.
AB  - Immunohistochemical detection of the p53 gene product by monoclonal antibodies
      has been shown to be associated with a poor clinical outcome in carcinomas of the
      breast and stomach. Because the prognostic relevance of p53 immunostaining in
      lung cancer is still under debate, we studied the expression pattern and clinical
      significance of such staining in 73 patients with operable non-small-cell lung
      cancer. p53 expression was detected on frozen sections with the use of monoclonal
      antibody p1801, which recognizes both the wild-type and mutant gene product
      (alkaline phosphatase-anti-alkaline phosphatase method). A tumor was considered
      p53 positive if more than 1% of the tumor cells were stained. The p53 expression
      pattern was compared with clinicopathologic parameters, and analysis of follow
      up, based on the data of 65 patients, was done by a log rank test (median
      observation time, 780 days). Nuclear p53 staining was detected in 33 of 73 non
      small-cell lung cancers (45.2%). Comparison with clinicopathologic parameters
      demonstrated that the p53 protein was detected more frequently in younger
      patients (younger than 50 years, p = 0.014), whereas no correlation was found
      with sex, tumor differentiation, tumor histologic type, or TNM stage.
      Surprisingly, follow-up analysis revealed that p53 staining was associated with
      an increased rate of disease-free survival, especially in patients with early
      stage tumor disease (p = 0.004) and in male patients (p = 0.023). Counter to
      previous studies in other solid tumors, immunocytochemical detection of p53
      expression does not predict a poor clinical outcome in non-small-cell lung
      cancer. In early-stage lung cancer it might be associated with an improved
      disease-free survival, which suggests that the majority of the detected protein
      inherits the wild-type tumor suppressor function.

PMID- 7776685
TI  - Immunotherapy with the use of tumor-infiltrating lymphocytes and interleukin-2 as
      adjuvant treatment in stage III non-small-cell lung cancer. A pilot study.
AB  - This study assesses the feasibility and toxicity of adoptive immunotherapy with
      tumor infiltrating lymphocytes and recombinant interleukin-2 in 29 patients who
      underwent resection for stage III non-small-cell lung cancer. In five patients
      cultures yielded no growth of tumor infiltrating lymphocytes. In the remaining 24
      patients (stage IIIa, 14 cases; stage IIIb, 10 cases) tumor infiltrating
      lymphocytes were in vitro expanded from surgically obtained tissue samples,
      including samples from both the tumor and surrounding lung. A number of tumor
      infiltrating lymphocytes, ranging from 4 to 70 billion cells, were reinfused
      intravenously 4 to 6 weeks after operation. Interleukin-2 was administered
      subcutaneously at escalating does for 2 weeks and then at reduced doses for 2 to
      3 months. Median survival was 14 months, and the 2-year survival was 40%. Three
      patients remain alive and disease-free at more than 2 years after operation. Two
      of these patients did not have complete resection at thoracotomy. Multivariate
      analysis showed no correlation between the factor of incomplete resection and
      survival. Intrathoracic recurrence without concomitant distant failure was
      documented in two patients only and none of the patients with incomplete
      resection (12 cases) had relapse within the thorax. The present experience
      demonstrates that adoptive immunotherapy may be applied with safety in patients
      operated on for stage III non-small-cell lung cancer and suggests that it can be
      useful, notably in patients with locally advanced disease.

PMID- 7776686
TI  - Pulmonary vascular resistance during exercise late after repair of large
      ventricular septal defects. Relation to age at the time of repair.
AB  - Postoperative pulmonary artery pressure and resistance were assessed during
      exercise in 32 patients late after repair of large ventricular septal defect with
      pulmonary hypertension. Nineteen patients had a preoperative pulmonary-to
      systemic resistance ratio of between 0.15 and 0.50 (group 1) and 13 had a ratio
      between 0.50 and 0.96 (group 2). Age at the time of operation was 0.9 to 13.0
      years (4.6 +/- 3.6) in group 1 and 0.8 to 15.8 years (4.3 +/- 4.2) in group 2.
      Age at the time of restudy was 9 to 21 years (14.5 +/- 3.0) in group 1 and 9 to
      22 years (13.5 +/- 4.1) in group 2. Pulmonary artery pressure was measured in the
      supine position at rest and during exercise, as were the measurements underlying
      the calculations of pulmonary vascular resistance. Mean pulmonary artery pressure
      was 13 to 21 mm Hg (17 +/- 2) and 10 to 26 mm Hg (20 +/- 5) in groups 1 and 2,
      respectively, at rest, and this increased to 17 to 27 mm Hg (22 +/- 3) and 14 to
      39 mm Hg (27 +/- 7) in groups 1 and 2, respectively, during exercise (p < 0.05).
      Pulmonary vascular resistance was 0.51 to 3.40 U.m2 (1.93 +/- 0.63) and 0.79 to
      3.31 U.m2 (2.05 +/- 0.65) in groups 1 and 2 at rest. It was 0.58 to 2.24 U.m2
      (1.36 +/- 0.57) and 0.81 to 3.85 U.m2 (2.18 +/- 0.97) in groups 1 and 2 during
      exercise (p < 0.01). Postoperative pulmonary vascular resistance during exercise
      correlated well with age at the time of repair in both groups (r = 0.65, p < 0.05
      in group 1; r = 0.86, p < 0.001 in group 2). These data suggest that 85% of
      patients with a preoperative pulmonary-to-systemic resistance ratio of between
      0.15 and 0.50 would have normal pulmonary vascular resistance during exercise
      when operated on at younger than 3.8 years old and 85% of those with a
      preoperative pulmonary-to-systemic resistance ratio of more than 0.50 would have
      normal pulmonary vascular resistance during exercise when operated on at younger
      than 1.1 years.

PMID- 7776687
TI  - The relationship of the outlet septum to the aortic outflow tract in hearts with
      interruption of the aortic arch.
AB  - We examined 13 hearts with concordant atrioventricular and ventriculoarterial
      connections and interruption of the aortic arch to establish and describe the
      morphologic features of the outflow tracts in relation to axial deviation and
      malalignment of the outlet septum as opposed to overriding of the arterial
      valvular orifices. Interruption in all cases but one was between the left common
      carotid and left subclavian arteries; the other arch was interrupted at the
      isthmus. A patent arterial duct and ventricular septal defect were universally
      present. When its borders were viewed from the right ventricle, the ventricular
      septal defect was perimembranous in seven hearts, had exclusively muscular
      borders in four hearts, and was doubly committed and juxta-arterial in the
      remaining two hearts. Malalignment between the muscular ventricular septum and
      outlet septum, or a fibrous raphe, as judged when the heart was viewed in its
      short axis, was found in 12 of the hearts. Posterior and leftward axial deviation
      of the outlet septum in its long axis was found in 4 of the 12 hearts and also in
      one heart that did not have short-axis malalignment. Attachments of the leaflets
      of the pulmonary valve in both right and left ventricles, however, were present
      in only one of the specimens, this being a case with a doubly committed and juxta
      arterial defect. These separate features of the outflow tract in hearts with
      interruption of the aortic arch, therefore, require thorough assessment when
      surgical management is planned. All these variable features can be assessed
      preoperatively by cross-sectional echocardiography, which should be directed
      toward defining the degree of development and alignment of the outlet septum, as
      well as the length of the subpulmonary infundibulum.

PMID- 7776689
TI  - Spinal cord protection during thoracoabdominal aneurysm resection.

PMID- 7776688
TI  - The modified Fontan operation. An analysis of risk factors for early
      postoperative death or takedown in 702 consecutive patients from one institution.
AB  - To better understand risk factors associated with early postoperative death or
      failure, we reviewed our entire experience with 702 consecutive patients who had
      the modified Fontan operation at the Mayo Clinic between October 1973 and
      December 1989. The event rate for takedown of repair or death during the initial
      hospitalization or within 30 days of the operation was 14.8% (successful takedown
      of the repair, n = 6; death, n = 98). To identify variables associated with early
      death or Fontan takedown, we analyzed 33 clinical and hemodynamic variables in a
      univariate and multivariate manner. On the basis of a stepwise logistic
      discriminant analysis, patients who were younger and operated on before 1980 with
      a higher preoperative pulmonary artery mean pressure, asplenia, higher
      intraoperative (after Fontan operation) right atrial pressure, longer aortic
      crossclamp time, and pulmonary artery ligation were more likely to have the
      outcome event of interest (p values < 0.05). A new variable, corrected pulmonary
      artery pressure (that is, mean preoperative pulmonary artery pressure divided by
      the ratio of pulmonary to systemic flow if the ratio of pulmonary to systemic
      flow is greater than 1.0), was significantly associated with the outcome event
      univariately (p = 0.002), but was no more predictive than the preoperative
      pulmonary artery mean pressure. Variables less predictive of the outcome event in
      this analysis included multiple prior operations, polysplenia syndrome, complex
      anatomy other than asplenia syndrome, and systemic atrioventricular valve
      regurgitation. These results represent the largest single-institution review of
      the Fontan operation and suggest that some anatomic and hemodynamic variables
      previously predictive of poor early outcome have been nullified by current
      operative methods.

PMID- 7776690
TI  - Successful operation for solitary fibrous tumor of the epicardium.

PMID- 7776691
TI  - Right atrial myxoma originating from the tricuspid valve.

PMID- 7776692
TI  - The effects of the rate of reoxygenation on the recovery of hypoxemic hearts.

PMID- 7776693
TI  - Impact of nitric oxide inhalation on right ventricular failure after implantation
      of Novacor left ventricular assist system.

PMID- 7776694
TI  - Malfunctioning of vascular staple cutter during thoracoscopic lobectomy.

PMID- 7776695
TI  - Fibrous tissue ring: an uncommon cause of severe prosthetic valve stenosis.

PMID- 7776696
TI  - Polyradiculoneuritis as an initial manifestation of bronchial carcinoma.

PMID- 7776697
TI  - Minimizing chest wall trauma in video-assisted thoracic surgery.

PMID- 7776698
TI  - Solitary coronary ostium and aberrant coursing left coronary arteries:
      unfavorable anatomic anomaly in a case of aortic valve replacement.

PMID- 7776699
TI  - Primary elective open sternum with only Steri-Drape film coverage after cardiac
      operations in pediatric patients.

PMID- 7776700
TI  - Infections and pathologic factors in the donor lung.

PMID- 7776701
TI  - Modified Senning operation for cavopulmonary connection with autologous tissue.

PMID- 7776702
TI  - N-acetyl-beta-D-glucosaminidase activity within BAL from macaques exposed to
      generic coal dusts.
AB  - N-acetyl-beta(beta)-D-glucosaminidase is a lysosomal enzyme secreted by alveolar
      macrophages in response to phagocytosis of particulate material. Alveolar
      macrophages participate in the degradation and fibrosis of pulmonary tissue that
      results in pneumoconiosis. Known quantities of four characterized respirable
      dusts were bronchoscopically placed into the right caudal lung lobe of macaque
      monkeys. Bronchoalveolar lavage (BAL) samples were collected from dust-exposed
      right lung and unexposed left lung of the same individuals at 2-week intervals
      for 12 weeks after dust instillation. The samples were tested for N-acetyl-beta-D
      glucosaminidase activity to determine if the enzyme levels could serve as an
      indicator of pulmonary injury induced by generic coal dusts when compared to
      known fibrogenic and nuisance dusts. Installation of generic quartz, anthracite,
      or TiO2 dusts produced significant elevations of enzyme activity and increased
      numbers of macrophages in the dust-exposed lobes. Elevations in enzymatic
      activity and macrophage numbers were greatest in response to generic quartz dust.
      These results suggest that quantitative levels of N-acetyl-beta-D-glucosaminidase
      activity may be a useful indicator of acute and chronic lung injury following
      exposure to fibrogenic and nonfibrogenic dusts.

PMID- 7776703
TI  - Pulmonary neuroepithelial bodies in neonatal and adult dogs: histochemistry,
      ultrastructure, and effects of unilateral hilar lung denervation.
AB  - In neonatal dogs, neuroepithelial bodies (NEB) are located in the distal lung.
      They consist of closely packed and granulated epithelial cells showing a positive
      immune reaction to serotonin and carrying well-developed apical microvilli. They
      make close contact with capillaries and form morphologically afferent synaptic
      junctions with intracorpuscular nerve endings. Since most nerve endings
      degenerate after hilar lung denervation, they are carried by extrinsic, most
      likely vagal, sensory nerve fibers. We conclude that pulmonary NEB probably are
      receptor organs, sampling the inspired air and secreting bioactive substances.
      These might have a local vaso- or bronchoactive regulatory effect, or could be
      carried to other body parts via the blood vessels. In addition, NEB might induce
      integrative reflexes via the central nervous system. The NEB intracorpuscular
      nerve endings also show spontaneous degeneration. This, in addition to the
      scarcity of NEB in the distal lungs of adult dogs, strongly suggests that the
      pulmonary NEB are particularly important during the perinatal period of life.

PMID- 7776704
TI  - Differential cell count and lymphocyte subsets in bronchoalveolar lavage during
      pneumonia with and without peripheral neutropenia.
AB  - One hundred immunocompromised HIV negative patients with microbiologically
      positive pneumonia underwent bronchoalveolar lavage (BAL) studies. Thirty cases
      showed peripheral neutropenia (< 1000 neutrophils/microL), 70 did not. The total
      cell number in BAL, the differential cell counts, and the lymphocyte subsets
      (CD4, CD8, CD19, CD57) were measured. Patients with pneumonia and normal or
      elevated peripheral neutrophils had a significantly increased total number of
      cells in BAL compared to patients with peripheral neutropenia (3.2 +/- 2 vs 1.3
      +/- 0.6 x 10(5) cells/ml2 lavage fluid, p < 0.01). Ninety percent of the BAL
      differential cell counts obtained in patients exceeding 1000 neutrophils/microL
      showed a lymphocytic and/or neutrophilic alveolitis, whereas only 54% of patients
      with peripheral neutropenia displayed abnormal counts (p < 0.01). Yet the typical
      pattern of neutrophilic alveolitis was found more often for peripheral neutrophil
      counts over 1000/microL with high significance (p < 0.0001). Abnormal BAL cell
      patterns for neutropenic patients uniformly showed a lymphocytic alveolitis, only
      10% additionally conformed with the pattern of neutrophilic alveolitis. Patients
      with pneumonia with and without peripheral neutropenia had similar findings in
      BAL lymphocyte subsets and exhibited a reduced CD4/CD8 ratio compared to controls
      (p < 0.05). The high susceptibility of severe neutropenic patients to pulmonary,
      especially fungal infections may be explained by the local lack of neutrophils.

PMID- 7776705
TI  - Forced midexpiratory time: reference values and the effect of cigarette smoking.
AB  - BACKGROUND: Forced midexpiratory time (FET25-75%), the time required to exhale
      from 25 to 75% of forced vital capacity (FVC), has been advocated as a relatively
      volume-independent measure of obstruction. Previous estimates of normal FET25-75%
      have not systematically studied the effect of age, height, sex, and smoking
      history. METHODS: We analyzed flow-volume loops from 369 normal lifetime
      nonsmokers and smokers, a random sample of the population of Michigan. Linear
      models including age and/or height were considered, with and without logarithmic
      transformation. RESULTS: The best models used age, or age and height, and no
      transformation. Age and height contributed much less to the variability of FET25
      75% than to spirometric flows previously investigated. The largest r2 was found
      in the male smokers, with the largest contribution from age, suggesting a smoking
      effect. CONCLUSIONS: As age was the major contributor to the value of FET25-75%
      and that contribution was small, we suggest the use of simplified age-stratified
      reference values derived from our data.

PMID- 7776706
TI  - Ozone exposure suppresses epithelium-dependent relaxation in feline airway.
AB  - We examined the effect of exposure to ozone on the epithelium-dependent
      relaxation (EpDR) of bronchioles evoked by electrical field stimulation (EFS) in
      a feline model with hyperresponsive airways induced by exposure to ozone. Airway
      responsiveness was assessed by measuring the increases in total pulmonary
      resistance (RL) produced by aerosolized acetylcholine (ACh) in vivo. Airway
      responsiveness was also measured in vitro in dissected bronchiolar ring
      preparations. Exposure to ozone (3 ppm, 2h) significantly increased the airway
      responsiveness in vivo. The concentration of ACh required increasing RL to 200%
      of the baseline value, decreased from 1.97 mg/ml (GSEM 1.94) to 0.12 mg/ml (GSEM
      1.77, p < 0.01) after exposure to ozone. EFS evoked atropine-, guanethidine-, and
      tetrodotoxin-resistant relaxations in the control bronchiolar rings precontracted
      by 5-hydroxytryptamine. Such relaxation was significantly suppressed by the
      mechanical denudation of epithelium, confirming that it was epithelium dependent.
      The amplitude of the EpDR was significantly suppressed in the animals exposed to
      ozone. These results suggest that EpDR is present in cats, and that its
      inhibition may contribute to the development of airway hyperresponsiveness.

PMID- 7776708
TI  - Physiotherapy and physical therapy at Mayo.

PMID- 7776707
TI  - Cellular and mediator profile in bronchoalveolar lavage of guinea pigs after
      toluene diisocyanate (TDI) exposure.
AB  - Toluene diisocyanate (TDI) is a volatile, highly reactive chemical widely used as
      a polymerizing agent in the production of polyurethane foams, lacquers,
      adhesives, and other items. Repeated airway exposures in the workplace to TDI may
      cause a concentration-dependent risk of developing chronic airway disorders.
      Different pathomechanisms are involved. IgE-mediated sensitization and irritative
      effects were clearly demonstrated in exposed subjects as well as in animals. In
      this study we examined the cellular and mediator composition in bronchoalveolar
      lavage fluid (BALF) of guinea pigs (eight in each group) exposed to TDI (10, 20,
      or 30 ppb) on 5 consecutive days for 2 hours each. Increased numbers of
      eosinophils and significantly elevated levels of LTB4 and LTC4/LTD4/LTE4 were
      obtained in BALF of all exposed animals when compared to nonexposed control
      animals. PGD2 and TXB2 remained unaltered in BALF. Stimulation of BALF cells of
      exposed and control animals with Ca-ionophore A23187 and arachidonic acid induced
      an increased generation of LTB4. Furthermore, BALF cells of the exposed animal
      groups generated immunoreactive LTC4/LTD4/LTE4, whereas controls did not show
      peptido-leukotriene formation in the presence and absence of stimuli. Our data
      clearly demonstrate an influx of eosinophils into the airways associated with
      mediator release and higher cellular responsiveness after TDI exposure.

PMID- 7776709
TI  - Early and late survival after surgical treatment of culture-positive active
      endocarditis.
AB  - OBJECTIVE: To describe a 30-year experience with surgically treated culture
      positive active endocarditis. DESIGN: We retrospectively reviewed the
      microbiologic, clinical, and operative findings and the survival data in 151
      patients with culture-positive active endocarditis encountered between 1961 and
      1991. RESULTS: The mean age of the 110 male and 41 female patients was 49.8
      years. Native valve endocarditis was present in 86 patients, and prosthetic valve
      endocarditis (PVE) was diagnosed in 65. The aortic valve was involved in 62% of
      patients, the mitral valve in 25%, and both valves in 10%. The operative
      mortality was 26%. The most important univariate determinants of mortality were
      an abscess at operation (P = 0.01) and renal failure (P = 0.03). A trend toward a
      higher mortality with PVE and staphylococcal infection was noted. For hospital
      survivors, the 5- and 10-year survival was 71% and 60%, respectively. Univariate
      determinants of an adverse long-term survival were annular abscess (P = 0.01),
      renal impairment (P = 0.01), heart failure (P = 0.02), and aortic valve
      involvement (P = 0.05). On multivariate analysis, the most important adverse
      determinants of long-term survival were heart failure (P = 0.02), renal
      impairment (P = 0.02), and PVE (P = 0.03). Thirty patients required a subsequent
      reoperation; of these, seven required a second and two a third operation. The
      most common reason for reoperation was periprosthetic regurgitation without
      infection (N = 19). Four operations were performed for recurrent endocarditis. At
      5 and 10 years, the risk of reoperation was 23% and 36%, respectively.
      CONCLUSION: Although surgical treatment of culture-positive active endocarditis
      is still associated with substantial mortality, the long-term outcome of hospital
      survivors is excellent. Subsequent reoperations for periprosthetic leak are
      common, but recurrent infection is uncommon.

PMID- 7776710
TI  - Urinary tract anomalies detected by prenatal ultrasound examination at Mayo
      Clinic Rochester.
AB  - OBJECTIVE: To determine the frequency of fetal urinary tract anomalies and to
      characterize the types of such abnormalities detected on ultrasonography and the
      outcome of affected patients during a 15-year period at our institution. DESIGN:
      We retrospectively reviewed the findings on maternal prenatal ultrasound
      examinations and the postnatal medical records of 56 children with urinary tract
      abnormalities detected by prenatal ultrasound examination at Mayo Clinic
      Rochester from November 1979 to June 1994. RESULTS: Of the 56 children, 18 (32%)
      had severe urinary tract anomalies in conjunction with oligohydramnios, pulmonary
      hypoplasia, and perinatal death (Potter's syndrome). The other 38 infants had
      various urinary tract abnormalities--most commonly, isolated hydronephrosis and
      multicystic dysplasia of the kidney. Six of the 38 children had more than one
      renal abnormality detected prenatally. Reflux was noted in association with
      prenatally detected urinary tract abnormalities in 4 of 32 newborns (12%) who
      underwent voiding cystourethrography. In fetuses with normal amniotic fluid
      volume, the perinatal outcome was good. Children with lower urinary tract
      obstruction had evidence of more severe renal dysfunction than did those with
      involvement at more proximal levels. The presence or absence of urinary tract
      obstruction postnatally could not be determined reliably on the basis of prenatal
      ultrasound appearance. CONCLUSION: In this study, more than half of all
      prenatally detected urinary tract abnormalities were isolated hydronephrosis or
      multicystic dysplasia of the kidney. Postnatal renal function could not be
      reliably predicted on the basis of prenatal ultrasound findings.

PMID- 7776711
TI  - Treatment of stable chronic demyelinating polyneuropathy with 3,4
      diaminopyridine.
AB  - OBJECTIVE: To determine whether 3,4-diaminopyridine (3,4-DAP) would improve
      clinical or electrophysiologic function in patients with stable chronic
      demyelinating polyneuropathy. DESIGN: We conducted a prospective, randomized,
      placebo-controlled, blinded, crossover study of 3,4-DAP in 34 patients with
      demyelinating polyneuropathy. MATERIAL AND METHODS: Of the 17 men and 17 women,
      who were 21 to 80 years of age, 27 had hereditary motor and sensory neuropathy
      type I and 7 had acquired demyelinating polyneuropathy. Treatment consisted of
      stepped doses of 3,4-DAP (increasing to 20 mg four times daily) or placebo for 4
      days. Pretreatment and posttreatment determination of the Neurologic Disability
      Score (NDS); isometric muscle strength testing; median, ulnar, and peroneal nerve
      conduction studies; and measurement of serum 3,4-DAP were performed. Quantitative
      computer-assisted sensory examinations were done in five patients. RESULTS: The
      results for the final day of treatment with 3,4-DAP or placebo and the
      differences between pretreatment and posttreatment findings for total NDS,
      sensory NDS, isometric muscle strength testing, compound muscle action potential
      amplitude, sensory nerve action potential amplitude, motor and sensory conduction
      velocities, and vibration and cold detection thresholds did not vary
      significantly. A small improvement of 4 points in the motor NDS (P < 0.05) was
      found. Five patients with electrophysiologic conduction block had no significant
      reduction in the degree of block. CONCLUSION: Because no improvement was noted in
      most measurements of neurologic function, despite use of high doses of drug, 3,4
      DAP is unlikely to be beneficial in the treatment of stable chronic demyelinating
      polyneuropathy.

PMID- 7776712
TI  - Hamilton Smith--Nobel Prize winner in medicine or physiology.

PMID- 7776713
TI  - Right ventricular dysplasia: the Mayo Clinic experience.
AB  - OBJECTIVE: To determine the initial clinical manifestations and echocardiographic
      features of right ventricular dysplasia as encountered in a major cardiovascular
      referral center in the United States. DESIGN: We conducted a retrospective study
      of cases of right ventricular dysplasia diagnosed at the Mayo Clinic between
      January 1978 and January 1993. MATERIAL AND METHODS: In an institutional data
      base search, we identified 20 patients with right ventricular dysplasia.
      Echocardiographic, electrophysiologic, Holter monitoring, cardiac
      catheterization, and endomyocardial biopsy results were analyzed. The mean
      duration of follow-up was 7 years. RESULTS: In the 12 female and 8 male patients
      (mean age, 30 years; range, 3 to 60), the initial manifestations of right
      ventricular dysplasia included ventricular arrhythmia (45%), congestive heart
      failure (25%), heart murmur (10%), asymptomatic (10%), complete heart block (5%),
      and sudden death (5%). First-order relatives were affected in 30% of the
      patients. Ventricular tachycardia with morphologic features of left bundle branch
      block was inducible in seven of nine patients. On Holter monitoring, all but 2 of
      15 patients studied had frequent ventricular ectopic activity (Lown grade 2 or
      more). Characteristic fatty infiltration of the myocardium was present in 7 of 13
      right ventricular biopsy specimens. Inordinate right ventricular enlargement was
      present in 60% of the patients at first echocardiographic assessment and in two
      other patients on follow-up assessment. Variable left ventricular involvement was
      noted in 50% of the cases. During the follow-up period, four patients died: two
      died suddenly, one died of congestive heart failure, and one died of respiratory
      failure after a coronary artery bypass operation. Of the 16 living patients, 8
      are doing well, 3 have an implanted cardiac defibrillator, 3 are receiving
      antiarrhythmic agents, and 2 have undergone cardiac transplantation because of
      progressive biventricular failure. CONCLUSION: Patients with right ventricular
      dysplasia have varied initial manifestations and a high frequency of serious
      cardiovascular symptoms and complications.

PMID- 7776714
TI  - Medical coverage for multievent sports competition: a comprehensive analysis of
      injuries in the 1994 Star of the North Summer Games.
AB  - OBJECTIVE: To determine the incidence and type of requests for medical assistance
      and the treatment required in 21 sports at the 1994 Star of the North Summer
      Games and to develop a plan, based on these findings, for efficient allocation of
      medical supplies and staff. DESIGN: We reviewed our experience with a large
      multisport amateur athletic event and analyzed the pattern of injuries for
      participants in the various sports. MATERIAL AND METHODS: Injury evaluation forms
      and medical supply kits were given to the health-care volunteers, who received
      preliminary instructions on classifications and definitions of injuries and on
      appropriate completion of the forms. When a medical contact occurred, an
      evaluation form was completed. The data from these forms were subsequently
      compiled and analyzed. RESULTS: Of 6,243 athletes who participated in the 1994
      Star of the North Summer Games, 55 (0.88%) received medical attention (2
      officials also required medical assistance). The sports with the greatest number
      of medical contacts were soccer and track and field--31 and 16 contacts for
      medical assistance, respectively. The lower extremities were the anatomic site
      most frequently involved in injury (62% of the medical contacts). The most common
      types of injury were contusions, strains, and sprains. CONCLUSION: Because few
      injuries were sustained and most were of minor severity, basic medical supplies
      (such as ice bags and compression wraps) were sufficient. For locations with a
      scarcity of medical personnel, a triage system can be established in which
      athletic trainers or registered nurses manage the initial assessments and refer
      cases, as needed, to physicians for specialized care. An effective communication
      system can also considerably reduce volunteer hours.

PMID- 7776715
TI  - Nicotinic acid decreases serum thyroid hormone levels while maintaining a
      euthyroid state.
AB  - OBJECTIVE: To evaluate the effects of nicotinic acid on serum thyroid hormone
      levels in the absence of systemic illness or hepatic dysfunction. DESIGN: We
      determined the effect of treatment with nicotinic acid on serum thyroid hormone
      levels in one female and four male patients (mean age, 44.4 years) with
      hyperlipidemia. MATERIAL AND METHODS: In the five study patients, we measured
      serum lipids in conjunction with serum thyroxine (T4), triiodothyronine (T3)
      resin uptake, T3, free T4, thyroid-stimulating hormone (TSH), and thyroxine
      binding globulin before, during, and after treatment with nicotinic acid.
      RESULTS: Serum lipid levels responded appropriately to nicotinic acid treatment.
      Thyroid function studies done a mean of 1.3 years (range, 0.5 to 3.5) after
      initiation of nicotinic acid therapy (mean daily dose, 2.6 +/- 0.7 g) revealed
      significant decreases in serum levels of total T4 (21%), free T4 index (16%), T3
      (13%), and thyroxine-binding globulin (23%) (P < 0.02), whereas no significant
      changes were noted in free T4, T3 resin uptake, and TSH levels. During the course
      of treatment, the patients, who were carefully questioned, had no symptoms of
      hypothyroidism. Hypothyroidism was further excluded in three patients who had a
      normal serum TSH response to administration of thyrotropin-releasing hormone. In
      two patients, measurements of thyroid function returned to pretreatment levels
      after discontinuation of nicotinic acid therapy. No patient had significant
      abnormalities in liver-associated enzymes or evidence of systemic illness during
      the course of treatment. CONCLUSION: These results suggest that nicotinic acid
      decreases serum thyroid hormone concentrations while maintaining a euthyroid
      state. This effect may be mediated through reduction in thyroxine-binding
      globulin, but other mechanisms may also be involved.

PMID- 7776717
TI  - Rheumatoid vasculitis manifesting as intra-abdominal hemorrhage.
AB  - Rheumatoid vasculitis, an extra-articular component of rheumatoid arthritis,
      causes a wide spectrum of manifestations that range from clinically insignificant
      to life-threatening disease. As a systemic necrotizing arteritis, rheumatoid
      vasculitis is usually characterized by end-organ ischemia. Herein we describe a
      patient with abdominal pain and syncope due to intra-abdominal hemorrhage from a
      ruptured aneurysm of the inferior pancreaticoduodenal artery in the setting of
      rheumatoid vasculitis. Although the intra-abdominal hemorrhage was the unusual
      manifestation of rheumatoid vasculitis in this patient, he had a history of prior
      extra-articular rheumatoid disease, including pulmonary fibrosis and Sjogren's
      syndrome with associated parotid lymphoproliferative disease. In patients with
      rheumatoid arthritis who have abdominal pain and an unexplained rapidly
      decreasing hemoglobin concentration, the diagnosis of intra-abdominal hemorrhage
      from a ruptured visceral aneurysm due to rheumatoid vasculitis should be
      considered, even in the absence of other indications of systemic vasculitis.

PMID- 7776716
TI  - Chronic hepatitis C and skin diseases: a review.
AB  - OBJECTIVE: To emphasize the ongoing role of chronic hepatitis C virus (HCV)
      infection in the cause or exacerbation of severe dermatologic disorders. DESIGN:
      We present two case reports to outline the pertinent findings in hepatitis C
      related cryoglobulinemia, leukocytoclastic vasculitis, and lichen planus and
      discuss the main disorders associated with chronic HCV infection. RESULTS:
      Chronic HCV infection has recently been recognized in association with various
      skin disorders. The most commonly reported association is the triad of
      leukocytoclastic vasculitis, cryoglobulinemia, and chronic HCV infection. Other
      cutaneous disorders associated with HCV infection include porphyria cutanea
      tarda, lichen planus, erythema nodosum, urticaria, erythema multiforme, and
      polyarteritis nodosa. CONCLUSION: Patients with onset or exacerbation of these
      disorders should undergo assessment for HCV infection.

PMID- 7776718
TI  - Schnitzler's syndrome: two case reports and review of the literature.
AB  - Schnitzler's syndrome is a combination of chronic urticaria, fever of unknown
      origin, disabling bone pain, hyperostosis, increased erythrocyte sedimentation
      rate, and macroglobulinemia. Since it was first described in 1974, only 26 cases
      have been published in the literature. In this report, we describe two additional
      cases and review the clinical features and pathogenesis of this uncommon
      syndrome.

PMID- 7776719
TI  - Commonly asked questions about thyroid function.
AB  - Thyroid function abnormalities in asymptomatic outpatients are common. When a
      patient is found to have an abnormality in thyrotropin (thyroid-stimulating
      hormone) or free or total thyroxine (T4), a review of the patient's medications
      and a careful neck examination will usually provide the explanation. Further
      diagnostic laboratory studies should include additional tests of T4 or
      thyrotropin. Determining the presence of antimicrosomal antibodies is useful for
      further assessment of "subclinical" hypothyroidism, and measures of protein
      binding (T4-binding capacity or T4-binding protein electrophoresis) help confirm
      a suspected congenital or acquired abnormality of T4 binding. Recognition of
      euthyroid hypothyroxinemia and hyperthyroxinemia is important in order to avoid
      intervention with inappropriate treatment. Management of subclinical
      hypothyroidism and hyperthyroidism necessitates clinical judgment about the
      patient's symptom profile and risks for long-standing or progressive thyroid
      dysfunction.

PMID- 7776720
TI  - Transcutaneous drug delivery: a practical review.
AB  - OBJECTIVE: To describe the advantages, disadvantages, practical considerations,
      and future developments of transcutaneous drug delivery. MATERIALS AND METHODS:
      The physiochemical properties of the drug preparation that are factors in the
      effectiveness of transcutaneous transport are drug stability or volatility, use
      of a solvent carrier or vehicle, use of a penetration enhancer, and type of
      delivery device. Because a drug should remain on the skin without evaporating or
      becoming otherwise inactive, it is suspended in a vehicle--any gel, lotion, or
      paste used to apply the drug to the skin. Penetration enhancers include several
      compounds that are mixed into vehicles to alter the molecular environment of the
      epidermis and facilitate absorption. The delivery system itself occasionally
      proves to be the ultimate determinant of transdermal drug flow. RESULTS: The
      advantages of transcutaneous drug delivery are avoidance of the gastrointestinal
      tract and hepatic first-pass biotransformation and metabolism, control of
      absorption, availability of multiple skin sites to avoid local irritation and
      toxicity, and improved patient compliance. The disadvantages include the
      potential for localized irritant and allergic cutaneous reactions, systemic
      toxicity, and difficulties associated with the time necessary for a drug to
      diffuse through the skin. CONCLUSION: Transdermal drug regimens are safe and
      effective. They provide clinicians the opportunity to offer more therapeutic
      options to their patients to optimize their care.

PMID- 7776722
TI  - New directions for pulse oximetry in sleep disorders.

PMID- 7776721
TI  - 39-Year-old man with fever, cough, and dyspnea.

PMID- 7776723
TI  - Assisted suicide and the savings clause.
AB  - In December 1994, the Michigan Supreme Court decided a group of cases comprising
      constitutional challenges to a Michigan statute against assisted suicide and
      prosecutions of Dr. Jack Kevorkian for his role in two incidents of suicide. The
      court rejected arguments that the statute infringed a right of "personal
      autonomy" under the Fourteenth Amendment to the US Constitution; it noted that,
      although US Supreme Court opinions indicate that decisions to withdraw or reject
      life-sustaining treatment are constitutionally protected, a legal difference
      exists between permitting death to occur by natural means and taking affirmative
      steps to end life. The Michigan court also decided that Kevorkian could not be
      charged with murder for supplying only the means by which suicide occurred, but
      he could be charged with a common law crime of assisting in suicide although the
      statute outlawing such actions became effective only after the suicides occurred.
      Because suicide was a crime under the prerevolutionary English Common Law, which
      forms the foundation of Michigan law, assisting in suicide is also a residual
      crime under the "savings clause" of the Michigan statutes, which incorporates
      common law crimes into the law of that state when no superseding statute exists.

PMID- 7776724
TI  - Ventilator care beyond the intensive-care unit.

PMID- 7776725
TI  - Surgical therapy for infective endocarditis.

PMID- 7776728
TI  - Kveim test.

PMID- 7776727
TI  - Management of fetal hydronephrosis.

PMID- 7776726
TI  - Fetal hydronephrosis.

PMID- 7776729
TI  - Technology and enlightenment philosophy.

PMID- 7776730
TI  - [Is medical care adequate in cases of the common cold? The result of an
      evaluation in 8 health centers].
AB  - BACKGROUND: In this study the quality of health care provided in cases of the
      common cold and similar was studied. These diseases were selected to seek
      opportunities for improvement for health care professionals by the nominal group
      technique. METHODS: A retrospective study of the health care procedures was
      carried out in randomized sample of cases attended in one month in eight health
      care centers randomly selected from among the centers in the Autonomic Community
      of Murcia. A total of 400 cases (50 per center) were studied with the variability
      among centers with regard to the fulfillment of consensus criteria (physical
      examination, treatment registration, and appropriate prescription) and the
      relationship with certain characteristics of the center (university, urban) and
      the health care staff (general physicians, or pediatricians) being analyzed.
      RESULTS: Great variability was found from one center to another regarding the
      criteria of physical examination and prescription, the simultaneous low
      fulfillment of the three criteria of quality (from 2 to 60%), the positive
      association between physical examination and the correct prescription (p < 0.01)
      and a higher level of quality in urban centers (OR: 7.5, p < 0.00001).
      Antibiotics were prescribed in 89% (CI 95%: +/- 4.6) of the cases with
      inappropriate prescription in 47% of the total (CI 95%: +/- 4.9; range among
      centers: from 4.1 to 75.7%). CONCLUSIONS: The quality of health care towards the
      common cold may be markedly improved in most of the centers studied. The
      frequency of the use of antibiotics and the lack of physical examination are the
      basis of problematic and ineffective performance, being more frequently observed
      in rural and semirural centers.

PMID- 7776731
TI  - [Energy balance and caloric profile in the elderly obese or in those with
      overweight compared to those of normal weight].
AB  - BACKGROUND: Elderly obese people have higher morbidity and mortality rates than
      those of normal weight and thus deeper knowledge of the problem of obesity is
      required in order to establish measures for prevention and correction. The aim of
      this study was to analyze the differences in the energetic ingestion and caloric
      profile in the diets of elderly patients based on their body mass index (BMI).
      METHODS: A collective of 127 elderly patients (44 institutionalized and 83 not)
      from 65 to 89 years of age were studied being grouped as: overweight-obese
      elderly (BMI > 25 kg/m2) and normal weight elderly patients (BMI < 25 kg/m2). The
      ingestion of energy and caloric profile of their diets was calculated in both
      groups by the "precise individual weight" method (in the institutionalized
      patients) and by the "register of food consumption" (in non institutionalized
      patients). The data of energetic ingestion were validated by comparison with the
      energy spent calculated on the basis of weight, age, and the daily activities of
      each patient. RESULTS: No significant differences were found between the
      energetic ingestion of overweight and obese elderly persons and those of normal
      weight, although the former had a more unbalanced caloric profile, with greater
      protein contribution and lesser carbohydrate contribution to total calories. It
      was also found that overweight and obese elderly patients underevaluate their
      energetic ingestion more than those of normal weight. CONCLUSIONS: The main
      difference observed between overweight-obese elderly patients with respect to
      those of normal weight was in the composition of their diets more than in the
      total energetic consumption.

PMID- 7776732
TI  - [The quantification of human immunodeficiency virus viremia in patients with
      rapid and slow progression of the disease].
AB  - BACKGROUND: The natural course of the human immunodeficiency virus type 1 (HIV-1)
      infection is very variable. The factors which appear to determine the speed of
      immunodeficiency progression are multiple, although the virulence of the
      predominant viral strain seems to be one the main factors. The plasmatic viremia
      in individuals with rapid and slow HIV-1 progression was analyzed in an attempt
      to establish the degree of correlation between HIV-1 replication and the natural
      course of the disease. METHODS: Forty-two samples from 34 seropositive patients,
      11 with rapid progression criteria (< 5 years from acute infection and CD4+
      lymphocytes < 0.2 x 10(9)/l) and 23 with slow progression (> 7 years from
      demonstrated infection and > 0.5 x 10(9) CD4+ lymphocytes/l) were studied. The
      plasmatic viremia was quantified by a new method of plasma DNA genetic
      amplification, denominated the branched DNA (bDNA) technique. As a reference
      circulating p24 was determined and the presence of several proviral regions were
      studied in peripheral blood lymphocytes by polymerase chain reaction (PCR).
      RESULTS: The presence of RNA molecules was detected in plasma of 7 (58.3%) out of
      12 samples of rapid progression (RP) patients by bDNA. To the contrary, this was
      negative in 30 samples from slow progression (SP) patients. Four of the 5
      negative RP samples corresponded to patients who had taken antiretroviral drugs
      at the time of the study. The p24 antigenemia was positive in 5 (41.6%) from the
      RP patients and in none of the SP patients. The presence of gag, pol and env
      sequences was positive by PCR in all RP patients and in most of the SP patients.
      However, repeatedly negative results by PCR were observed in 5 SP samples for all
      or some of the genomic regions studied. CONCLUSIONS: Patients with rapid
      progression of HIV-1 have higher plasmatic viremia than subjects with slow
      disease progression.

PMID- 7776733
TI  - [Do we know how to treat the common cold?].

PMID- 7776734
TI  - [The quality of medical care].

PMID- 7776735
TI  - [Oligoamnios associated with the use of magnesium dipyrone].
AB  - Oligohydramnios induced by indomethacin has been documented both clinically and
      experimentally. The same is not true for all the drugs inhibiting the synthesis
      of prostaglandins. The case of a full term pregnant woman diagnosed with renal
      cholic and treated with high doses of magnesium dipyrone who developed
      echographically diagnosed oligohydramnios at 60 h of initiation of the treatment
      is presented. Delivery was induced by the double intracervical application of 0.5
      mg of prostaglandin E2 over an interval of 24 h. At 35 h of the discontinuation
      of magnesium dipyrone the patient was echographically reevaluated with the volume
      of the amniotic fluid being found to be normal. Although no reports have been
      found concerning oligohydramnios by magnesium dipyrone, the negative effect of
      this drug on urine flow in healthy individuals is known. In the absence of other
      hypotheses, the authors suggest that the use of high doses of this drug may
      significantly reduce fetal urine flow and be responsible for a drastic reduction
      in amniotic fluid. The adverse effect was determined as possible by evaluation of
      secondary effects by Naranjo's algorithm.

PMID- 7776736
TI  - [Alcohol consumption indicators in Spain].

PMID- 7776737
TI  - [Stress and cardiovascular problems].

PMID- 7776738
TI  - [Myoclonia and psoriasiform syphilids in a case of late syphilis].

PMID- 7776739
TI  - [CD4+ lymphocytes in patients with a Leishmania-HIV coinfection].

PMID- 7776741
TI  - [The characteristics of food poisoning due to clenbuterol].

PMID- 7776740
TI  - [Cholestatic jaundice, an infrequent initial manifestation of primary
      amyloidosis].

PMID- 7776742
TI  - [A cerebral infarct associated with a giant cerebral arteriovenous malformation].

PMID- 7776743
TI  - [A pancreatic abscess due to Candida albicans].

PMID- 7776744
TI  - [Anaphylactic shock following the ingestion of a laxative].

PMID- 7776745
TI  - [Neologic smoke screens conceal depersonalization. What does "prioritization
      committees" mean?].

PMID- 7776746
TI  - [Tissue expansion--a sufficient factual basis is missing].

PMID- 7776747
TI  - ["Hjartsvikt" ("heart swing")--a mined field or virgin soil?].

PMID- 7776748
TI  - [Inter-professional ethics].

PMID- 7776749
TI  - [The first step towards a patient-originated medical record?].

PMID- 7776750
TI  - [Antibiotics against appendicitis. A promising alternative to surgery?].

PMID- 7776751
TI  - [Pollen registration--a social problem. Continuing increase of allergies].

PMID- 7776753
TI  - [27,800 visitors at the annual meeting of the Swedish Medical Society 1994].

PMID- 7776752
TI  - [Group living for individuals with chronic psychiatric disorders.A form of
      independent care that increases quality of life].

PMID- 7776754
TI  - [Nerve growth factors in future therapies. Protein mutation broadens the range of
      therapeutic possibilities].
AB  - The development and maintenance of the vertebrate nervous system requires a
      continuous supply of a number of polypeptide hormones known as neurotrophic
      factors. The ability of neurotrophic factors to promote the survival of
      peripheral and central neurons during development and after neuronal damage has
      aroused interest in these molecules as potential therapeutic agents for the
      treatment of nervous lesions and neurodegenerative diseases. Understanding of the
      molecular basis of the biological specificity of neurotrophic polypeptides has
      provided insight into their mechanisms of action and allowed strategies to be
      developed for the rational design of derivatives and analogues with specific
      pharmacological properties.

PMID- 7776756
TI  - [A new way of dealing with malpractice in the USA? Jail for physicians after
      medical mistakes].

PMID- 7776755
TI  - [Risk of overdiagnosis of urine cultures].

PMID- 7776757
TI  - [Estrogen treatment caused acute attacks of porphyria].
AB  - Two female patients with acute intermittent porphyria, who received oestrogen
      skin pads as supplementary treatment for postmenopausal discomfort, developed
      severe psychiatric disorders with persistent confusion, aggression and paranoid
      reactions. Some decades earlier they had reacted with symptoms of acute porphyria
      following oral contraceptive usage. There is well documented evidence of the
      advisability of restrictiveness in the use of oestrogens in conjunction with
      acute porphyria, particularly in cases of patients with a history of hormone
      related symptoms of acute porphyria. The putative mechanisms by means of which
      oestrogens may exert effects on neurotransmitters and peptides are discussed in
      the article. The authors would be grateful to hear from colleagues abroad who
      have treated patients with similar symptoms following postmenopausal treatment
      with oestrogens.

PMID- 7776759
TI  - [Evaluation of process economics is not a sufficient basis for decision on health
      policy].

PMID- 7776758
TI  - [Changed treatment of schizophrenic syndromes. More open care is not cheaper].

PMID- 7776760
TI  - [From what--to what? Reflections on terminal care].

PMID- 7776761
TI  - [New traumatology education will be introduced in Sweden in 1996].

PMID- 7776762
TI  - [Recommendations on treatment of peripheral mycoses. The importance of diagnosis
      prior to treatment].

PMID- 7776763
TI  - [No proof that hypersensitivity can be caused by electromagnetic fields.
      Patient's experience must be respected!].

PMID- 7776764
TI  - [It is not enough to be kind. Many physicians lack professional assurance].

PMID- 7776765
TI  - Humanitarian olympics: Solferino to Goma.

PMID- 7776766
TI  - Cryptococcosis, AIDS, and clinical trials.

PMID- 7776768
TI  - Birth of the midwife/obstetrician.

PMID- 7776767
TI  - Women as women with HIV.

PMID- 7776769
TI  - Interactions with selective MAOIs.

PMID- 7776770
TI  - Mental disorders and disability across cultures: a view from South Africa.

PMID- 7776771
TI  - Continuing increase in mesothelioma mortality in Britain.
AB  - Mesothelioma is closely related to exposure to asbestos, and mesothelioma
      mortality can be taken as an index of past exposure to asbestos in the
      population. We analysed mesothelioma mortality since 1968 to assess the current
      state of the mesothelioma epidemic, and to predict its future course. We found
      that rates of mesothelioma in men formed a clear pattern defined by age and date
      of birth. Rates rose steeply with age showing a very similar pattern in all five
      year birth cohorts. By date of birth, rates increased from mid-1893 to mid-1948,
      and then fell. Relative to the 1943-48 cohort, the risk for the 1948-53 cohort is
      0.79 and for the 1953-58 cohort 0.48. Despite these falls, if the age profile of
      rates for these cohorts follows the pattern of past cohorts, their predicted
      lifetime mesothelioma risks will be 1.3%, 1.0%, and 0.6%. Combining projections
      for all cohorts results in a peak of annual male mesothelioma deaths in about the
      year 2020 of between 2700 and 3300 deaths. If diagnostic trend is responsible for
      a 20% growth in recorded cases every 5 years--an extreme but arguable case--and
      if this trend has now ceased, the peak of annual male deaths will be reduced to
      1300, reached around the year 2010. Analysis of occupations recorded on death
      certificates indicate that building workers, especially plumbers and gas fitters,
      carpenters and electricians are the largest high-risk group. These data indicate
      that mesothelioma deaths will continue to increase for at least 15 and more
      likely 25 years. For the worst affected cohorts--men born in the 1940s-
      mesothelioma may account for around 1% of all deaths. Asbestos exposure at work
      in construction and building maintenance will account for a large proportion of
      these deaths, and it is important that such workers should be aware of the risks
      and take appropriate precautions.

PMID- 7776772
TI  - Randomised trial of hyperthermia as adjuvant to radiotherapy for recurrent or
      metastatic malignant melanoma. European Society for Hyperthermic Oncology.
AB  - The value of hyperthermia as an adjuvant to radiotherapy in patients with
      malignant melanoma was studied in a European multicentre trial. 134 metastatic or
      recurrent lesions of malignant melanoma in 70 patients were randomly assigned to
      receive radiotherapy (three fractions of 8 Gy or 9 Gy in 8 days) alone or
      followed by hyperthermia (43 degrees C for 60 min). Overall, the 2-year actuarial
      local tumour control was 37 (SE 5)%. Univariate analysis showed a beneficial
      effect of hyperthermia (radiation alone 28% vs combined treatment 46%, p = 0.008)
      and radiation dose (24 Gy 25% vs 27 Gy 56%, p = 0.02), but no effect of tumour
      size (< or = 4 cm 42% vs > 4 cm 29%, p = 0.21). Cox multivariate regression
      analysis showed the most important prognostic variables to be hyperthermia (odds
      ratio for 2-year local control 1.73 [95% CI 1.07-2.78], p = 0.023), tumour size
      (0.91 [0.85-0.99], p = 0.05), and radiation dose (1.17 [1.01-1.36], p = 0.05).
      Addition of heat did not significantly increase acute or late radiation
      reactions. Heating was well tolerated, but because of difficulties with equipment
      only 14% of treatments achieved the protocol objective. The overall 5-year
      survival rate was 19%, but 38% of the patients for whom all known disease was
      controlled survived 5 years. Adjuvant hyperthermia significantly improved local
      tumour control when applied in association with radiation in treatment of
      malignant melanoma. Successful local treatment of patients with a single or a few
      metastatic malignant melanoma lesions has significant curative potential.

PMID- 7776773
TI  - Aminophylline for methotrexate-induced neurotoxicity.
AB  - Methotrexate, a mainstay treatment for children with acute lymphoblastic
      leukaemia, can cause neurotoxicity, with paralysis, seizures, somnolence,
      anorexia, and headaches. The pathophysiology of this reaction is unknown. It has
      been suggested that the anti-inflammatory effect of methotrexate in patients with
      arthritis is due to adenosine release brought on by inhibition of purine
      synthesis. Since adenosine is a central nervous system depressant, we wondered
      whether adenosine release in the central nervous system could account for some of
      the neurotoxicity due to methotrexate, and whether that toxicity could be
      lessened by displacement of adenosine from its receptor by aminophylline. 6
      patients (age 3-16 years) who had methotrexate-induced neurotoxicity unresponsive
      to standard treatment received 2.5 mg/kg aminophylline. In addition, the
      concentration of adenosine in the cerebrospinal fluid (CSF) from 11 children
      completing a 24-h systemic methotrexate protocol was compared with that in 8
      newly diagnosed patients and 12 who had not received any treatment for at least a
      week. 4 of 6 patients with toxic signs and symptoms attributed to methotrexate
      and unrelieved by steroids, epidural blood patch, promethazine, 5
      hydroytryptamine antagonists, paracetamol, and narcotics, had complete resolution
      of neurotoxicity after or during a 1-h infusion of aminophylline; 2 others had a
      pronounced improvement but persistent nausea. CSF adenosine concentrations of
      patients receiving methotrexate, even when there was very slight or no toxicity,
      were greatly increased compared with control subjects (mean values of 217 and 51
      nmol/L, median 175 and 52 nmol/L). Subacute methotrexate neurotoxicity may be
      mediated by adenosine and relieved by aminophylline.

PMID- 7776776
TI  - Cardiac chamber-specific beta-adrenoceptor regulation and sympathetic
      innervation.
AB  - We assessed by radioligand binding techniques the effect of cardiac failure on
      beta-adrenoceptor density in 5 hearts from patients undergoing repeat
      transplantation and 5 normal (unused donor) hearts. Right ventricular total and
      subtype beta-adrenoceptors in the denervated repeat-transplant hearts were down
      regulated compared with the normally innervated controls. Within the denervated
      hearts, beta 1-adrenoceptors were selectively down-regulated in the right
      ventricle compared with the left ventricle. Tissue noradrenaline content
      confirmed sympathetic denervation in the transplanted hearts. Thus, regional
      sympathetic innervation is not necessary for chamber-specific beta-adrenoceptor
      down-regulation; other mechanisms for this process should be sought.

PMID- 7776774
TI  - Primary prevention of cryptococcal meningitis by fluconazole in HIV-infected
      patients.
AB  - To evaluate whether oral fluconazole reduces the risk of a first episode of
      cryptococcal meningitis in HIV-infected patients, we conducted a case-control
      study of patients cared for in a university teaching hospital and two urban HIV
      outpatient clinics. Cases consisted of HIV-infected patients with CD4 cell counts
      less than 250/microL who developed a first episode of cryptococcal meningitis
      between July 1, 1990, and June 30, 1993. For each case (n = 18), 4 control
      subjects were chosen from HIV-infected patients (CD4 count < 250/microL) whose
      cerebrospinal fluid was negative for cryptococcal antigen and culture, and who
      were matched by age, sex, and time of lumbar puncture. There were no significant
      differences between cases and controls in age, sex, insurance status, mean CD4
      count, history of oral candidosis, presence of a previous AIDS-defining illness,
      the number of visits to the HIV-outpatient clinic, or use of antiretroviral
      therapy. In the 6 months before lumbar puncture, 2 of 18 cases (11%) and 26 of 72
      controls (36%) were exposed to fluconazole, a finding that gives a matched odds
      ratio (adjusted for race, route of HIV infection, and CD4 count) of 0.08 (95% CI
      0.01-0.84; p = 0.035) and indicates a 92% protective efficacy. We conclude that
      fluconazole reduces the risk of a first episode of cryptococcal meningitis in HIV
      infected patients with a CD4 count less than 250/microL. Although the optimum
      dose and duration of fluconazole could not be determined, our results suggest
      that less than daily use was effective in the prevention of cryptococcal
      meningitis.

PMID- 7776777
TI  - Genetic diversity of hepatitis C virus: implications for pathogenesis, treatment,
      and prevention. Report of a meeting of Physicians and Scientists.

PMID- 7776775
TI  - Alpha-ketoglutarate for myocardial protection in heart surgery.
AB  - A low myocardial content of alpha-ketoglutarate during heart surgery might
      aggravate ischaemic injury. 24 men undergoing coronary surgery participated in a
      randomised controlled study. 28 g alpha-ketoglutarate was added to blood
      cardioplegia for intermittent antegrade intracoronary perfusion in 13 cases.
      alpha-ketoglutarate reduced the appearance in blood of the ischaemic markers
      creatine kinase MB and troponin T (at 4 h after release of aortic cross-clamp;
      median [95% CI] 49 [37-60] micrograms/L in controls vs 32 [27-37] micrograms/L
      for creatine kinase MB, 2.0 [1.2-2.8] vs 1.1 [0.8-1.4] micrograms/L for troponin
      T). These findings signify attenuated ischaemic injury, possibly secondary to
      enhanced myocardial oxidative capacity.

PMID- 7776778
TI  - Alarm over supervised discharge orders.

PMID- 7776779
TI  - Abolition of year-and-a-day rule in homicide recommended.

PMID- 7776780
TI  - Superspecialists and the Bolam test.

PMID- 7776781
TI  - Spotlight on inhibitors of HIV protease.

PMID- 7776782
TI  - Crisis in humanitarian action assessed.

PMID- 7776783
TI  - Trials of streptokinase in severe acute ischaemic stroke.

PMID- 7776784
TI  - Trials of streptokinase in severe acute ischaemic stroke.

PMID- 7776786
TI  - Does interferon beta cause initial exacerbation of multiple sclerosis?

PMID- 7776785
TI  - Nabilone in the treatment of multiple sclerosis.

PMID- 7776787
TI  - Oral rehydration solution as adjuvant for oral vaccination.

PMID- 7776788
TI  - Galactosaemia.

PMID- 7776789
TI  - Frequency of familial melanoma and MLM2 gene.

PMID- 7776790
TI  - Frequency of familial melanoma and MLM2 gene.

PMID- 7776791
TI  - Treatment of Indian kala-azar with pentavalent antimony.

PMID- 7776792
TI  - When to use fluconazole.

PMID- 7776793
TI  - Treatment of Indian Kala-azar with pentavalent antimony.

PMID- 7776795
TI  - Hormone replacement therapy and cardiovascular risk.

PMID- 7776794
TI  - Intestinal mycobacteria in African AIDS patients.

PMID- 7776796
TI  - Treatment of late Lyme borreliosis with cefoperazone and sulbactam.

PMID- 7776797
TI  - Abortion.

PMID- 7776798
TI  - Abortion.

PMID- 7776800
TI  - Abortion.

PMID- 7776799
TI  - Abortion.

PMID- 7776801
TI  - Is it possible to have an unconscious thought?

PMID- 7776802
TI  - Indirect drug-related costs.

PMID- 7776803
TI  - Essence of stress.

PMID- 7776804
TI  - Treatment of chlamydial infection in developing countries.

PMID- 7776805
TI  - Prenatal diagnosis in congenital muscular dystrophy.

PMID- 7776806
TI  - Cholesterol-lowering, simvastatin, and coronary heart disease.

PMID- 7776807
TI  - Laparoscopic hysterectomy.

PMID- 7776808
TI  - Laparoscopic hysterectomy.

PMID- 7776809
TI  - Laparoscopic hysterectomy.

PMID- 7776810
TI  - Laparoscopic hysterectomy.

PMID- 7776811
TI  - Enterococci and hospital laundry.

PMID- 7776812
TI  - Proteinase-resistant protein in human neuroblastoma cells infected with brain
      material from Creutzfeldt-Jakob patient.

PMID- 7776813
TI  - Apolipoprotein E in Creutzfeldt-Jakob disease. French Research Group on
      Epidemiology of Human Spongiform Encephalopathies.

PMID- 7776815
TI  - International Symposium on Cannabis and the Cannabinoids. Proceedings. Esterel,
      Quebec, Canada. July 21-23, 1994.

PMID- 7776814
TI  - Proctoclysis for hydration.

PMID- 7776816
TI  - A review of recent advances in cannabinoid research and the 1994 International
      Symposium on Cannabis and the Cannabinoids.

PMID- 7776817
TI  - Biochemical and pharmacological characterisation of SR141716A, the first potent
      and selective brain cannabinoid receptor antagonist.
AB  - SR141716A is a selective, potent and orally active antagonist of the brain
      cannabinoid receptor with a long duration of action. This compound shows high
      affinity for the central cannabinoid receptor (Ki = 2 nM), displays low affinity
      for the peripheral cannabinoid receptor (Ki > 1000 nM). In vitro, SR141716A
      antagonizes the inhibitory effects of cannabinoid receptor agonists on both mouse
      vas deferens contractions and dopamine-stimulated adenylyl cyclase activities in
      rat brain membranes. After oral administration SR141716A totally inhibited the ex
      vivo [3H]-CP55,940 binding to cerebral membranes with a ED50 value of 3.5 mg/kg.
      Furthermore SR141716A antagonizes the classical pharmacological responses
      elicited by cannabinoid receptor agonists. In addition, SR141716A reverses the
      inhibitory effect of WIN55212-2 on isoniazid-induced elevation of cGMP in rat
      cerebellum. This compound will provide a powerful tool for studying the in vivo
      functions of the anandamide/cannabinoid system.

PMID- 7776818
TI  - AM630, a competitive cannabinoid receptor antagonist.
AB  - AM630 (iodopravadoline), a novel aminoalkylindole, has been found to attenuate
      the ability of a number of cannabinoids to inhibit electrically-evoked twitches
      of the mouse isolated vas deferens. It did not block the inhibitory effects of
      morphine or clonidine on the twitch response. AM630 behaved as a competitive
      antagonist of CP 55,940, WIN 55,212-2, anandamide and (R)-(+)-arachidonyl-1'
      hydroxy-2'-propylamide (AM356), producing rightward shifts in the log
      concentration response curves of these cannabinoid receptor agonists that were
      concentration-dependent, essentially parallel and not accompanied by any decrease
      in the size of maximal response. AM630 also produced concentration-dependent,
      parallel rightward shifts in the log concentration-response curve of delta 9-THC.
      However, these shifts were accompanied by a decrease in the maximal response.
      AM630 was markedly more potent as an antagonist of delta 9-THC and CP 55,940 (Kd
      = 14.0 and 17.3 nM respectively) than as an antagonist of WIN 55,212-2, AM356 or
      anandamide (Kd = 36.5, 85.9 and 278.8 nM respectively). These differences in
      dissociation constant imply that the mouse vas deferens may contain more than one
      type of cannabinoid receptor. The data also indicate that the receptors for which
      AM630 has the highest affinity may not be CB1 cannabinoid receptors as the CB1
      selective antagonist, SR141716A, is known to be equally potent in attenuating the
      inhibitory effects of CP 55,940 and anandamide on the twitch response of the
      mouse vas deferens.

PMID- 7776819
TI  - A novel electrophilic high affinity irreversible probe for the cannabinoid
      receptor.
AB  - In order to explore the structural requirements for cannabinoid activity we have
      been involved in the design and synthesis of stereochemically defined high
      affinity probes for the cannabinoid receptor. This effort has involved the
      development of irreversible ligands which will allow us to obtain detailed
      information on the cannabinoid receptor active site(s). The irreversible ligands,
      which incorporate highly reactive functional groups in a strategic position of
      the ligand, may form covalent bonds with amino acid residues at the receptor
      active site or in the neighborhood of this site. We shall discuss the biochemical
      properties of one of these probes, which incorporates the electrophilic
      isothiocyanate group into the structure of the highly potent cannabinoid agonist
      (-)-1',1'-dimethylheptyl-delta 8-THC. This ligand, (-)-7'-isothiocyanato-1',1'
      dimethylheptyl-delta 8-THC (7'-NCS-DMH-delta 8-THC), was evaluated for its
      affinity for cannabinoid binding sites using rat forebrain membrane preparations
      and found to have an apparent IC50 value of 660 pM. Incubation of the membrane
      preparation with a ligand concentration of five times the apparent IC50 resulted
      in the irreversible occupation of nearly all of the receptor specific binding
      sites.

PMID- 7776820
TI  - Common cannabimimetic pharmacophoric requirements between aminoalkyl indoles and
      classical cannabinoids.
AB  - Aminoalkylindoles (AAIs) are structurally dissimilar from the classical
      cannabinoids (CCs), however, both AAIs and CCs appear to bind at the same site on
      the cannabinoid receptor. To obtain better insights on the structural correlation
      between AAIs and CCs, we have studied the conformational properties of the potent
      cannabimimetic AAI WIN 55212-2 and its inactive analogs using high resolution 2D
      NMR spectroscopy in combination with computer-assisted molecular modeling. The
      pharmacophoric similarities between the AAIs and the CCs were then investigated
      using superimposition techniques. The absolute stereochemistries of the
      biologically active enantiomer (-)HHC were used as superimposition points and
      considered as internal controls in order to test the molecular principles guiding
      this experiment. Our results show that the model is congruent with a
      superimposition in which the naphthoyl, morpholino and 3-keto groups in the AAI,
      respectively correspond to the side chain, cyclohexanol OH and phenolic OH of
      HHC. A good fit is obtained when the two biologically active antipodes are
      superimposed. Conversely, the fit is poor if the inactive AAI enantiomer is
      superimposed on the active HHC enantiomer. It can also be seen that in such an
      orientation a certain deviation of the C-ring from the plane of the phenol ring
      of the tricyclic HHC component and of the morpholinyl portion from the plane of
      the indole ring of WIN 55212-2 is essential for cannabimimetic activity. The
      inactive enantiomer WIN 55212-3 has its respective components aligned in the
      opposite quadrant. By comparing the stereoelectronic features of representative
      AAIs and CCs, we have developed a model which may help to uncover the
      pharmacophoric requirements of the AAIs and serve as a basis for future SAR and
      drug design.

PMID- 7776821
TI  - Construction of a 3D model of the cannabinoid CB1 receptor: determination of
      helix ends and helix orientation.
AB  - The goal of this study was to determine the ends and orientations of the seven
      transmembrane helices of the cannabinoid (CB1) receptor, a G-protein coupled
      receptor (GPCR). After initial sequence alignment, Fourier transform methods were
      used with the nPRIFT hydrophobicity scale and with a variability profile to
      calculate the alpha-helical periodicity (AP) in the primary amino acid sequence
      of the human CB1 receptor and of its alignment. AP plots were used to identify
      the amino acids which comprise each of the seven CB1 transmembrane helices. An
      intracellular alpha helix extension of Helix 7 was characterized by analyzing the
      relative direction of variability and hydrophobic moment vectors. Variability
      moment vectors were then used to delineate the orientation of each helix in the
      membrane. Based upon these vector calculations, a tentative helix bundle
      arrangement was obtained. This arrangement is largely consistent with the
      proposed transmembrane helix bundle arrangement in rhodopsin, a GPCR.

PMID- 7776822
TI  - Rat brain cannabinoid receptors are N-linked glycosylated proteins.
AB  - To study the N-linked glycosylation properties of the CB1 receptor, rat brain
      membranes were treated with exo- and endoglycosidases. For visualizing CB1
      receptors, an antipeptide antibody was raised against the N-terminal 14 amino
      acids and used to specifically detect the protein by Western blotting. We found
      that the apparent molecular weight of mature CB1 receptors was 64 kDa. Treatment
      of membranes with endoglycosidase F shifted the 64 kDa band to the 59 kDa and 53
      kDa bands. The latter is consistent with the calculated molecular weight of
      deglycosylated CB1 receptors. Treatment of membranes with endoglycosidase H and
      alpha-mannosidase partially shifted the 64 kDa band to 53 kDa band, indicating a
      portion of the oligosaccharides was of the high mannose type. These data
      confirmed that the CB1 receptors in brain are N-linked glycoproteins with
      heterogeneous carbohydrate composition. Among three potential N-linked
      glycosylation sites on the N-terminus of the CB1 receptor, only two sites are
      actually glycosylated.

PMID- 7776823
TI  - Cannabinoid photolabelling of a G-protein gamma-subunit in mouse peritoneal
      cells.
AB  - Binding and photoactivation of a cannabinoid-derived ligand to intact mouse
      peritoneal cells has resulted in the labelling of a G-protein gamma-subunit. The
      assignment of structure is based on the product's physical characteristics and
      its ability to react with a polyclonal antiserum raised against the partial amino
      acid sequence for a gamma-subunit expressed in spleen cells. The binding
      characteristics of the ligand to the cells suggests that this gamma-subunit, and
      its associated alpha and beta subunits, are located in close proximity to one of
      the transmembrane cannabinoid receptors. Our findings further suggest a possible
      experimental approach to identifying receptor-G-protein complexes in intact
      cells.

PMID- 7776824
TI  - Arachidonoyl ethanolamide-[1,2-14C] as a substrate for anandamide amidase.
AB  - Arachidonoyl ethanolamide-[1,2-14C] was prepared and evaluated as a substrate for
      anandamide amidase in a radioenzymatic assay that does not require a thin layer
      chromatography separation step. Using this substrate the release of ethanolamine
      [1,2-14C] is linear for approximately thirty minutes. Anandamide amidase exhibits
      maximal activity between pH 8 and pH 9 with a steep decline in activity at pH
      values below 6 and above 10. Arachidonoyl ethanolamide-[1,2-14C] was used for the
      assay of anandamide amidase from 10 micrograms to 100 micrograms protein, from
      cow brain homogenate, in a 0.2 ml incubation mixture. When plotted as a
      rectangular hyperbola of the steady-state Michaelis-Menten equation, an
      approximate Km of 30 +/- 7 microM and a Vmax of 198 +/- 13 nmoles ethanolamine
      formed per hour per mg protein homogenate was obtained.

PMID- 7776825
TI  - Classical/non-classical cannabinoid hybrids; stereochemical requirements for the
      southern hydroxyalkyl chain.
AB  - We have synthesized a range of hybrid classical/non-classical cannabinoids
      (CC/NCCs) combining the hexahydrocannabinol dibenzopyran structure with the
      hydroxyalkyl chain found in CP-55940, in order to investigate the role of the
      hydroxyalkyl pharmacophore in cannabimimetic activity. This was achieved by
      synthesizing CC analogs in which the 6 alpha- and 6 beta-methyl groups were
      modified to the corresponding hydroxyethyl groups. Our binding data indicated
      that beta position was the preferred orientation for the hydroxyalkyl moiety,
      affinity for the CB1 receptor being 20-fold greater for the 6 beta-hydroxyethyl
      than the corresponding 6 alpha-analog. Further studies using 6 beta
      hydroxyalkyldibenzopyran analogs varying the southern aliphatic chain length from
      6 beta-hydroxymethyl to 6 beta-hydroxyethyl to 6 beta-hydroxypropyl demonstrated
      little potency change with chain length. Therefore, we concluded that whilst the
      hydroxyalkyl pharmacophore was strongly affected by its configuration relative to
      the dibenzopyran ring, the chain length of the hydroxyalkyl moiety (up to the n =
      3 homolog) was not critical.

PMID- 7776827
TI  - Variation of the alkyl side chain in delta 8-THC.
AB  - The synthesis of (2'RS)-2'-methyl-, (3'RS)-, (3'S)-3'-methyl-, and 4'-methyl
      delta 8-THC has been carried out, and the pharmacology of all four compounds has
      been investigated. All four compounds showed typical cannabinoid activity both in
      vitro and in vivo. The 2'-methyl compound is somewhat more active than delta 8
      THC, while the 4'-methyl isomer is less active. The 3'-methyl-delta 8-THC has
      approximately the same activity as the parent cannabinoid.

PMID- 7776826
TI  - A novel class of potent tetrahydrocannabinols (THCS): 2'-yne-delta 8- and delta 9
      THCS.
AB  - A series of 3-alkyl-2'-yne (side chain) acetylenic analogs of delta 9-THC were
      synthesized and evaluated for in vitro and in vivo activity. Analogs were
      evaluated for receptor affinity in a [3H]CP-55,940 displacement assay and for in
      vivo pharmacological activity in a mouse procedure utilizing a tetrad of
      measures. These compounds represent a preliminary exploration of the consequences
      of restricting the flexibility of the side chain regarding cannabimimetic
      activity. All analogs proved to have receptor affinities (4-11 nM) that were five
      to ten times greater than that observed for delta 9-THC. However, the in vivo
      activities of these compounds varied greatly. All analogs proved to possess the
      greatest potency for production of antinociception, with activity similar to or
      less than that observed for the production of hypomotility, hypothermia, and
      catalepsy. The most potent analog 11b exhibited an ED50 of 0.031 mg/kg in the
      tail-flick procedure, with values in other measures being between 0.5 and 1.0
      mg/kg. The least active compound (11c), though still possessing a KI of 11 nM,
      exhibited ED50 values of 3.1 and 9.3 mg/kg for tail-flick and temperature
      procedures, as well as 41 and 48 mg/kg for ring-immobility and spontaneous
      locomotor activity, respectively. This profile (high receptor affinity but low in
      vivo potency) would normally be suggestive of a compound with antagonist
      properties (at least for immobility and activity measures). It is unclear why
      these acetylenic analogs were so potent in vitro, while only one (11b) exhibited
      the degree of in vivo potency anticipated based upon comparison to values for
      delta 9-THC. It is possible these side chain modifications do not interfere with
      receptor recognition, but limit receptor activation or second messenger signal
      transduction. Regardless, it is clear these novel analogs provide a basis for the
      further exploration of the cannabinoid receptor pharmacophore.

PMID- 7776828
TI  - The design, synthesis and testing of desoxy-CBD: further evidence for a region of
      steric interference at the cannabinoid receptor.
AB  - Cannabidiol CBD, a non-psychoactive constituent of marihuana, has been reported
      to possess essentially no affinity for cannabinoid CB1 receptor binding sites in
      the brain. Our hypothesis concerning CBD's lack of affinity for the cannabinoid
      CB1 receptor is that CBD is not capable of clearing a region of steric
      interference at the CB1 receptor and thereby not able to bind to this receptor.
      We have previously characterized this region of steric interference at the CB1
      receptor [P.H. Reggio, A.M. Panu, S. Miles J. Med. Chem. 36, 1761-1771 (1993)] in
      three dimensions using the Active Analog Approach. We report here a
      conformational analysis of CBD which, in turn, led to the design of a new analog,
      desoxy-CBD. Modeling results for desoxy-CBD predict that this compound is capable
      of clearing the region of steric interference by expending 3.64 kcal/mol of
      energy in contrast to the 12.39 kcal/mol expenditure required by CBD. Desoxy-CBD
      was synthesized by condensation of 3-pentylphenol with p-mentha-2,8-dien-1-ol
      mediated by DMF-dineopental acetal. Desoxy-CBD was found to behave as a partial
      agonist in the mouse vas deferens assay, an assay which is reported to detect the
      presence of cannabinoid receptors. The compound produced a concentration related
      inhibition of electrically-evoked contractions of the mouse vas deferens,
      possessing an IC50 of 30.9 nM in this assay. Taken together, these results
      support the hypothesis of the existence of a region of steric interference at the
      CB1 receptor. While the energy expenditure to clear this region was too high for
      the parent compound, CBD, the removal of the C6' hydroxyl of CBD produced a
      molecule (desoxy-CBD) able to clear this region and produce activity, albeit at a
      reduced level.

PMID- 7776829
TI  - The endogenous cannabinoid receptor ligand, anandamide, inhibits the motor
      behavior: role of nigrostriatal dopaminergic neurons.
AB  - The present study has been designed to test whether the recently described
      endogenous ligand for the cannabinoid receptor, arachidonylethanolamide, termed
      anandamide, can mimic the effects produced by exogenous cannabinoids on motor
      behavior and to test possible neurochemical substrates for this potential effect.
      To this end, adult male rats were submitted to an acute i.p. injection of
      anandamide, delta 9-tetrahydrocannabinol (THC) or vehicle. Animals were
      behaviorally tested ten minutes after injection of the drug and, then, sacrificed
      and their brains used for dopaminergic analyses. Ambulation was not significantly
      affected by the treatment with either THC or anandamide, but a very pronounced
      increase was observed in the time spent in inactivity in rats treated with either
      THC or anandamide. This was accompanied by a marked decrease in the frequency of
      spontaneous non-ambulatory activities, such as grooming and rearing, although
      only the administration of THC decreased shaking behavior. The anandamide-induced
      decrease in grooming was dose-dependent, but the decrease in rearing was higher
      with the dose of 3 mg/kg than with the dose of 10 mg/kg. The administration of
      anandamide also caused a dose-dependent decrease in the activity of tyrosine
      hydroxylase and in the ratio between the number of D1 and D2 receptors in the
      striatum. Moreover, the administration of 3 mg/kg of anandamide significantly
      decreased the contents of dopamine and L-3,4-dihydroxyphenylacetic acid in the
      striatum although lesser and higher doses were less effective. THC only tended to
      decrease these parameters. No changes were seen in dopaminergic activity in the
      limbic forebrain after either cannabimimetics. In summary, anandamide, as well as
      THC, decreases motor behavior. This effect was paralleled by reduction in the
      activity of nigrostriatal dopaminergic neurons. However, subtle differences in
      the behavioral and neurochemical effects between anandamide and THC could be
      observed.

PMID- 7776830
TI  - Pharmacological and behavioral evaluation of alkylated anandamide analogs.
AB  - Anandamide (arachidonylethanolamide), isolated from porcine brain, has been shown
      to bind to the cannabinoid receptor and also to produce cannabimimetic activity
      in pharmacological assays. This study examined structure-activity relationships
      in alkylated anandamide analogs. The analogs were evaluated for their ability to
      displace [3H]CP-55,940 in a filtration binding assay using rat brain membranes in
      the presence and absence of the enzyme inhibitor phenylmethylsulfonyl fluoride
      (PMSF). Behavioral activity was assessed by the ability of the analogs to produce
      hypomotility and antinociception. Methylations at carbons 2 and 1 produced
      compounds stable in the absence of PMSF with similar affinities and behavioral
      activity as anandamide. Addition of larger alkyl groups at these positions or
      nitrogen methylation reduced receptor affinity and behavioral potency. These
      results indicate that methylations at specific carbons of anandamide confer
      stability in vitro.

PMID- 7776831
TI  - Evaluation of cAMP involvement in cannabinoid-induced antinociception.
AB  - It has been proposed that cannabinoids act at a Gi protein-coupled receptor to
      produce antinociception. One action of Gi-proteins is to decrease intracellular
      cAMP via inhibition of adenylyl cyclase activity. Although cannabinoid inhibition
      of forskolin-stimulated adenylyl cyclase is used as a confirmation of functional
      cannabinoid receptors, it is unknown whether this second messenger system
      specifically mediates cannabinoid-induced antinociception. This in vivo study was
      conducted using enantiomeric cAMP analogs, Rp-cAMPS (an antagonist) and Sp-cAMPS
      (an agonist), and the cAMP agonist Cl-cAMP to test the hypothesis that
      cannabinoid-induced antinociception is due to decreased adenylyl cyclase
      activity. None of the cAMP analogs, forskolin, or 1,9-dideoxy-forskolin affected
      delta 9-THC or CP-55,940-induced antinociception produced by intrathecal (i.t.)
      or intracerebroventricular (i.c.v.) injections in mice. Experiments were also
      conducted to investigate whether i.c.v. administration of Sp-cAMPS would block
      i.c.v. cannabinoid-induced antinociception in rats. Sp-cAMPS failed to block CP
      55,940-induced antinociception. However, Sp-cAMPS produced hyper-excitability and
      reactive behavior indicating that it did elicit a pharmacological effect.
      Although, adenylyl cyclase may mediate other cannabinoid-induced actions, these
      results do not support the hypothesis that it is involved in cannabinoid-induced
      antinociception. Alternatively, other effector systems such as calcium or
      potassium channels coupled to cannabinoid receptors may mediate cannabinoid
      induced antinociception.

PMID- 7776832
TI  - Effects of anandamide (endogen cannabinoid) on anterior pituitary hormone
      secretion in adult ovariectomized rats.
AB  - It has been shown that the main psychoactive component of marihuana, delta 9
      tetrahydrocannabinol (THC) has mainly inhibitory effects on pituitary luteinizing
      hormone (LH), prolactin (PRL) and growth hormone (GH) and has no or little effect
      on follicle stimulating hormone (FSH) secretion. Recently the purification and
      availability of the putative endogenous ligand for the cannabinoid receptor,
      anandamide (arachidonyl ethanol-amide, anandamide) (ANA) provided us the
      opportunity to compare the effects of THC and ANA on the female neuroendocrine
      system in ovariectomized (OVX) rats. OVX was performed three weeks prior to the
      experimental period to avoid cyclic differences. OVX rats were injected i.p. with
      either THC or ANA (0.02 mg/kg.b.w./day, respectively) or vehicle for two weeks.
      The results show that both ANA and THC decrease serum LH level although THC with
      a higher degree. No significant differences were observed in serum FSH level.
      Both drugs decreased serum PRL. Serum GH was increased after THC administration
      and significantly decreased after ANA. The results indicate that ANA and THC
      alter pituitary hormone secretion, mainly by inhibitory action. The site of
      action requires further investigations.

PMID- 7776834
TI  - Conditioned place preference induced by delta 9-tetrahydrocannabinol: comparison
      with cocaine, morphine, and food reward.
AB  - The rewarding property of delta 9-tetrahydrocannabinol (THC), the psychoactive
      constituent of marijuana and hashish, was studied using the conditioned place
      preference paradigm, and compared to that of cocaine, morphine, and food reward.
      The results of Experiment 1 demonstrated that 2.0 and 4.0 mg/kg doses produced a
      reliable shift in preference for the THC-paired compartment. The THC place
      preference observed at 2.0 and 4.0 mg/kg was nearly equivalent to that produced
      by low doses of cocaine (5.0 mg/kg), morphine (4.0 mg/kg), and food in non food
      deprived animals. The second experiment used a different conditioning procedure
      that included a washout period for THC. The results of Experiment 2 demonstrated
      that a THC place preference could be obtained using a lower dose of THC (1.0
      mg/kg), and that this THC place preference was equivalent to that produced by 10
      mg/kg cocaine. At higher doses (2.0 and 4.0 mg/kg), THC produced a dose-dependent
      place aversion. These results suggest that THC's action on brain reward
      substrates, previously demonstrated by electrical brain stimulation reward, in
      vivo brain microdialysis, and in vivo brain electrochemistry studies, reflects
      itself behaviorally in increased appetitive motivational value for environmental
      stimuli associated with ingestion of marijuana and hashish.

PMID- 7776833
TI  - Anandamide inhibits macrophage-mediated killing of tumor necrosis factor
      sensitive cells.
AB  - Anandamide (arachidonoylethanolamide) was shown to inhibit macrophage-mediated
      killing of tumor necrosis factor-sensitive murine L929 fibroblasts. Scanning
      electron microscopy (SEM) demonstrated that L929 cells, co-cultured with
      Propionibacterium acnes (P. acnes)-activated peritoneal macrophages from mice
      treated with vehicle, were either disrupted or had surface abnormalities and
      numerous punctate lesions. In contrast, L929 cells co-cultured with macrophages
      from mice receiving P. acnes in concert with Anandamide (20 mg/kg-80 mg/kg) or
      the exogenous cannabinoid delta-9-tetrahydrocannabinol (THC; 80 mg/kg) did not
      exhibit ultrastructural abnormalities. Cytotoxicity assays were performed in
      parallel with SEM in order to determine whether ultrastructural observations
      correlated with target cell killing as measured by release of radiolabel from
      L929 target cells. P. acnes-activated macrophages from vehicle-treated mice
      elicited 41% specific release of radiolabel from [51Cr]-labeled L929 cells. In
      contrast, macrophages from animals treated with P. acnes and with 20, 40, or 80
      mg/kg Anandamide exhibited 38%, 25%, or 28% specific release of radiolabel,
      respectively. Similarly, macrophages from animals treated with P. acnes and with
      80 mg/kg THC exhibited 21% specific release of radiolabel. In vitro cytotoxicity
      studies using radiolabeled L929 target cells and conditioned medium from RAW264.7
      murine macrophage-like cells allowed for determination of the time interval over
      which Anandamide exerted its inhibitory effect. Maximal inhibition of target cell
      killing occurred when conditioned medium was obtained from macrophages exposed to
      Anandamide for 1 hr prior to activation. In contrast, conditioned medium from THC
      treated macrophages exerted its maximal inhibition of target cell killing when
      obtained from RAW264.7 cells pretreated for 24hr-48hr prior to activation. These
      results indicate that Anandamide and THC exert a similar inhibition of killing of
      TNF-sensitive target cells. However, the time interval over which these two
      substances elicit their suppressive effect differs.

PMID- 7776835
TI  - Role of cyclic AMP dependent protein kinase in cannabinoid receptor modulation of
      potassium "A-current" in cultured rat hippocampal neurons.
AB  - Cannabinoid receptor agonists have been previously shown to enhance a potassium A
      current (IA) in cultured rat hippocampal neurons. This effect has been further
      demonstrated to be dependent on G-protein linkage to adenylyl cyclase and levels
      of intracellular cyclic AMP (cAMP). The present study extends this analysis to
      the involvement of cAMP-dependent protein kinase (PKA) in this cascade. Specific
      activators and inhibitors of PKA were shown to have differential effects on the
      voltage dependence of IA. Specific activators of PKA produced a negative shift in
      voltage dependence of IA, whereas PKA inhibitors produced a positive shift in IA
      voltage dependence, the latter similar to that effected by the cannabinoid
      agonist WIN 55,212-2. Although the negative shift in IA induced by PKA
      stimulation could be reversed by PKA inhibitors, the positive shift produced by
      the PKA inhibitors alone was only 50-60% of the cannabinoid-produced shift in IA
      voltage dependence. This partial effect of PKA inhibition was confirmed by
      biochemical assays in the same cultured neurons that showed a similar 50-60%
      decrement in in vitro protein phosphorylation produced by PKA inhibitors. Results
      are discussed in terms of a diffusible second messenger linkage of the
      cannabinoid receptor to the A-current channel via the role of protein
      phosphorylation in modulation of IA.

PMID- 7776836
TI  - Metabolism of delta 9-tetrahydrocannabinol by cytochrome P450 isozymes purified
      from hepatic microsomes of monkeys.
AB  - The most abundant metabolite of delta 9-tetrahydrocannabinol (delta 9-THC) formed
      with hepatic microsomes of monkeys was 11-OH-delta 9-THC, followed by 8 alpha-OH
      , 8 beta-OH- and 3'-OH-delta 9-THCs. Two cytochrome P450 isozymes, P450RM-A and
      P450JM-C, were purified from monkey hepatic microsomes and found to have a
      molecular weight of 51,000. In the reconstituted system, the activities of P450RM
      A towards formation of 11-OH-, 8 alpha-OH-, 8 beta-OH- and 3'-OH-delta 9-THCs
      were 19-, 40-, 22- and 10-fold higher, respectively, than the corresponding
      activities of the hepatic microsomes. The activity of P450JM-C towards formation
      of 3'-OH-delta 9-THC was 10-fold higher than that of P450RM-A, while the
      activities of both isozymes for 11- and 8 alpha-hydroxylation were not so much
      different and the 8 beta-hydroxylation activity was 14-fold higher in P450RM-A
      than in P450JM-C. Antibodies against P450RM-A and P450JM-C markedly inhibited the
      microsomal formation of 11-OH- and 8 alpha-OH-delta 9-THCs, and 3'-OH-delta 9
      THC, respectively. These results suggest that P450RM-A and P450JM-C are major
      isozymes responsible for the formation of 11-OH- and 8 alpha-OH-delta 9-THCs, and
      3'-OH-delta 9-THC, respectively, in monkeys.

PMID- 7776837
TI  - An efficient new cannabinoid antiemetic in pediatric oncology.
AB  - Delta-8-tetrahydrocannabinol (delta-8-THC), a cannabinoid with lower psychotropic
      potency than the main Cannabis constituent, delta-9-tetrahydrocannabinol (delta-9
      THC), was administered (18 mg/m2 in edible oil, p.o.) to eight children, aged 3
      13 years with various hematologic cancers, treated with different antineoplastic
      drugs for up to 8 months. The total number of treatments with delta-8-THC so far
      is 480. The THC treatment started two hours before each antineoplastic treatment
      and was continued every 6 hrs for 24 hours. Vomiting was completely prevented.
      The side effects observed were negligible.

PMID- 7776838
TI  - An examination of the central sites of action of cannabinoid-induced
      antinociception in the rat.
AB  - Microinjections of low doses of the potent and selective cannabinoids WIN 55,212
      2 and CP 55,940 into the lateral ventricle produce long-lasting reduction in
      sensitivity to noxious thermal stimuli (1). To determine the central distribution
      of ventricularly administered WIN 55,212-2, we microinjected an analgesic dose of
      the drug with [3H]WIN 55,212-2. At the peak time of antinociception, the
      radiolabeled drug was confined to periventricular sites throughout the brain. The
      contribution of particular periventricular structures to the antinociceptive
      effect was evaluated using intracerebral microinjection techniques and the tail
      flick test. Guide cannulae were implanted above the following periventricular
      structures: the medial septal area, lateral habenlua, perihypothalamic area,
      arcuate nucleus of the hypothalamus, dorsal raphe nucleus and the dorsolateral
      and ventrolateral aspects of the periaqueductal gray. Microinjections of WIN
      55,212-2 (5 micrograms/0.5 microliter) into the medial septal area, lateral
      habenula, perihypothalamic area, arcuate nucleus, and ventrolateral
      periaqueductal gray did not significantly affect tail-flick latencies. By
      contrast, microinjections of WIN 55,212-2 into the dorsolateral periaqueductal
      gray and the dorsal raphe significantly elevated tail-flick latencies. The
      results of this study indicate that at least two periventricular structures
      within the brain are involved in cannabinoid antinociception.

PMID- 7776839
TI  - Inhibition of noxious stimulus-evoked activity of spinal cord dorsal horn neurons
      by the cannabinoid WIN 55,212-2.
AB  - The effects of a potent synthetic cannabinoid WIN 55,212-2 on nociceptive
      responses of wide dynamic range (WDR) neurons in the lumbar spinal cord were
      investigated in anesthetized rats. WDR neurons were identified by their responses
      to innocuous brushing and to a range of pressure stimuli from innocuous to
      noxious. Noxious pressure was applied to regions of the ipsilateral hind paw
      corresponding to the receptive field of the neuron. WIN 55,212-2 (125
      micrograms/kg and 250 micrograms/kg, i.v.) produced a profound inhibition of
      firing evoked by the noxious pressure stimulus. By contrast, the cannabinoid did
      not alter the evoked activity of non-nociceptive neurons in response to non
      noxious levels of stimulation. Treatment with either vehicle or the inactive
      enantiomer WIN 55,212-3 (250 micrograms/kg) failed to alter noxious stimulus
      evoked activity of WDR neurons. These data provide direct evidence for
      cannabinoid-mediated inhibition of pain neurotransmission in the spinal dorsal
      horn. The site of action for these effects remains to be determined.

PMID- 7776840
TI  - Do cognitive impairments recover following cessation of cannabis use?
AB  - Our previous research with long term cannabis users established an impaired
      ability to focus attention and filter out irrelevant information, which was
      progressive with the cumulative duration of exposure to cannabis. The current
      study examined these processes in a group of ex-cannabis users. The results
      suggested a partial recovery of function but the past duration of cannabis use
      continued to have an adverse effect on the ability to effectively reject complex
      irrelevant information. There was no indication of improvement with increasing
      length of abstinence. Whilst relatively subtle in nature, the consequences of
      such an enduring deficit associated with cannabis use are worthy of further
      investigation.

PMID- 7776841
TI  - Biopsychosocial changes associated with cessation of cannabis use: a single case
      study of acute and chronic cognitive effects, withdrawal and treatment.
AB  - A 35 year old male was cognitively assessed prior to cessation of 18 years of
      daily cannabis use and monitored for several weeks post cessation. Brain event
      related potential (ERP) measures of selective attention reflecting a difficulty
      in filtering out complex irrelevant information showed no indication of
      improvement over 6 weeks of abstinence. In contrast, when tested in the acutely
      intoxicated state prior to cessation of use, a dramatic normalisation of the ERP
      signature of this individual was observed. A treatment program based on
      supportive-expressive psychotherapy was administered and depression, anxiety and
      general psychological health were monitored over the course of withdrawal from
      cannabis.

PMID- 7776842
TI  - Auditory and visual P300 event related potentials are not altered in medically
      and psychiatrically normal chronic marihuana users.
AB  - Attempts to use Event Related Potentials, particularly the cognitive or P300
      evoked potential, as measures of CNS effects of THC use have been infrequent and
      have produced inconsistent results. We published a pilot study in which
      psychiatric patient THC users had significantly prolonged auditory P300 latencies
      and reduced amplitudes as contrasted with non-users. Because psychiatric
      diagnoses and medication effects could not be controlled, we repeated the study
      with medically and psychiatrically normal subjects selected with extremely
      stringent exclusion criteria and screening procedures. P300 latency differences
      between THC users and controls were not detected. Using all subjects, THC users
      displayed reduced auditory and visual P300 amplitudes. However, when age
      differences between THC users and controls were removed, all significant P300
      amplitude differences were removed as well. The contaminating effect of using
      psychiatric patients in THC research is discussed and the importance of using
      carefully screened normal subjects in studies of neurophysiological abuse drug
      effects is stressed.

PMID- 7776843
TI  - Specific thought patterns in chronic cannabis smokers observed during treatment.
AB  - Clinicians report that chronic cannabis users seem to have symptoms, such as
      mental confusion and memory problems when entering treatment. The present study
      systematizes observations that were made during treatment of cannabis users
      during and after cessation of cannabis use. Cognitive symptoms prior to cessation
      are described in the conceptual framework of cognitive categories in the I.Q.
      test. Normalization of these cognitive functions during therapy is discussed.

PMID- 7776844
TI  - Chronic cannabis use and the sense of coherence.
AB  - Chronic cannabis users undergoing therapy were tested using the Sense of
      Coherence scale to determine the extent to which patients showed improvements in
      perceived comprehensibility, manageability, and meaningfulness of life.
      Improvement was demonstrated between admission and the completion of therapy six
      weeks later. Post-treatment scores were in the range of control subjects. Users
      who had quit using cannabis for more than 40 days at admission, but who had not
      participated in therapy, had somewhat higher scores than those who had quit for
      17 days or less at admission. Patients in a methadone treatment program had
      scores below norms and did not show improvement during treatment. Poly-drug
      abusers, who had undergone psychosocial treatment, had scores somewhat below
      normative scores. Improvement in chronic cannabis users is discussed in the
      context of cognitive and psychosocial problems associated with chronic cannabis
      use.

PMID- 7776845
TI  - Relationships between motivation and depression in chronic marijuana users.
AB  - The "amotivational syndrome" which has been associated with marijuana use has not
      been examined systematically in relation to marijuana use and mental health.
      Light and heavy users were solicited by personal contact. They were asked to
      complete anonymous questionnaires which measured marijuana, alcohol and cocaine
      use, perceived states during marijuana intoxication, depressive symptoms in the
      last year, the Orientation to Life Scale and a modified form of the Thematic
      Apperception Test, from which Need for Achievement, Affiliation and Power were
      assessed. Several group comparisons were made: Chronic heavy-users (medians:
      daily use for 6 years) with and without significant symptoms of depression within
      the last year were compared with Light users (medians: several times per month
      for 4.5 years) with and without significant symptoms of depression within the
      last year. Subjects in all groups reported similar ratings of intoxication (being
      stoned) during marijuana use. No differences were found in alcohol or cocaine use
      among the comparison groups. Scores on Need for Achievement were significantly
      lower in heavy users with depressive symptoms when compared with all other
      groups. No effects were found among groups in measures of the Need for
      Affiliation and the Need for Power. Both light and heavy users with symptoms of
      depression had significantly lower scores than those without depressive symptoms,
      on the overall Orientation to Life questionnaire and on each subscale measuring
      Meaningfulness, Manageability and Comprehensibility. These data suggest that
      amotivational symptoms observed in heavy marijuana users in treatment are due to
      depression.

PMID- 7776846
TI  - Long-term behavioral effects of perinatal exposure to delta 9
      tetrahydrocannabinol in rats: possible role of pituitary-adrenal axis.
AB  - This work evaluated motor behaviors in adult male and female rats exposed to
      delta 9-tetrahydrocannabinol (THC, 5 mg/kg) during gestation and lactation. The
      possibility that perinatal THC exposure induces sensitization to other drugs of
      abuse has also been addressed by evaluating morphine place preference
      conditioning (MPP) in the adult offspring. Maternal exposure to THC resulted in
      long-term effects on motor behaviors such as rearing, grooming and sniffing, in
      the adult offsprings of both sexes. Additionally, female offspring exposed to THC
      showed greater locomotor activity than controls, when measured using an
      actimeter. THC-exposed males exhibited an increased exploratory behavior in a
      plus-maze paradigm. When the adult animals were tested for MPP, THC-exposed
      offspring of both sexes exhibited an enhanced sensitivity to the rewarding
      effects of a moderate dose of morphine (350 micrograms/kg), an effect which was
      more marked in the males. These results showed that perinatal exposure to this
      psychoactive cannabinoid affected motor behaviors in the adult, suggesting a
      psychomotor activation very similar to that observed after gestational exposure
      to other drugs of abuse. A possible role of a THC-induced hypothalamus-pituitary
      adrenal (HPA) axis activation was also evaluated in the present study. THC
      exposed females exhibited higher levels of both corticotropin releasing factor
      (CRF-41) in the medial basal hypothalamus (MBH) and plasma corticosterone,
      whereas THC-exposed males showed the lower levels of both endocrine parameters.
      Since glucocorticoids are important modulators of both brain development, and
      adult brain function, these results indicate a possible role of HPA axis
      disturbances in the mediation of the behavioral effects described after perinatal
      THC exposure.

PMID- 7776847
TI  - The prenatal exposure to delta 9-tetrahydrocannabinol affects the gene expression
      and the activity of tyrosine hydroxylase during early brain development.
AB  - We have previously reported that the exposure of pregnant female rats to delta 9
      tetrahydrocannabinol (THC) during the perinatal period affected the gene
      expression and the activity of tyrosine hydroxylase (TH) in the brain of their
      male offspring. Those studies were done in animals perinatally exposed to THC but
      tested at peripubertal and adult ages. In the present work, we explored whether
      these effects also appear during early fetal brain development, when TH
      expression plays an important role in neuronal development. To this end, TH-mRNA
      concentrations were measured by Northern blot analysis with a specific TH probe
      in the brain of fetuses at gestational days 14 and 16 which had been prenatally
      exposed to THC or vehicle from day 5 of gestation. In parallel, measurements of
      TH activity and catecholamine contents by HPLC were also done. The results
      obtained were as follows. The prenatal exposure to THC markedly affected the
      expression of the TH gene in the brain of fetuses at gestational day 14. Thus,
      the amounts of TH-mRNA at this age were higher (2-fold) in THC-exposed fetuses
      than in controls. This corresponded with a marked increase in the activity of
      this enzyme (3-fold) at this age. Normalization was found in both parameters at
      gestational day 16. In summary, the prenatal exposure to THC affected the
      expression of the TH gene and the activity of this enzyme in brain
      catecholaminergic neurons during early fetal brain development. These results
      support the notion that cannabinoids are able to act at the level of the gene
      expression of specific key proteins for brain development.

PMID- 7776848
TI  - The relationship of tobacco and marijuana smoking characteristics.
AB  - In an ongoing study of the pulmonary effects of heavy, habitual marijuana
      smoking, detailed marijuana and tobacco smoking histories were obtained from 467
      adult regular smokers of marijuana and/or tobacco. Frequency and cumulative
      amounts of tobacco and marijuana smoking were similar for smokers and nonsmokers
      of tobacco, except that pack-years and cigarettes/day at the time of the
      interview were both significantly less for tobacco smokers who also smoked
      marijuana compared those who did not. For all subjects who smoked both substances
      at any time, changes in tobacco and marijuana smoking amounts after commencement
      of regular smoking of the other substance were similar for tobacco and marijuana;
      the existing smoking habit decreased in approximately one third of the subjects
      and remained the same in slightly more than one half of the subjects. Of the dual
      smokers, 49% began smoking tobacco before marijuana, while 33% began smoking
      marijuana first; 85% of marijuana smokers who quit tobacco smoking did so after
      beginning regular marijuana smoking. Self-reported depth of inhalation and breath
      holding time of marijuana smoke were similar for tobacco and non-tobacco smokers;
      smoking topography for tobacco was also comparable for smokers and non-smokers of
      marijuana.

PMID- 7776849
TI  - Acute and chronic effects of marijuana smoking on pulmonary alveolar
      permeability.
AB  - Pulmonary clearance of technetium (99mTc)-labeled diethylene triamine
      pentaacetate (DTPA), a sensitive test of alveolar epithelial permeability, was
      measured twice in 34 healthy subjects, including 10 control nonsmokers (NS), 10
      habitual smokers of marijuana alone (MS) (> or = 10 joints/wk), 9 regular smokers
      of tobacco alone (TS) (> or = 15 cigarettes/day) and 4 habitual smokers of both
      marijuana and tobacco (MTS). In smokers, the first study was performed after > or
      = 12 hrs of abstinence from smoking to assess chronic effects of marijuana and/or
      tobacco smoking on alveolar permeability; the second study was performed within
      15 min of smoking to assess possible acute effects. TS exhibited abnormally rapid
      99mTc-DTPA clearance after > or = 12 hours of abstinence, indicating an increase
      in pulmonary epithelial permeability, consistent with chronic tobacco-induced
      lung injury. MS showed a more modest and less consistent chronic effect than TS
      on 99mTc-DTPA clearance, suggesting a more variable and smaller degree of
      marijuana-induced lung injury. No acute effect of tobacco or marijuana smoking on
      99mTc-DTPA clearance was apparent. Concomitant habitual smoking of marijuana and
      tobacco had no additive effect on alveolar permeability.

PMID- 7776851
TI  - Beta-carotene (provitamin A) decreases the severity of CCl4-induced hepatic
      inflammation and fibrosis in rats.
AB  - Earlier data from experiments in rats have shown that administration of retinyl
      esters (vitamin A) strongly influences the effects of CCl4 on the liver. The
      accumulation of collagen was inhibited, but an increase in CCl4-toxicity with
      high mortality was observed. The present study was conducted to examine the
      effects of beta-carotene (provitamin A) on CCl4-related general and hepatic
      toxicity in rats. Oral administration of beta-carotene during CCl4-treatment
      resulted, biochemically, in a significantly lower increase in the hydroxyproline
      liver content and, histopathologically, in less severe liver fibrosis as compared
      with the liver of rats not treated with beta-carotene. The study also showed that
      beta-carotene administration could prevent the long-term loss of retinoids from
      the CCl4-injured liver. No significant toxic effects of beta-carotene, as
      previously found with retinyl esters (vitamin A), were observed. This
      experimental study suggests that beta-carotene has the therapeutic potential to
      decrease the severity of liver fibrosis without marked toxicity.

PMID- 7776850
TI  - Effects of smoking marijuana, tobacco or cocaine alone or in combination on DNA
      damage in human alveolar macrophages.
AB  - This study examined the role of marijuana smoking in the pathogenesis of human
      lung cancer by measuring DNA damage in alveolar macrophages (AM). The alkaline
      unwinding method was used to determine DNA single-strand breaks in AM lavaged
      from non-smokers [NS] and smokers of marijuana [MS], tobacco [TS] or cocaine
      [CS], either alone or in combination. DNA damage was related to superoxide anion
      (O2-) production by AM stimulated with phorbol myristate acetate (PMA) and to
      nitric oxide content of smoke using cellular nitrite (NO2-) concentrations. The
      percentage of double-stranded DNA present after alkaline unwinding was higher in
      AM of NS (41 +/- 5% [11]) and CS (41 +/- 4% [9]) versus that of MS (31 +/- 4%
      [8]), TS (35 +/- 3% [11]), MTS (26 +/- 4% [3]), and CTS (27 +/- 5%* [10]), mean
      +/- SEM [n], * = p < 0.1 vs. NS). PMA stimulated O2- production by AM from NS and
      CS was lower than that of other smokers, but the differences were not
      significant. O2- release, however, had an inverse correlation with DNA single
      strand breaks (r = -0.38, p = 0.009). Nitrite content of AM from NS and CS was
      less than that of other smokers' cells (p < 0.1 for TS & CTS vs. NS), but DNA
      damage had no relationship to NO2- concentration. We conclude that AM recovered
      from MS, either alone or in combination with tobacco smoking, show a trend
      towards DNA damage. Studies utilizing a larger population should verify our
      findings and further define its relationship to enhanced oxidant production by
      macrophages.

PMID- 7776852
TI  - Protective effect of diltiazem against acetaminophen hepatotoxicity in mice.
AB  - There is evidence that an increase in cytosolic Ca++ concentration is a terminal
      event in the progression to cell death in toxic liver injury. We have compared
      the hepatoprotective effects of N-acetylcysteine (1 g/kg) and the calcium channel
      blocking agent, diltiazem (24 mg/kg), when given at 30 min, 3 h and 6 h after
      single intraperitoneal overdoses of acetaminophen (500 mg/kg) in mice. Overall
      beneficial effects on mortality, liver necrosis score, and plasma alanine
      aminotransferase (ALT) activity were found in diltiazem-treated mice 24 h after
      acetaminophen overdose. However, the most marked effects were obtained when
      diltiazem was given 6 h after acetaminophen. N-acetylcysteine was more effective
      than diltiazem at 30 min and 3 h, although it was less effective at 6 h. Mean
      plasma concentrations of the mercapturate metabolite (hepatic oxidative
      metabolism) were not significantly different among animals receiving
      acetaminophen alone or in combination with diltiazem, which suggests that the
      hepatoprotective effects of diltiazem are not exerted by inhibition of drug
      metabolic enzymes.

PMID- 7776854
TI  - Severe hepatotoxicity related to benzarone: a report of three cases with two
      fatalities.
AB  - We report three cases of severe hepatotoxicity related to benzarone, a benzofuran
      derivative. Our cases include a 35-year-old woman with (sub)fulminant hepatitis,
      a 67-year-old woman with macronodular cirrhosis, and a 68-year-old man with
      severe chronic active hepatitis and cirrhosis, with positivity of anti-smooth
      muscle antibodies. Two patients died. We stress the potential of benzarone to
      cause hepatotoxicity, which usually resembles severe chronic active hepatitis.
      Our cases constitute the most severe cases of benzarone hepatotoxicity reported
      so far, and comprise the first cases of (sub)fulminant hepatitis and cirrhosis
      related to benzarone.

PMID- 7776853
TI  - Lymphoblastoid interferon therapy in chronic hepatitis C: biochemical,
      virological and histological evaluation of two different doses.
AB  - Sixty patients of both sexes with biopsy-proven chronic hepatitis C were
      randomized to receive lymphoblastoid interferon 3 MU or 6 MU three times weekly
      for 6 months. A follow-up period of 3 months at the end of the therapy was
      scheduled. Thirty-two patients (53.3%) normalized alanine aminotransferase at the
      end of the therapy. Of these, 17 received 3 MU (56.7%) and 15 (50%) received 6
      MU. Eighteen of the 32 patients (56.2%) relapsed in the follow-up period after
      treatment. No significant difference in relapse rate was observed between the two
      groups. The overall percentage of the non-responder patients was 36.6%. The
      treatment was discontinued because of non-compliance and/or side effects in six
      patients (10%): three in the 3-MU group and three in the 6-MU group. An
      improvement in liver histology was observed in about a quarter of chronic active
      hepatitis patients whose overall diagnosis changed to chronic persistent
      hepatitis. Knodell's score system showed a significant improvement (p < 0.05)
      with regard to peripheral necrosis, fibrosis and total score. HCV-RNA was
      positive at the beginning in all patients and it became undetectable in almost
      all responder patients. In some cases there was no correlation between viraemia
      and biochemical signs of liver disease. Our study shows that 6 MU does not
      increase the response rate compared to 3 MU. Moreover, the lower dose is able to
      improve the liver histology and to abolish the HCV viraemia in responder
      patients.

PMID- 7776855
TI  - The role of the spleen in endotoxin-induced liver injury.
AB  - In these experiments, the role of the spleen in endotoxin-induced liver injury
      was evaluated, using rats which underwent splenectomy or splenic vein ligation
      with antecedent spleno-systemic shunt. Male Wistar rats were divided into three
      groups: a sham-operated group, a splenectomy group, and a splenic vein ligation
      group. In each animal, 48 h after surgery, 5 mg/kg lipopolysaccharide (LPS) were
      injected intravenously. Six rats from each group were sacrificed 6 or 12 h after
      LPS administration. Bronchoalveolar lavage fluid (BALF) and arterial blood were
      also collected. Splenectomy reduced the liver injury as indicated by the serum
      lactate dehydrogenase level. A decrease in liver tissue adenosine triphosphate
      and increase in lipid peroxide were induced by LPS administration and inhibited
      by splenectomy. Splenectomy also reduced alveolar protein release as indicated by
      the protein level in BALF. Splenic vein ligation provided similar protective
      effects on the liver, but did not affect lung injury. From these results, it
      appears that the spleen plays a significant role in endotoxin-induced liver
      injury, and a mediator derived from the spleen is likely associated with
      development of liver injury. This mediator may be cleared or inactivated by not
      only splenectomy but also splenic vein ligation.

PMID- 7776856
TI  - Mannan-binding protein and complement dependent opsonization in alcoholic
      cirrhosis.
AB  - Mannan-binding protein is synthesized by the liver and functions in first-line
      host defence by opsonizing mannose-rich microorganisms due to activation of the
      classical complement pathway independent of Clq, and by an intrinsic ability to
      opsonize and mediate phagocytosis. We have investigated whether the increased
      susceptibility to bacterial infections in patients with cirrhosis could be
      explained by low plasma concentrations of mannan-binding protein and impaired
      complement-dependent opsonization. We examined 51 patients with compensated
      alcoholic cirrhosis, 34 who were decompensated and 16 healthy controls.
      Irrespective of group, we found a significant correlation (p < 0.05) between
      plasma mannan-binding protein concentration and deposition of the complement
      opsonin C4 on mannan from baker's yeast. In contrast to what was expected, this
      kind of opsonization and plasma levels of mannan-binding protein were
      significantly increased in the patients with decompensated cirrhosis (p = 0.01
      and p = 0.007, respectively). A significant correlation (0 < 0.05) was found
      between mannan-binding protein and erythrocyte sedimentation rate, fibrinogen and
      haptoglobin in these patients. Though the correlations were weak (rho = 0.49, rho
      = 0.48 and rho = 0.40, respectively), the elevated levels of mannan-binding
      protein in the patients with decompensated cirrhosis may reflect an acute phase
      reaction. It is concluded that plasma levels of mannan-binding protein are
      increased in patients with decompensated cirrhosis and that complement-dependent
      opsonization of mannan does not seem to be compromized in patients with alcoholic
      cirrhosis.

PMID- 7776857
TI  - The French experience of treatment of chronic type D hepatitis with a 12-month
      course of interferon alpha-2B. Results of a randomized controlled trial.
AB  - Hepatitis due to hepatitis delta virus (HDV) infection is generally associated
      with severe histological abnormalities and rapid progression of the disease. To
      assess the efficacy of recombinant interferon-a2b in treatment of chronic delta
      hepatitis, 22 patients were entered into a randomized controlled trial: 11
      received interferon-a2b subcutaneously three times weekly for 12 months (5 MU/m2
      for 4 months and then 3 MU/m2 for a further 8 months) and 11 were untreated. All
      patients were followed up for 6 months after the completion of therapy. Nine
      treated patients completed the trial: one was withdrawn with hyperthyroidism and
      one committed suicide. Serum ALT levels were normalized or significantly reduced,
      always within 3 months of initiating treatment, and remained so in 73% of treated
      patients at the 4th month and in 54.5% at the 12th month, compared with 18% and
      18%, respectively, in the untreated group. Moreover, in seven of nine treated
      patients, interferon was associated with the clearance of serum HDV-RNA,
      associated with amelioration of the histological picture, whereas this occurred
      in only four of 11 untreated patients. On cessation of therapy, all patients but
      one experienced a biological and/or virological relapse over the 6-month follow
      up. In conclusion, our data confirm that HDV is sensitive to inhibition by
      interferon-a2b, although the schedule used did not achieve permanent control of
      the disease. The adverse effects of interferon require consideration; in
      particular, care will be needed to avoid serious psychiatric side effects.

PMID- 7776858
TI  - Association of primary sclerosing cholangitis, thymoma and hypogammaglobulinemia.
AB  - A 64-year-old Japanese woman with thymoma has been suffering from diarrhea and
      increased alkaline phosphatase levels without jaundice. Her serum immunoglobulin
      levels of IgM and IgG were less than half of the normal levels, with an increase
      in CD8 (suppressor/cytotoxic) T cell percentage and a decrease in CD4 (helper) T
      cell percentage, resulting in a lower CD4/CD8 ratio of 0.31. These immunological
      features are in accordance with those of hypogammaglobulinemia complicating
      thymoma. Cholangiography and a liver biopsy specimen disclosed the presence of
      primary sclerosing cholangitis (PSC). PSC has been recognized in various
      immunodeficiency syndromes and this case shows that thymoma complicated by
      hypogammaglobulinemia is associated with PSC.

PMID- 7776859
TI  - The vulnerabilities of mentally disordered witnesses.

PMID- 7776862
TI  - Representing and analysing the interviewee's account.

PMID- 7776860
TI  - The influence of witness appearance and demeanour on witness credibility: a
      theoretical framework.

PMID- 7776861
TI  - Quality investigation? Police interviewing of witnesses.

PMID- 7776863
TI  - Recording and disclosing statements by witnesses--law and practice.

PMID- 7776864
TI  - The admissibility of expert psychiatric and psychological evidence. Judicial
      training.

PMID- 7776865
TI  - Violent incidents in an adolescent forensic unit.
AB  - Violent incidents in psychiatric institutions have been the focus of much study
      over the past few decades. But there has been little work looking at similar
      incidents in child and adolescent units. The authors set out to examine whether
      some of the patterns observed in adult populations are true of adolescent groups.
      The Gardener Unit was considered appropriate in light of reports of a higher
      frequency of assaultative behaviour among younger clients and because of the
      nature of problems presented by clients needing a secure environment. All violent
      incidents are automatically recorded. The violent incident register was examined
      between 1 June 1991 and 1 June 1992 and the information cross-checked with case
      notes and nursing reports. Demographic details, etc. were obtained from case
      notes. The results indicated a slightly higher daily incident rate than adult
      studies. At least half of the population were involved in some form of violent
      episode over the 12-month period. The majority of incidents were minor in nature.
      Nursing staff were the most frequent targets, although females showed an excess
      of inwardly directed aggression (self harm). A prior history of violent behaviour
      did not serve as a realistic predictor of frequency of violent incidents in this
      study. With increasing concern regarding the care of this disturbed group of
      young people, it was felt important to look closely at the nature of and handling
      of violent incidents on this unit. A second paper will consider in detail how
      these incidents were dealt with.

PMID- 7776866
TI  - Mentally incapacitated adults and decision-making: a psychological perspective.
      Comments on Law Commission consultation papers, numbers 128, 129 and 130.
AB  - The law commission is currently proposing new legislation to protect the rights
      of mentally incapacitated adults. This paper describes, briefly, the proposed
      legislation. The author notes that the proposed legislation relies on categories
      established for the purposes of the Mental Health Act, 1983, which is itself
      under revision, and that these categories fail to capture the full range of cases
      to which the proposed legislation is intended to apply. The author suggests the
      use of more established international classification schemes which may be more
      readily understood across the European Community. Further, the author draws
      attention to developments in psychological theory and methodology, and urges the
      adoption of scientific methods in the assessment of cognitive incapacity, and in
      the more general application of the proposed legislation.

PMID- 7776867
TI  - Routine use of ultraviolet light in medicolegal examinations to evaluate stains
      and skin trauma.
AB  - The use of ultraviolet light induced fluorescence as an aid in forensic medical
      examinations of rape victims was evaluated preliminarily in a retrospective, non
      consecutive study. In a four-month period, 17 cases were referred by the police
      for examinations at the Institute of Forensic Pathology. Ultraviolet light
      illumination (UVI) was used in seven cases, and in six cases fluorescent skin
      areas were observed. The fluorescence was due to lesions in four cases and
      stainings with saliva and semen in other two cases. In at least two cases, skin
      trauma detected with UVI were unobserved in ordinary light. It is concluded that
      UVI should be a routine part of forensic medical examinations. It may assist the
      forensic medical examiner in finding skin trauma and in locating stains, thus
      enabling retrieval of material for serological analyses. UVI is simple to carry
      out, requiring only a small, portable ultraviolet light source.

PMID- 7776868
TI  - Neuroleptic induced sudden death--a case report and critical review.
AB  - A case report illustrates possible pathophysiological mechanisms of sudden death
      in psychiatric patients. Difficulties with the tendency to implicate
      phenothiazines as the cause of death are discussed in light of evidence that the
      death investigation and autopsy are often incomplete. Some suggestions are made
      to reduce the risk of a fatal outcome following a violent incident.

PMID- 7776869
TI  - Suicide by self-strangulation whilst under observation.
AB  - Two cases are reported of individuals who committed suicide after they had been
      identified as being acutely at risk of killing themselves. Self-strangulation by
      a ligature fashioned from the subjects' clothes was the mechanism of suicide in
      both cases. One death occurred in a police station and the other on an acute
      psychiatric ward. These cases highlight the need for those formulating policies
      concerning the supervision of the suicidal individual to pay attention to the
      minutiae of detail. In particular, a case is made for those at risk of suicide to
      be prevented from sleeping with their head covered by blankets.

PMID- 7776870
TI  - Forensic investigations in an arson case.
AB  - A case of arson is presented from the State of Himachal Pradesh, India. The case
      was initially reported as an accidental fire due to electrical short circuiting
      but was suspected by the police to be arson as Government money worth 1.32 lakh
      rupees was also stated to have been burned in the fire. Forensic investigations
      proved the case to be arson but no currency notes had been burned in the fire.

PMID- 7776872
TI  - Eye-witness testimony and judicial studies.

PMID- 7776871
TI  - Successful suicide by insulin injection in a non-diabetic.

PMID- 7776873
TI  - Contamination of witness memory in theory and practice.

PMID- 7776874
TI  - 42nd Meeting of the American College of Sports Medicine. Minneapolis, Minnesota,
      May 31-June 3, 1995. Abstracts.

PMID- 7776875
TI  - Three-dimensional spectroscopic imaging with time-varying gradients.
AB  - A spectroscopic imaging sequence with a time-varying readout gradient in the
      slice selection direction is used to image multiple contiguous slices. For a
      given voxel size, the imaging time and signal-to-noise ratio of the three
      dimensional spectroscopic sequence are the same as for a single slice acquisition
      without the oscillating readout gradient. The data reconstruction employs a
      gridding algorithm in two dimensions to interpolate the nonuniformly sampled data
      onto a Cartesian grid, and a fast Fourier transform in four dimensions: three
      spatial dimensions and the spectral dimension. The method is demonstrated by in
      vivo imaging of NAA in human brain at 1.5 T with 10 slices of 16 x 16 pixels
      spectroscopic images acquired in a total scan time of 17 min.

PMID- 7776876
TI  - Interpretation of 31P MRS spectra in determining intracellular free magnesium and
      potassium ion concentrations.
AB  - The current paper develops a simple mathematical model for the determination of
      the concentration of ionic species using the chemical shifts of ATP from
      phosphorus magnetic resonance spectroscopy (31P MRS) spectra. An iterative method
      is used to evaluate the equilibrium constants for a range of Mg/ATP equilibria.
      Initially, an expression for free magnesium concentration is determined by
      consideration of four equilibria. We then demonstrate how any number of
      equilibria may be included using this simplified analysis, by incorporation of
      pseudo equilibrium constants. This approach may be applied to the interpretation
      of both ex vivo and, more importantly, in vivo MRS spectra. Furthermore, the
      authors suggest that the commonly used equation for determining free
      intracellular magnesium concentration as presented by Gupta and colleagues is an
      oversimplification, particularly under conditions of fluctuating pH.

PMID- 7776877
TI  - A model for magnetization transfer in tissues.
AB  - Magnetization transfer in several tissues is measured and successfully modeled
      using a two-pool model of exchange. The line shape for the semi-solid pool is
      characterized by a superLorentzian and the liquid pool by a Lorentzian. The
      tissues investigated were white and gray matter, optic nerve, muscle, and liver.
      All tissues the authors studied are characterized by the same model but differ in
      the parameter values of the model. Blood and cerebral spinal fluid (CSF) were
      also investigated. The two-pool model with a Lorentzian line shape for both the
      semi-solid and liquid pools modeled the magnetization transfer in blood. In CSF,
      as expected, there is no measurable exchange of magnetization. The T2B associated
      with the semi-solid pool was short (approximately 10 microseconds) for all
      tissues indicating a fairly rigid semi-solid pool. In addition characterization
      of the line shape as superLorentzian indicates molecules such as integral
      membrane proteins or lipids in membranes are likely molecules participating in
      the exchange. Conversely, in blood large globular proteins are indicated due to
      the Lorentzian nature of the semi-solid pool and a T2B approximately 300
      microseconds.

PMID- 7776878
TI  - Action of compression and cations on the proton and deuterium relaxation in
      cartilage.
AB  - In this paper, investigations are described on the influence of osmotic pressures
      and of varying cation concentrations on water relaxation times in cartilage (pig
      articular cartilage and bovine nasal cartilage). Both water content and
      relaxation times decrease strongly with increasing osmotic pressure. This
      relaxation behavior can be explained in terms of a fast chemical exchange between
      unbound and bound water. Na+ does not influence water content or relaxation
      times, whereas Ca2+ causes a small reduction in these parameters.

PMID- 7776879
TI  - Magnetization transfer and T2 relaxation components in tissue.
AB  - T2 relaxation makes an important contribution to tissue contrast in magnetic
      resonance (MR) imaging. Many tissues are known to exhibit multicomponent T2
      relaxation that suggests some compartmental segregation of mobile protons on a T2
      timescale. Magnetization transfer (MT) is another relaxation mechanism that can
      be used to produce tissue contrast in MR imaging. The MT process depends strongly
      on water-macromolecular interactions. To investigate the relationship between
      multicomponent T2 relaxation and the MT process, multiecho T2 measurements have
      been combined with MT measurements for freshly excised samples of cardiac muscle,
      striated muscle, and white matter. For muscle, short T2 components show greater
      MT than long T2 components, consistent with the belief that they represent
      distinct water environments. For white matter, quantitative MT measurements were
      identical for the two major T2 components, apparently because of exchange between
      the T2 compartments on a time-scale characteristic of the MT experiment.
      Implications for accurate modeling of MT in tissue and the use of MT for MR image
      contrast are discussed.

PMID- 7776880
TI  - Phase constrained encoding (PACE): a technique for MRI in large static field
      inhomogeneities.
AB  - In spin echo imaging, magnetization is assigned to a location defined by its
      frequency of rotation. In the presence of a static magnetic field inhomogeneity,
      however, this location does not correspond to the true location of the
      magnetization. This paper describes a magnetic resonance imaging technique called
      phase constrained encoding (PACE) that assigns magnetization to its true location
      through the use of a spin echo train and alternating readout gradients. Small
      artifactual side-bands occur in the point spread function but can be minimized or
      eliminated using higher gradient strengths, more echoes, and/or additional
      acquisitions. Implementation of a simple version of this technique confirms
      simulations.

PMID- 7776881
TI  - Pharmacokinetic mapping of the breast: a new method for dynamic MR mammography.
AB  - A dynamic contrast-enhanced MRI technique for whole breast examinations is
      presented. The fast kinetics of tissue response during and after constant-rate
      intravenous infusion of gadolinium diethylenetriaminopentaacetic acid was
      resolved using a strongly T1-weighted saturation recovery TurboFLASH sequence
      that makes it possible to acquire signal-time courses sequentially from 15
      adjacent slices with a temporal sampling rate of 21 s. On the basis of the
      mathematically established and experimentally verified linear relationship
      between the measured saturation recovery TurboFLASH signal variation and the
      gadolinium diethylenetriaminopentaacetic acid concentration in the tissue, the
      signal-time courses were analyzed within the framework of pharmacokinetic
      modeling. In our study, the tissue response was parameterized adequately using an
      open linear two-compartment model. With this approach, the tissue specific
      information contained in the signal-time course can be described using only two
      parameters: an amplitude A, reflecting the degree of MR signal enhancement, and
      an exchange parameter k21, characterizing vascular permeability and perfusion of
      the tissue. A clearly arranged representation of the large amount of data (480
      saturation recovery TurboFLASH breast images/examination) was accomplished by
      means of color coding of the computed parameters, resulting in one color-coded
      pharmacokinetic parameter map/cross-section.

PMID- 7776882
TI  - Intracellular volume measurement and detection of edema: multinuclear NMR studies
      of intact rat hearts during normothermic ischemia.
AB  - The present study describes the cell volume dynamics in intact rat hearts, during
      ischemia and after reperfusion. Cell volumes were measured in isolated hearts by
      either 13C or 59Co NMR of mannitol or cobalticyanide, respectively, as
      extracellular markers and 1H NMR of water as the aqueous space marker. A constant
      volume chamber was built inside a 15-mm NMR tube; the contents of the chamber
      were measured with and without a heart. The intracellular volume of isolated rat
      hearts was estimated to be 2.45 +/- 0.13 ml/g dry weight. In the perfused heart,
      adenosine triphosphate (ATP) and phosphocreatine (PCr) concentrations were
      calculated to be 12.2 +/- 0.7 and 16.1 +/- 1.0 mM, respectively. Consecutive
      volume measurements showed cell swelling of 16% during 30 min of ischemia, which
      was reduced at reperfusion to 7%. After 30 min of reperfusion, ATP and PCr
      concentrations were 4.5 +/- 0.8 and 8.1 +/- 0.9 mM. It is concluded that: (1)
      cell swelling is an ischemic event, which is partially reversed by reperfusion;
      and (2) continuous measurement of cell volumes provides intracellular molar
      concentrations of metabolites, which are the physiologically significant
      parameters.

PMID- 7776883
TI  - Susceptibility magnetic resonance imaging using spectral decomposition.
AB  - Susceptibility differences of materials in magnetic resonance imaging (MRI)
      usually lead to the intravoxel spin phase variations. Subsequently, the phase
      variation in the voxel results in a reduction of the signal intensity. This
      signal intensity reduction is known as the susceptibility effect in MRI and has
      been studied extensively. In this paper, a new spectral decomposition technique
      is proposed with which the signal change due to the susceptibility effect can be
      analyzed. Further, an NMR pulse sequence for the spectral decomposition of the
      susceptibility was developed and applied to susceptibility imaging of venous
      blood possessing paramagnetic properties. The computer simulations of the
      spectral decomposition method and their corresponding experimental results
      obtained using both a phantom and human volunteers are reported.

PMID- 7776884
TI  - GRASE improves spatial resolution in single shot imaging.
AB  - In single shot echo train imaging all the data required for a two dimensional
      image is acquired from a series of echoes generated following a single RF
      excitation pulse. Spatial resolution is limited because all samples must be
      acquired before the signal decays. In this paper we show theoretically that more
      echoes and hence better spatial resolution can be obtained with single shot GRASE
      imaging than with either echo planar imaging or single shot RARE imaging. This
      conclusion holds for both conventional imaging hardware and specialized gradient
      hardware designed for EPI. High quality single shot GRASE images support the
      theoretical conclusions.

PMID- 7776885
TI  - An algorithm for MR angiography image enhancement.
AB  - This study describes a three-dimensional (3D) filtering algorithm for magnetic
      resonance angiography (MRA) image enhancement. Based on the properties of 3D MRA
      data, the algorithm uses the dispersion range of the 13 outputs of a 3D
      directional low-pass filter bank to identify the vessel structure and control the
      processing of MRA data. Vascular structures in the data are preserved while the
      components of static tissues and isolated noise impulses are reduced by the
      processing. As a result, the small vessels have been enhanced and visibility of
      vessels in the projected image has been improved.

PMID- 7776887
TI  - A velocity k-space analysis of flow effects in echo-planar and spiral imaging.
AB  - A velocity k-space formalism facilitates the analysis of flow effects for imaging
      sequences involving time-varying gradients such as echo-planar and spiral. For
      each sequence, the velocity k-space trajectory can be represented by kv(kr); that
      is, its velocity-frequency (kv) position as a function of spatial-frequency (kr)
      position. In an echo-planar sequence, kv is discontinuous and asymmetric.
      However, in a spiral sequence, kv is smoothly varying, circularly symmetric, and
      small near the kr origin. To compare the effects of these trajectory differences,
      simulated images were generated by computing the k-space values for an in-plane
      vessel with parabolic flow. Whereas the resulting echo-planar images demonstrate
      distortions and ghosting that depend on the vessel orientation, the spiral images
      exhibit minimal artifacts.

PMID- 7776886
TI  - Respiratory blur in 3D coronary MR imaging.
AB  - 3D MR imaging of coronary arteries has the potential to provide both high
      resolution and high signal-to-noise ratio, but it is very susceptible to
      respiratory artifacts, especially respiratory blurring. Resolution loss caused by
      respiratory blurring in 3D coronary imaging is analyzed theoretically and
      verified experimentally. Under normal respiration, the width for any Gaussian
      point spread function is increased to a new value that is at least several
      millimeters (about 3-4 mm). In vivo studies were performed to compare respiratory
      pseudo-gated 3D acquisition with breath-hold 2D acquisition. On average, the
      overall quality of a pseudo-gated 3D image is worse than that of the
      corresponding breath-hold 2D image (P = 0.005). In most cases, respiratory blur
      caused coronary arteries in pseudo-gated 3D data to have lower resolution than in
      breath-hold 2D data.

PMID- 7776889
TI  - Quantitative analysis of dynamic Gd-DTPA enhancement in breast tumors using a
      permeability model.
AB  - The MRI signal enhancement in a breast tumor, measured as a function of time
      after a bolus injection of Gd-DTPA, may contain enough information to
      differentiate malignant from benign tissue. We find a physiological model for
      measuring capillary permeability and leakage space (P. S. Tofts, A. G. Kermode,
      measurement of the blood-brain barrier permeability and leakage space using
      dynamic MR imaging. 1. Fundamental concepts. Magn. Reson. Med. 17, 357-367
      (1991)) fits the data well. The enhancement curve is particularly sensitive to
      the preinjection T1 of the tumor, the dose, and the time of injection. This model
      may provide a means of characterizing the pathophysiology of breast tumors from
      the Gd-DTPA enhancement curve.

PMID- 7776888
TI  - Quantitative combined phosphorus and proton PRESS of the brains of newborn human
      infants.
AB  - Techniques for quantitative, combined phosphorus and proton, point-resolved
      spectroscopy (PRESS) studies of newborn-infant brain have been developed.
      Phosphorus PRESS advantages include: voxel-shimming; rapid transmitter-pulse
      setting; novel use of brain-water as a localized quantitation reference; and
      reduced broad components. Proton spectra from 1-ml voxels and phosphorus spectra
      can both be acquired quantitatively within acceptable time. Cerebral lactate was
      consistently detected by proton PRESS and the normal concentration (approximately
      3 mmol/kg wet weight) may be higher than in adult brain. Phosphorus PRESS
      provided metabolite peak-area ratios and concentrations comparable with those
      obtained using ISIS.

PMID- 7776890
TI  - Deuterium magnetic resonance imaging of rabbit eye in vivo.
AB  - We used deuterium magnetic resonance imaging (2H MRI) to visualize water movement
      in the rabbit eye. Dynamic 2H MRI was obtained every 3.5 min at 2 tesla by FLASH
      pulse sequence (TR, 300 ms; TE, 10 ms; alpha = 90 degrees) with a slice thickness
      of 10 mm using a surface coil (4 cm in diameter). After topical administration
      (0.2 ml D2O), only the aqueous chamber was imaged, and the signals decreased mono
      exponentially. The flow rate was 0.113/min, in agreement with that already
      reported. After intravenous administration of deuterated saline (3 ml/kg), the
      aqueous chamber became visible first during imaging, then by the vitreous body.
      The signals around the lens were only faintly detected. Thus, deuterium MRI was
      determined to be useful for visualizing water movement in the eye.

PMID- 7776891
TI  - Echo-time-encoded burst imaging (EBI): a novel technique for spectroscopic
      imaging.
AB  - A new technique for rapid spectroscopic imaging is presented. The proposed
      experiment enables a complete mapping of the two-dimensional reciprocal space kx,
      k sigma, and thus the acquisition of a 1D spectroscopic image in a single scan.
      The properties of the pulse sequence, based on the use of a burst of low flip
      angle pulses, are analyzed in the framework of linear response theory, and it is
      shown that chemical shift information may be introduced into the spatially
      encoded echoes. First experimental results are presented demonstrating that 32 x
      32 proton spectroscopic images may be acquired within less than 1 min with a
      conventional imaging system.

PMID- 7776892
TI  - Quantitative mapping of ocular oxygenation using magnetic resonance imaging.
AB  - Retinal hypoxia is hypothesized to initiate angiogenesis, a leading cause of
      blindness in developed countries. Attempts to test this hypothesis suffer from
      the need to use highly invasive oxygen electrodes. In this communication,
      noninvasive and quantitative mapping of ocular oxygenation using magnetic
      resonance imaging is demonstrated for the first time.

PMID- 7776893
TI  - Susceptibility artifact reduction in fat suppression.
AB  - Strong fat signal in regions where a large susceptibility difference exists, for
      instance at the interface between air and tissue near the maxillary sinus, may
      not be eliminated by currently available fat suppression techniques without
      sacrificing the overall quality of the images. In this article, we show that this
      fat signal, which appears as a susceptibility artifact, can be significantly
      reduced by using an optimized presaturation pulse with sharp edges and a broad
      bandwidth, while causing minimal disturbance of the water signal. Several
      optimized presaturation pulses can be reproduced by the Fourier coefficients
      provided in the Appendix.

PMID- 7776894
TI  - Cumulative subject index. Volumes 195-198, 200-227.

PMID- 7776896
TI  - Sunspots and the recency theory of schizophrenia.
AB  - Schizophrenia, a disorder with a high, fairly uniform, global distribution, can
      occur with or without an accompanying family history of mental disorder. Given
      the preponderance of sporadic cases and the low fertility of genetic cases, this
      combination suggests that the disorder might be caused by a globally active
      teratogen. It has recently been shown that some factor associated with high
      sunspot activity acts transgenerationally to reduce lifespan. The following
      article discusses the relevance of that finding to changes in the incidence of
      schizophrenia and suggests that schizophrenia is caused by some factor associated
      with sunspots.

PMID- 7776895
TI  - The solution to the seven mysteries of AIDS: the 'Trojan horse'.
AB  - It is concluded that the sperm is the cause of AIDS but that HIV may slightly
      alter the symptoms of this disease, as compared to idiopathic CD4+ T
      lymphocytopenia, or ICL, where the sperm, but not HIV, is assumed present. In the
      proposed mechanism, the sperm selectively accepts into its interior only
      macrophage-tropic HIV through its CD4+ antigens and carries this HIV into a
      person through four possible pathways: rectum (anal sex), genital ulcers, blood
      transfusions, and female circumcision. Then the sperm acts as a 'Trojan horse' by
      entering HLA-DR+ CD4+ T cells and releasing the HIV into these cells. The
      released HIV in turn mutates to a form capable of attacking CD4+ T cells. Thus
      the sperm by a 'Trojan horse' mechanism has changed the tropism of HIV. However,
      experimental evidence indicates that this mutated HIV is essentially non-toxic.
      In contrast, it is concluded that the sperm is extremely toxic since it is
      capable of inducing autoimmune reactions (by means of its CD4+ antigens) and is
      capable of entering and destroying HLA-DR+ CD8+ and HLA-DR+ CD4+ T cells in
      either the presence or absence of HIV (AIDS or ICL). Hence, the mysteries of AIDS
      can be explained by the presence of the toxic sperm and its complicated
      interactions with HIV (the 'Trojan horse' mechanism).

PMID- 7776897
TI  - Preliminary evidence for idiotype-antiidiotype immune complexes cross-reactive
      with lymphocyte antigens in AIDS and lupus.
AB  - Several investigators have proposed that autoimmunity may be induced by idiotype
      antiidiotype antibody networks. It is generally assumed that the antiidiotype is
      produced in response to the idiotype, and therefore that autoimmune diseases have
      single antigenic initiators. The theory of multiple-antigen-mediated autoimmunity
      (MAMA) proposes, on the other hand, that idiotype and antiidiotype result from
      two primary immune responses to two chemically complementary antigens. Because of
      the complementarity of the antigens, and the complementarity of the antibodies
      for the antigens, the antibodies will themselves be complementary. They will thus
      form circulating immune complexes, the self-nonself distinction diffusion (DAD)
      experiments (a modification of Ouchterlony immunodiffusion), in which 1800 pairs
      of antibodies were screened for their ability to form precipitating complexes.
      Four sets of antibodies associated with AIDS (HIV + Staphylococcus; HIV +
      Mycoplasma; CMV + Mycoplasma; and HBV + Mycoplasma) specifically precipitated
      each other, and one of the antibodies in each set also precipitated monoclonal
      antibodies against one or more lymphocyte protein markers. These results
      therefore demonstrate that idiotype-antiidiotype antibodies can be elicited by
      independent antigens and may induce AIDS-related forms of autoimmunity directed
      at lymphocytes.

PMID- 7776898
TI  - The 'LXCXE' hydropathic superfamily of ligands for retinoblastoma protein: a
      proposal.
AB  - The present study reports structural similarities between viral oncoproteins,
      growth factors belonging to the insulin family, members of the steroid/thyroid
      receptor superfamily, a D-type cyclin, the Elf-1 transcription factor and Bcl
      oncoproteins in regions that have been shown or proposed to mediate complex
      formation of these proteins with the tumor suppressor retinoblastoma protein
      (RB). This relationship predicts a common intracellular pathway for mitogenic
      signals and molecules promoting cell survival. Conversely, the structural
      evidence described here suggests that RB may play a central role both at the
      boundary between negative and positive cell growth regulation as well as in
      developmental decisions between cell death and cell survival.

PMID- 7776899
TI  - Synthetic inducible biological response amplifiers (SIBRAs): rational peptides at
      the crossroads between molecular evolution and structure-based drug design.
AB  - The present study proposes a novel type of synthetic chimaeric polypeptides
      potentially useful in the therapy of various diseases. The prototype peptide
      termed 'synthetic inducible biological response amplifier' (SIBRA) would comprise
      a ligand-binding site, a DNA-binding region, a trans-activating domain as well as
      strings of residues ensuring bioavailability and targeting to specific
      compartments such as the cell nucleus. These domains would be selected from
      cellular proteins, artificially tailored to a SIBRA and further modified towards
      a molecule with both in vivo and intracellular activity. Since proposed to
      resemble a host molecule with autoregulatory properties, a SIBRA would be
      activated upon exposure to a defined environmental stimulus and amplify host
      responses appropriate for this stimulus. Proteins would accumulate that share
      functional domains with the administered SIBRA and have a positive autoregulatory
      capacity. The latter may involve the interaction of the induced protein with the
      promoter of its gene resulting in a direct positive autoregulatory loop or
      require the induction of intermediary proteins that eventually upregulate the
      production of SIBRA-like host proteins. Since the ligand-binding site of a SIBRA
      is rationally designed to target a pathogenic protein, SIBRAs could be regarded
      as the product of an artificial acceleration and refinement of strategies
      intrinsic to the immune system.

PMID- 7776901
TI  - Antihistamines, a possible risk factor for Alzheimer's disease.
AB  - Antihistamines are frequently administered to psychiatric patients for a variety
      of purposes. Several large studies of schizophrenics have revealed an extremely
      high prevalence of Alzheimer's disease neuropathology compared with that in the
      general population. The neuroleptic treatment of schizophrenia appears to be
      implicated in this phenomenon. Many of the neuroleptics have anticholinergic
      effects, some being antihistamines as well, including chlorpromazine. It is
      proposed here that anticholinergics, including many antihistamines, either
      exacerbate the Alzheimer process or possibly contribute to its
      etiology/pathogenesis through their effects on cerebral cholinergic systems.
      Parsimony in the use of antihistamines thus appears to be warranted both for non
      patients and schizophrenics pending the resolution of this issue.

PMID- 7776900
TI  - Meditation, melatonin and breast/prostate cancer: hypothesis and preliminary
      data.
AB  - The objective of this study was to test the hypothesis that the regular practice
      of mindfulness meditation is associated with increased physiological levels of
      melatonin. Melatonin may be related to a variety of biologic functions important
      in maintaining health and preventing disease, including breast and prostate
      cancer. Previous studies have shown melatonin production is photosensitive and we
      suggest here that it also may be psychosensitive. A cross-sectional study of 12
      hour (20:00-08:00) urinary 6-sulphatoxymelatonin was conducted from which we
      analyzed data from 8 women who regularly meditate (RM) and 8 women who do not
      meditate (NM). All samples were collected in the homes of study participants.
      Volunteers were recruited to provide 12-hour overnight samples of urine. All
      subjects collected the samples on one night during the same 1-week period. There
      was no explicit intervention. However, all RM were either graduates of, or
      teachers in, the University of Massachusetts Stress Reduction and Relaxation
      Program. The main outcome measure was the total excretion of urinary 6
      sulphatoxymelatonin. Multiple linear regression (Proc GLM in SAS) was performed
      to test the effect of meditation (RM vs NM) on 6-sulphatoxymelatonin. The results
      of the study were that after controlling for the non-significant effect of
      menstrual period interval, we found an effect of meditation group (RM vs NM: b =
      1.983; F = 6.78; p = 0.02) and age (for each integer year: b = 0.169; F = 8.41; p
      = 0.01). The conclusion is that study results are consistent with our hypothesis
      and indicate that melatonin might be a useful parameter in testing similar psycho
      social interventions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7776902
TI  - The biology of deception: emotion and morphine.
AB  - The biology of deception suggests that denial-like processes are at the core of
      the cognitive coping. In this regard, with cognitive ability, one associates or
      assumes that this process occurs by way of a 'rational' mind. Such a detailed
      cognitive process as being rational would also lead, counter intuitively, to
      inactivity and or major delays in conclusion reaching. Thus, our perceived
      rationality may also be a deceptive behavioral response. Of equal noteworthyness,
      man is also 'emotional'. We surmise that emotion represents the pre-cognitive
      short-cut to overcome this potential for excessive rationality. In this light, we
      may explain certain psychiatric disorders such as obsessive-compulsive behavior
      as emotional extremes dealing with cognitive habits used to bind anxiety
      operating most probably at the pre-cognitive level. Given recent discoveries in
      neuroimmunology and an understanding of naturally occurring morphine as both an
      immune and neurological down-regulatory substance we hypothesize that
      abnormalities associated with emotional extremes may be due, in part, to
      morphinergic imbalances.

PMID- 7776903
TI  - Cultured human keratinocytes as a model for studying the dopamine metabolism in
      schizophrenia.
AB  - The dopamine hypothesis is the major etiological hypothesis of schizophrenia
      which proposes that enhanced central nervous system dopaminergic activity is the
      causative factor for this disease. The hypothesis remains unproven despite
      decades of research. The major difficulty in studying the disease is due to the
      unavailability of a suitable animal model. Studies with human blood,
      cerebrospinal fluid or post-mortem brains lead only to inconclusive results, due
      to the effects of medication and other environmental factors. No extra-neuronal
      cells, with the exception of adrenal medulla, have been reported to contain a
      dopamine metabolic pathway. Literature evidence and our own study suggest that
      human keratinocytes express the enzymes to synthesize and degrade dopamine. We
      have compared the properties of tyrosine hydroxylase, the rate-limiting enzyme,
      from mouse striatum and from human skin keratinocytes cultured in vitro. Moreover
      we could also detect dopamine beta hydroxylase and catechol-o-methyl transferase
      in keratinocytes. We propose that human keratinocytes cultured in vitro can be
      used to study the relevance of dopamine metabolism to schizophrenia under
      controlled conditions avoiding the effects of medication and other environmental
      factors.

PMID- 7776905
TI  - The role of mast cells and diet in the onset and maintenance of multiple
      sclerosis: a hypothesis.
AB  - Mast cells may invade the brain as a consequence of a childhood infection or
      predisposition, and it is proposed that multiple sclerosis arises due to the
      effect of various mediators (histamine and protease) released from the
      perivascular mast cells after stimulation by some diet factor.

PMID- 7776904
TI  - Neutrophil-macrophage interaction: a paradigm for chronic inflammation.
AB  - Autoimmune diseases, such as rheumatoid arthritis and inflammatory bowel disease
      are characterized by chronic inflammatory responses resulting in tissue damage.
      These diseases have a number of common denominators including: abnormal cytokine
      expression, aberrant antigen-antibody complexes, T cell anomalies, and increased
      numbers of neutrophils and macrophages. We propose that the interaction between
      neutrophils and macrophages induces a state of chronic inflammation which
      contributes to the disease state. One of the central players in this scenario is
      myeloperoxidase (MyPo). This enzyme functions in the 'cytotoxic triad' and is
      involved in cell killing. Studies done by the present investigators have known
      that MyPo, which is released from neutrophils, induces macrophages to secrete
      interleukin-1, interferon alpha beta and tumor necrosis factor alpha.
      Furthermore, our studies have suggested a major immunoregulatory role of this
      enzyme. We propose that the release of MyPo from neutrophils and subsequent
      binding to macrophages initiates a cascade of events which enhance the production
      of reactive oxygen intermediates and cytokine expression resulting in the chronic
      inflammatory state associated with autoimmune diseases.

PMID- 7776906
TI  - Computers and the clinical laboratory.
AB  - Quality control in the clinical laboratory has long been an important concern.
      The techniques used for several decades have relied heavily on aggregated data
      analysis of the data within the clinical laboratory itself, techniques which were
      feasible even in a system of manually maintained laboratory records. The
      development of increasingly sophisticated computerized hospital information
      systems presents an opportunity to significantly expand upon traditional quality
      control efforts.

PMID- 7776907
TI  - Adaptation and cross-resistance: an explanation for the existence of different
      radiosensitivities among malignant melanoma cells.
AB  - A hypothesis is presented to explain the apparent difference in the
      radioresponsiveness of melanoma lesions whether they are located on the skin or
      in other parts of the body. The hypothesis states that the radiosensitivity of a
      cell may change when the cell adapts to live and grow in a different environment.
      The most important environmental factor that affects the radiosensitivity of
      cutaneous melanoma cells appears to be the partial pressure of oxygen in their
      immediate environment. By virtue of adapting to grow in an environment having a
      high partial pressure of oxygen, the melanoma cells located on the skin may have
      developed a better antioxidant defense mechanism than cells that metastasize to,
      and grow in, other parts of the body having lower partial pressures of oxygen
      such as lymph nodes, brain and viscera. Because some of the cell-damaging effects
      of both oxygen and ionizing radiation are mediated through a similar mechanism,
      the melanoma cells on the skin become cross-resistant to ionizing radiation
      because of their higher tolerance to oxygen toxicity.

PMID- 7776908
TI  - Reducing the toll of diabetic complications.

PMID- 7776909
TI  - Enterohaemorrhagic Escherichia coli: an emerging food-borne pathogen with serious
      consequences.

PMID- 7776910
TI  - Isolation of HIV-1 from experimentally contaminated multidose local anaesthetic
      vials.
AB  - OBJECTIVE: To investigate the hypothesis that HIV can be transmitted via
      contamination of multidose vials of local anaesthetic solution through reuse of
      needles and syringes. DESIGN AND SETTING: Laboratory study. (1) By experiments
      with multidose vials and disposable needles and syringes, we identified a
      sequence of events in which HIV could contaminate the anaesthetic solution. (2)
      Three anaesthetic solutions were contaminated with a laboratory strain of HIV and
      tested by viral culture and p24 enzyme immunoassay one, two and four hours later
      to see how long the virus remained active. RESULTS: (1) Needles and syringes
      retained small volumes of fluid after use (mean, 25 microL; in syringe alone,
      mean 16 microL) which could be transferred to multidose vials of local
      anaesthetic. (2) 10 mL of anaesthetic solution contaminated with 8 microL of HIV
      infected solution (equivalent to 1% infected lymphocytes in vivo) contained
      active virus one hour later. In some settings, HIV could be isolated four hours
      after exposure. CONCLUSION: When inadvertently contaminated with HIV, multidose
      solutions represent a potential source of transmissible virus.

PMID- 7776911
TI  - Screening for diabetic retinopathy.
AB  - OBJECTIVES: To identify factors associated with a high risk of diabetic
      retinopathy in order to rank patients for urgency of examination by fundal
      photography. DESIGN: Retrospective case survey. PATIENTS: Eight hundred and
      eighty-eight consecutive diabetic patients who were routinely referred for
      mydriatic fundal photography to the Queen Elizabeth Hospital, Adelaide, between
      August 1987 and May 1992. OUTCOME MEASURES: The prevalence of non-proliferative
      and proliferative diabetic retinopathy and patient biochemical and demographic
      characteristics and urinary albumin excretion rate. RESULTS: The prevalences of
      nonproliferative and proliferative diabetic retinopathy were 18.1% and 2.4%,
      respectively. Multiple logistic regression analysis established that treatment
      with insulin or oral hypoglycaemic drugs was associated with the highest risk of
      diabetic retinopathy (odds ratio [OR], 14.7; 95% confidence interval [CI], 3.4
      63.2), while duration of diabetes > or = 7 years (OR, 3.6; CI, 1.9-6.8), age 50
      66 years (OR, 2.1; 95% CI, 1.1-4.0) and albumin excretion rate > or = 21
      micrograms/min (OR, 2.2; 95% CI, 1.1-4.5) were also significant risk factors. Non
      significant variables were hypertension, obesity and sex. CONCLUSIONS: Diabetic
      patients may be ranked for urgency of retinal photographic screening based on
      mode of treatment and duration of diabetes, thereby facilitating examination of
      patients at highest risk of asymptomatic diabetic retinopathy and increasing the
      efficiency of the screening program.

PMID- 7776912
TI  - Trends in prostate cancer incidence and mortality rates in South Australia, 1977
      1993.
AB  - OBJECTIVE: To investigate trends in recorded incidence and mortality rates for
      prostate cancer in South Australia. DESIGN: A multiple Poisson regression
      analysis of recorded incidence (by diagnostic period) and mortality (by year of
      death), after adjusting for age at diagnosis and residential location. SUBJECTS
      AND SETTING: 8073 patients with prostate cancer and 2659 who died of prostate
      cancer as notified to the South Australian Cancer Registry for 1977-1993. MAIN
      OUTCOME MEASURES: The relative risk of a recorded diagnosis of prostate cancer
      (by period of diagnosis), and of a death from prostate cancer (by year of death).
      RESULTS: During 1977-1989, the recorded age-standardised incidence of prostate
      cancer was stable, but it increased markedly thereafter. The relative risk (95%
      confidence limits) of diagnosed prostate cancer was 1.36 (1.29, 1.43) in 1990
      1992, and 2.26 (2.12, 2.42) in 1993, when compared with 1977-1989. There was a
      smaller and less certain increase in prostate cancer mortality. CONCLUSIONS: The
      large increase in recorded incidence of prostate cancer in South Australia is
      thought to be due mostly to increased disclosure of latent cases from increased
      clinical investigations. Until there is experimental evidence of health benefits
      from screening and related investigations for prostate cancer in asymptomatic
      men, it will be difficult to reconcile benefits with costs.

PMID- 7776913
TI  - Diet modification in lowering plasma cholesterol levels. A randomised trial of
      three types of intervention.
AB  - OBJECTIVE: To compare the efficacy of three types of diet and lifestyle
      interventions for lowering plasma lipid levels. DESIGN: Randomised parallel-group
      trial. SUBJECTS AND SETTING: Adults with plasma cholesterol levels of 5.5-8.0
      mmol/L attending two Sydney community health screening clinics were asked to
      participate: 179 agreed and 131 completed the study. INTERVENTIONS: A pamphlet
      with brief advice; group dietary counselling; or individual counselling.
      Counselling included three sessions with a dietitian/nutritionist over six
      months. MAIN OUTCOME MEASURES: Plasma total cholesterol levels measured by
      Reflotron analyser; fasting serum lipid levels measured by standard laboratory
      methods; and calculated low-density lipoprotein cholesterol levels. RESULTS:
      Significantly lower plasma total cholesterol levels (Reflotron) were observed at
      two months and at six months with each of the three interventions. Additionally,
      both types of dietitian-based counselling resulted in small but significant
      decreases in plasma low-density lipoprotein cholesterol levels at six months in a
      subset of subjects. CONCLUSION: Although there were no statistically significant
      differences in efficacy between the three types of intervention, dietitians have
      a role to play in setting up such counselling programs.

PMID- 7776915
TI  - Prevention of suicide in old age.
AB  - The prevention of suicide in old age has received little attention, despite
      suicide rates being highest in older men. About 90% of older people who attempt
      or complete suicide have a mental disorder, usually depression, which often has
      been inadequately treated. Other treatable contributing factors include pain,
      grief, loneliness, alcoholism and carer stress. Few suicides in older people
      occur in the context of terminal illness or can be regarded as "rational".
      Educational programs are required to improve the recognition and treatment of
      depression in primary care.

PMID- 7776914
TI  - Confusion, cortical blindness and fever.

PMID- 7776916
TI  - Early detection of diabetic retinopathy.
AB  - Diabetic retinopathy remains a leading cause of blindness in Australia. Most
      cases can be prevented by timely laser photocoagulation and this requires early
      detection of asymptomatic retinopathy. The Australian Diabetes Society recommends
      regular retinal examinations through dilated pupils, either at diagnosis of
      diabetes (onset over 30 years), or five years after diagnosis (onset under 30
      years). Examination should be repeated at least every two years, or more
      frequently in the presence of visual symptoms, pregnancy or other risk factors.
      Diabetic patients and primary care physicians should be better informed about the
      effectiveness of timely treatment of diabetic retinopathy and the need for
      regular eye examinations, either by general practitioners or through referral to
      ophthalmologists.

PMID- 7776917
TI  - Drugs and the kidney in the elderly.
AB  - The high rates of drug-induced acute renal failure, worsening chronic renal
      dysfunction and systemic toxicity of renally excreted drugs in the elderly can be
      minimised by carefully assessing renal function, avoiding potentially nephrotoxic
      drugs as much as possible and closely monitoring drug concentrations and renal
      function when they must be used. The co-existence of impaired renal function,
      degenerative vascular disease or cardiac failure in the elderly substantially
      increases the risk of renal toxicity. When in doubt about potential
      nephrotoxicity or an increased risk of systemic toxicity from renally excreted
      drugs in the elderly, the practitioner should consult the numerous published
      guidelines.

PMID- 7776919
TI  - Health outcomes: of means and ends.

PMID- 7776918
TI  - Theophylline.

PMID- 7776920
TI  - Health outcomes: of means and ends.

PMID- 7776921
TI  - Stereotypes of aboriginal health.

PMID- 7776922
TI  - Invasive pneumococcal disease in central Australia.

PMID- 7776923
TI  - An improved workers' compensation and rehabilitation certificate.

PMID- 7776925
TI  - Peptic disease: can we afford current management?

PMID- 7776924
TI  - Possible serotonin syndrome with moclobemide and pethidine.

PMID- 7776926
TI  - Chronic intractable focal epilepsy: a case report.

PMID- 7776927
TI  - Fatal intracranial haematomas in two patients with brown snake envenomation.

PMID- 7776929
TI  - Malaria acquired in Bali.

PMID- 7776928
TI  - BreastScreen services.

PMID- 7776930
TI  - Ophthalmomyiasis: a shot in the eye.

PMID- 7776931
TI  - Surviving in the house of God.

PMID- 7776932
TI  - [Wiesbaden 1995: Medical orientation and priorities].

PMID- 7776933
TI  - [Duration of the effect of inhaled corticosteroids on lung function and
      sensitivity of the respiratory tract in patients with bronchial asthma].
AB  - AIM: The effects of cessation of therapy with inhaled steroids on symptoms, lung
      function, and airway responsiveness in stable bronchial asthma should be
      examined. PATIENTS AND METHODS: During a 4-week run-in period 24 patients inhaled
      beclomethasone dipropionate (BDP) 2000 micrograms/d and salbutamol 800
      micrograms/d. This was followed by a 6-week treatment period during which the
      patients obtained either placebo plus 800 micrograms salbutamol or 2000
      micrograms BDP plus 800 micrograms salbutamol in a randomized double-blind
      design. Symptoms, lung function, and airway responsiveness to histamine were
      measured before and after the run-in period and at the end of each week during
      the treatment period. RESULTS: Airway responsiveness was assessed as the
      concentration of inhaled histamine which caused a 20% fall in FEV1 compared to
      baseline (PC20). During the run-in period, 21 of the 24 patients showed an
      increase of PC20 (p = 0.0005). In the placebo group, 5 patients had to cease the
      protocol after 1 to 4 weeks of the treatment period because of intolerable
      symptoms and severe worsening of lung function; PC20 on entry was significantly
      smaller in these patients compared to those who completed the protocol (p =
      0.01). After 6 weeks, FEV1 had decreased by 8.5% (p = 0.005) and PC20 by 1.71
      doubling concentrations (p = 0.0003). In the BDP group, all patients completed
      the study and PC20 after the treatment period was significantly higher (p = 0.04)
      in the BDP than in the placebo group. CONCLUSION: Our data suggest that patients
      on long-term inhaled steroid therapy with a high degree of bronchial
      hyperresponsiveness are more likely to show early deterioration of their clinical
      state after cessation of inhaled steroids.

PMID- 7776934
TI  - [Socioeconomic evaluation of the effect of rhDNase on the cost of treating
      infections of the respiratory tract in patients with cystic fibrosis].
AB  - BACKGROUND: Data from a multicenter, placebo-controlled, double-blind, parallel
      clinical trial on the use of aerosolized recombinant human DNase (rhDNase), known
      as Pulmozyme produced by Genentech, about the treating of respiratory-tract
      infections among patients with cystic fibrosis (CF), has been used to evaluate
      possible economic effects by identifying the direct medical costs. To calculate
      the cost an intention-to-treat approach has been used. PATIENTS AND METHOD: The
      patients were randomly placed in one of three treatment groups. The first group
      was treated with a 2.5 mg dose of rhDNase and one dose of placebo daily, the
      second group with placebo twice a day. The third patient group (treated with a
      2.5 mg dose of rhDNase twice a day) was not included in this study. RESULTS: The
      main measurements of resource utilization of services for treatment of
      respiratory-tract infections were the number of hospitalizations in the follow-up
      period of 24 weeks (0.41 rhDNase once daily, 0.56 placebo), the number of total
      days in hospital (4.9 rhDNase, 6.4 placebo), the number of total days of
      outpatient intravenous antibiotic therapy (2.9 rhDNase, 4.4 placebo), the number
      of total days of inpatient intravenous antibiotic therapy (4.8 rhDNase, 6.2
      placebo), the number of total days of outpatient oral antibiotic therapy (23.5
      rhDNase, 25.2 placebo) and the number of total days of inpatient oral antibiotic
      therapy (0.59 rhDNase, 0.55 placebo). From a health insurance perspective the
      total direct cost based on a weighted per diem for German CF-centres was 5,879 DM
      (rhDNase) vs 7,849 DM (placebo) per patient respectively. Costs of antibiotics
      were estimated using all available information on the consumption of antibiotic
      drugs revealing 2,954 DM per patient in the rhDNase-group and 4,213 DM in the
      placebo-group. The large cost differences remain also true in a sensitivity
      analysis introducing minima and maxima as key factors. CONCLUSION: As a result of
      this study we conclude that the use of rhDNase in treatment of respiratory-tract
      infections in patients with cystic fibrosis is cost saving and less burdened for
      the patients. However, all cost estimates do not include the cost of rhDNase
      itself, which are DM 9,094 for the period of follow-up.

PMID- 7776935
TI  - [Traumatically-induced ischemia of the hands].
AB  - BACKGROUND: The widely unknown hypothenar hammer syndrome (HHS) is caused by
      chronic mechanical trauma; in these cases the hypothenar is used as a tool. This
      may cause intimal lesions of the ulnar artery usually near the hamate bone
      resulting in thrombosis or aneurysms. PATIENTS: Six patients with HHS are
      presented. In four cases occupational activities were most probable cause for
      HHS, in two patients sport activities. DIAGNOSIS: Clinical examination already
      indicates insufficient blood supply in the supply area of the ulnar artery. Non
      invasive methods of examination are doppler measurements of hand arteries and
      occlusion plethysmography of finger arteries. For differential diagnosis
      capillaroscopy, laboratory tests and hand arteriography can be necessary.
      THERAPY: Avoiding the releasing cause is main part in therapy of HHS. Only in few
      patients special medical treatment is indicated. CONCLUSION: Positive evidence of
      causal relationship between occupational exposure and appearance of HHS has to be
      acknowledged as occupational disease.

PMID- 7776936
TI  - [Therapy of tuberculosis in the adult].

PMID- 7776937
TI  - [Rheumatology update--1. Summary of clinically significant current knowledge and
      outlook perspective of relevant trends in etiopathogenetic research, diagnostic
      methods and therapeutic possibilities].

PMID- 7776938
TI  - [Torsade de pointes and QT syndrome].

PMID- 7776940
TI  - [God in the medical dialogue. Dialogue of the God-less?].

PMID- 7776939
TI  - [Asthma is asthma, is asthma...].

PMID- 7776941
TI  - [Meningoencephalitis caused by Listeria monocytogenes in excessive ultraviolet
      light irradiation in the whole-body solarium].

PMID- 7776942
TI  - [Toxic hydrocarbon pneumonitis in a "fire eater"].

PMID- 7776943
TI  - Reinventing the American hospital.
AB  - The American hospital is being reinvented to conform with the forces that are
      replacing the acute, inpatient-oriented illness model of health care with a
      disease-prevention, health-promotion, primary-care one. Although hospitals will
      no longer conduct the "core business" of American health care, they can play a
      key role by empowering others and facilitating the integration of health services
      across the continuum of care. New management and governance structures will be
      required, as will population-based health status needs assessments, new relations
      with physicians, re-engineering of the clinical processes, organization-wide
      commitment to improving quality, information systems that link patients and
      providers, and creation of an overall community care management system. Despite
      major barriers, there are examples of progress.

PMID- 7776944
TI  - Expanding the home care concept: blurring distinctions among home care,
      institutional care, and other long-term-care services.
AB  - Distinctions between home care and residentially based care are blurring because
      of two trends: home care providers are offering services, including personal
      assistance, outside of the private, self-contained family home or apartment; and
      a market-driven movement is underway to develop group residential settings where
      long-term-care (LTC) consumers with substantial disability receive personal care
      and nursing in their own, fully equipped, apartments where they largely control
      the schedule. For the customers, such boundary blurring can lead to experiences
      of greater power and normality in their everyday lives. State regulations will
      help determine the extent to which new, "residentially" oriented models of LTC
      are feasible. Home care providers are challenged to develop flexible and creative
      paradigms for service that are built on a recognition that older adults with
      disabilities have the right to choose risks.

PMID- 7776945
TI  - "Man, woman, and chore boy": transformations in the antagonistic demands of work
      and care on women in the nineteenth and twentieth centuries.
AB  - Because the population is aging when increasing numbers of women are entering the
      labor force, policy makers stress the problems of reconciling the conflict
      between work and care. This conflict has a long history, especially for poor
      women and women of color. During the nineteenth century, caregiving was more
      likely to clash with domestic work than with paid employment. The expansion of
      the health care delivery system between 1890 and 1940 removed some
      responsibilities from the home. But rather than disappearing, many caregiving
      obligations changed. The growth of women's labor force participation altered the
      relation between work and care. Some women quit jobs they desperately needed when
      family members fell ill. Others left serious sick or disabled family members
      unattended.

PMID- 7776946
TI  - Toward allocative efficiency in the prescription drug industry.
AB  - Traditionally, monopoly power in the pharmaceutical industry has been measured by
      profits. An alternative method estimates the deadweight loss of consumer surplus
      associated with the exercise of monopoly power. Although upper and lower bound
      estimates for this inefficiency are far apart, they at least suggest a
      dramatically greater welfare loss than measures of industry profitability would
      imply. A proposed system would have the U.S. government employing its power of
      eminent domain to "take" and distribute pharmaceutical patents, providing as
      "just compensation" the present value of the patent's expected future monopoly
      profits. Given the allocative inefficiency of raising taxes to pay for the
      program, the impact of the proposal on allocative efficiency would be at least as
      good at our lower bound estimate of monopoly costs while substantially improving
      efficiency at or near our upper bound estimate.

PMID- 7776947
TI  - Rare diseases, drug development, and AIDS: the impact of the Orphan Drug Act.
AB  - The Orphan Drug Act provides public subsidies and incentives to spur the
      development of drugs for rare diseases--drugs that the private sector might
      otherwise consider unprofitable to produce. Although the act has achieved
      numerous successes, the high prices and extraordinary sales generated by some
      orphan drugs lead to a pivotal policy question: how can the act be used to meet
      the legislative goal of stimulating drug development for small patient
      populations without resulting in prices that make drugs inaccessible? This
      question is explored using the example of AIDS drugs, many of which received
      subsidies under the act, to illustrate central points. The history of the act,
      its weaknesses, and strategies for reform are described as well.

PMID- 7776948
TI  - The illusion of failure: trends in the self-reported health of the U.S. elderly.
AB  - Data from the National Health Interview Survey showed a trend toward worsening
      self-reported health among older American men and women during the 1970s. This
      evidence--combined with the significant declines in age-specific mortality
      observed since the 1960s--led some researchers to suggest that the health of the
      older population is declining. An examination of recent trends in self-reported
      health indicates that the health declines observed during the 1970s generally
      reversed during the 1980s. This reversal not only belies the argument that lower
      adult mortality implies worse health, but also challenges the belief that trends
      in self-reported health during the 1970s reflected actual health declines. A more
      plausible explanation is that changes in the social and economic forces, combined
      with earlier diagnosis of preexisting conditions, influenced the options
      available for responding to health problems.

PMID- 7776949
TI  - Serious eye injuries associated with fireworks--United States, 1990-1994.
AB  - Eye injuries caused by fireworks are often severe and can cause permanently
      reduced visual acuity or blindness. Findings from the National Electronic Injury
      Surveillance System database maintained by the U.S. Consumer Product Safety
      Commission (CPSC) indicate that approximately 12,000 persons are treated each
      year in U.S. emergency departments because of fireworks-related injuries; of
      these, an estimated 20% are eye injuries. To improve characterization of
      fireworks-related eye injuries, data were analyzed from the United States Eye
      Injury Registry (USEIR) for July 1990-December 1994 and from the Eye Injury
      Registry of Alabama (EIRA) for August 1982-July 1989. This report summarizes the
      findings of these analyses.

PMID- 7776950
TI  - Achievement of dietary goals--Kansas, 1993.
AB  - Fat intake and other dietary factors are associated with increased risk for
      important chronic diseases, including cardiovascular disease and cancer (1-4). To
      characterize the nutritional behaviors of residents of Kansas, the Kansas
      Department of Health and Environment (KDHE) conducted a nutrition assessment
      survey in 1993 and has used the results as a baseline for monitoring progress
      toward attaining Healthy Kansans 2000 (HK2000) nutrition objectives. This report
      summarizes selected findings from the nutrition survey relative to three HK2000
      objectives: 1) increase to 35% the proportion of adults who consume five or more
      daily servings of fruits and vegetables; 2) increase to 40% the proportion of
      adults whose dietary fat intake constitutes < 30% of their total food-energy
      intake (a lower fat diet); and 3) increase to 70% the proportion of adults who
      consume > or = 600 mg of calcium daily (75% of the Recommended Dietary Allowance
      for adults aged > or = 25 years [5]).

PMID- 7776951
TI  - Lyme disease--United States, 1994.
AB  - For surveillance purposes, Lyme disease (LD) is defined as the presence of an
      erythema migrans rash > or = 5 cm in diameter or laboratory confirmation of
      infection with Borrelia burgdorferi and at least one objective sign of
      musculoskeletal, neurologic, or cardiovascular disease (1). In 1982, CDC
      initiated surveillance for LD, and in 1990, the Council of State and Territorial
      Epidemiologists adopted a resolution that designated LD a nationally notifiable
      disease. This report summarizes surveillance data for LD in the United States
      during 1994.

PMID- 7776952
TI  - African pygmy hedgehog-associated salmonellosis--Washington, 1994.
AB  - During 1994, the Washington Department of Health Public Health Laboratory
      reported the isolation from a human of a rare Salmonella serotype, Salmonella
      serotype Tilene. This report summarizes the epidemiologic investigation of the
      case by the Seattle-King County Department of Public Health, which suggested the
      infection was related to exposure to African pygmy hedgehogs.

PMID- 7776954
TI  - Evidence for aestivation specific proteins in Otala lactea.
AB  - Changes in [35S]methionine protein labeling patterns were examined by following
      incorporation into the acid precipitate protein fraction of land snails, Otala
      lactea (Muller) (Pulmonata, Helicidae). Labeled proteins were analyzed by SDS
      polyacrylamide gel electrophoresis and isoelectric focusing columns. Snails in
      four different physiological states were compared: active controls, short term
      aestivating snails (injected and allowed to enter aestivation), long term
      aestivating snails (aestivated for 14 days, injected, and maintained in the
      aestivating state), and snails aroused after aestivation (aestivated, injected,
      and aroused). Protein associated radioactivity was measured over a 7 day time
      course post injection. Autoradiographic analysis of SDS-polyacrylamide gels
      showed increases in the radioactivity of four proteins: 91 kDa (hepatopancreas,
      day 1 in long term aestivating animals), 50 kDa (hepatopancreas, day 2 in short
      term aestivating snails), 70 kDa and 30 kDa (foot, day 2 in short term
      aestivating animals). Hepatopancreas and foot from day 1 long term aestivating
      and day 2 short term aestivating animals were also analyzed by isoelectric
      focusing columns. Several pH-specific differences were apparent when controls and
      aestivating animals were analyzed. In particular a peak of radioactivity was
      observed at pH 5.05 in 1 d long term aestivating hepatopancreas and at pH 4.30 in
      2d short term aestivating animals. Several differences were noted in foot with no
      specific pattern emerging. SDS-polyacrylamide gel electrophoresis analysis of the
      hepatopancreas peaks showed the appearance of several bands with increased
      radioactivity, including the 91 kDa and 50 kDa proteins described above. These
      results suggest that O. lactea aestivation specific proteins may be involved in
      the transition to a depressed metabolic state.

PMID- 7776953
TI  - Cellular hypertrophy in cardiomyopathic patients is associated with lower
      creatine-stimulated mitochondrial respiration.
AB  - The mitochondrial respiration rate and morphometric indices in endomyocardial
      biopsy samples were measured in 43 patients with dilated cardiomyopathy selected
      in accordance to WHO criteria by endomyocardial biopsy studies after excluding of
      various forms of myocarditis, alcoholic cardiomyopathy and other specific
      diseases of the heart. A group of 13 patients with unusually high mean myocyte
      diameter, 30 +/- 4 microns, and nuclear size, 57 +/- 5 microns, was selected. The
      remainder of patients (n = 30) had significantly lower mean myocyte diameter and
      nuclear size, 23 +/- 3 and 42 +/- 6 microns, respectively, (p < 0.01). Creatine
      stimulated elevation in mitochondrial respiration rate as measured in saponin
      skinned fibers was found in the former group to be much lower (36 +/- 4%) as
      compared with the remainder (90 +/- 12%). Also, the former group of patients had
      higher left ventricular enddiastolic pressure and volume index with concomitantly
      decreased ejection fraction. The results indicate that marked nuclear and
      cellular hypertrophy is associated with lower creatine-stimulated mitochondrial
      respiration rate and more severe cardiac failure. They suggest that disorders in
      energy supply to myofibrils may be related to disturbances in cellular genetic
      apparatus.

PMID- 7776955
TI  - Ribosomal proteins of Thermomyces lanuginosus--characterisation by two
      dimensional gel electrophoresis and differential disassembly.
AB  - One- and two-dimensional gel electrophoresis were employed to characterise the
      proteins derived from the ribosomes of the thermophilic fungus Thermomyces
      lanuginosus. Approximately 32 (29 basic and 3 acidic) and 45 (43 basic and 2
      acidic) protein spots were resolved from Th. lanuginosus small and large
      ribosomal subunits, respectively. The molecular weight of the small subunit
      proteins ranged from 9,800-36,000 Da with a number average molecular weight of
      20,300 Da. The molecular weight range for the large subunit proteins was 12,000
      48,500 Da with a number average molecular weight of 25,900 Da. Most proteins
      appeared to be present in unimolar amounts. These data are comparable with but
      not identical to those from other eukaryotic ribosomes. The sensitivities of the
      ribosomal proteins to increasing concentrations of NH4Cl were also evaluated by
      two-dimensional gel electrophoresis. Most ribosomal proteins were gradually
      released over a wide range of salt concentrations but some were preferentially
      enriched in one or two salt conditions.

PMID- 7776956
TI  - Damage to cultured lens epithelial cells of squirrels and rabbits by UV-A (99.9%)
      plus UV-B (0.1%) radiation and alpha tocopherol protection.
AB  - The purpose of this research is to observe the near-UV radiation induced damage
      to cultured rabbit and squirrel lens epithelial cells as related to destruction
      and alterations of specific biochemical targets in the cells and to determine
      protective effects on the cells and targets that are provided by alpha
      tocopherol. Confluent monolayers of cultured rabbit and squirrel lens epithelial
      cells were exposed to black light (BL) lamps, which emit predominantly UV-A
      radiation. These cells received a mixture 3 J/cm2 of UV-A and 4 mJ/cm2 of UV-B
      per h. This mixture is termed near UVA (i.e.: predominantly UV-A). Cells were
      exposed in Tyrode's or in MEM without or with alpha-tocopherol added at 2.5-10
      micrograms/ml. Analyses of cell viability and survival, the physical state of
      cytoskeletal actin, and the activities of Na-K-ATPase and catalase were made.
      Exposure to near UVA damaged these cells as measured by vital staining and colony
      forming ability. Pretreatment with alpha-tocopherol decreased the magnitude of
      near UVA cytotoxicity. Near UVA exposure in MEM always produced more damage to
      the cells and biochemical targets than in Tyrode's. Cytoskeletal actin was
      degraded and the activities of Na-K-ATPase and catalase were markedly inhibited
      by UV-exposure. All of these targets were at least partially protected by alpha
      tocopherol in the medium. Without alpha-tocopherol added to the media, the
      viability and survival of the cells did not recover even after 25 h of
      incubation. Cell viability was better protected from near UVA by alpha-tocopherol
      than was the ability to grow into colonies. This indicates that alpha-tocopherol
      protects actin, catalase, and Na-K-ATPase from near UVA damage.

PMID- 7776957
TI  - Regulation of argininosuccinate synthetase level by corticosteroid and pancreatic
      hormones during perinatal period.
AB  - The urea cycle takes place in the hepatocyte of ureothelic animals. The
      conversion of ammonia into urea involves five reactions. The first 2 take place
      in the matrix of the mitochondria, the last 2 occur in the cytosol.
      Argininosuccinate synthetase (AS) is the third reaction of the urea cycle. It
      catalyses the condensation of citrulline and aspartate into argininosuccinate. We
      have previously reported that rat AS activity was present in the cytosol and the
      outer membrane of the mitochondria. We have shown that, at the activity level,
      the colocation of AS was changing during fetal and neonatal development and was
      under the control of corticosteroid and pancreatic hormones. However, an
      unresolved issue was whether both AS had the same specific activity and that
      their location was changing during ontogenesis or that the specific activities of
      mitochondrial and cytosolic enzymes were different and/or modified during this
      period. In the present report, we compared the compartmentalization of AS
      activity and protein level in the fetus, the new-born and the adult rat and the
      role of corticosteroid and pancreatic hormones. Specific activities of both AS
      remained unchanged during ontogenesis. Glucocorticoids induced an increase in
      mitochondrial AS while glucagon appeared to induce a concomitant decrease in the
      level of mitochondrial AS and an increase in cytosolic AS.

PMID- 7776958
TI  - Calcium administration increases calcium-binding protein regucalcin concentration
      in the liver of rats.
AB  - The alteration of regucalcin concentrations in the liver and serum of rats
      administered orally calcium is investigated. Rats received a single oral
      administration of calcium chloride solution (25, 50 and 75 mg Ca/100 g body
      weight). The administration of calcium (50 mg/100 g) produced a significant
      increase in liver regucalcin concentration between 30 and 180 min after the
      administration, while serum regucalcin concentration was not altered appreciably.
      The effect of calcium administration increasing liver regucalcin concentration
      was also seen with the dose of 25 mg/100 g. When liver cytosol prepared from
      normal rats was incubated for 6 h in the presence of 10 microM Ca2+, the
      cytosolic regucalcin concentration at 3 and 6 h of incubation was decreased about
      20% (p < 0.05) as compared with the value at zero time point, indicating that the
      presence of Ca2+ does not inhibit the decomposition of liver cytosolic
      regucalcin. Moreover, serum regucalcin concentration was not significantly
      altered by the incubation for 6 h at 37 degrees C, indicating a stability of
      regucalcin in rat serum. This suggests that the calcium administration-induced in
      liver regucalcin concentration is not based on the inhibition of regucalcin
      release from liver to serum. The present study demonstrates that regucalcin in
      the liver is clearly increased by calcium administration, presumably due to
      stimulating the protein synthesis.

PMID- 7776959
TI  - Production of native creatine kinase B in insect cells using a baculovirus
      expression vector.
AB  - A full-length human creatine kinase B (B-CK) cDNA was used to produce a
      recombinant baculovirus (AcDZ1-BCK). Sf9 cells infected with this recombinant
      expressed a homodimeric protein composed of 43 kDa subunits which, under optimal
      conditions, formed up to 30% of the total soluble cellular protein. Upon analysis
      by PAGE, zymogram assay and gel filtration chromatography the recombinant protein
      behaved like authentic dimeric human BB-CK protein. Studies with a newly produced
      monoclonal antibody (CK-BYK/21E10) directed against an epitope in the N-terminus
      of the protein confirmed the identity of the product. The recombinant BB-CK
      protein was purified to over 99% homogeneity from the total protein extract of
      AcDZ1-CKB infected cells in one single step involving anion exchange column
      chromatography on MonoQ in FPLC. Dialysed protein had a specific activity of 239
      U/mg protein.

PMID- 7776960
TI  - Specific species and tissue differences for the gene expression of calcium
      binding protein regucalcin.
AB  - The existence and expression of gene encoding the Ca(2+)-binding protein
      regucalcin in various species and tissues were investigated with Southern and
      Northern hybridization analyses using regucalcin cDNA (0.9 kb of open reading
      frame). Genomic Southern hybridization analysis demonstrated that regucalcin gene
      was widely conserved among higher animals including human, monkey, rat, mouse,
      dog, bovine, rabbit and chicken. The gene was not found in yeast. The Northern
      blot analysis of poly (A) +RNAs extracted from the liver of various species
      showed that regucalcin mRNA was predominantly expressed in rat and mouse,
      although the expression was also seen in human, bovine and chicken. Furthermore,
      the enzyme-linked immunoadsorbent assay (ELISA) with rabbit-anti-regucalcin IgG
      indicated that hepatic regucalcin concentration was most pronounced in rat as
      compared with that of guinea pig, mouse and chicken. These observations show that
      the gene expression of regucalcin and its protein synthesis is unique in the
      liver of rats, suggesting the existence of a specific mechanism in demonstrating
      regucalcin synthesis from gene.

PMID- 7776961
TI  - Protein phosphorylation patterns during aestivation in the land snail Otala
      lactea.
AB  - Protein phosphorylation patterns were investigated in whole tissues and
      subcellular fractions of active and aestivating Otala lactea (Muller) (Pulmonata,
      Helicidae). Measurement of overall protein phosphorylation showed that
      incorporation of 32P increased until the second day after injection and remained
      constant for the remaining 4 days of the time course. Comparison of tissues from
      aestivating and active snails on day 3 showed a decreased protein phosphorylation
      in aestivating snails (44% of active). No differences in total and protein
      associated radioactivity for foot, mantle or haemolymph were observed.
      Subcellular fractionation of the hepatopancreas localized the changes to plasma
      membrane, microsomal, and cytosolic fractions: values for aestivating animals
      were reduced to 71, 37 and 58% of the corresponding active values. Separation of
      the individual subcellular fractions on isoelectric focusing columns revealed
      differences in the phosphate incorporation patterns. Plasma membrane from
      aestivating animal hepatopancreas had a lower overall level of incorporation and
      fewer radioactive peaks in the pH 7-10 region than did the plasma membrane
      fraction from active animals. SDS-PAGE analysis of plasma membrane fractions from
      active and aestivating snails showed a relative decrease in phosphorylation
      between 60-80 kDa and 30-40 kDa. IEF analysis of cytosolic proteins from
      aestivating snail hepatopancreas also showed peaks of radioactivity that were
      apparently shifted by 0.3 pH units toward higher pI values. Increased phosphate
      incorporation was observed at a peak that corresponded to the pI value for
      pyruvate kinase in aestivating snails but definite assignment of peaks was not
      possible. SDS-PAGE analysis of cytosolic proteins showed an aestivation-related
      decrease in relative protein phosphorylation between 30-35 kDa and 40-45 kDa. A
      relative increase in phosphorylation during aestivation was observed for proteins
      between 16-22 kDa.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7776963
TI  - Basic fibroblast growth factor stimulates connexin-43 expression and
      intercellular communication of cardiac fibroblasts.
AB  - Gap junctions (GJ) are membrane specializations responsible for intercellular
      communication and for ensuring electrical and/or metabolic coupling between
      cells. They are composed of connexins, a family of related proteins. Connexin-43
      (Cx43) is a major connexin of the rat heart, expressed by myocytes as well as non
      muscle cells. In this communication we have examined expression of Cx43 by
      cardiac fibroblasts and regulation of its expression by an endogenous mitogen,
      basic fibroblast growth factor (bFGF). Recombinant human bFGF, administered to
      cultured cells which had been maintained in 0.5% serum for 48 h, induced dose
      dependent and statistically significant increases in Cx43 mRNA as well as protein
      accumulation, at 6 h after addition. Intercellular communication was also
      increased at 6 h but not 30 min after bFGF treatment, as assessed using a scrape
      loading protocol. It is concluded that the bFGF-induced stimulation of Cx43
      expression caused increased coupling between cardiac fibroblasts. This would be
      of importance in injured myocardium, the increased bFGF content of which might
      stimulate electrical coupling involving fibroblasts of the scar tissue.

PMID- 7776962
TI  - Glycated albumin modified by Amadori adducts modulates aortic endothelial cell
      biology.
AB  - Increased protein glycation has been mechanistically linked to accelerated
      vascular pathobiology in diabetes. To test the influence of protein modified by
      Amadori glucose adducts on vascular cell biology, we examined the effect of
      glycated albumin on replicative capacity and basement membrane collagen
      production by aortic endothelial cells in culture. Relative to carbohydrate-free
      albumin, which supported cell proliferation and Type IV collagen synthesis,
      glycated albumin significantly inhibited 3H-thymidine incorporation and Type IV
      collagen production. The glycated albumin-induced effects were prevented by
      monoclonal antibodies (A717) that specifically react with Amadori-modified
      albumin, but not by IgG that was unreactive with glycated albumin. A717 had no
      effect on thymidine incorporation or collagen synthesis by cells cultured in the
      presence of nonglycated albumin. The findings indicate that the interaction of
      glycated albumin with endothelial cells, which have been shown to display dose
      responsive, saturable receptors, limits cell replication and triggers maladaptive
      biosynthetic programs, which may contribute to degenerative macrovascular disease
      in diabetes.

PMID- 7776964
TI  - The lutropin/choriogonadotropin receptor is palmitoylated at intracellular
      cysteine residues.
AB  - Most members of the family of G protein-coupled receptors have one or more
      conserved cysteine residues in their carboxy-terminal cytoplasmic tails which are
      believed to be consensus sites for palmitoylation. Indeed, a growing number of G
      protein-coupled receptors (rhodopsin, beta 2-, and alpha 2-adrenergic receptors)
      have now been shown to have palmitic acid covalently attached to this position.
      In the case of the beta 2-adrenergic receptor, it was also reported that mutation
      of the palmitoylated cysteine to glycine greatly diminished the ability of this
      receptor to interact with and activate Gs. Mutation of this conserved cysteine
      appears to have little or no effect on the ability of other members of this
      receptor family (rhodopsin, alpha 2-adrenergic and M2 muscarinic) to activate
      their cognate G proteins, however. The studies presented here were designed to
      determine whether another Gs-coupled receptor, the LH/CG receptor, is
      palmitoylated, and whether this modification is important for receptor function.
      To facilitate biochemical analysis, we examined these issues using cell lines
      stably transfected with the wild type LH/CG receptor (LHR-wt) or with a mutant
      receptor in which the two conserved cysteins were mutated to alanines (designated
      LHR-C621,622A). Our results show that LHR-wt is palmitoylated but that LHR
      C621,622A is not. We also show that LHR-C621,622A is capable of binding human CG
      (hCG) and transducing the cAMP signal. The main difference that we detected
      between the wild type and mutant receptor is that the latter is trapped
      intracellularly and does not appear to mature into the 85 kilodalton protein
      previously identified as the mature cell surface LH/CG receptor.

PMID- 7776965
TI  - Human chorionic gonadotropin (CG)- and phorbol ester-stimulated phosphorylation
      of the luteinizing hormone/CG receptor maps to serines 635, 639, 649, and 652 in
      the C-terminal cytoplasmic tail.
AB  - In a number of instances, binding of a ligand to its receptor results in receptor
      phosphorylation that mediates receptor uncoupling from its effector. Recently, we
      showed that human CG (hCG)- or phorbol ester- [phorbol 12-myristate-13-acetate
      (PMA)] stimulation of cells transfected with the LH/CG receptor induced rapid
      LH/CG receptor phosphorylation and a reduced cAMP response upon reexposure to
      hCG. The fact that hCG and PMA both phosphorylate and uncouple the LH/CG receptor
      suggests a common mechanism of action, namely the activation of protein kinase C.
      The studies presented here were designed to investigate the role of the C kinase
      in LH/CG receptor phosphorylation and to locate the phosphorylation site(s)
      within the receptor protein. The experiments presented here show that although
      hCG activates the C kinase in these cells, phosphorylation of the LH/CG receptor
      in response to hCG is maintained in C kinase-deficient cells. This suggests that
      activation of protein kinase C is not required for hCG-induced phosphorylation of
      its receptor. As a first step in locating the phosphorylation sites within the
      receptor polypeptide, we performed phosphoamino acid analysis of the
      phosphorylated LH/CG receptor. Only phosphoserine residues were detected. Based
      on the assumption that the phosphoserine(s) must be located within the
      intracellular regions of the receptor, we isolated cell lines expressing the wild
      type LH/CG receptor or receptors with cytoplasmic tails truncated at residue 653
      or 631.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7776966
TI  - Identification of the sites of N-linked glycosylation on the follicle-stimulating
      hormone (FSH) receptor and assessment of their role in FSH receptor function.
AB  - The FSH receptor (FSHR) contains a large extracellular domain in which exist
      three potential sites for N-linked glycosylation. A truncated form of the FSHR
      representing only the extracellular domain was created and expressed in mammalian
      cells. We show that this truncated receptor is glycosylated, through the
      carbohydrates are not as fully processed as those of the full-length receptor.
      This truncated receptor, which remains intracellular, binds FSH with an affinity
      comparable to that of the full-length FSHR. Therefore, although other regions of
      the FSHR may contribute to hormone binding, the extracellular domain alone can
      confer high affinity binding. The above results suggest that N-linked FSHR
      carbohydrates may, in some way, be required for FSH binding. Therefore, further
      experiments, done in the context of the full-length receptor, were performed to
      determine the actual sites of glycosylation in the FSHR as well as to elucidate
      their role in the functions of the FSHR. Site-directed mutagenesis was done to
      individually or collectively disrupt the potential sites for N-linked
      glycosylation. Western blot analyses of the wild type vs. mutant receptors
      demonstrate that, of the three potential sites for N-linked glycosylation, Asn's
      174 and 276 are actually glycosylated. Binding assays demonstrate that these two
      N-linked FSHR carbohydrates are redundant in function since carbohydrate at
      either Asn174 or Asn276 allows the receptor to be expressed on the cell surface
      and to bind FSH with normal affinity. However, FSH binding activity is not
      observed with nonglycosylated mutant receptors where both sites have been
      collectively disrupted. Similarly, when cells expressing the wild type FSHR were
      treated with tunicamycin to prevent N-linked glycosylation, the resulting
      nonglycosylated FSHR was not able to bind FSH. In contrast, normal high affinity
      binding of FSH was maintained when N-linked carbohydrates were enzymatically
      removed from wild type receptors. Our results demonstrate that while N-linked
      carbohydrates on the FSH receptor are not required directly for the binding of
      hormone, a carbohydrate at either Asn174 or Asn276 is required for the efficient
      folding of the nascent receptor protein into a conformation that allows high
      affinity binding of hormone.

PMID- 7776968
TI  - E1a activation of insulin receptor gene expression is mediated by Sp1-binding
      sites.
AB  - E1a adenoviral oncoproteins have been known to modulate genes important for the
      growth and differentiation of cells. Our laboratory is interested in
      understanding how insulin promotes the growth and proliferation of cells. In this
      report, we have examined the ability of E1a to modulate the insulin receptor gene
      expression. In HepG2 cells, expression of the 243-amino acid E1a protein
      stimulated expression of the chloramphenicol acetyltransferase reporter under the
      control of the insulin receptor promoter. 5'-Deletion analysis of the insulin
      receptor promoter indicated that the region between -630 and -607 is important
      for regulation by E1a. This region contains two GA and four overlapping GC boxes
      that are putative Sp1-binding sites. A DNA fragment containing these sites was
      used as a probe in gel retardation assays. Three specific protein-DNA complexes
      were detected with HepG2 nuclear extract. These complexes could be competed
      partially by the DNA fragments with mutations in either the GA or GC boxes, but
      not by the DNA fragment with a mutation in both the GA and GC boxes. In addition,
      mutation of each of these sites lowered the basal activity of the promoter and
      partially reduced transactivation by E1a. Simultaneous mutation in both GA and GC
      boxes further reduced the basal activity and abrogated transactivation by E1a.
      Taken together, these results indicate that the loss of binding ability of Sp1
      (or Sp1-like factors) is concomitant with reduction of the basal activity and the
      loss of E1a inducibility of the gene.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7776967
TI  - In vivo growth hormone treatment rapidly stimulates the tyrosine phosphorylation
      and activation of Stat3.
AB  - The mechanisms by which GH regulates gene expression to alter growth and
      metabolism are unknown. We have demonstrated previously that in vivo GH treatment
      rapidly stimulates the tyrosine phosphorylation of multiple nuclear proteins and
      have identified the inducible transcription factor Stat1 (formerly Stat91) as one
      of the major GH-activated nuclear phosphoproteins. We now show that Stat3, a new
      member of the STAT (signal transducer and activator of transcription) family of
      transcription factors, is also phosphorylated on tyrosine residues and rapidly
      appears in the nucleus in response to GH. Activated Stat3 interacts with the
      naturally occurring c-sis-inducible element of the c-fos gene after GH treatment,
      as demonstrated by gel mobility shift assay, and is a component of gel-shifted
      bands A and B when the high affinity sis-inducible element is used as a probe.
      Our results suggest that multiple STAT proteins may mediate some of the
      pleiotropic effects of GH on gene expression.

PMID- 7776970
TI  - Induction of interferon-beta gene expression by dexamethasone in murine L929
      cells.
AB  - Glucocorticoids bind to their receptors and trigger the transcriptional
      activation or repression of target genes by binding to DNA sequences, the
      glucocorticoid responsive element (GRE). The murine interferon-beta (Mu-IFN beta)
      gene in L929 cells can be induced by dexamethasone to give both transcription and
      translation products specific to murine IFN beta. The 3'-noncoding region of the
      Mu-IFN beta gene was found to contain a GRE very similar to the consensus GRE
      sequence involved in glucocorticoid-regulated genes. Gel retardation assays
      showed that the oligonucleotide corresponding to that GRE competed with the MMTV
      GRE oligonucleotide for glucocorticoid receptor binding and was supershifted by
      human antiglucocorticoid receptor antibodies. Transiently transfected murine
      cells (L929) with the GRE-IFN beta 3' sequence inserted upstream of the thymidine
      kinase promoter and the chloramphenicol acetyl transferase gene treated with
      dexamethasone with or without the antiglucocorticoid RU486 and their
      chloramphenicol acetyl transferase activity assayed, show that this GRE is
      efficient. We conclude that the Mu-IFN beta gene in L929 murine cells can be
      induced by dexamethasone, and that the hormone effect may be mediated by the 3'
      GRE sequence.

PMID- 7776969
TI  - c-fos protooncogene is involved in the mitogenic effect of transforming growth
      factor-beta in osteoblastic cells.
AB  - We investigated the contribution of c-fos protooncogene in the mitogenic effect
      of transforming growth factor-beta (TGF beta) in serum-deprived, confluent rat
      calvaria osteoblastic cells. The TGF beta-induced growth in these cells was
      associated with an immediate and transient c-fos mRNA accumulation, similar to
      the inductive effect of fetal calf serum. To assess the role of c-fos in the
      response to TGF beta, we used a c-fos antisense (AS) oligonucleotide displaying
      duplex formation with rat c-fos mRNA. Studies of AS and sense (S) uptake by
      osteoblastic cells demonstrated that incorporation of labeled oligomers was
      maximal at 2 h, and the incorporated AS oligonucleotide remained intact for 24 h.
      Immunofluorescence analysis of c-Fos-labeled cells demonstrated that AS, but not
      S, oligonucleotide reduced c-Fos protein expression, suggesting specific
      efficient inhibition of c-fos translation by the AS oligomer. Proliferation
      assays showed that cell growth induced by fetal calf serum was inhibited by the
      AS, but not by the S oligonucleotide, in both normal rat osteoblasts and ROS
      17/2.8 osteosarcoma cells, demonstrating efficient and specific blockage of cell
      growth by the AS oligomer. The mitogenic effect of TGF-beta was abolished in
      cells cultured in the presence of AS, whereas S had no effect, showing that c-fos
      is required for TGF beta-induced osteoblast cell growth. The results show that
      the induction of c-fos is implicated in the mitogenic effect of TGF beta in
      osteoblastic cells and provide a cellular mechanism involved in the response of
      these cells to TGF beta.

PMID- 7776971
TI  - Specificity of ligand-dependent androgen receptor stabilization: receptor domain
      interactions influence ligand dissociation and receptor stability.
AB  - The molecular basis for the different physiological effects of testosterone (T)
      and dihydrotestosterone (DHT) was investigated using recombinantly expressed wild
      type and mutant androgen receptor (AR). Rates of androgen dissociation from
      nuclear and cytoplasmic AR were compared with hormone- and concentration
      dependent receptor degradation rates. T dissociates from AR 3 times faster than
      DHT or methyltrienolone (R1881) and is less effective in stabilizing the
      receptor. Analysis of AR deletion mutants and AR/glucocorticoid receptor chimeras
      indicates that the AR NH2-terminal domain has a specific role in stabilizing the
      receptor by slowing the rate of ligand dissociation and AR degradation. Amino
      acid mutations that abolish receptor dimerization, nuclear localization, or DNA
      binding activity have no significant effect on androgen dissociation or AR
      degradation. A naturally occurring steroid-binding domain mutation (Val889 to
      Met) that causes androgen insensitivity, but does not alter equilibrium androgen
      binding affinity, lowered the androgen-binding capacity as a result of increased
      rates of androgen dissociation and AR degradation. Thus, AR stabilization and
      function require prolonged receptor occupancy with androgen, with a similar
      extent of stabilization observed at higher concentrations of faster dissociating
      androgens and lower concentrations of slower dissociating androgens. Retention of
      receptor-bound androgen is enhanced by an interaction between the AR NH2-terminal
      and steroid-binding domains. The ligand specificity and concentration dependence
      of receptor stabilization provide an explanation for physiological differences in
      the actions of T and DHT.

PMID- 7776972
TI  - Functional interactions of peroxisome proliferator-activated receptor, retinoid-X
      receptor, and Sp1 in the transcriptional regulation of the acyl-coenzyme-A
      oxidase promoter.
AB  - Peroxisome proliferator-activated receptor (PPARs) are members of the nuclear
      receptor superfamily. For transcriptional activation of their target genes, PPARs
      heterodimerize with the retinoid-X receptor (RXR). The convergence of the PPAR
      and RXR signaling pathways has been shown to have an important function in lipid
      metabolism. The promoter of the gene encoding the acyl-coenzyme-A oxidase (ACO),
      the rate-limiting enzyme in peroxisomal beta-oxidation of fatty acids, is a
      target site of PPAR action. In this study, we examined the role and the
      contribution of both cis-and trans-acting factors in the transcriptional
      regulation of this gene using transient transfections in insect cells. We
      identified several functional cis-acting elements present in the promoter of the
      ACO gene and established that PPAR-dependent as well as PPAR-independent
      mechanisms can activate the ACO promoter in these cells. We show that the
      PPAR/RXR heterodimer exerts its effect through two response elements within the
      ACO promoter, in synergy with the transcription factor Sp1 via five Sp1-binding
      sites. Furthermore, this functional interaction also occurs when Sp1 is co
      expressed with PPAR or RXR alone, indicating that activation can occur
      independently of PPAR/RXR heterodimers.

PMID- 7776973
TI  - Ligand occupancy is not required for vitamin D receptor and retinoid receptor
      mediated transcriptional activation.
AB  - Although steroid hormone receptor activation has been known to be dependent on
      ligand binding, we report here ligand-independent transcriptional activation of
      the vitamin D receptor and retinoid receptors. In these studies, CV1 cells were
      transiently transfected with a human vitamin D receptor (VDR) expression vector
      and a reporter plasmid that contains multiple copies of the rat osteocalcin
      vitamin D response element up-stream of the bacterial chloramphenicol
      acetyltransferase (CAT) gene [osteocalcin (OC)VDREtkCAT]. Treatment of cells with
      10(-8) M 1,25-dihydroxyvitamin D3 resulted in a 25-fold induction of CAT
      activity. When cells were treated with 5-50 nM okadaic acid (OA), an inhibitor of
      protein phosphatase-1 and -2A, significant inductions of CAT activity (18- to 57
      fold) were observed. As VDR and dopamine receptors are colocalized in certain
      brain regions, we also examined whether VDR-mediated transcription can be
      activated by dopamine. VDR was found to activate CAT gene expression in cells
      treated with 200-500 microM dopamine (3- to 11-fold induction) or the selective
      D1 agonist SKF38393 (20-fold induction). Cells were also transfected with
      retinoic acid receptor (RAR) or retinoid-X receptor (RXR) expression vectors and
      reporter plasmids that contain either a retinoic acid response element or an RXR
      specific response element. OA alone induced chloramphenicol acetyltransferase
      (CAT) activity in cells transfected with RAR alpha, RAR beta, RXR alpha, RXR
      beta, or RXR gamma (3- to 18-fold induction). However, OA did not affect
      transcription by RAR gamma, suggesting specificity of activation by OA among the
      retinoid receptors. Although the retinoid receptors have been detected in brain,
      maximum stimulation of transcription was not greater than 1.6-fold in the
      presence of 100-500 microM dopamine or 100 microM SKF38393 treatment. These data
      suggest specificity for dopamine activation among steroid hormone receptors and
      that phosphorylation alone, in the absence of ligand, can activate VDR- and
      retinoid receptor-mediated transcription.

PMID- 7776975
TI  - Activating transcription factor-1 is a specific antagonist of the cyclic
      adenosine 3'.5'-monophosphate (cAMP) response element-binding protein-1-mediated
      response to cAMP.
AB  - We have investigated the molecular basis of the variability of the somatostatin
      cAMP response element (CRE) function in different cell lines. All cells tested
      contain detectable levels of the CRE-binding protein CREB-1, which mediates
      transactivation in response to the cAMP-dependent protein kinase (protein kinase
      A), in forms that can bind to a somatostatin CRE. Although both responsive and
      nonresponsive cells contain CREB-1 in heterodimers with activating transcription
      factor-1 (ATF-1), only cells that allow a cAMP response have a significant
      proportion of CREB-1 in a homodimeric form. Transfection experiments demonstrate
      that ATF-1 is capable of antagonizing CREB-1-dependent activation, suggesting
      that the ability of CREB-1 to mediate a cAMP response is down-regulated by
      heterodimer formation with ATF-1.

PMID- 7776974
TI  - Two classes of proteins dependent on either the presence or absence of thyroid
      hormone for interaction with the thyroid hormone receptor.
AB  - The thyroid hormone (T3) receptors (TRs) are hormone-dependent transcription
      factors that regulate expression of a variety of specific target genes. To help
      elucidate the mechanisms that underlie this transcriptional regulation and other
      potential TR activities, we used the yeast interaction trap to isolate clones
      encoding proteins that specifically interact with the ligand binding domain of
      the rat TR beta. Several such proteins, called Trips (TR-interacting proteins),
      were isolated from independent selections carried out either in the presence or
      absence of T3. Surprisingly, all of the Trips were dependent on hormone for
      interaction with the TR, with some interacting only when T3 is present and others
      only when it is absent. Nearly all of the Trips also show similar ligand
      dependent interaction with the retinoid X receptor (RXR), but none interact with
      the glucocorticoid receptor under any conditions. The sequences of three of the
      Trips predict specific functional roles: one is an apparent human homolog of a
      yeast transcriptional coactivator, one is a new member of a class of nonhistone
      chromosomal proteins, and one contains a conserved domain associated with
      ubiquitination of specific target proteins. Consistent with the pleiotropic
      effects of TR and RXR, several other Trips show significant amino acid sequence
      similarity with proteins involved in various regulatory pathways. The inherent
      transcriptional activity of the Trips was tested in yeast, and a chimeric protein
      consisting of a fusion of Trip4 to the bacterial LexA repressor protein is a
      relatively strong transcriptional activator. Similar LexA fusions to Trip9 and
      Trip10 had no transcriptional activity on their own but, when coexpressed with
      both TR and RXR, conferred T3-dependent activation to a reporter gene controlled
      by LexA binding sites. We suggest that this indirect T3 response provides a novel
      mechanism for hormonal activation of gene expression, and that studies of the
      Trips will provide important insights into the specific mechanisms of action of
      TRs and other receptors.

PMID- 7776976
TI  - Trout and chicken proglucagon: alternative splicing generates mRNA transcripts
      encoding glucagon-like peptide 2.
AB  - In mammals, the proglucagon gene is transcribed into a single identical mRNA in
      pancreas, intestine, and brain. The proglucagon mRNA encodes glucagon and two
      glucagon-like peptides (GLP 1 and GLP 2), whose production is regulated by tissue
      specific proteolytic processing. Previously characterized pancreatic proglucagon
      cDNAs from birds and fish encode glucagon and only one glucagon-like peptide, GLP
      1. The isolation of intestinal proglucagon cDNAs from the rainbow trout,
      Oncorhynchus mykiss, and chicken, Gallus gallus, shows that the proglucagon gene
      of fish and birds also contains the sequence of a second glucagon-like peptide,
      GLP 2. In contrast to the proglucagon mRNAs from mammals, fish and bird
      proglucagon mRNAs from pancreas and intestine have different 3'-ends that are due
      to alternative mRNA splicing. The intestinal mRNA was found to be spliced to one
      or more exons, which encode GLP 2, while the pancreatic mRNA terminates within
      the intron between the exons encoding GLP 1 and GLP 2. These results show that
      proglucagon gene expression is regulated at the level of mRNA splicing and serve
      to reemphasize the potential biological importance of GLP 2.

PMID- 7776978
TI  - Regulation by estrogen through the 5'-flanking region of the mouse calbindin-D28k
      gene.
AB  - Mouse calbindin-D28k expression is regulated in vivo by estradiol in ovaries,
      uterus, and oviduct. To determine whether estrogen can have an effect on the
      transcription of the calbindin-D28k gene, the human breast cancer cells T47D were
      transiently transfected with a plasmid containing a 1.1 kilobase (kb) PstI/SacII
      fragment (-1075/+34) of the mouse calbindin gene ligated to the chloramphenicol
      acetyltransferase (CAT) gene and cotransfected with human estrogen receptor
      expression vector. T47D cells, transfected and treated with estradiol (10(-11) -
      10(-7) M for 64-65 h), exhibited a dose-dependent increase in CAT activity (up to
      6.2-fold). Transfection of MCF-7 breast cancer cells with the chimeric gene
      construct alone also resulted in an estradiol-dependent induction in CAT
      activity. Deletion mutant analysis demonstrated that there are two regions of the
      mouse calbindin-D28k promoter (between -1075/-702 and between -175/-78) that
      contribute to the induction by estradiol. These fragments, when linked to the
      thymidine kinase promoter to construct a heterologous promoter chimera, were able
      to convert the thymidine kinase promoter to estrogen responsiveness. In these
      regions there are multiple imperfect half-palindromic estrogen-responsive
      elements. Gel retardation assays demonstrated weak protein-DNA interactions that
      were competed with cold oligonucleotide containing the vitellogenin estrogen
      response element. These findings indicate that the mouse calbindin-D28k promoter
      is capable of conferring estrogen responsiveness, which may be mediated by
      several imperfect half-palindromic estrogen-responsive elements, and suggest, in
      light of previous studies concerning 1,25-dihydroxyvitamin D regulation, multiple
      steroid regulation of the calbindin-D28k gene.

PMID- 7776977
TI  - Characterization of a prolactin-inducible gene, clone 15, in T cells.
AB  - To examine how PRL regulates lymphocyte proliferation, a number of PRL-activated
      genes were identified from a PRL-dependent rat T lymphoma cell line, Nb2. One of
      the downstream genes in the PRL signaling cascade was identified as clone 15
      (c15). PRL stimulation of quiescent Nb2 T cells results in the expression of a
      1.7-kilobase c15 mRNA, which reaches maximum levels between 8 and 10 h after
      stimulation. Corresponding [3H]thymidine incorporation experiments show that the
      maximum level of c15 mRNA expression correlates with the G1/S transition phase of
      the cell cycle. Sequencing of approximately 1.3-kilobase cDNA revealed one open
      reading frame that predicts a 332-amino acid protein. In vitro
      transcription/translation of c15 cDNA resulted in the production of a 45
      kilodalton protein. Sequence analysis revealed that the c15 open reading frame
      contains a potential nuclear localization signal, a very acidic region, and a
      carboxy-terminal region of 94 amino acids which are 68% identical and 78% similar
      to the nuclear movement protein, NUDC, found in Aspergillus nidulans. Such a high
      degree of conservation suggests that the NUDC-like motif in c15 has been
      conserved through evolution for an important structure and/or function.

PMID- 7776979
TI  - Mutually exclusive interactions of two nuclear orphan receptors determine
      activity of a cyclic adenosine 3',5'-monophosphate-responsive sequence in the
      bovine CYP17 gene.
AB  - ACTH-dependent transcriptional activation of the bovine CYP17 gene (the gene
      encoding cytochrome P450 steroid 17 alpha-hydroxylase) involves two cAMP
      responsive sequences (CRS1 and CRS2) located in the promoter region. Here we
      demonstrate that two nuclear orphan receptors, chicken ovalbumin upstream
      promoter transcription factor (COUP-TF) and steroidogenic factor-1 (SF-1), bind
      to the part of the CRS2 element that contains the repeated sequences AAGTCA and
      AGGTCA spaced by six nucleotides (repCRS2). Overexpression of COUP-TF and SF-1 in
      both steroidogenic and nonsteroidogenic cells demonstrated that SF-1 is an
      activator of repCRS2-dependent transcription of reporter genes. Furthermore, the
      SF-1-dependent transcription could be further stimulated by activation of the
      cAMP-dependent protein kinase. In contrast, COUP-TF alone had no effect on
      repCRS2-dependent reporter gene activity. Mutations that interfere with the
      binding of SF-1 to repCRS2 in vitro abolished the cAMP-induced activities
      mediated by the element in transfected Y1 cells. The mutational analysis of
      repCRS2 further indicated that the binding sites for the two receptors overlap,
      and electrophoretic mobility shift assays demonstrated that the receptors bound
      in a mutually exclusive manner. Overexpression of both SF-1 and COUP-TFI
      simultaneously demonstrated that COUP-TFI inhibited SF-1-dependent activation of
      reporter genes. Transient transfection experiments with a construct containing a 
      100/+19 base pair fragment from the bovine CYP17 gene demonstrated that SF-1 and
      COUP-TF had similar effects on the intact promoter as on the repCRS2/reporter
      gene constructs. Our data suggest that the two orphan receptors bind in a
      mutually exclusive manner to repCRS2 and that SF-1 is involved in the activation
      and COUP-TF in the repression of repCRS2-dependent transcription.

PMID- 7776980
TI  - Characterization of the sequences of the human CYP19 (aromatase) gene that
      mediate regulation by glucocorticoids in adipose stromal cells and fetal
      hepatocytes.
AB  - The biosynthesis of estrogens is catalyzed by aromatase P450 (P450arom), the
      product of the CYP19 gene. The tissue-specific expression of the CYP19 gene is
      regulated by means of tissue-specific promoters through the use of alternative
      splicing mechanisms. Thus, transcripts containing various 5'-untranslated termini
      are present in human placenta and other fetal tissues, ovary, brain, and adipose
      stromal cells. Sequence corresponding to untranslated exon 1.4 is present in 5'
      termini of transcripts expressed in adipose tissue and fetal liver, as well as
      adipose stromal cells in primary culture in the presence of dexamethasone and
      fetal calf serum (FCS). Identification of hormone-responsive, tissue-specific
      promoter regions, as well as growth factor-response elements upstream of exon
      1.4, may provide insight into the regulation of estrogen biosynthesis in adipose
      tissue, which is implicated in the development of breast and endometrial cancer.
      The goals of the present study were to define the 1.4 promoter region with
      respect to the start of transcription and to characterize the region(s)
      responsible for conferring glucocorticoid responsiveness on aromatase expression.
      The transcription initiation site was identified by means of primer extension and
      S1 nuclease protection analyses. No TATA-like sequence was evident upstream of
      this site. Various deletion mutations of the upstream flanking region of exon 1.4
      and including part of exon 1.4 were made using polymerase chain reaction or
      restriction enzyme digestion. The genomic fragments were fused upstream of the
      chloramphenicol acetyltransferase (CAT) reporter gene. These constructs were
      transfected into adipose stromal cells and fetal hepatocytes in primary culture
      in medium containing FCS with or without dexamethasone. The -560/+10 base pair
      (bp) construct expressed CAT activity after a putative silencer element was
      deleted, and expression was induced by dexamethasone about 3-fold. Transfection
      of the -330/+170 bp construct, which contains an upstream glucocorticoid response
      element (GRE) as well as an Sp1-like sequence in untranslated exon 1.4, resulted
      in an 8-fold stimulation of expression of CAT activity by dexamethasone. The
      upstream GRE as well as the Sp1-like sequence in untranslated exon 1.4 were
      mutated separately, and together, to further confirm whether the GRE or Sp1
      binding site play a role in the regulation of promoter 1.4-driven transcription.
      Mutation of either the GRE or Sp1 binding site, or both, in the -330/+170 bp
      construct, resulted in loss of dexamethasone-induced CAT reporter gene
      expression.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7776981
TI  - Interferon-gamma inhibits macrophage insulin-like growth factor-I synthesis at
      the transcriptional level.
AB  - Spontaneous production of insulin-like growth factor-I (IGF-I) by inflammatory
      macrophages contributes to aberrant wound healing, but little is known about
      regulation of IGF-I synthesis in myeloid cells. The T cell-derived cytokine
      interferon-gamma (IFN gamma) inhibits several fibrogenic and angiogenic
      components of the wound-healing response. We have used metabolic labeling of
      primary colony stimulating factor-1 (CSF-1)-derived macrophages and a transformed
      macrophage cell line (PU5-1R) followed by immunoprecipitation to demonstrate that
      synthesis of the 17 kilodalton (kDa) prepro-IGF-I protein by these cells is
      substantially inhibited by IFN gamma. An exon 4 IGF-I/beta-actin riboprobe
      expression cassette was used in RNase protection assays to show that IFN gamma
      also reduces steady state levels of IGF-I mRNA in three different populations of
      macrophages in a time- and dose-dependent manner. This effect is specific for IFN
      gamma because neither the IFNs-alpha/beta nor lipopolysaccharide (LPS) affects
      expression of steady state IGF-I transcripts. Down-regulation of IGF-I mRNA by
      IFN gamma is dependent on de novo protein synthesis and is abrogated by coculture
      with cycloheximide. Nuclear run-on assays revealed that elongation of IGF-I
      transcripts is absent in fresh bone marrow cells but is induced several-fold
      after cells are cultured for 6 days with CSF-1. Treatment of these CSF-1-derived
      macrophages with IFN gamma for 6 h substantially inhibits synthesis of IGF-I
      mRNA. Studies on the decay of IGF-I mRNA in PU5-1R macrophages treated with an
      RNA polymerase inhibitor confirmed that the decline in IGF-I steady state mRNA in
      IFN gamma-treated cultures arises from an inhibition of transcription rather than
      from a reduction in mRNA stability. Since a variety of inflammatory mediators can
      induce expression of IGF-I in macrophages, inhibition of macrophage IGF-I
      synthesis by IFN gamma provides a mechanism by which leukocytes regulate levels
      of this growth factor in their microenvironment.

PMID- 7776982
TI  - Hepatocyte-nuclear factor 3 beta gene transcripts generate protein isoforms with
      different transactivation properties on the glucagon gene.
AB  - Hepatocyte-nuclear factor 3 beta (HNF-3 beta), a member of the HNF-3 gene family,
      is expressed in glucagon-producing islet cells and represses glucagon gene
      expression. We show here that at least three different HNF-3 beta transcripts
      that encode HNF-3 beta protein variants are present in glucagon-producing cells,
      HNF-3 beta 1, HNF-3 beta 2, and HNF-3 beta 3. Compared with the HNF-3 beta 1
      cDNA, HNF-3 beta 2 cDNA lacks sequences of exon 1 while exons 1 and 4 are absent
      from the HNF-3 beta 3 cDNA. The deduced amino-acid (aa) sequence of HNF-3 beta 2
      and HNF-3 beta 3 proteins differs from HNF-3 beta 1 by a 6-aa amino-terminal
      extension and by the absence of the first 30 aa, respectively. HNF-3 beta 1, HNF
      3 beta 2, and HNF-3 beta 3 bind to the major enhancer of the rat glucagon gene G2
      with similar affinity. By contrast to HNF-3 beta 1, which represses glucagon gene
      expression when overexpressed in the glucagon-producing cell line InR1G9, HNF-3
      beta 2 and HNF-3 beta 3 do not affect transcriptional activity. Furthermore,
      cotransfection of HNF-3 beta 2 or HNF-3 beta 3 along with HNF-3 beta 1 decreases
      the negative effects of HNF-3 beta 1. We conclude that glucagon gene expression
      may be regulated by the relative abundance of the three different HNF-3 beta
      variants in alpha-cells.

PMID- 7776983
TI  - Regulated specific protein binding to a conserved region of the 3'-untranslated
      region of thyrotropin beta-subunit mRNA.
AB  - Thyroid hormone (T3) regulates the expression of rat TSH beta-subunit (TSH beta)
      mRNA, in part, at the posttranscriptional level, by reducing the half-life of TSH
      beta mRNA. The mechanism(s) mediating this alteration in mRNA stability are
      unknown, but previous work indicates that labile protein(s) are involved. The
      majority of cis-acting elements identified to date that have been implicated in
      the regulated destabilization of mRNAs have been located in the 3'-untranslated
      region (3'-UTR) of the mRNA. The 3'-UTR of rat, murine, and human TSH beta mRNA
      is highly conserved, and within this region is a 12-nucleotide consensus
      sequence, which is shared by the 3'-UTR of several other genes with unstable
      mRNAs. We reasoned that this homologous region could represent a binding motif
      for specific trans-acting RNA-binding protein(s), and that identification and
      characterization of such trans-acting factor(s) may provide critical insight into
      the mechanisms underlying T3-induced changes in TSH beta mRNA stability.
      Utilizing the RNA electrophoretic mobility shift assay and analysis of UV cross
      linked RNA-protein complexes, a cytoplasmic trans-acting factor of approximately
      80-85 kilodaltons was identified from rat pituitaries and several cell lines that
      binds in a sequence-specific manner to the 3'-UTR of rat TSH beta mRNA. Using
      competitive antisense oligonucleotides, the predominant binding site was mapped
      to the first 41 nucleotides of the 3'-UTR, which includes the consensus region.
      However, sequence upstream of the consensus was also shown to be important for
      binding. Using RNA electrophoretic mobility shift assay, two mRNAs containing
      sequence homology with the consensus region, c-erbA alpha-2 and a rat ferritin
      pseudogene, were shown to specifically compete with rat TSH beta mRNA for binding
      of this factor. Remarkably, the binding activity of this factor was regulated
      positively by T3 within 4 h, but only with rat pituitary extracts. These data
      suggest that in addition to binding rat TSH beta mRNA in a sequence-specific and
      T3-regulated manner, this novel trans-acting RNA-binding protein may also bind to
      other cytoplasmic mRNAs involved in diverse intracellular processes.

PMID- 7776984
TI  - Age-related variation in sister chromatid exchanges and cell cycle kinetics in
      peripheral blood lymphocytes of healthy individuals.
AB  - Sister chromatid exchanges (SCEs) and cell cycle kinetics were estimated in
      mitogen stimulated human lymphocytes from a selected group of healthy
      individuals. Data were examined to evaluate the relationship between SCE
      frequencies and cell cycle kinetics with donor's age, sex and smoking habit. No
      regular relationship was observed between the mean SCE frequencies and donor's
      age, although significant differences were observed between the age groups.
      Correlation of dispersion coefficient (H) of SCE with donor's age were
      significant in male and female populations. For cell cycle kinetics, a highly
      significant age-dependent depression in replicative index (RI) was observed.
      Female donors possessed a slightly higher SCE frequency and RI, although the
      variations between the two sexes were not significant. Smoking habit resulted in
      a significant enhancement of SCEs.

PMID- 7776985
TI  - Changes of the methylation pattern of the c-myc gene during in vitro aging of
      IMR90 human embryonic fibroblasts.
AB  - DNA modification by cytosine methylation has received considerable interest in
      the context of mammalian cell differentiation but is discussed controversially
      with respect to cellular aging. As the expression of c-myc affects strongly
      cellular aging and terminal differentiation, we have analysed the sequence
      specific methylation pattern of the c-myc gene during proliferative aging in
      vitro of human embryonic fibroblasts. In this study, both, 5-methylcytidine
      sensitive restriction enzymes as well as genomic sequencing were used. The
      overall methylation pattern was found essentially stable during proliferative
      aging. However, specific hypermethylation of exon II during aging was observed.
      Furthermore, one specific cytidine located in the consensus sequence of the DNA
      binding factor PEBP2 was found completely methylated during most of the course of
      proliferative aging of the cells but became demethylated as the cells reached the
      end of their proliferative life span. Our results indicate the importance of
      establishing the sequence-specific changes of the methylation pattern of the
      genome during in vitro aging.

PMID- 7776986
TI  - Effect of aging and interval between primary and secondary treatment in
      carcinogenesis induced by neonatal exposure to 5-bromodeoxyuridine and subsequent
      administration of N-nitrosomethylurea in rats.
AB  - LIO rats were exposed to s.c. injections (3.2 mg) of a synthetic analogue of
      thymidine, 5-bromo-2'-deoxyuridine (BrdUrd) on the 1st, 3rd, 7th and 21st days of
      life and at the age of 3 or 15 months they were i.v. injected with N
      nitrosomethylurea (NMU) at a single dose of 10 or 50 mg/kg or with solvent. It
      was shown that early neonatal exposure to BrdUrd was followed by the increase in
      the incidence of tumor development and by the decrease of their latency. The
      carcinogenic effect of NMU alone correlated with the dose of the carcinogen in 3
      month-old rats total and malignant tumors and tumors of some localization was
      decreased in the elder ones, but survival of tumor-bearing rats was decreased in
      the elder group as compared to the younger one. These data suggests the age
      related decrease in both the carcinogenic effect of NMU and in the number of
      events which are necessary for a tumor development. The exposure to BrdUrd was
      followed by the increase in the susceptibility of rats to subsequent carcinogenic
      effect of NMU injected at the doses of 10 or 50 mg/kg into 3- and 15-month-old
      rats, mostly to the tissues being target to NMU. Our data have demonstrated that
      the exposure to BrdUrd in the early life was followed by the irreversible
      initiating effect which persists over a long time in a several tissues.

PMID- 7776987
TI  - A comparison of symptoms after the consumption of milk or lactose-hydrolyzed milk
      by people with self-reported severe lactose intolerance.
AB  - BACKGROUND: Ingestion of a large dose of the milk sugar lactose--for example, the
      50-g load in 1 liter of milk--causes symptoms such as abdominal pain, diarrhea,
      bloating, and flatulence in the majority of people with lactose malabsorption. It
      is uncertain whether the ingestion of more common doses of lactose, such as the
      amount in 240 ml (8 oz) of milk, causes symptoms. Some people insist that even
      smaller quantities of milk, such as the amount used with cereal or coffee, cause
      severe gastrointestinal distress. METHODS: In a randomized, double-blind,
      crossover trial, we evaluated gastrointestinal symptoms in 30 people (mean age,
      29.4 years; range, 18 to 50) who reported severe lactose intolerance and said
      they consistently had symptoms after ingesting less than 240 ml of milk. The
      ability to digest lactose was assessed by measuring the subjects' end-alveolar
      hydrogen concentration after they ingested 15 g of lactose in 250 ml of water.
      Subjects then received either 240 ml of lactose-hydrolyzed milk containing 2
      percent fat or 240 ml of milk containing 2 percent fat and sweetened with
      aspartame to approximate the taste of lactose-hydrolyzed milk; each type of milk
      was administered daily with breakfast for a one-week period. Using a standardized
      scale, subjects rated the occurrence and severity of bloating, abdominal pain,
      diarrhea, and flatus and recorded each passage of flatus. RESULTS: Twenty-one
      participants were classified as having lactose malabsorption and nine as being
      able to absorb lactose. During the study periods, gastrointestinal symptoms were
      minimal (mean symptom-severity scores for bloating, abdominal pain, diarrhea, and
      flatus between 0.1 and 1.2 [1 indicated trivial symptoms; and 2, mild symptoms]).
      When the periods were compared, there were no statistically significant
      differences in the severity of these four gastrointestinal symptoms. For the
      lactose-malabsorption group, the mean (+/- SEM) difference in episodes of flatus
      per day was 2.5 +/- 1.1 (95 percent confidence interval, 0.2 to 4.8). Daily
      dietary records indicated a high degree of compliance, with no additional sources
      of lactose reported. CONCLUSIONS: People who identify themselves as severely
      lactose-intolerant may mistakenly attribute a variety of abdominal symptoms to
      lactose intolerance. When lactose intake is limited to the equivalent of 240 ml
      of milk or less a day, symptoms are likely to be negligible and the use of
      lactose-digestive aids unnecessary.

PMID- 7776988
TI  - Optimal oral anticoagulant therapy in patients with mechanical heart valves.
AB  - BACKGROUND: The optimal intensity of oral anticoagulant therapy for patients with
      mechanical heart valves (i.e., the level at which thromboembolic complications
      are effectively prevented without excessive bleeding) is not known. We attempted
      to determine the optimal intensity by calculating the incidence of both
      complications at different levels of anticoagulation. METHODS: Data were
      collected on all patients with mechanical heart valves who have been seen at four
      regional Dutch anticoagulation clinics since 1985. The primary outcome events
      were episodes of thromboembolism or major bleeding. The intensity-specific
      incidence of each type of event was calculated as the number of events that
      occurred at a certain intensity of anticoagulation (expressed in terms of the
      international normalized ratio [INR]) divided by the number of patient-years
      during which the INR was at this level in the total patient population. RESULTS:
      A total of 1608 patients were followed during 6475 patient-years. Cerebral
      embolism occurred in 43 patients (0.68 per 100 patient-years) and peripheral
      embolism in 2 (0.03 per 100 patient-years). Intracranial and spinal bleeding
      occurred in 36 patients (0.57 per 100 patient-years) and major extracranial
      bleeding in 128 (2.1 per 100 patient-years). The optimal intensity of
      anticoagulation, at which the incidence of both complications was lowest, was
      achieved when the INR was between 2.5 and 4.9. CONCLUSIONS: The intensity of
      anticoagulant therapy for patients with prosthetic heart valves is optimal when
      the INR is between 2.5 and 4.9. To achieve this level of anticoagulation, a
      target INR of 3.0 to 4.0 is recommended.

PMID- 7776989
TI  - Apoptosis and loss of renal tissue in polycystic kidney diseases.
AB  - BACKGROUND: Polycystic kidney disease is characterized by the enlargement of
      renal cysts, interstitial fibrosis, and gradual loss of normal renal tissue in
      association with progressive deterioration of renal function. The process causing
      the progressive loss of renal tissue is unknown, but it could be the result of a
      form of programmed cell death known as apoptosis. METHODS: We assayed apoptotic
      DNA fragmentation in normal and polycystic kidneys biochemically by gel
      electrophoresis and histochemically by in situ end-labeling. A DNA-specific dye,
      Hoechst 33258, was used to detect morphologic apoptosis in renal samples from
      patients with normal kidneys, polycystic kidney disease, and other kidney
      diseases. RESULTS: Apoptotic DNA fragmentation was detected in polycystic kidneys
      from 5 patients without renal failure and 11 patients with renal failure but not
      in kidneys from 12 patients with no renal disease. In situ end-labeling revealed
      apoptotic cells in glomeruli, in cyst walls, and in both cystic and noncystic
      tubules of the polycystic kidneys. No tubular apoptosis was detected in renal
      biopsy specimens from five patients with IgA nephropathy, three patients with
      nephrosclerosis, two patients with focal glomerulosclerosis, one patient with
      diabetic nephropathy, six patients with acute tubular necrosis, or four patients
      with acute and four patients with chronic renal-transplant rejection. The
      capacity of polycystic kidney cells to undergo apoptosis was retained in vitro in
      the absence of uremia, ischemia, and other confounding pathologic conditions.
      CONCLUSIONS: Apoptotic loss of renal tissue may be associated with the
      progressive deterioration of renal function that occurs in patients with
      polycystic kidney disease.

PMID- 7776990
TI  - The treatment of scabies with ivermectin.
AB  - BACKGROUND: Ivermectin is an anthelmintic agent that has been a safe, effective
      treatment for onchocerciasis (river blindness) when given in a single oral dose
      of 150 to 200 micrograms per kilogram of body weight. Anecdotal reports of
      improvement in patients who suffered from infestation with the mite Sarcoptes
      scabiei suggest that the ectoparasitic disease scabies might be treated with
      ivermectin. METHODS: We conducted an open-label study in which ivermectin was
      administered in a single oral dose of 200 micrograms per kilogram to 11 otherwise
      healthy patients with scabies and to 11 patients with scabies who were also
      infected with the human immunodeficiency virus (HIV), 7 of whom had the acquired
      immunodeficiency syndrome. All patients received a full physical and dermatologic
      examination; scrapings from the skin of all patients tested positive for scabies.
      Patients were reexamined two and four weeks after treatment, when the scrapings
      for scabies were repeated. The patients used no other scabicides during the 30
      days before ivermectin treatment or during the 4-week study period. RESULTS: None
      of the 11 otherwise healthy patients had evidence of scabies four weeks after a
      single dose of ivermectin. Of the 11 HIV-infected patients, 2 had < or = 10
      scabies lesions before treatment, 3 had 11 to 49 lesions, 4 had > or = 50
      lesions, and 2 had heavily crusted skin lesions. In eight of the patients the
      scabies was cured after a single dose of ivermectin. Two patients received a
      second dose two weeks after the first. Ten of the 11 patients with HIV infection
      (91 percent) had no evidence of scabies four weeks after their first treatment
      with ivermectin. CONCLUSIONS: The anthelmintic agent ivermectin, given in a
      single oral dose, is an effective treatment for scabies in otherwise healthy
      patients and in many patients with HIV infection.

PMID- 7776991
TI  - Images in clinical medicine. Polycystic liver and kidney disease.

PMID- 7776992
TI  - Gastric carcinoma.

PMID- 7776993
TI  - Jumping genes and the immunoglobulin V gene system.

PMID- 7776994
TI  - Clinical problem-solving. Diverted by the chief complaint.

PMID- 7776995
TI  - Optimal oral anticoagulant therapy in patients with nonrheumatic atrial
      fibrillation and recent cerebral ischemia.
AB  - BACKGROUND: A number of studies have demonstrated the efficacy of oral
      anticoagulant therapy in reducing the risk of stroke and systemic embolism in
      patients with nonrheumatic atrial fibrillation. However, both the targeted and
      the actual levels of anticoagulation differed widely among the studies, and a
      number of studies failed to report standardized prothrombin-time ratios as
      international normalized ratios (INRs). We therefore performed an analysis to
      determine the intensity of oral anticoagulant therapy in nonrheumatic atrial
      fibrillation that provides the best balance between the prevention of
      thromboembolism and the occurrence of bleeding complications. METHODS: We
      calculated INR-specific incidence rates for both ischemic and major hemorrhagic
      events occurring in 214 patients who received anticoagulant therapy in the
      European Atrial Fibrillation Trial, a secondary-prevention trial in patients with
      nonrheumatic atrial fibrillation and a recent episode of minor cerebral ischemia.
      RESULTS: The optimal intensity of anticoagulation was found to lie between an INR
      of 2.0 and an INR of 3.9. No treatment effect was apparent with anticoagulation
      below an INR of 2.0. The rate of thromboembolic events was lowest at INRs from
      2.0 to 3.9, and most major bleeding complications occurred with treatment at
      intensities with INRs of 5.0 or above. CONCLUSIONS: To achieve optimal levels of
      anticoagulation with the lowest risk in patients with atrial fibrillation and a
      recent episode of cerebral ischemia, the target value for the INR should be set
      at 3.0, and values below 2.0 and above 5.0 should be avoided.

PMID- 7776997
TI  - Lactose intolerance.

PMID- 7776996
TI  - Managed care and the morality of the marketplace.

PMID- 7776998
TI  - Aiming for safe anticoagulation.

PMID- 7776999
TI  - Polycystic kidney disease--there goes the neighborhood.

PMID- 7777000
TI  - Performance reports on quality--prototypes, problems, and prospects.

PMID- 7777002
TI  - Intramuscular injections and vaccine-associated poliomyelitis.

PMID- 7777001
TI  - Intramuscular injections and vaccine-associated poliomyelitis.

PMID- 7777003
TI  - Intramuscular injections and vaccine-associated poliomyelitis.

PMID- 7777004
TI  - Genetic predisposition to Hodgkin's disease.

PMID- 7777005
TI  - Hodgkin's disease and HIV infection.

PMID- 7777006
TI  - Pel-Ebstein fever.

PMID- 7777007
TI  - Transplantation of cord-blood cells.

PMID- 7777009
TI  - Transplantation of cord-blood cells.

PMID- 7777008
TI  - Transplantation of cord-blood cells.

PMID- 7777011
TI  - Abuse and neglect of elderly persons.

PMID- 7777010
TI  - Treatment of life-threatening infantile hemangiomas with vincristine.

PMID- 7777012
TI  - Abuse and neglect of elderly persons.

PMID- 7777015
TI  - Occupational asthma.

PMID- 7777013
TI  - Images in clinical medicine. Transverse leukonychia.

PMID- 7777016
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 21-1995. A 33-year-old man with a sore throat followed by
      swelling and pain in the leg.

PMID- 7777014
TI  - A pregnancy-prevention program in women of childbearing age receiving
      isotretinoin.
AB  - BACKGROUND: Isotretinoin is effective in treating severe acne, but it is also
      teratogenic. To minimize pregnancies among exposed women, the manufacturer,
      together with the U.S. Food and Drug Administration, implemented a multicomponent
      Pregnancy Prevention Program in 1988. We report the results of an ongoing survey
      designed to assess compliance with this program. METHODS: Treated women enrolled
      in the survey through their physician, by filling out a form in the medication
      package, or by calling a toll-free telephone number. They were randomly assigned
      to be followed by telephone or by mail. Telephone interviews were conducted at
      the start of therapy, in the middle of it, and 6 months after it ended; mailed
      questionnaires were completed 6 months after therapy ended (median duration of
      therapy, 20 weeks). RESULTS: Between 1989 and 1993, 177,216 eligible women
      enrolled in the survey. Interviews with 24,503 women within one month of
      enrollment revealed that 99 percent had been told to avoid pregnancy. At that
      time, approximately 54 percent were not sexually active (of whom 37 percent used
      contraception) and 42 percent were sexually active (of whom 99 percent used
      contraception); 4 percent were infertile. Among 124,216 women with completed
      telephone or mail follow-up results, there were 402 pregnancies during therapy
      (3.4 per 1000 courses of isotretinoin); 72 percent of the pregnant women had
      elective abortions, 16 percent spontaneous abortions, 3 percent ectopic
      pregnancies, and 8 percent live births. CONCLUSIONS: The pregnancy rate among
      women receiving isotretinoin therapy was substantially lower than that in the
      general population and was compatible with the characteristics and behavior of
      the enrolled women.

PMID- 7777017
TI  - Amiodarone in patients with heart failure.

PMID- 7777018
TI  - What causes wasting in AIDS?

PMID- 7777019
TI  - Protecting the embryo from X-rated drugs.

PMID- 7777020
TI  - Povidone-iodine to prevent ophthalmia neonatorum.

PMID- 7777021
TI  - Povidone-iodine to prevent ophthalmia neonatorum.

PMID- 7777023
TI  - Clinical problem-solving: decision making by analogy.

PMID- 7777022
TI  - Clinical problem-solving: decision making by analogy.

PMID- 7777024
TI  - Clinical problem-solving: decision making by analogy.

PMID- 7777025
TI  - Clinical problem-solving: decision making by analogy.

PMID- 7777026
TI  - Clinical problem-solving: decision making by analogy.

PMID- 7777027
TI  - Clinical problem-solving: decision making by analogy.

PMID- 7777028
TI  - Gastrointestinal cancer and the cystic fibrosis gene.

PMID- 7777029
TI  - Images in clinical medicine: corticosteroid osteonecrosis.

PMID- 7777030
TI  - Images in clinical medicine: corticosteroid osteonecrosis.

PMID- 7777031
TI  - Medical aspects of the persistent vegetative state--a correction. The Multi
      Society Task Force on PVS.

PMID- 7777032
TI  - Trans fatty acids in margarine.

PMID- 7777033
TI  - Energy expenditure and wasting in human immunodeficiency virus infection.
AB  - BACKGROUND: Increased expenditure of energy at rest has been considered a
      contributing factor to the negative energy balance and weight loss that occur in
      patients with human immunodeficiency virus (HIV) infection. However, the true
      determinant of energy balance is not resting but total energy expenditure. We
      sought to determine the contribution of total energy expenditure to weight
      changes in patients with HIV-associated wasting. METHODS: We performed 51
      assessments of energy metabolism in 27 men with HIV infection at different stages
      of disease, including periods of both rapid and slow weight loss. Resting energy
      expenditure was measured by indirect calorimetry, total energy expenditure by the
      doubly-labeled-water technique, and energy intake by recording the weight of food
      consumed. The results were compared with the rate of weight loss or gain.
      RESULTS: The mean (+/- SD) total energy expended by the HIV-infected men was 2750
      +/- 670 kcal per day, no more than that expended by normal men. There was a
      significant positive relation between total energy expenditure and the rate of
      weight change (r = 0.61, P < 0.001); thus, during rapid weight loss, total energy
      expenditure was reduced to 2180 +/- 580 kcal per day (P = 0.009), primarily
      because of reduced physical activity. During rapid weight loss, the negative
      energy balance (-850 +/- 580 kcal per day) was primarily the result of the
      reduction in energy intake, to 1330 +/- 610 kcal per day; intake correlated
      strongly with the rate of weight change (r = 0.84, P < 0.001). CONCLUSIONS: In
      patients with HIV infection, total energy expenditure is reduced during episodes
      of weight loss. Reduced energy intake, not elevated energy expenditure, is the
      prime determinant of weight loss in HIV-associated wasting.

PMID- 7777034
TI  - Natural history of peripheral neuropathy in patients with non-insulin-dependent
      diabetes mellitus.
AB  - BACKGROUND: There is little information on the incidence and natural history of
      neuropathy in patients with non-insulin-dependent diabetes mellitus (NIDDM).
      METHODS: We studied patients with newly diagnosed NIDDM and control subjects both
      at base line and 5 and 10 years later. Polyneuropathy was diagnosed on the basis
      of clinical criteria (pain and paresthesias) and electrodiagnostic studies (nerve
      conduction velocity and response-amplitude values). We investigated the relation
      between metabolic variables (results of oral glucose-tolerance tests, serum lipid
      and insulin concentrations, and glycosylated hemoglobin values) and the
      development of polyneuropathy. RESULTS: In 10 years, 36 patients with NIDDM and 8
      control subjects died; 86 patients and 121 control subjects completed the study.
      When the study ended, 18 percent of the patients were being treated only with
      diet, 59 percent with oral hypoglycemic drugs alone, 12 percent with insulin
      alone, and 11 percent with both insulin and oral hypoglycemic agents. At base
      line the prevalence of definite or probable polyneuropathy among the patients
      with NIDDM was 8.3 percent, as compared with 2.1 percent among the control
      subjects. These values 10 years later were 41.9 percent and 5.8 percent,
      respectively. The number of patients with NIDDM who had nerve-conduction
      abnormalities in the legs and feet increased from 8.3 percent at base line to
      16.7 percent after 5 years and to 41.9 percent after 10 years. The decrease in
      sensory and motor amplitudes, indicating axonal destruction, was more pronounced
      than the slowing of the nerve conduction velocities, which indicates
      demyelination. Among the patients with NIDDM, those with polyneuropathy had
      poorer glycemic control than those without. Low serum insulin concentrations
      before and after the oral administration of glucose were associated with the
      development of polyneuropathy, regardless of the degree of glycemia. CONCLUSIONS:
      The prevalence of polyneuropathy among patients with NIDDM increases with time,
      and the increase may be greater in patients with hypoinsulinemia.

PMID- 7777035
TI  - Developmental effects of fumonisin B1-containing Fusarium moniliforme culture
      extract in CD1 mice.
AB  - Pregnant Charles River CD1 mice were treated with a semipurified extract of
      Fusarium moniliforme culture containing 0, 12.5, 25, 50 or 100 mg FB1/kg each day
      orally (diluted in distilled water) between gestational days (GD) 7 and 15 to
      evaluate the developmental toxicity of FB1. Following sacrifice of dams on GD 18,
      litters were examined for gross abnormalities and divided equally for skeletal or
      visceral examination by routine techniques. Significant maternal mortality was
      observed at doses of 50 and 100 mg FB1/kg. Dose-dependent decreases in maternal
      body weight gains, number of live offsprings per litter, and mean body weight of
      the offspring were produced at FB1 doses of 25 mg/kg or higher. The percentage of
      implants resorbed increased at all doses in a dose-dependant manner. A dose
      dependant increase, except at the lowest dose tested, in the incidence of
      ossification deficits involving digits and sternum, short and wavy ribs, and
      hydrocephalus of lateral and third ventricles was also evident. Cleft palate was
      seen only at the highest FB1 dose. Maternal intoxication manifested as a dose
      dependant increase in the severity of ascites associated mainly with increased
      histopathologic scores reflecting hepatocellular damage at day 18. Concommittant
      increases in serum alanine amino transferase (ALT) on GD 12, reflecting
      parenchymal liver cell damage, was also observed at all doses above 12.5 mg of
      FB1/kg. These results suggest that FB1-containing F. moniliforme culture extract
      is developmentally toxic in mice, and that this toxicity may be mediated by
      maternal hepatotoxicity.

PMID- 7777036
TI  - Experimental paracoccidioidomycosis of hamster inoculated in the cheek pouch.
AB  - We compared the granuloma morphology and immune response of hamsters inoculated
      with Paracoccidioides brasiliensis (Pb) into the cheek pouch, which lacks
      lymphatic drainage, and into the footpad, which is rich in lymphatics. Our
      objective was to better understand the modulation of Pb granuloma in an
      immunocompetent animal inoculated in an immunologically privileged site. The
      humoral immune response (ELISA) and cell mediated immunity (footpad test) became
      positive on days 7 and 14, respectively in animals inoculated into footpad and on
      days 35 and 60 in animals inoculated into the pouch. Typical epithelioid
      granulomas were observed at both sites on day 14. The number of fungi gradually
      decreased from the beginning of the experiment in footpad lesions, but only after
      day 35 in pouch granulomas, when cell mediated immunity was detectable. The
      results indicate that typical epithelioid paracoccidioidomycotic granulomas may
      develop in the absence of a detectable immune response; however, they are
      incapable of controlling fungal reproduction. Lack of lymphatic drainage delays
      the appearance of a detectable immune response, but with time fungi escape from
      the pouch, elicit an immune response and reach other organs. Our results further
      indicate the importance of the lymphatics in the pathogenesis of
      paracoccidioidomycosis.

PMID- 7777037
TI  - A case of chronic necrotizing pulmonary aspergillosis due to Aspergillus
      nidulans.
AB  - A 55-year old man without immunosuppression clinically showed a coin lesion in
      the right lower lung on the chest radiographs. Aspergillus nidulans was isolated
      and identified in both trans-bronchial lung biopsy specimen and resected tissue.
      The specimens revealed characteristics of chronic necrotizing pulmonary
      aspergillosis pathologically. Very few reports on cases of pulmonary
      aspergillosis due to A. nidulans exist, and we were not able to find any reports
      of similar cases. This case may be the first reported case of chronic necrotizing
      pulmonary aspergillosis due to A. nidulans.

PMID- 7777038
TI  - Effect of amphotericin B on the lipids of five different strains of Cryptococcus
      neoformans.
AB  - Cells of five strains of Cryptococcus neoformans were obtained for partial
      analysis of lipid composition. Quantitative analysis of lipids and sterols were
      completed, as well as qualitative analysis of sterols by thin-layer
      chromatography and by the ultraviolet spectra. Such determinations were made on
      cells cultured in the absence and presence of amphotericin B at sub-MIC (minimal
      inhibitory concentration) levels. Marked alterations of the lipid and sterol
      contents were observed in the amphotericin B-treated cells. Moreover, ergosterol
      disappeared in these antibiotic-exposed cells. It is concluded that amphotericin
      B altered the lipid profiles, especially sterols of C. neoformans.

PMID- 7777040
TI  - NIH panel to monitor peer review in action.

PMID- 7777039
TI  - SDS-PAGE separation of dermatophyte antigens, and western immunoblotting in
      feline dermatophytosis.
AB  - Water-soluble antigens liberated from the disrupted mycelium of nine
      dermatophytes (seven isolates of Microsporum canis, one each of Microsporum
      gypseum and Trichophyton mentagrophytes) were compared by analytical slab SDS
      PAGE. No substantial differences were observed between the protein bands of the
      M. Canis isolates, but certain distinctive bands were apparent in the other two
      species examined. Western immunoblotting using M. canis-derived antigens
      separated by SDS-PAGE was used to investigate the humoral immune response in 79
      cats with naturally-occurring dermatophytosis (72 with M. canis, six with M.
      gypseum and one with T. mentagrophytes) and this information was compared to
      results of immunoblots from 46 control (non-dermatophyte exposed) cats. Seven
      dominant bands (bands which occurred frequently and stained heavily) were
      identified in immunoblots from the dermatophyte-infected cats with apparent
      molecular weights varying between 39 and 120 kD. None of these bands were totally
      specific markers for dermatophytosis as a variable proportion of the control cats
      showed reactivity to all these proteins. However, most (73%) of the dermatophyte
      infected cats showed reactivity to six or seven of the identified bands whereas
      most (80%) of the control cats showed reactivity to between zero and three of
      these bands (p < 0.005). Western immunoblotting could be used to select
      individual immunodominant antigens for further evaluation of protective (cell
      mediated) immunity.

PMID- 7777041
TI  - US cardiologist found guilty of theft.

PMID- 7777042
TI  - 'Science and reason' forum finds enemies all around.

PMID- 7777043
TI  - 'Euro-lab' scientists seek fairer deal on pay.

PMID- 7777044
TI  - Panel offers compromise on food labelling.

PMID- 7777045
TI  - French journalism defended.

PMID- 7777046
TI  - Necessary brain.

PMID- 7777047
TI  - Parents' rights.

PMID- 7777049
TI  - Biotechnology. Making selection work.

PMID- 7777048
TI  - Cognitive function. Acetylcholine revisited.

PMID- 7777051
TI  - Is thalidomide mutagenic?

PMID- 7777050
TI  - Neurotransmission. Keeping synapses up to speed.

PMID- 7777052
TI  - Sex of the last wild Spix's macaw.

PMID- 7777053
TI  - Delivery of a nematocyst toxin.

PMID- 7777054
TI  - Bacteriorhodopsin as a model for proton pumps.
AB  - According to a long-standing hypothesis, membrane pumps function by flip-flopping
      between two protein conformations that allow alternative access of the ion
      binding site to the two membrane surfaces. Site-specific mutagenesis, time
      resolved spectroscopy and X-ray diffraction confirm this mechanism for
      bacteriorhodopsin, and implicate change of electrostatic interaction at the
      active site as the trigger for the global protein conformation change during the
      proton transport cycle.

PMID- 7777055
TI  - Phantom-limb pain as a perceptual correlate of cortical reorganization following
      arm amputation.
AB  - Although phantom-limb pain is a frequent consequence of the amputation of an
      extremity, little is known about its origin. On the basis of the demonstration of
      substantial plasticity of the somatosensory cortex after amputation or
      somatosensory deafferentation in adult monkeys, it has been suggested that
      cortical reorganization could account for some non-painful phantom-limb phenomena
      in amputees and that cortical reorganization has an adaptive (that is, pain
      preventing) function. Theoretical and empirical work on chronic back pain has
      revealed a positive relationship between the amount of cortical alteration and
      the magnitude of pain, so we predicted that cortical reorganization and phantom
      limb pain should be positively related. Using non-invasive neuromagnetic imaging
      techniques to determine cortical reorganization in humans, we report a very
      strong direct relationship (r = 0.93) between the amount of cortical
      reorganization and the magnitude of phantom limb pain (but not non-painful
      phantom phenomena) experienced after arm amputation. These data indicate that
      phantom-limb pain is related to, and may be a consequence of, plastic changes in
      primary somatosensory cortex.

PMID- 7777056
TI  - Essential role of neocortical acetylcholine in spatial memory.
AB  - The cholinergic system plays a crucial role in learning and memory. Lesions of
      cholinergic nuclei, pharmacological manipulations of cholinergic systems,
      intracerebral transplantation of fetal tissue and anatomical changes in
      cholinergic pathways during ageing have all been correlated with altered
      cognitive behaviour. However, it has not been proved that regional acetylcholine
      is causally required for learning and memory. Here we describe how we achieved a
      permanent and selective impairment of learning and memory by damaging the nucleus
      basalis magnocellularis, a nucleus that provides the major cholinergic
      innervation of the neocortex, in adult rats. To test the hypothesis that
      acetylcholine is essential for restoration of cognitive function, we implanted
      genetically modified cells that produce acetylcholine into denervated neocortical
      target regions. After grafting, rats with increased neocortical acetylcholine
      levels showed a significant improvement in a spatial navigation task.
      Acetylcholine is thus not only necessary for learning and memory, as previously
      argued, but its presence within the neocortex is also sufficient to ameliorate
      learning deficits and restore memory following damage to the nucleus basalis.

PMID- 7777057
TI  - Essential functions of synapsins I and II in synaptic vesicle regulation.
AB  - Synaptic vesicles are coated by synapsins, phosphoproteins that account for 9% of
      the vesicle protein. To analyse the functions of these proteins, we have studied
      knockout mice lacking either synapsin I, synapsin II, or both. Mice lacking
      synapsins are viable and fertile with no gross anatomical abnormalities, but
      experience seizures with a frequency proportional to the number of mutant
      alleles. Synapsin-II and double knockouts, but not synapsin-I knockouts, exhibit
      decreased post-tetanic potentiation and severe synaptic depression upon
      repetitive stimulation. Intrinsic synaptic-vesicle membrane proteins, but not
      peripheral membrane proteins or other synaptic proteins, are slightly decreased
      in individual knockouts and more severely reduced in double knockouts, as is the
      number of synaptic vesicles. Thus synapsins are not required for neurite
      outgrowth, synaptogenesis or the basic mechanics of synaptic vesicle traffic, but
      are essential for accelerating this traffic during repetitive stimulation. The
      phenotype of the synapsin knockouts could be explained either by deficient
      recruitment of synaptic vesicles to the active zone, or by impaired maturation of
      vesicles at the active zone, both of which could lead to a secondary
      destabilization of synaptic vesicles.

PMID- 7777058
TI  - Distinct pools of synaptic vesicles in neurotransmitter release.
AB  - Nerve terminals are unique among cellular secretory systems in that they can
      sustain vesicular release at a high rate. Although little is known about the
      mechanisms that account for the distinctive features of neurotransmitter release,
      it can be assumed that neuron-specific proteins are involved. One such protein
      family, the synapsins, are believed to regulate neurotransmitter release through
      phosphorylation-dependent interactions with synaptic vesicles and cytoskeletal
      elements. Here we show that clusters of vesicles at synaptic release sites are
      composed of two pools, a distal pool containing synapsin and a proximal pool
      devoid of synapsin and located adjacent to the presynaptic membrane. Presynaptic
      injection of synapsin antibodies resulted in the loss of the distal pool, without
      any apparent effect on the proximal pool. Depletion of this distal pool was
      associated with a marked depression of neurotransmitter release evoked by high
      frequency (18-20 Hz) but not by low-frequency (0.2 Hz) stimulation. Thus the
      availability of the synapsin-associated pool of vesicles seems to be required to
      sustain release of neurotransmitter in response to high-frequency bursts of
      impulses.

PMID- 7777059
TI  - Glucosylation of Rho proteins by Clostridium difficile toxin B.
AB  - Toxin A and B, the major virulence factors of Clostridium difficile, are the
      causative agents of antibiotic-associated pseudomembranous colitis. In cultured
      cell lines their potent cytotoxicity results from their ability to induce
      disaggregation of the microfilament cytoskeleton. Toxin B acts on the low
      molecular-mass GTPase RhoA, which is involved in the regulation of the actin
      cytoskeleton. We report here that toxin B catalyses the incorporation of up to
      one mole of glucose per mole of RhoA at the amino acid threonine at position 37.
      The modification was identified and localized by tandem electrospray mass
      spectrometry. UDP-glucose selectively serves as cosubstrate for the
      monoglucosylation reaction catalysed by toxin B. Microinjection of RhoA
      previously glucosylated by toxin B into monolayer cells caused disaggregation of
      actin filaments, indicating a dominant-negative activity of glucosylated RhoA.

PMID- 7777060
TI  - Retinoblastoma-protein-dependent cell-cycle inhibition by the tumour suppressor
      p16.
AB  - D-type cyclins, in association with the cyclin-dependent kinases Cdk4 or Cdk6,
      promote progression through the G1 phase of the cell cycle by phosphorylating the
      retinoblastoma protein (RB). The activities of Cdk4 and Cdk6 are constrained by
      inhibitors such as p16, the product of the CDKN2 gene on human chromosome 9p21
      (refs 12-14). The frequent deletion or mutation of CDKN2 in tumour cells suggests
      that p16 acts as a tumour suppressor. We show that wild-type p16 arrests normal
      diploid cells in late G1, whereas a tumour-associated mutant of p16 does not.
      Significantly, the ability of p16 to induce cell-cycle arrest is lost in cells
      lacking functional RB, including primary fibroblasts from Rb-/- mouse embryos.
      Thus, loss of p16, overexpression of D-cyclins and loss of RB have similar
      effects on G1 progression, and may represent a common pathway to tumorigenesis.

PMID- 7777061
TI  - Tumour-derived p16 alleles encoding proteins defective in cell-cycle inhibition.
AB  - The cyclin-dependent kinase inhibitor p16 is a candidate tumour-suppressor
      protein that maps to a genomic locus strongly associated with familial melanoma
      and other tumour types. Screening of primary tumours and linkage analysis of
      familial melanoma pedigrees have identified many potential mutations in p16, but
      the functional significance of these sequence variants has remained unclear. We
      report here that p16 can act as a potent and specific inhibitor of progression
      through the G1 phase of the cell cycle, and we demonstrate that several tumour
      derived alleles of p16 encode functionally compromised proteins. The ability of
      p16 to arrest cell-cycle progression generally correlates with inhibition of
      cyclin D1/Cdk4 kinase activity in vitro, with two exceptions among the alleles
      tested. In vivo, the presence of functional retinoblastoma protein appears to be
      necessary but may not be sufficient to confer full sensitivity to p16-mediated
      growth arrest. Our results provide support for the notion that p16 is an
      important cell-cycle regulator whose inactivation contributes to the outgrowth of
      human tumours.

PMID- 7777062
TI  - A two-step mechanism for 5' and 3' splice-site pairing.
AB  - A fundamental question in the splicing of precursor messenger RNA is how the 5'
      and 3' splice sites are recognized and paired during the splicing reaction. It
      has been proposed that spliceosome assembly in metazoan pre-mRNAs can be
      initiated through interaction between the 3' splice site and specific sequence
      elements on the downstream exon (an exonic enhancer or a 5' splice site). Pairing
      of the intronic 5' and 3' splice sites occurs subsequently. We report here that
      5' and 3' splice sites located on separate synthetic pre-mRNA substrates can be
      efficiently trans-spliced if the 3' trans-splicing substrate contains these
      downstream sequence elements. Moreover, selection of the trans 5' splice site can
      occur after the second pre-spliceosomal complex A has assembled on the 3' trans
      splicing substrate. Thus our data demonstrate that 5' and 3' splice-site pairing
      in metazoans can occur in two distinct steps.

PMID- 7777063
TI  - Direct NMR evidence for an intermediate preceding the rate-limiting step in the
      unfolding of ribonuclease A.
AB  - It is commonly believed that there are no detectable intermediates in the kinetic
      unfolding reactions of small proteins. If such intermediates could be found, they
      would give important information about the nature of the transition state for
      unfolding, which is thought to occur close to the native state. We report here
      that one-dimensional proton magnetic resonance spectra recorded during the
      unfolding of ribonuclease A provide direct evidence for at least one unfolding
      intermediate in which side chains are free to rotate. This intermediate appears
      to be a 'dry molten globule' of the kind hypothesized by Shakhnovich and
      Finkelstein.

PMID- 7777064
TI  - 36th Spring meeting of the German Society for Experimental and Clinical
      Pharmacology and Toxicology. Mainz, March 14-17, 1995. Abstracts.

PMID- 7777065
TI  - Cardiovascular risks for hemodialysis and peritoneal dialysis patients.

PMID- 7777067
TI  - Donor rule, DOT budget gives AOPO issues to consider at upcoming meeting.

PMID- 7777068
TI  - The future of nephrology nursing care: a preview of 1995-1996 ANNA activities.

PMID- 7777066
TI  - Transplanting the older patient: what are the risks--and successes?

PMID- 7777070
TI  - Smile. Smile. Smile.

PMID- 7777069
TI  - The new year's challenges for nursing.

PMID- 7777071
TI  - Seeking success: effective orientation programs for experienced faculty.
AB  - Experienced faculty who change academic positions must adjust quickly to a new
      academic and clinical setting. Although strategies to facilitate integration for
      faculty new to the role are available, integrating experienced faculty presents a
      different challenge, and these strategies are not available in the literature.
      This article presents relevant orientation strategies for both clinical and
      academic settings.

PMID- 7777072
TI  - Budget, costs, and health care reform.

PMID- 7777073
TI  - Interdisciplinary faculty and student practice in a nurse-managed campus wellness
      program.
AB  - The concept of nurse-managed care in centers for nursing is a growing phenomenon
      in this era of health care reform. Nursing faculty are utilizing nurse-managed
      centers as alternative sites for clinical experiences and faculty practice. In
      this paper the authors highlight interdisciplinary faculty and student practice
      for a Campus Wellness Program at a midwestern university. Empowering faculty and
      students, and offering needed health promotion services to the university
      community, are addressed. Historical background, administrative, practice and
      educational challenges, and triumphs will be presented.

PMID- 7777074
TI  - Ethical implications of the Human Genome Diversity Project.

PMID- 7777075
TI  - A collaborative effort for rural health.
AB  - Collaboration between the W.K. Kellogg Foundation and a school of nursing helped
      to meet health care and environmental needs of the residents in two rural
      counties burdened with poverty and illiteracy. This endeavor also affords the
      faculty and students in the school of nursing opportunities to work with
      underserved populations in rural areas. The project continues its community
      service through evolving programs.

PMID- 7777076
TI  - Action research: a method for practitioners.
AB  - Nursing research has frequently been criticized for its inability to shape or be
      shaped by clinical practice. One method that involves clinicians and researchers
      in the pursuit of research and change is action research. The purpose of this
      paper is to present action research as a technique that combines grounded methods
      with organizational change to enhance clinical practice, an approach widely used
      in Australia and England. The presentation includes the steps in action research.
      Examples of nursing research conducted are also examined. The discussion focuses
      on techniques that enhance, maintain, or increase the scientific rigor of the
      methods.

PMID- 7777077
TI  - Fetal well-being. III: Strategies to diminish liability and improve patient care
      in all trimesters.

PMID- 7777078
TI  - Hidden scars: posttraumatic stress disorder.
AB  - Memories of traumatic incidents or experiences can cause deep but invisible
      scars. Without intervention, the emotional pain associated with the incident can
      continue unabated. For the most part, painful memories are likely to be
      suppressed. However, when a memory is "triggered" for some reason, a variety of
      symptoms may occur which may be termed "posttraumatic stress disorder" (PTSD). A
      nurse can use an understanding of unhealed psychological scars to gain awareness
      of unresolved personal stress. In addition to personal reflection, as nurses
      assess and care for patients, it is important to be alert to indications of
      unresolved emotional pain.

PMID- 7777079
TI  - [Rehabilitation of the CVA patient in the nursing home].

PMID- 7777080
TI  - [The preoperative examination; reconsideration].

PMID- 7777081
TI  - [Who should carry out which preoperative examination when?].

PMID- 7777082
TI  - [Preoperative internist consultation. I. General aspects and management in
      diabetes mellitus and obstructive lung disease].

PMID- 7777083
TI  - [Preoperative internist consultation. II. Management in hypertension and cardiac
      disease].

PMID- 7777084
TI  - [Outpatient preoperative examination by the anesthesiologist. I. Fewer procedures
      and preoperative hospital days].
AB  - OBJECTIVE: To study the effect of the reorganisation of the preoperative
      screening on the volume of laboratory and function tests, and on preoperative
      hospital days. SETTING: General Hospital De Weezenlanden, Zwolle, The
      Netherlands. DESIGN: Retrospective study. METHOD: In The Netherlands the surgeon
      is responsible for the preoperative screening (anamnesis and general
      examination). In 1992 the preoperative screening was reorganised and it was
      carried out in the outpatient department under the responsibility of the
      anaesthesiologist. Laboratory and function tests were only performed if
      indicated. Data on 3122 patients, operated in 1991, were compared with the data
      on 3258 patients from 1992. Multiple regression analysis and chi-square test were
      used. RESULTS: The proportions of the patients subjected to laboratory tests, ECG
      or a chest X-ray decreased from 90%, 55%, and 50% respectively in 1991 to 53%,
      43% and 10% in 1992 (p < 0.05). Admission on the day of surgery increased from
      13% in 1991 to 21% in 1992 (p < 0.01). Clinical preoperative evaluation with
      admission more than 1 day before surgery, decreased from 5% in 1991 to 4% in 1992
      (p = 0.02). The mean duration of the hospital stay before the operation decreased
      from 0.79 day per patient in 1991 to 0.65 in 1992 (p = 0.02). CONCLUSION: If the
      preoperative screening is carried out by the anaesthesiologist, all the patients
      have the opportunity to meet the anaesthesiologist before the operation. The
      number of preoperative hospital days can be reduced by outpatient preoperative
      screening. Laboratory and function testing on only if indicated reduces the
      volume of the laboratory tests, ECGs and chest X-rays.

PMID- 7777085
TI  - [Outpatient preoperative examination by the anesthesiologist. II. Patient
      satisfaction].
AB  - OBJECTIVE: To determine patient satisfaction after the reorganisation of the
      preoperative screening. SETTING: General Hospital De Weezenlanden, Zwolle, The
      Netherlands. DESIGN: Retrospective patient interview. METHOD: Before the
      reorganisation, the preoperative screening was performed clinically under the
      responsibility of the consultant surgeon. Thereafter it was performed in the
      outpatient department by the anaesthesiologist. Patients who had had two similar
      operations within two and a half years, one before and one after the
      reorganisation, were interviewed at home regarding the different methods of
      preoperative screening (n = 94). RESULTS: The preoperative screening had a
      reassuring effect on patients. 72% considered preoperative anaesthesia
      information important. The number of hospital visits before the operation did not
      significantly increase after the screening was reorganised. There was little
      objection to attending the hospital for preoperative screening (12%). Most
      patients (60%) had no preference for the previous or the present method of
      screening. Patients who remembered the interview with the anaesthesiologist (56%)
      preferred the new method (score: 8.2 on a scale 0-10; score of the former method:
      7.6; p < 0.01). A larger number of these had the opportunity to ask questions (p
      = 0.01) and more patients had received attention from the anaesthesiologist (p <
      0.01). 75% of the patients had received sufficient preoperative anaesthesia
      information. 28% of the patients wanted to see the anaesthesiologist again after
      admission. CONCLUSIONS: Preoperative screening reassures and informs the patient.
      The patients who could remember the interview with the anaesthesiologist
      preferred the preoperative screening in the outpatient department. A considerable
      number of the patients wanted to see the anaesthesiologist again after admission.

PMID- 7777086
TI  - [Geriatric rehabilitation in a nursing home and the Barthel Index as a
      parameter].
AB  - OBJECTIVE: To analyse patient characteristics and the results of rehabilitation
      among patients admitted for rehabilitation to a nursing-home. DESIGN:
      Retrospective study. SETTING: St. Jozefsheil in Bakel, part of the Stichting
      Verpleeghuizen Gewest Helmond Nursing Homes Foundation, District Helmond, SVGH).
      METHOD: On all 60 patients admitted to the SVGH homes in 1987, information was
      obtained from medical, paramedical and nursing records. The Barthel index was
      determined on admission and at discharge and the differences were tested
      statistically using a t-test. RESULTS: 37 female and 23 male patients were
      admitted, with a median age of 75.5 years. 62% had had a cerebrovascular accident
      and 90% were referred from the hospital, mainly by the neurologist. The median
      hospitalization time was 9 weeks and the waiting list for a nursing home 2.9
      weeks. In 1990, 47% of the patients were discharged, after a median
      rehabilitation time of 15 weeks; 23% had died and 30% remained in the nursing
      home. Among the discharged patients the increase in mean Barthel index from
      admission to discharge was 17.9 points. The difference in mean Barthel index at
      admission compared with non-discharged patients was 35.4 points and that compared
      with the decreased patients 37.7 points. For the 23 patients discharged within
      one year compared with the 5 patients discharged after more then one year the
      difference was 13.6 points. The mean Barthel index at admission of the 14
      discharged patients living alone was 21 points more then that of the 10
      discharged patients living with a partner. At discharge this difference was 9.9
      points. CONCLUSION: The Barthel index appears useful for evaluation and
      comparison of results of (geriatric) rehabilitation.

PMID- 7777087
TI  - [Balloon occlusion of the internal carotid artery in the treatment of inoperable
      aneurysms].
AB  - Three patients, women of 46, 63 and 47 years old, with a large or giant aneurysm
      of the internal carotid artery were treated by endovascular balloon occlusion of
      the internal carotid artery. In all three patients the aneurysm thrombosed
      completely. One patient became hemiplegic 12 days after carotid occlusion owing
      to hypoperfusion infarction.

PMID- 7777088
TI  - [Preconception consultation: a good idea?].

PMID- 7777089
TI  - [National education for residents in surgery: specialist course Surgery; a
      report. Advisory Commission Specialist Course Surgery].

PMID- 7777090
TI  - [Entering of patients in clinical-oncological trials: why not exclusive exclusion
      when inclusion is out of the question].

PMID- 7777091
TI  - [Entering of patients in clinical-oncological trials: why not exclusive exclusion
      when inclusion is out of the question?].

PMID- 7777092
TI  - [Good results in periodic screening in women with increased risk of breast
      cancer; retrospective study].

PMID- 7777094
TI  - Improving care through your cancer program.

PMID- 7777093
TI  - Play ball!

PMID- 7777095
TI  - Another 'alphabet' group to affect your practice.

PMID- 7777096
TI  - Coronary artery bypass graft surgery in patients with poor left ventricular
      performance: results in a community hospital. Lincoln Heart Failure Treatment
      Program.

PMID- 7777097
TI  - Dangerous sequelae of epidural anesthesia in geriatrics.
AB  - These three cases demonstrate: (1) an epidural hematoma (case three); (2) a
      probable anterior spinal artery occlusion (case two); and (3) a low cord damage
      of obscure nature (case one). Three serious neurological sequelae after epidural
      anesthesia among the operated patients of one physician seems alarming. The three
      occurred within two years. These are published to direct attention to potential
      risks from epidural anesthesia in older patients.

PMID- 7777098
TI  - Effect of 1,25-dihydroxyvitamin D on the immune activity of peritoneal
      macrophages in continuous ambulatory peritoneal dialysis patients.

PMID- 7777099
TI  - On the progression of chronic renal disease.

PMID- 7777100
TI  - C1Q complexes with beta-2-microglobulin and amyloid P-component in sera of
      patients with dialysis-associated amyloidosis.
AB  - We studied complexes composed of C1q and beta 2-microglobulin (C1q.beta 2M) or
      serum amyloid P-component (C1q.SAP) in the sera of 38 patients receiving
      hemodialysis (HD) and 20 healthy control subjects using an enzyme-linked
      immunoassay. We also compared complex levels in HD patients with and without
      symptoms of HD-associated amyloidosis (HA). Serum C1q-beta 2M levels were
      significantly higher in HD patients without HA than in healthy control subjects
      and significantly higher in HD patients with HA than in HD patients without HA.
      Serum C1q.SAP levels were significantly lower in patients with HA than in those
      without HA. These results suggest that C1q.beta 2M may contribute to HA.

PMID- 7777101
TI  - Changes in circulating immune complex and charge distribution with upper
      respiratory tract inflammation in IgA nephropathy.
AB  - The circulating IgA class immune complex (IgA-IC) and its charge distribution, at
      the appearance of macroscopic hematuria and after tonsillectomy in patients with
      IgA nephropathy, were investigated in the present study. 3.5% polyethylene glycol
      precipitate (3.5% PEG-IgA) was used for IgA-IC detection and isoelectric focusing
      for its charge distribution. The level of IgA in 3.5% PEG-IgA, principally IgA1,
      and the proportion of anionic 3.5% PEG-IgA (isoelectric point, pl, 4.8-5.6) were
      significantly elevated in episodes of macroscopic hematuria with upper
      respiratory tract inflammation and with the appearance of macroscopic hematuria 1
      day after tonsillectomy. Therefore, an increase in anionic IgA-IC (pl 4.8-5.6),
      principally IgA1, and the tonsils were considered to be concerned with the
      mechanism involved in the appearance of macroscopic hematuria.

PMID- 7777103
TI  - Urinary excretion of podocalyxin indicates glomerular epithelial cell injuries in
      glomerulonephritis.
AB  - Immunofluorescent study of urine sediments was performed to detect glomerular
      epithelial cell injuries using specific monoclonal antibody against podocalyxin,
      a glycoprotein that is prominently expressed on glomerular epithelial cells.
      Three kinds of structures (casts, granules and cells) were stained in urine
      sediments from various glomerular diseases. The presence of podocalyxin in urines
      was confirmed by absorption test, immunoelectron microscopy and Western blotting.
      Podocalyxin was detected in the urinary sediments of patients with various forms
      of glomerulonephritis, particularly those with acute onset. The amount of their
      urinary excretion apparently indicates the degree of the glomerular epithelial
      cell injuries in glomerular diseases.

PMID- 7777102
TI  - Sodium-lithium countertransport kinetics in IgA nephropathy: relation to plasma
      lipids and renal impairment.
AB  - We have investigated the activity and kinetics of sodium-lithium countertransport
      (SLC) in patients with IgA nephropathy and their relationship to plasma lipids.
      Standard SLC activity, the Michaelis constant (Km) and maximum velocity (Vmax)
      were measured in patients who had IgA nephropathy with either normal serum
      creatinine (IgA-NRF), or raised serum creatinine (IgA-IRF), and normal subjects
      (NC). The standard SLC activity was raised in hypertensive patients with IgA-NRF
      due to a raised Vmax in association with hyperlipidaemia. The Km was
      significantly lower and Vmax also tended to be lower in IgA-IRF. Km and Vmax were
      not different in IgA-NRF compared with the NC. There was no difference in the
      mean standard SLC activity between all three groups. The low Km and low Vmax
      resulted in a normal standard SLC activity being observed in IgA-IRF which is
      similar to the situation we have observed in a proportion of diabetic patients
      with nephropathy. The low Km in patients with IgA nephropathy may be due to
      inheritance associated with familial essential hypertension or to an acquired
      change of the kinetics related to a change in the environment of the plasma
      membrane during the development of renal impairment.

PMID- 7777104
TI  - Evaluation of red blood cell lipoperoxidation in hemodialysed patients during
      erythropoietin therapy supplemented or not with iron.
AB  - To investigate the effects of erythropoietin (rHuEPO) therapy supplemented or not
      with iron on hemolysis in hemodialysed patients (HD) we evaluated
      lipoperoxidation (LPO) by assaying (i) the red blood cell (RBC) antioxidant
      enzymatic system including superoxide dismutase (SOD), glutathione peroxidase,
      and catalase (Cat), (ii) RBC polyunsaturated fatty acids (PUFA) and (iii)
      malondialdehyde (MDA). Group 1 included 12 HD patients, group 2 had 7 HD patients
      with iron supplementation, group 3 comprised 12 HD patients with rHuEPO therapy
      and group 4 included 9 HD patients with both iron and rHuEPO therapies. No LPO
      was found in group 1 as regards MDA and PUFA levels. However, SOD and Cat
      activities were significantly elevated as compared to controls (p < 0.001). In
      the second group, a significant decrease in PUFA percentage was observed,
      particularly in 20:4(n-6) and 22:4(n-6) (the main ones involved in LPO) as
      compared to the other groups, whereas total MDA level was higher than that of the
      other groups. Similarly a decreased SOD activity was observed as compared to
      group 1 (p < 0.001), indicating its inactivation subsequent to an hyperproduction
      of reactive oxygen species through iron injection. In groups 3 and 4 no change
      was observed in MDA levels or PUFA percentages indicating no LPO. However, marked
      differences were observed in the enzymatic defense system. Particularly in group
      3, SOD and Cat activities decreased when compared to group 1 (p < 0.001) whereas
      the association of erythropoietin and iron (group 4) increased the three
      enzymatic activities (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7777105
TI  - Serum guanidino compound levels in uremic pediatric patients treated with
      hemodialysis or continuous cycle peritoneal dialysis. Correlations between nerve
      conduction velocities and altered guanidino compound concentrations.
AB  - Serum levels of twelve guanidino compounds (GCs) and nerve conduction velocities
      were determined in a dialyzed renal insufficient pediatric population. Two
      dialytic groups were considered: one subjected to hemodialysis (HD, 11 patients)
      and one subjected to continuous cycle peritoneal dialysis (CCPD, 13 patients).
      Before HD, marked increases were found for guanidino-succinic acid (207 times),
      methylguanidine (> or = 67 times), argininic acid (24 times), creatinine and
      alpha-N-acetylarginine (18 times) and guanidine (> or = 14 times) when compared
      to controls. Important significant increases were still present after an HD
      session for guanidinosuccinic acid (49 times), methylguanidine (34 times),
      creatinine (7 times) and alpha-N-acetylarginine and guanidine (6 times). After
      HD, creatine, arginine and homoarginine were lower than in controls. All GCs,
      with the exception of creatine, decreased significantly after a single HD session
      with percentage decrease ranging between 40% (for arginine) and 77% (for
      guanidinosuccinic acid). Creatine decreased in a statistically nonsignificant
      manner by 48%. Marked increases were found in the CCPD group for
      guanidinosuccinic acid (114 times), alpha-N-acetylarginine (12 times), argininic
      acid (15 times), creatinine (22 times), guanidine (> or = 11 times) and
      methylguanidine (> or = 48 times). Concentrations of guanidinosuccinic acid
      before and after HD and in CCPD were comparable to those reported to be toxic in
      vitro and in vivo. No clinical or electrophysiological indications of
      polyneuropathy were observed in our population. Sensory and motor nerve
      conduction studies showed few abnormalities apart from a significant correlation
      between argininic acid concentration or guanidine levels and the peroneal nerve
      conduction velocity in the CCPD-treated group.

PMID- 7777106
TI  - Hereditary interstitial nephritis without basement membrane changes.
AB  - Hereditary interstitial nephritides are a heterogeneous group of disorders
      comprising medullary cystic disease, several varieties of Alport's syndrome and
      also one familial disorder with a distinct clinical syndrome and without
      characteristic ultrastructural glomerular basement membrane changes. Our family
      consisted of 11 members, 5 of which presented with renal dysfunction of varying
      degrees. Clinically, the affected siblings presented with long-standing
      hypertension, minimal proteinuria and no hematuria. All known causes of a
      secondary diffuse interstitial nephritis, Alport's syndrome and medullary cystic
      disease have been excluded. An HLA association is suggested between the affected
      and unaffected members of the family. Renal biopsy subsequently showed the
      typical features of a chronic interstitial nephritis without basement membrane
      changes.

PMID- 7777107
TI  - Effect of glucose infusion on the renal transport of purine bases and oxypurinol.
AB  - The effect of glucose infusion on renal handling of purine bases and oxypurinol
      was examined in 6 normal subjects. Five hundred milliliters of 1.1 M glucose
      solution were administered intravenously in 1 h. Fractional clearances of uric
      acid, xanthine and oxypurinol were significantly increased during glucose
      infusion, but that of hypoxanthine was not changed, while a 1-hour infusion of
      500 ml of 1.1 M mannitol had no effect on the fractional clearances of purine
      bases and oxypurinol. These data indicate that the effect of glucose infusion on
      the renal clearances of uric acid, xanthine and oxypurinol was not related to
      osmotic diuresis but induced by glycosuria and/or hyperglycemia. Accordingly, the
      glycosuria- and/or hyperglycemia-induced decrease in the biological half-life of
      oxypurinol must be considered in the administration of allopurinol to gouty
      patients with uncontrolled diabetes mellitus.

PMID- 7777108
TI  - Avoiding acyclovir neurotoxicity in patients with chronic renal failure
      undergoing haemodialysis.
AB  - Acute neurotoxicity following the administration of the recommended oral dose of
      acyclovir (800 mg twice daily) to dialysis-dependent patients is increasingly
      recognised. This suggests that the recommended dose is too high. Little is known
      of the pharmacokinetics of oral acyclovir in dialysis patients. We studied 7
      patients with oliguric end stage renal failure receiving haemodialysis. Following
      haemodialysis, each patient received a single 800-mg tablet of acyclovir. Plasma
      acyclovir levels were monitored over the next 48 h as well as before and after
      the next routine dialysis. Peak plasma levels were achieved at 3 h (12.54 +/-
      1.76 microM, range 8.5-17.5 microM) with the half-life calculated to be 20.2 +/-
      4.6 h. Mean plasma level of 6.29 +/- 0.94 microM were within the quoted range to
      inhibit herpes zoster virus (4-8 microM) at 18 h. Haemodialysis (4-5 h)
      eliminated 51 +/- 11.5% of the acyclovir which remained at 48 h. Computer
      modelling of various dose modifications suggests that a loading dose of 400 mg
      and a maintenance dose of 200 mg twice daily is sufficient to maintain a mean
      plasma acyclovir level of 6.4 +/- 0.8 microM. A further loading dose (400 mg)
      after dialysis would raise the residual acyclovir concentration by 6.1 +/- 1.0
      microM. Such a dose modification should prevent neurotoxicity, whilst the rapid
      elimination of acyclovir by a single haemodialysis treatment provides both a
      diagnostic and therapeutic tool when toxicity is suspected.

PMID- 7777109
TI  - Bone mineral density evaluated by dual-energy X-ray absorptiometry after one-year
      treatment with calcitriol started in the predialysis phase of chronic renal
      failure.
AB  - Thirteen patients in the predialysis phase of chronic renal failure (CRF) were
      treated with calcitriol (0.25 micrograms/day) and 12 with placebo. After 1 year
      of study, an increase in bone mineral density in the calcitriol group measured by
      dual-energy X-ray absorptiometry was seen for the femoral neck and lumbar spine
      when compared to the placebo group (p < 0.001 and p < 0.01, respectively). We
      conclude that a steady low dose of calcitriol started in the predialysis phase of
      CRF is beneficial to the patients with CRF. This may be partly due to suppression
      of secondary hyperparathyroidism.

PMID- 7777110
TI  - Elevated serum levels of 3-deoxyglucosone, a potent protein-cross-linking
      intermediate of the Maillard reaction, in uremic patients.
AB  - 3-Deoxyglucosone (3-DG) has been identified as an intermediate of the Maillard
      reaction in vitro. We measured serum 3-DG levels using gas chromatography/mass
      spectrometry and found a marked elevation in serum 3-DG levels in uremic patients
      compared with healthy subjects. The uremic patients with diabetes showed
      significantly higher serum concentrations of 3-DG than those without diabetes. 3
      DG was demonstrated to be a potent protein-cross-linking agent in the reaction
      with lysozyme, leading to browning, fluorescence formation and polymerization of
      the protein by formation of advanced glycation end products (AGE). The increase
      in serum 3-DG levels in the uremic patients suggests that 3-DG may be responsible
      for the development of uremic complications by promoting the formation of AGE.

PMID- 7777111
TI  - Liposoluble vitamins E and A in human renal cortex and renal cell carcinomas.
AB  - Vitamin E was quantified in renal cell carcinomas (RCC) and in 'intact' renal
      cortex, obtained from 31 patients subjected either to unilateral nephrectomy or
      to partial resection of the only kidney. Histologically, 14 tumors consisted
      predominantly of clear cells (group 1) and 17 of other cell types (group 2). In
      both groups, a significant increase in vitamin E concentration, as compared to
      the 'intact' cortex, was observed: 167.8 +/- 27.9 and 68.2 +/- 15.2 micrograms/g
      wet tissue weight (mean +/- SEM) for groups 1 and 2, respectively, versus 10.1 +/
      0.53 micrograms/g wet tissue weight for the cortex. Although the total lipid
      content was also increased in tumors (especially in group 1), the vitamin E
      concentration in tumor tissue, calculated per milligram of total lipids, proved
      to be much higher in both groups than in 'intact' cortex. A significant positive
      correlation was observed between vitamin E and total lipid content in group 1 and
      2 carcinomas. It was also found that vitamin E accumulation in RCC is unlikely to
      be attributed to an enhanced lipid deposit in the tumor cells. Thus, in 8 tumors
      of group 2 the vitamin E levels were markedly enhanced although these tumors did
      not differ from the cortex in total lipid concentrations. Vitamin A content
      determined in 17 carcinomas, when calculated per milligram of total lipids, was
      the same as in 'intact' cortex.

PMID- 7777112
TI  - Morphological changes of the venous system in uremic patients. A histopathologic
      study.
AB  - Because of the decreased venous compliance in hypertensive dialysis patients, it
      was investigated whether their venous system exhibited structural abnormalities.
      Venous samples were taken during transplantation from the common and external
      iliac vein in 12 hypertensive and 6 normotensive uremic patients and from the
      distal inferior caval vein and the common iliac vein in 7 kidney donors and 5
      autopsy patients without history of cardiovascular disease. The thickness of the
      venous media was significantly increased in hypertensive uremic patients as
      compared to controls, but did not differ between normotensive patients and
      controls. The quantity of medial collagen did not differ among the various
      groups. The smooth muscle content of the media was increased in 5 uremic patients
      (2 normotensive and 3 hypertensive patients), whereas almost no smooth muscle was
      observed in the media of controls. Intimal thickening was observed neither in
      uremic patients nor in controls. IN CONCLUSION: increased medial thickness in
      hypertensive dialysis patients could be an explanation for the decreased venous
      compliance previously found in these patients.

PMID- 7777113
TI  - Impact of decreased serum transaminase levels on the evaluation of viral
      hepatitis in hemodialysis patients.
AB  - The value of serum transaminases (ST) in evaluating hepatitis B (HBV) and C (HCV)
      infection was studied in 217 hemodialysis (HD) patients and 804 normal controls.
      Mean serum aspartate aminotransferase (AST) was 22.3 (22.0-22.7) and 22.6 (21.6
      23.6) IU/l or 0.371 (0.366-0.378) and 0.376 (0.36-0.393) mu kat/l in controls and
      HD patients, respectively (nonsignificant), while mean serum alanine
      aminotransferase (ALT) was 20.3 (19.9-20.7) and 16.3 (15.3-17.3) IU/l or 0.338
      (0.331-0.345) and 0.271 (0.255-0.288) mu kat/l in these two groups (p < 0.001).
      However, both AST and ALT became significantly depressed in HD patients after
      adjusting for age, gender, HBV surface antigen (HBsAg) and anti-HCV. The usual
      practice of regarding AST and ALT as being 'abnormal' in evaluating viral
      hepatitis when they exceeded the upper reference range (40 and 46 IU/l or 0.666
      and 0.766 mu kat/l in our laboratory) was then critically assessed by the
      receiver operating characteristic (ROC) curve. ROC analysis showed that ST was
      useless in detecting HBsAg, while the best cutoff point for detecting the
      presence of anti-HCV was 18 IU/l (0.3 mu kat/l) for AST and 16 IU/l (0.266 mu
      kat/l) for ALT in HD patients, respectively. These are considerably lower than
      the conventional criteria for an 'abnormal' ST. We conclude that ST are decreased
      in HD patients and that the cutoff value of ST for detecting HCV should be set at
      lower levels to enhance their diagnostic yield.

PMID- 7777114
TI  - The cytochemical profile of visceral mesothelium under the influence of lactated
      hyperosmolar peritoneal dialysis solutions.
AB  - Male albino mice had one daily intraperitoneal injection of 4.25 g/100 ml glucose
      concentration fluid for peritoneal dialysis at pH 5.0-5.2, for a period of 30
      days. At the end of the experimental periods, mesothelial cell imprints were
      taken from the peritoneal layer of the anterior liver surface. Histochemical
      staining of imprints obtained from mice exposed to the peritoneal dialysis fluid
      showed a consistently increased activity of: (a) enzymes associated with the cell
      membrane: Na-K-ATP-ase, alkaline phosphatase and 5-nucleotidase; (b) cytoplasmic
      enzymes: acid phosphatase and cytochrome oxidase, and (c) a modestly increased
      activity of glucose-6-phosphatase. These changes, which are not far from those
      observed in activated mesothelial cells, suggest that exposure of mesothelial
      cells to high glucose concentrations of PD fluid is associated with increased
      production and disposal of energy to be used for maintaining the constancy of the
      cellular environment and, probably, for fuelling the transcellular transport of
      solutes of large molecular size.

PMID- 7777115
TI  - Renal magnesium wasting with hypercalciuria, nephrocalcinosis and ocular
      disorders.
AB  - We report a case of congenital magnesium-losing kidney with associated
      hypercalciuria and ocular derangements consisting of myopia, bilateral macular
      colobomata and bilateral papillary dysversion and hypoplasia. Our patient
      provides further evidence of the existence of an oculorenal syndrome associating
      abnormalities in the renal handling of magnesium and calcium, and myopia and
      chorioretinal disease.

PMID- 7777116
TI  - A case of renal vein thrombosis with posterior nut cracker syndrome.

PMID- 7777117
TI  - Acute renal failure secondary to antifibrinolytic therapy.

PMID- 7777119
TI  - Interleukin-2 therapy and renal enzyme excretion in patients with metastatic
      colorectal cancer.

PMID- 7777118
TI  - Accidental substitution of acidic concentrate for acetate in dialysis fluid
      concentrate: a cause of severe metabolic acidosis.

PMID- 7777120
TI  - Nephrotic syndrome associated with liver metastasis of rectal cancer.

PMID- 7777121
TI  - Acute piperazine encephalopathy in a hemodialyzed patient.

PMID- 7777122
TI  - Long-term persistence of improvement of renal anaemia in spite of discontinued
      erythropoietin treatment.

PMID- 7777123
TI  - Spontaneous perirenal hematoma as a rare complication of polyarteritis nodosa.

PMID- 7777124
TI  - Education and occupation as risk factors for dementia: a population-based case
      control study.
AB  - To further investigate the putative associations between education and dementia
      and between occupation and dementia, we conducted a population-based case-control
      study. Cases were all subjects affected by dementia ascertained through a
      prevalence survey conducted in the municipality of Appignano, Macerata Province,
      Italy. For each case (n = 48), we randomly selected 2 population controls
      residing in the same municipality and matched for age and sex (n = 96).
      Information regarding exposures was collected by nonmedical personnel during the
      first contact for the prevalence survey. Although we found a striking trend
      toward decreasing prevalence with increasing education, this association was
      suggestive but not significant after age and sex adjustment at case-control
      analyses (odds ratio for illiterates = 1.4; 95% CI 0.6-3.1). In contrast, we
      found a significant association between manual principal lifetime occupation and
      dementia using both unadjusted and adjusted analyses (odds ratio = 2.9; 95% CI
      1.2-7.4). Our findings suggest that, although education and occupation are
      related, occupation is a stronger indicator of risk than education.

PMID- 7777125
TI  - Methods for a prevalence survey of neurological disorders in Junin, Buenos Aires,
      Argentina.
AB  - A two-phase prevalence survey of major neurological disorders was conducted in
      the city of Junin, Buenos Aires, Argentina. In phase 1, a sample of households
      was screened to identify persons who possibly had a disorder of interest. In
      phase 2, persons screened as positive in phase 1 were clinically examined by
      neurologists. This article describes the survey methods used, discusses related
      methodologic issues (e.g., the problem of false negatives), and presents
      demographic findings and attrition tallies. A brief account of the pilot
      investigations is also included as an appendix.

PMID- 7777126
TI  - Case-control study on the epidemiology of cluster headache. I: Etiological
      factors and associated conditions. Italian Cooperative Study Group on the
      Epidemiology of Cluster Headache (ICECH).
AB  - The etiological and physiopathological mechanisms of cluster headache (CH) are
      still largely unknown. The majority of the studies published on the possible risk
      factors and conditions associated with CH rely on either anecdotal observations
      or generalizations and have not been supported by serious epidemiological
      investigations. The aim of this case-control study was to evaluate the real
      association of life habits and general risk factors with CH. CH was associated
      only with cigarette smoking, head trauma and a positive family history for
      headache. Further epidemiologic studies are probably necessary in order to find
      clues to CH etiology.

PMID- 7777127
TI  - Magnitudes of neurological disorders in a farming town in Kyushu, Japan:
      frequency of neurological symptoms and signs.
AB  - We examined 1,270 elderly residents aged 60 years and over in a cross-sectional
      study of a standardized clinical examination to determine the frequency of
      'abnormal' neurological findings in 27 randomly selected communities in the town
      of Mifune, Japan. The survey showed one or more neurological symptoms in 89.1%,
      and one or more signs in 94.4% of the examined elderly. Most of the symptoms and
      signs increased with age, especially after 70 years, indicating the importance of
      neurological afflictions in the community health of the elderly.

PMID- 7777128
TI  - Epidemiology of primary intracranial tumors in the Valle d'Aosta (Italy) during
      the 6-year period 1986-1991.
AB  - A total of 285 new cases of primary intracranial tumors (PIT: 178 cases, 62%) and
      secondary forms (107 cases, 38%) were detected by CT scan and MRI during a
      population-based study of the incidence rates of these neoplasms in the Aosta
      Valley (N.W. Italy: 114,325 residents in 1988) during the period 1986-1991. The
      PIT are discussed in this paper. Histological confirmation was obtained in 60%.
      Age- and sex-adjusted mean annual incidence rate for all PIT was 28.3/100,000
      (men 21.7; women 28.1). The incidence rates by types were 9.7 for meningiomas
      (men 5.3; women 13.9), 9.1 for tumors of the neuroepithelial group (men 10; women
      8.1), 3.7 for adenomas (men 2.6; women 4.6), and 1.9 for neurinomas (men 2.9;
      women 0.9). Incidence rate increased with age. Meningiomas comprised 37% of the
      PIT, followed by tumors of the neuroepithelial group (35%), adenomas (14%,
      neurinomas (7.3%) and malignant lymphomas (2.3%). The remaining subtypes were
      4.6%. Our data showed a clearly higher incidence rate than in previous population
      based surveys. The differences were most marked in the meningioma group. The
      extensive use of CT scan and the more intensive case-finding could explain the
      differences.

PMID- 7777130
TI  - Expression of tyrosine hydroxylase in the aging, rodent olfactory system.
AB  - Tyrosine hydroxylase (TH) mRNA, immunoreactivity, and activity were examined as a
      reflection of dopamine expression in juxtaglomerular neurons intrinsic to the
      olfactory bulbs of young (6-month-old), middle aged (18-month-old), and aged (25-
      to 29-month-old) rats and mice. TH expression was maintained at levels observed
      in young animals in the olfactory bulbs of aged animals from two mouse strains,
      C57Bl/6JNia and C57Bl/6NNia, and one rat strain, an F1 hybrid between F344 and
      Brown Norway strains. The parental F344 rat strain exhibited reductions in TH
      expression of about 20% in 26- to 29-month-old animals as compared to 6- and 18
      month-old rats. However, there was significant inter-animal variability. Some
      aged F344 rats had TH levels that were similar and others had activity levels
      that were 50% of those in young and middle aged animals. Neither the general
      condition of the animals nor the presence of adrenal tumors predicted the
      individuals with reduced TH expression. Olfactory bulb size, estimated from
      protein content, did not differ between rats and mice of different ages. In
      addition, expression of olfactory marker protein, a protein found primarily in
      mature olfactory receptor neurons, also was unchanged indicating the maintenance
      of afferent innervation. These data suggest that, in contrast to other brain
      dopamine systems, the expression of the dopamine phenotype is maintained in the
      aging olfactory bulb.

PMID- 7777129
TI  - Levels of stigmatization of patients with previously untreated epilepsy in
      northern Ecuador.
AB  - As part of a population-based study of epilepsy in northern Ecuador, 215 patients
      with epilepsy and 125 controls were given a questionnaire designed to elicit the
      degree of stigma associated with epilepsy. Evidence for stigma was also sought
      from local medical personnel. 144 patients and 98 controls were questioned again
      12 months later at study completion to see whether their perceptions had changed.
      Both intellectual and physical abilities of people with epilepsy were regarded as
      low by controls, and this opinion did not change over the study period.
      Observations by medical personnel also suggested stigmatizing attitudes in the
      community. The number of patients reporting problems with their marriage or
      childbearing as a result of their epilepsy did not alter over the 12-month
      period, unlike their estimates of their own intellectual and physical capacities
      which had significantly improved. Conversely, although their expectations of
      employment outside the home had diminished, the reasons stated for this related
      to continuing epilepsy and not to the objections of fellow workers and employers.

PMID- 7777131
TI  - Age-related cochlear degeneration in senescence-accelerated mouse.
AB  - Age-related hair cell loss and strial atrophy were investigated in an accelerated
      senescence-prone strain, SAMP1 mice, and an accelerated senescence-resistant
      strain, SAMR1 mice. The loss of inner and outer hair cells in SAMP1 progressed
      more rapidly than that in SAMR1 with age. In both strains, areas of the loss of
      inner and outer hair cells were located mainly in the apex and base. Atrophy of
      the stria vascularis was observed in both strains, but in SAMP1 it appeared to
      increase earlier than in SAMR1. These results reveal that age-related hair cell
      loss and atrophy of the stria vascularis comparable to that in the human cochlea
      occur earlier and progress more rapidly in SAMP1 than in SAMR1. Hearing
      impairment in SAM may be due to a combination of sensory and strial presbycusis
      as well as to neural presbycusis, as reported previously. The morphological
      changes in the cochlea observed in SAMP1 and SAMR1 make these strains suitable
      for the study of the mechanisms of presbycusis.

PMID- 7777132
TI  - Protein kinase C activity, translocation, and conventional isoforms in aging rat
      brain.
AB  - Protein kinase C was studied in various brain areas in aging Wistar rats. Histone
      directed kinase activity from the cortex, hippocampus and cerebellum did not
      change with aging. Using purified protein B-50 as a substrate, between 3 and 8
      months a decrease in in vitro phosphorylation was detected in the membrane
      fraction of the cortex but after this age values remained stable. In hippocampal
      membranes, B-50 phosphorylation was increased in aged rats. PKC translocation was
      impaired in aged rats in both the cortex and the hippocampus. PKC alpha and beta
      mRNA decreased in the cortex between 3 and 8 months with no further decline in
      aged animals. Hippocampal mRNA for calcium-dependent PKC isoforms was not
      modified during aging, as assessed by Northern and in situ hybridization. Western
      blot analysis revealed a change in PKC gamma protein only, which was increased in
      hippocampal membranes from aged rats. The data indicate that the key PKC function
      that is impaired in aged rats is enzyme translocation irrespective of the brain
      area investigated.

PMID- 7777133
TI  - Age-related spatial reference and working memory deficits assessed in the water
      maze.
AB  - Aged rats have spatial memory deficits relative to young rats. The extent of
      these deficits in intermediate-aged rats is not well established. The present
      study examined the pattern of age-related changes in spatial reference and
      working memory in four ages of Fischer-344 rats. Place discrimination (PD) in the
      Morris water maze measured spatial reference memory. Repeated acquisition (RA), a
      discrimination in which the escape platform location varied from session to
      session, measured spatial working memory. Fischer-344 rats, 4 months, 11 months,
      17 months, and 24 months of age, were tested. Compared to 4-month-olds, 24-month
      olds were significantly impaired on all six PD measures of performance, 17 months
      were significantly impaired on five PD measures, and 11 months were significantly
      impaired on only one PD measure. Only 24-month-olds had a significant working
      memory impairment in RA relative to 4 months. Reference and working memory
      measures were distinct as assessed by a principal components analysis. The
      results indicate a nonlinear age-related spatial memory decline in Fischer-344
      rats from 4 to 24 months of age.

PMID- 7777134
TI  - Cholinergic binding sites in rat brain: analysis by age and cognitive status.
AB  - Age-related alterations in the density of cholinergic receptor binding and
      reuptake sites were examined in discrete forebrain regions of behaviorally tested
      rats using quantitative autoradiography. Neurochemical changes associated with
      chronological age alone were distinguished from memory-dependent alterations by
      correlating density of binding sites with performance in the Morris water maze
      task. An initial analysis of tritium quenching indicated no reliable differential
      quenching in the study population. Modest age-related reductions in selected
      subtypes of cholinergic binding sites in basal forebrain, basal ganglia, and
      thalamus were observed. However, these reductions were not correlated with a
      spatial memory deficit. In contrast, no significant changes in the analysis by
      chronological age were detected for the density of [3H]hemicholinium binding to
      high affinity choline uptake sites or [3H]pirenzepine binding to M1 receptors in
      any brain region but strong correlations were found between behavioral
      performance of aged rats and density of these sites in dorsal hippocampal
      subfield CA3 and dentate gyrus. These findings indicate the value of combined
      neurobiological/behavioral assessment.

PMID- 7777135
TI  - Mesostriatal dopamine markers in aged Long-Evans rats with sensorimotor
      impairment.
AB  - Changes in the mesostriatal dopamine system associated with normal aging are
      observed in both human and laboratory animals, but the specific behavioral
      consequences of these nonpathological changes are largely unexplored. The present
      study (a) assessed the effects of normal aging on markers for the mesostriatal
      dopamine system, and (b) examined the relationship of age-related changes in this
      system to decline in reaction time performance. Decreased levels of midbrain
      dopamine (DA) and dihydroxyphenylacetic acid (DOPAC) were observed in the aged
      rats as compared to young, but there was no evidence for age-related changes in
      the density of D1 or D2 receptor binding or the density of dopamine uptake sites.
      Some differences were observed when the aged rats were grouped according to
      reaction time performance. Aged RT-unimpaired rats exhibited higher density of D1
      binding in rostrodorsal striatal patch areas, but lower overall levels of DA. In
      caudal striatum, aged RT-unimpaired rats exhibited lower DA and higher DOPAC
      levels.

PMID- 7777136
TI  - Anticonvulsants attenuate amyloid beta-peptide neurotoxicity, Ca2+ deregulation,
      and cytoskeletal pathology.
AB  - Increasing evidence supports the involvement of amyloid beta-peptide (A beta) and
      an excitotoxic mechanism of neuronal injury in the pathogenesis of Alzheimer's
      disease. However, approaches aimed at preventing A beta toxicity and
      neurofibrillary degeneration are undeveloped. We now report that anticonvulsants
      (carbamazepine, phenytoin, and valproic acid) can protect cultured rat
      hippocampal neurons against A beta- and glutamate-induced injury. Each of the
      anticonvulsants attenuated the elevation of intracellular free calcium levels
      [(Ca2+)i] elicited by A beta or glutamate suggesting that their neuroprotective
      mechanism of action involved stabilization of [Ca2+]i. These compounds were
      effective at clinically relevant concentrations (carbamazepine, 100 nM-10 microM;
      phenytoin, 100 nM-1 microM; valproic acid, 100 nM-100 microM). The
      anticonvulsants suppressed glutamate-induced alterations in tau and buiquitin
      immunoreactivities. Compounds that stabilize [Ca2+]i may afford protection
      against the kinds of insults believed to underlie neuronal injury in Alzheimer's
      disease.

PMID- 7777137
TI  - Age-related levels of GABA/benzodiazepine binding sites in cerebrum of F-344
      rats: effects of exercise.
AB  - We examined gamma-aminobutyric acid (GABA), benzodiazepine and convulsant sites
      of postsynaptic GABA/benzodiazepine receptors (GBZR) in cerebral membranes of
      inbred Fischer 344 male rats as a function of age. In aged rats (23 to 24
      months), the benzodiazepine binding site as determined by [3H]flunitrazepam was
      47% and 43% lower than corresponding values in young adult (3 to 4 months) and
      mature (10 to 12 months) rats, respectively. The decrease was due to the loss of
      binding density rather than a change in affinity. No statistically significant
      age-related changes in [3H]muscimol binding were observed when 5 nM or 40 nM
      labeled muscimol were used. GABA produced a dose-dependent stimulation of
      flunitrazepam binding in all age groups, but the maximum stimulation in aged
      animals was significantly higher (24%) than in young and mature animals. The
      [35S]TBPS binding site, the convulsant site of GABA/benzodiazepine receptors, was
      unaffected with age. We also studied the effects of exercise on GBZR binding
      sites of aged rats. The decline of flunitrazepam binding sites and the high
      sensitivity of flunitrazepam binding to regulation by GABA in aged animals were
      reversed by 8 to 10 weeks of endurance exercise. Endurance exercise did not have
      any significant effect on muscimol or TBPS binding sites. Results suggest that
      there are aged-related alterations of GBZR binding sites and that these
      modifications can be reversed by exercise.

PMID- 7777138
TI  - Hypothalamic-pituitary-adrenal system function in patients with Alzheimer's
      disease.
AB  - The neuropathologic hallmarks of Alzheimer's disease (AD) are very prominent in
      the hippocampus, a brain site which is pivotal for the regulation of the
      hypothalamic-pituitary-adrenal (HPA) system. Thus, the combined dexamethasone
      suppression/CRH-stimulation-test outcome in patients with AD was compared to that
      of healthy elderly controls to assess--with a more refined neuroendocrine
      challenge procedure--HPA function in AD. Cortisol secretion after dexamethasone
      (DEX) pretreatment and before CRH was increased in Alzheimer's patients and 21%
      of this group were DST-nonsuppressors. None of the healthy control subjects
      escaped DEX-induced suppression of cortisol. However, after additional CRH
      administration, AD patients released significantly less cortisol and ACTH than
      the control subjects. No correlations were found between any of the endocrine
      parameters and degree of severity of dementia. It is concluded that the DST part
      of the DEX/CRH test better reflects glucocorticoid feedback disturbances,
      probably at a suprapituitary level. The CRH part of the DEX/CRH-test outcome
      might indicate the loss of endogenous CRH-Arginine-Vasopressin (AVP) synergism of
      the HPA system of these patients.

PMID- 7777139
TI  - Color image analysis in neuroanatomical research: application to senile plaque
      subtype quantification in Alzheimer's disease.
AB  - Many problems in neuroanatomy and neuropathology require the collection of large
      data sets and would benefit from a method that allows for rapid quantitative
      analysis to be carried out on a routine basis. An example is the quantification
      and subtype classification of the number of senile plaques in post-mortem
      Alzheimer's disease tissue. A method to reliably automate the analysis of plaques
      and their underlying subtypes would allow more rigorous and quantitative
      correlations to be investigated. Computer assisted image analysis of data
      typically utilizes gray scale images. These methods, however, are only applicable
      to quantification of objects labeled with a single marker. We sought to extend
      this type of analysis to double-labeled tissue sections so we could quantify dual
      labels separately based on their peroxidase color characteristics, analyze the
      resultant occurrence of overlap between the two labels, and classify senile
      plaques into discrete subtypes. We present a method for semi-automated color
      image analysis which allows one to identify separate labels based on histogram
      mapping of hue, saturation and value as well as apply overlapping feature
      detection algorithms. The technique is application driven, so that a trained
      observer can set threshold or object criteria and verify the desired results.
      These methods were able to yield total "amyloid load" and "dystrophic neurite
      load" values, generate plaque histograms based on total size, and subtype plaques
      into diffuse/primitive and neuritic/classical categories. By adjusting feature
      criteria, we were able to achieve promising agreement (Fisher's R to Z
      correlation of 0.94) between a human observer and the computer algorithm in the
      classification of plaque subtypes using three AD cases.

PMID- 7777140
TI  - Influence of norepinephrine, acetylcholine, and their blockers on the activity of
      cortical neurons in goal-directed behavior.
AB  - The neurochemical mechanisms of the central organization of sequential stages in
      the formation of a goal-directed behavioral act were investigated by means of the
      microiontophoretic application of biologically active substances to individual
      neurons of the cerebral cortex of cats. It was demonstrated that the dynamics of
      the discharge activity of the neurons at particular stages of the behavioral act
      exhibited a contradictory character when neuromediators and their antagonists
      were applied. At the same time, differences in the impulse activity were more
      pronounced against the background of the application of propranolol and atropine
      than of norepinephrine and acetylcholine.

PMID- 7777141
TI  - Long-term posttetantic changes in the reaction of neighboring neurons in
      microsegments of the cat motor cortex.
AB  - The long-term postsynaptic changes of mono- and polysynaptic reactions of
      neighboring neurons of the MC were investigated following conditioning
      tetanization of different afferent inputs. Modifiable synapses were found both in
      the cells investigated and in local neuronal circuits which included the cells,
      i.e., possibly in interneurons. Alternating and concurrent conditioning of
      thalamocortical and corticocortical input showed that, depending upon the
      modality of the conditioned input, the tetanization parameters, the character of
      the distribution of the afferents, as well as on the character of local circuits
      which include excitatory and inhibitory interneurons, the effectiveness of
      synaptic inputs to neighboring neurons varies diversely, as a result of which a
      specific pattern of interneuronal connections forms in a microsegment of cortex,
      a pattern which may be maintained over the course of tens of minutes. It was
      found that modifiable synapses of different types may function simultaneously in
      one and the same micronetwork. The investigation may be of interest in developing
      models of memory and learning.

PMID- 7777143
TI  - Spontaneous potentiation of focal potentials of the CA1 field in long-surviving
      hippocampal slices of the rat in the absence of electrical stimulation.
AB  - The changes in the efficiency of the synaptic transmission in the Schaffer
      collaterals-field CA1 neurons pathways following prolonged deprivation of
      afferentation, the cessation (up to four hours) of stimulation of the tested
      input with brief series of tests every hour (the control afferent inputs, were
      stimulated throughout the entire experiment at a frequency of 0.05/sec), were
      investigated in surviving slices of the hippocampus of rats. The evoked focal
      potentials, population spikes (PS) and population excitatory postsynaptic
      potentials (pEPSP) were recorded. The prolonged cessation of stimulation led to a
      significant (p < 0.001) increase in the amplitude of the PS (up to 208% in
      relation to the baseline level). This phenomenon of potentiation was specific in
      relation to input and exhibited the properties of "E-S potentiation". A
      hypothesis is advanced regarding the association of mechanisms responsible for
      the development of "deprivational" potentiation and of the late phase of long
      term posttetanic potentiation.

PMID- 7777144
TI  - Basal and luliberin-stimulated secretion of gonadotropins in ovariectomized rat
      females with streptozotocin-induced diabetes.

PMID- 7777142
TI  - Dynamics of the reactivity of cortical neurons to the repeating isolated action
      of L-glutamate and acetylcholine.
AB  - A comparative analysis of the probability, directionality, and intensity of the
      changes in the average frequency of the baseline (BIA) and L-glutamate-induced
      (GlIA) and acetylcholine-induced (AChIA) impulse activity of individual neurons
      of the sensorimotor cortex of unanesthetized rats showed that the reactions to Gl
      are most variable; this is expressed in a significantly higher percent of neurons
      with potentiation of responses to Gl as compared with the proportion of cells
      which manifested an increase in the AChIA in the course of 20 applications of the
      mediators. As a result of 100 applications, the GlIA decreases most frequently;
      also, the degree of decrease in GlIA over the entire duration of the testing
      exceeds the degree of decrease in AChIA. It is more characteristic of ACh than of
      Gl to increase the level of BIA in the periods between the reactions to ACh,
      while in the case of repeated application of Gl, dynamics of decrease in BIA are
      characteristic. The results are discussed from the perspective of a possibly
      different functional role of the glutamatergic and cholinergic neuromediator
      systems in the cerebral cortex in the process of formation of the dynamics of
      neuronal activity during learning.

PMID- 7777145
TI  - Analysis of hypothalamohypophyseogonadal interrelationships in female rats in
      experimentally-induced diabetes.

PMID- 7777146
TI  - Reflection of internal and external determinants of behavior in the neuronal
      activity of the neostriatum of monkeys.
AB  - It has been demonstrated that some neurons of the neostriatum of monkeys (Macaca
      nemestrina) participate in supporting the reaction of the animal to the
      appearance of standard situations in which a decision is made on the basis of
      already existing skills. Other neurons (primarily non-baseline active), by
      contrast, are activated in nonstandard situations, when the use of existing
      skills is ineffective. It is hypothesized that their activity is associated with
      the shift of the animal to a different activity which consists in the rejection
      of the use of existing skills for the formation of new skills.

PMID- 7777147
TI  - Influence of the blockade of D2 dopamine receptors of the cat neostriatum on the
      baseline activity and saccadic eye movement-associated reactions of neurons of
      the reticular portion of the substantia nigra.
AB  - The activity of neurons of the reticular portion of the substantia nigra before
      and after the microinjection of haloperidol (25 micrograms/5 microliters) into
      the head of the caudate nucleus on the ipsilateral side was investigated under
      chronic experimental conditions in cats, using the extracellular microelectrode
      pickup technique. A significant (p < 0.05) increase, from 34 to 61%, of neurons
      with the burst type of spontaneous activity was established after the injection
      of haloperidol. A significant increase in the ratio of the number of excitatory
      responses to inhibitory responses, from 0.04 to 0.4, was identified among the
      reactions associated with saccadic eye movements following the microinjection of
      haloperidol. The number of orienting saccades in response to the visual stimulus
      decreased against this background from 58 to 37%. The identified changes are
      regarded as a result of the disinhibition of GABAergic neurons of the reticular
      portion of the substantia nigra under the influence of the blockade of D2
      dopamine receptors of the neostriatum.

PMID- 7777148
TI  - Structure of neuronal activity of the caudate nucleus of monkeys during decision
      making and the realization of the motor program in different variants of a
      delayed spatial choice task.
AB  - In this paper the results of investigations of the participation of caudate
      nucleus neurons in the decision-making process and the process of organization of
      the program of a future motor response during the performance by Macaca mulatta
      monkeys of a delayed spatial choice tasks of varying degrees of complexity are
      presented. The presence in the caudate nucleus of spatially selective neurons,
      which are subdivided into two groups, was established: the position of
      conditional signals is reflected in the activity of one of the groups, and the
      direction of the future motor response is reflected in the activity of the other.
      The decision-making process is reflected in the impulse activity of neurons of
      the head of the caudate nucleus in two of its aspects: as the formation or choice
      of a specific motor program (spatially selective activity) and as a transitional
      factor from the instructive to the executive phase of the behavior.

PMID- 7777149
TI  - Influence of dilantin on the reactions of neurons of the visual cortex and the
      behavior of rabbits during learning.
AB  - Changes in behavior in response to light flashes, the conditional stimulus of a
      defense reflex, were not observed following the administration of dilantin, a
      preparation which attenuates posttetanic potentiation, in rabbits with
      preliminarily developed defense and inhibitory conditioned reflexes; weak
      disinhibition of movements appeared in response to the action of flashes against
      the background of a conditional inhibitor. The similarity of the reactions of the
      neurons of the visual cortex to light flashes, the CS, with the responses to
      their joint action with the reinforcement, did not weaken in the majority of
      instances, while in several neurons, it intensified. The differences in the
      responses to reinforced and inhibitory light flashes did not disappear following
      the administration of dilantin, but they attenuated in some of the neurons due to
      filling of the inhibitory pause with impulses. The results obtained make it
      possible to draw the conclusion that posttetanic potentiation does not
      participate in the maintenance of developed conditioned reflexes.

PMID- 7777150
TI  - Afferent and efferent mechanisms of the intensification of neostriatal
      cholinergic activity.
AB  - Data have been obtained in chronic experiments on 34 dogs, based on an
      instrumental defense reflex model associated with the maintenance of a specific
      posture, which suggest that activation of the cholinergic system of the
      neostriatum leads to a large number of changes in both the sensory and the motor
      spheres. The influences on motor behavior, observed mainly through effects on the
      cholinergic system of the contralateral caudate nucleus, reside in the
      intensification of the tonic constituent of movement, in inhibition of the phasic
      component of movement, and restriction of locomotor activity, all the way up to
      complete shutdown. The influences on sensory mechanisms, observed both through
      ipsi- and contralateral effects on the cholinergic system of the neostriatum,
      reside in an improvement of the differentiation of significant signals and are
      evidently through inhibition of the nonspecific afferent stream. Data are
      presented on the important role of the cholinoreactive systems of the CM-Pf
      complex of the thalamus in the intensification of the cholinergic activity of the
      neostriatum.

PMID- 7777151
TI  - Disturbances in cognitive activity and its neuropharmacological correction in
      structural-functional insufficiency of the head of the caudate nucleus in cats.
AB  - The participation of the head of the caudate nucleus in the organization of
      praxis, perception, gnosis, and "ideational operations" has been demonstrated.
      The broad spectrum of dysfunctions observed in the presence of caudate
      insufficiency was eliminated by a specific set of psychotropic preparations
      acting on classical neuromediator systems of the brain of cats.

PMID- 7777152
TI  - Role of dopaminoreactive systems of the cortex and the neostriatum in the
      organization of situational conditioned reflexes.
AB  - The results of experiments on dogs with dysfunction of the dopaminoreactive
      system of the brain suggest the nonidenticality of its different divisions
      (cortical, striatal, mesencephalic) in the organization of situational
      conditioned reflexes. It was demonstrated that the nigrostriatal system is
      involved to a greater degree in the spatial analysis of signals, while the
      mesocortical system is more involved in the analysis of their biological
      significance. The dopaminoreactive system of the caudate nucleus is associated to
      a greater degree with the realization of cognitive, while that of the putamen is
      associated with the realization of motor programs of situational conditioned
      reflexes. The thesis of the necessity of the coordinated functioning of the DA
      reactive systems for the organization of goal-directed behavior is substantiated.

PMID- 7777153
TI  - A metabolic map of cytochrome oxidase in the rat brain: histochemical,
      densitometric and biochemical studies.
AB  - To examine brain patterns of metabolic and functional activity, the distribution
      of cytochrome oxidase, a mitochondrial enzyme marker for neuronal functional
      activity, was mapped throughout the rat brain. Mapping was done qualitatively by
      enzyme histochemistry of brain sections cut in three planes (coronal, sagittal
      and horizontal), and quantitatively by optical densitometry of stained sections
      and by biochemical assays of brain tissue homogenates. Activity of the enzyme was
      distributed in characteristic patterns and amounts that differed among various
      neural pathways, brain nuclei, cerebral cortical areas and layers, and neuron
      types. Gray matter essentially always had higher enzyme activity than did white
      matter, by a factor of eight- to 12-fold. Among different neural pathways,
      cytochrome oxidase activity was relatively high in special sensory, somatosensory
      and motor systems, and was relatively low in associative, limbic, autonomic and
      visceral regulatory systems (though exceptional areas were present). Among 11
      different neuron types, nearly a two-fold range of histochemical staining
      intensities was observed, with the darkest staining in neurons of the
      mesencephalic trigeminal nucleus. The observed patterns of cytochrome oxidase
      activity were mostly similar to the patterns of 2-deoxyglucose uptake seen
      previously [Schwartz W. J. and Sharp F. R. (1978) J. comp. Neurol. 177, 335-360;
      Sokoloff L. et al. (1977) J. Neurochem. 28, 897-916] in conscious, "resting"
      animals, though some differences were found. For example, whereas 2-deoxyglucose
      uptake was about three-fold higher in gray matter than in white matter [Sokoloff
      L. et al. (1977) J. Neurochem. 28, 897-916], cytochrome oxidase activity was
      about eight- to 12-fold higher. This and other discrepancies probably reflect
      basic technical differences between these two methods. Compared to 2
      deoxyglucose, cytochrome oxidase is more specific for oxidative rather than
      glycolytic metabolism, and more reflective of overall neuronal functional
      activity occurring over longer time periods lasting hours to weeks, rather than
      minutes. The anatomical resolution of cytochrome oxidase histochemistry is also
      finer than that of 2-deoxyglucose autoradiography, extending to the electron
      microscopic level. The metabolic map of cytochrome oxidase activity reveals
      patterns of normal brain function, and may be useful as a baseline for comparison
      in studies of brain disease, development, ageing and plasticity.

PMID- 7777154
TI  - Abdominal vagal stimulation excites bulbospinal barosensitive neurons in the
      rostral ventrolateral medulla.
AB  - We used extracellular recordings to examine the central pathway whereby
      electrical stimulation of abdominal vagal afferents elevates arterial pressure in
      the rabbit. Bulbospinal neurons in the rostral ventrolateral medulla were
      identified by antidromic activation from the dorsolateral funiculus of the
      thoracic spinal cord. Their barosensitivity was assessed by their response to
      intravenous phenylephrine and by their cardiac cycle-related rhythmicity. We used
      peristimulus histogram procedures to assess the effect of electrical stimulation
      of abdominal vagal afferents on the discharge rate of these neurons. Electrical
      stimulation (one to three pulses) activated 98 of 123 neurons tested (80%), had
      no effect on 22 neurons (18%) and inhibited the remaining three neurons. Latency
      to peak excitation was 228 +/- 3 ms, indicating that the conduction velocity of
      the vagal afferents was about 0.6 m/s, in the unmyelinated fibre range. Lower
      oesophageal distension with a balloon excited 22 of 48 neurons (46%), inhibited
      12 neurons (25%) and had no effect on the remaining 14 cells (29%). Vagally
      induced excitation was reduced by aortic depressor nerve stimulation in nine of
      13 neurons. Lightly touching the animal's back and legs had no effect on 56 of 60
      neurons. Nociceptive stimuli failed to affect 47 of 60 neurons tested. No
      excitation was seen with electrical stimulation of the sciatic or central ear
      nerves. Our study identifies a robust excitatory input from the abdominal vagus
      to bulbospinal barosensitive neurons in the rostral ventrolateral medulla.
      Relevant physiological stimuli include lower oesophageal distension. The pathways
      may be relevant to cardiovascular changes which accompany upper gastrointestinal
      function.

PMID- 7777155
TI  - Dopamine and complex sensorimotor integration: further studies in a conditioned
      motor task in the rat.
AB  - Rats were trained to depress a lever and wait for the onset of a light stimulus,
      occurring after four equiprobable and variable intervals. At the stimulus onset,
      they had to release the lever within a reaction time limit for food
      reinforcement. This paradigm required time estimation of the various intervals
      and high attentional load for correct performance. Following activation of the
      dopaminergic transmission after systemic injection of d-amphetamine (0.6 and 0.8
      mg/kg) or intrastriatal injection of dopamine (2.5 microgram/microliters), the
      rat's performance was impaired. Compared with control animals, the performance
      deficits were expressed as an increased number of premature lever releases before
      the conditional stimulus onset ("premature responses") and decreased reaction
      times. Indeed, the reaction times distribution was shifted to the left towards
      shortened reaction times. Although the number of premature responses was
      increased, the time estimation of the four different equiprobable intervals was
      not disturbed after stimulation of dopaminergic activity. A delay-dependent
      shortening of reaction times as a result of the conditional probability of the
      stimulus occurrence (i.e. reaction times are shorter as the duration of the delay
      increases) was found in control and drug sessions, indicating that the animals
      were still able to prepare their motor response (lever release) even after
      overstimulation of the dopaminergic transmission. In contrast, blocking dopamine
      receptors with the selective D2 antagonist raclopride was found to induce
      opposite effects on the reaction time performance. The number of delayed
      responses (i.e. occurring with a latency > 600 ms) was found to be significantly
      enhanced. Furthermore, the reaction times distribution showed a shift of the
      values to the right revealing a general tendency to lengthened reaction times.
      These results indicate that a "critical level" of dopamine activity (neither too
      low nor too high) in the striatum is necessary for a correct execution of the
      movement in a conditioned motor task with temporal constraint. Moreover, while
      delayed responses might reflect a motor impairment, anticipatory responses might
      reflect a "motor facilitation" revealed by a higher level of motor readiness,
      without disturbing time estimation nor attentional processes.

PMID- 7777156
TI  - Evidence of a complete independence of the neurobiological substrates for the
      induction and expression of behavioral sensitization to amphetamine.
AB  - The repeated administration of amphetamine in rats produces behavioral
      sensitization which is characterized either by a progressive enhancement of the
      locomotor activity induced by the drug or by an enduring behavioral
      hypersensitivity to the drug after the cessation of the treatment. Some authors
      have suggested that the action of amphetamine at the level of the nucleus
      accumbens is responsible for the expression of behavioral sensitization, whereas
      the action of amphetamine at the level of the dopamine cell bodies in the ventral
      tegmental area induces some changes responsible for the initiation of the
      phenomenon. The present study fully tested this hypothesis. In two separate
      experiments, the effects of different doses of amphetamine repeatedly
      administered in the ventral tegmental area or in the nucleus accumbens were
      tested on the later behavioral reactivity to the administration of amphetamine in
      the nucleus accumbens. Independent groups of rats received five repeated
      administrations (one injection every other day) of different doses of amphetamine
      either in the ventral tegmental area (0, 1, 2.5, 5 micrograms/0.5 microliters per
      side) or in the nucleus accumbens (0, 1, 3, 10 micrograms/l microliters per
      side). Two days following the last intracerebral amphetamine injection, each
      group received a phosphate buffer solution challenge directly into the nucleus
      accumbens followed two days later by an amphetamine challenge (1 microgram/l
      microliters per side) in the nucleus accumbens and two days later by a peripheral
      challenge with amphetamine (0.5 mg/kg, s.c.). Locomotor responses were recorded
      following each injection. Results showed that injections of amphetamine into the
      nucleus accumbens induced a dose-dependent increase in locomotor activity which
      remained identical with the repetition of the injections. No difference between
      the different intra-accumbens pretreated groups was observed following the
      diverse phosphate-buffered saline solution and amphetamine challenges. In
      contrast, intra-ventral tegmental area administration of amphetamine did not
      produce any modification of locomotor activity. However, whereas no difference
      between the differently pretreated groups was observed following phosphate
      buffered saline administration into the nucleus accumbens, a potentiation of the
      locomotor response to a challenge dose of amphetamine into the nucleus accumbens
      was observed which was dependent on the dose of amphetamine pretreatment into the
      ventral tegmental area. Similar potentiation was observed following peripheral
      challenge with amphetamine. Finally, cross-sensitization was observed when a
      challenge dose of cocaine (10 micrograms/1 microliter per side) was injected into
      the nucleus accumbens, as well as when a peripheral challenge dose of morphine
      (2.5 mg/kg, s.c.) was administered to the ventral tegmental area-pretreated
      groups.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7777158
TI  - Distribution of preproenkephalin messenger RNA in the basal ganglia and limbic
      associated regions of the monkey telencephalon.
AB  - We studied the distribution of preproenkephalin messenger RNA in the monkey
      forebrain, using a free-floating method for in situ hybridization histochemistry.
      Autoradiographs reveal a high level of specific hybridization to preproenkephalin
      messenger RNA in the monkey striatum and forebrain regions. In the monkey
      striatum, the distribution of preproenkephalin messenger RNA is heterogeneous.
      There is variation in the general labeling pattern between regions of the
      striatum. For example, a particularly densely labeled area of preproenkephalin
      messenger RNA is observed in the ventral part of the caudal putamen. In addition,
      at the macroscopic level, there are patches of specific hybridization
      intermingled with areas containing less specific labeling. This forms a mosaic
      like pattern. At the microscopic level, densely labeled individual cells are
      found among those with little or no specific labeling. Adjacent sections,
      processed for in situ hybridization and immunohistochemistry, show some
      correlation between the perikarya containing preproenkephalin messenger RNA and
      enkephalin-positive fibers in the striatum. Specific hybridization to
      preproenkephalin messenger RNA is evident throughout the cortical mantle,
      primarily concentrated in layers 2 and 3. Particularly high levels of
      preproenkephalin messenger RNA are found in specific limbic-associated cortices,
      including the piriform allocortex, the agranular area of the orbitofrontal
      cortex, the agranular insular cortex and the caudal field of the entorhinal
      cortex. Specific labeling is also present in the granular cell layer of the
      dentate gyrus and in the amygdaloid complex. This study reveals heterogeneous
      distribution of dense preproenkephalin messenger RNA in the basal ganglia and
      high levels of preproenkephalin messenger RNA in specific limbic-associated
      regions of the monkey telencephalon.

PMID- 7777157
TI  - Quinolinic acid-induced increases in calbindin D28k immunoreactivity in rat
      striatal neurons in vivo and in vitro mimic the pattern seen in Huntington's
      disease.
AB  - In Huntington's disease striatal neurons undergo marked changes in dendritic
      morphology and coincidently exhibit an increase in immunoreactive calbindin D28k
      (calbindin), a cytosolic calcium-binding protein which is highly abundant in
      these neurons. Previous studies in the rat striatum have shown that excitotoxic
      injury, which is linked to a rise in intracellular Ca2+, mimics many of the
      neurochemical and neuropathological characteristics of Huntington's disease. We
      speculated, therefore, that the apparent increase in calbindin labeling in
      Huntington's disease spiny neurons may signal the response to an excitotoxic
      process. To investigate this possibility, we compared the cellular features of
      calbindin immunoreactivity in grade 1-4 Huntington's disease cases with those
      seen in rat striatal neurons in vivo and in vitro following treatment with N
      methyl-D-aspartate (NMDA) receptor agonist, quinolinic acid. In human post mortem
      control cases calbindin immunoreactivity was seen primarily in the somata and
      proximal dendrites of striatal neurons. In the Huntington's disease cases,
      calbindin labeling was markedly increased throughout the second and third order
      dendrites and in spines, and this change was more prevalent in advanced cases
      (grades 3-4). In the rat brain, two weeks after intrastriatal injection of
      quinolinic acid (6-20 ng), surviving medium-spiny neurons in the transition zone
      around the lesion core exhibited a marked increase in calbindin immunoreactivity
      similar to that seen in Huntington's disease spiny neurons. In more peripheral
      areas away from the lesion and on the contralateral unlesioned side, calbindin
      immunostaining was confirmed to somata and proximal dendrites. In situ
      hybridization histochemistry with an 35S-labeled oligonucleotide probe showed no
      change or a decrease in calbindin mRNA levels in neurons within the transition
      zone, suggesting that the observed increase in calbindin staining was not the
      result of increased transcription. In 12 day old postnatal striatal cultures, 2-6
      h exposures to quinolinic acid (0.5 mM) significantly increased the length of
      neurites exhibiting calbindin immunoreactivity when compared to untreated
      controls. This effect was blocked by the selective NMDA receptor blocker (+/-)-2
      amino-5-phosphonopentanoic acid (AP-5), indicating that an NMDA receptor-mediated
      mechanism contributed to the change in staining pattern. Results in rats suggest
      that the subcellular redistribution of calbindin immunoreactivity observed in
      Huntington's disease spiny neurons may be related to an NMDA receptor-induced
      excitotoxic process. An increased availability of calbindin protein at dendrites
      and spines may reflect a greater demand for Ca2+ buffering precipitated by an
      abnormal rise in in intracellular Ca2+.

PMID- 7777159
TI  - D1- and D2 dopaminergic receptors in the developing cerebral cortex of macaque
      monkey: a film autoradiographic study.
AB  - Film autoradiography was used to study the distribution of D1- and D2
      dopaminergic receptors in the prefrontal association, somatosensory, primary
      motor and visual regions in the developing cerebral cortex of macaque monkeys. D1
      receptors were labeled with [125I]SCH23982, while D2 sites were visualized with
      [125I]epidepride. D1- and D2-dopaminergic sites are already present in all
      cortical areas at embryonic day 73, the earliest age observed in this study. In
      contrast to the adult cortex, where D1 and D2 receptors have different
      distributions, during development there are substantial similarities in the
      laminar patterns of these sites. In particular, both D1 and D2 receptors tend to
      concentrate in the marginal zone and layer V of the developing cortical plate.
      The autoradiograms also show a high density of D1-dopaminergic sites in the
      transient ventricular and subventricular zones, where cortical neurons are
      generated. Although there is a significant rearrangement of the early laminar
      patterns, the adult distribution of both dopaminergic receptors in most cortical
      areas is achieved prenatally, soon after all cortical neurons assume their final
      positions. An early presence in the cerebral wall, a high density in the
      proliferative zones and fast maturation of the laminar distribution suggests that
      dopaminergic receptors may be involved in the regulation of cortical development.

PMID- 7777160
TI  - Tyrosine hydroxylase- and dopamine-beta-hydroxylase-positive neurons and fibres
      in the developing human cerebellum--an immunohistochemical study.
AB  - Six human fetuses of gestational ages 16-28 weeks were employed. The
      immunocytochemical avidin-biotin-peroxidase complex method combined with the
      silver Bodian technique was used to evaluate the presence of tyrosine hydroxylase
      and dopamine-beta-hydroxylase neurons and afferent and efferent fibres in the
      cerebellum during development. Our results illustrated that by 16-18 weeks,
      immunoreactivity of the Purkinje cells and the granule cells was evident. By 23
      weeks, the positive Purkinje cells were tightly packed together and the
      perinuclear granules began to extend into the processes. The positive cells next
      to Purkinje cells were the basket cells and stellate cells. By 26-28 weeks, all
      positive cells increased in number and size. Mossy and climbing fibres appeared
      early in development (16-18 weeks of gestation) and were seen synapsing with the
      positive granule cells. At the same time, some parallel fibres were observed. At
      later stages, the tyrosine hydroxylase- and dopamine-beta-hydroxylase-positive
      Purkinje cells were surrounded by abundant climbing fibres, while parallel fibres
      were also evident in the molecular layer. In the deep cerebellar nuclei, positive
      tyrosine hydroxylase and dopamine-beta-hydroxylase neurons were present by 16-18
      weeks of development. Those in the dentate nucleus were more polymorphic but
      smaller in size. Some afferent fibres were also spotted around 16-18 weeks of
      gestation and their numbers increased later. Positive efferent fibres were
      present by 26 weeks. All these observations point to an early presence of
      tyrosine hydroxylase and dopamine-beta-hydroxylase components in cerebellar
      development.

PMID- 7777161
TI  - 192 immunoglobulin G-saporin produces graded behavioral and biochemical changes
      accompanying the loss of cholinergic neurons of the basal forebrain and
      cerebellar Purkinje cells.
AB  - Immunolesions of the cholinergic basal forebrain were produced in rats using
      various intraventricular doses of the immunotoxin 192 immunoglobulin G-saporin:
      0.34, 1.34, 2.0, 2.7 and 4.0 micrograms/rat. A battery of behavioral tests,
      chosen on the basis of reported sensitivity to conventional medial septal or
      nucleus basalis lesions, was administered. Dose-dependent impairments were found
      in acquisition, spatial acuity and working memory in the water maze. Dose
      dependent hyperactivity in the open field and in swimming speed was observed. The
      highest dose group (4.0 micrograms) exhibited motoric disturbances which were
      particularly apparent in swimming and in clinging to an inclined screen. Response
      and habituation to acoustic startle were diminished in the three higher dose
      groups. Histological results from acetylcholinesterase and low-affinity nerve
      growth factor receptor staining showed that the lesion was selective for
      cholinergic neurons bearing p75 nerve growth factor receptors in the basal
      forebrain nuclei. However, some Purkinje cells in the superficial layers of the
      cerebellum were also destroyed at the higher doses of immunotoxin. The activity
      of choline acetyltransferase, used as a marker of cholinergic deafferentation in
      regions innervated by the basal forebrain nuclei, was decreased with increasing
      doses to a plateau level of about 90% (average depletion) for the two highest
      dose groups. These two groups were the only ones to exhibit consistent and severe
      behavioral impairments on all behavioral tests performed. Thus, for a relatively
      selective cholinergic basal forebrain lesion, almost a 90% reduction in choline
      acetyltransferase activity is needed to produce substantial behavioral deficits.
      It appears that either a considerable safety factor exists or robust compensatory
      mechanisms can ameliorate behavioral deficits from a major, but incomplete loss
      of cholinergic basal forebrain innervation.

PMID- 7777163
TI  - c-fos antisense oligodeoxynucleotide increases formalin-induced nociception and
      regulates preprodynorphin expression.
AB  - Rats, receiving an intrathecal pretreatment of oligodeoxynucleotide complementary
      to c-fos mRNA (antisense), showed no increases in Fos protein or preprodynorphin
      messenger RNA in the outer laminae of the lumbar spinal cord when challenged 4 h
      later with a 50 microliters intraplantar injection of 5% formalin. Animals
      pretreated with saline or sense oligodeoxynucleotide showed marked increases in
      Fos protein (2 h after formalin challenge) and preprodynorphin mRNA (20 h after
      formalin challenge) in the lumbar region of the cord ipsilateral to the side of
      the injection. The behavioural consequences of antisense pretreatment were an
      increase in the formalin-induced licking/biting responses during the tonic, but
      not the acute phase. These observations could be interpreted as representing a
      sequence of events beginning with the formalin-induced increase in the
      transcription factor Fos, which in turn increases the synthesis of
      preprodynorphin messenger RNA resulting in the production of the dynorphin opioid
      peptides which then exert a modulatory antinociceptive action.

PMID- 7777162
TI  - Interaction of convergent pathways that inhibit N-type calcium currents in
      sensory neurons.
AB  - Norepinephrine and GABA inhibit omega-conotoxin GVIA-sensitive (N-type) calcium
      current in embryonic sensory neurons by separate pathways. We have investigated
      the mechanisms that limit the modulation of N current by varying the level of
      activation for a single pathway or simultaneously activating multiple pathways.
      Calcium currents were measured with tight-seal, whole-cell recording methods.
      Simultaneous application of the two transmitters at saturating concentrations
      produced a larger inhibition of the current than either transmitter by itself,
      but the maximal inhibition was not linearly additive. Maximal, direct activation
      of GTP-binding proteins by intracellular application of guanosine 5'-(3-O-thio)
      triphosphate (GTP gamma S) resulted in a similar limit to the inhibition;
      furthermore, GTP gamma S did not enhance the maximal inhibition produced by co
      application of transmitters. Interventions downstream in the modulatory pathway
      (e.g. direct activation of protein kinase C or inhibition of protein
      phosphatases) were also unable to alter the maximal limit for inhibition. These
      results suggest that transmitter-mediated inhibition is not limited by receptor
      number, levels of G-protein or protein kinase C activation, or degree of
      phosphorylation; rather, the extent of inhibition may be limited by the
      structural properties of the N channels themselves.

PMID- 7777164
TI  - Protective effect of basic fibroblast growth factor-heparin and neurotoxic effect
      of platelet factor 4 on ischemic neuronal loss and learning disability in
      gerbils.
AB  - Platelet factor 4, which has a potent affinity for heparin, has been shown to
      inhibit the binding of basic fibroblast growth factor to the cell surface
      receptor and to counteract the biological activities of basic fibroblast growth
      factor in certain peripheral tissues. In the present in vitro [125I]basic
      fibroblast growth factor binding experiments, platelet factor 4 consistently
      inhibited the binding of iodinated basic fibroblast growth factor to cell
      membranes of the gerbil hippocampus. To investigate the in vivo function of
      endogenous basic fibroblast growth factor and/or basic fibroblast growth factor
      receptor possibly activated in the ischemic gerbil brain, we infused platelet
      factor 4 continuously into the left lateral ventricle with an osmotic minipump.
      When platelet factor 4 infusion was started within three days after a 3-min
      ischemic insult, it significantly enhanced ischemia-induced learning disability
      and ischemic neuronal loss in the CA1 region of the hippocampus, as demonstrated
      by the results of the step-down passive avoidance task and by subsequent
      histological examinations. Infusion of platelet factor 4 into the cerebral
      ventricle of intact gerbils did not affect learning ability or CA1 neuron number.
      Basic fibroblast growth factor-neutralizing antibody, when infused continuously
      in the cerebral ventricle, also exhibited a neurotoxic effect in ischemic but not
      intact gerbils. Basic fibroblast growth factor co-infused with heparin, but not
      basic fibroblast growth factor alone, rescued a significant number of ischemic
      neurons which were destined to degenerate without the infusion of heparinized
      basic fibroblast growth factor, and it prevented ischemia-induced learning
      disability.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7777165
TI  - Peripheral lipopolysaccharide stimulation induces interleukin-1 beta messenger
      RNA in rat brain microglial cells.
AB  - The inflammatory cytokine interleukin-1 acts as an endogenous pyrogen in
      organisms affected by infectious diseases and has been shown to influence the
      activity of the central nervous system. Using in situ hybridization
      histochemistry, we have examined the cellular source of interleukin-1 beta in rat
      brain after peripheral stimulation with the bacterial lipopolysaccharide, a
      potent inducer of interleukin-1. Whereas no interleukin-1 beta messenger RNA
      could be detected in brains in unstimulated rats, lipopolysaccharide induced a
      transient, high and widespread expression of interleukin-1 beta messenger RNA in
      the entire brain. The highest levels of interleukin-1 beta messenger RNA were
      observed 6-8 h after stimulation with lipopolysaccharide. Using a combination of
      non-radioactive in situ hybridization and immunocytochemistry with the microglial
      specific antibody OX-42, interleukin-1 beta messenger RNA-positive cells could be
      identified as microglia. We conclude that brain microglial cells are the major
      source of interleukin-1 beta messenger RNA after peripheral administration of
      lipopolysaccharide.

PMID- 7777167
TI  - Previous stress alters corticotropin-releasing factor neurotransmission in the
      locus coeruleus.
AB  - Spontaneous and stress-evoked discharge of locus coeruleus neurons were
      characterized in rats with a history of stress. Rats exposed to one or five daily
      30-min sessions of footshock were anesthetized with halothane and surgically
      prepared for locus coeruleus single-unit recording immediately following the last
      session. Locus coeruleus spontaneous discharge rate and discharge evoked by
      sciatic nerve stimulation were comparable between acutely and repeatedly stressed
      rats and controls. In contrast, locus coeruleus activation produced by
      intracerebroventricular administration of corticotropin-releasing factor (3
      micrograms) or by hypotensive challenge (which requires endogenous corticotropin
      releasing factor release in the locus coeruleus) was greatly attenuated in
      acutely stressed rats. The corticotropin-releasing factor dose-response curve was
      shifted to the right in acutely stressed rats compared with controls. In
      repeatedly stressed rats, the effects of 3 micrograms corticotropin-releasing
      factor on locus coeruleus discharge were similarly diminished. Although the
      maximum effect produced by corticotropin-releasing factor was decreased in these
      rats, the dose-response curve was shifted to the left, indicative of
      sensitization. Hypotensive challenge, which was ineffective in acutely stressed
      rats, increased locus coeruleus discharge of repeatedly stressed rats by a
      similar magnitude as in matched controls. The return of locus coeruleus
      responsiveness to hypotension in repeatedly stressed rats may be related to the
      sensitization to corticotropin-releasing factor. Finally, the protocol of
      repeated stress did not alter the affinity or density of corticotropin-releasing
      factor receptors in either the frontal cortex or brainstem. Taken together, the
      results suggest that a history of stress alters corticotropin-releasing factor
      neurotransmission in the locus coeruleus at the postsynaptic level. However,
      these effects are not reflected by corticotropin-releasing factor binding
      kinetics in brainstem. Stress-induced changes in corticotropin-releasing factor
      neurotransmitter function in the locus coeruleus may play a role in certain
      symptoms of stress-related psychiatric disorders.

PMID- 7777166
TI  - Nitric oxide induces necrotic but not apoptotic cell death in oligodendrocytes.
AB  - We have investigated the mechanism of nitric oxide-induced damage in glial cells.
      Genomic DNA isolated from astrocytes and microglia, treated for 18 h with varying
      concentrations of a nitric oxide donor, was analysed by electrophoresis. No DNA
      damage was evident. Oligodendrocytes, treated with 2 mM nitric oxide for 3-48 h,
      showed single stranded breaks at 48 h but no laddering of nucleosomic fragments
      of DNA. When analysed by electron microscopy, ultrastructural changes in
      oligodendrocytes treated with 1 mM nitric oxide for 24 h showed intact nuclei but
      alterations in membranes and organelles characteristic of necrosis, including
      disrupted mitochondria with dissolution of their christae. Astrocytes, a glial
      cell type that we have previously shown to be much less sensitive to nitric oxide
      induced damage, did not show ultrastructural changes. DNA analysis by flow
      cytometry of glial cells treated with nitric oxide supported the apparent
      necrotic-type death in oligodendrocytes. Double staining of oligodendrocytes,
      using Hoechst 33342 and propidium iodide for the simultaneous assessment of both
      apoptotic and necrotic cells, demonstrated that, while the proportion of dead
      cells increased with time and increasing concentrations of nitric oxide, the
      death was due to necrosis and not apoptosis. In this study, we demonstrate that
      direct exposure to soluble nitric oxide, produced in vitro from a nitric oxide
      donor chemical, ultimately kills oligodendrocytes by necrosis. Microglia and
      astrocytes maintain DNA and organelle integrity when exposed to exogenous nitric
      oxide.

PMID- 7777168
TI  - Patterns of expression of SSTR1 and SSTR2 somatostatin receptor subtypes in the
      hypothalamus of the adult rat: relationship to neuroendocrine function.
AB  - The neuropeptide somatostatin is the major physiological inhibitor of growth
      hormone secretion. With the aim of identifying the receptor subtypes through
      which this neuropeptide may be exerting its neuroendocrine actions in the brain,
      we have examined by in situ hybridization the distribution of the messenger RNA
      for SSTR1 and SSTR2 isoforms in the hypothalamus of adult male and female rats.
      Both receptor subtypes were highly expressed in the medial preoptic area,
      suprachiasmatic nucleus and arcuate nucleus. High SSTR1, but low SSTR2,
      expression was evident in the para- and periventricular nuclei as well as in the
      ventral premammillary nucleus. Conversely, moderate to high SSTR2, but low SSTR1,
      messenger RNA levels were detected in the anterior hypothalamic nucleus,
      ventromedial and dorsomedial nuclei and medial tuberal nucleus. Taken together,
      these distributional patterns conform to those of somatostatin binding sites as
      visualized by in vitro autoradiography, suggesting that an important proportion
      of SSTR1 and SSTR2 receptors in the hypothalamus are associated with the
      perikarya and dendrites of intrinsic neurons. The distribution of SSTR1
      expressing cells within the periventricular, paraventricular and suprachiasmatic
      nuclei was similar to that of neurons previously reported to contain and/or
      express somatostatin in the brain suggesting that some of the SSTR1 receptors may
      correspond to autoreceptors. Within the arcuate nucleus, the distribution of
      SSTR1 and SSTR2 messenger RNA-expressing cells was comparable to that of neurons
      previously found to selectively bind somatostatin-14 within this area. Given that
      over one third of these cells also contain and express growth hormone-releasing
      factor, the present findings suggest that both of these receptor subtypes are
      involved in the central regulation of growth hormone-releasing factor secretion
      by somatostatin. Taken together, the present results suggest that SSTR1 and SSTR2
      somatostatin receptor messenger RNAs are heavily expressed in those neurons
      containing somatostatin and/or growth hormone-releasing factor and thereby imply
      a role for both SSTR1 and SSTR2 somatostatin receptor subtypes in neuroendocrine
      regulation of growth hormone secretion in both sexes of this species.

PMID- 7777169
TI  - The AMPA glutamate receptor GluR3 is enriched in oxytocinergic magnocellular
      neurons and is localized at synapses.
AB  - The cellular localization of alpha-amino-3-hydroxy-5-methyl-4-isoxazole
      propionate glutamate receptor, GluR3, was identified using antibodies that
      recognize the N-terminus of the predicted polypeptide sequence of GluR3. Regional
      immunoblot analysis of monkey brain homogenates identified a protein of
      approximately 102,000 mol. wt that was enriched in hypothalamus.
      Immunocytochemistry demonstrated that GluR3 was enriched within the hypothalamic
      magnocellular neurosecretory nuclei and axons of the hypothalamo-neurohypophysial
      tract in rat and monkey. GluR3 immunoreactivity co-localized to oxytocin
      containing, but not vasopressin-containing, neurons of the hypothalamic
      paraventricular nucleus, supraoptic nucleus and accessory magnocellular nuclei.
      Ultrastructurally, GluR3 immunoreactivity was enriched throughout cytoplasm of
      the somatodendritic compartment and was associated with postsynaptic and
      presynaptic structures. GluR3 immunoreactivity was frequently observed to be
      clustered at the plasma membrane of the somatodendritic compartment, consistent
      with the predicted localization of a membrane-bound ion channel. Additionally,
      GluR3-immunoreactive axon terminals in synaptic contact with unlabeled dendrites
      within the retrochiasmatic area and bed nucleus of the stria terminalis were
      observed, providing morphological evidence for a presynaptic alpha-amino-3
      hydroxy-5-methyl-4-isoxazole propionate receptor. By immunoblot analysis and
      immunocytochemistry using antibodies directed against a specific alpha-amino-3
      hydroxy-5-methyl-4-isoxazole propionate receptor in rat and monkey brain, our
      findings suggest a highly selective hypothalamic distribution of the GluR3
      subunit that may have functional significance in the glutamatergic regulation of
      oxytocinergic neurons.

PMID- 7777170
TI  - Nasal and temporal retinal ganglion cells projecting to the midbrain:
      implications for "blindsight".
AB  - We placed pellets of horseradish peroxidase in the superior colliculus of four
      macaque monkeys and retrogradely labelled the retinal ganglion cells of both
      eyes. The ratio of labelled cells in the contralateral nasal retina and the
      ipsilateral temporal retina was no different from the ratio found after implants
      in the optic nerve, which label the entire afferent pathway. Our finding
      therefore invalidates the proposal that prominent differences in the properties
      of "blindsight" in monocular nasal and temporal visual fields arise from
      differences in the projection from the nasal and temporal retina to the midbrain.
      We also measured the size of the soma and dendritic field of the labelled
      ganglion cells (mostly gamma cells) and compared them with those of alpha and
      beta cells that project to the dorsal lateral geniculate nucleus. Soma size was
      very close to that of beta cells at all eccentricities but was much smaller than
      that of alpha cells. Dendritic field size was significantly larger than that of
      beta cells but was smaller than that of alpha cells. The number of primary
      dendrites was counted for cells labelled from the midbrain and in samples of
      alpha and beta cells labelled from the optic nerve. At eccentricities of 3-7 mm
      there was a consistent and prominent difference between beta and gamma cells. The
      results show that at intermediate eccentricities even ganglion cells whose distal
      dendrites are too poorly labelled to reveal their morphological class can never
      the less be categorized as alpha, beta or gamma by using a combination of soma
      size and number of primary dendrites. This is particularly useful when attempting
      to classify retinal ganglion cells following microinjections into selected target
      nuclei of optic axons.

PMID- 7777171
TI  - Behavioural and cellular responses to light of the circadian system of tau mutant
      and wild-type Syrian hamsters.
AB  - The tau mutation shortens the free-running circadian period of the activity
      rhythm of the Syrian hamster from around 24 h in the wild-type, to 20 h in the
      homozygous mutant. The aim of this study was to examine the effects of light
      pulses on the activity rhythms and expression of c-fos in the suprachiasmatic
      nuclei of wild-type and mutant hamsters. This would make it possible to determine
      the relative durations of subjective day and night, and thereby characterize
      further the effect of the mutation upon the circadian cycle. Presentation of
      light pulses (15 min) to animals kept in dim red light for seven to 10 days
      induced phase-dependent shifts in the onset of activity. During subjective day
      (inactive phase) there was no effect of light upon the activity rhythm of either
      normal or mutant animals. Early in subjective night (i.e. after the start of the
      active phase), light pulses induced phase delays of approximately one circadian
      hour in both phenotypes. However, later in subjective night light pulses induced
      phase advances in activity rhythms. The magnitude of the advance phase shifts
      differed considerably between the two phenotypes, with the wild-types typically
      showing shifts of about one circadian hour, while the mutants showed much larger
      advances of up to 12 circadian hours. In both strains, advances were observed
      following light at circadian time 22 but not after light at circadian time 24.
      The relative duration of subjective night was therefore comparable in the mutants
      and wild-types i.e. around 11 circadian hours. In order to examine the light
      induced expression of the immediate early gene c-fos at different circadian
      phases, animals received a second light pulse (15 min) or a control "dark pulse"
      at the same circadian time as they had received the first, but seven to 10
      circadian days later. They were perfused 1 h after the start of the pulse and
      brains processed for the immunocytochemical detection of Fos, the protein product
      of c-fos. Animals receiving dark pulses showed minimal Fos immunoreactivity in
      the suprachiasmatic nucleus, regardless of the circadian time of presentation of
      the stimulus. During subjective day (circadian times 4-11), light induced very
      little Fos immunoreactivity. In contrast, light presented during subjective night
      (after circadian time 12) induced a dense pattern of Fos immunoreactivity in the
      ventrolateral, retino-recipient region of the suprachiasmatic nucleus of both
      wild-type and mutant animals.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7777172
TI  - Neuronal localization of pituitary adenylate cyclase-activating polypeptide 38 in
      the adrenal medulla and growth-inhibitory effect on chromaffin cells.
AB  - The chromaffin cells of the adult rat adrenal medulla are essentially growth
      arrested in situ, but can proliferate in vitro, suggesting the existence of
      growth inhibitory factors in the adrenal gland. We have investigated whether
      pituitary adenylate cyclase-activating polypeptide 38 (PACAP38) could be involved
      in the growth arrest of adrenal chromaffin cells. In adult rat adrenal gland,
      PACAP38 was detected by radioimmunoassay and high-performance liquid
      chromatography and its concentration in the medulla was estimated as 24 nmol/kg
      wet tissue. Immunohistochemistry of the neonatal and adult rat adrenal medulla
      showed PACAP38 immunoreactivity in a widely distributed network of delicate nerve
      fibers surrounding the chromaffin cells. In a primary culture system, PACAP38
      inhibited growth factor-stimulated DNA synthesis by 90% in neonatal and adult rat
      chromaffin cells with half-maximal inhibition at 4 and 0.5 nM, respectively, as
      demonstrated by bromodeoxyuridine pulse-labeling and immunocytochemical staining
      of cell nuclei. In comparison, corticosterone inhibited neonatal and adult
      chromaffin cell proliferation by 70% and 95%, respectively, with half-maximal
      effect at 100 nM. In neonatal chromaffin cells, 100 nM PACAP38 and 1 microM
      corticosterone added together abolished proliferation completely (99.8%
      inhibition). Finally, PACAP38 increased cell survival but showed little neurite
      promoting activity in the chromaffin cells. Our data suggest that neurally
      derived PACAP38, in conjunction with glucocorticoids, may override growth factor
      mitogenic signals, leading to the postmitotic state of chromaffin cells in the
      adult adrenal medulla.

PMID- 7777174
TI  - Unilateral grafting of fetal neocortex into a cortical cavity improves healing of
      a symmetric lesion in the contralateral cortex of adult rats.
AB  - Fetal neocortical tissue (ED 14) was grafted unilaterally into a cortical cavity
      made bilaterally in the sensorimotor cortex of adult rats. Transplantation was
      done immediately after the lesion (group TR0, n = 8) or with 14-day delay (group
      TR14, n = 8). Six rats served as lesion only controls (group LES). After long
      term survival (up to 15 months) the brains were photographed and surface areas of
      transplant and contralateral cavities were measured by means of a graphic tablet.
      The results show that (a) the presence of a transplant in one lesion cavity in
      the cortex decrease the size of a similar cavity in the contralateral cortex and
      that (b) the better host transplant integration there is, the greater the effect
      on the contralateral lesion. No correlation between the size of the transplant
      and the size of the symmetric traumatic lesion was found. The ameliorating effect
      of the transplant on the contralateral cortical lesion size is most likely
      related the long-term influence of growth of trophic factors released by
      transplanted cells which lead to the healing of the symmetric lesion.

PMID- 7777175
TI  - Cortical potentials during gap and non-gap paradigms using manual responses in
      humans.
AB  - An experiment was conducted on naive human subjects to measure the time benefits
      on finger reaction times produced by the offset of a central fixation point 200
      ms before the appearance of a target stimulus in the periphery. Subjects produced
      a shift advancement of manual reaction times. Simultaneously, the event-related
      potentials were recorded. The gap paradigm induced offset visual evoked
      potentials and a frontal negativity, it also induced a higher P300 than the non
      gap condition. The results suggest that the gap promotes the speeding of the
      response by a cortical priming.

PMID- 7777173
TI  - Development of direct GABAergic projections from the zona incerta to the
      somatosensory cortex of the rat.
AB  - The postnatal development of direct thalamocortical projections from the zona
      incerta of the ventral thalamus to the whisker representation area of the rat
      primary somatosensory cortex was investigated. Cytoarchitectonic analysis based
      on Nissl staining, cytochrome oxidase histochemistry and immunohistochemistry for
      glutamic acid decarboxylase, GABA, parvalbumin and calbindin D28K revealed that
      the zona incerta can be clearly distinguished from surrounding diencephalic
      structures from the day of birth. Moreover, four distinct anatomical subdivisions
      of this nucleus were identified: the rostral, dorsal, ventral and caudal. Of
      these, the ventral subdivision is by far the most conspicuous, containing the
      highest density of neurons, and the highest levels of cytochrome oxidase,
      glutamate decarboxylase, GABA, parvalbumin and calbindin D28K. In contrast, the
      dorsal, rostral and caudal subdivisions contain fewer cells, lower levels of
      glutamic acid decarboxylase and GABA and very few parvalbumin-positive and
      calbindin-positive neurons. Small injections of rhodamine coated microspheres or
      Fluoro-gold in the primary somatosensory cortex of animals at different stages of
      development revealed the existence of retrogradely labeled neurons in the rostral
      and dorsal subdivisions of the zona incerta from postnatal day 1. At this age,
      retrogradely labeled cells were also found in the ventral lateral, ventral
      posterior medial, posterior medial, centrolateral, ventral medial and
      magnocellular subdivision of the medial geniculate nuclei of the dorsal thalamus.
      The density of the incertocortical projection reaches its maximum between the
      first and second postnatal weeks, decreasing subsequently, until an adult pattern
      of labeling is achieved. Tracer injections combined with immunohistochemistry
      revealed that the majority of the incertocortical projection derives from
      GABAergic neurons, implying a potentially inhibitory role for the incertocortical
      projection. These results demonstrate that the rat trigeminal system contains
      parallel thalamocortical pathways of opposite polarity, emerging from both the
      dorsal (glutamatergic, excitatory) and ventral (GABAergic, inhibitory) thalamus
      since the day of birth. As such, these findings suggest that, contrary to the
      classical notion, not only the dorsal but also the ventral thalamus may play a
      special role in both cortical maturation and function.

PMID- 7777176
TI  - Spinal distribution and brainstem projection of lamina I neurons in the pigeon.
AB  - Lamina I neurons of the spinal dorsal horn serve nociception both in mammals and
      in birds. The projection of these neurons to the brain is largely unknown in
      birds. Injections of retrogradely transported fluorescent tracers into various
      brainstem nuclei showed that these neurons, which are distributed throughout the
      spinal cord, heavily project to the nucleus of the solitary tract and the
      parabrachial area but not to the hypothalamus. Injections into the nucleus of the
      solitary tract revealed a group of neurons located in Lissauer's tract of
      thoracic segments. These results point to a functional role of spinal lamina I
      neurons in avian visceronociception.

PMID- 7777177
TI  - Two conformational states of amyloid beta-peptide: implications for the
      pathogenesis of Alzheimer's disease.
AB  - Since the discovery of soluble amyloid-beta (sA beta), it became clear that the
      same amino acid sequence can have both a fibrillar or a soluble state. In this
      work, we describe the isolation of two different species derived from synthetic A
      beta(1-40) differing in their conformational and fibrillogenesis properties. The
      separation was performed taking advantage of the fact that only one species is
      sedimentable by centrifugation after 2 weeks of incubation at 1 mg/ml. One
      species is highly amyloidogenic (A beta ac) and has an antiparallel beta-sheet
      structure and the other one is poorly amyloidogenic (A beta nac) and contains
      mainly random coil or alpha-helix structure. Chemical changes were not detected
      in the primary structure of both species and the differences in the physical
      properties and very likely in biological behaviour are thought to have a
      conformational basis. We propose that the transformation of the non-amyloidogenic
      into the amyloidogenic conformation could be the fundamental event in the
      pathological polymerization of sA beta and in the development of Alzheimer's
      disease.

PMID- 7777179
TI  - Increased immunostaining for L-ornithine decarboxylase occurs in neocortical
      neurons of Alzheimer's disease patients.
AB  - We investigated the distribution of L-ornithine decarboxylase (ODC), an enzyme
      known to be involved in several developmental and restorative processes, in
      neocortical brain areas of Alzheimer's disease (AD) and normal patients by means
      of immunohistochemistry. While ODC immunoreactive material was only scarcely
      distributed in neocortical neurons of control brains, neocortical specimens from
      AD brains stood out by intense immunostaining for ODC. Dendrites and, to a lesser
      extent, axons of neurons from AD brains showed a strong immunoreaction to the
      enzyme, whereas neurons from non-affected brains displayed only a weak
      circumnuclear reaction pattern. Our results support the idea that
      neurorestorative processes take place in AD brains and that the ODC/polyamine
      system might be actively involved in this process.

PMID- 7777178
TI  - Pharmacological differentiation of the effects of co-activation of beta
      adrenergic and metabotropic glutamate receptors in rat hippocampus.
AB  - Activation of metabotropic glutamate receptors (mGluRs) can potentiate the cAMP
      response elicited by activation of beta-adrenergic receptors (beta ARs) in the
      hippocampus. We have shown that co-activation of mGluRs and beta ARs induces both
      an acute depression of excitatory synaptic transmission and a long-lasting
      excitation of CA1 pyramidal cells. However, these studies were performed using a
      non-selective mGluR agonist. We have now used subtype selective mGluR agonists,
      and report that while the acute depression of transmission exhibits a
      pharmacology consistent with mediation by this mGluR subtype, the lasting
      excitation of CA1 pyramidal cells may be mediated by an interaction between beta
      ARs and mGluRs that are coupled to phosphoinositide hydrolysis.

PMID- 7777180
TI  - Postcentral neurons of alert monkeys activated by the contact of the hand with
      objects other than the monkey's own body.
AB  - In the caudal postcentral finger region near or in the anterior bank of the
      intraparietal sulcus of alert monkeys, we found neurons that were activated
      selectively by the contact of the hand to certain common objects such as bottle
      brushes, acrylic plates, parts of the stabilized monkey's chair, etc. All of
      these neurons were not activated when the monkey's hand was contacted with the
      monkey's own body. We concluded that these neurons are concerned with the haptic
      discrimination of common objects with the selectivity to one of various material
      variables of objects, and that the process involves differentiation of the object
      from the animal's own body.

PMID- 7777181
TI  - Kappa opioid receptor agonists suppress absence seizures in WAG/Rij rats.
AB  - Involvement of the kappa opioid receptor in the regulation of epileptic activity
      was studied in WAG/Rij rats, a genetic model of absence epilepsy. I.c.v.
      administration of the kappa agonists U50,488H (trans-3,4-dichloro-N-methyl-N-[2
      (1-pyrrolidinyl)-cyclohexyl]- benzeneacetamide), U69,593 (5 alpha, 7 alpha, 8
      beta)-(-)-N-methyl-(1-pyrrolidinyl)-1- oxaspiro(4,5)dec-8-yl)benzeneacetamide) or
      PD117,302 ((+/-)-trans-N-methyl-N-[2-(1-pyrrolidinyl)-
      cyclohexyl]benzo[b]thiophene-4-acetamide), 50 and 150 micrograms/5 microliter
      each, dose-dependently decreased the number and mean duration of spike wave
      discharges (SWD). Peripheral administration of U50,488H (10 and 30 mg/kg s.c.)
      also attenuated the seizure activity in this model. The specific kappa opioid
      receptor antagonist nor-binaltorphimine (Nor-BNI, 10 micrograms/5 microliters
      i.c.v., 18 h before EEG registration) moderately increased the number of SWD,
      which suggests that endogenous opioids acting through kappa receptors may
      tonically inhibit the seizure activity in these rats. In addition, the
      enhancement of an absence-like seizure activity induced by the specific mu opioid
      receptor agonist D-Ala2-N-methyl-Phe4-Gly5-ol-enkephalin (DAMGO, 0.7 microgram/5
      microliters i.c.v.) was also attenuated in rats pretreated with U50,488H, U69,593
      or PD117,302. These data indicate that activation of the kappa opioid receptor
      exerts an inhibitory effect on absence-like seizure activity in WAG/Rij rats.

PMID- 7777182
TI  - Female rats are more susceptible to the development of neuropathic pain using the
      partial sciatic nerve ligation (PSNL) model.
AB  - A comparison study was conducted to determine if a gender difference could be
      detected using an animal model for causalgia. The sciatic nerve was tightly
      ligated so that 1/3 to 1/2 of the nerve thickness was trapped by the ligature,
      just distal to the point at which the posterior biceps semitendinosus nerve
      branches off the common sciatic nerve. By measuring paw withdrawal from innocuous
      stimulation with Von Frey filaments, the percent of rats displaying average
      mechanical sensitivity of the injured paw that was significantly elevated
      compared to sham or unoperated control animals (days 22-24) was 28.6% for the
      male group versus 63.6% for the female group. Our animals did not display a
      consistent response in withdrawal latency to heat applied to the plantar surface
      of the root (hyperpathia). The data suggests that female rats are significantly
      more susceptible to developing neuropathic pain than male rats using this
      experimental model for causalgia.

PMID- 7777183
TI  - Intracellular acidification is not a prerequisite for glutamate-triggered death
      of cultured hippocampal neurons.
AB  - Glutamate decreased intracellular pH (pHi) in cultured rat hippocampal neurons.
      The protonophore, FCCP (1 microM), produced an acidification comparable to that
      produced by glutamate. Application of glutamate to FCCP-treated cells, returned
      pHi to resting levels. This alkaline shift resulted from a glutamate-induced
      membrane depolarization that removed the driving force across the plasmalemma for
      H+ entry via FCCP. The endogenous protonophore, arachidonic acid (10 microM),
      produced pHi changes similar to those elicited by FCCP. Because application of
      glutamate and FCCP in combination did not change pHi, this treatment was used to
      determine the role of glutamate-induced acidification in neurotoxicity. FCCP (1
      microM, 5 min) did not affect neuronal viability, either alone or in combination
      with various concentrations of glutamate, as indicated by the release of lactate
      dehydrogenase into the bathing medium. Thus, acidification was not the cause of
      glutamate-induced cell death although, it may be symptomatic of neurotoxic
      processes.

PMID- 7777184
TI  - Differential effects of [3H]nemonapride and [3H]spiperone binding on human
      dopamine D4 receptors.
AB  - We compared some binding parameters of [3H]nemonapride and [3H]spiperone in human
      dopamine D4 (hD4) receptors with three different numbers of tandem repeat units.
      Although both of the radioligands showed similar affinity constants for each hD4
      receptor variant, the maximal number of binding sites labeled by [3H]nemonapride
      was approximately 1.35-fold higher than that by [3H]-spiperone for all variants.
      Estimated Ki values for the inhibition of [3H]nemonapride binding by a series of
      dopaminergic ligands were highly correlated to respective values obtained for the
      inhibition of [3H]spiperone binding to each hD4 receptor. These results suggest
      that the hD4 receptor, as shown for the D2 receptor, may exist in multiple
      molecular forms as a monomer-dimer equilibria, and that [3H]spiperone may
      discriminate in the multiple molecular forms.

PMID- 7777186
TI  - Temporal pattern of internucleosomal DNA fragmentation in the striatum and
      hippocampus after transient forebrain ischemia.
AB  - Transient forebrain ischemia in rodents caused internucleosomal DNA fragmentation
      that appeared in the striatum 24 h after reperfusion, and in the hippocampus 72 h
      after reperfusion. Gel electrophoresis and an in situ technique to label 3'
      termini of endonuclease generated DNA fragments demonstrated similar temporal
      patterns. These data show that endonuclease activation accompanies the demise of
      selectively vulnerable neurons following transient forebrain ischemia.

PMID- 7777185
TI  - Enhanced glutamatergic neurotransmission facilitates classical conditioning in
      the freely moving rat.
AB  - Centrally active drugs that enhance alpha-amino-3-hydroxy-5-methyl-4-isoxazole
      propionic acid receptor-gated currents by increasing the amplitude and duration
      of fast, excitatory synaptic responses in the hippocampus have recently been
      described. The effects of the compound 1-(1,3-benzodioxol-5-ylcarbonyl)
      perperidine (BDP) on associative and non-associative aspects of the classically
      conditioned eyeblink response in the freely moving rat were examined. Rats
      injected with BDP blinked significantly more to an acoustic stimulus of 85 dB
      than did vehicle controls, indicating that the drug enhances alpha responding to
      discrete auditory cues. Using a less intense stimulus of 80 dB, rats injected
      with BDP did not exhibit alpha responding or pseudo-conditioning, yet learned the
      conditioned response at a facilitated rate. These results suggest that increasing
      excitatory neurotransmission enhances the processing of sensory information and
      may contribute to subsequent contingency detection.

PMID- 7777187
TI  - Chronically administered 3-nitropropionic acid induces striatal lesions
      attributed to dysfunction of the blood-brain barrier.
AB  - 3-Nitropropionic acid (3-NPA), an irreversible inhibitor of succinate
      dehydrogenase, was administered to rats and the characteristics of the neuronal
      damage were investigated. Injections of 3-NPA (15 mg/kg s.c.) every 2 or 3 days
      for 1-2 weeks induced a mild neuronal loss and neutrophil invasions in the
      striatum (STR). The same administration for 4 weeks induced specific symmetric
      lesions in the lateral STR although the size was variable in each animal. Inside
      the lesions, strong neutrophil invasions and a strong immunoreaction for IgG, C3
      as well as complement factor C3b/C4b receptor (C3b/C4br) were detected. Lesioned
      sites lost the immunoreaction for GFAP while the marginal areas contained
      abundant GFAP-labeled astrocytes around the vessels. In intoxicated animals,
      there was a weak but stout immunoreaction for IgG and C3b/C4br localizing around
      vessels in the STR even when there were no lesions or neuronal loss. The data
      suggest that the blood-brain barrier dysfunction is responsible for the specific
      vulnerability of the STR for the toxin.

PMID- 7777188
TI  - The effect of post-ischemic hypothermia following repetitive cerebral ischemia in
      gerbils.
AB  - Repetitive ischemia may result in more severe damage than a single similar
      duration insult. Inter-ischemic hypothermia significantly decreases this damage.
      It is unclear if protection would be evident if cooling was delayed until after
      the repeated insults. In this study, we evaluated the effects of 3 h of mild
      cooling (34-35 degrees C) beginning immediately after the third insult of
      ischemia, 0.5 h after the third insult and 1 h after the third insult in a gerbil
      model of repetitive ischemia. Neuronal damage was assessed in the cerebral cortex
      (CTX), hippocampus (CA1, CA4), striatum (STR), thalamus (THL), medial geniculate
      nucleus (MGN), and the substantia nigra reticulata (SNr). A '4-point' damage
      scale was used and evaluation was done in a blinded way. Group comparisons were
      done using the Mann-Whitney U-test for significance between the control and
      hypothermic groups. Immediate hypothermia after the third ischemic insult
      produced a significant protection in the CTX (P < 0.05), hippocampus (CA1 and
      CA4, P < 0.01), STR (P < 0.001), SNr (P < 0.01), MGN (P < 0.01) and THL (P <
      0.01). Cooling at 0.5 and 1 h after the third insult produced no protection when
      compared to ischemic controls. The window of opportunity with hypothermia is
      narrow in repetitive ischemia. To be effective, therapy must be initiated as soon
      as possible after ischemic insults.

PMID- 7777189
TI  - Expression of glutamate (AMPA type) and gamma-aminobutyric acid (GABA)A receptors
      in the rat caudal trigeminal spinal nucleus.
AB  - The localization of GABAA receptor gamma 1 and gamma 2 subunits and the AMPA-type
      glutamate receptor subunits GluR1 and GluR2/3 were identified in the caudal
      trigeminal spinal tract nucleus (TNC) by immunohistochemistry using specific
      antibodies. The receptor species on the projecting neurons to the thalamus in TNC
      were also examined. A retrograde tracer, Fluoro-gold (FG), was injected into the
      thalamus, and the sections were simultaneously labeled with the antibodies.
      Injection of FG into the ventral posteromedial nucleus of the thalamus resulted
      in labeling of scattered neurons contralaterally in the TNC. Most of the neurons
      labeled by retrograde tracing also showed gamma 1- and gamma 2-like
      immunoreactivity, while many of the neurons containing FG lacked GluR1- and
      GluR2/3-like immunoreactivity. These findings show that neurons projecting to the
      thalamus from the TNC receive GABAergic input via GABAA receptors containing
      gamma 1 and gamma 2 subunits, while many neurons expressing the AMPA-type
      receptor did not project to the thalamus.

PMID- 7777190
TI  - Presence of specific platelet-activating factor binding-sites in neuroblastoma
      N1E-115 cells.
AB  - In this study we reported evidence for the existence of specific binding sites
      for platelet-activating factor (PAF) in neuroblastoma N1E-115 cells. The specific
      [3H]PAF binding reached a steady state level within 60 min at 25 degrees C.
      Scatchard analysis of the specific [3H]PAF binding revealed the presence of two
      apparent populations of binding sites. The high-affinity binding site possessed a
      Kd1 of 2.5 +/- 0.6 pM and Bmax1 = 57.3 +/- 20.0 fmol/mg protein. The low-affinity
      binding site possessed a Kd2 = 3.2 +/- 1.0 nM and Bmax2 = 4.4 +/- 2.1 pmol/mg
      protein. Furthermore, the total [3H]PAF binding was partially displaced by
      unlabelled PAF, PAF antagonists BN 52021 and BN 50730 in a dose-dependent manner.
      This study confirms the presence of specific PAF receptors in neuronal cells.

PMID- 7777191
TI  - Antioxidant lazaroids enhance differentiation of C2 skeletal muscle cells.
AB  - We have examined the incidence of new antioxidant compounds, so-called lazaroids,
      on the morphological and biochemical aspects of differentiation of C2 mouse
      skeletal muscle cells. We show that three lazaroids (U-74006F, U-74389F and U
      83836E) enhance fusion of myogenic cells when added at the day of fusion. A
      parallel increase in nicotinic acetylcholine receptor expression and skeletal
      muscle alpha-actin content was observed. This promoting effect of lazaroids on
      myogenesis could be related to inhibition of free radical-mediated muscle damage.
      Therefore, one could expect that lazaroids might be useful in the treatment of
      degenerating muscle diseases such as Duchenne muscular dystrophy.

PMID- 7777192
TI  - Tau in cerebrospinal fluids: establishment of the sandwich ELISA with antibody
      specific to the repeat sequence in tau.
AB  - Clinical diagnosis for Alzheimer's disease (AD) is provided by the criteria of
      DSMIV and clinical progress in addition to imaging analysis with MRI after
      negative screening. The final exclusive diagnosis is confirmed by the
      neuropathological findings of neurofibrillary tangles and senile plaques in
      autopsy brains. We developed a new ELISA system to measure the amount of tau in
      cerebrospinal fluids (CSF) using phosphorylation-independent and sequence
      specific antibodies. The present ELISA was sensitive enough to detect tau in CSF
      of normal subjects. The amount of tau was significantly elevated in CSF of AD
      subjects compared with those of normal subjects and subjects with dementia of
      cerebrovascular disease, suggesting that tau in CSF reflects the massive and
      continuous neuronal cell death in the AD brain. In conclusion, we established an
      ELISA system which enabled us to detect tau in CSF and demonstrated that tau was
      significantly and specifically elevated in CSF of AD subjects. This assay system
      can provide us with a potent diagnostic tool for clinical AD.

PMID- 7777193
TI  - Increased cerebrospinal fluid tau in patients with Alzheimer's disease.
AB  - One of the pathological features in Alzheimer's disease (AD) is neurofibrillary
      tangles in the brain. The main constituent of tangles is the microtubuli
      associated protein tau in a hyperphosphorylated state. Tau is also released into
      cerebrospinal fluid (CSF), and in this study we have used an enzyme linked
      immunosorbent assay to measure tau in CSF from AD and control cases. Our findings
      show that tau levels in AD cases are significantly elevated compared to healthy
      control individuals. We suggest that tau may serve as a biochemical marker of
      Alzheimer's disease.

PMID- 7777195
TI  - Neuronal pathways mediating head turning behavior in Aplysia.
AB  - Seaweed applied to the head of Aplysia elicits a head turning response in the
      direction of the stimulus. The major motor neurons involved in head turning
      appear to be located largely in the pedal ganglion. Using an autoradiographic
      technique, we obtained evidence that there are afferents in the skin of the head
      that project directly to the pedal ganglion by way of the cerebral-pleural
      connectives. Bilateral lesioning of the cerebral-pleural connectives, however,
      did not interfere with head turning, and unilateral lesions of either a cerebral
      pedal or cerebral-pleural connective did not differentially affect turns evoked
      by stimuli applied ipsilaterally or contralaterally to the lesion. However, a
      combined unilateral lesion of a cerebral-pedal and cerebral-pleural connective
      resulted in elimination or significant reduction of ipsilateral turns. The data
      suggest that head turns elicited by food, are mediated by the combined
      information travelling in both the pedal and pleural connectives.

PMID- 7777194
TI  - Neuroprotective effect of phenytoin against in utero hypoxic brain injury in
      fetal guinea pigs.
AB  - The present study tests the hypothesis that phenytoin, an antiepileptic agent
      known to block Na+ and Ca2+ channels, will prevent hypoxic brain injury in the
      fetus by preventing lipid peroxidation and preserving Na+,K(+)-ATPase activity.
      Studies were performed in 37 fetuses obtained from pregnant guinea pigs at 58-60
      days gestation (term). The pregnant guinea pigs were divided into four groups: a
      normoxic group, a hypoxic group, a normoxic group treated with phenytoin, and a
      phenytoin treated hypoxic group. There were eight to ten fetal guinea pigs in
      each group. The treatment groups were given phenytoin 30 mg/kg (50 mg
      phenytoin/ml solvent) intraperitoneally. Hypoxia was induced by exposing the
      guinea pigs to 7% oxygen for 60 min. This level of hypoxia has been shown to
      decrease ATP and phosphocreatine levels by 90%. The fetal brains were harvested
      and the brain cell membranes were prepared from each group of fetuses. Na+,K(+)
      ATPase activity and lipid peroxidation products, measured as relative fluorescent
      intensity, were determined. The mean Na+,K(+)-ATPase activity in the control,
      hypoxic, phenytoin-normoxic and phenytoin-hypoxic groups was 56.4 +/- 9.7, 37.9
      +/- 10.6, 47.0 +/- 8.4 and 52.0 +/- 9.7 mumol inorganic phosphate/mg protein per
      h, respectively. The hypoxic group had significantly less Na+,K(+)-ATPase
      activity than both the normoxic group (P < 0.01), and the phenytoin treated
      hypoxic group (P < 0.05). There was no significant difference between the
      normoxic group and either of the phenytoin-treated groups (P = ns).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7777196
TI  - Norepinephrine and epinephrine levels in the brain of alloxan diabetic rats.
AB  - Thirty days after induction of experimental diabetes the brain catecholamines
      namely, norepinephrine (NE) and epinephrine (E) were studied in discrete brain
      regions (striatum, hippocampus, hypothalamus, midbrain, pons and medulla,
      cerebellum and cerebral cortex) in control, alloxan-diabetic untreated and
      insulin-treated diabetic rats. E showed significant increase in striatum,
      hippocampus and hypothalamus, whereas NE was increased in hypothalamus, and
      decreased in pons and medulla significantly in untreated diabetic rats. These
      effects were not seen in the insulin-treated diabetic rats.

PMID- 7777197
TI  - Acceleration of GABA-dependent desensitization by mutating threonine 266 to
      alanine of the alpha 6 subunit of rat GABAA receptors.
AB  - Various GABAA receptor subunits share four highly homologous putative
      transmembrane domains (M1 to M4) and have been proposed to form an ion channel of
      pentameric structure with M2 lining the pore. The carboxyl terminal side of M2
      contains three amino acid residues containing a hydroxyl group, which are Thr
      265, 266 and serine 268 in the alpha 6 subunit. In order to study their
      functional role, we generated mutants of the alpha 6 subunit carrying a single
      point mutation of threonine 265 or 266 to alanine, or serine 268 to glycine. Co
      expression of the mutants with beta 2 and gamma 2 subunits in human embryonic
      kidney cells produced functional receptors which are similar to the wild type in
      their sensitivity to a benzodiazepine agonist (U-92330), insensitivity to Zn,
      anion permeability, and GABA dose-response profiles as monitored with the whole
      cell patch clamp technique. Only in the alpha 6T266A beta 2 gamma 2 subtype,
      however, GABA-induced Cl- currents decayed much more rapidly than the wild type
      (about 10 times faster). Analysis of the GABA dependency of desensitization
      indicates that the T266A mutation enhanced the desensitization rate with little
      effect on the recovery rate from desensitization or on the half-maximal GABA
      concentration. We conclude that threonine 266 in the alpha 6 subunit plays a
      pivotal role in desensitization processes of GABAA receptors.

PMID- 7777199
TI  - Protective effects of probucol against glutamate-induced cytotoxicity in neuronal
      cell line PC12.
AB  - The sympathetic nerve cell line PC12 is reportedly destroyed by glutamate in a
      concentration-dependent manner. In this study, cytotoxicity induced by 10 mM
      glutamate was blocked in a dose-dependent manner by incubating or pre-incubating
      cells with the antioxidant probucol (1-50 microM). Probucol also inhibited the
      increase in cellular thiobarbituric acid-reacting substances induced by glutamate
      exposure. These results suggest that the propagation of cellular lipid
      peroxidation may be related to glutamate-induced toxicity in PC12 cells.

PMID- 7777198
TI  - Expression and complex formation of soluble N-ethyl-maleimide-sensitive factor
      attachment protein (SNAP) receptors in clonal rat endocrine cells.
AB  - Syntaxin, synaptosome-associated protein 25 (SNAP-25) and synaptobrevin are
      neuronal receptors of N-ethylmaleimide-sensitive factor (NSF) and soluble NSF
      attachment protein (SNAP), cytosolic proteins essential for membrane transport.
      The expression of these SNAP receptors was investigated by immunoblotting in
      clonal endocrine cells; catecholamine-secreting adrenal medullary cells (PC12),
      growth hormone-secreting pituitary cells (GH3), and insulin-secreting pancreatic
      beta-cells (RINr and RINm5F). All of these receptors as well as NSF and SNAP are
      expressed in these cells and, co-immunoprecipitation experiments indicate that
      syntaxin is associated with SNAP-25 and synaptobrevin after solubilization. These
      results suggest that syntaxin, SNAP-25, and synaptobrevin form a complex and are
      involved in the secretion of hormones from endocrine cells by exocytosis.

PMID- 7777200
TI  - The role of acetate as a potential mediator of the effects of ethanol in the
      brain.
AB  - Acetate is the primary product of ethanol catabolism and can accumulate in the
      blood at concentrations of up to 2 mM following ethanol consumption. It has been
      suggested that some of the pharmacological actions of ethanol are mediated via
      acetate, which can lead indirectly to the release of endogenous adenosine. In the
      present experiments this hypothesis was tested by examining the effects of
      exogenous sodium acetate on the physiology of hippocampal slices from rat brain.
      Acetate had no significant effect on intracellular responses recorded from CA1
      pyramidal neurons or on extracellular field potentials evoked from the either the
      CA1 region or the dentate gyrus. There was also no significant difference in
      responses to the adenosine receptor antagonist theophylline in CA1 pyramidal
      neurons recorded using intracellular filling solutions containing potassium
      acetate, KCl, or potassium methylsulfate. These results suggest that the presence
      of acetate, either in the extracellular medium or within an intracellular
      electrode, does not induce a significant increase in adenosine receptor
      activation in the hippocampus.

PMID- 7777201
TI  - Decreased interleukin-6 level in the cerebrospinal fluid of patients with
      Alzheimer-type dementia.
AB  - We examined IL-6 levels in the cerebrospinal fluid (CSF) of patients clinically
      diagnosed with Alzheimer-type dementia (ATD) and with vascular dementia (VD) and
      of age-matched normal subjects. The IL-6 levels in the CSF of ATD, but not VD
      patients, were significantly decreased. In the early onset ATD patients (disease
      onset < 65 years), IL-6 levels were reduced to 21% of the control level. The IL-6
      levels in the CSF were not associated with the severity of the dementia or the
      duration of the disease since the identification of the first symptoms.

PMID- 7777202
TI  - Human recombinant IGF-I induces the functional expression of AMPA/kainate
      receptors in cerebellar granule cells.
AB  - We have previously reported that an excitatory amino acid resistant phenotype
      (EAA-) of rat cerebellar granule cells becomes EAA sensitive (EAA+) when cultured
      in the presence of human recombinant IGF-I. In order to assess the mechanism
      through which this somatomedin upmodulates the functional expression of EAAs
      receptors, we have performed studies using the whole-cell configuration of the
      patch-clamp technique to study macroscopic currents evoked by the application in
      the bath of kainate to (EAA-) and (EAA+) neurons, and compared their properties
      to sister cultures grown in classical conditions employing whole foetal calf
      serum (FCS). Kainate elicited macroscopic, 6-cyano-7-nitroquinoxaline-2,3-dione
      sensitive, inward currents at a holding potential of -60 mV in almost all the
      patched cells but the mean amplitude of the current was consistently smaller in
      (EAA-) neurons compared to (EAA+) neurons although the amplitude was still
      smaller than that observed in FCS-cultured neurons. The amplitude of the
      responses induced by kainate was a linear function of the membrane potential in
      the three groups of cells and the reversal potential of the currents was about 0
      mV, suggesting that the general property of each channel is identical in all
      three types of neurons while the different conductances observed are due either
      to a decreased expression, a different permeability or an altered affinity of the
      single receptor.

PMID- 7777203
TI  - Influence of intracisternal injection of somatostatin analog receptor subtypes 2,
      3 and 5 on gastric acid secretion in conscious rats.
AB  - Somatostatin (SST) and its analogs injected into the CSF induce different gastric
      acid response patterns. Five SST receptors have been characterized (SSTR-1 to 
      5). We studied the influence of selective SSTR-2, -3 and -5 ligands on basal
      gastric acid secretion after intracisternal (i.c.) injection in conscious rats
      equipped with chronic gastric and i.c. cannulae. Compared with pre-injection
      level, the SSTR-3 agonist, BIM-23056 (1 microgram) increased acid secretion by
      274 +/- 43% while the SSTR-2 agonist, DC 32-87 (1 microgram) inhibited acid
      secretion by 50.7 +/- 13.3%. SST-14 (1 microgram), the SSTR-5 agonist, BIM-23052,
      (0.5-1 microgram), SSTR-3 (0.5 micrograms) and -2 (0.5 microgram) or vehicle
      injected i.c. did not modify basal acid secretion. These results show that the
      activation of brainstem SSTR-3 receptors stimulate and SSTR-2 inhibit basal
      gastric acid secretion in conscious rats with chronic gastric fistulae.

PMID- 7777204
TI  - Developmental expression of the neural adhesion molecule F3 in the rat brain.
AB  - We cloned a cDNA encoding rat F3 and analyzed the nucleotide sequences. The
      results have shown that rat F3 is comprised of 1021 amino acid residues. It
      shared 99% and 76% identities with mouse and chicken homologs, respectively, at
      the amino acid sequence level. During postnatal development of the rat brain,
      cells expressing F3 mRNA appeared in the cortex, hippocampus, superior and
      inferior colliculi, anterior olfactory nucleus, olfactory bulb and cerebellum,
      whereas little was observed at postnatal day 1 (P1). Extraordinarily high
      expression of F3 mRNA was observed in the cerebral cortical neurons of layer 5 at
      P7. The number of cells with high expression of F3 mRNA expanded to the entire
      region of the cerebral cortex at P14. The whole cerebrum displayed expression at
      P90 in which the cortex still showed the highest expression level, although the
      overall signals were weak in comparison with those at P14. In the hippocampal
      formation, F3-expressing granule cells of the dentate gyrus were restricted to
      the outer aspect, then expanded to the inner aspect during development. Finally
      the granule cells in the entire region of the dentate gyrus transcribed F3 mRNA.
      We discuss the significance of the expression pattern of F3 mRNA during
      development.

PMID- 7777205
TI  - Axonal projections of utricular afferents to the vestibular nuclei and the
      abducens nucleus in cats.
AB  - Axonal projections of utricular (UT) afferents in cats were examined by three
      approaches: recordings of field potentials, labelling of UT nerve fibres by
      localized infusion of horseradish peroxidase (HRP) and intraaxonal infusion of
      HRP into a single UT afferent. UT afferents project principally into the rostral
      part of the descending nucleus and the ventral part of the lateral nucleus.
      Projection into the superior and the medial nuclei and the ipsilateral abducens
      nucleus were also observed.

PMID- 7777207
TI  - ATP release evoked by isoprenaline from adrenergic nerves of guinea pig atrium.
AB  - Mode and site of release of ATP evoked by isoprenaline were evaluated in the
      electrically driven left atrial segment of guinea pig. The peak release of ATP 5
      min after 1 microM isoprenaline was inhibited by 1 microM propranolol and 1
      microM butoxamine, but not by 1 microM atenolol, showing that the ATP release is
      due to stimulation of the presynaptic beta 2-adrenoceptor by isoprenaline. The
      maximum ATP release was markedly reduced by Ca2+/calmodulin antagonists, W-7 and
      trifluoperazine, and by a mitotic inhibitor, vinblastine. Further, the release
      was similarly inhibited by myosin light chain kinase inhibitors, ML-7 and
      wortmannin. Nifedipine, a Ca(2+)-channel blocker, decreased the release of ATP
      evoked by isoprenaline. By contrast, Bay K 8644, a Ca(2+)-channel opener, tended
      to enhance the ATP release. These findings suggest that isoprenaline produces ATP
      release from adrenergic nerve terminals of atrium, implying that ATP serves as a
      co-transmitter.

PMID- 7777206
TI  - Activation of inwardly rectifying potassium channels (GIRK1) by co-expressed rat
      brain cannabinoid receptors in Xenopus oocytes.
AB  - The neuronal cannabinoid receptor clone was expressed of saturable [3H]WIN 55,212
      2 binding sites. Co-expression of the cannabinoid receptor with cRNA coding for
      the G-protein-gated inwardly rectifying K+ channel (GIRK1) resulted in oocytes
      exhibiting large inward K+ currents in response to the cannabinoid agonist WIN
      55,212-2. The activation of the potassium current by WIN 55,212-2 was dose
      dependent with an EC50 of 630 nM. These results suggest that activation of
      inwardly rectifying K+ channels may be an additional effector mechanism for brain
      cannabinoid receptors.

PMID- 7777209
TI  - Visionary, creative nurse executive leaders.

PMID- 7777208
TI  - Autoradiographic study of mitochondrial complex I and glutamate receptors in the
      basal ganglia of rats after unilateral subthalamic lesion.
AB  - A unilateral lesion of the subthalamic nucleus (STN) induced, in the short-term
      (< or = 1 week), an ipsilateral decrease in [3H]dihydrorotenone binding to
      complex I in entopeduncular nucleus and substantia nigra pars reticulata (SNr). A
      slight reduction of [3H]MK-801 binding to N-methyl-D-aspartate (NMDA) receptors
      in the ipsilateral SNr was also found, whereas no changes in [3H]alpha-amino-3
      hydroxy-5-methylisoxazole propionic acid binding were observed. The complex I
      decrease likely reflects a reduction in neuronal activity subsequent to the
      interruption of excitatory signaling from STN. The unexpected decrease in [3H]MK
      801 binding in SNr may be related to presynaptic NMDA receptor modifications.

PMID- 7777210
TI  - Managed care and health care reform.

PMID- 7777211
TI  - Dollars and sense in health reform: interdisciplinary practice and community
      nursing centers.
AB  - Historically, community nursing centers (CNCs) provided care to underserved
      populations, and today they are reemerging to provide accessible, nurse-managed
      care in urban and rural settings. The quality and cost-effectiveness of care
      provided by advanced practice nurses in a managed-care environment is described
      using the Neuman Systems Model. Significant documentation from the literature
      underscores the value of nurse-managed care, but supports the need for
      interdisciplinary practice. CNC primary and preventive care in a "center without
      walls" is described and promoted for accessible, cost-effective and quality care
      in the context of health care reform.

PMID- 7777212
TI  - Beyond shared governance: restructuring care delivery for self-managing work
      teams.
AB  - Shared governance organizations have been highly successful in empowering nurses
      for professional practice. They have been more uneven in their effectiveness for
      solving day-to-day operational problems, however. This article discusses
      limitations of the traditional approaches and describes a process to develop self
      managing teams through patient care redesign. Milestones in the evolution of self
      managing teams are illustrated through a description of experiences at
      Presbyterian Hospital of Dallas over the past five years. Practical suggestions
      for the transition to self-managing work teams are outlined.

PMID- 7777213
TI  - Role restructuring: nurse, case manager, and educator.
AB  - A quality improvement team of nursing managers and staff nurses planned and
      implemented a new delivery system that combines a team nursing method of care
      delivery and a unit-based case manager. The new unit-based case manager role is
      unique because in addition to case management, the role is also responsible for
      the education of staff on an assigned unit and meeting the educational needs of
      patients/families. The role has proved to be cost effective and has improved
      patient outcomes. This model is an effective delivery system for hospitals with
      limited resources for bedside care.

PMID- 7777214
TI  - The Queen's Medical Center Honolulu, Hawaii.
AB  - The Queen's Medical Center created and almost fully realized a vision of
      professional nursing practice. This vision was mission-driven and philosophically
      oriented in that our Hawaiian heritage and commitment to a patient-centered focus
      dictated the direction taken. Utilizing the nursing process, we listened to our
      patients in identifying the nursing model to best meet their needs: primary
      nursing. In order to achieve that, the nurse at the bedside had to be empowered
      to make decisions directly impacting patient care. We further committed to
      treating the whole patient and considering complementary therapies. We have
      established an evaluation baseline and are committed to a process that will carry
      us into the year 2000.

PMID- 7777215
TI  - Differentiated practice: the new paradigm using a theoretical approach.
AB  - Differentiated practice is a term that has been identified in nursing for years.
      Nurses today, however, still practice under the old paradigm that disregards
      preparation and states that "a nurse is a nurse is a nurse." The idea of
      differentiated practice, which supports the restructuring of nursing roles based
      on education, experience, and competence, can again be found in recent
      literature. Current models for differentiated practice and rationales for
      implementation are reviewed. This article addresses the need to shift from the
      old paradigm and provides an analysis of the issues central to differentiated
      practice from two theoretical perspectives: role theory and nursing theory.

PMID- 7777217
TI  - Technology and managed care.

PMID- 7777216
TI  - Nursing care delivery models and nurse satisfaction.
AB  - The relative impact of various nursing care delivery models and management
      interventions on nurse satisfaction was assessed in 37 New Jersey hospitals.
      Nurses ranked pay as the most important factor, followed by autonomy and
      professional status. Changes in scores between pilot and comparison units were
      significantly different for satisfaction with interactions and task requirements.
      Change in satisfaction with interaction was significant for all initiatives in
      aggregate, as well as for each of the five types of initiatives separately. The
      change in satisfaction with task requirements was significant for all initiatives
      taken as a group and for those units that implemented reorganization, computer,
      and education initiatives. Even among nurses who eventually liked the new
      environment there was a period of initial dissatisfaction.

PMID- 7777218
TI  - Relationship among subjective mental workload, experience, and education of
      cardiovascular critical care RNs.

PMID- 7777219
TI  - Sharpening of frequency tuning by inhibition in the central auditory system:
      tribute to Yasuji Katsuki.
AB  - Frequency analysis is a fundamental function of the auditory system. Bekesy and
      Katsuki believed that sharpening of frequency tuning by lateral inhibition takes
      place in the central auditory system. However, most 'cat' auditory physiologists
      have believed that frequency tuning of neurons is not sharpened in the central
      auditory system, so that there is no lateral inhibition. Unlike quasi-triangular
      frequency-tuning curves of peripheral neurons, pencil- or spindle-shaped
      frequency-tuning curves have been found in the central auditory systems of many
      species of animals belonging in different classes. Inhibitory tuning curves are
      commonly associated with such 'level-tolerant' sharp excitatory tuning curves. It
      is that frequency-tuning curves of some central auditory neurons are sharpened by
      inhibition. Yasuji Katsuki (Professor, M.D., Ph.D.) passed away on 6 March 1994
      at the age of 88. I have written this article as a tribute to him, focusing on
      his major contribution to auditory neurophysiology: the finding of the sharpening
      of frequency tuning in the cat's central auditory system. Neural sharpening of
      frequency tuning is an old yet still current topic, as you will read in this
      article dedicated to Professor Katsuki.

PMID- 7777220
TI  - Influences on the gamma-muscle-spindle system from contralateral muscle afferents
      stimulated by KCl and lactic acid.
AB  - The aim of the present study was to investigate whether increased concentrations
      of lactic acid and potassium chloride (KCl) in contralateral muscles can
      influence the sensitivity of primary and secondary muscle spindle afferents
      (MSAs) from ipsilateral extensor and flexor muscles. The experiments were
      performed on 7 cats anaesthetised with alpha-chloralose. Recordings were made
      simultaneously from 2-12 single MSAs from the triceps surae (GS) and/or the
      posterior biceps and semitendinosus muscles (PBSt). The mean rate of firing and
      the amplitude of a fitted sine curve of MSA responses to sinusoidal stretching of
      the receptor bearing muscles were determined. Responses of 42 primary MSAs (17
      from PBSt and 25 from GS) were recorded. On 33 of these, clear-cut alterations in
      sinusoidal response were evoked by injection of 1 ml KCl (200-400 mM) or 1 ml
      lactic acid (20-50 mM) into the arterial supply of the contralateral GS or PBSt
      muscles. Six out of 8 secondary MSAs showed sizeable effects to increased
      intramuscular concentrations of KCl and/or lactic acid (3 from PBSt and 3 from
      GS). On both primary and secondary MSAs, from GS as well as from PBSt muscles,
      the large majority of effects were excitatory. All effects on secondary MSAs were
      compatible with reflex actions on static fusimotor neurones, whereas on primary
      MSAs different types of reflex responses were observed (i.e. pure static, pure
      dynamic and mixtures of static and dynamic fusimotor actions). Stimuli related
      alterations in MSA responses were completely abolished when the contralateral GS
      or PBSt nerves were anaesthetised.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7777222
TI  - Roles of GABAA, NMDA and muscarinic receptors in induction of long-term
      potentiation in the medial and lateral amygdala in vitro.
AB  - We have studied mechanisms underlying long-term potentiation (LTP) in the medial
      and lateral amygdala using in vitro slice preparations. In normal bathing medium,
      LTP was not induced by tetanic stimulation (100 pulses at 100 Hz). However, in
      the presence of a GABAA blocker, picrotoxin or bicuculline, LTP was reproducibly
      induced in both medial and lateral amygdala. In the medial amygdala, the LTP
      induced in the presence of picrotoxin was blocked by 2-amino-5-phosphonovalerate
      (APV), an NMDA receptor antagonist, and was significantly reduced by scopolamine,
      a muscarinic receptor antagonist. On the other hand, the LTP in the lateral
      amygdala was not affected by APV, but was significantly reduced by scopolamine.
      These results suggest that both NMDA receptors and muscarinic receptors are
      involved in the induction of medial amygdala LTP, while muscarinic receptors, but
      not NMDA receptors, are involved in the induction of lateral amygdala LTP.

PMID- 7777221
TI  - Effects of long-term administration of phenelzine on reticular-elicited
      hippocampal rhythmical slow activity.
AB  - All anxiolytics so far tested show a common reduction in the frequency of
      reticular-elicited hippocampal rhythmical slow activity (RSA). Acute
      administration of the tricyclic antidepressant imipramine shares this effect with
      anxiolytics. The present experiment tested whether the MAO inhibitor
      antidepressant phenelzine shares this common effect of anxiolytics and imipramine
      on hippocampal RSA. Rats, implanted with reticular stimulating electrodes and
      subicular recording electrodes, received four acute doses (0.2, 2.0, 6.0 and 18
      mg/kg) or one chronic dose (2 mg/kg/day for 35 days) of phenelzine. Acute
      administration of phenelzine failed to systematically affect RSA frequency.
      Chronic injections of phenelzine eventually produced a reduction in RSA frequency
      combined with a gradual increase in baseline RSA frequency. The absence of
      immediate action and the production of a chronic reduction in RSA frequency are
      distinct from the documented effects of anxiolytics and imipramine, whereas the
      increase in baseline RSA frequency is similar to imipramine. The different
      influence of phenelzine on RSA frequency compared with anxiolytics (including
      imipramine) is consistent with the different clinical profiles of these drugs.

PMID- 7777223
TI  - Noradrenaline inhibits preoptic sleep-active neurons through alpha 2-receptors in
      the rat.
AB  - Effects of noradrenaline (NA) on the activity of sleep-related neurons in the
      preoptic area (POA) and the neighboring basal forebrain were examined in the rat.
      Of 36 sleep-active neurons tested, 19 were inhibited and the other 17 were
      unaffected by NA applied through a multibarrel pipette. The alpha 2-agonist
      clonidine inhibited 11 of 14 sleep-active neurons and did not affect the other 3
      neurons, whereas the alpha 1-agonist methoxamine (n = 13) and the beta-agonist
      isoproterenol (n = 11) had no effect on any of the sleep-active neurons tested.
      Thus, alpha 2-receptors mediated the NA-induced inhibition. Of 22 waking-active
      neurons tested, NA excited 10, inhibited 1, and had no effect on the remaining
      11. Methoxamine excited 4 of 13 waking-active neurons tested, whereas
      isoproterenol (n = 9) and clonidine (n = 4) were without effect on any of the
      waking-active neurons tested. Accordingly, alpha 1-receptors probably mediated
      the NA-induced excitation. Seventy-seven state-indifferent neurons, which lacked
      activity related to the sleep-waking state, and 20 paradoxical sleep-active
      neurons were mostly (65%-70%) insensitive to NA. These results suggest that NA
      promotes wakefulness by inhibiting sleep-active neurons and by exciting waking
      active neurons.

PMID- 7777224
TI  - Glutamatergic and cholinergic inputs from the pedunculopontine tegmental nucleus
      to dopamine neurons in the substantia nigra pars compacta.
AB  - Postsynaptic responses of dopamine (DA) neurons in the substantia nigra pars
      compacta (SNc) to stimulation of the pedunculopontine tegmental nuclei (PPN) were
      studied in in vitro slice preparations in the rat. The recorded neurons were
      intracellularly injected with biocytin and also identified as DA neurons by an
      immunocytochemical technique. PPN stimulation induced in DA neurons monosynaptic
      excitatory postsynaptic potentials (EPSPs) that consisted of early transient and
      slow components. An application of anti-glutamatergic agents (1 mM kynurenic acid
      and/or 30 microM 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX)) in the bathing
      media partially suppressed the EPSPs, indicating that PPN inputs to SNc DA
      neurons are glutamatergic and non-glutamatergic. Anti-glutamatergic resistant
      EPSPs were suppressed by applications of anti-cholinergic agents such as
      atropine, mecamylamine, and pirenzepine. These data indicate a convergence of
      glutamatergic and cholinergic excitatory inputs from the PPN to SNc DA neurons
      and that both nicotinic and muscarinic receptors are involved in the cholinergic
      transmission.

PMID- 7777226
TI  - Campaign sends wrong message.

PMID- 7777225
TI  - Projection of cardiovascular afferents to the lateral nodulus-uvula of the
      cerebellum in rabbits.
AB  - Vagal and aortic afferent projections to the nodulus and uvula of the cerebellar
      vermis were examined in anesthetized and paralysed rabbits. Electrical
      stimulations of vagal and aortic nerves at a frequency of 1/s produced field
      potentials in the lateral cortical region of the contralateral nodulus-uvula with
      a latency of 6.5-19 ms. These potentials were negative in the molecular layer and
      positive in the granular layer. At a higher stimulation rate (30/s), these
      potentials were reduced by 60-65% of the control value. These results indicate
      that the lateral cortical region of the nodulus-uvula receives contralateral
      vagal and aortic afferent signals via climbing fibers. Electrical stimulation of
      vagal nerves also produced field potentials in the lateral region of the
      ipsilateral nodulus-uvula with a latency of 6-10.5 ms. Their laminal profile was
      characteristic of mossy fiber responses. At a higher stimulation rate (30/s), the
      reduction of these potentials was only 35%. Thus the lateral nodulus-uvula also
      receives the ipsilateral vagal afferent signals via mossy fibers. Following
      injection of horseradish peroxidase into the small areas of the lateral nodulus,
      labeled cells were found in bilateral intercalatus nucleus, prepositus
      hypogrossal nucleus, Roller nucleus, medial fascicullus longitudinalis, and
      medial and lateral vestibular nuclei. These nuclei may contain precerebellar
      neurons in the pathway from the vagal nerve to the lateral nodulus-uvula via
      mossy fibers.

PMID- 7777227
TI  - A second opinion.

PMID- 7777228
TI  - Informed consent. What it is, why it is.

PMID- 7777229
TI  - Implications for the practice of dentistry.

PMID- 7777232
TI  - IOM report on dental education is standard for the future.

PMID- 7777231
TI  - The Columbia experience.

PMID- 7777230
TI  - Patient-centered education. The NYU experience.

PMID- 7777233
TI  - A teacher's guide to the future of dental education.

PMID- 7777234
TI  - Steps in the right direction. A private practitioner's perspective.

PMID- 7777236
TI  - Continuing education brings its own rewards.

PMID- 7777235
TI  - UB researchers study mouthwashes and osteoporosis/gum disease link.

PMID- 7777238
TI  - Prognostic significance of necrosis, elastosis, fibrosis and inflammatory cell
      reaction in operable breast cancer.
AB  - We analyzed retrospectively the relationships and the prognostic significance of
      four anatomopathological features (elastosis, fibrosis, necrosis, inflammatory
      cell reaction) of the primary tumor in a series of 1,457 cases of infiltrating
      ductal carcinoma observed at our institution from January 1978 to December 1991.
      Necrosis, elastosis, fibrosis and inflammatory cell reaction were strongly
      associated among themselves (all p < 0.0001), the only exception being necrosis
      and elastosis. Necrosis was significantly related to tumor size (odds ratio [OR]
      = 5.40, p < 0.0001) and tumor grade (OR = 2.22, p < 0.0001). Univariate analysis
      showed that the presence of necrosis and cell reaction were significantly related
      to worse survival (p < 0.0001 and p = 0.03, respectively). Multivariate analysis,
      including the four variables plus nodal status, tumor size, grading, adjuvant
      therapy, age and first order interactions, revealed that greater tumor size (p <
      0.0001), positive nodal status (p < 0.0001), higher histologic grade (p < 0.0001)
      and presence of inflammatory cell reaction (p = 0.0007) independently worsened
      survival. On the other hand, adjuvant therapy had a significant independent role
      in preventing deaths (p = 0.03). The only first-order interaction retained in the
      model was that between grading and cell reaction (p = 0.002). Cell reaction had a
      different prognostic behaviour in the groups G1-G2 and G3: in the former group,
      survival was worse (p = 0.0001) when the inflammatory cell reaction was present.
      In conclusion, we demonstrate that cell reaction is an independent prognostic
      factor in the G1-G2 subgroup of patients, and propose a hypothesis as to the role
      of cell reaction in primary breast cancer.

PMID- 7777237
TI  - The role of fatty acids and eicosanoid synthesis inhibitors in breast carcinoma.
AB  - We have reviewed the literature concerning the role of fatty acids and eicosanoid
      synthesis inhibitors in breast carcinoma. The omega-6 polyunsaturated fatty acids
      (PUFAs), primarily linoleic acid, promote breast cancer tumorigenesis and tumor
      cell proliferation directly and indirectly via increased synthesis of
      cyclooxygenase- and lipoxygenase-catalyzed products. The omega-3 PUFAs, primarily
      docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), suppress breast
      carcinoma tumorigenesis and tumor cell proliferation, although the effect of DHA
      may be partly ascribed to increased amounts of EPA derived from DHA. Both
      cyclooxygenase and lipoxygenase inhibitors suppress tumorigenesis and/or tumor
      proliferation, with the latter being more active. Thus, arachidonic acid-derived
      eicosanoids play an important role in breast cancer, and the balance of the
      various eicosanoids may be a critical determinant of cell proliferation. However,
      the exact mechanism by which fatty acids and eicosanoid synthesis inhibitors
      exert stimulatory and inhibitory effects on breast carcinoma is still not well
      understood.

PMID- 7777239
TI  - Serial transplants of DMBA-induced mammary tumors in Fischer rats as model system
      for human breast cancer. IV. Parallel changes of biopterin and melatonin indicate
      interactions between the pineal gland and cellular immunity in malignancy.
AB  - Nocturnal (23.00-07.00 h) urinary melatonin and total biopterin (tBI; after
      acidic oxidation of reduced biopterins) were analyzed during the growth of two
      passages of a mammary tumor line in female F344 Fischer rats. In addition,
      nocturnal (02.00-03.00 h) peak concentrations of pineal melatonin in plasma were
      analyzed when tumors had reached comparable average tumor volumes of 25-30 cm3.
      Since tetrahydrobiopterin (BH4) is produced by murine macrophages in response to
      interferon-gamma released by activated T lymphocytes, measurements of tBI can
      serve to estimate the state of cellular immunity. At passage 2, a slow-growing
      localized carcinosarcoma, tBI showed a progressing increase during tumor growth
      reaching more than 200% (p < 0.05-0.005) of controls by the end of the
      experiment. Urinary and plasma melatonin were elevated by 30-50% (p < 0.05) and
      42% respectively. At passage 12, a fast-growing metastasizing sarcoma, a
      depression of about 20-30% was found for tBI (p < 0.05) and urinary melatonin (p
      < 0.025); plasma melatonin was depleted by 70% (p < 0.005). Parallel changes of
      both parameters at each tumor passage indicate a close link between the pineal
      hormone melatonin and cellular immunity. The opposite trends observed at the two
      passages indicate a clear stimulation of the immune system and the pineal gland
      at early but inhibition at advanced stages of cancer.

PMID- 7777240
TI  - Relapse of Hodgkin's disease after ten years.
AB  - We report four cases of Hodgkin's disease (HD) relapsing after complete remission
      for over a 10-year period after the initial therapy. Three of the patients had
      mixed-cellularity subtypes as a primary histological diagnosis, and the
      rebiopsies demonstrated mixed cellularity in all very late relapse cases. Two
      patients were initially treated with radiotherapy, while in the other two
      advanced cases polychemotherapy was administered. All patients had advanced
      disease at the time of the very late relapses, though the relapse was not
      identifiable in the previously involved regions. By rescue therapy, all patients
      achieved a second complete remission. However, two patients relapsed again with
      one of them dying during relapse. The three remaining patients are still in
      complete remission. Our report demonstrates the necessity of prolonged follow-up
      of patients with HD.

PMID- 7777242
TI  - Severe cardiotoxicity of high-dose 5-fluorouracil in combination with folinic
      acid, cisplatin and methotrexate in a 14-year-old boy with nasopharyngeal
      carcinoma (Schmincke tumor).
AB  - Cardiotoxicity by 5-fluorouracil has been reported as a rare complication in
      treatment protocols for adult patients with different malignant diseases. The
      combination with folinic acid as a biomodulatory substance and other cytotoxic
      drugs has been introduced to render protocols more effective and less toxic. We
      report severe but completely reversible cardiotoxicity of a treatment protocol
      for nasopharyngeal tumor (Schmincke tumor) of pediatric patients consisting of 5
      fluorouracil, methotrexate, cisplatin and folinic acid in a 14-year-old boy who
      had no preexisting cardiac disease. The pathomechanism is briefly discussed.

PMID- 7777243
TI  - The efficacy of continuous local arterial infusion of 5-fluorouracil and
      cisplatin through an implanted reservoir for severe advanced hepatocellular
      carcinoma.
AB  - There is not yet an effective standard therapy for severe advanced hepatocellular
      carcinoma (HCC). We attempted continuous local arterial infusion chemotherapy
      using 5-fluorouracil (5-FU) and cisplatin (CDDP) with an implanted reservoir for
      these patients, and evaluated its efficacy. Twenty-one HCC patients received
      continuous arterial infusion of 5-FU and CDDP for 1 week, followed by a 1-week no
      infusion period; this regimen was repeated 1-32 times, and patients were observed
      for 36-549 days. The 1-year survival rate was 61.1%, and alpha fetoprotein levels
      decreased in 13 patients. All could continue as outpatients for 94.0% of the
      entire course of therapy. Because CDDP amplifies the effect of 5-FU as a
      biochemical modulator, and because continuous infusion strengthens the effect of
      5-FU and reduces the side effects of CDDP, we consider this therapy to be
      effective for patients with severe advanced HCC, prolonging survival and
      improving the quality of life.

PMID- 7777241
TI  - Clinical evaluation of squamous cell carcinoma antigen in squamous cell carcinoma
      arising in mature cystic teratoma of the ovary.
AB  - We attempted to assess the clinical utility of squamous cell carcinoma antigen
      (SCC) for detecting squamous cell carcinoma arising in mature cystic teratoma of
      the ovary. SCC in serum from 16 patients with this malignancy and from 56
      patients with mature cystic teratoma without malignancy was measured using
      radioimmunoassay. Serum SCC levels exceeded the cut-off of 2.0 ng/ml in 9 (56%)
      of the 16 patients with malignancy. This rate was significantly higher than that
      in the patients with nonmalignant mature cystic teratoma (9 to 56, 16%; p <
      0.01). The positive rate for SCC was as low as 30% for stage I cancer. All cases
      in which the tumor size was > 500 cm3 had a positive response for SCC, whereas
      all other cases had a negative response (p < 0.001). SCC is useful as a tumor
      marker for this malignancy. However, the serum SCC level depends on the tumor
      volume, so it may not be suitable for early detection of small tumors.

PMID- 7777244
TI  - Effect of adriamycin, 5-fluorouracil and mitomycin-C combination chemotherapy in
      advanced colorectal cancer.
AB  - One hundred and seventy-four patients with advanced colorectal cancer were
      treated with 5-fluorouracil (5-FU), mitomycin-C (MIT-C) and Adriamycin (ADR)
      (FAM). The total response rate was 26.4%. A higher response rate (37%) was
      observed in patients with liver metastases only, compared to other sites of
      metastases (p < 0.02). Complete remission were achieved only in patients with
      liver metastases (15%). Male patients with liver metastases had a higher response
      rate than females (p < 0.03). Twenty-five patients previously treated
      unsuccessfully with 5-FU and MIT-C showed a response rate of 28% when ADR was
      added to the regimen. The patients' median survival was 11 months (range: from 3
      to > or = 60 months). The median survival of patients with liver metastases was
      11 months and that of responders (20 months) was significantly longer than that
      of nonresponders (7 months; p < 0.0001). These results suggest that the FAM
      combination might be considered an eligible chemotherapy schedule for patients
      with liver metastatic disease from colorectal cancer.

PMID- 7777245
TI  - Vanadium: a modifier of drug-metabolizing enzyme patterns and its critical role
      in cellular proliferation in transplantable murine lymphoma.
AB  - Vanadium, as ammonium monovanadate, has been found to stimulate tumour cell
      proliferation in mice bearing a transplantable ascitic lymphoma. Markers
      including microsomal cytochrome P-450, UDP-glucuronyltransferase and cytosolic
      glutathione-S-transferase showed substantial alterations in a dose-responsive
      manner with vanadium administration when compared to the controls. Stimulation of
      tumour progression is also reflected by increased tumour cell count and decreased
      survival of the host.

PMID- 7777247
TI  - Total suppression of spontaneous endometrial carcinoma in BDII/Han rats by
      melengestrol acetate.
AB  - Female virgin BDII/Han rats develop spontaneous endometrial carcinoma (EC) in
      incidences up to 90%. Our objective was to determine whether lifelong
      administration of the progestin melengestrol acetate (MGA) would suppress those
      tumors. Four groups of 20 rats aged 24-28 days were employed Group I animals were
      untreated controls. Groups II, III, and IV were fed 0.1, 0.2, and 0.4 mg MGA/kg
      daily in their diet during their lifetimes. All treated groups were free from EC
      during their lifetimes with an increased lifespan up to 30%. The controls, in
      contrast, had an EC incidence of 85%. Histologically, with one exception all
      tumors were classified as adenocarcinoma. While most of the control rats died
      from EC, nearly all animals of groups II and III died from age-related diseases.
      Rats in group IV showed side effects due to the glucocorticoid properties of MGA.
      Besides alopecia and obesity an acceleration of chronic progressive nephrosis was
      observed. The study establishes the validity of the prophylactic approach to
      spontaneous hormone-dependent cancers in a rat tumor model.

PMID- 7777246
TI  - Efficacy of ondansetron treatment with different timing schedules: a randomized
      double-blind study.
AB  - The purpose of this study was to determine whether preloading administration of
      ondansetron given 12.5 h before cisplatin therapy, every 6 h, is better in
      controlling acute cisplatin-induced emesis than a standard dose every 8 h. All
      patients had previously received three cycles of CDDP-based chemotherapy in a
      dose of 100 mg/m2. Ondansetron was given according to two schedules: in group A
      (40 patients) at a dose of 8 mg in 100 ml normal saline over 10 min by
      intravenous infusion before the infusion of CDDP continued with 1 tablet of 8 mg
      after 8 and 16 h; in group B (40 patients) it was administered in six intravenous
      doses (every 6 h) starting 12.5 h before cisplatin administration. During the
      following 3 days, patients from both groups continued with tablets of 8 mg
      orally, every 8 h in group A and every 6 h in group B. The only difference in
      terms of the antiemetic response noticed between the two groups was in the number
      of patients that presented with nausea, which was increased in group A (32) in
      comparison to group B (25; p < 0.022). No difference was found in the number of
      vomiting episodes, retches or control of emesis, during the 3-day evaluation
      period after cisplatin infusion, and in secondary side effects. In conclusion the
      total dose of 24 mg ondansetron during the acute phase of emesis is as effective
      as preloading and increasing the total dose to 32 mg.

PMID- 7777248
TI  - Dose-finding study of 5'-deoxy-5-fluorouridine in combination with fixed doses of
      cisplatin and L-folinic acid for the treatment of advanced or recurrent squamous
      cell carcinoma of the head and neck.
AB  - In order to assess the maximum tolerated dose of 5'-deoxy-5-fluorouridine (5dFUR)
      combined with a cisplatin (20 mg/m2 i.v.) and L-folinic acid (100 mg/m2 i.v.), 5
      day schedule 19 consecutive chemotherapy-naive patients affected by advanced or
      recurrent carcinoma of the head and neck were entered in this phase I trial.
      Doses of 5dFUR were escalated from a starting level of 2,000 mg/m2/day up to
      3,000 and 5,000 mg/m2/day. At the latter step the dose-limiting acute toxicities
      were stomatitis and diarrhea, which were of WHO grade 3-4 and occurred in 3 and 1
      out of 4 evaluated patients, respectively. Other grade 3 acute toxicities were
      leukopenia, anemia, renal impairment, and neurologic symptoms, observed in 1
      patient each. Furthermore, one possibly treatment-related death was registered
      among patients entered in the highest dose level. Eleven out of 19 patients (58%;
      95% CI:34-80%) showed a complete (2 cases) or partial (9 cases) response to this
      treatment, regardless of the 5dFUR dosage employed. From our results we may
      define the maximum tolerated dose of 5dFUR to be associated with cisplatin and L
      folin acid used in this trial as 3,000 mg/m2/day x 5 days. Assessment of the real
      activity of this combination chemotherapy deserves further studies.

PMID- 7777249
TI  - Mucinous adenocarcinoma arising in the renal pelvis of an ectopic pyelic kidney.
AB  - A case of mucinous adenocarcinoma probably originating in the renal pelvis of an
      ectopic pyelic kidney with infiltration of the adjacent urinary bladder is
      reported. Review of the literature shows that this is the 42nd case of such a
      tumor, the second one reported in the pelvis of an ectopic pyelic kidney, and the
      first infiltrating the urinary bladder.

PMID- 7777250
TI  - Histologic grade and cellular proliferation at the deepest invasive portion
      correlate with the high malignancy of submucosal invasive gastric carcinoma.
AB  - To establish appropriate indications for endoscopic treatment of submucosal
      invasive gastric carcinoma, we investigated clinicopathologic features and
      proliferating cell nuclear antigen (PCNA) expression at the deepest invasive
      portion of 192 differentiated submucosal invasive gastric carcinomas that had
      been surgically resected. Lymph node metastasis was demonstrated in 30 (15.6%) of
      192 lesions. Histologic heterogeneity (based on differentiation at the deepest
      invasive portion) was demonstrated in 36 (18.8%) of the 192 lesions. In 159
      lesions, excluding 33 undifferentiated lesions at the deepest invasive portion,
      the depth of invasion, histologic grade, lymph vessel involvement, infiltrative
      growth pattern (INF) and existence of an ulceration were all significantly
      correlated with the incidence of lymph node metastasis. The lesions with both
      well-differentiated adenocarcinoma (WELL) and minimal submucosal invasion (sm1)
      showed no lymph node metastasis. PCNA expression was estimated in 59 good stained
      lesions. The mean PCNA labeling index (LI) was 50.9 +/- 7.2% in lesions with
      lymph node metastasis and 43.7 +/- 9.3% in those without lymph node metastasis (p
      < 0.05). In addition, PCNA-LI also correlated significantly with the histologic
      grade, depth of invasion, INF and lymph vessel involvement. These results
      indicate that the submucosal invasive gastric carcinoma with both WELL and sm1,
      which shows no other risk factors, can be considered as the appropriate
      indication for curative endoscopic treatment. The PCNA-LI at the deepest invasive
      portion is useful in understanding the biology of lymph node metastasis in
      submucosal invasive gastric carcinoma.

PMID- 7777251
TI  - Association of immunohistochemical detection of urokinase-type plasminogen
      activator with metastasis and prognosis in colorectal cancer.
AB  - We evaluated urokinase-type plasminogen activator (uPA) expression with
      immunohistochemistry in 90 cases of colorectal cancer and compared it with the
      clinicopathological findings. Patients who had cancer cells which were stained
      intensively relative to the background were recognized as uPA-positive patients.
      The uPA-positive rate was 36.7% (33/90) in total cases. There was a significant
      correlation was also seen between uPA expression and liver metastasis. Prognosis
      was poorer in the uPA-positive patients than in the uPA-negative patients.
      Therefore, uPA may be a good predictor of metastasis and prognosis.

PMID- 7777252
TI  - [The effect of the duration of culturing on the pluripotency of mouse embryonic
      stem (ES) cells in vitro and in vivo].
AB  - A comparative analysis of two clones of mouse embryonic stem cells (ES-D3) that
      underwent different number of passages was performed to determine their potencies
      for in vitro and in vivo development. Cells of both clones had similar morphology
      characteristic of undifferentiated ES cells and were capable of forming embryoid
      bodies in the suspension cultures. Specific alkaline phosphatase activity of ES
      cells was revealed by cytochemical staining. Karyotyping showed that the
      proportion of aneuploid ES cells increases with an increase in the number of
      passages. The results of experiments on chimera production using ES cells showed
      that the clone D3W (passage 17) is superior to the clone D3M (passage 42) in
      terms of both the proportion of chimeras produced and the degree of coat color
      chimerism in them.

PMID- 7777254
TI  - [An electron microscopic study of the structure of the indirect flight
      musculature at the pupal stage in the muscle mutant of Drosophila melanogaster].
AB  - Ultrastructure of indirect flight muscles was analyzed in Drosophila pupae
      heterozygous for the mutation l(2)MhcM66, which is an allele of the locus Mhc
      (Myosin heavy chain). It is demonstrated that the initial stages of muscle fiber
      differentiation in mutants proceed normally. First visible changes (elimination
      of individual thick protofibrils) are observed when myofibrils attain a certain
      size. Disintegration of the contractile apparatus progresses with growth of
      myofibrils. Mechanisms responsible for onset and development of these destructive
      processes during ontogeny are discussed.

PMID- 7777255
TI  - [The functional characteristics of the beta 2-adrenoreceptors on the isolated
      membranes and intact erythrocytes of rats].
AB  - The main parameters of [3H]-propranolol binding were determined for beta
      adrenoreceptors of membrane preparations and intact erythrocytes of white rats.
      It was shown that two molecules of [3H]-propranolol bind to one beta
      adrenoreceptor. Two pools of adrenoreceptors differing in their affinity to the
      ligand and their number on the erythrocyte membrane were identified. In
      experiments on ligand binding to intact erythrocytes, dissociation constants (Kd)
      of high-affinity and low-affinity pools differed by a factor of 17 (0.92 +/- 0.22
      and 15.39 +/- 2.69 nM, respectively); the number of receptors per cell differed
      by a factor of 9 (28 +/- 6 and 258 +/- 58). The maximal number of adrenoreceptors
      per erythrocyte was 286 +/- 57. In experiments with erythrocyte membrane
      preparations, dissociation constants of high-affinity and low-affinity pools
      differed by a factor of 25 (0.74 +/- 0.04 and 18.47 +/- 0.71 nM, respectively).
      The number of binding sites for the ligand differed by a factor of 3 (15.88 +/-
      7.53 and 71.55 +/- 43.68 fmoles/mg protein, respectively). The main parameters of
      the ligand-receptor interaction obtained using two methods gave similar
      quantitative characteristics of the functional activity of erythrocyte beta
      adrenoreceptors.

PMID- 7777253
TI  - [The cloning of fragments of homeobox genes expressed during planarian
      regeneration].
AB  - The polymerase chain reaction with degenerate primers corresponding to the most
      conservative amino acids 16-21 (ELEKEF) and 49-54 (WFQNRR) of the Antennapedia
      class homeodomain was used for the amplification of cDNA from regenerating
      planarians (asexual race of Dugesia tigrina). A total of six new Antennapedia
      like homeobox sequences, designated Dutarh-1-Dutarh-6 (Dugesia tigrina asexual
      race homeobox gene), were obtained. Their comparison with other homeobox genes
      using a "Genebee" software (the EMBL Data Library) showed that all sequences
      except Dutarh-6 belong to the Antennapedia class. Dutarh-6 is closely related to
      a recently described novel homeobox gene subfamily that includes mouse mesodermal
      homeobox genes Mox-1 and Mox-2 and rat homeobox gene Gax.

PMID- 7777256
TI  - [The activity of melanin-aggregating hormones in the blood and eyes in the early
      postnatal development of rats].
AB  - The activity of melanin-aggregating hormones (MAH) in the blood serum and
      homogenates of the eyes in four strains of rats was determined using the method
      of bioassay on dermal melanophores of tadpoles (Rana temporaria). This test
      system is sensitive to melatonin at concentration of 25.1 mg/ml and higher. MAH
      is detected in the blood at 9th and in eye homogenates at 15th days after birth
      in grey Norway rats, while in albino Wistar and pale hooded Campbell rats with
      hereditary retinal degeneration MAH is observed at the 3rd and 4th postnatal days
      respectively. No increase of MAH activity is found in black hooded Hunter rats
      with inherent retinal degeneration during the first five days after birth. Thus,
      Wistar and Campbell rats differ significantly from grey and Hunter rats by MAH
      activity in the blood and eyes during early postnatal development.

PMID- 7777257
TI  - [The effect of para-aminobenzoic acid on the level of proliferative activity in
      the regenerating cornea of adult rats (a radioautographic study)].
AB  - [3H]-Thymidine radioautography showed that 0.005% p-aminobensoic acid (PABA)
      solution applied three times per day on penetrating wounds in central part of the
      adult rat cornea selectively stimulates proliferative activity of corneal stroma
      keratoblasts. In control rats, a curve showing changes in index of labeled nuclei
      in corneal stroma had two peaks, on the second and sixth day after injury (about
      5 and 3%, respectively), whereas in animals receiving PABA treatment it had a
      single peak on the second day (about 12%). On days 7-14, indices of labeled
      nuclei in corneal stroma of both experimental and control rats become similarly
      low. No difference between experimental and control animals was revealed in
      indices of labeled nuclei in corneal epithelium: in both groups, corresponding
      curves had two peaks (about 9%) on the first and fifths days, and proliferation
      still continued two weeks after injury.

PMID- 7777258
TI  - [The theory of germ layers: the debatable aspects].
AB  - Data on early embryonic development of animals provided the basis for the
      following conclusions. In most (if not in all) species, germinal layers are not
      primitive structures recapitulating the initial organs of ancestral forms. The
      initial cell differentiation in the embryo is not directly associated with
      gastrulation, and the common concept of a fundamental relationship between
      germinal layer formation and cell differentiation is erroneous. Specification of
      cell types during early development and morphogenetic movements during
      gastrulation are relatively autonomous processes controlled by different genetic
      systems. The formation of germinal layers during individual development of
      different multicellular animals can be understood taking into account that
      segregation of cell layers is an essential element of epithelial morphogenesis.
      Movement of cells and cell layers during gastrulation is a specific manifestation
      of a general morphogenetic principle.

PMID- 7777259
TI  - [The nature of a nuclear growth-inhibiting factor].

PMID- 7777260
TI  - [Enzymes of the antioxidant system in the postnatal ontogeny of mink].
AB  - The activity of the key antioxidant enzymes, superoxide dismutase and catalase,
      was estimated in various organs of mink (Mustela vison Briss.) pups during
      postnatal ontogenesis. The organ-specific distribution of these enzymes was
      established and the levels of their activity were matched to certain periods of
      ontogenesis. This enzymatic system is already formed by the moment of birth, and
      further changes in it are related to the growth of organs and the effects of
      environmental factors.

PMID- 7777261
TI  - [Dimensionless criteria of the time for the development of Drosophila embryos,
      larvae and pupae and of bee embryos in tables of normal development].
AB  - The work reported in this paper constitutes the first attempt to apply the method
      of the dimensionless characteristic of development duration (Dettlaff and
      Dettlaff, Arch. Biol. (Liege), 1961, vol. 72, pp. 1-16) to insects, specifically
      Drosophila melanogaster and Apis mellifera.

PMID- 7777262
TI  - [The role of chlorine ions in progesterone production and oocyte maturation
      induced by a pituitary suspension in the follicles of the common frog].
AB  - Chloride channel blockers SITS (4-acetamido-4'-isothiocyanostilbene-2,2'
      disulphonic acid) and DIDS (4,4'-diisothiocyanostilbene-2,2'-disulphonic acid)
      significantly suppressed progesterone production (0.01-10 microM) in Rana
      temporaria follicle-enclosed oocytes and oocyte maturation (0.1-10 microM)
      stimulated by the homologous pituitary suspension (0.00125-0.005 pit/ml).
      Inhibition was dose-dependent. SITS (1 and 10 microM) did not affect the
      production of progesterone stimulated by dibutyrylcyclic AMP (2 and 3 mM). The
      substitution of chloride salts for equimolar concentrations of corresponding
      gluconates or of sodium chloride for sodium methanesulfonate also significantly
      increased the production of progesterone stimulated by the pituitary suspension
      (0.00125-0.0025 pit/ml) and its production in the intact follicle-enclosed
      oocytes in four out of six females. The reduction of extracellular chloride
      concentration significantly potentiated the "spontaneous" maturation of oocytes
      of all females.

PMID- 7777263
TI  - [Sex differences in the consequences of the hormonal treatment of male rats for
      their progeny].
AB  - The effects on male rats of single injections of androgens have been shown; this
      paper considers the responses of the immune and genital systems. The consequences
      for the progeny, with special reference to their sex and age, of androgenization
      of the father are considered in a comparative aspect. Deviations have been
      recorded in physical and sexual development, as well as in the genital system, in
      the progeny of both sexes. Furthermore, the male progeny is characterized by
      increased reactivity of the thymus.

PMID- 7777265
TI  - [The preservation of mammalian ova and embryos at positive near-zero
      temperatures. II. The general patterns and mechanisms of hypothermic exposure].
AB  - General patterns of the sensitivity of embryos to hypothermia are described, such
      as its species-specific dependence, its relationship with the embryonic stage,
      etc. Data are provided on differences in the cold resistance of the inner cell
      mass and trophectoderm cells, as well as that of the nucleus and cytoplasm. The
      mechanisms underlying the effects of cold on mammalian eggs and embryos are
      considered, and ways of improving the method of hypothermic storage are
      discussed. The general technological principles of the storage of mammalian
      embryos at positive near-zero temperatures are formulated for the first time.
      Advantages and drawbacks of the method and its possible practical application are
      discussed.

PMID- 7777264
TI  - [The level of sex steroids in the blood of inbred-strain mice during a normal
      pregnancy and after zygote retransplantation].
AB  - The effect of genotypes on the blood content of progesterone and estradiol was
      studied in female CBA, C57BL and BALB mice. We also studied progesterone content
      at the early stages of pregnancy after the effect of stress factors, such as
      narcosis and surgery, involved in the retransplantation of the embryo from the
      donor to the recipient. The levels of sex hormones increased during pregnancy
      with two peaks on the 6-8th and 14-18th days. The pattern of changes in the level
      of both hormones depends on the female genotype: at some stages, reliable
      interstrain changes in the blood content of both progesterone and estradiol were
      found. At the same time, narcosis and bilateral laparotomy did not affect the
      blood level of progesterone within 12 h after mating, despite marked activation
      of the adrenocortical system. The data obtained should be taken into account when
      selecting mother-fetus pairs for retransplantation of embryos in experimental and
      farm animals.

PMID- 7777266
TI  - Persisting temporal arteritis.

PMID- 7777267
TI  - Blood glucose control and vision outcome in diabetes.

PMID- 7777268
TI  - Endophthalmitis after pars plana vitrectomy. The Postvitrectomy Endophthalmitis
      Study Group.
AB  - PURPOSE: To describe the clinical course and incidence of culture-proven
      postvitrectomy endophthalmitis in 18 patients from five academic centers and
      three private practices. METHODS: Patients undergoing pars plana vitrectomy for
      recent trauma or endophthalmitis were excluded. The average age was 58 years
      (range, 21-85 year). Sixty-one percent of the patients (11/18) had diabetes
      mellitus. The indication for initial vitrectomy was vitreous hemorrhage (n = 10),
      macular epiretinal membrane (n = 3), recurrent retinal detachment with
      proliferative vitreoretinopathy (n = 2), retinal detachment with retinoschisis (n
      = 1), proliferative diabetic retinopathy with tractional retinal detachment (n =
      1), and dislocated intraocular lens (n = 1). None of these eyes received
      prophylactic intraocular antibiotics during the vitrectomy. RESULTS: All eyes
      were treated with intraocular antibiotics after the diagnosis of postvitrectomy
      endophthalmitis was made. Final visual acuity ranged from 20/20 to no light
      perception and included five eyes with 20/50 or better visual acuity and 11 eyes
      with less than 5/200 visual acuity. Nine eyes had a final visual acuity of no
      light perception. Of the 16 eyes infected with a single organism, 71% (5/7) of
      eyes infected with coagulase-negative staphylococci retained 20/50 or better
      final visual acuity compared with no eyes (0/9) infected with other organisms (P
      = 0.005). Two eyes infected with both coagulase-negative Staphylococcus and
      Streptococcus had a final visual acuity of 20/400. Three eyes with a total
      hypopyon later had enucleation or evisceration. Based on the data from four
      medical centers, the incidence of endophthalmitis after pars plana vitrectomy
      performed over the last 10 years was 9/12,216 (0.07%). CONCLUSION:
      Endophthalmitis after vitrectomy is rare. Postvitrectomy bacterial
      endophthalmitis caused by organisms other than coagulase-negative staphylococci
      has a poor visual prognosis.

PMID- 7777269
TI  - Proptosis as the initial presentation of fungal sinusitis in immunocompetent
      patients.
AB  - BACKGROUND: Fungal sinusitis typically occurs in immunocompromised patients. The
      authors report four cases of fungal sinusitis in immunocompetent young adults,
      all of whom had proptosis. METHODS: The diagnosis in all four patients was
      determined after orbital imaging and sinus biopsies. RESULTS: All four patients
      required surgical removal of the fungal source and anti-fungal chemotherapy
      postoperatively. CONCLUSION: Patients with proptosis, ocular pain, or other
      symptoms suggestive of orbital cellulitis unresponsive to antibiotic treatment
      should undergo radiographic imaging. If sinus disease is present, biopsy and
      culture may lead to the diagnosis of fungal disease. Surgical debridement and the
      appropriate systemic antifungal therapy usually lead to cure.

PMID- 7777270
TI  - Therapy of nonnecrotizing anterior scleritis with subconjunctival corticosteroid
      injection.
AB  - OBJECTIVE: To determine the safety and efficacy of subconjunctival triamcinolone
      (Kenalog) in treating nonnecrotizing anterior scleritis. DESIGN: The authors
      conducted a retrospective review of all patients treated with depot
      subconjunctival corticosteroid injection for scleritis from January 1988 to May
      1993. Response to therapy was determined by subjective improvement in pain and a
      decrease in clinical signs of ocular inflammation. All patients received
      subconjunctival injections of triamcinolone by the same technique, and the
      minimum observation period for complications was 6 weeks. RESULTS: Eighteen
      patients (90%) had relief of their symptoms with clinically observable
      improvement in inflammation, whereas two patients (10%) responded poorly. Nine
      patients (45%) required no further therapy. Average symptom-free interval was 18
      weeks in patients with recurrent scleritis. No complications of scleral thinning,
      perforation, or glaucoma occurred in any patients. CONCLUSION: Subconjunctival
      triamcinolone injection is highly efficacious in treating nonnecrotizing anterior
      scleritis without unreasonable risk of thinning and/or perforation and should be
      considered as adjunctive therapy in localized disease.

PMID- 7777272
TI  - Condensation on the posterior surface of silicone intraocular lenses during fluid
      air exchange.
AB  - PURPOSE: Posterior chamber foldable silicone intraocular lenses (IOLs) are
      becoming increasingly prevalent in patients undergoing a pars plana vitrectomy
      with fluid-air exchange. The authors report an important limitation of foldable
      silicone IOLs during fluid-air exchanges in pars plana vitrectomies. METHODS: The
      charts of 18 pseudophakic patients with foldable silicone IOLs who underwent
      vitrectomy with fluid-air exchange by the authors were reviewed. RESULTS: There
      was a statistically significant difference in the occurrence of condensation
      during fluid-air exchange between the group of patients with a capsulotomy versus
      those that did not have a capsulotomy (P = 0.003). Condensation limiting the view
      of the retina occurred during fluid-air exchange in 11 of 11 of the patients with
      foldable silicone lenses and a capsulotomy. Attempts to remove the condensation
      with a soft-tipped aspiration cannula resulted in limited view of the retina for
      1 to 2 minutes in 6 of 11 patients. Use of a thin film of silicone oil restored
      the view in one patient. In the presence of an intact posterior capsule,
      condensation did not occur on identical foldable silicone IOLs in seven of seven
      patients. CONCLUSION: Recognition of the presence of a foldable silicone lens is
      important when an air-fluid exchange is anticipated. If a capsulotomy is present,
      the surgeon must be aware that condensation may limit the view of the retina
      severely during and after surgery. Intraoperatively, the view of the retina
      usually can be restored in short surgeries by wiping the posterior lens surface
      with a soft-tipped cannula, and in more complex surgeries by applying a thin film
      of silicone oil on the posterior surface of the lens.

PMID- 7777271
TI  - IgE, IgE receptors, and other immunocytochemical markers in atopic and nonatopic
      patients with vernal keratoconjunctivitis.
AB  - BACKGROUND: Vernal keratoconjunctivitis (VKC) often is associated with atopy but
      a considerable part of the patients lack evidence of specific hypersensitivity.
      An immunocytochemical study was undertaken with the aim of detecting possible
      differences in the tissue inflammatory response between atopic and nonatopic
      subjects with VKC. METHODS: Conjunctival biopsy specimens from six atopic and
      three nonatopic subjects with VKC (age range, 7-17 years) and eight healthy
      control subjects (age range, 3-15 years) were analyzed with a panel of monoclonal
      and polyclonal antibodies. RESULTS: No distinct differences in cell counts
      between atopic and nonatopic subjects with VKC were observed. Vernal
      keratoconjunctivitis specimens as a whole showed higher counts than control
      specimens for CD3+, CD4+, HLA-DR+, CD38+, EG2+, CD68+, IgE+, FC epsilon RI+,
      IgA+, IgG+, and IgM+ cells in the substantia propria; and for CD1a+, IgE+, and
      EG2+ cells in the epithelium. CONCLUSIONS: Because the number of cells expressing
      CD4, EG2, IgE, and the high-affinity receptor for IgE, all of which are
      considered relevant in infiltrates of allergic conditions, were similar in atopic
      and nonatopic subjects, the authors conclude that the role of allergen-specific
      IgE sensitization in the pathogenesis of VKC remains unclear.

PMID- 7777273
TI  - Bilateral bullous exudative retinal detachment complicating idiopathic central
      serous chorioretinopathy during systemic corticosteroid therapy.
AB  - PURPOSE: To present evidence that systemic corticosteroid therapy may cause
      bilateral bullous serofibrinous exudative retinal detachment in some patients
      with idiopathic central serous chorioretinopathy. BACKGROUND: Idiopathic central
      serous chorioretinopathy usually causes mild, transient loss of central vision,
      usually in otherwise healthy men with a type A personality. A few patients have
      permanent visual loss because of chronic and recurrent retinal detachment. The
      clinical findings in these patients may lead to incorrect diagnoses and use of
      corticosteroid therapy. METHODS: The clinical and photographic records of three
      patients in whom bilateral bullous serofibrinous exudative retinal detachment
      associated with idiopathic central serous chorioretinopathy developed after
      treatment with systemic corticosteroids were reviewed. RESULTS: Systemic
      corticosteroid treatment was instituted (1) as a prophylaxis to prevent
      exacerbation of the disease while undergoing surgery in the fellow eye, and (2)
      as the result of misdiagnoses of multifocal choroiditis and retinal vasculitis
      (Eales disease). Two of the patients had a history of chronic recurrent retinal
      detachments before institution of corticosteroid treatment. In one of these
      patients, bilateral chronic inferior retinal detachment developed, causing
      peripheral retinal vascular nonperfusion, retinal neovascularization, and
      vitreous hemorrhage. All three patients had severe permanent visual loss in one
      or both eyes. CONCLUSION: The findings in these patients provide further evidence
      that systemic corticosteroid treatment may cause severe exacerbation of retinal
      detachment and lasting visual loss in some patients with idiopathic central
      serous retinopathy. Recognition of the atypical presentations of this disorder is
      important to avoid incorrect diagnoses and treatment.

PMID- 7777274
TI  - Optical coherence tomography of macular holes.
AB  - PURPOSE: To assess the potential of a new diagnostic technique called optical
      coherence tomography (OCT) for diagnosing and monitoring macular holes. This
      technique is a novel noninvasive, noncontact imaging modality that produces high
      longitudinal resolution (10-micron) cross-sectional tomographs of ocular tissue.
      METHODS: Optical coherence tomography is analogous to ultrasound except that
      optical rather than acoustic reflectivity is measured. Cross-sectional tomographs
      of the retina profiling optical reflectivity in a thin, optical slice of tissue
      are obtained with a longitudinal resolution of 10 microns. Optical coherence
      tomography was used to examine 49 patients with the clinical diagnosis of
      idiopathic full-thickness macular hole, impending macular hole, epimacular
      membrane with macular pseudohole, or partial-thickness hole. The resulting OCTs
      were correlated with contact lens and slit-lamp biomicroscopy, fundus
      photography, and fluorescein angiography. RESULTS: The cross-sectional view
      produced by OCT was effective in distinguishing full-thickness macular holes from
      partial-thickness holes, macular pseudoholes, and cysts. Optical coherence
      tomography was successful in staging macular holes and provided a quantitative
      measure of hole diameter and the amount of surrounding macular edema. Optical
      coherence tomography also was used to evaluate the vitreoretinal interface in
      patients' fellow eyes and was able to detect small separations of the posterior
      hyaloid from the retina. CONCLUSION: Optical coherence tomography appears
      potentially useful as a new, noninvasive, diagnostic technique for visualizing
      and quantitatively characterizing macular holes and assessing fellow eyes of
      patients with a macular hole. The tomographic information provided by OCT
      eventually may lead to a better understanding of the pathogenesis of macular hole
      formation.

PMID- 7777275
TI  - Treatment of idiopathic macular holes by induced posterior vitreous detachment.
AB  - PURPOSE: To determine if an expansile gas bubble can relieve vitreofoveal
      traction without vitrectomy by inducing a posterior vitreous detachment (PVD) in
      eyes with an idiopathic impending or full-thickness macular hole (stages 1-3).
      The status of the impending and full-thickness macular holes after gas injection
      and tamponade also was studied secondarily. METHODS: Eighteen patients
      participated in this pilot study. Eleven patients with an impending macular hole
      (stages 1A and 1B) and seven patients (8 eyes) with a full-thickness macular hole
      (stages 2 and 3) received gas injections and prospectively were followed for an
      average of 15.6 months (range, 3-42 months). RESULTS: A complete PVD was achieved
      in 18 of 19 eyes without a prior PVD within 2 to 9 weeks after gas injection. Ten
      of the 11 impending holes (all 7 had stage 1A holes; 3 of 4 had stage 1B holes)
      resolved after gas injection. After gas tamponade, three of six early full
      thickness (stage 2) macular holes closed. None of the stage 3 macular holes
      closed after gas injection. The mean best-corrected visual acuity of the
      successful eyes was 20/32. There were no major complications. CONCLUSION: An
      expansile gas bubble consistently can induce a PVD in aging eyes. The ability of
      an expansile gas bubble to induce a PVD with minimal morbidity and expense may
      have clinical applications for macular hole therapy. Impending macular holes may
      resolve and some early full-thickness (stage 2) macular holes may close after gas
      injection and tamponade without vitrectomy. The efficacy and safety of this
      procedure may be evaluated further in the context of a carefully designed
      prospective and randomized study for selected patients with an idiopathic
      impending or early macular hole.

PMID- 7777276
TI  - Fundus photographic and fluorescein angiographic characteristics of pseudoholes
      of the macula in eyes with epiretinal membranes.
AB  - BACKGROUND: The fluorescein angiographic characteristics in eyes with pseudoholes
      of the macula associated with epiretinal membranes have not been studied
      extensively. METHODS: Stereo photographs and fluorescein angiograms from 83
      consecutive eyes of 80 patients with pseudoholes of the macula were evaluated by
      two independent graders for epiretinal membrane opacity, fluorescence in the base
      of the pseudohole, and late perifoveal pooling of dye. RESULTS: Hyperfluorescence
      in synchrony with choroidal fluorescence appeared within the base of the
      pseudohole in 52 (63%) of the 83 eyes studied. The hyperfluorescence was smaller
      than the pseudohole in 37 (45%) eyes. Diffuse hyperfluorescence filled the
      pseudohole in 15 (18%) eyes. No fluorescence was seen in 20 (24%) eyes. Eleven
      (13%) eyes could not be graded due to coexistent macular disease or media
      opacity. Fluorescence within the area of pseudohole was less common in eyes with
      opaque epiretinal membranes than in eyes with visible or transparent epiretinal
      membranes (P = 0.002). Fluorescence within the area of the pseudohole was also
      less common in eyes with evidence of macular edema on fluorescein angiography (P
      < 0.001). The mean visual acuity was better for eyes with hyperfluorescence
      within the area of the pseudohole than for eyes without hyperfluorescence (P <
      0.01). CONCLUSION: A common fluorescein angiographic characteristic associated
      with pseudoholes of the macula is early hyperfluorescence within the area of the
      pseudohole. This hyperfluorescence coincides with choroidal filling and appears
      to be a form of transmission defect rather than a blocking of surrounding
      choroidal fluorescence by the epiretinal membrane. This central hyperfluorescence
      may result in misdiagnosis of the macular pseudohole as a full-thickness macular
      hole.

PMID- 7777277
TI  - Posterior segment complications after vitrectomy for macular hole.
AB  - PURPOSE: The purpose of this study is to assess the rate of posterior segment
      complications after vitreous surgery for macular holes and to evaluate the effect
      of such complications on final visual outcome. METHODS: The authors reviewed
      retrospectively all cases of vitreous surgery for macular holes performed between
      June 1990 and October 1993. Among 98 patients with a followup of 3 months or
      more, all patients with posterior segment complications during the postoperative
      course were identified. The rate of complications was compared with that seen
      after vitreous surgery for macular pucker performed by the same surgeons.
      RESULTS: Posterior segment complications were noted in 23 (23%) of 98 patients.
      These included peripheral retinal breaks (3%), rhegmatogenous retinal detachment
      from a peripheral retinal break (14%), enlargement of the hole (2%), late
      reopening of the hole (2%), retinal pigment epithelium loss under the hole (1%),
      photic toxicity (1%), and endophthalmitis (1%). In 40% of these eyes, the final
      visual acuity was two lines or more below preoperative visual acuity. When
      compared with the macular pucker group, the rate of posterior segment
      complications, in particular the rate of peripheral retinal tears and
      detachments, was significantly higher (P < or = 0.05). CONCLUSIONS: The authors
      conclude that visually significant posterior segment complications may occur
      after vitrectomy for macular hole, and the rate of these complications appears to
      be higher than expected.

PMID- 7777278
TI  - Choroidal hypoperfusion in acute posterior multifocal placoid pigment
      epitheliopathy. An indocyanine green angiography study.
AB  - BACKGROUND: The pathogenesis of acute posterior multifocal placoid pigment
      epitheliopathy remains obscure. The placoid lesions and characteristic findings
      on fluorescein angiography have been interpreted as representing either primary
      disease of the retinal pigment epithelium or disease of the choroidal
      vasculature. This study used indocyanine green (ICG) choroidal videoangiography
      to investigate this controversy. METHODS: Sequential choroidal videoangiography
      was performed with ICG and a scanning laser ophthalmoscope on patients with acute
      posterior multifocal placoid pigment epitheliopathy. Image analysis was used to
      differentiate between masking and ischemia as to the cause of hypofluorescence on
      the angiograms. RESULTS: Indocyanine green angiograms of acute posterior
      multifocal placoid pigment epitheliopathy showed areas of hypofluorescence in
      both the early and late pictures that correlated with the placoid lesions. Image
      analysis identified these as areas of choroidal hypoperfusion. Successive films
      showed partial or complete resolution of these hypofluorescent areas.
      CONCLUSIONS: Indocyanine green choroidal videoangiography has shown choroidal
      hypoperfusion to underlie the pathogenesis of acute posterior multifocal placoid
      pigment epitheliopathy.

PMID- 7777279
TI  - Quantitative assessment of the blue-light hazard during indirect ophthalmoscopy
      and the increase in the "safe" operating period achieved using a yellow lens.
AB  - PURPOSE: The indirect ophthalmoscope presents a blue-light hazard with the
      potential for causing photochemical injury to the retina. In this study, this
      hazard was assessed with respect to the threshold limit values (TLVs) recently
      adopted by the American Conference of Governmental Industrial Hygienists. METHOD:
      Spectral radiometric measurements were made from a standard indirect
      ophthalmoscope headset used in conjunction with either a clear or a yellow lens.
      The results were weighted spectrally with the published blue-light hazard
      function. RESULTS: When the clear lens was used, the TLV was exceeded after
      approximately 2.5 minutes. The yellow lens filtered out the more hazardous blue
      wavelengths of light and this increased the "safe" operating period by a factor
      of approximately 20. CONCLUSION: In clinical practice, with a clear lens, the TLV
      could be exceeded easily if the patient is subjected to prolonged or repeated
      examination because the blue-light hazard is additive in a linear manner for
      periods as long as 3 hours with a potential for a cumulative effect over longer
      periods. Furthermore, some ophthalmic patients, such as those with aphakia, are
      less tolerant of blue-light than healthy subjects. In the interests of patient
      safety, it is recommended that yellow lenses are considered for use for routine
      indirect ophthalmoscopy.

PMID- 7777280
TI  - Histopathology of bone spicule pigmentation in retinitis pigmentosa.
AB  - PURPOSE: To evaluate bone spicule pigmentation, a fundus feature in retinitis
      pigmentosa (RP) formed by migration of pigment-containing cells to perivascular
      sites in the inner retina. METHODS: The authors performed light and electron
      microscopy, including immunocytochemistry, on the retinas from ten patients with
      RP and five normal donors. RESULTS: The pigment-containing cells in regions of
      bone spicule pigmentation were derived from the retinal pigment epithelium (RPE).
      The translocated cells were remarkably polarized with a number of specializations
      characteristic of RPE cells in situ, but they did not contain lipofuscin granules
      and were not immunoreactive for cellular retinaldehyde-binding protein. The cells
      were linked by junctional complexes and formed epithelial layers around retinal
      vessels and next to the inner limiting membrane. Adjacent Muller cell processes
      contained glial fibrillary acidic protein-positive filaments and formed
      microvilli and intermediate junctions, resembling those in the external limiting
      membrane. Vascular endothelial cells adjacent to the translocated RPE cells were
      thin and fenestrated, resembling the choriocapillaris, and were separated from
      the pigmented cells by a layer of extracellular matrix similar in organization to
      Bruch membrane. Thickening of the matrix layer caused narrowing and occlusion of
      the vascular lumina. CONCLUSIONS: The lack of lipofuscin granules and cellular
      retinaldehyde-binding protein immunoreactivity in the translocated RPE cells is
      probably related to the loss of photoreceptors. The development of fenestrations
      in the endothelial cells correlates with the leakiness of retinal vessels to
      fluorescein observed in some cases of RP. Narrowing and occlusion of vascular
      lumina by thickening of the surrounding layer of extracellular matrix may
      contribute to the loss of inner retinal neurons found in RP. These changes in the
      RPE, blood vessels, glia, and inner neurons warrant consideration in designing
      therapies to restore vision to degenerate retinas.

PMID- 7777281
TI  - Predictors of outcome in patients who underwent cataract surgery.
AB  - PURPOSE: To identify preoperative patient characteristics associated with a lack
      of improvement on one or more measures 4 months after cataract surgery. METHODS:
      The authors collected preoperative and 4-month postoperative information on 552
      patients undergoing first-eye cataract surgery from the practices of 72
      ophthalmologists in three cities. The principal outcomes assessed were (1)
      Snellen visual acuity, (2) a cataract-related symptom score (possible range: 0, 0
      of 6 symptoms present or bothersome, to 18, all 6 symptoms very bothersome), and
      (3) a measure of functional impairment in patients with cataract--the VF-14 score
      (possible range: 0, inability to perform any of the applicable activities, to
      100, no difficulty performing any of the applicable activities). Multiple
      logistic regression was used to assess the association between preoperative
      patient characteristics and failure to improve on one or more outcome measures.
      Multiple linear regression was used to estimate the adjusted rate of lack of
      improvement in one or more outcome measures for one group of patients compared
      with another. RESULTS: Although 91 patients (16.5%) failed to improve on one or
      more of the outcome measures assessed, only 2 (0.4%) failed to improve on all
      three measures. The 91 patients who did not improve on at least one measure were
      approximately one sixth as likely to be satisfied with their vision
      postoperatively as the 461 patients who improved on all three outcome measures.
      Preoperative age of 75 years of age or older, VF-14 score of 90 or higher,
      cataract symptom score of 3 or lower, and ocular comorbidity (glaucoma, diabetic
      retinopathy, or age-related macular degeneration) were associated independently
      with increased likelihood of not improving on one or more measure (odds ratio:
      3.57, 2.10, 3.29, and 2.16, respectively). The mean adjusted rate of failure to
      improve on at least one of the outcome measures ranged from 20.5% to 26.5% for
      patients with these preoperative characteristics compared with 8.8% to 13.8% for
      those patients without them. The preoperative level of Snellen visual acuity was
      not associated with the likelihood of not improving on one or more of the
      outcomes assessed. CONCLUSIONS: The authors conclude that specific preoperative
      characteristics (age, comorbidity, cataract symptom score, and VF-14 score) are
      independent predictors of patient outcome after cataract surgery.

PMID- 7777283
TI  - Growth of the internal and external eye in term and preterm infants.
AB  - BACKGROUND: Better knowledge of the growth patterns of the external and internal
      eyes of neonates would permit more accurate diagnosis of disorders that affect
      ocular size such as infantile glaucoma and microphthalmos. Such disorders
      preferentially may affect certain parts of the internal eye but not other parts.
      No previous study statistically has evaluated internal ocular growth in preterm
      newborns. METHODS: A-scan ultrasonography was applied directly to the corneas of
      101 healthy preterm and term newborns to determine axial length, anterior chamber
      depth, lens thickness, and vitreous chamber depth. The growth of these structures
      was evaluated by correlation and regression analyses. RESULTS: At term, the mean
      measurements were axial length, 16.2 mm; anterior chamber depth, 2.0 mm; lens
      thickness, 3.8 mm; and vitreous chamber depth, 10.5 mm. Postconceptional age
      correlated to axial length (P < 0.001), anterior chamber depth (P = 0.032), and
      vitreous chamber depth (P < 0.001), but not to lens thickness (P = 0.48). By
      regression analysis, the eyes of males grew faster than those of females (P <
      0.001) mainly due to the vitreous chamber. CONCLUSION: In the last trimester and
      first 2 postnatal months, lens thickness remains constant, while the anterior
      chamber and, especially, the vitreous chamber deepen.

PMID- 7777282
TI  - The ultrasonic localization of retrobulbar needles during retrobulbar block.
AB  - PURPOSE: The tips of retrobulbar needles were visualized during retrobulbar block
      using ultrasound. The purpose of this study is to see how often the needle tip
      was located 5 mm behind the hind surface of the globe. METHODS: Twenty-five
      patients ranging in age from 22 to 84 years were studied after written informed
      consent was obtained. An ultrasonic photograph was taken before needle placement,
      with the needle in the proper position, and after local anesthetic had been
      injected. RESULTS: In none of the 25 patients studied was the needle tip at the 5
      mm mark behind the eye. Placement ranged from 0.2 to 3.3 mm behind the globe. In
      14 to 25 placements, the needle shaft was seen actually to indent the globe. The
      optic nerve was seen to be at least 9 mm from the needle tip in 6 of 25 patients.
      CONCLUSION: This study demonstrates that retrobulbar needle tips are closer to
      the globe than thought previously. A false sense of security may occur when
      performing retrobulbar blocks using only anatomic landmarks.

PMID- 7777284
TI  - A novel antibiofilm technology for contact lens solutions.
AB  - PURPOSE: Nonsteroidal anti-inflammatory drugs, including sodium salicylate,
      inhibit extracellular bacterial biofilm production. The authors studied the
      effect of the addition of sodium salicylate on bacterial adherence and biofilm
      formation on contact lenses and cases and commonly used medical polymers.
      METHODS: The study was done in vitro with bacterial adherence and biofilm
      measured on lenses and cases that were exposed to saline contaminated with
      Staphylococcus epidermidis and Pseudomonas aeruginosa with and without 1 and 3 mm
      sodium salicylate. Bacterial adherence to contact lenses was quantitated by a
      vortex assay and by scanning electron microscopy. Biofilm formation on contact
      lens cases and other polymers was measured by an optical density assay and a
      radiolabeling assay. RESULTS: Inhibition of biofilm formation was demonstrated on
      plastic contact lens cases in a dose-related manner with 1 and 3 mm sodium
      salicylate. A dose-related decrease in bacterial adherence also was noted. Assays
      with contact lenses also demonstrated less adherence in the presence of sodium
      salicylate. Electron micrographs of the contact lens showed less biofilm, most
      noticeable with 3 mm salicylate. Other studies demonstrated decreased adherence
      of S. epidermidis to polyethylene and polystyrene. Sodium salicylate also
      decreased biofilm on plastic tissue culture wells, but sorbic acid paradoxically
      increased deposition. CONCLUSION: The authors found that the addition of low-dose
      sodium salicylate to saline decreased the adherence of S. epidermidis and P.
      aeruginosa to contact lenses and lens cases. Biofilm production also was
      decreased on the lens cases and on medical polymers used to make plastic cases.
      These studies suggest that sodium salicylate deserves additional study to
      determine its use in contact lens solutions.

PMID- 7777285
TI  - Three-dimensional high-frequency ultrasonic parameter imaging of anterior segment
      pathology.
AB  - PURPOSE: High-frequency ultrasound allows high-resolution imaging of anterior
      segment anatomy and pathology. Acoustic echo data, however, contain information
      relating to the microanatomic structure of the interrogated tissue which is not
      evident in B-mode images. The aim of this study is to develop imaging techniques
      to demonstrate and quantify the distribution of acoustic scattering properties in
      ocular tissues in three dimensions. METHODS: A tumor of the iris and a hyphema
      were scanned using a 50-MHz ultrasound probe mounted on a computer-controlled two
      axis positioning system. Scan data from sequential parallel planes were used to
      make three-dimensional reconstructions. Digital signal processing and a
      mathematical model of acoustic backscatter then were used to represent the
      effective size and acoustic concentration of scattering elements using a false
      color representation superimposed on B-mode images. RESULTS: Three-dimensional
      reconstructions improved appreciation of the size and extent of pathology and
      allowed computation of tissue volumes. Parameter images demonstrated distinctive
      differences between diffuse and organized blood and allowed quantification of
      tumor scattering properties. CONCLUSIONS: Three-dimensional imaging of the
      anterior segment with high-frequency ultrasound allows construction of
      perspective images, which adds to the already significant clinical use of
      individual high-resolution B-mode images. Acoustic backscatter properties
      determined by tissue microstructure can be computed from echo data and
      represented in false color in three-dimensional reconstructions.

PMID- 7777286
TI  - Relation between the microcirculation architecture and the aggressive behavior of
      ciliary body melanomas.
AB  - PURPOSE: To study the relation between vascular patterns and the biologically
      aggressive behavior of ciliary body melanomas. METHODS: The authors compared the
      frequency distribution of vascular patterns by location for 234 uveal melanomas
      (54 tumors involving the ciliary body, and 180 without ciliary body involvement).
      Stepwise Cox regressions (for the endpoint of time-to-death due to melanoma),
      performed separately for melanomas with and without ciliary body involvement,
      included the following variables: size, vascular patterns, cell type, mean of the
      largest nucleoli, mitoses, tumor infiltrating lymphocytes, age, and sex. A
      separate Cox regression procedure included the variable of tumor location. Kaplan
      Meier survival curves were generated for time to melanoma death with ciliary body
      involvement and melanomas without ciliary body involvement for tumors containing
      or lacking vascular networks. RESULTS: These vascular patterns appear more often
      in the ciliary body than in the choroid: parallel vessels (P = 0.022), arcs (P =
      0.003), and parallel with cross-linking, arcs with branching, and loops and
      networks (all P = 0.0001). Stepwise regression for tumors confined to the choroid
      indicated that the presence of networks was the most significant variable (P =
      0.0001); stepwise regression for tumors with ciliary body involvement suggested
      that only one variable, networks, was significant (P = 0.0066). Kaplan-Meier
      survival estimates indicated that the survival of patients with tumors containing
      networks in the ciliary body was comparable to those containing networks in the
      choroid. CONCLUSION: Regardless of location, ciliary body or choroid, the
      presence of vascular networks shortens survival. The tumor location does not
      enter a stepwise Cox regression model when vascular patterns are included as
      variables. Therefore, the aggressive behavior of ciliary body melanomas appears
      to be related to the tendency for vascular networks to develop in this location.

PMID- 7777287
TI  - Clinical use for AC IOLs.

PMID- 7777288
TI  - Laser iridotomy.

PMID- 7777289
TI  - Laser iridotomy.

PMID- 7777290
TI  - Past precedents, present pressures, future problems: ophthalmology in 2001.

PMID- 7777291
TI  - Glaucoma after congenital cataract surgery.
AB  - OBJECTIVES: To study eyes that manifested glaucoma after congenital cataract
      surgery and to identify factors that might lead to better diagnosis and treatment
      of such glaucoma. DESIGN: A retrospective review of patients treated for glaucoma
      that developed after congenital cataract surgery. RESULTS: Sixty-four eyes of 38
      patients were studied. Open-angle glaucoma was the more frequent type of glaucoma
      (51 eyes, 79.7%). Glaucoma was diagnosed a mean interval of 12.2 years after
      cataract surgery, but it could occur at any time from months to decades after the
      cataract surgery. Medications alone were successful in intraocular pressure
      control in 21 (63.6%) of 33 eyes, and additional surgical procedures resulted in
      successful intraocular pressure control in 11 of 14 eyes in which they were
      performed. CONCLUSION: The authors cannot predict in which eyes glaucoma will
      develop after surgery for congenital cataracts. Once detected, the glaucoma can
      be treated successfully in the majority of cases. Careful follow-up, including
      examinations with the patient sedated or anesthetized as needed, is required.

PMID- 7777292
TI  - Treatment of postfiltration bleb leaks with autologous blood.
AB  - BACKGROUND: Managing filtration surgery bleb leaks can be difficult as well as
      frustrating. Treatment options traditionally have included aqueous suppressants,
      patching, and bleb compression devices. Previously, if conservative management
      failed, surgical revision was considered. METHODS: Six patients with thin
      avascular blebs and discrete leaking holes (2 had had full-thickness procedures,
      4 had had trabeculectomy with mitomycin C) underwent subconjunctival injection of
      approximately 1 ml of whole autologous blood. Injections were made just lateral
      and just medial to the domed cystic elevation of the blebs. RESULTS: Five of six
      eyes were leak-free by the second day after the procedure. No complications
      occurred. After 4 to 12 months of follow-up, four eyes are currently leak-free.
      In these eyes, intraocular pressure is between 8 and 12 mmHg. CONCLUSION:
      Subconjunctival peribleb injection of autologous blood may be a safe and helpful
      adjunct in treating selected postfiltration surgery bleb leaks.

PMID- 7777293
TI  - Confrontation visual field loss as a function of decibel sensitivity loss on
      automated static perimetry. Implications on the accuracy of confrontation visual
      field testing.
AB  - PURPOSE: To evaluate the accuracy of confrontation visual field testing with
      regard to the density of the visual field defect and its location in the
      peripheral visual field. METHODS: A prospective comparison of confrontation
      visual field testing with full-threshold Humphrey automated static perimetry C24
      2 or C30-2 was conducted at a university eye center over a 3-month period.
      Seventy-two patients with a variety of neurologic and ophthalmologic conditions
      underwent confrontation visual field testing and automated perimetry as a part of
      their evaluation. One visual field from each patient was analyzed for this study.
      RESULTS: Confrontation visual field testing yielded an overall sensitivity for
      detecting an abnormal visual field (full-field analysis) of 63%, when sensitivity
      of confrontation testing rested on the detection of just one abnormal quadrant.
      The sensitivity of confrontation testing varied depending on the type of visual
      field loss present: 51% for arcuate scotomas, 67% for visual field constriction,
      78% for altitudinal scotomas, and 90% for hemianopias. The sensitivity of
      detecting abnormal visual field quadrants, rather than the full-field analysis,
      was, however, poor at 38%. The sensitivity of confrontation testing was lower for
      superior quadrant defects and higher for inferior quadrant defects. The estimated
      probability of detecting an abnormal visual field quadrant occurring at a -26
      decibel sensitivity loss from age-matched healthy patients for superior quadrant
      defects and a -19-decibel sensitivity loss for inferior quadrant defects was 50%.
      The increased sensitivity noted for visual field defects and for inferior
      quadrant defects appears to be related, in part, to the density of the visual
      field loss present. CONCLUSION: Confrontation visual field testing is relatively
      insensitive unless a moderate to dense defect is present, and as such is a poor
      screening test. However, when visual field defects are identified with
      confrontation visual field testing, the defects often are real as per the high
      specificity (97%) and high positive predictive value (96%).

PMID- 7777294
TI  - Elastosis of the lamina cribrosa in pseudoexfoliation syndrome with glaucoma.
AB  - BACKGROUND: Pseudoexfoliation syndrome is characterized by the presence of
      glycoprotein fibers in ocular and extraocular tissues, and often is associated
      with glaucoma. Pseudoexfoliation material may be associated closely with elastic
      microfibrillar-associated glycoprotein as well as elastin. METHODS: Four optic
      nerve heads of two patients with pseudoexfoliation syndrome and glaucoma were
      examined using electron microscopy and immunogold detection of elastin. Optic
      nerve heads from healthy age-matched individuals and patients with primary open
      angle glaucoma were used for comparisons. RESULTS: In all eyes with
      pseudoexfoliation and glaucoma, there was marked and widespread elastosis in the
      connective tissue of the lamina cribrosa. Elastotic fibers appeared as large and
      irregular aggregates of electron-dense material labeled with anti-elastin
      antibody. Abundant microfibrils were interspersed in the elastotic aggregates,
      whereas no typical pseudoexfoliation fibers were observed. In contrast, there
      were less elastotic fibers in the lamina cribrosa from patients with primary open
      angle glaucoma compared with pseudoexfoliation glaucoma. Other changes of
      extracellular matrix were similar to those observed in primary open-angle
      glaucoma: decreases in collagen fiber density, presence of basement membranes not
      associated with cell surfaces, and abundant bundles of microfibrils not labeled
      with elastin antibody. The elastic fibers appeared normal in other locations
      within the optic nerves of patients with pseudoexfoliation glaucoma, including in
      the pial septa and blood vessels of the retrolaminar myelinated optic nerve.
      CONCLUSION: The authors' findings demonstrate marked and site-specific elastosis
      in the lamina cribrosa of patients with pseudoexfoliation syndrome with glaucoma,
      suggesting an abnormal regulation of elastin synthesis and/or degradation in the
      optic nerve of patients with this disease.

PMID- 7777295
TI  - 5-Fluorouracil filtering surgery and neovascular glaucoma. Long-term follow-up of
      the original pilot study.
AB  - BACKGROUND: The long-term efficacy and safety of filtering surgery with 5
      fluorouracil (5-FU) in eyes with neovascular glaucoma are unknown. METHODS:
      Kaplan-Meier survival curve analysis of surgical outcome was performed on all 34
      patients (34 eyes) enrolled from May 1982 through April 1986 in the original
      pilot study of filtering surgery with 5-FU. RESULTS: Success rates at the 1-, 2-,
      3-, 4-, and 5-year intervals were 71%, 67%, 61%, 41%, and 28%, respectively. The
      median filter survival time was 38.7 months (95% confidence interval: 32-45
      months). Twelve (35%) of 34 patients lost light perception vision, and phthisis
      bulbi developed in 8 (24%) of 34 patients. Age of 50 years or younger (P <
      0.0001) and type 1 diabetes (P = 0.0004) were significant risk factors for
      surgical failure. The 1-year success rate for patients no older than 50 years of
      age was 23% compared with a 95% success rate in patients older than 50 years of
      age. After adjustment for age, type 1 diabetes was a borderline risk factor (P =
      0.06). CONCLUSION: There is a high risk of long-term failure of filtering surgery
      with 5-FU in neovascular glaucoma. Patients 50 years of age or younger have an
      extremely poor prognosis. Patients older than 50 years of age have initial short
      term success with an accelerated failure rate after 3 years.

PMID- 7777296
TI  - In vitro and in vivo flow characteristics of glaucoma drainage implants.
AB  - PURPOSE: To determine pressure-flow characteristics at physiologic flow rates in
      vitro and in vivo in rabbits for Ahmed, Baerveldt, Krupin disk, and OptiMed
      glaucoma implants. The Molteno dual-chamber implant also was evaluated in vivo
      only. METHODS: Five samples of each glaucoma implant were studied. Baerveldt
      implants were ligated partially for in vitro testing. Opening and closing
      pressures in air or after immersion in balanced salt solution or plasma were
      evaluated for the valved devices (Ahmed and Krupin). Pressures were measured in
      vitro and in vivo in normal rabbits at flow rates preset at between 2 and 25
      microliters/minute after the tubes were connected to a closed manometric system.
      In vivo measurements were made 24 hours after implantation. Resistance to flow
      was calculated using Poiseuille's equation after at least three separate flow
      rate readings. RESULTS: In air, the Ahmed and Krupin valves had opening pressures
      of 9.2 +/- 3.4 and 7.2 +/- 0.6 mmHg and closing pressures of 5.2 +/- 0.9 and 3.9
      +/- 1 mmHg, respectively. Neither opening nor closing pressures could be
      determined when Ahmed and Krupin valves were immersed. In vitro, the Ahmed and
      OptiMed devices had higher pressures than did other devices at a 2
      microliters/minute flow rate of balanced salt solution. During perfusion with
      plasma, only the OptiMed device maintained higher pressures than with balanced
      salt. With all devices, pressures fell rapidly to zero after flow was stopped.
      The OptiMed device demonstrated the highest resistance values. In vivo, the Ahmed
      device provided pressures of 7.5 +/- 0.8 mmHg and the OptiMed device gave
      pressures of 19.6 +/- 5.6 mmHg at a 2-microliters/minute flow rate. After 15
      minutes of flow shutdown, the OptiMed implant maintained pressures of 7.1 +/- 1.1
      mmHg. The Baerveldt (nonligatured), Krupin, and Molteno dual-chamber implants had
      similar resistances and pressures in vivo. Pressures with all devices in vivo
      fell rapidly to zero after conjunctival wound disruption. CONCLUSION: Neither the
      Ahmed nor Krupin devices had demonstrable opening or closing pressures when
      tested in vitro immersed in balanced salt solution or plasma. With all devices,
      pressures were higher in vivo than in vitro due to tissue-induced resistance
      around the explant. Both Ahmed and Krupin valves functioned as flow-restricting
      devices at the flow rates studied, but did not close after initial perfusion with
      fluid.

PMID- 7777297
TI  - Visual loss after neurosurgical repair of paraclinoid aneurysms.
AB  - OBJECTIVE: To describe three cases of unexplained visual loss after technically
      successful clipping of paraclinoid aneurysms. DESIGN: Three case reports are
      presented. RESULTS: Profound blindness occurred in all three patients. Only one
      patient had marked visual recovery. Two clinical patterns were observed. A
      fulminant orbital syndrome presumably from compromise of large draining veins of
      the orbit was observed in one patient. A retrobulbar optic neuropathy that might
      have resulted from either direct injury or damage to small dural vessels of the
      posterior optic nerve was observed in the other two patients. CONCLUSIONS: There
      is a risk of postoperative blindness after clipping of paraclinoid aneurysms. The
      frequency of this complication may increase because attempts to repair these
      aneurysms are becoming more common. Patients with paraclinoid aneurysms should
      receive preoperative and postoperative neuro-ophthalmologic examinations.

PMID- 7777298
TI  - The attenuation of blue-on-yellow perimetry by the macular pigment.
AB  - PURPOSE: To determine the influence of macular pigment absorption on blue-on
      yellow perimetry using a technique suitable for application with the Humphrey
      Field Analyzer. METHODS: The sample comprised one eye from each of 46 healthy
      subjects (age range, 20-80 years). Macular pigment absorption was assessed by
      measuring medium-wavelength sensitive cone sensitivity for 460- and 570-nm
      narrowband stimuli at the fovea, at 5.5 degrees and at 8 degrees eccentricity.
      The differences in sensitivities recorded between the fovea and 8 degrees
      eccentricity and between 5.5 degrees and 8 degrees eccentricity for the 460-nm
      stimulus relative to a value of zero at 570 nm were attributed to absorption by
      the macular pigment. Blue-on-yellow perimetry was undertaken using a 460-nm
      narrowband blue Goldmann size V stimulus and a yellow 330-cdm-2 background.
      RESULTS: Group macular pigment absorption (mean +/- standard error) was 0.40 +/-
      0.03 log units foveally and 0.00 +/- 0.03 log units at 5.5 degrees eccentricity.
      The group mean foveal macular pigment absorption was significantly different from
      zero (P < 0.01). The coefficient of repeatability for the macular pigment
      absorption procedure (based on test-retest data for 16 subjects) was +/- 0.28 log
      units at the fovea and +/- 0.35 log units at 5.5 degrees eccentricity.
      CONCLUSION: The net effect of ocular media and macular pigment absorption
      relative to 460 nm was to attenuate the blue-on-yellow visual field at the fovea
      by approximately 0.80 log units and elsewhere by 0.40 log units.

PMID- 7777299
TI  - Ciliary body neurilemoma. Unusual clinical findings intimating the diagnosis.
AB  - BACKGROUND: Neurilemomas (schwannomas) rarely occur intraocularly. When present,
      they pose a diagnostic dilemma for the physician and often are mistaken as a
      malignant lesion, resulting in enucleation. METHODS: The authors report the
      clinical findings of a 46-year-old man with a slowly progressive growing mass of
      the anterior chamber, associated with glaucoma and the development of cataract.
      To further delineate the tumor's features, ancillary techniques, including
      ultrasonography, computed tomography, and magnetic resonance imaging, were
      conducted. A definitive anterior chamber biopsy of the tumor was performed with
      histologic examination and electron microscopy. RESULTS: Ultrasonography, high
      resolution computed tomography and magnetic resonance imaging showed a well
      delineated mass of the inferior ciliary body involving nearly 5 clock hours of
      the angle. Two clinical features that suggested a longstanding tumor were
      brilliant transillumination of the mass (leading to the impression of a "cystic
      mass," not corroborated by ultrasonography) and retrodisplacement of the involved
      iris root. The histology, and particularly the electron microscopic features,
      confirmed the diagnosis of a neurilemoma, a benign tumor of the anterior segment.
      CONCLUSION: Intraocular neurilemomas are extremely rare tumors. Few are well
      documented with modern ancillary techniques. Clinical findings in conjunction
      with radiographic and ultrasonic features may support the diagnosis of a benign
      tumor. For this patient, confirmation via biopsy permitted combined cataract and
      glaucoma surgery to rehabilitate the eye, which retains 20/20 visual acuity 3
      years after the procedure.

PMID- 7777300
TI  - Acquired ptosis in the young and middle-aged adult population.
AB  - PURPOSE: The authors studied the etiology of acquired ptosis in the young to
      middle-aged adult population with specific attention to the role of rigid contact
      lens use. METHODS: The study consisted of all patients between the ages of 15 and
      50 years with acquired ptosis who presented between April 1986 and May 1994.
      Potential factors responsible for acquired ptosis were investigated in all
      patients with specific attention directed to history and duration of contact lens
      wear. RESULTS: In the consecutive series of 91 young to middle-aged adults with
      acquired ptosis, we found contact lens wear to be the only identifiable cause in
      47% of patients. This was the most common cause for acquired ptosis in this age
      group. Trauma was a distant second cause, accounting for 19% of patients. Of the
      contact lens-induced ptosis, 58% were unilateral and 42% were bilateral. Of the
      25 patients who wore contact lenses and had unilateral ptosis on examination,
      manual elevation of the ptotic lid showed an unsuspected contralateral ptosis to
      be manifest in seven patients due to Hering's law. Ptosis was overwhelmingly
      associated with rigid contact lens wear, and levator aponeurosis disinsertion was
      found in the large majority at the time of surgical repair. CONCLUSION: This
      study suggests that contact lens-induced ptosis is a much more common cause of
      acquired ptosis in young and middle-aged adults than has been suspected
      previously. The ptosis is primarily due to levator aponeurotic disinsertion,
      presumably due to recurrent traction on the aponeurosis during rigid contact lens
      removal.

PMID- 7777301
TI  - Pneumatic retinopexy failures. Cause, prevention, timing, and management.
AB  - BACKGROUND: Pneumatic retinopexy is a procedure for reattaching the retina by
      injecting an expanding gas bubble and using either laser or cryopexy. The
      procedure is controversial because there may be a lower initial success rate, and
      intraocular gas may increase the risk of proliferative vitreoretinopathy.
      METHODS: The authors performed a retrospective review of 107 unpublished
      consecutive cases of pneumatic retinopexy together with a literature review of 25
      statistical series with primary attention to failures. Univariate and
      multivariate analyses were carried out on the data set, and adjusted odds ratios
      for risk factors associated with failure were calculated using logistic
      regression. RESULTS: Initially, 74 (69%) of 107 patients had successful results,
      and with re-operations the success rate increased to 98%. Failure of the
      procedure to achieve retinal reattachment occurred soon after the initial
      procedure, with 86% of recorded failures occurring within the first month. The
      initial cause of failure was new or missed breaks in 14.9%, reopened initial
      breaks in 11.2%, and breaks never closed in 4.6%. Risk factors that showed a
      correlation with failure were patients being male (adjusted odds ratio = 2.65),
      eyes with preoperative visual acuity worse than 20/50 (adjusted odds ratio =
      1.21), eyes with four quadrants of retinal detachment or total detachment
      (adjusted odds ratio = 2.03), aphakic or pseudophakic eyes (adjusted odds ratio =
      1.91), and eyes with additional pathologic findings (adjusted odds ratio = 3.14).
      Poor visual outcome was associated with initial visual acuity less than 20/50
      (adjusted odds ratio = 15.7) and eyes with four quadrants of retinal detachment
      or total detachment (adjusted odds ratio = 5.01). CONCLUSIONS: Failures of
      pneumatic retinopexy occur early in the postoperative course. Factors known to be
      associated with failure of retinal reattachment using scleral buckling also were
      associated with failure in pneumatic retinopexy. A higher success rate in females
      was noted, suggesting that educational efforts may need to be greater in males.
      Poorer visual results occurred in patients with poor initial vision and in eyes
      with four quadrants of retinal detachment or total detachments.

PMID- 7777302
TI  - Macular changes in pseudotumor cerebri before and after optic nerve sheath
      fenestration.
AB  - PURPOSES: Macular abnormalities such as chorioretinal striae, pigmentary
      disturbances, exudates, and subretinal hemorrhage or scar can occur in patients
      with pseudotumor cerebri. The purpose of this study is to determine the potential
      resolution of the macular abnormalities after optic nerve sheath fenestration, as
      well as the visual significance of these changes. METHODS: The authors
      retrospectively compared the preoperative and postoperative examinations of seven
      patients with pseudotumor cerebri-associated macular changes who underwent
      unilateral optic nerve sheath fenestration. RESULTS: Preoperatively, visual
      acuity was worse than 20/25 in two patients with macular exudates and in one with
      a subretinal scar. Chorioretinal striae and pigment mottling did not appear to
      decrease visual acuity. With a mean postoperative follow-up of 14 months, the
      patients with exudates had improvement in visual acuity and clearing of the
      exudates, unlike the patient with the subretinal scar. Chorioretinal striae,
      pigment mottling, and the subretinal scar did not resolve with surgery.
      CONCLUSIONS: This study suggests that chorioretinal striae and pigment mottling
      in the setting of pseudotumor cerebri, unlike exudates and subretinal scars, do
      not have a significant effect on visual acuity. After optic nerve sheath
      fenestration, only macular exudates decreased. Therefore, the persistence of
      striae, pigment mottling, and macular scars, in the face of resolved papilledema
      and improved visual fields, does not indicate failure of the optic nerve sheath
      fenestration.

PMID- 7777304
TI  - Penetrating keratoplasty after radial keratotomy. A report of six patients.
AB  - BACKGROUND: For more than 15 years, radial keratotomy has increased in popularity
      as an option for treating myopia in the United States. During this period of
      time, the procedure has been modified to improve results and decrease
      complications. Despite these changes, complications from radial keratotomy
      continue to occur. The authors report six cases of penetrating keratoplasty
      performed to correct significant loss of vision resulting from complications of
      radial keratotomy. METHODS: The surgical records of one author (WR) were reviewed
      retrospectively for penetrating keratoplasties performed for complications of
      radial keratotomy. RESULTS: Six cases of penetrating keratoplasty performed for
      complications of radial keratotomy were found. Severe loss of vision was the
      indication for surgery in each case, and was associated with aggressive and
      repeated incisional refractive attempts to correct astigmatism, hyperopic
      overcorrection, residual myopia, or refractive errors associated with
      keratoconus. Glare associated with subepithelial scarring and irregular
      astigmatism were the primary findings associated with loss of vision.
      CONCLUSIONS: Despite advances in technique and instrumentation, radial keratotomy
      is limited in the amount of myopia it can correct. The risk for loss of vision
      increases with increasing number of incisions, intersecting incisions, very small
      optical zones, and keratoconus.

PMID- 7777303
TI  - Vortex vein exit sites. Scleral coordinates.
AB  - PURPOSE: The authors determined the frequency and scleral coordinates of vortex
      vein exit sites in 46 autopsy eyes to provide topographic data that will enable
      surgeons to locate these vessels more precisely. METHODS: Forty-six autopsy eyes
      were examined under a dissecting microscope to measure the frequency of vortex
      veins and the cord lengths between the vortex vein scleral exit sites and the
      limbus, rectus muscle insertions, and oblique muscle insertions. RESULTS: Data
      from this study showed that 32 (70%) of the 46 individual eyes studied had more
      than four vortex veins. The number of second or third vortex veins found in the
      nasal quadrants was significantly higher than the number found in the temporal
      quadrants (P < 0.01). Statistical analyses of the measurements provided mean
      values for distances between vortex vein scleral exit sites and the three nearest
      extraocular muscle insertions; these positions among eyes were found to be
      relatively uniform (standard deviation, 0.7-2.5 mm). CONCLUSION: The authors
      suggest that the majority of adult eyes encountered by a surgeon will have more
      than four vortex vein exit sites and that more vortex veins may be expected in
      the nasal quadrants than in the temporal quadrants. This study delineates the
      locations of vortex vein exit sites so that surgeons can reliably predict their
      surface positions to avoid vessel laceration and its ensuing complications.

PMID- 7777305
TI  - Corneal topography of phase III excimer laser photorefractive keratectomy.
      Optical zone centration analysis. Summit Photorefractive Keratectomy Topography
      Study Group.
AB  - PURPOSE: To determine the amount of optical zone decentration in patients who
      have undergone excimer laser photorefractive keratectomy (PRK) and assess
      associations of both decentration and optical zone size with clinical outcomes.
      METHODS: Optical zone centration in 185 patients after PRK was analyzed using
      computer-assisted videokeratography. A comparison of decentration among the five
      study centers was performed. Associations of clinical outcomes with procedure
      decentration and optical zone size were assessed. RESULTS: Decentration from the
      pupil center ranged from 0.00 to 1.44 mm (mean, 0.46 mm): 21.8% were decentered
      0.25 mm or less, 42.5% > 0.25 mm and < or = 0.50 mm, and 97.1% < or = 1.00 mm. In
      both eyes, the average decentration from the pupil center was located
      inferonasally. Decentrations among the five study centers were significantly
      different. Decentration was associated with attempted refractive correction,
      change in keratometric cylinder, and patient satisfaction. There was a trend
      toward worse postoperative uncorrected visual acuity with greater decentration
      but no association with best-corrected vision, predictability, or refractive
      astigmatism. No significant relation was found between decentration and
      glare/halo ranking; however, three of six patients with 1.00 mm or greater of
      decentration demonstrated a high glare/halo grade. Although optical zone size was
      not associated with glare or halo, subjective patient satisfaction was greater
      with a 5.0-mm optical zone than with a 4.5-mm optical zone. CONCLUSIONS:
      Centration is an important surgeon-controlled variable in excimer laser PRK.
      Decentration of excimer laser refractive procedures was found to be nonrandom and
      may be influenced by preoperative pupil management. Moreover, the amount of
      decentration may influence clinical outcomes. Improved techniques and centering
      procedures on nonmiotic pupils may improve future results.

PMID- 7777306
TI  - Corneal topography of phase III excimer laser photorefractive keratectomy.
      Characterization and clinical effects. Summit Photorefractive Keratectomy
      Topography Study Group.
AB  - PURPOSE: To define qualitative patterns of corneal topography after excimer laser
      photorefractive keratectomy (PRK), assess changes in patterns, associations with
      clinical outcomes, and the accuracy of videokeratography in predicting results,
      and define quantitatively the optical zone contour. METHODS: Computer-assisted
      videokeratography data obtained from 181 patients after PRK was analyzed.
      Topography patterns at two time points were characterized, and associations with
      clinical outcomes were tested. Power change predicted by topography was compared
      with refractive change, and cross-sectional power contours were analyzed.
      RESULTS: Seven topography patterns were defined. At 1 year, 58.6% of corneas
      showed a homogeneous topography, 17.7% showed a toric-with-axis configuration,
      2.8% showed a toric-against-axis configuration, 13.8% showed an irregularly
      irregular topography, 2.8% showed a keyhole/semicircular pattern, and 4.4% showed
      focal topographic variants. No central island patterns were found. Of the maps,
      41% changed over time. Uncorrected vision, predictability, and patient
      satisfaction were best in the homogeneous group. Astigmatism increased in the
      irregular and toric-against-axis groups and decreased in the toric-with-axis
      group. There was no relation of topography pattern to best-corrected vision or
      subjective glare/halo. Cross-sectional power profiles showed a homogeneous power
      change for the central 3 mm with a diminution in correction toward the periphery.
      The topography unit tended to overestimate refractive change for corrections of 5
      diopters or less and underestimate the change for corrections greater than 5
      diopters. CONCLUSIONS: Topography patterns after PRK are identifiable, time
      dependent, and may affect clinical outcomes. Understanding the actual corneal
      optical contour resulting from PRK may aid in improving both laser techniques and
      optical results in the future.

PMID- 7777309
TI  - Rabies in Southern and Eastern Africa. Proceedings of a workshop. Onderstepoort,
      South Africa, 3-5 May 1993.

PMID- 7777308
TI  - Shield ulcers and plaques of the cornea in vernal keratoconjunctivitis.
AB  - BACKGROUND: Shield-shaped corneal ulcers and plaques are serious sight
      threatening corneal manifestations of vernal keratoconjunctivitis. There are few
      reports describing the management of these patients and their outcomes. METHODS:
      The clinical presentation, treatment, and outcome of 66 shield ulcers and/or
      plaques in 55 eyes of 41 patients with vernal keratoconjunctivitis were studied
      in this retrospective study of patients treated at King Khaled Eye Specialist
      Hospital during an 11-year period. RESULTS: Patients with shield ulcers where the
      base of the ulcer was transparent usually had rapid re-epithelialization and an
      excellent visual outcome with medical treatment alone. Patients with shield
      ulcers and visible plaque formation had delayed re-epithelialization when
      receiving only medical treatment. Complications of delayed re-epithelialization
      consisted of bacterial keratitis in five eyes, amblyopia in one eye, and
      strabismus in one patient. CONCLUSIONS: Patients with shield ulcers and/or
      plaques that do not re-epithelialize once active vernal keratoconjunctivitis has
      been controlled should have surgical intervention. In this series, a simple
      scraping of the base and margins of the ulcer with removal of the inflammatory
      material (i.e., the plaque) resulted in rapid re-epithelialization in 20 of 23
      ulcers and plaques. An algorithm for treating shield ulcers and/or plaques is
      presented based on the experience at this institution.

PMID- 7777307
TI  - Controlled evaluation of a bandage contact lens and a topical nonsteroidal anti
      inflammatory drug in treating traumatic corneal abrasions.
AB  - BACKGROUND: Treating traumatic corneal abrasions is a common problem for the
      ophthalmologist. Traditional management has been the use of a pressure patch.
      Three different therapeutic modalities were evaluated for their efficacy in
      treating traumatic corneal abrasions. METHODS: Forty-seven consecutive patients
      with traumatic corneal abrasions were randomized prospectively in a single
      masked, controlled clinical trial which compared the efficacy of (1) pressure
      patching, (2) a bandage contact lens, and (3) a bandage contact lens with a
      topical nonsteroidal anti-inflammatory drug (0.5% ketorolac tromethamine).
      RESULTS: There was no significant difference in the healing time of the three
      groups. However, psychometric analysis showed a significant decrease in pain in
      the group that received a bandage contact lens with a topical nonsteroidal anti
      inflammatory drug. There was a significant difference in the ability to return to
      normal activities in both contact lens groups compared with the pressure-patch
      group. There was no significant difference among the three groups with respect to
      photophobia, redness, ocular irritation, headache, or tearing. CONCLUSION: Use of
      a bandage contact lens significantly shortens the time required for a patient to
      return to normal activities. Moreover, addition of a nonsteroidal anti
      inflammatory drug to a treatment regimen significantly decreases the pain
      associated with traumatic corneal abrasions. Use of a bandage contact lens with a
      topical nonsteroidal anti-inflammatory may prove to be an effective adjunct in
      treating traumatic corneal abrasions.

PMID- 7777310
TI  - The rabies virus genome: an overview.
AB  - The replication strategy, genome organization and extent of variation within the
      genome of the genus Lyssavirus is briefly reviewed. Strategies used in the
      approach to genome studies are discussed.

PMID- 7777311
TI  - Taxonomy and evolutionary studies on lyssaviruses with special reference to
      Africa.
AB  - Currently, the Lyssavirus genus is composed of four serotypes and the ungrouped
      European bat lyssaviruses (EBL). Using previously described PCR amplification and
      direct sequencing methods, the N genes of 70 representative lyssaviruses
      collected from 40 different countries were examined. From the results, a
      phylogenetic tree with six branches (genotypes) was constructed: genotypes 1-4
      correlated with the classification of serotypes 1-4 and in addition EBL 1 and EBL
      2 were identified as two further genotypes (5 and 6). Analysis of the 51 rabies
      (genotype 1) viruses in the study identified nine distinct groups which could be
      correlated with their geographical origins. A comparison of the six genotypes
      with four principal Vesiculovirus serotypes showed that their relationship was
      closer than that of even the two most closely related Vesiculovirus serotypes.
      Antigenic site sequences of isolates from vaccine/treatment failures were similar
      to vaccine and field strains, suggesting that failures were not due to genetic
      variation at the N protein level.

PMID- 7777314
TI  - Canid and viverrid rabies viruses in South Africa.
AB  - Historical records suggest that in South Africa rabies was present in viverrids
      in the early 1800s. In the early 1950s a wave of canine rabies spread from
      Namibia through Botswana into the northern Transvaal and by 1961 a second front
      had penetrated south from Mozambique into Swaziland and northern Natal. Today,
      rabies is regularly confirmed in a number of canid and viverrid species in most
      regions of South Africa. A panel of anti-nucleoprotein monoclonal antibodies was
      used to examine 83 virus isolates from these species. Two major reaction
      patterns, one chiefly confined to viruses from canids and the other to viruses
      from viverrids, were obtained. In addition, some variation in the reaction
      patterns of viverrid viruses was observed and spill-over of viverrid virus into
      canids and vice versa was recorded. Rabies in South Africa appears to behave as
      two distinct disease entities.

PMID- 7777313
TI  - Molecular analysis of rabies-related viruses from Ethiopia.
AB  - From brain samples collected from domestic animals in Ethiopia, two rabies
      related viruses were isolated. According to their reactivity pattern with anti
      nucleocapsid monoclonal antibodies, they were characterized as Lagos bat virus
      (isolate Eth-58) and Mokola virus (isolate Eth-16). This classification was
      confirmed by neutralization experiments with Mokola and Lagos bat specific
      antisera. Two potent anti-rabies vaccines were unable to protect mice against the
      two rabies-related viruses. In order to investigate molecular relationships to
      classical rabies virus, cDNA cloning and sequencing was performed. The RNA genome
      of both viruses comprises 12 kilobases (kb) and has an organization similar to
      that of rabies virus with the gene order 3'-N-P-M-G-L-5'. Using virus-specific
      cDNA as probes in heterologous hybridization experiments, the RNAs of other
      members of lyssavirus serotypes 2 and 3 were detected. From hybridization
      experiments and sequence analysis of the 3' terminal 5,5 kb of the genomes, Eth
      16 and Eth-58 viruses were shown to be equally genetically distant from rabies
      virus with 60% nucleotide identity; Eth-16 and Eth-58 had 68% homology.

PMID- 7777312
TI  - Monoclonal antibody studies on rabies-related viruses.
AB  - Rabies and rabies-related viruses are divided into four serotypes, although it
      has been suggested that the inclusion of European bat lyssaviruses results in six
      genotypes. Sixty-four rabies-related viruses were tested against a panel of 36
      anti-nucleocapsid monoclonal antibodies prepared from the immunization of Balb/c
      mice with five prototypic rabies-related viruses. Reaction patterns obtained
      confirmed the original distinction between serotype 1-4 viruses and revealed
      multiple variants of Lagos bat and Mokola viruses. In addition, two biotypes of
      European bat lyssavirus were identified and a clear distinction was shown between
      these biotypes and Duvenhage virus of Africa. The origins and importance of the
      rabies-related viruses are discussed.

PMID- 7777315
TI  - Molecular epidemiology of rabies virus in South Africa.
AB  - Nucleic acid sequence analysis was used to determine the phylogenetic
      relationships amongst rabies viruses isolated from typical canid hosts such as
      bat-eared fox, jackal and dog in South Africa (SA). Geographical factors were
      taken into account in the selection of isolates and three different regions
      within the genomes of the isolates were compared for their use as phylogenetic
      indicators. The three genome regions, being the cytoplasmic domain of the G-gene,
      the G-L intergenic pseudogene and the antigenic domain II of the N-gene were
      found to differ in terms of the of nucleic acid conservation, but produced
      similar results when analyzed phylogenetically. The SA canid isolates were found
      to be closely related and could clearly be distinguished from all other rabies
      virus groups for which sequence data is available. In addition four SA mongoose
      rabies isolates were studied which were shown to be distant from the SA canid
      rabies virus group as well as from any other rabies viruses (or group) for which
      sequence data is available. Our results also indicate that spillover between the
      distinct canid and viverrid host reservoirs may occur.

PMID- 7777316
TI  - Rabies in wild and domestic carnivores of Africa: epidemiological and historical
      associations determined by limited sequence analysis.
AB  - Virus isolates from three important reservoirs for rabies in Africa (domestic
      dogs, jackals and yellow mongooses) were compared by their reaction with a panel
      of monoclonal antibodies directed to the nucleocapsid protein and by the
      nucleotide sequence of a 200 base pair segment of the nucleocapsid gene. Although
      antigenically dissimilar, the variants commonly transmitted in dogs and jackals
      were very closely related by genetic analysis. Phylogenetic analysis and
      historical accounts support a common lineage for these variants in both past and
      present reservoirs for rabies in Europe. Two additional variants, distinct from
      the dog or jackal variant, were found in yellow mongoose samples and nucleotide
      sequence from these animals showed more divergence than any other group of
      samples. These variants and a third variant for which no host species could be
      identified, were shown to form two additional genetic groups only distantly
      related to each other. These three variants and a previously identified variant
      in Nigeria may be indigenous to African carnivores.

PMID- 7777317
TI  - Rabies in southern Africa.
AB  - The first confirmed outbreak of rabies in Africa, believed to have followed the
      importation of an infected dog from England in 1892, occurred in the eastern Cape
      Province of South Africa, and was brought under control in 1894. An unconfirmed
      epidemic of rabies in dogs occurred in western Zambia in 1901. By the following
      year the disease had apparently spread along a major trade route, to cause an
      outbreak in Zimbabwe which engulfed most of the country before being eradicated
      in 1913. The existence of endemic rabies of viverrids (mongooses and genets) was
      confirmed in South Africa in 1928, and since then the viverrid disease has
      continued to occur widely on the interior plateau of the country with spill-over
      of infection to cattle and a variety of other animals. From about 1947 onwards,
      an invasive form of dog rabies spread from southern Zambia and/or Angola into
      Namibia, across northern and eastern Botswana into Zimbabwe and the northern
      Transvaal by 1950, entered Mozambique in 1952, and spread from there to Swaziland
      in 1954. Dog rabies extended from southern Mozambique into Natal in 1961 to cause
      a major epidemic which was brought under control in 1968. The disease re-entered
      northern Natal from Mozambique in 1976 and since then dog rabies has proved
      difficult to control in the peri-urban settlements of Natal-KwaZulu. The disease
      spread from Natal to Lesotho in 1982, and into the Transkei region of the eastern
      Cape Province in 1987, to reach the Ciskei by 1990. The spread of the disease in
      dogs was followed by the emergence of rabies of jackals and cattle in central
      Namibia, northern Botswana, Zimbabwe and the northern Transvaal. A unique
      outbreak of rabies in kudu antelope occurred in central Namibia from 1977 to
      1985, apparently involving oral spread of infection between individuals. A few
      cases of rabies in the bat-eared fox were recognized each year in Namibia from
      1967 onwards, and from the 1970s the occurrence of the disease in the fox has
      emerged as a distinct problem in the northern Cape Province and spread to the
      west coast. The rabies-related viruses, Lagos bat, Mokola and Duvenhage,
      associated with bats, shrews and rodents in Africa, are known to have caused
      isolated cases of disease in South Africa, and on one occasion a small outbreak
      involving six cats and a dog in Bulawayo, Zimbabwe.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 7777319
TI  - Rabies and wildlife: a conservation problem?
AB  - Understanding the behavioural ecology of wild mammals in rabies epizootics is a
      prerequisite to scientifically sound management of the disease. The principal
      vectors of wildlife rabies in a region tend to be abundant representatives of the
      Carnivora. Although the population dynamics of these species may be radically
      affected by rabies, and by attempts to control it, they are generally not
      threatened with widespread extinction as a result. However, the cases of the
      Blanford's fox, Vulpes cana, the Ethiopian wolf, Canis simensis, and the African
      wild dog, Lycaon pictus, illustrate how rabies and its control can pose grave
      conservation problems for rare carnivores. Disease monitoring is therefore an
      important element of recovery plans for rare species which are potential victims
      of rabies and other epizootic pathogens, and the benefits and disbenefits of
      prophylactic vaccination merit serious evaluation.

PMID- 7777320
TI  - Current status of fox rabies in Europe.
AB  - There was a general decline in animal rabies in Europe in 1991 following the peak
      levels which occurred in 1989. This was ascribed, in France at least, to the
      normal decline in cases usually experienced following peak occurrence and also to
      oral immunization of foxes against rabies. European countries in which rabies
      occurs may be infected by fox, insectivorous bat or dog rabies. This paper makes
      a general summary of the rabies situation in Europe in 1991 and presents data
      obtained in 1991 from 15 European countries using oral vaccination against fox
      rabies.

PMID- 7777318
TI  - Wildlife rabies in perspective.
AB  - Populations of a number of species of the orders Carnivora and Chiroptera
      maintain independent rabies epidemics in different parts of the world. However,
      in large parts of Africa, Asia, and Latin America, rabid dogs outnumber diagnosed
      wildlife cases. Rabies virus variants circulating in different host populations
      can be distinguished by the use of monoclonal antibodies and by genomic analysis.
      Rabies virus strains and their hosts have to be co-adapted in order to allow
      their prolonged co-existence.

PMID- 7777321
TI  - Jackal rabies in Zimbabwe.

PMID- 7777322
TI  - Biology of the black-backed jackal Canis mesomelas with reference to rabies.
AB  - The black-backed jackal is represented in rabies records from southern Africa and
      is suspected of playing an important role in the disease in this region. The
      basic biology of the species suggests that it does have certain characteristics
      that could make it an ideal rabies vector. However, the engimatically low
      incidence of rabies in undisturbed jackal populations suggests that more subtle
      processes may be involved. It is suggested that jackal society is arranged in the
      form of cryptic packs and that disruption of the hierachy through persecution may
      increase agonistic encounters and thence the incidence of rabies. Suggestions are
      made for the incorporation of the jackal in rabies control programmes without
      resorting to extermination.

PMID- 7777323
TI  - The role of the yellow mongoose (Cynictis penicillata) in the epidemiology of
      rabies in South Africa--preliminary results.
AB  - Ninety-seven yellow mongooses were captured in six different localities in South
      Africa and blood specimens for rabies antibody determination as well as brain and
      salivary glands for virus isolation were collected. No rabies virus or antibody
      to it was detected in any of the specimens. Parallel to the field study, two
      experimental infections were undertaken in which yellow mongooses were
      artificially infected with serial dilutions of two different rabies isolates (one
      from a dog and the other of mongoose origin) in order to determine the minimal
      lethal dose (MLD50), clinical signs, duration of illness, course of the disease,
      presence of virus in the saliva and salivary glands and development of antibodies
      to rabies virus. A significantly higher proportion of mongooses inoculated with
      mongoose virus died than did those inoculated with the dog isolate. However, the
      clinical signs, incubation period, duration of illness and development of
      antibodies were independent of the dose of the inoculum. The levels of rabies
      virus in the saliva and salivary glands were high in all clinically affected
      animals infected with the mongoose isolate but only one of the two mongooses
      which died following inoculation of the dog isolate contained detectable levels
      of virus in the salivary glands. Antibodies to rabies were detected only in the
      terminal stages of clinical disease.

PMID- 7777324
TI  - A systematic and population genetic approach to the rabies problem in the yellow
      mongoose (Cynictis penicillata).
AB  - This paper reviews recent studies on the biology, systematics and population
      genetics of yellow mongoose populations in terms of possible implications for the
      epidemiology of rabies. Based on parallel studies, the existence of three
      distinct subspecies of yellow mongoose may have a direct bearing on rabies
      epidemiology; at least subspecific affiliation should be considered as a factor
      to be controlled for in rabies studies of the species. A direct correlation was
      found to exist between population genetics, social structure (and vagility) and
      aspects of the epidemiology of rabies in the yellow mongoose. The high frequency
      of enzyme polymorphisms restricted to single populations can be understood in
      terms of the well developed social structure and low vagility of yellow
      mongooses, which in turn explains the phenomenon of rabies outbreaks being
      restricted to highly localized foci which may flare up over a period of several
      years. Further research is required to establish whether predictable population
      genetic differences exist between high and low rabies-prone populations.

PMID- 7777326
TI  - The bat-eared fox: a prime candidate for rabies vector?
AB  - Bat-eared foxes, Otocyon megalotis, are small (3-5 kg), primarily insectivorous
      carnivores widespread in the more arid areas of southern and East Africa. For
      many months of the year they live in nuclear family groups, members of which
      frequently indulge in affiliative behaviour such as play, allogrooming, and
      huddling. Physical contact between individuals in any particular group is thus
      common. In addition, groups are non-territorial and intermingle freely at times
      when exploiting food-rich patches of clumped prey, e.g. individuals foraging for
      harvester termites, Hodotermes mossambicus.

PMID- 7777325
TI  - Bat-eared fox behavioural ecology and the incidence of rabies in the Serengeti
      National Park.
AB  - This paper provides a brief introduction into some aspects of bat-eared fox
      biology and social organization that is important to understanding rabies
      transmission and disease management in susceptible wildlife species (Macdonald
      1980; 1993). A detailed description of the effects of two rabies outbreaks on a
      population of known individuals in the Serengeti National Park is given, Inter-
      and intrasexual differences in adult mortality rates are reported and discussed.

PMID- 7777327
TI  - Rabies in bat-eared foxes in South Africa.
AB  - Rabies in bat-eared foxes was first recognized in South Africa in 1955 and is
      likely to have been derived from canine rabies introduced to South Africa in
      1950. Since then it has become established in this species in the drier western
      half of the country and the south-western Cape so that rabies now occurs in bat
      eared foxes adjacent to the peri-urban canine population of Cape Town. Peak
      incidence was recorded in the early 1980s and the incidence is seasonal with most
      cases occurring in winter.

PMID- 7777328
TI  - Social systems and behaviour of the African wild dog Lycaon pictus and the
      spotted hyaena Crocuta crocuta with special reference to rabies.
AB  - Differences in the social systems and behaviour of two potentially important
      hosts of rabies, the African wild dog and the spotted hyaena, may lead to
      differences in the epizootiology of the disease in the two species. Wild dogs are
      highly social animals in which pack members are in constant physical contact with
      each other, but in which inter-pack interactions are rare. Spotted hyaenas are
      more flexible in their social systems and behaviour. Clan members interact less
      frequently than do wild dogs, but inter-clan contact rates may be high in high
      density populations. Rabies transmission within wild dog packs should be rapid,
      but rare between packs. In spotted hyaenas rabies transmission between clan
      members may partially depend on the social status of the animals involved and
      between packs on the density of hyaenas in the area.

PMID- 7777329
TI  - Rabies in the Masai Mara, Kenya: preliminary report.
AB  - A serosurvey of rabies antibodies among domestic dogs (Canis familiaris, n =
      178), spotted hyaenas (Crocuta crocuta, n = 72) and African wild dogs (Lycaon
      pictus, n = 18) of the Masai Mara, Kenya, was carried out. Rabies antibodies were
      found in 9.6% of the domestic dog sera, but all wild dog and hyaena sera were
      negative. Rabies has been confirmed in this region among the above species as
      well as in a domestic cat (Felis catus) and a cow (Bos indicus) by fluorescent
      antibody tests (FAT) and/or histopathology. The disease was confirmed in three
      wild dogs in 1989 and in a fourth dog in early 1991. In 1992, a spotted hyaena
      attacked six people, one of whom died; the hyaena brain was positive for rabies.
      To date, rabies has been confirmed in one domestic cow (n = 22; 4.5%), one
      domestic cat (n = 9; 11.1%) and five domestic dogs (n = 32; 15.6%). The wild dog
      cases exhibited paralytic rabies whereas in the hyaena, domestic cat and domestic
      dogs furious rabies was observed. The dynamics of rabies in this ecosystem is not
      yet fully understood, but based on these preliminary data it is suspected that
      domestic dogs play a primary role in its maintenance.

PMID- 7777331
TI  - Canine rabies.
AB  - Dog rabies is still epizootic in most countries of Africa, Asia and South America
      and in these countries dogs are responsible for most human deaths from the
      disease. The incubation period in dogs may vary from one week to several months
      and may be influenced by the site of infection and the virus dose and strain.
      Diagnosis by clinical signs alone is inadequate since many rabid dogs develop
      dumb rabies which can easily be overlooked and others die without showing signs
      of rabies. Rabies virus may be excreted in the saliva before clinical signs
      appear and may lead to infection of an unsuspecting and untreated bite victim.
      Dogs may recover from clinical rabies and may then intermittently excrete virus
      in the saliva. Prevention of human rabies depends on the control of canine rabies
      which can only be achieved by mass-immunization and control of stray dog
      populations.

PMID- 7777330
TI  - Aspects of rabies infection and control in the conservation of the African wild
      dog (Lycaon pictus) in the Serengeti region, Tanzania.
AB  - Lycaon pictus is amongst the most endangered wildlife species in Africa. In 1990
      rabies virus was isolated from the brain of an adult Lycaon found dead in the
      Serengeti region of Tanzania. One adult and six pups of the same pack feeding on
      the carcass showed clinical signs and rabies was suspected; within two days they
      had disappeared and are presumed to have died. Subsequently, two Lycaon packs in
      the Serengeti National Park were given inactivated rabies vaccine either by dart
      or by parenteral inoculation following anaesthesia. Lycaon sera which had been
      collected over the previous two years and sera collected pre- and post
      vaccination were examined for the presence of rabies virus neutralizing antibody.
      Three of 12 unvaccinated Lycaon had antibody levels > 0.5 IU/ml; post-vaccination
      samples from two Lycaon showed increased antibody levels. Between four and ten
      months post-vaccination, at least four of the vaccinated animals had died from
      unknown causes. Issues relating to wildlife vaccination and veterinary
      intervention in conservation are discussed.

PMID- 7777333
TI  - A dog ecology study in an urban and a semi-rural area of Zambia.
AB  - Characteristics of dog populations and their accessibility for rabies vaccination
      were compared in an urban and a semi-rural area in Zambia. A total of 1,190
      households were interviewed. In the urban study area (Mutendere, a low income
      suburb of Lusaka) only 11% of the households kept dogs with a dog:human ratio of
      1:45. In the semi-rural area (Palabana) dogs were kept by 42% of households with
      a dog:human ratio of 1:6,7. In conjuction with the study of the dog populations
      in these two areas, immunization of dogs against rabies was provided by door-to
      door visits in both study areas and also through central point vaccination in the
      urban area. The attitude of the public towards free rabies vaccinations was
      positive, although some misconceptions regarding indications and modalities of
      treatment following exposure to suspect dogs were found. Approximately 50% of the
      dog removals were as a result of disease and the demand for dogs was higher than
      the supply. Although only information on the owned segment of the dog population
      was obtained during the study, the proportion of ownerless dogs appeared to be
      very low. Generally, there is a need for better co-ordination between the
      different services involved in rabies control in Zambia to enhance the
      sustainability of vaccination programmes and improve the treatment of persons
      bitten by dogs.

PMID- 7777332
TI  - Dog ecology in eastern and southern Africa: implications for rabies control.
AB  - With an apparent decline in rabies vaccination coverage in dog populations in
      many parts of eastern and southern Africa, consideration should be given to more
      effective targeting of rabies vaccination to protect those sectors of the dog
      population with the greatest capacity to transmit rabies. This paper discusses
      the potential contributions that dog ecology studies may make to the improved
      delivery of rabies control measures and the targeting of vaccination programmes
      in the region. Data requirements on dog population size and structure are
      discussed, methods for collection of such data are summarized, and the studies on
      dog ecology carried out to date within the region are reviewed.

PMID- 7777334
TI  - Features of dog ecology relevant to rabies spread in Machakos District, Kenya.
AB  - A random sample of households in Machakos District of Kenya was surveyed using
      personal interviews to determine features of dog ecology relevant to the spread
      of rabies. A mean of 1.35 dogs/household, a dog to person ratio of 1:9.6 and a
      mean of 10.4 dogs/km2 were estimated. The male to female ratio was 1:0.67 with
      26% of the dog population being less than three months old. The dogs had a mean
      age of 1.8 years. The proportion of the dogs which fed on household leftovers and
      waste was 94.7%. Dogs were restricted in 19.4% of the households, while 69% of
      the dogs spent all of their time free outdoors. One-third of the dog population
      over three months old had been vaccinated against rabies. Considering the endemic
      status of rabies in Machakos District, methods which could be devised to control
      the disease are discussed.

PMID- 7777335
TI  - The delivery of oral rabies vaccines to dogs: an African perspective.
AB  - Dog rabies control relies principally on the mass immunization of dogs in order
      to achieve population immunity levels sufficient to inhibit rabies transmission.
      In Africa, such high levels of population immunity are rarely achieved due to a
      number of reasons. Oral immunization has been shown to be an effective means of
      inducing high levels of immunity in fox populations in several European
      countries, and this technique has been mooted as a means of overcoming the
      logistical problems of delivering injectable rabies vaccines to dogs. This paper
      discusses the requirements for oral rabies vaccines for dogs in Africa and
      reviews the trials performed to date on baits and baiting systems suitable for
      the delivery of such vaccines. Issues affecting possible rabies vaccine
      distribution in the future are discussed and the major research issues still to
      be tackled are summarized.

PMID- 7777336
TI  - SAG-2 oral rabies vaccine.
AB  - The live modified rabies virus vaccine strain SAG-2 was selected from SADBerne in
      a two step process employing anti-rabies glycoprotein monoclonal antibodies. The
      first two nucleotides coding for the amino acid in position 333 of the rabies
      glycoprotein are mutated. Arginine at position 333, which is associated with
      rabies pathogenicity, was substituted first by lysine and then by glutamic acid.
      The two nucleotide differences at position 333 in SAG-2 to any of six possible
      arginine triplets translated into excellent genetic stability and apathogenicity
      for adult mice, foxes, cats and dogs. The vaccination of foxes and dogs by the
      oral route provided protection against a lethal challenge with rabies virus.

PMID- 7777337
TI  - Recombinant rabies vaccines: efficacy assessment in free-ranging animals.
AB  - With the advancement of recombinant DNA techniques, a number of potent
      biologicals are available for the oral vaccination of free-ranging animals. Once
      oral immunogenicity and vaccine safety have been demonstrated, efficacy then
      becomes of paramount importance. Classical assessment of efficacy is conducted
      under carefully controlled laboratory conditions, whereas efficacy of oral
      wildlife rabies vaccination programs, to date, have been assessed by the lack (or
      occurrence) of field cases of rabies in a vaccinated area. This communication
      describes an intermediate vaccine efficacy strategy in which self-vaccinated,
      free-ranging animals from a study site were captured seven months after vaccine
      laden bait distribution for laboratory rabies challenge. This technique is
      specifically reviewed in the context of available recombinant products for the
      consideration of extension towards dog rabies control.

PMID- 7777338
TI  - Rabies eradication in Belgium by fox vaccination using vaccinia-rabies
      recombinant virus.
AB  - Oral immunization of foxes against rabies, by distributing vaccine-baits in the
      field, has been in progress since 1993 in the whole of the infected area of
      Belgium (10,000 km2). A vaccinia-rabies recombinant virus (VR-G) was used as
      vaccine because of its efficacy, safety and heat-stability. The successive
      campaigns of fox vaccination have induced a drastic decrease in rabies incidence
      and in 1993 there were no cases of rabies detected in the fox population. A
      marked decrease of human post-exposure treatments and the elimination of the
      disease in domestic animals have been the consequence of fox rabies control.

PMID- 7777339
TI  - Oral rabies vaccination of jackals: progress in Zimbabwe.

PMID- 7777341
TI  - [Automated gonarthrosis diagnosis].

PMID- 7777340
TI  - Bait formulation and distribution for oral rabies vaccination of domestic dogs:
      an overview.
AB  - Current efforts to develop oral rabies vaccine baits for domestic dogs are
      reviewed and new materials (bait matrices, additives, vaccine containers, vaccine
      modification) for improving bait acceptance and vaccine delivery are suggested.
      Methods that have been used to evaluate the food or bait preferences of confined
      and free-ranging animals are summarized, as are the guidelines for bait
      distribution compiled by the World Health Organization.

PMID- 7777342
TI  - [The therapeutic principle of hyaluronic acid is very promising].

PMID- 7777343
TI  - [What is hyaluronic acid and how does it work?].

PMID- 7777345
TI  - Is it safe for pregnant nurses to be exposed to chemotherapy agents?

PMID- 7777344
TI  - [Effect of hyaluronic acid is examined in clinical studies].

PMID- 7777346
TI  - Fundamental immune mechanisms of the brain and inner ear.
AB  - Because of the blood-brain and blood-labyrinthine barriers, the brain and inner
      ear were once thought to be immunoprivileged sites. Although these barriers
      provide protection from inflammatory damage to the delicate structures of the
      organs, both sites have since been shown to be capable of active immune responses
      when appropriately stimulated. In the inner ear, perisacular tissue around the
      endolymphatic sac hosts resident lymphocytes and serves as a site of
      immunosurveillance. Lymphocytes also enter the inner ear from the circulation,
      and in the cochlea this occurs via the spiral modiolar vein. Immune responses can
      protect the labyrinth from infection, but they can also cause bystander injury.
      Moreover, the cochlea can itself become the target of immune responses that
      damage hearing. Such autoimmune sensorineural hearing loss can be site specific,
      with the primary manifestation of the disorder being hearing loss and
      dysequilibrium. Some of these cases can be diagnosed by antibody or lymphocyte
      responses to inner ear antigens. Alternately, systemic autoimmune disorders can
      result in inner ear dysfunction as part of a broader spectrum of disease. Both
      forms of immune-mediated inner ear dysfunction may respond to immunosuppressive
      therapies, including steroids, cytotoxic agents, and plasmapheresis.

PMID- 7777347
TI  - Cerebrospinal fluid leak after translabyrinthine acoustic neuroma surgery.
AB  - Cerebrospinal fluid leakage is the most common complication of translabyrinthine
      acoustic neuroma surgery. This retrospective study reviews patients who had
      translabyrinthine acoustic neuroma surgery at the Gruppo Otologico, Piacenza,
      Italy, and ENT Department of Bergamo General Hospital, Bergamo, Italy, during the
      last 6 years. The incidence of postoperative cerebrospinal fluid leakage was
      6.2%, and 75% of these patients underwent another surgery to control the
      cerebrospinal fluid leakage. A modification of translabyrinthine approach was
      used in patients with highly pneumatized temporal bones to prevent cerebrospinal
      fluid leakage in these high-risk patients.

PMID- 7777348
TI  - Detection of Epstein-Barr virus genome in sinonasal undifferentiated carcinoma by
      use of in situ hybridization.
AB  - Associations between Epstein-Barr virus and undifferentiated carcinomas of
      nasopharynx, parotid gland, and thymus have recently been reported. Epstein-Barr
      virus has also been associated with malignant lymphoma of the nose and paranasal
      sinuses. These findings raise the possibility that Epstein-Barr virus may
      additionally be linked to undifferentiated carcinoma of the nose and paranasal
      sinuses (SNUC), an uncommon but distinctive and highly aggressive neoplasm.
      Histologically, SNUC consists of small and medium cells, the precise
      characterization of which often requires immunocytochemical analysis. This study
      investigates the presence of DNA sequences of Epstein-Barr virus in biopsy
      specimens of 13 cases of SNUC that were defined immunocytochemically by use of
      previously reported criteria. In situ hybridization was used to detect Epstein
      Barr virus genome in different cell types in routinely processed, paraffin
      embedded tissues. Epstein-Barr virus-specific DNA sequences were detected in
      tumor cells of SNUC specimens from 5 of the 13 cases examined. No correlation was
      found between positive hybridization and primary tumor site, morphologic subtype,
      or disease course. Epstein-Barr virus DNA was detected in 38% (5 of 13) of the
      SNUC samples analyzed. This finding suggests that this virus may play a role in
      the pathogenesis of this rare neoplasm.

PMID- 7777349
TI  - Comparison of modified PhadezymRAST, ImmunoCAP, and serial dilution titration
      skin testing by receiver operating curve analysis.
AB  - Improved technology in in vitro tests for allergen-specific immunoglobulin E has
      led to increased efficiency and faster turnaround times. ImmunoCAP (Pharmacia
      Diagnostics, Clayton, N.C.) is an in vitro-specific immunoglobulin E test that
      uses a three-dimensional cellulose solid allergen phase, which allows quick
      results in 6 hours. In comparison, modified Phadezym-RAST (Pharmacia Diagnostics)
      uses a two-dimensional solid phase, and results take 3 days to obtain. This study
      compares the sensitivity and specificity of CAP with that of modified RAST in the
      detection of specific immunoglobulin E, and it assesses the correlation of the
      individual class scores of CAP and modified RAST with end points obtained from
      skin-dilutional end-point titration. The reproducibility of CAP was also
      assessed. Patients evaluated at the University of Chicago Allergy Clinic who had
      a history and physical examination consistent with immunoglobulin E-mediated
      allergy and in whom skin testing was clinically indicated as part of their
      allergy management, were asked to donate some blood for simultaneous in vitro
      testing by PhadezymRAST and ImmunoCAP. Testing was performed in batches. Random
      samples from the CAP batches were chosen for duplicate runs under conditions
      blinded to the technician. Receiver operating curve analysis was used for
      comparison of the sensitivity and specificity of RAST vs. that of CAP. We used
      Pearson product-moment correlation coefficients to compare the correlation of
      RAST and CAP classes with the end points from skin testing. Our results indicate
      that the sensitivity and specificity of RAST and CAP are similar, that the
      classes of these two tests correlate well with the end points from skin testing,
      and that duplicate samples of CAP also correlate well.

PMID- 7777350
TI  - Mastoid oscillation: a critical factor for success in canalith repositioning
      procedure.
AB  - The canalith repositioning procedure has recently gained controversial
      recognition as a treatment for benign paroxysmal positional vertigo. Some authors
      contend that the canalith repositioning maneuver is no more effective than no
      treatment at all. Unfortunately, its technique has not been uniformly applied and
      its outcomes have not been uniformly assessed. I have found the use of mastoid
      oscillation to be critical in the success of this procedure. Another important
      factor is the time interval between diagnosis and relief of symptoms. Because it
      is well known that benign paroxysmal positional vertigo can spontaneously resolve
      after many months, the time frame for comparison should be short. A 1-week time
      interval was chosen for study purposes. Sixty patients were randomly assigned to
      three initial groups. The control group (n = 23) was not given any treatment. A
      second group (n = 27) was given treatment with the canalith repositioning
      maneuver with mastoid vibration. A third group (n = 10) was assigned to receive
      the canalith repositioning maneuver without mastoid vibration. Resolution was
      defined as no symptoms and negative Dix-Hallpike test results. The results showed
      that none of the control group's symptoms resolved completely in 1 week. Although
      60% of those who received the canalith repositioning maneuver without mastoid
      vibration felt improved, none was free of nystagmus. An overwhelming 92% of those
      who received the canalith repositioning maneuver with mastoid vibration felt
      improved, and 70% were free of rotatory nystagmus after only one treatment. A
      review of all patients diagnosed with benign paroxysmal positional vertigo and
      treated with the canalith repositioning maneuver with mastoid vibration was also
      undertaken. In a series of 67 patients with a minimum of four weeks of follow-up,
      only two have not responded to the canalith repositioning maneuver, yielding a
      97% rate of symptom control.

PMID- 7777352
TI  - Reduced mastoidectomy complications with an open meatoplasty stent.
AB  - Open-tube stents were compared with standard petroleum gauze packs in
      meatoplasties after canal-wall-down mastoid surgery to determine whether any
      difference existed in postoperative complications. Tube stents were associated
      with much lower incidences of postoperative meatoplasty stenosis and
      postauricular wound complications in this series.

PMID- 7777351
TI  - Aphysiologic performance on dynamic posturography.
AB  - The remarkable ability of the body to maintain balance is the result of central
      nervous system integration of sophisticated inputs from the vestibular, visual,
      and somatosensory systems. Strategies by patients with balance dysfunction are
      aphysiologic when their performance is relatively better on more difficult
      conditions of sensory conflict than on easier ones. Twenty-two aphysiologic
      patterns on computerized dynamic posturography were compared with age-matched
      normal and vestibular patterns. The aphysiologic group performed significantly
      better than the patients in the vestibular dysfunction group on the most
      difficult subtests of computerized dynamic posturography, conditions 5 and 6, yet
      significantly poorer on the easier subtests, conditions 1 through 4. In addition,
      patients in the aphysiologic group tended to show greater intertrial variability
      compared with patients in both normal and vestibular system dysfunction groups. A
      stepwise linear discriminant analysis was used to determine a set of conditions
      that had significant value in discriminating between the three patient groups.
      Case studies are presented to further illustrate the clinical usefulness of
      computerized dynamic posturography testing in the evaluation of patients
      suspected of having a functional component to their on-feet balance problems.

PMID- 7777353
TI  - Superiority of the T and N integer score (TANIS) staging system for squamous cell
      carcinoma of the oral cavity.
AB  - An alternative to the TNM classification system has been proposed for patients
      with head and neck cancer. The T and N integer score (TANIS) system adds the
      integer values of T and N classifications. The TNM and TANIS staging systems were
      retrospectively evaluated for 186 patients with squamous cell carcinoma of the
      oral cavity (tongue and floor of mouth). The TANIS system was found to better
      separate the patients into prognostic groups and allowed a more accurate
      prediction of disease-free survival.

PMID- 7777354
TI  - Day care and the incidence of otitis media in young children.
AB  - OBJECTIVE: This study assesses whether day care is a significant risk variable
      for otitis media in children younger than 2 years in the United States after
      controlling for the number of children in the day care group. DESIGN: The
      computerized data source used is the 1988 Child Health Supplement (N = 17,110) of
      the National Health Interview Survey (NHIS-CH). SETTING: The NHIS-CH data is a
      multistage probability sample with clustering and stratification. It represents
      the civilian, noninstitutionalized population of the United States. PARTICIPANTS:
      The NHIS-CH sample consists of one randomly selected child from each NHIS
      household containing a child younger than 18 years. The overall response rate for
      the NHIS-CH was approximately 90%. For this analysis the focus is on children
      younger than 2 years (N = 2294). MAIN OUTCOME MEASURES: The NHIS-CH includes a
      direct questioning of an adult member of the household, usually the mother, about
      whether the child has ever had frequent or repeated ear infections. RESULTS:
      After controlling for the total size of the day care group for children younger
      than 12 months, the previously established relationship between attending a day
      care center and frequent ear infections is reduced from an odds ratio of 3.17
      (95% confidence interval, 1.50 to 6.71) to an odds ratio of 1.34 (not
      significant; p = 0.60). CONCLUSION: The total size of the day care group is an
      important intervening variable in the relationship between attending day care and
      frequent ear infections for children younger than 12 months. The size of the day
      care group rather than the day care per se is the primary "modifiable risk
      variable" for many working parents.

PMID- 7777355
TI  - Clinical and pathologic distinction between primary and metastatic mucosal
      melanoma of the head and neck.
AB  - Metastatic mucosal melanoma is extremely rare. Only 0.6% to 9.3% of patients with
      cutaneous malignant melanoma will have metastases to the mucosa of the upper
      aerodigestive tract. The records of all patients with mucosal melanoma of the
      head and neck at the University of California, Los Angeles Medical Center during
      the past 30 years were reviewed. Patients with primary tumors were separated form
      those with metastatic involvement from a cutaneous primary site. These two groups
      were compared for differences in clinical symptoms, histopathologic findings,
      treatment, and survival characteristics. Frequent sites of metastatic involvement
      included the base of tongue and nasal cavity. These arose from a variety of
      cutaneous sites including the trunk and extremities and, in most instances, did
      not arise until 2 to 7 years after the initial cutaneous lesion. Most of those
      with metastases to the head and neck mucosa had disseminated disease. The
      histopathologic distinction between the two groups is described with
      photomicrographs. Junctional activity in the overlying or adjacent mucosa
      distinguishes primary mucosal melanoma from metastatic disease, in which the
      overlying mucosa is usually intact. This difference is useful in determining
      workup and treatment options. Aggressive surgical resection is suggested in
      treatment of primary melanomas, whereas surgery is at best palliative in those
      with metastatic disease.

PMID- 7777356
TI  - Calvarial bone repair with porous D,L-polylactide.
AB  - Bone is a storehouse of biologic factors enabling it to regenerate without scar
      formation. Recombinant technology has made many of these factors available in
      significant quantity for therapeutic applications. However, a system to deliver
      recombinant bone-regenerating factors is needed. Biodegradable, biocompatible
      polymers have shown promise for delivering bone regenerative factors, such as
      bone morphogenetic protein. The polymer we selected to investigate was racemic
      D,L-polylactide. Our immediate objective was to engineer porous D,L-polylactide
      to promote bone ingrowth (osteoconduction). We tested the hypothesis that porous
      D,L-polylactide implanted in a standard intraosseous calvarial wound would not
      hinder but would support bone regeneration. Therefore porous polylactide disks
      (65% void volume) were manufactured with pores < or = 100 microns, < or = 200
      microns, and < or = 350 microns; implanted in rabbits' calvariae, and retrieved
      1, 2, 4, and 6 months after insertion. Quantitative histomorphometry revealed a
      possible relationship in the amount of bone ingrowth with increasing pore size
      over time. The D,L-polylactide disks < or = 350 microns had the greatest quantity
      of bone ingrowth (< or = 0.05). However, a disturbing finding was the
      multinucleated giant cell response associated with all implanted disks. We
      speculate these cells may have produced an inhospitable environment stifling
      osteoconduction. Consequently, postsynthesis engineering refinements of D,L
      polylactide to eliminate the giant cell response are crucial before loading with
      bone morphogenetic protein.

PMID- 7777357
TI  - Effects of halothane on mucociliary activity in vivo.
AB  - The effect of halothane on mucociliary activity in the rabbit maxillary sinus in
      vivo was recorded photoelectrically. Administration of halothane (1%, 2% or 4%)
      into the maxillary sinus induced a temporary acceleration of mucociliary
      activity. The peak increase (39.1% +/- 9.1%, p < 0.05, n = 5) was seen after the
      4% concentration. Long-term exposure (60 minutes) of the maxillary sinus to
      halothane (2%) first induced an increase of 28.4% +/- 4.6% (p < 0.05, n = 6),
      lasting approximately four minutes, and followed after about 15 minutes by a
      decrease of mucociliary activity. The maximum decrease during the 60-minute
      period was 19.6% +/- 2.8% (p < 0.05, n = 6). Mucociliary activity returned to its
      baseline level approximately 25 minutes after withdrawal of halothane. Halothane
      delivered to the rabbit through a tracheal cannula at 1.1% for 60 minutes did not
      impair mucociliary activity in the maxillary sinus. On the contrary, it initially
      stimulated mucociliary activity, 19.9% +/- 2.7% (p < 0.05, n = 5). There was also
      an initial increase in respiratory rate from 62 +/- 7.3 to 89 +/- 12.9 breaths
      per minute (p < 0.05), which was noticeable after approximately 10 seconds and
      lasted 4 to 5 minutes. The dose-dependent increase in mucociliary activity seen
      after short-term exposure to halothane is probably due to stimulation of afferent
      C fibers, because halothane may be considered an airway irritant. The reversible
      depressant effect seen after 15 minutes of exposure is in accordance with
      findings in previous studies in vitro. The mechanism by which halothane impairs
      mucociliary activity is at present not known. However, halothane administered to
      the lower airways does not impair mucociliary activity in the maxillary sinus,
      indicating that halothane affects the ciliated epithelium directly and that the
      state of anesthesia itself has no effect on mucociliary activity.

PMID- 7777358
TI  - Use of the guinea pig flank flap in skin flap research.
AB  - A variety of flaps in laboratory animals have been designed that propose to
      parallel the behavior of human skin under different experimental conditions. In
      the search for a readily available and affordable island skin flap model that
      combines reliable anatomy with a pedicle of substantial size, we have designed in
      the guinea pig a cutaneous flap based on the superficial circumflex iliac artery
      and vein. In 22 adult female Hartley guinea pigs, an 8 x 4 cm flank flap based on
      the superficial circumflex iliac pedicle was raised, and its characteristics were
      evaluated for applications to skin flap research. Dermofluorometric studies were
      performed that confirm the vascularity of this flap, and 100% survival of the
      flap was seen 5 days after surgery in all animals. Of particular benefit was the
      demonstration that both afferent and efferent blood samples can be taken from the
      pedicle directly, which allows for the direct quantification of plasma markers
      after physiologic insults to the skin flap, such as burn or ischemia. This
      anatomically reliable and easily dissected flap lends itself well to preliminary
      skin flap research and may contribute to standardization of a model for further
      studies examining the behavior of skin microcirculation under adverse physiologic
      conditions.

PMID- 7777360
TI  - Hemangioendothelioma of the maxillary sinus.

PMID- 7777359
TI  - Inhibition of head and neck squamous cell carcinoma cell lines by transforming
      growth factor-beta.
AB  - Transforming growth factor-beta is known to be a potent autocrine growth
      inhibitor produced by a wide variety of cells, including cells of the immune
      system. Other investigators have noted that the growth of nontransformed
      keratinocytes is inhibited by transforming growth factor-beta, whereas various
      carcinoma cell lines are resistant to these effects. Head and neck squamous cell
      carcinoma cells are known to have surface receptors for this cytokine. We thus
      assessed the effect of transforming growth factor-beta on the growth of head and
      neck squamous cell carcinoma cell lines. Four head and neck squamous cell
      carcinoma cell lines were incubated with varying concentrations of transforming
      growth factor-beta, and cytotoxicity was evaluated with a methylene blue
      colorimetric assay. After culturing in transforming growth factor-beta for 4
      days, inhibition of growth was detected in CAL-27 (maximal inhibition at 5.0
      ng/ml), UMSCC-1, and UMSCC-19 (maximal inhibition at 50 ng/ml) cell lines. One
      other cell line, UMSCC-8 was found resistant to the inhibitory effects of
      transforming growth factor-beta. Kinetics analysis experiments revealed minimal
      inhibition before day 2 of incubation, at which time inhibition increased
      linearly to day 4. Assessment of double-stranded DNA fragmentation suggested that
      DNA fragmentation occurs before significant cytotoxicity. Electron microscopic
      analysis and gel electrophoresis of extracted DNA revealed morphologic features
      consistent with apoptotic cell death. Our findings indicate that transforming
      growth factor-beta significantly inhibits the growth of head and neck squamous
      cell carcinoma cell lines by inducing apoptotic cell death.

PMID- 7777361
TI  - Atypical vestibular neuritis: a case report.

PMID- 7777362
TI  - Reversible blindness secondary to acute sphenoid sinusitis.
AB  - Sphenoid sinusitis is an elusive diagnosis with significant morbidity if not
      diagnosed and treated promptly. We have reported an unusual case of acute
      sphenoiditis mimicking Gradenigo's syndrome. This resulted in virtual bilateral
      blindness that entirely resolved with aggressive surgical and medical treatment.
      It is recommended that sphenoid sinusitis be strongly considered in patients with
      acute headache and fever. A detailed cranial nerve examination should be
      performed, and CT scans of the skull base and paranasal sinuses should be
      obtained. Immediate surgery is strongly recommended for acute sphenoid sinusitis
      at the first suggestion of a complication and in those patients not promptly
      responding to medical therapy. It is apparent that irreversible damage to the
      optic nerve can occur before the development of gross intraorbital pathology.
      Therefore we believe that delaying surgery until the visual acuity is worse than
      20/60, as advocated by some authors, may not be in the patient's best interest.
      Surgery should be directed at removing the purulent material, obtaining cultures,
      removing irreversibly diseased mucosa, and maintaining drainage of the sphenoid
      sinus.

PMID- 7777364
TI  - Cytomegalovirus sinusitis in a patient with acquired immunodeficiency syndrome.

PMID- 7777363
TI  - Odynophagia caused by inadvertent blister pack ingestion: a case report.

PMID- 7777365
TI  - Solitary extramedullary plasmacytoma of the epiglottis: a case report and review
      of the literature.

PMID- 7777366
TI  - Wegener's granulomatosis presenting as ophthalmoplegia and optic neuropathy.

PMID- 7777367
TI  - Subcutaneous bronchogenic cysts and sinuses.

PMID- 7777368
TI  - Lemierre's syndrome: two cases of postanginal sepsis.
AB  - Lemierre's disease consists of suppurative thrombophlebitis of the IJV in the
      presence of oropharyngeal infection and can be complicated by septic pulmonary
      emboli. If a patient has an oropharyngeal or deep neck infection and neck pain
      suspicious for IJV thrombosis, a CT or MRI is warranted to establish the
      diagnosis. Blood cultures should be obtained to establish the responsible
      organism. In most cases F. necrophorum, an anaerobic bacterium, is responsible
      for the sepsis. Once the diagnosis of Lemierre's disease is made, long-term, high
      dose intravenous antibiotics with beta-lactamase anaerobic activity should be
      initiated. In cases with persistent sepsis and emboli despite appropriate medical
      management, ligation or excision of the IJV should be performed. Finally, if
      there is clinical or radiologic evidence of retrograde cavernous sinus
      thrombosis, the use of anticoagulants should be considered.

PMID- 7777369
TI  - Acquired laryngomalacia: resolution after neurologic recovery.

PMID- 7777370
TI  - Intrinsic infiltrating intramuscular laryngeal lipoma.

PMID- 7777371
TI  - Parotid hemangioma in infancy: diagnosis with technetium 99m-labeled red blood
      cell pool imaging.

PMID- 7777373
TI  - Eurocancer 1994. Paris, France, 26-29 April 1994. Abstracts.

PMID- 7777372
TI  - Lingual necrosis as the initial symptom of small cell carcinoma.

PMID- 7777374
TI  - [Epidemiology of Creutzfeldt-Jakob disease].
AB  - Creutzfeldt-Jakob disease is a rare disease (incidence < 1 case per million
      inhabitants), reported in all continents. Certain characteristics are constant
      from one country to another: mean age of onset: 65 years, duration of the
      disease: about 6 months, sex ratio close to 1 and approximately 10% of familial
      cases. The geographical sites of this disease identified in Chile, Israel and
      Czechoslovakia suggest certain genetic and/or environmental risk factors. The
      principal environmental factor implicated is scrapie in sheep, especially in
      these regions. Genetic studies have demonstrated the presence of apparently
      causal mutations of the PrP gene and a high risk of CJD associated with certain
      normal polymorphisms of this gene (codon 129). Certain grafts (dura mater,
      cornea) and treatment by extracted growth hormone are responsible for iatrogenic
      transmission. Multicentre epidemiological studies recruiting a large number of
      cases are needed to define the risk factors of this disease.

PMID- 7777375
TI  - [Electrophysiology of transmissible encephalopathies].
AB  - The purpose of electrophysiological studies during the evolution of spongiform
      encephalopathies or prion diseases is to describe the changes of spontaneous or
      evoked electroencephalographic activity in natural and experimental diseases
      (natural and experimental scrapie, Kuru and Creutzfeldt-Jakob (CJ) disease in man
      and in different animal models) and to establish or to propose an action
      mechanism of the infectious agents. In the aim, the changes of
      electroencephalogram (EEG) and evoked potentials are described. Generally these
      modifications constitute an excellent and early marker of the initial phases of
      pathological mechanisms, replication of the agent and the cell membranes
      alterations. The changes of the sleep organisation occur generally later with the
      beginning of the clinical phase, just at the end of incubation period. The
      typical changes of EEG during the human CJ disease are rare in the experimental
      diseases. However, with animal models, it is possible to demonstrate the very
      univocal character of these diseases, creating pathophysiological modifications
      whose nature, origin and evolution are very comparable, with characteristic
      triade (loss of neurons, gliosis and spongiosis) and specific alterations of
      gabaergic, dopaminergic and inhibitory processes.

PMID- 7777376
TI  - [A funny story].

PMID- 7777377
TI  - [Neuropathology of non conventional infectious agents or prions].
AB  - The neuropathological diagnosis of infections by non conventional agents relies
      on four lesions: astrocytic gliosis (cell hypertrophy and proliferation) usually
      contrasting with absent mononuclear cell infiltrates (lymphocytes, monocytes
      macrophages, and/or microglia) revealed by conventional techniques, and neuronal
      loss in the most affected areas are little specific findings. Amyloid plaques
      that are inconstantly found, and spongiosis of gray matter, a characteristic and
      very frequent finding, are most specific. PrP immunohistochemistry brings
      additional data. The main diagnostic difficulties are emphasized, and guidelines
      for Pathological studies are recalled.

PMID- 7777378
TI  - [Human spongiform encephalopathies].
AB  - Clinical descriptions of Creutzfeldt-Jakob disease by the classical authors are
      compared with 209 transmitted cases at NIH between 1968-1992. Clinical comparison
      between Kuru, Gertsmann-Straussler-Sheinker Syndrome and Creutzfeldt-Jakob
      disease. Fatal Familial Insomnia is included into the latter. Familial forms: new
      acquisitions.

PMID- 7777379
TI  - [Prion protein: structure, functions and polymorphisms associated with human
      spongiform encephalopathies].
AB  - Transmissible subacute spongiform encephalopathies (TSSE), also known as prion
      diseases, are rare neurodegenerative disorders of both humans and animals. The
      biochemical hallmark of these diseases is an accumulation in the brain of an
      abnormal form of the host-encoded prion protein (PrP). This pathological
      accumulation could result from a protein conformational change under the
      influence of unknown factors. The normal function of PrP is unknown. The abnormal
      form is thought to induce neurodegeneration when experimentally or accidentally
      introduced in recipient hosts. Such a possibility would explain the transmissible
      character of these diseases illustrated in humans by iatrogenic contamination.
      Considerable attention has been focused on the host PrP gene and its relation
      with the genetic susceptibility of humans and animals. Mutations in PRNP, the
      gene which encodes PrP in humans, are present in 16% of the patients and might be
      causative. In patients without any PRNP mutation, a coding polymorphism (129
      Met/Val) defines a predisposing factor. Since few years, important progress in
      the molecular genetics of TSSE in both humans and animals have been performed and
      point out that the development of different forms of these diseases,
      experimental, iatrogenic or spontaneous, are strongly dependent on the primary
      structure of the host PrP.

PMID- 7777381
TI  - [Manipulation of prion in laboratory: precautions and possible methods of
      disinfection].

PMID- 7777382
TI  - [Nature and physicochemical and biological properties of non conventional
      transmissible agents or prions: consequences for public health].
AB  - Transmissible spongiform encephalopathies (TSE) are rare lethal diseases induced
      in humans and animals by unconventional agents (TSA) named also prions or
      virinos. TSA/prions have unconventional properties; in particular, they resist to
      almost all the chemical and physical processes which inactivate conventional
      viruses. Natural history of TSE indicates that organs are infectious a long time
      before the appearance of the clinical symptoms. The only specific marker of the
      TSA infections is the post-translational accumulation of the host encoded protein
      PrP (Prion Protein). Iatrogenic Creutzfeldt-Jakob disease (CJD) cases have been
      described after neurosurgery, treatment with pituitary derived hormones, and
      cornea and dura mater grafting. TSA associated infectivity is depending upon the
      nature of the organ in a given infected individual: central nervous system has
      the highest infectivity, spleen and lymph nodes a medium infectivity, and organs
      like bone or skin do not harbor any detectable infectious particle. Therefore,
      donors with neurologic history must be excluded and treatment with pituitary
      derived hormones should be considered as potentially infected with TSA, and
      excluded.

PMID- 7777380
TI  - [Prion, from crazy cows to iatrogenic Creutzfeldt-Jakob disease. Which risk in
      laboratory or in hospital?].
AB  - The long latency time, without any characteristic clinical sign, of transmissible
      degenerative encephalopathies, the transmissibility of the called "prion"
      infectious agent, associated with its exceptional resistance to normal
      inactivation methods, are resulting in accidental transmissions, both human
      (Creutzfeldt-Jakob disease), and animal (bovine spongiform encephalopathy). Among
      data about physical and chemical inactivation methods tested, we retain, to avoid
      professional or iatrogenic transmissions in the laboratory or in hospital, steam
      autoclaving and sodium hypochlorite or hydroxide treatment. But inactivation
      shall not be performed using the current processes as regarding parameters such
      as temperature, concentration and duration of exposure.

PMID- 7777383
TI  - [Bovine spongiform encephalopathy].
AB  - A new Transmissible Sub-acute Spongiform Encephalopathy (TSSE) appeared in 1986
      in the bovine species, mainly concerning Great Britain where more than 100,000
      cases have now been identified. This review describes the features of the disease
      that showed it belonged to this particular group of diseases. The currently
      available hypothesis about the origin of the disease, in Great Britain as well as
      in other countries where it has also been recognized, are presented. Lastly, the
      potential risks for the future, in the bovine species but also for other animal
      species or man, are discussed, in light of the known experimental data.

PMID- 7777384
TI  - [Scrapie in sheep and transmissible encephalopathy of the mink].
AB  - Scrapie in sheep and goat is the prototype of the group of the transmissible
      spongiform encephalopathies which affect man and some animal species, notably
      other ruminants with bovine spongiform encephalopathy (BSE) and chronic wasting
      disease of wild ruminants. Transmissible mink encephalopathy (TME) is a rare
      disease of ranch-raised mink caused by exposure to a contaminated food ingredient
      in the ration scrapie, unrecognised BSE-like disease...). There is clinical and
      pathological similarities between TME and scrapie. These diseases share the
      following characteristics: a prolonged incubation period; a progressive,
      debilitating, neurological illness (always fatal); pathological changes confined
      to the central nervous system (vacuolisation, neurological loss, astrocytosis);
      the presence of scrapie-associated-fibrils (SAF) in brain tissue; and absence of
      detectable inflammatory or immune responses. The genetic origin of scrapie in
      sheep and the natural transmission of these spongiform encephalopathies are
      discussed.

PMID- 7777385
TI  - [Juvenile form of Creutzfeldt-Jakob disease. Clinical and neuropathological
      aspects].
AB  - Creutzfeldt-Jakob disease in young people is frequently iatrogenic due to growth
      hormone cadaveric treatment. Ataxia and diplopia are the main symptoms at onset,
      and the absence of dementia and of neuroradiological and biological abnormalities
      is striking. The proof of the disease is given by histological examination
      (spongiosis, neuronal loss, astroglial proliferation, no inflammatory signs).
      Amyloid plaques are frequent in these iatrogenic cases. PrP storage in brain is
      recognised by immunohistochemistry and western-blot. Transmission to animals
      proves the power of the disease to be transmitted. The transmission by
      inoculation of a buffy coat from one patient and the recorded cases after blood
      transfusion justify it is necessary to exclude extractive growth hormone
      recipients from blood and organ donors.

PMID- 7777386
TI  - [Biological aspects of Creutzfeldt-Jakob disease related to the extractive growth
      hormone].
AB  - Today 34 young patients have been infected by the Creutzfeldt-Jakob Disease (CJD)
      agent in France after treatment with pituitary derived growth hormone. 974
      individuals received potentially contaminated batches of hormone. The authors
      then investigated the genetic structure of the prion protein (PrP) gene at the
      codon 129 in 32 of the 34 CJD patients. Their results show that all are
      homozygous, 50% of the individuals of the control group being heterozygous. These
      data strongly suggest that it may exist a genetic susceptibility to the early
      development of CJD in infected individuals.

PMID- 7777387
TI  - [Child kidnapping and organ trafficking].

PMID- 7777388
TI  - [Acute manifestation of constitutional hypoketotic organic aciduria].

PMID- 7777389
TI  - [Multiple acyl-CoA dehydrogenase deficiency. Report of 2 siblings].
AB  - The authors report on two siblings with a multiple acyl-CoA dehydrogenase
      deficiency. The first child died from a Reye's syndrome when he was 9 month-old.
      The diagnosis was made in the neonatal period in his brother. Early treatment
      with glucose and carnitine should prevent acute attacks.

PMID- 7777391
TI  - [Severe visceral leishmaniasis with hepatic involvement. Diagnostic value of the
      immunoblotting serologic technic].
AB  - The case of a 13 year old boy with a severe form of visceral leishmaniasis (VL)
      mimicking portal hypertension and of unfavorable outcome is presented. The
      authors stress the usefulness of investigating humoral immune response by using
      Western Blot assay in order to confirm the diagnosis when the parasite cannot be
      isolated. Since VL may be responsible for death if the treatment is delayed,
      screening of the disease in children presenting with chronic liver disease is
      important in endemic area.

PMID- 7777390
TI  - [Total thyroidectomy in a young girl presenting C cell hyperplasia at the time of
      a family screening for medullary carcinoma of the thyroid gland].
AB  - The authors report on the case of a 5,8 year-old girl whose father died of
      medullary thyroid carcinoma. When she was 4,5 year-old, her physical examination
      was normal but plasma calcitonin and katacalcin (PDN-21) levels were abnormally
      high in response to pentagastrin infusion. Total thyroidectomy was performed and
      immunohistochemical staining showed confluent C-cell hyperplasia. No recurrence
      occurred in this patient over four years on follow-up.

PMID- 7777392
TI  - [Recurrent cutaneous herpes in the newborn and acyclovir].
AB  - The authors report two cases of cutaneous recurrent herpes occurring after a
      neonatal herpes simplex virus type 2 (HSV2) infection and comment on the role of
      acute or suppressive therapy by aciclovir (ACV). The two infants were not treated
      by ACV after the neonatal period. None of the recurrent cutaneous herpes episodes
      was followed by viral widespread. One case reported by Bergstrom et al on a
      relapse of HSV2 encephalitis occurring after a cutaneous herpes in a child argues
      for the use of ACV in recurrent herpes. However, ACV might alter host defense
      response to HSV2 infection in neonates and children. Thus, it seems not yet
      recommended to use ACV either as acute or suppressive therapy in recurrent
      cutaneous herpes unless a progression of the viral disease is noted.

PMID- 7777393
TI  - [Hydroxy-methyl-glutaryl-coenzyme A lyase deficiency manifesting as Reye's
      syndrome in a 3-year-old girl].
AB  - The authors report on one case of 3-hydroxy-3-methylglutaryl-coenzyme A lyase
      (HMG-Co A lyase) deficiency in a 3 year-old girl, presenting as Reye's syndrome.
      Urinary organic profile suggested this inherited metabolic disease; decreased
      activity of HMG-Co A lyase was demonstrated in cultured fibroblasts. The
      metabolic etiologies of Reye's syndrome are summarized; clinical, biological, and
      therapeutic assessment of HMG Co A lyase deficiency are developed. The pattern of
      organic aciduria must be studied in all patients presenting with Reye's syndrome.

PMID- 7777394
TI  - [Cranio-cerebral gunshot wounds in civilian practice in children].
AB  - The circumstances and the prognosis of six gunshot craniocerebral wounds in
      civilian children are presented. The cause is a suicide in two cases and an
      accident in four cases. In three out of these four cases, another person is
      responsible for this accident, an adult two times, a child in one case. When the
      accident is due to a child, it is always by play and one time the accident is the
      autofact of a 2-year-old boy. In all cases, the fire arm was loaded and an
      adult's imprudence is present. The mortality is important (4/6). More than the
      initial clinical state, the seriousness of which is not a pejorative indice, the
      prognosis is subordinated to the CT scan aspect about the missile tract, and to
      the initial value of the intracranial pressure.

PMID- 7777396
TI  - [Does the time change affect school children?].
AB  - The aim of the study was to determine in young pupil the physiological effect of
      a 1 hour earlier awakening (summer time) by measuring: the salivary cortisol
      level. Results showed that the cortisol circadian rhythm synchronized with summer
      clock time after remaining synchronized with winter time (previous rhythm) for 15
      days at least.

PMID- 7777395
TI  - [Effectiveness of and tolerance to human recombinant erythropoietin in the
      treatment of kidney failure anemia in children undergoing continuous peritoneal
      dialysis. Multicenter study].
AB  - Eight young children with renal failure, undergoing continuous peritoneal
      dialysis (CDP) and presenting an anemia (hemoglobin level [Hb] 57 to 89 g/l) were
      treated by subcutaneous recombinant human erythropoietin (rHu EPO) twice weekly.
      The initial dose of 75 U/kg was adjusted to induce progressive increase of Hb
      with a target level of 100-120 g/l. Treatment duration was 24 weeks in five of
      these children and 10 to 13 weeks in the three others. In seven cases out of
      eight, anemia was corrected. The target Hb level was reached in 3 to 21 weeks
      with rHu EPO doses of 150 to 300 U/kg/w (mean: 200 U/kg/w) for four children
      without recent transfusion; then the median maintenance dose was 135 U/kg/w
      (range: 50-300 U/kg/w). In only one patient, Hb never reached a level higher than
      77 g/l despite weekly dose of 350 U/kg, a reticulocytosis of 5.6%, rHu EPO
      treatment lasting up to 24 weeks and the absence of iron deficiency. In any case,
      no transfusion was necessary after the first day of rHu EPO treatment. In three
      patients, the increase of a preexisting hypertension required the adaptation of
      antihypertensive treatments. One patient presented a marked thrombocytosis. In
      conclusion, twice-a-week subcutaneous injections of 75 to 150 U/kg of rHu EPO
      appear to be well tolerated and effective in the treatment of anemia of CPD
      children.

PMID- 7777397
TI  - [Two-stage repair of microtia].
AB  - Modifications of the total ear reconstruction technique allowing a two-stage
      procedure is described. However this is only possible if the soft tissue has not
      yet been damaged by previous plastic surgery or tympanoplasties. The framework
      sculpture is improved in order to obtain a posterior conchal wall at the first
      stage without using a skin graft. A tissue expander is used during the operative
      time in order to improve the framework coverage. A bone anchored hearing aid is
      preferred to tympanoplasty when necessary, for bilateral microtia. This method is
      effective and does not compromise the skin qualities. The osteointergrated
      implant is put in place during the second external ear reconstruction stage. The
      total hospitalisation period is no longer than 8 days.

PMID- 7777398
TI  - [Family violence and adolescence].
AB  - Intrafamilial violence represents a vast topic, even if one limits the subject to
      the nuclear family. Indeed it includes violence from parents to the child,
      violence between brothers and sisters, conjugal violence and violence exercised
      by the child to his parents. Although one can differentiate the types of violence
      (physical, sexual, and psychological), they often coexist within the same family.
      Adolescence favors the onset or the reactivation of familial violence; this
      violence often has repercussion on the psychological equilibrium of the
      adolescent. Very little is written about parents abused by one of their children
      (usually an adolescent). This phenomenon is relatively unrecognized and its
      frequency probably under-estimated. It points to a distortion in parent to child
      relationship. Therapeutic and/or socio-educational approach must be directed
      toward both the victim and the aggressor.

PMID- 7777399
TI  - [Cachectic diencephalic tumor].

PMID- 7777400
TI  - Transformation of the cardiovascular program. Leadership and organization.
AB  - The development of this organizational innovation continues to provide many
      challenges and opportunities for all involved. The authors emphasize that
      although cost containment is perhaps the most noticeable effect thus far, it is
      not the central goal of this endeavor. Obviously, it is important to be conscious
      of reducing costs in this very competitive health-care environment where quality
      of care is in danger of being substituted for lower-priced care. The challenge
      before all of us is to maintain excellence and efficiency less expensively within
      a collegial and risk-willing environment, as external forces seem to be
      countercurrent to these efforts. We hope that this new model for providing
      cardiovascular services within the institution will allow us to continue to
      improve our tradition of excellence in clinical care and will help us in
      retaining an environment and spirit conducive to the generation of new knowledge.
      The more long-lasting result achieved to date is the level of creativity and
      commitment demonstrated by all staff toward our common vision. The other articles
      in this issue of Nursing Clinics exemplify the collaborative spirit of our CVP
      and offer some initial evidence about the early effects of these changes.

PMID- 7777401
TI  - Restructuring. An integrated approach to patient care.
AB  - As scientific advances in biochemistry shaped the health-care system since World
      War II, the projected advances in molecular biology will drive the system of the
      future. With each scientific advancement or new technology there will continue to
      be the need for efficient organizations to provide acute care to the patients who
      will benefit most. Despite numerous projections about the viability of the acute
      care hospital as we know it and vigorous redirection of services to the patient
      at home in ambulatory settings or in their community, it is crucial for nurses to
      take a leadership role in developing long-term approaches to patient care
      delivery systems for the acute care hospital of the future.

PMID- 7777402
TI  - Clinical practice guidelines for quality patient outcomes.
AB  - In response to environmental changes brought about by the debate over health-care
      reform, hospitals are seeking means to decrease costs while improving quality. By
      examining the process of health-care delivery, problems in the system can be
      highlighted for further investigation. Development of clinical practice
      guidelines by an interdisciplinary team can be an effective approach to decrease
      undesirable practice variation, standardize appropriate resource use, and measure
      the effectiveness of care through defined expected-patient outcomes. By ensuring
      the appropriate, efficient, and effective delivery of health care, savings in
      cost can be realized by the elimination of duplication, rework, and waste.

PMID- 7777403
TI  - Peer review.
AB  - Peer review is a major component of a professional practice and shared governance
      model in which professional staff nurses are given responsibility for practice
      and patient outcomes. Careful planning is necessary for the development of a peer
      review program. Components include definition of roles, responsibilities, and
      performance standards, as well as the development of an evaluation tool and
      process. Peer review affords nurses many opportunities for growth and development
      and allows them to develop communication, evaluation, and presentation skills.
      The concept of peer review may expand to meet the needs of changing health-care
      delivery models.

PMID- 7777405
TI  - Facilitating continuity of care. The role of the patient care coordinator.
AB  - Continuity of care is essential for children with cardiac disease. The PCC works
      to ensure that these children continue to receive necessary care postdischarge.
      By collaborating with members of the health-care team, the PCC is able to
      coordinate appropriate services for patients in the Cardiovascular Program. The
      PCC acts as a resource for the interdisciplinary team by identifying
      postdischarge care options within the community. The PCC also furnishes
      information to community providers about individual patient care needs. Educating
      payers in regard to assessed postdischarge needs is another facet of the PCC
      role. In essence, the PCC provides a link among patients, families,
      interdisciplinary team members, community providers, and payers. This link
      facilitates continuity of care for patients in the Cardiovascular Program.

PMID- 7777404
TI  - The role of the cardiovascular social worker.
AB  - The clinical social worker is an integral component of the Integrated Care Model
      used in the Cardiovascular Program at Children's Hospital (Boston). This article
      provides the reader with an understanding of the social worker's role with
      families and as part of the interdisciplinary team. Case examples are used to
      illustrate the key components of clinical social work practice, including crisis
      intervention, solution-focused treatment, and grief counseling. The importance of
      maintaining sensitivity to cultural differences in working with families is
      discussed.

PMID- 7777406
TI  - Parent participation.
AB  - Ultimate care of the critically ill child is contingent on a parent-professional
      partnership that acknowledges both the needs and the strengths of families. In
      providing pediatric care, parent participation maintains and empowers parents to
      care for their child. Models of care must include programs that support
      reempowerment rather than dependence of families. The challenge of including
      parents as partners in care is one of the most rewarding privileges and
      responsibilities of pediatric nurses.

PMID- 7777407
TI  - Dyslipidemias in childhood. An overview.
AB  - This article reviews the current screening and treatment guidelines for
      dyslipidemias in the pediatric and adolescent populations. In addition, the
      components of a comprehensive lipid program are reviewed.

PMID- 7777409
TI  - Cardiovascular manifestations of pediatric HIV infection.
AB  - Infection with human immunodeficiency virus (HIV) has become a major pediatric
      health concern in the United States and around the world. Pediatric HIV infection
      is a multisystem illness that presents an ongoing challenge to practicing nurses.
      Most clinical cardiovascular diseases in children with HIV have been
      underreported, and often are clinically occult. The preclinical detection of
      cardiovascular abnormalities results in early therapeutic interventions and
      reduces cardiovascular morbidity and mortality. Cardiovascular involvement is
      important in the natural history and prognosis of HIV infection.

PMID- 7777408
TI  - Current management of congestive heart failure in infants and children.
AB  - Although the general goals of therapy for the medical and nursing management of
      CHF in children have not changed in the last decade, advances have been made in
      understanding the unique characteristics of the neonatal heart and tailoring
      therapy to best support cardiac function (Table 6). In addition, strides have
      been made in manipulating the loading conditions of the ventricle to enhance
      cardiac output, which has fostered the development of new therapeutic agents and
      more aggressive treatment of these patients with improved outcomes. In situations
      in which the infant is unresponsive to therapy, surgical intervention is now done
      at an earlier age with good results. When surgery is not an option and the
      patient continues to deteriorate despite maximum medical management, mechanical
      support can be instituted as a bridge to transplantation.

PMID- 7777410
TI  - Advances in the treatment of aortic stenosis across the lifespan.
AB  - With these results, the pulmonary autograft constitutes the valve of choice for
      the left ventricular outflow tract in children of all ages, as well as
      adolescents and adults. Because there is a growth potential, permanent relief
      from LVOT obstruction might become possible at any age, especially in the number
      of infants with critical aortic stenosis who survive a valvotomy or repair of
      interrupted aortic arch during infancy, but return with multiple level outflow
      tract obstructions early in childhood. If, however, a child is at risk for
      developing endocarditis or has a history of cardiac infections, it may be a wise
      choice to use a homograft initially and replace it later with an autograft when
      the homograft degenerates.

PMID- 7777412
TI  - Overview of pediatric arrhythmias.
AB  - Cardiac arrhythmias are being depressed with increased frequency in the pediatric
      population. Causes of pediatric arrhythmias in the general population include
      severe metabolic or electrolyte disturbances, drug toxicity, and chest trauma.
      Repairs of complex congenital heart disease have frequently left this population
      with persistent or recurrent postoperative arrhythmias. The diagnosis,
      evaluation, and management of pediatric arrhythmias requires nurses to be skilled
      in hemodynamic assessment and arrhythmia detection. The registered nurse's grasp
      of developmental issues and family education is vital in providing quality care
      to families dealing with these diagnoses.

PMID- 7777411
TI  - Patient care for interventional cardiac catheterization.
AB  - This article describes the current management of patients undergoing an
      interventional cardiac catheterization. New catheters, monitoring equipment, and
      standards for skilled personnel have allowed for more aggressive and definitive
      treatments for improving the life of a fragile patient.

PMID- 7777414
TI  - Implantable cardioverter defibrillator therapy: 15 years experience and future
      expectations. Proceedings of an international symposium. Paris, October 21-22,
      1994.

PMID- 7777413
TI  - Inhalation of nitric oxide. An innovative therapy for treatment of increased
      pulmonary vascular resistance.
AB  - Critical care of patients during pulmonary hypertensive crises is difficult and
      treatment is hazardous. Conventional therapy has relied on hyperventilation with
      oxygen and the use of nonselective intravenous vasodilators. The limitations of
      this approach have prompted clinical investigations of new therapeutic modalities
      based on recent advances in vascular biology. Inhaled nitric oxide can be used
      selectively to manipulate the pulmonary vasculature and treat a variety of
      pulmonary hypertensive disorders. Preliminary studies appear promising as results
      of properly conducted trials to evaluate efficacy and toxicity are awaited.

PMID- 7777415
TI  - Implantable cardioverter defibrillator therapy: 15 years experience and future
      expectations. In the beginning: from dogs to humans.

PMID- 7777417
TI  - Optimizing defibrillation through improved waveforms.
AB  - Defibrillation of the heart is achieved if an electrical current depolarizes the
      majority of the unsynchronized fibrillating myocardial cells. The applied current
      or the corresponding voltage described as a function of time is called the
      waveform. In pacing, to stimulate myocardial cells close to the electrode, a
      relatively low voltage is needed for a relatively brief duration. However, in
      defibrillation, approximately a 100-fold higher voltage is needed and achieved by
      the use of capacitors. The exponential voltage decay of a capacitor during its
      discharge determines the basic waveform for defibrillation. In an attempt to
      lower the energy needed for defibrillation, the steepness of the decay (different
      capacitances), the duration (fixed duration waveforms) or tilt (fixed tilt
      waveforms), or the initial polarity can be changed. Additionally, the polarity of
      the electrodes can be reversed during the discharge of the capacitor once
      (biphasic waveform) or twice (triphasic waveform). If two capacitors and
      defibrillation pathways are available, bidirectional defibrillation pulses can be
      delivered sequentially. In humans, the original standard waveform used with
      endocardial leads was a single monophasic pulse delivered by a 125-microF
      capacitor using the endocardial right ventricular electrode as cathode. It is now
      known that a reversal of the initial polarity and a reversal of polarity during
      capacitor discharge may significantly lower the energy needed for defibrillation,
      thereby preventing formerly frequent failures of defibrillation with endocardial
      lead systems. The use of sequential pulses showed no or only slight reductions of
      energy requirements and was abandoned due to the additional electrode needed. The
      use of a smaller capacitance (60-90 microF reduced maximum energy output but
      generally did not reduce energy requirements for defibrillation. However, with
      more efficient electrodes, smaller capacitances that will help to reduce the size
      of the defibrillator might be used. Thus, today defibrillation is optimized with
      respect to energy, capacitor size, and ease of implantation if an approximately
      90-microF capacitor is used to deliver a biphasic pulse via a bipolar lead system
      using the right ventricular electrode as anode.

PMID- 7777416
TI  - Correlation among fibrillation, defibrillation, and cardiac pacing.
AB  - An electrical stimulus must create an electric field of approximately 1 V/cm in
      the extracellular space to stimulate myocardium during diastole. To initiate
      fibrillation by premature stimulation during the vulnerable period or to
      defibrillate, an extracellular electric field of approximately 6 V/cm is
      required, a value approximately six times greater than that necessary for
      diastolic pacing. Yet, the current strength of the pulse given to the stimulating
      electrode to initiate fibrillation or to defibrillate is much greater than six
      times the diastolic pacing threshold. The ventricular fibrillation threshold is
      typically 40 times greater than the diastolic pacing threshold expressed in terms
      of current. The defibrillation threshold in terms of current is typically
      thousands of times greater than the diastolic pacing threshold. The reason that
      these thresholds vary so much more in terms of stimulus current than in terms of
      extracellular potential gradient is that each of the three thresholds requires
      creation of the required potential gradient at different distances from the
      stimulating electrode. Pacing requires a potential gradient of approximately 1
      V/cm only in a small liminal volume of tissue immediately adjacent to the
      electrode. Initiation of ventricular fibrillation by premature stimulation during
      the vulnerable period requires a potential gradient of approximately 6 V/cm about
      1 cm away from the stimulating electrode to allow sufficient space for the
      central common pathway of a figure-eight reentrant circuit to form. Since the
      potential gradient falls off rapidly with distance from the stimulating
      electrode, a stimulating current about 40 times greater than the diastolic pacing
      threshold is required to generate an electric field of 6 V/cm approximately 1 cm
      away from the stimulating electrode. Defibrillation requires an electric field of
      approximately 6 V/cm throughout all or almost all of the ventricular myocardium.
      Since some portions of the ventricles can be more than 10 cm away from the
      defibrillation electrodes, a shock of several amps is required to create this
      field, a current thousands of times greater than the pacing threshold.

PMID- 7777418
TI  - Programmable VT detection enhancements in implantable cardioverter defibrillator
      therapy.
AB  - This report describes the distribution of automatically measured values of
      enhanced arrhythmia detection parameters such as "rate stability" and "rate
      onset" in various forms of spontaneous arrhythmia episodes in patients treated
      with a new, third-generation, tiered therapy implantable cardioverter
      defibrillator (ICD). The study population consisted of 27 patients who received
      the Ventak PRxII cardioverter defibrillator, which provides extensive diagnostic
      options such as electrogram storage capabilities, and the ability to store
      measured values of additional arrhythmia detection parameters such as rate
      stability and rate onset during spontaneous arrhythmia episodes. During a follow
      up period of 11.1 +/- 5.2 months, this device detected 264 arrhythmia episodes.
      The analysis of stored electrograms revealed 13 episodes of sinus tachycardia, 52
      episodes of atrial tachyarrhythmias, and 201 episodes of monomorphic ventricular
      tachycardias (VTs). The mean measured values of rate stability and rate onset
      were: 2.2 +/- 0.9 msec, 0% in sinus tachycardias; 41.0 +/- 24.1 msec, 8.5% +/-
      9.5% in atrial tachyarrhythmias; and 7.8 +/- 6.0 msec, 30.6% +/- 12.1% in
      monomorphic VTs. There was a wide zone of overlapping measured values for rate
      stability and rate onset in ventricular and nonventricular rhythms. No episode of
      VT showed a measured rate stability criterion > 35 msec. The subanalysis of
      arrhythmia episodes presenting with a heart rate < 160 beats/min revealed no
      episode of VT with a rate stability value > 24 msec. The calculated, rate
      dependent specificities for these programmed rate stability parameters in
      detecting VTs were 46.2% and 81.8%, respectively. The analysis of the rate onset
      algorithm revealed no comparable relationship between sensitivity and specificity
      in the detection of VTs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7777419
TI  - Implantable cardioverter defibrillator lead technology: improved performance and
      lower defibrillation thresholds.
AB  - The performance of an ICD system depends, in part, on the effectiveness with
      which the lead system functions. Engineering trade-offs are made during the
      design of a lead to optimize one or more performance characteristics: e.g., lead
      handling, fatigue life, size, and optimized therapy delivery. To assure low
      defibrillation thresholds, careful attention must be taken during the design
      process to prevent these trade-offs from hampering the lead's therapy
      effectiveness. Four basic design rules are described that capture many of the
      engineering concepts that will enhance a lead's efficacy: (1) minimize electrode
      pullback, (2) deliver current to the apex, (3) minimize energy loss in the lead,
      and (4) use large, efficient electrodes. These rules speak to optimizing delivery
      of current to the heart and efficiency of the lead and electrode interface. When
      the lead performs its function well, the complete ICD system of the heart, lead,
      and implantable pulse generator will provide optimal safety margins for device
      implant and an increased number of patients that can be implanted with a single
      lead system.

PMID- 7777420
TI  - Holter functions of the implantable cardioverter defibrillator: what is still
      missing?
AB  - The technology of the implantable cardioverter defibrillator (ICD) offers the
      opportunity to overcome the present limits of the invasive and noninvasive
      approaches of clinical electrophysiology. The invasive approach enables us to
      reproduce severe arrhythmias if they are inducible, but does not give information
      concerning the way they spontaneously arise. The noninvasive approach (Holter)
      gives this information, but it usually concerns only trivial arrhythmias with
      different therapeutic targets. One hopes in the future, by means of an important
      extension to ICD technology, which is not technically possible for the time
      being, to have access to pertinent information and to a better understanding of
      the circumstances leading to severe spontaneous arrhythmias, potentially lethal.
      For the moment, we only have the diagnostic certainty leading to the therapeutic
      intervention. It is based on an ECG and on the sequence of cardiac cycles
      preceding the rhythmic controlled accident. These data allow verification of but
      not explanation of the events. To have a chance to be understood and explained,
      these "events" must be replaced in the context of the "nonevents." Ideally, one
      should have all the gross information concerning the last 24 hours and
      subsequently analyze them. It is already a big step, thanks to the defibrillators
      the right to therapeutic error has been gained, a unique and fatal accident has
      been transformed into a repeatable event, and therefore, access is gained to the
      evolution of the responsible disease.

PMID- 7777423
TI  - Pacing techniques to terminate ventricular tachycardia.

PMID- 7777422
TI  - Antiarrhythmic drugs in patients with an automatic implantable defibrillator.

PMID- 7777421
TI  - Implantable cardioverter defibrillator: effect on survival.

PMID- 7777424
TI  - Italian multicenter clinical experience with endocardial defibrillation: acute
      and long-term results in 307 patients. The Italian Endotak Investigator Group.
AB  - This study presents the acute and long-term results of 307 patients (267 men,
      mean age 57.5 years, 205 suffering from coronary artery disease, mean left
      ventricular ejection fraction 33.3%) with malignant ventricular tachyarrhythmias
      who underwent attempted transvenous ICD implantation with the CPI Endotak lead
      system in 37 Italian centers. Transvenous ICD implantation was ultimately
      accomplished in 306 (99.7%) patients. These included 19 subjects with high (< 10
      J below output energy of implanted device) defibrillation threshold (DFT) at
      implant. One hundred sixty-four patients (53%) were implanted with the
      endocardial lead alone, while 142 also received an SQ patch or SQ array. The mean
      DFT (not always step-down DFT) at implant was 16.9 +/- 5.7 joules; 15.3 +/- 5.2
      joules with biphasic shock and 19.6 +/- 5.4 joules with monophasic shock; P <
      0.0001. A significantly higher percentage of patients tested with a biphasic
      shock could be implanted with adequate safety margin and without an additional SQ
      patch or SQ array (98% and 81%, respectively). No perioperative deaths occurred.
      During the mean follow-up of 14.5 +/- 10.2 months, 140 patients (52%) received at
      least one appropriate shock. An inappropriate shock was observed in 26% of
      episodes. The 1- and 3-year actuarial incidence of sudden death was 2% and 4%,
      respectively, and that of total death was 10% and 20%, respectively. A pocket
      infection requiring ICD explantation occurred in 4 patients (1.4%) and an
      endocardial lead dislodgment in 11 patients (3.6%). Two patients (0.3%) showed a
      sensing pin disconnection and six patients (2.3%) had a lead insulation break.
      The results of this Italian multicenter trial indicate that the CPI Endotak lead
      system is a simple, safe, and reliable system for endocardial defibrillation.
      When compared to epicardial leads, it clearly reduces the perioperative mortality
      and morbidity, while maintaining a similar efficacy in preventing sudden death
      and terminating ventricular arrhythmias.

PMID- 7777425
TI  - Future expectations of implantable cardioverter defibrillator therapy.

PMID- 7777426
TI  - Atrial defibrillator: is it needed? Would society pay for it?

PMID- 7777427
TI  - Cardioverter defibrillator therapy as a bridge to heart transplantation.
AB  - The prognosis of patients with severely impaired left ventricular function is
      poor, with an annual mortality rate of about 50%, and the majority die from
      sudden cardiac death. Heart transplantation is an accepted therapy for patients
      with end-stage heart disease; however, about 30% of candidates for
      transplantation die from sudden cardiac death while on the waiting list. It has
      been shown that implantable cardioverter defibrillator (ICD) therapy has a low
      surgical mortality and is highly effective in the prevention of sudden death.
      Therefore, prophylactic ICD implantation may prevent sudden death in patients
      with end-stage heart disease while on the waiting list, and it is highly probable
      that patients with an ICD have a greater chance of survival until a donor heart
      becomes available. However, this hypothesis still has to be proven by prospective
      studies.

PMID- 7777428
TI  - 7th European Symposium on Cardiac Pacing. The official meeting of the Working
      Groups on Cardiac Pacing and Arrhythmias, European Society of Cardiology.
      Istanbul, Turkey, June 4-7, 1995. Abstracts.

PMID- 7777429
TI  - [Repeats of DNA].

PMID- 7777430
TI  - [Guanosine tetraphosphate, ppGpp, as a factor of stringent control of DNA
      replication].

PMID- 7777431
TI  - [Nobel prize 1994 -- G proteins].

PMID- 7777432
TI  - [Molecular basis of steroid 21-hydroxylase deficiency].

PMID- 7777434
TI  - [Neurosteroids--synthesis and metabolism].

PMID- 7777433
TI  - [Pioneers in molecular biology: Emil Fischer, Erwin Schrodinger and Oswald T.
      Avery].

PMID- 7777435
TI  - [Prenylation of proteins].

PMID- 7777436
TI  - [Cytochrome c conformation and its interactions with cytochrome c oxidase].

PMID- 7777437
TI  - [The role of inositol cycle in signal transduction in the cell nucleus].

PMID- 7777438
TI  - [Cancer as a disease of the genes].

PMID- 7777439
TI  - Peripheral arterial disease. When to consider percutaneous revascularization.
AB  - Currently, percutaneous revascularization techniques are recommended for
      peripheral arterial disease only when limiting or disabling symptoms are present.
      However, the cost of these procedures is less than that of surgery and the risk
      is much lower. Additional prospective, randomized studies are needed for better
      definition of the role of percutaneous techniques in clinical practice. In the
      future, as techniques evolve and outcomes become better defined, this role may be
      expanded.

PMID- 7777440
TI  - Adolescent sexual intercourse. Strategies for promoting abstinence in teens.
AB  - As sex, drugs, and rock 'n' roll have given way to STDs, HIV, and AIDS,
      adolescent sex has become an increasingly high-risk behavior. Dr Kay strongly
      believes that primary care physicians can have a prominent role in educating
      teens and their parents about the consequences of premature sexual activity and
      in promoting healthy living. In this article, he presents the case against
      adolescent sexual intercourse and outlines a concrete approach to dealing with
      adolescent patients at risk and their families.

PMID- 7777441
TI  - Trichinosis. Still a public health threat.
AB  - Trichinosis remains a worldwide public health problem, although most US
      physicians have little or no experience with the disease. A history of exposure
      to raw or undercooked pork and findings of myopathy, eosinophilia, and
      periorbital edema are characteristic. The diagnosis can be confirmed with tissue
      biopsy or serodiagnostic testing. Mild infections respond to limited bed rest and
      use of analgesics and antipyretics. More severe cases can be treated effectively
      with corticosteroids and anthelminthics.

PMID- 7777442
TI  - Vertebral osteomyelitis. How to differentiate it from other causes of back and
      neck pain.
AB  - Vertebral osteomyelitis, an uncommon infection, usually presents with the very
      common symptom of neck or back pain. Awareness of this disorder and its
      distinctive features aids physicians in prompt ordering of appropriate imaging
      studies, which usually lead to the diagnosis. Early diagnosis, identification of
      the infecting microbe, and appropriate antimicrobial therapy are the keys to
      preventing complications and reducing the need for surgical intervention.

PMID- 7777443
TI  - Free dinners for seniors who listen to HMO spiel.

PMID- 7777445
TI  - Borderline personality disorder. Interpersonal and behavioral problems that
      sabotage treatment success.
AB  - Patients with borderline personality disorder may be the most psychologically
      challenging patients a primary care physician ever encounters. Early diagnosis is
      important to avoid interpersonal enmeshment and personalization in dealings with
      these patients, who often appear intact initially. The acronym PISIA is useful in
      recalling the major characteristics of the disorder: psychotic episodes,
      impulsivity, superficially intact social adaptation, interpersonal-relationship
      problems, and affective disorders. Specific techniques (eg, setting limits,
      separating medical and psychological issues, consulting a psychiatrist to
      determine a psychotropic drug regimen) promote effective treatment of these
      difficult patients.

PMID- 7777444
TI  - Myocardial infarction in the 1990s. Complications, prognosis, and changing
      patterns of management.
AB  - Arrhythmias are the most common complications of acute myocardial infarction.
      However, other complications, such as ventricular free-wall rupture, thrombosis
      in locations other than the primary site of infarction, and thromboembolic
      strokes, also may occur. In addition, thrombolytic therapy given after infarction
      may cause intracranial hemorrhage, allergic reactions, and hypotension. To reduce
      the 1-year mortality rate in patients who survive hospitalization, an effort
      should be made to detect and treat residual ischemia, ventricular dysfunction,
      and electrical instability. Follow-up rehabilitation and prevention are
      essential. In this endeavor, primary care physicians, emergency personnel,
      specialists, nursing staff, and technicians form an integral team.

PMID- 7777446
TI  - Physiologic evaluation of bronchial asthma. Why objective testing is essential.
AB  - Physiologic evaluation of bronchial asthma is extremely valuable. Simple
      objective measurements of expiratory airflow and lung volume help physicians
      determine disease status and monitor patient response to therapy. More elaborate
      measurements of pulmonary function are not commonly needed in primary care
      practice. The three case studies described in this article show that objective
      assessment of lung function is critical in effective treatment of asthma.

PMID- 7777447
TI  - Acute severe asthma. How to recognize and respond to a life-threatening attack.
AB  - A disturbing increase in mortality from asthma has occurred over the past decade.
      Asthmatic patients who are over age 55 and have coexisting cardiac or pulmonary
      disease, those who have a history of mechanical ventilation, and those who
      require continuous outpatient use of corticosteroids to control symptoms have an
      increased risk of severe or fatal exacerbations of their disease. Patients
      hospitalized for severe asthma should receive inhaled beta 2-adrenergic agonists
      for bronchodilation and intravenous corticosteroids. Patients requiring
      mechanical ventilation have about a 20% incidence of pneumothorax and an enhanced
      risk of nosocomial pneumonia, and their mortality rate approaches 20%. Once
      severe asthma improves, patients must have their outpatient regimen strengthened
      by the use of oral corticosteroids, inhaled corticosteroids, and/or inhaled
      cromolyn sodium (Intal).

PMID- 7777448
TI  - Nocturnal asthma and exercise-induced bronchospasm. Why they occur and how they
      can be managed.
AB  - Asthma is increasing in prevalence and morbidity worldwide. Worsening of asthma
      symptoms during sleep and following exercise is an important component of this
      morbidity. Better recognition and management of nocturnal asthma and exercise
      induced broncho-constriction should lead to improved outcomes. Measures to
      alleviate nocturnal asthma include elimination of exposure to allergens, use of
      measures to control contributing factors (rhinitis, sinusitis, gastroesophageal
      reflux, sleep apnea), maximization of the dosage of daytime asthma medications,
      and appropriately timed use of medications such as a long-acting inhaled beta 2
      agonist, a once-daily sustained-release theophylline product, and an oral
      corticosteroid. Bronchoconstriction after exercise can be decreased by physical
      conditioning, warm-up exercises, wearing of a face mask in cold weather,
      postponement of exercise until at least 2 hours after a meal, and pretreatment
      with an inhaled beta agonist. Pretreatment with inhaled cromolyn sodium (Intal),
      nedocromil sodium (Tilade), or ipratropium bromide (Atrovent) may be added if
      necessary.

PMID- 7777449
TI  - Occupational asthma. Serious consequences for workers and employers.
AB  - Patients affected by occupational asthma have respiratory symptoms that may
      persist for months, years, or even life. Hundreds of substances have been
      implicated in the disease, and the list is expected to grow. The authors discuss
      management of this sometimes life-threatening condition and emphasize the
      importance of environmental controls to prevent future cases.

PMID- 7777450
TI  - XXXVIII Nordic Meeting of Pharmacology and XIII Helsinki University Course in
      Drug Research. Helsinki, Finland, May 18-20, 1995. Abstracts.

PMID- 7777451
TI  - [Laser therapy in renal tuberculosis: mechanism of action].
AB  - Etiotropic therapy in urinary tuberculosis fails to provide adequate repair.
      Normalization of renal function requires additional pathogenetic measures, laser
      treatment, in particular. Experience with laser treatment is now available for
      respiratory tuberculosis only. Mechanism of action of low-intensity laser
      radiation in nephrotuberculosis and rationale for its use are described.

PMID- 7777452
TI  - [Combined use of the Koch tuberculin provocation test and immunological tests in
      patients with urinary tuberculosis].
AB  - The use of provocative Koch test proved most effective in enhancing sensitivity
      of serological diagnostic tests EIA and IHA with PHA. This contributed to more
      accurate assessment of the tuberculous process activity in patients with advanced
      destruction of the kidneys. Quantitation of antituberculous antibodies may serve
      an additional criterium in evaluation of effectiveness of urological tuberculosis
      chemotherapy.

PMID- 7777453
TI  - [Distribution of histocompatibility antigens in patients with pulmonary
      tuberculosis depending on disease course and immune response pattern].
AB  - Genetic relationships with tuberculous process and immunity were investigated
      within immunogenetic study of 178 patients with active pulmonary tuberculosis.
      Tuberculosis occurrence seemed to be associated with phenotypical antigen Cw2.
      Unfavorable outcome of the disease was observed in the presence of HLA A9, A11,
      B14, B40, B41 antigens. A pronounced specific humoral and cellular responses more
      frequently arise in carriers of antigens Cw2 and B13, while high proliferative
      activity of T-cells in carriers of A10, B7 and Cw2. Production of IgA, IgG and
      IgM is determined by different genetic factors. The results obtained are
      essential for prognosis of tuberculosis course and choice of individual therapy.

PMID- 7777454
TI  - [Teaching phthisio-pulmonology in medical college].

PMID- 7777455
TI  - [Generation of platelet activating factor by neutrophils in patients with
      pulmonary tuberculosis].
AB  - PAF levels in native blood neutrophils before and after 1-hour incubation with
      killed BCG culture and in relevant incubation medium were measured in 44 patients
      with active pulmonary tuberculosis according to rabbit platelet aggregation. A
      control group consisted of 12 healthy volunteers. Neutrophil PAF concentrations
      in the patients were 6 times higher than those in the controls and caused a rise
      in plasma PAF levels. Intracellular PAF content was related to the process
      characteristics (new-onset tuberculosis, exacerbation, recurrence), intoxication,
      hemogram shifts and immune status of the patient. In vitro experiments showed
      that in response to a specific phagocytosis object, generation of PAF in
      neutrophils and its release into the intercellular space depend on initial PAF
      levels in native cells. In normal and moderately elevated PAF in native
      neutrophils contact with killed BCG culture entailed its intracellular content
      increase, while in initially high intracellular PAF additional stimulation
      induced primarily its release.

PMID- 7777457
TI  - [Antibodies to Bacillus megaterium H glycoprotein in patients with lung
      diseases].
AB  - Enzyme immunoassay performed in patients with malignant and benign affections of
      the lungs determined antibodies (Abs) to glycoprotein isolated from saprophyte
      microorganism Bacilus megaterium H. In pulmonary tuberculosis and nonspecific
      pulmonary inflammation the above Abs occurred in patients with fibrous
      proliferative changes and associated neoplastic conditions. In lung cancer the
      Abs were detected in well and moderately differentiated tumors. Nondifferentiated
      and poorly differentiated variants did not exhibit any rise in Abs to
      glycoprotein.

PMID- 7777456
TI  - [Development of protective antituberculosis immunity after BCG vaccination in
      mice with silicon deficiency in water and feed].
AB  - An experimental mouse model of normal and deficient content of silicon in the
      diet in CBA strain has been developed. It is shown that after BCG vaccination
      silicon deficiency brought about a dramatic decrease of in vitro proliferation of
      splenic lymphocytes in the presence of mycobacterial antigens, ConA or in the
      absence of the stimuli. DTH response to tuberculin in silicon deficient mice was
      also reduced. The level of specific serum IgG did not depend upon silicon content
      in the diet. The addition of silicon into the diet of silicon-deficient mice
      beginning from BCG vaccination restored the level of immune reactions.

PMID- 7777458
TI  - [Basic principles of the diagnosis in pulmonary tuberculosis (lecture)].

PMID- 7777459
TI  - [Biological characteristics of M. tuberculosis and difficulties in
      microbiological diagnosis of tuberculosis].
AB  - The paper outlines difficulties in tuberculosis diagnosis and effectiveness of
      various methods of mycobacteria identification. The latter along with direct and
      indirect determination of mycobacterial drug resistance require perfection. There
      is a need in investigation of diagnostic samples from tuberculous and respiratory
      sarcoidosis patients for mycobacterial granular forms. A multimodality diagnostic
      approach to examination of clinical material from tuberculous patients is
      advocated.

PMID- 7777461
TI  - [Prognostic significance of seroepidemiological check-up in leprosy].

PMID- 7777460
TI  - [Cytokines in immunopathogenesis of pulmonary tuberculosis].
AB  - Production of IL-1, IL-2, gamma-interferon and PNO was measured in 46 patients
      with various forms of pulmonary tuberculosis. Cytokins quantitation was conducted
      biologically, using radioimmunoassay and enzyme immunoassay in supernatants of
      cellular structures (blood lymphocytes). There were high levels of IL-1 and PNO,
      reduced production of IL-2 and gamma-IFN by stimulated blood mononuclears. In
      effective chemotherapy (3-4 months) production of IL-1 tented to a decline, while
      that of IL-2 and gamma-IFN went up.

PMID- 7777462
TI  - [Immunomodulating role of endogenous thyroid hormones in mycobacterioses].
AB  - Radionuclide tracing in peripheral blood of patients with mycobacterial
      infections varying in activity (lepromatous lepra, n = 98; pulmonary
      tuberculosis, n = 51) provided information on lymphocyte proliferative response
      to PHA, tuberculin, sensitin from lepra mycobacteria, on thyroid hormones
      concentrations. Endogenic thyroid hormones are shown to have immunomodulating
      properties closely related to the disease activity.

PMID- 7777463
TI  - [Affinity isolation of mycobacterial antigens on monoclonal antibodies].
AB  - Affinity chromatography on monoclonal antibodies specific to tuberculous
      mycobacteria was used to isolate mycobacterial antigens from ultrasonic
      disintegrate M. tuberculosis H37Rv. Disk-electrophoresis on polyacrylamide gel
      showed purified antigens to consist of polypeptides with molecular mass 16, 19,
      32, 60, 27, 70 and 55 kD. The antigens were tested for enzyme immunoassay of
      antibodies in the sera from patients with infiltrative pulmonary tuberculosis.

PMID- 7777464
TI  - [Phenotypic and functional analysis of blood lymphocytes and pathological focus
      in patients with pulmonary tuberculosis].
AB  - A subpopulation study of lymphocytes concentrating in cavernous, lymph node
      tissues and blood from patients with fibrous-cavernous tuberculosis of the lungs
      showed that in spite of high CD3+ and CD4+ cell levels in the cavern, the
      response of these cells to mitogens may be weaker than blood lymphocyte response.
      IL-2 production by cavern lymphocytes varied and was unrelated to proliferative
      response of these cells to M. tuberculosis antigens.

PMID- 7777465
TI  - [Protective properties of M. lufu in experimental leprosy].
AB  - A protective potential of M. lufu against experimental lepra was studied in mice
      infected with M. leprae according to Shepard. 5 and 9 months after the
      inoculation quantitation of the causative agent in the animals' paws indicated a
      protective action of M. lufu which exceeded that of BCG, M. vaccae and M. leprae.
      High protective activity of M. lufu is due both to its antigenic composition
      similarity with M. leprae and influence on immune response regulation. It is
      suggested to use M. lufu for design of highly effective antilepra vaccine.

PMID- 7777466
TI  - [Effects of endogenous cortisol on the function of nonspecific T-suppressors and
      quantitative characteristics of main subpopulations of circulating T-lymphocytes
      in leprosy].
AB  - Serum hydrocortisone levels, cellular immunity and their correlation were studied
      in 38 patients with lepromatous lepra in regression. 12 of them had exacerbation
      of specific polyneuritis. The latter condition is accompanied by a rise in
      hydrocortisone concentrations. Relative number of blood CD8+ lymphocytes
      correlated positively with hydrocortisone content, whereas the quantity of CD4+
      cells correlated negatively. In patients without neurological complications in
      negative correlation between blood hydrocortisone and lymphocyte glucocorticoid
      sensitivity there was a positive relationship between nonspecific T-suppressor
      activity and hydrocortisone levels. The involvement of endogenic hydrocortisone
      in T-suppressor activity regulation in regressive lepra can help understand the
      role of endocrine dysfunction and stress in pathogenesis of lepra relapses.

PMID- 7777467
TI  - [Effectiveness of isoniazid in tuberculosis chemoprophylaxis in children with
      rising tuberculin sensitivity].
AB  - 70 children aged 4-15 with growing tuberculin sensitivity received preventive
      treatment with isoniazid in children's sanatorium. The drug was taken for 2 or 3
      months in a dose 10 mg/kg daily (19 and 51 children, respectively). Preventive
      isoniazid course proved effective as none of the children treated developed
      tuberculosis within 3 years. The 3-month course is preferable as it is more
      potent in relation to tuberculin sensitivity immediately after the treatment
      termination and 1, 2 years after it.

PMID- 7777468
TI  - [Effects of diaminodiphenylsulfone and rifampicin on biorhythms of lymphocyte
      level in intact mice].
AB  - Administration of DDS and R alone as well as in combination to CBA mice was
      studied for effects on blood lymphocyte biorhythms. These drugs were found to
      affect circadian rhythms of lymphocyte number. The changes depended on the season
      and time of administration. Allowances for the above changes help correct
      asynchronism thus improving the response rate.

PMID- 7777469
TI  - [Broncholytic activity of dose-adjusted aerosols in active respiratory
      tuberculosis].

PMID- 7777471
TI  - Noncalcific cusp thickening in Ionescu-Shiley cardiac valvular bioprostheses.
AB  - This study was undertaken to examine the morphological basis for noncalcific cusp
      thickening in 20 standard-profile Ionescu-Shiley bovine pericardial cardiac
      valvular bioprostheses (16 aortic, four mitral) with primary valve failure due to
      cusp tears. The patients included 17 males and three females, with a mean age of
      52.0 years; their valves had been implanted for a mean of 105.8 months. All cases
      had variable degrees of "plasma insudation" without correlation to identifiable
      patient parameters. This was accentuated in individual valves in the cusp with
      the most extensive tears. In addition, the three valves with the thickest cusps
      were grossly distorted by massive deposits of amyloid (identified as AL-amyloid
      in two index cases studied). Two other valves had incidental amyloid deposits,
      identifiable only by electron microscopy. Amyloid involvement of pericardial
      bioprostheses has not been previously reported. The literature pertaining to
      amyloid involvement and plasma insudation of bioprostheses is reviewed.

PMID- 7777472
TI  - Fine needle aspiration biopsy of proliferative breast disease.
AB  - Proliferative breast disease (PBD) is a well-recognized histologic entity that
      has received increasing attention in the cytologic literature. We have attempted
      to prospectively identify and subclassify PBD by fine needle aspiration biopsy
      since 1987 using criteria we developed through our experience. Over 2800 breast
      FNABs were performed on breast lesions from 1987 to mid-1992; 257 were
      cytologically diagnosed as PBD with or without atypia. Eighty-four were
      significantly worrisome clinically to warrant surgical excision. Forty of these
      were designated PBD without atypia by cytology; 23 (58%) were in agreement with
      histology; three (8%) were PBD with atypia by histology; five (13%) were cancers;
      and nine (22%) were nonproliferative. Forty-four cases were designated PBD with
      atypia; 24 (55%) were in agreement with the histologic diagnosis; 12 (27%) proved
      to be PBD without atypia; six (13%) were carcinoma; and two (5%) were
      nonproliferative. After 1991 we employed stricter criteria for PBD, improving on
      the results from 1991-1992. During this period, there were 53 diagnoses of PBD
      with or without atypia and 34 were excised. Nine of the 10 (90%) aspirates
      designated as PBD without atypia were in agreement with histologic findings. The
      other case was nonproliferative. Fifteen of the 24 cases diagnosed as PBD with
      atypia were in concordance with histologic findings (63%), one was
      nonproliferative, seven were PBD without atypia (29%), and one (4%) proved to be
      carcinoma.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7777470
TI  - [Clinical aspects and course of extrapulmonary sarcoidosis].
AB  - Follow-up results (3-15 years) are available for 95 patients with extrapulmonary
      sarcoidosis. The disease presented with multiple lesions and recurrent course.
      Peripheral lymph nodes were the most frequent location. Severe course was more
      typical for sarcoidosis of the nervous system, liver, and the kidneys. Combined
      treatment (corticosteroids, antioxidants, immunocorrection) proved an effective
      modality.

PMID- 7777473
TI  - Diagnosis of chronic lung transplant rejection by transbronchial biopsy.
AB  - Chronic rejection in the form of obliterative bronchiolitis (OB) associated with
      chronic inflammation and fibrosis of bronchi (CIB) is a significant cause of
      morbidity and mortality in long-term heart-lung and single-lung transplant
      recipients. To determine the utility of transbronchial biopsy in diagnosing
      chronic rejection, we reviewed 24 transbronchial biopsies (TBBs) performed at the
      time of, or subsequent to, a clinical diagnosis of OB of chronic rejection in
      eight heart-lung and single-lung transplant recipients at the Methodist Hospital,
      Houston, Texas. These were compared with 36 randomly selected control TBBs from
      14 patients without a clinical or histopathologic diagnosis of OB of chronic
      rejection at any time in their course. In the former group of TBBs, nine (38%)
      were diagnostic of OB and seven (29%) showed CIB suspicious for chronic
      rejection. TBBs diagnosed as negative had significantly fewer samples of tissue
      (1.0 versus > 3) and significantly smaller size of tissue (1.44 mm versus > 4.5
      mm) than did TBBs in the OB or CIB categories. When strict criteria were used, no
      false diagnoses of OB of chronic rejection were made on control TBBs. However, OB
      associated with bronchiolitis obliterans organizing pneumonia of viral
      pneumonitis was present in three (8%) and CIB in 15 (42%) of control TBB
      associated with acute rejection and infection. This finding emphasizes the
      nonspecificity of CIB. We conclude that TBB is potentially useful in diagnosing
      OB of chronic rejection in some cases and in suggesting chronic rejection in
      other cases. Inadequate sampling by the bronchoscopist was the major reason for a
      negative biopsy.

PMID- 7777474
TI  - AgNORs predictive value of prognosis in non-Hodgkin's lymphoma according to the
      Kiel classification.
AB  - Application of the colloidal silver method for demonstration of argyrophilic
      proteins of nucleolar organizer regions (AgNORs) in histological sections of non
      Hodgkin's lymphomas (NHLs) has been shown to be a helpful method for the
      discrimination of high- and low-grade NHL. In this study correlation between the
      mean number of AgNORs and other morphological and clinical parameters with
      survival in 58 patients with NHL, classified according to the Kiel
      classification, was investigated. It was shown that the mean number of AgNORs
      differed between the low- and high-grade group of NHLs (P < 0.001), as did
      survival (P < 0.0001). The mean number of AgNORs was also highly significant when
      describing actuarial survival. The value of 2.9 NORs per nuclei was the cut-point
      for separating the whole group into two subgroups, which differed the most when
      related to survival of patients with NHL.

PMID- 7777475
TI  - bcl-2 protein expression in melanocytic neoplasms of the skin.
AB  - Since the discovery of bcl-2 proto-oncogene in follicular lymphomas, the protein
      product has been detected in a variety of normal tissues including skin, where it
      is expressed in basal keratinocytes. Recent studies indicate that bcl-2 protein
      is detected in nonlymphoid malignancies such as neuroblastoma and carcinomas of
      the lung and prostate. This study investigates the presence of bcl-2 protein in
      benign and malignant melanocytic neoplasms of the skin. Immunohistochemical
      analysis of bcl-2 protein expression was performed on 39 nevi and 60 malignant
      melanomas, including 21 metastases. There was diffuse strong immunopositivity for
      bcl-2 protein in 100% of nevi and 65% (43/60) of primary and metastatic
      melanomas. bcl-2 protein was diffusely expressed in 67% (30/39) of primary
      melanomas and 54% (11/21) of metastases. Although bcl-2 immunoreactivity was
      observed in all levels of primary cutaneous malignant melanomas, in 43% (9/21) of
      deep melanomas (Clark level > or = III), and 100% (7/7) of thick tumors
      (thickness > or = 4.00 mm), there was focal loss of immunoreactivity. Metastatic
      melanomas showed focal loss of bcl-2 expression in 10% (2/21) of cases and total
      loss of bcl-2 protein in 39% (8/21). We conclude from our results that bcl-2
      protein is expressed by benign and malignant melanocytic tumors of the skin, but
      there is loss of bcl-2 protein expression with increasing tumor progression.

PMID- 7777476
TI  - Fibroma and giant cell tumor of tendon sheath: a comparative histological and
      immunohistological study.
AB  - Giant cell tumor of tendon sheath (GCTTS; "nodular tenosynovitis") and fibroma of
      tendon sheath (FTS) have traditionally been considered to be two points in a
      single neoplastic continuum. However, no systematic studies have addressed this
      concept directly to date. To more clearly define their relationship to one
      another, we studied five FTSs and seven typical GCTTSs by light microscopy and
      paraffin section immunohistochemistry. Tissue samples were stained for vimentin,
      desmin, smooth muscle actin (SMA), S100 protein, leukocyte common antigen (CD45),
      CD68 antigen (KP1), HAM56 antigen, alpha-1-antichymotrypsin (AACT), and MAC387
      antigen. These reagents were chosen to address proposed "fibrohistiocytic" and
      myofibroblastic lineages for the two lesions. All tumors had a lobular
      appearance. GCTTS was more cellular than FTS; it contained conspicuous numbers of
      osteoclast-like cells, and the stroma was not extensively hyalinized. In
      contrast, FTS was matrix-rich, often with extensive stromal sclerosis, and
      contained only rare giant cells. Immunophenotyping of GCTTS showed that both the
      spindle cell and giant cell components were positive for vimentin, LCA, CD68,
      HAM56, AACT, and MAC387, suggesting monocyte-macrophage-like features. Limited
      reactivity for desmin and SMA also implied conjoint myofibroblastic
      differentiation. On the other hand, FTS showed focal staining with HAM56 (all
      cases) and for CD68 (one case); staining for vimentin and SMA was uniformly
      intense and diffuse. Based on these results, we conclude that GCTTS and FTS both
      exhibit varying degrees of monocyte-macrophage-like and myofibroblastic
      differentiation. The predominance of macrophage-related determinants in GCTTS and
      myofibroblastic markers in FTS supports the premise that these lesions represent
      phenotypic extremes of a single clinicopathologic entity.

PMID- 7777477
TI  - Biologic markers of invasive pituitary adenomas involving the sphenoid sinus.
AB  - The biologic behavior of invasive pituitary adenomas is poorly understood and
      appears to be intermediate between intrasellar adenomas and pituitary carcinoma.
      Utilizing immunohistochemistry on tissue sections, we examined 10 invasive
      pituitary adenomas involving the sphenoid sinus with a panel of cellular and
      molecular markers and compared the results with 10 noninvasive pituitary adenomas
      and five normal pituitary glands. The panel included Ki-67 and PCNA
      (proliferation cell nuclear antigen), cell proliferation indicators; interleukin
      6 (IL-6), a multifunctional cytokine; heat shock protein 27 (HSP 27), a stress
      response protein; and p53, a tumor suppressor gene product. We found strong
      expression of IL-6 in normal pituitary glands, 20% of noninvasive and 50% of
      invasive adenomas. HSP 27 was absent in normal glands and present in 10% of
      noninvasive and 50% of invasive adenomas. The Ki-67 and PCNA proliferation index
      was above normal but was essentially the same in the two groups. p53 was not
      detected in any specimens. We propose that both IL-6 and HSP 27 may be markers of
      biologic aggression in pituitary adenomas.

PMID- 7777478
TI  - Alveolar cell hyperplasia in association with adenocarcinoma of lung.
AB  - We studied 41 patients, 22 men and 19 women, with surgically resected
      adenocarcinoma (AD) of the lung, to determine the frequencies of associated
      alveolar cell hyperplasia (ACH) and atypical alveolar cell hyperplasia (AACH),
      and to define the immunohistochemical profiles (IHP) of the AD, ACH, and AACH.
      The criteria used to look for ACH included a single row of cuboidal cells along
      alveolar walls, cell morphology distinct from bronchiolar epithelium, and the
      absence of chronic inflammation. AACH was considered whenever nuclear size was
      double the size of neighboring ACH and/or in cases with marked nuclear
      irregularity or hyperchromatism. ACH was identified in 24 of the 41 cases of AD.
      AACH was further demonstrated in six of the 24 cases of ACH. Twenty-three of the
      24 cases of ACH were suitable for IHP. The tumors yielded positive results in
      23/23, 22/23, 17/23, 22/23, and 18/23 cases when stained with Cam 5.2, AE1/AE3,
      Leu M-1, CEA, and B72.3, respectively. ACH reacted positively in 17/23, 17/23,
      0/23, 4/22, and 1/23 cases stained with Cam 5.2, AE1/AE3, Leu M-1, CEA, and
      B72.3, respectively. AACH reacted positively in 6/6, 6/6, 0/6, 1/6, and 0/6 cases
      stained with Cam 5.2, AE1/AE3, Leu M-1, CEA, and B72.3, respectively. These
      findings suggest that ACH and AACH are common features found in 24 and six of the
      41 cases of AD, respectively. The significance of this finding is not known, but
      it is possible that ACH/AACH may represent precursor changes similar to the
      bronchial epithelial dysplasia described in squamous cell carcinoma of the
      lung.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7777479
TI  - p53 gene mutations in human urothelial carcinomas: analysis by
      immunohistochemistry and single-strand conformation polymorphism.
AB  - We examined 60 cases of human urothelial carcinomas (27 superficial and 33 deeply
      invasive) for the frequency of p53 gene mutations. Forty-two cases were analyzed
      by both the immunohistochemical and the single-strand conformation polymorphism
      (SSCP) methods, and the remaining 18 cases were assayed by SSCP alone. For the
      latter assay, exons 4 to 8 were amplified by polymerase chain reaction, and the
      amplified nucleotides were analyzed for the evidence of mutations by gel
      electrophoresis. When mobility shift was observed, direct nucleotide sequencing
      was performed to determine mutation sequence. Three superficial and eight deeply
      invasive carcinomas demonstrated evidence of mutations. Mutations involved
      various codons randomly. The fact that all tumors with mutations of the p53 gene
      except for one were of high nuclear grade (grade III) suggests that p53 mutation
      is associated with the progression of bladder cancers. Our results indicate that
      SSCP is a sensitive screening assay for detecting gene mutations.
      Immunohistochemical analysis is also a sensitive method but may yield false
      positive as well as false negative results.

PMID- 7777480
TI  - Influence of formalin fixation time and tissue processing method on
      immunoreactivity of monoclonal antibody PC10 for proliferating cell nuclear
      antigen.
AB  - Proliferating cell nuclear antigen (PCNA), an auxiliary protein of DNA polymerase
      delta, has recently been proposed as a marker of proliferation that is detectable
      in formalin-fixed paraffin-embedded tissue. Fixation time has been known to
      influence protein immunoreactivity and therefore can significantly influence the
      results of a quantitative immunohistochemical assay. In this study, we
      investigate the relationship between formalin fixation time and immunoreactivity
      for PCNA in paraffin-embedded sections and examine the effect of postfixation
      tissue treatment with modified Bouin's solution. Samples of small and large
      intestine from two freshly sacrificed rats were fixed in 10% buffered formalin
      for 6, 30, 54, 174, 340, and 508 h. Standard histological processing was
      performed on paired specimens whose treatment differed only by predehydration
      immersion in a picric acid and mercuric chloride-containing solution. Paraffin
      sections were reacted with monoclonal antibody PC10 in a standard
      immunoperoxidase assay. Staining intensity for PCNA was scored on a scale of 0 to
      10, and the mean number of PCNA-positive cells per crypt (10 crypts counted) was
      determined. No difference between animals was found. PCNA immunoreactivity was
      maximal in specimens fixed for 6 to 30 h, exponentially declining with longer
      fixation time. The rate of decline was mitigated in the treated sections.
      Fixation-time dependence of PCNA immunoreactivity has immediate implications for
      intra- and interlaboratory comparisons, especially in experimental studies in
      which specimens can be stored in formalin for variable times followed by batch
      processing. With regard to surgical pathology specimens, this study suggests that
      sample comparisons are valid, since routine fixation time is within the optimal
      rage for PCNA immunodetection.

PMID- 7777481
TI  - Interphase cytogenetic analysis of single cell suspensions prepared from
      previously formalin-fixed and paraffin-embedded tissues.
AB  - Fluorescence in situ hybridization (FISH) provides a rapid and accurate method
      for the detection of chromosomal aneuploidy. We have developed a technique for
      the use of FISH on single cell suspensions produced from either formalin-fixed or
      paraffin-embedded tissues. Preparation of such tissues involves sequential
      rehydration, enzymatic digestion to release single nuclei, and hybridization with
      a fluorescently labeled chromosome-specific centromeric probe. In a clinical
      setting formalin-fixed tissue from many tissue types is readily available for
      additional retrospective study. FISH on formalin-fixed tissues is especially
      beneficial in follow-up studies of cases involving termination after prenatal
      diagnosis or patients with a malignant disease where previous routine
      cytogenetics established the chromosomal aneuploidy. The use of this technique
      eliminates the biases of cytogenetic analysis due to clonal selection in tissue
      culture, the low number of cells analyzed, and the restriction to only dividing
      cell populations. We have demonstrated that this application of interphase
      cytogenetics to the study of various formalin-fixed tissues is amenable to the
      detection of chromosomal aneuploidies and has specific advantages over
      cytogenetic analysis.

PMID- 7777482
TI  - Nuclear morphometry in breast cancer: the influence of sampling rules and
      freezing of samples.
AB  - We studied nuclear morphometry of human breast cancer with special emphasis on
      two sources of variation: freezing prior to fixation and selection of measured
      objects on the basis of different sampling rules. Samples of 147 histologically
      verified invasive breast cancer cases were examined with a computer-based image
      overlay drawing system. Thirty-eight of the 147 samples of tissue frozen before
      embedding in paraffin were analyzed separately. Among the latter we found
      shrinkage of 35% and 46% (depending on the sampling rule) of the nuclear profile
      area as compared with samples not frozen before the standard tissue processing.
      These findings confirm that nuclear morphometry results from frozen and unfrozen
      tissue are not comparable. Frozen tissue later embedded in paraffin should not be
      used with prognostication models based on traditionally fixed tissue. In
      morphometry we applied two sampling rules that differed in the criteria used for
      selecting nuclei for measurement. We registered a significant difference in
      nuclear size and in the variation of nuclear size between the two sampling
      methods. Of the morphometric features studied, nuclear area was affected most.
      Finally, we examined the two sampling rules in light of the established
      prognosticators in breast cancer: tumor size, axillary lymph node status, and the
      Multivariate Prognostic Index (MPI). The two sampling rules resulted in different
      distributions of morphometric results in the prognostic groups. Our findings
      emphasize the significance of the sources of variation in nuclear morphometry.
      They also stress the need for well-standardized morphometric methods in
      predicting the outcome of breast cancer.

PMID- 7777483
TI  - Gastrointestinal stromal tumor: evidence for a smooth-muscle origin.
AB  - A gastrointestinal stromal tumor, arising from the rectal ampulla of a 63-yr-old
      man, was investigated using conventional techniques as well as Western blot
      analysis of its cytoskeleton proteins. The expression of desmin, muscle-specific
      actins, vimentin, S-100 protein, chromogranin, neuron-specific enolase, and
      keratins was studied using the avidin-biotin technique. The tumor cells showed a
      positive reaction only to antivimentin antibody. Ultrastructural analysis failed
      to provide conclusive evidence for neural or muscular origin of the tumor.
      Western blot analysis of the tumor whole-protein extract allowed identification
      of the presence of gamma-smooth-muscle actin, thus suggesting an enteric smooth
      muscle origin of the tumor. This result seems partially to support a parenchymal
      smooth-muscle origin for S-100 protein and desmin-negative gastrointestinal
      tumors.

PMID- 7777484
TI  - The pathology of AIDS.

PMID- 7777485
TI  - Crystallization, molecular replacement solution, and refinement of tetrameric
      beta-amylase from sweet potato.
AB  - Sweet potato beta-amylase is a tetramer of identical subunits, which are arranged
      to exhibit 222 molecular symmetry. Its subunit consists of 498 amino acid
      residues (Mr 55,880). It has been crystallized at room temperature using
      polyethylene glycol 1500 as precipitant. The crystals, growing to dimensions of
      0.4 mm x 0.4 mm x 1.0 mm within 2 weeks, belong to the tetragonal space group
      P4(2)2(1)2 with unit cell dimensions of a = b = 129.63 A and c = 68.42 A. The
      asymmetric unit contains 1 subunit of beta-amylase, with a crystal volume per
      protein mass (VM) of 2.57 A3/Da and a solvent content of 52% by volume. The three
      dimensional structure of the tetrameric beta-amylase from sweet potato has been
      determined by molecular replacement methods using the monomeric structure of
      soybean enzyme as the starting model. The refined subunit model contains 3,863
      nonhydrogen protein atoms (488 amino acid residues) and 319 water oxygen atoms.
      The current R-value is 20.3% for data in the resolution range of 8-2.3 A (with 2
      sigma cut-off) with good stereochemistry. The subunit structure of sweet potato
      beta-amylase (crystallized in the absence of alpha-cyclodextrin) is very similar
      to that of soybean beta-amylase (complexed with alpha-cyclodextrin). The root
      mean-square (RMS) difference for 487 equivalent C alpha atoms of the two beta
      amylases is 0.96 A. Each subunit of sweet potato beta-amylase is composed of a
      large (alpha/beta)8 core domain, a small one made up of three long loops [L3
      (residues 91-150), L4 (residues 183-258), and L5 (residues 300-327)], and a long
      C-terminal loop formed by residues 445-493. Conserved Glu 187, believed to play
      an important role in catalysis, is located at the cleft between the (alpha/beta)8
      barrel core and a small domain made up of three long loops (L3, L4, and L5).
      Conserved Cys 96, important in the inactivation of enzyme activity by sulfhydryl
      reagents, is located at the entrance of the (alpha/beta)8 barrel.

PMID- 7777487
TI  - A new protein folding recognition potential function.
AB  - On the study of protein inverse folding problem, one goal is to find simple and
      efficient potential to evaluate the compatibility between structure and a given
      sequence. We present here a novo empirical mean force potential to address the
      importance of electrostatic interactions in protein inverse folding study. It is
      based on protein main chain polar fraction and constructed in a way similar with
      Sippl's from a database of 64 known independent three-dimensional protein
      structures. This potential was applied to recognize the protein native
      conformations among a conformation pool. Calculated results show that this
      potential is powerful in picking out native conformations, in addition it can
      also find structure similarity between proteins with low sequence similarity. The
      success of this new potential clearly shows the importance of electrostatic
      factors in protein inverse folding studies.

PMID- 7777486
TI  - A vector projection method for predicting the specificity of GalNAc-transferase.
AB  - The specificity of UDP-GalNAc:polypeptide N-acetylgalactosaminytransferase
      (GalNAc-transferase) is consistent with the existence of an extended site
      composed of nine subsites, denoted by P4, P3, P2, P1, P0, P1', P2', P3', P4',
      where the acceptor at P0 is being either Ser or Thr. To predict whether a peptide
      will react with the enzyme to form a Ser- or Thr-conjugated glycopeptide, a
      vector projection method is proposed which uses a training set of amino acid
      sequences surrounding 90 Ser and 106 Thr O-glycosylation sites extracted from the
      National Biomedical Research Foundation Protein Database. The model postulates
      independent interactions of the 9 amino acid moieties with their respective
      binding sites. The high ratio of correct predictions vs. total predictions for
      the data in both the training and the testing sets indicates that the method is
      self-consistent and efficient. It provides a rapid means for predicting O
      glycosylation and designing effective inhibitors of GalNAc-transferase.

PMID- 7777488
TI  - Affinities of phosphorylated substrates for the E. coli tryptophan synthase alpha
      subunit: roles of Ser-235 and helix-8' dipole.
AB  - The roles of Ser-235 and helix-8' (residues 235-242) in the functional binding
      and turnover of phosphorylated substrates by the alpha-subunit of the E. coli
      tryptophan synthase (TSase) alpha 2 beta 2-holoenzyme complex are examined.
      Previous crystallographic analyses indicated that this region was one of several
      near the phosphate moiety of the physiological substrate, indole-3-glycerol
      phosphate (IGP). The peptidyl amido group of Ser-235 was suggested to H-bond to
      the phosphate group; a helix macrodipole binding role was suggested for helix-8'.
      The activities and substrate Kms of mutant alpha-subunits altered in this region
      by site-specific mutagenesis are reported here. Substitutions at Ser-235 by an
      acidic (glutamic acid, mutant SE235), basic (lysine, mutant SK235), or a non
      peptidyl amido-containing residue (proline, mutant SP235) exhibit 40- to 180-fold
      Km increases for IGP and D-glyceraldehyde-3-phosphate; no Km defects for indole
      were observed. kcat values for SP235, SE235, and SK235 are 100, 70, and 40%,
      respectively, of the wild-type value. Steric considerations may explain the
      results with the SE235 and SK235 mutant alpha-subunits; however, the SP235
      results are consistent with the suggested phosphate binding role for the Ser-235
      peptidyl amido group during catalysis, A helix-8' dipole role was explored
      following proline substitutions separately at the first six (of eight) residues.
      Proline substitutions at positions-1 through -4 in helix-8' have normal indole
      Kms and catalytic activities in all four TSase reactions, suggesting no major
      global structural changes in these proteins. By these criteria, substitutions at
      positions-5 and -6 lead to significant structural alterations. Km increases for
      phosphorylated substrates are substantial (up to 40-fold) and are dependent upon
      the presence of L-serine at the beta-subunit active site. In the absence of L
      serine, substitution only at the first position results in binding defects; in
      the presence of L-serine, substitutions at the first, second and third positions,
      show binding defects of decreasing magnitude, sequentially. Substitutions at the
      fourth and fifth position have no effect on substrate binding. It is suggested
      that during catalysis a helix dipole effect on binding may be exerted but only
      via intersubunit-induced conformational changes due to ligand (L-serine) binding
      to the beta-subunit.

PMID- 7777489
TI  - A model of the complex between interleukin-4 and its receptors.
AB  - A three-dimensional model of interleukin-4 (IL-4) bound to one molecule each of
      the high- and low-affinity receptors (IL-4R and IL-2R gamma) was built, using the
      crystal structure of the complex of human growth hormone (HGH) with its receptor
      (HGHR) as a starting model. The modeling of IL-4 with its receptors was based on
      the conservation of the sequences and on the predicted structural organization
      for cytokine receptors, and assuming that the binding mode of the ligands would
      be similar. Analysis of the interface between IL-4 and both receptor molecules
      was carried out to reveal which residues are important for complex formation. The
      modeling procedures showed that there were no major problems in maintaining a
      reasonable fit of IL-4 with the two receptor molecules, in a manner analogous to
      the complex of HGH-HGHR. Many of the residues that appear by modeling to be
      important for binding between IL-4 and the receptors have been previously
      implicated in that role by different methods. A striking motif of aromatic and
      positively charged residues on the surface of the C-terminal domains of the
      receptors is highly conserved in the structure of HGH-HGHR and in the models of
      IL-4 complexed with its receptors.

PMID- 7777490
TI  - Structural studies of a synthetic peptide derived from the carboxyl-terminal
      domain of RNA polymerase II.
AB  - The conformation of the repeating heptapeptide unit of the carboxyl-terminal
      domain of RNA Polymerase II, Y1S2P3T4S5P6S7 has been examined using nuclear
      magnetic resonance spectroscopy and circular dichroism. Nuclear Overhauser
      effects and CD spectra for the synthetic 56-residue peptide H2N-(S2P3T4S5P6S7Y1)8
      COOH in water indicate that the peptide is largely unordered. A small population
      of folded molecules is observed to contain beta-turns located at Ser2-Pro3-Thr4
      Ser5 (SPTS) and Ser5-Pro6-Ser7-Tyr1 (SPSY). CD and NMR results in 90% TFE also
      indicate an equilibrium population of structures, but the fraction of turns is
      higher. Similarities of nuclear Overhauser effects in water and in 90% TFE
      suggest that the structures in TFE are biologically relevant. Based on these
      observations, the average structure of a single conformer of the heptapeptide
      repeat in 90% TFE was obtained by a distance geometry-simulated annealing method,
      using distance restraints extracted from nuclear Overhauser data. NMR spectra of
      the 56-mer show signals corresponding to only one repeat indicating that each
      repeat is in an identical environment. Thus it is possible to obtain an average
      structure of the heptapeptide repeat from NOE data on the 56-mer. Twenty-seven
      final structures were calculated and the root mean square deviations between the
      27 structures and the mean coordinates was 1.52 A for the backbone and 2.2 A for
      all nonhydrogen atoms. The heptapeptide repeat consists of two overlapping beta
      turns which are potentially stabilized by hydrogen bonds. The hydroxyl side
      chains of Ser2, Ser5, Thr4, and Ser7 all appear to be equally exposed for
      potential phosphorylation. The tyrosyl side chain of each repeat is folded
      inwards to the backbone and can potentially hydrogen bond to the carbonyl oxygen
      of the tyrosine in the preceding repeat. Interation of the average structure of
      the heptapeptide repeat results in a model of the carboxyl-terminal domain with a
      regular but unusual secondary structure consisting of a series of staggered beta
      turns.

PMID- 7777491
TI  - Crystallization and preliminary X-ray diffraction studies of an a1/alpha 2/DNA
      ternary complex.
AB  - Crystals have been obtained of a ternary complex containing the yeast a1/alpha 2
      homeodomain heterodimer bound to a 21-base pair DNA site containing two 5'
      overhanging bases at each end. The crystals are grown from cobaltic hexamine and
      form in space group P6(1) or P6(5) with a = b = 133 A, c = 45.4 A. Crystals that
      are flash-frozen at -179 degrees C diffract to 2.7 A along the c-axis and to 2.4
      A in perpendicular directions. The crystals contain one protein-DNA complex in
      the crystallographic asymmetric unit.

PMID- 7777492
TI  - Three-dimensional structure prediction of the NAD binding site of proton-pumping
      transhydrogenase from Escherichia coli.
AB  - A three-dimensional structure of the NAD site of Escherichia coli
      transhydrogenase has been predicted. The model is based on analysis of conserved
      residues among the transhydrogenases from five different sources, homologies with
      enzymes using NAD as cofactors or substrates, hydrophilicity profiles, and
      secondary structure predictions. The present model supports the hypothesis that
      there is one binding site, located relatively close to the N-terminus of the
      alpha-subunit. The proposed structure spans residues alpha 145 to alpha 287, and
      it includes five beta-strands and five alpha-helices oriented in a typical open
      twisted alpha/beta conformation. The amino acid sequence following the GXGXXG
      dinucleotide binding consensus sequence (residues alpha 172 to alpha 177)
      correlates exactly to a typical fingerprint region for ADP binding beta alpha
      beta folds in dinucleotide binding enzymes. In the model, aspartic acid alpha 195
      forms hydrogen bonds to one or both hydroxyl groups on the adenosine ribose sugar
      moiety. Threonine alpha 196 and alanine alpha 256, located at the end of beta B
      and beta D, respectively, create a hydrophobic sandwich with the adenine part of
      NAD buried inside. The nicotinamide part is located in a hydrophobic cleft
      between alpha A and beta E. Mutagenesis work has been carried out in order to
      test the predicted model and to determine whether residues within this domain are
      important for proton pumping directly. All data support the predicted structure,
      and no residue crucial for proton pumping was detected. Since no three
      dimensional structure of transhydrogenase has been solved, a well based tertiary
      structure prediction is of great value for further experimental design in trying
      to elucidate the mechanism of the energy-linked proton pump.

PMID- 7777493
TI  - Rethinking cell structure.
AB  - Cell structure, emerging from behind the veil of conventional electron
      microscopy, appears far more complex than formerly realized. The standard plastic
      embedded, ultrathin section can image only what is on the section surface and
      masks the elaborate networks of the cytoplasm and nucleus. Embedment-free
      electron microscopy gives clear, high-contrast micrographs of cell structure when
      combined with removal of obscuring material such as soluble proteins. The
      resinless ultrathin section is the technique of choice; it is simple and
      inexpensive, and it uses ordinary electron microscopes. The resulting pictures
      reveal a world of complex cell structure and function. These images necessarily
      change our conception of the cytoskeleton, nuclear matrix, mitosis, and the
      relation of membranes to cytostructure.

PMID- 7777495
TI  - Gene targeting approaches to complex genetic diseases: atherosclerosis and
      essential hypertension.
AB  - Gene targeting allows precise, predetermined changes to be made in a chosen gene
      in the mouse genome. To date, targeting has been used most often for generation
      of animals completely lacking the product of a gene of interest. The resulting
      "knockout" mice have confirmed some hypotheses, have upset others, but have
      rarely been uninformative. Models of several human genetic diseases have been
      produced by targeting--including Gaucher disease, cystic fibrosis, and the
      fragile X syndrome. These diseases are primarily determined by defects in single
      genes, and their modes of inheritance are well understood. When the disease under
      study has a complex etiology with multiple genetic and environmental components,
      the generation of animal models becomes more difficult but no less valuable. The
      problems associated with dissecting out the individual genetic factors also
      increases substantially and the distinction between causation and correlation is
      often difficult. To prove causation in a complex system requires rigorous
      adherence to the principle that the experiments must allow detection of the
      effects of changing only a single variable at one time. Gene targeting
      experiments, when properly designed, can test the effects of a precise genetic
      change completely free from the effects of differences in any other genes (linked
      or unlinked to the test gene). They therefore allow proofs of causation.

PMID- 7777494
TI  - The causes and prevention of cancer.
AB  - Epidemiological evidence indicates that avoidance of smoking, increased
      consumption of fruits and vegetables, and control of infections will have a major
      effect on reducing rates of cancer. Other factors include avoidance of intense
      sun exposure, increases in physical activity, and reduction of alcohol
      consumption and possibly red meat. A substantial reduction in breast cancer is
      likely to require modification of sex hormone levels, and development of
      practical methods for doing so is a high research priority. Resolution of the
      potential protective roles of specific antioxidants and other constituents of
      fruits and vegetables deserves major attention. Mechanistic studies of
      carcinogenesis indicate an important role of endogenous oxidative damage to DNA
      that is balanced by elaborate defense and repair processes. Also key is the rate
      of cell division, which is influenced by hormones, growth, cytotoxicity, and
      inflammation, as this determines the probability of converting DNA lesions to
      mutations. These mechanisms may underlie many epidemiologic observations.

PMID- 7777496
TI  - Symbiotic induction of a MADS-box gene during development of alfalfa root
      nodules.
AB  - In response to infection by Rhizobium, highly differentiated organs called
      nodules form on legume roots. Within these organs, the symbiotic association
      between the host plant and bacteria is established. A putative plant
      transcription factor, NMH7, has been identified in alfalfa root nodules. nmh7
      contains a MADS-box DNA-binding region and shows homology to flower homeotic
      genes. This gene is a member of a multigene family in alfalfa and was identified
      on the basis of nucleic acid homology to plant regulatory protein genes (MADS-box
      containing genes) from Antirrhinum and Arabidopsis. RNA analysis and in situ
      hybridization showed that expression of this class of regulatory genes is limited
      to the infected cells of alfalfa root nodules and is likely to be involved in the
      signal transduction pathway initiated by the bacterial symbiont, Rhizobium
      meliloti. The expression of nmh7 in a root-derived organ is unusual for this
      class of regulatory genes.

PMID- 7777497
TI  - Emergence of a new epidemic/epizootic Venezuelan equine encephalitis virus in
      South America.
AB  - One of the most important questions in arbovirology concerns the origin of
      epidemic Venezuelan equine encephalitis (VEE) viruses; these viruses caused
      periodic, extensive epidemics/epizootics in the Americas from 1938-1973 (reaching
      the United States in 1971) but had recently been presumed extinct. We have
      documented the 1992 emergence of a new epidemic/epizootic VEE virus in Venezuela.
      Phylogenetic analysis of strains isolated during two outbreaks indicated that the
      new epidemic/epizootic virus(es) evolved recently from an enzootic VEE virus in
      northern South America. These results suggest continued emergence of epizootic
      VEE viruses; surveillance of enzootic viruses and routine vaccination of equines
      should therefore be resumed.

PMID- 7777498
TI  - Structural variety of arginine-rich RNA-binding peptides.
AB  - Arginine-rich domains are used by a variety of RNA-binding proteins to recognize
      specific RNA hairpins. It has been shown previously that a 17-aa arginine-rich
      peptide from the human immunodeficiency virus Rev protein binds specifically to
      its RNA site when the peptide is in an alpha-helical conformation. Here we show
      that related peptides from splicing factors, viral coat proteins, and
      bacteriophage antiterminators (the N proteins) also have propensities to form
      alpha-helices and that the N peptides require helical conformations to bind to
      their cognate RNAs. In contrast, introducing proline mutations into the arginine
      rich domain of the human immunodeficiency virus Tat protein abolishes its
      potential to form an alpha-helix but does not affect RNA-binding affinity in
      vitro or in vivo. Based on results from several peptide-RNA model systems, we
      suggest that helical peptides may be used to recognize RNA structures having
      particularly wide major grooves, such as those found near loops or large bulges,
      and that nonhelical or extended peptides may be used to recognize less accessible
      grooves.

PMID- 7777499
TI  - Tumorigenic activity of the BCR-ABL oncogenes is mediated by BCL2.
AB  - BCR-ABL is a chimeric oncogene generated by translocation of sequences from the c
      abl protein-tyrosine kinase gene on chromosome 9 into the BCR gene on chromosome
      22. Alternative chimeric proteins, p210BCR-ABL and p190BCR-ABL, are produced that
      are characteristic of chronic myelogenous leukemia and acute lymphoblastic
      leukemia, respectively. Their role in the etiology of human leukemia remains to
      be defined. Transformed murine hematopoietic cells can be used as a model of BCR
      ABL function since these cells can be made growth factor independent and
      tumorigenic by the action of the BCR-ABL oncogene. We show that the BCR-ABL
      oncogenes prevent apoptotic death in these cells by inducing a Bcl-2 expression
      pathway. Furthermore, BCR-ABL-expressing cells revert to factor dependence and
      nontumorigenicity after Bcl-2 expression is suppressed. These results help to
      explain the ability of BCR-ABL oncogenes to synergize with c-myc in cell
      transformation.

PMID- 7777501
TI  - Direct measurement of hydrogen bonding in DNA nucleotide bases by atomic force
      microscopy.
AB  - We have used self-assembled purines and pyrimidines on planar gold surfaces and
      on gold-coated atomic force microscope (AFM) tips to directly probe
      intermolecular hydrogen bonds. Electron spectroscopy for chemical analysis (ESCA)
      and thermal programmed desorption (TPD) measurements of the molecular layers
      suggested monolayer coverage and a desorption energy of about 25 kcal/mol.
      Experiments were performed under water, with all four DNA bases immobilized on
      AFM tips and flat surfaces. Directional hydrogen-bonding interaction between the
      tip molecules and the surface molecules could be measured only when opposite base
      pair coatings were used. The directional interactions were inhibited by excess
      nucleotide base in solution. Nondirectional van der Waals forces were present in
      all other cases. Forces as low as two interacting base pairs have been measured.
      With coated AFM tips, surface chemistry-sensitive recognition atomic force
      microscopy can be performed.

PMID- 7777502
TI  - Efficient high-resolution genetic mapping of mouse interspersed repetitive
      sequence PCR products, toward integrated genetic and physical mapping of the
      mouse genome.
AB  - The ability to carry out high-resolution genetic mapping at high throughput in
      the mouse is a critical rate-limiting step in the generation of genetically
      anchored contigs in physical mapping projects and the mapping of genetic loci for
      complex traits. To address this need, we have developed an efficient, high
      resolution, large-scale genome mapping system. This system is based on the
      identification of polymorphic DNA sites between mouse strains by using
      interspersed repetitive sequence (IRS) PCR. Individual cloned IRS PCR products
      are hybridized to a DNA array of IRS PCR products derived from the DNA of
      individual mice segregating DNA sequences from the two parent strains. Since gel
      electrophoresis is not required, large numbers of samples can be genotyped in
      parallel. By using this approach, we have mapped > 450 polymorphic probes with
      filters containing the DNA of up to 517 backcross mice, potentially allowing
      resolution of 0.14 centimorgan. This approach also carries the potential for a
      high degree of efficiency in the integration of physical and genetic maps, since
      pooled DNAs representing libraries of yeast artificial chromosomes or other
      physical representations of the mouse genome can be addressed by hybridization of
      filter representations of the IRS PCR products of such libraries.

PMID- 7777500
TI  - Distinct regions of c-Mpl cytoplasmic domain are coupled to the JAK-STAT signal
      transduction pathway and Shc phosphorylation.
AB  - c-Mpl, a member of the hematopoietic cytokine receptor family, is the receptor
      for thrombopoietin. To investigate signal transduction by c-Mpl, a chimeric
      receptor, composed of the extracellular domain of human growth hormone receptor
      and the intracellular domain of c-Mpl, was introduced into the interleukin 3
      dependent cell line Ba/F3. In response to growth hormone, this chimeric receptor
      induced growth in the absence of interleukin 3. Deletion analysis of the 123
      amino acid intracellular domain indicated that the elements responsible for this
      effect are present within the 63 amino acids proximal to the transmembrane
      domain. Mutation of the recently described box 1 motif abrogated the
      proliferative response. Tyrosine phosphorylation of the tyrosine kinase JAK-2 and
      activation of STAT proteins were dependent on box 1 and sequences within 63 amino
      acids of the plasma membrane. STAT proteins activated by thrombopoietin in a
      megakaryocytic cell line were purified and shown to be STAT1 and STAT3. A
      separate region located at the C terminus of the c-Mpl intracellular domain was
      found to be required for induction of Shc phosphorylation and c-fos mRNA
      accumulation, suggesting involvement of the Ras signal transduction pathway.
      Thus, at least two distinct regions are involved in signal transduction by the c
      Mpl.

PMID- 7777503
TI  - DNA-mediated immunization to the hepatitis B surface antigen in mice: aspects of
      the humoral response mimic hepatitis B viral infection in humans.
AB  - Intramuscular injection of plasmid DNA expression vectors encoding the three
      envelope proteins of the hepatitis B virus (HBV) induced humoral responses in
      C57BL/6 mice specific to several antigenic determinants of the viral envelope.
      The first antibodies appeared within 1-2 weeks after injection of DNA and
      included antibodies of the IgM isotype. Over the next few weeks, an IgM to IgG
      class switch occurred, indicating helper T-lymphocyte activity. Peak IgG titers
      were reached by 4-8 weeks after a single DNA injection and were maintained for at
      least 6 months without further DNA injections. The antibodies to the envelope
      proteins reacted with group- and subtype-specific antigenic determinants of the
      HBV surface antigen (HBsAg). Expression vectors encoding the major (S) and middle
      (preS2 plus S) envelope proteins induced antibodies specific to the S protein and
      preS2 domain, and preS2 antibodies were prominent at early time points. In
      general, the expression vectors induced humoral responses in mice that mimic
      those observed in humans during the course of natural HBV infection.

PMID- 7777504
TI  - A wortmannin-sensitive phosphatidylinositol 4-kinase that regulates hormone
      sensitive pools of inositolphospholipids.
AB  - The synthesis of phosphatidylinositol 4,5-bisphosphate [PtdIns(4,5)P2], the
      immediate precursor of intracellular signals generated by calcium-mobilizing
      hormones and growth factors, is initiated by the conversion of
      phosphatidylinositol to phosphatidylinositol 4-phosphate [PtdIns(4)P] by
      phosphatidylinositol 4-kinase (PtdIns 4-kinase). Although cells contain several
      PtdIns 4-kinases, the enzyme responsible for regulating the synthesis of hormone
      sensitive PtdIns(4,5)P2 pools has not been identified. In this report we describe
      the inhibitory effect of micromolar concentrations of wortmannin (WT) on the
      synthesis of hormone-sensitive PtdIns(4)P and PtdIns(4,5)P2 pools in intact
      adrenal glomerulosa cells, and the presence of a WT-sensitive PtdIns 4-kinase in
      adrenocortical extracts. In addition to its sensitivity to the PtdIns 3-kinase
      inhibitor WT, this enzyme is distinguished from the recognized membrane-bound
      PtdIns 4-kinases by its molecular size and weak membrane association. Inhibition
      of this PtdIns 4-kinase by WT results in rapid loss of the hormone-sensitive
      PtdIns(4,5)P2 pool in angiotensin II-stimulated glomerulosa cells. Consequently,
      WT treatment inhibits the sustained but not the initial increases in inositol
      1,4,5-trisphosphate and cytoplasmic [Ca2+] in a variety of agonist-stimulated
      cells, including adrenal glomerulosa cells, NIH 3T3 fibroblasts, and Jurkat
      lymphoblasts. These results indicate that a specific WT-sensitive PtdIns 4-kinase
      is critical for the maintenance of the agonist-sensitive polyphosphoinositide
      pool in several cell types.

PMID- 7777505
TI  - Dynamics of active lamellae in cultured epithelial cells: effects of expression
      of exogenous N-ras oncogene.
AB  - We examined the functional consequences of cellular transformation of rat IAR-2
      epithelial cells, by a mutant N-ras oncogene, on the dynamics of active lamellae,
      structures that play an important role in cell motility, adhesion, and surface
      receptor capping. Lamellar activity was assessed by measuring the rate of outer
      edge pseudopodial activity and by analyzing the motility of Con A-coated beads
      placed on lamellar surfaces with optical tweezers. Although transformation
      dramatically affected the shape and size of active cellular lamellae, there was
      little detectable effect on either pseudopodial activity or bead movement. To
      investigate the potential relationship between functional lamellar activity and
      the microtubule cytoskeleton, lamellar activity was examined in nontransformed
      and transformed cells treated with the microtubule-disrupting drug nocodazole. In
      the absence of microtubules, transformed cells were less polarized and possessed
      decreased rates of pseudopodial and bead motility. On the basis of these
      observations, it is suggested that ras-induced transformation of epithelial cells
      consists of two cytoskeletal modifications: overall diminished actin cytoskeletal
      dynamics in lamellae and reorganization of the microtubule cytoskeleton that
      directs pseudopodial activity to smaller polarized lamellae.

PMID- 7777506
TI  - The folding of GroEL-bound barnase as a model for chaperonin-mediated protein
      folding.
AB  - We have analyzed the pathway of folding of barnase bound to GroEL to resolve the
      controversy of whether proteins can fold while bound to chaperonins (GroEL or
      Cpn60) or fold only after their release into solution. Four phases in the folding
      were detected by rapid-reaction kinetic measurements of the intrinsic
      fluorescence of both wild type and barnase mutants. The phases were assigned from
      their rate laws, sensitivity to mutations, and correspondence to regain of
      catalytic activity. At high ratios of denatured barnase to GroEL, 4 mol of
      barnase rapidly bind per 14-mer of GroEL. At high ratios of GroEL to barnase, 1
      mol of barnase binds with a rate constant of 3.5 x 10(7) s-1.M-1. This molecule
      then refolds with a low rate constant that changes on mutation in parallel with
      the rate constant for the folding in solution. This rate constant corresponds to
      the regain of the overall catalytic activity of barnase and increases 15-fold on
      the addition of ATP to a physiologically relevant value of approximately 0.4 s-1.
      The multiply bound molecules of barnase that are present at high ratios of GroEL
      to barnase fold with a rate constant that is also sensitive to mutation but is 10
      times higher. If the 110-residue barnase can fold when bound to GroEL and many
      moles can bind simultaneously, then smaller parts of large proteins should be
      able to fold while bound.

PMID- 7777507
TI  - Restriction fragment length polymorphism-coupled domain-directed differential
      display: a highly efficient technique for expression analysis of multigene
      families.
AB  - In this paper, a reverse-transcriptase PCR-based protocol suitable for efficient
      expression analysis of multigene families is presented. The method combines
      restriction fragment length polymorphism (RFLP) technology with a gene family
      specific version of mRNA differential display and hence is called "RFLP-coupled
      domain-directed differential display. "With this method, expression of all
      members of a multigene family at many different developmental stages, in diverse
      tissues and even in different organisms, can be displayed on one gel. Moreover,
      bands of interest, representing gene family members, are directly accessible to
      sequence analysis, without the need for subcloning. The method thus enables a
      detailed, high-resolution expression analysis of known gene family members as
      well as the identification and characterization of new ones. Here the technique
      was used to analyze differential expression of MADS-box genes in male and female
      inflorescences of maize (Zea mays ssp. mays). Six different MADS-box genes could
      be identified, being either specifically expressed in the female sex or
      preferentially expressed in male or female inflorescences, respectively. Other
      possible applications of the method are discussed.

PMID- 7777508
TI  - Pax5 (BSAP) regulates the murine immunoglobulin 3' alpha enhancer by suppressing
      binding of NF-alpha P, a protein that controls heavy chain transcription.
AB  - The Pax5 transcription factor BSAP (B-cell-specific activator protein) is known
      to bind to and repress the activity of the immunoglobulin heavy chain 3' alpha
      enhancer. We have detected an element--designated alpha P--that lies
      approximately 50 bp downstream of the BSAP binding site 1 and is required for
      maximal enhancer activity. In vitro binding experiments suggest that the 40-kDa
      protein that binds to this element (NF-alpha P) is a member of the Ets family
      present in both B-cell and plasma-cell nuclei. However, in vivo footprint
      analysis suggests that the alpha P site is occupied only in plasma cells, whereas
      the BSAP site is occupied in B cells but not in plasma cells. When Pax5 binding
      to the enhancer in B cells was blocked in vivo by transfection with a triple
      helix-forming oligonucleotide an alpha P footprint appeared and endogenous
      immunoglobulin heavy chain transcripts increased. The triple-helix-forming
      oligonucleotide also increased enhancer activity of a transfected construct in B
      cells, but only when the alpha P site was intact. Pax5 thus regulates the 3'
      alpha enhancer and immunoglobulin gene transcription by blocking activation by NF
      alpha P.

PMID- 7777509
TI  - Age-related learning deficits in transgenic mice expressing the 751-amino acid
      isoform of human beta-amyloid precursor protein.
AB  - The beta-amyloid precursor protein (beta-APP), from which the beta-A4 peptide is
      derived, is considered to be central to the pathogenesis of Alzheimer disease
      (AD). Transgenic mice expressing the 751-amino acid isoform of human beta-APP
      (beta-APP751) have been shown to develop early AD-like histopathology with
      diffuse deposits of beta-A4 and aberrant tau protein expression in the brain,
      particularly in the hippocampus, cortex, and amygdala. We now report that beta
      APP751 transgenic mice exhibit age-dependent deficits in spatial learning in a
      water-maze task and in spontaneous alternation in a Y maze. These deficits were
      mild or absent in 6-month-old transgenic mice but were severe in 12-month-old
      transgenic mice compared to age-matched wild-type control mice. No other
      behavioral abnormalities were observed. These mice therefore model the
      progressive learning and memory impairment that is a cardinal feature of AD.
      These results provide evidence for a relationship between abnormal expression of
      beta-APP and cognitive impairments.

PMID- 7777510
TI  - Purification and identification of pituitary cytotropic factor.
AB  - It has been shown that the pituitary contains a cytotropic factor (CTF) that
      stimulates the secretion of catecholamines by dopaminergic neurons of the
      hypothalamus. In the present study, CTF was purified from rat pituitaries and
      found by means of mass spectrometric analysis to be adenosine. This finding was
      corroborated by the observations that CTF behaves identically to adenosine when
      subjected to liquid chromatography, is inactivated and converted to inosine by
      adenosine deaminase, and is qualitatively and quantitatively indistinguishable
      from adenosine in its biological activity. It is concluded that pituitary
      adenosine is a trophic factor for hypothalamic dopaminergic neurons.

PMID- 7777511
TI  - DNA polymerase beta bypasses in vitro a single d(GpG)-cisplatin adduct placed on
      codon 13 of the HRAS gene.
AB  - We have examined the capacity of calf thymus DNA polymerases alpha, beta, delta,
      and epsilon to perform in vitro translesion synthesis on a substrate containing a
      single d(GpG)-cisplatin adduct placed on codon 13 of the human HRAS gene. We
      found that DNA synthesis catalyzed by DNA polymerases alpha, delta, and epsilon
      was blocked at the base preceding the lesion. Addition of proliferating cell
      nuclear antigen to DNA polymerase delta and replication protein A to DNA
      polymerase alpha did not restore their capacity to elongate past the adduct. On
      the other hand, DNA polymerase beta efficiently bypassed the cisplatin adduct.
      Furthermore, we observed that DNA polymerase beta was the only polymerase capable
      of primer extension of a 3'-OH located opposite the base preceding the lesion.
      Likewise, DNA polymerase beta was able to elongate the arrested replication
      products of the other three DNA polymerases, thus showing its capacity to
      successfully compete with polymerases alpha, delta, and epsilon in the stalled
      replication complex. Our data suggest (i) a possible mechanism enabling DNA
      polymerase beta to bypass a d(GpG)-cisplatin adduct in vitro and (ii) a role for
      this enzyme in processing DNA damage in vivo.

PMID- 7777512
TI  - Phosphorylation of the human leukemia inhibitory factor (LIF) receptor by mitogen
      activated protein kinase and the regulation of LIF receptor function by
      heterologous receptor activation.
AB  - We used a bacterially expressed fusion protein containing the entire cytoplasmic
      domain of the human leukemia inhibitory factor (LIF) receptor to study its
      phosphorylation in response to LIF stimulation. The dose- and time-dependent
      relationships for phosphorylation of this construct in extracts of LIF-stimulated
      3T3-L1 cells were superimposable with those for the stimulation of mitogen
      activated protein kinase (MAPK). Indeed, phosphorylation of the cytoplasmic
      domain of the low-affinity LIF receptor alpha-subunit (LIFR) in Mono Q
      fractionated, LIF-stimulated 3T3-L1 extracts occurred only in those fractions
      containing activated MAPK; Ser-1044 served as the major phosphorylation site in
      the human LIFR for MAPK both in agonist-stimulated 3T3-L1 lysates and by
      recombinant extracellular signal-regulated kinase 2 in vitro. Expression in rat H
      35 hepatoma cells of LIFR or chimeric granulocyte-colony-stimulating factor
      receptor (G-CSFR)-LIFR mutants lacking Ser-1044 failed to affect cytokine
      stimulated expression of a reporter gene under the control of the beta-fibrinogen
      gene promoter but eliminated the insulin-induced attenuation of cytokine
      stimulated gene expression. Thus, our results identify the human LIFR as a
      substrate for MAPK and suggest a mechanism of heterologous receptor regulation of
      LIFR signaling occurring at Ser-1044.

PMID- 7777513
TI  - Full-length myotonin protein kinase (72 kDa) displays serine kinase activity.
AB  - We describe the full-length (72 kDa) myotonin protein kinase (Mt-PK) and
      demonstrate its kinase activity. The 72-kDa protein corresponds to the
      translation product from the first in-frame AUG codon. This protein was found in
      the cytoplasmic fraction, whereas the previously reported 55-kDa protein was
      observed in nuclear extracts. Only the 72-kDa protein was phosphorylated by
      [32P]phosphate in normal human fibroblasts. To investigate the putative kinase
      activity of Mt-PK, a construct containing the full-length open reading frame of
      Mt-PK was expressed in bacterial cells. The recombinant Mt-PK autophosphorylates
      a Ser residue and phosphorylates the synthetic peptide Gly-Arg-Gly-Leu-Ser-Leu
      Ser-Arg, which contains a Ser residue in the phosphorylation site. We examined
      phosphorylation of the voltage-dependent Ca(2+)-release channel, or
      dihydropyridine receptor (DHPR), by recombinant Mt-PK. We observed that the beta
      subunit of DHPR was phosphorylated in vitro by Mt-PK. A beta-subunit DHPR peptide
      containing some of the Ser residues predicted to be phosphorylated was
      synthesized and found to be a substrate for Mt-PK in vitro. We conclude that the
      72-kDa Mt-PK has a protein kinase activity specific for Ser residues.

PMID- 7777514
TI  - Position-dependent variegation of globin transgene expression in mice.
AB  - Expression of genes in eukaryotes has commonly been analyzed in a whole tissue,
      and levels of expression have been interpreted as the result of equivalent rates
      of transcription in every cell. We have produced transgenic mouse lines that
      express beta-galactosidase under the control of globin promoters linked to the
      major tissue-specific regulatory element of the alpha-globin locus, which permits
      the analysis of transgene expression in individual red blood cells. We find that
      expression of the transgene within all mouse lines is heterocellular. Individual
      cells either do not express the transgene at all or express it at a level
      characteristic of that line. The number of beta-galactosidase-expressing cells
      varies greatly between different lines of transgenic mice at any defined stage of
      development, but within a transgenic line, individual mice have strikingly
      similar numbers of expressing cells. This suggests that the degree of
      heterocellular expression is determined by the site of integration, as is seen in
      position-effect variegation.

PMID- 7777515
TI  - Chimeric tumor necrosis factor receptors with constitutive signaling activity.
AB  - Many hormone and cytokine receptors are crosslinked by their specific ligands,
      and multimerization is an essential step leading to the generation of a signal.
      In the case of the tumor necrosis factor (TNF) receptors (TNF-Rs), antibody
      induced crosslinking is sufficient to trigger a cytolytic effect. However, the
      quaternary structural requirements for signaling--i.e., the formation of dimers,
      trimers, or higher-order multimers--have remained obscure. Moreover, it has not
      been clear whether the 55-kDa or 75-kDa TNF-R is responsible for initiation of
      cytolysis. We reasoned that an obligate receptor dimer, targeted to the plasma
      membrane, might continuously signal the presence of TNF despite the actual
      absence of the ligand. Such a molecule, inserted into an appropriate vector,
      could be used to project receptor-specific "TNF-like" activity to specific cells
      and tissues in vivo. Accordingly, we constructed sequences encoding chimeric
      receptors in which the extracellular domain of the mouse erythropoietin receptor
      (Epo-R) was fused to the "stem," transmembrane domain, and cytoplasmic domain of
      the two mouse TNF-Rs. Thus, the Epo-R group was used to drive dimerization of the
      TNF-R cytoplasmic domain. These chimeric proteins were well expressed in a
      variety of cell lines and bound erythropoietin at the cell surface. Both the 55
      kDa and the 75-kDa Epo/TNF-R chimeras exerted a constitutive cytotoxic effect
      detected by cotransfection or clonogenic assay. Thus, despite the lack of
      structural homology between the cytoplasmic domains of the two TNF-Rs, a similar
      signaling endpoint was observed. Moreover, dimerization (rather than
      trimerization or higher-order multimerization) was sufficient for elicitation of
      a biological response.

PMID- 7777516
TI  - Inhibition of human immunodeficiency virus replication by nonimmunosuppressive
      analogs of cyclosporin A.
AB  - Analogs of the immunosuppressive cyclic undecapeptide cyclosporin A (CsA) with
      substitutions in positions 1, 4, 6, and/or 11 were rationally designed to possess
      substantially diminished or no immunosuppressive activity. When these compounds
      were assayed for their capacity to interfere with the replication of human
      immunodeficiency virus, some displayed a potent antiviral activity in newly
      infected cells. However, only CsA could interfere with virus replication in
      persistently infected cells. One CsA analog with antiviral activity costimulated
      the phytohemagglutinin-induced production of interleukin 2 by human lymphocytes.
      Human immunodeficiency virus particles from drug-exposed cells showed lower
      infectivity than virions from untreated cells. Thus, these nonimmunosuppressive
      analogs of CsA constitute a promising class of lead compounds to develop drugs
      for effective treatment of the acquired immunodeficiency syndrome.

PMID- 7777517
TI  - Scavenger receptor A gene regulatory elements target gene expression to
      macrophages and to foam cells of atherosclerotic lesions.
AB  - Transcription of the macrophage scavenger receptor A gene is markedly upregulated
      during monocyte to macrophage differentiation. In these studies, we demonstrate
      that 291 bp of the proximal scavenger receptor promoter, in concert with a 400-bp
      upstream enhancer element, is sufficient to direct macrophage-specific expression
      of a human growth hormone reporter in transgenic mice. These regulatory elements,
      which contain binding sites for PU.1, AP-1, and cooperating ets-domain
      transcription factors, are also sufficient to mediate regulation of transgene
      expression during the in vitro differentiation of bone marrow progenitor cells in
      response to macrophage colony-stimulating factor. Mutation of the PU.1 binding
      site within the scavenger receptor promoter severely impairs transgene
      expression, consistent with a crucial role of PU.1 in regulating the expression
      of the scavenger receptor gene. The ability of the scavenger receptor promoter
      and enhancer to target gene expression to macrophages in vivo, including foam
      cells of atherosclerotic lesions, suggests that these regulatory elements will be
      of general utility in the study of macrophage differentiation and function by
      permitting specific modifications of macrophage gene expression.

PMID- 7777518
TI  - Two Drosophila nervous system antigens, Nervana 1 and 2, are homologous to the
      beta subunit of Na+,K(+)-ATPase.
AB  - A nervous system-specific glycoprotein antigen from adult Drosophila heads,
      designated Nervana (Nrv), has been purified on the basis of reactivity of its
      carbohydrate epitope(s) with anti-horseradish peroxidase (HRP) antibodies that
      are specific markers for Drosophila neurons. Anti-Nrv monoclonal antibodies
      (mAbs), specific for the protein moiety of Nrv, were used to screen a Drosophila
      embryo cDNA expression library. Three cDNA clones (designated Nrv1, Nrv2.1, and
      Nrv2.2) were isolated that code for proteins recognized by anti-Nrv mAbs on
      Western blots. DNA sequencing and Southern blot analyses established that the
      cDNA clones are derived from two different genes. In situ hybridization to
      Drosophila polytene chromosomes showed that the cDNA clones map to the third
      chromosome near 92C-D. Nrv1 and Nrv2.1/2.2 have open reading frames of 309 and
      322/323 amino acids, respectively, and they are 43.4% identical at the amino acid
      level. The proteins deduced from these clones exhibit significant homology in
      both primary sequence and predicted topology to the beta subunit of Na+,K(+)
      ATPase. Immunoaffinity-purified Nrv is associated with a protein (M(r) 100,000)
      recognized on Western blots by anti-ATPase alpha-subunit mAb. Our results suggest
      that the Drosophila nervous system-specific antigens Nrv1 and -2 are neuronal
      forms of the beta subunit of Na+,K(+)-ATPase.

PMID- 7777520
TI  - Complex flexibility of the transforming growth factor beta superfamily.
AB  - The transforming growth factors beta (TGF-beta s) are important modulators of
      growth and differentiation. They are intermolecular disulfide-bonded homodimeric
      molecules. The monomer fold has a conserved cystine knot and lacks a hydrophobic
      core. The biological specificity of a given member of the family is believed to
      be determined by the conformational flexibility of the variable loop regions of
      the monomer. The monomer subunit assembly in the dimer is stabilized mainly by
      hydrophobic contacts and a few hydrogen bonds. Since these interactions are
      nondirectional, we examined subunit assemblies of TGF-beta by using
      conformational analysis. The different subunit assemblies in TGF-beta 2 dimer
      were characterized in terms of the intersubunit disulfide torsion. Our analyses
      show that the subunit assemblies fall into two states: the crystallographically
      observed gauche+conformation and the previously not reported gauche-
      conformation, both having almost identical interaction energies. Furthermore,
      there is significant flexibility in the subunit assembly within the gauche+ and
      the gauche- states of the disulfide bond. The monomer subunit assembly is
      independent of the variations about the loop regions. The variations in the loop
      regions, coupled with flexibility in the monomer assembly, lead to a complex
      flexibility in the dimer of the TGF-beta superfamily. For the TGF-beta
      superfamily, the cystine knot acts as a scaffold and complex flexibility provides
      for biological selectivity. Complex flexibility might provide an explanation for
      the diverse range of biological activities that these important molecules
      display.

PMID- 7777519
TI  - Interferon gamma signals via a high-affinity multisubunit receptor complex that
      contains two types of polypeptide chain.
AB  - Signaling by interferon gamma (IFN-gamma) requires two structurally related cell
      surface proteins: a ligand-binding polypeptide, known as the IFN-gamma receptor
      (IFN-gamma R), and an accessory factor. However, it is not known whether IFN
      gamma forms a ternary complex with the IFN-gamma R and accessory factor to
      initiate signaling. Here we demonstrate complex formation between IFN-gamma and
      the two proteins, both in solution and at the cell surface. We observe complexes
      containing ligand, two molecules of IFN-gamma R (designated the IFN-gamma R alpha
      chain), and one or two molecules of accessory factor (designated the IFN-gamma R
      beta chain). Transfected cells expressing both IFN-gamma R chains bind IFN-gamma
      with higher affinity than do cells expressing alpha chain alone. Anti-beta-chain
      antibodies prevent the beta chain from participating in the ligand-receptor
      complex, reduce the affinity for IFN-gamma, and block signaling. Soluble alpha-
      or beta-chain extracellular domains also inhibit function. These results
      demonstrate that IFN-gamma signals via a high-affinity multisubunit complex that
      contains two types of receptor chain and suggest a potential approach to
      inhibiting specific actions of IFN-gamma by blocking the association of receptor
      subunits.

PMID- 7777521
TI  - Nascent polypeptide-associated complex protein prevents mistargeting of nascent
      chains to the endoplasmic reticulum.
AB  - We show that, after removal of the nascent polypeptide-associated complex (NAC)
      from ribosome-associated nascent chains, ribosomes synthesizing proteins lacking
      signal peptides are efficiently targeted to the endoplasmic reticulum (ER)
      membrane. After this mistargeting, translocation across the ER membrane occurs,
      albeit less efficiently than for a nascent secretory polypeptide, perhaps because
      the signal peptide is needed to catalyze the opening of the translocation pore.
      The mistargeting was prevented by the addition of purified NAC and was shown not
      to be mediated by the signal recognition particle and its receptor. Instead, it
      appears to be a consequence of the intrinsic affinity of ribosomes for membrane
      binding sites, since it can be blocked by competing ribosomes that lack
      associated nascent polypeptides. We propose that, when bound to a signalless
      ribosome-associated nascent polypeptide, NAC sterically blocks the site in the
      ribosome for membrane binding.

PMID- 7777522
TI  - Identification of functionally important helical faces in transmembrane segments
      by scanning mutagenesis.
AB  - We applied mutational analysis to a protein domain that functions in neither
      catalysis nor binding but, rather, in transmembrane signaling. The domain is part
      of chemoreceptor Trg from Escherichia coli. It contains four transmembrane
      segments, two from each subunit of the homodimer. We used cysteine scanning to
      investigate the functional importance of each of 54 residues in the two
      transmembrane segments. Cysteines at some positions resulted in subtle but
      significant reductions in tactic response. Those positions defined a specific
      helical face on each segment, implying that the segments function as helices. The
      functionally important faces corresponded to structural, helical packing faces
      identified independently by biochemical studies. All functionally impaired
      receptors exhibited altered signaling properties, either reduced signaling upon
      stimulation or induced signaling in the absence of stimulation. The distribution
      of substitutions creating these two phenotypes implied that conformational
      signaling involves movement between the two transmembrane helices within a
      subunit and that signaling is optimal when stable interactions are maintained
      across the interface between subunits.

PMID- 7777523
TI  - Enhanced secretion of glycocholic acid in a specially adapted cell line is
      associated with overexpression of apparently novel ATP-binding cassette proteins.
AB  - Secretion of anionic endo- and xenobiotics is essential for the survival of
      animal and plant cells; however, the underlying molecular mechanisms remain
      uncertain. To better understand one such model system--i.e., secretion of bile
      acids by the liver--we utilized a strategy analogous to that employed to identify
      the multidrug resistance (mdr) genes. We synthesized the methyl ester of
      glycocholic acid (GCE), which readily enters cells, where it is hydrolyzed to
      yield glycocholic acid, a naturally occurring bile acid. The rat hepatoma-derived
      HTC cell line gradually acquired resistance to GCE concentrations 20-fold higher
      than those which inhibited growth of naive cells, yet intracellular accumulation
      of radiolabel in resistant cells exposed to [14C]GCE averaged approximately 25%
      of that in nonresistant cells. As compared with nonresistant cells, resistant
      cells also exhibited (i) cross-resistance to colchicine, a known mdr substrate,
      but not to other noxious substances transported by hepatocytes; (ii) increased
      abundance on Northern blot of mRNA species up to 7-10 kb recognized by a probe
      for highly conserved nucleotide-binding domain (NBD) sequences of ATP-binding
      cassette (ABC) proteins; (iii) increased abundance, as measured by RNase
      protection assay, of mRNA fragments homologous to a NBD cRNA probe; and (iv)
      dramatic overexpression, as measured by Western blotting and immunofluorescence,
      of a group of 150- to 200-kDa plasma membrane proteins recognized by a monoclonal
      antibody against a region flanking the highly conserved NBD of mdr/P
      glycoproteins. Finally, Xenopus laevis oocytes injected with mRNA from resistant
      cells and incubated with [14C]GCE secreted radiolabel more rapidly than did
      control oocytes. Enhanced secretion of glycocholic acid in this cell line is
      associated with overexpression of ABC/mdr-related proteins, some of which are
      apparently novel and are likely to include a bile acid transport protein.

PMID- 7777524
TI  - Library of libraries: approach to synthetic combinatorial library design and
      screening of "pharmacophore" motifs.
AB  - Construction of synthetic combinatorial libraries is described that allows for
      the generation of a library of motifs rather than a library of compounds. Peptide
      libraries based on this strategy were synthesized and screened with model targets
      streptavidin and anti-beta-endorphin antibody. The screens resulted in
      observation of expected motifs providing evidence of the effectiveness of the
      suggested approach.

PMID- 7777525
TI  - Translational termination efficiency in mammals is influenced by the base
      following the stop codon.
AB  - The base following stop codons in mammalian genes is strongly biased, suggesting
      that it might be important for the termination event. This proposal has been
      tested experimentally both in vivo by using the human type I iodothyronine
      deiodinase mRNA and the recoding event at the internal UGA codon and in vitro by
      measuring the ability of each of the 12 possible 4-base stop signals to direct
      the eukaryotic polypeptide release factor to release a model peptide,
      formylmethionine, from the ribosome. The internal UGA in the deiodinase mRNA is
      used as a codon for incorporation of selenocysteine into the protein. Changing
      the base following this UGA codon affected the ratio of termination to
      selenocysteine incorporation in vivo at this codon: 1:3 (C or U) and 3:1 (A or
      G). These UGAN sequences have the same order of efficiency of termination as was
      found with the in vitro termination assay (4th base: A approximately G >> C
      approximately U). The efficiency of in vitro termination varied in the same
      manner over a 70-fold range for the UAAN series and over an 8-fold range for the
      UGAN and UAGN series. There is a correlation between the strength of the signals
      and how frequently they occur at natural termination sites. Together these data
      suggest that the base following the stop codon influences translational
      termination efficiency as part of a larger termination signal in the expression
      of mammalian genes.

PMID- 7777526
TI  - Deficiency of retinoblastoma protein leads to inappropriate S-phase entry,
      activation of E2F-responsive genes, and apoptosis.
AB  - The retinoblastoma susceptibility gene (Rb) participates in controlling the G1/S
      phase transition, presumably by binding and inactivating E2F transcription
      activator family members. Mouse embryonic fibroblasts (MEFs) with no, one, or two
      inactivated Rb genes were used to determine the specific contributions of Rb
      protein to cell cycle progression and gene expression. MEFs lacking both Rb
      alleles (Rb-/-) entered S phase in the presence of the dihydrofolate reductase
      inhibitor methotrexate. Two E2F target genes, dihydrofolate reductase and
      thymidylate synthase, displayed elevated mRNA and protein levels in Rb- MEFs.
      Since absence of functional Rb protein in MEFs is sufficient for S-phase entry
      under growth-limiting conditions, these data indicate that the E2F complexes
      containing Rb protein, and not the Rb-related proteins p107 and p130, may be rate
      limiting for the G1/S transition. Antineoplastic drugs caused accumulation of p53
      in the nuclei of both Rb+/+ and Rb-/- MEFs. While p53 induction led to apoptosis
      in Rb-/- MEFs, Rb+/- and Rb+/+ MEFs underwent cell cycle arrest without
      apoptosis. These results reveal that diverse growth signals work through Rb to
      regulate entry into S phase, and they indicate that absence of Rb protein
      produces a constitutive DNA replication signal capable of activating a p53
      associated apoptotic response.

PMID- 7777527
TI  - Drosophila 5-HT2 serotonin receptor: coexpression with fushi-tarazu during
      segmentation.
AB  - Serotonin, first described as a neurotransmitter in invertebrates, has been
      investigated mostly for its functions in the mature central nervous system of
      higher vertebrates. Serotonin receptor diversity has been described in the
      mammalian brain and in insects. We report the isolation of a cDNA coding for a
      Drosophila melanogaster serotonin receptor that displays a sequence, a gene
      organization, and pharmacological properties typical of the mammalian 5-HT2
      serotonin receptor subtype. Its mRNA can be detected in the adult fly; moreover,
      a high level of expression occurs at 3 hr of Drosophila embryogenesis. This early
      embryonic expression is surprisingly organized in a seven-stripe pattern that
      appears at the cellular blastoderm stage. In addition, this pattern is in phase
      with that of the even-parasegment-expressed pair-rule gene fushi-tarazu and is
      similarly modified by mutations affecting segmentation genes. Simultaneously with
      this pair-rule expression, the complete machinery of serotonin synthesis is
      present and leads to a peak of ligand concomitant with a peak of 5-HT2-specific
      receptor sites in blastoderm embryos.

PMID- 7777528
TI  - Structure and stability of a second molten globule intermediate in the
      apomyoglobin folding pathway.
AB  - Apomyoglobin folding proceeds through a molten globule intermediate (low-salt
      form; I1) that has been characterized by equilibrium (pH 4) and kinetic (pH 6)
      folding experiments. Of the eight alpha-helices in myoglobin, three (A, G, and H)
      are structured in I1, while the rest appear to be unfolded. Here we report on the
      structure and stability of a second intermediate, the trichloroacetate form of
      the molten globule intermediate (I2), which is induced either from the acid
      unfolded protein or from I1 by > or = 5 mM sodium trichloroacetate. Circular
      dichroism measurements monitoring urea- and acid-induced unfolding indicate that
      I2 is more highly structured and more stable than I1. Although I2 exhibits
      properties closer to those of the native protein, one-dimensional NMR spectra
      show that it maintains the lack of fixed side-chain structure that is the
      hallmark of a molten globule. Amide proton exchange and 1H-15N two-dimensional
      NMR experiments are used to identify the source of the extra helicity observed in
      I2. The results reveal that the existing A, G, and H helices present in I1 have
      become more stable in I2 and that a fourth helix--the B helix--has been
      incorporated into the molten globule. Available evidence is consistent with I2
      being an on-pathway intermediate. The data support the view that apomyoglobin
      folds in a sequential fashion through a single pathway populated by intermediates
      of increasing structure and stability.

PMID- 7777529
TI  - Involvement of the cell-cycle inhibitor Cip1/WAF1 and the E1A-associated p300
      protein in terminal differentiation.
AB  - The mechanism of cell cycle withdrawal during terminal differentiation is poorly
      understood. We report here that the cyclin-dependent kinase (CDK) inhibitor
      p21Cip1/WAF1 is induced at early times of both keratinocyte and myoblast
      differentiation. p21Cip1/WAF1 induction is accompanied by a drastic inhibition of
      total Cdk2, as well as p21Cip1/WAF1-associated CDK kinase activities.
      p21Cip1/WAF1 has been implicated in p53-mediated G1 arrest and apoptosis. In
      keratinocyte differentiation, Cip1/WAF1 induction is observed even in cells
      derived from p53-null mice. Similarly, keratinocyte differentiation is associated
      with induction of Cip1/WAF1 promoter activity in both wild-type and p53-negative
      keratinocytes. Induction of the Cip1/WAF1 promoter upon differentiation is
      abolished by expression of an adenovirus E1A oncoprotein (d1922/947), which is
      unable to bind p105-Rb, p107, or cyclin A but which still binds the nuclear
      phosphoprotein p300. Overexpression of p300 can suppress the E1A effect,
      independent of its direct binding to E1A. Thus, terminal differentiation-induced
      growth arrest in both keratinocyte and myoblast systems is associated with
      induction of Cip1/WAF1 expression. During keratinocyte differentiation, Cip1/WAF1
      induction does not require p53 but depends on the transcriptional modulator p300.

PMID- 7777530
TI  - Binding of purified multiple antibiotic-resistance repressor protein (MarR) to
      mar operator sequences.
AB  - Elevated expression of the marORAB multiple antibiotic-resistance operon enhances
      the resistance of Escherichia coli to various medically significant antibiotics.
      Transcription of the operon is repressed in vivo by the marR-encoded protein,
      MarR, and derepressed by salicylate and certain antibiotics. The possibility that
      repression results from MarR interacting with the marO operator-promoter region
      was studied in vitro using purified MarR and a DNA fragment containing marO. MarR
      formed at least two complexes with marO DNA, bound > 30-fold more tightly to it
      than to salmon sperm DNA, and protected two separate 21-bp sites within marO from
      digestion by DNase I. Site I abuts the downstream side of the putative -35
      transcription-start signal and includes 4 bp of the -10 signal. Site II begins 13
      bp downstream of site I, ending immediately before the first base pair of marR.
      Site II, approximately 80% homologous to site I, is not required for repression
      since a site II-deleted mutant (marO133) was repressed in trans by wild-type
      MarR. The absence of site II did not prevent MarR from complexing with the site I
      of marO133. Salicylate bound to MarR (Kd approximately 0.5 mM) and weakened the
      interaction of MarR with sites I and II. Thus, repression of the mar operon,
      which curbs the antibiotic resistance of E. coli, correlates with the formation
      of MarR-site I complexes. Salicylate appears to induce the mar operon by binding
      to MarR and inhibiting complex formation, whereas tetracycline and
      chloramphenicol, which neither bind MarR nor inhibit complex formation, must
      induce by an indirect mechanism.

PMID- 7777532
TI  - Triplet repeat expansion in myotonic dystrophy alters the adjacent chromatin
      structure.
AB  - Myotonic dystrophy is caused by an expansion of a CTG triplet repeat sequence in
      the 3' noncoding region of a protein kinase gene, yet the mechanism by which the
      triplet repeat expansion causes disease remains unknown. This report demonstrates
      that a DNase I hypersensitive site is positioned 3' of the triplet repeat in the
      wild-type allele in both fibroblasts and skeletal muscle cells. In three
      unrelated individuals with myotonic dystrophy that have large expansions of the
      triplet repeat, the allele with the triplet repeat expansion exhibited both
      overall DNase I resistance and inaccessibility of nucleases to the adjacent
      hypersensitive site. These results indicate that the triplet repeat expansion
      alters the adjacent chromatin structure, establishing a region of condensed
      chromatin, and suggests a molecular mechanism for myotonic dystrophy.

PMID- 7777531
TI  - Reciprocal modulations between p53 and Tat of human immunodeficiency virus type
      1.
AB  - Infection by human immunodeficiency virus type 1 (HIV-1) causes acquired
      immunodeficiency syndrome (AIDS) after a long clinical latency. This disease is
      associated with a spectrum of cancers. Here we report that wild-type p53 is a
      potent suppressor of Tat, a major transactivator of HIV-1. Reciprocally, Tat
      inhibits the transcription of p53. Downregulation of p53 by upregulated tat may
      be important for the establishment of productive viral infection in a cell and
      also may be involved in the development of AIDS-related malignancies.

PMID- 7777533
TI  - The dietary adaptations of European Miocene catarrhines.
AB  - European Miocene "apes" have been known for nearly a century and a half but their
      phylogenetic significance is only now becoming apparent with the recent discovery
      of many relatively complete remains. Some appear to be close in time and
      morphology to the last common ancestor of modern great apes and humans. The
      current study is an attempt to reconstruct the diets of these fossils on the
      basis of quantitative data. Results suggest that these primates varied more
      greatly in their diets than modern apes, with adaptations ranging from hard
      object feeding to soft-object frugivory to folivory.

PMID- 7777535
TI  - Adaptive reversion of an episomal frameshift mutation in Escherichia coli
      requires conjugal functions but not actual conjugation.
AB  - Adaptive reversion of a lac- frameshift mutation in Escherichia coli appears to
      be due to DNA polymerase errors, implying that DNA is being synthesized although
      the cells are not dividing. Here we report that the production of adaptive lac+
      revertants (i) is much higher when the mutational target is on the F' episome
      than when it is on the bacterial chromosome; (ii) is enhanced by functions
      required for conjugation; but (iii) does not require conjugation per se. These
      results suggest that, in static cells, DNA synthesis is initiated from the
      conjugal origin of transfer. Mutations may arise as polymerase errors during this
      synthesis or during synthesis stimulated by recombination among the multiple gene
      copies.

PMID- 7777534
TI  - Activation of Stat5 by interleukin 2 requires a carboxyl-terminal region of the
      interleukin 2 receptor beta chain but is not essential for the proliferative
      signal transmission.
AB  - The high-affinity interleukin 2 (IL-2) receptor (IL-2R) consists of three
      subunits: the IL-2R alpha, IL-2R beta c, and IL-2R gamma c chains. Two members of
      the Janus kinase family, Jak1 and Jak3, are associated with IL-2R beta c and IL
      2R gamma c, respectively, and they are activated upon IL-2 stimulation. The
      cytokine-mediated Jak kinase activation usually results in the activation of a
      family of latent transcription factors termed Stat (signal transducer and
      activator of transcription) proteins. Recently, the IL-2-induced Stat protein was
      purified from human lymphocytes and found to be the homologue of sheep
      Stat5/mammary gland factor. We demonstrate that the human Stat5 is activated by
      IL-2 and that Jak3 is required for the efficient activation. The cytoplasmic
      region of the IL-2R beta c chain required for activation of Stat5 is mapped
      within the carboxyl-terminal 147 amino acids. On the other hand, this region is
      not essential for IL-2-induced cell proliferation.

PMID- 7777536
TI  - Growth factors can enhance lymphocyte survival without committing the cell to
      undergo cell division.
AB  - Growth factors have been defined by their ability to promote the proliferative
      expansion of receptor-bearing cells. For example, antigen-activated T cells
      expressing the alpha beta gamma form of the interleukin 2 (IL-2) receptor will
      proliferate in response to IL-2. In contrast, resting T cells, which express the
      IL-2 receptor beta and gamma chains, do not proliferate in response to IL-2. We
      demonstrate that the survival of resting T cells following gamma irradiation is
      greatly enhanced by pretreatment with IL-2. The radioprotective effect of IL-2 is
      dose dependent, does not result from the induction of cell proliferation, and
      does not require expression of the IL-2 receptor alpha chain. Thus, the beta
      gamma IL-2 receptor expressed on resting T cells can transduce signals that
      promote cell survival without committing the T cell to undergo cell division. IL
      4 and IL-7, but not IL-1, IL-3, or IL-6, were also found to enhance the survival
      of quiescent T cells following gamma irradiation. Thus, certain growth factor
      receptor interactions can serve to maintain cell viability in a manner that is
      independent of their ability to initiate or maintain cell proliferation. These
      data may have important implications for the use of growth factors in patients
      being treated with radiation and/or chemotherapy.

PMID- 7777537
TI  - The Lutheran blood group glycoprotein, another member of the immunoglobulin
      superfamily, is widely expressed in human tissues and is developmentally
      regulated in human liver.
AB  - Glycoproteins expressing the Lutheran blood group antigens were isolated from
      human erythrocyte membranes and from human fetal liver. Amino acid sequence
      analyses allowed the design of redundant oligonucleotides that were used to
      generate a 459-bp, sequence-specific probe by PCR. A cDNA clone of 2400 bp was
      isolated from a human placental lambda gt 11 library and sequenced, and the
      deduced amino acid sequence was studied. The predicted mature protein is a type I
      membrane protein of 597 amino acids with five potential N-glycosylation sites.
      There are five disulfide-bonded, extracellular, immunoglobulin superfamily
      domains (two variable-region set and three constant-region set), a single
      hydrophobic, membrane-spanning domain, and a cytoplasmic domain of 59 residues.
      The overall structure is similar to that of the human tumor marker MUC 18 and the
      chicken neural adhesion molecule SC1. The extracellular domains and cytoplasmic
      domain contain consensus motifs for the binding of integrin and Src homology 3
      domains, respectively, suggesting possible receptor and signal-transduction
      function. Immunostaining of human tissues demonstrated a wide distribution and
      provided evidence that the glycoprotein is under developmental control in liver
      and may also be regulated during differentiation in other tissues.

PMID- 7777538
TI  - Reduced surface expression of transforming growth factor beta receptor type II in
      mitogen-activated T cells from Sezary patients.
AB  - Sezary syndrome (SzS), the leukemic form of cutaneous T-cell lymphoma, is
      characterized by clonal proliferation of CD4+ T cells and immune dysfunctions,
      raising the possibility of cytokine-related abnormalities. We previously
      described a decreased response to the growth-inhibitory effects of transforming
      growth factor type beta (TGF-beta) in SzS T cells accompanied by apparent loss of
      surface type II TGF-beta receptor (TGF beta RII). To specifically determine if
      defects exist in TGF beta RII protein expression and/or transport in SzS
      patients, we developed a sensitive flow cytometric method to detect TGF beta RII
      on the surface and intracellularly in the CD4+ T cells. Our results indicate that
      unlike normal CD4+ T cells, CD4+ T cells from 9 of 12 SzS patients expressed
      little, if any, surface TGF beta RII in response to mitogen stimulation. At the
      intracellular level, however, pools of TGF beta RII were comparable to those in
      normal CD4+ T cells. This indicates that defective trafficking of this inhibitory
      cytokine receptor may contribute significantly to the development of this
      disease.

PMID- 7777539
TI  - A simple test of the vicarious trial-and-error hypothesis of hippocampal
      function.
AB  - Vicarious trial-and-error (VTE) is a term that Muenzinger and Tolman used to
      describe the rat's conflict-like behavior before responding to choice. Recently,
      VTE was proposed as a mechanism alternative to the concept of "cognitive map" in
      accounts of hippocampal function. That is, many phenomena of impaired learning
      and memory related to hippocampal interventions may be explained by behavioral
      first principles: reduced conflicting, incipient, pre-choice tendencies to
      approach and avoid. The nonspatial black-white discrimination learning and VTE
      behavior of the rat were investigated. Hippocampal-lesioned and sham-lesioned
      animals were trained for 25 days (20 trials per day) starting at 60 days of age.
      Each movement of the head from one discriminative stimulus to the other was
      counted as a VTE instance. Lesioned rats had fewer VTEs than sham controls, and
      the former learned much more slowly or never learned. After learning, VTE
      frequency declined. Male and female rats showed no significant differences in VTE
      behavior or discrimination learning.

PMID- 7777540
TI  - Chromosomal insertion of foreign (adenovirus type 12, plasmid, or bacteriophage
      lambda) DNA is associated with enhanced methylation of cellular DNA segments.
AB  - Insertion of foreign DNA into an established mammalian genome can extensively
      alter the patterns of cellular DNA methylation. Adenovirus type 12 (Ad12)
      transformed hamster cells, Ad12-induced hamster tumor cells, or hamster cells
      carrying integrated DNA of bacteriophage lambda were used as model systems. DNA
      methylation levels were examined by cleaving cellular DNA with Hpa II, Msp I, or
      Hha I, followed by Southern blot hybridization with 32P-labeled, randomly
      selected cellular DNA probes. For several, but not all, cellular DNA segments
      investigated, extensive increases in DNA methylation were found in comparison
      with the methylation patterns in BHK21 or primary Syrian hamster cells. In eight
      different Ad12-induced hamster tumors, moderate increases in DNA methylation were
      seen. Increased methylation of cellular genes was also documented in two hamster
      cell lines with integrated Ad12 DNA without the Ad12-transformed phenotype, in
      one cloned BHK21 cell line with integrated plasmid DNA, and in at least three
      cloned BHK21 cell lines with integrated lambda DNA. By fluorescent in situ
      hybridization, the cellular hybridization probes were located to different
      hamster chromosomes. The endogenous intracisternal A particle genomes showed a
      striking distribution on many hamster chromosomes, frequently on their short
      arms. When BHK21 hamster cells were abortively infected with Ad12, increases in
      cellular DNA methylation were not seen. Thus, Ad12 early gene products were not
      directly involved in increasing cellular DNA methylation. We attribute the
      alterations in cellular DNA methylation, at least in part, to the insertion of
      foreign DNA. Can alterations in the methylation profiles of hamster cellular DNA
      contribute to the generation of the oncogenic phenotype?

PMID- 7777541
TI  - A region of consistent deletion in neuroblastoma maps within human chromosome
      1p36.2-36.3.
AB  - Deletion of the short arm of human chromosome 1 is the most common cytogenetic
      abnormality observed in neuroblastoma. To characterize the region of consistent
      deletion, we performed loss of heterozygosity (LOH) studies on 122 neuroblastoma
      tumor samples with 30 distal chromosome 1p polymorphisms. LOH was detected in 32
      of the 122 tumors (26%). A single region of LOH, marked distally by D1Z2 and
      proximally by D1S228, was detected in all tumors demonstrating loss. Also, cells
      from a patient with a constitutional deletion of 1p36, and from a neuroblastoma
      cell line with a small 1p36 deletion, were analyzed by fluorescence in situ
      hybridization. Cells from both sources had interstitial deletions of 1p36.2-36.3
      which overlapped the consensus region of LOH defined by the tumors. Interstitial
      deletion in the constitutional case was confirmed by allelic loss studies using
      the panel of polymorphic markers. Four proposed candidate genes--DAN, ID3 (heir
      1), CDC2L1 (p58), and TNFR2--were shown to lie outside of the consensus region of
      allelic loss, as defined by the above deletions. These results more precisely
      define the location of a neuroblastoma suppressor gene within 1p36.2-36.3,
      eliminating 33 centimorgans of proximal 1p36 from consideration. Furthermore, a
      consensus region of loss, which excludes the four leading candidate genes, was
      found in all tumors with 1p36 LOH.

PMID- 7777542
TI  - Misexpression of the white (w) gene triggers male-male courtship in Drosophila.
AB  - We report here that the general ectopic expression of a tryptophan/guanine
      transmembrane transporter gene, white (w), induces male-male courtship in
      Drosophila. Activation of a hsp-70/miniwhite (mini-w) transgene in mature males
      results in a marked change in their sexual behavior such that they begin to
      vigorously court other mature males. In transformant populations containing equal
      numbers of both sexes, most males participate, thus forming male-male courtship
      chains, circles, and lariats. Mutations that ablate the w transgene function also
      abolish this inducible behavior. Female sexual behavior does not appear to be
      altered by ectopic w expression. By contrast, when exposed to an active
      homosexual courtship environment, non-transformant males alter their behavior and
      actively participate in the male-male chaining. These findings demonstrate that,
      in Drosophila, both genetic and environmental factors play a role in male sexual
      behavior.

PMID- 7777543
TI  - Neural-network-based classification of cognitively normal, demented, Alzheimer
      disease and vascular dementia from single photon emission with computed
      tomography image data from brain.
AB  - Single photon emission with computed tomography (SPECT)
      hexamethylphenylethyleneamineoxime technetium-99 images were analyzed by an
      optimal interpolative neural network (OINN) algorithm to determine whether the
      network could discriminate among clinically diagnosed groups of elderly normal,
      Alzheimer disease (AD), and vascular dementia (VD) subjects. After initial image
      preprocessing and registration, image features were obtained that were
      representative of the mean regional tissue uptake. These features were extracted
      from a given image by averaging the intensities over various regions defined by
      suitable masks. After training, the network classified independent trials of
      patients whose clinical diagnoses conformed to published criteria for probable AD
      or probable/possible VD. For the SPECT data used in the current tests, the OINN
      agreement was 80 and 86% for probable AD and probable/possible VD, respectively.
      These results suggest that artificial neural network methods offer potential in
      diagnoses from brain images and possibly in other areas of scientific research
      where complex patterns of data may have scientifically meaningful groupings that
      are not easily identifiable by the researcher.

PMID- 7777544
TI  - Cloning and expression of a second photoreceptor-specific membrane retina
      guanylyl cyclase (RetGC), RetGC-2.
AB  - One of the membrane guanylyl cyclases (GCs), RetGC, is expressed predominantly in
      photoreceptors. No extracellular ligand has been described for RetGC, but it is
      sensitive to activation by a soluble 24-kDa protein (p24) and is inhibited by
      Ca2+. This enzyme is, therefore, thought to play a role in resynthesizing cGMP
      for photoreceptor recovery or adaptation. By screening a human retinal cDNA
      library at low stringency with the cytoplasmic domains from four cyclases, we
      cloned cDNAs encoding a membrane CG that is most closely related to RetGC. We
      have named this GC RetGC-2, and now term the initially described RetGC RetGC-1.
      By in situ hybridization, mRNA encoding RetGC-2 is found only in the outer
      nuclear layer and inner segments of photoreceptor cells. By using synthetic
      peptide antiserum specific for each RetGC subtype, RetGC-2 can be distinguished
      from RetGC-1 as a slightly smaller protein in immunoblots of bovine rod outer
      segments. Membrane GC activity of recombinant RetGC-2 expressed in human
      embryonic kidney 293 cells is stimulated by the activator p24 and is inhibited by
      Ca2+ with an EC50 value of 50-100 nM. Our data reveal a previously unappreciated
      diversity of photoreceptor GCs.

PMID- 7777545
TI  - Priming of tumor-specific T cells in the draining lymph nodes after immunization
      with interleukin 2-secreting tumor cells: three consecutive stages may be
      required for successful tumor vaccination.
AB  - Although both CD4+ and CD8+ T cells are clearly required to generate long-lasting
      anti-tumor immunity induced by s.c. vaccination with interleukin 2 (IL-2)
      transfected, irradiated M-3 clone murine melanoma cells, some controversy
      continues about the site and mode of T-cell activation in this system.
      Macrophages, granulocytes, and natural killer cells infiltrate the vaccination
      site early after injection into either syngeneic euthymic DBA/2 mice or athymic
      nude mice and eliminate the inoculum within 48 hr. We could not find T cells at
      the vaccination site, which argues against the concept that T-cell priming by the
      IL-2-secreting cancer cells occurs directly at that location. However, reverse
      transcription-PCR revealed transcripts indicative of T-cell activation and
      expansion in the draining lymph nodes of mice immunized with the IL-2-secreting
      vaccine but not in mice vaccinated with untransfected, irradiated M-3 cells. We
      therefore propose that the antigen-presenting cells, which invade the vaccination
      site, process tumor-derived antigens and, subsequently, initiate priming of tumor
      specific T lymphocytes in lymphoid organs. These findings suggest a three-stage
      process for the generation of effector T cells after vaccination with IL-2
      secreting tumor cells: (i) tumor-antigen uptake and processing at the site of
      injection by antigen-presenting cells, (ii) migration of antigen-presenting cells
      into the regional draining lymph nodes, where T-cell priming occurs, and (iii)
      circulation of activated T cells that either perform or initiate effector
      mechanisms leading to tumor cell destruction.

PMID- 7777546
TI  - Transforming growth factor beta induces the cyclin-dependent kinase inhibitor p21
      through a p53-independent mechanism.
AB  - The transforming growth factor beta s (TGF-beta s) are a group of multifunctional
      growth factors which inhibit cell cycle progression in many cell types. The TGF
      beta-induced cell cycle arrest has been partially attributed to the regulatory
      effects of TGF-beta on both the levels and the activities of the G1 cyclins and
      their kinase partners. The activities of these kinases are negatively regulated
      by a number of small proteins, p21 (WAF1, Cip1), p27Kip1, p16, and p15INK4B, that
      physically associate with cyclins, cyclin-dependent kinases, or cyclin-Cdk
      complexes. p21 has been previously shown to be transcriptionally induced by DNA
      damage through p53 as a mediator. We demonstrate that TGF-beta also causes a
      rapid transcriptional induction of p21, suggesting that p21 can respond to both
      intracellular and extracellular signals for cell cycle arrest. In contrast to DNA
      damage, however, induction of p21 by TGF-beta is not dependent on wild-type p53.
      The cell line studied in these experiments, HaCaT, contains two mutant alleles of
      p53, which are unable to activate transcription from the p21 promoter when
      overexpressed. In addition, TGF-beta and p53 act through distinct elements in the
      p21 promoter. Taken together, these findings suggest that TGF-beta can induce p21
      through a p53-independent pathway. Previous findings have implicated p27Kip1 and
      p15INK2B as effectors mediating the TGF-beta growth inhibitory effect. These
      results demonstrate that a single extracellular antiproliferative signal, TGF
      beta, can act through multiple signaling pathways to elicit a growth arrest
      response.

PMID- 7777547
TI  - A class of single-stranded telomeric DNA-binding proteins required for Rap1p
      localization in yeast nuclei.
AB  - We have identified a class of proteins that bind single-stranded telomeric DNA
      and are required for the nuclear organization of telomeres and/or telomere
      associated proteins. Rlf6p was identified by its sequence similarity to Gbp1p, a
      single-stranded telomeric DNA-binding protein from Chlamydomonas reinhardtii.
      Rlf6p and Gbp1p bind yeast single-stranded G-strand telomeric DNA. Both proteins
      include at least two RNA recognition motifs, which are found in many proteins
      that interact with single-stranded nucleic acids. Disruption of RLF6 alters the
      distribution of repressor/activator protein 1 (Rap1p), a telomere-associated
      protein. In wild-type yeast cells, Rap1p localizes to a small number of
      perinuclear spots, while in rlf6 cells Rap1p appears diffuse and nuclear.
      Interestingly, telomere position effect and telomere length control, which
      require RAP1, are unaffected by rlf6 mutations, demonstrating that Rap1p
      localization can be uncoupled from other Rap1p-dependent telomere functions. In
      addition, expression of Chlamydomonas GBP1 restores perinuclear, punctate Rap1p
      localization in rlf6 mutant cells. The functional complementation of a fungal
      gene by an algal gene suggests that Rlf6p and Gbp1p are members of a conserved
      class of single-stranded telomeric DNA-binding proteins that influence nuclear
      organization. Furthermore, it demonstrates that, despite their unusual codon
      bias, C. reinhardtii genes can be efficiently translated in Saccharomyces
      cerevisiae cells.

PMID- 7777550
TI  - Genomic DNA fingerprinting by restriction fragment end labeling.
AB  - A typing method for bacteria was developed and applied to several species,
      including Escherichia coli and Actinobacillus actinomycetemcomitans. Total
      genomic DNA was digested with a restriction endonuclease, and fragments were
      enabled with [alpha-32P]dATP by using the Klenow fragment of DNA polymerase and
      separated by electrophoresis in 6% polyacrylamide/8 M urea (sequencing gel).
      Depending on the restriction endonuclease and the bacterium, the method produced
      approximately 30-50 well-separated fragments in the size range of 100-400
      nucleotides. For A. actinomycetemcomitans, all strains had bands in common.
      Nevertheless, many polymorphisms could be observed, and the 31 strains tested
      could be classified into 29 distinct types. Furthermore, serotype-specific
      fragments could be assigned for the three serotypes investigated. The method
      described is very sensitive, allowing more distinct types to be distinguished
      than other commonly used typing methods. When the method was applied to 10 other
      clinically relevant bacterial species, both species-specific bands and strain
      specific bands were found. Isolates from different locations of one patient
      showed indistinguishable patterns. Computer-assisted analysis of the DNA
      fingerprints allowed the determination of similarity coefficients. It is
      concluded that genomic fingerprinting by restriction fragment end labeling (RFEL)
      is a powerful and generally applicable technique to type bacterial species.

PMID- 7777549
TI  - Induction of intracellular cAMP by a synthetic retroviral envelope peptide: a
      possible mechanism of immunopathogenesis in retroviral infections.
AB  - A synthetic heptadecapeptide, CKS-17, represents the highly conserved amino acid
      sequences occurring within the transmembrane envelope protein of many animal and
      human retroviruses. CKS-17 has been demonstrated to exhibit suppressive
      properties for numerous immune functions. We have recently shown that CKS-17 acts
      as an immunomodulatory epitope causing an imbalance of human type 1 and type 2
      cytokine production and suppression of cell-mediated immunities. cAMP, an
      intracellular second messenger, plays an important role in regulation of cytokine
      biosynthesis--i.e., elevation of intracellular cAMP levels selectively inhibits
      type 1 cytokine production but has no effect or enhances type 2 cytokine
      production. Here, we demonstrate that CKS-17 induces dramatic rises in the
      intracellular cAMP levels of a human monocyte cell line and of human peripheral
      blood mononuclear cells in a time- and dose-dependent manner. A peptide
      corresponding to the reverse sequence of CKS-17, used as control, has no effect
      on intracellular cAMP levels. The cAMP-inducing ability of CKS-17 is
      significantly blocked by SQ-22536, an inhibitor of adenylate cyclase. These
      results indicate that CKS-17, a highly conserved component of the transmembrane
      proteins of immunosuppressive retroviruses, induces increased intracellular
      levels of cAMP via activation of adenylate cyclase and suggest that this
      retroviral envelope peptide may differentially modulate type 1 and type 2
      cytokine production through elevation of intracellular cAMP levels.

PMID- 7777548
TI  - Human immunodeficiency virus 1 reservoir in CD4+ T cells is restricted to certain
      V beta subsets.
AB  - The human immunodeficiency virus 1 (HIV-1) replicates more efficiently in T-cell
      lines expressing T-cell receptors derived from certain V beta genes, V beta 12 in
      particular, suggesting the effects of a superantigen. The targeted V beta 12
      subset was not deleted in HIV-1-infected patients. It was therefore possible that
      it might represent an in vivo viral reservoir. Viral load was assessed by
      quantitative PCR with gag primers and with an infectivity assay to measure
      competent virus. It was shown that the tiny V beta 12 subset (1-2% of T cells)
      often has a higher viral load than other V beta subsets in infected patients.
      Selective HIV-1 replication in V beta 12 cells was also observed 6-8 days after
      in vitro infection of peripheral blood lymphocytes from normal, HIV-1 negative
      donors. Viral replication in targeted V beta subsets may serve to promote a
      biologically relevant viral reservoir.

PMID- 7777551
TI  - Emergent spindle oscillations and intermittent burst firing in a thalamic model:
      specific neuronal mechanisms.
AB  - The rhythmogenesis of 10-Hz sleep spindles is studied in a large-scale thalamic
      network model with two cell populations: the excitatory thalamocortical (TC)
      relay neurons and the inhibitory nucleus reticularis thalami (RE) neurons.
      Spindle-like bursting oscillations emerge naturally from reciprocal interactions
      between TC and RE neurons. We find that the network oscillations can be
      synchronized coherently, even though the RE-TC connections are random and sparse,
      and even though individual neurons fire rebound bursts intermittently in time.
      When the fast gamma-aminobutyrate type A synaptic inhibition is blocked,
      synchronous slow oscillations resembling absence seizures are observed. Near
      maximal network synchrony is established with even modest convergence in the RE
      to-TC projection (as few as 5-10 RE inputs per TC cell suffice). The
      hyperpolarization-activated cation current (Ih) is found to provide a cellular
      basis for the intermittency of rebound bursting that is commonly observed in TC
      neurons during spindles. Such synchronous oscillations with intermittency can be
      maintained only with a significant degree of convergence for the TC-to-RE
      projection.

PMID- 7777552
TI  - Mechanisms underlying the sensitivity of songbird forebrain neurons to temporal
      order.
AB  - Neurons in the songbird forebrain area HVc (hyperstriatum ventrale pars caudale
      or high vocal center) are sensitive to the temporal structure of the bird's own
      song and are capable of integrating auditory information over a period of several
      hundred milliseconds. Extracellular studies have shown that the responses of some
      HVc neurons depend on the combination and temporal order of syllables from the
      bird's own song, but little is known about the mechanisms underlying these
      response properties. To investigate these mechanisms, we recorded intracellular
      responses to a set of auditory stimuli designed to assess the degree of
      dependence of the responses on temporal context. This report provides evidence
      that HVc neurons encode information about temporal structure by using a variety
      of mechanisms including syllable-specific inhibition, excitatory postsynaptic
      potentials with a range of different time courses, and burst-firing nonlinearity.
      The data suggest that the sensitivity of HVc neurons to temporal combinations of
      syllables results from the interactions of several cells and does not arise in a
      single step from afferent inputs alone.

PMID- 7777553
TI  - Cortical correlate of pattern backward masking.
AB  - The perception of a briefly presented shape is strongly impaired when it is
      followed by another pattern, a phenomenon called backward masking. We found that
      the vast majority of a sample of shape-selective neurons in the macaque inferior
      temporal cortex respond selectively to backward-masked shapes, although these
      shapes could not be discriminated by human and monkey subjects. However, this
      selective response was brief, since it was either interrupted by the mask or
      overridden by a response to the mask itself. We show that reliable discrimination
      of briefly presented shapes by single neurons depends on the temporal integration
      of the response. Presentation of the mask, however, reduces the number of spikes
      available for integration, explaining backward masking. These results also
      provide direct neurophysiological evidence for the "interruption theory" of
      backward masking.

PMID- 7777555
TI  - Significant discrepancies between van't Hoff and calorimetric enthalpies.
AB  - In this paper we show that the usual assumption in studies of the temperature
      variation of equilibrium constants for equilibria of the form A+B <-->AB that a
      plot of ln K vs. 1/T (K = equilibrium constant, T = temperature in degrees
      kelvin) is a straight line with slope equal to -delta HvH/R (delta HvH = van't
      Hoff or apparent enthalpy, R = gas constant) is not valid in many cases. In all
      the cases considered here, delta HvH is temperature dependent and is
      significantly different from the true or calorimetrically measured enthalpy, and
      the respective values for delta Cp are also significantly different.

PMID- 7777554
TI  - Vector-mediated delivery of a polyamide ("peptide") nucleic acid analogue through
      the blood-brain barrier in vivo.
AB  - Polyamide ("peptide") nucleic acids (PNAs) are molecules with antigene and
      antisense effects that may prove to be effective neuropharmaceuticals if these
      molecules are enabled to undergo transport through the brain capillary
      endothelial wall, which makes up the blood-brain barrier in vivo. The model PNA
      used in the present studies is an 18-mer that is antisense to the rev gene of
      human immunodeficiency virus type 1 and is biotinylated at the amino terminus and
      iodinated at a tyrosine residue near the carboxyl terminus. The biotinylated PNA
      was linked to a conjugate of streptavidin (SA) and the OX26 murine monoclonal
      antibody to the rat transferrin receptor. The blood-brain barrier is endowed with
      high transferrin receptor concentrations, enabling the OX26-SA conjugate to
      deliver the biotinylated PNA to the brain. Although the brain uptake of the free
      PNA was negligible following intravenous administration, the brain uptake of the
      PNA was increased at least 28-fold when the PNA was bound to the OX26-SA vector.
      The brain uptake of the PNA bound to the OX26-SA vector was 0.1% of the injected
      dose per gram of brain at 60 min after an intravenous injection, approximating
      the brain uptake of intravenously injected morphine. The PNA bound to the OX26-SA
      vector retained the ability to bind to synthetic rev mRNA as shown by RNase
      protection assays. In summary, the present studies show that while the transport
      of PNAs across the blood-brain barrier is negligible, delivery of these potential
      neuropharmaceutical drugs to the brain may be achieved by coupling them to vector
      mediated peptide-drug delivery systems.

PMID- 7777556
TI  - Accelerated evolution in the protein-coding regions is universal in crotalinae
      snake venom gland phospholipase A2 isozyme genes.
AB  - The nucleotide sequences of four genes encoding Trimeresurus gramineus (green
      habu snake, crotalinae) venom gland phospholipase A2 (PLA2; phosphatidylcholine 2
      acylhydrolase, EC 3.1.1.4) isozymes were compared internally and externally with
      those of six genes encoding Trimeresurus flavoviridis (habu snake, crotalinae)
      venom gland PLA2 isozymes. The numbers of nucleotide substitutions per site (KN)
      for the noncoding regions including introns were one-third to one-eighth of the
      numbers of nucleotide substitutions per synonymous site (KS) for the protein
      coding regions of exons, indicating that the noncoding regions are much more
      conserved than the protein-coding regions. The KN values for the introns were
      found to be nearly equivalent to those of introns of T. gramineus and T.
      flavoviridis TATA box-binding protein genes, which are assumed to be a general
      (nonvenomous) gene. Thus, it is evident that the introns of venom gland PLA2
      isozyme genes have evolved at a similar rate to those of nonvenomous genes. The
      numbers of nucleotide substitutions per nonsynonymous site (KA) were close to or
      larger than the KS values for the protein-coding regions in venom gland PLA2
      isozyme genes. All of the data combined reveal that Darwinian-type accelerated
      evolution has universally occurred only in the protein-coding regions of
      crotalinae snake venom PLA2 isozyme genes.

PMID- 7777557
TI  - Direct detection and isolation of restriction landmark genomic scanning (RLGS)
      spot DNA markers tightly linked to a specific trait by using the RLGS spot
      bombing method.
AB  - We have developed a technique for isolating DNA markers tightly linked to a
      target region that is based on RLGS, named RLGS spot-bombing (RLGS-SB). RLGS-SB
      allows us to scan the genome of higher organisms quickly and efficiently to
      identify loci that are linked to either a target region or gene of interest. The
      method was initially tested by analyzing a C57BL/6-GusS mouse congenic strain. We
      identified 33 variant markers out of 10,565 total loci in a 4.2-centimorgan (cM)
      interval surrounding the Gus locus in 4 days of laboratory work. The validity of
      RLGS-SB to find DNA markers linked to a target locus was also tested on pooled
      DNA from segregating backcross progeny by analyzing the spot intensity of already
      mapped RLGS loci. Finally, we used RLGS-SB to identify DNA markers closely linked
      to the mouse reeler (rl) locus on chromosome 5 by phenotypic pooling. A total of
      31 RLGS loci were identified and mapped to the target region after screening 8856
      loci. These 31 loci were mapped within 11.7 cM surrounding rl. The average
      density of RLGS loci located in the rl region was 0.38 cM. Three loci were
      closely linked to rl showing a recombination frequency of 0/340, which is < 1 cM
      from rl. Thus, RLGS-SB provides an efficient and rapid method for the detection
      and isolation of polymorphic DNA markers linked to a trait or gene of interest.

PMID- 7777558
TI  - Transient transfection and expression of firefly luciferase in Giardia lamblia.
AB  - We have developed a gene transfer system for the protozoan parasite Giardia
      lamblia. This organism is responsible for many cases of diarrhea worldwide and is
      considered to be one of the most primitive eukaryotes. Expression of a
      heterologous gene was detected in this parasite after electroporation with
      appropriate DNA constructs. We constructed a series of transfection plasmids
      using flanking sequences of the Giardia glutamate dehydrogenase (GDH) gene to
      drive expression of the firefly luciferase reporter gene. The optimal construct
      consisted of a GDH/luciferase fusion gene in which the first 18 codons of the GDH
      gene immediately preceded the luciferase gene; this fusion gene was flanked by
      the upstream and downstream sequences of the GDH gene. Electroporation of this
      construct into Giardia yielded luciferase activity that was 3000- to 50,000-fold
      above background. Removal of either the 5' or 3' GDH flanking sequences from this
      construct resulted in significantly reduced luciferase activity, and removal of
      both flanking sequences reduced luciferase activity to background levels.
      Luciferase activity was proportional to the amount of DNA electroporated and was
      maximal at 6 hr after electroporation.

PMID- 7777559
TI  - Evidence for five divergent thioredoxin h sequences in Arabidopsis thaliana.
AB  - Five different clones encoding thioredoxin homologues were isolated from
      Arabidopsis thaliana cDNA libraries. On the basis of the sequences they encode
      divergent proteins, but all belong to the cytoplasmic thioredoxins h previously
      described in higher plants. The five proteins obtained by overexpressing the
      coding sequences in Escherichia coli present typical thioredoxin activities
      (NADP(+)-malate dehydrogenase activation and reduction by Arabidopsis thioredoxin
      reductase) despite the presence of a variant active site, Trp-Cys-Pro-Pro-Cys, in
      three proteins in place of the canonical Trp-Cys-Gly-Pro-Cys sequence described
      for thioredoxins in prokaryotes and eukaryotes. Southern blots show that each
      cDNA is encoded by a single gene but suggest the presence of additional related
      sequences in the Arabidopsis genome. This very complex diversity of thioredoxins
      h is probably common to all higher plants, since the Arabidopsis sequences appear
      to have diverged very early, at the beginning of plant speciation. This diversity
      allows the transduction of a redox signal into multiple pathways.

PMID- 7777560
TI  - Strand specificity in the transcriptional targeting of recombination at
      immunoglobulin switch sequences.
AB  - B-lymphocyte-specific class switch recombination is known to occur between pairs
      of 2- to 10-kb switch regions located immediately upstream of the immunoglobulin
      constant heavy-chain genes. Others have shown that the recombination is
      temporally correlated with the induction of transcription at the targeted switch
      regions. To determine whether this temporal correlation is due to a mechanistic
      linkage, we have developed an extrachromosomal recombination assay that closely
      recapitulates DNA deletional class switch recombination. In this assay, the rate
      of recombination is measured between 24 and 48 hr posttransfection. We find that
      recombinants are generated in a switch sequence-dependent manner. Recombination
      occurs with a predominance within B-cell lines representative of the mature B
      cell stage and within a subset of pre-B-cell lines. Transcription stimulates the
      switch sequence-dependent recombination. Importantly, transcription activates
      recombination only when directed in the physiologic orientation but has no effect
      when directed in the nonphysiologic orientation.

PMID- 7777561
TI  - Identification of a plastid protein involved in vesicle fusion and/or membrane
      protein translocation.
AB  - Structural evidence has accumulated suggesting that fusion and/or translocation
      factors are involved in plastid membrane biogenesis. To test this hypothesis, we
      have developed an in vitro system in which the extent of fusion and/or
      translocation is monitored by the conversion of the xanthophyll epoxide
      (antheraxanthin) into the red ketocarotenoid (capsanthin). Only chromoplast
      membrane vesicles from red pepper fruits (Capsicum annuum) contain the required
      enzyme. Vesicles prepared from the mutant yellow cultivar are devoid of this
      enzyme and accumulate antheraxanthin. The fusion and/or translocation activity is
      characterized by complementation due to the synthesis of capsanthin and the
      parallel decrease of antheraxanthin when the two types of vesicles are incubated
      together in the presence of plastid stroma. We show that the extent of conversion
      is dependent upon an ATP-requiring protein that is sensitive to N-ethylmaleimide.
      Further purification and immunological analysis have revealed that the active
      factor, designated plastid fusion and/or translocation factor (Pftf), resides in
      a protein of 72 kDa. cDNA cloning revealed that mature Pftf has significant
      homology to yeast and animal (NSF) or bacterial (Ftsh) proteins involved in
      vesicle fusion or membrane protein translocation.

PMID- 7777562
TI  - RuvC protein resolves Holliday junctions via cleavage of the continuous
      (noncrossover) strands.
AB  - The RuvC protein of Escherichia coli resolves Holliday junctions during genetic
      recombination and the postreplicational repair of DNA damage. Using synthetic
      Holliday junctions that are constrained to adopt defined isomeric configurations,
      we show that resolution occurs by symmetric cleavage of the continuous
      (noncrossing) pair of DNA strands. This result contrasts with that observed with
      phage T4 endonuclease VII, which cleaves the pair of crossing strands. In the
      presence of RuvC, the pair of continuous strands (i.e., the target strands for
      cleavage) exhibit a hypersensitivity to hydroxyl radicals. These results indicate
      that the continuous strands are distorted within the RuvC/Holliday junction
      complex and that RuvC-mediated resolution events require protein-directed
      structural changes to the four-way junction.

PMID- 7777564
TI  - Low concentrations of diacylglycerol promote the binding of apolipophorin III to
      a phospholipid bilayer: a surface plasmon resonance spectroscopy study.
AB  - The binding of the exchangeable apolipoprotein apolipophorin III (apoLp-III) to
      an egg phosphatidylcholine bilayer as a function of the concentration of
      diacylglycerol (DG) in the bilayer was studied by surface plasmon resonance
      spectroscopy. At a DG concentration of 2 mol % in the bilayer, the binding of
      apoLp-III reached saturation. Under saturating conditions, apoLp-III forms a
      closely packed monolayer approximately 55 A thick, in which each molecule of
      protein occupies approximately 500 A2 at the membrane surface. These dimensions
      are consistent with the molecular size of the apoLp-III molecule determined by x
      ray crystallography, if apoLp-III binds to the bilayer with the long axis of the
      apoLp-III normal to the membrane surface. In the absence of protein, the overall
      structure of the lipid bilayer was not significantly changed up to 2.5 mol% DG.
      However, at 4 and 6 mol % DG, the presence of nonbilayer structures was observed.
      The addition of apoLp-III to a membrane containing 6 mol % DG promoted the
      formation of large lipid-protein complexes. These data support a two-step
      sequential binding mechanism for binding of apoLp-III to a lipid surface. The
      first step is a recognition process, consisting of the adsorption of apoLp-III to
      a nascent hydrophobic defect in the phospholipid bilayer caused by the presence
      of DG. This recognition process might depend on the presence of a hydrophobic
      sensor located at one of the ends of the long axis of the apoLp-III molecule but
      would be consolidated through H-bond and electrostatic interactions. Once primary
      binding is achieved, subsequent enlargement of the hydrophobic defect in the
      lipid surface would trigger the unfolding of the apolipoprotein and binding via
      the amphipathic alpha-helices. This two-step sequential binding mechanism could
      be a general mechanism for all exchangeable apolipoproteins. A possible
      physiological role of the ability of apoLp-III to bind to lipid structures in two
      orientations is also proposed.

PMID- 7777565
TI  - Mitochondrial DNA replication but no nuclear DNA replication during development
      of Dictyostelium.
AB  - Dictyostelium discoideum cells initiate development when nutrients are depleted.
      DNA synthesis decreases rapidly thereafter but resumes during late aggregation,
      only in prespore cells. This observation has been previously interpreted as
      indicating progression of prespore cells through the cell cycle during
      development. We show that developmental DNA replication occurs only in
      mitochondria and not in nuclei. We also show that the prestalk morphogen known as
      differentiation-inducing factor 1 can inhibit mitochondrial respiration. A model
      is proposed for cell type divergence, based on competition to become prespores,
      that involves mitochondrial replication in prespore cells and reduction of
      mitochondrial activity in prestalk cells.

PMID- 7777563
TI  - Rep protein of tomato yellow leaf curl geminivirus has an ATPase activity
      required for viral DNA replication.
AB  - The Rep protein of geminiviruses is the sole viral protein required for their DNA
      replication. The amino acid sequence of Rep protein contains an NTP binding
      consensus motif (P-loop). Here we show that purified Rep protein of tomato yellow
      leaf curl virus expressed in Escherichia coli exhibits an ATPase activity in
      vitro. Amino acid exchanges in the P-loop sequence of Rep causes a substantial
      decrease or loss of the ATPase activity. In vivo, mutant viruses carrying these
      Rep mutations do not replicate in plant cells. These results show that ATP
      binding by the Rep protein of geminiviruses is required for its function in viral
      DNA replication.

PMID- 7777567
TI  - Adaptive mutations in Escherichia coli as a model for the multiple mutational
      origins of tumors.
AB  - The cells in most tumors are found to carry multiple mutations; however, based
      upon mutation rates determined by fluctuation tests, the frequency of such
      multiple mutations should be so low that tumors are never detected within human
      populations. Fluctuation tests, which determine the cell-division-dependent
      mutation rate per cell generation in growing cells, may not be appropriate for
      estimating mutation rates in nondividing or very slowly dividing cells. Recent
      studies of time-dependent, "adaptive" mutations in nondividing populations of
      microorganisms suggest that similar measurements may be more appropriate to
      understanding the mutation origins of tumors. Here I use the ebgR and ebgA genes
      of Escherichia coli to measure adaptive mutation rates where multiple mutations
      are required for rapid growth. Mutations in either ebgA or ebgR allow very slow
      growth on lactulose (4-O-beta-D-galactosyl-D-fructose), with doubling times of
      3.2 and 17.3 days, respectively. However, when both mutations are present, cells
      can grow rapidly with doubling times of 2.7 hr. I show that during prolonged (28
      day) selection for growth on lactulose, the number of lactulose-utilizing mutants
      that accumulate is 40,000 times greater than can be accounted for on the basis of
      mutation rates measured by fluctuation tests, but is entirely consistent with the
      time-dependent adaptive mutation rates measured under the same conditions of
      prolonged selection.

PMID- 7777566
TI  - Yeast histone H3 and H4 N termini function through different GAL1 regulatory
      elements to repress and activate transcription.
AB  - Previous work has shown that N-terminal deletions of yeast histone H3 cause a 2-
      to 4-fold increase in the induction of GAL1 and a number of other genes involved
      in galactose metabolism. In contrast, deletions at the H4 N terminus cause a 10-
      to 20-fold decrease in the induction of these same GAL genes. However, H3 and H4
      N-terminal deletions each decrease PHO5 induction only 2- to 4-fold. To define
      the GAL1 gene regulatory elements through which the histone N termini activate or
      repress transcription, fusions were made between GAL1 and PHO5 promoter elements
      attached to a beta-galactosidase reporter gene. We show here that GAL1
      hyperactivation caused by the H3 N-terminal deletion delta 4-15 is linked to the
      upstream activation sequence. Conversely, the relative decrease in GAL1 induction
      caused by the H4N-terminal deletion delta 4-28 is linked to the downstream
      promoter which contains the TATA element. These data indicate that the H3 N
      terminus is required for the repression of the GAL1 upstream element, whereas the
      H4N terminus is required for the activation of the GAL1 downstream promoter
      element.

PMID- 7777569
TI  - Natural killer and lymphokine-activated killer cells require granzyme B for the
      rapid induction of apoptosis in susceptible target cells.
AB  - Granzyme (Gzm) B-deficient mice obtained by gene targeting were used to assess
      the role of Gzm B in the mechanisms used by natural killer (NK) and lymphokine
      activated killer (LAK) cells to destroy target cells. Gzm B-/- NK cells, LAK
      cells, and cytotoxic T lymphocytes (CTL) all are defective in their ability to
      rapidly induce DNA fragmentation/apoptosis in susceptible target cells. This
      defect can be partially corrected with long incubation times of effector and
      target cells. Moreover, Gzm B-/- NK cells (but not CTL or LAK cells) exhibit a
      defect in 51Cr release from susceptible target cells. This 51Cr release defect in
      Gzm B-deficient NK cells is also not overcome by prolonged incubation times or
      high effector-to-target cell ratios. We conclude that Gzm B plays a critical and
      nonredundant role in the rapid induction of DNA fragmentation/apoptosis by NK
      cells, LAK cells, and CTL. Gzm B may have an additional role in NK cells (but not
      in CTL or LAK cells) for mediating 51Cr release.

PMID- 7777568
TI  - Cytotoxic T-lymphocyte clones from different patients display limited T-cell
      receptor variable-region gene usage in HLA-A2-restricted recognition of the
      melanoma antigen Melan-A/MART-1.
AB  - To determine whether T-cell-receptor (TCR) usage by T cells recognizing a defined
      human tumor antigen in the context of the same HLA molecule is conserved, we
      analyzed the TCR diversity of autologous HLA-A2-restricted cytotoxic T-lymphocyte
      (CTL) clones derived from five patients with metastatic melanoma and specific for
      the common melanoma antigen Melan-A/MART-1. These clones were first identified
      among HLA-A2-restricted anti-melanoma CTL clones by their ability to specifically
      release tumor necrosis factor in response to HLA-A2.1+ COS-7 cells expressing
      this tumor antigen. A PCR with variable (V)-region gene subfamily-specific
      primers was performed on cDNA from each clone followed by DNA sequencing.
      TCRAV2S1 was the predominant alpha-chain V region, being transcribed in 6 out of
      9 Melan-A/MART-1-specific CTL clones obtained from the five patients. beta-chain
      V-region usage was also restricted, with either TCRBV14 or TCRBV7 expressed by
      all but one clone. In addition, a conserved TCRAV2S1/TCRBV14 combination was
      expressed in four CTL clones from three patients. None of these V-region genes
      was found in a group of four HLA-A2-restricted CTL clones recognizing different
      antigens (e.g., tyrosinase) on the autologous tumor. TCR joining regions were
      heterogeneous, although conserved structural features were observed in the
      complementarity-determining region 3 sequences. These results indicate that a
      selective repertoire of TCR genes is used in anti-melanoma responses when the
      response is narrowed to major histocompatibility complex-restricted antigen
      specific interactions.

PMID- 7777570
TI  - Multiple loci govern the bone marrow-derived immunoregulatory mechanism
      controlling dominant resistance to autoimmune orchitis.
AB  - The existence of immunoregulatory genes conferring dominant resistance to
      autoimmunity is well documented. In an effort to better understand the nature and
      mechanisms of action of these genes, we utilized the murine model of autoimmune
      orchitis as a prototype. When the orchitis-resistant strain DBA/2J is crossed
      with the orchitis-susceptible strain BALB/cByJ, the F1 hybrid is completely
      resistant to the disease. By using reciprocal radiation bone marrow chimeras, the
      functional component mediating this resistance was mapped to the bone marrow
      derived compartment. Resistance is not a function of either low-dose irradiation-
      or cyclophosphamide (20 mg/kg)-sensitive immunoregulatory cells, but can be
      adoptively transferred by primed splenocytes. Genome exclusion mapping identified
      three loci controlling the resistant phenotype. Orch3 maps to chromosome 11,
      whereas Orch4 and Orch5 map to the telomeric and centromeric regions of
      chromosome 1, respectively. All three genes are linked to a number of
      immunologically relevant candidate loci. Most significant, however, is the
      linkage of Orch3 to Idd4 and Orch5 to Idd5, two susceptibility genes which play a
      role in autoimmune insulin-dependent type 1 diabetes mellitus in the nonobese
      diabetic mouse.

PMID- 7777571
TI  - Blockade of T- and B-lymphocyte development by antibody to the gamma c subunit of
      the receptors for interleukins 2, 4, and 7.
AB  - Cytokines are important regulators of hematopoesis. Mutations in gamma c, which
      is a subunit shared by the receptors for interleukin (IL) 2, IL-4, and IL-7, have
      been causally associated with human X chromosome-linked severe combined
      immunodeficiency disease. This finding indicates a mandatory role for cytokine
      receptor signaling at one or more stages of lymphocyte development. To evaluate
      the cellular level at which gamma c is critical for lymphopoiesis, the effect of
      monoclonal antibodies to gamma c on the capacity of syngeneic bone marrow cells
      to reconstitute the hematopoietic compartment of lethally irradiated recipient
      mice was examined. We show that monoclonal antibody to gamma c blocked lymphocyte
      development at or before the appearance of pro-B cells and prior to or at the
      seeding of the thymus by precursor cells while erythromyeloid cell development
      was normal. These results suggest that one level of lymphocyte development that
      requires gamma c is a point in hematopoietic cell differentiation near the
      divergence of lymphopoiesis and erythromyelopoesis.

PMID- 7777572
TI  - A mutation in the epithelial sodium channel causing Liddle disease increases
      channel activity in the Xenopus laevis oocyte expression system.
AB  - We have studied the functional consequences of a mutation in the epithelial Na+
      channel that causes a heritable form of salt-sensitive hypertension, Liddle
      disease. This mutation, identified in the original kindred described by Liddle,
      introduces a premature stop codon in the channel beta subunit, resulting in a
      deletion of almost all of the C terminus of the encoded protein. Coexpression of
      the mutant beta subunit with wild-type alpha and gamma subunits in Xenopus laevis
      oocytes resulted in an approximately 3-fold increase in the macroscopic amiloride
      sensitive Na+ current (INa) compared with the wild-type channel. This change in
      INa reflected an increase in the overall channel activity characterized by a
      higher number of active channels in membrane patches. The truncation mutation in
      the beta subunit of epithelial Na+ channel did not alter the biophysical and
      pharmacological properties of the channel--including unitary conductance, ion
      selectivity, or sensitivity to amiloride block. These results provide direct
      physiological evidence that Liddle disease is related to constitutive channel
      hyperactivity in the cell membrane. Deletions of the C-terminal end of the beta
      and gamma subunits of rat epithelial Na+ channel were functionally equivalent in
      increasing INa, suggesting that the cytoplasmic domain of the gamma subunit might
      be another molecular target for mutations responsible for salt-sensitive forms of
      hypertension.

PMID- 7777573
TI  - Construction and characterization of a highly complex retroviral library for
      lineage analysis.
AB  - Replication-incompetent retroviral vectors encoding histochemical reporter genes
      have been used for studying lineal relationships in a variety of species. A
      crucial element in the interpretation of data generated by this method is the
      identification of sibling relationships, or clonal boundaries. The use of a
      library of viruses in which each member is unique can greatly facilitate this
      aspect of the analysis. A previously reported murine retroviral library
      containing about 80 members demonstrated the utility of the library approach.
      However, the relatively low number of tags in the murine library necessitated
      using low infection rates in order to give confidence in clonal assignments. To
      obviate the need for low infection rates, a far more complex library was created
      and characterized. The CHAPOL library was constructed such that each member
      encodes a histochemical reporter gene and has a DNA tag derived from a degenerate
      oligonucleotide pool synthesized to have a complexity of > 1 x 10(7). The library
      was tested after infection of cells in vitro or in vivo. The DNA tag from each
      histochemically labeled cell or clone of cells was recovered by PCR and sequenced
      for unambiguous identification. Three hundred and twenty tags have been
      identified after infection, and so far no tag has been seen to result from more
      than one independent infection. Thus, an equal distribution of inserts is
      suggested, and Monte Carlo analysis predicts a complexity of > 10(4) members.

PMID- 7777574
TI  - Deregulated expression of PAX5 in medulloblastoma.
AB  - Medulloblatoma is a pediatric brain tumor originating in the human cerebellum. A
      collection of 23 medulloblastomas was analyzed for expression of the
      developmental control genes of the PAX and EN gene families by RNase protection
      and in situ hybridization. Of all nine PAX genes investigated, only PAX5 and PAX6
      were consistently expressed in most medulloblastomas (70 and 78% of all cases,
      respectively), as were the genes EN1 (57%) and EN2 (78%). EN1, EN2, and PAX6
      genes were also expressed in normal cerebellar tissue, and their expression in
      medulloblastoma is consistent with the hypothesis that this tumor originates in
      the external granular layer of the developing cerebellum. PAX5 transcripts were,
      however, not detected in the neonatal cerebellum, indicating that this gene is
      deregulated in medulloblastoma. In the desmoplastic variant of medulloblastoma,
      PAX5 expression was restricted to the reticulin-producing proliferating tumor
      areas containing undifferentiated cells; PAX5 was not expressed in the reticulin
      free nonproliferating islands undergoing neuronal differentiation. These data
      suggest that deregulated expression of PAX5 correlates positively with cell
      proliferation and inversely with neuronal differentiation in desmoplastic
      medulloblastoma.

PMID- 7777575
TI  - DNA synthesis and topoisomerase inhibitors increase transduction by adeno
      associated virus vectors.
AB  - Viral vectors based on adeno-associated virus (AAV) preferentially transduce
      cells in S phase of the cell cycle. We recently found that DNA-damaging agents
      increased the transduction of nondividing cells. However, the optimal
      concentrations were toxic to cells. Here we show that the transduction of normal
      human fibroblasts by AAV vectors is increased by prior exposure to DNA synthesis
      inhibitors, such as aphidicolin or hydroxyurea, and topoisomerase inhibitors,
      such as etoposide or camptothecin. Transduction efficiencies could be increased >
      300-fold in stationary cultures at concentrations that did not affect cell
      viability or proliferative potential. Both S-phase and non-S-phase cells were
      affected, suggesting that cellular functions other than replicative DNA synthesis
      may be involved. Applying these methods to gene transfer protocols should improve
      prospects for gene therapy by AAV vectors.

PMID- 7777576
TI  - The carboxyl-terminal domain of the p53 protein regulates sequence-specific DNA
      binding through its nonspecific nucleic acid-binding activity.
AB  - The murine p53 protein contains two nucleic acid-binding sites, a sequence
      specific DNA-binding region localized between amino acid residues 102-290 and a
      nucleic acid-binding site without sequence specificity that has been localized to
      residues 364-390. Alternative splicing of mRNA generates two forms of this p53
      protein. The normal, or majority, splice form (NSp53) retains its carboxyl
      terminal sequence-nonspecific nucleic acid-binding site, which can negatively
      regulate the sequence-specific DNA-binding site. The alternative splice form of
      p53 (ASp53) replaces amino acid residues 364-390 with 17 different amino acids.
      This protein fails to bind nucleic acids nonspecifically and is constitutive for
      sequence-specific DNA binding. Thus, the binding of nucleic acids at the carboxyl
      terminus regulates sequence-specific DNA binding by p53. The implications of
      these findings for the activation of p53 transcriptional activity following DNA
      damage are discussed.

PMID- 7777577
TI  - Somatodendritic expression of an immediate early gene is regulated by synaptic
      activity.
AB  - Trans-synaptic activation of gene expression is linked to long-term plastic
      adaptations in the nervous system. To examine the molecular program induced by
      synaptic activity, we have employed molecular cloning techniques to identify an
      immediate early gene that is rapidly induced in the brain. We here report the
      entire nucleotide sequence of the cDNA, which encodes an open reading frame of
      396 amino acids. Within the hippocampus, constitutive expression was low. Basal
      levels of expression in the cortex were high but can be markedly reduced by
      blockade of N-methyl-D-aspartate receptors. By contrast, synaptic activity
      induced by convulsive seizures increased mRNA levels in neurons of the cortex and
      hippocampus. High-frequency stimulation of the perforant path resulted in long
      term potentiation and a spatially confined dramatic increase in the level of mRNA
      in the granule cells of the ipsilateral dentate gyrus. Transcripts were localized
      to the soma and to the dendrites of the granule cells. The dendritic localization
      of the transcripts offers the potential for local synthesis of the protein at
      activated postsynaptic sites and may underlie synapse-specific modifications
      during long-term plastic events.

PMID- 7777578
TI  - Redistribution of synaptic vesicles and their proteins in temperature-sensitive
      shibire(ts1) mutant Drosophila.
AB  - From an extract of Drosophila melanogaster head homogenates, a membrane fraction
      can be isolated that has the same sedimentation properties as vertebrate synaptic
      vesicles and contains Drosophila synaptotagmin. The fraction disappears from
      homogenates of temperature-sensitive (ts) mutant shibire(ts1) (shi(ts1)) flies
      paralyzed by exposure to non-permissive temperatures, and reappears on return to
      permissive temperatures. Since reversible, temperature-dependent depletion of
      synaptic vesicles is known to occur in shibire(ts1) flies, we conclude that the
      fraction we have identified contains synaptic vesicles. We have examined the fate
      of synaptic vesicle membrane proteins in shibire flies at nonpermissive
      temperatures and found that all of these vesicle antigens are transferred to
      rapidly sedimenting membranes and codistribute with a plasma membrane marker by
      both glycerol velocity and metrizamide density sedimentation and by confocal
      microscopy. Three criteria were used to establish that other neuron-specific
      antigens--neuronal synaptobrevin and cysteine-string proteins--are legitimate
      components of synaptic vesicles: cosedimentation with Drosophila synaptotagmin,
      immunoadsorption, and disappearance of these antigens from the vesicle fractions
      in paralyzed shibire flies.

PMID- 7777579
TI  - Phosphatidylinositol 3-kinase signals activation of p70 S6 kinase in situ through
      site-specific p70 phosphorylation.
AB  - The p70 S6 kinase is activated by insulin and mitogens through multisite
      phosphorylation of the enzyme. One set of activating phosphorylations occurs in a
      putative autoinhibitory domain in the noncatalytic carboxyl-terminal tail.
      Deletion of this tail yields a variant (p70 delta CT104) that nevertheless
      continues to be mitogen regulated. Coexpression with a recombinant constitutively
      active phosphatidylinositol (PI) 3-kinase (EC 2.7.1.137) gives substantial
      activation of both full-length p70 and p70 delta CT104 but not Rsk. Activation of
      p70 delta CT104 by PI 3-kinase and inhibition by wortmannin are each accompanied
      by parallel and selective changes in the phosphorylation of p70 Thr-252. A Thr or
      Ser at this site, in subdomain VIII of the catalytic domain just amino-terminal
      to the APE motif, is necessary for p70 40S kinase activity. The inactive ATP
      binding site mutant K123M p70 delta CT104 undergoes phosphorylation of Thr-252 in
      situ but does not undergo direct phosphorylation by the active PI 3-kinase in
      vitro. PI 3-kinase provides a signal necessary for the mitogen activation of the
      p70 S6 kinase, which directs the site-specific phosphorylation of Thr-252 in the
      p70 catalytic domain, through a distinctive signal transduction pathway.

PMID- 7777580
TI  - Insertional mutagenesis and marker rescue in a protozoan parasite: cloning of the
      uracil phosphoribosyltransferase locus from Toxoplasma gondii.
AB  - Nonhomologous integration vectors have been used to demonstrate the feasibility
      of insertional mutagenesis in haploid tachyzoites of the protozoan parasite
      Toxoplasma gondii. Mutant clones resistant to 5-fluorouracil were identified at a
      frequency of approximately 10(-6) (approximately 2 x 10(-5) of the stable
      transformants). Four independent mutants were isolated, all of which were shown
      to lack uracil phosphoribosyl-transferase (UPRT) activity and harbor transgenes
      integrated at closely linked loci, suggesting inactivation of the UPRT-encoding
      gene. Genomic DNA flanking the insertion point (along with the integrated vector)
      was readily recovered by bacterial transformation with restriction-digested, self
      ligated total genomic DNA. Screening of genomic libraries with the recovered
      fragment identified sequences exhibiting high homology to known UPRT-encoding
      genes from other species, and cDNA clones were isolated that contain a single
      open reading frame predicted to encode the 244-amino acid enzyme. Homologous
      recombination vectors were exploited to create genetic knock-outs at the UPRT
      locus, which are deficient in enzyme activity but can be complemented by
      transient transformation with wild-type sequences--formally confirming
      identification of the functional UPRT gene. Mapping of transgene insertion points
      indicates that multiple independent mutants arose from integration at distinct
      sites within the UPRT gene, suggesting that nonhomologous integration is
      sufficiently random to permit tagging of the entire parasite genome in a single
      transformation.

PMID- 7777582
TI  - delta 9-Tetrahydrocannabinol, cytokines, and immunity to Legionella pneumophila.
AB  - The major psychoactive component of marijuana, delta 9-tetrahydrocannabinol
      (THC), has been shown to suppress the functions of various immune cells. However,
      the relationship of these findings to THC-induced suppression of host resistance
      to infection has not been firmly established. In this report, we review the
      literature concerning THC's effects on cytokine production and resistance to
      infection with Legionella pneumophila (Lp). Recent reports have linked THC
      induced immunomodulation with drug-induced modulation of the cytokine network.
      Specifically, THC in vivo suppresses interferon (IFN) production while in vitro
      modulates the production of tumor necrosis factor (TNF), interleukin-1 (IL-1),
      interleukin-2 (IL-2), and interleukin-2 receptor (IL-2R). These results suggested
      that THC treatment might alter host immunity by disrupting the cytokine network.
      Immunity and resistance to infection with Lp depends upon the activation of
      killer cells and the stimulation of the cytokine network. THC injection into
      rodents was observed to augment acute phase cytokine mobilization in response to
      a primary Lp infection; on the other hand, the drug suppressed the development of
      protective immunity and resistance to secondary Lp infection by causing a change
      in the profile of T helper cell cytokines produced by Th1 and Th2 cells. Thus, it
      appears that THC injection suppresses resistance to Lp infection by disrupting
      the cytokine network. Regarding the molecular mechanisms of these effects of THC,
      data is reviewed concerning the role of cannabinoid receptors (CR) in cells of
      the immune system. In summary, the literature to date supports the role of THC as
      an immunomodulator capable of suppressing resistance to infection through
      mechanisms involving alteration of the cytokine network. The role of CR receptors
      in these events has yet to be determined.

PMID- 7777583
TI  - Diet, autoimmunity, and insulin-dependent diabetes mellitus: a controversy.
AB  - Insulin-dependent diabetes mellitus (IDDM) is a serious disorder comprising
      approximately 10% of the total diabetic population. The majority of the genetic
      mutations that result in the phenotypic expression of the IDDM genotype are in
      the immune system. In some, the disease arises as a consequence of a viral
      infection. While some viruses target the islet beta cell and destroy it, other
      viruses induce changes in the antigen recognition system such that the affected
      individual appears to have autoimmune disease. Autoimmune-IDDM results from one
      or more mutations in the immune system that result in a failure to distinguish
      self antigens from foreign antigens. As a result, the beta cells of the endocrine
      pancreas are destroyed. This review addresses the issue of whether dietary
      factors, in particular, milk protein, can initiate the autoimmune process. Based
      on the population studies available in the literature, the conclusion is reached
      that, while antibodies to milk proteins can be found in the patient with
      autoimmune diabetes mellitus, these antibodies were probably elicited by a
      closely related protein (antigen mimicry). Because one of the features of
      autoimmune disease is a loss of antibody specificity, cross-reactivity occurs and
      appears to identify milk protein(s) as the antigen.

PMID- 7777581
TI  - Endogenous mutagenesis by an insertion sequence element identifies Aeromonas
      salmonicida AbcA as an ATP-binding cassette transport protein required for
      biogenesis of smooth lipopolysaccharide.
AB  - Analysis of an Aeromonas salmonicida A layer-deficient/O polysaccharide-deficient
      mutant carrying a Tn5 insertion in the structural gene for A protein (vapA)
      showed that the abcA gene immediately downstream of vapA had been interrupted by
      the endogenous insertion sequence element ISAS1. Immunoelectron microscopy showed
      that O polysaccharides did not accumulate at the inner membrane-cytoplasm
      interface of this mutant. abcA encodes an unusual protein; it carries both an
      amino-terminal ATP-binding cassette (ABC) domain showing high sequence similarity
      to ABC proteins implicated in the transport of certain capsular and O
      polysaccharides and a carboxyl-terminal potential DNA-binding domain, which
      distinguishes AbcA from other polysaccharide transport proteins in structural and
      evolutionary terms. The smooth lipopolysaccharide phenotype was restored by
      complementation with abcA but not by abcA carrying site-directed mutations in the
      sequence encoding the ATP-binding site of the protein. The genetic organization
      of the A. salmonicida ABC polysaccharide system differs from other bacteria. abcA
      also differs in apparently being required for both O-polysaccharide synthesis and
      in energizing the transport of O polysaccharides to the cell surface.

PMID- 7777584
TI  - Chronic energy restriction versus energy cycling and mammary tumor promotion.
AB  - Chronic energy restriction significantly inhibits mammary tumor promotion in
      rodents. The present work studied the effect of short-term, intermittent energy
      restriction or energy cycling on mammary tumor promotion since this feeding
      paradigm mimics the dieting habits of humans. Female Sprague-Dawley rats were
      given 7,12-dimethylbenz[a]anthracene (DMBA) at 50 days of age (5 mg ig). One week
      later, rats were randomly divided into three dietary groups. One group was fed ad
      libitum throughout the study (AL), another (ER) was fed 40% fewer calories than
      the AL group, and a third, energy-cycled group (EC) was fed in repeated cycles of
      2 days of feeding at a level comparable to that of AL rats followed by 2 days of
      40% energy restriction. At 10 weeks post-DMBA, the mammary tumor incidences in
      the AL and EC groups were the same, but incidence in the ER group was
      significantly lower. A second experiment examined serum levels of three hormones
      thought to play a role in mammary tumorigenesis. After 12 or 24 days on diet, ER
      rats had lower insulin levels compared with the other groups. Serum insulin
      levels in AL and EC rats were the same. After 24 days on diet, estradiol levels
      were significantly lower and corticosterone levels higher in the ER and EC groups
      compared with the AL group. Although energy cycling is a type of energy
      restriction that lowers overall weight gain and energy intake, it does not
      inhibit mammary tumor promotion as does chronic energy restriction. These data
      also suggest that feed efficiency and serum insulin levels correlate with
      susceptibility to mammary tumor promotion.

PMID- 7777585
TI  - Luteinizing hormone response to N-methyl-D, L-aspartic acid in the presence of
      physiological estradiol concentrations: influence of age and the ovary.
AB  - We have previously reported that the pituitary of intra-atrially cannulated old
      female C57BL/6J mice is as capable of responding to a GnRH challenge as is that
      of young females (10). We have observed elevated luteinizing hormone (LH) levels
      in ovariectomized (OVX) intra-atrially cannulated mice. Sustained physiologic
      levels of estradiol (E2) for 6 days suppressed circulating LH to intact levels.
      However, in that model, a bolus of E2 following E2 priming was unable to elicit
      an LH surge (Joshi et al., unpublished findings). The present studies were
      designed to examine: first, whether GnRH neurons are competent to release GnRH in
      the presence of tonic physiologic levels of E2 and, second, whether either age or
      the ovary can influence GnRH neuronal responsiveness. The N-methyl-D, L-aspartic
      acid (NMA)-evoked GnRH response was assessed indirectly by measuring LH in two
      groups of OVX C57BL/6J mice: short-term OVX (S-OVX) (1 week) mice were either
      prepubertal (5 weeks), postpubertal (10 weeks), young (5 months), middle aged (12
      months), or old (24 months). Long-term OVX (L-OVX) mice were either young (5
      months), or old (24 months) and OVX at puberty; middle-aged L-OVX mice were OVX
      at 8 months and examined at 12 months of age. Animals were administered
      physiologic levels of E2 by subcutaneous silastic capsule for 1 week before
      testing. LH secretion was inhibited by E2 in S-OVX mice of all ages. In no case
      did NMA overcome this inhibition in E2 primed S-OVX females. E2 also inhibited LH
      secretion in L-OVX mice of all ages, but NMA was able to overcome the E2
      inhibition of LH secretion in L-OVX mice (young: 0.5 +/- 0.1, 0.84 +/- 0.19
      ng/ml, first and second challenge, respectively; middle-aged: 0.46 +/- 0.1, 1.08
      +/- 0.16 ng/ml; and old: 1.44 +/- 0.19, 0.99 +/- 0.27 ng/ml). This last effect
      was independent of animal maturity at the time of OVX or animal age at the time
      of experiment. These findings suggest that although the ovaries in the 24-month
      old S-OVX mice had not produced enough E2 to alter the vaginal cytology for 2 +/-
      0.5 months before the experiment, the ovarian modulation of the inhibitory effect
      of E2 on NMA-induced LH secretion was still present. The nature of the ovarian
      factor(s) modulating this effect is unknown.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7777586
TI  - Immunoreactive insulin in rat salivary glands and its dependence on age and serum
      insulin levels.
AB  - The major salivary glands of adult rodents contain immunoreactive insulin (IRI).
      To determine if the concentration of IRI in salivary glands is modulated by the
      level of serum insulin, insulin immunoreactivity in the parotid and submandibular
      glands of male rats at different ages (sucklings, pubescent, mature, and elderly)
      was assayed and compared with corresponding serum insulin concentrations.
      Salivary glands from suckling rats contained 94 ng/g (wet weight) insulin, which
      is 1.6 times higher than the level in pubescent rats, and about 10 times higher
      than levels in mature and elderly rats. No direct relationship between salivary
      gland content and serum IRI levels was indicated by the data. In an attempt to
      increase insulin levels in serum, insulin-secreting pancreatic islet adenomas
      were induced in young male rats by injecting streptozotocin (an islet tumor
      inducing drug) with nicotinamide (which reduces the drug's beta-cell
      cytotoxicity). The mean insulin content of salivary glands from drug-treated rats
      that had not yet expressed tumors was no higher than controls. After the
      development of visible tumors of pancreatic islet tissue, however, salivary gland
      IRI was markedly elevated, reaching 40 times control levels, whereas serum
      insulin, and the immunoreactive insulin content of two insulin-sensitive tissues
      (vis. hepatic, adipose), were elevated only 2-fold. Examination of histologic
      sections of the parotid and submandibular glands from drug-treated animals
      revealed no evidence for the formation of salivary tumors. The data indicate that
      salivary gland insulin content (i) is age-related, being highest in neonates and
      declining thereafter, (ii) is generally identical in parotid and submandibular
      glands at a given age, and (iii) is not modulated solely by the animal's serum
      insulin concentration. These results are discussed in regard to the possible
      sources of insulin detected in the major salivary glands.

PMID- 7777587
TI  - Establishment and characterization of human fetal liver epithelial cell line
      transfected with SV40 T antigen.
AB  - The aim of the present study was to establish a stable cell line useful for the
      study of growth and differentiation of human fetal liver cells. We have
      established an immortalized human fetal liver cell line (designated NFL/T) by
      transfection with simian virus 40 (SV40) large T antigen, without any culture
      crisis. The cells showed growth properties similar to normal cells, including
      density-dependent cell growth. Electron microscopy demonstrated liver-specific
      differentiated morphological properties. Moreover, positive albumin and
      cytokeratin 7 production was detected immunologically. Thus, the NFL/T cell line
      is less transformed than the other fetal liver cell lines established by this
      method, and might be useful to study the growth and differentiation of human
      fetal liver cells.

PMID- 7777588
TI  - Investigation of intracellular signals mediating the anti-apoptotic action of
      prolactin in Nb2 lymphoma cells.
AB  - Studies were undertaken to identify intracellular mediators of prolactin
      inhibition of glucocorticoid-induced apoptosis in Nb2 lymphoma cells. A short
      term assay was implemented that quantitates fragmented DNA released from the
      genome by reaction with diphenylamine. Induction and inhibition of
      internucleosomal DNA cleavage (indicative of apoptosis) was verified by agarose
      gel electrophoresis of extracted cellular DNA. Synchronized Nb2 cells (G0/G1)
      exhibited increased DNA fragmentation after 4-hr incubation with dexamethasone
      (DEX) (25-100 nM) which was inhibited by ovine prolactin (oPRL) (0.1-1 ng/ml),
      the glucocorticoid receptor antagonist, RU486 (500 nM), and the nuclease
      inhibitor, aurintricarboxylic acid (100 microM). Signals previously implicated in
      prolactin induction of mitogenesis in Nb2 cells were investigated for their role
      in prolactin inhibition of apoptosis including: protein kinase C activation,
      arachidonic acid metabolism, polyamine production, tyrosine phosphorylation, and
      extracellular calcium. Protein kinase C agonists, phorbol-12-myristate-13
      acetate, and 1,2-dioctanoyl-sn-glycerol, +/- the calcium ionophore, A23187 (200
      nM), did not mimic oPRL inhibition of DEX-induced DNA fragmentation. Protein
      kinase C inhibitors, gossypol and quercetin, did not block prolactin action.
      Arachidonic acid did not mimic prolactin protection against DEX-induced DNA
      fragmentation. Inhibitors of arachidonic acid metabolism, 5,8,11,14
      eicosatetraynoic acid, nordihydroguaiaretic acid, and indomethacin did not block
      prolactin action. The polyamine, spermine, inhibited DEX-induced DNA
      fragmentation at 1.5 to 2.5 mM. However, inhibition of polyamine synthesis with
      alpha-difluoromethyl ornithine or methylglyoxal bis(guanylhydrazone) did not
      inhibit prolactin action. Prolactin action was not blocked by inhibitors of
      tyrosine kinase activation, genistein and tyrphostin-47. On the other hand,
      pervanadate, a potent tyrosine phosphatase inhibitor, consistently inhibited DEX
      induced DNA fragmentation. Prolactin action and DEX-induced apoptosis both
      occurred in calcium-free PBS. In summary, protein kinase C activation and
      eicosanoid production do not appear to mediate this prolactin action. Although
      spermine could block DNA fragmentation, blockade of the polyamine cascade did not
      inhibit prolactin action, suggesting that polyamines do not mediate this
      prolactin effect. While inhibitors of tyrosine kinase activation did not block
      prolactin action, tyrosine phosphatase inhibition in the presence of basal
      tyrosine kinase activity mimicked prolactin action, suggesting tyrosine
      phosphorylation participation in the anti-apoptotic effect. Extra-cellular
      calcium was not required for prolactin or DEX action.

PMID- 7777590
TI  - Transferrin reduces the production of soluble transferrin receptor.
AB  - The effect of homologous diferric transferrin from which contaminating
      transferrin receptor has been removed by monoclonal antibody affinity
      chromatography on soluble transferrin receptor concentrations was studied in K562
      cells and HL60 cells in culture. Diferric transferrin in K562 cells caused a dose
      dependent decrease in cellular receptor expression, a dose-dependent increase in
      cellular ferritin content, and a reduction in soluble receptor concentration
      which was of greater proportional magnitude than the reduction in cell receptor
      content. In HL60 cells, while there was a dose-dependent increase in cellular
      ferritin, cellular receptor content was relatively unaffected, while there was a
      consistent reduction in soluble receptor concentration. In both cells, the
      inhibitory effect of diferric transferrin on soluble receptor concentration was
      evident as early as 3 hr into the incubation. Apotransferrin, by contrast, did
      not reduce soluble receptor concentration. While elemental iron was capable of
      producing similar changes in cellular receptor and ferritin content, it had no
      inhibitory effect on proportional soluble receptor content. Studies employing
      other proteins, including human and bovine serum albumin, human lactoferrin, and
      rat ferritin, had no inhibitory effect on soluble receptors concentration, thus
      confirming the specificity of the findings. Control studies excluded an assay
      artifact as the explanation for the current findings. Prior contrary reports
      appear completely explained by the combination of soluble transferrin receptor
      contaminating the transferrin employed for study and a systematic difference in
      the assays employed between free and transferrin-bound receptor.

PMID- 7777589
TI  - Gastrointestinal vasculitis in autoimmune-prone (NZW X BXSB)F1 mice: association
      with anticardiolipin autoantibodies.
AB  - Gastrointestinal vasculitis is a fatal aspect of systemic lupus erythematosus.
      Whether lupus-prone strains of mice develop gastrointestinal vasculitis, and
      whether it is accompanied by elevated titres of anticardiolipin autoantibody is
      not known. Lupus-prone (NZW X BXSB)F1 (W/BF1) mice, and other strains were
      examined immunohistologically. Levels of anticardiolipin autoantibody and
      circulating immune complexes were determined by microELISA. Reciprocal
      haploidentical marrow transplantations between W/BF1 and autoimmune-resistent
      B6C3F1 mice were made. Young adult W/BF1 mice had the highest incidence of
      gastrointestinal vasculitis (61%), and the highest mean titre of anticardiolipin
      autoantibody. Lesions consisted of subintimal fibrinoid degeneration in
      arterioles of the duodenum, jejunum and ileum, and were prevented, or
      alternatively induced by reciprocal marrow transplantations between W/BF1 and
      B6C3F1 mice. Mice engrafted with W/BF1 marrow which developed vasculitis had
      higher titres of anticardiolipin autoantibodies than engrafted mice free of
      vasculitis (P < 0.005). This represents the first report of gastrointestinal
      vasculitis as an aspect of systemic autoimmunity in lupus-prone mice. The
      concurrent elevation of anticardiolipin autoantibody and development of
      vasculitis suggests that anticardiolipin autoantibodies, and their proposed
      thrombogenic and vascular injury consequences, contribute to development of
      microvasculitis in lupus-prone mice.

PMID- 7777591
TI  - Leg design and jumping technique for humans, other vertebrates and insects.
AB  - Humans, bushbabies, frogs, locusts, fleas and other animals jump by rapidly
      extending a pair of legs. Mathematical models are used to investigate the effect
      muscle properties, leg design and jumping technique have on jump height. Jump
      height increases with increased isometric force exerted by leg muscles, their
      maximum shortening speeds and their series compliances. When ground forces are
      small multiples of body mass (as for humans), countermovement and catapult jumps
      are about equally high, and both are much better than squat jumps. Vertebrates
      have not evolved catapult mechanisms and use countermovement jumps instead. When
      ground forces are large multiples of body mass, catapult jumps (as used by
      locusts and fleas) are much higher than the other styles of jump could be.
      Increasing leg mass reduces jump height, but the proximal-to-distal distribution
      of leg mass has only a minor effect. Longer legs make higher jumps possible and
      additional leg segments, such as the elongated tarsi of bushbabies and frogs,
      increase jump height even if overall leg length remains unchanged. The effects of
      muscle moment arms that change as the leg extends, and of legs designed to work
      over different ranges of joint angle, are investigated.

PMID- 7777593
TI  - 23rd Annual Meeting of the American Society for Photobiology. Washington, D.C.,
      June 17-22, 1995. Abstracts.

PMID- 7777594
TI  - Mating in the monogamous male: behavioral consequences.
AB  - In monogamous mammals, males typically show selective affiliation with a single
      mate, high levels of paternal care, and aggression towards conspecifics to
      protect male and offspring. We have previously described how selective aggression
      and affiliation increase after mating in the male prairie vole, Microtus
      ochrogaster. The current studies further explored the behavioral changes that
      follow mating in the male of this species. The first set of experiments tested
      males on several behavioral measures after 24 h of either mating, social (but not
      sexual) exposure, or no social contact. After 24 h of mating, but not after the
      other two conditions, aggression and affiliation (partner preference) increased
      as previously reported. In addition, mated animals showed increased exploration
      of the open arms of a plus maze, consistent with decreased fearfulness. There
      were no group differences in paternal behavior (which was high in all three
      conditions) or analgesia (assessed by tail flick latency). To determine the
      minimum amount of mating necessary for the induction of aggression, males were
      tested in a resident-intruder paradigm after 1,6, or 24 h of mating. Although 1 h
      of mating was associated with a transient increase in the frequency of threats
      and attacks, the full spectrum of enduring aggression was observed only in the
      males given 24 h of mating. In a final experiment, the behavioral consequences of
      mating were studied in males of the closely related montane vole (Microtus
      montanus) which does not pair bond. Males of this nonmonogamous vole species did
      not show increased aggression, partner preference, or alterations in plus maze
      exploration following 24 h of mating. These results demonstrate the importance of
      prolonged mating for the induction of pair bonding in the monogamous male and
      they suggest that increases in aggression and affiliation are associated with
      decreased fearfulness in pair bonded males.

PMID- 7777592
TI  - Molecular genetic variation and individual survival during population crashes of
      an unmanaged ungulate population.
AB  - Theoretical models of the effect of population bottlenecks on genetic variation
      assume that individuals are removed at random from the population. We
      investigated this assumption in a naturally regulated, unstable population of
      Soay sheep (Ovis aries). During rapid population declines or 'crashes',
      individuals were not removed at random with respect to genotype: we found
      associations between individual survival and certain genotypes at five
      polymorphic protein or microsatellite DNA loci (Ada, Got, Tf, MAF18 and OPACAP).
      Some loci appeared to show simple associations with survival whereas others had
      more complex interactions with crash year or age: all displayed different
      patterns of association between the sexes. Simple overdominance was not a general
      feature of our data; it seems likely that fluctuating selecting, countervailing
      selection in different fitness components or frequency-dependent selection may
      explain the pattern and complexity of the associations shown at different loci.
      Our study cannot distinguish between selection acting at these loci or at other,
      closely linked loci. However, our empirical study implies that the molecular
      genetic outcome of population bottlenecks in natural populations does not always
      follow theoretical expectations based on the random removal of genotypes.
      Bottlenecks in which individuals are removed at random are distinct from
      bottlenecks in which there is scope for selection via non-random survival of
      individuals.

PMID- 7777595
TI  - Ontogenetic development and pentylenetetrazol seizure thresholds in rats.
AB  - Ontogenetic differences in seizure thresholds to pentylenetetrazol (PTZ) were
      examined in young, developing rats (ages: 10, 18, 28, and 60 days). A
      subconvulsive dose of PTZ (15 mg/kg IP) was administered every 10 min and the
      occurrence of partial and full (clonic tonic) seizures was noted. Ten day old
      pups displayed complete seizures more rapidly than any of the other groups (p <
      .01) without any behavioral indication of going through the partial stages. Among
      18 day old pups the development of early seizure stages was followed rapidly by
      the full seizure, while in the weaned groups the early seizure stages tended to
      persist much longer before the appearance of the full generalized convulsion. The
      preweanling rat's immature brain seems less able to suppress PTZ induced
      generalized convulsions compared to the brain of the older rats.

PMID- 7777596
TI  - Effects of chronic intermittent cold stress on pituitary adrenocortical and
      sympathetic adrenomedullary functioning.
AB  - Basal and stress-induced pituitary-adrenocortical (PA) and sympathetic
      adrenomedullary (SAM) function was investigated in rats exposed to chronic
      intermittent cold stress (4 degrees C for 4 h a day for 21 days; CHR). We found
      that basal plasma levels of corticosterone (B), corticosteroid-binding-globulin,
      ACTH, epinephrine (E) and norepinephrine (NE) were similar in CHR and control
      (CTL) animals. In contrast, activity of the adrenal catecholamine-synthesizing
      enzyme tyrosine hydroxylase, but not phenylethanolamine-N-methyl transferase, was
      significantly elevated in CHR compared to CTL. Following exposure to a
      heterotypic stressor (20 min restraint), plasma levels of B were significantly
      higher in CHR than CTL, but the stress-induced levels of E and NE were not
      different between groups. These data suggest that, although basal PA function is
      not altered by exposure to chronic intermittent cold stress, components of the
      SAM system are affected by this paradigm, and that co-ordinate facilitation of
      both PA and SAM responses to a novel stressor is not a necessary consequence of
      exposure to chronic intermittent stress.

PMID- 7777597
TI  - Priming of locomotor initiation by electrical stimulation in the hypothalamus and
      preoptic region in the anesthetized rat.
AB  - Electrical stimulation at a locomotor site can prime (i.e., shorten the latency
      to initiate) stepping elicited by subsequent stimulation of the same or a
      different site. We tested for the priming effect in representative sites along
      the medial forebrain bundle, and determined if its magnitude showed regional
      differences. Rats (n = 20) were anesthetized with Nembutal and held in a
      stereotaxic apparatus over a wheel. Stepping was detected by accelerometers
      attached to the hindlimbs. Priming and test trains of stimulation (0.5-ms
      cathodal pulses, 50 Hz, 25-75 microA, 7-9-s train duration) separated by 20 s
      were delivered every 90 s. When the priming and test stimulations were applied to
      the same site, the priming effects were similar along the entire extent of the
      medial forebrain bundle. When the priming and test sites were different, the
      priming effect depended on their relative positions. Anterior stimulation primed
      posterior sites at magnitude comparable to those produced by stimulating the same
      posterior site. Posterior stimulation primed anterior sites at a level half of
      that produced by stimulation of the same anterior site. This pattern was found
      for priming and test sites that were ipsilateral and contralateral. Priming is a
      general and robust phenomenon with properties that may be useful for studying
      locomotor initiation pathways.

PMID- 7777598
TI  - Impact of differential housing on humoral immunity following exposure to an acute
      stressor in rats.
AB  - The purpose of this study was to examine the effect of differential housing on
      humoral immunity following exposure to an acute stressor. Forty male Sprague
      Dawley adult rats were randomly assigned to either a singly housed or group
      housed (five rats/cage) condition. Approximately 2 weeks after the start of the
      study, all animals were immunized with 1 ml of a 10% suspension of sheep red
      blood cells (SRBC) in saline. After the injections, half of the animals from each
      housing condition were subjected to an acute stressor (forced swim, 60 min/day
      for 3-5 days). Animals exposed to the acute stressor displayed adrenal gland
      hypertrophy and reduced thymus and spleen weights compared to the unstressed
      (control) animals. Both behavioral stimuli (housing and forced swim) demonstrated
      no effect on antibody production to SRBC. However, singly housed animals showed
      an increase in lymphocyte percentage, and corticosterone and glucose levels
      regardless of subsequent exposure to acute stress. Within a treatment condition,
      there were no significant correlations between the immune and endocrine measures.
      It was concluded that reduced social contact (i.e., individual housing) with
      subsequent exposure to an acute stressor does not appear to inhibit immunological
      responsiveness to an antigen.

PMID- 7777599
TI  - Effects of naloxone on oxygen consumption and ventilation in awake golden Syrian
      hamsters.
AB  - Endogenous opioids are known to inhibit chemoreception and ventilatory control.
      The opioid antagonist naloxone stimulates ventilation by removing this
      inhibition. To study whether the effects of opiate receptor antagonism are
      mediated by a central or a peripheral mechanism, we administered equal doses of
      naloxone hydrochloride (NHCl, an agent that crosses the blood-brain barrier) and
      naloxone methiodide (NM, an agent that does not cross the blood-brain barrier) to
      awake golden Syrian hamsters. Both naloxone preparations significantly increased
      the oxygen consumption (46% for NHCl and 90% for NM) in these animals relative to
      saline. Naloxone hydrochloride, but not NM, stimulated ventilation (30%) and
      tidal volume (34%) when the animal was subjected to a hypercapnic challenge,
      predominantly sensed in the brain. In contrast, both naloxones stimulated
      ventilation by 52% compared to saline treatment when the hamsters were exposed to
      a hypoxic challenge, predominantly sensed peripherally. These results suggest
      that endogenous opioids modulate both central and peripheral chemoreception in
      the hamster.

PMID- 7777600
TI  - Mineral content of the diet alters sucrose-induced obesity in rats.
AB  - The effects of dietary mineral levels on caloric intake, nutrient choice, body
      weight, adipose tissue weight, interscapular brown adipose tissue (IBAT) weight,
      and thermogenic capacity, and plasma insulin and glucose levels were examined in
      adult male Sprague-Dawley rats. In Experiments 1 and 2, rats were fed a purified
      diet with zinc (Zn), chromium (Cr), and selenium (Se) added, or the same diet
      without the addition of these minerals. In Experiment 3, the effects of Zn and Cr
      were examined separately. In all experiments, half of the rats in each diet group
      were given a 32% sucrose solution in addition to their standard diet and water.
      Rats given sucrose consumed more calories and gained more weight than rats not
      given sucrose. However, mineral levels altered the effects of sucrose on these
      measures. Added minerals increased percent sucrose intake, reduced weight gain
      and feed efficiency, increased GDP binding in IBAT mitochondria, improved glucose
      tolerance, and reduced plasma insulin levels. The reduction in weight gain and
      increased feed efficiency found when Zn alone was added to the diet was
      independent of sucrose condition. In comparison, the alterations observed in
      these measures when Cr alone was added to the diet varied as a function of
      sucrose availability.

PMID- 7777601
TI  - Age-related decrease of plasma testosterone in SAMP8 mice: replacement improves
      age-related impairment of learning and memory.
AB  - Corticosterone increases with aging but pregnenolone, dehydroepiandrosterone, and
      testosterone decrease. The marked decrease in hormones that occurs with aging may
      contribute to the age-related deficit in learning and memory. Administration of
      these hormones after training was found to improve long-term memory processing in
      normal young mice. SAMP8 (P8) mice show an age-related loss of learning and
      memory for a variety of tasks whereas age-matched control mice of the closely
      related SAMR1 (R1) strain do not. In this study, we found an age-related decrease
      in serum testosterone levels of 71% between P8 mice 4 and 12 months of age, but
      only a 26% decrease between R1 mice of the same ages. The difference between the
      P8 mice was significant (p < 0.01) and the difference between the R1 mice was
      not. The decrease in testosterone in 12-month-old P8 mice was not accompanied by
      gross morphological change in the testes. A SC testosterone implant, sufficient
      to increase plasma testosterone levels to 414 +/- 25 ng/dl, alleviated impaired
      learning and memory of a foot shock avoidance task in P8 mice. Castration of 4
      month-old P8 mice did not produce a deterioration in learning and memory,
      indicating that low levels of testosterone per se are not responsible for the
      impairment seen in 12-month-old P8 mice. This suggests that impaired cognitive
      functioning of the older P8 mice was due to an interaction of aging and reduced
      testosterone levels.

PMID- 7777603
TI  - High-fat feeding during pregnancy and lactation affects offspring metabolism in
      rats.
AB  - This study was designed to examine the interaction of pregnancy and dietary fat
      on pregnancy outcome and offspring metabolism in rats. Wistar rats were divided
      into four groups: HF (40% fat by weight) feeding and pregnant (HFP, n = 15); HF
      nonpregnant control (HFNP, n = 10); control diet (4.5% fat) and pregnant (CHP, n
      = 12); and control diet nonpregnant (CHNP, n = 10). Rats were fed the same diets
      throughout gestation and lactation and were sacrificed at weaning. Litter size
      was kept at six pups with extra pups killed at birth. HF-fed dams had
      significantly less caloric intake than control counterparts. HFP had similar body
      weight changes as CHP during gestation and lactation, whereas HFNP had
      significantly higher weight and fat content than CHNP. There was no difference in
      pup's birth weight. However, significantly more HF dams cannibalized their pups.
      Newborns delivered to HF-fed dams had higher insulin/glucose ratios than CH pups.
      HFP weanlings weighed more, had more body fat (%), higher liver weight, liver
      lipid content, and higher blood glucose and triglyceride levels than CHP
      weanlings. The long-term effects of these metabolic abnormalities need to be
      further examined.

PMID- 7777602
TI  - Gender, dietary restraint, and smoking's influence on hunger and the reinforcing
      value of food.
AB  - Smoking may enhance satiety following meal consumption, thereby reducing
      subsequent eating (i.e., between-meal snacks), especially in women high in
      dietary restraint. Female smokers (n = 20, 10 high and 10 low restraint) and male
      smokers (n = 10) participated in two sessions, involving overnight abstinence
      from food and smoking (smoking abstinence day) or from food only (smoking day),
      in a within-subjects design. The reinforcing value of food was determined by the
      number of responses made to obtain food reinforcers (100-kcal snack portions) vs.
      money using a concurrent schedules computer task. Subjects were given a small
      caloric load on each day followed by access to food vs. money. On the smoking
      day, subjects were allowed to smoke every 30 min during the session as well as ad
      lib before the session. Self-reported hunger was also assessed upon arrival
      (after fasting) and following the caloric load during each session. Results
      indicated no effect of smoking on initial hunger rating, after fasting, but
      hunger ratings following the caloric load declined significantly more during
      smoking vs. abstinence days for all subjects, consistent with an enhancement of
      postmeal satiety due to smoking. There was no overall main effect of smoking on
      food-reinforced responding. However, responding for food was significantly less
      during the smoking vs. abstinence days for high-restraint females only and not
      for low-restraint females or for males. These findings indicate that smoking's
      acute influence on reducing food intake does not reflect a broad gender
      difference but may be specific to dietary restraint.

PMID- 7777605
TI  - Is nest building an important component of thermoregulatory behaviour in the
      pouched mouse (Saccostomus campestris)?
AB  - The thermoregulatory significance of nest building in Saccostomus campestris was
      investigated by examining the effect of temperature and photoperiod on the size
      and thermal conductance of nests built within artificial burrows by pouched mice
      from four localities in southern Africa that experience contrasting thermal
      conditions. There was no correlation between the amount of nesting material used
      and the thermal conductance of nests, which indicates that nest size was not a
      reliable measure of nest quality. For this reason, the significant interactive
      effect of sex and locality on the quantity of nesting material used, and the
      significantly larger nests built by wild-caught animals, appear to be unrelated
      to differences in nesting ability, particularly as there were no similar
      differences in the thermal conductance of nests between these groups. Several
      animals blocked the entrance to their artificial burrows and caused a significant
      reduction in the rate of heat loss from nests therein. However, heat conservation
      may not have been the primary function of plugging burrow entrances because this
      did not occur more frequently at lower temperatures and was not more common among
      animals from cooler localities. Instead, animals that sealed the entrance to
      their burrows were found to hoard significantly more food than animals that left
      the entrance open, which suggests that burrows may have been blocked to prevent
      the potential theft of stored food. Despite substantial variability in both the
      size and thermal conductance of nests built throughout the present study, there
      was no significant effect of temperature, photoperiod, or locality on these
      characteristics.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7777604
TI  - Stimulation of fluid intake by maltodextrins and starch.
AB  - Maltodextrin solutions are more potent stimulators of fluid intake than are
      starch suspensions, even though these two substances are both glucose polymers.
      When rats were offered a choice of two fluids, one containing maltodextrin and
      the other containing the same concentration of starch, rats preferred
      maltodextrin; this preference increased over successive days for rats given 7.4%
      or 10% carbohydrate but not for rats given 1% carbohydrate. Rats offered fluids
      containing artificial flavors mixed with maltodextrin and starch acquired
      preferences for flavors paired with 10% or 7.4% maltodextrin but not for flavors
      paired with 1% maltodextrin. In an attempt to determine whether this greater
      preference for maltodextrin is due to an innate flavor preference, rats were
      given a choice of maltodextrin containing sucrose octaacetate vs. plain starch;
      these rats initially preferred starch but subsequently ingested more maltodextrin
      flavored with sucrose octaacetate than plain starch. Direct evidence for a
      postingestive factor was obtained by giving rats intragastric infusions of either
      maltodextrin, starch, or vehicle whenever they drank a dilute saccharin solution.
      Both carbohydrates stimulated fluid intake, but maltodextrin did so more rapidly
      (within 1 day rather than the 2 days of training required with starch infusions).
      These results indicate that some difference in the postingestive effects of
      maltodextrin and starch contributes to the greater intake-stimulating effect of
      maltodextrin. The postingestive factor responsible for the difference between
      maltodextrin and starch has not been identified, but it is not the amount of
      utilizable energy because rats prefer maltodextrin over starch even when the
      starch suspension contains more calories than does the maltodextrin solution. It
      is proposed that the postingestive factor differentiating these substances is
      rate of digestion.

PMID- 7777606
TI  - Effects of illumination and handling upon rat open field activity.
AB  - Eighty male rats (Crj:CD, 4 weeks old), were randomly assigned to four groups in
      a 2 x 2 (brightness x handling) factorial design. Ambulation and three types of
      defecations [pre-open-field defecation (PRD), post-open-field defecation (POD),
      and testing defecation (TD)] were examined for 3 consecutive days, for 3 min per
      day. In this study, the effects of handling treatment were illumination
      dependent. The changes in TD and POD were opposite in relation to the trial day,
      whereas the changes during the trial, the sum of the TD and POD, were invariable.
      Considering the invariable changes of the sum of TD and POD, time per trial may
      be an important factor to measure emotional activity. The TD-POD inversion may
      reflect the strength of the stress response against a novel placement in open
      field, because of the change of the time for evoking defecation behavior.

PMID- 7777607
TI  - Acute intraventricular CRF lowers the hoarding threshold in male rats.
AB  - The influence of intracerebroventricular rat-CRF on the food-hoarding behavior of
      rats has been studied in relation to the animals' body weights. A group of six
      male rats was trained to feed every day from 1000 to 1200 h. Then their threshold
      for the onset of food hoarding was measured from the intercept of regression line
      of food hoarded during meal time vs. body weight with the x-axis. Thirty minutes
      before the hoarding session, the rats received 4 micrograms CRF, or saline
      control, in the lateral ventricle. The mean threshold for food hoarding was
      significantly lowered to 299 +/- 61 g after CRF, from control 418 +/- 68 g. Mean
      food intake during the hoarding sessions was also diminished to 6.0 +/- 0.6 g
      after CRF, from control 14.5 +/- 0.5 g. These results suggest that the set-point
      for body weight regulation is acutely lowered by intracerebral CRF.

PMID- 7777608
TI  - Relative contributions of pituitary-adrenal hormones to the ontogeny of
      behavioral inhibition in the rat.
AB  - Recent investigations revealed that adrenalectomized (ADX) rat pups exhibit
      deficits in behavioral inhibition. Furthermore, administration of exogenous
      corticosterone (CORT) restores behavioral inhibition in ADX pups. Although these
      studies suggest that CORT has an important role in the development of behavioral
      inhibition, the relative behavioral effects of elevated pituitary hormone
      secretion induced by ADX are not known. Therefore, experiments were conducted to
      assess the potential behavioral effects of elevated adrenocorticotropin (ACTH)
      secretion induced by ADX and to further evaluate the contribution of endogenous
      CORT to the development of behavioral inhibition. In Experiment 1., we verified
      that 10-day-old ADX rats exhibit high levels of plasma ACTH throughout the
      preweaning period associated with the development of behavioral inhibition. In
      Experiment 2, 10-day-old pups were hypophysectomized (HYPOX) and ADX and were
      compared behaviorally to sham-operated controls on day 14. When tested in the
      presence of an anesthetized unfamiliar adult male rat, HYPOX + ADX pups exhibited
      low levels of freezing accompanied by ultrasonic vocalizations. These pups also
      had reduced concentrations of plasma ACTH and CORT. In Experiment 3, 10-day-old
      pups were HYPOX and tested for behavioral inhibition on day 14. In comparison to
      sham-operated controls, HYPOX rats exhibited significantly lower levels of
      freezing and had reduced plasma concentrations of ACTH and CORT. Results
      demonstrate clearly that deficits in freezing occur even in the presence of low
      plasma ACTH concentrations. Therefore, elevated secretion of pituitary hormones
      is not a major factor that contributes to the ADX-induced deficits in behavioral
      inhibition.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7777609
TI  - Pancreatic beta-cell function and islet-cell proliferation: effect of
      hyperinsulinaemia.
AB  - Pancreatic beta-cell function was studied in adult female rats, in which
      endogenous insulin demand was fully met by SC infusion of human insulin (4.8
      IU/24 h) for 6 days, resulting in hyperinsulinaemia and severe hypoglycaemia. The
      amount of pancreatic endocrine tissue declined by 40%, (pro)insulin mRNA, as
      determined by in situ hybridisation by 95%, and the amount of stored insulin by
      90%. Islet-cell proliferation as determined by 24 h of BrdU infusion declined by
      60%. Basal glucose levels normalized within 2 days after the insulin treatment
      was ended, whereas about 1 week was needed to restore the amount of pancreatic
      insulin, glucose-induced insulin release, and glucose tolerance to normal values.
      The amount of endocrine tissue recovered within 48 h and mRNA abundance within 96
      h after discontinuation of the insulin infusion, whereas at that time islet-cell
      proliferation still showed a sixfold increase, before returning to control levels
      after 1 week. These results show that after a period of suppression of beta-cell
      function, recovery of insulin synthetic capacity does not immediately result in
      normalization of insulin stores and insulin release. Under these conditions,
      episodes of hyperglycaemia may occur, which may act as a stimulus for islet-cell
      proliferation.

PMID- 7777610
TI  - Modification of body temperature and sleep state using behavioral conditioning.
AB  - Previous research has demonstrated the conditionability of events within the
      acute-phase response. This study examined whether two such responses, fever and
      sleep alterations, were conditionable in the rat during the dark photoperiod. The
      experimental animals were administered a novel saccharin solution as the
      conditioned stimulus (CS) in conjunction with lipopolysaccharide as the
      unconditioned stimulus (UCS). This group displayed significantly higher body
      temperatures than controls upon saccharin representation, 7 days after the
      original CS-UCS pairing. The experimental animals additionally displayed a
      conditioned increase in slow wave sleep (SWS); however, the LPS-induced reduction
      in rapid eye movement (REM) sleep was unable to be reenlisted. Similar to the
      acute-response, the conditioned alteration in SWS appeared to be due to an
      increase in episode frequency, rather than duration. These results suggest that
      the multiple acute-phase events may be simultaneously conditionable, producing an
      optimum environment for pathogen elimination.

PMID- 7777611
TI  - Daily cycles in body temperature, metabolic rate, and substrate utilization in
      pigeons: influence of amount and timing of food consumption.
AB  - Pigeons lived in individual chambers where instantaneous metabolic rate (MR;
      indirect calorimetry), body temperature (Tb), and substrate utilization (RQ) were
      measured 24 times each hour throughout the 12h:12h light:dark cycle. The amount
      of food consumed influenced the amplitude of the MR and Tb cycles, primarily by
      affecting the dark-phase segment of the cycle: when food was consumed ad lib, low
      amplitude daily cycles in MR and Tb occurred in which levels in the dark phase
      were lower than in the light; during reduced food intake in restricted feeding or
      in fasting, high-amplitude cycles occurred primarily because nocturnal
      hypometabolism and hypothermia developed; in restricted feeding, the level of MR
      and Tb during the dark-phase segment of the cycle was directly related to short
      term variation in amount consumed. The timing of food consumption primarily
      affected the light-phase segment of the MR and Tb cycles: when feeding was
      restricted to a time late in the light phase, these measures became depressed
      early in the light phase, and then greatly elevated near the scheduled time of
      feeding. This distinctive light-phase pattern developed quickly after the
      restricted feeding schedule began and may reflect the influence of a circadian
      food-entrainable oscillator. RQ indicated carbohydrate utilization for most of
      the 24-h cycle during ad lib feeding and in restricted feeding. However,
      approximately 2 h before the first feeding bout of the day, the RQ cycle
      indicated a sizable shift towards lipid utilization, which terminated after the
      bout was completed. There was a smaller, more transient, decrease in RQ near the
      time of the light-dark transition, which may imply cessation of digestive
      activity in preparation for the nocturnal decrease in Tb. During fasting, RQ
      indicated lipid utilization throughout the entire cycle. Whole-day energy
      expenditure by pigeons in these laboratory circumstances was shown to be closely
      related to the changes in within-day cycles associated with variations in the
      amount and timing of food intake.

PMID- 7777612
TI  - Central action of basic fibroblast growth factor on ingestive behaviour in mice.
AB  - Intracerebroventricular (ICV) infusion of basic fibroblast growth factor (FGF-2)
      at 50 ng/h for 5 days in male BALB/c mice suppressed the daily intakes of water
      and food (n = 4). Intakes were reduced on the second day, and were suppressed
      until the second day after stopping the infusion. The same infusion for 4 days
      had little effect on the high intakes of 0.3 M NaCl solution and water induced by
      prolonged ICV infusion of angiotensin II, or the daily food intake in these
      experiments (n = 7). However, the same infusion for 3-4 days reduced the
      increased intake of NaCl solution in Na-depleted mice (n = 8), reduced the
      increased water intake of water-restricted mice (n = 6 or n = 7), and reduced
      daily food intake in both experiments. Ventricular enlargement was noted in mice
      at the end of these experiments but, for reasons advanced, did not appear to
      account for the responses. The results indicate that FGF-2 may have an inhibitory
      role in these ingestive behaviours.

PMID- 7777613
TI  - Preference for NaCl solutions in sham drinking Sprague-Dawley rats: water
      deprivation, sodium depletion, and angiotensin II.
AB  - Male Sprague-Dawley rats were fitted with closable gastric fistulas and were then
      tested under closed fistula (real intake) and open fistula (sham intake--fluids
      drain from the stomach without appreciable absorption) conditions in one of three
      states: fluid deprivation, sodium depletion, and infusion of angiotensin (Ang)
      II. Water and various concentrations of NaCl were offered to drink in 1-h one- or
      two-bottle intake tests. In Experiment 1, water-deprived rats with closed
      fistulas drank more 0.15 M NaCl than either water or 0.3 M NaCl, offered in one
      bottle tests. In sham drinking tests, the intake decreased monotonically as NaCl
      concentration increased. In two-bottle tests, water was greatly preferred over
      NaCl solutions. In Experiment 2, sodium-depleted rats preferred NaCl over water,
      again demonstrating a peak intake at 0.15 M in closed fistula conditions.
      However, with the fistula open the intakes of 0.05 and 0.15 M were similar, and
      0.45 M considerably lower. In Experiment 3, Ang II-infused rats consumed both
      water and NaCl in two-bottle tests in both open and closed fistula trials. The
      quantity ingested on sham trials was only modestly elevated over real intake
      trials with Ang II compared with sham tests in Experiments 1 and 2.

PMID- 7777614
TI  - Glucose homeostasis and sympathoadrenal activity in mercaptoacetate-treated rats.
AB  - The effect of the fatty acid oxidation inhibitor, sodium mercaptoacetate (MA, 600
      mumol/kg) on peripheral energy substrate metabolism was investigated in rats with
      permanent heart catheters. Rats were either fed, 48-h food deprived, or
      exercising for 30 min. Before and after intravenous MA injection, stress-free
      blood samples were taken for measurement of blood glucose, plasma free fatty
      acids (FFA), insulin, epinephrine (E), and norepinephrine (NE) concentrations. In
      fed animals, MA increased blood glucose, plasma FFA, and NE and decreased insulin
      concentrations. Plasma E levels did not change. In 48-h-deprived animals, MA
      elevated low baseline glucose concentrations to levels observed in MA-treated fed
      animals. Plasma insulin concentrations decreased to almost undetectable levels.
      Plasma catecholamines and FFA were increased compared to fed rats. In exercising
      rats, MA caused an exaggerated increase of blood glucose and a pronounced
      reduction of plasma insulin without affecting exercise-induced FFA and
      catecholamine responses. The data revealed that the mechanisms that regulate
      blood glucose concentrations during MA treatment are dependent on the nutritional
      state and ambient energy expenditure.

PMID- 7777615
TI  - An evaluation of the use of total body electrical conductivity for the estimation
      of body composition in adult rats: effect of dietary obesity and adrenalectomy.
AB  - Total body electrical conductance (TOBEC) has been recommended for serial
      measurements of body composition in animals and humans. This study examined the
      accuracy of the TOBEC technique in predicting body composition of a population of
      adult male rats that had undergone seven different treatments, including
      adrenalectomy and blocking of glucocorticoid receptors, in the study of the
      etiology of obesity. The predicted body composition values of the animals (n =
      57, body weight 550 +/- 8 g) obtained by using the manufacturer's and Baer's
      equations were compared to the actual body composition obtained by direct carcass
      analysis. Both equations underestimated lean body mass and reciprocally
      overestimated body fat (manufacturer's 103 +/- 4 g, Baer's 55 +/- 3 g). A new
      prediction equation was developed based on the conductivity index and the actual
      lean body mass. This revised equation was able to accurately estimate the lean
      body mass of the animals used in the same experiment but over-estimated lean body
      mass of larger animals (n = 10, wt. 647 +/- 13 g). Conclusions based on multiple
      comparisons (Duncan's) of predicted and actual values resulted in different
      effects of treatments on body composition. To improve accuracy and reliability of
      the TOBEC technique, a prediction equation should be developed from the same
      population as the studied population, and experimental group sizes used for
      examining treatment effects should be relatively large.

PMID- 7777616
TI  - Amiloride suppression of the taste intensity of sodium chloride: evidence from
      direct magnitude scaling.
AB  - The transduction of Na+ salts has been shown in many species to be mediated in
      part by an epithelial ion channel on the apical surface of the taste receptor
      cell membrane, which is blockable by the diuretic amiloride. In addition to this
      apical ion channel, Na+ is also transduced via a paracellular pathway, which is
      not sensitive to amiloride. There are significant species differences in the
      contribution of the amiloride-sensitive pathway to Na+ transduction. Previous
      human psychophysical studies have reported conflicting results on the effects of
      amiloride in suppressing the intensity of NaCl. In general, these studies used
      amiloride doses that were much higher than those showing clear suppressive
      effects in electrophysiological studies in other species. In the present
      experiment, we used direct magnitude scaling of the intensities of five NaCl
      concentrations flowed over the anterior portion of the tongue to determine the
      effects of amiloride treatment at lower doses. NaCl was presented after
      adaptation of the tongue to water or mixed with and presented after adaptation to
      10, 50, or 100 microM amiloride-HCl. Subjects estimated the intensity of NaCl and
      of these concentrations of amiloride in each treatment condition using magnitude
      estimation with a 0.1 M NaCl modulus presented following a water rinse prior to
      each session. Results showed that amiloride had a significant suppressive effect
      on the perceived intensity of NaCl, with a similar effect seen at all three
      amiloride doses. The psychophysical function after amiloride showed a parallel
      shift to the right. The average suppression over all NaCl concentrations was
      21%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7777617
TI  - A reevaluation of dimethyl disulfide as a sex attractant in golden hamsters.
AB  - Dimethyl disulfide (DMDS) is present in hamster vaginal secretion and has been
      reported to be responsible for a sizable proportion of a male hamster's
      attraction to vaginal secretion. We evaluated this claim by testing two
      predictions that follow from its purported pheromonal role: (a) male hamsters
      should spend more time than females investigating DMDS; and (b) attraction to
      DMDS by males should be dependent on testosterone. In the first experiment, males
      investigated vaginal secretions more than females, but no sex difference was
      apparent in investigation of DMDS or a control odor. In the second experiment,
      gonadectomized males with testosterone implants investigated vaginal secretion
      more than castrates without testosterone; however, these hormone manipulations
      did not affect the attraction of males to DMDS or the control odor. We conclude
      that DMDS does not elicit sex differences in attraction and that in males the
      attraction to DMDS is not dependent on gonadal hormones. These results suggest
      that DMDS is not a sex attractant by itself nor is it a major component of an
      attractant mixture.

PMID- 7777618
TI  - Performance of four different rat strains in the autoshaping, two-object
      discrimination, and swim maze tests of learning and memory.
AB  - The performance of four strains of rats commonly used in behavioural research was
      assessed in three different tests of learning and memory. The four strains
      included three outbred lines (Long-Evans, Sprague-Dawley, Wistar) and one inbred
      strain (S3). Learning and memory were tested using three different paradigms:
      autoshaping of a lever press, a two-object discrimination test, and performance
      in a two-island swim maze task. The pigmented strains showed better performance
      in the autoshaping procedure: the majority of the Long-Evans and the S3 rats
      acquired the response, and the majority of the Wistar and Sprague-Dawley failed
      to acquire the response in the set time. The albino strains were slightly better
      in the swim maze than the pigmented strains. There appeared to be a
      speed/accuracy trade-off in the strategy used to solve the task. This was also
      evident following treatment with the cholinergic-depleting agent hemicholinium-3.
      The performance of the Long-Evans rats was most affected by the treatment in
      terms of accuracy and the Wistar and Sprague-Dawleys in terms of speed. In the
      two-object discrimination test only the Long-Evans showed satisfactory
      performance and were able to discriminate a novel from a known object a short
      interval after initial exposure. These results show large task- and strain
      dependent differences in performance in tests of learning and memory. Some of the
      performance variation may be due to emotional differences between the strains and
      may be alleviated by extra training. However, the response to pharmacological
      manipulation may require more careful evaluation.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7777619
TI  - Saccharin-induced increase in daily fluid intake as a predictor of voluntary
      alcohol intake in alcohol-preferring rats.
AB  - This study examined the relationship between saccharin intake and ethanol
      consumption in alcohol preferring (P) rats and Fawn Hooded (FH) rats before and
      after exposure to forced ethanol (10%, v/v) solution. Both groups exhibited large
      increases (> 2X) in daily fluid intake (DFI) when saccharin (0.1%, w/v) was
      present and exhibited moderate levels of ethanol intake. Only the P rats
      significantly increased their ethanol consumption after exposure to ethanol as
      the sole drinking fluid. Correlational analyses revealed that the absolute
      intakes of saccharin and ethanol were not significantly correlated in either
      group, but the increase in DFI in the presence of saccharin was highly correlated
      with ethanol intake after forced ethanol exposure (r > +0.8; p < 0.05).
      Similarly, when correlations were conducted for these variables over both the P
      and FH groups, the correlation between increase in DFI in the presence of
      saccharin and alcohol intake was significantly higher than that between saccharin
      and alcohol intakes. Reexamination of previous data from 6 different rat strains
      also revealed a significant correlation between increase in DFI in the presence
      of saccharin and ethanol intake. These findings suggest that the dramatic
      increase in of DFI in the presence of saccharin may be an animal analog of the
      clinical phenomenon known as a loss of control.

PMID- 7777620
TI  - Effect of inhibition of gluconeogenesis on arginine-induced insulin secretion.
AB  - It is well known that several amino acids, such as arginine, are potent stimuli
      for insulin and glucagon secretion from the pancreas. Recently, vagal arginine
      sensors, which modulate arginine-induced pancreatic hormone secretion, have been
      reported to exist in the liver. The present investigation was designed to
      evaluate the role played by gluconeogenesis in this hepatic influence. To this
      end, we studied the effects of an intraperitoneal injection of 3
      mercaptopicolinic acid (3-MPA), a gluconeogenic inhibitor, on the pancreatic
      hormonal response induced by intraperitoneal administration of arginine (1 g/kg
      body mass) to hepatic vagotomized and sham vagotomized rats. Fifteen min
      following the injection of arginine, the increases in glucose and insulin
      concentrations were significantly lower in rats with an inhibited gluconeogenesis
      than in rats with an intact capacity for gluconeogenesis. There were no effects
      of the hepatic vagotomy on the arginine-induced hormonal responses either with or
      without the 3-MPA injection. The results suggest that gluconeogenesis is
      implicated in the hepatic modulation of arginine-induced pancreatic hormone
      secretion.

PMID- 7777621
TI  - Active immunization against insulin affects sleep and feeding in rats.
AB  - The effects of active immunization against peripheral insulin on different sleep
      parameters and food consumption were studied in rats. Insulin coupled to
      thyroglobulin was used as immunogen and rats immunized with thyroglobulin alone
      served as controls. Active immunization against insulin is summarized as follows:
      (a) the number of arousals was reduced; (b) waking time decreased by about 20%;
      (c) slow wave sleep was increased; (d) The amount of sleep increased during the
      light and dark period; (e) feeding was decreased; (f) body weight was reduced;
      and (g) the blood glucose level rised. These results are compatible with previous
      studies showing positive correlation between decrease of insulin secretion, sleep
      disturbances and decrease of feeding. A possible association between peripheral
      insulin and brain noradrenergic system, sleep and feeding is suggested.

PMID- 7777622
TI  - Repeated blood glucose measures using a novel portable glucose meter.
AB  - We describe the use of a novel portable blood glucose meter to repetitively and
      rapidly measure blood glucose levels in mice. We used this apparatus to replicate
      in the mouse, an insulin tolerance test (ITT) developed for humans. This test
      involves repeated glucose sampling (0, 1, 3, 5, 7, 10, 15, and 20 min) after an
      IV bolus of 0.4 IU/Kg of insulin. We first ran comparative tests with a
      conventional automated glucose analyser to assess the precision and reliability
      of the blood glucose meter for use in the mouse. High correlation were found
      between the two measures using either capillary or trunk whole blood. The
      variability of measurement over five consecutive determinations was about 3%. It
      was possible to take repetitive measures at about 70 s intervals.

PMID- 7777623
TI  - Surgical reconstruction of patients with Crouzon's syndrome: a lifetime of needs.
AB  - Crouzon's Syndrome is an inherited craniofacial deformity. Unfortunately, like
      with many other complex disorders, there is no quick fix. Treatment consists of
      numerous surgeries over a long period of time. Nurses are crucial team members as
      they are best educated to balance the physical, psychosocial, and developmental
      needs of patients and families.

PMID- 7777624
TI  - Malignant hyperthermia: a review.
AB  - Malignant hyperthermia (MH) was first identified as an anesthetic-related patient
      syndrome with familial tendencies in 1960. It is defined as a chain reaction of
      abnormalities triggered in susceptible individuals by commonly used anesthetic
      agents, and is classified as a hypermetabolic disorder of skeletal muscle. It is
      believed that susceptible patients possess a genetic predisposition for the
      development of the disease. In an acute episode of MH, the anesthetic triggering
      agent appears to interfere with the calcium ion reentry into the sarcoplasmic
      reticulum after muscle contraction. This process involving the calcium ion is the
      basis for all the clinical symptoms observed.

PMID- 7777625
TI  - Is it quality assurance or quality improvement; and what is it?
AB  - The term quality has a different meaning for everyone. Persons seeking health
      care have predetermined expectations that the care they receive is efficient,
      effective, and meets their needs. Through nursing quality improvement programs,
      nurses themselves can evaluate the efficiency of the care they provide. Through
      the use of patient surveys, nurses become aware of the patient's needs and degree
      of satisfaction. Monitor tools based on nursing standards and policies are used
      to assess the components of care. A successful nursing quality improvement
      program requires a climate that educates, supports, and encourages staff
      involvement.

PMID- 7777626
TI  - Paradigms for successful management in 1995.

PMID- 7777627
TI  - Patient education materials for facelifts and blepharoplasty.

PMID- 7777628
TI  - Guidelines for surgical decontamination.

PMID- 7777629
TI  - Interpretation: what do the study results mean?

PMID- 7777630
TI  - Ethical codes and policy standards affecting health care practice and research: a
      bibliography.

PMID- 7777631
TI  - Arteriovenous malformations: a team approach to management.

PMID- 7777633
TI  - President's message: promoting excellence in nursing care begins with students!

PMID- 7777632
TI  - Heck, it could be worse.

PMID- 7777634
TI  - Common injuries in the child or adolescent athlete.
AB  - As more primary care physicians enter the field of Sports Medicine, they will
      inevitably encounter more injured young athletes than what they may have
      experienced in their private practices. Recognizing the differences that exist
      between the young athlete and adult is essential in properly diagnosing and
      rehabilitating these athletes. As mentioned in our previous article (Caring for
      the School-Aged Athlete, Primary Care, December 1994), comprehensive care of the
      young athlete can be quite involved and somewhat different from care of the adult
      population. This article focuses on some specific injuries unique to younger,
      skeletally immature athletes, while mentioning the differential diagnosis of some
      of the other common sports injuries shared by both younger and older athletes.

PMID- 7777635
TI  - Contraception in the adolescent patient.
AB  - Having presented an overview of the available methods of contraception, the
      authors present one approach to prescribing contraceptives based on their
      experience. First, adolescent patients in our practice are discouraged from
      engaging in sexual intercourse. Abstinence is the only fail-safe method of
      contraception and provides benefits both emotionally and physically (i.e.,
      prevention from sexually transmitted diseases and unwanted pregnancies). If the
      adolescent plans to be sexually active, however, she is encouraged to select some
      form of hormonal contraception, namely Norplant, Depo-Provera, or oral
      contraceptives, in conjunction with condoms. The authors have had little success
      recommending barrier methods alone. Condoms are used sporadically and the
      diaphragm is very awkward for adolescents who are still uncomfortable with their
      bodies and with touching themselves. Of the three hormonal methods, Depo-Provera
      seems to be well-accepted by our patients. It offers several advantages that we
      believe make it attractive. First, it does not require any forethought by the
      patient other than coming in for the injection every 3 months. There is an
      effective grace period, so the patient is afforded good contraception even if she
      is up to a month late for her injection. The frequent visits for injections
      actually can be looked upon as positive, frequent contacts with the patient and
      can provide opportunities for counseling. In addition, some patients become
      amenorrheic, which teens view as an advantage, increasing compliance. If it is
      not likely that a patient will be compliant with every-3-month injections,
      Norplant is recommended. Studies have shown good acceptance of Norplant by
      adolescents and that has been the experience of the authors. With appropriate
      counseling prior to insertion and a counseling session with patients who request
      removal, the number of actual Norplant removals has been limited. If Depo-Provera
      and Norplant are not acceptable to the patient, then oral contraceptives are
      recommended. Of the three methods, more opportunities for failure exist with oral
      contraceptives. Pills are missed for a variety of reasons, including going away
      for the weekend; not having a regular schedule, which can interrupt pill-taking;
      and even ambivalence about becoming pregnant. One recent study demonstrated
      certain patient characteristics that were associated with good compliance with
      oral contraceptives, including white race, higher education level, suburban
      residence, and older age of both the patient and her mate. Keeping these
      characteristics in mind may be helpful when prescribing oral contraceptives. Of
      course, it is the patient's prerogative to choose the type of contraception she
      feels will be best suited for her.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7777636
TI  - Managing the child infected with HIV.
AB  - Care of the HIV-infected/exposed infant and child is both routine and
      challenging. Routine well child care and immunizations are an important part of
      maintaining and monitoring health status. Challenges arise in the management of
      acute illnesses and the numerous crises that are experienced by the family caring
      for that child. Therapy guidelines now provide a logical way in which to initiate
      antiretroviral treatment and PCP prophylaxis. In HIV-infected children with early
      disease, common pathogens initially predominate, and only in advanced immune
      suppression does care become complicated enough to require expert consultation.
      With increasing numbers of HIV-infected women, perinatally acquired infections in
      infants will become more common. Early testing and identification will
      increasingly be important as a way to impact on the significant morbidity and
      mortality seen in infants less than 6 months old. A caring, compassionate, and
      comprehensive approach to the care of HIV-infected infants and children results
      in increased survival and lengthening of disease-free time. Providing this
      vitally needed care is both satisfying and stimulating.

PMID- 7777637
TI  - Assisting with school placement and intervention for children with special needs-
      from disabled to gifted.
AB  - Collaboration of physicians, parents, and teachers is essential in obtaining the
      best education for children. The spectrum of interaction ranges from acute and
      chronic medical care, routine exams, and sports evaluations to learning
      disabilities and attention-deficit hyperactivity disorder to giftedness.

PMID- 7777638
TI  - Children and environmental toxins.
AB  - Environmental toxins have been shown to produce harmful effects in children, who
      may be exposed in the home, in public spaces, and by passive contact with adults.
      This review discusses common toxic substances, including lead, radon, tobacco
      smoke, asbestos, pesticides, mercury, carbon monoxide, and electric/magnetic
      fields. The focus is on identification, environmental abatement, and parent
      education. Practical suggestions for the primary care clinician in a community
      setting are emphasized.

PMID- 7777639
TI  - Common behavioral problems in infants and children.
AB  - Primary care physicians can serve as important sources of behavioral information
      to patients of infants, toddlers, school-aged children, and adolescents. Behavior
      results from a blend of biologic qualities, such as gender and temperament, and
      social experiences, such as attachment and family experiences. Common problems
      include disorders of sleep, crying, feeding and diet, discipline and sexuality,
      aggression and biting, toilet training, and school avoidance. Family physicians
      should be aware of the management of behavioral problems and provide anticipatory
      or responsive guidance or reference information.

PMID- 7777640
TI  - Common skin problems of infancy, childhood, and adolescence.
AB  - Common dermatological problems as a frequent presenting complaint are stratified
      by infancy, childhood, and adolescence. The common manifestations and questions
      asked by parents are discussed. Both infectious and noninfectious rashes are
      included. Convenient treatment modalities are listed.

PMID- 7777641
TI  - [Changes in biological rhythm and sleep structure during the menstrual cycle in
      healthy women].
AB  - It is well known that clinical symptoms such as psychosis, epileptic seizures and
      sleep disturbances aggravate around the time of menstruation. In some healthy
      women, subjective sleep feelings or moods have been reported to change throughout
      the menstrual cycle, which suggests that sleep structure and sleep-wake rhythm
      may change during the menstrual cycle. We investigated a circadian pattern of
      plasma melatonin, sleep-wake rhythm and sleep characteristics in the different
      phases of the menstrual cycle in young healthy women under controlled
      environmental conditions. The subjects were seven healthy women, aged 18 to 19,
      with regular menstrual cycles. They stayed in an experimental facility, where
      temperature and humidity were kept within a narrow range, for three days in
      successive five weeks. They got up and went to bed at their preferable time.
      Polysomnography was performed using ambulatory cassette EEG system on the first
      and second night. Sleep stages were scored according to Rechtshaffen and Kales'
      criteria. Plasma melatonin was measured at 1-hour intervals for 24 hours on the
      third day. The menstrual cycle was divided into four phases (menstruation,
      follicular, early luteal and late luteal). Although the plasma melatonin level in
      the late luteal phase tended to be higher than in other phases, no significant
      difference was observed across four phases. The phase in plasma melatonin level
      did not change. As for sleep-wake rhythm, the time of getting up on the first day
      was significantly late in the late luteal phase (p < 0.05), although it showed no
      significant change on the second day. The time of going to bed did not change.
      Sleep characteristics changed during the menstrual cycle. There was a significant
      difference in the amount of stage 3 + 4, slow wave sleep (p < 0.05), which was
      more abundant in the follicular phase than in the luteal phase. TIB (time in
      bed), SPT (sleep period time), TST (total sleep time) seemed to increase in the
      menstrual and follicular phases, while stage W increased in the early and late
      luteal phases. However, there were no significant differences in these
      parameters. The other parameters did not show any changes. The changes in amount
      of stage 3 + 4 throughout the menstrual cycle seem to be due to endogenous
      factors, because environmental factors were controlled in this experiment. It is
      possible that the menstrual cycle also affect the plasma melatonin level and
      sleep-wake rhythm.

PMID- 7777642
TI  - [Case report of a schizophrenic patient who exhibited amnesia of personal history
      for 15 years].

PMID- 7777643
TI  - [Care for patients with Pick's disease--by using their preserved procedural
      memory].
AB  - Pick's disease are more often complicated than Alzheimer's disease by behavioral
      disturbances such as social misconduct and stereotypy, that are troublesome and
      clinically difficult to manage. The purpose of this study was to investigate the
      possibility of improvement in care for patients with Pick's disease by using
      their presumably preserved procedural memory. Four inpatients and two outpatients
      with Pick's disease were studied. Case 1: A 54-year-old right-handed retired
      clerk presented with a 3-year history of increasing restlessness, word-finding
      difficulty and impaired comprehension of nominal terms. He was forced to retire
      from his work because of his social misconduct and incommunicability. On
      admission he wandered about the ward irritably, did not enter into any
      conversation, and destroyed all keys in the ward by putting a pencil into
      keyholes. Neuroradiological examination revealed circumscribed bilateral
      frontotemporal atrophy which was more marked on the left side. However, he has
      become more adaptive to the life in the ward and his expression has become
      peaceful since he began to play othello games with other patients and his
      doctors. Case 2: A 71-year-old right-handed housewife had progressively altered
      in her personality and behavior over 4 years. She was restless and showed
      striking palilalia with marked right frontotemporal atrophy when initially
      evaluated 2 years after her initial symptoms. Subsequently, her verbal output
      decreased. She ate large amounts of food and her overweight became a serious
      problem in her care at home. On admission she wandered about the ward irritably,
      ate meals of other patients, and put on a quilt on their head. However, these
      troublesome behavior disappeared when she was bent on knitting that was her
      former hobby. Case 3: A 63-year-old right handed physician presented with a 5
      year history of increasing word-finding difficulty and impaired comprehension of
      nominal terms. His conversation was limited to continuous repetition of a few
      phrases. He wandered into several hospitals around his house in fixed order every
      day. On examination, he was mildly disinhibited and distractible with
      circumscribed bilateral frontotemporal atrophy which was more marked on the left
      side. Wandering away from home overnight necessitated admission to the hospital.
      In the ward he wandered about and tried to open each door restlessly and
      irritably. However, he has become calm and his expression has become peaceful
      since he was conducted to measure blood pressures of his nurses. Case 4: A 65
      year-old right-handed retired office worker.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7777644
TI  - Assessment of the Rescorla-Wagner model.
AB  - The Rescorla-Wagner model has been the most influential theory of associative
      learning to emerge from the study of animal behavior over the last 25 years.
      Recently, equivalence to this model has become a benchmark in assessing
      connectionist models, with such equivalence often achieved by incorporating the
      Widrow-Hoff delta rule. This article presents the Rescorla-Wagner model's basic
      assumptions, reviews some of the model's predictive successes and failures,
      relates the failures to the model's assumptions, and discusses the model's
      heuristic value. It is concluded that the model has had a positive influence on
      the study of simple associative learning by stimulating research and contributing
      to new model development. However, this benefit should neither lead to the model
      being regarded as inherently "correct" nor imply that its predictions can be
      profitably used to assess other models.

PMID- 7777645
TI  - Adult attachment representations, parental responsiveness, and infant attachment:
      a meta-analysis on the predictive validity of the Adult Attachment Interview.
AB  - About a decade ago, the Adult Attachment Interview (AAI; C. George, N. Kaplan, &
      M. Main, 1985) was developed to explore parents' mental representations of
      attachment as manifested in language during discourse of childhood experiences.
      The AAI was intended to predict the quality of the infant-parent attachment
      relationship, as observed in the Ainsworth Strange Situation, and to predict
      parents' responsiveness to their infants' attachment signals. The current meta
      analysis examined the available evidence with respect to these predictive
      validity issues. In regard to the 1st issue, the 18 available samples (N = 854)
      showed a combined effect size of 1.06 in the expected direction for the secure
      vs. insecure split. For a portion of the studies, the percentage of
      correspondence between parents' mental representation of attachment and infants'
      attachment security could be computed (the resulting percentage was 75%; kappa =
      .49, n = 661). Concerning the 2nd issue, the 10 samples (N = 389) that were
      retrieved showed a combined effect size of .72 in the expected direction.
      According to conventional criteria, the effect sizes are large. It was concluded
      that although the predictive validity of the AAI is a replicated fact, there is
      only partial knowledge of how attachment representations are transmitted (the
      transmission gap).

PMID- 7777647
TI  - Vocational rehabilitation of drug abusers.
AB  - Employment has been identified as an important element in the rehabilitation of
      drug abusers and, together with abstinence from illicit drugs and criminal
      involvement, is frequently used as a criterion of treatment outcome. The research
      literature for the last 20 years on variables affecting employment and the
      vocational rehabilitation of drug abusers is reviewed with an emphasis on (a) the
      identification of variables influencing the employment of drug abusers and (b)
      the evaluation results of interventions that have been developed for this
      purpose. It is concluded that a number of programs have been demonstrated to have
      had some success in the vocational rehabilitation of drug abusers. Specific
      recommendations are made concerning both the direction of further research in
      this area and the application of existing knowledge in current practice.

PMID- 7777646
TI  - Of the way we were: adult memories about attachment experiences and their role in
      determining infant-parent relationships: a commentary on van IJzendoorn (1995).
AB  - In his meta-analysis of studies demonstrating the predictive validity of the
      Adult Attachment Interview (AAI), van IJzendoorn (1995) relies on current
      thinking in attachment theory. Although the data he presents are forceful, there
      are alternate explanations for the relations he finds that are ignored. Narrative
      about personal memories may be a function of personal theories about
      developmental processes as well as current psychological state (e.g., personal
      self-esteem). There is currently no evidence that the coherency of discourse
      about early childhood experiences is a function of either actual early experience
      or reworkings of that experience. In the absence of such evidence, the data
      indicating that maternal personality influences infant behavior are not
      theoretically surprising.

PMID- 7777648
TI  - Life events and bipolar disorder: implications from biological theories.
AB  - Although a number of studies suggest that stressful life events play a role in
      bipolar disorder, methodological flaws impose serious limitations on this
      literature. Nonetheless, better designed studies indicate that life events
      influence the course of bipolar disorder. Little is known, however, about the
      nature of events that are of particular importance to this disorder. Given the
      strong biological vulnerability and the unique clinical aspects of bipolar
      disorder, certain forms of stress may have stronger interactions with
      vulnerability characteristics. Three major biological theories of bipolar
      disorder are discussed, with particular attention to their implications for
      investigations of life events. Although tenuous, these models suggest that
      greater attention needs to be paid to particular dimensions of life events and
      the course of disorder.

PMID- 7777649
TI  - Effects of psychotherapy with children and adolescents revisited: a meta-analysis
      of treatment outcome studies.
AB  - A meta-analysis of child and adolescent psychotherapy outcome research tested
      previous findings using a new sample of 150 outcome studies and weighted least
      squares methods. The overall mean effect of therapy was positive and highly
      significant. Effects were more positive for behavioral than for nonbehavioral
      treatments, and samples of adolescent girls showed better outcomes than other Age
      x Gender groups. Paraprofessionals produced larger overall treatment effects than
      professional therapists or students, but professionals produced larger effects
      than paraprofessionals in treating overcontrolled problems (e.g., anxiety and
      depression). Results supported the specificity of treatment effects: Outcomes
      were stronger for the particular problems targeted in treatment than for problems
      not targeted. The findings shed new light on previous results and raise
      significant issues for future study.

PMID- 7777650
TI  - Sexual fantasy.
AB  - This article reviews the research literature on sexual fantasy, a central aspect
      of human sexual behavior. Topics include (a) gender similarities and differences
      in the incidence, frequency, and content of sexual fantasies and how they relate
      to sociocultural and sociobiological theories of sexual behavior; (b) the
      association between frequency or content of sexual fantasies and variables such
      as age, sexual adjustment and satisfaction, guilt, sexual orientation,
      personality, and sexual experience; and (c) "deviant" sexual fantasies (i.e.,
      what they are, whether they play a role in the commission of sexual crimes, and
      whether they can be modified). The article ends with a summary of major findings
      and suggestions for future research.

PMID- 7777651
TI  - The need to belong: desire for interpersonal attachments as a fundamental human
      motivation.
AB  - A hypothesized need to form and maintain strong, stable interpersonal
      relationships is evaluated in light of the empirical literature. The need is for
      frequent, nonaversive interactions within an ongoing relational bond. Consistent
      with the belongingness hypothesis, people form social attachments readily under
      most conditions and resist the dissolution of existing bonds. Belongingness
      appears to have multiple and strong effects on emotional patterns and on
      cognitive processes. Lack of attachments is linked to a variety of ill effects on
      health, adjustment, and well-being. Other evidence, such as that concerning
      satiation, substitution, and behavioral consequences, is likewise consistent with
      the hypothesized motivation. Several seeming counterexamples turned out not to
      disconfirm the hypothesis. Existing evidence supports the hypothesis that the
      need to belong is a powerful, fundamental, and extremely pervasive motivation.

PMID- 7777652
TI  - Delta-sleep-inducing peptide does not affect CRH and meal-induced ACTH and
      cortisol secretion.
AB  - Besides sleep-promoting properties, delta-sleep-inducing peptide (DSIP) has been
      reported to act as a corticotropin-releasing inhibiting factor in vitro and in
      vivo. We examined, first, the influence of DSIP on ACTH and cortisol release
      following stimulation with human corticotropin-releasing hormone (h-CRH; 1.0
      microgram/kg body weight, and 0.5 microgram/kg body weight, respectively) in
      healthy young men (n = 5 in each condition). DSIP (total doses of 3 and 4 mg,
      respectively, vs. placebo) was infused intravenously between 30 min prior to and
      90 min after CRH injections. Responses of ACTH and cortisol were almost identical
      during and after infusion of DSIP and placebo. In a second experiment, the
      influence of DSIP (4 mg, also administered as intravenous infusion) on meal
      related ACTH and cortisol secretion was studied in another 10 men. Meal-related
      midday surge of ACTH and cortisol was also not affected by DSIP. Our data do not
      support an inhibitory role of DSIP on ACTH and cortisol secretion in man.

PMID- 7777653
TI  - Differential inhibition of stress-induced adrenocortical responses by 5-HT1A
      agonists and by 5-HT2 and 5-HT3 antagonists.
AB  - The present studies were designed to determine the effects of 5-HT1A receptor
      agonists and 5-HT2A/2C and 5-HT3 antagonists on adrenocortical responses to a
      variety of stress paradigms in conscious male rats. The following stressors were
      examined: acoustic stress (105 dB for 2 min); foot shock (0.2 mA, five shocks
      over 5 min); conditioned fear (animals placed in the foot shock chamber for 5
      min, 24 h after foot shock); restraint (Plexiglas restrainer for 5 min);
      injection of recombinant human interleukin-1 alpha (IL-1, 20 micrograms/kg, IP);
      injection of cocaine hydrochloride (20 mg/kg, IP). Drug treatments consisted of
      intracerebroventricular (ICV) or intraperitoneal (IP) injections of the 5-HT1A
      agonists, 8-OH-DPAT and ipsapirone (0.1 pmol, ICV), the 5-HT2A/2C antagonist,
      ketanserin (2 mumol/kg, IP), and the 5-HT3 antagonist, MDL-72222 (20 nmol, ICV).
      The plasma corticosterone (CS) responses to foot shock and restraint stress were
      not affected by any of the serotonergic drugs tested. The 5-HT1A agonist, 8-OH
      DPAT, was able to attenuate the adrenocortical responses to acoustic stimulation,
      conditioned fear, IL-1 alpha, and cocaine administration, with ipsapirone also
      being effective in reducing the responses to acoustic stimulation and cocaine
      injection. The 5-HT2 antagonist, ketanserin was able to reduce the adrenocortical
      response in the conditioned fear paradigm and the response to IL-1 alpha
      injection. The 5-HT3 antagonist, MDL-72222 was only effective in reducing the
      response to acoustic stimulation. Thus, adrenocortical responses to each of the
      applied stressors were differentially affected by the 5-HT receptor ligands
      tested. The results of this study indicate that 5-HT1A agonists may be efficient
      stress response-reducing agents. However, their efficacy depends on the lack of a
      somatosensory component to the applied stressor and their agonist properties
      suggest that their action may not involve direct effects on serotonergic pathways
      mediating the observed responses. In contrast, the specificity of the 5-HT2 and 5
      HT3 antagonists in blocking adrenocortical responses to certain stressors
      suggests that these drugs exert their effects by blocking serotonergic
      neurotransmission in pathways mediating the adrenocortical responses to specific
      stimuli.

PMID- 7777654
TI  - Daily plasma estradiol and progesterone levels over the menstrual cycle and their
      relation to premenstrual symptoms.
AB  - The present study extends a previous report of lower plasma ACTH levels in women
      with premenstrual syndrome (PMS) compared with asymptomatic controls. Plasma
      levels of estradiol and progesterone were measured daily in 10 women with
      confirmed PMS and 8 asymptomatic women. Daily symptom reports were maintained
      during the same menstrual cycle. Both estradiol and progesterone levels were
      consistently, but not significantly, higher throughout the cycle in PMS subjects
      compared with controls. From the follicular to the early luteal phase, estradiol
      levels were significantly higher in a previously defined PMS subgroup 2 with more
      severe symptoms throughout the cycle compared with both the less severe PMS
      subgroup 1 and controls. Progesterone levels were significantly and positively
      correlated with PMS symptoms along the entire menstrual cycle, preceding the
      symptoms by 5-7 days. These preliminary results provide support for the
      hypothesis that the presence of progesterone at early luteal phase levels is
      required for PMS symptoms to occur.

PMID- 7777655
TI  - The glucocorticoid sensitivity of lymphocytes changes according to the activity
      of the hypothalamic-pituitary-adrenocortical system.
AB  - Cortisol inhibition of phytohemagglutinin (PHA)-induced lymphocyte activation was
      studied in vitro in peripheral blood mononuclear cells (PBMC) of patients with
      pathologies of the hypothalamic-pituitary-adrenocortical (HPA) system (n = 18) as
      well as in students under and out of academic stress. In patients with HPA
      pathologies, cortisol-induced inhibition of lymphocyte interleukin-2 (IL-2)
      secretion in vitro positively correlated (p < .005) with IL-2 synthesis, such
      that lymphocytes secreting less IL-2 were less cortisol sensitive. Similarly, in
      stressed students there was a positive correlation (p < .02) between lymphocyte
      DNA synthesis and cortisol inhibition in vitro. Academic stress also resulted in
      a decrease (p < .01) of lymphocyte cortisol sensitivity. The same tendency was
      observed in patients with Cushing's syndrome when compared with hypocortisolemic
      patients. Normal controls whose lymphocytes were glucocorticoid resistant showed
      higher lymphocyte activation than glucocorticoid sensitive subjects. This pattern
      of glucocorticoid sensitivity was reversed in individuals with abnormal
      glucocorticoid secretion due to HPA pathology or stress.

PMID- 7777656
TI  - Natural killer cell activity is reduced in association with oral contraceptive
      use.
AB  - Oral contraceptive (OC) use has been associated with increased incidence of a
      number of infections, but the mechanisms behind these changes is unclear. The
      present study compared OC users and nonusers in natural killer (NK) cell
      activity, NK phenotype, and illness frequency. Subjects were 55 female medical
      students (19 OC users, 36 nonusers). Three blood samples were obtained, 1 mo
      apart. Natural cytotoxicity was tested with a 51Cr assay. Self reports of illness
      symptoms during the previous week were collected at each blood sampling. NK
      phenotype number was assessed by flow cytometry. Oral contraceptive users had
      lower natural cytotoxicity and increased frequency of sneezing, gastrointestinal
      distress, runny nose, sore throat, coughing, and total illness symptoms, relative
      to nonusers. No differences were found between OC users and nonusers in NK
      phenotype number. These findings support the hypothesis that differences between
      users and nonusers in infection rates might be due to alterations in NK activity.

PMID- 7777657
TI  - Menstrual cycle and social behavior in vervet monkeys.
AB  - We assessed the relationship between social behavior and the menstrual cycle in
      11 adult female vervet monkeys (Cercopithecus aethiops sabaeus) living in an
      established, stable social group. The findings indicated that fluctuations in
      ovarian steroids are accompanied by behavioral changes in vervet monkeys. A
      significant increase in aggressive action, avoidance of social overtures, and
      retreats from threat occurred during the late luteal phase. However, the social
      environment can greatly affect behavior independent of the phase of the menstrual
      cycle. The 10 nondominant (or subordinate) individuals not only exhibited
      behavioral changes across their own menstrual cycles, but also were responsive to
      the dominant female's cycle. During the dominant female's late luteal phase,
      subordinate females significantly increased aggression and decreased social
      activity. Some of behavioral patterns in female vervet monkeys are therefore
      relatively independent of direct hormonal modulation and support the contention
      of the dominant female as the driving force for behavioral changes related to
      aggression and social interaction. The differential effect of hormones and social
      status and other environmental factors on behavior has not been critically
      evaluated in human studies of the premenstrual syndrome. The present study
      suggests that it is important to assess which behavioral patterns in women are
      hormonally mediated and which are dependent on the environment.

PMID- 7777658
TI  - Postweaning housing conditions and partner preference and sexual behavior of
      neonatally ATD-treated male rats.
AB  - Male rats were neonatally treated with cholesterol or a substance that blocks the
      aromatization of testosterone to estradiol (1,4,6-androstatriene-3,17-dione:
      ATD). At weaning (21 days) they were either housed alone or in small groups (2-3
      animals) and tested for partner preference behavior (PPB) in adulthood. Choice
      was between an estrous female and an active male (Part I) and between an estrous
      female and an ATD-male (Part II). Tests were carried out in a 3-compartment box.
      Social isolation did not have major effects on PPB except when sexual interaction
      with the stimulus animals was prevented (Part I). In this case, isolates (ATD and
      control) showed higher preference scores (PS) for the estrous female and spent
      less time in the empty middle compartment. When the choice was between an estrous
      female and an ATD-male, partner PS decreased in all males, most clearly in ATD
      males. The latter animals spent more time with the stimulus ATD-male than they
      had done in previous PPB tests with the normal stimulus male. In contrast to
      partner preference behaviors, sexual behavior was clearly affected by social
      isolation. Isolates (ATD and control) displayed lower frequencies of mounts and
      intromissions. These effects persisted over consecutive tests. Ejaculation was
      not affected. In conclusion, the present results confirm earlier findings about
      the significance of neonatal endocrine conditions for the organization of adult
      PPB in male rats. The presence or absence of social conspecifics after weaning
      appears to have little influence on adult PPB.

PMID- 7777662
TI  - Regional differences in fat cell lipolytic mechanisms: a critical review.

PMID- 7777659
TI  - Gonadotropin (LH and FSH) response after submaximal GnRH stimulation in depressed
      premenopausal women and healthy controls.
AB  - Although hormonal response abnormalities in depression have been demonstrated in
      several hypothalamic-pituitary-target organ axes after a variety of
      neuroendocrine challenge tests, studies of hypothalamic-pituitary-gonadal (HPG)
      axis function have been inconsistent in their findings. The use of maximal or
      supramaximal doses of gonadotropin-releasing hormone (GnRH) in early studies (150
      600 micrograms) may have masked the presence of more subtle disturbances in
      luteinizing hormone (LH) and follicle-stimulating hormone (FSH) responsiveness in
      depression. We hypothesized that submaximal doses of GnRH might reveal a more
      subtle dysregulation in gonadotropin responsiveness in depression, and therefore
      measured LH and FSH responses after GnRH 10 micrograms and 90 micrograms doses in
      nine premenopausal depressed women and six healthy controls. There were no
      statistically significant differences between subject groups for mean basal LH,
      FSH, and estradiol concentrations, nor for any of the LH and FSH response values
      after either GnRH stimulation dose. The present observations of an intact HPG
      axis in depression contrast with findings of disturbances in most other
      hypothalamic-pituitary axes, and suggest that neuroendocrine dysregulation in
      depression might not represent a generalized limbic system-hypothalamic-pituitary
      abnormality, but rather a more restricted lesion sparing the medial preoptic
      and/or arcuate region of the hypothalamus which regulates gonadotropin secretion.

PMID- 7777660
TI  - Stress, serotonergic function, and mood in users of oral contraceptives.
AB  - The relationship between stress and changes in insulin levels, plasma ratio of
      tryptophan to other large neutral amino acids (LNAAs), mood, and food intake was
      investigated in women taking monophasic oral contraceptives containing
      progestagens. Subjects experiencing high levels of stress displayed significant
      decreases of insulin and tryptophan to other LNAAs ratios, before and after the
      consumption of a standard meal during the pill-free period as compared with the
      period of pill use. The decline of the tryptophan to other LNAAs ratio was
      accompanied by worsening of mood. In a control group of subjects experiencing low
      levels of stress there was no relationship between insulin and tryptophan to
      other LNAAs ratio, nor between tryptophan to other LNAAs ratio and mood. These
      results suggest that the combination of stress and alterations in sex hormones
      may be responsible for mood changes during the pill-free period in women taking
      oral contraceptives.

PMID- 7777661
TI  - Circadian variations in antigen-specific proliferation of human T lymphocytes and
      correlation to cortisol production.
AB  - Cortisol is a well-known immunosuppressant when used therapeutically. The present
      investigation was set out to study if diurnal variations in endogenous cortisol
      production are reflected by changes in proliferative responses of human
      lymphocytes to either a mitogen (phytohemagglutinin-A, PHA) or an antigen
      (tetanus toxoid, TT) stimulus. The study included eight healthy volunteers. Blood
      was withdrawn at 0200, 0600, 1000, and 1800h for preparation of lymphocytes and
      determination of cortisol in plasma. Isolated cells were incubated without
      (baseline activity) or with inclusion of either 1 micrograms PHA or 10 micrograms
      TT. Proliferation was measured by labelling with 3H-thymidine for 16 h of
      culture. The cortisol plasma levels exhibited the well known diurnal variations
      with highest concentrations at 1000h and lowest levels at 0200h. Baseline
      activity or PHA stimulated cell proliferation did not show significant diurnal
      fluctuations. The response to TT, however, decreased by 38% between 0600 and
      1000h (p = .01). Correlation analyses revealed that the reduction of the
      proliferative responses to TT correlated significantly (p < .05) with increases
      in cortisol plasma levels. It was concluded that diurnal fluctuations in the
      production of endogenous cortisol might be relevant for daytime dependent
      variations in immune responsiveness.

PMID- 7777663
TI  - Pulmonary dirofilariasis: first reported case in Puerto Rico.
AB  - The first case of human pulmonary dirofilariasis in our country is reported. The
      etiopathogenesis and pathological findings of the zoonosis are discussed.

PMID- 7777664
TI  - Acquired nevus flammeus.
AB  - This is the case of a 55-year-old male with cirrhosis who required a LeVeen shunt
      for relief of refractory ascites. After eight months he developed recurrence of
      the ascites and a erythematous patch around the surgical scar. Skin biopsy
      revealed a proliferation of small and medium-sized vessels throughout the dermis.
      The acquired form of nevus flammeus is rare an is usually preceded by trauma.
      This is the report of a patient with an acquired nevus flammeus associated to an
      obstructed peritoneovenous shunt.

PMID- 7777665
TI  - RCMI International AIDS Symposium. AIDS in Hispanic and Other Minority
      Populations. San Juan, Puerto Rico, November 3-4, 1994. Abstracts.

PMID- 7777666
TI  - Readmission in unstable angina.
AB  - To determine the characteristics of patients re-admitted after unstable angina
      (UA) pectoris, 120 consecutive patients hospitalized due to primary UA pectoris
      were prospectively studied 22 +/- 3 months after discharge. The patients were
      grouped based on the readmission rate. Those in group A (50) had recurrent
      admissions (mean 2.6, range 2 to 5). Seventy patients (group B) did not have
      readmissions during the follow-up period. All patients underwent coronary
      angiogram and symptoms-limited exercise stress test before discharge. The
      univariate characteristics for readmission were: age over 70 years (p = 0.02),
      nondiagnostic exercise stress testing (p = 0.03), angiographically diffuse
      coronary artery disease (p = 0.004), and non-interventional management (P <
      0.001). Patients readmitted had increased incidence of myocardial infarction (p =
      0.004) but similar survival at 2 years. By regression analysis, important
      variables for readmission were non-interventional management (Chi-Square = 7.6, p
      = 0.01), non diagnostic treadmill test (Chi-Square = 6.9, p = 0.03) and diffuse
      coronary artery disease (Chi-Square = 6.2, p = 0.04). It is concluded that in the
      interventional era the most important factor for readmission after primary UA
      pectoris is non-interventional management. Coronary revascularization should not
      be denied solely on the basis of age.

PMID- 7777667
TI  - Pulmonary factors limiting exercise capacity in patients with heart failure.
AB  - Patients with heart failure are frequently limited by exertional dyspnea. The
      mechanisms underlying dyspnea in these patients remain unclear. In this review,
      the pathologic changes that occur in the lung as a consequence of chronic
      pulmonary venous hypertension, pulmonary function test abnormalities, and
      potential mechanisms for dyspnea including airflow obstruction and/or respiratory
      muscle dysfunction are discussed.

PMID- 7777668
TI  - Cellular adaptations of the myocardium to chronic exercise.
AB  - The heart responds positively to programs of chronic dynamic exercise. Hallmark
      adaptations of the heart include a training bradycardia, increases in end
      diastolic dimension and maximal stroke volume, and a general improvement in
      ventricular performance and contractile function. Of considerable clinical
      significance are the general observations that chronic exercise renders the
      myocardium less susceptible to the deleterious effects of acute ischemic episodes
      and can effectively prevent and/or reverse many of the cardiac functional
      deficits that are known to occur in settings of chronic hypertension, advanced
      age, and myocardial infarction. In the text that follows, information gathered
      over the last 25 to 30 years has been reviewed in an attempt to identify cellular
      myocardial adaptations, both known and hypothetical, that are responsible for the
      observed effects of chronic dynamic exercise on the function and morphology of
      the heart in both normal and selected pathophysiologic settings. Finally, a
      variety of unresolved issues regarding the ability of chronic exercise to elicit
      adaptive cardiocyte responses has been identified. In so doing, it is hoped that
      creative thought and future work in the area will be stimulated.

PMID- 7777671
TI  - Sotalol: a new beta-adrenergic blocker for ventricular arrhythmias.
AB  - Sotalol is a water-soluble, nonselective, beta-adrenergic blocker that was
      recently approved in oral form in the United States for the treatment of
      ventricular arrhythmias that are judged to be life-threatening. As a beta
      blocker, sotalol is unique in having additional class-III antiarrhythmic
      activity. It is still not resolved whether sotalol is more effective than other
      beta-blockers in managing arrhythmias, but there are suggestions that it might
      possess greater antiarrhythmic and life-protecting activities than other types of
      antiarrhythmic drugs. The drug is well tolerated, but, because of its
      electrophysiologic activity, there is a small risk of proarrhythmia, specifically
      the development of polymorphic ventricular tachycardia and torsade de pointes.

PMID- 7777669
TI  - Neural regulation of sympathetic nerve activity in heart failure.
AB  - One of the hallmarks of chronic congestive heart failure is an increase in
      sympathetic tone to the peripheral circulation and to the heart. A correlation
      between plasma norepinephrine and the severity of the heart failure state has
      been demonstrated. One mechanism that has been proposed to account for this
      sympathoexcitation is a depression in the baroreflex and, perhaps, cardiac reflex
      control of sympathetic nerve activity. This review summarizes work from several
      laboratories, including our own, that documents a depressed baroreflex control of
      heart rate and sympathetic nerve activity in both animals and humans with heart
      failure. The mechanism of the depressed baroreflex most likely is caused by
      reduced baroreceptor sensitivity as well as enhanced input to the central nervous
      system from cardiac receptors that are chemosensitive. Although sympathetic tone
      and arterial baroreflex sensitivity are altered in heart failure, there have been
      no studies showing a cause-and-effect relationship. Increases in plasma
      norepinephrine are similar in baroreceptor-denervated and intact dogs paced into
      heart failure. This latter observation cells into question the traditional
      concept of baroreceptor-mediated increases in sympathetic tone in heart failure.

PMID- 7777670
TI  - Optimal use of coronary care units: a review.
AB  - Patients at a low probability of acute cardiac pathology constitute a
      considerable proportion in many coronary care units (CCUs), such that physicians
      should consider more effective alternatives than CCU admission "to rule out
      myocardial infarction." In this article, strategies to increase the efficiency of
      managing patients with acute chest pain are reviewed. Algorithms aiming to
      improve the diagnostic accuracy of the general practitioner have been developed
      but require an electrocardiogram recorded at the home of the patient. Another
      method of triage encompasses the identification in the emergency room of the
      hospital of patients at a low probability of acute cardiac pathology by using
      predictive models that include laboratory assessments. A third strategy includes
      alternatives to CCUs for patients at a low risk of acute cardiac pathology, such
      as the creation of a simple observation unit. Finally, some investigators have
      sought to identify patients with good prognosis for early transfer from the CCU
      to lower levels of care. It is concluded that a combination of these approaches
      will be most efficient, and that the most appropriate choice will be determined
      by local circumstances.

PMID- 7777672
TI  - Teeth and tooth nerves.
AB  - (1) Although our knowledge on teeth and tooth nerves has increased substantially
      during the past 25 years, several important issues remain to be fully elucidated.
      As a result of the work now going on at many laboratories over the world, we can
      expect exciting new findings and major break-throughs in these and other areas in
      a near future. (2) Dentin-like and enamel-like hard tissues evolved as components
      of the exoskeletal bony armor of early vertebrates, 500 million years ago, long
      before the first appearance of teeth. It is possible that teeth developed from
      tubercles (odontodes) in the bony armor. The presence of a canal system in the
      bony plates, of tubular dentin, of external pores in the enamel layer and of a
      link to the lateral line system promoted hypotheses that the bony plates and
      tooth precursors may have had a sensory function. The evolution of an efficient
      brain, of a head with paired sense organs and of toothed jaws concurred with a
      shift from a sessile filter-feeding life to active prey hunting. (3) The wide
      spectrum of feeding behaviors exhibited by modern vertebrates is reflected by a
      variety of dentition types. While the teeth are continuously renewed in toothed
      non-mammalian vertebrates, tooth turnover is highly restricted in mammals. As a
      rule, one set of primary teeth is replaced by one set of permanent teeth. Since
      teeth are richly innervated, the turnover necessitates a local neural plasticity.
      Another factor calling for a local plasticity is the relatively frequent
      occurrence of age-related and pathological dental changes. (4) Tooth development
      is initiated through interactions between the oral epithelium and underlying
      neural crest-derived mesenchymal cells. The interactions are mediated by cell
      surface molecules, extracellular matrix molecules and soluble molecules. The
      possibility that the initiating events might involve a neural component has been
      much discussed. With respect to mammals, the experimental evidence available does
      not support this hypothesis. In the teleost Tilapia mariae, on the other hand,
      tooth germ formation is interrupted, and tooth turnover ceases after local
      denervation. (5) Prospective dental nerves enter the jaws well before onset of
      tooth development. When a dental lamina has formed, a plexus of nerve branches is
      seen in the subepithelial mesenchyme. Shortly thereafter, specific branches to
      individual tooth primordia can be distinguished. In bud stage tooth germs, axon
      terminals surround the condensed mesenchyme and in cap stage primordia axons grow
      into the dental follicle.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7777674
TI  - Spatially selective firing properties of hippocampal formation neurons in rodents
      and primates.

PMID- 7777673
TI  - Hippocampal markers of age-related memory dysfunction: behavioral,
      electrophysiological and morphological perspectives.

PMID- 7777675
TI  - [Roles of phospholipase D in cell functions and its regulatory mechanisms].

PMID- 7777676
TI  - [Biological significance of lipid modifications of G-proteins].

PMID- 7777678
TI  - [Biochemical studies of magnetotactic bacteria].

PMID- 7777677
TI  - [Areal specification of the cerebral cortex].

PMID- 7777679
TI  - [The current view of molecular biology of DNA tumor virus].

PMID- 7777680
TI  - [Postoperative lesions of the peripheral nerves. 8 years' analysis].
AB  - Damage to a plexus or peripheral nerve is a rare and avoidable complication of
      surgical anesthesia. We reviewed 2,750 case histories of patients who underwent
      surgery between 1985 and 1992, finding 6 cases of nerve lesions presenting
      postoperatively. Sequelae involved 1 abdomino-genital neuralgia, 1 case of post
      epidural radicular pain, 2 cases of peroneal nerve palsies and 2 of cubital
      paresis. Three of these cases were related to position during surgery, 1 to
      position during a prolonged period in bed in the intensive care unit, 1 to the
      anesthetic technique and 1 to surgical manipulation. Our data are important given
      the difficulty of studying the incidence of such cases due to patient dispersion
      and the loss of records of possible occurrences. The mechanisms by which lesions
      are produced are sometimes difficult to pinpoint but all are generally
      preventable.

PMID- 7777682
TI  - [Accidental perforation of the dural sac with a spinal needle introducer].

PMID- 7777681
TI  - [Level of information on prices in an anesthesia department].
AB  - The rationalization of health care spending has high priority in these times of
      economic difficulty. Anesthesiologists can contribute to more efficient use of
      resources and therefore must be well aware of the cost of the products they use.
      This study aims to evaluate their knowledge of the cost of commonly used
      products. Seventy-eight anesthesiologists with varying levels of experience and
      from different levels in the hierarchy were questioned about the cost of 20
      products, drugs and disposable items commonly used in their work. The physicians
      were within 50% of the real price of 4 of the 11 drugs studied and were 100%
      right about 3 drugs. The respondents were 100% correct about 2 of the disposable
      items studied but did not give estimates within 50% of real cost for any of the
      remaining 7 items. Neither position in the hierarchy nor years of experience was
      related to degree of correctness in pricing the products studied. Awareness of
      the prices of commonly used products, particularly of disposable material, was
      low in the population of anesthesiologists studied.

PMID- 7777683
TI  - [Anesthesia from the patient's point of view].

PMID- 7777684
TI  - [Severe hypophosphatemia and coma in a critically ill patient].

PMID- 7777685
TI  - [Subarachnoid block for ovariectomy in a patient with pulmonary
      lymphangioleiomyomatosis].

PMID- 7777686
TI  - [Quality of health care in anesthesiology and resuscitation].

PMID- 7777688
TI  - [Quality control in anesthesiology].
AB  - The process of quality control and auditing of anesthesiology allows us to
      evaluate care given by a service and solve problems that are detected. Quality
      control is a basic element of care giving and is only secondarily an area of
      academic research; it is therefore a meaningless effort if the information does
      not serve to improve departmental procedures. Quality assurance procedures assume
      certain infrastructural requirements and an initial period of implementation and
      adjustment. The main objectives of quality control are the reduction of morbidity
      and mortality due to anesthesia, assurance of the availability and proper
      management of resources and, finally, the well-being and safety of the patient.

PMID- 7777687
TI  - [Postoperative infection and anesthesia: analysis of various risk factors].
AB  - OBJECTIVES: To study the possible relation between anesthetic techniques and
      other perioperative circumstances and factors and the presentation of infections
      after surgery. PATIENTS AND METHODS: We studied 22 patients who suffered
      infections after surgery and 54 who did not, analyzing the anesthetic technique
      used as well as other data on age, sex, concomitant disease, toxic habits,
      practice of invasive procedures, duration and nature of the surgical procedure
      and the use of antibiotic prophylaxis. Multivariate analysis (logistical
      regression) was performed in order to identify independent risk factors. RESULTS:
      None of the anesthetic techniques studied was associated with greater frequency
      of postoperative infection. Infected patients were significantly older than
      uninfected patients (75 +/- 9 years versus 61 +/- 18 years). Likewise the number
      of infections was higher among ASA III and IV (n = 20) patients than among ASA I
      and II (n = 2). The duration of surgery for infected patients was 4.15 +/- 2.12
      hours whereas it was 2.87 +/- 1.86 hours (p < 0.001) for uninfected patients.
      Placement of a urinary catheter, repeated surgery, diabetes and blood transfusion
      all signified greater risk of infection, as did prophylaxis with second and third
      generation cephalosporins (OR = 12.5; 95% CI = 1.8-85.6) or tobramycin (OR =
      66.4; 95% CI = 3.5-1,270). CONCLUSION: The risk of postoperative infection
      increases with age and poor physical status of patients (ASA III and IV), with
      diabetes, repeated surgery, transfusion of blood products and prophylaxis with
      third generation cephalosporins and tobramycin.

PMID- 7777690
TI  - [Pneumology Society of French Language. List of members 1995].

PMID- 7777689
TI  - [Failure of the central oxygen supply to a surgical area. Analysis of a critical
      incident].
AB  - An incident involving central oxygen supply failure affecting 4 anesthetized
      patients in the operating theatre was analyzed by way of interviews with the
      anesthesiologists and a review of graphic records of anesthesia. The 4
      ventilators involved had been checked by each anesthesiologist according to his
      own method. The oxygen supply failure alarm warned of the supply cutoff in 2
      cases and the oxygen analyzer detected the other 2 within approximately 1 minute.
      After the failure, 2 patients were ventilated with ambient air through the
      ventilator, 1 was given medicinal air with the resuscitator. None suffered damage
      or recalled having awakened as a result of the incident. The cause of the failure
      in oxygen supply has not been determined but its duration has been estimated to
      be between 4 and 7 minutes. Our investigation shows that: 1) the operating rooms
      are not equipped with an alarm that warns of a drop in pressure within the tubes
      that supply central oxygen and in 2 cases the alarm warning of a cutoff in oxygen
      supply to the respirator did not sound correctly; 2) the ventilator equipment
      check did not follow a standard method and did not cover the possibility of
      oxygen supply failure, and 3) no alternative oxygen supply is available inside
      the operating theatre.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7777691
TI  - Editor's viewpoint: do you know the way to San Jose?

PMID- 7777692
TI  - A comparison of grip strength and selected psychomotor performance measures in
      healthy and frail elderly females.
AB  - Researchers have examined the relationships between strength and psychomotor
      skills among healthy male subjects far more thoroughly than among female
      subjects, especially elderly females. The purpose of the present investigation
      was to compare healthy and frail elderly females on grip strength and psychomotor
      performance measures. Nineteen healthy elderly females (M = 75.7 years of age)
      and 20 frail elderly females (M = 80.5 years of age) performed simple aiming
      movements in order for the investigators to obtain psychomotor measures (e.g.,
      reaction time, movement time, kinematic movement characteristics). In addition,
      strength measures were obtained in the dominant and nondominant hands.
      Significant differences were found between elderly females on grip strength and
      psychomotor performance measures. In general, healthy subjects were stronger and
      exhibited superior control of movements (e.g., greater impulse, fewer movement
      adjustments).

PMID- 7777693
TI  - Imaging goal-directed movement.
AB  - The main purpose of the present investigation was to determine how Shepard's
      (1968) second-order isomorphic principle relates to imaging goal-directed
      movement. Reports of movement times for actual and imaged movements were obtained
      using Fitts-type tapping tasks. Displays consisted of two different (referential)
      or two identical (nonreferential) stimulus pairs. In Experiments 1a and 1b,
      target width and amplitude were manipulated to produce two indexes of difficulty.
      In Experiments 2a and 2b, the index of difficulty was constant, and biases were
      created by indicating that movement time increased with decreases in target width
      or increases in amplitude. In all four experiments, reported movement time
      reflected Fitts' (1954) law for actual tapping and during early trials for
      referential imagery. In Experiments 1a and 1b, reported movement times for the
      two indexes of difficulty were similar for nonreferential imagery and at later
      trials for referential imagery. In Experiments 2a and 2b, reported movement times
      reflected the biases for nonreferential imagery and at later trials for
      referential imagery. The results suggest that propositional knowledge and
      information processing interact to control movement imagery.

PMID- 7777694
TI  - Skill-related task structures, explicitness, and accountability: relationships
      with student achievement.
AB  - The purpose of this study was to determine relationships of task structures,
      explicitness, and accountability with student achievement in physical education.
      The subjects were teachers of 10 physical education classes and their 202
      students. Each class participated in instruction that was videotaped, and the
      students were pre- and posttested. Videotapes were coded to collect data on each
      skill-related task including the task presentation time, skill being taught,
      explicitness of the task presentation, primary and secondary accountability
      systems used, level of student participation, and total task time. Among the many
      results, for the volleyball forearm pass, significant relationships were found
      for the total number of tasks and time spent in tasks when expectations included
      outcome, situation, and criteria-product. For the volleyball underhand serve,
      significant relationships were found for the total number of tasks and time spent
      in tasks when accountability included teacher feedback with follow-up and
      monitoring of off-task behavior.

PMID- 7777695
TI  - Teachers' value orientations in urban and rural school settings.
AB  - The purpose of this research was to describe physical educators' value
      orientations for curricular decision making in urban and rural teaching settings.
      The revised Value Orientation Inventory (Ennis & Chen, 1993) was used to collect
      data from 495 physical educators in urban and rural districts. Data were analyzed
      descriptively using a full-design and a nested MANOVA model. Results indicated
      that teachers in urban school districts placed a higher priority on self
      actualization and social responsibility than did teachers in rural school
      districts. Conversely, teachers in rural school districts placed a higher
      priority on disciplinary mastery and learning process than did their colleagues
      in urban schools. The discussion focused on differences in school contexts in
      urban and rural schools. Teachers appeared to shape their curriculum to reflect
      the opportunities and constraints within their school settings.

PMID- 7777696
TI  - Effects of goal-setting interventions on selected basketball skills: a single
      subject design.
AB  - The purpose of this investigation was to examine the effects of a goal-setting
      intervention program on selected components of basketball performance over the
      course of a competitive season. A multiple-baseline, single-subject design was
      used with baseline observations on various performance components (e.g.,
      turnovers, rebounds), collected for four elite college basketball players during
      their first eight games of the season. At the midseason break, these players
      selected one aspect of their play that they felt would benefit from improvement.
      A goal-setting program was designed based on the goal attainment scaling
      procedure recommended by Smith (1988), whereby subjects generated numerical
      targets for their chosen components. Performance components were then assessed
      for the next eight games as they had been in the preintervention phase. Following
      the intervention, 3 of the 4 subjects showed consistent improvements in their
      targeted areas of performance. Also, there were no outcome changes in the
      performance components that weren't targeted by the subjects. The findings
      suggest that future studies may benefit from achieving greater ecological
      validity and utilizing alternative designs to the traditional nomothetic
      approaches which may tend to mask positive intervention effects on certain
      individuals.

PMID- 7777697
TI  - Brain slow potentials reflecting successful shooting performance.
AB  - Preparatory brain activity from frontal, centro-lateral, and occipital areas were
      recorded from top-level rifle shooters during shooting performance. The aim of
      the study was to examine the relation of brain slow potentials to qualitative
      (rifle holding) and quantitative (hit) aspects of superior shooting performance.
      For this purpose, a typology of slow potentials (SPs) was developed. The
      resulting SP types were used for unraveling the associations between the
      electrocortical activity and behavioral output. The main finding was that frontal
      positivity was associated with successful performance, but only if the central
      right SP was more negative than the central-left one. This finding was explained
      as showing that, in the case of superior performance, a shooter is able to
      refrain from irrelevant motor activity (frontal positivity) and concomitantly
      concentrate on the visual-spatial processing (right-sided negativity). In all,
      the present experiment suggests that the SPs are consistently related to the
      covert aspects of shooting performance, which lack an overt manifestation. At the
      practical level, this means that the SPs provide a tool for accessing information
      concerning the optimal balance between visual-spatial targeting and motor
      activity which can make a valuable contribution to the understanding of superior
      shooting performance.

PMID- 7777698
TI  - The paradox of the contented working woman in intercollegiate athletics
      administration.
AB  - We investigated the paradox of the contented working woman among middle and first
      line intercollegiate athletics administrators. In this paradox, women report
      lower salaries than men but express comparable job satisfaction. The sample
      comprised 143 women and 371 men in 106 National Collegiate Athletic Association
      (NCAA) Division I-A institutions. Job satisfaction was measured with the Job
      Descriptive Index (Smith, Kendall & Hulin, 1969) and Job in General (Ironson,
      Smith, Brannick, Gibson & Paul, 1989) scales. Analyses revealed the existence of
      the paradox: Women were paid significantly less, but were equally satisfied with
      their jobs. Neither gender was satisfied with promotion opportunities or pay, but
      both were highly satisfied with their jobs in general--another apparent paradox.
      The disproportionate number of male respondents raised questions about gender
      equity in athletics administration.

PMID- 7777699
TI  - Allometric scaling of grip strength by body mass in college-age men and women.

PMID- 7777700
TI  - The effects of a physical fitness program on low-fit children.

PMID- 7777702
TI  - Persistent increased lung response to methacholine after normobaric hyperoxia in
      rabbits.
AB  - This study was performed to determine the occurrence and time course of airway
      hyperreactivity following exposure to normobaric hyperoxia. Twenty-six rabbits
      were studied. Twelve served as control (group 1), and 14 were exposed to
      normobaric hyperoxia (FiO2 > or = 95%) for 48 h: 9 rabbits (group 2) were studied
      after 1 day of recovery in room air and 5 (group 3) after 7 days. The rabbits
      were anesthetized, curarized and artificially ventilated. Respiratory resistance
      (Rrs) and elastance (Ers) and their respective changes induced by cumulative
      doses of aerosolized methacholine were assessed by the multiple linear regression
      analysis of airway pressure, tidal flow and volume. Weight-specific Rrs and Ers
      were significantly higher in group 2 (respectively, 87.7 +/- 6.5 cmH2O.L-1.sec.kg
      and 1100.2 +/- 87.1 cmH2O.L-1.kg, mean +/- SEM) than in group 1 (respectively,
      65.2 +/- 3.2 cmH2O.L-1.sec.kg and 904.4 +/- 49.7 cmH2O.L-1.kg (P < 0.05)), but
      were not different from group 3 (79.4 +/- 7.9 cmH2O.L-1.sec.kg and 952.3 +/-
      125.0 cmH2O.L-1.kg, respectively). The dose of methacholine required to increase
      Rrs by 50% (PDRrs50) was significantly lower in both treated groups: 0.37 +/-
      0.11 mg in group 2 and 0.51 +/- 0.19 mg in group 3 vs 2.07 +/- 0.51 mg in group 1
      (P < 0.05)). PDErs50 was significantly lower in group 2 (0.45 +/- 0.15 mg) and 3
      (0.75 +/- 0.43 mg) compared with controls (1.11 +/- 0.26 mg (P < 0.05)). These
      results show that hyperoxia induces an increase in Rrs and Ers, and airway
      hyperreactivity in the rabbit. The latter is prolonged beyond the immediate post
      exposure period.

PMID- 7777703
TI  - Ventilatory sensitivity to single breaths of CO2 around the control point in man.
AB  - We used single inspiratory capacity breaths of 5, 6 or 8% CO2 in air to obtain
      ventilatory responses in normal subjects, with ensemble averaging of repeated
      runs to define stimulus and response (Protocol 1). We also compared the effect of
      an inspiratory capacity (IC) breath of 8% CO2 with that of two tidal volumes (TV)
      at the same concentration (Protocol 2). The ventilatory response was defined
      first as the ratio of peak changes in ventilation and end-tidal PCO2, and
      secondly by the ratio of their integrals. We obtained group mean values of 0.21 L
      min-1 mmHg-1 for the peak method and 0.80 L min-1 mmHg-1 for integrals (Protocol
      1). There was no significant difference between IC and TV response values
      (Protocol 2) either by the peak method (0.17 vs 0.19 L min-1 mmHg-1) or by
      integrals (0.47 vs 0.53 L min-1 mmHg-1). A significant decrease in ventilation
      was seen in the second tidal volume 8% CO2 breath, even though the stimulus was
      unperceived by four out of five subjects. CO2 responses can be obtained from
      these techniques, but the necessary analysis is too cumbersome for general use.
      Taking a deep breath had no detectable separate effect, but CO2 in the airway may
      depress ventilation even at concentrations which the subject cannot detect.

PMID- 7777701
TI  - Cellular mechanisms of hypoxia-induced contraction in human and rat pulmonary
      arteries.
AB  - The effect of hypoxia was investigated in human (HPA) and rat (RPA) pulmonary
      arteries. Hypoxia-induced contraction was 95 +/- 8.7% and 9.3 +/- 4.8% of the
      control response to K(+)-rich (80 mM) solution in HPA and RPA, respectively (n =
      10). When RPA strips were precontracted with phorbol 12,13 dibutyrate (0.2
      microM), hypoxia elicited a larger contraction (105 +/- 13.4% of the control
      response, n = 8). In both types of artery, hypoxia-induced contraction was
      dependent on the extracellular calcium concentration (66 +/- 8.4% and 40 +/-
      14.4%, reduction for 1.25 mM Ca2+ in HPA and RPA, respectively, n = 6) and was
      inhibited by verapamil (0.05-10 microM) and nifedipine (0.05-1 microM).
      Glibenclamide (5-10 microM) increased the amplitude of hypoxia-induced
      contraction (+42 +/- 5.3%, n = 5). Hypoxia-induced contraction was blocked by
      cromakalim (1 microM) and this effect was reversed by glibenclamide (5 microM).
      This contraction was also inhibited by iodoacetic acid (250 microM). In beta
      escin skinned pulmonary arterial strips, hypoxia had no effect on the calcium
      concentration-tension relationship. These results suggest that the O2 sensor in
      the pulmonary artery is located on the vascular smooth muscle plasmalemma.
      Hypoxia-induced contraction is dependent on calcium influx through voltage
      sensitive calcium channels. Its amplitude is modulated by the functioning of
      potassium channels.

PMID- 7777704
TI  - Effects of carotid body sympathetic denervation on ventilatory acclimatization to
      hypoxia in the goat.
AB  - Our objective was to test the hypothesis that diminishing sympathetic input to
      the carotid body (CB) during prolonged exposure to hypoxia results in increased
      CB afferent activity and increased ventilatory drive. Six awake goats were
      studied prior to and following sectioning of the efferent sympathetic input to
      the CB from the superior cervical ganglion. Ventilatory responses to acute and
      prolonged isocapnic hypoxia (PaO2 40 Torr) and drugs (norepinephrine and
      dopamine, 0.5, 1.0 and 5.0 micrograms.kg-1 min-1) were collected prior to the
      denervation. One week and 3-4 weeks following the sympathetic denervation, the
      animals were restudied following the above protocol. Ventilation was
      significantly lower following sympathetic denervation in normoxia and during the
      hypoxic exposure. However, the response to acute hypoxia and the time-course of
      ventilatory acclimatization to hypoxia was not altered by sympathetic
      denervation. All doses of norepinephrine and dopamine significantly inhibited VE
      in a dose-dependent manner. Sympathetic denervation did not significantly alter
      the response to the drug infusions. The sympathetic innervation to the CB does
      not appear to play a role in either the acute or prolonged ventilatory responses
      to hypoxia in the awake goat, but may affect overall ventilation.

PMID- 7777705
TI  - Oxygen enrichment of room air to relieve the hypoxia of high altitude.
AB  - Recently there has been increasing commercial activity at altitudes of 3500-6000
      m. Examples include new mines in northern Chile at altitudes of about 4500 m.
      Because the workers come from sea level, intolerance of the high altitude is a
      major problem. This degree of hypoxia reduces work capacity, mental efficiency
      and sleep quality. One novel solution is to raise the PO2 of the room air by
      adding oxygen to the room ventilation. This is remarkably effective. For example,
      at altitudes of 4000-5000 m, increasing the O2 concentration by 1% (e.g. from 21
      to 22%) reduces the equivalent altitude by about 300 m. Thus raising the O2
      concentration by 5% at the new mines reduces the equivalent altitude to 3000 m
      which is easily tolerated. The introduction of oxygen concentrators (molecular
      sieve) which require only electrical power makes O2 enrichment feasible. The fire
      hazard is less than in air at sea level. Everybody now expects that the
      ventilation of a room will provide a comfortable temperature and humidity.
      Control of the oxygen concentration can be regarded as a further logical step in
      man's control of his environment.

PMID- 7777706
TI  - Hemoglobin function in a skin-breathing aquatic salamander, Desmognathus
      quadramaculatus.
AB  - Adult black-bellied salamanders (Desmognathus quadramaculatus) were maintained in
      humidified gas at 12 degrees C. Hypoxic salamanders were exposed to 8.1-9.6% O2
      for 10-11 days; normoxic animals were maintained in air (20.9% O2). Hypoxia
      acclimation had no effect on blood O2 affinity, O2 equilibrium curve shape or CO2
      Bohr effect. At pH 7.7, P50 values for hypoxic and normoxic salamanders were 28.2
      +/- 0.4 and 28.6 +/- 0.8 Torr, respectively. Hill plots were curvilinear for both
      treatments; Hill's n increased from values of 2.1-2.2 below 40% saturation (S) to
      2.6 above 50% S. CO2 Bohr slopes (delta log P50/delta pH) were -0.19 +/- 0.01 and
      -0.23 +/- 0.02 for hypoxic and normoxic animals, respectively. Resting MO2 for a
      separate group of normoxic salamanders fell into two categories; low MO2 (1.46 +/
      0.16 mumol.g-1.h-1) and high MO2 (3.51 +/- 0.52) animals. Exposures to 5 and 25%
      CO had no effect on MO2 of low metabolism Desmognathus, but reduced MO2 of high
      metabolism animals to levels similar to the low MO2 group. Hb-O2 binding results
      suggest that D. quadramaculatus blood is ideally suited for respiratory O2
      exchange during normoxic activity. While submerged and inactive, hypoxic boundary
      layers surround the skin-breather. Contributions of Hb during hypoxic inactivity
      may be to augment O2 content and increase blood buffering capacity.

PMID- 7777707
TI  - Effects of carbonic anhydrase inhibition on the acid base status in lamprey and
      trout.
AB  - Inhibition of red cell carbonic anhydrase (CA) activity resulted in the rapid
      development of a respiratory acidosis (0.25 pH depression within 15 min post
      injection) in the blood of trout. In the lamprey, however, the onset of the
      respiratory acidosis was delayed and its magnitude was less (0.18 pH depression
      at 6 h post-injection). Erythrocyte pH of both species decreased by about 0.12
      units by 1 h after CA inhibition. These data, combined with the lack of rapid
      anion (Cl-/HCO3-) exchange in the red cells of agnathans but not in other lower
      vertebrates, support the hypotheses that (1) the majority of total CO2 in lamprey
      is transported within the erythrocyte, and (2) the limiting step in the evolution
      of a functioning Jacobs-Stewart cycle, and thus the evolution of the common
      mechanism of systemic CO2 transport in vertebrate blood, was the incorporation of
      the band-3 anion exchange protein into the membrane of the red cell.

PMID- 7777709
TI  - Factors limiting maximal O2 consumption: effects of acute changes in ventilation.
AB  - The response of the O2 transport system to acute changes in alveolar ventilation
      (VA) was analysed. The fractional limitations to maximal O2 consumption (VO2max)
      imposed by the lungs (ventilation, FV, and lung-blood transfer, FL), the
      cardiovascular system (FQ), and peripheral O2 diffusion (Fp) were calculated
      according to a multifactorial model. A reference set of data, describing the
      status of O2 transport at maximal exercise in normoxia was used. The effects of
      VA on VO2max were assessed on the assumption of a constant reference O2 flow in
      mixed venous blood (QVO2). The changes in reference data after given independent
      changes in VA were calculated by an iterative procedure, until the VO2max value
      compatible with the constant reference QVO2 was found, at PIO2 values of 150
      (normoxia), 130, 110 and 90 Torr. The VO2max changes in normoxia were less than
      expected assuming a linear O2 transport system, because of the flatness of the O2
      dissociation curve around normoxic PO2. This affected the cardiovascular
      resistance to O2 flow, and its changes counterbalanced the effects on VO2max of
      induced changes in VA. This phenomenon was reversed in hypoxia, as the steep part
      of the O2 dissociation curve was approached. The fractional limitations to VO2max
      in normoxia resulted as follows: FV and FL provided between 5 and 12%, FQ between
      59 and 78%, and Fp between 13 and 19% of the overall VO2max limitation. In
      hypoxia, FV and FL increased and FQ decreased. At PIO2 = 90 Torr, when VA was
      halved, FV, FL, FQ and Fp amounted to 0.35, 0.31, 0.20 and 0.14, respectively.

PMID- 7777708
TI  - Effect of phorbol myristate acetate-induced lung injury on airway blood flow.
AB  - The effects of phorbol myristate acetate (PMA) induced lung injury on the
      pulmonary and systemic blood flow contributions to the trachea and main bronchi
      (upper airways) were assessed in anesthetized dogs by injecting 15 microns
      radiolabeled microspheres into the right and left heart, respectively. Upper
      airway blood flow was studied in lungs given the following treatments: (1) PMA;
      (2) PMA in lungs pretreated with the thromboxane synthetase inhibitor OKY-046,
      and (3) PMA in lungs pretreated with the antioxidant catalase. After microsphere
      injections, the tracheal cartilage, tracheal muscle-mucosa, and main bronchi were
      excised. The results of this study indicate that under normal conditions,
      tracheal mucosa [33-52 ml.min-1.(100 g)-1] and tracheal cartilage [18-27 ml.min
      1.(100 g)-1] blood flow is primarily systemic while both the systemic [12-18
      ml.min-1.(100 g)-1] and pulmonary [6-12 ml.min-1.(100 g)-1] circulations
      contribute substantial amounts of blood flow to the main bronchi. PMA
      significantly decreased the systemic blood flow contribution to the tracheal
      cartilage and muscle-mucosa, and both the systemic and pulmonary blood flow
      contributions to the main bronchi to less than 50% of control values, an effect
      that was inhibited by catalase, but not by OKY-046. These results suggest that
      the effect of PMA-induced lung injury on the pulmonary and systemic blood flow
      contributions to the upper airways is at least partially mediated by oxygen
      radical production, probably hydrogen peroxide (H2O2), but not by the production
      of the arachidonic acid metabolite thromboxane.

PMID- 7777710
TI  - Gas conductance and metabolism of shorebird eggs: variation within and between
      species.
AB  - Fresh egg mass (M0; g), water vapor conductance of the egg shell (GH2O;
      mg.[Torr.d]-1), and neonate mass (Mn; g) were measured in the ruff (Philomachus
      pugnax), common redshank (Tringa totanus), northern lapwing (Vanellus vanellus),
      black-tailed godwit (Limosa limosa), and Eurasian curlew (Numenius arquata). In
      addition, the development of embryonic O2 consumption (MO2; ml.d-1) and CO2
      production (MCO2; ml.d-1) were measured in these species, except the ruff. In
      northern lapwing and black-tailed godwit eggs the coefficients of variation for
      GH2O were 3.8 and 2.3 times higher, respectively, than those for M0. In these two
      species only about 10% of the variation for GH2O was attributable to M0, and
      about 77% to differences between clutches, suggesting a strong maternal
      component. In the northern lapwing, embryonic MO2 plateaued prior to internal
      pipping, but not in the common redshank and black-tailed godwit. The latter
      result is in contrast to embryonic patterns previously described for other
      precocial species. In shorebirds the occurrence of an embryonic MO2 plateau is
      not related to the neonatal level of cold-induced thermogenesis.

PMID- 7777711
TI  - [Trends in thyroid surgery at the Instituto Nacional de la Nutricion Salvador
      Zubiran].
AB  - The diagnosis and treatment of thyroid disease has significantly changed with
      time. With the aim of analysing changes in thyroid surgery in our institution, a
      representative sample of patients from the first three years in four decades
      (1960-1992) were comparatively analysed. In the sixties, the diagnosis of thyroid
      cancer was made during surgery; by contrast, this diagnosis was correctly done by
      fine needle aspiration (FNA) in most patients of the last decade. Thyroid
      lobectomy, infrequently used in the treatment of differentiated thyroid carcinoma
      in earlier times, has now been abandoned and currently most patients undergo
      total or near-total thyroidectomy. Complications such as hypoparathyroidism and
      recurrent laryngeal nerve paralysis have importantly decreased with time and were
      not seen in the last decade. A trend toward an earlier diagnosis of thyroid
      carcinoma was also observed. In summary, the number of thyroidectomies for benign
      diseases has been importantly reduced by the use of FNA with the proportional
      increment of surgery for malignant disease.

PMID- 7777712
TI  - [Response of insulin and C-peptide to a mixed meal in non-insulin-dependent
      diabetics treated with insulin and chlorpropamide].
AB  - Glucose control in NIDDM is prone to progressive deterioration due to secondary
      failure to oral hypoglycemic therapy. Insulin may subsequently be required for
      optimal control in spite of peripheral hyperinsulinemia. In Mexico, diabetes
      associated with obesity is common. We therefore designed a prospective study
      combining insulin and chloropropamide in order to evaluate any improvement in
      insulin response to a standardized meal load and a consequent amelioration of
      glucose control. METHODS. Twenty diabetic patients with secondary failure to full
      doses of hypoglycemic drugs and moderate hyperglycemia were recruited. Therapy
      was initiated with human insulin 20 IU/day and 500 mg cholopropamide, titrating
      insulin dosage in order to achieve euglycemia. Before treatment and at the end of
      the study period, a glucose/insulin/C peptide response curve to a mixed
      standardized meal was performed. Blood glucose, serum lipids fructosamine and
      glycosylated hemoglobin levels were also determined. All patients were followed
      by capillary glucose measurements three times a week and glucose and fructosamine
      concentrations every two weeks during the study period. RESULTS. All patients
      required less insulin, and glucose control improved significantly. Glucose,
      fructosamine and glycosylated hemoglobin levels decreased from 262 mg/dL, 369
      mmol/L and 14% to 111 mg/dL, 252 mmol/L, and 8% respectively; all differences
      were statistically significant. Insulin and C peptide levels increased
      significantly from 22.2 mU/mL and 1.65 ng/mL to 29.8 mU/mL and 1.97 ng/mL,
      respectively. When we measured the area under the curve, total values improved
      from 110 and 7.69 to 127 and 9.37, respectively; this was also statistically
      significant. Lipids levels decreased significantly, including triglicerides,
      total and LDL cholesterol whereas HDL cholesterol levels increased. CONCLUSIONS.
      Glucose control improved in our patient cohort the pancreatic insulin response
      probably due to a more adequate glycemic microenvironment and a possible enhanced
      exogenous and endogenous insulin function.

PMID- 7777713
TI  - [Productivity before and after installing a computerized system in a clinical
      laboratory].
AB  - A laboratory information system was installed on January 1991 in the clinical
      laboratory of the Instituto Nacional de Cancerologia. Our main objective was to
      speed up the administrative work and integrate its operations under one
      management. We evaluated the productivity before (1990) and after installing the
      system (1992), using the parameters proposed by the College of American
      Pathologists. In 1990 there were 30,764 patients who underwent 191,070 laboratory
      studies, resulting in 131 tests/clerk/day and 21 patients/clerk/day. In 1992
      these figures were 43,679 patients, 245,280 tests, 168 tests/clerk/day and 30
      patients/clerk/day. The productivity indexes showed a 41% increase in the number
      of patients and of 28% in the number of tests. In addition, the laboratory
      personnel started activities in teaching and research which had been non existent
      before, i.e. in 1992 they started three research projects and participated in
      three national or international scientific meetings. In summary, no additional
      personnel was required even though there was an increase in the workload,
      basically due to a more efficient organization of the work when using a
      computerized system.

PMID- 7777715
TI  - [Cystic neoplasms of the pancreas: report of 3 cases presenting diagnostic
      difficulties].
AB  - Cystic tumors of the pancreas are rare, although their detection has become more
      frequent with the advent of imaging techniques. In most cases, surgical
      exploration and often resection of the cystic neoplasm is necessary for
      establishing a definitive diagnosis; resection remains the treatment of choice.
      This paper describes three patients who underwent surgery because of cystic
      tumors of the pancreas. Abdominal pain was the main clinical manifestation;
      abdominal CT showed the cystic tumor in all three cases. Surgical exploration and
      resection was successfully accomplished in all. The definitive histological
      diagnoses were serous cystadenoma, multicystic hamartoma, and choriocarcinoma
      metastatic to the head of the pancreas. To our knowledge, the last two are the
      first ones with such diseases reported in the literature.

PMID- 7777714
TI  - [Lymph node biopsy using fine-needle aspiration. Clinical and cytohistological
      correlation in 179 cases].
AB  - We reviewed the institutional experience with fine needle aspiration biopsy
      (FNAB) of peripheral lymph nodes in the Instituto Nacional de la Nutricion
      Salvador Zubiran from January 1988 to December 1992. A total of 298 FNAB had been
      performed in 288 patients. Aspirates with just blood, few stromal cells or with
      desiccation changes were excluded (63 cases), as well as those in whom it was not
      possible to establish a clinical or morphologic correlation (56 cases). In the
      179 cases included, the FNAB diagnosis was histologically confirmed in 137 and in
      42 cases the correlation was established by clinical follow-up and response to
      treatment. According to the diagnosis, aspirates were divided in benign and
      malignant in the analysis. We observed 70 aspirates (39%) with benign lesions and
      109 (61%) with primary or metastatic neoplastic cells. The most frequent benign
      diagnosis was hyperplasia followed by epithelial metastatic neoplasms. In 25
      aspirates there was a discrepant cyto-histologic diagnosis but only six were
      false negatives. No false positive or complications were identified. The FNAB in
      our cases showed: sensitivity 95%, specificity 100%, positive predictive value
      100% and negative predictive value 91.4%. Our data support the value of FNAB as a
      reliable, safe, inexpensive and easy to perform method in the diagnosis of lymph
      node enlargements. Thus, we believe this method should be recommended as the
      initial approach in the study of lymphadenopathies.

PMID- 7777716
TI  - [Hormone replacement therapy in the climacteric].
AB  - Menopause is the physiologic state that is a consequence of the cessation of
      ovarian function. A large number of vasomotor, psychological and gynecological
      symptoms have been associated with menopause. Hormonal replacement therapy is
      effective in treating these conditions. The use of estrogens and progestins
      including dosages, routes of administration and their advantages and
      disadvantages are reviewed in this article. In addition, hormonal replacement
      therapy may reduce the risk of atherosclerosis and prevent the osteoporosis of
      climateric women. Hormonal therapy is associated with side effects but they do
      not contraindicate its use.

PMID- 7777717
TI  - [Medical attitude and legal concepts about some patient rights].
AB  - OBJECTIVE: To explore medical attitudes toward some patient rights and some legal
      aspects involving medical practice in Mexico. DESIGN: Prospective, transversal
      and nonrandomized study using a multiple choice survey of 12 questions. SETTING:
      An urban general hospital in the city of Aguascalientes, Mexico. SUBJECTS:
      Seventy five physicians at the beginning of a specialty medical residency. MAIN
      MEASUREMENTS: They covered four areas: the patient's right to decide, the medical
      attitude of benefit to the patient above all considerations, the patient's
      capacity to make decisions, and some legal aspects of medical practice. RESULTS:
      34% of the physicians gave the patient the right to decide, 34% were opposed, and
      32% referred it to a third person; 26% showed a benevolent attitude to the
      patient, 69% did not and 5% referred it; 73% recognized the patient's capacity of
      decision and 27% did not; only 40% knew about legal aspects of medical practice.
      CONCLUSIONS: This study suggests an important lack of knowledge of the Mexican
      physicians in regard to patient rights and to legal aspects in medical practice.

PMID- 7777718
TI  - [Renal and extra-renal mechanisms of sodium and water retention in cirrhosis with
      ascites].
AB  - In this work we analyze the renal and systemic factors involved in the sodium
      retention in two conditions: in extracellular volume depletion and in edema
      forming states, particularly liver cirrhosis with ascitis. In this paper we
      accept that the volume loss of body fluids stimulates the "effective arterial
      blood volume" (VAE). This term results from a decrease in the arterial blood
      volume secondary to a fall in cardiac output or a peripheral arterial
      vasodilatation. The reduction in the VAE stimulates: the high pressure
      baroreceptors (carotid sinus and aortic arch); the intrarrenal mechanisms, such
      as the yuxtaglomerular apparatus and the renin angiotensin aldosterone system;
      the sympathetic adrenergic system; the non osmotic release of antidiuretic
      hormone; prostaglandins (PGE1, Tromboxane) and endothelin; and inhibits the
      atrial natriuretic peptide. We also describe the sodium transport mechanisms
      along the nephron during physiological conditions and after volume depletion, and
      in edema formation states, specially hepatic cirrhosis with ascitis. We speculate
      that the intrarenal mechanisms are more important and persistent than the
      systemic mechanisms. It is possible that the sodium retention of these states
      might be the result of direct stimuli of the tubular sodium transport mechanisms
      in the different segments of the nephron, mediated by the co and counter
      transports, ATPase activity or by the second messengers cyclic AMP and cyclic
      GMP. The clonation and structural characterization of the different sodium
      transports may help us to establish, more precisely, the intracellular tubular
      mechanisms responsible for the tendency of the body to retain sodium. The amount
      of information generated in the future may help us to demonstrate, with more
      precision, the mechanisms responsible for the sodium retention and excretion in
      normal and pathological conditions, particularly the edema forming states such as
      cardiac failure, nephrotic syndrome and hepatic cirrhosis with ascitis.

PMID- 7777719
TI  - [Smoking and the "protective effect "].

PMID- 7777720
TI  - [Essential thrombocythemia].

PMID- 7777721
TI  - Endocrine causes of hypertension.
AB  - Hypertension is a prominent feature of various endocrine diseases including
      primary aldosteronism, pheochromocytoma (considered separately in this issue),
      Cushing's syndrome, adrenal enzymatic deficiencies like 11 beta-hydroxylase, 17
      alpha-hydroxylase deficiencies, and congenital or acquired 11 beta-hydroxysteroid
      dehydrogenase deficiencies. Patients with 11 beta-hydroxylase deficiency cannot
      convert 11-deoxycortisol or deoxycorticosterone into the active glucocorticoids
      cortisol and corticosterone, respectively. The increase in the powerful
      mineralocorticoid deoxycorticosterone, resulting from the enzymatic block,
      promotes sodium retention, hypertension, and hypokalemia. Females who have the
      deficiency also show signs of virilization due to the shunting of the precursors
      to the synthesis of adrenal androgens. Patients with 17 alpha-hydroxylase
      deficiency present with hypertension and/or hypokalemia, and male members exhibit
      pseudohermaphroditism with no development of male sexual characteristics. The
      defect is due to the lack of 17-hydroxylated steroids, which are necessary
      precursors in the synthesis of androgens and estrogens. The hypertension is due
      to the accumulation of the mineralocorticoid deoxycorticosterone. The
      mineralocorticoid receptor derives its specificity from the co-expression of the
      11 beta-hydroxysteroid dehydrogenase, which converts the active steroids
      corticosterone and cortisol to the inactive 11-dehydrocorticosterone and
      cortisone, preventing their interaction with the receptor. Congenital absence of
      the 11 beta-hydroxysteroid dehydrogenase or acquired deficiency induced by
      consuming licorice or its derivatives result in occupancy of the
      mineralocorticoid receptor by cortisol and corticosterone, and production of
      mineralocorticoid-type hypertension.

PMID- 7777722
TI  - Primary aldosteronism.
AB  - Primary aldosteronism occurs much more commonly than generally appreciated.
      Diagnosis is facilitated by measuring urinary aldosterone excretion in
      conjunction with determination of the level of plasma aldosterone suppression
      after infusion of 2,000 mL of normal saline over 4 hours. Multiple diagnostic
      procedures are required to determine the specific type of primary aldosteronism.
      Patients with aldosterone-producing tumors, unilateral adrenal hyperplasia, and
      primary adrenal hyperplasia are treated surgically, whereas those with bilateral
      zone glomerulosa hyperplasia and glucocorticoid-remediable aldosteronism are
      treated medically.

PMID- 7777723
TI  - Pheochromocytoma.
AB  - Although a rare cause of secondary hypertension, timely recognition and
      management of pheochromocytoma are crucial to prevent serious complications that
      can result from this tumor. The cause of pheochromocytoma is unknown. It may be a
      component of a polyglandular endocrine disturbance or associated with other
      neuroectodermal tumors, but usually it is recognized as an isolated finding.
      Because of the variable clinical manifestations, proper diagnostic quest for
      pheochromocytoma depends on a high index of suspicion. Availability of
      biochemical assays for catecholamines and their metabolites has improved our
      ability to establish or exclude the diagnosis of pheochromocytoma in a suspected
      patient. However, before ordering the biochemical tests, it is important to be
      certain that the patient has not taken any drugs or substances that can lead to a
      spurious value. Confirmatory localization of pheochromocytoma has become a
      straightforward exercise owing to current radiological techniques. Blockade of
      the effects of catecholamines provides the pharmacological basis for medical
      treatment of pheochromocytoma. Surgical removal of the tumor is the treatment of
      choice for most patients with pheochromocytoma.

PMID- 7777725
TI  - Renovascular hypertension.
AB  - Renovascular hypertension is one of the more common causes of secondary
      hypertension. The true prevalence of this condition is not known, because only a
      selected few with hypertension are considered for thorough diagnostic work-up.
      The higher incidence figures come from centers with a special interest in this
      disease. The ability of a clinician to detect renovascular hypertension has
      improved substantially, thanks to the advances in radiology. The predominant
      mechanism of blood pressure elevation from renal ischemia is activation of the
      renin-angiotensin system. Clinically, the pathological lesions that cause renal
      artery stenosis are atherosclerosis and fibromuscular dysplasia; the former is
      typically seen in older men, and the latter is typically found in young women.
      Suspicion of the presence of renovascular disease should prompt the physician to
      obtain appropriate screening and confirmatory tests. Once diagnosed, the
      management of patients with renovascular hypertension requires a carefully
      planned multidisciplinary approach to offer the patient a best possible
      therapeutic option, with surgical revascularization or balloon angioplasty, or
      chronic medical therapy. However, these options are not mutually exclusive. The
      best long-term results are obtained with surgical therapy. Although balloon
      angioplasty is being increasingly used perhaps as the preferred initial
      therapeutic procedure for many patients with renal artery stenosis, long-term
      results comparable with surgery are not yet available. The ideal rational therapy
      for patients with renal artery stenosis is reperfusion of the ischemic kidney
      either by surgical correction or by balloon dilation. The aim is not only to
      improve the blood pressure control, but also to prevent and at times to reverse
      renal failure. Although effective antihypertensive drugs have become available,
      the role of medical management of renovascular hypertension is shrinking and
      should be limited to patients who have contraindications to or unwilling to
      undergo corrective procedures to relieve renal ischemia.

PMID- 7777724
TI  - Renal parenchymal disease and hypertension.
AB  - Renal parenchymal disease is the most common cause of secondary hypertension,
      accounting for 2.5% to 5.0% of all cases. Hypertension associated with renal
      parenchymal disease occurs as a complication of a wide variety of glomerular and
      interstitial renal diseases and may accelerate the decline in renal function if
      inadequately controlled. Renal parenchymal hypertension most probably represents
      the combined interactions of multiple independent mechanisms: potential factors
      include impaired sodium handling leading to volume expansion, perturbations of
      the renin-angiotensin system, alterations in endogenous vasodepressor compounds,
      and possibly increased activity of vasoactive substances. The past several years
      have witnessed newer insights into both the pathophysiology and the therapeutics
      of this disorder. The characterization of endothelin and the nitric oxide (NO)
      arginine pathway and their roles in biology and medicine has provided additional
      new insights with regard to the pathogenesis of hypertension in renal parenchymal
      disease. For example, methylated L-arginine derivatives that possess NO synthase
      inhibitor capabilities including NG-N-dimethylarginine and N-monomethyl-L
      arginine are found in human plasma and in urine. Patients with chronic uremia
      have impaired elimination of these compounds, and circulating concentrations of
      these compounds may increase sufficiently to result in inhibition of NO
      production. Thus, accumulation of endogenous NO synthase inhibitors might
      contribute to the hypertension of advanced renal failure. Similarly, it has been
      proposed that increased endothelium-derived endothelin that results from
      hypertensive injury to vascular endothelium could lead to further
      vasoconstriction and worsening of hypertension. Additional insight into this
      fascinating problem must await further biochemical characterization of some of
      the mediators and a more precise delineation of their pathophysiological role.

PMID- 7777726
TI  - Hypertension induced by drugs and other substances.
AB  - The purpose of this article is to review and summarize the literature regarding
      the effects of medications and other substances on blood pressure. Many
      substances are known to cause or exacerbate hypertension, including sodium
      chloride, substances of abuse, nonprescription sympathomimetics, nonsteroidal
      anti-inflammatory drugs, sex steroids, immunosuppressive therapies,
      erythopoietin, antidepressants, ergot alkaloids, anesthetic agents, and other
      substances. With the population aging, the increasing incidence of polypharmacy,
      and the growth of over-the-counter pharmacological agents, including those which
      were previously available only by prescription, drug-induced hypertension is
      assuming heightened importance. Furthermore, these agents represent an important
      modifiable cause of secondary hypertension, and it is imperative that clinicians
      recognize this causal relationship.

PMID- 7777727
TI  - Coarctation of the aorta.
AB  - Coarctation of the aorta is an important and treatable cause of secondary
      hypertension. The prevalence of aortic coarctation varies from 5% to 8% of all
      congenital heart defects. Neonates and infants, especially when they have other
      associated cardiac defects, may present with signs and symptoms of heart failure.
      Children beyond infancy are usually asymptomatic and are most often diagnosed
      because of a murmur or hypertension on a routine examination. Palpation of the
      brachial and femoral pulses simultaneously will show decreased and delayed or
      absent femoral pulses. On measurement of blood pressure from arms and legs, a
      pressure difference of more than 20 mm Hg in favor of the arms may be considered
      as evidence for coarctation of the aorta. The coarctation can be demonstrated on
      suprasternal notch two-dimensional echocardiographic views along with increased
      Doppler flow velocity across the coarctation site. Cardiac catheterization shows
      significant peak-to-peak systolic pressure gradient across the coarcted segment,
      and aortography demonstrates the degree and nature of the aortic narrowing.
      Aortic coarctation may be relieved by surgery or by balloon angioplasty; in
      asymptomatic patients, therapy during the ages of 2 and 5 years is suggested.
      Surgical relief of coarctation may be achieved by resection and end-to-end
      anastomosis or by subclavian flap or prosthetic path angioplasty. Although
      results of surgery are generally good, there are some problems with the
      procedure, namely, mortality, morbidity and recoarctation, particularly in
      neonates and young infants and development of aneurysm, paraplegia, and
      paradoxical hypertension. Balloon angioplasty has been used by some cardiologists
      with resultant relief of obstruction, but concern for development of aneurysms
      and arterial complications remain. Although the immediate results for surgical or
      balloon therapy for isolated coarctation are good, long-term prognosis is largely
      undetermined. Limited long-term follow-up studies suggest significantly lower
      survival rates compared with normal population; age at intervention and the
      degree and duration of hypertension before intervention may affect long-term
      survival.

PMID- 7777728
TI  - Evidence based practice.

PMID- 7777729
TI  - Compliance, clinical effects, and factors predicting weight reduction during a
      very low calorie diet regime.
AB  - OBJECTIVE: To study compliance, clinical effects, and factors predicting weight
      reduction in obese patients treated with a very low calorie diet (VLCD) regime.
      SETTING: A general practice in Oslo, Norway. SUBJECTS: 253 obese volunteers, aged
      15-72, with a mean body mass index (BMI) of 33.4 (25-51) kg/m2. DESIGN: Open, non
      comparative trial. Patients used a VLCD for eight consecutive weeks to achieve
      weight loss. The following were recorded every second week: weight, blood
      pressure, anthropometric measurements, compliance, side-effects, and patient
      acceptability. Blood parameters were tested before and after the trial. RESULTS:
      VAS-measurements showed that patients found it easy to comply with treatment, and
      87.0% completed the study. Mean weight loss was 13.2 (2-33) kg. Blood pressure,
      serum lipids, and anthropometric measurements were significantly reduced. Side
      effects were few and occurred mainly during the first two weeks of the trial.
      Main factors predicting weight reduction were gender, initial weight, initial
      BMI, and age. There was no correlation between weight loss and duration of
      obesity or reported number of weight reduction attempts. By VAS-measurements good
      acceptability of satiety and taste was recorded, and patients reported improved
      physical fitness and better quality of life after weight reduction.

PMID- 7777730
TI  - Current health as a general health indicator. II: Evaluation of reliability and
      validity.
AB  - OBJECTIVE: To examine whether a Current Health scale produces reliable and valid
      measures of self perceived health status. DESIGN: Examination of reliability,
      based on internal consistency (Cronbach's alpha coefficient). Examination of
      validity focusing on convergent and discriminant validity. SUBJECTS: 2263 male
      and female heads of households who participated in The Danish Health Study 1982
      83. The survey used items pertaining to health status from Rand's Health
      Insurance Study. RESULTS: The scale has acceptable properties and is preferable
      to a single item measure of general health status. It can be used in general
      practice.

PMID- 7777731
TI  - Characteristics of attenders and non-attenders at health examinations for
      ischaemic heart disease in general practice.
AB  - OBJECTIVE: To clarify the importance of health beliefs and some socio-demographic
      data for accepting an invitation to take part in a health examination by
      comparing attenders and non-attenders with respect to health beliefs and social
      status. DESIGN: Multipractice study including questionnaires for men. SETTINGS:
      65 GPs in two areas in the county of Aarhus, Denmark, invited 2452 40-49 year old
      men to a health examination for ischaemic heart disease. The examination was free
      in one area, whereas there was a fee in the other. All 1272 attenders and
      423/1180 non-attenders completed the questionnaire. RESULTS: The attendance rate
      was 66% in the area with free examination and 37% in the fee-paying area. The
      attendance was significantly higher for cohabitants than for single men in both
      areas. There was a slightly higher attendance of men with an occupational
      training in both areas, but the difference was not significant. In general, all
      agreed that IHD is a serious disease, and that it can be prevented by a personal
      effort. There were only minor differences in the attenders' and non-attenders'
      health beliefs. CONCLUSION: The main conclusion is that 40-49 year old men are in
      general concerned about IHD. Whether they want to have a health examination for
      IHD depends mainly on its availability (exemplified here as fee versus free),
      since the differences were small with respect to health beliefs between attenders
      and non-attenders.

PMID- 7777732
TI  - To prescribe--or not to prescribe--antibiotics. District physicians' habits vary
      greatly, and are difficult to change.
AB  - OBJECTIVE: To study how different doctors at a primary health care centre
      prescribe antibiotics for respiratory tract infections, and, if possible, to
      identify reasons for differences in prescribing habits. DESIGN: All medical
      visits to the health centre because of respiratory tract infections during
      January and February were studied in four consecutive years (1990-1993). The
      principles for prescribing antibiotics were discussed continuously to obtain more
      uniform routines. SETTING: The health centre of Teleborg serves a suburban
      district with about 10,000 inhabitants, and rural surroundings with another 2,000
      inhabitants. SUBJECTS: All 2150 visits because of respiratory tract infections
      (except acute otitis media) made during the studied eight months. All physicians
      employed at the health centre (five physicians were employed for the whole study
      period). MAIN OUTCOME MEASURES: Percentage of visits resulting in prescription of
      antibiotics, and diagnoses given. RESULTS: Antibiotics were prescribed for 76% of
      the patients by the most generous doctor, but only for 21% by the most
      restrictive one. The use of diagnoses suggesting bacterial infection varied in a
      similar way. Otherwise, the patients of the various doctors looked very much the
      same, and the return visits for the same complaint during the study months were
      about 5% for all doctors. In spite of the on-going policy discussions, the
      doctors kept their positions as generous or restrictive prescribers throughout
      the study period. CONCLUSION: Doctors have an individual and very constant
      pattern of prescribing antibiotics, and it seems that the diagnoses are often
      given to justify the treatment, rather than the other way round.

PMID- 7777733
TI  - Are frequent attenders of primary health care distressed?
AB  - OBJECTIVE: To measure the level of distress among frequent attenders of primary
      health care. DESIGN: A cross-sectional study. SETTING: Two public primary health
      care stations in Turku, south-western Finland PARTICIPANTS: 96 frequent attenders
      (eleven or more visits to a physician during the previous 12 months) and 466
      control patients. MAIN OUTCOME MEASURE: SCL-25, GP evaluations, self-reported
      symptoms and self-experienced need for care. RESULTS: Frequent attenders were
      significantly more distressed than other patients in primary care. However, their
      self-experienced need for psychiatric care was very low and it did not differ
      from other patients self-experienced need. The GPs estimated that over 1/3 of
      frequent attenders suffered from mixed (physical and psychiatric) illnesses and
      over 1/2 from subclinical or clinical psychiatric symptoms. The corresponding
      proportions for other patients were significantly lower.

PMID- 7777734
TI  - Measurement of C-reactive protein and the erythrocyte sedimentation rate in
      general practice.
AB  - OBJECTIVE: To evaluate the NycoCard:::CRP test (Nycomed A/S, Oslo, Norway) in
      relation to ESR in consecutive patients in general practice. NycoCard:::CRP test
      was also compared with a reference method for CRP quantitation. DESIGN: C
      reactive protein and ESR were simultaneously measured in 607 consecutive patients
      at four community health centres. SETTING: Four community health centres in
      southern Sweden. RESULTS: We obtained consistent results in 71% of the cases. In
      20% CRP was increased more than ESR, while ESR was increased more than CRP in 9%.
      CRP was increased in 16% while ESR was below the upper reference limit for age
      and sex. On the other hand ESR was increased while CRP was below 10 mg/l in five
      % of the patients. In most of the cases where there was a discrepancy- for
      example, in infectious diseases-the CRP results were more clear-cut. Using the
      NycoCard test the CRP concentration can be measured directly in a whole blood
      sample with the result available within minutes. Comparison of the NycoCard:::CRP
      test with the reference method for CRP quantitation showed good agreement.
      CONCLUSION: In clinical situations with suspected inflammatory diseases, the CRP
      test appears often to yield more useful results than the ESR. The NycoCard:::CRP
      test is suitable for use in general practice.

PMID- 7777735
TI  - Do out-of-office laboratory tests affect diagnoses in general practice?
AB  - OBJECTIVE: To find out whether the GP diagnosis changed by out-of-office
      laboratory test results and whether his diagnosis became more certain. DESIGN:
      Descriptive study. SETTING: Dutch survey of morbidity and interventions in
      general practice: stratified random sample of 161 GPs with a total list of
      335,000 patients. SUBJECTS: 2,081 episodes of illness with at least one
      consultation with clinical chemistry, haematology, or serology tests and at least
      one follow-up consultation. MAIN OUTCOME MEASUREMENTS: Change in ICPC component
      or chapter between the consultation in which a laboratory test was ordered and
      the follow up contact; change in exact ICPC code in cases with important diseases
      (infectious diseases, haematological disorders, endocrine abnormalities, auto
      immune processes and malignancies (n = 330)); change in certainty of a diagnosis
      and change in somatic/psychosocial orientation. RESULTS: After laboratory tests
      done in the first consultation the ICPC component changed in 46% of the
      diagnoses. Of the diagnoses made in first consultations without laboratory tests
      41% changed in the follow up consultation. The diagnosis after laboratory tests
      was the same as before in 51% of the consultations with important diseases.
      Certainty about a diagnosis increased significantly after laboratory tests (p <
      0.001). An abnormal laboratory result did not affect the clinical certainty of
      the general practitioner or the percentage of altered diagnoses. CONCLUSION: The
      usefulness of tests should be assessed not only in terms of the number of
      diagnoses changed or of the percentage of abnormal results, but also in terms of
      the changed certainty concerning a diagnosis.

PMID- 7777736
TI  - Physical examinations and laboratory tests in antenatal care visits in Denmark.
      Do reported practice and current official guidelines concord with results of
      literature reviews? A nationwide study of the public scheme of shared antenatal
      care in general practice, centres of midwifery and hospital outpatients' clinics.
AB  - OBJECTIVE: To analyse physical examinations and laboratory tests reported in
      antenatal care visits in relation to official guidelines and reviews of
      appropriateness. DESIGN: A nationwide cross sectional study based on
      questionnaires completed by general practitioners (GPs), midwives, and hospital
      doctors. Physical examinations and laboratory tests in connection with one
      specific visit were reported. SUBJECTS: The questionnaires were completed by 722
      GPs (61% of eligible from a random sample), 584 midwives (86% of eligible), 250
      hospital doctors who made health examinations in pregnancy, week 16-18 (63% of
      eligible), and 181 hospital doctors who saw women with at-risk pregnancies (55%
      of eligible). RESULTS: General practice: weight, blood pressure (BP) measurement,
      and test for proteinuria were reported in more than 90% of visits. Urine culture
      was reported in 46%, and cervical smear in 41% of first visits. Rubella antibody
      test at the first visit was only reported in 23% of nulliparae. Vaginal
      examination was reported in 95% of first visits. Fewer were reported in second
      (27%) and third (48%) routine visits during pregnancy. Midwives: checks of BP,
      oedema, and proteinuria were reported in more than 95% of visits irrespective of
      week of gestation. Vaginal examination was reported in about a third of checkups.
      Hospitals: vaginal examination was reported in 66% of checkups in at-risk
      pregnancies. CONCLUSIONS: A surplus of resources were spent on (repeat)
      examinations and tests with little or no documented benefit. Cervical cytology
      was grossly overused. Urine culture and rubella serology were not sufficiently
      applied.

PMID- 7777737
TI  - Patients' stories: science, clinical facts or fairy tales?
AB  - OBJECTIVE: To explore potentials and attributes of the qualitative research
      interview as a tool for acquiring knowledge about illness. DESIGN: A qualitative
      approach, comparing knowledge about consultations originating from 1) data from
      interviews with immigrant female patients, and 2) evaluative data from
      registration forms from the doctors. SETTING AND SUBJECTS: 24 Pakistani female
      patients, recruited from the appointment list at a primary health care centre in
      central Oslo were interviewed in their homes. Evaluation forms were filled in by
      the ten physicians consulted. MAIN OUTCOME MEASURES: Illness knowledge derived
      from different communicative contexts. Contextual prerequisites suggest potential
      roads to the inquiry of illness applicable in the clinical context. CASE STORIES:
      Patients' illness perspectives and resources were probably encouraged in the
      interview by means of discourse underlining the women's resources. This position
      may have emerged because the women were actually consulted by the interviewer.
      Dialogues actively seeking out the other person's illness perspective, as
      recommended in the qualitative interview, seem to encourage adequate exchange of
      medical information. CONCLUSION/IMPLICATIONS: Pursuing and modifying strategies
      from the qualitative interview for exploration of illness may contribute to
      clinical facts as well as scientific knowledge concerning illness.

PMID- 7777738
TI  - Day-of-the-week effect on doctors' response to a postal questionnaire.
AB  - OBJECTIVE: To test a possible day-of-the-week effect on doctors' response rate to
      a postal questionnaire. DESIGN: Dispatch of postal questionnaire randomized to
      Thursday or Saturday. SETTING: A nationwide survey on doctors' attitudes.
      SUBJECTS: 200 general practitioners and 260 practising specialists/consultants.
      MAIN OUTCOME MEASURES: Response rate and Kaplan-Meier survival curve for no
      response. RESULTS: The probability of response was not influenced by receiving
      the questionnaire just before or just after a week-end. CONCLUSION: Response
      rates in postal surveys sent to doctors cannot be improved by their receiving the
      questionnaire just before a week-end.

PMID- 7777740
TI  - The public view on cardiovascular risk factors and changes in lifestyle.
AB  - OBJECTIVE: To investigate the public knowledge of cardiovascular risk factors
      including hyperlipidaemia, and attitudes to changes in lifestyle and to the role
      of the primary health care in preventive work. DESIGN: Postal questionnaire.
      SETTING: A physically defined area in south-western Stockholm. SUBJECTS: 1000
      randomly selected individuals of both sexes 40 to 64 years, stratified into 5
      year groups. MAIN OUTCOME MEASURES: Knowledge of and attitudes to cardiovascular
      risk factors. Contact with the primary health care and expectancy of physicians'
      interest in patients' lifestyles. RESULTS: Response rate was 75%. The awareness
      of cardiovascular risk factors was high, but only 51% knew what constitutes
      healthy food, and two thirds doubted that they could change their eating habits.
      Forty-eight percent had visited the primary health care during the previous year.
      Eighty-four percent thought that the physicians should know about their patients'
      smoking, 83% about drinking habits, and 75% about eating habits. Physicians were
      expected to spend 40% of their time on preventive work. Only 26% believed that
      press information about hyperlipidaemia and heart disease did more good than
      harm. CONCLUSION: Knowledge was good about causative cardiovascular risk factors,
      but poor about healthy eating. Physicians were expected to have an interest in
      patients' lifestyle and in prevention. This type of knowledge is important for
      preventive work.

PMID- 7777739
TI  - Meeting cancer patients. Interviews with Swedish district nurses.
AB  - OBJECTIVE: To illuminate district nurses' experiences in the home care of cancer
      patients. DESIGN: A qualitative approach. SETTING: Primary health care in the
      south-east of Sweden. PARTICIPANTS: 39 district nurses employed in the eastern
      part of the county council area. MAIN OUTCOME MEASURE: Interpretation of tape
      recorded interviews concerning positive and negative experiences of caring for
      cancer patients. FINDINGS: In the meeting with cancer patients nurses reported
      some satisfaction, but mainly dissatisfaction and strong feelings of mental
      strain. Situations identified as especially trying were connected with dressing
      of ulcerous cancer wounds, managing physical pain, being too close to the
      patient, not being allowed to communicate openly, not being allowed to help, and
      patient's trust in alternative medicine. Positive experiences were described when
      nurses were accepted as helpers. District nurses felt like cowards, and also
      experienced meaninglessness, uncertainty, shame, irresolution, and insufficiency
      in the trying situations. The overall emotional tone in the interviews was,
      however, positive. The deep human contacts were described as a source of both
      strain and enrichment. CONCLUSION: It seems important to develop support systems
      to provide district nurses with an opportunity to discuss and handle emotions
      evoked in the care, thereby improving their possibilities of caring for
      terminally ill cancer patients.

PMID- 7777741
TI  - Acute bronchitis: course of symptoms and restrictions in patients' daily
      activities.
AB  - OBJECTIVE: To obtain information on the course of complaints and restrictions in
      daily activities of patients with acute bronchitis. DESIGN: Prospective study.
      SETTING: General practice. SUBJECTS: Otherwise healthy persons over 16, who
      visited their GP with an acute cough with purulent sputum and/or auscultatory
      abnormalities. MAIN OUTCOME MEASUREMENTS: Recordings by patients on reasons for
      encounter, symptoms and restrictions in daily activities at entry, and one and
      two weeks after entry. RESULTS: 99 Patients were included, of whom 79 were
      suitable for further analysis. Discomfort caused by coughing and concern in the
      patient and his/her social environment were the main reasons why patients visited
      their general practitioner. Counting from the onset of the disease it took three
      to four weeks before most patients were well and able to perform all their usual
      daily activities again. CONCLUSION: In most cases acute bronchitis has
      considerable impact on patients' well-being and daily activities for some weeks.

PMID- 7777742
TI  - Adult uncertainty in illness: a critical review of research.
AB  - Nursing interest in the uncertainty associated with life-threatening illnesses
      and their treatment technology is growing. Nurse investigators have begun to
      study variables that precede and influence this uncertainty, as well as how
      persons appraise, cope with, and adapt to uncertainty. This paper reviews and
      examines data from both quantitative and qualitative nursing studies of adult
      illness-related uncertainty published after 1980. Findings demonstrate that
      uncertainty is a pervasive stressful accompaniment of illness and its treatment
      that influences persons' coping and adaptive responses. Implications for nursing
      practice and future research are explored.

PMID- 7777743
TI  - Health-promoting behaviors and quality of life among individuals with multiple
      sclerosis.
AB  - Chronic conditions have profound and pervasive effects on the quality of life of
      millions of Americans (USDHHS, 1991). The estimated one-quarter million Americans
      with MS face a unique set of stressors and challenges as they seek to adapt to a
      chronic illness with an unknown cause, few medical therapies, and an uncertain
      prognosis that almost always includes some degree of functional disability
      (Wasserman, 1988). The purpose of this study was to explore factors related to
      performance of health-promoting behaviors and to examine the relationship between
      the practice of health-promoting behaviors and perceived quality of life for
      individuals with MS. A general conceptual model was used as a framework for
      exploring the relationships among antecedent variables (demographic/disease
      factors, barriers, resources, perceptual factors), health-promoting behaviors,
      and perceived quality of life with a convenience sample of 61 individuals with
      MS. Analyses supported a hypothesized relationship between health-promoting
      behaviors and quality of life. Subsequent research with larger samples is needed
      to clearly address the relative strength and path of variables in the proposed
      model.

PMID- 7777744
TI  - An analysis of some dimensions of the concept of moral sensing exemplified in
      psychiatric care.
AB  - There are few studies that focus on the interpersonal aspect of everyday ethical
      conflicts. Conceptual frameworks for research into ethical decision making in the
      health care system are mainly based on an ethic in which objectivity and
      principle-based thinking is emphasized, leaving the experience of concrete moral
      conflicts relatively unexplored. The aim of this paper is to analyze the
      dimensions of "moral sensing," a concept identified in an earlier grounded theory
      study of psychiatric nursing. Four dimensions of the concept of moral sensing,
      i.e., feeling, intuition, benevolence and genuineness, were synthesized by
      reviewing the works of past and contemporary philosophers. The analysis of moral
      sensing and its dimensions is exemplified by actual nurse-patient encounters in
      psychiatric nursing practice.

PMID- 7777745
TI  - In-home communication intervention training for parents of multiply handicapped
      children.
AB  - Two major questions derived from social-interactional theory were addressed: What
      are the effects of an in-home communication training program for parents on (1)
      the acquisition of child-training skills (imitating/animating and expectant
      waiting) by parents of developmentally delayed children who have severe language
      impairments and autistic features and (2) the acquisition of communication
      behaviors in the children themselves? Questions regarding the social value of the
      intervention and effects on parent-child interactions were also addressed. Four
      mothers were taught two parent-training skills (imitating/animating and expectant
      waiting) during two in-home training sessions. Following the parent training, the
      mothers conducted training sessions in their homes with their children for 10
      minutes, three times per week for 8-12 weeks. All sessions were videotaped and
      frequency counts taken of the target parent skills and child target behaviors. A
      single subject experimental research design was used incorporating a multiple
      baseline across two parental child-training skills (i.e., imitating/animating,
      expectant waiting). Data were analyzed visually as is customary in single subject
      experimentation, and direct behavioral counts showed that all four mothers
      demonstrated increases in the frequency with which they used the child-training
      skills following treatment. Increases in four child behavior frequencies (i.e.,
      vocal utterances, social responding, social initiating, and intelligible words
      spoken) were also noted. The ECO Scales Interaction Profile results supported
      direct behavioral count data, showing significantly improved parent-child
      interactions for the subject dyads over three conditions (p < .034).
      Additionally, Parental Consumer Satisfaction Questionnaire results indicated that
      the intervention was positively perceived by the parents. Furthermore, the
      utility of single subject experimentation procedures in clinical nursing practice
      was clearly demonstrated in this research, and the findings support nurse
      conducted, in-home parent training as a practical and socially valid means of
      addressing the complex needs of chronically disabled children and their families.

PMID- 7777746
TI  - Clarity in the caring sciences.

PMID- 7777747
TI  - Acceptance of ostomy surgery--a Swedish pilot study.
AB  - The main purpose of this pilot study was instrument development, focused on
      personal adjustment following ostomy surgery. Two instruments were used: a
      translated and revised version of the Acceptance of Disability Scale, Modified
      (ADM), and Antonovsky's Sense of Coherence (SOC) questionnaire. A sample of 26
      patients enrolled consecutively at the Ostomy Care Centre at a Swedish hospital
      were included in the study. A Cronbach's coefficient alpha of 0.95 was obtained
      for the ADM Scale, Swedish version, which is consistent with the results of
      similar studies. A significant difference between the ADM scores and type of
      ostomy surgery indicated that persons with a continent ostomy had a greater
      acceptance of ostomy surgery than had subjects with conventional ostomy surgery.
      A close correlation between ADM and SOC was obtained, indicating that persons who
      accept ostomy surgery will also have a good sense of coherence. The result of
      this pilot study indicates that further research using both measures may be
      useful in order to identify which factors are of relevance for nursing practice.

PMID- 7777748
TI  - District nurses' stories of difficult care episodes narrated during systematic
      clinical supervision sessions.
AB  - In systematic clinical supervision sessions 23 Swedish district nurses narrated
      147 difficult care situations. The aim of the study was to illuminate their lived
      experiences of those situations. The following themes emerged in the analysis of
      the stories: coming too close to the patient; keeping and restoring patient's
      hope; conflicting opinions; feeling powerless; meeting unrealistic demands;
      patients' trust in alternative medicine; feeling disgust, shame and guilt;
      relations to patients' families; and communication gaps. The findings strongly
      emphasize that district nurses experienced problems in the home care of seriously
      ill patients. They must not only serve as containers for patients' emotional
      strain, but they also have to support relatives in their anxiety. However,
      findings also showed that there was often a balance between negative and positive
      dimensions in these meetings with dying patients and their families. It seems
      important to form support groups to help district nurses deal with demanding care
      situations and to relieve them of feelings and thoughts aroused in the provision
      of care. Support in the form of clinical supervision may impact the quality of
      care in a positive way.

PMID- 7777750
TI  - Some aspects of colour perception among patients with Alzheimer's disease.
AB  - The proportion of elderly people in western societies is on the increase. At the
      same time, demands are being heard for improvements in the quality of health
      care, including the design of the physical environment. The aim of this study was
      to call attention to some aspects of colour and the possibilities of using it as
      an orientational aid for institutionalized demented patients and thereby enhance
      the quality of their care. A pilot study was carried out to establish whether
      patients with Alzheimer's disease are different from non-demented patients
      regarding certain aspects of colour perception. Twelve hospitalized patients with
      Alzheimer's disease were compared with a matched control group of non-demented
      patients regarding colour naming, colour discrimination and colour preference. No
      significant differences were found between the groups. In an additional
      experiment to test short-term memory it was found that the patients with
      Alzheimer's disease gained substantial help from colour cues. It is concluded
      that colour should be taken into account in the designing of the health care
      environment, particularly geriatric wards.

PMID- 7777749
TI  - The trustworthiness of the stories of elder abuse narrated by district nurses.
AB  - The aim of the present study was to assess the trustworthiness of previously
      reported stories about elder abuse narrated by 21 district nurses (DNs) regarded
      as witnesses. Firstly, the stories were coded as to whether they were based on
      direct observation, hearsay or a mixture, and whether there were whole stories or
      story fragments. Secondly, they were coded and classified regarding a
      modification of the characteristics of reality developed from statement reality
      analysis. The DNs' single stories matched most of the characteristics. The
      results indicate that the DNs' stories are a reliable account of a personally
      experienced real event. Witnesses' stories are important sources in revealing
      phenomena, such as elder abuse. It also seems important to develop usable methods
      further.

PMID- 7777751
TI  - Activities of daily living ratings of elderly people using Katz' ADL Index and
      the GBS-M scale.
AB  - Instruments for measuring activities of daily living (ADL) are useful in
      estimating institutionalized elderly ill people's need of care. The aim of the
      present study was to investigate to what extent the GBS-M scale measures ADL
      status, as determined by Katz' ADL Index. Forty-two elderly patients in long-term
      care in a psychiatric hospital were rated independently using each of the two
      scales. The correlation coefficient between results of the ratings was r = 0.93,
      i.e., high scores on one of the scales gave high scores on the other scale. Fifty
      per cent of severely demented patients had maximal scores on measures of ADL.

PMID- 7777752
TI  - The helping encounter--occupational therapists' perception of therapeutic
      relationships.
AB  - The present paper deals with the art of occupational therapy in terms of
      therapeutic, helping relationships. The aim was to get a picture of how
      occupational therapists perceive the therapeutic encounter with their patients.
      Sixteen qualified occupational therapists, from various occupational areas, were
      interviewed and a qualitative approach was employed to analyze their description
      of therapeutic encounters in clinical settings. The qualitative analyses were
      performed with sensitization as the principle objective and a tentative
      theoretical model was formed, developed by three content categories; 1) Basic
      Professional-Oriented Helping; 2) Understanding-Oriented Helping; and 3) Action
      Oriented Helping. The relationships between these categories constitute a dynamic
      complex pattern. One conclusion drawn from this model was that the therapists
      might have problems finding a balance between their aspiration for becoming
      professionalized and their belief in egalitarian patient-therapist relationships
      in the rehabilitation treatment sessions.

PMID- 7777754
TI  - [The hypoxic patient. Introduction].

PMID- 7777753
TI  - Improvement after surgery in patients with osteoarthrosis of the knee.
AB  - To ascertain both physical and psychosocial effects of knee surgery in patients
      with moderate gonarthrosis, clinical examination of patients has been
      supplemented with a questionnaire SIP (Sickness Impact Profile) to describe the
      functional health status. Sixty patients, 35 women and 25 men, mean age 63 years,
      with moderate medial osteoarthrosis of the knee were included in the study.
      Sixteen patients had bilateral symptoms of gonarthrosis. Patients considered that
      their knee ostheoarthrosis had great influence physically as well as
      psychosocially. All patients graded pain during walking. Thirty-five patients
      were treated with a medial unicompartmental knee endoprosthesis and 25 patients
      were treated with a valgus osteotomy. After surgery the mean values for all
      measured variables were improved. Superior results were found among patients with
      unilateral disease compared to patients with bilateral disease. No differences in
      results were found between patients given different surgical treatments. The
      physical and psychosocial influence of osteoarthrosis of the knee were more
      pronounced in women. It is concluded that the SIP appears to be a measure with
      sufficient sensitivity to detect physical and psychosocial changes in patients
      with moderate osteoarthrosis of the knee.

PMID- 7777755
TI  - [Diurnal and nocturnal hypoxia].

PMID- 7777756
TI  - [Adaptation to chronic hypoxia].

PMID- 7777758
TI  - [Continuous home oxygen therapy: benefits, indications, methods].

PMID- 7777757
TI  - [The traveling patient with hypoxia].

PMID- 7777759
TI  - [Monitoring of continuous home oxygen therapy].

PMID- 7777760
TI  - [Exertional hypoxia and portable oxygen therapy].

PMID- 7777761
TI  - [Uronephrological and urogenital tumors: the urologist's viewpoint].

PMID- 7777762
TI  - [Cancer of the kidney].

PMID- 7777763
TI  - [Superficial bladder tumors. Pathological and clinical review and presentation of
      a new diagnostic method: fluorescence photodetection of transitional epithelial
      carcinomas based on protoporphyrin IX induction with delta-aminolevulinic acid (5
      ALA)].

PMID- 7777764
TI  - [Spontaneous development and treatment of localized cancer of the prostate].

PMID- 7777765
TI  - [Metastatic cancer of the prostate: course, diagnosis and therapeutic
      management].

PMID- 7777766
TI  - [Efficacy of Rhinomer Force 3 in the postoperative course of endonasal surgery].

PMID- 7777767
TI  - [Ultrasonic lipolysis. Liposculpture with ultrasound].

PMID- 7777768
TI  - [Andropause, male climacteric and crisis of the fifties: should androgens be
      administered?].

PMID- 7777769
TI  - [Discussion apropos of a case of ulcerative colitis].

PMID- 7777770
TI  - [Certificate of continuous education in public health: a Swiss first at the
      University of Geneva].

PMID- 7777771
TI  - [Which psychotherapy by which physician?].

PMID- 7777772
TI  - [Homage to a grand lady].

PMID- 7777773
TI  - [The content of nitrates and nitrites in fruits, vegetables and other
      foodstuffs].
AB  - There are presented the results of the investigation of many popular fresh and
      frozen vegetables as well as in fresh and frozen fruits, such as different kind
      of apples, strawberries, currants, raspberries and many other tender fruits
      mainly from market and few from own allotment-cottages performed in the year 1989
      1992. The nitrate and nitrite was determined according to the Griess reaction.
      High levels of nitrate was encountered in lettuce, frozen spinach, fennel,
      radishes, parsley. Many of this samples contained more than 1000 mg of KNO3/kg of
      fresh product, but the highest level, over the 3500 mg/kg was found in lettuce.
      The remaining vegetables like carrots, celery, leeks and frozen French bean
      contained from several dozen to more than 800 mg KNO3/kg. The level of nitrite in
      all samples of the investigated vegetables and fruits was very low from zero to
      decimal part of milligram per kg. Very low level of nitrate was found in 7
      species of investigated apples (from 1.3 to 9.7 mg KNO3/kg). A little higher
      level of this compound was ascertained in currants, gooseberries, raspberries,
      cherries (from 0.0 to 36.0 mg KNO3/kg product). The highest levels of nitrate
      occurred in samples of strawberries (maximum to 322.3 mg KNO3/kg) but mean level
      amounted 58.7 mg KNO3/kg. The encountered levels of nitrate in frozen vegetables
      and fruits as well as in jams and stewed fruits was only little less than in
      fresh products. Very high level (from 355.30 to 584.53 mg KNO3/kg) was
      ascertained in the fruit-vegetable juice named "Rinberen" and "Malberen" to which
      red beet extract was used for their production. It should be pointed out that
      when the containers of these juice was opened and stored at the room temperature
      (+20 degrees C) during 30 days, no changes was observed in the level of nitrate
      and nitrite. In the juice prepared from blanched carrot, the rate of the
      reduction of nitrate to nitrite has not been lowered, when this product was
      storage of this juice at room temperature, the mean level of nitrite increased
      significantly (from 0.14 to 82.89 mg NaNO2/kg) and the level of nitrate lowered
      from 261.0 to 46.4 mg KNO3/kg. It should be strongly recommended for consumption
      the juices from carrot only fresh prepared. There are also presented the results
      of investigation of nitrate in fermented cheeses.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 7777774
TI  - [Occurrence of aluminum in some foodstuffs].
AB  - Results of aluminium determinations in breads and biscuits as well as in fish
      preserves, vegetables, strawberries and teas including fruit-herb teas are
      presented. Also the percent of extraction of aluminium of various kind of tea
      leaves into the infusions was determined. The commercially available sample of
      foods was used for investigation. Aluminium was determined by using two methods:
      a spectrophotometric extraction method with-hydroxyquinoline and less sensitive
      AAS method with nitrous oxide-acethylene flame on PU 9100X Philips Spectrometer
      could with IBM compatible Computer (Hundai) provided with 9178/9X Flame Program
      Unicam Limited--1991. The sample was at first digested with mixture of
      concentrated acids (H2SO4 + HNO3 + HClO4) in teflon vessels and then finished in
      platinum dishes. Solutions of the destroyed samples was kept in polethylene
      bottles. The methods was checked by recovery tests. In the 8-hydroxyguinoline
      extraction-method about 88.5% to 106.5% of the added aluminium was determined and
      in the AAS method it was of 75% to 100%. The highest level of aluminium was found
      in the eas: from 445 to 1522 mg/kg (mean 879 mg/kg) and then in herb-fruit teas
      (consisting of dried herbs and fruits of sloe plum, briar-rose juneberry Aronia
      etc.) from 45 to 379 mg Al/kg of dry matter. About 29% of the metal was extracted
      from teas into the infusion. Lower levels was found in breads (0.0-92.0 mg mean
      29.95 mg/kg) and in the fish preserves (0.0-57.0 mg mean 18.1 mg AL/kg). Similar
      levels were also found in 7 kinds of popular vegetables (0.0-100 mg mean 33.3 mg
      Al/kg). The lowest levels was found in strawberries (0.50-3.0 mg Al/kg). It was
      calculated that drinking three glasses of tea daily may supply about 2.6 to 3.7%
      of the provisional tolerable weekly intake dose set by the Joint FAO/WHO Expert
      Committee. It is concluded that the obtained results are similar to those
      published by other authors and represents a levels normally encountered in foods,
      and do not create any risk for human consumption.

PMID- 7777775
TI  - [Comparative analysis of certain nutritional parameters of fat in food rations of
      various population groups. II. Composition of fatty acids].
AB  - Daily food rations showed a high content of saturated fatty acids, especially in
      males and females employed in white collar work. The content of monounsaturated
      acids was lower, and the per cent of energy from these acids complied with the
      present nutritional suggestions. The per cent of energy from polyunsaturated
      acids was below these suggestions. The studied food rations contained high
      amounts of fatty acids with properties favouring hyper-cholesterolaemia and
      platelet aggregation, while those causing hypocholesterolemia (unsaturated acids)
      were present in insufficient amounts. This was noted particularly in the food
      rations of working people and retired workers. The variance analysis showed
      statistical. Significance of the differences between the mean values of the
      studied parameters of fats of various population groups.

PMID- 7777776
TI  - [Comparative analysis of certain nutritional parameters of fat in food rations of
      various population groups. III. Use of correlation and regression analysis for
      assessment of the nutritional quality of fat].
AB  - Correlation and regression analysis demonstrated a high degree of correlation
      between saturated and monounsaturated fats, on the one hand, and the absolute fat
      content, and lower correlation with polyunsaturated fats. The increase of fat
      content raised the saturated fat content in the daily food rations of mental and
      physical workers with the lowest rise of polyunsaturated fatty acids. The rise of
      the per cent share of saturated fatty acids was always at the expense of
      monosaturated fatty acids whose content decreased. A similar change was observed
      in polyunsaturated fatty acids. From the standpoint of nutrition another
      unfavourable finding was the demonstrated negative correlation between
      monosaturated and polyunsaturated fatty acids.

PMID- 7777777
TI  - [Codex foodstuffs committee FAO/WHO on methods of analysis and sampling].
AB  - The topics of the XIX Session of the Codex Alimentarius Committee held in
      Budapest are reviewed. In the report on the Session the main stress was laid on
      the matters connected with guidelines on sampling, endorsement of methods of
      analysis for codex standards and the matters concerning quality assurance systems
      in laboratories.

PMID- 7777778
TI  - [Formaldehyde determination using the colorimetric method with acetylacetone. II.
      Formaldehyde determination in cosmetic emulsions and certain household products].
AB  - Total formaldehyde content was determined by the colorimetric method with
      acetylacetone in cosmetic emulsions and household products. The commercial
      products not containing formaldehyde were fortified with 150 micrograms of the
      investigated compound. Recovery in this method was 93.3-102.6%. The method was
      found useful in routine determinations of formaldehyde in cosmetics and household
      products and can be used by the State Sanitary Inspections.

PMID- 7777779
TI  - [Formaldehyde determination in packing paper for food products by the
      colorimetric method with acetylacetone].
AB  - Papers used for food packing were studied for formaldehyde migration from them by
      the colorimetric method with acetylacetone. The studied material comprised 14
      samples of paper of Polish or foreign production: pergamenous paper, offset and
      sulphite papers and one sample from waste paper imported from Germany.
      Formaldehyde migration from these samples differed but never exceeded 1 mg/dm2,
      with the exception of the recycled paper from which it was 1.77 mg/dm2.

PMID- 7777781
TI  - [Bacterial age and their susceptibility to disinfectants].
AB  - The comparative tests were carried out on 4 standard test microorganisms grown 24
      h, 48 h, 72 h, with regard to their susceptibility to 6 disinfectants. The
      activity of disinfectants was examined by Berry and Bean method--mean single
      survival time (MSST). The results indicate that 24 h grown bacteria have the
      lowest susceptibility to phenol, Septyl, formalin, glutaraldehyde, chloramine and
      Sterinol. The MSST of these short time grown bacteria was 2-3 times longer than
      that of 72 h grown.

PMID- 7777780
TI  - [Studies on the chronic toxicity of a mixture of lead, cadmium and iron given to
      white rats with drinking water].
AB  - The experiment was carried out on male white rats of own breed which were
      receiving for 8 months lead acetate 200 mg/l, cadmium acetate 50 mg/l and ferrous
      chloride 100 mg/l with drinking water. The experimental groups received lead,
      cadmium, lead with cadmium, and the last group received every other day
      alternatingly iron or lead with cadmium. The activity of selected blood enzymes,
      haematological indices was determined and the memory test was carried out. In all
      experimental groups a decrease was noted of haemoglobin level and haematocrit
      value, with an increase of choline esterase and reduced learning effectiveness-
      most pronounced in the group treated with cadmium, less evident in groups
      drinking water with lead or cadmium and lead, and not significant in the group
      receiving iron with lead and cadmium.

PMID- 7777782
TI  - [The effect of temperature on bactericidal activity of certain disinfectants].
AB  - Increase of the temperature by 10 degrees C (on the temperature range 22-32
      degrees C) grows up the bactericidal activity of the disinfectants like
      Laurosept, Chloramine, Sterinol and Jodoseptan against E. coli and S. aureus. It
      has not observed the influence on the bactericidal activity of Septyl against S.
      aureus. Surface-active agents are more effective at higher temperature against S.
      aureus, phenolic disinfectants and Chloramine against E. coli.

PMID- 7777784
TI  - [Noise in vocational schools. Causes of occurrence and assessment of exposure to
      schoolchildren].
AB  - Acoustic conditions in the classrooms of vocational schools are comparable with
      those in high schools. However, much worse acoustic conditions are observed in
      vocational school workshop. The evaluation of acoustic conditions in 712 school
      shops showed, that noise exposure of schoolchildren is very various and depends
      upon type of workshop and tasks performed by schoolchildren. The major source of
      noise exposure is machinery in mechanic workshops (plastic working--up to 105 dB,
      machine noise-from 80 to 90 dB), in textile workshops--from 90 to 100 dB and
      woodworking machines-from 92 to 102 dB. It should be noted that in such acoustic
      conditions schoolchildren stay for a relatively long time. Average exposure time
      of schoolchildren in mechanic or textile workshops was about 4.5 hours. At
      another training subjects i.e. electric, building, welding craft or gastronomy-
      noise exposure is usually below recommended standards (80 dB). The critical
      values accepted for hearing protection for occupational exposure (85 dB) were
      exceeded at 10% investigated training places of schoolchildren. This mostly
      occurred in mechanic workshops. Taking into account increased sensitivity of
      young people it would be worthwhile to work out separate criteria in this range
      for school workshops. Tentatively, problem should be solved by shortening
      exposure time depending on actual noise level.

PMID- 7777783
TI  - [The stability of biological indicators used for monitoring ethylene oxide gas
      sterilization].
AB  - It was found the correlation between the storage time of biological indicators
      and their usefulness for monitoring of gas sterilization with ethylene oxide
      (EO). Bacillus subtilis var niger ATTC 9372 was used as a test organism. Two
      kinds of investigations were done: observation of bacterial growing or lack of
      growing after 1 hour exposition of storage tests in EO (EO concentration- 750
      mg/l, temperature +/- 50 degrees C, (humidity-40%) and examination of drop in
      number of spores on strip tests after storage time. The results show that
      sterilization efficacy may be monitored using such spore strip tests up to six
      months of storage.

PMID- 7777785
TI  - [Noise level in Szczecin schools and selected health indicators of students].
AB  - There was an examination made in thirty schools chosen at random in Szczecin as
      for the level of indoor and outdoor noise. In two-thirds of the schools noise was
      found out to exceed the accepted limit. There was larger number of children with
      hearing deficiencies and/or psychic disturbances in those schools. The conclusion
      of the investigation can be drawn that one of the causes of transgression of
      indoor noise limit in newly built schools is the use of building materials of low
      insulating power. Additionally green areas should be set up and acoustic screens
      in order to separate schools in the centre of the city which are exposed to a
      high level of outdoor noise.

PMID- 7777786
TI  - [Competence of families for providing sex education of children].
AB  - This investigation explores the conditions under which children's sex education
      in families takes place. In particular, types of parents activities are examined,
      the parents attitude toward sexual concerns of children is assessed, as well as,
      moderating social ties are identified. The study population includes 1239 primary
      school students of the 7th grade, randomly selected from Warsaw primary schools.
      The findings show insufficient proficiency of families in sex education of their
      children. Although parents are the most desired source of sex related
      information, the range of their info-educational activities is found to be
      limited. This is particularly true when sons are considered; more attention is
      being paid to daughters. The results also indicates that mothers are more engaged
      in sex education than fathers. The findings show positive correlation between
      proficiency of parents in this field and their social status. This competence is
      also higher in families with better communication between members and families in
      which child freedom is not essentially limited.

PMID- 7777788
TI  - 3rd Current Topics in Gastroenterology Symposium. Sandpiper, Florida, October 31
      November 2, 1993. Proceedings.

PMID- 7777789
TI  - Transplantation of isolated hepatocytes and their role in extrahepatic life
      support systems.
AB  - Transplantation of isolated hepatocytes for the replacement of liver function and
      the use of isolated hepatocytes as a bridge-to-transplantation in extrahepatic
      bioartificial liver support devices offer important therapeutic advances for
      treating severe liver disease. Progress in cell biology, tissue culture
      techniques and biotechnology have led the way for the potential therapeutic use
      of isolated hepatocytes in a wide array of liver disorders. Transplanted
      hepatocytes show considerable promise of performing the full range of liver
      functions in several animal models of liver disease, ranging from fulminant
      hepatic failure to congenital metabolic liver disease. Recently, several
      interesting designs for extrahepatic liver support systems have been proposed.
      Although there is no current consensus on its eventual design configuration, the
      hollow fiber hepatocyte bioreactor design has the greatest potential for
      therapeutic benefit.

PMID- 7777787
TI  - [Remembrance of Professor Bruno Nowakowski].

PMID- 7777791
TI  - Small bowel transplantation.
AB  - The small bowel, the largest lymphoid organ in the body and host to a myriad of
      foreign antigens has presented a formidable challenge for transplantation. In the
      past 5 years, small bowel transplantation has become a viable clinical entity.
      Successful transplantation of the small bowel has been achieved as part of
      multivisceral grafting, combined small bowel and liver grafts and even as
      isolated small bowel grafts. Allograft rejection remains an important post
      transplantation problem, although graft versus host disease has been less of a
      clinical problem than initially feared. Markers that may serve to predict early
      rejection have been identified and include: assessment of endoscopic biopsies for
      enterocyte Class II antigen expression and for mucosal T cell and macrophage
      infiltration, bowel permeability studies, and measurement of changes in
      transepithelial potential difference. Earlier detection of rejection and more
      potent therapy for rejection episodes will be necessary to further improve
      outcomes.

PMID- 7777790
TI  - Early clinical experience with a hybrid bioartificial liver.
AB  - BACKGROUND: Severe liver failure is associated with high mortality. Orthotopic
      liver transplantation (OLT) is the only effective therapeutic modality; there is
      a need for a 'bridge' system to support patients until an organ becomes
      available. METHODS: A bioartificial liver (BAL) was used to treat 10 patients
      with severe liver failure. A plasmapheresis system was used to pump patient
      plasma through a module with porcine hepatocytes. Each treatment lasted 6-7 h.
      RESULTS: All patients tolerated the procedure(s) well. Eight patients underwent
      OLT following BAL treatment(s). There were two late deaths after recovery from
      liver failure. Five patients with increased intracranial pressure (ICP) and
      decerebration had ICP normalization, increased cerebral perfusion pressure and
      full neurologic recovery after OLT. There was improvement in the level of
      encephalopathy and a significant decrease in serum ammonia after BAL
      treatment(s). CONCLUSIONS: BAL treatment is safe and beneficial and can be
      successfully used as a 'bridge' to transplantation.

PMID- 7777792
TI  - Transplantation of islets of Langerhans in patients with insulin-dependent
      diabetes mellitus.
AB  - From 1974 to December, 1992, as reported by the International Islet Transplant
      Registry, there have been 175 adult islet allografts worldwide. Ninety-eight of
      these transplants have been performed since 1989. Eleven patients with Type I
      diabetes mellitus who have received islet allografts since 1989 have achieved
      insulin-independence for variable periods of time. As of June, 1993, four
      patients remain insulin-independent (from > 127 to > 326 days). Insulin
      independence after human islet cell transplantation is not yet a consistent
      achievement. Several key issues in pancreas procurement, islet cell isolation,
      islet preservation, islet engraftment and the prevention of islet allograft
      rejection still need to be addressed. The expansion of current clinical trials
      should be limited to patients who are taking or who require immunosuppressive
      drugs for other reasons (kidney or liver transplant recipient) since the risks of
      chronic immunosuppression probably outweight the risks from chronic diabetes,
      although as we are able to induce a more specific state of immunosuppression this
      rationale may become debatable.

PMID- 7777793
TI  - Aspects of quality of life in gastrointestinal disease: some methodological
      issues.
AB  - Quality of Life assessments have many applications in clinical trials. In the
      evaluation of gastrointestinal disease for example. Quality of Life outcomes
      provide a useful tool for assessing treatment response. There are a number of
      standard measures currently available that may be utilized to determine Quality
      of Life. In clinical trials the use of questionnaires allows the clinician to
      assess the impact of disease and its subsequent treatment upon the patient's
      daily life. In order to facilitate comparison of data between studies, it is
      important that the measures selected are well validated. Patients with
      gastrointestinal problems do not only experience symptoms. The symptoms have an
      adverse impact on well-being and ability to enjoy day-to-day activities. It is
      important to provide appropriate treatment for the large and heterogeneous
      population with gastrointestinal complaints who have a poor Quality of Life.

PMID- 7777794
TI  - Quality of Life assessments in the evaluation of gastroesophageal reflux and
      peptic ulcer disease before, during and after treatment.
AB  - BACKGROUND: It has recently been suggested that Quality of Life (QOL) be used in
      the evaluation of new medical treatment regimens together with cost-benefit,
      efficacy and safety. In this overview we point out some aspects of use of the
      Psychological General Well-Being Index (PGWB) in patients with peptic ulcer and
      reflux disease gained from our own investigations in later years. METHODS: QOL
      was assessed using questionnaires before diagnosis, during medical healing
      treatment and at a 1-year follow-up in peptic ulcer disease or before and after
      surgery in reflux disease. RESULTS: Untreated patients with unknown diagnosis had
      low QOL scores. With treatment, scores increased rapidly to supernormal values
      and fell off to normal values during the follow-up year. CONCLUSION: QOL
      evaluations seem sensitive and reflect the patient's subjective feeling of
      disease. They add another new aspect of treatment effect not earlier included in
      treatment evaluations.

PMID- 7777795
TI  - Quality of Life in inflammatory bowel disease: biases and other factors affecting
      scores.
AB  - Health-Related Quality of Life (HRQOL) measurement has become a key element in
      the assessment of chronic diseases during the execution of clinical research and
      in the delivery of health care. Poor HRQOL is clearly recognized in patients with
      inflammatory bowel disease (IBD) and relates to the type of disease (Crohn's
      disease or ulcerative colitis) and disease severity. It is also linked to non
      disease elements e.g., gender, age, personality, cultural factors and coping
      skills. The dynamic properties of HRQOL may be depicted using different
      measurement tools and the portrayal may well differ when using a generic- or a
      disease-specific instrument. HRQOL status also changes with time, as do disease
      and non-disease parameters. Several examples of population selection bias are
      demonstrated using the Sickness Impact Profile (SIP), the time trade-off and the
      McMaster Inflammatory Bowel Disease Questionnaire (IBDQ). While HRQOL is
      generally good in IBD patients, mean HRQOL scores are still significantly
      depressed compared to normal controls. The IBDQ, a disease-specific HRQOL
      instrument, has yielded consistent results in both cross-sectional studies and
      prospective clinical trials. Such HRQOL instruments can be used to identify the
      types of new therapies that are needed, subgroups of patients which might benefit
      from specific treatments, patient satisfaction, treatment efficacy and
      efficiency. These applications must always be undertaken with careful attention
      to rigorous research methodology.

PMID- 7777797
TI  - Quality of Life: a critical assessment.
AB  - There is increased recognition that Health-Related Quality of Life (HRQOL) or
      Health Status (HS) is important and, together with other outcome measures, highly
      relevant to evaluating both the impact of diseases, and the individual and
      societal benefits/costs of different interventions, management strategies and
      health policies: yet many problems remain. While the methodology of HS assessment
      has been extensively studied and greatly improved, implementation has lagged in
      practice and in clinical research. Resources have been forthcoming for studies
      which promise increased profit (e.g., marketing advantage) or cost-containment,
      but funding has been scarce when the focus is on quality of care, patient
      utility, or health issues such as screening, monitoring or disease prevention.
      There are well-defined limitations associated with various assessment
      instruments, with interpretation of scores, and with the lack of relationship
      between disease activity and overall HRQOL. For these reasons, to date, HS
      assessment has not been clearly shown to be useful to physicians or to benefit
      patient outcomes to a degree sufficient to justify the burden of widespread use.
      Physicians remain cautious of the processes, especially with those aspects that
      relate to values, autonomy, equity, legal liability and potential for abuse.

PMID- 7777796
TI  - Gastric blood flow in ulcer diseases.
AB  - BACKGROUND: Gastric blood circulation maintains the structure and functions of
      the stomach, and thereby is closely associated with the pathogenesis and the
      healing of gastrointestinal lesions. Gastric mucosal blood flow, regulated by
      systemic neural and humoral factors, is also modified by local metabolic factors
      such as prostaglandins, leukotrienes. PAF and other endogenous chemical mediators
      in mucosa. Endothelium-derived factors that are produced by vascular endothelial
      cells, inducing relaxation or contraction of the blood vessels, are also
      recognized as basic mediators that regulate the circulation in the stomach.
      RESULTS: The regionally disturbed gastric circulation in combination with the
      presence of acid is closely associated with the pathogenesis of NSAIDs and
      ethanol-induced gastric lesions. Blood flow and oxygenation in the surface mucosa
      surrounding the peptic ulcer change during healing, depending on the quality of
      the ulcer healing process: an increased blood circulation with increased oxygen
      supply to the ulcer margin is important for rapid ulcer healing shown by
      reflectance spectrophotometry. Factors altering the blood flow during the ulcer
      healing are discussed.

PMID- 7777798
TI  - Hepatitis C in 1994.
AB  - Since the discovery of hepatitis C in 1989 its role in the development of acute
      and chronic liver disease has been carefully evaluated. Hepatitis C has a mean
      incubation period of between 6 and 8 weeks. It is often indolent and
      asymptomatic. Interferon may be helpful in chronically infected patients. After 6
      months of therapy approximately 40-50% enter remission. Relapses are common
      however, up to 80% within 6 months. Effective long-term treatment has not yet
      been established.

PMID- 7777799
TI  - Influence of initial therapy on outcome of peptic ulcer.
AB  - Histamine 2 (H2) receptor antagonists, proton pump inhibitors, prostaglandin
      analogues, colloidal bismuth and sucralfate have all proved safe and effective in
      the initial treatment of peptic ulcer. Yet, most ulcers will recur when treatment
      is stopped. Continuous maintenance with H2 antagonists results in low symptomatic
      relapse, complications occur rarely, and such treatment is safe. An alternative
      is Symptomatic Self Care (on-demand therapy), which provides an economic option
      for patients with no concomitant disease or previous complications. Meta-analyses
      suggest a higher relapse rate after H2 antagonist therapy than that following
      sucralfate or bismuth. Whilst improved morphology and/or functional status of the
      gastro-duodenal mucosa ('quality of healing') has been claimed, the difference
      has not been explained. Successful prolonged eradication of Helicobacter pylori
      leads to a very low relapse rate, but more effective, predictable and safer
      eradication regimens are needed.

PMID- 7777800
TI  - Mechanisms of mucosal injury and healing: the role of non-steroidal anti
      inflammatory drugs.
AB  - Biological insights into injurious effects of non-steroidal anti-inflammatory
      drugs (NSAIDs), including aspirin (ASA), on mucosal protection and repair, are
      largely from studies of acute injury. That chronic ulceration is similar is not
      established. NSAIDs directly injure tissues, including endothelia, and at the
      same time impair the operation of many of the processes that normally contribute
      to mucosal protection, whatever the injurious agent. Many protective processes
      are mediated through prostaglandins, whose synthesis is abolished by inhibition
      of the constitutive isoenzyme, cyclooxygenase I (COX I) or Prostaglandin H
      Synthase1 (PGHS1). The aims of therapy are aimed at inhibiting the inducible
      isozyme cyclooxygenase II (COX II) or prostaglandin-H Synthase2 (PGHS2), which
      contributes to prostanoid synthesis at sites of inflammation. Newer NSAIDs,
      selectively inhibiting COX II, promise to revolutionize the treatment of
      inflammatory disease while reducing mucosal injury. Meanwhile, there is
      increasing evidence that direct injury to both mucosae and endothelia is mediated
      by free-radical species, exacerbated by reduced blood flow, and by the local
      release of inflammatory and other mediators, which accentuate vascular leakage
      and hemorrhage, and cause intravascular aggregation of blood elements, stasis,
      hypoxia, and additional free-radical injury. The NSAIDs also inhibit epithelial
      cell division and the angiogenesis critical to healing and repair.

PMID- 7777801
TI  - Molecular and cellular basis of ulcer healing.
AB  - BACKGROUND: The high ulcer recurrence rates after treatment with antacids or
      antisecretory drugs illustrate the need for direct treatment of GI ulcers by
      stimulating repair and healing mechanisms. The molecular regulators of ulcer
      healing include polyamines and growth factors such as EGF, TGF-beta, bFGF and
      PDGF. METHODS AND RESULTS: Oral treatment of rats with bFGF or PDGF accelerated
      the healing of chronic cysteamine-induced duodenal ulcers without decreasing
      gastric secretion. We found that sucralfate binds bFGF in vitro and in vivo, and
      the elevated local concentration of this growth factor may contribute to the
      ulcer healing properties of sucralfate. Parallel treatment with bFGF + sucralfate
      resulted in synergistic healing of chronic duodenal ulcers and chronic gastritis.
      CONCLUSIONS: Rapid changes in mucosal concentration of bFGF and EGF receptors
      during ulceration suggest that these peptides play a role in the natural history
      of GI ulcers. Thus, treatment based on molecular and cellular mechanisms of ulcer
      healing allows a direct and efficient ulcer therapy.

PMID- 7777803
TI  - Helicobacter pylori.
AB  - Helicobacter pylori is an important cause of chronic active gastritis and is
      strongly associated with peptic ulcer disease and gastric cancer. H. pylori
      colonizes the surface of the gastric epithelium with production of a number of
      factors, resulting in inflammation and an altered mucosa. H. pylori infection
      occurs world-wide and the mode of transmission most likely is from human to human
      via the fecal-oral and/or the oral-oral route. Treatment and, in the future,
      prevention of this infection may result in a marked diminution of upper
      gastrointestinal tract disease.

PMID- 7777802
TI  - Mucosal immune response to Helicobacter pylori and cytotoxic mechanism.
AB  - BACKGROUND: Helicobacter pylori is widely accepted as a major pathogen in
      gastritis. The histologic features of H. pylori gastritis are the numerous
      infiltrating mononuclear cells (MNCs) and neutrophils. It is not clear what role
      the infiltrating MNCs and neutrophils play in H. pylori gastritis. METHODS: In
      this study, we have established enzyme-linked immunospot (ELISPOT) assay for the
      measurement of H. pylori antibody-producing cells in gastric mucosa. RESULTS:
      Using ELISPOT assay, we found that H. pylori-specific IgA-producing cells as well
      as IgG-producing cells were distributed in gastric mucosa. These H. pylori
      specific antibodies in gastric mucosa and neutrophils are responsible for the
      induction of cytotoxic effect to cultured Vero cells. CONCLUSIONS: These
      observations suggest that a mucosal immune response specific to H. pylori is
      closely associated with the pathogenesis of gastritis.

PMID- 7777804
TI  - The current role of Helicobacter pylori eradication in clinical practice.
AB  - Helicobacter pylori is probably the commonest bacterial infection worldwide and
      is now accepted as the cause of chronic active type B gastritis. It is
      increasingly accepted as having a critical role in duodenal ulcer, where the
      prevalence of infection is 90 to 100%. More important is the dramatic reduction
      in duodenal ulcer recurrence after successful eradication of the organism to
      about 4% in a year compared to recurrences of up to 80% in those whose ulcers
      have been healed but in whom the infection persists. There is increasing evidence
      that what is now clear for duodenal ulcers may also hold true for patients with a
      gastric ulcer who are infected with H. pylori. Moreover, evidence is accumulating
      that the risk of a duodenal ulcer complication, such as, bleeding, is reduced
      following successful eradication of H. pylori. The treatment of duodenal ulcer
      patients with H. pylori eradication treatment has been advocated by an
      international working party who met first in Sydney at the 1990 World Congress
      and subsequently in Athens during the First European Gastroenterology Week. The
      most recent recommendation suggests that the infection should be treated in any
      duodenal ulcer patient after the first recurrence, and that a triple therapy
      regimen or a proton pump inhibitor combined with either amoxicillin or
      clarithromycin may be prescribed. The combination of a proton pump inhibitor and
      an antibiotic can eradicate H. pylori in over 80% of cases and simultaneously
      offers the advantage of rapid symptom relief and the highest rates of duodenal
      ulcer healing.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7777805
TI  - Malnutrition in the developing and developed world: is small intestinal bacterial
      colonization important?
AB  - Malnutrition is a major problem on a global basis and will continue if current
      world population trends persist. Small intestinal bacterial colonization may
      contribute to malnutrition in populations whose dietary intake is marginal, such
      as those in developing countries and many elderly in the developed world. This
      review focuses on the evidence for small intestinal bacterial colonization in
      these subjects and briefly revises current thinking on the pathogenesis and
      diagnosis of this condition.

PMID- 7777807
TI  - Laparoscopy for abdominal emergencies.
AB  - The role of laparoscopy has been reviewed for these conditions: abdominal trauma,
      acute abdomen, abdominal pain of uncertain etiology, appendicitis and the acute
      abdomen in the intensive care unit patient. Laparoscopy should only be performed
      in trauma patients who are hemodynamically stable and who have some evidence for
      abdominal injury, such as a positive peritoneal lavage or a positive CT scan.
      Laparoscopy is an excellent procedure for determining whether a knife or missile
      has penetrated the peritoneum. For penetrating wounds in the chest and upper
      abdomen, laparoscopy also allows excellent evaluation of the diaphragm. In blunt
      trauma, laparoscopy identifies the majority of injuries, but there has been a 5
      15% incidence of missed injuries to the small bowel and colon. The acute abdomen
      is generally caused by perforation, acute inflammation or intestinal obstruction.
      Of the various types of perforation, diagnostic and therapeutic laparoscopy is
      most applicable for duodenal perforation. Acute perforation of the stomach and
      colon should probably be treated by standard open techniques. For acute
      inflammatory disorders, laparoscopy is an excellent diagnostic tool and can also
      provide definitive treatment in the form of drainage of an abscess or
      appendectomy. The role of laparoscopy for ileus and bowel obstruction is
      controversial; some surgeons advocate diagnostic laparoscopy and treatment, while
      many others still consider bowel obstruction and abdominal distention to be
      contra-indications. Finally, there are the intensive care unit patients in whom
      an acute intraabdominal process is suspected. Laparoscopy in such patients alters
      the clinical management in about 50% of patients.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7777808
TI  - Totally preperitoneal laparoscopic inguinal herniorrhaphy using balloon
      distention.
AB  - BACKGROUND: After having performed over 200 transabdominal preperitoneal (TAPP)
      laparoscopic hernia repairs with no recurrences and no neuropathies, we recently
      changed to a totally preperitoneal repair due to the development of a balloon
      trocar that easily 'creates' the preperitoneal space. METHODS: The totally
      preperitoneal operation is similar to our TAPP procedure in that it involves
      detailed delineation of Cooper's ligament, spermatic cord and transversus
      abdominis arch with fixation of mesh to Cooper's ligament and arch for an
      anatomic tension-free hernia repair. RESULTS: Our early experience consists of 60
      hernia repairs in 50 patients (46 male, 4 female). There were 32 direct, 26
      indirect and two femoral hernias. Eight hernias were recurrent. The operation
      takes approximately 1 h. There has been no morbidity. As with the TAPP procedure,
      minimal postoperative discomfort and return to regular activity within 2 to 3
      days is the norm. CONCLUSIONS: We believe that the avoidance of the peritoneal
      incision and the attendant risks of intraabdominal adhesions associated with the
      TAPP procedure make the totally preperitoneal technique the preferred method of
      laparoscopic hernia repair.

PMID- 7777806
TI  - Laparoscopic Rosetti fundoplication.
AB  - BACKGROUND: Early experiences with laparoscopic fundoplication using the Rosetti
      technique are presented and compared with retrospective results from conventional
      fundoplication procedures. METHODS AND RESULTS: We have performed 70 consecutive
      laparoscopic procedures. Conversion to open surgery was done in seven cases
      because of anatomical reasons and in two because of peroperative progressive
      subcutaneous emphysema and CO2-retention. The complication rate was low. The
      range of postoperative hospital stay is 1-4 days for non-converted patients.
      Symptomatic follow-up has hitherto been performed in 41 patients with a follow-up
      time of 3-9 months. The follow-up results do not differ from those achieved in
      patients operated upon with the conventional open Nissen (n = 41) and Rosetti (n
      = 36) techniques. Pre- and postoperative control of 24 h pH and lower esophageal
      sphincter pressure (LESP) in 19 laparoscopically treated patients showed
      normalization of LESP in all cases and postoperative 24 h pH < 4 ranging between
      0 and 3%. CONCLUSIONS: Laparoscopic and reflux surgery is effective for the
      treatment of reflux esophagitis. Follow-up results compare well with open
      surgery.

PMID- 7777809
TI  - Medical management of chronic pancreatitis.
AB  - Chronic pancreatitis should be considered in all patients with unexplained
      abdominal pain. The importance of small duct disease without obvious radiographic
      abnormalities is an important new concept. Diagnostic evaluation should begin
      with simple, non-invasive, inexpensive tests (serum trypsinogen) to be followed
      by more complicated testing (hormone stimulation test) if needed. Enteric-coated
      pancreatic enzymes are the drugs of choice for treating steatorrhea, while
      conventional non-enteric coated enzymes are preferred for managing pain. The
      somatostatin analogue octreotide may become an important therapy for treating
      abdominal pain unresponsive to pancreatic enzyme therapy. Endoscopic approaches
      to the treatment of chronic pancreatitis are experimental and may cause damage to
      the pancreas. Surgical ductal decompression is appropriate in selected patients.

PMID- 7777810
TI  - Endoscopic management of recurrent and chronic pancreatitis.
AB  - Endoscopic therapy is now being utilized in the setting of recurrent acute and
      chronic pancreatitis. This review analyzes the current state of the art of these
      new applications of endoscopy. Selection of appropriate candidates for the
      various treatment modalities appears important for optimal results of therapy.
      Patients with gallstone pancreatitis, pancreas divisum, obstructing main
      pancreatic duct stones, and bulging pseudocysts appear to be the best candidates
      for endoscopic therapy.

PMID- 7777811
TI  - Quality of gastric ulcer healing. Is it influenced by antiulcer drugs?
AB  - BACKGROUND: Chronic administration of sucralfate (SCR), a non-systemic ulcer
      healing drug, exerts a trophic action on the gastric mucosa and prevents or
      reduces ulcer recurrence. The aim of this study was to determine whether SCR
      and/or the acid inhibiting drug omeprazole (OME) may affect the quality of ulcer
      healing, i.e., restoration of mucosal architecture. METHODS: Gastric ulcers were
      produced in male rats by serosal application of acetic acid. Rats were gavaged
      twice daily for 14 days with 2 ml of: (a) Placebo (PLA), (b) SCR 500 mg/kg, or
      (c) OME, 50 mg/kg starting 48 h after ulcer induction. We determined ulcer size
      under a dissecting microscope, and performed quantitative histologic assessment
      of quality of healing score (QS) on a scale from 0 (normal) to 5 (most abnormal).
      RESULTS: Ulcer size was 1.4 +/- 0.15 mm in the PLA group, 0.61 +/- 0.1 mm in the
      SCR group and 0.86 +/- 0.13 mm in the OME group (both OME and SCR p < 0.01 versus
      PLA). In the PLA group, histology showed (in rats with ulcers) a well-developed
      ulcer margin with cystically dilated glands. The QS of the ulcer scar in the PLA
      group was 3.3 +/- 0.22. IN the SCR-treated group, within the scar gastric glands
      were less dilated, more vertically oriented and the healing zone and granulation
      tissue were well developed and organized. The QS was 1.6 +/- 0.2, p < 0.001
      versus PLA and OME. In the OME group, the ulcer margin and the scar were thinner
      reduction of mucosal thickness by 43 +/- 2% (p < 0.005) and 18 +/- 1%,
      respectively, versus SCR and PLA groups. The number of dilated glands and
      connective tissue components in the scar was increased by 60%. The QS was 3.6 +/-
      0.3. CONCLUSIONS: (1) Both SCR and OME significantly reduced the size of the
      experimental gastric ulcer. (2) Restoration of mucosal architecture, assessed
      quantitatively, was much better in the SCR than in the OME and PLA-treated
      groups. (3) a trophic action of SCR on the gastric mucosa may be the basis of
      better quality of ulcer healing with SCR.

PMID- 7777812
TI  - Sexual and physical abuse and gastrointestinal illness.
AB  - BACKGROUND: Clinicians are becoming aware of the increased attention paid to the
      occurrence of sexual and physical abuse in our society and its consequences.
      However, only recently has attention been paid to their association with medical
      and particularly gastrointestinal illnesses. METHODS AND RESULTS: Recently, we
      investigated the frequency of sexual or physical abuse among female patients in
      our gastroenterology clinic, and their association with health status. Of 206
      women, 89 (44%) reported some type of sexual or physical abuse in their lifetime.
      We also found that patients diagnosed with functional GI disorders when compared
      with those with organic diagnoses reported a significantly greater frequency of
      sexual (53% versus 37%) and physical abuse (13% versus 2%). Of these, 59% had
      never discussed the abuse experience outside their families, a third had never
      told anyone, and only 17% of their GI physicians were aware of this history. We
      also found that abuse history led to a poorer health outcome: more severe GI pain
      and a higher frequency of pelvic pain (16% versus 6%), more non-GI symptoms (7.1
      versus 5.8), more physician visits in the previous six months (4.2 versus 3.3)
      and more lifetime operations (2.8 versus 2.0). CONCLUSIONS: In a GI referral
      practice, abuse history is a hidden factor that is associated with poorer
      adjustment to illness, greater symptom severity and higher health care use rates.
      Since the publication of these data, several groups have supported our findings
      and obtained additional new data on associating factors and possible mechanisms
      of symptom generation. This paper will: (i) review this epidemiologic data, (ii)
      propose hypotheses about their association, (iii) offer suggestions to identify
      this information in a sensitive and supportive manner, and (iv) discuss how to
      initiate referral for ancillary psychosocial care.

PMID- 7777813
TI  - New techniques for liver transplantation: reduced-size, split-liver, living
      related and auxiliary liver transplantation.
AB  - Mortality among patients on a waiting list for orthotopic liver transplantation
      continues to be 10-15%; this is of particular concern in the pediatric population
      and may become more problematic in adult patients as longer waiting lists for
      cadaveric transplantation accrue. The longer cold ischemia times afforded by use
      of University of Wisconsin (UW) solution and improved hepatic surgery techniques
      have allowed the development of reduced-size liver transplantation (RSLT), split
      liver transplantation (SLT), and living-related liver transplantation (LRLT).
      These new surgical techniques have been predominantly employed in children, up to
      40% of whom may be candidates for one of these modified procedures. With the
      exception of SLT, these approaches have been associated with comparable rates of
      biliary tract and vascular complications, rejection episodes and graft and
      patient survival when compared to whole organ transplantation. Right hepatic lobe
      graft recipients have approximately 15% decreased graft survival rates, limiting
      the acceptance of SLT as a standard approach to decrease waiting list times.
      Application of LRLT to the adult population, where 5-10% of recipients are
      potential candidates, is expected to increase. Over 100 LRLTs have been performed
      worldwide and while recipient survival with LRLT is excellent, concerns about
      donor morbidity and mortality, psychosocial factors and reimbursement issues
      remain obstacles. Living-unrelated liver transplantation and auxiliary orthotopic
      partial liver transplantation are developing approaches to be considered only in
      highly selected cases.

PMID- 7777814
TI  - [From risk assessment to risk communication].

PMID- 7777815
TI  - [Retrospective overview of contributions to the radioactivity studies specialty].

PMID- 7777816
TI  - [Nordenham--memories lead poisoning].

PMID- 7777817
TI  - [Formaldehyde--toxicologic aspects].

PMID- 7777819
TI  - [Maximum exposure values for substances in the environment as an measurement of
      environmental health].

PMID- 7777820
TI  - [Prevention of water pollution of the Rhine river--from the thiodan accident
      until today].

PMID- 7777818
TI  - [Formaldehyde--public health related aspects of building construction regarding
      toxicology].

PMID- 7777821
TI  - [The effect of night time airplane noise on excretion of stress hormones in
      residents living near airports].

PMID- 7777822
TI  - Osteoporosis: a matter of concern to rheumatology!

PMID- 7777823
TI  - Pelvic pain and low back pain in pregnant women--an epidemiological study.
AB  - BACKGROUND: Pelvic Pain in Pregnancy (PPP) has been diagnosed increasingly often
      in Norway. The relation to Low Back Pain (LBP) is unclear. METHODS: The answers
      to 5,400 questionnaires were collected from Norwegian women shortly after
      delivery, and the occurrence of PPP and LBP in relation to various
      characteristics was studied. RESULTS: 21% of primipara had had both PPP and LBP,
      whereas 51% had had neither. The figures in multipara were 31% and 33%. After
      stratification by parity the frequency of both types of pain decreased with
      increasing age. The largest occupational risk factor of PPP and/or LBP was having
      to twist or bend several times an hour. This may be preventable. Partial
      regression coefficients for parity, smoking, and weight of newborn were
      significantly larger with PPP than with LBP. CONCLUSION: The association of PPP
      and LBP to occupational exposure was similar. The statistical explanatory
      pattern, and thus possibly the etiology, is different in the two conditions.

PMID- 7777824
TI  - Mental health status in systemic lupus erythematosus.
AB  - Mental health status was assessed in 43 SLE patients and 32 healthy controls
      applying the GHQ-30 version of The General Health Questionnaire. A 46.5%
      prevalence of non-psychotic psychiatric disturbance was found in SLE patients
      compared to 15.6% in the control group (p = 0.01). Factor analysis displayed that
      SLE patients reported far more depression and difficulty in coping compared to
      controls. In SLE patients, impaired mental health showed significant associations
      to several disease associated neurological manifestations, as well as to disease
      activity. The results indicate that the disease itself influences the
      psychological well being in a substantial number of patients with SLE.

PMID- 7777825
TI  - IgM, IgA, and IgG rheumatoid factors in early rheumatoid arthritis predictive of
      radiological progression?
AB  - The significance of IgM, IgA and IgG rheumatoid factors (RF) for the prediction
      of radiological progression, and as process variables during follow-up, was
      evaluated in a three-year prospective study of 149 patients with early rheumatoid
      arthritis (symptoms < 1 year at study entry). The occurrence of IgA-RF and IgG-RF
      at study entry without simultaneous occurrence of IgM-RF, and the seroconversion
      from RF-negative at entry to RF-positive during follow-up appeared to be unusual.
      A significant correlation was found between each of the RF-isotype levels at
      entry and radiological progression after three years. However, no significant
      prognostic value of IgA-RF and IgG-RF could be demonstrated if analysed in
      combination with IgM-RF, initial disease activity (as measured by C-reactive
      protein level), initial radiologic score, HLA-DR4 and HLA-DR2. Although IgM-RF
      levels generally reflected the course of disease activity and did so better than
      IgA-RF and IgG-RF levels, their clinical significance as process variables
      appeared to be limited compared to C-reactive protein.

PMID- 7777826
TI  - Rheumatoid factor and HLA antigens in wrist tenosynovitis and humeral
      epicondylitis.
AB  - A matched case-referent study was undertaken to assess whether rheumatoid factor
      (RF) is associated with repeating tenosynovitis or peritendinitis and whether HLA
      B27 predisposes to epicondylitis. The study subjects consisted of 25 workers in
      manually strenuous jobs with a history of at least two episodes of tenosynovitis
      or peritendinitis in the wrist or forearm, or humeral epicondylitis, and their
      matched referents. The latex agglutination test was positive in seven of the 23
      cases with tenosynovitis and in one of the referents (p = 0.03). The
      corresponding figures for IgM-RF by enzyme immunoassay were ten and two,
      respectively (p = 0.008). HLA-B27 antigen was found in five of the 13 workers
      with epicondylitis and in one worker with no such history (p = 0.13). It is
      possible that RF-positive repeating tenosynovitis represents an incomplete form
      of rheumatoid disease.

PMID- 7777827
TI  - The risk of cancer in rheumatoid patients in Japan.
AB  - In order to clarify the risk of cancer development in patients with rheumatoid
      arthritis (RA), the incidence of malignant tumors during a follow-up period was
      investigated in RA patients at the Center for Adult Diseases, Osaka, Japan. Six
      hundred and fifty-five eligible rheumatoid patients (131 males, 524 females) who
      were admitted to our institute between 1980 and 1989 were matched against the
      files of the Osaka Cancer Registry. Among them, a total of 26 patients (5 males,
      21 females) were noted to have developed some kinds of cancer. The female RA
      patients demonstrated a significantly higher incidence of all cancers than the
      general population, with an observed/expected (O/E) ratio of 1.71 (95% confidence
      interval = 1.06-2.62). Cancer of the buccal cavity/pharynx and thyroid cancer
      also showed a higher incidence in female RA patients, with O/E ratios of 12.93
      and 2.74, respectively.

PMID- 7777828
TI  - Comparative evaluation of anti-heat shock protein antibodies in SLE and healthy
      controls.
AB  - Presence of anti-heat shock protein (anti-hsp) antibodies have earlier been
      demonstrated in children as well as adult patients with systemic lupus
      erythmatosus (SLE). Since hsp share homology across several species, it is
      presumed that anti-E. coli antibodies could in fact be autoantibodies. Surface
      expression of hsps has also been shown to play a role in the generation of
      antibodies. In the present study antibodies to a recombinant hsp70 of Leishmania
      dnonvani origin have been investigated in patients with SLE and data compared
      with the incidence in control sera. One clone from the cDNA library of Leishmania
      donovani confirmed previously to be expressing hsp70, cloned in pBluescript and
      antibodies to the expressed protein were checked by ELISA and western blot
      assays. The results indicate the presence of anti-hsp70 antibodies in 22/26 (85%)
      SLE patients and 12/20 (60%) control sera. Our observations reconfirm the
      presence of antibodies to hsp in normal controls and therefore they may not bear
      any direct relation to the pathogenesis of SLE.

PMID- 7777829
TI  - Increased frequency of the C4A*6 rare allele in rheumatic heart disease.
AB  - The aim of the present investigation was to determine whether the alleles of the
      MHC class III complement proteins BF, C2 and C4 (C4A and C4B) could be markers
      for RHD in the Brazilian population. Forty-nine patients with chronic RHD were
      studied. The controls included 65 healthy unrelated individuals, matched with the
      patients according to sex, age and ethnical background. BF, C2, C4A and C4B
      allotypes were determined by standard technologies including Western blots for C2
      and C4 variants with monoclonal and policlonal antibodies. The results showed a
      significantly elevated presence of the C4A*6 rare allele (p = 0.003 RR = 11.85)
      and a decrease of C4A*3 in the patients. In addition, C4 null and BF and C4 rare
      alleles were more frequent in patients than in the controls. Considering that in
      this investigation only RHD patients were included, further studies are necessary
      in order to clarify whether C4A6 is a marker for the cardiac form or for the
      disease itself.

PMID- 7777830
TI  - Correlations between PAF-acether and tumor necrosis factor in rheumatoid
      arthritis. Influence of parenteral corticosteroids.
AB  - The aim of this study was to evaluate the presence of PAF-acether (PAF), its
      specific degrading enzyme acetylhydrolase, and tumor necrosis factor (TNF)
      concentrations in blood and synovial fluid (SF) from patients with active RA. The
      variations of the mediators were also evaluated after corticosteroid perfusions
      in 7 patients. Lipo-PAF (PAF complexed to lipoproteins) was the main form of PAF
      detected both in blood and in SF, whereas unbound PAF was uncommon.
      Acetylhydrolase activity was also present in SF, with a strong correlation
      between serum and SF levels. TNF was detected in most of the samples, and TNF and
      acetylhydrolase levels were strongly correlated both in blood and in SF. Despite
      dramatic clinical improvement, corticosteroid treatment was not accompanied by a
      significant reduction of the concentration of blood mediators, suggesting that
      these molecules should not be considered as markers of disease activity.

PMID- 7777831
TI  - The variable clinical picture of arthritis induced by human parvovirus B19.
      Report of seven adult cases and review of the literature.
AB  - Seven patients with arthritis due to infection with human parvovirus B19 are
      reported, and the literature association reviewed. B19 virus arthritis most
      frequently affects young to middle aged women and occurs predominantly during the
      first six months of the year. The majority of cases have oligoarthritis or
      polyarthritis, and the joints most often involved are the proximal
      interphalangeal joints and knees. Of the seven patients reported, one case
      developed systemic lupus erythematosus, one case evolved into erosive,
      seropositive rheumatoid arthritis while one case was subsequently diagnosed as
      undifferentiated connective tissue disease.

PMID- 7777832
TI  - A prospective evaluation of antithyroid antibody prevalence in 100 patients with
      rheumatoid arthritis.
AB  - The prevalence of thyroid antibodies in 100 patients with rheumatoid arthritis in
      Northern Norway was studied. The serological data were compared with those from a
      major population survey in the same area. Compared to the prevalence in the
      normal population, the present study demonstrates that patients with rheumatoid
      arthritis have a higher prevalence of antibodies to both thyroid microsomal
      antigen and thyroglobulin.

PMID- 7777833
TI  - Sepsis and tumor emboli mimic vasculitis.
AB  - An unequivocal diagnosis of vasculitis typical of polyarteritis was made in a
      sixty one year old male. At post mortem no vasculitis was found, but there were
      widespread microabscesses and tumour emboli from an occult adenocarcinoma of the
      caecum. The importance of considering other pathologies which may mimic
      vasculitis is emphasised.

PMID- 7777834
TI  - Pseudoporphyria due to naproxen. A cluster of 3 cases.
AB  - Pseudoporphyria is a photo-induced blistering disorder with increased skin
      fragility, caused among others by nonsteroidal antiinflammatory drugs. Lesions
      heal with scarring and milia. Porphyrin screen studies are normal in this
      disease. Histology and immunofluorescence resembles porphyria cutanea tarda. In
      this report we describe a cluster of three cases of naproxen-induced
      pseudoporphyria, and review briefly previously reported cases induced by
      naproxen. The majority of reported cases involve children. Physicians should be
      aware of this reversible skin disorder.

PMID- 7777835
TI  - [Ethology and good health in pets].
AB  - Ethology, or the comparative study of behaviour and its biological roots, has
      made significant contributions to our understanding of companion animal behaviour
      and thereby, the welfare of these animals. Ethological questions, concepts and
      methods can be readily applied to companion animal studies and the interpretation
      of results. In particular, comparison of behaviour shown in a 'reference system'
      with that exhibited in more restricted environments has proven very useful.
      Although emphasis has been placed on farm animals in the past, more and more
      animal protection laws require that regulations and guidelines, including those
      concerning companion animals, be based upon sound ethological studies. It is only
      through such observations that we can objectively determine what 'species
      typical' behaviour is and what the animal's 'needs' are. Based upon these,
      recommendations for proper housing conditions can be made, which in turn reduce
      the number of cases where behavioural disturbances tarnish the relationship
      between humans and their companion animals. Using past research on the domestic
      cat and human-cat interactions, the author illustrates these points and makes
      suggestions for future research.

PMID- 7777836
TI  - [Malignant melanoma in two cats].
AB  - Malignant melanomas with extensive metastasis in various organs were diagnosed in
      a 8-year-old European shorthair cat and a 10-year-old Persian cat. The primary
      tumor in the European shorthair cat was located within the eye. The clinical
      progress, gross pathology and histology are outlined. The possibility of an
      increase of melanomas in combination with FIV- or FeLV-infections is discussed.

PMID- 7777837
TI  - [Lung tumor with unusual metastasis in a cat--a case report].
AB  - Metastasis of an adenocarcinoma was diagnosed histologically in a foot pad biopsy
      of a cat exhibiting progressive locomotion problems, foot pad swelling and nail
      loosing. A bronchial gland adenocarcinoma was identified as primary tumour at
      necropsy. Metastases were found in all foot pads, the kidneys and various lymph
      nodes. A review of the literature and of the own necropsy reports an affinity of
      bronchial gland carcinoma metastases to skeletal muscles and bones, especially
      digital bones. Non-respiratory signs as lameness, foot pad swelling and nail loss
      appear to predominate clinically whereas respiratory signs are observed only in
      about one third of all cases.

PMID- 7777838
TI  - [Multiple congenital heart abnormalities in a boxer: a case report].

PMID- 7777839
TI  - Neuronal vacuoles in the canine brain.
AB  - Intraneuronal vacuoles have been observed in the motor trigeminal nucleus of the
      medulla oblongata of two dogs which showed neurological deficits. Its
      significance and possible relation with the same lesions observed in other animal
      species are discussed.

PMID- 7777840
TI  - [What is your diagnosis? Hypoadrenocorticism in a domestic cat].

PMID- 7777841
TI  - Spinal cord injury and pregnancy: the stories of two women.
AB  - This article describes some of the experiences encountered by two women with
      spinal cord injuries (SCI) during pregnancy. Pregnant women, with or without a
      SCI, encounter some common experiences. Common complaints of pregnancy for both
      include urinary tract infections, sleep problems, and constipation. Complaints
      specific to those women with a SCI centered around issues such as increased
      urinary incontinence, autonomic dysreflexia and delayed wound healing. The women
      with SCI neither developed pressure areas nor experienced premature deliveries,
      major complications predicted by literature. Women with SCI have felt that they
      were victims of inadequate environmental designs that hindered their mobility and
      inhibited their independence. Many of the psychosocial aspects studied proved to
      be common to pregnant women in general and not specific to individuals with
      spinal cord injury.

PMID- 7777842
TI  - Comparison of seat pressures on three bowel care/shower chairs in spinal cord
      injury.
AB  - Pressure, positioning, and postural support are critical aspects in the design of
      a new bowel care/shower chair for persons with spinal cord injuries (SCI). The
      purpose of this evaluation was to evaluate seating pressures on three existing
      bowel care/shower chairs commonly used by persons with spinal cord injuries. A
      pressure mapping device, the Force Sensing Array, was used to measure seat
      pressure, position and postural support. Three seated subjects with spinal cord
      injuries were evaluated on each of the following three bowel care/shower chairs:
      Lumex, TRAUM-AID and E&J. The results of this evaluation will be briefly
      presented. This study is part of a larger study to design a bowel care/shower
      chair that uniquely meets the needs of persons with spinal cord injury.

PMID- 7777843
TI  - Basing practice on nursing research.

PMID- 7777844
TI  - Presidential address: instead of resisting change, we accepted it.

PMID- 7777845
TI  - Endourethral prosthesis for treatment of detrusor sphincter dyssynergia: impact
      on quality of life for persons with spinal cord injury.
AB  - Neurogenic bladders with detrusor sphincter dyssynergia (DSD) are common in
      persons with spinal cord injury and with multiple sclerosis. Treatment options
      such as sphincterotomy, urethral foley and suprapubic catheters are not without
      complications or failure; however, they are recommended for patients who are
      unable to do intermittent catheterization. An endourethral prosthesis for DSD has
      been developed for experimental use in the United States. We report one year
      results of the clinical trials with endourethral prostheses implanted in ten
      patients. Initial subjective and objective results show an 80% success rate. At
      present, preliminary data show that an endourethral prosthesis, which is simple
      to insert and has few complications, appears to offer an alternative to
      conventional treatment. A key to success is to prepare for changes in life style
      that impact the patient's quality of life. Both patient and staff education are
      necessary pre-operatively to achieve successful outcomes post-operatively.

PMID- 7777846
TI  - Genetic chimerism.

PMID- 7777847
TI  - Quantitative trait locus for reading disability: correction.
AB  - In the news article "Can risky mergers save hospital-based research?" by Wade
      Roush (19 May, p. 968), the statement that University Hospitals of Cleveland rose
      from 20th in the rankings of teaching hospitals funded by the National Institutes
      of Health (NIH) in 1991 to 12th at present was incorrect. In fact, it was Case
      Western Reserve University (CWRU), with which University Hospitals of Cleveland
      is affiliated, that received $69 million in NIH grants in 1993, making it the
      20th largest recipient of such grants among medical centers; the university then
      received $97 million in 1994, raising its rank to 12th. About $15 million of the
      increase, or 53%, was attributable to CWRU's 1992 affiliation with Henry Ford
      Hospital in Detroit. Other hospitals affiliated with Case Western include
      MetroHealth Medical Center, Mount Sinai Medical Center, St. Luke's Medical
      Center, and Cleveland Veterans' Affairs Medical Center.

PMID- 7777848
TI  - Germany warily maps genome project.

PMID- 7777850
TI  - Closing in on the complete yeast genome sequence.

PMID- 7777849
TI  - Russia readies its first gene law.

PMID- 7777852
TI  - Gathering airs schemes for averting asteroid doom.

PMID- 7777851
TI  - Imanishi-Kari case. Marathon hearing gets under way.

PMID- 7777853
TI  - France. AIDS expert charged in HIV-blood case.

PMID- 7777854
TI  - Mapping the cell's nucleus.

PMID- 7777855
TI  - Can one type of HIV protect against another type?

PMID- 7777856
TI  - Linked regularities in the development and evolution of mammalian brains.
AB  - Analysis of data collected on 131 species of primates, bats, and insectivores
      showed that the sizes of brain components, from medulla to forebrain, are highly
      predictable from absolute brain size by a nonlinear function. The order of
      neurogenesis was found to be highly conserved across a wide range of mammals and
      to correlate with the relative enlargement of structures as brain size increases,
      with disproportionately large growth occurring in late-generated structures.
      Because the order of neurogenesis is conserved, the most likely brain alteration
      resulting from selection for any behavioral ability may be a coordinated
      enlargement of the entire nonolfactory brain.

PMID- 7777857
TI  - Extreme discordant sib pairs for mapping quantitative trait loci in humans.
AB  - Analysis of differences between siblings (sib pair analysis) is a standard method
      of genetic linkage analysis for mapping quantitative trait loci, such as those
      contributing to hypertension and obesity, in humans. In traditional designs,
      pairs are selected at random or with one sib having an extreme trait value. The
      majority of such pairs provide little power to detect linkage; only pairs that
      are concordant for high values, low values, or extremely discordant pairs (for
      example, one in the top 10 percent and the other in the bottom 10 percent of the
      distribution) provide substantial power. Focus on discordant pairs can reduce the
      amount of genotyping necessary over conventional designs by 10- to 40-fold.

PMID- 7777858
TI  - Identification of a stimulator of steroid hormone synthesis isolated from testis.
AB  - Gonadal steroidogenesis is regulated by pituitary gonadotropins and a locally
      produced, unidentified factor. A 70-kilodalton (kD) protein complex secreted from
      rat Sertoli cells was isolated. The complex, composed of 28- and 38-kD proteins,
      stimulated steroidogenesis by Leydig cells and ovarian granulosa cells in a dose
      dependent and adenosine 3',5'-monophosphate-independent manner. The follicle
      stimulating hormone-induced 28-kD protein appeared to be responsible for the
      bioactivity, but the 38-kD protein was indispensable for maximal activity. The 28
      and 38-kD proteins were shown to be identical to the tissue inhibitor of
      metalloproteinase-1 (TIMP-1) and the proenzyme form of cathepsin L, respectively.
      Thus, a TIMP-1-procathepsin L complex is a potent activator of steroidogenesis
      and may regulate steroid concentrations and, thus, germ cell development in both
      males and females.

PMID- 7777859
TI  - Association of increased spontaneous mutation rates with high levels of
      transcription in yeast.
AB  - Complex processes such as transcription, replication, repair, and recombination
      require changes in chromatin structure and the interactions of numerous trans
      acting factors with DNA sequences, raising the possibility that these processes
      may be interrelated. Here the effect of transcription on the rate of spontaneous
      mutation in the yeast Saccharomyces cerevisiae was examined. With the use of a
      lys2 frameshift allele under the control of a highly inducible promoter, the rate
      of spontaneous reversion was shown to increase when the mutant gene was highly
      transcribed. Thus, transcriptionally active DNA and enhanced spontaneous mutation
      rates are associated in yeast.

PMID- 7777860
TI  - Correction of radiation sensitivity in ataxia telangiectasia cells by a truncated
      I kappa B-alpha.
AB  - Cells from patients with ataxia telangiectasia (AT) are hypersensitive to
      ionizing radiation and are defective in the regulation of DNA synthesis. A
      complementary DNA that corrects the radiation sensitivity and DNA synthesis
      defects in fibroblasts from an AT group D patient was isolated by expression
      cloning and shown to encode a truncated form of I kappa B-alpha, an inhibitor of
      the nuclear factor kappa B (NF-kappa B) transcriptional activator. The parental
      AT fibroblasts expressed large amounts of the I kappa B-alpha transcript and
      showed constitutive activation of NF-kappa B. The AT fibroblasts transfected with
      the truncated I kappa B-alpha expressed normal amounts of the I kappa B-alpha
      transcript and showed regulated activation of NF-kappa B. These results suggest
      that aberrant regulation of NF-kappa B and I kappa B-alpha contribute to the
      cellular defect in AT.

PMID- 7777861
TI  - A nuclear-encoded form II RuBisCO in dinoflagellates.
AB  - The chloroplasts of most dinoflagellates are unusual in that they are surrounded
      by three membranes and contain the carotenoid peridinin. The ribulose-1,5
      bisphosphate carboxylase-oxygenase (RuBisCO) in dinoflagellate chloroplasts was
      found here to also be unusual. Unlike other eukaryotes, dinoflagellates
      containing peridinin use a form of RuBisCO (form II) previously found only in
      some species of proteobacteria. Furthermore, this RuBisCO is not encoded in the
      chloroplast DNA, as is the case in other organisms, but is encoded by the nuclear
      DNA. The unusual nature of this enzyme and location of its gene support the idea
      that dinoflagellate chloroplasts may have had a distinctive evolutionary origin.

PMID- 7777862
TI  - Presynaptic component of long-term potentiation visualized at individual
      hippocampal synapses.
AB  - Long-term potentiation has previously been studied with electrophysiological
      techniques that do not readily separate presynaptic and postsynaptic
      contributions. Changes in exocytotic-endocytotic cycling have now been monitored
      at synapses between cultured rat hippocampal neurons by measuring the
      differential uptake of antibodies that recognize the intraluminal domain of the
      synaptic vesicle protein synaptotagmin. Vesicular cycling increased markedly
      during glutamate-induced long-term potentiation. The degree of potentiation was
      heterogeneous, appearing greater at synapses at which the initial extent of
      vesicular turnover was low. Thus, changes in presynaptic activity were visualized
      directly and the spatial distribution of potentiation could be determined at the
      level of single synaptic boutons.

PMID- 7777863
TI  - Integration of visual and linguistic information in spoken language
      comprehension.
AB  - Psycholinguists have commonly assumed that as a spoken linguistic message unfolds
      over time, it is initially structured by a syntactic processing module that is
      encapsulated from information provided by other perceptual and cognitive systems.
      To test the effects of relevant visual context on the rapid mental processes that
      accompany spoken language comprehension, eye movements were recorded with a head
      mounted eye-tracking system while subjects followed instructions to manipulate
      real objects. Visual context influenced spoken word recognition and mediated
      syntactic processing, even during the earliest moments of language processing.

PMID- 7777864
TI  - Dukes C2 colon cancer: what is appropriate follow-up?

PMID- 7777865
TI  - The biology of hematopoietic stem cells.

PMID- 7777866
TI  - High-dose therapy with stem cell infusion in lymphoma.

PMID- 7777867
TI  - Transplantation in multiple myeloma.

PMID- 7777868
TI  - Peripheral blood stem cell transplant in breast cancer.

PMID- 7777869
TI  - High-dose chemotherapy and hematopoietic progenitor cell support for patients
      with epithelial ovarian cancer.

PMID- 7777870
TI  - Complications of peripheral blood stem cell transplantation.

PMID- 7777871
TI  - Peripheral blood stem cell transplant: future directions.

PMID- 7777872
TI  - Peripheral blood progenitor cell generation and harvesting.

PMID- 7777873
TI  - Lessons learned from Hurricane Andrew: recommendations for care of the elderly in
      long-term care facilities.
AB  - We report on the experience of a 500-bed, long-term care facility in Miami, Fla,
      which provides housing and nursing care units for patients--ranging from those
      who are independently ambulatory to those who are acutely ill and feeble--in
      preparing for, during, and in the immediate aftermath of Hurricane Andrew, which
      struck on August 24, 1992. The problems encountered included a massive influx of
      evacuated elderly to the facility, facility isolation, loss of electrical power,
      loss of running water, special dietary needs, and limited professional staffing
      due to personal property losses or loss of transportation. Overwhelmed county
      emergency medical services, limited access to hospitals and patient care, and
      difficulty in procuring supplies exacerbated the already complicated situation
      resulting from the storm. As a result of these catastrophic conditions, a number
      of challenges specific to the care of the elderly were identified. In conjunction
      with the Florida Department of Elder Affairs, we drafted a comprehensive
      blueprint that could serve as a disaster plan for other long-term care facilities
      facing a similar threat during the hurricane season.

PMID- 7777874
TI  - Understanding federal medical device statutes and their application to various
      penile prostheses.
AB  - Medical devices have become an important component of our professional
      armamentarium. This paper exposes the practitioner to the Food and Drug
      Administration and its control over medical devices. Specifically, the 1976
      amendment to the Food and Drug Administration Acts is described, along with the
      subsequent federal laws. Because of all the new technology available, physicians
      should be aware of the applicable laws and regulations. In addition, a review of
      the penile prosthesis includes its history and evolution, as well as the entire
      product line available for use. Attention is directed to the problems that have
      arisen from malfunctioning components.

PMID- 7777875
TI  - Hurricane Andrew-related injuries and illnesses, Louisiana, 1992.
AB  - To determine the extent and types of injuries and illnesses in Louisiana
      associated with or related to Hurricane Andrew, we gathered data from hospital
      emergency departments and coroner's offices on demographic variables,
      institution, nature and cause of the injury or illness, body part affected,
      location, and date and time of the event. A hurricane-related injury or illness
      was defined as one that occurred from noon on August 24, 1992, through midnight
      on September 21, 1992, as a direct or indirect result of the preparation for
      (preimpact), the impact of, or the clean-up after the hurricane (postimpact).
      Nineteen parishes in south-central Louisiana that were most affected by Hurricane
      Andrew provided data from patients seen in emergency departments and reports from
      coroner's offices. Active, advance surveillance of this type promotes and
      facilitates the reporting of disaster-related health outcomes. Future planning
      for hurricanes should take into account the high rate of cuts, lacerations, and
      puncture wounds, particularly during the postimpact phase.

PMID- 7777876
TI  - Epilepsy surgery: removing the thorn from the lion's paw.
AB  - In the United States, 10,000 to 20,000 patients have epilepsy uncontrolled by
      medication. The addition of a second-line drug to the primary regimen has a 2% to
      11% chance of controlling the seizures. We present a series of 35 patients with
      intractable epilepsy who had surgical resection of their seizure focus. Seventy
      five percent of the patients with temporal lobe epilepsy were made seizure free,
      with an additional 14% sustaining a greater than 90% reduction in seizures
      (decrease in number and frequency). Seventy-one percent of the patients with
      extratemporal lobe epilepsy (seizures originating outside the temporal lobe) had
      a worthwhile reduction (> 90%) in their seizures. Two patients sustained
      permanent clinically significant deficits as a result of their presurgical
      evaluation or resection. There were no deaths. Epilepsy surgery offers a cure for
      the "incurable" patient with a morbidity of 5% to 6%.

PMID- 7777877
TI  - Significance of solitary and multiple esophageal ulcers in patients with AIDS.
AB  - We endoscopically evaluated odynophagia and/or dysphagia in 23 patients with
      acquired immunodeficiency syndrome (AIDS). Eleven patients (48%) were found to
      have esophageal ulcers. Seven of them had deep, sharply demarcated, well
      circumscribed ulcer craters with raised edges; in two the ulcer extended to the
      muscularis propria. Ulcers were single in four patients, multiple in six, and
      unspecified in one. Biopsies were nondiagnostic. In eight patients,
      mycobacterial, viral, and fungal cultures were negative. Specific infections
      diagnosed in three patients were treated with appropriate agents. Ulcers were
      treated symptomatically, and seven patients received therapy for suspected viral
      etiology. Symptoms remained unchanged in five patients, improved in three, and
      resolved in two. Fifty-five percent of patients died within 3.6 months (mean) of
      diagnosis. Large solitary and multiple esophageal ulcers are common in AIDS
      patients with odynophagia and dysphagia.

PMID- 7777878
TI  - Alfentanil for conscious sedation during colonoscopy.
AB  - This investigation was designed to determine whether the narcotic alfentanil, a
      relatively new fentanyl derivative with rapid onset of action and offset of
      activity, alone or in combination with midazolam has advantages over the
      traditional meperidine and midazolam regimen for conscious sedation. Thirty-five
      subjects were randomized to receive an initial dose of narcotic and sedative with
      additional narcotics or sedatives administered as needed. Subjects receiving no
      midazolam sedative (alfentanil and placebo group, n = 13) had less desaturation
      and had the need for supplemental oxygen less often than those receiving
      alfentanil and midazolam (n = 11) or meperidine and midazolam (n = 11). There
      were no differences as assessed by patient and colonoscopist for tolerance and
      discomfort, procedure ease, recovery time, complications, electrocardiogram, and
      blood pressure. Baseline evaluation did not predict the need for supplemental
      oxygen. We concluded that alfentanil, with or without a sedative, has no
      advantage over the commonly used meperidine and midazolam regimen.

PMID- 7777879
TI  - Myelolipoma of the adrenal gland: a case report.
AB  - Adrenal myelolipomas are rare benign neoplasms composed of mature fat and bone
      marrow elements. Most are asymptomatic tumors found incidentally at postmortem
      examinations. We report the natural history of an adrenal myelolipoma in a middle
      aged man over a 6-year interval.

PMID- 7777880
TI  - Extra-adrenal myelolipoma: report of two cases.
AB  - Myelolipomas are benign tumors composed of an admixture of mature adipose tissue
      and normal hematopoietic cells. The vast majority occur within the adrenal
      glands, but several extra-adrenal myelolipomas (EAMLs) have been reported. The
      typical EAML is a solitary, well-defined mass within the abdomen, most commonly
      in the retroperitoneal presacral area. EAMLs may produce symptoms related to
      their mass effect, but they are occasionally incidental findings. Most commonly,
      the patient is older than 40 years and has no hematologic abnormalities. It is
      important to distinguish EAMLs from other soft tissue tumors, in particular
      liposarcomas, myxoid malignant fibrous histiocytomas, and extramedullary
      hematopoietic tumors. We discuss two cases of EAML. The first was in the
      retroperitoneum of a 76-year-old woman. It is the largest EAML ever reported,
      measuring 26 cm x 15 cm x 11 cm. The second, a presacral mass in a 68-year-old
      man, was diagnosed preoperatively by percutaneous computed tomography-guided fine
      needle aspiration biopsy. Preoperative diagnosis facilitated surgical management
      in this case. We discuss the clinical, radiologic, and pathologic characteristics
      and the differential diagnosis of this rare entity.

PMID- 7777881
TI  - Gold pulmonary toxicity in a patient with a normal chest radiograph.
AB  - We report a case of gold pulmonary toxicity in a patient with adult-onset Still's
      disease with dyspnea on exertion and a normal chest radiograph. Withdrawal of
      gold therapy resulted in complete resolution of pulmonary toxicity in our patient
      without the need for additional steroid therapy.

PMID- 7777883
TI  - Disseminated histoplasmosis in a patient from a nonendemic area who has acquired
      immunodeficiency syndrome.
AB  - Disseminated histoplasmosis is a serious opportunistic infection in patients with
      the acquired immunodeficiency syndrome (AIDS), often seen as the first
      manifestation of the syndrome. However, cases are reported almost exclusively
      from patients who live in or have traveled to endemic areas. We describe a case
      of disseminated histoplasmosis in a black woman with a 50-lb weight loss and
      marked weakness that occurred over a 6-month period. This case is one of the few
      in which disseminated histoplasmosis occurred as the first manifestation of AIDS
      in a patient in a nonendemic area. We believe it to be the first case reported in
      Michigan in which the patient has no history of prior residence in an endemic
      area. Disseminated histoplasmosis should be suspected in patients with AIDS and
      unexplained febrile illness, even in nonendemic areas.

PMID- 7777882
TI  - Intramural gastric actinomycosis.
AB  - We report a case of intramural gastric actinomycosis and review the features of
      the additional 16 cases of this uncommon infection reported in the literature.
      The patient had gastrointestinal symptoms, weight loss, and fever after gastric
      operation. At laparotomy, an infiltrating gastric tumor-like lesion was found.
      Histology revealed actinomycosis, and the patient was successfully treated with
      oral penicillin. Because of its rarity, intramural actinomycosis is an entity
      overlooked by most surgeons. Reporting of such cases may help increase the
      awareness of this important and curable disease.

PMID- 7777884
TI  - Hepatic iron overload associated with self-medication.
AB  - A patient with the incidental finding of an elevated serum ferritin level was
      found to have hepatic iron overload associated with iron injections. Liver
      disease is an example of one of the potential complications of folk remedies or
      patient self-medication that physicians may encounter, especially along the US
      Mexican border.

PMID- 7777886
TI  - Perforation of a Meckel's diverticulum during laparoscopic cholecystectomy.
AB  - Laparoscopic procedures incur risks and complications that differ from their
      "open" counterparts. Although rare, injury to asymptomatic umbilical remnants
      (eg, Meckel's diverticulum) is one of these unique complications.

PMID- 7777885
TI  - Progressive pulmonary cryptococcosis in a patient who is immunocompetent.
AB  - Pulmonary cryptococcal disease can have variable clinical and roentgenographic
      presentations. Symptoms and radiographic abnormalities can resolve prior to
      therapy, even in a patient who is immunocompromised. Antifungal therapy is
      generally not recommended for a patient who is immunocompetent with
      nonprogressive, nondisseminated pulmonary cryptococcosis. We present a case of
      pulmonary cryptococcosis that progressed despite fluconazole therapy in a patient
      who was immunocompetent. This appears to be the second reported case of a
      discrete endobronchial cryptococcoma.

PMID- 7777887
TI  - Torsion, necrosis, and inflammation of an epiploic appendix of the large bowel: a
      diagnostic and therapeutic dilemma.
AB  - We present the case of a young patient with abdominal pain of 3 weeks' duration
      and a preoperative presumptive diagnosis of acute appendicitis, diverticulitis,
      colon perforation, or possibly neoplasm. Even after resection of a large mass
      involving the right colon, the diagnosis was not confirmed until surgical
      pathology identified torsion, partial necrosis, and inflammation of an epiploic
      appendix of the right colon.

PMID- 7777888
TI  - Tracheoesophageal fistula as the initial presentation of Hodgkin's disease.

PMID- 7777889
TI  - Training room evaluation of chest pain in the adolescent athlete.
AB  - A physician or athletic trainer will often be faced with an athlete complaining
      of chest pain during or after an event. Chest pain in children and adolescents is
      usually of a noncardiac origin; only 5% of cases are due to cardiac problems.
      With a properly documented history and physical evaluation, one can usually
      identify the etiology of the chest discomfort or at least rule out any serious
      difficulties. The various diagnostic possibilities include cardiac,
      musculoskeletal, pulmonary, gastrointestinal, and psychiatric causes of pain. We
      discuss several specific conditions, as well as the signs, symptoms, and basic
      management.

PMID- 7777890
TI  - Association of systemic lupus erythematosus and gluten enteropathy.
AB  - Systemic lupus erythematosus presents various clinical manifestations. The
      coexistence of systemic lupus erythematosus and celiac sprue has been rarely
      reported. We present a patient who had systemic lupus erythematosus with
      malabsorption demonstrating characteristic clinical and pathologic findings of
      celiac sprue (gluten enteropathy).

PMID- 7777891
TI  - Primary lymphoma of the liver mimicking metastatic liver disease.
AB  - Primary lymphoma of the liver is rare. In the 50 previously reported cases in the
      literature, computed tomography usually showed a solitary, bulky hypodense area
      in the liver. We report a case of primary lymphoma of the liver presenting
      multiple lesions in the liver and clinical and biochemical evidence suggestive of
      metastatic adenocarcinoma of the liver.

PMID- 7777892
TI  - Multiple symmetrical lipomatosis: computed tomographic appearance.
AB  - In a case of localized multiple symmetrical lipomatosis (Madelung's disease), we
      examined the cervical fat accumulation by computed tomography. We describe the
      radiographic features of this process and briefly review the pathophysiology of
      this rare disorder.

PMID- 7777894
TI  - To care for health.

PMID- 7777893
TI  - Microangiopathic hemolytic anemia as an initial presentation of metastatic cancer
      of unknown primary origin.
AB  - Microangiopathic hemolytic anemia (MAHA) is a well-documented but rare
      complication of disseminated cancer; it usually occurs in the late or terminal
      stage of cancer. We describe a case of metastatic carcinoma of unknown origin in
      which MAHA was the initial presentation. A 36-year-old woman came to our hospital
      with lower back pain and progressive exertional dyspnea for 8 weeks. Hemolytic
      anemia, thrombocytopenia, and leukoerythroblastosis were found on admission. The
      peripheral blood smear revealed polychromasia, poikilocytosis, and many
      schistocytes. Bone marrow biopsy disclosed metastatic carcinoma. After careful
      workup, we failed to find the primary site of cancer. The anemia and
      thrombocytopenia responded dramatically to combination chemotherapy with 5
      fluorouracil, mitomycin C, and cisplatin. This case indicates that metastatic
      carcinoma should be included in the differential diagnosis in previously healthy
      patients with MAHA.

PMID- 7777895
TI  - Health system reform: whither the academic medical center?

PMID- 7777896
TI  - Overheating of drugs during shipping and storage.

PMID- 7777897
TI  - Altered responses to medications exposed to excessive temperatures during
      shipping.

PMID- 7777899
TI  - Tuberculous mastitis.

PMID- 7777898
TI  - Fingerstick glucose determination and CPR.

PMID- 7777900
TI  - Human genetic disease in Asia.

PMID- 7777901
TI  - Perspectives of using Euphorbia splendens as a molluscicide in schistosomiasis
      control programs.
AB  - A total of 1,426 species of plants had been tested in order to find out a vegetal
      derived molluscicide against the vectors of Schistosoma mansoni. Euphorbia
      splendens is one of the most promising molluscicides. In this article we briefly
      present the main aspects that have to be considered to use this plant as a
      molluscicide, which include some agricultural aspects and operational methods for
      application. This can be done by the extraction of the active principles
      (millaminas) present in the latex or in the raw juice obtained through total
      maceration of plants. The culture of E. splendens, which spreads out by
      vegetative sprouts, showed an annual average growth of 30 cm. After 1.5 years the
      average productivity of crude latex with a DL90 of 12 ppm concentration, was 1
      liter by 8m2 by cultivated area. This amount is enough to treat a volume of water
      of 97,200 liters. A comparative analysis between the cost of snail control
      through synthetic molluscicides was carried out based upon the data presented by
      Jobim (1979) for six controlling methods in several countries, and some cost
      aspects for E. splendens. This analysis was done considering a geographic
      parameter expressed by the index cubic meters of treated habitat per square
      kilometer, from which we can obtain an estimate dimension of the geographic area
      to be cultivated with E. splendens necessary to treat the same volume of water
      treated by synthetic molluscicides.

PMID- 7777902
TI  - Epidemiological studies of malaria at Pong Nam Ron, eastern Thailand.
AB  - Malaria is still a serious health problem in Thailand. Present attempts at
      controlling the disease by drug treatment and other means remain unsatisfactory.
      Thus, development of vaccination against malaria is a major research goal of
      malaria immunology. The objective of this study was to acquire epidemiological
      base line data for subsequent vaccine trials. A cross-sectional descriptive
      survey was conducted among 451 local inhabitants during the beginning of the
      transmission season in June 1989 at Pong Nam Ron District, Chanthaburi Province,
      Eastern Thailand where malaria transmission was likely to be high. Following the
      cross-sectional survey weekly morbidity surveillance was started to detect new
      cases of malaria by using active and passive case detection at the district
      hospital, local health centers and at neighboring malaria clinics. Entomological
      observations were made monthly to determine inoculation rates. Forty-six percent
      of the population were male and 54% female; one third were under the age of 15
      and 14% under the age of 5 years. Eighty percent of the adults were married.
      Sixty percent of the subjects interviewed gave a history of malarial illness in
      the past. Malaria, malnutrition, abnormal hemoglobin diseases and parasitic
      infestation were the main health problems in the study area. The annual parasite
      incidence of malaria was 149.6/1,000 population and two-thirds of them were
      asymptomatic indicating a semi-immune condition among these subjects. It was
      difficult to interpret the results of entomological studies due to low density of
      the malaria vector.

PMID- 7777903
TI  - Field evaluation of simplified radioactive and nonradioactive DNA probe methods
      for the diagnosis of falciparum malaria.
AB  - Specific DNA probe hybridization technique is one method of choice for detection
      of malaria infection. It provides an obvious advantage over conventional
      microscopy when large numbers of samples are simultaneously monitored. The method
      was simplified so that preparation and processing of blood specimens were all
      performed on membrane filters. Background signals generated from blood components
      were removed by treating samples spotted on the membrane with a series of buffer
      washes without the necessity of a protease digestion step. Hybridization was
      monitored using either 32P-or digoxigenin-labeled DNA probe. 849 field samples
      collected from various malaria endemic areas in Thailand have been evaluated by
      this protocol and compared with microscopic examination. Sensitivity obtained by
      this procedure was comparable to that of microscopy at a malaria clinic. The
      specificities of both types of DNA probes were better than 93%, but digoxigenin
      labeled probe performed better than 32P-labeled one when the numbers of parasites
      were less than 25 per 200 white blood cells.

PMID- 7777905
TI  - Significance of blood coagulation and platelet profiles in relation to pulmonary
      thrombosis in beta-thalassemia/Hb E.
AB  - In beta-Thalassemia hemoglobin E (beta-thal Hb E), hypoxemia with abnormal lung
      function was described and postmortem examination in these patients showed
      organized pulmonary trombi with thickened arterial wall, particularly in post
      splenectomized cases. Coagulation and platelet profiles were studied in 58 beta
      thal Hb E patients. In 35 cases with intact spleen, the fibrinolytic activity was
      significantly decreased with high antithrombin III activity, while coagulation
      tests revealed mild abnormality. The platelet aggregation to ADP, adrenaline,
      collagen and ristocretin were defective and platelet 5-hydroxytryptamine content
      was lower than normal. Twenty-three patients who had been splenectomized for 5-18
      years, decreased fibrinolytic activity and high antithrombin III activity were
      also observed. The coagulation profiles and platelet aggregation in response to
      ADP, adrenaline and collagen showed better results. Fourteen cases exhibited
      thrombocytosis and their thrombin generation was in the hypercoagulable range.
      Platelet aggregation in response to ristocetin remained defective and platelet 5
      hydroxytryptamine content was lower than in cases with intact spleens. Defective
      aggregation to ristocetin would indicate abnormal von Willebrand's factor (vWF).
      Decreased fibrinolysis should very likely have a role in the occurrence of
      thrombosis and the better hemostatic profiles in post-splenectomized cases would
      contribute to the more frequent thrombotic incidence in these cases.

PMID- 7777904
TI  - Exotoxin profiles of Campylobacters isolated in Malaysia.
AB  - Approximately 57% of clinical and 33% of poultry isolates examined produced a
      cytotoxin. Cytotoxic activity was detected in 25 (50%) isolates of Campylobacter
      of which 12 were isolated from bloody diarrhea and 9 from watery stools. The
      cytotoxin titers were low, ranging from 2 to 16. The crude filtrates from 50
      Campylobacter isolates showed no cytotoxic effect in Vero cells, no fluid
      accumulation in suckling mice and no hemolytic activity.

PMID- 7777906
TI  - The increasing importance of vitamin B12 deficiency as a contributing factor to
      anemia in Malaysia.
AB  - A comparative study was done to determine the profile of vitamin B12 and folate
      status in Malaysians during two different periods. For the period of 1987/88, we
      analysed a total of 9,162 cases (inpatients) referred for vitamin B12 estimation
      and 10,290 cases for folate estimation. We found that 2.6% were vitamin B12
      deficient and 31.2% were folate deficient. For the period of 1992/93, of the
      9,962 cases assayed, 8.2% were found to be vitamin B12 deficient whereas 7.6% of
      the 10,355 cases referred were folate deficient. Vitamin B12 and folate were
      assayed either using microbiological or radioassays. These findings indicate that
      there appears to be a change in the status of both vitamin B12 and folate over
      the five year interval.

PMID- 7777907
TI  - Hookworm anemia in the adult population of Jagapati village, Bali, Indonesia.
AB  - A cross sectional study was conducted in Jagapati Village, Bali to assess some
      characteristics of hookworm anemia among the adult population. Hookworm anemia
      was defined as an iron deficiency anemia in heavily infected individuals (EPG >
      2,000). WHO criteria for anemia and criteria of Hercberg for iron deficiency were
      used. In this study, 15 cases of hookworm anemia were found among 454 total
      samples (3.3%), or among 123 cases of iron deficiency anemia (12.2%). The age
      varied between 16-69 years with male to female ratio of 1:2.8. Twelve cases were
      found with symptoms and signs of anemia, 1 case with full blown hookworm anemia,
      and 2 cases were asymptomatic. The hemoglobin level was found to be 4.5-12.9
      g/dl, with 12 cases (80.0%) being classified as mild anemia, 2 cases (13.3%) as
      moderate anemia, and 1 case as severe anemia. The mean serum iron level was 39.6
      mg/dl, mean transferrin saturation was 11.1%, and mean serum ferritin level was
      9.6 ng/dl. Hypoalbuminemia was found in 9 cases (60.0%), eosinophilia in 8 cases
      (53.3%), and low serum folic acid level in 5 cases (38.5%). High total serum IgE
      level was found in all but one case, with mean total serum IgE level of 3,739
      U/ml. The intensity of hookworm infection was moderate in 11 cases (73.3%) and
      severe in 4 cases (26.7%). It could be concluded that hookworm anemia was
      characterized by iron deficiency anemia with eosinophilia, high serum total IgE
      level, hypoalbuminemia and moderate to severe hookworm infection.

PMID- 7777908
TI  - Detection by immunoblot assay of antibodies to Taenia solium cysticerci in sera
      from residents of rural communities and from epileptic patients in Bali,
      Indonesia.
AB  - Several studies from Bali have indicated the presence of Taenia solium.
      Relatively little has been reported, however, implicating human exposure to this
      parasite on Bali based upon the prevalence of anti-T. solium antibodies in
      asymptomatic and epileptic individuals. This study was conducted to determine by
      immunoblot assay and ELISA the frequency of anti-cysticercus antibodies in two
      groups of Balinese. Among 746 residents of four ecologic zones, 94 (13%) were
      positive by immunoblot. Of 74 epileptic patients from throughout the island, 10
      (14%) were positive by immunoblot and 8 (11%) by ELISA; however, only 4 (22%) of
      the 18 sera positive in either test were positive in both assays. The previously
      defined high specificity and sensitivity of immunoblot indicates that T. solium
      cysticercosis is well established in Bali and that a significant amount of
      epilepsy may be due to neurocysticercosis.

PMID- 7777909
TI  - Intestinal parasitoses in the Kandy area, Sri Lanka.
AB  - The prevalence of intestinal protozoa and geohelminths was assessed among two
      diverse populations in the Kandy area: adults attending medical outpatients
      clinics at the Teaching Hospital Peradeniya, and pre-school children in low-cost
      housing areas within the Kandy Municipality. In addition to a brief history and
      examination, a fresh stool sample was obtained and examined by direct smears in
      saline and iodine, and by formol-ether concentration. The children's stool
      samples were also examined for Cryptosporidium by cold Ziehl-Neelsen staining. A
      total of 192 stool samples from the adult outpatients (101 males, age range 15-82
      years, mean 51.4 years) and 354 samples from the pre-school children (age range 1
      72 months, mean 30 months) were examined. Entamoeba histolytica was not seen in
      any of the samples; Giardia cysts and Cryptosporidium oocysts were seen in three
      and one sample respectively from the pre-school children. The overall prevalence
      of geohelminth infections was 21.3% among the adults and 24.5% among the
      children. Ascaris lumbricoides was the predominant species in both populations.
      Comparison of the rate of intestinal parasite infection among 37 adult patients
      patients with non-specific abdominal complaints, with the rate among 37 matched
      controls with no abdominal complaints showed no significant difference (16% and
      19% respectively). This suggests that the presence of abdominal pain or diarrhea
      was unrelated to the presence of intestinal parasites in the adult study
      population. Although the techniques used were not highly sensitive, the absence
      of E. histolytic probably reflects a true decline in the prevalence of this
      parasite in Sri Lanka.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7777910
TI  - Quetelet index, hemoglobin and parasitic infection of rural women in northeast
      Thailand.
AB  - The Quetelet index, hemoglobin and parasitic infection rates of adolescent and
      young women from 21 villages in Northeast Thailand were assessed. Data were
      collected in the hot, rainy and cold seasons of the year. The proportion of
      undernourished females varied between 10 and 15% when a cut-off point of 18.7 of
      the Quetelet index was chosen. 23 to 33% of the women had hemoglobin levels below
      12 g%. Parasitic infection rates with various intestinal helminths were high but
      not related to the nutritional status or anemia.

PMID- 7777911
TI  - Seroepidemiological study of toxoplasmosis in two different geographical areas in
      Nepal.
AB  - A total of 302 serum samples collected from Chitawan (159) and Mustang (143)
      districts of Nepal were included in this study. Anti-toxoplasma antibody was
      detected using micro-latex agglutination (MLA) and ELISA methods. An overall
      positive rate was found to be 57.9%. The positive rate in Chitawan was
      significantly higher (64.1%) (less than 1,000 m altitude) compared to that in
      Mustang (51.0%) (more than 3,000 m altitude) (p < 0.05). Females in Chitawan
      showed significantly higher positive rate (71.2%) compared to males (56.9%) (p <
      0.05). On the contrary, though insignificantly, males showed higher positive rate
      (57.9%) compared to that of females (43.3%) in Mustang. Almost equal positive
      rate was observed among males in both study area. Females in Chitawan showed
      significantly higher (71.2%) positive rate compared to their counterparts in
      Mustang (43.3%) (p < 0.001). A slight increase in positive rate with age was
      observed in Chitawan while in Mustang a decreasing trend was noticed. Ethnically
      though statistically not significant, Indo-Aryans showed a higher positive rate
      (69.2%) compared to the positive rate shown by Tibeto-Burmans (63.1%) in Chitawan
      while the reverse was true in Mustang (Tibeto-Burmans: 53.8% and Indo-Aryans:
      38.4%). Interestingly, 2.9% and 1.3% of MLA positive samples showed toxoplasma
      IgM antibody. None of the IgM positive samples were positive for toxoplasmic
      antigens.

PMID- 7777913
TI  - Blastocystis hominis infection, a cause of human diarrhea.
AB  - Blastocystis hominis has long been described as a non pathogenic protozoan
      parasite until recently when claims have been made that it can result in
      pathogenic conditions. Of the 729 stool samples (614 from survey and 115 from
      pediatric wards) examined, 18.1% of them were found to be positive for one or
      more intestinal protozoan cyst. The commonest was Giardia intestinalis (8.4%)
      Followed by Entamoeba coli (7.1%) and Entamoeba histolytica (5.1%) in the normal
      children without symptoms of diarrhea. When diarrheic stools were examined, the
      commonest parasite encountered was Giardia (20.4%), followed by E. coli (15.9%)
      and E. histolytica (9.7%). Blastocystis was observed in 4.4% of the children who
      had diarrhea and 1.1% among the children taken from the normal population in the
      rural areas.

PMID- 7777912
TI  - Distribution of anti-Toxoplasma gondii antibodies among Orang Asli (aborigines)
      in Peninsular Malaysia.
AB  - The distribution of anti-toxoplasma antibodies among the aborigines in Malaysia
      and its association with other soil transmitted infections and eosinophilia were
      studied. A total of 415 serum samples were collected and tested by IFA test.
      Overall prevalence was 10.6%, lower than previously reported. The antibody titers
      showed a unimodal distribution peaking at 1:8 dilution. There was a higher
      proportion of high antibody titer (> 1:128) in the adult compared to the children
      with no significant difference in prevalence rate by sex. The pattern of
      infection does not differ from other soil transmitted infections and there was no
      association between raised Toxoplasma antibodies with eosinophilia.

PMID- 7777914
TI  - Enterobius vermicularis infection among children aged 1-8 years in a rural area
      in Malaysia.
AB  - The infection rate and relationship of enterobiasis with socio-economic status
      were determined in children aged 1-8 years, living in a rural area in Malaysia.
      Of the 178 subjects 40.4% were infected with Enterobius vermicularis. The
      distribution of enterobiasis among these children were analyzed in relation to
      age groups and sex. The rate of infection was significantly higher in older
      children (5-7 years). The association of enterobiasis with other factors studied
      such as number of persons per house, household income per months and mother's
      employment status were not significant. The sensitivity of three successive days
      anal swabs compared to a single swab was found to be statistically significant.

PMID- 7777915
TI  - Occurrence of the infective stage of Angiostrongylus cantonensis in the yellow
      tree monitor (Varanus bengalensis) in five Provinces of Thailand.
AB  - Twenty-two yellow tree monitors (Varanus bengalensis) were trapped and
      transported from 5 provinces, namely Lampang, Phitsanulok, Kamphaeng Phet, Tak
      and Prachin Buri to look for the infective larvae stage of Angiostrongylus
      cantonensis. In 4 provinces all of the yellow tree monitors were infected with
      the infective stage larvae of A. cantonensis altogether. Twenty-one of the 22
      yellow tree monitors (95.5%) in the five provinces were infected. Our results of
      this study extend our knowledge of natural prevalence of A. cantonensis in yellow
      tree monitors. The snail eating habit of the yellow tree monitor might possibly
      be the source of the larvae.

PMID- 7777916
TI  - Ultrastructural observations on cercaria of Schistosoma japonicum.
AB  - The present paper describes the ultrastructure of the surface topography, head
      organ, tegument, musculature, glandular system, primary alimentary tract and
      flame cells of the Chinese mainland strain of Schistosoma japonicum cercaria, as
      visualized with both scanning and transmission electron microscopes. The results
      not only illustrate the morphological features of the cercarial surface and its
      internal structure reflecting an adaptation to the aqueous habitat but also
      reveal the correlation between the morphological structure and physiological
      function.

PMID- 7777917
TI  - Studies on host-parasite relationship between the Puerto Rican strain of
      Schistosoma mansoni and Biomphalaria snails.
AB  - Immunoelectrophoretic studies on common antigenicities were carried out by using
      rabbits sera immunized with the Puerto Rican strain of Schistosoma mansoni adult
      worms or eggs and antigens of several adult Biomphalaria snails and vice versa.
      As the result, S. mansoni adult worm extracts produced 8 bands both with extracts
      of Biomphalaria glabrata pigmentation and B. glabrata pigmentado, 3 to 4 bands
      with those of B. glabrata albino and 1 to 2 bands with those of B. straminea. On
      the other hand, S. mansoni egg extracts produced 5 bands with extracts of B.
      glabrata pigmentation, 4 bands with those of B. glabrata pigmentado, 2 bands with
      those of B. glabrata albino and 1 band with those of B. straminea. In the
      experimental infection of adult Biomphalaria snails with five S. mansoni
      miracidia, the infection rate in B. glabrata pigmentation was 78.8%, and 71.2% in
      B. glabrata pigmentado, whereas the infection rate in B. glabrata albino was
      10.3%, and B. straminea was not susceptible to S. mansoni. The infectivity of
      each snail corresponded with the number of bands representing common
      antigenicities between host and parasite. Crude antigens of Biomphalaria snails
      were fractionated by Sephadex G-100 column, and each antigen fraction was tested
      with anti-S. mansoni adult worm and egg sera by immunoelectrophoresis. The common
      antigenicities between fractionated antigens of Biomphalaria snails and of ani-S.
      mansoni adult worm or egg sera mostly existed in the first fraction 1 with Mr >
      45 kDa.

PMID- 7777918
TI  - Cumulative exposure and its relationship with chronic filarial disease in
      bancroftian filariasis.
AB  - Several hypotheses have been put forth about the factors influencing the dynamics
      of infection and disease in lymphatic filariasis. However, appropriate validation
      of these hypotheses by real situation analyses of epidemiological data is
      lacking. The present analyses examine the relationship between cumulative
      exposure to infection and prevalence of disease by utilizing the existing
      entomological and clinical data collected between 1981 and 1986 in Pondicherry,
      South India, endemic for bancroftian filariasis. While there was a significant
      negative association when the cumulative exposure was correlated with total
      prevalence of disease (r = 0.70, p = 0.024) as well as hydrocele alone (r = 0.74,
      p = 0.014), a significant positive association was found with prevalence of
      lymphedema (r = 0.72, p = 0.018). These results suggest that hydrocele
      development follows early after exposure, but prolonged exposure could result
      either in development of lymphedema or immune tolerance resulting in
      microfilaremia. These could also suggest that the pathomechanisms in development
      of hydrocele and lymphedema could follow different pathways. Implications of the
      present findings are discussed in light of the various hypotheses put forward by
      earlier studies.

PMID- 7777919
TI  - Composite fish culture for mosquito control in rice fields in southern India.
AB  - Composite culture of edible fishes (common carp, Cryprinus carpio; silver carp,
      Hypopthalmithys molitrix, grass carp, Ctenopharyngodon idella; catla, Catla
      catla; rohu, Labeo rohita; and mrigal, Cirrhinus mrigala) in rice fields in the
      Cauvery delta of Tamil Nadu, southern India, resulted in 81.0% reduction in the
      immature mosquito population of anophelines and 83.5% of culicines. Analysis of
      fish feces for mosquito larval head capsules showed that common carp and silver
      carp are effective larvivores. The selective feeding of common carp on culicines
      and silver carp on anophelines is correlated to their trophic niches. Net profit
      in the fish-cum-rice fields was 2.5 times greater than fields in which rice alone
      was cultured. Hence, rice-cum-fish culture can be recommended to the farming
      community in this area.

PMID- 7777920
TI  - Comparative susceptibility of Periplaneta americana (L) to five pyrethroid
      insecticides.
AB  - Five pyrethroids namely, lambda-cyhalothrin, permethrin, deltamethrin, cyfluthrin
      and alpha-cypermethrin were evaluated using adult male and female cockroaches,
      Periplaneta americana (L). The American cockroaches were exposed for 10 minutes
      to glass jars treated with different concentrations of the five pyrethroids. The
      cockroaches were susceptible to all five pyrethroids and the susceptibility based
      on LC50 and LC50 were observed to be in the following order: lambda-cyhalothrin >
      permethrin > deltamethrin > cyfluthrin > alpha-cypermethrin The results showed
      that lambda-cyhalothrin was the most effective and alpha-cypermethrin was the
      least effective against Periplaneta americana (L).

PMID- 7777921
TI  - Adult population differences in response to six insecticides in Culex
      fuscocephala Theobald.
AB  - Adult bioassay was conducted in the laboratory on two populations of Culex
      fuscocephala, a vector of Japanese encephalitis (JE) in India, against two
      organochloride compounds (DDT and dieldrin), an organophosphate compound
      (malathion), a carbamate pesticide (propoxur) and two synthetic pyrethroids
      (deltamethrin and cyfluthrin) using WHO techniques. The adult populations from
      Mandya an irrigated agricultural area, and Mysore, a non-agricultural place in
      Karnataka, India, have been employed for the experiments. JE outbreaks were
      reported from these places at different times. Among the insecticides used
      malathion in 5% concentration was found to be the most effective while,
      cyfluthrin (0.05%) and deltamethrin (0.025%) were very effective in much lesser
      concentration. For both propoxur (0.1%) and DDT (4.0%) the two populations of Cx.
      fuscocephala expressed least susceptibility in terms of the LT50. Against
      dieldrin (0.4%), cyfluthrin, DDT and malathion Mysore population showed
      relatively more susceptibility than Mandya population. However for deltamethrin
      and propoxur the Mandya population registered less tolerance than the Mysore
      population. Thus adult population responses to different insecticides are
      variable in the present study.

PMID- 7777922
TI  - Effect of sublethal dosages of insecticides on chikungunya virus susceptible and
      refractory strains of Aedes aegypti.
AB  - Three strains of Aedes aegypti mosquitos viz (i) CRS, refractory to Chikungunya
      (CHIK) virus by oral route of infection but susceptible to DDT (2) CSS,
      susceptible to CHIK virus and also susceptible to DDT (3) CSS-DDTR, susceptible
      to CHIK virus but resistant to DDT, were examined for the effect of sublethal
      dosages of DDT and deltamethrin on their fecundity. Biochemical analysis showed
      that there was an increase in glutathione s-transferase activity in the CSS-DDTR
      strain which was associated with DDT resistance. There was an increase in
      acetylcholinesterase activity in the CRS strain, however it was not associated
      with resistance to all the three insecticides tested. No significant differences
      in the fecundity of these three strains were observed, though there was some
      increase in the number of non layers in CSS-DDTR strain after the treatment of
      DDT and mean number of eggs laid by CSS and CRS strains was slightly reduced (0.5
      > p < 0.1) after the treatment with deltamethrin.

PMID- 7777923
TI  - Breeding of Aedes aegypti (L.) and Aedes albopictus (Skuse) in urban housing of
      Sibu town, Sarawak.
AB  - An Aedes survey using various larval survey methods was conducted in 12 urban
      housing areas and 29 vacant lands in Sibu town proper. Aedes albopictus larvae
      were found in all areas surveyed while Aedes aegypti larvae were present in 10
      localities and 4 vacant lands. There were no significant difference in the house
      index, breteau and larval density index of these two Aedes (Stegomyia) species
      from the survey areas. The proportion of containers positive with Ae. aegypti and
      Ae. albopictus in area outside the house compound and near the house fencing were
      3.2 times higher than outdoor compound. The indoor/outdoor breeding ratio for Ae.
      aegypti alone is 1.6:1. The most preferred breeding habitats outdoor were plastic
      cups and used tires while indoor habitats were ant traps and flower vases. In the
      vacant lands, the average number of larvae per containers was significantly
      higher than in houses and over 51% of the containers inspected were positive.
      Shared breeding between Ae. aegypti and Ae. albopictus larvae accounted for 9% in
      house surveys and 4.5% in vacant land survey. The use of various methods in Aedes
      larval survey may provide essential information in the study of vector
      epidemiology in dengue and dengue hemorrhagic fever transmission.

PMID- 7777925
TI  - Dengue-3 (16562) PGMK 33 vaccine: neurovirulence, viremia and immune responses in
      Macaca fascicularis.
AB  - Investigation of monkey neurovirulence of dengue-3 viruses (DEN-3, 16562) was
      undertaken to provide an evaluation of the relative safety of virus strain
      attenuated for potential use of live virus vaccine. Ten flavivirus-negative,
      cynomolgus monkeys (Macacafascicularis) were used in the test. The animals were
      inoculated intrathalamically, intraspinally and intramuscularly with DEN-3 PGMK
      33 attenuated live virus vaccine (6 monkeys): parent virus (2) and control cell
      culture fluid (2). Blood samples were collected on days 0, 1, 2, 4, 6, 8, 10, 12
      and 21 for virus isolation and days 0 and 21 or 22 for serologic testing. One
      monkey with DEN-3 (16562) PGMK 33 candidate vaccine had detectable viremia on day
      10. By day 21, all recipients of PGMK 33 and both monkeys with DEN-3 parent virus
      developed serum neutralizing antibodies to DEN-3 titers ranged from 56-320. The
      monkeys showed no evidence of illness and none died of dengue infection.
      Histopathological examination of tissue collected on day 21 or 22 revealed only
      minimal neurovirulence lesions as scored by the routine grading system. No
      differences were observed between the DEN-3 parent and vaccine viruses and it is
      concluded that neither virus is neurovirulent for cynomolgus monkeys.

PMID- 7777924
TI  - Early mental and neurological sequelae after Japanese B encephalitis.
AB  - Japanese B encephalitis is a disease with high mortality and many of those
      surviving suffer from serious sequelae. During the 1992 epidemic in northern
      Vietnam 50 patients treated at the Institute for Protection of Children's Health
      in Hanoi were studied concerning the type of sequelae and the development of the
      symptoms during the first two months of the disease. The age span was 1 to 15
      years. 29 of the patients (58%) did not recover fully during the observation
      period. Fifteen (30%) showed signs of both neurological and mental disturbances.
      Nine (18%) only had mental symptoms while 5 (20%) suffered from isolated
      neurological sequelae. EEG was pathological in 9 out of 30 tested cases (30%); 9
      of 23 patients (39%) performed subnormal IQ tests. Deep coma, bronchopneumonia
      with cyanosis, apnea attacks, prolonged fever and coma were all correlated
      (without statistical significance) to a higher risk for subsequent sequelae.

PMID- 7777928
TI  - Vaccine-preventable disease susceptibility in a young adult Micronesian
      population.
AB  - Current US military recruit vaccination policy presumes that recruits have had a
      complete childhood immunization series. This assumption may not be appropriate
      for recruits from Micronesia, who may have had limited access to modern health
      care, including immunization programs. During 1988 and 1990, a cross-sectional
      serosurvey was conducted among 66 US military recruits, 56 from the Federated
      States of Micronesia and 10 from the Republic of the Marshall Islands,
      collectively referred to as Micronesia. Antibody seronegativity levels for 12
      vaccine-preventable (or potentially so) diseases were: measles (52%), mumps
      (14%), rubella (21%), varicella (38%), diphtheria (39%) tetanus (0%), polio type
      1 (4%), polio type 2 (0%), polio type 3 (14%), hepatitis A (9%), hepatitis B
      (17%), and hepatitis C (98%). Compared with Army recruits in general, Micronesian
      recruits were significantly more likely to be seronegative for measles and
      varicella and seropositive for hepatitis types A and B. Personal histories of
      disease were felt to be inadequate in predicting antibody status.

PMID- 7777927
TI  - Poliomyelitis and measles serosurvey in northern Malaysia.
AB  - In 1990 the Institute for Medical Research carried out a serosurvey in the state
      of Kelantan to study the age stratified immune prevalence rates for measles and
      poliomyelitis. Our findings indicate that 981 out of 1,097 (89%) of the
      population screened had measles antibodies and more than 90% (366 out of 400) had
      antibodies to all three serotypes of poliovirus. The susceptible group for
      measles was infants below one year of age, of whom 53.3% (8/15) did not have
      measles antibody. Of 400 subjects, 125 (31.3%) who were either incompletely
      vaccinated or had not been vaccinated against poliomyelitis, had polio
      neutralizing antibodies to all three poliovirus serotypes, suggesting herd
      immunity in the population. No high risk age group could be identified for
      poliomyelitis.

PMID- 7777929
TI  - Endemic goiter in the Lemanak and Ai river villages of Sarawak.
AB  - In a survey of 974 villagers (408 males, 566 females; ages = 11-82 years) of the
      Ai (n = 496; 212 males, 284 females) and Lemanak (n = 478; 196 males, 282
      females) rivers in the district of Lubuk Antu in Sarawak's Sri Aman Division
      during July 1993, goiter was found in 31.8% of the subjects. The goiter
      prevalence was higher in the more interior Ai river area than in the Lemanak
      river area (36.9% vs 26.5%). In females aged 15 years and above, the goiter
      prevalence was 75.4% and 49.1%, respectively, in the Ai and Lemanak river areas.
      The difference in goiter prevalence between the two areas was related to the
      degree of iodine deficiency in the two areas. The median urinary iodine excretion
      in the Ai river villagers was 22.1 micrograms/l compared to 72.9 micrograms/l in
      the Lemanak river villagers (p < 0.0001). Goitrous subjects tended to have lower
      urinary iodine concentration than non-goitrous subjects. In the males, smoking of
      tobacco was associated with a two-fold increase in goiter frequency. Despite on
      going distribution of iodized salt by the medical and health services in the
      State, only 23% of the 135 salt samples obtained from the households in the areas
      contained detectable iodine.

PMID- 7777926
TI  - Storage stability of dengue IgM and IgG antibodies in whole blood and serum dried
      on filter paper strips detected by ELISA.
AB  - Blood specimens from 133 patients clinically diagnosed as dengue virus infection
      by physicians in Nakhon Phanom Hospital, Thailand, were examined to detect anti
      dengue IgM and IgG antibodies by antibody capture ELISA. The blood specimens were
      divided into 3 types of storage; (1) frozen serum aliquots, (2) whole blood dried
      on filter paper strips, and (3) sera dried on filter paper strips. These
      specimens were stored for the periods of 1, 3, 4, and 5 months, at -20 degrees C
      in the case of frozen serum aliquots, or at room temperature in the case of
      specimens dried on filter paper strips, before examined in paralleled by the
      ELISA. Anti-dengue IgG antibodies were stable for at least 5 months of storage as
      dried whole blood or serum on filter paper strips. So were the anti-dengue IgM
      antibodies in the dried whole blood from secondary dengue cases. Anti-dengue IgM
      antibodies from primary dengue cases declined slowly in whole blood and more
      rapidly in serum, both dried on filter paper strips. In the serum dried on filter
      paper strips, even anti-dengue IgM antibodies from secondary cases decreased
      significantly on storage. We suggest that diagnosis on dengue infections by IgM
      capture ELISA should be performed within 1 month after the test specimens are
      collected as whole blood, not as serum, when the filter paper method is used for
      sample collection.

PMID- 7777930
TI  - Hospital admissions due to acute poisoning in the New Territories, Hong Kong.
AB  - To study the pattern of acute poisoning in the New Territories East of Hong Kong,
      291 adult cases admitted to the Prince of Wales Hospital in 1989 were reviewed.
      The female-to-male ratio was 2.3 to 1 and the majority of patients (83%) were
      below the age of 40. The main poisons involved were hypnotics and sedatives
      (44.3%), household products (14.8%) and analgesics (10%). The poisoning was
      intentional in the majority of cases (98.6%). A specific antidote was necessary
      in 5.2% of cases. Four patients died after admission giving an overall mortality
      of 1.4%. When compared to the findings from other western countries, important
      variations in the pattern of acute poisoning were seen in Hong Kong. Firstly, a
      substantial proportion of drugs ingested were not dispensed labeled although
      their nature could usually be determined. Secondly, "Dettol", a household
      antiseptic, was commonly used in self-poisoning episodes. The lack of drug
      identification labeling on dispensed medicines outside hospitals is of great
      concern to all physicians in Hong Kong.

PMID- 7777931
TI  - Socio-demographic characteristics and health status of urban Thai elderly.
AB  - Socio-demographic and health status of 205 elderly aged 60-90 years who attended
      a special clinic for the elderly at Rajvithi Hospital were investigated. All of
      the subjects had no major complaints and seemed to be apparently healthy. Socio
      economic situation, life-style pattern and other health related information was
      assessed. Nearly all of the elderly lived with their relatives. Quite a high
      number of the females had never attended school. Almost 60% of the elderly had no
      regular income. The health situation of the individuals under investigation
      seemed to be satisfactory. The majority did not smoke and did not drink alcohol.
      There are indications that in the future more of the elderly population will stay
      alone and will face economical problems because of the absence of general social
      security scheme for Thailand.

PMID- 7777932
TI  - Knowledge, attitudes and practices of mothers on childhood acute respiratory
      infections (ARI).
AB  - A total of three hundred mothers in both rural and urban areas were interviewed
      and their knowledge, attitude and practice (KAP) on acute respiratory infections
      (ARI) were compared. It was observed that KAP on ARI of mothers in both
      categories was almost the same with the exception of their health care seeking
      practice. Most had traditional beliefs as to the cause of ARI with only a
      minority knowing the causes. Only one third of mothers knew signs and symptoms of
      pneumonia; the majority had not experienced the fatal danger sign, chest
      indrawing and could not recognize it. As regards health care seeking practices,
      private general practitioners were identified as favorite health providers in
      urban areas. Utilization of government health facilities was higher among rural
      mothers. Self medication was found to be common in both categories of mothers,
      with western medicine being the top of the list.

PMID- 7777934
TI  - Capillariasis with chronic intestinal pseudo-obstruction.

PMID- 7777933
TI  - Meningoencephalomyelitis and neuritis clinically diagnosed as multiple sclerosis.

PMID- 7777935
TI  - Melioidotic spondylitis mimicking tuberculous spondylitis.

PMID- 7777936
TI  - Control of intractable gastric hemorrhage by monosodium glutamate.

PMID- 7777937
TI  - Evaluation of neem oil as sandfly, Phlebotomus papatasi (Scopoli) repellent in an
      Oriental sore endemic area in Rajasthan.

PMID- 7777938
TI  - [Forensic expert relevance of imaging examinations in diagnosis of degenerative
      and occupational diseases of the lumbar spine].

PMID- 7777939
TI  - [Pulsating tinnitus in aberrant internal carotid artery combined with abnormal
      position of the jugular vein bulb. Case report].

PMID- 7777940
TI  - [Paravertebral extramedullary hematopoiesis in congenital dyserythropoietic
      anemia type II (CDA II)].

PMID- 7777941
TI  - [Radiotherapy and survival in CNS involvement in non-Hodgkin's lymphoma].

PMID- 7777942
TI  - [Area-wide supply of advanced radiologic devices in Bavaria].

PMID- 7777943
TI  - [What is the prognosis for patients with recurrent gastric carcinoma?].
AB  - The authors discuss the problem of relapses of gastric cancer, the conditions of
      its development and its possible treatment. As a basis they use experience with
      the treatment of 167 patients operated on account of this condition at the First
      Surgical Clinic in Olomouc in 1986-1993. In these patients 77 radical operations
      were performed, 25 developed a relapse of the tumor. Only in two patients it was
      possible to perform another resection--total gastrectomy. In these two re
      resected patients the mean survival period was 9 months, in the remainder only
      two months. The authors conclude that in relapses of gastric cancer even several
      months' survival are a success.

PMID- 7777944
TI  - [Variations in extrahepatic bile ducts, their arteries and pancreatic ducts].
AB  - The author presents a brief account of congenital varieties of extrahepatic
      biliary pathways, a cystica and pancreatic ducts and explains their development.
      Good knowledge of these varieties is of great importance for detailed preparation
      in laparoscopic cholecystectomy and during fibroscopic examination of duodenal
      papillae.

PMID- 7777945
TI  - [Inguinal hernia surgery in 1993 in Slovakia].
AB  - The authors present an account of a survey (by questionnaires) focused on surgery
      of inguinal hernias. The recovery rate of questionnaires was 84%. The standard
      techniques in surgery of child hernias are Gross (29%) and Girard (29%). In
      primary hernias more than 50% are made by Bassini's and Girard's plastic
      operation. So far the worldwide accepted plastic operation of Shouldice is rarely
      used 14%. In the techniques of relapsing hernias also inadequate plastic
      operations are used; the ratio of Lichtenstein's plastic operation which has the
      lowest relapse rate is only 4.5%.

PMID- 7777946
TI  - Infected late false aneurysm of the superficial femoral artery. Case-report.
AB  - A 24-year-old Croatian soldier sustained a comminuted fracture of the femur and
      after stabilization with AO external fixation an infected late false aneurysm of
      the superficial femoral artery developed. The aneurysm was extirpated and the
      artery reconstructed using the saphenous vein.

PMID- 7777947
TI  - [Right-sided pneumothorax--a complication of laparoscopic cholecystectomy].
AB  - In a 49-years old woman cholecystolithiasis was confirmed by sonography and she
      was admitted for laparoscopic cholecystectomy. During the operation right-sided
      pneumothorax developed as a result of the injury of diaphragma by monopolar
      electrocautery. Operation was converted and the injury was treated by continuous
      suture. Carbon dioxide was spontaneously resorbed from thoracic cavity during the
      5 days following the operation without tube thoracostomy. The operating wound was
      healed per primam and the patient was discharged on the 14th postoperative day.

PMID- 7777948
TI  - [Modern dressings. Hydrogels].
AB  - Hydrogels are occlusive types of dressings. They are three-dimensional nets made
      up of hydrophil polymers. They can be produced from synthetic or semisynthetic
      materials or a combination of the two. Hydrogels retain different percentages of
      water but are themselves insoluble in water. This is why they maintain on the
      wound surface their structure and do not dissolve. They are suited for the
      dressing of wounds with low secretion such as grade I and II burns, grade I and
      II bedsores and above all epithelial defects, major skin abrasions and areas
      after collection of epithelial grafts. Their use is contraindicated in infected
      wounds, in wounds with a massive secretion and ulcers of arterial origin.
      Although the domain of their clinical use are clean granulating or already
      epithelizing wounds, they are very well suited also for rehydration of dry and
      black skin necroses. Their advantages include minimal pain in the wound as well
      as the fact that they can be left on the wound without redressing till complete
      healing. This is made possible also by the fact that they are translucent.

PMID- 7777949
TI  - [Personal experience with administration of Zinacef in the form of a "protected
      coagulum" in patients after heart surgery].
AB  - Antibiotic prophylaxis in the form of a so-called protected coagulum is an
      important part of prevention of postoperative infections in cardiosurgery. The
      selection of a suitable antibiotic depends on many factors--its effectiveness
      against the most frequent pathogens, the tissue penetration, undesirable effects.
      The authors compared two groups of patients operated on account of IHD using
      prophylaxis with cefalotine (491 patients) and cefuroxime (241 patients). The
      groups are comparable as to baseline parameters. In the cefuroxime-treated group
      was a significantly lower incidence of infections of the surgical wound (12.6 %
      vs. 5.8 %). The number of serious infectious complications (mediastinitis,
      osteomyelitis) and the incidence of other infections did not differ in the two
      groups.

PMID- 7777951
TI  - Academic health service complexes.

PMID- 7777950
TI  - The use of volatile agents in southern Africa.

PMID- 7777952
TI  - Practical application of data obtained from a Perinatal Problem Identification
      Programme.

PMID- 7777953
TI  - Private sector health care expenditure in South Africa.

PMID- 7777954
TI  - Putting the records straight--a plea for improved abortion data.

PMID- 7777955
TI  - Toxaemia--a question of balance.

PMID- 7777956
TI  - Abortion--a debate.

PMID- 7777957
TI  - Abortion reform--imperative or outrageous?

PMID- 7777958
TI  - Confidentiality concerning HIV/AIDS status--the implications of the Appeal Court
      decision.
AB  - The Appellate Division recently overturned a Supreme Court judgement concerning
      the disclosure of a patient's HIV status by his general practitioner to another
      general practitioner and a dentist. This article examines the content of both
      judgements with particular reference to its implication for the medical
      profession, and considers the arguments that may be raised for and against
      disclosure of a patient's HIV seropositivity.

PMID- 7777959
TI  - The value of incorporating avoidable factors into perinatal audits.
AB  - OBJECTIVE: To assess whether incorporating a system of identifying, classifying
      and grading avoidable factors into a perinatal audit can be useful in identifying
      problem areas. DESIGN: Descriptive study. SETTING: Black urban population,
      Pretoria, South Africa. SUBJECTS: All perinatal deaths of infants weighing more
      than 1,000 g from urban areas served by Kalafong Hospital between August 1991 and
      July 1992. METHODS: All perinatal deaths were classified according to the primary
      obstetric cause of death and neonatal cause of death, and whether any avoidable
      factors were present which could have contributed to the death. RESULTS: The
      perinatal mortality rate was 26/1,000 deliveries. Avoidable factors occurred in
      58% of perinatal deaths. Our problem areas which were immediately remedial were
      identified as labour management-related problems, administrative problems in
      obtaining syphilis results, and estimation of fetal weight. Other problem areas
      which need to be solved are patient education, early attendance at clinics,
      improved documentation and continuing education of medical personnel. CONCLUSION:
      The use of this classification of avoidable factors has enabled the detection of
      problem areas that can be improved immediately at very little cost.

PMID- 7777960
TI  - Audit incorporating avoidability and appropriate intervention can significantly
      decrease perinatal mortality.
AB  - OBJECTIVE: To evaluate the role of the ICA (Identification, Cause, Avoidable
      factor) Solution method of perinatal audit in reducing perinatal mortality.
      DESIGN: Retrospective audit of 1,060 perinatal deaths between 1 January 1991 and
      31 December 1992. SETTING: Livingstone Hospital Maternity Service. SUBJECTS: One
      thousand and sixty perinatal deaths, where the gestational age exceeded 28 weeks
      or, when gestational age was unknown, the birth weight was equal to or exceeded
      1,000 g. MAIN OUTCOME MEASURES: All perinatal deaths were identified and
      classified by primary obstetric cause for perinatal loss. In the second year of
      the study avoidable factors were sought and, if found, graded and categorised.
      RESULTS: The major primary obstetric causes of perinatal loss identified and
      amenable to intervention were intrapartum trauma, intrapartum asphyxia and
      infection. In the second year of study potentially avoidable factors were sought
      and identified in almost 50% of perinatal deaths. Appropriate intervention
      lowered the perinatal mortality rate by 23% (P < 0.05; odds ratio 0.76; 95%
      confidence interval 0.67-0.86). CONCLUSION: The ICA Solution method of perinatal
      audit identified problems in overall obstetric care, facilitating a significant
      fall in perinatal mortality.

PMID- 7777961
TI  - The impact of the Perinatal Education Programme on cognitive knowledge in
      midwives.
AB  - OBJECTIVE: To determine whether the Maternal Care and Newborn Care manuals from
      the Perinatal Education Programme significantly improves the cognitive knowledge
      of midwives. DESIGN: Assessment of cognitive knowledge by means of multiple
      choice testing. These tests were conducted before and after each of the 30 units
      of the Programme. In addition, a multiple-choice examination was arranged on
      completion of each of the two manuals. SETTING: Level I, II and III hospitals and
      level I clinics in urban and rural areas of South Africa. PARTICIPANTS: One
      hundred and fourteen midwives from hospitals and clinics. INTERVENTION: Maternal
      and Newborn Care manuals of the Perinatal Education Programme, studied at home
      and later discussed by the participants in groups every few weeks. MAIN OUTCOMES
      MEASURED: Number of participants who completed a manual, mean results of the
      pretests and post-tests, mean results of the final examination, and percentage of
      participants achieving 80% or more in the pretests, post-tests and final
      examination. RESULTS: Mean pretest and post-test results for the Maternal Care
      manual were 65% and 85% respectively. Mean pretest and post-test results for the
      Newborn Care manual were 72% and 93% respectively. The mean result for the final
      examination for the Maternal Care manual was 90%, while the mean result for the
      Newborn Care manual was 95%. There was a significant improvement in cognitive
      knowledge when either manual was used. CONCLUSION: The cognitive knowledge of
      both maternal and newborn care can be significantly improved when midwives use
      the Perinatal Education Programme in an outreach, co-operative learning course.

PMID- 7777962
TI  - Reregistration of gynaecologists in South Africa--the profession's opinion.
AB  - OBJECTIVE: Testing of the profession's opinions and attitudes with regard to a
      possible reregistration system. METHODS: A questionnaire was sent to all the
      gynaecologists in South Africa to test their opinions and attitudes with regard
      to reregistration. RESULTS: After two mailings, 62.4% of the 603 gynaecologists
      had responded. Seventy per cent of the respondents were in private practice while
      19% were in full-time academic positions. More than two-thirds (68%) of the
      respondents resided in a city, close to a medical school. Although 74% were in
      favour of the implementation of a reregistration system, only 56% were
      enthusiastic about it. Congress attendance and self-study programmes were the
      categories in which more than 85% of the respondents would be able to earn
      points. The general feeling was that such a system should be governed by the
      profession. CONCLUSIONS: The profession was in favour of a system of
      reregistration, but great concern was expressed at the contents of such a
      programme and the manner in which it would be governed.

PMID- 7777963
TI  - Use of saliva as an alternative to serum for HIV screening in Africa.
AB  - Saliva has been recommended as a safe and effective alternative to serum for
      enzyme-linked immunosorbent assay (ELISA) for HIV antibodies in surveillance
      programmes in developing countries. We evaluated the use of saliva specimens for
      detection of HIV antibodies using three different commercially available ELISAs.
      Saliva specimens from 107 patients selected at random from HIV high-risk (38),
      medium-risk (27) and low-risk (42) areas of the hospital were screened with the
      Wellcozyme HIV1 + 2 GACELISA VK61 (recommended for use with saliva), Wellcozyme
      HIV1 + 2 VK54/55 and Wellcozyme HIV-1 recombinant VK56/57. Of the 107 patients,
      50 were positive and 57 negative for antibodies to HIV on confirmatory Western
      blot testing. For detection of antibodies to HIV in saliva, the Wellcozyme HIV1 +
      2 GACELISA VK61 had a sensitivity and a specificity of 98%, the Wellcozyme HIV-1
      recombinant VK56/57 a sensitivity and specificity of 96%, and the Wellcozyme HIV1
      + 2 VK54/55 a sensitivity of 94% and a specificity of 95%. For detection of
      antibodies to HIV in serum, the Wellcozyme HIV-1 recombinant VK56/57 had a
      sensitivity and a specificity of 100%, the Wellcozyme HIV1 + 2 GACELISA VK61 a
      sensitivity and a specificity of 98%, and the Wellcozyme HIV1 + 2 VK54/55 a
      sensitivity and a specificity of 96%. This study illustrates that saliva can be
      used as an alternative to serum for screening for anti-HIV antibodies in African
      patients.

PMID- 7777965
TI  - Drug policy.

PMID- 7777964
TI  - Retinal detachment in black South Africans.
AB  - Rhegmatogenous retinal detachments seen in black patients attending King Edward
      VIII Hospital Ophthalmology Clinic over a 5-year period from January 1987 to
      December 1991 were reviewed. Penetrating trauma and diabetic retinopathy were
      excluded. There were 114 detachments in 112 patients, which gave incidence of
      0.46/100,000 of the population served per annum. This confirms the low incidence
      of this disorder found in black patients in other series. Patients were
      comparatively young (37.5% less than 30 years of age), men outnumbered women 2:1,
      and the incidence of blunt trauma was high (29.8%). Over one-third (36.6%)
      presented with a blind or poorly sighted opposite eye. Late presentation was
      common. Large posterior breaks occurred in 15.7% of detachments with severe
      proliferative vitreoretinopathy in 33.3%. These last characteristics accounted
      for the use of vitrectomy with tamponade as a primary surgical procedure in 32.5%
      of cases and contributed to the relatively low success rate of reattachment
      (72.8%). Some of the findings may be influenced by social disadvantage, but the
      reason for the low incidence of retinal detachment in black patients is not
      known. A stronger adherence of the retina to the retinal pigment epithelium in
      black patients is postulated.

PMID- 7777966
TI  - Pulmonary complications in 110 consecutive renal transplant recipients.
AB  - The pulmonary complications in 110 consecutive renal transplant recipients on
      cyclosporin and low-dose steroid immunosuppression were studied retrospectively.
      The pulmonary complications were: acute pulmonary oedema in 19 patients,
      pneumonia in 18, tuberculosis in 9, acute pulmonary embolism in 5, and lung
      abscess in 1. Sixty-nine patients (62.7%) had no pulmonary complications; 69% of
      the complications occurred in the first 4 months after the transplant. Pulmonary
      tuberculosis became evident later. The mean age, period of follow-up, human
      leucocyte antigen (HLA) B/DR mismatches, mean serum urea and serum creatinine
      concentrations, systolic and diastolic blood pressures, and cyclosporin dosage
      did not differ between the groups with no complications, infectious complications
      and non-infectious complications. The number of rejection episodes treated with
      bolus steroids was significantly higher in the infectious and non-infectious
      complications groups compared with the group with no complications. The incidence
      of pulmonary complications after renal transplantation, especially pneumonia and
      tuberculosis, was still high despite the use of low-dose steroids and
      cyclosporin. Pulmonary complications were the commonest cause of death in the
      first 3 years after the transplant. A high index of suspicion for pulmonary
      tuberculosis and pulmonary embolism in these patients is necessary.

PMID- 7777967
TI  - [Chronic osteomyelitis - a diagnostic dilemma].
AB  - Infective skeletal lesions can mimic bony tumours. Bony lesions without
      periosteal reactions in adult patients with normal leucocyte counts will have a
      different differential diagnosis from that of children with bony lesions and a
      periosteal reaction. In the latter, osteomyelitis should be distinguished from
      Ewing's sarcoma and osteogenic sarcoma. Due to the difficult preoperative
      diagnosis a retrospective study was undertaken which included 14 patients with
      the histological diagnosis of chronic osteomyelitis but normal leucocyte count
      and no periosteal reaction. Radiographs showed cavities in 82%, infiltration in
      12% and sclerosis in 6% of cases. All patients who underwent skeletal
      scintigraphy studies showed increased uptake in the lesions. Magnetic resonance
      showed increased signal intensity in T2 images. Ordinary radiographs are still
      the most valuable primary investigation for skeletal lesions.

PMID- 7777968
TI  - BCG vaccination status of children with tuberculous meningitis and the use of
      unsupervised isoniazid prophylaxis.
AB  - From 1985 to 1992, 193 children with tuberculous meningitis (TBM) with a median
      age of 26 months were admitted to the Department of Paediatrics and Child Health,
      Tygerberg Hospital. Of these children 143 (74%) were documented to have received
      BCG, either by reference to 'Road to Health' cards or by contact with local
      authority clinic staff. In a further 18 children a BCG scar was visible.
      Therefore at least 161 of the children (83%) had received BCG vaccination. As the
      Western Cape has also been shown to have the highest incidence of TBM in South
      Africa, there is concern that BCG as currently used does not have a significant
      protective effect against disseminated tuberculosis. Seventy-seven children (40%)
      were also reported to have a close household contact who had been treated for
      pulmonary tuberculosis within the previous 24 months. Only 17 of these children
      (22%), however, were prescribed prophylactic isoniazid and only 7 of these
      completed 3 months or more prophylaxis.

PMID- 7777969
TI  - Human resources for health.

PMID- 7777970
TI  - A prospective study of iron status in white and black pregnant women in an urban
      hospital.
AB  - Evaluation of the iron status (haemoglobin and ferritin concentrations, and
      percentage transferrin saturation) in a prospective study of 65 pregnant women
      (55 white and 10 black) revealed that adequate maternal iron stores during
      pregnancy cannot be maintained with prevailing dietary patterns. Although 80.6%
      of the patients had normal indices in the first trimester, only 12.3% were normal
      in the third. Significant depletion of iron stores occurred in the second
      trimester, but significant iron-deficient erythropoiesis only occurred in the
      third trimester. Despite the decline in iron status, iron deficiency anaemia was
      only seen in 7-8% of the patients. Even after correction for the haemodilution
      and increased transferrin concentrations in pregnancy, over 70% of women had
      depleted iron stores in the third trimester. No beneficial effect on fetal birth
      weights was found on withholding of maternal iron supplementation. This study
      clearly demonstrated that white and urban black pregnant women require iron
      prophylaxis to maintain iron stores.

PMID- 7777971
TI  - Hyperosmolar non-ketotic diabetic coma as a cause of emergency hyperglycaemic
      admission to Baragwanath Hospital.
AB  - There were 136 emergency hyperglycaemic admissions to Baragwanath Hospital over a
      6-month period during 1992-1993, representing 1.2% of the total number of medical
      admissions; 24 (18%) patients died. Diabetic keto-acidosis (DKA) accounted for 88
      (65%) admissions (mortality rate 9%) while 16 admissions (12%) were as a result
      of hyperosmolar non-ketotic coma (HNKC), defined as hyperglycaemia, dehydration
      and an altered level of consciousness with a plasma osmolality > or = 330 and an
      arterial pH > or = 7.30, with absent or minimal ketonuria. Of these 16 patients,
      9 (56%) were known to have diabetes mellitus. Patients with HNKC were
      significantly older than those with DKA (P < 0.001) and other patients with
      nonketotic hyperglycaemia (P < 0.05). The overall mortality rate was 44%;
      prophylactic low-molecular-weight heparin appeared of benefit (P < 0.05).

PMID- 7777972
TI  - Brucellosis in childhood in the Western Cape.
AB  - Human brucellosis, a multisystem disease which may mimic other conditions, has a
      low incidence in childhood and the diagnosis may easily be missed. Over a 7-month
      period 9 children with brucellosis presented to the Department of Paediatrics and
      Child Health, Tygerberg Hospital. Six of the children had consumed unpasteurized
      milk. The main presenting symptoms were fever, fatigue, headache, myalgia and
      haematuria. Clinical signs included lymphadenopathy (3), nasopharyngitis (2),
      features of lower respiratory tract infection (2), splenomegaly (2) and pyrexia
      (1). The diagnosis was made on the basis of a positive serological titre (>
      1:160) for Brucella abortus. The prozone phenomenon was encountered in 6 cases;
      however, the Coombs test confirmed the diagnosis in these cases. Children under 7
      years were treated with co-trimoxazole and rifampicin and those over 7 years with
      tetracycline and rifampicin, for at least 6 weeks. No relapses were detected on
      follow-up.

PMID- 7777974
TI  - Implications of cost-cutting in the academic health complexes.

PMID- 7777973
TI  - MEDUNSA out of the woods. Interview by Ina van der Linde.

PMID- 7777975
TI  - Perinatal mortality rates.

PMID- 7777976
TI  - Some issues in screening, staging and treatment of oesophageal cancer.

PMID- 7777977
TI  - Antidepressants in patients with porphyria.

PMID- 7777979
TI  - Screening for cervical neoplasia.

PMID- 7777980
TI  - Weight reduction--what is a "good" diet?

PMID- 7777981
TI  - Problems caused by incorrect referrals to tuberculosis clinics.

PMID- 7777982
TI  - Abdominal pregnancy ending in a live birth.

PMID- 7777978
TI  - Abortion--some practical and ethical considerations.

PMID- 7777983
TI  - Familial spread of HTLV-I in KwaZulu/Natal.

PMID- 7777984
TI  - Misdiagnosis of Gilles de la Tourette syndrome.

PMID- 7777985
TI  - Fetal fibronectin in vaginal secretions--a predictor of preterm delivery?

PMID- 7777986
TI  - Measles--traditional Indian beliefs and practices.

PMID- 7777987
TI  - 'Happy feet'--a lighter side to pathology.

PMID- 7777988
TI  - Registering TB.

PMID- 7777989
TI  - Breakthrough imminent into brain damage.

PMID- 7777990
TI  - Doctors on abortion.

PMID- 7777991
TI  - Gossiping about an HIV patient can be costly.

PMID- 7777992
TI  - Are our health goals realistic or idealistic?

PMID- 7777993
TI  - Mental health and the RDP.

PMID- 7777994
TI  - The problems and promises of decentralisation of health services--a commentary.

PMID- 7777995
TI  - Towards national health insurance.

PMID- 7777996
TI  - Breast-milk substitutes--a South African perspective urgently needed.

PMID- 7777997
TI  - An integrated analysis of health facilities in the nine provinces of South
      Africa.
AB  - The development of a comprehensive national health plan must take into account an
      analysis of the provision and distribution of health facilities. This study
      collected and verified data from a number of different sources, on the number and
      types of hospital beds, the number of fixed clinics, and the population sizes in
      each of the nine new provinces of South Africa. A comprehensive database of these
      figures was compiled for the years 1988 and 1993. Integrated analyses were made
      of the distribution and types of health facilities in South Africa by using
      population/facility ratios. Notable disparities were found to exist between
      provinces in the total (public and private) distribution of hospital beds per
      1,000 population, but the distribution of acute hospital beds between provinces
      is more even. In provinces where there is more than one medical school, there is
      a marked imbalance between the levels of care, with greater emphasis placed on
      tertiary care, at the expense of the secondary level. Given the World Health
      Organisation recommendation of 10,000 people per clinic, there is a shortfall in
      most provinces. Recommendations are made with regard to the rationalisation of
      academic and referral beds, and the factors to be considered in the addressing of
      shortages of clinic facilities. However, the limitations of a resource-based
      planning approach must be recognised, and it is recommended that comprehensive
      analyses be carried out at regional and sub-regional levels to determine the
      appropriate delivery of health care.

PMID- 7777998
TI  - Red kidney beans--to eat or not to eat?
AB  - The importation of dry red kidney beans (a variety of the species Phaseolus
      vulgaris) for cultivation or consumption in South Africa is prohibited because of
      their potential toxicity to humans. It has been established that the
      haemagglutinating lectins (e.g. phytohaemagglutinin (PHA)) in kidney beans are
      responsible for this toxicity. Dry bean varieties available on the South African
      market for human consumption as well as locally produced (for this study) and
      imported dry red kidney beans and imported canned red kidney beans were compared.
      The PHA activity and the effect of heat thereon were measured, before and after
      overnight soaking. The PHA activity in extracts of uncooked and incompletely
      cooked red kidney beans was not higher than the levels measured in 50% of the
      other bean varieties included in the study. These findings indicate that the
      toxic potentials and health risks associated with red kidney beans are similar to
      those of other dry beans already commercially available to South Africans.

PMID- 7777999
TI  - Dietary cholesterol--the role of eggs in the prudent diet.
AB  - The recommendation that not more than 300 mg cholesterol be consumed daily to
      prevent high serum cholesterol levels and coronary heart disease is often used to
      justify a restriction of egg intake to three or four per week. One egg contains
      about 200 mg of cholesterol, but eggs are also excellent and relatively
      inexpensive sources of essential amino acids and certain vitamins. In this paper,
      the place of eggs in a prudent, cholesterol-lowering diet as a substitute for
      other animal products, is scrutinised. The extra cholesterol, where considered as
      the only variable, will increase serum cholesterol levels, but the effect is
      relatively small. The exclusion of eggs from the diet should be weighed against
      deprivation of essential nutrients especially in vulnerable groups. While
      restriction of egg intake in westernised populations seems justifiable, the upper
      limit of three or four per week may not always be applicable, depending on the
      overall diet and lipid profile of the individual.

PMID- 7778000
TI  - The changing medical student population at the University of Cape Town.
AB  - OBJECTIVE: Since 1981, the composition of applicants and students admitted to the
      medical school of the University of Cape Town has changed gradually. The
      objective of this paper is to quantify these changes and explore possible reasons
      for them. DESIGN: A retrospective analysis of the actual data accumulated at each
      annual intake was performed and the trends determined. SETTING: Only data for the
      University of Cape Town medical school were evaluated. Data published by similar
      institutions were used for comparative purposes. RESULTS: The number of
      applicants has risen steadily from 1,229 in 1981 to 2,330 in 1994, so that the
      applicant/admission ratio now stands at 12,1:1. During this same period, the
      percentage of women in the class has increased, with women outnumbering men in
      both 1992 and 1993. In 1994, black African students comprised 24% of those
      admitted to the M.B. Ch.B. programme, and of these 30.4% were women. By
      comparison, their white colleagues constituted 45.3% of the class, 57.5% of this
      cohort being women. CONCLUSIONS: The composition of the 1st-year M.B. Ch.B. class
      at the University of Cape Town has become multiracial in character, a factor
      achieved partly through academic support and affirmative action. The
      heterogeneity of the class, particularly in respect of gender, language and socio
      economic factors, while appropriate and necessary, will have an impact on the
      university and the profession.

PMID- 7778001
TI  - A.R.P. Walker Lecture. Food and the gut.
AB  - A.R.P. Walker pioneered the research into the association between food, gut
      function and disease patterns in southern Africa. His attention to ways in which
      dietary differences can explain geographical differences in disease patterns has
      led to the realisation that civilisation and modern food technology can exert a
      strong influence on dietary practices, gut function and disease tendencies.
      Recognition that South African blacks have a very low incidence of colonic
      problems such as diverticulitis, adenomatous polyps and carcinoma drew attention
      to the possibility that the traditional African diet, with a high fibre content,
      may maintain colonic health and prevent disease in old age. This review explores
      some of the mechanisms that may account for these differences and also examines
      ways in which malnutrition alters gut function. To quote Walker's conclusions:
      'There is a need, indeed a duty, for writers on nutrition to devote a portion of
      their space to the nutritional lessons to be learned from the past, from war-time
      experiences and from present day Third-World populations.'

PMID- 7778002
TI  - The use of DNA markers in the pre-clinical diagnosis of familial adenomatous
      polyposis in families in South Africa.
AB  - Haplotype association studies were performed in 10 unrelated South African
      families and 1 German immigrant family with familial adenomatous polyposis (FAP).
      Three DNA probes, recognising five restriction fragment length polymorphisms
      (RFLPs) around the gene locus for FAP on chromosome 5q, were used. The RFLP
      analysis was informative or partially informative in all the families studied.
      Five haplotypes were found to segregate with the disease locus. The predominant
      association of two of these haplotypes with FAP in the South African families
      suggests that two mutations may cause the disease in about 70% of families in
      this population. Meiotic recombination events were detected between the FAP gene
      and probe M4 (D5S6), but not probes Pi227 (D5S37) and C11p11 (D5S71). Haplotype
      analysis allowed the preclinical diagnosis of FAP in 5 subjects.

PMID- 7778003
TI  - The outcome of familial adenomatous polyposis in the absence of a polyposis
      registry.
AB  - From 1964 to 1990, 70 patients with familial adenomatous polyposis were diagnosed
      at an institution without a polyposis registry. Those with symptoms at diagnosis
      were older (mean 34 v. 24 years) and more often had large-bowel cancer (7/30 v.
      1/30, 23% v. 3%). The introduction of systematic screening significantly
      increased the number of cases diagnosed annually, from 2,3 to 5 per year, reduced
      the median age at diagnosis from 29 to 21 years and increased the proportion of
      cases diagnosed without symptoms from 52% to 90%. A colectomy with an ileorectal
      anastomosis achieved a low incidence of rectal cancer at 20 years (1/15, 7%)
      despite imperfect follow-up and annual sigmoidoscopy in only 40%. However, bowel
      cancer caused at least 35% of all deaths and 62% of deaths due to a known cause.
      A registry which maintained a screening programme should therefore prevent most
      large-bowel cancers and improve the life expectancy of patients with familial
      adenomatous polyposis who are managed at this institution. It might also refine
      the current method of screening by sigmoidoscopy alone, by facilitating the use
      of ophthalmoscopy and blood tests for DNA markers.

PMID- 7778004
TI  - Non-invasive management of organic impotence.
AB  - OBJECTIVE: To establish the efficacy of a vacuum device (ErecAid) in the
      management of organic impotence. DESIGN: Cohort study; questionnaire before and
      after a 6-month study period. SETTING: Groote Schuur Hospital, Cape Town.
      PARTICIPANTS: A total of 19 men with organic impotence, 8 diabetic and 11 with
      previous pelvic surgery or radiotherapy. INTERVENTION: Vacuum device (ErecAid,
      Osbon Medical Systems). OUTCOME MEASURE: Efficacy of ErecAid. RESULTS: Six of 8
      diabetics and 6 of 11 non-diabetics reported successful intercourse, while 16 of
      the participants would recommend the device to others. Some difficulty with the
      device was experienced by 11 and only 9 described an increase in self-esteem.
      CONCLUSION: Although some difficulties may be experienced in the use of the
      ErecAid, it clearly has a role to play in the management of patients with organic
      impotence, who ideally should be able to select their preferred form of therapy.

PMID- 7778005
TI  - A lumbar body support (KBS 2000) alters lumbar muscle recruitment patterns in
      patients with acute-upon-chronic lower back pain.
AB  - OBJECTIVE: To determine the effects of a locally designed lumbar body support
      (LBS) on integrated electromyographic (IEMG) activity of the lumbar erector
      spinae muscles, on heart rate and on ratings of discomfort in patients with low
      back pain. DESIGN: Non-randomised controlled trial. SETTING: Patients referred
      from general practitioners and back pain rehabilitation programmes in Cape Town.
      PATIENTS AND OTHER PARTICIPANTS: Ten patients with low back pain of diverse
      causes. Values were compared with those in 10 control subjects without low back
      pain. INTERVENTION: Patients and controls lay supine on (in random order) either
      a flat conventional mattress or a LBS placed on top of the flat mattress, for a
      30-minute period (acute exposure), and every night for 2 weeks (chronic
      exposure). MAIN OUTCOME MEASURES: IEMG activity of the lumbar erector spinae
      muscles, heart rate, and perception of comfort. RESULTS: IEMG activity of the
      lumbar erector spinae muscles did not differ between controls and patients when
      lying on the LBS on top of the CM after either acute or chronic exposure.
      However, it was significantly greater (P < 0.05) in patients than in controls
      when lying on the flat mattress. Subjective ratings of discomfort and heart rates
      mirrored these changes and were higher in patients only when lying on the flat
      mattress (P < 0.05). Patients with low back pain also reported that sleeping
      overnight on the LBS on top of their own mattress significantly reduced
      discomfort ratings. CONCLUSIONS: When lying on a mattress with a flat surface,
      patients with chronic low back pain have higher IEMG activity of the erector
      spinae muscles, higher heart rates and higher subjective ratings of discomfort
      than do control subjects. These differences disappear when both groups use a
      specially designed lumbar body support placed on top of the flat surface. These
      preliminary studies suggest that a lumbar body support should be evaluated in the
      chronic management of low back pain.

PMID- 7778006
TI  - Hepatitis B vaccine failure in medical students.

PMID- 7778007
TI  - Antibody decline after hepatitis B vaccination and the effects of boosters.

PMID- 7778009
TI  - Retrospective analysis of a snakebite at a rural hospital in Zululand.

PMID- 7778008
TI  - Retrospective analysis of snakebite at a rural hospital in Zululand.

PMID- 7778010
TI  - Cisapride labelling change.

PMID- 7778011
TI  - Pseudoephedrine and imipramine for depression--grounds for caution?

PMID- 7778013
TI  - Traditional healers and psychiatric health care.

PMID- 7778012
TI  - Anabolic steroids--a contemporary perspective.

PMID- 7778014
TI  - Asthma 1995.

PMID- 7778015
TI  - [Surgical techniques in dislocations, cartilage and tendon injuries: refresher
      course].

PMID- 7778016
TI  - [Dynamic stability of the glenohumeral joint. A biomechanical study].
AB  - Stability of the glenohumeral joint with an anterior, posterior and inferior
      displacement force of 50 Newton was measured in a dynamic shoulder model.
      Controlled hydrodynamic actuator forces were applied to the deltoid muscle and to
      the rotator cuff in seven anatomic specimens. During elevation of the arm, the
      position of the humerus was measured with a six-degree-of-freedom ultrasonic
      sensor device. The rotational center of the humeral head was used as reference
      point for translation. A displacement force of 50N led to significant humeral
      head displacement anteriorly and posteriorly, but not inferiorly. A 50% reduction
      of rotator cuff forces increased anterior displacement by 46% and posterior
      displacement by 31%. Venting of the glenohumeral joint space and of the
      subacromial bursa resulted in a 50% increase of anterior displacement, a 19%
      increase of posterior displacement and in significant inferior displacement. This
      study demonstrates that, in addition to passive stabilizers and negative
      intraarticular pressure, rotator cuff force significantly contributes to
      stabilization of the glenohumeral joint during arm motion. Muscle strength and
      coordination should gain more emphasis in the diagnosis and treatment of shoulder
      instability.

PMID- 7778017
TI  - [Possibilities of ultrasound diagnosis in Tossy type III acromioclavicular joint
      injuries in comparison with loaded roentgen images].
AB  - We inform about 20 patients (19 men, 1 woman) with acute acromioclavicular
      striking, type Tossy III, which were operated. By usual preoperative diagnostic
      and physical examination, x-ray standard pictures of the shoulder in two planes
      and x-ray panoramic picture (loaded with 10 kp and unloaded) in ap-axis we made
      an additional sonographic examination of the hurt shoulder. This is practiced in
      the commendable standardised pattern of DEGUM (German Society of Ultrasound in
      Medicine). After the standardised sonographic examination we focussed the
      acromioclavicular joint sonographically in a modified lateral vertical axis. All
      of the 20 examined shoulder joints belong to the stage Tossy III. In the
      preoperative diagnosis the difference in elevation between the lateral portion of
      the clavicula and the medial portion of the acromion amounts in comparison to the
      two shoulders (loaded versus unloaded shoulder joints) sonographically 6.2 +/-
      2.6 mm (max. difference of the sides 10 mm), by the radiological examination 6.5
      +/- 3.7 mm (max. difference of the sides 14 mm). The sonographical examination of
      the shoulder joint makes it possible to get more information about the
      acromioclavicular lesion, especially by an AC examination according to Tossy
      degree III. At present there is no possibility of substituting the standardised x
      ray pictures in two axes to diagnose or exclude fractures.

PMID- 7778018
TI  - [Results of treatment after traumatic shoulder dislocation. Thoracic abduction
      plaster case or Desault dressing].
AB  - In 80 patients with primary traumatic shoulder dislocation treated at the
      Heidelberg Orthopaedic University Hospital we had a follow-up examination. We
      wanted to know about age and sex of the patients, the number of redislocations in
      correlation to time and way of fixation. We had 70% male and 30% female patients
      with 97.5% of anterior dislocation. The minimum age was 16 and the maximum 87
      years with an average of 44 years. 48 patients had a Desault bandage for 2 weeks
      and 32 had a shoulder-arm plaster cast for 3 weeks. There was no difference
      between both ways of fixation. We also could not see any better results after
      more than a 3 weeks' fixation. The most important fact for redislocation is the
      age and activity of the patients. A young man has a very high risk of
      redislocation within the first year.

PMID- 7778019
TI  - [Fatal soccer injury as an unfortunate sequela of collision].
AB  - The tragic death of a 26-year old hobby soccer player is described, who had a
      collision with the opposing goalie and suffered from a fracture of the left
      lateral process of the atlas, an extensive subarachnoid haemorrhage, tamponade of
      the third and fourth cerebral ventricles, bleeding into both lateral cerebral
      ventricles, infratentorial and supratentorial cerebral oedema. Furthermore, a
      survey of the literature concerning acute death in soccer is presented.

PMID- 7778020
TI  - [Unilateral, paramedian spinal contusion after athletic injury with complete
      recovery].
AB  - The acute injury of the spinal column and the spinal cord asks for immediate
      diagnostic techniques and adequate therapeutical intensive care in order to
      secure the possibility of a maximum of neurologic recovery. An impact trauma of
      the spinal cord in sports accidents can cause an incomplete paraplegia. In some
      cases, morphologic lesions of the myelon cannot be detected. We present an
      exceptional and striking case of a 15-year old young woman who suffered from a
      contusio spinalis after high jump with the clinical signs of an incomplete,
      sensomotoric paraplegia which showed a strictly unilateral and paramedian border
      at the right side of her body for about two weeks. Additionally, the diagnostic
      possibilities of physical examination, magnetic resonance imaging, computed
      tomography and neurophysiologic diagnostic techniques in detecting spinal cord
      injuries are demonstrated.

PMID- 7778021
TI  - [Injuries in athletic mountain climbers in ambulatory sports medicine].

PMID- 7778022
TI  - [Double-contrast arthro-CT in diagnosis of shoulder instability].
AB  - Timeless and lesion-related treatment are important in the different shoulder
      instabilities in order to get a good functional result. Within the step-by-step
      programme of diagnostic possibilities the double contrast computerised
      arthrotomography is particularly indicated in recurrent posttraumatic and
      habitual dislocations, in subluxations as well as for clarification of causes of
      postoperative recurrence. Besides the documentation of skeletal changes (Hill
      Sachs-lesion, Bankart defect), double-contrast arthro-CT offers the possibility
      to identify detachments of the joint capsule or labral tears. Between 11/90 and
      9/93 we performed 38 double contrast arthro-CTs for recurrent shoulder
      instabilities. 35 men and 3 women were examined. The mean age of the sportive
      patients were 29 years. Preoperatively we diagnosed in 21 cases a recurrent
      posttraumatic, in 7 cases a habitual shoulder instability. Apart from one
      multidirectional and three posterior instabilities we found two cases of
      subluxation. In the meantime 24 patients were treated with an open stabilising
      operation of the shoulder. The operative findings were compared with the results
      of double contrast arthro-CT. In a total of 38 performed arthro-CTs we found
      labral tears in 4 cases, 14 labral dissections, and 10 times a complete labral
      discontinuity. 8 of 9 labrum dissections found intraoperatively were correctly
      identified on CT. One dissection was not even seen retrospectively on arthro-CT.
      Six of nine complete labrum discontinuities were seen on arthro-CT, three
      described as a dissection. All capsular detachments and bony Bankart lesions
      found on CT were confirmed intraoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778024
TI  - Colorectal carcinomas: diagnosis and preoperative staging by hydrocolonic
      sonography.
AB  - BACKGROUND: The aim of this study was to determine the sensitivity, specificity,
      and predictive value of hydrocolonic sonography (HS) in the detection and
      preoperative staging of colonic carcinomas. METHODS: One hundred four patients
      referred to our department for colorectal disease were examined in a prospective
      study with conventional transabdominal sonography followed by HS and other well
      established means for detection of colorectal cancer. In all diagnosed colorectal
      carcinomas, surgical resection and histologic examination were carried out, and
      the histologically confirmed tumor stage was then compared with the stage
      predicted by HS. RESULTS: HS staged and made a correct diagnosis of carcinoma in
      39 of 40 patients, with a sensitivity of 97.5% and a specificity of 98%. Positive
      predictability was 97.5% and negative predictability 98%. In the evaluation of
      cancer depth invasion, HS staging was correct in all but one case, in which a T3
      tumor was incorrectly judged to be T2. In the assessment of the presence or
      absence of peritumor metastatic lymph nodes, HS had a sensitivity of 50% and a
      specificity of 100%. CONCLUSIONS: HS allows the diagnosis and preoperative
      staging of colorectal carcinomas with high sensitivity, specificity, and
      predictive value. We highly recommend its preoperative use because of its
      definitive influence on surgical approach.

PMID- 7778023
TI  - Prognostic significance of three novel biologic factors in a clinical trial of
      adjuvant therapy for node-negative breast cancer.
AB  - BACKGROUND: Five products of human breast carcinoma cells, including membrane
      associated phospholipase A2 (M-PLA2), polymorphonuclear leukocyte elastase (PMN
      E), tissue-type plasminogen activator (t-PA), urokinase-type plasminogen
      activator (u-PA), and endothelin-1 (ET-1), have been implicated in the processes
      of tumor cell invasion and metastasis in human breast carcinoma. However, the
      prognostic significance of these factors has not been assessed previously in node
      negative breast carcinoma, in which adjuvant treatment is dependent on risk
      stratification. METHODS: The five products of breast carcinoma cells were
      measured in 184 patients with node-negative breast carcinoma who were enrolled in
      the Kumamoto Adjuvant Chemo-Endocrine Therapy for Breast Cancer prospective
      randomized trial, and the predictive values of these factors for relapse-free and
      overall survival were evaluated. RESULTS: M-PLA2, PMN-E, and t-PA were found to
      be significant independent predictors of relapse-free and overall survival,
      whereas u-PA and ET-1 were not independently predictive. Further statistical
      analyses showed that the predictive powers of M-PLA2, PMN-E, and t-PA were
      additive. A combination of these three factors identified a group of patients
      (approximately 50% of those who manifested node-negative breast carcinoma) with a
      favorable prognosis, regardless of the administration of adjuvant therapy.
      CONCLUSIONS: This study identified three biologic factors that are valuable
      predictors of survival in node-negative breast carcinoma. A combination of these
      biologic factors may allow identification of low-risk patients who could be
      spared adjuvant therapy.

PMID- 7778025
TI  - Surgical strategy for carcinoma of the pancreas head area based on
      clinicopathologic analysis of nodal involvement and plexus invasion.
AB  - BACKGROUND: The pattern of tumor spread, vis-a-vis nodal involvement and invasion
      of the extrapancreatic plexus (Plx), has not been thoroughly described for
      carcinoma of the pancreatic head area. METHODS: From 1973 to 1991, 110 patients
      (49 with carcinoma of the pancreatic head [Ph], 29 with distal bile duct cancer
      [Bi], and 32 with carcinoma of the papilla of Vater [Pv]) underwent
      pancreatectomy at Kanazawa University Hospital. Nodal involvement and Plx
      invasion were precisely evaluated by histopathologic examination. RESULTS: Thirty
      seven (76%) of the 49 patients with Ph, 20 (69%) of the 29 with Bi, and 14 (44%)
      of the 32 with Pv had nodal involvement. The lymph nodes most commonly involved
      for Ph were the posterior pancreaticoduodenal lymph nodes (numbers 13a [superior]
      and 13b [inferior]), the superior mesenteric lymph nodes (number 14), the
      paraaortic lymph nodes (number 16), and the anterior pancreaticoduodenal lymph
      nodes (number 17) (13a, 51%; 13b, 47%; 14, 36.7%; 16, 18.4%; 17a, 33%; 17b, 22%).
      In patients with Bi, lymph nodes around the hepatoduodenal ligament (number 12)
      and lymph nodes numbers 13a and 14 were most commonly involved (12, 27.6%; 13a,
      51.7%; 14, 34.5%). In patients with Pv, lymph node numbers 13b and 14 were most
      frequently involved (13b, 34.4%; 14, 15.6%). No significant correlation was noted
      between the tumor size and nodal involvement in these three lesions. Nodal
      involvement was an important prognostic factor for carcinoma of the pancreatic
      head area. Plx invasion in these three carcinomas was observed in 61% of patients
      with Ph, 29% of patients with Bi, and 3% of patients with Pv. CONCLUSIONS: Nodal
      involvement and Plx invasion differed significantly among carcinomas of the
      pancreatic head area. We believe that nodal dissection of at least group number
      14 is needed for Ph, Bi, and Pv cancers. In addition, dissection of lymph nodes
      of number 16 and the Plx around the superior mesenteric artery and celiac axis
      are needed in Ph cancer. Plx dissection of the first portion of plexus
      pancreaticus capitalis is needed in Bi cancer.

PMID- 7778026
TI  - Continuous hepatic arterial infusion of 5-fluorouracil for unresectable
      colorectal liver metastases: phase II study.
AB  - BACKGROUND: Although hepatic arterial infusion therapy (HAIT) with 5-fluoro-2'
      deoxyuridine for colorectal liver metastases yielded a good response, the
      treatment may be limited by hepatic toxicities. This study was designed to
      evaluate HAIT by using 5-fluorouracil (5-FU), with the expectation of a good
      response with little hepatic toxicities. METHODS: HAIT was begun at a dose of 360
      mg/m2 of 5-FU for 7 days by using an extracorporeal infusion pump, followed by
      180 mg/m2 of 5-FU for 21 days. After a 7-day interval, 180 mg/m2 of 5-FU was
      infused for 7 days; this 7-day infusion/7-day no infusion cycle was repeated.
      RESULTS: Fifty-three of the 68 patients who were referred to this study were
      evaluable. Complete response was observed in two patients and partial response in
      25 (response rate of 50.9%), with a median survival time of 11 months: 18 months
      for 27 responders and 7 months for 26 nonresponders. Gastrointestinal
      complications were observed in 18 patients: abdominal pain in nine, vomiting in
      five, and bleeding in four. No hepatobiliary or hematologic toxicities occurred.
      Infusion-related complications occurred in 20 patients. CONCLUSIONS: HAIT with 5
      FU may provide an effect similar to HAIT with fluoro-2' deoxyuridine but without
      hepatobiliary complications.

PMID- 7778027
TI  - Localization of gastrinomas by endoscopic ultrasonography in patients with
      Zollinger-Ellison syndrome.
AB  - BACKGROUND: Preoperative localization of gastrinomas by current imaging
      techniques such as computed tomography (CT) scan and angiography is still
      difficult because of the small size of tumor(s) in most patients undergoing
      operation. This study evaluated the diagnostic value of endoscopic
      ultrasonography. METHODS: Twenty-two patients presenting with Zollinger-Ellison
      syndrome underwent exploratory laparotomy after preoperative attempts to identify
      the gastrinoma(s) by CT scan, upper gastrointestinal endoscopy, and endoscopic
      ultrasonography. Surgery included intraoperative ultrasonography and duodenal
      transillumination in all cases. The sensitivity and specificity of imaging
      techniques were then evaluated. RESULTS: At least one tumor was found in 19
      patients (four had two tumors and one had multiple tumors). Duodenal, lymph node,
      and pancreatic gastrinomas were found in 42%, 38%, and 17% of the patients,
      respectively. Sensitivity of endoscopic ultrasonography was 50% for duodenal wall
      tumors (conventional endoscopy, 40%), 75% for pancreatic tumors (CT scan, 25%),
      and 62.5% for tumoral lymph nodes (CT scan, 0%). The specificity of all
      techniques was excellent. Correct diagnosis was made by endoscopic
      ultrasonography alone in 41% of the patients. The combination of conventional
      endoscopy and endoscopic ultrasonography provided correct diagnosis in 60% of the
      patients. CONCLUSIONS: Endoscopic ultrasonography should be considered as a first
      choice imaging technique for preoperative detection of gastrinomas. Although
      small duodenal gastrinomas are still obviously difficult to detect, an accurate
      exploration of the pancreatic area was provided by this technique.

PMID- 7778028
TI  - Tube jejunostomy in liver transplant recipients.
AB  - BACKGROUND: Nutritional support after liver transplantation most often uses
      intravenous hyperalimentation followed by nasoduodenal tubes until adequate
      intake is achieved. Because of difficulties with nasoduodenal tubes, we place
      jejunostomy tubes (j-tube) at the time of the transplantation, allowing immediate
      postoperative enteral nutrition. This review analyzes the complications of this
      procedure in transplant recipients. METHODS: J-tubes were placed in 108 of 119
      adults who underwent liver transplantation between October 1989 and June 6, 1994.
      These patients were retrospectively reviewed for the type and frequency of j-tube
      related complications. J-tube feeds with a semielemental formula were started
      within 24 to 48 hours after transplantation. RESULTS: Eighteen complications
      occurred in 16 patients. Six were mechanical obstructions of the j-tube because
      of kinking by the fascia. Six exploratory laparotomies were required, two each
      for infection, small bowel obstruction, or catheter displacement. Four other
      infections were treated by local incision and drainage or percutaneous drainage.
      One tube required surgical removal in the operating room. CONCLUSIONS: Tube
      jejunostomies can be safely placed at the time of liver transplantation with a
      low risk of serious complications. We recommend the routine use of j-tubes in
      patients receiving a liver transplant for the immediate posttransplantation
      institution of enteral nutrition.

PMID- 7778029
TI  - Protective effects of a novel 32-amino acid C-terminal fragment of CAP18 in
      endotoxemic pigs.
AB  - BACKGROUND: Cationic antimicrobial protein of 18 kd (CAP18) is a neutrophil
      derived peptide that binds lipopolysaccharide (LPS) with high affinity. We
      hypothesized that CAP18(106-137), a novel synthetic 32-amino acid C-terminal
      fragment of CAP18, would neutralize the physiologic derangements induced by LPS
      in anesthetized swine. METHODS: Pigs were randomly allocated into three groups.
      Those in the LPS group (n = 6) were infused with LPS (3 micrograms/kg/hr for 4
      hours). Pigs in the LPS/CAP18 group (n = 6) were challenged with LPS (3
      micrograms/kg/hr for 4 hours) and also treated with CAP18(106-137) (4 mg/kg/hr
      for 4 hours). Pigs in the RL group (n = 4) received neither LPS nor CAP18(106
      137). RESULTS: Treatment with CAP18(106-137) blocked LPS-induced increases in
      plasma levels of 6-keto-prostaglandin F1 alpha and tumor necrosis factor-alpha
      and prevented LPS-induced changes in cardiac output, arterial PO2, phagocyte
      activation, and peripheral leukocyte count. Changes in circulating concentrations
      of thromboxane B2, mean pulmonary artery pressure, and dynamic pulmonary
      compliance were attenuated in the LPS/CAP18 group. CONCLUSIONS: Treatment with
      CAP18(106-137) neutralizes many of the deleterious effects of LPS in pigs.

PMID- 7778030
TI  - Effects of perfluorocarbon exchange transfusion on reducing myocardial infarct
      size in a primate model of ischemia-reperfusion injury: a prospective, randomized
      study.
AB  - BACKGROUND: This study was undertaken to test the hypothesis that
      perfluorocarbons were able to reduce myocardial infarct size in a baboon model of
      ischemia-reperfusion injury. Exchange transfusion of perfluorocarbons has been
      shown to reduce myocardial infarct size in the dog, who, unlike the baboon, has
      an extensive collateral circulation. METHODS: After 15 minutes of occlusion of
      the left anterior descending coronary artery, 14 baboons were bled to attain a
      hematocrit of 24% to 26% and were simultaneously transfused, six with Fluosol-DA
      20% emulsion and eight with FC-43 emulsion. After 2 hours of ligation, the
      coronary arteries were reperfused. Baboons were killed 24 hours after ligation,
      and the hearts were excised. Microvascular dye was infused into the coronary
      artery to delineate its perfusion bed. Ratios of the mean volume of infarct to
      the mean volume of perfusion bed were calculated and compared by use of
      planimetry. A similar protocol was followed in two other groups of baboons except
      that lactated Ringer's solution was infused into six of them, whereas eight had
      no exchange transfusions. RESULTS: The ratios of the mean volume of infarct to
      the mean volume of perfusion bed of the four groups were as follows: Fluosol-DA,
      38.1% +/- 7.5%; FC-43, 37.7% +/- 8.3%; lactated Ringer's, 46.9% +/- 10.5%;
      controls, 65.6% +/- 6.9%. Statistical significance was reached when comparing
      both perfluorocarbon-treated groups with the controls (p < 0.05 for both groups)
      but not significant when comparing them with the Ringer's lactate-treated group.
      CONCLUSIONS: Results suggest that the beneficial effects of exchange transfusion
      with the perfluorocarbons may be primarily due to hemodilution.

PMID- 7778032
TI  - Three-dimensional pressure image and muscular structure of the human lower
      esophageal sphincter.
AB  - BACKGROUND: The structural equivalent to the manometric high pressure zone
      separating the stomach from the esophagus is still a matter of dispute. We
      compared the three-dimensional (3D) manometric pressure image with muscular
      thickness and architecture at the human gastroesophageal junction. METHODS: Three
      dimensional manometric images were obtained in 25 volunteers by using a stepwise
      pullback technique of a catheter with eight radially oriented pressure
      transducers. Muscle thickness was measured in four radial directions at 10 levels
      between the midesophagus and stomach in 37 specimens obtained from organ donors.
      Muscular architecture was assessed in specimens from 10 organ donors and 12 human
      cadavers and was related to muscle thickness. RESULTS: Manometric 3D images of
      the lower esophageal high pressure zone showed a marked radial and longitudinal
      asymmetry. Radial pressures peaked at the respiratory inversion point and were
      highest toward the left posterior direction. Anatomic evaluation showed an
      asymmetric thickening of the muscular layer at the gastroesophageal junction that
      mirrored the manometric image. Muscle thickness was highest toward the greater
      curvature side corresponding to the gastric "sling" fibers and toward the lesser
      curvature corresponding to the semicircular "clasp" fibers. CONCLUSIONS: The
      human lower esophageal sphincter is not a muscular ring. Rather, the perfect
      match between the manometric pressures and the arrangement of muscular structures
      at the gastroesophageal junction indicates that the gastric sling fibers and the
      semicircular clasps are the anatomic correlate of the manometric lower esophageal
      sphincter in human beings.

PMID- 7778031
TI  - Right or left trisegment portal vein embolization before hepatic trisegmentectomy
      for hilar bile duct carcinoma.
AB  - BACKGROUND: Percutaneous transhepatic embolization of the right portal vein plus
      the left medial portal branch (R3-PE) and the left portal vein plus the right
      anterior portal branch (L3-PE) is not well described. METHODS: Four patients with
      far advanced carcinoma of the hepatic hilus underwent R3-PE (n = 1) or L3-PE (n =
      3) as preoperative management for right hepatic trisegmentectomy or left hepatic
      trisegmentectomy. The portal vein embolization was performed with the ipsilateral
      approach through the right anterior portal branch. RESULTS: In all patients the
      embolizations were successful without complications. Volumetric study with
      computed tomography showed sufficient hypertrophy of the nonembolized hepatic
      segments. Three of the four patients eventually underwent trisegmentectomy. The
      postoperative courses in two of the patients were uneventful. The remaining
      patient suffered from posthepatectomy liver failure but recovered. CONCLUSIONS:
      R3-PE or L3-PE is advisable as preoperative management for trisegmentectomy and
      appears effective for increasing the safety of the operation. This embolization
      is achievable only through the ipsilateral approach.

PMID- 7778033
TI  - Synergism of acid and duodenogastroesophageal reflux in complicated Barrett's
      esophagus.
AB  - BACKGROUND: The role of acid and duodenogastroesophageal reflux (DGER) in the
      development of complications in Barrett's esophagus is controversial. We
      characterized the esophageal reflux constituents in patients with and without
      complications of Barrett's esophagus. METHODS: Using a new fiber-optic system we
      studied 12 normal subjects (six male; mean age, 46 years) and 20 patients with
      Barrett's esophagus (17 male; mean age, 58 years), nine with uncomplicated (seven
      male; mean age, 55 years) and 11 with complicated Barrett's esophagus (seven with
      stricture, two with ulcer, and two with dysplasia; 10 male; mean age, 61 years).
      Fasting gastric bile acid concentrations were measured. Twenty-four-hour
      ambulatory acid and bilirubin measurements were obtained with the fiber-optic
      system by using a glass electrode and fiber-optic sensor. The data were then
      analyzed for percent total time pH < 4 and > 7 and bilirubin absorbance > 0.14%.
      RESULTS: Percent times pH < 4, bilirubin absorbance > 0.14%, and fasting gastric
      bile acid concentrations were significantly greater in patients with complicated
      Barrett's esophagus compared with patients with uncomplicated Barrett's esophagus
      with both being higher than the controls. Acid reflux paralleled bile reflux in
      the two Barrett's esophagus groups (r = 0.44, p < 0.05), but percent time pH > 7
      did not differentiate between the two groups. CONCLUSIONS: (1) Patients with
      complicated Barrett's esophagus reflux significantly greater amounts of both acid
      and duodenal contents than patients with uncomplicated Barrett's esophagus. (2)
      Complications in Barrett's esophagus may be due to synergism between acid and
      bile rather than either constituent alone.

PMID- 7778034
TI  - Plasma cholecystokinin levels and gallbladder volumes after proctocolectomy with
      ileal pouch-anal anastomosis.
AB  - BACKGROUND: The colon and rectum contain regulatory peptides in mucosal endocrine
      cells, which suggests a hormonal role. In animal studies colectomy leads to
      increased plasma levels of cholecystokinin. Little is known about the effects of
      proctocolectomy with ileal pouch-anal anastomosis on the release of
      cholecystokinin in human beings. Therefore we studied the effects of this
      procedure on fasting, postprandial, and bombesin-stimulated plasma
      cholecystokinin levels and gallbladder volumes. METHODS: Ten patients who had
      undergone proctocolectomy with ileal pouch-anal anastomosis and 12 healthy
      volunteers participated in the study. Fasting and postprandial plasma
      cholecystokinin levels and gallbladder volumes were studied for 3 hours at 15
      minute intervals. In a second experiment plasma cholecystokinin levels were
      measured before and during intravenous administration of bombesin in six patients
      with ileal pouch and five healthy volunteers. RESULTS: Fasting plasma
      cholecystokinin levels were higher (p < 0.05) in patients with ileal pouch-anal
      anastomosis (2.6 +/- 0.3 pmol/L) compared with controls (1.7 +/- 0.2 pmol/L).
      Integrated postprandial plasma cholecystokinin levels were also distinctly higher
      (p < 0.01) in patients (978 +/- 126 pmol/L.180 min) than in controls (588 +/- 60
      pmol/L.180 min). Mean fasting gallbladder volume was significantly (p < 0.01)
      decreased in patients with ileal pouch-anal anastomosis (18 +/- 2 ml) compared
      with controls (28 +/- 2 ml). Postprandial gallbladder emptying as measured by
      percentage change was similar in both groups. After infusion of bombesin,
      integrated plasma cholecystokinin responses were higher (p < 0.05) in patients
      (161 +/- 20 pmol/L.20 min) than in controls (90 +/- 12 pmol/L.20 min).
      CONCLUSIONS: Fasting, postprandial, and bombesin-stimulated plasma
      cholecystokinin levels are elevated in patients with ileal pouch-anal anastomosis
      compared with controls. Fasting gallbladder volume is decreased after ileal pouch
      anal anastomosis. These findings suggest that the colon contains a factor that
      inhibits the release of cholecystokinin.

PMID- 7778035
TI  - Successful intraarterial fragmentation and urokinase therapy in superior
      mesenteric artery embolisms.

PMID- 7778036
TI  - Extended left hepatic trisegmentectomy with resection of main right hepatic vein
      and preservation of middle and inferior right hepatic veins.

PMID- 7778037
TI  - Young adults with hernias.

PMID- 7778038
TI  - Treatment of liver cancers with complete hepatic venous isolation and
      extracorporeal chemofiltration.

PMID- 7778040
TI  - 34th Annual meeting of the Japanese Teratology Society. Kochi, Japan, July 14-16,
      1994. Abstracts.

PMID- 7778041
TI  - Hypothesis: the pathogenesis of the birth defects reported in cvs-exposed
      infants.

PMID- 7778039
TI  - Wound and port site recurrence.

PMID- 7778042
TI  - Early events following maternal exposure to 5-fluorouracil lead to dysmorphology
      in cultured embryonic tissues.
AB  - The chemotherapeutic agent 5-fluorouracil (5-FU) is teratogenic in a number of
      species, yet the mechanism(s) of its developmental toxicity are not fully
      understood. Administration of 5-FU to the pregnant CD rat on day 14 of gestation
      results in dose-dependent growth retardation and numerous malformations in near
      term fetuses, including hindlimb defects and cleft palate. Following treatment, a
      number of rapid biochemical and cellular alterations are detectable in embryonic
      hindlimbs, craniofacial and other tissues, which include thymidylate synthetase
      (TS) inhibition and altered cell cycle progression. In order to assess the
      importance of these early events in 5-FU-induced dysmorphogenesis, embryonic mid
      facial tissues and hindlimbs were dissected 3 or 6 hr after administration of 5
      FU to the dam and placed in explant culture. After 5 days in culture,
      craniofacial explants were evaluated morphologically for palatal closure and
      growth was assessed by measuring total protein and DNA content. Hindlimb explants
      were stained for cartilage using alcian blue to evaluate development of the
      digits. Craniofacial explants cultured at either 3 or 6 hr after exposure
      exhibited dose-dependent growth retardation and defects of palatal fusion at the
      end of the culture period. Deficits in protein and DNA content were similar to
      those in craniofacial tissues that continued to develop in utero after treatment,
      although morphological defects in cultured explants did not correlate well with
      the incidence of cleft palate in vivo. Dose-dependent deficits in metatarsal and
      phalanx development were observed in hindlimb explants dissected either 3 or 6 hr
      after maternal treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778043
TI  - Developmental toxicity of the HMG-CoA reductase inhibitor, atorvastatin, in rats
      and rabbits.
AB  - The developmental toxicity of the 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA)
      reductase inhibitor, atorvastatin, was investigated in pregnant rats and rabbits
      given daily oral doses during organogenesis. Rats received 0, 10, 100, or 300
      mg/kg on days 6-15 of gestation, and rabbits received 0, 10, 50, or 100 mg/kg on
      days 6-18 of gestation. Maternal and fetal parameters were evaluated on day 20
      (rats) or 29 (rabbits) of gestation. Live fetuses were examined for external,
      visceral, and skeletal malformations and variations. At 300 mg/kg in rats, 1
      treatment-related death occurred on day 12 of gestation, and maternal body weight
      gain and food consumption were decreased during treatment (43% and 23%,
      respectively). In addition, 1 animal at 300 mg/kg had total litter resorption.
      Increased postimplantation loss (not statistically significant) and slightly
      decreased fetal body weight (statistically significant only in males) were also
      observed at 300 mg/kg. There were no significant differences between treated and
      control groups in the incidence of fetal malformations or variations. No maternal
      or developmental toxicity was observed in rats at 10 or 100 mg/kg. In rabbits,
      marked maternal toxicity (7 deaths, body weight loss during and after treatment,
      and decreased food consumption) and abortion occurred at 100 mg/kg. At 50 mg/kg,
      maternal toxicity (2 deaths and 72% body weight gain suppression) and abortion
      also occurred. There were no treatment-related effects on live litter size or sex
      ratio. At 50 and 100 mg/kg, nonstatistically significant increases in
      postimplantation loss and decreases in gravid uterine weight were observed, and
      at 100 mg/kg, decreases in fetal body weight were observed relative to
      controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778045
TI  - Teratogen update: angiotensin-converting enzyme inhibitors.
AB  - Occasionally there is a drug whose record in pregnancy is so frequently
      associated with adverse outcome of so specific a pattern that it becomes clear
      that its use must be restricted before scientific proof from epidemiological
      studies is obtained. I believe this to be the case with the drug class of ACEIs.
      There are mammalian models suggesting substantial fetotoxicity in a dose-related
      fashion. There is a strong and consistent pattern to the reported cases of ACEI
      related adverse outcomes: the syndrome of oligohydramnios-anuria, neonatal
      hypotension, renal dysplasia, and hypocalvaria is too specific in association
      with the use of these drugs to be ignored. There is a very plausible biologic
      mechanism to explain the relationship. The features of ACEI fetopathy suggest
      that the underlying pathogenetic mechanism is fetal hypotension, which may also
      result from other exposures. Thus, while the fetopathy may not be truly specific
      to ACEIs, they are particularly liable to produce adverse fetal renal effects
      with their sequels (anuria-oligohydramnios, pulmonary hypoplasia, growth
      restriction) and hypocalvaria.

PMID- 7778046
TI  - Board trouble. What activities attract the attention of the Texas State Board of
      Medical Examiners.
AB  - Every year about 45,000 Texas physicians dutifully get out their checkbooks and
      send off a few hundred dollars to this state institution. Besides taking the test
      for their licenses in the first place, mailing that yearly check marks the extent
      to which most Texas physicians ever come into contact with the Texas State Board
      of Medical Examiners (TSBME). But for a number of physicians each year, a brush
      with TSBME is akin to facing a medical malpractice lawsuit, only the board has
      the power to take away their licenses. And under the Medical Practice Act of
      Texas, there is no statute of limitations for bringing accusations against a
      physician for possible violations.

PMID- 7778044
TI  - Growth profiles of human autosomal trisomies at midgestation.
AB  - Somatic and visceral growth profiles of midgestation human fetuses with trisomy
      21, 18, or 13 demonstrate that each disorder has a characteristic pattern of
      growth aberration. The most striking deviations are short limbs in trisomy 21,
      subnormal adrenal and lung weights in trisomy 18, and supranormal spleen and
      kidney weights in trisomy 13.

PMID- 7778047
TI  - 'I fell down the stairs.' Physicians can help by learning to recognize the signs
      of domestic violence.
AB  - The baby lay on the examining table, his elbow swollen to grotesque proportions
      like some jumbo orange had sprouted from his tiny arm. And Diana Fite, MD,
      remembers wondering how the 1-year-old child could have sustained such an awful
      fracture from just falling out of bed. In 2 years as an emergency physician,
      she'd seen her share of injuries from out-of-bed falls--usually split lips, minor
      head lacerations, or, at worst, fractured clavicles. But nothing like what this
      baby had.

PMID- 7778048
TI  - Survival tactics. 75 strategies for success in the changing medical marketplace.

PMID- 7778049
TI  - Why Johnny hates science. Poor student performance worries physicians, educators.
AB  - Imagine medical schools faced with applicants who know or care little about
      science because they are the products of an educational system that did not
      motivate them to take an interest in the subject. Now imagine what kind of
      physicians they would be if they managed to get into medical school and graduate.
      John Burnside, MD, has imagined it, and it scares him.

PMID- 7778050
TI  - Prevention is key to combating stroke.

PMID- 7778051
TI  - What's new in stroke?
AB  - More than 30,000 strokes occur each year in Texas, even though most strokes can
      be prevented by currently available and well-tolerated therapies. Antiplatelet
      therapy with aspirin or ticlopidine reduces stroke by about 25% in many patients
      with transient ischemic attack or initial stroke. Warfarin should not be used
      routinely for primary cerebrovascular disease but is useful to prevent
      cardioembolic stroke. Carotid endarterectomy is highly beneficial for patients
      with symptomatic, high-grade carotid stenosis, but its value for lesser degrees
      of symptomatic carotid plaque and for asymptomatic stenosis is less clear.
      Patients with nonvalvular atrial fibrillation have a substantial risk for stroke;
      most should be treated with warfarin. Risk-factor management (eg, control of
      hypertension, cessation of smoking, and treatment of hyperlipidemia) is as
      important as antithrombotic or surgical therapies for most patients with
      threatened stroke. Treating isolated systolic hypertension in elderly patients
      reduces stroke risk. Determining the cause of threatened stroke strongly
      influences preventive management. The tools are at hand to prevent most strokes;
      the challenge remains to apply them optimally.

PMID- 7778052
TI  - An overview of tick-borne relapsing fever with emphasis on outbreaks in Texas.
AB  - Tick-borne relapsing fever (TBRF), a disease of humans and other animals, has
      been recognized in North America since early in this century. Caused by Borrelia
      spirochetes, TBRF is transmitted by softshelled Ornithodoros ticks, which may
      also act as reservoirs for the etiologic agents. Initial symptoms include sudden
      onset of fever, chills, headache, arthralgias, and myalgias. Persons with TBRF
      may suffer several febrile episodes or relapses unless they are diagnosed and
      treated promptly because TBRF spirochetes are able to alter their outer surface
      proteins and, thus, escape the infected host's immune response. Laboratory
      diagnosis is made by detecting spirochetes in peripheral blood specimens or by
      inoculating laboratory mice with blood collected during febrile episodes. In the
      1930s and '40s, TBRF was reported commonly in Texas. More recently, fewer cases
      have been reported, although 13 cases were confirmed between 1990 and the first
      half of 1994.

PMID- 7778053
TI  - Pulling in the reins. TMA-backed legislation seeks to halt managed care free-for
      all.

PMID- 7778054
TI  - A memorial to Gwendolyn J. Stewart, Ph.D. (November 12, 1926--August 22, 1994).

PMID- 7778055
TI  - Studies on in vitro effect of picotamide on human platelet aggregation in
      platelet-rich plasma and whole blood.
AB  - Picotamide is a new antiaggregating agent influencing the platelet prostaglandin
      pathway through an inhibition of thromboxane A2 (TXA2) synthesis and a
      competitive antagonism of platelet TXA2 receptors. In the present study, we
      investigated the in vitro effect of this drug on human platelet aggregation
      induced by different agents (adenosine 5'-diphosphate [ADP], collagen, Na
      arachidonate) both in platelet-rich plasma (PRP; Born's method) and whole blood
      (WB; impedance method). For each aggregating agent, ED50 value (agonist
      concentration necessary to induce a maximal aggregation of 50%) was determined in
      control samples and following addition of different picotamide concentrations on
      the basis of dose-response curves. Picotamide decreased the response to each
      aggregating agent in both WB and PRP samples. In WB, 25 microM picotamide was
      able to induce a highly significant enhancement of ED50 values for ADP (from 6.6
      +/- 1 microM to 12.7 +/- 1.7 microM, p < 0.01), Na arachidonate (from 740 +/- 240
      microM to 1,080 +/- 280 microM, p < 0.01) and collagen (from 2.4 +/- 0.3
      micrograms/ml to 3.8 +/- 0.15 micrograms/ml, p < 0.01). In PRP, the same
      picotamide concentration significantly enhanced ED50 for each aggregating agent
      (from 2.0 +/- 0.1 microM to 3.1 +/- 0.3 microM for ADP, p < 0.01; from 960 +/- 80
      microM to 1,850 +/- 260 microM for Na arachidonate, p < 0.001; from 3.0 +/- 0.3
      microgram/ml to 5.0 +/- 0.8 micrograms/ml for collagen, p < 0.01). Present
      results show that picotamide effect on platelet response is present also in WB.
      Data might support the use of picotamide as antiaggregating agent in vascular
      diseases.

PMID- 7778057
TI  - Aspects of haemostatic function in healthy subjects with microalbuminuria--a
      potential atherosclerotic risk factor.
AB  - Microalbuminuria, i.e., slightly elevated urinary albumin excretion rate (UAER),
      notifies increased risk for atherosclerotic disease and may reflect an early
      generalized vascular abnormality in healthy subjects. This study was designed in
      order to examine whether such abnormality is associated with a shift of the
      haemostatic balance in prothrombotic direction. The following haemostatic factors
      were measured in two representative groups of clinically healthy subjects, 28
      with microalbuminuria (UAER of 6.6-150 micrograms/min) and 60 age- and sex
      matched controls with normoalbuminuria (UAER < 6.6 micrograms/min): Coagulation
      factors: blood platelet count and mean volume, plasma Factor VII antigen
      concentration and coagulant activity, and plasma concentrations of prothrombin
      fragment 1 + 2, thrombin-antithrombin III complexes, fibrinogen, and
      fibrinopeptide A; fibrinolytic and endothelial factors: plasma concentrations of
      tissue plasminogen activator antigen and plasminogen activator inhibitor type 1
      antigen; and endothelial factor: plasma von Willebrand factor antigen
      concentration. The fibrinolytic and endothelial factors were measured both before
      and after 10 minutes of venous occlusion of the arm. None of the haemostatic
      factors were significantly altered in the microalbuminuric group. Plasma
      fibrinogen concentration tended to be elevated but not statistically significant
      ((mean (95% C.I.) 7.8 (7.2-8.3) vs. 7.2 (6.9-7.5) mumol/l; p < 0.1). Neither did
      any of the haemostatic factors correlate with UAER in regression analyses. It is
      concluded that the haemostatic balance is unaltered in healthy subjects with
      microalbuminuria. It is unlikely that a prothrombotic state is present as an
      intermedial factor early in a causal chain between microalbuminuria and
      atherosclerotic vascular disease.

PMID- 7778056
TI  - Effects of thromboxane A2 synthase inhibitors (CV-4151 and ozagrel), aspirin, and
      ticlopidine on the thrombosis caused by endothelial cell injury.
AB  - The antiplatelet and antithrombotic effects of CV-4151 (isbogrel), a potent
      selective thromboxane A2 (TXA2) synthase inhibitor, were compared with those of
      ozagrel (OKY-046), aspirin, and ticlopidine in rats. Two hours after oral
      administration, CV-4151, ozagrel and aspirin inhibited blood TXA2 generation with
      ID50 values of 0.04, 0.3 and 6.4 mg/kg, respectively. These values were similar
      to the oral ID50 values of CV-4151 (0.06 mg/kg), ozagrel (0.92 mg/kg) and aspirin
      (7.0 mg/kg) for arachidonic acid (AA)-induced platelet aggregation ex vivo. Two
      hours after p.o. administration, CV-4151 and ozagrel inhibited femoral vein
      platelet-rich thrombosis caused by endothelial injury with ID50 values of 2.46
      and 13.7 mg/kg, respectively. However, aspirin (100 mg/kg, p.o.) only slightly
      inhibited the thrombosis. Ticlopidine (300 mg/kg, p.o.) slightly but
      significantly inhibited AA-induced and ADP-induced platelet aggregation, however,
      it potently inhibited the thrombosis. CV-4151 and ozagrel given by i.v. injection
      showed therapeutic effects on the thrombosis with ED50 values of 0.026 and 0.066
      mg/kg, respectively. These values were similar to the i.v. ED50 values of CV-4151
      (0.0056 mg/kg) and ozagrel (0.042 mg/kg) for blood TXA2 generation. However,
      aspirin (30 mg/kg, i.v.) only moderately reduced the thrombosis. CV-4151 (> 0.3
      mg/kg, p.o.), ozagrel (> 3 mg/kg, p.o.) and ticlopidine (300 mg/kg, p.o.) all
      significantly prolonged tail bleeding time. Aspirin (100 mg/kg, p.o.) tended to
      prolong the bleeding time. The antiplatelet and antithrombotic effects of CV-4151
      are more potent than those of ozagrel, aspirin and ticlopidine in rats. CV-4151
      may therefore be a useful drug for the treatment of thrombotic diseases.

PMID- 7778058
TI  - Interferon-gamma modulates the fibrinolytic response in cultured human
      endothelial cells.
AB  - The fibrinolytic potential of the endothelial cells gives important
      antithrombotic properties to the vascular wall. Thrombosis is a frequent
      complication to atherosclerosis and other conditions where inflammatory mediators
      are present in the vascular wall. Inflammatory agents like lipopolysaccharide
      (LPS) and tumor necrosis factor-alpha (TNF alpha) have been demonstrated to
      modulate the expression of fibrinolytic factors in cultured endothelial cells. In
      the present study the expression of tissue-type plasminogen activator (t-PA),
      urokinase plasminogen activator (u-PA) and plasminogen activator inhibitors-1 and
      -2 (PAI-1 and PAI-2) antigen in conditioned medium from cultured human umbilical
      vein (HUVEC) and human saphenous vein (HSVEC) endothelial cells was investigated
      under basal conditions and after stimulation with LPS, TNF alpha, interferon
      gamma (IFN-gamma) or interleukin-6 (IL-6) alone or in combinations. Stimulation
      with LPS or TNF alpha increased the expression of PAI-1, u-PA and PAI-2 in HUVEC
      and HSVEC, while the t-PA response differed between the two cell types. The
      effects of TNF alpha were modulated by IFN-gamma but not by IL-6. The increased
      expression of u-PA after stimulation with TNF alpha was reduced by IFN-gamma. In
      contrast, TNF alpha-induced expression of PAI-2 was synergistically increased by
      addition of IFN-gamma. These effects of IFN-gamma represent additional mechanisms
      by which inflammatory mediators may turn the fibrinolytic potential of the
      endothelium in a prothrombotic direction.

PMID- 7778059
TI  - LPS induced procoagulant activity and plasminogen activator activity in
      mononuclear cells from persons with high or low levels of HDL lipoprotein.
AB  - We have examined spontaneous and lipopolysaccharide (LPS) induced procoagulant
      activity (PCA) and plasminogen activator activity (PA) in peripheral blood
      mononuclear cells (PBMC) from ten persons with high, and ten persons with low
      levels of serum high-density lipoprotein (HDL). PBMC were incubated +/- 100 ng
      LPS/ml up to 160 h. Additionally, we have measured the release of urokinase
      (uPA), tissue plasminogen activator (tPA), plasminogen activator inhibitor 1 (PAI
      1) and plasminogen activator inhibitor 2 (PAI-2) into the cell culture media.
      Spontaneous PA was significantly higher in PBMC from persons with low HDL,
      combined with lower release of uPA to the media and higher uPA-receptor (uPA-R)
      bound uPA on PBMC. Upon stimulation with LPS, PCA and released PAI-2 increased
      sharply, while PA and released uPA declined. These changes were not significantly
      different between the two groups. tPA and PAI-1 were not detected in cell lysates
      or in cell culture media. CONCLUSIONS: 1) LPS sharply stimulated PBMC PCA
      (similar in both groups). 2) PBMC from persons with low HDL showed higher
      spontaneous PA, due to higher uPA-R bound uPA, probably of importance in cell
      migration during the early events of atherosclerosis.

PMID- 7778060
TI  - Platelet aggregation monitored in a 96 well microplate reader is useful for
      evaluation of platelet agonists and antagonists.
AB  - Optimal conditions for a method to simultaneously measure aggregation in 96
      samples using a microplate reader were developed. The temperature of the assay
      was set at 25 degrees C, the optimal platelet concentration range was determined
      to be from 1-3 x 10(8) per mL, the assay volume was determined to be best at 100
      microL and an agitation rate of setting #5 on the vortex was found to yield the
      most reliable aggregation response. After these initial assay parameters were
      established, EC50 values for standard platelet agonists including ADP, thrombin,
      collagen and thrombin receptor activating peptides were determined using the
      plate assay and compared to those obtained by measuring light transmittance in an
      aggregometer. The results were quantitatively similar, and qualitatively the
      shapes of the aggregations as monitored by both methods were characteristic of
      those expected for each agonist. The use of this assay was then extended to
      quantitate the inhibition of aggregation by antagonists of the fibrinogen
      receptor as well as by an inactive thrombin receptor peptide and by antibodies
      against the thrombin receptor. This method provided useful data for
      characterization of both platelet agonists and antagonists and should be useful
      for future platelet aggregation studies.

PMID- 7778061
TI  - Evaluation of plasma 11-dehydro-thromboxane B2 as an indicator for thromboxane A2
      synthesis in vivo in laboratory animals.
AB  - Since thromboxane (TX) B2 is not a reliable indicator of TXA2 generation in vivo,
      because of artifactual TXA2 generation during blood collection, we tested the
      feasibility of replacing TXB2 with 11-dehydro (dh)-TXB2 as the indicator. Plasma
      levels of TXB2 and 11-dh-TXB2 were measured after i.v. administration of TXB2 to
      rabbits, guinea pigs, rats, dogs and a monkey, and after i.v. infusion of
      collagen in rabbits. In the rabbits and dogs, 2,3-dinor-TXB2 levels were also
      measured. After intravenous injection of TXB2 (10 micrograms/kg) in rabbits, the
      ratio of the area under the curve (AUC) of 11-dh-TXB2 to that of TXB2 (1.94) was
      far higher than the AUC ratio between 2,3-dinor-TXB2 and TXB2 (0.42). When
      endogenous TXA2 was generated by infusion of collagen (2 mg/kg/5 min), the plasma
      level of 11-dh-TXB2 was significantly increased, and had a longer half-life than
      TXB2. In the guinea pigs, rats and monkey, the peak plasma levels of 11-dh-TXB2
      were significantly increased after injection of TXB2 (10 micrograms/kg, i.v.),
      whereas the AUC ratios of 11-dh-TXB2/TXB2 were less than one fourth of that in
      rabbits. No significant increase in 11-dh-TXB2 was observed after TXB2 injection
      (10 micrograms/kg) in dogs, but the 2,3-dinor-TXB2 level rose significantly, its
      AUC ratio to TXB2 being 0.29, comparable with that in rabbits. The order of the
      11-dh-TXB2/TXB2 AUC ratios was: rabbits > guinea pigs > monkey > rats >>
      dogs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778062
TI  - Thrombolysis with tissue plasminogen activator (tPA) is temperature dependent.
AB  - Thrombolysis with tissue plasminogen activator (tPA) and hypothermia are two
      potential treatment modalities for acute ischemic stroke. Many investigators are
      studying these modalities both in the laboratory and in clinical trials. Because
      these modalities each appear to show benefit in animal models, there is
      considerable interest in studying combined therapy with both thrombolysis and
      hypothermia. However, it is known that alterations in the coagulation system can
      occur with decreased body temperature. Clinicians have frequently observed
      bleeding problems when patients are subjected to hypothermia for a variety of
      reasons. Hypothermia induced coagulopathy has been attributed to a variety of
      factors. Hypothermia can cause platelet dysfunction, inhibition of clotting
      factors, increased fibrinolysis and endogenous production of a heparin-like
      factor. Groups who studied fibrinolysis and temperature, however, found the
      opposite to be the case. Clot lysis studies with streptokinase showed increased
      fibrinolysis at higher temperatures. Data by Mumme suggested that the peak
      fibrinolytic activity of streptokinase was at 40 degrees C, but at 43 degrees C
      fibrinolytic activity was decreased. Rijken et al studied plasminogen activation
      with tissue plasminogen activator (tPA), urokinase and streptokinase at extremely
      low temperatures. They found less plasminogen activation and fibrinogen
      degradation at 25 degrees C compared to 37 degrees C, but negligible differences
      at 10 degrees C, 0 degrees C and -8 degrees C. To our knowledge, there is no data
      studying the fibrinolytic activity of tissue plasminogen activator (tPA) at
      temperature ranges between 25-37 degrees C which is the range of temperatures
      used clinically for therapeutic purposes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778063
TI  - Antiphospholipid-protein antibodies: laboratory detection and clinical relevance.

PMID- 7778064
TI  - Mechanisms of the platelet aggregation induced by activated neutrophils and
      inhibitory effect of specific PAF receptor antagonists.
AB  - The supernatant of polymorphonuclear neutrophils after their activation by
      opsonized zymosan induces the aggregation of washed platelets in human. It
      potentiates platelet aggregation induced by agonists in platelet rich plasma as
      well as in whole blood. This activation involves the phosphoinositide metabolism.
      Specific PAF receptor antagonists gingkolides (BN 50726, BN 52021, BN 54068, BN
      54062, BN 50730, BN 50749, BN 50744) and benzodiazepine Web2086 antagonize this
      neutrophil-induced platelet aggregation. BN 50,730, BN 50,749 and Web 2086 can
      fully inhibit this aggregation at the final concentration of 10(-6) M.
      Preincubation of platelets with synthetic PAF also inhibits this activation
      through a desensitization of the receptor. These data suggest the major
      involvement in our model of PAF acether in the platelet-neutrophil interactions.

PMID- 7778065
TI  - Zinc (II) selectively enhances the inhibition of coagulation factor XIa by
      protease nexin-2/amyloid beta-protein precursor.
AB  - Protease nexin-2 (PN-2) is the secreted isoform of the Alzheimer's Amyloid beta
      Protein Precursor (A beta PP) that contains the Kunitz-type protease inhibitor
      (KPI) domain. PN-2/A beta PP is a potent inhibitor of coagulation factor XIa
      (FXIa) and is secreted in large quantities by activated platelets suggesting a
      normal function in regulating this protease at sites of vascular injury. In the
      present study, the effect of Zn2+ on the protease inhibitory properties of PN-2/A
      beta PP was quantitatively investigated. Zn2+ (1 microM to 1 mM) had no effect on
      the inhibition of trypsin or chymotrypsin by PN-2/A beta PP. In contrast, Zn2+ at
      concentrations > 1 microM increased the inhibition of FXIa by PN-2/A beta PP.
      Enhancement of FXIa inhibition was virtually saturated at approximately 100
      microM Zn2+ resulting in a final Ki approximately 6.0 x 10(-11) M. Zn2+ had no
      effect on the inhibition of FXIa by a purified, recombinant KPI domain of PN-2/A
      beta PP indicating that the native protein is required for the potentiation of
      FXIa inhibition. Heparin and Zn2+ were found to further augment each other's
      ability to stimulate the inhibition of FXIa by PN-2/A beta PP. Together, these
      findings suggest that the interaction of Zn2+ with PN-2/A beta PP may be
      important for optimal inhibition of FXIa.

PMID- 7778066
TI  - Endothelin influences pHi of human platelets through protein kinase C mediated
      pathways.
AB  - Stimulation of human platelets with endothelin raises cytosolic pH (pHi). In
      order to determine whether this effect is mediated via protein kinase C and Na(+)
      H+ linked pathways, the effects of staurosporine and calphostin C (protein kinase
      C inhibitors) and 5-(N,N-hexamethylene) amiloride (Na(+)-H+ exchange blocker) on
      endothelin-induced pHi responses in human platelets were assessed. In addition,
      platelet endothelin receptor subtypes were determined pharmacologically using the
      selective ETA receptor antagonist BQ-123 and the ETB receptor agonist sarafotoxin
      S6c. pHi was measured spectrofluorometrically using the fluorescent probe BCECF
      AM in platelets obtained from 15 healthy subjects. Endothelin-1 at a fixed
      concentration of 10(-9) M significantly increased pHi from 7.11 +/- 0.01 ([H+]i =
      77 +/- 0.9 nM) to 7.19 +/- 0.04 ([H+]i = 64 +/- 0.9 nM) (p < 0.01). The pHi
      stimulating effect of endothelin-1 was inhibited by 10(-7) M staurosporine,
      calphostin C and 5-(N,N-hexamethylene) amiloride. BQ-123 (10(-7) M) abolished the
      pHi responses to endothelin-1, whereas sarafotoxin S6c had no effect on platelet
      pHi. These data suggest that in vitro effects of endothelin-1 on platelet pHi are
      receptor-mediated via a pathway involving protein kinase C. Platelet endothelin
      receptors appear to be of the ETA subtype.

PMID- 7778068
TI  - Bioavailability and pharmacokinetics of a new low molecular weight heparin (RO
      11)--a three way cross-over study in healthy volunteers.
AB  - This study reports on the bioavailability and pharmaco kinetics of a new low
      molecular weight heparin (RO-11), with a mean molecular weight of 3,600-3,800
      daltons. It was administered to 12 healthy individuals in an open, cross-over
      study. Each subject was randomly assigned to three experimental treatments: a) 30
      mg by subcutaneous route, b) 60 mg subcutaneously and c) 60 mg intravenously,
      leaving a wash-out period of one week between treatments. The pharmacokinetic
      profile was calculated by means of the anti-FXa effect, measured on serial
      samples taken before and during the 24 h period after each treatment. The effects
      of the drug on global coagulation tests, Antithrombin-III levels, tissue-factor
      pathway inhibitor activity and anti-FIIa activity were also assessed. After the
      intravenous injection, a maximal anti-FXa effect of 1.30 +/- 0.18 IU/ml was
      measured at 0.05 h and was not measurable after 12 h. After the subcutaneous
      injection of 30 and 60 mg, the maximal anti-FXa effect (0.34 +/- 0.08 IU/ml and
      0.54 +/- 0.06 IU/ml) was reached after 2-4 h, and was not measurable after 12-18
      h. The magnitude of this effect was dose-dependent and the absorption and
      elimination processes followed a first-order pattern for every dose and route. RO
      11 showed a biological half-life of about 5 h and a high subcutaneous
      bioavailability (96%).

PMID- 7778067
TI  - Activation of factors XII and VII induced in citrated plasma in the presence of
      contact surface.
AB  - Activated factor XII (XIIa), activated factor VII (VIIa) and factor VII coagulant
      activity (VIIc) were determined in non-treated and in treated (cold-incubated)
      citrated plasmas from women in late pregnancy and from norma volunteers. All
      three activities were higher in the non-treated plasmas from women in late
      pregnancy than from normal subjects. The incubation of citrated plasmas from
      women in late pregnancy, on ice for 24 hours, resulted in a many-fold increase of
      factor XIIa activity, factor VIIa levels and VIIc. The dilution of these plasmas
      resulted in a sharp decrease of all three activities in the post-incubation
      mixture, so that in the plasmas diluted 2:1 with buffer all three activities were
      similar to those in fresh plasmas. Similar incubations of diluted plasmas (1:1)
      from normal volunteers resulted in no increase of factor XIIa activity, factor
      VIIa levels and VIIc. However, the presence in the incubation mixture of micellar
      stearate resulted in a stearate concentration-dependent increase of all three
      activities in treated plasmas. Levels of factor XIIa activity and factor VIIa in
      the treated plasmas from both groups of subjects were highly correlated (r =
      0.987; p < 0.001). There was also a highly significant correlation between VIIc
      and factor VIIa levels (0.989; p < 0.001). These results demonstrate that the in
      vitro increase in factor VIIa levels is due to the activation of the contact
      system of coagulation and is dependent on the potency of the contact surface.
      Moreover, VIIc over a wide range of values, observed in the present experiments,
      can provide an accurate measure of factor VIIa concentration.

PMID- 7778069
TI  - Thrombin treatment of endothelial cells stimulates adhesion of oncogene
      transformed but not parent rat liver epithelial cells.

PMID- 7778070
TI  - [Vaccine against Haemophilus influenzae type b. A new great achievement in the
      research on vaccines].

PMID- 7778071
TI  - [Treatment of acute head injuries in Norway].

PMID- 7778072
TI  - [Minor head injuries. May early CT-scanning replace in-hospital observation?].
AB  - A one-year prospective study was undertaken to judge whether in-hospital
      observation after minor head injury could be partly replaced by early
      computerized tomography (CT), and if such a practice would save hospital
      resources. All 146 patients had a Glasgow Coma Score (GCS) > or = 14 and no
      neurological deficits. 128 had suffered loss of consciousness. CT of 97 (67%)
      patients revealed intracranial lesions in eight (contusions six, oedema one and
      epidural haematoma in one). Mean duration of hospitalization was 9.4 days in
      patients with intracranial lesions and 1.6 days in patients without such lesions.
      We observed no complications to the head injury in patients with normal CT. There
      is no need for hospitalization after minor head injury in patients with GCS > or
      = 14 with no neurological deficits and normal CT. We advocated wide use of early
      CT in cases of minor head injury, to allow early detection of intracranial
      haematomas, diagnoses of brain contusions and avoidance of unnecessary
      hospitalization.

PMID- 7778073
TI  - [Vaccine against Haemophilus influenzae type b--antibody response and adverse
      effects].
AB  - In 1992 it was decided to implement vaccination against Haemophilus influenzae
      type b (Hib) in the Norwegian vaccination programme. The chosen vaccine consists
      of Hib-polysaccharide conjugated to tetanus toxoid. To suit the Norwegian
      vaccination schedule, Hib-vaccine was given together with vaccine against
      diphtheria, tetanus and pertussis (DTP) at three, five and ten months of age.
      Since all earlier studies with the Hib-vaccine have used other time schedules, a
      pilot study was conducted to test antibody response and side effects when using
      the Norwegian schedule. 44 infants were vaccinated with Hib-vaccine and DTP at
      three, five and ten months of age. Blood samples showed that 95% had protective
      antibody titer against Hib after two doses, 100% after three. The response to the
      other antigens was adequate. There were only minor side effects. After
      introduction of the Hib-vaccine the incidence of invasive Hib-infection in
      children below three years of age has decreased considerably.

PMID- 7778074
TI  - [Relation between erythrocyte sedimentation and C-reactive protein in serum of
      adults with lower respiratory tract infections. Significance of microbiological
      agents].
AB  - Correlation between erythrocyte sedimentation rate and C-reactive protein was
      determined in 239 adult patients in general practice who were suspected of having
      an infection of the lower respiratory tract. A correlation coefficient of 0.62
      (95% CI 0.54-0.69) was found, but there was no association between the results of
      the two tests when the illness had lasted less than four days. With such a short
      duration of illness a test for C-reactive protein is to be preferred before
      erythrocyte sedimentation rate when evaluating lower respiratory tract
      infections.

PMID- 7778075
TI  - [The value of C-reactive protein testing in suspected lower respiratory tract
      infections. A study from general practice on the effect of a rapid test on
      antibiotic research and course of the disease in adults].
AB  - We wanted to assess whether routine use of a rapid test for C-reactive protein
      (CRP) could reduce prescription of antibiotics for adults with possible lower
      respiratory tract infection. 239 patients were randomized into a CRP group,
      tested with the rapid test (n = 108) and a control group (n = 121). Before
      knowing to which group the patient belonged the doctors made a preliminary
      decision about antibacterial treatment. The C-reactive protein value was then
      released if the patient belonged to the CRP group, and the therapy could be
      adjusted in light of the result. Antibacterial courses prescribed during the
      consultations and in the following three weeks were registered. The clinical
      course was evaluated by interview after one week and again after three weeks.
      Antibiotics were prescribed for altogether 56% of the patients in the CRP group
      and 60% in the control group. The difference was not statistically significant.
      Prescription of antibiotics was strongly associated with the finding of crackles
      and wheezes, but not with cough, dyspnoea or chest pain. Slow recovery was
      associated with high age, absence of fever and a normal value of C-reactive
      protein. No significant benefit of the CRP test was demonstrated. We discuss
      whether the doctors made full practical use of the information provided by the
      test. Bronchial obstruction should probably be considered to be the problem more
      often in coughing patients with a normal CRP value.

PMID- 7778076
TI  - [The effect of an antidepressive agent on premature ejaculation].
AB  - Premature ejaculation is a common male sexual dysfunction. Many kinds of
      medication have been used without great success. The start-stop technique is
      usually preferred. However, some patients and couples do not want to learn this
      kind of sexual therapy. One common adverse effect of the new selective serotonin
      re-uptake inhibitors is delayed ejaculation. This article discusses a patient
      with a premature ejaculation problem combined with minor depression and anxiety,
      who was successfully treated with paroxetine.

PMID- 7778077
TI  - [How to monitor the development of a population of specialists? A method for
      prognostic estimation of needs in anesthesiology].
AB  - The Norwegian Medical Association has been delegated responsibility for
      suggesting guidelines to monitor the quality and capacity of postgraduate
      specialist training. In every specialty, a committee for specialist training has
      to monitor the availability of specialists in their field on behalf of the
      Association. The authors describe a systematic approach to monitoring, in which
      available information was carefully matched with selected survey data, to enable
      prognostications. The method was then applied to anaesthesia, and revealed a need
      for higher production of specialists in this field. More than 10% of the 309
      consultant anaesthetist positions were vacant, owing to lack of applicants, and
      another 36 consultants are needed to ascertain a minimum of three specialists in
      every hospital providing emergency services. 15% of the certified specialists did
      not work as anaesthesiologists. It was estimated that ten persons would leave
      annually, either to do research or take up another specialty, and that 15 would
      retire. Based on the findings, it is suggested that the present specialist
      production of about 20 per year should be increased to secure the nation's future
      need of anaesthesiologists.

PMID- 7778078
TI  - [Surgical treatment of acute head injuries, especially epidural hematomas.
      Current and future practice in Norway].
AB  - A survey among the 13 general county hospitals and the five regional
      neurosurgical units in Norway showed that 263 patients were operated on for acute
      head injuries in 1993. More than 80% of these operations took place in a
      neurosurgical unit, and most county hospitals had only 1-2 such surgical
      procedures each year. Most county hospitals also limited their surgical
      activities to extradural conditions. Data from 68 patients operated on for
      epidural haematomas in our neurosurgical department were therefore analysed. The
      outcome of these operations was good in 83.8%, and only 5.9% showed a poor
      result. One patient died. It is concluded that these good results probably
      reflect the standard of handling, diagnostic work and transport of the patient
      prior to surgery, rather than the surgery itself. It seems unreasonable to
      continue the infrequent practice of treating these conditions surgically in local
      hospitals.

PMID- 7778079
TI  - [Diagnosis and treatment of headache].
AB  - In the recent last decades, important advances have been made in the
      understanding of the mechanisms behind headache. This has resulted in more
      efficient treatment. New forms of headache have been described where a specific
      treatment can be used. Therefore, in order to give rational therapy to headache
      patients, the physician must be able to distinguish between the most important
      primary headaches. He should also be aware of the warning signals that should
      prompt further investigations or admission to hospital in search of underlying
      causes. The article describes the most important primary headaches and the
      current treatment, and discusses the problem of unclassifiable and untreatable
      headaches.

PMID- 7778080
TI  - [C-reactive protein and biological defense].
AB  - This article reviews recent findings suggesting a specific tumouricidal effect of
      C-reactive protein (CRP). A peptidic fragment of CRP, called RS 83277, has shown
      a significant anti-tumour effect in laboratory animals. The mechanism is not
      fully understood, but is possibly mediated via the macrophages. Both macrophages
      and monocytes show increased tumoricidal activity after stimulation with RS
      83277. The article also reviews the regulation of CRP synthesis and secretion, as
      well as the structure, binding capacities, and important biological properties of
      CRP.

PMID- 7778082
TI  - [Steady homosexual relationship and HIV infection].
AB  - In order to study the relative impact of a steady homosexual relationship on the
      presence of HIV antibodies, a cross-sectional study was undertaken of 719
      homosexual men in Oslo during the period of 1983-1987. 74/719 (10%) were HIV
      positive. 37/74 (50%) of the HIV positives and 185/645 (29%) of the HIV negatives
      were having a steady homosexual relationship that had lasted six months or more
      (chi-square test, p < 0.05). In a multivariate logistic regression analysis the
      adjusted odds ratio of being HIV positive was 2.3 (1.3-4.3, 95% confidence
      interval (CI)) for homosexual relationship lasting 1/2-4 years and 3.1 (1.5-6.6,
      95% CI) for homosexual relationship lasting 5 years or more as compared with not
      being in a homosexual relationship. The number of male partners and frequent anal
      intercourse were also significantly associated with presence of HIV antibodies.
      The results suggest that situational variables associated with a steady
      partnership may be barriers to HIV-preventive measures.

PMID- 7778081
TI  - [The migraine remedy sumatriptan (Imigran) and coronary heart disease].
AB  - The new drug, sumatriptan, used to treat migraine, causes substernal tightness
      and severe angina-like pain in 3-21% of patients. Several reports have described
      sumatriptan-induced death, ventricular fibrillation, myocardial infarction,
      ischaemia and coronary vasospasm. We describe the case of a woman aged 40 years
      who suffered from bronchial asthma but was without known coronary heart disease.
      She experienced chest pain after intake of 100 mg sumatriptan orally. ECG was
      normal and there was no increase in coronary enzymes. Sumatriptan has a weak
      coronary constrictor effect. Endothelial dysfunction, with reduced release of
      vasodilating nitric oxide, may potentiate vasoconstriction induced by sumatriptan
      in the presence of thromboxane A2.

PMID- 7778083
TI  - [Current medical education in Sweden].

PMID- 7778084
TI  - [From the richness in knowledge to economic poverty--quo vadis, health and social
      occupations?].

PMID- 7778085
TI  - [Fat-soluble vitamins in clinical practice].

PMID- 7778086
TI  - [The Norwegian Society for Stroke].

PMID- 7778088
TI  - [The world of concepts in social medicine].

PMID- 7778087
TI  - [With Rudolf Ludwig Virchow as a guide into the new social medicine].

PMID- 7778089
TI  - [Medical emergency service].

PMID- 7778090
TI  - [An agreement on insurance in medical practice].

PMID- 7778091
TI  - Building a testis.
AB  - Specific cellular, subcellular and acellular components of the rat testis
      including the capsule, the peritubular tissue (tunica propria) and the lymphatic
      endothelium were analyzed using morphometric techniques at cellular and
      subcellular levels to yield volume and surface area data. These data were
      integrated with previously published data for other cellular components of the
      rat testis to provide information about the volumetric composition for virtually
      every component of this organ. For major cell types (Leydig, Sertoli, myoid cells
      and germ cells) the data are expressed to the subcellular level in terms of
      volume and, in some instances, surface area. Graphic portrayals of testis
      constituents are used for rapid visual understanding of testis structure. The
      data presented herein are useful in conjunction with biochemical data to describe
      physiological properties of cells and cell components and also for understanding
      how structure differs under experimental and in pathological situations.

PMID- 7778092
TI  - Ultrastructural changes of female Syrian hamster cystic duct epithelium as a
      result of sex steroid treatment.
AB  - In view of the lack of sufficient data regarding the morphology of the cystic
      duct and the extensive focus on the gallbladder, a preliminary examination of the
      cystic duct response to female sex steroid treatment was conducted to follow up a
      detailed ultrastructural study of the gallbladder epithelial response to a
      similar treatment. As observed in the gallbladder epithelium, the cystic duct
      epithelial cells of nulliparous Syrian hamsters demonstrate morphologic changes
      in response to female sex steroid treatment. Control (C) cystic duct epithelial
      cells are covered by short microvilli and each cell appears to exhibit a single
      vestigial cilium. Estrogen (E)- and estrogen + medroxyprogesterone (E + MP)
      treatments induce differential duct cell morphologic changes. These changes are
      the result of steroid treatments in the significant decreasing sequence E > E +
      MP > C for nuclear volume, indentations and perinuclear lysosomal/lipofuscin
      bodies. Moreover E + MP-treatment results in larger cytoplasmic volume and more
      sloughing of apical cell excrescences than following E treatment. It is suggested
      that, similar to that in the gallbladder, the action of progestin is paramount in
      favoring cytoplasmic morphological changes in the cystic duct which, along with
      the alteration of mucus, cell sloughing, decreased bile acids and motility could
      also participate in the gallstone nucleation process as they are brought into the
      gallbladder with the incoming bile flow.

PMID- 7778093
TI  - Cystatin S in secretory granules fractions isolated from submandibular gland of
      infected rats by Trypanosoma cruzi.
AB  - We have measured the relative concentrations of cysteine proteinase in the
      granular fractions of submandibular glands of control and Trypanosoma cruzi
      infected rats by using a sensitive solid phase ELISA. Gland samples were
      homogenized in 0.34 M sucrose and 0.5 mM EDTA in 10 mM HEPES buffer at a pH of
      7.4. The extract was centrifuged and filtered through Millipore filters to
      prepare a purer granular fraction. Immunochemical studies using antibody against
      cystatin S and electrophoretic analysis showed higher cystatin S levels in
      infected rats than in control. The role of this inhibitor during acute phase of
      Chagas disease is discussed.

PMID- 7778094
TI  - Adaptive cellular response to osmotic stress in pig articular chondrocytes.
AB  - The authors studied the effects of a wide range of medium osmolarities (from 0.28
      osM (physiological osmolarity of plasma and synovial fluid) to 0.58 osM) by
      altering Na+ concentration in high density cultures of pig articular chondrocytes
      in order to analyze the behaviour of some functional and structural parameters
      during cell adaptation to these imposed changes in the ionic environment.
      Biochemical and morphological results indicated that, even if isolated from the
      tissue matrix and cultured in vitro, chondrocytes maintained active
      osmoregulation systems which are present in living conditions. They showed a
      similar biochemical and morphological behavior when cultured at 0.28 osM and 0.38
      osM but they were able, with regard to protein synthesis, aminoacid transport and
      proliferation rates, to respond quickly and to adapt to 0.48 osM medium as well.
      On the contrary, the treatment at the highest osmolarity (0.58 osM) early altered
      these biochemical parameters and was detrimental or even gave rise to lethal
      damage during long-term treatment. Furthermore, while chondrocytes cultured in
      0.28-0.38 osM medium maintained phenotypic characteristics in culture, the higher
      osmolarities (0.48-0.58 osM) caused morphological changes in cell populations
      resulting in loss of phenotypic cell stability as demonstrated by their taking on
      a fibroblast-like shape as well as a lack of ability to assembly matrix
      proteoglycans.

PMID- 7778095
TI  - Estrous cycle-related alterations in the expression of glycoconjugates and
      lectins in the mouse endometrium shown histochemically.
AB  - Alterations of the hormonal status may influence diverse cell features relevant
      to intra- and intercellular communication. We studied histochemically the
      expression of glycans and endogenous sugar-binding proteins (endolectins) in the
      mouse endometrium during the estrous cycle. The avidin-biotin-peroxidase complex
      (ABC) technique was used on paraffin sections with a panel of biotinylated
      lectins and neoglycoproteins. Stage-specific changes were observed with Galanthus
      nivalis agglutinin (GNA), Ulex europaeus-I agglutinin (UEA-1), Sambucus nigra
      agglutinin (SNA), Ricinus communis agglutinin (RCA-I) and Glycine max agglutinin
      (SBA) in both the luminal and the glandular epithelium, but to a lesser extent in
      the latter. The stromal constituents also exhibited modifications in lectin
      binding profiles in cyclic mice. In addition to the analysis of cell glycans
      endogenous carbohydrate-binding sites were studied using synthetic probes,
      biotinylated neoglycoproteins. These tools made it possible to conclude that
      hormonal status can affect the expression of endolectins. We have attempted to
      correlate the glycohistochemical findings with recently published data obtained
      biochemically. The results indicate that phase-specific alterations in lectin
      binding glycoproteins and endolectins occur in the endometrium of mice associated
      with their short reproductive cycle.

PMID- 7778096
TI  - Correcting cell density measurements for tissue hydration changes in scanning
      electron microscopy--application to the rabbit corneal endothelium.
AB  - Chemical fixation with glutaraldehyde (followed by osmium tetroxide treatment,
      methanol dehydration and critical point drying) of biological tissue can result
      in a reduction in tissue size. As a result, cell density estimates can be much
      higher than in the original tissue. For rabbit corneal endothelium (cell density
      of 3300 cells/mm2); preparation of fresh tissue (73% hydrated) results in a net 2
      fold increase in apparent endothelial cell density unless the dimensions of the
      tissue before and after processing for scanning electron microscopy (SEM) are
      taken into consideration. The increase in endothelial cell density (ECD) is the
      same regardless of whether the fresh tissue is subjected to primary fixation for
      1-14 days or if the fixed (and osmium tetroxide treated) tissue is stored in
      methanol for up to 80 weeks. However, if the tissue hydration is acutely altered
      during ex vivo perfusion techniques, the cell density, as assessed by SEM, is
      found to increase proportionately to the tissue hydration (as measured by corneal
      thickness); the increase was 600 cells/mm2 for each 100 microns increase in
      corneal thickness. The latter phenomenon does not appear to be the result of a
      differential reduction of tissue size associated with either primary fixation or
      secondary processing. For some tissues, therefore, a change in the tissue
      hydration level prior to fixation, may produce secondary effects in measures of
      cell densities.

PMID- 7778097
TI  - Response of guanylate cyclase to atrial natriuretic factor in epithelial cells of
      the frog choroid plexus.
AB  - This study shows that the choroid plexus of Rana esculenta contains a guanylate
      cyclase particulate (GCp), similar to that identified in Mammalia, that is quite
      sensitive to the atrial natriuretic factor (ANF). The cytochemical tests for GCp
      show that ANF increases the enzymatic reaction products. Deposits are observed on
      the apical portion, at the basal level and along the lateral edges of the
      epithelial cells, with the exclusion of some intercalary epithelial cells with
      reaction-lacking microvilli. In particular, ANF seems to intensely stimulate the
      GCp activity along the lateral membranes of the epithelial cells delimiting
      enlarged intercellular spaces, which are probably dilated for the transport of
      water and solutes. These data confirm the osmoregulatory role of the hormone and
      its control of cephalorachidian liquid composition.

PMID- 7778098
TI  - Proceedings of the Conference on Low-Level Exposure to Chemicals and
      Neurobiologic Sensitivity. Baltimore, Maryland, 6-7 April 1994.

PMID- 7778099
TI  - White paper: Chemical sensitivity: history and phenomenology.
AB  - Nearly everyone has heard something about chemical sensitivity, either from
      personal experience with someone who has the condition or from the media. The
      television series Northern Exposure recently featured a chemically sensitive
      attorney who lived in a geodesic dome in Alaska, and L.A. Law depicted the
      struggles of a Persian Gulf veteran with chemical sensitivities who lost his case
      against the Veterans Administration, but may appeal later in the season.
      Television news programs and the printed media have showcased patients living
      spartan existences in remote areas or in aluminum foil-lined rooms. Our views of
      the illness no doubt are colored by our own personal experiences of it. While
      some discount or make jokes about chemical sensitivity or these patients,
      physicians who have seen a number of them are discovering that many appear to be
      credible individuals with prior good work records who say they became ill
      following an identifiable exposure to chemicals.

PMID- 7778100
TI  - White paper: Neuropsychiatric aspects of sensitivity to low-level chemicals: a
      neural sensitization model.
AB  - The present paper summarizes the proposed time-dependent sensitization (TDS) and
      partial limbic kindling model for illness from low-level chemicals; reviews and
      critiques prior studies on CNS aspects of multiple chemical sensitivity (MCS);
      and outlines possible experimental approaches to future studies. TDS is the
      progressive and persistent amplification of behavioral, neurochemical, endocrine,
      and/or immunological responses to repeated intermittent stimuli over time.
      Partial limbic kindling is a progressive and persistent lowering of the threshold
      for eliciting electrical afterdischarges, but not motor seizures, in certain
      brain structures such as amygdala and hippocampus; behavioral consequences
      include increased avoidant behaviors. The focus of the paper is the controversial
      claim of altered sense of smell and illness from low levels of environmental
      chemicals (i.e., "cacosmia"), levels that should not have any biologically
      harmful effects by the rules of classical neurotoxicology. A major perspective of
      this paper is that the phenomenology of MCS is similar to that of time-dependent
      sensitization (reverse tolerance) and tolerance as studied in the substance abuse
      literature. The TDS model for MCS proposes that neurobiological amplification
      underlies the symptoms and phenomenology of these patients, including their
      behavioral features of heightened affective and somatic distress. It is
      hypothesized that MCS patients, who are mostly women, may be individuals who
      sensitize to substances rapidly and to the extreme, to the point of aversive
      symptomatology with less complete capacity for development of tolerance. Possible
      parallels between MCS and TDS include: (a) initiation by single or multiple
      intermittent stimuli; (b) lasting changes in subsequent reactivity to low levels
      of chemically unrelated substances; (c) cross-sensitization between the stressors
      and pharmacological agents; (d) greater vulnerability of individuals who are
      female, who have certain genetic characteristics, and/or who may be hyperreactive
      to novelty (cf. trait shyness); (e) lack of obvious differences between
      sensitized and unsensitized individuals at baseline without eliciting exposures;
      (f) bidirectionality (bipolarity) of sensitized responses; (g) both context
      dependent (conditioned) and context-independent (unconditioned) amplification of
      responses. To minimize variability between studies, research in this area needs
      (a) consensus on a working case definition of MCS or at least of cacosmia as a
      specific symptom in a subset of well-defined medical and psychiatric disorders;
      and (b) proper design of chemical challenge studies in MCS, controlling for
      individual differences in sensitizability and for the properties of sensitization
      (e.g., repeated intermittent exposure tests) and tolerance (e.g., removal from
      customary ambient air exposures prior to testing).

PMID- 7778101
TI  - Patient statement: chemically sensitive.
AB  - There are three areas of my experience with chemical sensitivity that may
      interest you. The first is the onset of this condition and what happened to me
      over time as I became chemically sensitive in my work place. The second is my
      experience with the "medical community." The third is the effect chemical
      sensitivity has had on my career.

PMID- 7778103
TI  - Time-dependent sensitization in animals: a possible model of multiple chemical
      sensitivity in humans.
AB  - It often happens in science that clues to the nature of a problem under study
      come from a completely different, seemingly unrelated, line of investigation.
      This may be the case with MCS and Time-Dependent Sensitization (TDS), a
      phenomenon we discovered in rats in the late 1970s and later named. TDS refers to
      the ability of mild stressors--whether pharmacological or environmental--to
      induce physiological and behavioral effects which then progress, i.e., get
      stronger, entirely as a function of the passage of time since stressor
      presentation. This strengthening is revealed when the organism is later exposed
      to either the original or another stressor. The characteristics of TDS bear a
      remarkable resemblance to the features of MCS and that similarity is the subject
      of this manuscript.

PMID- 7778102
TI  - Patient statement: chemical sensitivity--one victim's perspective.
AB  - Not a day goes by that I don't miss my old life and the old me. To illustrate how
      my life has changed, I have two brief stories. In 1982, I developed a lending
      procedure in conjunction with Banker's Life Insurance Company that enabled
      commercial real estate developers to secure permanent financing for property that
      had not yet been developed--in essence using a permanent loan in place of a
      construction loan. It fixed the interest rate, at a time when new construction
      rates were bankrupting many projects and it allowed the developer to invest the
      excess funds to offset interest expenses. I received national recognition for
      this loan. In 1989, the police found me wandering around in 15 inches of snow, in
      below zero weather with no shoes or coat. The officer took me to the hospital
      because I was obviously disoriented. I didn't even know my name or where I lived.
      These stories show the disparity between my life as a successful, independent
      business woman and my life as someone who is chemically disabled.

PMID- 7778104
TI  - Neuroanatomy and neurochemical mechanisms of time-dependent sensitization.
AB  - Time-dependent sensitization (TDS) is a phenomenon described in rodents as an
      enhancement in the behavioral and neurochemical responses to intermittent
      exposure to psychostimulant drugs. Time-dependent sensitization also occurs after
      repeated encounters with environmental stress. Several features of TDS parallel
      those of multiple chemical sensitivity (MCS) in humans, and these similarities
      have led to the hypothesis that MCS may be explained in part by a similar
      sensitization process that occurs in rodents. In the studies presented here, we
      discuss some of the critical features of TDS following repeated exposure to
      cocaine and environmental stress, including the anatomical and neurochemical
      pathways utilized in expressing TDS. In addition, we discuss the possible
      neurochemical basis for individual differences in responsiveness to stimuli,
      including novelty and cocaine. The striking similarities between TDS and MCS
      suggest it may be possible to develop an animal model of MCS, using TDS in
      rodents as its basis.

PMID- 7778106
TI  - Caveats in the use of the kindling model of affective disorders.

PMID- 7778105
TI  - Modelling anxiety disorders following chemical exposures.
AB  - The effects of kindling and inverse benzodiazepine receptor agonist beta
      carbolines on animal models of anxiety are briefly reviewed in relation to
      affective disorder associated with chemical exposure. Recent experimental results
      are described. In the present study, cats were given the inverse benzodiazepine
      receptor agonist, FG-7142, a powerful anxiogenic compound in humans and animals.
      Neural transmission in pathways involved in defensive behavior in the cat was
      monitored using evoked potential techniques. Change in these pathways was related
      to behavioral changes induced by the drug. It was found that a single dose of FG
      7142 lastingly increased defensive response to rodents for at least 40 days after
      drug administration. Behavioral change was specific to defensive response, since
      approach-attack behavior remained unchanged, replicating previous studies. The
      benzodiazepine receptor antagonist, Flumazenil, reversed the increase in
      defensiveness in a drug-dependent manner, replicating previous findings.
      Increased defensiveness was paralleled by a delayed onset potentiation of neural
      transmission between the amygdala and the medial hypothalamus of the left
      hemisphere. Potentiation in the left hemisphere was transient, decaying between 6
      and 12 days after the drug. There was a longer lasting potentiation (LTP) of
      activity evoked in the left and right amygdalo-periacqueductal gray pathways and
      in the right amygdalo-medial hypothalamic pathway. Potentiation in these pathways
      appeared at the time of behavioral change. Potentiation of the right amygdalo
      periacqueductal gray and right amygdalo-medial hypothalamic pathways persisted
      until the end of the experiment. In contrast, potentiation of the left amygdalo
      periacqueductal gray pathway faded by 40 days after the drug. Flumazenil
      decreased potentiation ony in the right amygdalo-periacqueductal gray pathway.
      These data strongly suggest that lasting affective change is mediated by lasting
      changes in particular efferents of the amygdala of the right hemisphere.
      Behavioral and physiological effects of FG-7142 were blocked by the N-methyl-D
      Aspartate (NMDA) receptor blocker, AP7. The data suggest that failure of neural
      inhibition induced by FG-7142 engages NMDA receptor processes to produce lasting
      potentiation of transmission in neural circuits that mediate defensive response
      with behavioral consequences. Since FG-7142 interferes with GABA mediated neural
      inhibition and is proconvulsant, its action might mimic the action of other
      environmental chemicals with similar properties, such as chlorinated hydrocarbon
      insecticides. The relationship of the present data to the literature on the
      neural and behavioral effects of insecticide exposure is discussed. The
      significance of these findings for multiple chemical sensitivity disorder is also
      briefly discussed.

PMID- 7778107
TI  - Neurobiological sensitization models of post-traumatic stress disorder: their
      possible relevance to multiple chemical sensitivity syndrome.
AB  - Neurological sensitization has been proposed as a model for post-traumatic stress
      disorder (PTSD) (Lipper et al., 1986; van der Kolk, 1987; Friedman, 1988; Post et
      al., 1988, 1994; Charney et al., 1993). Laboratory paradigms in which repeated
      exposure to a discrete stimulus is associated with progressive intensification of
      a neurophysiologic, behavioral, or pharmacologic response has many parallels with
      the sequence of events that precipitates PTSD. Investigators with other clinical
      interests have also been attracted to sensitization models. Specifically, Bell
      and associates (1992) have proposed that olfactory-limbic kindling is a very good
      model for understanding the etiology of multiple chemical sensitivity (MCS)
      syndrome. A number of articles in this volume have addressed the goodness-of-fit
      between this model and MCS. My major assignment is to review laboratory data and
      clinical observations pertinent to sensitization models of PTSD. I will show that
      although there are intriguing parallels between the two phenomena, one must have
      great respect for the complexity and polymorphism of both sensitization and PTSD
      before grasping for simplistic theoretical conclusions. Secondly, I will address
      the following question; if both PTSD and MCS can be understood as sensitization
      phenomena, are PTSD patients at greater risk to develop MCS and vice versa? This
      article is divided into four sections: a) a description of three distinct
      sensitization phenomena; b) a description of the symptoms of PTSD; c) a review of
      the applicability of sensitization models to the clinical phenomenology of PTSD;
      and d) a review of the hypothesis that PTSD patients might be more vulnerable to
      MCS.

PMID- 7778108
TI  - Drug sensitization, substance abuse, and chemical sensitivity.
AB  - Substance abuse, involving drugs such as cocaine, heroin, alcohol, marijuana,
      nicotine, barbiturates, etc., is by far by the most prevalent psychiatric
      disorder. Much has been learned about the abuse of these substances that may be
      useful to consider in designing and analyzing research concerning multiple
      chemical sensitivities (MCS). We review the central role of sensitization in this
      literature, including its definition, measurement, and expression in animals and
      human volunteers. Common factors among abused drugs, including sensitization, are
      discussed. Finally, empirical studies are delineated or proposed to test some of
      the notions presented in this paper.

PMID- 7778110
TI  - Psychological bases of symptom reporting: perceptual and emotional aspects of
      chemical sensitivity.
AB  - The reporting of physical symptoms is influenced to a large degree by
      psychological processes. Individuals are more likely to notice subtle sensations
      in environments lacking in stimulation than those demanding external attention.
      The beliefs or schemas that people hold dictate where and how they attend to
      their bodies as well. These normal perceptual processes help explain why people
      are often poor at accurately detecting internal physiological activity. Several
      individual differences are also related to the symptom reporting process. Females
      are more likely to base their symptom reports on external situational cues than
      are males. In addition, individuals with chronic anxiety--those high in Negative
      Affectivity (NA)--report more symptoms than those low in NA. Finally,
      individuals, who have had traumatic experiences, either in childhood or within 1
      6 months prior to a major symptom reporting episode, tend to be high symptom
      reporters. Several recommendations are made to help researchers and clinicians
      distinguish between psychological or perceptual factors with presumed biological
      effects. One implication of this work is that MCS and allied syndromes should be
      viewed as both a mental and a physical health problem.

PMID- 7778109
TI  - Psychiatric symptoms in multiple chemical sensitivity.
AB  - Neuropsychiatric symptoms are among the most prominent manifestations of
      generalized chemical sensitivity. Patients, clinicians, and researchers are in
      agreement that symptoms such as depression, irritability, and mood instability
      are prominent among the distressing and disabling symptoms occurring in response
      to low-level chemical exposure. Beyond that point, however, agreement is
      difficult. The pathophysiology and clinical management of these symptoms remain
      quite controversial. This paper will review available data on the prevalence and
      form of psychiatric symptoms among those suffering from multiple chemical
      sensitivity. Various models explaining the relationship of psychiatric symptoms
      to chemical sensitivity will be discussed. Finally, the implications of these
      models for clinical management and future research will be reviewed.

PMID- 7778111
TI  - Neuropsychiatric status of patients with chronic fatigue syndrome: an overview.
AB  - Chronic fatigue syndrome (CFS) is an illness that results in debilitating fatigue
      as well as rheumatological, infectious, and neuropsychiatric symptoms. The
      present paper is a brief overview of the neuropsychological and psychiatric
      research on CFS. Studies from our laboratory contrasting CFS with patients with
      multiple sclerosis, depression, and healthy controls are detailed. Our hypothesis
      of neuropsychological impairments in CFS is discussed.

PMID- 7778112
TI  - The utility of psychophysiological measures in assessing the correlates and
      consequences of organic solvent exposure.

PMID- 7778113
TI  - Neuropsychology and psychology of MCS.
AB  - Neurological symptoms are frequently reported by patients with multiple chemical
      sensitivities (MCS). Methods to compare the psychiatric, personality, and
      neuropsychological function of patients with MCS, chronic fatigue syndrome (CFS),
      and normal controls are described. Increased rates of Axis I psychiatric
      diagnoses are observed in the literature for MCS and CFS subjects relative to
      controls. Findings on the MMPI-2 and the Toronto Alexithymia Scale reveal
      profiles consistent with the tendency to report somatic rather than emotional
      symptoms in response to stress. However, many of the reported somatic symptoms
      also coincide with those found in neurologic disorders. The overall
      neuropsychological profile for MCS subjects does not reflect cognitive
      impairment. Relative to normal controls, the only difference in
      neuropsychological performance observed is reduced recognition of nontarget
      designs on a visual memory task. More fruitful areas for future psychological
      research will include measurement of the interaction between behavioral response
      styles and attentional processes in cognition, as well as observations under
      controlled challenge conditions.

PMID- 7778116
TI  - EEG and ERP studies of low-level odor exposure in normal subjects.
AB  - Evidence from four EEG/ERP experiments is presented. Findings of these
      experiments consistently demonstrate the ability of low-level and undetected
      odors to alter neurophysiology. Behavioral and cognitive effects are also
      described. These data may have applicability to theories of MCS since they
      illustrate the possibility that low-level or undetected odors affect central
      nervous system activity and may precipitate or cue MCS symptoms.

PMID- 7778114
TI  - NeuroSPECT findings in patients exposed to neurotoxic chemicals.
AB  - Exposures to neurotoxic chemicals such as pesticides, glues, solvents, etc. are
      known to induce neurologic and psychiatric symptomatology. We report on 41
      patients--16 young patients (6 males, 10 females, age 34 +/- 8 yrs.) and 25
      elderly patients (9 males, 16 females, age 55 +/- 7 yrs). Fifteen of them were
      exposed to pesticides, and 29 to solvents. They were studied with quantitative
      and qualitative analysis of regional cerebral blood flow (rCBF), performed with
      30 mCi of Xe-133 by inhalation, followed by 30 mCi of Tc-HMPAO given
      intravenously. Imaging was performed with a brain dedicated system, distribution
      of rCBF was assessed with automatic ROI definition, and HMPAO was normalized to
      maximal pixel activity in the brain. Results of Xe rCBF are expressed as mean and
      S.D. in ml/min/100g, and HMPAO as mean and S.D. uptake per ROI, and compared with
      age-matched controls--10 young and 20 elderly individuals. table: see text] We
      conclude that patients exposed to chemicals present with diminished CBF, worse in
      the right hemisphere, with random presentation of areas of hypoperfusion, more
      prevalent in the dorsal frontal and parietal lobes. These findings are
      significantly different from observations in patients with chronic fatigue and
      depression, suggesting primary cortical effect, possibly due to a vasculitis
      process.

PMID- 7778115
TI  - Single photon emission computed tomography of the brain in patients with chemical
      sensitivities.
AB  - Chemical sensitivities display a recurrent pattern on scintigraphic examinations
      of the brain. The pattern can include mismatching between early and late imaging,
      multiple hot and cold foci distributed throughout the cortex without regard to
      lobar distribution (salt and pepper pattern), temporal asymmetries, and sometimes
      increased activity in the basal ganglia. This study used Desert Shield/Desert
      Storm veterans who present with abnormal neurological and psychological symptoms
      as a model to exhibit abnormalities by brain scintigraphy. These are typical of
      those seen in patients with documented exposure to neurotoxic compounds who
      develop a clinical syndrome that has been termed "chemical sensitivity." Exposure
      to cocaine, alcohol, and other substances of abuse can result in abnormal
      scintigrams of the brain using tracers such as [technetium
      99m]hexamethylpropyleneoxime. This study used techniques combining regional
      cerebral blood flow data with delayed distributional data after the intracellular
      conversion of the tracer into a hydrophilic molecule. In addition to delayed
      image abnormalities, a mismatch occurs in the regional activity between the two
      image sets of the veterans. This degree of mismatch was not seen in control
      subjects who were screened for avoidance of neurotoxic agents. Patterns
      identified from examinations performed on patients with known exposure to
      petroleum distillates, pesticides and other materials linked with neurotoxicity
      were identified in some veterans of the Desert Shield/Desert Storm operation. A
      single case of repeated examinations on a veteran showed a reversion of these
      patterns toward normal after therapy. This reversion followed independent
      assessments of clinical improvement.

PMID- 7778117
TI  - Olfactory (chemosensory) event-related potentials.
AB  - Chemosensory event-related potentials (CSERPs) have found their way into a number
      of fields of research where they help to determine the function of both the
      trigeminal and the olfactory system. The investigation of chemosensory deficits
      in patients with Parkinson's or Alzheimer's disease is only one of the typical
      applications. It can be assumed that scientists involved in research on patients
      with multiple chemical sensitivities will also benefit from having access to
      objective data covering different aspects of the sense of smell.

PMID- 7778118
TI  - Low-level chemical sensitivity: a perspective from behavioral toxicology.
AB  - Low-level chemical sensitivity is hardly a new issue in environmental toxicology.
      It is, in fact, the focus of risk assessment. The risk assessment process is
      designed explicitly to estimate the health threats posed by low exposure levels,
      typically by extrapolating from high experimental or environmental levels. The
      conventional risk assessment structure, however, was designed primarily around
      cancer. It is only awkwardly applicable to neurobehavioral toxicants because of
      the multiplicity of endpoints that have to be considered in evaluating
      neurotoxicity. At the same time, neurotoxic risk assessment maintains certain
      advantages over cancer risk assessment because of diminished uncertainties over
      dose extrapolation. It does not have to depart as far from the range of
      observable data. The main problem with extending the risk assessment model to
      issues such as Multiple Chemical Sensitivity (MCS) and Sick Building Syndrome
      (SBS) is the absence of a specific chemical whose concentration can be measured
      and then manipulated. A prototypical agent, however, such as a volatile organic
      solvent, might be selected and studied. Beyond the choice of agent, however, is
      the question of which behavioral criteria are likely to yield the most useful
      information. Although neuropsychological test batteries provide one source of
      data, they typically are administered in a setting other than the one allegedly
      provoking the syndrome. A different approach invokes what might be called a
      miniature work situation. Here, a test subject is evaluated in a setting that
      emphasizes sustained performance testing in the presence of target chemicals.
      Experimental design is another factor to be considered. Two features are
      especially critical. The most sensitive design, at least for the current stage of
      knowledge, would probably emphasize consistency of response, and would choose as
      subjects individuals who claim to be afflicted with low-level sensitivity.
      Consistency in a single individual may be more informative than significance
      tests in a large sample. In addition, consistency as a criterion helps overcome
      the problem that, in any such sample, only a minor proportion of the subjects may
      truly exhibit such sensitivity. At a later stage, a broader range of subjects
      might be targeted. Research on behavioral disorders evoked by food additives
      illustrates the importance of such questions. It also demonstrates that the
      methods currently used to assess the potential toxicity of many substances,
      including food additives, typically ignore subtle, and often sensitive,
      neurobehavioral measures.

PMID- 7778119
TI  - Multiple chemical sensitivity: lessons from seasonal affective disorder.

PMID- 7778120
TI  - EEG responses to low-level chemicals in normals and cacosmics.
AB  - Recent studies from the University of Arizona indicate that normal subjects, both
      college students and the elderly, can register the presence of low-intensity
      odors in the electroencephalogram (EEG) in the absence of conscious awareness of
      the odors. The experimental paradigm involves subjects sniffing pairs of bottles,
      one containing an odorant (e.g. isoamyl acetate) dissolved in an odorless solvent
      (water or liquid silicone), the other containing just the solvent, while 19
      channels of EEG are continuously recorded. For the low-intensity odor conditions,
      concentrations are adjusted downward (decreased) until subjects correctly
      identify the odor bottle at chance (50%). The order of odorants, concentrations,
      and hand holding the control bottle, are counterbalanced within and across
      subjects. Three previous experiments found that alpha activity (8-12 hz)
      decreased in midline and posterior regions when subjects sniffed the low
      intensity odors. The most recent study suggests that decreased theta activity (4
      8 hz) may reflect sensory registration and decreased alpha activity may reflect
      perceptual registration. In a just completed experiment involving college
      students who were selected based on combinations of high and low scores on a
      scale measuring cacosmia (chemical odor intolerance) and high and low scores on a
      scale measuring depression, cacosmic subjects (independent of depression) showed
      greater decreases in low-frequency alpha (8-10 hz) and greater increases in low
      frequency beta (12-16 hz) to the solvent propylene glycol compared to an empty
      bottle. Topographic EEG mapping to low-intensity odorants may provide a useful
      tool for investigating possible increased sensitivity to specific chemicals in
      chemically sensitive individuals.

PMID- 7778121
TI  - Critique: SPECT studies of multiple chemical sensitivity.

PMID- 7778122
TI  - Production of type II ribotoxins by Aspergillus species and related fungi in
      Taiwan.
AB  - A molecular investigation was conducted on the production of type II ribotoxin of
      the species Aspergillus and related fungi in Taiwan. Species that carried
      ribotoxin were confirmed by (1) cross-reactivity to anti-alpha-sarcin serum; (2)
      Southern dot hybridization; (3) PCR amplification of genomic DNA with specific
      primers; and (4) analysis of ribotoxic activity. Five new strains, A. clavatus,
      A. oryzae var. effusus, A. ostianus, A. tamarii, and Neosartorya fischeri var.
      spinosa, were identified to contain an alpha-sarcin-like ribotoxin. These
      positive strains exhibit ribotoxic activity by cleaving ribosomes and generating
      an alpha-fragment.

PMID- 7778123
TI  - Binding of muscarinic toxins MTx1 and MTx2 from the venom of the green mamba
      Dendroaspis angusticeps to cloned human muscarinic cholinoceptors.
AB  - Muscarinic toxins MTx1 and MTx2 are 7500 mol. wt polypeptides isolated from the
      venom of the green mamba snake Dendroaspis angusticeps. Previous competition
      binding studies indicate that the MTxs may be selective for the M1 subtype of
      muscarinic acetylcholine receptors. The present work was undertaken in order to
      clarify the muscarinic subtype specificity and functional effects of MTx1 and
      MTx2. Binding interactions were determined using 3H-N-methyl scopolamine (NMS)
      and cloned human muscarinic receptor subtypes m1, m2, m3 and m4. Some preliminary
      functional studies were performed on rabbit vas deferens preparations, which
      contain M1 cholinoceptors. MTx1 and MTx2 inhibited 3H-NMS binding to m1 and m3
      receptors, with little effect on binding to m2 and m4 receptors. Affinity was
      higher for m1 receptors: Ki for MTx1 were 48 nM at m1 receptors and 72 nM at m3
      receptors, and Ki for MTx2 were 364 nM at m1 and 1.2 microM at m3 receptors. At
      m1 receptors, about 90% of the binding of MTx1 and MTx2 appears to be
      irreversible. On rabbit vas deferens preparations, MTx1 and MTx2 at
      concentrations above 50 nM behaved in a similar way to the relatively selective
      M1-agonists McN-A-343 and CPCP (4-[N-(chlorophenyl)carbamoyloxy]-4-20-ynyl
      trimethylammoniu m iodide) by reducing responses to nerve stimulation. The
      results confirm that MTx1 and MTx2 bind to m1 receptors rather than to m2 or m4
      receptors, but they also reveal a slightly weaker effect at m3 receptors. The
      interaction at m1 receptors appears to be essentially irreversible, implying that
      the toxins could be useful tools in studies of the functional role of m1
      muscarinic receptors.

PMID- 7778124
TI  - A study on the cause of death due to waglerin-I, a toxin from Trimeresurus
      wagleri.
AB  - Waglerin-I, a lethal toxin isolated from the venom of Trimeresurus wagleri,
      consists of 22 amino acid residues with a proline-rich sequence. In the present
      study, we investigated the cause of death and the possible site of action of this
      toxin. In anesthetized mice, i.v. administration of waglerin-I at 0.5 microgram/g
      produced respiratory failure within 5 min. The blood pressure could be maintained
      by the application of artificial respiration immediately after respiratory
      arrest. Waglerin-I at 4 microM reversibly blocked the indirect twitch of the
      mouse phrenic nerve-hemidiaphragm preparation, but had no effect on the direct
      twitch. It is concluded that respiratory failure, resulting from neuromuscular
      block, is the primary cause of death due to waglerin-I in mice. In contrast to
      the results obtained in mice, in anesthetized rats no toxic effects on
      respiration and blood pressure were observed except for a transient hypotension
      up to 10 micrograms/g (i.v.). In accordance with the in vivo experiments,
      waglerin-I at concentrations up to 40 microM did not block the indirect twitch of
      the rat diaphragm. It thus appears that rats are resistant to the toxic effects
      of waglerin-I.

PMID- 7778125
TI  - Bibliography of toxinology.

PMID- 7778126
TI  - Isolation and characterization of a metalloproteinase with weak hemorrhagic
      activity from the venom of the snake Bothrops asper (terciopelo).
AB  - A metalloproteinase, named BaP1, was purified to homogeneity from the venom of
      Bothrops asper (Pacific region) of Costa Rica by ion-exchange chromatography on
      CM-Sephadex and gel filtration on Sephacryl S-200. The enzyme has a mol. wt of
      24,000 and contains few Cys and high numbers of Asp, Leu, Ser and Glu. BaP1
      hydrolyzes casein, hide powder azure and fibrinogen, having an optimal pH of 8.0.
      It rapidly digests the A alpha-chain of fibrinogen and, later on, the B beta
      chain, leaving the gamma-chain unaffected. Chelating agents (EDTA and 1,10
      phenanthroline) inhibited proteolytic activity, whereas 2-mercaptoethanol and
      soybean trypsin inhibitor did not affect this activity. BaP1 has a weak
      hemorrhagic activity, with a minimum hemorrhagic dose of 20 micrograms; this
      activity was inhibited by EDTA and was abolished after incubation at 60 degrees
      C. In addition, BaP1 induces edema and a mild myotoxic effect, lacking coagulant,
      defibrinating and lethal effects.

PMID- 7778127
TI  - Pharmacological study of edema induced by venom of the snake Bothrops asper
      (terciopelo) in mice.
AB  - The effect of several drugs on the edema-forming activity of Bothrops asper venom
      was studied plethysmographically using the mouse foot pad assay. Bothrops asper
      venom induced a dose-dependent edema which developed rapidly and peaked 1 hr
      after envenomation. Incubation of venom with EDTA before injection resulted in a
      significant reduction of edema. In addition, pretreatment with prazosin,
      indomethacin, dexamethasone, yohimbine and mepacrine resulted in a significant
      reduction in edema-forming activity. However, no inhibitory effect was observed
      when mice were pretreated with verapamil, nordihydroguaiaretic acid, pyrilamine,
      cimetidine and propranolol. When drugs were administered after venom injection,
      only prazosin and indomethacin were effective in reducing edema. These results
      suggest that B. asper venom-induced edema in the mouse foot pad model is
      mediated, at least partially, by metalloproteinases, phospholipase A2, eicosanoid
      products and activation of alpha 1 and alpha 2 adrenergic receptors.

PMID- 7778128
TI  - Medium molecular weight factor X activating enzyme from Vipera berus berus venom.
AB  - Vipera berus berus venom contains several factor X activating enzymes. One of
      them (VBFXAE) was separated by gel-filtration on Sephadex G-100 superfine and on
      a bacitracin-agarose column. The enzyme is a single-chain glycoprotein with mol.
      wt 38,000. The enzyme has several molecular forms with pI 3.5-4.5. After
      neuraminidase treatment the enzyme has pI 4.5. VBFXAE contains 2 Ca per mole. The
      activator is inactive on synthetic substrates, on casein, prothrombin, and
      fibrinogen, and appears to act specifically on factor X. The activator also
      weakly hydrolyses the insulin B-chain at the positions Ala14-Leu15 and Tyr16
      Leu17. The cleavage of the insulin B-chain is inhibited by EDTA, suggesting the
      metalloproteinase nature of the enzyme.

PMID- 7778129
TI  - The effect of cleavage by a Crotalus atrox alpha-proteinase fraction on the
      properties of C1-inhibitor.
AB  - The effect of cleavage of C1-inhibitor at Pro36 by a Crotalus atrox alpha
      proteinase fraction on the properties of this serpin was studied. This truncated
      C1-inhibitor (des 1-36) was fully active as an inhibitor of kallikrein, beta
      factor XIIa, and C1s, and modulated the functions of C1 in a normal manner. Also,
      the half-life of the truncated protein in the circulation of rabbits, both alone
      and in complex with C1, was not altered. These results show that shock-like
      symptoms caused by C. atrox envenomation are not attributable to a deficiency in
      C1-inhibitor caused by the action of the metalloproteinase in the alpha
      proteinase fraction.

PMID- 7778130
TI  - A major lethal factor of the venom of Burmese Russell's viper (Daboia russelli
      siamensis): isolation, N-terminal sequencing and biological activities of
      daboiatoxin.
AB  - A major lethal factor, daboiatoxin (DbTx), showing strong PLA2 activity (specific
      activity 91.7 nmoles/min/mg), was purified to homogeneity from the venom of
      Burmese Russell's viper (Daboia r. siamensis) by a combination of gel filtration
      on Sephadex G-75 and ion-exchange chromatography on CM-Sephadex C-25, followed by
      purification on high-performance gel filtration Shim-pack Diol-150 column. DbTx
      is a single-chain PLA2 toxin with approximate mol. wt 15,000 as determined by
      HPLC gel filtration and SDS-PAGE. It constitutes 12% of total venom protein and
      is the main lethal component of Burmese Russell's viper venom with an LD50 i.p.
      (0.05 mg/kg) 12-fold greater than that of the whole venom (LD50 i.p. 0.6 mg/kg).
      DbTx produces neurotoxic symptoms in mice and exhibits potent oedema-inducing
      activity (minimum oedema dose 0.05 microgram), indirect haemolytic activity and a
      strong myonecrotic activity, but no haemorrhagic activity. DbTx is cytotoxic to
      HeLa cells causing cytolysis of the cells 24 hr post-exposure to toxin (50
      micrograms/ml). The first 20 N-terminal amino acid sequence (NFFQF AEMIV KMTGK
      EAVHS) shows a significant resemblance to those of the PLA2s from the venoms of
      Bulgarian viper (V. a. ammodytes) and Taiwan Russell's viper (V. r. formosensis).

PMID- 7778131
TI  - Therapeutic effects of antivenom supplemented by antithrombin III in rats
      experimentally envenomated with Russell's viper (Daboia russelli siamensis)
      venom.
AB  - The effects of equine antivenom and antithrombin III (AT-III) on the coagulopathy
      induced by Russell's viper venom (RVV, Daboia russelli siamensis) were
      investigated in the rat. After taking blood samples from the femoral vein for
      determination of simple blood clotting time and AT-III activity, all
      anaesthetized rats received an intramuscular injection of venom (2 micrograms/g).
      Treatment (antivenom or AT-III or both) was given intravenously through another
      femoral vein 30 min after venom injection. All untreated rats (n = 7) developed
      AT-III depletion (< 70%) [mean (S.D.)] 70 (36) min, and incoagulable blood 85
      (53) min after venom injection. Supplementation with AT-III (either 0.25 U/g or
      0.5 U/g) had no effect on the RVV induced coagulopathy (n = 20). Treatment with
      antivenom alone (10 micrograms/g) reduced the incidence of abnormal clotting
      significantly (8/15, 53%) (P = 0.03). When antivenom was given in combination
      with AT-III (0.5 U/g), abnormal clotting was prevented in all but one animal
      (1/15, 7%) (P = 0.007). AT-III activity declined progressively in all rats which
      developed non-clotting blood. These results suggest that coagulopathy in
      Russell's viper envenoming is associated with activation of coagulation and
      consumption of AT-III. Antivenom can prevent coagulopathy, but its neutralizing
      activity is augmented significantly by AT-III supplementation.

PMID- 7778133
TI  - Antivenom activity of opossum (Didelphis marsupialis) serum fraction.
AB  - We have found an opossum serum fraction of approximately 97,000 mol. wt to be
      highly proficient in inactivating the haemorrhagic and proteolytic fractions of
      Bothrops lanceolatus venom. This antivenom substance, isolated from opossum serum
      or a synthetic peptide based on the aforementioned protein, would probably be
      useful in the medical management of Bothrops accidents.

PMID- 7778132
TI  - Purification and amino acid sequence of the insecticidal neurotoxin Tx4(6-1) from
      the venom of the 'armed' spider Phoneutria nigriventer (Keys).
AB  - An insecticidal peptide referred to as Tx4(6-1) was purified from the venom of
      the spider Phoneutria nigriventer by a combination of gel filtration, reverse
      phase fast liquid chromatography on Pep-RPC, reverse-phase high performance
      liquid chromatography (HPLC) on Vydac C18 and ion-exchange HPLC on cationic
      columns. Tx4(6-1) is highly toxic to house flies. At levels of 0.5 ng/house fly
      it caused excitatory symptoms immediately after intrathoracical injection.
      However, in mice injections of 0.03 mg of the toxin intracerebroventricularly
      resulted in no apparent symptoms of intoxication. These results demonstrate that
      Tx4(6-1) of P. nigriventer has no toxicity for mice, and suggest that it is a
      specific anti-insect toxin. The mol. wt (5244.6) and purity of the toxin were
      determined by desorption mass spectroscopy. The complete amino acid sequence of
      this toxin was established by direct automated Edman degradation and manual 4
      N,N'-dimethylaminoazobenzene-4'isothiocyanate/phenyl-isothiocyanate microsequence
      analyses of peptides obtained from digests with various proteases. The protein
      contains 48 amino acids including 10 Cys and 6 Lys. The N-terminal and C-terminal
      residues were Cys. The Tx4(6-1) sequence differs from that of previously
      characterized neurotoxins found in the same and other venom spiders, but
      exhibited sequence similarities in the location of the Cys residues.

PMID- 7778134
TI  - The antibody response in seabather's eruption.
AB  - Thirty-six of 44 patients with seabather's eruption had specific IgG antibodies
      against Linuche unguilata (thimble jelly) medusae antigen. ELISA detected
      antibodies in serum stored for 10 years. The extent of the cutaneous eruption or
      sting severity was correlated with antibody titer. Antibodies were detected in
      patients acquiring the eruption in Florida, the Bahamas and Aruba, reflecting the
      habitat of these jellyfish. This serological assay can be useful to confirm the
      clinical diagnosis.

PMID- 7778135
TI  - A small scale field trial with expanded polystyrene beads for mosquito control in
      septic tanks.
AB  - A field trial of the use of expanded polystyrene beads (EPSB) to control the
      breeding of mosquito larvae in household septic tanks was conducted in Sarawak.
      One week after treatment, the breeding of Culex quinquefasciatus and Aedes
      albopictus was reduced by 100% and 68.7% respectively. For both species combined,
      a 57.25% reduction in the adult emergence rate was achieved. No adult was caught
      in the emergence trap one month after treatment. A reduction in mosquito biting
      rates was reported by 87.3% of respondents. All households regarded the EPSB
      treatment as effective. This study has reduced the relatively high infestation
      rate of A. albopictus in the septic tanks to 16-20%. The EPSB treatment is
      feasible and practical. Post-treatment assessment using adult emergence traps and
      the implications for the vector control programme of the local authority are
      discussed.

PMID- 7778137
TI  - Socio-economic risk factors for malaria in a peri-urban area of The Gambia.
AB  - Successful control of malaria depends upon a detailed knowledge of its
      epidemiology, including knowledge of the social and economic factors that
      influence its prevalence. Little is known about the socio-economic factors that
      influence the prevalence of malaria in tropical Africa. Therefore, we undertook
      such a study in over 350 Gambian children with malaria resident in a peri-urban
      area with seasonal transmission, using the case-control approach. Malaria was
      associated with poor quality housing and crowding and with travel to rural areas,
      where the level of malaria transmission is higher than in urban centres. No
      association was found between the risk of malaria and the overall education level
      of parents or guardians of study children. However, the knowledge of malaria
      possessed by mothers of cases of malaria was less than that of controls,
      suggesting that further education of the study community on the causation of
      malaria and on ways of preventing it could be of value.

PMID- 7778136
TI  - An epidemic of Plasmodium falciparum malaria in Balcad, Somalia, and its
      causation.
AB  - The causative factors of an epidemic of falciparum malaria were investigated in
      Balcad, Somalia, a town with previously low malaria transmission, where malaria
      incidence rose more than twenty-fold between 1986 and 1988. The emergence of
      chloroquine resistance, accelerated by high drug pressure, low herd immunity and
      favourable meteorological conditions were identified as major causes of the
      epidemic. Chloroquine resistance of grades RII and RIII was first observed in
      Balcad in 1987 and rapidly increased to 72% of the Plasmodium falciparum
      infections in 1988. In the absence of alternative treatment, resistance resulted
      in the accumulation of a massive infective reservoir and therefore increased
      malaria transmission, associated with intensive clinical symptomatology. The
      advent of chloroquine resistance was less violent in the area of Malable, where
      malaria is stable and communal immunity higher than in Balcad.

PMID- 7778138
TI  - Socio-economic determinants are not major risk factors for severe malaria in
      Gambian children.
AB  - Only a small proportion of subjects infected with Plasmodium falciparum develop
      severe disease. Why this should be is not fully understood. To investigate the
      possible importance of socio-economic variables on the severity of malaria in
      Gambian children we undertook a case-control study of 384 children with severe or
      mild malaria. Few differences were found between the 2 groups. Children with
      severe malaria had a longer duration of symptoms when recruited than mild cases
      but this difference was largely accounted for by the fact the most children with
      severe disease were recruited at a referral hospital, whilst mild cases were
      recruited at a primary health care facility nearer their home. There was no
      difference between groups in the time before mothers sought some form of health
      care. Mothers of children with severe disease were less ready to take their child
      to hospital than mothers of mild cases, suggesting that education on the
      importance of taking a child with features of malaria to a health centre as soon
      as possible might have some effect on the development of severe disease. However,
      overall, the results of this study suggested that socio-economic and behavioural
      factors are not the major determinants for severe malaria in African children.

PMID- 7778140
TI  - Visceral leishmaniasis and HIV-1 co-infection in southern France.
AB  - Between 1986 and 1993 visceral leishmaniasis (VL) was diagnosed in 50 adult
      patients with human immunodeficiency virus type 1 (HIV-1) infection (8 females,
      42 males: 31 intravenous drug users, 11 homosexual or bisexual men, 6
      heterosexual individuals, 2 blood recipients) from 5 hospital centres in southern
      France. Diagnosis of VL was by demonstration of Leishmania and isolation of
      promastigotes by culture in Novy-McNeal-Nicolle medium. Leishmania isolates were
      identified by their isoenzyme profile in 28 patients. All the patients were
      immunocompromised when VL was diagnosed. Their median CD4 cell count was 25 x
      10(6) (0-200). However, only 21 patients (42%) fulfilled the 1987 CDC criteria
      for the acquired immune deficiency syndrome before VL developed. Fever (84%),
      splenomegaly (56%), hepatomegaly (34%), and pancytopenia (62%) were the most
      common presenting features. Clinical signs were lacking in 10% of patients. Anti
      leishmanial antibodies were detected by indirect immunofluorescence or enzyme
      linked immunosorbent assay in 26/47 cases (55%). Combining these techniques with
      Western blotting (WB) gave a positivity rate of 95%. Amastigotes were
      demonstrated in bone marrow aspirates in 47 cases (94%). Unusual sites for
      parasites were found in 17 patients (34%), mainly in the digestive tract but also
      skin and lung. Viscerotropic L. infantum zymodeme MON-1 was characterized in 86%
      of cases. Dermotropic zymodemes MON-24, MON-29, MON-33, and a previously
      undescribed zymodeme MON-183, were isolated from 4 patients. The response rate to
      pentavalent antimony was 50% and to amphotericin B 100%, but clinical relapses
      were noted in both groups. In endemic areas, VL should be considered as a
      possible opportunistic infection in HIV-infected patients.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7778139
TI  - Visceral leishmaniasis in a new ecological niche near a major metropolitan area
      of Brazil.
AB  - In 1991, a community cross-sectional study was conducted in a village situated
      near the beach and close to Salvador, the capital city of Bahia, in Brazil, to
      determine the prevalence of visceral leishmaniasis since 1989. A serological
      survey was made of human and canine reservoirs and an intradermal skin test for
      leishmaniasis was used to assess cellular immune responses. Nearly 30% of the 243
      individuals in the study area had positive skin tests and 14% had positive
      serology, the latter being compatible with recent infection; 29 of 460 dogs
      examined were seropositive. A possible association was observed between human
      infection and the presence of dogs in or near residences, but not between human
      infection and malnutrition. This report describes the evolution of a new focus of
      visceral leishmaniasis, its expansion toward a metropolitan area, and current
      measures taken to control the epidemic.

PMID- 7778141
TI  - Epidemiology of subperiodic Wuchereria bancrofti infection in the Nicobar
      Islands, India.
AB  - Diurnally subperiodic filariasis due to Wuchereria bancrofti has been reported
      from tribal populations in the Nancowry group of islands in the Andaman and
      Nicobar Islands, India. This was confirmed in a survey carried out during the
      monsoon season in 1993. Microfilariae were detected in the peripheral blood
      throughout a 24 h period with a peak at 18:00. The microfilaria (mf) rate ranged
      from 1.2% to 18.7%, with a low disease rate (mean = 1.9%). Incidence of mf was
      low in children less than 10 years old (3.5%), but increased with increasing age.
      Culex (Culex) quinquefasciatus was present at a very low density. Aedes (Finlaya)
      niveus and Aedes (Stegomyia) malayensis were the only species commonly biting
      man. The former was incriminated as a vector, and found naturally infected with
      W. bancrofti (infection and infectivity rates 1.1% and 0.9% respectively). After
      experimental feeding on donors, W. bancrofti developed to L3 stage larvae in A.
      niveus but failed to develop in A. malayensis and A. aegypti.

PMID- 7778142
TI  - Effect of iron and pH on the survival of Vibrio cholerae in water.
AB  - Many physicochemical factors affect the survival of Vibrio cholerae in the
      aquatic environment. An attempt was made to study the combined effect of pH and
      iron on the survival of V. cholerae in water in a laboratory environment. None of
      the 6 strains of V. cholerae used survived at pH 5.0; survival of all strains
      increased with increasing pH. The effect of ferric oxide on survival was
      significant for V. cholerae O1 only, not for non O1 strains. The longest survival
      of V. cholerae non O1 was 82 d, of El Tor V. cholerae 68 d, and of classical V.
      cholerae 56 d.

PMID- 7778143
TI  - The epidemiology of snake bite in Central Province and National Capital District,
      Papua New Guinea.
AB  - Snake bite is an important medical problem in some areas of Papua New Guinea and
      appears to be most common in the Central Province and National Capital District.
      The overall incidence for Central Province is 215.5 per 100,000 population, but
      Kairuku subprovince has an incidence of 526 per 100,000, which is amongst the
      highest in the world. The clinical pattern of envenoming also varies within the
      Province, suggesting that different species of snake may be responsible for bites
      in different areas. Most envenomed patients are bitten during daylight on the
      lower limb and are rarely able to describe the snake. The mortality rate in
      Central Province is 7.9 per 100,000; most patients die from ventilatory failure
      due to severe neurotoxicity. Mortality might be reduced by increased use of
      compression bandaging as a first aid measure, earlier treatment with antivenom
      and earlier referral to hospital.

PMID- 7778144
TI  - Visceral leishmaniasis in Bangladesh: the value of DAT as a diagnostic tool.
AB  - The direct agglutination test (DAT) was performed on 480 serum samples from
      suspected cases of visceral leishmaniasis (VL) in different parts of Bangladesh.
      Significant titres (> or = 1:3200) were found in 257 sera (53.5%). All patients
      with positive bone-marrow aspirates also had significant DAT titres. The
      male:female seroprevalence ratio was 2:1 and the age-group 0-20 years was the
      most affected. The DAT proved a simple, economical and reliable diagnostic test
      for VL.

PMID- 7778145
TI  - Polymerase chain reaction-solution hybridization enzyme-linked immunoassay (PCR
      SHELA) for the differential diagnosis of pathogenic and non-pathogenic Entamoeba
      histolytica.

PMID- 7778146
TI  - Detection of dengue virus from mosquito cell cultures inoculated with human serum
      in the presence of actinomycin D.
AB  - We report the use of cultures of mosquito cells (TRA-284) to detect dengue virus
      in serum from cases of dengue fever in the state of Puebla, Mexico. Using the
      conventional procedure 56 of 171 samples (32.7%) were positive. The negative sera
      (67.3%) were passaged 'blind' in mosquito cell cultures but no virus was
      detected. However, when these sera were incubated in the presence of actinomycin
      D (an inhibitor of deoxyribonucleic acid transcription) 20 of the 115 samples
      (17.4%) became positive. This procedure increased the virus detection rate from
      32.7% to 44.4%. Serotypes 1 and 4 were identified for the first time in the state
      of Puebla, where the transmission of dengue virus is increasing. The addition of
      actinomycin D to mosquito cell cultures may improve the detection of dengue virus
      and could be a useful tool for virological surveillance in endemic countries.

PMID- 7778147
TI  - Massive splenomegaly responsive to proguanil and with features of hairy cell
      leukaemia.
AB  - A recent Ethiopian immigrant to Israel presented with pneumococcal sepsis,
      massive splenomegaly and lymph-adenopathy. Investigations revealed many features
      of both hairy cell leukaemia (HCL) and hyperreactive malarious splenomegaly
      (HMS). Proguanil therapy for HMS was followed by rapid, marked decrease in spleen
      size, disappearance of the tartrate-resistant acid phosphatase-positive cells
      characteristic of HCL, and increasing eosinophilia, but unchanged
      lymphadenopathy.

PMID- 7778148
TI  - Fever in uncomplicated Plasmodium falciparum infection: effects of quinine and
      paracetamol.
AB  - The effects of quinine and paracetamol on fever were studied in 21 adult patients
      with acute uncomplicated falciparum malaria. Quinine alone (n = 7) had no
      significant effect on fever, whereas paracetamol given 2 h after quinine (n = 7)
      or 2 h before quinine (n = 7) reduced temperature by a mean of 2.1 degrees C
      (standard deviation [SD] 0.95) and 2.1 degrees C (SD 0.79) respectively. A
      temperature reduction of 1 degree C was associated with a mean decrement of 9.7
      beats/min (SD 3.3) in the pulse rate. Quinine does not possess useful antipyretic
      activity.

PMID- 7778149
TI  - Intraleucocytic malaria pigment and prognosis in severe malaria.
AB  - The quantity of malaria pigment liberated into the circulation at schizogony
      reflects the pathogenic sequestered parasite burden in Plasmodium falciparum
      malaria, and may therefore be a measure of disease severity. Among 300
      consecutive adult patients with severe falciparum malaria, the 40 who died had
      significantly higher proportions of malaria pigment-containing neutrophils on
      admission (mean = 7.7%, standard deviation (SD) = 5.9%) and pigment-containing
      monocytes (mean = 8.6%, SD = 5.9%) than did survivors (mean 3.2%, SD = 4.1% and
      mean 4.8%, SD = 4.6%, respectively) (P < 0.0001). This proved a better indicator
      of prognosis than the peripheral parasite count. A count of peripheral
      neutrophils containing visible pigment > or = 5% predicted a fatal outcome with
      73% sensitivity and 77% specificity (relative risk 6.2, 95% confidence interval
      (CI) 3.2-11.8) compared to 60% sensitivity and 57% specificity for parasitaemia >
      100,000/microL (relative risk 1.8, 95% CI 1.0-3.3). The peripheral blood count of
      pigment-containing neutrophils in severe malaria is a rapid, simple, and
      practical prognostic test.

PMID- 7778150
TI  - Ethiopian visceral leishmaniasis patients co-infected with human immunodeficiency
      virus.
AB  - This communication reports 7 Ethiopian visceral leishmaniasis (VL) patients co
      infected with human immunodeficiency virus (HIV). The clinical and laboratory
      findings in 6 patients did not differ from classical VL. All patients had highly
      elevated anti-leishmanial antibody titres, determined by immunoglobulin G-based
      enzyme-linked immunosorbent assay; they most probably acquired the Leishmania
      infection before HIV. Amastigotes were identified in the splenic aspirates of 6
      patients and in the lymph node aspirate of the 2 patients whose lymph nodes were
      examined. The CD4:CD8 lymphocyte ratio was depressed in those patients whose
      ratio was determined. Most patients showed some initial response to pentavalent
      antimonial therapy.

PMID- 7778151
TI  - Ultrasonographical assessment of morbidity in schistosomiasis mansoni in
      Madagascar: a community-based study in a rural population.
AB  - Between June and November 1993, a parasitological, clinical and
      ultrasonographical survey was carried out in the mid west of Madagascar, among
      the whole population of a village where Schistosoma mansoni was endemic. S.
      mansoni eggs were found in the stools of 61.8% of the 544 individuals examined;
      the highest prevalence of infection (85.7%) was observed in the 15-19 years old
      age group. The most intense infections were recorded in the 10-14 years age
      group, in which the geometric mean egg count was 265 eggs/g of faeces and 34.3%
      of the individuals excreted more than 400 eggs/g. The egg count decreased
      steadily from the age of 15 years. Ultrasonographical examination was performed
      in 482 inhabitants older than 2 years: 29% of them presented definite schistosome
      associated liver alterations according to the proposals for staging S. mansoni
      infection made by the World Health Organization Cairo working group. Stage 3 was
      never observed in subjects under 30 years old. This is consistent with the need
      for a long-standing infection before serious lesions occur. A significant
      relationship between egg count and degree of liver alterations was found only in
      the 20-29 years age group.

PMID- 7778152
TI  - Artemether-mefloquine combination in multidrug resistant falciparum malaria.
AB  - Plasmodium falciparum in Thailand is highly resistant to chloroquine and
      sulfadoxine/pyrimethamine and there is increasing resistance to the alternative
      antimalarials, quinine and mefloquine. In eastern Thailand, the cure rates of
      mefloquine at 750 and 1250 mg were 30% and 55%, respectively. The use of drug
      combinations may be necessary in areas where drug-resistant parasites exist. 159
      male Thai patients in Chantaburi, eastern Thailand, were allocated at random to
      receive either oral artemether at a single dose of 300 mg on the first day
      followed by mefloquine 750 mg at 24 h and 500 mg at 30 h (group A), or oral
      artemether at a single dose of 300 mg on the first day, mefloquine 750 mg at 24 h
      and placebo at 30 h (group B). The follow-up was on days 1, 2, 7, 14, 21, 28, 35
      and 42. Most patients in both groups had a rapid initial response to treatment,
      parasitaemia being cleared within 24 h and fever cleared within 48 h in both
      groups. The cure rates were 97% and 90%, respectively, for groups A and B. No
      serious adverse effect was seen in either group; mild and transient nausea,
      vomiting and loss of appetite were noted. The adverse effects did not differ
      between the 2 groups. The results suggested that a single oral dose of artemether
      (300 mg) can markedly improve the cure rate of mefloquine at a dose of 750 or
      1250 mg in multiple drug-resistant falciparum malaria.

PMID- 7778153
TI  - Inhibition of tumour necrosis factor (TNF) production by antimalarial drugs used
      in cerebral malaria.

PMID- 7778154
TI  - Antimalarial activity in vitro of Cochlospermum tinctorium tubercle extracts.
AB  - Resistance of Plasmodium falciparum to current antimalarial compounds has
      drastically increased during the last few years and is now a major public health
      problem. We have studied plants traditionally used in Africa against malaria.
      Extracts of the tubercles of Cochlospermum tinctorium A. Rich, commonly used in
      Burkina Faso, were tested in vitro on 2 strains of P. falciparum, one (FcB1
      Colombia) chloroquine resistant and the other (F32-Tanzania) chloroquine
      sensitive. Extracts were obtained by infusion and decoction. The 50% inhibitory
      concentrations (IC50) were determined by measuring [3H]hypoxanthine incorporation
      and also by microscopical examination which permitted the determination of
      parasite stages. We obtained similar results with fresh extracts, frozen
      extracts, and lyophilized extracts of C. tinctorum. IC50 values were of the order
      of 1-2 micrograms/mL, about one-tenth of those reported for extracts of neem
      leaves (Azadirachta indica) and about half the values reported for Artemisia
      annua extracts.

PMID- 7778156
TI  - Criterion for inclusion in onchocerciasis control programmes based on ivermectin
      distribution.
AB  - Data on onchocercal lymphatic and skin lesions from 45 communities located in the
      West African savanna were analysed to determine if the criterion for inclusion in
      ivermectin mass treatment based on risk of onchocercal blindness needs to be
      modified. Only 16 cases of elephantiasis were reported among 10,108 people
      examined. Other lymphatic lesions were almost exclusively found in people older
      than 30 years living in villages at risk of onchocercal blindness. Permanent skin
      lesions also affected older people and were 3 times more frequent in villages at
      risk of onchocercal blindness. Papular rash and pruritus affected younger people.
      No evidence was, therefore, found to change the criterion based on risk of
      onchocercal blindness presently in use in savanna areas.

PMID- 7778155
TI  - Aminosidine plus sodium stibogluconate for the treatment of Indian kala-azar: a
      randomized dose-finding clinical trial.
AB  - This randomized, open sequential design trial was set up to assess the efficacy,
      tolerability and toxicity of 20 d courses of combined intramuscular aminosidine
      and sodium stibogluconate at various dosages in patients with newly-diagnosed
      kala-azar in Bihar, India. Three successive studies of 96 patients each were
      originally planned with aminosidine administered at 12, 6 and 3 mg/kg/d,
      respectively. For each aminosidine dosage, patients were randomly assigned to
      receive sodium stibogluconate at 20, 10 or 5 mg/kg/d of antimony. Ninety-six
      patients were enrolled and assigned aminosidine 12 mg/kg/d as scheduled. In the
      subsequent study with aminosidine at 6 mg/kg/d, the trial was interrupted after
      40 patients had entered owing to inadequacy of the treatment. With aminosidine 12
      mg/kg/d the success rates with sodium stibogluconate at 20, 10 and 5 mg/kg/d were
      88%, 71% and 72%, respectively and did not differ significantly. With aminosidine
      6 mg/kg/d, 69%, 50% and 46% of patients were cured with the same sodium
      stibogluconate doses, respectively; again, there was no significant difference
      between the subgroups. The overall success rate with aminosidine at 12 mg/kg/d
      (76%) was significantly higher than that with 6 mg/kg/d (55%) (odds ratio = 2.69;
      95% confidence interval, 1.11-6.4). Patients improved clinically and the
      treatments were equally well tolerated. The combination of aminosidine 12 mg/kg/d
      and sodium stibogluconate 20 mg/kg/d for 20 d appears to be an effective and safe
      replacement in Bihar for sodium stibogluconate alone for > or = 40 d.

PMID- 7778157
TI  - A new tool to assess the adulticidal efficacy in vivo of antifilarial drugs for
      bancroftian filariasis.

PMID- 7778158
TI  - Antiepileptic drugs and teratogenicity in Nigerians.

PMID- 7778159
TI  - Serological responses to brucellosis in HIV-seropositive patients.
AB  - Serial sera from 2 patients infected with the human immunodeficiency virus (HIV)
      type 1 attending a clinic in Nairobi, Kenya, and with blood cultures yielding
      Brucella melitensis, were tested by enzyme-linked immunosorbent assay for their
      serological response (Brucella-specific immunoglobulin (Ig) M and IgG) to
      Brucella infection. Antibody responses were comparable to those of
      immunocompetent individuals, one patient showing serology typical of acute
      brucellosis, the other of chronic brucellosis. Sera from 100 other patients, 65
      of whom were HIV-positive, attending the same clinic but whose routine
      microbiological cultures were negative for Brucella, were tested retrospectively
      for Brucella-specific antibody. Eight had Brucella-specific IgM and IgG, 6 had
      IgM only and 21 had IgG only, suggesting relatively high levels of exposure to
      Brucella in the study cohort. There was no association between Brucella antibody
      status and HIV status. Brucellosis is probably underdiagnosed in Kenya. Brucella
      serology may be helpful in the diagnosis of patients with non-specific symptoms
      in East Africa, regardless of HIV status.

PMID- 7778160
TI  - Leishmania (Viannia) lainsoni occupies a unique niche within the subgenus
      Viannia.
AB  - Leishmania lainsoni has recently been recognized as a new peripylarian species
      belonging to the subgenus Viannia and the L. braziliensis complex. It has been
      isolated from its sandfly vector, reservoir host and cutaneous lesions of human
      patients. Microscopical examination has shown characteristics which are different
      from those of other members of the L. braziliensis complex. Nuclear
      deoxyribonucleic acid (DNA) hybridization patterns with a beta tubulin probe and
      kinetoplast DNA buoyant density measurements show close similarities with other
      species of the L. braziliensis complex. However, kinetoplast DNA restriction
      enzyme fragment patterns of L. (V.) lainsoni isolates show similarities to L.
      mexicana complex species as well as weak cross hybridization. L. (V.) lainsoni is
      also amplified with L. braziliensis complex specific polymerase chain reaction
      (PCR) primers but it requires a lower annealing temperature and gives a 300 base
      pair PCR product. A possible model for the binding of PCR primers to the L. (V.)
      lainsoni kinetoplast DNA minicircle is proposed.

PMID- 7778161
TI  - Female genital schistosomiasis: a neglected risk factor for the transmission of
      HIV?

PMID- 7778162
TI  - The prognostic value of finding schizonts of Plasmodium falciparum in the
      peripheral blood.

PMID- 7778163
TI  - Abdominal tuberculosis.

PMID- 7778164
TI  - A novel and rapid assay to detect anti-idiotypic anti-OKT3 antibodies.

PMID- 7778165
TI  - Assessment of pathological changes associated with chronic allograft rejection
      and tolerance in two experimental models of rat lung transplantation.
AB  - Lung transplantation is now routinely performed for a wide range of end-stage
      cardiopulmonary disorders. Despite overcoming the problems associated with early
      acute rejection, chronic rejection (CR) in the form of obliterative bronchiolitis
      has emerged as the primary cause of late graft loss. The mechanisms involved in
      the development of CR of lung allografts are poorly understood, and no effective
      therapy is currently available. To better understand the pathological events
      associated with CR and tolerance, we examined two models of lung allograft
      rejection established in our laboratory. First, we exchanged left lung allografts
      between moderately histoincompatible inbred rat strains (WKY-->F344: n = 42 and
      F344-->WKY: n = 40). The WKY-->F344 model was previously shown to develop
      spontaneous tolerance, while the converse model (F344-->WKY) showed persistent
      acute rejection. The purpose of this investigation was to assess
      histopathological changes associated with long-term grafts left in place up to
      140 days after transplant. To confirm that tolerance had developed, skin-grafting
      experiments were performed. Five skin grafts from each strain were placed on lung
      allograft recipients on day 35 after transplant and skin allograft survival was
      assessed and compared with controls. Acute rejection (AR) was graded
      histologically (stage O-IV) and the pathologic intensity of inflammation and CR
      were graded (0-4: 0 = 0%, 1 = 1-25%, 2 = 26-50%, 3 = 51-75%, and 4 = 76-100%) on
      percentage of involvement with the following categories being examined: (a)
      lymphocytic infiltration (perivascular, peribronchial, and peribronchiolar) and
      (b) vasculitis, edema, hemorrhage, and necrosis. Finally, chronic rejection was
      diagnosed by the presence of intimal hyperplasia, interstitial fibrosis,
      peribronchiolar fibrosis, bronchiolitis obliterans, and bronchiectasis. The WKY-
      >F344 animals showed progressive AR (stage III, day 21). Thereafter, the AR
      subsided spontaneously and was stage 0 on day 140. There were no signs of CR in
      these animals. In the F344-->WKY model, the AR progressed up to stage III-IV (day
      21) and maintained for several weeks at stage III. Thereafter, pictures of the
      lungs showed CR on days 49, 70, and 98. There were significant differences
      between the two models during the chronic phase, such as interstitial fibrosis (0
      +/- 0 vs. 1.8 +/- 1.3, P < 0.005), peribronchiolar fibrosis (0 +/- 0 vs. 3.6 +/-
      0.55, P < 0.01), vasculitis (0.2 +/- 0.45 vs. 2.0 +/- 0, P < 0.008), and intimal
      hyperplasia (0.2 +/- 0.45 vs. 2.6 +/- 0.9, P < 0.008).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7778167
TI  - Simultaneous occurrence of rejection and graft-versus-host reaction after
      allogeneic small bowel transplantation.
AB  - Small bowel transplantation may be complicated not only by rejection but also by
      graft-versus-host reaction (GVHR). So far, little is known about the association
      between these two immunological reactions, partly because of the lack of
      standardized, reproducible experimental models for such studies. In this work, a
      rat model in which GVHR and rejection occur simultaneously was established. When
      transplanting small bowel grafts from BN donors to Lewis recipients and
      thereafter treating the grafts locally with the immunomodulating substance LS
      2616, a clinically visible GVHR occurred on day 6, at the same time the first
      signs of rejection became visible. The GVHR was confirmed by immunohistochemical
      staining for MHC class II-positive cells in liver and ear skin biopsy specimens.
      An obvious quantitative difference in the number of positive cells in both organs
      was observed when local treatment was compared with oral LS-2616 treatment or
      with findings in organs from untreated animals. We conclude that GVHR and
      rejection are not mutually exclusive and thus may occur simultaneously, and that
      this pharmacological model might facilitate further studies of the impact of GVHR
      on graft rejection and recipient survival.

PMID- 7778166
TI  - Inhibition of transplant arteriosclerosis in rat aortic grafts by low molecular
      weight heparin derivatives.
AB  - The effects of low molecular weight heparin derivatives with a low anticoagulant
      activity on transplant arteriosclerosis (TA) in a rat aortic transplant model
      were investigated. TA was induced by ischemia in the syngeneic transplants and
      primarily by immunological mechanisms in the allogeneic transplants. Treatment
      with the heparin derivatives, OAM 71262 or LA-heparin, was administered in a
      dosage of 250 micrograms/kg/hr by mini-osmotic pumps during 8 weeks. No
      immunosuppressive regimen was given to the recipient rats in either model. All
      rats were killed 8 weeks after aortic grafting. The grafts were examined for
      intimal and medial changes using an image analysis system. Heparin derivatives
      had a beneficial effect on both the intimal thickening and the medial injury in
      the syngeneic transplants, but not in the allogeneic grafts. In the syngeneic LA
      heparin treated grafts, the thickness of the intima was less than that in the
      syngeneic control grafts (P < 0.05). In the syngeneic transplants, a significant
      increase was observed in the media after treatment with OAM 71262 (P < 0.01) as
      well as those with LA-heparin (P < 0.001). In the syngeneic grafts treated with
      both heparin derivatives, a significant reduction in the antigen expression of
      alpha-actin-containing smooth muscle cells in the intima, transforming growth
      factor-beta 1 both in the media and adventitia, and platelet-derived growth
      factor-beta receptors in the adventitia was observed immunohistochemically. In
      summary, low molecular weight heparin derivatives with low anticoagulant activity
      partially inhibited ischemia-induced syngeneic TA, whereas no such effect could
      be demonstrated in nonimmunosuppressed recipients with allogeneic grafts.

PMID- 7778168
TI  - Protection by pentoxifylline against normothermic liver ischemia/reperfusion in
      rats.
AB  - Previously, pentoxifylline treatment of graft recipients was shown to protect
      against liver graft failure from storage/reperfusion injury after orthotopic rat
      liver transplantation. To determine whether pentoxifylline also protects against
      normothermic ischemia/reperfusion injury to liver, we induced lobar ischemia in
      rats followed by reflow and partial hepatectomy of the noninvolved liver. In rats
      receiving pentoxifylline 2 hr before surgery and then twice daily for 5 days, the
      1-week survival rate more than doubled from 25% to 67% (P < 0.05). Liver enzymes
      (alanine transaminase, aspartate transaminase, and lactate dehydrogenase) in the
      serum and liver necrosis evaluated histologically were also significantly reduced
      in the pentoxifylline-treated rats (P < 0.01). Hepatic ischemia/reperfusion
      increased leukocyte infiltration into the lungs, and pentoxifylline tended to
      reduce this lung injury (P = 0.06). These results show that pentoxifylline
      treatment reduces hepatic injury and improves survival after normothermic
      ischemia and reperfusion.

PMID- 7778169
TI  - Arginase release following liver reperfusion. Evidence of hemodynamic action of
      arginase infusions.
AB  - Immediately after hepatic reperfusion in human orthotopic liver transplantation,
      high amounts of arginase are released from the graft, thereby influencing nitric
      oxide metabolism. This metabolic alteration may be one component of the ischemia
      reperfusion syndrome in OLT with its hemodynamic disturbances (e.g., systemic
      hypotension, pulmonary hypertension). The aim of this study was to compare
      hemodynamic and metabolic changes following OLT in the pigs with those obtained
      under arginase infusions in catheterized, anesthetized pigs. Following liver
      revascularization in the pigs, plasma arginase concentrations increased from 48
      +/- 19 IU/L to 2613 +/- 944 IU/L, resulting in a drop in plasma levels of L
      arginine (-87%) and in a drop in nitrite (-82%) and nitrate (-53%)
      concentrations. Of the measured organ-specific hemodynamic alterations, the mean
      pulmonary arterial pressure increased from 17 +/- 2 mmHg to 30 +/- 5 mmHg,
      whereas the flow/pressure index of the portal vein decreased about 60%. A primed
      continuous infusion of arginase (25,000 IU) increased plasma arginase levels to a
      maximum of 3,690 +/- 962 IU and evoked a decrease of L-arginine, but did not
      alter plasma nitrite or nitrate levels. The administration of arginase in healthy
      pigs did not influence cardiac output, mean arterial pressure, heart rate, or
      total peripheral resistance, but led to an increase of mean pulmonary arterial
      pressure from 19 +/- 3 to 48 +/- 5 mmHg and to a reduction of arterial hepatic
      blood flow from 229 +/- 65 ml/min to 154 +/- 41 ml/min. From this we conclude
      that high levels of liver arginase cause hemodynamic alterations in the lung and
      the liver. We hypothesize that the pulmonary hypertension and the reduced hepatic
      blood flow found during the immediate reperfusion period after OLT are possibly
      related to the increased arginase release due to the hepatic damage of the graft.

PMID- 7778171
TI  - Cyclosporine (Sandimmun) in cadaveric renal transplantation. Ten-year follow-up
      of a multicenter trial. European Multicentre Trial Group.

PMID- 7778170
TI  - Randomized clinical trial of antithymocyte globulin induction in renal
      transplantation comparing a fixed daily dose with dose adjustment according to T
      cell monitoring.
AB  - Antithymocyte globulin (ATG) has been used successfully for induction therapy as
      well as for treatment of established allograft rejection. However, this therapy
      has often been associated with problems of overimmunosuppression and increased
      costs. In a randomized clinical trial, we compared the immunosuppressive
      benefits, complication rates, and treatment costs when ATG is given as a fixed
      daily dose or when the dose is adjusted daily according to its biologic effects
      on T cells. Forty-five recipients of cadaver renal allografts were randomized
      into two groups. In group 1 (n = 23), ATG (ATGAM) was administered in variable
      doses to maintain the absolute number of peripheral CD3 T cells at 50
      100/microliters. In group 2 (n = 22), ATG was given at a fixed dose of 15
      mg/kg/day. All patients received azathioprine and prednisone. ATG was
      discontinued at 7-14 days when cyclosporine was introduced. In both groups, CD2,
      CD3, CD4, CD8, and CD19 cells were measured by flow cytometry and the levels of
      cytokines IL-1 beta, IL-2R, ICAM-1, IL-6, IL-7, and levels of cytokines IL-1
      beta, IL-2R, ICAM-1, IL-6, IL-7, and levels of cytokines IL-1 beta, IL-2R, ICAM
      1, IL-6, Il-7, and IL-10 were measured by ELISA. In group 2, the levels of all T
      cell subsets were profoundly suppressed. In group 1, the number of CD3 and other
      T cells was maintained at about 100 cells/microliters, while the CD19 T cells
      remained unsuppressed. Cytokine levels were greatly suppressed in group 2
      compared with group 1, except for IL-10 levels, which remained elevated in the
      latter group. Patient survival, graft function, and the incidence of acute and
      recurrent rejections were similar in the two groups. Bone marrow suppression and
      infective complications were greater in group 2 than in group 1. The mean daily
      dose and the total quantity of ATG used in group 1 were significantly smaller
      than in group 2, resulting in a savings of $2,398.00 per patient per treatment.
      It is concluded that monitoring of ATG by its biologic effects on T cells is a
      rational and safe method of regulating the dose of this important agent; in this
      way, it is possible to reduce the total amount of the drug given to patients with
      consequent reduction in undesirable complications as well as in the cost of
      treatment without loss of immunosuppressive benefits.

PMID- 7778172
TI  - Critical role of interleukin 4 in the induction of neonatal transplantation
      tolerance.
AB  - Neonatal injection of semiallogeneic cells is known to promote differentiation of
      donor-specific CD4+ T cells into TH2-like cells in the peripheral lymphoid
      organs. We reasoned that the propensity of neonatal T cells to synthesize high
      levels of IL-4 might be involved in this polarization of the alloreactive
      response and thereby in the development of neonatal transplantation tolerance.
      First, analysis of cytokine gene expression in lymph nodes after neonatal
      injection of 10(7) (A/J x BALB/c)F1 cells in BALB/c mice indicated that IL-4 but
      not IL-2 is rapidly produced by CD4+ cells after allogeneic challenge in vivo. To
      determine whether the early production of IL-4 was involved in the establishment
      of allotolerance, BALB/c mice neonatally injected with (A/J x BALB/c)F1 spleen
      cells received on days 1 and 3 after birth 1 mg of anti-IL-4 mAb (11B11) or the
      same amount of control mAb. When grafted with A/J skin at 4 weeks, 88% of mice
      treated with control mAb retained their graft for more than 50 days, whereas
      rejection occurred within 30 days in 93% of mice treated with anti-IL-4 mAb.
      Analysis of T cell functions after in vitro restimulation with A/J spleen cells
      indicated that early IL-4 neutralization did not prevent donor-specific CTL
      unresponsiveness but allowed the emergence of alloreactive T cells secreting
      increased levels of IL-2 and IFN-gamma. We conclude that early production of IL-4
      is critical for the establishment of neonatal transplantation tolerance in this
      strain combination, which has disparities across the entire H-2 region.

PMID- 7778173
TI  - Prevention of bone marrow and cardiac graft rejection in an H-2 haplotype
      disparate mouse combination by an anti-LFA-1 antibody.
AB  - The aim of the present study was to compare the preventive effect of a
      nondepleting monoclonal antibody specific for the LFA-1 alpha chain (CD11a) on
      the rejection of bone marrow, vascularized cardiac, and nonvascularized skin
      grafts in the same haplotype-disparate mouse strain combination. A 7-day
      treatment with a total dose of 0.5 mg of anti-LFA-1 antibody (H-129) had no
      effect on the rejection of BDF1(H-2b/d) skin grafts by CDF1 (H-2k/d)-treated
      mice. In contrast, the same treatment regimen significantly prolonged the
      survival of BDF1 cardiac allografts in CDF1 mice: 7 out of 10 mice had a
      functional graft after 70 days, whereas all control mice had rejected their graft
      by 11 days. Nevertheless, cardiac allografts were ultimately rejected. In
      contrast, infusion of anti-LFA-1 antibody was able to promote definitive
      engraftment of T-depleted BDF1 marrow in 9 gray-irradiated CDF1 recipients: in
      surviving mice, engraftment increased from 10% in controls to 78% in antibody
      treated recipients. In mice that tolerated their cardiac graft for more than 70
      days, there was a slight delay in the rejection of donor skin graft but no in
      vitro evidence of tolerance. In contrast, mice with successful marrow engraftment
      did not reject donor skin graft and failed to mount proliferative and cytotoxic
      responses against donor alloantigens, whatever the percentage of engrafted donor
      leukocytes. These results indicate that a nondepleting anti-LFA-1 antibody can
      efficiently protect against rejection of MHC-incompatible heart and bone marrow.
      The protective effect of anti-LFA-1 antibody was associated with the induction of
      T cell tolerance toward donor antigens after bone marrow transplantation.

PMID- 7778175
TI  - Variation in the level of xenoantigen expression in porcine organs.
AB  - Hyperacute rejection of vascularized porcine to primate xenografts is initiated
      by the binding of xenoreactive natural antibodies to donor endothelium. We tested
      the hypothesis that the level of xenoantigen expression varies in the population
      of potential porcine donors and may determine the amount of binding of
      xenoreactive natural antibodies to a porcine organ perfused by xenogeneic blood.
      Two hundred ninety pigs were studied using an inhibition ELISA that quantitated
      the xenoantigen level on porcine platelets. Based on this assay, the levels of
      xenoantigen expression in the population adhered to a normal distribution.
      Kidneys from pigs found to express high antigen levels and kidneys from pigs
      found to express low antigen levels were perfused with baboon blood using an
      extracorporeal circuit. In multiple experiments, a significant difference was
      observed in the amount of xenoreactive natural antibody adsorbed by high antigen
      versus low antigen organs. Normalizing for the weight of the perfused organs and
      for levels of natural antibody in individual baboons, high antigen organs
      adsorbed 3.6 +/- 1.3 U of xenoreactive natural antibody/g and low antigen organs
      adsorbed -0.8 +/- 1.0 U of xenoreactive natural antibody/g (P < 0.002).
      Immunopathology of tissues from the perfused organs demonstrated more deposition
      of IgM and C4 in high than in low xenoantigen organs. The quantitative
      relationship between binding of xenoreactive natural antibodies to platelets and
      to whole organs suggests that platelets are a valid representation of endothelial
      cell antigen expression in vivo. Despite the probable importance of Gal alpha(1
      3)Gal as an epitope recognized by xenoreactive natural antibodies, differences in
      the binding to platelets or to organs of the GS-I-B4 lectin that recognizes that
      sugar had no correlation with the differences in binding of IgM to these tissues.
      Variation in expression of xenoantigen may be exploited to selectively breed
      donors for xenotransplantation that are less susceptible to attack by
      xenoreactive natural antibodies.

PMID- 7778174
TI  - Inadequate antibody response against respiratory viral infection in long
      surviving rat lung allografts.
AB  - Lung transplant recipients suffer from a high number of viral infections. It has
      been suggested that the defense against viral infections is impaired in lung
      transplants. Therefore, we investigated in rat lung transplants whether antibody
      responses against an intrapulmonary viral infection were impaired in 3 groups of
      rats with: (1) BN-to-LEW allogeneic lung transplants, (2) LEW-to-LEW syngeneic
      lung transplants, and (3) nontransplanted LEW lungs. All rats (including those
      with nontransplanted, normal lungs) were treated with cyclosporine on days 2 and
      3 after operation; this treatment is adequate to induce permanent graft
      acceptance of the allografts. Six months after transplantation, viral infections
      with Sendai virus (parainfluenza type I) were induced intratracheally. At day 0,
      immediately before infection, and at days 4, 7, 21, and 56 after infection, 4
      rats in each group were killed for histological evaluation of the lungs. The
      number of antibody-positive cells in the bronchus-associated lymphoid tissue
      (BALT) in the lungs and in the spleen, and presence of the virus in the lungs
      were determined by immunohistology. Serum antibody titers were followed for 56
      days after infection. The allogeneically transplanted lungs failed to respond
      adequately against the virus: the number of antibody-positive cells in the BALT
      did not increase after infection, serum antibody titers were hardly detectable,
      and virus was present in the airways of the lungs up to day 21 after infection.
      In contrast, in the syngeneically and nontransplanted lungs, the number of
      antibody-forming cells in the BALT increased steeply until day 7, serum antibody
      titers rose until day 14, and virus could be detected only on day 4 after
      infection. This study shows that in rat lung allografts, both the local antibody
      production in the BALT and the systemic antibody response against a respiratory
      viral infection are inadequate. As a consequence, the virus is present longer in
      these allografted lungs and can exert its damaging effect over a longer period of
      time. These results may explain why lung transplants are so susceptible to viral
      infections.

PMID- 7778176
TI  - X-irradiation of the thymus is not required for the induction of cyclosporine
      induced autoimmunity.
AB  - The thymus-dependent model of cyclosporine-induced autoimmunity (CsA-AI) in the
      Lewis rat requires a lethal total body X-irradiation and rescue with syngeneic or
      autologous bone marrow and cyclosporine (CsA) administration for at least 4
      weeks; two to three weeks after cessation of CsA, the animals develop a graft
      versus-host-like disease. The obligatory role of the thymus in the etiology of
      CsA-AI has been established unequivocally, but the way in which disease is thymus
      dependent is a topic of debate. In the present study we demonstrate that the
      model of CsA-AI requires the presence of a thymus for at least 2 weeks after
      total body irradiation and CsA administration, but that X-irradiation of the
      thymus itself is not necessary to bring about disease. Transplantation of
      neonatal thymus shows in addition that in the absence of X-irradiation of the
      thymus, CsA therapy is required to generate autoreactive cells, but that disease
      occurs only if peripheral autoregulatory cells are eliminated by X-irradiation.

PMID- 7778177
TI  - Human lymphocytotoxic monoclonal autoantibodies from a highly sensitized renal
      dialysis patient.
AB  - A panel of 5 human monoclonal autolymphocytotoxic antibodies (IRM-3, IRM-4, IRM
      7, IRM-8, and IRM-10) of the IgM class was established from a highly sensitized
      renal dialysis patient (IRM), by the generation of mouse-human heterohybridomas.
      This panel was screened for reactivity against foreign and autoantigens by ELISA,
      and for reactivity against different tissue sections and HEp-2 slide preparations
      by indirect immunofluorescence. Cytotoxicity screening of heterohybridoma
      supernatants gave broad panel reactivity profiles, being cytotoxic against B
      cells from patient IRM and also against most B cells tested and less reactive
      with chronic lymphocytic leukemia B cells; T cells were the least sensitive
      target. Immunoblotting showed that monoclonal IRM displayed some heterogeneity in
      their binding profiles, although all of them recognized a cellular structure of
      26 kDa. None of the heterohybridoma cell lines exhibited cytoplasmic nor surface
      staining with an anti-CD5 mAb. Results obtained showed that all the
      autolymphocytotoxic mAbs generated were also able to react against certain
      nuclear and cytoplasmic self-structures as well as foreign compounds. Monoclonal
      antibody IRM-7 and, to a lesser degree, IRM-10 exhibited multispecific properties
      similar to those observed for polyreactive or natural antibodies.

PMID- 7778178
TI  - Immunological fate of Schwann cell-populated acellular basal lamina nerve
      allografts.
AB  - Acellular basal lamina allografts are known to exhibit reduced immunogenicity,
      but the extent of host axonal regeneration through such grafts is reduced in
      comparison to the cellular isografts. The present study was designed to determine
      both the ability of cultured Schwann cells to populate acellular allografts, and
      the effects of Schwann cells on immunogenicity and regenerative potential.
      Isogeneic and allogeneic Schwann cell-populated acellular allografts of 2.0 cm
      length were used to repair a surgically created gap in the host rat peroneal
      nerve. Transplanted nerves were analyzed at 1, 2, 4, and 8 weeks later to
      determine their fate and ability to support axonal regeneration. Acellular
      allografts cocultured with isogeneic Schwann cells survived and supported axonal
      regeneration through them. In contrast, acellular allografts cocultured with
      allogeneic Schwann cells underwent rejection and were unsuccessful. The results
      show that cultured Schwann cells continue to exhibit immunogenicity and are a
      critical factor in allograft survival. It is thus important to use host-matched
      (isogeneic or autologous) Schwann cells to populate acellular basal lamina grafts
      in order to enhance their axonal growth-supporting function.

PMID- 7778179
TI  - Comparison of the effects of enalapril and theophylline on polycythemia after
      renal transplantation.
AB  - Posttransplant erythrocytosis (PTE) is a potentially serious complication for
      which (apart from phlebotomy) two alternative treatments have been proposed:
      theophylline (Theo) and angiotensin-converting enzyme inhibitors. We investigated
      28 patients with PTE, who were assigned to 3 matched groups. Group 1 (10
      patients) received 10 mg of Enalapril (Ena)/day. After 2 months, mean hematocrit
      (Ht) had dropped from 0.57 (range 0.52-0.62) to 0.45 (0.34-0.49). Ena was stopped
      and, after a period of 3.8 +/- 0.3 months, Ht had risen again to baseline values
      (0.56, range 0.52-0.61) in 8 of them. These 8 patients were then given 5 mg/day
      Ena. Ht decreased more slowly, and after 3 months reached a mean of 0.49 (0.44
      0.54). Group 2 (9 patients) received 600 mg/day Theo in 2 doses. After 2 months,
      Ht had decreased from 0.56 (0.52-0.61) to 0.52 (0.46-0.63), but in 5 patients, Ht
      remained above 0.51. After 1 month discontinuation of treatment, PTE persisted in
      7 patients. These patients were given 10 mg/day Ena, whereupon Ht decreased from
      0.55 (0.52-0.64) to 0.46 (0.40-0.53) after 2 months and to 0.41 (0.33-0.47) after
      3 months. Group 3 did not receive medical treatment. After 3 months, PTE
      persisted in 8 out of the 9 patients and remained unchanged during the following
      3 months. Mean values for Ht were: baseline, 0.55 (0.52-0.58); after 3 months,
      0.56 (0.53-0.59); and after 6 months, 0.55 (0.52-0.60). We conclude that Ena is
      superior to Theo in the treatment of PTE. There were no resistant patients, but
      individual sensitivity differs. Its effect is dose dependent, reversible, and
      reproducible. Excessive Ht decrease may occur; thus, doses should be titrated
      individually.

PMID- 7778180
TI  - alpha-Interferon-induced rejection of a hepatitis C virus-infected liver
      allograft tolerated with a low dosage immunosuppressive regimen.

PMID- 7778181
TI  - Lack of sustained efficacy of combination ganciclovir and foscarnet for hepatitis
      B virus recurrence after liver transplantation.

PMID- 7778182
TI  - Renal transplantation without chronic immunosuppression after T cell-depleted,
      HLA-mismatched bone marrow transplantation.

PMID- 7778183
TI  - American Society of Histocompatibility and Immunogenetics Crossmatch study.

PMID- 7778184
TI  - Antigen-dependent activation of T helper cell subsets by endothelium.

PMID- 7778185
TI  - Effects of interleukin 2 on leukemia development after bone marrow
      transplantation in AKR/J mice.

PMID- 7778186
TI  - Inositol 1,4,5-trisphosphate receptors, secretory granules and secretion in
      endocrine and neuroendocrine cells.
AB  - Recent studies have revealed the presence of inositol 1,4,5-trisphosphate
      receptors in the secretory granules of endocrine and neuroendocrine cells. This
      distribution suggests that inositol 1,4,5-trisphosphate-regulated release of
      granule stores of Ca2+ might facilitate the secretory process. In addition,
      inositol 1,4,5-trisphosphate receptors might participate directly in the
      biogenesis of secretory granules. The presence of inositol 1,4,5-trisphosphate
      receptors in synaptic nerve terminals raises the possibility that they might also
      be involved in the control of neurotransmitter release.

PMID- 7778187
TI  - Mutations in the cell adhesion molecule L1 cause mental retardation.
AB  - Recently, studies in the usually disparate fields of human genetics and
      developmental neurobiology have converged to reveal that some types of human
      mental retardation and brain malformations are due to mutations that affect the
      neural cell adhesion molecule L1. L1 has a very complex biology, interacting with
      a variety of ligands, and functioning in migration of neurons and growth of
      axons. Over the past few years, it has also become clear that L1 is able to
      influence intracellular second messengers. The identification of a number of
      different mutations in L1, some of which alter the extracellular portion of the
      molecule, and others that change only the cytoplasmic tail, confirm that L1 is a
      crucial player in normal brain development. The information gained from genetic
      analysis of human L1 is giving new insights into how L1 functions in the
      formation of major axon pathways, but it also raises unanticipated questions
      about how L1 participates in the development of cortical and ventricular systems.

PMID- 7778188
TI  - Radical AGEing in Alzheimer's disease.
AB  - The pathological presentation of Alzheimer's disease, the leading cause of senile
      dementia, involves regionalized neuronal death and an accumulation of
      intracellular and extracellular filamentous protein aggregates that form lesions
      termed neurofibrillary tangles and senile plaques, respectively. Several
      independent parameters have been suggested as the primary factor that is
      responsible for this pathogenesis, including apolipoprotein epsilon genotype,
      hyperphosphorylation of cytoskeletal proteins, or metabolism of amyloid beta.
      However, at present, no one theory explains adequately the host of complex
      biochemical and pathological facets of the disease. Recent findings suggest that
      age-related increases in oxidative stress and protein glycation either
      individually, or more probably in a synergistic manner, could, exclusive of the
      other theories or in concert with them, account for all aspects of Alzheimer's
      disease.

PMID- 7778189
TI  - Synaptotagmin controls and modulates synaptic-vesicle fusion in a Ca(2+)
      dependent manner.
AB  - Although numerous electrophysiological and biochemical studies have defined many
      of the properties of the putative Ca2+ receptor for exocytosis at the synapse,
      the molecular mechanisms that couple influx of Ca2+ and release of
      neurotransmitter have remained elusive. Several proteins have emerged recently as
      putative Ca2+ sensors. Interestingly, one of these proteins, synaptotagmin,
      shares many properties with the putative Ca2+ receptor. Recent genetic
      experiments in Caenorhabditis elegans, Drosophila and mouse have provided
      important insights about synaptotagmin's role in neurotransmitter release. These
      experiments, combined with electrophysiological and biochemical studies, suggest
      that synaptotagmin is a key Ca2+ sensor, converting the ubiquitously used
      cellular secretory pathway into a Ca(2+)-regulated exocytotic pathway.

PMID- 7778190
TI  - Ca2+ and secretory-vesicle dynamics.
AB  - Exocytosis in neurones and neuroendocrine cells is triggered by an increase in
      the cytosolic concentration of Ca2+, and is followed by endocytotic membrane
      retrieval. Electrophysiological studies have characterized the nature of the Ca2+
      signal that is required for exocytosis, and have defined the Ca(2+)-dependent
      steps in exocytotic and endocytotic vesicle cycling. In parallel, biochemical
      approaches have led to the discovery of a range of proteins that appears to
      function in synaptic- and secretory-vesicle dynamics. The nature of the Ca(2+)
      binding proteins, and how they interact with the identified components of the
      exocytotic and endocytotic machinery, remain key unresolved issues. However, it
      is apparent that exocytosis involves multiple Ca(2+)-binding proteins with
      different affinities, and that the Ca2+ sensor involved in the final membrane
      fusion step has different affinities for Ca2+ in synapses and neuroendocrine
      cells.

PMID- 7778191
TI  - From contact to connection: early events during synaptogenesis.
AB  - When neuronal processes first come into contact, chemical synapses can form
      rapidly. Many neurons synthesize synaptic machinery through intrinsic programs
      before cell-cell interactions. During the formation of chemical synapses, contact
      with appropriate targets has been found to trigger intracellular signals that
      induce the assembly of pre-existing synaptic machinery. We propose that
      'promiscuous' neurons secrete transmitter before contacting their targets, and
      form over-abundant synapses, which undergo additional activity-dependent
      refinement; 'selective' neurons, which retain their original connectivity,
      require concerted retrograde and anterograde signaling to ensure their correct
      matching.

PMID- 7778192
TI  - Helicobacter pylori infection.

PMID- 7778193
TI  - Integrated health programmes.

PMID- 7778194
TI  - Evaluation of performance of reused HIVCHEK 1 + 2 test blocks which have shown
      negative result: a reliable method for rural hospital?
AB  - The performance of the reusing of test membranes which have been used previously
      for negative tests for the detection of antibody to HIV (HIVCHEK 1 + 2 of Ortho
      Diagnostic Systems, Paris, France) was evaluated under field conditions. The
      sensitivity and specificity of the reusing strategy compared with a HIV
      determination obtained by using new HIVCHECK 1 + 2 tests were 89.1% and 100%,
      respectively. The positive predictive value was 100% and the negative predictive
      value was 91.5%. The authors conclude that the reduction in sensitivity of the
      reusing strategy in comparison with the use of new tests makes this strategy
      ethically unacceptable for the detection of HIV infection in blood donors. On the
      other hand, the reusing strategy could be very useful for diagnostic purpose and
      for epidemiological HIV surveillance in resource-poor countries.

PMID- 7778195
TI  - The partograph in community obstetrics.

PMID- 7778196
TI  - Hypokalaemic paralysis precipitated by working in hot weather.
AB  - Twenty-two cases of hypokalaemic paralysis seen over the past 7 years, are
      presented here. They included five Chinese, five Bangladeshis, six Arabs, four
      Philippinos and two Indians. The number of cases related to the population of
      each nationality in our area showed that the Chinese had the biggest number of
      cases in relation to their population in our area, followed by Philippinos then
      Bangladeshis. All patients were men admitted in the hot season, dehydrated and
      not able to walk. It seems that dehydration was an important precipitating factor
      in our cases. Although family history was positive in one patient, apart from
      four thyrotoxic patients, the others were apparently healthy. Patients improved
      dramatically with i.v. potassium and rehydration. Four patients were readmitted
      with the same picture.

PMID- 7778197
TI  - Incidence of duodenal ulcer and its surgical management in a teaching hospital in
      Bangladesh.
AB  - Duodenal ulcer patients with or without complications admitted in the surgical
      departments of Rajshahi Medical College Hospital (RMCH) during the period of 13
      years from 1980-1992 were studied retrospectively. Duodenal ulcer accounted for
      10/1000 admission and five operations per week. Of the 1623 patients with
      uncomplicated ulcer, only 623 needed surgical treatment. However, all of the 1599
      who presented with pyloric stenosis, 1047 with peritonitis due to perforation,
      and 13 with hematemesis were operated upon. This study confirms previously
      published reports of high incidence of duodenal ulcer admissions in the hospital
      but shows a diminishing number in the uncomplicated cases requiring surgery.

PMID- 7778198
TI  - Case management quality assessment in rural areas of Papua New Guinea.
AB  - A study was carried out to assess the quality of case management of malaria,
      malnutrition, diarrhoea and acute respiratory tract infections in children in
      rural primary health services in Papua New Guinea. In particular, the study
      focused on the knowledge and skills of different categories of rural health
      workers (HW) in history taking, examination, diagnosis, treatment and patient
      education. Quality criteria were defined and health centre (HCW) and aidpost
      workers' (APWs) knowledge and practices were assessed. Primary health workers'
      (PHW) knowledge of case management was weak, but in all cases better than their
      actual practice. History taking and examination practices were rudimentary. HWs
      tended not to make or record diagnoses. Treatment knowledge was often incorrect,
      with inappropriate or insufficient drugs prescribed, being worst at aidpost
      level. These findings raise serious questions about the effectiveness of
      providing health services through small, isolated health units. Far greater
      attention must now be directed to focus on the institutionalization of problem
      based training, continuous supportive supervision and maintenance of clinical
      skills and provision of essential drugs, supplies and equipment to ensure that
      rural health workers (RHW) can provide sound care.

PMID- 7778199
TI  - Health management and action research: bringing them together for the district
      medical officer.

PMID- 7778200
TI  - Successful treatment of antimony-resistant visceral leishmaniasis with liposomal
      amphotericin B (L-AmpB-LRC) in a child.

PMID- 7778201
TI  - Sheehan's syndrome presenting as a psychosis.

PMID- 7778202
TI  - Pulmonary blastomycosis.

PMID- 7778203
TI  - Perforation in acute acalculus Salmonella cholecystitis.

PMID- 7778204
TI  - Human bite injuries to the nose.

PMID- 7778205
TI  - New diagnostic tools to improve tropical primary health care: the Jabric
      multipurpose manual centrifuge.

PMID- 7778206
TI  - Perinatal health--a hospital staff survey in Nepal.

PMID- 7778207
TI  - Dyspepsia and Helicobacter pylori infection in rural south west Cameroon.

PMID- 7778208
TI  - Herniation of ureter in inguinal hernia.

PMID- 7778209
TI  - A simple method for the removal of retained urinary balloon catheters.

PMID- 7778210
TI  - Transport and referral of medical inpatients in Blantyre, Malawi.

PMID- 7778211
TI  - Neuroparalytic complications after anti-rabies vaccine (inactivated nervous
      tissue vaccine)

PMID- 7778212
TI  - The feasibility of repetitive courses of high-dose continuous intravenous
      infusion interleukin-2 and subcutaneous alpha-interferon with polychemotherapy in
      advanced malignant melanoma.
AB  - AIMS AND BACKGROUND: A Phase I study of repetitive courses of chemotherapy
      (carmustine, cis-platinum, dacarbazine) and immunotherapy (continuous intravenous
      infusion recombinant interleukin-2 (rIL-2) and subcutaneous (sc) alpha-interferon
      2b) plus tamoxifen was performed in order to establish a more efficacious way to
      sequence this kind of treatment for advanced malignant melanoma. STUDY DESIGN:
      Patients who had measurable metastatic melanoma, a Karnofsky performance status >
      or = 80, and no clinically significant hematologic or cardiac disfunction were
      considered eligible. Treatment consisted of BCNU, 150 mg/m2 i.v. day 1 in
      alternating cycles; DTIC, 220 mg/m2 i.v. days 1, 2 and 3; CDDP, 25 mg/m2 i.v.
      days 1, 2 and 3; tamoxifen 10 mg twice/day per os continuously; rIL-2, 18 x 10(6)
      IU/m2/day continuous i.v. infusion days 5-8 (96 h) and days 19-22 (96 h); alpha
      interferon (IFN) s.c. 3 x 10(6) U day 12, 6 x 10(6) U day 14, 9 x 10(6) U days
      16, 19, 21, 23, 26, and 28 (from cycle 2, 9 x 10(6) U days 2, 5, 7, 9, 12, 14,
      16, 19, 21, 23, 26, and 28). Two consecutive cycles were planned until response
      evaluation. RESULTS: Three patients were treated according with the protocol;
      none of them was able to respect the planned dose-intensity schedule. The given
      dose intensity/planned dose intensity ratios were as follows: DTIC, 0.74 (range,
      0.70-0.80); CDDP, 0.77 (0.72-0.80); BCNU, 0.77 (0.72-0.80); rIL-2, 0.65 (0.36
      0.80); alpha-IFN, 0.01 (0-0.03); tamoxifen, 1.0. Systemic side effects of rIL-2
      and myelotoxicity were the main reasons for treatment delay and/or dose
      reduction, and for the long period of hospital care. CONCLUSIONS: We conclude
      that the treatment schedule is not feasible. However, since we believe that
      combined chemo-immunotherapy is a potentially active treatment in metastatic
      malignant melanoma, we have modified it in order to make it more feasible and
      consequently efficacious.

PMID- 7778213
TI  - Combination of epirubicin and lonidamine for treatment of advanced breast cancer.
AB  - AIMS AND BACKGROUND: In vitro and in vivo studies have shown that lonidamine
      potentiates the cytotoxic effect of anthracyclines in simultaneous and sequential
      combination. On the basis of such evidence, we evaluated the activity and
      toxicity of a combination of epirubicin plus lonidamine in advanced breast
      cancer. METHODS: Between January 1991 and November 1993, 33 patients with
      advanced breast cancer, age < 75 years and PS < 2, were treated with epirubicin
      (75 mg/m2 i.v. on day 1, every 3 weeks), plus lonidamine (450 mg/day orally from
      day 1 continuously until disease progression). RESULTS: Thirty patients were
      evaluable for response: 4 achieved complete response (13%) and 8 partial response
      (27%) (total response rate = 40%), 6 (20%) had stabilization of disease, and 12
      (40%) progression of disease. The median duration of response was 10 months
      (range, 4-24+ months). This scheme was tolerated, with a mild additional toxicity
      related to lonidamine: only WHO grade III myalgia in 1 patient (3%) and
      epigastralgia in 3 patients (9%). CONCLUSIONS: Although some patients seem to
      have benefited from the combination at the dose levels of the drug used in the
      study, the therapeutic advantages of addition of lonidamine remain unclear.

PMID- 7778214
TI  - Indium-111-DTPA-octreotide scintigraphy modulation by treatment with unlabelled
      somatostatin analogue in small-cell lung cancer.
AB  - AIMS AND BACKGROUND: Small-cell lung cancer (SCLC) tissue expresses somatostatin
      receptors and can be visualized by means of the indium-111-labelled somatostatin
      analogue DTPA-D-Pheoctreotide. The aim of the study was to investigate whether
      treatment with a cold somatostatin analogue can affect the imaging of
      somatostatin receptor scintigraphy. METHODS: Three patients with SCLC were
      treated with 200 micrograms of cold octreotide three times a day subcutaneously
      for 7 days. Whole body and planar scintigraphy was performed before and after the
      treatment. RESULTS: 111In-DTPA-octreotide uptake was increased in cancer lesions,
      whereas fixation in normal tissues (liver, spleen, kidneys) decreased.
      CONCLUSIONS: This is the first demonstration of an enhancement of SCLC imaging
      following unlabelled somatostatin analogue administration. Similar results have
      been described by other authors in a limited number of carcinoid tumors.

PMID- 7778215
TI  - Immunoglobulin heavy chain gene rearrangement in B-cell non-Hodgkin's lymphomas
      detected by the polymerase chain reaction.
AB  - AIMS AND BACKGROUND: Immunoglobulin heavy chain gene rearrangement serves as a
      marker of clonality and cell lineage in B-cell lymphoproliferative disorders. In
      this study we used the polymerase chain reaction (PCR) to detect clonal
      rearrangements of the immunoglobulin heavy chain gene in a group of patients with
      B-cell lymphomas. METHODS: DNA was extracted from frozen tissue of 40 B-cell non
      Hodgkin's lymphomas and subjected to PCR amplification using primers that
      recognize conserved sequences of the variable and joining regions of the
      immunoglobulin heavy chain gene. RESULTS: Monoclonal rearrangements were detected
      in 23 of 40 malignant B-cell lymphomas. No clonal rearrangements were detected in
      the 10 control cases. CONCLUSIONS: We conclude that this PCR-based technique may
      provide a simplified and rapid approach for the detection of clonal
      immunoglobulin heavy chain gene rearrangements in B-cell lymphomas without
      recourse to Southern blotting, which can be reserved for cases in which PCR is
      negative.

PMID- 7778216
TI  - Differences in blood glutathione levels of patients with advanced or localized
      carcinoma.
AB  - AIMS AND BACKGROUND: The increased level of blood glutathione (GSH) is an
      important biochemical feature in animal epithelial tumor. The aim of this study
      was to investigate the blood GSH concentrations in well characterized cancer
      patients and healthy volunteers. METHODS: Two different groups of carcinoma cases
      were used. The first group consisted of 15 blood samples drawn from disseminated
      gastric adenocarcinoma patients, and the second group comprised 15 samples
      obtained from localized or locally advanced skin carcinoma cases without lymph
      node metastasis. GSH and hemoglobin concentrations were measured by using the
      method of Beutler et al. RESULTS: The mean blood GSH in patients who had advanced
      malignant disease was 129.13 +/- 7.49 mg/dl and in patients who had localized
      cancer was 96.24 +/- 3.90 mg/dl. These results indicate that the blood GSH level
      is 31% higher in localized carcinoma cases and 78% higher in metastatic disease
      than those of controls. Blood GSH concentrations were expressed on the basis of
      blood volume and also on hemoglobin content. Similar results were calculated with
      either mode of expression. CONCLUSION: By comparing the two groups of patients,
      we found that higher blood GSH concentration was correlated with metastatic
      growth.

PMID- 7778217
TI  - Breast carcinoma with osteoclast-like giant cells: immunohistochemical and
      ultrastructural study of a case and review of the literature.
AB  - We describe an unusual case of infiltrating ductal carcinoma, not otherwise
      specified, containing numerous benign stromal osteoclast giant cells (OGCs).
      Macroscopically, the tumor appeared as a well-outlined dark brown mass and was
      initially interpreted as a benign lesion on the mammograms. OGCs were uniformly
      distributed in the tumor and were found in vascularized, hemorrhagic stroma often
      abutted on the nests of tumor cells. Electron microscopy supported a histiocytic
      origin of the OGCs, but immunohistochemistry failed to confirm the observation.
      The patient was alive and well 30 months following the operation. A review of the
      literature concerning breast carcinoma with OGCs is also presented.

PMID- 7778218
TI  - Solitary brain metastases from thyroid carcinoma: study of 6 cases.
AB  - AIMS AND BACKGROUND: Although systemic metastases from thyroid cancer are
      relatively frequent, they rarely affect the nervous system and only exceptionally
      originate from well-differentiated carcinoma. METHODS: The authors describe 6
      cases of solitary brain metastases from thyroid carcinoma, well-differentiated in
      3 cases and anaplastic in the other 3 cases. RESULTS: Four patients were females
      and 2 males (M:F ratio, 1:2); average age was 51 yrs (range 48-56). On average,
      the interval between diagnosis of the thyroid tumor and appearance of the
      metastasis was 2.8 years (range 1-12 years) and was shorter in the anaplastic
      forms (1.2 versus 4.4 years). Average survival was 15 months (range 6-48 months);
      in particular, average survival was longer in patients with well-differentiated
      carcinoma (9 vs 21 months) as also in those who did not present other metastatic
      sites (6 vs 24 months). Death was due to systemic progression of the disease in 4
      cases and to brain-relapse in the other 2 cases. CONCLUSIONS: Surgery,
      radioactive iodine (where uptake is demonstrable), and radiotherapy are the main
      therapies available for metastases from thyroid carcinoma. However, survival of
      patients appears to be modified by the type of treatment performed.

PMID- 7778219
TI  - Lymphoepithelioma-like carcinoma of the lung. Two cases diagnosed in Caucasian
      patients.
AB  - Lymphoepithelioma-like carcinoma is a non-nasopharyngeal undifferentiated
      carcinoma with prominent lymphoid infiltration. Ten cases arising in the lung
      have been reported so far; seven cases were diagnosed in Orientals, with the
      Epstein-Barr virus (EBV) genome demonstrated in neoplastic cells by in situ
      hybridization; the remaining three cases affected Caucasian patients and showed
      no evidence of hybridized viral genome. The present study describes two
      additional cases of lymphoepithelioma-like carcinoma of the lung in Caucasians,
      with reference to the differential diagnosis versus other thoracomediastinal
      malignancies. The neoplastic nuclei, blast-like in appearance, together with the
      immunohistochemical profile of the neoplastic cells (positivity for cytokeratins,
      and negativity for CD antigens, S100 protein, placental alkaline phosphatase, and
      neuroendocrine markers) represent the basic pathologic features of a
      lymphoepithelioma-like carcinoma and allow its recognition even on small bioptic
      fragments, in which the typical biphasic, Regaud-like morphology might be
      inapparent. In accordance with the previously reported cases of pulmonary
      lymphoepithelioma-like carcinoma in Caucasian patients, the present study found
      no evidence of the Epstein-Barr virus genome in neoplastic cells with in situ
      hybridization.

PMID- 7778220
TI  - Neuroendocrine carcinoma of the skin: a case report of "multiple neuroendocrine
      carcinoma" onset and long-term remission after chemotherapy.
AB  - We herein report a case of "multiple neuroendocrine carcinoma" onset, with a
      torpid course, metastasis in the left breast, and an initial considerable
      sensitivity to the chemotherapy. We conclude that a re-evaluation of the studies
      on this neoplasia carried out to date is needed, in order to identify new
      regimens, which increase the complete response rates and their duration.

PMID- 7778221
TI  - Inflammatory pseudotumor of the liver. A report of two cases with unusual
      histologic picture.
AB  - Two cases of inflammatory pseudotumor (IPT) of the liver are reported. Clinical
      presentation was vague and aspecific. Laboratory tests and data from imaging
      techniques provided no specific information on the actual nature of the lesions
      and were misleading, suggesting a malignant lesion in one patient and a
      complicated hydatid cyst in the other. On gross examination, the tumors appeared
      yellowish ore grey-yellow in color, with a firm cut surface and well
      circumscribed from the surrounding parenchyma, although a true capsule was not
      evident. Variability in the histological pattern was also observed, even though
      the major finding was in both cases an admixture of lymphocytes, plasmacells,
      granulocytes and monocytes. Lymphocytes were immunohistochemically heterogeneous;
      monocytes showed in one case large hyperchromic atypical nuclei, confirming the
      previously, reported possibility that some cases of IPT may be mistaken for
      sarcomas. Further evidence is added in support of the hypothesis that some liver
      IPT may result from the evolution of cholangitic abscesses.

PMID- 7778224
TI  - Diagnostic accuracy of primary liver cancer: implications for cancer
      registration.
AB  - AIMS AND BACKGROUND: We evaluated some standardized criteria for classifying
      incident cases of liver cancer into either primary liver cancer (PLC) or
      unspecified liver cancer (ULC) on the basis of the diagnostic examinations
      performed and their results. METHODS: A pilot hospital-based study (98 cases) was
      carried out in Verona, northern Italy, with the main aim of assessing the
      feasibility of the method. The same procedures were subsequently applied in a
      population-based study (349 cases) in Brescia, northern Italy. RESULTS: Diagnosis
      was made on histologic data in 38.7% and 41.8% of the hospital based and
      population-based studies, respectively, with a wide variation among different
      hospitals. The percentage of cases classified as PLC was 78.6% in the hospital
      based study and 78.8% in the population-based study. No differences in the
      proportion of cases attributed to PLC were found according to patients' age and
      sex or hospital of admission. The repeatibility of the procedure was assessed by
      a cross-panel review of 198 cases, and concordance was found in 91.9% of them.
      CONCLUSIONS: An operational method for case definition of PLC based on the
      results of the diagnostic examinations currently performed and some suggestions
      for cancer registration are proposed.

PMID- 7778222
TI  - Second-generation aromatase inhibitors.

PMID- 7778223
TI  - Prostate cancer: population-based survival rates in central Italy.
AB  - AIMS: To evaluate survival in prostate cancer patients in the Province of
      Florence where the Tuscany Cancer Registry is active. METHODS: The survival of
      777 patients with prostate cancer diagnosed in the period 1985-87 was evaluated.
      The observed and relative survival rates 1, 3 and 5 years after diagnosis were
      computed. Also the prognostic effect of age, disease extension, tumor grade,
      histological verification, place of residence and year of diagnosis were
      evaluated using univariate and multivariate analysis. RESULTS: The observed
      survival was 73.4% 1 year, 42.5% 3 years and 29.2% 5 years after diagnosis. The
      relative survival was respectively 78.7%, 53.0% and 43.0%. Significant
      independent risks were evident when the disease was extended out of the prostate,
      for patients older than 80 years, for high grade tumors and for patients without
      histological verification. CONCLUSION: The 5-year relative survival rate in the
      province of Florence is similar to those from other European Registries and the
      Latina Registry, but much lower than the one reported by the SEER program in the
      US. Data on histological verification percentage, availability of information on
      disease extension, and tumor grade are discussed as indicators of the quality of
      the diagnostic approach in comparison with other registries.

PMID- 7778226
TI  - [Laparoscopic surgery of the digestive system: present and future].

PMID- 7778225
TI  - Feasibility of intraportal chemotherapy with fluorouracil and folinic acid
      immediately after hepatic resection for colorectal metastases.
AB  - BACKGROUND: About 50% of recurrence after resection of hepatic metastases from
      colorectal cancer remain confined to the liver. Adjuvant locoregional treatments
      could reduce the failure rate, but these treatments have been scantily
      investigated. Experimental models have shown that both intra-arterial
      chemotherapy (IAC) and intraportal chemotherapy (IPC) in adjuvant setting were
      able to reduce metastatic growth, but IPC should be initiated in the immediate
      postoperative period. AIMS: To evaluate the feasibility of immediate
      postoperative IPC of fluorouracil (5-FU) plus folinic acid (FA) in a consecutive
      series of patients undergoing hepatic resection for metastatic colorectal cancer.
      METHODS: Forty-three consecutive patients underwent hepatic resection. The first
      25 (Control Group = CG) received only surgery; the latter 18 (Treated Group = TG)
      were candidate to postoperative IPC of 5-FU 750 mg/m2 plus FA 20 mg/m2/day
      continuous infusion for 8 days. One patient was not treated owing to bleeding,
      thus only 17 received the treatment. RESULTS: Postoperative morbidity was 14%,
      equally distributed in both groups. Biochemical hepatic parameters of TG were not
      statistically different from those of CG. Five patients (29%) developed systemic
      toxicity: one hematologic grade 4; 3 mucositis grade 3 and one allergic erythema.
      Three of these patients had been treated by systemic chemotherapy less than one
      year before. DISCUSSION: IPC of 5-FU plus FA in the immediate postoperative
      period has not yet been tested. The schedule we have investigated neither
      affected the postoperative outcome, nor influenced hepatic function and
      regeneration. Systemic toxicity was evident and severe mainly in patients already
      pretreated by systemic chemotherapy. In these patients, however, toxicity did not
      affect further outcome. This study confirms the feasibility of immediate
      intraportal chemotherapy after hepatic resection.

PMID- 7778228
TI  - [Surgical treatment of poliomyelitis sequelae in the legs. 118 cases in Togo].

PMID- 7778227
TI  - [Allergic rhinitis].

PMID- 7778229
TI  - [Blunt kidney traumas. 51 cases].

PMID- 7778230
TI  - [Evaluation in neonates of infectious risk during premature rupture of membranes.
      (Prospective study of 100 cases)].

PMID- 7778231
TI  - [Contraception and unwanted pregnancies. 139 cases].

PMID- 7778232
TI  - [Treatment of divergent intermittent strabismus].

PMID- 7778233
TI  - [A rare cause of liver abscess].

PMID- 7778234
TI  - [Management of undesirable side effects of medications].

PMID- 7778236
TI  - [Alternative physical treatment--a real offer?].

PMID- 7778235
TI  - [New medical treatments in Great Britain].

PMID- 7778237
TI  - [Alternative treatment of athletic injuries].
AB  - A questionnaire was carried out in a Danish sports clinic to find out how many
      sports-injured patients seek alternative medical treatment. One hundred and fifty
      persons (81%) answered the questionnaire. Forty-seven percent of the women and
      35% of the men had at some time tried alternative medicine. These high numbers
      might be explained by dissatisfaction with the official medical treatment of
      sports injuries in Denmark. No age or income difference was found between the
      persons who had tried alternative medicine compared to the patients who had never
      tried it. Fifty-nine percent of those who had sought alternative medicine did not
      find it effective. There is a need for clinically controlled trials to find out
      if some alternative medical treatments do have effects on some specified
      injuries.

PMID- 7778238
TI  - [Intracoronary ultrasonography--a supplement to coronary arteriography].
AB  - Intracoronary ultrasound is a new technique, by means of which it is possible for
      the first time to visualise coronary artery wall structures in vivo. Compared to
      conventional coronary angiography the advances of this new modality appear to be:
      1) Improved diagnosis of minimal and non-obstructive atherosclerosis; 2)
      Characterisation of plaque morphology, thereby being an aid in decision on
      interventional procedures (PTCA, atherectomy, stent placement); 3) Better
      delineation of coronary artery lumen area, which improves the accuracy of
      stenosis graduation both before and after interventional procedures. The
      examination can be performed in up to 95% of cases. The procedure appears to be
      safe with a reported complication rate of myocardial infarction and bypass
      surgery of 0.16% in 1837 cases; transient coronary artery spasms occurred in
      about 3%. Complications are predominantly associated with interventional
      procedures. Although intracoronary ultrasound has mainly been used for research
      purposes, results of ongoing trials assessing its clinical utility, as well as
      technological improvement providing more consistent image quality, suggest that
      the procedure will evolve into an important adjunct to coronary angiography.

PMID- 7778239
TI  - [Non-invasive transcranial brain stimulation in man].
AB  - Magnetic stimulation of the brain in awake human subjects was introduced ten
      years ago and has since then been used extensively both in the clinic and for
      research purposes. So far the method has been shown to be of importance as a
      supplement to other methods in the diagnosis and monitoring of multiple
      sclerosis. It may also achieve importance as a prognostic tool in early cerebral
      haemorrhage. It is yet unclear whether the method will achieve any importance in
      the diagnosis of other diseases such as Parkinsons disease, migraine and
      epilepsy. The method has caused a major breakthrough in the investigation of the
      central control of voluntary movement in man. The method thus provides a
      possibility of monitoring the activity of defined corticospinal pathways during
      voluntary movements.

PMID- 7778240
TI  - [Prognosis for patients admitted to intensive care units with acute renal failure
      requiring dialysis].
AB  - The mortality of critically ill patients who develop acute renal failure (ARF) is
      persistingly high. We reviewed all patients who developed ARF that required
      dialysis in a single intensive care unit (n = 167) during the period 1977 to
      1989, in order to identify variables with possible influence on outcome. Overall
      mortality within hospital was 75%. Age above 60 (p < 0.02), requirement for
      mechanical ventilation (p < 0.0005), requirement for inotropic drugs (p < 0.0005)
      and increased levels of P-bilirubin (p < 0.005) had negative impacts on survival.
      Mortality increased significantly from 63% in the early period (1977-1985) to 84%
      in the late period (1986-1989) (p < 0.001), a rise that could not be explained by
      a single variable. The patients in the later period were, though, characterized
      by a higher morbidity with a higher frequency of additional organ failure.

PMID- 7778241
TI  - [Optimization of radiotherapy of cervical cancer. Introduction of an extern
      radiotherapy based on CT and low-dosage afterload technique at the
      Rikshospitalet].
AB  - In September, 1987 remote controlled afterloaded caesium in treatment of
      carcinoma was introduced at the Department of Oncology, Copenhagen University
      Hospital. All patient data, treatment, complications and deaths were registered
      prospectively. This study describes treatment results of the first 178
      consecutively treated patients. The four year survival rates for patients stage
      I, II and III were 70%, 68% and 43%, respectively. The stage I patients were all
      considered unfit for surgery due to age or other medical conditions. During the
      observation period 13 patients developed severe complications requiring surgery,
      and three of these patients died. It was concluded that treatment with
      afterloaded caesium for carcinoma of the cervix has reduced radiation of the
      medical personnel to an almost unmeasurable dose, that the treatment results were
      comparable to those of the larger centres in the world and that the new treatment
      technique suggests further improvement in the treatment of cervical carcinoma.

PMID- 7778242
TI  - [Upper dyspepsia in persons aged 50 to 60 years. Results from a 5-year follow-up
      population study in Glostrup].
AB  - A five year follow-up study of a large random cohort was carried out with the aim
      of finding prevalence, incidence, prognosis and risk factors for upper dyspepsia
      according to different definitions. Fifty-four percent of the men and 47% of the
      women had experienced symptoms of upper dyspepsia within the past 12 months,
      while the prevalence of frequently occurring symptoms was 13% among men and 15%
      among women. Similarly the incidence was 22% among men and 25% among women,
      declining to 5% and 6% respectively when only frequent symptoms were considered.
      At five years follow-up approximately one quarter of the subjects with upper
      dyspepsia had recovered from all symptoms, while two thirds of the subjects who
      had experienced frequent symptoms did not do so any more. Psychological
      vulnerability increased the risk of having upper dyspepsia by 3.8, and risk of
      developing upper dyspepsia within five years 2.3. Different definitions
      identified different subjects as suffering from upper dyspepsia, and less than
      one quarter of the subjects fitted all the definitions.

PMID- 7778243
TI  - [Quality assurance of scintigraphic examinations of cerebral circulation.
      Presentation of a method].

PMID- 7778244
TI  - [Femoral pseudoaneurysms in drug addicts].
AB  - Four cases of femoral pseudoaneurysms from substance abuse are presented. One
      patient, a 32 year-old women needed amputation (by disarticulation of the hip)
      after failed revascularization. Another patient had symptoms of claudication
      after triple ligation and resection without bypass grafting. The last two had an
      uneventful recovery: one after saphenous vein bypass, the other after simple
      resection and repair with a vein patch.

PMID- 7778245
TI  - [Breast cancer].

PMID- 7778246
TI  - [Endoscopy for treatment with H2 blockaders?].

PMID- 7778247
TI  - [Infertility].

PMID- 7778248
TI  - Vascular supply of the tendon of the equine deep digital flexor muscle within the
      digital sheath.
AB  - The vascular and microvascular anatomy of the equine deep digital flexor tendon
      (DDFT) within the digital sheath was studied by injecting the vasculature with
      either colored latex or barium sulphate for radiographic, microangiographic,
      histologic, and computed tomographic (CT) evaluation. Consecutive 4-mm thick two
      dimensional CT slice data were reconstructed to 3-dimensional volumetric images
      to enhance spatial evaluation of the blood supply. Gross dissection and
      angiographic studies identified three major vascular sources. Above the fetlock,
      the DDFT was supplied by either a branch of the medial palmar artery (Arteriae
      digitalis palmaris communis II) or a branch of the medial palmar digital artery
      (A. digitalis [palmaris propria III] medialis). Below the fetlock, the DDFT was
      supplied by branches from the lateral and medial palmar branches to the proximal
      phalanx (Ramus palmaris phalangis proximalis). The most distal aspect of the
      tendon received small branches from the medial and lateral palmar digital
      arteries. Using histology and microangigraphy we observed an extensive and
      uniform intratendinous vascular network above and below the fetlock, with a
      relatively avascular region of tendon palmar to the fetlock. The most distal 2.0
      to 2.5 cm of the tendon within the sheath was heavily infiltrated with
      fibrocartilage along its dorsal aspect.

PMID- 7778250
TI  - An evaluation of fiberglass cast application techniques.
AB  - Cylindrical casts constructed from 2, 3, 4, and 5 inch widths of fiberglass
      casting material were evaluated for strength in bending using an unstable
      fracture model. Five-inch casting material produced the strongest casts. The
      effect of longitudinal splinting with 2-inch fiberglass tape was evaluated in
      cylindrical casts constructed from 4-inch tape. Casts with splints on the
      compression side or with splints on both the tension and compression sides were
      stronger in bending than casts with a single splint on the tension side or casts
      without splints.

PMID- 7778249
TI  - Intraperitoneal use of sodium carboxymethylcellulose in horses undergoing
      exploratory celiotomy.
AB  - The effect of intraperitoneal sodium carboxymethylcellulose (SCMC) administration
      on clinical outcome and survival was evaluated in horses undergoing exploratory
      celiotomy for acute gastrointestinal disease. Comparison of variables was made
      retrospectively between 44 horses that had SCMC and 92 horses (controls) not
      treated with SCMC. Mean age, body weight, heart rate, packed cell volume and
      plasma total protein of horses at admission, and convalescent period were not
      significantly different between control and SCMC groups. No significant
      differences were noted between control horses and SCMC horses with respect to
      incisional infection, hernia formation, recurrent episodes of colic, clinical
      outcome, and long-term survival (> 6 months). Seventy-six (83%) control horses
      and 34 (77%) SCMC horses survived long-term. Seventy (76%) control horses and 30
      (68%) SCMC horses survived without complications and returned to their previous
      use. These results suggest that intraperitoneal use of SCMC does not adversely
      affect abdominal incisional wound healing, clinical outcome or long-term
      survival, however, the efficacy of SCMC in prevention of postoperative intestinal
      adhesions in horses requires further investigation.

PMID- 7778251
TI  - Clinical effects of longitudinal division of the corpus callosum in normal dogs.
AB  - Longitudinal division of the corpus callosum was performed in six normal beagles
      to determine surgical morbidity. The corpus callosum was divided sagittally on
      the midline and the effect on neurological function was determined. Five of six
      dogs were clinically normal within 14 days or less after surgery. One dog had
      persistent but improving clinical signs consistent with a forebrain disturbance
      at 30 days after surgery. Overall, minimal morbidity and no mortality was
      associated with this surgical procedure. Further study is indicated to determine
      the efficacy of this surgical treatment for seizure control in dogs with
      idiopathic epilepsy.

PMID- 7778252
TI  - Clinicopathologic effects of a 21-aminosteroid compound (U74389G) and high-dose
      methylprednisolone on spinal cord function after simulated spinal cord trauma.
AB  - A model simulating acute-compressive spinal cord trauma at the second lumbar
      spinal cord segment (100 g, 300 seconds) was used to evaluate the efficacy of a
      vehicle control, methylprednisolone sodium succinate (MPSS), and a 21
      aminosteroid compound (U74389G). Dogs were allocated into one of five treatment
      groups (A to E) using ultrasonographic determination of spinal cord diameters to
      ensure even distribution of spinal cord diameters among the treatment groups.
      Initial dosages of the vehicle control (A), methylprednisolone (30 mg/kg of body
      weight) (B), or U74389G (30 mg/kg, 3 mg/kg, or 10 mg/kg of body weight) (C, D, or
      E, respectively) were administered intravenously 30 minutes after trauma. Dosages
      were reduced by one-half for 2 and 6 hour treatments. Then every 4 hours for 42
      hours, dosages were reduced one-third and one-sixth from the original dose of
      methylprednisolone and U74389G, respectively. Neurological examinations were
      performed daily for 21 days. Histopathological examination of the traumatized
      spinal cord showed malacic and degenerative lesions. Although significant
      differences in some portions of the neurological and histopathologic examinations
      were observed, clinical efficacy for MPSS and U74389G could not be established in
      this model.

PMID- 7778253
TI  - Treatment of perianal fistulas with ND:YAG laser--results in twenty cases.
AB  - Excision of perianal fistulas using a 1.064 micron wavelength neodymium:yttrium
      aluminum garnet (ND:YAG) contact tipped laser with primary wound closure was used
      to treat 20 dogs with perianal fistulas. Overall, 19 of 20 (95%) dogs had
      resolution of fistulas after one or more ND:YAG treatments. The period of
      resolution ranged from 10 to 42 months with a mean of 22.9 months. Sixteen of 20
      (80%) dogs had resolved fistulas after one laser excision. Three of the four
      recurrences underwent additional laser treatments with successful results. The
      total number of laser procedures ranged from one to three with a mean of 1.2
      procedures. Postoperatively, anal tone as judged by digital rectal examination
      was reduced in about 60% of the cases, but clinical evidence of fecal
      incontinence only occurred in four of 20 cases. This was managed effectively with
      diet modification. The tendency toward loss of anal tone or fecal incontinence
      depended on the severity of preexisting anal stenosis. On a client survey, 19 of
      20 owners believed that their animals experienced less pain during defecation
      after surgery and rated the results as excellent or good. The overall success
      rate using ND:YAG laser excision compared very favorably with previously reported
      studies of other methods of treatment for perianal fistulas in dogs.

PMID- 7778254
TI  - The intercondylar fossa of the normal canine stifle an anatomic and radiographic
      study.
AB  - The intercondylar fossa (ICF) in dogs consists of a cranial outlet, intercondylar
      shelf, caudal arch, caudal outlet, a medial wall, and a lateral wall. The normal
      cranial outlet is bell-shape and, in mixed-breed dogs (mean body weight 19.2 kg,
      N = 21), measured 5.8 mm cranially, 8.1 mm centrally, and 10.3 mm caudally. The
      ICF is oriented 12 degrees from the dorsal plane of the femoral diaphysis and
      obliqued 7 degrees, proximolateral to distomedial, in the sagittal plane. To
      adjust for dog size, a fossa width index (FWI) was calculated by dividing the
      cranial outlet width by the distance between epicondyles. The normal FWI as
      determined in this study was 0.18 cranially, 0.25 centrally, and 0.32 caudally.
      The fossa height index 0.31. Contact between the ICF and the cranial cruciate
      ligament began at about 115 degrees of extension. The contact area moved
      cranially in the intercondylar fossa as the stifle was extended. Evaluation of
      the ICF can be performed radiographically but positioning is critical.

PMID- 7778256
TI  - Ovariohysterectomy in six mares.
AB  - Six mares had ovariohysterectomy performed for chronic pyometra associated with
      cervical abnormalities, uterine neoplasia, or removal of a macerated fetus.
      Ovariohysterectomy was performed through a ventral midline incision with access
      to the ovarian and uterine vessels aided by traction on the uterus and retraction
      of abdominal viscera. Abdominal pain, the most common complication after surgery,
      occurred in four mares but resolved within 36 hours. Peritonitis occurred in two
      mares; one mare was subsequently euthanatized. Other complications that resolved
      with treatment included infection of the uterine stump (two mares), abdominal
      hemorrhage (one mare), diarrhea (one mare), and incisional infection (one mare).
      Complications after surgery can be reduced by removing as much of the uterus as
      possible, minimizing peritoneal contamination with uterine contents, and
      providing a secure closure of the caudal reproductive tract.

PMID- 7778255
TI  - The effect of intercondylar notchplasty on the normal canine stifle.
AB  - This study evaluated the effect of notchplasty (enlargement of the intercondylar
      fossa) in stable and unstable canine stifles. Bilateral notchplasty and
      unilateral cranial cruciate ligament (CrCL) transection were performed in 6 dogs.
      Exercise, consisting of walking 1.5 miles three times a week, began 1 month after
      surgery and continued until euthanasia 6 months after surgery. Evaluation methods
      included orthopedic examination, serial radiographs, thin section radiography,
      histopathology, and gross pathology. Notchplasty in the stable stifle did not
      cause lameness beyond 3 weeks, joint instability, or degenerative joint disease.
      In the stable stifle, smooth resurfacing of the notchplasty site with fibrous and
      osseous tissue occurred. Stifles with notchplasty and CrCL transection exhibited
      persistent lameness, instability, and degenerative joint disease. In CrCL
      deficient stifles osteophytes formed within the notchplasty site, resulting in a
      rough surface. Our observations indicated significant refilling in notchplasties
      of both stable and unstable stifles (P < .05). However, the intercondylar fossa
      (ICF) width 6 months after notchplasty was significantly smaller in unstable
      stifles compared with stable stifles (P < .05) indicating that greater refilling
      of the notchplasties occurred in the unstable stifles. In clinical cases,
      notchplasty should be larger than the desired final result to accomodate the
      partial refilling that occurs even in stable stifles.

PMID- 7778257
TI  - Skin fold advancement flaps for closing large sternal and inguinal wounds in cats
      and dogs.
AB  - Skin fold advancement flaps can be created from the elbow and flank folds to
      close large wounds in the pectoral and inguinal regions of cats and dogs,
      respectively. The attachments of the laterally facing (outer) and medially facing
      (inner) layers of the skin fold to the adjacent limb are divided to produce a U
      shaped pedicle graft attached to the trunk. This mobilizes skin that can be
      advanced over large wounds involving the ventral chest or abdomen, or both. The
      use of skin fold advancement flaps enables direct closure of large skin defects
      without undue tension and without compromising the mobility of the adjacent limb.

PMID- 7778258
TI  - Demineralized bone matrix (DBM)

PMID- 7778259
TI  - Incomplete ossification of the humeral condyle in spaniels.

PMID- 7778260
TI  - Evaluation of the hemodynamic effects of interpleural bupivacaine in dogs.
AB  - The hemodynamic effects of interpleural (IP) bupivacaine were studied in six
      halothane-anesthetized dogs. On four separate occasions, each dog received IP
      saline (S), or bupivacaine at a low dosage of 1.5 mg/kg (L), high dosage of 3.0
      mg/kg (H), or high dosage of 3.0 mg/kg with epinephrine 5 micrograms/mL (HE).
      Heart rate, systolic and mean arterial pressures, and base excess were
      significantly lower in the H dosage group than in the other treatment groups.
      Cardiac output, expressed as a percentage of change from baseline, was
      significantly higher in the L group than in the H and S groups. Pulmonary
      arterial pressure and respiratory rate were significantly higher in the HE group
      than in the other three groups. Mean plasma concentrations of bupivacaine peaked
      between 5 and 15 minutes after IP injection. Maximum plasma concentrations in
      individual dogs were variable; however, mean maximum plasma concentrations in the
      H and HE groups were not significantly different. Clinically significant
      hypotension occurred in one dog in the H group and in one dog in the HE group. No
      pulmonary complications were detected.

PMID- 7778261
TI  - Evaluation of propofol as a general anesthetic for horses.
AB  - This study provides baseline information on the potential use of propofol as a
      general anesthetic for horses. Using a Latin square design, propofol (2, 4, and 8
      mg/kg) was administered intravenously on three separate occasions to six mature
      horses. Information about anesthetic induction, duration, and recovery was
      recorded along with results of rectal temperature, heart rate, respiratory rate,
      pHa, PaCO2 and PaO2. Statistical analysis included a mixed model analysis of
      variance, a general linear model analysis and least square means test for post
      hoc comparisons. A P < .05 was considered significant. The quality of induction
      of anesthesia varied from poor to good. Two horses were not recumbent following
      the lowest dose of propofol. Brief paddling limb movements occurred occasionally
      and unpredictably after recumbency induced by all three doses. During recovery,
      horses were uniformly calm and coordinated in their moves to stand. Duration of
      recumbency (minutes) was dose related; 15.05 +/- 1.58 (mean +/- SD) following 2
      mg/kg, 31.06 +/- 5.56 following 4 mg/kg, and 47.85 +/- 13.63 following 8 mg/kg.
      During recumbency at all doses, heart rate significantly increased from a predrug
      value of 40 +/- 6 beats per minute. Substantial respiratory depression,
      characterized by a significant decrease in respiratory rate (from 11.7 +/- 2.9 to
      3.7 +/- 1.6 breaths per minute) and increased PaCO2 (from 44.5 +/- 2.5 to 52.7 +/
      8.0 mm Hg) was seen only after 8 mg/kg. A significant decrease in PaO2 was
      observed throughout the recumbency induced by 8 mg/kg, and also at 3 and 5
      minutes following induction of anesthesia with 4 mg/kg propofol.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7778262
TI  - Alterations of endothelium-dependent digital vascular responses in horses given
      low-dose endotoxin.
AB  - Low doses of endotoxin cause vasoconstriction and hypoperfusion of the digit,
      small intestine, and cecum in horses. To determine the potential cause of these
      vascular alterations, in vitro vascular responses of palmar digital arteries and
      veins were determined in 8 horses after intravenous (IV) infusion of 1 L 0.9%
      NaCl (control) and 0.1 microgram/kg Escherichia coli 055:B5 endotoxin in 1 L of
      0.9% NaCl (endotoxin-treated). Vessels were surgically removed under general
      anesthesia, cut into 4-mm vascular rings, suspended in tissue baths, and attached
      to force displacement transducers for measurement of vascular tension. Cumulative
      concentration response curves to acetylcholine, bradykinin, nitroprusside,
      norepinephrine, 5-hydroxytryptamine (serotonin), and endothelin were determined.
      Maximal relaxation or contraction and the concentrations needed to produce 50%
      maximal relaxation or contraction were determined. Palmar digital arteries from
      endotoxin-treated horses relaxed significantly less in response to acetylcholine
      and bradykinin (endothelium-dependent), but not to nitroprusside (endothelium
      independent) when compared with arteries from control horses. Digital arteries
      from endotoxin-treated horses also contracted significantly more with
      norepinephrine but less with serotonin. Digital veins responded less than digital
      arteries. In another study, vascular reactivity experiments documented that
      acetylcholine and bradykinin were endothelium-dependent vasodilators (endothelium
      denuded vessels relaxed less than control vessels) in palmar digital vessels.
      Additionally, maximal relaxations for both vasodilators were significantly
      inhibited by N-nitro-L-arginine methyl ester (L-NAME), a nitric oxide antagonist,
      suggesting that acetylcholine and bradykinin cause relaxation through the nitric
      oxide pathway. The data from these studies indicate that low dose endotoxin
      impairs endothelium-dependent relaxation and augments adrenergic contraction of
      palmar digital arteries in horses.

PMID- 7778263
TI  - Development of a colic severity score for predicting the outcome of equine colic.
AB  - Thirty-two physical examination and laboratory variables were recorded during
      examination of 165 horses admitted for acute abdominal disease. Univariate
      analyses were performed to determine which of the variables were significantly
      different between horses that lived or died. Stepwise logistic regression was
      performed to identify variables with the best predictive value. Four variables
      (heart rate, peritoneal fluid total protein concentration, blood lactate
      concentration, and abnormal mucous membrane) remained significant when entered
      into the model. Histograms for each significant variable were used to set
      "cutting-points," establishing categories that were made into a table of assigned
      values from which a Colic Severity Score (CSS) for each horse was calculated.
      Seventy-one horses in a second group were used to validate the scoring chart.
      Case mortality rate was similar in both groups (20.6% in development group versus
      21.1% in validation group). All horses with a CSS > 7 died, whereas 75% of those
      with a score of < or = 7 lived. For the validation group, use of the scoring
      table yielded a positive predictive value of 100%, negative predictive value of
      91.8%, sensitivity of 66.7%, and specificity of 100%. The overall accuracy of the
      CSS was 93%. The CSS is a rapid and accurate method for predicting survival in
      cases of equine acute abdominal disease.

PMID- 7778266
TI  - Intragenomic complementation of a 3AB mutant in dicistronic polioviruses.
AB  - We report the construction of a poliovirus genome [pPVM-VPg(3F4A)] harboring a
      double mutation in VPg. This mutant, in which the tyrosine and the threonine at
      residues 3 and 4 of the VPg region were replaced by phenylalanine and alanine,
      respectively, is lethal, that is, all RNA synthesis was abolished and no
      revertants could be isolated. Using the properties of dicistronic polioviruses
      (with the general genotype PV 5'NTR-3AB-EMCV IRES-PV ORF-3'NTR), we have observed
      that the defect in RNA synthesis of the VPg(3F4A) mutant could be rescued by
      providing wild-type protein 3AB from the first open reading frame in trans. We
      conclude that the 3AB provided by the first cistron of the dicistronic construct
      was capable of "intragenomic complementation." Intragenomic complementation,
      however, was inefficient. Thus, the dicistronic RNAs were only quasi-infectious,
      and even first-passage viruses were found to have reverted to a functioning VPg
      in the polyprotein. This phenomenon underlines the role of polypeptide 3AB in
      multiple functions of viral proliferation. First-passage viruses, all of which
      expressed a small-plaque phenotype, had retained the original dicistronic
      genotype. At the fourth passage, however, all isolates were monocistronic, and
      they displayed complex genetic rearrangements revealing interesting information
      regarding IRES function.

PMID- 7778265
TI  - Generation of thymidine kinase-deficient mutants of infectious laryngotracheitis
      virus.
AB  - Current vaccines for the avian respiratory disease infectious laryngotrachetitis
      consist of naturally attenuated strains of the causative agent--the herpesvirus
      infectious laryngotracheitis virus (ILTV). Due to the dissemination of these
      viruses from vaccinated chickens as well as their possible reversion to more
      pathogenic forms, the use of genetically engineered viral vaccines lacking
      virulence factors while retaining antigenicity is being considered. Since the
      thymidine kinase (TK) activity of herpesviruses has been associated with
      virulence, inactivation of the encoding gene in the ILTV genome should attenuate
      the virus. Moreover, by analogy to other TK- herpesviruses, the ability of such
      ILTV mutants to induce a protective response in chickens should not be
      compromised. Therefore, the deliberate genetic alteration of ILTV was attempted.
      In order to prevent reversion and also to enable identification of the modified
      virus, a "marker" transcriptional unit (Escherichia coli lacZ gene fused to a SV
      40 3'-polyadenylation signal sequence and regulated by the pseudorabies virus gX
      gene promoter) was inserted via homologous recombination at one of two loci
      within the ILTV TK gene. Recombinant viruses were identified and plaque-purified
      on the basis of their ability to produce beta-galactosidase. Retention of the
      foreign DNA at the predicted sites in the genomes of the recombinant ILTV was
      verified by Southern hybridization. Since their replication was unaffected by the
      thymine analog 1-(2-fluoro-2-deoxy-beta-D-arabinofuranosyl)-5-methyluracil, the
      recombinants appeared to have a TK- phenotype. Despite this apparent deficiency,
      prior inoculation of either recombinant virus into chickens afforded the birds
      protection against a lethal challenge of virulent ILTV. Moreover, the degree of
      respiratory distress in the chickens vaccinated with the recombinants was
      relatively mild compared to the severe reaction in birds receiving the parental
      virus. Thus, ILTV can be genetically attenuated without an accompanying loss of
      immunogenicity.

PMID- 7778264
TI  - Erratic G-->A hypermutation within a complete caprine arthritis-encephalitis
      virus (CAEV) provirus.
AB  - The complete nucleotide sequence of an integrated provirus of caprine arthritis
      encephalitis virus (CAEV) has been determined. The provirus was defective due to
      extensive G-->A hypermutation. Rather than being a smooth phenomenon distributed
      throughout the genome it was highly erratic with hypermutated and normal regions
      being juxtaposed, probably reflecting local fluctuations in the intracellular
      dCTP pool during reverse transcription of the CAEV genome. The pattern of
      sequence variation within the surface glycoproteins differs subtly from that of
      the primate lentiviruses.

PMID- 7778267
TI  - Isolation of high-affinity RNA ligands to HIV-1 integrase from a random pool.
AB  - We were able to isolate high-affinity RNAs from a random pool that binds to
      integrase protein from the human immunodeficiency virus-type 1 using the
      procedure now known as SELEX. Generally, the RNAs fell into three different
      classes in binding buffer containing 250 mM NaCl: group I class of molecules
      binds integrase with a dissociation constant (Kd) on the order of 10 nM, group II
      molecules had a Kd of about 80 nM, and group III about 800 nM. The RNA with the
      highest affinity from the group I class of molecules, designated P5, was
      characterized using computer modeling, chemical and enzymatic probing, and
      deletion analysis. Our secondary structure model for this RNA suggests
      interactions between looped-out fixed nucleotides and nucleotides from the
      randomized region; a GNRA tetraloop is also in the structure. We showed that our
      integrase was able to process a U5 mimic in vitro. P5 competes effectively for
      binding with the double-stranded DNA mimic of U5 at 180 mM NaCl concentration.

PMID- 7778268
TI  - Evolution of mouse hepatitis virus (MHV) during chronic infection: quasispecies
      nature of the persisting MHV RNA.
AB  - Coronavirus infection of mice has been used extensively as a model for the study
      of acute encephalitis and chronic demyelination. To examine the evolution of
      coronavirus RNA during chronic demyelinating infection, we isolated RNA from
      intracerebrally inoculated mice at 4, 6, 8, 13, 20, and 42 days postinfection and
      used reverse transcription-polymerase chain reaction amplification methods (RT
      PCR) to detect viral sequences. RNA sequences from two viral structural genes,
      the spike gene and the nucleocapsid gene, were detected throughout the chronic
      infection. In contrast, infectious virus was not detectable from brain
      homongenates beyond 13 days postinfection. These results indicate that
      coronavirus RNA persists in the brain at times when infectious virus is not
      detected. To determine if genetic changes were occurring during viral replication
      in the host, we cloned and sequenced the RT-PCR products from the spike and
      nucleocapsid regions and analyzed the sequences for mutations. Sequencing of the
      cloned products revealed that a variety of mutant forms of viral RNA persisted in
      the CNS, including point mutants, deletion mutants, and termination mutants. The
      mutations accumulated during persistent infection in both the spike and the
      nucleocapsid sequences, with greater than 65% of the mutations encoding amino
      acid changes. These results show that a diverse population or quasispecies
      consisting of mutant and deletion variant viral RNAs (which may not be capable of
      producing infectious virus particles) persists in the central nervous system of
      mice during chronic demyelinating infection. The implications of these results
      for the role of persistent viral genetic information in the pathogenesis of
      chronic demyelination are discussed.

PMID- 7778269
TI  - Identification of a novel human zinc finger protein that specifically interacts
      with the activation domain of lentiviral Tat proteins.
AB  - Transcriptional activation of HIV-1 gene expression by the viral Tat protein
      requires the interaction of a cellular cofactor with the Tat activation domain.
      This domain has been shown to consist of the cysteine-rich and core motifs of HIV
      1 Tat and is functionally conserved in the distantly related Tat proteins of HIV
      2 and EIAV. Using the yeast two-hybrid system, we have identified a novel human
      gene product, termed HT2A, that specifically and precisely binds to the
      activation domain of HIV-1 Tat and that can also interact with the HIV-2 and EIAV
      Tat proteins in vivo. We present data further demonstrating that the interaction
      between the activation domain of HIV-1 Tat and the HT2A protein can be readily
      detected in the mammalian cell nucleus. Sequence analysis demonstrates that HT2A
      is a novel member of the C3HC4 or ring finger family of zinc finger proteins that
      includes several known oncogenes and transcription factors. Overall, these data
      suggest that HT2A may play a significant role in mediating the biological
      activity of the HIV-1 Tat protein in vivo.

PMID- 7778270
TI  - Altered dinucleotide content within the latently transcribed regions of the DNA
      of alpha herpes viruses--implications for latent RNA expression and DNA
      structure.
AB  - The alphaherpesviruses establish latent infections in sensory neuronal cells,
      during which a number of latency-associated RNA transcripts (LATs) are produced.
      The reasons for the production of the LATs, however, and the mechanism by which
      the LAT region of the genome remains active during latency are unknown. Here we
      have analysed alphaherpesvirus sequences in an attempt to assess any differences
      between latently active regions of the genomes and the genomes as a whole which
      might be necessary for this differential expression pattern or for the LAT
      function, whatever that might be. We show that the LAT regions of all of the four
      alphaerpesviruses examined exhibit a previously unidentified and marked increase
      in CC + GG dinucleotides within the region and that three of the four viruses
      examined also show a marked decrease in CG + GC dinucleotides. The CC + GG
      increase was shown to occur throughout the LAT regions of these viruses, but the
      GC + CG decrease was shown to be confined only to LATs which are thought to be
      expressed as introns, and also to the intron sequences of the IE1 genes (at least
      for herpes simplex viruses 1 and 2), which overlap the LAT region. Bovine
      herpesvirus, the virus which did not show the GC + CG reduction in its LAT region
      but did show the GG + CC increase, is thought not to express LATs by a mechanism
      involving splicing, again indicating that the CG + GC reduction may be an intron
      related phenomenon and also further suggesting that the two effects of CG + GC
      decrease and GG + CC increase may be independent of one another. Possible reasons
      for these unusual dinucleotide frequencies within the latently active regions of
      the alphaherpesviruses relating to DNA and RNA structure and to LAT function are
      discussed.

PMID- 7778271
TI  - Genetic stability and mutant selection in Sabin 2 strain of oral poliovirus
      vaccine grown under different cell culture conditions.
AB  - Mutations that consistently accumulated in the attenuated Sabin 2 strain of
      poliovirus during propagation in cell cultures were identified by sequence
      heterogeneity assay and quantified by mutant analysis by PCR and restriction
      enzyme cleavage (MAPREC). Eight additional sites previously identified in stool
      isolates were also examined by MAPREC in the virus passages. The pattern of
      selectable mutations and the rate of their accumulation depended on the type and
      confluence of the cell culture and the temperature of virus growth. Five unstable
      genomic sites were identified in Sabin 2 virus passaged 10 times at 34 degrees in
      African green monkey kidney (AGMK) cells, with the mutations accumulating in the
      range 1 to 24%. Accumulation of these mutations did not appear to result in a
      loss of attenuated phenotype since the virus passaged under these conditions
      passed the monkey neurovirulence test (MNVT). The content of the 481-G revertant
      known to be related to neurovirulence in monkeys did not increase. Thus, our
      results suggest that upon growth of Sabin 2 virus in AGMK cells at 34 degrees,
      the key determinant(s) of attenuation remained stable, and the mutations that
      occurred did not affect monkey neurovirulence. In virus passaged 10 times at 37
      degrees in AGMK cells, 4 unstable genomic sites were identified, in some of them
      accumulating up to 12% of the mutants. This virus sample severely failed the
      MNVT. Virus passaged in Vero cells at 34 and 37 degrees accumulated mutants at 7
      and 14 genomic sites, respectively, including 481-G in both cases, with almost
      complete substitution of the original nucleotides at some of the sites. We tested
      44 commercial monopools of Type 2 OPV and found out that all of them contained
      481-G revertants in the range 0.4-1.1%. An increase in the 481-G revertants in
      passaged viruses to the level of 4% and above correlated with failure of these
      samples by the MNVT. Since the pattern of selectable mutations differed in
      viruses grown in the two cell cultures used in this study, specific mutation
      profiles should be determined for each cell substrate used for vaccine production
      to assess manufacturing consistency.

PMID- 7778273
TI  - Developmental resistance in fourth instar Trichoplusia ni orally inoculated with
      Autographa californica M nuclear polyhedrosis virus.
AB  - Larvae of lepidopteran insects commonly become increasingly resistant to
      baculovirus infections as they age. The mechanism responsible for this
      development resistance is not known, but the phenomenon does not occur if the
      viral inoculum is administered intrahemocoelically instead of orally, which is
      the natural route of infection. This observation indicates that the factors
      mediating developmental resistance are operative during infection of the primary
      target tissue, the larval midgut, and not during subsequent systemic infection.
      To learn more about the mechanism of developmental resistance, we orally
      inoculated four cohorts of fourth instar Trichoplusia ni larvae with a
      recombinant of Autographa californica M nuclear polyhedrosis virus expressing a
      reporter gene. While these cohorts differed only by a few hours in age, we found
      increasing resistance to infection in successively older cohorts. By assessing
      the presence and location of infected cells at intervals during the first 48 hr
      after inoculation, we identified two key factors relevant to the resistance
      pattern among the developmental cohorts. These factors were: (i) an age-dependent
      rate of establishing and/or sloughing infected midgut cells and (ii) the ability
      of fourth instar T. ni to completely clear infection of the midgut epithelium by
      ecdysis to the fifth instar.

PMID- 7778272
TI  - Transmissible retrovirus in Epstein-Barr virus-producer B95-8 cells.
AB  - Epstein-Barr virus (EBV) released from the B95-8 marmoset cell line has served as
      a prototype for biologic and biochemical studies of EBV. Here we identify and
      characterize a retrovirus carried by many cultures of B95-8 cells. The
      experiments were stimulated by the isolation of a cDNA clone from B95-8 cells in
      which sequences from the EBV large internal repeat were linked to gag sequences
      similar to those of squirrel monkey retrovirus, human isolate, SMRV-H. However,
      among 413 amino acids predicted from the nucleotide sequence of the gag region of
      the B95-8 SMRV isolate there were 48 amino acid changes that distinguished this
      virus from SMRV-H originally isolated from a human lymphoid cell line by Oda et
      al. (1988, Virology 167, 468-476). Nucleic acid and antibody probes were
      developed for the B95-8 isolate of SMRV. Using such probes, we found that SMRV
      B95-8 was readily transmissible, independent of EBV, as an infectious virus to
      human B and T cell lines. SMRV-B95-8 was highly fusogenic in the presence or
      absence of EBV. The ultrastructural appearance of the B95-8 retrovirus was
      characteristic of a type D retrovirus. Cells dually infected with EBV and SMRV
      B95-8 did not demonstrate increased levels of lytic EB viral replication. SMRV
      B95-8 did not by itself cause lymphocyte immortalization or enhance
      immortalization by EBV. Thus SMRV-B95-8 does not contribute to the major biologic
      properties of the B95-8 strain of EBV.

PMID- 7778274
TI  - Feline immunodeficiency virus (FIV)-specific cytotoxic T lymphocytes from
      chronically infected cats are induced in vitro by retroviral vector-transduced
      feline T cells expressing the FIV capsid protein.
AB  - We have previously reported the presence of feline immunodeficiency virus (FIV)
      specific, major histocompatibility complex (MHC)-restricted cytolytic T
      lymphocytes (CTL) in experimentally FIV-infected cats. However, the fine
      specificity of the CTL and the role of individual FIV proteins in inducing FIV
      specific CTL responses remain unknown. In this study, we examined the in vitro
      induction and activity of FIV p24 capsid-specific CTL obtained from cats that had
      been experimentally infected with FIV Petaluma for 30 to 56 months. An
      amphotropic murine retroviral vector was used to generate transgenic primary
      feline T lymphoblasts that expressed the FIV capsid protein. When the autologous
      capsid-transduced T cells were used in vitro to stimulate CTL responses from
      peripheral blood mononuclear cells of chronically infected cats, MHC-restricted
      lysis of virus-infected target cells was observed. The majority of the CTL
      expressed CD8, and depletion of this population, but not CD4+ cells, effectively
      diminished the CTL activity. When the autologous capsid-transduced T cells were
      used as target cells, lysis by capsid-induced effectors was not observed.
      Analysis of capsid-transduced T cell clones revealed a variable and low level of
      capsid expression among the clones. This study demonstrates the potential for
      using retroviral vectors as a means of inducing CTL effector cells that will
      specifically kill lentivirus-infected cells during lentiviral infection.

PMID- 7778275
TI  - Sequence of ovine adenovirus homologs for 100K hexon assembly, 33K, pVIII, and
      fiber genes: early region E3 is not in the expected location.
AB  - Ovine adenovirus OAV287 was previously isolated from sheep in Western Australia.
      As a first step in characterizing the genome of this virus we have determined the
      sequence of its genome between map units 65 and 81. This region was expected to
      contain the nonessential E3 region which, in other adenoviruses, lies between the
      genes encoding the pVIII and fiber proteins, although its size and complexity
      varies. OAV287 genes coding for the hexon assembly, 33K, pVIII, and fiber
      proteins were identified by their homologies with human Ad2. These genes lie in
      the same relative positions in the OAV287 genome, but the intergenic region
      between the pVIII and the fiber genes is only 197 nucleotides and these appear to
      be incapable of coding for any protein. Thus, the ovine adenovirus E3 region is
      not present in the expected location. In addition, using cDNA synthesis, PCR
      amplification, and nucleotide sequencing we determined the location of splice
      junctions and transcription termination signals in mRNA species encoding these
      proteins. This showed that a family of variably spliced L4 RNAs is produced and
      that the region between the pVIII and the fiber genes contains several signals
      for RNA synthesis and processing. As the E3 region in human adenoviruses is
      nonessential for replication, in many instances it has been replaced with foreign
      DNA during the construction of recombinants. Because of this unexpected
      difference in the organization of the OAV287 genome further experimentation will
      be required to determine whether potential vaccine recombinants can be
      constructed for this adenovirus by making insertions into the pVIII/fiber
      intergenic region.

PMID- 7778276
TI  - Identification and analysis of a putative origin of DNA replication in the
      Choristoneura fumiferana multinucleocapsid nuclear polyhedrosis virus genome.
AB  - A recombinant plasmid containing the Choristoneura fumiferana multinucleocapsid
      nuclear polyhedrosis virus (CfMNPV) HindIII R fragment (m.u. 2.2-3.9) was shown
      to undergo CfMNPV infection-dependent DNA replication in Cf-124T cells.
      Replication of this DNA sequence was detectable by 24 hr p.i. and did not appear
      to have resulted as a consequence of recombination with the virus genome.
      Replication was inhibited by mimosine, an inhibitor of eukaryotic DNA
      replication. These data suggest that HindIII R of CfMNPV DNA contains an origin
      of DNA replication which we call ori1. HindIII R contains five GC-rich and three
      AT-rich regions and a 0.9-kb homologous repeat region 1 (hr1). Two short 440- and
      740-bp contiguous sequences at the right end of the HindIII R fragment separately
      exhibited limited ori function. HindIII R subfragments with optimal ori activity
      contained a cluster of repeated and inverted sequences including nine copies of a
      50-bp homologous repeat sequence (hr1a to hr1i) within hr1. The CfMNPV hr1
      sequence was somewhat homologous with the homologous repeat (hr) of the putative
      Autographa californica MNPV (AcMNPV) replication origins. HindIII Y, another
      CfMNPV DNA fragment containing an hr sequence, hr3, also supported infection
      dependent DNA replication, suggesting that it too contains an ori. Although
      replication of a putative AcMNPV origin (HindIII Q) was detectable in CfMNPV
      infected Cf-124T cells, replication of CfMNPV HindIII R was not detectable in
      AcMNPV-infected Spodoptera frugiperda cells.

PMID- 7778277
TI  - Characterisation and mutational analysis of an ORF 1a-encoding proteinase domain
      responsible for proteolytic processing of the infectious bronchitis virus 1a/1b
      polyprotein.
AB  - Coronavirus gene expression involves proteolytic processing of the mRNA 1-encoded
      polyproteins by viral and cellular proteinases. Recently, we have demonstrated
      that an ORF 1b-encoded 100-kDa protein is proteolytically cleaved from the 1a/1b
      fusion polyprotein by a viral-specific proteinase of the picornavirus 3C
      proteinase group (3C-like proteinase). In this report, the 3C-like proteinase has
      been further analysed by internal deletion of a 2.3-kb fragment between the 3C
      like proteinase-encoding region and ORF 1b and by substitution mutations of its
      catalytic centre as well as the two predicted cleavage sites flanking the 100-kDa
      protein. The results show that internal deletion of ORF 1a sequences from
      nucleotide 9911 to 12227 does not influence the catalytic activity of the
      proteinase in processing of the 1a/1b polyprotein to the 100-kDa protein species.
      Site-directed mutagenesis studies have confirmed that the predicted nucleophilic
      cysteine residue (Cys2922) and a histidine residue encoded by ORF 1a from
      nucleotide 8985 to 8987 (His2820) are essential for the catalytic activity of the
      proteinase, and that the QS(G) dipeptide bonds are its target cleavage sites.
      Substitution mutations of the third component of the putative catalytic triad,
      the glutamic acid 2843 (Glu2843) residue, however, do not affect the processing
      to the 100-kDa protein. In addition, cotransfection experiment shows that the 3C
      like proteinase is capable of trans-cleavage of the 1a/1b polyprotein. These
      studies have confirmed the involvement of the 3C-like proteinase domain in
      processing of the 1a/1b polyprotein, the predicted catalytic centre of the
      proteinase, and its cleavage sites.

PMID- 7778278
TI  - A cis-acting viral protein is not required for the replication of a coronavirus
      defective-interfering RNA.
AB  - Mouse hepatitis virus (MHV), a coronavirus, generates defective-interfering (DI)
      RNAs of different sizes during passages at high multiplicities of infection. All
      MHV DI RNAs characterized so far contain an open reading frame (ORF) encoding a
      fused viral protein; in addition, DI RNAs with a long ORF have a competitive
      advantage over those with a shorter ORF. These findings suggest that DI RNA
      replication may require an ORF encoding a cis-acting viral protein. In this
      study, we used a naturally occurring DI RNA and inserted a 12-nucleotide (nt)
      amber-mutation linker at various positions to truncate the ORF. Most of the
      mutants replicated as well as the wild-type DI RNA, irrespective of the presence
      or absence and the length of the ORF in the RNA. Sequence analysis showed that
      all of the mutants retained the insertional mutations even after two viral
      passages in tissue culture, establishing that the mutant DI RNAs replicated. We
      have further introduced two 3-nucleotide substitutions of the first two AUG
      codons of the ORF, thus completely closing the ORF. This DI RNA replicated as
      well as the wild-type DI, but, after a single passage, the majority of the mutant
      RNAs was replaced by recombinant RNAs which contain a restored functional ORF.
      However, an additional insertion of a 12-nt amber-mutation linker downstream of
      the AUG substitutions prevented recombination, and the DI RNA still replicated.
      These data indicate that DI RNA replication does not require a DI-specific ORF
      encoding cis-acting viral proteins and that a 12-nucleotide insertion could
      prevent or delay the occurrence of RNA recombination, suggesting the importance
      of direct or indirect RNA alignment in homologous RNA recombination.

PMID- 7778279
TI  - Theiler's virus growth in murine macrophage cell lines depends on the state of
      differentiation.
AB  - Theiler's murine encephalomyelitic virus (TMEV) preferentially replicates in
      macrophages in the central nervous system of mice during the persistent phase of
      infection. Macrophages accumulate in demyelinating lesions and are evidently the
      primary cell to harbor virus. To investigate TMEV-macrophage interactions, we
      studied GDVII infection of three cell lines, M1, P388D1, and RAW264.7,
      representing various stages of macrophage differentiation/activation. GDVII virus
      was bound and internalized by RAW264.7 and P388D1 cells, but not by the precursor
      cell line M1. While infection of P388D1 cells produced a typical lytic
      cytopathology with marked loss of cellular activity to 10-20% of the uninfected
      control cells, RAW264.7 cells showed little cytopathology despite a decrease in
      cellular activity of 50-60%. Morphologic changes in infected RAW264.7 cells were
      similar to those occurring after cell activation. Although an infectious center
      assay showed that all P388D1 and RAW264.7 cells were infected, synthesis of viral
      RNA and proteins was markedly reduced and virus titers were restricted compared
      to permissive BHK-21 cells. Infected RAW264.7, but not infected P388D1, cells
      secreted tumor necrosis factor-alpha and nitric oxide. Therefore, depending on
      the differentiation and/or activation state, murine macrophages may be resistant
      to TMEV infection (M1), semipermissive and activated to secrete cytokines
      (RAW264.7), or semipermissive and not activated to secrete cytokines (P388D1).

PMID- 7778280
TI  - Localization of a domain on the paramyxovirus attachment protein required for the
      promotion of cellular fusion by its homologous fusion protein spike.
AB  - The promotion of membrane fusion by the paramyxovirus hemagglutinin-neuraminidase
      (HN) and fusion (F) proteins requires that they be derived from homologous
      viruses, suggesting the possibility that the promotion of fusion requires a virus
      specific communication between the two glycoprotein spikes. We have evaluated the
      ability of chimeric HN proteins, composed of domains from the HN proteins of two
      heterologous members of the group, human parainfluenza virus 3 (hPIV3) and
      Newcastle disease virus (NDV), to complement the F protein of each virus in the
      promotion of fusion. Specificity for the F protein of hPIV3 segregates with a
      segment composed of the transmembrane anchor and the first 82 residues of the
      ectodomain of its HN protein. Specificity of NDV HN for its homologous F protein
      is determined by a similar domain. These findings suggest that determinants
      specific to this segment of the attachment protein spike may be involved in the
      triggering of the fusion process.

PMID- 7778281
TI  - Gene organization of chicken anemia virus.
AB  - The genomic DNA of chicken anemia virus (CAV) was cloned and sequenced from a
      Japanese isolate CAA82-2. The nucleotide sequence of CAA82-2 isolate was 98%
      identical with that of the European Cuxhaven-1 strain (Noteborn et al., J. Virol.
      65, 3131-3139, 1991). Nine open reading frames (ORFs) consisting of more than 100
      nucleotides were found, i.e., four ORFs (CA1-CA4) on the plus strand and five
      ORFs (CA1R-CA5R) on the minus strand. These ORFs with the exception of CA4 are
      conserved between the two CAV isolates. All of these ORFs were expressed in
      Escherichia coli as fusion proteins with beta-galactosidase. By Western blot
      analysis, the CA2 and CA3 fusion proteins were found to react with CAV-infected
      chicken sera. Rabbit hyperimmune sera against the CA1, CA2, and CA3 fusion
      proteins were produced and tested their reactivity to CAV-infected cells. Two
      viral proteins with the apparent size of 54 and 16 kDa reacted with the
      antibodies against CA1 and CA3 fusion proteins, respectively. The 16-kDa protein,
      CA3, was suggested to be a major immunogen on CAV infection.

PMID- 7778282
TI  - The Capsicum L3 gene-mediated resistance against the tobamoviruses is elicited by
      the coat protein.
AB  - The L3 gene is responsible for the hypersensitive response in Capsicum plants
      against infection by tobamoviruses. The resistance conferred by this gene is one
      of the most effective so far described against tobamoviruses. Certain isolates of
      pepper mild mottle virus (PMMV) are the only tobamoviruses able to overcome the
      L3 resistance. Chimeric viral genomes between PMMV-S (to which L3 plants are
      hypersensitive) and PMMV-I (an L3 resistance-breaking isolate) led us to conclude
      that sequence variation within the coat protein gene of both isolates determines
      their different virulence in L3L3 plants. Furthermore, the results indicate that
      a single amino acid substitution, Asn to Met, at position 138 of the PMMV-I coat
      protein is sufficient to induce the hypersensitive response and localization of
      viral infection in C. chinense plants. Finally, the use of a mutant coding for a
      truncated coat protein (maintaining the Met138 coding sequence at the RNA level)
      demonstrates that a functional coat protein is required for elicitation of the L3
      gene-mediated resistance.

PMID- 7778283
TI  - Sequence determination of human papillomavirus type 6a and assembly of virus-like
      particles in Saccharomyces cerevisiae.
AB  - Human papillomavirus 6a (HPV6a), the most abundant HPV6 subtype, was detected in
      a vulvar condyloma acuminatum. The complete genome of HPV6a was cloned, and its
      DNA sequence was shown to be over 97% identical to the HPV6b sequence. Of the
      eight open reading frames (ORFs) of HPV6a, only the imputed amino acid sequence
      of the major capsid protein L1 was identical to the corresponding HPV6b sequence;
      all other HPV6a ORFs showed amino acid changes compared to the HPV6b ORFs. The
      HPV6a L1 or the L1 + L2 ORFs were expressed in the yeast Saccharomyces
      cerevisiae. Self-assembly of the L1 capsid protein into virus-like particles
      (VLPs) was demonstrated both in the L1 as well as L1 + L2 coexpressing yeast
      strains. Copurification of the L1 and L2 proteins showed complex formation of the
      L1 and L2 proteins in the yeast-derived VLPs of coexpressing strains.

PMID- 7778284
TI  - The wild-type Autographa californica nuclear polyhedrosis virus induces apoptosis
      of Spodoptera littoralis cells.
AB  - Spodoptera littoralis cells infected with the Autographa californica multiple
      nuclear polyhedrosis virus (AcMNPV) yielded significantly lower budded virus
      titers than Spodoptera frugiperda-infected cells and produced very low levels of
      polyhedrin. Relative to AcMNPV-infected S. frugiperda SF9 cells viral DNA
      replication was severely reduced in Spodoptera littoralis SL2 cells. Microscopic
      examination of SL2-infected cells revealed progressive cell blebbing starting at
      6-8 hr postinfection and culminating in total cell destruction at 24 hr
      postinfection. The data suggested that AcMNPV-infected SL2 cells undergo
      apoptosis. The occurrence of an active apoptotic process in the infected cells
      was confirmed by: (1) observation of fragmentation of the cell nuclei stained
      with the specific fluorescent dye DAPI (4',6'-diamidino-2-phenylindole) and (2)
      the presence of low-molecular-weight DNA oligomers. Neither SL2 cells infected
      with S. littoralis nuclear polyhedrosis virus (SINPV) nor SF9 cells infected with
      AcMNPV, respectively, showed nuclear fragmentation or oligonucleosomal ladder
      formation.

PMID- 7778286
TI  - Identification, localization, transcription, and sequence analysis of the
      Choristoneura fumiferana nuclear polyhedrosis virus DNA polymerase gene.
AB  - The location of the Choristoneura fumiferana baculovirus DNA polymerase gene was
      determined by hybridization analysis using a probe prepared from the previously
      identified polymerase gene from the Autographa californica multiple nuclear
      polyhedrosis virus. DNA sequence analysis revealed that the Choristoneura
      fumiferana baculovirus DNA polymerase gene consists of 2970 base pairs encoding
      990 amino acids (114.2 kDa). Transcriptional analysis demonstrated that
      overlapping transcripts of 3.2 and 4.6 kb, first detected at 6 hr postinfection,
      potentially coded for the DNA polymerase gene. The major transcription starts
      sites, identified at 6 hr postinfection, mapped to baculovirus consensus early
      start sites CGTGCTCA and CAGT. The relatively low level and late initiation of
      the DNA polymerase gene coupled with our previous data on the temporal control of
      DNA replication and late gene synthesis (Liu and Carstens, 1993) suggests that
      the low virulence of the spruce budworm baculovirus may be related to the
      regulation of its gene expression at the transcriptional level.

PMID- 7778285
TI  - Genetic polymorphism in the rabies virus nucleoprotein gene.
AB  - In an attempt to compare intrinsic and extrinsic genetic diversity of the
      lyssavirus genotypes, 69 rabies virus isolates from various part of the world
      were partially sequenced and compared to 13 representative isolates of the 6
      lyssavirus genotypes. The analysis of their phylogenetic relationships, performed
      on the complete nucleoprotein (N) coding gene (1350 bases), established that the
      rabies virus isolates all belonged to genotype 1 and that at least 11
      phylogenetic lineages could be identified in accordance with their geographical
      localization and species of origin. These lineages diverged mostly by the
      accumulation of synonymous mutations. Stabilizing selection, possibly related to
      host specificity, limits amino acid sequence and antigenic drift. Analyses were
      also performed either on the highly variable 400-base region coding for the amino
      terminus of the N protein or on the 93-base noncoding region corresponding to the
      3' end of the N mRNA, the intergenic N-phosphoprotein (M1) region, and the 5' end
      of the M1 mRNA. These shorter nucleotide sequences were shown to provide
      phylogenetic data suitable for the completion of large epidemiological studies,
      but with less robustness. This latter noncoding sequence, despite a 3.1 times
      higher mutation rate than its adjacent coding N gene, followed a parallel
      evolutionary pattern.

PMID- 7778287
TI  - Identification of S71-related human endogenous retroviral sequences with full
      length pol genes.
AB  - The human genome contains sequences related to the simian sarcoma-associated
      virus SSAV. One of these endogenous retroviral elements, S71, is truncated in the
      pol gene and carries an insertion of a solitary HERV-K LTR. Using a PCR approach
      we have now identified further S71-related retroviral elements that lack the HERV
      K LTR insertion and contain a full-length retroviral reverse transcriptase. Two
      of these sequences, pCRTK1 and pCRTK6, were cloned and further characterized.
      Clones pCRTK1 and pCRTK6 showed between 85 and 90% nucleotide homology to each
      other and to S71 within the "tether" region of the pol gene, indicating that
      pCRTK1 and pCRTK6 clearly belong to the S71 subgroup of C-type-related human
      endogenous retroviral elements. Some point mutations inactivating the reverse
      transcriptase are located at the same positions in pCRTK1 and pCRTK6. Therefore,
      we assume that these S71-related elements were dispersed in the human genome by
      reintegration as defective proviruses, probably using enzymes for
      retrotransposition provided in trans by other retrotransposons or by cellular
      genes. Examination of the presence of S71-related elements in apes and Old World
      monkeys revealed that the deletion of reverse transcriptase sequences in S71 has
      occurred in the lineage of primates prior to the insertion of the HERV-K LTR.

PMID- 7778288
TI  - Comparative pathogenesis of Autographa californica M nuclear polyhedrosis virus
      in larvae of Trichoplusia ni and Heliothis virescens.
AB  - We compared early viral pathogenesis and dose-mortality relationships for larvae
      of two highly susceptible hosts, Trichoplusia ni and Heliothis virescens, using a
      construct of AcMNPV containing the lacZ reporter gene. Larvae were inoculated
      either as newly molted fourth instars (4(0)) or 15 hr after the molt (4(15)). In
      4(0)-inoculated larvae, first lacZ expression was detected in the midgut
      epithelium of T. ni at 4 hr postinoculation (hpi) compared to 18 hpi in H.
      virescens, and systemic infections were initiated from tracheole cells servicing
      the midgut epithelia beginning at 12 and 20 hpi, respectively. The longer viral
      tenure within the midgut and the slower progression of systemic infections within
      H. virescens ultimately contributed to its longer time to death. For 4(0)
      inoculated H. virescens, proportions of lacZ-expressing larvae increased from 18
      hpi until the onset of the molt to the fifth instar at 36 hpi; at this time
      point, the proportion of signaling insects equaled the final larval mortality.
      Viral infections within the midgut epithelium of H. virescens were lost during
      the molt to the fifth instar. Dose-mortality relationships suggested that the
      peritrophic membrane provided little protection from AcMNPV infections for either
      species.

PMID- 7778289
TI  - Immune responses to nucleic acid vaccines to rabies virus.
AB  - A plasmid vector expressing the full-length rabies virus glycoprotein (G protein)
      under the control of the simian virus 40 (SV40) promoter has previously been
      shown to induce upon intramuscular (i.m.) inoculation into mice a specific B- and
      T-cell-mediated immune response and protection against challenge with a virulent
      strain of the virus. Here we tested two parameters that might affect the efficacy
      of this DNA vaccine. First, we replaced the SV40 promoter of the original vector
      with the early promoter derived from cytomegalovirus leaving all other parameters
      of the plasmid intact. Although upon transfection in vitro the two vectors showed
      a striking difference in their ability to cause stable expression of the rabies
      virus G protein, upon i.m. inoculation into mice both constructs induced
      comparable immune responses. Second, we constructed a vector that induces
      expression of a secreted form of rabies G protein by inserting a stop codon just
      upstream of the transmembrane domain of the rabies G protein gene. The immune
      responses to the DNA vaccines expressing the two different forms of the G
      protein, secreted and membrane bound, were compared and found to be similar in
      magnitude. The long-term effect of DNA vaccination was also investigated
      especially with regard to adverse immunological reactions such as the induction
      of unresponsiveness against rabies virus and the development of antibodies to
      DNA. DNA vaccination was found to induce long-lasting immunity to rabies virus
      without apparent negative side effects such as development of T cell tolerance or
      generation of anti-DNA antibodies.

PMID- 7778290
TI  - Mutated forms of human cytomegalovirus glycoprotein B are impaired in inducing
      syncytium formation.
AB  - Human cytomegalovirus (HCMV) glycoprotein B (gB) promotes virion entry into cells
      by fusing the virion envelope with the cellular membrane. We recently reported
      that UB cells (U373 glioblastoma cells constructed to produce HCMV gB
      constitutively) form multinucleate syncytia that are dependent on the density of
      gB in the plasma membrane. In this report, we describe the properties of a clonal
      cell line, UB31-B3, that expressed a spontaneously mutated form of gB which
      lacked the fusion-inducing function of the wild-type molecule, and three UB cell
      lines that were constructed to investigate the effect of specific mutations in gB
      on syncytium formation. Flow cytometry analysis with a pool of monoclonal
      antibodies (mAbs) showed that the UB cells contained a high density of gB, which
      was associated with the cell surface. Immune precipitation experiments with UB31
      B3 cells showed that the mutant gB reacted with all of the mAbs to the ectodomain
      of gB but with none of those to the cytoplasmic carboxy terminus, and that it was
      35 kDa smaller than wild-type gB. Nucleotide sequence analysis showed that a
      termination codon had been introduced after amino acid lysine at position 669 in
      the ectodomain of UB31-B3 gB, generating a truncated glycoprotein. UB31-B3 gB was
      not secreted into the medium and was stably anchored in the plasma membrane,
      which suggested that a hydrophobic stretch of amino acids from 629 to 652 in the
      ectodomain may serve as a membrane anchor for this truncated form. Analysis of
      the UB cell lines expressing deleted forms of gB showed that deletion of all or
      part of the cytoplasmic and transmembrane domains reduced or abolished syncytium
      formation. In contrast, deletion of a major neutralizing region in the ectodomain
      of gB did not alter syncytium formation. Results of these studies indicate that
      different regions of the gB molecule participate in syncytium formation.

PMID- 7778291
TI  - The baculovirus GP64 envelope fusion protein: synthesis, oligomerization, and
      processing.
AB  - The baculovirus GP64 envelope fusion protein (GP64 EFP) is a class I integral
      membrane protein that enters the secretory pathway and is oligomerized and
      extensively processed during transport to the plasma membrane. The kinetics of
      GP64 EFP biosynthesis, oligomerization, and processing in Orgyia pseudotsugata
      multicapsid nuclear polyhedrosis virus (OpMNPV)-infected Lymantria dispar cells
      were examined by pulse label, pulse-chase, and immunoprecipitation experiments.
      Relative rates of GP64 EFP synthesis in OpMNPV-infected L. dispar cells were
      examined at various times throughout the infection cycle. Using pulse labeling
      and immunoprecipitation, GP64 EFP synthesis was detected within 2 hr p.i., and
      the maximal rate of synthesis was observed in the period of 24-26 hr p.i., a time
      coincident with the onset of high level production of budded virus in OpMNPV
      infected L. dispar cells. To determine the oligomeric structure of GP64 EFP, a
      soluble form of OpMNPV GP64 EFP was produced and examined by a combination of gel
      filtration chromatography, nonreducing SDS-PAGE, and mass spectrometry.
      Oligomeric GP64 EFP was identified as a trimeric molecule, that migrates as two
      discrete bands on nonreducing SDS-PAGE. Pulse-chase studies, performed at both
      early (12 hr p.i.) and late (36 hr p.i.) stages of the infection cycle, showed
      that GP64 EFP oligomerization is complete within 15 min after synthesis.
      Efficiency of oligomerization however was relatively low, with less than 33% of
      the synthesized GP64 EFP converted to trimers. The majority of monomeric GP64 EFP
      remaining in the cell appeared to be degraded within 30 to 45 min after
      synthesis. Analysis of the kinetics of carbohydrate processing at early (12 hr
      p.i.) and late (36 hr p.i.) times postinfection showed that for both early and
      late phases of infection, carbohydrate was rapidly added, and processing began
      between 10 and 20 min after GP64 EFP synthesis. Although carbohydrate processing
      was completed within approximately 90 min after synthesis during the early phase,
      the same process required approximately 150 min during the late phase. Thus,
      carbohydrate processing appeared to become less efficient as infection
      progressed. These studies thus show that GP64 EFP undergoes a rapid but
      inefficient oligomerization step that results in a homotrimeric structure for
      GP64 EFP. While carbohydrate addition is rapid, carbohydrate processing requires
      prolonged periods of time (with half-times of 45 to 75 min) and appears to become
      less efficient during the late phase of the infection.

PMID- 7778292
TI  - cis-acting regulatory elements in the bovine immunodeficiency virus long terminal
      repeat.
AB  - Functional cis-acting regulatory elements in the bovine immunodeficiency virus
      (BIV) long terminal repeat (LTR) were identified by deletion mapping and nuclear
      protein gel shift analysis using three BIV-infectible cell lines, Cf2Th, BLAC-20,
      and EREp. Deletion mapping studies indicated that putative NF-kappa B, GRE, AP-4,
      AP-1, CAAT, and ATF/CRE transcription factor elements positively contribute to
      LTR-directed gene expression in each cell line both in the presence and absence
      of the viral transactivator Tat. Sp1 and overlapping AP-3 and retroviral core
      enhancer elements had variable effects on LTR-directed gene expression depending
      on cell type and presence or absence of Tat. In addition, a sequence spanning the
      LTR U5 region and the untranslated viral leader was strongly repressive in all
      cell lines. Tat transactivated the LTR 25-fold over basal levels in a TAR
      dependent manner in Cf2Th cells. In contrast, Tat transactivated the LTR only 2.5
      fold over basal levels in EREp and BLAC-20 cells in a TAR-independent manner.
      Probes for putative NF-kappa B, GRE, Sp1, AP-4, AP-1, overlapping AP-3 and
      retroviral core enhancer, and juxtaposed CAAT and ATF-CRE elements specifically
      bound nuclear proteins from these three cell lines and HeLa cells, with the
      stoichiometry of binding being cell-type dependent. Probes for AP-4, AP-1, and
      juxtaposed CAAT and ATF/CRE elements exhibited greater protein binding with
      extracts from virally infected cells than with extracts from uninfected cells,
      suggesting that viral infection can modulate nuclear factor binding. The present
      studies indicate that several transcription factor elements in the BIV LTR have
      functional roles and that cell type can strongly determine the role they play in
      gene expression.

PMID- 7778294
TI  - Comparison of the response to T-cell activation by integrated HIV-1 and HTLV-1
      LTR-lacZ vectors.
AB  - Human Jurkat T-cell clones containing stably integrated HIV-1 LTR or HTLV-1
      LTR/lacZ vectors were studied to compare the responses of integrated LTRs to T
      cell activation. Responses were compared also with those obtained in parallel
      with Jurkat cells stably expressing lacZ under the control of the cellular
      enhancer element NF-AT of the IL-2 promoter. Activation induced via the cell
      surface TCR/CD3 complex or the CD28 receptor elicited responses from the LTR of
      HIV-1; however, HTLV-1 LTR-directed expression was not observed following
      triggering of these cell surface pathways. Mitogenic activation by elevation of
      intracellular calcium (Ca2+) levels along with protein kinase C (PKC) signals was
      required for optimal expression of the HIV-1 LTR and the NF-AT element; however,
      increased intracellular Ca2+ was inhibitory to PKC-mediated expression from the
      HTLV-1 LTR. Time course experiments revealed a sustained PKC-mediated response by
      the HTLV-1 LTR, which was detectable in the absence of Ca2+ as early as 6 hr
      following stimulation. In contrast to the HTLV-1 LTR, in time course experiments
      the HIV-1 LTR responded to stimulation by mitogenic activation of PKC in the
      absence and presence of Ca2+ and by antiCD3 with lacZ expression beginning as
      early as 3 hr poststimulation. These results suggest that the HTLV-1 LTR appears
      to be refractory to several cellular pathways which are upregulatory to the HIV-1
      LTR.

PMID- 7778293
TI  - Degradation of CD4 induced by human immunodeficiency virus type 1 Vpu protein: a
      predicted alpha-helix structure in the proximal cytoplasmic region of CD4
      contributes to Vpu sensitivity.
AB  - The HIV-1-encoded Vpu protein induces a rapid and specific degradation of CD4
      molecules in the endoplasmic reticulum (ER). In this study, Vpu-induced
      degradation of CD4 in the ER was investigated by quantitative immunoprecipitation
      of CD4 following cotransfection of COS-7 cells with CD4 and Vpu expressors in the
      presence of brefeldin A, a drug that blocks protein transport from the ER to the
      Golgi complex. In order to precisely define the sequence(s) or structural
      element(s) in the CD4 cytoplasmic domain necessary for Vpu-induced degradation, a
      panel of deletion and substitution mutants in the cytoplasmic domain of CD4 was
      generated and analyzed. In agreement with previous reports, our deletion analysis
      indicates that a region encompassing amino acids 411 to 419 (KRLLSEKKT) in the
      cytoplasmic domain of CD4 was required to confer Vpu sensitivity. However, six
      specific substitution mutations within this region did not confer CD4 resistance
      to Vpu, suggesting that neither the amino acid sequence nor the charge of the
      amino acids in this region was critical to Vpu-induced CD4 degradation. A
      dileucine motif that is important for internalization of CD4 and Nef-induced CD4
      down-regulation was also not required for Vpu-induced CD4 degradation.
      Interestingly, two substitution mutants (CD4EMKL and CD4MK407,11PP) located in a
      more proximal cytoplasmic region of CD4 abolished Vpu-induced CD4 degradation.
      Computer-assisted analysis of the substitution and deletion mutants conferring
      CD4 resistance to Vpu-induced degradation indicated that these mutations
      disrupted a putative alpha-helix formed in the proximal cytoplasmic region of
      CD4. Taken together, these studies strongly suggest that a structural element in
      the proximal cytoplasmic region of CD4 contributes to Vpu sensitivity.

PMID- 7778295
TI  - Sequence of the genome of lactate dehydrogenase-elevating virus: heterogenicity
      between strains P and C.
AB  - The complete nucleotide sequence of genomic RNA (14104 nt) of one strain of
      lactate dehydrogenase-elevating virus (LDV), LDV-P, is reported. It exhibits only
      about 80% nucleotide identity with the sequence reported for another LDV strain,
      LDV-C (Godeny et al., Virology 194, 585-596 (1993), and is 68 nucleotides shorter
      than the reported LDV-C sequence. The difference in length is largely due to the
      lack of a 59-nucleotide-long direct repeat in ORF 1a of the reported LDV-C
      sequence. Sequence analysis of a total of 1.4 kb of ORF 1a of LDV-C via reverse
      transcription/polymerase chain reaction (RT/PCR) technology failed to confirm the
      presence of this repeat in the LDV-C genome as well as of 24 deletions/insertions
      of single nucleotides that give rise to apparent transient reading frame
      differences between the LDV-P and LDV-C genomes and might have represented
      frameshift mutations. An additional 35 nucleotides in ORF 1a of the RT/PCR LDV-C
      products were the same as in the LDV-P rather than the reported LDV-C genome. The
      nucleotide sequences of the 5' leader and the 3' noncoding ends of the two
      genomes and the heptanucleotides involved in joining the 5' leader to the bodies
      of the subgenomic mRNAs were highly conserved or identical. The predicted LDV-P
      proteins, however, differed from those predicted for the LDV-C proteins between
      25% for the ORF 2 protein and 1% for the ORF 7 nucleocapsid protein. All
      functional motifs of the ORF 1a and ORF 1b proteins were conserved. The ORF 1a
      protein possesses 11 potential transmembrane segments that flank the serine
      protease domain.

PMID- 7778296
TI  - Lack of pseudotype formation between human immunodeficiency virus type 1 and
      Epstein-Barr virus in productively coinfected B lymphoblastoid cell lines.
AB  - Human immunodeficiency virus (HIV) can form pseudotypes with other enveloped
      viruses, including herpes simplex virus, when the two viruses coinfect the same
      cell. Pseudotypes between HIV and Epstein-Barr virus (EBV) have not been
      described. We observed unusually high levels of HIV-1 replication in SCID mice
      transplanted with human peripheral blood mononuclear cells (hu-PBL-SCID mice)
      when the mice developed EBV-associated human B cell lymphoproliferative disease.
      If this enhancement of HIV-1 replication were due to pseudotype formation rather
      than direct infection of B lymphoblastic cells by HIV-1, the pseudotypes could
      pose a novel biohazard to laboratory workers. To assess whether HIV-1 and EBV can
      form such pseudotypes, we established and characterized CD4-positive B
      lymphoblastoid cell lines (LCL) that contained cells infected with both EBV and
      HIV-1. A high-titered virus pool from these LCL could induce HIV infection in the
      Burkitt's lymphoma (BL) line BJA-B, but not in the BL line Ramos. Infection of
      BJA-B was blocked by neutralizing antibody to HIV gp120 but not by neutralizing
      anti-EBV gp350. These experiments provide no evidence for pseudotype formation,
      suggesting a low risk for EBV:HIV pseudotypes in natural infection of humans or
      in human cells transplanted to SCID mice.

PMID- 7778297
TI  - Fusogenic determinants of highly cytopathic subtype D Zairian isolate HIV-1 NDK.
AB  - Phenotypic characterization of subtype B strains of human immunodeficiency virus
      type 1 (HIV-1) indicates that the major determinants of their cytopathogenicity
      and tropism are contained in the gene coding for the envelope glycoprotein gp120,
      namely in its variable regions V1, V2, and V3. Recombinant viruses derived from
      HIV-1 LAV, the subtype B prototype virus, and HIV-1 NDK, the Zairian subtype D
      virus highly cytopathic for CD4-positive lymphocytes, were used to elucidate
      genetic control of fusogenic functions in subtype D viruses. Our data demonstrate
      that multigenic determination of fusogenic properties is more complex in the
      subtype D than in clade B viruses. Variability in three regions of HIV-1 NDK
      genome correlated with formation of large syncytia. These regions consisted of
      the matrix protein, the C-terminal portion of vpr up to the C1 region of gp120,
      and the V1-V3 regions of gp120. Variability in the envelope glycoprotein but not
      in other regions of the HIV-1 genome was related to enhanced resistance of HIV-1
      NDK to treatment of target cells with OKT4-A anti-CD4 MAb. Therefore, a different
      genetic control affects two aspects of HIV-1 fusogenicity: (i) variability in the
      envelope glycoprotein itself is sufficient to influence a virus-to-cell fusion at
      the virus/cell entry, and (ii) a more complex genetic function including genes of
      matrix protein and envelope glycoprotein is related to variability of cell-to
      cell fusion during formation of syncytium.

PMID- 7778298
TI  - A single amino acid changes enhances the fusion promotion activity of human
      parainfluenza virus type 1 hemagglutinin-neuraminidase glycoprotein.
AB  - Clinical isolates of human parainfluenza virus type 1 in our laboratory were
      found to induce significantly different degrees of syncytium formation in CV-1
      cells. Sequence analysis of high- and low-fusion strains suggested that the
      hemagglutinin-neuraminidase (HN) protein was responsible for the differences in
      fusion activity. We exploited the strain differences to define the specific amino
      acid residues of the HN protein which were responsible for the low and high
      fusion activities. The HN proteins of the two low-fusogenic strains 8389 and
      45785, and the highly fusogenic strain C35, were expressed in HeLa T4+ cells and
      their fusion promotion activities were compared. When coexpressed with C35 F, HNs
      from the low-fusogenic viruses were associated with much lower fusion activity
      than was C35 HN, suggesting that the HN proteins modified the fusogenicity of the
      viruses. To identify the region of the HN protein responsible for this
      difference, we constructed a series of chimeric HN cDNAs combining 8389 and C35
      sequences. All chimeric HNs that contained C35 sequence in the central 36% of the
      protein exhibited high fusion promotion activity. Further analysis by site
      directed mutagenesis showed that a single Asn-to-Lys substitution at position 242
      converted 8389 HN to a highly fusion-promoting molecule. Thus, the globular head
      of the HN molecule is involved in fusion promotion activity.

PMID- 7778300
TI  - Do hemagglutinin genes of highly pathogenic avian influenza viruses constitute
      unique phylogenetic lineages?
AB  - Avian influenza A viruses of the H5 and H7 subtypes periodically cause severe
      outbreaks of disease in poultry. The question we wished to address in this study
      is whether these highly pathogenic strains constitute unique lineages or whether
      they and related nonpathogenic viruses are derived from common ancestors in the
      wild bird reservoir. We therefore compared the nucleotide and amino acid
      sequences of the hemagglutinin (HA) genes of 15 H5 and 26 H7 influenza A viruses
      isolated over 91 years from a variety of host species in Eurasia, Africa,
      Australia, and North America. Phylogenetic analysis indicated that the HA genes
      of H5 and H7 viruses that cause severe disease in domestic birds do not form
      unique lineages but share common ancestors with nonpathogenic H5 and H7 viruses.
      These findings predict that highly pathogenic avian H5 and H7 influenza A viruses
      will continue to emerge from wild bird reservoirs. Another important question is
      whether H7 influenza viruses found in mammalian species are derived from avian
      strains. We included eight equine influenza viruses and one seal isolate in the
      phylogenetic analysis of H7 HA genes. We could show that the HA genes of both,
      the equine and the seal viruses, shared ancestors with avian H7 HA genes. This
      indicates that currently circulating H7 viruses with an avian HA gene may have
      the potential to adapt to mammalian species and to cause an influenza outbreak in
      the new host.

PMID- 7778299
TI  - Deletion of thymidine kinase gene attenuates channel catfish herpesvirus while
      maintaining infectivity.
AB  - A recombinant thymidine kinase (TK) gene deletion mutant of channel catfish
      herpesvirus (CCV) was constructed and compared to the parent virus for
      replicative ability in cell culture, for the ability to infect, replicate, and
      cause lethal disease in the channel catfish host, and for the ability to induce
      protective immunity in channel catfish fingerlings. There was no difference
      between parent CCV and the TK-negative mutant (CCVTK-) in viral production in
      cell culture. However, in immersion challenge trials, 100-fold more CCVTK- than
      parent CCV was required to kill similar numbers of channel catfish fingerlings.
      The attenuation was confirmed as a TK-associated characteristic in marker rescue;
      the revertant regained the pathogenic characteristic of the parent virus. When
      catfish were immersion challenged with equal amounts of CCVTK- or CCV, the levels
      of virus isolated from the posterior kidney were similar through the peak
      production period which occurred 4 days postinfection. Subsequently, CCVTK-
      levels decreased dramatically when compared to CCV levels. Exposure to CCVTK-
      induced protective immunity against challenge with a lethal dose of wild-type
      CCV. The degree of protection provided by CCVTK- was related to the dose of CCVTK
      given. This study demonstrates that the genetically distant CCV retains
      recombination properties and TK-associated attenuation properties of
      herpesviruses of higher vertebrates. Additionally, the unique characteristic of
      CCV containing two copies of the TK gene did not prevent the use of this gene as
      a selectable site of homologous recombination.

PMID- 7778301
TI  - Analysis of ALV-based packaging cell lines for production of contaminant
      defective viruses.
AB  - We have previously described avian leukosis virus-based packaging cell lines that
      express gag, pol, and env proteins from two transcomplementing genomes and
      produce helper-free stocks of retroviral vectors with different host ranges. In
      this report, we demonstrated that (i) despite the deletion of the psi packaging
      sequence, the packaging-defective transcomplementing retroviral transcripts were
      packaged into virions at a level that could reach 2.3% of a wild-type virus
      packaging level and (ii) despite deletion of the 3' LTR, these genomes were
      transferred along with the vector to target cells. As these genomes were also
      bearing a selectable gene, titers of the resulting contaminant particles could be
      estimated, depending on the cell line to be between 0 and 6 infectious
      particles/ml of supernatant.

PMID- 7778302
TI  - Mutations in the p53 tumor-suppressor gene are frequently associated with bovine
      leukemia virus-induced leukemogenesis in cattle but not in sheep.
AB  - To investigate the mechanisms of bovine leukemia virus (BLV)-induced
      leukemogenesis, we have examined the alterations of the p53 tumor-suppressor gene
      in sheep and in cattle. The sequences of the open reading frames as well as the
      intron/exon junctions of the ovine and bovine p53 genes were determined.
      Pathological samples were screened for the presence of p53 mutations using a
      single-strand conformational polymorphism assay. Five of ten BLV-induced bovine
      tumors harbored p53 mutations. In contrast, only one of seven samples
      corresponding to circulating leukocytes from cattle in persistent lymphocytosis
      showed an alteration of the p53 gene. Surprisingly, no p53 mutation was found
      among the 10 BLV-induced sheep tumors analyzed. Altogether, these data indicate
      that p53 mutations are linked to BLV-induced leukemogenesis in cattle at the
      transition to the lymphomic stage. These results also enlighten different
      molecular mechanisms involved in sheep and in cattle during BLV-induced
      pathogenesis.

PMID- 7778303
TI  - Fidelity of homologous recombination in vaccinia virus DNA.
AB  - The fidelity of homologous recombination in vaccinia virus (VV) DNA was examined
      by constructing a viral recombinant whose genome contained a copy of the
      Escherichia coli lac z gene in which the central third of the gene was repeated
      on either side of the VV thymidine kinase (tk) gene. In this virus, homologous
      DNA recombination and consequent excision of the tk gene were necessary to
      restore the open reading frame for beta-galactosidase and thereby to confer a lac
      z+ phenotype. Imprecise recombination was predicted to increase the frequency of
      lac z- virus. However, after several passages during which almost every viral
      genome underwent homologous recombination, the frequency of lac z- plaques was
      indistinguishable from that of a control virus that could express beta
      galactosidase without prior recombination. We conclude that homologous
      recombination in VV DNA occurs with perfect fidelity at least 99% of the time.

PMID- 7778304
TI  - Minimum origin requirements for linear duplex AAV DNA replication in vitro.
AB  - We have investigated the minimal requirements for a functional origin of DNA
      replication in an in vitro assay which requires the adeno-associated virus (AAV)
      Rep 68/78 protein. When a linear duplex template was used, initiation of one
      round of DNA replication was achieved when nucleotides 1-56 of the AAV inverted
      terminal repeat (in the flop orientation) were present at the terminus of the
      template. A terminal resolution site was not required. Deletion of an additional
      11 nucleotides from the terminal repeat blocked the reaction.

PMID- 7778305
TI  - Cell-to-cell fusion, but not virus entry in macrophages by T-cell line tropic HIV
      1 strains: a V3 loop-determined restriction.
AB  - T-cell lines chronically infected with laboratory adapted, T-cell tropic HIV-1
      strains (RF, LAI, CBL-4, and NY5) induced syncytia after cocultivation with
      primary macrophages. Such fusion-competent strains, however, replicated
      inefficiently after cell-free infection of macrophage cultures. Evidence based on
      proviral DNA synthesis, pseudotype penetration, and a V3 loop mutation revealed
      that cell-free infection was restricted at a prepenetration stage in entry and
      controlled by envelope sequences. Our results suggest that primary macrophages
      are sensitive to cell-to-cell but not to virion-to-cell fusion induced by the
      envelope glycoproteins of several T-cell tropic HIV-1 strains.

PMID- 7778307
TI  - The value of individualism.

PMID- 7778306
TI  - Interaction of Sendai viral F, HN, and M proteins with host cytoskeletal and
      lipid components in Sendai virus-infected BHK cells.
AB  - We have studied the interaction of Sendai viral fusion (F),
      hemagglutinin/neuraminidase (H/N), and matrix (M) proteins with host cytoskeletal
      and lipid components in Sendai virus-infected BHK cells using two nonionic
      detergents Triton X-100 (TX-100) and octyl glucoside (OG). Our results show that
      while M protein acquired resistance to both TX-100 and OG extraction, F and HN
      exhibited insolubility only to TX-100 but not to OG. Furthermore, in the presence
      of high salt (1 M NaCl), M, but not F or HN, became TX-100 soluble. Both type I
      (F) and type II (HN) viral glycoproteins acquired TX-100 insolubility at a late
      stage during exocytic transport as they acquired endo H resistance. In addition,
      TX-100 insoluble F and HN exhibited a lighter density compared to TX-100
      resistant M by flotation analysis. Using recombinant vaccinia viruses that
      express Sendai virus HN, F, or M protein individually, we observed that each
      viral protein (F, HN, or M) was independently capable of acquiring TX-100
      insolubility in the absence of other viral components. These results would
      indicate that while Sendai viral F and HN became bound to TX-100 insoluble
      lipids, M protein bound ionically to TX-100 insoluble cytoskeletal components and
      not to TX-100 insoluble lipids.

PMID- 7778308
TI  - Emotions, coping, and psychological well-being in elderly people with arthritis.
AB  - Rheumatoid arthritis, the most destructive and crippling of all forms of
      arthritis, poses a number of stressful demands on individuals. In a sample of
      elderly women (N = 59) and men (N = 19) with rheumatoid arthritis, the
      relationship between social economic status, severity of impairment, sex, stress
      emotions, type of coping strategy, and psychological well-being was explored.
      Path analysis results indicated that higher social economic status was directly
      related to greater use of confrontive types of coping strategies. Severity of
      impairment had a direct, negative influence on psychological well-being, but sex
      was not an important factor. Optimistic coping strategies were used most often
      and emotive coping strategies the least.

PMID- 7778309
TI  - Christian patients' views of spiritual care.
AB  - The purpose of this qualitative study was to discover the essential structure of
      spiritual care by obtaining detailed descriptions of the phenomenon from those
      who have received such care. Data were generated through open-ended interviews
      with 10 Christian volunteers and analyzed using Colaizzi's phenomenological
      approach. Findings revealed that spiritual care was given and received in a
      context in which the recipient was vulnerable and receptive to spiritual care.
      Three theme clusters included enabling transcendence of the present situations
      for higher meaning and purpose, enabling hope, and establishing connectedness.
      Implications for nurse clinicians, educators, and researchers are discussed.

PMID- 7778311
TI  - Risking involvement with cancer patients.
AB  - The helping relationship has been identified by Brammer (1988) as central to the
      practice of nursing. This study explored the process of developing special
      relationships with cancer patients. Interviews were conducted with 32 nursing
      personnel. The grounded theory method of constant comparative analysis was
      selected for this investigation. An open-ended interview guide explored the
      difference between the usual relationships nurses had and the special
      relationships they formed with selected patients. A basic psychosocial process,
      "risking involvement" in special relationships with cancer patients, was
      identified. The willingness to risk involvement took the forms of resisting
      involvement or practicing involvement.

PMID- 7778310
TI  - Moral reasoning among professional caregivers in nursing homes.
AB  - This article examines the responses from a sample of Swedish nursing home staff
      workers to a hypothetical ethical conflict highlighting the issue of restraint.
      The responses were analyzed in two ways: first, Piaget's theory of moral
      development was used to differentiate between "autonomous" and "heteronomous"
      awareness, and second, the responses were analyzed from the perspective of
      ethical principles, that is, autonomy, beneficence, nonmaleficence, and justice.
      The findings indicate that autonomous ethical awareness took precedence over
      heteronomous ethical awareness. The dominant moral values were the principle of
      beneficence, followed by the principle of autonomy.

PMID- 7778312
TI  - Characteristics of intuitive nurses.
AB  - A description is provided of the process used to verify characteristics of
      intuitive nurses that had been reported in the literature. These characteristics
      supplied the framework for construction of the Miller Intuitiveness Instrument
      (MII) reported earlier (Miller, 1993). Evidence for validity of the MII was
      provided in the Miller (1993) study by examining factor analyses and correlations
      with the intuitive component of the Myers-Briggs Type Indicator (MBTI). The
      following characteristics were subsequently verified: Intuitive nurses are
      willing to act on their intuitions, are skilled clinicians, and incorporate a
      spiritual component in their practices. In addition, intuitive nurses express an
      interest in the abstract nature of things and are risk takers. Intuitive nurses
      prefer intuition to sensing (as reflected by the MBTI) as a way to take in
      information. They are extroverted and express confidence in their intuitions.
      Likewise, nurses who delay making decisions until all the information is in are
      more intuitive than those who make decisions abruptly.

PMID- 7778313
TI  - Structure and faculty perception of climate in schools of nursing.
AB  - The purpose of this descriptive study was to explore the relationship between
      dimensions of structure (i.e., centralization, formalization, and complexity) and
      climate in schools of nursing, using the framework of contingency theory. Data
      were collected from 111 full-time faculty from 11 baccalaureate and 7 associate
      degree schools of nursing in Minnesota accredited by the National League for
      Nursing. The findings indicated a significant relationship between structure and
      climate in the schools of nursing. Dispersion of influence throughout the school
      was associated with a more favorable climate. A higher degree of supervision by
      superiors was related to a less favorable climate.

PMID- 7778314
TI  - Comparison of subjects who fully versus minimally participated in a breast
      feeding study.
AB  - Sampling bias occurs in research when a large percentage of subjects who are
      eligible for the study refuse to participate. During Phase I of a two-phase
      multisite Mother-Baby Feeding Project, approximately 50% of the 235 potential
      participants at four of five sites declined to enter the study. This report
      compares subjects who fully participated with those who minimally participated
      and explores factors related to subjects' refusal to participate. Data regarding
      sociodemographic data, breast-feeding experience, and reason for refusal were
      collected from 92 subjects who declined to enter but agreed to minimally
      participate. The fully participating subjects had more education than those who
      participated minimally. However, the breast-feeding outcomes studied were similar
      for both groups. This provides support for generalizing additional study findings
      beyond the group of fully participating subjects when considering breast-feeding
      outcomes. Findings lend insight into the problem of subject recruitment that is
      not well-addressed in the nursing literature.

PMID- 7778315
TI  - Computer networks as a source of research subjects.
AB  - Acquiring access to subjects for research is a problem that confronts many nurse
      researchers. Methods commonly used for subject recruitment may provide an
      inadequate subject pool for successful study completion. Computer networks can be
      a viable alternative for subject recruitment through the use of on-line bulletin
      boards and support groups for many health-related issues. The use of an on-line
      network to augment the subject pool in one study is briefly described. Nurses are
      encouraged to use this technology as one creative way to recruit and access
      subjects in order to continue to be successful in the clinical research arena.

PMID- 7778316
TI  - [Prostaglandins and prostaglandin analogs: experimental studies on their effect
      of tumor metastasis].
AB  - Metastatic tumor spread is regarded as the highest degree of malignancy of tumors
      and generally determines the prognosis. Before clinically detectable metastases
      are evident in distant organs, tumor cells interact with cellular and non
      cellular components of the host as they complete the multistep process referred
      to as the metastatic cascade. Many investigational drugs acting at different
      levels of the metastatic process were tested for beneficial effects on
      metastasis. Because of the influence of prostaglandins on host components
      essential for tumor metastasis, this group of a compounds was tested in model of
      tumor growth and metastasis. Prostaglandins of the E, D and J series inhibit
      growth of variety of tumor cells and cause a reduction of primary tumor growth in
      vivo. The antiproliferative action of prostaglandins of the E series seems to be
      related to an induction of differentiation, whereas prostaglandins of the D and J
      series mediate growth inhibition by a blockade of the cell cycle and an
      inhibition of RNA and DNA synthesis. There is no conclusive evidence that
      prostaglandins of the E, D and J series may specifically interfere with
      mechanisms of tumor metastasis. In contrast to the prostaglandins of the E, D and
      J series, prostacyclin has been shown to inhibit several processes involved in
      tumor metastasis, but without exerting a direct cytotoxic effect on tumor cells.
      Our own studies have shown that Cicaprost, a stable prostacyclin analogue,
      prevents metastasis if given continuously from the day of tumor implantation, and
      is also effective in reducing metastasis if treatment is begun following surgical
      removal of the primary tumor, when micrometastases are already present.

PMID- 7778317
TI  - [Stimulation of platelet mitogen-induced prostaglandin I2 synthesis in
      periodontal tissue of cyclosporin A treated patients].
AB  - Cyclosporine A (CsA) is a highly potent immunosuppressive agent that has proven
      to be particularly useful in organ transplantation. Like phenytoin and the
      calcium antagonists, this drug may be associated with gingival hyperplasia. This
      study examined the interaction of platelet derived growth factor (PDGF) with
      prostaglandin I2 (PGI2)--a potent mediator in inflammation and bone resorption.
      PGI2 synthesis was examined by bioassay in gingival tissue from rats, rabbits and
      humans. Gingival tissue from CsA-treated patients generates less PGI2. PDGF
      causes a dose-dependent increase in PGI2 release in both CsA-treated and control
      subjects. The actual and percentage increase in PGI2 synthesis, however, was
      significantly higher in control tissue. While PDGF on the other hand modulated
      cellular proliferation, it causes on the other hand liberation of PGI2 from
      gingival tissue, thus interfering with its own action and further synthesis. If
      the PGI2 response is insufficient as after CsA therapy, the proliferative action
      might dominate. These findings therefore suggest an important pathogenetic role
      of PDGF and possibly other growth factors in CsA-induced gingival hyperplasia.
      "CsA gingivitis" seems to be a predominantly proliferative process, whereby
      inflammatory reactions appear only as a secondary phenomenon.

PMID- 7778319
TI  - [Counseling in smoking--therapy for smoking--help for the smoker].

PMID- 7778318
TI  - The mechanism of anti-thrombotic, thrombolytic and fibrinolytic actions of
      camonagrel--a new thromboxane synthase inhibitor.
AB  - So far pharmacological consequences of inhibition of thromboxane A2 (TXA2)
      synthase by imidazole derivatives (e.g., camonagrel or dazoxiben) were linked to
      suppression of platelet activity. Here we report that in patients with peripheral
      atherosclerosis or in cats with extracorporeal thrombogenesis treatment with
      camonagrel is associated with activation of fibrinolysis or thrombolysis. These
      phenomena seem to be related to the camonagrel-induced shift in metabolism of
      prostaglandin endoperoxides from TXA2 to prostacyclin (PGI2), although in an in
      vitro model the involvement of the L-arginine/nitric oxide pathway cannot be
      excluded. In cats camonagrel (10 mg/kg i.v.) produced not only a fall in TXB2 but
      also a rise in 6-keto-PGF1 alpha and no change in cyclic-GMP plasma levels. This
      points to PGI2 rather than to nitric oxide as an in vivo mediator of camonagrel
      induced thrombolysis. The crucial role of endogenous PGI2 in the thrombolytic
      response to camonagrel in cats was evidenced by its blockade following
      pretreatment of animals with a megadose of aspirin (50 mg/kg i.v.) and lack of
      any effect on pretreatment with L-NAME (100 micrograms/kg/min, i.v.). Obviously
      TXA2 synthase inhibitors (e.g., camonagrel) and cyclo-oxygenase inhibitors (e.g.,
      aspirin) antagonize each other in their anti-thrombotic actions and must not be
      administered at the same time. Furthermore, in patients camonagrel (800 mg
      orally) suppressed TXA2 generation by 99.5% and doubled the plasma level of 6
      keto-PGF1 alpha.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778320
TI  - [Therapy for smoking: a challenge for the physician].
AB  - Smoking cessation is an outstanding and absolute necessity. But there is less
      possibility of permanent cessation by the first treatment. Combined therapy (e.
      g. psychological and drugs etc) will reduce relapses. Frequent information of the
      public via the media is most important and improves the changes of lasting
      smoking cessation. No doubt smoking cessation has great relevance in health
      policy and should be supported by all institutions concerned.

PMID- 7778321
TI  - [Psychological and physiological dependence in smokers and there effect on
      motivation for smoking cessation].
AB  - The typical onset of cigarette smoking is determined on various psychological and
      social factors. The period of experimental smoking may be followed by
      habituation. Habituation involves development of skill in inhalation and
      regulation of nicotine dose, becoming accustomed to the mood-altering and other
      pharmacologic effects of nicotine, and development of a pattern of conditioned
      reinforcement from smoking. Many smokers continue to smoke because nicotine helps
      them to regulate mood. The nicotine intake leads promptly and noticeable to
      pleasant, desired psychotropic effects. In the event of physical dependence, the
      occurrence of withdrawal symptoms results in renewed nicotine intake.
      Psychological and physiological dependence could be very different among smokers
      and this has important implications on the motivation for smoking cessation.
      Using the Fagerstrom Test for Nicotine Dependence (FTND) to assess nicotine
      dependence in a population 6.000 randomly selected Austrians were interviewed.
      42% of men and 27% of women were found to be smokers. 3 groups of smokers
      differing in dependence can be described: 36.5% are nicotine addicted; 30.2% must
      be psychosocial dependent because they show nearly no sign of nicotine
      dependence; and there is a group between, difficult to classify them as more
      psychological or more nicotine addicted.

PMID- 7778322
TI  - [Women and smoking].
AB  - Of the 300,000 deaths attributable to smoking among women in developed countries
      in 1985, 21% were coded to lung cancer, for example, 41% to cardiovascular
      diseases, primarily coronary heart disease and stroke, and 18% to chronic
      obstructive pulmonary disease. Overall, female deaths rates from lung cancer in
      developed countries increased by almost 200% between 1957 and 1987. Smoking and
      tobacco consumption is a health risk for women at all ages. All women, regardless
      whether they are pregnant, performing oral contraception or estrogen replacement
      should not smoke; if they are not able to stop on their own, appropriate
      counselling and therapy should be provided according to the state of the art.
      Women who smoke typically go through the menopause 2 or 3 years earlier than non
      smokers. Cigarette smoking to increase the risk of estrogen-deficiency diseases,
      as cardiovascular risk and postmenopausal osteoporosis. Many women want to give
      up smoking for a number of reasons, such as health, freedom from smoking
      dependence, financial worries and of course pregnancy. Women find it more
      difficult to quit than men because of lack of social support, more reliance on
      cigarette to cope with stress and anxiety and fear of weight gain. Although many
      women manage to refrain from smoking for a long, they may relapse in situations
      involving negative emotions, such as conflicts, stress, loss. Men however, tend
      to relapse in positive situations, such as social events. Smoking cessation
      programmes have to cover specifically women's need including basic health
      education, discussion of withdrawal symptoms, strategies to maintain non-smoking
      and prevent relapse, continuing group support, stress management, advice on
      weight management, nutrition, fitness and exercise.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7778323
TI  - Nicotine chewing gum and nicotine patch.
AB  - The nicotine gum is a flexible dosing form that allows for self-titration of
      nicotine. In order to secure adequate use instructions and guidance are
      necessary. The patches are fixed dose systems with no possibility to adjust dose,
      generally or momentarily. Because of its convenience to use, patch may be the
      first choice in a general practice setting while gum may prove more effective in
      a cessation clinic setting where more time and experience is available. Using
      both patch and gum in combination a certain base level of nicotine is established
      with patch, often insufficient in itself, but with adding of gum the desire for
      smoking will be better controlled.

PMID- 7778324
TI  - [Smoking cessation in a rehabilitation center].
AB  - Diseases related to smoking are of enormous social and medical importance and
      thereby justify great efforts in all areas of prevention. Apart from the general
      practitioner, the hospital probably provides the ideal setting to motivate
      smokers to give up smoking. In the past 5 years 656 patients participated in such
      a programme in our rehabilitation centre. After an average of 1 year 265 of these
      patients were interviewed about their smoking habits. 40% of them had completely
      given up smoking. As we can see, the long-term results are good. Programmes to
      help smokers to give up their habit are certainly necessary and have successfully
      been tested.

PMID- 7778325
TI  - [Smoking cessation in the hospital].
AB  - The paper surveys methods, experiences and problems in our smoking cessation
      ambulance we run in our hospital since 1980. In smokers lung function tests
      showed more restrictive then obstructive ventilation problems. This is in
      opposite to international literature. Therapy was successful in 48%.

PMID- 7778326
TI  - [Smoking cessation at work exemplified by "action blanca casa", a project for
      smoking cessation in the D. Swarovski & Co., Wattens, firm].
AB  - Recent studies about the efficacy of smoking cessation programs in the workplace
      have brought up to common difficulties. Only long-term-programs show remarkable
      effects on smoking habits of the workers. Presenting ongoing long-term strategies
      for open discussion can improve the design of more powerful cessation programs in
      the future. Our program as an important part of modern "human resources
      management" is demonstrated and the results after 18 months are discussed.

PMID- 7778327
TI  - [Smoking and prevention at the work site].
AB  - Risk factors for smoking are seduction of apprentices, but also work monotony,
      stress and indolence. Model prevention programs for workers proved to be
      effective in combining individual (smoking, nutrition, blood pressure) and
      occupational risk reduction. A smoking cessation program at the workplace is a
      group dynamic process and has to include the protection of nonsmokers from ETS.
      With a new workers protection law Austria has started to improve the protection
      of nonsmokers at the workplace according to the EEA treaty.

PMID- 7778328
TI  - A better way to reduce AFDC costs.

PMID- 7778329
TI  - Do seatbelts save lives?

PMID- 7778330
TI  - Conjoint screening questionnaires for alcohol and other drug abuse: criterion
      validity in a primary care practice.
AB  - The US Preventive Services Task Force recommended that physicians use the CAGE
      questions to screen patients for alcohol abuse. A similarly brief screening
      instrument for abuse of other drugs is needed. Two conjoint screening
      questionnaires for alcohol and other drug abuse were adapted from the CAGE
      questions and the Short Michigan Alcoholism Screening Test (SMAST). For 124
      patients of an academic, community family practice, the conjoint questionnaires
      and their forerunners were compared with DSM-III-R diagnoses of substance use
      disorders as measured by the Diagnostic Interview Schedule-Revised (DIS-R). The
      SMAST and its conjoint analog exhibited low sensitivity. The CAGE Adapted to
      Include Drugs (CAGE-AID) was more sensitive but less specific for substance abuse
      than the CAGE, especially when a reduced criterion score was employed. The CAGE
      AID was more sensitive than the CAGE for subjects of varying sex, income, and
      level of education, as well as most patterns of substance use disorders. The
      diminished specificity of the CAGE-AID may have been, at least in part,
      artifactual. The CAGE-AID holds promise for identifying primary care patients
      with alcohol and drug disorders.

PMID- 7778331
TI  - Necrotizing granulomatous cervical lymphadenitis associated with B lymphocyte
      abnormalities and a positive PPD reaction.
AB  - Sarcoidosis is a diagnosis often made by exclusion. We present a case of what we
      believe is sarcoidosis presenting as cervical lymphadenopathy. Complicating
      issues in this patient included B lymphocyte abnormalities, and a positive PPD
      reaction. The patient continues to be steroid dependent. This case illustrates
      the difficulties in diagnosis and management of sarcoidosis.

PMID- 7778332
TI  - Hypernatremic dehydration in breast-fed infants.
AB  - Three cases highlight the association between elevated breast milk sodium and
      hypernatremic dehydration in the infant. All three mothers, breast-feeding
      exclusively, had sodium levels in breast milk elevated significantly above
      normal. Severe hypernatremic dehydration in otherwise normal infants who are
      exclusively breast fed can be due to elevated sodium levels in breast milk.

PMID- 7778334
TI  - Working women and insurance.

PMID- 7778333
TI  - The costs of traumatic spinal cord and brain injuries in Wisconsin.

PMID- 7778335
TI  - The objectives approach to assessing quality care.

PMID- 7778336
TI  - [Chronic pancreatitis as an interdisciplinary concept].

PMID- 7778337
TI  - [Biological effect of shock waves--more than "just" lithotripsy?].
AB  - After their introduction into medicine for kidney stone lithotripsy,
      extracorporeal shock waves have gained an established or promising role in the
      treatment of bileduct, pancreatic and salivary stones during the last years.
      Treatment of gallbladder stones is possible in a large proportion of patients,
      yet is cumbersome. Beyond lithotripsy, treatment of pseudarthrosis by shock waves
      reveals positive results. The role of shock waves in the treatment of soft tissue
      pain is at present unknown. There is a potential for further therapeutic
      applications of shock waves since shock waves exert a strong biological effect on
      tissue which is mediated by cavitation. Experiments using shock waves for tumor
      therapy have shown some promising results, yet devices which generate other
      waveforms than lithotripters are probably better suited. Shock waves cause a
      transient increase in the permeability of the cell membrane, and this might lead
      to further applications of shock waves.

PMID- 7778338
TI  - [Development of chronic pancreatitis from acute pancreatitis: a pathogenetic
      concept].
AB  - Clinically, alcohol-induced chronic pancreatitis is commonly indistinguishable
      from acute pancreatitis. A relationship between these two forms of pancreatitis
      has therefore been suggested. This article presents a pathogenetic model which
      views the development and course of chronic pancreatitis as a consequence of
      severe acute pancreatitis.

PMID- 7778339
TI  - [The natural course of chronic pancreatitis--pain, exocrine and endocrine
      pancreatic insufficiency and prognosis of the disease].
AB  - The natural course of the classical symptoms of chronic pancreatitis, i.e. pain,
      exocrine and endocrine pancreatic insufficiency, was followed up in 335 patients
      over a median of 9.8 years (mean 11.3 +/- 8.3 years). Pain relief was not
      obtained in the majority of patients, even after a longterm observation of > 10
      years, and severe exocrine and/or endocrine insufficiency, severe duct
      abnormalities and pancreatic calcifications developed. Alcohol abstinence failed
      to have a significant beneficial effect on pain. Pancreatic surgery led to pain
      relief immediately after operation, but later on the pain course between operated
      and nonoperated patients was not significantly different. Repeated exocrine
      pancreatic function tests in 143 patients showed that functional exocrine
      impairment came to a standstill (46%), or improved (11%). At the end of the
      observation, 22% of 335 patients still had normal endocrine function and only 40%
      required insulin treatment. Alcohol abstinence had a significant beneficial
      effect on endocrine, but not on exocrine pancreatic insufficiency. Chronic
      pancreatitis led to a sharp increase in unemployment and retirement. Pancreatic
      carcinoma occurred in 3% and extrapancreatic carcinoma in 4%. The mortality rate
      within the observation period was 22%, pancreatitis-induced complications
      accounted for 13% of these deaths.

PMID- 7778341
TI  - [Chronic pancreatitis with inflammatory enlargement of the pancreatic head].
AB  - A number of patients with chronic pancreatitis develop an inflammatory
      enlargement of the head of the pancreas leading to complications such as common
      bile duct, duodenal, pancreatic duct, and/or vascular obstruction. The duodenum
      preserving pancreatic head resection has been developed to treat these lesions
      and to avoid a Whipple procedure in chronic pancreatitis. Between 1972 and 1992
      280 patients (231 male, 49 female, mean age 44, range 22-76 years) underwent a
      duodenum preserving pancreatic head resection for chronic pancreatitis. The
      indication to operate was a cholestases syndrome in 50% of the patients, a
      duodenal compression in 36% and an obstruction of the portal vein in 16% of the
      patients. 94% suffered from pain, 53% had recurrent severe pain attacks and 72%
      had daily pain. Hospital mortality was 1.1% (3/280). Pancreatic fistula, leakage
      of pancreatic anastomosis and postoperative bleeding occurred in 4.6%, 1.8% and
      3.2% of the patients, respectively. A relaparotomy needed 16 patients (5.7%).
      With respect to glucose tolerance in the early postoperative period 88% of the
      patients, showed no change in comparison with the preoperative glucose tolerance
      analysis. In a long-term follow-up (mean follow-up time was 3.7 years (3 months
      to 18 years)) 219 patients were included. The late mortality within the follow-up
      period was 5.0% (11/219). 90% of the patients had no or rare pain in the long
      term follow-up. 63% of the patients were full rehabilitated professionally. The
      duodenum preserving pancreatic head resection represents a new standard procedure
      which solves most surgical problems in chronic pancreatitis. It does not lead to
      diabetes mellitus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778340
TI  - [The Whipple partial duodenopancreatectomy--its value in the treatment of chronic
      pancreatitis].
AB  - The surgical treatment of chronic pancreatitis is indicated only in the
      complicated disease. The aim is mainly the treatment of pain, of mechanical
      obstacles and to exclude suspicion of cancer. Between October 1972 and January
      1993 713 patients with chronic pancreatitis were treated at the Surgical
      University Hospital in Mannheim. In 40% of the patients conservative treatment
      was continued or intensified. Only in 123 patients a Whipple operation was
      performed. The leading symptom was pain in these patients. We saw postoperative
      surgical complications in 14 patients (11.4%). One of them died due to an
      operative leak (0.8%). Late results are based on a median follow up of 4.8 years
      and showed a complete or substantial pain relief in 94%. 66% went back to work.
      77% gained weight with an average of more than 10 kg. The rate of postoperative
      endocrine insufficiency was 10% (total 40%), of exocrine insufficiency 26 (total
      51%). Late mortality was 11% and mostly caused by continued alcoholic abuse.
      Based on these results, the Whipple operation seems to be the best standardized
      method for surgery of the complicated chronic pancreatitis within the head of the
      pancreas.

PMID- 7778342
TI  - [The status of duodenum-preserving resection of the head of the pancreas in
      therapy of chronic pancreatitis].
AB  - AIM OF THE STUDY: To evaluate the efficacy of duodenum-preserving resections of
      the head of the pancreas in the treatment of chronic pancreatitis this study was
      devised. So far studies on the natural course and the different therapeutic
      approaches have primarily focused on pain measurement in rough categories and
      hard data as mortality and morbidity. In this study the improvement of the
      quality of life was assessed to determine the therapeutic success of both
      procedures. PATIENTS AND METHODS: In a prospective randomized study 24 patients
      underwent either Beger's (n = 11) or Frey's procedure (n = 13) so far. 15
      patients suffered from distal common bile duct stenosis, 2 from segmental
      duodenal stenosis, 4 from segmental portal hypertension, and one from pancreato
      pleural fistula. The quality of life questionnaire of the European Organization
      for Research and Treatment of Cancer was assessed before surgery and during
      follow-up. The multidimensional questionnaire incorporates functional scales
      (physical, cognitive, emotional, and social), symptom scales (fatigue, pain,
      dyspnea, loss of appetite, sleep disturbance, obstipation, diarrhea, nausea, and
      vomiting), and a global quality of life scale. Follow-up was 12 months in all
      patients. RESULTS: There was no postoperative mortality in neither group.
      Postoperative morbidity was 17% (n = 2 in either group). This included one
      transitory common bile duct stenosis, one bronchopneumonia, and two postoperative
      bleedings which were treated conservatively. The pain index was reduced by 94% in
      the Beger- and 90% in the Frey group. The physical status, working ability,
      emotional and social functioning, and global quality of life score had
      significantly improved by 46%, 50%, 69%, 60%, and 67% in the Beger group and by
      38%, 50%, 64%, 80%, and 67% in the Frey group. CONCLUSION: The duodenum
      preserving resections of the head of the pancreas according to Beger and Frey are
      equivalently safe and effective. Both techniques result in a significant
      improvement of the patients' quality of life.

PMID- 7778343
TI  - [Intraoperative risks and early postoperative complications in surgery of chronic
      pancreatitis].
AB  - 69 patients (1986-1991) who underwent conventional surgery for chronic
      pancreatitis (n = 42) or related pseudocysts (n = 27) were analyzed
      retrospectively. 17 patients underwent partial duodenopancreatectomy (pDPE), 13
      pancreaticojejunostomy (PJ), 20 cystojejunostomy (CJ), 9 resection of the left
      pancreas and 10 other procedures. We evaluated especially time spent in hospital
      (pDPE:28,5d (mean), PJ:29d, CJ:22,3d, others:28,8d), duration of operation
      (pDPE:6h, PJ:4,6h, CJ:2,6h, others:2,6h), requirement for blood substitution
      (pDPE:3,2 units, PJ:3, CJ:0,8, others:1,9), postoperative surgical (pDPE:6%,
      PJ:15%, CJ:5%, others:29%) and nonsurgical (pDPE:0, PJ:0, CJ:15%, others:14%)
      complications, and operative mortality (0 in all groups). Conventional surgery
      for chronic pancreatitis and pseudocysts carries a very low mortality risk but
      may cause prolonged morbidity in a minority of cases.

PMID- 7778344
TI  - [Endoscopic therapy in chronic pancreatitis].
AB  - In chronic pancreatitis obstruction of the pancreatic ductal system by
      strictures, stones or pseudocysts seems to play an important part in
      pathogenesis. Therefore, therapeutic efforts are directed mainly towards
      reestablishing a free flow of pancreatic secretion. Endoscopic techniques allow
      decompression of the organ by stenting or stone extraction, as well as evacuation
      and drainage of pseudocysts. Thus, interventional endoscopy offers safe and long
      lasting therapy for many patients suffering from chronic pancreatitis. This paper
      gives a review of the literature and reports on own clinical data.

PMID- 7778345
TI  - [Results of surgical therapy of acute pancreatitis].
AB  - Operative treatment of acute pancreatitis was carried out in 143 patients. The
      disease was caused by bilestones in 68%, by alcohol in 23%, idiopathic in 8%, and
      by different reasons (postoperative, helminthic disease) in 1% of the patients.
      The severity of the disease was classified into the grades I to III according to
      Kummerle. The lowest rate of complications and lowest mortality rates were
      observed in operations performed within the first hours or after two weeks after
      the beginning of the disease. The alcoholic pancreatitis showed the lowest
      mortality rate (16%), despite of 81% of these patients suffering from the severe
      grades II and III. This may result from the decision in favour of early second
      look operations in these patients.

PMID- 7778346
TI  - [How urgent is an operation in enterothorax?].
AB  - The emergency treatment of the enterothorax is problematic due to weak lung
      functions and unstable hemodynamics, and because it does not influence the stage
      of maturity of the lungs. By delayed operation children with a critical starting
      position have a greater chance to survive, after their condition has been
      stabilised by intensive care treatment. During the stabilising period we managed
      to decrease the FiO2 level below 50% and to decrease the pCO2 level to 43 +/- 13
      mm Hg in our patients (n = 10). Furthermore we succeeded to raise the O2 degree
      of saturation from 72 +/- 13 to 89 +/- 9%. The pH level went up from 7,238 +/-
      0,181 to 7,394 +/- 0,060. If the condition of the patients worsens during the
      stabilising period--in our patients the stabilising period was between 12 and 24
      hours--immediate operation is indicated. We have no experience so far in using
      ECMO in such situations.

PMID- 7778347
TI  - [Necrosis of the ligamentum teres hepatis and the anterior abdominal wall in
      acute pancreatitis].
AB  - The varying sites of extrapancreatic tissue necrosis in acute pancreatitis seldom
      include the anterior abdominal wall. In cases of liver enlargement causing a high
      portal pressure, the umbilical vein serves as a vent, shunting the portal blood
      through the teretic hepatic ligament to the anterior abdominal wall.
      Corticosteroids make the tissues even more susceptible to the activated
      pancreatic enzymes and are thus a contributing factor to the tissue necrosis. We
      describe a case of necrosis of the teretic hepatic ligament and the anterior
      rectus abdominis muscle following acute biliary pancreatitis.

PMID- 7778348
TI  - [Congenital diaphragmatic hernia with symptoms in adulthood].
AB  - A left-sided diaphragmatic defect in the centrum tendineum of a 27-year-old
      female patient, who complained about dyspnea and hemoptysis, will be reported
      concerning symptoms, diagnostic procedure and operative therapy. This presumably
      congenital diaphragmatic defect caused an organ prolapse into the pleural cavity
      probably enhanced by an increased intraabdominal pressure during pregnancy and
      delivery. The defect was primarily closed after laparotomy. No plastic surgical
      reconstruction with autologous or homologous materials was necessary.

PMID- 7778349
TI  - [Bacterial clearance of the terminal ileum in relation to the ileocolic
      connection].
AB  - The ecology of the (neo-)terminal ileum was investigated in three groups of
      mongrel dogs (group 1 to 3; 6 animals per each group) depending on the ileocolic
      connection and the resection of the terminal ileum. The efficacy of a stabilized
      nipple-valve-anastomosis (SNVA) was evaluated comparing the physiological
      ileocecal valve and the conventional end-end-anastomosis. The relations of the
      aerobic and anaerobic bacterial counts of all 18 dogs (group 0) preoperatively
      served as reference-values. Under this physiological condition the median counts
      were found to be lower in the ileum than in the colon, two logs for the aerobic
      bacteria and three logs for the anaerobic bacteria, confirming statistical
      significance (p < or = 0.05). The resection of the terminal ileum conserving the
      ileocecal valve (group 1) had no influence on the bacterial flora of the
      neoterminal ileum, whereas the limited resection of the ileocecal valve with
      ileocolic end-end-anastomosis (group 2) induced a bacterial colonisation of the
      terminal ileum. In contrast, following wide ileocoecal resection and replacement
      of the ileocecal valve by the SNVA (group 3) the bacterial counts were lower in
      the terminal ileum than in the colon: five logs for aerobic and seven logs for
      anaerobic bacteria. This difference was statistically significant within this
      group between ileum and colon and between ileum preoperatively and
      postoperatively (p < or = 0.05). In conclusion, the bacterial clearance of the
      (neo-)terminal ileum depends more on the retrograde barrier-function of the
      ileocecal valve or an appropriate mechanical substitute than on the propulsive
      motility of the ileum.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778350
TI  - [10 years quality assurance in perinatology].

PMID- 7778351
TI  - [100 years radical abdominal operation of cervix carcinoma: in memory of
      Wertheim's predecessors].
AB  - 1895 was a crucial year in the course of the development of abdominal radical
      surgery for effective treatment of cervical cancer. In March of 1895, Ries
      presented the rationale of modern radical hysterectomy and was the first to call
      for systematic removal of pelvic lymph nodes. Independently, Clark in Baltimore,
      Rumpf in Berlin, and Latzko in Vienna performed the first radical hysterectomies.
      This article is dedicated to the memory of the contributions by these four
      pioneers of surgical gynecology presented in 1895.

PMID- 7778352
TI  - [Causes of perinatal brain damage].
AB  - The incidence of cerebral palsy has remained constant at 2 per 1000 life births
      in western countries through cesarean section and electronic fetal monitoring
      have been applied increasingly often since the last decades. There has been a
      shift towards prenatal causes and consequences of early prematurity. High risk
      deliveries (3% of all) should be performed only in specialized centers for
      perinatal medicine. For low risk deliveries local hospitals are more convenient
      and are traditionally well accepted in Germany. Perinatal hypoxia as a cause of
      perinatal brain damage is rare. Documentation of clinical symptoms of hypoxic
      ischemic encephalopathy is mandatory in these cases. To investigate regional risk
      factors of perinatal brain damage we propose to connect the data of the perinatal
      inquiries and of the examinations of preschool children directed by german law.

PMID- 7778353
TI  - [Interventional therapy of inferior vena cava thrombosis in pregnancy--use of a
      new kind of temporary vena cava filter].
AB  - Several changes occur during pregnancy that cause hypercoagulability such as
      venous stasis, increased levels of clotting factors, and decreased fibrinolytic
      activity. Nearly half of all maternal mortality can be attributed to
      thromboembolic disease. Recurrent embolism from venous thrombosis in pregnancy
      constitutes a major diagnostic and management problem. Treatment of deep venous
      thrombosis by anticoagulation alone may not be sufficient to prevent fatal
      pulmonary embolism. Because pulmonary embolism is a potential preventable and
      treatable condition, early and accurate diagnosis and treatment are mandatory.
      Prevention can be obtained by the implantation of clips, umbrellas or vena cava
      filters. There are only a few reports of the use of permanent inferior vena cava
      filters in the prevention of pulmonary embolisation in pregnancy mostly using the
      Greenfield-Filter. We present the indication and efficacy of a new retrievable
      vena-cava filter (FCP 2002) inserted through the internal jugular veins in
      pregnancy in two patients, which enables them to continue pregnancy, resulting in
      a vaginal delivery of healthy infants near term. The safety and effectiveness of
      this filter-system suggests that the indication for its use might be liberalized
      to include prophylactic insertion of this device in patients at risk known for
      thromboembolic disorders.

PMID- 7778355
TI  - [Experimental microendoscopy of the milk duct system (ductoscopy)].
AB  - According to recent reports, the microendoscopic lactiferous duct investigation
      (ductoscopy) could improve diagnosis in case of pathological nipple discharge.
      However, the description of a reproducible and reliable methodology, suitable for
      thorough evaluation of the lactiferous duct is missing so far. Therefore, the
      pressure study developed a procedure, that may serve now as an experimental basis
      for further clinical evaluation. Access to the mamillary duct is primarily gained
      using atraumatic flexible teflon catheters. Corresponding to the diameter of the
      duct, either a semirigid 0.87 mm fiberendoscope can be successfully introduced
      via a 1.2 mm catheter, or a flexible 0.50 mm fiberendoscope via a 1.0 mm
      catheter. A controlled distension using few milliliters of ringer's lactate is
      the prerequisite for clear visualization of the intraductal space and protection
      against iatrogenic wall lesions. Metal microtocars are available as prototypes.
      They carry a somewhat higher risk to perforate, but are advantageous when
      pointing at an intraductal structure and using the microtrocar as a mark for
      microdochectomy.

PMID- 7778356
TI  - [Tubal sterilization in the new unified Germany--results of a survey].
AB  - A total of 4 statistical reviews of pelviscopic surgery had been issued in the
      Federal Republic of Germany until 1988. The five new federal states started such
      reviewing first in 1989 by quoting the number of tubal sterilization at 800. Our
      study, covering the period from May 31, 1991 to June 01, 1992 reveals an increase
      in pelviscopic surgery up to 20,000 with upward tendency. All 198 hospitals of
      the five new states were included in the inquiry and 133 of them took part in the
      survey. Out of 20,915 sterilization reported, 18,873 (90.3%) were performed by
      endoscopic surgery. Coagulation techniques such as monopolar and bipolar HF
      methods, the endocoagulation according to Semm, and Laser techniques were
      available for endoscopic tubal sterilization. Mechanical methods such as a clip
      or Yoon's ring were used in less than 10% and were therefore of limited practical
      importance. Severe complications were reported in 32 cases.

PMID- 7778354
TI  - [Effectiveness of beta-hydroxyethylrutoside in patients with varicose veins in
      pregnancy].
AB  - Pregnancy is a critical risk for development of varicosis, therefore early
      detection and treatment are strongly recommended. In our study we examined 51
      patients subdivided into three groups. One group underwent physical therapy (cold
      foot-baths in the morning an in the evening), the other group was administered
      beta-hydroxyethyl rutosides, and the patients of the third group had appeared
      only once for examination. Leg circumference and diameter of vein (by sonography)
      were measured, and the subjective criteria evaluated. In the group of patients
      who were additionally given drugs, a significant reduction of all parameters was
      found: leg circumference was reduced by 3% and diameters of veins were reduced by
      15% on average, the reduction of the subjective criteria was by 34%. Provided the
      veins were prevented from further extension through progressive varicosis,
      apparent beneficial clinical effects can be achieved by administration of beta
      hydroxyethyl rutosides.

PMID- 7778357
TI  - Curative treatment of clinical stage II endometrial carcinoma.
AB  - In a retrospective study of 54 patients we compared three treatment policies of
      clinical stage II endometrial carcinoma: One group of patients (n = 29) was
      surgically staged with histological examination made at surgery and treated by
      abdominal total hysterectomy with bilateral salpingo-oophorectomy. In case of
      cervical infiltration by tumour, a pelvic node sampling was added. The second
      group was treated by radical hysterectomy (n = 9) and the third group of patients
      (n = 16) was treated by abdominal total hysterectomy with bilateral oophorectomy
      only. The median follow-up time was 68 months. The overall five year-survival was
      64%. The overall five year-survival rates according to surgical procedure were
      not significantly different. The survival curves were significantly different
      from each other as were those according to surgical stage and age. In a
      multivariant analysis stage, grading and age proved to have an independent
      relation with the survival rate whereas type of surgical procedure, depth of
      myometrial infiltration and type of radiotherapy had no influence on survival.
      Intraoperative histological staging allows adaption of treatment to the true
      stage, thus minimising treatment-related morbidity.

PMID- 7778358
TI  - [Examination by image analysis for determining quantitative DNA parameters of
      serous papillary adenocarcinoma of the endometrium--a single case analysis].
AB  - Serous-papillary adenocarcinoma of the endometrium are rare tumors. We describe
      DNA-parameters of such a tumor. Imprint-cytologies were taken from 6 different
      tumor sites (myometrial invasion and 5 additional tumor localizations) and
      subjected to image-cytophotometry in order to determine their DNA-parameters. All
      histograms showed an aneuploid DNA-pattern. The DNA-malignancy grade (DNA-MG) was
      2.21 +/- 0.11 on median and the 5c exceeding rate (5c ER) was 15.37 +/- 4.17 on
      median. These results and the slight variability of DNA-pattern at the reported
      serous-papillary adenocarcinoma support the hypothesis of an own entity of this
      tumor. Additionally, the high values of DNA-MG and 5c ER confirm the well known
      aggressive behavior of this tumor entity.

PMID- 7778359
TI  - [Cystosarcoma phylloides of the breast--2 case reports].
AB  - Two cases of Cystosarcomata phylloides (C. ph.) in the breast were reported. In
      the first one after excision of the palpaple tumour mass the histological
      examination revealed a fibroadenoma with signs of C. ph. in the excision margins.
      The reported high rate of local recurrence also in cases of benign tumour type
      and/or in situ remained tumour structures (stromal hyperplasia) gave the reason
      for a second operation procedure, an enlarged quadrantectomy. In the second case
      sarcomatic degenerated areas and a high rate of atypical mitotic figures were
      found (> 20 mitosis/10 HPF). Therefore an ablative surgery was recommended.

PMID- 7778360
TI  - [Therapy of extensive lymphangioma of the vulva].
AB  - The lymphangioma of the vulva offers difficulties in differential diagnosis
      because of its wart-like appearance [7]. Is the diagnosis histologically
      confirmed, there often arise uncertainties about an adequate therapy [7, 2, 15].
      By this case report these problems will be explained. Vaporisation with the CO2
      Laser showed to be the predominant therapeutical procedure.

PMID- 7778361
TI  - [The cellular fatty acid composition of bacteria in the family Vibrionaceae].
AB  - Vibrio cholerae strains, serovar O1, biovar eltor, subtype Ogawa, isolated from
      different sources, V. cholerae classica and NAG vibrios have identical cell fatty
      acid composition with the prevalence of hexadecenoic, hexadecanoic and
      octadecenoic acids. V. parahaemolyticus and V. alginolyticus fatty acid profiles,
      being identical, are similar to V. cholerae profile, differing from it mainly by
      a higher content of dodecanoic acid. The similarity of the fatty acid profiles of
      Aeromonas sp. and Vibrio strains is indicative of their phylogenetic
      relationship. The fatty acid composition of Plesiomonas shigelloides
      characterized by the presence of methylenehexadecanoic acid and at the same time
      by its similarity to that of Vibrio and Aeromonas in the content of the majority
      of fatty acids, confirms the position on the intermediate status of the genus
      Plesiomonas between the families Enterobacteriaceae and Vibrionaceae.

PMID- 7778362
TI  - [Bacterial, viral and fungal infections of the lungs in AIDS].

PMID- 7778363
TI  - [The mechanisms of infection transmission in the light of new data].

PMID- 7778364
TI  - [The problems of preventing the most important helminthiases in Russia].

PMID- 7778365
TI  - [Clonality and the phase variability of bacterial species and their relationship
      to the manifestations of an epidemic process].

PMID- 7778366
TI  - [Phages of halophilic vibrios].
AB  - The morphology and antigenic properties of 34 phages of Vibrio parahaemolyticus
      and V. alginolyticus strains isolated from Black Sea water, as well as their
      range of lytic activity and specificity of action, have been studied. Most of
      these phages have been found to lyze both V. parahaemolyticus and V.
      alginolyticus strains. In addition, highly specific phages capable of lyzing only
      V. parahaemolyticus serotype O5:K15, have been detected. The latter fact is a
      precedent indicating the possibility of search for other typing phages and the
      development of the scheme for the phage typing of V. parahaemolyticus in future.

PMID- 7778367
TI  - [Natural killer cells in middle-aged and elderly tuberculosis patients].
AB  - The immunological study of 76 patients belonging to two age groups (group 1
      consisting of 46 patients aged 60-85 years and group 2 consisting of 30 patients
      aged 20-40 years) was made. For control, healthy persons aged 60 years and older
      (30 subjects) and 20-40 years (28 subjects) were examined. The study revealed
      that, in contrast to the tuberculosis patients of the younger age group, the old
      age patients exhibited a decrease in the activity of natural killer (NK) cells.
      The greatest decrease in the activity of NK cells was observed in patients with
      chronic fibrocavernous forms of tuberculosis (in comparison with other forms of
      tuberculosis).

PMID- 7778368
TI  - [The epidemiology and epizootiology of rabies on the territory of the former
      USSR].
AB  - On the territory of the former USSR rabies is as infection with natural foci in
      the western and central regions. In the republics of Central Asia and
      Transcaucasia, in the North Caucasus the presence of natural foci of infection is
      combined with appearance of the foci of rabies, mainly among dogs, due to human
      activities. The existence of natural epizootic cycles of three years has been
      established, and the natural foci of rabies have been found to prevail in certain
      landscape zones: steppes, forest-steppes, tundra, forest tundra. A vast zone of
      northern taiga remained free from this disease. About half a million persons
      asked for medical assistance in connection with rabies annually, and about 50% of
      them received urgent antirabies treatment. Of the total number of persons asking
      for antirabies assistance, the proportion of rural dwellers was about 30%, while
      the majority of rabies patients were from rural areas (about 70%). During the
      period under study the incidence of this disease among humans did not show any
      tendency towards a decrease and constituted 0.01-0.02 cases per 1,000 persons. Of
      the total number of persons contacting this disease, only 30% went to a clinic
      for medical assistance.

PMID- 7778369
TI  - [The complex study of the epidemic situation and of the immunological structure
      of the population in brucellosis foci].
AB  - As the result of the complex clinico-laboratory examination of 265 cattle
      breeders working on 5 farms where cases of brucellosis among agricultural animals
      had been detected, 62 persons (21.8%) were found to have the positive reaction to
      brucellosis. A strikingly high proportion (38.3%) of infected persons was found
      among the workers of a cattle-feeding complex. Out of 62 persons with the
      positive reaction to brucellosis, 32 had different clinical manifestations of the
      disease. Treatment for all persons who needed it was organized, the rest were
      placed under dispensary observation. Regular complex clinico-laboratory
      examinations of cattle breeders to brucellosis were recommended.

PMID- 7778370
TI  - [The interrelationship of the capacity for the expression of different
      serovariants of the Yersinia pestis capsular antigen with the degree of reduction
      of the lipopolysaccharide of the bacterial cells].
AB  - The immunochemical study of the expression of different serovariants of Y. pestis
      capsular antigen in Escherichia coli HB 101, Salmonella minnesota R595 and Y.
      pestis EV recipient strains with different degrees of LPS reduction was made.
      Plasmids pFS1, pFBK7 and pFBK10 coding initial and serologically atypical
      variants of the capsular antigen were introduced into microbiol cells. Altered
      LPS structures were shown to have no influence on the serological specificity of
      the capsular antigen. Immunochemical activity was determined in the diffuse
      precipitation test, the passive hemagglutination test and the antibody
      neutralization test. Changes in the structure of LPS were shown to produce no
      effect on the serological activity of the capsular antigen coded by intact fra
      operon (plasmid pFS1). The transfer of hybrid plasmids pFBK7 and pFBK10 to
      recipient microorganisms led to the synthesis of serovariant Fl1 in recombinant
      strains with O-LPS, which was immunochemically different from serovariant Fl2
      synthesized in strains with R-LPS.

PMID- 7778372
TI  - [The role of the outer membrane proteins, determined by the Shigella flexneri
      invasiveness plasmid, in inducing cellular immune reactions].
AB  - Fractions of S.flexneri 2a 516 outer membrane proteins determined by plasmid
      pSF140 have been shown to possess immunomodulating activity and to be capable of
      influencing the intensity of hematopoiesis, manifested by the stimulation of
      endocolony formation, the increase of the amount of splenic colony-forming units
      in the marrow, the increase of the pool of proliferating splenic colony-forming
      units of the marrow and their intensive migration into the blood. Outer membrane
      proteins have been shown to produce an immunostimulating effect on the functional
      activity of effector B-lymphocytes shortly after their injection. On the
      contrary, S.flexneri 2a 516/4 pSF140- outer membrane proteins produce a less
      pronounced effect on hematopoietic stem cells and reproduce unspecific
      immunostimulating effect on the formation of B-cells, synthesizing antibodies to
      heterologous antigen.

PMID- 7778371
TI  - [Q fever in the western region of Ukraine].
AB  - Multiple natural and mixed foci of Q fever have been revealed at the territory of
      six administrative regions of the western part of the Ukraine. Coxiella burnetii
      strains have been isolated from small animals and ticks, the specific features of
      their ecology in Poles'e and forest-steppe zones have been determined. The
      necessity of the study of natural foci of Q fever at not yet surveyed territories
      for at least 3-4 years has been substantiated.

PMID- 7778373
TI  - [The induction of an immune response to influenza virus antigens by anti
      idiotypic antibodies].
AB  - The present investigation indicate that homologous polyclonal anti-idiotypic
      antibodies induce both humoral and cell-mediated immune response. Experiments on
      the exhaustion of immune sera with vaccine have revealed that anti-idiotypic
      antibodies induce not only specific antibodies to influenza virus antigens, but
      also antibodies to other epitopes of the globulin molecule of the anti-idiotype.
      Anti-idiotypic antibodies, when reintroduced into animals, induce the production
      of anti-influenza antibodies of the anamnestic type, but do not induce the
      formation of antihemagglutinins. The injection of influenza vaccine to animals,
      previously immunized with anti-idiotypic antibodies, induces the production of
      antihemagglutinins; an increase in the level of immune complexes and antibodies
      to anti-idiotype, i.e. anti-idiotypic antibodies, induces the development of
      immunological memory with respect to influenza virus antigens, including
      antihemagglutinins.

PMID- 7778374
TI  - [The adsorbed-DTP-m vaccination of children with allergically altered
      reactivity].
AB  - Immunization and booster immunization with adsorbed DPT-m vaccine was carried
      out, respectively, in 45 and 15 children with different severity of the course of
      an allergic disease, each child receiving simultaneously individually prescribed
      complex drug therapy. The postvaccinal period took a relatively favorable course.
      General and allergic reactions and complications observed after the injection of
      the preparation did not hinder the continuation of the course of immunization,
      while the appearance of neurological reactions provoked doubts on the expediency
      of the repeated injection of this preparation. A decrease in the content of
      diphtheria and tetanus toxoids in one immunization dose did not lead to the
      decreased synthesis of specific antibodies. The present investigation showed the
      possibility of using adsorbed DPT-m vaccine with reduced antigen content in cases
      of both the remission of an allergic disease and the subacute course of such
      disease.

PMID- 7778375
TI  - [The immunological activity of Neisseria meningitidis lipo-oligosaccharide
      incorporated into liposomes].
AB  - Immune response to lipooligosaccharide (LOS), isolated from group B N.
      meningitidis cell wall, was studied after its incorporation into liposomes. The
      adjuvant effect produced by liposomal LOS, more pronounced in comparison with
      that produced by native LOS, was observed after the injection of the preparation
      by different routes (intravenous, intraperitoneal and subcutaneous injections),
      but the highest level of response was achieved after the intravenous and
      intraperitoneal injections of the preparation. Experiments aimed at the study of
      the dynamics of plaque-forming cells and the level of antibodies after
      intraperitoneal immunization of CBA mice with LOS revealed that immune response
      to liposomal LOS was more intense and prolonged than that to the free antigen.
      Liposomal LOS induced genetically nonrestricted and T-independent immune
      response. This fact was confirmed in experiments on mice having different
      haplotypes, such as CBA (k), C57BL/6 (b), BALB/c (d) and in nude mice with
      congenital thymic aplasia. In addition, liposomal LOS induced mainly the
      accumulation of IgM and IgG and did not produce the effect of immunological
      memory.

PMID- 7778376
TI  - [The effect of substances produced by a strain of Streptococcus sp. Thom-1606 on
      phagocytic activity].
AB  - Among the substances produced by Streptococcus sp. strain TOM-1606 two fractions
      having the opposite influence on the phagocytic activity of peritoneal
      macrophages of white mice were detected. The fraction corresponding to peptides
      with a molecular weight not exceeding 10 kD activated natural phagocytosis. As
      shown in our earlier works, this fraction also had the maximum antimicrobial
      activity. The fraction with a molecular weight of 70-100 kD inhibited natural
      phagocytosis, acting as an immunosuppressive agent.

PMID- 7778377
TI  - [The immunosuppressive activity of Streptococcus aureus peptidoglycan].
AB  - The immunosuppressive activity of peptidoglycan, obtained from S. aureus was
      studied in mouse experiments on the model of delayed hypersensitivity (DH) to
      guinea pig antigens. The study revealed that PG suppressed DH, this action being
      linked with its insoluble fraction. The soluble part of PG did not suppress DH.
      Experiments with the use of immunosorbent demonstrated the existence of
      serological similarity between the active factor of the soluble part of PG and
      its insoluble part.

PMID- 7778378
TI  - [The determination of specific Pseudomonas aeruginosa antitoxins in commercial
      preparations of human immunoglobulin].
AB  - The comparative study of the activity of P. aeruginosa specific antitoxins in 134
      lots of commercial preparations of human immunoglobulin in parallel mouse
      experiments on the neutralization of the lethal effect of exotoxin and in ELISA
      made it possible to establish a high degree of correlation between their results
      and the possibility of using immunochemical assays instead of biological tests in
      the large-scale production of anti-P. aeruginosa immunoglobulin.

PMID- 7778379
TI  - [The effect of the level of lipid peroxidation and the pH value of a liposomal
      suspension on its antibacterial activity].
AB  - Multilamellar phosphatidylcholine liposomes have been shown to possess
      antibacterial activity with respect to Pseudomonas aeruginosa and Staphylococcus
      aureus. An increase in the level of lipid peroxidation products in liposomal
      suspension as the consequence of the earlier oxidation of liposomal lipid leads
      to a considerable increase in the antibacterial activity of liposomes. The pH of
      the liposomal suspension has also an essential influence on its activity. If the
      pH of the suspension has acidic values, its antibacterial activity increases. The
      bactericidal action of liposomal suspension is more pronounced with respect to S.
      aureus, than to P. aeruginosa.

PMID- 7778380
TI  - [Anti-Escherichia antibodies in the blood sera from nonimmunized donors and in
      preparations of human immunoglobulin].
AB  - The anti-Escherichia activity of 188 serum samples obtained from nonimmunized
      blood donors and 157 batches of the preparation of commercial normal human
      immunoglobulin were evaluated in the passive hemagglutination test with
      diagnostica containing E. coli antigens (serovars O2, O14, O26) and Kunin
      antigen, as well as Re-glycolipid Salmonella minnesota strain R595, used as
      sensitins. The study demonstrated that from sera of nonimmunized blood donors and
      from normal human immunoglobulin preparations 5-8% of batches containing anti
      Escherichia antibodies to E. coli lipopolysaccharide (serovar O2) in titers of
      1:640 and more could be selected. The study revealed that certain anti
      Escherichia antibodies of commercial normal human immunoglobulin, to IgG.

PMID- 7778382
TI  - [The demonstration of the genes controlling enterotoxigenicity in Staphylococcus
      aureus strains by using the polymerase chain reaction].
AB  - The selection and subsequent synthesis, according to the nucleotide sequences of
      S. aureus genes responsible for the expression of enterotoxins A and B, of highly
      specific primers for polymerase chain reaction Pcr were carried out with the use
      of the program "Primer". The optimum temperature conditions of polymerase chain
      reaction for all pairs of primers were selected. The method for the rapid
      determination of the enterotoxigenic properties of S. aureus strains by means of
      Pcr was proposed. The enterotoxigenic properties of several S. aureus strains
      were determined, which revealed that 3 clinical isolates had the gene of
      enterotoxin A in their genome, while laboratory strain FRI-722(H) carried the
      genes of enterotoxins A and B.

PMID- 7778381
TI  - [The lymphocyte proliferative response to Staphylococcus aureus antigen in mice
      with an opposite susceptibility to staphylococcal infection].
AB  - The difference between the proliferative response of spleen cells to S. aureus
      cytoplasmic antigen on days 5 and 9 of the infectious process was shown in
      experiments of CBA and C3HA mice, opposite in their susceptibility to systemic
      staphylococcal infection. Hybrid mice F1 (CBA x C3HA) inherited a high level of
      proliferative response on day 5 (as in resistant CBA mice) and its low level on
      day 9 (as in susceptible C3HA mice). These data on genetic differences in
      proliferative response to S. aureus cytoplasmic antigen were confirmed in the
      test of the proliferation of lymph node lymphocytes taken from mice of these
      lines immunized with the above-mentioned antigen in Freund incomplete adjuvant
      into the pad of their paws 14 days before the test.

PMID- 7778383
TI  - [New methodological approaches to the use of the PHA reaction in determining anti
      Shigella antibodies].
AB  - Pronounced correlation between the titers of hemagglutinating antibodies to
      different types of shigellae and other bacteria in healthy persons and in sick
      persons of control groups has been established. On the basis of this regularity a
      new approach to the use of the passive hemagglutination test in shigellosis,
      taking into account the ratio of antibody titers to different Shigella types, has
      been developed. This essentially increases the sensitivity and specificity of the
      test, thus making it possible to standardize its evaluation and permitting the
      effective diagnosis of shigellosis from the onset of the disease.

PMID- 7778384
TI  - [The effect of oral rehydration therapy on pancreatic function in patients with
      acute intestinal infections].
AB  - The results of the study of the level of pancreatic hormones (insulin, glucagon,
      C-peptide and trypsin), carried out with the aim of finding out the character of
      relationship between hormonal disturbances and the state of carbohydrate
      metabolism, as well as the influence of oral rehydration therapy (ORT) with
      glucose-salt solutions on the function of the pancreas, are summarized. All
      subjects to be examined were divided into two groups receiving different kinds of
      ORT. The patients in group 1 (153 subjects) were treated with glucosolan and in
      group 2 (73 subjects), with sodium citrate in an amount of 2.5-5 lit. over the 6
      hour period of treatment. The determination of the content of immunoreactive
      insulin, glucagon C-peptide and trypsin in the blood as the characteristics of
      the hormonal activity of the pancreas has made it possible to find out
      disturbances in the incretory and excretory activity of the pancreas in patients
      with acute enteric infections of different etiology. ORT with glucosolan and
      sodium citrate facilitates the restoration of pancreatic function in 65-70% of in
      patients with acute enteric infections of different etiology.

PMID- 7778386
TI  - [The theoretical problems of forensic psychiatric expertise in a civil trial].

PMID- 7778385
TI  - [The Amben regulation of the intestinal microflora and macrophage functional
      activity in an experiment].
AB  - The possibility of the correction of intestinal microflora disorders and the
      functional activity of macrophages in dysbiosis, caused by the intragastric
      administration of ampiox, with the use of amben (PAMBA), an inhibitor of
      proteolytic enzymes, was studied. Quantitative and qualitative changes in the
      main representatives of automicroflora, the functional activity of macrophages in
      the phagocytosis of 51Cr-labeled sheep red blood cells, the intensity of protein
      synthesis, the content of cathepsin D, acidic phosphatase and nitro blue
      tetrazolium activity were determined. The combined administration of ampiox and
      amben normalized quantitative and qualitative ratios of the main representatives
      of intestinal microflora, as well as the characteristics of macrophage functional
      activity, studied in this investigation. The administration of amben to intact
      animals was found to stimulate bifido- and lactoflora.

PMID- 7778387
TI  - [A comprehensive clinico-neurophysiological study of the efficacy of the
      pharmaceutical preparation glycine in acute ischemic stroke].
AB  - In intensive care unit 226 patients underwent step-by-step clinical and
      neurophysiological investigation of glycin chemotherapy efficiency in the acute
      period of ischaemic stroke. Investigation included double-blind placebo
      controlled method, monitoring (by means of EEG, toposelective mapping of EEG,
      SSEP, transcutaneous cortical electric stimulation, ENMG) of changes of brain
      functional state after the first drug dose and course of treatment, analysis of
      dose-dependent action of the drug, posticchemic follow-up. It was found out, that
      usage of the drug glycin (daily dose 1-2 grams) in the combined intensive
      treatment of stroke provided for significant acceleration of regress of disorders
      of consciousness and other general and focal signs (in comparison with severity
      matched control group), and more complete and stable restoration of function to
      the end of acute period of the disease.

PMID- 7778388
TI  - [The amyotrophic lateral sclerosis syndrome--frontal-type dementia].
AB  - The article presents analysis of clinical case of and review of literature on
      "ALS-dementia complex", a combination of ALS syndrome and dementia predominantly
      of frontal lobe type. The review of literature contains discussion on the problem
      of lobe dementia, analysis of relation of ALS-dementia syndrome and the following
      diseases: Alzheimer, Pick, Creutzfeldt-Jakob, Lewy bodies, Charcot (classic
      type), multisystem degeneration. Polymorphism of ALS-dementia complex and the
      possibilities of its differential diagnosis are considered.

PMID- 7778390
TI  - [The angioarchitectonics in the areas of greatest brain atrophy in Alzheimer's
      and Pick's diseases].
AB  - Atrophic brain diseases (Alzheimer's disease, senile dementia, Pick disease,
      etc.) associated with grave dementia have clinical and neuroanatomical
      differences. The differences in angioarchitectonics concerned to the degree of
      vessel arborization, twisting, their direction, as well as congenital anomalies.
      These changed were more expressed in Alzheimer disease. In Pick disease
      predominated atrophic changes.

PMID- 7778391
TI  - [Synaptic plasticity and the glio-synaptic relationships of the rat hippocampus
      in age-related memory dysfunction].
AB  - Qualitative and quantitative studies of structural changes of synaptic contacts
      and processes were performed in aged memory-non-impaired an aged memory-impaired
      rats compared to young rats in the stratum lucidum of the hippocampus. Aged
      memory-impaired rats (compared with young adults) showed alteration in the
      ultrastructure of mossy fiber expansions and the loss of axospinous synapses
      formed by them. These changes were more pronounced than in memory-non-impaired
      rats. There were no significant differences between aged memory impaired and aged
      memory non-impaired rats except for a significant decrease in volume density of
      postsynaptic density in axodendritic synapses formed by mossy fiber expansions in
      memory impaired animals.

PMID- 7778389
TI  - [Changes in the immunological parameters in Alzheimer's disease: their relation
      to disease severity].
AB  - The peculiarities of the immune system in patients with Alzheimer's dementia (AD)
      and their relations with some clinical parameters were investigated. 21 patients
      with AD aged 51-70 and 16 age-matched healthy subjects were included in this
      study. The following parameters were examined: 1) total lymphocyte numbers, 2)
      the functional activity of T- and B-lymphocytes under conditions of stimulation
      by nonspecific mitogens phytohemagglutinin (PHA) and pokeweed mitogen (PWM) and
      3) the production of interleukin-1 (IL-1) and interleukin-2 (IL-2). A
      statistically significant decrease (p < 0.01) in lymphocyte number and
      significant increase of proliferative activity of T-lymphocytes, stimulated by
      PHA (when the small mitogen doses in the range of 1.25-2.5 mg/ml were used) were
      found in patients with moderate and severe dementia (p < 0.05, p < 0.01). No
      significant changes of lymphocyte proliferative activity were detected in
      patients with mild dementia. Some tendency for higher IL-1 production was found
      in AD patients, but it was not statistically significant. No changes of
      functional activity of B-cells and of production of IL-2 in AD patients were
      found in comparison with the control group.

PMID- 7778392
TI  - [The basic factors affecting outcomes in strokes].
AB  - Outcomes in 1102 patients with 3 main types of stroke have been analysed to
      determine the significance of basic stroke outcome predictors. They are: type of
      the stroke, location of the focus, gravity of the patient's condition when the
      first aid is performed, spectrum of hospital facilities, diseases of the patient
      before and besides the stroke. A decrease of the mortality rate and optimal level
      of ADL score after stroke can be provided in cases when intensive care units
      general hospitals are the first step of treatment.

PMID- 7778394
TI  - [The topographic EEG mapping of patients with an organic brain lesion].
AB  - Brain mapping was carried out in 50 patients with organic brain lesions (tumors,
      disturbances of vascular circulation, multiple sclerosis, consequences of brain
      trauma ets.) The parallelism between the severity of the organic brain lesion and
      the degree of bioelectrical activity disturbances has been discovered. In
      patients with brain tumors, consequences of the stroke, severe trauma and
      multiple sclerosis the focuses of pathological activity corresponded to location
      of the brain lesion.

PMID- 7778393
TI  - [Mossy fibers of the hippocampus in Alzheimer's disease].
AB  - An ultrastructural study of changes in synaptic contacts and astrocytic processes
      of postmortem hippocampus was performed in 5 cases of Alzheimer's disease. Mossy
      fibres in the stratum lucidum were examined. Pronounced alterations included
      clustering of synaptic vesicles, membranous damage and multilamellar profiles in
      synaptic terminals. There were many hypertrophic astrocytic processes around
      synapses. The findings suggest that the ultrastructural alterations in mossy
      fibers expansion, and the disturbance of glio-synaptic relationships might
      contribute to memory impairment in Alzheimer's disease.

PMID- 7778395
TI  - [Triplet expansion analysis--a new molecular genetic method for studying the
      mechanism of mutations in neurogenetics (exemplified by Huntington chorea)].

PMID- 7778396
TI  - [The Gerstmann-Straussler syndrome: new diagnostic possibilities].
AB  - On the basis of clinical picture of the disease, data of CT, MRT, psychological
      study, original laboratory investigation aimed at indication of changes in
      transposed neuroglia cells induced by the causal agent of subacute spongious
      transmissible encephalopathies, the diagnosis of patient K., 49 years old, was
      considered to be: syndrome of Gertsmann-Straussler [correction of Herstmann
      Streussler]. Duration of the disease was 2 years. The case was sporadic. The
      history of the problem, modern views on etiology, pathogenesis of preventive
      measures are presented.

PMID- 7778397
TI  - [The characteristics of the cognitive defect in patients with different variants
      of late paranoia].
AB  - Evoked cortical activity in response to acoustic stimuli (oddball paradigm) was
      studied in patients with different paranoid disorders. The analysis covered the
      N150 negative wave and positive complex P300. In patients with paranoid
      schizophrenia and paranoid form of involutional psychosis cortical responses to
      the stimuli and cortex effects were not recorded. Such cognitive deficiency is
      believed to be typical for schizophrenia.

PMID- 7778398
TI  - [The psychological and psychiatric study of children living in Kaluga and Bryansk
      provinces, Russia (the aftermath of the Chernobyl accident)].
AB  - According to WHO project "Brain Damage in Utero" in the framework of the
      screening phase of the programme, 1025 children (725 in experimental group
      Novozybkov and Klintsy towns of Bryansk region; 300 in control group--Obninsk
      town of Kaluga region) and 600 parents (300 in experimental group and 300 in
      control group) were studied using standardized methods of psychological
      psychiatric assessment (Draw-a-man test, British picture vocabulary test, Raven
      coloured matrices, Parental and teacher Rutter Scales, CHQ-28, Verbal subtest of
      Wechsler test) for potential psychological and psychiatric effects of Chernobyl
      accident on child's intelligence, behavioural and emotional state, mental health
      of parents and parental intellectual level. The following results were obtained:
      comparison of verbal IQ scores in children revealed a 6-fold increase of these
      values in experiment group. Comparison of nonverbal IQ scores in children
      revealed that these values are 4 times higher in experimental group. Comparison
      of scores according to Rutter parental and teacher scales revealed that emotional
      and behavioural disorders are 1.5 times more prevalent in children of
      experimental group. All the above differences were statistically significant.
      Comparison of CHQ-28 scores was indicative of relative prevalence of these values
      in parents of experimental group, but there was no statistically significant
      difference between such score in experimental and control groups. Comparison of
      scores of parental IQ showed relative prevalence of these values in experimental
      group. The results obtained can not be completely estimated without thorough
      identification of individual doses received by mothers and their children. Only
      after obtaining these data it will be possible to solve the problem of dose
      effect.

PMID- 7778399
TI  - [Electroencephalographic markers and the computerized evaluation of the severity
      of depression].
AB  - In 24 patients with moderate, pronounced and extremely pronounced (according to
      Hamilton Scale) sings of depression EEG of frontal, temporal, parietal and
      occipital areas of brain hemispheres were investigated. Control group consisted
      of 24 normals, being under supervision for a year. 4 types of EEG patterns
      (matrices) probabilities of changes were selected; those parameters correlated
      with severity of depression and stage of depressive phase. A cyclic character of
      transformation of organization of bioelectric processes during the disease has
      been demonstrated: orders of matrices changes in cases with reduction and
      aggravation of depressive signs were opposite. Linear discriminant functions or
      EEG markers, significantly different for groups of patients with different
      severity of depression, have been obtained. It allowed to create the computer
      based system of evaluation of depression severity with high diagnostic accuracy.

PMID- 7778400
TI  - [The catamnesis of patients with stenosis of the internal carotid artery who have
      undergone carotid endarterectomy and of unoperated patients].
AB  - Investigation of catamnesis of 100 patients with atherosclerotic carotid artery
      stenosis (50 were operated and 50--non-operated) revealed, that in some cases
      carotid endarterectomy prevented repeated cerebrovascular disorders and had
      prophylactic significance. The frequency of repeated stroke in the group of non
      operated patients was 3 times higher than in the group of operated patients. In
      operated cases no more TIAS were observed, but they persisted in non-operated
      cases.

PMID- 7778401
TI  - [The economic aspects of the activities of a mental health service].
AB  - Integral economic loss of the society, connected with mental disease, were
      calculated by the author and presented. The author determined "direct" and
      "connected" state costs for psychiatric patients, and the volume of non produced
      national income (indirect costs) because psychiatric patients with temporal or
      constant disability are excluded from producing process. Financial state of
      psychiatric hospitals in Moscow was analysed and reserves for improvement of
      money spending were found out. Calculations of expenses of admission of patients
      with different diseases to Psychiatric Hospital N 1 by P.P. Kashenko in 1988 were
      performed. Principles of financing of psychiatric hospitals on the basis of
      clinical-statistic groups are discussed. The method of determination of prices
      for medical and diagnostic services to patients is presented.

PMID- 7778402
TI  - [The clinico-social structure of the geriatric patient contingent of a
      psychiatric hospital].
AB  - In order to study the problem of setting down of mental patients in geriatric
      units of a mental hospital, a clinico-epidemiological one-day overall study was
      conducted. It appeared that among 600 patients of a provincial mental hospital
      124 (20.6%) were residents of such units. Long-term stayers (over 5 years)
      comprised a group of 25 patients (20.2%). Most of them were those in whom the
      onset of schizophrenia took place at young age. The second (according to the
      number) group consisted of patients with mental disturbances due to organic brain
      disorders. This group was characterized by an unfavourable previous social
      status. 80% of them had no place to live in, no close relatives. The authors
      think it necessary to set up special units of a hostel type for rehabilitation of
      "precipitated" patients within the framework of a mental hospital.

PMID- 7778403
TI  - [The diagnosis and treatment of neurosarcoidosis].
AB  - In 14% of patients with respiratory tract sarcoidosis granulomatous lesions were
      found in the central nervous system. Clinical classification of neurosarcoidosis
      was developed which included specific granulomatous forms: CNS arachnoiditis and
      perivasculitis, sarcoid myositis, as well as nonspecific forms (vasoautonomic
      dystonic syndrome, angiotrophoneurosis). Diagnostic and therapeutic techniques
      are presented.

PMID- 7778404
TI  - [Familial paroxysmal ataxia].
AB  - The paper provides clinical and paraclinical findings on 3 patients from one
      family (two brothers and father) suffering from familial paroxysmal ataxia. The
      authors observed psychosensory disturbances not typical, according to the
      literature for attacks of ataxia, dysarthria and nystagmus. The evidence obtained
      on cerebral and spinal evoked potentials made it possible to diagnose multilevel
      impairment of nervous impulse conduction in the somatosensory system which may be
      due to metabolic disturbances underlying the disease.

PMID- 7778405
TI  - [Binswanger's disease and the problem of vascular dementia: on the centenary of
      its first description].

PMID- 7778406
TI  - Electrophysiological evidence of Ranvier node clustering in human sensory nerve
      fascicles.
AB  - Thin concentric needle electrodes were used to explore intact median nerve
      fascicles in human subjects. In particular, the presence of single units,
      probably recorded from nodes of Ranvier, was studied in different parts of a
      fascicle. Single-unit activity in myelinated fibers was rarely found at numerous
      sites. In many other intrafascicular areas, a substantial number of single units
      could be discriminated in the same or nearby recording sites with the same
      technique. To account for the neurophysiological results, stochastic models and
      statistical tests were developed to test various hypotheses concerning
      intrafascicular nerve fiber arrangements. The acquired data suggested both an
      intrafascicular modality grouping of nerve fibers and a simultaneous clustering
      of the Ranvier nodes of these fibers within very restricted areas of a fascicle.
      It was further concluded that the yield when searching for units in different
      types of nerve preparations may depend upon the ultrastructure of the explored
      nerve segments.

PMID- 7778407
TI  - The influence of spatial summation on human tactile directional sensibility.
AB  - Spatial summation is known to influence the magnitude of sensation for stationary
      cutaneous stimuli. Yet analysis of moving stimuli may also be pertinent, since
      most stimuli that attract our attention involve movements over the skin surface.
      The present investigation dealt with the importance of spatial summation for the
      appreciation of the direction of motion for moving stimuli. The ability to detect
      the direction of motion was tested on the radial surface of the forearm with the
      two-alternative forced-choice method. Stimulation was performed with a rolling
      wheel, in order to exclude friction-generated activation of stretch receptors.
      Each subject was tested with two wheels with the same radius but different
      widths, 1 mm and 15 mm. On average, the subjects performed better with the wide
      wheel than with the narrow one for stimulation distances > or = 16 mm. This value
      also probably exceeds the threshold distance for directional discrimination for
      the narrow wheel, which indicates that spatial summation improves suprathreshold
      performance.

PMID- 7778408
TI  - Thresholds for the perception of pressure, sharpness, and mechanically evoked
      cutaneous pain: effects of laterality and repeated testing.
AB  - Twenty-four healthy human subjects provided thresholds for their perception of
      pressure, sharpness, and pain. Mechanical forces were applied to the dorsal
      surface of the digits with flat-tipped probes of various sizes. Thresholds
      (expressed as force) increased with increasing probe size, as previously
      described. There was no evidence of a laterality difference for any of the
      thresholds. There was a trend for increasing thresholds with repeated testing,
      but this trend was not statistically significant for the group as a whole.
      Examination of individual subjects' thresholds over time revealed that 27% showed
      significant increases in pain threshold over the 15 days of testing. In contrast,
      only 6% of subjects showed significant increases in sharpness or pressure
      thresholds over the same period. Thus, whereas most subjects exhibited stable
      pain thresholds, approximately one-fourth showed significant increases in pain
      threshold over time. We conclude that for evaluating regional dysesthesia or
      hemidysesthesia, a right-left difference in pain thresholds will provide a more
      sensitive and reliable measure than absolute pain threshold.

PMID- 7778409
TI  - Activation of the c-fos proto-oncogene in the spinal cord following noxious
      stimulation of the urinary bladder.
AB  - Activation of the c-fos proto-oncogene following mechanical or chemical noxious
      stimulation of the urinary bladder was studied at T12-L2 and L5-S1, the spinal
      cord segments of projection of the hypogastric nerve (HGN) and pelvic nerve (PN)
      fibers, respectively. In intact adult rats, c-fos expression was found at T12-L2
      only in lamina I. At L5-S1, Fos cells occurred in lamina I, the intermediolateral
      gray matter (ILG), and the dorsal commissure (DCM). These two areas contained the
      highest number of immunoreactive cells. Although more Fos cells were induced by
      mechanical than by chemical stimulation, the distribution of the reactive neurons
      was similar after both types of stimuli. In adult rats that had been treated
      neonatally with capsaicin, there was a marked fall in c-fos activation by
      mechanical or chemical noxious stimuli in all immunoreactive areas. The loss of
      Fos cells was more pronounced in ILG and DCM at L5-S1 (95%) than in lamina I at
      the two spinal domains (70%). The confinement of c-fos activation to lamina I at
      T12-L2, the spinal cord domain of the HGN, suggests that the input carried from
      the bladder by this nerve is preferentially used for pain perception. The same
      function is expected for noxious input reaching lamina I at L5-S1, the spinal
      cord territory of termination of the PN. However, the striking number of Fos
      cells in ILG and DCM supports the important role played by this nerve in the
      control of the micturition reflex.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778410
TI  - Response of monkey glabrous skin mechanoreceptors to random-noise sequences: I.
      Temporal response characteristics.
AB  - The response of slowly adapting (SA, Merkel cell), rapidly adapting (RA,
      Meissner), and Pacinian corpuscle (PC) mechanoreceptors in monkey glabrous skin
      were recorded while being activated with a vibrotactile indenting stimulus. For
      one set of experiments, the stimulator was driven by an 800-point (400-msec)
      pseudorandom-noise (PRN) sequence, repeated 40 times. For a second set of
      experiments, a non-repeating-noise (NRN) sequence was used. SA impulse patterns
      generated with the PRN sequence were highly regular and similar for all afferents
      tested. RA and PC response patterns were more varied, but exhibited basic
      intraclass similarities. SA and RA PRN stimulus impulse patterns were often
      nearly indistinguishable at low to medium discharge rates. At higher discharge
      rates, RA and SA discharge patterns differed, primarily because of the
      unambiguous suprathreshold velocity sensitivity and shorter recovery periods of
      RA afferents. PC impulse patterns were substantially different from SA and RA
      patterns, being clearly dependent on the stimulus velocity at all stimulus
      intensities. Input-output correlation analysis, coupled with PRN stimulus
      response analysis, provided a basis for hypothesizing the basic dynamic encoder
      function of each type of mechanoreceptor.

PMID- 7778411
TI  - The effects of aging on information-processing channels in the sense of touch: I.
      Absolute sensitivity.
AB  - Thresholds for detecting vibrotactile signals of variable frequency applied to
      the thenar eminence of the hand by small and large contactors were measured in
      subjects ranging in age from 10 to 89 years. Thresholds were found to increase as
      a function of age, but the rate of increase was greater after than before the age
      of 65 years. The rate of loss of vibrotactile sensitivity was substantially
      greater in the P channel (mediated by Pacinian corpuscles) than in the NP I
      channel (mediated by rapidly adapting fibers), the NP II channel (mediated by
      slowly adapting type II fibers), or the NP III channel (mediated by slowly
      adapting type I fibers). Women were frequently found to have greater sensitivity
      than men.

PMID- 7778412
TI  - The effects of aging on information-processing channels in the sense of touch:
      II. Temporal summation in the P channel.
AB  - Thresholds for detecting 250-Hz vibrotactile signals of variable duration applied
      to the thenar eminence of the hand were measured in 16 subjects ranging in age
      from 19 to 81 years. Detection thresholds were higher in older than in younger
      subjects. Correlation coefficients for the relation between threshold and age
      ranged from 0.94 to 0.96, depending on signal duration. In addition, the amount
      of temporal summation was negatively correlated with age. Both the elevated
      detection thresholds and the reduced amount of temporal summation in elderly
      subjects may be partially due to the decrease in the number of Pacinian
      corpuscles in the hand that occurs with aging. Another factor that could be
      responsible for reduced temporal summation in older as compared to younger
      subjects is impairment of the temporal integrator.

PMID- 7778413
TI  - Classification systems for health information: nursing components. Part 1: Client
      status.

PMID- 7778414
TI  - Betadine cleansing: central venous catheter sites. Interview by Eve Henderson.

PMID- 7778415
TI  - Nursing research support services: Foothills Hospital.

PMID- 7778416
TI  - Nurses' perceptions of informed consent.

PMID- 7778417
TI  - To incorporate or not?

PMID- 7778418
TI  - Community health nursing ready to meet the challenges of health reform.

PMID- 7778420
TI  - You called.

PMID- 7778419
TI  - A rural experience for nursing students.

PMID- 7778421
TI  - African strategy. How to fight the human immunodeficiency virus.

PMID- 7778422
TI  - Effects of single and combined application of anti-cancer drugs on cervical
      adenocarcinoma. I. Antitumor activity in vitro.
AB  - BACKGROUND: Establishment of effective combination chemotherapy regimen for
      patients with an adenocarcinoma of the uterine cervix has been long-awaited
      because there has been no documentation concerning chemosensitivity of this tumor
      against conventional antitumor agents. METHODS: To search for an effective
      combination regimen, 15 conventional antitumor drugs were tested for growth
      inhibitory effects on five different cervical adenocarcinoma cell lines. RESULTS:
      Etoposide, mitomycin C, adriamycin, epirubicin, and vinblastine, were singularly
      effective. Effects of combination chemotherapy were also tested using the above
      five antitumor agents plus interferon-gamma. Etoposide, mitomycin C, and
      interferon-gamma were the most effective when given in combination. CONCLUSIONS:
      Combined treatment with the above three drugs seems worthy of consideration for
      clinical application.

PMID- 7778424
TI  - Placenta previa, maternal smoking and recurrence risk.
AB  - In order to assess the risk of placenta previa among women who smoked during
      pregnancy and to study the recurrence risk of placenta previa, we analyzed data
      from the Swedish Medical Birth Registry. Among 1,825,998 infants of women
      delivered in 1973-1990, 5,683 had placenta previa registered. The overall
      incidence of placenta previa was 0.3%, the incidence in twin deliveries was also
      0.3%. The recurrence rate of placenta previa was 2.4%, which is an eightfold
      increase compared with the rate of a placenta previa among all births. Maternal
      smoking was studied for births in 1983-1990 and appeared as an independent risk
      factor for placenta previa. A dose-response between the number of cigarettes
      smoked during pregnancy and the risk of having a placenta previa was indicated.

PMID- 7778423
TI  - Hemodynamic, hematological and hemorrheological evaluation of post-term
      pregnancy.
AB  - OBJECTIVE: To evaluate the hemorrheological modifications in post-term pregnant
      women. METHODS: Pregnant women (n = 48) at > 280 days' gestation, were tested on
      alternate days by nonstress test; ultrasound assessment of amniotic fluid volume,
      placental grading, hourly measurement of fetal urine production, and maternal
      fetal Doppler analysis. We further recorded maternal: plasma viscosimetry, red
      blood cells, hemoglobin, hematocrit, platelet count, mean platelet volume,
      fibrinogen, antithrombin III, creatinine, uric acid, plasma calcium, hPL, and
      estriol. We analyzed the last values obtained within 48 hours prior to delivery.
      RESULTS: The subjects were divided into Group I (40 wks to 40 wks+3 days; n =
      16); Group II (40 wks+4 days to 41 wks; n = 16); Group III (> 41 wks; n = 16).
      The time-averaged maximum velocity of the fetal descending thoracic aorta was
      lower at Doppler analysis in Group III (29.0 +/- 3.5 cm/s) than in Group I (34.0
      +/- 4.3 cm/s; p < 0.05). A decrease of the middle cerebral/umbilical pulsatility
      index ratio (1.75 in the Group I vs 1.52 in the Group III; p < 0.05) was shown.
      Furthermore, the incidence of oligohydramnios; Grannum placental grade III;
      plasma viscosity and coagulation parameters were significantly higher in Group
      III patients. The plasma viscosity resulted positively correlated with uric acid,
      and inversely correlated with fibrinogen, antithrombin III and platelet number
      values. CONCLUSIONS: From the present data we conclude that post-term pregnancy
      may mimic a mild 'fetal growth restriction'.

PMID- 7778425
TI  - Symphysis-fundus height: construction of a new Swedish reference curve, based on
      ultrasonically dated pregnancies.
AB  - Repeated measurements of the symphysis-fundus (SF) distance is generally regarded
      as an acceptable screening instrument for antenatal detection of intrauterine
      growth retardation (IUGR). In the present investigation an SF curve is
      constructed, based on measurements from 1650 Swedish women with ultrasound dated
      pregnancies. The SF measurements were included in a cross-sectional stratified
      manner; only one measurement from each woman was used and the same number of
      measurements (n = 75) was used for each gestational week from 20 through 41. A
      regression analysis by a polynomial equation of third degree was applied on the
      means and standard deviations of the SF measurements in each week respectively to
      construct a graph of fundal height. This SF curve was compared with the SF curve
      in common use in Sweden (constructed by Westin); in the new curve the mean
      measurement was about one cm higher up to 37 gestational weeks, after which time
      the curves almost coincided. Neither did the mean SF height differ between
      smokers and non-smokers nor between nulliparous and parous women. The mean SF
      difference between the heaviest women (> or = 79 kg) and the lightest (> or = 53
      kg) was about two cm throughout pregnancy. The validity of the constructed SF
      curve as a screening instrument for IUGR needs to be investigated in a different
      study.

PMID- 7778426
TI  - Umbilical artery Doppler ultrasound predicts low birth weight and fetal death in
      hypertensive pregnancies.
AB  - BACKGROUND: Doppler ultrasound is nowadays common in the management of
      pregnancies complicated with hypertension, as an indirect assessment of fetal
      well-being. However, the value of abnormal umbilical artery Doppler results in
      predicting poor fetal outcome in hypertensive pregnancies has been studied in
      only a small number of patients. We designed a study to investigate the relation
      between abnormal umbilical artery Doppler velocimetry and fetal outcome in
      hypertensive pregnancies. DESIGN: A prospective observational study over a 2-year
      period was performed at the Hospital Clinic, University of Barcelona. Pulsed
      Doppler examinations of the umbilical artery were performed in one hundred and
      seventy-two hypertensive pregnant women. The physicians managing the case were
      not aware of the Doppler results. The incidence of low birth weight and fetal
      death were considered as the main outcome measures. RESULTS: When low birth
      weight was used as an end-point, abnormal resistance index showed a high
      specificity (95.16%), positive predictive value (83.33%), and negative predictive
      value (86.76%). Sensitivity was 62.5%. The absence of end-diastolic velocity
      predicted low birth weight in 100% of pregnancies and fetal death in 66.66%. All
      stillbirths had absence of end-diastolic velocity (sensitivity 100%). CONCLUSION:
      This study demonstrates that umbilical artery Doppler velocimetry is a useful
      tool to assess fetal well being in hypertensive pregnancies.

PMID- 7778427
TI  - Microalbuminuria following gestational diabetes.
AB  - BACKGROUND: Microalbuminuria (MA) precedes clinical nephropathy in patients with
      insulin-dependent diabetes mellitus, and is associated with an increased
      mortality, mostly due to cardiovascular disease in patients with non-insulin
      dependent diabetes mellitus. Microalbuminuria is rarely detected in patients with
      diabetes of less than five years' duration. Our study was designed to determine
      whether MA and its sequelae also appear 5-8 years after pregnancy complicated by
      gestational diabetes mellitus (GDM). METHODS: We examined the presence of MA in
      72 women who had not conceived since a previous GDM-pregnancy 5-8 years ago and
      compared them to a control group of 35 women who had no GDM history, and who were
      matched for age, parity and time since last pregnancy. Microalbuminuria was
      determined in all subjects using an overnight 8 hours urine collection. Mann
      Whitney rank-sum test was used to compare data between the study and the control
      groups. Student's t test was used to compare data within the study group.
      RESULTS: Median value of the urinary albumin excretion rate (AER) in the study
      group was significantly higher than median value of urinary AER of the control
      group (p < 0.0001), but only 30.5% of the subjects of the study group were found
      to be microalbuminuria-positive, defined as urinary AER value of more than 21
      mg/24 h. No correlation between MA and blood pressure, fasting blood glucose,
      serum creatinine, blood urea nitrogen and parity was found. CONCLUSIONS: MA was
      found to be more frequent after GDM and no predisposing factors for its
      appearance were elucidated. Hence, we suggest that it may well be a sign of early
      renal disease and that long-term follow-up of all GDM patients for MA and other
      markers of renal disease is strongly indicated.

PMID- 7778428
TI  - Laparoscopic surgical procedures for early ovarian cancer.
AB  - Early stage la ovarian cancer diagnosed at the time of laparoscopic procedure was
      managed by laparoscopy accordingly. The procedures included oophorectomy,
      contralateral ovarian biopsy, total omentectomy, paraaortic lymphadenectomy and
      appendectomy. The patient tolerated the procedures smoothly and resumed work in
      two days.

PMID- 7778429
TI  - Persistent episiotomy granulation polyps; a polysymptomatic clinical entity.
AB  - We describe a number of patients with persistent symptoms of vaginal discharge
      and discomfort, dyspareunia and postcoital bleeding. They presented 2-4 months
      following delivery with episiotomy. In these patients, the symptoms were
      associated with localised granulation tissue polyps, on the episiotomy site.
      Simple ablation resulted in rapid and effective relief of the symptoms. These
      lesions may be more common in clinical practice than is suggested by the lack of
      published reports. They should be looked for in women who may suffer from
      symptoms for several months after delivery.

PMID- 7778430
TI  - A quality of life perspective on who benefits from estradiol replacement therapy.
AB  - STUDY OBJECTIVE: To examine who may benefit from estrogen replacement therapy
      from a quality of life (QoL) perspective, taking both disease-specific and
      general aspects at baseline into account. DESIGN: A double-blind multi-center
      randomized placebo-controlled prospective study. The subjects were randomized to
      receive either transdermal estradiol or placebo for 12 weeks. QoL measures were
      disease-specific and generic. LOCATION: University hospital, teaching hospital
      and private practice. MATERIAL: Post-menopausal volunteering Swedish women (n =
      223) with mild to severe climacteric symptoms, as clinically evaluated by the
      Kupperman's Index. RESULTS: All QoL assessments showed highly significant
      improvement in the estradiol group in comparison with the placebo group. The
      women receiving placebo treatment also improved, but their improvement reached a
      peak at six weeks of treatment and then declined. In the estradiol group the
      improvement continued throughout the 12 weeks. After 12 weeks of treatment the
      change in the placebo-treated group was smaller on the disease-specific scales
      than on the generic scales and the Kupperman's Index. A high correlation was seen
      between the baseline score for a certain QoL assessment and the change in this
      score during treatment. The most striking result was that the mean change in QoL
      for the two groups was statistically significant for almost any pre-treatment QoL
      status. CONCLUSIONS: Women with slightly, moderately or severely diminished QoL
      status would benefit from estrogen treatment during the climacteric period. A
      similar tendency was seen in women with mild symptoms at baseline.

PMID- 7778432
TI  - Computerized colposcopy and conservative management of cervical intraepithelial
      neoplasia in pregnancy.
AB  - BACKGROUND: Computerized colposcopy is the noninvasive digital processing of
      colposcopic images acquired using a charge-coupled device camera. The purpose of
      this study was to evaluate the clinical applications of computerized colposcopy,
      and to record the colposcopic changes associated with progression or regression
      of cervical intraepithelial neoplasia in pregnancy. METHODS: Forty-one pregnant
      patients, with abnormal Papanicolaou smears and a fully visualized squamo
      columnar junction, were serially monitored throughout their pregnancies using
      computerized colposcopy. All patients had baseline computer-assisted measurements
      of their cervical lesions and a repeat measurement at monthly intervals and at 3
      months postpartum. RESULTS: During the period of gestation, 17.1% of lesions
      increased in size, 21.9% remained unchanged, 41.5% decreased in size and 19.5%
      disappeared completely. In patients with an increase in lesion size, a
      colposcopically directed punch biopsy was performed which revealed CIN III but no
      microinvasion. Cervical biopsy during pregnancy was unnecessary in 82.9% of
      cases. CONCLUSION: The ability to sequentially monitor and quantify
      colposcopically visualized lesions, using computerized colposcopy, provides a
      noninvasive objective mode to evaluate progression, stability, or regression of
      CIN lesions during pregnancy.

PMID- 7778431
TI  - Management of uterine perforations in connection with legal abortions.
AB  - The incidence of uterine perforation while performing legal abortions was
      evaluated in the Stockholm area. Among 84,850 legal abortions performed during
      1982-1992 there were 145 cases of uterine perforation, 0.17%. In about half of
      these cases an immediate exploration of the abdomen was decided upon and in 18
      patients there were significant bleeding and/or lacerations to organs situated in
      the pelvis. No case of intestinal perforation was encountered. It is likely that
      many of these injuries would have healed just as well unattended. Based on this
      study, the authors advocate a conservative approach in dealing with uterine
      perforation in connection with vacuum aspiration for legal abortion.

PMID- 7778433
TI  - Therapeutic and prognostic considerations in primary carcinoma of the vagina.
AB  - We analyzed 46 patients with primary carcinoma of the vagina treated between 1969
      and 1990. Median age of the patients was 67 years (range 33-89 years). Most (52%)
      of them were obese and 35% were nulliparous. Four (9%) had suffered from other
      gynecologic carcinoma and had been operated six to 23 years before the current
      carcinoma. Forty (87%) patients had squamous cell carcinoma. Stage 0 (carcinoma
      in situ) was found in three (7%) cases and stage I-IV in 21 (54%), 10 (22%), four
      (9%) and eight (17%) cases, respectively. Most (81%) of the patients were treated
      with radiotherapy (alone or in combination with other treatments): combination of
      brachytherapy and external radiotherapy were used in 45% of the cases. Surgery
      was used in all stage 0 cases and in 52% of stage I cases. Recurrence of the
      disease was found in 20 (43%) cases during the follow-up of 10 years. Most often
      (40%) site of the recurrence was the vagina. Both 5- and 10-year survival were
      38%. Stage and extent of the tumor were independent prognostic factors in
      stepwise multivariate analysis.

PMID- 7778435
TI  - Pregnancy complicated by malignant melanoma.

PMID- 7778434
TI  - Malignant germ cell tumors of the ovary: Hacettepe hospital experience.
AB  - BACKGROUND: To determine the most important prognostic factors in patients with
      malignant germ cell tumors of the ovary. METHODS: Age, histologic type, tumor
      size, stage, treatment mode, type of surgery of 67 patients with malignant germ
      cell tumors managed consecutively were evaluated retrospectively using
      multivariate analysis. RESULTS: The overall survival rate was 60.6%. This figure
      was 78.5% for dysgerminoma, 53.3% for immature teratoma, 12.0% for endodermal
      sinus tumor, 33.3% for mixed germ cell tumor and 100.0% for others. The patients
      with endodermal sinus tumor had significantly poorer survival than other groups.
      Among the factors analyzed for survival histologic type was found to be the most
      significant predictor for survival. CONCLUSIONS: Finding of histologic type as
      the strongest independent risk factor may be evaluated in correlation with the
      literature that these tumors have historically been investigated as
      dysgerminomatous and nondysgerminomatous tumors. Furthermore, endodermal sinus
      tumors had long been known for poor survival. Based on this data, despite advent
      of staging and effective chemotherapy, prognosis still is basically related to
      histologic type and histology of tumor should be taken into account while
      comparing results.

PMID- 7778436
TI  - Postpartum systemic capillary leak syndrome: a possible etiology.

PMID- 7778437
TI  - Twin transfusion syndrome associated with placental venous calcification.

PMID- 7778438
TI  - Dorsoposterior fetal position near term--a sonographic finding worth noting?

PMID- 7778439
TI  - Flow characteristics in infants with hypoplastic left heart syndrome: an
      echocardiographic study.
AB  - From July 1992 to January 1993, a total of 5 cases of hypoplastic left heart
      syndrome were diagnosed by echocardiograms and confirmed by available
      angiographic, surgical or autopsy results. The flow dynamics disclosed by
      spectrum display in the aortic root and patent ductus arteriosus (PDA), in
      systole, were: (1) antegrade in the ascending aorta and descending aorta (below
      PDA), and retrograde in the transverse aorta, and (2) right-to-left shunt in the
      PDA. While in diastole, there were (1) antegrade in the transverse aorta, and
      retrograde in the ascending aorta and descending aorta (below PDA), and (2) left
      to-right shunt in the PDA. No ventriculocoronary fistulas were identified. With
      both the characteristic flow pattern and the extremely narrow diameters of the
      ascending aorta in hypoplastic left heart syndrome, we can differentiate it from
      those heart diseases associated with secondary hypoplastic left heart due to
      total anomalous pulmonary venous connection or congenital pulmonary venous
      stenosis. Both help us understand better the hemodynamics and pathophysiology of
      hypoplastic left heart syndrome in these patients.

PMID- 7778440
TI  - Sinusitis and bronchial asthma in children.
AB  - Sinus disease has been assumed to exist in children with respiratory tract
      allergies. We consecutively evaluated 375 patients (245 male, 130 female) with
      childhood onset asthma, between 5 and 15 years of age (mean 7.8 years of age).
      Abnormal Waters radiographs were found in 205 patients (54.7%) which included
      mucosal wall thickening greater than 6 mm (67.3%), complete opacification (22.9%)
      and air-fluid levels (9.8%). The level of immunoglobulin (Ig) E was found to be
      much higher in non-sinusitis asthmatic children than in asthmatic children with
      sinusitis (1207 IU/mL vs. 644 IU/mL). The IgG, IgA, IgM and erythrocyte
      sedimentation rate (ESR) values were not significantly different in the two
      groups. All patients were treated with antibiotics for 3 to 6 weeks. Five
      patients required surgical intervention after antibiotic treatment had little
      success. Streptococcus viridans was isolated from 4 patients following surgical
      aspirates and Peptostreptococcus anaerobius was isolated in only one patient. In
      conclusion, sinusitis in children may be an aggravating factor for chronic
      reactive lower airway disease. Optimal treatment may decrease the need of
      asthmatic medication.

PMID- 7778441
TI  - Non-hyperventilation respiratory therapy of persistent pulmonary hypertension of
      the newborn.
AB  - Persistent pulmonary hypertension of the newborn (PPHN) is one of the most
      challenging situations in the neonatal intensive care nursery and it is
      associated with a high mortality rate. Hyperventilation therapy has been
      recommended as the primary ventilator management during recent decades. The
      associations of pulmonary barotrauma, chronic lung disease and hearing impairment
      raised the questions of significant pulmonary and neurological complications with
      this therapeutic modality. From July 1990 to April 1993, 14 cases of neonatal
      persistent pulmonary hypertension were treated with nonhyperventilation
      respiratory therapy at the Chang Gung Memorial Hospital. The goals of this
      therapy were to attain a pH level between 7.40 and 7.50, a PaO2 level between 60
      and 90 mmHg and a PaCO2 level between 30 and 50 mmHg. High peak inflating
      pressure (> 35 cmH2O) and high ventilator rates (> 60/min) were avoided. The
      average duration on a ventilator was 6.8 +/- 2.9 days. Four patients had
      pulmonary barotrauma (29%); three of which were pulmonary interstitial emphysema
      and one pneumothorax. Three patients died (21%). Only one patient had
      neurological sequelae. No one had developed chronic lung disease. The non
      hyperventilation approach for PPHN may be considered as an alternative ventilator
      management before starting a more aggressive hyperventilation therapy.

PMID- 7778443
TI  - The VATER association: analysis of forty six cases without karyotyping.
AB  - Forty-six patients with two or more features of the VATER association admitted to
      the Mackay Memorial Hospital from May, 1983 to Mar, 1992 were retrospectively
      enrolled in this study. We compared the incidence of major features with that
      reported in the literature. Imperforate anus, congenital heart disease, and renal
      anomalies were the three most common major features in our study. Thirteen
      patients died. Heart failure was the major cause of mortality. We noted many
      patients associated minor features, and among them there was a relatively high
      ratio of cleft lip, cleft palate, and hypospadius. The overall outcome and
      development were good among the survivals. We suggest that children who have any
      congenital anomaly included in the VATER association should get a careful
      examination and evaluation of their heart, genitourinary tract, limbs and
      vertebrae. Early correction if possible is indicated in such patients.

PMID- 7778442
TI  - Characterization of Albright hereditary osteodystrophy and related disorders.
AB  - Albright hereditary osteodystrophy (AHO) is an autosomal dominant disorder with
      characteristic skeletal and developmental defects and reduced expression or
      activity of the alpha chain of the G protein that stimulates adenylyl cyclase (Gs
      alpha). Most patients with AHO exhibit target tissue resistance to multiple
      hormones whose actions are mediated by cyclic AMP (cAMP) as a second messenger,
      such as the parathyroid hormone (PTH). This form of the disorder is known as
      pseudohypoparathyroidism (PHP) type Ia. Patients with PHP type Ia usually have
      relatives with AHO who do not exhibit hormone resistance despite having the same
      defect in Gs alpha. This variant, yet unexplained, is known as
      pseudopseudohypoparathyroidism (PPHP). PHP type Ib is manifested by a limited
      hormone resistance to PTH and is believed to be caused by defects in the PTH
      receptor. Patients with PHP type Ic have normal Gs alpha activity and show
      morphologic defects similar to those in AHO as well as resistance to multiple
      hormones. PHP type II, a much rarer disease, is probably caused by vitamin D
      deficiency.

PMID- 7778444
TI  - Self-management and attributes of juveniles with insulin-dependent diabetes
      mellitus.
AB  - The purpose of this study was to investigate the self-reported self-management of
      juveniles with IDDM and the factors influencing self-management. Sixty-eight
      subjects, ranging from the fourth grade of primary school to the third year of
      junior high school, were recruited from the enrollment list of the Taipei IDDM
      Registry and from the list of the Kang-Tai IDDM Association. Results illustrated
      that patient's age, educational level, knowledge about IDDM, self-concept, and
      family rearing behaviors had significant associations with some aspects of self
      management. Intensive health education or counselling for patients and their
      parents is highly recommended in order to improve their knowledge, self
      management practice and psychosocial adjustment.

PMID- 7778446
TI  - Chylous ascites: report of one case.
AB  - Chylous ascites is rare if found in the pediatric age group, and is usually of
      unknown etiology or comes from congenital anomalies of the lymphatic system. A
      3.2 kg male newborn was born at 36-week gestation by Cesarean section prompted by
      fetal distress. Distended abdomen was noted after birth and abdominal ultrasound
      revealed significant ascites. Repeated paracenteses were done to relieve the
      respiratory distress, and a milky ascitic fluid with specific gravity of 1.031,
      WBC 1.32 x 10(4)/mm3 (lymphocytes predominant), and triglycerides 812 mg/dl was
      noted at the third tapping after feeding with normal infant formula. The
      lipoprotein electrophoresis of the ascites showed great increase in proportion of
      chylomicron to 19.05%. Pregestimil was given, and the ascites gradually subsided.
      The patient was discharged on the 13th day after birth. His growth was normal at
      one-month follow up without recurrence of ascites.

PMID- 7778445
TI  - The study of pollen and Der p mite-specific IgE antibodies in children with
      allergic rhinitis.
AB  - The role of pollens and house dust mites in perennial chronic rhinitis has been
      investigated for the Taipei area. Fifty-four serum specimens were collected from
      children with chronic rhinitis. EIA kits (Phadezyme RAST) were used to detect
      specific IgE antibody of nine allergens, including house dust mite (Der p) and
      eight common pollens. The children were divided into allergic (AR) and
      nonallergic (NAR) groups, based on the results of skin tests, inhalant allergen
      specific IgE screen (Phadiatop), physical examination, past history and family
      history. The results showed: (1) 41 (76%) patients were defined as allergic
      rhinitis; (2) Der p specific IgE was detected in 41 (100%) AR patients and 7
      (54%) NAR patients (P < 0.005), a strong positive reaction (> 2+) in 83% AR and
      none NAR patients (P < 0.005); (3) one, or more than one, pollen-specific IgE
      were found in 13 (32%) AR and 4 (31%) NAR patients. No strong positive reaction
      was detected in either group. THE CONCLUSION: (1) three-fourths of the children
      with chronic rhinitis are allergic by nature; (2) house dust mite is the major
      allergen of allergic rhinitis; (3) in the Taipei area, pollen does not play an
      important role for children with allergic rhinitis.

PMID- 7778447
TI  - Common atrium with Ebstein's anomaly in a neonate with Ellis-van Creveld
      syndrome.
AB  - A female newborn with characteristic multiple anomalies of Ellis-van Creveld
      syndrome is reported. Common atrium with Ebstein's malformation of the tricuspid
      valve was diagnosed by serial echocardiographic examinations. Such a combination
      of cardiac anomalies have not previously been reported in this syndrome.

PMID- 7778448
TI  - Experience of intravenous immunoglobulin and acyclovir in neonates at risk for
      severe varicella infection--report of five cases.
AB  - Five cases of at-risk neonates for severe varicella infection were reported.
      Intravenous immunoglobulin (IVIG) was given soon after birth in different ways to
      four of them (Case 1 received 400 mg/kg/day for the first three days of life;
      Case 2 received a single dose of 200 mg/kg on day 2, and another dose of 160
      mg/kg on day 7; Cases 3 and 4 received 400 mg/kg on day 2). All five patients
      were given acyclovir therapy, 40 to 45 mg/kg/day for five to nine days. (Case 1
      for prophylaxis, Cases 2, 3, 4, 5 for treatment). Case 2, 3, 4, 5 developed
      vesicular rash, mild to moderate in degree, with rapid resolution without any
      constitutional symptoms. Case 1, who received both IVIG and acyclovir for
      prophylaxis, had no vesicle occurrence. IVIG, in combination with acyclovir, is a
      safe and probably effective regimen for preventing severe varicella in at-risk
      neonates. A multi-centered, collaborative study is mandatory to study the
      efficacy of prophylactic acyclovir with IVIG in these neonates.

PMID- 7778449
TI  - Intestinal volvulus caused by a persistent omphalomesenteric band: report of one
      case.
AB  - Persistent omphalomesenteric band is a rare cause of volvulus or intestinal
      obstruction. A 7-month-old male infant was brought to this Emergency Room after
      having shown poor appetite for three days, frequent bilious vomiting, and fever
      for half a day. Physical examination revealed the infant was dehydrated and had
      slight abdominal distension as well as hypoactive bowel sounds with a tender, ill
      defined mass over right lower quadrant. Radiography and sonography were
      consistent with distal small bowel obstruction. Emergent laparotomy was done and
      a fibrous band found extending from the anti-mesenteric border of the ileum to
      the posterior wall of the umbilicus. Small bowel volvulus had occurred around the
      band and dilated small bowel was noted. An understanding of the embryologic
      development of these structures and their normal disappearance may assist
      pediatricians and surgeons to make the correct diagnosis and select the right
      pathoanatomic approach in surgery.

PMID- 7778451
TI  - Characterization of sports by the VO2 dynamics of athletes in response to
      sinusoidal work load.
AB  - The purpose of this study was to evaluate the specificity of maximal oxygen
      uptake (VO2max) and the dynamic response of oxygen uptake (VO2) to sinusoidal
      work load in distance runners and in American-football players. Sinusoidal work
      load during ergometer cycling was carried from 30 W to 60% to VO2max (60% VO2max)
      for a 2 min period. VO2 was measured by the breath-by-breath method. The subjects
      were 10 distance runners (DRs), 10 American-football players (AFPs), and 11
      untrained men (UTM). Mean VO2max was 64.4 mL kg-1 min-1 in the DRs, 53.1 mL kg-1
      min-1 in the AFPs and 47.3 mL kg-1 min-1 in the UTM. The fundamental amplitudes
      of the VO2 response, normalized by dividing by steady state VO2 at 60% VO2max,
      were similar in the AFPs (20.3%) and the UTM (19.5%), and both were significantly
      less than in the DRs (25.5%). Phase shift to work load expressed in degrees was
      similar in the AFPs (87.7 degrees) and UTM (88.0 degrees), but significantly
      greater than in the DRs (80.4 degrees). HR dynamics in all three groups were
      similar to a dynamic VO2 response. These findings suggest that development of the
      dynamic VO2 response and higher VO2max is achieved in the DRs. They also suggest
      that despite the higher VO2max in the AFPs there is no improvement in the dynamic
      VO2 response. The results of the present study demonstrate that athletes
      participating in different sports have characteristic dynamic VO2 responses
      during cycling exercise.

PMID- 7778450
TI  - Thyroid hormone regulation of myosin heavy chain isoform composition in young and
      old rats, with special reference to IIX myosin.
AB  - The effects of 4 weeks of thyroid hormone (3,5,3'-triiodothyronine, T3) treatment
      on the myosin heavy chain (MHC) composition were compared in the slow-twitch
      soleus and the fast-twitch extensor digitorum longus (EDL) muscles from young (3
      6 months) and old (20-24 months) male albino rats. Four MHC isoforms were
      separated on silver-stained 6% sodium dodecyl sulphate polyacrylamide gel
      electrophoresis. According to immunoblotting experiments with specific MHC
      monoclonal antibodies, the four MHCs corresponded to types I, IIB, IIX and IIA.
      In the soleus, the type I MHC content was higher in the old than in the young
      animals, and the type IIA content lower. Type IIX myosin was observed in some
      young control soleus, but not in old ones. After T3 treatment, the content of
      type I MHC decreased substantially in both young and old animals and that of type
      IIA increased. After T3 treatment, type IIX myosin was observed in both young and
      old animals, with a slightly higher IIX myosin content in old age, but the age
      related difference in the contents of types I and IIA was diminished. In EDL, the
      type IIX MHC content was significantly higher in the old animals, at the expense
      of a lower content of type IIB MHC. MHC composition was not affected
      significantly by T3 treatment in EDL, either in young or old animals. In
      conclusion, an age-related motor unit transformation is observed in both the slow
      twitch soleus and the fast-twitch EDL and the capacity for MHC isoform switching
      in response to T3 treatment is not impaired in old age.

PMID- 7778452
TI  - Pitfalls in the interpretation of spectral analysis of the heart rate variability
      during exercise in humans.
AB  - The recent use of spectral analysis of the R-R interval variability to assess the
      autonomic drive during exercise has produced inconsistent results. The purpose of
      this study was to assess whether the spectral components of the R-R interval
      variability reflect different mechanisms at rest and during exercise.
      Autoregressive spectral analysis of the electrocardiographic and breathing
      signals was performed in 11 healthy young men at rest and during incremental
      cycle ergometry. The amplitude of respiratory sinus arrhythmia, i.e. the absolute
      power of the high frequency spectral component, fell at the onset of exercise,
      consistent with a reduction in cardiac vagal activity. Conversely, the normalized
      power of the high frequency component, (i.e. the percentage of R-R interval
      variance due to the respiratory sinus arrhythmia) increased with increasing work
      rates. The low frequency spectral component of the R-R interval variability,
      which when expressed in normalized units is believed to reflect cardiac
      sympathetic activity, was no longer detectable in severe exercise when the
      adrenergic drive is known to be elevated. In conclusion, autoregressive spectral
      analysis of the R-R interval variability does not adequately reflect the
      autonomic changes that occur during incremental exercise. In particular, the
      evidence indicates that as the cardiac vagal tone falls with increasing levels of
      exercise, a greater percentage of the residual power of the high frequency
      component may be due to non-neural mechanisms.

PMID- 7778453
TI  - Excitation and contraction in atrial and ventricular myocardium of the guinea
      pig.
AB  - Several parameters of excitation-contraction coupling were compared in two types
      of muscle, using thin strips from the left atria and papillary muscles from the
      right ventricles of guinea-pigs. (1) The duration of the action potential and
      twitch is much longer in ventricular than in atrial muscle. (2) Mechanical
      restitution can usually be described by a monoexponential function in ventricular
      and biexponential function in atrial muscle. (3) Post-extrasystolic potentiation,
      when related to the steady state force, is greater in ventricular muscle. (4)
      When priming with paired-pulse stimulation, mechanical restitution can be studied
      after the short interval and after the long interval. In atrial muscle,
      mechanical restitution is very similar after the short and long intervals but in
      ventricular muscle they are different in size. (5) Ryanodine (10(-6) M) can
      decrease the steady state force to about 10% of control in atrial but only to
      about 35% in ventricular muscle. Ryanodine (10(-8) M) causes the slow phase of
      restitution in atrial muscle to disappear but in ventricular muscle only
      increases the rate of mechanical restitution. (6) Ca-antagonists (Cd2+ 0.2 mM)
      can decrease the steady state force to zero in atrial and ventricular muscle. Ca
      antagonists, in low concentrations (Cd2+ 0.01 mM), mainly affected the fast phase
      of mechanical restitution. (7) The recirculation fraction of calcium was about
      0.64 in atrial and 0.27 in ventricular muscle. The findings are discussed in the
      light of known ultrastructural differences between atrial and ventricular
      myocardium.

PMID- 7778454
TI  - Myocardial inositoltrisphosphate is depressed by dibutyryl cAMP. An experimental
      study in the isolated working rat heart.
AB  - A possible interrelation between IP3 and cAMP was studied in rat myocardium
      through circumvention of the receptor mediated stimulatory step of adenylyl
      cyclase by the administration of dibutyryl cAMP (db-cAMP). Changes in IP3 and
      cyclic nucleotide contents were correlated to changes in contractility after 40
      min of beta- and alpha-adrenergic stimulation. Rat hearts (n = 23) were perfused
      with Krebs-Henseleit buffer in a modified Langendorff apparatus as a working
      preparation. The hearts were allocated to perfusion as control (n = 6); or with
      phenylephrine (10(-6) mol L-1, n = 6); (-)-isoproterenol (10(-6) mol L-1, n = 6);
      db-cAMP (2 x 10(-4) mol L-1, n = 5). All hearts were freeze-clamped after 40 min
      of perfusion. Phenylephrine produced a slow increase in maxdP/dt reaching a
      maximal value after 10 min (P < 0.05); thereafter it decreased, reaching the
      control level at 30 min. Isoproterenol perfusion resulted in an early (20 s)
      increase in maxdP/dt (P < 0.05). Over the next 10s maxdP/dt decreased markedly
      reaching an inflection point at 30 s. Thereafter only a slow increase during the
      rest of the perfusion was seen. Dibutyryl cAMP increased maxdP/dt slowly during
      the whole perfusion period reaching maximum after 40 min. Cyclic-AMP was
      increased by 21% after 40 min of phenylephrine perfusion while the corresponding
      increases by isoproterenol and db-cAMP were 131 and 105%, respectively (P <
      0.05). Phenylephrine increased IP3 content to the same extent as isoproterenol
      perfusion (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778455
TI  - Carbachol-induced increase in inositol trisphosphate (IP3) content is attenuated
      by adrenergic stimulation in the isolated working rat heart.
AB  - The interrelated responses of concomitant adrenergic and muscarinic receptor
      stimulation on second messengers and mechanical activity in the isolated perfused
      working rat heart were studied. The hearts were perfused with Krebs-Henseleit
      buffer in a modified Langendorff apparatus. The hearts were perfused with
      noradrenaline (10(-6) mol L-1, n = 20), with carbachol (3 x 10(-7) mol L-1, n =
      11) or with noradrenaline plus carbachol (n = 20) in the above-mentioned
      concentrations. The hearts were frozen at 20 s, 30 s and 40 min after addition of
      noradrenaline and noradrenaline plus carbachol and at 20 s and 40 min after
      addition of carbachol. Five hearts were freeze-clamped directly after
      preperfusion and another five hearts after 40 min of perfusion and used as
      controls. Myocardial cAMP increased at 20 s and 40 min after noradrenaline
      perfusion. In contrast to this cAMP was unchanged at 20 s and decreased at 40 min
      after perfusion with noradrenaline plus carbachol. IP3 content increased after 20
      s of carbachol- and after 40 min of noradrenaline perfusion (P < 0.05). However,
      noradrenaline plus carbachol did not induced any significant increase in IP3
      content after 20 s and 30 s, but after 40 min a decrease below basal level was
      found (P < 0.05). Noradrenaline stimulation attenuated muscarinic agonist induced
      IP3 formation. A reciprocity existed in that noradrenaline induced IP3 formation
      was attenuated by carbachol. No direct relationship was observed between the IP3
      response and contractility, also valid for cAMP.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778456
TI  - Intravenous lipid infusion results in myocardial lipid droplet accumulation
      combined with reduced myocardial performance in heparinized rabbits.
AB  - The question addressed in this study was whether a relation between myocardial
      lipid droplet accumulation and depressed myocardial function existed following
      intralipid infusion for 45 min in open chest, anaesthetized rabbits. One group of
      rabbits (n = 8) received intralipid infusion whereas a control group (n = 8)
      received sodium chloride. Local myocardial performance was obtained by
      sonomicrometry and the fractional volume of myocardial lipid droplets was
      measured by morphometric methods. The fractional volume of lipid droplets was
      0.667 +/- 0.116% in the intralipid group compared with 0.318 +/- 0.080% in the
      control group (P < 0.03). Cardiac output and stroke volume fell 26% (P < 0.0001)
      and 34% (P < 0.0001), respectively, as a result of intralipid infusion. However,
      myocardial blood flow obtained by radiolabelled microspheres remained unchanged.
      Local myocardial function was reduced for both segments after intralipid
      infusion; maximal systolic shortening was reduced from 15.63 +/- 1.45 to 12.07 +/
      1.55% (P < 0.002) in the circumferential segment and from 9.46 +/- 1.17 to 7.40
      +/- 0.53% (P < 0.05) in the longitudinal segment. The end-diastolic length of the
      circumferential segment was reduced by 3% (P < 0.05) after intralipid infusion.
      The reduced end-diastolic length of circumferential segments together with
      unchanged left ventricular end-diastolic pressure might indicate reduced left
      ventricular end-diastolic compliance. We conclude that acute intralipid infusion
      in rabbits results in myocardial lipid droplet accumulation and depressed local
      myocardial function.

PMID- 7778457
TI  - Renal sodium excretion after oral or intravenous sodium loading in sodium
      deprived normotensive and spontaneously hypertensive rats.
AB  - Spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto (WKY) rats
      that had been on a low sodium diet for 3 days were given 1.5 mmol sodium chloride
      kg-1 body weight either orally or intravenously. The rats receiving an oral
      sodium load showed a greater natriuresis than those receiving the same saline
      load intravenously. No increase of renal sodium excretion was observed when the
      rats received a hypertonic mannitol solution orally. The cumulative sodium
      excretion during the 8 h following oral loading was two to three times larger in
      SHR than in WKY, whereas no difference between strains could be demonstrated
      after giving saline intravenously. Furthermore, after switching from normal to
      low sodium diet the rate of decrease of renal sodium excretion was greater in SHR
      than in WKY rats. It is proposed that there exists a gastrointestinal sensory
      mechanism for sodium controlling the renal sodium excretion. Furthermore, it is
      suggested that the function of this mechanism differs between SHR and WKY.

PMID- 7778458
TI  - The effects of hypothermia on renal function and haemodynamics in the rat.
AB  - The effects of 1-2 h of hypothermia at 28 degrees C and rewarming on renal
      function were investigated in anaesthetized rats, using conventional clearance
      methods and the micropuncture technique. Renal blood flow (RBF) decreased from
      7.3 +/- 0.51 mL min-1 at 37.5 degrees C (control) to 4.0 +/- 0.47 at 28 degrees
      C, with almost complete restoration to 6.9 +/- 0.59 mL min-1 after rewarming.
      Systemic blood pressure remained essentially unaltered. The RBF reduction seen
      during hypothermia was due to a 75% increase in vascular resistance, mainly
      attributable to constriction of the afferent arteriole and increased blood
      viscosity. This was accompanied by a decline in glomerular capillary pressure
      from 56.7 +/- 0.6 to 46.4 +/- 1.3 mmHg, overshooting to 59.0 +/- 0.7 mmHg. The
      glomerular filtration rate (GFR) decreased from 1.1 +/- 0.08 to 0.6 +/- 0.04 mL
      min-1, returning to 1.0 +/- 0.07 after rewarming, a pattern also observed for
      single nephron GFR. This resulted from a decrease in net driving force for
      glomerular filtration, whereas the filtration coefficient was not affected. Both
      proximal and distal tubular fluid flow decreased, but fractional reabsorption
      remained unchanged. In contrast, urine flow increased from 1.8 +/- 0.16 to 5.7 +/
      1.08 microL min-1, returning to 2.1 +/- 0.18, the increase during hypothermia
      mainly resulting from a disproportionately reduced fluid reabsorption beyond the
      mid-distal tubule.

PMID- 7778459
TI  - Fat content affects heat capacity: a study in mice.
AB  - The specific heat capacity of the human body is a widely used number in
      calculations related to studies in energy metabolism and temperature regulation.
      A value of 3.47 kJ kg-1 K-1 has been used during the last century, but there have
      been no direct studies on the dependence of this value on the body fat content.
      We present here results of measurements of the specific heat capacity of lean and
      obese mice. The mice were killed and heated to 40.6 degrees C, transferred to a
      calorimeter and the specific heat capacity was determined from body mass of the
      mice and temperature rise of water in the calorimeter. We measured the fat
      fraction of body mass (mf), fat free body mass and water content of the mice and
      found a marked dependency of the specific heat capacity (Cp) on body fat. In
      obese mice (fat content 52.76% body wt) the heat capacity was 2.65 kJ kg-1 K-1
      and in lean mice (fat content 7.55% body wt) the heat capacity was 3.66 kJ kg-1 K
      1.

PMID- 7778461
TI  - Haem oxygenase activity in blood vessel homogenates as measured by carbon
      monoxide production.

PMID- 7778460
TI  - Sympathetic regulation of fructose secretion in the seminal vesicle of the guinea
      pig.
AB  - Fructose secretion of everted guinea-pig seminal vesicles was studied in vitro.
      Carbachol produced dose dependent increase in fructose secretion. The effect was
      blocked by scopolamine but not by hexamethonium, mecamylamine, tetrodotoxin or
      previous denervation. High concentrations of acetylcholine also increased
      fructose secretion. This response was not augmented by physostigmine. Methoxamine
      reduced secretion. Methoxamine, terbutaline, clonidine and vasoactive intestinal
      peptide counteracted carbachol. Field stimulation produced increased secretion
      that was not blocked by autonomic drugs, tetrodotoxin or previous denervation.
      Stimulation of the hypogastric nerve produced frequency dependent increase in
      fructose secretion. The effect was blocked by tetrodotoxin and scopolamine but
      not enhanced by physostigmine. If the hypogastric nerve was stimulated close to
      the seminal vesicle the response was unaffected by hexamethonium but proximal
      stimulation was blocked. After chronic proximal denervation of the hypogastric
      nerve, stimulation close to the seminal vesicle produced enhanced response.
      Destruction of the peripheral ganglia at the base of the seminal vesicle
      abolished the response. Sections showed that most secretory nerves enter the
      organ at its base. Phentolamine or yohimbine but not prazosine or propranolol or
      guanethidine enhanced the secretory response to distal hypogastric nerve
      stimulation. Tyramine counteracted the response but after reserpinization it was
      enhanced by tyramine. It is concluded that the secretory cells of the guinea-pig
      seminal vesicle have a sympathetic secretomotor innervation by short cholinergic
      neurones with a preganglionic supply via the hypogastric nerve. Inhibitory alpha
      1 and beta 2-adrenoreceptors are present on the cells but neurogenic adrenergic
      inhibition of the secretion is essentially prejunctional and due to activation of
      inhibitory alpha 2-receptors on the secretomotor nerves.

PMID- 7778463
TI  - The effect of creatine monohydrate ingestion on anaerobic power indices, muscular
      strength and body composition.

PMID- 7778462
TI  - Insulinotropic action of truncated glucagon-like peptide-1 in mice.

PMID- 7778464
TI  - Effect of branched-chain amino acid and carbohydrate supplementation on the
      exercise-induced change in plasma and muscle concentration of amino acids in
      human subjects.
AB  - Five male endurance-trained subjects performed exhaustive exercise on a cycle
      ergometer at a work rate corresponding to 75% of their VO2max after reduction of
      their muscle glycogen stores. During exercise the subjects were given in random
      order a 6% carbohydrate solution continuing 7 g L-1 of branched-chain amino acids
      (BCAA), a 6% CHO solution and flavoured water. The physical performance was
      lowered in four of the five subjects when they were given flavoured water during
      exercise as compared with the two conditions when CHO was supplied. No difference
      in performance was found when the subjects were given CHO + BCAA or only CHO
      during exercise. When CHO + BCAA was supplied the plasma and muscle (vastus
      lateralis) concentrations of BCAA increased during exercise by 120 and 35%,
      respectively. In the other conditions there was no change or a slight decrease in
      the plasma concentrations of BCAA, but the muscle concentrations of BCAA were
      decreased after exercise. The plasma concentration of glutamine over the whole
      exercise period and 5 min after exercise was higher when CHO + BCAA were supplied
      during exercise compared with a supply of CHO alone or water. However, exercise
      caused no change in the muscle concentration of glutamine, whereas that of
      glutamate decreased in all three conditions. A supply of CHO + BCAA or CHO alone
      did not affect the exercise-induced increase in the plasma and muscle
      concentration of aromatic amino acids, indicating that neither BCAA nor CHO
      influenced the net protein degradation during exercise.

PMID- 7778465
TI  - Phosphate metabolism of prior eccentrically loaded vastus medialis muscle during
      exercise in humans.
AB  - The possible alteration of metabolism of the m. vastus medialis was investigated
      during exercise after eccentric loading. Twelve male subjects performed stepping
      exercise for 25-60 min. One week before and 24 h after stepping they performed
      concentric leg exercise at stepwise increasing intensity, while power output was
      measured. During this concentric exercise and recovery therefrom, phosphorous
      metabolites were also measured in the m. vastus medialis with magnetic resonance
      spectroscopy. Creatine kinase and myoglobin in blood were measured before and 72
      h after stepping. T1 and T2 1H-relaxation times for water were calculated from
      magnetic resonance images collected 72 h after stepping, and used as measures for
      oedema. The subjects perceived substantial soreness from 24 to 72 h after
      stepping. The ratio of inorganic phosphate over phosphocreatine at rest increased
      from 0.12 +/- 0.02 (before) to 0.19 +/- 0.04 (24 h after stepping) (P < 0.05).
      Creatine kinase activity was slightly elevated 72 h after stepping (71 [49-812] U
      L-1 [median, range]; P < 0.05) compared with baseline values (58 [26-409] U L-1),
      whereas myoglobin concentration was not significantly elevated (15 [8-120]
      micrograms L-1 compared with 8 [8-41] micrograms L-1). In the eccentrically
      exercised muscles, T1 and T2 values were not or only slightly higher than in the
      concentrically exercised contralateral muscles. The relation between power and
      the ratio of inorganic phosphate over phosphocreatine during concentric exercise,
      and the recovery data for inorganic phosphate, phosphocreatine and pH did not
      alter after stepping. These data suggest that quadriceps metabolism during
      concentric exercise and recovery therefrom is not affected by prior eccentric
      overload, but it cannot be excluded that metabolism will alter during exercise
      after more strenuous prior eccentric overload.

PMID- 7778466
TI  - Personality dimensions of opiate addicts.
AB  - A survey of 80 opiate addicts included in a detoxification program was conducted
      at the Institute on Addictions in Belgrade. In addition to a dependence diagnosis
      and mental disorders based on DSM-III-R, we applied a Tridimensional Personality
      Questionnaire (TPQ) that measures the 3 major personality dimensions: novelty
      seeking (NS), harm avoidance (HA) and reward dependence (RD). When compared with
      a control group (a sample of Yugoslav undergraduate students), the opiate addicts
      demonstrate significantly high NS dimension as well as significant divergences of
      HA and RD subscales. The surveyed opiate addicts demonstrate a high percentage of
      personality disorders specifically in cluster B. The personality dimensions of
      opiate addicts showed certain temperament traits, such as: impulsiveness, shyness
      with strangers, fear of uncertainty and dependence. NS, HA and RD determined by
      temperament specifics may be an etiological factor in forming of a personality
      disorder, an affective disorder as well as of a drug choice.

PMID- 7778467
TI  - Clinical recovery from panic disorder is associated with evidence of changes in
      cardiovascular regulation.
AB  - Cardiovascular measures (spectral derivatives of heart rate variability, the
      blood pressure response to standing and plasma noradrenaline levels) have been
      shown to change as clinical recovery follows the treatment of panic disorder
      patients with either imipramine or cognitive therapy. These findings can be
      interpreted as evidence of changes in baroreflex modulation, an important feature
      of the cardiovascular expression of arousal. This offers further evidence of a
      dysregulation of arousal in this disorder.

PMID- 7778468
TI  - The predictive value of depression in anorexia nervosa. Results of a seven-year
      follow-up study.
AB  - This study investigated the predictive value of depression in patients with
      adolescent anorexia nervosa. Thirty-four anorectic inpatients were assessed for
      DSM-III-R comorbid major depression at admission and at 3-year and 7-year follow
      ups. Two standardized instruments, the Zung Self-rating Depression Scale and the
      Hamilton Depression Rating Scale, were applied to improve objective rating of
      depression. The findings suggest that severity of depressive symptoms at
      admission does not correlate with the severity of depression at follow-up,
      initial depressive psychopathology is not a valid prognostic indicator for the
      outcome of the eating disorder and at follow-up there is a highly significant
      relationship between depression and the outcome of anorexia nervosa. Patients
      with persisting eating disorder are also very likely to suffer from comorbid
      depression.

PMID- 7778469
TI  - Schizophrenics with small P300: a subgroup with a neurodevelopmental disturbance
      and a high risk for tardive dyskinesia?
AB  - Schizophrenics with a neurodevelopmental disturbance resulting in micro- and
      macroanatomical cortical abnormalities are supposed to form a subgroup clinically
      characterized by low premorbid adjustment, early onset, incomplete remission,
      poor outcome, male predominance and high risk for tardive dyskinesia. A small
      amplitude of the event-related P3 (P300) potential could be a marker of this
      subgroup, because the cortical neurons and their orderly laminar arrangement are
      crucial for the electrogenesis of P3. In a 2-year follow-up study, auditory
      evoked P3 was recorded in 89 stabilized schizophrenic outpatients. Patients who
      developed tardive dyskinesia during the follow-up had smaller P3 than matched
      controls. Furthermore, a small P3 was associated with low premorbid adjustment,
      pronounced residual symptoms, low relapse rate, and male predominance. These
      findings indicate that schizophrenic patients with a reduced P3 have a higher
      risk of developing tardive dyskinesia and correspond clinically to a
      schizophrenic subgroup with a supposedly neurodevelopmental disturbance.

PMID- 7778471
TI  - Definite and undetermined forensic diagnoses of suicide among immigrants in
      Sweden.
AB  - A total of 707 cases of violent death (suicide, undetermined mode or accident)
      occurring in 1990 were investigated at the Department of Forensic Medicine in
      Stockholm. The catchment area of the Department includes about 1.9 million
      people. Fourteen percent of the population in the area are immigrants. The
      largest single immigrant group was the 91,015 Finnish-born inhabitants, who
      represented 33% of the overall immigrant population. Thirty percent of all
      undetermined deaths and 20% of the suicides were among people born outside
      Sweden. A significant overrepresentation of the largest immigrant group (Finnish
      born) was found in both the definite and undetermined suicide categories. There
      was also an overall overrepresentation of immigrants among the undetermined cases
      and a trend towards overrepresentation among definite suicides. Also, there was a
      significant overall overrepresentation of immigrants in the total cases of
      undetermined and definite suicide. Some psychosocial factors found predominant
      among the immigrant sample were social isolation, low social class and poor
      social network. The findings in this study indicates that immigrant status should
      be considered as a risk factor for suicide in Sweden. Previous reports on the
      high suicide rates among immigrants in Australia, Canada, Great Britain and the
      United States suggest that the overrepresentation of immigrants found in our
      study could represent a worldwide epidemiological trend related to voluntary and
      forced migration. Possible hypotheses that could explain this phenomenon are
      discussed.

PMID- 7778470
TI  - Blood pressure as a risk factor for depression in elderly people: a prospective
      study.
AB  - A total of 1070 men and women aged 65 years and over living in the community in
      Liverpool were interviewed using the Geriatric Mental State. Diagnoses of
      depression at case and subcase level were made using the GMS-AGECAT package from
      an initial interview and at follow-up three years later. Data relating to blood
      pressure at year 0 was available on 748 subjects. Men not taking anti
      hypertensives or antidepressants with diastolic blood pressure greater than 85
      mmHg were significantly less likely to be subcases than men with low or normal
      diastolic pressure. People in this group were also significantly less likely to
      be cases 3 years later. There were no other significant findings. These results
      do not support an association between low blood pressure and coincidental or
      future subcase- or case-level depressive illness.

PMID- 7778472
TI  - Dhat syndrome: is it a distinct clinical entity? A study of illness behaviour
      characteristics.
AB  - Dhat syndrome is a culture-bound neurotic disorder seen in the Indian
      subcontinent. The disorder has recently been included in ICD-10. In the present
      study, illness behaviour of 50 dhat syndrome patients was studied using a Hindi
      version of Illness Behaviour Questionnaire (IBQ) and was compared with 50
      controls. Sixty-six percent of dhat syndrome patients received unspecified
      diagnoses on DSM-III-R. Patients with dhat syndrome showed a distinct illness
      behaviour profile consisting of higher scores on IBQ factors of general
      hypochondriasis and affective discomfort and lower scores on denial compared with
      controls, suggesting that the disorder may be a distinct entity.

PMID- 7778473
TI  - Season of birth: comparison of patients with schizophrenia, affective disorders
      and alcoholism.
AB  - The distribution of patients suffering from schizophrenia, affective disorders
      and alcoholism by months of their birth was studied, all patients having been
      reliably diagnosed using Research Diagnostic Criteria. Significant differences
      were found between the three groups. The winter-spring birth rate excess in
      schizophrenia was confirmed, a spring-summer birth rate excess in alcoholics was
      demonstrated. Different distributions are due to different reasons: for
      schizophrenic patients the harmful effects hypothesis and for alcoholics the
      procreational hypothesis seem to be appropriate explanations.

PMID- 7778474
TI  - Relationships between mental disorders in childhood and adulthood.
AB  - Research findings on continuities and discontinuities in psychopathology between
      childhood and adult life are reviewed with respect to major depressive disorders,
      anxiety states, obsessional conditions, anorexia nervosa, conduct disorders,
      hyperkinetic disorders, autism, specific developmental disorders of language and
      schizophrenia. The findings are used to consider both the conceptual issues and
      possible mediating mechanisms.

PMID- 7778475
TI  - Cerebral dysfunction in fibromyalgia: evidence from regional cerebral blood flow
      measurements, otoneurological tests and cerebrospinal fluid analysis.
AB  - Measurements of regional cerebral blood flow (rCBF), analysis of cerebrospinal
      fluid, auditory brain stem responses (ABR) and oculomotor tests were performed in
      19 patients with fibromyalgia. The results from the rCBF measurements showed a
      normal flow level with slight but significant focal flow decreases in
      dorsolateral frontal cortical areas of both hemispheres. The ABR results showed
      signs of dysfunction at least at the brain stem level and the oculomotor tests
      showed high frequency of pathology. The cerebrospinal fluid analysis showed
      discrete changes in the cell differential count. Possible explanations for the
      involvement of the central nervous system in fibromyalgia are discussed.

PMID- 7778476
TI  - Individual coping style and psychological attitudes during pregnancy and predict
      depression levels during pregnancy and during postpartum.
AB  - Fifty primigravidae were investigated from 30 weeks of gestation until 6 months
      after delivery to assess the predictive value of individual coping style,
      conception time and specific psychological changes during pregnancy for the
      depression levels assessed during the third trimester of pregnancy and 5 days, 6
      weeks and 6 months after delivery. The individual coping style is an effective
      predictor of depression levels during the third trimester of pregnancy and 6
      months after delivery, but not for the depression levels 5 days and 6 weeks after
      delivery. A path analysis revealed that high depressive coping and low social
      support-seeking predict a longer conception time, which all predict a more
      important lack of spousal support during pregnancy. Higher depressive coping, a
      longer conception time and a more important lack of spousal support during
      pregnancy all predict high depression levels 6 months after delivery. The present
      findings thus suggest helpful predictors for the psychological adaptation during
      the transition to parenthood.

PMID- 7778477
TI  - Hyperthyroidism in adults: variable clinical presentations and approaches to
      diagnosis.
AB  - BACKGROUND: Hyperthyroidism is a disease that has various symptoms and can
      present in many ways. In the elderly patient hyperthyroidism often is not
      expressed in the classical manner. A case report of a middle-aged man who had
      hyperthyroidism with only one symptom is detailed. METHODS: A literature review
      utilizing MEDLINE files from 1988 to the present, as well as current textbooks of
      medicine and endocrinology, was used to prepare this report. Keywords for the
      search were "hyperthyroidism," "symptoms," "unintentional weight loss," and
      "differential diagnosis." RESULTS AND CONCLUSIONS: The clinical presentation of
      hyperthyroidism can vary from almost asymptomatic to apathetic in appearance to a
      marked hyperdynamic physiologic response. Family physicians must be well informed
      of this variation in disease expression. Overlooking the diagnosis of this
      relatively easily treated condition can be detrimental to patient care and
      expensive.

PMID- 7778478
TI  - Management of infants and children 0 to 36 months of age with fever without
      source.

PMID- 7778479
TI  - Obstetric privileges for family physicians: a national study.
AB  - BACKGROUND: We surveyed family physicians in the US to determine how many include
      obstetric services in their practices and to compare trends over time. METHODS:
      In the 1993 Practice Profile Survey, the American Academy of Family Physicians
      (AAFP) surveyed a random sample of active members whose mailing address was in
      one of the 50 states or the District of Columbia. The sample was stratified by
      nine census divisions; after two mailings 2460 responses were received from the
      4400 physicians in the sample (56 percent response). RESULTS: Eighty-seven
      percent of active members had hospital admission privileges. Although there were
      regional disparities in the proportion of family physicians with various hospital
      privileges, overall 94 percent perceived that the privileges afforded them were
      appropriate. Approximately 26 percent of AAFP active members in 1993, compared
      with 29 percent in 1988, included routine obstetric care in their hospital
      practices. A higher proportion of family physicians in the West North Central
      census division had privileges at various levels of obstetric care than did
      family physicians in other census divisions; for example, while 57 percent of
      family physicians in the West North Central census division had privileges in
      routine obstetric care, only 9 percent of family physicians in the East South
      Central division had these privileges. For those family physicians who did not
      have privileges for any obstetric care, most indicated that they chose not to
      include obstetric care in their hospital practices. Family physicians most likely
      to have had obstetric privileges included those who practiced in nonmetropolitan
      areas (39 percent of family physicians had privileges in routine obstetric care
      compared with 21 percent in an urban setting) and those who completed a family
      practice residency program (33 percent with routine obstetric privileges compared
      with 13 percent who did not complete a 3-year residency in family practice.

PMID- 7778480
TI  - Acute bacterial thyroiditis secondary to urosepsis.

PMID- 7778481
TI  - Severe co-trimoxazole reaction in a man with AIDS.
AB  - Although other drugs can be used in the prophylaxis and treatment of HIV-infected
      persons, family physicians will prescribe co-trimoxazole frequently. These
      providers need to recognize the overall increased frequency of adverse reactions
      to this drug in this population and the potential for severe hypersensitivity
      effects requiring intensive hospital care. While the exact importance re-exposure
      has in causing this reaction remains unclear, certainly providers must pay
      particular attention to patients who have had any earlier sensitivity to the drug
      before treatment is resumed. Desensitization therapy has been used successfully
      in some HIV-positive individuals, even after severe reactions; however, this case
      again teaches the need for prudence in the use of all pharmacological agents.

PMID- 7778483
TI  - Clonidine as a drug of abuse.

PMID- 7778482
TI  - Ectopic gastric mucosa of the common bile duct.

PMID- 7778485
TI  - Cesarean section competence, maternity care training, and community need.

PMID- 7778484
TI  - Treatment of AIDS and HIV-related conditions--1995.

PMID- 7778486
TI  - Obstetric privileges in family practice.

PMID- 7778487
TI  - Family practice maternity care.

PMID- 7778488
TI  - Family practice maternity care.

PMID- 7778489
TI  - Family practice maternity care.

PMID- 7778490
TI  - Family practice maternity care.

PMID- 7778491
TI  - Canadian health care system.

PMID- 7778492
TI  - Children's health.

PMID- 7778494
TI  - Vaccine storage in the physician's office: a community study.
AB  - BACKGROUND: A survey was conducted of 26 physician offices and the County Health
      Department to determine the quality of vaccine storage. METHODS: All
      refrigerators were examined for secure electrical supply, firmly shut door,
      storage of inappropriate items, and expired vaccines. A maximum-minimum
      thermometer was then placed in the middle of the storage area for 24 hours, and
      temperatures were recorded. RESULTS: Of the 27 sites, only two had refrigerator
      temperatures in which both maximum and minimum temperatures fell within the
      acceptable range of 2 degrees to 8 degrees C. Sixty-three percent fell below
      minimum, 59 percent were above maximum, and 93 percent fell either below or above
      or both. Eight of the offices had a designated cold chain monitor, but there was
      no correlation with appropriate monitoring and storage of vaccines. Nine of the
      offices had permanent thermometers, but no correlation could be found between
      these sites and appropriate storage temperatures. CONCLUSIONS: A majority of
      vaccines in the community have been exposed to conditions that could reduce or
      destroy their potency. Physicians must educate their personnel in proper storage
      techniques of vaccines to ensure the potency of these vaccines.

PMID- 7778495
TI  - Relation between passive tobacco smoke exposure and the development of bacterial
      meningitis in children.
AB  - BACKGROUND: The adverse effects of passive smoking have received wide attention
      in recent years. Although a number of childhood illnesses are known to be
      affected by exposure to tobacco smoke, to date the medical literature is silent
      about the effect of tobacco smoke on the development of bacterial meningitis in
      children. The purpose of this study was to learn whether any such association
      exists. METHODS: Parents of 93 children admitted for bacterial meningitis were
      surveyed to ascertain which of the children were exposed to passive tobacco
      smoke. A similar survey was conducted of an age- and sex-matched control group.
      RESULTS: Children admitted for bacterial meningitis were significantly more
      likely to have been exposed to tobacco smoke than was a control group of children
      admitted for abdominal surgery. (P = 0.017; odds ratio 2.63, 95 percent
      confidence interval 1.15, 4.87). CONCLUSIONS: The results of this study indicate
      that bacterial meningitis in children should be added to the growing list of
      illnesses associated with passive exposure to cigarette smoke.

PMID- 7778493
TI  - Outcomes of cesarean sections performed by family physicians and the training
      they received: a 15-year retrospective study.
AB  - BACKGROUND: Family physicians are the major or sole providers of Cesarean section
      services in many communities. Approximately 2800 family physicians provide
      Cesarean section services in communities of all sizes across the country.
      METHODS: The outcomes of all Cesarean sections performed at two rural hospitals
      during a 10- to 15-year period were examined and compared with standard quality
      outcome criteria published in the medical literature. Outcome criteria included
      rates of various surgical complications, use of blood transfusion, infant Apgar
      scores, and length of postoperative hospital stay. Other descriptive data were
      examined including patient demographics, operating time, anesthesia type, and
      choice of incision. Statistical analysis consisted of chi-squares, odds ratios,
      and stepwise multiple regression. RESULTS: Five hundred sixty-three Cesarean
      sections were performed by 12 residency-trained family physicians, 68 by general
      practitioners, 70 by general surgeons, and 9 by obstetrician-gynecologists.
      Family physicians met or surpassed the referenced standards in all measures
      examined. The number of Cesarean sections each physician performed while in
      residency training was also examined. The average number of in-training Cesarean
      sections was 46, ranging from 25 to 100. CONCLUSIONS: The results of this study
      support the ability of family physicians to provide Cesarean section services
      based on a wide range of training backgrounds and variable numbers of procedures
      done in training.

PMID- 7778497
TI  - Morphological and colour mutants of Aspergillus fumigatus.
AB  - By using the scanning electron microscope the morphological deviations of 17
      colour mutants of Aspergillus fumigatus were characterized. These mutants
      originated by genetic blocks in various stages of conidiophores and conidia
      differentiation. The complementation test was carried out with the light
      pigmented mutants. The group of allelic strains was found and 4 diploid strains
      were isolated.

PMID- 7778496
TI  - Obesity: a move from traditional to more patient-oriented management.
AB  - BACKGROUND: Family physicians have been encouraged to be aggressive in their
      treatment of obesity in their overweight patients. This article examines our
      traditional management of obesity and presents a management approach that is
      relatively safe, healthy, and patient-oriented. METHODS: A review of the
      literature on obesity and its treatment was performed by searching MEDLINE,
      PsychINFO, ERIC, and SOCA data bases from 1980 to 1993. Additional references
      were accessed by cross-referencing the bibliographies of the articles obtained
      through this search. RESULTS AND CONCLUSIONS: Both physicians and society in
      general tend to be biased against obese individuals, and this bias has negative
      consequences in that it reinforces patients' negative stereotypes about their
      fatness and could contribute to their avoidance of physicians. To circumvent this
      tendency, physicians should make a conscious effort to treat their obese patients
      with understanding and respect and to offer treatment that optimizes their risk
      benefit profile. Regardless of weight, all patients should be asked about their
      diet and exercise history, and a brief mental status evaluation should be
      performed to screen for eating disorders and other psychosocial disorders. In
      addition, all patients should be encouraged to follow a healthy lifestyle, which
      includes regular, moderate exercise and a balanced, low-fat diet. Repeated
      dieting should be avoided, because it can produce more harm than benefit by
      contributing to binge eating, loss of self-esteem, and increased risk of sudden
      death and cardiovascular disease. Thus, only obese patients who have never
      attempted comprehensive weight reduction programs should be encouraged to try
      such a program. Patients who have severe obesity that interferes with their lives
      or who have moderate obesity and a comorbid condition can be offered a
      gastroplasty or gastric bypass procedure, coupled with an explanation and
      discussion of the success and failure rates involved. Regardless of whether
      patients are able to lose weight, the family physician can still provide long
      term support and care and encourage a healthy lifestyle in these patients.

PMID- 7778498
TI  - Mutants of dermatophytes resistant to ketoconazole.
AB  - Authors describe the frequency and properties of mutants resistant to
      ketoconazole, obtained from the dermatophytes Microsporum gypseum and
      Trichophyton mentagrophytes. Spontaneous mutants occurred with the frequency of
      10(-9) to spore and nucleus. Ultraviolet radiation increased the frequency of
      mutants by two numeric orders. The resistance level was relatively small in both
      types of mutants (RL within the range of 2-5).

PMID- 7778499
TI  - Effect of ketoconazole on potassium pool, c-AMP-release and ergosterol synthesis
      in resistant mutants of Microsporum gypseum.
AB  - The effect of ketoconazole (KK) on chosen biochemical indexes was studied in
      three mutants of dermatophyte Microsporum gypseum (MG-155 wild strain) resistant
      to KK. Fungistatic concentration of KK added to liquid cultivate medium increases
      significantly ergosterol pool and nonsignificantly demethylation activity,
      potassium content, cAMP release in three days old mycelium of mutants when
      compared to the cultivation without KK. On the contrary, there is a significant
      suppression of ergosterol level and demethylation activity followed by highly
      significant increasing of potassium content and cAMP release in the case of wild
      strain MG-155.

PMID- 7778500
TI  - Enzymatic equipment of the nasal mucosa in the developing human nasal cavity.
AB  - The activities of some enzymes were described in the developing human nasal
      cavity in relatively early stages. In cryostat sections of the 8-14-week-old
      fetuses processed by standard Lojda methods, activities of the following enzymes
      were found in the respiratory and olfactory regions: ALP, ACP, ATP, TPP, alpha
      GPDH, G6PDH, SDH and ANE. The positive reaction for DPP IV failed to be proved in
      this localization, it was not detected even in the capillary bed of the nasal
      cavity.

PMID- 7778501
TI  - [Differentiation in the human heart. I. Ultrastructural findings].

PMID- 7778503
TI  - Unsaturated fatty acids incorporated in HDL in hypo- and
      hyperalphalipoproteinemia--relation to the HDL-cholesterol level.
AB  - Proportions of unsaturated fatty acids of high density lipoprotein (HDL) lipids
      and their relationships to the HDL-cholesterol level were compared in hypo- and
      hyperalphalipoproteinemic subjects. Both groups did not differ in the level of
      serum cholesterol. However, hypoalphalipoproteinemia was associated with
      hypertriglyceridemia, higher HDL-triacylglycerol level, and higher proportion of
      HDL-18:1 (oleic acid) and lower proportions of HDL-18:2 (linoleic acid) and 20:4
      (arachidonic acid) than hyperalphalipoproteinemia. The HDL-20:4 was the only
      fatty acid correlating (negatively) with HDL-cholesterol. However, HDL-18:1
      correlated positively and HDL-18:2 negatively with HDL-triacylglycerols, lipids
      related to the fall of HDL-cholesterol. These results suggest 1) an antagonism of
      20:4 and 18:2 as structural components of HDL lipids in relation to the HDL
      cholesterol level, and 2) an association of replacement of HDL 18:2 by 18:1 with
      the disorder of plasma triacylglycerol metabolism.

PMID- 7778502
TI  - Ultrastructure of mice Leydig cells at chronic lead intoxication.
AB  - In the present paper we report on the study of the ultrastructure of Leydig cells
      of male mice after application of various doses of Pb(NO3)2 in drinking water for
      2, 3, 4, 5, 7, 9 and 11 weeks. The increasing dose and time interval lead to
      formation of numerous concentric lamellar systems, accumulation of fatty
      vacuoles, vacuolization of mitochondria, pronounced surface differentiation, and
      changed shape of the nucleus of Leydig cells. The ultrastructural picture
      corresponded with an enhanced metabolic activity in some cells; in other cells
      dystrophic changes were observed in other. In addition to that, some cells were
      found that are considered by us to be an intermediary stage between the
      nondifferentiated mesenchymal cells and the fully functional Leydig cells.

PMID- 7778505
TI  - Descriptive epidemiology of tetanus in the Czech Republic in the period of 1960
      1993.
AB  - Tetanus represented a serious health problem in the Czech Republic until 1974
      with a substantial number of deaths. In the period of 1974 to 1976 a mass
      vaccination campaign was implemented, covering almost all adult population in
      both sexes. Since that time the incidence of tetanus has sharply decreased and
      during recent years only sporadic cases of tetanus were reported. There are some
      important problems pending, which are to be solved as a part of tetanus
      surveillance in the country. One of the most important is the occurrence of
      tetanus cases in fully vaccinated subjects.

PMID- 7778504
TI  - Some biochemical characteristics of the early phase of immunomodulation.
AB  - The study estimates some biochemical changes of chosen immunological and
      biochemical parameters after intraperitoneal application of a) immunomodulators
      of microbial origin--Propionibacterium acnes and Geotrichum candidum, b) chemical
      substances--indomethacin and phenobarbital. The estimation was concentrated above
      all to the changes of chemiluminiscence, phagocytic activities, the amount of
      cAMP in peritoneal macrophages, the amount of liver cytochrome P-450 and cAMP in
      the liver, spleen and thymus. The experiments also included histological
      examination of the spleen, thymus, lungs and diaphragm. The effect of
      Propionibacterium acnes was evident as soon as 24 hrs after application. In the
      frame of studied parameters, there was manifested the nonspecific activation of
      the immune system by the mechanisms independent to oxygen. The early changes were
      accompanied by the increase of cAMP in macrophages. In contrary, the
      intraperitoneal application of Geotrichum candidum activated the release of
      oxygen radicals from peritoneal macrophages. The amount of the cytochrome P-450
      correlated to the intensity of immunomodulation. On the other hand, the induction
      of cytochrome P-450 by phenobarbital decreased the value of several immunity
      indices.

PMID- 7778506
TI  - Epidemiology of cryptogenic fibrosing alveolitis in Moravia and Silesia.
AB  - Cryptogenic fibrosing alveolitis in Moravia and Silesia (4 million inhabitants)
      was evaluated using standard epidemiological and clinical parameters. During 1981
      1990 the incidence of cryptogenic fibrosing alveolitis ranged from 0.74 to
      1.28/100,000. The trend of incidence was increasing slightly. The prevalence rose
      from 6.5 to 12.1/100,000. The male/female ratio was 1:1.2; 54% of patients were
      less than 40 years old. Biopsy (mostly open lung biopsy) supported the diagnosis
      in 38% of cases. During 1981-1990 years 379 new cases were detected, 488 cases
      altogether were registered up to 1990. The death rate calculated by incidence and
      prevalence was 13% and 10% resp. The mean regional incidences varied from 0.34 to
      2.69/100,000, regional prevalences varied from 4.1 to 27.6/100,000. No
      correlation with the regional incidences of sarcoidosis and tuberculosis was
      found. No significant differences in coal mining areas with a high occurrence of
      pneumoconiosis or in areas with developed agriculture were detected.
      Significantly higher values were found in the regions of the four major
      diagnostic centres: a mean incidence of 1.58/100,000 and a mean prevalence of
      20.8/100,000 (p < 0.05). The results suggest that the level of diagnostic
      possibilities and efforts dominates over ecological and environmental factors in
      the detecting of cryptogenic fibrosing alveolitis.

PMID- 7778507
TI  - [The so-called "complicated AV-fistula" for hemodialysis. Contribution to
      preoperative examinations].

PMID- 7778508
TI  - [Erythrocytosis after kidney transplantation].

PMID- 7778509
TI  - Possibilities of the surgery therapy of chronic pancreatitis.
AB  - A group of 16 patients with chronic pancreatitis was studied in this paper. All
      patients were treated for a long time by drug therapy on medical departments.
      Because of severe pain they were indicated to surgery therapy. Eleven of them
      were treated by derivation procedure and five by resection one. If a good
      indication for surgery is done the results are very satisfactory.

PMID- 7778510
TI  - Epileptic seizures following subarachnoideal haemorrhage.
AB  - An origin of epileptic seizures on the sample of 100 patients with SAH, treated
      at the Neurological Clinic from 1981-1993, was followed. The haemorrhage was
      shown by CT and/or cerebrospinal fluid. The sample consisted of 45 men and 55
      women. Among the patients under 30 years of age men and over 30 women were
      predominant. Arterial hypertension was present in 17 cases. A positive
      angiographical finding of cerebrovascular malformation or aneurysm was
      ascertained in 38 cases. In 5 cases an early epileptic seizures with generalized
      convulsions occurred. Three women i.e. 3% of the sample, had late epileptic
      seizures occurring from 1 month to 5 years after SAH. The percentage of epileptic
      seizures described elsewhere is higher.

PMID- 7778511
TI  - EMS induced morphological and thermo-sensitive mutants of Aspergillus fumigatus.
AB  - The sensibility of the strain As-F2 Aspergillus fumigatus to EMS was determined
      by using the scale of doses. Seventeen thermo-sensitive or thermotolerant
      morphological mutants with decreased sporulation and growth rate as compared with
      a wild strain was isolated. Their more detailed characteristic will be a contents
      of our further paper.

PMID- 7778512
TI  - Encouraging faculty to use writing as a tool to foster learning in the
      disciplines through writing across the curriculum.
AB  - Writing Across the Curriculum (WAC), the national movement to infuse writing
      activities into the academic disciplines, promises eventually to enhance student
      writing competence, although its immediate goal is to foster mastery of course
      learning objectives. Those faculty who use WAC solely to improve writing skills
      assume the role of an English instructor and obligate themselves to take on an
      enormous amount of additional work perhaps without advancing their primary
      instructional missions. A limited return on this investment of effort will have
      the likely effect of prompting a faculty member to discard WAC. Over the long
      run, doing so will diminish opportunities for students to engage in productive
      writing experiences. Presented in this article are five strategies used in a
      faculty- development seminar that are designed to encourage the use of writing as
      an instructional tool. Individual teachers may use these strategies as
      justification for initiating WAC; just as important, program supervisors may use
      them to sustain a WAC program once it has begun.

PMID- 7778513
TI  - Efficiency of screening procedures for assigning levels of the Stanford
      Achievement Test (eighth edition) to students who are deaf or hard of hearing.
AB  - Assignment to an appropriate test level is crucial to the validity of
      standardized test scores. The present study examined the efficiency of the
      Reading Screening Tests and Mathematics Screening Tests developed by the Center
      for Assessment and Demographic Studies (CADS) of Gallaudet University for
      assigning levels of the Stanford Achievement Test, 8th edition (SAT-8), to deaf
      and hard-of-hearing students. Data were collected from programs participating in
      the 1990 test standardization with this population. It was found that while the
      screening procedures provide a credible means of assigning test levels, they are
      more effective for the SAT-8's Reading Comprehension, Total Language, Mathematics
      Computation, and Mathematics Applications subtests than for the Spelling and
      Concepts of Number subtests. This article concludes with recommendations in
      regard to individual subtest assignments.

PMID- 7778514
TI  - Cooperative conversations. The effect of cooperative learning on conversational
      interaction.
AB  - An ongoing challenge for educators of deaf and hard-of-hearing students is to
      find opportunities for students to use their language skills in a functional way,
      that is, through conversation. This study was initiated to determine whether
      cooperative learning is a viable means of encouraging mainstreamed hard-of
      hearing students to engage in conversational interaction with their hearing peers
      and teachers. A single-subject design utilizing three mainstreamed hard-of
      hearing subjects attending middle school was used to examine this question.
      Results of the study indicated that cooperative learning positively influenced
      the conversational turns, initiations, moves, and mean length of turn in these
      hard-of-hearing subjects.

PMID- 7778515
TI  - Partially funded mandates.

PMID- 7778516
TI  - In-service trends. General education teachers working with educational
      interpreters.
AB  - The "inclusion" movement has resulted in a shift of placement for children who
      are deaf or hard of hearing. Over 50% of students who are deaf or hard of hearing
      are now attending academic classes with hearing students in public school
      settings (Schildroth & Hotto, 1993). As the enrollment of deaf and hard of
      hearing students in public schools continues to increase, so does the need for
      qualified educational interpreters. The present study was designed to investigate
      nationwide the in-service training that general-education teachers receive with
      regard to the roles and responsibilities of educational interpreters. One hundred
      elementary and secondary general education teachers were surveyed, yielding a 59%
      return rate. Less than 33% of those teachers who returned surveys had attended in
      services on the topic of educational interpreters. Neither the academic level
      (i.e., elementary and secondary) of the teachers who participated or the number
      of students who were deaf or hard of hearing and in attendance at a school
      influenced the number of in-services provided on the topic of interpreting.

PMID- 7778517
TI  - Robarts revisited.

PMID- 7778518
TI  - On deciding to implant.

PMID- 7778520
TI  - Cochlear fallout.

PMID- 7778521
TI  - Preschool teachers' theoretical and pedagogical stances on the language and
      literacy development of deaf and hard-of-hearing children. Implications for
      teacher preparation and in-service programs.
AB  - This study was an investigation into three preschool teachers' theoretical and
      pedagogical stances on the language and literacy development of deaf and hard-of
      hearing children. Transcripts from formal, audiotaped interviews provided the
      primary data source for the investigation of the teachers' theoretical
      orientations toward language and literacy learning. The primary data sources used
      in examining the teachers' instructional practices were videotape recordings,
      handwritten field notes, and photographs of the teachers and their students
      participating in classroom language and literacy events over a six-month period.
      Data were analyzed inductively using the procedures and techniques related to
      grounded theory analysis. Results of the study indicated that the teachers held
      differing theories and that these theories influenced the teachers' instruction
      in significant ways. The study highlights the growth in one teacher's
      perspectives and the resulting changes in her classroom practice.

PMID- 7778519
TI  - Language preference and communication development of a hearing and deaf twin
      pair.
AB  - This observational study examined the development and use of communication in a
      pair of deaf and hearing monozygotic twins from 13 months of age until 36 months
      of age. One twin contracted meningitis at 7 months, leaving her profoundly deaf
      but without other measurable sequelae. The other twin is normal in all respects.
      The prelingual twins were enrolled in a total communication preschool program
      where, with their parents, they participated in activities designed to enhance
      the language skills of deaf children. The twins were videotaped monthly, first at
      their preschool program and later at home. All forms of communication were
      recorded, including signs, vocalizations, and hand and body gestures.
      Additionally, eye gaze direction and body positions during communication were
      noted. Comparisons between the deaf and hearing twins showed that although both
      children were able to learn language and communicate successfully, the hearing
      twin preferred a vocal form of language, whereas the deaf twin used mostly sign
      language. Moreover, the hearing twin's communication was usually responsive,
      while the deaf twin's communication was comprised mostly of imitative signs and
      gestures. Methods of teaching a profoundly deaf child to communicate are
      discussed.

PMID- 7778522
TI  - Technical report: service provision under the Individuals with Disabilities
      Education Act-Part H, as Amended (IDEA-Part H) to children who are deaf and hard
      of hearing ages birth to 36 months. Joint Committee of American Speech-Language
      Hearing Association and the Council on Education of the Deaf.
AB  - At the request of the Council on Education of the Deaf (CED) and the American
      Speech-Language-Hearing Association (ASHA), the Annals is publishing in its
      entirety and verbatim the report of a joint CED/ASHA committee designed to
      provide information to professionals about the services to deaf and hard of
      hearing children below three years of age and their families mandated by the
      Individuals with Disabilities Education Act-Part H, as Amended. This information
      should be of benefit to all professionals providing services through an
      individual family service plan. The report has also been published in the August,
      1994 issue of the ASHA Journal.

PMID- 7778523
TI  - The effectiveness of an interactive instructional context. Principles from the
      parent-child interaction literature.
AB  - In the present study, the effectiveness of embedding a targeted linguistic
      structure within an interactive instructional context is examined. Ten subjects
      participated in a communication-games intervention which contained seven
      interactive elements drawn from the parent-child interaction literature. Ten
      subjects were assigned to a control group. A comparison of student performance
      before and after intervention supports the effectiveness of adopting
      instructional strategies that are consistent with a social-interaction
      perspective on language development. Qualitative results are presented that
      illustrate each of the interactional characteristics of the intervention.
      Implications for practice are discussed.

PMID- 7778526
TI  - Use of ozone generating devices to improve indoor air quality.
AB  - Room ozonization has been in widespread use to "freshen" indoor air for more than
      100 years. This use is sometimes promoted with the claim that ozone can oxidize
      airborne gases, and even particulates, to simple carbon dioxide and water vapor.
      Aside from whether ozone can improve indoor air quality, the potentially
      deleterious consequences to public health of overexposure to ozone are of
      concern. The literature on both allegations is reviewed. It indicates that ozone
      is not a practical and effective means of improving indoor air quality,
      especially in light of its potentially serious risk to health.

PMID- 7778525
TI  - Hand skin temperature variations for work in moderately cold environments and the
      effectiveness of periodic rewarming.
AB  - An investigation of skin surface temperature variations under actual work
      conditions for four locations on the hand studied the utility of hot water
      immersion sinks for restoring heat to the hands during exposure to moderately
      cold temperatures in a food processing plant. Hand skin temperature was recorded
      for 15 subjects in 2 jobs with an ambient temperature of 13.3 degrees C (56
      degrees F) and 1 job with an ambient temperature of 23.9 degrees C (75 degrees
      F). Averaged over all jobs, the mean temperature for the dorsal and palmar third
      finger was 17.7 degrees C (63.9 degrees F), which was significantly (p < 0.01)
      cooler than the mean dorsal and palmar hand temperature of 28.9 degrees C (84.0
      degrees F). There was no significant difference between dorsal and palmar
      temperatures for either the finger or the hand (p > 0.05). In the warm
      environment there were no significant differences in skin temperature for any of
      the four hand locations (p > 0.05). An exponential model of digital warming and
      cooling was empirically derived using 12 subjects for predicting finger skin
      temperature when periodically rewarming the hands using a hot water immersion
      sink. The dorsal and palmar finger had a mean time constant of 151 sec for
      warming during immersion, 640 sec for initial cooling after a 15- to 30-min rest
      break at room temperature, and 198 sec for cooling after rewarming in the hot
      sink. The sink did not appreciably raise minimum finger skin temperature after
      subjects rewarmed the hands for as long as 2 min and then worked for more than 10
      min without a rewarming session.

PMID- 7778524
TI  - Experimental considerations for the study of contaminant dispersion near the
      body.
AB  - Experimental considerations are discussed for conducting controlled studies of
      the dispersion of contaminants released near a mannequin. A 183 cm x 183 cm cross
      section wind tunnel was modified to study the low velocity range of 10 to 100
      cm/sec (20 to 200 ft/min). Installation of a removable biplanar slat grid
      produced turbulent intensities up to 15%. The results of validation testing for
      selected experimental components are reported, including (1) a minimum,
      unambiguous velocity measurement capability of 2.0 cm/sec (4.0 ft/min); (2) a
      minimum required integration interval for velocity and contaminant measurements
      of at least 3 min; (3) a determination that smoke streamline plume settling may
      be a problem at velocities < or = approximately 15 cm/sec (approximately 30
      ft/min); (4) a determination that a 14% tunnel blockage by the mannequin was not
      of consequence for frontal measurements; and (5) a finding that the biplanar grid
      produced turbulence spectra representative of low velocity indoor settings. A
      deceleration zone was noted that extended 50 cm upstream from the mannequin, with
      freestream velocities reduced 50 to 60%, 2.5 cm from the chest. A contaminant
      tracer released as a point source 60 cm upstream typically dispersed laterally
      only 10 to 15 cm and diluted by a factor of 10(4) before reaching the chest.

PMID- 7778527
TI  - Development of an ISO 9000 compatible occupational health standard: defining the
      issues.
AB  - Corporate ISO 9000 registration is gaining international acceptance as the
      hallmark of quality system achievement. The International Organization for
      Standardization (ISO) is currently drafting environmental standards that will
      complement ISO 9000. Should the international community also consider development
      of an ISO 9000-compatible occupational safety and health management standard
      (OSHMS)? To determine the advantages and disadvantages of this issue, the
      investigators conducted interviews with government and private sector experts,
      reviewed publicly accessible ISO documents, and evaluated published literature
      germane to the subject. Major advantages of an ISO OSHMS were the harmonization
      of national standards, maximizing Occupational Safety and Health Administration
      (OSHA) efficiency through third-party registration audits, and increased emphasis
      on employee-driven health and safety programs. Major disadvantages were the
      single vote of the American National Standards Institute at international
      proceedings, direct and indirect program development costs, potential unethical
      or incompetent conduct of registrars, and the logistics of developing an
      acceptable standard to all stakeholders. Some unresolved issues were the
      inevitability of an ISO OSHMS, auditor indemnification, and the scope of OSHA
      participation. Industrial health and safety professionals should initiate formal
      discussion on this issue to elaborate on findings presented here and to establish
      a consensus on future activities.

PMID- 7778528
TI  - Pharmacologic data reveal the heterogeneity of angiotensin-converting enzyme
      according to its source (lung versus heart).
AB  - Angiotensin-converting enzyme (ACE) has 2 different active sites: a C-site (in
      the carboxy terminal region) and an N-site (in the amino terminal part). Some ACE
      inhibitors have a relatively greater affinity for the C-sites, whereas others
      bind to the 2 sites with equal affinity. The different ontogenesis of lung and
      heart endothelial cells can be related to binding differences to the C- and N
      sites. We labeled Ro31-8472, a clizapril derivative, which has the same affinity
      for the 2 ACE sites. Binding of 125I-Ro31-8472 to human left ventricle and lung
      plasma membranes was saturable, inhibited by ethylene diaminetetraacetic acid and
      displayed affinities of 360 +/- 41 pM in heart and 320 +/- 51 pM in lung. For
      captopril the Hill slope was 0.57 +/- 0.03 for heart and 0.48 +/- 0.05 for lung;
      for delaprilat, a nonsulfhydryl analogue of captopril, the slope was 0.43 +/-
      0.05 for heart and 0.55 +/- 0.05 for lung. These drugs were characterized by
      biphasic competition isotherms. The Hill slope of enalaprilat was 1.01 +/- 0.06
      for heart and 0.93 +/- 0.06 for lung, and Ro31-8472 had a slope of 0.97 +/- 0.04
      for heart and 0.93 +/- 0.03 for lung. The affinity of ACE inhibitors with Hill
      slope different from unity varied according to the source of ACE; in fact,
      delaprilat had greater affinity for the high-affinity sites of heart than lung
      (pKi, 9.89 and 9.47, respectively), whereas captopril had greater affinity for
      the high-affinity sites of lung than heart (9.40 and 8.85,
      respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778529
TI  - Multicenter, randomized, placebo-controlled, double-blind study of the safety and
      efficacy of oral delapril in patients with congestive heart failure.
AB  - A total of 101 patients (67 delapril, 34 placebo) with congestive heart failure,
      New York Heart Association (NYHA) classes II and III, entered a multicenter,
      randomized (2:1), double-blind, placebo-controlled study to determine the minimum
      effective and maximum tolerated doses of delapril. Patients received placebo or
      increasing doses of delapril. After a 2-week run-in period on placebo, patients
      were randomly assigned to delapril or placebo. The dose of delapril was 7.5 mg
      twice daily for 2 weeks, 15 mg twice daily for another 2 weeks, followed by 30 mg
      twice daily for 4 weeks. The dose was increased only if the patient did not
      present any symptoms of orthostatic hypotension. If such symptoms developed, the
      code was broken and an open treatment was continued on the minimum effective dose
      (delapril group). Patients with symptoms of orthostatic hypotension in the
      placebo group were withdrawn. At the end of the 8-week treatment, 36 (54.5%)
      patients in the delapril group completed the study on 30 mg twice daily, 12
      (18.2%) on 15 mg twice daily, and 18 (27.3%) on 7.5 mg twice daily. Seven
      patients on placebo were withdrawn because of insufficient therapeutic response;
      one patient on delapril was lost to follow-up. There was a significant
      improvement (p < 0.01) in bicycle ergometric performance involving an increase in
      the exercise duration and the maximum workload tolerated in those patients
      completing the study on delapril 30 mg twice daily and those finishing on 15 mg
      twice daily.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778530
TI  - Comparison of the safety and efficacy of delapril with enalapril in patients with
      congestive heart failure.
AB  - To evaluate the safety and efficacy of delapril versus enalapril in patients with
      congestive heart failure (CHF), New York Heart Association (NYHA) class II and
      III, 198 patients were enrolled in a study in 13 centers involving a double-blind
      parallel group design. After completing a 2-week run-in period on placebo,
      patients were randomized to receive delapril 7.5 mg twice daily or enalapril 2.5
      mg twice daily for 2 weeks. The dose was then doubled for the remaining 6 weeks.
      In this phase, 1 patient in each group experienced orthostatic hypotension; the
      dose was then reduced to the initial dose for study completion. A total of 195
      patients received active treatment (96 delapril, 99 enalapril). After 8 weeks'
      treatment, bicycle ergometry demonstrated a significant increase in exercise
      duration (p < 0.01) and workload (p < 0.01). Echo Doppler investigations showed a
      significant reduction (p < 0.01) in left ventricular end-systolic volume
      associated with a significant increase (p < 0.01) in ejection fraction and
      cardiac output. No clinically significant changes in blood pressure, heart rate,
      electrocardiogram, or biochemical and hematologic tests were found. There were no
      significant differences between treatment groups. Three patients in each group
      experienced adverse reactions requiring withdrawal of 1 patient in each group.
      Delapril 15 mg twice daily, like enalapril 5 mg twice daily, was effective in
      improving signs and symptoms of CHF and was well tolerated.

PMID- 7778531
TI  - Comparison of the safety and efficacy of delapril with captopril in outpatients
      with congestive heart failure.
AB  - In this study delapril and captopril were compared in outpatients with congestive
      heart failure (CHF), New York Heart Association (NYHA) classes III and IV, in a
      double-blind study of efficacy and safety. Efficacy was evaluated by monitoring
      changes in the NYHA classification, exercise work, hemodynamic parameters,
      Kostuk's classification, and clinical signs and symptoms. Safety was monitored by
      a variety of laboratory tests, including renal and hepatic function, urinalysis,
      routine hematology testing, and the reporting of adverse events. Analysis of the
      data obtained revealed that delapril and captopril exhibit equal efficacy over
      the dosage ranges studied. There was a greater improvement of NYHA classification
      in terms of CHF signs and symptoms and ergometric workload in the delapril group;
      however, this did not reach statistical significance. The safety of the 2 drugs
      was also comparable, with no significant differences in any of the parameters
      measured at the start and end of the study. There was no statistically
      significant difference in the reporting of adverse events between the 2 drugs,
      although the sample size studied was small. There were no significant differences
      between the 2 drugs in terms of their effects on arterial blood pressure and no
      difference between prestudy and post-treatment arterial blood pressure
      measurements.

PMID- 7778532
TI  - Fundamental role of angiotensin-converting enzyme inhibitors in the management of
      congestive heart failure.
AB  - Angiotensin-converting enzyme (ACE) inhibition therapy has now become firmly
      ensconced in the modern therapeutic approach to all stages of congestive heart
      failure (CHF), including the early presymptomatic phase. Although its benefit is
      abundantly proven as add-on therapy in established CHF, after digitalis and
      diuretics, smaller and shorter studies have shown that, as second-line therapy
      and combined with diuretics, it may be preferable to digoxin with an undoubted
      benefit in postinfarction failure. As first-line therapy in early presymptomatic
      CHF, the evidence is also good, based on the prevention arm of the Studies of
      Left Ventricular Dysfunction (SOLVD), albeit in predominantly postinfarction
      patients, and on the Survival and Ventricular Enlargement (SAVE) study on
      postinfarction patients. ACE inhibitors given prophylactically or therapeutically
      helped to prevent clinical heart failure in the SOLVD and SAVE studies. These
      data suggest a role for ACE inhibitors as effective first-line monotherapy in
      early heart failure, acting on left ventricular function to avoid or lessen
      unfavorable remodeling. There are some contraindications or cautions for the use
      of ACE inhibitors in CHF, such as preexisting hypotension, high-renin states such
      as bilateral renal artery stenosis with hypertensive heart failure, aortic
      stenosis combined with CHF, overdiuresis with excess sodium depletion, and
      significant preexisting renal failure. ACE inhibition therapy may have
      deleterious effects on renal function in heart failure, for example, by
      decreasing the glomerular filtration rate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778534
TI  - Safety and efficacy study of delapril versus enalapril in patients with
      congestive heart failure.
AB  - The results after the first 6 months of the 1-year treatment of this multicenter,
      randomized, open, parallel-group design study of delapril versus enalapril in
      patients with congestive heart failure (CHF), New York Heart Association (NYHA)
      classes II and III, are presented. The initial dose of delapril (7.5 mg twice
      daily) and enalapril (2.5 mg twice daily) could be doubled on a 2-weekly basis
      (from the beginning of the study) to a maximum of 30 mg twice daily and 10 mg
      twice daily, respectively. The evaluation of the efficacy was based on the
      changes of NYHA class, results of exercise testing involving bicycle ergometry
      (duration of exercise, workload, work performed, double product) performed before
      and after 3 months' treatment, echocardiography (left ventricular end-diastolic
      volume and end-systolic volume, ejection fraction, and left ventricular wall
      stress) at baseline and after 3 and 6 months of treatment and changes in
      cardiothoracic ratio, electrocardiography, and NYHA class, and patient's opinion
      of efficacy. Safety was evaluated by monitoring the adverse reactions, laboratory
      tests, and blood pressure. At 3 months, both treatments had produced a
      significant improvement compared with baseline in the duration of exercise,
      workload, and work performed in the bicycle ergometry test as well as in the
      ejection fraction and in left ventricular wall stress after 6 months of
      treatment. In addition, after 3 and 6 months of treatment, delapril produced a
      significant decrease in left ventricular end-systolic volume. Improvement of at
      least one NYHA class was observed in 20% of delapril patients and 14% of
      enalapril patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778533
TI  - Congestive heart failure in elderly patients: controlled study of delapril versus
      captopril.
AB  - In this controlled trial, 30 elderly patients with congestive heart failure, New
      York Heart Association (NYHA) classes II and III, were randomly assigned to
      treatment with captopril 25 mg three times daily or delapril 15 mg twice daily.
      At the end of an 8-week treatment period, clinical symptoms of heart failure were
      significantly relieved by both drugs, with a consistent and statistically
      significant improvement in patients' quality of life evaluated using a
      symptoms/activity scale (p < 0.001). None of the patients was judged NYHA class
      III at the end of the trial and 40% were assigned to class I (p < 0.01). There
      was a relevant, but not statistically significant, increase in exercise duration
      in both treatment groups (10% captopril group, 14% delapril group), but the
      number of patients discontinuing the exercise test for dyspnea was 50% less in
      the delapril group. Neither drug had evident effects on echocardiographic left
      ventricular parameters. Two patients treated with captopril and 3 with delapril
      complained of mild-to-moderate adverse reactions. The safety of both drugs was
      confirmed by laboratory tests.

PMID- 7778535
TI  - Angiotensin-converting enzyme inhibitors in the clinical setting of chronic
      congestive heart failure.
AB  - The addition of an angiotensin-converting enzyme (ACE) inhibitor to digitalis and
      diuretics in chronic congestive heart failure (CHF) prolongs survival and
      improves the clinical condition of patients. These actions depend on the
      inhibition of ACE and are, therefore, common to all ACE inhibitors. Thus, the
      inclusion of an ACE inhibitor in the therapeutic regimen of chronic CHF is
      mandatory, whenever feasible. The use of ACE inhibitors in chronic CHF should
      avoid symptomatic hypotension and inordinate decreases in renal function. To this
      end, ACE inhibitor therapy should progress by gradually increasing doses, and
      sodium intake and dosages of diuretics and ACE inhibitors should be adjusted in
      the light of changing circumstances. ACE inhibitors with short elimination half
      lives should be preferred in chronic CHF, since they allow quicker dose
      adjustment than their longer-acting congeners, and given that compliance with
      once and twice daily dosing would be similar.

PMID- 7778536
TI  - Pharmacokinetic and pharmacologic properties of delapril, a lipophilic
      nonsulfhydryl angiotensin-converting enzyme inhibitor.
AB  - Delapril is a carboxy-alkyl-dipeptide mainly converted in animals and humans to
      an active diacid derivative (M-I), which in turn is converted to an active 5
      hydroxy-indane diacid (M-III). In humans these metabolites are excreted in the
      urine. The presence of the indanyl-glycine moiety gives delapril a high
      lipophilicity, greater than several other angiotensin-converting enzyme (ACE)
      inhibitors, such as captopril and enalapril. Due to its greater lipophilicity,
      delapril has been shown to exert a more effective inhibition of vascular ACE than
      captopril and enalapril, both in vitro and in vivo. The activity of delapril on
      tissue ACE also lasts longer than on the circulating enzyme. At doses ranging
      from 1-10 mg/kg orally, delapril exerts a marked and long-lasting
      antihypertensive action in various experimental models of hypertension. The blood
      pressure reduction has been shown to be accompanied by suppression of angiotensin
      II release from the vascular wall. In stroke-prone spontaneously hypertensive
      rats (SHR-SP) and in SHR with chronic renal failure, besides reducing
      hypertension, delapril significantly improves survival rate and prevents the
      development of stroke, cardiac hypertrophy, and renal sclerosis. The ability of
      delapril to reduce hypertrophy in vascular and cardiac tissue has been
      demonstrated in both in vitro and in vivo experiments.

PMID- 7778537
TI  - Prevalence of dyslipidemic phenotypes in ischemic heart disease (prospective
      results from the Quebec Cardiovascular Study)
AB  - In 1985, plasma cholesterol, triglyceride, high-density lipoprotein cholesterol,
      and plasma apoprotein (apo) B levels were measured in 2,103 men (aged 45 to 76
      years) without ischemic heart disease from the Quebec city suburbs. Occurrence of
      a first ischemic event (i.e., angina pectoris, acute myocardial infarction, or
      coronary-related death) was recorded in 114 men between 1985 and 1990. Men with
      and without ischemic heart disease were classified as normal or in various
      dyslipidemic groups according to an established algorithm. Of the 1,989 men who
      remained free of ischemic events, 50% had a normal lipid profile compared with
      32% in men with ischemic heart disease. Although the prevalence of type IIb and
      IV dyslipidemias was similar in men with and without ischemic heart disease, type
      IIa (16% vs 10%), hyperapo B-hypertriglyceridemia (12% vs 6%), hyperapo B
      normotriglyceridemia (11% vs 7%), and hypoalphalipoproteinemia (18% vs 13%) were
      more prevalent in men with than without ischemic heart disease. Adjusted odds
      ratios (ORs) were not increased in type IIb and IV phenotypes, whereas men with
      type IIa (OR 2.8), with the 2 hyperapo B phenotypes (hyperapo B
      normotriglyceridemia, OR 2.7; hyperapo B-hypertriglyceridemia, OR 3.1) or with
      isolated hypoalphalipoproteinemia (OR 2.2), were at higher risk. The results of
      this prospective study confirm the importance of both elevated plasma cholesterol
      and decreased high-density lipoprotein cholesterol levels as risk factors for
      ischemic heart disease. They also emphasize the high prevalence of an elevated
      apo B dyslipidemic state in ischemic heart disease.

PMID- 7778539
TI  - Trends in acute myocardial infarction prognosis and treatment in southwestern
      France between 1985 and 1990 (the MONICA Project-Toulouse).
AB  - Since 1984, the Multinational Monitoring of Trends and Determinants in
      Cardiovascular Disease (MONICA project) has studied progress in acute coronary
      artery disease (CAD) in defined geographic areas. This study, based in a French
      MONICA center in Southwestern France, assessed acute myocardial infarction (AMI)
      frequency, prognosis, and treatment between 1985 and 1990. The age-standardized
      AMI attack rate showed a slight decrease in men (218.3 of 100,000 in 1985 and
      200.1 of 100,000 in 1990, p < 0.05). In men, the AMI age-standardized 28-day case
      fatality rate decreased from 38% in 1985 to 27% in 1990 (p < 0.001), with a
      dramatic reduction in the age-standardized in-hospital case fatality rate (21% in
      1985 and 11% in 1990, p < 0.001). Furthermore, the in-hospital 28-day case
      fatality decreased exclusively in male patients with a history of CAD (33% in
      1986 and 19% in 1990, p < 0.01). AMI treatment improved between 1986 and 1990
      with increased use of antiplatelets (40.7% in 1986, 73.6% in 1989, and 84.8% in
      1990, p < 0.001), beta-blockers (29.5% in 1986, 45.7% in 1989, and 57.7% in 1990,
      p < 0.001), and thrombolytic therapy (23.6% in 1986, 45.3% in 1989, and 39.5% in
      1990, p < 0.001). Invasive cardiology technique utilization increased
      dramatically between 1986 and 1990 with the generalized use of coronary
      angiography (68.2% in 1986, 89.3% in 1989, and 87.3% in 1990, p < 0.001) and
      percutaneous transluminal coronary angioplasty (17.7% in 1986, 49.6% in 1989, and
      55.3% in 1990, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778538
TI  - Distribution of lipids in 8,500 men with coronary artery disease. Department of
      Veterans Affairs HDL Intervention Trial Study Group.
AB  - In the present study we measured fasting lipid profiles in over 8,500 community
      living men with coronary artery disease (CAD) to determine the distribution of
      lipid abnormalities in this population: 81% were white and 16% black; mean age
      62.9 +/- 8 years; mean total cholesterol 214 +/- 41 mg/dl; low-density
      lipoprotein (LDL) cholesterol 140 +/- 37 mg/dl; high-density lipoprotein (HDL)
      cholesterol 39 +/- 11 mg/dl; and triglycerides 190 +/- 142 mg/dl. After adjusting
      for age, the only significant difference between blacks and whites was a higher
      HDL cholesterol in blacks (45 vs 38 mg/dl, p < 0.003). With use of cut points
      established by the National Cholesterol Education Program, 87% of subjects had
      high LDL cholesterol (> or = 100 mg/dl), 38% had low HDL cholesterol (< 35
      mg/dl), and 33% had high triglycerides (> 200 mg/dl). We estimated that 42% of
      men with CAD would be definite candidates for cholesterol-lowering medication
      according to the National Cholesterol Education Program guidelines and that 41%
      of those in whom cholesterol-lowering medication would not be definitely
      indicated had low levels of HDL cholesterol. We conclude that (1) black men with
      CAD have substantially higher HDL cholesterol than white men, (2) almost 90% of
      male patients with CAD are candidates for dietary intervention and > 40% may need
      medications to lower LDL cholesterol, and (3) 40% of patients without a definite
      indication for cholesterol-lowering medications have low levels of HDL
      cholesterol.

PMID- 7778540
TI  - Electrocardiographic diagnosis of reperfusion during thrombolytic therapy in
      acute myocardial infarction.
AB  - Continuous 12-lead electrocardiographic monitoring was performed in 61 patients
      receiving thrombolytic therapy for an acute myocardial infarction. Coronary
      angiography within 90 minutes revealed a patent vessel (Thrombolysis in
      Myocardial Infarction [TIMI] trial 2 or 3) in 44 patients. Early signs of
      reperfusion were ST-segment normalization (likelihood ratio 16.0), development of
      terminal T-wave inversion (likelihood ratio 10.6), accelerated idioventricular
      rhythm (likelihood ratio 6.0), and a twofold increase in ventricular premature
      complexes (likelihood ratio 2.5). Relief of chest pain after 60 minutes was
      reported by 96%. During reperfusion of the infarct-related vessel, an increase in
      ST-segment deviation was recorded in 61% of the patients, whereas 69% had an
      increase in chest pain preceding the eventual decline.

PMID- 7778541
TI  - Psychosocial factors related to unrecognized acute myocardial infarction.
AB  - Acute myocardial infarction (AMI) often is unrecognized (i.e., a patient fails to
      notice or report the event to the physician, or the physician fails to diagnose
      it). Psychosocial differences between patients with recognized and unrecognized
      AMI have not been examined. We compared 40 patients who sought treatment for a
      documented AMI with 30 patients who were found on routine electrocardiogram to
      have had an AMI for which they did not seek medical care. Patients with
      unrecognized AMI showed greater "alexithymia," or deficient psychologic awareness
      (p = 0.04; Alexithymia Provoked Response Interview), and a greater belief that
      chance factors determine their health (p = 0.004; Multidimensional Health Locus
      of Control Scale). Patients with unrecognized AMI were less likely to have
      angina, yet did not differ from those with recognized AMI with regard to
      demographics, smoking, systemic hypertension, diabetes mellitus, AMI location,
      depression, or hypochondriasis. We hypothesize that deficient psychologic
      awareness may impede AMI symptom perception or recognition, and that the belief
      in chance or fate as determining health may inhibit treatment-seeking.

PMID- 7778542
TI  - Comparison of sestamibi single-photon emission computed tomography with positron
      emission tomography for estimating left ventricular myocardial viability.
AB  - Technetium-99m methoxyisobutyl isonitrile (technetium-99m sestamibi [MIBI]) is
      distributed in the myocardium according to blood flow. Reports comparing stress
      rest sestamibi protocols with reinjection thallium or resting fluorodeoxyglucose
      (FDG), or both, in patients with coronary artery disease have shown appreciable
      discordance regarding myocardial viability in these settings. We performed this
      analysis with regard to regional comparisons within discordant segments and made
      comparisons in a subset of patients who underwent revascularization. Thirty-seven
      patients with coronary artery disease had single-photon emission computed
      tomography MIBI, N-13 ammonia/18FDG positron emission tomography (PET), and
      radionuclide ventriculography performed at rest. One hundred two segments were
      viable and 29 were nonviable by both MIBI and FDG. The concordance was 71%. In
      MIBI nonviable/FDG viable segments, most of the discordance was in the inferior
      wall. In MIBI nonviable discordant segments, FDG accurately predicted an increase
      in percent regional ejection fraction (preoperative 36% [+/- 5 SE] to
      postoperative 48% [+/- 5.5 SE][p < 0.0006]). MIBI underestimates myocardial
      viability as assessed by PET. Seventy-one percent of myocardial segments were
      concordant by both quantitative sestamibi single-photon emission computed
      tomography and FDG PET. Discordance in MIBI nonviable segments was predominantly
      in the inferior wall. PET can be helpful in detecting myocardial viability in
      patients suspected of having had MIBI nonviability in the inferior wall.

PMID- 7778543
TI  - Design of the Beta-Blocker Evaluation Survival Trial (BEST). The BEST Steering
      Committee.
AB  - Central to our current understanding of heart failure is the concept that
      compensatory mechanisms that maintain blood pressure and perfusion ultimately
      contribute to worsening of ventricular function. Studies of the effect of
      angiotensin-converting enzyme inhibitors in patients with heart failure are
      consistent with this paradigm. This manuscript describes a 2,800-patient
      randomized trial that will definitively determine whether sympathetic nervous
      system antagonism with a beta blocker prolongs the life of patients with moderate
      to severe heart failure.

PMID- 7778544
TI  - Lipoprotein(a) distribution in a French Canadian population and its relation to
      intermittent claudication (the Quebec Cardiovascular Study)
AB  - This study was undertaken to evaluate the distribution and the relation of
      lipoprotein(a) (Lp[a]) concentration with intermittent claudication in a cohort
      of men aged 35 to 64 years, randomly selected in 1974 and followed until 1990. In
      1985, blood samples for a complete fasting lipid profile and Lp(a) were obtained
      in 2,424 men representing 62% of the living cohort. The diagnosis of intermittent
      claudication was made by trained nurses using a standardized questionnaire and
      confirmed by a cardiologist. Lp(a) distribution did not change with age and was
      similar to that of other Caucasian populations. Because Lp(a) concentration did
      not vary with age, its relation to the incidence of intermittent claudication was
      assessed for the years 1974 to 1990. The incidence of intermittent claudication
      was 42 of 10,000 person-years. The 113 men with intermittent claudication, in
      contrast to men without this symptomatology, were older at entry (49 +/- 7 vs 45
      +/- 7 years), and had higher systolic pressure (144 +/- 20 vs 136 +/- 16 mmHg)
      and Lp(a) levels (46 +/- 45 vs 33 +/- 35 mg/dl) (all p < 0.05). There was also a
      significantly greater prevalence of smoking and diabetes among men with
      intermittent claudication. The risk of intermittent claudication was doubled in
      men in the second and third tertiles of Lp(a) concentration (p < 0.001). Thus,
      high Lp(a) levels constitute a significant risk for intermittent claudication in
      this population.

PMID- 7778545
TI  - Long-term outcomes and modes of death of patients treated with nonthoracotomy
      implantable defibrillators.
AB  - Long-term outcomes of all patients who underwent nonthoracotomy implantable
      cardioverter-defibrillator (ICD) implantation at our institution from April 1991
      to October 1994 were studied using the intention-to-treat analysis. Of 94
      consecutive patients, 81 underwent nonthoracotomy ICD implantation and 13
      underwent thoracotomy (for concomitant surgery in 11 and unavailability of
      nonthoracotomy leads in 2). Six of 81 patients had a high defibrillation
      threshold, 4 subsequently underwent thoracotomy, and 2 were treated with
      amiodarone. Surgical mortality was 0%. The duration of follow-up was 20 +/- 13
      months, and was > 12 months in 74% of 67 living patients. Actuarial survival
      rates at 1 and 2 years were, respectively, 98% and 94% for sudden death and 91%
      and 83% for total mortality. Deaths during long-term follow-up were mostly due to
      nonsudden cardiac or noncardiac deaths. Two-year mortality rates were 12% and 25%
      in patients with ejection fraction > or = 30% and < 30%, respectively. Thus,
      instances of sudden death and surgical mortality are very few in patients with
      nonthoracotomy ICDs. Deaths during long-term follow-up are mostly due to
      nonsudden cardiac and noncardiac deaths. Therefore, ICD therapy may have greater
      impact on survival in patients with lower risks of nonsudden cardiac and cardiac
      death (e.g., younger patients with minimal heart disease) than in patients with
      severe cardiac or noncardiac disease. Prospective studies are needed to address
      this question.

PMID- 7778546
TI  - Relation between electrocardiography and echocardiography for left ventricular
      mass in mild systemic hypertension (results from Treatment of Mild Hypertension
      Study).
AB  - Clinical recognition of hypertensive cardiac involvement depends primarily on use
      of noninvasive methods. The performance of 8 electrocardiographic (ECG) criteria
      sets were compared with an echocardiographic standard in the treatment of Mild
      Hypertension Study. Electrocardiograms were computer processed to define the
      following ECG criteria sets: (1) Casale/Devereux, (2) Cornell product, (3)
      Cornell voltage, (4) 12-lead voltage product, (5) sum of 12-lead voltage, (6)
      Rautaharju, (7) Sokolow-Lyon, and (8) Romhilt-Estes. Echocardiographic left
      ventricular (LV) mass index was calculated by using the Penn convention on a
      biracial population of 834 men and women. Correlations between ECG and
      echocardiographic LV mass index were modest (<0.40). ECG-LV hypertrophy
      sensitivity at 95% specificity was < 34%. The Casale/Devereux ECG criteria showed
      the highest average sensitivity (17%) at 95% specificity for all race-sex groups.
      Whites had significantly higher correlation values than blacks. ECG correlations
      with LV mass index were consistently improved by including systolic blood
      pressure and body mass index. ECG criteria sets appear to be optimized for white
      men. The study findings confirm the poor ECG sensitivity and correlation with
      echocardiographic LV mass and suggest: (1) further refinement of ECG criteria
      alone in white men is unlikely to improve its relationship with LV mass; and (2)
      combining the electrocardiogram with other non-ECG variables or noninvasive
      measurements offers the best strategy for improving ECG sensitivity and its
      prognostic value.

PMID- 7778547
TI  - Relation between diurnal variation of blood pressure and left ventricular mass in
      a Chinese population.
AB  - In western populations, patients with hypertension who have a nocturnal decrease
      in blood pressure (BP) may have less left ventricular (LV) hypertrophy and
      cardiovascular morbidity than those without a diurnal variation in BP. To further
      examine this association between nocturnal BP reduction and LV mass index, we
      studied 720 normotensives (< 140/90 mm Hg), 380 borderline hypertensives (140 to
      159/90 to 94 mm Hg), and 582 hypertensives (> or = 160/95 mm Hg) from Taiwan and
      Quemoy island by using 24-hour ambulatory BP monitoring and 2-dimensional
      echocardiography to obtain LV mass index during a community-based cardiovascular
      survey. After controlling for age, sex, height, weight, daytime BP, and daytime
      heart rate, the nocturnal reduction of systolic BP was found to associate weakly
      with LV mass index, for the whole population (partial correlation coefficient = 
      0.06, p < 0.05), as well as for the patients with hypertension (partial
      correlation coefficient = -0.09, p < 0.05), but these associations were
      eliminated when 24-hour BP and heart rate were accounted for. The average and
      percent nocturnal decrease of systolic BP (mean +/- SD; mm Hg, [%]) of 3.2 +/-
      5.9 (2.7 +/- 4.8%); 3.3 +/- 7.3 (2.4 +/- 5.4%); and 4.6 +/- 9.0 (3.0 +/- 6.1%) in
      normotensives, borderline hypertensives, and hypertensives, respectively, was
      smaller than that found in previous studies. Hence, in this large Chinese
      population, a small nocturnal BP drop was found and it was only weakly associated
      with LV mass index. These results emphasize the general need for ambulatory BP
      reference values based on internal controls.

PMID- 7778549
TI  - Quantitation of cardiac output with velocity-encoded, phase-difference magnetic
      resonance imaging.
AB  - Velocity-encoded, phase-difference magnetic resonance imaging (MRI) previously
      has been used to measure flow in the aorta, as well as in the pulmonary, carotid,
      and renal arteries, but these measurements have not been validated against
      currently accepted invasive techniques. To determine the accuracy of velocity
      encoded, phase-difference MRI measurements of cardiac output, 23 subjects (11 men
      and 12 women, aged 15 to 72 years) underwent velocity-encoded, phase-difference
      MRI measurements of cardiac output in the proximal aorta, followed immediately by
      cardiac catheterization, with measurement of cardiac output by the Fick principle
      and by thermodilution. For MRI, Fick, and thermodilution measurements, stroke
      volume was calculated by dividing cardiac output by heart rate. The magnetic
      resonance images were acquired in 1 to 3 minutes. For all patients, the agreement
      between measurements of stroke volume was 3 +/- 9 ml for MRI and Fick, -3 +/- 11
      ml for MRI and thermodilution, and 0 +/- 8 ml for MRI and the average of Fick and
      thermodilution. Compared with standard invasive measurements, velocity-encoded,
      phase-difference MRI can accurately and rapidly determine cardiac output.

PMID- 7778548
TI  - Lack of long-term ventricular arrhythmia reduction by enalapril in heart failure.
      SOLVD Investigators.
AB  - Previous studies have indicated that angiotensin-converting enzyme inhibitors may
      reduce the frequency of ventricular arrhythmias in patients with heart failure.
      These reports were mostly small and of short duration. We prospectively studied
      734 patients recruited in 11 universities for 1 year who were enrolled in the
      Studies of Left Ventricular Dysfunction (SOLVD) to determine the long-term
      effects of enalapril and placebo on the frequency and complexity of ventricular
      arrhythmias in patients with symptomatic (treatment trial) or asymptomatic
      (prevention trial) heart failure and depressed left ventricular function
      (ejection fraction < or = 35%). Five hundred fifty-three patients from the
      prevention trial and 181 from the treatment trial of SOLVD underwent ambulatory
      electrocardiographic monitoring at baseline, and then at 4 and 12 months of
      double-blind therapy with either placebo or enalapril (2.5 to 10 mg twice daily).
      The prospectively defined primary analysis was by intent-to-treat and revealed no
      significant differences in ventricular premature complexes between the placebo
      and enalapril groups at baseline (87 +/- 13 vs 84 +/- 13/hour), 4 months (100 +/-
      15 vs 85 +/- 12/hour), or 12 months (80 +/- 12 vs 90 +/- 14/hour). Likewise,
      there was no difference between the placebo and enalapril groups in runs of
      nonsustained ventricular tachycardia: baseline (8.3 +/- 4.1 vs 1.9 +/- 0.4
      runs/day), 4 months (16 +/- 12 vs 7.2 +/- 4.1 runs/day), or after 12 months of
      blinded therapy (11 +/- 7.0 vs 6.1 +/- 4.4 runs/day).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7778550
TI  - Feasibility and accuracy of Doppler echocardiographic estimation of pulmonary
      artery occlusive pressure in the intensive care unit.
AB  - Mitral inflow and pulmonary vein inflow variables have been shown to relate to
      left ventricular filling pressures. However, the feasibility and accuracy of
      Doppler estimation of pulmonary artery (PA) occlusive pressure in the intensive
      care unit have not been previously assessed. Accordingly, 67 consecutive patients
      in intensive care units who had PA catheters underwent Doppler recordings of
      mitral inflow, pulmonary vein flow, and isovolumic relaxation time (IVRT). Thirty
      six patients met Doppler inclusion criteria. Most exclusions were due to atrial
      fibrillation, merging of peak velocity during early diastole (E) and atrial
      contraction (A) mitral flow velocities, and inadequate recordings. Mean age (+/-
      SD) was 65 +/- 12 years, ejection fraction varied between 19% and 80%, and 45% of
      patients were on mechanical ventilation. Doppler-derived variables were related
      to occlusive pressure (mean 16 +/- 6 mm Hg, range 6 to 40), and the most
      significant variables were entered into a multiple linear regression analysis.
      The derived relation was tested in 30 repeat studies after a variety of
      hemodynamic interventions and in a prospective group of 32 additional patients
      (mean age 63 +/- 11.6 years, pressure range 7 to 28 mm Hg). The highest
      correlations with occlusive pressure were observed with the E/A ratio (r = 0.75),
      IVRT (r = -0.55), atrial filling fraction (r = -0.65), and deceleration time (r =
      -0.50). Pulmonary venous recording could be obtained in only 16% of patients. The
      best model was with E/A and IVRT: PA occlusive pressure = 17 + (5.3 E/A)-(0.11
      IVRT), r = 0.79.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778551
TI  - Is there anything to add to our lipid risk factors for coronary heart disease?

PMID- 7778552
TI  - Increased susceptibility of angiographically smooth left anterior descending
      coronary artery to an impairment of vasoresponse to acetylcholine, and the
      relation between impaired vasoresponse and low-density lipoprotein cholesterol
      level.
AB  - In the present study, we demonstrated that the angiographically smooth LAD is
      more susceptible than the LC to an impairment of vasoresponse to acetylcholine,
      suggesting the more severe endothelial dysfunction in the LAD. We also showed
      that levels of LDL play a partial but important role on endothelial dysfunction.

PMID- 7778553
TI  - Reproducibility of the intravascular ultrasound assessment of stent implantation
      in saphenous vein grafts.
AB  - IVUS measurements of stent and reference lumen dimensions and cross-sectional
      areas are highly reproducible. Furthermore, paramedical personnel can be trained
      to perform these measurements accurately. Thus, IVUS measurements may become the
      gold standard for the acute, chronic, and serial assessment of stent implantation
      procedures.

PMID- 7778555
TI  - Serial changes in left ventricular diastolic indexes derived from Doppler
      echocardiography after anterior wall acute myocardial infarction.
AB  - Restrictive ventricular filling pattern derived from Doppler echocardiography
      after anterior wall AMI may serve as an indicator of diastolic dysfunction due to
      initial myocardial stiffness and complications such as extension of the
      infarction, Dressler syndrome, septal rupture, or myocardial failure. Later
      changes, such as prolongation of deceleration time, may indicate remodeling
      process, healing of the complications of AMI, or improved revascularization.

PMID- 7778554
TI  - Usefulness of mitral regurgitation in protecting against left ventricular
      thrombus after acute myocardial infarction.
AB  - In conclusion, we documented an increased incidence of LV thrombus in patients
      with MR after AMI.

PMID- 7778556
TI  - Usefulness of an abnormal signal-averaged electrocardiogram for predicting
      cardiac death in elderly persons without heart disease.
AB  - We found an abnormal signal-averaged ECG in 7 of 51 elderly patients (14%) (mean
      age 83 years) without clinical evidence of heart disease, and in 1 of 25
      volunteers (4%) (mean age 31 years range [17 to 47]) without clinical evidence of
      heart disease. The data from our prospective study indicate that at 43-month mean
      follow-up, elderly patients with an abnormal signal-averaged ECG but no clinical
      evidence of heart disease do not have an increased incidence of sudden cardiac
      death, total cardiac death, or total death.

PMID- 7778557
TI  - Effect of combined 17 beta-estradiol and vitamin E on low-density lipoprotein
      oxidation in postmenopausal women.
AB  - In conclusion, combined administration of 17beta-estradiol and vitamin E protects
      LDL in postmenopausal women from oxidation with no synergism noted compared with
      either therapy given alone.

PMID- 7778558
TI  - Are gender differences in QTc present at birth? MISNES Investigators. Multicenter
      Italian Study on Neonatal Electrocardiography and Sudden Infant Death Syndrome.
AB  - The analysis of 9,725 electrocardiograms recorded on the fourth day of life has
      shown that gender-related differences in QTc observed in the adult population are
      not present at birth.

PMID- 7778559
TI  - Use of adenosine-sensitive nondecremental accessory pathways in assessing the
      results of radiofrequency catheter ablation.
AB  - Adenosine can cause conduction block in about 20% of nondecremental accessory
      pathways. Along with atrial activation mapping, adenosine may help differentiate
      retrograde AV node conduction versus residual accessory pathway conduction after
      radiofrequency catheter ablation; however, it is important to test the accessory
      pathway response to adenosine before ablation, particularly with a concealed
      accessory pathway.

PMID- 7778560
TI  - Role of endothelin in the exercise intolerance of chronic heart failure.
AB  - In conclusion, plasma levels of the endothelial-derived vasoconstrictor
      endothelin-1 (but not those of other neurohormonal vasoconstrictor factors),
      measured during exercise correlated closely with objective variables of exercise
      capacity in patients with heart failure. These findings suggest that endothelin-1
      may contribute to exercise intolerance in patients with heart failure, perhaps by
      limiting the ability of the peripheral vasculature to dilate during exercise.

PMID- 7778562
TI  - Pulmonary and systemic venous flow patterns assessed by transesophageal Doppler
      echocardiography in congenital absence of the pericardium.
AB  - In conclusion, alterations in venous return are more marked in the right side of
      the heart than in the left side of the heart in patients with complete absence of
      the left pericardium.

PMID- 7778561
TI  - Comparison of thallium-201 myocardial single-photon emission computed tomography
      and cine magnetic resonance imaging in Duchenne's muscular dystrophy.
AB  - In conclusion, thallium-201 myocardial SPECT is useful not only in detecting
      myocardial degeneration and estimating cardiac functions, but also in predicting
      the prognosis of cardiomyopathy in patients with Duchenne's muscular dystrophy.

PMID- 7778563
TI  - Initial experience with percutaneous transhepatic cardiac catheterization in
      infants and children.
AB  - Percutaneous transhepatic cardiac catheterization is a straightforward procedure
      that can be performed by experienced pediatric interventionalists with little
      additional training. We believe that this technique can be a valuable tool in the
      treatment of selected patients with complex congenital heart defects.

PMID- 7778564
TI  - An experimental model examining the role of magnesium in the therapy of acute
      myocardial infarction.
AB  - In conclusion, considering the results from our model, magnesium infusion is
      effective as adjunct therapy to enhance myocardial salvage in the setting of
      acute myocardial infarction. However, its effectiveness may be limited to a
      subset of patients whose magnesium therapy can be started early and combined with
      early reperfusion therapy.

PMID- 7778565
TI  - Anomalous origin of the left main pulmonary artery from the ascending aorta
      associated with DiGeorge syndrome.
AB  - We place on record 2 infants with the DiGeorge syndrome and anomalous origin of
      the left pulmonary artery from the ascending aorta. We postulate that: (1)
      embryogenesis of anomalous origin of the left pulmonary artery from the ascending
      aorta might be due to the persistent fifth aortic arch connecting both arterial
      systems; (2) an anomalous pulmonary artery arising from the ascending aorta is
      part of the aortic arch abnormality accompanied by normal conotruncal septation;
      and (3) in the DiGeorge syndrome, cardiac anomalies that originate from the
      conotruncus or aortic arch, or both, may have the same embryologic mechanisms.

PMID- 7778566
TI  - ACP Community-Based Teaching Project.

PMID- 7778567
TI  - ASIM: building ties between medical practice and academia.

PMID- 7778568
TI  - The revision of government-sponsored health care.

PMID- 7778569
TI  - Capitated Medicaid and the process of care of elderly hypertensives and
      diabetics: results from a randomized trial.
AB  - PURPOSE: To measure the quality of care for hypertensive and diabetic elderly
      Medicaid beneficiaries enrolled in managed care versus fee-for-service (FFS)
      plans. METHODS: Individuals enrolled in the Medicaid Demonstration Project in
      Hennepin County, Minnesota, were randomly assigned to receive their care either
      in one of seven managed care health plans in which the Medicaid payment for their
      care was capitated or in an FFS plan. Two hundred ninety-one hypertensives and 96
      diabetics who were aged 65 years or over at the beginning of the evaluation were
      interviewed at baseline and followed for 1 year. Drug and nondrug therapy,
      monitoring, monthly medication costs, and access to medications were assessed.
      RESULTS: The prepaid and FFS did not differ in drug or nondrug therapy, with the
      exception that slightly more FFS enrollees were on human insulin after 1 year.
      Mean monthly medication costs and access to medications were similar for both
      groups. CONCLUSIONS: In this randomized trial, we were unable to detect
      differences in the process of care for hypertensive and diabetic Medicaid
      enrollees.

PMID- 7778570
TI  - Methodologic sources of inconsistent prognoses for post-acute myocardial
      infarction.
AB  - PURPOSE: To investigate basic methodologic problems that could explain
      inconsistent and contradictory results for predictor variables in studies of
      prognosis after myocardial infarction (MI). MATERIALS AND METHODS: Studies on
      postinfarct prognosis published in English between 1979 and 1991 were identified
      with a MEDLINE literature search. The key words used for the computer search
      were: "prognosis" and "myocardial infarction" in the title and "mortality" or
      "survival" or "outcome" in the title or abstract. Reference lists in the reports
      captured by the search were examined for pertinent articles, and additional
      articles were sought in the index pages of two prominent journals. To be included
      in the analysis, a study had to fulfill the following eligibility criteria: a
      cohort study or randomized, controlled trial; sample size > or = 50 patients; a
      clear identification of the time when follow-up began, after the acute phase of
      MI and either before or at hospital discharge; follow-up for a minimum of 6
      months or median/mean of 1 year; and multivariable analysis for intervals no
      longer than 2 years after the MI. Eight methodologic standards addressing sources
      of major problems were established and applied to each study. RESULTS: Of 766
      reports identified, 111 fulfilled the eligibility criteria. The median number of
      standards fulfilled was 3, the highest 6. The proportions of studies complying
      with each of the 8 methodologic standards were: (1) inception cohort, 60%; (2)
      total death as an unequivocal outcome, 54%; (3) verification of cause-specific
      deaths (in 62 studies analyzing cardiac death), 37%; (4) analysis of crucial
      variables describing baseline severity, 13%; (5) indication of quantitative scope
      of the spectrum of baseline severity, 20%; (6) reproducible classification of
      candidate predictor variables, 40%; (7) adequate identification of quantitative
      importance of and boundaries for statistically significant predictor variables,
      39%; and (8) evaluation of impact of treatment on predictor variables, 13%.
      CONCLUSIONS: The results show that studies on postinfarct prognosis have
      frequently disregarded basic methodologic principles. Suitable adherence to these
      principles in future research will allow improved interpretation of results and
      can reduce inconsistent findings, while improving the applicability of the
      identified predictors.

PMID- 7778571
TI  - Accuracy of anticardiolipin antibodies in identifying a history of thrombosis
      among patients with systemic lupus erythematosus.
AB  - OBJECTIVE: To measure the accuracy of anticardiolipin antibodies (aCL) in
      identifying a history of thrombosis among patients with systemic lupus
      erythematosus (SLE) or the primary antiphospholipid syndrome (PAPS). PATIENTS AND
      METHODS: Patients with SLE or PAPS who attended our rheumatology clinic between
      April 1992 and March 1994 were included in a retrospective analysis of the
      relationship between thrombotic events and aCL. All aCL measurements were
      performed in the same laboratory by enzyme-linked immunosorbent assay, blinded as
      to the presence or absence of thrombosis. The diagnostic accuracy of IgG, IgM,
      and IgA aCL was quantified by means of the receiver operating characteristic area
      under the curve (ROC AUC) for each isotype. Stratum-specific likelihood ratios
      and their 95% confidence intervals were calculated to define strata with optimal
      discriminant power. RESULTS: During the period of study, aCL was measured in 117
      patients (113 SLE and 4 PAPS), of whom 24 (20.5%) had experienced thrombotic
      events. The ROC AUC +/- the standard error for IgG aCL was 0.81 +/- 0.05,
      signifying an 81% accuracy in the identification of a history of thrombosis. In
      contrast, the accuracy of the IgM and IgA aCL was significantly lower (0.60 +/-
      0.08 and 0.54 +/- 0.07, respectively, P < 0.05). Using stratum-specific
      likelihood ratios, we defined three strata in the IgG aCL scale that discriminate
      between patients with low, indeterminate, and high probabilities of thrombosis.
      For IgG aCL levels below 21.4 IgG phospholipid (GPL) U/mL, the posttest
      probability of thrombosis was 0.07, whereas for IgG aCL levels > or = 65.1 GPL
      U/mL, the posttest probability of thrombosis was 0.75. For IgG aCL values between
      21.4 and 65.0 GPL U/mL, the probability of thrombosis was 0.20, equivalent to the
      entire cohort. CONCLUSIONS: The IgG aCL determinations perform well in the
      identification of thrombosis in SLE or PAPS, while the IgM and IgA aCL have poor
      diagnostic accuracy. These findings may have implications for management of these
      patients.

PMID- 7778573
TI  - Extensive bone marrow necrosis associated with antiphospholipid antibodies.
AB  - Bone marrow necrosis (BMN), defined morphologically by destruction of
      hematopoietic tissue, including the stroma, with preservation of the bone, is a
      rare syndrome. The conditions in which it is seen include sickle cell disease,
      acute leukemia, metastatic neoplasia, and bacterial infection, particularly when
      hypovolemia and septic shock are present. BMN is also associated with
      disseminated intravascular coagulation (DIC) following irradiation and
      antineoplastic therapy. The antiphospolipid syndrome (APS) is characterized by
      antibodies directed against the antiphospolipid substrate. Because this substrate
      is prominently involved in the coagulation cascade and widely distributed on cell
      walls, patients present with venous or arterial thromboses, recurrent abortion,
      thrombocytopenia, and Coombs' positive hemolytic anemia, typically with raised
      anticardiolipin antibodies or a diagnostic lupus anticoagulant test. BMN does not
      appear to have been previously recognized in this context. We report what we
      believe to be the first such case and suggest that the high titers of antibodies
      present may have played a central role in its pathogenesis.

PMID- 7778572
TI  - Extremely elevated serum ferritin levels in a university hospital: associated
      diseases and clinical significance.
AB  - PURPOSE: To establish the frequency with which serum ferritin levels > or = 1,000
      ng/mL occur in a general hospital population, and to determine the clinical
      significance of this finding. PATIENTS AND METHODS: All serum ferritin
      determinations performed between June 1992 and July 1993 at the University of
      Cincinnati Medical Center were reviewed and patients with serum ferritin levels >
      or = 1,000 ng/mL identified. The medical records of these patients were then
      reviewed. RESULTS: Of 1,826 serum ferritin determinations performed during the
      study period, 122 (6.7%) were > or = 1,000 ng/mL. Associated clinical syndromes
      found in the 95 patients with serum ferritin > or = 1,000 ng/mL included liver
      disease (20.0%), renal disease (17.9%), malignant disease (17.9%), human
      immunodeficiency virus (HIV) infection (16.8%), non-HIV systemic infections
      (15.8%), chronic transfusions (10.5%), and sickle cell syndromes (10.5%). No
      syndrome usually associated with extreme serum ferritin elevations was identified
      in 8.4% of patients, and 16.8% of the patients fell into more than one category.
      The highest mean serum ferritin levels occurred in the chronically transfused and
      sickle cell groups. Concomitant serum transferrin saturation values were
      determined with 82 (86.3%) of the elevated serum ferritin levels and did not
      correlate well with them. The highest mean transferrin saturation levels occurred
      in the liver disease group. Transferrin saturation > or = 50%, suggestive of iron
      overload, was significantly more frequent in the liver disease group (P = 0.002);
      and saturation < or = 15%, suggestive of iron-deficient erythropoiesis, was
      significantly more frequent in the HIV group (P = 0.001). CONCLUSION: Outside the
      setting of clinical syndromes associated with iron overload (liver disease,
      transfusions, sickle cell syndromes), serum ferritin levels > or = 1,000 ng/mL
      serve as a nonspecific marker for a variety of significant disorders, including
      infectious and neoplastic diseases. Further study of the regulation of ferritin
      production may provide insight into the pathogenesis of disorders associated with
      extreme serum ferritin elevations.

PMID- 7778574
TI  - Heparin-induced aldosterone suppression and hyperkalemia.
AB  - PURPOSE: To review the effects of heparin and heparinoid compounds on aldosterone
      physiology and associated induction of hyperkalemia. MATERIALS AND METHODS: A
      comprehensive literature search (of human and animal data) was carried out by
      computer and by using reference citations from primary sources. RESULTS: Heparin
      and its congeners are predictable, potent inhibitors of aldosterone production.
      This inhibitory effect is specific for the zona glomerulosa; other
      corticosteroids are not affected. Aldosterone suppression occurs within a few
      days of initiation of therapy, is reversible, and is independent of either
      anticoagulant effect or route of administration. Decreases in aldosterone levels
      may occur with heparin dosages as low as 5,000 U BID. The most important, but
      probably not the only mechanism of aldosterone inhibition appears to involve
      reduction in both the number and affinity of the angiotensin-II receptors in the
      zona glomerulosa. Prolonged use of heparin causes marked reduction in the width
      of the adrenal zona glomerulosa. CONCLUSIONS: Aldosterone suppression results in
      natriuresis and less predictably in decreased excretion of potassium. Greater
      than normal serum potassium levels occur in about 7% of patients, but marked
      hyperkalemia generally requires the presence of additional factors perturbing
      potassium balance (in particular, renal insufficiency, diabetes mellitus, or the
      use of certain medications). Heparin-induced increases in serum potassium need to
      be better anticipated by clinicians. Serum potassium levels should be monitored
      periodically in patients being given heparin for 3 or more days, and in patients
      at relatively high risk for hyperkalemia, the monitoring interval should probably
      be no greater than 4 days.

PMID- 7778575
TI  - Doctor talk: technology and modern conversation.

PMID- 7778576
TI  - Sustained response in Felty's syndrome to prolonged administration of recombinant
      human granulocyte-macrophage colony-stimulating factor (rhGM-CSF).

PMID- 7778577
TI  - A case of severe cytolysis after hepatitis B vaccination.

PMID- 7778578
TI  - Measuring HIV-1 infection among needle/syringe exchange attenders.

PMID- 7778579
TI  - Gender: measuring its influence on senior medical students' "professional
      personality" and career choice.

PMID- 7778580
TI  - Methicillin-resistant Staphylococcus aureus.

PMID- 7778581
TI  - Liver damage in patients with CSF-producing tumors.

PMID- 7778582
TI  - Case report of dapsone-related thrombocytosis in an AIDS patient.

PMID- 7778583
TI  - Prenatal diagnosis and fetopathological findings in five fetuses with trisomy 9.
AB  - Five male fetuses with trisomy 9 are discussed. Three were detected prenatally
      and terminated, 1 aborted spontaneously, and the fifth delivered prematurely and
      died soon after. Multiple congenital abnormalities characteristic of trisomy 9
      were detected in all 5 cases and are compared to those of previous reports.

PMID- 7778584
TI  - Trisomy 9: review and report of two new cases.
AB  - Trisomy 9 is a relatively uncommon chromosome abnormality that may sometimes be
      seen in the nonmosaic state. We reviewed 23 mosaic and 15 nonmosaic cases of
      trisomy 9, including 2 new cases, in order to better define the prognosis and
      phenotype of this disorder. A recognizable trisomy 9 phenotype was identified and
      included a "bulbous" nose, microphthalmia, and dislocated limbs. Other
      nonspecific anomalies involving various organ systems were also common. With one
      exception, all survivors had severe mental impairment. Mosaicism for trisomy 9
      predicted longer survival, but the degree of mosaicism in lymphocytes or
      fibroblasts did not predict survival or degree of impairment. Parental chromosome
      variations were not uncommon. In contrast to prior reports, no specific
      prognostic finding was identified. A meiotic origin with loss of a trisomic cell
      line in mosaic cases is suggested.

PMID- 7778586
TI  - Unusual case of Smith-Lemli-Opitz syndrome "type II".
AB  - We describe a fetus with abnormalities suggestive, but not typical, of severe
      Smith-Lemli-Opitz syndrome (SLO). Biochemical studies demonstrated that there was
      a defect of cholesterol biosynthesis similar to that recently discovered in
      children with SLO. The findings in this fetus extend even further the wide
      spectrum of abnormalities of the SLO phenotype, and emphasize that a genetic
      pathological examination and biochemical studies should always be undertaken on
      atypical cases, especially fetuses.

PMID- 7778585
TI  - Trisomy 9 syndrome: report of a case with Crohn disease and review of the
      literature.
AB  - We report on a 6-year-old boy with mosaic trisomy 9. The patient was born at 42
      weeks of gestation to a 27-year-old G1 white woman. Birth weight was 2,820 g,
      length 52 cm, and Apgar scores were 4 and 6 at 1 and 5 min, respectively. The
      infant presented with apparently low-set ears, overfolded helices, epicanthal
      folds, prominent nasal bridge, high-arched palate, micrognathia, bilateral
      dislocated hips, left genu recurvatum, and cryptorchidism. Chromosome analysis
      showed an unusual karyotype: 47,XY,+inv(9qh+)/47,XY,+mar. The marker chromosome
      was thought to be a remnant of the inv(9qh+) chromosome. The mother's karyotype
      was 46,XX,inv(9qh+), while the father's was 46,XY. At age 5 months, the patient
      developed seizures and gastroesophageal reflux. Crohn disease was diagnosed at
      age 2 years, although symptoms began at age 1 year. Recurrent bouts of pneumonia
      have occurred since the patient's birth. Severe psychomotor retardation was also
      noted. Trisomy 9 syndrome was first reported in 1973. Over 30 cases have been
      reported since then. Of these cases reports, only 5 patients were older than 1
      year. Inflammatory bowel disease has been reported in association with other
      chromosome abnormalities, but to our knowledge, has not been reported in trisomy
      9 syndrome.

PMID- 7778587
TI  - Prenatal diagnosis of Smith-Lemli-Opitz syndrome.
AB  - An abnormality in cholesterol synthesis was described recently in the Smith-Lemli
      Opitz (SLO) syndrome. Here we describe how the application of this finding has
      enabled an accurate prenatal diagnosis. We also discuss the possible use of this
      test in detecting heterozygotes.

PMID- 7778588
TI  - Smith-Lemli-Opitz syndrome: prenatal diagnosis by quantification of cholesterol
      precursors in amniotic fluid.
AB  - Until recently, the diagnosis of Smith-Lemli-Opitz syndrome (SLOS), an autosomal
      recessive malformation/mental retardation syndrome, was made on the basis of
      clinical criteria alone. As a result, prenatal diagnosis has been possible only
      if sonography disclosed distinct fetal malformations in a subsequent pregnancy.
      However, the recent description of increased levels of 7-dehydrocholesterol
      (cholesta-5,7-dien-3 beta-ol) in patients with SLOS, most likely caused by a
      deficiency of 3 beta-hydroxysteroid-delta 7-reductase, has provided an apparently
      reliable biochemical marker for diagnosis of SLOS. To determine if this
      abnormality of sterol metabolism has utility for prenatal diagnosis of SLOS, we
      measured the levels of neutral sterols in stored amniotic fluid samples from two
      SLOS pregnancies. In both cases, the diagnosis of SLOS was made in the neonatal
      period by clinical criteria and the finding of markedly increased levels of 7
      dehydrocholesterol in plasma. Quantitative analysis by gas chromatography of
      sterols extracted from the amniotic fluid of both pregnancies revealed similar,
      markedly increased levels of 7-dehydrocholesterol and its precursor, lathosterol
      (cholest-7-en-3 beta-ol), both of which were undetectable in reference amniotic
      fluids. These findings suggest that abnormalities of cholesterol biosynthesis in
      SLOS may be sufficiently expressed in fetal life to permit prenatal diagnosis of
      this disorder by measurement of 7-dehydrocholesterol in amniotic fluid.

PMID- 7778589
TI  - Severe Smith-Lemli-Opitz syndrome with prolonged survival and lipid
      abnormalities.
AB  - We have studied a girl with multiple congenital anomalies, growth and mental
      deficiency, characteristic facial anomalies, cataracts, cerebellar atrophy, and
      severe hypocholesterolemia. Death occurred at age 7 years. After excluding
      several syndromes, i.e., peroxisomal disorders, mevalonic acidaemia, and
      Marinesco-Sjogren syndrome, it is concluded that this girl had severe Smith-Lemli
      Opitz Syndrome (SLOS) with exceptionally long survival. This diagnosis was
      confirmed through assay of 7-dehydrocholesterol in cultured fibroblasts.

PMID- 7778590
TI  - Prenatal detection of the cholesterol biosynthetic defect in the Smith-Lemli
      Opitz syndrome by the analysis of amniotic fluid sterols.
AB  - The Smith-Lemli-Opitz (SLO or RSH) syndrome is an autosomal recessive disorder
      characterized by a recognizable pattern of minor facial anomalies, congenital
      anomalies of many organs, failure to thrive, and mental retardation. Its cause is
      a defect in cholesterol biosynthesis characterized by abnormally low plasma
      cholesterol levels and concentrations of the cholesterol precursor 7
      dehydrocholesterol (7DHC) elevated up to several thousand-fold above normal. We
      used capillary column gas-chromatography to quantify sterols in amniotic fluid,
      amniotic cells, plasma, placenta, and breast milk from a heterozygous mother who
      had previously given birth to an affected son and in cord blood and plasma from
      her affected newborn daughter. The cholesterol concentration in amniotic fluid at
      16 weeks gestation was normal, but 7DHC, normally undetectable, was greatly
      elevated. In cultured amniocytes, the level of 7DHC was 11% of total cholesterol,
      similar to cultured fibroblasts from patients with SLO syndrome. At 38 weeks, a
      girl with phenotype consistent with the syndrome was born. Cholesterol
      concentrations were abnormally low in cord blood and in the baby's plasma at 12
      weeks, while levels of 7DHC were grossly elevated, confirming the prenatal
      diagnosis. The mother's plasma cholesterol increased steadily during gestation
      but remained below the lower 95% limit reported for normal control women. We
      conclude that it is now possible to detect the SLO syndrome at 16 weeks gestation
      by analyzing amniotic fluid sterols.

PMID- 7778591
TI  - Prenatal diagnosis of Smith-Lemli-Opitz syndrome.

PMID- 7778592
TI  - Concerning "Agamanolis disease".

PMID- 7778593
TI  - Inconsistencies in pedigree symbols in human genetics publications: a need for
      standardization.
AB  - To determine consistency in usage of pedigree symbols by genetics professionals,
      we reviewed pedigrees printed in 10 human genetic and medical journals and 24
      medical genetics textbooks. We found no consistent symbolization for common
      situations such as pregnancy, spontaneous abortion, death, or test results.
      Inconsistency in pedigree design can create difficulties in the interpretation of
      family studies and detract from the pedigree's basic strength of simple and
      accurate communication of medical information. We recommend the development of
      standard pedigree symbols, and their incorporation into genetic publications,
      professional genetics training programs, pedigree software programs, and genetic
      board examinations.

PMID- 7778594
TI  - De novo tandem duplication of chromosome segment 22q11-q12: clinical,
      cytogenetic, and molecular characterization.
AB  - We report on a case of duplication of the segment 22q11-q12 due to a de novo
      duplication. Molecular cytogenetics studies demonstrated this to be a tandem
      duplication, flanked proximally by the marker D22Z4, a centromeric alpha
      satellite DNA repeat, and distally by D22S260, an anonymous DNA marker proximal
      to the Ewing sarcoma breakpoint. The segment includes the regions responsible for
      the "cat-eye," Di George, and velo-cardio-facial syndromes and extends distal to
      the breakpoint cluster region (BCR). The clinical picture is dominated by the
      cardiac defects and includes findings reminiscent of "cat-eye" syndrome. These
      findings reinforce the hypothesis that the proximal 22q region contains dosage
      sensitive genes involved in development.

PMID- 7778595
TI  - Histopathology of fetal diastrophic dysplasia.
AB  - We report on three cases of diastrophic dysplasia in second trimester fetuses and
      discuss the differential diagnosis and clinical, radiologic, and histopathologic
      findings. Manifestations of typical diastrophic dysplasia in infants and older
      patients include abnormal pinnae, scoliosis, and joint contractures; these were
      absent in the fetuses, in keeping with the tendency for the clinical and
      radiologic aspects of this disease to become more severe with age. The
      histopathologic characteristics of the cartilage appear to be similar in the
      fetus and older patient, and therefore may be useful in differentiating
      diastrophic dysplasia from other osteochondrodysplasias in the second trimester.

PMID- 7778596
TI  - Web neck anomaly and its association with congenital heart disease.
AB  - To investigate the relationship between congenital heart disease and jugular
      lymphatic obstruction as manifested in web neck anomaly, we used the Iowa Birth
      Defects Registry to determine the incidence of congenital heart defects (CHD) in
      infants with and without web neck. Sixty percent of infants with web neck had
      CHD, with a high incidence of flow-related defects such as hypoplastic left
      heart, coarctation, and secundum atrial septal defect. Sixty-eight percent of
      infants with web neck had a genetic syndrome (37% Down syndrome, 13% Ullrich
      Turner syndrome, and 5% Noonan syndrome), and 24% had dysmorphic features
      consistent with lymphatic obstruction sequence. When infants with Down, Ullrich
      Turner, and Noonan syndrome and web neck were compared to infants with the same
      syndrome but without web neck, those with web neck were significantly more likely
      to have flow-related heart defects. Infants with Ullrich-Turner syndrome and web
      neck had an 11-fold higher incidence of coarctation, compared to those with a
      normal neck. Our data suggests web neck is associated with both flow and nonflow
      related heart defects. This association implies a pathogenetic relationship and
      appears to be independent of causal factors. The finding of web neck or nuchal
      cystic hygroma on a prenatal ultrasound or newborn examination should prompt a
      search for CHD.

PMID- 7778597
TI  - Further study of genetic interactions: loss of short arm material in patients
      with ring chromosome 4 changes developmental pattern of del(4)(q33).
AB  - Segment 4q33 is not considered a probable location of a gene related with limb
      deficiency by Roberts and Tabin [Am J Hum Genet 55:1-6, 1994]; however, the
      occurrence of ectrodactyly or its equivalents in at least 9 published cases of
      monosomy 4q33 suggests probable location of one of these genes in that region.
      Ulnar ray defects and/or ectrodactyly were the prevailing forms. An additional
      loss of the tip of 4p in patients with ring chromosome 4 leads to a change of
      limb deficiency type: 8 of 9 patients with r(4) and limb deficiency had radial
      ray defects. Therefore, interactions between a proposed 1/2 dose "ectrodactyly"
      gene on 4q33 and some 1/2 dosage genes on distal 4p (or disturbed cellular
      homeostasis due to a ring chromosome 4) can change the developmental pattern of
      limb deficiency. Possible mechanisms and significance of the phenomenon are
      discussed.

PMID- 7778598
TI  - Autosomal recessive Melnick-Needles syndrome or ter Haar syndrome? Report of a
      patient and reappraisal of an earlier report.
AB  - We report on a patient with congenital glaucoma, brachycephaly with flat occiput,
      large anterior fontanel, hypertelorism, anteverted nostrils, thoracolumbar
      kyphosis, prominent coccyx with skin fold, short hands and feet, flexion
      deformity of fingers, and clubfeet. He had a double-outlet right ventricle with
      ventricular septal defect, and severe tricuspid insufficiency. Mild skeletal
      changes included short tubular bones, absence of distal phalanges of toes,
      caliber variation of ribs, and scalloping of the anterior surface of vertebrae.
      The patient died at age 21 months. He belongs to the same extended family as 3
      similarly affected patients, previously described by ter Haar et al. [1982: Am J
      Med Genet 13:469-477] as representing an autosomal recessive form of Melnick
      Needles syndrome. We believe this diagnosis is no longer tenable. After having
      reviewed the relevant literature, we conclude that most probably we are dealing
      with a new autosomal recessive syndrome. We propose to name this entity ter Haar
      syndrome.

PMID- 7778599
TI  - Multiple congenital malformations in two sibs reminiscent of hydrolethalus and
      pseudotrisomy 13 syndromes.
AB  - We report on two sibs, born to consanguineous parents, with defects of the
      midline including cleft lip and palate, flat nose, hypotelorism, and dysgenesis
      of corpus callosum, in addition to short limbs, radiolucent tibial notch, digital
      anomalies, ambiguous genitalia, and hypopituitarism. In spite of the similarities
      between this condition and the hydrolethalus and pseudotrisomy 13 syndromes, our
      patients had neither preaxial nor postaxial polydactyly, but had previously
      undescribed bilateral radiolucent tibial notch, which is not known to be part of
      those two syndromes. The cases presented here may very well represent a new
      autosomal recessive syndrome.

PMID- 7778600
TI  - Autosomal-recessive neural crest syndrome with albinism, black lock, cell
      migration disorder of the neurocytes of the gut, and deafness: ABCD syndrome.
AB  - We report on a macrosomic newborn girl with albinism, a black lock at the right
      temporo-occipital region, and retinal depigmentation. Bilateral deafness was
      confirmed by brainstem auditory-evoked potentials. In addition, the infant had a
      severe defect of intestinal innervation. Biopsy showed aganglionosis of the large
      intestine, and total absence of neurocytes and nerve fibers in the small
      intestine, indicating a total lack of sympathetic and parasympathetic
      innervation. The infant died of intestinal dysfunction at 5 weeks. She was the
      14th child of consanguineous Kurdish parents. Four sibs of our patient had the
      same syndrome and died a few days after birth. The other 9 sibs are well, with an
      unremarkable phenotype. A syndrome of albinism, black lock, deafness, and a total
      lack of intestinal neural innervation has not yet been reported. It represents a
      new neural crest syndrome with autosomal-recessive inheritance.

PMID- 7778601
TI  - Brief clinical report on a deletion 5q35.3.

PMID- 7778603
TI  - Asperger syndrome in a boy with a balanced de novo translocation:
      t(17;19)(p13.3;p11)

PMID- 7778602
TI  - Further patient with Angelman syndrome due to paternal disomy of chromosome 15
      and a milder phenotype.

PMID- 7778604
TI  - Lipomatosis and partial lipohypoplasia in Proteus syndrome: a clinical clue for
      twin spotting?

PMID- 7778605
TI  - Craniosynostoses: phenotypic/molecular correlations.

PMID- 7778606
TI  - Sound-alike cephalosporins. How drugs with similar spellings and sounds can lead
      to serious errors.

PMID- 7778607
TI  - Managing pain from pressure ulcers.

PMID- 7778608
TI  - Insights into conscious sedation.

PMID- 7778609
TI  - Branching out into home care.

PMID- 7778610
TI  - Back to basics. Would you hang these i.v. solutions?

PMID- 7778611
TI  - Using imagery to help your patient heal.

PMID- 7778612
TI  - Clinical snapshot: deep vein thrombosis.

PMID- 7778613
TI  - The revolution in health care. What's your readiness quotient?

PMID- 7778615
TI  - Choosing a life insurance policy.

PMID- 7778617
TI  - Seeing forever.

PMID- 7778614
TI  - Emergency: autonomic dysreflexia.

PMID- 7778616
TI  - Leverage, exploitation, and intellectual capital.

PMID- 7778618
TI  - Shoes.

PMID- 7778619
TI  - Trial of labor after cesarean delivery with a lower-segment, vertical uterine
      incision: is it safe?
AB  - OBJECTIVE: Our purpose was to assess maternal and perinatal outcomes associated
      with a trial of labor and attempted vaginal birth after prior low-segment
      vertical cesarean delivery. STUDY DESIGN: During a 10-year period in a single
      tertiary hospital, all patients with a prior low-segment uterine incision
      (whether vertical or transverse) were considered candidates for a trial of labor
      in the absence of other contraindications or patient refusal. Among the 1137
      women who underwent low-segment vertical cesarean delivery, 262 were subsequently
      delivered of 322 live-born infants, and 174 (54%) of them were identified
      retrospectively as having attempted vaginal birth. The maternal and perinatal
      outcomes of patients who did or did not undergo a trial of labor were analyzed
      and compared. RESULTS: No significant differences between the two patient groups
      were observed regarding demographic characteristics, antepartum complications,
      gestational age at delivery (mean 37.4 weeks), birth weight, and cord pH at
      delivery. Vaginal delivery was accomplished successfully in 144 of 174 (83%)
      patients who underwent a trial of labor. Abdominal delivery was necessary for 17
      mothers with labor disorders and 13 with suspected fetal distress. Postpartum
      hemorrhage occurred more often in the trial of labor group (7/174 [4.0%] vs 2/148
      [1.4%], p not significant), but endometritis developed significantly more often
      in patients with elective repeat cesarean delivery (16.9% vs 6.3%, p = 0.006).
      Rupture of the low-segment vertical cesarean scar occurred in 2 patients during a
      trial of labor (1.1%) versus none in the elective repeat cesarean group. Neither
      mother experienced fetal extrusion or adverse maternal or fetal sequelae.
      Frequency of serious neonatal complications (8.1% vs 10%) and neonatal mortality
      (1.7% vs 2.0%) were similar between groups. All neonatal deaths were a result of
      extreme prematurity or congenital anomalies. CONCLUSIONS: Our experience
      indicates that a mother with a prior low-segment vertical cesarean delivery can
      undertake a trial of labor with relative maternal-perinatal safety. The
      likelihood of successful outcome and the incidence of complications are
      comparable to those of published experience with a trial of labor after a
      previous low-segment transverse incision.

PMID- 7778620
TI  - Uterine prolapse complicated by endometrial cancer.
AB  - OBJECTIVE: An infrequent clinical dilemma arises when a patient with uterine
      prolapse that is best treated vaginally is discovered to have coexisting
      endometrial cancer. Often the underlying cancer is only discovered
      intraoperatively or postoperatively. We have reviewed our experience in this
      situation in an effort to evaluate efficacy of treatment, strategies to avoid
      late postoperative discovery of cancer, and general guidelines for optimal
      treatment. STUDY DESIGN: At the Mayo Clinic from 1950 to 1993, 54 patients with
      coexisting endometrial carcinoma underwent vaginal hysterectomy with repairs for
      uterine prolapse. RESULTS: We have retrospectively reviewed these cases for
      relevant data and survival analysis. Complete follow-up is available for 53
      patients, and there were four recurrences. In 19 patients bilateral oophorectomy
      was not performed for multiple reasons, and one of these patients had a
      recurrence. Twenty-five percent of all patients had disease confined to the
      endometrium, and 80% overall had low-grade lesions with superficial or no
      myometrial invasion. Of the four recurrences, three would have been considered
      low risk of extrauterine spread, and it is doubtful that an abdominal approach
      would have yielded additional useful information. No patient required reoperation
      for recurrent pelvic relaxation. CONCLUSION: We believe that for certain selected
      patients vaginal surgery for uterine prolapse is adequate treatment in the
      presence of endometrial cancer. We discuss the selection strategies, exclusion
      criteria, and general guidelines to optimize care for these challenging patients.

PMID- 7778621
TI  - Flashlamp-excited dye laser therapy of idiopathic vulvodynia is safe and
      efficacious.
AB  - OBJECTIVE: The management of chronic vulvovaginal pain, not explicable on
      specific histologic grounds, presents a major problem in referral centers for
      lower genital tract diseases. STUDY DESIGN: This article reports on a two-step
      protocol in a sample of 175 medical nonresponders, drawn from a 2-year cohort of
      725 women with vulvovaginal pain. The first maneuver was the use of a flashlamp
      excited dye laser to selectively photocoagulate symptomatic subepithelial blood
      vessels in 168 women; the second was the microsurgical removal of chronically
      painful Bartholin's glands in 52 women not responsive or not suited to flashlamp
      excited dye laser photothermolysis. RESULTS: Dye laser response rates were
      independent of whether patients manifested macroscopic foci of painful erythema
      ("vestibular adenitis") or just colposcopically apparent hyperemia-ectasia of the
      individual blood vessels ("pruritic papillomatosis") (56% vs 45% after a single
      surgical procedure; 76% vs 65% after serial retreatment; p not significant).
      Conversely, response rates were much lower among women in whom pressure on the
      Bartholin's glands produced sharp, lancinating pain (15% vs 66% after a single
      surgical procedure; 22% vs 93% after serial retreatment; p < 0.001). Forty-two
      (85%) of 50 patients with flashlamp-excited dye laser failure had deep pain;
      however, the impasse to progress was broken by gland removal. Final response
      rates were 92.5% (complete response 62%; partial response 30%) in the "surface
      only" group and 80.3% in the "surface-plus-deep" group (chi 2 = 14.9; p < 0.001).
      The major complication was acute bacterial cellulitis, occurring in the first
      postoperative week. Modification of the treatment protocol to include topical
      antibiotics with an occlusive dressing reduced the cellulitis rate from 17.2% to
      2.5%. In four women (1.8%) Koebner-like exophytic condylomas also developed
      within 1 month of flashlamp-excited dye laser surgery. CONCLUSION: The
      availability of a safe, efficacious, and relatively noninvasive treatment should
      reduce the need for resective surgery in most patients with idiopathic
      vulvodynia.

PMID- 7778623
TI  - The medical and economic impact of laparoscopically assisted vaginal hysterectomy
      in a large, metropolitan, not-for-profit hospital.
AB  - OBJECTIVE: Our purpose was to evaluate the medical and economic impact of of
      operative laparoscopy on the surgical approach to hysterectomy for benign disease
      in a large, metropolitan, not-for-profit hospital. STUDY DESIGN: Retrospective
      analyses were performed on 2563 hysterectomies (without vaginal or bladder
      repair) for benign disease, performed by 37 gynecologists between January 1991
      and December 1993. Disposable laparoscopic instruments and stapling devices were
      not used at any time during the study period. Electrosurgery and sutures were
      used for hemostasis. Parameters analyzed included surgical approach (total
      abdominal hysterectomy, vaginal hysterectomy, laparoscopically assisted vaginal
      hysterectomy, and failed laparoscopically assisted vaginal hysterectomy),
      operative time, postoperative diagnosis, operative blood loss, length of stay,
      complications, uterine weight, and hospital changes. Charges in each of these
      parameters were analyzed and compared in 6-month increments. RESULTS: During the
      study period the percent of hysterectomies performed abdominally declined from
      65% to 36%. Laparoscopically assisted vaginal hysterectomy increased from 12% to
      45%, and vaginal hysterectomy varied from 23% to 19%. Average operative time was
      82 minutes (+/- 2 minutes) for total abdominal hysterectomy, 102 minutes (+/- 2.3
      minutes) for laparoscopically assisted vaginal hysterectomy, and 63 minutes (+/-
      2 minutes) for vaginal hysterectomy. Hospital stay was 68 hours (+/- 1.5 hours)
      for total abdominal hysterectomy, 44 hours (+/- 1.2 hours) for laparoscopically
      assisted vaginal hysterectomy, and 43 hours (+/- 4.1 hours) for vaginal
      hysterectomy. The average hospital charge was $6552 (+/- $108) for total
      abdominal hysterectomy, $6431 (+/- $100) for laparoscopically assisted vaginal
      hysterectomy, and $5869 (+/- $116) for vaginal hysterectomy. CONCLUSIONS:
      Contrary to previously published studies, our study demonstrates (1)
      laparoscopically assisted vaginal hysterectomy is a cost-effective procedure when
      performed with reusable instruments, (2) laparoscopically assisted vaginal
      hysterectomy is a safe procedure, even when performed by a variety of
      gynecologists with different skill levels, and (3) the number of hysterectomies
      performed abdominally was decreased by 29% without incurring more complications
      or reducing the number of vaginal cases.

PMID- 7778622
TI  - Cervical ripening before medical induction of labor: a comparison of
      prostaglandin E2, estradiol, and oxytocin.
AB  - OBJECTIVE: Our purpose was to evaluate the effectiveness of oxytocin,
      prostaglandin E2 intracervical gel, and estradiol cream for ripening the very
      unfavorable cervix in patients requiring induction of labor at term. STUDY
      DESIGN: This prospective, randomized study was conducted in a population of women
      with a very unfavorable cervix (Bishop score < 4) requiring induction of labor.
      The patients received prostaglandin E2 gel (0.5 mg) intracervically (three doses
      6 hours apart), 4 mg estradiol cream in the anterior fornix of the vagina (three
      doses 6 hours apart), or oxytocin at induction per protocol with an infusion
      pump. RESULTS: Ninety-nine women were recruited into this trial and evenly
      distributed among the three groups. The demographics of maternal age, race,
      parity, gestational age, initial Bishop score, and indication for induction were
      similar among the groups. The incidence of cesarean deliveries was similar in the
      three groups with approximately 59% of pregnancies delivered abdominally. For
      patients undergoing abdominal delivery the maximum cervical dilatation among the
      oxytocin, estradiol, and prostaglandin E2 groups was similar (3.90 +/- 3.02 cm,
      3.63 +/- 2.79 cm, and 4.65 +/- 2.78 cm, respectively; p > 0.05). For all patients
      birth weight and Apgar scores at 1 and 5 minutes were comparable across all
      regimens (p > 0.05). In the subset of patients delivered vaginally patients
      receiving oxytocin for cervical ripening had the greatest improvement in Bishop
      score over baseline (p = 0.023) with an improvement of 7.08 +/- 2.42. CONCLUSION:
      No differences were detected among prostaglandin E2 gel, estrogen, and oxytocin
      in relation to cervical ripening in patients with an unfavorable cervix at term
      who require an induction of labor. Patients with a very unfavorable cervix at
      term who require delivery may benefit from serial ripening and inductions.

PMID- 7778624
TI  - Primary and preventive care in a university obstetrics and gynecology group
      practice.
AB  - OBJECTIVE: Our purpose was to determine whether primary and preventive care is
      practiced by a university obstetrician-gynecologist group practice. STUDY DESIGN:
      A retrospective chart review spanning 2 years of four academic physicians'
      private practices was performed. A total of 335 patients were reviewed with 739
      patient encounters and 1032 patient problems identified. The definition of a
      primary care physician according to The American College of Obstetricians and
      Gynecologists was used to standardize data collection and evaluation. RESULTS:
      Obstetric complaints accounted for 27.7% of all visits, whereas 65.4% were for
      gynecologic problems. Almost 7% of all complaints were neither obstetric nor
      gynecologic, and of those 74.6% were primary care problems completely managed by
      the obstetrician-gynecologist. Only 19.7% of these were referred for management.
      More than 89% of all encounters (659/739) involved some element of primary care.
      CONCLUSION: This study provides evidence that the majority of health care
      provided by the obstetrician-gynecologist is primary care.

PMID- 7778625
TI  - Incisional bowel herniations after operative laparoscopy: a series of nineteen
      cases and review of the literature.
AB  - OBJECTIVES: The objectives of this report were (1) to identify all cases of
      incisional bowel herniations noted after operative laparoscopy in 11
      participating institutions and (2) to report the clinical details of such
      patients. STUDY DESIGN: A retrospective case review was performed. RESULTS:
      Nineteen cases of incisional bowel herniation were identified. The average age of
      the patients was 50.5 years. Initial laparoscopic procedures varied and included
      laparoscopically assisted vaginal hysterectomy (six patients), laparoscopically
      assisted vaginal hysterectomy with lymphadenectomy (five patients), oophorectomy
      (two patients), adhesiolysis (two patients), myomectomy (two patients),
      lymphadenectomy alone (one patient), and ovarian cystectomy (one patient). The
      average time to reoperation was 8.5 days. CONCLUSIONS: Incisional bowel
      herniation is a serious complication of operative laparoscopy. Herniations occur
      through ports > or = mm in size at both umbilical and extraumbilical sites. New
      techniques are needed to avoid this serious complication.

PMID- 7778627
TI  - The accuracy of antenatal fetal echocardiography screening in high- and low-risk
      patients.
AB  - OBJECTIVE: The purpose of this study was to evaluate the accuracy of four-chamber
      and left ventricular outflow tract views in low-risk patients and comprehensive
      fetal echocardiographic examinations in high-risk patients to diagnose structural
      heart disease or thoracic anomalies. STUDY DESIGN: A prospective outcome study of
      two cohorts was performed; 1136 low-risk patients and 886 high-risk patients were
      evaluated during a 2-year period. Low-risk patients underwent routine four
      chamber and left ventricular outflow tract evaluation whereas high-risk patients
      had detailed fetal echocardiographic examinations. Accuracy of the
      ultrasonographic diagnosis was evaluated from neonatal discharge data. RESULTS:
      Only 2 of 14 patients with congenital heart disease in the low-risk group were
      correctly identified (sensitivity 14.3%) whereas 10 of 16 patients with
      congenital heart disease or thoracic anomalies were correctly identified in the
      high-risk group (sensitivity 62.5%). CONCLUSION: The current study showed poor
      diagnostic accuracy of the standard four-chamber and left ventricular outflow
      tract views in low-risk patients for the diagnosis of structural cardiac
      anomalies. Patients with risk factors for congenital heart disease should be
      referred for comprehensive fetal echocardiographic examination.

PMID- 7778626
TI  - Preterm external cephalic version in an outpatient environment.
AB  - OBJECTIVE: Our purpose was to study the safety and efficacy of external cephalic
      version before term (37 weeks' gestation). STUDY DESIGN: We retrospectively
      reviewed 114 pregnancies in 110 women at 30 to 41 weeks' gestation who had a
      total of 133 attempts at external cephalic version. RESULTS: Seventy-nine percent
      of the versions performed before the thirty-seventh week and 53% performed during
      or after the thirty-seventh week were successful. After adjustment parity and
      body mass index, a version performed before the thirty-seventh week was 27 times
      more likely to be successful than if performed during or after the thirty-seventh
      week. Ninety-nine percent of the successful versions were delivered with a vertex
      presentation, and of these only 16% required cesarean delivery. CONCLUSION:
      External cephalic version is safe and successful if performed before 37 weeks'
      gestation, hence substantially reducing the rate of cesarean section among
      nonvertex presentations and reducing the risks associated with breech delivery.

PMID- 7778629
TI  - Time-quantified fetal movement detection with two-transducer data fusion.
AB  - OBJECTIVE: Our purpose was to develop an automated ultrasound-based fetal
      movement detection system to better define fetal movements. STUDY DESIGN: One
      hundred one patients had fetal movements recorded over a 20-minute period.
      Results of movement detection by a single-transducer system (Russell 1) and a two
      transducer fusion system (Russell 2) were compared with those of Hewlett-Packard
      (HP-M-1350-A), maternal perception, and expert ultrasonography review. RESULTS: A
      total of 86,592 seconds of videotape was scored for fetal movement. Russell 2 had
      a second-per-second sensitivity of 57.21% compared with Russell 1 at 40.95%, the
      HP-M-1350-A at 31.44%, and maternal perception at 30.80%. Russell 2 detected
      67.57% of discrete movements compared with 57.52%, 41.98%, and 37.92%,
      respectively, in other systems. CONCLUSION: Russell 2 represents a significant
      improvement over existing systems in detection of fetal movements on a second-per
      second basis.

PMID- 7778628
TI  - Evolving patterns of iatrogenic multifetal pregnancy generation: implications for
      aggressiveness of infertility treatments.
AB  - OBJECTIVE: Our purpose was to assess the changes in multifetal pregnancy
      generation as a function of utilization of ovulation stimulation and assisted
      reproductive techniques and to document the relative control of hyperstimulation
      between the methods. STUDY DESIGN: The methods of infertility treatment, number
      of fetuses, and outcomes of 220 patients referred for multifetal pregnancy
      reduction were compared over three time periods (1986 to 1989, 1991 to 1992, and
      1992 to 1993). Clomiphene, human menopausal gonadotropin, and ovulation
      stimulation with urofollitropin were compared against gamete intrafallopian
      transfer, zygote intrafallopian transfer, and in vitro fertilization (assisted
      reproductive techniques). RESULTS: The proportion of multifetal pregnancies
      generated by assisted reproductive techniques has steadily risen from 26% in the
      first two time periods to nearly half in the last 2 years. However, the number
      and proportion of quintuplet and greater pregnancies from assisted reproductive
      techniques have steadily fallen while for ovulation stimulation the proportion
      has remained about one third. CONCLUSION: Despite considerably increased use and
      proportionate generation of triplet and quadruplet pregnancies, the incidence of
      quintuplets has fallen for assisted reproductive techniques while there has been
      no improvement for ovulation stimulation. Continued, greater vigilance,
      particularly in the use of human menopausal gonadotropin and urofollitropin, must
      be emphasized.

PMID- 7778630
TI  - Underappreciated risks of the elderly multipara.
AB  - OBJECTIVE: Our purpose was to identify the age-related increased risks of the
      elderly gravida by clarifying the effects of age and parity, their combination,
      and their interaction. STUDY DESIGN: We studied 9556 singleton pregnancies in
      women aged 20 to 29 years or > or = 35 years delivered over an 8-year period.
      Data were analyzed by stepwise multiway contingency table analysis, with p <
      0.002 considered significant. RESULTS: Many of the previously reported risks of
      the elderly gravida are expected on the basis of age and parity. Significant
      associations (primarily related to advanced age) included higher frequencies of
      obesity, chronic hypertension, gestational diabetes, and large-for-gestational
      age and macrosomic infants. These elderly gravidas, on the other hand, had fewer
      postdates pregnancies. Although often overlooked, the greatest age-related
      increases in risk for induction (1.8 times), preeclampsia (2.7 times),
      gestational diabetes (4.5 times), clinical diabetes (3.2 times), oxytocin use
      (1.7 times), and macrosomia (1.6 times) occur in multiparas, not nulliparas. The
      risk for preeclampsia in the elderly multipara is significantly higher than
      expected on the basis of age and parity. CONCLUSION: The increased risks of the
      elderly multipara may have been overshadowed by the previous focus on the elderly
      nullipara. It is important to recognize the increases in age-related risks of the
      elderly multipara to appropriately counsel and manage this group of patients.

PMID- 7778631
TI  - The effect of tocolytic use in the management of symptomatic placenta previa.
AB  - OBJECTIVE: The null hypothesis is that tocolysis has no effect on pregnancy
      prolongation in the aggressive expectant management of symptomatic preterm
      placenta previa. STUDY DESIGN: One hundred twelve preterm pregnancies with
      confirmed placenta previa and an initial episode of acute vaginal bleeding were
      selected for this retrospective analysis. Exclusion criteria included gestational
      age > or = 35 weeks, delivery within 24 hours of admission, prior treatment for
      bleeding or preterm labor, and contraindications to tocolytic use. Tocolysis was
      prescribed, at the discretion of the treating clinical staff, in selected
      pregnancies with significant uterine contractions after admission of the patient.
      The majority of treated patients (85%) received intravenous magnesium sulfate
      and/or oral or subcutaneous beta-sympathomimetics within 24 hours of admission.
      Most patients remained hospitalized until delivery under this aggressive
      expectant management protocol. Both treated and untreated control study groups
      were similar at inclusion with regard to parity, gestational age, contraction
      frequency, and degree of initial bleeding. Outcome variables for each treatment
      group were obtained from final chart review. Continuous and categoric variables
      were compared with Student t test or chi 2 analysis-Fisher's exact test,
      respectively. RESULTS: The clinical use of tocolysis in symptomatic placenta
      previa was associated with a clinically significant delay of preterm delivery.
      Significant improvement in clinical parameters such as interval from admission to
      delivery (39.2 vs 26.9 days, p < 0.02) and birth weight (2520 vs 2124 gm, p <
      0.03) was observed in the tocolysis group. There was no observed statistical
      difference between the two treatment groups with regard to incidence of recurrent
      bleeding, interval from admission to first recurrent bleeding, and need for
      transfusion. There was a trend for patients with multiple bleeding episodes to
      have been receiving tocolytic therapy (p < 0.10). A trend for requiring a
      postpartum transfusion was also noted in the tocolysis group (p < 0.09). Treated
      pregnancies receiving long-term maintenance tocolysis with oral or subcutaneous
      terbutaline exhibited a greater degree of pregnancy prolongation than those
      treated with short-term intravenous magnesium alone (43.7 vs 15.3 days, p <
      0.02). CONCLUSIONS: This retrospective analysis suggests that tocolytic
      intervention in cases of symptomatic preterm previa may be associated with
      clinically significant prolongation of pregnancy and increased birth weight.
      Tocolytic therapy in these cases does not appear to have an impact on frequency
      or severity of recurrent vaginal bleeding. Further prospective analysis may
      delineate the role of tocolysis in the aggressive expectant management of
      symptomatic placenta previa.

PMID- 7778632
TI  - Magnetic resonance imaging of defects in DeLancey's vaginal support levels I, II,
      and III.
AB  - OBJECTIVE: The aim was to demonstrate paravaginal defects at DeLancey's levels I,
      II, and III by pelvic magnetic resonance imaging scanning in patients with
      symptomatic pelvic relaxation preoperatively and to demonstrate the disappearance
      of such defects after surgical repair. STUDY DESIGN: Magnetic resonance imaging
      scans of the pelvis were performed in 12 patients exhibiting cystourethroceles
      and symptomatic urinary stress incontinence. RESULTS: Magnetic resonance imaging
      scans of bilateral fascial defects at the upper third of the vagina (level I)
      were unremarkable except for the constant "chevron sign," whereas the middle
      third of the vagina (level II) displayed the "saddlebags sign," and the lower
      third of the vagina (level III) displayed the "mustache sign." These defects
      disappeared postoperatively. CONCLUSIONS: Bilateral defects in the paracolpium at
      vaginal support levels I, II, and III may be found by magnetic resonance imaging
      scans before surgery in certain patients with symptomatic pelvic relaxation.
      Postoperative scans after paravaginal repair demonstrate the disappearance of
      these defects.

PMID- 7778633
TI  - Neonatal outcome after preterm delivery for preeclampsia.
AB  - OBJECTIVE: Our purpose was to determine whether maternal preeclampsia per se has
      a beneficial effect on neonatal outcome after delivery before 35 weeks. STUDY
      DESIGN: A matched cohort study design was used. Two hundred twenty-three infants
      of strictly defined preeclamptic women were matched for gestational age, race,
      gender, and mode of delivery with infants of normotensive women with preterm
      labor and delivery. Pregnancies with multiple gestation, premature rupture of
      membranes, known fetal anomalies, diabetes, or maternal medical disease were
      excluded. Information was obtained by review of maternal and neonatal charts.
      Paired categoric and continuous data were compared by McNemar's test and the
      Wilcoxon signed-rank test, respectively. RESULTS: There was no difference in the
      incidence of neonatal death (4.5% vs 4.5%, p = 0.82), respiratory distress
      syndrome (22.0% vs 22.0%, p = 0.88), grades 3 and 4 intraventricular hemorrhage
      (2.2% vs 2.2%, p = 0.72), grades 2 and 3 necrotizing enterocolitis (5.8% vs 4.0%,
      p = 0.48), and culture-proved sepsis (9.0% vs 9.0%, p = 0.85). Results were
      similar when analysis was limited to infants born at < or = 32 weeks, infants
      born to mothers with severe preeclampsia, and infants with intrauterine growth
      restriction. CONCLUSION: Maternal preeclampsia per se does not have a beneficial
      effect on the postnatal course of infants born at 24 to 35 weeks' gestation.

PMID- 7778634
TI  - The expert witness: real issues and suggestions.
AB  - Medical malpractice lawsuits generally require expert testimony. Defendants and
      plaintiffs deserve expert testimony that is exacting, accurate, and consistent. A
      study of four frequently testifying experts was undertaken with review of
      depositions, reports, and trial transcripts of those experts. Contradictions in
      claimed medical principles from one case to the next were found and examples were
      cited for each expert. The review suggested that expert testimony regarding the
      standard of care may be neither reliable nor accurate for the purposes of judging
      physician conduct is lawsuits. Presently, no peer review or sanction process has
      been implemented to ensure accuracy and reliability of expert testimony used in
      medical malpractice lawsuits. We recommend changes that would include independent
      court-appointed experts, central filing of opinion letters by experts with
      authoritative text citations, and a sanction process by courts and/or authorized
      boards for testimony that is deemed inaccurate, false, or contradictory to the
      standard of care.

PMID- 7778635
TI  - Tolerance, patience, forbearance, and charity.

PMID- 7778636
TI  - A comparison of misoprostol and prostaglandin E2 gel for preinduction cervical
      ripening and labor induction.
AB  - OBJECTIVE: Our purpose was to compare the safety and efficacy of intravaginal
      misoprostol versus intracervical prostaglandin E2 (dinoprostone) gel for
      preinduction cervical ripening and induction of labor. STUDY DESIGN: One hundred
      thirty-five patients with indications for induction of labor and unfavorable
      cervices were randomly assigned to receive either intravaginal misoprostol or
      intracervical dinoprostone. Fifty microgram tablets of misoprostol were placed in
      the posterior vaginal fornix every 3 hours for a maximum of six doses.
      Prostaglandin E2 in gel form, 0.5 mg, was placed into the endocervix every 6
      hours for a maximum of three doses. Medication was not given after either
      spontaneous rupture of membranes or beginning of active labor. RESULTS: Among 135
      patients enrolled, 68 received misoprostol and 67 received dinoprostone. The
      average interval from start of induction to vaginal delivery was shorter in the
      misoprostol group (903.3 +/- 482.1 minutes) than in the dinoprostone group
      (1410.9 +/- 869.1 minutes) (p < 0.001). Oxytocin augmentation of labor occurred
      more often in the dinoprostone group (65.7%) than in the misoprostol group
      (33.8%) (p < 0.001). There were no significant differences between routes of
      delivery. Ten of the misoprostol-treated patients (14.7%) and 13 of the
      dinoprostone-treated patients (19.4%) had cesarean deliveries. There was a higher
      prevalence of tachysystole (six or more uterine contractions in a 10-minute
      window for two consecutive 10-minute periods) in the misoprostol group (36.7%)
      than in the dinoprostone group (11.9%) (p < 0.001). However, there were no
      significant differences in frequency of uterine hyperstimulation or hypertonus.
      There was a higher prevalence of meconium passage in the misoprostol group
      (27.9%) than in the dinoprostone group (10.5%) (p < 0.05). There was no
      significant difference in frequency of abnormal fetal heart rate tracings, 1- or
      5-minute Apgar scores < 7, neonatal resuscitations, or admissions to the neonatal
      intensive care unit between the two groups. CONCLUSIONS: Vaginally administered
      misoprostol is an effective agent for cervical ripening and induction of labor;
      however when given at this dosage, it is associated with a higher prevalence of
      tachysystole and meconium passage than is dinoprostone. Further studies to
      compare the safety of misoprostol to that of dinoprostone and to delineate an
      optimal dosing regimen for misoprostol are needed.

PMID- 7778637
TI  - Misoprostol: an effective agent for cervical ripening and labor induction.
AB  - OBJECTIVE: Our purpose was to compare the safety and efficacy of intravaginal
      misoprostol versus intracervical prostaglandin E2 gel (dinoprostone) for
      preinduction cervical ripening and induction of labor. STUDY DESIGN: Two hundred
      seventy-six patients with indications for induction of labor and unfavorable
      cervices were randomly assigned to receive either intravaginal misoprostol or
      intracervical dinoprostone. Twenty-five micrograms of misoprostol were placed in
      the posterior vaginal fornix every 3 hours, with a potential maximum of eight
      doses. Prostaglandin E2 in gel form, 0.5 mg, was placed in the endocervix every 6
      hours, with a maximum of three doses. Further medication was withheld with the
      occurrence of spontaneous rupture of membranes, entry into active phase of labor,
      or a "prolonged contraction response." RESULTS: Among those evaluated, 138
      received misoprostol and 137 received dinoprostone. The average interval from
      start of induction to vaginal delivery was shorter in the misoprostol group
      (1323.0 +/- 844.4 minutes) than in the dinoprostone group (1532.4 +/- 706.5
      minutes) (p < 0.05). Need for oxytocin augmentation of labor occurred more
      commonly in the dinoprostone group (72.6%) than in the misoprostol group (45.7%)
      (p < 0.0001). There were no significant differences in the routes of delivery.
      Twenty-eight of the misoprostol-treated patients (20.3%) and thirty-eight of the
      dinoprostone-treated patients (27.7%) required abdominal delivery. Complications
      such as uterine tachysystole and thick meconium passage occurred with similar
      frequency in the two treatment groups. CONCLUSIONS: Intravaginal administration
      of misoprostol appears to be as effective as intracervical dinoprostone for
      cervical ripening and labor induction. Complications associated with
      prostaglandin administration were not statistically different between the two
      treatment groups. The cost of misoprostol ($0.36/100 micrograms) is much less
      than that of dinoprostone ($75/0.5 mg).

PMID- 7778638
TI  - Ureteral injury in gynecologic surgery: a ten-year review in a community
      hospital.
AB  - OBJECTIVE: Our purpose was to review and analyze ureteral injuries incidental to
      gynecologic surgery in a community hospital. STUDY DESIGN: During the study
      period from Jan. 1, 1983, through Dec. 31, 1992, all patient records in which
      ureteral injury resulted from gynecologic surgery were reviewed. The operative
      procedure, pathologic result, location of injury, and type of repair were
      studied. Additionally, the time of recognition and diagnostic methods in these
      ureteral injuries were analyzed. RESULTS: Nineteen ureteral injuries were
      incurred during the performance of 4665 gynecologic surgical procedures, an
      incidence of 0.4%. Patients ranged in age from 23 to 70 years. Recognition of the
      ureteral injury occurred intraoperatively in 10 patients and was delayed from 1
      to 16 days in 9 patients. Six of the ureteral injuries were repaired by end-to
      end anastomosis, 3 by deligation, and 10 by ureteroneocystostomy. Immediate
      postoperative urinary integrity was found in all patients. CONCLUSION:
      Gynecologic surgical procedures in this study resulted in a 0.4% incidence of
      ureteral injury, and repair of these injuries was successful in all cases for the
      short term.

PMID- 7778639
TI  - Satellite in vitro fertilization: the Oregon experience.
AB  - OBJECTIVE: This study was designed to compare the results of preliminary
      evaluation, ovarian hyperstimulation, and monitoring of patients at a distant in
      vitro fertilization satellite center with those treated at the main campus of the
      program. STUDY DESIGN: Fifty-four patients completing oocyte retrieval cycles at
      the Eugene satellite Oregon Health Sciences University in vitro fertilization
      program for the period Jan. 1, 1991, through Dec. 31, 1993, were compared with
      222 patients at the main campus for age, peak estradiol level, number of oocytes
      retrieved, number of embryos, clinical pregnancy rate, and pregnancy outcome.
      RESULTS: There were no statistically significant differences between the Eugene
      in vitro fertilization satellite center and the main campus for any of the
      factors analyzed with the exception of clinical pregnancy rate. The clinical
      pregnancy rate per cycle at the Eugene satellite center was 39% while the
      Portland main campus rate was 23% (p = 0.027), presumably because of a larger
      number of couples with severe male factor infertility at the central site.
      CONCLUSION: A distant in vitro fertilization satellite program was highly
      successful in the Oregon experience. In addition to greater convenience to the
      patients, the program was highly comparable to the main campus program in
      measured parameter of ovarian hyperstimulation, oocyte retrieval, number of
      embryos, and pregnancy rate.

PMID- 7778640
TI  - Do concepts of causes and prevention of cerebral palsy require revision?
AB  - OBJECTIVE: My purpose was to explore the criteria of The American College of
      Obstetricians and Gynecologists (Technical Bulletin No. 163) for perinatal
      asphyxia to be linked to subsequent cerebral palsy. STUDY DESIGN: Analysis of
      four cases of intrapartum fetal insults with subsequent cerebral palsy and a
      literature review are presented. RESULTS: All of the four cerebral palsy cases
      had sufficient intrapartum causes of cerebral palsy, yet none fulfilled The
      American College of Obstetricians and Gynecologists' linkage criteria.
      Complications in the cerebral palsy cases were as follows: maternal intrapartum
      cardiac arrest, fetal skull fracture with brain infarct, intrapartum fetal
      stroke, and a newborn delivered after uterine rupture with only central nervous
      system defects. There are no well-done laboratory or clinical studies that
      unequivocally support the "criteria" that umbilical artery pH must be < 7.00 or
      the requirements of Apgar score < 3, hypoxic-ischemic encephalopathy, and
      multiple organ dysfunction. Apparent exceptions to these criteria occur.
      CONCLUSIONS: The American College of Obstetricians and Gynecologists Technical
      Bulletin's criteria for cerebral palsy linkage and the role of parturition in
      cerebral palsy should be reevaluated. A rebirth of obstetric enthusiasm for
      cerebral palsy research, teaching, and treatment needs to occur.

PMID- 7778641
TI  - Insulin-like growth factor I promotes leiomyoma cell growth in vitro.
AB  - OBJECTIVE: Our purpose was to determine whether insulin-like growth factors I and
      II preferentially stimulate uterine leiomyoma cells versus myometrial cells in
      monolayer culture. STUDY DESIGN: Leiomyomas and normal myometrium were obtained
      at hysterectomy from five premenopausal women. Specimens were enzymatically
      digested for use in primary monolayer cell cultures. By use of serum-free media,
      insulin-like growth factor I or II was added in 1, 10, and 100 ng/ml
      concentrations to both cell types with the patient serving as her own control.
      Cell number, prolactin production, and proliferative index values were measured
      on day 15 of cell culture. RESULTS: Significant increases in cell number were
      found in the leiomyoma cultures (p < 0.05) treated with 10 and 100 ng/ml insulin
      like growth factors I but not with insulin-like growth factors II. Neither factor
      exerted a stimulatory effect on myometrial cells. CONCLUSION: Insulin-like growth
      factors I preferentially stimulates leiomyoma cells in monolayer culture. These
      results suggest an autocrine-paracrine role in vivo for this factor in
      conjunction with gonadal steroids in promoting leiomyoma growth.

PMID- 7778642
TI  - A simplified method of timing frozen embryo transfers.
AB  - OBJECTIVE: Our purpose was to compare a simple artificial hormone replacement
      regimen with two other protocols incorporating pituitary down-regulation with
      gonadotropin-releasing hormone agonist for frozen embryo transfers. STUDY DESIGN:
      We performed a retrospective analysis of pregnancy outcomes after 366 frozen
      embryo transfers timed by one of three hormone replacement regimens. The three
      regimens used were regimen A, leuprolide acetate and transdermal estradiol
      patches; regimen B, leuprolide acetate and oral micronized estradiol; regimen C,
      only oral micronized estradiol. RESULTS: The outcomes of 366 consecutive frozen
      embryo transfers according to one of the three regimens were compared and
      analyzed. The clinical pregnancy rates were 13.7%, 11.4% and 13.5% in regimens A,
      B and C, respectively. No statistical differences were found among the three
      regimens. The mean age of the patients in the three groups was comparable. The
      mean number of frozen embryos transferred with regimen B was slightly higher, but
      it did not have a positive impact on the pregnancy rate in this group.
      CONCLUSION: Controlled sequential hormone replacement results in an endometrium
      suitable for frozen embryo transfers. Pituitary down-regulation is not necessary.
      Therefore this regimen is not only more simple to use but also more economical.

PMID- 7778643
TI  - Spontaneous rupture of the unscarred uterus.
AB  - OBJECTIVE: By presentation of cases of spontaneous (nontraumatic) ruptures of
      previously intact uteri, we sought to emphasize important aspects of this rare
      and dangerous event. STUDY DESIGN: Two case presentations of oxytocin-associated
      unscarred uterine rupture and review of pertinent literature are used to study
      risk factors and accompanying clinical characteristics. RESULTS: Both spontaneous
      ruptures of previous unscarred uteri were associated with low-dose oxytocin
      augmentation, bradycardia, and uterine hyperstimulation monitor patterns and
      occurred at the onset of the second stage of labor. CONCLUSION: Because of its
      rarity, further investigation of spontaneous uterine rupture will depend on case
      presentations where the associated events listed are noted and uterine
      hyperstimulation, fetal bradycardia, and second-stage onset are proved or
      disproved as valid clinical associations.

PMID- 7778644
TI  - Pulsatile pelvic masses: options for evaluation and management of pelvic
      arteriovenous malformations.
AB  - Three recent and previously unreported cases of pelvic arteriovenous malformation
      are presented. Two were surgically resected in conjunction with elective
      gynecologic surgery, and the third was embolized by retrograde femoral
      superselective coaxial catheterization. The causal significance of birth or
      surgical trauma is discussed, and guidelines for diagnostic angiographic imaging
      and therapeutic embolization are presented.

PMID- 7778645
TI  - Comparison of obstetric outcome of a primary-care access clinic staffed by
      certified nurse-midwives and a private practice group of obstetricians in the
      same community.
AB  - OBJECTIVE: The purpose of this study was to compare the obstetric outcome of a
      primary-care access clinic staffed by certified nurse-midwives, supervised by a
      private practice group of four obstetricians, with the obstetric outcome of that
      group's private practice patients. STUDY DESIGN: A retrospective cohort study was
      performed. Obstetric outcome of 496 clinic patients was compared with that of 611
      private patients in the same community from Aug. 1, 1991, to March 31, 1994.
      RESULTS: Obstetric outcomes as measured by (1) perinatal morbidity and mortality,
      (2) Apgar score, (3) birth weights, and (4) prematurity rates were comparable
      between the two groups. Significant was the cesarean section rate of 13.1% (10.5%
      primary) for the clinic patients and 26.4% (18.5% primary) for the private
      patients and the high percentage (81.8%) of private patients who elected to have
      repeat cesarean sections. CONCLUSIONS: (1) Low-income, uninsured, and
      underinsured women who have access to excellent prenatal care with supervised
      certified nurse-midwives can have obstetric outcomes similar to women having
      prenatal care with private obstetricians. (2) Prenatal care with supervised
      certified nurse-midwives can reduce the cesarean section rate without
      compromising infant outcome. (3) Utilization of certified nurse-midwives
      supervised by obstetricians may provide the optimum model for perinatal care,
      particularly for those women who are at high risk because of social and economic
      factors and who are currently underserved.

PMID- 7778646
TI  - Validity of indications for transabdominal cervicoisthmic cerclage for cervical
      incompetence.
AB  - OBJECTIVE: Our purpose was to review the indications for transabdominal
      cervicoisthmic cerclage to determine whether it is a valid alternative to
      transvaginal cerclage. STUDY DESIGN: A retrospective review of transabdominal
      cerclage patients at one institution from 1978 to 1994, analysis of the
      indications for the transabdominal rather than the vaginal approach, and
      evaluation of fetal outcomes was performed. RESULTS: Twenty-three patients
      underwent 24 transabdominal cerclages. The primary indication for transabdominal
      cervicoisthmic cerclage was failed transvaginal cerclage in 14 patients and
      anatomic unsuitability for transvaginal cerclage in nine. Of the latter, five
      were a result of diethylstilbestrol exposure and four a result of cervical
      surgery. All patients were successfully delivered of one or more live babies
      (total 28, including two sets of twins). Two losses occurred, one after rupture
      of membranes at 21 weeks on the second pregnancy after cerclage placement and one
      intraoperative loss with herniation of the membranes. The live birth rate was
      93%, compared with 18% salvage of pregnancies beyond the first trimester before
      the transabdominal cervicoisthmic cerclage procedure. Complications included
      blood loss requiring transfusion (four patients), although none of these occurred
      in the last 12 patients. CONCLUSION: We conclude that all the patients had a
      history compatible with incompetent cervix requiring a cerclage, and none were
      suitable candidates for a vaginal cerclage. We further conclude that with strict
      indications transabdominal cervicoisthmic cerclage offers a high rate of fetal
      salvage with a minimum of complications in patients with extremely poor obstetric
      histories because of cervical incompetence.

PMID- 7778647
TI  - HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets) presenting
      as generalized malaise.
AB  - The syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP)
      was first described by Weinstein in 1982 and is generally thought to represent a
      variant of the preeclampsia-eclampsia syndrome. As with other severe
      manifestations of preeclampsia-eclampsia, epigastric pain and liver tenderness
      are commonly recognized presenting symptoms of this syndrome, but an
      underappreciated presenting symptom is generalized malaise or symptoms similar to
      a flulike syndrome. Two case examples, a review of one private hospital's recent
      cases, and data contained in the literature are presented to stress the
      importance of malaise as a presenting complaint during late pregnancy, with
      recommendations for screening these patients.

PMID- 7778648
TI  - The use of intraoperative radiation therapy in radical salvage for recurrent
      cervical cancer: outcome and toxicity.
AB  - OBJECTIVE: Our purpose was to evaluate the contribution of intraoperative
      radiation therapy in the management of recurrent cervical cancer. STUDY DESIGN:
      Twenty-two patients were treated with electron beam intraoperative radiation
      therapy for recurrent cervical cancers that were confined to the pelvis but were
      too extensive to be adequately treated by radical surgery alone. All patients
      underwent extensive surgical dissection for exposure and maximal tumor resection.
      Doses of intraoperative radiation therapy ranged from 14 to 27.8 Gy (median 22
      Gy). Twelve patients received intraoperative radiation therapy to address gross
      residual disease, and 10 patients were treated for microscopically positive or
      close surgical margins. RESULTS: The five-year disease-specific survival and
      local control rates were 43% and 48%, respectively. There were trends toward
      better local control and disease-specific survival in patients with microscopic
      residual disease compared with those with gross residual disease. Seven patients
      had peripheral neuropathy related to treatment, and four of these cases resolved.
      CONCLUSION: In carefully selected cases intraoperative radiation therapy
      contributes to radical salvage of patients with recurrent cervical cancer
      involving the pelvic wall.

PMID- 7778649
TI  - Endocervical sampling by Kevorkian curette or Pipelle aspiration device: a
      randomized comparison.
AB  - OBJECTIVE: Our purpose was to compare two means of endocervical sampling-the
      Kevorkian curette and the Pipelle aspiration device (Unimar Co., Wilton, Conn.)
      with respect to patient discomfort, tissue volume, and specimen adequacy for
      diagnosis. STUDY DESIGN: Fifty-two women undergoing investigation of abnormal
      cervical cytologic results were assigned randomly to endocervical sampling by
      Kevorkian or Pipelle instruments. Pain associated with the procedure was assessed
      by having each subject indicate her pain level on a visual analog scale. Tissue
      volume was graded by examination of the microscopic slides by two investigators
      blinded to assignment. Adequacy for diagnosis was evaluated by reviewing
      pathology reports. RESULTS: Subjects having Pipelle endocervical aspiration (n =
      24) had significantly lower mean (+/- SEM) pain scores (27 +/- 5 vs 48.5 +/- 7, p
      = 0.02) than those in whom the Kevorkian instrument was used (n = 28). However,
      there were no significant differences in tissue volume obtained or in proportions
      considered adequate for diagnosis. CONCLUSIONS: Use of the Pipelle instrument was
      associated with less patient discomfort than Kevorkian curettage for endocervical
      sampling while providing similar tissue volume and adequacy for diagnosis.

PMID- 7778650
TI  - Fixation of the vaginal apex to the coccygeus fascia during repair of vaginal
      vault eversion with enterocele.
AB  - OBJECTIVE: This study was undertaken to compare the effectiveness of fixation of
      the vaginal apex to the coccygeus fascia with fixation to the sacrospinous
      ligament during surgical repair of vaginal vault eversion with enterocele. STUDY
      DESIGN: The records of 121 patients with posthysterectomy vaginal vault eversion
      with enterocele treated by the author between 1983 and 1994 were reviewed.
      Preoperative and postoperative symptoms and findings on pelvic examination and
      postoperative recovery were compared in patients undergoing sacrospinous ligament
      suspension and coccygeus fascial suspension. Statistical analysis was performed
      with chi 2 analysis and Kaplan-Meier life tables. RESULTS: Eighty-one patients
      underwent fixation to the coccygeus fascia and 30 underwent sacrospinous ligament
      suspension. The two groups are similar for clinical history, symptoms, and
      findings on pelvic examination. Ten patients underwent an abdominal sacral
      colpopexy for specific indications and are not comparable. The incidence of
      postoperative complications and length of hospital stay were similar for the two
      vaginal procedures. Patients with coccygeus fascial suspension have a projected
      96% cure rate at 2 years compared with an 80% cure rate for patients with a
      sacrospinous ligament suspension. CONCLUSION: Bilateral vaginal vault suspension
      to the coccygeus fascia is a safe, simple, and effective technique in the
      management of vaginal vault eversion with enterocele.

PMID- 7778651
TI  - Cesarean birth: how to reduce the rate.
AB  - The cesarean section rate, which approached 25%, has stabilized and started a
      modest decline. A stated United States national goal by the year 2000 is a rate
      of 15%. Suggested rates are 12% for primary and 3% for repeat cesarean sections.
      The major indications for cesarean section are prior cesarean delivery (8%),
      dystocia (7%), breech presentation (4%), fetal distress (2% to 3%), and others.
      The major areas of reduction must occur in the categories of prior cesarean
      delivery and dystocia. An expanded use of trial of labor and vaginal birth after
      a prior cesarean section will produce further reductions. Countries in Europe
      achieve > 50% vaginal birth after a prior cesarean section compared with 25% in
      the United States. A heightened awareness must occur regarding the decision to
      perform the first cesarean section. The residual impact, a scarred uterus,
      affects 12% to 14% of women seen for delivery. Even if 50% achieve a vaginal
      birth after a prior cesarean section, the national goals are unachievable. The
      obstetrician must consciously consider the impact of "once a cesarean, always a
      scar."

PMID- 7778652
TI  - Virilizing adrenal carcinoma in a woman of reproductive age: a case presentation
      and literature review.
AB  - Virilizing adrenal carcinoma is a rare disease, especially in women of
      reproductive age. A young woman who was seen with hirsutism, virilization, and
      infertility had a well-differentiated adrenal cortical carcinoma. After treatment
      she conceived twice and currently is disease free 8 years after treatment. This
      case illustrates that adrenal carcinoma and its treatment need not eliminate a
      woman's reproductive potential.

PMID- 7778653
TI  - Management of term breech presentation: a protocol of external cephalic version
      and selective trial of labor.
AB  - OBJECTIVE: The results of a program of external version and selective trial of
      labor for term breech presentation are reviewed. This is a follow-up to our 1987
      report describing management of singleton, term breech presentations and expands
      our 16-year experience to 1180 cases. STUDY DESIGN: All term breech presentations
      cared for in 1985 through 1992 are reviewed and outcome contrasted with those
      predicted in our earlier report. During these 8 years a trial of external version
      was offered if a breech presentation was identified after 36 completed weeks'
      gestation and before active labor. The criteria for allowing a trial of labor are
      detailed. RESULTS: Four hundred sixty-four breech presentations were identified
      for review. Three hundred eighty-two (82%) were diagnosed before active labor. Of
      these, 344 (90%) underwent an attempt at external version, of which 174 (51%)
      were successful. The 290 breech presentations where version either was not
      attempted or was unsuccessful were stratified into three groups: cesarean section
      without labor (147), trial of labor with cesarean section (90), and trial of
      labor with vaginal delivery (53). The 174 cases where version was successful were
      stratified into two additional groups on the basis of the eventual route of
      delivery. Careful review of maternal and fetal variables indicates that a trial
      of labor in selected patients resulted in vaginal delivery in only 37% but was
      achieved without an increase in fetal or maternal mortality or morbidity.
      Surprisingly, 54 of the 174 cases where version was successful were ultimately
      delivered by cesarean section. This 31% rate of cesarean delivery is
      significantly higher than the 15% rate observed for all cases of term, singleton
      vertex presentation. A higher prevalence of cases complicated by failed progress
      in labor and failed induction contributed to the excess. CONCLUSION: External
      version is successful in 51% of cases of term breech presentation. With careful
      selection, cases where version has failed can be allowed to labor and be
      delivered vaginally. The incidence of cesarean section (31%) for those cases
      where version had been successful was surprisingly high, largely because of an
      increase in labor abnormalities and failed labor inductions.

PMID- 7778654
TI  - Endovaginal ultrasonographically guided transvaginal drainage for treatment of
      pelvic abscesses.
AB  - OBJECTIVE: This study assessed the ability of endovaginal ultrasonographically
      directed transvaginal drainage of pelvic abscesses to treat patients who failed
      intravenous antibiotic therapies and whose abscesses were not amenable to
      percutaneous or colpotomy drainage. STUDY DESIGN: Thirty-one women who would
      otherwise have required surgery to treat their pelvic abscesses underwent the
      procedure. Immediate clinical response and longer-term follow-up results were
      collected retrospectively. RESULTS: Thirty-four procedures were performed on 31
      women. Purulent material (10 to 350 ml) was aspirated in every case. Twenty-six
      of the 31 women (84%) were successfully treated by drainage. In the 6- to 21
      month follow-up period, 10 women remained without problems, eight had sequelae
      related to pelvic infection, and eight were lost to follow-up. CONCLUSION:
      Endovaginal ultrasonographically guided transvaginal drainage is a safe,
      effective procedure for treatment of pelvic abscesses and should be considered
      the route of choice for draining collections not amenable to percutaneous or
      colpotomy drainage.

PMID- 7778655
TI  - On the treatment of vesico-vaginal fistula.

PMID- 7778656
TI  - Pregnancy in an anephric woman.

PMID- 7778658
TI  - Cerebral arterial-umbilical cord arterial systolic/diastolic ratios: an
      independent predictor of poor neonatal outcome.

PMID- 7778657
TI  - Effects of maternal inhalation of 40% oxygen on fetal oxygen saturation.

PMID- 7778659
TI  - Vascular anatomy of the anterior abdominal wall in gynecology and obstetrics.

PMID- 7778660
TI  - A vasoactive drug as a risk to pregnancy outcome.

PMID- 7778661
TI  - Evaluation of stress during labor and parturition.

PMID- 7778662
TI  - Are low-dose oral contraceptives safer and better?

PMID- 7778663
TI  - Low-dose oral contraceptives are safer than high-dose pills.

PMID- 7778664
TI  - Rectal bleeding complicating radiofrequency-induced thermal destruction of the
      endometrium.

PMID- 7778665
TI  - Preventing mother-to-child transmission of human immunodeficiency virus
      infection.

PMID- 7778666
TI  - Ultrasonographic diagnosis of "cervical incompetence".

PMID- 7778667
TI  - The role of patient mobilization after embryo transfer in in vitro fertilization
      programs.

PMID- 7778668
TI  - The American Board of Obstetrics and Gynecology, Inc.

PMID- 7778670
TI  - Immunohistochemical analysis of Mcl-1 protein in human tissues. Differential
      regulation of Mcl-1 and Bcl-2 protein production suggests a unique role for Mcl-1
      in control of programmed cell death in vivo.
AB  - The mcl-1 gene encodes an approximately 37-kd protein that has significant
      homology with Bcl-2, an inhibitor of programmed cell death that is expressed in
      many types of long-lived cells. In this study we determined the in vivo patterns
      of Mcl-1 protein production in normal human tissues by immunohistochemical means,
      using specific polyclonal antisera, and made comparisons with Bcl-2. Like Bcl-2,
      Mcl-1 immunostaining was observed in epithelial cells in a variety of tissues,
      including prostate, breast, endometrium, epidermis, stomach, intestine, colon,
      and respiratory tract. However, often the expression of mcl-1 and bcl-2 in
      complex epithelia occurred in gradients with opposing directions, such that Bcl-2
      immunostaining tended to be higher in the less differentiated cells lining the
      basement membrane, whereas Mcl-1 immunostaining was more intense in the
      differentiated cells located in the upper layers of these epithelia. The in vivo
      patterns of mcl-1 and bcl-2 expression were also strikingly different in several
      other tissues as well. Within the secondary follicles of lymph nodes and tonsils,
      for example, germinal center lymphocytes were Mcl-1 positive but mostly lacked
      Bcl-2; whereas mantle zone lymphocytes expressed bcl-2 but not mcl-1. Intense Mcl
      1 immunoreactivity was also detected in several types of neuroendocrine cells,
      including the adrenal cortical cells that are Bcl-2 negative, sympathetic neurons
      that also contain Bcl-2, a subpopulation of cells in the pancreatic islets,
      Leydig cells of the testis, and granulosa lutein cells of the ovarian corpus
      luteum but not in thyroid epithelium, which is strongly Bcl-2 positive. Little or
      no Mcl-1 was detected in neurons in the brain and spinal cord, in contrast to Bcl
      2, which is present in several types of central nervous system neurons.
      Conversely, strong Mcl-1 immunostaining was found in cardiac and skeletal muscle,
      which contain comparatively less Bcl-2. Additional types of cells that are Bcl-2
      negative but that expressed mcl-1 include chondrocytes and hepatocytes. These
      findings demonstrate that mcl-1 expression is widespread in vivo and imply that
      the Mcl-1 and Bcl-2 proteins fulfill different roles in the overall physiology of
      cell death regulation.

PMID- 7778671
TI  - Acetylcholine receptor alpha-subunit and myogenin mRNAs in thymus and thymomas.
AB  - Myasthenia gravis is an autoimmune disorder characterized in most cases by
      serological antibody against the acetylcholine receptor (AChR). Evidence for
      intrathymic localization of AChR suggests that the thymus has an important role
      in the pathogenesis of this disorder. Using reverse transcription followed by the
      polymerase chain reaction, we have demonstrated AChR alpha-subunit mRNA in
      thymuses and thymomas from patients with and without myasthenia gravis. We have
      also studied the expression of myogenin which is known to be involved in the
      regulation of AChR expression. By using the reverse transcription polymerase
      chain reaction, we found myogenin mRNAs in all of the thymuses and thymomas.
      Thus, both AChR alpha-subunit and myogenin mRNA are present in all of these
      specimens. By immunohistochemistry myoid cells (desmin and myoglobin positive)
      were present in all (four of four) thymuses studied and in two of five thymomas.
      Thus, in thymomas, nonmyoid cells might express both AChR and myogenin. These
      results indicate that cells within the thymus and thymoma express AChR and its
      regulatory protein myogenin and that such cells, under certain conditions, might
      play a role in the triggering of myasthenia gravis.

PMID- 7778672
TI  - DNA fragmentation of human infarcted myocardial cells demonstrated by the nick
      end labeling method and DNA agarose gel electrophoresis.
AB  - Myocardial tissue taken from 19 autopsy cases of myocardial infarction were
      examined both by the nick and labeling method (NELM) and by DNA agarose gel
      electrophoresis in order to demonstrate the localization of cells with fragmented
      DNA and to confirm the internucleosomal cleavage of DNA biochemically. The nuclei
      corresponding to those with the histological features of acute myocardial
      infarction in hematoxylin and eosin (H&E)-stained sections were stained strongly
      positive with the nick end labeling method. Myocardial cells corresponding to
      those with nick end labeling method-stained nuclei, on the other hand, had mostly
      pyknotic and karyolytic nuclei and some unremarkable nuclei, even nuclear ghosts,
      and showed degenerated cytoplasm, including contraction band necrosis in H&E
      stained preparations. The agarose gel electrophoresis of DNA extracted from the
      corresponding areas mentioned above showed the ladder pattern of internucleosomal
      cleavage characteristic of apoptosis. The present study revealed that infarcted
      myocardial cells with nuclear outlines, even nuclear ghosts, showed a distinct
      DNA fragmentation with the ladder pattern of internucleosomal cleavage. It is
      concluded from this study that the damaged myocardial cells of acute myocardial
      infarction represent a coagulation necrosis having the biochemical nature of
      apoptosis.

PMID- 7778673
TI  - Correlation of microscopic phenotype with genotype in a formalin-fixed, paraffin
      embedded testicular germ cell tumor with universal DNA amplification, comparative
      genomic hybridization, and interphase cytogenetics.
AB  - We present a strategy for the evaluation of numerical copy number changes of DNA
      segments within a solid tumor genome that allows the correlation of microscopic
      phenotype with genotype in formalin-fixed, paraffin-embedded tumor material.
      Cells from a human testicular germ cell tumor and adjacent tissue areas with
      normal seminiferous tubules were selected separately from microscopically
      analyzed histological tissue sections, and DNA was extracted from the selected
      areas. After universal DNA amplification, the amplification products were
      subjected to comparative genomic hybridization. The results confirmed balanced
      chromosome copy numbers for the normal tissue area, although the analysis of the
      tumor tissue area revealed numerous gains and losses of chromosome segments. The
      comparative genomic hybridization results were used to select DNA probes for
      interphase cytogenetics on serial sections. We conclude that this technique
      allows the screening of selected tissue areas for numerical DNA alterations, thus
      enabling a direct phenotype-genotype comparison.

PMID- 7778669
TI  - Chemokines and tissue injury.
AB  - Accumulation of leukocytes at sites of inflammation is essential for host
      defense, yet secretory products of the white cells may augment injury by damaging
      surrounding healthy tissues. Members of the chemokine family of chemotactic
      cytokines play a fundamental role in this process by attracting and stimulating
      specific subsets of leukocytes. In vitro studies suggest that chemokines
      participate in at least three phases of leukocyte recruitment. First, they foster
      tight adhesion of circulating leukocytes to the vascular endothelium by
      activating leukocytic integrins. Second, because of their chemoattractant
      properties, chemokines guide leukocytes through the endothelial junctions and
      underlying tissue to the inflammatory focus. Finally, chemokines activate
      effector functions of leukocytes, including production of reactive oxygen
      intermediates and exocytosis of degradative enzymes. Animal studies in which
      antibodies are used to neutralize the activity of individual members of the
      chemokine family confirm that these mediators contribute to the development of
      both acute and chronic inflammatory conditions. A number of mechanisms may
      operate in vivo to limit the proinflammatory properties of chemokines. Therapies
      that target chemokines directly or enhance the body's mechanisms for controlling
      their activity may prove to be reasonable approaches for treatment of
      inflammatory diseases.

PMID- 7778674
TI  - Detection of chromosomal imbalances in transitional cell carcinoma of the bladder
      by comparative genomic hybridization.
AB  - Comparative genomic hybridization (CGH) was applied for a comprehensive screening
      of chromosomal aberrations in 14 transitional cell carcinomas of the bladder of
      different grade and stage. The results were compared in a number of selected
      cases with those obtained by restriction fragment length polymorphism analyses
      and targeted fluorescence in situ hybridization. Distinct amplifications, found
      with CGH, were located on 3p22-24, 10p13-14, 12q13-15, 17q22-23, 18p11, and 22q11
      13. These high copy number amplifications and the frequency of imbalances
      involving chromosome 5, occurring in 4 of 14 cases, have not yet been identified
      in transitional cell carcinomas. Apart from these new aberrations, imbalances
      were detected in 3 or more cases for chromosomes 9 and 11, as already described
      previously in the literature. In four tumors, the copy number of specific
      chromosomal regions was also analyzed by interphase cytogenetics. Although in
      most instances the CGH data were confirmed, in one tumor, distinct differences
      were observed, possibly a result of heterogeneity of the tumor cell population.
      Furthermore, the CGH data were compared with loss of heterozygosity as revealed
      by restriction fragment length polymorphism analysis in the same tumors. In 80%
      of informative cases, no loss was detected by restriction fragment length
      polymorphism or by CGH. Of the 15 cases of loss of heterozygosity, 7 showed a
      loss also with CGH, whereas in 8 cases no loss was observed. In summary, CGH is a
      fast method to obtain a comprehensive picture of chromosomal imbalances in
      transitional cell carcinomas, including a number of previously unknown genomic
      alterations such as high level amplifications.

PMID- 7778675
TI  - Undifferentiated, nonkeratinizing, and squamous cell carcinoma of the
      nasopharynx. Variants of Epstein-Barr virus-infected neoplasia.
AB  - Nasopharyngeal carcinoma (NPC) samples of distinct histological types, including
      squamous cell carcinoma (WHO type 1), nonkeratinizing carcinoma (WHO type 2), and
      undifferentiated carcinoma (WHO type 3), were analyzed for Epstein-Barr virus
      (EBV) infection and gene expression by using in situ and biochemical techniques.
      The EBV-encoded RNAs (EBER) were detected in situ in most tumor cells of all
      three WHO types of NPC. In foci of squamous differentiation and keratinization
      within less differentiated NPC and throughout the expanse of well differentiated
      squamous cell carcinoma, EBER expression was less abundant. Latent membrane
      protein, an EBV-encoded membrane protein, was detected in 72% (36/50) of all NPC
      and 67% (6/9) of the cases of squamous cell carcinoma. The EBV genomes were
      present as clonal episomal forms, without detectable linear viral DNA, in all
      cases of squamous cell carcinoma analyzed. Polymerase chain reaction
      amplification of cDNA detected EBV transcription for Epstein-Barr nuclear antigen
      1, latent membrane proteins 1 and 2, and BamHI A in all samples, indicating that
      all forms of NPC express the same EBV genes. These results reveal that EBER
      expression is significantly decreased in areas with squamous differentiation and
      confirm that all types of NPC, regardless of histological type or differentiation
      contain clonal episomal EBV genomes, express specific EBV genes and are a clonal
      expansion of EBV-infected cells.

PMID- 7778676
TI  - Castration therapy rapidly induces apoptosis in a minority and decreases cell
      proliferation in a majority of human prostatic tumors.
AB  - Major differences in the long-term clinical response to castration therapy of
      prostatic carcinoma suggests intertumoral differences in cellular response and
      defines a need for identification of patients with an eventually positive outcome
      as well as those in need of additional treatment. Using morphometry, monoclonal
      antibodies against Bcl-2, c-myc, Ki-67, and p53 proteins, and an in situ method
      to visualize apoptotic cells, we examined the short-term response of prostatic
      tumors to castration in core biopsies from 18 prostatic cancer patients taken the
      day before and 7 days after castration. At the histological level, 3 tumors
      seemed practically unaffected by castration. In 15 tumors, castration induced
      vacuolization of tumor cell cytoplasm and decreases in nuclear area and Ki-67
      index. In these 15 tumors, apoptotic index was significantly increased in 6,
      principally unaffected in 6, and decreased in 3. The 6 tumors responding with an
      increase in apoptotic index were WHO grade 1 or 2 and negative for p53, c-myc,
      and Bcl-2 or contained only few Bcl-2- or c-myc-positive tumor cells before
      therapy. The 12 tumors in which apoptotic index was unaffected or decreased were
      WHO grade 2 or 3 and immunopositive for one or more of p53, Bcl-2, and c-myc
      proteins before therapy. The Bcl-2 index was significantly increased in 10
      patients. Prostatic tumors may respond in a variety of possibly predictable ways
      to castration therapy including a decrease in apoptotic index. The magnitude of
      these responses are not correlated in individual tumors, suggesting that the
      common classification of prostatic tumors as either androgen dependent (dying
      after castration) or independent (not responding at all to castration) may be an
      oversimplification.

PMID- 7778677
TI  - Dynamics of cell proliferation and cell death during the emergence of primitive
      neuroectodermal tumors of the immature central nervous system in transgenic mice.
AB  - Cell proliferation and cell death play critical roles in embryonic development,
      postnatal tissue maintenance, and tumor formation. To understand the interplay
      between cell proliferation and death in tumor formation, we studied these two
      processes in nascent primitive neuroectodermal tumors that arose postnatally from
      neuroepithelial cells ventral to the median eminence of transgenic mice
      (designated rTH-Tag mice) carrying a Simian virus 40 large T antigen transgene
      driven by a rat tyrosine hydroxylase promoter. Cell proliferation continued in
      the neuroepithelium of the ventral median eminence in wild-type and transgenic
      animals for the first 2 weeks of postnatal life but subsided completely in the
      wild-type mice after 2 weeks of age. In contrast, mitotic activity persisted in
      these progenitor cells of the rTH-Tag mice, and there was a dramatic increase in
      mitotic activity after 10 weeks leading to the formation of primitive
      neuroectodermal tumors despite sustained cell death activity. We conclude that
      primitive neuroectodermal tumors originate from progenitor cells in the ventral
      median eminence of rTH-Tag mice in early postnatal life when progenitors fail to
      respond to signals to exit the cell cycle. Thus, the disruption of mechanisms
      that regulate cell proliferation and cell death in the developing brain may
      underlie the emergence of primitive neuroectodermal tumors in the rTH-Tag mice.

PMID- 7778679
TI  - Expression of cell adhesion molecules on liver-associated lymphocytes and their
      ligands on sinusoidal lining cells in patients with benign or malignant liver
      disease.
AB  - Liver sinusoids, in contrast with the capillaries of other tissues, contain large
      numbers of sequestered lymphocytes. These blood-borne cells preferentially home
      in the liver. The mechanism regulating the recruitment of these cells and
      molecular regulation of the recognition of endothelial cells is as yet unclear.
      The present study sought to evaluate the cell adhesion molecules on human liver
      associated lymphocytes and their ligands on sinusoidal lining cells in 29
      patients undergoing partial hepatectomy for liver tumors. Liver-associated
      lymphocytes and peripheral blood lymphocytes were analyzed by flow cytometry
      using monoclonal antibodies. Frozen sections of liver tissue were stained
      according to alkaline phosphatase anti-alkaline phosphatase method. Cytometric
      analysis showed that virtually all liver-associated lymphocytes expressed on
      their surface the cell adhesion molecules LFA-1 and VLA-4. This liver-associated
      lymphocyte population also presented a significantly higher percentage of Mac 1,
      ICAM-1, and LFA-3 and an increased surface expression of LFA-1, LFA-2, and NCAM
      in comparison with peripheral blood lymphocytes. It was likewise shown that
      sinusoidal cells express ICAM-1, ICAM-2, ICAM-3, VCAM-1 and LFA-3 ligands. Liver
      associated lymphocytes thus strongly express a number of different adhesion
      molecules. The corresponding ligands were also detected on sinusoidal lining
      cells. LFA-1 and VLA-4 would seem to be important pathways of temporary
      lymphocyte-endothelial adhesion in liver sinusoids.

PMID- 7778678
TI  - Widespread cytoskeletal pathology characterizes corticobasal degeneration.
AB  - Corticobasal degeneration (CBD) is a rare, progressive neurological disorder
      characterized by widespread neuronal and glial pathology. Using
      immunohistochemistry and laser confocal microscopy, we demonstrate that the
      nonamyloid cortical plaques of CBD are actually collections of abnormal tau in
      the distal processes of astrocytes. These glial cells express both vimentin and
      CD44, markers of astrocyte activation. Glial pathology also includes tau-positive
      cytoplasmic inclusions, here localized to Leu 7-expressing oligodendrocytes. In
      addition, a wide array of neuronal pathology is defined with tau-positive
      inclusions in multiple domains of a variety of cortical neurons. CBD thus
      exhibits widespread glial and neuronal cytoskeletal pathology, including a novel
      structure, the astrocytic plaque. CBD is a disease of generalized cytoskeletal
      disruption affecting several cell types and multiple domains of these cells. The
      further definition of CBD pathology refines the diagnosis and pathophysiological
      understanding of this unique disease and has important implications for other
      neurodegenerative diseases, like Alzheimer's disease, characterized by abnormal
      tau deposition.

PMID- 7778680
TI  - Abnormal morphology of fibrillin microfibrils in fibroblast cultures from
      patients with neonatal Marfan syndrome.
AB  - The Marfan syndrome (MFS) is a connective tissue disorder manifested by variable
      and pleiotropic features in the skeletal, ocular, and cardiovascular systems. The
      average life span in MFS is about 35 years. A group with much more severe
      cardiovascular disease and a mean life span of approximately 1 year also exists.
      We refer to this latter group as "neonatal Marfan syndrome" (nMFS). Fibrillin
      defects are now known to be the cause of MFS and nMFS. Immunofluorescence studies
      were the first to demonstrate this association. Here we describe
      immunofluorescence studies in a series of 10 neonates and summarize their salient
      clinical features. In vitro accumulation of fibrillin reactive fibers was assayed
      using monoclonal antibodies to fibrillin in hyperconfluent fibroblast cultures.
      As was previously observed in MFS, fibroblast cultures from nMFS patients showed
      an apparent decrease in accumulation of immunostainable fibrillin. Significantly,
      however, the morphology of the immunostained fibrils in the nMFS cultures were
      abnormal and differed not only from control cultures, but also from those seen in
      cultures of MFS fibroblasts. The nMFS fibrils appeared short, fragmented, and
      frayed, characteristics that are not seen in MFS. Both the clinical and fibrillin
      morphology data provide evidence to suggest a useful subclassification of nMFS in
      the spectrum of MFS.

PMID- 7778681
TI  - Anion exchanger immunoreactivity in human salivary glands in health and Sjogren's
      syndrome.
AB  - Salivary gland ducts play a relevant role in saliva secretion through transport
      processes. Na(+)-independent chloride-bicarbonate anion exchangers (AE) may be
      involved in these processes by generating ion fluxes into the salivary secretion.
      In Sjogren's syndrome, a disorder with gland dysfunction, there might be an
      impaired expression of AE proteins. Here we study AE immunoreactivities in human
      salivary glands, both in health and in Sjogren's syndrome. Immunohistochemistry
      was carried out on salivary glands from normal subjects and patients with
      Sjogren's syndrome, using two monoclonal antibodies against AE1 and AE2. Normal
      salivary glands showed AE2 immunoreactivity, which was restricted to the
      epithelium of the ducts, with no staining at the acini. A strong positivity was
      seen in the basolateral portion of the striated ducts, while interlobular duct
      cells showed a discrete positivity at their apical pole. In salivary glands from
      most of the patients with Sjogren's syndrome, AE2 immunoreactivity was absent in
      the ducts as well as in the acini. In both normal and diseased salivary glands,
      AE1 immunoreactivity was only located at the erythrocyte membrane. The recently
      reported AE0 was discarded because no AE0 message was found in salivary glands by
      reverse transcription polymerase chain reaction. In conclusion, AE2
      immunoreactivity is observed in the ducts of normal salivary glands, particularly
      in the striated ducts. AE2 immunoreactivity is virtually absent in salivary
      glands from patients with Sjogren's syndrome, which may reflect either a loss of
      AE2 after inflammatory atrophy, or a primary defect occurring in the disease.

PMID- 7778682
TI  - Immunopathology of chronic lentivirus-induced arthritis.
AB  - This study evaluated histopathology and mononuclear cell phenotypes in synovial
      lesions of chronic arthritis induced by experimental infection of Saanen goats
      with caprine arthritis-encephalitis lentivirus. Histological examination of
      carpal joint synovium of three infected goats with clinical arthritis revealed
      progressive lesions consisting of membrane villus hypertrophy with extensive
      angiogenesis and mononuclear cell infiltration and degenerative changes of
      membrane villus necrosis associated with loss of vasculature and infiltrates.
      Changes in synovial tissue of five age-matched infected goats without clinical
      arthritis were limited to moderate synovial membrane hyperplasia also noted in an
      age-matched uninfected goat. Immunohistochemistry identified CD45R+ CD5- B
      lymphocytes as the principal component of most perivascular infiltrates in
      arthritic synovium. Other mononuclear cells included perivascular CD4+ and CD8+ T
      lymphocytes and macrophages with a prominent accumulation of CD8+ T lymphocytes
      at the lining surface of inflamed villi. T lymphocytes and macrophages as well as
      synovial lining cells were activated with respect to MHC class II but not for
      interleukin-2 receptors. Inflamed villi also contained lymphoid aggregates
      comprised of B cell germinal centers and activated T-cell mantles. B cells
      expressing immunoglobulin occurred around follicles and throughout inflamed
      villi. These findings indicate that memory immune responses that favor expansion
      and maturation of B cells and immunoglobulin production contribute to the
      immunopathology of chronic arthritis.

PMID- 7778684
TI  - Early and persistent up-regulated expression of renal cortical osteopontin in
      experimental hydronephrosis.
AB  - The mechanical disturbance after unilateral ureteral obstruction (UUO) is a
      nonimmune stimulus that is capable of eliciting a florid macrophage infiltration
      of the kidney and subsequent post-inflammatory renal scarring. Osteopontin has
      potential chemoattractant activity and, for this reason, we delineated the
      kinetics of its expression in the renal cortex of rats with UUO. Whole body X
      irradiation and reversal of UUO were utilized as interventional maneuvers to give
      additional pathobiological insight into this protein's role in the response of
      the kidneys to ureteral obstruction. Increased osteopontin mRNA levels in
      obstructed kidneys versus contralateral unobstructed specimens were evident as
      early as 4 hours after UUO and steadily increased at 12, 24, 48, and 96 hours
      after UUO. Both X-irradiation and reversal of UUO failed to significantly
      modulate renal cortical osteopontin mRNA expression at all of the above time
      points. Paralleling the increments in renal cortical osteopontin mRNA levels were
      significant elevations in the cortical renal interstitial macrophage number,
      which was significantly diminished by previous X-irradiation but not reversal of
      UUO. Focal labeling of osteopontin was noted in both tubular and Bowman's
      capsular epithelium in obstructed kidneys as early as 4 hours after UUO, whereas,
      in the contralateral unobstructed specimens, there was only faint staining in
      Bowman's capsule. By 96 hours after UUO, obstructed kidneys exhibited intense,
      diffuse staining for osteopontin in both tubules and Bowman's capsule.
      Osteopontin's immunolocalization was not modulated by X-irradiation or reversal
      of UUO. These data support the contention that osteopontin is involved in the
      accumulation of macrophages within the peritubular and periglomerular
      interstitium in the obstructed renal cortex.

PMID- 7778683
TI  - Tumor necrosis factor-alpha is expressed by glomerular visceral epithelial cells
      in human membranous nephropathy.
AB  - The role of tumor necrosis factor alpha (TNF-alpha) was examined in biopsy-proven
      glomerulonephritis by immunohistochemistry, in situ hybridization, immunogold
      electron microscopy, immunoassay in serum and urine, and urinary immunoblot.
      Striking glomerular capillary wall and visceral glomerular epithelial cell TNF
      alpha protein staining was observed in all cases of membranous nephropathy and
      membranous lupus nephropathy. Staining was less frequently observed in crescentic
      glomerulonephritis and in isolated cases of other histological subtypes of
      glomerulonephritis, usually in association with glomerular macrophages. By
      immunogold electron microscopy TNF-alpha was localized in membranous nephropathy
      within the visceral glomerular epithelial cells, and also in the glomerular
      basement membrane, especially in relation to immune deposits. In situ
      hybridization localized TNF-alpha mRNA exclusively to glomerular epithelial cells
      in all biopsies with membranous morphology but not in other histological
      subtypes. Concentrations of TNF-alpha were significantly increased compared with
      normal controls in the urine of patients with membranous nephropathy and with
      crescentic glomerulonephritis. The expression of TNF-alpha by glomerular
      epithelial cells exclusively and universally in biopsies showing a membranous
      morphology strongly suggests this cytokine has a role in the pathogenesis of
      membranous nephropathy.

PMID- 7778685
TI  - Autoantibodies to the laminin P1 fragment in HgCl2-induced membranous
      glomerulopathy.
AB  - Exposure to mercuric chloride induces the development of a membranous
      glomerulopathy with high proteinuria in DZB rats, in which immunoglobulin (Ig)G1
      and IgG2a bound in the glomeruli were previously found to react with laminin of
      the EHS tumor and several unidentified glomerular basement membrane components.
      Monoclonal antibodies were prepared by fusing cervical and mandibular lymph node
      cells from a HgCl2-treated DZB rat with a nonsecreting mouse myeloma. Monoclonal
      antibodies were screened for reactivity with collagenase-digested glomerular
      basement membrane and kidney sections; upon subcloning, eight stable hybridomas
      were obtained, named MEC1 to MEC8. MEC2 (IgG1, kappa), MEC3 (IgM, kappa), and
      MEC5 (IgG1, kappa), as well as the polyclonal glomerular eluate, reacted
      preferentially with the P1 fragment of the laminin-1 (alpha 1 beta 1 gamma 1)
      isoform. MEC8 (IgM, kappa) reacted with the P1 and the E4 fragment of laminin.
      Both MEC6 (IgM, kappa) and MEC8 bound to actin and to various other, unidentified
      cellular antigens, indicating that MEC6 and MEC8 are polyreactive antibodies.
      MEC7 (IgM, kappa) bound to a cytoskeleton-linked cell membrane antigen, present
      on various epithelial cells and between heart muscle fibers and associated with
      small peripheral, intramuscular nerves. Several of the MEC monoclonal antibodies
      bound in vivo along the glomerular capillary wall. Although discrete electron
      dense subepithelial immune aggregates were not detected and proteinuria was not
      induced, MEC3 localization changed from a continuous pattern into a fine granular
      pattern along the glomerular basement membrane, and focally along the TBM, upon
      passive transfer into naive DZB rats. These findings suggest a pathogenetic role
      for the P1 fragment of laminin either in the induction phase of HgCl2-induced
      membranous glomerulopathy as an immunogen or in the effector phase as a target
      antigen.

PMID- 7778686
TI  - Transcription and translation of gp600 and receptor-associated protein (RAP) in
      active Heymann nephritis.
AB  - Active Heymann nephritis (HN) of rat, an autoimmune glomerular disease, is a
      model for human membranous glomerulonephropathy. The autoantigen of HN is a
      glycoprotein of approximately 600 kd that is present in both rat and human
      kidneys. Another kidney protein of 39-45 kd called receptor-associated protein
      (RAP) is associated with gp600. In normal kidney very little gp600 and RAP can be
      detected in glomeruli. This study was undertaken to determine whether the
      synthesis of gp600 and RAP would increase after development of active HN. Kidneys
      from normal (n = 5) and active (n = 11) HN rats were studied for expression of
      gp600 and RAP and their mRNAs by immunofluorescence and in situ hybridization. In
      all HN kidneys in contrast to normal kidneys both the transcription and
      translation of gp600 were markedly increased in glomeruli and proximal tubules.
      Transcription and translation of RAP were also increased but less so than gp600.
      The site of increased transcription of gp600 and RAP in glomeruli was clearly
      localized to the visceral glomerular epithelial cells. CONCLUSIONS: This is the
      first study to show increased transcription of gp600 and RAP in active HN and the
      first study to identify the visceral glomerular epithelial cell as the cell for
      the increased transcription.

PMID- 7778687
TI  - Platelet-derived growth factor ligand and receptor expression by large vessel
      endothelium in vivo.
AB  - Using an injury model of the rat carotid artery and aorta, we have determined the
      time course of expression for PDGF ligands and receptors in endothelium by in
      situ hybridization and immunostaining. Platelet-derived growth factor (PDGF)-A
      and -B chains-were expressed in endothelial cells at the wound edge, but no
      expression was detectable in uninjured endothelium. PDGF-alpha receptor was
      expressed in a similar pattern as PDGF-A chain whereas expression of PDGF-beta
      receptor was not detected at any time. Expression of PDGF-B chain did not
      correlate with endothelial cell replication and a neutralizing antibody against
      PDGF-B had no effect on endothelial regrowth in the denuded aorta. Intimal smooth
      muscle cells are known to express PDGF-beta receptors and could thus be
      stimulated to migrate in response to PDGF-B from endothelial cells.

PMID- 7778688
TI  - Expression of hemidesmosomal and extracellular matrix proteins by normal and
      malignant human prostate tissue.
AB  - The progression of prostate carcinoma may be influenced by the biochemical nature
      of the basal lamina surrounding the primary carcinoma cells. As a first step
      toward understanding this process, the composition and structure of the basal
      lamina in normal prostate, prostatic intraepithelial neoplasia, and human
      carcinoma were determined. In addition, a comparison was made between the
      attachments of the normal basal cell to its underlying basal lamina and those
      made by primary prostate carcinoma. The normal basal cells form both focal
      adhesions and hemidesmosomal-like structures as observed by transmission electron
      microscopy. The normal basal cells exhibited a polarized distribution of
      hemidesmosomal associated proteins including BP180, BP230, HD1, plectin, laminin
      gamma 2(B2t), collagen VII, and the corresponding integrin laminin receptors
      alpha 6 beta 1 and alpha 6 beta 4. The expression and distribution pattern of
      these proteins were retained in the prostate intraepithelial neoplasia lesions.
      In contrast, the carcinoma cells uniformly lacked hemidesmosomal structures, the
      integrin alpha 6 beta 4, BP180, laminin-gamma 2 (B2t), and collagen VII but did
      express BP230 (30%), plectin, HD1 (15%), and the integrin laminin receptors alpha
      3 beta 1 and alpha 6 beta 1. These results suggest that, although a detectable
      basal lamina structure is present in carcinoma, its composition and cellular
      attachments are abnormal. The loss of critical cellular attachments may play a
      role in influencing the progression potential of prostate carcinoma.

PMID- 7778690
TI  - Inhibition of parathyroid hormone-related protein release by extracellular
      calcium in dispersed cells from human parathyroid hyperplasia secondary to
      chronic renal failure and adenoma.
AB  - The relationship between parathyroid hormone-related protein (PTHrP) release from
      parathyroid cells and extracellular calcium ion concentration was investigated in
      three cases of parathyroid hyperplasia secondary to chronic renal failure and in
      four cases of parathyroid adenoma. Amounts of PTHrP released from individual
      parathyroid cells dispersed from surgical specimens were estimated by cell
      immunoblot assay. Parathyroid cells from both hyperplasias and adenomas showed
      significant suppression in the release of PTHrP with increase in extracellular
      calcium ions, but the amounts of PTHrP released from adenoma cells were
      significantly larger than from hyperplasia cells. The maximal value for PTHrP
      released within 120 minutes from adenoma cells was 2.91 +/- 2.11 x 10(-2)
      fmol/cell ([Ca2+], 0.4 mmol/L), and the minimal value was 1.32 +/- 0.35 x 10(-2)
      fmol/cell ([Ca2+], 2.0 mmol/L). On the other hand, the maximal value for PTHrP
      released from hyperplasia cells was 1.79 +/- 1.56 x 10(-2) fmol/cell ([Ca2+], 0.4
      mmol/L), and the minimal value was 0.32 +/- 0.19 x 10(-2) fmol/cell ([Ca2+], 2.0
      mmol/L). These results demonstrate actual release of PTHrP from abnormal
      parathyroid tissues into the extracellular space with the response to
      extracellular calcium ions depending on the cell status. Given the lack of
      definite histological criteria to differentiate between hyperplasias and adenomas
      in the parathyroid gland, the presently demonstrated significant difference in
      the ability to release PTHrP is important in pointing to parathyroid hyperplasia
      secondary to chronic renal failure as a distinct pathological entity separate
      from parathyroid adenoma.

PMID- 7778691
TI  - Mammalian tyrosinase-related protein-1 is recognized by autoantibodies from
      vitiliginous Smyth chickens. An avian model for human vitiligo.
AB  - The Smyth line (SL) chicken is an animal model for the human acquired
      depigmentary disorder vitiligo. Affected birds from this line express a postnatal
      loss of melanocytes in feather and ocular tissues. This vitiligo-like
      depigmentation is considered to be a disorder with two interacting components:
      melanocyte dysfunctions and autoimmune reactions. Previously, SL chicks were
      shown to express high levels of circulating autoantibodies that bind to chicken
      melanocyte proteins with molecular masses between 65 and 80 kd. Three mammalian
      melanocyte proteins known to have isoforms in this molecular mass range are
      tyrosinase, tyrosinase-related protein (TRP)-1 and TRP-2. Of these, only
      tyrosinase is reported to be expressed in chicken melanocytes. The results
      presented in this study indicate that, of these three candidate proteins, TRP-1
      is the primary antigen recognized by the SL autoantibodies. SL autoantibodies
      recognize a chicken melanocyte protein that is different from that of tyrosinase
      or the candidate chicken TRP-2. In addition, several types of experiments
      incriminate TRP-1 as the primary mammalian melanocyte antigen recognized by SL
      autoantibodies. We further verified that chicken melanocytes expressed messages
      for TRP-1 by finding positive signals on Northern blots of chicken melanocyte RNA
      probed with mammalian TRP-1 cDNA fragments. Therefore, we conclude from these
      results that the SL autoantibodies primarily recognize TRP-1 in mammalian
      melanocytes and suggest that chicken melanocytes express a homologue of TRP-1
      (the human gp75 and the murine brown/b locus protein).

PMID- 7778694
TI  - In pursuit of excellence.

PMID- 7778689
TI  - Characterization and functional studies on rat liver fat-storing cell line and
      freshly isolated hepatocyte coculture system.
AB  - We developed and characterized a coculture system composed of a fat-storing cell
      clone (CFSC-2G) and freshly isolated hepatocytes that can reproduce in vitro some
      of the physical and functional relationships observed in vivo. Hepatocytes in the
      coculture are polarized, are smaller in size than hepatocytes plated on plastic,
      maintain a cuboidal shape, and have a tendency to form cords. Fat-storing cells,
      which are initially extended, retract and leave spaces that resemble liver
      sinusoids. Both cell types in the coculture system are functional for at least
      two weeks as determined by the expression of high levels of liver-specific
      protein mRNAs as well as by the production and secretion of liver-specific
      proteins into the culture medium. The hepatocytes maintain relatively high levels
      of asialoglycoprotein receptor on their cell surface and form functional gap
      junctional complexes with fat-storing cells. Hence, this coculture system retains
      a number of differentiated functions of hepatocytes, making it a useful model to
      study cell-cell interactions in culture and to analyze regulation of hepatocyte
      functions.

PMID- 7778693
TI  - Rodent model of reproductive tract leiomyomata. Clinical and pathological
      features.
AB  - Mesenchymal tumors of the lower reproductive tract of women are poorly understood
      at the molecular level as a result in part of the lack of relevant animal models.
      The present study describes a novel model of gynecological smooth muscle tumors
      in which these neoplasms arise in Eker rats as part of a familial cancer
      syndrome. The tumors develop as a result of a germline mutation in the tuberous
      sclerosis 2 (TSC2) gene, and predisposition to tumor development is inherited in
      an autosomal dominant fashion. Uterine and/or cervical tumors arise spontaneously
      as single or multicentric neoplasms and increase in incidence with increasing
      age. The tumors were classified into three phenotypic variants of
      leiomyoma/leiomyosarcoma and into stromal cervicovaginal tumors on the basis of
      cytological and histological features and immunostaining patterns for smooth
      muscle actin and desmin. Tumors histologically identical to the typical human
      myometrial leiomyoma arose, as did a subset of atypical leiomyomas having an
      epithelioid phenotype. Eker rats were found to develop both benign and malignant
      smooth muscle tumors. The high spontaneous incidence of smooth muscle tumors of
      uterus and cervix in this rodent model provides a unique opportunity to study the
      molecular mechanisms underlying the development of these clinically important
      gynecological neoplasms.

PMID- 7778692
TI  - Presence of CD3+CD8+Bcl-2(low) lymphocytes undergoing apoptosis and activated
      macrophages in lymph nodes of HIV-1+ patients.
AB  - Infection with human immunodeficiency virus 1 causes profound changes in the
      lymph nodes of infected patients. In particular, large numbers of CD8+CD45RO+ T
      cells infiltrate both the paracortex and the germinal centers. These cells
      contained the cytotoxic granule-associated protein TIA-1 but showed no detectable
      levels of perforin and shared the same characteristics of the expanded,
      activated, short-lived CD8+ population found during acute viral infections. These
      cells expressed low levels of Bcl-2 and are likely to be short-lived in vivo as
      evidenced by the direct observation of CD8+ apoptotic cells in the paracortical
      areas of the infected nodes. Changes in the paracortical nonlymphoid populations
      were also seen. There were reactive changes in the blood vessels, and the
      macrophage population was expanded and activated. Furthermore, apoptotic bodies
      were seen in the cytoplasm of the activated CD68+RFD-7+RFD-1+ macrophages
      pointing to the phagocytic capacity of these cells and their role in the
      clearance of the apoptotic cells from the tissues. These observations suggest
      that the persistance of CD8+ population in human immunodeficiency virus 1
      infection is not a result of the presence of an abnormal CD8+ population but
      rather a result of an inappropriate over-stimulation of the CD8+ cells.

PMID- 7778695
TI  - Magnetic resonance imaging evaluation of the rotator cuff tendons in the
      asymptomatic shoulder.
AB  - Thirty shoulders in 20 volunteers (average age, 29 years; range, 17 to 49) with
      no shoulder symptoms or known abnormalities were scanned using magnetic resonance
      imaging. All scans were interpreted by one radiologist who was blinded to
      clinical data. Appearance of rotator cuff tendons on the images was graded. Grade
      0 was normal, homogeneous low signal intensity structure. Grade 1 lesion was
      focal, linear, or diffuse intermediate signal through the tendon. Grade 2 lesion
      was high signal intensity within the tendon and less than full thickness. Grade 3
      was high signal intensity through full thickness of the tendon. No supraspinatus
      or infraspinatus tendons were grade 0 (normal); all supraspinatus and
      infraspinatus tendons had grade 1 changes through the tendons; and 7 of 30 (23%)
      of the tendons had grade 2 changes. None of the 30 shoulders had grade 3 changes
      in the rotator cuff tendons. There is a wide array of abnormal magnetic resonance
      imaging signals in shoulders of young asymptomatic individuals, but they do not
      have full-thickness rotator cuff tears (grade 3 lesion). Nonenhanced magnetic
      resonance imaging may be of limited value in defining rotator cuff injury in a
      patient with shoulder pain unless a full-thickness rotator cuff tear is suspected
      clinically.

PMID- 7778696
TI  - Articular hypermobility and chondral injury in patients with acute patellar
      dislocation.
AB  - Thirty adolescents with acute, primary patellar dislocation were assessed for a
      relationship between articular hypermobility and chondral injury. The 15 patients
      without articular hypermobility had a 2.5 times increased frequency of articular
      lesions when compared with 15 patients with hypermobility. Assessment of
      articular hypermobility should be part of the examination in patients with
      patellar dislocation.

PMID- 7778697
TI  - A biomechanical comparison of lateral retinacular releases.
AB  - A lateral patellar retinacular release that transects the tendon of the vastus
      lateralis muscle may result in significant complications. To avoid such
      complications, the superior extent must be limited, and maximizing the inferior
      extent may be important in achieving an adequate release. The effective release
      of the patella from its lateral retinaculum was examined for 2 incision lengths
      using 10 fresh-frozen human cadaveric knees and comparing the medial displacement
      of the patella relative to the femur for 3 study groups (control, intact
      retinacula; Group A, retinacula cut from the inferior third of the vastus
      lateralis tendon down to the anterolateral arthroscopic portal; and Group B,
      retinacula cut from the inferior third of the vastus lateralis tendon down to the
      tibial tubercle) when a 22-N medially directed force was applied to the patella
      with the knee at 30 degrees and 60 degrees of flexion. The extended release
      (Group B) resulted in a significantly more effective release when compared with
      the standard release (Group A) or control group. This technique may allow an
      adequate release of the patella while preserving the function of the vastus
      lateralis muscle.

PMID- 7778698
TI  - "Aggressive" nontreatment of lateral meniscal tears seen during anterior cruciate
      ligament reconstruction.
AB  - Based on our experience, we hypothesized that certain lateral meniscal tears
      identified at the time of anterior cruciate ligament reconstruction can be left
      without removal or repair and that they will remain asymptomatic. We looked at
      189 lateral meniscal tears that were left in situ at the time of anterior
      cruciate ligament reconstruction. At an average clinical followup of 2.6 years
      (range, 1 to 9 years) we found that 1) posterior horn avulsion tears, if left
      alone, do not cause clinical symptoms after anterior cruciate ligament
      reconstruction; 2) vertical tears totally posterior to the popliteus tendon are
      asymptomatic before and after reconstruction; and 3) other complete and
      incomplete lateral meniscal tears (vertical longitudinal, radial, or anterior
      vertical), if stable at the time of anterior cruciate ligament reconstruction,
      can be left in situ without becoming clinically symptomatic. All patients in the
      study population returned to their desired level of sporting activities by the
      time of follow-up evaluation. Our high clinical success rate in leaving selected
      lateral meniscal tears in situ is an "aggressive" attempt at meniscal salvage
      without increased morbidity from repair or resection. During the time we observed
      the patients (1 to 9 years), the lateral menisci remained asymptomatic.

PMID- 7778699
TI  - Nonoperative treatment of acute anterior cruciate ligament injuries in a selected
      group of patients.
AB  - Conservative treatment of acute anterior cruciate ligament injuries was
      recommended to selected patients, including those with sedentary occupations, low
      athletic demands, or ages greater than 30 years. Patients with generalized
      hyperligamentous laxity were excluded. Fifty-five of 61 patients were available
      at an average followup of 46 months from the time of initial injury. At followup,
      giving-way symptoms had not occurred in 23 patients (42%); in 22 (40%) giving way
      occurred occasionally. Of the 44 patients involved in high- or moderate-demand
      athletics, 33 (70%) were able to continue with moderate-demand sports. Presence
      of a medial collateral ligament sprain did not affect the longterm function.
      Forty-eight percent of the patients scored excellent or good (9 and 18 patients,
      respectively) on the Hospital for Special Surgery ligament scoring system; 8
      (15%) later chose surgical reconstruction. The remaining 47 patients did not
      believe that their symptoms were severe enough to warrant any further
      intervention. In a group of individuals who are older and relatively inactive,
      nonoperative management of anterior cruciate ligament injuries can yield
      satisfactory results, provided the patients are willing to accept a modest amount
      of instability and a slight risk of meniscal injury.

PMID- 7778700
TI  - Correlation of joint line tenderness and meniscal lesions in patients with acute
      anterior cruciate ligament tears.
AB  - We sought to evaluate the accuracy with which joint line tenderness is associated
      with meniscal lesions in knees with acute anterior cruciate ligament tears. The
      physical assessment of joint line tenderness was performed at a mean of 8 days
      after the initial injury in 173 patients who subsequently underwent anterior
      cruciate ligament reconstruction. Identification of meniscal lesions was
      documented at the time of anterior cruciate ligament reconstruction. Eighty-nine
      patients (51%) had medial joint line tenderness; of this subgroup, 40 (45%) had a
      medial meniscal tear. Eighty-four patients (49%) had no medial joint line
      tenderness; of this subgroup, 29 (35%) had a medial meniscal tear. Fifty-nine
      patients (34%) had lateral joint line tenderness; of this subgroup, 34 (58%) had
      a lateral meniscal tear. One hundred fourteen patients (66%) had no lateral joint
      line tenderness; of this subgroup, 56 (49%) had a lateral meniscal tear. Medical
      joint line tenderness was 44.9% sensitive and 34.5% specific predicting medial
      meniscal injury. Lateral joint line tenderness was 57.6% sensitive and 49.1%
      specific in predicting lateral meniscal injuries. Therefore, we determined that
      the presence or absence of joint line tenderness in patients with an acute
      anterior cruciate ligament tear is not a reliable criterion to predict the
      likelihood of an associated meniscal tear.

PMID- 7778701
TI  - Meniscal injuries associated with acute anterior cruciate ligament tears in
      alpine skiers.
AB  - We reviewed the records of 315 patients receiving an arthroscopically assisted
      stabilizing procedure for an acute anterior cruciate ligament injury incurred
      while alpine skiing to evaluate associated meniscal injuries. Meniscal injuries
      were classified by type, location, and treatment of the tear. Of the 317 knees
      operated on, all demonstrated an anterior cruciate ligament tear at arthroscopy.
      Ninety-eight percent of the injuries (310) were diagnosed within 3 days of
      injury, and 97% (307) were reconstructed within 28 days of injury. All tears
      occurred in the intrasubstance of the ligament; 32% were isolated injuries and
      68% were combined with other injuries. In 159 patients with 170 meniscal tears
      141 of the tears (83%) were lateral and 29 (17%) were medial. The injury triad of
      anterior cruciate ligament-medial collateral ligament-lateral meniscus was seen
      nine times as often as the anterior cruciate ligament-medial collateral ligament
      medial mensicus combination.

PMID- 7778702
TI  - Allograft failure in cruciate ligament reconstruction. Follow-up evaluation of
      eighteen patients.
AB  - Previous authors have reported the efficacy of cruciate ligament allograft
      reconstruction of the knee suggesting that allograft strength is not
      significantly different than that of autografts. The purpose of this study was to
      elicit the cause of a higher-than-expected failure rate in cruciate ligament
      allograft reconstructions. After clinical diagnoses, 12 male and 6 female
      patients with cruciate ligament instability underwent intraarticular allograft
      reconstruction followed by an aggressive rehabilitation program. Deep-frozen,
      freeze-dried, ethylene oxide-sterilized, bone-patellar tendon-bone allografts
      were rehydrated, prestressed, and implanted by an open or arthroscopically
      assisted technique. Results revealed 6 of 18 failures. Knee instability,
      postoperative complications, and roentgenographic changes were evident.
      Evaluation of procurement technique showed that graft failure was significantly
      correlated with time to implantation. A significant difference in mean time from
      procurement and deep freezing to freeze-drying and sterilization between failed
      versus-successful grafts was 265.5 +/- 61.9 versus 66.8 +/- 43.8 days,
      respectively. Total mean time of failed grafts from procurement to implantation
      was significantly greater (528.3 +/- 75.1 versus 207.3 +/- 53.1 days) than for
      successful grafts. All graft failures came from the same batch number. These
      findings indicate that cruciate ligament allograft reconstruction can be
      successful; however, longer shelf life negatively affects graft integrity.

PMID- 7778703
TI  - Arthrometric results of arthroscopically assisted anterior cruciate ligament
      reconstruction using autograft patellar tendon substitution.
AB  - Sixty-two patients who underwent arthroscopically assisted anterior cruciate
      ligament reconstruction with the middle-third patellar tendon autograft without
      extraarticular augmentation were retrospectively reviewed at a minimum 2-year
      (mean, 37-month) followup. A postoperative KT-1000 arthrometric evaluation
      revealed a mean maximum manual difference of 0.3 mm (range, -6 to +16). Ninety
      percent of the patients had a mean maximum difference of < or = 3 mm. Three
      patients had a > or = 5 mm mean maximum difference; positive pivot shifts were
      noted in two of these patients. Despite an early range of motion, early
      weightbearing protocol without an extraarticular backup, the pivot shift (92%
      negative) was reliably eliminated at postoperative followup. Arthrometric
      parameters were statistically reduced (P < 0.0001) from preoperative status and
      were consistent with the diagnostic criteria established for normal knees. There
      was no relationship established in the "tighter" knees (those with negative side
      to-side arthrometric differences) and the incidence of knee flexion contractures,
      patellar pain symptoms, Cybex extension deficit (> 20%), functional indices, or
      postoperative rating scales.

PMID- 7778704
TI  - Iliotibial band tenodesis: a new strategy for attachment.
AB  - We investigated the changes in distance between Gerdy's tubercle on the tibia and
      points on the posterior two thirds of the lateral surface of the lateral femoral
      condyle and adjacent lateral femoral shaft in 15 cadaveric knees. A three
      dimensional digitizer was used to quantify motion of the knee during flexion
      ranging from full extension to 120 degrees of flexion. Four load states were
      applied: internal, external, and neutral rotation, and quadriceps muscles loads
      based on one third of values in the literature for maximal isometric quadriceps
      muscles moments. The femoral location most isometric to Gerdy's tubercle was
      found to be strongly influenced by the load state. A 1.0 cm wide iliotibial band
      tenodesis was modelled by five straight lines arising from Gerdy's tubercle and
      attaching to a simulated washer at the junction of the lateral femoral condyle
      and shaft. Using this model and the motion data obtained from the cadavers, we
      investigated the effects of quadriceps muscles loading and external rotation of
      the knee on changes in the distances between these tibial and femoral attachments
      for each of the five lines. A 180 degrees twist modelled into the tenodesis
      significantly reduced the range of changes in distance (difference between the
      largest and smallest changes in distance among the lines for a given angle of
      flexion) for both of these load states. Therefore, a 180 degrees twist in the
      tenodesis can enhance isometry among the fibers of the tenodesis. This implies
      that a 180 degrees twist can enhance load sharing among the fibers of the
      tenodesis and, therefore, enhance the overall strength of the tenodesis.

PMID- 7778705
TI  - Collagen fibril organization in the patellar tendon autograft after posterior
      cruciate ligament reconstruction. A quantitative evaluation in a sheep model.
AB  - We replaced the posterior cruciate ligament in 30 skeletally mature sheep with a
      patellar tendon autograft using the central third of the ipsilateral patellar
      tendon. The healing autograft was compared with the contralateral posterior
      cruciate ligament and the patellar tendons and posterior cruciate ligaments of
      nonoperated animals. The collagen fibril diameters were analyzed using
      transmission electron photomicrographs of fibril cross sections taken at six
      periods during the 2 years after surgery. The patellar tendon and posterior
      cruciate ligament were characterized by a broad, nongaussian distribution of
      collagen fibril diameters. The autografts shifted to a unimodal distribution by
      an increase of small-diameter collagen fibrils. The frequency of small-diameter
      fibrils measuring up to 100 nm was 99% after 2 years. At that time, these small
      diameter fibrils represented 91.6% of the area covered by collagen fibrils. The
      mean diameter of the collagen fibrils in the autografts significantly decreased
      to 45% of the controls at Week 26 and remained at this level until the end of
      this study. The percentage of area covered by collagen fibrils per 1 micron 2 was
      78% of the controls 2 years post-operatively. This study suggests that the
      patellar tendon autograft could not reproduce the collagen fibril organization of
      the posterior cruciate ligament. This may be a biologic factor responsible for
      inconsistent results in posterior cruciate ligament replacement.

PMID- 7778706
TI  - Collagen fibril populations in human anterior cruciate ligament allografts.
      Electron microscopic analysis.
AB  - We studied human anterior cruciate ligament allograft specimens by quantitative
      electron microscopy to analyze their collagen fibril populations. The specimens
      were procured at the time of second-look arthroscopy from the superficial region
      of the midzone of the anterior cruciate ligament grafts after synovial clearage.
      The grafts used for the anterior cruciate ligament reconstructions were from
      fresh-frozen allogenic Achilles, tibialis anterior or posterior, or peroneus
      longus or brevis tendons and had been implanted 3 to 96 months previously. By 12
      months after surgery, the anterior cruciate ligament allografts consisted
      predominantly of small-diameter collagen fibrils (30 to 80 nm), which resulted in
      a unimodal pattern in the collagen fibril profile. The number of large-diameter
      fibrils (90 to 140 nm) within the allogenic tendon grafts had decreased. This
      predominance of small-diameter collagen fibrils persisted in almost all specimens
      older than 12 months. The anterior cruciate ligament allografts had collagen
      fibril profiles that did not resemble normal tendon grafts or normal anterior
      cruciate ligaments, even several years after surgery.

PMID- 7778707
TI  - Anatomic reconstruction of the lateral ankle ligaments using a split peroneus
      brevis tendon graft.
AB  - Fifteen patients with recurrent inversion ankle sprains and documented lateral
      ankle instability were treated with an anatomically oriented ligament
      reconstruction using a split peroneus brevis tendon graft. This reconstruction is
      designed to augment repair of the anterior talofibular and calcaneofibular
      ligaments without restricting subtalar motion. Of the 12 patients available for
      long-term followup, all were functionally improved, with no recurrences of
      instability. Stress radiographic examination at followup confirmed that
      mechanical stability had been restored in all ankles. Eversion strength and
      subtalar joint motion were maintained after surgery. We recommend this procedure
      in patients who require augmented reconstruction of the lateral ankle ligaments.

PMID- 7778708
TI  - Resection and repair for medial tennis elbow. A prospective analysis.
AB  - Fifty cases in 48 patients of intractable medial tennis elbow tendinosis (medial
      humeral epicondylitis) were treated surgically from 1985 to 1990 with
      identification and excision of the injured tendon, while retaining and closing
      the resection defect. All patients had symptoms that were aggravated by
      repetitive upper extremity activities and had failed to improve with nonoperative
      therapy. At surgery, the flexor carpi radialis-pronator teres interval was
      involved in 28 cases. Histologic examination revealed angiofibroblastic
      tendinosis and fibrillary degeneration of collagen. Postoperative followup
      averaged 37 months. An analog scale was used to analyze pain intensity, and pain
      occurrence was evaluated by a pain phase scale. All patients reported partial or
      complete pain relief postoperatively (improvement in their pain phase and pain
      intensity scales). Preoperatively, 14 patients had pain at rest; all 14 had
      relief of this pain postoperatively. Ten patients did not return to their
      sporting or occupational activities. Objective dynamometer strength testing
      revealed a significant improvement postoperatively in all patients; no major
      complications were seen in this series. A large percentage of patients who fail
      conservative treatment for medial humeral epicondylitis (tendinosis) can obtain
      pain relief and return to activities with the described operative technique.

PMID- 7778709
TI  - Acute gamekeeper's thumb. Quantitative outcome of surgical repair.
AB  - Ten consecutive patients with 11 complete ulnar collateral ligament tears who had
      early surgical repair were evaluated at an average of 42 months' followup. The
      mean arc of motion at the metacarpophalangeal joint at 50.9 degrees was less than
      the 73.7 degrees seen in the uninjured thumbs. At the interphalangeal joint, the
      mean arc of motion in the injured thumb was 101.6 degrees compared with 112.6
      degrees on the uninjured side. Ulnar laxity was decreased slightly compared with
      the contralateral thumb (14.0 degrees versus 15.3 degrees) and radial laxity was
      10.3 degrees on both sides. The mean grip strength and key pinch were similar
      between the injured and uninjured sides: grip strength was 32.3 kg in the injured
      thumbs and 34.0 kg in the uninjured; key pinch was 8.1 kg in the injured thumbs
      and 8.8 kg in the uninjured. Good stability with slight decrease in motion was
      obtained in our patients.

PMID- 7778710
TI  - The effects of anabolic steroids on rat tendon. An ultrastructural,
      biomechanical, and biochemical analysis.
AB  - Forty-eight male rats were randomly separated into four groups: a control group,
      a group treated with anabolic steroids, a group treated with daily exercise, and
      a group treated with both steroids and exercise. At 6 weeks, biomechanical,
      ultrastructural, and biochemical testing was performed on the Achilles tendons of
      half of the rats in each group. The remaining rats continued in the experimental
      protocol, but steroid administration was discontinued. Similar testing was then
      performed on the remaining rats at 12 weeks. Testing showed anabolic steroids
      produced a stiffer tendon that absorbs less energy and fails with less
      elongation; tendon strength was unaffected. Effects were entirely reversible on
      discontinuation of the steroids. Light microscopic analysis revealed no changes
      in the appearance of the fibrils. No change in fibril diameter or shape was noted
      on electron microscopic analysis. Biochemical testing revealed no change in
      qualitative immunofluorescence staining with Type III collagen or fibronectin.
      Abuse of anabolic steroids is a widespread problem among competitive athletes;
      consequently, complications after their use are seen with increasing frequency.
      Knowledge of the effects of these drugs on tendon and the musculotendinous unit
      may prove helpful in counseling athletes who use anabolic steroids.

PMID- 7778711
TI  - Kinetics of baseball pitching with implications about injury mechanisms.
AB  - Elbow and shoulder kinetics for 26 highly skilled, healthy adult pitchers were
      calculated using high-speed motion analysis. Two critical instants were 1)
      shortly before the arm reached maximum external rotation, when 67 N-m of shoulder
      internal rotation torque and 64 N-m of elbow varus torque were generated, and 2)
      shortly after ball release, when 1090 N of shoulder compressive force was
      produced. Inability to generate sufficient elbow varus torque may result in
      medial tension, lateral compression, or posteromedial impingement injury. At the
      glenohumeral joint, compressive force, joint laxity, and 380 N of anterior force
      during arm cocking can lead to anterior glenoid labral tear. Rapid internal
      rotation in combination with these forces can produce a grinding injury factor on
      the labrum. After ball release, 400 N of posterior force, 1090 N of compressive
      force, and 97 N-m of horizontal abduction torque are generated at the shoulder;
      contribution of rotator cuff muscles in generating these loads may result in cuff
      tensile failure. Horizontal adduction, internal rotation, and superior
      translation of the abducted humerus may cause subacromial impingement. Tension in
      the biceps tendon, due to muscle contraction for both elbow flexion torque and
      shoulder compressive force, may tear the anterosuperior labrum.

PMID- 7778713
TI  - Functional anatomy of the flexor pronator muscle group in relation to the medial
      collateral ligament of the elbow.
AB  - To describe the relationship of the pronator teres, flexor carpi radialis, flexor
      digitorum superficialis, and flexor carpi ulnaris muscles to the medial
      collateral ligament at 30 degrees, 90 degrees, and 120 degrees of elbow flexion,
      we dissected 11 cadaveric specimens. The flexor carpi ulnaris muscle is the
      predominant musculotendinous unit overlying the medial collateral ligament in the
      majority of cases and is the only one at 120 degrees of elbow flexion. The flexor
      digitorum superficialis muscle is the only other significant contributor. The
      medial collateral ligament is the primary stabilizer of the medial elbow with
      elbow flexion greater than 30 degrees, as in throwing. The flexor carpi ulnaris
      muscle, because of its position directly over the medial collateral ligament, and
      the flexor digitorum superficialis muscle, with its near proximity and relatively
      large bulk, are the specific muscles best suited to provide medial elbow support.
      This is especially relevant to overhand throwing athletes who encounter extreme
      valgus force across the elbow during the cocking and acceleration phases of the
      throwing motion. Exercise and conditioning of the medial elbow musculature,
      specifically the flexor digitorum superficialis muscle and the flexor carpi
      ulnaris muscle, may prevent injury or assist in rehabilitation of medial elbow
      instability, especially in overhand throwing athletes.

PMID- 7778712
TI  - Osteoarthritis after arthroscopic partial meniscectomy.
AB  - The purpose of this study was radiologic assessment of osteoarthritis after
      arthroscopic partial meniscectomy. At an average followup of 53.5 months, 284
      consecutive patients were retrospectively evaluated clinically and
      radiologically. Two hundred forty-seven patients had been treated for medial
      (Group I) and 37 for lateral meniscal tears (Group II). Preoperative radiographs
      were compared with those at followup and were classified. The results were
      analyzed statistically. Osteoarthritic changes were classified as being worse in
      38% of the patients after medial and in 24% of the patients after lateral
      arthroscopic partial meniscectomy. Further subclassification and comparison of
      patients with or without already existing articular surface damage at the time of
      arthroscopy were not found to have significant impact on the prevention of
      osteoarthritic changes. Patients who were older than 40 years of age and who had
      undergone arthroscopic partial medial meniscectomy were radiologically classified
      with a significantly higher rate of osteoarthritis than patients who were younger
      than 40 years. Partial medial or lateral meniscectomy leads to a significant
      increase of osteoarthritic changes, even when this intervention is performed
      arthroscopically.

PMID- 7778715
TI  - [Morphological and morphometric study of the tympanic and mastoid portions of the
      fallopian aqueduct].
AB  - In surgery of the temporal bone the best way to avoid injuries to the facial
      nerve is to be acquainted with its location in all the surgical steps of the
      procedure scheduled. That is to say: an exact knowledge of its normal
      intratemporal run, having always in mind some characteristic landmarks, is
      absolutely essential. This work has been done through drilling 92 human temporal
      bones, measuring the length of both the tympanic and mastoidal segments and also
      considering the bending of the 2nd knee of the nerve. In the issue the mastoidal
      portion resulted the most straight (by half of the cases) whereas the tympanic
      one was slightly sloping downwards between the lateral semicircular canal upwards
      and the oval window below. Topographically has not been possible to establish
      neither a strict correlation between the location of the pyramide and the 2nd
      knee nor this knee was found by uns (in contrast to other AA's findings) at
      higher angle than 90 degrees in our specimen.

PMID- 7778714
TI  - The effect of elastic bandages on human knee proprioception in the uninjured
      population.
AB  - Elastic bandages are often used to treat musculoskeletal disorders, even though
      there is little scientific evidence currently to support this generalized
      practice. We tested the hypothesis that elastic bandages improve proprioception
      of the bandaged joint during their use, and that this benefit was more than
      temporary. The uninjured human knee was used as a model. Fifty-four volunteers
      (54 knees), aged 22 to 40 years, were asked to identify a prior set joint angle
      as their knee was passively extended. Each knee was tested without the elastic
      bandage, immediately after bandage application, after 1 hour of bandage wear, and
      finally after removal of the bandage. Results showed that elastic bandages
      significantly improved knee joint proprioception in the uninjured knee during the
      entire interval of their use (mean decrease in inaccuracy of 1.0 degree,
      equivalent to 25% improvement, P < 0.05), and that this benefit was lost when the
      bandage was removed. The magnitude of the improvement, or the potential
      beneficial effect of the bandage, was inversely related to the participant's
      inherent knee proprioceptive ability, which was demonstrated in the test group
      before the initial application of the bandage.

PMID- 7778716
TI  - [Descriptive analysis of evoked laryngeal potentials of the brainstem in
      rabbits].
AB  - The present study evaluated comparatively the laryngeal brainstem responses (LBR)
      evoked, through electrical stimulation of the superior laryngeal nerve, in 2
      groups of mature rabbits, using a far field technique. Each group is formed
      according to the shifting of the stimulation parameters followed for the
      research, namely: intensity (from 0.5 to 3 mA), stimulus frequency (from 2
      stimuli/second to 5 stimuli/second) and total stimulation time (between 200
      microseconds to 500 microseconds). Afterwards the values attained are compared
      with those supplied for the control-group (having 2 mA intensity, 4 stimuli per
      second and 100 microseconds as time). We got significative statistical
      differences regarding the stimulus intensity and the outcome is a shortening in
      latency wawe of LBR when using 3 mA.

PMID- 7778717
TI  - [Leishmaniasis and ENT].
AB  - Three cases of the infrequent mucocutaneous Leishmaniasis, with nasal involvement
      in two of them and affection of the hypophrarynx and larynx in the other one are
      presented. We remark, in the case with laryngeal disease, that it was the onset
      of an AIDS in a patient unknown to be HIV+. Leishmaniasis of the larynx has not
      been described before as the onset of an AIDS. Symptomatology, evolution and
      treatment of this disease are revised, pointing out the increasing association,
      in our country, between leishmaniasis and AIDS, and considering the possibility
      of including the leishmania infection as an AIDS criteria in HIV+ patients, and
      to rule out an IVH infection in a patient with an atypical leishmaniasis either
      for the site involved or the evolutive course of the disease.

PMID- 7778718
TI  - [Approach to the laryngeal reflex through the study of laryngeal evoked
      potentials from the brainstem in rabbits].
AB  - The present study evaluated the laryngeal brainstem response evoked by electrical
      stimulation of the superior laryngeal nerve in rabbits, using a far-field
      technique with an intensity of 2 mA, 100 microseconds duration and frequency of
      4/second. Five reproducible positive and four negative waves, both reproducible,
      were obtained and they may represent the laryngeal brainstem activity.

PMID- 7778719
TI  - [Pilomatrixoma of the auricle. Differential diagnosis with carcinoma
      pilomatrixoma].
AB  - A 34 year-old man, with a two centimeter diameter quickly growing nodule on the
      auricular pavillion is presented. After mass excision the histologic diagnosis of
      pilomatrixoma was made. Pilomatrixoma is a rare benign tumor arising on the hair
      matrix. The differential diagnosis include pilomatrix carcinoma, a locally and
      recurrent aggressive tumor capable to make pulmonary metastasis. A review of the
      literature is included, with emphasis on the clinical and histopathological
      aspects and the therapeutic attitude.

PMID- 7778720
TI  - [Adjuvant chemotherapy in the treatment of pharyngolaryngeal cancers in advanced
      stages].
AB  - Since 1980 we use adjuvant chemotherapy in advanced laryngopharyngeal carcinomas.
      These cases were resectable and unresectable lesions with tumoral extent to the
      pharynx as a common characteristic. We analyze the survival of the first 50 cases
      treated with chemotherapy followed by: A) surgery and radiotherapy (36 cases) and
      B) radiotherapy alone (14 cases). Results of this not randomized study are
      compared with a historic group of advanced laryngopharyngeal carcinomas (T4/N+)
      treated with conventional therapy (surgery +/- radiotherapy). Response to
      chemotherapy was complete or partial (> 50% reduction) in 56 percent of the
      patients. There was improvement in overall survival and five-years disease-free
      survival in the latter group compared with those who did show any response (p <
      0.01). We would point out that disease-free survival of the group A was better
      than historic group (60% vs 36%, p < 0.05), although these result should be
      carefully interpreted. Laryngeal preservation was achieved in 47 percent in the
      group A by modification of the initially scheduled radical surgery, in selected
      cases.

PMID- 7778721
TI  - [Oncogenic activity of head and neck tumors].
AB  - Some types of malignant neoplasms are consequence of genetic changes. The
      starting of oncogenesis begins when some genetic alterations arises, or the
      genome acquires some peculiar and pathological traits owing to the action of
      physical, chemical or viral agents. These alterations set in motion an activatory
      phenomenon upon the proto-oncogene which is turned into an oncogene. The oncogene
      is responsible for fixed alterations of the genome inducing to an anomalous
      cellular growth. In squamous carcinomata of the head and neck has been observed
      mutations of the p-53 tumour-suppressor gene, alike amplifications of the ras
      gene, of the C-myc proto-oncogene and also of the epidermal growth factor gene
      (EGFG). The viruses induce mutations on the genome. That would be the explanatory
      reason for the association carcinoma of the rhinopharynx-Epstein-Barr virus.

PMID- 7778722
TI  - Australia and New Zealand Intensive Care Society Statement and Guidelines on
      Brain Death and Model Policy on Organ Donation.

PMID- 7778723
TI  - Successful anaesthetic management of a patient with thyrotoxic hypokalaemic
      periodic paralysis for coincidental appendicitis.

PMID- 7778725
TI  - Brain death and organ donation.

PMID- 7778724
TI  - Brain death and organ donation.

PMID- 7778726
TI  - Spinal subdural haematoma following combined spinal-epidural anaesthesia.

PMID- 7778727
TI  - Anaesthesia and undiagnosed myasthenia gravis.

PMID- 7778728
TI  - Difficult intubation following bilateral subtemporal decompression.

PMID- 7778729
TI  - Respiratory arrest with patient-controlled analgesia.

PMID- 7778730
TI  - Preventing epidural overdose.

PMID- 7778731
TI  - Intramuscular ketorolac for analgesia after laparoscopic sterilization.

PMID- 7778732
TI  - Ondansetron for the prevention of nausea and vomiting.

PMID- 7778733
TI  - Foley catheter and post-nasal bleeding.

PMID- 7778735
TI  - Topical anaesthesia for cataract surgery.

PMID- 7778734
TI  - Dilating veins, a simple approach.

PMID- 7778736
TI  - Circle absorption system hazard.

PMID- 7778737
TI  - HME plus heated humidifier danger.

PMID- 7778738
TI  - Predicting outcome in anaesthesia.

PMID- 7778739
TI  - Chlorhexidine catheter lubricant anaphylaxis.

PMID- 7778740
TI  - A personal comment: whole brain death versus cortical death.

PMID- 7778741
TI  - Brain death and organ donation--a point of view.

PMID- 7778742
TI  - Further thoughts on brainstem death.

PMID- 7778743
TI  - Brain death: an update on the North American viewpoint.

PMID- 7778744
TI  - The physiological changes associated with brain death--current concepts and
      implications for treatment of the brain dead organ donor.
AB  - The profound physiological disturbances associated with severe intracerebral
      pathology have long been recognized. These changes have also been described in
      the brain dead potential organ donor but have only been studied since the early
      1980s. Physiological disturbances in the brain dead organ donor result in a
      diffuse vascular regulatory injury and a diffuse metabolic cellular injury. The
      net result of these changes is an inexorable deterioration of all organs and
      eventual "cardiovascular death" of the patient. This paper reviews these
      physiological changes and the effect they may have on solid transplantable
      tissues, and discusses the management of brain dead organ donor with regard to
      these changes. Current concepts of brain death and how they may affect the
      interpretation of the observed physiological changes are also reviewed.

PMID- 7778745
TI  - Skinner's chloroform mask.

PMID- 7778746
TI  - Clinical confirmation of brain death.

PMID- 7778747
TI  - The imaging of brain death.

PMID- 7778748
TI  - Medical management of the (potential) organ donor.

PMID- 7778749
TI  - An overview of transplantation in Australia.
AB  - Organ donation in Australia has permitted transplantation of the kidneys, heart,
      lung, pancreas, liver and cornea. Each of these programs has successfully
      provided life and rehabilitation to Australians with end-stage failure of one or
      more organs. The programs are supported by an infrastructure of donor
      coordinators, matching and allocation procedures and national co-operative
      registries, which record and publish the outcome of each form of transplant. Four
      national organizations work to promote transplantation: the Transplantation
      Society of Australia and New Zealand; the Australasian Transplant Coordinators'
      Association; the Australian Kidney Foundation; and the Australian Co-ordinating
      Committee for Organ Registries and Donation. Australian donation rates are lower
      than in many, but not all, comparable developed democracies, however utilization
      of those donor offers is high, leading to 698 organ transplants being performed
      in 1993.

PMID- 7778750
TI  - Organ donation in Australia: an historical overview, current directions and
      future principles.

PMID- 7778751
TI  - A survey of personal and professional attitudes of intensivists to organ donation
      and transplantation.
AB  - A questionnaire survey was carried out to examine the attitudes and practices of
      Australian and New Zealand intensivists with regard to brain death and organ
      donation. A return rate of 82.5% was achieved. Fifty-eight per cent had written
      evidence of their own wishes to donate organs and 94% would agree to donation
      from a dependent. At least one intensivist is involved in certifying brain death
      on 95% of occasions. Intensivists are involved in the request for organ donation
      over 90% of the time although one-third do not believe that it is their role to
      request organ donation. Although two-thirds believe that the family should always
      be approached for organ donation, another 52 out of 254 indicated that it was
      their (the intensivist's) role to decide if families should be asked for organ
      donation. Possible reasons for not requesting are language or other communication
      problems, perceptions of cultural differences and degrees of family distress.
      Twenty per cent of respondents do not provide haemodynamic support before brain
      death confirmation. Australian and New Zealand intensivists overwhelmingly
      support the concept of brain death, current methods of confirmation of brain
      death, organ donation and transplantation. Possible reasons behind loss of
      potential donors include decisions not to resuscitate both before and after brain
      death is confirmed. Perceptions of family grief and cultural differences clearly
      inhibit requests for organ donation. A very few units have an effective policy on
      approaching families about organ donation. Intensivists have almost exclusive
      control over requests for organ donation and thus bear a full professional
      responsibility for this element of hospital practice.

PMID- 7778752
TI  - The identification of potential cadaveric organ donors.
AB  - Most Australian transplantation programs are severely restricted in their
      activities by a limited availability of cadaveric donor organs. To investigate
      possible reasons for this problem, an audit was undertaken over three 12-month
      periods of all deaths in 13 hospitals in New South Wales and the Australian
      Capital Territory. From 7406 deaths, 271 patients were classified as having been
      realistic, medically suitable potential donors. Of these, only 60 (22%) became
      actual donors. In the other 211 patients, donation did not occur because of
      unsuccessful resuscitation (30%), permission refusal by relatives (34%), and
      failure to identify or support the potential donors (36%). If the impediments to
      organ donation which were identified in this study could be overcome, allowing a
      greater number of potential donors to become actual donors, the chronic shortage
      of cadaveric donor organs for transplantation could be at least partly relieved.

PMID- 7778753
TI  - Obtaining consent for organ donation in nine NSW metropolitan hospitals.
AB  - Organ donation rates vary markedly around the world. In an attempt to analyse why
      some patients' families are not asked about organ donation, the case notes of
      6080 patients who died over a twelve-month period from April 1991 to March 1992
      in nine hospitals in Sydney, NSW, were studied. Irreversible coma occurred in 515
      patients. Of these, 177 were considered to be potentially brain dead donors, 126
      of whom had a formal diagnosis of brain death. The clinicians caring for the
      patients at the time of death were asked at follow-up about the reasons for not
      considering donation, or the reasons for family refusal. Consent to proceed to
      organ donation was requested in 112 cases (49 donated and 63 refused) and not
      requested in 65. Analysis of the proportions asked and consenting in each
      hospital revealed no correlation. Half of the families refusing gave no reason
      (24/50) while eleven gave religious or cultural reasons, and six expressed a
      desire to prevent mutilation of the body as their primary reason for not
      consenting. There was universal failure to gain consent from families when the
      patient was not in an Intensive Care Unit. Analysis of those patients of whom
      consent was not sought showed that they died more quickly after admission, were
      older and died from causes other than trauma or intracranial haemorrhage. The
      odds of the family being asked dropped by about half as the age increased from
      one group to the next.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778755
TI  - Donor families' experience of organ donation.
AB  - This retrospective study surveyed families who consented to organ donation in the
      State of Queensland, Australia, from January 1991 to December 1992 inclusive, and
      evaluated their experience of the organ donation process. The survey questioned
      families in relation to the preparation they received, their understanding of
      brain death, the request process, influencing factors, and post donation follow
      up. One hundred and eight families consented to organ donation over this 24-month
      period. Twelve families of paediatric donors under the age of twelve years were
      excluded, and twelve families were not able to be contacted. Of the remaining 84
      families, 42 participated in this study. Overall the study results indicated a
      positive attitude towards the organ donation process. The majority of families
      did not find the process stressful and indicated that they were provided with
      sufficient information and preparation, and that the request was made in a
      sensitive manner. A few important issues and areas for improvement were
      highlighted: in particular, the need for families to have an opportunity to view
      the body after procurement, and the importance of counselling throughout and
      after the donation process.

PMID- 7778754
TI  - A survey of families of brain dead patients: their experiences, attitudes to
      organ donation and transplantation.
AB  - A questionnaire survey of 69 families of brain dead patients is reported. The
      study population included those who had been asked about organ donation as well
      as those who had not, those who had agreed to organ donation and those who had
      declined. Their experiences and their perceptions of treatment and explanations
      of underlying disease, brain death and organ donation were examined. Their own
      knowledge of and attitudes towards organ donation as well as the prior knowledge
      and wishes of their deceased relative were also explored. Statistical analysis
      did not show any differences between the three groups of families with regard to
      their experiences, their perceptions of the treatment they received, or in the
      resolution of their grief. Family members who had agreed to organ donation were
      significantly more likely to donate their own organs and to be more resolved in
      their grief. There was a strong correspondence between the attitudes of
      respondents and their agreement or otherwise to donate their relatives' organs.
      One quarter, however, made the opposite choice for their relative, where their
      relative's wishes were known. There was a highly significant relationship between
      those who had previously discussed organ donation to have expected to be asked or
      to raise the subject themselves. Hospital treatment in general did not appear to
      have any effect on the decision to donate. Involvement in organ donation was felt
      by most of the donor families to have been helpful to the grieving process.

PMID- 7778756
TI  - Can cadaveric organ donation rates be improved?
AB  - There are many reasons why potential cadaveric organ donors may fail to become
      actual donors. These include permission refusal by the next of kin, incorrect
      assumptions about medical suitability and, occasionally, an excessive workload in
      the intensive care unit. Some potential donors currently regarded in Australia as
      "unrealistic" might become actual donors if attitudes were to change towards
      ventilation of patients with a clearly hopeless prognosis who have expressed a
      wish to be organ donors. "Required request" legislation ignores the wishes of the
      potential donor and "presumed consent" laws also present some ethical
      difficulties, but a suggested "required response" process could ensure that an
      individual's wishes concerning organ donation would be known and able to be
      carried out after death. For the present, however, it is clear that operating
      within existing Australian legislation and abiding by currently accepted codes of
      practice, we can still find considerable scope for improving cadaveric organ
      donation rates.

PMID- 7778757
TI  - Quantitation of red blood cell folates by stable isotope dilution gas
      chromatography-mass spectrometry utilizing a folate internal standard.
AB  - We report a new gas chromatography-mass spectrometry (GC-MS) method of
      measurement of red blood cell folates utilizing a stable isotope-labeled
      bacterial synthesized folate internal standard. The GC-MS method exploits the
      fact that the common feature of all folate molecules is a p-aminobenzoic acid
      moiety sandwiched between a pteridine ring and a polyglutamate chain of varying
      length. In this method, red blood cell folates together with a folate internal
      standard are specifically purified using bovine folate binding protein and the
      folates are subsequently chemically cleaved to p-aminobenzoic acid, pteridines,
      and glutamic acids. Since all six carbon atoms of the benzene ring in the p
      aminobenzoic acid moiety of the folate internal standard are labeled with [13C],
      it is possible to use selected ion monitoring and stable isotope dilution GC-MS
      to quantitate folates. The method appears to be sensitive, specific, and
      accurate. The method has been applied to generate a reference range of red blood
      cell folates based on assay of 25 normal individuals.

PMID- 7778758
TI  - A novel and simple method to assay the activity of individual protein kinases in
      a crude tissue extract.
AB  - Protein kinases and phosphatases play an important role in a variety of cellular
      functions. Thus, it is of interest to develop an assay system that can be used to
      quantify the activity of individual enzymes specifically in a crude cellular
      extract, is simple to perform, and is amenable to automation. Here we report on
      the development of a protein kinase assay that addresses these points and
      circumvents the pitfalls of existing methodologies. The assay is based on the
      high affinity and strong binding of streptavidin toward biotin-linked peptide
      substrates. The biotinylated peptide substrate is phosphorylated by the cognate
      protein kinase using [gamma-32P]ATP under optimal enzyme condition, and the
      phosphorylated peptide product is then captured by a streptavidin-linked disk.
      After removal of free [gamma-32P]ATP, the 32P incorporated into the peptide
      substrate can be used as an expression of enzyme activity. In contrast to the
      commonly used phosphocellulose method, only the phospho-, biotinylated peptide
      (and not other phosphorylated proteins present in the extract) will bind to the
      disks, thus giving a true estimate of enzymatic activity. In addition to
      specificity, this assay does not require the peptide substrate to contain basic
      amino acids or to be modified by the addition of basic amino acid residues as
      required for the phosphocellulose method which may result in altered specificity
      of the substrate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778759
TI  - Isotope dilution gas chromatographic-mass spectrometric method for the
      determination of unconjugated lignans and isoflavonoids in human feces, with
      preliminary results in omnivorous and vegetarian women.
AB  - We describe an isotope dilution gas chromatographic-mass spectrometric (GC/MS)
      method for the identification and quantitative determination of the lignans
      enterolactone, enterodiol, and matairesinol and the isoflavonoids daidzein,
      equol, O-desmethylangolensin, and genistein in feces. Following the addition of
      deuterated internal standards for all compounds, the feces samples are extracted
      and purified in several ion exchange chromatographic steps. Following formation
      of trimethylsilyl ethers, the samples are analyzed by combined capillary column
      GC/MS in the selective ion monitoring mode and corrected for all losses during
      the procedure using the deuterated internal standards. Results on the reliability
      of the method and values for nine Finnish omnivorous and nine vegetarian women
      are presented.

PMID- 7778760
TI  - A fluorometric assay for pyridoxal kinase applicable to crude cell extracts.
AB  - We have developed an assay for pyridoxal kinase which takes advantage of the
      intense fluorescence yield of the oxime of pyridoxal or pyridoxal-5'-phosphate
      and the substantial difference in the rates of formation of these two oximes.
      Evidence is presented which demonstrates that the assay is linear with respect to
      time and amount of protein and is applicable to the activity in crude cell
      extracts as well as purified enzyme.

PMID- 7778761
TI  - A novel method for analysis of viral proteinase activity encoded by hepatitis C
      virus in cultured cells.
AB  - We developed a novel method for analysis of hepatitis C viral proteinase activity
      in cultured cells, in which the proteinase activity was measured as the
      enhancement of reporter gene expression. In this system, plasmids encoding a
      reporter gene, the enzyme gene, and the substrate gene were simultaneously
      transfected into COS-1 cells. The reporter plasmid contains chloramphenicol
      acetyltransferase (CAT) gene downstream of an enhancer/promoter sequence derived
      from the human T-cell leukemia virus type-1 (HTLV-I) long-terminal repeat (LTR).
      The substrate expression plasmid was a triple chimera; HCV nonstructural protein
      2 (NS2) and the Tax1 protein of HTLV-I sandwiched the substrate polypeptide,
      which was inserted upstream of Tax1. This method assumes that since the HCV NS2
      appears to be located in the lipid bilayer of endoplasmic reticulum (ER)
      membranes, the Tax1 of the chimeric substrate was trapped on the surface of the
      ER in the absence of HCV proteinase activity. After release from the chimera by
      HCV proteinase-dependent cleavage, Tax1 could transactivate the expression of the
      CAT gene through the enhancer sequence of HTLV-I LTR. This system should enable
      us to simply and safely screen the potential antiviral activity of proteinase
      inhibitors in vivo, although this system may be limited to proteinase inhibitors
      that are permeable to the plasma membrane.

PMID- 7778762
TI  - A capillary zone electrophoresis assay for the nucleoside transfer enzyme
      adenosine diphosphate-glucose pyrophosphorylase.
AB  - Conditions are described for a capillary zone electrophoresis-based assay of ADP
      glucose pyrophosphorylase, the first enzyme in the de novo synthesis for alpha
      glucan synthesis in plants and bacteria. ATP, ADP-glucose, and other adenine
      derivatives are effectively resolved and quantified in 12 min of electrophoresis.
      The method requires minimal sample manipulations and no postincubation
      hydrolyses, is effective over a wide range of enzyme and substrate
      concentrations, has a sensitivity comparable to radioisotope assays, and yields
      reproducible results in either the forward and reverse directions. Moreover, the
      assay is applicable to other enzymes that utilize nucleosides or their bases as
      substrates or products.

PMID- 7778764
TI  - Characterization of glycopeptides from recombinant coagulation factor VIIa by
      high-performance liquid chromatography and capillary zone electrophoresis using
      ultraviolet and pulsed electrochemical detection.
AB  - Four glycopeptide (GP) fractions containing glycosylated Asn 322 were isolated
      from a tryptic digest of recombinant coagulation factor VII by reversed-phase
      HPLC (RP-HPLC). Characterization of the GPs by enzymatic desialylation and RP
      HPLC as well as by enzymatic deglycosylation, RP-HPLC, and high-pH anion-exchange
      chromatography indicated that the four GPs consisted of the same decapeptide but
      with 0, 1, 2, or 4 residues of sialic acid. In comparison to HPLC, capillary zone
      electrophoresis (CZE) using uv and pulsed electrochemical detection (PED)
      afforded improved separation of GPs from each other and from contaminants. CZE-uv
      and CZE-PED of the desialylated GPs and deglycosylated GPs corroborated the
      results obtained with the chromatographic methods.

PMID- 7778763
TI  - A homogeneous immunofluorescence assay based on dye-sensitized photobleaching.
AB  - A novel homogeneous immunoassay requiring only one incubation step, and
      applicable in principle to the determination of low- as well as high-molecular
      weight substances, has been developed. The method is based on (a) photooxidation
      by singlet oxygen (1O2) of a fluorescent substrate (1,3-diphenylisobenzofuran,
      DPBF) embedded in unilamellar vesicles on the surface of which antibody to the
      analyte antigen is covalently attached (DPBF-immunoliposomes); (b) generation of
      singlet oxygen, upon illumination, by a chromophore (erythrosine) covalently
      attached to an antibody (Ab*) or antigen (Ag*); (c) formation of a "sandwich"- or
      "competition"-type complex whereupon the singlet oxygen-generating chromophore
      conjugate (Ab* or Ag*) and immunoliposome-embedded DPBF are brought into close
      proximity. Competition- and sandwich-type model assay systems for the detection
      of protein antigens and viruses were investigated. The detection range with
      protein antigens in competition- and sandwich-type assays was three (10(-10) -
      10(-7) M) and two (10(-10) - 10(-8) M) orders of magnitude, respectively. With
      poliovirus using a sandwich-type assay, the detection range was 10(2) - 10(6)
      plaque-forming units per milliliter (pfu/ml).

PMID- 7778765
TI  - Electrochemical determination for enzymic production of ultimate carcinogen from
      tryptophan pyrolysate by rat hepatic microsomes.
AB  - This study established a rapid and sensitive method of determining the level of
      the ultimate carcinogen from 3-amino-1-methyl-5H-prido[4,3-b]indole (Trp-P-2)
      produced by rat hepatic microsomes. An electrochemical detector (ECD) used with
      high-performance liquid chromatography (HPLC) gave a linear calibration curve for
      synthetic N-hydroxy-Trp-P-2 (the ultimate carcinogenic form) at concentrations
      ranging between 0.3 and 340 pmol. The enzymic production of N-hydroxy-Trp-P-2
      from Trp-P-2 was also determined by the ECD with HPLC. Hepatic microsomes (0.2 mg
      as protein) from rats treated with methylcholanthrene (MC) and phenobarbital (PB)
      were incubated with Trp-P-2 for 5 min. The mixture was centrifuged with
      acetonitrile and the supernatant was then analyzed using HPLC. The ECD determined
      the level of N-hydroxy-Trp-P-2 to levels nearing 1 pmol, and the preparation
      before submission to the HPLC took such a short time (5 min) that N-hydroxy-Tr-P
      2 did not have sufficient time to decompose. Then, the microsomal N-hydroxylation
      activity on Trp-P-2 was compared with five different sources of microsomes. The
      microsomes from rats treated with MC plus PB, MC, PB, or polychlorinated biphenyl
      showed an activity level (mol/min/mol P450 enzymes) of 2.41 +/- 0.19, 1.92 +/-
      0.21, 0.048 +/- 0.017, and 1.79 +/- 0.15, respectively, and those from untreated
      rats showed no activity. This method was useful for evaluating the N
      hydroxylation activity of P450 enzymes.

PMID- 7778766
TI  - Two-color double in situ hybridization using enzymatically hydrolyzed
      nonradioactive riboprobes.

PMID- 7778767
TI  - Amplification of the entire mitochondrial DNA by polymerase chain reaction in two
      large overlapping segments.

PMID- 7778768
TI  - Quick preparation of mitochondrial DNA fractions free from nuclear DNA for
      polymerase chain reaction amplification.

PMID- 7778770
TI  - Separation of two proline-containing peptides by capillary electrophoresis.

PMID- 7778769
TI  - A spectrophotometric method for quantitative determination of allicin and total
      garlic thiosulfinates.

PMID- 7778771
TI  - Extraction and determination of ascorbate and dehydroascorbate from plant tissue.

PMID- 7778772
TI  - Determination of S-adenosyl-L-methionine: L-methionine S-methyltransferase
      activity by selective adsorption of [methyl-3H]S-adenosylmethionine onto
      activated charcoal.

PMID- 7778774
TI  - Transformation of Escherichia coli increases 260-fold upon inactivation of T4 DNA
      ligase.
AB  - It was possible to obtain high-efficiency transformation of E. coli MC1061 by the
      following modifications of the standard procedure: cells were harvested at A600
      of 550-650, washed with 1, 1/2, and 1/40, and were resuspended in 1/500 culture
      vol of 1 mM Hepes, pH 7.0, to a cell concentration of 6 x 10(10)-6 x 10(11)
      cells/ml. Electrocompetent cells were used immediately for electroporation to
      yield 1.3 +/- 0.5 x 10(9) (mean +/- SD) transformants micrograms of plasmid DNA,
      which is comparable to the efficiency of bacteriophage lambda infection.
      Alternatively, cells can be stored frozen in 10% glycerol, although glycerol
      reduced transformation efficiency to approximately 30% (data not shown). Freezing
      and thawing of glycerol-treated cells did not result in any further loss of
      transformation efficiency (data not shown). This study showed that it is crucial
      to inactivate the T4 DNA ligase prior to electrotransformation of ligated DNA,
      which can be ensured by the introduction of a simple heat inactivation step,
      increasing the number of transformants by 260-fold. Although this paper focuses
      on the use of E. coli MC1061/p3, the experiments were repeated with a different
      plasmid in the parental strain E. coli MC1061 and showed the same result (data
      not shown.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778773
TI  - Overcoming polymerase chain reaction inhibition in old animal tissue samples
      using ethidium bromide.

PMID- 7778775
TI  - Dibromobimane as a fluorescent crosslinking reagent.

PMID- 7778776
TI  - Fluorometric assay of GTPase activity: application to the couple elongation
      factor eEF-2-ribosome.

PMID- 7778777
TI  - Enzymatic synthesis of guanine nucleotides labeled with 15N at the 2-amino group
      of the purine ring.
AB  - GMP and dGMP labeled with 15N at the 2-amino group of the purine ring was
      obtained enzymatically from NH4Cl (> 99 at.% 15N) and from IMP or dIMP,
      respectively, by several reactions involving IMP-dehydrogenase, GMP-synthetase,
      adenylate kinase, and creatine kinase. The first three enzymes were obtained by
      overexpression in Escherichia coli of the corresponding genes. The isotope
      content of the primary amino group of guanine determined by mass spectrometry
      after acid hydrolysis of nucleotides was found higher than 98 at.% 15N. The
      proton NMR spectrum of [15N]GMP in solution in the absence of nitrogen decoupling
      showed a doublet with a coupling constant of 92 Hz. When nitrogen decoupling was
      used during the acquisition time, the doublet was replaced by a single peak at
      6.47 ppm, indicating that the corresponding proton is bound to 15N.

PMID- 7778778
TI  - Inhibition of human spleen protein tyrosine kinases by phenolic compounds.

PMID- 7778779
TI  - Desalting inositolpolyphosphates by dialysis.

PMID- 7778781
TI  - A procedure for the rapid preparation of guanosine tetraphosphate (ppGpp) from
      Escherichia coli ribosomes.

PMID- 7778782
TI  - A nonradioactive method to determine levels of in vitro transcription in nuclear
      extracts.

PMID- 7778780
TI  - A low-pH reverse-phase high-performance liquid chromatography system for analysis
      of the phenylthiohydantoins of S-carboxymethylcysteine and S
      carboxyamidomethylcysteine.

PMID- 7778783
TI  - Direct mass spectrometric analysis of glycosphingolipid transferred to a
      polyvinylidene difluoride membrane by thin-layer chromatography blotting.
AB  - A simple, rapid method for the analysis of glycosphingolipid that combines "thin
      layer chromatography (TLC) blotting" and mass spectrometry is reported.
      Glycosphingolipids developed by TLC were transferred to a polyvinylidene
      difluoride membrane by TLC blotting, after which the glycosphingolipid band on
      the membrane was excised and placed on a mass spectrometer probe tip, and a few
      microliters of triethanolamine was added as the matrix. The sample was analyzed
      by secondary ion mass spectrometry. About 1 microgram of glycosphingolipid
      subjected to TLC can be analyzed. The major advantage of this method is that
      glycosphingolipid can be analyzed structurally without purification by repeated
      column chromatography.

PMID- 7778784
TI  - Effect of beta-mercaptoethanol on the detection of biotinylated proteins.
AB  - Biotinylated proteins were visualized by enhanced chemiluminescence (ECL) or
      conventional autoradiography following sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis and protein transfer onto nitrocellulose. Soaking polyacrylamide
      gels run under nonreducing conditions in beta-mercaptoethanol (2-ME) prior to
      protein transfer onto nitrocellulose resulted in a 2- to 10-fold augmentation of
      the resultant signal. This enhancement was observed for both disulfide- and
      nondisulfide-bonded proteins. Furthermore, 2-ME had no effect on either the
      activity of the extravidin-horse-radish peroxidase conjugate, used to detect
      biotin moieties, or the net protein transfer onto nitrocellulose. Thus, we
      propose that amplification of either ECL or gamma emission following 2-ME
      treatment is due to its ability to modify protein conformation, which in turn
      provides greater access of avidin to biotin.

PMID- 7778785
TI  - Prediction of protein secondary structure from circular dichroism spectra: an
      attempt to solve the problem of the best-fitting reference protein subsets.
AB  - In least-squares fitting of protein circular dichroism (CD) spectra using basis
      CD spectra for the respective secondary structure components, as given by
      reference proteins of known structural composition, good fits of the CD spectrum
      do not necessarily correspond to appropriate fits of the underlying structural
      composition of a test protein. In an attempt to overcome this problem, CD
      similarity measures were used to construct a subset of five reference CD spectra
      which permitted three-component fitting of the CD and prediction of the relative
      magnitude of total beta-sheet (antiparallel + parallel) and total other structure
      (beta-turn + remainder), relative to helix, in the test protein. A
      backpropagation neural network (BPN) was also trained to make this prediction. In
      subsequent five-component fitting of the CD spectrum, using a Monte Carlo method
      to generate subsets of reference proteins from the working data set, only those
      secondary structure fits which conformed to the consensus prediction of the CD
      similarity measures and the BPN were accepted. The method enhanced the fitting of
      antiparallel beta-sheet and beta-turn for 16 proteins, compared to the variable
      selection method of P. Manavalan and W. C. Johnson (1987, Anal. Biochem. 167, 76
      85). Some other proteins were less well fitted. Improvement in results is
      expected with a larger representation of feasible basis CD spectra in the working
      reference proteins.

PMID- 7778786
TI  - Simple and efficient method for isolation and measurement of cyanobacterial
      hepatotoxins by plant tests (Sinapis alba L.).
AB  - A simple and cost-effective method for isolating and assaying microcystins,
      cyanobacterial toxins, by C-18 cartridges, DEAE-cellulose (DE-52) chromatography,
      and a mustard (Sinapis alba L.) plant seedling test is described. The procedure
      results in a purity of up to 95-97% microcystin without the need for an HPLC
      system and justifies the use of the S. alba L. seedling test in the quantitative
      assessment of the toxin with an IC50 of 3 micrograms ml-1 instead of the mouse
      intraperitoneal test.

PMID- 7778787
TI  - A fluorescence assay for geranylgeranyl transferase type I.
AB  - A new fluorescence assay for measuring the activity of geranylgeranyl transferase
      (type I) is described. It does not require the use of either radiolabeled
      geranylgeranyl diphosphate or the purified recombinant Ras protein substrate with
      the carboxy terminal sequence of CVLL. Dansyl GCVLL and unlabeled geranylgeranyl
      diphosphate are used as substrates. The Km for Dansyl GCVLL and for
      geranylgeranyl diphosphate is 5 microM and 800 nM, respectively. At equimolar
      concentrations, enzymatic activity is higher when Dansyl GCVLL is used as a
      substrate compared to Dansyl GCVII. Dansyl GCVLS, a substrate for farnesyl
      transferase, is inactive in this assay. CVFL is a competitive inhibitor of
      geranylgeranyl transferase and exhibits a Ki of 200 nM.

PMID- 7778788
TI  - A microtiter plate assay using cascade amplification for detection of
      nonisotopically labeled DNA.
AB  - We describe a microtiter-plate-based, colorimetric assay for DNA, the enzyme
      linked DNA-enzyme-linked coagulation assay (EDNA-ELCA). The EDNA-ELCA uses
      amplification of the common pathway of coagulation for the ultrasensitive
      detection of DNA which is tagged by incorporation of functional groups such as
      biotin and fluorescein. The EDNA-ELCA enables detection of attomole amounts of
      DNA (< 1 pg per microtiter well), with a sensitivity 200-1000 times higher than
      other colorimetric techniques. The assay has been applied as an adjunct to PCR
      for quantitative determination of methicillin-resistant Staphylococcus aureus DNA
      at levels corresponding to 1-10(5) organisms. The EDNA-ELCA can also be used to
      assay DNA by hybridization; < 50 amol of an unlabeled DNA template is detected by
      hybridization to biotin- and fluorescein-labeled probes.

PMID- 7778789
TI  - Determination of cholesterol oxidation products in human plasma by isotope
      dilution-mass spectrometry.
AB  - A method based on isotope dilution-mass spectrometry was developed for the
      determination of nine cholesterol oxidation products in human plasma. The
      cholesterol oxidation products determined were cholest-5-ene-3 beta,7 alpha-diol,
      cholest-5-ene-3 beta,7 beta-diol (7 alpha- and 7 beta-hydroxycholesterol,
      respectively), 3 beta-hydroxycholest-5-en-7-one(7-oxocholesterol),5,6 alpha-epoxy
      5 alpha- cholestan-3 beta-ol (cholesterol-5 alpha,6 alpha-epoxide),5,6 beta-epoxy
      5 beta-cholestan-3 beta-ol (cholesterol-5 beta,6 beta-epoxide), (cholesterol-5
      beta,6 beta-epoxide), cholestane-3 beta,5 alpha,6 beta-triol, cholest-5-ene-3
      beta,24-diol (24-hydroxycholesterol), cholest-5-ene-3 beta,25-diol (25
      hydroxycholesterol), and cholest-5-ene-3 beta,27-diol (27-hydroxycholesterol). A
      corresponding deuterium-labeled internal standard, containing 3 to 6 deuterium
      atoms, was synthesized for each cholesterol oxidation product except 5 beta,6
      beta-epoxycholesterol which was determined using the internal standard for 5
      alpha,6 alpha-epoxycholesterol. Plasma from 31 healthy volunteers was analyzed by
      the new method and 27-, 24-, and 7 alpha-hydroxycholesterol were the most
      abundant cholesterol oxidation products (mean values 154, 64, and 43 ng/ml,
      respectively). The other oxysterols determined were present in concentrations
      lower than 30 ng/ml. Males had higher 27-hydroxycholesterol concentrations in
      plasma than females. The 5,6-oxygenated products were present mainly unesterified
      while the other oxidation products were mostly in esterified form.

PMID- 7778791
TI  - Alternative methods of preparing whole-cell DNA from fungi for dot-blot,
      restriction analysis, and colony filter hybridization.
AB  - There is a large and increasing number of methods for preparing whole-cell DNA
      from fungi. Modifications have evolved for two reasons. This first is to simplify
      the protocol as much as possible to allow processing of large sample numbers, in
      some cases for very specific uses, e.g., dot-blots. The second is to increase the
      quality of the DNA. Most preparations are contaminated with varying amounts of
      polysaccharides and unknown wall contaminants that can inhibit subsequent
      restriction or ligation. The extent of contamination varies with the species, the
      individual isolate, and at least in Neurospora, with the method or extent of
      growth. This paper offers three new methods. The first is a simplified procedure
      for isolating denatured DNAs from filamentous fungi for dot-blot analysis. The
      second is a rapid method for isolating DNAs from large numbers of small- to
      medium-scale cultures of filamentous fungi. These preparations are sufficiently
      pure for a variety of enzymatic reactions. The third is a nonenzymatic method for
      yeast colony filter hybridization that is simple, inexpensive, and efficient and
      results in uniform signals for a variety of species.

PMID- 7778790
TI  - Codelivery to mammalian cells of a transcriptional factor with cis-acting element
      using cationic liposomes.
AB  - The human immunodeficiency virus-1 transactivator protein (tat) was codelivered
      efficiently with a reporter gene under the control of a tat-responsive DNA
      element using different formulations of cationic liposomes. Expression of a tat
      responsive reporter gene was induced by incubating cells with a mixture of
      purified recombinant tat protein, reporter DNA, and liposomes. Different cell
      lines were tested successfully as targets for the codelivery. Tat was shown to
      trans-activate the codelivered virus promoter specifically in the cells tested.
      Codelivery of tat with DNA is a useful model for studying the function of trans
      acting factors and their cis-acting DNA elements. The currently available methods
      such as foot-printing only reveal the binding, but not the functional consequence
      of the binding, of the factor with the element. In addition, this system may
      prove useful as a model for high level and regulated transgene expression in
      target cells.

PMID- 7778793
TI  - [Antibiotic prophylaxis in a surgical setting].

PMID- 7778792
TI  - [Antibiotic prophylaxis in the surgical setting. Consensus development
      conference. Paris, 11-12 December 1992].

PMID- 7778794
TI  - [General principles of choice of antibiotics for antibiotic prophylaxis in
      surgery].
AB  - A large amount of knowledge has been obtained in the field of prophylactic
      antibiotics over the past few years. Only procedures with a reasonable risk
      (incidence or severity) ought to be covered. Antibiotics must be present not only
      in plasma but also in the tissues during the surgical procedure. In most cases a
      very short prophylaxis, usually using a single bolus, is convenient. The best
      cost/benefit ratio has to be obtained. Several points remain unclear and require
      further investigations: what is the best dosage? What is the adequate timing for
      reinjections according to the duration of surgical procedure, and to the risk of
      postoperative infection using a "risk index"? Must we modulate the type of
      prophylaxis according to the duration of hospital stay before surgery? What is
      the value of selective decontamination of the digestive tract?

PMID- 7778795
TI  - [Antibiotic prophylaxis in ORL surgery and oral medicine].
AB  - Postsurgical infection has always been a cause for major concern in ENT surgery.
      Papers on the topic allowed to identify indications for antibiotic prophylaxis.
      In ear surgery, in the absence of prior infection (stapes surgery, medium dry ear
      surgery), studies' results are not in favour of antibiotic prophylaxis. On the
      other hand, however, when the ear is inflamed or infected, the use of antibiotics
      is indicated, if possible after having first taken a sample. For nose and sinus
      surgery, antibiotic prophylaxis seems to be worthless in the absence of a
      prolonged packing. If a packing has to be maintained or if a transplant is used,
      an antibiotic administration has to be considered; the most appropriate
      antibiotic and its mode of use still have to be specified. In case of facial
      trauma, antibiotic prophylaxis using cefazolin reduces the risk of infection of
      paraymphysis fractures and angle fractures. The postoperative course after
      tonsillectomy is simplified by a prolonged antibiotic administration based on
      ampicillin. In clean cervico-facial surgery, without buccopharyngeal opening, the
      antibiotic prophylaxis seems to be worthless. In the opposite, antibiotherapy is
      required in case of buccopharyngeal opening. Indeed the presence of potential
      pathogenic bacteria in the buccopharyngeal cavity, the difficulties of mucosa
      closing, the importance of the tumoral extension, the length of the procedure,
      radiotherapy and use of myocutaneous flaps may all be the cause of a high
      infection rate (80%) in the absence of antibiotic prophylaxis. Two types of
      antibiotics seem to be suitable, cefazolin and clindamycin. Antibiotics active
      against Gram negative bacteria seem to be useless. There is a disagreement
      concerning the duration of antibiotic administration. The populations studied are
      too small to obtain significant results. Both points of view (prolonged
      antibiotic administration or true antibiotic prophylaxis) can be considered. Only
      large scale prospective studies with an adequate methodology will provide
      credible data for this debate.

PMID- 7778796
TI  - [Antibiotic prophylaxis in urology. Surgical and endoscopic surgery. Lithotripsy.
      Transplantation].
AB  - The opening of the urinary tract switches surgical and endoscopic urology to the
      clean contaminated category and therefore for each of them antibiotic prophylaxis
      has to be considered. Prophylactic antibiotics are only recommended before
      surgery in patients with sterile urine. Those with infected urine should have
      curative antibiotics. Prophylactic antibiotics are commonly recommended for
      transurethral resection of the prostate, transrectal biopsy of the prostate,
      renal transplant and radical cystectomy with ileal or colonic pouch for urinary
      diversion. It is worthless in diagnostic cystoscopy. ESWL and scrotal surgery.
      For other procedures more data are required to conclude.

PMID- 7778797
TI  - [Antibiotic prophylaxis in gynecologic surgery].
AB  - Hysterectomies are contaminated procedures; surgical wound related sepsis ranges
      from 10 to 25%. Several randomised controlled studies demonstrated a significant
      benefit with prophylactic antibiotics. The study results were more controversial
      for abdominal hysterectomies. Ureidopenicillins, cephamycins and other
      antibacterial agents active on Gram negative rods and anaerobes can be
      recommended as a preoperative flash at anaesthesia induction, followed by a
      second injection whenever the procedure duration exceeds 3 hours. In case of
      extended hysterectomy for cancer, broad spectrum antibiotic prophylaxis is usual;
      some recent studies demonstrated the efficacy of a short duration antibacterial
      agent use. Mastectomies are at low risk for postoperative infection.
      Antibacterial prophylaxis is common, especially in plastic surgery.

PMID- 7778798
TI  - [Antibiotic prophylaxis in cesarean section and voluntary termination in
      pregnancy].
AB  - Infection is the main complication after voluntary termination of pregnancy
      through vacuum aspiration, with an infection rate of 3.6% in the subsequent three
      weeks. This rate is comparable to that observed in the so-called clean surgical
      procedures. However the consequences on fertility remain unknown. Studies using
      systematic antibiotic administration in all vacuum aspirations (voluntary
      termination of pregnancy and spontaneous abortion) demonstrated the value of such
      a preventive measure. Factors of risk are difficult to identify and systematic
      bacteriological specimen collection in all patients undergoing a termination of
      pregnancy is quite impossible to do. Therefore, the best strategy consists in the
      oral administration of 200 mg of doxycycline before the aspiration and 200 mg 12
      hours later. The incidence of operative-site infection and endometritis after
      Caesarean section without perioperative antimicrobial prophylaxis varies from 5
      to 85%. A variety of risk factors have been identified such as low social
      category, rupture of membranes, the number of vaginal examinations, labour, and
      emergency sections. Most clinical trials have shown no significant difference in
      the efficacy of various antibiotic regimens. However, prophylactic antibiotics
      decrease significantly the rate of infections. We recommend one or three doses of
      intravenous prophylactic antibiotic, after clamping and section of the umbilical
      cord in high risk patients. Cephalosporin of 1st or 2nd generation or ampicillin
      associated with an inhibitor of beta-lactamases are recommended.

PMID- 7778799
TI  - [Antibiotic prophylaxis in gastroduodenal surgery].
AB  - The incidence of postoperative wound infections is increased up to 35% after
      gastroduodenal surgery, when gastric motility and acidity are decreased, as in
      case of gastric ulcer or cancer, obstruction, bleeding, antacid therapy. The
      endogenous flora contaminating the operative-site consists of organisms of the
      oropharynx and the jejunum and includes anaerobes like bacteroides, aerobes like
      streptococci, staphylococci, E. coli. Antimicrobial prophylaxis is therefore
      indicated in these high risk patients. All groups of antibiotics have been used,
      however 1st and 2nd generation cephalosporins are the most effective. A single
      dose given intravenously just before anaesthesia is recommended, a second dose is
      advisable intraoperatively when surgery is prolonged or massive blood loss
      occurs. Antibiotic prophylaxis is also recommended in gastric bypass surgery for
      obesity, but remains controversial for percutaneous endoscopic gastrotomy.

PMID- 7778800
TI  - [Antibiotic prophylaxis in hepatobiliary surgery].
AB  - Today, hepatic and biliary surgery includes conventional biliary surgery,
      laparoscopic surgery, interventional radiology, endoscopy and hepatic resection
      surgery. In conventional biliary surgery, the benefit of antibiotic prophylaxis
      has been demonstrated. Among the risk factors, some are specific (age > 65 years,
      gallstones in the common bile duct with or without jaundice, history of acute
      cholecystitis or of biliary surgery) and the others are non specific such as the
      CDC new index risk (for scoring from 0 to 3, wound infection rates are
      respectively 1.36, 2.01, 7.11, 11.54%). The targets for antibiotics used in
      conventional biliary surgery are E. coli, Klebsiella and Streptococcus. In
      biliary laparoscopic surgery, the rate of infectious complications and results of
      antibiotic prophylaxis have not been assessed. However, in laparoscopic surgery,
      the use of an antibiotic prophylaxis similar to that employed in conventional
      biliary surgery seems logical. In interventional radiology and endoscopy, the
      modalities and the benefit of antibiotic prophylaxis have not yet been assessed.
      Infections (angio-cholecystitis) secondary to these procedures are frequent and
      severe. They are due to multiresistant hospital microorganisms. Antibiotic
      prophylaxis regimens for hepatic resections have not yet been assessed and are
      the same as for conventional biliary surgery.

PMID- 7778801
TI  - [Criteria of validity of studies on antibiotic prophylaxis].

PMID- 7778802
TI  - [Antibiotic prophylaxis in colorectal surgery].
AB  - In elective colorectal surgery, the benefit of preoperative antibiotic
      prophylaxis is well established, with a reduction in wound infection rate to less
      than 10%. The antimicrobial agent used has to be active against aerobic and
      anaerobic pathogens such as Escheria coli and Bacteriodes fragilis. The efficacy
      of three schemes of administration: oral and/or parenteral prophylaxis associated
      with a mechanical preparation, has been demonstrated. Oral antibiotic
      administration is current practice in USA; the most widely used oral regimen is
      the combination of erythromycin and neomycin given the day before surgery.
      Parenteral prophylaxis with a cephalosporin active against Bacteriodes fragilis
      such as cefoxitin and cefotetan, is preferred in Europe. The issue of whether a
      systemic prophylaxis should be added to the oral regimen or not has not yet been
      resolved. However it seems that the association should be proposed in various
      situations: patients with a high risk factors score (rectal resection and
      operations lasting more than three hours), patients with incomplete mechanical
      preparation, delay of the onset of surgery after the last oral dose.

PMID- 7778803
TI  - [Antibiotic prophylaxis and appendectomy].
AB  - Analysis of clinical studies shows that a single preoperative systematic
      administration of antibiotics may reduce postoperative sepsis rate after
      appendicectomy. If the appendix is gangrenous or perforated, this therapy must
      last for a longer time and is not considered as a prophylaxis. In clinical
      practice, there are obvious advantages in the use of a single agent efficient
      against both aerobes and anaerobes. According to the literature, cefotetan or
      cefoxitin (2 g in adults, 40 mg.kg-1 in children) can be proposed.

PMID- 7778804
TI  - [Antibiotic prophylaxis of penetrating injuries of the abdomen].
AB  - Antibiotic prophylaxis for a penetrating injury of the abdomen has a distinctive
      feature as contamination occurs before administration of antibiotics and because
      important blood loss can modify the pharmacokinetics of antibiotics. Due to the
      rate and severity of infectious complications, no controlled study has been
      undertaken. All authors agree to use prophylactic antibiotics in patients with
      penetrating injury of the abdomen. Various antibiotic regimens have been
      administered, but it seems that those using an antibiotic active against
      anaerobes are more efficient to prevent postoperative infectious complications
      than without them. There is no benefit to administer antibiotics for more than 24
      hours.

PMID- 7778805
TI  - [Antibiotic prophylaxis in surgery of the esophagus].
AB  - Surgery of oesophagus carcinoma is a long and major procedure. Perioperative
      radiochemotherapy is often required. Therefore many factors favour the occurrence
      of local and general postoperative infection, justifying an antibiotic
      prophylaxis directed against oesophageal and gastric flora. In case of
      oesophageal stenosis, the oesophageal floral often switches to the fecal type.
      Antimicrobial agents diffuse to the surgical site and reach there high
      concentrations for the time of surgery. We recommend, just prior the induction of
      anaesthesia the intravenous administration of a single dose of a third generation
      cephalosporin (ceftriaxone 2 g) and nitroimidazole (ornidazole 1 g). The long
      half-life of these agents allows sufficient concentrations at surgical site to be
      obtained and the efficacy of this regimen has been demonstrated. Selective
      decontamination of the digestive tract with systemic antibiotherapy is another
      approach for the prevention of postoperative complications of surgery of
      oesophagus carcinoma.

PMID- 7778806
TI  - [Antibiotic prophylaxis in digestive endoscopy].
AB  - The increasing use of endoscopy in diseases of the digestive tract has been
      associated with an increase in complications related to is technique. Because of
      this, various authors have recommended the administration of prophylactic
      antibiotics in an attempt to avoid infectious complications. This attitude has
      however been largely empirical, without a real assessment of the benefits and
      disadvantages. Although no prospective study has shown any clear benefit, it is
      generally accepted that prophylactic antibiotics should be given systematically
      whenever a digestive endoscopy is to be performed in a patient with a cardiac
      valvular disease or a history of bacterial endocarditis. Apart from these
      situations, prophylactic antibiotics may be indicated for sclerotherapy of
      actively bleeding oesophageal varices and prior to colonoscopy in immunodepressed
      patients or in those with an inflammatory disease of the colon.

PMID- 7778807
TI  - [The role of new molecules in surgical antibiotic prophylaxis].
AB  - The preoperative administration of a new antibiotic for antimicrobial prophylaxis
      is questionable because of the methodological difficulties to demonstrate its
      efficiency and benefits in decreasing the postoperative infectious complications.
      As their rate is very low, especially in clean surgery, the number of patients to
      be included in a comparative trial is very high. Most studies assessed only small
      groups and therefore any extrapolation for clinical practice is of limited value.
      Because of their therapeutic efficiency the fluoroquinolones are often
      recommended for antimicrobial prophylaxis. However, the rapid occurrence of
      resistances, directly related to their prescription should invite the prescribers
      to be cautions. They should be contra-indicated as long as an alternative of
      similar efficiency is existing, in case of bacteraemia, when an administration of
      more than 48 hours in required or when the intra-hospital resistance rate exceeds
      10 p. 100.

PMID- 7778808
TI  - [Surgical antibiotic prophylaxis in a patient undergoing immunosuppressive
      treatment].

PMID- 7778809
TI  - [Economic aspects of surgical antibiotic prophylaxis].
AB  - The cost of an antibiotic is easily evaluated in the case of antimicrobial
      prophylaxis. The other expenses, either direct or indirect costs, are much more
      difficult to assess. Studies evaluating the economical impact of the prophylactic
      antibiotics are rather rare. Antibiotic prescription for prophylaxis is evaluated
      to represent about 20 to 30% of the total antibiotic administration in French
      hospitals. The most significant studies evaluate the cost/benefit ratio and
      demonstrate the advantage of prophylaxis in orthopaedic, vascular and
      gynaecologic surgery.

PMID- 7778810
TI  - [Microbiologic criteria of the choice of antibiotic for antibiotic prophylaxis in
      surgery].
AB  - The choice of an antibiotic for antimicrobial prophylaxis is based on
      microbiological, pharmacokinetic, chemical and pharmacodynamic parameters. The
      knowledge of the bacterial flora allows the identification of bacteria which
      could be responsible for postsurgical infections. These floras are complex and
      their equilibrium can be modified by various factors, such as hospitalization, co
      existing disease, medico-surgical procedure, administration of antibiotics, which
      cause the selection of the so-called hospital-bacteria feared by therapists. The
      infection will develop according to the quantity of bacteria that have been
      introduced and to their virulence, which is often altered by local factors,
      especially the biomaterials. The knowledge of pharmacodynamic parameters such as
      bactericidal activity, postantibiotic effect, activity on virulence factors
      (bacterial adhesion), allows the refinement of the choice of the antibiotic and
      the optimization of its posology.

PMID- 7778811
TI  - [Pharmacokinetic criteria of the choice of antibiotic for antibiotic prophylaxis
      in surgery].
AB  - The prevention of surgical infections with perioperative prophylactic antibiotics
      is experimentally and clinically well founded in both principle and practice. The
      evaluation of the role of antimicrobial agents in the success of failure of
      infection prophylaxis in surgery involves a discussion of both the
      pharmacokinetic and the pharmacodynamic properties of particular agents. A main
      concern in surgical prophylaxis is the relation between the respective time
      course of antibiotic concentrations in serum and in the tissue (wound). Several
      problems arise in both the measurement and the interpretation of drug
      concentrations in tissues and the results of this approach are still
      controversial. However, the knowledge of the numerous factors influencing the
      penetration into a tissue and the characteristics of the relative distribution of
      the antibiotic between the compartments inside the tissue, i.e. the vascular,
      interstitial and intracellular spaces, could allow a valuable approach to this
      problem. The concentrations of free drugs in serum are valuable predictors of the
      time course of unbound drug in interstitial fluid, where the bacteria are
      generally located. An increase in protein binding does not reduce the area under
      the curve (AUC) of free drug for beta lactam agents eliminated predominantly by
      glomerular filtration, but prolongs their elimination half life. Timing and route
      of administration are also important factors to consider in relation with the
      pharmacokinetic profile of the drug. Pharmacodynamic studies of persistent growth
      suppression and bactericidal activity predict that the period during which the
      free drug concentration exceeds the MIC is an important parameter of the efficacy
      of beta lactam antibiotics. In the opposite, the Cmax and/or the AUC are the
      major parameters of the efficacy of aminoglycosides and quinolones against Gram
      negative bacteria. Thus, the goal of prophylaxis with beta lactams could be to
      provide levels of free drug above the MIC for the whole surgical period, while
      the obtention of a high Cmax with a one-day therapy should be required for
      aminoglycosides. Further clinical trials are warranted to assess this approach.

PMID- 7778812
TI  - [Impact of antibiotic prophylaxis on microbial ecology].
AB  - This review of the literature analysed the impact of prophylactic antibiotics on
      patients, nurses, the ecosystem of the wards, the hospital and the general
      environment. After prophylactic antibiotics a qualitative and quantitative
      modification of the cutaneous and digestive flora of the patient can occur, as
      well as modification of susceptibility to antibiotics. Several factors may
      modulate their action on the bacterial flora: the breadth of the spectrum, the
      administered dose, the duration of treatment, the form of development of
      resistance and the type of antibiotics. Numerous studies have demonstrated the
      role of the nursing staff as a reservoir of multi-resistant micro-organisms.
      Staff of intensive care units is apparently the most affected. Prophylactic
      antibiotics can also induce changes in the quantitative and qualitative features
      both in the ward and hospital flora. An increase in the bacterial resistance to
      antibiotics in the general environment can occur; a long duration of oral
      prophylactic antibiotic administration is undoubtedly associated with this
      phenomenon. Thus, the benefit associated with prophylactic antibiotic in the
      prevention of postoperative infections, unquestionable in some indications, must
      be balanced with the possible selection of resistant micro-organisms and their
      consequences on the environment.

PMID- 7778813
TI  - [Antibiotic prophylaxis in orthopedic surgery].
AB  - The efficiency of prophylactic antibiotics in total hip replacement has been
      demonstrated by several studies. The rate of infection decreased approximatively
      from 3% to 1% with a cephalosporine 1 protocol. The rate of infection was not
      different after a five-day administration of cephalosporine 1 and a 2-day
      treatment of cephalosporine 2. In open fractures, the value of prophylactic
      antibiotics has to take in account the usual organisms of peroperative
      contamination as well as the anaerobes. Short administration can be used, however
      no randomized studies have proven their efficiency. For clean, planned surgery
      (grade II in the classification of Health National Research Council),
      prophylactic antibiotics seem to be of value. However, the prescription should
      not be systematic, but correlated with the local conditions of surgery and the
      infection rate of the type of the planned procedure.

PMID- 7778814
TI  - [Antibiotic prophylaxis in multiple trauma patients].
AB  - Infection prophylaxis in multiple trauma patients includes prophylaxis of
      infections due to surgery, which is the true one as well as the prophylaxis of
      secondary acquired infections which are more frequent, especially in case of co
      existing shock. The association an aminopenicillin with a beta-lactamase
      inhibitor is recommended for prophylaxis of surgical infections. These
      antibiotics need to be administered early and in high doses, as the
      pharmacokinetic parameters are modified in trauma patients, with an increased
      volume of distribution and a shortened half-life of elimination. Prevention of
      secondary infection relies on a medico-surgical treatment of haemorrhagic shock.
      Other preventive measures, such as early enteral nutrition, selective
      decontamination of the digestive tract and immunotherapy, still need to prove
      their efficacy.

PMID- 7778815
TI  - [Prevention of infectious endocarditis].
AB  - An antibiotic prophylaxis of infective endocarditis is recommended in patients at
      high risk for infective endocarditis (patients with valvular prosthesis, or
      cyanogen congenital or obstructive cardiac defect) or those with aortic, mitral
      or tricuspid valvulopathy, a non-cyanogen congenital or obstructive cardiac
      defect. Dental procedures (except treatment for superficial decay and preparation
      for the fitting of prostheses to teeth with intact pulp) are to be carried out
      under local antisepsis and a prophylactic antibiotics, such as 3 g of oral
      amoxicillin or in case of allergy to penicillin, 600 mg of clindamycin or 1g of
      pristinamycin, administered one hour prior to the procedure. A similar
      prophylaxis is recommended for the procedures on the upper respiratory tract.
      Amoxicillin, or vancomycin or teicoplanin are recommended for procedures under
      general anaesthesia. For surgery on the intestinal or urogenital tract, regimens
      combine amoxicillin with gentamicin, or in case of allergy to penicillin,
      vancomycin or teicoplanin with gentamicin.

PMID- 7778816
TI  - [Antibiotic prophylaxis in thoracic surgery, pulmonary endoscopy, thoracic
      injuries and lung transplantation].
AB  - Effectiveness of prophylactic antibiotics is at present time well documented for
      many surgical procedures. In lung surgery, numerous randomized double-blinded
      studies have demonstrated the effectiveness of 1st or 2nd generation
      cephalosporins, administered over a short period of time, not exceeding 24 h. In
      the opposite, thoracic injuries do not seem to require prophylactic antibiotics,
      except penetrating injuries of the chest, which could benefit from a single
      antibiotic injection. In case of lung transplantation, infectious complications
      result from many factors, among which immunosuppression plays an important role.
      A prolonged antibiotherapy is routinely used by many transplantation teams,
      despite the lack of studies proving the effectiveness of this practice.

PMID- 7778817
TI  - [Antibiotic prophylaxis in heart surgery].
AB  - Cardiac surgery enters mainly into the class I of Altemeier ("clean surgery").
      However, many factors may explain an intraoperative contamination: surgery of
      long duration, extra-corporeal circulation, aspiration of blood and air,
      immunodepression...). In fact, the infectious risk decreases from about 25% with
      placebo to 5% with prophylactic antibiotics. The staphylococcal infections are
      the most frequent (mediastinitis, endocarditis, parietal infections...).
      Cephalosporins, particularly of second-generation type (cefamandole, cefuroxime),
      perform better than antistaphylococcal penicillins. The combination with an amino
      side may be used when Gram negative bacilli infection prevalence is high.
      Vancomycin is efficient but hypotension and renal impairment have been reported.
      Therefore, vancomycin is used in patients allergic to cephalosporins, when a high
      prevalence of methicillin-resistant Staphylococcus or enterococci infections is
      reported, or when the patient has recently received broad-spectrum antimicrobial
      therapy. The antibiotic doses must take into account the haemodilution due to
      extracorporeal circulation and the necessity to obtain sufficient serum
      concentrations throughout surgery. A prophylaxis of more than 48 hours is not
      associated with an improved outcome. In cardiac transplantation a prophylaxis is
      essential, but is still questioned during the insertion of pace-markers. In any
      case, the antibiotic prophylaxis must take into account the bacterial prevalence
      of each institution.

PMID- 7778819
TI  - [Antibiotic prophylaxis in neurosurgery].
AB  - Postoperative wound infections are a serious complication in neurosurgery. The
      average infection rate without antibiotics ranges between 5-11% in CSF shunts,
      between 2-5% in craniotomies and spinal surgery in clean and clean contaminated
      patients, and 11-38% in CSF fistulas. In CSF shunt procedures as well as in
      craniotomies, common skin commensals, mainly coagulase negative and positive
      staphylococci are responsible for most postoperative infections. Contradictory
      results of the studies evaluating the efficacy of prophylactic antibiotics (PA)
      make it impossible to conclude whether antibiotics have any impact on the
      incidence of infections or not. Nevertheless the decision to use PA must be left
      to each surgeon and based on own experience (the mean rate of infection decreased
      from 5-11% to 1% with PA in France). In clean and clean contaminated surgery, the
      weight of evidence based on some large, prospective, randomized studies, suggests
      that PA exerts a protective effect, for which an antistaphylococci antibiotic
      would be appropriate. In case of methi-R organisms, a second generation
      cephalosporin is an alternative. Association of vancomycin-gentamicin is not
      recommended routinely because of the risk of development of resistance.

PMID- 7778818
TI  - [Antibiotic prophylaxis in vascular surgery].
AB  - Vascular surgery includes various surgical procedures and sites. Infectious risk
      is low but with a high functional risk and a high mortality rate. Infection risk
      factors are numerous. Among them the incision in the Scarpa's triangle is at the
      first place. Antimicrobial prophylaxis in vascular surgery has shown its efficacy
      whatever the agent. The second generation cephalosporins are the most logical,
      with a duration of administration of less than 24 hours. In case of re-operation
      glycopeptides have shown their efficacy.

PMID- 7778820
TI  - [Prophylactic antibiotic therapy in ocular surgery].
AB  - Prophylactic antibiotics have been used by ophthalmic surgeons routinely before
      and after surgery. However, the optimal type of antibiotics and route of
      administration have not yet been clearly established. In this article, ocular
      surgery patterns, bacteriology and pharmacokinetics of antibiotics within the eye
      are reviewed, to try to provide rationale for antimicrobial prophylaxis.

PMID- 7778822
TI  - Increased nitric oxide in the exhaled air of patients with decompensated liver
      cirrhosis.
AB  - OBJECTIVE: To determine if nitric oxide output in exhaled air is increased in
      patients with liver cirrhosis. DESIGN: Cross-sectional study. SETTING: A
      university hospital. PATIENTS: 50 patients with liver cirrhosis, 6 patients with
      chronic hepatitis, and 15 healthy controls. MEASUREMENTS: Nitric oxide in exhaled
      air was measured using a chemiluminescence analyzer. Cardiac index was determined
      using echocardiography. RESULTS: Patients with decompensated liver cirrhosis had
      higher levels of exhaled nitric oxide output (Child C patients, 190 +/- 11 nL/min
      per m2 body surface area) than controls (97 +/- 8 nL/min per m2 body surface
      area; P < 0.001), whereas patients with compensated liver cirrhosis or chronic
      hepatitis had levels of nitric oxide output similar to those found in controls.
      Cardiac index was greater in patients with liver cirrhosis (Child C patients, 4.3
      +/- 0.3 L/min per m2 body surface area) than in controls (2.9 +/- 0.2 L/min per
      m2 body surface area; P < 0.001). Cardiac index correlated with nitric oxide
      levels (r = 0.621; P < 0.001). CONCLUSIONS: Increased nitric oxide output in
      exhaled air is associated with systemic circulatory disturbances in patients with
      liver cirrhosis.

PMID- 7778821
TI  - Plasma metanephrines in the diagnosis of pheochromocytoma.
AB  - OBJECTIVE: To examine whether tests for plasma metanephrines, the o-methylated
      metabolites of catecholamines, offer advantages for diagnosis of a
      pheochromocytoma over standard tests for plasma catecholamines or urinary
      metanephrines. DESIGN: Cross-sectional study. SETTING: 3 clinical specialist
      centers. PATIENTS: 52 patients with a pheochromocytoma; 67 normotensive persons
      and 51 patients with essential hypertension who provided reference values; and 23
      patients with secondary hypertension and 50 patients with either heart failure or
      angina pectoris who served as comparison groups. MEASUREMENTS: Plasma
      concentrations of catecholamines (norepinephrine and epinephrine) and
      metanephrines (normetanephrine and metanephrine) were measured in all patients.
      The 24-hour urinary excretion of metanephrines was measured in 46 patients with
      pheochromocytoma. RESULTS: Pheochromocytomas were associated with increases in
      plasma concentrations of metanephrines that were greater and more consistent than
      those in plasma catecholamine concentrations. No patient with a pheochromocytoma
      had normal plasma concentrations of both normetanephrine and metanephrine. The
      sensitivity of these tests was 100% (52 of 52 patients [95% CI, 94% to 100%]),
      and the negative predictive value of normal plasma concentrations of
      metanephrines was 100% (162 of 162 patients). Tests for plasma catecholamines
      yielded eight false-negative results and a sensitivity of 85% (44 of 52 patients
      [CI, 72% to 93%]). The negative predictive value of normal plasma concentrations
      of catecholamines was 95% (156 of 164 patients). Tests for urinary metanephrines
      yielded five false-negative results and a sensitivity of 89% (41 of 46 patients
      [CI, 76% to 96%]). Because no statistical difference was noted in the number of
      false-positive results between tests for plasma metanephrines (15%) and tests for
      plasma catecholamines (18%), the specificities of the two tests did not differ.
      CONCLUSIONS: Normal plasma concentrations of metanephrines exclude the diagnosis
      of pheochromocytoma, whereas normal plasma concentrations of catecholamines and
      normal urinary excretion of metanephrines do not. Tests for plasma metanephrines
      are more sensitive than tests for plasma catecholamines or urinary metanephrines
      for the diagnosis of pheochromocytoma.

PMID- 7778823
TI  - Hemodynamically significant extrinsic left atrial compression by gastric
      structures in the mediastinum.

PMID- 7778824
TI  - Cardiovascular problems in pregnant women with the Marfan syndrome.
AB  - PURPOSE: To review the available information on the diagnostic, prognostic, and
      therapeutic aspects of cardiac complications in women with the Marfan syndrome
      during the peripartum period and to develop guidelines for the approach to these
      patients on the basis of this information. DATA SOURCES: A MEDLINE search and a
      manual search of bibliographies from reviewed articles. STUDY SELECTION AND DATA
      EXTRACTION: Articles that reported on pregnancy in patients with the Marfan
      syndrome or that discussed potentially relevant aspects of the syndrome. RESULTS:
      Pregnancy in the Marfan syndrome is associated with two primary problems:
      potential catastrophic aortic dissection and the risk for having a child with the
      syndrome. The risk for peripartum aortic dissection is especially high in women
      in whom aortic root dilatation is diagnosed before pregnancy. Gestation seems to
      be safer in women without preexisting cardiovascular disease; however, an event
      free pregnancy cannot be guaranteed. The Marfan syndrome is inherited in an
      autosomal dominant manner, and the fetus has a 50% risk for inheriting the mutant
      gene. CONCLUSIONS: Women with the syndrome should be counseled before conception
      about the risks of pregnancy to both mother and fetus. Because preconceptual
      dilatation of the ascending aorta seems to be an important predictor for aortic
      dissection, it should be excluded before pregnancy. Transesophageal
      echocardiography seems to be preferable for noninvasive assessment of aortic
      dilatation before and during pregnancy. Prophylactic use of beta-blockers may be
      useful in preventing aortic dilatation. Surgery should be considered during
      gestation in patients with progressive aortic dilatation when or before the
      aortic root reaches 5.5 cm. Because of the potential risk of ionizing radiation
      to the fetus, noninvasive methods such as transesophageal echocardiography and
      magnetic resonance imaging are preferred to contrast aortography for the
      diagnosis of aortic dissection during pregnancy. Vaginal delivery can be done in
      patients with the Marfan syndrome who do not have cardiovascular system
      abnormalities. In patients with aortic dilatation, aortic dissection, or other
      important cardiac abnormalities, cesarean section should be the preferred method
      of delivery.

PMID- 7778825
TI  - Medical resources on the Internet.
AB  - Advances in telecommunications technology in the last decade have fostered the
      development of computer networks that allow access to vast amounts of information
      and services. Of the many computer networks that have been developed, the most
      prominent is the Internet. Originally intended to be a way to share computing
      resources among academic and research institutions in the United States, the
      Internet has gradually evolved into a worldwide network of computers that
      provides various services reflecting the eclectic nature of its component
      networks. The recent upsurge in interest in the Internet is due to several
      mutually reinforcing factors: increased ease and availability of access to the
      Internet, lower access charges, faster communications, and more organizations
      offering commercial and noncommercial services over the Internet. Of particular
      interest to the medical community is the large and increasing number of
      technical, scientific, and biomedical resources that can be accessed through the
      Internet. Most large medical centers have publicly accessible information, and
      some large organizations, such as the National Institutes of Health, have
      extensive databases and services that can be used by medical researchers,
      clinicians, and educators. In addition, many medical organizations and some
      medical journals are advertising their services over the Internet and can be
      contacted through electronic mail. As the cost of telecommunications decreases
      and the speed of telecommunications increases, new forms of computer
      communication, such as long-distance, real-time audio, and video services will
      become available. Computer networks in general and the Internet in particular are
      likely to play more important roles in many aspects of medicine in the future.

PMID- 7778826
TI  - Azathioprine and 6-mercaptopurine in Crohn disease. A meta-analysis.
AB  - PURPOSE: To assess the effectiveness of azathioprine and 6-mercaptopurine in
      inducing remission of active Crohn disease and the effectiveness of azathioprine
      in maintaining remission of quiescent disease. DATA SOURCES: Pertinent studies
      were selected from the MEDLINE database (1966 to May 1994), abstracts from major
      gastrointestinal meetings, and references from published articles and reviews.
      STUDY SELECTION: Nine randomized, placebo-controlled trials of azathioprine or 6
      mercaptopurine therapy were identified: Four addressed active disease, two
      addressed quiescent disease, and three had multiple therapeutic arms. DATA
      EXTRACTION: Data were extracted by three independent observers on the basis of
      the intention-to-treat principle and were analyzed with logistic regression. Each
      study was given a quality score on the basis of predetermined criteria. DATA
      SYNTHESIS: Compared with placebo, azathioprine or 6-mercaptopurine therapy had an
      odds ratio of response of 3.09 (95% CI, 2.45 to 3.91) in patients with active
      Crohn disease. When the single trial that used 6-mercaptopurine in active disease
      was excluded from the analysis, the odds ratio of response was 1.45 (CI, 1.12 to
      1.87). No trials of quiescent disease used 6-mercaptopurine; the odds ratio of
      response in these trials of quiescent disease was 2.27 (CI, 1.76 to 2.93). For
      active disease, continuation of therapy for at least 17 weeks improved response
      (P = 0.03). For quiescent disease, a higher dose improved response (P = 0.008).
      Increased cumulative dose improved response in both groups (P < 0.001 for active
      disease and P = 0.01 for quiescent disease). A steroid-sparing effect was seen in
      active disease (odds ratio, 3.69 (CI, 2.12 to 6.42) and in quiescent disease
      (odds ratio, 4.64 [CI, 1.00 to 21.54]). Fistulae improved with therapy (odds
      ratio, 4.44 [CI, 1.50 to 13.20]). Adverse events requiring withdrawal from a
      trial, primarily allergy, leukopenia, pancreatitis, and nausea, were increased
      with therapy (odds ratio, 5.26 [CI, 2.20 to 12.60]). CONCLUSIONS: Azathioprine
      and 6-mercaptopurine are effective in treating active Crohn disease and in
      maintaining remission. Cumulative dose was an important factor in predicting
      response. Adverse effects were more common among patients receiving therapy.

PMID- 7778827
TI  - Esophageal ulceration in human immunodeficiency virus infection. Causes, response
      to therapy, and long-term outcome.
AB  - OBJECTIVE: To determine the causes of esophageal ulceration, the response rate to
      currently available therapies, and the long-term outcome in patients with human
      immunodeficiency virus (HIV) infection. DESIGN: Prospective cohort study.
      SETTING: An urban county hospital. PATIENTS: Consecutive patients with HIV
      infection and endoscopically detected esophageal ulceration during a 4-year
      period. INTERVENTION: Causes of ulcers were determined from clinical, endoscopic,
      and pathologic findings. Standard medical therapies for the identified causes
      were instituted, and ulcer healing was endoscopically confirmed when possible.
      MEASUREMENTS: Symptomatic and endoscopic response to therapy and long-term
      outcome, including survival. RESULTS: 100 patients with esophageal ulcer were
      identified. Ulcers caused by cytomegalovirus alone were the most common (n = 45);
      idiopathic ulcers were almost as frequent (n = 40). Herpes simplex virus
      esophagitis alone was identified as a cause in only 5 patients. Several potential
      causes of ulcer were found in 5 patients, including Candida esophagitis in 27
      patients. Ten patients developed more than one cause of ulceration during long
      term follow-up. Eighty-five patients had specific medical therapy for their
      identified disorders and had an overall response rate of 98%. Median survival
      from time of diagnosis was 8.9 months (range, 2 days to > 42 months). A
      difference in median survival was found between patients with cytomegalovirus
      esophagitis and those with idiopathic esophageal ulcer (7.6 months compared with
      13.1 months; P = 0.03). CONCLUSIONS: Given 1) the broad spectrum of causes of
      esophageal ulceration, 2) that each of these causes requires specific therapy,
      and 3) the apparent high response rate, it is important to do endoscopic
      evaluation with mucosal biopsy in patients with HIV infection so that a diagnosis
      can be established and appropriate therapy instituted. Despite effective therapy,
      long-term survival is poor; however, long-term remission and survival may occur
      in some patients.

PMID- 7778828
TI  - Searching for pheochromocytoma: a new and better test?

PMID- 7778829
TI  - Internet-based medical information: time to take charge.

PMID- 7778831
TI  - Clarithromycin therapy for Mycobacterium avium complex bacteremia.

PMID- 7778830
TI  - Clarithromycin therapy for Mycobacterium avium complex bacteremia.

PMID- 7778832
TI  - Treatment of the hypereosinophilic syndrome with interferon-alpha.

PMID- 7778833
TI  - The future general internist.

PMID- 7778835
TI  - The future general internist.

PMID- 7778834
TI  - The future general internist.

PMID- 7778836
TI  - The future general internist.

PMID- 7778837
TI  - The future general internist.

PMID- 7778838
TI  - Revised formula for study meal.

PMID- 7778839
TI  - Chronic fatigue and the chronic fatigue syndrome: prevalence in a Pacific
      Northwest health care system.
AB  - OBJECTIVES: To investigate the point prevalence of the chronic fatigue syndrome
      and unexplained debilitating chronic fatigue in a community-based sample of
      persons and to describe demographic, clinical, and psychosocial differences among
      those with the chronic fatigue syndrome, those with chronic fatigue, and healthy
      controls. DESIGN: Prospective cohort study. SETTING: A health maintenance
      organization in Seattle, Washington. PARTICIPANTS: A random sample of 4000
      members of the health maintenance organization was surveyed by mail for the
      presence of chronic fatigue. MEASUREMENTS: Persons with chronic fatigue were
      evaluated using a questionnaire that requested information about medical history
      and fatigue and related symptoms; validated measures of functional status and
      psychological distress; a physical examination; and standardized blood tests. A
      structured psychiatric interview was done in persons who appeared to meet the
      original Centers for Disease Control and Prevention (CDC) criteria for the
      chronic fatigue syndrome. Participants completed self-report measures at 12 and
      24 months. Those with chronic fatigue were reevaluated in person 1 year after
      study enrollment. RESULTS: 3066 (77%) of the 4000 members surveyed responded.
      Chronic fatigue was reported by 590 persons (19%). Of these, 388 (66%) had a
      medical or psychiatric condition that could account for the fatigue. Of the 74
      persons (37%) with chronic fatigue who were enrolled in the study, only 3 met the
      CDC criteria for the chronic fatigue syndrome. The remaining 71 persons were
      designated as having chronic fatigue alone. Seventy-four healthy, age- and sex
      matched controls who were drawn from the same sample but who denied having
      chronic fatigue were also studied. Demographic characteristics were similar in
      persons with the chronic fatigue syndrome, persons with chronic fatigue alone,
      and controls. Those with the chronic fatigue syndrome or chronic fatigue alone
      had more frequent cervical and axillary adenopathy, poorer functional status, and
      greater psychological distress than controls. Women and minorities were not
      overrepresented among cases with chronic fatigue. CONCLUSIONS: Using different
      assumptions about the likelihood that persons who did not participate in the
      study had the chronic fatigue syndrome, the estimated crude point prevalence of
      the syndrome in this community ranged from 75 to 267 cases per 100,000 persons.
      The point prevalence of chronic fatigue alone was strikingly higher; it ranged
      from 1775 to 6321 cases per 100,000 persons.

PMID- 7778841
TI  - Stool composition in factitial diarrhea: a 6-year experience with stool analysis.
AB  - OBJECTIVE: To evaluate the utility of stool water analysis in the management of
      patients with chronic diarrhea. DESIGN: Retrospective analysis of 6 years of
      experience. SETTING: A specialized laboratory in a major referral center.
      PATIENTS: 325 patients with diarrhea who were referred for stool chemistry
      analysis. Fecal analysis was requested by many internists and
      gastroenterologists. Patient records were reviewed to establish the final and
      most likely cause of diarrhea. RESULTS: One third of patients provided samples
      that were inappropriate for analysis, but data from 202 persons were available.
      The usefulness of the general separation of cases of chronic diarrhea into those
      in which patients had predominantly osmotic pathophysiologies and those in which
      patients had predominantly secretory pathophysiologies was confirmed, but overlap
      and intra-individual variability limited the usefulness of this approach in
      individual patients. Thirty-five patients (17%) had a diagnosis of factitial
      diarrhea (30 because of laxative use and 5 because of fluid added to stools).
      CONCLUSIONS: Among selected subpopulations, the chemical analysis of fresh stools
      has a role in the evaluation of obscure examples of chronic diarrhea. It is
      especially useful in identifying factitial diarrhea.

PMID- 7778840
TI  - Famciclovir for the treatment of acute herpes zoster: effects on acute disease
      and postherpetic neuralgia. A randomized, double-blind, placebo-controlled trial.
      Collaborative Famciclovir Herpes Zoster Study Group.
AB  - OBJECTIVE: To document the effects of treatment with famciclovir on the acute
      signs and symptoms of herpes zoster and postherpetic neuralgia. DESIGN: A
      randomized, double-blind, placebo-controlled, multicenter trial. SETTING: 36
      centers in the United States, Canada, and Australia. PATIENTS: 419
      immunocompetent adults with uncomplicated herpes zoster. INTERVENTION: Patients
      were assigned within 72 hours of rash onset to famciclovir, 500 mg; famciclovir,
      750 mg; or placebo, three times daily for 7 days. MEASUREMENTS: Lesions were
      assessed daily for as long as 14 days until full crusting occurred and then
      weekly until the lesions healed. Viral cultures were obtained daily while
      vesicles were present. Pain was assessed at each of the visits at which lesions
      were examined and then monthly for 5 months after the lesions healed. Safety was
      assessed throughout the study. RESULTS: Famciclovir was well tolerated, with a
      safety profile similar to that of placebo. Famciclovir accelerated lesion healing
      and reduced the duration of viral shedding. Most importantly, famciclovir
      recipients had faster resolution of postherpetic neuralgia (approximately twofold
      faster) than placebo recipients; differences between the placebo group and both
      the 500-mg famciclovir group (hazard ratio, 1.7 [95% CI, 1.1 to 2.7]) and the 750
      mg famciclovir group (hazard ratio, 1.9 [CI, 1.2 to 2.9]) were statistically
      significant (P = 0.02 and 0.01, respectively). The median duration of
      postherpetic neuralgia was reduced by approximately 2 months. CONCLUSIONS: Oral
      famciclovir, 500 mg or 750 mg three times daily for 7 days, is an effective and
      well-tolerated therapy for herpes zoster that decreases the duration of the
      disease's most debilitating complication, postherpetic neuralgia.

PMID- 7778842
TI  - Lyme neuroborreliosis.
AB  - Neuroborreliosis, an infection of the nervous system caused by spirochetes of the
      genus Borrelia, has achieved worldwide attention in the last decade as part of
      the clinical spectrum of Lyme disease. This disorder, caused by Borrelia
      burgdorferi, has increased in incidence to become the most frequent arthropod
      borne infection in North America and Europe. As a result of this rapid rise in
      incidence and of its protean neurological manifestations, this disease has
      created an important challenge to modern neurology. The diverse manifestations of
      neuroborreliosis require that it be included in the differential diagnosis of
      many neurological disorders. This review takes a chronological approach to
      clinical neuroborreliosis to summarize its most important aspects. The
      limitations as well as the benefits of laboratory diagnosis are also considered,
      with the aim of providing assistance in this area. Recent advances in
      neuroimmunology regarding the pathogenesis of neuroborreliosis that may elucidate
      its protean clinical spectrum are summarized.

PMID- 7778843
TI  - Magnetic stimulation over the cerebellum in humans.
AB  - Magnetic stimulation performed with a double-cone coil placed over appropriate
      positions on the back of the head reduced the size of electromyographic responses
      evoked by magnetic cortical stimulation in the first dorsal interosseous muscle
      when it preceded the cortical stimulus by 5, 6, and 7 msec. No suppression of
      responses to electrical cortical stimulation occurred. Greater suppression was
      evoked by stronger cerebellar stimuli; lesser suppression was elicited by
      stronger cortical stimuli. These physiological findings correspond to those
      obtained with electrical cerebellar stimulation. The most effective position for
      magnetic stimulation over the back of the head was slightly rostral to the
      foramen magnum level on the ipsilateral side of the muscle studied. This
      indicates that the conditioning stimulus activates certain structures at the back
      of the head on the ipsilateral side of the muscle, consistent with the
      cerebellum, because the part of the cerebellum regulating limb muscles is
      positioned about there on the ipsilateral side. In 2 patients with only
      cerebellar dysfunction, this suppression effect was not elicited, which also
      supports that the suppression is caused by activity in cerebellar structures. We
      conclude that magnetic stimulation over the cerebellum with a double-cone coil
      elicits the same suppressive effect on the motor cortex as electrical
      stimulation, but with less discomfort; moreover, we believe that this effect is
      produced by activation of certain cerebellar structures.

PMID- 7778845
TI  - Recovery from Wernicke's aphasia: a positron emission tomographic study.
AB  - Changes in the organization of the brain after recovery from aphasia were
      investigated by measuring increases in regional cerebral blood flow (rCBF) during
      repetition of pseudowords and during verb generation. Six right-handed patients
      who had recovered from Wernicke's aphasia caused by an infarction destroying the
      left posterior perisylvian language zone were compared with 6 healthy, right
      handed volunteers. In the control subjects, strong rCBF increases were found in
      the left hemisphere in the posterior part of the superior and middle temporal
      gyrus (Wernicke's area), and during the generation task in lateral prefrontal
      cortex (LPFC) and in inferior frontal gyrus (Broca's area). There were some weak
      right hemisphere increases in superior temporal gyrus and inferior premotor
      cortex. In the patients, rCBF increases were preserved in the frontal areas.
      There was clear right hemisphere activation in superior temporal gyrus and
      inferior premotor and lateral prefrontal cortices, homotopic to the left
      hemisphere language zones. Increased left frontal and right perisylvian activity
      in patients with persisting destruction of Wernicke's area emphasizes
      redistribution of activity within the framework of a preexisting, parallel
      processing and bilateral network as the central mechanism in functional
      reorganization of the language system after stroke.

PMID- 7778844
TI  - Low platelet mitochondrial complex I and complex II/III activity in early
      untreated Parkinson's disease.
AB  - Following the discovery of inhibition of electron transport complex 1 by the
      neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), which produces a
      parkinsonian syndrome in humans, monkeys, and mice, several laboratories have
      reported abnormalities of complex I and other electron transport complexes (ETCs)
      in various tissues from patients with Parkinson's disease (PD). Criticism of the
      significance of these findings in the etiology of PD has centered on whether drug
      treatments or the debilitation of the disease process itself produced the low ETC
      activities. We present results from a blinded study of platelet mitochondrial ETC
      activities in 18 early untreated PD patients and 18 age- and sex-matched controls
      and in 13 spousal controls. Lower complex I activity in platelet mitochondria of
      PD patients was seen in early untreated disease and thus cannot be due to
      debilitation or drug therapy. Home environmental factors seem an unlikely
      explanation for the reduced complex I activity in PD patients but have not been
      excluded. Complex II/III activity was also reduced by 20% in PD compared with age
      /sex-matched controls. The low complex I and II/III activities in platelet
      mitochondria appear to be related to the etiology of PD.

PMID- 7778846
TI  - First seizures associated with playing electronic screen games: a community-based
      study in Great Britain.
AB  - Active surveillance by virtually all electroencephalographic departments
      throughout Great Britain identified 118 patients who had a first seizure while
      playing an electronic screen game during two 3-month periods. Patients were
      divided into Group A (46 patients)--those for whom there was thought to be a
      definite causal relationship (type 4 photoparoxysmal response); Group B (25
      patients)--those for whom there was a probable causal relationship (types 1-3
      photoparoxysmal response, clinical evidence of photosensitivity, subsequent
      recurrent seizures on repeat exposure to electronic screen games, and/or
      occipital spikes in the resting electroencephalogram); and Group C (47 patients)-
      those for whom there was no apparent causal relationship. The number of patients
      in Group C did not exceed that expected by the chance occurrence of two common
      events (playing electronic screen games and incidence of epilepsy). Most
      (103/118) of the patients were in the age range of 7 to 19 years. Within this age
      group the annual incidence of first seizures triggered by playing electronic
      screen games (Groups A and B combined) was estimated to be 1.5/100,000.

PMID- 7778847
TI  - Comparison of ictal SPECT and interictal PET in the presurgical evaluation of
      temporal lobe epilepsy.
AB  - We retrospectively compared ictal technetium 99m hexamethylpropyleneamineoxime
      single-photon emission computed tomography (SPECT) and interictal 18F
      fluorodeoxyglucose positron emission tomography (PET) in 35 patients with well
      lateralized temporal lobe epilepsy (TLE). Based on SPECT scans the two observers
      correctly lateralized seizure foci with certainty in 89% of patients;
      interobserver agreement was excellent. Both observers incorrectly lateralized the
      seizure focus on two SPECT scans; one error was explained by rapid
      electroencephalographic spread to the contralateral side and for the other
      patient, isotope was injected during a brief aura. Based on PET scans, observers
      correctly lateralized the foci with certainty in 63% and with lesser confidence
      in 83%; four incorrect lateralizations were made by one observer and none by the
      other. PET interobserver disagreement was explained by differences between
      observers in weighting the relative hypometabolism in medial and lateral temporal
      regions. The detection rate for PET was lower in the absence of structural
      imaging abnormalities (60 vs 87%). PET yielded correct lateralizations in the 2
      patients for whom SPECT interpretation was difficult. We conclude that both ictal
      SPECT and interictal PET are sensitive methods for the lateralization of TLE, but
      SPECT can be interpreted with greater certainty and is more sensitive when
      magnetic resonance imaging findings are negative. False lateralization is rare
      with ictal SPECT and can be explained when interpreted in conjunction with
      electroclinical data. Both investigations have complementary roles when
      localization is difficult.

PMID- 7778848
TI  - Motor reorganization in acquired hemidystonia.
AB  - Regional cerebral blood flow (rCBF) was measured with H2(15)O positron emission
      tomography in 5 patients with acquired hemidystonia (AHD) due to structural
      lesions of the basal ganglia or posterior thalamus contralateral to the dystonic
      limb. Patients were scanned at rest and when performing paced joystick movements
      in freely chosen directions with the dystonic and then the unaffected arm.
      Findings were compared with those of 5 age-matched controls performing joystick
      movements with the right arm. At rest, there was decreased activity in
      ventroanterior thalamus, posterior thalamus, angular gyrus ipsilateral to the
      lesion, and bilateral frontoorbital cortex. At a similar level of significance,
      increased resting activity was found in lentiform nucleus, hippocampus, and
      anterior insula contralateral to the lesion. Using the affected arm, AHD cases
      showed significant overactivity of contralateral prefrontal, lateral premotor
      cortex, rostral supplementary motor area, anterior cingulate area 32, bilateral
      sensorimotor cortex (SMC) and insula, mesial parietal cortex, and ipsilateral
      cerebellum. There was similar frontal overactivity when the unaffected arm
      performed the joystick movements, though SMC and insula overactivity was
      contralateral rather than bilateral. The associated frontal overactivity on
      movement is consistent with acquired dystonia being a syndrome of thalamofrontal
      disinhibition due to structural disruption of basal ganglia inhibitory control.
      Our findings also suggest that cortical activation during movement of the
      unaffected limb is abnormal in acquired hemidystonia.

PMID- 7778849
TI  - Expression of heme oxygenase-1 in the senescent and Alzheimer-diseased brain.
AB  - Heme oxygenase-1 is a cellular stress protein expressed in brain and other
      tissues in response to oxidative challenge and other noxious stimuli. Using
      immunohistochemistry and immunofluorescent labeling in conjunction with laser
      scanning confocal microscopy, we observed intense immunoreactivity of heme
      oxygenase-1 in neurons of the hippocampus and temporal cortex of Alzheimer
      diseased (AD) brain relative to age-matched control specimens. Furthermore, we
      demonstrated consistent colocalization of heme oxygenase-1 to glial fibrillary
      acidic protein-positive astrocytes, neurofibrillary tangles, and senile plaques
      in the AD specimens. In AD hippocampus, approximately 86% of glial fibrillary
      acidic protein-positive astrocytes expressed heme oxygenase-1, whereas only 6.8%
      of hippocampal astrocytes in normal senescent control specimens were
      immunopositive for heme oxygenase-1 (p < 0.0001). In regions other than the
      hippocampus and neocortex, such as the substantia nigra, the proportion of
      astrocytes expressing heme oxygenase-1 in the experimental group (12.8%) was not
      significantly different from that in the controls (6.4%, p > 0.05). Robust 32-kd
      bands corresponding to heme oxygenase-1 were observed by Western blotting of
      protein extracts derived from AD temporal cortex and hippocampus after sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis. Heme oxygenase-1 bands were
      very faint or absent in protein extracts prepared from control specimens. These
      results indicate that heme oxygenase-1 is significantly overexpressed in neurons
      and astrocytes of AD hippocampus and cerebral cortex relative to control brains.
      Upregulation of heme oxygenase-1 in AD brain supports the contention that the
      affected tissues are experiencing chronic oxidative stress. In addition, the
      excessive generation of carbon monoxide, a metabolite of heme degradation, may
      participate in the pathogenesis of AD.

PMID- 7778850
TI  - Dentatorubral-pallidoluysian atrophy: clinical features are closely related to
      unstable expansions of trinucleotide (CAG) repeat.
AB  - Dentatorubral-pallidoluysian atrophy is an autosomal dominant neurodegenerative
      disease characterized by various combinations of ataxia, choreoathetosis,
      myoclonus, epilepsy, and dementia as well as a wide range of ages at onset. A
      specific unstable trinucleotide repeat expansion in a gene on the short arm of
      chromosome 12 was recently identified as the pathogenic mutation for this
      disease. We investigated how the degree of expansion of the CAG repeat effects
      the clinical manifestations of dentatorubral-pallidoluysian atrophy. The size of
      the expanded alleles was well correlated with the age at onset (r = -0.696, p <
      0.001). Patients with the progressive myoclonus epilepsy phenotype had larger
      expansions (62-79 repeats) and an earlier age at onset (onset before age 21).
      Furthermore, most of the patients with the progressive myoclonus epilepsy
      phenotype inherited their expanded alleles from their affected fathers. On the
      other hand, patients with the non-progressive myoclonus epilepsy phenotype showed
      smaller expansions (54-67 repeats) and a later age at onset (onset at or after
      age 21). Detailed analyses of clinical features demonstrated that ataxia,
      involuntary movement of either myoclonus or choreoathetosis, and intellectual
      decline are cardinal features of dentatorubral-pallidoluysian atrophy, with
      myoclonus and epilepsy being observed more frequently in patients with an earlier
      age at onset. Thus the wide variation in clinical manifestations of dentatorubral
      pallidoluysian atrophy can now be clearly explained based on the degree of CAG
      repeat expansion, which strongly indicates that the expanded alleles are
      intimately involved in the neuronal degeneration in dentatofugal and pallidofugal
      systems.

PMID- 7778851
TI  - Pallidotomy increases activity of motor association cortex in Parkinson's
      disease: a positron emission tomographic study.
AB  - Stereotactic posteroventral pallidotomy can improve motor performance in
      Parkinson's disease. Interruption of inhibitory pallidal projections to
      ventrolateral thalamus, components of a cortical-basal ganglia motor loop allows
      for this clinical benefit. We hypothesized that pallidotomy would lead to
      increased movement related activity in motor cortical areas receiving projections
      from ventrolateral thalamus. This was tested in 6 Parkinson's disease patients
      who underwent stereotactic posteroventral pallidotomy. Each patient was imaged
      with positron emission tomography (PET) measures of regional cerebral blood flow
      (rCBF) during performance of a simple prehension task and at rest. Scans were
      acquired before and 17 weeks after surgery. After pallidotomy, movement-related
      changes of rCBF increased significantly in both the supplementary motor area
      (SMA) and premotor cortex but not in primary motor cortex. The results
      demonstrate the importance of pallidothalamic circuitry for regulating volitional
      movements and confirm that disruption of inhibitory input to the ventrolateral
      thalamus can augment movement-related activity in motor association areas.

PMID- 7778852
TI  - The vasculopathy of varicella-zoster virus encephalitis.
AB  - Varicella-zoster virus (VZV) encephalitis has become more prevalent in the era of
      acquired immunodeficiency syndrome and other immunosuppressive diseases and poses
      diagnostic and therapeutic challenges for clinicians, radiologists, and
      pathologists. Six cases studied at our institutions shed light on the patterns
      and pathogenesis of the disease. VZV encephalitis is predominantly a
      vasculopathy, involving small and large vessels, that generates seizures, mental
      changes, and focal deficits. Brain imaging reveals large and small ischemic or
      hemorrhagic infarcts, often both, of cortex and subcortical gray and white
      matter. Deep-seated white matter lesions often predominate and are ischemic
      and/or demyelinative, depending on the size of blood vessels involved and the
      amount of additional demyelination caused by infection of oligodendrocytes. The
      demyelinative lesions are smaller and less coalescent than those seen in
      progressive multifocal leukoencephalopathy.

PMID- 7778853
TI  - Movement-related cortical potentials preceding repetitive and random-choice hand
      movements in Parkinson's disease.
AB  - The movement-related cortical electroencephalographic potential was recorded from
      scalp electrodes in 8 patients with idiopathic Parkinson's disease studied at
      least 12 hours after withdrawal of their normal drug therapy, and compared with
      the results from a group of 8 age-matched control subjects. Two types of self
      paced voluntary arm movements were examined: repetitive forward movement of a
      joystick, and random-choice movements of the same joystick in which subjects had
      to choose freely the direction in which they were to move the stick (forward,
      backward, left, or right). In normal subjects, the movement-related cortical
      potential was larger prior to random-choice movements, whereas in the patients,
      the amplitude was the same in both tasks. The implication is that processes
      involved in self-selection of movement are abnormal in Parkinson's disease. This
      may contribute to the difficulty that patients have in initiating voluntary
      movement in the absence of any external cues.

PMID- 7778855
TI  - Common variable immunodeficiency and inclusion body myositis: a distinct myopathy
      mediated by natural killer cells.
AB  - Inclusion body myositis developed in two men, 36 and 48 years old with long
      standing common variable immunodeficiency. Immunophenotypic analysis of the
      endomysial cells showed an increased number of natural killer (NK) cells (defined
      as CD57+, CD56+, CD3-, CD8-, CD68-) accounting for 8.5 to 9.5% of the total
      cells, compared with a mean of 1% in sporadic inclusion body myositis. The
      remaining cells were CD8+, macrophages, and CD4+ T cells. NK cells were positive
      for intercellular cell adhesion molecule-1 and invaded muscle fibers negative for
      major histocompatibility complex (MHC) class I. In contrast to ubiquitous
      endomysial expression of MHC class I antigen in sporadic inclusion body myositis,
      the MHC class I in common variable immunodeficiency and inclusion body myositis
      was absent or weakly expressed in only some of the muscle fibers surrounded by
      CD8+ cells. Enteroviral or retroviral RNA sequences were not amplified. Treatment
      with intravenous immunoglobulin improved strength in 1 patient whose repeated
      muscle biopsy specimen showed normal NK cells. We conclude that inclusion body
      myositis can develop in patients with common variable immunodeficiency. Common
      variable immunodeficiency with inclusion body myositis is an immune myopathy
      mediated by NK cells in a non-MHC class I-restricted cytotoxicity, and by CD8+
      cells in an MHC class I-restricted process. This is the first description of an
      inflammatory myopathy in which NK cells participate in the myocytotoxic process.

PMID- 7778854
TI  - Interleukin-6 and interleukin-1 receptor antagonist in acute stroke.
AB  - Elevated plasma levels of interleukin-6 (IL-6), a key regulator of the acute
      phase response that includes increased fibrinogen synthesis, have recently been
      detected in patients with acute stroke. Nevertheless, the role of the acute phase
      response in stroke has been controversial, with some studies suggesting that
      preexisting infection accounts for most of the acute phase response. Increased IL
      6 could signal the involvement of antiinflammatory activity, since IL-6
      stimulates the production of endogenous antiinflammatory mediators such as
      interleukin-1 receptor antagonist (IL-1RA). To better understand the interaction
      of pro- and antiinflammatory acute phase processes in brain infarction, plasma
      levels of IL-1RA, IL-6, and acute phase proteins including fibrinogen and c
      reactive protein (CRP) were measured within 4 +/- 2 days of onset in 50 patients
      with acute ischemic stroke and in 20 age-matched healthy controls. After
      excluding patients with evidence of infection, both IL-1RA and IL-6 were
      significantly elevated in stoke patients compared with controls (p < 0.0001). IL
      1RA and IL-6 were both significantly correlated with levels of CRP, p < 0.05 and
      p < 0.001, respectively, but not with each other. Levels of IL-6 and IL-1RA,
      together with fibrinogen and CRP were higher in patients with infarcts of greater
      than 3 cm and lowest in patients with lacunar syndromes.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7778856
TI  - Encephalopathy with parkinsonian features in children following bone marrow
      transplantations and high-dose amphotericin B.
AB  - Encephalopathy, leukoencephalopathy, and secondary parkinsonism occurred in 3
      children with refractory leukemia undergoing allogenic bone marrow
      transplantation (BMT) who were treated with high-dose amphotericin B for
      pulmonary aspergillosis or sinus aspergillosis that did not involve the nervous
      system. Treatment included high-dose cytosine arabinoside, cyclophosphamide, and
      total body irradiation prior to the BMT. The children developed a progressively
      worsening encephalopathy and parkinsonian features, characterized by resting
      tremor, cogwheel rigidity, and masklike facies. Neuroimaging studies showed
      cerebellar, cerebral, and basal ganglia atrophy, as well as frontal and temporal
      lobe white matter involvement. Two of the 3 patients recovered, although 1 has
      residual intellectual impairment. The third succumbed to non-central nervous
      system Epstein-Barr virus-lymphoproliferative disease and had autopsy-confirmed
      leukoenephalopathy.

PMID- 7778857
TI  - Cephalosporin-induced recurrent aseptic meningitis.
AB  - A 66-year-old woman had several episodes of aseptic meningitis associated with
      exposure to cephalexin, cefazolin, and ceftazidime. The cerebrospinal fluid IgG
      index was elevated, specific IgG-ceftazidime binding was shown, and skin allergy
      testing with cefazolin provoked a recurrence of meningitis. We postulate an acute
      hypersensitivity reaction involving an antigen-specific humoral immune response.

PMID- 7778858
TI  - Studies of the coding region of the neuronal glutamate transporter gene in
      amyotrophic lateral sclerosis.
AB  - Studies of the coding region of the neuronal glutamate transporter of 6
      amyotrophic lateral sclerosis (ALS) patients and 10 controls show an identical
      pattern of four reported amino acid variations. No mutations and polymorphisms
      were detected in 5 sporadic ALS patients and a single patient with the familial
      form of the disease.

PMID- 7778859
TI  - Amarcord.

PMID- 7778861
TI  - Extracellular metabolism of pulmonary surfactant: the role of a new serine
      protease.

PMID- 7778860
TI  - Regulation of pulmonary vascular tone in the perinatal period.

PMID- 7778862
TI  - Chemical regulation of pulmonary airway tone.
AB  - Over the past three years, substantial progress has been made in dissecting out
      the role of each of these individual effector systems, namely, the leukotrienes,
      neuropeptides, and nitrogen oxides. The next major challenge is to understand how
      they function in an integrated fashion.

PMID- 7778864
TI  - Thermal adaptation in biological membranes: is homeoviscous adaptation the
      explanation?

PMID- 7778863
TI  - Endothelium as an endocrine organ.

PMID- 7778865
TI  - Regulation of glucose fluxes during exercise in the postabsorptive state.
AB  - The increase in glucose utilization by the working muscle would lead to
      hypoglycemia were it not accompanied by an increase in hepatic glucose
      production. Although the increase in glucose uptake is normally driven by
      mechanisms that are primarily independent of the action of insulin and other
      hormones, the response of the liver appears to be closely controlled by the
      endocrine system. Although considerable progress has been made in understanding
      the bases for the increases in glucose utilization and production, the means by
      which these two processes are coordinated to form the exercise response are
      unclear (e.g. feedback or central feedforward control). Work intensity affects
      the mechanisms by which glucose fluxes are regulated. For example, during
      moderate-intensity exercise, the glucoregulatory response resembles
      glucoregulation in the basal state in that under both conditions, glucose release
      from the liver is controlled by glucagon and insulin, and blood glucose levels
      are tightly controlled. The response to high-intensity exercise, on the other
      hand, takes on characteristics of the stress response, as described by Cannon
      (13). That is, the catecholamine response increases disproportionately for a
      given increment in work intensity, and glucose levels are no longer closely
      regulated, but increase. The specific factors that turn exercise into stress at
      higher work intensities are not well defined. Determining factors involved in the
      regulation of glucose fluxes are limited in some respects because the body is
      more sensitive than are experimental detection methods to various stimuli
      (glucose, hormones, neurotransmitter release). More complete delineation of
      mechanisms involved in the regulation of glucose fluxes will require the
      development of improved techniques and unique experimental models. The trend in
      the physiological sciences is for more study at the level of the gene. Technical
      limitations will be overcome or circumvented as knowledge of gene regulation and
      the development of genetically engineered animal models provide new avenues with
      which to address basic questions regarding the control of glucose fluxes during
      exercise.

PMID- 7778866
TI  - Inhibin, activin and the female reproductive axis.

PMID- 7778867
TI  - The role of reactive oxygen metabolites in glomerular disease.

PMID- 7778868
TI  - Progression of renal disease and renal hypertrophy.

PMID- 7778869
TI  - Transforming growth factor-beta and angiotensin II: the missing link from
      glomerular hyperfiltration to glomerulosclerosis?
AB  - Both angiotensin II and TGF-beta are key mediators of glomerular and
      tubulointerstitial injury and fibrosis in progressive kidney diseases. It was
      thought that angiotensin II damages the kidney by increasing glomerular
      filtration pressure, whereas autocrine TGF-beta overexpression occurs from
      unidentified mechanisms. Recent studies reveal that angiotensin II is a potent
      inducer of TGF-beta synthesis in a variety of cells and that this mechanism
      exerts important biological effects including extracellular matrix accumulation,
      cell proliferation, and hypertrophy. Because these studies were performed in
      vitro, there is clear evidence that the biological effects were observed
      independently of the vasoconstrictive properties of angiotensin II. Although it
      is difficult to study angiotensin II-mediated effects in vivo without influencing
      systemic and glomerular blood pressure, further studies are needed to evaluate
      the ability of ACE-inhibitors and angiotensin II receptor blockers to suppress
      TGF-beta overexpression in selected models of chronic progressive kidney disease.

PMID- 7778870
TI  - Role of platelet-derived growth factor in renal injury.
AB  - Evidence indicates that PDGF is a major cytokine that impacts on the biology of
      renal cells and the pathogenesis of renal disease. The biologic effects of PDGF
      on cells and tissue, whether contraction, proliferation, matrix expansion, or
      cell migration, can result in beneficial or injurious consequences depending on
      the particular setting. Although expression of PDGF and PDGF receptors is
      required for glomerular development, their overexpression can be detrimental in
      renal disease. The chemotactic and mitogenic effects of PDGF are beneficial in
      recruitment and repopulation by mesangial cells in focal or diffuse necrotizing
      diseases. On the other hand, a sustained proliferative response can be
      detrimental to renal function. There is much to understand about PDGF's role in
      the cytokine network during renal development and renal injury. Understanding the
      mechanism of action of PDGF and, specifically, the signaling molecules transduced
      by the PDGF receptor may lead to the development of new therapeutic strategies to
      offset the detrimental effect of PDGF. Methods of targeting PDGF to hypocellular
      or necrotic areas to effect tissue remodeling and repair are a desirable goal
      (28). On the other hand, promotion of fibroblast proliferation and smooth muscle
      cell proliferation is a detrimental effect of PDGF that contributes to
      interstitial and perhaps periglomerular fibrosis as well as atherosclerosis.
      Ultimately, understanding the role of PDGF and other cytokines in renal
      development and organogenesis will provide the means to treat glomerular
      pathology without residual scarring.

PMID- 7778871
TI  - Physiologic mechanisms of postischemic tissue injury.

PMID- 7778872
TI  - Molecular pathology of the skeletal muscle sodium channel.

PMID- 7778873
TI  - The multifunctional calcium/calmodulin-dependent protein kinase: from form to
      function.

PMID- 7778874
TI  - Proteins and temperature.

PMID- 7778875
TI  - Mechanisms of activation of glutamate receptors and the time course of excitatory
      synaptic currents.

PMID- 7778876
TI  - Physiological diversity of nicotinic acetylcholine receptors expressed by
      vertebrate neurons.

PMID- 7778877
TI  - In defense of the oral cavity: structure, biosynthesis, and function of salivary
      mucins.

PMID- 7778878
TI  - The hydrophobic barrier properties of gastrointestinal mucus.
AB  - Impressive evidence has accumulated over the past 12 years indicating that one of
      the potentially important biophysical characteristics of mucus relates to its
      hydrophobic character. This surface property is region specific and reaches high
      values in the stomach and colon, where barrier properties against noxious agents
      in the lumen are most important. The hydrophobic properties of mucus appear to be
      related to its lipidic constituents and specifically to the presence of
      phospholipid surfactants that are synthesized, stored, and secreted by GI mucus
      cells in a regulated fashion.

PMID- 7778879
TI  - Signal transduction, packaging and secretion of mucins.

PMID- 7778880
TI  - Epithelial mucin genes.
AB  - The last seven years have been exciting in the world of mucin biology. Molecular
      analyses of mucin genes and deduced protein structures have provided insight into
      structural features of mucins and tools with which to examine expression,
      secretion, and glycosylation, thereby enabling a better understanding of the role
      of mucins in normal physiological processes and in disease. Functional studies
      are in progress both in vitro using cDNAs and cell lines and in vivo utilizing
      mutant mice in which a particular mucin gene has been inactivated or
      overexpressed. These studies should help determine whether the functions of
      mucins are restricted to protection and lubrication, or if they are involved in
      the adhesion of tumor cells to other cells or tissue components or in modulation
      of the immune system.

PMID- 7778881
TI  - Mucin biophysics.

PMID- 7778882
TI  - The evolution of endothermy in mammals and birds: from physiology to fossils.

PMID- 7778883
TI  - Cell biology of atherosclerosis.
AB  - The process of atherosclerosis is a life-threatening disease that affects
      critical organs including the heart and brain. It results from the influence of
      noxious agents associated with hyperlipidemia, hypertension, diabetes, cigarette
      smoking, homocysteinemia, and other agents that may, in altering the homeostatic
      condition of the artery wall, injure the endothelium and smooth muscle. The
      result is a protective, inflammatory, fibroproliferative response that becomes
      excessive and in its excess results in the disease process we call
      atherosclerosis.

PMID- 7778884
TI  - Angiotensin-converting enzyme inhibition and ventricular remodeling after
      myocardial infarction.

PMID- 7778885
TI  - Traffic signals on endothelium for lymphocyte recirculation and leukocyte
      emigration.

PMID- 7778886
TI  - Leukocyte traffic in the lung.

PMID- 7778887
TI  - Collaborative development of middle-range nursing theories: toward a theory of
      unpleasant symptoms.
AB  - One promising approach to strengthening theory-research and theory-practice
      linkages is to place greater emphasis on developing and using theories of the
      middle range to underpin nursing research and practice. In this article, a
      postpositivistic definition of middle-range theory is advanced, an argument is
      made for shifting nursing's theory development activities from discipline
      defining grand theories to middle-range theories, and a collaborative and
      incremental approach to middle-range theory development is described and
      illustrated. A sustained substantive example is provided by the beginning
      development of a theory of unpleasant symptoms.

PMID- 7778888
TI  - Evolution of a grounded theory: conflict resolution through culture brokering.
AB  - This article describes the evolution of the middle-range substantive theory of
      culture brokering. The theory was generated by first conducting a concept
      analysis that yielded 12 attributes of the concept of culture brokering. The
      concept analysis was accomplished using the anthropology, health-related, and
      business literature. In addition, data from an interpretive ethnographic study
      were used to further develop the concept of culture brokering. The theory was
      then generated from four grounded theory studies. Each study was used to frame
      the grounded theory model and to strengthen and refine the categories and links
      between categories within the basic social process of culture brokering. The
      culture brokering theory can guide the practice of nurses in situations where
      conflict is present in the health care interaction. The theory is grounded in the
      experiences of nurses attempting conflict resolution in the context of health
      care interactions.

PMID- 7778889
TI  - Exploring the theoretical basis of nursing using advanced techniques of concept
      analysis.
AB  - In this article, the traditional methods of concept development are critiqued,
      and alternative methods that use qualitative methods of inquiry are presented.
      Variations of concept development techniques appropriate to the maturity of the
      concept being explored are then described, including methods for concept
      delineation, concept comparison, concept clarification, concept correction, and
      concept identification. To illustrate the application of concept development
      methods to nursing theory, a research program to delineate the construct of
      comfort is described.

PMID- 7778890
TI  - Casuistry, care, compassion, and ethics data analysis.
AB  - Traditional approaches to descriptive ethics data analysis do not explicate the
      nature of ethical dilemmas in critical care and emergency nursing. Using
      sensitizing concepts of causes of nurse compassion, 168 stories of ethical
      dilemmas were categorized. They were analyzed from the theoretical perspective of
      an ethic of care using casuistry. Paradigm cases for each sensitizing concept
      were constructed. The nature of ethical dilemmas is in the disparity between
      actual and ideal nursing practice.

PMID- 7778892
TI  - A treatise on nursing knowledge development for the 21st century: beyond
      postmodernism.
AB  - This article explicates a framework for nursing knowledge development that
      incorporates both modernist and postmodernist philosophies. The framework derives
      from an "open philosophy" of science, which links science, philosophy, and
      practice in development of nursing knowledge. A neomodernist perspective is
      proposed that upholds modernist values for unified conceptualizations of nursing
      reality while recognizing the dynamic and value-laden nature of all levels of
      theory and metatheory. It is proposed that scientific inquiry extend beyond the
      postmodern critique to identify nursing metanarratives of nursing philosophy and
      nursing practice that serve as external correctives in the critique process.
      Philosophic positions related to the science, philosophy, and practice domains
      are put forth for continued dialogue about future directions for knowledge
      development in nursing.

PMID- 7778891
TI  - Consciousness raising in participatory research: method and methodology for
      emancipatory nursing inquiry.
AB  - Nursing practice and research that are grounded in emancipatory inquiry challenge
      the inequalities and injustices that affect health in this society. Increasing
      numbers of nurse scholars have explored the use of emancipatory inquiries
      (particularly feminist theory and critical theory) as philosophic bases for
      nursing practice and as theoretical or methodologic perspectives for nursing
      research. This article presents participatory research as a methodology and
      consciousness raising as a method for nursing research that addresses the
      emancipatory goals of feminist and critical theories. An example of consciousness
      raising in a participatory nursing research project is offered. It is argued that
      participatory research can produce a revolutionary emancipatory knowledge for the
      future of nursing and health care.

PMID- 7778894
TI  - Expression of the pCloDF13 encoded bacteriocin release protein or its stable
      signal peptide causes early effects on protein biosynthesis and Mg2+ transport.
AB  - The effect of the pCloDF13 encoded bacteriocin release protein (BRP) on
      Escherichia coli cell lethality was studied. Induction of the BRP resulted in a
      strong inhibition of the incorporation of radioactive labeled amino acids and
      affected the transport of Mg2+ ions. Similar effects were obtained when the BRP
      stable signal peptide was expressed as a separate entity. Kinetic studies
      revealed that these effects occurred prior to quasi-lysis and release of cloacin
      DF13. The results indicated that the BRP induced cell lethality is caused by
      early effects on protein synthesis and Mg2+ transport, due to the accumulation of
      stable BRP signal peptides in the cytoplasmic membrane.

PMID- 7778893
TI  - Effects of growth conditions on mitochondrial morphology in Saccharomyces
      cerevisiae.
AB  - Effects of growth conditions on mitochondrial morphology were studied in living
      Saccharomyces cerevisiae cells by vital staining with the fluorescent dye
      dimethyl-aminostyryl-methylpyridinium iodine (DASPMI), fluorescence microscopy,
      and confocal-scanning laser microscopy. Cells from respiratory, ethanol-grown
      batch cultures contained a large number of small mitochondria. Conversely, cells
      from glucose-grown batch cultures, in which metabolism was respiro-fermentative,
      contained small numbers of large, branched mitochondria. These changes did not
      significantly affect the fraction of the cellular volume occupied by the
      mitochondria. Similar differences in mitochondrial morphology were observed in
      glucose-limited chemostat cultures. In aerobic chemostat cultures, glucose
      metabolism was strictly respiratory and cells contained a large number of small
      mitochondria. Anaerobic, fermentative chemostat cultivation resulted in the
      large, branched mitochondrial structures also seen in glucose-grown batch
      cultures. Upon aeration of a previously anaerobic chemostat culture, the maximum
      respiratory capacity increased from 10 to 70 mumole.min-1.g dry weight-1 within
      10 h. This transition resulted in drastic changes of mitochondrial number,
      morphology and, consequently, mitochondrial surface area. These changes continued
      for several hours after the respiratory capacity had reached its maximum. Cyanide
      insensitive oxygen consumption contributed ca. 50% of the total respiratory
      capacity in anaerobic cultures, but was virtually absent in aerobic cultures. The
      response of aerobic cultures to oxygen deprivation was qualitatively the reverse
      of the response of anaerobic cultures to aeration. The results indicate that
      mitochondrial morphology in S. cerevisiae is closely linked to the metabolic
      activity of this yeast: conditions that result in repression of respiratory
      enzymes generally lead to the mitochondrial morphology observed in anaerobically
      grown, fermenting cells.

PMID- 7778896
TI  - Kinetics of conversion of Neisseria gonorrhoeae to resistance to complement by
      cytidine 5'-monophospho-N-acetyl neuraminic acid.
AB  - Freshly isolated gonococci upon subculture are readily lysed by normal human
      serum although a few strains remain inherently resistant to the complement
      activity. The sensitive gonococci can be converted to serum resistance by
      incubation with a host derived factor referred to as cytidine 5'-monophospho-N
      acetylneuraminic acid (CMP-NANA). These gonococci resist complement mediated
      killing due to their sialylation of an epitope structure on a component of lipo
      oligosaccharide (LOS). In the present study, the kinetics of conversion to serum
      resistance by the action of sialyltransferase (STase) in Neisseria gonorrhoeae
      was followed with very low concentrations of CMP-NANA. This conversion could not
      be perceived at 2 x 10(-3) nmol.ml-1 but was fully attainable from 8 x 10(-3) to
      2 x 10(-2) nmol.ml-1 CMP-NANA. When pretreated up to 100 min in presence of the
      very low concentration of 2 x 10(-3) nmol.ml-1, a potentiating effect on the
      conversion of gonococci by 2 x 10(-2) nmol.ml-1 was observed in relation to the
      time of preincubation. This action was abolished after exposure to a
      subinhibitory concentration of chloramphenicol (0.5 microgram.ml-1). The
      gonococci recovered their ability to convert to serum resistance following
      adequate washing. The potential for increase in STase activity should be of
      interest for understanding the conversion from a serum sensitive to a serum
      resistance state.

PMID- 7778895
TI  - Physiological and technological aspects of large-scale heterologous-protein
      production with yeasts.
AB  - Commercial production of heterologous proteins by yeasts has gained considerable
      interest. Expression systems have been developed for Saccharomyces cerevisiae and
      a number of other yeasts. Generally, much attention is paid to the molecular
      aspects of heterologous-gene expression. The success of this approach is
      indicated by the high expression levels that have been obtained in shake-flask
      cultures. For large-scale production however, possibilities and restrictions
      related to host-strain physiology and fermentation technology also have to be
      considered. In this review, these physiological and technological aspects have
      been evaluated with the aid of numerical simulations. Factors that affect the
      choice of a carbon substrate for large-scale production involve price, purity and
      solubility. Since oxygen demand and heat production (which are closely linked)
      limit the attainable growth rate in large-scale processes, the biomass yield on
      oxygen is also a key parameter. Large-scale processes impose restrictions on the
      expression system. Many promoter systems that work well in small-scale systems
      cannot be implemented in industrial environments. Furthermore, large-scale fed
      batch fermentations involve a substantial number of generations. Therefore, even
      low expression-cassette instability has a profound effect on the overall
      productivity of the system. Multicopy-integration systems may provide highly
      stable expression systems for industrial processes. Large-scale fed-batch
      processes are typically performed at a low growth rate. Therefore, effects of a
      low growth rate on the physiology and product formation rates of yeasts are of
      key importance. Due to the low growth rates in the industrial process, a
      substantial part of the substrate carbon is expended to meet maintenance-energy
      requirements. Factors that reduce maintenance-energy requirements will therefore
      have a positive effect on product yield. The relationship between specific growth
      rate and specific product formation rate (kg product.[kg biomass]-1.h-1) is the
      main factor influencing production levels in large-scale production processes.
      Expression systems characterized by a high specific rate of product formation at
      low specific growth rates are highly favourable for large-scale heterologous
      protein production.

PMID- 7778899
TI  - Children, chronic illness, and surgery--an inoperable combination without caring
      perioperative nurse champions.

PMID- 7778900
TI  - AORN urges members to share expertise with Congressional representatives.

PMID- 7778898
TI  - The diversity of Malassezia yeasts confirmed by rRNA sequence and nuclear DNA
      comparisons.
AB  - One hundred and four Malassezia strains (52 isolated from humans and 52 from
      animals) were compared using large subunit (LSU) ribosomal RNA sequence
      similarity and nuclear DNA complementarity. Eight groups of strains were
      recognized as genetically distinct species. Each taxon was confirmed by a
      homogeneous mole % GC and percentages of DNA/DNA reassociations higher than 85%.
      The non-lipid-dependent Malassezia yeasts were maintained as the unique taxon M.
      pachydermatis. In contrast, lipid-dependent strains were shown to be distributed
      among seven species: M. furfur, M. sympodialis and M. species 1-5. These taxa
      matched remarkably well with morphological and serological differences documented
      by previous investigators. The LSU rRNA sequences allowed a further intraspecific
      resolution with most of genomic taxa represented by several closely related
      sequences: M. pachydermatis counted up to seven sequences, M. furfur four
      sequences, M. species 1 comprised three sequences and M. species 2 and M. species
      5 two sequences. Three species, M. sympodialis, M. species 3 and M. species 4,
      displayed a unique type of sequence. Thus, the present report demonstrates the
      usefulness of sequencing for both taxonomic and epidemiological purposes.

PMID- 7778897
TI  - Secretion of an antibacterial factor during resuscitation of dormant cells in
      Micrococcus luteus cultures held in an extended stationary phase.
AB  - A high proportion of Micrococcus luteus cells in cultures starved for 3-6 months
      in spent medium following growth to stationary phase in batch culture lost the
      ability to grow and form colonies on agar plates, but could be resuscitated from
      dormancy by incubation in liquid medium containing supernatant taken from the
      late log phase of viable cultures of the same organism (Kaprelyants et al. 1994).
      In the present work, we found that during the first 50-70 h of such resuscitation
      the dormant cells actually divide for 10-17 generations in lactate minimal medium
      containing yeast extract whilst remaining nonculturable on agar plates. Further
      incubation results in a decrease in the total cell number in liquid medium. The
      addition of viable (culturable) Micrococcus luteus cells in concentrations of up
      to 10(4) ml-1 to test tubes containing either resuscitating cells or supernatant
      from these cultures revealed the excretion of a factor or factors which inhibited
      the proliferation of otherwise viable cells. The maximum production of this
      factor took place after some 96 h of incubation of starved cells in resuscitation
      medium. Supernatant from late logarithmic phase batch cultures of M. luteus
      abolished the antibacterial effect of starved cultures incubated in resuscitation
      medium. It is concluded that the stimulating effect of viable cells, and of
      supernatant taken from batch cultures, on the resuscitation of dormant cells
      might be connected in part with overcoming the activity of an antibacterial
      factor causing self-poisoning of dormant cells during their resuscitation.

PMID- 7778901
TI  - AORN recommended education standards for RN first assistant programs.

PMID- 7778902
TI  - Laparoscopic Nissen fundoplication to treat gastroesophageal reflux.
AB  - Laparoscopic Nissen fundoplication is an effective treatment for gastroesophageal
      reflux. The procedure involves wrapping the gastric fundus around the lower end
      of the esophagus to augment the lower esophageal sphincter. The procedure offers
      several advantages over open laparotomy, including smaller abdominal incisions,
      reduced postoperative discomfort, and shortened postoperative recovery and
      hospital stays. The laparoscopic approach also reduces the length of time a
      patient has an ileus.

PMID- 7778903
TI  - Congenital idiopathic clubfoot deformities.
AB  - Clubfoot is a birth defect that is marked primarily by a deformed talus (ie,
      ankle) and calcaneous (ie, heel) that give the foot a characteristic "club-like"
      appearance. In congenital idiopathic clubfoot (ie, talipes equinovarus), the
      infant's foot points downward (ie, equinus) and turns inward (ie, varus), while
      the forefoot curls toward the heel (ie, adduction). This congenital disorder has
      an incidence of 1 in 400 live births, with boys affected twice as often as girls.
      Unilateral clubfoot is somewhat more common than bilateral clubfoot and may occur
      as an isolated defect or in association with other disorders (eg, chromosomal
      aberrations, cerebral palsy, spina bifida, arthrogryposis). Infantile clubfoot
      deformity is painless and is correctable with early diagnosis and prompt
      treatment.

PMID- 7778904
TI  - Selective dorsal rhizotomy to decrease spasticity in cerebral palsy.
AB  - Until recently, treatment of muscle spasticity in children with cerebral palsy
      has consisted of physical therapy, bracing, and surgery to release and lengthen
      tight tendons of contracted muscles and correct muscle contractures. Selective
      dorsal rhizotomy is a surgical intervention that selectively cuts the spinal
      sensory nerve rootlets carrying the most abnormal signals, thereby reducing
      spasticity in all muscle groups of the affected extremities. It is not a cure for
      spastic cerebral palsy. Children who have this procedure can gain significant
      increases in knee and thigh ranges of motion and increased strength and muscle
      control if they have good family support and follow through with intensive
      postoperative physical therapy.

PMID- 7778905
TI  - Implementing a parent-present induction program.
AB  - One of the greatest fears of children undergoing surgery is separation from their
      parents. Children for whom preoperative sedation is contraindicated often endure
      the distress of this separation and the beginning of anesthesia surrounded by
      masked strangers. Those who receive sedation often experience the invasiveness of
      a medication administered rectally or intramuscularly or the insertion of an IV
      line. Until recently, the doors to the operating room remained closed to family
      members. Like other hospitals throughout the country, however, Children's
      Hospital in Boston has responded to the concerns of parents and staff members by
      implementing a parent-present anesthesia induction program. As a result, the
      surgical experience for many children and families has changed significantly for
      the better.

PMID- 7778906
TI  - Laser ablation of recurrent laryngeal papillomas in children.
AB  - Papillomas are the most common laryngeal tumors in childhood, and their etiology
      is thought to be viral. Papillomatosis (ie, widespread, multiple papillomas) may
      involve a child's airway from the epiglottis to the bronchi. Hoarseness is an
      early sign of juvenile laryngeal papillomas (JLP), and airway obstruction is a
      later, life-threatening sign. The recurrence and spread of JLP is common. An
      otorhinolaryngologist may perform a tracheostomy on a child with JLP; however,
      this procedure is avoided if possible, because a tracheostomy predisposes the
      trachea to papilloma seeding. Laser ablation of papillomas through the use of
      rigid endoscopic equipment and a carbon dioxide laser is the mainstay of therapy.

PMID- 7778907
TI  - Development of a perioperative nursing diagnoses flow sheet.
AB  - Traditionally, health care professionals in the preoperative, intraoperative, and
      postoperative phases of care have used perioperative records that focus on the
      technical aspects of the care provided (eg, blood pressure, pulse measurements;
      equipment used) and leave room for only short narratives to document nursing
      care. Such formats often do not document the multitude of activities or
      interventions perioperative nurses provide. The question raised at the DePaul
      Health Center, St Louis, was: "Where do we document our nursing diagnoses and
      plan of care?" The response was to create a nursing diagnosis task force that
      investigated the feasibility of a form professional nurses could use in all
      phases of patient care. This investigation led to the development,
      implementation, and universal use of a perioperative nursing diagnoses flow sheet
      within the surgical services department.

PMID- 7778908
TI  - Implementation of a regional pediatric trauma center.
AB  - Today's hospitals face unique challenges in the treatment of pediatric trauma
      patients. With the advent of more sophisticated regional trauma systems, there is
      a growing awareness that children are not "little adults," but are a special
      component of the trauma patient population. As few communities can provide
      pediatric health care facilities committed to trauma care, regional pediatric
      trauma centers need to be developed and implemented so hospitals can provide
      pediatric trauma patients with comprehensive and age-appropriate care. This
      article describes the steps taken by the Children's Hospital Medical Center,
      Cincinnati, to develop a regional pediatric trauma center according to the
      guidelines set forth by the American College of Surgeons committee on trauma.

PMID- 7778910
TI  - Physicians are my coworkers, not my clients.

PMID- 7778909
TI  - Hepatic artery chemoembolization therapy for hepatic tumors.
AB  - Patients with hepatocellular carcinomas who undergo chemoembolization therapies
      require skilled perioperative nursing care that addresses their knowledge
      deficits about chemoembolization techniques, their anxieties related to
      chemoembolization procedures and adverse effects, and their impaired mobility
      resulting from the presence of arterial lines and the progression of the cancer.
      Perioperative nursing participation in chemoembolization procedures is an example
      of the expanded role of today's OR nurse.

PMID- 7778912
TI  - Alcohol abuse and nurses.

PMID- 7778911
TI  - Debate about "any willing provider" laws continues in 1995.

PMID- 7778913
TI  - Proposed recommended practices for selection and use of packaging systems.

PMID- 7778914
TI  - Proposed recommended practices for documentation of patient care in the
      perioperative practice setting.

PMID- 7778915
TI  - Addition of rifampin to conventional therapy for recurrent furunculosis.

PMID- 7778916
TI  - Bart's syndrome. Ultrastructure and genetic linkage.
AB  - BACKGROUND AND DESIGN: Bart's syndrome, originally described in a large family in
      1966, consists of congenital localized absence of skin, blistering, and
      associated nail abnormalities. Since then, several descriptions of patients with
      similar clinical findings have suggested that this syndrome may represent any of
      the three subtypes of epidermolysis bullosa: epidermal, junctional, or dermal.
      Because no histologic or ultrastructural studies were done in Bart's kindred, and
      neither immunohistologic nor genetic linkage technology was available at that
      time, classification of the syndrome has been unclear. We report the findings of
      clinical, ultrastructural, immunohistologic, and genetic linkage studies of the
      original kindred and their descendants. We contacted original family members and
      their descendants by telephone and questionnaire. Skin biopsy specimens adjacent
      to blisters were obtained for ultrastructural and immunochemical analysis. Blood
      samples were drawn from affected members and their spouses and children for
      genetic linkage studies. RESULTS: The clinical findings seen in the descendants
      of the original family with Bart's syndrome were similar to those described in
      1966. We did, however, detect persistence of blistering into adult life and mild
      atrophic scarring and milia formation at sites of blistering in some family
      members, a finding not noted in the original study. Hypertrophic scarring and
      albopapuloid lesions were not detected. Ultrastructural analysis of skin from
      affected family members showed poorly formed anchoring fibrils and cleavage below
      the lamina densa. Immunohistochemical staining localized type IV collagen at the
      roof of blistered skin. Staining for type VII collagen was found to have a normal
      distribution in nonblistered skin. Genetic linkage studies mapped the gene for
      the disease in this family to chromosome 3p at or near the site of the gene
      encoding type VII collagen. CONCLUSION: Bart's syndrome is a subtype of
      dominantly inherited dystrophic epidermolysis bullosa.

PMID- 7778917
TI  - Characteristics of toxic epidermal necrolysis in patients undergoing long-term
      glucocorticoid therapy.
AB  - BACKGROUND AND DESIGN: The usefulness of steroid therapy in toxic epidermal
      necrolysis (TEN) remains controversial. Up to 5% of the TEN cases occur in
      patients who undergo long-term steroid therapy. We, thus, looked for the
      potential effect of long-term glucocorticosteroid therapy before the onset of TEN
      on altering the progression of the disease. The records of 179 patients were
      reviewed. The characteristics of the 13 patients who were undergoing long-term
      glucocorticosteroid therapy were compared with those of 166 other patients with
      TEN. The following parameters were studied: age, mortality, delay between the
      introduction of the suspect drug and the onset of TEN, length of hospital stay,
      body surface area involved, time elapsed between the first symptom of TEN and
      hospital admission, number of medications taken by the patients before the onset
      of TEN, lymphocyte count, granulocyte count, platelet count, glycemia, serum
      aspartate aminotransferase level, and total disease duration. RESULTS: Patients
      who were undergoing long-term glucocorticosteroid therapy differed from other
      patients with TEN in the administration of more drugs, longer delay between the
      introduction of the suspect drug and the onset of TEN, and a longer time elapsed
      between the first symptom of TEN and hospital admission. We observed no
      differences for the other parameters that were studied. CONCLUSION: Our study
      shows that long-term steroid therapy may delay the onset of TEN, but it does not
      halt its progression.

PMID- 7778918
TI  - Lymphoproliferative responses to Borrelia burgdorferi in patients with erythema
      migrans, acrodermatitis chronica atrophicans, lymphadenosis benigna cutis, and
      morphea.
AB  - BACKGROUND AND DESIGN: Specific humoral and cell-mediated immune responses play
      an important role in the pathogenesis of Lyme borreliosis. Several previous
      studies demonstrated that a specific cellular immune response to Borrelia
      burgdorferi can occur independently of a diagnostic humoral response. Little is
      known about T-cell reactivities against B burgdorferi in early and late cutaneous
      manifestations of Lyme borreliosis. We studied the lymphoproliferative response
      of peripheral blood mononuclear cells to B burgdorferi antigen from 99 patients
      (25 with erythema migrans, 16 with acrodermatitis chronica atrophicans, 13 with
      lymphadenosis benigna cutis, and 45 with localized scleroderma) and 21 control
      subjects. The results are expressed as a stimulation index (SI) (mean count per
      minute of triplicate cultures with stimulant divided by mean count per minute
      without stimulant). The serum samples from all patients and control subjects were
      tested for antibodies to B burgdorferi by indirect immunofluorescence assay.
      RESULTS: The 21 healthy seronegative controls had an SI of 3.3 +/- 2.0 (mean +/-
      SD). Compared with that of control subjects, the SIs were significantly elevated
      in patients with erythema migrans (9.8 +/- 9.1), acrodermatitis chronica
      atrophicans (11.8 +/- 8.2), and lymphadenosis benigna cutis (7.2 +/- 6.2). The 45
      patients with localized scleroderma had elevated proliferative responses, with an
      SI of 6.5 +/- 7.3, but these responses did not significantly differ from those of
      controls. Elevated titers of antibodies to B burgdorferi were present in six
      (24%) of 25 patients with erythema migrans, five (38%) of 13 patients with
      lymphadenosis benigna cutis, and 13 (29%) of 45 patients with localized
      scleroderma. All 16 patients with acrodermatitis chronica atrophicans had
      markedly elevated antibody titers. CONCLUSIONS: Our findings show that a
      significant lymphoproliferative response to B burgdorferi occurs in the majority
      of patients with cutaneous manifestations of Lyme borreliosis. The lymphocyte
      proliferation assay may be of diagnostic value in patients in whom Lyme
      borreliosis is strongly clinically suspected and who have nondiagnostic levels of
      antibodies against B burgdorferi.

PMID- 7778919
TI  - No detection of Borrelia burgdorferi-specific DNA in erythema migrans lesions
      after minocycline treatment.
AB  - BACKGROUND AND DESIGN: Early treatment of erythema migrans is important to
      prevent late complications. Minocycline possesses several attributes, making it
      potentially useful in the treatment of borrelial infections. In our study,
      minocycline was administered to 14 patients with erythema migrans. Punch biopsy
      specimens were obtained from the (affected) skin of all patients before and after
      therapy. The formalin-fixed, paraffin-embedded specimens were analyzed by
      polymerase chain reaction for the presence of Borrelia burgdorferi-specific DNA.
      RESULTS: Polymerase chain reaction assay succeeded in amplifying B burgdorferi
      specific DNA from the first biopsy specimen, obtained from the border of erythema
      migrans before initiating treatment, in eight (57%) of 14 patients. At the end of
      minocycline therapy, however, polymerase chain reaction analysis disclosed no B
      burgdorferi-specific DNA in any of the 14 patients. The good clinical response of
      our patients with erythema migrans substantiates our molecular findings.
      CONCLUSIONS: The presented polymerase chain reaction data, together with the
      clinical outcome, indicate that minocycline may be useful for treatment of early
      Lyme borreliosis.

PMID- 7778920
TI  - Transforming growth factor alpha gene expression in cultured human keratinocytes
      is unaffected by cellular aging.
AB  - BACKGROUND: Cultured human keratinocyte grafts have been shown to stimulate
      endogenous reepithelialization of both chronic nonhealing and acute partial
      thickness wounds. This effect is most likely mediated by cytokines that stimulate
      keratinocyte growth, such as transforming growth factor alpha. The effect of
      cellular age on cytokine expression by cultured grafts used for this purpose is
      presently undefined. In this study, transforming growth factor alpha gene
      expression in cultured foreskin keratinocytes from donors varying in age from 2
      to 82 years was analyzed semiquantitatively by two separate methods, ie, Northern
      hybridization and competitive polymerase chain reaction. RESULTS: No pattern of
      decline in transforming growth factor alpha messenger RNA expression with
      increasing cellular age was observed by either analysis. CONCLUSION: The results
      indicate that expression of transforming growth factor alpha by cultured grafts
      may not be significantly affected by increasing cellular age and suggest that,
      even in the elderly, cultured autografts may be effective as pharmacologic agents
      for wound treatment.

PMID- 7778922
TI  - Dynamic epidermal cooling during pulsed laser treatment of port-wine stain. A new
      methodology with preliminary clinical evaluation.
AB  - BACKGROUND AND DESIGN: The clinical objective in the treatment of a patient with
      port-wine stain (PWS) undergoing laser therapy is to maximize thermal damage to
      the PWS, while at the same time minimizing nonspecific injury to the normal
      overlying epidermis. With dynamic cooling, the epidermis can be cooled
      selectively. When a cryogen spurt is applied to the skin surface for an
      appropriately short period of time (on the order of tens of milliseconds), the
      cooling remains localized in the epidermis, while leaving the temperature of the
      deeper PWS vessels unchanged. RESULTS: Comparative measurements obtained by a
      fast infrared imaging detector demonstrated that the surface temperature prior to
      laser exposure could be reduced by as much as 40 degrees C using the dynamic
      cooling technique. No skin surface textural changes were noted on PWS test sites
      cooled with a 20- to 80-millisecond cryogen spurt after flashlamp-pumped pulsed
      dye laser (FLPPDL) exposure (lambda = 585 nm; tau p = 450 microseconds) at the
      maximum light dosage possible (10 J/cm2). In contrast, epidermal necrosis
      occurred on the uncooled sites after such exposure. Six months after laser
      exposure, clinically significant blanching on the cooled sites indicates laser
      photothermolysis of PWS blood vessels did occur. CONCLUSIONS: Our preliminary
      experiments demonstrate the feasibility of selectively cooling the normal
      overlying epidermis without affecting the temperature of the deeper PWS vessels.
      Furthermore, protection of the epidermis from thermal injury, produced by melanin
      light absorption at clinically relevant wavelengths, can be achieved effectively.
      An additional advantage of dynamic epidermal cooling is reduction of patient
      discomfort associated with FLPPDL therapy. Further studies are under way to
      determine an optimum strategy for applying this dynamic cooling technique during
      pulsed laser treatment of patients with PWS and others with selected dermatoses
      (dermal melanocytic lesions and tattoos).

PMID- 7778921
TI  - Full-thickness skin grafts. Clinical observations on the impact of using
      epinephrine in local anesthesia of the donor site.
AB  - BACKGROUND AND DESIGN: A recent animal study indicated that epinephrine in local
      anesthesia adversely affects the survival of full-thickness skin grafts. Because
      animal models do not always correlate to humans, we performed a prospective
      observational study to elucidate the clinical outcome of using epinephrine in
      local anesthesia of the donor site. Seventy-two patients had cutaneous tumors
      excised by the Mohs micrographic technique. The resultant surgical defects were
      repaired using full-thickness skin grafts. Patients were randomly divided into
      two groups based on the local anesthetic used at the donor site: (1) 1% lidocaine
      (Xylocaine) (n = 33) or (2) 1% lidocaine with 1:100,000 epinephrine (n = 39).
      RESULTS: Assessment of the skin grafts at 1 week revealed a significantly
      increased risk of developing graft complications in the lidocaine with
      epinephrine group compared with the plain lidocaine group. The overall cosmetic
      outcome of the grafted site at 6 weeks revealed no significant difference between
      the two groups. CONCLUSIONS: Because there was only a minimal clinical effect of
      epinephrine on graft survival observed at 1 week and there was no effect on the 6
      week cosmetic outcome, we do not recommend harvesting all full-thickness skin
      grafts with plain lidocaine. In certain clinical circumstances with compromised
      vascular supply or poor oxygenation, the use of plain lidocaine may be
      advantageous.

PMID- 7778923
TI  - Human papillomavirus and widespread cutaneous carcinoma after PUVA
      photochemotherapy.
AB  - BACKGROUND: Oral psoralen with UV-A (PUVA) photochemotherapy is known to cause
      cutaneous malignancies and has been associated with cutaneous immunosuppression.
      Human papillomavirus infection has also been associated with cutaneous
      malignancies and with immunosuppressed individuals. We therefore sought evidence
      of human papillomavirus infection in a patient with a long history of PUVA
      therapy and multiple cutaneous malignancies. OBSERVATIONS: During a 15-year
      period, an otherwise healthy patient with psoriasis who had undergone a 10-year
      course of PUVA photochemotherapy developed 13 squamous cell carcinomas, eight
      lesions diagnosed as "squamous cell carcinoma vs keratoacanthoma," 14 other
      keratoacanthomas, six basal cell carcinomas, one melanoma in situ, and 18 other
      keratinocytic dysplasias. Twenty-two of the 30 lesions tested for human
      papillomavirus DNA by polymerase chain reaction were positive for type 16/18,
      including six of the seven basal or squamous cell carcinomas tested. CONCLUSION:
      We hypothesize that PUVA therapy-induced immunosuppression may play an important
      role in PUVA-related carcinogenesis by affecting the extent and pathogenicity of
      human papillomavirus infection.

PMID- 7778924
TI  - Leukocytoclastic vasculitis following staphylococcal protein A column
      immunoadsorption therapy. Two cases and a review of the literature.
AB  - BACKGROUND: Protein A immunoadsorption is a novel therapy for the treatment of
      diseases mediated by pathogenic autoantibodies. This procedure consists of
      circulating patients' plasma through a column containing staphylococcal protein
      A, which binds to the Fc portion of IgG, enabling removal of IgG. Presently,
      protein A immunoadsorption is used in the treatment of idiopathic
      thrombocytopenic purpura, but may be more widely used as an immunomodulator in
      human immunodeficiency virus infection and metastatic carcinoma. OBSERVATIONS: We
      present two histologically documented cases of leukocytoclastic vasculitis in the
      setting of protein A immunoadsorption. This potentially severe adverse effect is
      probably more common than the literature reflects and should be recognized by
      physicians who are treating patients with protein A column pheresis. CONCLUSIONS:
      The pathogenesis of protein A therapy-associated leukocytoclastic vasculitis
      remains unclear. Further study of vasculitis in the setting of protein A column
      pheresis may lead to modifications of this therapy, resulting in fewer adverse
      effects. Protein A-associated leukocytoclastic vasculitis may serve as a useful
      model of the relation of immune complexes and vasculitis.

PMID- 7778926
TI  - A young adult with a recalcitrant scalp folliculitis. Langerhans' cell
      histiocytosis (LCDH) presenting as scalp folliculitis in an adult.

PMID- 7778925
TI  - Fibroblastic rheumatism.
AB  - BACKGROUND: Fibroblastic rheumatism was first described in the French literature
      in 1980. Since that time, 11 other patients with this disorder have been
      identified in the literature, mostly from France. This is a unique syndrome
      characterized by the sudden onset of symmetric polyarthritis and cutaneous
      nodules ranging from 5 to 20 mm in diameter, with predilection for the upper and
      lower extremities. While the cutaneous findings resolve spontaneously after
      several months, permanent joint sequelae are common. OBSERVATIONS: We present the
      first two patients with fibroblastic rheumatism reported in the United States.
      The clinical features and histologic findings were identical to those of patients
      described in the European literature. CONCLUSIONS: Fibroblastic rheumatism is a
      relatively rare syndrome characterized by the association of multiple cutaneous
      nodules with polyarthritis. The clustering of cases in France may, in part, be
      attributable to increased recognition by clinicians owing to prevalence of
      reports in the European literature. Perhaps, as clinicians in the United States
      become familiar with this disorder, further cases will be diagnosed, and the
      pathogenesis of the disorder will be elucidated.

PMID- 7778927
TI  - Scalp mass. Giant molluscum contagiosum.

PMID- 7778928
TI  - Chronic alopecia. Trichotillomania.

PMID- 7778929
TI  - Enlarging scalp nodule. Proliferating trichilemmal cyst (PTC).

PMID- 7778930
TI  - Erythema multiforme. Should anyone care about the standards of care?

PMID- 7778932
TI  - Flashless office macro photography.

PMID- 7778931
TI  - Cutaneous heterotopic meningeal nodules.

PMID- 7778933
TI  - Combined features of pemphigus foliaceus and bullous pemphigoid: immunoblot and
      immunoelectron microscopic studies.

PMID- 7778934
TI  - Cutaneous malignancies in patients treated with psoralen photochemotherapy (PUVA)
      for vitiligo.

PMID- 7778935
TI  - Treatment of lentigo maligna with the carbon dioxide laser.

PMID- 7778936
TI  - Photodynamic therapy of nonmelanoma skin cancer with topical aminolevulinic acid:
      a clinical and histologic study.

PMID- 7778937
TI  - Olmsted syndrome in twins.

PMID- 7778938
TI  - Sezary's syndrome and human immunodeficiency virus infection.

PMID- 7778939
TI  - Traditional treatment of Buruli ulcer in Benin.

PMID- 7778940
TI  - Allergic reaction to intralesional triamcinolone acetonide: a case report.

PMID- 7778941
TI  - Herpetic whitlow in an infant without defined risks.

PMID- 7778942
TI  - Acute generalized livedo reticularis with myasthenialike syndrome revealing
      parvovirus B19 primary infection.

PMID- 7778943
TI  - [Cysticercosis in Madagascar: consensus research. Research group on
      cysticercosis].

PMID- 7778945
TI  - [Workshop on cysticercosis. Antananarivo, 4 December 1993. Proceedings and
      abstracts].

PMID- 7778944
TI  - [Relations between pathology and immunity in cysticercosis].
AB  - Human Taenia solium cysticercosis is identified as a main Public Health problem
      in many developing countries, such as Mexico, India or Madagascar. In this paper
      are presented the complex relationships between the anatomical position of the
      cysts, the associated pathology and the immune reactions observed in the
      laboratory. Detecting specific antibodies, or circulating antigens in a near
      future, in serum or cerebrospinal fluid is not enough for a reliable diagnosis. A
      crucial aspect remains concentrated on the use of computed tomography in a first
      step.

PMID- 7778946
TI  - [Value of immunodiagnosis by ELISA and Western blotting for the diagnostic and
      therapeutic management of neurocysticercosis].
AB  - The humoral immune response in neurocysticercosis was studied in seventy patients
      from the Reunion Island (Indian Ocean). In the serum and the cerebrospinal fluid,
      specific antibodies were quantified using an enzyme-linked (ELISA) and Western
      blot (EITB) technique. It was found that two antigenic fractions, of 13 and 14kd
      molecular weight, are highly specific of an active disease, for which the
      treatment is recommended. This new result, established in the quite simple
      epidemiologic environment of the Reunion island, is under validation in
      Madagascar.

PMID- 7778948
TI  - [History of a hepatic lesion: Schistosoma mansoni bilharziasis].
AB  - Schistosomiasis mansoni is a widespread tropical disease affecting about 200
      million people in the world (data from the World Health Organization). The adult
      worms, settled in the mesenteric venous plexus, can survive in the host during 5
      to 20 years. They evade the immune response and are not, by themselves, the main
      cause of the pathological events. Most eggs are swept into the portal circulation
      and trapped in different systemic organs, including the liver. The continuous egg
      deposition results in a T cell-mediated granulomatous response that is
      responsible for the disease syndrome (chronic hepatitis associated with a dense
      fibrosis and a concurrent portal hypertension). Current immunological and
      molecular concepts on the modulation of the granuloma, and the associated
      fibrosis, lead to a better understanding of the pathogenesis of human
      schistosomiasis. Chemotherapy with praziquantel is presently the main approach of
      morbidity control, before using in conjunction a human vaccine still in
      development.

PMID- 7778947
TI  - [Clinical immunology of hepato-splenic bilharziasis].
AB  - Field studies on immunity in human schistosomiasis gave evidence for a slow
      development with age of an acquired resistance to reinfection. Recent results
      support the idea of a progressive build-up of high levels of protective IgE, and
      probably IgA, overcoming the initial influence of blocking Ig G4 antibodies.
      Chemotherapy does not apparently modify the susceptibility to infection. A.
      Capron's candidate vaccine is now ready for human trials, and represents a
      promising tool in controlling schistosomiasis morbidity while diminishing the
      parasite transmission efficiency.

PMID- 7778949
TI  - [Why compare hepatosplenic bilharziasis in six African countries with the help of
      ultrasonography? Presentation of a WHO project including Madagascar].
AB  - During a morbidity survey in two endemic foci of hepatosplenic schistosomiasis in
      the malagasy Hauts Plateaux (Tetikanana, 80 km East of Ambositra and Lohanosy, in
      the vicinity of Antananarivo), the objectives of a comparative pathology WHO
      project are presented. The survey in Madagascar was concurrently organized by the
      Ministry of Health (Bilharziasis central laboratory, DLMT), the Parasitology Unit
      of the local Pasteur Institute and the Medical Parasitology Institute of Bonn
      University, in Germany. This was the fourth part of this investigation of the
      morbidity variation due to Schistosoma mansoni infection in six african
      countries, a project sponsored by the WHO within its TDR programme. This
      comparison was based on the standardized description of morbidity as visualized
      by echography, following the "Cairo-1990" and the "Hannover-Managil-1989"
      classifications, and on coprology. One of the main objectives of this study was
      to demonstrate a morbidity variation at the scale of the African region (due to
      different S. mansoni strains or to a variable genetic background within the
      studied human populations), while participating to an international
      standardization effort for field echography. The project was conducted since July
      1991 by a constant medical staff from Bonn and Hannover german universities.
      Eight foci in four african countries (Senegal, Mali, Uganda and Madagascar) are
      still analyzed and we are presenting here the first results. The data of an
      independent ultrasonographic investigation, organized by the Blair Institute and
      the Danish Bilharziasis Laboratory in Zimbabwe, was kindly proposed for this
      comparison. This project will end with the study of two supplementary foci in
      Tanzania and Burundi.

PMID- 7778950
TI  - [Schistosomiasis mansoni infection in a hyperendemic region of midwestern
      Madagascar: epidemiology, morbidity and secondary effects of praziquantel
      treatment].
AB  - The examination of 544 inhabitants (93.2% of the whole population) of a village
      in the middle west of Madagascar, where Schistosoma mansoni is hyperendemic and
      where no previous antischistosomal treatment had been delivered at a community
      level, showed a prevalence rate of 61.8%. The highest prevalences and the most
      intense infections were observed in the 10-24 age group. The egg count decreases
      dramatically from the age of 25. A highly significant relationship was found
      between recent histories of bloody diarrhoea and S. mansoni eggs excretion.
      Clinical examination showed a high frequency of splenomegalies (62.2% > or =
      stade 2 Hackett), with two modes: one in the 10-14 age group and the other in the
      35-39 age group. The respective liability of S. mansoni and malaria remain to be
      clarified. Side effects after treatment of the entire population with
      praziquantel were observed in 27.2% of treated individuals. Side effects occurred
      mainly in infected people. A highly significant relationship was found between
      intensity of infection and frequency of these side effects which are essentially
      mild and disappear in the 24 hours.

PMID- 7778951
TI  - [Evolution of Schistosoma mansoni bilharziasis in Ampefy (Lake Itasy) from 1986
      to 1993].
AB  - In 1976, 1983, 1986 to 1989 and 1993, the population of Ampefy, on the shores of
      lake Itasy, was invited to participate in an active detection programme of
      Schistosoma mansoni infection. An increase in the global prevalence was observed
      from 1976 (17.0%) to 1983 (40.0%). This prevalence level was then stabilized
      during the four years annual selective treatment (1986 to 1989) and the mean
      intensity of infection for positive patients fell from 393 eggs/g to 271 eggs/g
      and the proportion of severe infections, with a high risk of developing
      "hepatosplenic disease", fell from 8% to 4.2%. Selective treatment was
      interrupted from 1989 to 1993, during which time the global prevalence rose to
      70.6% and mean intensity of infection to 594 eggs/g, with 22% of those examined
      classified as severely infested. This local control programme, associating active
      detection with annual treatment, seems effective in stabilizing prevalence and
      intensity of infection in spite of a regular arrival of infested, and never
      treated, immigrants. However, its impact throughout time is limited.

PMID- 7778952
TI  - [Experimental study of a Malagasy strain of Schistosoma haematobium:
      compatibility with different Bulinus snails, potential intermediate hosts].
AB  - Experimental investigation on a malagasy strain of S. haematobium: compatibility
      with different Bulinus snails, potential intermediate hosts. A comparative
      experimental study of the infectivity of different Bulinus snails by a reference
      S. haematobium strain was made under laboratory conditions. The results support
      the role of Bulinus obtusispira as an intermediate host in Madagascar but some
      other Bulinus species could exist and play a role in the fields far away from the
      experimental criteria here described.

PMID- 7778953
TI  - [ Reflections on the national program for bilharziasis control in Madagascar].

PMID- 7778954
TI  - 'You promised me I wouldn't die like this!' A bad death as a medical emergency.

PMID- 7778955
TI  - What do apple pie and motherhood have to do with feeding tubes and caring for the
      patient?

PMID- 7778956
TI  - Treating the dying patient. The challenge for medical education.

PMID- 7778957
TI  - Early switch from intravenous to oral cephalosporins in the treatment of
      hospitalized patients with community-acquired pneumonia.
AB  - BACKGROUND: Switch therapy is defined as the early transition from intravenous to
      oral antibiotics during treatment of infection. This study was designed to
      evaluate the clinical outcome and length of stay of hospitalized patients with
      community-acquired pneumonia treated with an early switch from intravenous to
      oral third-generation cephalosporins. METHODS: Patients with a new
      roentgenographic pulmonary infiltrate and at least two symptoms (cough, fever, or
      leukocytosis) were enrolled in this study and treated with intravenous
      ceftizoxime sodium (1 g every 12 hours) or ceftriaxone sodium (1 g every 24
      hours). Patients were switched to oral cefixime (400 mg every 24 hours) as soon
      as they met the following criteria: (1) resolution of fever; (2) improvement of
      cough and respiratory distress; (3) improvement of leukocytosis; and (4) presence
      of normal gastrointestinal tract absorption. RESULTS: Of the 120 patients
      enrolled, 75 (62%) had clinical data evaluated. Long-term follow-up showed that
      74 patients (99%) were cured; one patient required readmission for further
      intravenous therapy. Mean duration of hospital stay was 4 days. CONCLUSIONS: This
      investigation demonstrated that an early switch to oral cefixime may be
      reasonable in hospitalized patients with community-acquired pneumonia who have
      already shown a good clinical and laboratory response to therapy with intravenous
      third-generation cephalosporins. This approach is clinically effective and
      minimizes hospital stay.

PMID- 7778958
TI  - Cardiopulmonary resuscitation in intensive care unit and non-intensive care unit
      patients. Immediate and long-term survival.
AB  - OBJECTIVE: To determine the effect of location within the hospital and
      preexisting electrocardiographic rhythm on the outcome of cardiopulmonary
      resuscitation, the cardiopulmonary resuscitation records for a 3-year period,
      including 668 hospitalized patients, were retrospectively reviewed. RESULTS:
      Resuscitation was successful in only 12 patients in the intensive care unit
      (3.3%) and 43 patients not in the intensive care unit (14.0%), 20 of whom were on
      a telemetry unit. Patients who survived to discharge had similar 1-year survival
      rates regardless of initial hospital location, although intensive care unit
      patients had the best 3-year survival rate, and there were no survivors at 3
      years in the group that received cardiopulmonary resuscitation in the
      nonmonitored hospital bed. Survival was best with an initial cardiac rhythm of
      ventricular tachycardia or fibrillation, but all non-ventricular tachyarrhythmias
      were associated with survival. Age was not an apparent factor, while survival to
      hospital discharge favored whites over blacks. CONCLUSIONS: Futile resuscitative
      efforts are routinely performed in part because physicians and patients are
      unaware of outcome results and factors that influence survival. A wider
      recognition of the limitations of cardiopulmonary resuscitation should lead to
      advanced directives that reflect this awareness, with substantially more patients
      choosing not to have cardiopulmonary resuscitation.

PMID- 7778959
TI  - National trends in the concurrence of tuberculosis and acquired immunodeficiency
      syndrome.
AB  - BACKGROUND: Elucidation of the relationship between tuberculosis (TB) and the
      acquired immunodeficiency syndrome (AIDS) is needed to help predict the future
      course of these two epidemics. We examined nationwide trends in TB and AIDS
      occurring in the same individual. METHODS: Health departments in the 50 states,
      District of Columbia, Puerto Rico, and Guam matched their TB and AIDS case
      registries to determine the number of persons diagnosed with both TB and AIDS.
      The number of AIDS cases, TB cases, AIDS cases that matched with a TB case on the
      TB registry, and TB cases that matched with an AIDS case on the AIDS registry
      were reported to the Centers for Disease Control and Prevention, Atlanta, Ga.
      Data were analyzed for the period from 1981 through 1991. The number of matched
      TB-AIDS cases was compared with a modeled estimate of excess TB cases during the
      period from 1985 through 1990. RESULTS: From 1981 through 1991 there were 11,299
      AIDS cases that matched with a TB case on the TB registry, representing 5.1%
      (geographic variation, 0% to 9.3%) of AIDS cases. The TB cases that matched with
      an AIDS case on the AIDS registry represent 4.3% (geographic variation, 0% to
      15.1%) of TB cases from 1981 through 1991. Since 1981, matched TB and AIDS cases
      increased yearly through 1990. When examined by year of AIDS report, the
      percentage of AIDS cases that matched with a TB case increased from 1981 to 1982
      (1.9% to 5.1%), remained fairly constant from 1983 through 1987 (range, 4.0% to
      4.7%), increased in 1988 (5.4%) after extrapulmonary TB was added to the AIDS
      case definition, and increased slightly through 1990 (5.8%). When examined by
      year of TB report, the percentage of TB cases that matched with an AIDS case
      increased steadily from 1981 through 1990 (0.1% to 9.5%). The calculated fraction
      of excess TB cases during the period from 1985 through 1990 that could be
      accounted for by identified TB-AIDS cases was 30%. CONCLUSION: The risk of TB or
      AIDS among persons already diagnosed with one disease is much higher than among
      the general population. The percentage of persons with TB who are also diagnosed
      with AIDS has been increasing rapidly. Human immunodeficiency virus-induced
      immunosuppression is an important contributor to the TB epidemic and probably
      accounts for a minimum of 30% of excess TB cases during the period from 1985
      through 1990.

PMID- 7778960
TI  - Physicians as patients. Choices regarding their own resuscitation.
AB  - BACKGROUND: Attitudes toward cardiopulmonary resuscitation have changed
      considerably during the last 30 years. Although physicians are routinely involved
      in the decision making about cardiopulmonary resuscitation for their patients,
      little is known about their collective preferences regarding it for themselves.
      METHODS: A questionnaire was distributed at an internal medicine primary care
      review course at an urban community hospital. Of the 111 physicians registered at
      the meeting, 72 (65%) completed the questionnaire and serve as the basis for the
      results. Physicians were asked if they would want cardiopulmonary resuscitation
      for themselves in the presence of an acute myocardial infarction, Alzheimer's
      disease, and nine other advanced chronic diseases at the projected ages of 40,
      60, and 80 years. RESULTS: At all projected ages, physicians' desire for
      cardiopulmonary resuscitation with any advanced chronic disease was significantly
      less than with an acute myocardial infarction (P < or = .000001 except for
      rheumatoid arthritis). Fewer physicians wanted cardiopulmonary resuscitation at
      age 80 years than at 40 years for any disease (P < or = .002). The results did
      not differ when analyzed by respondents' age, gender, or primary care specialty,
      or the size of the community in which they practiced. CONCLUSIONS: The results of
      this initial survey indicate that most physicians would not want cardiopulmonary
      resuscitation with a variety of underlying chronic diseases and corresponding
      functional impairments--particularly with advancing age. Conversely, with an
      acute myocardial infarction, all physicians surveyed would desire cardiopulmonary
      resuscitation at age 40 years, and many would continue to desire it with
      advancing age.

PMID- 7778961
TI  - Nocturnal dyspnea and atrial fibrillation predict Cheyne-Stokes respirations in
      patients with congestive heart failure.
AB  - BACKGROUND: Cheyne-Stokes respirations have frequently been noted in highly
      selected groups of patients with congestive heart failure, but their prevalence
      in an unselected population with congestive heart failure is undefined. METHODS:
      One hundred consecutive unselected outpatients or stable inpatients with clinical
      congestive heart failure encountered by three clinical cardiologists during a 6
      month period were screened for Cheyne-Stokes respirations with overnight
      oximetry. RESULTS: The mean age (+/- SD) of the patients was 70 +/- 8.6 years. Of
      the 100 patients, 33% had had previous coronary bypass surgery, 77% were men, 57%
      had hypertension, and 32% had atrial fibrillation. The mean ejection fraction (+/
      SD) was 34% +/- 13%. Periodic breathing was assessed qualitatively as Cheyne
      Stokes respirations in 27% of patients, nonspecific sleep-disordered breathing
      (apneas and/or hypopneas) in 43%, and normal in 30%. For patients with Cheyne
      Stokes respirations, patients with nonspecific sleep-disordered breathing, and
      normal subjects, the mean numbers of oxyhemoglobin desaturation events per hour
      were 24, 10, and 2, and the total numbers of desaturations of 4% or more that
      lasted less than 3 minutes were 172, 74, and 13. Independent predictors of Cheyne
      Stokes respirations vs non-Cheyne-Stokes respirations included a history of
      nocturnal dyspnea (odds ratio, 4.00; 95% confidence interval, 1.33 to 12.04; P =
      .01) and atrial fibrillation (odds ratio, 3.24; 95% confidence interval, 1.21 to
      8.48; P = .02). CONCLUSIONS: Cheyne-Stokes respirations and nonspecific sleep
      disordered breathing are common in unselected patients with congestive heart
      failure, and Cheyne-Stokes respirations are predicted by a history of nocturnal
      dyspnea and the presence of atrial fibrillation. Techniques designed to modify
      the nocturnal breathing pattern of patients with congestive heart failure may be
      applicable to a large portion of the congestive heart failure population.

PMID- 7778962
TI  - Temporal trends of incident human immunodeficiency virus infection in a cohort of
      injecting drug users in Baltimore, Md.
AB  - OBJECTIVE: To measure the temporal trends in the incidence of infection with
      human immunodeficiency virus in a cohort of injecting drug users in Baltimore,
      Md, between 1988 and 1992. DESIGN: Study subjects were screened for antibodies to
      human immunodeficiency virus by enzyme-linked immunosorbent assay and confirmed
      with Western blot. They were followed up at 6-month intervals with repeated
      serologic screening and comprehensive interviews for human immunodeficiency virus
      risk factors. SETTING: Special study clinic. PARTICIPANTS: A cohort of 2960
      participants were recruited and screened between February 1988 and March 1989.
      Recruitment criteria included an age of 18 years or older, a history of illicit
      drug injection since 1978, and the absence of the acquired immunodeficiency
      syndrome; subjects were subsequently tested for human immunodeficiency virus
      antibodies. Most subjects (85%) were not receiving methadone treatment at
      baseline and were recruited by word of mouth. MAIN OUTCOME MEASURE: Human
      immunodeficiency virus seroconversion. RESULTS: Of the 2247 seronegative
      participants at baseline, 1532 were followed up, and 188 (12.3%) had
      seroconverted by December 1992. The incidence of human immunodeficiency virus
      infection over time among users declined somewhat, especially among women; the
      overall incidence was 1.90 per 100 person-semesters, or 3.80% annually. The
      incidence, adjusted for gender, was higher in younger (< 35 years) than older (>
      or = 35 years) subjects (relative incidence, 1.75; 95% confidence interval, 1.29
      to 2.38) and in women compared with men, adjusted for age (relative incidence,
      1.29; 95% confidence interval, 0.95 to 1.80). The relative incidence among active
      compared with inactive drug users adjusted for age and gender was 1.58 (95%
      confidence interval, 1.06 to 2.35). CONCLUSIONS: Although the incidence of human
      immunodeficiency virus infection in this cohort of injecting drug users in
      Baltimore declined somewhat during the 4 years of follow-up, especially among
      women, the persistent annual incidence of nearly 4% during 3 1/2 to 4 1/2 years
      of observation suggests the need for additional strategies for prevention of
      infection, especially among those who continue injecting drugs. Newer methods of
      prevention, such as provision of sterile injection equipment, an effective human
      immunodeficiency virus vaccine, and wider availability of effective treatment or
      prevention of drug addiction, are urgently needed in these high-risk populations.

PMID- 7778963
TI  - Impact of continued geriatric outpatient management on health outcomes of older
      veterans.
AB  - BACKGROUND: Although previous trials have proved inpatient-based geriatric
      assessment to be beneficial, to our knowledge, the effectiveness of outpatient
      geriatric assessment has not been established. We examined the effectiveness of
      an outpatient geriatric evaluation and management (GEM) clinic. METHODS:
      Hospitalized veterans aged 65 years or older with impairment of activities of
      daily living, chronic disease, polypharmacy, or two or more hospitalizations in
      the previous year were randomized to an outpatient GEM team clinic (n = 60) or
      usual care (n = 68). After an initial comprehensive assessment, they received
      long-term management in the geriatric clinic. Principal outcomes included health
      status (mortality, hospitalizations, health perception, and medications),
      function (activities of daily living, instrumental ADL, and social activity),
      affect (Center for Epidemiologic Studies-Depression test score and life
      satisfaction), and cognition (Mini-Mental State examination score). RESULTS: At
      randomization, no significant differences were noted between the groups. The
      average age of the patients was 71 years (range, 65 to 93 years). At 1 year
      following randomization, GEM clinic patients compared with subjects receiving
      usual care had significantly improved health perception, took fewer medications
      despite increased number of diagnoses, reported greater social activity, had
      improved Center for Epidemiologic Studies-Depression scale scores, and had higher
      life satisfaction scores. There was a trend toward improved performance of
      activities of daily living for GEM clinic patients. The GEM clinic patients had a
      54% lower mortality (6.8% vs 14.9%). Overall, no differences were observed in the
      total number of hospitalizations between the groups. CONCLUSIONS: The combination
      of long-term management following comprehensive outpatient assessment
      significantly improved aspects of health status (including health perception and
      medications), function (including social activity), and affect (including
      depression and life satisfaction) for older veterans and may influence mortality
      and function.

PMID- 7778964
TI  - Determinants of black-white differences in the risk of cerebral infarction. The
      National Health and Nutrition Examination Survey Epidemiologic Follow-up Study.
AB  - OBJECTIVE: To determine whether blacks in the First National Health and Nutrition
      Examination Survey Epidemiologic Follow-up Study remained at increased risk for
      cerebral infarction after adjusting for stroke risk factors and sociodemographic
      factors. METHODS: A cohort study involving 8203 whites and 1362 blacks who
      participated in the First National Health and Nutrition Examination Survey
      Epidemiologic Follow-up Study. During the 13-year follow-up, 538 and 122 cerebral
      infarctions occurred in whites and blacks, respectively. RESULTS: The black-white
      risk for cerebral infarction varied by age (P = .007 for race-age interaction).
      Compared with whites of the same age, blacks aged 35 to 44 years were at
      significantly increased risk for cerebral infarction (relative risk, 2.62; 95%
      confidence interval, 1.23 to 5.57), while older blacks, those older than 64
      years, were not at increased risk (relative risk, 1.14; 95% confidence interval,
      0.90 to 1.46). The relative risk for cerebral infarction decreased to 2.07 (95%
      confidence interval, 0.97 to 4.42) in younger blacks and 0.82 (95% confidence
      interval, 0.29 to 2.33) in older blacks after adjustment for age, sex, education,
      history of heart disease, diabetes, systolic blood pressure, treatment for
      hypertension, Quetelet index, and serum hemoglobin and magnesium levels.
      CONCLUSIONS: These results indicate that much of the increased risk for cerebral
      infarction experienced by blacks can be explained by their higher prevalence of
      stroke risk factors, especially diabetes, hypertension, and lower educational
      attainment. Younger blacks, however, may still be at increased risk after
      adjusting for stroke risk factors.

PMID- 7778965
TI  - Sweet taste (dysgeusia). The first symptom of hyponatremia in small cell
      carcinoma of the lung.
AB  - Three patients with small cell carcinoma of the lung presented with a persistent
      unpleasant sweet taste as their initial and only symptom. On further evaluation,
      they were found to have hyponatremia secondary to the syndrome of inappropriate
      secretion of antidiuretic hormone. In each case, resolution of the sweet taste
      paralleled an increase in serum sodium concentration after water restriction
      alone. Linkage of the sweet taste with a low serum sodium concentration strongly
      implicates hyponatremia--rather than tumor, antidiuretic factor, medications, or
      chemotherapy--as the central mechanism responsible for this previously unreported
      (to our knowledge) sentinel symptom of small cell carcinoma of the lung.

PMID- 7778966
TI  - Calculating gains in life expectancy with risk factor reduction.

PMID- 7778967
TI  - Clinical laboratory test findings in patients with chronic fatigue syndrome.

PMID- 7778968
TI  - [Myxoma of the left atrium as the cause of sudden death? An unusual fatality].
AB  - Case report of a 67-year-old woman who was found under mysterious circumstances 3
      weeks after she had died. Main result of the autopsy was a myxoma of considerable
      size in the left atrium. Epidemiology, pathology and clinical aspects are
      presented. The myxoma's possible meaning as cause of death is examined in a
      fatality where the inquiry was restricted because of the corpse being putrefied
      and partly eaten away by maggots.

PMID- 7778969
TI  - [Suicide in the Geneva canton (1971-1990). An analysis of the forensic medicine
      autopsy sample].
AB  - During the twenty-year period from 1971 to 1990, 1654 cases of suicide were
      examined at the Institute of Forensic Medicine of Geneva University. The suicide
      rate for the entire population averaged 22,75 per 100,000 population per annum.
      The male to female ratio was 1.5:1. The average age was 47. The highest suicide
      rate lay between ages 27 and 32 for men and between ages 45 and 50 for women. The
      most common means of suicide chosen by men were the use of firearms (28%) and
      hanging (21%) whilst women preferentially chose falling from a height (26%),
      poisoning (24%) or drowning (22%). Carbon monoxide poisoning, the major means of
      suicide before 1971 (20%), has greatly decreased whereas firearms, formerly
      representing only 13% of all suicides before 1971, have become the principal
      means (19%). May, January and September have, respectively, the highest rate of
      suicide.

PMID- 7778971
TI  - [Recoil-induced rifle butt mark on the ceiling in suicidal gunshot injury].
AB  - In a suicide case the butt of the weapon (double-barrelled shotgun) produced a
      characteristically shaped mark at the ceiling, which could be physically
      explained by the recoil effect and was a clue that the victim had fired the shot
      himself. The ammunition used was a cartridge with a rifled shotgun slug (Brenneke
      type). The contact shot into the temple resulted in the rupture of the skull with
      exenteration of the brain. As the weapon remained lying on the body of the
      suicide after the shot, brownish traces of rust could form at the places of
      contact with steel parts.

PMID- 7778970
TI  - [6 cases of premeditated murder of adults by drowning].
AB  - Premeditated murder of adults by drowning is rare and hard to investigate. Six
      cases are reported. If the aim of the killer is homicide by drowning to begin
      with (primary drowning), it is usually difficult to prove as morphological
      findings are missing of may be insignificant and ambiguous. If, on the other
      hand, the killer opts for drowning only as a conclusion to a primarily
      differently planned assault (e.g. strangling), the finding patterns are
      different, and their interpretation is usually easier (secondary drowning).

PMID- 7778972
TI  - [Fatal gunshot wound injuries with so-called shooting ball-point pens].
AB  - Report on two suicides using shooting ball-point pens (with .22 lr and .22 lr Hv
      cartridges respectively). Both cases were contact shots (in the first case in the
      area of the right ear, in the second case in the left temple). Corresponding to
      the configuration of the barrel end, the muzzle imprints were uncharacteristic
      (ring-shaped and narrow). The other morphological findings of the wounds did not
      differ from the injuries inflicted by conventional small-bore weapons.

PMID- 7778973
TI  - Isolation and characterisation of a strain of Pseudomonas putida that can express
      a periplasmic nitrate reductase.
AB  - A strain of Pseudomonas putida that can express a nitrate reductase that is
      located in the periplasmic compartment was isolated from freshwater. The enzyme
      was active in vivo during arginine fermentation and at the onset of oxygen
      limitation in batch cultures. The activity of the enzyme increased the yield of
      bacteria following fermentative growth under anoxic conditions with arginine, but
      nitrate reduction did not support growth on non-fermentable carbon substrates
      under anoxic conditions. Cells expressing the periplasmic nitrate reductase were
      capable of reducing nitrate in the presence of oxygen. Nitrate reduction under
      oxic conditions was clearly coupled to a respiratory electron transport chain
      because: (1) the process was sensitive to the respiratory inhibitors rote-none
      and 2-n-heptyl-4-hydroxyquinoline N-oxide, and (2) membrane-bound and periplasmic
      cytochromes were involved. This is the first report of the presence of a
      periplasmic nitrate reductase in a member of the gamma proteobacteria.

PMID- 7778974
TI  - Evidence of two pathways for the metabolism of phenol by Aspergillus fumigatus.
AB  - Aspergillus fumigatus (ATCC 28282), a thermotolerant fungus, has been shown to be
      capable of growth on phenol as the sole carbon and energy source. During growth
      of the organism on phenol, catechol and hydroquinone accumulated transiently in
      the medium; cells grown on phenol oxidised these compounds without a lag period.
      Two different routes operating simultaneously, leading to different ring-fission
      substrates, are proposed for the metabolism of phenol. In one route, phenol
      undergoes ortho-hydroxylation to give catechol, which is then cleaved by an
      intradiol mechanism leading to 3-oxoadipate. In the other route, phenol is
      hydroxylated in the para-position to produce hydroquinone, which is then
      converted into 1,2,4-trihydroxybenzene for ring fission by ortho-cleavage to give
      maleylacetate. Cell-free extracts of phenol-grown mycelia were found to contain
      enzymic activities for the proposed steps. Two ring-fission dioxygenases, one
      active towards 1,2,4-trihydroxybenzene, but not catechol, and one active towards
      both ring-fission substrates, were separated by FPLC. Succinate-grown mycelia did
      not oxidise any of the intermediates until a clear lag period had elapsed and did
      not contain any of the enzymic activities for phenol metabolism.

PMID- 7778975
TI  - Metabolic pathways and energetics of the acetone-oxidizing, sulfate-reducing
      bacterium, Desulfobacterium cetonicum.
AB  - Acetone degradation by cell suspensions of Desulfobacterium cetonicum was CO2
      dependent, indicating initiation by a carboxylation reaction. Degradation of
      butyrate was not CO2-dependent, and acetate accumulated at a ratio of 1 mol
      acetate per mol butyrate degraded. In cultures grown on acetone, no CoA transfer
      apparently occurred, and no acetate accumulated in the medium. No CoA-ligase
      activities were detected in cell-free crude extracts. This suggested that the
      carboxylation of acetone to acetoacetate, and its activation to acetoacetyl-CoA
      may occur without the formation of free acetoacetate. Acetoacetyl-CoA was
      thiolytically cleaved to two acetyl-CoA, which were oxidized to CO2 via the
      acetyl-CoA/carbon monoxide dehydrogenase pathway. The measured intracellular acyl
      CoA ester concentrations allowed the calculation of the free energy changes
      involved in the conversion of acetone to acetyl-CoA. At in vivo concentrations of
      reactants and products, the initial steps (carboxylation and activation) must be
      energy-driven, either by direct coupling to ATP, or coupling to transmembrane
      gradients. The delta G' of acetone conversion to two acetyl-CoA at the expense of
      the energetic equivalent of one ATP was calculated to lie very close to 0 kJ (mol
      acetone)-1. Assimilatory metabolism was by an incomplete citric acid cycle,
      lacking an activity oxidatively decarboxylating 2-oxoglutarate. The low specific
      activities of this cycle suggested its probable function in anabolic metabolism.
      Succinate and glyoxylate were formed from isocitrate by isocitrate lyase.
      Glyoxylate thus formed was condensed with acetyl-CoA to form malate, functioning
      as an anaplerotic sequence. A glyoxylate cycle thus operates in this strictly
      anaerobic bacterium. Phosphoenolpyruvate (PEP) carboxykinase formed PEP from
      oxaloacetate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778976
TI  - Molecular cloning and characterization of the extracellular sucrase gene (sacC)
      of Zymomonas mobilis.
AB  - The Zymomonas mobilis gene sacC that encodes the extracellular sucrase (protein
      B46) was cloned and expressed in Escherichia coli. The gene was found to be
      present downstream to the already described levansucrase gene sacB in the cloned
      chromosomal fragment of Z. mobilis. The expression product was different from
      SacB and exhibited sucrase but not levansucrase activity; therefore, SacC behaves
      like a true sucrase. Expression of sacC in E. coli JM109 and XL1 was very low;
      overexpression was observed in E. coli BL21 after induction of the T7 polymerase
      expression system with IPTG. Subcellular fractionation of the E. coli clone
      carrying plasmid pLSS2811 showed that more than 70% of the sucrase activity could
      be detected in the cytoplasmic fraction, suggesting that the enzyme was soluble
      and not secreted in E. coli. The nucleotide sequence analysis of sacC revealed an
      open reading frame 1239bp long coding for a 413 amino acid protein with a
      molecular mass of 46 kDa. The first 30 deduced amino acids from this ORF were
      identical with those from the N-terminal sequence of the extracellular sucrase
      (protein B46) purified from Z. mobilis ZM4. No leader peptide sequence could be
      identified in the sacC gene. The amino acid sequence of SacC showed very little
      similarity to those of other known sucrases, but was very similar to the
      levansucrases of Z. mobilis (61.5%), Erwinia amylovora (40.2%) and Bacillus
      subtilis (25.6%).

PMID- 7778977
TI  - Fatty acid profiles of "Pasteurella" piscicida: comparison with other fish
      pathogenic gram-negative bacteria.
AB  - The fatty acid methyl ester (FAME) profiles of "Pasteurella" piscicida were
      determined by gas chromatography and subjected to numerical analysis in
      comparison with those obtained for Vibrio anguillarum, Aeromonas salmonicida and
      Pasteurella species of clinical origin. The bacterial species studied shared
      important characteristics with respect to their FAME content: in all of them the
      saturated and unsaturated fatty acids of 16 carbon atoms were the predominant
      fatty acids. However, distinguishing features could be detected for each
      pathogen. Using either single linkage or complete linkage algorithms, strains
      were divided into four phena that corresponded to the different species, but
      showed a high degree of correlation among them. Although single linkage
      discriminated strains better within each phenum, complete linkage was more useful
      to establish the relationships among clusters. The results obtained support the
      idea that "Pasteurella" piscicida is related to members of the genera Vibrio and
      Aeromonas and indicate the need for exhaustive genetic studies to clarify the
      taxonomic position of this fish pathogen.

PMID- 7778978
TI  - Growth-phase-dependent alginate synthesis, activity of biosynthetic enzymes and
      transcription of alginate genes in Pseudomonas aeruginosa.
AB  - Alginate synthesis by the highly mucoid Pseudomonas aeruginosa 8821 M is growth
      phase-dependent, and the alginate produced per unit of biomass reaches maximum
      values in the deceleration phase of growth. However, the degree of polymerization
      increases as batch growth proceeds, reaching maximum values at the stationary
      phase of growth. The activity of the four enzymes leading to GDP-mannuronic acid
      formation, phosphomannose isomerase, phosphomannomutase, GDP-mannose
      pyrophosphorylase and GDP-mannose dehydrogenase peaked earlier at the late
      exponential phase. Growth-phase-dependent activity of alginate biosynthetic
      enzymes correlates with the level of transcription of the encoding alginate genes
      algA, algC and algD during growth, as indicated by Northern blot hybridization
      experiments. The pattern of coordinate transcriptional growth-phase regulation of
      these alginate structural genes concurs with the growth-dependent transcription
      of the regulatory gene algR1.

PMID- 7778979
TI  - [The effect of a different protein and fiber intake on the ileal flow of
      endogenous protein in 15N-labeled swine].
AB  - The endogenous N in ileal digesta of pigs was estimated in two experimental
      variants. In variant 1 the crud protein content of a wheat-maize-fish meal diet
      was 18% and the crude fibre content was 1.9% (diet 1) and 2.7% resp. (diet 2). In
      variant 2 the crude protein content was 12.5% (wheat-maize-diet) and the crude
      fibre content was 4.1% (diet 3) and 5.5% resp. (diet 4). The higher crude fibre
      content of the diets 2-4 was provided by means of a supplementation with
      partially hydroyzed straw meal plus pectin (2:1 w/w). Four miniature pigs with an
      average initial body weight of 29 kg, were fitted with a ileocaecal re-entrant
      cannula and received each one of the four different diets. 15NH4Cl, added to the
      diets, was given for 5 days (150 mg 15N-excess/kg0.75 BW*d) to label the animals
      with 15N. Ileal digesta, urine and faeces were collected over 24 hours on 8th,
      10th and 12th day after the first intake of 15N. The 15N-excess of urine N was
      used as the comparative measure of 15N-excess of endogenous protein. The amount
      of nitrogen collected in ileal digesta was in order of the diets 1-4 = 258, 299,
      200 and 224 mg/kg0.75 BW*d and of these amounts were 50.1, 52.1, 56.1 and 50.4%
      of endogenous origin. This were corresponding, after conversion into crude
      protein to 9.1, 11.2, 10.8 and 11.0 g/100 g crude protein intake or 16.9, 19.7,
      13.8 and 13.4 g/kg dry matter intake, respectively. The bacterial N-flow were in
      order the diets 1-4 = 94.0; 72.7; 55.8 and 52.6 mg/kg0.75 BW*d and 73, 46, 50 and
      47% resp. of the endogenous N or 36, 24, 28 and 24% of the ileal total N. The
      results show, that the absolute amounts of endogenous and bacterial N at the
      terminal ileum were significantly increased by a higher crude protein content of
      the diet. The percentage of endogenous and bacterial N on the total N of the
      ileal digesta was not affected neither by the crude protein content of the diets
      nor by the fibre supplements.

PMID- 7778980
TI  - [The effect of avilamycin and tylosin on the apparent digestibility of iron,
      zinc, copper, manganese and selenium in the beginning and ending performance of
      swine].
AB  - In two metabolism trials with growing and finishing pigs the effect of the
      antibiotic feed additives Avilamycin and Tylosin on the apparent digestibility of
      Fe, Zn, Cu, Mn and Se was investigated. The feed additives were supplied to the
      diet in levels of 40 ppm (growing pigs) and 20 ppm (finishing pigs) each. Dietary
      contents of Fe, Zn, Cu, Mn and Se covered the requirements of all treatment
      groups. Avilamycin and Tylosin increased the apparent digestibility by 4 (Fe), 4
      (Zn), 5 (Cu), 2 (Mn) and 2 (Se) percentage units on an average.

PMID- 7778981
TI  - [Age and sex dependent variation in the content of Fe, Zn, Cu and Mn in different
      body parts and their retention in fattening pigs].
AB  - The concentrations of Fe, Zn, Cu and Mn were determined in meat, inner organs,
      blood and residual carcass in a total of 24 barrows and gilts of 60 kg and 100 kg
      of live weight, respectively. the finisher diet contained 192 ppm Fe, 113 ppm Zn,
      18 ppm Cu and 65 ppm Mn with, as calculated, a great proportion originating from
      the mineral supplement. During growth, the contents of Fe, Cu and Mn were
      significantly reduced. No sex differences occurred. In the lean meat of the 100
      kg pigs, common values accounting for 1.1 mg Fe, 2.8 mg Zn and 0.05 mg Cu per 100
      g were analyzed. The manganese concentration of 0.01 mg per 100 g, however, was
      considerably lower as the corresponding figure from nutrient tables. In the
      finishing period, the animals retained per animal and day about 18 mg Fe, 15 mg
      Zn and 0.2 mg Cu. Mn retention was not significantly different from zero. The low
      utilization rates calculated from these data can be partly explained by the
      moderately excessive supply in this fattening period. In order to reduce the
      trace element load of the soils, a considerably lower tolerance of excessive
      trace element contents in finisher diets has to be developed.

PMID- 7778982
TI  - Effect of raising dietary protein, amino acids and/or energy levels as an attempt
      to alleviate severity of the chronic aflatoxicosis by broiler chicks. 1.
      Performance and toxicity symptoms.
AB  - In an attempt to alleviate the aflatoxicosis symptoms by broiler chicks fed on
      low (50 ppb) aflatoxin-contaminated diet; the dietary nutrients were elevated by
      2.6% for protein, 0.54 MJ ME/kg for energy or 0.5% for each of methionine and
      lysine. These supplements were mixed altogether and applied as well. All the
      experimental diets were offered for a 6-week period followed by a 2-week period
      on aflatoxin--free diet without supplements as a withdrawal period. It was proved
      after the treatment period that the raising of energy concentration was
      beneficial to overcome the aflatoxin effects on the body weight, feed conversion
      rate, and dressing (eviscerated weight) percentage and stability of relative
      weights of liver and kidneys. Additionally, the supplements' mixture improved the
      body weight and the relative weight of the liver comparing with the chicks fed on
      the aflatoxin diet without additives. All of the contaminated diets, except that
      of the high energy, caused apparently toxic symptoms besides the internal gross
      pathology. The high energy diet reflected the lowest mortality rate, whereas the
      highest was with the amino acids supplemented one. The withdrawal period resulted
      in lower differences among treatments in the body weight. It improved also the
      dressing percentage (significantly) and to some extent the results of the post
      mortem examination.

PMID- 7778984
TI  - The adherence of three Streptococcus bovis strains to cells of rumen epithelium
      primoculture under various conditions.
AB  - Three Streptococcus bovis strains were tested in biotype assay and examined for
      the adherence to cells of rumen epithelium primoculture. The adherence pattern of
      ruminal streptococci in phosphate buffered saline at pH values ranging from 4.1
      to 8.5 was determined. Our isolates of Streptococcus bovis strains adhered best
      at pH 7.0-7.3. To characterize the adhesive determinants, the bacterial cells
      were exposed to various treatments. Protease treatment dramatically decreased the
      adherence of all Streptococcus bovis strains, thus suggesting that the
      determinants responsible for the adherence are largely proteinaceous.
      Carbohydrates could be also significantly involved in the active sites of
      bacterial surface because metaperiodate-treated cells adhered much more poorly
      than control, sodium iodate-treated cells. Addition of carbohydrates (lactose,
      maltose and saccharose) had no significant effect on the adherence of
      Streptococcus bovis strains although a slight decrease in the adhesion was
      detected.

PMID- 7778983
TI  - Effect of raising dietary protein, amino acids and/or energy levels as an attempt
      to alleviate severity of the chronic aflatoxicosis by broiler chicks. 2.
      Biochemical characteristics.
AB  - Aflatoxin caused some reduction in moisture contents of chest and liver, lipids
      of thigh and blood, blood glucose, muscular protein and GOT in liver. It led also
      to increase of moisture contents of thigh and kidneys; chest lipids; blood
      cholesterol; protein of liver, kidneys and blood and blood creatinine. The
      different supplements used herein led to increasing moisture of muscles, liver
      and kidneys (except on oil addition); lipids of muscles (except of chest on high
      energy diet) and blood (except on amino acids-supplemented diet); blood
      cholesterol (except on high energy one); protein of thigh (except on high protein
      one) and blood (except on high energy or amino acids diets) and liver GPT (except
      on high energy diet). The additives led also to low blood glucose; protein of
      chest (except on high energy), liver, and kidneys; blood creatinine; liver GOT
      (particularly with high energy or amino acids); plasma GOT (on high amino acids)
      and plasma GPT. The 2-week withdrawal period led to low moisture contents of
      muscles and kidneys of most treatments, although they continued higher than in
      the control for chest, liver and kidneys. It increased blood glucose and
      cholesterol with continuous higher lipid content of muscles and blood and blood
      cholesterol than in the control. It led to elevated protein content of muscles,
      liver (except on the control or supplements mixture), kidneys (on the aflatoxin
      alone or with the amino acids) and blood (except on the control or aflatoxin
      alone or with high protein) and blood creatinine (except on the control or on the
      high energy or the supplements mixture).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7778985
TI  - [15N-flow after in sacco incubation and feeding of sheep and goats with untreated
      wheat straw or straw treated with 15N horse urine].
AB  - Chopped wheat straw was homogeneously mixed with urine of horses (5.75 gN per 1,
      16.88 atom-% 15N-excess) and airtightly stored in plastic containers for 6
      months. Three rumen fistulated sheep and goats each were fed with untreated or
      urine treated straw. Concentrate was added to straw. Untreated and urine treated
      straw were given in nylon bags and incubated in the rumen of sheep and goats for
      1, 3, 6, 12, 24, 48 and 72 hours. A three compartment exponential function was
      used to fit the measurements of 15N-excess and 15N-amount of bag content. The
      curves and the calculated partial Y-values of the three compartments show the
      inflow and outflow of 15N into or from the bags and allow conclusions about the
      binding of urine N. Most N of urine was not compactly bound by straw during
      storage. Primarily microbial N was attached to the straw in the rumen. About 6%
      of urine N were bound more compact to the straw. Similar curves were calculated
      for 15N-excess and 15N-amount of nylon bags. The curves allow conclusions about
      tracer flows without quantitative knowledge. There were no significant
      differences between animal species.

PMID- 7778986
TI  - [Delirium after open-heart surgery. Prevalence, risk factors and therapeutic
      approach].

PMID- 7778987
TI  - [Infective endocarditis in children and adolescents].
AB  - PURPOSE: To assess infective endocarditis (IE) predisposing factors, etiologic
      agents and hospital course in infants and adolescents. METHODS: We Studied 222
      patients admitted under compatible IE diagnosis, from 1985 to 1990. The
      population of this study is fifty patients (23%) under 16 years of age. RESULTS:
      Rheumatic valvular disease, as predisposing cardiopathy was proeminent within 9
      to 16 years of age, markedly Statistical difference when compared to age range of
      0 to 8 years (p < 0.05). Among congenital cardiopathies, the most frequent were:
      interventricular septal defect (26.0%) and tetralogy of Fallot (21.7%). Blood
      cultures, surgical material or emboli cultures were positive in 35 (70.0%)
      assessed patients. Streptococcus viridans (45.7%) and Staphylococcus aureus
      (42.8%) were the etiologic agents most often isolated. It was found that
      endocarditis by Staphylococcus aureus had mortality rate of 53.3% [(clinical
      (66.6%) and surgical (44.4%)], (p < 0.05) when compared to those by Streptococcus
      viridans; with total mortality of 6.2% (no clinical death and 16.6% in the
      surgical group). Total in-hospital mortality (clinical and surgical) was 26.0%
      (13 deaths). CONCLUSION: IE in infants and adolescents in this studied population
      presented Streptococcus viridans responsible for 46.7% of patients with
      endocarditis and the Staphylococcus aureus for 42.8% were the etiologic agents
      most often found. Total, clinical and surgical mortality was greater in patients
      with endocarditis by Staphylococcus aureus when compared with those by
      Streptococcus viridans. Among the congenital cardiopathies, whether operated on
      or not, ventricular septal defect and of Fallot's tetralogy were the most
      involved ones; rheumatic cardiopathy Still remains a significant predisposing
      factor to infective IE in our country.

PMID- 7778988
TI  - [Comparative study of transthoracic Doppler echocardiogram, computed tomography
      and aortography in the diagnosis of thoracic aortic dissection].
AB  - PURPOSE: Comparative and prospective evaluation of three methods (transthoracic
      echo-Doppler (TTE), computerized tomography (CT) and aortography (AORT) utilized
      for aortic dissection diagnosis. METHODS: The 39 patients with confirmed aortic
      dissection (surgery or autopsy) underwent, within a few hours of each other, all
      three methods scrutinized. There were 19 cases of type A and 20 of type B
      dissection. RESULTS: In type A dissection the methods were equivalent (TTE =
      73.7%, CT = 84.2%, AORT = 73.7% p = NS) but for type B, TTE was significantly
      inferior to the other two methods (TTE = 60%, TC 90%, AORT = 80%, p < 0.05 for
      TTE, for TC and AORT p = NS). In three occasions, even though all three methods
      were performed, the diagnosis was not obtained. CONCLUSION: The methods which
      were evaluated make the diagnosis in the majority of cases. In type A all methods
      are similar, however, in type B, TC and AORT are superior to TTE. Even performing
      all three methods in each patient, in three instances the diagnosis was not made.

PMID- 7778990
TI  - [Radiofrequency catheter ablation of type I atrial flutter].
AB  - PURPOSE: To verify the efficacy and safety of the creation of a barrier with
      radiofrequency (RF) in the tricuspid annulus and the vena cava ostium (TA-IVC).
      METHODS: Nine consecutive patients, 7 males, with age ranging from 36 to 76
      years, with paroxysmal (7 patients) or permanent (2) type I atrial flutter
      (negative P wave in lead II, III and F) were submitted to RF ablation of TA-IVC
      istmo. One deflectable catheter with 4mm size tip was introduced into the right
      ventricle apex and pulled back to the inferior vena cava. When the atrial
      electrogram was detected the RF application was started. The RF was applied (20
      watts during 60s) up to the proximity of inferior vena cava ostium. The end point
      was to stop atrial flutter. Then a vigorous atrial stimulation protocol,
      including isoproterenol infusion was used. In the next day, patients were
      submitted to transesophageal stimulation with the same protocol. RESULTS: Atrial
      flutter was interrupted in all patients (100%) with 4 to 28 (mean 16.7 +/- 7.7)
      applications. Eight patients (88.8%) with one session and 1 (11.1%) with two
      sessions. The mean time spent to stop the atrial flutter with one application was
      30.5 +/- 18.5s. There were no complications. After a mean follow up of 3 +/- 1.6
      month all patients (100%) are asymptomatic. Two of them are taking propranolol to
      control symptomatic atrial and ventricular ectopic beats. CONCLUSION: RF ablation
      of the TA-IVC istmo is efficient and safe in a short term follow up to interrupt
      and prevent re-induction and recurrence of type I atrial flutter.

PMID- 7778989
TI  - [Comparative study of the extension of coronary arteriosclerosis with risk
      factors and changes in the retinal artery].
AB  - PURPOSE: To identify a possible relationship of the extent of coronary artery
      disease, with risk factors for coronary artery disease and the retinal arteriolar
      changes (evaluated by fundoscopic examination). METHODS: We studied 96 patients
      (66 males), 36 to 72 years of age. All patients were studied by selective
      cinecoronaryarteriography, fundoscopic examination, as well as evaluated for the
      common risk factors, cigarette smoking diabetes, dislipidemia, systemic
      hypertension, age, alcoholism, male sex, family history and obesity. RESULTS:
      Male (p < 0.001) and smoking (p < 0.01) were the statistically significant
      associations with the extent of coronary artery disease. No significant
      relationship with the extent of coronary artery disease was present for the other
      risk factor nor for changes in retinal arteriolar branches. CONCLUSION: A
      relationship between extent of coronary artery disease with male sex and a
      cigarette smoker is occurred. No relationship with other risk factors, nor with
      retinal arteriolar changes were present.

PMID- 7778991
TI  - [Evaluation of QRS voltage in 12 derivations and Cornell criteria in the
      diagnosis of left ventricular hypertrophy].
AB  - PURPOSE: To search for the existence and degree of correlation between total 12
      lead ECG amplitude and the sum of RaVL + SV3 > 28 mm (for men) or > 20mm (for
      women) and left ventricular hypertrophy (LV mass calculated by echocardiography >
      215g for both sexes). METHODS: ECG and echocardiograms of 227 consecutive
      patients were examined and submitted to statistical analysis searching for
      correlation between total 12 lead ECG amplitude and Cornell criteria and LV mass
      (ASE formula modified by Devereux). RESULTS: Patients had ischemic heart disease,
      hypertension, valvular disease, cardiomyopathy or other less common heart
      diseases, or had no cardiac illness at all. There was statistically significant
      association of total 12 lead amplitude > 120mm and Cornell criteria with LV mass
      > 215g (p = 0.02 and p = 0.01 respectively). Total ECG amplitude showed 74.3%
      sensitivity, 42.6% specificity, and 52.4% accuracy. Cornell criteria showed
      values of 37.8%, 82.7% and 68.7% respectively. CONCLUSION: Total 12-lead
      amplitude presented limited diagnostic performance for detecting LV hypertrophy,
      as well as did ECG Cornell criteria, although the latter was more specific and
      more accurate.

PMID- 7778992
TI  - [Acquired ventricular septal defect during infective endocarditis].
AB  - We studied five patients with acquired ventricular septal defect during the
      course of an infective endocarditis. All patients were male and had a previous
      aortic valve disease associated with an aortic ring abscess. Clinical examination
      was useful for the diagnosis of 4 cases, emphasizing the following findings:
      systolic murmur and/or left paraesternal thrill and right-heart failure.
      Incidence of congestive heart failure was 60%, while 40% of all patients died
      during the in-hospital course. No specific etiologic agent was detected.
      Therefore, acquired ventricular septal defect should be suspected in patients
      with infective endocarditis of the aortic valve that evolve with a systolic
      murmur and/or paraesternal thrill and right-heart failure. Immediate surgical
      treatment is mandatory in these cases.

PMID- 7778993
TI  - [Congenital cerebral arteriovenous fistula. Diagnostic peculiarity and surgical
      repair in an infant with heart failure].
AB  - A case of 3 month-old-boy with Down's syndrome and heart failure due to a
      localized arteriovenous fistula of the cranial vessels is reported. Clinical
      diagnosis was made after cranial bruit detection based on a retroauricular thrill
      incidentally felt by the mother. The diagnosis was confirmed by digital
      subtraction angiography and a good result was achieved by means of embolization
      and surgical ligation of the fistula. Three years after the operation the patient
      is asymptomatic, on no medication and with normal magnetic resonance image of the
      cranial vessels.

PMID- 7778994
TI  - [Beta-hemolytic streptococcus endocarditis in an adolescent with hypertrophic
      cardiomyopathy].
AB  - A 15 year-old male adolescent was hospitalized in a severe septic condition, due
      to infectious endocarditis which abided for 20 days. The admittance
      echocardiogram displayed a mitral valve vegetation in conjunction to a
      hypertrophic cardiomyopathy. In spite of applied antibiotics the patient expired.
      The authors emphasize the diagnostic difficulties of this compound entity and
      stress the need of antibiotic prophylaxis for patients who bear a hypertrophic
      cardiomyopathy, even in those with a non-obstructive disposition.

PMID- 7778995
TI  - [Percutaneous balloon aortic valvuloplasty in the newborn].
AB  - Two cases of aortic valvar stenosis are presented, each of them submitted to
      balloon valvoplasty in the newborn period, with instant relief of the obstruction
      and clinical improvement. Studies about the aortic balloon valvuloplasty are
      being accomplished, showing results similar to the surgical approach, but with
      lower risks.

PMID- 7778996
TI  - [Rupture of sinus of Valsalva aneurysm].
AB  - A 35 year-old man with aneurysm of the noncoronary sinus of Valsalva ruptured
      into the right atrium, detected by echodopplercardiogram and submitted to
      surgical correction is reported. The authors discuss peculiar aspects of this
      disease, with emphasis to the echodopplercardiographic diagnosis.

PMID- 7778997
TI  - [Case 5/94 (Instituto Dante Pazzanese de Cardiologia)].

PMID- 7778998
TI  - [Cardiomyoplasty. A new Biotronik generator].

PMID- 7778999
TI  - [Design, manufacturing, and testing of a pulsatile ventricular assist device].
AB  - PURPOSE: To describe the design of a ventricular assist device (VAD), its
      manufacturing and testing. METHODS: The VAD is pulsatile, with a free floating
      membrane, smooth internal surfaces, and pericardium valves. It comprises also a
      pneumatic driving unit capable of operating in the "full to empty", EKG
      synchronized or asynchronous modes. The system was tested "in vitro" to assess
      its mechanical durability, hydrodynamic performance and hemolysis. "In vivo"
      tests were performed in 22 sheep and 8 calves aiming at optimizing cannulas and
      implant techniques. In these experiments, hemolysis and the device's capacity of
      restoring to normal hemodynamic parameters during induced cardiac failure were
      evaluated. RESULTS: The device was worked 4,000 hours without failure in a mock
      circulatory loop. Hydrodynamic performance was satisfactory for adult circulatory
      support. In "full to empty" mode it displayed a frequency mediated "Starling
      like" performance. Optimum output was achieved with a systole duration of 40% of
      the cycle. "In vitro" hemolysis index was 6.7 +/- 2.1. Hemolysis in animal
      experiments was clinically non significant. In calves under induced cardiac
      failure the VAD was able to normalize hemodynamic parameters within 120 minutes.
      CONCLUSION: This VAD is capable to circulatory assist for cardiogenic shock in
      conditions needed for an adult patient and the average time span anticipated for
      bridge to transplantation or post cardiotomy cardiogenic shock.

PMID- 7779001
TI  - [Mechanical assistance in cardiogenic shock after cardiac surgery].

PMID- 7779000
TI  - [Human heart transplantation in Brazil].
AB  - PURPOSE: To analyze patients operated on in Brazil from May 1968 until June 1993.
      METHODS: Three patients were transplanted in the historical period of 1968 and
      1969. In the modern period from 1984-1993, 380 transplants were performed in 379
      patients. These patients were transplanted in 23 services in 20 hospitals. These
      services are in 12 cities of 11 states. The state with the larger number of
      patients was Sao Paulo with 239 transplants followed by Minas Gerais with 58.
      RESULTS: In this casuistry, the patients were predominantly male (81%) with age
      between 31 and 40 years (30%). The most frequent indication was idiopathic
      dilated cardiomyopathy (53.4%) followed by ischemic (26.8%) and with a special
      reference for the Chagas' etiology (11%). The results in 297 patients showed 48
      immediate and 49 late deaths. The actuarial survival curve showed 64.7% and 47.4%
      respectively after one and five years. CONCLUSION: Important differences were
      observed in relation to the international casuistry but even so benefits were
      present when compared with medical treatment.

PMID- 7779002
TI  - [Mechanical circulatory support as a bridge to cardiac transplantation].

PMID- 7779003
TI  - [Cardiomyoplasty perspectives in the treatment of heart failure].

PMID- 7779004
TI  - CAD/CAM/CAE in the medical engineering lab.

PMID- 7779005
TI  - Cardiomyoplasty: a summing up.

PMID- 7779006
TI  - 5th WAA Congress therapeutic artificial organs, 10 years after.
AB  - In 1983, more than 10 years ago, the concept of therapeutic artificial organs was
      proposed by this author. Currently developments of various types of
      immunomodulation technologies are well established, and therapeutic artificial
      organs for the treatment of autoimmunodiseases have become a well-accepted
      concept. It is this author's opinion that if we utilize apheresis technologies
      properly we should be able to prevent the aging process of mankind. Physical
      youth, and perhaps mental youth, can be achieved by apheresis technologies.
      However, in order to maintain youth and enjoy a high quality of life, it is
      essential to maintain a strong will to live. In this paper a new type of an
      artificial organ is proposed. This antiaging artificial organ is named "Juzo,"
      the organ for a longer life, in Japanese, by this author.

PMID- 7779007
TI  - Present trends in clinical experience with dynamic cardiomyoplasty.
AB  - Dynamic cardiomyoplasty has been performed to reinforce the myocardium in the
      treatment of patients with severe cardiomyopathies. At the Heart Institute of Sao
      Paulo University Medical School, 36 patients were submitted to cardiomyoplasty
      between May 1988 and December 1993. The indications were idiopathic dilated
      cardiomyopathy in 31, ischemic cardiomyopathy in 3, and Chagas' disease
      cardiomyopathy in 2 patients. Twenty-eight patients were categorized in New York
      Heart Association (NYHA) Class III and 8 in Class IV despite the use of maximal
      medical therapy. There were no hospital deaths, and patients were followed up
      from 2 to 70 months (mean, 24 months). Besides the improvement of NYHA functional
      class from 3.2 +/- 0.6 to 1.6 +/- 0.9 at 6 months of follow-up, patients also
      presented significant changes in the left ventricular systolic and diastolic
      functions. Nevertheless, 16 patients died, and 2 patients were submitted to heart
      transplantation during late follow-up. Actuarial survival rates were 82.3% at 1
      year, 61.5% at 2 years, and 38.8% at 5 years of follow-up. Otherwise, the
      analysis of factors influencing the outcome showed that long-term survival was
      significantly affected by preoperative functional class and by pulmonary vascular
      resistance. The 26 patients operated in NYHA functional Class III and with
      pulmonary vascular resistance below 4 Wood units presented survival rates of
      72.7% at 2 years and of 63% at 5 years of follow-up. In conclusion dynamic
      cardiomyoplasty improves functional class and left ventricular function in
      patients with severe cardiomyopathies. However, the long-term survival after this
      surgical procedure may be limited by the patients' condition before the
      operation.

PMID- 7779008
TI  - Effects of muscle length, frequency of stimulation, and fatigue on the isometric
      tension in canine latissimus dorsi.
AB  - An experimental protocol was designed to study the mechanical response of the
      canine latissimus dorsi muscle stimulated to contract isometrically. Active and
      passive tensions were measured with the muscle's initial length varying within
      10% of its physiologic length in situ. The force-frequency relationship was
      obtained at frequencies of stimulation of 1, 10, 15, 30, and 60 Hz. Muscle
      fatigability was assessed during 3 min of successive contractions. Tests were
      performed in pedicled muscles of anesthetized mongrel dogs (n = 10). Force-length
      characteristics were found to affect evoked tension markedly. Maximal active
      tension was generated near the muscle length in situ. Specific isometric tension
      measured with unit pulse stimulation was 2 +/- 0.4 N/cm2, and the time to peak
      twitch was 92.8 +/- 2.67 ms. With 60 Hz of stimulation frequency, the tension was
      9.31 +/- 0.32 N/cm2, and the time to peak tension was 216.05 +/- 16.28 ms. After
      the fatigue test, the tension generated decreased to 62.5% of its initial value,
      and this decline was paralleled by the rate of tension development and tension
      relaxation.

PMID- 7779009
TI  - A feasibility study on a new artificial sphincter for colostomy.
AB  - Although many efforts have been put forth, fecal incontinence of colostomates is
      still an unsolved problem. Among the techniques available to improve continence,
      the use of electromagnetic/mechanical power has not been explored. Our work looks
      at the characteristics needed by the components of an artificial sphincter where
      the power of sphincteric muscles is substituted with electromagnetic/mechanical
      power, and the mechanical absence of muscles is replaced by a plastic band.
      Experimental work was done with isolated colon of 26 mongrel dogs, and all of
      them became continent by an intraluminal gas pressure over 80 mm Hg when a final
      perimeter between 3.7 and 4.7 cm was reached. No macroscopic lesions were noted
      on the guts' surface beneath the plastic band. The largest band displacement was
      4.2 cm, and the traction force was under 50 N.

PMID- 7779010
TI  - Electrotactile stimulator for artificial proprioception.
AB  - With the goal of investigating artificial proprioception elicited by electrical
      stimulation, we have developed a tactile phi phenomenon-based stimulator. This
      two-channel microprocessed pulse amplitude modulation system generates two
      different envelope waveforms (triangular and elliptical) and allows programming
      and visualizing of its main parameters: pulse with (0.1-10 ms), pulse frequency
      (0.1-10 kHz), modulation frequency (0.3-10 Hz), current intensity (up to 20 mA),
      and the amplitude modulation index (0-100%). In vivo experiments with 5 normal
      persons have shown that it is possible to elicit a moving fused phantom image
      with good resolution. A triangular envelope is good for straight line sensations
      while the elliptical one is more comfortable and has better resolution for all
      kinds of moving images.

PMID- 7779011
TI  - An artificial neural system for closed loop control of locomotion produced via
      neuromuscular electrical stimulation.
AB  - The use of neuromuscular electrical stimulation for restoration of gait in spinal
      cord injured subjects has been seriously pursued by many investigators for the
      past 15 years. By and large, however, systems to date require the intervention of
      a person, be it the patient or an observer, and are restricted to control of
      stimulation onset and termination. Further, existing systems are not adaptable to
      environmental and patient variations. This work proposes a system that relies on
      neural computing to determine proper muscle activation patterns from
      biomechanical signals. The intelligent system is trained to perform gait under
      supervision, after which it can be used to control muscle stimulation in an
      unknown environment. Computer simulations suggest that the best neural
      architecture for control of gait is a neural network including units
      corresponding to movement history. Separate networks for the stance and swing
      phases, respectively, were found to work better than a single neural network
      trained on the entire gait cycle. The artificial neural device proposed here also
      includes a voice recognition system that will allow for voluntary locomotion. A
      safety circuit has been designed to preclude acceptance of unwanted vocal
      commands in the latter system.

PMID- 7779012
TI  - Effects of electronic autodefense devices on cardiac pacemakers.
AB  - The problem of interference on pacemakers as a result of extraneous electric
      current and electromagnetic fields is important since more than 1.5 million
      people worldwide have pacemakers implanted. Each year at least 100,000 people
      have cardiac pacemakers implanted. This article reports several effects of two
      electronic autodefense devices on some cardiac pacemakers. The results show that
      the interference affects severely the behavior of the cardiac pacemakers, but if
      the duration is no more than 5 s, the effects are not permanent, and the
      pacemakers return to the correct action as soon as the interference ceases.

PMID- 7779013
TI  - Hemodialysis versus continuous ambulatory peritoneal dialysis: effects on the
      heart.
AB  - In this study we compared the influence of 2 different modalities of treatment,
      CAPD and hemodialysis, on the prevalence and severity of left ventricular
      hypertrophy and cardiac arrhythmias of chronic renal failure patients. We
      compared 27 patients on the CAPD program with 27 patients on the chronic
      hemodialysis matched for sex, age, and duration of dialysis treatment. The
      prevalence of hypertension was significantly lower in CAPD than in hemodialysis
      patient (41% vs. 81%, p = 0.0023). Blood pressure levels were also lower in CAPD
      than in hemodialysis patients (systolic pressure 124.9 +/- 4.7 vs. 154.8 +/- 4.6
      mm Hg, p < 0.0001; diastolic pressure 77.5 +/- 2.9 vs. 93.3 +/- 2.8 mm Hg, p =
      0.0001). Left ventricular hypertrophy (LVH) was present in 52% of CAPD and in 93%
      of hemodialysis patients (p = 0.0008). Severe cardiac arrhythmias (Lown 3-4)
      occurred in only 4% of CAPD and in 33% of the hemodialysis group (p = 0.0149).
      The lower frequency of LVH in CAPD might explain the lower incidence of severe
      arrhythmias.

PMID- 7779014
TI  - Comparison of echocardiographic changes associated with hemodialysis and renal
      transplantation.
AB  - Long-term hemodialysis has been reported to cause progression of left ventricular
      (LV) hypertrophy with a tendency toward asymmetric septal hypertrophy. Renal
      transplantation is believed to reverse some of these changes. The aim of this
      prospective study was to compare the effects of long-term hemodialysis and of
      successful renal transplantation on cardiac structure and function assessed by
      echocardiography. Fifty-three patients were submitted to two echocardiographic
      evaluations separated by a 30 +/- 8 month interval. At the first control, all
      patients were on hemodialysis; at the second, 36 patients remained on dialysis
      while 17 had been submitted to renal transplantation. Age (44 +/- 13 vs. 40 +/-
      10 years), gender (male, 50% vs 53%), and duration of dialysis at the initiation
      of the study (43 +/- 34 vs. 47 +/- 32 months) were comparable in the 2 groups.
      The prevalence of LV hypertrophy were 83% (first control) and 69% (second
      control) in the dialysis group and 82% and 71% in the transplant group.
      Comparisons between the two periods within each group showed that hemodialysis
      was associated with a significant reduction of the E/A ratio (1.25 +/- 0.4 vs.
      1.02 +/- 0.4, p < 0.001) and systolic (155 +/- 28 vs. 137 +/- 26 mm Hg, p <
      0.001) and diastolic (94 +/- 21 vs. 84 +/- 16 mm Hg, p < 0.05) blood pressure,
      and no change in LV mass index (171 +/- 51 vs. 156 +/- 43 g/m2, NS). In the
      transplanted group, there were reductions in the E/A ratio (1.42 +/- 0.6 vs 1.10
      +/- 0.4, p < 0.05) and in LV diastolic dimension (50 +/- 7 vs. 46 +/- 5 mm, p <
      0.05), but not in systolic (155 +/- 27 vs. 152 +/- 31 mm Hg, NS) or diastolic (97
      +/- 11 vs. 97 +/- 20 mm Hg, NS) blood pressure. The LV mass index also did not
      change significantly (157 +/- 51 vs. 133 +/- 31 g/m2, NS).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7779015
TI  - Mathematical model for a new mode of artificial ventilation: volume assisted
      pressure supported ventilation: a comparative study.
AB  - The patient submitted to artificial ventilation generally is connected to a high
      impedance flow source with controlled respiratory cycles to assure volume
      requirements or to a low impedance pressure source with spontaneous cycles to
      allow synchronization between his effort and system flow delivery. These two
      types of cycles represent the initial and final stages of artificial ventilation.
      The patient who needs a volume guarantee and at the same time presents unstable
      or insufficient inspiratory effort is difficult to manage with assisted cycles
      which are analogous to the controlled presence of a high impedance flow source.
      This paper presents a new approach where the respiratory cycles are obtained by
      the combination of flow and pressure sources using mathematical modeling. These
      cycles, named volume assisted pressure supported (VAPS) cycles, are compared with
      conventional assisted cycles showing a decrease in the patient work of breathing
      (WOB) during assisted ventilation. The theoretical results have been confirmed by
      clinical trials.

PMID- 7779017
TI  - Computational prediction of hemolysis in a centrifugal ventricular assist device.
AB  - This paper describes the use of computational fluid dynamics (CFD) to predict
      numerically the hemolysis in centrifugal pumps. A numerical hydrodynamical model,
      based on the full Navier-Stokes equation, was used to obtain the flow in a
      vaneless centrifugal pump (of corotating disks type). After proper
      postprocessing, critical zones in the channel were identified by means of two
      dimensional color-coded maps of %Hb release. Simulation of different conditions
      revealed that flow behavior at the entrance region of the channel is the main
      cause of blood trauma in such devices. A useful feature resulting from the CFD
      simulation is the visualization of critical flow zones that are impossible to
      determine experimentally with in vitro hemolysis tests.

PMID- 7779018
TI  - Design, manufacturing, and testing of a paracorporeal pulsatile ventricular
      assist device: Sao Paulo Heart Institute VAD.
AB  - This paper describes the design of a ventricular assist device (VAD), its
      manufacturing, and testing. The VAD presented is pulsatile, with a free-floating
      membrane, smooth internal surfaces, and pericardial valves. It comprehends also a
      pneumatic driving unit capable of operating in the "full to empty," EKG
      synchronized or asynchronous modes. In vitro tests were performed to assess its
      mechanical durability, hydrodynamic performance, and hemolysis. To optimize
      cannulas and implant techniques, we performed in vivo tests in 22 sheep and 8
      calves. In these tests, we also evaluated hemolysis and the device's capacity to
      normalize hemodynamic parameters during induced cardiac failure. The VAD worked
      for 4,000 h without failure in a mock circulatory loop. In full to empty mode, it
      displayed a rate-mediated "Starling-like" performance. Optimum output was
      achieved with a systole duration of 40% of the cycle. The in vitro hemolysis
      index (IH) was 6.7 +/- 2.1. Hemolysis in animal experiments was clinically
      nonsignificant. In calves with induced cardiac failure, the VAD was able to
      normalize hemodynamic parameters within 120 min.

PMID- 7779016
TI  - Clinical comparison of blood oxygenators: a retrospective study.
AB  - The results for platelet count (PC), activated clotting time (ACT), postoperative
      bleeding, and hemoderivatives usage in cardiac surgeries were crossed against the
      type of oxygenator used. These were two bubble and one membrane type. A sample of
      the surgery population for each type was selected at random. Thus, the patients
      in this study were divided into 3 groups: BA: 87 patients, bubble oxygenator; BB:
      87 patients, bubble oxygenator; M: 73 patients, membrane oxygenator. The groups
      were statistically similar (p > 0.05) for age, body surface area, cardiopulmonary
      bypass (CPB) time, and prevalence of cardiac disease. The rate of PC 15 min after
      CPB end and before its beginning was BA, 0.48 +/- 0.02; BB, 0.49 +/- 0.02; M,
      0.55 +/- 0.03. The rate of ACT after protamine administration and before CPB was
      BA, 1.22 +/- 0.03; BB, 1.16 +/- 0.03; M, 1.16 +/- 0.03. Volume (ml) of total
      postoperative bleeding (POB) was BA, 904 +/- 72; BB, 963 +/- 73; M, 867 +/- 83.
      Patient percentage that used hemoderivatives (HD) was BA, 86.3%; BB, 88.5%; M,
      90.0%. No statistical difference was found between groups (p > 0.05). This study
      indicates that although membrane oxygenators have better theoretic and
      experimental biocompatibility, no significant difference in PC, ACT, POB, and HD
      usage was observed in the clinical setting. All values are expressed as the mean
      +/- standard error of the mean.

PMID- 7779019
TI  - A paradigm for design of closed loop neuromuscular electrical stimulator control
      systems.
AB  - The use of neuromuscular electrical stimulation (NMES) for rehabilitation of gait
      in spinal patients is widely known. The best results can be obtained with the use
      of biomechanical sensors and a closed loop NMES system. One of the biggest
      problems faced in the design of control systems for closed-loop operation, in
      gait rehabilitation, is the variation of the mechanical conditions during the
      phases of gait. This work presents a new approach to ease the design of rule
      based closed loop systems for operation in conditions such as gait
      rehabilitation.

PMID- 7779020
TI  - Neural responses to electrical stimulation of the cochlea in guinea pigs.
AB  - A special bridge circuit was constructed to compensate stimulus artifact to
      determine the effects of an alternating current (AC) in the range of 3 to 20 kHz
      and direct current (DC) stimulation on the activity of cochlear nerve fibers.
      When AC and DC stimulation of the same fiber were compared, a greater current
      intensity was required to change the spike rate with AC stimulation than DC
      stimulation. While positive DC stimulation reduced activity, negative DC
      stimulation increased the spike rate. AC stimuli excited fibers in a manner
      similar to that observed with negative DC stimulation. Thresholds increased with
      stimulus frequency, suggesting that the effects of AC stimulation on the
      discharge rate are independent of the CF (characteristic frequency) of a fiber.
      The effects of short-time AC and DC stimulation on cochlear fiber activity lasted
      only during the stimulation, and the spontaneous activity did not significantly
      differ before and after electrical stimulation.

PMID- 7779021
TI  - Motile responses of isolated vestibular hair cells.
AB  - Vestibular sensory cells were isolated from the utricular macula or crista
      ampullaris of the guinea pig by enzymatic and mechanical dissociation. Isolated
      vestibular hair cells, especially type I hair cells, showed an active motile
      capacity. After exposure to a medium containing high concentration of potassium,
      or to a hypoosmotic medium, the type I hair cells showed tilting of their hair
      bundle to about 15 degrees. Given the tight and dense structure of the vestibular
      epithelium, the changes in shape of the isolated vestibular hair cells may in
      vivo lead to an influence of the mechano-sensitive stereocilia and modulate
      stiffness and compliance of the receptor structure as a whole including its
      cupular or macular relationship. This active mechanical events could be closely
      related to an active adaptation process.

PMID- 7779022
TI  - Atrophy of the tongue with persistent articulation disorder in myasthenia gravis:
      report of 10 patients.
AB  - Ten patients with atrophy of the tongue, from a group of 752 with generalized
      acquired myasthenia gravis (MG), were studied. Tongue atrophy developed late in
      the majority of patients and was accompanied by tongue paresis (70% of the cases)
      and eventually associated to atrophy of other muscles of the palate, especially
      the uvula. All the patients exhibited severe forms of MG with bulbar involvement,
      mainly persistent dysphonia and dysphagia, almost always refractory to treatment.
      There is no correlation among atrophy of the tongue, sex, and thymus pathology.
      There is correlation between severeness of symptoms and early, persistent and
      treatment refractory dysphonia and dysphagia.

PMID- 7779023
TI  - Mucociliary function of chronic inflammation in upper and lower airways.
AB  - Mucociliary function was examined to investigate the association of chronic
      inflammation in the upper and lower airways in four groups of subjects. They were
      composed of: 1) non-inflammatory subjects (control group), 2) patients with
      chronic sinusitis (S group), 3) patients with chronic bronchitis (B group), and
      4) patients with chronic sinusitis and bronchitis (SB group). Mucociliary
      clearance (MCC), ciliary beat frequency (CBF) in the nose and left main bronchus
      and dynamic viscoelasticity (DVE) of these airway fluids were examined.
      Significant prolongation of nasal MCC in the S and SB groups were observed
      compared with the control group. CBF in the nose of the S, B, and SB groups were
      not different from that of the control group. DVE of nasal mucus in the S, B, and
      SB groups were higher than that in the control group. Significantly diminished
      bronchial MCC in the B and SB groups were observed compared with the control
      group. CBF of the bronchus was within normal range in all examined subjects. DVE
      of tracheobronchial mucus in the S, B, and SB groups were higher than that in the
      control group. It was suggested that high viscoelasticity of the tracheobronchial
      mucus in patients with chronic sinusitis and of the nasal mucus in patients with
      chronic bronchitis may be one of the causes of sinobronchitis.

PMID- 7779024
TI  - The contact Nd-YAG laser for oral and oropharyngeal malignant tumors.
AB  - Nine oral and oropharyngeal squamous cell carcinomas were removed with a contact
      Nd-YAG laser. Clinical and morphological studies on wound healing and effects of
      the Nd-YAG laser were performed. The wounds were not sutured and patients did not
      complain of any severe symptoms. The wound healing was prolonged to 3-6 weeks.
      Cells and glands degenerated at a depth of 2-3 mm by the direct effects of the
      laser. The epithelium exhibited acantholysis 5 mm from the site of laser injury.
      Scanning electron microscopy showed no coagulation or other coated material in
      the wound created by a surgical knife, while the wound surface by laser consisted
      of carbonization, well-coated and non-coated areas. These findings varied with
      the laser power. The coagulation and thermal effects of the Nd-YAG laser resulted
      in autolysis of tumor cells at least within 5 mm of the cutting surface. The
      contact Nd-YAG laser was useful for the removal of the malignant tumor in the
      oral cavity and oropharynx where it is difficult to maintain a generous safety
      margin.

PMID- 7779025
TI  - Tissue transmigration of CZON (Cosmosin) to middle ear mucosa, maxillary sinus
      mucosa, and palatine tonsils.
AB  - The concentration of CZON was determined by HPLC in surgical patients with
      chronic otitis media, sinusitis, and tonsillitis. One gram of CZON was injected
      intravenously prior to surgery. The time course of the mean tissue CZON level was
      as follows: In the middle ear mucosa, 3.7 micrograms/g at 15 min, 7.2
      micrograms/g at 30 min, and 2.9 micrograms/g at 1 hr (the half life: 21.3 min).
      In the maxillary sinus mucosa, 10.5 micrograms/g at 15 min, 11.8 micrograms/g at
      30 min, and 2.8 micrograms/g at 1 hr (the half life: 17.5 min). In the tonsils,
      14.9 micrograms/g at 15 min, 9.3 micrograms/g at 30 min, and 2.0 micrograms/g at
      1 hr (the half life: 13.2 min). The concentration was high in the maxillary sinus
      mucosa and the tonsils, but was low in the middle ear mucosa. In the formers the
      transfer ratio reached its peak 15 to 30 min after administration, but in the
      latter the peak was reached 30 to 60 min after administration. The order of the
      transfer ratio at each region was above 25%. The tissue concentration exceeded
      the MIC80s of frequent isolates from these infections. CZON is considered to be a
      highly useful drug in the treatment of these infections.

PMID- 7779026
TI  - Thyroid allograft after total thyroidectomy in a rat model.
AB  - The fact that in vitro culture of murine organ allografts prior to
      transplantation enhances graft survival is commonly accepted. In this study, we
      examined the possibility of thyroid allotransplantation for the therapy of total
      thyroidectomy in the rat model. Transplanted thyroid function was determined by
      125I uptake ratio and evaluated by immunohistochemical and
      microautoradiographical assessments. Fully allogeneic thyroid glands cultured for
      8-24 hr in Hank's balanced salt solution (HBSS) at pH 6.3 or 7.2 were
      transplanted to rats under the kidney capsule. Five weeks after
      allotransplantation, thyroid glands cultured for 16 hr in HBSS at pH 6.3
      presented prolonged survival. This procedure could be used as an initial therapy
      not only for total thyroidectomized patients but also for patients with primary
      hypothyroidism.

PMID- 7779028
TI  - Malignant melanoma of the nasal cavity.
AB  - We report a case of amelanotic melanoma arising in the nasal cavity and paranasal
      sinuses, that could not be positively diagnosed as malignant melanoma before the
      patient's death in spite of repeated biopsies both from primary and metastatic
      lesions, including ultrastructural examination and immunohistochemical staining
      for S-100 protein with usual polyclonal antibody. The patient died of rapid wide
      spread dissemination of the tumor. In autopsy specimens, melanin pigment was
      detected, for the first time, by the Fontana's silver stain. The posthumous
      diagnosis of malignant melanoma was immunohistochemically confirmed for the
      specific antibodies, anti alpha-subunit of S-100 protein antibody and SK-46
      (original antibody for melanoma made at the Department of Pathology, University
      of Gunma School of Medicine) from specimens obtained while alive. The application
      of a specific antibody for S-100 protein is recommended as useful for the
      diagnosis of malignant melanoma even when routine immunohistochemical procedures
      fail to demonstrate S-100 protein.

PMID- 7779027
TI  - Acute simultaneous bilateral vestibulocochlear impairment in neuro-Behcet's
      disease: a case report.
AB  - The central nervous system (CNS) is often a preferential target of Behcet's
      disease and diverse neurological manifestations have been described. Isolated
      hearing impairment or disequilibrium is also known to occur, but the simultaneous
      bilateral impairment of both vestibular and cochlear functions has been only
      rarely documented in Behcet's disease. A 52-year-old Japanese woman with neuro
      Behcet's disease had meningoencephalitis, a profound thrombocytopenia, and
      bilateral vestibulocochlear impairment during the acute exacerbation. Although
      the CNS involvement was apparent, the clinical history and neuro-otological
      findings pointed to bilateral inner ear involvement rather than the brainstem or
      the 8th nerve lesions. She has made an excellent clinical response to pulse-dose
      methylprednisolone therapy with improvement in her neurological symptoms and in
      arresting the acute deterioration of hearing loss, but repeated audiograms failed
      to maintain the improvement with a modest dose of oral prednisolone. Since the
      bilateral vestibulocochleopathy can be as incapacitating as oculopathy in
      Behcet's disease, an early detection and prompt instillation of adequate
      corticosteroid therapy may be mandatory, although not curative.

PMID- 7779029
TI  - Cervical neurofibroma in a patient with von Recklinghausen's disease.
AB  - A case of a huge cervical neurofibroma associated with von Recklinghausen's
      disease is reported. The patient with von Recklinghausen's disease was a 48-year
      old woman complaining of a rapidly growing mass around the neck for the last 6
      months. In von Recklinghausen's disease, which corresponds to neurofibromatosis
      I, gigantic tumors around the neck often occur. The present case was classified
      as a plexiform neurofibroma which is derived from the peripheral nervous system,
      and this type frequently shows malignant change in contrast to other types of
      neurofibroma. In general, it is difficult to determine the origin of the nerve in
      cervical neurofibromas. A total extirpation of the tumor was done in our case,
      and revealed the nerve of origin to be the vagal nerve. Pathologically, H-E
      stained specimens showed that the tumor was a benign neurofibroma. However,
      immunostaining of the majority of the tumor cells were positive for PCNA. These
      results suggest that the tumor of our case possessed a low malignant potential.
      To date, neither local recurrence nor distant metastasis has been found on
      subsequent examinations.

PMID- 7779030
TI  - Primary papillary carcinoma of the thyroglossal duct: case report and review of
      the literature.
AB  - Primary malignancies of the thyroglossal duct are rare. Around 150 cases are
      described in the world literature, most of them being papillary thyroid
      carcinomas. Other types of tumors are squamous cell carcinomas, mixed follicular
      papillary carcinomas, or adenocarcinomas. Women are affected more often than men,
      the ratio being 2:1. Preoperative diagnosis of primary malignancies of the
      thyroglossal duct is uncommon. Initial treatment of primary malignancies of the
      thyroglossal duct is usually sufficiently done operatively by the so-called
      Sistrunk's procedure which, however, was first described in 1893 by Schlange.
      Some patients may need further treatment such as wider excision, thyroidectomy,
      radioiodine therapy, or neck dissection. In this report the case of a papillary
      carcinoma of the thyroglossal duct in a 63-year-old man is presented. It is
      intended to remind the reader of this pathology which is often forgotten because
      of its rarity. The problems that occur during the process of evaluation regarding
      ideal treatment of the individual case are discussed. The literature is reviewed.

PMID- 7779032
TI  - Inflammation and increased numbers of bacteria in the lower respiratory tract of
      horses within 6 to 12 hours of confinement with the head elevated.
AB  - Confinement of horses with their heads elevated for periods up to 24 hours was
      used to evaluate the extent and the effects of bacterial contamination of the
      equine lower respiratory tract. Significant (P < 0.05) increases in bacterial
      numbers (up to 10(9) colony forming units/mL in transtracheal aspirate derived
      samples) occurred within 6 or 12 hours in most horses. Pasteurella/Actinobacillus
      spp and Streptococcus spp were most commonly isolated. Lowering of the head for
      30 minutes every 6 hours to facilitate postural drainage did not prevent
      multiplication of organisms to levels equivalent to those achieved by horses
      where the head was elevated for 24 hours. When horses were released from
      confinement and heads were no longer maintained in an elevated position,
      clearance of accumulated secretions and bacteria occurred within 8 to 12 hours.
      Thus, confinement with the head elevated resulted in significant bacterial
      contamination and multiplication within the lower respiratory tract during a
      period often encountered in routine management procedures, such as
      transportation. The clearance of accumulated secretions occurred over a prolonged
      period after release from such confinement.

PMID- 7779031
TI  - Acute febrile diarrhoea in horses: 86 cases (1986-1991).
AB  - Eighty-six horses presented for examination at the Rural Veterinary Centre
      between January 1986 to December 1991 with acute diarrhoea. The average age of
      affected horses was 3.2 +/- 0.2 years (mean +/- SE), with 69% three years or
      younger. Sixty-one horses were male (36 stallions, 25 geldings) and 83 horses
      were Thoroughbreds (47) or Standardbreds (36). Sixty-six horses were undergoing
      routine training at the time of onset of diarrhoea. Eight horses were afflicted
      with a non-specific illness within one to five days before the onset of
      diarrhoea, whereas eight horses developed diarrhoea during or within 48 h of
      discontinuation of antimicrobial therapy. Three horses developed the diarrhoea
      within 24 h of road transportation. Clinically, the disorder was characterised by
      a fever, sudden onset of profuse diarrhoea, clinical evidence of dehydration
      (estimated to be 5 to 12% of body weight at the time of admission) and shock.
      Degenerative leucopaenia, hyponatraemia, hypochloraemia, hyperkalaemia,
      hyperglycaemia and azotaemia were characteristic laboratory findings. Laminitis
      was a sequel in about 30% of cases. The cause of diarrhoea remained undetermined
      in most cases. Salmonellas were isolated from faecal or tissue samples in only
      two cases. Similarly, there was no evidence of seroconversion to Erhlichia
      risticii in 17 cases. Sixty-two of the horses survived the acute phase of the
      disease in response to supportive care. In horses that did not survive,
      necropsies were performed and revealed sanguineous or turbid peritoneal fluid.
      The colonic and caecal walls were oedematous and thickened with serosal
      congestion and discolouration of these organs evident grossly.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7779033
TI  - Chronic vascular catheterisation of the koala and the rabbit.
AB  - Vascular access ports were surgically placed, first in rabbits maintained under
      laboratory conditions, and then in koalas maintained in a wildlife park. The
      ports remained patent for 9 months in rabbits and for up to 13 months in the
      koalas and were removed successfully. They allowed collection of blood samples
      without assistance or disturbance in koalas, and without stress as reflected by
      plasma cortisol concentration. The use of retention rings on the cannula tubing
      is recommended.

PMID- 7779034
TI  - Last occurrence and survival during winter of the arbovirus vector Culicoides
      brevitarsis at the southern limits of its distribution.
AB  - Linear regression analysis was used to describe the decline in numbers of
      Culicoides brevitarsis Kieffer into winter with monthly maximum, average and
      minimum temperatures at the southern limits to its distribution in New South
      Wales. From this, low temperature thresholds were derived when C brevitarsis
      would be absent from the field. The low minimum threshold +/- 2 SE (95%
      Confidence Interval) of 8.1 +/- 0.3 degree C was used with historical temperature
      data to estimate the last month that the species should occur (March to June) and
      the mean number of months (2 to 6.5) below the threshold at 17 selected sites.
      Probability for survival during winter at these sites was estimated from years
      when the number of consecutive months below the threshold was < or = 2 months.
      This varied from zero to 51% depending on the location of the site. Last
      occurrence was 0.7 months later on average and absolute probabilities for
      survival ranged from zero to 100% when the temperatures were increased by an
      arbitrary 2 degrees C.

PMID- 7779035
TI  - Bluetongue and Douglas virus activity in New South Wales in 1989: further
      evidence for long-distance dispersal of the biting midge Culicoides brevitarsis.
AB  - Infection of cattle with bluetongue and Douglas viruses was detected on the
      central and southern coast of New South Wales from January to April 1989.
      Bluetongue virus infection was found well south of areas of expected occurrence.
      Evidence is presented to support wind-borne dispersal of infected vectors,
      Culicoides brevitarsis, southwards from the Hunter Valley.

PMID- 7779037
TI  - Eimeria leuckarti infections in three foals.

PMID- 7779036
TI  - Production losses in Merino ewes and financial penalties caused by
      trichostrongylid infections during winter and spring.
AB  - The productivity of Merino ewes treated with ivermectin and a controlled-release
      capsule containing albendazole was compared with untreated ewes grazing the same
      pastures on each of 3 farms. Treated breeding ewes had significantly increased
      greasy fleece weights (GFW, 6.5% and 7.1%) compared with untreated breeding ewes,
      on 2 of 3 farms but treatment caused no significant increase in the GFW of non
      breeding ewes. Other benefits of treatment on all farms were a significant
      increase in body weight gain (from 1.7 to 3.7 kg) and a significant decrease in
      the weight of dag removed at crutching (from 42 to 622 g). These benefits
      occurred despite the presence on each farm of worms resistant to benzimidazoles.
      One disadvantage of treatment was an increase in mean fibre diameter of wool from
      treated ewes of from 0.12 to 0.41 microns. This increase reduces the value of the
      wool. Partial budgets indicated a net loss of from 8 to 62 cents per ewe for
      treatment. However, potential benefits such as increased growth rate and wool
      production from lambs of treated ewes were not included in the analysis. On one
      farm ewes were classified as 'susceptible' to severe dag if they had a dag score
      > or = 4 at the time of capsule treatment. Ewes classified as 'susceptible' were
      about 7 times more likely to develop severe dag than were other ewes. There was
      no significant difference between the GFW of untreated 'susceptible' ewes and
      untreated ewes not classified as 'susceptible'.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779038
TI  - Testing the concept of virally vectored immunosterilisation for the control of
      wild rabbit and fox populations in Australia.
AB  - Virally vectored immunosterilisation is a concept whereby a gene encoding an
      antigen from an animal's reproductive system is inserted into a virus and, during
      infection, stimulates the formation of antibodies to that antigen such that the
      animal is rendered infertile. There is good evidence that certain proteins from
      sperm or egg when introduced parenterally will induce infertility. This paper
      summarises the work of the Cooperative Research Centre for the Biological Control
      of Vertebrate Pest Populations and reviews progress toward the isolation of the
      genes for gamete antigens from rabbits and foxes and their introduction into
      suitable viral vectors as a means of control of these pests in Australia.

PMID- 7779039
TI  - Equine herpesvirus 1 HVS25A isolated from an aborted foetus produces disease in
      balb/C mice.

PMID- 7779040
TI  - Relationship between vitamin B12 and cobalt concentrations in bovine liver.

PMID- 7779041
TI  - Serological studies of bovine leukaemia virus infection in Queensland beef
      cattle.

PMID- 7779042
TI  - An encrusted cystitis caused by Corynebacterium urealyticum in a dog.

PMID- 7779043
TI  - Suspected traumatic rupture of the urinary bladder in an alpaca.

PMID- 7779044
TI  - Diarrhoea in Merino ewes during winter: association with trichostrongylid larvae.

PMID- 7779045
TI  - Neospora caninum--request for specimens for research.

PMID- 7779046
TI  - Treatment of superficial tumours on horses with dimethyl sulfoxide and cisplatin.

PMID- 7779047
TI  - Myocardial hibernation in terms of the flow-function relationship.

PMID- 7779048
TI  - Contractile pattern in acutely hibernating myocardium.

PMID- 7779049
TI  - Excitation-contraction coupling in hibernating myocardium.

PMID- 7779050
TI  - Critical role of energy supply and glycolysis during short-term hibernation.

PMID- 7779052
TI  - Myocardial hibernation.
AB  - From available results, the following schematic can be drawn: Reductions in
      perfusion pressure are not associated with impaired ventricular function as long
      as they take place within the autoregulatory range. Additional reductions in
      perfusion pressure that moderately diminish coronary blood flow will result in a
      particular ischemia with decreased but stable function: perfusion and contraction
      match, the myocardium hibernates. The process responsible for this new
      equilibrium could be termed down regulation of function. The trigger inducing
      hibernation is so far unknown. The strategy, however, is similar to that used by
      hibernating animals. Likewise, myocardial hibernation is a protective mechanism.
      As hibernators recover initial function after unfavourable periods are
      terminated, hibernating myocardium recovers after institution of physiologic
      perfusion. It is under debate, whether function quickly recovers or remains
      temporarily depressed. As hibernating animals might finally even die, if
      unfavourable periods last too long, myocardium might become irreversibly injured
      due to ischemia lasting too long. Additional reductions in perfusion pressure and
      oxygen supply below the hibernating range produce ischemia in the more classical
      sense, because oxygen supply and demand no longer match. Damage will become
      irreversible in case the situation persists longer than about 20 min. After onset
      of reperfusion, the myocardial function would remain depressed, however, for a
      considerable period: myocardial stunning. Considering the regional
      heterogeneities of myocardial blood flow, distinct differentiation between
      moderate and severe ischemia is difficult. Ischemia will induce more articulate
      damage in subendocardial than in subepicardial layers. Similarly, damage in the
      ischemic core will be more pronounced than in the border zone.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7779051
TI  - Hibernating myocardium: a hypometabolic state for energy conservation.

PMID- 7779053
TI  - Acute adaptation to ischemia: short-term hibernating myocardium.

PMID- 7779054
TI  - Myocardial hibernation: unresolved physiological and clinical issues.

PMID- 7779055
TI  - Hibernating myocardium.

PMID- 7779056
TI  - Hibernating myocardium: a brief article.

PMID- 7779057
TI  - Myocardial hibernation, stunning, or both?

PMID- 7779058
TI  - Structural aspects of the chronic hibernating myocardium in man.

PMID- 7779059
TI  - Hibernating myocardium: adaptation or degeneration?

PMID- 7779060
TI  - The hibernating myocardium: identification of viable myocardium in patients with
      coronary artery disease and chronic left ventricular dysfunction.

PMID- 7779061
TI  - Hibernating myocardium represents a primary downregulation of regional myocardial
      oxygen consumption distal to a critical coronary stenosis.

PMID- 7779062
TI  - Commentary on hibernating myocardium and its clinical relevance.

PMID- 7779063
TI  - Hibernating myocardium, a clinical entity.

PMID- 7779064
TI  - Identification of "hibernating myocardium" by imaging approaches.

PMID- 7779065
TI  - alpha-adrenergic responses of isolated canine coronary microvessels.
AB  - Although alpha-adrenergic activation is known to increase coronary microvascular
      resistance in vivo, the magnitude of its segmental microvascular consequences is
      not well understood. Quantification of these effects in vivo is hindered by
      escape mechanisms that minimize the influences of constrictors, and alterations
      in flow and pressure, which effect microvascular tone by shear stress-dependent
      and myogenic mechanisms, respectively. To eliminate these confounding influences,
      we have studied responses in vitro under conditions with these variables
      controlled. We evaluated the diameter changes of isolated canine coronary
      arterioles (110 +/- 12 microns, n = 35) response to alpha-adrenergic activation
      by norepinephrine (10(-10) to 10(-4) M) in the presence of beta-adrenergic
      blockade by alprenolol (10(-6) M). In contrast to the situation in vivo, alpha
      adrenergic activation did not constrict isolated coronary arterioles, but
      constricted isolated coronary venules in a dose-dependent manner over a range of
      10(-10) to 10(-4) M (-27 +/- 3% maximum diameter change). Coronary arteriolar
      alpha-adrenergic constriction was not promoted by 1) subthreshold or vasoactive
      doses of the vasoconstrictors KCl, angiotensin II, U46619, endothelin-1,
      neuropeptide Y or arginine vasopressin, 2) inhibition of the presynaptic uptake
      of norepinephrine by imipramine (10(-6) M), 3) inhibition of EDRF synthesis by NG
      monomethyl-L-arginine (10(-5) M) or 4) inhibition of prostaglandin synthesis by
      indomethacin (10(-5) M).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779066
TI  - No adrenergic constriction in isolated coronary arterioles?

PMID- 7779068
TI  - Myocardial hibernation: relationship to a model for segmental dyskinesis.

PMID- 7779070
TI  - Prevention of bovine ketosis with glucogenic substance and its effect on
      fertility in Finnish dairy cows.
AB  - To avoid a harmful peak of negative energy balance, 200 ml of a 50% propylene
      glycol and 1% nicotinic amide solution were given twice a day to dairy cattle for
      ten days starting at day 14 post partum (p.p). Acetone content in milk was used
      as an indicator of energy balance and fertility was used as an indicator of the
      efficiency of the treatment. In addition, other factors affecting fertility were
      evaluated. During the prevention period, the acetone level in the prevention
      group (N = 31) decreased from 0.40 +/- 0.1 O mmol/l to 0.23 +/- 0.06 mmol/l (p =
      0.09), but in the control group (N = 35) it increased from 0.23 +/- 0.04 mmol/l
      to 0.43 +/- 0.29 mmol/l acetone from the beginning to the end of the trial (p >
      0.10). At day 50 p.p., however, the acetone levels in the two groups were the
      same. The treatment did not prevent clinical ketosis. Clinical ketosis tended to
      be associated with impaired fertility; in contrast, cows in the prevention group
      treated for ketosis had high fertility. A high daily milk yield at the first
      monthly recording test as well as high annual milk, fat and protein yields were
      correlated with the interval from calving to conception, r = 0.33, r = 0.50, r =
      0.37 and r = 0.47, respectively. A low percentage of annual milk protein and at
      test 1 was significantly correlated with a long interval from calving to
      conception, r=-0.31 and r=-0.45, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779067
TI  - Alpha 1-adrenergic tone does not influence the transmural distribution of
      myocardial blood flow during exercise in dogs with pressure overload left
      ventricular hypertrophy.
AB  - This study was carried out to test the hypothesis that alpha 1-adrenergic
      activation during exercise causes preferential vasoconstriction of subepicardial
      coronary resistance vessels, thereby augmenting blood flow to the subendocardium.
      Studies were performed in 7 dogs in which left ventricular hypertrophy was
      produced by banding the ascending aorta at 6-9 weeks of age. Animals were studied
      at approximately 1 year of age when the left ventricular/body weight ratio was
      7.7 +/- 0.3 g/kg (mean +/- SE). Left anterior descending (LAD) coronary artery
      flow was measured with a Doppler velocity flow probe at rest and during a three
      stage graded treadmill exercise protocol. The transmural distribution of
      myocardial blood flow was assessed with radioactive microspheres. Coronary blood
      flow increased progressively as a function of heart rate and rate-pressure
      product in response to exercise. In contrast to normal dogs which maintain
      preferential blood flow to the subendocardium (ENDO) relative to the
      subepicardium (EPI) during exercise, the ENDO/EPI flow ratio in the hypertrophied
      left ventricles was 0.88 +/- 0.10 during exercise. Selective alpha 1-adrenergic
      blockade by infusion of prazosin (10 micrograms/kg) into the LAD decreased mean
      aortic pressure during exercise from 86 +/- 6 to 76 +/- 4 mmHg (p < 0.05), but
      did not change coronary pressure, heart rate, left ventricular systolic or
      enddiastolic pressures, or LVdP/dtmax. Coronary blood flow was not significantly
      altered by prazosin at rest, but was progressively increased during increasing
      levels of exercise levels. During the heaviest level of exercise prazosin caused
      a 22 +/- 3% increase in mean myocardial blood flow which was similar in all
      transmural layers, with no change in the transmural distribution of perfusion
      (ENDO/EPI = 0.85 +/- 0.09). These findings demonstrate that alpha 1-adrenergic
      vasoconstrictor tone limits blood flow during exercise in the hypertrophied left
      ventricle, but do not support the concept that alpha 1-adrenergic activation
      augments perfusion of the subendocardium during exercise.

PMID- 7779069
TI  - [Physiologic parameters and locomotor activity in Fleckvieh and Schwarzbund
      cattle during an alpine summer].
AB  - The investigation on an alpine pasture was performed on 15 heifers of the breeds
      Fleckvieh and Friesians from different farms. Some physiological parameters and
      locomotor activities in dependence of breed, farm of origin and weather
      conditions were studied. Animals of one farm were pastured in spring, the animals
      of the other farm were brought directly from the barn to the mountain area.
      Physiological parameters were influenced by farm, but not by breed. The
      activities of GOT and CK increased in unprepared heifers only (due to the release
      from skeletal muscles) as did levels of free fatty acids and beta-hydroxybutyrate
      obviously due to adaptation-difficulties linked with energy-deficiency. Pre
      pastured animals showed higher blood-urea concentrations, due to their ability to
      locate always fresh grass with high protein content. The breed influence on the
      daily number of steps and on the distance covered was statistically not
      significant. Animals already pastured in spring showed more movement than
      unprepared ones. Among weather conditions thunderstorm showed a striking increase
      in activity which resulted from the search for shelter. On rainy days without
      wind the animals showed least movement. Cloudy, dry weather as well as sunshine
      was associated with average activity. These reactions to meteorological
      conditions were manifested more clearly in prepared heifers. The other animals
      obviously had to learn first how to minimize untoward effects by suitable
      behaviour.

PMID- 7779072
TI  - [The occurrence of Listeria monocytogenes in fecal samples of pigeons].
AB  - Listeria spp. were isolated from faeces samples from 12 (3.4%) of 350 pigeons
      examined. Three isolates were identified as L. monocytogenes (1x serovar 1/2a,
      1/2b, and 4ab), eight isolates were L. innocua (2x serovar 6a, 6x serovar 6b),
      and two isolates L. seeligeri (serovar 6b). One fecal sample yielded a mixed
      culture of L. monocytogenes and L. innocua. The results indicate that pigeons are
      not important in the epidemiology of listeriosis in man and animals.

PMID- 7779071
TI  - Assessment of safety and protective value of a cell culture modified strain "C"
      vaccine of hog cholera/classical swine fever virus.
AB  - The protective value of a commercial strain "C" vaccine of classical swine fever
      (CSF) was tested in weaner pigs. Vaccinated animals were challenged intranasally
      with the virulent hog cholera virus (HCV) strain ALFORT/187 in groups of four
      pigs each at one to four weeks post vaccination, respectively. Non-vaccinated
      control animals were challenged in the same manner. Some vaccinated pigs
      seroconverted as early as one week post vaccination with all pigs yielding
      neutralizing antibodies (nAb) against the vaccine virus at two weeks post
      vaccination. After challenge no clinical signs were observed in any of the
      vaccinated animals whereas non-vaccinated control animals developed fever
      starting in general on the fourth day post challenge. In vaccinated pigs no
      challenge virus could be isolated from leucocyte samples taken on days 3 to 7
      post challenge while HCV was isolated from buffy coat leucocytes of all non
      vaccinated animals. Six out of eight control animals were sacrificed and viral
      antigen was detected in tonsils, mandibular lymph node and spleen in four
      animals, exclusively in tonsils in one animal and none in another animal. Two non
      vaccinated animals that survived the experiment seroconverted after challenge and
      developed nAb against the HCV strain ALFORT/187.

PMID- 7779073
TI  - [The specificity of antibodies reacting with Salmonella antigens in ELISA].
AB  - Among cattle sera from herds without a history of salmonellosis and without
      vaccination against salmonellas, we sometimes found samples which reacted
      positively in the ELISA with salmonella antigen. Contrary to antibodies caused by
      a proved salmonella infection, these antibodies could be eliminated by a whole
      cell lysate of E. coli. In the colostra of cows which had received a salmonella
      live vaccine orally in the first days of life but were raised and kept without
      known exposition to salmonellas, we also found antibodies which reacted in the
      salmonella ELISA. They could not be eliminated by E. coli lysate.

PMID- 7779074
TI  - [The peripartal disease complex of the sow in the industrial swine breeding
      facility. 4. The effect of prophylactic oral medication on the occurrence of the
      peripartal disease complex of the sow with the symptoms of urinary tract
      infection and vaginal-vulvar discharge].
AB  - In an industrial pig production unit 20 sows were selected at random. All the
      sows had a puerperal disease in their anamnesis. The sows were divided in two
      groups consisting of ten sows each. Group 1 received Ampicillin per os (3 g per
      sow and day) four days a.p. and four days p.p. The majority of the sows showed a
      significant E. coli bacteriuria and non of the sows showed a significant
      Enterococcus bacteriuria prior to treatment. The development of puerperal disease
      was registered. The treated group showed less occurrence of disease compared to
      the control. Group 1 revealed significant (p < 0.05) less early postnatal losses
      than the untreated control. Group 1 showed better four weeks weaning weights as
      well. It is the authors opinion that sows having significant bacteriuria a.p.
      should be treated a.p. and p.p. before periparturient disease occurs.

PMID- 7779075
TI  - A regulatory element in the 5'UTR directs cell-specific expression of the mouse
      alpha 4 gene.
AB  - Transfection experiments showed that the mouse alpha 4 promoter contains a
      downstream element in its 5'UTR which is essential for efficient promoter
      activity. DNaseI footprinting and electrophoretic mobility shift assays (EMSA)
      demonstrated that the region from nt +113 to +148 can bind a cell type-specific
      factor (MIII-3) present in the alpha 4m expressing cell line L1210 but not in the
      non-expressing cell lines A9 and LMTK. Two consensus SP1 sites in this 5'UTR were
      recognised in L1210, A9 and LMTK, and with extracts from A9 and LMTK, an AP2-like
      protein was shown to bind a downstream AP2 site. Thus both ubiquitous and cell
      type-specific factors regulate the expression of alpha 4m.

PMID- 7779076
TI  - A chicken Wnt gene, Wnt-11, is involved in dermal development.
AB  - We have isolated a new member of the Wnt gene family, Wnt-11, from chick embryo
      cDNA library and examined the expression pattern during embryogenesis by in situ
      hybridization. The Wnt-11 gene encodes Cys-rich secretory protein distantly
      related to Wnt-1 through Wnt-8 from the mouse and Xenopus. Expression of the Wnt
      11 gene became evident at stage 14 in the dorsolateral region of somites and
      gradually restricted to the dermatome at stage 19 and later. In contrast to the
      other Wnt genes, Wnt-11 was not expressed in the neuroepithelium throughout
      stages 14-26. At stage 24 and later, Wnt-11 was expressed in the subectodermal
      mesenchyme of the limb and feather buds. The unique expression pattern of Wnt-11
      in the paraxial mesoderm and dermatome suggests that Wnt-11 may play an important
      role in dermal development.

PMID- 7779077
TI  - HIV-1 gp120 produces DNA fragmentation in the cerebral cortex of rat.
AB  - In the present experiments we have used morphological techniques to study the
      neuropathological profile of the brain of rats after intracerebroventricular
      (i.c.v.) injection of recombinant HIV-1 gp 120. Using brain cryostat sections (10
      microns) from rats treated with a single, daily dose of gp120 (100 ng/rat) given
      for 7 and 14 consecutive days, in situ DNA fragmentation was revealed in the
      neocortex but not in the hippocampus by terminal deoxynucleotidyl transferase
      (TdT)-mediated dUTP-biotin nick end-labelling (TUNEL). In these rats, dark
      degenerating neurones were observed in the neocortex but not in the hippocampus.
      Treatment with bovine serum albumin (300 ng/rat, i.c.v.) for up to 14 days did
      not produce DNA fragmentation nor did it yield neuropathological lesions of the
      neocortex or hippocampus. In conclusion, the present data demonstrate that gp 120
      given i.c.v. produced DNA fragmentation in the neocortex, thus suggesting that
      apoptosis is the mechanism through which neurones of the neocortex are killed.

PMID- 7779078
TI  - Leukemia inhibitory factor (LIF) enhances trophoblast differentiation mediated by
      human chorionic gonadotropin (hCG).
AB  - We investigated the effect of LIF on the differentiation of trophoblasts.
      Isolated cytotrophoblasts were cultured with and without LIF and cell smears were
      immunocytochemically analyzed, using anti-hCG antibody. The percentage of
      differentiated trophoblasts stimulated by 10ng/ml of LIF was about 2.5-fold that
      in the control culture. The effect of LIF in inducing the differentiation of
      cytotrophoblasts to syncytiotrophoblasts was dose-dependent. The same effect was
      shown when hCG was added to the medium. This enhancing effect of LIF on
      trophoblast differentiation was blocked by adding anti-hCG antibody to the
      culture system. These results indicate that LIF enhanced trophoblast
      differentiation by stimulating hCG production in trophoblasts, and not by
      exerting a direct effect on the trophoblasts.

PMID- 7779079
TI  - Sequence and structural homologies between M. tuberculosis chaperonin 10 and the
      MHC class I/II peptide binding cleft.
AB  - The peptide corresponding to the C-terminal half of M.tuberculosis hsp10 was
      synthesised based on the prediction that it might represent an independent
      structural region of the protein. This hypothesis was confirmed by aggregation
      and CD studies using this peptide and longer sequences of the protein. The
      peptide shares about 40-50% sequence homology with alpha 2 and beta 1 chains of
      MHC class I and II antigens. This and the CD results which indicated that the
      peptide at acidic pHs folds into an anti-parallel beta-sheet were used to
      generate a 3D model which has the same "W" fold contained in the MHC peptide
      binding groove. These data suggest that the hypothesis of molecular mimicry
      proposed to be one of the mechanisms which triggers autoimmune diseases may be
      extended to hsp10 proteins. Furthermore the suggested evolutionary relationship
      between hsp's and MHC antigens may find support from these data.

PMID- 7779080
TI  - The novel aldehyde dehydrogenase gene, ALDH5, encodes an active aldehyde
      dehydrogenase enzyme.
AB  - The mRNA for the novel aldehyde dehydrogenase 5 (ALDH5) gene was detected in HuH7
      hepatoma cells. The cells also expressed cytosolic aldehyde dehydrogenase (ALDH1)
      mRNA, but no mitochondrial aldehyde dehydrogenase (ALDH2) mRNA. Extracts of the
      hepatoma cells contained an enzymatic activity with an isoelectric point similar
      to that of ALDH1. This enzyme activity was insensitive to inhibition by
      disulfiram, a potent inhibitor of ALDH1. The enzyme was active with short chain
      aldehydes (acetaldehyde and propionaldehyde) and NAD+, but not with NADP+, and
      the activity was higher in the mitochondrial pellet than other cell fractions.
      These studies demonstrate the expression of ALDH5 mRNA in a human hepatoma and
      suggest that the gene product is enzymatically active and probably resides in the
      mitochondria.

PMID- 7779081
TI  - Activation of mitogen-activated protein kinase by the human prostaglandin EP3A
      receptor.
AB  - Mitogen-activated protein (MAP) kinases are involved with cellular proliferation,
      and while the traditional activators of these kinases have been the growth factor
      receptors, recent data indicate that G-protein coupled receptors which inhibit
      adenylyl cyclase can activate MAP kinases as well. We have recently cloned an
      alternative splice variant of a human receptor for prostaglandin E2 (PGE2) which
      inhibits adenylyl cyclase and as been defined as the EP3A (Brit. J. Pharmacol.
      112:377, 1994). In the present study the ability of this receptor to activate MAP
      kinase was examined. In crude lysates of COS-7 cells transfected with the human
      EP3A, 1 microM PGE2 stimulated MAP kinase activity approximately 1.3-fold with an
      EC50 of approximately 6 nM. Ion exchange chromatography followed by immunoblot
      analysis showed that the stimulation of MAP kinase activity co-fractionated with
      immunoreactive MAP-2 kinase (ERK1). This activation of MAP kinase activity by the
      EP3A receptor may explain the proliferative actions of PGE2 in some tissues.

PMID- 7779082
TI  - Potent inhibitors of the HIV-1 protease with good oral bioavailabilities.
AB  - A series of novel pseudo-symmetrical and unsymmetrical inhibitors based on the
      backbone modification of a peptidomimetic were synthesized and found to be highly
      potent inhibitors of the HIV-1 protease (IC50 = 2.9 to < 0.5 nM). These compounds
      also possess good antiviral activity in vitro as measured by inhibition of the
      cytopathic effect of HIV-1(3B) in MT-4 lymphocytes. Importantly, some of these
      compounds also have good oral bioavailabilities in rats (F = 30.6% to 100%). One
      of these compounds 4C, also has good oral bioavailability in beagle dogs and
      cynomolgus monkeys.

PMID- 7779084
TI  - Telomere repeat fragment sizes do not limit the growth potential of uterine
      leiomyomas.
AB  - We have compared the length of telomere repeat fragments (TRF's) in 19 uterine
      leiomyomas from 6 patients with the corresponding myometrium. The advantage of
      this study of TRF length is that cells from uterine leiymyoma and cells from
      corresponding myometrium do not contain any considerable proportions of other
      cells as revealed by analysis of clonality. In all tumor samples a loss of TRF
      length ranging from 1120 to 4690 bp was noted. There was no correlation between
      tumor volume or size of tumor population as revealed by histological examination
      and loss of TRF length. From the obtained TRF length data (an average myometrial
      TFR length of 13 kb and an average loss of TRF length in myoma cells of 83 bp per
      cell division) we concluded that TRF length reduction does not limit the growth
      potential of uterine leiomyomas.

PMID- 7779083
TI  - ATP induces dissociation of the 90 kDa heat shock protein (hsp90) from F-actin:
      interference with the binding of heavy meromyosin.
AB  - The 90 kDa heat shock protein (hsp90) is a major cytoplasmic molecular chaperone
      associating with various other proteins such as steroid receptors, protein
      kinases and filamentous actin. hsp90 has also been shown to bind ATP, which
      causes a conformational change of the protein. The physiological role and
      significance of ATP binding by hsp90, however, has remained unclear. Here we show
      through direct, microscopic observations, that ATP induces the dissociation of
      actin filaments from immobilized molecules of hsp90 as well as the dissociation
      of F-actin from heavy meromyosin in the presence of hsp90.

PMID- 7779085
TI  - EPR and redox characterization of ferredoxins I and II from Desulfovibrio
      vulgaris Miyazaki.
AB  - Detailed redox titrations monitored by EPR and UV-visible spectroscopies have
      been carried out on the dimeric ferredoxins I and II from Desulfovibrio vulgaris
      Miyazaki. Ferredoxin II contains a unique [4Fe-4S] cluster per subunit
      characterized by a midpoint potential of -417 mV at 24 degrees C. The enthalpic
      and entropic contributions to the redox free energy variation of this cluster
      have been determined from the temperature dependence of the midpoint potential
      and compared to the data reported for other iron-sulfur proteins. The molecular
      arrangement of the two subunits is such that two [4Fe-4S]i+ clusters are
      magnetically coupled in the fully reduced state of the protein. Ferredoxin I
      contains one [3Fe-4S] and one [4Fe-4S] cluster per subunit, whose spectral and
      redox properties are very similar to those of the same clusters in ferredoxin III
      from Desulfovibrio africanus. The strong heterogeneity in the redox properties of
      the [3Fe-4S] center supports a bridging position between the N-terminal and C
      terminal parts of the protein.

PMID- 7779086
TI  - Constitutive activation of the thyrotropin receptor by deletion of a portion of
      the extracellular domain.
AB  - Mutations involving the transmembrane domain of the thyrotropin receptor (TSHR)
      confer constitutive activation of the receptor and can cause human diseases.
      Naturally occurring activating mutations identified to date are located only in
      the transmembrane domain of the receptor. We now report a mutant involving the
      extracellular domain of the TSHR which also shows constitutive activation. This
      mutation is missing residues 339-367 located in the C-terminal portion of the
      extracellular domain. When expressed in COS-7 cells, the mutated TSHR (M3B)
      retained similar TSH binding ability to that of the wild-type receptor. However,
      the basal cAMP production without TSH stimulation in COS-7 cells transfected with
      M3B cDNA was significantly higher than that of COS-7 cells with wild-type
      receptor, indicating that the mutant receptor is constitutively activated. Our
      results provide new insight into the mechanism of receptor activation.

PMID- 7779087
TI  - Cloning of rat and mouse P2Y purinoceptors.
AB  - The cellular responses to ATP are mediated by specific high-affinity receptors
      designated as P2 purinoceptors, five subclasses of which have been defined
      pharmacologically-P2X, P2Y, P2U, P2T, and P2Z. A cDNA clone encoding a rat P2Y
      purinoceptor was isolated from an insulinoma cDNA library. The 373-amino acid rat
      P2Y purinoceptor sequence has 85.7% and 37.8% identity with chicken P2Y and rat
      P2U purinoceptors, respectively. The sequence of the mouse P2Y purinoceptor was
      also determined and there was 97.1% amino acid identity with the corresponding
      rat sequence. RNA blotting studies showed that rat P2Y purinoceptor mRNA was
      expressed at variable levels in many tissues including heart, brain, spleen,
      lung, liver, skeletal muscle and kidney, although it was not detected in testis.
      The cloned rat P2Y purinoceptor was expressed in Xenopus laevis oocytes and
      possessed the properties expected for this receptor subtype.

PMID- 7779088
TI  - Direct measurement for elasticity of myosin head.
AB  - During muscle contraction, chemical energy from ATP hydrolysis is converted to
      the relative sliding movement of actin and myosin filaments. In order to
      elucidate the molecular mechanism of sliding-force generation, it is a crucial
      clue to know an elastic modulus of myosin. Here, we report direct measurements of
      Young's modulus of myosin head (myosin subfragment-1) isolated from rabbit
      skeletal muscle, using a surface forces apparatus. Our results show that the
      elasticity of myosin subfragment-1 has direction and is about 0.3 GPa along the
      long axis during ATP hydrolysis. When the bow-shaped subfragment-1 is modelled as
      an elastic rod, the stiffness and the bending fluctuations of subfragment-1 are
      calculated to be 3-7 pN/nm and about 1 nm, respectively. These results strongly
      support a model of multiple power strokes rather than the conventional tilting
      crossbridge model.

PMID- 7779089
TI  - The human bradykinin B2 receptor gene: full length cDNA, genomic organization and
      identification of the regulatory region.
AB  - Hybridization of Northern blots with a probe corresponding to the coding region
      of the bradykinin B2 receptor revealed a single transcript of approximately 4.0
      kb. Using the same probe, we detected a 2.6 kb human cDNA clone that overlapped
      103 bp with the 3' end of the known coding region and contained a classical
      polyadenylation site and a polyA tail. The gene for the human B2 receptor was
      isolated from a human placenta genomic library. Analysis of several genomic
      lambda clones indicated that the B2 receptor gene is organized in three exons.
      Genomic Southern analysis revealed the B2 receptor to be encoded by a single copy
      gene. In situ hybridization showed that the gene is located on chromosome 14q32.
      By testing different putative regulatory fragments in a luciferase reporter
      assay, a gene activating function of the 5' upstream region of exon 1 was
      demonstrated.

PMID- 7779090
TI  - Identification of polymorphic sites of the human bradykinin B2 receptor gene.
AB  - The characterization of the genomic organization of the B2 bradykinin receptor
      gene enabled us to systematically search for polymorphic markers in this gene in
      a South German cohort (N = 179). We identified at least three polymorphic sites
      in each of the three exons existing: (i) in exon 1 next to the promoter region, a
      tandem repeat polymorphism consists of three common alleles, (ii) in exon 2 at
      nucleotide position 181 of the cDNA a C to T transition leads to an aminoacid
      substitution from arginine to cysteine in the receptor protein at position 14
      (R14C), and (iii) a more complex repeat polymorphism, located in the 3' not
      translated region of exon 3, comprises at least two common alleles and two rare
      variants. These new genetic markers provide valuable tools to elucidate a
      potential role of a hereditary dysfunction of the B2 bradykinin receptor gene in
      disorders such as hypertension or ischemic heart disease.

PMID- 7779091
TI  - Angiotensinogen gene expression is induced by cyclical mechanical stretch in
      cultured rat cardiomyocytes.
AB  - The effect of cyclical mechanical stretch on angiotensinogen gene expression was
      examined using a neonatal rat cardiocyte culture system. Cultured cardiocytes
      grown on a flexible membrane base were stretched by vacuum to 20% of maximum
      elongation, at 60 cycles/min. The angiotensinogen gene was activated 2 to 5 fold
      after stretch for 3 to 24 hr, as shown by quantitative reverse transcription
      polymerase chain reaction. The 5'-flanking region of the angiotensinogen promoter
      was activated after stretch for 24 hr. This gene expression could be completely
      suppressed by losartan, a specific antagonist of angiotensin II receptor. These
      results indicate that (1) cyclical mechanical stretching of cardiocytes is a good
      model for the study of cardiac hypertrophy-related gene expression; (2) cyclical
      stretch up-regulates expression of the angiotensinogen gene and (3) the increase
      in promoter activity may contribute to the induction of angiotensinogen mRNA by
      cyclical stretch.

PMID- 7779092
TI  - Expression of the endothelin-converting enzyme gene in human tissues.
AB  - Based on the cDNA sequence of the human and bovine endothelin converting enzyme
      (ECE-1) we have developed a novel reverse transcription polymerase chain reaction
      to investigate the tissue expression of this gene. We were able to specifically
      detect the gene mRNA starting from very limited amount of tissue in all human as
      well as bovine tissues examined. Thus, our results confirm a widespread
      expression of the ECE-1 gene in human tissues, in keeping with the findings in
      other species, and suggest a major biological role of ECE-1.

PMID- 7779093
TI  - Transcription initiation is localized to a TATAless region in the ovine beta 1
      adrenergic receptor gene.
AB  - We cloned and sequenced the ovine beta 1 adrenergic receptor (beta 1AR) gene and
      promoter region. The transcription start site was localized by RNase protection
      and primer extension to a GC-rich region. The predominant initiation sequence did
      not resemble an initiator element and there was no upstream TATA box. Sequence
      analysis revealed several potential thyroid hormone and glucocorticoid regulatory
      elements. Identification of the promoter structure of this important gene will
      help define its novel regulation during development.

PMID- 7779095
TI  - Elucidation of the region responsible for EDTA tolerance in PQQ glucose
      dehydrogenases by constructing Escherichia coli and Acinetobacter calcoaceticus
      chimeric enzymes.
AB  - We constructed various chimeric PQQ glucose dehydrogenases (PQQGDHs) from an EDTA
      sensitive PQQGDH from Escherichia coli and an EDTA-tolerant PQQGDH from
      Acinetobacter calcoaceticus by homologous recombination of their structural
      genes. The EDTA tolerance of the resulting chimeric enzymes was investigated. Our
      results demonstrated that EDTA tolerance of PQQGDHs can be completely altered by
      substituting each corresponding region. The EDTA tolerance of A. calcoaceticus
      PQQGDH is mostly within a region composed of about 90 amino acid residues located
      between 45 and 56% of the distance from the N-terminal region.

PMID- 7779094
TI  - Formation of heparan sulfate or chondroitin/dermatan sulfate on recombinant
      domain I of mouse perlecan expressed in Chinese hamster ovary cells.
AB  - Recombinant domain I of mouse perlecan was expressed in Chinese hamster ovary
      (CHO K1) cells and affinity purified on Ni-agarose. Gel chromatography followed
      by characterization of glycosaminoglycans by the use of glycosaminoglycan lyases
      showed that the recombinant proteoglycans contained, on average, three
      glycosaminoglycan chains of heparan sulfate or chondroitin/dermatan sulfate of
      approximately 12 kDa median size. These data demonstrate that domain I has
      functional sites for attachment of glycosaminoglycans and indicate that the
      glycosaminoglycan chains of native perlecan are grouped at its N-terminal end.
      This, in turn, suggests that the likely function of domain I in perlecan would be
      to provide for the addition of glycosaminoglycan chains to the core protein.

PMID- 7779096
TI  - Dopamine transporter gene polymorphism and alcoholism.
AB  - In this search for a possible association between the dopamine transporter gene
      (DAT1) polymorphism and alcoholism, 655 Japanese alcoholics were grouped
      according to their aldehyde dehydrogenase-2 (ALDH2) genotypes. Because inactive
      ALDH2 is an established negative risk factor for alcoholism, alcoholics with the
      mutant allele, ALDH2*2, were considered a relatively homogeneous group. The
      frequency of the 7-repeat allele of the DAT1 variable number of tandem repeat was
      significantly higher in alcoholics with ALDH2*2 than in control subjects. These
      results are consistent with the hypothesis that alteration in the dopaminergic
      system plays some role in the development of alcoholism.

PMID- 7779097
TI  - Not Ca2+ but CAMP is the second messenger for morphological changes in rat
      megakaryocyte.
AB  - ATP and thrombin both induced Ca2+ mobilization from intracellular Ca2+ store
      site of megakaryocyte, the progenitor cell of platelet (Uneyama C., Uneyama H.
      and Akaike N. (1993) J. Physiol. (Lond.), 470, 73-749). Since in platelet,
      thrombin is known as a strong agonist and ADP is known as a weak agonist, we
      further investigated the effect of these agonists on megakaryocyte. Thrombin
      induced Ca2+ mobilization, 5-hydroxy tryptamine (5-HT) release and aggregatory
      morphological changes in megakaryocyte, but ATP induced only Ca2+ mobilization.
      Thrombin-induced 5-HT release was inhibited by adenylate cyclase-activating
      drugs, and the morphological changes could be induced by H-8, an inhibitor of
      cAMP-dependent protein kinase. These results suggest that the Ca2+ mobilization
      is not sufficient to induce morphological changes, and the signal to cause
      morphological changes in megakaryocyte may be cAMP.

PMID- 7779098
TI  - Molecular cloning and posttranscriptional regulation of macrophage inflammatory
      protein-1 alpha in alveolar macrophages.
AB  - Macrophage inflammatory protein-1 alpha (MIP-1 alpha) belongs to the "chemokine"
      superfamily of chemoattractant pro-inflammatory cytokines. MIP-1 alpha is
      chemotactic for monocytes and neutrophils and thus, plays an important role in
      initiation and control of inflammation. We have isolated and sequenced a cDNA
      clone encoding rat MIP-1 alpha. This 0.75 kb cDNA includes a single open reading
      frame of 92 amino acids. Expression of MIP-1 alpha mRNA was characterized in
      NR8383, a rat alveolar macrophage cell line (RAM). In resting RAM cells, MIP-1
      alpha mRNA decayed rapidly, with a half life of less than 2 hours.
      Lipopolysaccharide (LPS) treatment of RAM cells resulted in a dose-dependent
      increase in MIP-1 alpha steady state mRNA expression. The induction of MIP-1
      alpha mRNA by LPS was partially the result of mRNA stabilization, as half life
      increased to over 6 hours.

PMID- 7779099
TI  - Purification and characterization of Rab GDI beta from rat brain.
AB  - A new Rab GDI was purified from the synaptic soluble fraction of rat brain by
      several column chromatographies as a protein that inhibited the dissociation of
      [3H]GDP from Rab3A but was not recognized by an anti-Rab GDI alpha antibody. The
      partial amino acid sequence analysis revealed that it was identical with rat Rab
      GDI beta. Purified Rab GDI beta showed the kinetic properties similar to those of
      Rab GDI alpha, including the inhibitory effect on the dissociation of GDP from
      Rab3A, the substrate specificity, the requirement of the post-translational lipid
      modifications of Rab3A, the stoichiometric interaction with the GDP-bound form of
      Rab3A, the inhibitory effect on the binding of Rab3A to erythrocyte ghosts, and
      the stimulatory effect on the dissociation of Rab3A from the membrane.

PMID- 7779101
TI  - The influence of sterols on the sensitivity of lipid bilayers to melittin.
AB  - The sensitivity of planar lipid bilayers to the permeabalizing effect of melittin
      was evaluated when sterols of varying structure were incorporated into the
      membrane. The addition of increasing amount of cholesterol (0-50 mole %)
      decreased the sensitivity of membranes formed from negatively charged
      phospholipids to melittin but did not (in amount of up to 66 mole %) change the
      sensitivity of membranes formed from zwitterionic lipids. 7-Dehydrocholesterol,
      stigmasterol and ergosterol had the same ability as that of cholesterol to
      decrease the membrane sensitivity to melittin, while lanosterol had no effect on
      the sensitivity of membranes to melittin. The results suggest that the effect of
      sterols is complex and cannot be explained only by a direct interaction of
      melittin with cholesterol, by a decrease of membrane fluidity, or by changes in
      distribution of surface charge.

PMID- 7779100
TI  - Activation of membrane-bound phospholipase D by protein kinase C in HL60 cells:
      synergistic action of a small GTP-binding protein RhoA.
AB  - Regulation of phospholipase D (PLD) activation by protein kinase C (PKC) was
      studied in membranes isolated from human promyelocytic leukemia HL60 cells. The
      activation of membrane-bound PLD by PKC partially purified from rat brain was
      most effectively induced with phorbol 12-myristate 13-acetate (PMA) and Ca2+ (1
      microM) which caused translocation of PKC to membranes. Ro31-8425, a potent
      inhibitor of PKC, suppressed the catalytic activity of PKC in a concentration
      dependent manner, with complete inhibition at 5 microM. However, the PKC-mediated
      PLD activation was not affected by Ro31-8425. It was thus suggested that membrane
      bound PLD of HL60 cells was activated by PKC translocation but probably via a
      phosphorylation-independent mechanism. Furthermore, addition by guanosine 5'-3-O
      (thio)trisphosphate (GTP gamma S) potentiated the PKC-mediated PLD activation and
      this potentiating effect was abolished by Rho GTPase dissociation inhibitor
      (RhoGDI). The suppressed PLD activation by RhoGDI was completely restored by
      addition of recombinant RhoA. These results indicate that the PKC-mediated PLD
      activation can be synergistically potentiated by RhoA in HL60 membranes.

PMID- 7779102
TI  - An extracellular inositol phospholipid-specific phospholipase C is released by
      cultured Swiss 3T3 cells.
AB  - A phosphatidylinositol-cleaving phospholipase C (PI-PLC) activity is released
      into the extracellular environment by intact Swiss 3T3 cell cultures. The
      activity is found in both serum-containing and serum-free defined culture medium.
      The cells remain attached and intact by Trypan Blue exclusion and lactate
      dehydrogenase assays. The activity is specific for phosphoinositides as no
      cleavage of phosphatidylcholine is observed. The activity is a phospholipase C
      rather than D since the water soluble products formed from cleavage of
      [3H]phosphatidylinositol were inositol phosphates and not inositol. Analysis of
      the inositol phosphate products showed a variation in composition with the pH of
      the assay, the ratio of noncyclic:cyclic forms being 60:40 at pH 7.5 and 40:60 at
      pH 5.5. This external phospholipase C resembles the well-characterized
      intracellular isozymes in that it is calcium-dependent and has a pH optimum
      between 5 and 6. From membrane filter assays the molecular weight of the native
      enzyme is estimated to be between 50 and 100 kDa.

PMID- 7779103
TI  - Telomere shortening in chronic liver diseases.
AB  - We measured the telomere length in patients with chronic hepatitis or liver
      cirrhosis and found a significant telomere shortening in the liver with chronic
      liver disease compared to that in the normal liver. The telomere length tended to
      decrease with the progression of chronic liver disease.

PMID- 7779104
TI  - Identification of brush border myosin-I in liver and testis.
AB  - Brush border myosin-I, or BBMI, constitutes the lateral links that connect in
      intestinal microvilli the core bundle of actin filaments to the membrane.
      Although related molecules have been identified in other higher eukaryotic
      tissues, northern blot analysis has indicated that the distribution of this
      particular myosin-I isoform is restricted essentially to intestine. Using reverse
      transcriptase polymerase chain reaction we have identified BBMI in a wide range
      of tissues including liver and testis. Our results also indicate that in testis
      the BBMI gene might be alternatively spliced.

PMID- 7779105
TI  - Acute endotoxin tolerance is accompanied by stimulated glucose use in macrophage
      rich tissues.
AB  - A single injection of E. coli LPS at a dose of 10 mg/kg b.w. ("high dose") is
      lethal in Sprague Dawley rats. However, animals given a sublethal dose of LPS
      (0.5 mg/kg bw; "low dose") at time zero, followed by a second high dose injection
      at 48 h, display endotoxin tolerance with 100% survival. The aim of the present
      study was to assess the relationship between this observed endotoxin tolerance
      and the endotoxin-induced glucose metabolic response in selected tissues and
      nonparenchymal hepatic cells. In each experimental group two injections, the
      first at time zero, the second at 48 h were given in vivo. Four experimental
      groups constituted these studies: A) saline followed by saline, B) low dose LPS
      followed by saline, C) saline followed by high dose LPS, and D) low dose LPS
      followed by high dose LPS. In vivo glucose use in tissues and cells was measured
      3h after the last treatments employing the 2-deoxy-glucose tracer technique.
      Glucose use by liver, lung, spleen and intestine was not different between
      saline/saline (group A) and low dose LPS/saline injected (group B) animals.
      Saline/high dose LPS injection (group C) doubled glucose uptake, while the
      sequential LPS injections (group D) caused an additional, 2-3 fold increase in
      the glucose use by these tissues. Hepatic endothelial cells showed a similarly
      elevated glucose use in vivo in both group C and D. Kupffer cells from group D
      animals, however, displayed markedly elevated glucose use in vivo as compared to
      cells from group C. Our data indicate that high dose LPS in endotoxin tolerant
      animals is accompanied by a more markedly stimulated tissue glucose use than
      found following lethal LPS treatment alone. This increased peripheral glucose use
      may support cellular functions responsible for the protection of the host.

PMID- 7779106
TI  - Genomic cloning of the human histo-blood group ABO locus.

PMID- 7779107
TI  - Analysis of translational termination of recombinant human methionyl-neurotrophin
      3 in Escherichia coli.
AB  - A highly efficient UGA stop codon readthrough event during the synthesis of human
      neurotrophin 3 in E. coli is described. The incorporation of a Trp residue at the
      UGA stop codon is confirmed combining both the chemical analyses and the
      molecular and genetic data in this report. The 3' adjacent nuleotide to the UGA
      stop codon plays a crucial role in determining the readthrough efficiency in the
      order of A > G > C > U. The replacement of UGA with UAA or UAG totally abolished
      this readthrough phenomenon and the use of StpR host cells also prevented the
      occurrence of UGA readthrough. Gene dosage (or plasmid copy number) effect was
      not indicated in this event; however, the titration of RF-2 by mRNA transcripts
      under over-expression conditions might explain why tRNAtrp competes so well with
      RF-2 for UGA. Another apparently less produced readthrough product resulting from
      a transcript with no stop codon is also recorded, and the addition of a second in
      frame stop codon increased the amount of the observed readthrough product.

PMID- 7779108
TI  - cis-splicing and polyadenylation of actin RNA can precede 5' trans-splicing in
      nematodes.
AB  - In nematodes many precursor RNAs undergo both cis-splicing (intron removal) and
      trans-splicing (spliced leader addition) via molecular mechanisms thought to be
      very similar. We examined the temporal order of trans- and cis-splicing by
      analyzing cDNAs of partially processed transcripts from an actin gene of the
      parasitic nematode, Onchocerca volvulus, which has five short introns. We found
      that in this model gene system trans-splicing can follow cis-splicing and
      polyadenylation, and we obtained no evidence for alternative pathways of
      splicing. This result is in contrast to the tubulin genes of African trypanosomes
      where trans-splicing precedes polyadenylation (1).

PMID- 7779109
TI  - Calreticulin is the major Ca2+ storage protein in the endoplasmic reticulum of
      the pea plant (Pisum sativum).
AB  - A 56kDa protein with high similarity in its N-terminal amino acid sequence to
      animal calreticulin and 100% homology with the N-terminal amino acids of spinach
      calreticulin has been identified in seeds of the pea plant (Pisum sativum). A new
      purification procedure is described by which the calreticulin-like protein was
      selectively solubilized by incubation with deoxycholate and HgCl2 from microsomes
      enriched for endoplasmic reticulum. Following Mono Q ion exchange chromatography
      of the deoxycholate extract by fast protein liquid chromatography, the
      calreticulin-like protein was obtained in nearly pure form. This purified protein
      is similar to animal calreticulin in apparent mass, characteristic blue staining
      with Stains-all dye and calcium-binding ability. In addition, this protein is
      recognized only by affinity purified antibodies against rabbit calreticulin and
      is not recognized by anti-calsequestrin antibodies. Our data suggested that
      calreticulin rather than calsequestrin functions as the Ca(2+)-storage protein in
      the endoplasmic reticulum of pea plants.

PMID- 7779110
TI  - Cyclodextrins as protein folding aids.
AB  - Aggregation of proteins is a frequent occurrence during their transition from
      random coil to native structure. The influence of cyclodextrins in the refolding
      of carbonic anhydrase under aggregating conditions was studied. Cyclodextrin
      prevented formation of protein aggregates during renaturation of carbonic
      anhydrase. In addition, over 90% of active enzyme was recovered even at protein
      concentrations as high as 67 microM. The enhanced protein reactivation by
      cyclodextrins may be due to their ability to bind to hydrophobic sites in protein
      folding intermediate(s) followed by their subsequent removal as the protein
      refolds.

PMID- 7779111
TI  - Antibodies to ICAM-1 protect kidneys in severe ischemic reperfusion injury.
AB  - ICAM-1 has been implicated in the pathophysiology of ischemic-reperfusion injury
      in a number of organs, but its role in mediating severe ischemic-reperfusion
      injury in the kidney has not been extensively studied. Uninephrectomized Sprague
      Dawley rats were pretreated with either control monoclonal antibody (mAb) or mAb
      to ICAM-1 and subjected to 60 min of renal artery occlusion. The serum
      creatinine, complete blood count and kidney histo-pathological damage scores
      (PDS) (Scale:0-4) were assessed prior to and 24 hours after ischemia. Mean serum
      creatinine (mg/dl) 24 hours after ischemia was significantly decreased in the
      anti-ICAM-1 group (1.38 +/- 0.23, p < 0.001) compared to control (2.87 +/- 0.34).
      PDS was also reduced in anti-ICAM-1 (2.55 +/- 0.20, p < 0.05) group compared to
      control (3.35 +/- 0.30). These data demonstrate that blocking ICAM-1
      significantly mitigates severe ischemic acute renal failure, findings which may
      lead to improved therapy for this condition.

PMID- 7779112
TI  - Formation of an extremely stable polyalanine beta-sheet macromolecule.
AB  - We have designed a 16-mer peptide composed of a stretch of alanine residues (Ac
      KA14K-NH2) which is an effective, simple model for the study of beta-sheet
      formation in the hydrophobic cores of proteins. This peptide adopts an aqueous
      soluble "bundling" macromolecular beta-sheet structure, which is extremely stable
      to a wide range of pHs, temperatures and/or denaturants. Its unusual stability
      appears to be due to tight hydrophobic packing of the alanine residues in
      multilayer sheets or micellar forms with the multimeric lysine array being
      directed outward at the aqueous environment, allowing aqueous solubility.

PMID- 7779114
TI  - American College of Rheumatology. Preliminary definition of improvement in
      rheumatoid arthritis.
AB  - OBJECTIVE: Trials of rheumatoid arthritis (RA) treatments report the average
      response in multiple outcome measures for treated patients. It is more clinically
      relevant to test whether individual patients improve with treatment, and this
      identifies a single primary efficacy measure. Multiple definitions of improvement
      are currently in use in different trials. The goal of this study was to
      promulgate a single definition for use in RA trials. METHODS: Using the American
      College of Rheumatology (ACR) core set of outcome measures for RA trials, we
      tested 40 different definitions of improvement, using a 3-step process. First, we
      performed a survey of rheumatologists, using actual patient cases from trials, to
      evaluate which definitions corresponded best to rheumatologists' impressions of
      improvement, eliminating most candidate definitions of improvement. Second, we
      tested 20 remaining definitions to determine which maximally discriminated
      effective treatment from placebo treatment and also minimized placebo response
      rates. With 8 candidate definitions of improvement remaining, we tested to see
      which were easiest to use and were best in accord with rheumatologists'
      impressions of improvement. RESULTS: The following definition of improvement was
      selected: 20% improvement in tender and swollen joint counts and 20% improvement
      in 3 of the 5 remaining ACR core set measures: patient and physician global
      assessments, pain, disability, and an acute-phase reactant. Additional validation
      of this definition was carried out in a comparative trial, and the results
      suggest that the definition is statistically powerful and does not identify a
      large percentage of placebo-treated patients as being improved. CONCLUSION: We
      present a definition of improvement which we hope will be used widely in RA
      trials.

PMID- 7779115
TI  - Joint and connective tissue ultrasonography--a rheumatologic bedside procedure? A
      German experience.

PMID- 7779113
TI  - The orphan receptor TAK1 acts as a repressor of RAR-, RXR- and T3R-mediated
      signaling pathways.
AB  - Recently, we reported the cloning and characterization of the novel orphan
      receptor TAK1. In this study, we analyze the interaction of TAK1 with a variety
      of response elements (RE's) and demonstrate that TAK1 binds effectively to RE's
      composed of the core motif PuGGTCA configured in direct repeats spaced by one or
      more nucleotides. TAK1 bound poorly to palindromic or inverted palindromic motifs
      and was unable to bind to a single core motif, suggesting that a dimeric site is
      required for binding. Transfection experiments with CV-1 cells revealed that TAK1
      is able to repress retinoid- and thyroid-hormone-induced transactivation through
      a subset of retinoid and thyroid hormone RE's. Our studies indicate that the
      antagonism of RAR-mediated transactivation does not involve the formation of
      heterodimers between TAK1 and RAR or RXR but is due to the competition of TAK1
      homodimers with RAR-RXR heterodimers and RXR homodimers for binding to RARE and
      RXRE, respectively. Our results suggest that the orphan receptor TAK1 can be a
      negative modulator of the regulation of gene expression mediated by retinoid and
      thyroid hormone signaling pathways.

PMID- 7779116
TI  - Distinct oligosaccharide content of rheumatoid arthritis-derived immune
      complexes.
AB  - OBJECTIVE: To investigate the association between glycosylation and immune
      complex formation in various disease groups. METHODS: Immune complexes and IgG
      were isolated from serum and their carbohydrate content evaluated in a dot-blot
      assay using specifically binding lectins. RESULTS: Significantly more N
      acetylglucosamine was detected in complexes from patients with rheumatoid
      arthritis (RA) than in those from patients with systemic lupus erythematosus,
      Crohn's disease, or infectious endocarditis, or from normal controls (P < 0.001).
      The immune complex concentration in the circulation was strongly associated with
      N-acetylglucosamine levels (P < 0.001 by chi-square analysis). CONCLUSION: The
      composition of immune complexes from RA patients is distinct in carbohydrate
      content from those found in other disease groups.

PMID- 7779118
TI  - Serum hyaluronic acid level as a predictor of disease progression in
      osteoarthritis of the knee.
AB  - OBJECTIVE: To investigate the prognostic value of serum hyaluronic acid (HA) and
      keratan sulfate (KS) levels in relation to tibiofemoral osteoarthritis (OA) of
      the knee. METHODS: Clinical and demographic data were collected on 94 patients.
      Radiographs were obtained at study entry and at 5-year followup. Disease
      progression was defined as 2 mm of joint space narrowing of any tibiofemoral
      compartment, and/or knee joint surgery during the study period. Serum HA and KS
      were measured and levels were correlated with entry data and disease progression.
      RESULTS: At entry, HA levels were significantly related to disease duration (P =
      0.036), minimum joint space (P = 0.049), and previous surgery (P = 0.001). After
      these variables were taken into account, patients whose disease had progressed
      were shown to have had significantly higher levels of HA at baseline compared
      with those whose disease had not progressed (P = 0.019). However, there were no
      significant differences in levels of serum KS between those with and those
      without disease progression, at entry (P = 0.779) or at subsequent visits.
      CONCLUSION: These results suggest that serum HA levels predict disease outcome in
      OA of the knee and confirm that a single measurement of the serum level of KS is
      not useful as a prognostic marker in OA.

PMID- 7779117
TI  - Correlation between gold-induced enterocolitis and the presence of the HLA
      DRB1*0404 allele.
AB  - OBJECTIVE: In recent years we have treated 4 rheumatoid arthritis (RA) patients
      who developed gold-induced enterocolitis, a well-recognized, although rare,
      complication of chrysotherapy. The aim of the present study was to seek any
      genetic predisposition for this complication. METHODS: HLA DNA typing was done on
      fresh white blood cells from the 4 patients. RESULTS: Three of the 4 patients
      (75%) exhibited the DRB1*0404 allele, whereas the prevalence of this allele among
      the Ashkenazi Jewish population of RA patients without colitis was 9.2% and 10.2%
      in 2 different studies. CONCLUSION: The results indicate that the DRB1*0404 may
      be associated with risk for the development of gold-induced enterocolitis in this
      population and suggest that HLA DNA typing should be considered in Jews who may
      be undergoing chrysotherapy.

PMID- 7779119
TI  - The role of nitric oxide in lipoxin A4-induced polymorphonuclear neutrophil
      dependent cytotoxicity to human vascular endothelium in vitro.
AB  - OBJECTIVE: To assess the mechanism for the cytotoxicity of human
      polymorphonuclear neutrophils (PMN) to human umbilical vein endothelial cells
      (HUVEC) induced by the 5- and 15-lipoxygenase product of arachidonate, lipoxin A4
      (LXA4), and the phorbol ester, phorbol myristate acetate (PMA). METHODS: HUVEC
      were grown to confluence and labeled with 51Cr. PMN and stimuli were added, and
      the release of 51Cr into supernatants was assessed after 4 hours. RESULTS: Both
      LXA4 and PMA conferred highly significant PMN-dependent cytolysis. The
      cytotoxicity activated by LXA4 was inhibited by NG-monomethyl-L-arginine (L-NMA)
      and by nitro-L-arginine methyl ester, specific inhibitors of the nitric oxide
      (NO)-producing enzyme NO synthase. Also, the scavenger of extracellular NO,
      oxyhemoglobin (HbO2), prevented LXA4-induced cytolysis in a dose-dependent
      manner. In sharp contrast, L-NMA did not significantly affect the cytolysis
      induced by PMA, whereas HbO2 showed a modest inhibitory action. In experiments
      without PMN, addition of the NO donor S-nitroso-N-acetyl-penicillamine to HUVEC
      induced marked cytolysis, which was inhibited by HbO2, but not by L-NMA. Addition
      of L-arginine or arginine analogs did not affect superoxide anion production in a
      cell-free hypoxanthine/xanthine oxidase system. Both LXA4 and PMA induced the
      production of superoxide anion from PMN and of NO from HUVEC: CONCLUSION: NO
      produced by HUVEC, interacting with PMN which produce superoxide anions, is of
      marked significance for the endothelial cell damage in this in vitro model of
      vasculitis. This is probably due to the subsequent formation, via a radical
      radical interaction between NO and .O2-, of cytotoxic products, such as
      peroxynitrite and its metabolites. Furthermore, although LXA4 and PMA induced
      comparable cytolysis at optimal concentrations, the relative importance of NO
      compared with other mechanisms mediating cytotoxicity was stimulus dependent, and
      NO was relatively more important for LXA4-induced PMN-dependent endothelial
      injury.

PMID- 7779120
TI  - Autoimmune response to the spliceosome. An immunologic link between rheumatoid
      arthritis, mixed connective tissue disease, and systemic lupus erythematosus.
AB  - OBJECTIVE: To assess the significance of autoantibodies to RA33, the A2 protein
      of the heterogeneous nuclear ribonucleoproteins (hnRNP), and to the related hnRNP
      proteins A1, B1, and B2 in rheumatic diseases. METHODS: Using a partially
      purified preparation of hnRNP-A and hnRNP-B proteins, sera from 303 patients with
      various rheumatic diseases were investigated by immunoblotting. For the analysis
      of cross-reactivities, autoantibodies were affinity purified by blot elution.
      RESULTS: Anti-A2/RA33 was found in 35% of rheumatoid arthritis (RA) patients, 38%
      of mixed connective tissue disease (MCTD) patients, 23% of systemic lupus
      erythematosus (SLE) patients, and, apart from single exceptions, not in patients
      with other rheumatic diseases. All anti-A2/RA33-positive sera were also reactive
      with B1 and B2, and anti-A2/RA33 antibodies cross-reacted with both proteins.
      Antibodies to hnRNP-A1 were found less frequently; moreover, the majority of anti
      A1-positive sera also contained anti-A2/RA33 antibodies. In anti-A1, anti-A2/RA33
      double-positive sera, cross-reactivity between the 2 antibodies was generally
      observed. In SLE patients, the presence of anti-A2/RA33 was correlated with the
      presence of anti-(U1) small nuclear RNP (snRNP) and anti-Sm (P < 0.0001 and P <
      0.005, respectively), but there was no evidence for cross-reactivity between
      antibodies to hnRNP and antibodies to snRNP antigens. CONCLUSION: Since both
      hnRNPs and snRNPs are essential components of the spliceosome, the data show that
      the immune systems of patients with RA, SLE, and MCTD react to this functional
      complex. However, compared with MCTD and SLE patients, RA patients have a more
      restricted immune response to the spliceosome: they react to hnRNP proteins,
      particularly to hnRNP-A2/RA33, but not to snRNPs.

PMID- 7779121
TI  - Finger tendon involvement in rheumatoid arthritis. Evaluation with high-frequency
      sonography.
AB  - OBJECTIVE: To characterize finger tendon involvement in patients with rheumatoid
      arthritis (RA). METHODS: The finger tendons of 20 RA patients were studied by
      ultrasonography using a high-frequency (13-MHz) transducer. RESULTS: Eighteen
      patients (90%) showed finger tendon abnormalities: widening of the flexor tendon
      sheath (80%), loss of the normal fibrillar echotexture (60%), irregularity of the
      extensor (30%) and flexor (50%) tendon margins, tendon tear (10%), synovial cyst
      (20%). CONCLUSION: High-frequency sonography is helpful in assessing even minimal
      finger tendon lesions in RA patients.

PMID- 7779122
TI  - A self-administered rheumatoid arthritis disease activity index (RADAI) for
      epidemiologic research. Psychometric properties and correlation with parameters
      of disease activity.
AB  - OBJECTIVE: To examine the psychometric properties and construct validity of a
      self-administered Rheumatoid Arthritis Disease Activity Index (RADAI). METHODS:
      Five items of the Rapid Assessment of Disease Activity in Rheumatology (RADAR)
      questionnaire were aggregated into the RADAI and assessed for their factor
      loading, internal consistency, and construct validity. RESULTS: In 55 patients
      with RA, the RADAI had a high internal consistency (Cronbach's alpha = 0.91) and
      correlated with physician's assessment of disease activity (r = 0.54, P < 0.01),
      the swollen joint count (r = 0.54, P < 0.01), and the C-reactive protein value (r
      = 0.43, P < 0.01). CONCLUSION: The RADAI is a highly reliable and valid self
      administered measure of disease activity for clinical, health services, and
      epidemiologic research. Its sensitivity to change in longitudinal studies needs
      further study.

PMID- 7779123
TI  - Cardiovascular fitness and health in patients with end-stage osteoarthritis.
AB  - OBJECTIVE: To evaluate the cardiovascular fitness of a group of patients with
      severe osteoarthritis (OA). METHODS: Thirty-seven patients with end-stage OA were
      evaluated just before hip or knee replacement surgery. Severity of arthritis was
      evaluated using standardized techniques. Patients and age- and sex-matched
      controls underwent a single, maximal, symptom-limited, cardiopulmonary exercise
      test using arm or leg ergometry and a metabolic cart to measure expired
      respiratory gases. RESULTS: Severe musculoskeletal disability and deformity was
      confirmed in the OA patient group. During exercise testing, OA patients were able
      to perform physiologically maximal cardiopulmonary exercise. Arthritis patients
      were noted to be severely deconditioned, with reduced peak oxygen consumption (OA
      hips mean +/- SD 14.9 +/- 4.2 versus control hips 19.0 +/- 4.6, P < 0.0001; OA
      knees 12.8 +/- 3.7 versus control knees 17.6 +/- 5.2 ml/kg/minute, P < 0.0005). A
      trend for more frequent manifestations of coronary heart disease in OA patients
      than in controls (27% versus 13%; P > 0.05) was also noted. CONCLUSION: Patients
      with end-stage lower extremity OA are severely deconditioned. This may place them
      at incremental risk for the development of coronary heart disease.

PMID- 7779124
TI  - Osteoporosis in rheumatoid arthritis. A monozygotic co-twin control study.
AB  - OBJECTIVE: To quantify the magnitude and distribution of osteoporosis in
      rheumatoid arthritis (RA). METHODS: Bone mineral density (BMD) was measured by
      dual x-ray absorptiometry, in a monozygotic co-twin control study. RESULTS: BMD
      was reduced at most skeletal sites in the twin with RA compared with the co-twin
      (lumbar spine 4.6%, femoral neck 9.7%, total body 5.7%). Differences in lean soft
      tissue (5.6% for total body) correlated with differences in BMD between twins at
      multiple sites. CONCLUSION: Osteoporosis in RA is generalized and may be related
      to loss of mobility or muscle mass associated with the disease.

PMID- 7779125
TI  - Spin-spin relaxation of brain tissues in systemic lupus erythematosus. A method
      for increasing the sensitivity of magnetic resonance imaging for neuropsychiatric
      lupus.
AB  - OBJECTIVE: To correlate the spin-spin relaxation time (T2) of brain tissue in
      neuropsychiatric systemic lupus erythematosus (NPSLE) with the patient's clinical
      condition. METHODS: T2 values were determined in 54 SLE patients and 45 non-SLE
      controls at 1.5 Tesla, using intensity from multi-echo magnetic resonance (MR)
      images fitted to an exponential decay curve with rate-constant T2. RESULTS: The
      T2 of white matter was increased in SLE patients compared with controls (P =
      0.01) and was increased in those patients who had previously experienced major
      NPSLE: Patients with acute diffuse neurologic manifestations (seizures,
      psychosis, coma) demonstrated a longer T2 of the gray matter (mean +/- SD 92.75
      +/- 6.35 ms, n = 10) than did other SLE patients (mean +/- SD 79.61 +/- 5.04 ms,
      n = 44) (P = 0.02 by t-test), which suggests acute cerebral edema. The mean T2
      values of reversible and nonreversible focal lesions were significantly different
      (P < 0.02), indicating different microenvironments and micropathology.
      CONCLUSION: Quantitative T2 measurement extends the utility and sensitivity of
      conventional MR imaging for evaluating NPSLE:

PMID- 7779127
TI  - The contributions of disease activity, sleep patterns, and depression to fatigue
      in systemic lupus erythematosus. A proposed model.
AB  - OBJECTIVE: This study describes lupus fatigue multidimensionally and introduces a
      multivariate model: Sleep problems and depression, through reciprocal effects on
      each other, act as mediators through which lupus disease activity increases
      fatigue. METHODS: Self-reported sleep patterns, depression, and fatigue were
      assessed in 48 women with systemic lupus erythematosus (SLE) and 27 women from
      the general population. Rheumatologists rated current lupus disease activity.
      RESULTS: The SLE group reported greater overall fatigue than did the controls.
      Temporal and affective dimensions of fatigue were more differentiating than
      sensory or severity dimensions. The SLE group also reported longer sleep latency
      and total sleep time, but not higher depression. Using 2-stage regression, a form
      of structural equation modeling, the proposed lupus fatigue model was supported.
      CONCLUSION: These preliminary results describe fatigue as a multidimensional
      phenomenon arising out of several contributing factors. They suggest that fatigue
      treatment strategies should address mediating processes such as sleep and
      depression, in addition to disease activity.

PMID- 7779128
TI  - The early clinical recognition of juvenile-onset ankylosing spondylitis and its
      differentiation from juvenile rheumatoid arthritis.
AB  - OBJECTIVE: To determine which early clinical data differentiate juvenile-onset
      ankylosing spondylitis (AS) from juvenile rheumatoid arthritis (JRA). METHODS:
      Medical records of 35 patients with juvenile-onset AS and 75 with JRA (excluding
      type II pauciarticular JRA), all of whom had disease onset at age < or = 16
      years, disease duration of < or = 2 1/2 years at the initial visit to the
      rheumatology clinic, and followup of > or = 10 years, were analyzed
      retrospectively with regard to features of disease found 6 months, 12 months, and
      10 years after onset. RESULTS: At 6 months, various features appeared more
      frequently in the juvenile-onset AS group than in the JRA group, i.e.,
      pauciarthritis (54.3% versus 30.7%; P = 0.03, odds ratio [OR] = 2.7),
      enthesopathy (82.9% versus 0%; P < 0.0001, OR = 321.4), tarsal disease (71.4%
      versus 1.3%; P < 0.0001, OR = 185.0), and lumbar/sacroiliac symptoms (11.4%
      versus 0%; P = 0.02, OR = 11.9). At 12 months, the features found more frequently
      among juvenile-onset AS patients than JRA patients were enthesopathy (88.6%
      versus 4.0%; P < 0.0001, OR = 186.0), tarsal disease (85.7% versus 10.7%; P <
      0.0001, OR = 50.3), and knee disease (100.0% versus 82.7%; P = 0.04, OR = 8.0).
      Involvement of the upper extremities (especially the hands) was found in
      significantly fewer juvenile-onset AS patients compared with the JRA group.
      Definite involvement of the spine and sacroiliitis in juvenile-onset AS occurred
      after a mean +/- SD of 7.3 +/- 2.0 years. CONCLUSION: Regardless of axial
      disease, enthesopathy and tarsal disease in children who have arthritis of the
      lower, but not of the upper extremities differentiate juvenile-onset AS from JRA
      within 1 year of symptoms. The discriminative value of these parameters
      approaches that of axial disease (the gold standard) throughout the followup
      period.

PMID- 7779126
TI  - Use of magnetic resonance imaging and positron emission tomography in the
      assessment of synovial volume and glucose metabolism in patients with rheumatoid
      arthritis.
AB  - OBJECTIVE: To measure the anatomic and physiologic changes in the synovium of
      patients with active rheumatoid arthritis (RA) before and after the initiation of
      treatment with low-dose systemic glucocorticoids and methotrexate (MTX). METHODS:
      Two patients with RA with active synovitis involving the carpus were evaluated by
      imaging parameters at baseline and again after 14 weeks (of treatment with low
      dose prednisone and MTX). Standard clinical parameters, laboratory measurements,
      and contrast-enhanced magnetic resonance imaging (MRI) (synovial volume estimate)
      and positron emission tomography (PET) with 18F-fluoro-2-deoxyglucose (18-FDG)
      (synovial metabolism estimate) were performed. RESULTS: Compared with baseline,
      standard clinical parameters (i.e., joint count, joint index, morning stiffness,
      global assessments of arthritis activity, and erythrocyte sedimentation rate)
      improved dramatically in both patients after treatment with low-dose prednisone
      and MTX. In concert with this trend, the synovial volume of the affected wrist
      was reduced by 60%, and 76% and the metabolism of 18-FDG was reduced by 66% and
      69% in the 2 patients. CONCLUSION: These preliminary observations indicate that a
      volumetric estimate of inflamed synovium (using contrast-enhanced MRI) and
      quantification of synovial deoxyglucose metabolism (using PET) are technically
      feasible and, in the 2 reported cases, correlate well with standard outcome
      measures. These imaging modalities may provide new objective parameters to
      determine RA disease activity and effectiveness of antirheumatic medications;
      however, the potential clinical utility of these measures remains to be defined.

PMID- 7779129
TI  - The role of HLA antigens as indicators of disease progression in psoriatic
      arthritis. Multivariate relative risk model.
AB  - OBJECTIVE: To identify HLA markers for the development of severe disease in
      psoriatic arthritis (PsA). METHODS: Patients with PsA who were followed up
      prospectively over a 14-year period were included. Clinical and laboratory
      assessments of both active inflammation and clinical damage were performed at 6
      month intervals according to a standard protocol, which also included serologic
      HLA typing for class I and II antigens. Progression of damage was defined as
      transition into higher damage states, defined by the number of damaged joints.
      Both univariate and multivariate models were developed to identify predictors for
      progression of damage. RESULTS: Univariate analysis revealed that the HLA
      antigens B27, B39, and DQw3 were associated with disease progression, while HLA
      DR7 was "protective." The best multivariate model identified the HLA antigens
      B27, when DR7 was present, and DQw3, when DR7 was not present, as predicting
      disease progression across all transitions, while HLA-B39 was associated with
      progression in early disease. The addition of these HLA indicators to a model
      containing clinical variables resulted in a significant improvement in fit.
      CONCLUSION: The HLA antigens associated with PsA, B27 and B39, are risk factors
      for disease progression, as is the HLA class II antigen DQw3. In combination with
      clinical measures of disease, these HLA variables are the dominant predictors of
      progression.

PMID- 7779130
TI  - Comparative prospective, double-blind, multicenter study of the efficacy of
      tiludronate and etidronate in the treatment of Paget's disease of bone.
AB  - OBJECTIVE: To compare the efficacy and safety of tiludronate and etidronate at
      the same dosage (400 mg/day) for the treatment of active Paget's disease of bone.
      METHODS: We studied 234 patients with radiologic lesions characteristic of
      Paget's disease of bone and serum alkaline phosphatase (AP) concentrations at
      least twice the upper limit of normal, in a prospective, randomized, double
      blind, multicenter clinical trial lasting 6 months. Patients were randomly
      allocated into 1 of 3 treatment groups: tiludronate for 3 months followed by
      placebo for 3 months, tiludronate for 6 months, or etidronate for 6 months. Serum
      AP levels and urinary hydroxyproline excretion were measured at baseline and
      after 3 months and 6 months. Patients with a reduction of at least 50% in the
      serum AP concentration were considered to be responders. RESULTS: After 3 months,
      the proportion of responders was higher in the tiludronate group (57.4%) than in
      the etidronate group (13.9%) (P < 0.0001). In the etidronate group, this
      percentage was lower among patients who had received previous treatment with a
      bisphosphonate (2.3%) than among those who had not (28.6%) (P < 0.01). Previous
      bisphosphonate treatment was not associated with response in the tiludronate
      group. After 6 months, the proportion of responders did not differ between the 2
      tiludronate groups (60.3% and 70.1%), but was lower in the etidronate group
      (25.3%) (P < 0.0001). There was a higher proportion of patients with treatment
      resistant disease (< 25% reduction of serum AP) in the etidronate group (51.9%)
      than in the tiludronate 3-month group (17.9%) or the tiludronate 6-month group
      (19.5%) (P < 0.0001). Gastrointestinal disturbances were more common, and
      occurred earlier, with tiludronate, but they were mostly mild, requiring no
      treatment. CONCLUSION: Tiludronate at 400 mg/day for 3 months or 6 months is more
      effective than the same dosage of etidronate for 6 months in the treatment of
      Paget's disease.

PMID- 7779132
TI  - Gottron's papules? Acanthosis nigricans.

PMID- 7779131
TI  - Diagnostic use of office-based ultrasound. Baker's cyst of the right knee joint.

PMID- 7779133
TI  - Epstein-Barr virus-associated Hodgkin's lymphoma in a rheumatoid arthritis
      patient treated with methotrexate and cyclosporin A.

PMID- 7779135
TI  - Fibromyalgia prevalence in patients with systemic lupus erythematosus: comment on
      the article by Middleton et al.

PMID- 7779134
TI  - On focal lymphocytic sialadenitis as a gold standard for the diagnosis of
      Sjogren's syndrome: comment on the article by Daniels and Whitcher.

PMID- 7779136
TI  - Prevalence of fibromyalgia in systemic lupus erythematosus patients: comment on
      the article by Middleton et al.

PMID- 7779137
TI  - Western blot analysis by image processing: comment on the article by Kowal and
      Weinstein.

PMID- 7779138
TI  - Use of genetic typing versus other markers for predicting outcome in patients
      with inflammatory arthritis: comment on the article by Gough et al.

PMID- 7779139
TI  - Improved methotrexate patient information.

PMID- 7779140
TI  - Aliphatic and heterocyclic analogues of arecaidine propargyl ester. Structure
      activity relationships of mono- and bivalent ligands at muscarinic M1 (M4), M2
      and M3 receptor subtypes.
AB  - The pharmacological profiles of tertiary and quaternary monovalent (1b-6b) and
      bivalent ligands (7a-12b), closely related to arecaidine propargyl ester (CAS
      35516-99-5, APE, 1a), were evaluated at muscarinic receptors in rat superior
      cervical ganglia (M1), rabbit was deferens (M1/M4-like), guinea-pig atria (M2)
      and guinea-pig ileum (M3). In the monovalent ligand series (1a-6b) APE (1a)
      displayed the highest potency at all three muscarinic receptors [M2 (-log EC50 =
      8.12) > or = M3 (-log EC50 = 7.77) = M1/M4 (-log EC50/vas deferens = 7.72)],
      whereas in the bivalent ligand series (7a-12b) arecaidine 2-butyne-1,4-diyl
      bisester (bisABE, 7a) was the most potent agonist with functional selectivity for
      M1/M4 (-log EC50/vas deferens = 6.94) and M2 receptors (-log EC50 = 7.10) over M3
      receptors (-log EC50 = 6.27). On ganglia bisABE elicited M2 receptor-mediated
      hyperpolarisations, which were followed by long-lasting pirenzepine-sensitive
      depolarisations. However, the potency at M1 receptors in ganglia of APE (-log
      EC50 = 6.96) and bisABE (-log EC50 = 5.69) was lower than that in rabbit vas
      deferens. All bivalent molecules exhibited decreased potencies when compared with
      their monovalent analogues. However, a change in potency profiles was often
      obtained. The quaternary isonicotinic acid 2-butyne-1,4-diyl bisester (10b)
      displayed some functional selectivity for M2 receptors (-log EC50 = 5.78) [6- to
      9-fold over M1/M4 (-log EC50/vas deferens = 5.03) and M3 receptors (-log EC50 =
      4.83)] without showing nicotinic effects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779141
TI  - General pharmacology of the putative cognition enhancer linopirdine.
AB  - The putative cognition enhancer linopirdine (3,3-bis(4-pyrindinylmethyl)-1
      phenylindolin-2-one, CAS 105431-72-9) is supposed to act by enhancing the release
      of neurotransmitters, especially acetylcholine. The present study assessed the
      effects of a single administration of this compound on the central nervous system
      in eight different rat and mouse models (CNS general pharmacology). In each test
      performed, linopirdine was administered subcutaneously in doses of 3, 10, and 30
      mg/kg. The compound did not affect traction ability and nociceptive
      responsiveness nor did it induce catalepsy. Linopirdine impaired motor
      coordination in the balance rod test. The compound showed a distinct
      proconvulsive action in the pentylenetetrazole threshold dose test and induced in
      the highest dose tested (30 mg/kg) lethal seizures in some mice. It increased the
      duration of hexobarbital-induced anaesthesia in mice. Rats treated with
      linopirdine showed ptosis, salivation, slight sedation, paw beating and slight
      hypothermia. These results support the hypothesis that linopirdine acts by
      elevating the release of different neurotransmitters such as acetylcholine and
      dopamine. The compound has a low potential to produce side effects at
      pharmacodynamic active doses.

PMID- 7779142
TI  - Steady-state pharmacokinetics of nimodipine during chronic administration of
      indometacin in elderly healthy volunteers.
AB  - The possible influence of chronic indometacin (CAS 53-86-1) medication on
      nimodipine (CAS 66085-59-4) pharmacokinetics was investigated in 24 elderly
      healthy subjects. Both drugs were orally administered in a non-blinded,
      randomized, twofold crossover design. The study periods with a 5-day treatment
      each were separated by a 2-week washout period. The Css,max of nimodipine was
      increased after the combined administration of nimodipine (30 mg t.i.d.) and
      indometacin (25 mg b.i.d.) as compared with those after nimodipine monotherapy:
      24.2 +/- 14.7 micrograms/l vs. 19.7 +/- 10.3 micrograms/l. This increase,
      however, was not of an order to become clinically relevant. Nimodipine AUCss
      slightly increased under indometacin co-medication from 57.9 +/- 27.5
      micrograms.h.l-1 to 62.8 +/- 26.6 micrograms.h.l-1, resulting in a mean relative
      bioavailability of nimodipine of 111% with a 90%-confidence interval of 96-128%
      for the combined medication. There was no evidence of any clinically relevant
      difference in hemodynamics and other findings between both treatments. The
      overall frequency of side effects was low after both medication regimens. The
      findings of this study indicate that a combined treatment with both compounds
      should not be associated with a clinically relevant interaction.

PMID- 7779143
TI  - [Effects of intravenous anaesthetics on excitation, conduction, and refractory
      parameters of the heart. Experimental study in the dog].
AB  - Cardiac excitation, conduction, and refractory parameters of the heart were
      investigated in 59 beagle dogs to obtain basic values under the influence of the
      following 11 intravenous anaesthetic regimes using HIS-bundle electrography and
      programmed stimulation: 1. Alfentanil/midazolam/succinylcholine; 2.
      alfentanil/midazolam/succinylcholine/atropine; 3. fentanyl/midazolam/pancuronium
      bromide; 4. fentanyl-droperidol/chloralose/urethane; 5. ketamine/xylazine; 6.
      ketamine/xylazine/atropine; 7. propionylpromazine/pentobarbital; 8.
      propionylpromazine/levomethadon; 9. propofol; 10. propofol/alfentanil; 11.
      Tiletamine-zolazepam. It could be shown, that some intravenous anaesthetics under
      laboratory conditions have a strong influence on the observed cardiac parameters
      that must be considered in experiments with other substances or in cardiovascular
      results.

PMID- 7779144
TI  - Mechanisms of the potent and long-lasting antihypertensive action of the new
      calcium channel blocker pranidipine. Evidence for strong affinity to the calcium
      channels or membranes.
AB  - To elucidate the mechanisms of the potent and long-lasting antihypertensive
      action of pranidipine (CAS 99522-79-9, OPC-13340), a wash-out experiment in
      isolated rat aorta preparations and a displacement binding experiment of
      (+)[3H]PN200-110 (isradipine) with pranidipine and other dihydropyridines to
      porcine skeletal T-tubules was conducted. It was revealed that the inhibition of
      KCl-induced contraction by pranidipine remained complete even after washing out
      the drug 9 times. Also, pranidipine had the lowest Ki value for (+)[3H]PN200-110
      binding in skeletal T-tubules. The lipophilicity of pranidipine measured by
      octanol-buffer partition coefficient was the highest among the tested compounds,
      and the order of lipophilicity coincided with the order of potency in the
      displacement binding experiments. These results suggest that pranidipine has a
      very high affinity to Ca channels or to T-tubule membranes, and strongly support
      the "membrane-bilayer pathway hypothesis" which assumes the partitioning of the
      drug into the lipid bilayer before drug binding to Ca channels as an explanation
      of the potent and long-lasting action of pranidipine compared with other
      dihydropyridines.

PMID- 7779145
TI  - Protection of myocardial tissue against deleterious effects of oxygen free
      radicals by ceruloplasmin.
AB  - This study describes the carioprotective effect of ceruloplasmin (CAS 9031-37-2)
      against oxygen free radical injury, as indicated by several biochemical
      indicators and some cardiodynamic variables. Isolated rat hearts (n = 4-8, p <
      0.05, for each experimental point) in Langendorff preparation were exposed to
      oxygen free radicals generated by electrolysis (10 mA) in the absence and the
      presence of 0.25 mumol/l purified ceruloplasmin and denaturated ceruloplasmin, in
      Krebs-Henseleit perfusion solutions. Biochemical indicators (noradrenaline,
      malondialdehyde, creatine-kinase, lactate dehydrogenase, aspartate
      aminotransferase, Ca2+ and Mg2+) as well as the electrocardiogram and the left
      ventricular pressure (LVP), were altered by oxygen free radicals formation,
      denoting major cellular and tissular damages in the nontreated hearts.
      Ceruloplasmin exhibited a cardioprotective effect and prevented the oxygen free
      radical-induced release of noradrenaline, indicating that it can also protect the
      sympathetic nerve endings from oxygen free-radical injury. Purified
      ceruloplasmin, a circulating extracellular antioxidant and oxygen free radical
      scavenger, seems to be an effective heart protective agent against myocardial and
      neuronal injuries generated by oxygen free radicals.

PMID- 7779146
TI  - Effects of the natural flavonoid delphinidin on diabetic microangiopathy.
AB  - The purpose of the present study was to investigate the effects of the flavonoid
      delphinidin chloride (CAS 528-53-0, IdB 1056) on diabetic microangiopathy.
      Hamsters were injected with alloxan and cheek pouch microcirculation was observed
      by a fluorescent microscopy technique 90 days from alloxan. The increase in
      permeability, the number of adhering leukocytes to venular vessel wall and
      vasodilatory responses to acetylcholine (Ach) and sodium nitroprusside (SNP) were
      measured. In diabetic group microvascular permeability and the number of sticking
      leukocytes to the venular endothelium were increased. Vasoconstriction by Ach was
      observed while the vasodilation by SNP was significantly attenuated in diabetic
      animals. These results are consistent for a decreased relaxation and suggest also
      an impairment in the smooth muscle cell function in diabetic arterioles. IdB 1056
      exhibited an inhibitory effect on increased microvascular permeability and on
      leukocytes adhering to the venular vessels. Indeed, the treatment with IdB 1056
      in diabetic hamsters pretreated or not with indometacin, a cyclooxygenase
      inhibitor, restored the relaxant responses to Ach and SNP. In conclusion, the
      effects of IdB 1056 observed in vivo at the microcirculatory level prevent the
      injury to endothelial cell function associated with diabetes and/or oxidative
      stress.

PMID- 7779147
TI  - Studies on the in vitro and in vivo genotoxicity of [2,2-dimethyl-6- (4
      chlorophenyl)-7-phenyl-2,3-dihydro-1H-pyrrolizine-5-yl]-acetic acid.
AB  - [2,2-Dimethyl-6-(4-chlorophenyl)-7-phenyl-2,3-dihydro-1H-pyrrolizine-5- yl]
      acetic acid (CAS 156897-06-2, ML 3000) was examined for genotoxic activity in
      bacteria and mammalian cells in vitro as well as in vivo. The substance did not
      increase gene mutation frequencies either in a bacterial system or in a cultured
      V79 cell line of the Chinese hamster. Both in vitro tests were conducted in the
      presence and absence of S9-mix. In the unscheduled DNA synthesis assay in vitro
      with primary rat hepatocytes, negative results were also obtained. A cytogenetic
      analysis of the bone marrow of male and female Wistar rats was performed. After
      oral application ML 3000 did not increase the number of cells with structural
      chromosomal aberrations. The results suggest that ML 3000 has no genotoxic
      potential in vitro and in vivo.

PMID- 7779148
TI  - Gastrointestinal blood loss induced by three different non-steroidal anti
      inflammatory drugs.
AB  - A clinical study was performed on 18 healthy volunteers to compare the
      gastrointestinal daily blood loss induced by oral intake of three different non
      steroidal anti-inflammatory drugs, lysine clonixinate (CAS 55837-30-4), ibuprofen
      (CAS 15687-27-1) and acetylsalicylic acid (CAS 50-78-2 ASA). For quantitative
      determination of gastrointestinal blood loss, autologous erythrocytes were
      radiolabelled in vitro with 51Cr and reinfused at study start. The amount of
      radioactivity excreted in faeces was measured during a placebo baseline phase of
      three days, a treatment phase of five days with thrice daily dosing of ASA,
      ibuprofen or lysine clonixinate and a subsequent wash-out phase of five days. The
      highest increase of mean daily blood loss over baseline was observed after
      treatment with ASA (+ 1.66 ml/d versus baseline). Treatment with ibuprofen led to
      an increase of mean daily blood loss by + 0.52 ml/d. During treatment with lysine
      clonixinate the mean increase of daily blood loss was +0.32 ml/d versus baseline.
      In the ibuprofen and lysine clonixinate treatment groups the values of mean daily
      blood loss decreased during the wash-out phase with respect to the verum phase,
      whereas the mean daily blood loss during the wash-out phase after treatment with
      ASA even increased in comparison to the verum phase (mean daily blood loss: +2.07
      ml/d versus baseline.

PMID- 7779150
TI  - [Symptomatic therapy with famotidine in non-erosive gastro-esophageal reflux.
      Results of an open multicenter study].
AB  - 180 patients suffering from frequent heartburn and endoscopically normal
      oesophageal mucosa or mild non-erosive oesophagitis entered an open, multicentre
      study to evaluate the 6-week safety profile and efficacy on symptom relief of
      famotidine (CAS 76824-35-6, Pepdul mite), a potent and long-acting H2-receptor
      antagonist. By week 6 the cumulative percentage of patients with defined
      response, that is complete relief of heartburn in 5 days and only mild discomfort
      in the remaining 2 days of a week, reached 68.9%, whereas the cumulative
      percentage of patients with complete relief of heartburn within a week reached
      52.7%. Throughout the evaluation period famotidine relieved nighttime heartburn
      better than daytime heartburn. More than 75% of the responders remained without
      recurrence. Even the non-responders experienced a 60-70% reduction of heartburn
      severity assessed using scores. Antacid consumption was reduced from 18 tablets
      (median) in week 0 to 5 tablets in week 6. 90% of the patients reported at week 6
      excellent (67.2%) or moderate (22.8%) symptomatic improvement. No serious adverse
      events attributable to famotidine occurred. It is concluded that in patients with
      non-erosive gastro-oesophageal reflux disease famotidine therapy, 20 mg twice
      daily, is highly effective in reducing reflux disease symptoms.

PMID- 7779149
TI  - Study on the possible interaction between tenoxicam and atenolol in hypertensive
      patients.
AB  - Sixteen hypertensive male out-patients (33-54 y), whose blood pressure (BP) had
      been normalized (diastolic BP < 90 mmHg) by treatment with a daily dose of 50 mg
      atenolol (CAS 29122-68-7), participated in this double-blind, placebo-controlled,
      parallel group study, which investigated the possible influence of the non
      steroidal anti-inflammatory drug tenoxicam (CAS 59804-37-4) on the control of BP
      by atenolol. After a run-in of 10 days, to assess the stability of BP control by
      atenolol, and to determine baseline parameters, 8 patients in group A received 20
      mg tenoxicam (2 x 20 mg on days 1 and 2), and 8 patients in group B received
      placebo, daily over 15 days (days 0-14), concomitantly with their atenolol
      regimen. BP was measured under standardized conditions on several days. Heart
      rate (EHR) after 5 min of exercise by bicycle ergometry (constant 75W), and
      parameters of renal function were assessed before (baseline) and during
      concomitant dosing of atenolol and tenoxicam. On day 14 the mean changes (delta
      A, delta B) from baseline of pre-dose BP (mmHg) and EHR (beats/min) in groups A
      and B, and the one-sided 95% confidence regions (R) for delta A, respectively,
      were (delta A, delta B, R): 4.4, 1.6, < 9.5 for sitting systolic BP, 2.8, -0.3, <
      4.5 for sitting diastolic BP, -0.3, -0.6, < 5.5 for standing systolic BP, -0.6, 
      1.9, < 3.0 for standing diastolic BP, 0.4, -7.5, < 0.4 for EHR at pre-dose, 3.1,
      0.6, < 7.8 for EHR at 3.5 h post-dose.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779152
TI  - Pharmacokinetics and bioavailability of different formulations of aciclovir.
AB  - The pharmacokinetics and bioavailability of aciclovir (CAS 59277-89-3) were
      examined after administration of newly developed 200 mg and 400 mg tablets. Two
      studies, each with 24 subjects of either sex, were performed. In the three-way
      study I, two different tablets containing 200 mg of aciclovir (test and reference
      products) and a short infusion of 250 mg aciclovir were compared. In the two-way
      study II, the bioequivalence of a newly developed 400 mg aciclovir tablet was
      tested against a standard product. Irrespective of dose, the peak plasma
      aciclovir levels were obtained 1.5 h after administration of the tablets. In the
      case of the 200 mg tablets, the mean Cmax-values were 454 ng/ml (pilot test
      formulation, T) and 525 ng/ml (reference formulation, R), whereas the mean Cmax
      values after administration of the 400 mg tablets were 779 (T) and 800 (R) ng/ml
      for test and reference formulation, respectively. The mean AUC calculated to the
      time of the last measurement in each instance was in the order of 2290 (T) and
      2275 (R) ng/ml x h (200 mg tablets) or 3726 (T) and 3855 (R) ng/ml x h (400 mg
      tablets). The amount of the dose renally excreted as unchanged aciclovir was
      measured at 20.8 (T) - 21.8 (R)% with the 200 mg tablets and 14.3 (T) - 15.1% (R)
      with the 400 mg tablets.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779151
TI  - [Immunoactive effects of various mistletoe lectin-1 dosages in mammary carcinoma
      patients].
AB  - Cellular aspects of the immunomodulating activity of a proprietary mistletoe
      extract (Eurixor) standardized for mistletoe lectin-1 (ML-1) were investigated in
      patients suffering from mammary carcinoma (n = 20). Regular subcutaneous
      injections of the different dosages (0.5 and 1.0 ng ML-1/kg body weight, twice a
      week, for 5 weeks) yielded statistically significant increases of defined
      peripheral blood lymphocyte subsets (helper T-cells, natural killer (NK)-cells)
      which are generally believed to be involved in antitumor activity. Moreover,
      administration of either ML-1 concentration resulted in enhanced expression of
      activation markers such as interleukin-2 receptors and HLA/DR-antigens on
      peripheral blood T-lymphocytes. This study suggests that regular subcutaneous
      administration of both ML-1 concentrations (0.5 and 1.0 ng/kg body weight) can
      efficiently stimulate the cellular immune system of cancer patients.

PMID- 7779154
TI  - Efficacy of a combination of metrifonate and praziquantel in the treatment of
      Schistosoma mansoni infection in albino mice.
AB  - This study aimed to test the therapeutic effect of two antischistosomal drugs
      metrifonate (CAS 52-68-6) and praziquantel (CAS 55268-74-1), either alone or in
      combination, on mice infected with schistosoma mansoni. Both drugs were given in
      half of their therapeutic doses 8 weeks post infection. Animals were sacrificed
      two weeks after the last dose. The efficacy of the drugs was evaluated using the
      number of ova/g tissue, the distribution and the number of Schistosoma worms.
      Praziquantel and metrifonate alone produced about 91% and 22% reduction in total
      worm burden. The reduction in ova count in intestine and liver was 96% and 85%,
      respectively, using praziquantel alone while it was only 6 and 12%, respectively,
      after metrifonate treatment. After treatment with both drugs given in combination
      the number of ova count was not changed as compared with praziquantel alone; also
      there was no change in the worm load as compared with praziquantel. It is
      concluded that a combination of a low dose of praziquantel with metrifonate
      failed to produce any significantly better effect.

PMID- 7779153
TI  - Effect of cimetidine, bicarbonate and glucose on the bioavailability of different
      formulations of praziquantel.
AB  - The effects of cimetidine, bicarbonate and glucose on the bioavailability of the
      two brands of praziquantel (CAS 55268-74-1) available in Egypt were studied in
      normal healthy volunteers. Brand 1 when coadministered with cimetidine showed
      elevated concentration of the drug at all time intervals. The difference was
      statistically significant at 3, 4, 6 and 8 h following treatment. On the other
      hand coadministration of cimetidine with brand 2 (Distocide) showed elevated
      concentration of the drug 1 h post treatment. Analysis of the pharmacokinetic
      parameters revealed insignificant difference comparing brand 1 versus brand 1
      plus cimetidine. Significant differences were observed between the elimination
      rate constant Ke (h-1) for brand 2 (0.017 +/- 0.004) alone versus brand 2 plus
      cimetidine (0.006 +/- 0.001). Coadministration of bicarbonate or glucose with
      either brand 2 or brand 1 tended to depress the serum concentration of
      praziquantel. Possible explanations of these findings are discussed.

PMID- 7779157
TI  - Families facing choices.

PMID- 7779155
TI  - Immunogenicity of biosynthetic human LysPro insulin compared to native-sequence
      human and purified porcine insulins in rhesus monkeys immunized over a 6-week
      period.
AB  - Development of insulin antibodies in rhesus monkeys was investigated after
      immunization with 3 forms of insulin in Freund's adjuvant. Insulins examined
      included: 1. biosynthetic LysPro insulin (LY275585), a new human insulin analog,
      2. biosynthetic native-sequence human insulin, and 3. purified porcine insulin.
      Male monkeys, 4/insulin type, were immunized weekly over a 6-week period with
      increasing doses of insulin, ranging from 10 to 100 micrograms/monkey. An ELISA
      assay was used to measure IgG insulin antibodies in sera collected prior to
      immunization and 5, 10, and 16 days after final immunization. One monkey had
      detectable pretreatment levels of antibody. This monkey, which had been assigned
      to the LysPro insulin treatment group, responded to immunization with a peak
      antibody level of 20 micrograms/ml. IgG insulin antibody responses were not
      detected in any of the other monkeys. A passive cutaneous anaphylaxis (PCA) assay
      was used to measure IgE insulin antibodies in sera collected prior to
      immunization and 10 days after final immunization. No IgE antibodies were
      detected in any of the monkeys pre- or post-immunization. Considering that 1. an
      immunological adjuvant was used, 2. eleven of twelve monkeys failed to develop an
      antibody response, and 3. the IgG insulin antibody level observed in the single
      responding monkey was low, it was concluded that these insulins have an extremely
      weak immunogenic potential in rhesus monkeys. It is suggested that immunization
      of non-human primates with new therapeutic proteins in adjuvant may be a useful
      primary screen to determine their immunogenic potential.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7779158
TI  - Showing sensitivity to deaf culture.

PMID- 7779156
TI  - Seize the day.

PMID- 7779159
TI  - The challenge of literacy.

PMID- 7779160
TI  - Where are dysphagia courses?

PMID- 7779161
TI  - AuD should do more.

PMID- 7779162
TI  - Look who's laughing.

PMID- 7779163
TI  - [New clinical tests in diagnosis of collagen diseases and allergic diseases].

PMID- 7779164
TI  - Activin enhances osteoclast-like cell formation in vitro.
AB  - The effect of activin (activin A/EDF) on osteoclast formation was investigated.
      In mouse bone marrow cell cultures, activin enhanced the formation of tartrate
      resistant acid phosphatase (TRACP)-positive multinucleated cells (MNC) in a dose
      dependent manner, either in the presence or absence of 1,25-(OH)2D3 or PTH. In
      organ cultures of neonatal mouse calvaria, activin also enhanced the generation
      of TRACP-positive giant cells in the endosteal periosteum and increased the TRACP
      staining of whole calvaria, but did not exhibit bone resorbing activity. These
      results indicate that activin stimulates the formation of osteoclasts, but not
      osteoclast activation. Activin is produced by bone marrow cells and might be
      involved in the local process of osteoclast differentiation.

PMID- 7779165
TI  - Involvement of adhesion molecules LFA-1 and ICAM-1 in osteoclast development.
AB  - We report here that leukocyte function-associated antigen-1 (LFA-1) and
      intercellular adhesion molecule-1 (ICAM-1) are involved in osteoclast
      development. Osteoclast development was observed on co-culture of mouse spleen
      cells and mouse bone marrow derived clonal stromal cells, TMS-14, in the presence
      of 1 alpha, 25-dihydroxyvitamin D-3 (1 alpha, 25-(OH)2D3) for 8 days, and
      quantified with respect to tartrate-resistant acid phosphatase (TRACP) activity.
      When either one of the monoclonal antibodies (MAbs) to mouse LFA-1 and mouse ICAM
      1 was added to the co-culture system, the TRACP activity was significantly
      inhibited. The experiment in which one-day treatment with each of these MAbs was
      performed during the 8 days of cultivation showed that the inhibitory effects of
      both MAbs on the TRACP activity at 8 days were observed from an early stage of
      the culture, but were more notable at a later stage (days 4-6). As the expression
      of ICAM-1 was observed on both spleen cells and TMS-14, we next examined whether
      the interaction between stromal cells and osteoclast progenitors or among
      osteoclast progenitors was more important for osteoclast development. To
      determine this, rat spleen cells and a MAb to rat ICAM-1 were used instead of
      those of mouse. When MAb to rat ICAM-1 or mouse ICAM-1 was added to the co
      culture system of rat spleen cells and TMS-14, the inhibitory effect of the MAb
      to rat ICAM-1 was mainly observed at a later stage of the culture period and that
      of anti-mouse ICAM-1 antibody was only observed at an earlier stage. These
      results indicate that adhesion molecules LFA-1 and ICAM-1 may play a role in
      osteoclast development via interaction between stromal cells and osteoclast
      progenitors as well as among osteoclast progenitors.

PMID- 7779166
TI  - [Does no Helicobacter pylori mean no duodenal ulcer?].

PMID- 7779167
TI  - Beyond Moore: issues of law and policy impacting human cell and genetic research
      in the age of biotechnology.

PMID- 7779168
TI  - [Assessment of selective intestinal permeability using a novel, simple
      carbohydrate absorption test].

PMID- 7779169
TI  - [Large differences in phototherapy policy for neonatal jaundice in Dutch
      centers].

PMID- 7779170
TI  - [Ointments or tweezers?].

PMID- 7779171
TI  - [Leukemia, cytostatic therapy and pregnancy].

PMID- 7779172
TI  - [Infant nutrition].

PMID- 7779173
TI  - [Annual test for occult blood in stool and intestinal cancer mortality].

PMID- 7779174
TI  - [Bovine heterologous bone graft in orbital surgery].
AB  - Lubboc (T650) is a bovine heterologous bone implant obtained by specific
      preparation of trabecular of bone. In vitro and in vivo biocompatibility studies
      have revealed the absence of any cytotoxicity or systemic toxicity. Lubboc has
      many fields of application, including all bone graft surgical indications. We
      report our first results concerning the use of this product in orbital surgery
      either as a filling or contention material or as an apposition material. On all
      20 operated patients we did not encounter any intolerance, inflammation or
      infection. The follow-up is still too short to appreciate the long term
      integration of this material which has the advantage of being a substitute for
      autologous bone, avoiding bone graft harvesting.

PMID- 7779175
TI  - Access to specialty care.

PMID- 7779176
TI  - A B-cell coactivator of octamer-binding transcription factors.
AB  - The octamer motif (ATGCAAAT) paradoxically plays a central role in mediating the
      activity of both B-cell specific and ubiquitous promoters. It has been widely
      assumed that the predominantly lymphoid-restricted octamer-binding factor Oct-2
      mediates tissue-specific promoter activity, whereas the ubiquitously expressed
      Oct-1 mediates general promoter activity, but this view has been challenged. Here
      we use a modified yeast one-hybrid assay to isolate a B-cell factor, Bob1, which
      associates with either Oct-2 or Oct-1. In transfection experiments, this factor
      boosts Oct-1-mediated promoter activity and to a lesser extent, that of Oct-2.
      This coactivation is strictly dependent on the specific interaction with Oct-1 or
      Oct-2 because deletion of the octamer motif abolishes coactivation. We conclude
      that Bob1 could represent a new tissue-specific transcriptional coactivator which
      may convert a ubiquitously expressed transcription factor to a cell-type-specific
      activator.

PMID- 7779177
TI  - Isolation and studies of the mutagenic activity of saponins in the Ames test.
AB  - Mutagenic activity of medicagenic acid, medicagenic acid 3-0-glucopyranoside and
      soyasaponin I was tested by the Ames method with S. typhimurium strains TA97,
      TA98, TA100, TA102 in the absence and the presence of metabolic activation (S9
      mix). These saponins have been isolated and identified from alfalfa roots and
      clover Trifolium incarnatum seeds. All of them were found to be non-toxic and non
      mutagenic for testing doses.

PMID- 7779178
TI  - Measurement of specific and nonspecific IgG4 levels as diagnostic and prognostic
      tests for clinical allergy. AAAI Board of Directors.

PMID- 7779180
TI  - Variants of liposarcoma.

PMID- 7779181
TI  - Negotiating a successful return to work program.
AB  - This article has examined selected reasons why companies resist implementation of
      return to work programs. The reasons include many fears that companies can
      readily justify. Nearly all the fears can be eliminated when the occupational
      health nurse applies both nursing and management principles. As a specialized
      line manager in the company, with a specialty in people and systems management,
      the occupational health nurse is the most likely person to plan and implement a
      successful program. To design, implement, and manage the plan to a successful
      end, the occupational health nurse must enhance skills in language, salesmanship,
      and quantifying results. Success must be measured in both people and dollar terms
      to have relevance to the company, its bottom line, and its employees. People
      results, the harder of the two to measure, have value in helping to establish
      positive attitudes of program participants toward the company. People results
      also help prevent the development of disability syndrome by ill or injured
      employees by keeping them connected to work and productivity. People results also
      can be measured by the change in culture the return to work program is likely to
      produce among managers and employees. The resulting culture will reflect a sense
      of caring by the company about employees, and expectation that manipulation of
      the company by opportunists will be reduced, as scarce company resources will be
      conserved. The early return to work program is managed within employee
      capabilities in a therapeutic environment during the recovery process. In the
      long term, financial success of the return to work program can be measured by
      reduced costs per claim annually. Using the nursing, management, financial, and
      marketing principles discussed in this article, the occupational health nurse can
      improve chances of negotiating implementation of a successful early return to
      work program.

PMID- 7779179
TI  - X-ray diffraction evidence for the extensibility of actin and myosin filaments
      during muscle contraction.
AB  - To clarify the extensibility of thin actin and thick myosin filaments in muscle,
      we examined the spacings of actin and myosin filament-based reflections in x-ray
      diffraction patterns at high resolution during isometric contraction of frog
      skeletal muscles and steady lengthening of the active muscles using synchrotron
      radiation as an intense x-ray source and a storage phosphor plate as a high
      sensitivity, high resolution area detector. Spacing of the actin meridional
      reflection at approximately 1/2.7 nm-1, which corresponds to the axial rise per
      actin subunit in the thin filament, increased about 0.25% during isometric
      contraction of muscles at full overlap length of thick and thin filaments. The
      changes in muscles stretched to approximately half overlap of the filaments, when
      they were scaled linearly up to the full isometric tension, gave an increase of
      approximately 0.3%. Conversely, the spacing decreased by approximately 0.1% upon
      activation of muscles at nonoverlap length. Slow stretching of a contracting
      muscle increased tension and increased this spacing over the isometric
      contraction value. Scaled up to a 100% tension increase, this corresponds to a
      approximately 0.26% additional change, consistent with that of the initial
      isometric contraction. Taken together, the extensibility of the actin filament
      amounts to 3-4 nm of elongation when a muscle switches from relaxation to maximum
      isometric contraction. Axial spacings of the layer-line reflections at
      approximately 1/5.1 nm-1 and approximately 1/5.9 nm-1 corresponding to the
      pitches of the right- and left-handed genetic helices of the actin filament,
      showed similar changes to that of the meridional reflection during isometric
      contraction of muscles at full overlap. The spacing changes of these reflections,
      which also depend on the mechanical load on the muscle, indicate that elongation
      is accompanied by slight changes of the actin helical structure possibly because
      of the axial force exerted by the actomyosin cross-bridges. Additional small
      spacing changes of the myosin meridional reflections during length changes
      applied to contracting muscles represented an increase of approximately 0.26%
      (scaled up to a 100% tension increase) in the myosin periodicity, suggesting that
      such spacing changes correspond to a tension-related extension of the myosin
      filaments. Elongation of the myosin filament backbone amounts to approximately
      2.1 nm per half sarcomere. The results indicate that a large part (approximately
      70%) of the sarcomere compliance of an active muscle is caused by the
      extensibility of the actin and myosin filaments; 42% of the compliance resides in
      the actin filaments, and 27% of it is in the myosin filaments.

PMID- 7779182
TI  - Serving the community.
AB  - Occupational health nurse managers have been known to deliver Meals on Wheels,
      volunteer as Girl Scout leaders, consultants, and trainers, teach first aid and
      CPR classes to the public, as well as company employees, and work with community
      leaders and health science students to develop company and community health
      fairs. The positive image created by such activity for the company, the nurse,
      and the profession is far reaching and ultimately cost effective. Community
      service is important now more than ever. It is evident that government cannot
      solve our problems. Fortunately, the answer to many of our current health and
      social concerns is in our own backyard our communities. Occupational health
      managers have a unique opportunity to garner the support of business and industry
      and contribute to the grassroots movement to improve the health of all Americans.

PMID- 7779183
TI  - Putting prevention into clinical practice: a program for occupational health
      nurses.
AB  - 1. Preventive services are delivered much less frequently than recommended by
      primary care providers. Many barriers exist. 2. Occupational health nurses can
      access the valuable, inexpensive resource--"Put Prevention Into Practice" program
      -to incorporate prevention into illness care, screening, and other visits to
      their worksite clinics. 3. Use of the "Guide to Clinical Preventive Services,"
      the tools in a kit of materials, and the passport size, client held minirecords
      can improve the delivery of clinical preventive services.

PMID- 7779184
TI  - Adherence to worksite exercise programs: an integrative review of recent
      research.
AB  - 1. Improving worker physical fitness through worksite exercise programs offers
      many benefits to the employee and the employer. Unfortunately, a small percentage
      of workers who begin an exercise program adhere to it. 2. It is essential to
      design program strategies to promote exercise adherence among persons who do not
      currently exercise at levels that achieve health benefits. 3. The results of this
      review of worksite research suggest a number of strategies that were successful
      in increasing at least short term exercise adherence. 4. Carefully controlled
      studies are needed to identify specific worksite exercise interventions or
      combination of interventions that maximize the initiation of exercise as well as
      short and long term adherence. A combination of strategies improves exercise
      adherence for at least 6 months, but more research is needed to determine long
      term maintenance of an exercise program.

PMID- 7779185
TI  - Occupational low back disability: effective strategies for reducing lost work
      time.
AB  - 1. The important variables related to lost work time in this study are: back
      diagnosis (lumbar disc displacement), history of back surgery, job satisfaction,
      and employee reluctance to report low back pain to supervisor. 2. The findings
      support the complexity of low back disability. Lost work time related to low back
      pain must be managed using a "holistic" approach by addressing all dimensions of
      a person (physical, emotional, and environmental). 3. To minimize low back
      disability, occupational health providers should be part of a community task
      force with representatives from other disciplines who can plan and develop low
      back disability guidelines and standards of care.

PMID- 7779186
TI  - Emotional aftermath of a major earthquake: lessons for business.

PMID- 7779187
TI  - Intraperitoneal foreign body as a cause of acute abdomen in pregnancy.
AB  - Although surgical textbooks commonly include foreign bodies in the differential
      diagnosis of acute abdomen, this cause of abdominal pain has not been reported in
      the obstetric literature. A 35-year-old woman presented at 24 weeks' gestation
      with right lower quadrant pain and peritoneal signs. The only abnormal finding at
      exploratory laparotomy was a free-floating intraperitoneal foreign body,
      presumably left inadvertently during prior surgery. The differential diagnosis of
      acute abdomen in pregnancy should include intraperitoneal foreign body in any
      woman with a history of previous abdominal surgery.

PMID- 7779188
TI  - Decreased platelet counts in infants of diabetic mothers.
AB  - Infants of diabetic mothers (IDMs) have hematologic indices consistent with
      increased fetal erythropoiesis, presumably in response to chronic intrauterine
      hypoxemia. We hypothesized that increased erythropoiesis, as is evident from
      increased nucleated erythrocyte counts, would be accompanied by interrelated
      changes in thrombopoiesis and would correlate with maternal glycemic control
      during pregnancy. We compared absolute nucleated erythrocyte counts and platelet
      counts obtained in the first 24 hours of life in 32 term, nonasphyxiated IDMs
      with 47 controls. The IDM group had higher absolute nucleated erythrocyte counts
      (1.0 +/- 1.3 x 10(9)/L versus 0.4 +/- 0.7 x 10(9)/L; p < 0.05), and lower
      platelet counts (235 +/- 77 x 10(9)/L versus 348 +/- 79 x 10(9)/L; p < 0.001)
      than controls. Absolute nucleated erythrocyte counts correlated inversely with
      platelet counts (r = -0.28; p < 0.02). These neonatal hematologic measurements
      did not correlate with various parameters of maternal glycemic control. We
      conclude that in IDMs, increased erythropoiesis is accompanied by decreased
      platelet counts. These data are consistent with the theory of an erythropoietin
      induced shift of fetal multipotent stem cell differentiation toward
      erythropoiesis at the expense of thrombopoiesis.

PMID- 7779189
TI  - The very low birthweight infant: maternal complications leading to preterm birth,
      placental lesions, and intrauterine growth.
AB  - The placental lesions of the very low birthweight (VLBW) infant were investigated
      in relation to clinical complications leading to preterm birth and evidence of
      growth impairment. The 249 singleton gestations yielding infants less than 1500 g
      were grouped according to the clinical complications leading to preterm birth as
      premature membrane rupture (116/249, 47%) preterm labor (55/249, 22%), pregnancy
      induced hypertension (PIH, 54/249, 22%), and normotensive abruption (ABR, 24/249,
      10%). Specifically excluded from this data set were cases with greater than 2
      weeks discordance, fetal congenital anomalies, placenta previa, and maternal
      medical or gestational diseases such as chronic hypertension and diabetes
      mellitus, and intrauterine growth retardation (IUGR) as a primary indication for
      delivery. Placental weight and lesions including decidual vasculopathy and
      related villous lesions, chronic villitis/intervillositis, and decidual
      plasmacytosis were considered as variables in analyses in which raw birthweight
      was the dependent variable and gestational age a confounder. Of the 195 VLBW, 79
      (41%) infants from normotensive mothers had lesions of decidual vasculopathy or
      chronic inflammation. In the VLBW infants from hypertensive mothers, growth
      restriction was related to markers of decidual vasculopathy. In the absence of
      maternal hypertension the growth restriction was independently associated with
      chronic villitis. Decidual vasculopathy (characteristic of PIH) and chronic
      intrauterine inflammation underlie the complications of many normotensive VLBW
      infants. The placental lesions in VLBW-IUGR depend on the presence or absence of
      maternal hypertension. In the absence of maternal hypertension, VLBW-IUGR is
      associated with chronic inflammation and is independent of decidual vasculopathy.
      In the presence of maternal hypertension, VLBW-IUGR is directly related to
      decidual vasculopathy.

PMID- 7779190
TI  - Labor and delivery complicated by acute mitral regurgitation due to ruptured
      chordae tendineae.
AB  - Acute mitral regurgitation due to ruptured chordae tendineae is a dramatic and
      life-threatening clinical situation. Rarely does this complication occur during
      pregnancy. We present a case of a 30-year-old woman in week 31 of her pregnancy
      who developed acute mitral regurgitation, secondary to bacterial endocarditis and
      ruptured chordae tendineae. This acute event resulted in preterm labor a few
      hours later. Delivery was uneventful and successful and was followed by open
      heart surgery 5 days later. A review of the literature on chordae tendineae
      rupture and resulting mitral regurgitation during pregnancy is presented.

PMID- 7779191
TI  - Plasma immunoreactive endothelin-1 concentration in cord blood of normal term
      neonates.
AB  - Plasma immunoreactive endothelin-1 (ir-ET-1) concentrations in cord blood of 20
      term infants were measured by radioimmunoassay. The mean (+/- SEM) ir-ET-1
      concentration was 1.04 +/- 0.29 pg/mL. There was no relationship between ir-ET-1
      concentrations and race, sex, mode of delivery, and prenatal characteristics,
      such as cocaine exposure. The current methodologies were reviewed in an effort to
      explain the differences in ET-1 concentrations reported in various studies.

PMID- 7779192
TI  - Nonlinearity of heart rate in the neonate.
AB  - The relationship between heart rate variability and level of illness was
      examined. Fifteen patients (10 male and 5 female), gestational ages 25 to 42
      weeks, postnatal ages 1 to 42 days, birthweights 545 to 4375 g receiving care in
      the neonatal intensive care nursery were randomly selected. Data from each infant
      was transferred from the bedside physiologic monitor to a microcomputer for
      analysis. A severity of illness index (the Children's Hospital Illness Score
      [CHILLS]) correlated with heart rate variability. Four patterns of heart rate
      variability were identified: (1) infants whose CHILLS score indicated that they
      were cardiovascularly normal demonstrated a modest amount of variability; (2)
      infants with a CHILLS score indicating a moderate amount of illness had heart
      rates and heart rate variability greater than the normal infants; (3) three
      infants exhibited bimodality (period doubling) in their heart rates; each of
      these infants had a CHILLS score that indicated that they were less ill than the
      most critically ill patients, but sicker than those moderately ill infants
      without period doubling; and (4) heart rate decreased in the most critically ill
      infants identified by the CHILLS, but it remained above the heart rate of a
      healthy newborn; heart rate variability collapsed below that of a healthy
      newborn. Our data suggest that the variability of heart rate may increase as an
      infant becomes sicker. When the infant becomes critically ill and unstable, heart
      rate variability is less than the normal infant. Nonlinear dynamics theory may be
      a potential model for fitting the data.

PMID- 7779193
TI  - Sonographic assessment of amniotic fluid in normal twin pregnancy.
AB  - A sonographic standard for assessment of amniotic fluid volume in normal twin
      pregnancy is provided. In 210 uncomplicated twin pregnancies, amniotic fluid
      volume was assessed sonographically, by measuring the total amniotic fluid index
      (AFI), as well as the deepest single vertical pocket in each sac. The mean AFI
      was greater than values found in singleton gestations; the AFI increased up to 27
      weeks' gestation, and decreased thereafter. It correlated well with measurement
      of the deepest vertical pocket in each sac (r = 0.71; p < 0.0001). In twin
      pregnancy at 26 to 32 weeks' gestation a fluid pocket of at least 8 cm was found
      in 9.8% of cases and did not indicate pathologic states. Either AFI or
      measurement of the deepest fluid pocket in each sac can be used to assess fluid
      volume in twin pregnancy. A table specific to twin pregnancy should be used when
      evaluating twin gestations sonographically.

PMID- 7779194
TI  - Electromyography with acrylic plug surface electrodes after delivery.
AB  - Pelvic floor neuromuscular function was evaluated with surface electromyography
      using acrylic plug electrodes and interactions between neuromuscular function and
      factors pertinent to the delivery process were explored. Fifty-two women who were
      primiparas participated in this prospective cohort study. Circumvaginal and
      circumrectal muscles were assessed. Corrected vaginal-rectal flicks and holds
      were calculated. The results were compared by delivery route, birthweight, race,
      lactational status, and delivery anesthetic and to a group of nulliparous
      subjects. The mean interval from delivery was 46.3 days. Birthweight, race,
      lactational status, and anesthetic technique were not associated with
      statistically significant changes in electrical activity, although our ability to
      detect such differences was low due to the small number of subjects. Women who
      delivered vaginally had lower vaginal flick voltage than those delivering
      abdominally. Women who delivered vaginally had lower vaginal flick and hold
      voltages and rectal flick voltage when compared with nulliparous women studied
      earlier. Abdominally delivered women had values similar to the nulliparous group.
      Women delivering vaginally had less surface electromyographic activity in the
      circumvaginal muscles, implying that vaginal delivery impairs the neuromuscular
      function of the pelvic floor.

PMID- 7779195
TI  - Metatropic dysplasia: a case report.
AB  - A case of metatropic dysplasia is presented, stressing the utility of prenatal
      diagnosis.

PMID- 7779196
TI  - Intrauterine diagnosis and management of transient myeloproliferative disorder.
AB  - Transient myeloproliferative disorders can be associated with hydrops in Down
      syndrome fetuses. No cases of prenatal management of such a condition have been
      reported in the literature. We report a case of myeloproliferative disorder
      diagnosed by cordocentesis at 31 weeks in a Down syndrome fetus with pericardial
      effusion. A pericardiocentesis was performed at the first signs of hydrops and
      successfully improved fetal cardiac function, allowing for continuation of
      pregnancy.

PMID- 7779198
TI  - Mathematical modeling of fetal organ growth using the Rossavik growth model: IV.
      Lung.
AB  - Growth of the fetal lung has been monitored by left lung area (LLA), right lung
      area (RLA), and total lung area (TLA) from 14 to 41 weeks menstrual age in 116
      normal Japanese fetuses. Growth of the fetal heart and chest has also been
      monitored by heart area (HA) and chest area (CA), respectively. Growth curves for
      these parameters have been determined by using a Rossavik growth model [p =
      c(t)k+s(t)]. R2 values of 95.3%, 90.3%, 89.0%, 88.7%, and 92.1% were obtained for
      CA, HA, LLA, RLA, and TLA, respectively. Variability analysis indicated a
      progressive increase in variability with fetal age for these five parameters.
      Variability data were used with the growth curve models to determine standard
      curves for these parameters. These standard curves provide a superior means for
      evaluating the normal fetal lung growth in the fetus and for identifying
      pulmonary hypoplasia in utero.

PMID- 7779197
TI  - Effect of dehydroepiandrosterone sulfate on ophthalmic artery flow velocity
      waveforms in full-term pregnant women.
AB  - The possible effects of dehydroepiandrosterone sulfate on orbital circulation in
      14 term pregnant women were examined by color Doppler flow mapping and pulsed
      Doppler ultrasound assessments of ophthalmic artery blood flow velocities before
      and 3 minutes after the intravenous drug injection. Blood pressure, heart rate,
      peak systolic velocity, end-diastolic velocity, time-averaged mean peak velocity,
      and pulsatility index were studied. Dehydroepiandrosterone sulfate injected
      intravenously had little effect on blood pressure, heart rate, and peak systolic
      velocity, increasing (p < 0.02) the mean end-diastolic velocity from 3.7 +/- 1.7
      to 4.9 +/- 2.0 cm/s (mean +/- SD) and the mean time-averaged mean peak velocity
      (p < 0.02) from 9.8 +/- 3.2 to 12.1 +/- 3.9 cm/s (mean +/- SD). The mean
      pulsatility index decreased simultaneously (p < 0.02) from 2.75 +/- 0.79 to 2.29
      +/- 0.58 (mean +/- SD). Dehydroepiandrosterone sulfate vasodilates the ophthalmic
      artery, increasing blood flows in term pregnant women, and similar changes might
      occur in other cerebral vessels. It seems that this vasodilative effect of
      dehydroepiandrosterone sulfate is expected for treatment of preeclampsia.

PMID- 7779199
TI  - Herpes simplex type II infection in monozygotic twins.
AB  - The unusual occurrence of herpes simplex virus (HSV) type II infection in a set
      of monozygotic premature twins is described. The cases highlight the difficulty
      of early diagnosis of HSV disease in the absence of a positive maternal history
      and cutaneous lesions. Risk factors for mortality and morbidity are discussed.

PMID- 7779200
TI  - Intrauterine coxsackie virus, group B type 1, infection: viral cultivation from
      amniotic fluid in the third trimester.
AB  - We report a case that presents clear evidence of an intrauterine infection of
      twin fetuses with an enterovirus. The mother had signs and symptoms of
      chorioamniotitis at 34 weeks' gestation. Coxsackie virus, group B type 1 (CVB1),
      was cultured from amniotic fluid obtained by transabdominal amniocentesis when
      the membranes of both fetuses were still intact. Delivery occurred vaginally
      approximately 24 hours later, following spontaneous rupture of membranes. At
      birth, both twins showed signs of sepsis. Postpartum, CVB1 was recovered from the
      mother's cervix, and the newborns' cerebrospinal fluid, nasopharyngeal, and
      rectal swabs. The present significance of this case is discussed.

PMID- 7779201
TI  - Changes in blood velocities of fetal circulation in association with fetal heart
      rate abnormalities: effect of sublingual administration of nifedipine.
AB  - Nifedipine has been used to treat hypertension in pregnancy, and does not
      influence fetal or uteroplacental circulations in patients with preeclampsia. A
      29-year-old multi-gravid woman presented at 32 weeks' gestation with significant
      elevation of her blood pressure. After sublingual administration of nifedipine,
      the blood pressure decreased from 208/122 to 136/96 mm Hg at 30 minutes. In her
      growth-retarded fetus with abnormal flow velocity waveforms, pulsatility index
      values for middle cerebral artery and umbilical artery did not change; however,
      peak systolic velocities, end-diastolic velocities, and time-averaged mean peak
      velocities for these arteries became significantly elevated. Simultaneously,
      severe variable decelerations and late decelerations occurred. The adverse effect
      of nifedipine on fetal circulation might occur in a growth-retarded fetus with
      abnormal flow velocity waveforms.

PMID- 7779202
TI  - Successful radiofrequency ablation in a 3-month-old baby with permanent
      junctional reciprocating tachycardia: a new era in the treatment of incessant
      life-threatening arrhythmias in infants.
AB  - We report our experience in treating a 3-month-old baby with accessory
      atrioventricular pathway by radiofrequency (RF) ablation. The baby was discovered
      to have incessant supraventricular tachycardia at 4 weeks of age. At that time,
      two-dimensional echocardiography showed dilated cardiomyopathy. Multiple direct
      current shocks and multipharmaceutical treatment failed to restore sinus rhythm.
      Electrophysiology study showed the presence of posteroseptal accessory pathway.
      Immediately after delivery of two RF pulses, successful ablation of the accessory
      pathway and complete atrioventricular (AV) block with good junctional escape
      rhythm were observed. Normal rhythm and AV conduction subsequently returned and
      all medical treatment was discontinued. To our best knowledge, this is the first
      case of successful treatment with RF ablation in early infancy.

PMID- 7779203
TI  - Renal cell carcinoma presenting as hemolytic anemia in pregnancy.
AB  - A patient presented at 29 weeks' gestation with severe hemolytic anemia. She was
      subsequently diagnosed as having renal cell carcinoma and had a radical
      nephrectomy at 31 weeks' gestation, which demonstrated stage I disease. This was
      followed by a normal vaginal delivery of a healthy infant at term and complete
      resolution of her anemia. This unusual presentation of renal cell carcinoma in
      pregnancy is discussed.

PMID- 7779204
TI  - Benign fetal bradycardias diagnosed by echocardiography.
AB  - Five cases of benign fetal arrhythmias presented with dramatic pictures of
      sustained irregular bradycardias. These cases were not associated with structural
      heart disease, the development of hydrops fetalis, or maternal autoantibodies. In
      all but one case, the arrhythmias resolved before delivery. Two fetuses had 2:1
      atrioventricular block and the other three showed group beating due to blocked
      atrial trigeminy. With regular intermittent reevaluation, and if no signs of
      hydrops occur, watchful waiting is the suggested therapeutic modality.

PMID- 7779205
TI  - Fetal urine production and micturition and fetal behavioral state.
AB  - The rate of fetal urine production and the incidence of fetal micturition was
      compared in periods of fetal sleep and awakeness. Sonography and fetal heart rate
      monitoring were concomitantly performed on 12 normal term pregnancies. Fetal
      bladder volumes were serially calculated, and the rate of urine production and
      micturition were compared between the periods of fetal sleep and awakeness. Fetal
      micturition occurred almost exclusively during periods of fetal awakeness (p =
      0.001). There were no demonstrable differences in the rates of urine production
      during periods of fetal sleep and awakeness. Fetal micturition is behavioral
      state dependent. Nevertheless, the fetal behavioral state is not a necessary
      consideration when applying urine production measurements as a test of fetal well
      being.

PMID- 7779206
TI  - Antacid bezoar in a premature infant.
AB  - A premature infant with severe enteroviral infection was treated with Maalox for
      gastric bleeding. Bezoars formed, which were shown to contain high concentrations
      of magnesium. An association between antacid administration and bezoar formation
      in neonates has been previously suggested but has not until now been clearly
      documented.

PMID- 7779207
TI  - Cerebral blood flow and EEG changes in preterm infants with patent ductus
      arteriosus.
AB  - It is unknown whether the decreased cerebral blood flow seen in infants with a
      large patent ductus arteriosus is associated with cerebral dysfunction. Decreased
      cerebral blood flow in adult human and animal models has been associated with
      altered electroencephalography (EEG), spectral-analyzed EEG, and EEG response to
      photic stimulation. Cerebral blood flow velocity, EEG, spectral analysis of EEG,
      and photic alteration of EEG spectra were evaluated in 8 infants before and after
      closure of a significant patent ductus arteriosus and in 10 control infants
      without a patent ductus arteriosus. All infants with patent ductus arteriosus had
      moderate or large shunts associated with a 25% mean reduction in cerebral blood
      flow velocity. There were no differences, however, in EEG, spectral analysis of
      EEG, or photic alteration of the spectral analysis for these infants before and
      after patent ductus arteriosus closure as compared to controls. It is concluded
      that the degree of decreased cerebral blood flow in infants with a significant
      patent ductus arteriosus is not sufficient to cause measurable alteration in
      electrocortical activity.

PMID- 7779208
TI  - Diagnostic value of pediatric outpatient video-EEG.
AB  - Outpatient video-electroencephalography (OVEEG) was performed in 100 infants,
      children, and adolescents with diagnosed (group I, n = 64) or suspected (group
      II, n = 36) epilepsy. Median monitoring duration was 4 hours. Indications for
      OVEEG in group I were classification of seizures, reported seizure exacerbation,
      or onset of new signs. OVEEG indications in group II were repetitive paroxysmal
      and stereotyped signs of myoclonic movements, fixed gaze, abnormal behavior, or
      nonmyoclonic motor activity. In group I patients, symptomatic events were
      recorded in 89%, half of which were seizures. Among group II patients, events
      were recorded in 67% and were seizures in 22%. Overall, OVEEG was successful in
      83% of patients. Compared to a 24-hour inpatient admission for video-EEG
      monitoring, OVEEG represented cost reductions of 55-80% per patient. We conclude
      that OVEEG is a cost-effective, useful alternative to continuous inpatient video
      EEG monitoring in the investigation of selected infants, children, and
      adolescents with diagnosed or suspected epilepsy.

PMID- 7779209
TI  - Acute confusional migraine: variant of transient global amnesia.
AB  - Acute confusional migraine in children and transient global amnesia in adults
      share a number of similar clinical manifestations. Acute confusional migraine in
      6 children (mean age: 11.7 years; range: 7.5-17 years) was characterized by
      transient episodes of amnesia and acute confusion lasting 1-12 hours. Episodes
      were preceded by headache and vomiting in 4 patients. In 2 patients acute
      confusional migraine was the initial symptom. A history of preceding trivial head
      injury was reported in 3 patients and migraine in 4. Urine and serum drug screens
      were negative. Cerebral imaging studies and interictal electroencephalograms were
      normal. Ictal electroencephalograms in 3 patients revealed diffuse or bioccipital
      delta wave slowing. Recurrent episodes of acute confusional migraine occurred in
      2 children during 1-3 years of follow-up. The clinical manifestations of acute
      confusional migraine in this series of children are similar to those reported in
      transient global amnesia. The similarity of the clinical manifestations of acute
      confusional migraine in children and transient global amnesia in adults suggests
      that these disorders may share a common pathophysiology.

PMID- 7779210
TI  - Changes of P300 latency with age in childhood epilepsy.
AB  - Auditory event-related potentials (P300 latency; odd-ball paradigm) were examined
      in 129 patients with childhood epilepsies and 53 controls. The P300 latency in
      the patients with epilepsies (373 +/- 39.4 ms) was significantly longer than in
      controls (356 +/- 38.4), and the prolongation was greatest in the patients with
      symptomatic partial epilepsies (390 +/- 40.5), mild in those with idiopathic
      generalized epilepsies (370 +/- 24.3), and minimum in those with idiopathic
      partial epilepsies (363 +/- 28.9). Abnormal P300 latency occurred at all ages
      during childhood in patients with symptomatic partial epilepsies, and at older
      ages in patients with idiopathic generalized epilepsies. The shortening of
      latency with age was relatively small in patients with epilepsies compared with
      controls. These results suggest that the prolongation of P300 latency (i.e.,
      existence of cognitive disturbance) displays characteristic changes with age in
      each epileptic syndrome.

PMID- 7779211
TI  - Seizures associated with stroke in childhood.
AB  - Seventy-three consecutive children younger than 17 years of age seen from 1978 to
      1992 with acute hemiplegia from stroke, were retrospectively reviewed to evaluate
      the incidence of seizures and the risks of recurrent seizures after stroke. The
      population consisted of 56 children with cerebral infarction, 12 with
      intracranial hemorrhage, and 5 with transient ischemic attack. Children whose
      strokes occurred in the neonatal period and those secondary to trauma,
      malignancy, or infection were excluded. Mean follow-up time was 43.5 months
      (range: 12-156 months). At least 1 seizure occurred in 36 patients (49.3%) and
      recurrent seizures occurred in 21 patients (28.8%). Recurrent seizures developed
      more often among patients who had initial seizures with delayed onset (P < .05).
      In 56 patients with cerebral infarction, 16 of 31 patients (51.6%) with cortical
      involvement documented by neuroradiologic studies and 1 of 25 patients (4%)
      without cortical involvement developed recurrent seizures (P < .01). In 12
      patients with intracranial hemorrhage, 3 of 10 patients with cortical involvement
      and none of 2 patients without cortical involvement developed recurrent seizures.
      It is concluded that seizures commonly occur in childhood stroke. Risk factors
      for recurrent seizures include later onset of initial seizures and presence of
      cortical involvement.

PMID- 7779212
TI  - Stroke in purine nucleoside phosphorylase deficiency.
AB  - The first documented case of cerebrovascular disease occurring in a 13-year-old
      girl with purine nucleoside phosphorylase deficiency is reported. This patient,
      the oldest known survivor with purine nucleoside phosphorylase deficiency, had
      previously experienced multiple sequential neurologic problems. She presented
      with episodes of transient left hemiparesis, followed shortly thereafter by dense
      left hemiplegia. Magnetic resonance imaging revealed a right internal capsule
      infarct; cerebral angiography revealed vasculopathy of the proximal vessels.
      Proposed mechanisms for neurologic dysfunction and cerebrovascular disease in
      purine nucleoside phosphorylase deficiency are discussed.

PMID- 7779213
TI  - Complete heart block in nonfamilial hyperekplexia.
AB  - An infant with nonfamilial hyperekplexia had multiple episodes of tonic spasms
      that mimicked tonic seizures. They were accompanied by complete heart block and
      apnea. These episodes did not correlate with electroencephalographic epileptiform
      changes and were partially responsive to clonazepam, valproic acid, and cardiac
      pacemaker. Sudden death in hyperekplexia may be related to complete heart block
      and apnea during seizurelike episodes.

PMID- 7779214
TI  - Optic neuritis with silent cerebral lesions: availability of FLAIR sequences.
AB  - A 10-year-old male suffering from acute optic neuritis is reported with multiple
      silent cerebral lesions, which remained visible only with fluid-attenuated
      inversion recovery sequences at 3-week intervals. Conventional sequences with
      magnetic resonance imaging did not visualize the lesions. Fluid-attenuated
      inversion recovery sequences are highly sensitive for the detection of silent
      lesions in acute optic neuritis.

PMID- 7779215
TI  - Hemolytic uremic syndrome with particular involvement of basal ganglia and
      favorable outcome.
AB  - Two children with hemolytic uremic syndrome and extrapyramidal complications are
      presented. Neuroimaging studies demonstrated bilateral basal ganglia (striatal)
      involvement with favorable recovery in both patients. The pathophysiology of the
      neurologic complications in hemolytic uremic syndrome are probably
      multifactorial. Our patients suggest a reversible process because both patients
      recovered clinically and radiographically. Neurologic complications do not always
      portend a poor prognosis and, in general, involvement of the basal ganglia is
      associated with favorable outcome.

PMID- 7779216
TI  - Severe cerebellar atrophy following acute cerebellitis.
AB  - The clinical course and serial magnetic resonance imaging findings of a 4-year
      old girl with acute cerebellar ataxia due to acute cerebellitis are described.
      Multifocal white matter lesions visualized by magnetic resonance imaging in both
      cerebellar hemispheres in the acute phase disappeared in the convalescent phase.
      Cerebellar signs became less prominent within 2 weeks, but mild ataxic gait
      remained. During the follow-up period of 32 months, there was a gradual
      development of cerebellar atrophy along with a recurrence of cerebellar ataxia.

PMID- 7779218
TI  - Pre-eruptive neurologic manifestations associated with multiple cerebral infarcts
      in varicella.
AB  - A boy, 4 years, 9 months of age, presented with acute hemiplegia, lethargy,
      ataxia, and dysarthria 24 hours prior to the eruption of typical varicella
      exanthem. Magnetic resonance imaging findings were typical of multiple cerebral
      ischemic infarcts. It is suggested that during the period of secondary viremia
      varicella zoster virus invaded the cerebral blood vessels causing vasculopathy
      and cerebrovascular infarcts.

PMID- 7779217
TI  - Vertebral artery compression due to head rotation in thalamic stroke.
AB  - Vertebral artery compression from head turning has been described in adults,
      especially in those who have spondylosis of the spine and osteophytes. There are
      no reports that demonstrate vertebral artery compression due to head turning in
      children without vertebral abnormalities. A child is reported with thalamic
      stroke in whom cerebral arteriography revealed vertebral artery compression on
      head turning. Blood flow in the vertebral artery, however, could be demonstrated
      by Doppler ultrasonography with the head in the midline. It is concluded that the
      vertebral artery is vulnerable to mechanical compression in the neck even in the
      absence of bony abnormalities.

PMID- 7779219
TI  - Acute transverse myelitis and brainstem encephalitis associated with hepatitis A
      infection.
AB  - A 4-year-old boy became paraplegic during the course of hepatitis A infection.
      There were significant magnetic resonance imaging changes in the cervical spinal
      cord and brainstem. The patient's cervical myelopathy resolved entirely after 10
      weeks.

PMID- 7779220
TI  - Primary malignant melanoma of meninges: atypical presentation of subacute
      meningitis.
AB  - Primary malignant melanoma of the meninges is described in a 5-year-old boy who
      presented with a 3-month history suggestive of subacute meningitis. Clinically
      the diagnosis of tuberculous meningitis was made and antituberculous treatment
      was begun. Despite this treatment, the patient's condition continued to
      deteriorate. Through cytologic examination of the cerebrospinal fluid malignant
      melanoma cells were identified, emphasizing the importance of this investigation
      in children with atypical meningitis. The diagnosis of malignant melanoma of the
      meninges was confirmed on brain biopsy.

PMID- 7779221
TI  - Visual system electrodiagnosis in neurologic disease of childhood.
AB  - Electrodiagnostic examination of the visual system includes visual evoked
      potentials and electroretinography. These tests can be applied to all ages.
      Pitfalls in the clinical ophthalmologic examination of children, such as optic
      nerve pallor and pigmentary retinopathy, can be clarified by these tests.
      Investigation of neurodegenerative disease may be directed to the most likely
      defect by results of visual evoked potential testing and electroretinography. The
      child who is unable to meaningfully communicate sensory experience can be
      objectively evaluated by these studies. Familiarity with the applications and
      limitations of these tests will allow the examiner to choose the appropriate
      setting and time to apply each of them.

PMID- 7779222
TI  - Effective care in pregnancy and childbirth: a synopsis.
AB  - Evidence about the effects of care practices is not a sufficient guide to the
      most appropriate care. Those who provide care, who receive care, who advocate
      care, or who pay for care must choose on the basis of many factors: personal
      experience, personal preference, personal values, availability of resources and
      facilities, and a myriad of other considerations, among which knowledge of the
      effects of care is certainly important. This knowledge is essential for choices
      to be properly informed. The most reliable evidence about the effects of care is
      provided by randomized controlled trials. Unfortunately, this evidence is not
      readily accessible. It is scattered through a large number of journals throughout
      the world, and is hidden among a mass of weak, inadequate, and sometimes frankly
      misleading studies. Those who wish to use all the valid evidence must rely on
      properly prepared, up-to-date, systematic reviews. The Cochrane Collaboration has
      taken on the task of preparing, maintaining, and disseminating reviews of
      randomized trials of health care, published electronically as the Cochrane
      Database of Systematic Reviews. The reviews are provided by a number of
      Collaborative Review Groups, and the Cochrane Pregnancy and Childbirth Database
      is the first specialty database to appear. It is regularly updated to incorporate
      data that have become available since the previous issue.

PMID- 7779223
TI  - Baby-Friendly Expert Work Group in the United States: blowing the whistle.

PMID- 7779224
TI  - Changes in cesarean delivery in the United States, 1988 and 1993.
AB  - The rate of cesarean delivery in the United States (22.8% in 1993) has remained
      stable since the mid-1980s after dramatic increases during the 1970s and early
      1980s. The primary cesarean rate (16.3 cesareans in 1993 per 100 women with no
      history of previous cesarean delivery) was also stable from 1988 to 1993. During
      this same period, the rate of vaginal birth after previous cesarean (VBAC)
      doubled, from 12.6 to 25.4 percent. In both 1988 and 1993, rates of cesarean
      delivery were higher in the South than in other regions, for mothers 35 years or
      older than for younger women, for proprietary than for nonprofit or state and
      local government hospitals, and for women with private insurance than for women
      with Medicaid or self-pay as the expected source of payment. Even if VBAC rates
      continue to increase at the same rate as in the past, the Year 2000 goal of an
      overall cesarean rate of 15 percent cannot be met without reducing the primary
      cesarean rate by 50 percent.

PMID- 7779225
TI  - Midwifery care and medical complications: the role of risk screening.
AB  - This study analyzed the 147,293 births attended by midwives in the United States
      in 1989. It used the revised and expanded standard national certificate of a live
      birth, which for the first time systematically records prenatal medical risk,
      intrapartum complications, obstetric procedures, and birth outcomes. It builds on
      earlier findings of positive outcomes for midwife-attended births to examine the
      prenatal medical risk profile of mothers served by midwives, the performance of
      obstetric procedures by midwives in different birth settings, more specific
      measures of outcomes, and possible explanations for these findings. Although
      midwives attending births in birth centers and homes generally serve mothers who
      are at much less than average medical risk, and in cases of intrapartum
      complications risk screening appears to occur, nurse-midwife-attended births in
      hospitals involve mothers whose risk profiles compare with, and in some cases are
      worse than, the national average. Nonetheless, the outcomes of these births are
      better than the national average. Mothers attended by midwives in birth centers
      and homes also have a different pattern of prenatal care, which begins later and
      includes fewer visits, but gives more apparent attention to self-care, and
      results in less smoking and alcohol use and greater weight gain.

PMID- 7779226
TI  - What predicts breastfeeding intention in Mexican-American and non-Hispanic white
      women? Evidence from a national survey.
AB  - We examined the effects of a series of predictors on the prepartum intention to
      breastfeed in both Mexican-American and non-Hispanic white women. A national
      sample included 430 Mexican-American women and 3659 non-Hispanic white women who
      had a pregnancy in 1988. Prenatal behavioral, sociodemographic, and biomedical
      information was obtained through the 1988 National Maternal and Infant Health
      Survey. Two dependent variables were constructed to identify significant
      predictors of breastfeeding intention: exclusive versus partial and bottle
      feeding, and exclusive and partial versus bottle-feeding. Results from the
      multiple logistic regression models indicated that advice to breastfeed at
      prenatal care was the strongest predictor of intentions in both Mexican-American
      (OR = 2.15, OR = 1.86) and non-Hispanic white mothers (OR = 2.29, OR = 3.61). In
      Mexican-Americans the father's being Hispanic was negatively associated with
      breastfeeding intention (OR = 0.63). In non-Hispanic whites the advice to formula
      feed at the Women, Infants, and Children's nutrition program was a significant
      negative predictor of breastfeeding intention (OR = 0.33, for exclusive and
      partial breastfeeding vs exclusive bottle-feeding). These results have important
      implications for public health policy and practice.

PMID- 7779227
TI  - Women's reasons for not seeking prenatal care: racial and ethnic factors.
AB  - Our objective was to determine if there were differences in the reasons for not
      seeking early prenatal care among low-income black, Hispanic, and white women who
      had four or fewer prenatal care visits or care only in the third trimester, and
      who gave birth at Denver General Hospital in Colorado. Data were gathered from
      606 women (48% Hispanic, 26% black, 26% white) after delivery, using a 188-item
      questionnaire and abstracted medical charts. The most important reasons for not
      seeking early prenatal care were attitudinal (47%), financial (26%), and
      structural and system problems (8.5%). Financial reasons were more important to
      white than to black or Hispanic women, and attitudinal reasons were more
      important to black and Hispanic than to white women. The analysis showed that
      education and marital status were sometimes confounding variables. Clear
      differences in reasons for not seeking prenatal care were reported by women of
      dissimilar racial and ethnic groups in this public hospital. Cultural variations
      in women's views should be taken into account in developing programs intended to
      improve prenatal care and pregnancy outcome in Denver.

PMID- 7779228
TI  - Anemia and insufficient milk in first-time mothers.
AB  - Insufficient milk is a poorly understood problem that is often identified as a
      major reason for early discontinuation of breastfeeding. This study explored the
      relationship between anemia and insufficient milk in 630 first-time mothers. The
      frequency of anemia (postpartum hemoglobin < 10 g/dL) was 22 percent. Anemic
      mothers reported a higher level of symptomatology associated with insufficient
      milk and were more frequently classified as having insufficient milk syndrome.
      Mothers with the syndrome reported a shorter period of full breastfeeding, and
      weaned at an earlier age. They identified not having enough milk, baby nursing
      too often, and baby not gaining enough weight as the main reasons for
      discontinuing breastfeeding, compared with baby's disinterest and conflicts with
      school or work as main reasons among mothers not reporting symptoms related to
      insufficient milk syndrome. The study results suggest that anemia is associated
      with the development of insufficient milk, which in turn, is related to duration
      of full breastfeeding and to age at weaning.

PMID- 7779229
TI  - Variables related to nausea and vomiting during pregnancy.
AB  - Seventy to 90 percent of all pregnant women experience nausea, and 50 percent
      have at least one episode of vomiting or retching. A continuous measure was used
      to quantify symptoms of nausea with or without vomiting or retching during
      pregnancy in 126 women. Relationships between symptoms and selected variables
      were evaluated. Nausea with or without vomiting or retching was associated with
      maternal age, occupation, parity, cigarette smoking, infant gender, and the
      personality trait of independence. Significant associations were entered into
      multiple regression equations. Fourteen percent of the variation in symptoms
      overall, 25.1 percent of the variation in nausea symptoms, and 16.6 percent of
      the variation in vomiting or retching symptoms were explained by a combination of
      these selected independent variables. Although this study found associations,
      independent variables contributed little to predicting or explaining the presence
      and severity of nausea and vomiting during pregnancy. More sensitive measures and
      evaluation are required to understand and treat this perplexing phenomenon.

PMID- 7779230
TI  - Research & writing basics: elements of the case study.

PMID- 7779231
TI  - Minimizing factors that impair wound healing: a nursing approach.
AB  - Chronic wounds present tremendous challenges to the healthcare team. Unlike acute
      wounds that usually progress neatly in a timely manner through the inflammation,
      proliferation and maturation phases of the healing process, chronic wounds
      deviate from the predictable sequence of regeneration and repair. To aid the
      healing process, there are five questions a nurse should ask when assessing a
      wound: "What is it?" "At what stage in the wound healing process is this wound?"
      "Is this wound healing at the expected rate?" "What local factors exist that may
      be delaying the healing process of this wound?" and "What systemic factors exist
      that may be delaying the healing process of this wound?" At various points in the
      process, specific concerns then need to be targeted. Initially, prevent or
      control infection. Then optimize exudate control and remove foreign bodies.
      Finally, prevent premature wound closure or contracture, especially in infected
      or undermining wounds. When the five assessment questions are answered and
      specific concerns have been addressed, the wound should proceed through the
      normal phases of the wound healing process. Throughout the process, attention to
      factors such as nutrition, systemic conditions, and perfusion is essential if
      healing is to be optimized.

PMID- 7779232
TI  - Standardizing performance-based criteria for support surfaces.
AB  - Due to the sparsity of prospective, controlled, clinical studies on the efficacy
      of and the lack of standardized information about support surfaces, current
      literature does not clearly define how these surfaces address patient needs.
      Standardization would help healthcare professionals make better informed
      decisions about the use of support surfaces. Standardization would also help
      researchers design and implement controlled, clinical studies by defining
      characteristics of surface evaluation, making it possible to replicate research
      activities. The first step toward standardization is to develop a performance
      based set of criteria for classifying these surfaces. With respect to the three
      purposes identified: comfort, postural control and pressure management, only
      parameters that can be measured noninvasively, have been considered. The nine
      parameters are life expectancy of the surface, skin moisture control, skin
      temperature control, redistribution of pressure, product service requirements,
      fail safety, infection, flammability, and patient/product friction. Specific
      guidelines for each of these nine parameters are discussed in depth. With testing
      and evaluation of support surfaces standardized, clinicians will be able to
      choose a surface to meet the needs of patients the same way they make other
      treatment decisions: based on outcomes and the results of controlled, clinical
      studies.

PMID- 7779234
TI  - Pressure reduction with a hospitalized population using a mattress overlay.
AB  - Billions of dollars are spent each year on treating pressure ulcers. With
      healthcare costs climbing and reform the order of the day, it is essential for
      researchers to identify a device which reduces pressure, is easy to use and is
      cost effective. This study used a Mini-Tipe pressure sensor to measure pressure
      readings over the sacral and trochanter areas of 17 subjects identified as being
      at risk for skin breakdown. Pressures were compared on a standard hospital
      mattress and an anatomically contoured mattress overlay. There was a 48 percent
      reduction in mean pressures over the sacral area and a 23 percent reduction over
      the trochanter. No correlations between pressures and demographic data were
      identified. Further research is warranted to determine the effects of variables
      found in an "at risk" population on pressure reduction with various products.

PMID- 7779233
TI  - Case study: a modified topical treatment regimen for sodium warfarin-induced
      necrotizing fasciitis.
AB  - This case study describes an atypical case of refractory, sodium warfarin-induced
      necrotizing fasciitis and myonecrosis. This patient did not initially receive
      surgical debridement and systemic antibiotics, the standard treatment for
      necrotizing fasciitis of bacterial origin. This patient's wound care regimen
      began with silver sulfadiazine and wet-to-dry dressings, modified to initial
      cleansing with a zinc-saline solution, followed with application of a zinc-saline
      wet dressing, impregnated with an aluminum hydroxide ointment. The patient
      experienced pain relief after the first application. After 4 weeks, the necrotic
      tissue sloughed off, the early signs of healing appeared making surgical
      debridement possible. Therapy with the zinc-saline dressings was continued and
      restoration of all tissues was documented within 225 days. If aggressive surgical
      therapy is not an option, the prevention of secondary complications such as
      infection becomes the goal of treatment until the necrotic process stops and
      healing begins. For this goal, a moist environment may be the optimal choice for
      topical therapy.

PMID- 7779235
TI  - Important information to consider regarding previously published tissue interface
      pressures.

PMID- 7779236
TI  - Comparing healing rates across studies is the vision, but first, a correct
      equation please!

PMID- 7779237
TI  - Using the nursing process to solve a problem: post-op tape blisters.
AB  - ET nursing consultation was requested for the treatment of ten cases of tape
      blisters within six months, the majority of which were post-op following hip
      surgery. When the ET nursing staff was asked to develop a standard treatment
      protocol for these blisters, they used the nursing process. They identified the
      problem, assessed the situation, planned and implemented a response, and
      evaluated the results in an ongoing manner. It was then theorized that lack of
      "stretch" in the tape might be causing the tape blisters. After five stretch
      tapes were assessed for ease of removing the paper backing, handling,
      application, flexibility, and adhesion, one tape was preferred by the operating
      room and nursing unit staffs and was put into routine use in October 1992. No
      further blisters have been noted since this change was made. By using the nursing
      process, the authors ultimately eliminated post-op tape blisters in the facility.

PMID- 7779238
TI  - The nurse's role in sexual counseling.
AB  - Sexual concerns can result from many common illnesses or treatments. If problems
      or potential problems are left unresolved, the patient's self-concept is
      decreased and adjustment to altered body image or altered bodily functions are
      difficult. Sexuality should be a part of the plan of care for patients as are
      nutrition, elimination and mobility. If sexuality and sexual activity are part of
      a patient's normal life, they must be considered with other components of daily
      living. Jack Annon developed a model for sexual counseling called PLISSIT:
      Permission, Limited Information, Specific Suggestions, and Intensive Therapy.
      This short-term supportive counseling during hospitalization can enhance self
      esteem and assist with adaptation. In providing this support, nurses can help
      patients to know and understand their own abilities and disabilities brought on
      by their illness or surgery, allowing them to adjust accordingly.

PMID- 7779239
TI  - Chronic imipramine administration alters the activity and phosphorylation state
      of tyrosine hydroxylase in dopaminergic regions of rat brain.
AB  - In the present study the influence of imipramine, a tricyclic antidepressant, on
      the expression and function of tyrosine hydroxylase (TH) in dopaminergic rat
      brain regions was examined. Chronic administration of imipramine (18 days)
      decreased levels of TH enzyme activity in ventral tegmental area (VTA) and
      substantia nigra (SN), dopaminergic cell body regions, as well as in caudate
      putamen (CP), nucleus accumbens (ACB), prefrontal cortex (PFC), and olfactory
      tubercle (OT), dopaminergic terminal fields. These effects were dependent on
      chronic drug treatment, as imipramine administration for 1 or 7 days did not
      significantly influence levels of TH activity in either SN or VTA. In contrast to
      drug regulation of enzyme activity, chronic imipramine treatment did not decrease
      levels of TH immunoreactivity in any of the dopaminergic cell body or terminal
      field regions studied, although levels of TH immunoreactivity were decreased in
      locus coeruleus (LC) as previously reported. However, imipramine treatment
      increased levels of TH back phosphorylation in VTA, suggesting that the
      antidepressant-induced decrease in levels of TH activity is a result of decreased
      phosphorylation of the enzyme. These results demonstrate that imipramine
      treatment regulates levels of TH enzyme activity in dopaminergic brain regions,
      and may account for some of the previously observed effects of these drugs on
      dopaminergic function. Finally, imipramine regulation of TH enzyme activity in
      VTA and immunoreactivity in LC was observed in Sprague Dawley, but not Wistar
      rats, demonstrating that different rat strains exhibit different biochemical
      responses to antidepressant treatment.

PMID- 7779240
TI  - Depression of thalamic metabolism by lorazepam is associated with sleepiness.
AB  - Though it is well recognized that the pharmacological actions of benzodiazepines
      are mediated by facilitation of GABAergic neurotransmission, the consequences of
      these changes in regional brain function are not well understood. This study
      measured regional brain glucose metabolism using Positron Emission Tomography and
      2-deoxy-2[18F]fluoro-D-glucose in normal controls (n = 21) investigated with and
      without lorazepam (30 micrograms/kg IV) and with flumazenil given after lorazepam
      (n = 9). Lorazepam markedly decreased metabolism in thalamus (23 +/- 8%) and
      occipital cortex (19 +/- 8%), and flumazenil partially reversed these changes.
      Changes in metabolic activity in thalamus were significantly correlated with
      lorazepam-induced sleepiness (r = .69, df 20, p < .0005) and there was a trend of
      an association between the reversal by flumazenil of lorazepam-induced change in
      thalamus and in sleepiness (r = .63, df 8, p = .07). Benzodiazepine-induced
      changes in thalamic activity may account for their sedative properties.

PMID- 7779241
TI  - Treatment of polydipsia and hyponatremia in psychiatric patients. Can clozapine
      be a new option?
AB  - Polydipsia occurs frequently in chronic schizophrenic patients, some of whom
      develop intermittent hyponatremia. Most therapeutic efforts have tried to control
      the hyponatremia. Four schizophrenic patients, followed for more than one year,
      showed improvement on clozapine. Case 1 was an outpatient without history of
      hyponatremia who improved from polydipsia and psychosis. The last three were
      inpatients with polydipsia, intermittent hyponatremia, and psychosis who showed
      minimal improvement of psychosis but significant decrease in polydipsia and water
      intoxication. Case 2 relapsed to polydipsia when clozapine was discontinued on
      two occasions. Case 3 demonstrated polyuria during 39% of days before clozapine
      and in 0% of days after two weeks of clozapine. In case 4, most baseline sodium
      levels were abnormal, but all became normal after clozapine. A time-series
      analysis for intervention effects showed a significant effect of clozapine (p =
      .017). The limited information provided by these case reports suggest the need
      for controlled studies of the clozapine effect on polydipsic patients.

PMID- 7779242
TI  - Effects of D3/D2 dopamine receptor agonists and antagonists on prepulse
      inhibition of acoustic startle in the rat.
AB  - Prepulse inhibition (PPI) is the normal reduction in a startle response that
      occurs when a weak stimulus ("prepulse") precedes the startling stimulus by 30 to
      500 msec. Schizophrenic patients are deficient in this operational measure of
      sensorimotor gating; therefore, animal models of deficient PPI may provide
      information useful in the understanding and treatment of schizophrenia. Prepulse
      inhibition is disrupted in rats by systemic administration of direct dopamine
      agonists having affinity for the D2 subtype family (D2, D3, and D4) of dopamine
      receptors. This study tested the hypothesis that dopamine agonists and
      antagonists with different affinities for D3 and D2 receptors differ in their
      relative potencies to modulate PPI. The dopamine agonists quinpirole, 7-hydroxy
      N,-N-di-n-propyl-2-aminotetralin (7-OH-DPAT) and apomorphine were approximately
      equipotent in decreasing PPI. Pretreatment with haloperidol (13 to 130 nmol/kg
      sc), but not equimolar doses of UH 232, prevented the disruption of PPI produced
      by the highest dose (0.6 mumol/kg sc) of each agonist. Given the 100-fold higher
      affinity of haloperidol relative to UH 232 for D2 receptors, and equal relative
      affinities of these antagonists for D3 receptors, these data are consistent with
      previous studies suggesting that dopamine agonists may modulate PPI in the rat
      through the D2 subtype of dopamine receptors.

PMID- 7779244
TI  - Fluoxetine and oculomotor activity during sleep in depressed patients.
AB  - The effects of fluoxetine on automated measures of electrooculographic (EOG) and
      electromyographic (EMG) activity were evaluated in 41 patients with nonpsychotic,
      major depressive disorder. Sleep EEG evaluations were conducted at baseline,
      while patients were symptomatic and unmedicated, and following four to five weeks
      of treatment with fluoxetine (20 mg). The number of eye movements (> 75 microV)
      and the amplitude of EOG and EMG activity increased significantly on treatment in
      REM, stages 1, 2, and slow-wave sleep. All patients showed EOG and EMG
      abnormalities in at least one stage of sleep. Thirty-four percent of patients
      showed increased EOG and EMG activity on treatment in every sleep stage. It is
      suggested that fluoxetine-induced oculomotor abnormalities are likely to be the
      result of increased availability of serotonin and secondary dopaminergic effects.

PMID- 7779243
TI  - Benzodiazepine sensitivity in panic disorder: effects of chronic alprazolam
      treatment.
AB  - The aim of the current study was to determine the degree to which patients with
      panic disorder develop tolerance to subjective and physiological effects of
      benzodiazepine after chronic treatment with alprazolam. Response to acute
      administration of diazepam was assessed in 19 panic disorder patients receiving
      chronic treatment with alprazolam and 23 untreated panic disorder patients. At
      baseline in the laboratory, the two groups did not differ in peak saccadic eye
      movement velocity, saccade latency, short-term memory, plasma cortisol and growth
      hormone concentrations, heart rate, and self-rated levels of sedation and
      anxiety. Compared with untreated patients, alprazolam-treated patients displayed
      significantly less diazepam-induced change in peak saccadic velocity, saccade
      latency, growth hormone secretion, memory, and self-rated levels of sedation.
      There was no difference between groups in diazepam effects on plasma cortisol
      concentrations or self-rated anxiety. Within alprazolam-treated patients,
      diazepam-induced slowing of peak saccade velocity was significantly inversely
      correlated with illness severity, as measured by reported panic attacks per week
      and severity of phobic avoidance, but not with alprazolam dose, blood level, or
      duration of treatment. Because the alprazolam-treated group reported more panic
      attacks per week than the untreated panic patients, treated patients were divided
      into those who were asymptomatic versus those with continuing panic attacks. The
      subgroup of nine alprazolam-treated subjects who were asymptomatic also showed
      significantly less diazepam effects than the group of untreated panic disorder
      patients, suggesting that overall group differences were at least partially
      attributable to the development of tolerance to selected benzodiazepine effects
      with chronic alprazolam treatment.

PMID- 7779246
TI  - Psychopharmacology: finding one's way.
AB  - The paper recalls the experiences of the author over the past forty-eight years
      in a field which later became known as psychopharmacology. The author began in
      physical chemistry and traditional pharmacology. His interest in the nervous
      system stemmed from X-ray diffraction studies on the structure of living myelin,
      and led, by way of studies on the distribution of cholinesterases and the effects
      of atropine, to the study of the effects of drugs on the electrical activity of
      the brain in the conscious animal. At the clinical level it included studies of
      the effects of drugs on catatonic schizophrenic stupor. These studies took place
      before the discovery of chlorpromazine. They led to the creation, in 1951, of the
      Department of Experimental Psychiatry in Birmingham, England, the first
      department of its kind in the world. The department included neurochemical,
      electrophysiological, and animal behavior laboratories and a strong clinical
      facility (the Uffculme Clinic). The first blind trial of chlorpromazine was
      carried out in that department in 1953 and 1954. The existence of families of
      neuroregulatory compounds, having uneven distribution in the brain, and exerting
      regional chemical field effects in relation to function was postulated on the
      basis of experimental and clinical findings. The work of colleagues and
      participants in the various studies is gratefully acknowledged in the text. In
      1954 the author served as convening executive secretary of the first
      International Symposium on Neurochemistry at Oxford, England, the first meeting
      of its kind. He came to the United States in 1957 and founded, and served as
      first director of, the new Clinical Neuropharmacology Research Center, now the
      Center for Neuroscience at St. Elizabeth's Hospital, Washington, DC. He directed
      this program from 1957 to 1963. Subsequent activities at Johns Hopkins, the World
      Health Organization, and the International Brain Research Organization (IBRO) are
      recalled. In 1961 he was elected first president of the American College of
      Neuropsychopharmacology. In looking back, he notes the sparse and personal nature
      of the field in the late 1940s and early 1950s, its explosive growth in the wake
      of the major clinical discoveries, and above all, the emergence of a new science
      through the interaction of neurochemistry, electrophysiology, studies of animal
      behavior, and the refinement of the clinical trial. He regards the emergence of
      concepts of regional chemistry of the brain as particularly significant, and
      feels that psychopharmacology is ideally positioned to act as an intermediary
      between classical pharmacology and quantrum biology. The transdisciplinary nature
      of psychopharmacology provides a template for a comprehensive psychiatry of the
      future--a discipline which is now positioned to lead.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 7779245
TI  - The serotonin reuptake inhibitor paroxetin is superior to the noradrenaline
      reuptake inhibitor maprotiline in the treatment of premenstrual syndrome.
AB  - Recent studies indicate that antidepressant drugs with potent serotonin reuptake
      inhibiting properties are effective in reducing the symptoms of premenstrual
      syndrome (PMS). In order to elucidate whether all antidepressant drugs are
      equally effective in the treatment of PMS or whether potent serotonin reuptake
      inhibition is a prerequisite for reducing premenstrual complaints, women
      suffering from severe PMS were treated daily for three menstrual cycles with a
      selective serotonin reuptake inhibitor, paroxetine (n = 22), or with a selective
      noradrenaline reuptake inhibitor, maprotiline (n = 21); in addition, a placebo
      group was included (n = 22). Six symptoms (irritability, depressed mood,
      tension/anxiety, increased appetite/craving for carbohydrates, bloating, and
      breast tenderness) were rated by the participants daily throughout the study.
      With respect to all outcome measurements, the symptom reduction obtained with
      paroxetine was significantly superior to that obtained with placebo; with respect
      to irritability, increased appetite/carbohydrate craving, bloating, and breast
      tenderness, as well as global self-rating, paroxetine was significantly superior
      also to maprotiline. The clear-cut superiority of paroxetine over maprotiline
      indicates that not all antidepressant drugs are equally effective in the
      treatment of PMS; rather, like panic disorder and obsessive compulsive disorder,
      but in contrast to depression, PMS apparently responds better to serotonin
      reuptake inhibitors than to antidepressants with a noradrenergic profile.

PMID- 7779247
TI  - Disease susceptibility, transplantation and the MHC.

PMID- 7779248
TI  - A new era for carnitine?

PMID- 7779249
TI  - 3rd Jenner International Glycoimmunology Meeting.

PMID- 7779250
TI  - Cytokine-binding proteins: stimulating antagonists.
AB  - Cytokine-binding proteins (CBPs) block the ability of cytokines to interact with
      their receptors. These agents can potentially provide a means of treating
      pathological conditions that have a significant cytokine involvement. However, a
      major drawback of such approaches relates to the fact that CBPs stabilize the
      cytokine in the form of a cytokine-CBP complex in vivo. Here, Bernard Klein and
      Herve Brailly discuss the possibility that CBPs behave either as agonists or
      antagonists according to their pharmacokinetic characteristics in vivo, and
      suggest a mechanism by which stable complexes might be cleared from the system.

PMID- 7779251
TI  - Polarization of Th-cell responses: a phylogenetic consequence of nonspecific
      immune defence?
AB  - CD4+ T helper (Th)-cell responses are polarized into Th1 and Th2 types. Here,
      Paul Garside and Allan McI. Mowat propose that this is an evolutionary
      consequence of the relationship between specific adaptive immunity, individual
      components of the nonspecific inflammatory response and different types of
      infection. This concept has important implications both for understanding
      protective immunity and for vaccine design and delivery.

PMID- 7779252
TI  - Ligands for the T-cell receptor: hard times for avidity models.
AB  - T-cell activation occurs when the T-cell receptor (TCR) binds to a self major
      histocompatibility complex (MHC) molecule carrying a specific peptide. Small
      changes in peptide structure can alter or inhibit this response. Although this
      phenomenon is normally attributed to a lowering of the avidity of the ligand for
      its receptor, recent data suggest that conformational changes in the receptor
      itself may be playing a critical role, as discussed here by Charles Janeway.

PMID- 7779253
TI  - An important role for intestinally derived T cells in respiratory defence.
AB  - Margaret Dunkley, Reinhard Pabst and Allan Cripps discuss the role of
      intestinally derived T cells in protecting the lung against Gram-negative
      bacterial infection. They describe the factors directing T-cell migration from
      gut-associated lymphoid tissue to lung, and focus on the role of T cells and T
      cell-derived cytokines in bacterial clearance from the lung.

PMID- 7779254
TI  - The human immunoglobulin VH repertoire.
AB  - A complete map of the human immunoglobulin VH locus on chromosome 14 has recently
      been constructed. The locus is 1100kb in length and contains 51 functional VH
      segments interspersed amongst a similar number of pseudogenes. Here, Graham Cook
      and Ian Tomlinson review the organization of the locus, its polymorphism and the
      repertoire it encodes.

PMID- 7779255
TI  - Molecular chaperones and the biosynthesis of antigen receptors.
AB  - Oligomeric antigen receptors must fold and assemble in the endoplasmic reticulum
      (ER) before they can be expressed on the surface of lymphocytes. It is
      increasingly evident that these processes are facilitated by molecular
      chaperones. Here, Jeffrey Melnick and Yair Argon review the known ER chaperones,
      summarize their roles in the maturation of antigen receptors, and discuss how
      they may affect lymphocyte differentiation and function.

PMID- 7779256
TI  - Combination therapies for HIV infection.

PMID- 7779257
TI  - Circulating adhesion molecules in inflammatory and atherosclerotic vascular
      disease.

PMID- 7779258
TI  - Sarcoidosis and malaria.

PMID- 7779259
TI  - Conserved nonplanar heme distortions in cytochromes c.
AB  - A nonplanar distortion of the heme of c-type cytochromes is conserved in the
      proteins isolated from diverse species based upon a comprehensive analysis of
      available high-resolution X-ray crystal structures. This distortion is induced
      through the cysteine thioether linkages between the porphyrin pyrrole groups and
      the polypeptide and results in an asymmetric pyrrole distortion. This asymmetry
      in the heme distortion is also conserved. For other heme proteins which lack
      these covalent bonds, nearly planar porphyrins are observed. Resonance Raman
      evidence indicates that nonplanar distortion of porphyrins containing metals,
      like iron, with large core sizes (> or = 2.00 A) is energetically unfavorable and
      can occur only in the presence of significant environmental perturbations.
      Further, energy minimization and dynamics calculations on the ferric form of
      yeast iso-1-cytochrome c, starting from the crystallographic coordinates and
      using a molecular mechanics force field which accurately reproduces nonplanar
      distortions in metalloporphyrins, suggest that this distortion is indeed
      maintained by the protein tertiary structure. It is proposed that this protein
      linked heme distortion modulates electron transfer function through modification
      of redox potentials of the porphyrin ring and the protein binding properties of c
      type cytochromes.

PMID- 7779260
TI  - Unfolding of tertiary structure of Halobacterium halobium flagellins does not
      result in flagella destruction.
AB  - The structure of Halobacterium halobium R1M1 flagella is investigated by the
      methods of scanning microcalorimetry, circular dichroism, and electron
      microscopy. It is shown that melting curves of flagella in solutions with a
      different concentration of NaCl display only one peak of heat capacity that
      corresponds to one cooperatively melting domain. It is found that flagella do not
      dissociate after melting. The possible structural organization of archaebacterial
      flagella is discussed.

PMID- 7779261
TI  - Conformation of the transmembrane domain of the c-erbB-2 oncogene-encoded protein
      in its monomeric and dimeric states.
AB  - The human c-erbB-2 oncogene is homologous to the rat neu oncogene, both encoding
      transmembrane growth factor receptors. Overexpression and point mutations in the
      transmembrane domain of the encoded proteins in both cases have been implicated
      in cell transformation and carcinogenesis. In the case of the neu protein, it has
      been proposed that these effects are mediated by conformational preferences for
      an alpha-helix in the transmembrane domain, which facilitates receptor
      dimerization, an important step in the signal transduction process. To examine
      whether this is the case for c-erbB-2 as well, we have used conformational energy
      analysis to determine the preferred three-dimensional structures for the
      transmembrane domain of the c-erbB-2 protein from residues 650 to 668 with Val
      (nontransforming) and Glu (transforming) at position 659. The global minimum
      energy conformation for the Val-659 peptide from the normal, nontransforming
      protein was found to contain several bends, whereas the global minimum energy
      conformation for Glu-659 peptide from the mutant, transforming protein was found
      to be alpha-helical. Thus, the difference in conformational preferences for these
      transmembrane domains may explain the difference in transforming ability of these
      proteins. The presence of higher-energy alpha-helical conformations for the
      transmembrane domain from the normal Val-659 protein may provide an explanation
      for the presence of a transforming effect from overexpression of c-erbB-2. In
      addition, docking of the oncogenic sequences in their alpha-helical and bend
      conformations shows that the all-alpha-helical dimer is clearly favored
      energetically over the bend dimer.

PMID- 7779262
TI  - Isolation and partial characterization of basic proteinases from stem bromelain.
AB  - Crude bromelain extracts from pineapple stems (Ananas comosus) were fractionated
      by two-step FPLC-cation-exchange chromatography. At least eight basic
      proteolytically active components were detected. The two main components F4 and
      F5 together with the most active proteinase fraction F9 were characterized by SDS
      PAGE, mass spectroscopy, multizonal cathodal electrophoresis, partial amino acid
      sequence, and monosaccharide composition analysis. F9 amounts to about 2% of the
      total protein and has a 15 times higher specific activity against the substrate L
      pyroglutamyl-l-phenylanalyl-l-leucine-p-nitroanilide (PFLNA) than the main
      component F4. The molecular masses of F4, F5, and F9 were determined to 24,397,
      24,472, and 23,427, respectively, by mass spectroscopy. Partial N-terminal amino
      acid sequence analysis (20 amino acids) revealed that F9 differs from the
      determined sequence of F4 and F5 by an exchange at position 10 (tyrosine-
      >serine) and position 20 (asparagine-->glycine). F4 and F5 contained fucose, N
      acetylglucosamine, xylose, and mannose in ratio of 1.0:2.0:1.0:2.0, but only 50%
      of the proteins seem to be glycosylated, whereas F9 was found to be
      unglycosylated. Polyclonal antibodies (IgG) against F9 detected F4 and F5 with
      tenfold reduced reactivity. The pH optimum of F4 and F5 was between pH 4.0 and
      4.5 and for F9 close to neutral pH. The kinetic parameters for PFLNA hydrolysis
      were similar for F4 (Km 2.30 mM, kcat 0.87 sec-1 and F5 (Km 2.42 mM, kcat 0.68
      sec-1), and differed greatly from F9 (Km 0.40 mM, kcat 3.94 sec-1).

PMID- 7779264
TI  - A collaborative approach to using new technologies for the management of heart
      disease at the University of Ottawa Heart Institute.
AB  - Nursing in the Cardiac Operating Rooms and Catheterization Laboratories at the
      University of Ottawa Heart Institute has played a collaborative role in advancing
      and promoting the use of new technologies for treating heart disease. This has
      been demonstrated in the Catheterization Laboratories with the introduction of
      such procedures as angioplasties, atherectomies, stents and rotablators and in
      the Cardiac Operating Rooms with heart transplants and total artificial heart
      implants. Currently, nurses in the Operating Rooms are actively involved in
      research on the electrohydraulic totally implantable ventricular assist device
      (EVAD) which is an internal pump to assist the left ventricle to eject blood into
      the systemic circulation. Clinical and research professionals work together so
      that any problems related to using new technologies are identified and solved
      during both the planning and implementation stages. This article will focus on
      the collaborative process as it was used for the Artificial Heart Program and on
      new technologies related to the implant of the electrohydraulic ventricular
      assist device.

PMID- 7779263
TI  - Physicochemical and immunological characterization of the type E botulinum
      neurotoxin binding protein purified from Clostridium botulinum.
AB  - Type E botulinum neurotoxin is produced by Clostridium botulinum along with a
      neurotoxin binding protein which helps protect the neurotoxin from adverse pH,
      temperature, and proteolytic conditions. The neurotoxin binding protein has been
      purified as a 118-kDa protein. Secondary structure content of the neurotoxin
      binding protein as revealed by far-UV circular dichroism spectroscopy was 19%
      alpha-helix, 50% beta-sheets, 28% random coils, and 3% beta-turns. This compared
      to 22% alpha-helix, 44% beta-sheets, 34% random coils, and no beta-turns of the
      type E botulinum neurotoxin. The complex of the two proteins revealed 25% alpha
      helix, 45% beta-sheets, 27% random coils, and 3% beta-turns, suggesting a
      significant alteration at least in the alpha-helical folding of the two proteins
      upon their interaction. Tyrosine topography is altered considerably (28%) when
      the neurotoxin and its binding protein are separated, indicating strong
      interaction between the two proteins. Gel filtration results suggested that type
      E neurotoxin binding protein clearly complexes with type E neurotoxin. The
      interaction is favored at low pH as indicated by an initial binding rate of 8.4
      min-1 at pH 5.7 compared to 4.0 min-1 at pH 7.5 as determined using a fiber optic
      based biosensor. The neurotoxin and its binding protein apparently are of
      equivalent antigenicity, as both reacted equally on enzyme-linked immunosorbent
      assay to polyclonal antibodies raised against the toxoid of their complex.

PMID- 7779265
TI  - A family systems nursing approach to hypertension.
AB  - This article focuses on a family systems nursing approach for essential
      hypertension. A case example is presented that describes the approach with a
      hypertensive woman with agoraphobia symptoms. A clinically significant decrease
      in the client's blood pressure occurred following the family sessions. Clinical
      observations of improved family relationships and symptom reduction corroborate
      research findings on the variables of perceived stress, anxiety levels and family
      coping resources. Interventions such as split-opinions, reframing, and rituals
      are described.

PMID- 7779266
TI  - PTCA: the role of the angioplasty program nurse.
AB  - Developing a program to provide continuity of care for patients undergoing
      percutaneous transluminal coronary angioplasty (PTCA) or directional coronary
      atherectomy (DCA) for coronary artery disease was the major task of the
      Angioplasty Program Nurse at the Sunnybrook Health Science Centre. To assist the
      patient and their family throughout the course of treatment and to offer
      strategies and resources for risk factor reduction required development of a
      patient assessment tool with clearly defined goals and objectives for
      documentation. Helping patients set realistic expectations in terms of procedural
      outcome and lifestyle modification is an important part of patient education and
      health promotion. Short hospital stays require good planning and comprehensive
      educational strategies in order to meet patient teaching outcomes. Evaluation is
      an important component of any program and having well defined goals and
      objectives with measurable outcomes aids the process.

PMID- 7779267
TI  - Patient outcomes research: Part II.

PMID- 7779268
TI  - Patient perceptions of the experience of electrophysiologic studies.
AB  - This descriptive study explored perceptions, feelings and attitudes related to
      electrophysiologic studies (EPS). Structured one hour taped interviews were
      conducted with 11 participants and data was subjected to qualitative analysis.
      Powerlessness, anticipation and total exhaustion were the categories identified
      from the data. Overall, participants generally perceived their EPS as a negative
      experience and illustrated this with words like invasion, horrible,
      uncomfortable, etc. Anxiety was predominant throughout the entire experience.
      Nurses are in an ideal position to impact these negative perceptions by helping
      patients incorporate the threatening nature of EPS into a cognitive plan, thus
      reducing anxiety. Strategies and interventions to help patients cope with this
      aversive event are offered as well as suggestions for future research.

PMID- 7779269
TI  - [Biologically active lignins from Magnolia biondii Pamp].
AB  - Guided by PAF induced platelet aggregation, six active lignins were isolated from
      the flower buds of Magnolia biondii and identified as fargesin,
      demethoxyaschantin, aschantin, pinoresinol dimethyl ether, magnolin, lirioresinol
      B dimethyl ether. The 13CNMR and CD data were reported and the configurations
      were determined.

PMID- 7779270
TI  - [Chemical compositions of Podocarpus imbricatus].
AB  - Twelve components were isolated from Podocar pus imbricatus, of which ten were
      identified as imbricatafiavone A (1), imbricataflavone B (2), robustaflavone (3),
      robustaflavone-7"-methyl ether (4), podocarpusflavone A (5), sandaracopimaric
      acid (6), beta-sitosterol (7), p-hydroxybenzoic acid (8), n-C34H69OH (9) and 10
      nonacosanone (10). 4, 5, 8, 9 and 10 are obtained from the species for the first
      time.

PMID- 7779271
TI  - [Pharmacological studies of Polygonum capitatum Buch-Ham. ex D. Don].
AB  - The pharmacological effect of aqueous extract of Polygonum capitatum has been
      studied. The experimental results show that Polygonum capitatum markedly
      decreases WBC and RBC in urine of pyelonephritis mode in rats, the death rate of
      Escherichia coli infected mice, and the temperature of feverish rabbits. It has
      also been found that after oral administration of Polygonum capitatum the animal
      urine markedly inhibits the growth of Escherichia coli, but diuretic action of
      the herb has not been observed.

PMID- 7779272
TI  - [A comparative study on the effect of absorbable components of several drugs on
      the growth and population doublings of rat diploid fibroblast].
AB  - Embryonic skin fibroblast of Sprague-Dawley rats cultivated in vitro was used in
      this experiment. The cultural medium was added with absorbable components of
      several drugs. The result reveals that Yan Shou recipe, vitamin E and Huan Jing
      Jian have conspicuous promotive effect on the growth of diploid fibroblast and
      also help to increase population doublings. The experiment suggests that all
      these drugs possess anti-aging effect on the skin diploid fibroblast of rats.

PMID- 7779273
TI  - [Effects of isorhynchophylline on physiological characteristics of isolated
      guinea pig atrium].
AB  - Isorhynchophylline (Iso) inhibits the automaticity and contractile force of
      isolated guinea pig atrium in a concentration-dependent manner, 30 mumol/L
      markedly depresses adrenaline-induced automaticity, 10 mumol/L prolongs
      functional refractory period and decreases excitability. Furthermore, 10 mumol/L
      of Iso reduces the effect of ouabain on contractile force in left atrium and 0.3
      mmol/L markedly inhibits the response to paired stimulation.

PMID- 7779274
TI  - [Preliminary study on the anti-tubercular effect of Ottelia alismoides (L.)
      Pers].
AB  - In clinical trials, the extract of Ottelia alismoides cured two cases of
      bilateral tuberculosis of cervical lymph gland within 3 months. The result of
      drug sensitive test showed that water extract of this herb could kill or inhibit
      human tubercular bacteria effectively, which suggests that Ottelia alismoides is
      a promising medicinal herb with anti-tubercular effect.

PMID- 7779275
TI  - [Review of constituents in fruits of Psoralea corylifolia L].
AB  - Thirty-five constituents in the fruits of Psoralea corylifolia (identified since
      1933) and their main physiological activities and clinical uses have been
      reviewed.

PMID- 7779276
TI  - [Identification on the botanical origin of xueshangyizhihao produced in Shaanxi,
      Gansu, Sichuan Provinces and Ningxia Hui Autonomous Region].
AB  - The botanical origin of Xueshangyizhihao should be Aconitum brachypodum var.
      laxiflorum produced in Dongchuan, Huize and Xundian districts in Yunnan Province.
      Recently, this herb has been found coming from Shaanxi, Gansu, Sichuan Provinces
      and Ningxia Hui Autonomous Region. Botanical identification show that except the
      one from Sichuan being of the same origin as that from Yunnan, this herb consists
      essentially of the species of genus Aconitum, mainly A. flavum, A. pendulum, and
      others such as A. sungpanense, A. polyschistum and A. iudlowii.

PMID- 7779277
TI  - [High yield techniques for bupleurum falcatum L].
AB  - The growth of plants may be controlled by clipping the aerial part. This may
      increase the yield of Bupleurum falcatum. Different methods of cultivation may
      result in different outputs of crude drugs. Compared with land plotting, deep
      ploughing and high ridging may increase the root weight of one-year-old plant by
      28% and 50% respectively.

PMID- 7779278
TI  - [Influence of different processing methods of four alkaloid contents in Strychnos
      nux-vomica L].
AB  - The contents of four alkaloids in different processed products of Strychnos nux
      vomica hamely, vomicine, icajine, strychnine N-oxide and brucine N-oxide, were
      determined by TLC-densitometry. The relationship between alkaloid contents and
      processing methods was studied.

PMID- 7779279
TI  - [Rectal administration of ash bark].
AB  - A TLC-densitometric method was applied to determine aesculin in rabbit blood. The
      best way for ash bark rectal administration was found by orthogonal design
      [L4(2(3))]. The two routes of administration (per rectal, P.O.) were compared by
      bioavailabilities and the result indicated that per rectal was better than P.O.
      Modified isolated rectum-bag method was applied successfully to finding the best
      way for rectal administration of ash bark.

PMID- 7779281
TI  - [Stability of angesin solution].
AB  - Chemical kinetics of ethyl acetate extract from the roots of Angelica sinensis in
      aguerus solution (angesin solution) was studied by isothermal acceleration test.
      The useful life (t0.9) calculated for angesin solution is one year.

PMID- 7779280
TI  - [Preparation method for compound Hirudo oral liquid].
AB  - The extraction efficiency of alcohol, water and alcohol followed by water for
      Hirudo and the principal constituents of compound Hirudo oral liquid were
      compared with the extraction rate of nitric substances and pharmacological
      activity as the evaluation marker. Based on results of the above experiments, a
      new preparation method for the oral liquid was established.

PMID- 7779282
TI  - [Determination of psoralen and isopsoralen in tincture of fructus Psoraleae by
      HPLC].
AB  - A reversed-phase HPLC method was described for the determination of psoralen and
      isopsoralen in tincture of Fructus Psoraleae. After adding the internal standard
      and diluting the sample to a definite volume, the sample was injected and
      analysed. The RSDs were within 2% and the minimum working concentrations below 1
      microgram/ml; the average recoveries of psoralen and isopsoralen 102.8% and 99.5%
      respectively and the linear ranges of psoralen and isopsoralen 12-200
      micrograms/ml and 13-210 micrograms/ml (r = 0.999) respectively.

PMID- 7779283
TI  - [Humoral immune response to the proteins of an antimeningococcal BC vaccine in a
      trial carried out in Antioquia, Colombia].
AB  - This study evaluated the humoral response to protein components of the Cuban
      produced vaccine against serogroups B and C meningococcus, VA-MENGOC-BC, in
      adults and children 1 to 5 years old. The trial was conducted in an area of the
      Department of Antioquia, Colombia, in which an elevated incidence of
      meningococcal disease had been recorded. The serum anti-vaccine-protein response
      was studied before (T0) and after (T1) vaccination by means of enzyme-linked
      immunosorbent assay (ELISA), and lytic capacity was evaluated through the
      bactericidal antibodies test (BAT). The ELISA was performed before and after
      vaccination on the sera of 407 adults and 213 children. Lytic capacity against
      Cuban meningococcal strain B:4:P1.15 was studied with BAT in paired sera from 90
      adults and 114 children. The two techniques showed a statistically significant
      response (P < 0.01) to the vaccine, in both adults and children. Of the total
      number of subjects tested with ELISA, 81% showed an immune response to the
      vaccine (T1/T0 > or = 2) (95% confidence interval, CI95%: 78% to 84%); among
      children, immune response was 91% (CI95%: 87% to 94%). All the children 1 year of
      age (n = 7) responded. Seroconversion (T1/T0 > or = 4), as shown by ELISA, was
      80% among adults (CI95%: 73% to 86%) and 90% among children (CI95%: 83% to 100%).
      BAT demonstrated seroconversion in 85% (CI95%: 78% to 92%) of subjects who had
      been seronegative before vaccination, 85% of the adults (CI95%: 76% to 95%) and
      84% of the children (CI95%: 72% to 96%). Seroconversion among children 3 and 4
      years of age was 80%. The group of sera from children 1, 2, and 5 years old
      available for study with BAT was too small for meaningful statistical analysis;
      all of them seroconverted. In 20 sera chosen randomly for study of their
      bactericidal activity against all the strains isolated from patients in Colombia
      (B:4:P1.15, B:8:P1.nt, and two strains of serogroup C), seroconversion was found
      in all 20 cases. These results give reason to think that vaccination in this
      group produced an effective immune response, as measured serologically, and this
      belief is corroborated in practice by the lack of any cases of meningococcal
      disease through September 1994 among the people vaccinated.

PMID- 7779284
TI  - [Humoral immune response to the capsular polysaccharide of Neisseria meningitidis
      serogroup C in an antimeningococcal BC vaccination trial in Antioquia, Colombia].
AB  - As a complement to studying humoral immune response to the proteins of an
      antimeningococcal vaccine (VA-MENGOC-BC) against serogroups B and C, the humoral
      immune response to polysaccharide C of the vaccine was also evaluated in 142
      children from 1 to 5 years of age in an area of the Department of Antioquia,
      Colombia. Paired pre-(T0) and post-vaccination (T1) sera were tested for IgG
      response by means of ELISA and for serum lytic capacity against a strain of
      serogroup C by means of the bactericidal antibodies test (BAT). Response to the
      vaccine was statistically significant (P < 0.01) by both techniques. PAB
      demonstrated seroconversion (T1/T0 > or = 4) in 88% (95% confidence interval,
      CI95%: 80% to 95%) of all those who were seronegative before vaccination. The
      proportion of seroconversion in children 2, 3, and 4 years of age was 86% or
      more. Of all the sera tested with ELISA, 93% (CI95%: 89% to 97%) showed response
      to the vaccine (T1/T0 > or = 2), and 98% (CI95%: 94% to 100%) of the subjects
      with T0 < or = 500 U/mL seroconverted. In this sample, the vaccine stimulated a
      specific and protective response as measured by ELISA and BAT, the latter test
      being utilized to evaluate protection status.

PMID- 7779285
TI  - [Bactericidal effect of hydrated lime in aqueous solution].
AB  - This study determined the bactericidal effect of the supernatants of saturated
      solutions of common lime and of micronized calcium hydroxide (Ca(OH)2) (1500
      mg/L), which was used as a control, compared with disinfectants made of solutions
      of 0.33% colloidal silver (0.0016 mg/L), toluene sulfachloramine (41 mg/L) with
      sodium bicarbonate (9 mg/L), and sodium hypochlorite (5 mg/L). The test involved
      four strains of Vibrio cholerae 01, V. parahaemolyticus, Escherichia coli,
      Salmonella typhimurium, Shigella flexneri, Sh. sonnei, and Sa. enterititidis.
      These bacteria were inoculated into the bactericidal substances listed above and,
      after different incubation times, the number of surviving bacteria was determined
      in vitro by using a counting plate. The results were expressed in colony-forming
      units (CFU). An in situ estimate was made of the amount of V. cholerae on 35
      strawberries and 35 radishes (having a weight of about 10 g per unit) after they
      were washed under a flow of potable water, submerged in the supernatant of the
      saturated lime solution (1.5 g/L), or both. The greatest bactericidal effect was
      obtained against V. cholerae 01 and was observed in 3 minutes. Other
      enterobacteria were resistant to the effect for up to 30 minutes.

PMID- 7779286
TI  - Kinetics: our window into the goals and strategies of the central nervous system.
AB  - The goal of this chapter is to demonstrate the role of integrated biomechanical
      analyses in complex movements such as gait in alerting researchers of the goals
      and synergies of the CNS. Because of the large number of segments involved and
      the potential for the CNS to take advantage of inter-limb coupling it is only
      through appropriate biomechanical analyses that such collaboration can be
      identified. Examples from normal, perturbed, elderly and pathological gait are
      presented to demonstrate the principles of total limb and total body analysis to
      pinpoint the goals of the CNS and to identify total limb or body synergies and
      adaptations in the elderly and in gait pathologies. Such findings reinforce the
      generalizations made many years ago by Bernstein [2] when he postulated several
      simplifying principles of CNS control. Also, evident from these analyses are the
      precision and accuracy of biomechanical variables that make these measures
      particularly sensitive to small changes within an individual or across a
      population group.

PMID- 7779287
TI  - Electrically evoked behaviors: axons and synapses mapped with collision tests.
AB  - The properties of many axon bundles mediating electrically evoked responses have
      been described using double-pulse methods in behaving animals. The directly
      stimulated axons whose activation leads to the behavior are defined by their
      refractory periods, conduction velocities and trajectories in those studies. In
      this review, new collision effects (asymmetric collision) are described that
      locate synapses mediating turning and startle responses. The direction, time and
      reliability of transmission are determined by the direction, time and strength of
      the asymmetry. In systems mediating turning, five axon bundles have been
      localized with symmetric collision effects and evidence for two synapses has been
      provided with asymmetric collision effects. In systems mediating startle
      responses, three fast, reliable synapses have been located with asymmetric
      collision. Asymmetric collision effects between a loud acoustic stimulus and a
      single electrical pulse in hindbrain sites define the timing and location of the
      acoustic volley that produces acoustic startle. Therefore, when synapses are
      strong, circuit diagrams can be constructed by use of collision tests in behaving
      animals.

PMID- 7779288
TI  - Stress-induced behavioral responses and multiple opioid systems in the brain.
AB  - Various stressor produce a wide range of behavioral responses such as analgesia,
      catalepsy and motor suppression, which are sensitive to opioid receptor
      antagonists. These behavioral responses in stress are accompanied by changes in
      the contents of opioid peptides, the mRNAs encoding their precursors and opioid
      receptor binding in the brain. In the present article, experimental data
      concerning stress-induced analgesia and motor suppression is reviewed and
      discussed in relation to a possible involvement of different opioid systems in
      the various observed behavioral responses in stress. Pharmacological studies with
      subtype-selective antagonists have demonstrated that not only mu- but also delta-
      and/or kappa-opioid receptors are involved in opioid-mediated stress-induced
      analgesia. There are two types of stress-induced analgesia referred to as opioid
      mediated and non-opioid mediated forms. It has been proposed that the intensity
      and temporal pattern of stressor may be a critical factor determining the nature
      of stress-induced analgesia. Accumulated evidence demonstrate that these two
      forms of pain inhibitory systems interact each other according to a collateral
      inhibition model. Recent studies show that parallel activation of multiple opioid
      receptors mediates non-opioid froms of stress-induced analgesia. Dynorphins, by
      acting at kappa-opioid receptors, may play a pivotal role in the expression of
      stress-induced motor suppression, whereas enkephalins may act to attenuate this
      response.

PMID- 7779289
TI  - The dorsomedial frontal cortex: eye and forelimb fields.
AB  - This review yields three conclusions: first, the eye field as described using
      unit recording and electrical stimulation on behaving monkeys trained to fixate
      visual targets is much larger than the 4 mm2 area originally described. Second,
      the eye field and forelimb field share a similar neural space within the
      dorsomedial frontal cortex (DMFC); thus the electrophysiogical studies that have
      been conducted on visually guided and sensory-triggered forelimb movements must
      be re-evaluated, since none of these studies controlled eye movement and eye
      position independently. Third, a topographic map representing eye position in
      orbit has been discovered in the DMFC; it is proposed that this topographic map
      records the order of positions of the eyes and forelimbs during the acquisition
      of visually guided movement sequences.

PMID- 7779290
TI  - The role of serotonergic-cholinergic interactions in the mediation of cognitive
      behaviour.
AB  - Cholinergic systems have been linked to cognitive processes such as attention,
      learning and mnemonic function. However, other neurotransmitter systems, such as
      the serotonergic one, which may have only minor effects on cognitive function on
      their own, interact with cholinergic function and their combined effects may have
      marked behavioural actions. Some studies have dealt with serotonergic-cholinergic
      interactions, but it is unclear whether both systems affect cognition directly or
      whether interactions at a behavioural level result from additional alterations in
      non-cognitive factors. This distinction is difficult, since it is possible that
      the diverse cholinergic and serotonergic systems serve different roles in the
      mediation of cognitive processes, both at the neuroanatomical and neurochemical
      level. Nevertheless, it is possible that cholinergic systems primarily alter
      accuracy in cognitive tasks, whereas serotonergic neurotransmission modulates
      behaviour by altering bias (motivation, motor processes). Whether serotonin
      alters accuracy or bias, however, may also depend on the cognitive process under
      investigation: it is suggested that attention, stimulus processing and/or arousal
      can be influenced by both cholinergic and serotonergic systems independently from
      each other. Cholinergic and serotonergic projections to cortex and thalamus may
      be of importance in the mediation of these cognitive processes. Serotonergic
      cholinergic interactions could also be of importance in the mediation of learning
      processes and trial-by-trial working memory. The data available do not allow an
      unambiguous conclusion about the role of these interactive processes in the
      mediation of long-term reference memory. These processes may rely on serotonergic
      cholinergic interactions at the hippocampal level. It is concluded that
      serotonergic-cholinergic interactions play an important role in the mediation of
      behavioural, including cognitive, performance, but that further studies are
      necessary in order to elucidate the exact nature of these interactions.

PMID- 7779291
TI  - Cerebellar contributions to cognition.
AB  - This review summarises the present evidence for the contribution of the
      cerebellum to cognition. While a data base from both animal and human clinical
      research supports the hypothesis of an important cerebellar role in motor
      adaptation, motor learning and timing, the evidence for the implication of the
      cerebellum in psychopathology and non-motor cognitive functions is incomplete and
      does not allow unequivocal conclusions. Methodological shortcomings and the lack
      of theoretical models on the nature of the cerebellar contribution to cognition
      limit the interpretation of the empirical studies available so far.

PMID- 7779292
TI  - Effects of short-term transcutaneous electrical nerve stimulation on memory and
      affective behaviour in patients with probable Alzheimer's disease.
AB  - The present study investigated whether a 30-minute-a-day transcutaneous
      electrical nerve stimulation (short-term TENS) might improve disturbances in
      memory and affective behaviour in patients with probable Alzheimer's disease. The
      hypothesis was derived from former studies in which beneficial effects on memory
      and affective behaviour of Alzheimer patients were found after a daily
      application of 6-h TENS and a 30-min tactile stimulation. The present data reveal
      that short-term TENS improved some aspects of verbal and visual short-term and
      long-term memory. Moreover, patients who had undergone this treatment felt, e.g.,
      less dejected, less gloomy, less irritable, more cheerful, more active, and more
      alert. They were also more interested in social contacts and participated more in
      daily activities. After a period of 6 weeks following treatment, the effects on
      memory as well as the improvements in affective behaviour partially remained.

PMID- 7779293
TI  - Influence of prefeeding and scopolamine upon performance in a delayed matching-to
      position task.
AB  - The present study compared the influence of prefeeding (0, 10, 20 g or an
      unlimited amount of food pellets for a 90 min period prior to testing) with the
      effects of scopolamine (0, 0.03, 0.075 or 0.1 mg/kg s.c.) and scopolamine
      methylbromide (0.1 mg/kg s.c.) upon performance in the food reinforced delayed
      matching-to-position (DMTP) task. In preliminary studies using separate groups of
      rats, both scopolamine (but not scopolamine methylbromide) and prefeeding
      impaired choice accuracy in a seemingly delay-independent manner. Both treatments
      also increased omissions. However, while prefeeding increased all task latencies,
      scopolamine only increased sample latency. In a subsequent experiment, an
      intermediate dose of scopolamine (0.075 mg/kg s.c.) was directly compared with
      prefeeding in the same animals. Both treatments impaired choice accuracy,
      however, the effects of scopolamine were significantly larger than prefeeding.
      Conversely, prefeeding caused significantly greater omissions and larger
      increases in task latencies compared with scopolamine. These findings demonstrate
      some dissociation between the effects of scopolamine and prefeeding in the DMTP
      task, suggesting that the actions of scopolamine are not entirely due to
      reduction in motivation. Furthermore, the effects of scopolamine are likely to be
      centrally mediated.

PMID- 7779294
TI  - Distractibility and locomotor activity in rat following intra-collicular
      injection of a serotonin 1B-1D agonist.
AB  - The superior colliculus (SC) is thought to be the decision center for reactions
      to novel and/or moving stimuli in the peripheral visual field. Serotonin 1B (5
      HT1B) receptors were previously demonstrated to be located on collicular axon
      terminals of retinal ganglion cells and their activation might depress afferent
      inputs from the retina. The effects of intra-collicular injections of 5-HT1 drugs
      on distractibility were studied in hooded rats trained to run toward illuminated
      targets for a food reward in a 2-choice runway. 8-hydroxy-2-(di-n
      propylamino)tetraline (8-OH-DPAT), a 5-HT1A receptor agonist, RU 24969, a mixed 5
      HT1A and 5-HT1B agonist, serotonin-O-carboxymethylglycyltyrosinamide (S-CM
      GTNH2), a mixed 5-HT1B and 5-HT1D receptor agonist and saline (control) were
      alternately injected. Following the S-CM-GTNH2 treatment alone, animals exhibited
      an erratic running style, involving side-to-side movements of the head, without
      change in the overall accuracy of their locomotor trajectories, but with
      substantial decrease in their running speed. When distracting peripheral lights
      were introduced at the mid-points of the animals' run, in the weaker distracting
      condition (unilateral distractor) only, distraction indexes were found lower
      following the S-CM-GTNH2 treatment than following the other drug or saline
      treatments. It is concluded that serotonin, via 5-HT1B-1D receptors, may induce
      an elevation of the visual distractibility threshold by modulating directly the
      transmission of the primary visual signal.

PMID- 7779295
TI  - Attention and memory trials during neuronal recording from the primate pulvinar
      and posterior parietal cortex (area PG).
AB  - Cynomolgus monkeys were trained on a delayed match-to-sample (DMS) task. Several
      controls were performed for the separation of memory effects from other factors
      such as attention, stimulus attributes and eye movements. One of the controls
      employed a standardised sequence of events ('window trial') during which a window
      in a black screen was opened and a face, an object or a picture was presented.
      Unit cell activity was recorded from 209 sites in the posterior parietal cortex
      (area PG) and 186 sites in the pulvinar. Some units responded during the
      presentation of the DMS stimuli, mostly those in that part of area PG located in
      the superior temporal sulcus. They often appeared to be related to the task
      related state of attention. There was no indication of pure memory-related
      changes in activity such as sustained responses during the inter-stimulus
      interval or specific responses to the second stimulus that would indicate a
      dependence on the kind of the preceding stimulus. In the window trial, some
      parietal units, mostly in that part of area PG located in the intraparietal
      sulcus (a region termed area LIP), responded in a relatively specific manner
      during and sometimes even after, the presentation of a human face. The responses
      often seemed to be related to the animal's state of attention. Almost no pulvinar
      unit responded in this paradigm. It is concluded that area PG and, to a lesser
      extent, the pulvinar are involved in the modulation of attention in relation to
      behaviourally relevant changes in the environment. If these structures have a
      role in memory function, it must be secondary to a role in controlling or
      regulating attention.

PMID- 7779297
TI  - Molecular dynamics simulation of anesthetic-phospholipid bilayer interactions.
AB  - To probe the hypothesis of a lipid-mediated mechanism of general anesthetic
      action on a molecular level, and to help elucidate the nature of the interactions
      of bioactive compounds with membranes, the effects of trichloroethylene (TCE), an
      inhalational general anesthetic, on a dioleoylphosphatidylcholine (DOPC) lipid
      bilayer have been investigated by molecular dynamics (MD) simulations at 37
      degrees C and 1 atm and the results compared with 31P and 2H NMR experimental
      studies (Ref 1). The model used included a single TCE molecule embedded in a
      lipid bilayer consisting of 24 DOPC molecules and an 8 A layer of explicit water
      of solvation in each polar head group region of the bilayer, together with
      constant-pressure periodic boundary conditions in three dimensions. A comparison
      of the bilayer properties calculated in the presence and absence of the
      anesthetic led to the detection of three major perturbations of the bilayer
      caused by the anesthetic at 1 atm: i) an increase in the ratio of the effective
      areas of hydrocarbon tails and the head group per lipid, predicting the tendency
      of lipids near the anesthetic site of action to form a hexagonal phase (HII); ii)
      a slight increase in the frequency of chain dihedral angles found in the gauche
      conformation; and iii) a significant increase in the lateral mean-square
      displacement of lipid molecules, an indication of increased lipid lateral
      diffusion and membrane fluidity. The pressure antagonism of these effects was
      also studied by MD simulations at pressures of 200 and 400 atm. The study of the
      pressure reversibility of these effects at 200 and 400 atm indicated that they
      were partially prevented at 200 atm and essentially blocked at 400 atm,
      suggesting their probable relevance to the pressure reversal effect seen with
      general anesthesia. These results may thus provide insights into the interaction
      between general anesthetics and similar small organic molecules with membranes.

PMID- 7779296
TI  - Low-dose challenge by the NMDA receptor antagonist dizocilpine exacerbates the
      spatial learning deficit in entorhinal cortex-lesioned rats.
AB  - We investigated the effects of a bilateral quinolinic acid lesion of the medial
      entorhinal cortex (EC) on acquisition of a spatial learning task. During reversal
      of the same task, we challenged the animals by the N-methyl-D-aspartate (NMDA)
      receptor antagonist dizocilpine (MK-801). Training took postoperatively place in
      an eight-arm radial maze in which four of eight arms were baited. In the
      acquisition phase (ten blocks of five trials) of the test, EC-lesioned animals
      showed a working (WM) and a reference memory (RM) deficit. The WM deficit was
      prominent at the beginning and fully compensated at the end of the acquisition
      phase. The RM deficit became more evident during the course of the experiment. In
      the reversal learning phase (seven blocks of five trials), the formerly unbaited
      arms were baited and half of the control and lesioned animals were challenged by
      a low dose of dizocilpine (0.04 mg/kg i.p.) before training. Only lesioned and
      additionally dizocilpine-treated animals showed a WM deficit that was again
      compensated and a RM deficit that was stronger at the end of the test. In
      summary, quinolinic acid lesion of the medial EC induces both WM and RM deficits
      in rats. The WM deficit is rapidly compensated. Enhancement of these deficits by
      challenge with dizocilpine in the reversal learning phase suggests that the NMDA
      receptor system was rendered more sensitive by this type of lesion.

PMID- 7779298
TI  - Conformational properties of the Arg-Leu-Gly tripeptide--DMSO--water clusters
      with the combined use of molecular dynamics and energy minimization studies.
AB  - The Arg-Leu-Gly tripeptide is the repeating fragment of sequential arginine-rich
      polypeptides capable of interacting with DNA. The conformational influence of
      solvent molecules (DMSO/H2O) were investigated with the combined use of molecular
      dynamics and energy minimization. It was found that water molecules greatly
      contribute to the peptide structure by solvating all its hydrophylic sites even
      in the presence of DMSO excess, whereas one water molecule links the ammonium and
      carboxylic ends of the Arg-Leu-Gly. The persistence of residual water, which was
      confirmed by varying the computer simulation parameters, indicates that
      pretreatment of peptide segments in aqueous solutions should greatly affect their
      conformational properties in organic media. A satisfactory agreement between
      experimental data (1H-NMR and IR spectroscopy) and the presented computational
      study deserves also to be noted.

PMID- 7779299
TI  - Mathematical modelling of electrostatic fluctuations in subtilisin active site.
AB  - The intensities of electrostatic fluctuations in subtilisin active site generated
      by conformational motion of charged side chains, polar side chains and peptide
      bonds of the main chain are calculated. The comparative analysis of all these
      fragments reveals that there are few of them which make the main contribution to
      the total value of the intensity, which has been found to be approximately 10(7)
      g.cm-1.s-2. These are Ser 125, Thr 220 and peptide bonds of aminoacids 125-126,
      218-219. Our present analysis enables us to compare the relative contribution of
      different fragments but we do not pretend to obtain precise absolute values. The
      reason for this is the lack of the detailed selective information on the mean
      square amplitudes and correlation times of conformational motion of the fragments
      and on the values of local dielectric constants in the interior of subtilisin.
      The possibility for electrostatic fluctuations in enzyme active site to be an
      efficient nonspecific source of substrate activation is discussed.

PMID- 7779300
TI  - A statistical analytical approach to decipher information from biological
      sequences: application to murine splice-site analysis and prediction.
AB  - A simple statistical approach for the analysis of biological sequences, such as
      splice-sites, promoter regions, helices and extended structure forming regions or
      any other sequence dependent functional entities in proteins, is presented. The
      approach has been proved useful to develop a method for prediction of such
      entities in newly available sequences. We first search for invariant sequence
      features of each functional entity from the experimentally available sequences
      and identify a set of 'like' sequences with similar sequence features. In the
      next step, concrete features of sequence entities in terms of occurrences of
      smaller subsequences are identified at various positions which are used as a
      knowledge base to select potential functional entities from the identified 'like'
      sequences. The third step consists of refinement of this pattern learning,
      statistical improvements of the knowledge base weight matrices, and finally its
      application to predict functional entities in newly available sequences. Such an
      analysis is operationally described for murine splice-site predictions. Regions
      comprising -30 to +30 nucleotides from the splice-junction at the murine splice
      sites (donors and acceptors), reported earlier, were analyzed. Invariant sequence
      specific features in terms of monomer frequency average were used to identify
      splice-site-like sequences in the EMBL murine DNA sequence data base. The
      frequencies of occurrence of mono-, di-, tri- and tetranucleotides in the known
      splice-sites were studied in comparison with the splice-site-like sequences; the
      significant differences in their occurrences were extracted as statistical
      knowledge coded in weight matrices for computer to identify potential splice
      sites. The algorithm was refined and a method was developed to predict potential
      splice-sites in a given murine DNA; the analysis was also extended to human DNA.
      The success rate of the method to predict correct splice-sites in these species
      is found to be 80% and 85%, respectively. The major strength of this method lies
      in reducing significantly the number of false positives which are normally picked
      up in such analysis.

PMID- 7779301
TI  - Solution structure of a selectively 13C-labeled intramolecular DNA triplex.
AB  - The three-dimensional structure of an intramolecular triple helix whose three
      strands have been linked by a hexaethylene glycol chain, and selectively 13C
      enriched in position C1' on the third strand was investigated by NMR spectroscopy
      and constrained molecular mechanics calculations. Starting from different initial
      conformations, we show that the NOE constraints determined by the complete
      relaxation matrix calculation and iterative back-calculations allowed us to reach
      the same final restrained triple helix, taking into account implicitly the
      solvent effect. We conclude that this triplex adopted a B-type conformation
      rather than a A-type. The sugar pucker was found predominantly in the S-type
      conformation, in the range of C2'-endo geometry.

PMID- 7779302
TI  - Chirality and surface twist of DNA wrapped on protein surfaces.
AB  - The surface twist, STw, is a measure of the component of duplex twist associated
      with the trajectory of the DNA axis wrapped on a protein surface. We calculate
      STw for various surfaces of revolution, including the cylinder and truncated
      paraboloid, ellipsoid, and hyperboloid of revolution. We show that the sign of
      STw cannot be stated unequivocally from knowledge of the chirality of the
      wrapping but depends also upon the nature of the wrapping (protein) surface. We
      define and discuss three geometric classes. Class (1) includes the cylinder,
      certain types of convex paraboloids, all concave paraboloids, the prolate
      ellipsoid, and the hyperboloid; here STw > 0 for right-handed wrapping and STw <
      0 for left-handed wrapping. Class (2) is the sphere, for which STw = 0 for both
      types of handedness. Case (3) includes oblate ellipsoids and some regions of
      convex paraboloids; here STw < 0 for right handed wrapping and STw > 0 for left
      handed wrapping.

PMID- 7779303
TI  - Interaction with DNA of photoactive viologens based on the 6-(2-
      pyridinium)phenanthridinium structure.
AB  - A new type of DNA-interacting violgens derived from the N,N'-dialkyl 6-(2
      pyridinium)-phenanthridinium structure (in which dialkyl is -CH2CH2-,-CH2CH2CH2-,
      or (-CH3)2) have been synthesized. Electronic spectroscopy, steady-state and time
      resolved fluorescence, cyclic voltammetry, binding isotherms, viscosity
      titrations, and molecular modeling techniques were employed to characterize the
      structural, photophysical and redox properties of the novel drugs as well as the
      corresponding drug-DNA complexes. The viologens display significant visible
      absorption (up to ca. 490 nm), and a rather intense luminescence (phi cm from
      0.06 to 0.20 at 491-565 nm wavelength maxima) which is efficiently quenched by
      DNA. The calculated redox potentials of these drugs in their singlet excited
      state (+2.1 V vs. SHE) predict a large driving force for a photoelectron transfer
      reaction from the nucleobases to the drugs. Photochemical measurements of the
      viologens in the presence of mononucleotides, nucleosides, and deoxyribose
      indicate that the observed fluorescence quenching occurs indeed by electron
      transfer from the DNA bases rather than the sugar phosphate backbone. Large
      association constants to double helical DNA (in the order of 10(5) M-1) have been
      evaluated from the absorbance-based binding isotherms. Viscosimetry supports
      intercalation of the drugs into the DNA helix. Computer simulations (molecular
      mechanics of d(CGCGCG)2-drug complexes) confirm the intercalative nature of the
      binding and provide finer details about the geometry of the different viologen
      DNA complexes. Molecular modeling has also revealed a stereoselective interaction
      of the enantiomeric drug conformers with the chiral DNA helix. A DNA-targeted
      drug design of future generations of these ligands in order to improve and/or
      modulate their photochemical, redox, and nucleic acid binding properties appears
      to be possible by a careful selection of the N,N'-dialkylating chain and/or the
      substituents on the azaheterocyclic moieties.

PMID- 7779304
TI  - DNA interaction of the imidazole-containing lexitropsin ImPy: titration
      viscometric study in comparison to netropsin.
AB  - The imidazole (Im) containing lexitropsin ImPy related to netropsin (Nt) is a
      sequence reading DNA ligand which, in contrast to Nt, permits binding to a GC
      base pair. The ImPy induced DNA conformational changes differ significantly from
      those induced by Nt as monitored by titration viscometry, although interaction
      modes have also been resolved with boundaries at the same ligand to DNA phosphate
      ratio, r. Evidently ImPy covers similar binding sites (in the same sequence) as
      Nt for natural calf thymus DNA at r < 0.023. This result suggests that the
      preferred binding sites of ImPy are A tracts (cf. K.E.R. JBSD 9(1993) 973), in
      agreement with previous data. The respective DNA coil expansion, most probably
      caused by unbending (l.c.), is similar but smaller compared to the Nt-DNA
      interaction. These results again suggest that, at low r values, the van der Waals
      interaction in the narrowed minor groove of AT clusters provides a dominating
      energy contribution to ImPy binding. At r > 0.03 the DNA coil expansion increases
      to extremely high values in that r range where Nt binding (to mixed AT/GC
      sequences) induces no effect at all owing to steric hindrance with the amino
      group of guanine. On the basis of many quantitative results for the Nt-DNA
      systems these effects can be understood in terms of an unbending of intrinsic
      helix bends (l.c.). They are of considerable interest in connection with the
      ability of such compounds to influence the direction of the local regulatory
      relevant DNA curvature.

PMID- 7779305
TI  - Comparison of different footprinting methodologies for detecting binding sites
      for a small ligand on DNA.
AB  - In order to assess the utility of different methods of footprinting applied to
      the study of sequence-selective small molecule-DNA interaction we have performed
      a homologous series of experiments on the binding of echinomycin, a bis
      intercalator, to a 133 base pair DNA restriction fragment containing a small
      number of discrete binding sites. Two of those sites each contained a pair of
      closely clustered CpG steps, the cognate dinucleotide sequence which is the
      common denominator of sites recognised by echinomycin. DNAse I was found to be
      much the best enzyme for footprinting in terms of sensitivity, accuracy, and ease
      of handling. DNAase II and micrococcal nuclease were of limited value. Excellent
      results were recorded with methidiumpropyl-EDTA.FeII which picked up strong
      binding sites and yielded sharp footprints from which a parsimonious estimate of
      site size could be determined. Orthophenanthroline.CuI proved to be a very
      suitable, sensitive chemical nuclease but hydroxyl radical footprinting with
      EDTA.FeII was only partially successful. Positive footprinting with conformation
      sensitive probes diethylpyrocarbonate, osmium tetroxide and potassium
      permanganate yielded information to complement that afforded by the enzymic and
      chemical nucleases. Evidence of binding to both CpG steps in the clustered pair
      was obtained, with indications of possible cooperativity.

PMID- 7779306
TI  - Distortion after monofunctional alkylation by mitomycin C of a dodecamer
      containing its major binding site.
AB  - The structural distortions of the duplex dodecamer d(ATTAACGTTAAT)2
      monofunctionally alkylated by mitomycin C have been studied by the use of
      chemical probes reactivity and resonance Raman spectroscopy. This sequence
      contains the 5'-ACGT sequence for which mitomycin C was determined to present the
      best affinity (S. Kumar, R. Lipman, and M. Tomasz, Biochemistry 31, 1399 (1992)).
      Raman spectroscopy as well as osmium tetroxyde reactivity indicate that the
      distortion of the double helix structure is located around the central CG bases.
      Mitomycin C reacts exclusively with the 2-amino group of guanine and this binding
      does not disrupt the inter bases H-bonds, as indicated by chloroacetaldehyde
      reactivity. Although resonance Raman spectroscopy does not allow the handedness
      of the monoalkylated CG/GC sequence to be determined, it indicates a similarity
      between the base stacking and that which would be observed for alternating
      purine/pyrimidine sequences at high salt concentration.

PMID- 7779307
TI  - Molecular dynamics simulations of chlorambucil/DNA adducts. A structural basis
      for the 5'-GNC interstrand DNA crosslink formed by nitrogen mustards.
AB  - The alkylation of DNA by chlorambucil has been studied using a computational
      approach. Molecular dynamics simulations were performed on the fully solvated non
      covalent complex, two monoadducts and a crosslinked diadduct of chlorambucil with
      the d(CGG3G2CGC).-d(GCG1CCCG) duplex, in which the N7 atoms of G1, G2 and G3 are
      potential alkylation sites. The results provide a structural basis for the
      preference of nitrogen mustards to crosslink DNA duplexes at a 5'-GNC site (a 1,3
      crosslink, G1-G3) rather than at a 5'-GC sites (a 1,2 crosslink, G1-G2). In the
      non-covalent complex simulation the drug reoriented from a non-interstrand
      crosslinking location to a position favorable for G1-G3 diadduct formation. It
      proved possible to construct a G1-G3 diadduct from a structure from the non
      covalent simulation, and continue the molecular dynamics calculation without
      further disruption of the DNA structure. A crosslinked diadduct developed with
      four BII conformations on the 3' side of each alkylated guanine and of their
      respective complementary cytosine. In the first monoadduct simulation the
      starting point was the same DNA conformation used in the crosslinked diadduct
      simulation with alkylation at G1. In this simulation the DNA deformation was
      reduced, with the helix returning to a more canonical form. A second monoadduct
      simulation was started from a canonical DNA conformation alkylated at G3. Here,
      no significant motion towards a potential crosslinking conformation occurred.
      Collectively, the results suggest that crosslink formation is dependent upon the
      drug orientation prior to alkylation and the required deformation of the DNA to
      permit 1,3 crosslinking can largely be achieved in the non-covalent complex.

PMID- 7779308
TI  - Predictors of fear of falling in dizzy and nondizzy elderly.
AB  - Fear of falling may constitute an independent risk factor for disability, leading
      older people to unnecessarily restrict their activity. Sixty older adults with
      chronic dizziness and 66 healthy controls were studied to help clarify the
      interrelationships among demographic factors, psychological status, physical
      health, and fear of falling. Chronic dizziness was strongly associated with fear
      of falling; among dizzy patients, nearly half (47%) expressed fear of falling, in
      comparison with 3% of controls. In participants with dizziness, 3 factors
      predicted fear of falling: an activity of daily living score, the revised Symptom
      Checklist 90 Depression (Derogatis, 1983) score, and stability when standing with
      feet together. These results support the concept that fear of falling is multiply
      determined and that psychological factors play a major role in influencing the
      symptoms and responses in many older patients with dizziness.

PMID- 7779309
TI  - Age differences in conversational source monitoring.
AB  - The present investigation simulated a group conversation in which participants
      asked (inquirer) and answered (responder) questions, as well as listened to
      others exchange information. Source (inquirer; responder) identification accuracy
      was evaluated immediately or after 1 week. Older adults were less adept at source
      identification, although this difference was reduced with personal (Experiment 2)
      rather than categorical (Experiment 1) topics. The age difference was independent
      of explicit memory (cued recall and recognition), suggesting that memory for
      source and information are separable. Older adults were comparable to younger
      adults in responder identification but worse at inquirer identification.
      Responder identification was better than inquirer identification, with the latter
      dropping to chance at 1 week. Source identification was most accurate when
      participants were in the responder role; there was little difference between the
      inquirer and listener roles.

PMID- 7779310
TI  - Adult life span changes in immediate visual memory and verbal intelligence.
AB  - A sample of 558 women and 1,163 men 17 to 102 years old, screened for
      neurodegenerative and neuropsychiatric disease, was administered tests of
      immediate visual memory (Benton Visual Retention Test) and crystallized
      intelligence (Wechsler Adult Intelligence Scale Vocabulary subtest) from 1 to 5
      times over 27.7 years. Cross-sectional and longitudinal evidence led to the
      conclusion that the 65-74-year decade was a watershed for decremental changes in
      immediate visual memory and verbal intelligence. Age accounted for considerably
      less variance in vocabulary than in immediate memory. The proportion of
      individuals whose longitudinal trajectories were contrary to group trends
      decreased substantially with increased age; observed age changes remained when
      analyses were restricted to individuals who had perfect or near-perfect mental
      status scores. Selected neuronal loss and slower reproduction times were
      considered as possible causes.

PMID- 7779311
TI  - Emotional behavior in long-term marriage.
AB  - In exploring the emotional climate of long-term marriages, this study used an
      observational coding system to identify specific emotional behaviors expressed by
      middle-aged and older spouses during discussions of a marital problem. One
      hundred and fifty-six couples differing in age and marital satisfaction were
      studied. Emotional behaviors expressed by couples differed as a function of age,
      gender, and marital satisfaction. In older couples, the resolution of conflict
      was less emotionally negative and more affectionate than in middle-aged
      marriages. Differences between husbands and wives and between happy and unhappy
      marriages were also found. Wives were more affectively negative than husbands,
      whereas husbands were more defensive than wives, and unhappy marriages involved
      greater exchange of negative affect than happy marriages.

PMID- 7779312
TI  - Realization of generativity in two samples of women at midlife.
AB  - On the basis of E. H. Erikson's (1950/1963) theory of midlife development, a
      measure of generativity realization was constructed with items from J. Block's
      (1961/1978) California Adult Q-Set (CAQ). Convergent and discriminant validity
      for the new CAQ measure were established through a survey of 2 samples of
      educated women at about 43 years of age (N = 208). These 2 samples, 1 from a
      study of Mills College graduates and the other from a study of Radcliffe College
      graduates, were also used to examine the personality, attitudinal, and life
      outcome correlates of generativity at midlife. Results indicated that generative
      women have prosocial personality characteristics, express generative attitudes
      through their work, are invested in the parenting process, and exhibit an
      expanded radius of care. In general, results conceptually replicated in the Mills
      and Radcliffe samples.

PMID- 7779313
TI  - Playing with pets and longevity among older people.
AB  - Models of the relations between contact with pets and better health are examined
      in an archival prospective study using data derived from the longitudinal study
      initiated by Terman in 1921 (current N = 343 men, 300 women). In survival
      analyses of documented longevity, playing with pets in 1977 (M age = 67 years)
      was not associated with mortality risk through 1991 for the total sample nor for
      those who were unmarried or those who were less satisfied with their human
      relationships. Playing with pets was not associated with health-prone attributes
      or healthy behaviors such as personality, social ties, education, and smoking.

PMID- 7779314
TI  - Cognition and depression in a cohort of aging men: results from the Western
      Collaborative Group Study.
AB  - Relationships between cognitive performance and self-ratings of depression on the
      Center for Epidemiologic Studies Depression scale (CES-D; L.S. Radloff, 1977)
      were examined for 1,217 older men. After controlling for demographic variables
      and both objective and subjective measures of health, significant associations
      were observed between several CES-D variables and measures of cognitive mental
      status, memory, and psychomotor speed. The Well-Being factor of the CES-D was the
      most robust predictor of cognitive scores. Therefore, for older adults with
      generally favorable health and socioeconomic resources, there may be a link
      between positive affect and maintenance of cognitive effectiveness.

PMID- 7779315
TI  - Aging and negative priming in a location suppression task: the long and the short
      of it.
AB  - The role of temporal parameters in aging and inhibitory function was examined
      using negative priming (NP) and repetition priming (RP) in a task involving a
      series of visually presented prime-probe sets; responses were made on the basis
      of the location of a target stimulus. Preparatory intervals (PI) preceding prime
      probe sets were 3,000 ms or 1,500 ms. The longer PI resulted in less NP in older
      adults than did the shorter PI. Further analysis suggest that older adults may be
      less prepared to inhibit the distractor following the longer PI. The longer PI
      also produced more RP than did the shorter PI for both age groups, indicating a
      greater emphasis on facilitatory processes in this condition. In addition,
      evidence was obtained to suggest that an inverse relationship between NP and RP
      exists for both young and old adults. These data suggest that individuals or task
      conditions may emphasize either facilitation or inhibition in selection.

PMID- 7779317
TI  - Sleep compression and sleep education for older insomniacs: self-help versus
      therapist guidance.
AB  - A treatment package consisting of a bed-time restriction strategy and education
      was administered to 50 insomniacs and 50 noninsomniacs 60 years or older. Half of
      the insomniacs and noninsomniacs received treatment through a self-help video
      only, whereas the remaining treated participants received therapist guidance to
      supplement the video. A waiting-list control group of 25 senior insomniacs was
      also included. Sleep knowledge was equivalent for senior insomniacs and
      noninsomniacs. The self-help insomniac group exhibited improvement on multiple
      sleep variables, but the addition of therapist guidance appeared to enhance
      treatment outcome for sleep latency, wake time after sleep onset, and sleep
      satisfaction. Control participants also improved across time but were generally
      outperformed by treated insomniacs.

PMID- 7779318
TI  - A comparison of coping strategies of aging mothers of adults with mental illness
      or mental retardation.
AB  - Differences in coping by 105 aging mothers of adults with mental illness and 389
      similar mothers of adults with mental retardation were investigated. Although no
      differences in problem-focused coping were found, mothers of adults with mental
      illness used more emotion-focused coping, which predicted greater maternal
      depression. For mothers of adults with retardation, depressive symptoms were a
      function of their child's behavior problems, although this source of stress was
      buffered by coping. For mothers of adults with mental illness, depression was a
      function of caregiving demands, but coping did not buffer the effects of stress.
      Explanations for findings include maternal perceptions of the context of care, of
      her control over the disability, and her caregiving efficacy.

PMID- 7779319
TI  - Predictors of planned retirement age: an application of Beehr's model.
AB  - Given the aging workforce, understanding the retirement process is an area of
      increasing interest to organizations. T. A. Beehr's (1986) model of retirement
      behavior was used in this study as a basis for selecting personal, psychological,
      and organizational predictors of subsequent planned retirement age. In addition,
      potential differences in predictors of the planned retirement age of retirement
      eligible and retirement-ineligible respondents were explored. Two hundred sixty
      four respondents working for a large multinational firm completed 2 surveys on
      their attitudes toward work and retirement. Results showed that chronological
      age, employee health, and self-perceptions of the ability to adjust to retirement
      predicted subsequent planned retirement age. Interactions of the predictors with
      retirement eligibility are reported along with implications for retirement
      planning programs.

PMID- 7779316
TI  - Genetic mediation in the relationship of education to cognitive function in older
      people.
AB  - We used data from 136 monozygotic and 125 dizygotic human, male twin pairs (M age
      = 64 years, range = 59 to 70 years) to test whether the previously observed
      association (r = .30, p < .01) between cognitive performance and education in
      this sample is genetically mediated. Biometric genetic modeling found that a
      common genetic latent variable accounted for 44% of the total variance in the
      Mini-Mental State Exam (MMSE: M. F. Folstein, S. E. Folstein, & P. R. McHugh,
      1975), 40% of the variance in the Iowa Screening Battery for Mental Decline (P.
      J. Eslinger, A. R. Damasio, & A. L. Benton, 1984), and 21% of the variance in
      educational attainment. In addition, specific genetic and environmental variables
      contributed significantly to individual differences in education and cognitive
      performance of the participants.

PMID- 7779320
TI  - Generalized slowing in sinusoidal tracking by older adults.
AB  - Older and younger adults manually tracked sinusoidal input signals. Older adults
      exhibited 2 forms of slowing. First, they lagged behind the target somewhat more
      than younger adults. Second, they made considerably smaller movements than the
      younger adults. Because the velocity of a sinusoidal pattern is proportional to
      its amplitude, these smaller movements were also slower. Both older and younger
      adults made smaller movements with a compensatory display and with higher
      frequency inputs. The high degree of proportionality among these effects was
      taken as evidence for generalized slowing by the older adults. This slowing may
      prevent older adults from successfully adjusting an internal pattern generator to
      match their motions to the sinusoidal input signal.

PMID- 7779321
TI  - Discourse comprehension and problem solving: decisions about the treatment of
      breast cancer by women across the life span.
AB  - The 1st study examined the decision making and prose comprehension of 94 women
      interacting with an authentic, unfolding health scenario about breast cancer. The
      2nd study involved questionnaire data focusing on the decisions made by 75 women
      who had been diagnosed with breast cancer. Two major findings emerged from this
      laboratory and survey research. First, older women sought less information when
      making treatment decisions about breast cancer. However, the outcome of those
      decisions were equivalent to those of younger women. Second, older women made
      these decisions faster than younger women. In addition, treatment decisions were
      related to prose processing, the type of information underlined as important
      while reading as well as the type of information remembered about various
      treatment options.

PMID- 7779322
TI  - Bis(acetato)amminedichloro(cyclohexylamine)platinum(IV), an orally active
      anticancer drug.
AB  - The structure of the anticancer drug bis(acetato)
      amminedichloro(cyclohexylamine)platinum(IV), [PtCl2-(C2H3O2)2(C6H13N)(NH3)], is
      reported. The acetato groups are axial to the square plane composed of the
      chlorine and amine substituents. The cyclohexane ring may sterically hinder one
      of the acetato groups for metabolic attack. The amine groups are hydrogen bonded
      to the carbonyl O atoms of the acetato groups.

PMID- 7779323
TI  - (2,3,7,8,12,13,17,18-Octaethylporphinato)perchloratomanganese(III).
AB  - The crystal structure of [Mn(OEP)(OClO3)] (where OEP = C36H44N4) has been
      determined. The axial Mn-O bond length is 2.183 (2) A and the equatorial Mn-Np
      bond lengths have an average value of 2.000 (5) A. The molecules form weak dimers
      in the solid state with interring distances of 3.49 A and a lateral shift of 3.27
      A. The compound is found to be isomorphous with the iron derivative
      [Fe(OEP)(OClO3)]. A brief comparison of the structural parameters for the two
      molecules is given.

PMID- 7779324
TI  - KR-25003, a potent analgesic capsaicinoid.
AB  - The crystal structure of N-[3-(3,4-dimethylphenyl)propyl] (4-hydroxy-3
      methoxyphenyl)acetamide, C20H25NO3, was determined to a final R value of 0.047.
      The vanilloid, amide and dimethylphenyl groups of the compound are nearly
      perpendicular with respect to one another. The overall conformation in the
      crystalline state is somewhat different from that of other capsaicinoids. The
      molecules are stabilized by intermolecular hydrogen bonds.

PMID- 7779325
TI  - 8-Acid derivative of the antitumour agent mitozolomide.
AB  - The crystal structure of 3-(2-chloroethyl)-3,4-dihydro-4-oxoimidazo[5,1
      d][1,2,3,5]tetra zine-8- carboxylic acid, C7H6CIN5O3, a derivative of the novel
      bicyclic antitumour agent mitozolomide, 3-(2-chloroethyl)-3,4-dihydro-4
      oxoimidazo[5,1-d][1,2,3,5]tetra zine-8- carboxamide, has been determined at 293
      K. The expected dimer, hydrogen bonded via the two carboxyl groups, does not
      occur. In preference, the two molecules in the asymmetric unit utilize hydrogen
      bonding between the carboxyl group of one and the N atom and CH in the imidazo
      ring of the other. These two then further interact via the same scheme with their
      centrosymmetrically related pair to produce a fully hydrogen-bonded planar
      tetramer.

PMID- 7779326
TI  - Methyl (2S,6S:2R,6R)-6-(2-cyanoethyl)-4,6-dimethyl-2-morpholineacetate.
AB  - The morpholine ring of the title compound, C12H20N2O3, adopts a chair
      conformation with an equatorial (methoxycarbonyl)methyl group. The cyanoethyl and
      (methoxycarbonyl)methyl groups are trans with respect to each other. The global
      minimum conformation, as computed by PCMODEL [Gajewski & Gilbert (1992).
      Molecular Modeling Package. Version 4.0], of the title compound agrees with that
      observed in the crystal. In the crystal, the torsion angles (N identical to)C-CH2
      CH2-C(O), (N identical to C)CH2-CH2-C-O, O-CH-CH2-C(OOCH3) and (O)CH-CH2-C(O)
      O(CH3) have values -170.0 (1), -45.9 (2), -71.6 (2) and 142.8 (1) degrees,
      respectively.

PMID- 7779327
TI  - X-ray microscopy.
AB  - The subject of X-ray microscopy (high-resolution X-ray imaging of general
      nonperiodic structures), an area in which much progress has been made in recent
      years, is reviewed. The main techniques are briefly described. Achievable
      performance levels, which for many years were highly speculative, can now be
      understood with fair accuracy in terms of basic X-ray and specimen properties,
      and techniques have progressed to the point where actual results are nearing
      those levels. In terms of specimen size and imaging resolution, X-ray
      microscopies lie between electron and light microscopy, and are thus suited to
      imaging extremely large and complex structures; in addition, they demand little
      or no specimen preparation, and can be used to observe local composition and
      chemical state as well as structure. Thus X-rays, which have played the leading
      role in imaging crystallizable materials, may also prove to be highly valuable in
      the imaging of very large non-crystalline structures. Throughout the treatment,
      attention is paid to the relationships connecting the subject with X-ray
      crystallography.

PMID- 7779328
TI  - Physiatry as a primary care specialty.
AB  - The ongoing changes in health care seek to create an affordable, accessible, and
      high-quality health care delivery system for all Americans. In response to this,
      Physical Medicine and Rehabilitation (PM&R) is re-examining its role in the
      provision of health care to the disabled, particularly the severely affected. We
      surveyed 100 physiatrists and 100 PM&R residents across the country regarding
      their opinions on the competence, qualifications, and desire of physiatrists to
      provide primary care for the disabled. Fifty-five physiatrists and 51 residents
      responded (55% overall). Thirty-nine percent of all respondents agreed that PM&R
      should be designated as a primary care specialty, and 53% believed that
      physiatrists should provide primary care to the severely disabled (e.g., spinal
      cord and head injury). Overall, 53% felt that physiatrists are competent in
      general medical care, but 38% are convinced that the current 4-yr PM&R residency
      training sufficiently prepares physiatrists to assume the role of a primary care
      provider. Of the patient populations considered, the respondents thought that
      physiatrists should manage the care of spinal cord injury (60%) and head injury
      (51%), but only 40% were willing to assume primary care responsibilities.

PMID- 7779329
TI  - Postoperative transcutaneous oxygen measurement in the prediction of delayed
      wound healing and prosthetic fitting among amputees during rehabilitation. A
      pilot study.
AB  - Postoperative assessment of amputation wound healing remains largely subjective
      in nature, being based on the physician's clinical judgement. These
      considerations significantly impact on the rehabilitation course, as premature
      prosthetic fitting may result in wound breakdown. Alternatively, delayed healing
      may result in prolonged hospital length of stay. Few attempts have been made to
      correlate objective parameters of limb perfusion with amputation wound healing or
      prosthetic fitting outcome during the rehabilitation phase of treatment. A pilot
      study was conducted, in which the transcutaneous oxygen monitor, a noninvasive
      device measuring transcutaneous partial pressure of oxygen (tcpO2), was applied
      to the stumps of 11 consecutive above-or below-knee amputees admitted for
      rehabilitation after amputation. All patients were tested within 1 wk of
      admission and 45 days of amputation. The treatment team was blinded as to the
      test results. A direct correlation was observed between wound healing outcome and
      tcpO2 results (Fisher's exact test [FET], P = 0.03), and no patient with a tcpO2
      of < or 15 mm Hg healed during their rehabilitation stay (FET, P = 0.006). TcpO2
      of < or = 15 mm Hg was significantly correlated with prolonged length of stay
      (Point Biserial Correlation Coefficient [rpbi], = -0.835; P = 0.01), delayed
      prosthetic fitting (rpbi = 0.742; p = 0.01), and poorer wound healing at
      admission (rpbi = 0.932; P = 0.001). Postoperative tcpO2 measurement may have use
      in objectively identifying patients at greater risk of delayed wound healing and
      prosthetic fitting, although further study is warranted.

PMID- 7779330
TI  - Transcutaneous electrical nerve stimulation. Relevance of stimulation parameters
      to neurophysiological and hypoalgesic effects.
AB  - Although Transcutaneous Electrical Nerve Stimulation (TENS) has become a popular
      modality in pain management over the past 20 yr, there is still debate over its
      mechanisms of action and the precise relevance of stimulation parameters to its
      hypoalgesic effects. Thus, confusion still surrounds the selection of optimal
      stimulation parameters. Two separate studies (total n = 88) were carried out to
      investigate the effect of four combinations of TENS pulse durations (50
      microseconds & 200 microseconds) and frequencies (4 Hz and 110 Hz) on nerve
      conduction in the human superficial radial nerve and on Mechanical Pain Threshold
      (MPT) within the associated sensory distribution of the nerve over the dorsum of
      the hand. Results showed that application of one combination of TENS parameters
      (110 Hz, 200 microseconds) directly over the course of the nerve produced a
      significant increase in both peripheral nerve conduction latency (P < or = 0.05;
      analysis of variance (ANOVA)) and MPT (P < or = 0.01). In addition, there was a
      high correlation (r = 0.9) between shifts in MPT and negative peak latency for
      the groups treated with this combination of TENS parameters. The results of this
      study thus illustrate that combinations of TENS parameters are important to the
      peripheral neurophysiological effects of this modality and, further, its
      associated hypoalgesic effects, at least on the model of pain used here.

PMID- 7779331
TI  - Facilitatory effect of thinking about movement on motor-evoked potentials to
      transcranial magnetic stimulation of the brain.
AB  - Two experiments using transcranial magnetic stimulation (TMS) were undertaken to
      investigate facilitatory effects of thinking about a specific movement without
      voluntary discharges on motor-evoked potentials (MEP). First, surface
      electromyographic (EMG) responses from the abductor pollicis brevis were recorded
      with maximal stimulator output in the three conditions: the muscle being at rest,
      contracting with 10% of maximal muscle activity, and with the subject "only
      thinking" about thumb abduction (nine subjects). Median value of MEP amplitudes
      during "only thinking" was twice that at rest (P = 0.008) and one-half that
      during voluntary contraction (P = 0.008). Second, needle EMG responses from the
      first dorsal interosseus were compared at rest, during thinking about index
      finger abduction, and during TMS at threshold intensity. Four normal subjects
      were tested with stimulation of each cerebral hemisphere for a total of eight
      tests. The number of detectable MEP responses of 20 stimuli to one hemisphere was
      counted for each condition of rest or thinking. The mean MEP response rate during
      thinking (58%) was higher than that at rest (12%) (P < 0.005). These results
      demonstrate that thinking about a specific movement has facilitatory effects on
      MEP and that the degree of facilitation in thinking is smaller than in voluntary
      contraction.

PMID- 7779332
TI  - Prevalence of depression and outcome on the geriatric rehabilitation unit.
AB  - Although numerous studies have examined the prevalence of depression after stroke
      and its relationship to functional outcome, minimal research attention has been
      focused on depression in the acute inpatient rehabilitation setting. Fifty-one
      consecutive admissions to a geriatric rehabilitation unit were screened for
      depression using the Geriatric Depression Scale at both admission and discharge.
      Depressed v nondepressed patients were compared on the following variables: age,
      length of stay (days), admission Functional Independence Measure (FIM) score,
      discharge FIM score, change in FIM score, Mini-Mental State Exam score, and
      discharge to nursing home v home. Depression was prevalent in 29.4% at admission.
      Depression at admission was not associated with any significant differences in
      the above variables, but patients classified as depressed at discharge had lower
      FIM scores at both admission and discharge. Clinical implications and
      recommendations for future research are discussed.

PMID- 7779333
TI  - Admission motor impairment as a predictor of physical disability after stroke
      rehabilitation.
AB  - The purpose of this study is to investigate the Fugl-Meyer Motor Impairment Scale
      and physical disability as measured by the Functional Independence Measure (FIM)
      as predictors of physical independence after stroke inpatient rehabilitation.
      Forty-eight patients admitted to a rehabilitation hospital within 6 wk of their
      first unifocal stroke were prospectively studied. Upper and lower extremity Fugl
      Meyer scores were obtained near rehabilitation admission. FIMs were obtained on
      admission and discharge. Discharge FIM self-care was predicted best by admission
      FIM total (rs = 0.75; P < 0.0001), although admission FIM self-care, other FIM
      components, and upper- and lower-extremity Fugl-Meyer scores were also good
      predictors. Discharge FIM mobility and locomotion correlated well with their
      admission counterparts (rs = 0.54 and 0.45; P < 0.001 and < 0.01, respectively)
      but were even more strongly related to admission Fugl-Meyer scores (rs = 0.63 and
      0.74, respectively; P < 0.0001). As expected, cognitive and psychosocial
      components of the FIM at discharge correlated poorly with admission Fugl-Meyer.
      These data confirm the strong motor impairment basis for the physical disability
      subdimensions of the FIM and suggest that dependency in physical activities of
      daily living after stroke is primarily determined by degree of motor impairment.

PMID- 7779334
TI  - Journal clubs. Prevalence, format, and efficacy in PM&R.
AB  - Journal clubs can play an integral part in graduate medical education. They
      promote critical thinking, dissemination of information, and research and impact
      clinical practice. Little has been written, however, about how to organize a
      journal club or improve its efficacy. Although numerous articles discuss how
      journal clubs can be used to evaluate medical literature, only a few have
      examined what physicians are actually doing. We surveyed all accredited PM&R
      program chief/residents to ascertain the prevalence, format, and efficacy of PM&R
      residency journal clubs. All programs that responded (89%) reported having a
      journal club, with most stating its purpose was to disseminate information from
      the current literature. Review of classic articles and specialty topics (e.g.,
      electromyography, sports medicine) was fairly uncommon. Eighty-four percent of
      journal clubs were department-sponsored, and most met monthly for 1 hr during the
      workday. Typically, four or more articles were presented under the guidance of
      the chief or other resident. Impacting clinical practice and teaching critical
      analysis were other important goals of the journal clubs, yet most (76%) lacked
      an organized method for critical review. This, in addition to poor faculty
      attendance, was a chief concern of those surveyed. Surprisingly, journal club
      participation was not felt to significantly alter the amount of reading residents
      did. Although most felt their journal clubs were successful, improving faculty
      participation, strengthening critical analysis skills, identifying and
      incorporating classic articles, improving clinical relevance, and providing a
      mechanism for feedback may further improve journal club efficacy and participant
      satisfaction.

PMID- 7779336
TI  - Need for academic physiatry in the era of health care reform.

PMID- 7779335
TI  - Guillain-Barre syndrome leading to a conversion reaction in a teenage girl. Case
      report.
AB  - Conversion disorder can sometimes simulate Guillain-Barre Syndrome (GBS). This
      often involves the mimicry of organic symptoms similar to those experienced by a
      relative or acquaintance. The patient with the conversion unconsciously adopts
      these symptoms to convert their psychologic stress to a physical phenomenon. This
      case is of 15-yr-old girl who had a documented case of GBS and who subsequently
      had recurrent episodes of a conversion disorder that simulated her original GBS
      presentation. The methods for diagnostically separating recurrent GBS from
      conversion reaction are noted.

PMID- 7779338
TI  - Failure to diagnose osteoporosis.

PMID- 7779337
TI  - Epidemiology of walker-related injuries and deaths in the United States.

PMID- 7779339
TI  - Conference report: an agenda for medical rehabilitation outcomes research.
AB  - On August 29 to 31, 1994, a conference was conducted to develop recommendations
      for needed initiatives in medical rehabilitation outcomes research. Organized by
      the National Center for Medical Rehabilitation Research and cosponsored with the
      Agency for Health Care Policy and Research, the conference was entitled "An
      Agenda for Medical Rehabilitation Outcome Research." The resulting
      recommendations are presented in four areas: philosophic issues; strategy and
      design issues; measurement of disability and handicap; and measurement of quality
      of-life and of health status.

PMID- 7779340
TI  - Four well documented cases of adventitious bursae on the distal anterior stumps
      of below-knee amputees.

PMID- 7779341
TI  - How many muscles should be studied (via needle electromyography (EMG)) to
      identify a lumbosacral radiculopathy.

PMID- 7779342
TI  - Parent perspectives of peer relationships and friendships in integrated and
      specialized programs.
AB  - In-depth interviews of a large community-based sample of mothers of preschool-age
      children with established disabilities and those classified as at-risk were
      conducted focusing on issues of children's peer relations and friendships.
      Results revealed that mothers of children enrolled in both integrated and
      specialized programs perceived their respective settings as valuable for the
      development of their child's peer relations and friendships. Mothers of children
      in integrated settings reported that their child played better and was more
      social due to the participation of children without special needs. A similar
      pattern was obtained for mothers of children enrolled in specialized programs in
      response to a hypothetical situation. Nevertheless, both groups of mothers were
      clearly concerned about peer rejection and noted the importance of having other
      children with special needs in the program available as a means of promoting
      tolerance and acceptance.

PMID- 7779343
TI  - Emotion specificity in mental retardation.
AB  - The emotion-specificity hypothesis states that mental retardation is associated
      with deficits in decoding facially expressed emotions that cannot be fully
      accounted for by MA. Research has demonstrated repeatedly that subjects with
      mental retardation do not perform as well on emotion recognition tasks as do
      control subjects but not whether those performance deficits are specific to
      affective cues. The emotion-specificity hypothesis was tested further with three
      groups of 16 subjects: adults with mild to moderate mental retardation, similar
      age adults without mental retardation, and children without mental retardation
      matched for mental age (MA). Subjects completed the Facial Discrimination Task,
      which has two subtasks consisting of 40 monochrome facial photographs, and rated
      stimuli on scales ranging from happy to sad or from young to old. Results
      supported the emotion-specificity hypothesis: The retarded group was
      significantly less accurate on the emotion task than were both control groups. On
      the age task the retarded adult group and nonretarded child group were less
      accurate than the adult control group.

PMID- 7779344
TI  - Elderly mothers caring at home for offspring with mental retardation: a model of
      permanency planning.
AB  - A theoretical model of permanency planning based on the double ABCX model of
      family stress and adaptation (McCubbin & Patterson, 1982) was tested using
      structural equation modeling. We interviewed 235 mothers, ages 58 to 96, who
      cared for adult offspring with mental retardation at home. Four variables were
      confirmed to directly influence their stage of planning: use of services for
      offspring, non-use of avoidance coping, the self-perception of being adversely
      affected by age-related changes, and help from offspring without mental
      retardation. Variables found to affect planning indirectly were perceived need
      for services, mothers' subjective burden, extent of caregiving tasks, offsprings'
      disability, and mothers' disability.

PMID- 7779346
TI  - Effect of object and movement cues on receptive communication by preschool
      children with mental retardation.
AB  - Preschool children with mental retardation typically have delays in language
      comprehension that may result in difficulty understanding spoken messages. The
      effect of the systematic application of object and movement cues was investigated
      to determine whether either or both cues would facilitate children's
      comprehension of a partner's intended referent during play and snack activities.
      Children were presented with stimulus items that the communication partner
      referred to under three conditions: object cue and speech, movement cue and
      speech, or speech alone. All children identified the intended referents with
      fewer trials to criterion when object or movement cues were used with speech than
      when speech alone was employed.

PMID- 7779345
TI  - Psychotropic drugs in group homes: prevalence and relation to
      demographic/psychiatric variables.
AB  - All 1,101 clients residing in over 120 group homes of a residential services
      agency were surveyed on one date for presence of psychotropic medication. In all,
      27% received one or more psychotropic drugs for behavioral or emotional
      disorders. Disorders and target behaviors listed for each drug group were
      examined and the relations between drug groups and diagnostic/demographic
      variables analyzed. In addition, logistic regression analyses were used to
      examine subject variable/drug relations further and the likelihood of receiving a
      specific class of medication given the presence of a subject variable. Certain
      physical and sensory handicaps were associated with less medication use.
      Generally speaking, the existence of DSM diagnoses (especially psychosis and mood
      disorder) and certain target behaviors were associated with greater medication
      use. In the main, medication use was consistent with known or presumptive
      indications for the respective drug groups, although unestablished applications
      were also observed.

PMID- 7779347
TI  - Measuring behavioral phenotypes: provocations from the "new genetics".
AB  - Recent revolutionary advances in genetics bring a renewed importance to the
      behavioral phenotypes of mental retardation syndromes. Although the so-called
      "new genetics" calls for improved research on syndromic behavior, this work has
      not been a priority in the larger mental retardation field. Further, the work has
      suffered from inconsistent definitions and methodologies. In this paper key
      properties of behavioral phenotypes were clarified, including within-syndrome
      variability and between-syndrome similarities and qualitative differences. Three
      strategies were offered that improve the traditional focus on easily observed
      syndromic traits: a psychiatric approach, psychometric methods, and syndrome
      specific observations. The need to combine these approaches was discussed as were
      complications of the work due to developmental and environmental issues.

PMID- 7779348
TI  - Benefit-cost analysis of community residential versus institutional services for
      adults with severe mental retardation and challenging behaviors.
AB  - A benefit-cost analysis was conducted to compare services in community residences
      versus an institution for 11 individuals with severe mental retardation and
      challenging behaviors who had been moved from an institution to a community
      setting. Effects that were not readily quantifiable in economic terms also were
      examined. Overall, the community-based program costs represented slight public
      savings over costs of the state institution. However, community living netted
      significant increases in variables such as resident's social networks,
      opportunities for integrated activities, and income.

PMID- 7779350
TI  - Relations of scores on the Stanford Binet Fourth Edition and form L-M: concurrent
      validation study with children who have mental retardation.

PMID- 7779349
TI  - Early intervention for low birthweight, premature infants: participation and
      intellectual development.
AB  - The Infant Health and Development Program was an eight-site randomized controlled
      trial of comprehensive early intervention for low birthweight, premature infants
      during the first 3 years of life in which intellectual development was an outcome
      of major importance. At 24 and 36 months, but not at 12 months, higher Mental
      Development Index and IQ were associated with higher levels of participation in
      the intervention. In a longitudinal analysis of these data, we found that the
      intellectual development of children in the intervention group was associated
      with each of the three intervention modalities (the number of home visits
      received, days attended at child centers, and the number of parent meetings
      attended) but not with children's background characteristics (i.e., maternal
      education, birthweight). We suggest that these findings represent a dose-response
      relation between intervention and outcome.

PMID- 7779351
TI  - Conditional discrimination by adults with mental retardation: establishing
      relations between physically identical stimuli.

PMID- 7779352
TI  - 2nd European Conference on Vaccinology: Combined Vaccines for Europe;
      Pharmaceutical, Regulatory and Policy-Making Aspects. Proceedings. Brussels,
      Belgium, 18-20 May 1994.

PMID- 7779353
TI  - Regulatory framework of immunologicals in the European Union.

PMID- 7779354
TI  - Immunisation policies and programmes in Europe.

PMID- 7779355
TI  - Development of combined vaccines: manufacturers' viewpoint.
AB  - Rapid and exciting research breakthroughs in the fields of immunology and
      molecular biology in recent years have greatly enhanced the potential for
      developing new vaccines or improving existing ones. The resulting rising number
      of diseases that can be prevented by vaccination, coupled with the growing trend
      of preferring cost-effective preventive medical interventions over expensive
      therapeutic modalities, has increased the complexity of administering to all
      those who need them, the many different vaccines that will soon be available.
      Hence attention in the field of vaccinology is now focusing on the development of
      combined vaccines that, in a few inoculations, can elicit protection against as
      many diseases as possible. Some of the recent achievements, future objectives and
      difficulties of vaccine manufacturers in the development of combined vaccines are
      surveyed.

PMID- 7779356
TI  - Epidemiological views into possible components of paediatric combined vaccines in
      2015.
AB  - Efforts to develop combined vaccines for childhood immunization schedules will
      during the next years focus on combined administration of the existing vaccines
      which have already shown their impact. First candidate components for more wide
      spectrum combinations could be the new antigens against severe invasive
      infections caused by encapsulated bacteria. Multivalent pneumococcal and
      meningococcal group A and C conjugate vaccines are already in clinical trials,
      and the same is true of the first candidates for the meningococcal group B
      vaccine. Pneumococcal conjugate vaccines are also important in prevention of a
      large variety of respiratory infections. Since viruses are important causative
      agents of bronchiolitis and pneumonia, components of the paediatric combined
      vaccine should include at least respiratory syncytial virus, and possibly also
      other respiratory viruses like parainfluenza and adenoviruses. The third group of
      diseases to be considered from the preventive point of view are congenital
      infections, and vaccines against herpes simplex viruses, cytomegalovirus, or
      group B streptococci might be included in a combined vaccine to be administered
      to adolescents in order to afford protection to their future children.

PMID- 7779357
TI  - Combination vaccines: present practices and future possibilities.

PMID- 7779358
TI  - Role of the European Commission in pharmaceuticals research.

PMID- 7779359
TI  - Pharmaceutical aspects of combined vaccines: a manufacturer's perspective.

PMID- 7779360
TI  - Combination of DTP and Haemophilus influenzae type b conjugate vaccines can
      affect laboratory evaluation of potency and immunogenicity.
AB  - A commonly used Diphtheria-Tetanus-Pertussis (whole-cell) vaccine was combined
      with each of three different Haemophilus influenzae type b (Hib) capsular
      polysaccharide vaccines. Each Hib vaccine incorporated one of three different
      protein conjugates: tetanus toxoid, diphtheria CRM197 toxoid or group B Neisseria
      meningitidis outer membrane vesicles. The effects of these combinations on the
      subsequent laboratory control testing were examined. The addition of the Hib
      vaccines had no significant effect on the reactogenicity or the potency of the
      whole-cell pertussis component. The potency of, and antibody responses to, the
      diphtheria component were also unaffected in all three combinations. However,
      combination with the Hib vaccine comprising polysaccharide conjugated to tetanus
      toxoid had dramatic effects on tetanus potency and immunogenicity when assayed in
      mice. This combination resulted in a five-fold potentiation of the tetanus
      potency and a similarly large increase in the antibody responses to tetanus toxin
      and toxoid. The level of the antibody response to the Hib polysaccharide in this
      vaccine was also elevated, more than 20-fold, as a result of the combination.
      Such phenomena were not evident with combinations involving the other two Hib
      vaccines. These results have implications for the control testing of combined
      vaccines containing a whole-cell pertussis component and Hib polysaccharide
      tetanus protein conjugate vaccine.

PMID- 7779361
TI  - Combined vaccines--the European contribution.
AB  - Efforts to develop new vaccine combining as many immunogens as possible have
      stimulated researchers of most European vaccine manufacturers to contribute with
      new vaccine designs. Besides the conventional combinations the following
      approaches are under development: new carrier systems for inactivated antigens;
      new adjuvants for subunit antigens; live attenuated combined vaccines; vector
      combined vaccines; synthetic polypeptide combined vaccines. The availability of
      new combined vaccines will greatly facilitate immunization programmes for the
      control of many diseases around the world. The whole of modern society in general
      is moving towards prevention--for example on safety issues--as well as in
      medicine, where prophylactic approaches are medically, scientifically, ethically,
      and mortally more justifiable as well as being more cost-effective. Besides
      improving the health and overall quality of life of the world's population, the
      use of combined vaccines will further reduce already overstretched health care
      budgets.

PMID- 7779363
TI  - Stability testing on vaccines--results of activities of the International
      Conference on Harmonization (ICH) of technical requirements for registration of
      pharmaceuticals for human use.

PMID- 7779362
TI  - Control testing of combined vaccines: a consideration of potential problems and
      approaches.
AB  - Vaccines comprising combinations of diphtheria, tetanus and pertussis (DTP)
      components with Haemophilus influenzae b polysaccharide--protein conjugates (DTP
      Hib) are now available. Combinations of DTP-Hib with additional components such
      as inactivated poliomyelitis vaccine, hepatitis B vaccine, meningococcal and
      pneumococcal polysaccharide-protein conjugates are under development. Other
      combinations, such as Hib vaccine with meningococcal A, B and C components and
      possibly pneumococcal conjugates, or non-capsulated Haemophilus components
      combined with pneumococcal conjugates, developed against bacterial meningitis and
      otitis media respectively, are of potential interest. Combination vaccines
      against enteric infections and including potentially cholera, typhoid, ETEC,
      Shigella, rotavirus and possibly Campylobacter and Helicobacter components, may
      become available in the longer term. The control of these combinations is likely
      to be based on pharmacopoeial requirements for the individual components.
      However, the evaluation of combinations may not be straightforward and the
      interaction of the components with each other may influence reactogenicity,
      immunogenicity and stability and will complicate laboratory control tests.
      Indications of this have already arisen with some DTP-Hib combinations but are
      likely to increase as additional components are added. For example, the use of
      diphtheria and tetanus proteins as carriers for multiple polysaccharide
      conjugates may lead to excessive antitoxin production and epitope suppression of
      anti-polysaccharide responses. Other problems may result from competition for
      binding sites on adjuvant molecules. The requirements for new vaccine
      combinations need to be considered carefully and should not be made solely on
      assumptions based on the properties of individual components.

PMID- 7779364
TI  - The system of mutual recognition of batch release in the EU--implications for
      combined vaccines.

PMID- 7779365
TI  - Combined vaccines: policy and practice in the European Pharmacopoeia.

PMID- 7779366
TI  - Definition of minimum standards for immunogenicity--potential problems of
      serological correlates--possible interference. Serological correlates for
      diphtheria-tetanus-whole cell pertussis vaccines.

PMID- 7779368
TI  - Difficulties in establishing a serological correlate of protection after
      immunization with Haemophilus influenzae conjugate vaccines.
AB  - In several studies the protective concentration of anti-Haemophilus influenzae
      type b (Hib) capsular polysaccharide (PS) antibodies has been concluded to be
      around 0.04 to 0.20 microgram/ml. After the Finnish Hib polysaccharide vaccine
      trial it was estimated that 1 microgram/ml has to be achieved to predict long
      term protection after vaccination. These estimates of protective anti-Hib PS
      antibody concentrations were based on the assumption that protection from
      invasive Hib disease is mediated by antibodies and the role of cell-mediated
      immunity is negligible. This assumption was justified since the Hib PS is a T
      cell-independent antigen. The matter becomes quite different when the character
      of the PS vaccine is altered by conjugating it to a protein carrier, so that it
      acquires the ability to stimulate T cells, and the immunological memory plays a
      role in the protection. The immunized infants are thought to be able to respond
      with a rapid and high antibody response after exposure to the organism. After
      immunization with conjugate vaccines, protection can be seen at a lower serum
      antibody concentration than after polysaccharide vaccine. In addition, higher
      avidity of anti-Hib PS antibodies is associated with the response to conjugate
      than PS vaccine, and there are differences between the conjugates. This might
      have an influence on the functional activity of the antibodies. Hib conjugate
      vaccines are also able to reduce the carriage rate of Hib. This should be kept in
      mind when estimating what is needed from protective immune response after
      immunization with Hib conjugate vaccines.

PMID- 7779369
TI  - Clinical evaluation of HB vaccine as a component of combination vaccines.

PMID- 7779367
TI  - Immunogenicity of acellular pertussis vaccines.

PMID- 7779370
TI  - Definition of acceptable levels for safety and potential problems.

PMID- 7779371
TI  - Problems in the choice of combined vaccines for Europe.

PMID- 7779373
TI  - American experience in harmonizing national policy.

PMID- 7779374
TI  - Pertussis in combined vaccines.

PMID- 7779372
TI  - Cost benefit of combining antigens.

PMID- 7779375
TI  - Are different combined vaccines needed in different parts of Europe? A point of
      view from a northern-European country.

PMID- 7779377
TI  - Inclusion of IPV in combined vaccines.

PMID- 7779376
TI  - Integration of hepatitis B and Hib vaccine in national vaccination programmes in
      southern Europe.

PMID- 7779378
TI  - Booster doses and combined vaccines.

PMID- 7779379
TI  - Uracil-USE, an improved method for site-directed mutagenesis on double-stranded
      plasmid DNA.

PMID- 7779380
TI  - Gene assembly-aided mutagenesis (GAAM).

PMID- 7779381
TI  - Improved recombinant PCR mutagenesis procedure that uses alkaline-denatured
      plasmid template.

PMID- 7779382
TI  - Visual detection method for identifying recombinant bacterial colonies.

PMID- 7779384
TI  - DNA sequencing with delta Taq DNA polymerase.

PMID- 7779383
TI  - Direct cloning of mutant alleles from the bacterial chromosome into plasmid
      vectors in vivo.

PMID- 7779385
TI  - Efficient creation of sequencing libraries from blunt-ended restriction enzyme
      fragments.

PMID- 7779386
TI  - Nonradioactive method for restriction mapping of lambda phage DNA.

PMID- 7779388
TI  - DIG-labeled RNA in situ hybridization without coverslipping.

PMID- 7779387
TI  - Method identifying hybridizing regions of DNA within an insert.

PMID- 7779389
TI  - Efficient isolation of whole genomic DNA from cell cultures and blood samples.

PMID- 7779390
TI  - Extraction of genomic DNA from extracellular polysaccharide-synthesizing gram
      negative bacteria.

PMID- 7779391
TI  - 33P and beta-Imager: application for genotyping of microsatellite markers.

PMID- 7779392
TI  - Heat-treated bovine serum albumin is a better blocking reagent for adhesion
      studies.

PMID- 7779393
TI  - Detection of wild-type contamination in a recombinant adenoviral preparation by
      PCR.
AB  - A rapid and sensitive method of detecting wild-type virus contamination is needed
      for the preparation of recombinant adenoviruses for adenoviral vector
      applications in which purified vectors free of wild-type virus are required for
      preclinical studies and clinical trials. In response to this demand, we developed
      a PCR assay that uses two pairs of primers in the same reaction to detect
      adenoviral E1 DNA with co-amplification of E2B DNA as an internal control.
      Template DNA preparation was simplified and required only 365 microL of culture
      medium of 293 cells that displayed a cytopathic effect following adenovirus
      infection. Evaluation of the sensitivity of the assay demonstrated that it
      detected the E1 DNA in a reconstruction of one plaque-forming unit (pfu) of wild
      type virus in 10(9) pfu of recombinant viruses. This method may be useful for
      quality control in the production of adenoviral vectors free of wild-type virus
      for gene therapy applications.

PMID- 7779394
TI  - Direct sequencing of DNA isolated from mRNA differential display.
AB  - A recently developed mRNA differential display technique has a potential power
      for identifying genes that are differentially expressed in a variety of in vitro
      and in vivo systems. One critical feature of this technique is to display most of
      the mRNA population on a sequencing gel after polymerase chain reaction using a
      5' decamer and a 3' T12MN anchored primer. However, these primers are too small
      to be successfully used as a sequencing primer using the classical sequencing
      protocol. In the present report we described the application of an extended
      primer set for the re-amplification after mRNA differential display, which
      renders the amplified DNA suitable for direct sequencing using either of these
      extended oligonucleotides as a primer without further subcloning. This improved
      technique will greatly save the time, cost and labor-intensive work for the
      discovery of genes using mRNA differential display.

PMID- 7779395
TI  - Improved strategy for large-scale DNA sequencing using DNaseI cleavage for
      generating random subclones.
AB  - Large-scale DNA sequencing projects require the use of specific and reliable
      strategies. Here, we describe an improved strategy using DNaseI cleavage and
      sequencing strategy using DNaseI cleavage and sequencing from both ends of the
      plasmid inserts. This strategy yields better results than those obtained using
      partial digestion with restriction enzymes and cloning in single-stranded
      vectors.

PMID- 7779397
TI  - Determination of the poly(A) tail lengths of a single mRNA species in total
      hepatic RNA.
AB  - Poly(A) tail length is important in the stability and translation of mRNA. We
      describe procedures for the rapid and reproducible analysis of poly(A) tail
      length of a single mRNA species contained in a sample of total hepatic RNA. A
      short 3' fragment of a specific mRNA is prepared by RNase H digestion of the
      targeted mRNA region annealed to a short DNA oligonucleotide. The length of the
      poly(A) tail of the 3' fragment is then determined by running the sample on a
      polyacrylamide gel, by electrophoretic transfer, by probing with a radiolabeled
      cDNA and by comparing the size of the detected region with a specific RNA ladder
      or a DNA ladder.

PMID- 7779396
TI  - Multisite oligonucleotide-mediated mutagenesis: application to the conversion of
      a mitochondrial gene to universal genetic code.
AB  - Using multisite oligonucleotide-mediated mutagenesis in conjunction with a
      mutagenesis selection procedure and rapid screening by allele-specific
      oligonucleotide hybridization has allowed us to develop a reliable protocol that
      enables a large number of base changes to be introduced rapidly into a piece of
      DNA, with the minimum number of manipulations. We have applied this protocol to
      generate synthetic versions of four mouse mitochondrial genes capable of being
      expressed in the nucleus/cytosol.

PMID- 7779399
TI  - Identification of ABO alleles on forensic-type specimens using rapid-ABO
      genotyping.
AB  - Historically, forensic and clinical laboratories utilize serological techniques
      to identify ABO blood types. These techniques rely on the detection of ABO
      associated proteins and are sensitive with very accurate results. This laboratory
      has simplified the identification of ABO types by taking advantage of previously
      reported ABO DNA sequence differences. The Rapid-ABO technique involves a two
      step process: (i) amplification of DNA samples using primer sets specific for the
      ABO alleles and (ii) electrophoresis and visualization of amplified ABO fragments
      on a 3% MetaPhor agarose gel. The major advantage of the Rapid-ABO technique is
      the identification of ABO genotypes compared to serological tests for ABO
      phenotypes. This two-step process identifies six possible ABO genotypes including
      AB, AA, BB, AO, BO and OO. The Rapid-ABO protocol works well with DNA extracted
      organically or using Chelex 100. Results can be obtained in less than a day
      utilizing 2 ng of DNA in the amplification reaction. Analysis of 23 animal
      species shows the Rapid-ABO primers amplify ABO alleles from only human,
      chimpanzee and gorilla DNA.

PMID- 7779398
TI  - Restriction endonuclease fingerprinting (REF): a sensitive method for screening
      mutations in long, contiguous segments of DNA.
AB  - Restriction endonuclease fingerprinting (REF) is a modification of single-strand
      confirmation polymorphism (SSCP) that was developed to detect the presence of
      essentially all mutations in a 1-kb segment. To test REF, a 1-kb segment of the
      human factor IX gene was amplified with PCR and digested with each of five groups
      of restriction endonucleases. The endonucleases in each group were chosen so that
      the average size of the fragments was about 150 bp. After separate digestions,
      the products were mixed, 5' end-labeled with T4 polynucleotide kinase, denatured
      and electrophoresed under nondenaturing conditions. Each lane screened 1 kb and
      typically contained 68 segments (6.8 fragments per average digestion x 5
      digestions x 2 strands). REF was performed with 5.6% polyacrylamide and 7.5%
      GeneAmp at temperatures of either 23 degrees or 8 degrees C. Point mutations
      resulted in the gain or loss of a restriction site in 21% of 24 test mutations
      (informative restriction component). In cases in which the restriction component
      was not informative, mutations were detected if any of the five mutation
      containing restriction fragments (producing 10 single-stranded segments)
      displayed abnormal mobility (SSCP component). The average efficiency per single
      stranded segment of the SSCP component for the 24 point mutations ranged from 49%
      for polyacrylamide at 23 degrees C to 68% with GeneAmp at 8 degrees C. REF
      detected 96% of the mutations with polyacrylamide at 23 degrees C and 100% with
      GeneAmp at 23 degrees or 8 degrees C. GeneAmp at 23 degrees and 8 degrees C also
      detected 100% of a subsequent blinded sample that contained normal controls and
      27 different point mutations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779400
TI  - Generation of high-titer retroviral vectors following receptor-mediated,
      adenovirus-augmented transfection.
AB  - A new procedure is described for the generation of high-titer, helper-free
      retrovirus vectors employing receptor-mediated, adenovirus-augmented transfection
      into a standard packaging cell line. Viral titers are increased 30-fold to 100
      fold in transiently (> 10(5) infectious units per mL) and stable (> 10(7)
      infectious units per mL) transfected cells as compared with either CaPO4-mediated
      transfection or retroviral infection of a packaging cell line. Further,
      expression of the transduced genes was drastically increased in the transfected
      cells, but, as expected, there was no difference in transduction efficiency and
      gene expression in the infected target cells. The increases in viral titers were
      most likely due to the high number of stable, integrated copies of the vector
      plasmid DNA in the resulting packaging lines following G418 selection. In
      addition, experiments generating recombinant retroviruses from non-packaging cell
      lines are presented. The results suggest that this procedure may be of use to
      generate high-titer retrovirus vectors in packaging cell lines as well as in
      primary cells, thus providing a technical basis for in vivo gene transfer upon
      transplantation of these cells into various organs.

PMID- 7779401
TI  - A pre-loading method of evaluating gap junctional communication by fluorescent
      dye transfer.
AB  - We describe a simple method for evaluating gap junctional communication (GJC)
      between cells in culture. The procedure involves pre-loading cells with two
      fluorescent dyes: calcein and DiI. Calcein is able to pass through gap junctions,
      while DiI is not. These pre-loaded cells are then plated with unlabeled cells.
      The number of cells receiving calcein from each pre-loaded cell can then be
      quantified after the cells settle on the plate. Potent and reversible inhibitors
      of GJC can be used in this system to evaluate dye transfer within a given period
      of time.

PMID- 7779402
TI  - Fast hybridization solution for the detection of immobilized nucleic acids.
AB  - We have developed a fast hybridization solution, termed ExpressHyb, for the rapid
      and sensitive detection of nucleic acids immobilized on membrane supports. This
      solution reduces typical hybridization times of 12-24 h to as little as 1 h while
      simultaneously increasing the sensitivity of detection in many applications.
      Using ExpressHyb, human beta-actin mRNA was detected on a human multiple tissue
      Northern (MTN) blot following a 30-min hybridization, with optimal detection
      occurring with a 1-h hybridization interval. The moderately abundant human
      glyceraldehyde-3-phosphate dehydrogenase (G3PDH) mRNA was detected using similar
      hybridization conditions and yielded improved signal-to-background
      characteristics relative to overnight hybridizations in conventional solutions.
      ExpressHyb can be used with either 32P- or digoxigenin-labeled probes and works
      effectively with both cDNA and oligonucleotide probes. For non-isotopic detection
      in particular, ExpressHyb reduces the nonspecific background commonly encountered
      with this technique. In cDNA library screening, ExpressHyb was found to both
      reduce the time required for effective hybridizations and to increase the number
      of positive colonies obtained relative to conventional overnight procedures.
      Taken together, these results illustrate the broad capability of ExpressHyb
      Hybridization Solution to improve nucleic acid detection in a variety of
      important techniques.

PMID- 7779403
TI  - Quantitation of cellular receptors by a new immunocytochemical flow cytometry
      technique.
AB  - Flow cytometry provides a rapid qualitative method for analyzing the binding of a
      fluorescent probe to a cell. To quantitate the binding of a probe using flow
      cytometry, one must be able to first calibrate the fluorescent signal with some
      known standard. We have compared a new one-step method with a previous two-step
      method for determining the number of binding sites (receptors) on the surface of
      cells using immunofluorescent staining of the cells and analysis by flow
      cytometry. Experimentally, recombinant chinese hamster ovary cells, expressing
      cell surface glycoprotein receptors, IIb/IIIa or Mac-1, were assayed using
      specific mouse monoclonal antibodies against these receptors. The two methods
      yielded comparable results and, depending on the cell type, detected anywhere
      from 100,000 to 300,000 antibody-binding sites per cell, respectively.

PMID- 7779404
TI  - Structure-function relationships for the EGF/TGF-alpha family of mitogens.
AB  - Epidermal growth factor (EGF) and transforming growth factor alpha (TGF-alpha)
      are ligands for the EGF-receptor and act as mitogens for a variety of tissues.
      TGF-alpha, in particular, has been implicated as an autocrine growth factor for
      several cancer cell lines. Over the last 10 years many groups have examined the
      structure-function relationships in EGF/TGF-alpha in attempts to develop
      antagonists or agonists. In this review the results of these studies are
      summarised and related to the three-dimensional structure of EGF/TGF-alpha. The
      difficulties associated with the purification and characterisation of analogues
      of EGF/TGF-alpha and with the biological assays are discussed. It is clear that
      these difficulties have, in some cases, led to apparently contradicting results.
      The available binding data indicate that the receptor interaction surface for
      EGF/TGF-alpha might encompass one complete side of the molecule with a few strong
      binding determinants, in particular Arg41 and Leu47. The arginine at position 41
      is the most critical residue and its full hydrogen-bonding capacity is needed for
      strong binding of EGF/TGF-alpha to the EGF-receptor. As this side of the molecule
      consists of residues from both the N- and C-terminal domain, it seems unlikely
      that agonists or antagonists can be developed on the basis of short peptides
      taken from the primary sequence. This concept is supported by the available
      binding and activity data.

PMID- 7779405
TI  - Triplex-forming oligonucleotide binding represses transcription of the human c
      erbB gene in glioma.
AB  - Mixed purine-pyrimidine oligodeoxynucleotides were designed to form collinear DNA
      triplexes with pyrimidine-rich elements in the EGFR gene promoter. Their effects
      as mediators of human epidermal growth factor receptor (EGFR) gene transcription
      and subsequent gene expression were evaluated using human squamous cell carcinoma
      (A431) and human glioma cell line (U251MG and U87MG). Gel shift analysis
      indicated that the oligonucleotide forms a collinear triplex within the duplex Sp
      1 binding site. An in vitro assay system revealed a correlation between triplex
      formation and the repression of EGFR transcription. We postulate that guanine
      residues are not always optimum in apposition to G-C pairs to form triple helices
      in the target. Site-specific oligodeoxynucleotides binding to a DNA duplex may
      serve as the basis for an alternative program of gene control in vitro.

PMID- 7779407
TI  - Immunolocalisation of vascular endothelial growth factor in human endometrium.
AB  - Angiogenesis is an essential component of endometrial regeneration after menses
      in preparation for implantation. Vascular endothelial growth factor (VEGF) is a
      secreted angiogenic peptide with mitogenic activity specific for endothelial and
      trophoblast cells. VEGF-immunoreactivity was detected in glandular epithelium
      throughout the menstrual cycle by immunohistochemistry, but, showed cyclic
      variation in the stroma and the blood vessels. During the early proliferative
      phase, strong staining was seen in the glandular epithelial cells while staining
      in the stroma was confined to a subpopulation of stromal cells and endometrial
      blood vessels appeared negative. In contrast, very intense staining of the
      endometrial stromal cells was seen in the mid proliferative endometrium possibly
      due to increased synthesis of VEGF by oestrogen. In the late proliferative
      endometrium, staining was seen in the endothelial cells and the perivascular
      stromal cells around the endometrial blood vessels. The greatest degree of
      immunostaining of stromal cells was observed in the mid to late proliferative
      endometrium. Throughout the secretory phase no staining was seen around the
      endometrial blood vessels and staining of endometrial stromal cells was confined
      to early secretory endometrium. In the late secretory endometrium only the glands
      were positive to VEGF antibody. The observed increase in the immunostaining of
      stroma suggests increased production of VEGF from early to mid and late
      proliferative endometrium which parallels the increase in the oestradiol levels
      in the proliferative phase of the menstrual cycle. It is proposed that VEGF may
      serve as a paracrine mediator of the effects of ovarian steroids on endometrial
      vascular development.

PMID- 7779406
TI  - NMR studies of a murine-human chimera of leukaemia inhibitory factor (LIF).
      Comparison with human LIF.
AB  - Leukaemia inhibitory factor (LIF) is a polyfunctional cytokine active on many
      cell types. We present here 1H NMR studies on the solution properties and
      stability of MH35, a chimera of murine and human LIF which can be expressed at
      high levels in Escherichia coli, thus enabling efficient labelling of the protein
      with the stable isotopes 13C and 15N. MH35 has 85% sequence identity with human
      LIF and similar activity in biological assays. The 1H chemical shifts of the 12
      conserved aromatic residues and the pKa values of the five conserved histidine
      residues in MH35 and human LIF are very similar. Temperature dependence studies
      indicate that both proteins are stable, with significant conformational changes
      occurring only above 70 degrees C. These results show that these proteins have a
      similar overall structure and stability and that MH35 is therefore a suitable
      analogue of human LIF for structural studies in solution.

PMID- 7779408
TI  - Effects of transforming growth factor beta 1 on the adenylyl cyclase-cAMP pathway
      in prostate cancer.
AB  - We reported previously that MATLyLu rat prostate cancer cells engineered to
      overproduce transforming growth factor beta 1 (TGF beta 1) produce larger, more
      metastatic tumors in vivo. We recognized that this ability of TGF beta 1 to act
      as a positive modulator of prostate tumor behavior might be due to effects of TGF
      beta 1 on the host and/or on the tumor cells. In this study we demonstrated that
      the cells themselves respond to endogenously produced TGF beta 1, and that the
      adenylyl cyclase (AC)-cAMP pathway is affected. TGF beta 1-overproducing cells
      had lower membrane AC activity, lower intracellular cAMP content, and a lower Gs
      alpha protein level than did control cells. Prostate cancer cells were growth
      inhibited by 8-bromo-cAMP or forskolin, agents that elevate intracellular cAMP.
      Thus, TGF beta 1 overproduction affects the phenotype of the tumor cells,
      deliberate activation of endogenously produced latent TGF beta 1 is not required
      (indicating that the cells themselves are capable of activating latent TGF beta
      1), and TGF beta 1 overproduction lowers the cellular concentration of the growth
      inhibitor cAMP. Therefore, TGF beta 1 overproduction could affect tumor behavior
      in vivo in part via a direct effect on the tumor cells.

PMID- 7779410
TI  - The Tumor Microenvironment--Its Characterization, Modification and Clinical
      Implications. Proceedings of an international workshop. Granada, Spain, September
      23-25, 1994.

PMID- 7779409
TI  - Des (1-3) IGF-I potently enhances differentiated cell growth in olfactory bulb
      organ culture.
AB  - We recently provided evidence that newborn rat olfactory bulb (OB) could be
      maintained in serum-free organ culture with combinations of insulin-like growth
      factor-I (IGF-I) and basic fibroblast growth factor (bFGF), both of which are
      locally synthesized. Des (1-3), or truncated, IGF-I is a potent analog of IGF-I
      isolated from rat and human brain. We proposed in this study to examine the
      effects of des (1-3) IGF-I on cell function, morphology and on neuronal and glial
      cell differentiation in our cultured OB model, using cell-specific immunostains
      for neurons (150 kDa neurofilament) and glial cells (glial fibrillary associated
      protein--GFAP). OB were cultured in Iscove's serum-free medium containing IGF-I
      or des (1-3) IGF-I both alone or in combination with bFGF. Dose dependent
      responses of 14C amino acid uptake showed des (1-3) IGF-I to be 3-5 fold more
      potent than IGF-I with a half maximal response at about 20 ng/ml in comparison to
      100 ng/ml of IGF-I. The maximum response to IGF-I +/- bFGF was seen at 150 ng/ml;
      a ten-fold higher dose of insulin +/- bFGF was required to achieve the same
      response. While morphology was close to fresh 6 day OB following culture with IGF
      I (150 ng/ml) and bFGF (25 ng/ml), the substitution of des (1-3) IGF-I at 50
      ng/ml markedly improved morphology. Neurons were identified following culture in
      IGF-I or bFGF alone, but showed greater organisation in the mitral layer
      following combined IGF-I/bFGF culture. However, in contrast to IGF-I (150 ng/ml),
      des (1-3) IGF-I (50 ng/ml) supported marked neuronal expression. Furthermore,
      when des (1-3) IGF-I (50 ng/ml) was substituted for IGF-I, in combination with
      bFGF, the pattern of enhanced neuronal expression in the mitral layer was very
      close to that seen in the fresh 6 day bulb, with dendrites projecting to the
      glomerular layer. In OBs treated with no growth factors, or either IGF-I, des (1
      3) IGF-I or bFGF alone, glial expression was widespread and poorly organised,
      suggesting an injury response. In contrast, following treatment with combinations
      of bFGF with IGF-I or des (1-3) IGF-I, a more ordered, though enhanced glial
      response was seen in glomerular and granule cell layers.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 7779411
TI  - Modulation of spatial O2 tension distribution in experimental tumors by
      increasing arterial O2 supply.
AB  - Tumor oxygenation has been measured polarographically in s.c. implanted DS
      sarcomas on the dorsum of the hind foot of male Sprague-Dawley rats. pO2 was
      determined in all 3 spatial dimensions and 3-dimensional pO2 distributions as
      well as the mean extent of confluent areas with pO2 < 5 mmHg were calculated.
      Finally, the effect of elevating arterial pO2 (by carbogen breathing) as well as
      of increasing tumor blood flow (by angiotensin infusion) on the spatial pO2
      distribution was analyzed. Depending on the tumor volume, the spatial pO2
      distribution is more or less anisotropic. In smaller tumors, areas with
      physiological pO2 values are found adjacent to large hypoxic areas whereas larger
      tumors are almost completely hypoxic/anoxic. With carbogen breathing, the mean
      tissue pO2 is elevated although hypoxia is not eradicated in larger tumors. In
      small tumors, angiotensin leads to a vasoconstriction of tumor vessels followed
      by a worsening of tumor oxygenation whereas in large tumors the increased
      systemic perfusion pressure resulted in an improvement of oxygenation. Thus,
      carbogen predominantly affects pO2 diffusion by increasing the arterial pO2
      whereas angiotensin influences tumor perfusion and leads to an increased oxygen
      supply to the tumor tissue.

PMID- 7779412
TI  - The importance of determining necrotic fraction when studying the effect of
      tumour volume on tissue oxygenation.
AB  - The relationship between tumour tissue oxygenation and necrosis at different
      tumour sizes was investigated in a C3H mammary carcinoma implanted in the feet of
      female CDF1 mice. Experiments were performed using tumours that ranged in size
      from 80 to 800 mm3. Necrosis was estimated histologically. Tumour tissue
      oxygenation (pO2) was estimated with an Eppendorf electrode. Our results showed
      that as tumour volume increased there was a corresponding increase in necrotic
      fraction ranging from 1% in small tumours up to 51% in large tumours. The
      percentage of pO2 values < or = 5 mmHg increased from 2% up to 79%, in small and
      large tumours respectively. After correcting for necrosis, the apparent,
      significant increase in the % of pO2 values < or = 5 mmHg was lost. We conclude
      that correcting for necrotic fraction in this tumour model is necessary when
      attempting to measure tumour oxygenation using electrodes.

PMID- 7779413
TI  - Use of the comet assay to detect hypoxic cells in murine tumours and normal
      tissues exposed to bioreductive drugs.
AB  - The alkaline comet assay was applied to individual cells from mice exposed to two
      bioreductive drugs, tirapazamine and RSU 1069, with the goal of comparing DNA
      damage to tumours and normal tissues. More DNA single-strand breaks (SSBs) and a
      greater heterogeneity in DNA damage were observed in tumour cells than in spleen
      and marrow cells of mice exposed to 10-100 mg/kg tirapazamine, consistent with
      the presence of hypoxic cells and the greater bioreductive capacity of tumours.
      In mice injected with 25-200 mg/kg RSU 1069, aerobic cells exhibited large
      numbers of SSBs while toxic DNA interstrand crosslinks were produced only in
      hypoxic cells. Cells from bone marrow and spleen showed extensive numbers of
      SSBs, but minimal crosslinking compared to tumours where 10-20% of cells were
      heavily crosslinked. DNA damage produced by these two bioreductive drugs may be
      useful in estimating the range of individual cell oxygen contents within tumours
      and normal tissues.

PMID- 7779414
TI  - Are direct measures of tumor oxygenation reflective of changes in tumor
      radiosensitivity following oxygen manipulation?
AB  - The present study investigates the correlation between tumor oxygen availability
      and radiosensitivity following oxygen manipulation. Previous work has shown that
      tumors may contain both diffusion- and perfusion-limited hypoxic cells. Recently,
      the combination of nicotinamide (NIC) administration plus carbogen breathing has
      been proposed as a means of targeting both hypoxic cell subpopulations.
      Intravascular HbO2 saturations were measured for KHT murine sarcomas following
      either NIC, carbogen breathing, or the combination, and compared with
      determinations of tumor cell survival under matched conditions. The percentage of
      vessels > or = 25% HbO2 increased significantly for both the carbogen and NIC
      carbogen combination, while remaining unchanged from controls following NIC.
      These findings contrast with the survival data, where all treatments showed
      identical cell survival. A possible explanation is that different proportions of
      clonogenic versus nonclonogenic cells may be oxygenated by the alternative
      treatments. Thus direct determinations of alterations in tumor oxygenation may
      not reflect corresponding changes in radiosensitivity.

PMID- 7779415
TI  - Analysis of the effects of oxygen supply and demand on hypoxic fraction in
      tumors.
AB  - The extent of hypoxic regions in a tumor tissue depends on the arrangement, blood
      flow rate and blood oxygen content of microvessels, and on the tissue's oxygen
      consumption rate. Here, the effects of blood flow rate, blood oxygen content and
      oxygen consumption on hypoxic fraction are simulated theoretically, for a region
      whose microvascular geometry was derived from observations of a transplanted
      mammary andenocarcinoma (R3230AC) in a rat dorsal skin flap preparation. In the
      control state, arterial PO2 is 100 mmHg, consumption rate is 2.4 cm3 O2/100
      g/min, and hypoxic fraction (tissue with PO2 < 3 mmHg) is 30%. Hypoxia is
      abolished by a reduction in consumption rate of at least 30%, relative to
      control, or an increase in flow rate by a factor of 4 or more, or an increase in
      arterial PO2 by a factor of 11 or more. These results suggest that reducing
      oxygen consumption rate may be more effective than elevating blood flow or oxygen
      content as a method to reduce tumor hypoxia.

PMID- 7779416
TI  - Contribution of transient blood flow to tumour hypoxia in mice.
AB  - Tumours grown in mice typically exhibit regions of hypoxia believed to result
      from two different processes: chronic oxygen deprivation due to
      consumption/diffusion limitations, and periodic deprivation resulting from
      transient reductions in tumour blood flow. The relative contribution of each is,
      however, not generally known. We have addressed this issue in transplanted SCCVII
      squamous cell carcinomas in C3H mice, using a quantitative extension of the
      fluorescence 'mismatch' technique coupled with cell sorting from irradiated
      tumours. At least half of the vessels in these tumours exhibit transient
      perfusion changes. Additionally, a majority of the 15-20% of cells that are
      sufficiently hypoxic to be resistant to radiation in the SCCVII tumours appear to
      result from cyclic, not continuous (diffusion-limited) hypoxia. Since different
      strategies may be necessary to counteract cyclic hypoxia in tumours, the
      possibility of transient blood flow changes should not be ignored when planning
      cancer therapy for humans.

PMID- 7779417
TI  - Reoxygenation in a C3H mouse mammary carcinoma. The importance of chronic rather
      than acute hypoxia.
AB  - The role that chronic and acute hypoxia play in tumour reoxygenation after
      irradiation was investigated in a C3H mouse mammary carcinoma grown in the feet
      of female CDF1 mice. Tumours at 200 mm3 in size were locally irradiated with a
      priming dose of 20 Gy and then at various times after given a range of radiation
      doses under normal or clamped conditions. Local tumour control was determined 90
      days later from which the tumour hypoxic fractions were calculated. Untreated
      tumours contained 23% hypoxic cells. Immediately after 20 Gy this increased to
      52% and by 24 h had fallen to 10%. These reoxygenation experiments were repeated,
      giving either nicotinamide (1000 mg/kg; i.p. injected 30 min before each
      irradiation) to remove acute hypoxia, or carbogen breathing (for 5 min before and
      during irradiation) to decrease chronic hypoxia. With nicotinamide the normal
      hypoxic fraction was reduced to 7%, but after irradiation it had risen to 46% and
      by 24 h there was full reoxygenation with a value of 5% being observed. Carbogen
      breathing also decreased the normal hypoxic fraction to 6%, and immediately after
      irradiation this was increased to 38%. However, by 24 h it was still elevated at
      around 23%. These results suggest that chronic rather than acute hypoxia is
      necessary for reoxygenation in this tumour.

PMID- 7779418
TI  - Relationship between tumour oxygenation, bioenergetic status and radiobiological
      hypoxia in an experimental model.
AB  - Tumour oxygenation and bioenergetic status were measured in the same tumour and
      these results related to radiobiological hypoxia. A C3H mouse mammary carcinoma
      grown in the feet of CDF1 mice was used. Bioenergetic status was assessed by 31P
      MRS using a SISCO 7 Tesla magnet, oxygen measurements were done by a
      polarographic electrode and the hypoxic fraction was determined from direct
      analysis of the radiation dose-response data. During all examinations restrained,
      non-anaesthetized mice were allowed to breathe either 100% oxygen, carbogen,
      normal air, carbon monoxide (CO) at 75, 220, or 660 ppm or had blood flow
      occluded by clamping. Results showed a significant correlation between the
      radiobiological hypoxic fraction and % pO2 < or = 5 mmHg under the different
      treatment conditions, whereas no correlation was found between beta
      nucleosidetriphosphate/inorganic phosphate (beta-NTP/Pi) ratio and either the
      hypoxic fraction or the % of pO2 values < or = 5 mmHg under the different
      treatment conditions. In conclusion, oxygen electrode measurements were sensitive
      to changes in tumour hypoxia whereas the bioenergetic status alone seemed to be a
      less precise measure of hypoxia in this tumour model. Furthermore, the present
      study demonstrated that tumour cells in vivo can actually maintain the
      bioenergetic status during a period of severe hypoxia.

PMID- 7779419
TI  - Energy status parameters, hypoxia fraction and radiocurability across tumor
      types.
AB  - Under full nutrient in vitro conditions, the cellular adenylate energy charge of
      six different rodent and human tumor cell types was identical, i.e., 0.94 +/-
      0.01, suggesting the potential utility of this parameter as a cell (and tissue)
      independent marker of nutrient deprivation and hypoxia, across tumor types. The
      adenylate energy charge values of tumors, arising from these cells, was reduced
      and variable ranging from 0.72 to 0.91 for the various tumor types. However,
      neither the tumor adenylate energy charge, NTP/Pi, nor PCr/Pi ratios correlated
      with the radiobiologic hypoxic cell fractions across tumor types. The reduced
      adenylate energy charge in vivo suggests varying degrees of nutrient deprivation
      in the different tumor types, however, factors other than or in addition to
      hypoxia likely contribute to tumor energy status.

PMID- 7779420
TI  - Spin-lattice relaxation time of inorganic phosphate in human tumor xenografts
      measured in vivo by 31P-magnetic resonance spectroscopy. Influence of oxygen
      tension.
AB  - Previous 31P-magnetic resonance spectroscopy (31P-MRS) studies have suggested
      that the spin-lattice relaxation time (T1) of the inorganic phosphate (Pi)
      resonance is shorter in well-oxygenated than in poorly oxygenated tumors.
      Amelanotic human melanoma xenografts were therefore subjected to 31P-MRS to
      investigate whether the T1 of the Pi resonance might be a useful parameter for
      assessment of tumor oxygenation status. It was searched for possible correlations
      between the T1 of the Pi resonance and oxygen tension or parameters closely
      related to oxygen tension, including 31P-MRS tumor energy status and blood supply
      per viable tumor cell. Oxygen tension, tumor energy status, and blood supply per
      viable tumor cell decreased with increasing tumor volume. In contrast to previous
      suggestions, the T1 of the Pi resonance decreased with increasing tumor volume
      and decreasing oxygen tension, tumor energy status, and blood supply per viable
      tumor cell, possibly because the tumors developed necrotic regions concomitantly
      with the decrease in oxygenation status, resulting in increased concentrations of
      freely dissolved para-magnetic ions in the tissue. Consequently, the T1 of the Pi
      resonance can probably not be utilized to estimate the oxygenation status of
      tumors, at least not in tumors with necrotic regions.

PMID- 7779421
TI  - Distribution of hypoxia and proliferation associated markers in spontaneous
      canine tumors.
AB  - The therapeutic response of malignant tumors depends on a number of factors
      associated with tumor microenvironments including the possibility that these
      microenvironments change during treatment. Two factors, tumor hypoxia and cell
      proliferation, have been examined in spontaneous canine tumors undergoing
      multifraction radiation therapy. The approach utilizes immunohistochemical
      analyses of hypoxia (CCI-103F) and proliferation associated (PCNA) antigens in
      biopsy samples taken before and after 5 daily fractions of 3 Gy (total dose 15
      Gy). The tissue samples were formalin-fixed and paraffin-embedded for the
      immunohistochemical study. Immunostaining of the sections for PCNA and hypoxia
      marker reveals little or no overlap when the analysis is made prior to
      irradiation. An increased degree of overlap seems to occur after 15 Gy but the
      situation is complicated by a change towards more diffuse PCNA immunostaining in
      the cells of the irradiated tissues.

PMID- 7779422
TI  - Development of bioreductive markers for tumour hypoxia.
AB  - Hypoxic cells in tumours can be identified by exposing them to an immunologically
      identifiable 2-nitroimidazole (NITP) with a theophylline substituent which
      becomes bioreductively metabolised and binds to cellular macromolecules in the
      absence of oxygen. A range of monoclonal and polyclonal antibodies raised against
      theophylline or caffeine can identify cells containing bound adducts of NITP, in
      some cases with higher specificity than the standard product used. An alternative
      approach utilizes the very high specificity of FITC-avidin as a reagent to detect
      metabolic binding of a 2-nitroimidazole with a biotinylated side-chain (NIB),
      with the advantage of a single-step staining protocol. Both proliferating and
      hypoxic cell populations within tumours can be identified by simultaneous
      staining for incorporation of NITP and BrdUrd and this has shown that some cells
      incorporate both markers, suggesting that there is some overlap between the
      proliferating and hypoxic cell compartments.

PMID- 7779423
TI  - Characterisation of the vasculature within a murine adenocarcinoma growing in
      different sites to evaluate the potential of vascular therapies.
AB  - Numerous vaso-active agents can affect vasculature in experimental solid tumours
      growing subcutaneously (s.c.), but these models are unlikely to reflect the
      vasculature of metastatic disease in man. The present study describes a murine
      orthotopic colon tumour which metastasises to the liver. Morphology and vascular
      pattern of caecal tumours is similar to s.c. tumours. Vascular occlusion caused
      by intravenous (i.v.) noradrenaline (NA) (160 micrograms kg-1) and hydralazine
      (HDZ) (10 mgkg-1) was 32% and 59% respectively for the caecal tumours compared
      with 35% and 78% for s.c. tumours. Significant morphological differences were
      seen between liver metastases and systemic deposits produced by i.v. inoculation
      of tumour cells. Liver metastases following orthotopic transplantation contained
      functional vasculature but no significant occlusion was seen with NA or HDZ. The
      vascular development and morphological appearance of secondary disease resulting
      from orthotopic implantation suggests that this would be a useful model for the
      study of agents that act either by vascular or anti-angiogenic mechanism.

PMID- 7779424
TI  - Interstitial fluid pressure in human melanoma xenografts. Relationship to
      fractional tumor water content, tumor size, and tumor volume-doubling time.
AB  - The interstitial fluid pressure (IFP) has been shown to be elevated in malignant
      tissue, but the possibility that IFP might be related to other pathophysiological
      parameters of the tissue has not been fully explored. The purpose of the study
      here reported was to measure the IFP in human melanoma xenografts and to search
      for possible correlations between tumor IFP and fractional tumor water content,
      tumor wet weight, or tumor volume-doubling time. Tumors of four melanoma lines (A
      07, D-12, R-18, U-25), grown orthotopically in BALB/c-nu/nu mice, were included
      in the study. Tumor IFP, measured by using the wick-in-needle technique, ranged
      from 2 to 10 mm Hg (D-12), from 2 to 15 mm Hg (A-07 and U-25), and from 2 to 30
      mm Hg (R-18). Statistically significant correlations between tumor IFP on the one
      hand and fractional tumor water content, tumor wet weight, or tumor volume
      doubling time on the other were not found, whether the tumor lines were analyzed
      individually or together. These observations suggest that simple general
      relationships between the IFP and the other pathophysiological parameters
      measured here, might not exist in tumors.

PMID- 7779425
TI  - Effect of vasoactive drugs on tumour blood flow as determined by 2H nuclear
      magnetic resonance spectroscopy.
AB  - A selective reduction in tumour blood flow (TBF) could enhance the effects of
      hyperthermia treatment and of drugs toxic to hypoxic cells. Vasodilator-induced
      changes in TBF were monitored in transplanted rat fibrosarcomas by non-invasively
      measuring the uptake of D2O using 2H nuclear magnetic resonance spectroscopy.
      Hydralazine (1 or 5 mg kg-1) caused a large (45%) reduction in mean arterial
      blood pressure (MABP) and a 40-60% reduction in TBF. Low-dose hydralazine (0.1 mg
      kg-1) caused a 20% reduction in MABP but no significant change in TBF. The doses
      of prazosin (1 mg kg-1) and calcitonin-gene related peptide (CGRP, 1 nmol kg-1)
      which caused a 20% reduction in MABP led to a 50-60% reduction in TBF. These
      results demonstrate the advantage of prazosin and CGRP over hydralazine for the
      reduction of TBF despite a small hypotensive effect. CGRP may be the most
      suitable of these agents for clinical use because of its short physiological half
      life.

PMID- 7779427
TI  - Pentoxifylline increases RIF-1 tumour pO2 in a manner compatible with its ability
      to increase relative tumour perfusion.
AB  - The time course and dose response of 600 mm3 subcutaneous RIF-1 tumours to
      pentoxifylline was measured in terms of relative tumour perfusion, assayed by
      86Rb extraction, and pO2 distribution measured by the Eppendorf histograph. Both
      perfusion and pO2 distribution were maximally increased by 20 mg/kg
      pentoxifylline 15 min after administration, perfusion to 141 +/- 15% (2 SE) of
      control, and median pO2 from 3 to 15 mmHg, with the percentage of values < 2.5
      mmHg falling from 44 +/- 8% to 22 +/- 7%. Fifteen minutes after administration
      the pO2 increases were linearly dose-dependent up to 20 mg/kg. Correlation
      coefficients for perfusion data with the percentages of low values were, for time
      course and dose response data respectively, 0.76 and 0.84 for median pO2, 0.84
      and 0.97 for percentage < 2.5 mmHg and 0.81 and 0.87 for percentage < 10 mmHg.
      The data show good correlation between changes in perfusion and pO2 distribution
      parameters, with better correlation for percentage of low values than for median
      pO2.

PMID- 7779426
TI  - Tumor oxygenation in anemic rats: effects of erythropoietin treatment versus red
      blood cell transfusion.
AB  - Anemia was induced in rats by the development of a hemorrhagic ascites. These
      animals also bore solid tumors (DS-sarcomas) on the hind foot dorsum. The effects
      of two methods for anemia correction on oxygenation in the solid tumors were
      compared in this study. Anemia was corrected either chronically by erythropoietin
      administration (1000 IU/kg) over 14 days (EPO) or acutely by transfusion with red
      blood cells (TR). Non-anemic and untreated anemic animals served as controls.
      Tumor oxygenation was determined in anesthetized animals using polarographic
      needle electrodes and pO2 histography. The reduction in hematocrit and hemoglobin
      content found in anemic animals could successfully be corrected either by EPO or
      by TR. Anemia resulted in a worsening of tumor oxygenation which could partially
      be reversed by EPO or TR in small tumors (< 1.4 ml). In larger tumors (> or = 1.4
      ml), neither method of anemia correction resulted in significant changes in tumor
      oxygenation.

PMID- 7779428
TI  - Effect of nicotinamide and pentoxifylline on normal tissue and FSA tumor
      oxygenation.
AB  - Nicotinamide (NA) and pentoxifylline (PTX) sensitize experimental murine tumors
      to radiation without sensitizing normal tissues. They are presumed to exert this
      effect by reducing hypoxia in tumors. The present study evaluated the individual
      and combined effects of NA and PTX on oxygen levels in subcutaneous normal tissue
      and subcutaneous FSa fibrosarcoma tumors in the hind foot dorsum of C3H mice.
      Oxygen measurements were made using a polarographic needle electrode inserted
      into the tissue immediately before and/or 15-60 min after intraperitoneal
      administration of 500 mg/kg of NA, 50 mg/kg of PTX, or saline. The median tumor
      pO2 increased from a mean +/- S.E.M. of 4.1 +/- 1.1 mm Hg in saline-treated
      control mice to 6.8 +/- 1.9 mm Hg 15 min after NA, 7.6 +/- 1.4 mm Hg 60 min after
      PTX, and 6.7 +/- 1.1 mm Hg after NA and PTX in combination. PTX raised the median
      tumor pO2 level from 21% to 39% of the median subcutaneous normal tissue pO2 (p <
      0.01). PTX also significantly reduced the proportion of tumor pO2 values < or = 2
      mm Hg from 41 +/- 10% to 8 +/- 7% (p = 0.02). Although NA did increase the
      proportion of tumor that was well oxygenated, it did not significantly reduce the
      proportion of tumor pO2 values < or = 2 mm Hg (p = 0.34). The combination of NA
      and PTX did not add to the tumor oxygenation enhancement achieved by PTX alone.
      NA increased the median subcutaneous normal tissue pO2 by an average of 5.1 +/-
      2.2 mm Hg from a baseline of 17.1 +/- 2.2 mm Hg (p = 0.04). PTX had no effect on
      the median normal tissue pO2 (p = 0.93). PTX showed greater therapeutic potential
      in this model system than did NA.

PMID- 7779429
TI  - The modification of blood flow in tumours and their supplying arteries by
      nicotinamide.
AB  - We have studied the ability of the radiosensitizer nicotinamide (NA) to alter the
      contractility of normal and tumour blood vessels using an ex vivo isolated artery
      perfusion system. NA at a concentration of 8.2 mM reduced the constrictions
      produced by phenylephrine (PE) by 2-fold in both normal epigastric arteries and
      those that had been supplying p22 tumours in BD9 rats. At that same concentration
      NA also attenuated the spontaneous, rhythmic contractions that were seen in many
      tumour arteries. When the tumour arteries were perfused together with the tumour
      they supplied NA had little effect on the flow resistance of the tumour vascular
      network but reduced the resistance by up to 30% when the arteries were
      preconstricted with phenylephrine. These direct effects on vascular resistance
      together with the reduction of interstitial fluid pressure could combined to
      improve the homogeneity of tumour perfusion.

PMID- 7779430
TI  - The effect of nicotinamide on microregional blood flow within tumours assessed
      using laser Doppler probes.
AB  - Laser Doppler probes have been used to provide real-time spatial flow mapping of
      microregional erythrocyte flux within the murine Sarcoma F (SaF). The results
      demonstrate that fluctuations in microregional red blood cell flux are a common
      feature of SaF tumours, with approximately 50% of regions demonstrating a change
      of at least a factor of 2 over a one-hour sampling period and 16% of regions
      showing a greater than 5-fold change. Administration of 250 mg/kg nicotinamide
      induced a small reduction in the number of microregions showing fluctuations, 9%
      of regions demonstrated large fluctuations (i.e., > or = 5) relative to 16% in
      control tumours. At a dose of 500 mg/kg, the number of changes in microregional
      erythrocyte flux was increased. However, unlike either untreated or nicotinamide
      250 mg/kg pretreated animals, these changes were mostly increases in
      microregional flow. Indeed, 12 of the 13 changes by a factor of 5 or greater,
      observed following nicotinamide at 500 mg/kg, were increases. This effect on
      microregional flow translated into only a 25% increase in macroregional flow
      determined by averaging all the regions sampled.

PMID- 7779431
TI  - The role of tumor volume in 'reoxygenation' upon cyclophosphamide treatment.
AB  - The effect of cyclophosphamide (CP) injection (60 mg/kg i.p., single dose) on
      volume growth and tissue oxygenation (pO2 distribution) was investigated in rat
      DS-sarcomas. CP was administered 4 days after subcutaneous (s.c.) tumor
      implantation (volume approximately 0.35 ml). Polarographic pO2 measurements were
      performed in the subcutis at the hind foot dorsum and in tumors 72 h after CP
      administration. The oxygenation status of these tissues was compared with that of
      saline-treated controls. CP-injection caused a mean growth delay of 11 days in DS
      sarcomas and had no impact on the oxygenation status of the subcutis. In
      contrast, in s.c. growing DS-sarcomas the pO2 distribution improved significantly
      when treated tumors (0.59 ml volume) were compared with their untreated
      counterparts (1.15 ml volume). Comparison of the oxygenation data of CP-treated
      tumors with size-matched controls revealed an identical oxygenation status in the
      experimental tumors used. Thus, when 'reoxygenation' is discussed, one should
      consider whether it is solely the result of tumor shrinkage or a volume
      independent phenomenon.

PMID- 7779432
TI  - Tumor reoxygenation as a mechanism of taxol-induced enhancement of tumor
      radioresponse.
AB  - Paclitaxel is a novel chemotherapeutic agent that arrests cells in the
      radiosensitive G2 and M phases of the cell cycle and as such may act as a
      specific cell cycle radiosensitizer. We recently reported that paclitexel induces
      mitotic arrest in the MCA-4 murine mammary carcinoma and enhances radio-response
      of this tumor. However, the greatest enhancement was observed not when radiation
      was given at the time of peak mitotic arrest, which was 9 h after paclitaxel
      administration, but when it was given 24 h after paclitaxel. This implied the
      involvement of other mechanisms in radiosensitization; we hypothesized that tumor
      reoxygenation was a likely mechanism based on the observed massive loss of
      mitotically arrested cells at 24 h. The present study shows that paclitaxel
      greatly enhanced MCA-4 tumor radioresponse when radiation was given under air
      breathing conditions (DMF = 1.74), but not when it was performed under hypoxic
      conditions. This observation supports the hypothesis of tumor reoxygenation as a
      mechanism of enhancement of tumor radioresponse. That reoxygenation occurred in
      tumors treated with paclitaxel 24 h earlier was confirmed by direct measurements
      of pO2 values, using the Eppendorf pO2 histograph. Median pO2 values increased
      from 6.2 mmHg in untreated tumors to 10.0 mmHg in tumors treated with paclitaxel.
      These observations emphasize the importance of timing of paclitaxel
      administration in relation to radiation treatment.

PMID- 7779433
TI  - Interaction between ionizing radiation, estrogens and antiestrogens in the
      modification of tumor microenvironment in estrogen dependent multicellular
      spheroids.
AB  - MCF7 human breast cancer cells growing as multicellular spheroids were examined
      as a model of three-dimensional cellular organization. Estrogen-free medium
      inhibited spheroid formation. In medium containing estrogens, the antiestrogen
      hydroxytamoxifen decreased the spheroid growth rate. Analyses with the recursion
      formula after Gompertz fitting showed that the rate of exponential decrease in
      growth rate (alpha) was alpha 0.099 +/- 0.013 d-1, and the decrease in alpha' was
      0.061 +/- 0.015 d-1 for 0.1 microM hydroxytamoxifen and control spheroids
      respectively. MCF7 cells which had been growth arrested in an estrogen-free
      medium showed a significant decrease in radiosensitivity (surviving fraction at 2
      Gy, SF2 = 63%) when compared with 0.1 nM 17 beta-estradiol-treated cells (SF2 =
      38%). No differences in radiosensitivity were seen in MCF7 spheroids in estrogen
      supplemented medium (radiation dose necessary to control 50% of spheroids (SCD50)
      was 5.51 Gy; derived alpha, beta and SF2 were 0.301 +/- 0.110 Gy-1, 0.018 +/-
      0.005 Gy-2, and 51% respectively) when compared with monolayer cultures in the
      same medium (alpha = 0.316 +/- 0.059 Gy-1, beta = 0.023 +/- 0.006 Gy-2 and SF2 =
      50%). In the spheroid model, manipulating the cellular environment, i.e., with
      estrogen treatment, modulates sensitivity to ionizing radiation.

PMID- 7779434
TI  - Effect of intraperitoneal ATP on tumor growth and bone marrow radiation
      tolerance.
AB  - Transplants of a spontaneous murine fibrosarcoma (FSaII) treated with
      intraperitoneal ATP were studied in vitro, and in both C3H and nu/nu mice. Daily
      ATP treatment prolonged tumor volume doubling time in vivo and in vitro. Daily
      ATP treatments at the maximally tolerated dose (2 mmol/kg i.p.) did not
      significantly affect the pH or the PCr/Pi, or beta ATP/Pi ratios (measured by
      MRS). In contrast to the reduced tumor growth rate, there was no change in bone
      marrow recovery after whole body irradiation. ATP is minimally toxic to animals
      at active dose levels. It slows tumor growth rate without adversely affecting
      bone marrow radiation tolerance. ATP might therefore be useful as a biological
      modifier of chemotherapy or radiation therapy.

PMID- 7779435
TI  - Cytotoxic effect of tumour necrosis factor -alpha on sarcoma F cells at tumour
      relevant oxygen tensions.
AB  - We have investigated the response of a murine tumour cell line, the sarcoma F
      (SaF), to tumour necrosis factor-alpha (TNF) at oxygen tensions known to occur in
      vivo. Using the Eppendorf pO2 histograph, the oxygen status of SaF tumours grown
      in situ was assessed. The median pO2 of the SaF is less than 1% oxygen with over
      90% of values at or below 15 mmHg (< 2% O2). SaF cells primed in vitro for 24 h
      at tumour relevant oxygen tensions required at least four times more TNF to
      reduce cell number to 50% of controls following a 24 h incubation period in 21%
      oxygen. Chronic exposure of SaF cells to hypoxia during several passages
      increased resistance to TNF more than 60-fold. The oxygen sensitizing effect is
      transient as the resistance of hypoxic cells to TNF was reversed after 24 h
      incubation in air. These data clearly show that oxygen tension is a key modulator
      of the cytotoxic action of this important cytokine.

PMID- 7779436
TI  - Modification of tumour glucose metabolism for therapeutic benefit.
AB  - Tumours have a much greater dependence than normal tissues on anaerobic
      glycolysis for energy generation. We have studied the effects of glycolysis
      inhibition on tumour cells in vitro. Cellular ATP fell during exposure of cells
      in air to 2-deoxy glucose or to the lactate dehydrogenase inhibitor oxamate.
      Glycolysis inhibition alone did not alter clonogenic cell survival over 6 h, but
      a 6-h exposure to oxamate combined with doxorubicin (Dox) gave greater than
      additive cell killing. This effect was greatest when oxamate was dosed after Dox,
      suggesting that oxamate inhibited repair of Dox-induced damage. Oxamate also gave
      greater than additive cell killing in multicellular spheroids when combined with
      Dox and there was a greater than additive growth delay in spheroids dosed with
      Dox plus oxamate. These data demonstrate that inhibition of anaerobic glycolysis
      might be used to obtain a significant therapeutic gain in combination treatments
      with cytotoxic drugs or radiotherapy.

PMID- 7779437
TI  - Basic fibroblast growth factor radioprotects bone marrow and not RIF1 tumor.
AB  - We examined the potential of bFGF to function as a radioprotector of bone marrow
      (BM). Total intravenous doses of bFGF ranged from 1 to 24 micrograms/mouse, in 2
      divided doses. Whole body radiation (WBI) was given in a single fraction to C3H
      mice. Histologic observations were performed on femur BM at various times after
      bFGF (or placebo) treatment. Thigh radiation in thigh-tumor bearing mice was
      delivered in a single fraction. bFGF increased the LD50/30 of mice in a dose
      dependent fashion, with an apparent maximum protection obtained with > or = 6
      micrograms given half 24 h and half 4 h before irradiation. BM histology shows
      prominent recovery of megakaryocytes and all cell lineages along with less loss
      in cellularity compared to control irradiated animals. No radioprotection of RIF1
      tumors after bFGF was detected. These results indicate that bFGF may be a
      selective radioprotector of normal tissue.

PMID- 7779438
TI  - Modification of tumor microenvironment by cytokine gene transfer.
AB  - The tumor microenvironment is determined by the interactions between host and
      tumor cells, a process in which cytokines play a major role. We have used
      retroviral vectors to insert and express cytokine genes in tumor cells so as to
      induce predictable changes in the host cells that infiltrate tumors. This
      frequently caused changes in tumor cell phenotype through autocrine/intracrine
      pathways. We reasoned that cytokine-induced alterations in tumor cell phenotype
      and/or in infiltrating host cells might alter the in vitro and in vivo cellular
      response to irradiation. In the present paper we document some of the effects of
      expression of interleukin-6 (IL-6) and IL-7 genes in tumor cells in this regard.
      The studies support the hypothesis that cytokines may play a role in determining
      both intrinsic tumor radioresponsiveness and the tumor microenvironment and in
      these ways may influence in vivo tumor irradiation responses. Possible cytokine
      gene-mediated approaches to radiotherapy cancer are discussed.

PMID- 7779439
TI  - Protection against inhalation toxicity of ricin and abrin by immunisation.
AB  - 1. Abrin and ricin are highly toxic plant proteins which are very similar in
      structure and function and inhibit protein synthesis in eukaryotes. 2. Rats have
      been immunised against either toxin using formaldehyde-toxoids by three
      subcutaneous injections at intervals of 3 weeks. For abrin, serum titres in 14
      out of 15 rats were raised to between 1:12800 and 1:51200 after two injections, 6
      weeks from the start of the experiment. Titres of between 1:256 and 1:1024 were
      also measured in lung washes after challenge with active abrin toxin. 3. The
      three major antibody classes, IgG, IgM and IgA were present in the immune sera
      but IgG and IgA only were detected in lung washes. The proportion of IgA to IgG
      was higher in the lung fluid than in sera. Rats immunised by abrin toxoid were
      protected against 5 LCt50's of abrin by inhalation but others exposed to ricin
      were not. 4. For ricin, serum titres ranged from 1:800 to 1:25600 after two
      injections and after a third injection the titre range was the same but
      population samples were weighted towards the higher titres. All rats immunised
      with ricin toxoid survived the challenge of 5 LCt50's of ricin toxin by
      inhalation over the observation period of 28 days post-challenge. 5.
      Representative immunised rats (abrin toxoid) were taken at various times post
      exposure, humanely killed and tissues were examined for pathological changes. It
      was concluded that an apparently severe lung lesion occurred at a later time than
      in non-immunised, toxin challenged rats. This damage was not lethal over the
      experimental observation periods. 6. Immunisation by the sub-cutaneous route
      therefore protects against lethality from challenge by inhalation of ricin or
      abrin toxins but does not prevent significant lung damage.

PMID- 7779440
TI  - Decorporation of thorium-228 from the rat by 3,4,3-LIHOPO and DTPA after
      simulated wound contamination.
AB  - 1. With DTPA as a comparison, the siderophore analogue 3,4,3-LIHOPO has been
      examined for its ability to remove 228Th nitrate from the rat after subcutaneous
      (sc) and intramuscular (im) injection to simulate wound contamination. The
      commencement of treatment was delayed 30 min, 6 h or 1 d and the animals killed
      at 7 d. 2. In all cases 3,4,3-LIHOPO was appreciably more effective than DTPA
      although the efficacy of treatment and the relative effectiveness of the ligands
      decreased rapidly with their delay in administration. 3. Optimum removal with
      both ligands occurred when initial local administration at 30 min after exposure
      was followed by repeated intraperitoneal injection at 6 h, 1, 2 and 3 d. Under
      these conditions the body content of 228Th was reduced to 20% of controls after
      sc injection and 15% after im injection. The corresponding values using repeated
      DTPA administration were 80% and 54%. 4. It is concluded that 3,4,3-LIHOPO
      represents, potentially, a considerable advance on DTPA, the current agent of
      choice for the treatment of wounds contaminated by 228Th.

PMID- 7779441
TI  - Prevention of drug absorption in simulated theophylline overdose.
AB  - 1. The effects of emesis, gastric lavage and oral activated charcoal on
      theophylline absorption were compared in healthy volunteers. 2. One of four
      regimes (ipecacuanha-induced emesis, gastric lavage, oral activated charcoal and
      no treatment) was randomly chosen one hour after a simulated overdose with
      sustained-release theophylline on four separate occasions in twelve healthy
      volunteers. 3. Syrup of ipecacuanha produced emesis in all twelve volunteers but
      only seven vomited any tablets. Gastric lavage yielded tablets in only one
      volunteer. 4. The mean systemic availabilities (areas under the concentration
      time curves relative to control) of theophylline for ipecacuanha-induced emesis,
      gastric lavage and charcoal, were 107.1%, 101.1% and 16.9%, respectively. 5. Oral
      activated charcoal was thus highly effective, while gastric lavage and emesis
      were ineffective in preventing theophylline absorption. Activated charcoal is
      potentially the most effective first-line treatment for acute overdosage with
      sustained-release theophylline tablets.

PMID- 7779442
TI  - Setting air quality standards for carcinogens: an alternative to mathematical
      quantitative risk assessment--discussion paper.
AB  - 1. It has been accepted in many countries that the regulation of ambient air
      quality should involve the use of health-based air quality standards. 2. Setting
      standards for air pollutants which are genotoxic carcinogens presents difficult
      problems to the regulator, in that the prediction of the effects on health of low
      levels of exposure is suspected to be inaccurate, and is not presently amenable
      to either experimental or epidemiological verification. 3. In some countries,
      techniques of Mathematical Quantitative Risk Assessment (MQRA) have been adopted
      to calculate acceptable levels of exposure to, or the unit risk factors for,
      genotoxic carcinogens. We regard these approaches as unsatisfactory. 4. An
      alternative approach, based upon a number of argued premises, a strategy which
      identifies decision points and the cautious application of uncertainty factors,
      is described.

PMID- 7779443
TI  - The clinical value of screening for paracetamol in patients with acute poisoning.
AB  - In this retrospective study, we determined the clinical value of screening for
      paracetamol in 294 Chinese patients with acute poisoning presenting to the
      general medical wards at the Prince of Wales Hospital between January 1992 and
      June 1993. Of the 86 patients suspected of having ingested paracetamol, eight had
      levels above the recommended 'treatment line'. Of the 208 patients with no
      suspected paracetamol ingestion, four were found to have elevated but non-toxic
      plasma levels. The incidence of missed, potentially serious paracetamol poisoning
      in our patients with no suspected paracetamol ingestion is extremely uncommon.
      Routine screening of all patients with acute poisoning for toxic plasma
      paracetamol concentrations is therefore not indicated and should never be a
      substitute for thorough history taking and physical examination.

PMID- 7779444
TI  - The risk of aspiration in Dettol poisoning: a retrospective cohort study.
AB  - 1. To determine if the risk of aspiration is increased in 'Dettol' (4.8%
      chloroxylenol, pine oil and isopropyl alcohol) poisoning and the factors that may
      be responsible, a study was made of 89 patients and 89 matched control subjects
      with other forms of poisoning admitted to the Prince of Wales Hospital, Hong
      Kong. 2. Aspiration was more common in patients with Dettol poisoning (8% vs 3%,
      P = 0.16). There were more control subjects with drowsiness at presentation (54%
      vs 24%, P < 0.0001), but the use of gastric lavage (88% vs 64%, P < 0.001) and
      the occurrence of vomiting (62% vs 17%, P < 0.0001) were more common in patients
      with Dettol poisoning. 3. Our findings suggest that Dettol poisoning may be
      associated with an increased risk of aspiration. This increase in risk may be
      related to the use of gastric lavage and the common occurrence of vomiting in
      patients with Dettol poisoning.

PMID- 7779445
TI  - Continuous intravenous infusion in the unrestrained rat--procedures and results.
AB  - 1. A method of continuous infusion in the unrestrained rat is described, which
      provides a scientifically acceptable and easily maintained rodent model for use
      in toxicological investigations. 2. Sprague Dawley SPF rats had cannulas
      implanted into the vena cava via the femoral vein, and were continuously infused
      with physiological saline for a total of 28 or 90 days. 3. The results indicate
      that there was no change in body weight, food consumption, clinical observations
      or clinical biochemistry of infused rats when compared to non-infused rats. There
      were small changes in haematological parameters, however none were
      toxicologically significant. Urinary volume was increased and urinary specific
      gravity and osmolality were decreased. At macroscopic and microscopic examination
      there were findings of scar formation associated with the area of surgery and
      minimal irritation in the area of the vena cava which accommodated the cannula.
      4. These results indicate that implantation of a cannula into the vena cava of a
      rat and subsequent continuous intravenous infusion of physiological saline
      produces no toxicological adverse effects over a period of 90 days. Consequently,
      this model can be recommended for the continuous intravenous administration of
      test substances to rats.

PMID- 7779447
TI  - A stepwise procedure for evaluating irritant materials in normal volunteer
      subjects.
AB  - 1. The cutaneous response to a known irritant has been assessed in human
      volunteer subjects using both clinical scoring and two non-invasive instrumental
      methods; erythema measurement using an erythema meter and capillary blood flow
      using a laser Doppler device. 2. Aqueous solutions (0.5% and 1%) of sodium
      hydroxide were applied to back skin for 3, 15 and 60 min with assessments
      immediately after removal and at 1, 24 and 48 hours. 3. Increased erythema was
      seen with increasing duration of exposure and an increase was also seen at 1 h,
      24 h and 48 h after removal of the patch. The results obtained with the erythema
      meter paralleled the clinical erythema scores. However, the laser Doppler device
      showed the greatest changes immediately after removal of the patch with
      subsequent readings showing a gradual decrease. 4. Statistical analysis of the
      data has been carried out to determine the accuracy and precision of the
      assessment procedures and to determine the minimum test panel size for detecting
      irritant reactions. 5. Comparison between back and forearm skin indicated a
      greater sensitivity to sodium hydroxide on the back. 6. The results of this study
      define an ethical approach to testing irritant materials in human subjects and
      provide the basis for the development of a classification system for cutaneous
      irritants.

PMID- 7779450
TI  - Old enzymes in new roles.

PMID- 7779448
TI  - Persistence of sodium monofluoroacetate in rabbits and risk to non-target
      species.
AB  - 1. Sodium monofluoroacetate (1080), a vertebrate pesticide used in New Zealand,
      was administered orally to rabbits at two dose levels (sub-lethal and lethal) to
      determine how long 1080 would persist in plasma, liver, kidney, and muscle so
      that the risk of consumption of meat from lethally or sub-lethally poisoned
      rabbits by non-target species could be assessed. 2. The plasma elimination half
      life in rabbits receiving a sub-lethal dose was 1.1 h. Retention of 1080 in
      tissue was greater in rabbits dosed with a lethal dose than in those that
      received a sub-lethal dose. Irrespective of the dose level, concentration of 1080
      in muscle, kidney, and liver was substantially lower than in the plasma. 3.
      Poisoning of dogs is possible because of their extreme susceptibility to 1080.
      Poisoning of birds is less likely. The risk of secondary poisoning is reduced as
      the concentration of 1080 declines in putrefying carcasses.

PMID- 7779451
TI  - To pop or not to pop: p53 as a critical modulator of tumour responsiveness to
      therapy in vivo?

PMID- 7779449
TI  - A comparison of the acute pathology induced by 3-phenylamino-1,2-propanediol
      (PAP) and its mono-oleoyl ester in rodents with the toxic oil syndrome in man.
AB  - Phenylamino-1,2 propanediol (PAP) and its mono-oleoyl ester have been identified
      in samples of the cooking oil thought to be responsible for the Toxic Oil
      Syndrome (TOS) which occurred in Spain in 1981. The acute toxicity of PAP and its
      mono-oleoyl ester have been examined in rats and mice, after daily administration
      for periods of up to 14 days to determine whether these compounds could produce
      any of the pathologies of TOS. Even at the highest dose, the 1-mono-oleoyl ester
      of 3-phenylamino-1,2 propanediol did not cause any toxicity in rats or mice when
      given intraperitoneally. 3-Phenylamino-1,2 propanediol, however, was toxic when
      administered to rats by this route. After 6-10 consecutive daily doses of PAP, at
      the highest dose administered (350 mg kg-1), all of the rats became unwell.
      Postmortem examination showed that the major pathology present was massive
      pulmonary thromboembolism. Further investigations of the toxicity of PAP after
      intravenous administration showed that it was not directly vasotoxic. The
      pulmonary thromboembolism seen with intraperitoneally administered PAP was due to
      the toxic effect of PAP on the mesenteric tissue and blood vessels, causing
      thrombosis which subsequently embolised the blood vessels in the lung. Intra
      gastric administration of PAP caused no toxicity in rats. Comparatively, the
      pathology seen after intraperitoneal administration of PAP was not thought to be
      representative of the pathology of the toxic oil syndrome in man.

PMID- 7779446
TI  - Effects of variation in detoxification rate on dose monitoring through adducts.
AB  - 1. Fost et al. (Human & Experimental Toxicology 1991; 10: 25) have shown that
      ethylene oxide (EO) added to human blood gave rise to a higher level of adducts
      to haemoglobin (Hb) when the donors were deficient in an erythrocytic glutathione
      S-transferase (GST, later found to be GST-theta) than in blood from persons
      possessing this enzyme, and drew the conclusion that this polymorphism in
      detoxification rendered Hb adducts less suitable for biological monitoring. 2. By
      fitting a kinetic model to the data, the present study shows that the Hb adduct
      level gives a correct measure of the dose (concentration integrated over time)
      relevant to risk estimation. 3. It does illustrate, however, the importance of
      knowing an individual's detoxification efficiency, when Hb adduct measurements
      are used to assess environmental exposure, for example in occupational
      surveillance.

PMID- 7779452
TI  - The ying-yang of RAR and AP-1: cancer treatment without overt toxicity.

PMID- 7779453
TI  - Apoptosis: regulation and relevance to toxicology.
AB  - 1. Apoptosis is a remarkably stereotyped morphological event across all tissues
      in response to a vast array of damaging agents. 2. Our very existence depends
      upon a willing exchange of old life for new: apoptotic cell death is our guardian
      and saviour from genetic damage. 3. There is a close link between cell
      proliferation and apoptosis: When a cell picks up the machinery to proliferate it
      also acquires an abort pathway--'better dead than wrong'. 4. A wide variety of
      highly conserved genes have been implicated in triggering apoptosis. 5. The
      release of DNA loops from the nuclear scaffold is a more crucial intracellular
      event than DNA 'laddering' in apoptotic cells. 6. The manipulation of apoptotic
      rates in many of the common diseases in man will be a major therapeutic strategy
      in the future.

PMID- 7779455
TI  - Sarin-induced neuropathology in rats.
AB  - Sarin, a highly toxic cholinesterase (ChE) inhibitor, administered at near 1 LD50
      dose causes severe signs of toxic cholinergic hyperactivity in both the
      peripheral and central nervous systems (CNS). The present study evaluated acute
      and long-term neuropathology following exposure to a single LD50 dose of sarin
      and compared it to lesions caused by equipotent doses of soman described
      previously. Rats surviving 1 LD50 dose of sarin (95 micrograms/kg; IM), were
      sacrificed at different time intervals post exposure (4 h-90 days) and their
      brains were taken for histological and morphometric study. Lesions of varying
      degrees of severity were found in about 70% of the animals, mainly in the
      hippocampus, piriform cortex, and thalamus. The damage was exacerbated with time
      and at three months post exposure, it extended to regions which were not
      initially affected. Morphometric analysis revealed a significant decline in the
      area of CA1 and CA3 hippocampal cells as well as in the number of CA1 cells. The
      neuropathological findings, although generally similar to those described
      following 1 LD50 soman, differed in some features, unique to each compound, for
      example, frontal cortex damage was specific to soman poisoning. It is concluded
      that sarin has a potent acute and long-term central neurotoxicity, which must be
      considered in the design of therapeutic regimes.

PMID- 7779454
TI  - Superoxide radical and toxicity of environmental nickel exposure.
AB  - Three nickel compounds were tested for pancreatic, hepatic and osteogenic damage
      in rats by a single i.m. injection Ni++ (7 mg kg-1). The nickel induced
      biochemical alterations included significantly increased levels of serum alkaline
      phosphatase in rats with NiS (75%) and NiO (50%). Amylase and aspartate
      transaminase were also increased, and lipoperoxide was increased in rats with NiO
      (5.6-fold) and NiS (3.4-fold). No serum changes were observed with NiCl2. Daily
      injection of Cu-Zn superoxide dismutase (SOD) conjugated with polyethylene glycol
      prevented the serum level changes, indicating that superoxide radical is an
      important intermediate in toxicity of nickel insoluble compounds.

PMID- 7779456
TI  - In vitro and in vivo percutaneous absorption of 14C-chloroform in humans.
AB  - Chloroform has been found in potable water and there is concern that significant
      dermal absorption may arise from daily bathing and other activities. The present
      study examines percutaneous absorption of 14C-chloroform in vivo using human
      volunteers and in vitro using fresh, excised human skin in a flow-through
      diffusion cell system. Fifty microlitre doses of either 1000 micrograms ml-1
      chloroform in distilled water, (16.1 micrograms cm-2) or 5000 micrograms ml-1 of
      chloroform in ethanol, (80.6 micrograms cm-1) were applied to the forearm of
      volunteers with exhaled air and urine being collected for analysis. Single doses
      of either 0.4 microgram ml-1 chloroform in distilled water (low dose, 0.62
      microgram cm-2, 1.0 ml dosed) or 900 micrograms ml-1 chloroform in distilled
      water (high dose, 70.3 micrograms cm-2, 50 microliters dosed) were applied to
      discs of the excised abdominal skin placed in flow-through diffusion cells and
      perfused with Hepes buffered Hank's balanced salt solution, with a wash at 4 h.
      In vivo absorption was 7.8 +/- 1.4% (water as vehicle) and 1.6 +/- 0.3% (ethanol
      as vehicle). Of the dose absorbed in vivo, more than 95% was excreted via the
      lungs (over 88% of which was CO2), and the maximum pulmonary excretion occurred
      between 15 min and 2 h after dosing. The percentage of dose absorbed in vitro
      (skin+perfusate) was 5.6 +/- 2.7% (low dose) and 7.1 +/- 1.4% (high dose). The
      above data demonstrate that a significant amount of the dissolved chloroform
      penetrates through the human skin, and that a higher percentage of the applied
      dose was absorbed using water as vehicle.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779457
TI  - Effects of a protein kinase C inhibitor, Ro 31-7549, on the activation of human
      leukocytes by particulate stimuli.
AB  - 1. A new specific protein kinase C (PKC) inhibitor, Ro 31-7549, was used to
      explore the mechanisms by which particulate stimuli, quartz and chrysotile,
      stimulate human polymorphonuclear leukocytes (PMNL) to produce reactive oxygen
      metabolites (ROM). Also soluble stimuli, formyl-Methionyl-Leucyl-Phenylalanine
      (fMLP) and phorbol myristate acetate (PMA) were used. 2. Ro 31-7549 inhibited
      chrysotile-induced free intracellular calcium ([Ca2+]i) elevations but did not
      have an effect on quartz-induced elevations of [Ca2+]i. Both quartz and
      chrysotile induced production of ROM were partially inhibited by Ro 31-7549. fMLP
      induced elevation of [Ca2+]i was inhibited by Ro 31-7549 whereas PMA did not
      affect [Ca2+]i. Ro 31-7549 strongly inhibited fMLP-induced ROM production, and
      completely abolished that induced by PMA. 3. These result suggest that PKC may
      have an important role in the activation of PMNL to produce ROM by particulate
      and soluble stimuli. However, the inhibition of chrysotile-, but not of quartz
      induced [Ca2+]i elevations by Ro 31-7549 provides evidence that both PKC
      dependent and -independent mechanisms may play a role in the activation of human
      leukocytes to produce ROM.

PMID- 7779458
TI  - A biologically-based algorithm for predicting human tissue: blood partition
      coefficients of organic chemicals.
AB  - A biologically-based algorithm for predicting the tissue: blood partition
      coefficients (PCs) of organic chemicals has been developed. The approach
      consisted of (i) describing tissues and blood in terms of their neutral lipid,
      phospholipid, and water contents, (ii) obtaining data on the solubility of
      chemicals in n-octanol and water, and (iii) calculating the tissue: blood PCs by
      assuming that the solubility of a chemical in n-octanol corresponds to its
      solubility in neutral lipids, the solubility in water corresponds to the
      solubility in tissue/blood water fraction, and the solubility in phospholipids is
      a function of solubility in water and n-octanol. The adequacy of this approach
      was verified by comparing the predicted values with previously published
      experimental data on human tissue (liver, lung, muscle, kidney, brain, adipose
      tissue): blood PCs for 23 organic chemicals. In the case of liver, lung, and
      muscle, the predicted PC values were in close agreement with the higher-end of
      the range of experimental PC values found in the literature. The predicted brain:
      and kidney: blood PCs were greater than the experimental PCs in most cases by
      approximately a factor of two. Whereas the adipose tissue: blood PCs of
      relatively less hydrophilic chemicals were adequately predicted, the predicted
      PCs for relatively more hydrophilic chemicals were much greater than the
      experimentally-determined values. There was a good agreement between the
      predicted and experimentally-determined blood solubility of the 23 chemicals
      chosen for this study, indicating that the over-estimation of tissue:blood PCs by
      the present method is not due to under-estimation of blood solubility of
      chemicals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779459
TI  - Measurement of the respiratory burst and chemotaxis in polymorphonuclear
      leukocytes from mercury-exposed workers.
AB  - The chemotactic and nitroblue tetrazolium reducing activities of neutrophils from
      48 mercury-exposed workers were examined and compared with those of non-exposed,
      age- and sex-matched individuals. At the time of testing, the exposed population
      had a mean (+/- s.d.) urinary mercury concentration of 24.0 +/- 20.1 micrograms g
      1 creatinine and in 44 of these workers urinary mercury levels were below the
      accepted threshold level (TLV) of 50 micrograms g-1 creatinine. The two
      neutrophil functions were significantly reduced in the mercury-exposed workers
      compared with the controls. In 28 of these workers, chemotaxis was re-evaluated 6
      months later. During the intervening 6 months, the level of hygiene was improved
      throughout the plant and urinary mercury concentrations were determined monthly
      in each worker. Despite a significant reduction in urinary mercury
      concentrations, neutrophil migration did not return to within the normal range.
      These results suggest that 'safe' level mercury exposure may lead to impairment
      of neutrophil function.

PMID- 7779460
TI  - Human metabolism of aluminium-26 and gallium-67 injected as citrates.
AB  - 1. 26Al and 67Ga were given as citrates to a healthy male volunteer by
      intravenous injection. The retention of both tracers was studied by body
      radioactivity measurement. Levels in blood and excreta were determined by gamma
      ray spectrometry and/or accelerator mass spectrometry. 2. More than half of the
      26Al had left the blood after 15 min and the decline continued, leaving < 1% in
      blood after 2 d; the losses occurred both to renal excretion and through uptake
      by other compartments. Estimated excretion up to 13 d was 83% (urine) and 1.8%
      (faeces). Whole-body retention of 15% at 13 d declined to approximately 4% at
      1178 d, when the daily reduction corresponded to a biological half-life of 7 y,
      suggesting that sustained intake of dietary aluminium may lead to a progressively
      increasing internal deposit. 3. The metabolism of 67Ga differed markedly from
      that of 26Al in all aspects studied.

PMID- 7779461
TI  - Amisulpride poisoning: a report on two cases.
AB  - The first two observations of human poisoning involving the recently developed
      neuroleptic amisulpride are described. In both cases drug determination was
      performed using reversed-phase HPLC coupled with diode array detection. Case 1
      was a nonfatal overdosage in which the ingestion of 3.0 g amisulpride induced an
      attack of seizures, then light coma with agitation, hyperthermia, mydriasis,
      minimal extrapyramidal features, tachycardia and slight prolongation of the QT
      interval; the blood concentration of amisulpride was 9.63 micrograms ml-1. Case 2
      was a fatality attributed to amisulpride in which the measured blood
      concentration was 41.70 micrograms ml-1. Our results are discussed in the light
      of data previously reported on the toxicity of substituted benzamides.

PMID- 7779462
TI  - Cimetidine as adjunctive treatment for acetaminophen overdose.
AB  - The aim of this study was to determine if cimetidine in addition to N
      acetylcysteine and standard supportive care provide additional hepatoprotection
      following acute acetaminophen poisoning. It was designed as a prospective study
      with alternate month treatment protocol, and the work was carried out at a
      regional certified poison information centre. For a 2-year period, consultations
      received by the Rocky Mountain Poison Center involving acute acetaminophen
      overdose patients with a serum level above the nomogram line, but who would not
      receive N-acetylcystine therapy until at least 8 h postingestion, were
      prospectively evaluated for adjunctive treatment with cimetidine. All patients
      received standard supportive therapy and N-acetylcysteine treatment. During odd
      numbered months, cimetidine 300 mg was administered intravenously every 6 h for
      the duration of N-acetylcysteine therapy. Forty-one cimetidine treated patients
      were compared to 66 patients in the control group. The peak measured AST levels
      (+/- s.e.) were 1259+/-330 and 1301+/-451 for the control and cimetidine
      treatment groups, respectively (P = 0.94). Fourteen of 64 patients (21%) in the
      control group and 8/41 patients (20%) in the cimetidine group developed an AST >
      1000 IUL-1. There were no statistical differences between the cimetidine-treated
      and control groups when classified by AST < 100 IUL-1, 100-1000 IUL-1, or > 1000
      IUL-1. The addition of cimetidine therapy to standard N-acetylcysteine treatment
      did not provide additional hepatoprotection in acutely acetaminophen poisoned
      patients when treatment was started later than 8 h post overdose.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7779463
TI  - Guideline limit volumes for dosing animals in the preclinical stage of safety
      evaluation. Toxicology Subcommittee of the Association of the British
      Pharmaceutical Industry.
AB  - Guideline limit volumes for dosing laboratory animals by oral and parenteral
      routes in the preclinical stage of safety evaluation were agreed following
      discussions by the Toxicology Subcommittee of the Association of the British
      Pharmaceutical Industry. The guideline values represent common practice rather
      than absolute maxima. Whilst the guideline values are expected to be of value to
      scientists and technical staff involved in study design and applicable to the
      majority of routine safety evaluation studies, scope remains to make the case for
      special investigations. The need to carefully consider animal welfare and
      physiology, current legislation, the use of appropriate dosing technology and
      formulations, and other practical aspects of study conduct, is emphasised.

PMID- 7779464
TI  - NO wonder paraquat is toxic.

PMID- 7779465
TI  - The good, the bad and the ugly of T-cell selection in the thymus.

PMID- 7779466
TI  - Arty-crafty fact of life?

PMID- 7779467
TI  - Isolation of renal multidrug transporter.

PMID- 7779468
TI  - General practitioners' tacit and stated policies in the prescription of lipid
      lowering agents.
AB  - BACKGROUND: Research into general practitioners' prescribing behaviour with
      regard to lipid lowering agents has relied on survey methods which presume that
      doctors have insight into their prescribing behaviour and can describe it
      accurately. AIM: This study set out to measure the tacit policies used by general
      practitioners in prescribing lipid lowering agents and to compare these with
      their stated policies. METHOD: Effects of 13 separate cues on decisions to
      prescribe were examined. The cues included cholesterol levels and a number of
      associated risk factors for coronary heart disease. Doctors rated 130 imaginary
      cases presented by a computer. Thirty five general practitioners in the Plymouth
      area participated in the study. Their ages ranged from 31 to 55 years and all but
      four were men. The raw data in each case was a rating of the likelihood that the
      doctor would prescribe for the patient described. These were converted into
      statistical weightings by use of multiple linear regression. The pattern of
      (standardized) weights constituted the tacit policy for each doctor. Stated
      policies were measured in a subsequent interview by asking doctors to rate the
      influence of each cue. RESULTS: Both tacit and stated policies diverged widely
      between different doctors. Most doctors overestimated the number of cues that had
      actually influenced their decisions, and many believed that they had taken into
      account associated factors for coronary heart disease when they had not. On
      lifestyle related risks doctors were generally less likely to treat overweight
      people and most stated this as their policy. Most were also less likely to treat
      smokers but some had the opposite policy. Those less likely to treat smokers were
      also less likely to treat obese patients. There was also considerable variation
      in the extent to which the doctors took account of the attitude of the patient to
      receiving treatment. CONCLUSION: Doctors' policies are highly variable and
      particularly inconsistent in the treatment of smokers. Relevant risk factors may
      be ignored--even though they are understood--because the risk assessment involved
      is too psychologically complex a task to be performed intuitively. Decision aids
      and clear protocols are needed in this area.

PMID- 7779469
TI  - Should medical students learn more about management?

PMID- 7779470
TI  - Use of blood tests in general practice: a collaborative study in eight European
      countries. Eurosentinel Study Group.
AB  - BACKGROUND: Laboratory tests are routine examinations in general practice and are
      associated with increasing costs in industrialized countries. AIM: The objective
      of this collaborative study was to determine the differences in general
      practitioners' use of blood tests in different European countries and to evaluate
      the relationship between these differences and organizational aspects of the
      health care system and also characteristics of the participating general
      practices. METHOD: A descriptive study was conducted by eight European sentinel
      networks. Voluntary participating general practitioners registered all blood
      tests requested for four weeks, specifying the type of test, and age group and
      sex of patients. Details of all face-to-face encounters with patients by age
      group and sex were collected for the same period. Information on the
      participating practices and general practitioners was collected by questionnaire.
      RESULTS: The request rate for blood tests varied considerably between countries.
      The characteristics of general practitioners and practice were only slightly or
      were not associated with the use of blood tests while dummy 'country' variables
      were strongly associated. The number of general practitioners per 1000
      inhabitants was the most positively associated variable partly explaining the
      intercountry variation. CONCLUSION: This European study suggests that some
      national characteristics of the health system could determine the use of blood
      tests in general practice and underlines the need for further investigation in
      order to develop successful strategies for promoting the optimal use of
      diagnostic technology.

PMID- 7779471
TI  - Health care sought and received by men with urinary symptoms, and their views on
      prostatectomy.
AB  - BACKGROUND: Urinary symptoms are common among middle aged and elderly men. AIM: A
      study was undertaken to describe the health care sought by men aged 55 years and
      over with urinary symptoms, the action taken by general practitioners and
      urologists, and the men's views on prostatectomy. METHOD: A postal questionnaire
      was sent to 516 men aged 55 years and over in the North West Thames Regional
      Health Authority, with previously identified mild, moderate or severe urinary
      symptoms. RESULTS: The response rate among eligible subjects was 83%. Of 420
      respondents 45% had seen their general practitioner for their symptoms. General
      practitioners had referred 62% of these men to a urologist, reassured 21% and
      prescribed medication to 17%. The probability of a man seeking medical advice
      increased with increasing symptom severity. In contrast, the decision to refer
      was independent of symptom severity. Of the men referred to a urologist, the
      majority (71%) were offered and accepted surgery. The remainder were reassured
      (17%), or received a prescription (4%). Eight per cent were offered surgery but
      declined. When presented with details and information on the risks and benefits
      of prostatectomy, 22% of men with symptoms would probably or definitely refuse
      treatment, while a further 47% of men were unsure. CONCLUSION: There are many men
      who do not seek treatment for urinary symptoms and, of those who do, subsequent
      referral is not associated with symptom severity. There is scope for improving
      the referral process through the shared development of guidelines between general
      practitioners, hospitals and commissioning agencies.

PMID- 7779472
TI  - Living up to expectations?

PMID- 7779473
TI  - One counsellor, two practices: report of a pilot scheme in Cambridgeshire.
AB  - BACKGROUND: Despite limited evidence of their effectiveness, counsellors are
      increasingly being employed as part of the primary health care team. Evaluation
      of counsellor services is therefore important. AIM: In 1990 the Cambridgeshire
      Family Health Services Authority initiated a pilot scheme to evaluate the role of
      counsellors in general practice and to help the authority determine its policy
      towards claims by general practitioners for reimbursement through the ancillary
      staff scheme. METHOD: Two group practices were identified and an external
      evaluator appointed. The evaluator and the general practitioners developed their
      aims and objectives for counselling in the general practice context, the number
      of counsellor hours per week and the type and process of referral. An experienced
      counsellor was appointed to work in both practices. Information was gathered over
      two years about doctors' reasons for referral, counsellor's initial assessment,
      patient outcome at the end of treatment, the patients' and practice teams'
      opinions about the counselling service, and patient outcome a year after
      counselling. RESULTS: A total of 293 patients were referred in the first two
      years of the scheme, of whom 75% were women. The main reasons for referral were
      that the general practitioners considered the patients to be suffering from
      anxiety/stress (33%), interpersonal difficulties (33%) and depression (20%).
      Almost all referrals (98%) were considered by the counsellor to be appropriate.
      The counsellor was able to provide an assessment for the 248 patients who
      attended and either take on the case for short-term counselling (69%) or suggest
      referral to a more appropriate service (25%) (6% withdrew). The expected maximum
      of six sessions of 45 minutes duration per referral was achieved in 87% of cases.
      The service was valued by patients and doctors. It coped effectively with a high
      proportion of patients with problems who did not reappear as demand elsewhere in
      the practice, and achieved a reduction in dose of psychotropic drugs among those
      seen. CONCLUSION: This study has shown the value of clarifying referral criteria
      and the intended role of the counsellor prior to the counsellor's introduction.
      This ensures effective use of a scarce resource and a high level of satisfaction
      among doctors and patients.

PMID- 7779474
TI  - Practice nurse workload before and after the introduction of the 1990 contract
      for general practitioners.
AB  - BACKGROUND: A study of practice nurse workload in 1989 by the East Anglian
      reporting system revealed that nurses were undertaking a wide range of
      activities, with 12% of nursing time being spent on administration. The 1990
      contract for general practitioners emphasized the role of general practice in
      health promotion. AIM: The 1989 study was repeated by the East Anglian reporting
      system in 1992 to investigate changes in practice nurse workload. METHOD: Nurses
      in 22 practices recorded all the procedures they performed and their duration,
      over a two week period. RESULTS: The number of practice nurses in each practice
      had increased from 0.7 full time equivalents in 1989 to 1.2 in 1992. The
      proportion of time spent on administration had increased to 19%. The number of
      different procedures performed by practice nurses had risen from 36 in 1989 to 54
      in 1992, with most new activity in well person and new patient clinics.
      CONCLUSION: Changes have taken place in the volume and range of work undertaken
      by practice nurses. There is potential for practice nurses to use the results
      both for negotiation and for education.

PMID- 7779476
TI  - Audit as part of summative assessment of vocational training.
AB  - Written evidence of the ability to carry out audit and performance review looks
      likely to be one of the four components of a summative assessment package for the
      end of vocational training. This paper seeks to raise the issues involved in this
      process. The features of audit which lend themselves to assessment of the
      attributes of a general practitioner are discussed. The criteria which might be
      used to assess a written submission are presented. A possible mechanism for
      marking and grading is suggested, and strategies for optimizing the validity and
      reliability of that assessment discussed. A timescale for implementation is also
      suggested. These issues need to be discussed and a process piloted if a credible
      mechanism is to be in place by August 1996.

PMID- 7779475
TI  - Primary care management of acute herpes zoster: systematic review of evidence
      from randomized controlled trials.
AB  - Although a number of randomized controlled trials of treatment for herpes zoster
      have been performed, there is no consensus on how it should be managed in general
      practice. A systematic review of existing trials, including meta-analysis, was
      performed to determine the efficacy of available therapies in reducing the
      incidence of postherpetic neuralgia. The treatments studied included antiviral
      agents, corticosteroids and other drugs which had been studied in randomized
      trials. Trials were included if the subjects were immunocompetent adults and the
      intervention was feasible in general practice. The main outcome measure was
      prevalence of pain at one, three and six months after onset of the acute herpetic
      rash. Data for each time point were not available for all trials. The quality of
      studies was also assessed. Pooled analyses of trials with acyclovir failed to
      detect a significant reduction of pain in the treatment group at one or six
      months, but found a 35% reduction at three months. Confidence limits were wide,
      and a modest benefit of treatment cannot be ruled out at one and six months.
      Pooled analyses were not possible for other treatments, either because too few
      trials had been performed, or because completed trials demonstrated significant
      heterogeneity. Many clinical trials in this area have been too small to give
      reliable results. Variations in the definition and reporting of postherpetic
      neuralgia create difficulties in combining data from different studies. Firm
      recommendations for clinical practice are not possible because existing evidence
      neither confirms nor refutes the hypothesis that treatment during the acute phase
      of herpes zoster reduces pain later.

PMID- 7779478
TI  - Patients in fundholding and non-fundholding practices.

PMID- 7779477
TI  - Readiness for lifestyle advice: self-assessments of coronary risk prior to
      screening in the British family heart study. Family Heart Study Group.
AB  - BACKGROUND: Where health professionals and patients hold similar views of a
      problem, health outcomes may be better. AIM: The aims of this paper were to
      document how attenders at primary care cardiovascular screening clinics perceived
      their risks of coronary heart disease prior to screening; the degree of
      similarity between perceived level of risk and an epidemiologically derived risk
      score; and the relative importance assigned to individual risk factors by
      subjects compared with those assigned by the risk score. METHOD: These issues
      were investigated in 3725 middle aged men and women who accepted an invitation to
      attend health screening as part of the British family heart study. RESULTS:
      Overall, there was a tendency for subjects to be optimistic (37%) rather than
      pessimistic (21%) when judging their risk of coronary heart disease.
      Nevertheless, there were strong significant associations between perceived risk
      and the levels of individual risk factors, particularly personal and family
      medical history and body mass index. There was also a strong association with the
      overall risk score though a large minority (31%) held views of their risk of
      coronary heart disease that were quite different from those based upon the
      epidemiologically derived index of risk. Respondents accorded greater importance
      to smoking and parental death from coronary heart disease and less importance to
      cholesterol level and blood pressure than did the risk score. CONCLUSION:
      Possible explanations for the observed disagreement are over-optimism or the
      relative importance given to individual risk factors. The relationships between
      patients' perceptions of risk and the epidemiological indices likely to be
      espoused by health professionals are important in understanding the difficulties
      in communication that might arise in offering lifestyle advice after screening
      for cardiovascular risk.

PMID- 7779479
TI  - Surveys of GPs: methodological considerations.

PMID- 7779480
TI  - Leicester assessment package.

PMID- 7779481
TI  - Identifying the agenda in the consultation.

PMID- 7779482
TI  - Quality of minor surgery in general practice.

PMID- 7779483
TI  - Quality of minor surgery in general practice.

PMID- 7779484
TI  - Rural general practice.

PMID- 7779485
TI  - Paperless medical records--approval still awaited.

PMID- 7779487
TI  - Marfan's syndrome.

PMID- 7779488
TI  - Diagnosis and treatment of Helicobacter pylori infection in peptic ulcer disease.

PMID- 7779486
TI  - A family care approach for managing childhood asthma.
AB  - Asthma is the most common chronic illness in childhood, affecting more than 2
      million children annually. Although families have always been responsible for
      daily maintenance care, management of acute exacerbations of asthma are now
      coming within the province of home care management. The comprehensive family care
      approach discussed in this article incorporates environmental therapy,
      psychoeducational therapy, and medication therapy in a three-pronged approach to
      promote successful management of asthma episodes while working to reduce their
      incidence.

PMID- 7779490
TI  - A College for Europe?

PMID- 7779489
TI  - Psoriasis.
AB  - Psoriasis is a chronic skin disease that has multiple presentations. Patients
      frequently present with concerns about the cosmetic changes that psoriasis
      produces. While psoriasis is rarely life-threatening, it can be very devastating
      to the affected individual. Consequently, the various presentations of psoriasis
      need to be known by the health care provider. In addition, other dermatological
      conditions that may be confused with psoriasis need to be identified as part of
      the differential diagnosis so that the appropriate treatment may be instituted
      and potential effects of psoriasis, both physical and emotional, may be
      minimized.

PMID- 7779491
TI  - Newcastle Dental School and Hospital celebrates its centenary.

PMID- 7779492
TI  - A misplaced molar.

PMID- 7779493
TI  - Inadequately trained dental surgeons.

PMID- 7779494
TI  - Broken dental forceps.

PMID- 7779495
TI  - HIV awareness.

PMID- 7779496
TI  - Traumatised teeth.

PMID- 7779497
TI  - Weekend orthodontists.

PMID- 7779498
TI  - April fool.

PMID- 7779499
TI  - April fool.

PMID- 7779500
TI  - Clinically essential.

PMID- 7779501
TI  - The status of the LDS qualification.

PMID- 7779502
TI  - Cross-infection control in general dental practice: dentists' behaviour compared
      with their knowledge and opinions.
AB  - This study aimed to establish how dentists' knowledge, opinion and behaviour
      about cross-infection control were related and how they were affected by their
      ages, gender and the sizes of the practices in which they worked. In 1990/91 all
      general dental practitioners in the North Western Health Region of England were
      asked to complete a questionnaire about cross-infection control; 917 (75%) did
      so. Responses from all single-handed and one dentist selected randomly from each
      group practice were analysed (n = 546). The score to measure behaviour was based
      on guidelines on cross-infection control issued by the British Dental Association
      and this was correlated with scores for knowledge and opinion. The more
      knowledgeable not only tended to hold favourable opinions about the guidelines
      but also to practise them. Younger dentists were more knowledgeable about cross
      infection control measures than older and more likely to wear gloves.
      Irrespective of age, all female dentists were more likely to wear gloves than
      their male colleagues. Single-handed dentists were less willing to treat carriers
      of HIV and HBV. Although 65% thought that recommended control procedures are
      feasible, 43% considered them prohibitively expensive.

PMID- 7779503
TI  - The relationship between the index of orthodontic treatment need and consensus
      opinion of a panel of 74 dentists.
AB  - This study looked at the aesthetic and dental health components of the index of
      orthodontic treatment need in relation to peer assessment of dental health and
      aesthetic need (panel of 74 dentists). The dental health component had a
      Spearmans correlation coefficient of +0.64 and the aesthetic component +0.86 when
      compared with the mean subjective opinion of 74 dentists. It has been proposed to
      have three categories for both the dental health and aesthetic components in
      accordance with consensus opinion. The panel of 74 examiners were more likely to
      regard aesthetics as a greater need for treatment than dental health.

PMID- 7779504
TI  - Palatal root hemisections and subsequent tooth restoration: a simple procedure?
AB  - This article describes a simple procedure for palatal root hemisection in
      maxillary molars and their subsequent restoration. Hemisection has several
      advantages over resection at all stages and allows for simple prosthetic
      restoration, especially when treating the palatal root.

PMID- 7779505
TI  - Periodontology: a clinical approach. 6. Reconstructive periodontal treatment.

PMID- 7779506
TI  - The first triennium of the Commonwealth Dental Association.
AB  - Formed in 1991 to address the increasing prevalence of oral diseases and shortage
      of resources in many of the Commonwealth countries, the Commonwealth Dental
      Association (CDA) is celebrating its first triennium. Having achieved a
      successful and productive 3 years, the CDA is now looking to the next three with
      further goals in mind.

PMID- 7779507
TI  - Letters from California--the safety police.
AB  - I am sure many people imagine the United States of America as the land of the
      free, where people can do what they want unfettered by unnecessary rules,
      regulations and taxation. Unfortunately, the truth is very different and there
      are as many rules and regulations in the USA as almost anywhere else, and in some
      cases they are more complex since regulations come from both the federal
      government and the state government. Both may pass similar laws which differ in
      small degrees so there may be considerable areas of overlap but also considerable
      differences between the federal and state regulations. For dentists, a particular
      area of concern in recent years has been the agency known as OSHA, the Office of
      Safety and Health Administration.

PMID- 7779508
TI  - Seeing patients.
AB  - Seeing patients is something that we do most days. Indeed patients seeing us is
      something that happens most days too. Both situations are fine in the practice
      setting, but what happens outside?

PMID- 7779509
TI  - The molecular biology of nucleotide excision repair and double-strand break
      repair in eukaryotes.

PMID- 7779510
TI  - Uses for GAL4 expression in mammalian cells.

PMID- 7779511
TI  - The genetics of nuclear migration in fungi.

PMID- 7779512
TI  - Structure and function of the platelet-derived growth factor family and their
      receptors.

PMID- 7779513
TI  - Recombination between prokaryotic and eukaryotic DNA: integration of
      Agrobacterium tumefaciens T-DNA into the plant genome.

PMID- 7779514
TI  - Manipulating and mapping DNA with RecA-assisted restriction endonuclease (RARE)
      cleavage.

PMID- 7779515
TI  - Molecular studies on the virulence of Listeria monocytogenes.

PMID- 7779516
TI  - Role of molecular chaperones in the initiation of plasmid DNA replication.

PMID- 7779518
TI  - President's message: successful office practice management summit.

PMID- 7779519
TI  - Patient-focused care: been there, done that.

PMID- 7779517
TI  - Structure, function and engineering of Bacillus thuringiensis toxins.
AB  - Nature has provided potent insecticidal toxins as fermentation products of many
      Bacillus thuringiensis strains. Elucidation of structure-function relationships
      for this class of natural toxins is in its early stages. Both direct
      experimentation and application of theoretical structure-function principles
      emerging from the rapidly growing field of protein structure are accelerating
      understanding of these toxins. Coupled with the increasing demand for
      biologically sound pesticides, the benefits from engineering nature's toxins for
      improved performance set the stage for exciting, fast growth in discovery,
      characterization and commercialization of new active ingredients for
      biopesticides and transgenic plants.

PMID- 7779520
TI  - Review of ectodermal dysplasias for nurses.
AB  - The purpose of this continuing education feature is to introduce nurses to a
      group of disorders called ectodermal dysplasias. The ectodermal dysplasias are
      genetic disorders that affect individuals from all ethnic groups. Most of the
      features of ectodermal dysplasias can be evaluated easily and useful information
      can be given to affected individuals and their families about the disorder and
      readily available treatment.

PMID- 7779521
TI  - The role of home health nursing: a dermatologic case study.
AB  - The role of home health nursing is described in managing a postoperative wound
      infection. An 87-year-old woman underwent Mohs' cutaneous micrographic excision
      of an extensive basal cell carcinoma of the nose, with immediate reconstruction
      using a bilobed transposition flap. Her postoperative course was notable for an
      extensive wound infection characterized by cellulitis and local abscess
      formation. Inpatient admission was averted by using extensive home health nursing
      resources.

PMID- 7779522
TI  - What's your assessment?

PMID- 7779523
TI  - Dermatological management of Kaposi sarcoma.
AB  - Kaposi sarcoma (KS) is a chronic wound care problem for health care providers.
      Management of KS includes topical, intralesional, and systemic treatment
      modalities. The type of treatment used for KS depends on the classification of
      the disease which can be classical KS, African or endemic KS, iatrogenic
      immunosuppression KS, and epidemic or AIDS KS.

PMID- 7779524
TI  - Differential mechanism of retention of Cu-pyruvaldehyde-bis(N4
      methylthiosemicarbazone) (Cu-PTSM) by brain and tumor: a novel
      radiopharmaceutical for positron emission tomography imaging.
AB  - The reductive retention of 62Cu-PTSM was comparatively studied in the brain and
      Ehrlich ascites tumor cells by electron spin resonance spectrometry and
      nonradioactive Cu-PTSM. In the brain, only the mitochondrial fraction showed the
      ability to reduce Cu-PTSM, and the other subcellular fractions did not. In
      contrast, the cytosolic fraction of Ehrlich ascites tumor cells was the specific
      site of Cu-PTSM reduction. It was therefore considered that the retention of Cu
      PTSM in the brain is closely related to mitochondrial reduction, most probably
      involving the mitochondrial electron transport system.

PMID- 7779525
TI  - Regional cerebral blood flow, blood volume, oxygen extraction fraction, and
      oxygen utilization rate in normal volunteers measured by the autoradiographic
      technique and the single breath inhalation method.
AB  - By means of a high resolution PET scanner, the regional cerebral blood flow
      (rCBF), cerebral blood volume (rCBV), oxygen extraction fraction (rOEF), and
      metabolic rate of oxygen (rCMRO2) for major cerebral gyri and deep brain
      structures were studied in eleven normal volunteers during an eye-covered and ear
      unplugged resting condition. Regional CBF was measured by the autoradiographic
      method after intravenous administration of H2(15)O. Regional OEF and rCMRO2 were
      measured by the single inhalation of 15O2. With MR T1-weighted images as an
      anatomical reference, thirteen major cerebral gyri, caudate nucleus, lentiform
      nucleus, thalamus, midbrain, pons, cerebellum and vermis were defined on the
      CMRO2 images. Values were read by using circular regions of interest 16 mm in
      diameter. The posterior part of the cingulate gyri had the highest rCBF and
      rCMRO2 values among brain structures, followed by the lentiform nucleus, the
      cerebellum, the caudate nucleus, and the thalamus. Parahippocampal gyri had the
      lowest rCBF and rCMRO2 values among the cortical gyri. Regional OEF for the
      pontine nuclei (0.34 +/- 0.04), the midbrain (0.35 +/- 0.05), the parahippocampal
      gyri (0.35 +/- 0.04 for the right and 0.37 +/- 0.05 for the left), and the
      thalami (0.37 +/- 0.05 for the right and 0.36 +/- 0.04 for the left) were
      significantly lower than the mean OEF for the cerebral cortices (0.42 +/- 0.04)
      (p < 0.05 or less). The global CBF and CMRO2 were consistent with those obtained
      by the Kety-Schmidt method.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779526
TI  - Qualitative and quantitative evaluation of renal parenchymal damage by 99mTc-DMSA
      planar and SPECT scintigraphy.
AB  - The initial 99mTc-DMSA studies carried out over a four year period in 229
      patients with various heterogenic causes of lower urinary tract abnormalities
      were reviewed. Anatomical damage to the renal parenchyma was graded by means of
      planar and SPECT studies into a six group classification proposed by Monsour et
      al.: grade 0 (normal), I (equivocal), II (single defect), III (more than 2
      defects), IV (contracted or small) and V (no visualization). Parenchymal uptake
      of 99mTc-DMSA was quantitated from planar images at 2 hours postinjection by a
      computer assisted gamma camera method. SPECT studies could enhance the pick-up
      rate for parenchymal uptake defects by a factor of 1.5 in comparison with planar
      imaging. The incidence of anatomical damage to the renal parenchyma increased
      with a high radiological grade for VUR, and renal uptake per injection dose of
      99mTc-DMSA by the individual kidney significantly decreased in grades III and IV
      of the anatomical classification. These data revealed that 99mTc-DMSA planar is
      still useful for evaluating gross structural damage and for quantitative
      evaluation of the kidney with computer assistance. SPECT scintigraphy is more
      effective in disclosing anatomical damage to the renal parenchyma than planar,
      although it needs further discussion as to whether SPECT may increase sensitivity
      with minimal or no adverse affect on specificity.

PMID- 7779527
TI  - Postgastrectomy osteomalacia with pseudofractures assessed by repeated bone
      scintigraphy.
AB  - A patient with osteomalacia secondary to vitamin D deficiency after gastrectomy
      for gastric cancer is presented. Initial bone scintigrams showed both asymmetric
      and symmetric focal areas of intense uptake due to pseudofractures reminiscent of
      bone metastases. Radiographs only confirmed the presence of pseudofractures at
      some, but not all, of the abnormal sites demonstrated by bone scintigraphy. At
      first, metastatic bone disease was suspected. However, the appearance of repeated
      bone scintigram was normalized after treatment with vitamin D. A diagnosis of
      osteomalacia was established. The present case serves to illustrate that
      symmetric focal lesions are important features of pseudofractures secondary to
      osteomalacia, and comparison with radiographs and repeated bone scintigraphy are
      necessary in distinguishing between bone metastases and pseudofractures.

PMID- 7779528
TI  - Indium-111 antimyosin monoclonal antibody Fab imaging in patients with
      cardiomyopathy.
AB  - Six patients with cardiomyopathy were imaged following intravenous injection of
      an indium-111 labeled monoclonal antibody directed against the heavy chain of
      cardiac myosin. Two patients had hypertrophic non-obstructive cardiomyopathy
      (HNCM), two patients had dilated cardiomyopathy (DCM), and two patients had
      specific heart muscle disease. One of 2 patients with HNCM and one of 2 patients
      with DCM had a positive antimyosin scan. The 2 patients with specific heart
      muscle disease manifested persistent blood pool activity of the antibody, thereby
      precluding interpretation of the images. The present report demonstrates that
      antimyosin antibody imaging may provide evidence of myocardial injury, or
      necrosis in some patients with cardiomyopathy.

PMID- 7779529
TI  - A case of an intra-atrial tumor thrombus from hepatocellular carcinoma (HCC),
      first indicated by 67Ga-citrate scintigraphy.
AB  - We encountered a very rare case of an intra-atrial tumor thrombus from
      hepatocellular carcinoma (HCC). Conventional XCT and US gave evidence of HCC. In
      nuclear medicine studies performed incidentally, the first study with 99mTc
      phytate liver scintigraphy showed 2 SOLs and evidence of chronic liver disease,
      and the second study with 67Ga-citrate scintigraphy demonstrated 2 hot lesions
      within the liver parenchyma, and also another unexpected hot area just above the
      left lobe of the liver, seemingly beyond the diaphragm. When echocardiography was
      performed, in addition to ECG, because the patient began to complain of dyspnea,
      an oblong mass lesion was detected within the right atrium. Reexamination with
      XCT and angiography clearly proved the existence of an intraatrial tumor
      thrombus. These results indicate the need for routine examination by
      echocardiography for HCC patients complaining of dyspnea.

PMID- 7779530
TI  - Luxury perfusion phenomenon in acute herpes simplex virus encephalitis.
AB  - In a patient with acute herpes simplex virus (HSV) encephalitis, positron
      emission tomography (PET) demonstrated increased cerebral blood flow in the
      affected temporal lobe accompanied by reduction in the cerebral oxygen extraction
      fraction and the cerebral metabolic rate of oxygen, i.e., luxury perfusion.
      Follow-up PET studies showed reduction in cerebral perfusion until it was more
      closely coupled with oxygen metabolism after the resolution of the acute
      inflammation. These findings support previous single photon emission computed
      tomographic data and provide a pathophysiological background for the occurrence
      of hyperperfusion in HSV encephalitis. This is an interesting example of the
      luxury perfusion phenomenon occurring in a disease other than cerebral ischemia.

PMID- 7779531
TI  - Canine SPECT studies for cerebral amino acid transport by means of 123I-3-iodo
      alpha-methyl-L-tyrosine and preliminary kinetic analysis.
AB  - We have already reported that 123I-3-iodo-alpha-methyl-L-tyrosine (123I-L-AMT) is
      superior as a single-photon emitter labeled radiopharmaceutical reflecting
      cerebral amino acid transport. In this study, we investigated the distribution of
      123I-L-AMT in the canine head by means of SPECT and kinetically analyzed the data
      in the brain. As a result, clear SPECT images of the canine brain were obtained.
      Kinetic analysis with a 2-compartment model, including or expressing membrane
      transport of the amino acid, was performed with time-activity curves in the
      arterial blood and in the cerebral region. The results of the analysis coincided
      closely with the experimental data and the relevance of the model was strongly
      suggested. Therefore 123I-L-AMT is considered to be useful as a single photon
      radiopharmaceutical which enables us to measure the cerebral amino acid transport
      rate.

PMID- 7779532
TI  - Synthesis and preliminary evaluation of [1-11C]hexanoate as a PET tracer of fatty
      acid metabolism.
AB  - The potential of [1-11C]hexanoate (11C-HA) as a radiopharmaceutical assessing
      fatty acid metabolism of the myocardium and brain tissues by PET studies was
      evaluated. 11C-HA was synthesized by the Grignard reaction of pentylmagnesium
      bromide and 11CO2. 11C-HA, [1-14C]acetate and [3H]deoxyglucose were
      simultaneously injected i.v. into mice, and the tissue distribution of the three
      radionuclides was measured. In the heart, high uptake and rapid clearance of 11C
      and 14C was found. The brain uptake of 11C was twice as high as that of 14C, and
      both 11C and 14C decreased slowly compared to the heart. The level of 3H
      increased with time in both the heart and brain. In fasting conditions, the
      uptake of 11C by the heart was enhanced and the level of 3H decreased with time.
      The brain uptake of 11C and 3H was also enhanced. The fasting conditions did not
      affect the distribution of 14C. The radiation absorbed dose of 11C-HA was also
      estimated.

PMID- 7779533
TI  - Concentration and distribution of tumor associated antigens TAG-72 and CEA in
      stomach cancer.
AB  - We measured the concentration and distribution of tumor associated antigens, TAG
      72 and CEA, in stomach cancer by in vitro quantitative autoradiography (IV-QAR).
      Frozen sections of 33 specimens were incubated with varying concentrations of
      125I-labeled CEA-79.1 and B72.3 antibodies specific for carcinoembryonic antigen
      (CEA) and tumor-associated glycoprotein-72 (TAG-72), respectively. Computer
      analysis of specific antibody binding gave maximal binding values which were
      equal to the concentrations of the antigen or epitope. TAG-72 was detected in 25
      specimens, at a concentration ranging from 8.4 to 562.9 pmol/g. CEA was detected
      in 32 of the 33 specimens and its concentration ranged from 8.8 to 525.3 pmol/g.
      The distribution of TAG-72 by IV-QAR coincided with that of the tumor cells in
      41.4% of the pathologic lesions. The distribution of CEA coincided with the tumor
      cells in 80.5% of pathologic lesions, nearly twice the TAG-72. The concentration
      of TAG-72 was significantly higher in mucinous adenocarcinoma and mucin
      containing adenocarcinomas than other types of adenocarcinomas. There was no
      significant difference in the concentration of CEA among the pathologic types of
      stomach cancer. In summary, stomach cancer exhibited wide variations in TAG-72
      and CEA expression. CEA expression was more frequent and homogeneous than TAG-72.

PMID- 7779534
TI  - Trace Elements and Free Radicals in Oxidative Diseases. Proceedings of the 4th
      International Congress on Trace Elements in Medicine and Biology. Chamonix,
      France, April 5-9, 1993.

PMID- 7779535
TI  - Antioxidant status and lipid peroxidation in athymic mice xenografted with two
      types of human tumors.
AB  - Antioxidants and reactive oxygen species are considered to play an important role
      in experimental in vivo carcinogenesis studies. We attempted in this study to
      evaluate the repercussions on the antioxidant and lipid peroxide status of the
      growth of human malignant tumors xenografted into athymic mice. We selected three
      tumor models: two urothelial carcinomas (bladder tumors stage 3) and one brain
      tumor (glioblastoma stage 4). All these tumors exhibited a fast growth pattern
      when xenografted into athymic mice. Tumoral tissue was implanted subcutaneously.
      After growth establishment each tumor size was measured at regular intervals:
      every 2 d for bladder tumor and twice a week for glioblastoma. The period of
      observation was 3 wk for bladder tumors and 5 wk for glioblastoma. At the end of
      the observation period, all mice were sacrificed; tumoral tissue was taken and
      blood collected. Superoxide dismutase activity (SOD), glutathione peroxidase
      activity (GSH-Px), zinc (Zn), selenium (Se), and thiobarbituric acid reactive
      substances (TBARS) were measured in blood. TBARS alone were measured into tumoral
      tissue. A modification of the antioxidant blood status was observed in mice
      xenografted with bladder tumors with decrease in Se status and GSH-Px activities,
      and increase in TBARS. Such an effect was absent in mice xenografted with
      glioblastoma. It would appear that an oxygen-mediated stress exists in the animal
      bearing an implanted tumor compared with the control group, and that tumoral
      tissue itself is able to induce an oxidative stress into its host. All this leads
      to a disturbance of the antioxidant defense system.

PMID- 7779536
TI  - Effect of antioxidants on adriamycin-induced microsomal lipid peroxidation.
AB  - Adriamycin (25 microM) stimulated NADPH-dependent microsomal lipid peroxidation
      about fourfold over control values. The tested antioxidants, zinc, superoxide
      dismutase, vitamin E, and desferrioxamine (Desferal) inhibited Adriamycin
      enhanced lipid peroxidation to varying degrees. Others antioxidants, e.g.,
      glutathione, catalase, and selenium, were found to have no effects. Our in vitro
      studies suggest that adriamycin effect is mediated by a complex oxyradical
      cascade involving superoxide, hydroxyl radical, and small amounts of iron.

PMID- 7779537
TI  - Lipid peroxidation products, and vitamin and trace element status in patients
      with cancer before and after chemotherapy, including adriamycin. A preliminary
      study.
AB  - Adriamycin is a potent chemotherapeutic agent used in the treatment of human
      neoplastic diseases. A major side effect limiting the use of this drug is its
      toxic effect on the heart. Several hypotheses have been proposed to explain the
      cardiotoxicity of Adriamycin. However, the most plausible hypothesis seems to be
      the reduction of Adriamycin and free radical production, which induces lipid
      peroxidation and oxidative damages in the heart. We have thus undertaken this
      preliminary study to investigate Adriamycin-induced lipid peroxidation by the
      measurement of plasma thiobarbituric acid reactant materials and antioxidant
      systems, namely glutathione content, glutathione peroxidase activity, and vitamin
      and trace element status, in patients with cancer before and after chemotherapy,
      including Adriamycin. The concentration of thiobarbituric acid reactant materials
      in plasma of patients with cancer was higher than in controls and was further
      increased after chemotherapy. Blood glutathione and plasma glutathione peroxidase
      activity, as well as plasma zinc and selenium in patients with cancer, were
      decreased, but not further modified by chemotherapy. However, only zinc and
      selenium levels reached a significant level. In contrast, plasma vitamin E and
      beta-carotene levels were not significantly increased in patients with cancer.
      Finally, plasma vitamin A and copper levels were not modified either in patients
      with cancer or by chemotherapy.

PMID- 7779539
TI  - Relationship of trace element, immunological markers, and HIV1 infection
      progression.
AB  - Trace elements (selenium, zinc, copper), beta 2 microglobulin levels, CD4, and
      CD8 cell counts have been determined in 80 HIV1 seropositive patients. The study
      group consisted of 19 females and 61 males with age mean of 35 +/- 10 yr, at
      stage IV of infection (CDC--Atlanta classification) and treated by AZT. No severe
      renal or liver diseases or hypoalbuminemia were observed in this group. Se values
      were significantly lower than in normal adults, 48.3 +/- 17 micrograms/L vs 71 +/
      12 micrograms/L; Zn was moderately diminished, 1 +/- 0.2 mg/L vs 1.2 +/- 0.2
      mg/L, whereas copper values were in the normal range, 1.2 +/- 0.3 mg/L vs 1.1 +/-
      0.5 mg/L. Se or Zn deficiency was found in 60 and 30 subjects, respectively.
      Blood Se and Zn decreases were associated in 23 patients. Moreover, all patients
      showed higher beta 2 microglobulin values than the upper normal limit of 2.4
      mg/L. Negative correlations were found between Zn and beta 2 microglobulin (p <
      0.005) and between Se and beta 2 microglobulin (p < 0.05). Moreover, there was a
      positive correlation between Se and Zn values (p < 0.05). Nineteen subjects died
      1 yr later (group I), and 61 remained alive (group II). With respect to the
      clinical evolution, a significant difference between both groups was found in Se
      and beta 2 microglobulin levels as well as in CD4 cell counts. The correlations
      previously observed persisted in group II, whereas no correlation was noted in
      group I. In addition, the patients of group one had significantly lower Se
      values, which were below 30 micrograms/L in 10 cases.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7779538
TI  - Lipoperoxides as an index of free radical activity in bone marrow transplant
      recipients. Preliminary observations.
AB  - It has been previously demonstrated that the conditioning therapy given to bone
      marrow transplant (BMT) recipients creates a high oxidant stress, resulting in a
      measured reduction in antioxidants, such as glutathione peroxidase (GSH-Px),
      vitamin E, and cell peroxide fragilities. As part of a current intervention trial
      of antioxidant therapy in BMT recipients, plasma thiobarbituric acid reactive
      substances (TBARS) were measured to assess peroxidation and free radical
      activity. Measurements were performed before and after conditioning therapy, and
      then at weekly intervals for a period of 6 wk after transplantation in 20
      patients (10 controls and 10 antioxidant therapy [AOT] recipients). The TBARS
      results were compared with concurrent measurements of more specific elements of
      the antioxidant pathways, such as red blood cell glutathione peroxidase (RBC-GSH
      Px), plasma vitamin C, and serum vitamin E. In all cases, TBARS concentration was
      significantly increased after conditioning compared with baseline levels (p <
      0.001), an increase that correlated inversely with RBC-GSH-Px (r = -0.81; p <
      0.01). The TBARS concentration fell gradually after conditioning in all patients.
      The fall in the AOT group was more rapid than in the control group, and it
      paralleled the gradual return toward normal levels of the other antioxidants. The
      change in TBARS concentration occurred faster than changes in other indices,
      suggesting that TBARS might be a better index of overall free radical activity.
      Although the patient numbers are small, there is some evidence to suggest that
      MDA may act as a prognostic marker.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779540
TI  - Evaluation of zinc content in children's hair.
AB  - The zinc content in the hair of 654 children living in various rural and
      industrial areas in southern Poland was assayed by means of the atomic absorption
      spectrometry, following the dry digestion procedure. The hair of girls exhibited
      statistically significant higher level of Zn than the boys' hair, although in the
      site of extremal Zn contamination, the inverse relation was found.

PMID- 7779541
TI  - Lipid peroxidation assessed by serum thiobarbituric acid reactive substances in
      healthy subjects and in patients with pathologies known to affect trace element
      status.
AB  - Serum thiobarbituric acid reactive substances (TBARS), Zn, Cu, and Se
      concentrations were determined in 47 healthy adults and in patients with
      diseases, such as renal insufficiency, insulin-dependent diabetes mellitus,
      chronic pancreatitis, liver cirrhosis, or cancer, in order to clarify the
      relationship between this indicator of lipid peroxidation and antioxidative trace
      element status. TBARS levels were higher than control values in all pathological
      cases, except in cancer patients. Cu levels in patients highly correlated with
      ferroxidase ceruloplasmin activity (r = 0.86), but were only statistically
      different from controls in diabetics. Zn levels were lower than normal in
      dialysis, liver cirrhosis, and cancer patients. Se levels were significantly
      decreased in all pathological cases. Half of the subjects with liver cirrhosis or
      renal insufficiency and 3/4 of chronic pancreatitis or cancer patients had an
      active inflammatory process. Despite intense modifications in determined
      indicators, no clear correlation could be demonstrated between the different
      parameters. Basic antioxidative trace element status and inflammation are
      therefore not major determinants of TBARS levels in normal and in pathological
      conditions, despite of the frequent association of low serum Zn and mainly low
      serum Se with high TBARS levels.

PMID- 7779543
TI  - The relevance of malondialdehyde as a biochemical index of lipid peroxidation of
      postischemic tissues in the rat and human beings.
AB  - By using a recently developed ion-pairing high-performance liquid chromatographic
      method for the direct determination of malondialdehyde (MDA) and several other
      acid-soluble low-mol-wt compounds (ascorbate, oxypurines, nucleosides, nicotinic
      coenzymes, high-energy phosphates), the variations of tissue and plasma MDA as a
      function of ischemia and reperfusion were determined in the rat (isolated
      Langendorff-perfused hearts and short-term incomplete cerebral ischemia) and in
      human beings (patients suffering from acute myocardial infarction subjected to
      fibrinolysis). In the rat, the data obtained indicate that, contrary to what had
      been previously reported in literature, MDA is not present either in control
      heart or in control brain. Oxygen deprivation induces the production of a low,
      but detectable amount of MDA in both heart and brain, whereas reperfusion causes
      a marked increase of MDA in both tissues. In human beings, plasma MDA was deeply
      affected only in patients suffering from acute myocardial infarction with
      successful thrombolysis, thus indicating the occurrence of oxygen radical
      mediated tissue injury also in humans. On the whole, these results suggest that
      MDA is a valid biochemical marker of lipid peroxidation of postischemic tissues,
      which however needs a reliable analytical technique for its determination.

PMID- 7779542
TI  - Selenium, oxygen-derived free radicals, and ischemia-reperfusion injury. An
      experimental study in the rat.
AB  - Circulatory shock and its treatment have been compared to a whole-body ischemia
      and reperfusion with activation of oxygen-derived free radicals. A pilot study
      had suggested a selenium redistribution in this context. To verify this
      hypothesis, an experimental study was designed. Temporary occlusion of the
      superior mesenteric artery was performed in 18 male adult Wistar rats using
      clamping for 0, 10, and 20 min. Hemodynamic and biochemical data were assessed
      before clamping and 20 min after release of the mesenteric blood flow. After
      release, mean arterial pressure decreased, plasma lactate increased, and
      erythrocyte glutathione peroxidase decreased. Plasma and erythrocyte selenium did
      not change; however, a slight decrease in plasma selenium was observed when
      related to hematocrit (to take into account the fluid balance). Erythrocyte
      reduced glutathione did not change. In contrast, liver and kidney selenium
      increased, whereas reduced glutathione decreased in kidney, but not in liver
      after 20 min of clamping as compared to the sham-operated group. These results
      suggest that, after temporary intestinal ischemia, the changes in selenium and
      reduced glutathione observed in blood and tissues, like liver or kidney, could be
      related to a redistribution pattern in selenium metabolism during shock injury.

PMID- 7779544
TI  - Immunological approach to investigating membrane cell damages induced by
      lipoperoxidative stress. Application to far UV-irradiated erythrocytes.
AB  - Oxygen-reactive species are being described as agents responsible for cell
      degeneration mechanisms resulting from membrane, enzyme, and nuclear alterations.
      Lipid peroxidation on its own is considered to be one of the consequences of the
      free radicals attack, and among the different reactive aldehydes that can be
      formed from the decomposition of lipid peroxides, the most extensively assayed
      have been malondialdehyde (MDA). However, the different techniques currently used
      for MDA assay (HPLC, GLC) are barely sensitive enough to follow its production at
      the cellular level. In order to develop an immunofluorescent technique able to
      detect cellular damages provoked by lipoperoxidation, polyclonal antibodies
      against lysozyme modified by MDA treatment have been raised in rabbits. We show
      that this immunserum recognizes specifically all the MDA-treated proteins tested,
      but not the intact proteins or the proteins treated by other aldehydes. Moreover,
      we demonstrate using an ELISA technique that the amount of immunoreactive
      proteins in MDA-treated membrane erythrocytes is proportional to the
      concentration of MDA applied, suggesting that this assay may represent a
      quantitative method of determination of lipoperoxidative alterations. In
      addition, when coupled to an indirect fluorophore antibody (FITC), the immunserum
      allows a precise location of these modified proteins within the membranes of
      erythrocytes in which lipid peroxidation was initiated by far UV irradiation. In
      summary, the interest of this work is to provide an immunological probe that can
      precociously detect membrane damages induced by MDA, regardless of the cell type
      and pro-oxidant (physiological or pathological) conditions.

PMID- 7779546
TI  - Increase in cellular pool of low-molecular-weight iron during ethanol metabolism
      in rat hepatocyte cultures. Relationship with lipid peroxidation.
AB  - Ethanol-induced lipid peroxidation was studied in primary rat hepatocyte cultures
      supplemented with ethanol at the concentration of 50 mM. Lipid peroxidation was
      assessed by two indices: (1) conjugated dienes by second-derivative UV
      spectroscopy in lipid extract of hepatocytes (intracellular content), and (2)
      free malondialdehyde (MDA) by HPLC-UV detection and quantitation for the
      incubation medium (extracellular content). In cultures supplemented with ethanol,
      free MDA increased significantly in culture media, whereas no elevation of
      conjugated diene level was observed in the corresponding hepatocytes. The
      cellular pool of low-mol-wt (LMW) iron was also evaluated in the hepatocytes
      using an electron spin resonance procedure. An early increase of intracellular
      LMW iron (< or = 1 hr) was observed in ethanol-supplemented cultures; it was
      inhibited by 4-methylpyrazole, an inhibitor of alcohol dehydrogenase, whereas
      alpha-tocopherol, which prevented lipid peroxidation, did not inhibit the
      increase of LMW iron. Therefore, the LMW iron elevation was the result of ethanol
      metabolism and was not secondarily induced by lipid hydroperoxides. Thus, ethanol
      caused lipid peroxidation in rat hepatocytes as shown by the increase of free
      MDA, although no conjugated diene elevation was detected. During ethanol
      metabolism, an increase in cellular LMW iron was observed that could enhance
      conjugated diene degradation.

PMID- 7779545
TI  - Time-course of changes in plasma levels of trace elements after thrombolysis
      during the acute phase of myocardial infarction in humans.
AB  - It has been suggested that the injury induced by reperfusion of the ischemic
      myocardium could result, in part, from the cytotoxic effects of oxygen free
      radicals. Since various trace elements are involved in several of the reactions
      leading to free radical production, we have measured plasma levels of copper,
      zinc, selenium, and iron: 1. In 18 patients (mean age 60 yr old) subjected to
      thrombolytic therapy within 6 h after the onset of a myocardial infarction (G1);
      2. In 16 patients with coronary artery disease, but without a history of a
      previous myocardial infarction (MI) (mean age 50 yr old, G2); and 3. In 50
      healthy volunteers divided into two subgroups according to age (mean age 33 yr
      old, G3 and 55 yr old, G4). Plasma myosin levels were used to estimate
      quantitatively the extent of the infarcted mass. Plasma trace element levels were
      measured in blood samples following centrifugation and storage at -80 degrees C.
      The main results were as followed: In G1 patients who have been subjected to
      thrombolysis, an important release of myosin was measured in plasma, with a peak
      at D6 (1678 vs 95 microU/L at H0). In those G1 patients after MI: 1. A
      significant increase in plasma copper levels was observed from day 4 to day 10
      postinfarction (x1.15 in reference to the baseline data at H0); 2. A decrease in
      plasma zinc levels was observed and was maximum 12 h after the onset of the
      thrombolytic treatment; 3. A decrease in selenium concentration was observed in
      G1, as well as in G2 patients, compared to the control groups (80% of G3 and G4
      values); and 4. A significant decrease in plasma iron levels was observed in G1
      (67.8% of G3 and G4 control values) and was significant from H0 to day 7 (p <
      0.01). In conclusion, this study underlined the time-course evolution of plasma
      trace element levels in the followup of patients who have been subjected to
      thrombolysis following a MI and the potential prognostic implication of such
      variations.

PMID- 7779547
TI  - Zinc, iron, and peroxidation in liver tissue. Cumulative effects of alcohol
      consumption and virus-mediated damage--a preliminary report.
AB  - In an attempt to elucidate further the mechanisms involved in alcohol-mediated
      liver damage and the correlation between alcohol and viruses in chronic liver
      lesions, we determined the levels of liver glutathione (GSH), thiobarbituric acid
      reactive substances (TBARS), iron (Fe), and zinc (Zn) in 31 patients with chronic
      viral hepatitis (CAH), 6 with alcohol-related chronic hepatitis (CALD), 6 with
      alcoholic cirrhosis (AC), 8 with primary biliary cirrhosis (PBC), and 10 healthy
      controls (C). Liver GSH was significantly lower in CALD and AC patients (p <
      0.005). TBARS levels were significantly higher in CAH, CALD, and PBC patients (p
      < 0.001, < 0.02, and < 0.001, respectively). In CAH patients, alcohol consumption
      correlated inversely with GSH and directly with TBARS (p < 0.05). Patients with
      both CAH and alcohol abuse had a further reduction in liver GSH levels (p <
      0.005). Tissue levels of Fe were significantly increased in CALD and AC patients
      with respect to controls and CAH patients, whereas no significant difference was
      observed in Zn. These data confirm that patients with chronic ethanol exposure
      reveal a depletion in liver GSH content clearly correlated with an increase in
      lipid peroxidation and Fe liver storage. On the other hand, these findings appear
      to suggest no significant change in Zn levels in chronic hepatitis.

PMID- 7779549
TI  - Trace element status and inflammation parameters during chronic indomethacin
      treatment in adjuvant arthritic rats.
AB  - Oral indomethacin administration (2 mg/kg/d) was investigated in rats with
      adjuvant arthritis up to a period of 5 wk. Baseline low serum zinc levels in
      arthritic rats increased rapidly from the first week of indomethacin treatment
      (started 1 or 2 wk after disease induction), whereas baseline high serum copper
      decreased after 1-2 wk. After 3-4 wk of treatment, serum zinc levels returned to
      control values, but serum copper was somewhat higher in arthritic animals having
      received indomethacin 2 wk after disease induction than in controls. Clinical
      indices of inflammation simultaneously improved to reach control values at the
      end of the trial. Biological indicators of inflammation also improved, but did
      not reach control levels. Serum zinc correlated negatively with plasma fibrinogen
      (r = -0.69, p < 0.0005) and serum copper correlated positively with serum
      ceruloplasmin (r = 0.92, p < 0.0005) both in indomethacin-treated and untreated
      arthritic rats. Contrary to long-term glucocorticoid administration that was
      previously reported to maintain or aggravate hypozincemia, indomethacin treatment
      normalized perturbed zinc and copper status in arthritic animals.

PMID- 7779550
TI  - The susceptibility to stress-induced gastric injury of rats exposed to cadmium.
AB  - In this experimental study, the effect of cadmium on cold and restraint stress
      induced gastric lesions has been studied. Rats received 15 micrograms/mL cadmium
      containing water for 30 d, and at the end of this period, they were subjected to
      cold and restraint stress. Cadmium accumulation in gastric mucosa was associated
      with increased mucosal lesions, as well as decreased mucin and PGE2 levels in
      rats exposed to cadmium. Stress-induced mucosal injury was more pronounced, and
      the hemoglobin leakage into gastric lumen owing to breakdown in the barrier was
      17.30 +/- 3.45 micrograms/mL in control and 35.71 +/- 6.18 micrograms/mL in
      treated rats. Our data suggest that high cadmium intake facilitates the
      occurrence of stress-induced mucosal lesions by diminishing the mucin content and
      PGE2 generation in gastric mucosa.

PMID- 7779548
TI  - Low selenium status in alcoholic cirrhosis is correlated with aminopyrine breath
      test. Preliminary effects of selenium supplementation.
AB  - The relationship among impaired selenium status, lipid peroxidation, and liver
      function was examined in 19 hospitalized patients with severe alcoholic
      cirrhosis. Plasma selenium was found to be significantly lower (mean +/- SD: 54
      +/- 13 micrograms/L) than in healthy controls (83 +/- 11 micrograms/L) and plasma
      malondialdehyde, assessed as thiobarbituric acid reactants, which reflects lipid
      peroxidation, was increased (2.0 +/- 1.2 mumol/L vs < 1.2 mumol/L in controls).
      The mean 14C aminopyrine breath test, an indicator of liver function, was lower
      than normal (2.7 +/- 1.9 vs 6.3 +/- 0.9% in controls) and found to be
      significantly correlated with plasma selenium (r = 0.59, p < 0.05). A
      prospective, randomized selenium supplementation trial was conducted in a group
      of 16 patients who received either daily 100 micrograms selenium as enriched
      yeast during 4 mo or a placebo. Among the 10 patients who completed the study,
      plasma selenium significantly increased in the supplemented group (n = 4; before:
      58 +/- 10 micrograms/L, and after 101 +/- 12 micrograms/L, p < 0.01) contrary to
      the placebo group (n = 6, before: 47 +/- 10 micrograms/L, after: 57 +/- 9
      micrograms/L, n.s.). 14C aminopyrine breath test improved in three out of four
      selenium-supplemented patients and in three out of six placebo patients, but the
      small number of patients did not allow statistical evaluation. These results
      demonstrate that low selenium status in alcoholic cirrhosis is correlated to
      liver function and could be improved by supplementation.

PMID- 7779551
TI  - Modification of the blood-brain barrier through chronic intoxication by aluminum
      glutamate. Possible role in the etiology of Alzheimer's disease.
AB  - The authors have used an experimental rat model of chronic aluminum (Al)
      intoxication to reproduce pathological signs analogous to those observed in
      humans for Alzheimer's disease or dialysis encephalopathy. Preliminary chronic
      intoxication was achieved during 5 wk by daily subcutaneous injection of a
      suspension of glutamate and Al prior to intravenous (i.v.) administration of
      sodium L-glutamate and Al chloride. A significant increase in Al content was
      observed in different areas of the brain, such as the hippocampus, the occipito
      parietal cortex, the cerebellum, and the striatum. Moreover, half of the animals
      subcutaneously treated with Al glutamate had neurological disturbances, such as
      trembling, equilibrium difficulties, and convulsions leading to death about 1 h
      after i.v. administration. A significant increase in glutamic acid at the level
      of the occipito-parietal cortex was found in comparison with controls, which
      received only sodium L-glutamate or saline solution. These results show that the
      Al-L-glutamate complex may well induce a modification of the blood-brain barrier.

PMID- 7779552
TI  - Serum aluminum levels in Alzheimer's disease and other senile dementias.
AB  - The exact cause of Alzheimer's disease and the part played in it by aluminum is
      still speculative. We have studied serum aluminum in 356 healthy people, and we
      have observed that serum aluminum concentration is increased in aging people in
      relation to age. We suggest that this could be associated with an enhanced
      gastric permeability or by an increase in metal accumulation proportional to age.
      We have measured serum aluminum levels in patients with probable Alzheimer's
      disease, patients with other senile dementias, and age-matched group. Patients
      with probable Alzheimer's disease have statistically significant higher serum
      aluminum levels than patients with other types of senile dementias (alcoholic,
      vascular, multi-infart) and an age-matched control group. When we compare serum
      aluminum of patients with senile dementias from other causes with the age-matched
      control group, we do not find significant differences.

PMID- 7779553
TI  - Incomplete cerebral ischemia in the rat provokes increase of tissue and plasma
      malondialdehyde.
AB  - Short-term incomplete cerebral ischemia was induced in the rat by bilaterally
      clamping for 5 min the common carotid arteries; subsequent reperfusion of 10 min
      was obtained by removing carotid occlusion. At the end of ischemia or
      reperfusion, animals were sacrificed by decapitation. A control group was
      represented by sham-operated rats. Peripheral venous blood samples were withdrawn
      from the femoral vein from rats subjected to cerebral reperfusion 5 min before
      ischemia, at the end of ischemia, and 10 min after reperfusion. A highly
      sensitive HPLC method for the direct determination of malondialdehyde,
      oxypurines, and nucleosides was used on 200 microL of brain tissue and plasma
      extracts. Incomplete cerebral ischemia induced the appearance of a significant
      amount of tissue malondialdehyde (undetectable in control animals) and a decrease
      of ascorbic acid. A further 6.6-fold increase of malondialdehyde and a 18.5%
      decrease of ascorbic acid occurred after 10 min of reperfusion. Plasma
      malondialdehyde, which was present in minimal amount before ischemia,
      significantly increased after 5 min of ischemia, being strikingly augmented after
      10 min of reperfusion. A similar trend was observed for oxypurines and
      nucleosides. From these data, it can be affirmed that tissue concentrations of
      malondialdehyde and ascorbic acid, and plasma levels of malondialdehyde,
      oxypurines, and nucleotides, reflect both the oxygen radical-mediated tissue
      injury and the depression of energy metabolism, thus representing early
      biochemical markers of short-term incomplete brain ischemia and reperfusion in
      the rat.

PMID- 7779554
TI  - In vitro influence of zinc and magnesium on the deformability of red blood cells
      artificially hardened by heating.
AB  - Trace elements have been shown to improve red blood cell (RBC) deformability:
      zinc in sickle cell disease and magnesium in an in vitro model of chemically
      rigidified erythrocytes. In this study, we investigated the effect and the
      influence of incubation time of zinc or magnesium on an in vitro model of
      rigidified RBCs by heating. Erythrocyte rigidity was determined by viscosimetry
      at high shear rate by a falling ball viscosimeter MT 90. In the first part of the
      study, six normal volunteers participated. Viscosimetry was performed on native
      blood before and after heating the sample for 10 min at 50 degrees C. Therefore,
      increasing concentrations of zinc gluconate (final concentration: 0.5-4 g/L) or
      isotonic NaCl as control medium were added to the sample. Heating induced a
      twofold increase in all indices of RBC rigidity (p < 0.05). At all these
      concentrations of zinc, a highly significant, dose-related fluidifying effect was
      observed (40-70%): this effect was immediately obtained and did not change over
      60 min. Even at the highest concentration, recovery was not complete. In the
      second part of the study, we studied magnesium's effects on blood. In a first
      protocol, whole blood was rigidified by heating at 56 degrees C for 10 min, and
      the correcting effect of 5 min of incubation at 37 degrees C of RBCs in 150
      mmol/L NaCl, MgSO4, magnesium acetate, and magnesium gluconate was investigated.
      In a second protocol, the same incubation with NaCl and magnesium salts was made
      on blood that had not been previously heated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779555
TI  - The effect of age and selenium on some biochemical parameters in rat liver.
AB  - Two age groups, 3 and 15 mo, were used to investigate whether age-associated
      changes in some parameters related to lipid peroxidation occur in the liver of
      male Wistar rats and to observe possible effects of dietary selenium
      supplementation (0.25 and 0.50 ppm) for 12 mo on the same parameters. At these
      experimental conditions, the most important observation was that peroxidation did
      not change by aging, at least until 15 mo of age. In addition, the activity of Se
      dependent glutathione peroxidase (GSH-Px, EC 1.11.1.9) was higher in the liver of
      the older animals. It is suggested that the enzyme could have a role in the
      unchanged hepatic peroxidation observed in aged male rats. On the other hand, an
      effect of dietary selenium supplementation on those parameters was not observed,
      probably because the selenium levels were still at an adequate plateau.

PMID- 7779556
TI  - Free radicals production and estimation of oxidative stress related to gamma
      irradiation.
AB  - The effectiveness of chemiluminescence (ChL) in vitro to measure free radicals
      generated as a result of metabolic disorganization caused by radiation sickness
      is evaluated. The results are correlated with those obtained by measuring
      superoxide dismutase (SOD) activity and lipid peroxide as levels of
      thiobarbituric acid reacting substances (TBARS). To this aim, livers from
      irradiated Wistar rats were removed immediately (day 0) after irradiation and
      also 7 and 14 d later. ChL results, expressed in arbitrary units (AU)/min/mg
      protein, were analyzed for irradiated samples and controls, for different doses
      at different times. Increased levels of ChL emission were observed not only on
      day 0, but also on days 7 and 14. On the other hand, SOD activity showed a
      decrease on the 7th d, and significantly higher lipid peroxide levels were
      observed in the assays performed on the 14th d, at all exposure doses. The
      correlation between temporal changes in the SOD activity, ChL emission, and
      higher TBARS levels a week later were evident from the data. These results
      indicate that the ChL technique proved to be useful in combination with other
      techniques currently used for evaluating radiation oxidative injury.

PMID- 7779557
TI  - Serum zinc in highly trained adolescent gymnasts.
AB  - Serum zinc was measured in 20 adolescent gymnasts (9 boys, 11 girls, age 12-15
      yr) explored for detecting possible adverse effects of intense training on
      pubertal maturation and growth. They had low serum zinc (0.599 +/- 0.026 mg/L)
      when compared to matched control sedentary children (n = 118 mean 0.81 +/- 0.014
      p < 0.001). Girls had lower zinc than boys (0.557 +/- 0.023 vs 0.651 +/- 0.044 p
      < 0.001). Zinc was correlated to isometric adductor strength (r = 0.468 p <
      0.05). Children with serum zinc < 0.6 mg/L had lower insulin-like growth factor
      binding protein 3 than others (2.326 +/- 0.264 vs 2.699 +/- 0.12 p < 0.01). Thus,
      zinc is lowered in trained adolescent gymnasts and even lower in females. This
      reduction could play some role in abnormalities of puberty, growth, or muscular
      performance.

PMID- 7779558
TI  - Muscle GSH-Px activity after prolonged exercise, training, and selenium
      supplementation.
AB  - A double-blind study of the effects of supplementing with selenium vs. placebo on
      the physiological responses to acute and chronic exercise was conducted in 24
      healthy, nonsmoking males, mean age 22.9 +/- 2.1 yr, randomly divided into two
      groups of 12 (Pla/Sel). After a controlled period in the absence of training, all
      subjects were put on an individualized endurance training program with the same
      rules of progression and overload (3 sessions/wk x 10 wk). Supplementation,
      either real (240 micrograms of organic selenium/d in Sel group) or imaginary (Pla
      group) was administered during the same period. In each of the conditions Pre-
      and Post- (training +/- sel supplementation), muscle, plasma, and systemic
      parameters were determined before (BF) and after (AF) acute exercise, involving
      the repetition of muscle work cycles separated by 5-min recovery periods,
      combining 20 min at 65% and a maximal duration of 100% VO2 max of running on a
      treadmill, leading the subjects to exhaustion between 2 h 40 min and 3 h 30 min.
      Changes in parameters as a function of three independent variables: 1. Acute
      exercise (E); 2. Chronic exercise (T); and 3. Selenium supplementing (S) were
      tested with ANOVA and the Student's t-test on paired series. Among the variables
      examined, muscle glutathione peroxidase (GPx) presented a remarkable
      behavior.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779559
TI  - Environmental effects of nationwide selenium fertilization in Finland.
AB  - To study the possible pollution of natural waters by selenium added to
      agricultural fertilizers, water selenium concentrations were determined in lakes
      and ground water pools during the year 1992, when the enrichment of fertilizers
      by selenium had continued for 8 yr. Water samples were preconcentrated by
      evaporating, and selenium concentrations were analyzed fluorometrically using the
      dye 2,3-diaminonaphthalene after wet digestion. In lake water samples from 13
      lakes, no significant correlations were found between selenium and pH,
      chlorophyll A, total nitrogen, or phosphorus. Agriculturally affected and
      nonaffected lakes had no differences in their selenium concentrations. In the
      lakes that were surrounded by cultivated fields mean water selenium was 83.4 ng/L
      (range: 75.2-93.4 ng/L, n = 9). Correspondingly, in lakes situated in forests
      without agricultural surroundings, mean water selenium concentration was 76.5
      ng/L (range: 51.2-110 ng/L, n = 3). Only one lake in the close vicinity of a coal
      power plant had a high water selenium concentration (mean 272 ng/L). In ground
      water samples, there was a big variation in selenium levels between different
      pools, the levels varying between 33 and 260 ng/L. This variation may partly be
      explained by different selenium concentrations of the bedrock and sediments.
      However, simultaneous increase of total nitrogen, phosphorus, and selenium levels
      in consecutive samples from some ground water pools indicates leaching of
      selenium from the fertilizers into the ground water in certain areas.

PMID- 7779560
TI  - A comparison of four assays detecting oxidizing species. Correlated reactivity of
      Fe(III)-quin2, but not Fe(III)-EDTA, with hydrogen peroxide.
AB  - Quin2, a fluorescent calcium probe, has a low affinity for calcium in comparison
      to its affinities for transition metal ions. Chelation of ferric ion with quin2
      strongly enhanced the formation of oxidizing species in the presence of bolus
      H2O2 as detected with four assays, electron spin resonance with the spin-trap
      DMPO, the deoxyribose assay, the DMSO assay, and plasmid DNA strand breakage. In
      comparison, Fe(III)-EDTA reacted with bolus H2O2 only as detected with electron
      spin resonance and deoxyribose assay, but not as detected with the two latter
      assays. The addition of reductants, like ascorbate or superoxide generated by
      hypoxanthine/xanthine oxidase, to Fe(III)-EDTA in the presence of H2O2 produced
      plasmid DNA strand breakage and strong reactivity in both the DMSO and the
      deoxyribose assays. Our findings suggest that the main oxidizing species produced
      in Fenton-type reactions is hydroxyl radical. However, the reaction between
      Fe(III)-EDTA and bolus H2O2 appears to be exceptional and dominated by a
      nonhydroxyl radical species.

PMID- 7779561
TI  - In vitro anti- and pro-oxidative effects of natural polyphenols.
AB  - The anti- and pro-oxidative effects of phenolic compounds and antioxidants were
      studied in two different in vitro model systems utilizing ethyl linoleate and 2'
      deoxyguanosine (2'-dG) as oxidative substrates, and a Fenton reaction (H2O2,
      Fe2+) to initiate oxidation. Oxidation of the biomolecules in both model systems
      exhibited dose dependency. In the 2'-dG assay, oxidation was closely related to
      H2O2 generation, which occurred during autoxidation of the phenolics.
      Hydroxylating activity was greatly enhanced by Mn2+ and Cu2+, but not by Zn2+ or
      Co2+. Ethyl linoleate peroxidation was inhibited by low concentrations of
      catechol, quercitin, and instant coffee. However, peroxidation was promoted by
      high concentrations of the same compounds, probably by recycling of chelated
      inactive Fe3+ to the active Fe2+ state.

PMID- 7779562
TI  - Lack of correlation between TBARS production and PUFA degradation during
      incubation of membrane erythrocytes in an OH. (Fe2+/H2O2) generator system.
AB  - We investigated the effects of an OH. (Fe2+/H2O2) generator system on erythrocyte
      membrane, particularly the time-course of lipid peroxidation as estimated by
      measurement of conjugated dienes, thiobarbituric reactive substances (TBARS),
      lipofuscin-like pigments, and alpha-tocopherol. Polyunsaturated fatty acids
      (PUFAs), especially arachidonic acid (20:4 omega 6) and docosahexenoic acid (22:6
      omega 3), were also measured. Erythrocyte membranes were suspended in phosphate
      buffer containing Fe2+ (200 microM) and H2O2 (1.42 mM), and incubated in a
      shaking water bath at 37 degrees C. Initially, there was an increase in TBARS and
      lipofuscin-like pigments, two well-known end products of PUFA oxidative
      degradation, whereas PUFAs remained unchanged (incubation time: 1 h). After two
      or more hours of incubation, marked lipid peroxidation was noted, with the
      appearance of conjugated dienes and a decrease of PUFAs, indicating that lipid
      peroxidation had occurred after a lag phase during which TBARS were not produced
      from PUFAs. This suggests that another OH. target was involved.

PMID- 7779563
TI  - Pentoxifylline. A hydroxyl radical scavenger.
AB  - Pentoxifylline (PTX), a tri-substituted purine and xanthine derivative, has been
      used for several years to improve microcirculation because of its hemorheological
      properties. PTX has also antifibrotic and anti-inflammatory effects. We studied
      the reaction of PTX with the hydroxyl radical and superoxide anion. Hydroxyl
      radical was generated by a mixture of ascorbic acid, H2O2 and Fe(III)-EDTA. We
      evaluated the iron-dependent degradation of deoxyribose, mediated by hydroxyl
      radical, in the presence of different concentrations of PTX (from 0.05 to 3 mM),
      measuring the degradation products of deoxyribose that react with 2
      thiobarbituric acid (TBA). The reaction of PTX with hydroxyl radical occurred
      with a rate constant of (1.1 +/- 0.2) x 10(10) M-1/s. These results support the
      properties of PTX as a hydroxyl radical scavenger. Some authors verified that PTX
      decreases the release of superoxide anion from activated neutrophils. We studied
      the effect of PTX as a scavenger of superoxide generated in vitro by a
      hypoxanthine-xanthine oxidase system. PTX was not a superoxide anion scavenger in
      this system.

PMID- 7779565
TI  - Induction of lipid peroxidation and alteration of glutathione redox status by
      endosulfan.
AB  - The oxidant stress-inducing effects of endosulfan, a chlorinated hydrocarbon
      insecticide of the cyclodiene group, have been examined following ig
      administration of single and repeated doses. A single dose of 30 mg/kg
      (approximately 30% LD50) endosulfan significantly (p < 0.001) increased the TBARS
      and, hence, the lipid peroxidation in cerebral and hepatic tissues of rats.
      Administration of endosulfan with doses of 10 or 15 mg/kg/d for 5 d has also
      induced lipid peroxidation significantly (p < 0.05). The same doses caused a
      significant alteration in glutathione redox status of cerebral and hepatic
      tissues, where total glutathione and oxidized glutathione were measured by an
      enzymatic cycling procedure. Selenium levels were also determined and compared
      with controls. With repeated doses, oxidant stress was more pronounced in
      cerebral tissue, where endosulfan shows a GABA-antagonistic activity. The
      possible relationship between the neurotoxicity of endosulfan and its oxidant
      stress-inducing effect was discussed.

PMID- 7779564
TI  - Catechin protection of 3T3 Swiss fibroblasts in culture under oxidative stress.
AB  - The effects of catechin, a well-known in vitro antioxidant, on 3T3 Swiss
      fibroblasts are studied under different conditions of oxidative stress leading to
      cell proliferation or cytotoxicity. Various levels of reactive oxygen species
      (ROS), generated extracellularly by the xanthine-xanthine oxidase (X-XO) system,
      are at the origin of the biphasic effect on DNA synthesis by 3T3 Swiss
      fibroblasts. The addition of 10(-2) U XO/mL, in the absence of exogenous X,
      catalyzes the production of low levels of O2-. and H2O2 in the extracellular
      medium, which stimulate DNA synthesis and cell division. The increase in the
      level of ROS, by addition of increasing X concentrations, did not enhance this
      effect proportionally. On the contrary, high levels of ROS inhibit DNA synthesis,
      the cytotoxicity induced being proportional to the level of H2O2 generated by the
      enzyme system. Catechin does not significantly modify DNA synthesis induced by
      low levels of ROS, but protects in a dose-dependent manner against the cytoxicity
      of high levels of ROS.

PMID- 7779566
TI  - Structure-activity relationship of flavonoids with superoxide scavenging
      activity.
AB  - The superoxide scavenging activities of 12 flavonoids were measured. The
      superoxide anions were generated by a hypoxanthine-xanthine oxidase system and
      measured by the nitrite method. The results showed that the scavenging ability
      enhanced with an increasing number of hydroxyl groups in ring B. Substitution at
      C3 position with a hydroxyl group increased the activity. Compared to a methoxyl
      group or a glycoside in this position, a free hydroxyl group showed the highest
      activity. A saturated C2-C3 bond showed a higher activity than a unsaturated
      bond. The absence of a carbonyl group at C4 position increased the activity.

PMID- 7779567
TI  - Effect of selenium supplementation on polyunsaturated fatty acids in rats.
AB  - The purpose of this work was to study plasma, adipose tissue, and liver fatty
      acids percentages of Wistar rats that drank water supplemented with several
      levels of sodium selenite for 1, 3, and 6 mo. In a general way, percentages of
      saturated, monounsaturated, and polyunsaturated fatty acids of supplemented
      groups were not different from those obtained with nontreated animals in the
      analyzed tissues. However, in rats supplemented with 0.5 ppm Se, mainly in
      adipose tissue, a polyunsaturated fatty acids increase (p < 0.005) was observed
      for all times of treatment. This could suggest that 0.5 ppm Se supplement
      probably exercises a protective role on polyunsaturated fatty acids in that
      tissue. Supplements of 6.0, 15.0, and 54.0 ppm Se did not change unsaturation
      levels of fatty acids in the analyzed tissues.

PMID- 7779568
TI  - Effect of selenium supplementation on some blood biochemical parameters in male
      rats.
AB  - The long-term effect of selenium supplementation on blood glutathione peroxidase
      (GSH-Px) activity and plasma TBARS' production (as an index of peroxidation) was
      evaluated in 15-mo-old male rats fed a diet supplemented with 0.25 or 0.50 ppm
      selenium, for 12 mo. A group of nonsupplemented age-matched rats was the control.
      In addition, triglycerides, phospholipids, total and free cholesterol, HDL
      cholesterol, and HDL-phospholipids levels were measured in plasma. Plasma
      testosterone levels were also determined in order to control the aging process in
      these animals. The GSH-Px activity and the peroxidation level were unchanged in
      all the groups. However, concerning the lipid parameters, a decrease in
      triglycerides concentration was observed in both treated groups (p < 0.05).
      Therefore, in these experimental conditions, despite no observed changes in
      parameters related to lipid peroxidation, selenium seems to be involved with
      triglycerides metabolism, eventually improving the triglycerides status of aged
      animals.

PMID- 7779569
TI  - Effects of selenium supplementation on thyroid hormone metabolism in
      phenylketonuria subjects on a phenylalanine restricted diet.
AB  - Type I 5'-deiodinase was recently characterized as a selenocysteine-containing
      enzyme in humans and other mammals. Up to now, the effect of selenium (Se)
      supplementation on thyroid hormone metabolism in humans has only been reported in
      the very peculiar nutritional environment of Central Africa, where combined
      severe iodine and Se deficiency occurs. In this study, a group of phenylketonuria
      subjects with a low selenium status, but a normal iodine intake were supplemented
      with selenium to investigate changes in their thyroid hormone metabolism. After 3
      wk of selenium supplementation (1 microgram/kg/d), both the concentrations of the
      prohormone thyroxine (T4) and the metabolic inactive reverse triiodothyronine
      (rT3) decreased significantly. Clinically, the phenylketonuria subjects remained
      euthyroid before and after selenium supplementation. The individual changes of
      plasma Se and glutathione peroxidase activity were closely associated with
      individual changes of plasma T4 and rT3.

PMID- 7779570
TI  - Serum selenium levels in diabetic children. A followup study during selenium
      enriched agricultural fertilization in Finland.
AB  - The effect of increased selenium uptake on serum selenium in diabetic children
      was investigated during the first 9 yr of the Finnish nationwide selenium
      fertilization program, which started in 1984. Serum selenium concentrations were
      followed in 237 diabetic children (mean age 8.1 yr) and 214 controls from 1984 to
      1992. The control group consisted of 107 siblings of the diabetics and of 107
      other healthy children of corresponding age groups. Selenium was determined by
      direct electrothermal atomic absorption spectrophotometry. The effect of the
      increased uptake was seen in both diabetic and in control persons. Before the
      autumn of 1985, diabetic patients had significantly higher serum selenium levels
      than their siblings or the other healthy controls. Toward the end of year 1987,
      this difference had disappeared. After that, serum selenium levels continued to
      increase until the year 1990. In 1990 the mean selenium serum level of diabetic
      patients was 1.36 mumol/L and that of controls 1.33 mumol/L. The duration of
      diabetes did not have any effect on selenium serum levels. Slightly higher serum
      selenium in new diabetic patients before the start of therapy was explained by
      the dehydration state. The patients who were younger than 3 yr had slightly lower
      selenium serum levels when compared with older age groups. This difference was
      observed, however, only during the first 3 yr of the study. After that, when the
      selenium intake increased in general, no age-dependent differences were found
      anymore. There were no significant differences in serum selenium levels between
      males and females in either diabetic patients or in controls.

PMID- 7779571
TI  - Evaluation of selenium supply and status of inhabitants in three selected rural
      and urban regions of the Czech Republic.
AB  - Blood serum selenium of 65 men and hair selenium of 77 men from three regions of
      the Czech Republic (CR) were analyzed by neutron activation analysis, and 202
      samples of urine from the same populations were analyzed for Se by the
      fluorimetric method to assess selenium status of these regions. Low status (53
      micrograms Se/L of serum and 0.29 micrograms Se/g lyophilized hair as means) and
      very low urine selenium (8.7 micrograms/L urine) were detected. By these data,
      the CR is among the countries with the lowest Se intake. A comparison of studied
      regions is presented. Moreover, values of serum zinc were within the reference
      range, but mild to moderate deficiency in the supply of iodine was detected.

PMID- 7779572
TI  - Effect of iron and phagocytosis on murine macrophage activation in vitro.
AB  - Iron-exposed murine macrophages have a modified bactericidal activity as shown by
      previous observations. In order to assess the role of iron in macrophage
      activation, as measured by free radical production and by intracellular bacterial
      killing, murine peritoneal macrophages were cultivated in the presence of various
      sources of iron, human iron-saturated transferrin and ammonium ferric citrate, or
      iron chelators, Desferal, and human Apo-transferrin, and were infected with an
      enteropathogenic strain of E. coli. The release of nitrite (NO2-), and the
      production of superoxide anion (O2-) and hydrogen peroxide (H2O2) by the
      phagocytes were measured and compared to the production by uninfected
      macrophages. The synergistic action with murine r.IFN-gamma was also studied in
      the radical production reaction and for the bactericidal activity of macrophages.
      Our results show that in vitro phagocytosis of E. coli induced elevated
      production of NO2- and H2O2 by macrophages, and that oxygen derivatives were
      released independently of the presence of added iron or chelator. Despite a
      phagocytosis-related enhancement of NO2- release, reactive nitrogen intermediates
      (RNI) are not directly involved in the bactericidal mechanism, as revealed by
      increased intracellular killing owing to RNI inhibitors. Moreover, bacterial
      killing may depend on oxygen derivatives, as suggested by the effect of the
      antioxidant sodium ascorbate leading to both a diminished H2O2 production and a
      decreased bactericidal activity of macrophages.

PMID- 7779573
TI  - Seleno-lactobacillus. An organic selenium source.
AB  - Lactic acid bacteria are nonpathogenic bacteria commonly used in food processing.
      An evaluation was made of the capacity to concentrate selenium in species of
      Lactobacillus. A selenium concentration of 1 microgram/mL in the culture medium
      yielded in a bacterial content of 400 micrograms/g dry biomass. Dialysis and TCA
      precipitation experiments of a native intracellular extract proved that at least
      80% of the total selenium is associated with organic molecules. Seleno-cysteine
      was identified as the only seleno-amino acid present in the intracellular
      selenoproteins. This study shows that species of the lactic acid bacteria are
      able to concentrate selenium intracellular as seleno-cysteine, which could be
      applied in supplementation studies.

PMID- 7779574
TI  - Effects of oral zinc gluconate on glucose effectiveness and insulin sensitivity
      in humans.
AB  - Zinc improves both insulin secretion and insulin sensitivity, and exerts insulin
      like effects. We investigated its acute effects on the parameters of glucose
      assimilation determined with the minimal model technique from frequent sampling
      intravenous glucose tolerance test (FSIVGTT) in seven healthy volunteers.
      FSIVGTTs (0.5 g/kg of glucose, followed by 2 U insulin i.v. injection at 19 min)
      were performed after the subjects had taken 20 mg zinc gluconate twice (the
      evening before and 30 min before the beginning of the test) or placebo pills
      (simple blind randomized protocol). Glucose assimilation was analyzed by
      calculating Kg (slope of the exponential decrease in glycemia), glucose
      effectiveness Sg (i.e., ability of glucose itself to increase its own disposal
      independent of insulin response), and SI (insulin sensitivity, i.e. the effect of
      increases in insulinemia on glucose disposal). The two latter parameters were
      calculated by fitting the experimental data with the two equations of Bergman's
      "minimal model." Zinc increased Kg (p < 0.05) and Sg (p < 0.05), whereas SI and
      insulin first-phase secretion did not significantly increase. This study suggests
      that zinc improves glucose assimilation, as evidenced by the increase in Kg, and
      that this improvement results mainly from an increase in glucose effectiveness
      (insulin-like effect), rather than an action on insulin response or insulin
      sensitivity.

PMID- 7779575
TI  - Effects of zinc on copper-induced and spontaneous lipid peroxidation.
AB  - Zinc (Zn) is an essential nonredox metal that has been regarded as having
      antioxidant properties. Some epidemiological indications and therapeutic results
      point to a role of Zn in restricting the development and the progression of some
      diseases. Redox-active metals like iron and copper are involved in oxidative
      injury mechanisms, and a decrease in the Zn:Cu ratio may be associated with
      certain pathologies. We studied the effect of Zn on the copper-induced lipid
      peroxidation in diluted human plasma. Lipid peroxidation was evaluated by
      measuring the formation of conjugated dienes and of thiobarbituric acid reactive
      products. We found that 20 microM Zn reduced the 125-microM copper-dependent
      formation of conjugated dienes by 27% and of thiobarbituric acid reactive
      products by 49%, during a 3-h incubation period. The inhibition of lipid
      peroxidation by 125 microM Zn is almost total in the same conditions. The time
      course study of the inhibitory effect of 125 microM Zn showed that it lasted for
      7 h, which was the maximum incubation period tested. We also found that Zn had an
      inhibitory effect on the spontaneous lipid peroxidation in rat brain whole
      homogenates. Our results support the antioxidant properties of Zn, which may be
      potentially relevant to the protection of human plasma constituents, competing
      with the transition metals for redox reactions.

PMID- 7779576
TI  - Effect of aluminum and lead salts on lipid peroxidation and cell survival in
      human skin fibroblasts.
AB  - The aim of this study was to see whether aluminum (Al) and lead (Pb) salts are
      toxic for cultured human fibroblasts under different experimental conditions, in
      the controllable situation offered by cell cultures. Cell survival and membrane
      lipid peroxidation served as markers of Al and Pb toxicity. Evaluation of the
      living cells was carried out using a colorimetric method, the mitochondrial
      reduction of 1-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT).
      Lipoperoxidation assay was performed on whole cell homogenates by measuring
      thiobarbituric acid-reactive substances (TBARS) produced after incubation with
      ascorbic acid-ferrous sulfate. Al(III) and Pb(II) salts (300 microM) produce a
      considerable decrease in cell survival after an exposure period of 4d, evident
      with the three fetal calf serum concentrations in the culture media: 2, 5, and
      10%. Taking into account in vitro cell aging, the cytotoxic effects of Al(III)
      and Pb(II) are greater in senescent fibroblasts than in young cells. Lead-induced
      cytotoxicity is higher than Al-induced cytotoxicity. A mechanism that contributes
      to cellular toxicity is membrane lipid peroxidation; our results demonstrate that
      Al(III) and Pb(II) ions, 400 microM, exert an antioxidant-like effect or a pro
      oxidant action on cell membranes depending on exposure time. We describe
      significant increases in TBARS formation associated with the presence of 400
      microM Al(III) or Pb(II) salts in the culture media. Our study also revealed that
      these heavy metals induce a cell age-dependent action on membrane
      lipoperoxidation that is greater in senescent fibroblasts and this could have
      severe consequences for maintenance of cellular integrity.

PMID- 7779577
TI  - Antioxidant effect of vitamin E and glutathione on lipid peroxidation in boar
      semen plasma.
AB  - The protective effect of vitamin E and reduced glutathione (GSH) against lipid
      peroxidation in boar semen plasma was studied. The lipid peroxidation, measured
      by the test for thiobarbituric acid reactive substances (TBARS), doubled in the
      presence of the lipid peroxidation Fe(2+)-sodium ascorbate-inducing system. The
      ascorbate-induced TBARS were inhibited by about 62% through the water-soluble
      vitamin E analog (TROLOX) and about 57% by GSH. In the in vivo experiments, 7 wk
      of oral DL-alpha-tocopherol acetate (1000 IU/d/animal) administration caused a
      significant fall in the level of the semen plasma TBARS, from 2.2 +/- 0.09 to 1.2
      +/- 0.13 nmol MDA/mL. The semen plasma superoxide dismutase (SOD) and GSSG tended
      to increase with the time of vitamin E administration, but the increment did not
      reach a significant level by the seventh week. The vitamin E supplementation
      significantly increased the number of spermatozoa per 1 cm3 of ejaculate. The
      protective role of vitamin E and GSH with respect to boar semen against fatty
      acid peroxidation and a positive influence of vitamin E supplementation on semen
      quality have been evidenced.

PMID- 7779578
TI  - Zinc deficiency does not enhance LDL uptake by P 388 D1 macrophages in vitro.
AB  - The aim of the study was to investigate the effect of zinc depletion on the
      susceptibility of Wistar rat low-density lipoproteins (LDL) to peroxidation and
      their uptake by macrophages, before and after in vitro oxidation. The rats were
      fed for 7 wk a Zn-adequate diet (100 ppm) ad libitum (AL), a Zn-deficient diet
      (0.2 ppm) ad libitum (ZD), or a Zn-adequate diet according to the pair-feeding
      method (PF). Zinc status was determined and, for each group, blood was pooled,
      and LDS were isolated and labeled with 125Iodine. An aliquot of each LDL sample
      was oxidized using FeII 10 microM/ascorbate 250 microM. Oxidized and nonoxidized
      (native) LDL were incubated with P 388 D1 macrophages, and their rates of uptake
      and degradation by macrophages were measured. Before oxidation, LDL uptake and
      degradation were not modified by the diet, suggesting that Zn deficiency did not
      modify rat LDL in vivo. After oxidation, both LDL uptake and degradation were
      significantly enhanced in the three groups. Nevertheless, we did not observe a
      significant effect of Zn deficiency. This observation suggests that, in our
      experimental conditions, Zn deficiency did not modify LDL catabolism.

PMID- 7779579
TI  - alpha-Tocopherol, ascorbic acid, and rutin inhibit synergistically the copper
      promoted LDL oxidation and the cytotoxicity of oxidized LDL to cultured
      endothelial cells.
AB  - Low-density lipoproteins (LDL) mildly oxidized by copper ions or UV radiations
      exhibit a cytotoxic effect to cultured endothelial cells. Rutin, a polyphenolic
      flavonoid, ascorbic acid, and alpha-tocopherol were able to inhibit the
      peroxidation of LDL and their subsequent cytotoxicity. The mixture of the three
      compounds (rutin/ascorbic acid/alpha-tocopherol, 4/4/1) exhibited a supra
      additive antioxidant effect. The inhibition of the cytotoxic effect was well
      correlated with that of TBARS formation. Another important conclusion is that
      these antioxidants were able to prevent directly at the cellular level the
      cytotoxic effect of oxidized LDL, since cells preincubated with them were
      protected against the cytotoxic effect of previously oxidized LDL. The protective
      effect of antioxidants was limited because of their own toxicity. The antioxidant
      mixture permitted a maximal cytoprotective effect with relatively lower
      concentrations to be obtained and the cytotoxicity of high concentrations to be
      avoided. In conclusion, rutin, ascorbic acid, and alpha-tocopherol constitute two
      lines of defense in protecting cells against injury owing to oxidation of LDL (1)
      at the LDL level, by inhibiting the LDL oxidation and the subsequent
      cytotoxicity, and (2) at the cellular level, by protecting the cells directly,
      i.e., by increasing their resistance against the cytotoxic effect of oxidized
      LDL.

PMID- 7779580
TI  - Microsomal membrane peroxidation by an Fe3+/paraquat system. Consequences of
      phenobarbital induction.
AB  - Descriptions of the effects of paraquat (P2+) on the peroxidation of liver
      microsomes are very divergent. Therefore, the presence of ferric iron in the
      medium and the activity of microsomal mixed-function oxidase system are two
      factors that we have taken into consideration to explain the discrepancies. The
      results showed that 100 microM P2+ potentializes the slight production of MDA
      induced by low concentrations of Fe3+ (< or = 15 microM). In these conditions,
      P+., arising from the one-step reduction of P2+ by NADPH-cytochrome C reductase,
      could reduce Fe3+ and cause the formation of species that initiate peroxidation.
      However, unlike the results obtained with CBrCl3, for animals induced by
      phenobarbital (Ph), the production of MDA in the presence of FeCl3 and of P2+ was
      weaker than for the controls. The establishment of a new Fe3+/Fe2+ equilibrium
      owing to increased production of P+. could be responsible.

PMID- 7779581
TI  - A site-directed mutant of Cu,Zn-superoxide dismutase modeled after native
      extracellular superoxide dismutase.
AB  - The well-studied cytosolic Cu,Zn-superoxide dismutase (SOD) protects against
      reperfusion injury, although its short (6 min) plasma half-life and negative
      charge create undesirable pharmacokinetics. We have designed, cloned, and
      expressed a genetic variant of SOD with altered pharmacological properties. A
      fusion gene consisting of the entire coding region of human SOD followed by a
      positively charged carboxy-terminal (C-terminal) "tail" of eight glycine and six
      arginine residues was constructed. The tail was modeled after the extracellular
      SOD (EC-SOD) C-terminal 26-amino acid basic peptide. This EC-SOD tail binds to
      heparin-like proteoglycans on cell surfaces and contributes to the enzyme's very
      long (30 h) plasma clearance time. After expression in Escherichia coli, the
      mutant enzyme was purified and characterized. No differences in specific activity
      or UV absorption spectrum between the mutant and the native enzyme were found.
      The thermal stability of the fusion protein was greater than that of native SOD.
      Although native SOD has no affinity for heparin, the modified enzyme bound to a
      heparin-agarose column. A "designer" SOD able to bind to cell surfaces may aid in
      the prevention of superoxide-mediated endothelial damage.

PMID- 7779582
TI  - Antimetabolites.

PMID- 7779583
TI  - New anticancer agents.

PMID- 7779584
TI  - Monoclonal antibody therapy of cancer.

PMID- 7779585
TI  - Gene therapy of cancer.

PMID- 7779587
TI  - Adoptive immunotherapy.

PMID- 7779586
TI  - Biological response modifiers.

PMID- 7779588
TI  - Alkylating agents.

PMID- 7779589
TI  - Differentiation agents in cancer therapy.

PMID- 7779590
TI  - Leukemias and myeloma.

PMID- 7779591
TI  - Lymphomas.

PMID- 7779592
TI  - Head and neck cancer.

PMID- 7779593
TI  - Lung cancer.
AB  - In SCLC, combination chemotherapy including agents such as etoposide, teniposide,
      cisplatin, carboplatin, doxorubicin, vincristine and cyclophosphamide continues
      to be the backbone of therapy. Epipodophyllotoxin derivatives, together with
      cisplatin or carboplatin are being increasingly used as part of the initial
      therapy. Complete plus partial responses to combination chemotherapy occur in 80
      90% of all patients with a median duration of 9-11 months. Median survival in
      these studies is at present 11-16 months, depending on the initial tumour stage.
      At this point, 5-year survival is around 5% and includes a small fraction of
      patients (1%) initially presenting with extensive disease. The optimum duration
      of treatment is still uncertain, but the tendency is to shorten the duration of
      treatment to 6-9 months. The results of intensifying the treatment with the use
      of hematopoietic growth factors have hitherto been disappointing. The results of
      several phase II studies stress the importance of dose scheduling of etoposide in
      SCLC, with continuous treatment of 5 days' duration or more being superior. The
      therapeutic results for squamous cell carcinoma, adenocarcinoma, large cell
      carcinoma and mesothelioma are essentially unchanged. The treatment of patients
      with these types of lung cancer should continue to be considered experimental,
      since no standard chemotherapy has as yet been developed, neither when given as
      single modality nor in combination with surgery or radiotherapy.

PMID- 7779594
TI  - Upper gastrointestinal tumors.

PMID- 7779595
TI  - Cancers of the large bowel and hepatobiliary tract.

PMID- 7779596
TI  - Mitomycin C.

PMID- 7779597
TI  - Endocrine tumors.

PMID- 7779598
TI  - Genitourinary malignancy.

PMID- 7779599
TI  - Gynecologic malignancies.

PMID- 7779600
TI  - Mitotic inhibitors.

PMID- 7779601
TI  - Breast cancer.

PMID- 7779602
TI  - Malignant melanoma.

PMID- 7779603
TI  - Soft tissue and bone sarcomas.

PMID- 7779604
TI  - Brain tumor chemotherapy.

PMID- 7779605
TI  - Malignant tumors of children and adolescents.

PMID- 7779606
TI  - Supportive care.

PMID- 7779607
TI  - DNA topoisomerase inhibitors.

PMID- 7779608
TI  - Cisplatin.

PMID- 7779609
TI  - Multidrug resistance.

PMID- 7779610
TI  - Role of human papillomaviruses in benign and malignant lesions.

PMID- 7779611
TI  - Mechanisms of invasion by head and neck cancers.

PMID- 7779612
TI  - Cellular and molecular mechanisms of radioresistance.

PMID- 7779613
TI  - Early detection and screening for head and neck cancer.

PMID- 7779614
TI  - Photodynamic therapy for cancer of the head and neck.

PMID- 7779615
TI  - Molecular phenotyping of head and neck cancer.

PMID- 7779616
TI  - Timing and sequencing of chemoradiotherapy.

PMID- 7779617
TI  - Organ preservation in advanced head and neck cancer.

PMID- 7779618
TI  - Elective modified neck dissection for treatment of the clinically negative (N0)
      neck.

PMID- 7779619
TI  - Distant metastases from head and neck squamous cancer: the role of adjuvant
      chemotherapy.

PMID- 7779620
TI  - Experimental therapeutic approaches for recurrent head and neck cancer.

PMID- 7779621
TI  - Head and neck cancer: the year 2000.

PMID- 7779622
TI  - Squamous differentiation and retinoids.

PMID- 7779623
TI  - Risk factors and genetic susceptibility.
AB  - Tobacco use is such a major determinant of head and neck cancer risk that
      classical epidemiologic techniques were more than adequate to document and
      characterize the etiologic association. However, the new emphasis in
      epidemiologic research is multidisciplinary, centering on the role of
      interindividual differences in susceptibility to carcinogenic exposures and
      particularly on the interaction of genetic susceptibility and environmental
      forces, that is, ecogenetics. For upper aerodigestive tract cancers, measurements
      of carcinogen metabolic activation and DNA repair capability are especially
      relevant. These susceptibility markers will enable the identification of high
      risk population subgroups who can be targeted for the most intensive primary and
      secondary preventive strategies.

PMID- 7779624
TI  - Biology and reversal of aerodigestive tract carcinogenesis.

PMID- 7779625
TI  - [The prognostic significance of the measurement of Ca 15-3 in the fluid of large
      breast cysts].
AB  - Ca 15-3 was assayed in serum and in breast cysts fluid of 78 non neoplastic
      patients presenting Gross Cysts (GCD). In apocrine cysts and in the mixed type
      (serous and apocrine, class III) relapse was indicated by high serum and
      intracystic levels of the marker. Ca 15-3, therefore, may discriminate in a group
      of cysts a higher cellular resistance as well as an increased cell proliferation.
      Results suggest an important role of the marker in the follow up of patients with
      GCD and for the early detection of cyst relapse.

PMID- 7779626
TI  - [Diagnostic findings and the surgical treatment of liver metastases: our
      experience].
AB  - The authors report their 10 year experience of 32 consecutive hepatic resections
      for metastases. All patients were preoperatively evaluated with US and CT,
      however, in 9 cases the diagnosis was obtained at laparotomy. In the first years
      there were no codified criteria for indications to surgery, while recently these
      were restricted, because of more favourable prognostic evaluations, to the
      metastases from colorectal carcinoma, endocrine or carcinoid tumours, digestive
      system neoplasms invading adjacent liver (in this case usually with palliative
      goal). The low mortality and morbidity registered explain the safety and efficacy
      of this procedure, also taking into account the fact that currently surgery is
      the only effective procedure with curative purpose. Criteria for patients
      selection, particularly in case of colorectal cancer, are referred and discussed
      and consequently prognostic factors are proposed: hepatic involvement extent,
      stage of primary tumour, absence of extrahepatic metastases, disease free
      interval between resection of primary tumour and hepatic resection for
      metachronous metastases.

PMID- 7779627
TI  - [Abdominal aortic aneurysm and rectal cancer: what surgical strategy?].
AB  - The incidence of abdominal aortic aneurysm and colorectal cancer association is
      0.5-1%. This concomitance of two potentially lethal diseases creates a decision
      making problem regarding priority of treatment. The Authors report a case in
      which colorectal cancer and abdominal aortic aneurysm were present. This patient
      first underwent surgery for colorectal cancer, then for aortic aneurysm.
      Moreover, the Authors review the Literature and discuss their decisional
      principles about treatment priorities.

PMID- 7779628
TI  - [The large hiatal stomach hernia and its surgical correction: the authors'
      personal experience].
AB  - The authors report their experience with hiatus hernia surgery (9 cases of large
      hernia with severe gastroesophageal reflux). The fundamental role of instrumental
      diagnostics in establishing both a clear indication for surgical correction and
      the quality of the results obtained is emphasized. Technical details of the
      surgical treatment are report as well. On the basis of their experience and in
      accordance with other authors the Nissen fundoplication is considered a valid
      antireflux procedure. Furthermore, the abdominal approach used for this procedure
      allows to treat other abdominal pathologies often associated with hiatal hernia.

PMID- 7779629
TI  - [Primary acute acalculous cholecystitis].
AB  - Acute acalculous cholecystitis (AAC) is a life-threatening condition whose
      incidence is steadily increasing although still lower than the corresponding
      lithiasic forms: AAC represents around 5-10% of all cases of acute cholecystitis.
      The severity of the disease is due to the rapid evolution towards gallbladder
      necrosis and biliary peritonitis. AAC is more frequently a disease of the
      critically ill patient arising in postoperative courses or in stressing
      conditions. Not rarely, however, it may occur with no evident predisposing
      factors and it seems related, in such cases, to elderly ages and to atheromatous
      vascular conditions. The authors report two cases of idiopathic AAC in elderly
      patients: pathogenic and clinical features as well as therapeutic options are
      analyzed and discussed.

PMID- 7779630
TI  - [The diagnostic-therapeutic picture in liver injuries: a review of the literature
      and clinical cases].
AB  - Approximately 80% of liver trauma cases have a good prognosis and do not create
      decision-making problems for the surgeon, while in the remaining 20% the correct
      choice still represents a problem. Recently there has been a trend toward more
      conservative surgical management with emphasis on hemostasis and debridement, as
      well as a move toward a non-surgical alternative (surgical abstention) where
      feasible, relying in such cases on first-line CT scans for trauma evaluation. We
      report 51 cases of liver trauma observed in the period 1985-1993 graded according
      to the AAST Liver Injury Scale as follows: 12 grade I lesions (23.5%), 7 grade II
      lesions (13.7%), 19 grade III lesions (37.3%), 7 grade IV lesions (13.7%), and 6
      grade V lesions (11.8%). In managing these cases we relied on two first-line
      diagnostic procedures: diagnostic peritoneal lavage (DPL) and CT scans. DPL,
      performed on 10 blunt trauma victims with unstable vital signs, was positive in 7
      who thus underwent immediate surgery, and negative in 3 who subsequently
      underwent CT scan. Another 14 blunt trauma victims with stable vital signs
      underwent first-line CT scanning. In the event of a CT grade III or IV lesion
      patients underwent surgery, while patients with a CT grade I or II lesion were
      followed expectantly. Deaths (14) occurred only among patients with grade III or
      IV lesions (including 9 multiple trauma victims) who underwent surgery.

PMID- 7779631
TI  - [The physiopathology of carcinoids: current findings].

PMID- 7779632
TI  - [Duplication of the gastrointestinal tract: a report of a rare case of
      mediastinal cyst].
AB  - An unusual case of alimentary tract duplication located in the left anterior
      mediastinum and observed in a 37-year-old woman is reported. Resection of the
      lesion through a left thoracotomy approach was resolutive and followed by an
      excellent long term outcome. Etiology, diagnosis and therapeutic problems as well
      as differential diagnosis with benign and malignant chest lesions of adult
      population are briefly discussed.

PMID- 7779633
TI  - [Peroperative endoscopic papillotomy in a patient with an abdominal aortic
      aneurysm and biliary calculi].
AB  - The authors report a case of abdominal aortic aneurysm associated with biliary
      tract lithiasis. The need to simultaneously treat both diseases is stressed. A
      technique which involves endoscopy during open surgery in order to prevent
      contamination is illustrated. The technique used together with other manoeuvres
      is part of a methodology aiming to broaden indications to the treatment of
      abdominal diseases associated with vascular diseases, limiting at the same time
      the risks of prosthetic infection.

PMID- 7779634
TI  - [The biological effects of the CO2 laser studied in experimental intestinal
      resections].
AB  - An histological and E.M. study has been performed on rat's intestinal tract
      resection to evaluate CO2 laser effects. Necrotic effect of laser is evident up
      to 120 micron. While the intestinal tissue results normal at 480 micron from
      resection line. Muscular and fibrous components appear more resistant to damage
      while E.M. presents a new organization of its components forming a new compact
      and continue tissue. This new organization may be involved in the protection of
      the subepithelial spaces, and may have an important role in intestinal
      anastomosis scar process.

PMID- 7779635
TI  - [The current controversies over video laparoscopic cholecystectomy as the
      treatment of choice for cholelithiasis].
AB  - Recently, the widespread use of laparoscopic cholecystectomy allowed to reach
      several goals such as a minimal invasive approach, a minimal operative trauma,
      the absence of aesthetic or functional damage of the abdominal wall, and a quick
      return to full activities. On the other hand, as all innovations, laparoscopic
      cholecystectomy is matter of debate and a number of controversies have recently
      appeared in the Scientific Literature. On the basis of their experience and
      through a critical review of the Literature, the Authors have therefore analyzed
      possible solutions to such controversies. Particularly, current indications and
      contraindications of this approach, surgical technique and relative sites of
      insertion of the trocars, the need to drain or not, the pre- and intra-operative
      study of the bile duct and the approach in case of bile duct stones pre- or intra
      operatively demonstrated, have been evaluated as possible answers. The Authors
      conclude that indications to laparoscopic cholecystectomy are the same of those
      for laparotomy, contraindications are represented by coagulopathies, liver
      cirrhosis and plastic peritonitis. At present it is still impossible to affirm
      which is the best surgical technique, the best position for the surgeon, and the
      best site for the insertion of the trocars, while drainage must be used only in
      those cases in which further manoeuvres on the bile duct are required. At last
      the Authors underline there is no need for a routine intraoperative
      cholangiography during laparoscopic cholecystectomy, however such technique must
      be known by laparoscopic surgeons since it may be mandatory in some selected
      cases. ERCP, on the contrary, is a valid support to laparoscopic cholecystectomy
      in the treatment of gallbladder stones associated with bile duct stones.

PMID- 7779636
TI  - Deliberate self-harm using yew leaves (Taxus baccata).

PMID- 7779637
TI  - Pseudotumour of the orbit: bilateral metachronous presentation.
AB  - A case is presented of a pseudotumour that developed in the left orbit 4 years
      after surgery and histological confirmation of a pseudotumour in the right orbit.
      There was no evidence of any thyroid pathology.

PMID- 7779638
TI  - Recurrent cerebral abscesses 20 years before recognition of multiple pulmonary
      arteriovenous malformations.

PMID- 7779639
TI  - Cutaneous SCC: metastases with a predilection for lungs 6 years after excision of
      the primary tumour.
AB  - An 80-year-old woman developed an ulcerated, moderately differentiated squamous
      cell carcinoma (SCC) on the lower leg. Despite local excision and radiotherapy,
      the patient presented 6 years later with multiple lung metastases which were
      histologically indistinguishable from the original skin tumour. There was no
      evidence of metastases to lymph nodes or other viscera.

PMID- 7779640
TI  - Candida albicans infection complicating percutaneous gastrostomy in cystic
      fibrosis.

PMID- 7779641
TI  - Dual-energy X-ray absorptiometry in rheumatoid arthritis: comparison between
      axial and appendicular skeleton findings.
AB  - Bone mineral density was measured by dual-energy x-ray absorptiometry (DXA) at
      the lumbar spine, both hips and distal radius in 10 postmenopausal patients with
      rheumatoid arthritis (RA). DXA values at the lumbar spine and distal radius were
      compatible with osteoporosis in all but 1 patient. Only 4 patients had
      osteoporosis of the hip, and 3 of these were over 65. Preliminary results over
      this small population suggest that in RA a correlation may be expected between
      DXA values in lumbar spine and distal radius, but not between either of these and
      the hip.

PMID- 7779642
TI  - HRT: another piece of the coronary jigsaw.

PMID- 7779643
TI  - HRT: a view from primary care.

PMID- 7779644
TI  - Do clinicians prescribe HRT for hypertensive postmenopausal women?
AB  - Despite the benefits of hormone replacement therapy (HRT) in relieving menopausal
      symptoms, there continues to be anxiety about its use in women who also have
      hypertension. To examine clinical practice in relation to HRT, especially in
      patients with hypertension, and to canvass opinions on potential or perceived
      side-effects, the authors conducted a postal survey of HRT prescribing habits
      among 285 GPs, physicians and obstetricians in the West Midlands. The overall
      response rate to the questionnaire was 191 (66.3%): 61 clinicians reported that
      they would not prescribe HRT in women whose hypertension was difficult to
      control, but only 3 would withhold treatment if blood pressure was well
      controlled; 9% of physicians and 13% of gynaecologists did not routinely measure
      blood pressure before starting HRT or monitor BP at follow-up (24% and 10%
      respectively). A proportion of GPs (20%), physicians (21%) and gynaecologists
      (9%) reported that in their opinion HRT raised blood pressure, and a minority in
      each group considered that HRT increased the risk of venous thrombosis, stroke
      and myocardial infarction. This study demonstrates differences among GPs,
      physicians and gynaecologists in the use of HRT in menopausal women with
      hypertension, the authors suggest that, in view of data from studies of the
      effects of HRT on blood pressure and the possible reduction of cardiovascular
      disease, these clinicians can be reassured and hypertensive women need not be
      denied the benefits of HRT, as long as there is careful monitoring.

PMID- 7779645
TI  - Comparison of clotrimazole, fluconazole and itraconazole in vaginal candidiasis.
AB  - Women attending a genitourinary medicine clinic (n = 229) with mycologically
      confirmed acute vulvovaginal candidiasis were randomised to receive either
      clotrimazole (500 mg pessary and 1% cream), fluconazole (150 mg single oral dose)
      or itraconazole (200 mg bd oral dose for 1 day). Mycological cure rates were 96%
      in the itraconazole group, 95% in the clotrimazole group, and 83% in the
      fluconazole group (P = 0.008). The proportion of patients who were clinically
      cured showed a similar pattern (itraconazole 80%, clotrimazole 80%, fluconazole
      62%). This suggests that itraconazole or clotrimazole are more effective than
      fluconazole in the treatment of acute vaginal candidiasis.

PMID- 7779646
TI  - Gastrointestinal side-effects of NSAIDs in the community.
AB  - The prevalence of a range of gastrointestinal symptoms was compared in 1014
      cases, identified in general practice, receiving chronic non-steroidal anti
      inflammatory drug (NSAID) treatment and 975 matched community controls. The
      NSAIDs being taken included aspirin (33%), ibuprofen (17%), naproxen (11%),
      piroxicam (9%), indomethacin (8%), and diclofenac (7%). The 12-month prevalence
      of dyspepsia in cases was 46% and in controls 43%, with no differences in
      symptoms prevalence between those taking aspirin and other NSAIDs or between
      individual NSAIDs. About one-third of the cases had consulted a GP about their
      symptoms and 7% had a co-prescription for an H2-receptor antagonist. Lower-bowel
      symptoms were more common in the NSAID-taking cases, particularly constipation
      and straining, and constipation was a more common reason for stopping medication
      than dyspepsia.

PMID- 7779647
TI  - Use of solvents to disperse ear wax.

PMID- 7779648
TI  - The effect of ranitidine on symptom relief and quality of life of patients with
      gastro-oesophageal reflux disease.
AB  - A 4-week study involving 354 patients with the symptoms of gastro-oesophageal
      reflux disease was conducted to assess the effect of ranitidine (as effervescent
      tablets) on their relief and quality of life. All patients received 150 mg bd for
      2 weeks, with those responding to treatment continuing on the same dosage for a
      further 2-week period and 'non-responders' having the dosage increased to 150 mg
      qds for a further 2 weeks. Quality of life and symptom assessments were carried
      out at 0, 2 and 4 weeks. Two weeks' treatment with ranitidine 150 mg bd was
      effective at controlling the GORD symptoms in 78% of patients. A 4-week treatment
      with either 150 mg bd or qds controlled the symptoms in 85% of patients. All
      patients had significant improvements in all dimensions of their quality of life
      over the study period.

PMID- 7779649
TI  - Hyperventilation and dizziness: case reports and management.
AB  - Dizziness is a common symptom in patients presenting to an otorhinolaryngologist.
      Hyperventilation accounts for up to 5% of cases with dizziness and is a
      contributory factor in a further 20% of cases. Six cases of dizziness due to
      hyperventilation are presented to illustrate the author's simple management
      policy. A high index of suspicion in the absence of an organic cause of dizziness
      and a simple provocation test will identify these cases. Management is aimed at
      demonstrating resting hypocapnia, investigations to exclude organic causes of
      hyperventilation and rehabilitation in collaboration with a clinical psychologist
      ensures the appropriate treatment for the dizziness and can avoid the development
      of chronic somatisation behaviours.

PMID- 7779650
TI  - Screening and treatment for hyperlipidaemia in non-insulin-dependent diabetes: a
      prospective assessment of 350 patients.
AB  - This report presents experiences in screening 350 non-insulin-dependent diabetics
      for hypercholesterolaemia and results of 1 year's treatment. Mean serum total
      cholesterol was 6.4 mmol/l at screening; 46 patients whose initial total serum
      cholesterol was above 7.0 mmol/l attended for detailed assessment and treatment.
      Mean total cholesterol concentrations fell between screening and review (7.8 vs
      7.1 mmol/l, P < 0.01). Levels fell below 7.0 mmol/l in 13 patients with diet
      alone. After excluding patients with secondary dyslipidaemia (including poor
      diabetic control), 10 patients received lipid-lowering drug treatment. Total
      cholesterol and triglyceride concentrations fell significantly and the HDL/non-
      HDL cholesterol ratio improved on treatment. Screening diabetic patients
      identifies a small group of hyperlipidaemic patients, whose lipoprotein profiles
      improve with drug treatment. Many of those screened, however, do not ultimately
      require drug treatment using a cut-off of 7.0 mmol/l.

PMID- 7779651
TI  - The metabolic and cardiovascular consequences of HRT.
AB  - Hormone replacement therapy comprises natural oestrogen and, when appropriate,
      progestogen given to postmenopausal women. Population studies have shown that
      postmenopausal oestrogen administration results in a marked reduction in
      cardiovascular disease, particularly coronary heart disease, an effect that does
      not appear to be lost when cyclical progestogen is also included. The way in
      which the hormones confer this protection has not been fully elucidated, but it
      includes effects on metabolic processes that contribute to atheroma formation as
      well as direct effects on the arteries themselves. Oestrogens and progestogens
      can produce beneficial changes in lipids and lipoproteins, glucose and insulin
      metabolism, body fat distribution, and coagulation and fibrinolysis. Oestrogen
      acts directly on blood vessels through both endothelium-dependent and calcium
      dependent mechanisms to improve arterial function. More widespread use of HRT
      could result in a major beneficial impact on cardiovascular disease, the leading
      cause of death in women.

PMID- 7779652
TI  - Selecting patients for HRT: positive indications.
AB  - As our understanding of the nature of modern postmenopausal hormone replacement
      therapy (HRT) has improved, the number of true contraindications to its use has
      declined. As a result, the question of whether or not to take HRT has become
      determined more by patient choice and less by medical factors, a trend that is
      likely to continue. Thus, women (as well as their doctors) need to be told of the
      indications for HRT so that they can make an informed choice.

PMID- 7779654
TI  - Polycythaemia rubra vera presenting with depression: recognising the syndrome
      abulia.
AB  - A patient with polycythaemia rubra vera is described, presenting primarily with
      symptoms attributed to depression. While in the ward she developed a stroke,
      confirmed on CT scan of the head. Venesection alone produced marked improvement
      in her neurological and psychiatric symptoms. The clinical picture corresponds
      most accurately to the neurological syndrome of abulia, which is an important
      differential diagnosis of depression with psychomotor retardation. The
      pathophysiology of impaired cerebral blood flow causing neuropsychiatric symptoms
      in polycythaemia is discussed.

PMID- 7779653
TI  - Miller Fisher syndrome and anti-GQ1b antibodies.
AB  - A case is presented of Miller Fisher syndrome in a 77-year-old woman. The
      diagnosis was confirmed by the presence of serum IgG antibody to ganglioside
      GQ1b. Miller Fisher syndrome, although uncommon, enters the differential
      diagnosis of brainstem stroke.

PMID- 7779655
TI  - Dieulafoy haemorrhage in association with polycythaemia rubra vera.

PMID- 7779656
TI  - The betrayers.

PMID- 7779657
TI  - Management of erectile disorder.

PMID- 7779658
TI  - The use of long-term acid-suppression therapy.
AB  - Drug therapy to suppress gastric acid secretion is commonly used in the
      management of dyspepsia, many patients taking such therapy over long periods of
      time. An audit of patients on long-term (> 12 months) acid-suppression therapy
      was carried out in the two practices providing primary healthcare to a town in
      Northeast England. Patients on continuous therapy (> 10 months' supply in the
      previous year) and intermittent therapy (6-10 months' supply in the previous
      year) were identified through computerised prescribing records. Their written and
      computer records were scrutinised to determine diagnosis, duration of therapy,
      use of NSAIDs and other features. A total of 365 patients were identified (208
      men, 157 women): 132 were on intermittent and 233 on continuous therapy. Of the
      total, 83% were over 45 years and one-fifth were taking NSAIDs. Of the 310
      patients investigated for their dyspepsia, only 250 had a positive diagnosis, of
      which duodenal ulcer (154) was the most common.

PMID- 7779659
TI  - Surgical patients with surprising laboratory data.
AB  - Preoperative laboratory tests were performed on elective ambulant orthopaedic
      patients (n = 26) on the afternoon after their arrival in hospital and on the
      next morning before the operation. Significantly lower concentrations of
      leukocytes, albumin, total protein, platelets, and total calcium were observed in
      samples taken in the morning. Posture and chronobiological rhythms may be
      responsible for these changes. An overnight change in laboratory values may lead
      to unnecessary further investigations and postponement of surgery. The clinician
      should be aware of the effects of preanalytical factors on laboratory data.

PMID- 7779660
TI  - Atrial fibrillation in the elderly: physicians' attitudes to anticoagulation.
AB  - The use of warfarin and aspirin for the primary prevention of stroke in elderly
      patients with atrial fibrillation (AF) is controversial. To establish current
      practice we circulated a questionnaire to 300 geriatricians (G) and 300
      cardiologists (C). The response rates were 47% G and 51% C. Most physicians
      prescribed warfarin in AF associated with mitral stenosis (G vs C, 86% vs 89%,
      NS). Cardiologists were more likely to prescribe warfarin in AF associated with
      dilated cardiomyopathy (G vs C, 52% vs 86%, P < 0.01). A minority would prescribe
      warfarin in aortic valve disease and AF (G vs C, 37% vs 24%, P < 0.05) and lone
      AF (G vs C, 10% vs 26%, P < 0.01). Aspirin was favoured in aortic valve disease
      and lone AF. The cardiologists were less reluctant to use warfarin in the young
      and more likely to electrically cardiovert the young with chronic AF.

PMID- 7779661
TI  - Training and supervision of temporary transvenous pacemaker insertion.
AB  - To assess the current training and practice of central venous cannulation and
      temporary transvenous pacemaker insertion, a telephone survey of senior house
      officers (n = 60) and registrars (n = 20) was carried out in 80 acute hospitals
      in England and Wales. A median of one central line and two pacings were performed
      under supervision before the respondents were left unsupervised. The procedures
      were almost invariably taught at the bedside and usually by a fellow SHO or
      registrar. Virtually all the doctors surveyed were familiar with subclavian
      puncture, but experience with other routes was limited; 39/80 doctors questioned
      were unhappy about the training they had received, and 47 felt that formal
      training, such as tutorials or videos, would have helped. Training in central
      vein cannulation and temporary pacing needs to be more structured. This could be
      done by the use of videos or mannequins, and should include the use of routes
      other than the subclavian.

PMID- 7779662
TI  - Season of birth in Down's syndrome.
AB  - Previous studies have found a summer peak in the birth of individuals with Down's
      syndrome but have not tended to examine them into adulthood. The aims of this
      study were to look for evidence of a seasonal effect in birth and to uncover any
      differences in adulthood between those born in different seasons. The casenotes
      of all adults with Down's syndrome from the catchment area of a hospital for
      people with learning disability were examined. A summer peak in births was
      confirmed. Only 6% of births took place during January and February compared with
      the 17% expected (P = 0.019); birth during these 2 months was associated with
      female sex (P = 0.047). There was a trend for those born in December to March not
      to develop epilepsy (P = 0.053).

PMID- 7779663
TI  - Fluticasone propionate in the treatment of inflammatory dermatoses.
AB  - Fluticasone propionate is a new, topically active glucocorticoid which shows high
      specificity for the glucocorticoid receptor. After topical application systemic
      absorption is low. The small amount that is absorbed is rapidly and completely
      inactivated by esterase-catalysed hydrolysis in the liver. Even when applied in
      large doses under occlusion, there is no evidence of
      hypothalamic/pituitary/adrenal (HPA) axis suppression. Studies on skin thinning
      have shown no significant effect on skin thickness after once-daily application
      of fluticasone propionate 0.05% cream for 8 weeks. This cream has been shown to
      be highly effective in the treatment of eczema, and once-daily application shows
      no significant difference in efficacy compared with twice-daily treatment.
      Limited studies using 0.005% ointment in moderate to severe psoriasis showed
      similar efficacy to 0.1% betamethasone-17-valerate ointment. Fluticasone
      propionate 0.05% thus represents a major advance in topical corticosteroids. It
      has a high safety profile and the cream formulation is effective in a single
      daily application.

PMID- 7779664
TI  - New therapies for rheumatoid arthritis.
AB  - There are two major thrusts in the development of effective treatments in RA: the
      use and development of entirely new drugs; and the more effective usage of the
      currently available drugs. This represents a comprehensive review of the
      pharmacological agents that have been recently developed or will be available in
      the near future.

PMID- 7779665
TI  - Holistic approach to the management of erectile disorders in a male sexual health
      clinic.
AB  - A holistic view is given of the management of erectile disorders in a male sexual
      health clinic. Responsibility for the choice of treatment programme is shared
      with the patient, who makes informed consent. Involvement of the patient's
      partner is encouraged throughout. The increasing importance of good management
      for erectile dysfunction is indicated by the prevalence of the condition and the
      fact that, with a growing proportion of the population over the age of 65, it is
      age-related.

PMID- 7779666
TI  - Individualisation of HIV therapy: the clinician's perspective.
AB  - Assessment of clinical and laboratory markers of HIV infection may be used to
      individualise antiretroviral therapy. Data suggest that measures of viral load
      may be of considerable value as both a baseline and dynamic therapy marker,
      making these tools particularly useful in driving therapeutic decisions.
      Similarly, in-vitro data regarding intracellular pharmacokinetics and activity,
      resistance patterns and potential synergy of antiretroviral agents may be used to
      guide selection of optimal treatment regimens in clinical practice.

PMID- 7779667
TI  - Strategies for intractable ascites after hepatic resection: analysis of two
      cases.
AB  - Intractable ascites after hepatic resection is one of the gravest complications
      pertaining to deterioration in a patient's quality of life. Two cases are
      presented with intractable ascites that did not respond to ordinary conservative
      treatment after hepatic resection but were eventually successfully treated. The
      authors propose the following strategies: the conducting of aggressive and
      extensive examinations including angiography; and a peritoneovenous shunt for
      patients demonstrating no definite cause, to improve their quality of life.

PMID- 7779668
TI  - Volvulus of the stomach associated with colon in the chest.

PMID- 7779669
TI  - Primary peritonitis in a paraplegic patient.

PMID- 7779670
TI  - Non-convulsive status epilepticus as a complication of Mycoplasma pneumoniae
      infection.
AB  - Described is a confirmed case of non-convulsive status epilepticus, an unusual
      presentation of M. pneumoniae infection. The postulated pathological mechanisms
      in this infection are reviewed.

PMID- 7779671
TI  - Colonoscope incarceration within an inguinal hernia: a cautionary tale.
AB  - Incarceration of the colonoscope, within an undetected left-sided inguinal
      hernia, is a rarely reported event. The literature is reviewed, a possible
      mechanism described, and the technique used to remove the colonoscope outlined.

PMID- 7779672
TI  - Transection of the pancreatic head following blunt abdominal trauma.
AB  - Pancreatic trauma is rare, with a reported incidence of 0.4 per 100,000.
      Transection of the pancreas is extremely rare and usually involves the body
      region. An unusual case of pancreatic trauma, with complete transection through
      the pancreatic head, is described.

PMID- 7779673
TI  - Infected hydrocele complicating acute appendicitis.

PMID- 7779674
TI  - Severe hyperkalaemia due to mefenamic acid-induced hyporeninaemic
      hypoaldosteronism.
AB  - Described is a case of severe hyperkalaemia and hyporeninaemic hypoaldosteronism
      due to the inappropriate use of mefenamic acid. The causes of hyporeninaemic
      hypoaldosteronism are discussed and the importance of a detailed drug history
      emphasised.

PMID- 7779676
TI  - A complex true knot of the umbilical cord.

PMID- 7779675
TI  - Partial hypopituitarism in Klinefelter's syndrome.
AB  - A patient with Klinefelter's syndrome, secondary hypothyroidism and absent growth
      hormone and prolactin reserves is described. This combination of pituitary
      hormone deficiency has not been reported previously in association with
      Klinefelter's syndrome.

PMID- 7779677
TI  - Cor triatriatum: unusual cause of transient ischaemic attacks in a 67-year-old
      man.
AB  - Cor triatriatum is a rare congenital cardiac malformation, and in its most common
      form is characterised by a membrane that separates the left atrium into a
      proximal and distal chamber. First manifestation in adulthood has been reported
      previously, but at 67 years of age this patient is one of the oldest to present
      for the first time. It was diagnosed after a probable TIA, episodic vertigo and
      central retinal artery occlusion. The value of echocardiography in patients with
      neurological disease of presumed embolic origin is demonstrated here.

PMID- 7779678
TI  - Disability among older people: United States and Canada.
AB  - Data from two national surveys of community-dwelling people 55 years of age and
      over are the basis of tables presenting 25 measures of disability for each
      country. The report includes discussions of similarity and differences between
      the countries, methods used to make the data comparable, and limitations on
      interpretation of the data.

PMID- 7779679
TI  - The puzzle of Hox genes.
AB  - During the last few years, the regionalization of the rostral-caudal axis has
      been extensively studied through treatments with RA and genetic manipulations of
      Hox-C genes. RA shifts several Hox expression boundaries rostrally, deletes
      anterior rhombomeres but expands the caudal ones, and induces homeotic
      transformations in the vertebral column. These phenotypes indicate that retinoids
      may act in a graded fashion in the A-P axis, with maximum activity caudally. This
      excludes forebrain and midbrain, which apparently depend on neither Hox-C genes
      nor RA modulations, at least during early development. The phenotypes resulting
      from ectopic overexpression and loss of function of Hox genes described so far
      show homeotic transformations in paraxial mesoderm derivatives but not in the
      neurectoderm. An explanation for this discrepancy implies that the paraxial
      mesoderm may be already segmented in molecular terms at the time of Hox
      activation. Conversely, the activation of a distinct Hox-code without a previous
      "molecular segmentation" may specify rhombomeres with their own boundaries. This
      would explain why RA expands but does not duplicate the postotic rhombomeres.
      Finally, the atavistic transformations obtained by overexpressing Hox genes in
      the wrong place suggest that evolution might be introducing modifications within
      Hox regulatory regions. Thus, changes in their expression domains could sustain
      phylogenetic requirements.

PMID- 7779680
TI  - Tumor suppressor and overgrowth suppressor genes of Drosophila melanogaster:
      developmental aspects.
AB  - In Drosophila about 27 developmental genes have been identified which suppress
      tumorous growth and about as many genes are known to suppress overgrowth.
      Recessive lethal mutations in tumor suppressor genes block in one step the
      differentiation of specific target cells, leaving unaffected their capacity to
      divide in an autonomous, malignant and lethal fashion. The structural analysis of
      eight tumor suppressor genes predicts putative functions in differentiation
      events, such as cell-cell communication, protein transport and protein synthesis,
      signal transduction, sex determination splicing and cytokinesis. Their predicted
      products function as effectors of the differentiated state being vital components
      of cell junctions, the cytoskeleton, the protein synthetic apparatus, the
      splicing machinery and signal transduction. In contrast to the tumor suppressor
      genes, which are instrumental in the establishment and maintenance of the
      differentiated state, overgrowth suppressor genes seem to control cell-specific
      division rates while leaving unaffected the capacity of the cells to
      differentiate. The Drosophila tumor suppressor and overgrowth suppressor genes
      show clearly the mutual exclusion of the genetic programs controlling cell
      division and cell differentiation. Some of the genes exhibit homologies to
      mammalian genes. Their functional homology, however, is still an open question.

PMID- 7779681
TI  - Control of skeletal muscle-specific transcription: involvement of paired
      homeodomain and MADS domain transcription factors.
AB  - In the last few years, many aspects of skeletal muscle-specific gene regulation
      have been explained by the activity of the helix-loop helix (HLH) myogenic
      regulatory factors of the MyoD family, which are sequentially expressed during
      skeletal muscle formation. However, evidence is accumulating that muscle specific
      transcription requires functional interactions of these muscle-specific HLH
      factors with other regulatory proteins whose expression is not only restricted to
      skeletal muscle. These regulators include the SRF and MEF2 MADS domain and the
      MHox paired homeodomain transcription factors. Together with the aforementioned
      HLH factors, they build an increasingly complex network of regulatory factors.
      Two members of the Pax multigenic family of developmental control transcription
      factors, Pax-3 and 7, have been shown to be expressed not only in nervous tissue
      but also in skeletal muscle precursor cells. Their possible involvement in the
      control of muscle-specific transcription is discussed in light of known molecular
      properties of Pax gene products described in other biological systems.

PMID- 7779682
TI  - Expression of mesoderm markers in Xenopus laevis Keller explants.
AB  - In an attempt to document at the molecular level the behavior of mesodermal cells
      in Keller explant preparation, we have analyzed the time course of expression of
      four molecular markers of mesoderm gsc, Xbra, Xnot and XLIM-1. Our findings
      demonstrate that, (i) all mesodermal markers tested were expressed in the
      explants, but patterning of the mesoderm appeared incomplete; (ii) during
      convergence and extension of the explants, mesodermal cells did not invade the
      ectodermal tissue at any time tested, supporting the view that mesoderm
      establishes exclusively planar contacts with the ectoderm in this preparation;
      (iii) planar contacts were not sufficient to promote the neural expression of
      XLIM-1 protein in these explants.

PMID- 7779683
TI  - Widespread expression of the Xenopus homeobox gene Xhox3 in zebrafish eggs causes
      a disruption of the anterior-posterior axis.
AB  - The widespread expression of the Xenopus homeobox gene Xhox3 in zebrafish was
      performed by microinjection of synthetic Xhox3 mRNA into uncleaved fertilized
      eggs and resulted in embryos displaying varying degrees of anterior-posterior (A
      P) axis disruption. The phenotype observed was dose-dependent and showed
      anomalies, mainly in neural keel development, from microphthalmia to acephaly.
      Injection of 5 pg to 10 pg of mRNA caused a range of phenotypes in prim 5 stage
      embryos from normal to acephalic. Anomalies have been categorized according to an
      index of axis deficiency (Zf-IAD). We further characterized the axis disturbance
      by analyzing the expression of two genes implicated in axis formation: engrailed
      (eng) and brachyury (ntl). eng could not be detected in the muscle pioneer cells
      of embryos injected with Xhox3. The pattern distribution of brachyury (Ntl)
      protein is abnormal in Xhox3 injected embryos. Evidence for the conservation of
      the NH2 terminal region of the Xhox3 protein in frogs and fish is provided by the
      detection of a nuclear Xhox3-like protein in 24 h zebrafish embryos located in
      posterior mesoderm tissue. Previous results in Xenopus embryo research and the
      data presented here support the conservation of an A-P patterning mechanism
      involving the Xhox3 gene.

PMID- 7779684
TI  - Comparative analysis of Engrailed-1 and Wnt-1 expression in the developing
      central nervous system of Xenopus laevis.
AB  - Expression of the Engrailed-1 (XEn-1) gene was studied in Xenopus embryogenesis
      by Northern blot analysis and whole-mount in situ hybridization. One transcript
      of 2.2 kb was detected from stage 17 (midneurula) onwards, until stage 47
      (swimming tadpole). The expression pattern of the XEn-1 gene as revealed by in
      situ hybridization can be divided in three regions. The first domain of transient
      expression appears at the midneurula stage (st. 17) in the anterior part of the
      neural fold, forming a complete ring of positive cells at the mid/hindbrain
      border after neural tube closure. A second region of transient expression is
      detected as groups of ventro-lateral cells in the spinal cord and the hindbrain
      from late-neurula till tadpole stages. A third area of transient expression of
      XEn-1 is formed by the anterior part of the developing pronephros. Comparison of
      XEn-1 expression at the mid/hindbrain border with that of the Xenopus wnt-1 and
      engrailed-2 genes reveals that XEn-1 and Xwnt-1, in contrast to XEn-2, are both
      detected in a narrow stripe of positive cells in this region. Analysis in
      exogastrulated embryos reveals that expression of XEn-1 and Xwnt-1, but not XEn
      2, is induced by planar signaling in the presumptive midbrain. Of the three genes
      only XEn-1 is expressed in the floorplate at the mid/hindbrain border, while Xwnt
      1 is expressed in adjacent cells in the neural ectoderm. The results suggest that
      in vertebrates at the interface between cells in the floorplate and in the
      paraxial neuroectoderm, at the limited region of the mid/hindbrain border, En-1
      interacts with wnt-1 in a signaling pathway analogous to the engrailed/wingless
      signaling in the parasegments of the Drosophila embryo.

PMID- 7779686
TI  - Expression of Hox A11 in the limb and the regeneration blastema of adult newt.
AB  - Homeoproteins are functionally involved in pattern formation of developing
      systems and are potentially good candidates to regulate positional information
      during limb regeneration in the newt. Here we report the molecular structure of
      Hox A11 and its pattern of expression during the regeneration of adult newt
      appendages. The transcriptional unit of the gene is composed of two exons
      separated by an intron. Northern blots revealed two major transcripts; a size
      difference would result from using two different polyadenylation signals.
      Therefore, the gene would encode a single protein that is very homologous to
      other vertebrate counterparts. The pattern of expression of Hox A11 in the adult
      newt shows interesting findings in relation to limb regeneration. First,
      expression is found in both intact limb and tail, showing maintenance of
      expression of an important regulator of development in the appendages of the
      adult newt. Second, Hox A11 is expressed mainly in the muscle and the bone of
      intact limbs, two tissue fractions known to participate in blastemal fate
      determination. Third, the level of Hox A11 expression increases drastically in
      both limb and tail regeneration blastemas, suggesting that the population of
      expressing cells is preferentially recruited during blastemal formation. Finally,
      proximal blastemas (mid-humerus) significantly express higher levels of
      transcript compared with distal ones (mid-radius and ulna). These features of
      expression suggest that Hox A11 may participate in limb pattern formation by
      specifying positional information to the progenitor cells of the regenerate.

PMID- 7779685
TI  - Differential expression of two different homeobox gene families during mouse
      tegument morphogenesis.
AB  - The expression of six genes belonging to two different homeobox gene families was
      studied during the embryonic and postnatal morphogenesis of head and body regions
      of the mouse integument. The first family included the Otx1 and Otx2 genes, both
      related to the orthodenticle Drosophila gene and the second was represented by
      four members of the Antennapedia class HOX genes: Hoxc8 and three Hoxd genes, d9,
      d11 and d13. In situ hybridizations with 35S labeled antisense RNA probes were
      performed on head serial frontonasal sections, as well as entire embryo and
      postnatal tail longitudinal sections. The expression of these genes shows a
      differential spatiotemporal pattern along the cephalo-caudal axis. In 12.5-day
      and 15.5-day embryos, the Otx2 gene expression is restricted to the nasal
      epithelium and its associated glands, while the Otx1 transcripts are present in
      both nasal and facial integuments, including nasal glands and hair vibrissa
      follicles. The Hoxc8 expression first appears in skin at 14.5 days of gestation
      in the sternal region and is extended at 16.5 days to the thoracic ventral and
      lumbar dorsal regions. The Hoxd9 and Hoxd11 genes are only expressed in the
      caudal skin from 14.5 days of gestation. The Hoxd13 transcripts are the last to
      appear, 2 days after birth, and are limited to the last epidermal cells to
      differentiate, i.e. those of the hair matrix of the caudal pelage hair follicles.
      Taken together, these observations strengthen the hypothesis that different
      homeobox gene families specify the regional identity of the skin in the cephalic
      and body regions.

PMID- 7779687
TI  - Association of p34cdc2 kinase and MAP kinase with microtubules during the meiotic
      maturation of Xenopus oocytes.
AB  - p34cdc2 protein is found in prophase, metaphase and activated Xenopus oocytes at
      a similar level whereas its kinase activity oscillates within meiosis. Using an
      anti-PSTAIRE antibody that recognizes Xenopus p34cdc2, it was demonstrated that
      the major part of p34cdc2 was associated with microtubules isolated in vitro from
      Xenopus oocytes. Conversely, tubulin was recovered in association with p34cdc2 in
      p13-Sepharose pellets. The abundance of the fraction of p34cdc2 which was
      associated with microtubules did not oscillate during the meiotic maturation and
      the activation process. By contrast, the histone H1 kinase activity of p34cdc2
      estimated in microtubular oocyte pellets was much higher in metaphase than in
      prophase oocytes. Cyclin B, which is associated in vivo with p34cdc2 in prophase
      and metaphase oocytes, was also present in the microtubular fractions. However,
      cyclin was not necessary for the binding of p34cdc2 to microtubules since p34cdc2
      from activated eggs, where cyclin was missing, still copurified with
      microtubules. Purified MAP2, but not tubulin, was able to bind to p34cdc2,
      demonstrating that the association between p34cdc2 and microtubules was mediated
      by microtubule-associated proteins. During the meiotic maturation of Xenopus
      oocytes, several protein kinases were activated, among them MAP kinase. MAP
      kinase also associated with microtubules. It was demonstrated that both p34cdc2
      kinase and MAP kinase purified from Xenopus oocytes were able to phosphorylate in
      vitro rat brain MAP2. However both protein kinases phosphorylated different
      domains of MAP2, suggesting that they might regulate microtubules in different
      ways.

PMID- 7779688
TI  - Distribution of TNF alpha-like proteins correlates with some regions of
      programmed cell death in the chick embryo.
AB  - Early chick embryos have previously been shown to express tumor necrosis factor
      alpha-cross-reactive proteins (TNF alpha-CRPs) in a developmentally regulated
      manner, thus implicating these proteins in programmed cell death and in tissue
      remodeling. In this study, cells undergoing DNA fragmentation have been
      identified, using terminal deoxynucleotide transferase (TdT) mediated dUTP-biotin
      nick-end-labeling (TUNEL), during the embryonic development of the chick, between
      stages 18 and 29. DNA fragmentation is indicative of cells undergoing programmed
      cell death. TUNEL-positive cells were identified in several well documented areas
      of programmed cell death, including the limb buds, the heart, spinal motoneurons,
      dorsal root ganglia, and the ventral horn of the neural tube. In addition, other
      areas of cell death were identified including the floor plate and the
      mesonephros. In several locations, a close correlation was noted between the
      presence of TUNEL-positive cells and regions of TNF alpha-immunoreactivity. These
      regions included the ventral horn and marginal zone of the neural tube, spinal
      motoneurons, paravertebral ganglia, parts of the myotome, mesenchyme of the body
      wall, and the mesonephros. In addition, using the TNF alpha-sensitive L929-8
      bioassay it was shown that homogenate of stage 18 chick embryos is cytotoxic to
      L929-8 cells and that this toxicity can be reduced using neutralizing antibodies
      to mouse TNF alpha. This bioassay allowed us to estimate the mean concentration
      of TNF alpha-like activity in embryo homogenate, which is within the range of
      physiological (pg/ml) levels of TNF alpha found in other systems. These results
      suggest that proteins with TNF alpha-like activity may have a role in programmed
      cell death in some tissues during early chick embryo development.

PMID- 7779689
TI  - Hypertrophy is not a prerequisite for type X collagen expression or
      mineralization of chondrocytes derived from cultured chick mandibular
      ectomesenchyme.
AB  - Meckel's cartilage in the avian mandible is a neural crest-derived permanent
      cartilage. To investigate whether chondrocytes that form Meckel's cartilage can
      be induced to undergo maturation and mineralization by manipulating the
      environment, we used in vitro micromass culture in which young embryonic
      mandibular ectomesenchymal cells were maintained at a high cell density (2 x
      10(7) cells/ml) and treated with ascorbic acid (AA) or with dexamethasone and
      ascorbic acid (DEX + AA). Chondrogenesis and chondrocyte maturation were analyzed
      by histological, immunohistochemical and SDS/PAGE techniques. Chick mandibular
      ectomesenchymal cells from Hamburger and Hamilton (J. Morphol. 88:49-92, 1951)
      stage 21 (HH stage 21) chick embryos undergo chondrogenesis forming cartilage
      nodules when maintained under micromass culture conditions. These chondrocytes
      undergo maturation in response to AA but not DEX. Addition of AA to culture
      medium induced type X collagen expression by these chondrocytes. With prolonged
      culture, chondrocytes began to mineralize turning cartilage nodules into
      completely mineralized structures. There was no correlation between chondrocyte
      size and type X collagen expression. Small chondrocytes as well as large
      (hypertrophic) chondrocytes expressed type X collagen and then underwent
      mineralization. Co-treatment of cultures with DEX + AA caused reduction of
      chondrogenesis and inhibited chondrocyte maturation and mineralization seen with
      AA alone.

PMID- 7779690
TI  - Immunofluorescent confocal analysis of tropomyosin in developing hearts of normal
      and cardiac mutant axolotls, Ambystoma mexicanum.
AB  - Tropomyosin is a major component of the thin filaments in organized myofibrils of
      cardiac muscle cells. A purported role for this protein is to prevent myosin
      thick filaments from interacting with actin thin filaments until the cell
      contracts. Recently, tropomyosin has been implicated in actin filament
      formation/stabilization as well. In the cardiac mutant axolotl, Ambystoma
      mexicanum, heart development is arrested. Mutant embryos form hearts that fail to
      beat due to a lack of organized sarcomeric myofibrils. There is also a
      concomitant reduction in the amount of tropomyosin in mutant heart cells.
      Previous studies have suggested that the addition of purified tropomyosin to
      glycerinated homogenates of mutant hearts causes amorphous actin to polymerize
      (or stabilize) into thin filaments. The current study was undertaken to examine
      the three-dimensional distribution of tropomyosin during myofibrillogenesis in
      normal hearts over the course of development from the heart-beat stage (35)
      through the advanced embryonic stage (41) and to investigate whether myofibrils
      form and/or significant quantities of tropomyosin accumulate in developing mutant
      hearts of comparable ages.

PMID- 7779691
TI  - Guidance of filopodial extension by fibronectin-rich extracellular matrix fibrils
      during avian gastrulation. A study using confocal microscopy.
AB  - We have used double-label confocal microscopy to examine the relationships
      between the orientation of filopodial extension in mesoderm cells and the
      orientation of fibronectin-rich extracellular matrix fibrils during chick embryo
      gastrulation. We fluorescently labeled mesoderm tissue dissected from donor
      embryos by immersion in carboxyfluorescein and then grafted it into unlabeled
      host embryos at the same stage of gastrulation. After further incubation, the
      host embryos were fixed, the endoderm removed, and the extracellular matrix was
      immunostained with antibodies to fibronectin conjugated to Texas Red. We found
      that both the general shape of the mesoderm cells and the orientation of
      filopodial extension were influenced by the surrounding matrix fibrils. Elongated
      shape was associated with individual fibrils which impinge on only one side of
      the cell. Similarly, filopodial extension followed a single fibronectin-rich
      fibril, although filopodia were also observed to be channeled between pairs of
      parallel fibrils. Cells attached to non-aligned regions of substratum showed no
      polarity. The mesoderm cells themselves apparently synthesize their own
      fibronectin, and deposit this on the cell surface not attached to the substratum.
      We conclude that individual fibronectin-rich substratum fibrils, in the size
      range 0.7-2.8 microns, are able to exert contact guidance on the mesoderm cells,
      despite the production of endogenous fibronectin by the cells themselves. These
      results support the contention that contact guidance is a physiological mechanism
      influencing the orientation and directionality of cells during the morphogenetic
      movements of embryogenesis.

PMID- 7779692
TI  - The emergence of an adult muscle phenotype in urodelan amphibians: an
      immunohistochemical study.
AB  - Electrophoretic techniques adapted for the analysis of muscles of lower
      invertebrates reveal four myosin heavy chain isoforms in the dorsalis trunci of
      Pleurodeles waltlii: two fast (MHC-IIA, MHC-IIB), and one slow (MHC-I) in the
      adult and one isoform (MHC-La) in the larvae. Polyclonal antibodies were prepared
      against the larval (anti-MHC-La) and one of the fast myosin (MHC-IIA) isoforms
      and their specificity was confirmed by western blot analysis. An
      immunohistochemical analysis was then carried out on frozen sections of the
      dorsalis trunci of P. waltlii at different stages of development. From stage 44
      it was possible to demonstrate the presence of MHC-IIA in the small diameter
      fibers at the periphery of the muscle; the number and diameter of these fibers
      increased from stage 44 to stage 56 when anatomical metamorphosis had finished.
      By stage 56 these fibers could also be readily identified using standard
      histochemical techniques as type IIA fibers. We conclude that fast IIA myosin is
      expressed well before the final adult muscle phenotype has been established and
      its expression is therefore independent of thyroid hormone.

PMID- 7779693
TI  - Effects of age and genetic growth rate on the crystallin composition of the chick
      lens.
AB  - This two part study continues and extends our examination of the effects of age
      and of genetically determined intrinsic growth rate on the overall protein
      composition of chick lens epithelia, lens fiber masses and whole lenses. Water
      soluble proteins were analyzed by SDS-polyacrylamide and 2-dimensional gel
      electrophoresis. First, detailed age-related changes in protein expression
      between day 4 of embryonic development and the 8-week adult stage are described
      for one normal chick strain. Secondly, comparisons are made between day-old post
      hatch chicks of four different genotypes: two genetically unrelated chick strains
      with a high growth rate and propensity for hyperplasia of the lens epithelium and
      two unrelated slow-growing strains, both with normal lens morphology. We find
      that the beta/delta-crystallin ratio in lens epithelia and fiber masses is higher
      in both the slow- than in both the fast-growing strains. The data emphasizes the
      importance of quantitative and non-coordinate changes in crystallin polypeptide
      expression during lens growth and development, and implicates growth rate as a
      modifier of the pattern of crystallin expression.

PMID- 7779694
TI  - Preimplantation development of manipulated mouse zygotes fused with the second
      polar bodies: a cytogenetic study.
AB  - Immediately after fertilization one chromatid of each maternally-derived
      chromosome is extruded into the second polar body (2PB). We tested the ability of
      these "extra" chromosomes to support preimplantation development.
      Micromanipulation and electrofusion techniques were used to fuse 2PBs with
      diploid, haploid, or enucleated mouse zygotes. Androgenetic haploids, intact
      embryos, and digynic triploids served as the controls for the reconstructed
      embryos. Androgenetic haploid zygotes developed to the blastocyst stage only when
      fused with the 2PBs. This result demonstrates that even when extruded into the
      2PB, chromosomes retain their ability to support normal preimplantation
      development. However, 2PB fusion with diploid zygote impaired preimplantation
      development. Normal development of experimentally produced digynic triploids
      (zygotes with one extra maternal pronucleus) indicated that developmental
      arrests, caused by the 2PB fusion, were not the result of triploidy or
      micromanipulation procedures. Cytogenetic studies showed that developmental
      failures of the reconstructed embryos were caused by premature chromosome
      condensation of the polar body chromosomes. This result indicates that 2PB must
      be removed from the zygotes' perivitelline space during animal cloning
      experiments. In addition, we showed that 2PB fusion with enucleated zygote is a
      reliable method for 2PB karyotyping and may be used in the studies of mammalian
      meiosis.

PMID- 7779696
TI  - Mononuclear leukocytes in the newt limb blastema: in vitro behavior.
AB  - Since the precise interactions of the various newt limb blastema cell types
      (pleiomorphic, bipolar, signet and multinucleated cells) with one another are
      difficult to ascertain in vivo, in this study we describe the in vitro behavior
      and interactions of these cell types with one another. The data show that the
      mononuclear signet cells interact (fuse) with other signet cells or fuse directly
      with the multinucleated cells. Further, they indicate that the signet cells are
      in fact mononuclear leukocytes and the giant cells are osteoclasts. Therefore, we
      conclude that these two cell types are not formed by dedifferentiation but are of
      hematopoietic origin and may play minor roles in blastema production.

PMID- 7779695
TI  - A reversible block at the G1/S border during cell cycle progression of mouse
      embryos.
AB  - Late 2-cell stage mouse embryos were cultured in M-199 plus 100 micrograms/ml Na
      pyruvate 25 micrograms/ml gentamycin and 0.3% BSA with or without mimosine (200
      microM, 150 microM, 100 microM and 50 microM) for a short (4-5 h) or long (18-20
      h) culture period; after drug removal subsequent embryo development was
      evaluated. Late 2-cell stage mouse embryos treated with mimosine were blocked at
      the 4-cell stage. Autoradiographic studies show that mimosine inhibits cell cycle
      progression in mouse embryos at the G1/S boundary. The onset of DNA replication
      occurs within 15 min of releasing the embryos from mimosine block. Embryos
      pretreated with mimosine at 200 microM and 150 microM for 4-5 h progress after 3
      4 days in culture to hatched blastocyst (71% and 79%, respectively) compared with
      control (90%). However a longer pretreatment (18-20 h) with mimosine at 200
      microM was significantly detrimental to the subsequent developmental progression
      to hatched blastocyst (2% vs 81%, p < or = 0.05); the proportion of degenerated
      embryos was significantly increased with mimosine at 200 microM and 150 microM
      compared with control (57% and 28% vs 4%, p < or = 0.05) after 3-4 days in
      culture. Preliminary studies with mimosine treatment at 100 microM and 50 microM
      for 18-20 h show that 70% and 37% of the embryos were blocked at 4-cell stage,
      respectively. These results indicate that mimosine inhibits cell cycle progress
      in mouse embryos at the G1/S border and thus induces a reversible arrest in a
      dose- and time-dependent manner.

PMID- 7779697
TI  - Virofection: a new procedure to achieve stable expression of genes transferred
      into early embryos.
AB  - A new procedure, virofection, designed to stabilize the expression of transfected
      DNA has been developed. It exploits the capacity of retroviruses to integrate
      their genome into the chromosomes of host cells. The co-transfection of two
      plasmids, one carrying the genome of a defective retrovirus vector, the other one
      encoding all the retroviral proteins, results in a transient production of
      infectious virus particles. These particles can infect the neighboring cells and
      this leads to the stable integration of the vector genome. This procedure is time
      saving and appears to be quite efficient. When applied to chicken embryonic
      fibroblasts cultured in vitro, it resulted in the stable expression of the lacZ
      gene in more than 30% of the cells, and did not induce chronic viremia. Stable
      lacZ expression was also achieved in chicken embryos in ovo. Virofection appears
      to be a promising and generally applicable method for implementing stable, safe
      and efficient gene transfer in vitro and in vivo.

PMID- 7779699
TI  - Can we improve the professional and personal fulfillment of doctors in cancer
      medicine?

PMID- 7779700
TI  - The recruitment of patients into clinical trials.

PMID- 7779698
TI  - Is neuroblastoma screening evaluation needed and feasible?
AB  - Despite the five million children who have been screened for neuroblastoma in
      Japan through detection of catecholamine metabolites, it is still uncertain
      whether screening for this disease is beneficial. The Japanese study has clearly
      indicated that screening at 6 months or earlier leads to heavy overdiagnosis. It
      is shown in this paper that screening at a later age may give the same reduction
      in mortality with possibly less overdiagnosis. However, it is estimated that,
      even with two screens at 12 and 18 months, the reduction in mortality would not
      greatly exceed 25%, under realistic hypotheses on the length of the preclinical
      phase of the disease. The evaluation of the efficacy of this screening strategy
      would need the recruitment of half a million children per year over 5-7 years and
      the follow-up of an equal number of controls. Such a trial would improve our
      knowledge of the natural history of the disease and might help to answer some
      questions raised recently regarding its biological heterogeneity.

PMID- 7779701
TI  - Does autocrine growth factor secretion form part of a mechanism which
      paradoxically protects against tumour development?
AB  - Autocrine growth factor secretion has classically been considered as a mechanism
      by which tumour cells achieve autonomous growth. However, there is now
      considerable evidence that autocrine circuits operate in the growth regulation of
      normal adult tissues. Here we consider the possible advantages to the normal
      epithelial cell of utilising such an external growth factor circuit and suggest
      that autocrine growth factor secretion, when viewed in a multicellular context,
      could paradoxically form part of a mechanism for preventing tumour development.

PMID- 7779702
TI  - Adjuvant therapy for operable breast cancer; more answers, new questions.

PMID- 7779703
TI  - The effect of dose and interval between 5-fluorouracil and leucovorin on the
      formation of thymidylate synthase ternary complex in human cancer cells.
AB  - We examined the importance of dosing interval between leucovorin (LCV) and 5
      fluorouracil (5-FU) on intracellular thymidylate synthase (TS) ternary complex,
      free TS and total TS protein levels in human MCF-7 breast and NCI H630 colon
      cancer cell lines. A 2- to 3-fold increase in total TS was noted when either cell
      line was exposed to 5-FU 10 microM plus LCV (0.01-10 microM) compared with a 1.4-
      to 1.6-fold increase in total TS due to 5-FU 10 microM alone. The amount of TS
      ternary complex formed was 2- to 3-fold higher in both cell lines treated with
      the combination of 5-FU and LCV compared with 5-FU alone. TS complex formation
      and total TS protein increased with LCV dose (0.1-10 microM). In MCF-7 cells, the
      maximal increase in total TS protein and TS ternary complex formation was
      observed when 5-FU was delayed for 4 h after the start of LCV exposure. In NCI
      H630 cells, maximal total TS protein and ternary complex formation occurred when
      5-FU was delayed for 18 h after the start of LCV exposure. The amount of free TS
      did not change in either cell line whether 5-FU was given concurrently with LCV
      or delayed for up to 24 h. The accumulation rate of intracellular folates in the
      form of higher glutamates Glu3-Glu5 was rapid in MCF-7 cells (maximal formation
      after 4 h), whereas in H630 cells accumulation of higher polyglutamates continued
      to increase up to 18 h. The time of peak folate polyglutamate (Glu3-Glu5)
      formation coincided with the time of peak TS complex formation and total TS
      protein in each cell line. In these human carcinoma cell lines, the LCV dose and
      interval between 5-FU and LCV play a role in increased TS total protein and TS
      ternary complex; however, the amount of free TS is independent of the interval
      between 5-FU and LCV. The time-and dose-dependent increases in TS ternary complex
      and TS total protein are associated with differences in the accumulation of
      folate polyglutamates in these cell lines.

PMID- 7779705
TI  - Thermal enhancement of both tumour necrosis factor alpha-induced systemic
      toxicity and tumour cure in rats.
AB  - In vitro and in vivo studies have suggested synergistic anti-tumour activity of
      combined hyperthermia and tumour necrosis factor alpha (TNF-alpha). However, some
      studies indicated an increased systemic toxicity of TNF by additional
      hyperthermia. The aim of this study was to obtain starting dosages for a clinical
      phase I study on the application of deep local hyperthermia and systemic TNF. We
      investigated the effect of local hyperthermia on the toxicity and efficacy of
      systemic TNF. Rats (Wag/Rij) carrying a subcutaneously transplanted osteosarcoma
      in the hind leg received a single intravenous dose of recombinant human (rh) TNF
      alpha, either at normothermia or at hyperthermia, by positioning the tumour
      bearing hind leg in a water bath of 43 degrees C. Dose-effect curves for
      lethality and tumour cure were established and LD50 and TCD50 values were
      calculated. Systemic toxicity was increased by local hyperthermia. The LD50
      values (+/- s.e.) were 1088 (+/- 61) micrograms kg-1 at normothermia and 205 (+/-
      23) micrograms kg-1 at hyperthermia, resulting in a thermal enhancement ratio
      (TER) of 5.3. Following normothermia, tumour cures were observed at TNF
      concentrations of 1000-1300 micrograms kg-1, while this was observed at doses of
      50-300 micrograms kg-1 when combined with hyperthermia (TCD50 values of 1211 and
      188 micrograms kg-1 respectively), resulting in a TER of 6.4. Systemic toxicity
      and anti-tumour activity of TNF are both increased by local hyperthermia. A safe
      starting dose for the combined clinical treatment would be 10% of the dose of TNF
      alpha that has been recommended for phase II studies on intravenous bolus
      administration of TNF-alpha at normothermia. In view of the large variability in
      tumour sensitivity for TNF-alpha, the clinical usefulness of this combined
      treatment modality has to be determined.

PMID- 7779704
TI  - Increased thymidylate synthase protein levels are principally associated with
      proliferation but not cell cycle phase in asynchronous human cancer cells.
AB  - We have analysed cell cycle variations in thymidylate synthase (TS) protein in
      asynchronously growing NCl H630 and HT 29 colon cancer and MCF-7 breast cancer
      cell lines. Western immunoblot analysis using the TS 106 monoclonal antibody
      revealed a 14- to 24-fold variation in TS levels between the peak exponential and
      confluent growth phase in the three cell lines. Similar variations in TS levels
      and TS activity were detected using the 5-fluorodeoxyuridine monophosphate and
      deoxyuridine monophosphate biochemical assays. The percentage of cells in S
      phase, which paralleled changes in TS levels, reached a maximum of 38-60% in
      asynchronous exponentially growing cells compared with 5-10% in confluent cells.
      In asynchronous exponential cells, analysis of TS levels in each cell cycle phase
      using two-parameter flow cytometric analysis revealed that TS protein levels were
      1.3- to 1.5-fold higher in S than in G0/G1 phase cells, and 1.5- to 1.8-fold
      higher in G2/M than G0/G1 cells. Similar differences of 1.1- to 1.5-fold between
      G0/G1 and S-phase and 1.6- to 1.9-fold between G0/G1 and G2/M-phase were detected
      by Western immunoblot and biochemical assays. TS protein was not detectable by
      Western blot analysis, flow cytometry or biochemical analysis in the G0/G1
      population of confluent cells. Twenty-six per cent of cells in this population
      were G0 cells compared with 2% in exponentially growing cells. In contrast to TS,
      a 4-fold difference in thymidine kinase (TK) was detected between G0/G1 and S
      phase cells in exponentially growing MCF-7 cells. The level of TS enzyme is
      associated with cellular proliferation and the percentage of cells in S-phase;
      however, TS protein is not exclusively associated with S-phase in asynchronously
      growing cells. The variation in TS levels between exponentially growing and
      confluent cell population appears to be due to differences in TS levels between
      G0 and G1 cells.

PMID- 7779706
TI  - Variation of growth rate of a rat tumour during a light-dark cycle: correlation
      with circadian fluctuations in tumour blood flow.
AB  - To determine whether tumour growth is influenced by circadian variations in
      tumour tissue blood flow, we measured changes in area doubling time of tumours
      (Sato lung carcinoma) within transparent chambers and changes in tissue blood
      flow of rat subcutaneous tumour during a light-dark cycle. Rats were subjected to
      an artificial light-dark cycle with light from 7 a.m. to 7 p.m. Tumour doubling
      times (TDTs) during the dark and the light spans were 33.5 +/- 11.9 h (n = 38, 20
      rats) and 70.6 +/- 36.9 h (n = 39, 20 rats) respectively. The former was
      significantly shorter than the latter (P < 0.001). In addition, the larger the
      tumour became, the longer was the TDT during the light span (P < 0.05). Tumour
      tissue blood flow during the night (10 p.m.-4 a.m.) was approximately 1.5 times
      greater than that during the day (10 a.m.-4 p.m.). The time during which tumours
      actively grow and that during which tissue blood flow in tumours increases
      coincided. These results strongly suggest that tumour tissue blood flow is a
      determining influence on tumour proliferative activity and that tumour growth is
      influenced by circadian variations in tumour tissue blood flow.

PMID- 7779707
TI  - Perfusion changes in the RIF-1 tumour and normal tissues after carbogen and
      nicotinamide, individually and combined.
AB  - The strategy of combining carbogen breathing and nicotinamide to overcome chronic
      and acute hypoxia respectively is being evaluated clinically. The effects of both
      agents individually and in combination on relative perfusion of 400-700 mm3 RIF-1
      tumours and normal tissues were measured by 86Rb extraction. Carbogen breathing
      alone for 6 min increased relative tumour perfusion by 50-70% compared with
      control at flow rates of 50 to 200 ml min-1, but the effect was lost at 300 ml
      min-1. All flow rates also produced similar increases in relative perfusion of
      lung, of between 36% and 58%, and smaller increases in skin, of between 20% and
      34%. The minimum breathing time at 150 ml min-1 to produce a significant increase
      in relative tumour perfusion was 4.5 min, and the effect was maintained up to 9
      min. Nicotinamide alone at 1000 mg kg-1 60 min before assay did not alter
      relative tumour perfusion. Comparing the combination of nicotinamide with 6 min
      carbogen breathing at 150 ml min-1 with carbogen breathing alone showed no
      difference in relative tumour perfusion; increases were of 36% and 42%
      respectively. Nicotinamide-induced alterations in microcirculation associated
      with reduction of acute hypoxia have therefore not been detected by 86Rb
      extraction. The perfusion-enhancing effect of carbogen in this tumour is probably
      an important component of its radiosensitising ability, in addition to its known
      ability to increase the oxygen-carrying capacity of the blood, and should be
      taken into consideration in clinical studies.

PMID- 7779708
TI  - Flunarizine enhancement of melphalan activity against drug-sensitive/resistant
      rhabdomyosarcoma.
AB  - Flunarizine, a diphenylpiperazine calcium channel blocker, is known to increase
      tumor blood flow. It also interferes with calmodulin function, repair of DNA
      damage and drug resistance associated with P-glycoprotein. Flunarizine was tested
      for its ability to modulate either cyclophosphamide- or melphalan-induced growth
      delay for a drug-resistant rhabdomyosarcoma xenograft (TE-671 MR) and the drug
      sensitive parent line (TE-671), in which P-glycoprotein is not involved in the
      mechanism of drug resistance. Tumour blood flow was increased by 30% after a
      flunarizine dose of 4 mg kg-1, but no modification in growth delay was induced by
      melphalan (12 mg kg-1). In contrast, a 60 mg kg-1 dose of flunarizine had no
      effect on tumour blood flow, but the same dose created significant enhancement in
      melphalan-induced tumour regrowth delay in both tumour lines. The dose-modifying
      factor for flunarizine as an adjuvant to melphalan was approximately 2 for both
      tumour lines. Although blood flow measurements were not performed with the
      combination of flunarizine and melphalan, the results from flunarizine alone
      suggested that augmentation of melphalan cytotoxicity is not mediated by changes
      in blood flow. In contrast, flunarizine did not affect drug sensitivity to
      cyclophosphamide in groups of animals bearing the drug-sensitive parent tumour
      line. These results suggest that the mechanism of drug sensitivity modification
      by flunarizine is not related to modification of tumour blood flow, but may be
      mediated by modification of transport mechanisms that are differentially
      responsible for cellular uptake and retention of melphalan as compared with
      cyclophosphamide.

PMID- 7779709
TI  - In vitro anthracycline cross-resistance pattern in childhood acute lymphoblastic
      leukaemia.
AB  - Daunorubicin (DNR) is a major front-line drug in the treatment of childhood acute
      lymphoblastic leukaemia (ALL). Previously, we showed that in vitro resistance to
      DNR at diagnosis is related to a poor long-term clinical outcome in childhood ALL
      and that relapsed ALL samples are more resistant to DNR than untreated ALL
      samples. In cell line studies, idarubicin (IDR), aclarubicin (ACR) and
      mitoxantrone (MIT) showed a (partial) lack of cross-resistance to the
      conventional anthracyclines DNR and doxorubicin (DOX), but clinical studies in
      childhood ALL have been inconclusive about the suggested lack of cross
      resistance. In the present study we determined the in vitro cross-resistance
      pattern between DNR, DOX, IDR, ACR and MIT in 48 untreated and 39 relapsed
      samples from children with ALL using the MTT assay. The relapsed ALL group was
      about twice as resistant to DNR, DOX, IDR, ACR and MTT as the untreated ALL
      group. Thus, resistance developed to all five drugs. We found a significant cross
      resistance between DNR, DOX, IDR, ACR and MIT, although in some individual cases
      in vitro anthracycline cross-resistance was less pronounced. We conclude that
      IDR, ACR and MIT cannot circumvent in vitro resistance to DNR in childhood ALL.
      Clinical studies may still prove whether IDR, ACR or MIT has a more favourable
      toxicity profile than DNR.

PMID- 7779710
TI  - S-phase specificity of cell killing by docetaxel (Taxotere) in synchronised HeLa
      cells.
AB  - Cell viability following short (1 h) contact with paclitaxel or docetaxel was
      assayed using synchronised HeLa cells. Docetaxel proved almost totally lethal
      against S-phase cells. Its toxicity was only partial against cells in mitosis,
      and declined to a minimum with progression to G1. For paclitaxel, cytotoxicity
      increased with progression through S and G2, peaked at the time of mitosis, and
      decreased thereafter. Maximum resistance to paclitaxel was in early S. Although
      lethal, brief exposure to docetaxel in S-phase did not delay progression through
      S and G2. Gross damage was detectable immediately after mitosis, with dysfunction
      in cytokinesis and accumulation of multinucleated, non-viable cells. Arrest of
      cells at prometaphase required continuous contact with lethal amounts of
      docetaxel or reintroduction of drug shortly before mitosis following pulse-chase
      treatment in mid-S-phase. Paclitaxel at moderate doses presumably acts mostly via
      damage to the mitotic spindle. In contrast, the available data suggest that
      docetaxel primarily targets centrosome organisation, leading to abortive mitosis
      and cell death.

PMID- 7779711
TI  - EO9: relationship between DT-diaphorase levels and response in vitro and in vivo.
AB  - EO9 [3-hydroxy-5-aziridinyl-1-methyl-2(1H-indole-4,7-dione)-prop-beta-en- alpha
      ol] was selected for clinical trial in Europe because of its preclinical profile
      but also because of its distinct mechanism of bioactivation. Several studies have
      shown that cells rich in DT-diaphorase may be particularly sensitive to EO9. The
      present study examined the relationship between DT-diaphorase activity and
      sensitivity to EO9 in a panel of cell lines largely derived from human and rodent
      leukaemias/lymphoma and solid tumours. A possible relationship between
      chemosensitivity and enzyme activity was demonstrated (correlation coefficient
      0.796). A number of the human cell lines were established as xenografts in nude
      mice but, with the exception of HT29, DT-diaphorase specific activity was greatly
      reduced compared with the corresponding cell lines. These data suggest that in
      vitro studies of bioactivation of drugs by specific enzymes is unlikely to be
      relevant for the same tumour in vivo. Except for HCLO, all xenografts failed to
      respond to EO9 as a single dose. HT29 tumours in vivo had similar DT-diaphorase
      activity [359 nmol of 2,6-dichlorophenol-indophenol (DCPIP) reduced per min per
      mg of protein] to the cell line (337) but failed to respond to a single dose or
      daily dose schedule. A preliminary attempt to investigate an hourly dose schedule
      demonstrated a modest anti-tumour effect accompanied by enhanced toxicity.
      Attempts to optimise EO9 exposure parameters to potentiate activity in tumours
      with high DT-diaphorase activity are under way, but as yet the relevance of this
      particular enzyme for in vivo EO9 activity requires further investigation.

PMID- 7779712
TI  - Preclinical in vitro and in vivo activity of 5,6-dimethylxanthenone-4-acetic
      acid.
AB  - 5,6-Dimethylxanthenone-4-acetic acid (5,6-MeXAA) is a fused tricyclic analogue of
      flavone acetic acid (FAA) which was developed in an attempt to improve on the
      activity of FAA. Previous studies have shown 5,6-MeXAA to be curative in 80% of
      mice bearing colon 38 tumours and 12 times more dose potent than FAA. This
      investigation has demonstrated that a murine colon tumour cell line (MAC15A) is
      approximately 60 times more sensitive to 5,6-MeXAA than to FAA, although these
      differences were not seen in three human cell lines tested. 5,6-MeXAA caused
      significant blood flow shutdown and haemorrhagic necrosis in subcutaneous MAC15A
      tumours in syngeneic and nude hosts, but measurable changes in tumour volume were
      seen only in syngeneic hosts. 5,6-MeXAA was inactive against intraperitoneal
      MAC15A but produced significant anti-tumour effects against the same cell line
      inoculated via an intravenous route. FAA has been shown previously to be inactive
      in this model. Interestingly, the effects against lung colonies were not
      accompanied by obvious necrotic changes, suggesting that they may be the result
      of increased direct cytotoxicity rather than an indirect host mechanism. Further
      studies to investigate the effects against systemic tumour deposits are under
      way.

PMID- 7779713
TI  - Temporal heterogeneity in microregional erythrocyte flux in experimental solid
      tumours.
AB  - Using a multichannel laser Doppler system equipped with custom-developed
      microprobes, we have evaluated real-time fluctuations in microregional blood flow
      in two experimental murine tumour systems. The results show that in both the
      sarcoma F and the carcinoma NT over 50% of the microregions evaluated show a
      fluctuation in red blood cell flux by at least a factor of 2 over a 60 min time
      period. Approximately 20% of the regions monitored demonstrated a change in flow
      by a factor of 5 or more. Within the 1 h monitoring period, approximately 20% of
      the changes were reversed (SaF, 21%; CaNT, 19%). The duration of change for these
      regions ranged from 6 to 45 min. Similar temporal fluctuations in flow were seen
      in anaesthetised and unanaesthetised animals, indicating that artifacts due to
      probe movement were minimal. These findings clearly demonstrate that fluctuations
      in microregional erythrocyte flux are a common feature of the experimental
      tumours studied.

PMID- 7779714
TI  - Inhibitory effect of vanadium on rat liver carcinogenesis initiated with
      diethylnitrosamine and promoted by phenobarbital.
AB  - The chemoprotective effect of vanadium, a dietary micronutrient, against
      chemically induced hepatocarcinogenesis in rats was investigated. Initiation was
      performed by a single intraperitoneal injection of diethylnitrosamine (DENA; 200
      mg kg-1) followed by promotion with phenobarbital (0.05%) in the diet.
      Supplementary vanadium (0.5 p.p.m.) in the drinking water was provided ad libitum
      throughout the experiment, before the initiation or during the promotion period.
      At the end of the study (20 weeks), vanadium supplementation throughout the
      experiment reduced the incidence (P < 0.01), total number and multiplicity (P <
      0.001) and altered the size distribution of visible persistent nodules (PNs) as
      compared with DENA control animals. Mean nodular volume (P < 0.05) and nodular
      volume as a percentage of liver volume (P < 0.01) were also attenuated following
      long-term vanadium treatment. It also caused a large decrease in the number (P <
      0.001) and surface area (P < 0.01) of gamma-glutamyltranspeptidase (GGT)-positive
      hepatocyte foci and in the labelling index (P < 0.001) of focal cells, coupled
      with increased (P < 0.01) remodelling. The activity of GGT, measured
      quantitatively, was found to be significantly less in the PNs (P < 0.001) and non
      nodular surrounding parenchyma (P < 0.01) of vanadium-supplemented rats. The
      anticarcinogenic effect of vanadium was also reflected in the histopathological
      analysis of liver sections that showed a well-maintained hepatocellular
      architecture as compared with DENA control. Similar results were observed when
      vanadium was given only before the initiation. However, supplementation of
      vanadium during the promotion period did not result in significant alterations of
      these parameters. Our results, thus, strongly suggest that vanadium may have a
      unique anti-tumour potential which is primarily exerted on the initiation phase
      and only secondarily on the promotion stage.

PMID- 7779715
TI  - Abnormal pattern of post-gamma-ray DNA replication in radioresistant fibroblast
      strains from affected members of a cancer-prone family with Li-Fraumeni syndrome.
AB  - Non-malignant dermal fibroblast strains, cultured from affected members of a Li
      Fraumeni syndrome (LFS) family with diverse neoplasms associated with radiation
      exposure, display a unique increased resistance to the lethal effects of gamma
      radiation. In the studies reported here, this radioresistance (RR) trait has been
      found to correlate strongly with an abnormal pattern of post-gamma-ray DNA
      replicative synthesis, as monitored by radiolabelled thymidine incorporation and
      S-phase cell autoradiography. In particular, the time interval between the gamma
      ray-induced shutdown of DNA synthesis and its subsequent recovery was greater in
      all four RR strains examined and the post-recovery replication rate was much
      higher and was maintained longer than in normal and spousal controls. Alkaline
      sucrose sedimentation profiles of pulse-labelled cellular DNA indicated that the
      unusual pattern of DNA replication in irradiated RR strains may be ascribed to
      anomalies in both replicon initiation and DNA chain elongation processes.
      Moreover, the RR strain which had previously displayed the highest post-gamma-ray
      clonogenic survival was found to harbour a somatic (codon 234) mutation
      (presumably acquired during culture in vitro) in the same conserved region of the
      p53 tumour-suppressor gene as the germline (codon 245) mutation in the remaining
      three RR strains from other family members, thus coupling the RR phenotype and
      abnormal post-gamma-ray DNA synthesis pattern with faulty p53 expression.
      Significantly, these two aberrant radioresponse end points, along with documented
      anomalies in c-myc and c-raf-1 proto-oncogenes, are unprecedented among other LFS
      families carrying p53 germline mutations. We thus speculate that this peculiar
      cancer-prone family may possess in its germ line a second, as yet unidentified,
      genetic defect in addition to the p53 mutation.

PMID- 7779716
TI  - Coexpression of cdk2/cdc2 and retinoblastoma gene products in colorectal cancer.
AB  - The retinoblastoma gene (Rb gene) is a tumour-suppressor gene and its product
      (pRB) is known to act as a negative regulator of the cell cycle. Although lack of
      pRB expression resulting from gene alterations is considered to be responsible
      for the genesis of several human malignancies, increased expression of pRB has
      been demonstrated in a majority of colorectal cancer cases. In the present study,
      we investigated the expression of pRB as well as that of its related kinases,
      cdk2 and cdc2, in colorectal cancer, since these kinases have been reported to
      phosphorylate and inactivate pRB. Western blot analysis revealed that colorectal
      cancer expressed higher levels of cdk2 and cdc2 than did normal mucosa and that
      the ratio of the hyperphosphorylated form of pRB was higher in colorectal cancer.
      Furthermore, immunohistochemical studies showed that cdk2/cdc2 was expressed
      exclusively in the cancer cells positive for pRB. These results suggest that an
      increase in the expression of cdk2/cdc2 in colorectal cancer may have prevented
      pRB from braking the cell cycle through phosphorylation.

PMID- 7779717
TI  - Immunohistochemical assay for epidermal growth factor receptor on paraffin
      embedded sections: validation against ligand-binding assay and clinical relevance
      in breast cancer.
AB  - Epidermal growth factor receptor (EGFR) has been the subject of much research
      since it was first described as a prognostic factor in breast cancer. The assay
      methods used and results obtained vary widely between studies. In this study 88
      primary breast cancers were assayed for EGFR using a novel immunohistochemical
      assay performed on paraffin-embedded sections. The monoclonal antibody used was
      raised against purified, denatured EGFR, reacts with an epitope on the external
      domain and does not interfere with ligand binding. Twenty-two per cent of the
      tumours were EGFR positive using this assay. The results obtained were
      significantly correlated with those obtained by ligand-binding assay (r = 0.621,
      P = 0.011). The concordance rate was 82% (P < 0.001). The majority of discordant
      results could be explained by the presence of benign breast tissue and other non
      malignant elements which could be seen to express EGFR on the immunohistochemical
      assay and were excluded from the score for this, but would be incorporated into
      ligand-binding assay results. The well-established inverse relationship between
      EGFR (as measured by this assay) and oestrogen receptor (ER) was seen (chi 2 =
      24.9, P < 0.0001). In addition, in this exploratory study on a limited tumour
      set, EGFR was a significant adverse prognostic factor (on univariate but not
      multivariate analysis) for both relapse-free survival (P = 0.02) and overall
      survival (P = 0.03) when measured by this immunohistochemical assay, but was not
      significant when measured by ligand-binding assay.

PMID- 7779719
TI  - p53 status of head and neck cancer: relation to biological characteristics and
      outcome of radiotherapy.
AB  - p53 status was investigated in 99 patients with squamous cell carcinoma of the
      head and neck region uniformly treated with accelerated radiotherapy and in whom
      tumour cell proliferation and DNA aneuploidy were assessed using
      bromodeoxyuridine (BrdUrd) incorporation and flow cytometry (FCM). Seventy-six
      percent of tumours were immunohistochemically positive for p53 protein, but
      heterogeneity was noticed both in the percentage of cells positive for p53 and in
      their level of expression. However, tumours which were either essentially all
      positive or all negative or showed sporadic positivity for p53 protein showed no
      differences in their level of aneuploidy, proliferation rate, tissue organisation
      or outcome with radiotherapy. There was a trend for those p53-positive tumours
      with the strongest expression to have more DNA aneuploidy and deregulation of
      proliferation organisation than weaker expressors; but there were no differences
      in proliferation rate or outcome of radiotherapy. These studies suggest that p53
      protein stabilisation as assessed by immunohistochemistry does not have any major
      relationship with the biological characteristics and outcome of squamous cell
      cancer treated by accelerated radiotherapy.

PMID- 7779718
TI  - Expression of fibronectin, fibronectin isoforms and integrin receptors in
      melanocytic lesions.
AB  - In vitro studies have demonstrated that fibronectin (FN) can deliver a mitogenic
      signal to quiescent human melanoma cells and that the alpha 5/beta 1-integrin
      receptor mediates this stimulus. In view of this finding we have analysed the in
      vivo expression of FN, and of ED-A and ED-B FN isoforms, in benign and malignant
      lesions of melanocyte origin. In the same specimens the expression of fibronectin
      integrin receptors was evaluated. The results demonstrate that, while detection
      of FN does not correlate with transformation and tumour progression, the
      expression of the two isoforms is associated with transformation and that only
      the ED-A variant is found in metastases. Integrin phenotyping disclosed that
      alpha 3/beta 1 expression is associated with tumour progression, alpha v/beta 3
      is a marker of transformation, alpha 4 is rarely expressed and alpha 5 is
      expressed by about 50% and 30% of the primary and metastatic lesions
      respectively. Taken together, the results of this study demonstrate that
      transformation and tumour progression of the melanocyte lineage are associated
      with modulation of expression of FN isoforms and FN integrin receptors.
      Furthermore, the expression of alpha 5-integrin in a considerable percentage of
      primary and metastatic lesions indicates that FN may deliver a proliferative
      stimulus to melanoma cells in vivo.

PMID- 7779720
TI  - Absence of p53 autoantibodies in a significant proportion of breast cancer
      patients.
AB  - We analysed antibodies specific for human p53 in sera from primary breast cancer
      patients using three different immunoassays and we related these results to the
      p53 level in tumour tissue detected by immunohistochemistry. Only 44% (11/25) of
      apparently enzyme-linked immunosorbent assay (ELISA)-positive sera were from
      patients with a high level of p53 protein in more than 50% of their tumour cells.
      Surprisingly, 36% (9/25) of the sera originated from patients with no detectable
      p53 protein at all. Immunoprecipitation data suggested that the reason for this
      discrepancy is that at least some of the antibodies detected as positive in the
      ELISA in these sera from patients with clinical stage I and stage II breast
      cancers may be induced by immunogens other than p53 protein. Many of these
      reactions give apparently positive signals in a variety of p53 assays, and very
      stringent analysis is required to avoid possible misinterpretation of these
      responses as a p53-specific B-cell response in human cancer patients.

PMID- 7779722
TI  - Volunteers or victims: patients' views of randomised cancer clinical trials.
AB  - Randomised clinical trials are essential for the objective evaluation of
      different treatment strategies in cancer. However, in the field of oncology, very
      few of the eligible patients are entered into trials, and most treatments have
      only been tested on a small percentage of patients. For doctors, a major
      deterrent to participating in trials is the lack of resources--particularly time,
      but often also the local facilities. This report suggests that patients
      themselves are willing to take part in clinical research, and are attracted by
      being treated by a doctor with a specialist interest in the disease and
      encouraged by the possibility that their progress will be monitored closely. With
      the recent NHS changes, it is timely for the Department of Health and other
      national health departments to consider carefully what can be done to ensure that
      no new treatments are adopted without effective evaluation. This will require
      departments of health to identify and implement ways to facilitate accrual of
      appropriate numbers of patients onto research protocols (whether non-randomised
      phase I or phase II studies or large, multicentre phase III trials) over short
      time periods.

PMID- 7779721
TI  - Evaluation of p53 protein expression as a marker for long-term prognosis in
      colorectal carcinoma.
AB  - Mutation of the p53 gene is reported to be of prognostic importance in colorectal
      carcinomas. Immunohistochemical staining of the accumulated p53 gene product may
      be a simple alternative for p53 mutation analysis. Previous studies addressing
      the prognostic importance of p53 expression, however, yielded contradictory
      results. Therefore, we evaluated the importance of p53 expression as a marker for
      long-term prognosis in a well-characterised study population of 109 colorectal
      carcinomas. After antigen retrieval with target unmasking fluid (TUF),
      immunostaining of p53 was performed with both monoclonal antibody DO7 and
      polyclonal antibody CM1. Objective quantification of the p53 signal was assessed
      by a computerised image analyser. p53 expression was higher in non-mucinous
      tumours than in mucinous tumours (p53 labelling index = 30% and 17% respectively,
      P = 0.05), and in metastatic tumours compared with non-metastatic tumours (p53
      labelling index = 37% and 22% respectively, P = 0.05). Other histopathological
      features were not related to p53 expression. In multivariate analysis, Dukes'
      stage (P = 0.02) and histological grade (P = 0.05) stood out as independent
      markers for prognosis. p53 expression was not an independent marker for
      prognosis. At present, p53 expression is not a useful marker for long-term
      prognosis. Further insight into the relationship between p53 mutations and p53
      expression is needed to elucidate more precisely the clinical relevance of p53
      alterations.

PMID- 7779723
TI  - Does it matter where you live? Treatment variation for breast cancer in
      Yorkshire. The Yorkshire Breast Cancer Group.
AB  - Over 27,000 patients with breast cancer were identified from cancer registry data
      from 1978 to 1992 and differences in treatment practice across the 16 districts
      of Yorkshire studied. A total of 50 surgeons treated more than an average of ten
      cases a year. Surgeons who expressed an interest in breast cancer were more
      likely to treat a greater number of patients than those who had no special
      interest in the disease and offered patients chemotherapy, hormone therapy and
      radiotherapy more often. The average regional mastectomy rate fell from 70% to
      44% over this period, but the rate varied between districts from 13% to 87%, with
      those at the extremes occupying these positions year on year. The rate of uptake
      of radiotherapy varied between districts from 13% to 58% over the period 1978-92.
      The use of adjuvant chemotherapy increased from 5% to 19% and hormone therapy
      from 19% to 80% over this time period. An audit of the facilities available
      within each district carried out in early 1994 also showed considerable
      variation, although all districts now have access to a nurse specialist. There
      were wide variations in treatment offered to patients with breast cancer.
      Patients in some districts were denied access to chemo- and and radiotherapy
      despite published guidelines showing these modalities to be useful. It is
      recommended that patients are referred to units with an interest in breast cancer
      rather than to general surgical out-patients.

PMID- 7779724
TI  - CMF vs alternating CMF/EV in the adjuvant treatment of operable breast cancer. A
      single centre randomised clinical trial (Naples GUN-3 study).
AB  - The aim of this study was to test the hypothesis of Goldie and Coldman that the
      use of non-cross-resistant regimens of chemotherapy could lead to maximal anti
      tumour effect. We compared standard CMF (cyclophosphamide, methotrexate,
      fluorouracil) with alternating CMF/EV (epirubicin, vincristine) in the adjuvant
      therapy of early breast cancer. Stage II premenopausal node-positive or post
      menopausal node-positive oestrogen receptor-negative and stage III breast cancer
      patients were eligible for the study. From January 1985 to December 1990, 220
      patients were randomised (115 to CMF and 105 to CMF/EV). Toxicity was mild;
      neurotoxicity, vomiting and hair loss were more frequent in the CMF/EV group,
      while permanent amenorrhoea, diarrhoea, stomach ache and minor infections
      occurred more often in the CMF arm. At a follow-up of 48 months, 113 patients
      (51.4%) had had recurrence (62 on CMF and 51 on CMF/EV) and 54 (24.5%) had died
      (30 on CMF and 24 on CMF/EV). There was no significant difference in disease-free
      and overall survival between the two arms. After adjusting for menopausal status
      and stage, the relative risk (RR) of recurrence for CMF/EV patients was 0.93 (95%
      CL 0.64-1.35), while the RR of death was 0.85 (95% CL 0.49-1.47). In conclusion,
      the Goldie-Coldman model of alternating therapy is not confirmed in this trial of
      adjuvant therapy of early breast cancer, although in view of its design a
      difference of less than 20% in 3 year disease-free survival could not be
      excluded.

PMID- 7779725
TI  - An evaluation of preoperative CA 15-3 measurement in primary breast carcinoma.
AB  - In this study of 500 patients with breast carcinoma, we have prospectively
      assessed the role of preoperative CA 15-3 as a marker of disease burden over a 7
      year period. CA 15-3 levels at presentation correlate with stage of disease,
      tumour size, lymph node status, the presence of metastases and lymphocyte
      infiltration into the tumour. CA 15-3 alone is not an independent prognostic
      indicator, although a serum level of > 40 U ml-1 has a positive predictive value
      of 83% for the presence of advanced disease. We recommend the routine use of this
      marker in the preoperative assessment of primary breast carcinoma.

PMID- 7779726
TI  - Reduced mitogenic stimulation of peripheral blood mononuclear cells as a
      prognostic parameter for the course of breast cancer: a prospective longitudinal
      study.
AB  - Immunosuppression has been often associated with the course of malignant
      diseases. In the present study, the proliferation of peripheral blood mononuclear
      cells (PBMCs) in response to mitogenic stimulation with phytohaemagglutinin (PHA)
      was assessed prospectively in 90 patients with stage I-III breast cancer. Whereas
      PHA-induced proliferation of PBMCs derived from patients with breast cancer
      preoperatively was significantly decreased when compared with data obtained in
      healthy control individuals (P < 0.001), the degree of the defect in PHA-induced
      proliferation of PBMCs depended upon the tumour burden as manifested by tumour
      size and axillary lymph node involvement (P < 0.003 in each case). PHA-induced
      proliferation of PBMCs dropped significantly in patients who received adjuvant
      chemotherapy consisting of cyclophosphamide, methotrexate and fluorouracil (CMF)
      after an observation period of 6 months (P < 0.01), but not in patients under
      adjuvant treatment with tamoxifen only. After an additional 6 months (i.e. 12
      months after surgery), PHA-induced proliferation of PBMCs was similar in patients
      after adjuvant chemotherapy with CMF and in those receiving continued adjuvant
      tamoxifen treatment (P > 0.1), but in all patients still significantly decreased
      as compared with healthy controls (P < 0.001). When data obtained preoperatively
      and after 12 months were compared, it was found that out of 23 patients whose
      PBMCs had experienced a drop in their PHA-induced proliferation, 14 (61%) had
      developed metastatic disease within the subsequent 24 months (i.e. 36 months
      after surgery). In contrast, out of 59 patients whose PBMCs showed an increase in
      their PHA-induced proliferation within the first 12 months after surgery, only
      one (2%) presented with disease progression. We thus conclude that PHA-induced
      proliferation of PBMCs derived from patients with breast cancer depends upon the
      tumour load and is a good clinical predictor for the further course of the
      disease.

PMID- 7779727
TI  - Microvessel quantitation in invasive breast cancer by staining for factor VIII
      related antigen.
AB  - The clinical importance of microvessel quantitation as a prognostic indicator in
      invasive breast cancer was examined. This study included 155 patients with
      invasive breast cancer, with a median follow-up of 82 months. Microvessels were
      identified by immunohistochemical staining for factor VIII-related antigen in
      formalin-fixed, paraffin-embedded primary tumours. For each tumour, microvessels
      were counted within a 200 x magnification field in the area of highest
      microvessel density. Microvessel counts (MVCs) had no correlation with tumour
      size, lymph node status or histological grade. When patients were classified by
      MVC, higher counts were associated with shorter disease-free survival and overall
      survival (P < 0.025 and P < 0.01 respectively). Multivariate analysis showed that
      MCV is an independent prognostic factor. Microvessel quantitation may be a useful
      predictor for identifying breast cancer patients at high risk for relapse and
      death.

PMID- 7779729
TI  - Platinum-Taxol non-cross resistance in epithelial ovarian cancer.
AB  - The aim of this study was to assess the clinical evidence for platinum-Taxol non
      cross-resistance in patients with epithelial ovarian cancer. Unlike other
      studies, only patients who had demonstrably progressive disease on platinum
      therapy were analysed. Patients received 135-200 mg m-2 of Taxol over 3 or 24 h
      and all patients were assessed for response by computerised axial tomography. The
      overall response rate was 22.2% (8/36 patients, 95% CI 10-39%). Only patients who
      received > or = 175 mg m-2 of Taxol responded (26.7%; 8/30 patients, 95% CI 12
      46%). No complete responses were seen and the duration of response was short,
      median 7 months (range 5-9+). Response was associated with a short treatment-free
      interval (P = 0.02); only those who were treated immediately after they had
      progressed on their previous platinum therapy responded. Response duration was
      associated with a good performance status (P < 0.05). Platinum and Taxol are non
      cross-resistant in a proportion of patients and therefore patients who are
      resistant to platinum compounds may benefit from Taxol although the duration of
      any response is short. These data support current strategies that involve
      combining Taxol with platinum compounds as first-line therapy in advanced
      epithelial ovarian cancer.

PMID- 7779728
TI  - Phase II and pharmacokinetic study of lobaplatin in patients with relapsed
      ovarian cancer.
AB  - In phase I studies, lobaplatin showed activity in ovarian cancer patients
      pretreated with platinum. A phase II trial with lobaplatin was performed in
      patients with refractory or relapsed ovarian cancer to define activity and
      pharmacokinetics. Twenty-two patients were treated with lobaplatin administered
      as an intravenous bolus every 4 weeks. Dependent on creatinine clearance (CRCL)
      patients received 30 or 50 mg m-2 lobaplatin as the starting dose. Twenty-two
      patients received 78 courses (median 3, range 1-6). In eight patients total
      platinum (TPt) in plasma and urine, free platinum (FPt) in plasma ultrafiltrate
      (both measured by atomic absorption spectrometry) and lobaplatin in plasma
      ultrafiltrate measured (by high-performance liquid chromatography) were measured.
      Toxicity was confined to mild nausea and vomiting, mild leucocytopenia (WHO grade
      3 in 18% of the courses), and renal function-related thrombocytopenia (WHO grade
      3/4 in 53% of the courses). A correlation was found between CRCL and reduction in
      platelet count (r = -0.77; P < 0.01). No renal toxicity was encountered. Five of
      21 evaluable patients (24%) achieved a response (four complete remissions and one
      partial remission). Remissions occurred mainly in patients who relapsed more than
      6 months after primary treatment. The median survival from start of lobaplatin
      treatment was 8 months. The mean areas under the curve (AUCs) were 4.2 +/- 0.5,
      3.0 +/- 0.6, and 3.2 +/- 1.1 h mgl-1 for TPt, FPt and lobaplatin respectively.
      The free platinum fraction (FPt/TPt) was initially very high, indicating low
      protein binding. FPt was essentially present as intact lobaplatin. Four hours
      after infusion 54 +/- 5% and 24 h after infusion 74 +/- 3% of the lobaplatin dose
      was excreted in the urine. In conclusion, lobaplatin is a platinum compound with
      anti-tumour activity in patients with relapsed ovarian cancer, especially in
      those who have platinum-sensitive tumours. The main toxicity of lobaplatin is
      thrombocytopenia and its dose should be corrected according to renal function.

PMID- 7779730
TI  - A pilot study of mitomycin, cisplatin and continuous infusion 5-fluorouracil
      (MCF) in advanced non-small-cell lung cancer.
AB  - A pilot study of continuous infusional 5-fluorouracil 200 mg m-2 per 24 h by
      ambulatory pump and Hickman line for the entire treatment cycle with mitomycin C
      8 mg m-2 i.v. on day 1 and cisplatin 75 mg m-2 i.v. on day 1, both repeated every
      28 days, was carried out in 31 previously untreated patients with advanced non
      small-cell lung cancer (NSCLC). Of 31 patients assessable for response, one
      attained a complete remission and eight a partial remission, an overall response
      rate of 29%. Haematological toxicity was minimal, with only 3% of patients
      developing WHO grade III/IV neutropenia and 13% grade III/IV thrombocytopenia.
      Significant side-effects included moderate to severe emesis (41%), mucositis
      (34%), diarrhoea (31%) and palmar-plantar syndrome (14%). Seven patients (23%)
      had Hickman line complications requiring line removal. Continuous infusional
      chemotherapy with this regimen is active in advanced non-small-cell lung cancer,
      but its complexity and associated treatment toxicity offer little advantage over
      equally active but simpler and less toxic cisplatin-based regimens.

PMID- 7779731
TI  - Final report of a phase II study of interleukin 2 and interferon alpha in
      patients with metastatic melanoma.
AB  - Fifty-seven patients with metastatic melanoma were treated with interleukin 2 (IL
      2) 7.8 MIU m-2 day-1 as a continuous infusion for 4 days combined with interferon
      alpha (IFN-alpha) 6 MIU m-2 day-1 subcutaneously on days 1 and 4. The cycle was
      repeated every 2 weeks for a maximum number of 13 cycles. Of the 51 evaluable
      patients, one (2%) achieved a complete and seven (14%) a partial response (total
      response rate 16%; CI 7-29%). Median time to progression and median survival were
      2.5 and 11.3 months respectively. This regimen of IL-2 and IFN-alpha appeared to
      be only moderately active.

PMID- 7779733
TI  - Improving the acceptability of high-dose radiotherapy by reducing the duration of
      treatment: accelerated radiotherapy in high-grade glioma.
AB  - Radiotherapy, although clearly beneficial in patients with high-grade glioma, is
      largely palliative, and a protracted course of treatment may not be the most
      appropriate approach in the context of limited survival. We therefore assessed
      the feasibility, toxicity and survival results of a short accelerated
      radiotherapy regimen given twice daily over a period of 3 weeks. A total of 116
      patients with high-grade glioma were treated with radiotherapy in a prospective
      study using an accelerated fractionation regimen. The total dose of 55 Gy was
      given in 32-36 fractions of 1.72-1.53 Gy, twice daily 5 days a week, with a
      minimum 6 h interval between fractions. Toxicity was assessed using Karnofsky
      performance status scale and in the later part of the study with the Barthel
      index. Survival data were compared with a control group treated with 60 Gy in 30
      daily fractions in a previous MRC study, matched for known prognostic factors.
      The median survival of 116 patients treated with accelerated radiotherapy was 10
      months. Survival comparison of accelerated patients with matched controls treated
      with conventional fractionation demonstrated a hazard ratio of 1.13 (95%
      confidence interval 0.85-1.51; P = 0.39). Early treatment toxicity was
      acceptable, with only seven patients developing transient decrease in performance
      status. The accelerated radiotherapy regimen was logistically feasible and
      acceptable to patients, carers and staff. Treatment time was reduced without
      apparent increase in early toxicity and there was no loss of survival benefit.
      The effectiveness and convenience of a short accelerated regimen makes this a
      suitable alternative to a 6 week course of radiotherapy in patients with high
      grade glioma. However, a full randomised trial comparing conventional and
      accelerated radiotherapy may be required as proof of equivalence.

PMID- 7779732
TI  - Quality of life following bone marrow transplantation: findings from a
      multicentre study.
AB  - Questionnaires assessing a range of quality of life (QOL) outcomes were completed
      by 200 adult bone marrow transplant (BMT) recipients from five BMT treatment
      centres. Respondents had undergone allogeneic (46%) or autologous BMT (54%) for a
      haematological malignancy and were disease free and at least 12 months post BMT
      (mean 43 months). Variability in post-BMT QOL was reported with deficits in
      physical, sexual and occupational functioning particularly likely. Allogeneic
      recipients reported poorer QOL than autologous recipients. Greater age at BMT,
      lower level of education and more advanced disease at BMT were consistent risk
      factors for poorer QOL. Contrary to previous research, evidence for improved
      functional status with the passage of time post BMT was obtained. Factors
      generally not associated with post-BMT QOL included disease diagnosis, dose of
      total body irradiation, presence of chronic graft-versus-host disease (GVHD),
      type of GVHD prophylaxis and extent of marrow graft match. In conclusion, while
      many BMT recipients reported normal QOL, the majority indicated that their QOL
      was compromised relative to premorbid status. Prospective, longitudinal research
      will be necessary to further identify risk factors for poor post-BMT QOL and
      identify the temporal trajectory of post-BMT QOL.

PMID- 7779734
TI  - Cancer in the offspring of survivors of childhood leukaemia and non-Hodgkin
      lymphomas.
AB  - Understanding the extent to which childhood leukaemia and non-Hodgkin lymphomas
      are heritable is important to the survivors of these diseases, their families and
      clinicians who provide genetic counselling. Such understanding is also relevant
      to the possibility raised by Gardner et al. (1990, Br. Med. J., 300, 423-429)
      that paternal preconception irradiation may be an aetiological factor in these
      diseases. No malignant neoplasm was diagnosed among 382 offspring of survivors of
      childhood leukaemia and non-Hodgkin lymphoma followed up for a median period of
      5.8 years, the largest available cohort of such offspring. These data indicate
      that it is unlikely that the risk of a malignant neoplasm occurring in the
      offspring exceeds eight times that expected in the general population. Similarly,
      the risk of leukaemia and non-Hodgkin lymphoma among offspring is unlikely to
      exceed 21 times that expected. The proportion of survivors of childhood leukaemia
      and non-Hodgkin lymphoma with the heritable form of these diseases is unlikely to
      exceed 5%, assuming an autosomal dominant pattern of transmission, with
      penetrance of at least 70% and that all heritable cases develop by age 15 years.
      The best (i.e. at present most likely) estimates of these risks are of course
      much lower. There was no evidence of an excess of congenital abnormalities among
      the offspring and the sex ratio was similar to that expected from the general
      population.

PMID- 7779735
TI  - Endometrial and ovarian cancer and oral contraceptives--findings in a large
      cohort study.
AB  - Many case-control studies have shown that oral contraceptives protect against
      endometrial cancer and epithelial ovarian cancer, but little information is
      available from cohort studies. The findings from the Oxford Family Planning
      Association contraceptive study are reported here; the relative risks for ever
      users of oral contraceptives in comparison with never users were 0.1 (95%
      confidence interval 0.0-0.7) for endometrial cancer and 0.4 (95% confidence
      interval 0.2-0.8) for ovarian cancer. There was a strong negative relationship
      between duration of oral contraceptive use and ovarian cancer risk. Thus, in
      comparison with never users of oral contraceptives, the relative risk for users
      of up to 48 months' duration was 1.0 (95% confidence interval 0.4-2.5), while the
      relative risk for users of 97 months' duration or more was only 0.3 (95%
      confidence interval 0.1-0.7).

PMID- 7779736
TI  - Widowhood and divorce in relation to overall survival among middle-aged Norwegian
      women with cancer.
AB  - The aim of the study was to examine the relations between widowhood and divorce
      and overall survival among women with cancer. All Norwegian women born between
      1935 and 1954, and diagnosed with cancer between 1966 and 1990, were followed up
      until 1991. In all, 14,231 cases were followed up for a median length of
      approximately 4.5 years (mean = 6 years), and 4311 women died during follow-up.
      In addition to overall cancer, separate analyses have been made for cancer at
      specific sites. Widows had a risk of dying which was nearly identical to that of
      married women for all sites except colorectal cancer, for which widows had a 2
      fold increased death rate compared with married women. Divorced women had an
      overall increased hazard ratio of 1.17 (95% CI 1.07-1.27), which was confined to
      cancer of the breast, lung and cervix. With few clear exceptions women with
      children had a better survival than nulliparous women (overall hazard ratio =
      0.80, 95% CI 0.74-0.87).

PMID- 7779738
TI  - Diet and breast cancer in Shanghai and Tianjin, China.
AB  - Various aspects of adult diet have been linked to breast cancer development.
      These include intake of fat (risk factor), and intake of fibre, soy protein and
      vitamins A, C and E (protective factors). Results of previous studies have been
      inconsistent. We examined the possible associations between breast cancer and
      various indices of nutrient and food intake in two Chinese populations who are at
      relatively low risk for breast cancer (one-fifth the rate in US white women). Two
      case-control studies of breast cancer were conducted in the cities of Shanghai
      and Tianjin, China. In Shanghai, 534 women aged 20-69 years with histologically
      confirmed breast cancer were recruited, whereas in Tianjin 300 women aged 20-55
      years with histologically confirmed breast cancer were interviewed. All controls
      were community controls who were individually matched to the cases by sex and age
      (case-control ratio = 1:1). All interviews were conducted in person. Findings
      from the two studies were similar, although the diets in Shanghai and Tianjin
      were different in many respects. Cases and controls were similar in their
      consumption of soy protein, measured either in absolute levels or as percentages
      of total protein. Overall, all components of dietary fat (saturated fat,
      monounsaturated fat, polyunsaturated fat) showed a modest, non-significant
      association with breast cancer after adjustment for energy intake and other non
      dietary risk factors for breast cancer. Intake of crude fibre, carotene and
      vitamin C, on the other hand, exhibited strong, statistically significant inverse
      associations with breast cancer risk. The last three indices were highly
      correlated, rendering it impossible to disentangle their individual effects; they
      were closely associated with intake of green vegetables in the two study
      populations. Vitamin E intake was unrelated to breast cancer risk in Shanghai and
      Tianjin. In the multivariate logistic regression model which included all non
      dietary risk factors for breast cancer and energy intake, Shanghai women in the
      lowest tertile of crude fibre intake and highest tertile of fat intake had a 2.9
      fold increased risk for breast cancer relative to those in the highest tertile of
      crude fibre intake and lowest tertile of fat intake. The comparable relative risk
      in Tianjin women was 2.4. Our data indicate a strong protective effect against
      breast cancer development with intake of foods rich in fibre, vitamin C and
      carotene. Our results are also compatible with dietary fat having a modest,
      positive effect on breast cancer risk within the range of exposure experienced by
      women in China.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779737
TI  - Incidence, mortality and survival in cancer of the cervix in Bangalore, India.
AB  - Cancer of the cervix is the most common cancer among women in India, constituting
      between one-sixth to one-half of all female cancers with an age-adjusted
      incidence rate ranging from 19.4 to 43.5 per 100,000 in the registries under the
      National Cancer Registry Programme (NCRP) (Annual Reports, NCRP, ICMR). It has
      been estimated that 100,000 new cases of cancer of the cervix occur in India
      every year, and 70% or more of these are Stage III or higher at diagnosis.
      However, the incidence of cancer of the cervix as suggested in this report
      appears to be on the decline in Bangalore. Besides incidence and clinical stage
      at presentation knowledge of survival is essential to complete the picture of
      establishing baseline indicators to monitor and evaluate cancer control
      programmes. Survival analysis was carried out in 2121 patients diagnosed during
      1982-89 in the population of Bangalore, India. The observed 5 year survival was
      34.4% and the relative survival 38.3%. Clinical stage at presentation was the
      single most important variable in predicting survival. The 5 year observed
      survival for stage I disease was 63.3%, for stage II 44.0%, for stage III 30.3%
      and for stage IV 5.7%.

PMID- 7779739
TI  - Risk factors for male breast cancer.
AB  - Risk factors for male breast cancer were investigated in a case-control study of
      21 cases and 82 controls admitted to hospital for acute, non-neoplastic, non
      hormone-related diseases in the Greater Milan area between 1988 and 1994. More
      educated men tended to be at higher risk of breast cancer, with a multivariate
      odds ratio (OR) of 2.6 [95% confidence interval (CI) 0.7-9.4]. The OR was 3.2
      (95% CI 1.1-9.6) for those in the higher social class. Men with no offspring were
      at higher risk than fathers, with an OR of 5.5 (95% CI 1.8-16.7). A history of
      breast cancer in female relatives was reported by two cases and one control,
      giving an OR of 8.5 (95% CI 1.1-69.0). Cases were somewhat heavier than controls,
      and significantly taller, with an OR of 5.7 (95% CI 1.6-19.9) for subjects taller
      than 170 cm vs shorter ones. The association with weight, however, decreased
      after allowance for height, and no difference was observed for body mass index.
      Socioeconomic correlates and family history are similar to well-assessed risk
      factors for female breast cancer. The associations with anthropometric measures
      and childlessness may find an explanation in chromosomal abnormalities, such as
      Klinefelter's syndrome, or other hormone-related disorders.

PMID- 7779741
TI  - An overview of clinical and psychological research findings in anorexia nervosa.

PMID- 7779740
TI  - Cognitive and motor retardation in depression.
AB  - The study analysed the profile of psychomotor retardation in depression by
      clinically and psychometrically assessing its motor, speech and cognitive
      components. Psychomotor performance level of a group of 100 moderately depressed
      patients was significantly lower than that of controls on most psychometric
      tests. The interrelations among the variables evaluating various aspects of the
      depressive psychomotor retardation were examined and factor analyses were
      performed. Clinical ratings of motor, speech and mental retardation were strongly
      intercorrelated and a general factor emerged. When psychometric evaluations of
      depressive psychomotor retardation were factor analysed only separate factors
      characterizing cognitive and motor slowing were identified. Few and weak
      correlations were recorded between clinical and psychometric evaluations of
      depressive psychomotor retardation. Factors responsible for psychomotor slowing
      in depression were discussed.

PMID- 7779742
TI  - Neurosurgical stress and immune function.
AB  - The present study was carried out in 31 neurosurgical patients with unaffected
      consciousness and concerned by the severity of their condition. The severity of
      stress was established by the comparison between the pre- and postoperative
      peripheral blood lymphocyte populations and subpopulations (B, T, Th lymphocytes,
      serum complement and circulating immune complexes). The peripheral blood
      lymphocyte populations and subpopulations were determined by the technique of
      sheep red blood cell rosette. Circulating immune complexes were determined by
      precipitation of polyethylene glycol (PEG, M = 6000) whereas the serum complement
      by the usual 50% hemolytic method. Our data show that the decrease in Th cells
      and the consecutive diminution of antibody production is a cause of lower
      resistance against cancer and infections.

PMID- 7779743
TI  - Postoperative outcome of intracranial meningiomas; long-term prognosis.
AB  - A retro- and prospective study was carried out in 150 patients who underwent
      surgery for benign (grade I) intracranial meningiomas (ICM). The mean duration of
      the follow-up was of 4 years. The subjects were divided into 4 groups according
      to the intervals of follow-up examination. The following variables were analysed:
      preoperative (clinical and paraclinical diagnosis), operative (macroscopic
      investigation) and postoperative (complications, sequelae, recurrences). The data
      were statistically processed. Conclusions are drawn concerning early results as
      well as predictors of long-term prognosis. Immediate improvement of the
      neurological and mental status was noted in 51% of patients. Late favourable
      outcome was found in only 35% of patients, demonstrating a tendency of late
      worsening. Postoperative morbidity includes complications (21%), sequelae (32%)
      and recurrence (22%). Predictor criteria in operated ICM patients are: onset type
      of illness, preoperative score, tumor location, edema and excessive
      vascularization of the brain as inspected at operation, early and late sequelae.
      Histological predictors for recurrence are: nuclear pleiomorphism, cellular
      mitoses, cell agglomerations. The frequency of recurrence, regardless of the
      operative technique, demonstrates the tendency toward malignancy of many of these
      tumors.

PMID- 7779744
TI  - Acute hemiplegia in one infant.
AB  - A previously healthy 9-month-old girl, obese (12,500 gm) with sudden onset of
      hyperthermia (40 degrees C), generalized tonic-clonic seizures, followed by focal
      seizures, drowsiness, left facial nerve palsy, left lagophthalmos and mydriasis
      is presented. CT-scan and MRI suggested temporal-parietal infarction due to
      Sylvian artery occlusion in a 9-month-old infant with familial
      hypercholesterolemia (type 2 A dyslipidemia). The possibility of a cerebral
      abscess or herpetic encephalitis was considered. Negative clinic and serologic
      results excluded this diagnosis. The management of the symptomatology was made
      with parenteral antibiotics, anticonvulsive and antioedematous cerebral therapy.
      Favourable evolution with residual left hemiparesis after 30 days, when the child
      was discharged. CT-scan reevaluation (after 5 months of evolution) showed a
      hypodense temporal-parietal area abnormality due to a right ischemic infarction.

PMID- 7779745
TI  - The biology of nitric oxide.

PMID- 7779746
TI  - Option for surgical management of cerebral haematoma: case report.
AB  - A 48-year-old male patient, a surgeon, displayed a right temporo-occipital
      cerebral haematoma (5 x 7 cm). He had a history of chronic left occipital
      migraine-like cephalalgia from the age of 16 and hypertension was diagnosed when
      he was 42 years old. As therapy, he used ACE inhibitors, nifedipine and clonidine
      for hypertension and for cephalalgia a combination of aspirin, phenacetin and
      caffeine. During the last 2-3 months before the detection of cerebral haematoma,
      injections with piritramide were made when severe headaches were unbearable. The
      patient was operated on the 7th day since the onset of cerebral haematoma after a
      "wait and see" period of repeated clinical and CT-scan assessment. The initial
      option of the patient was surgical. We consider that the patient's profession
      (medical/surgical profile) may have played a positive motivation for the surgical
      option.

PMID- 7779747
TI  - Symptom distress, anxiety, depression, and discharge information needs after
      peripheral arterial bypass.
AB  - The purpose of this study was to describe the symptom distress, anxiety,
      depression, and discharge information needs of patients after peripheral arterial
      bypass surgery. Patients (n = 38) were interviewed before and after hospital
      discharge. The symptoms of incisional pain and broken sleep, as measured by
      Visual Analogue Scales, were the most distressing symptoms experienced before and
      after discharge. Patients reported low levels of anxiety and depression as
      measured by the Profile of Mood States. A moderate amount of information,
      assessed by the Patient Learning Need Scale, was perceived by patients to be
      important to help manage their care after discharge. The most important
      information related to the recognition, prevention, and management of
      complications. The findings contribute to an understanding of discharge
      information needs after peripheral arterial bypass and emphasizes the importance
      of patient education to facilitate transition to the home.

PMID- 7779748
TI  - The inclusion of women in clinical trials of antihypertensive medications: a
      review of twenty-four trials in one pharmacology journal.
AB  - Historically the inclusion of women in clinical trials of medications has been
      limited. To ascertain the inclusion of women in clinical trials of
      antihypertensive medications, an integrative review of 24 articles was
      undertaken. The articles were chosen from a representative journal of
      pharmacology from the years 1992 to 1993. Pharmacology journals frequently are
      the journal in which clinical trials of medications are published. All trials of
      antihypertensive medications in this journal from the years 1992 and 1993 were
      included. Analysis is made of inclusion and exclusion criteria, inclusion rates
      of women (22.4%), and the inclusion of the elderly and minority groups. Based on
      this review and others it is difficult to recommend generalization of
      antihypertensive medication guidelines to women on the basis of clinical trials
      that include few women.

PMID- 7779749
TI  - Clinical path coordinator: pulling it all together.
AB  - Institutions across the country are using different approaches to restructuring
      health care delivery systems. At Lehigh Valley Hospital collaborative practice
      was instituted to ensure the achievement of patient outcomes within appropriate
      time frames and with efficient use of resources. The role of the clinical path
      coordinator emerged from the collaborative practice model developed to manage the
      care of the patient with an abdominal aortic aneurysm. The step-by-step process
      for selecting, orienting, and implementing the role of the coordinator is
      discussed. Since the implementation of the coordinator role, patient satisfaction
      has been positive, length of stay and cost have decreased, and quality of care
      has improved for these patients.

PMID- 7779750
TI  - One vascular nurse's perspective on nursing roles in clinical research.

PMID- 7779751
TI  - A review: bedside nursing research.

PMID- 7779752
TI  - Splenic artery aneurysm.

PMID- 7779753
TI  - Carotid artery aneurysm.

PMID- 7779754
TI  - Tissue distribution, hormone regulation and evidence for a human homologue of the
      estrogen-inducible Xenopus laevis vitellogenin mRNA binding protein.
AB  - 17 beta-estradiol induces the synthesis of massive amounts of the hepatic mRNA
      encoding the Xenopus laevis egg yolk precursor protein, vitellogenin.
      Vitellogenin mRNA exhibits a half life of approx. 500 h when 17 beta-estradiol is
      present, and 16 h after removal of 17 beta-estradiol from the culture medium. We
      recently reported that Xenopus liver contains a protein, which is induced by 17
      beta-estradiol and binds with a high degree of specificity to a binding site in a
      segment of the 3'-untranslated region (3'-UTR) of vitellogenin mRNA implicated in
      17 beta-estradiol stabilization of vitellogenin mRNA. To determine if this mRNA
      binding protein was specific to this system, or if it was present elsewhere, and
      regulated by other steroids, we examined the tissue distribution and androgen
      regulation of this protein. Substantial amounts of the vitellogenin 3'-UTR
      binding protein were found in several Xenopus tissues including testis, ovary and
      muscle. In the absence of hormone treatment, lung and intestine contained minimal
      levels of the mRNA binding protein. Testosterone administration induced the
      vitellogenin 3'-UTR RNA binding protein in several tissues. Additionally, we
      found a homologous mRNA binding protein in MCF-7, human breast cancer cells.
      Although the MCF-7 cell protein was not induced by 17 beta-estradiol, the MCF-7
      cell mRNA binding protein appears to be closely related to the Xenopus protein
      since: (i) the human and Xenopus proteins elicit gel shifted bands with the same
      electrophoretic mobility using the vitellogenin mRNA 3'-UTR binding site; (ii)
      The human and Xenopus proteins exhibit similar binding specificity for the
      vitellogenin 3'-UTR RNA binding site; and (iii) RNA from MCF-7 cells is at least
      as effective as RNA from control male Xenopus liver in blocking the binding of
      the Xenopus and human proteins to the vitellogenin mRNA 3'-UTR binding site. Its
      broad tissue distribution and regulation by both 17 beta-estradiol and
      testosterone suggests that this mRNA binding protein may play a significant role
      in steroid hormone regulation of mRNA metabolism in many vertebrate cells.

PMID- 7779755
TI  - Expression of sex hormone-binding globulin mRNA in human endometrial cancers.
AB  - To more fully understand the role of sex hormone-binding globulin (SHBG) on the
      intracellular steroidal action in endometrial cancers, we investigated the
      expression of SHBG mRNA as the substitute of SHBG expression in human endometrial
      cancers. In the present study, the levels of SHBG mRNA were analyzed using
      competitive reverse transcription-polymerase chain reaction (RT-PCR)-Southern
      blot analysis. The higher level of SHBG mRNA tended to be expressed in the normal
      secretory and late proliferative phase endometrium > early proliferative phase
      endometrium > well differentiated adenocarcinoma of the endometrium (G1) >
      moderately differentiated adenocarcinoma (G2) > poorly differentiated
      adenocarcinoma (G3), in the order shown. These studies indicate that endometrial
      cancer cells might synthesize intracellular SHBG to conserve their estrogen
      dependent properties. Further, it indicates that endometrial cancer cell
      synthesis of SHBG mRNA is lost as these cells undergo de-differentiation.

PMID- 7779756
TI  - Stable expression of rat cytochrome P450 11 beta-hydroxylase (CYP11B1) and
      aldosterone synthase (CYP11B2) in MA-10 cells.
AB  - Glucocorticoids and mineralocorticoids are synthesized in the adrenal cortex
      through the action of two different cytochrome 11 beta-hydroxylases, CYP11B1 (11
      beta-hydroxylase) and CYP11B2 (aldosterone synthase) which are distributed in the
      zona fasciculata and glomerulosa, respectively. We have created stably
      transfected cell lines using the Leydig tumor cell line MA-10 with CYP11B1 and
      CYP11B2 cDNA-containing plasmids which have a selectable gene to confer
      resistance to geneticin. The expression of the transfected cDNA in the cells was
      characterized by Northern-blot and measurement of enzymatic activity. The cell
      lines express the enzymes stably for many generations. CYP11B1 transfected cells
      converted DOC into corticosterone, 18-OH-DOC and small amounts of 18-OH
      corticosterone, in a time and concentration dependent manner. Incubation of the
      cells with corticosterone generated 18-OH-corticosterone especially at
      concentrations of 30 and 100 microM. The production of 18-OH-corticosterone from
      corticosterone at these doses was significantly higher than incubations with
      similar concentrations of DOC. CYP11B2 transfected cells converted DOC into
      corticosterone, 18-OH-corticosterone, aldosterone and small amounts of 18-OH-DOC
      in a time and concentration dependent manner. They converted corticosterone into
      18-OH-corticosterone and aldosterone in a time and concentration dependent
      manner. The absolute and relative production of aldosterone from DOC was
      significantly higher than when cells were incubated with corticosterone, and the
      ratio of aldosterone to 18-OH-corticosterone was higher at all concentrations of
      DOC compared to corticosterone. CYP11B2 transfected cells (but not the CYP11B1
      transfected cells) transform 18-OH-DOC into 18-OH-corticosterone, but can not
      convert 18-OH-DOC into aldosterone. In conclusion, stably transfected MA-10 cells
      with the cDNAs for the CYP11B1 and CYP11B2 enzymes were prepared and their
      enzymatic activity studied. These cells are useful in the study of inhibitors of
      the specific enzymes, as well as determining the roles that each enzyme plays in
      zone-specific steroidogenesis in the adrenal cortex.

PMID- 7779757
TI  - Bacterial expression and characterization of a cDNA for human liver estrogen
      sulfotransferase.
AB  - A distinct human estrogen sulfotransferase (hEST-1) cDNA has been isolated from a
      human liver lambda Zap cDNA library using a PCR procedure. The enzymatically
      active protein has been expressed in two bacterial expression systems and the
      kinetic and immunologic properties of the enzyme have been characterized. The
      full-length cDNA for hEST-1 is 994 base pairs in length and encodes a 294 amino
      acid protein with a calculated molecular mass of 35,123 Da. Purified hEST-1
      migrated with an apparent molecular mass of 35,000 Da during SDS-polyacrylamide
      gel electrophoresis. Immunoblot analysis of hEST-1 expressed in E. coli with a
      rabbit anti-hEST-1 antibody yields a band of approximately 35,000 Da. The anti
      hEST-1 antibody also detects a single band in human liver and jejunum cytosol
      which migrates with the same molecular mass as expressed hEST-1. There was also
      no cross-reactivity of hEST-1 with rabbit anti-hP-PST or rabbit anti-hDHEA-ST
      antibodies upon immunoblot analysis. hEST-1 was expressed in bacteria and
      purified to homogeneity. Expressed hEST-1 activity has a significantly greater
      affinity for estrogen sulfation than that found for the other human STs which
      conjugate estrogens. hEST-1 maximally sulfates beta-estradiol and estrone at
      concentrations of 20 nM. hEST-1 also sulfates dehydroepiandrosterone,
      pregnenolone, ethinylestradiol, and 1-naphthol, at significantly higher
      concentrations; however, cortisol, testosterone and dopamine are not sulfated.
      The results presented in this paper describe the expression and characterization
      of a human EST distinct from other human STs which sulfate estrogens. The high
      affinity of hEST-1 for estrogens indicates that this ST may be important in both
      the metabolism of estrogens and in the regulation of their activities.

PMID- 7779758
TI  - Testosterone, dihydrotestosterone and oestradiol levels in postmenopausal breast
      cancer tissues.
AB  - The ability of breast tumours to synthesize hormones is well recognized, and
      local production of sex steroids is thought to play a role in breast cancer
      growth. We measured the intratumour and circulating levels of testosterone,
      dihydrotestosterone (DHT) and oestradiol in 35 histologically confirmed
      carcinomatous mammary tissues obtained at breast surgery from 34 postmenopausal
      patients, age 50-85 years. Intra-tissue steroids were extracted with
      ethanol:acetone (1:1; v/v), defatted with 70% methanol in water, and extracted
      with ether. Steroids, from tissue and serum, were separated by partition
      chromatography on celite columns and were measured by RIA. Intratumour
      testosterone and DHT concentrations were significantly correlated, after the
      exclusion of an outlier (rs = 0.71; P = 0.0001). No association was found between
      oestradiol and either of the two androgens. Mean oestradiol and DHT
      concentrations were significantly higher in tissue than in blood (P = 0.0001).
      Mean testosterone levels in tissues did not significantly differ from those
      measured in blood. Our data suggest that at least a part of intratissue DHT is
      produced locally from testosterone. The meaning of high oestradiol and DHT levels
      in cancer tissue still needs to be defined.

PMID- 7779759
TI  - Synthesis and biological activities of thioether derivatives related to the
      antiestrogens tamoxifen and ICI 164384.
AB  - The catalyzed coupling reaction of activated alcohol and mercaptan was used for
      the short and efficient synthesis of 14 thioether compounds. Two types of side
      chains, the methyl butyl alkylamide related to the pure steroidal antiestrogen
      ICI 164384 and the dimethylamino ethyloxy phenyl related to the clinically used
      nonsteroidal antiestrogen tamoxifen, were introduced by a thioether link on two
      types of nuclei (triphenylethane or estradiol). The new thioether derivatives
      were tested to assess their relative binding affinity for the estrogen receptor
      and their estrogenic or antiestrogenic activity in the ZR-75-1 (ER+) cell line.
      The results indicate that of the three types of compounds studied, only the
      nonsteroidal derivatives with an alkylamide side chain possess antiestrogenic
      activity. In the steroidal series, displacement of the alkylamide side chain from
      the 7 to the 6 position produced compounds with chemical characteristics similar
      to ICI 164384 or EM-139 but without antiestrogenic activity. In the nonsteroidal
      series of compounds with an aryl side chain, compounds with estrogenic activity
      were obtained. One compound, a nonsteroidal derivative with a methyl butyl
      alkylamide side chain 20, possesses a relative binding affinity for the estrogen
      receptor identical to EM-139 (1.1 and 1.2%, respectively) and a relatively good
      antiestrogenic activity that is 10-fold lower than EM-139 (IC50 values of 250 and
      25 nM, respectively). This nonsteroidal thioether with an alkylamide side chain
      is free of estrogenic activity.

PMID- 7779760
TI  - Luteolytic action of RU486: modulation of luteal 3 beta-hydroxysteroid
      dehydrogenase and 20 alpha-hydroxysteroid dehydrogenase activities in late
      pregnant rats.
AB  - The effect of the synthetic antiprogestin RU486 on luteal function in late
      pregnant rats was studied by evaluating the activities of the enzymes 3 beta
      hydroxysteroid dehydrogenase (3 beta-HSD) and 20 alpha-hydroxysteroid
      dehydrogenase (20 alpha-HSD). RU486 (2 mg/kg) administered to rats on day 18 of
      pregnancy at 10.00 h induced preterm delivery 26.4 +/- 0.35 h (n = 8) after
      treatment. Luteal 3 beta-HSD activity increased 24 and 34 h after RU486
      injection, but a significant and progressive decrease started at 48 h with the
      maximal reduction 72 h after RU486 treatment, when compared with controls. Serum
      progesterone concentration decreased at the time of 3 beta-HSD activity
      reduction. Interestingly, 20 alpha-HSD activity started to increase 58 h after
      RU486 injection. The administration of the cyclooxygenase inhibitor, diclofenac
      (1.3 mg/kg), on days 17-19 of pregnancy to RU486-treated rats, delayed abortion
      and the duration of delivery, and prevented the decrease in 3 beta-HSD and the
      increase in 20 alpha-HSD activities observed 58 h after antiprogesterone
      treatment. RU486 administered intrabursally (1 microgram per ovary) on day 20
      (14.00-15.00 h) increased 3 beta-HSD and decreased 20 alpha-HSD luteal activities
      at 18.00 h on day 21 of pregnancy, without modifying serum progesterone
      concentration, when compared with normal pregnant rats. In conclusion, the
      luteolytic process after preterm delivery induced by RU486 administration in late
      pregnant rats is characterized by a decrease in luteal 3 beta-HSD activity and
      circulating progesterone, which may trigger the increase in luteal 20 alpha-HSD
      activity. Prostaglandins seems to be involved in the increase of 20 alpha-HSD
      activity and therefore, in the demise of corpora lutea.

PMID- 7779762
TI  - Aldosterone synthase activity in the Y-1 adrenal cell line.
AB  - The Y-1 adrenal cell line was shown to produce 20 alpha-dihydroaldosterone from
      deoxycorticosterone. This compound was identified by GC-MS by comparison with the
      previously synthesized reference compound. Two other 18-hydroxylated metabolites
      were identified as 11 beta,18-dihydroxy-20 alpha-dihydroprogesterone from
      endogenous cholesterol and 18-hydroxy-20 alpha-dihydro-11-dehydrocorticosterone
      from DOC. The conditions necessary for the synthesis of these compounds are
      culturing in 20% serum-supplemented medium and repeated incubations with the
      substrate. The production of 11 beta-hydroxylated steroids and that of 18
      oxygenated steroids is stimulated differently by ACTH and angiotensin II
      suggesting the expression of two different enzymes, cytochrome P-450(11)beta and
      cytochrome P-450aldo. The Y-1 cell line can secrete either 11 beta-hydroxylated
      steroids characteristic of the glucocorticoid pathway or 18-oxygenated steroids
      characteristic of the mineralocorticoid pathway, which in vivo are generally
      produced in two different zones of the adrenal cortex. This cell line should be
      an interesting model for the study of the molecular mechanisms regulating the
      expression of these two enzymes involved in the final steps of the steroidogenic
      pathways.

PMID- 7779761
TI  - Sex hormone changes induced by the parasite lead to feminization of the male host
      in murine Taenia crassiceps cysticercosis.
AB  - Female mice are more susceptible to Taenia crassiceps (TC) infection than males.
      However, after a month parasite load increases massively in both genders reaching
      thousands of parasites per host. The possibility of hormonal changes in the
      infected mice was envisaged. Sex hormones levels were assayed after different
      periods of infection, the parasites present in the peritoneal cavity were
      collected and gonads, uterus and seminal vesicles were weighed. In male mice,
      serum estradiol increased to levels 200 times their normal values whilst those of
      testosterone decreased 90% relative to controls. The weight of seminal vesicles
      was significantly diminished. Infected female mice also showed a slight increase
      in estrogen blood levels after 8 weeks of infection and the weight of the uterus
      was significantly increased relative to controls. Serum estradiol and
      testosterone were almost undetectable after gonadectomy. Cytokines such as IL-6
      are capable of stimulating aromatase activity and we found that splenocytes from
      infected mice produced amounts of IL-6 higher than control as measured by ELISA.
      In conclusion T. crassiceps infection triggers a feminization process in the
      infected hosts. The gonads are required for the parasite to induce higher
      estrogen synthesis. IL-6 could be involved in the immunoendocrine mechanism used
      by the parasite to maintain a highly permissive environment for its rapid growth.

PMID- 7779763
TI  - 31P NMR study of phosphorus containing metabolites in the uterus of hamster:
      changes during the estrous cycle and the effect of hormonal manipulation.
AB  - Changes in the concentrations of phosphorus containing metabolites were monitored
      by 31P NMR in the uteri of hamsters during the estrous cycle. Concentrations of
      phosphocreatine (PCr) and ATP were significantly increased in estrus animals
      compared to diestrus animals. Concentrations of these metabolites were also
      increased in immature female hamsters and ovariectomized (OVX) adult hamsters
      treated with estradiol indicating that estradiol was responsible for this effect.
      However, the steroid hormones progesterone and testosterone did not increase the
      concentrations of the phosphorus containing metabolites. Further, immature female
      hamsters also following treatment with estradiol showed an initial decline in
      phosphomonoester (PME), PCr, ATP and inorganic phosphate but by 24 h of treatment
      the concentrations returned to control levels. The NMR study also revealed that
      the intracellular pH of the hamster uterus was around 7.4 all through the estrous
      cycle.

PMID- 7779764
TI  - Effect of PCBs on androgen production by suspension of adult rat Leydig cells in
      vitro.
AB  - The effects of PCBs (mixture of 2, 3, 4, 5-tetra; 2, 2', 4, 5, 5'-penta; 2, 2',
      3, 3', 6, 6'-hexa and 2, 2', 3, 3', 4, 4', 5, 5'-octa congeners) on androgen
      production were investigated by suspension of Leydig cells from adult rat testis.
      hCG-stimulated androgen production was significantly inhibited by PCBs while
      progesterone level was not affected. Progesterone supported testosterone
      production was also decreased by PCBs, while conversion of androstenedione to
      testosterone was unchanged. These results suggest that the activity of microsomal
      enzyme C21 side-chain cleavage P450 was decreased by PCB treatment of Leydig
      cells in vitro.

PMID- 7779765
TI  - Therapist contributions to psychotherapeutic assimilation: an alternative to the
      drug metaphor.
AB  - A psychotherapist's verbal interventions may be understood as promoting a
      client's eventual improvement by facilitating developmental change processes
      within the client. This approach is an alternative to the traditional search for
      statistical links between aggregates of therapist interventions and global
      outcome measures. Our approach employs models of clients' assimilation of
      problematic experiences within problem domains and therapists' implementation of
      theoretically specified aims. In an empirical illustration, one client's change
      within a particular problem domain and its links with therapist interventions
      were assessed qualitatively across the course of brief psychodynamic
      interpersonal treatment.

PMID- 7779768
TI  - Psychopathology and personal agency: modernity, culture change and eating
      disorders in south Asian societies.
AB  - The cultural contribution to psychopathology may become more salient in
      situations of social change, but it remains difficult to distinguish individual
      agency among wider social and economic transitions, such as 'modernization' or
      simply 'culture change', which carry the potential for recourse to new patterns.
      Eating disorders, a biosocial pattern once identified exclusively with European
      societies, do occur among South Asian women including those living in the West.
      This seems not just a simple appropriation of contemporary Western ideals of
      female morphology--the 'fear of fatness'-but a reassertion of an instrumental
      strategy of self-renunciation in situations of experienced constraint.

PMID- 7779767
TI  - Post-adoption incest and phenotypic matching: experience, personal meanings and
      biosocial implications.
AB  - Recent changes in British law have enabled adults who were adopted when young to
      trace their biological relatives. The reported frequency of incestuous sentiments
      and relationships in these reunions, together with the individual experiences and
      the meanings which are attached to them, challenge fundamental assumptions of
      both Westermarck's and Freud's theories. Post-adoption incest is characterized
      experientially by a romantic search for attachment followed by a recognition of
      oneself in the other. The question of incest has been fundamental to biosocial
      theories of individual and cultural development. Some revisions are proposed,
      principally that adult sexual interests remain constrained both by early
      attachments and later phenotypic matching, reinforced by personal contingencies
      and cultural rules.

PMID- 7779766
TI  - Pornography and the paedophile: is it criminogenic?
AB  - There are few case-study-based reports of the role of pornography in the lives of
      sex offenders in contrast with numerous studies of a survey and statistical
      nature. Very little is known about the ways in which offenders process
      pornographic and other erotic materials as part of their offending patterns. The
      research reported in this study was based on case studies of fixated paedophiles
      in a private clinic for sex offenders. The men were interviewed about a range of
      matters including their offending, their psychosexual histories, pornography,
      fantasy, and sexual abuse in childhood. Commercial pornography was rarely a
      significant aspect of their use of erotica although some experience of such
      materials was typical of the men. Most common was 'soft-core' heterosexually
      oriented pornography. Explicit child pornography was uncommon. However, offenders
      also generated their own 'erotic' materials from relatively innocuous sources
      such as television advertisements, clothing catalogues featuring children
      modelling underwear, and similar sources. In no case did exposure to pornography
      precede offending-related behaviour in childhood. All of the offenders had
      experienced childhood sexual abuse by adults or older peers. The relationship of
      these findings to previous research and implications for legislation are noted.

PMID- 7779769
TI  - The ideas and experiences of pregnancy and childbirth of Asian and non-Asian
      women in east London.
AB  - This study examined differences between the ideas and experiences of pregnancy
      and childbirth of Asian and non-Asian women giving birth in East London, and
      sources of variability in Asian women's accounts. In line with the findings of
      previous research, Asian women's ideas about diet in pregnancy, the gender of
      their children and postnatal care (e.g. the need for rest and recovery, and
      restrictions on their activities) were influenced by cultural beliefs and
      practices. However, in other ways Asian women demonstrated a strong commitment to
      Western maternity care. In contrast to some other studies Asian women wanted
      their husbands or partners present at delivery, indicating the extent to which
      traditional ideas are being modified. Qualitative analysis of Asian women's
      fuller accounts indicated that women subscribed to traditional practice as well
      as Western maternity care. Acculturation or familiarity with Western ideas about
      maternity care was associated with variability in Asian women's ideas and
      experiences, in line with previous research. However, in spite of frequent
      assumptions about its significance, religion was not associated with variability
      in Asian women's ideas and experiences. Parity, however, was a major variable,
      for Asian and for non-Asian women, suggesting that the first birth has different
      significance for parents than subsequent births. The implications for the
      provision of maternity care are discussed, especially the need to go beyond
      stereotypical views based on women's ethnicity or religion to consider the
      beliefs and preferences of women as individuals and their personal circumstances.

PMID- 7779770
TI  - The process of coping with a gross anatomy exam during the first year of medical
      school.
AB  - A total of 42 freshman medical students were evaluated before a major exam, after
      the exam and before grades were announced and after grades were announced. They
      completed measures relating to mood, emotions, coping, social support and stakes.
      Significant time and academic performance differences were found in many domains.

PMID- 7779772
TI  - Phase polymorphism, molecular interactions, and miscibility of binary mixtures of
      dimyristoyl-N-biotinylphosphatidylethanolamine with
      dimyristoylphosphatidylcholine.
AB  - The phase diagram of hydrated binary mixtures of dimyristoyl-N
      biotinylphosphatidylethanolamine with dimyristoylphosphatidylcholine in 1 M NaCl
      has been established by differential scanning calorimetry. Identification of the
      structures of the phases involved has been made by using X-ray diffraction, spin
      label ESR spectroscopy, and 31P NMR spectroscopy. On the composition axis, the
      phase diagram is divided into three regions corresponding to formation of
      compounds in the gel phase with biotinyl lipid to phosphatidylcholine
      stoichiometries of approximately 1:1 and 1:3 mol/mol. For the first two regions
      (up to 75 mol % phosphatidylcholine), the lipids in the gel phase have
      interdigitated chains (L beta i), whereas in the third region the gel phase is
      not interdigitated (L beta' or L beta). For the first region (up to 50 mol %
      phosphatidylcholine), the fluid phase is of the novel isotropic type (IMI)
      composed of aggregated normal micelles that is characteristic of shorter
      chainlength biotinylated lipids [Swamy, M.J., Wurz, U., & Marsh, D. (1993)
      Biochemistry 32, 9960-9967], whereas for the other two regions a normal fluid
      lamellar (L alpha) phase obtains. The equimolar mixture, which lies at a
      stoichiometric phase boundary, melts isothermally and then undergoes a transition
      from the isotropic IMI structure to the lamellar L alpha structure with
      increasing temperature in the fluid phase.

PMID- 7779771
TI  - Immobilized proteoliposome affinity chromatography for quantitative analysis of
      specific interactions between solutes and membrane proteins. Interaction of
      cytochalasin B and D-glucose with the glucose transporter Glut1.
AB  - An affinity gel bed was prepared by reconstitution of a transmembrane protein,
      the human red cell glucose transporter (Glut1), followed by steric immobilization
      of the proteoliposomes in small and rigid gel beads by freeze-thawing. The
      specific interactions between the reconstituted Glut1, the transport inhibitor
      cytochalasin B (CB), and the transported solute D-glucose were analyzed by
      isocratic chromatography of CB on the Glut1-proteoliposome gel bed. Specific
      retardation of CB which decreased upon inclusion of the competitor D-glucose in
      the eluent was observed on-line. The equilibrium constants for CB and D-glucose
      interaction with Glut1 (Kd 1.5 x 10(-7) M and 67 mM, respectively) obtained by
      use of equations derived for the affinity chromatographic analysis were
      consistent with values obtained by others by conventional methods. Effects of
      liposome composition, pH, and time on the CB binding activity of Glut1 were
      studied. Reconstitution of a membrane protein into a lipid environment and steric
      immobilization of the proteoliposomes favor retention of the protein activity.
      Immobilized proteoliposome affinity chromatography (IPAC) is a novel, powerful
      method for analysis of interactions between membrane proteins and solutes.

PMID- 7779773
TI  - Purification and reconstitution of murine mitochondrial glycerol-3-phosphate
      acyltransferase. Functional expression in baculovirus-infected insect cells.
AB  - Glycerol-3-phosphate acyltransferase (GPAT) catalyzes the initial step in
      glycerolipid biosynthesis. We recently cloned a cDNA to a 6.8-kb mRNA, a message
      that can be induced dramatically by feeding a high-carbohydrate diet [Paulauskis
      & Sul (1988) J. Biol. Chem. 263, 7049-7054; Shin et al. (1991) J. Biol. Chem.
      266, 23834-23839], and identified the open reading frame, p90, as mitochondrial
      GPAT [Yet et al. (1993) Biochemistry 32, 9486-9491]. To initiate characterization
      of mitochondrial GPAT, we purified and reconstituted the GPAT activity using
      phospholipids after expressing functional enzyme in Sf9 insect cells. Infection
      with recombinant virus containing p90 sequence resulted in high levels of GPAT
      expression in mitochondria, compared to noninfected cells or cells infected with
      the reverse orientation insertion baculovirus. There was a dramatic increase in N
      ethylmaleimide-resistant mitochondrial GPAT activity. The GPAT protein was not
      detectable by Western blot in noninfected Sf9 cells or in cells infected with the
      GPAT sequence in the reverse orientation. However, in cells infected with GPAT in
      the correct orientation, there was a dramatic increase in the GPAT protein that
      was readily detectable by Coomassie staining both in total extracts and in the
      mitochondrial fraction. To ease the purification, we next expressed GPAT as a
      polyhistidine fusion protein in insect cells. The polyhistidine tag did not
      interfere with targeting to mitochondria or with the catalytic activity of
      GPAT.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779774
TI  - Structure of the catalytic region of human complement protease C1s: study by
      chemical cross-linking and three-dimensional homology modeling.
AB  - C1s is a multidomain serine protease that is responsible for the enzymatic
      activity of C1, the first component of the classical pathway of complement. Its
      catalytic region (gamma-B) comprises two contiguous complement control protein
      (CCP) modules, IV and V (about 60 residues each), a 15-residue intermediary
      segment, and the B chain (251 residues), which is the serine protease domain.
      With a view to identify domain-domain interactions within this region, the gamma
      B fragment of C1s, obtained by limited proteolysis with plasmin, was chemically
      cross-linked with the water-soluble carbodiimide 1-ethyl-3-[3
      (dimethylamino)propyl]carbodiimide; then cross-linked peptides were isolated
      after CNBr cleavage and thermolytic digestion. N-Terminal sequence and mass
      spectrometry analyses allowed us to identify two cross-links between Lys 405 of
      module V and Glu 672 of the B chain and between Glu 418 of the intermediary
      segment and Lys 608 of the B chain. Three-dimensional modeling of the CCP modules
      IV and V and of the catalytic B chain was also carried out on the basis of their
      respective homology with the 16th and 5th CCP modules of complement factor H and
      type I serine proteases. The information provided by both the chemical cross
      linking studies and the homology modeling enabled us to construct a three
      dimensional model for the assembly of the C-terminal part of the gamma-B region,
      comprising module V, the intermediary segment, and the B chain. This model shows
      that module V interacts with the serine protease B chain on the side opposite to
      both the activation site and the catalytic site. Functional implications of this
      interaction are discussed in terms of the possible role of module V in the
      specific recognition and positioning of C4, one of the two substrates of C1s.

PMID- 7779775
TI  - Phospholipase A2 engineering. Probing the structural and functional roles of N
      terminal residues with site-directed mutagenesis, X-ray, and NMR.
AB  - The N-terminal residues of phospholipase A2 (PLA2) are believed to be involved in
      the hydrogen-bonding network, the interfacial binding site, or the hydrophobic
      channel. Site-directed mutants of bovine pancreatic PLA2 with substitutions at
      positions 2, 3, 4, 5, 6, and 9 were constructed to test the roles of these
      residues in the structure and function of PLA2. Nonconservative mutations of Phe
      5 and Ile-9, which are located inside the hydrophobic channel, led to significant
      perturbations in the conformation and conformational stability. Kinetic studies
      also indicated that mutations at Ile-9 and Phe-5 caused significant decreases in
      the rate of hydrolysis toward micellar and vesicle substrates. Scooting mode
      kinetic analysis showed that the binding step of the mutant enzymes to the DC14PM
      (1,2-dimyristoyl-sn-glycero-3-phosphomethanol) vesicle interface is not
      significantly affected and that the perturbations in catalysis occur mainly in
      kcat at the interface. The results taken together suggest that the residues Ile-9
      and Phe-5 are important for both structure and catalysis. The mutant W3A (Trp-3
      to Ala) also showed decreased rates of hydrolysis but to a lesser extent than Ile
      9 and Phe-5 mutants. In addition, the binding affinity of W3A to the surface of
      the vesicles (i.e., the E to E* step) has been perturbed to the extent that
      hopping between anionic vesicles has been observed. On the other hand, the
      mutants of Gln-4 and Asn-6, which are located at or near the surface, displayed
      structural and kinetic properties similar to those of the wild-type PLA2 with the
      exception of the highly hydrophilic lysine mutant. The X-ray structure of the Q4E
      mutant indicates that the overall structure, the catalytic triad, and the link
      between residue 4 and Asp-99 via hydrogen bonding through Ala-1 and the
      structural water remain the same as in the WT. Substitutions for Leu at position
      2 showed an acyl chain length discrimination toward different substrates, which
      may reflect the contacting position(s) of the substrate acyl chain with Leu-2.

PMID- 7779776
TI  - Electron tunneling and ab initio calculations related to the one-electron
      oxidation of NAD(P)H bound to catalase.
AB  - Models for NAD(P)H le- oxidation in bovine catalase were studied using Hartree
      Fock ab initio calculations, along with information taken from the published X
      ray structure of the enzyme. Geometries and energies of ground states and
      transition states were calculated at the 6-31G* level for N-methyl-1,4
      dihydropyridine and N-methyl-1,4-dihydronicotinamide undergoing the pathway (i)
      le- oxidation to yield the radical cation, (ii) general-base-catalyzed (hydroxide
      and/or imidazole) deprotonation of the radical cation to yield the neutral
      radical, and (iii) le- oxidation of the neutral radical to the N-methylpyridinium
      or N-methylnicotinamide cation. Barrier heights for deprotonation of the radical
      cation intermediates were calculated to be 7-11 kcal/mol. Kinetic isotope effects
      were calculated for general-base-catalyzed deprotonation of the N-methyl-1,4
      dihydropyridine radical cation and the 4,4-dideuterio species and found to be
      kH/kD2 = 5.38 (hydroxide) or 3.64 (imidazole), in qualitative agreement with
      published experimental isotope effects for the analogous deprotonation of N
      methyl-1,10-dihydroacridan or the N-methyl-1,10-dideuterioacridan radical cation.
      In the calculated transition state for imidazole deprotonation of the N-methyl
      1,4-dihydronicotinamide radical cation, an unusual short contact was calculated
      and interpreted as a hydrogen bond (2.35 A) between the amide oxygen and the
      hydrogen attached to C2 of imidazole. Similar hydrogen bonds were also observed
      and calculated at the 3-21G and 6-31G* levels between His234 of catalase and the
      amide oxygen of bound NAD(P)H and complexes of N,N'-dimethyl-1,4
      dihydronicotinamide or cis-N-methylformamide with N-methylimidazole. Comparison
      of these results to the X-ray structure of bovine catalase allows for further
      interpretation of the possible roles of the imidazole bases His234 and His304 and
      the hydrogen-bonded contacts in the NAD(P)H binding site. Electron tunneling
      pathways between NAD(P)H and the iron protoporphyrin IX (PP-IX) axial tyrosinate
      ligand Tyr357 in molecular dynamics and X-ray crystal structures of bovine
      catalase were calculated using PATHWAYS II (version 2.01). The pathways which
      were calculated included those involving the amino acid residue Tyr214, which is
      near the NAD(P)H binding site. Coupling involving Tyr357 was not particularly
      efficient; however, strong coupling between Tyr214 and iron-protoporphyrin IX was
      observed. These pathways may be important if electron transfer is stepwise; i.e.,
      Tyr214 oxidized first, followed by NAD(P)H.

PMID- 7779777
TI  - Functional role of arginine-11 in the N-terminal helix of skeletal troponin C:
      combined mutagenesis and molecular dynamics investigation.
AB  - The two main structural differences between calmodulin (CaM) and skeletal
      troponin C (sTnC) are the absence in CaM of (i) the short N-terminal helix in TnC
      and (ii) the triplet KGK (residues 91-93; numbering according to chicken sTnC).
      It was recently shown that deletion of both structural groups from sTnC imparted
      to the resulting construct the CaM-like ability to activate phosphodiesterase
      (PDE) and to regulate force development in smooth muscle. To continue probing of
      the structural basis of the differential behavior of sTnC and CaM, residue Arg-11
      in rabbit sTnC was mutated to Ala because the interactions of Arg-11 with distal
      residues in the N-terminal domain seem to link the N-terminal helix to the rest
      of the structure. The mutant exhibits CaM-like function in its ability to
      activate PDE (about 50% of CaM at 5 microM concentration). If, in addition, the
      KGK triplet is also deleted, PDE activation increases to about 80%. Both
      constructs retain their TnC function to nearly 100%. To explore the mechanistic
      basis of this remarkable observation, computational simulations of the molecular
      dynamics (MD) were carried out for both wild-type 4Ca2+.sTnC and the 4Ca2+.R11A
      mutant, and the results were compared to those from earlier simulations of
      4Ca2+.CaM. Two types of structural changes observed from such simulations of the
      molecular dynamics of CaM had been considered to have a functional role: (i) a
      compaction to a more globular form and (ii) a reorientation of the Ca-binding
      domains around the central tether helix.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779778
TI  - Calcium-induced dimerization of troponin C: mode of interaction and use of
      trifluoroethanol as a denaturant of quaternary structure.
AB  - Protein aggregation can be a problem, especially as a large number of proteins
      become available for structural studies at fairly high concentrations using
      solution techniques such as NMR spectroscopy. The muscle regulatory protein
      troponin C (TnC) undergoes a calcium-induced dimerization at neutral pH with a
      dissociation constant for the dimerization of 0.4 mM at 20 degrees C. The present
      study indicates that the mode of dimerization involves the N-domain of one
      monomer interacting with the N-domain of another monomer. Addition of the solvent
      trifluoroethanol (TFE) to a concentration of 15%, v/v, results in a 10-fold
      increase in the dimer dissociation constant of calcium-saturated TnC (4 mM at 20
      degrees C), making TnC predominantly a monomer for spectroscopic studies.
      Further, TFE, at the concentrations used herein, acts to perturb the quaternary
      structure of TnC without adversely affecting the secondary or tertiary structure
      as evidenced by minimal changes to its CD spectra and 1H, 13C, and 15N NMR
      chemical shifts.

PMID- 7779779
TI  - Neurofilament-associated protein phosphatase 2A: its possible role in preserving
      neurofilaments in filamentous states.
AB  - Neurofilament phosphatase (NF-phosphatase) activity, which dephosphorylates NF
      proteins phosphorylated by cyclic AMP-dependent protein kinase (A-kinase), was
      detected in NF fractions prepared from bovine spinal cords. This phosphatase was
      suggested to be associated with NFs by gel filtration and sedimentation analysis
      and was further demonstrated by dephosphorylation-dependent binding assay of NFs
      to microtubules. The NF-associated NF-phosphatase was identified as a type of
      protein phosphatase 2A (PP2A) by (i) its complete inhibition with 100 nM okadaic
      acid, at which concentration the purified type 1 protein phosphatase (PP1) was
      inhibited only 25%; (ii) the absence of effect of inhibitor-2, a specific
      inhibitor of PP1, on the NF-phosphatase activity; and (iii) the detection of 38
      kDa catalytic and 65-kDa regulatory subunits of PP2A by immunoblotting. The NF
      associated PP2A was partially solubilized from NFs by a high concentration of
      MgSO4, and the solubilized PP2A was suggested by gel filtration to be a dimeric
      holoenzyme consisting of a 38-kDa catalytic and a 65-kDa regulatory subunit.
      Phosphorylated NF-L, which is assembly incompetent, was induced to assemble into
      filaments by dephosphorylation with PP2A. These results suggest a role of NF
      associated PP2A in preserving filamentous forms of NF in neurons.

PMID- 7779781
TI  - Insect immunity. The inducible antibacterial peptide diptericin carries two O
      glycans necessary for biological activity.
AB  - A bacterial challenge of larvae of the dipteran insect Phormia terranovae induces
      the rapid synthesis of diptericin, an antibacterial polypeptide, previously
      characterized at the amino acid level and indirectly by cDNA cloning studies.
      This 82-residue polypeptide consists of an N-terminal proline-rich domain and a
      central and C-terminal glycine-rich domain. Using liquid chromatography coupled
      to electrospray ionization-mass spectrometry, we demonstrate here that this
      molecule is more complex than anticipated and carries two O-substitutions on
      threonine residues, one in the proline-rich domain (residue 10) and one in the
      glycine-rich domain (residue 54). These substitutions consist of identical
      trisaccharides: glucose-->galactose-->N-acetylgalactosamine-->(threonine).
      Treatment of diptericin with O-glycosidase, which selectively removes the
      substitutions without altering the polypeptide proper, abolishes the
      antibacterial activity, indicating that this posttranslational modification is
      essential for biological activity of the polypeptide. We also show that
      diptericin is posttranslationally modified by a C-terminal amidation.

PMID- 7779780
TI  - Characterization of the N-terminal and C-terminal domains of human
      apolipoprotein(a): relevance to fibrin binding.
AB  - The structural domains of human apolipoprotein(a) (apo(a)) in the lipoprotein(a)
      (Lp(a)) particle have been recently investigated by limited proteolysis [Huby,
      T., Doucet, C., Dieplinger, H., Chapman, J., & Thillet, J. (1994) Biochemistry
      33, 3335-3341]. We have shown that apo(a) can be cleaved into two structural
      domains: one was of constant size (170 kDa) and corresponded to the C-terminal
      (Cter) domain of apo(a). This domain was linked by a disulfide bond to apo B100.
      By contrast, the N-terminal (Nter) domain, whose size varied according to the
      digested apo(a) isoform, was not linked to apo B100. We now describe the
      purification of these apo(a) domains and their interaction with fibrin surfaces
      in an in vitro binding assay. The Nter domain of apo(a) was purified as a soluble
      protein in a two-step procedure which involved sequential use of a heparin
      Sepharose column and a lysine-Sepharose column. The Cter domain of apo(a), which
      remained in disulfide linkage with apo B100 of Lp(a), was isolated as a
      lipoprotein particle by a combination of chromatographic steps on heparin
      Sepharose and Q-Sepharose columns. This particle, termed "mini-Lp(a)", appeared
      homogeneous in nondenaturing polyacrylamide gels and exhibited a particle size
      (285 A) which was intermediate between that of Lp(a) (300 A) and LDL (265 A). The
      cleavage site between the respective apo(a) domains was determined by N-terminal
      sequencing of the purified Cter domain. Such cleavage occurred between residues
      3532 and 3533, which are located in the interkringle region between apo(a)
      kringles 4(4) and 4(5).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779782
TI  - Conformation of two peptides corresponding to human apolipoprotein C-I residues 7
      24 and 35-53 in the presence of sodium dodecyl sulfate by CD and NMR
      spectroscopy.
AB  - Peptides corresponding to the proposed lipid-binding domains of human
      apolipoprotein C-I, residues 7-24 (ALDKLKEFGNTLEDKARE) and 35-53
      (SAKMREWFSETFQKVKEKL), were studied by CD and two-dimensional 1H NMR
      spectroscopy. Sodium dodecyl sulfate (SDS) was used to model the lipoprotein
      environment. Analysis of the CD data shows that both peptides lack well-defined
      structure in aqueous solution but adopt helical, ordered structures upon the
      addition of SDS. The helical nature of the peptides in the presence of SDS was
      confirmed by H alpha secondary shifts. A total of 199 (apoC-I(7-24)) and 266
      (apoC-I(35-53)) distance restraints were used in distance geometry and simulated
      annealing calculations to generate average structures for both peptides in
      aqueous solutions containing SDS. The backbone (N, C alpha, C = O) RMSD from the
      average structure of an ensemble of 20 structures was 0.73 +/- 0.22 and 0.48 +/-
      0.14 A for apoC-I(7-24) and apoC-I(35-53), respectively. In the presence of SDS,
      the distance geometry and simulated annealing calculations show that both
      peptides adopt well-defined amphipathic helices with distinct hydrophobic and
      hydrophilic faces. The calculated structures are discussed relative to predicted
      structures. Comparing our CD and NMR results for the apoC-I fragments in SDS with
      CD results of others obtained in the presence of dimyristoylphosphatidylcholine
      indicates that SDS may be a better model of the lipoprotein environment.

PMID- 7779784
TI  - The conformations of a functional spin-labeled derivative of gastric H/K-ATPase
      investigated by EPR spectroscopy.
AB  - A spin-labeled derivative of porcine gastric H/K-ATPase with high ATP hydrolyzing
      activity (77 mumol of Pi/(mg.h)) has been prepared. Over 65% of initial ATPase
      activity (115 mumol of Pi/(mg.h)) was preserved after complete reaction of the
      enzyme with the lysine reactive nitroxide spin-labeled TEMPO isothiocyanate
      (TITC). In contrast, rapid and complete loss of ATPase activity occurred after
      reaction of the enzyme with the lysine directed fluorescent probe FITC.
      Conventional EPR spectra of TITC labeled H/K-ATPase reflected mainly the slow
      rotational diffusion of the enzyme in the membrane. An upper limit enzyme
      intramembranous radius of 108 A was calculated on the basis of rotational
      correlation times estimated from saturation transfer (ST) EPR spectral
      lineshapes. Conventional EPR spectra exhibited two major components corresponding
      to at least two populations of strongly constrained spin-labels. Difference
      spectroscopy revealed that the proportion of these two components changed
      markedly with temperature. Moreover, the proportion of the components was
      sensitive to the presence of the activating ionic ligands Mg2+ and ATP, which
      induce enzyme conformational transitions, and to the reversible inhibitor SCH
      28080, which binds to the K+ sensitive form of the enzyme. These findings show
      that EPR spectroscopy is able to report functionally coupled conformational
      changes of gastric H/K-ATPase and imply that the spin-labels are attached to
      lysines within functionally important regions of the enzyme.

PMID- 7779783
TI  - Site-directed mutagenesis of putative GTP-binding sites of yeast beta-tubulin:
      evidence that alpha-, beta-, and gamma-tubulins are atypical GTPases.
AB  - The exchangeable GTP-binding site on beta-tubulin has been extensively studied,
      but the primary sequence elements which form the binding site on beta-tubulin
      remain unknown. We have used site-directed mutagenesis of the single beta-tubulin
      gene of Saccharomyces cerevisiae to test a model for the GTP-binding site on beta
      tubulin, which was based on sequence comparisons with members of the GTPase
      superfamily [Sternlicht, H., Yaffe, M.B., & Farr, G. W. (1987) FEBS Lett. 214,
      226-235]. We analyzed the effects of D295N, N298K, and N298Q mutations in a
      proposed base-binding motif, 295DAKN298, on tubulin-GTP binding and on nucleotide
      binding specificity. We also examined the effects of a D203S mutation in a
      putative phosphate-binding region, 203DNEA206, on nucleotide binding affinity, on
      the assembly-dependent tubulin GTPase activity in vitro, and on the dynamic
      properties of individual "mutant" microtubules in vitro. The effects of the
      mutations on cell phenotype and on microtubule polymerization in cells were also
      measured. The results do not support the proposal that the 203DNEA206 and
      295DAKN298 [corrected] motifs are cognate to motifs found in GTPase superfamily
      members. Instead, the data argue that the primary sequence elements of beta
      tubulins that interact with bound nucleotide, and presumably also those of the
      alpha- and gamma-tubulin family members, are different from those of "typical"
      GTPase superfamily members, such as p21ras. The GTPase superfamily should thus be
      broadened to include not just the typical GTPases that show strong conservation
      of primary sequence consensus motifs (GxxxxGK, T, DxxG, NKxD) [corrected] but
      also "atypical" GTPases, exemplified by the tubulins and other recently
      identified GTPases, that do not show the consensus motifs of typical GTPases and
      which also show no obvious primary sequence relationships between themselves. The
      tubulins and other atypical GTPases thus appear to represent convergent solutions
      to the GTP-binding and hydrolysis problem.

PMID- 7779785
TI  - Secretion of yeast aspartic protease 3 is regulated by its carboxy-terminal tail:
      characterization of secreted YAP3p.
AB  - Yeast aspartic protease 3 (YAP3p), a basic-residue specific proprotein processing
      enzyme, was shown to be a membrane-associated protease. The membrane association
      of YAP3p was demonstrated to be through a glycophosphatidylinositol anchor
      situated in the carboxy terminus of the enzyme. Carboxy-terminal truncation of
      YAP3p by 37 amino acids resulted in secretion of YAP3p into the growth medium.
      Western blot analysis after sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis showed two secreted forms of YAP3p with apparent molecular masses
      of approximately 180 and approximately 90 kDa. YAP3p has an isoelectric point of
      approximately 4.5 as determined by isoelectric focusing gel electrophoresis.
      Treatment of YAP3p with endoglycosidase H reduced the size of both forms of the
      protein to approximately 65 kDa, consistent with the presence of 10 potential N
      linked glycosylation sites in the deduced amino acid sequence of this protein.
      Removal of the N-linked sugars did not affect the enzymatic activity of YAP3p.
      Analysis of the effect of temperature on the stability and the rate of enzymatic
      activity of YAP3p showed that the enzyme retained 100% of its activity when
      incubated for 1 h at 37 degrees C, while incubation at 50 degrees C for 1 h
      resulted in approximately 80% loss of activity. The dependence of activity on
      temperature demonstrated a calculated Q10 of 1.95.

PMID- 7779786
TI  - Incision at diaminopurine: thymine base pairs but not at guanine:O4-methylthymine
      base pairs in DNA by extracts of human cells.
AB  - Cell-free extract from the A1235 human malignant glioma cell line was employed to
      study the possibility of incision at 2,6-diaminopurine:T (DiAP:T), 2-amino-6
      methylaminopurine:T (AMAP:T), and G:O4-methylthymine (G:m4T) mismatches, each
      placed in a 45 bp DNA at a defined site. The incision of a 45 bp DNA containing a
      G:T mispair at the same site was followed to determine the relationship between
      base pair structure and repair activity (ies) in the extract. The cell-free
      extract incised DNAs containing DiAP:T, AMAP:T, and G:T pairs similarly.
      Reminiscent of the known pattern of incision at G:T mismatches, products from
      each substrate were consistent with two incisions, one immediately 5' and one
      immediately 3' to the mismatched T, and only in the strand containing the
      mismatched T. While DNA with an O6-methylguanine:T (m6G:T) pair was also incised,
      DNA containing the G:m4T pair was not, but was rendered inciseable by
      pretreatment with O6-methylguanine-DNA methyltransferase. Incision of DiAP:T
      containing DNA by the extract was less in the presence of unlabeled DNA
      containing G:T mispairs than in the presence of A:T- or G:A-containing DNA or in
      the absence of competing DNA. We suggest that the mechanism operating on DiAP:T
      and/or AMAP:T pairs may be the same as the human G:T repair pathway, possibly
      initiated by the action of a glycosylase as described by Wiebauer and Jiricny
      [Wiebauer, K., & Jiricny, J. (1989) Nature 339, 234-236; Wiebauer, K., & Jiricny,
      J. (1990) Proc. Natl. Acad. Sci, U.S.A. 87, 5842-5845].(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7779787
TI  - Photoincorporation of 4,4'-bis(1-anilino-8-naphthalenesulfonic acid) into the
      apical domain of GroEL: specific information from a nonspecific probe.
AB  - The use of noncovalent hydrophobic probes such as bis-ANS has become increasingly
      popular in gaining structural information about protein structure and
      conformation. While these probes have provided rich information about protein
      conformation, specific information has been limited. In this report, we extend
      the usefulness of the probe bis-ANS by showing that it can be covalently
      photoincorporated into various proteins. Using the chaperonin GroEL, we have
      shown that it is possible to locate important hydrophobic surfaces through
      photoincorporation and peptide sequencing. It has been proposed that hydrophobic
      surfaces on the chaperonin may be responsible for the binding of unfolded
      polypeptides. We show here that photoincorporation of bis-ANS is able to locate a
      distinct hydrophobic surface on GroEL. Incorporation of the bis-ANS occurs within
      a 45 residue fragment of the monomer near the middle of the primary sequence.
      Interestingly, photoincorporation occurs within this fragment in both
      tetradecamers and assembly-competent monomers. From the three-dimensional
      structure of GroEL, this region maps to the apical domain (residues 191-376),
      which has been implicated in polypeptide binding [Fenton, W. A., Kashi, Y.,
      Furtak, K., & Horwich, A. L. (1994) Nature 371, 614-619]. In addition, the
      fluorescent properties of the probe are retained including the excitation and
      emission maxima and the sensitivity to the polarity of its environment. These
      results suggest that photoincorporated bis-ANS may be a useful probe for protein
      structure and dynamics.

PMID- 7779788
TI  - Characterization of tyrocidine synthetase 1 (TY1): requirement of
      posttranslational modification for peptide biosynthesis.
AB  - Tyrocidine synthetase 1 (TY1), produced by Bacillus brevis ATCC 8185, consists of
      a single multifunctional polypeptide chain catalyzing the activation,
      thioesterification, and epimerization of phenylalanine. Because we were concerned
      about possible posttranslational issues, a comparative study between the wild
      type isolate and the in Escherichia coli overexpressed protein was performed.
      Analysis by matrix assisted laser desorption mass spectrometry (MALDI) provided a
      molecular mass of 122,516 +/- 120 Da for the recombinant protein, which is in
      agreement with the value of 122,590 Da calculated from the gene sequence. MALDI
      analysis of the tryptic fragments revealed that in the recombinant TY1 the
      putative 4'-phosphopantetheine binding site (562Ser) is not modified by the
      cofactor. The substrate specificity profiles of the amino acid dependent
      ATP[32P]PPi exchange reactions were identical, including activation of L
      phenylserine, L-tyrosine, and L-methionine. However, the rates of the reverse
      adenylation reaction for the recombinant protein were only 22% relative to those
      of the wild-type enzyme. The aminoacylation levels of about 60% for TY1 from
      Bacillus brevis reduced to 1.4% in the overexpressed protein. A similar
      distribution of the D- and the L-isomer was detected at the thioester attachment
      site. The pI values of the wild-type and expressed TY1 are 4.9 and 5.0,
      respectively. In conclusion, it could be established that apo- and holo-TY1
      differ in their amino acid activating properties. Posttranslational modification
      by 4'-phosphopantetheine is an essential requirement for aminoacylation,
      epimerization, and thus the functioning of the multienzyme in peptide synthesis.

PMID- 7779790
TI  - Conversion of cytochrome f to a soluble form in vivo in Chlamydomonas
      reinhardtii.
AB  - We introduced a stop codon in place of the ATT codon encoding Ile283 (numbered
      from the Met initiation codon) in the petA gene from Chlamydomonas reinhardtii.
      The resulting protein was expected to be truncated on its carboxy-terminus end,
      lacking the last 35 amino acids. This region of the polypeptide sequence
      encompasses a hydrophobic stretch assumed to anchor the protein in the thylakoid
      membrane. Once introduced in whole cells of C. reinhardtii by chloroplast
      transformation, the modified petA gene expressed a truncated apoprotein which was
      efficiently converted to a truncated holocytochrome f. This protein accumulated
      in the lumen of the thylakoids in a soluble form. Thus the conversion of
      preapocytochrome f to holocytochrome f does not require an interaction with the
      membrane through its C-terminus anchor. We show that the rest of the cytochrome
      b6f complex failed to accumulate in the transformants, most probably because of a
      lack of interaction between soluble cytochrome f and the other cytochrome b6f
      subunits. However, soluble cytochrome f was still able to donate electrons to
      photosystem I, which is indicative of its ability to maintain interactions with
      plastocyanin. The control of the rate of synthesis of cytochrome f by the
      neighboring subunit, suIV (Kuras & Wollman (1994) EMBO J. 13, 1019-1027), was not
      observed with the truncated cytochrome f. This observation suggests that either
      the transmembrane anchor of cytochrome f contains a target for the regulation of
      cytochrome f translation by suIV or there is a transient form of membrane-bound
      cytochrome f which is highly sensitive to proteolysis at an early post
      translational stage.

PMID- 7779789
TI  - Characterization and sequential localization of the metal clusters in sea urchin
      metallothionein.
AB  - The mode of metal binding in sea urchin metallothionein (MT) was explored by
      electronic absorption, chiroptical, NMR, and mass spectroscopic methods.
      Recombinant sea urchin MT containing 7 equiv of the natural mixture of Cd
      isotopes was stripped of the metal by exposure to low pH and reconstituted with
      113Cd (> 95% enriched). Comparison of the electronic spectroscopic and
      chiroptical features and the 113Cd NMR spectra of the reconstituted material with
      those of the native recombinant material indicated that the reconstituted
      material had regained the native conformation. The shoulder at 250 nm in the
      electronic absorption spectrum, the biphasic circular dichroism profile centered
      at 250 nm, and the chemical shift positions (605-695 ppm) of the seven 113Cd NMR
      resonances all strongly suggested that sea urchin MT like all other well
      characterized MTs contains clusters made up of tetrahedral Cd-thiolate units. The
      113Cd chemical shift correlation spectrum of the reconstituted protein proved the
      existence of such metal clusters and allowed the unambiguous assignment of some
      of the metal connectivities. Homonuclear decoupling experiments in which Cd
      resonances were selectively saturated indicated moreover a partitioning of the
      metal complement into two separate clusters containing three and four Cd ions.
      The same proposition was supported by the selective reduction of three 113Cd
      resonances upon partial metal depletion following exposure of the protein to
      EDTA. Thus, the three-metal cluster is energetically less stable than the four
      metal cluster.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779791
TI  - Topographical organization of cytochrome b in the yeast mitochondrial membrane
      determined by fluorescence studies with N-cyclohexyl-N'-[4
      (dimethylamino)naphthyl]carbodiimide.
AB  - In previous studies, we reported that dicyclohexylcarbodiimide (DCCD) inhibited
      proton translocation in the cytochrome bc1 complex from yeast mitochondria and
      was bound selectively to cytochrome b. Extensive trypsin digestion of [14C]DCCD
      labeled cytochrome b isolated from a cytochrome bc1 complex treated with DCCD
      yielded a single radiolabeled 7.0 kDa peptide with the N-terminus VTLWNVG,
      indicating that trypsin cleavage had occurred at arginines-110 and -178. This
      segment of cytochrome b contains one acidic residue, aspartate-160, localized in
      amphiphilic, non-membrane-spanning, helix cd. To explore the environment of
      amphiphilic helix cd, we employed a fluorescent derivative of DCCD, N-cyclohexyl
      N'-[4-(dimethylamino)naphthyl]carbodiimide (NCD-4). After incubation of NCD-4
      with a cytochrome bc1 complex isolated from yeast mitochondria, a fluorescent
      compound was formed with a 340 nm excitation peak and a 441 nm emission peak. NCD
      4 was selectively bound to cytochrome b and inhibited proton translocation with
      only a minimal inhibitory effect on electron transfer in the cytochrome bc1
      complex reconstituted into proteoliposomes. Competition experiments and trypsin
      digestion of NCD-4-labeled cytochrome b indicated that NCD-4 and DCCD were bound
      to the same site on cytochrome b. The fluorescence of NCD-4 bound to the
      cytochrome bc1 complex was quenched equally by CAT-16, an amphiphilic spin-label
      that intercalates at the membrane surface, and 5-doxylstearic acid, a nitroxide
      derivative of stearic acid, and to a lesser extent by 7-doxylstearic and 12
      doxylstearic acids.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779792
TI  - Control of electron delivery to the oxygen reduction site of cytochrome c
      oxidase: a role for protons.
AB  - We have studied the reaction of oxidized "pulsed" cytochrome c oxidase with
      reduced cytochrome c and with ruthenium(II) hexaammine using stopped-flow mixing.
      The rate of reduction of Fea3 (the oxygen-binding heme) is not a linear function
      of the population of reduced Fea (the low-spin heme), as would be expected if
      electron transfer between these sites is rate-limiting. Instead, the rate can be
      increased significantly by increasing the driving force of the reductant
      (lowering of Eh) even after Fea is almost completely reduced. Reduction of Fea3
      becomes slower as the pH is raised, and consumption of protons can be seen
      simultaneously with electron entry into Fea3. Both the reduction of Fea3 and the
      proton uptake are biphasic. To explain these findings, we propose a model in
      which (1) intramolecular heme-heme electron transfer is fast, and has an
      essentially constant rate; (2) when reduction begins, the midpoint potentials of
      Fea3 and CuB are initially low, and only a small fraction of these centers become
      reduced; and (3) this reduced population is then stabilized by the uptake of
      protons. Thus, net reduction of Fea3 and CuB is controlled by the amount of the
      low-potential population which becomes reduced together with the rate of proton
      uptake by this reduced low-potential species. Important consequences of this
      mechanism for the function of the enzyme and for the respiratory chain as a whole
      are discussed.

PMID- 7779793
TI  - Interaction of the 33-kDa extrinsic protein with photosystem II: identification
      of domains on the 33-kDa protein that are shielded from NHS-biotinylation by
      photosystem II.
AB  - The structural association of the spinach 33-kDa extrinsic protein of photosystem
      II with the membrane-bound components of the photosystem was investigated by
      labeling the 33-kDa extrinsic protein with the amino group-specific reagent N
      hydroxysuccinimidobiotin both on NaCl-washed photosystem II membranes and free in
      solution. After quenching of the labeling reagent and isolation of the
      biotinylated molecules, the biotinylation sites were identified by Staphylococcus
      V8 protease digestion and analysis of the resultant peptide fragment mixture by
      matrix-assisted laser desorption/ionization mass spectrometry. When the 33-kDa
      extrinsic protein was modified on PS II membranes, three domains were
      biotinylated: 14K, 41K-76K, and 190K-236K. When the 33-kDa extrinsic protein was
      modified in solution, four additional domains were biotinylated: 1E-4K, 20K, 101K
      105K, and 159K-186K. These additional modified domains reside in portions of the
      33-kDa protein that are not accessible to the bulk solvent when the protein is
      associated with PS II and may define regions of interaction with the photosystem.

PMID- 7779794
TI  - Trypsin treatment of reaction centers from Rhodobacter sphaeroides in the dark
      and under illumination: protein structural changes follow charge separation.
AB  - Reaction centers from Rhodobacter sphaeroides R-26 were treated with trypsin in
      the dark and during illumination (in the charge-separated state). Trypsination
      resulted in a time-dependent modification of the reaction centers, reflected in
      changes in the charge recombination rate, in the inhibition of QA- to QB electron
      transfer, and eventually to inhibition of charge separation. Comparisons of
      centers with ubiquinone or anthraquinone in the QA site, in which the charge
      recombination pathways are different, indicate that trypsination affects charges
      close to the QA(-)-binding site. Studies of light-induced voltage changes from
      moving charges in reaction centers incorporated in lipid layers on a Teflon film,
      a technique which allows the discrimination of effects on donor and acceptor
      sides, indicate that the acceptor side is preferentially degraded by trypsin in
      the dark. Tryptic digestion during illumination generally resulted in a marked
      strengthening and acceleration of the effects seen already during dark treatment,
      but new effects were also detected in gel electrophoretic peptide patterns, in
      optical spectra, and in the kinetic measurements. Optical kinetic measurements
      revealed that the donor side of the reaction centers became susceptible to
      modification by trypsin during illumination as seen in the value of the binding
      constant for soluble cytochrome c2 which increased by a factor of 2, whereas it
      was much less affected after trypsination of reaction centers in the dark. The
      influence of illumination on the rate and mode by which trypsin acts on reaction
      centers indicates that changes in the protein conformation follow charge
      separation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779795
TI  - Resonance Raman studies of the heme active site of the homodimeric myoglobin from
      Nassa mutabilis: a peculiar case.
AB  - A spectroscopic investigation by resonance Raman has been carried out at pH 7.0
      in 0.1 M phosphate buffer on the cooperative homodimeric myoglobin from Nassa
      mutabilis. The study has been performed on the unligated ferrous form, as well as
      on the ligated species MbO2 and MbC, and on the ferric form met-Mb. Two v(C = C)
      vinyl stretching modes have been observed in all the investigated forms,
      reflecting different degrees of vinyl conjugation with the porphyrin ring, as a
      consequence of a strongly asymmetric environment for the two side groups of the
      heme. Furthermore, the ferric form displays a hexacoordinate low-spin heme, which
      suggests the presence of an endogenous ligand bound to the Fe atom. The frequency
      of the v(Fe-Im) stretching mode of Mb from Nassa mutabilis shifts down by 4 cm-1
      as compared with that of horse heart myoglobin, reflecting a protein-induced
      proximal strain as a result of heme-heme interaction due to the close proximity
      of the two hemes in the dimer. The lower frequency of the v(Fe-Im) stretching
      mode agrees well with the lower affinity for oxygen binding found for Nassa
      mutabilis Mb and with the slight heme core expansion with respect to horse heart
      Mb, suggesting a critical role for the Fe-His bond on the heme's function and
      structure.

PMID- 7779796
TI  - Substrate determinants of the course of tartrate dehydrogenase-catalyzed
      reactions.
AB  - The substrate specificity of tartrate dehydrogenase has been probed using a
      series of alternative substrates to identify the molecular interactions which
      determine whether a particular substrate undergoes enzyme-catalyzed
      decarboxylation or not. A series of 3-substituted malate analogs, in which F, Cl,
      Br, I, SH, or NH2 substituents were placed at the 3R- or 3S-position, was
      prepared, and the product resulting from the action of tartrate dehydrogenase on
      each compound was identified. All of the halomalates and both diastereomers of
      aminomalate underwent oxidative decarboxylation; both diastereomers of 3
      thiomalate underwent net nonoxidative decarboxylation. The results were
      interpreted in terms of a model in which decarboxylation is conformationally
      controlled. The data are not consistent with a model which suggests that
      substrates assume the conformation that is necessary to avoid steric crowding
      between the enzyme and the substituent at the 3-position of the substrate. These
      data are consistent with a model in which the course of the reaction with (+)
      tartrate and meso-tartrate is dictated by the coordination of the substrate
      hydroxyls to the active site Mn2+. However, the observed reactivities of the 3
      methyltartrate diastereomers are not consistent with this model, either: (2R,3R)
      3-methyltartrate undergoes oxidative decarboxylation, and (2R,3S)-3
      methyltartrate undergoes simple oxidation. These results suggest that for these
      compounds the conformation is dictated by the positioning of the hydrophobic
      substituent in a specific binding pocket.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779797
TI  - Mechanism of metal-independent hydroxylation by Chromobacterium violaceum
      phenylalanine hydroxylase.
AB  - Phenylalanine hydroxylase converts phenylalanine to tyrosine utilizing a
      tetrahydrobiopterin cofactor. Several key mechanistic questions have yet to be
      resolved, specifically the identity of the hydroxylating species and the role of
      the non-heme iron which is present in all of the mammalian PAHs. Recently, we
      have demonstrated that a bacterial PAH from Chromobacterium violaceum does not
      require any redox active metal for activity [Carr, R. T., & Benkovic, S. J.
      (1993) Biochemistry 32, 14132-14138]. To identify the function of iron in the
      mammalian PAH's, we have undertaken a series of experiments to compare the
      mechanisms of this metal-independent PAH with the iron-dependent PAH from rat
      liver. Using [4-2H]phenylalanine as a substrate gave a kinetic isotope effect on
      hydroxylation of unity for CVPAH which is in agreement with previous values
      reported for RLPAH. The [4-2H]phenylalanine underwent an NIH shift upon
      hydroxylation by CVPAH. The extent of deuterium retention at the 3-position of
      the tyrosine product was identical within experimental error for both RLPAH and
      CVPAH using [4-2H]phenylalanine and [2,3,5,6-2H]phenylalanine as substrates. This
      suggests that PAH from either source probably does not directly mediate the NIH
      shift mechanism. No uncoupled pterin turnover was observed for CVPAH with either
      L-tyrosine or p-chloro-L-phenylalanine as substrate or tetrahydropterin as
      cofactor, each of which causes uncoupled turnover with RLPAH. CVPAH readily
      accepts 4-methylphenylalanine as a substrate giving 4
      (hydroxymethyl)phenylalanine as the major product and 3-methyltyrosine as the
      only other minor product.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779798
TI  - Determination of subunit dissociation constants in native and inactivated CTP
      synthetase by sedimentation equilibrium.
AB  - Sedimentation equilibrium was used to correlate changes in aggregation state with
      active site modification of Escherichia coli CTP synthetase. The native enzyme
      equilibrated between monomers, dimers, and tetramers in the absence of
      substrates. At enzyme concentrations above 5 microM, tetramers represented 40% of
      the species in solution. Inactivation by 6-diazo-5-oxonorleucine (DON) or
      thiourea dioxide reduced the amount of tetramer to below detectable limits.
      However, inactivated enzyme still equilibrated between monomers and dimers.
      Simultaneous analysis of multispeed data at three protein concentrations yielded
      estimates of the dissociation constants for the monomer-dimer and dimer-tetramer
      equilibria. For multiple data sets of native enzyme, K1,2 was between 1 and 2
      microM, and K2,4 was between 1 and 18 microM. For DON inactivated enzyme, K1,2
      was 3-4 microM, and for thiourea dioxide inactivated enzyme, K1,2 was
      approximately 1 microM. The values for K1,2 are consistent with previously
      published studies by gel filtration, demonstrating that the enzyme dissociates to
      monomers in very dilute solution (Anderson, 1983). However, the sedimentation
      equilibrium experiments are the first to show that the enzyme forms tetramers in
      the absence of nucleotides. This result implies the presence of stable
      conformations in the native enzyme capable of dynamic equilibrium between
      monomers, dimers, and tetramers. The results presented here illustrate the
      sensitivity of sedimentation equilibrium for measuring the aggregation state of
      equilibrating enzyme species and demonstrate that active site modifications
      disrupt the quaternary structure of CTP synthetase.

PMID- 7779799
TI  - Tritium isotope effects in adenosylcobalamin-dependent glutamate mutase:
      implications for the mechanism.
AB  - The transfer of tritium between adenosylcobalamin and substrate in the reaction
      catalyzed by glutamate mutase was examined to investigate the possibility of a
      protein-based radical intermediate. There was no evidence that tritium was
      transferred to the protein during the reaction, as tritium neither became stably
      bound to the protein nor exchanged with water. The kinetics of tritium transfer
      from adenosylcobalamin to 3-methylaspartate was investigated. Both the transfer
      of tritium to product and the exchange of enzyme-bound and free coenzyme
      contribute to the kinetics of tritium loss from adenosylcobalamin. By varying the
      experimental conditions, the rates of both coenzyme exchange and tritium transfer
      could be measured. Exchange of adenosylcobalamin with enzyme is very slow, k off
      = 0.01 s-1, which may reflect a conformational change in the coenzyme and/or
      protein involved in forming active holo enzyme. The rate constants for the loss
      of tritium from adenosylcobalamin and the appearance of tritium in 3
      methylaspartate are much faster and very similar, k = 0.67 +/- 0.05 s-1 and k =
      0.50 +/- 0.05 s-1, respectively, consistent with the transfer of tritium
      occurring directly between coenzyme and substrate. The isotope effect, calculated
      from the rate constants for tritium transfer, and kcat, determined for the
      overall reaction under the same conditions, are between 13.5 and 18. These values
      are typical of primary isotope effects seen for enzymes in which hydrogen
      transfer is substantially rate limiting. A protein radical, therefore, appears
      unlikely to feature in the mechanism of this enzyme.

PMID- 7779801
TI  - Nucleoplasmin-mediated decondensation of Mytilus sperm chromatin. Identification
      and partial characterization of a nucleoplasmin-like protein with sperm-nuclei
      decondensing activity in Mytilus californianus.
AB  - We have been able to induce sperm nuclear decondensation in the mussel Mytilus
      californianus (mollusc) using either egg extracts or pure nucleoplasmin from
      Xenopus (amphibian). The nuclear decondensation involves removal of the sperm
      nuclear basic proteins (SNBPs) which bind to nucleoplasmin. An attempt has been
      made to isolate an ooplasmic factor from Mytilus with a similar sperm-chromatin
      decondensing activity. An acidic, thermostable protein with a molecular mass of
      58,000 has been purified and partially characterized.

PMID- 7779800
TI  - A heuristic approach to the analysis of enzymic catalysis: reaction of delta-(L
      alpha-aminoadipoyl)-L-cysteinyl-D-alpha-aminobutyrate and delta-(L-alpha
      aminoadipoyl)-L-cysteinyl-D-allylglycine catalyzed by isopenicillin N synthase
      isozymes.
AB  - Isopenicillin N synthase (IPNS) catalyzes the oxidative cyclization of delta-(L
      alpha-aminoadipoyl)-L-cysteinyl-D-valine to isopenicillin N. It is proposed that
      the multiple products produced from certain substrate analogues result from
      pathway branching after formation of a ferryl oxene intermediate. We have been
      interested in ascertaining the reasons for multiple product formation. One
      possibility is that the products are predisposed toward formation once the beta
      lactam ring and the ferryl oxene are produced. Alternately, the products may be
      persuaded into being by the enzyme restricting conformations such that otherwise
      less favorable chemistry can take place. With the existing description of the
      IPNS catalytic cycle, this fundamental question has not been answerable. We
      describe here the application of a heuristic method to resolve this key issue. It
      was reasoned that by comparing the ratios of products formed by a set of
      perturbed IPNS variants it might be possible to generate qualitative information
      about the relative magnitude of certain activation parameters. If certain product
      ratios are affected but others are not, then it should be possible to say which
      steps in the reaction are dictated merely by chemical fundamentals and which
      steps are directly effected by the enzyme. In this paper we report the high-level
      expression, purification, and characterization of four IPNS isozymes. Comparison
      of the product ratios obtained on incubation of unnatural substrate analogues
      with four IPNS isozymes corresponding to perturbed active site variants shows
      substantial variation in some cases and little in others. Interpretation of the
      results obtained with delta-(L-alpha-aminoadipoyl)-L-cysteinyl-D-alpha
      aminobutyrate (ACAB) allows conclusions to be drawn regarding the role of the
      enzyme in restricting available conformations of the natural substrate to
      disfavor certain otherwise chemically favorable pathways and hence products. The
      results obtained with delta-(L-alpha-aminoadipoyl)-L-cysteinyl-D-allylglycine,
      while rather more complex, substantiate the conclusions drawn from the ACAB data.
      A major conclusion is that, in the oxidation of ACV, IPNS is a negative catalyst
      of cepham formation but a positive catalyst of penam formation.

PMID- 7779802
TI  - The crystal structure of r(CCCCGGGG) in two distinct lattices.
AB  - The structure of the RNA octamer r(C4G4) has been determined in two different
      crystal forms. The conformations of the RNA duplex in the rhombohedral and
      hexagonal lattices display only minimal deviations, demonstrating that the RNA
      double helix is considerably less deformable than the DNA double helix. For the
      first time the crystal structures of an A-RNA and an A-DNA with identical
      sequence can now be compared. The large number of ordered water molecules
      observed in the minor groove of the RNA duplex suggests that an important
      contribution to its higher rigidity derives from the improved hydration due to
      the presence of the 2'-hydroxyl groups. Our finding that the conformation of the
      RNA double helix is virtually unaffected by different crystal packing modes
      provides evidence that proteins may not alter the conformation of RNA stem
      regions in a significant way.

PMID- 7779803
TI  - Cyanide and carbon monoxide binding to the reduced form of cytochrome bo from
      Escherichia coli.
AB  - Cyanide binds to fully reduced cytochrome bo and induces a blue shift of the
      Soret absorption band of the high-spin heme o and a change in the visible region
      spectrum consistent with the expected conversion to a low-spin state. The
      dissociation constant, determined by titration of the extent of the binding
      spectrum, is 7.0 +/- 0.6 mM at pH 7.0. In contrast, cyanide does not bind
      significantly in this concentration range to the reduced form of cytochrome bd.
      The reduced cyanide compound of cytochrome bo can be laser photolyzed. Typically,
      less than 20% photolysis was attained with conditions that give essentially full
      photolysis of the carbon monoxide compound. The subsequent monophasic kinetics of
      recombination of cyanide at varying cyanide concentrations were used to determine
      kon, koff, and dissociation constant values at pH 7.0 of 572 +/- 43 M-1 s-1, 4.2
      +/- 0.7 s-1, and 7.3 +/- 1.3 mM, respectively. The dissociation constant changes
      very little in the pH range 6-8, indicating that a proton is bound together with
      the cyanide anion, as predicted by our recent proposal of a requirement for
      electroneutrality in the binuclear center [Mitchell, R., & Rich, P. R. (1994)
      Biochim. Biophys. Acta 1186, 19-26]. Competition studies confirm that cyanide and
      carbon monoxide cannot bind simultaneously, so that their binding sites must
      overlap. A small fraction of the reduced unliganded enzyme appears to have a
      distinct photolysis spectrum in the absence of added ligands, and this is
      transformed into a typical ferrous cyanide compound only at very high cyanide
      concentrations. Cyanide binding and photolysis were also examined in a number of
      mutant forms of cytochrome bo, and in a wild-type form which was partially
      depleted in CuB. Dramatic changes in rate constants and binding constants were
      found in several cases. Data from several mutants were compared with analogous
      data on the binding and photolysis of carbon monoxide, and the effects of
      mutation were quite different with the two ligands. A model is developed to
      explain the observed effects of point mutations on the recombination kinetics of
      both carbon monoxide and cyanide. Overall, the results indicate that the CuB site
      is required for binding of cyanide, but not carbon monoxide, to the reduced
      enzyme, possibly by providing the site for binding of the associated proton.

PMID- 7779804
TI  - Analysis of site-directed mutants locates a non-redox-active metal near the
      active site of cytochrome c oxidase of Rhodobacter sphaeroides.
AB  - Substoichiometric amounts of Mn are bound by the aa3-type cytochrome c oxidase of
      Rhodobacter sphaeroides and appear in the EPR spectrum of the purified enzyme as
      signals that overlay those of CuA in the g = 2.0 region. The Mn is tightly bound
      and not removed by a high degree of purification or by washing with 50 mM EDTA.
      The amount of bound Mn varies with the ratio of Mg to Mn in the growth medium.
      Oxidase containing no EPR-detectable Mn can be prepared from cells grown in low
      Mn/Mg, while high Mn/Mg in the growth medium gives rise to near stoichiometric
      levels (0.7 mol/mol of aa3). Incubation of purified Mn-deficient oxidase with 1
      mM Mn does not allow incorporation into the tight binding site, indicating that
      this site is not accessible in the assembled protein. When bound Mn is depleted
      by growth in high Mg, there is no change in electron transfer activity,
      suggesting that Mg may substituted for Mn and maintain protein structure.
      Analysis of site-directed mutants in an extramembrane loop close to the active
      site of cytochrome oxidase identifies His-411 and Asp-412 of subunit I as
      probable ligands of the Mn. Mutation of either residue leads to lower activity
      and loss of Mn binding, even in cells grown in elevated concentrations of Mn.
      Since Mn binding correlates with the [Mn] to [Mg] ratio in the culture medium, we
      propose that Mn competes for the site that normally binds a stoichiometric Mg ion
      in aa3-type cytochrome c oxidases.

PMID- 7779805
TI  - A continuous wave and pulsed EPR characterization of the Mn2+ binding site in
      Rhodobacter sphaeroides cytochrome c oxidase.
AB  - The ligation environment of the tightly bound Mn2+ in cytochrome c oxidase from
      Rhodobacter sphaeroides has been characterized by electron paramagnetic resonance
      (EPR) and electron spin echo envelope modulation (ESEEM). The EPR data show that
      the Mn2+ is six-coordinate and located in a highly symmetric binding site.
      Analyses of X- and Q-band EPR spectra show that the zero field splitting
      parameter D is 115 +/- 25 G (0.0107 +/- 0.0023 cm-1) in the fully oxidized enzyme
      and 125 +/- 15 G (0.0117 +/- 0.0014 cm-1) in the fully reduced enzyme. For both
      redox forms of the enzyme the value of E is < or = 25 G (0.0023 cm-1). By
      comparison with crystal structures of Mn2+ binding proteins, the structural
      changes at the Mn2+ binding site upon redox state change of the enzyme are
      estimated to be < or = 0.2 A in ligand bond lengths and < or = 10 degrees in bond
      angle. This analysis indicates that little modification occurs at the Mn2+ site
      upon redox change at the other metal centers. Considering the proximity of the
      Mn2+ site to heme a and heme a3-CuB [Hosler, J. P., Espe, M. P., Zhen, Y.,
      Babcock, G. T., & Ferguson-Miller, S. (1995) Biochemistry 34, 7586-7592], we
      interpret these results to imply also that there is no large protein
      conformational change near the heme a and heme a3-CuB sites upon a change in
      their redox states. Multifrequency 3-pulse ESEEM results provide direct evidence
      for a nitrogen ligand to the Mn2+, which is assigned to a histidine by comparison
      with ESEEM studies of Mn(2+)-bound lectins [McCracken, J., Peisach, J.,
      Bhattacharyya, L., & Brewer, F. (1991) Biochemistry 30, 4486-4491] and
      specifically to His-411 in subunit 1 on the basis of mutagenesis studies (Hosler
      et al., 1995). From these results a partial model of the Mn2+ binding site has
      been constructed.

PMID- 7779807
TI  - Molecular dynamics simulations of isolated helices of myoglobin.
AB  - The apo form of myoglobin has two non-native stable states that have been
      experimentally characterized. Investigation of these states has suggested
      possible folding pathways for myoglobin. We have performed molecular dynamics
      simulations on solvated isolated helices of myoglobin to investigate the
      relationship between the intrinsic stabilities of the isolated helices and the
      structure and folding pathway of apomyoglobin. Analyses of hydrogen bonding and
      fluctuations from simulations at 298 and 368 K are used to explore the relative
      stabilities of the helices of myoglobin. The ordering observed is A approximately
      G approximately H > B > E > F, which mirrors both the experimental equilibrium
      and kinetic data available for apomyoglobin. The experimental observation that a
      subdomain comprising helices A, G, and H is an important early intermediate and
      our result that these helices are the most stable suggest that the intrinsically
      more stable helices form early in the folding process and that this significantly
      influences the folding pathway.

PMID- 7779806
TI  - Solution structure of the cytoplasmic domain of phopholamban: phosphorylation
      leads to a local perturbation in secondary structure.
AB  - Peptides representing the N-terminal domain (Ia) of the cardiac sarcoplasmic
      reticulum protein phospholamban (residues 1-25 [PLB(1-25)] and a phosphorylated
      form [pPLB(1-25)]) were synthesized and their conformations examined using
      circular dichroism and nuclear magnetic resonance spectroscopy. In aqueous
      solution, both PLB(1-25) and pPLB(1-25) adopt a primarily disordered
      conformation. In 30% trifluoroethanol/10 mM phosphate, PLB(1-25) exhibits a CD
      spectrum consistent with 60% helical structure. This value decreases to 27% for
      the phosphorylated peptide. CD spectra in 2% SDS indicate 40% alpha-helix for
      PLB(1-25) and 20% for pPLB(1-25). Full chemical shift assignments were obtained
      by conventional homonuclear NMR methodologies for both PLB(1-25) and pPLB(1-25)
      in 30% trifluoroethanol/water and 300 mM SDS. The solution structure of PLB(1-25)
      in 30% TFE/water was determined from distance geometry calculations using 54 NOE
      distance constraints and 17 torsion angle constraints. In the family of 20
      calculated conformers, the root mean square deviation from the mean structure is
      0.79 A for backbone heavy atoms of residues 1-17. The structure comprises a
      regular alpha-helix extending from M1 to S16 with the remaining C-terminal
      residues disordered. The calculated structure is supported by analysis of C alpha
      H secondary shifts which are significantly negative for residues 1-16. Chemical
      shift degeneracy is substantially more extensive in the phospho form and
      precludes a direct comparison of calculated structures. However, the magnitudes
      of upfield secondary shifts are decreased by 20% in residues 1-11 and are not
      significantly helical for residues 12-16 according to the criteria of Wishart et
      al. [(1992) Biochemistry 31, 1647-1651]. 3JHN alpha coupling constants measured
      for I12, R13, A15, and S16 also suggest that residues 12-16 undergo a local
      unwinding of the helix upon phosphorylation. Similar results are obtained for
      PLB(1-25) and pPLB(1-25) in 300 mM perdeuterated sodium dodecyl sulfate except
      that differences in backbone dynamics for the helical and nonhelical regions of
      the peptide are evident in the DQF-COSY line shapes for fingerprint cross-peaks.
      This disruption of structure at the C-terminus of the helix suggests a model for
      phosphorylation-induced dissociation of the PLB/Ca(2+)-ATPase complex.

PMID- 7779808
TI  - Solution structure of the C-terminal single-stranded DNA-binding domain of
      Escherichia coli topoisomerase I.
AB  - Escherichia coli DNA topoisomerase I catalyzes the interconversion of different
      topological forms of DNA. In this paper we describe NMR studies of a 14K C
      terminal fragment of this enzyme that binds preferentially to single-stranded DNA
      and enhances the enzyme's ability to relax negatively supercoiled DNA under high
      salt conditions. The 1H, 13C, and 15N resonances of the protein were assigned
      from a number of heteronuclear multidimensional NMR experiments, and the three
      dimensional structure of the protein was determined from a total of 2188 NMR
      derived restraints. The root-mean-square deviation about the mean coordinate
      positions for residues 13-120 is 0.68 +/- 0.11 A for the backbone atoms and 1.09
      +/- 0.09 A for all heavy atoms. The overall fold, which consists of two four
      stranded beta-sheets separated by two helices, differs from other DNA- and RNA
      binding proteins such as gene 5, cold shock protein, and hnRNP C. From an
      analysis of the changes in chemical shift upon the addition of single-stranded
      DNA, the location of the oligonucleotide binding site was determined. The binding
      site consists of a beta-sheet containing positively charged and aromatic amino
      acids and, in spite of its different structure, is similar to that found in other
      proteins that bind single-stranded oligonucleotides.

PMID- 7779809
TI  - pH-dependent conformations of the amyloid beta(1-28) peptide fragment explored
      using molecular dynamics.
AB  - Molecular dynamics simulations were used to successfully reproduce the
      experimentally observed pH-dependent conformational behavior of a monomeric
      peptide in aqueous solution. Simulations were conducted at 298 K on a peptide
      corresponding to residues 1-28 of the amyloid beta-peptide [referred to as beta(1
      28)], which is the primary component of the plaques associated with Alzheimer's
      disease. beta(1-28) was found to be entirely alpha-helical at low pH. Upon
      deprotonation of acidic residues at medium pH, helical structure was lost in the
      N-terminal region. At high pH, some secondary structure was recovered to yield
      two helices joined by a kink. These results are in good agreement with the NMR
      solution structure at low pH [Zagorski and Barrow (1992) Biochemistry 31, 5621
      5631; Talafous et al. (1994) Biochemistry 33, 7788-7796] and CD and NMR evidence
      of an alpha-helix to beta-sheet transition at mid-range pH [Barrow et al. (1992)
      J. Mol. Biol. 225, 1075-1093]. Additional simulations were also able to
      regenerate folded species from partially unfolded conformers. A mechanism for the
      pH-dependent structural rearrangements is proposed that involves the creation of
      a hydrogen-bonded pair between Ser 8 and Glu 11. The evidence for the existence
      of a multiconformational equilibrium of folded and unfolded species of the
      peptide is discussed.

PMID- 7779810
TI  - Sequence effects on the conformational properties of the amyloid beta (1-28)
      peptide: testing a proposed mechanism for the alpha-->beta transition.
AB  - Molecular dynamics simulations have been used to successfully reproduce the
      observed pH-dependent conformational properties of the amyloid beta(1-28) peptide
      [Kirshenbaum and Daggett (1995) Biochemistry, 34, 7629-7639]. On the basis of
      these simulations a mechanism was proposed for the unfolding of the N-terminal
      portion of the peptide at neutral pH when beginning from the helical
      conformation. It was proposed that interactions between the side chains of Ser 8
      and Glu 11 are important in determining the pH dependence of the helix content.
      Here we further investigate this proposed mechanism and the residues involved in
      the conformational transition by performing computational "mutagenesis" studies.
      On the basis of simulations of the mutant peptides, the importance of the Ser 8
      Glu 11 interaction is substantiated, and further details of the conformational
      transition are elucidated.

PMID- 7779811
TI  - Functional role for Sp1 in the transcriptional amplification of a cell cycle
      regulated histone H4 gene.
AB  - The promoter of the cell cycle regulated histone FO108 H4 gene is mediated by two
      in vivo protein/DNA interaction domains, sites I and II. We have shown previously
      that site II mediates the cell cycle controlled enhancement of H4 gene
      transcription at the G1/S phase boundary. Here we show that site I, an element
      containing both G-rich and ATF-like consensus sequences, confers maximal levels
      of transcription in proliferating cells. By the combined application of gel shift
      assays with site-directed mutagenesis, DNase I footprinting, oligonucleotide
      competition, in vitro expression of recombinant proteins, and specific antibody
      supershift studies, we demonstrate that the proximal G-rich sequence within site
      I interacts with the transcription factor Sp1, while the distal portion of site I
      interacts with members of the ATF family of proteins, including ATF-1. In vitro
      transcription studies as well as expression assays of transiently and stably
      transfected genes in HeLa cells reveal that the deletion of site I causes a
      dramatic decrease in expression. Mutation of the Sp1 element, which abolishes Sp1
      binding, results in a 6-10-fold reduction in reporter activity. In addition,
      overexpression of Sp1 in Sp1-deficient cells results in the dramatic activation
      of the histone promoter. In contrast, mutation of the asymmetric ATF binding
      site, located distally within site I, has a more limited effect upon expression.
      Interestingly, the contribution of the Sp1 site to maximal transcription was cell
      type dependent. Thus, we demonstrate that the Sp1 binding site of the site I
      histone H4 promoter in particular is critical for maximal expression in living
      cells and postulate that this site may act to amplify the cell cycle response.

PMID- 7779812
TI  - Inhibition of nuclear protein binding to two sites in the murine c-myc promoter
      by intermolecular triplex formation.
AB  - The c-myc gene is overexpressed in a variety of tumor types and appears to play
      an important role in the abnormal growth of a number of cell types. In an effort
      to determine the ability of sequence- and species-specific triplex-forming
      oligonucleotides to inhibit expression of a targeted gene in animals, we have
      identified two novel triplex-forming sites in the murine c-myc promoter. One is
      homologous to the triplex-forming human PuF binding element located upstream of
      the P1 transcription start site. The other triplex-forming site is found in a
      region between P1 and P2 that encompasses the ME1a1 binding site and part of the
      E2F binding site and is highly homologous to the human sequence. Synthetic
      oligodeoxyribonucleotides designed to target these essential regulatory elements
      form sequence-specific triple helices as demonstrated by gel mobility shift
      analysis and DNase I footprinting. Polypurine: polypyrimidine regions in the P1
      and P2 promoters form specific protein-DNA complexes upon incubation with a
      murine YC8 nuclear extract. Preincubation of each of the promoter fragments with
      its respective triplex-forming oligonucleotide results in the inhibition of
      nuclear protein binding. Non-triplex-forming oligonucleotides do not
      significantly affect protein binding. The data presented are a preliminary step
      toward generating an animal model for the phenotypic effects of triplex formation
      within the c-myc promoter.

PMID- 7779814
TI  - Stereoelectronic activation of methylenetetrahydrofolate by thymidylate synthase:
      resonance Raman spectroscopic evidence.
AB  - Resonance Raman (RR) spectra are reported for the ternary complex of Escherichia
      coli thymidylate synthase with the cofactor 5,10-methylenetetrahydrofolate (CH2
      H4-folate) and the inhibitor 5-fluoro-2'-deoxyuridylate, excited at 337 or 356
      nm, in resonance with perturbed absorption bands of the p-aminobenzoylglutamate
      (PABA-Glu) portion of the cofactor. For comparison, RR spectra were obtained with
      260 nm excitation for PABA-Glu in various solvents, and for CH2H4-folate and H4
      folate in aqueous solution. These reference spectra are assigned to modes of PABA
      Glu in its benzenoid form. The ternary complex RR spectra are very different,
      however, and are assigned, with the aid of isotopic data, to the PABA-Glu in a
      predominantly quinoid form. Similar spectra were obtained for the ternary
      complexes of the E58Q and K48Q mutants, indicating that neither Glu58 nor Lys48
      are essential for maintaining the quinoid structure, even though their side
      chains complement the dipolar charge distribution of the quinoid form of PABA
      Glu. Since these are the only charged residues in the PABA-Glu vicinity,
      electrostatic stabilization is not essential to maintenance of the quinoid
      structure. It is proposed that quinoid formation results from steric forces,
      probably resulting from the protein conformation change known to accompany
      cofactor binding, which enforce coplanarity of the PABA-Glu ring and
      substituents. This stereoelectronic change activates the cofactor by opening the
      methylene bridge. A second RR spectrum of the ternary complex, previously
      proposed to reflect an alternate structure, is shown to result instead from
      irreversible formation of a laser-induced photoproduct.

PMID- 7779813
TI  - Heteronuclear NMR studies of the interactions of 15N-labeled methionine-specific
      transfer RNAs with methionyl-tRNA transformylase.
AB  - In Escherichia coli the methionylated initiator methionyl-tRNA (tRNAfMet) is
      formylated on the aminoacyl moiety by the enzyme methionyl-tRNA transformylase.
      The methionylated elongator methionyl-tRNA (tRNAmMet) is not modified in this
      way. In order to gain structural information about this specific recognition,
      solution NMR studies were carried out. To be able to identify changes that were
      occurring in the tRNA molecule on interaction with the methionyl-tRNA
      transformylase, the imino protons involved in secondary and tertiary base pairing
      in the tRNAfMet and tRNAmMet molecules first had to be assigned to specific
      resonances in the NMR spectra. A combination of 2D NOESY, 2D HMQC, and 3D NOESY-
      HMQC spectra were used on uniformly 15N-labeled samples. After assignment of the
      base pairs of the tRNA, the two forms of tRNA were separately mixed with
      transformylase in a 1:1 molar ratio. The HMQC spectra of both the tRNAmMet and
      the tRNAfMet showed general broadening, but in the tRNAfMet HMQC spectra a
      decrease in the intensity of several resonances was also observed. These
      resonances had been assigned to the acceptor stem of the tRNA, confirming site
      directed mutagenesis experiments that it is the acceptor stem of the tRNA which
      is important in conferring the specificity for the transformylase. The loss of
      intensity of the acceptor stem resonances suggests that this part of tRNAfMet
      melts upon binding to the enzyme.

PMID- 7779815
TI  - Resonance Raman characterization of the binary and ternary complexes of
      thymidylate synthase with 5-nitrodeoxyuridylate.
AB  - Resonance Raman (RR) spectra are reported for the binary complex of Escherichia
      coli thymidylate synthase (TS) with the substrate analog inhibitor 5
      nitrodeoxyuridylate (NDU). The TS/NDU binary complex RR spectrum shows many
      similarities to the RR spectra of thiol adducts of NDU or of 5-nitro-1
      methyluracil formed in solution, providing strong evidence in support of the
      formation of a covalent link between Cys146 of TS and C6 of NDU. Spectral
      differences between the model compounds and the binary complex reflect the
      consequences of fixing the conformations of the uracil and ribose rings at the
      enzyme active site. The RR spectra of the ternary complexes of TS/NDU with either
      tetrahydrofolate (H4-folate) or the cofactor 5,10-methylenetetrahydrofolate
      (CH2H4-folate) show that a covalent link is not formed between C11 of CH2H4
      folate and C5 of NDU. Neither does the methylene bridge of CH2H4-folate remain
      intact in the ternary complex; either CH2H4-folate is present as the N5 iminium
      cation species or the methylene group is lost as formaldehyde. A shift in the NO2
      symmetric stretching frequency in the ternary complex indicates expulsion of
      water molecules from the region of the NO2 group by the cofactor.

PMID- 7779816
TI  - Involvement of histidine-91 of the beta subunit in proton translocation by the
      pyridine nucleotide transhydrogenase of Escherichia coli.
AB  - The pyridine nucleotide transhydrogenase (EC 1.6.1.1) carries out transmembrane
      proton translocation coupled to transfer of a hydride equivalent between NAD+ and
      NADP+. Mutations were made in histidine-91 of the beta subunit of the pyridine
      nucleotide transhydrogenase of Escherichia coli. This amino acid is the only
      conserved charged residue in the transmembrane domains of this enzyme and thus
      potentially is involved in proton translocation by the transhydrogenase. The
      mutant beta H91N retained 80% of the hydride transfer activity while proton
      translocation was reduced to 7%. This behavior is consistent with a role for beta
      His91 in the proton translocation pathway. Other mutations at this residue
      affected the conformation of the enzyme. Thus, the enzyme in mutants beta H91C,
      beta H91T, and beta H91S was unable to undergo the conformational change that
      occurred on binding of the substrates NADP+ or NADPH. By contrast, the enzyme in
      the beta H91K mutant was present in the NADP(H)-induced conformation even in the
      absence of these substrates. Further evidence for the linkage between beta His91
      and the conformation of the beta subunit was obtained by labeling the
      transmembrane domain of the beta subunit with [14C]N,N'-dicyclohexylcarbodiimide
      (DCCD). Labeling occurred most readily with the enzyme of beta H91K. It is
      concluded that beta His91 is a component of the proton translocation pathway of
      the transhydrogenase and that its state of protonation is probably linked to
      conformational changes induced by binding/debinding of substrates during the
      catalytic cycle of the enzyme.

PMID- 7779817
TI  - Effect of lipid packing on the conformational states of purified GLUT-1 hexose
      transporter.
AB  - The purpose of this study was to determine the effect of increased lipid packing
      on the conformational states of the GLUT-1 hexose transporter purified in
      endogenous lipids. The binding of glucose results in a conformational change that
      can be followed by a decrease in fluorescence intensity. Lipid packing was
      increased by subjecting the samples to hydrostatic pressure. We have found that
      in the absence of ligand, the fluorescence intensity decreased approximately 20%
      in the 600 bar range studied. In the presence of either saturating or half
      saturating amounts of D-glucose, a substantial loss in intensity (approximately
      80%) was observed. Similar decreases were also seen the presence of a glucose
      analog, maltose, or a noncompetitive inhibitor, cytochalasin B. Changes in the
      accessibility of aqueous soluble quenchers (I- and acrylamide) to GLUT-1 Trp and
      Tyr residues suggested that ligand binding causes interfacial fluorophores to
      move closer to ionic groups in the lipid head group region of the membrane. This
      idea was substantiated by (1) increased static quenching of the GLUT-1
      fluorophores in the presence of ligand, (2) increased energy transfer efficiency
      between GLUT-1 fluorophores and a fluorescent membrane probe located close to the
      head group region, and (3) reduced change in rotational motion with temperature
      in the presence of ligand. Since the application of pressure results in an
      increase in bilayer thickness, and ligand binding causes a population of
      fluorophores to move closer to the membrane surface, then these interfacial
      interactions can be more stabilized under pressure. Studies monitoring the change
      in quenching of membrane probes by GLUT-1 tryptophans and energy transfer of GLUT
      1 tryptophans to membrane probes support this idea.

PMID- 7779818
TI  - Synthetic peptides corresponding to the four P regions of Electrophorus
      electricus Na+ channel: interaction with and organization in model phospholipid
      membranes.
AB  - The hydropathy plot of the alpha subunit of the voltage-gated Na+ channel reveals
      four homologous repeats, each of which is homologous to Shaker type K+ channel
      monomer and contains six putative transmembrane segments and a hydrophobic
      segment within the loop connecting transmembrane segments S5 and S6. Current
      models predict that the four homologous segments [designated H5 or P regions
      (PR)] from the S5-S6 loop of each repeat lie in the aqueous pore. Peptides
      corresponding to the P regions of the four domains of the Electrophorus
      electricus (eel) Na+ channel (25-36 aa long, designated as PR-I, PR-II, PR-III,
      and PR-IV) and a 23-mer preceding PR-II (designated pre-PR-II) were synthesized
      and fluorescently labeled. The segments were then structurally and functionally
      characterized for their interaction with phospholipid membranes. Although the
      sequences of the four P regions are significantly different, they all bind to
      zwitterionic phospholipid membranes with similar partition coefficients
      (approximately 10(4) M-1). The pre-PR-II does not bind membranes at all.
      Resonance energy transfer measurements, between donor/acceptor-labeled pairs of
      peptides, revealed that besides the PR-I/PR-III pair, all other pairs form
      heteroaggregates but do not coassemble with unrelated membrane-bound peptide.
      Circular dichroism (CD) spectroscopy revealed that PR-I, PR-II, and PR-III adopt
      similar partial alpha-helical structures (approximately 30%) in 40%
      trifluoroethanol and in solutions of 1% sodium dodecylsulfate (SDS). The PR-IV
      (36 aa) adopts approximately 18% alpha-helical structure, and pre-PR-II gives a
      low CD signal. These findings are in line with proposed models in which the P
      regions are packed in close proximity in the lumen of the hydrophobic core of the
      channel. Furthermore, the finding that the PRs adopt similar partial alpha
      helical structures in two different hydrophobic environments might suggest that
      partial alpha-helical structures also exist in the native channel as proposed by
      recent models. The results are discussed in terms of proposals that various
      regions of membrane proteins participate in driving folding or oligomerization of
      the parent molecules.

PMID- 7779819
TI  - Functional significance of beta gamma-subunit carboxymethylation for the
      activation of phospholipase C and phosphoinositide 3-kinase.
AB  - The gamma subunits of heterotrimeric G proteins are isoprenylated and methylated
      at their carboxyl-terminal cysteine residues. Since methylation is the only
      reversible reaction in the isoprenylation pathway, it could be a site of
      regulation of G protein activity. beta gamma subunits have been shown to activate
      a number of effectors involved in signal transduction pathways. The methyl group
      of retinal transducin (T) can be hydrolyzed by an immobilized form of pig liver
      esterase, allowing for a direct determination of the activities of methylated and
      demethylated T beta gamma. The abilities of methylated and demethylated T beta
      gamma to stimulate G protein regulated phosphatidylinositol-specific
      phospholipase C (PIPLC) and phosphoinositide 3-kinase (PI3K) were determined. It
      is reported here that there is a strong dependence on methylation for activating
      both PIPLC and PI3K. Demethylated T beta gamma is at least 10-fold less active
      than its methylated counterpart. Therefore, methylation may play an important
      role in the regulation of these effectors and of signal transduction processes in
      general.

PMID- 7779820
TI  - An improved version of the hairpin ribozyme functions as a ribonucleoprotein
      complex.
AB  - Most RNA molecules that are endowed with catalytic activity function in the form
      of ribonucleoproteins within cells. These complexes are frequently large, poorly
      defined, and difficult to study. As a model system to study biological catalysis
      by ribonucleoproteins, we have modified the hairpin ribozyme by inserting an RNA
      structure that serves as a binding site for bacteriophage R17 coat protein in the
      form of an extension to ribozyme helix 4, which lies at the periphery of the
      catalytic domain. In the absence of protein, we find that incorporation of the
      protein-binding domain increases the catalytic efficiency of the hairpin ribozyme
      by 2-fold for the cleavage reaction and 16-fold for the ligation reaction. This
      increase in activity correlates with an increase in the proportion of molecules
      which fold into the active tertiary structure, as measured by a UV cross-linking
      assay. Mobility-shift and filter-binding assays of complex formation show that
      R17 coat protein binds to the chimeric ribozyme with a dissociation constant
      essentially identical to that of the isolated protein-binding domain; no binding
      of the protein to the unmodified ribozyme could be detected. The kinetics of
      cleavage and ligation reactions are not altered by the presence of saturating
      concentrations of coat protein, and competition studies demonstrate that the
      protein remains bound to the ribozyme throughout the catalytic cycle. These
      studies establish that the hairpin ribozyme can be engineered to function
      efficiently in the form of a ribonucleoprotein in vitro and will serve as the
      basis for future experimentation to understand mechanisms of protein modulation
      of catalytic RNA activity, and to introduce other protein-binding domains, for
      example, HIV-1 rev-binding and tar elements, which may be useful for influencing
      subcellular localization, regulating intracellular activity, or generating
      ribozymes that also function as "decoys" in antiviral applications.

PMID- 7779821
TI  - Nature of the inactivation of elastase by N-peptidyl-O-aroyl hydroxylamine as a
      function of pH.
AB  - The mechanism of inactivation of porcine pancreatic elastase (PPE) by N-peptidyl
      O-aroylhydroxylamine was studied by X-ray crystallography. The inactivator forms
      a stable complex with the enzyme by means of a covalent attachment to the active
      site Ser 203(195) O gamma. The nature of the complex is, however, different
      depending on the pH at which the inactivation reaction occurs. At pH 5, the
      complex formed is a hydroxylamine derivative of Ser 203(195) in which the O gamma
      of serine is the oxygen of the hydroxylamine derivative. At pH 7.5, the complex
      formed is a carbamate derivative at Ser 203(195) O gamma. In both types of
      complexes, the inactivator binds in the S' subsites of the enzyme instead of
      forming the usual antiparallel beta-sheet with the S subsites. The implication
      for the mechanism of inactivation at different pHs is discussed.

PMID- 7779822
TI  - Role of asparagine 152 in catalysis of beta-lactam hydrolysis by Escherichia coli
      AmpC beta-lactamase studied by site-directed mutagenesis.
AB  - The role of asparagine 152 in the catalytic mechanism of Escherichia coli AmpC
      beta-lactamase has been investigated by site-directed mutagenesis. The residue
      has been replaced by aspartic acid, glutamic acid, histidine, and leucine. All
      the substitutions had similar effects on the activity toward substrates and
      inhibitors. The rate of substrate hydrolysis decreased by factors of 500-5000.
      The rates of both acylation (2-50-fold decrease) and deacylation (50-500-fold
      decrease) were affected, indicating a role for Asn152 in both processes. The wild
      type AmpC beta-lactamase appears to exist as an equilibrium mixture of two forms,
      identified by their different kinetic properties. The Asn152 mutations affected
      the activity of the slow-reacting form much more than that of the fast-reacting
      form, but they did not appear to affect the interconversion of these two kinetic
      forms. Comparison of these observations with results obtained with mutation of
      the equivalent residues in other classes of penicillin-sensitive enzyme indicates
      that there are quite profound differences between the catalytic mechanisms of
      these enzymes despite a high degree of conservation of amino acids in the active
      center, and of the overall three-dimensional structure.

PMID- 7779823
TI  - Lignin peroxidase-catalyzed oxidation of sulfonated azo dyes generates novel
      sulfophenyl hydroperoxides.
AB  - Lignin peroxidase (LiP) is an extracellular enzyme produced by the lignin
      degrading fungus Phanerochaete chrysosporium and is involved in azo dye
      degradation by this organism. In this study, LiP oxidation of the sulfonated azo
      dyes 4-(4'-sulfophenylazo)-2,6- dimethylphenol (I), Orange II [1-(4'
      sulfophenylazo)-2-naphthol] (II), a dimethyl analog of Orange II [1-(2',6'
      dimethyl-4'-sulfophenylazo)-2-naphthol] (III), and 4-(4'-sulfonamidophenylazo)
      2,6-dimehtylphenol (IV) was examined. Azo dye I was oxidized to 2,6-dimethyl-1,4
      benzoquinone and 4-sulfophenyl hydroperoxide. Orange II (II) was oxidized to 1,2
      naphthoquinone and 4-sulfophenyl hydroperoxide. The dimethyl analog of Orange II
      (III) was oxidized to 1,2-naphthoquinone and 2,6-dimethyl-4-sulfophenyl
      hydroperoxide. Azo dye IV was oxidized predominantly to 2,6-dimethyl-1,4
      benzoquinone and another product, tentatively characterized as 4
      sulfonamidophenyl hydroperoxide. In the 18O-labeling studies with 18O2, oxygen
      incorporation into the phenyl hydroperoxides from the oxidation of I and III was
      observed. A mechanism for azo dye degradation consistent with product
      identification and the 18O-labeling studies is proposed. Two successive one
      electron oxidations of the phenolic ring of an azo dye by the H2O2-oxidized forms
      of LiP produces a carbonium ion. Then water attacks the phenolic carbon bearing
      the azo linkage, producing an unstable hydroxy intermediate which breaks down to
      yield a quinone and a sulfo- or sulfonamidophenyldiazene. The phenyldiazene is
      oxidized by O2 to generate the corresponding phenyldiazene radical, which
      eliminates N2 to yield a sulfo- or sulfonamidophenyl radical. O2 scavenges the
      latter to yield the corresponding hydroperoxide.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779824
TI  - Lignin peroxidases can also oxidize manganese.
AB  - The peroxidase isozymes secreted by the white rot fungus Phanerochaete
      chrysosporium include lignin peroxidases and manganese-dependent peroxidases. The
      major isozymes, called lignin peroxidases, are thought to oxidize chemicals
      directly. The manganese-dependent peroxidases (H3, H4, H5, and H9) are relatively
      minor, making up only a fraction of the total peroxidase protein. However, we
      have found that lignin peroxidases will also catalyze the H2O2-dependent
      oxidation of Mn2+ to Mn3+. We have used lignin peroxidase isozyme H2 (LiPH2) to
      characterize the manganese peroxidase activity of lignin peroxidases. Transient
      state kinetic studies were used to obtain a second-order rate constant of 4.2 x
      10(4) M-1 S-1 for the reaction of LiPH2-compound I with free or chelated Mn2+ at
      pH 6.0. This reaction was too fast to monitor at pH 4.5. Only chelated Mn2+ could
      reduce LiPH2-compound II to ferric enzyme. The Mn(2+)-chelate (oxalate) first
      bound LiPH2-compound II with a Kd of (1.5 +/- 0.3) x 10(-5) M and then reduced
      LiPH2-compound II to ferric enzyme with a first order rate constant of 215 +/- 6
      S-1. Steady-state kinetic studies on LiPH2 were performed by directly monitoring
      the formation of Mn(3+)-oxalate. These results show that oxidation of Mn2+ by a
      lignin peroxidase does not occur through free radical mediation as proposed
      previously [Popp et al. (1990) Biochemistry 29, 10475-10480). Electron spin
      resonance and oxygen evolution studies also indicate that Mn2+ is directly
      oxidized by LiPH2.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779825
TI  - Abortion services for adolescents: who will provide them?

PMID- 7779826
TI  - Attention deficit disorder during adolescence: a review.
AB  - Attention deficit disorder (ADD) in adolescents has received scant attention when
      compared with that given to children. With or without hyperactivity, ADD does not
      disappear at puberty and is an important factor in scholastic and social failure
      in adolescents. As a condition associated with decreased metabolism in the
      premotor and prefrontal superior cerebral cortex, ADD in adolescents responds
      well to treatment with stimulants, tricyclic antidepressants and monoamine
      oxidase inhibitors. Nonpharmacologic modalities such as behavior modification,
      individual and family therapy, and cognitive therapy are useful adjuncts to
      psychopharmacologic management. Without effective treatment, ADD often results in
      increased risk of trauma, substance abuse and conduct and affective disorders
      during adolescence, and marital disharmony, family dysfunction, divorce, and
      incarceration in adulthood. Properly treated with medication and counseling,
      adolescents with ADD succeed as well as their peers.

PMID- 7779827
TI  - Informed consent in children and adolescents: age, maturation and psychological
      state.
AB  - PURPOSE: The purpose of this investigation was to examine the relationship of
      understanding of research participation to anxiety, control, and stage of
      cognitive development. METHODS: Participants included 44 boys and girls ages 7 to
      20 years. All were inpatients for the first time in pediatric units of a research
      hospital. Twenty participants were admitted for experimental treatment of
      pediatric cancers and 24 were admitted for a 3-week treatment of extreme obesity.
      An interview was conducted to assess 12 elements of knowledge of research
      participation of a medical protocol. The interview was coded for: 1) knowledge of
      research participation score, 2) weighted knowledge of participation in research
      score (based on physician ratings of what was most-to-least important for
      children and adolescents to know), and 3) global control (perceived control over
      life, illness and treatment). A measure of anxiety and one Piagetian task to
      measure stage of cognitive development also were administered. RESULTS: Pearson
      correlations, significant at p < or = .05, were as follows: knowledge of
      participation in research and global control, (r = .40) and weighted knowledge of
      participation in research score and global control (r = .38). Hierarchical
      regression showed that the best predictors of knowledge of research participation
      or the weighted knowledge of research participation score was global control
      alone or an interaction of global control with anxiety. CONCLUSIONS: Emotional
      factors were more frequently related to understanding of research participation
      than age or cognitive development. Providing medical environments that decrease
      anxiety and increase control may enhance children's and adolescent's
      understanding of the research process.

PMID- 7779828
TI  - Relationship of alcohol expectancies to problem drinking among college women.
AB  - PURPOSE: To evaluate the stability of expectancies about alcohol and their
      ability to prospectively explain drinking patterns and the occurrence of alcohol
      related problems among college freshman women. METHODS: College women (n = 120)
      completed a standardized measure of expectations and subjective evaluations of
      positive and negative outcomes associated with drinking and a questionnaire
      assessing drinking patterns and common alcohol-related problems at both the
      beginning and end of the school year. Ninety percent of the students were
      Caucasian with a mean age of 17.9 years (SD = 0.5). RESULTS: Students' positive
      and negative outcome expectations and their subjective evaluations at the
      beginning of the year were significantly correlated with drinking patterns at the
      end of the year (p's < .05). During the year, students at low risk for problem
      drinking developed stronger positive attitudes toward the effects of alcohol upon
      courage, became less concerned about potential behavioral impairment, and
      perceived less negative effects upon self-perception. High risk students showed a
      significant decline in their positive attitudes toward the effects of alcohol
      upon their sociability. Expectancies about alcohol at the beginning of the school
      year explained 33% of variance in subsequent drinking (F = 6.17; p < .0004) and
      20% of the variance in alcohol-related problems occurring during the year (F =
      3.26; p < .02). Outcome evaluation scales at the beginning of the year explained
      more variance in subsequent drinking and alcohol-related problems than did
      outcome expectation scales. CONCLUSIONS: Alcohol outcome expectations and their
      subjective evaluations were relatively stable across the freshman year for these
      college women. Alcohol expectancies on entry into college explained significant
      amounts of variability in drinking behavior and the occurrence of alcohol-related
      problems during the subsequent freshman year. Students' attitudes toward
      perceived outcomes may be more important than the perceived likelihood of the
      outcomes themselves.

PMID- 7779829
TI  - Family and peer influences on smoking behavior among American adolescents: an age
      trend.
AB  - PURPOSE: To study the age trend of family and peer influence on adolescent
      smoking behavior using a national sample. METHODS: Adolescents (N = 6,900), ages
      14 through 18 years, from the 1988-89 Teenage Attitudes and Practices Survey,
      were selected for analyses. Data collected included measures for smoking status
      of the adolescent and their family and peers. RESULTS: Peer influence, such as
      the smoking status of best male/female friends, proved to be the most significant
      and consistent predictor across all ages, while parental influence had little
      effect on adolescent smoking status. Gender-specific effects were noted in the
      peer influence of adolescent smoking. CONCLUSIONS: The peer influence on
      adolescent smoking, across ages 14 through 18 years, confirmed previous
      literature. However, no differential effect of family and peer influence on
      adolescent smoking was evident.

PMID- 7779830
TI  - The self-image of adolescents with cystic fibrosis.
AB  - PURPOSE: The changing expectations, therapies and outcomes for young people with
      cystic fibrosis (CF) necessitate a re-evaluation of the impact of this chronic
      illness on adolescent development. The aim of this study was to assess the
      psychological well-being and adjustment of contemporary adolescents with CF.
      METHODS: Forty-nine adolescents with CF (24 males, 25 females) aged 14-18 years
      were enrolled from the Royal Children's Hospital CF Clinic, Melbourne, Australia.
      The Offer Self-Image Questionnaire was administered to participating subjects
      whose growth and pubertal developmental and pulmonary function was assessed.
      RESULTS: The mean (SD) FEV1% was 82 (21), and mean (SD) National Institute of
      Health clinical score was 81 (12). There were no significant differences between
      males and females in pulmonary function or clinical scores, but growth and
      pubertal development were delayed in both sexes. Females, but not males, with CF
      were less well-adjusted than their healthy peers. Two-way analysis of variance
      was performed and showed significant sex differences in sub-scales of the Offer
      questionnaire numbers I, II, III, VI, VIII, IX, as well as in the total score.
      Age was significant only for scales II and VIII, and only scale II displayed an
      interaction between sex and age. CONCLUSIONS: This study suggests that adjustment
      and self-esteem are less than ideal in young people with CF, especially females.

PMID- 7779831
TI  - Fighting as a marker for multiple problem behaviors in adolescents.
AB  - PURPOSE: Behaviors that put adolescents at risk frequently occur together. To
      help identify high-risk adolescents, we analyzed a national, self-reported
      behavior survey of high school students to assess the suitability of fighting as
      a marker for students with multiple problem behaviors. METHODS: A cross-sectional
      cluster survey of 11,631 U.S. high school students in 1990 was used to compare
      the prevalence of recent problem behaviors among all students and those who
      fight. RESULTS: One (8%) of every 12 students was in a fight during the 30 days
      before the survey. Reported problem behaviors were prevalent among fighters:
      during the previous 12 months, 24% attempted suicide; during the previous 30
      days, 26% carried a firearm, 13% used cocaine, and 39% drove a motor vehicle
      while intoxicated; during the previous 3 months 41% had two or more sex partners;
      and 45% had sexual intercourse and did not use a condom the last time they had
      sex. Of all students, fighters accounted for 22% of those who reported attempting
      suicide, 49% carrying a firearm, 46% using cocaine, 18% driving while
      intoxicated, 25% having sex with multiple partners, and 11% not using condoms.
      Three or more of these six problem behaviors were reported by 26% of the
      fighters. The problem behaviors were all positively correlated, and the first
      principal component accounted for 35% of the total variation among the individual
      variables.

PMID- 7779832
TI  - The co-morbidity of violence-related behaviors with health-risk behaviors in a
      population of high school students.
AB  - PURPOSE: To describe the frequency of violence-related behaviors and their
      association with other health behaviors among high school students. METHODS: The
      Youth Risk Behavior Survey was administered to all ninth and eleventh graders (n
      = 2075) of a school district in Texas. It provided information regarding violence
      related behaviors and other health behaviors. Students were classified into four
      mutually exclusive, violence-related categories according to whether they were
      involved in a physical fight and/or carried a weapon. RESULTS: Overall, 20% of
      the students were involved in a physical fight but had not carried a weapon, 10%
      carried a weapon but had not been involved in a physical fight, and 17% had been
      involved in a physical fight and had carried a weapon. Prevalence of weapon
      carrying and fighting were higher among males than females, and among ninth
      graders than eleventh graders. Among males, 48% had carried a weapon the month
      prior to the survey. Students who both fought and carried a weapon were 19 times
      more likely to drink alcohol six or more days than students who did not fight nor
      carried a weapon. Logistic regression analyses showed that drinking alcohol,
      number of sexual partners, and being in ninth grade were predictors of fighting.
      These three variables plus having a low self-perception of academic performance
      and suicidal thoughts were predictors of fighting and carrying a weapon.
      CONCLUSIONS: The data indicate that violence-related behaviors are frequent among
      high school students and that they are positively associated with certain health
      behaviors. Interventions designed to reduce violence should also address
      coexisting health-risk behaviors and target high-risk groups.

PMID- 7779834
TI  - Effects of long term treatment with sertraline (Zoloft) simulating hypothyroidism
      in an adolescent.
AB  - A 16-year-old depressed adolescent, who had received sertraline treatment for the
      previous 18 months, developed insomnia, daytime somnolence and lack of energy.
      His thyroid function tests revealed low levels of total T4 with normal levels of
      free T4 and TSH, and a normal thyrotropin-releasing hormone (TRH) stimulation
      test. Discontinuing sertraline resulted in improved sleep and disappearance of
      daytime somnolence. Although daytime somnolence and low levels of total T4 can
      mimic hypothyroidism, in this case sertraline only displaced the bound-fraction
      of total T4 and was not associated with true hypothyroidism.

PMID- 7779833
TI  - Self-reported health problems and physical symptomatology in adolescent alcohol
      abusers.
AB  - PURPOSE: Few studies have examined the impact of alcohol abuse on the health
      status of adolescents. The purpose of this investigation was to determine whether
      adolescents with a diagnosis of alcohol abuse differed from controls on the
      frequency of self-reported health problems, clinical signs and symptoms detected
      upon clinical examination, and liver injury test results. METHODS: Cases were
      ascertained from in-patient drug and alcohol treatment centers. Age- and sex
      matched controls were recruited from community sources. The Health Problems
      Checklist (HPC) was used to measure self-reported problems; the clinical
      examination was performed by a physician or a physician's assistant. RESULTS:
      Alcohol-abusing adolescents reported significantly more physical symptoms than
      did controls as measured by the HPC. The results of the clinical examination
      revealed a low prevalence of overt abnormalities in both groups, however, alcohol
      abusing adolescents reported a higher frequency of appetite changes, weight loss,
      eczema, headaches and episodes of loss of consciousness than did controls. As
      expected, alcohol-abusing adolescents had significantly higher levels of ALT, AST
      and GGTP as compared to controls. CONCLUSIONS: The findings of this study are
      generalizable only to in-patient adolescent alcohol abusers. In this study,
      alcohol abuse was also associated frequently with psychiatric disorders, drug
      abuse, cigarette smoking, and low parental education. Future studies using larger
      sample sizes should address the importance of social environmental and behavioral
      variables in moderating the relationship between alcohol abuse and decreased
      health status in adolescents.

PMID- 7779835
TI  - Sexual histories of adolescent girls: comparison between interview and chart.
AB  - PURPOSE: The purpose of this study is to determine the reliability of sexual
      histories obtained from adolescents and the adequacy of chart documentation by
      providers of adolescent health care. METHODS: Responses to an interview by a
      female research assistant about sexual activity were compared to chart-documented
      sexual histories taken by physicians and nurse practitioners. The setting was an
      urban, hospital-based adolescent clinic. The subjects were 106 females, 15-18
      years old; 82% were African-American and 18% Caucasian. RESULTS: Significant
      correlations between interview and chart were seen for information about
      menarche, age at first intercourse, number of sexually transmitted diseases
      (STDs), and number of sexual partners. Accuracy of reporting sexually transmitted
      infections varied according to the organism; HPV infection was underreported more
      than other infections. Chart documentation of sexual histories was inadequate.
      CONCLUSIONS: Adolescents generally provide reliable sexual histories, but health
      care providers may not be documenting these histories adequately.

PMID- 7779836
TI  - Identifying adolescent drug users: results of a national survey on adolescent
      health in Switzerland.
AB  - OBJECTIVE: To explore the proportion and characteristics of adolescents who use
      illicit drugs and contrast them with adolescents who do not use such drugs in
      Switzerland. To facilitate the detection of adolescents with drug related
      difficulties. METHODS: We used data from a national survey on adolescent health
      in Switzerland (N = 9,273) conducted in 1992 and 1993. The survey is based on
      self-administered questionnaires among a representative sample of adolescents
      enrolled in schools and apprenticeship programs. We used exploratory analysis for
      identifying characteristics which set the drug user apart from non-users and
      performed confirmatory multivariate logistic regression analysis to examine which
      variables remain independently associated with heroin or cocaine use. RESULTS: In
      Switzerland, 3.1% of adolescents have taken heroin or cocaine at least once in
      their life, and 27.7% have already used cannabis. Analysis of lifestyles and
      health of adolescents show that young drug users present difficulties in
      integrating in society, have health problems and difficulties in relationships,
      situations which tend to be less common among other adolescents. Yet, they also
      display marked similarities, most notably in that over 70% had seen a physician
      in the past year. However, while 40% of the drug users expressed a need for help
      with drug related problems, only 6% had actually talked about them with a
      physician. Characteristics that remained independently associated with heroin and
      cocaine use after controlling for confounding factors were age, sex, nationality,
      type of education, feelings of suicide, past and present smoking, and use of
      cannabis. CONCLUSION: The level of illicit drug use among Swiss adolescents is
      high compared to other European countries but lower than the United States. Drug
      using adolescents display a constellation of characteristics which should make it
      possible to identify them and offer help. Yet, even though they may have frequent
      contact with the health services, their drug problems are generally not
      recognized by the gatekeepers of the health services and no specific aid is
      available to them. Drug prevention must be intensified and medical doctors
      sensitized to the drug problems which adolescents may face.

PMID- 7779837
TI  - Induction of adhesion molecules on the endothelia of rejecting cardiac
      allografts.
AB  - BACKGROUND: Adhesion of leukocytes to vascular endothelium and their migration
      from the circulation into underlying tissue is regulated by an array of inducible
      cell adhesion molecules. We determined the kinetics and expression patterns of
      adhesion molecules expressed by the endothelia of rat cardiac allografts
      including the following: major histocompatibility complex class II (OX6),
      intercellular adhesion molecule-1 (1A29), vascular cell adhesion molecule-1
      (5F10), leukocyte function-associated antigen-1 alpha-chain (WT.1), the common
      beta-chain of beta 2 integrins (WT.3), and very late activation antigen-4 (HP2.1)
      on inflammatory cells. METHODS: Intraabdominal heterotopic cardiac allografts (n
      = 12) were transplanted from the dark agouti (DA) rats (AG-B4, RT1a) to the
      Wistar-Furth (WF) rats (AG-B2, RT1v) strain and syngeneic controls (n = 12) were
      transplanted from dark agouti rat donors to dark agouti rat recipients. The
      grafts were removed 1, 3, and 5 days after transplantation, and cryostat sections
      were prepared for indirect immunoperoxidase staining with monoclonal antibodies.
      The intensity of adhesion molecule expression was scored from 0 to 3 in a blind
      review. RESULTS: In nontransplanted dark agouti rat hearts, intercellular
      adhesion molecule-1 was constitutively expressed at a low level on capillary (0.5
      +/- 0.5) and postcapillary venular (0.5 +/- 0.2) endothelia. In syngeneic
      controls, the expression of intercellular adhesion molecule-1 and vascular cell
      adhesion molecule-1 was also faint and not induced, but a clear induction of
      class II expression was found on capillary endothelia. Large vessels stained
      negative for adhesion molecules. In allografts, intercellular adhesion molecule-1
      and vascular cell adhesion molecule-1, but not class II, were significantly
      upregulated on capillary endothelia (p < 0.05). On postcapillary venular
      endothelia, a distinct induction (p < 0.05) of all three molecules was observed
      during acute rejection 5 days after transplantation. Concomitantly, the
      inflammatory leukocytes expressed high levels of leukocyte function-associated
      antigen-1 alpha-chain and beta-chain in the perivascular space. The expression of
      very late activation antigen-4 by lymphocytes was, however, nonexistent. In
      allograft arteries and arterioles, class II and vascular cell adhesion molecule
      1, but not intercellular adhesion molecule-1, were weakly expressed during acute
      rejection. CONCLUSIONS: Our results suggest that postcapillary venular endothelia
      may be the major site for leukocyte extravasation during acute cardiac allograft
      rejection in the rat model.

PMID- 7779838
TI  - Pretransplantation seronegative Epstein-Barr virus status is the primary risk
      factor for posttransplantation lymphoproliferative disorder in adult heart, lung,
      and other solid organ transplantations.
AB  - BACKGROUND: The relative importance and interrelationship of risk factors for
      posttransplantation lymphoproliferative disorder are poorly understood. METHODS:
      The prospective pretransplantation serologic testing for Epstein-Barr virus of
      all nonrenal solid organ transplant recipients at our institution made it
      possible to assess the relative risk for posttransplantation lymphoproliferative
      disorder in seropositive and seronegative recipients. RESULTS: Fourteen cases of
      lymphoproliferative disorder were identified in the first 389 consecutive
      transplant recipients (288 liver, 44 heart, 20 lung, 37 kidney-pancreas)
      undergoing transplantation from 1985 to 1992 (mean follow-up 33 months). The
      incidence rates of lymphoproliferative disorder (per 100 person-years) during the
      first 2 years after transplantation (a period in which all cases occurred) were
      1.4 for liver, 2.0 for heart, 6.2 for lung, and 5.2 for kidney-pancreas
      transplant recipients and were significantly different between liver and lung (p
      = 0.005) and liver and kidney-pancreas (p = 0.002) groups. Of 367 seropositive
      patients, lymphoproliferative disorder developed in only three. The incidence
      rate ratios between seronegative and seropositive recipients were as follows: 76
      ([95% confidence interval; 46, 144], p = 0.0000) for any form of
      lymphoproliferative disorder and 145 ([60, 347], p = 0.0000) for fatal or brain
      forms. The incidence rate of lymphoproliferative disorder was significantly
      higher for seronegative recipients who required antilymphocyte antibody therapy
      for rejection than for those who received none. CONCLUSIONS: The high intrinsic
      risk for lymphoproliferative disorder in the Epstein-Barr virus seronegative
      patient, which is amplified by higher levels of immunosuppression, may, in some
      instances, preclude transplantation.

PMID- 7779839
TI  - Use of exercise electrocardiography, technetium-99m-MIBI perfusion tomography,
      and two-dimensional echocardiography for coronary disease surveillance in a low
      prevalence population of heart transplant recipients.
AB  - BACKGROUND: Coronary artery disease has been reported to be a significant cause
      of long-term morbidity and mortality after heart transplantation. However, the
      diagnosis of coronary disease by means of noninvasive procedures has shown
      disappointing accuracy, and many centers currently recommend an annual
      surveillance coronary angiogram. METHODS: We prospectively studied the accuracy
      and feasibility of a symptom-limited upright bicycle exercise, combined with
      computerized electrocardiogram analysis, echocardiography, and perfusion
      scintigraphy in 37 consecutive heart transplant recipients at 2.8 +/- 1.4 years
      after transplantation for routine follow-up coronary angiography. RESULTS: No
      patient had any hemodynamically significant (> 50% diameter) coronary stenosis,
      but luminal irregularities were detectable in four patients. The exercise
      electrocardiogram was interpretable in only 22 patients (59%), and two of the
      remaining patients (9%) had false-positive results. The feasibility of perfusion
      tomography (100%) and two-dimensional echocardiography (97%) were greater than
      for stress electrocardiogram (p < 0.001 and p < 0.01 respectively). False
      positive results were obtained at stress echocardiography in one patient (3%),
      and at scintigraphy in six patients (16%, p = not significant). None of these
      methods detected coronary artery stenoses of less than 50% diameter. CONCLUSIONS:
      Both exercise perfusion tomography and two-dimensional echocardiography are
      feasible and can be used with adequate specificity for the noninvasive diagnosis
      of coronary artery disease in heart transplant recipients. However further
      studies are needed to determine their respective sensitivity.

PMID- 7779841
TI  - Heart transplantation in the United Kingdom: who waits longest and why.
AB  - BACKGROUND: This study aims to identify characteristics that increase the chance
      of death of potential cardiac transplant recipients before donor organs become
      available. METHODS: Between June 1, 1988, and May 31, 1993, 332 patients were
      accepted for heart transplantation; 235 underwent surgery. Ninety-seven patients
      had not received transplants; of these, 71 died, 13 were transferred to other
      lists, and 13 were awaiting organs at the close of the study. Median waiting time
      for those patients who received organs was 109 days, whereas patients who did not
      receive organs spent a median of 94 days on the list. Recipients are matched to
      donor organs according to blood group, size (height), and, recently, preoperative
      transpulmonary pressure gradient. Recently cytomegalovirus antibody mismatches
      (positive donor to negative recipient) have been avoided where possible. These
      factors, together with age, gender, underlying diagnosis, previous heart surgery,
      and Toxoplasma antibody status were studied to assess their influence on waiting
      time and survival. RESULTS: No characteristics were found significantly to
      influence survival after acceptance, so that the chance of death while the
      patient was waiting for heart transplantation is mainly affected by the severity
      of disease and the length of time a patient waits. In multivariate analyses the
      following were independently significantly associated with shorter waiting times:
      small patients (< 1.7 m tall; p = 0.005), patients with blood types B and AB (p =
      0.003), and patients with cardiomyopathy (p < 0.001). CONCLUSIONS: These results
      can be used by cardiologists to help assess the time at which a patient should be
      referred for transplantation.

PMID- 7779842
TI  - Assessment of forced expiratory volume in one second-fraction of the engrafted
      lung with 133-Xe radiospirometry improves the diagnosis of bronchiolitis
      obliterans syndrome in single lung transplant recipients.
AB  - BACKGROUND: Staging of bronchiolitis obliterans syndrome is based on the decline
      of forced expiratory volume in 1 second, a measure of overall ventilatory
      capacity. A single staging system is applied to all lung recipients, regardless
      of the bias which can be caused by the native lung after single lung
      transplantation. METHODS: We determined the decline of graft function in single
      lung recipients by a combination of two methods: 133-Xe radiospirometry and
      dynamic spirometry. The forced expiratory volume in 1 second fraction of the
      transplant (FEV1tx) was calculated from the proportion of ventilation of the
      transplant (Vtx) and forced expiratory volume in 1 second. Eight single lung
      recipients were followed up for a median observation period of 17 months;
      bronchiolitis obliterans syndrome developed in four of them. RESULTS: The
      fractional decline of forced expiratory volume in 1 second of the transplant was
      significantly greater than the decline of forced expiratory volume in 1 second (p
      = 0.016) in all patients during the follow-up. In the patients with bronchiolitis
      obliterans syndrome, the mean decline in forced expiratory volume in 1 second was
      1.1 L (39.5%), and in forced expiratory volume in 1 second of the transplant it
      was 0.9 L (55.8%). The measurement of forced expiratory volume in 1 second of the
      transplant suggested stage 2a and 3a dysfunction in two grafts in which the
      assessment of forced expiratory volume in 1 second indicated stage 1a
      bronchiolitis obliterans syndrome. In one patient, decrease of forced expiratory
      volume in 1 second of the transplant was suggestive of chronic dysfunction 4
      months before it was diagnosed by biopsy and declined lung function. CONCLUSIONS:
      The assessment of forced expiratory volume in 1 second seems to underestimate the
      severity of chronic dysfunction in single lung grafts. Instead, the determination
      of forced expiratory volume in 1 second of the transplant with radioactive
      tracers provides selective information of the graft function, which could be used
      for clinical evaluation of bronchiolitis obliterans syndrome in single lung
      recipients.

PMID- 7779840
TI  - Transcoronary and pulmonary vascular dynamics of endothelin-1 in heart transplant
      recipients.
AB  - BACKGROUND: Endothelin-1, a potent endothelium-derived vasoconstrictor peptide,
      has recently been shown to be elevated in heart transplant recipients and may be
      a participant in posttransplantation vasculopathy. METHODS: We measured
      peripheral venous endothelin-1 concentrations in eight heart transplant
      recipients and eight age- and gender-matched healthy controls. Subsequently, in
      21 transplant recipients, right atrial, aortic, and coronary sinus plasma was
      obtained and endothelin-1 levels were measured. Potential correlations to donor
      and recipient age, cyclosporine levels, hemodynamic parameters, donor heart
      ischemic time, time from transplantation, and serum creatinine were examined. In
      eight more patients, right atrial levels of endothelin-1 were measured before and
      after endomyocardial biopsy to examine the effect of this procedure on endothelin
      1 concentrations. RESULTS: Peripheral endothelin-1 concentrations were
      significantly higher in heart transplant recipients (45.6 +/- 1.8 versus 25.8 +/-
      2.3, p < 0.001). Multiple regression analysis showed a significant correlation
      between right atrial endothelin-1 and pulmonary artery systolic pressure (r =
      0.48), as well as serum creatinine (r = 0.52). No relation to blood pressure,
      right atrial pressure, pulmonary vascular resistance, recipient age, cyclosporine
      levels, or donor heart ischemic time was observed. In 11 patients, a 38% +/- 7%
      fall in endothelin-1 levels across the pulmonary bed was observed, suggesting
      extraction across the lung in these subjects. Nine patients had net release of
      endothelin-1 (95% +/- 26% rise) across the coronary vascular bed, whereas 12
      patients showed net extraction (24% +/- 4% fall). Endomyocardial biopsy had no
      influence on endothelin-1 levels (prebiopsy: 48.3 +/- 1.7; postbiopsy: 42.3 +/-
      2.34; p = Not significant). CONCLUSION: These findings suggest that endothelin-1
      levels in transplant recipients may be influenced by renal function and may
      contribute to pulmonary hypertension. The significance of transcardiac release of
      endothelin in some patients is unclear: further studies are needed to determine
      the pathophysiologic significance of endothelin-1 in heart transplant recipients.

PMID- 7779843
TI  - Dobutamine thallium 201 perfusion imaging in candidates for lung transplantation.
AB  - BACKGROUND: Thallium-201 stress imaging is the most often used noninvasive test
      for detection of coronary artery disease. Its utility in patients with end-stage
      lung disease has not been defined. METHODS: Feasibility, safety, and reliability
      of thallium 201 perfusion imaging was evaluated in 23 consecutive candidates for
      lung transplantation. All underwent graded dobutamine thallium 201 single photon
      emission computed tomography imaging. The perfusion imaging results were
      correlated with results of coronary angiography, radionuclide angiography, and
      right heart catheterization. RESULTS: The testing was completed without
      complications in all patients. No perfusion abnormality was detected in five
      patients, and none had evidence of coronary artery disease on coronary
      angiography. In 18 patients with abnormal thallium 201 imaging, coronary artery
      disease was detected in four patients only, and no angiographic data was
      available in three patients. Thus, in at least 11 of 23 patients, thallium 201
      imaging was falsely positive. There was a trend toward lower left ventricular
      ejection fraction in patients with abnormal thallium 201 imaging. No correlation
      was found between thallium 201 results, pulmonary artery and right atrial
      pressures at rest. Possible noncoronary origin of the perfusion defects include
      the following (1) presence of sarcoid in the myocardium, (2) left ventricular
      attenuation by hypertrophied right ventricle, and (3) altered left ventricular
      anatomy, function, and coronary perfusion as a result of right ventricular
      pressure overload. CONCLUSIONS: Dobutamine thallium 201 stress test can be safely
      performed in lung transplant candidates. However, its specificity for detection
      of coronary artery disease is low. Selective use of coronary angiography in
      patients with multiple risk factors is likely a more cost-effective approach.

PMID- 7779844
TI  - Evaluation of ischemic heart disease in potential lung transplant recipients.
AB  - BACKGROUND: The prevalence of coronary artery disease in potential lung
      transplant recipients has not been extensively studied. Given the limited donor
      supply, a high degree of sensitivity for detecting occult disease is essential.
      METHODS: This retrospective study examined both the clinical indications for
      coronary angiography and the extent of coronary arteriosclerotic disease in 105
      consecutive potential lung transplant candidates. RESULTS: Fifty-one patients
      (49%) underwent angiography to either exclude asymptomatic atherosclerosis (n =
      46) or define the extent of known symptomatic ischemic heart disease (n = 5). The
      perceived risk of occult disease according to a semiquantitative coronary risk
      assessment score that included hypertension, hyperlipidemia, diabetes, smoking, a
      family history of coronary artery disease, and electrocardiographic or
      echocardiographic abnormalities influenced the decision to perform angiography: 4
      of 44 patients (9%) with two or fewer risk factors underwent angiography versus
      42 of 56 patients (75%) with more than two risk factors (p < or = 0.05). A higher
      risk factor score also correlated with angiographic evidence of coronary artery
      disease. In the 46 patients without symptoms who were studied, two
      hemodynamically significant but unsuspected coronary lesions were identified. Six
      other patients without symptoms had noncritical (< 50%) lesions. Among the five
      patients with angina or a prior myocardial infarction, coronary angiography
      showed either minimal atherosclerosis (n = 2) or non-life threatening anatomy (n
      = 3). Angiographic findings did not exclude any patient from transplant listing.
      CONCLUSION: Coronary angiography appears most useful in patients without symptoms
      with multiple coronary risk factors and in a subset of patients who might
      otherwise be excluded from lung transplantation because of a history of
      symptomatic cardiovascular disease.

PMID- 7779845
TI  - Acute lung injury in lung allografts.
AB  - BACKGROUND: Acute alveolar injury is a pathologic description of a nonspecific
      response of the lung to an acute injury. It has been our experience that acute
      alveolar injury may be seen in transbronchial biopsy and open lung biopsy
      specimens from patients who have successfully undergone lung transplantation.
      Because no studies of the clinical significance of acute alveolar injury in lung
      transplant recipients are available in the literature, we reviewed the impact of
      this pathologic finding in patients who underwent transplantation in the Toronto
      Lung Transplant Program. METHODS: From November 1983 through December 1992, we
      retrospectively reviewed all transbronchial biopsies and open lung biopsies
      performed in lung transplant recipients. RESULTS: Of the 137 transplantations
      performed (53 single and 84 double) acute alveolar injury was observed in 21
      single (34 of 173 transbronchial biopsy and 3 of 11 open lung biopsy) lung
      biopsy) and 22 double (38 of 415 transbronchial biopsy and 3 of 11 open lung
      biopsy) lung transplantations. We sought to explain this finding on the basis of
      the concurrent clinical scenario. Acute alveolar injury occurred most commonly in
      association with infection (52%) followed by postoperative period (19%) and acute
      (16%) rejection. Acute alveolar injury occurred as an isolated finding in 7% of
      patients. It occurred within the first 4 months after transplantation in 80% of
      cases. In 10 of 21 single lung transplantations and 12 of 22 double lung
      transplantations, acute alveolar injury was seen at least twice. However, no
      difference was found in mortality between such patients (6 of 10 single and 6 of
      12 double lung transplantations) and patients with only one episode of acute
      alveolar injury. CONCLUSION: Acute alveolar injury is a relatively common finding
      in histologic specimens from patients with lung transplantation and is most
      commonly associated with infection.

PMID- 7779846
TI  - Improved outcome of rat lung transplantation with modification of the nonsuture
      external cuff technique.
AB  - BACKGROUND: The development of lung transplantation in inbred rats has simplified
      immunologic studies concerning lung allografts. Unfortunately, up to now, such
      models have been limited by the high level of surgical expertise required.
      METHODS: In this study 92 rats underwent left lung transplantation with a
      simplified cuff technique. The feasibility and reliability of this technique was
      determined by examining graft patency through the use of gross and histologic
      examination, angiography, and bronchography. RESULTS: On gross examination,
      grafts looked well perfused and ventilated. Histologic examination showed little
      evidence of foreign body reaction against the Teflon cuff devices, and
      angiography showed no abnormalities; however, bronchography did show signs of
      airway stricture at the site of the anastomosis. CONCLUSION: We conclude that the
      nonsuture external cuff technique with Teflon devices represents a reliable,
      safe, and fast method for performing orthotopic left lung transplantation in the
      rat.

PMID- 7779847
TI  - Pulmonary vasodilatory properties of prostaglandin E1 are blunted after
      experimental single lung transplantation.
AB  - BACKGROUND: Pulmonary dysfunction and right heart failure are still a common
      clinical problem after single lung transplantation. METHODS: In this study we
      investigated the pulmonary vasodilatory properties of prostaglandin E1 in pigs
      during the first 4 hours after left lung allotransplantation. With the use of
      extracorporeal circulation and total right heart bypass, the right and left
      pulmonary arteries could be individually perfused and the drug effect in each
      lung separately analyzed either at equal blood pressures or at equal blood flows
      in the pulmonary arteries. Twelve animals received in a randomized double-blind
      fashion either saline solution or an increasing prostaglandin E1 infusion (10,
      25, 50, and 100 ng/kg/min; 15 minutes each). After a drug-free period of 75
      minutes, the infusion schedule with 25, 50, and 100 ng/kg/min was repeated.
      RESULTS: During the first part of the study the highest dose of prostaglandin E1
      decreased the mean systemic arterial pressure by 25%, but an almost similar
      decrease occurred in the control animals. During the second infusion period a 28%
      decrease was observed only in the animals treated with prostaglandin E1. None of
      the infusions was able to decrease pulmonary vascular resistance. Instead
      prostaglandin E1 diverted two thirds of the pulmonary blood flow toward the
      native lung, and this diversion manifested itself as an earlier improvement of
      the arterial oxygen tension in the drug-treated animals. The end-tidal carbon
      dioxide values measured from each lung corresponded to those from the common
      expiratory limb of the system, but there was a distinct gradient in the range of
      14 to 20 mm Hg between the arterial and end-tidal carbon dioxide values.
      CONCLUSIONS: We conclude that prostaglandin E1, in doses tolerated by the
      systemic circulation, is ineffective in the treatment of the increased pulmonary
      vascular resistance after single lung transplantation.

PMID- 7779849
TI  - Heterotopic heart transplantation for elevated pulmonary vascular resistance in
      pediatric patients.
AB  - BACKGROUND: The presence of significant elevation of pulmonary vascular
      resistance is a major risk factor for death after orthotopic heart
      transplantation. The choice of procedure for the pediatric patient remains
      contentious. METHODS: We report three pediatric patients with pulmonary
      hypertension and raised pulmonary resistance, including two infants, in whom
      heterotopic transplantation was performed with smaller donor hearts. The hearts
      were anastomosed to provide left ventricular support alone because predominant
      left ventricular failure was present, the pulmonary resistance was expected to
      fall gradually after surgery, and we wished to avoid the potential problems of a
      pulmonary conduit associated with growth and possible reoperation. RESULTS: The
      clinical results have been satisfactory in all three patients, who were well and
      without symptoms. No pulmonary compromise was observed in the smaller thoracic
      cavity of the two infants. The transpulmonary gradient fell in all three
      patients, although this reduction was not immediate. CONCLUSIONS: This technique
      in carefully selected recipients can allow safer transplantation in pediatric
      patients with elevated pulmonary resistance, can increase the donor pool by
      allowing use of smaller hearts and nonideal donors, and may reduce the mortality
      on the transplant waiting list by providing earlier transplantation.

PMID- 7779848
TI  - A new flush solution for extended lung preservation.
AB  - BACKGROUND: The aim of this study was to compare the effect of the most
      frequently used clinical preservation solution (Euro-Collins, group I) with a
      newly composed low potassium, glucose- and insulin-containing preservation
      solution (141 mmol/L sodium, 6.4 mmol/L potassium, 119 mmol/L chloride, 5 mmol/L
      magnesium, 10 gm/L glucose, 10 gm/L dextrane and 20 U/L insulin) (group II) on
      postischemic lung function. METHODS: We studied 12 isolated New Zealand White
      rabbit lungs in a closed circuit model during the first 4 hours of reperfusion
      after 24 hours of ischemic hypothermic storage. RESULTS: Oxygenation capacity,
      defined by the difference between the arterial and venous oxygen tension was
      significantly higher in group II compared with group I after 10 (58.7 +/- 5.8
      versus 34.9 +/- 7.5 mm Hg), 30 (63.5 +/- 7.8 versus 27.3 +/- 10.4 mm Hg) and 180
      minutes (77.7 +/- 7.2 versus 8.8 +/- 5.6 mm Hg). Ventilatory pressure was
      significantly lower in group II after 1 minute (11.3 +/- 1.3 mm Hg versus 13.7 +/
      0.5 mm Hg, p < 0.05), with no significant difference thereafter. No significant
      difference was found in pulmonary vascular resistance except after 20 minutes
      (30.8 +/- 1.2 dyns/cm5 [group I] versus 27.1 +/- 1.1 dyns/cm5 [group II], p <
      0.05). CONCLUSION: These data suggest that this new solution provides superior
      lung function after 24 hours ischemic time compared with Euro-Collins solution.

PMID- 7779850
TI  - A valid experimental brain death organ donor model.
AB  - BACKGROUND: This study was designed to establish a validated canine brain death
      model. Ten consecutive dogs were studied to investigate the effects of brain
      death on hemodynamic, metabolic, and hormonal function. METHODS: Brain death was
      induced by inflation of a subdurally placed balloon and was validated
      neuropathologically. Functional data and blood samples were collected before and
      15, 45, 90, 240, 360, and 420 minutes after the induction of brain death. No
      inotropic or vasoactive support was given. The results are expressed as mean +/-
      standard error of the mean. RESULTS: The Cushing reflex occurred in all animals
      and lasted 13.3 +/- 1.5 minutes. Raised catecholamine levels were documented at
      15 minutes, whereas the pituitary gland hormones vasopressin and
      adrenocorticotrophic hormone decreased significantly after 15 and 45 minutes,
      respectively. Triiodothyronine, thyroxine, and glucagon decreased significantly
      from 0.58 +/- 0.05 ng/ml, 2.20 +/- 0.15 micrograms/dl, and 49.7 +/- 9.1 pg/ml to
      0.34 +/- 0.03 ng/ml (p < 0.05 versus baseline; paired two-tailed t-test), 1.14 +/
      1.14 micrograms/dl (p < 0.05), and 6.9 +/- 1.4 pg/ml (p < 0.05). Insulin and
      lactate dehydrogenase showed a moderate increase after brain death. Diabetes
      insipidus occurred after 45 minutes in nine animals (urine output 13.5 +/- 1.8
      ml/kg/hour). Left and right ventricular end-diastolic pressure increased
      significantly toward the end of all experiments. Cardiac output increased and
      systemic and pulmonary vascular resistance decreased, but heart rate remained
      unchanged. CONCLUSION: This simple, reproducible, moderately invasive, and
      reliable model of brain death in animals assesses donor organ function and
      preservation. Cushing reflex, hyperdynamic state, catecholamine storm,
      vasopressin and adrenocorticotropic hormone cessation, total cerebral necrosis,
      and diabetes insipidus were consistent findings.

PMID- 7779851
TI  - Does the mode of donor death influence the early outcome of lung transplantation?
      A review of lung transplantation from donors involved in major trauma.
AB  - BACKGROUND: Pulmonary dysfunction, often delayed in presentation, is among the
      sequelae of major trauma. Transplantation of lungs from donors involved in major
      trauma therefore carries a risk of early graft dysfunction. This study was
      conducted to assess this risk. METHODS: A retrospective comparison of the outcome
      from 123 donors (57 donors resulting from major trauma, group T, and 66 donors
      with nontraumatic origin, group NT) in 125 consecutive technically successful
      lung or heart-lung transplantations. Variables analyzed included the following:
      clinical and bacteriologic details of donors and indexes of early graft
      dysfunction in the recipients. RESULTS: Group T donors were more likely to be
      younger and male (p < 0.05) and more likely to have had lung ventilation for over
      48 hours (p < 0.05) than group NT donors. Microbial contamination of routine
      donor bronchial lavage (72 of 122, 61%) was no higher in group T (34 of 57, 60%),
      but, in this group, enteric gram-negative bacilli were more common (30% versus
      7%; p < 0.05). Male patients were more likely to receive lungs from group T
      donors (35 male, 23 female), and female patients were more likely to receive
      lungs from group NT donors (27 male, 40 female). Mode of donor death did not
      affect the following indexes of early graft function: length of postoperative
      ventilation, ratio of arterial oxygen tension to fractional concentration of
      inspired oxygen at 1 or 24 hours after transplantation, or the incidence of
      diffuse alveolar damage in lung biopsy specimens at 7 days. Thirty-day mortality
      (28%) was no higher among recipients of group T lungs, but six recipient deaths
      were donor-related (donor-transmitted pneumonia in five and donor acquired fat
      embolism in one case). CONCLUSION: The use of donors involved in major trauma
      does not increase the risk of early complications after lung transplantation
      providing their specific characteristics are recognized.

PMID- 7779852
TI  - Lack of successful reanimation of pig hearts harvested more than 10 minutes after
      death.
AB  - BACKGROUND: The aim of this study was to evaluate the viability of arrested pig
      hearts harvested after animal death. METHODS: Hearts (n = 25) were preserved for
      2 hours by cold storage (4 degrees C) with St. Thomas' cardioplegic solution no
      warm ischemia (0 minutes; control) or 10, 20, 30, or 60 minutes of in situ warm
      ischemia (animal exsanguination). Hearts were then reperfused for 1 hour with
      whole blood with an in vitro functional testing system. Left ventricular
      developed pressure and coronary flow were measured during reperfusion. Energetic
      compound measurements and histologic analysis were performed on tissue biopsy
      specimens. RESULTS: After 10- and 20-minute warm ischemia, hearts showed a
      significant decrease in energetic compounds, a 51% and 73% decreases of left
      ventricular developed pressure, and 38% and 65% decreases in coronary flow,
      respectively. After 30 minutes hearts showed irreversible ischemic injury with
      ultrastructural tissue damage, a large decrease in energetic adenine nucleotide
      compounds, and an inability to beat more than 15 minutes after reperfusion.
      CONCLUSION: We conclude that in contrast with other species, pig hearts harvested
      10 minutes or more after animal exsanguination fail to be successfully
      reanimated.

PMID- 7779853
TI  - Heat shock protein-induced T-lymphocyte propagation from endomyocardial biopsies
      in heart transplantation.
AB  - BACKGROUND: Recent studies have shown that heat shock proteins can be recognized
      by T cells during various immunologically mediated inflammatory processes.
      Injurious stimuli to cells induce an increased production of heat shock proteins
      which could lead to their cell surface expression and subsequent recognition by
      the immune system. We have postulated that allograft infiltrating cells may
      recognize heat shock proteins, especially during rejection. METHODS: This
      hypothesis was tested by incubating heart transplant biopsy specimens from 89
      heart transplant recipients with soluble Mycobacterium tuberculosis extracts, a
      source of heat shock proteins or recombinant mycobacterial heat shock protein 65.
      T cell phenotypes were determined by flow cytometry. RESULTS: Mycobacterium
      tuberculosis extract can induce lymphocyte propagation from heart transplant
      biopsy specimens especially during rejection. A highly significant correlation
      was seen between Mycobacterium tuberculosis extract and interleukin-2-induced
      lymphocyte growth and an accelerated growth was seen for cultures incubated with
      Mycobacterium tuberculosis extract + interleukin-2. A second series of
      experiments has also shown the propagation of lymphocytes induced by recombinant
      mycobacterial heat shock protein-65. T-cell phenotype analysis of biopsy
      propagated lymphocytes has shown higher frequencies of CD8 cells in Mycobacterium
      tuberculosis extract and heat shock protein-65 propagated lymphocytes from early
      posttransplantation biopsy specimens, whereas, later on, most cultures showed a
      predominance of CD4 cells. T-cell receptor gamma delta cells were more frequently
      found in biopsy-derived lymphocyte cultures from long-term survivors, especially
      after propagation with Mycobacterium tuberculosis extract and heat shock protein
      65. These gamma delta cells expressed primarily the delta 1 rather than the gamma
      9 phenotype. CONCLUSIONS: These observations provide first evidence for the
      presence of heat shock protein-reactive lymphocytes in cellular infiltrates of
      transplants undergoing rejection.

PMID- 7779854
TI  - Activation of intravascular macrophages within myocardial small vessels is a
      feature of acute vascular rejection in human heart transplants.
AB  - BACKGROUND: We investigated the pathogenesis of acute vascular rejection by
      performing immunofluorescent screening on frozen sections for C1q, C3c, and
      immunoglobulin M in endomyocardial biopsy specimens from all new heart
      transplants. METHODS: Immunofluorescence for C4c, C5, immunoglobulin G, and
      immunoglobulin A was performed on all positive endomyocardial biopsy specimens.
      Twenty-eight positive endomyocardial biopsy specimens from six patients were
      identified, and 22 of those were studied with transmission electron microscopy.
      RESULTS: Endothelial hyperplasia and myocyte necrosis were prominent in the five
      female patients with positive immunofluorescence. In addition, macrophages with
      ultrastructural cytologic features of activation were seen filling capillaries
      and venules in intimate contact with endothelium and exiting those vessels.
      Activated macrophages were large cells with abundant cytoplasm and ruffled
      borders and contained numerous lysosomes, rough endoplasmic reticulum, and
      mitochondria. Intravascular activated macrophages were identified in five of six
      patients with positive immunofluorescence but were not seen in any of the
      endomyocardial biopsy specimens with negative immunofluorescence, including
      multiple examples of moderate (grades 2 to 3B) and severe (grade 4) acute
      cellular rejection. In the five female patients with activated macrophages, acute
      vascular rejection recurred multiple times with one fatality. Review of the files
      showed three additional, similar cases. The one male patient with positive
      immunofluorescence but without activated macrophages had only a single episode of
      acute vascular rejection. CONCLUSIONS: Complement and antibodies can activate
      macrophages, so this finding is not surprising. To the best of our knowledge,
      this is the first report of the intravascular activation of macrophages, and the
      first association of this process with acute vascular rejection. Activated
      macrophages may contribute to myocyte necrosis in acute vascular rejection by
      compromising blood flow in small vessels.

PMID- 7779856
TI  - Comparison of myocardial cell injury in acute cellular rejection versus acute
      vascular rejection in cyclosporine-treated heart transplants.
AB  - BACKGROUND: Myocyte necrosis has been cited as a key feature in the diagnosis and
      classification of both moderate and severe acute cellular rejection
      (International Society for Heart and Lung Transplantation grades 3A to 4).
      However, our previous work suggests that myocyte necrosis is not a typical
      feature of cellular rejection. METHODS: To clarify this point and to elucidate
      differences between cellular rejection and acute vascular rejection, we compared
      the light and electron microscopic features of 35 consecutive endomyocardial
      biopsy specimens from six patients with acute vascular rejection diagnosed with
      positive immunofluorescence, 12 consecutive endomyocardial biopsy specimens from
      three patients with mixed acute vascular rejection and cellular rejection, and
      435 endomyocardial biopsy specimens of International Society for Heart and Lung
      Transplantation grades 2 to 4 cellular rejection. RESULTS: Endomyocardial biopsy
      specimens from eight of nine patients with acute vascular rejection and mixed
      acute vascular rejection/cellular rejection exhibited classic myocyte necrosis as
      the typical form of myocardial cell injury. Myocyte necrosis was characterized by
      lysis of the sarcolemma, marked swelling of mitochondria, and intramitochondrial
      flocculent densities. In contrast, the typical form of myocardial cell injury in
      cellular rejection was reversible. Reversible cellular rejection was
      characterized by extensive loss of myosin filaments and Z-lines with
      subsarcolemmal and intracytoplasmic accumulation of Z-band material. Cell
      swelling, mitochondrial swelling, intramitochondrial densities, and lysis of
      sarcolemma were not observed. CONCLUSIONS: We conclude that myocyte necrosis is a
      characteristic feature of acute vascular rejection, whereas reversible myocardial
      cell injury is characteristic of cellular rejection, including grade 4. Myocyte
      necrosis is not a feature of cellular rejection. The presence of true myocyte
      necrosis in endomyocardial biopsy specimens from cyclosporine-treated heart
      transplants implicates some process other than cellular rejection. Processes
      producing myocyte necrosis include acute vascular rejection, peritransplantation
      ischemia, and accelerated atherosclerosis.

PMID- 7779855
TI  - Intragraft monitoring of rejection after prophylactic treatment with monoclonal
      anti-interleukin-2 receptor antibody (BT563) in heart transplant recipients.
AB  - BACKGROUND: Anti-interleukin-2 receptor monoclonal antibodies have been used
      successfully in the prevention of rejection in cardiac allografts in several
      animal models. METHODS: In an open randomized study murine monoclonal CD3
      antibody and BT563, a murine anti-interleukin-2 receptor monoclonal antibody,
      were given as rejection prophylaxis during the first week after heart
      transplantation. Cyclosporine therapy was initiated at the third postoperative
      day. RESULTS: In half the BT563-treated patients an early rejection was
      histologically shown at week 1, whereas heart transplant recipients treated with
      murine monoclonal CD3 antibody had a rejection incidence at week 1 of only 9%.
      During BT563 treatment CD25-positive cells (i.e., cells bearing the interleukin-2
      receptor) were not detectable in peripheral blood. However, immunohistologic
      studies of endomyocardial biopsy specimens taken 1 week after transplantation
      showed the presence of CD25-positive cells within these specimens in 8 of 10
      (80%) of patients with rejection. In patients without rejection CD25-positive
      cells were present in the biopsy specimens of only two of nine patients (22%).
      Reverse-transcriptase polymerase chain reaction studies on biopsy material showed
      the presence of messenger RNA for the interleukin-2 receptor in all and for
      interleukin-2 in three of five (60%) of biopsy specimens of rejecting grafts.
      CONCLUSIONS: Although CD25-positive cells were not detectable in peripheral blood
      during BT563 treatment, these cells were at the same time found to be present
      within 80% of the endomyocardial biopsy specimens from the rejecting grafts. By
      initiating cyclosporine treatment at day 0, the synergistic effect of combining
      cyclosporine and anti-interleukin-2 receptor monoclonal antibodies may result in
      a lower rejection incidence.

PMID- 7779857
TI  - Factors affecting the integrity of latissimus dorsi muscle grafts: implications
      for cardiac assistance from skeletal muscle.
AB  - BACKGROUND: Severe latissimus dorsi muscle damage may compromise cardiomyoplasty
      performance. We analyzed factors underlying the damage produced in 20 sheep
      latissimus dorsi muscles by isolating the influences of electrical stimulation,
      mobilization (with some loss of vascular supply), loss of normal resting tension,
      or a combination of these. METHODS: In group I (n = 3), the muscle was mobilized
      except for its neurovascular pedicle and reattached at normal resting length. In
      group II (n = 3), the muscle was mobilized and reattached at about 80% of resting
      length. Groups III (n = 6) and IV (n = 4) were as groups I and II except that
      continuous indirect stimulation at 2 Hz was added after 2 weeks. In group V (n =
      4), the undisturbed muscle received stimulation alone. After 10 to 12 weeks,
      muscle samples were taken for morphometric analysis. RESULTS: Loss of resting
      muscle tension appeared to be the single most damaging intervention, though
      mobilization and stimulation had further deleterious effects. The worst damage
      was seen when all three factors were combined, when 60% of the muscle cross
      section was occupied by connective tissue and fat. The changes were significantly
      more severe in the distal than in the proximal part of the muscle, implicating
      ischemia as a contributory factor. CONCLUSIONS: Fiber damage reduces the
      effectiveness of muscle grafts used for cardiac assistance and merits further
      systematic investigation.

PMID- 7779859
TI  - Changes in health-related quality of life and depression in heart transplant
      recipients.
AB  - BACKGROUND: The intent of this study was to measure health-related quality of
      life and depression in 94 heart transplant recipients. METHODS: Changes in health
      related quality of life and depression were examined by administering the
      Sickness Impact Profile and the Beck Depression Inventory before heart
      transplantation, as well as 4, 8, 12, 24, 36, 48, and 60 months after surgery.
      RESULTS: Sickness Impact Profile scores obtained before heart transplantation
      highlighted the greatest health-related quality of life dysfunction in work,
      sleep and rest, home management, and recreation and pastimes. Posttransplantation
      measures suggested improvement (p < 0.05) in emotional behavior, home management,
      mobility, ambulation, depression, eating behavior, social interaction, body care
      and movement, sleep and rest, recreation and pastimes, depression, and physical,
      overall, and psychosocial functioning. Continued improvement was noted up to 5
      years after transplantation although patients continued to have marked work
      related dysfunction. Age, medication regimen, rejection episodes, and a variety
      of preoperative medical variables were not related to health-related quality of
      life. Actuarial survival rates at 1, 2, 3, 4, and 5 years were 89%, 87%, 80%,
      79%, and 79%, respectively. CONCLUSIONS: Our results suggest that as early as 4
      months after heart transplantation, patients show excellent functioning in most
      health-related quality of life areas. Survival rates are encouraging. Patients
      did not generally experience problems with depression within the first 4 months
      after heart transplantation. Notable problems remain after transplantation in
      rate of return to work where only 53% returned to work by 5 years after heart
      transplantation.

PMID- 7779858
TI  - Heart transplantation charges: status 1 versus status 2 patients.
AB  - BACKGROUND: The current health care environment mandates closer scrutiny of
      health care dollar allocation. To better understand the distribution of heart
      transplantation costs, we reviewed hospital and physician billing of patients who
      underwent orthotopic heart transplantation between August 1988 and September
      1993. METHODS: This study is a retrospective review of 107 consecutive cases.
      Charges and clinical results of United Network for Organ Sharing status 1
      patients (n = 46), including 17 bridge to transplantation patients, were compared
      with those of United Network for Organ Sharing status 2 patients (n = 57).
      Charges were converted to 1992 dollars. RESULTS: During the first 12 months of
      the study, 77% of heart transplantations were performed in United Network for
      Organ Sharing status 2 patients, whereas over the last 12-month period, 25% of
      the transplantations were performed in status 2 patients. No significant
      differences were found in age, gender, type of cardiomyopathy, or survival
      between the status 1 and status 2 groups. The length of hospitalization for the
      status 1 group ranged from 8 to 138 days (mean 49 days) as opposed to 5 to 82
      days (mean 17.5 days) for the status 2 group (p < 0.0001). Pretransplantation
      hospital charges were significantly higher for the status 1 group ($47,917 to
      $341,215, mean $109,116) when compared with status 2 ($0 to $10,035, mean $250)
      (p < 0.0001). No significant difference was found in posttransplantation hospital
      charges between status 1 ($47,917 to $210,027, mean $95,379) and status 2
      patients ($48,093 to $380,745, mean $102,265). Total charges were significantly
      higher (p < 0.0001) for the status 1 group ($89,910 to $512,331, mean $239,375)
      when compared with the status 2 group ($63,885 to $455,680, mean $128,594). Total
      transplantation charges for the study period were $18,341,108. This amount could
      have paid for 77 status 1 transplantations or 143 status 2 transplantations.
      CONCLUSIONS: If current trends continue and the donor pool remains the same, most
      transplant recipients will be status 1, resulting in a comparable number of
      transplantations performed at twice the charges.

PMID- 7779860
TI  - Experience with heart transplantation for cardiac tumors.
AB  - BACKGROUND: Primary cardiac tumors are rare clinical entities. Benign tumors are
      often amenable to surgical excision, whereas malignant tumors are seldom
      resectable. Five patients have been reported to undergo orthotopic heart
      transplantation for inoperable primary cardiac tumors. We review the clinical
      course of these five patients and present our institutional experience with three
      patients who underwent orthotopic heart transplantation as primary therapy for
      unresectable cardiac tumors. METHODS: Retrospective chart review and telephone
      interview, when possible, were used to gather historical and clinical course
      data. RESULTS: Of the eight patients who underwent orthotopic heart
      transplantation for primary cardiac neoplasms, four had malignant tumors (three
      sarcomas, one lymphoma) and four had locally invasive neoplasms (three fibromas,
      one pheochromocytoma). For those patients in whom cardiectomy resulted in
      surgical margins free of tumor (six of eight), orthotopic heart transplantation
      provided long-term survival (range 14 to 78 months) without tumor recurrence
      despite therapeutic immunosuppression. The only death in this group, at 6.2 years
      after operation, was unrelated to tumor recurrence. The patients with tumor
      identified at the surgical margins died of metastatic disease at 14 and 15 months
      after the operation in spite of adjuvant chemotherapy. CONCLUSIONS: An awareness
      by clinicians of the presenting clinical picture of these tumors is warranted in
      view of the potential for cure by resection or transplantation. Patients with
      benign primary cardiac tumors appear to benefit from the complete resection
      afforded by cardiectomy and transplantation. The role of transplantation for
      patients with malignant tumors remains unclear. Additional studies and continued
      follow-up with serial echocardiography is necessary to further ascertain the role
      of heart transplantation in the management of patients with primary cardiac
      tumors.

PMID- 7779861
TI  - Potential mechanism of vasomotor dysregulation after lung transplantation for
      primary pulmonary hypertension.
AB  - BACKGROUND: Vasomotor regulation in the lung is controlled by a dynamic balance
      between humoral factors and autonomic innervation. Lung transplantation is a
      unique clinical situation in which vasoregulation is dependent on humoral factors
      alone. METHODS: We illustrate the problem of vasomotor dysregulation with a lung
      transplant recipient in whom life-threatening hypoxemia was dramatically reversed
      with the administration of organic nitrates. The potential mechanism for this
      dysregulation was explored by exposing human endothelial cells to hypoxic
      conditions in vitro and analyzing the cells for the expression of pulmonary
      vasoconstrictor gene transcripts. RESULTS: The hypoxic microenvironment induced a
      tenfold increase in the transcription of the pulmonary vasoconstrictor genes
      endothelin-1 and platelet-derived growth factor within 24 hours. The addition of
      organic nitrates had a dramatic effect on decreasing the levels of
      vasoconstrictor transcripts within 30 minutes of exposure. CONCLUSION: These
      findings suggest that a potential mechanism for the clinical effect of organic
      nitrates is the inhibition of vasoconstrictor synthesis by hypoxic endothelium.

PMID- 7779862
TI  - Giant cell myocarditis.
AB  - BACKGROUND: Giant cell myocarditis is a rare and frequently fatal disorder of
      unknown origin that is defined histopathologically as diffuse myocardial necrosis
      with multinucleated giant cells in the absence of sarcoidlike granulomata. The
      clinical and pathologic features of lymphocytic myocarditis have been described
      in several recent publications, but the features of idiopathic giant cell
      myocarditis have not been adequately addressed. METHODS AND RESULTS: We describe
      five patients with idiopathic giant cell myocarditis who were seen at Stanford
      University over the past 10 years. In each case the onset was subacute congestive
      heart failure. After diagnosis each patient received immunosuppressive therapy
      and was evaluated for heart transplantation. Progressive heart failure and
      ventricular arrhythmias developed in all. Three died rapidly, two of progressive
      heart failure and one of sudden cause. Two patients underwent orthotopic heart
      transplantation and are currently alive, one with disease recurrence. Pathologic
      studies, including endomyocardial biopsy and evaluation of postmortem or
      explanted material at transplantation were reviewed. The pathologic studies
      provided additional support that the giant cells derive from a
      monocytic/histiocytic lineage. Segmental wall motion abnormalities suggest giant
      cell myocarditis can be a focal, as well as diffuse process at certain stages of
      its course. This experience is compared with published cases and implications for
      diagnosis and treatment are discussed. CONCLUSIONS: In view of the uniformly
      fatal nature of the disease, heart transplantation should be a serious
      consideration, and the patients evaluated once the diagnosis is established.
      Triple-drug immunosuppressive therapy should be considered at the time of
      diagnosis.

PMID- 7779863
TI  - Pulmonary amyloidosis occurring after heart transplantation for amyloid heart
      disease.

PMID- 7779864
TI  - Modulation by GM1 ganglioside of beta 1-adrenergic receptor-induced cyclic AMP
      formation in Sf9 cells.
AB  - The effect of ganglioside GM1 on isoproterenol-induced cAMP accumulation was
      studied in insect Sf9 cells expressing the human beta 1-adrenergic receptor by
      infection with recombinant baculovirus. When such Sf9 cells were treated with
      isoproterenol plus IBMX, intracellular cAMP formation increased approximately 10
      fold over the basal level. Preincubation of the baculovirus-infected cells with
      GM1 for 1 h caused a concentration-dependent inhibition of the isoproterenol
      induced cAMP accumulation. Phosphatidylserine, GM3, GT1b and a bovine brain
      ganglioside preparation lacking GM1 did not cause significant inhibition.
      Forskolin-induced cAMP accumulation was not affected by the GM1 treatment.
      Inhibition of isoproterenol-induced cAMP formation by GM1 was not observed in Sf9
      cells expressing beta 2-adrenergic receptor instead of the beta 1-adrenergic
      receptor. Binding studies with (-)-[3H]CGP12177 showed that preincubation with
      GM1 significantly reduced the affinity of antagonist binding to the beta 1
      adrenergic receptor. These results suggest that GM1 or related ganglioside
      structure(s) may function as natural modulator(s) of the beta 1-adrenergic
      receptor.

PMID- 7779866
TI  - Selenoperoxidase-dependent glutathione cycle activity in peroxide-challenged
      leukemia cells.
AB  - Murine leukemia L1210 cells rendered deficient in glutathione peroxidase (GPX)
      and phospholipid hydroperoxide glutathione peroxidase (PHGPX) by Se deprivation
      (L.Se(-) cells) were found to be more sensitive to tert-butyl hydroperoxide (t
      BuOOH) cytotoxicity than Se-replete controls (L.Se(+) cells). Human K562 cells,
      which express PHGPX, but not GPX, were also more sensitive to t-BuOOH in the Se
      deficient (K.Se(-)) than Se-satisfied (K.Se(+)) condition. In examining the
      metabolic basis for selenoperoxidase-dependent resistance, we found that glucose
      replete Se(-) cells reduce t-BuOOH to t-butanol far more slowly than Se(+) cells,
      the ratio of the first-order rate constants approximating that of the GPX
      activities (L1210 cells) or PHGPX activities (K562 cells). Monitoring peroxide
      induced changes in GSH and GSSG gave consistent results; e.g., glucose-depleted
      L.Se(+) cells exhibited a first order loss of GSH that was substantially faster
      than that of glucose-depleted L.Se(-) cells. Under the conditions used, peroxide
      induced conversion of GSH to GSSG could be stoichiometrically reversed by
      resupplying D-glucose, indicating that no significant lysis or GSSG efflux and/or
      interchange had taken place. The apparent first-order rate constant for GSH decay
      increased progressively for L1210 cells expressing a range of GPX activities from
      approximately 5% to 100%, demonstrating that peroxide detoxification is strictly
      dependent on enzyme content. The initial rate of 14CO2 release from D-[1
      14C]glucose supplied in the medium was much greater for L.Se(+) or K.Se(+) cells
      than for their respective Se(-) counterparts, consistent with greater hexose
      monophosphate shunt activity in the former. These results highlight the
      importance of selenoperoxidase action in the glutathione cycle as a means by
      which tumor cells cope with hydroperoxide stress.

PMID- 7779865
TI  - The effects of terbium on the accumulation of cisplatin in human ovarian cancer
      cells.
AB  - In this investigation, we report a relationship between the terbium (Tb3+)
      binding protein and the accumulation of cisplatin in human ovarian cancer cells.
      The number of Tb3+ binding sites in cisplatin-resistant C13+ cells is
      significantly greater by 79% than those in cisplatin-sensitive 2008 cells.
      Exposure to Tb3+ also increased the cellular accumulation of cisplatin. The
      accumulation of cisplatin as a function of the Tb3+ concentration in the C13+
      cells (0.85%/microM Tb3+) was significantly greater than the accumulation of
      cisplatin in 2008 cells with respect to Tb3+ (0.46%/microM Tb3+). The number of
      Tb3+ binding sites in revertant RH4 cells was similar to that in 2008 cells. The
      RH4 cells were less sensitive to the stimulatory effects of Tb3+ than the C13+
      cells. Our results show that the Tb3+ binding protein correlates with cisplatin
      resistance, and the receptor binding of Tb3+ increases the accumulation of
      cisplatin in cisplatin-resistant cells.

PMID- 7779867
TI  - Reaction of nitric oxide and its derivatives with sulfites: a possible role in
      sulfite toxicity.
AB  - The reaction between sulfites and nitric oxide or proposed carriers of nitric
      oxide (nitrosylated bovine serum albumin and S-nitrosoglutathione) was
      investigated as a potential source of the adverse effects of sulfites on
      biological systems. Rapid reaction occurred between sulfites and all of these
      reagents. Also, the ability of nitric oxide and these carriers of nitric oxide to
      inhibit platelet aggregation was reversed by low concentrations of sulfites.
      Counteraction of nitric oxide's ability to function in cell signaling processes
      may be a major cause of sulfite toxicity.

PMID- 7779868
TI  - Protein kinase C isoforms in muscle cells and their regulation by phorbol ester
      and calpain.
AB  - Objectives were to identify the PKC isoforms in cultured muscle cells, to examine
      roles of Ca(2+)-dependent proteinases (calpains) in processing of various muscle
      PKC isozymes and to obtain a mechanistic description of the processing of PKCs by
      examining the temporal relationships between phorbol ester-dependent
      translocation of muscle PKCs and calpains between cytosolic and membrane
      compartments. Using six isoform (alpha, beta, gamma, delta, epsilon, zeta)
      specific polyclonal antibodies, PKC alpha, delta and zeta were detected in rat
      skeletal muscle and in L8 myoblasts and myotubes. PKC alpha and zeta were
      primarily localized in the cytosolic fraction of L8 myotubes whereas PKC delta
      was more abundant in the membrane fraction. Phorbol ester (TPA) caused rapid
      depletion of myotube PKC alpha and PKC alpha and PKC delta isoforms from the
      cytosolic compartment and rapid appearance of these isoforms in the membrane
      fraction. However, long-term exposure of myotubes to TPA eventually caused down
      regulation of PKCs in the membrane compartment. Down-regulation of PKCs in the
      membrane fraction was partially blocked by calpain inhibitor II. However, the
      rapid TPA-dependent cytosolic depletion of PKCs was unaffected by calpain
      inhibitor. This suggests that calpains may be responsible for membrane-associated
      down-regulation of PKCs but not for cytosolic depletion. In the final study we
      assessed the effects of phorbol ester on compartmentation of m-calpain with PKCs
      in muscle cells. Like the PKCs, TPA caused rapid association of m-calpain with
      the membrane fraction followed by down-regulation. This demonstrates that phorbol
      esters cause translocation of both PKCs and calpains to membranes where
      processing of PKCs may occur via the limited proteolysis exerted by calpains.

PMID- 7779869
TI  - Modulated glycosylation of proteoglycans during differentiation of human B
      lymphocytes.
AB  - Proteoglycans are mediators of cellular adhesion and regulate growth factor
      activities. Proteoglycans of B lymphocytes undergo structural changes during B
      cell ontogeny which may correspond to the specific requirements of the respective
      microenvironment of the maturing cell. We analyzed three human B cell lines
      representing pre-B cells (Nalm-6), activated B cells (Jok-1) and plasma cells
      (U266) for their cellular proteoglycans. Gel filtration of the 35S-labeled
      macromolecules of the three cell lines revealed an increase in size in the order
      Nalm-6 < Jok-1 < U266. In Jok-1 and U266 cells the major pool of proteoglycans
      consisted of proteochondroitin sulfates of 50 to 90 kDa. These proteolglycans
      carried a protein core of approx. 30 kDa to which 1 to 3 glycosaminoglycan chains
      in the range of 28 to 32 kDa were attached. In Nalm-6 cells only free chondroitin
      sulfate chains of 23 kDa, but no intact proteoglycans, were detected. Chondroitin
      sulfate chains were predominantly composed of chondroitin-4-sulfate, those of
      Nalm-6 and U266 cells additionally contained 10-20% of unsulfated disaccharides.
      In U266 cells 30% of glycosaminoglycans consisted of heparan sulfate either bound
      to pure proteoheparan sulfate or to chondroitin sulfate/heparan sulfate hybrid
      proteoglycans. Earlier, syndecan-1 was described as a hybrid proteoglycan
      containing heparan sulfate/chondroitin sulfate chains which is transcribed by
      murine B cells at early and late maturation stages. In order to see whether
      syndecan is transcribed by the human B cell lines used here, we measured
      expression of syndecan mRNA by the reverse transcriptase polymerase chain
      reaction. Similar to murine lymphocytes, syndecan-specific mRNA was detected in
      Nalm-6 and U266 cells, equivalent to early and late B cells, but not in
      lymphoblastoid Jok-1 cells. However, Nalm-6 cells do not produce proteoheparan
      sulfate. In these cells, syndecan synthesis may be blocked at the translational
      level. Also, the proteoglycans of U266 are different from syndecan-1 in their
      composition of glycosaminoglycans and in size of protein cores. Together, these
      results indicate that the major pool of proteoglycans produced by human B cells
      consists of proteochondroitin sulfate and additionally in later stages of a
      smaller proportion of proteoheparan sulfate which is not identical to syndecan-1.
      During distinct phases of B cell differentiation, modulations in the
      glycosaminoglycan moiety concerning size and sulfation of glycosaminoglycan
      chains were also found.

PMID- 7779870
TI  - [Louis Pasteur at the 100th anniversary of his death].

PMID- 7779871
TI  - [Puerperal endometritis: study of 52 clinically and microbiologically diagnosed
      cases].
AB  - BACKGROUND: To know the epidemiologic features, clinical manifestations and
      etiology of puerperal endometritis in our environment in addition to the use of
      endometrial cultures in the microbiologic diagnosis of this infection. METHODS: A
      retrospective study of 52 cases of puerperal endometritis, clinically and
      microbiologically diagnosed over a 4-year period. RESULTS: Fifty percent of
      patients had undergone a cesarean, 36.5% presented puerperal anemia and 23%
      presented upper amniorrhexis at 12 hours. All the patients presented puerperal
      fever greater than 38 degrees C, 46% uterine subinvolution and 24% fetid lochia.
      The most frequently isolated microorganisms in the endometrial aspirate were
      Escherichia coli, Streptococcus agalactiae and Bacteroides spp. The association
      of ampicillin plus cefoxitine and clindamycin plus tobramycin presented in vitro
      efficacy in more than 85% of the isolates. CONCLUSIONS: The practice of
      endometrial aspirate and blood cultures in patients suspected of having puerperal
      endometritis effectively contributes to the diagnosis and treatment of this
      infection.

PMID- 7779872
TI  - [Assessment of the sensitivity to antifungal agents of clinical isolates of
      Candida albicans serotype A and B by the ATB Fungus method].
AB  - BACKGROUND: Candida albicans is the most frequently species isolated in patients
      with candidiasis. This species may be antigenically divided in serotypes A and B,
      which have a different pathogenic behavior and antifungal susceptibility pattern.
      METHODS: The antifungal susceptibility of 443 clinical isolates from both
      serotypes of C. albicans to 5-fluorocytosine (5FC), amphotericin B, nystatin,
      econazole, miconazole and ketoconazole has been tested by means of the ATB Fungus
      method. RESULTS: Both serotypes showed a similar in vitro susceptibility to
      amphotericin B, nystatin, econazole, miconazole and ketoconazole. All the
      isolates were susceptible to amphotericin B and nystatin. A small number of in
      vitro resistant isolates were observed to azole compounds. However, serotype B
      was significantly more resistant than serotype A (p = 0.0001) to 5FC.
      CONCLUSIONS: C. albicans serotype B shows a lower susceptibility than serotype A
      to 5FC, an antifungal product not marketed in Spain. Serotyping of C. albicans
      does not offer additional information on antifungal susceptibility of clinical
      isolates from this species.

PMID- 7779873
TI  - [Use of+Rambach agar for the detection of Salmonella in feces using broth
      enrichment. Comparison with our methodology].
AB  - BACKGROUND: A comparative study between Rambach agar and our previously published
      methodology (Salmonella-Shigella agar + C8-esterase test) was carried out to
      isolate Salmonella from 815 stools samples after enrichment in selenite broth.
      METHODS: On Rambach agar all pink and colourless colonies which were oxidase
      negative and red colonies were also identified. On SS agar, black colonies and
      colourless colonies which were oxidase negative and C8-esterase test positive
      were identified biochemically. RESULTS: One hundred and twenty-three colourless,
      81 pink and 112 red colonies grown in Rambach agar, and they were subcultured in
      Kliger agar yielding 7, 2 and 109 Salmonella, respectively. From SS agar, the 113
      black and 10 colourless colonies which had previously been positive in the C8
      esterase test and oxidase-negative, yielded 113 Salmonella strains (111 and 2,
      respectively). CONCLUSIONS: Rambach agar is an excellent media for isolating
      Salmonella after enrichment in selenite broth. If all colourless and pink
      colonies are further investigated the number of isolates will increase although
      the workload will increase, too. Therefore, it would be interesting to study a
      combination of C8-esterase and Rambach agar since it could reduce the workload.

PMID- 7779874
TI  - [Rickettsia slovaca: an agent of the group of exanthematous fevers, in Portugal].
AB  - BACKGROUND: Identification of Rickettsia isolated from Dermacentor marginatus
      ticks from Portugal. METHODS: Using recently developed techniques (shell-vial
      isolation, PCR/RFLP genetical methods, SDS-PAGE), serological studies and animal
      induced pathology to isolate and characterize tick-borne rickettsiae. RESULTS: A
      total of 632 adults D. marginatus ticks were captured. From the collected ticks,
      we isolated 18 Rickettsia strains and the results confirm that the isolates from
      the haemolymph were identical to R. slovaca reference strain. CONCLUSIONS:
      Dermacentor marginatus ticks infected with Rickettsia slovaca were found in
      Portugal. This occurrence extended the known, geographical area for this
      microorganism. It is also a factor that could alter the seroprevalence rates of
      butonneuse fever. The pathogenicity of this Rickettsia should be evaluated to
      determine its responsibility for diseases other than butonneuse fever.

PMID- 7779875
TI  - [Spontaneous mononucleosis caused by cytomegalovirus in the immunocompetent
      adult].
AB  - BACKGROUND: The first Spanish series of spontaneous infectious mononucleosis (IM)
      by cytomegalovirus (CMV) in immunocompetent adults is reported. METHODS: Patients
      whose clinical manifestations, physical exam, analysis and serology were
      compatible with acute CMV infection from 1984 to 1993 were retrospectively
      reviewed. RESULTS: Thirty patients with a mean age of 36 years fulfilled the
      diagnostic criteria. All presented fever, alone or associated with other
      symptoms, with a mean duration of 18 days, which persisted over 3 weeks in 36%.
      Physical exam showed lymph node enlargement (50%), hepatomegaly (33%),
      splenomegaly (20%) and was normal in 8 patients (26%). Mean leukocyte count was
      9.75 x 10(9) (+/- 4.63 x 10(9) with more than 50% lymphomonocytic cells in 22
      patients (76%) and reactive lymphocytes, principally from the outset, although
      this was observed on days 2 and 60 in 11 cases (36%). LDH, ASAT and ALAT were
      moderately elevated and ESR was normal. Serologic diagnosis was established from
      IgM (13%) seroconversion or positive IgM in the two samples with IgG four-fold
      increase (23%), as well as the presence of positive IgM and invariable high IgG
      in both determinations (26%) or all IgM positive titers in a single sample (36%).
      CONCLUSIONS: Infectious mononucleosis by cytomegalovirus is an infrequently
      diagnosed disease which should be considered in any young patient with fever
      despite a little demonstrative initial physical exam absence of atypical
      lymphocytes or a lack of diagnostic serology.

PMID- 7779876
TI  - [Comparative study of 2 technics for the diagnosis of invasive candidiasis].
AB  - BACKGROUND: We evaluate test for the detection of antibodies against-Candida
      albicans by indirect immunofluorescence (Candida Spot-IF, BioMerieux, Lyon,
      France and a test developed in our laboratory to detect anti-germ tube
      antibodies) comparatively for the serodiagnosis of invasive candidiasis. METHODS:
      A total of 121 sera from 62 patients were studied retrospectively. They were
      divided into two groups: group I included 71 sera from 28 patients with invasive
      candidiasis and group II, used as control, included 50 sera from 34 patients with
      non-invasive candidiasis or without evidence of infection by Candida. RESULTS:
      Eighty-two percent of group I samples presented anti-germ tube antibodies and 57%
      of the patients in this group were positive by the Candida Spot-IF test. Both
      techniques were negative in 5 patients. Five patients in group II showed false
      positive results by Candida Spot-IF and two of them presented anti-germ tube
      antibodies also. Both techniques presented a poor correlation (R2 = 0.159; p <
      0.001). Detection of anti-germ tube antibodies showed a sensitivity of 82% and a
      specificity of 94% and Candida Spot-IF showed a sensitivity of 57% and a
      specificity of 85%. Detection of anti-germ tube antibodies in immunocompetent
      patients showed a sensitivity of 90% but it decreased to 62% in immunocompromised
      patients. With the Candida Spot-IF test the sensitivity was 70 and 25%,
      respectively. CONCLUSIONS: The detection of anti-germ tube antibodies was more
      sensitive and specific than detection of antibodies by the Candida Spot-IF test
      and it can be used for the serodiagnosis and follow up of patients with invasive
      candidiasis.

PMID- 7779877
TI  - [Virulence factors and 0 serogroups of Escherichia coli as a cause of community
      acquired urinary infections].
AB  - BACKGROUND: The aim of this study was to determine the virulence factors and 0
      serogroups of E. coli strains that cause community acquired urinary tract
      infections (UTI). METHODS: We examined 103 E. coli strains isolated from the
      urine of patients with UTI. The following virulence factors were investigated
      using phenotypic techniques: the alpha-haemolysin (Hly), the cytotoxic
      necrotizing factor type 1 (CNF-1) and the mannose-resistant haemagglutination
      (MRHA) types III, IVa and IVb expressed by P fimbriated E. coli. Serotyping of 0
      antigen was carried out by means of a microtechnique using 163 antisera. RESULTS:
      Fifty-five (53%) of the 103 E. coli strains examined showed some of the virulence
      factors investigated in this study; 41% of the strains were Hly+, 28% were CNF-1+
      and 48% expressed MRHA types III, IVa or IVb. The uropathogenic strains
      characterized belonged to 27 different 0 serogroups. However, 68% were from one
      of 10 serogroups (01, 02, 04, 06, 09, 018, 027, 073, 075 and 077) and 36% were
      from one of only 3 serogroups (02, 04 and 06). Furthermore, the virulence factors
      were concentrated in strains belonging to the 3 serogroups most frequently
      detected. Thus, 36 (97%) of the 37 strains of these 3 serogroups showed virulence
      factors, versus only 19 (29%) of 66 belonging to other serogroups (p < 0.001).
      CONCLUSIONS: Our results support the special pathogenicity theory and suggest
      that many cases of community acquired UTI may be caused by a limited number of
      uropathogenic E. coli strains that produce toxins (Hly+ and/or CNF-1+) and
      possess P fimbriae or P-related adhesins (with MRHA types III, IVa or IVb), and
      that usually belong to 02, 04 and 06 serogroups.

PMID- 7779878
TI  - [Ocular toxocariasis or retinoblastoma?].
AB  - BACKGROUND: Seroprevalence studies in Spain have shown that a high number of the
      population has been in contact with Toxocara canis although no cases of ocular
      involvement by this helminth have been described. The clinical and age of
      presentation makes differential diagnosis with retinoblastoma necessary, which is
      at time difficult, although essential since the treatment and prognosis are very
      different. METHODS: One case of ocular toxocariosis and the diagnostic keys based
      on the following are described: ophthalmologic exploration, imaging techniques
      (ECHO, TC, NMR), aqueous humor cytology, LDH quotient of aqueous/serum humor, and
      determination of specific anti-Toxocara antibodies by ELISA in serum and aqueous
      humor. CONCLUSIONS: Correct differential diagnosis between ocular toxocariosis
      and retinoblastoma is required.

PMID- 7779879
TI  - [The 8th cholera pandemic: Vibrio cholerae serogroup 0139 (Bengala strain)].

PMID- 7779880
TI  - [Criteria for antibacterial susceptibility in vitro. Ampicillin as an example].

PMID- 7779881
TI  - [Axillary suppurative adenitis in an HIV-positive patient].

PMID- 7779882
TI  - [Ungual dystrophy, erythemo-desquamative and nodular lesions in the legs of a
      patient with trisomy 21].

PMID- 7779884
TI  - [Ceftibuten].

PMID- 7779883
TI  - [Which of the 2 patients has osteomyelitis?].

PMID- 7779885
TI  - [Endocarditis and renal abscess caused by Gemella morbillorum].

PMID- 7779886
TI  - [Conjunctivitis caused by Capnocytophaga ochracea in a 2-year-old girl].

PMID- 7779887
TI  - [Human ehrlichiosis in Spain. Various epidemiologic considerations].

PMID- 7779888
TI  - [Nosocomial pneumonia caused by Neisseria meningitidis. Diagnosis by aspiration
      transthoracic puncture].

PMID- 7779889
TI  - [Acute bronchiolitis and oral vaccination with attenuated poliovirus].

PMID- 7779890
TI  - [Visceral leishmaniasis and AIDS: detection of Leishmania infantum antibodies
      with western blot].

PMID- 7779891
TI  - [Streptococcus group A: new faces of an old know].

PMID- 7779893
TI  - [Evaluation of the E test method in the antimicrobial sensitivity of Neisseria
      meningitidis to penicillin].
AB  - BACKGROUND: The E test (AB Biodisk, Solna, Sweden) is a rather new method for
      performing antimicrobial susceptibility test--their results are generated
      directly as MICs. Due to its simplicity, is available in nearly all laboratories.
      The present study evaluates the effectiveness of the E test for susceptibility
      studies of Neisseria meningitidis to penicilline. METHODS: The MICs of
      penicilline of 55 strains of Neisseria meningitidis, studied by E test and by
      microdilution method, were compared to those obtained by agar dilution using both
      Mueller-Hinton (MH) and Mueller-Hinton with a 5% of sheep blood (MH+S) as test
      culture bases. RESULTS: The concordance rate (+/- 1 log2 of dilutions) was 100%
      in all cases, except for the E test on MH+S which yielded a 98.2% value. The
      Pearson's correlation coefficients were 0.95 and 0.84 for the E test and 0.88 and
      0.85 for microdilution, using MH and MH+S. Roughly 70% of strains were considered
      susceptible to penicillin using MH for the in vitro tests, whereas only 40% of
      them were so considered using MH+S. CONCLUSIONS: The E test can be considered a
      good alternative to agar dilution method when testing susceptibility of N.
      meningitidis to penicilline, and MH is the best culture base for these assays.

PMID- 7779892
TI  - [Resistance to imipenem in Enterobacter aerogenes].
AB  - BACKGROUND: In June, 1993, an Enterobacter aerogenes strain was isolated in the
      Hospital de la Creu Roja from Hospitalet de Llobregat (Barcelona), which was
      resistant against all beta-lactams, including imipenem. Since is unusual in
      Enterobacter sp. to isolate imipenem resistant strains, we decided to study its
      resistance mechanism. METHODS: To study the E. aerogenes 174004/H resistance
      mechanism beta-lactamase isoelectrofocalization was performed together with the
      determination of kinetic constants in order to characterize the beta-lactamase,
      and a polyacrylamide gel electrophoresis in order to observe the profile.
      RESULTS: The strain of E. aerogenes 174004/H exhibits a chromosomic beta
      lactamase with a pI higher than 9.2 and a decrease in an outer membrane protein
      of 42 kDa, probably a porine. CONCLUSIONS: E. aerogenes 174004/H resistance
      against imipenem is due to an hyperproduction of a chromosomic beta-lactamase
      with a pI higher than 9.2 and to a 42 kDa decrease of an outer membrane protein
      expression.

PMID- 7779894
TI  - [Evaluation of specificity of pneumococcal antigen detection in clinical samples
      by using the polymerase chain reaction as reference method].
AB  - BACKGROUND: Sensitivity and specificity of latex agglutination test on samples
      obtained by transthoracic needle aspiration was evaluated for diagnosis of
      pneumococcal pneumonia by using the polymerase chain reaction as reference
      method. METHODS: Samples from 29 patients with community acquired pneumonia were
      processed for culture, antigen detection and polymerase chain reaction. The latex
      agglutination test was performed with a reagents kit (Slidex meningite kit,
      BioMerieux, France) using the procedure recommended by the manufacturer. The
      polymerase chain reaction was carried out by using two primers: Pn2x up and Pn2x
      down that amplify the PBP2x gene of Streptococcus pneumoniae. RESULTS: Culture
      was positive in 5 patients, antigen detection in 15 and polymerase chain reaction
      in 14 patients. The specificity of latex agglutination test was 93% compared with
      polymerase chain reaction as reference method. CONCLUSION: The pneumococcal
      antigen detection by latex agglutination test is as sensitive as the polymerase
      chain reaction, it seems to be highly specific, and it is rapid and easy to
      perform.

PMID- 7779895
TI  - [Evaluation of Mycobacterium fortuitum acyltrehaloses in the serologic diagnosis
      of pulmonary tuberculosis].
AB  - BACKGROUND: Several glycolipids of Mycobacterium tuberculosis are antigenic and
      their use in the serodiagnosis of pulmonary tuberculosis has been postulated.
      Acyltrehaloses (SL-IV) are among the strongest antigenic glycolipids of M.
      tuberculosis; similar compounds have been found in M. fortuitum. The aim of the
      present study was to evaluate the usefulness of the acyltrehaloses of M.
      fortuitum in the serodiagnosis of pulmonary tuberculosis. METHODS: Two
      glycolipids, identified as triacyl- (TAT-MF) and diacyl- (DAT-MF) trehaloses,
      were studied by an ELISA method. Two independent analyses were carried out. In
      the first one, IgG and IgM were determined in sera from patients with pulmonary
      tuberculosis (84-24 bacteriologically not confirmed--), healthy individuals (46)
      and patients with respiratory pathologies other than pulmonary tuberculosis (38),
      using TAT-MF. In the second one, IgG was determined in sera from pulmonary
      tuberculosis patients (34) and from healthy individuals (20), using DAT-MF.
      RESULTS: The sensitivity of the IgG ELISA using TAT-MF varied, according to the
      cut-off point, between 79.8 and 39.3%; the specificity values ranged between 83.3
      and 98.8%. In sera from bacteriologically not confirmed pulmonary tuberculosis
      patients the sensitivity was 87.5-45.8%. The sensitivity for IgM was very low
      using TAM-MF (10.7-2.3%), with specificity values ranging from 77.4 to 100%. The
      sensitivity and specificity values of IgG using DAT-MF were, respectively, 34.3
      9.3% and 90-100%. CONCLUSIONS: The IgG ELISA using TAT-MF has similar values of
      sensitivity and specificity to those reported for the acyltrehaloses of M.
      tuberculosis, although this antigen, by itself, can not be used in the
      serodiagnosis of pulmonary tuberculosis. DAT-MF has no value in the serodiagnosis
      of pulmonary tuberculosis.

PMID- 7779896
TI  - [Tuberculosis presenting as diffuse pulmonary infiltrates in AIDS patients:
      diagnostic performance of clinical samples].
AB  - BACKGROUND: In patients with human immunodeficiency virus (HIV) infection,
      tuberculosis is frequently presented with diffuse pulmonary infiltrates which are
      indistinguishable from those caused by other respiratory pathogens. It is
      therefore useful to know the diagnostic performance of different clinical
      samples. METHODS: We have retrospectively analyzed the clinical histories of 56
      patients seen over a 3-year period. All the patients had HIV infection,
      Mycobacterium tuberculosis isolated in at least one clinical sample and presented
      with diffuse bilateral infiltrates in thorax radiography. The results of all the
      clinical samples submitted to the microbiology laboratory. RESULTS: The highest
      performance in both stainings and cultures were obtained from the biopsy (or
      aspirate) of adenopathies (93 and 100%, respectively), sputum (57 and 88%) and
      urine (31 and 64%). A lower than expected sensitivity was obtained in the
      fibrobronchoscopy samples (bronchoalveolar lavage and transbronchial biopsy). The
      staining had low sensitivity for predicting positive cultures in all the samples
      except in the adenopathies. Visualization of granulomas in transbronchial
      biopsies and bone marrow was more sensitive for diagnosis than the demonstration
      of resistant acid-alcohol bacilli in the same samples. Globally, rapid diagnosis
      was obtained in 43 patients (76%). The remaining 13 (24%) patients were not
      diagnosed until the culture results had been received despite the adequate use of
      diagnostic procedures. CONCLUSIONS: These findings support the use of empiric
      treatment when tuberculosis is suspected despite initial negativity of the
      microbiologic and pathologic examinations following the discarding of other
      potential causes.

PMID- 7779898
TI  - [Adnexitis in a woman of fertile age].

PMID- 7779897
TI  - [Invasive disease by Haemophilus influenzae type b: current state of prevention
      by vaccination].

PMID- 7779899
TI  - [Depigmented cutaneous lesions in a Equatorial-Guinean woman].

PMID- 7779900
TI  - [Foscarnet related vulvar ulcers. Description of 2 AIDS patients].

PMID- 7779901
TI  - [Terminal ileum involvement by cytomegalovirus in an immunocompetent patient].

PMID- 7779902
TI  - [Infection by Clostridium septicum as a presenting form of colonic neoplasia].

PMID- 7779903
TI  - [Cryptococcus neoformans pleuritis in an HIV infected patient].

PMID- 7779904
TI  - [Community acquired pneumonia due to Enterococcus. An entity for consideration?].

PMID- 7779905
TI  - [Evaluation of a commercial ELISA technique for the diagnosis of respiratory
      infections by Mycoplasma pneumoniae].

PMID- 7779906
TI  - [Demonstration of a cross contamination in the 460TB Bactec system by molecular
      typing of the strains with IS6110].

PMID- 7779907
TI  - [Streptococcus agalactiae infections and toxoplasmosis in pregnancy].

PMID- 7779909
TI  - [Edemas as a form of presentation of spotted Mediterranean fever].

PMID- 7779908
TI  - [Macroscopic hematuria secondary to the administration of intravenous
      pentamidine].

PMID- 7779910
TI  - FDA reform: arguments on both sides.

PMID- 7779911
TI  - In vitro and in vivo transfer and expression of human surfactant SP-A- and SP-B
      associated protein cDNAs mediated by replication-deficient, recombinant
      adenoviral vectors.
AB  - Congenital pulmonary alveolar proteinosis (CPAP) is a fatal disease of full-term
      infants that is unresponsive to current medical therapy. It is now recognized
      that at least some forms of this disorder are associated with a deficiency of SP
      B, one of the surfactant-associated proteins, as well as probable aberrations in
      the surfactant-associated proteins SP-A and SP-C. Given these developments, it is
      logical to hypothesize that CPAP may be amenable to gene therapy, in which the
      human SP-B cDNA, and possibly the cDNAs of the other surfactant associated
      proteins, are transferred to the epithelium of the lower respiratory tract. We
      constructed replication-deficient, recombinant adenovirus vectors in which a
      constitutive viral promoter drives the expression of the DNAs for the surfactant
      associated proteins, SP-B (AdCMV.SP-B) and SP-A (AdCMV.SP-A). Following infection
      of the human lung A549 epithelial cell line with these vectors in vitro, the
      appropriately sized mRNAs for these cDNAs were detected, whereas cells infected
      with a control virus or uninfected cells produced none. Western blots
      demonstrated expression of these proteins, including appropriate processing of
      the hydrophobic protein, SP-B. Following in vivo intratracheal infection of rats
      with these vectors, Northern analysis of the lungs revealed appropriately sized
      mRNAs for these cDNAs whereas rats infected with control virus or uninfected rats
      show no hybridization with the human surfactant-associated protein probes. In the
      AdCM-V.SP-A-infected rats, Western blots confirmed the overproduction of the
      human SP-A protein in both the bronchoalveolar lavage and lung homogenates
      compared to controls. Thus, it is feasible to utilize adenovirus vectors to
      transfer and express the human surfactant associated protein cDNAs in vitro and
      in vivo, presenting a possible mode of therapy for CPAP, as well as other
      surfactant deficiency states such as the neonatal respiratory distress syndrome
      and possibly the adult respiratory distress syndrome.

PMID- 7779912
TI  - The effect of selection for high-level vector expression on the genetic and
      functional stability of a single transcript vector derived from a low
      leukemogenic murine retrovirus.
AB  - Single-gene murine leukemia virus-based retroviral vectors carrying the G418
      resistance gene (neo) under transcriptional control of the long terminal repeat
      were used to study the effect of selection on long-term vector expression in a
      murine lymphoid cell line, L691. We used two isogenic vectors carrying either a
      strong or a weak transcriptional enhancer from low-leukemogenic Akv and high
      leukemogenic SL3-3 murine leukemia virus, respectively. Effects of G418 selection
      were studied at the level of vector-transduced cell populations and at the level
      of single-vector-transduced cell clones obtained without selection for vector
      expression. Selection for vector expression prior to isolation of cell clones
      changed the range of vector expression for the two populations of cell clones.
      Cell clones harboring the Akv enhancer, isolated without selection and then
      subjected to prolonged growth under selective conditions, exhibited no mutations
      in the enhancer region or major vector rearrangements although showing increased
      vector expression in some cases. Our results are discussed in terms of retrovirus
      mediated gene transfer strategies employing selection for expression of a
      selective marker in single-gene or bicistronic vectors with a low- or
      nonleukemogenic virus-derived backbone.

PMID- 7779913
TI  - Polyoma virus pseudocapsids as efficient carriers of heterologous DNA into
      mammalian cells.
AB  - Polyoma virus VP1 pseudocapsids, generated from a recombinant baculovirus, have
      been successfully used to transfer exogenous DNA stably into rodent (rat-2)
      cells. To evaluate the efficiency and biological usefulness of this route for
      introducing heterologous DNA into cells, the gene for a transforming deletion
      mutant of the middle T antigen of polyoma virus, dl8 MT, was used initially.
      Whereas the amount of DNA packaged together with pseudocapsids was found to be
      variable (2-30%), even at low efficiency its transfer as biologically functional
      information was high. The dl8 MT gene was stably transferred and integrated in
      low copy numbers into the host chromosome. Transformed cell lines (derived from
      single foci) were shown to produce high levels of the corresponding mutant
      protein, which was active in an in vitro protein kinase assay. In comparisons
      with the calcium phosphate DNA coprecipitation procedure (or lipofectin route),
      the VP1 pseudocapsid approach was shown to have many advantages in terms of
      maintenance of DNA fidelity and increased efficiency of gene expression. This
      system was also assessed for its ability to transfer into and express the
      chloramphenicol acetyl transferase (CAT) gene in a human liver cell line. Here
      again, the assay for functional CAT expression showed the pseudocapsid transfer
      procedure to compare favorably with lipofectin transfer. In another transient
      assay, a low-level endogenously expressed gene, p43, was complexed with
      pseudocapsids and transferred into human embryo lung fibroblasts, thereby
      increasing the expression levels. The ease of production of VP1 pseudocapsids,
      coupled with their efficient transfer of biologically useful information, should
      make this route of gene delivery an attractive proposition for further
      exploration with regard to gene therapy.

PMID- 7779914
TI  - Inhibition of interleukin-1-induced effects in synoviocytes transduced with the
      human IL-1 receptor antagonist cDNA using an adenoviral vector.
AB  - In this report, we present data showing that a recombinant adenoviral vector
      (Ad.RSVIL-1ra) containing the cDNA for human interleukin-1 receptor antagonist
      protein (IL-1ra) can genetically modify synoviocytes both in vitro and in vivo.
      Human synoviocytes infected with Ad.RSVIL-1ra in vitro expressed and secreted
      high levels of human IL-1ra that were detected by ELISA of tissue culture
      supernatants. New Zealand White rabbits that received intra-articular injections
      of Ad.RSVIL-1ra expressed transgenic IL-1ra in synoviocytes, and secretion was
      detected for at least 4 weeks post-infection. Further, biological activity of the
      transgenic IL-1ra was demonstrated by its ability to inhibit IL-1-induced
      prostaglandin E2 (PGE2) synthesis in vitro and IL-1-induced glycosaminoglycan
      (GAG) degradation in vivo. These data demonstrate that recombinant adenoviral
      vectors can mediate the intra-articular expression of anti-inflammatory proteins
      and may be a reasonable method to deliver therapeutically relevant proteins for
      the regional treatment of synovial inflammation.

PMID- 7779915
TI  - Bacterial lipopolysaccharide copurifies with plasmid DNA: implications for animal
      models and human gene therapy.
AB  - During the course of gene therapy experiments in rodents, using intramuscular
      injections of plasmid DNA derived from Escherichia coli, we noted dose-related
      toxicity. This observation prompted a search for possible contaminants of DNA
      samples. We used the highly specific and sensitive limulus amoebocyte lysate
      assay (LAL), to monitor endotoxin bioactivity in DNA samples, and found plasmid
      DNA derived from standard E. coli bacterial strains, using traditional DNA
      isolation protocols, to be heavily contaminated with endotoxin, or
      lipopolysaccharide (LPA). Standard DNA isolation procedures resulted in the
      copurification of up to 500 micrograms/ml of LPS. LPS is a potent inducer of
      cytokines and other inflammatory mediators, and may complicate the use of naked
      DNA in gene therapy. The copurification of endotoxin with plasmid DNA also has
      important implications for in vitro transfection studies and microinjection of
      DNA into embryos. A simple and efficient protocol to reduce LPS contamination of
      plasmid DNA was developed. The conversion of intact bacteria to spheroplasts
      prior to the isolation of plasmid DNA, incubation with lysozyme, treatment with
      the detergent n-octyl-beta-D-thioglucopyranoside (OSPG) and polymyxin-B (PMB)
      chromatography, allowed the isolation of plasmid DNA containing less than 50
      ng/ml LPS. This represents a 10,000-fold reduction in LPS contamination, compared
      to conventional methods of plasmid DNA purification, avoids potentially toxic
      reagents such as ethidium bromide, and produces a higher yield of plasmid DNA.

PMID- 7779917
TI  - Guidance on making proposals to conduct gene therapy research on human subjects.
      Report of the United Kingdom Health Ministers' Gene Therapy Advisory Committee.

PMID- 7779916
TI  - Construction of a novel bovine papillomavirus vector without detectable
      transforming activity suitable for gene transfer.
AB  - Bovine papillomavirus type 1 (BPV-1)-derived vectors may be useful for gene
      therapy because of their episomal maintenance at intermediate to high copy number
      and stable, high-level expression of gene products. To increase the safety of BPV
      1 for human trials, the transforming early genes E5, E6, and E7 were deleted and
      a new vector, B45-Neo, was established and its transforming potential, episomal
      maintenance, and cDNA expression determined. Deletion of E5, E6, and E7, caused a
      decrease of the copy number to 80 in 3T3 fibroblasts when B45-Neo was compared to
      the parent vector that supported more than 1,000 copies per cell. No significant
      difference in the copy number, which ranged between 13 and 30 per cell, was
      detected in other cell lines of murine or human origin. The episomal maintenance
      of B45 and its ability to express cDNA was retained. B45-Neo, in contrast to BMG
      Neo, however, was unable to transform NIH-3T3 and C1271 cells in soft agar colony
      assays. Unlike BMG-Neo, B45-Neo did not cause morphological changes in 3T3 and
      C1271 cells characteristic for transformation. It is concluded that B45-Neo is an
      efficient expression vector without detectable transforming activity and may be
      useful and safe for human gene therapy trials.

PMID- 7779918
TI  - Phase I study of non-replicating autologous tumor cell injections using cells
      prepared with or without GM-CSF gene transduction in patients with metastatic
      renal cell carcinoma.

PMID- 7779919
TI  - Phase I study of transfected cancer cells expressing the interleukin-2 gene
      product in limited stage small cell lung cancer.

PMID- 7779920
TI  - Markers of past syphilis in HIV infection comparing Captia Syphilis G anti
      treponemal IgG enzyme immunoassay with other treponemal antigen tests.
AB  - The sensitivity of the Captia Syphilis G anti-treponemal IgG enzyme immunoassay
      (EIA-IgG) was compared with the Treponema pallidum haemagglutination assay (TPHA)
      and the Fluorescent Treponemal Antibody Absorbed (FTA-Abs) test as a marker for
      past syphilis in 28 HIV-infected and 31 HIV-negative patients with a past history
      of syphilis. The specificity of EIA-IgG was compared in 89 patients without a
      history of syphilis who were known to be HIV antibody positive with a control
      group of 89 patients who had tested HIV negative. In patients with a past history
      of syphilis each treponemal test (EIA-IgG, TPHA and FTA-Abs) gave a lower
      sensitivity (82%, 86%, 79%) in the HIV-positive group than in the HIV-negative
      group (97%) but the difference was significant only in the case of the FTA-Abs
      test (P < 0.05). In the HIV-positive patients 11% (3/28) were negative in all 3
      treponemal tests while 25% (7/28) were negative in at least one treponemal test.
      In patients without a past history of syphilis the EIA-IgG antibody index in the
      HIV-positive group (0.436) was significantly higher than in the HIV-negative
      group (0.378): the specificity, however, was similar in the HIV-positive (100%)
      and HIV-negative group (99%). We conclude that the Captia Syphilis G anti
      treponemal IgG enzyme immunoassay is of similar specificity in HIV-positive and
      HIV-negative patients and is of similar sensitivity to the TPHA and FTA-Abs as a
      marker of past syphilis in HIV-infected patients.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7779921
TI  - Impact of counselling on safer sex and STD occurrence among STD patients in
      Malawi.
AB  - In developing countries where professional manpower and basic supplies are
      lacking for STD control, low-cost prevention strategies must be explored. This
      study assesses the impact of counselling on STD treatment and prevention in
      Malawi. Increases in safer sex practices are used as indicators of prevention
      behaviour. A pre-test post-test control group design over a 4-month interval was
      conducted in 1991 in 2 comparable hospitals approximately 100 km apart. STD was
      diagnosed symptomatically and Knowledge Attitude Practice and Behaviour (KAPB)
      data collected using a structured questionnaire. In one group, trained
      counsellors discussed modes of transmission and prevention of STD/AIDS including
      a condom demonstration; symptoms and treatment of STDs; partner notification;
      risk taking and reasons for doing so; and motivations for behaviour change. The
      results show that counselling reduces the occurrence of STDs; increases concern
      for sexual partners; increases knowledge about and use of condoms; reduces mean
      number of partners; and reduces health costs due to fewer hospital visits.
      Although the observed behaviour change was short term, these outcomes argue in
      favour of counselling as a low-cost effective strategy for STD control.

PMID- 7779922
TI  - Temporal changes in the sensitivity of Neisseria gonorrhoeae to penicillin in
      Edinburgh, Scotland.
AB  - Increased resistance of Neisseria gonorrhoeae to penicillin has been reported
      from many centres around the world since the introduction of antibiotic therapy
      in the 1940s. This study reports the temporal changes in gonococcal penicillin
      sensitivity over a 3-year period. All patients with a diagnosis of gonorrhoea in
      the city of Edinburgh, Scotland between 1990 and 1992 were included in the study.
      Penicillin sensitivity of isolates was analysed in relation to the sex and sexual
      orientation of the patient and the antibiotic therapy given. Four hundred and
      twenty-seven new patient episodes of infection occurred of which penicillin
      sensitivities were available in 426. Eleven episodes of PPNG infection occurred.
      Chromosomally mediated penicillin resistance did not increase over the study
      period. No differences were evident in the sensitivity of isolates from
      homosexual and heterosexual patients. Unlike many other areas the relative
      resistance of N. gonorrhoeae is not increasing in Edinburgh at present. This may
      relate to local antibiotic policies combined with intrinsic characteristics of N.
      gonorrhoeae itself. Unlike previous reports there did not appear to be any
      increased resistance to penicillin in isolates from gay men.

PMID- 7779923
TI  - Response to podophyllotoxin treatment of genital warts in relation to HIV-1
      infection among patients in Dar es Salaam, Tanzania.
AB  - Forty-two Tanzanian patients with genital warts were treated with 0.5%
      podophyllotoxin solution (Wartec) for 3 days. Thirteen patients (30.9%) were
      cured and a further 7 patients (16.7%) had more than 50% of lesions cleared at 6
      weeks, while 19 patients were resistant to treatment. Three patients had a
      recurrence of lesions after an initial response. Thirty-three patients were
      tested for serological evidence of infection with human immunodeficiency virus
      (HIV) and 15 (45.5%) patients were shown to be HIV-1 antibody positive. The
      response to treatment was analysed in relation to HIV antibody status. The cure
      rate was significantly higher in HIV seronegative patients (8/18 = 44.4%)
      compared to HIV seropositive patients (1/15 = 6.7%) (P = 0.018). We conclude that
      podophyllotoxin treatment provides a useful non-hospital based treatment for
      genital warts, but HIV infection appears to contribute to the failure of
      treatment for genital warts.

PMID- 7779925
TI  - HIV infection in a long-term renal transplant recipient.

PMID- 7779926
TI  - Successful prevention of recurrent pneumonia caused by Pseudomonas aeruginosa in
      a patient with AIDS.

PMID- 7779924
TI  - HIV-1 variants in South and South-East Asia.
AB  - HIV spread in South and South-East Asia is most alarming, and genetic variability
      of HIV-1 is an important consideration in vaccine development. In this study, we
      examined the third variable (V3) region of env gene of HIV-1 variants prevalent
      in Thailand, Malaysia, India, and the Philippines. By phylogenetic tree analyses,
      an HIV-1 variant from an injecting drug user (IDU) in Thailand belonged to
      subtype B, and HIV-1 variants from 2 IDUs in Malaysia were classified into 2
      subtypes, B and E. One HIV-1 variant from a male homosexual in the Philippines
      belonged to subtype B. Out of 8 HIV-1 variants from sexually transmitted disease
      patients in India, 7 belonged to subtype C, and one to subtype A. Although the
      total number of individuals examined in this study was limited, 4 HIV-1 subtypes
      were found in South and South-East Asia and large international movements of HIV
      1-infected individuals in this region could induce global dissemination of these
      HIV-1 variants.

PMID- 7779927
TI  - Disseminated cutaneous leishmaniasis in an HIV-infected patient.

PMID- 7779928
TI  - Multiple tropical pathology in an HIV-positive man.

PMID- 7779929
TI  - Investigation and management guide for sexually transmitted diseases (excluding
      HIV).

PMID- 7779930
TI  - High prevalence of herpes simplex virus type 1 in female anogenital herpes
      simplex.

PMID- 7779931
TI  - Mycoplasma genitalium in non-gonococcal urethritis.

PMID- 7779933
TI  - Is there a risk of human immunodeficiency virus (HIV) transmission in dialysis
      centres?

PMID- 7779932
TI  - Unilateral vulval hypertrophy and Crohn's disease.

PMID- 7779935
TI  - Balanitis xerotica obliterans.

PMID- 7779934
TI  - Epidemiological characteristics of human immunodeficiency virus type-2 infection
      in Africa.
AB  - There are things yet to be clarified about African HIV-2 infection, compared to
      HIV-1 infection. However, the epidemiological characteristics have gradually been
      elucidated through various studies. HIV-2 infection is believed to have existed
      in the 1960s in Africa and is presently epidemic in West Africa. The HIV-2
      seropositive rate for the general population is higher in urban regions than in
      rural areas. The peak age of persons infected with the HIV-2 tends to be higher
      than that of persons infected with the HIV-1, but no sex difference was
      recognized between the HIV-2 and HIV-1 seropositive rates. Sexual contact, mother
      to-child transmission and blood transfusion have been confirmed as HIV-2
      transmission modes. Prostitutes and patients with other STD are recognized as
      being high-risk groups for the HIV-2 infection. Patients who are infected with
      both HIV-1 and HIV-2 have also been identified, but it is suggested that the
      pathogenicity of HIV-2 is lower than that of HIV-1.

PMID- 7779936
TI  - HIV at the hospital/general practice interface: bridging the communication
      divide.
AB  - Good communication between hospital HIV units and general practitioners is
      essential if people with HIV are to receive appropriate medical care in the
      community. However, in the UK the experience of general practitioners looking
      after people with HIV has been that communication is often inadequate. The
      reasons for this relate to the way that the HIV epidemic has evolved in the UK
      and the way that health services providing care in HIV have developed. In this
      review we will examine the causes of the present situation and suggest ways of
      improving communication which will have beneficial effects on the care of people
      with HIV.

PMID- 7779937
TI  - Preventing unprotected anal intercourse in gay men: a comparison of two
      intervention techniques.
AB  - This study compared the effectiveness of getting gay men to evaluate the self
      justifications they use when breaking their safe sex rules to that of a standard
      approach to AIDS education. Men (n = 109) who had 'slipped up' (broken their safe
      sex rules by having unprotected anal intercourse) kept diaries of their sexual
      behaviour for 16 weeks. After 4 weeks they were allocated to one of 3 conditions,
      2 involving brief interventions--Self-justifications (evaluation of self
      justifications) and Standard (examination of posters used in AIDS education)--and
      a Control (diary only). At the time of the intervention, more members of the Self
      justifications than the Standard group thought that it would help them not to
      slip up. In the post-intervention period, the 3 groups did not differ in the
      incidence of sexual activity or in the proportion who slipped up at least once,
      but the Self-justifications group were less likely to have had multiple slip-ups.
      Three possible explanations are offered for the effectiveness of the Self
      justifications intervention. This approach may provide a useful alternative to
      standard techniques of AIDS education.

PMID- 7779939
TI  - [Epidemiologic research and clinical research: a proposal for their integration].

PMID- 7779938
TI  - Prior sexual assault reported by male attenders at a department of genitourinary
      medicine.
AB  - One-hundred-and-fifty male patients who attended the department of genitourinary
      medicine (GUM) completed a questionnaire which enquired into a past history of
      sexual assault and asked certain details about the assault and various sequelae
      of such an experience. Twenty-one men gave a history of sexual assault, 11 of
      whom had been abused before the age of 16, 7 afterwards and 3 in both age groups.
      Victims of such an assault were more likely to be homosexual or bisexual than
      heterosexual. The substantial majority i.e. 104 (81%) of the 129 patients who had
      not been assaulted in the past had been brought up by both natural parents.
      However, of the 21 males who reported a history of previous sexual abuse only 11
      (52%) had been raised by both natural parents alone and 9 of the remaining 10 who
      divulged such information had been brought up in other circumstances. The
      association between not being raised entirely by both natural parents and a
      history of previous sexual assault was significant (P < 0.01). Overall, physical
      contact of a sexual nature was the most commonly reported type of abuse, followed
      by anal and then by oral penetration. All of the perpetrators of assault were
      male except in one instance. Only 3 cases of assault were reported to the police
      or other agencies. Those who had been abused as minors were more likely to
      acknowledge subsequent psychological difficulties and to have obtained
      professional counselling. This problem is a significant one which goes largely
      undetected in GUM departments and elsewhere.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779940
TI  - Platelet function in patients with lupus anticoagulant and thrombosis.
AB  - In a group of 337 patients with a history of thrombotic episodes, pregnancy
      losses and/or thrombocytopenia, 66 cases of lupus anticoagulant (LA) were found.
      Spontaneous platelet aggregation and the aggregatory responses of platelet rich
      plasmas (PRP) from 14 patients, with a history of thrombotic episodes, with
      anticardiolipin (ACA) levels above 21 IgG antiphospholipid antibodies units and
      normal platelet counts were studied and compared with those of 8 patients with
      history of thrombosis and negative LA and ACA (controls). Epinephrine, adenosine
      diphosphate, collagen and ristocetin were used as platelet aggregation inducers.
      Early collagen-whole blood interaction (BASIC WAVE), as a measure of platelet
      recruitment, and the levels of von Willebrand factor were also determined. The
      results of each test were compared with those of nine patients, used as controls,
      with thrombotic antecedents but negative LA and ACA. None of the patients with
      LA, or the control group, showed spontaneous platelet aggregation. The
      aggregatory responses, when epinephrine, ADP or collagen were added to the
      patient's PRP, were within normal range in most cases (64.2%, 52% and 72%
      respectively). The highest rate of hyperaggregation after the above mentioned
      inducers, was 12% and corresponded to the response to collagen. On the contrary,
      platelet aggregation rate with ristocetin was higher than 100% in 61.0% of the
      problem group, with no significative difference from the controls. The BASIC WAVE
      was of low rate and similar in the two groups studied. The von Willebrand factor
      was significantly higher (150 +/- 55%) in the problem group than in the controls
      (98 +/- 25.6%) (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779941
TI  - [Creutzfeldt-Jakob disease. Report of 2 cases].
AB  - The authors report two cases of Creutzfeldt Jakob disease in a 48 year old woman
      and a 60 year old man. This demential disorder is induced by a non conventional
      virus and its characterized from a clinical point of view by progressive
      dementia, myoclonus and seizures, it follows a subacute course with progressive
      deteriorization that invariably leads to death. Neuropathological features
      include: neuronal loss, astrocytosis and neuropil vacuolization in cortical areas
      of the brain. A review of the medical literature suggests that these constitute
      the fourth and fifth case respectively reported in Venezuela, of this unusual
      neurological disorder. This paper emphasizes the clinical and neuropathological
      features of this entity and suggests its inclussion among the differential
      diagnoses of the different demential processes.

PMID- 7779942
TI  - [REMENEN. Mental representation of natural whole numbers].
AB  - Study was carried out to find the existence, form of presentation and
      commonalities and individual differences in the mental representation of natural
      whole numbers (REMENEN). The design used was an ex-post-factor exploratory and
      descriptive field study. A questionnaire was developed and administered to a
      sample of 153 senior students at the Universidad Catolica Andres Bello (UCAB).
      The hypotheses were: a) that REMENEN exists in all individuals, b) that REMENEN
      are individual, c) that there are intergroup differences and intragroup
      similarities in REMENEN according to major field of study and sex. The existence
      of REMENEN in the great majority of individuals was demonstrated as well as their
      individuality in all subjects. There were no significant differences according to
      major or sex, and no significant intragroup similarities. The present study opens
      the field for a new line of research and allows a relationship between isolated
      statements regarding numbers made by Galton, Jung and some cognitive
      psychologists.

PMID- 7779943
TI  - [Sudanophilic cavitating leukodystrophy: adult familial form].
AB  - Sudanophilic cavitating leukodystrophy is an unusual disorder of the cerebral
      white matter, clinically characterized by deafness, mental retardation,
      behavioural alterations and lesions of the descending long tracts.
      Neuropathological features include: extensive subcortical and deep central
      demyelination, conspicuous astrocytosis and macro and micro cavitation. We
      describe a 34 year-old male with personal and family history, clinical features
      and neuropathological changes consistent with Sudanophilic cavitating
      leukodystrophy. As far as our knowledge is concerned this constitutes the first
      report of this entity in Venezuela.

PMID- 7779944
TI  - Fibrosing granulomas in the equine liver and peritoneum: a retrospective
      morphologic study.
AB  - Fibrosing granulomas were found in the liver and occasionally on the intestinal
      and diaphragmatic serosae and in the lung of 11 horses submitted for necropsy.
      Although these granulomas were considered incidental findings in most of the
      horses, they had caused liver failure in 1 horse. The granulomas typically were
      characterized by a dense collagenous core that frequently was mineralized. The
      periphery contained a rim of inflammatory cells. Only in 1 of the 11 horses was
      there evidence of an egg shell suggestive of schistosomes. Schistosomal eggs were
      not detected in the feces of the horses. The typical architecture of the
      granulomas combined with the occasional finding of a residual egg led to the
      circumstantial conclusion that the fibrosing granulomas were the result of
      chronic schistosomiasis of undeterminable origin.

PMID- 7779946
TI  - Spontaneous glomerulonephritis in swine.
AB  - In this investigation, 32 cases of naturally occurring glomerulonephritis in
      swine were studied retrospectively (1973-1993). Almost all affected pigs were
      crossbred and more than half were growing pigs. Nearly two thirds of the pigs
      showed gross renal lesions characterized by bilateral kidney enlargement, palor,
      edema, and/or cortical petechiation. The most commonly encountered extrarenal
      lesions were serous bodily effusions and gastric ulcers. The renal disease was
      considered the primary cause of death in 11 pigs. Histologically, the renal
      lesions in all pigs were characterized by a generalized and global proliferative
      glomerulonephritis. Mesangioproliferative glomerulonephritis was diagnosed in 2
      pigs, whereas the glomerular lesions found in the other pigs (30/32) were
      characterized by a proliferative and exudative glomerulonephritis frequently
      associated with crescent formation. In all pigs, there was histologic evidence of
      proteinuria. A focal necrotizing vasculitis was found in the kidneys of 7 pigs.
      Although probably of immune origin, the precise etiopathogenesis of the porcine
      glomerulonephritis described herein after remains unknown.

PMID- 7779945
TI  - Chronic generalized obliterative arteriopathy in cattle: a sequel to sheep
      associated malignant catarrhal fever.
AB  - Malignant catarrhal fever (MCF) in cattle is generally associated with a short
      clinical course and a high case fatality rate (90-95%). The lesions in cattle
      that survive acute MCF for a prolonged period or appear to recover have not been
      documented. In a naturally occurring outbreak of MCF in a herd of beef cattle in
      Wyoming, 7 of 84 yearling heifers (8.3% of replacement herd) and 2 of 230 cows
      (0.9% of cow herd) developed clinical signs of pyrexia, mucopurulent discharge,
      bilateral keratitis, and weight loss following contact with ewes that had lambed
      34-62 days earlier. Six of 9 affected cattle were examined postmortem following
      clinical signs (CS) that developed 2-150 days earlier. Three cattle with CS for <
      or = 39 days had lesions of regional lymphadenopathy and widespread severe
      segmental lymphoid arteritis-phlebitis that were typical of acute MCF, and
      proliferative intimal lesions were present in a small proportion of arteries at
      days 20 and 39 of CS. By contrast, 3 cattle that survived to 90, 105, and 150
      days after clinical onset had distinctive arterial lesions in multiple organs,
      characterized by proliferative concentric fibrointimal plaques, disrupted inner
      elastic lamina, focally atrophic tunica media, and vasculitis of variable
      severity. Immunohistochemical and ultrastructural examination of intimal plaques
      identified the predominant cellular component to be smooth muscle cells with a
      contractile phenotype. No viral structures were seen. Serologic studies, using a
      competitive inhibition enzyme-linked immunosorbent assay (CI-ELISA) that detects
      antibody to an epitope broadly conserved among isolates of the MCF virus, found
      that 2 chronically affected cattle were serologically positive between days 42
      and 100 of CS, with seroconversion in 1 animal between days 52 and 73 of CS.
      Seroprevalence was 7.9% in the 76 remaining healthy animals of the replacement
      heifer herd and 40% (75% in adult sheep and 4% in lambs) in the in-contact sheep
      flock 77 days after onset of CS in the index case. This episode suggests that, in
      addition to the common and well recognized acute form of MCF in cattle, this
      viral infection encompasses a disease spectrum that includes chronic disease and
      partial to "complete" clinical recovery, and in recovered animals chronic
      obliterative arteriopathy is the preeminent lesion.

PMID- 7779947
TI  - Comparison of argyrophilic nucleolar organizer regions (AgNORs) and mitotic index
      in distinguishing benign from malignant canine smooth muscle tumors and in
      separating inflammatory hyperplasia from neoplastic lesions of the urinary
      bladder mucosa.
AB  - Staining for argyrophilic nucleolar organizer regions (AgNORs) has proven useful
      in differentiating recurrent or malignant neoplasms from less aggressive or
      benign ones. We applied this stain to benign and malignant smooth muscle tumors
      and to hyperplastic and carcinomatous lesions in the urinary bladder of dogs in
      an effort to determine its utility in diagnostic situations. The stain was simply
      performed, and the results were repeatable for different staining intervals and
      between staining batches. For smooth muscle tumors, enumeration of AgNORs in 100
      nuclei was about as efficient as mitotic index in correctly categorizing
      histologically benign and malignant neoplasms. The mean number of AgNORs/100
      nuclei for leiomyomas was significantly less than that obtained for
      leiomyosarcomas and significantly greater than that obtained for normal smooth
      muscle. Counts for smooth muscle tumors correlated with the mitotic indexes.
      Counts by an individual observer were repeated without introducing significant
      variation, but there was variability between observers, particularly in AgNOR
      counts for leiomyosarcomas. AgNORs were not useful in separating hyperplastic or
      polypoid cystitis from transitional cell carcinoma, misclassifying both. Mean
      AgNOR counts for these 2 conditions did not differ at the 5% level of
      significance; mitotic index was more efficient at separating the 2 conditions.
      There was no correlation between mitotic index and AgNOR in urinary tract mucosal
      specimens. This easily prepared stain may be useful in separating benign and
      malignant smooth muscle tumors, although AgNORs were less contributory to
      diagnosing mucosal lesions of the urinary bladder of dogs.

PMID- 7779948
TI  - Isolation and culture of large vessel endothelium from white-tailed deer
      (Odocoileus virginianus).
AB  - Endothelial cells were obtained from white-tailed deer carotid arteries and
      umbilical vessels by instilling a weak collagenase type II solution. Cell growth
      was best when cultures were grown in plates coated with either fibronectin or
      laminin. Several commercially available media supported the growth of these cells
      when supplemented with a commercially available endothelial growth supplement and
      10% fetal calf serum. Cells obtained could be characterized as endothelium by
      ultrastructural characteristics and by the uptake of fluorescent acetylated low
      density lipoprotein. Cells stained positive for factor VIII-related antigen up to
      passage 2, but staining was inconsistent by passage 3, and no immunoreactivity
      could be demonstrated after passage 4.

PMID- 7779949
TI  - Bovine viral diarrhea serologic diagnostic reagents prepared from bacterially
      expressed recombinant proteins.

PMID- 7779950
TI  - Neutralizing activity in bovine secretions against foot-and-mouth disease virus.

PMID- 7779951
TI  - Group B rotavirus associated with an outbreak of neonatal lamb diarrhea.

PMID- 7779952
TI  - Inclusion body hepatitis and hemorrhagic enteritis in two African grey parrots
      (Psittacus erithacus) associated with adenovirus.

PMID- 7779953
TI  - Recovery of two mycoplasma species from abscesses in a cat following bite wounds
      from a dog.

PMID- 7779954
TI  - Rhodococcal abortion and pneumonia in an equine fetus.

PMID- 7779955
TI  - Antimicrobial susceptibility profiles of multidrug-resistant Salmonella anatum
      isolated from horses.

PMID- 7779956
TI  - Evaluation of a commercial system for the identification of gram-negative,
      nonfermenting bacteria of veterinary importance.

PMID- 7779957
TI  - Sporadic multicentric lymphosarcoma in a three-year-old bull.

PMID- 7779958
TI  - Presumptive botulism in cattle associated with plastic-packaged hay.

PMID- 7779959
TI  - A comparison of three avidin-biotin complex immunoenzyme systems for detection of
      African swine fever virus antigen in paraffin-embedded tissues.
AB  - The sensitivity and specificity of 3 avidin-biotin complex (ABC) immunostaining
      systems were compared on paraffin-embedded tissues from African swine fever virus
      (ASFV)-infected pigs. Results were also compared with immunofluorescent detection
      on cryosections of the same tissue for optimal detection of ASFV antigen. The ABC
      alkaline phosphatase (ABC-AP) and ABC-peroxidase (ABC-PO) systems were at least
      as sensitive as direct fluorescent antibody (FA) and 10-fold more sensitive than
      the ABC-glucose oxidase system. Three ABC-AP and 2 ABC-PO chromagens with
      different counterstains were compared. In addition, 2 fixatives, 2 biotinylation
      procedures, 7 endogenous peroxidase blocking regimes, 6 tissue adhesives, and 3
      mounting media were compared. The ABC-AP system with a red chromagen and
      hematoxylin counterstaining was preferred and most closely approximated routinely
      stained pathologic sections. Fixation in paraformalde-hydelysine-periodate
      fixative preserved ASFV antigen for research studies for at least 3 years.
      Formalin-fixed tissues retained some staining for up to 10 years.

PMID- 7779960
TI  - Early infection of interdigitating dendritic cells in the pig lymph node with
      African swine fever viruses of high and low virulence: immunohistochemical and
      ultrastructural studies.
AB  - The role of interdigitating dendritic cells (IDCs) in the early pathogenesis of
      African swine fever (ASF) was investigated using mandibular lymphoid tissue from
      normal pigs and pigs inoculated oronasally with highly virulent Lisbon 60 (L-60)
      and moderately virulent Dominican Republic 1979 (DR-2) ASF virus (ASFV) isolates.
      Paraffin-embedded tissue sections were immunostained for ASFV antigen and S-100
      protein, a marker of IDCs, using an avidin-biotin alkaline phosphatase procedure.
      Swine IDCs were identified morphologically by light microscopy, electron
      microscopy, and S-100 immunostaining. Infection with ASFV caused a marked
      reduction in S-100 staining by 3 days postinfection (DPI) that persisted through
      14 DPI. Early ASFV infection of IDCs was demonstrated at 3 DPI by double
      immunohistochemical staining of cryosections and by transmission electron
      microscopy. These results support the hypothesis that the failure of a humoral
      immune response to virulent ASFV may be due to a primary infection of IDCs and
      the inability of IDCs to initiate an immune response. Infection of IDCs has also
      been demonstrated with human immunodeficiency virus (HIV-1), and these infections
      have some aspects in common.

PMID- 7779961
TI  - Diagnosis of porcine reproductive and respiratory syndrome.
AB  - The most suitable tissue samples and test procedures for the etiologic diagnosis
      of porcine reproductive and respiratory syndrome (PRRS) were found to depend on
      several variables including the age of the pig from which tissues were collected,
      the stage of infection (acute or persistent), the available complement of
      diagnostic reagents, and the urgency in obtaining results. When the diagnosis
      involved acute infection of congenitally or neonatally infected pigs, and
      susceptible cell culture(s) was available for virus isolation, then both serum
      and alveolar macrophages (AM) were reliable samples. Alveolar macrophages flushed
      from infected lungs provided a temporal advantage, however, in that in addition
      to their use for virus isolation, i.e., from a lysate of AM, they could be
      cultured in vitro and examined for the presence of viral antigens by
      immunofluorescence microscopy (FA) as early as 1 hour after they were added to
      the culture vessel. The examination of AM in this manner also circumvented the
      need for additional cell cultures to test for infectious virus. Testing
      presuckling sera by indirect FA for antibodies to PRRS virus also was of
      diagnostic value and, like FA with AM, could be completed soon after sample
      collection. For older pigs, AM were more reliable than serum, lungs, or any of 27
      other tissues evaluated as diagnostic samples and were often the only samples in
      which infectious virus and viral antigens were detected when pigs were euthanized
      more than 3 weeks postexposure. A simple procedure for on-farm collection of AM
      as well as methods for testing AM for viral antigens and neonatal (presuckling)
      sera for homologous antibody in a modestly equipped laboratory, such as one that
      might be maintained by a veterinary practitioner, are described and discussed.

PMID- 7779962
TI  - African swine fever interference with foot-and-mouth disease infection and
      seroconversion in pigs.
AB  - Initial oral infection of pigs with either highly virulent (L-60) or moderately
      virulent (DR-2) African swine fever virus (ASFV), followed in 3 days with
      exposure to foot-and-mouth disease virus (FMDV) (tongue inoculation and contact),
      failed to cause FMDV infection or seroconversion in 18 of 22 L-60-infected pigs
      and 13 of 34 DR-2-infected pigs. Of the 13 DR-2-infected pigs remaining free of
      foot-and-mouth disease (FMD), 2 pigs survived to 24 days without antibody to
      FMDV, despite constant contact with clinically infected pigs with FMD. Three
      other DR-2-infected pigs never developed FMD lesions but did develop low levels
      of antibody to FMDV by day 17. A group of larger pig (in which DR-2 is less
      virulent) infected with DR-2 and then FMDV had a rapid but suppressed immune
      response to FMDV. Contact pigs introduced 3 days postinoculation and inoculated
      with FMDV only all became infected with ASFV by contact and died. This remarkably
      long lasting 1-way interference with FMD infection during acute and subacute
      African swine fever was not anticipated. Infection with ASFV may have blocked the
      initial target cells (possibly dendritic cells) necessary for establishment of
      FMDV infection.

PMID- 7779963
TI  - African swine fever virus infection of skin-derived dendritic cells in vitro
      causes interference with subsequent foot-and-mouth disease virus infection.
AB  - Highly purified skin-derived dendritic cells (SDDCs) isolated from swine skin by
      a simple novel method were cultured for 24 hours before independent or sequential
      inoculation with African swine fever virus (ASFV) and foot-and-mouth disease
      virus (FMDV). By avidin-biotin immunohistochemical staining, ASFV antigen was
      detected in 50% of SDDCs as early as 1.5 hours postinfection (HPI) and in 80% by
      3 HPI when cytopathic effect was noted. Cell lysis was detected with FMDV
      infection as early as 8 HPI; immunostaining for FMDV antigen was found in 10% of
      the cells. African swine fever virus replication was detected by transmission
      electron microscopy in a high percentage of SDDCs by 11 HPI. Sequential infection
      with FMDV 3 hours after ASFV inoculation blocked FMDV infection. These findings
      demonstrate that both ASFV and FMDV infect dendritic cells of Langerhans cell
      type in vitro and ASFV interferes with FMDV infection.

PMID- 7779964
TI  - Detection and subtyping of foot-and-mouth disease virus in infected cattle by
      polymerase chain reaction and amplified VP1 sequencing.
AB  - Fast and accurate detection of foot-and-mouth disease (FMD) outbreaks is needed
      to limit spread of the disease by proper vaccination. The use of the polymerase
      chain reaction (PCR) has revolutionized the way in which viral diseases are
      diagnosed. Sequence analysis of the amplified VP1 sequence can enable the
      classification of FMD virus detected in the morbid animal. PCR assays were
      carried out to identify the virus and its serotype in suspect animals from 2
      outbreaks of FMD type O virus. Sequence analysis of the amplified VP1 cDNA showed
      78% homology with O1K and over 95% homology between the samples. These findings
      suggest that the 2 outbreaks were due to infection with the same virus
      serosubtype.

PMID- 7779965
TI  - Survival of pseudorabies virus on swabs maintained under standard field sample
      shipping conditions.
AB  - Pseudorabies virus survival was compared using three different types of
      applicator swabs in Eagle's minimum essential medium held under shipping
      conditions (packed with frozen gel packs) for up to 96 hours. Virus titer decay
      rates for dacron-tipped applicators were not statistically different from those
      of controls. Titer decay rates were statistically different from controls for
      cotton- and calcium alginate-tipped applicators. With the lowest input virus
      titer, virus was detectable up to 96, 72, or 24 hours after inoculation for
      dacron-, cotton-, and calcium alginate-tipped applicators, respectively. Dacron
      tipped applicators were chosen to evaluate pseudorabies virus survival on tonsil
      swabs collected from experimentally challenged or contact control pigs to
      simulate field sampling and shipping conditions. Virus was still detectable in 20
      of 24 swab samples after 72 hours in cell culture medium under shipping
      conditions.

PMID- 7779966
TI  - Evaluation of a blocking ELISA using monoclonal antibodies for the detection of
      porcine epidemic diarrhea virus and its antibodies.
AB  - Two blocking enzyme-linked immunosorbent assays (ELISAs) involving the use of
      monoclonal antibodies (MAb) as capture and detecting agents and an indirect
      fluorescence test (IFT) were used for the detection of porcine epidemic diarrhea
      virus (PEDV) antigen or its antibodies. In the ELISA for viral antigen detection,
      the blocking step is accomplished by incubation of fecal samples, in duplicate
      wells, with PEDV-specific positive or negative serum, whereas in the ELISA for
      antibody detection the blocking step is accomplished by incubation of serum
      samples with a gut-origin virus suspension. All the methods developed were used
      to monitor an experimental infection in piglets with the CV-777 strain of PEDV
      and a natural PED outbreak in a swine fattening unit. The antigen-detection ELISA
      was able to detect PEDV shedding for a longer time than have previously described
      methods. The blocking ELISA for antibody detection was able to detect the serum
      antibody response sooner after PEDV infection than did IFT.

PMID- 7779967
TI  - Evaluation of an antigen-capture ELISA for detection of bovine viral diarrhea
      virus in cattle blood samples.
AB  - From blood samples routinely received for bovine viral diarrhea (BVD) diagnosis,
      860 samples without antibodies to BVD virus were examined in both virus isolation
      and in an antigen-detecting enzyme-linked immunosorbent assay (ELISA) based on
      monoclonal antibodies (MAbs) against the nonstructural BVD virus protein
      p125/p80. A total of 843 samples (98%) were positive (n = 170, 20%) or negative
      (n = 673, 78%) in both tests, corresponding to an agreement of kappa = 0.94.
      Among 17 samples with diverging results, 3 were from animals transiently infected
      with BVD virus, and 5 came from clinically affected animals. The reactivity of
      the MAbs was controlled against 387 field isolates of BVD virus. All were
      detected by the MAbs, thereby confirming the general view that the p125 virus
      protein is highly conserved among different BVD viruses.

PMID- 7779968
TI  - Immunoperoxidase detection of ophidian paramyxovirus in snake lung using a
      polyclonal antibody.
AB  - In a retrospective study of proliferative interstitial pneumonia in viperid and
      nonviperid snakes, formalin-fixed, paraffin-embedded lungs from 52 snakes were
      screened for immunohistochemical reactivity to ophidian paramyxovirus. All snakes
      were from zoological collections that experienced mortalities attributed to
      paramyxovirus infection. Of the 52 snakes, 47 had pulmonary lesions compatible
      with ophidian paramyxovirus infection. Histologic changes in affected lungs
      included hyperplasia and hypertrophy of septal and faveolar epithelial cells,
      loss of ciliated cells, mixed leukocytic interstitial infiltrates,
      fibrinonecrotic exudate in the lumen of proximal and distal faveolar
      compartments, and occasional epithelial syncytial cell formation or
      intraepithelial eosinophilic intracytoplasmic inclusions. Lungs were
      immunohistochemically stained for paramyxovirus antigens by utilizing rabbit
      polyclonal antibodies against a paramyxovirus isolate from a black mamba
      (Dendroaspis polyepis polyepis). Virus infection in 6 snakes was confirmed by
      virus isolation from frozen lung tissue. Of the 6 lungs from which paramyxovirus
      was isolated, 5 lungs stained positively for viral antigens utilizing antisera to
      the black mamba isolate. Altogether, 36 lungs stained positively for
      paramyxovirus antigens. There was multifocal to diffuse linear staining of the
      lumenal surface of faveolar epithelium, and there were multiple foci of granular
      cytoplasmic staining. Immunohistochemical staining of formalin-fixed lungs from
      snakes with proliferative interstitial pneumonia was helpful as a routine
      diagnostic test for substantiating a diagnosis of ophidian paramyxovirus
      infection.

PMID- 7779969
TI  - Outbreaks of yersiniosis caused by Yersinia pseudotuberculosis in farmed cervids.
AB  - Yersiniosis, caused by Yersinia pseudotuberculosis, was diagnosed in 25 deer
      submitted to the Veterinary Diagnostic Laboratories of the Ontario Ministry of
      Agriculture and Food from 8 farms in Ontario, Canada, over the 4-year period of
      January 1990 to December 1993. The organism was cultured, usually in large
      numbers, from the intestines and, less frequently, mesenteric lymph nodes and/or
      the spleen of 13 red deer (Cervus elaphus), 6 elk (C. e. canadiensis), 4 fallow
      deer (Dama dama), and 2 red deer-elk hybrids. Outbreaks occurred almost
      exclusively in the fall (September-November) and affected recently weaned calves,
      4-6 months old. Sudden death usually signalled the start of an outbreak.
      Outbreaks often occurred during inclement weather; usually a sudden cold snap,
      with or without rain, after a period of relatively mild fall weather. At
      necropsy, the animals were usually emaciated and dehydrated, and the perineum and
      tail were sometimes fecally stained. The small and large intestines were
      congested and filled with serofibrinous and/or seroanguineous fluid. Mesenteric
      lymph nodes were edematous and congested. Microabscesses surrounding large
      bacterial colonies in the lamina propria in the jejunum and ileum were typical
      lesions seen histologically. Peyer's patches were depleted and sometimes
      contained microabscesses. Purulent lymphadenitis associated with bacterial
      colonies was the prominent histologic lesion in mesenteric lymph nodes.

PMID- 7779970
TI  - Detection of anti-listeriolysin O in dairy cattle experimentally infected with
      Listeria monocytogenes.
AB  - A dot-blot assay and an enzyme-linked immunosorbent assay (ELISA) to detect
      listeriosis in dairy cattle were developed that detected anti-listeriolysin O
      antibodies in the serum of cows experimentally infected with Listeria
      monocytogenes. The tests utilized purified listeriolysin O (LLO) as the detection
      antigen and streptolysin O (SLO) to absorb cross-reacting antibodies. The two
      tests were compared with an agglutination test that used formalin-killed whole L.
      monocytogenes cells. Blood samples were collected periodically from 17 cows after
      intramammary gland infection, and the development of anti-LLO antibodies was
      followed by an agglutination test, the dot-blot test, and the ELISA. In general,
      an agglutination titer of > 640 was needed for a positive dot-blot anti-LLO test
      for nonpregnant cows. However, 1 pregnant cow with an agglutination titer of 20
      was positive in the dot-blot test. The ELISA was as sensitive as the dot-blot
      assay but gave a quantitative measurement to distinguish serum samples of
      positive reactors from cross-reactors. The specificity of the LLO-based tests was
      further evaluated using serum from cows that had been experimentally infected
      with Staphylococcus aureus, 17 of which had agglutination titers for L.
      monocytogenes > 640. These elevated agglutination titers were probably due to
      cross-reacting bacterial antigens because serum from 9 of 17 of these animals did
      not react to the purified LLO antigen. A positive response to the LLO-based dot
      blot and ELISA assays is indicative of previous or current infection with L.
      monocytogenes.

PMID- 7779971
TI  - Prevalence and serovars of leptospira involved in equine abortions in central
      Kentucky during the 1991-1993 foaling seasons.
AB  - In this study, the prevalence of leptospira-induced abortions/stillbirths for the
      past 3 foaling seasons (1991-1993) was determined, and fetal tissues and/or the
      mare's urine from positive cases were cultured in an attempt to isolate and
      identify the leptospira serovars responsible for the abortions. The sensitivity
      and specificity of the primary diagnostic tests, the fluorescent antibody test
      (FAT) and the microscopic agglutination test (MAT), used for the diagnosis of
      leptospirosis were also determined. For the 3 years, 74 (3.3%) of 2,264
      abortion/stillborn submissions were diagnosed as leptospirosis. Twelve cases
      occurred in the 1991, 19 in the 1992, and 43 in the 1993 foaling seasons.
      Leptospires were isolated from 45 (60.8%) of the 74 cases, and they were
      identified as serovar kennewicki (43 cases), serovar grippotyphosa (1 case), and
      a serovar similar to pomona (1 case). Of the 29 culture-negative cases, serologic
      results indicated that leptospires in the Pomona serogroup (kennewicki is a
      member of this serogroup) were responsible for 25 abortions, leptospires in the
      Grippotyphosa serogroup for 1 abortion, and leptospires in the Sejroe serogroup
      for 1 abortion. The specificities of the FAT on fetal tissues and mare's placenta
      and of the MAT on fetal fluid were 100%. The sensitivity of the FAT was 98.7%,
      and that of the MAT was 81.3%.

PMID- 7779972
TI  - Use of commercial enzyme kits and fatty acid production for the identification of
      Serpulina hyodysenteriae: a potential misdiagnosis.
AB  - The accuracy of identification of Serpulina hyodysenteriae strains grown in a
      complex medium was 90% when 2 commercial test kits were used. Unlike the other S.
      hyodysenteriae strains, S. hyodysenteriae strain P35/2 was unusual in being
      indole negative. The nonpathogenic intestinal spirochete PWS/A, which is from a
      different species, was indole positive and alpha-galactosidase negative.
      Identification of these spirochetes on the basis of these kits alone would have
      been incorrect. The analysis of volatile fatty acids by gas chromatography showed
      that the ratio of acetic to butyric acid was from 11:1 to 44:1 for S.
      hyodysenteriae strains, which distinguished them from the other spirochetes. The
      exception was PWS/A (acetic: butyric of 32:1), but this spirochete, unlike the S.
      hyodysenteriae spirochetes, also produced isobutyric acid. Short chain fatty acid
      (SCFA) analysis by high-performance liquid chromatography detected different
      SCFAs in addition to acetic and butyric acids. These additional SCFAs did not
      contribute to further differentiation of the porcine spirochetes.

PMID- 7779973
TI  - Immunohistochemical detection of Tritrichomonas foetus in formalin-fixed,
      paraffin-embedded sections of bovine placenta and fetal lung.
AB  - An immunohistochemical technique using a monoclonal antibody was evaluated as a
      diagnostic tool to specifically label Tritrichomonas foetus in formalin-fixed,
      paraffin-embedded sections of placenta and fetal lung from bovine abortions.
      Trichomonads were demonstrated in tissues from each of 12 abortions due to T.
      foetus and none of 15 abortions due to other or unidentified causes. Moderate to
      marked background staining occurred only in severely autolyzed tissues from T.
      foetus-infected fetuses. The antibody faintly labeled 1 of 3 other species of
      trichomonads (Trichomonas gallinae) but did not label other protozoa, bacteria,
      or fungi tested.

PMID- 7779974
TI  - [The role of heme in activating rat myocardial guanylate cyclase by sodium
      nitroprusside].
AB  - The basal activity of soluble rat myocardial guanylate cyclase (105000 x g
      supernatant) is stimulated by 2 mM dithiothreitol (2-fold). In the presence of 2
      mM dithiothreitol, sodium nitroprusside enhances the enzyme activation up to 26.5
      fold. Addition of heme-containing proteins (hemoglobin or myoglobin) produces
      further stimulation of the enzyme--by 44% and 69%, respectively. Ion-exchange
      chromatography of rat myocardial 105000 x g supernatant by stepwise elution with
      50 mM Tris-HCl buffer pH 7.6 containing 0.22 M NaCl revealed two protein peaks (I
      and II), of which only peak II possessed the guanylate cyclase activity. The
      spectrum of the 105000 x g supernatant had an absorption maximum at 415 nm (Soret
      band) which disappeared from the spectrum of the protein peak II but was detected
      in the inactive protein peak I. The guanylate cyclase preparation (peak II) lost
      its ability to be activated by sodium nitroprusside. All the attempts to
      reconstitute the nitroprusside-induced activation of the enzyme by adding the
      inactive protein peak I or the heme-containing proteins (hemoglobin or myoglobin)
      to peak II were unsuccessful. The possible mechanism of rat myocardial guanylate
      cyclase activation by sodium nitroprusside is discussed.

PMID- 7779975
TI  - [Structure and biological properties of a conjugate of Bowman-Birk type soy
      proteinase inhibitor with a block copolymer of ethylene oxide and propylene
      oxide].
AB  - The structure of the conjugate of Bowman-Birk soybean proteinase inhibitor (BBI)
      with the block copolymer of ethylene oxide and propylene oxide (proxanol)
      containing five moles of proxanol per mole of protein, has been studied. Data
      from reverse phase hydrophobic HPLC suggest that the conjugate is less
      hydrophobic compared to native BBI. A shift of the second derivative UV
      absorption spectrum for the conjugate towards the shortwave region indicates a
      greater accessibility of the Tyr-59 residue localized in the interdomain region
      of the BBI molecule for the solvent. It has been assumed that the conjugate
      induced increase in Ki for chymotrypsin may be due to both disturbances in the
      intact structure of the interdomain region of BBI and screening of the anti
      chymotrypsin reactive center as a result of hydrophobic interactions of propylene
      oxide blocks of proxanol with exposed hydrophobic groups around the reactive
      center. Supporting evidence in favour of BBI molecule hydrophilization as a
      result of modification by proxanol can be derived from decreased conjugate
      penetration into intestinal epithelial cells as well as from the slow elimination
      of the conjugate from mouse blood stream.

PMID- 7779976
TI  - [Adsorption of bile acids and cholesterol from model solutions and biological
      liquids modified with charcoal enterosorbents].
AB  - Adsorption of some bile acids and cholesterol from simulated solutions and body
      fluids by medical carbons of different origin has been studied in order to
      elucidate the role of adsorption in cholesterol reduction as well as in
      prophylaxis and treatment of atherosclerosis by orally applied carbon adsorbents.
      Oxidized carbons modified by different metal cations were tested for the first
      time for their ability to correct the saline composition of body fluids.

PMID- 7779978
TI  - [The effect of energy metabolism inhibitors on phosphoinositide metabolism in
      peripheral nerve fibers].
AB  - It has been established that inhibitors of the energy turnover acting on rat and
      rabbit sciatic nerves decrease the polyphosphoinositide level and reduce the 32P
      incorporation into these phospholipids. The results obtained are suggestive of
      the interaction between phosphoinositide and energy metabolisms in nerve fibers.

PMID- 7779977
TI  - [The role of nonparenchymal liver cells in activating protein synthesis in
      hepatocytes upon stimulating the mononuclear phagocyte system with
      lipopolysaccharide].
AB  - It has been found that the rate of hepatocyte protein synthesis depends on the
      functional state of nonparenchymal liver cells (NPC), of Kupffer cells, in
      particular. When Kupffer cells were stimulated by intravenously injected
      lipopolysaccharide (LPS), zymosan or dextran sulfate, the rate of [14C]leucine
      incorporation into hepatic proteins increased 1.5-2-fold. Similar effects were
      observed in hepatocytes cocultured with NPC isolated from LPS-stimulated rats as
      well as in hepatocytes cultured in a conditioned medium from NPC treated with
      LPS, high density lipoproteins (HDL) and hydrocortisone. It is proposed that
      apoproteins of HDL resecreted by Kupffer cells may participate in the regulation
      of hepatocyte gene expression during stimulation of resident macrophages.

PMID- 7779979
TI  - [Supramolecular organization of erythrocyte glycolysis. I. Composition of the
      cytoplasm].
AB  - The problems of supramolecular organization of glycolysis in human erythrocytes,
      molecular composition of the cytoplasm and putative forms of glycolysis
      organization have been reviewed. A hypothetical complex of glycolytic enzymes
      (metabolon) is discussed. Based on the molecular composition and experimental
      evidence, the maximally (approximately 1250) and minimally possible
      (approximately 30) numbers of the complexes per one cell as well as putative
      values of the "catalytic constant" for the metabolon have been estimated.

PMID- 7779980
TI  - [Supramolecular organization of erythrocyte glycolysis. II. Viscosity of the
      cytoplasm].
AB  - Based on the molecular composition of the human erythrocyte cytoplasm, the
      contribution of each of the components (proteins, metabolites, electrolytes) in
      the overall values of the cytoplasm viscosity has been estimated. The viscosity
      of the human erythrocyte cytoplasm may be thought of as being determined by the
      protein component and is no less than 10 mPa.s at 37 degrees C.

PMID- 7779981
TI  - [Proteolytic processes in the rat brain and serum in hypokinesia and the adaptive
      effect of delta-sleep inducing peptide].
AB  - It has been demonstrated for the first time that a single injection of the delta
      sleep inducing peptide (DSIP) results in long-term alteration of proteolytic
      enzyme activity within a broad range of pH. Using Ca(2+)-independent neutral
      endopeptidases from the synaptosomal fraction of rat brain and blood serum
      kallikrein as an example, it has been shown that DSIP activates limited
      proteolysis. This effect may contribute to the alteration of the set and "active"
      concentration of regulatory peptides and peptide hormones to the induction of the
      preadaptive state. DSIP also causes the redistribution of activity between Ca(2+)
      dependent and Ca(2+)-independent neutral endopeptidases associated with
      synaptosomal membranes, particularly under hypokinetic conditions. The
      significant decrease of the Ca(2+)-activated neutral proteinase I activity may be
      one of the mechanisms whereby the modulating effect of DSIP manifested as
      regulation of the number of glutamate receptors and limitation of effect of this
      excitatory neuromediator is realized under stress. Preliminary injection of DSIP
      prevents disturbances in the permeability of lysosomal membranes under long-term
      (24 hours) hypokinesia.

PMID- 7779982
TI  - [Biochemical mechanisms of resistance to a new antineoplastic agent
      amin(cyclopeptidylamin)-S-(-)-malatoplatinum (II) (cycloplatam)].
AB  - The "in vivo" effect of cycloplatam on DNA synthesis in leukemia P388/o (parent
      strain), P388/c (cycloplatam-resistant strain) and in some organs of tumour
      bearing mice, such as spleen, kidney, gastrointestinal mucosa (GI mucosa) and
      bone marrow, has been studied. Cycloplatam induced a deep and stable inhibition
      of DNA synthesis in leukemia cells and kidney. DNA synthesis in normal dividing
      cells (GI mucosa, bone marrow, spleen) was shown to recover more rapidly than in
      leukemia cells and kidney after cycloplatam treatment. The GSH level was
      increased tenfold in leukemia P388/c cells in comparison with P388/o. The
      glutathione peroxidase and glutathione reductase activities were increased
      twofold in the resistant strain in comparison with the parent strain, while the
      activity of glutathione-S-transferase showed a 1.5-fold increase. Administration
      of cycloplatam to tumour-bearing mice caused a marked increase of the GSH level
      in the both leukemia strains. Alterations in GSH-dependent enzymes following
      cycloplatam therapy were expressed in a lesser degree. These data indicate that
      GSH and GSH-dependent enzymes may play an important role in the resistance of
      P388 leukemia cells to cycloplatam.

PMID- 7779983
TI  - [The effect of a chalone-containing fraction on passage of the S-phase of the
      cell cycle in regenerating liver].
AB  - The duration and reversibility of the liver chalone-containing fraction on DNA
      synthesis in regenerating liver cells have been studied. It has been shown that
      administration of the [14C] chalone-containing fraction results in a rapid
      specific binding of the label to liver cells in which the label is retained for
      no less than 12 hours. The specific radioactivity of DNA in regenerating liver
      cells decreases 3-4-fold irrespective of the time of administration of the [14C]
      chalone-containing fraction. After repeated injections of the fraction under
      study, the hepatocytes loss their sensitivity towards this fraction. It is
      suggested that chalones exclude some part of the hepatocytes from the cell cycle
      which, in turn, leads to the asynchronous involvement in the cell cycle of a new
      hepatocyte population which is resistant to the chalone action.

PMID- 7779984
TI  - [Modulation of the level of sphingomyelin cycle products and expression of the
      CD3 receptor in immunocompetent organs by fumonisin B1].
AB  - The fungi (Fusarium moniliforme) residing on cereals produce a broad range of
      mycotoxins, among which fumonisins display a high toxicity alongside with
      carcinogenic and teratogenic activities. Taking into account the ability of
      fumonisins to inhibit sphingolipid synthesis, the role of sphingomyelin cycle
      products in immune reactions was studied with the view of establishing the
      correlation between the expression of the surface receptor CD3 in immunocompetent
      organs (spleen, thymus) (T-cell mediated immunity) and the degree of
      sphingomyelin cycle activation (changes in the activities of sphingomyelinase and
      sphingomyelin and ceramide content) in the spleen, thymus and liver 2.5 hours
      after intraperitoneal injection of fumonisin B1 (FB1) (5 and 20
      micrograms/animal). Significant sphingomyelinase activation was found in the
      thymus of animals injected with 20 micrograms of fumonisin. It coincides with a
      loss of the sphingomyelin and ceramide content. The changes in the
      sphingomyelinase activity and sphingomyelin content in the spleen and in the
      liver caused by fumonisin were insignificant, while the ceramide content dropped
      drastically. Fumonisin decreased the receptor CD3 expression on the surface of
      thymus cells "in vitro" and "in vivo", which is consistent with the sharp
      decrease of the ceramide content in this organ. Ceramide accumulation in thymus
      and spleen cells treated with sphingomyelinase in vitro correlates with the
      increased affinity of receptor CD3. The putative role of ceramide in the
      expression of receptors modulating T-cell mediated immunity under the influence
      of fumonisin is discussed.

PMID- 7779985
TI  - [Participation of SH-groups in regulating oxidative phosphorylation by malate and
      palmitate-uncoupled respiration in liver mitochondria].
AB  - The effect of malate on respiration in liver mitochondria has been studied during
      oxidation of succinate in the presence of rotenone both in state 3 and after
      palmitate addition. Malate was shown to stimulate the rate of mitochondrial
      respiration in the both respiratory states, its effect being increased in the
      presence of the NAD-dependent substrates of oxidation-glutamate and pyruvate or
      thiols (cysteine and thiourea) Preincubation of mitochondria for 5 min in the
      absence of respiratory substrates eliminated the stimulating effect of malate.
      However, this effect was manifested in the conditions when the NAD-dependent
      respiratory substrates or thiols were added after preincubation of mitochondria.
      p-Chloromercuribenzoate eliminated the stimulating effect of malate.
      Carboxyatractyloside and ATP inhibited mitochondrial respiration in the presence
      of palmitate. Malate did not influence the action of the first effector but
      eliminated that of the second effector. It is concluded that malate can regulate
      oxidative phosphorylation and palmitate-uncoupled respiration by affecting the
      adenine nucleotide transported. The SH-groups localized outside the mitochondria
      in the hydrophilic region play an important role in the realization of malate
      effects.

PMID- 7779986
TI  - [Stability of a new product of oxidative stress in bacterial cells].
AB  - Data on 32P-label incorporation with subsequent addition of non-radiolabelled o
      phosphate suggest that the new phosphorus compound, 2-C-methyl-D-erythritol-2,4
      cyclopyrophosphate (MEC), accumulated in the cells of some bacterial species in
      response to oxidative stress does not rapidly exchange phosphorus with external o
      phosphate 3 hours after the introduction of its synthesis inducers into the
      Corynebacterium ammoniagenes culture. The accumulated MEC is retained in the
      cells despite the action of the cell wall synthesis inhibitor, chloramphenicol,
      or the energetic poisons, KCN and iodoacetate and also under anaerobic
      conditions. It has been shown that incubation of the cell-free lysate of a non
      induced culture, Micrococcus luteus, with MEC does not result in MEC hydrolysis;
      therefore, MEC accumulation after the redox-mediator addition is hardly due to
      the hydrolase inactivation but, rather, is due to the activation of the MEC
      synthesizing enzyme. The cells of C. ammoniagenes incorporate 32P from [32P]MEC
      but not 14C from [14C]MEC. This points to MEC hydrolysis prior to the uptake of
      its phosphoryl fragment by the cells. In this case 32P is found in the fractions
      differing by their position from MEC fractions. Experiments with sheep
      erythrocytes and mouse splenocytes revealed that MEC (10-100 micrograms per
      1,000,000 splenocytes) does not influence the antibody production by these cells,
      whereas used at concentrations of 200-550 micrograms per 1,000,000 cells, MEC
      enhances the antibody production. However, while doing so, MEC causes the
      destruction of a considerable portion of splenocytes and sheep erythrocytes.

PMID- 7779987
TI  - Chalcone synthase localization in early stages of plant development. I.
      Immunohistochemical use of plasmolysis for localizing the enzyme in epidermal
      cell cytoplasm of illuminated buckwheat hypocotyls.
AB  - Immunohistochemical methods combined with progressive plasmolysis were used to
      localize chalcone synthase (CHS), an important enzyme for plant metabolism of
      aromatics in hypocotyls of illuminated buckwheat (Fagopyrum esculentum M.)
      seedlings. Illumination of etiolated seedlings with white light results in
      anthocyanin synthesis in the epidermal layer of the hypocotyl. Anthocyanin
      containing epidermal peels, after fixation for 30 min in 4% paraformaldehyde,
      2.5% glutaraldehyde, 0.1% caffeine, were treated with a specific rabbit anti
      buckwheat CHS antibody and a 20 nm goat anti-rabbit IgG gold conjugate. CHS is
      specifically shown in epidermal cells as pink to dark red deposits. Progressive
      plasmolysis combined with our immunohistochemical method showed that CHS was
      located exclusively in the cytoplasm of the epidermal cells of buckwheat
      hypocotyls except for the guard cells, which contained no detectable CHS.

PMID- 7779988
TI  - A quick embedding method for light microscopy and image analysis of cotton
      fibers.
AB  - A quick embedding method using UV polymerization of methacrylate plastic has been
      devised for embedding fibers encased in a polyvinyl chloride tube. The resulting
      embedments are suitable for light microscopy and image analysis.

PMID- 7779989
TI  - Anti-fading agents for confocal immunofluorescence: colocalization of nuclear
      polypeptides.
AB  - We evaluated the performance of four anti-fading agents during acquisition of
      multiple optical sections near the widest diameter of Drosophila accessory gland
      nuclei using indirect immunofluorescence and confocal laser scanning microscopy.
      Two commercially available agents, Vectashield and SlowFade showed anti-fading
      properties that alleviated fluorochrome fading associated with the acquisition of
      multiple fluorescent optical Z-series from a single specimen by a confocal laser
      scanning system. Using these reagents, we were able to colocalize polypeptides
      through immunostained whole Drosophila nuclei.

PMID- 7779990
TI  - The influence of specimen preparation on artefacts in scanning electron
      microscopy of respiratory cilia.
AB  - The effects of various handling procedures used in preparing specimens of human
      and pig respiratory mucosa for scanning electron microscopy (SEM) were studied.
      Using five different washing methods, the percentage area of mucosa covered with
      extracellular material varied from 1.5 to 53.1%. The best results were achieved
      when specimens were washed by gently inverting a sample 30 times in a container
      filled with physiological saline. Fixation and drying of the surface layer caused
      disorientation of cilia and made examination difficult. Mechanical damage caused
      loss of cilia and rupture of the cell membrane. For SEM of respiratory cilia it
      is important to wash the specimen in saline before fixation and to use biopsy
      forceps as little as possible.

PMID- 7779991
TI  - Silver enhancement of colloidal gold particles in deplasticized semithin epoxy
      sections.
AB  - A simple method for light microscope screening of pre-embedded, gold-labeled
      samples, by silver enhancing deplasticized semithin epoxy sections is presented.
      This method is of great help in visualizing the topography of gold labeled sites
      at low magnification and for selecting labeled sample regions for subsequent
      electron microscope analysis on serial ultrathin sections. The method was
      developed during a study of lectin binding sites on the egg surface of the anuran
      amphibian Discoglossus pictus.

PMID- 7779992
TI  - Intracytoplasmic sperm injection in the mouse.
AB  - Intracytoplasmic sperm injection (ICSI) was successful in the mouse when a piezo
      driven micropipette was used instead of a mechanically driven conventional
      pipette. Eighty percent of sperm-injected oocytes survived, and approximately 70%
      of them developed into blastocysts in vitro. When 106 embryos at the 2- to 4-cell
      stage were transferred to eight naturally mated foster mothers, 30% of the
      embryos (25-43%, depending on the host) reached the full term. Except for two
      that were cannibalized soon after birth, all of the young (30 pups) grew into
      normal adults. Studies of this type on the mouse may increase understanding of
      the fertilization process and of how ICSI works.

PMID- 7779993
TI  - Influence of the muscarinic agonist carbachol on intracellular Ca2+ in chicken
      granulosa cells: I. Dependence on follicular maturation.
AB  - The present study addressed the influence of follicular development on
      carbamylcholine chloride (Cch)-induced Ca2+ transients and inositol 1,4,5
      trisphosphate (IP3) production in granulosa cells isolated from the first (F1),
      third (F3), and fifth and sixth (F5,6) largest follicles. Intracellular free
      calcium, [Ca2+]i, was measured in fura-2-loaded cells about 20-36 h after their
      isolation. The percentage of cells responding to a maximal stimulatory
      concentration of Cch (0.2 mM) was higher in the F1 (89%) granulosa cells than in
      cells from the F3 (68%) and the F5,6 (72%) follicles. Most of the Ca2+ transients
      that were elicited in F1 granulosa cells were characterized by large (696 +/- 119
      nM), fast (260 +/- 55 nM/sec) increases in [Ca2]i followed by a slow, uneven
      decrease in [Ca2+]i to the resting concentration. In contrast, Cch-induced
      changes in [Ca2+]i in F3 and F5,6 granulosa cells were generally both smaller
      (154 +/- 37 nM and 165 +/- 37 nM, respectively) and slower (36 +/- 25 nM/sec and
      46 +/- 16 nM/sec, respectively) than those observed in cells from the largest
      follicle. Removal of external Ca2+ did not alter the large, fast increases in
      [Ca2+]i; however, it nearly blocked the slow responses observed in F3 and F5,6
      cells. IP, production was elevated in 3H-myo-inositol-loaded F1 granulosa cells
      after 1 min of Cch (0.2 mM) treatment, whereas inositol bisphosphate (IP2)
      production and inositol monophosphate (IP) production were elevated only after
      longer incubations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779994
TI  - Mitochondrial deoxyribonucleic acid 4977-bp deletion is associated with
      diminished fertility and motility of human sperm.
AB  - The accumulation of mitochondrial DNA (mtDNA) mutations has been suggested to be
      an important contributor to human aging and degenerative diseases. In previous
      studies, we found an age-dependent increase of mtDNA mutations in various human
      tissues. Sperm motility is one of the determinants of male fertility. The
      possible relationship between mtDNA deletions and diminished fertility and
      motility of sperm was explored in the present study. We examined accumulation of
      the 4977-bp mtDNA deletion in spermatozoa obtained from patients with infertility
      or subfertility and compared these values with those of normal individuals. Using
      polymerase chain reaction (PCR) techniques, we determined the frequency of
      occurrence and the proportion of mtDNA with the 4977-bp deletion in human
      spermatozoa with different motilities. Human spermatozoa were separated by self
      migration in Percoll gradients into five fractions with different motility
      scores. The highest frequency of occurrence of the 4977-bp mtDNA deletion was
      found in sperm in the fraction with the lowest motility. The results revealed a
      negative correlation between sperm motility and the proportion of 4977-bp-deleted
      mtDNA. Furthermore, we found a significantly higher incidence of the 4977-bp
      mtDNA mutation in patients with asthenospermia, oligospermia, and primary
      infertility compared to normal individuals. These findings suggest that mtDNA
      mutations may play an important role in some pathophysiological conditions in
      human spermatozoa.

PMID- 7779995
TI  - Prostaglandin synthase activity of fetal sheep cotyledons at 122 days of
      gestation and term: expression of prostaglandin synthetic capacity in fetal
      cotyledonary tissue near labor is location-dependent.
AB  - An activity assay is described quantification of prostaglandin synthase (PGHS) in
      sheep placental cotyledon under initial velocity conditions through measurement
      of the stable product prostaglandin E2 (PGE2). The effects of temperature, time,
      and substrate concentration on initial reaction velocity, and lipoxygenase and
      PGHS product formation in cotyledonary tissue, were examined in detail. We used
      this activity assay to determine whether or not an increase of active PGHS by
      placental location within the uterus might contribute selected prostaglandins
      (PG) for the directed initiation of parturition. Sheep cotyledon tissue was
      collected (n = 6 animals) from the ventral aspect of the uterine body, mid-horn,
      and horn tip at 122 days of gestation (dga), and from the same locations in the
      ventral body and horn tip at 142-145 dga (in animals at term but not in labor; n
      = 4). At 122 dga, there was no increase in active PGHS in cotyledonary tissue
      from the horn tip, mid-horn, or uterine body. By 142-145 dga, the horn showed
      significantly (p < 0.01) more enzyme activity than the body. At the same time,
      production of PGE2, expressed as a percentage of total eicosanoids, had not
      changed significantly. The development of an increase in PGHS toward the uterine
      tip implies that variations in regional PG production may contribute to the
      progression of labor.

PMID- 7779996
TI  - Tumor necrosis factor alpha inhibits rat granulosa cell plasminogen activator
      activity in vitro during follicular development.
AB  - The objective of the present in vitro study was to examine the potential
      modulatory influence of tumor necrosis factor-alpha (TNF alpha) on the granulosa
      cell plasminogen activator (PA) system during follicular development.
      Undifferentiated and differentiated rat granulosa cells of preantral follicles
      and antral follicles, respectively, were cultured in a chemically defined medium
      with or without TNF alpha and in the absence or presence of FSH (400 ng/ml). TNF
      alpha (0.5-50 ng/ml) inhibited basal and FSH-induced net PA activities in
      cultures of granulosa cells from preantral and antral follicles in a
      concentration- and time-dependent manner. Although PA activities with
      corresponding molecular masses of 55 kDa and 30 kDa (tissue-[tPA] and urokinase
      [uPA] type PA, respectively) were observed in culture of undifferentiated
      granulosa cells, only tPA was detectable in differentiated cells. Concomitant to
      the stimulation in PA activities by FSH was a marked increase in progestin
      secretion and a decrease in DNA synthetic capacity at both stages of follicular
      development. Independent of the differentiative state of the granulosa cells, TNF
      alpha suppressed FSH-stimulated tPA activity, but potentiated FSH-induced uPA
      activity in undifferentiated granulosa cells. The inhibition of the gonadotropin
      action by TNF alpha was accompanied by an increase in PA inhibitor activity,
      which was more pronounced in cultures of differentiated granulosa cells. TNF
      alpha inhibited FSH-induced progestin secretion and reversed the action of the
      gonadotropin on DNA synthesis irrespective of stage of follicular maturation.
      These studies demonstrate that TNF alpha modulates gonadotropic action on
      granulosa cell differentiation (PA and progestin secretion) and proliferation
      (DNA synthesis) during follicular development.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7779997
TI  - Parthenogenetic activation of porcine oocytes with guanosine-5'-O-(3'
      thiotriphosphate).
AB  - A possible mechanism by which sperm activate oocytes may involve a G protein
      mediated signal-transducing pathway. Artificial stimulation of G proteins leads
      to events very similar to those at fertilization in oocytes of several species.
      Here we report the effects of activation of a G protein with guanosine-5'-O-(3'
      thiotriphosphate) (GTP-gamma-S), a hydrolysis-resistant analog of guanosine
      triphosphate (GTP), in porcine oocytes. Mature oocytes were injected with 1 mM
      GTP-gamma-S. In response to injection, oocytes underwent changes normally
      occurring at fertilization, i.e. cortical granule exocytosis, changes in the
      protein synthetic profile, pronuclear formation, and development to the
      blastocyst stage. Guanosine-5'-O-(2-thiodiphosphate) (GDP-beta-S; a metabolically
      stable analog of guanosine diphosphate [GDP] that inactivates the G protein) and
      the carrier medium (CM; medium in which the injected compounds were dissolved)
      were significantly less effective in oocyte activation. It is suggested that
      porcine oocytes contain the components of a G protein-mediated signaling pathway
      that might function in oocyte activation at fertilization.

PMID- 7779998
TI  - Effects of matrix proteins and heparin-binding components in fetal bovine serum
      upon the proliferation of ectoplacental cone cells in mouse blastocysts cultured
      in vitro.
AB  - Trophoblastic invasion of the endometrium is among the events that are crucial
      for successful implantation and hemochorial placentation. To understand the
      mechanism underlying the trophoblastic invasion, we investigated effects of
      fibronectin substratum and heparin-binding components in fetal bovine serum (FBS)
      upon trophoblast and ectoplacental cone (EPC) cells derived from mouse
      blastocysts produced by IVF and cultured in vitro. The results demonstrated that
      1) in these blastocysts, contact of EPC cells with fibronectin-coated glass
      substratum in the presence of FBS triggered an outburst of cell proliferation
      with the eventual differentiation of the EPC cells into secondary giant
      trophoblast cells and 2) frequencies of blastocysts that exhibited EPC cell
      proliferation significantly increased if FO medium (modified Eagle's minimum
      essential medium) was supplemented with FBS depleted of heparin-binding
      substances (H-FBS). One possible interpretation of the effect of H-FBS is that
      free fibronectins or related substances in the serum might interfere with EPC
      cell proliferation, for which the presence of substratum-bound fibronectin is
      essential. Alternatively, the serum might contain heparin-binding competitive
      inhibitors of yet unidentified growth factor(s) necessary for EPC cell
      proliferation.

PMID- 7779999
TI  - Influence of follicular maturation on inhibition of luteinizing hormone-, cyclic
      3',5'-adenosine monophosphate-, and forskolin-stimulated progesterone production
      in chicken ovarian granulosa cells exposed to bursal anti-steroidogenic peptide.
AB  - Previously, we demonstrated that a peptide from chicken bursa of Fabricius,
      bursal anti-steroidogenic peptide (BASP), inhibited LH-stimulated progesterone
      biosynthesis by granulosa cells from the two largest preovulatory follicles of
      the chicken ovary. In the present study, we investigated the influence of
      follicular maturation on the ability of BASP to inhibit granulosa cell
      steroidogenesis. Granulosa cells from the largest (F1), third largest (F3), and
      fifth largest (F5), preovulatory follicles of the laying hen were exposed to BASP
      in the presence or absence of ovine LH, forskolin, or dibutyryl-cAMP (db-cAMP).
      BASP (0.125 or 0.25 bursal equivalents [BEQ]) suppressed basal progesterone
      production in F5, but not in F1 or F3, granulosa cells. BASP suppressed LH
      stimulated progesterone production in F1, F3, and F5 granulosa cells in a
      concentration-dependent manner; however, the lowest level (0.06 BEQ) did not
      suppress progesterone production in F5 granulosa cells. All levels of BASP
      suppressed forskolin-stimulated progesterone production in F1 granulosa cells,
      but only the highest level (0.25 BEQ) inhibited forskolin-stimulated
      steroidogenesis in F3 and F5 granulosa cells. Similar results were obtained with
      db-cAMP-stimulated granulosa cells. The inhibitory effects of BASP on F1, F3, and
      F5 granulosa cells were directly compared on a percentage basis. In the presence
      of each secret-agogue, the lowest level (0.06 BEQ) of BASP effectively suppressed
      progesterone synthesis in F1 and F3 but not F5 granulosa cells. At higher levels,
      there was no consistent difference in the ability of BASP to suppress stimulated
      progesterone production in granulosa cells at different stages of
      maturation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780000
TI  - Quantitative evaluation of the cell cycle-related retinoblastoma protein and
      localization of Thy-1 differentiation protein and macrophages during follicular
      development and atresia, and in human corpora lutea.
AB  - Ovarian follicular development is dependent on growth and differentiation of the
      oocyte, as well as the granulosa and theca cell layers. The majority of primary
      follicles in the adult human ovary are not growing, and most antral follicles
      undergo atresia. The mechanisms regulating follicular growth and differentiation
      are poorly understood. Expression of key regulatory proteins in cells of certain
      follicles may be involved. We have studied the distribution of retinoblastoma
      protein (pRb), a key cell cycle regulator, in human follicles and CL by
      quantitative immunohistochemistry. Recent studies suggest that high nuclear
      concentrations of pRb are associated with the arrest of cell proliferation and
      the beginning of differentiation; during advanced differentiation of cells pRb is
      markedly depleted or absent. We also studied follicular distribution of Thy-1
      differentiation protein, a morpho-regulatory molecule associated with cell
      differentiation, and the presence of macrophages. Macrophages have been shown to
      stimulate steroidogenesis in granulosa cells in vitro, and they are required for
      release of Thy-1 differentiation protein from vascular pericytes among granulosa
      cells in vivo. Our results indicate that oocytes in resting follicles exhibit pRb
      in the nucleoli. During initiation of follicular growth, the pRb expression first
      extends over the oocyte nuclei and then diminishes from both nuclei and nucleoli
      in preantral follicles. When the oocytes reach maximum size in small antral
      follicles, the pRb expression is reestablished in oocyte nucleoli. In
      differentiating granulosa and theca cell layers of preantral and small antral
      follicles, pRb expression is high, but it is low in growing large antral
      follicles. During CL development and regression, pRb expression in the nuclei of
      granulosa lutein cells first increases and then decreases. Follicular development
      is accompanied by the presence of Thy-1 differentiation protein and macrophages
      under the follicular basement membrane. In growing large antral follicles, during
      the mid-follicular phase, larger macrophages exhibit physical contacts with
      granulosa cells through the follicular basement membrane, and, during the late
      follicular phase, small dendritic macrophages can be detected among granulosa
      cells, but not within the follicular antrum. Large antral follicles undergoing
      atresia exhibit strong pRb expression in granulosa cells. This is accompanied by
      a lack of Thy-1 differentiation protein among granulosa cells and the occurrence
      of large phagocytic macrophages in the follicular antrum. This is the first
      report of pRb expression in the human ovary.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7780001
TI  - Expression of mitochondrial heat shock protein 60 in distinct cell types and
      defined stages of rat seminiferous epithelium.
AB  - Changes in the level of the gene transcript of heat shock protein (hsp)60, a
      mitochondrial chaperonin, during the cycle of rat seminiferous epithelium and its
      cellular localization were studied. The seminiferous epithelium showed a cell
      type-specific expression of hsp60. Immunostaining of adult rat testis revealed
      localization in Sertoli and Leydig cells. In germ cells, mitochondria of
      spermatogonia and early primary spermatocytes were immunoreactive for hsp60.
      Mitochondria of all other germ cell types were completely negative for hsp60.
      Stage-specific expression of hsp60 was determined from pooled segments of stage
      specific microdissected tubules by a combination of Western blotting and
      polymerase chain reaction (PCR). High concentrations of hsp60 were found in
      stages I-V and IX-XIV, and low levels were detected in the other stages, i.e., VI
      VIII. In stages with high hsp60 expression, spermatogonia divide mitotically,
      whereas in stages lacking mitosis, the hsp60 level was much weaker. In
      seminiferous epithelium, two different types of mitochondria are present.
      Therefore, immunoelectron microscopy was used to differentiate these two
      morphologically distinct types of mitochondria. The crista type of mitochondria
      (e.g., in Sertoli cells and spermatogonia) reacted with the antibody against
      hsp60, whereas hsp60 was negative in so-called "condensed"-type mitochondria
      found in midpachytene spermatocytes and more advanced germ cells. It could be
      shown for the first time that expression of the hsp60 gene is regulated during
      the cycle of the seminiferous epithelium. The results indicate that the gene
      product is primarily needed during the initial steps of spermatogenesis in which
      most of the cell divisions occur, while its expression during the differentiation
      of spermatids and sperm is obviously not necessary. The presence of hsp60 in
      stages with mitotic activity suggests a very active mitochondrial protein import
      and protein assembly machinery that generates further mitochondria for the
      dividing cells.

PMID- 7780002
TI  - Modulation of gonadotropin secretion at the pituitary level by testosterone in
      gonadotropin-releasing hormone-treated male rats during food deprivation.
AB  - Testosterone (T) inhibits the synthesis and secretion of FSH and LH by decreasing
      the secretion of GnRH from the hypothalamus. However, T is also able to stimulate
      FSH gene expression and synthesis at the pituitary level when the release or
      action of GnRH is blocked. In the present study, we analyzed whether the positive
      effect of T on pituitary FSH could also be brought about during food restriction,
      which represents a model of suppressed GnRH secretion. We also wanted to learn
      whether this positive effect could be detected if GnRH pulsatility is maintained
      by exogenous injections. Adult male rats were subjected to various combinations
      of the following treatments: 1) implantation of silastic capsules containing T
      for Days 0-4 of the experiment, 2) starvation for Days 1-4 of the experiment, and
      3) GnRH-treatment at 2-h intervals (500 ng/kg BW) for Days 3-4. The combined
      treatments were as follows: 1) control, 2) only starvation, 3) only GnRH, 4)
      starvation+GnRH, 5) only T, 6) starvation+T, 7) GnRH+T, and 8) starvation+GnRH+T
      (n = 12/group; two independent experiments). Serum FSH level was decreased 20% by
      starvation (p < 0.01), but no decrease was observed when the starving animals
      were treated with T. GnRH treatment increased serum FSH in both ad libitum-fed
      and starving animals to 266% and 333% of the respective control values (both p <
      0.01). When T was added to these treatments, the increases in serum FSH were
      smaller, 219% and 272%, respectively (p < 0.01 vs. respective groups without
      T).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780003
TI  - Daily patterns of pituitary prolactin secretion and their role in regulating
      maternal serum progesterone concentrations across pregnancy in the Djungarian
      hamster (Phodopus campbelli).
AB  - Profiles of serum prolactin (PRL) and progesterone (P4) were determined in
      repeatedly (every 2 h) sampled female Djungarian hamsters (Phodopus campbelli)
      over a 24-h period on Days 3, 6, 9, 12, and 15 of the 18-day pregnancy. The first
      half of pregnancy was characterized by significant surges of PRL within a 2-h
      period around dawn (0500 h) and dusk (1900 h), with some females also showing a
      weak midday surge at 1300 h. By Day 9, dusk and midday surges were absent, but
      the dawn surge remained at its initial amplitude. On Day 12, no PRL surges were
      seen. Resumption of both the dusk and dawn PRL surges occurred on Day 15 of
      gestation. Considerable interindividual variability in the amplitude of PRL
      surges, the timing of PRL surges, and the number of surges per day was detected
      and would complicate any assessment of PRL levels based on single samples per
      female. Serum P4 concentrations were 8-10 ng.ml-1 before doubling on Day 15. A 3
      day treatment of 50 and 300 micrograms bromocryptine (CB 154; on Days 13-15)
      effectively suppressed PRL during late pregnancy (Day 15) but did not alter serum
      P4 concentrations or interfere with parturition. Therefore, surges of PRL are not
      an essential luteotropic stimulus during late gestation. Compared to oil-injected
      controls, CB 154-treated females had a higher incidence of infanticide
      postpartum. Growth rates of the pups, mammary gland development, and successful
      delivery of milk to pups, however, did not differ between groups. Further studies
      will be required to determine the function of late-gestation PRL surges.

PMID- 7780004
TI  - Estrogen-induced guinea pig model for uterine leiomyomas: do the ovaries protect?
AB  - A guinea pig model was used to study the hormonal control of uterine leiomyomas.
      Twenty female guinea pigs were divided into four groups--young, old,
      ovariectomized (OVX), and non-OVX animals--and were given two estradiol-17 beta
      (E2) silastic implants each for 3-10 mo; another four older OVX animals served as
      controls and received empty implants. After 3 mo, 100% (8 of 8) of the OVX
      animals, but none of the OVX controls, developed tumors, mainly on the uterine
      serosa and the abdominal wall. Electron microscopy and desmin immunostaining
      demonstrated that the tumors were leiomyomas. In E2-treated animals, E2 levels in
      serum, leiomyomas, or leiomyoma-free uterine segments rose significantly while
      serum progesterone (P4) was negligible. Surprisingly, only 8% (1 of 12) of the
      non-OVX animals developed a tumor. This apparent "ovarian protection" was
      transient: after 6-9 mo, 50% of the remaining non-OVX animals developed
      leiomyomas, but these were smaller and fewer than in OVX animals. On the basis of
      this model, we propose the hypothesis that some factors from the ovaries suppress
      leiomyoma growth in response to estrogen but that as the ovaries age this
      protection is diminished, allowing the clinical development of leiomyomas.

PMID- 7780005
TI  - Influence of prenatal and postnatal photoperiods on postnatal testis development
      in the Siberian hamster (Phodopus sungorus).
AB  - In Siberian hamsters, juvenile testicular development is regulated to a large
      extent by photoperiod. Mother hamsters are able to pass photoperiodic information
      to their male fetuses, and this information can influence their postnatal gonadal
      development. In this study, we investigated the effects of gestation in long
      (16L:8D) and short (10L:14D) day lengths on the rates of juvenile testicular
      growth in several different postnatal photoperiods. On the day of parturition,
      parents and young from each gestation photoperiod were raised in 14L:10D through
      Day 13 of life and then were exposed to one of six photoperiods--16L:8D, 15L:9D,
      14L:10D, 13L:11D, 12L:12D, or 10L:14D--until Day 32 of age. The data indicated
      that 15L and 14L are the minimal day lengths required to prevent complete
      inhibition of testis growth in long (16L) and short day (10L)-gestated hamsters,
      respectively. These results support earlier findings suggesting that gestation
      photoperiod can influence the rate of reproductive development in a certain range
      of "intermediate" postnatal day lengths (14L to 15L), but that gestation
      photoperiod does not alter the pattern of testis development in hamsters exposed
      to other (i.e., longer or shorter) postnatal photoperiods. Thus, both the
      absolute length and the direction of change of photoperiods experienced in early
      life can influence prepubertal testis growth.

PMID- 7780006
TI  - Interleukin 4 production by human amnion epithelial cells and regulation of its
      activity by glycosaminoglycan binding.
AB  - The pro-inflammatory molecules, tumor necrosis factor alpha (TNF alpha),
      interleukin 1 (IL-1), interleukin 6 (IL-6), and prostaglandin E2 (PGE2), are
      postulated to have a role in human pregnancy and parturition. The ability of
      interleukin 4 (IL-4) to suppress the production of TNF alpha, IL-1, IL-6, and
      PGE2 by activated monocytes prompted us to investigate a possible regulatory role
      for IL-4 in human gestation. Immunohistochemical techniques were used to show
      that human amnion epithelium stained positively for IL-4. Tissue from both the
      first (n = 5) and third (n = 46) trimester expressed immunoreactive IL-4, which
      was detected by the use of four antihuman IL-4 monoclonal antibodies. Analysis of
      mRNA by reverse transcriptase-polymerase chain reaction (RT-PCR) on RNA extracts
      of amnion epithelial cells indicated that they were the source of IL-4. One of
      the anti-IL-4 antibodies used stained IL-4 protein associated with the basement
      membrane of the amnion epithelium. The mechanism of this association was
      investigated. IL-4 was shown to be a heparin-binding cytokine, which would enable
      it to bind to components of the extracellular matrix. Thus, this study identified
      a previously undescribed cellular source of IL-4, implicating a role for IL-4 in
      human gestation. Additionally, glycosaminoglycan binding may regulate IL-4
      activity in vivo.

PMID- 7780007
TI  - Secretion of bovine uterine proteins in response to type I interferons.
AB  - Bovine interferon-tau (bIFN-tau) is secreted by the developing conceptus and
      initiates antiluteolytic events by interacting with uterine membrane receptors.
      We have identified three endometrial proteins (approximately 8, 16, and 28 kDa;
      P8, P16, and P28; respectively) that are secreted in response to recombinant (r)
      bIFN-tau. The objective of this study was to determine whether or not secretion
      of these proteins was a unique response to IFN-tau during early pregnancy. Three
      experiments were designed to examine secretion of endometrial proteins as a
      function of time in culture (0, 3, 6, 12, 18, 24 h), stage of the estrous cycle
      and pregnancy (Days 15, 18, 0/21), and dose of Type I IFN (0, 0.5, 5, and 25 nM;
      rbIFN-tau, rbIFN-alpha, and roIFN-tau). Endometrium was cultured for times
      specified with L-[3H]leusine to generate radiolabeled proteins. Secreted proteins
      were quantitated by using one-dimensional (1D)-PAGE, fluorography, and
      densitometry. Secretion of P8, P16, and P28 increased over time (p < 0.0001) in
      culture and in response to 25 nM rbIFN-tau (p < 0.05). Secretion of P8 in
      response to rbIFN-tau was higher (p < 0.05). Secretion of P8 in response to rbIFN
      tau was higher (p < 0.0005) in endometrium collected from pregnant than
      nonpregnant heifers, but did not differ across the days examined. Although
      secretion of P8 was higher (p < 0.0001) in the presence than in the absence of
      rbIFN-tau, it was not affected by rbIFN-alpha.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780008
TI  - Progesterone, estradiol, and prolactin involvement in lactation, including
      lactation following a postpartum mating, in the Djungarian hamster (Phodopus
      campbelli).
AB  - The endocrinology of lactation in the Djungarian hamster was investigated through
      once-daily sampling of females on Days 0, 3, 6, 9, 12, 15, and 18 postpartum.
      Serum prolactin (PRL) was elevated during early lactation but declined with time.
      Serum progesterone (P4) levels were uniformly low, and serum estradiol (E2)
      levels increased after Day 9. New CL were formed after the postpartum ovulation
      and persisted throughout lactation. During the first 9 days, the CL had the high
      P4 content typical of pregnancy. After Day 9, each individual CL decreased in P4
      content and increased in E2 content. As evidenced by the reappearance of large
      antral follicles, lactating females probably returned to ovulatory cycles at
      about that time. The Djungarian hamster has a postpartum estrus and is capable of
      delivering a second litter without a diapause (18 days), although the majority of
      second litters are delayed. Mating during the postpartum estrus had no detected
      effect on growth or survival of the first litter. Second pregnancies were
      developmentally delayed by 3 to 7 days. P4 was effectively absent from serum for
      the first 12 days after mating. Although CL contained high levels of P4, the CL
      remained small and poorly vascularized. Mated females did not have higher serum
      P4 levels than nonpregnant, lactating females until Day 18. In response to the
      competing demands of lactation and concurrent gestation, the endocrine conditions
      associated with pregnancy were the most affected.

PMID- 7780009
TI  - In vitro transformation of rabbit cytotrophoblast cells into syncytiotrophoblast:
      stimulation of hormone secretion by progesterone and dibutyryl cyclic 3',5'
      adenosine monophosphate.
AB  - Rabbit placenta syncytiotrophoblast cells exhibit immunostaining for the hormone
      relaxin. The objectives of this study were to evaluate the ability of cultured
      rabbit trophoblast cells to secrete immunoreactive (IR) relaxin and then to study
      the effects of progesterone, which is essential for maintenance of the placenta
      and of pregnancy in the rabbit, on that secretion. On Day 1, both treated and
      untreated trophoblast cell cultures consisted of 90% relaxin-negative mononuclear
      cells (cytotrophoblast and fibroblast) and 10% relaxin-positive multinuclear
      cells (syncytiotrophoblast). Media from untreated cultures, collected throughout
      9 days of culture, contained low but constant levels of relaxin. Electron
      microscopy studies indicated that relaxin was localized in dense granules of the
      multinuclear cells and that these cells formed by fusion of mononuclear
      cytotrophoblast. Progesterone treatment (40 and 80 ng/ml) increased (p < 0.0001)
      media concentrations of relaxin, increased the number of desmosomes between
      cytotrophoblast cells (12 vs. 4 for controls on Day 5), and increased the
      percentage of multinuclear cells (73% of the cell population vs. 20% for controls
      on Day 7). Specificity of the progesterone effect was evaluated by treatment of
      cultures with dibutyryl cAMP (dbcAMP), insulin, hCG, estradiol-17 beta,
      prostaglandin E2, and prostaglandin F2 alpha. Only dbcAMP (2 mM and 4 mM)
      produced an increase (p < 0.0001) in media concentrations of relaxin. These
      results indicate that, like the intact placenta, cultured cytotrophoblast cells
      fuse to form syncytiotrophoblast and that the latter contain IR relaxin.

PMID- 7780010
TI  - Effects of passive immunization of ewes against an inhibin-peptide on
      gonadotropin levels, ovulation rate, and prolificacy.
AB  - The experimental objectives were to determine whether injection of semi-purified
      (sp; ammonium sulfate-precipitated) and highly purified (hp; immunoaffinity
      purified) ovine antibody (Ab) against an inhibin-peptide fragment (alpha-IF)
      before the preovulatory period would 1) stimulate FSH secretion in a dose
      response manner, 2) induce an increase in ovulation rate, and 3) affect pregnancy
      rate and prolificacy (lambs born alive per ewe lambing). During the early
      breeding season, estrus was synchronized in 30 2-yr-old crossbred ewes through
      use of progesterone-releasing pessaries (CIDR-G). Two doses (330 and 660
      laboratory reference preparation [RP-2] kU) of sp- and hp-alpha-IF-Ab were
      injected i.m. 48 h before CIDR-G removal (6 ewes per group). Six other ewes
      received control solution. Plasma alpha-IF-Ab titers peaked at 12 h
      postinjection. Plasma FSH levels were higher (p < 0.02) in alpha-IF-Ab-treated
      ewes than in control ewes from 12 to 24 h postimmunization. Magnitudes of FSH
      increases were similar in ewes administered sp- and hp-alpha-IF-Ab and were
      greater (p < 0.05) in ewes receiving 660 than in those receiving 330 RP-2 kU.
      Compared to control values, the higher alpha-IF-Ab dose increased FSH levels by
      44 +/- 5% and the lower dose increased the levels by 22 +/- 3%. Plasma LH levels
      were similar among passively immunized and control sheep. Ovulation rate was
      increased (p < 0.0005) by alpha-IF-Ab treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780011
TI  - Expression of collagen alpha 1(VI), alpha 2(VI), and alpha 3(VI) chains in the
      pregnant mouse uterus.
AB  - The alpha 1, alpha 2, and alpha 3 chains of collagen VI and mRNAs for these
      chains were localized in the female mouse reproductive tract by
      immunofluorescence and in situ hybridization. High levels of collagen VI protein
      and mRNAs were present in the endometrium and myometrium of the uterus up to Day
      4.5 of pregnancy. After embryo implantation, reduction in collagen VI protein
      within the decidualizing endometrium correlated with significantly reduced steady
      state levels of alpha 1(VI), alpha 2(VI), and alpha 3(VI) mRNAs, indicating
      either transcriptional down-regulation of collagen VI gene expression or
      decreased stability of transcripts. High levels of alpha 1(V1) and alpha 2(VI)
      mRNAs, but not alpha 3(VI) mRNA, in cells surrounding the uterine epithelium in
      the mesometrial region did not correlate with deposition of collagen VI protein
      in this region. These data are consistent with an important role of alpha 3(VI)
      in assembly of collagen VI heterotrimers. However, distinct immunostaining with
      antiserum to alpha 2(VI) chains in the extracellular matrix immediately beneath
      the uterine epithelium may indicate that alpha 2(VI) chains are deposited without
      the alpha 1(VI) or alpha 3(VI) collagen chains. No collagen VI protein or mRNAs
      were detected in any tissue layers of the embryo on Days 5.5 or 6.5 of gestation.

PMID- 7780012
TI  - Induction of precocious germinal vesicle breakdown (GVB) by GVB-incompetent mouse
      oocytes: possible role of mitogen-activated protein kinases rather than p34cdc2
      kinase.
AB  - In contrast to fully grown mouse oocytes, growing oocytes released from their
      preantral follicles are not capable of resuming meiosis spontaneously. However,
      when these denuded growing oocytes are incubated for 2-3 days in control medium
      and then treated with okadaic acid, 95% undergo precocious germinal vesicle
      breakdown (GVB) and chromosome condensation within 24 h. This study shows that
      both events apparently occur through a p34cdc2 kinase-independent pathway, since
      activity of this kinase was detected only after the oocytes had undergone okadaic
      acid-stimulated GVB. In contrast, microtubule-associated or mitogen-activated
      protein (MAP) kinases 1 and 2 were activated before GVB and their level of
      activity was correlated with the percentage of oocytes undergoing GVB, suggesting
      that these kinases may promote GVB and chromosome condensation under these
      experimental conditions. In addition, it is shown that MAP kinases accumulate
      during normal oocyte growth in vivo, but not in cultured denuded oocytes in vitro
      even when these oocytes become competent to undergo okadaic acid-stimulated GVB.
      Unlike p34cdc2, the accumulation of MAP kinases requires close physical
      interactions between the oocytes and the granulosa cells but is not necessary for
      the oocyte to become GVB-competent. Therefore, it MAP kinases are actually
      involved in the induction of GVB and chromosome condensation during normal oocyte
      maturation, acquisition of GVB competence requires oocyte-autonomous accumulation
      of MAP kinase activator(s) rather than the MAP kinases themselves.

PMID- 7780013
TI  - Monoclonal antibody directed to Le(y) oligosaccharide inhibits implantation in
      the mouse.
AB  - We investigated the role of carbohydrates in blastocyst attachment to the uterine
      epithelium. Le(y) (Fuc alpha 1-->2Gal beta 1-->4[Fuc alpha 1-->3] GlcNAc) was
      localized by indirect immunofluorescence to the surface of the mouse blastocyst
      and uterine epithelium. Western blot analysis showed that Le(y) is carried on
      many uterine glycoproteins in both pregnant and nonpregnant females; however, new
      species were detected on Day 4 postcoitum (p.c.) coincident with the onset of
      uterine receptivity. The function of Le(y) in implantation was tested by
      injecting monoclonal antibody (mAb) directly into the uterine lumen on Days 3-5
      p.c. The effects of intrauterine injections on implantation were scored by
      comparing the number of viable embryos to the number of CL on Day 10 p.c.
      Injection of purified anti-Le(y) IgM into the uterine lumen on the afternoon of
      Day 4 significantly inhibited implantation. This effect was dose-dependent and
      was obtained during a narrow time window, from 87 to 93 h p.c. Inhibition of
      implantation was not observed in contralateral uterine horns injected with
      saline, nor was it observed in uterine horns injected with other anti
      carbohydrate mAbs. We conclude that binding of anti-Le(y) to the blastocyst or
      luminal epithelium masks a ligand involved in implantation. Although the
      mechanism of inhibition is unknown, we show that Le(y) can interact with another
      oligosaccharide (H) that has been described as a possible uterine ligand for
      blastocyst attachment. We hypothesize that Le(y) and H form carbohydrate
      carbohydrate interactions that promote close apposition of cell surface membranes
      during an early step in implantation.

PMID- 7780014
TI  - Atresia in follicles grown after ovulation in the pig: measurement of increased
      apoptosis in granulosa cells and reduced follicular fluid estradiol-17 beta.
AB  - The incidence of atresia in the first group of follicles grown after ovulation
      was investigated in the pig. At slaughter, 113 follicles 3-6 mm in diameter were
      dissected from the ovaries of four pregnant pigs per day on Days 5, 6, and 7
      after the onset of estrus. Granulosa cells were isolated from each follicle. The
      percentage of granulosa cells containing sub-diploid amounts of DNA (%Ao cells),
      a measure of apoptosis, was determined for each follicle by DNA fluorescence flow
      cytometry of propidium iodide (PI) stained nuclei of ethanol-fixed cells.
      Granulosa cell DNA condition was used to classify follicles. Follicles with > or
      = 10% Ao cells (n = 33) were designated biochemically atretic (BA), and follicles
      with < 10% Ao cells (n = 80) were designated biochemically healthy (BH).
      Internucleosomal cleavage, also indicative of apoptosis, was determined by
      autoradiographic analysis of [32P]-3'-end-labeled DNA from granulosa cells.
      Densitometric analysis showed that optical density of [32P]-3'-end-labeled DNA
      fragments in the 0.18-20-kb size range was correlated with the %Ao cells (R > or
      = 0.90, N = 22, p < 0.001). The incidence of pigs with BA follicles was 2 of 4, 3
      of 4, and 4 of 4 on Days 5, 6, and 7, respectively. The %BA follicles per pig
      (mean +/- SEM) increased (p < or = 0.01) between Days 5 and 7; values were 6.2 +/
      3.6, 28.1 +/- 13.5, and 50.0 +/- 7.1, respectively, on Days 5, 6, and
      7.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780016
TI  - Sperm pairing in the opossum increases the efficiency of sperm movement in a
      viscous environment.
AB  - In order to understand why sperm pairing has evolved in most American marsupials,
      the movement parameters of spermatozoa from Monodelphis domestica were analyzed
      after incubation in capacitating medium for 15 min, 2 h, and 24 h to induce a
      proportion of sperm pairs to uncouple. Motility characteristics of paired and
      single spermatozoa were measured in media of differing composition and viscosity
      by means of computer-aided semen analysis. In minimum essential medium or in RPMI
      1640 medium alone, the absolute mean straight-line and curvilinear velocity
      values of paired spermatozoa (342 +/- 34 and 361 +/- 19 microns/sec,
      respectively, at 37 degrees C) were significantly greater than those of single
      spermatozoa (247 +/- 14 and 319 +/- 16 microns/sec), while mean lateral head
      displacement for paired spermatozoa (5.6 +/- 2.1 microns) was significantly less
      than for single spermatozoa (11.4 +/- 2.6 microns). However, when medium was made
      more viscous with polyvinyl pyrrolidone (0.8-82 poise) and sperm motility was
      calculated as a percentage of maximum attained velocity (in medium alone), there
      was no significant difference in straight-line or curvilinear velocity for single
      or paired spermatozoa in medium of the lowest viscosity (0.8 poise). In contrast,
      paired spermatozoa in medium of higher viscosity (above 1.92 poise) maintained
      straight-line velocity (e.g., 54 +/- 3% of maximum straight-line velocity in
      medium of 2.28 poise) while single sperm moved in tight circles and exhibited
      poor straight-line velocity (5 +/- 1% of maximum velocity). The data show that
      paired spermatozoa exhibit a significant motility advantage over single
      spermatozoa in a viscous medium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780015
TI  - Progesterone secretion and proliferation in cultured rabbit granulosa cells under
      conditions of beta-D-xyloside-induced inhibition of proteoglycan synthesis.
AB  - Proteoglycans present in follicular fluid are synthesized by granulosa cells
      under gonadotropin control. An inhibitor of proteoglycan synthesis, p-nitrophenyl
      beta-D-xyloside (beta-D-xyloside) was used as a probe to study rabbit granulosa
      cell steroidogenesis and proliferation under abrogated proteoglycan synthesis.
      Granulosa cells isolated from rabbit preovulatory follicles were cultured 24 h in
      Minimum Essential Medium plus 2.5% fetal calf serum in the presence or absence of
      beta-D-xyloside and were then treated with FSH or dibutyryl cAMP (db-cAMP) alone
      or in combination with beta-D-xyloside for a further 24 h. The exposure for 48 h
      of granulosa cells to 1 mM beta-D-xyloside in the absence or presence of FSH
      inhibited proteoglycan synthesis and increased the amount of glycosaminoglycans
      (GAG). FSH-stimulated progesterone production was significantly correlated only
      with proteoglycan synthesis and not with GAG production. The addition of various
      concentrations of beta-D-xyloside (0.1-4 mM) for 48 h to granulosa cells induced
      a dose-dependent inhibition of FSH-stimulated progesterone secretion and
      [3H]thymidine incorporation into DNA. beta-D-Xyloside concentrations lower than 1
      mM induced an inhibition of FSH-stimulated progesterone secretion but had no
      significant effect on FSH-induced proliferation. One millimolar beta-D-xyloside
      did not modify basal progesterone production, but in the presence of various
      doses (0.1-2.5 ng/ml) of FSH or hCG (0.1-1 IU/ml) it exerted a significant
      inhibitory effect on steroid secretion. Fifty percent inhibition was obtained for
      doses of FSH above 0.5 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780017
TI  - Luteotrophic and luteolytic interactions between bovine small and large luteal
      like cells and endothelial cells.
AB  - Endothelial cells, the most abundant cell type in the bovine CL, were shown to
      establish intercellular contact with steroidogenic cells of the CL. Two
      experimental models were used to study the involvement of endothelial cells in
      luteal cell function: 1) luteal slices in which the integrity and communication
      between the different cells were maintained and 2) pure large and small luteal
      like cells, cultured separately or co-cultured with endothelial cells. The
      luteolytic effect of prostaglandin (PG) F2 alpha was examined in these two
      models. Treatment with PGF2 alpha did not alter P4 secretion stimulated by LH in
      young (2-4-day-old) CL slices, whereas, in slices from mature (6-12 days old) CL,
      PGF2 alpha significantly reduced (by 40%) the stimulatory effect of LH on P4
      secretion. In pure large luteal-like cells, the effect of forskolin plus PGF2
      alpha on P4 secretion did not differ from forskolin given alone after 3 or 24 h
      of incubation. However, when co-cultured with endothelial cells, PGF2 alpha
      significantly inhibited forskolin stimulation. Endothelial cells significantly
      stimulated P4 production from large luteal-like cells only. This effect may be
      attributed to the action of PGI2 secreted by endothelial cells. In summary,
      endothelial cells may play an essential role in luteal functions by being
      involved in both luteotrophic and luteolytic processes.

PMID- 7780018
TI  - Construction of an engineered bivalent vaccine strain consisting of Vibrio
      cholerae CT-B and LPS-O antigens.
AB  - In this study, the engineered E. coli strain 1046 containing V. cholerae LPS-O
      and CTB bivalent antigen genes has been successfully obtained by using DNA
      recombinant techniques. E. coli 1046 (pMG305) could not only express CT-B antigen
      but also secret CTB into medium as shown by GM1-ELISA. Meanwhile, whole cell O
      antigen-ELISA, bacterial agglutination test and hemagglutination inhibition assay
      demonstrated that LPS-O antigen could be expressed on the cell surface by E. coli
      1046 (pMG305) and shown LPS band specific for V. cholerae by SDS-PAGE assay.
      Mouse intraperitoneal immunization and challenge trial indicated that the E. coli
      1046 (pMG305) provided good protection against virulent V. cholerae. The
      engineered vaccine strain reported here is expected to be a live oral candidate
      vaccine for V. cholerae.

PMID- 7780019
TI  - Construction and expression of high efficiency expressing plasmid of transforming
      growth factor alpha-Pseudomonas aeruginosa exotoxin fusion protein TGF alpha
      PE40.
AB  - The XbaI/EcoRI cleaved TGF alpha-PE40 gene from plasmid pXY382 was inserted into
      the same cloning site of the expression vector pCB604 resulting in the plasmid
      p2X-TP1. E. coli BL21 (lambda DE3) cells were transformed with the p2X-TP1 and
      then induced with IPTG. The product expressed was accumulated mainly in the form
      of inclusion bodies. The expression level was closely related to the cell
      density, induction temperature and medium but not to the inductor dosage and the
      induction period within certain range. The expressed amount of the fusion protein
      TGF alpha-PE40 was about 50 mg/L.

PMID- 7780020
TI  - Expression and secretion of alpha-amylase and glucoamylase in Saccharomyces
      cerevisiae.
AB  - alpha-Amylase genes of Bacillus licheniformis and glucoamylase cDNA of
      Aspergillus niger were ligated to a E. coli-yeast shuttle vector. The resultant
      plasmid was used to transform Saccharomyces cerevisiae to construct starch
      degrading yeast strain. The results of enzyme activity assay and enzyme property
      analysis show that alpha-amylase and glucoamylase genes have been expressed
      simultaneously in yeast under the control of promoters and terminators of yeast
      MF-alpha 1 factor and PGK genes and over 99% of enzyme activities were secreted
      to the medium. The engineered yeast strain hydrolyses 97% of the starch (10%) in
      the medium after 6 days. The recombinant plasmid exists stably in yeast.

PMID- 7780021
TI  - Expression and immunogenicity of tripeptide repeat region on P190 of Plasmodium
      falciparum.
AB  - A DNA fragment, designated as P190TR, encoding amino acid residues of the
      tripeptide region of the P190 antigen was amplified by polymerase chain reaction
      from genomic DNA of FCC1/HN Plasmodium falciparum isolated from Hainan Province,
      China. Upon comparison with the nucleotide sequences of MAD20 allele, it was
      found that there were five bases substitution in the P190TR which cause amino
      acid changes. The DNA fragment sequenced were ligated to BamHI and XbaI-digested
      pGEX-2T vector. Competent E. coli JM109 (DE3) were transformed with either
      parental or recombinant pGEX-2T for expression. Analysis of soluble cellular
      proteins revealed the high level expression of GST-P190TR as fusion proteins.
      Affinity purification of the fusion protein under nondenaturing condition
      resulted in the removal of almost all other E. coli proteins. The purified P190TR
      protein was highly immunogenic in rabbits. The antibodies against the recombinant
      protein recognized the malaria parasite with the titers at 1:320 measured by IFA
      and antisera from malarial patients reacted with the expressed protein in Western
      Blot.

PMID- 7780022
TI  - Human alpha atrial natriuretic peptide fermentation by using a genetically
      engineered yeast strain.
AB  - The genotype of the recombinant yeast strain Y33::YFD71-3 used in this study is
      alpha, his, leu, ade and suc. Preliminary batch cultures in shaking flasks showed
      the expression level of atrial natriuretic peptide (ANP) was 1-2 mg/L. Shaking
      flask cultures were carried out in YG medium which contained glucose, yeast
      nitrogen base (YNB), and different amounts of adenine, histidine and leucine.
      When the growth was limited by adenine, protein secreted from Y33::YFD71-3 cells
      was increased obviously. Adenine became the limiting substrate when the YG medium
      was supplemented with 5 g/L of casamino acid (CAA) and the level of ANP
      expression was influenced by the concentrations of adenine, YNB and leucine in
      the medium. In fed batch cultures carried out in a RIBE-5 fermenter, the cultures
      were fed with glucose and a mixture of YNB, CAA, adenine, histidine and leucine
      to improve cell growth and ANP expression, and the maximum ANP concentration in
      the culture reached 24.8 mg/L.

PMID- 7780023
TI  - Establishment of the microorganism growth model at an inhibitory condition by
      microcalorimetric method.
AB  - The growth thermograms of Staphylococcus albus and Staphylococcus aureus were
      determined by using the 2277 thermal activity monitor, using a microorganism
      growth model with inhibitory conditions, the specific growth rate and the
      thermogram curves at different temperature and acidities were determined. From
      these curves, the microorganism optimum growth temperature and acidity were
      defined.

PMID- 7780024
TI  - Pseudohomogeneous kinetic study on a two-liquid-phase fermentation process.
AB  - The fermentation process for producing undecane dicarboxylic acid from tridecane,
      which includes gas-oil-water-cell four phases (two-liquid-phase), was studied.
      The metabolic characters of the cell growth phase and the production phase of the
      process were analyzed. It was proposed that cell growth can be identified by the
      carbon dioxide production rate (CPR) before the production phase. The kinetic
      models of both the cell growth phase and the production phase were established,
      respectively. The parameters of the models have been estimated by regression. The
      calculated curves fit the experimental data very well. The average deviation
      between those over the cell growth phase and the production phase are 2.4% and
      3.6%, respectively.

PMID- 7780025
TI  - Studies on the condition of fermentation of pullulan by Aureobasidium pullulans.
AB  - Studies on optimal conditions for pullulan fermentation based on the results
      obtained from a shaking flask were carried out in a 16-L auto-controlling
      fermentor. It found that the optimal DE value of starch hydrolyzate was 40-50
      when 10% starch hydrolysate was used as carbon source. The optimal concentration
      of ammonium sulfate in the medium for fermentation was different from that of the
      shaking flask. The fermentation kinetics and effects of seed age, seed volume,
      airflow rate, pressure of tank, agitation speed and number of vane group on the
      production of pullulan were investigated.

PMID- 7780026
TI  - Determination of L-glutamate using flow injection analysis with immobilized L
      glutamate oxidase reactor.
AB  - L-Glutamate oxidase (GOD) and horseradish peroxidase (HRP) were covalently
      coupled on alkylamine pretreated controlled pore glass (CPG) by means of
      glutaraldehyde. The immobilized enzymes were packed into a teflon tube and used
      in flow injection analysis (FIA) system for L-glutamate determination. A good
      linearity range was obtained at 0.1-2.0 mM, and the coefficient of variation was
      0.7% (n = 8). More than 80 samples were measured within an hour. The stability of
      the immobilized GOD reactor was good, retaining 50% of its initial activity after
      4 months storage in buffer at 4 degrees C. When the concentration of L-glutamate
      remained lower than 2.5 mM, the determination of L-glutamate in this system was
      not affected by pH and temperature within the range of 6.0-8.0 and 20-35 degrees
      C, respectively. The system was applied to determine L-glutamate in broth samples
      during L-glutamate fermentation and good correlations were achieved between
      results obtained with the FIA system, L-glutamate oxidase kit and Warburg's
      method.

PMID- 7780027
TI  - Exploring the peptide 3(10)-helix reversible alpha-helix equilibrium with double
      label electron spin resonance.
AB  - Over the last several years we have used spin labeling as a means for exploring
      the structure of helical peptides. Two nitroxide labels are engineered into a
      peptide sequence and distances are ranked with electron spin resonance (ESR). We
      have found that there is a significant amount of 3(10)-helix in 16-residue model
      peptides containing only L-amino acids. This review covers several facets of the
      methodology including spin labeling strategy, interpretation of ESR spectra and
      the influence of molecular dynamics on the spectral line shapes. Also covered are
      recent findings of a length-dependent 3(10)-helix-->alpha-helix transition and
      the role of Arg+ in the stabilization of specific helix structures.

PMID- 7780028
TI  - Vibrational optical activity of oligopeptides.
AB  - Vibrational optical activity (VOA) is a relatively new spectroscopic technique,
      which has two principal manifestations, ir vibrational CD and vibrational Raman
      optical activity. Progress in the study of oligopeptides using both of these
      forms of VOA is reviewed from the perspective of theoretical and instrumental
      techniques, spectral results, and structural interpretations.

PMID- 7780029
TI  - Cloning, tissue expression and regulation of rat interleukin 1 beta converting
      enzyme.
AB  - Using oligomer primers based on the cDNA sequence of human interleukin 1 beta
      converting enzyme (ICE), we have employed the RT-PCR method and rat spleen RNA to
      clone and sequence rat ICE. We report here that the predicted amino acid sequence
      of rat ICE proenzyme consists of 402 amino acids (p45) and shares 61% and 90%
      identity, respectively, with human and mouse ICE amino acid sequences. The active
      site cysteine (Cys284) and 3 or 3 potential processing sites are conserved
      suggesting that their the rat ICE heterodimer consists of a p22 (Ser104-Asp296)
      and a p10 (Gly315-His402) subunit or a cryptic processing site creates a smaller
      heterodimer. Northern blot analysis has revealed a approximately 2.2 kb and a
      more abundant approximately 1.45 kb ICE transcript both widely expressed in the
      rat with the highest expression in spleen and intestine and lowest in brain. IL-1
      beta mRNA was similarly distributed. Injection of the immunostimulant,
      lipopolysaccharide (0.2 mg/kg, i.p.), increased rICE mRNA content between 2- to 3
      fold in the rat brain with smaller increases measured in testis and spleen. The
      structural conservation of this enzyme suggests that rat models of inflammation
      will be useful for evaluating the therapeutic potential of ICE inhibitors in
      humans.

PMID- 7780030
TI  - Human interleukin for DA cells/leukemia inhibitory factor and oncostatin M
      enhance membrane expression of intercellular adhesion molecule-1 on melanoma
      cells but not the shedding of its soluble form.
AB  - ICAM-1-mediated cell-cell adhesion is essential for different immunologic
      functions including non-MHC-restricted cytotoxicity. The shedding of a soluble
      form of ICAM-1 from melanoma impairs immune recognition and leads to tumour
      escape. Pretreatment of the Foss human melanoma cell line with HILDA/LIF or OSM,
      two cytokines involved in acute-phase response, increased the expression of
      membrane ICAM-1 twofold without inducing sICAM-1 shedding. Conversely, TNF-alpha,
      in the same conditions, strongly stimulated membrane ICAM-1 expression and the
      shedding of the soluble form. The same phenomenon was observed on the A375 human
      melanoma cell line. ICAM-1 upregulation was concomitant with an increase in the
      non-MHC-restricted cytotoxicity of tumour cells mediated by LAK cell.s This
      higher sensitivity to LAK lysis was abolished by RR1/1, a specific monoclonal
      antibody against ICAM-1. Our results demonstrate for the first time the ability
      of HILDA/LIF and OSM to upregulate ICAM-1 expression on the melanoma cell
      surface, suggesting a potential role for these cytokines in human immune
      surveillance during tumour progression.

PMID- 7780031
TI  - Synergistic effects of IL-6 and IFN-gamma on carcinoembryonic antigen (CEA) and
      HLA expression by human colorectal carcinoma cells: role for endogenous IFN-beta.
AB  - When administered as single agents, both interferon gamma (IFN-gamma) and
      interleukin 6 (IL-6) significantly increase carcinoembryonic antigen (CEA) and
      HLA class I antigen expression on the surface of human colorectal tumour cells.
      Studies were carried out to determine whether by combining those cytokines a
      synergistic enhancement of CEA and HLA expression could result. The findings
      revealed that the administration of 20 units IFN-gamma along with 1.7 ng IL-6,
      concentrations of each cytokine that individually induced minimal antigenic
      changes, together synergistically increased CEA and HLA class I as well as
      induced qualitative changes in HLA expression on WiDr human colon carcinoma
      cells. The magnitude of the synergistic increases in CEA and HLA class I
      expression were reminiscent of the level of antigen augmentation observed when
      administering 20- to 100-fold higher amounts of each cytokine as a single agent.
      Also, the addition of IL-6 potentiated the IFN-gamma induction of HLA class II
      expression. The combined administration of IL-6 potentiated the IFN-gamma did not
      have any additive or synergistic effects on the growth suppression of those
      tumour cells. Interestingly, utilization of specific neutralizing antibodies for
      type I interferons abrogated the increases of CEA and HLA expression seen with IL
      6 treatment alone or in combination with IFN-gamma. Moreover, reverse
      transcriptase/polymerase chain reaction analyses revealed a constitutive
      expression as well as a temporal increase of IFN-beta mRNA transcripts in colon
      tumour cells treated with IL-6. Therefore, the findings provide indirect evidence
      that IFN-beta production seems to play a critical role in the ability of IL-6 to
      upregulate antigen expression alone or in combination with IFN-gamma. These
      findings provide insight into cytokine combinations that synergistically
      upregulate tumour-associated and normal HLA antigen expression on the surface of
      human tumour cells. Those results provide the rationale for the combined use of
      such cytokines to heighten tumour cell recognition in monoclonal antibody- or
      cell-mediated-based immunotherapeutic approaches.

PMID- 7780032
TI  - Leukaemia inhibitory factor (LIF) suppresses proteoglycan synthesis in porcine
      and caprine cartilage explants.
AB  - Leukaemia Inhibitory Factor (LIF) has been implicated in connective tissue damage
      in arthritis. We have previously shown that LIF stimulates proteoglycan release
      in pig cartilage explants. The aim of this study was to determine whether LIF
      modulates proteoglycan synthesis in vitro. The methods used were as follows:
      slices of pig and goat articular cartilage were incubated overnight in Dulbecco's
      modification of Eagles medium (DMEM), supplemented with 5% foetal calf serum
      (FCS) and then cultured for 48 h without FCS and either no cytokines (negative
      control) or LIF. During the final 6 h the tissue was cultured in sulphate free
      DMEM containing 35SO4. The radioactivity in the medium and tissue was determined
      in cetylpyridinium chloride precipitates. Biosynthetic activity was expressed as
      DPM per mg wet weight of cartilage. Dose-dependent suppression of proteoglycan
      synthesis was observed with murine and human recombinant LIF in pig and goat
      cartilage. The degree of inhibition was similar to the maximal suppression
      observed with IL-1 alpha, but was not IL-1 dependent. In conclusion, LIF is a
      potent inhibitor of proteoglycan synthesis in cultured pig and goat articular
      cartilage.

PMID- 7780033
TI  - Soluble interleukin 6 receptor is biologically active in vivo.
AB  - A cancer cell transfection model was used to evaluate biological activity of
      soluble IL-6 receptor (sIL-6R) in vivo. B-78 melanoma cells were stably
      transfected with cDNAs encoding human IL-6, murine sIL-6R and human leukaemia
      inhibitory factor (LIF). Control and transfected cells were intravenously (i.v.)
      and/or subcutaneously (s.c.) injected into B57BL/6 x C3H or SCID mice. Whereas B
      78 cells formed tumours and lung metastasis in injected animals, transfected
      animals, transfected cells showed greatly reduced tumour and metastasis
      formation. Transfection of IL-6, sIL-6R or LIF had similar protective effects.
      The combination of IL-6 and sIL-6R was most effective. Kinetic analysis
      demonstrated a 3 week lag period between formation of tumours by B-78 cells and
      the combination of B-78 cells transfected with IL-6 and sIL-6R. No such lag phase
      was seen when B-78-IL-6 or B-78-IL-6 or B-78-sIL-6R were injected alone. These
      results indicate that IL-6 alone exhibits a different quality of activity when
      compared to the IL-6-soluble receptor complex. Our results demonstrate for the
      first time that sIL-6R is a biologically active molecule in vivo.

PMID- 7780034
TI  - Ciliary neurotrophic factor (CNTF) induces serum amyloid A, hypoglycaemia and
      anorexia, and potentiates IL-1 induced corticosterone and IL-6 production in
      mice.
AB  - Ciliary neurotrophic factor (CNTF) supports the survival of ciliary ganglion
      neurons and was shown to induce the synthesis of acute-phase proteins and fever.
      We studied the effect of CNTF, alone or in association with IL-1, on levels of
      corticosterone (CS), glucose, serum amyloid A (SAA), and IL-6. We also compared
      the effect of CNTF with that of IL-6, since the gp130 receptor subunit for CNTF
      is shared with that of IL-6. A single intravenous injection of CNTF induced
      hypoglycaemia and SAA and potentiated IL-1-induced CS and IL-6. Chronic CNTF, but
      not IL-6, resulted in decreased food intake and body weight up to days 6-7. After
      this time, body weight and food intake recovered even if CNTF treatment was
      continued, indicating that a phenomenon of tolerance occurred. Finally, CNTF
      (unlike IL-1) was not toxic in adrenalectomized mice. Therefore the similarities
      of CNTF activities with those of other cytokines, particularly IL-6, might go
      beyond the activation of the same receptor-signal transduction pathway of IL-6.

PMID- 7780035
TI  - The role for host-immune factors in the in vivo antiviral effects of tumour
      necrosis factor.
AB  - This report examines the host-immune response to vaccinia virus in mice exposed
      to tumour necrosis factor (TNF). Exposure to TNF was done via two approaches; (1)
      mice were treated with TNF in complex with a specific anti-TNF antibody (Ab 301)
      which enhances the antiviral efficacy of this cytokine, prior to vaccinia virus
      (VV) infection; and (2) mice were infected with a recombinant VV which encodes
      the murine TNF gene (VV-HA-TNF). The antiviral effect induced by TNF plus Ab 301
      in CBA/H mice was not sensitive to sub-lethal gamma irradiation, indicating that
      a proliferative immune cell population was not responsible for the observed
      attenuated VV growth. This was further evidenced by NK cell and CTL studies which
      showed, when compared to controls, that TNF plus Ab 301 treated animals had
      decreased spleen NK cell and CTL activities. This suggests that a non-specific
      factor, effective earlier than day 2 postinfection, was responsible for the
      restriction of VV growth. To further investigate this possibility, mice were
      treated with either the TNF/Ab 301 regimen, or infected with VV-HA-TNF, and their
      peritoneal exudate cells (PEC) examined during early VV infection. Control
      recombinant VV infection resulted in an increase in neutrophil numbers, and
      TNF/Ab 301 treatment before infection did not increase this further. VV-HA-TNF
      infection of mice, however, induced a massive but transient increase in the
      number of neutrophils, suggesting that this cell population was important to the
      in vivo restriction of VV-HA-TNF growth.

PMID- 7780036
TI  - In vitro cytokine production and T-cell proliferation in patients undergoing
      cardiopulmonary by-pass.
AB  - Cardiac surgery, employing cardiopulmonary by-pass (CPB), has long been
      associated with a generalized immunosuppression. To further understand the
      complex physiological and immunological changes related to CPB, we decided to
      investigate whether CPB affects the immune response, with regard to T-cell
      activation and cytokine production. Using phytohaemagglutinin (PHA) as mitogen
      and peripheral blood mononuclear cells (PBMC) isolated from patients undergoing
      CPB, we investigated whether this procedure has any effect on interferon
      gamma(IFN-gamma) and other cytokine production and/or PBMC proliferation.
      Comparisons were made between the responsiveness of PBMC obtained before, during
      and at the end of CPB. In all patients, CPB significantly reduces IFN-gamma and
      interleukin 2 (IL-2) production in response to PHA. On the other hand, tumour
      necrosis factor-alpha (TNF-alpha) production was also significantly diminished,
      while interleukin 6 (IL-6), interleukin 1 beta (IL-1 beta) and interleukin 8 (IL
      8) release in response to PHA was not significantly affected. Reduced IFN-gamma,
      IL-2 and TNF-alpha production was associated with a significant decrease in PBMC
      proliferation. These results might be related to the mechanical damage on blood
      cells described during extracorporeal circulation procedures as well as the
      release of immunosuppressive factors during surgery. The immunosuppression
      observed during CPB may play an important role in the development of infectious
      complications after CPB.

PMID- 7780037
TI  - Interleukin 4, but not interleukin 10, regulates the production of inflammation
      mediators by rheumatoid synoviocytes.
AB  - Rheumatoid synovitis is characterized by increased activation and proliferation
      of synoviocytes, which are an important source of cytokines. The role of
      Interleukin 4 (IL-4) and IL-10 on the production of mediators of inflammation by
      rheumatoid synoviocytes was studied herein. While IL-4 weakly affected the
      spontaneous PGE2 production, it strongly inhibited its production when cells were
      stimulated with IL-1 beta and TNF-alpha. IL-4 decreased by 60% to 80% the
      spontaneous and the IL-1 beta or TNF-alpha induced synthesis of GM-CSF. In
      contrast, IL-4 enhanced the spontaneous (2.6-fold), and to a lower extent (1.3
      1.8-fold), the cytokine stimulated production of IL-6. This induction was not due
      to a passive release of pre-synthesized IL-6, since IL-4 increased the level of
      IL-6 mRNA expression induced by IL-1 beta. The D50 was 5 U/ml of IL-4 for both
      the stimulation of IL-6 synthesis and the inhibition of GM-CSF production.
      Kinetic studies of the action of IL-4 revealed a rapid and sustained inhibition
      of GM-CSF production, and a late increase of IL-6 secretion. By contrast, IL-10
      had no effect on the production of either IL-6 or GM-CSF by synoviocytes. Thus,
      by inhibiting synoviocyte proliferation and inhibiting their secretion of PGE2
      and GM-CSF, IL-4 displays on synoviocytes a series of biological effects which
      complements its anti-inflammatory properties on monocytes.

PMID- 7780038
TI  - Immunolocalization of TGF-beta 1 in human hypertrophic scar and normal dermal
      tissues.
AB  - Following severe thermal injury and other injuries to the deep dermis of the
      skin, patients frequently develop hypertrophic scarring (HSc) which is
      characterized by an over-abundance of extracellular matrix (ECM) proteins
      including collagen. Our previous work revealed a synchronous elevation in
      expression of mRNA for transforming growth factor (TGF)-beta 1, type I and type
      III procollagen in human HSc tissue, suggesting a possible role of locally
      synthesized TGF-beta 1 in matrix production. In this study the immunoreactive
      sites of TGF-beta 1 protein in hypertrophic and normal dermal (ND) tissue
      obtained from the same patients have been determined by an immunoperoxidase
      staining system. We used two TGF-beta 1-specific rabbit polyclonal antibodies
      known as anti-LC and anti-CC which were prepared to different synthetic
      preparations of a peptide corresponding to the first 1-30 amino acids of the
      amino-terminus of mature TGF-beta 1. These antibodies have affinity for two
      distinct epitopes of TGF-beta 1. The anti-LC antibody localized TGF-beta 1 to non
      proliferating/differentiated epidermal cells, suprabasal keratinocytes in both
      normal and HSc tissues. The intensity of this staining was significantly higher
      (150 +/- 26 sq. micron vs 77 +/- 7 sq. micron, n = 5, P < 0.05) in normal tissues
      compared to HSc tissues. When the anti-CC antibody was used as the primary
      antibody, intense staining of focal regions was observed in the dermis of HSc
      tissue, but not in ND tissue obtained from the same patient. These foci contained
      collagen which was nodular, distributed in whorl-like arrangements and highly
      enriched with microvessels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780039
TI  - Serum interleukin 6 as a predicator of the therapeutic effect and adverse
      reactions after transcatheter arterial embolization.
AB  - To evaluate the value of serum interleukin 6 (sIL-6) for the prediction of
      therapeutic effect and adverse reaction after transcatheter arterial embolization
      (TAE), sIL-6 was measured before and after angiography or TAE in 18 patients
      (three after angiography and 15 after TAE for hepatocellular carcinoma). The
      three patients with only angiography showed no elevation of sIL-6, while a
      significant increase was observed after TAE in the 15 hepatocellular carcinoma
      patients. The sIL-6 levels of patients with a partial response to TAE were higher
      at 48-72 hours after the procedure than those of patients with no response (P =
      0.045), and the sIL-6 levels of patients who showed adverse reactions were higher
      at 6-24 h than those of patients without adverse reactions (P = 0.019). sIL-6
      level at 48-72 h after TAE reflects the efficacy of TAE, whereas the level at 6
      24 h after TAE is related to the severity of adverse reactions. Therefore, sIL-6
      may be a useful indicator for prediction of the therapeutic effect of TAE as well
      as adverse reactions.

PMID- 7780040
TI  - Inhibition of cytokine activation processes in vitro by tenidap, a novel anti
      inflammatory agent.
AB  - Tenidap is a novel anti-inflammatory and anti-arthritic agent that lowers
      intracellular pH and suppresses anion transport when applied to cells in vitro.
      Both of these parameters are known to influence pro-inflammatory cell function.
      To investigate whether tenidap can modulate cellular responses to cytokine
      stimulation, several in vitro cytokine-driven assays were characterized with
      respect to their tenidap sensitivity. Human monocytes treated with granulocyte
      macrophage colony stimulating factor (GM-CSF) demonstrated an increased
      production of IL-6 as well as an increased total translational activity. Tenidap
      dose-dependently inhibited both cytokine-induced responses; the effect on IL-6,
      however, occurred at lower tenidap concentrations than those required to prevent
      the increase in total translational activity. In contrast, the known
      translational inhibitor cycloheximide did not demonstrate selectivity for IL-6;
      this agent decreased the GM-CSF-induced increase in total translational activity
      in parallel with its effects on IL-6. GM-CSF-treated monocytes also produced
      greater amounts of IL-1 beta in response to LPS stimulation than did non-GM-CSF
      treated cells, and tenidap again suppressed this cytokine-induced activation.
      Human Hep3B cells treated with a combination of interleukin (IL)-1 beta and IL-6
      demonstrated an acute phase-type of response. These hepatoma cells increased
      production of the positive acute phase protein serum amyloid A (SAA) while they
      decreased production of a negative acute phase protein human serum albumin (HSA).
      Tenidap dose-dependently inhibited the cytokine-induced increase in SAA
      production without effecting synthesis of HSA or total TCA-precipitable
      macromolecules. Importantly, the ability of tenidap to alter these various
      cytokine responses was not shared with piroxicam, a potent cyclooxygenase
      inhibitor. Finally, human neutrophils treated with either GM-CSF or tumor
      necrosis factor (TNF)-alpha demonstrated an increased chloride conductance as
      measured by the loss of radioactive chloride from 36Cl-loaded cells. When tenidap
      was included within the medium during cytokine stimulation, loss of radioactive
      chloride was prevented. Thus, tenidap inhibited the cytokine-induced increase in
      anion transport. Together, these results indicate that tenidap can suppress
      cellular activation processes induced by a variety of cytokines. This functional
      antagonism is not dependent on cyclooxygenase inhibition but, rather, appears to
      link to tenidap's unique ability to alter ionic homeostasis. These in vitro
      observations, therefore, may help to explain how this novel anti-inflammatory
      agent acts to lower acute phase proteins and IL-6 levels in man.

PMID- 7780041
TI  - Synovial fluid from rheumatoid arthritis patients contains sufficient levels of
      IL-1 beta and IL-6 to promote production of serum amyloid A by Hep3B cells.
AB  - The presence of positive acute phase proteins within the circulation of
      rheumatoid arthritis patients suggests that elevated cytokine production
      associated with this chronic inflammatory disorder initiates the hepatic acute
      phase response. Cytokines produced at inflammatory lesions are believed to travel
      via the circulation to the liver where they induce acute phase protein production
      by hepatocytes. To test whether serum from rheumatoid arthritis patients
      contained sufficient levels of cytokines to promote an acute phase response in
      vitro, a bioassay was developed that employed the human hepatoma cell line Hep3B.
      These cells produced the acute phase protein serum amyloid A (SAA) in response to
      a combination of recombinant IL-1 beta and IL-6 or to monocyte conditioned
      medium. Serum (or plasma) from normal individuals or from rheumatoid arthritis
      patients did not induce SAA production by Hep3B cells. Moreover, these serum
      samples did not prevent SAA production induced by monocyte conditioned medium,
      indicating that they did not contain inhibitors of cytokine activity. Despite the
      inactivity of serum samples, synovial fluid samples obtained from rheumatoid
      arthritis patients were active in the hepatocyte bioassay and promoted SAA
      synthesis. One synovial fluid sample was analysed in detail to identify cytokines
      responsible for the SAA-inducing activity. Neutralizing antisera against IL-6 and
      IL-1 beta blocked this activity by > 90% whereas anti-IL1 alpha and anti-TNF
      alpha sera were without effect. Absolute cytokine levels within the synovial
      fluid sample were determined by ELISA; IL-6, IL-beta and TNF-alpha, but not IL-1
      alpha, were confirmed to be present. Moreover, the synovial fluid sample
      contained a large amount of the IL-1 receptor antagonist. These data indicate,
      therefore, that synovial fluid recovered from an inflamed joint contains all the
      necessary cytokines in balance with inhibitors to promote SAA production by Hep3B
      cells. The steady state levels of these factors within the plasma compartment,
      however, were insufficient to induce the acute phase response by cultured Hep3B
      cells, suggesting that this system does not mimic the relationship between the
      circulation and the liver that likely exists in rheumatoid arthritis patients.

PMID- 7780042
TI  - Increased levels of serum macrophage colony stimulating factor (M-CSF or CSF-1)
      in patients with chronic renal insufficiency (CRF): facts and hypotheses.

PMID- 7780043
TI  - Chemical synthesis, purification and folding of the human monocyte chemotactic
      proteins MCP-2 and MCP-3 into biologically active chemokines.
AB  - Monocyte chemotactic proteins 2 and 3 (MCP-2 and MCP-3) are chemokines
      structurally and functionally related to MCP-1. In contrast to MCP-1, they are
      produced in low amounts by stimulated leukocytes or tumour cells. As an
      alternative method to generate sufficient protein for in vitro and in vivo
      characterization of MCP-2 and MCP-3, we have synthesized both 76-residue
      chemokines using Fmoc chemistry. After automated solid phase peptide synthesis at
      a 0.05 to 0.25 mmol scale, and purification to homogeneity by C-8 RP-HPLC,
      correct disulfide bridges were formed in a mixture of oxidized and reduced
      glutathione. The synthesis was biochemically controlled by peptide sequencing of
      intermediate products and proteolytic fragments of the 76-residue chemokines and
      by mass analysis. Purified synthetic MCP-2 and MCP-3 coeluted and comigrated with
      their natural counterparts on analytical reverse phase columns and SDS-PAGE,
      respectively. Purified and folded MCP-2 and MCP-3 were chemotactic for monocytes
      at 7.5 ng/ml and 5 ng/ml, respectively. These minimal effective concentrations
      are comparable to those of the natural chemokines. Synthetic MCPs did not induce
      neutrophil chemotaxis. Automated Fmoc peptide synthesis is thus a useful method,
      allowing fast production of chemokines and analogues thereof.

PMID- 7780044
TI  - Pharmacokinetics of the novel anticonvulsant HEPP after single intravenous
      administration of three different doses in dogs.
AB  - HEPP (D, L-3-hydroxy-3-ethyl-3-phenylpropanamide) is a novel compound with a wide
      spectrum of anticonvulsant activity and relatively low toxicity. The aim of this
      investigation was to study the pharmacokinetics of HEPP in mongrel dogs and to
      assess its linearity after intravenous administration of 8, 15, and 30 mg kg-1. A
      biphasic disappearance pattern with a rapid distribution phase was observed in
      the plasma concentration versus time curve. The mean terminal half-life (t1/2
      beta) was the same after the three doses (3.4 +/- 0.15 h) and the mean half-lives
      of the distribution phase (t1/2 alpha) were not significantly different after the
      three doses (0.09 +/- 0.02, 0.08 +/- 0.07, and 0.11 +/- 0.03 h for 8, 15, and 30
      mg kg-1 respectively). The mean AUC0-infinity values were 44.1 +/- 10.8, 72.1 +/-
      8.8, and 127.4 +/- 23.2 micrograms h mL-1, respectively, showing a linear
      increase. The individual values of AUC0-infinity corrected for the administered
      dose (AUC0-infinity/D) were 0.29 +/- 0.04, 0.23 +/- 0.05, and 0.22 +/- 0.06 h mL
      1. These values were not statistically different. Neither the mean residence time
      (MRT = 4.55 +/- 1.50, 4.90 +/- 1.32, and 5.07 +/- 1.95 h), the steady state
      volume of distribution (Vss = 0.86 +/- 0.11, 1.01 +/- 0.17, and 1.20 +/- 0.40 L
      kg-1) nor the systemic clearance (Cl = 3.36 +/- 0.82, 3.53 +/- 0.44, and 4.02 +/-
      0.68 mL min-1 kg-1) showed significant differences between doses. The values of
      Vss suggest that HEPP is distributed in the whole body fluid.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7780045
TI  - Kinetic modelling of liposome degradation in peritoneal macrophages.
AB  - The objective of this study was to quantify and model the degradation process of
      liposomes in peritoneal macrophages (PMs). Iodinated albumin (125I-alb) was
      chosen to be the marker of liposome degradation. The time course of the
      degradation of free 125I-alb after pinocytosis by PMs followed first-order
      kinetics with a half-life of 23 min. The degradation of liposomally encapsulated
      125I-alb was also quantified. Kinetic modelling of liposome degradation indicated
      the existence of two kinetically different processes, one with a half-life of 13
      min and the other with a half-life of 7.5 h. Comparing the degradation of
      liposomal and free 125I-alb suggested that 125I-alb was delivered to lysosomes
      much faster through phagocytosis than pinocytosis. These results indicate that
      the intracellular degradation kinetics of pinosomes and phagosomes is different.
      This method can quantify the rate and extent of liposomal degradation in
      macrophages and provide kinetic information on the intracellular destiny of
      liposomally encapsulated compounds.

PMID- 7780046
TI  - Dose proportionality of stavudine in HIV seropositive asymptomatic subjects:
      application to bioequivalence assessment of various capsule formulations.
AB  - The dose proportionality and bioequivalence of the capsule formulations used in
      clinical trials and the proposed commercial formulations of stavudine were
      assessed in an open-label, single-dose, randomized four-way crossover study in 16
      asymptomatic HIV-infected males. One capsule of stavudine (5, 10, 20, or 40 mg)
      was administered orally to each subject in each of the four treatment periods.
      Serial blood samples were collected for 10 h after each dose and the plasma was
      assayed for intact stavudine by a validated radioimmunoassay method. The plasma
      concentration-time data were subjected to non-compartmental pharmacokinetic
      analysis. For doses ranging from 5 to 40 mg, mean Cmax and AUC0-infinity values
      were in the range of 110.36-889.34 ng mL-1 and 246.46-1945.97 h ng mL-1
      respectively. The mean Cmax and AUC0-infinity of stavudine increased in a dose
      proportional manner. Irrespective of the dose, mean Cmax values were observed at
      a median tmax of 0.75 h or less. Mean t1/2 values were 1.97, 1.77, 1.67 and 1.66
      h for the 5, 10, 20, and 40 mg capsules, respectively. For bioequivalence
      assessment, Cmax and AUC0-infinity values were normalized to the 10 mg dose since
      these parameters were dose proportional. The 10 mg capsule formulation used in
      phase-3 clinical trials was chosen as the reference. The relative bioavailability
      estimates and 90% confidence limits for the dose-normalized Cmax values with the
      10 mg capsule as the reference were 86% (76%, 96%), 99% (88%, 110%), and 90%
      (80%, 100%) for the 5, 20, and 40 mg capsules, respectively. The differences in
      the point estimates of the dose-normalized AUC0-infinity values for the 5, 20,
      and 40 mg capsules relative to the 10 mg phase-3 capsule were 1% or less, and the
      90% confidence limits were all within 95-106%. These results indicate that
      stavudine exhibits linear pharmacokinetics and that the 5, 10, 20, and 40 mg
      capsules of stavudine are bioequivalent.

PMID- 7780047
TI  - The effect of the fat content of food on the pharmacokinetics and
      pharmacodynamics of SDZ FOX 988, an antidiabetic agent, in the dog.
AB  - SDZ FOX 988 (FOX 988) is being developed for the treatment of type II diabetes.
      The objective of this study was to examine the effect of the fat content of food
      on the pharmacokinetics and pharmacodynamics of FOX 988 following oral
      administration in the dog. In a randomized, cross-over design, four dogs received
      a single 10 mg kg-1 dose of 14C-FOX 988 suspension concomitantly with food
      containing 10% fat or 40% fat, or with the 10% fat food at 4 h post-dose. Serial
      blood, urine, and fecal samples were collected for 96 h and analyzed for total
      radioactivity. Blood concentrations of 53-450, the active metabolite of FOX 988,
      were also determined. Serum concentrations of beta-hydroxybutyrate and glucose,
      pharmacological markers for the antidiabetic effects, were measured serially for
      24 h after dosing. The animals receiving the low-fat meal at dosing and at 4 h
      post-dose exhibited similar extents of absorption, as shown by similar AUC values
      and urinary radioactivity recovery. Administration of the high-fat meal at dosing
      significantly enhanced the absorption of FOX 988 and resulted in high blood
      concentrations of 53-450. However, no significant differences in the
      pharmacological activity of the drug were observed among the three treatments.

PMID- 7780048
TI  - Uptake and biodisposition of 2-ylcyanamide-1,3,4-thiadiazole (LY217896) by red
      blood cells.
AB  - In man, 14C-2-ylcyanamide-1 3 4-thiadiazole (LY217896) accumulates into red blood
      cells (RBCs) where it is rapidly metabolized. Both in man and ex vivo, within a
      few hours of administration of 14C-LY217896 at least two intracellular
      metabolites were detected within the RBCs using HPLC. These metabolites were
      never detected extracellularly. After 24 h no detectable radioactivity was found
      in the plasma and all the radioactivity was detected within the cellular
      fraction. All radioactivity was identified as a single peak within the RBCs,
      indicating the metabolite(s) to be highly polar compared to LY217896. Parent
      LY217896 was never detected within the RBCs at any time point, suggesting
      transport, either by diffusion or a carrier mediated mechanism, was the rate
      limiting step. Due to the nature of the preparation it was impossible to
      separately characterize uptake and biotransformation. Nevertheless,
      uptake/biotransformation was found to be temperature sensitive, sodium
      independent, and energy dependent. Both niacin and vitamin B6, but not
      nicotinamide, competitively blocked the uptake and subsequent intracellular
      metabolism of LY217896.

PMID- 7780049
TI  - Disposition kinetics of HEPP in rats after intravenous, oral, and intraperitoneal
      administration. Correlation of plasma and brain levels with the anticonvulsant
      effect.
AB  - D, L-3-hydroxy-3-ethyl-3-phenylpropanamide (HEPP) is a synthetic drug with
      anticonvulsant effects in a variety of seizure models. HEPP pharmacokinetics was
      studied after single 50 mg kg-1 intravenous (i.v.), intraperitoneal (i.p.), and
      oral (PO) administration in male albino Wistar rats. The plasma concentration
      against time curves showed a biphasic decay pattern with a similar distribution
      phase and the same terminal rate constant (beta = 0.22 h-1) by all three routes.
      The apparent volume of distribution at steady state (Vss = 0.80 L kg-1) indicates
      that HEPP is extensively distributed in extracellular tissues. This finding
      agrees very well with its low binding to plasma protein (mean bound fraction =
      19.3 +/- 1.1%). The systemic clearance (Cl) was very low (3.30 mL min-1 kg-1).
      The bioavailability after IP and PO administration was 0.80 and 0.60
      respectively. In the pharmacokinetic-pharmacodynamic studies a direct
      relationship was found between the protective effect of HEPP against
      pentylenetetrazole (PTZ) induced seizures and its concentration in plasma and/or
      brain. The concentrations at half-maximal effect (EC50) with 95% confidence
      interval (Cl) were 70.6 (66-75.5) micrograms mL-1 in serum and 60.1 (55.4-65.1)
      micrograms g-1 in brain. There was a rapid uptake of HEPP into the brain, and
      after the distributive phase, the disappearances in plasma and brain were almost
      parallel [C(serum) = 109 e-0.25t, r2 = 0.95; C(brain) = 38 e-2.53t + 91 e-0.21t,
      r2 = 0.93], with a C(brain)/C(plasma) ratio of 1.1.

PMID- 7780050
TI  - Plasma lipoproteins as targeting carriers to tumour tissues after administration
      of a lipophilic agent to mice.
AB  - We synthesized 14C-warfarin hexadecyl ether (14C-WHE) by addition of a palmityl
      moiety to the hydroxyl group at the 4-position of 14C-warfarin, a compound known
      to bind to serum albumin. 14C-WHE preferentially bound to the lipoproteins, low
      density lipoprotein (LDL) and high-density lipoprotein (HDL), in mouse plasma
      both in vitro and in vivo. 14C-Warfarin mainly concentrated in the liver
      immediately after intravenous administration to mice bearing M5076 sarcoma, and
      was found at only low concentrations in other tissues including the tumour. 14C
      WHE highly distributed to the tumour, adrenal, and spleen, as well as the liver.
      These tissues coincided with those in which human 125I-LDL was vigorously
      incorporated. The results indicate that chemical modification of an agent, giving
      it high lipophilicity, will enable it to bind to lipoproteins after intravenous
      administration. These modifications raise the possibility of lipoproteins as
      endogenous targeting carriers into tumour cells, which have high LDL-receptor
      activity.

PMID- 7780051
TI  - The thymic way to transplantation tolerance.
AB  - Within the past three decades, extensive research has been carried out with the
      aim to prevent graft rejection by minimizing the side effects related to the use
      of immunosuppressants. The major goal in transplantation research remains the
      development of strategies that would allow one to achieve a state of donor
      specific unresponsiveness in order to promote a condition of true tolerance
      without the need of immunosuppressants. Recent evidence has been provided that
      this is a pursuing goal, at least in experimental animals. The thymus plays the
      major role in the development of self-tolerance, and initial work in the late
      1960s indicated that the thymus also plays a critical role in the induction of
      acquired tolerance to exogenous antigens. Recently, the interest in acquired
      thymic tolerance has been renewed by the observation that, in the rat, the thymus
      is an immunologically privileged site in which isolated pancreatic islets can be
      engrafted and survive indefinitely. Moreover, intrathymic injection of the islets
      induced donor-specific unresponsiveness, which allowed survival of a second donor
      strain islet cell allograft transplanted into an extrathymic site. These findings
      on cellular allografts have been extended to vascularized organ
      allografts.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780052
TI  - Syndrome of flank pain and acute renal failure after binge drinking and
      nonsteroidal anti-inflammatory drug ingestion.
AB  - The binge drinking of alcohol combined with the ingestion of a nonsteroidal anti
      inflammatory drug (NSAID) is a recently described cause of reversible acute renal
      failure. The pathogenetic mechanisms leading to acute tubular necrosis in this
      setting include the initial compromise in renal perfusion due to alcohol-induced
      extracellular volume contraction and the superimposed renal hemodynamic
      alterations induced by the NSAID that interfere with the renal autoregulation.
      Although alcohol may also cause rhabdomyolysis leading to acute tubular necrosis,
      this is usually not apparent in these cases. Previously, only three such cases
      have been reported but the incidence is likely to be higher in view of the
      prevalence of alcohol and NSAID use. Herein is presented another patient in whom
      the features of flank pain and acute renal failure in association with binge
      drinking and NSAID ingestion constitute a characteristic syndrome.

PMID- 7780053
TI  - Renal amyloidosis in a drug abuser.
AB  - Drug abusers, particularly those who inject drugs s.c. ("skin popping"), may
      develop amyloidosis. Chronic infections are thought to play a pathogenetic role
      in this setting. A patient is presented who had a history of "skin popping"
      cocaine and heroin and developed nephrotic syndrome, with an elevated serum
      creatinine and a creatinine clearance of 61 mL/min. Renal biopsy demonstrated
      amyloidosis. Treatment with colchicine was initiated, and proteinuria decreased
      to near normal levels after 12 months. Concomitant with the decrease in
      proteinuria, creatinine clearance improved, although a repeat renal biopsy failed
      to show any significant improvement in amyloid burden. These observations suggest
      that colchicine may be a useful treatment in reversing the proteinuria of renal
      amyloidosis associated with drug abuse. Furthermore, clinical improvement may
      occur before any demonstrable regression in the amyloidosis.

PMID- 7780054
TI  - Structural-functional relationships in Alport syndrome.
AB  - Renal morphometric analysis was performed in 15 (13 male) Alport syndrome
      patients ages 4 to 26 years, along with 10 controls ages 3 to 26 years, to better
      understand the structural basis of renal dysfunction in Alport syndrome. The
      glomerular basement membrane (GBM) width class frequencies of controls were
      normally distributed; those of Alport syndrome patients were slightly skewed,
      especially toward thicker classes, although there was also an increase in the
      proportion of thinner classes. Mesangial volume fraction was not different
      between Alport syndrome patients (0.21 +/- 0.09) and controls (0.19 +/- 0.04).
      There was an inverse correlation between mesangial volume fraction and creatinine
      clearance in Alport syndrome patients (r = -0.72, P < 0.01); however, the
      creatinine clearances in Alport syndrome patients were far less than in insulin
      dependent diabetic patients with similar mesangial volume fraction. Similarly,
      there was no significant difference in the surface density of the peripheral GBM
      (in square micrometers per cubic micrometer) in Alport syndrome patients (0.12 +/
      0.04) versus controls (0.13 +/- 0.02). The surface density of the peripheral GBM
      correlated with creatinine clearance in Alport syndrome patients (r = 0.71, P <
      0.01). However, there was a greater reduction in creatinine clearance as related
      to declining the surface density of the peripheral GBM in Alport syndrome than in
      diabetic patients. The cortical interstitial volume fraction was highly inversely
      correlated with creatinine clearance in Alport syndrome patients (r = -0.85, P <
      0.01). Global glomerular sclerosis was 0% in five and 5 to 61% in nine Alport
      syndrome patients and correlated inversely with creatinine clearance (r = -0.74,
      P < 0.01). However, the creatinine clearance was lower in Alport syndrome than in
      diabetic patients with similar cortical interstitial volume fraction and percent
      glomerular sclerosis. There was no significant difference in an index of
      glomerular number between Alport syndrome patients and controls. Thus, changes in
      mesangial volume fraction, cortical interstitial volume fraction, percent
      glomerular sclerosis, and surface density of the peripheral GBM in Alport
      syndrome patients only partially account for the reduction in creatinine
      clearance. It was speculated that decreased glomerular capillary wall hydraulic
      conductivity in Alport syndrome could explain many of these observations.

PMID- 7780055
TI  - Genesis of renal cysts is associated with clusterin expression in experimental
      cystic disease.
AB  - Phenol II is a cystogenic chemical that rapidly induces renal cysts, which
      regress after drug withdrawal. Cyst formation in this model parallels changes in
      the tubular basement membrane. Clusterin is a potent cohesive factor induced in
      states of tissue remodeling. The purpose of this study was to determine if renal
      clusterin was increased in the Phenol II model and to define the time course and
      distribution of its induction. Male Sprague-Dawley rats were given, by daily
      gavage, Phenol II (1.2 mg/kg per day) or vehicle (control). The kidneys were
      harvested after 1, 2, or 4 days of Phenol II treatment or 3 or 7 days after drug
      withdrawal. An increase in immunoreactive clusterin was seen in the kidneys of
      Phenol II-treated rats but not in controls. The appearance of clusterin followed
      a time course similar to that for cyst formation, with expression confined to the
      epithelial lining and intratubular casts of dilated or cystic tubules. After
      Phenol II withdrawal, renal cysts regressed and clusterin staining disappeared.
      The development of cysts was associated with an increase in clusterin mRNA that
      decreased after drug withdrawal. In conclusion, a marked, yet reversible
      induction of clusterin occurred in chemically induced polycystic kidney disease.
      The function of clusterin in this setting remains enigmatic.

PMID- 7780056
TI  - Differential mRNA expression of renal cortical tissue inhibitor of
      metalloproteinase-1, -2, and -3 in experimental hydronephrosis.
AB  - The pathophysiologic sequelae of both acute and chronic experimental unilateral
      ureteral obstruction (UUO) in the rat are the result of a variety of complex
      humoral and cellular interactions. The development of interstitial fibrosis is
      dependent on the tightly coupled regulation of synthesis and degradation of
      extracellular matrix proteins. This laboratory, among others, has shown an up
      regulated expression of renal cortical transforming growth factor (TGF)-beta 1
      within hours of the onset of UUO. Because a potential contribution of TGF-beta to
      fibrosis may be its ability to increase the expression of proteinase inhibitors
      such as members of the tissue inhibitor of metalloproteinase (TIMP) family, this
      laboratory now sought to delineate the kinetics of TIMP-1, TIMP-2, and TIMP-3
      mRNA expression in the renal cortex after UUO. There was a marked elevation of
      TIMP-1 mRNA expression after UUO, which was first noted at 12 h after ureteral
      ligation. By 96 h after UUO; there was a 30-fold increment in TIMP-1 mRNA in the
      obstructed kidneys compared with the contralateral unobstructed kidney or sham
      operated rat specimens. In contradistinction to TIMP-1, a decrease in TIMP-3 mRNA
      levels was noted at 12 h after ureteral obstruction and persisted at the 24-, 48
      , and 96-h time intervals. TIMP-2 gene expression remained at a relatively
      constant level during the entire study. It is proposed that the increased
      expression of TGF-beta 1 post-UUO induces a profibrogenic state and initiates a
      cascade of dysregulatory events including the up-regulation of TIMP-1.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7780057
TI  - Renal effects of oral prostaglandin supplementation after ibuprofen in diabetic
      subjects: a double-blind, placebo-controlled, multicenter trial.
AB  - Prostaglandins of the E series (PGE) are known to contribute to the maintenance
      of renal hemodynamics in subjects with chronic renal insufficiency. Agents that
      block PGE synthesis, nonsteroidal anti-inflammatory agents (NSAID), are widely
      used by people with renal insufficiency. This study was undertaken in subjects
      with renal insufficiency secondary to diabetes to evaluate the acute effects of a
      PGE1 analog, misoprostol, on NSAID-induced changes in RBF, as calculated by para
      aminohippurate clearance, and GFR, as calculated by inulin clearance. Sodium
      excretion was also assessed. Twenty-five fasting subjects with a mean age of 56
      +/- 4 yr received 800 mg of ibuprofen orally. A concomitant dose of either a
      placebo (PL) or 200 micrograms of misoprostol was also given. This was followed
      in 1 h by either a placebo or an additional 200-micrograms dose of misoprostol.
      Measurements for the determination of RBF, GFR, blood pressure, and fractional
      excretion of sodium were performed every 30 min for the next 5 h. The greatest
      reduction in both GFR (-25 +/- 7 mL/min per 1.73 m2 PL versus -10 +/- 4 mL/min
      per 1.73 m2, misoprostol delta GFR; P < 0.05) and RBF (-48 +/- 21 mL/min per 1.73
      m2 PL versus -15 +/- 8 mL/min per 1.73 m2, M delta RBF; P < 0.05) occurred
      approximately 2 h after the NSAID dose. No significant differences were noted in
      blood pressure, fractional excretion of sodium, or other measured parameters
      between groups during the entire study. Gastrointestinal upset was the most
      common side effect observed in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780058
TI  - Impaired cation transport in thymocytes of rats with chronic uremia includes the
      Na+/H+ antiporter.
AB  - To examine how uremia changes sodium, potassium, and proton transport, thymocytes
      from chronic renal failure (CRF) rats were studied. If alterations in cation
      transport associated with chronic uremia (CRF) extend to intracellular pH
      regulation, the susceptibility to the catabolic effects of acidosis might be
      increased. To evaluate the influence of acidosis, cation transport in thymocytes
      from normal rats with NH4Cl-induced acidosis was also studied. Ouabain-sensitive
      86Rb influx in thymocytes from acidotic CRF rats was 32% lower than in control
      cells (P < 0.05), but intracellular sodium concentration was unchanged. This may
      be related to a 47 +/- 22% reduction in 22Na influx. In thymocytes from
      nonuremic, acidotic rats, ouabain-sensitive 86Rb influx was decreased 39% (P <
      0.025), similar to the change in CRF. In CRF thymocytes, Na(+)-H+ antiporter
      activity in response to cell acidification (7.13 +/- 0.8 versus 9.42 +/- 0.8 mmol
      of H+/L per min; CRF versus control), or to osmotic shrinkage (0.43 +/- 0.09
      versus 0.82 +/- 0.11 mmol of H+/L per min; CRF versus control), was significantly
      (P < 0.01) reduced. Buffering capacity at resting and acidic intracellular pH was
      unchanged by uremia, but Na+/H+ antiporter activity in response to acid loading
      or osmotic shrinkage was unchanged in thymocytes of nonuremic rats with metabolic
      acidosis. Thus, CRF reduces both Na/K-ATPase and Na+/H+ antiporter activities in
      rat thymocytes. The former may be secondary to reduced sodium influx. Impaired
      Na+/H+ antiporter activity is not caused by metabolic acidosis alone, whereas
      reduced Na/K-ATPase activity is found in both acidosis and uremia.

PMID- 7780059
TI  - Polymorphonuclear leukocyte oxidative burst is enhanced in patients with chronic
      renal insufficiency.
AB  - Previous reports that polymorphonuclear leukocyte (PMN) function is impaired in
      hemodialysis patients do not differentiate between effects of dialysis and of
      uremia. The hypothesis that chronic renal insufficiency impairs PMN function was
      tested. Phagocytosis and oxidative burst were measured in PMN from patients with
      varying degrees of chronic renal insufficiency impairs PMN function was tested.
      Phagocytosis and oxidative burst were measured in PMN from patients with varying
      degrees of chronic renal insufficiency (creatinine clearance, 6 to 35 mL/min per
      1.73 m2) and normal subjects. The ability of tumor necrosis factor-alpha (TNF
      alpha) to prime the oxidative burst was also assessed. Phagocytosis of
      Staphylococcus aureus and basal H2O2 and O2- release by PMN did not differ
      between normal subjects and patients with chronic renal insufficiency. However,
      the oxidative burst stimulated by S. aureus and formyl-Met-Leu-Phe, but not
      phorbol myristate acetate, was significantly enhanced in PMN from patients with
      chronic renal insufficiency. The increase in formyl-Met-Leu-Phe-stimulated
      oxidative burst correlated significantly with the level of renal function. TNF
      alpha significantly increased S. aureus-induced H2O2 production in normal PMN,
      but not in PMN from patients with chronic renal insufficiency. These data
      indicate that chronic renal insufficiency does not impair PMN phagocytosis and
      oxidative burst. To the contrary, it enhances receptor-mediated oxidative burst.
      The inability of TNF-alpha to further enhance the oxidative burst suggests that
      PMN exist in a primed state in patients with chronic renal insufficiency.

PMID- 7780060
TI  - High-flux dialysis membranes improve lipid profile in chronic hemodialysis
      patients.
AB  - In a controlled prospective trial, the effect of a switch from cellulose-based,
      low-flux dialysis membranes to polysulphone, high-flux membranes on lipid
      parameters was evaluated. Baseline values of lipid parameters were identical in
      the study group and the control group in which the dialysis membrane remained
      unchanged. After 6 wk, total triglyceride, very low-density lipoprotein (VLDL)
      triglyceride, and VLDL cholesterol decreased, respectively, 28 +/- 17 (P < 0.01),
      38 +/- 17 (P < 0.01), and 24 +/- 21% (P < 0.05), and the proportion of total
      cholesterol that was high-density lipoprotein cholesterol increased from 15 +/- 5
      to 18 +/- 5% (P < 0.05) in the high-flux polysulphone group, whereas these
      variables remained unchanged in the control group. Low-density lipoprotein and
      total cholesterol as well as Kt/V, protein catabolic rate, parathyroid hormone,
      albumin, and body weight did not change. No change in lipoprotein lipase activity
      was found. In a second study, the effects of a single hemodialysis session with
      high-flux polysulphone and low-flux, cellulose-based membranes on lipid
      parameters and lipolytic activity were compared in a cross-over fashion.
      Treatment with both membranes resulted in a significant decrease in plasma
      triglyceride, VLDL triglyceride, and VLDL cholesterol. Lipoprotein lipase
      activity increased during hemodialysis. Changes in lipid parameters and lipolytic
      activity were identical during the two treatments.

PMID- 7780061
TI  - How should renal hemodynamic data be indexed in obesity?
AB  - Clearance data are customarily indexed to body surface area of 1.73 m2. This
      study examined whether this standard procedure gives correct values for renal
      perfusion in obese subjects. In 215 subjects who varied in age, gender, height,
      weight, obesity, and mean arterial blood pressure, RPF was determined by
      measuring the clearance of (131I)para-aminohippuric acid. Multiple regression
      analysis of the whole study group revealed that age (beta = -0.44, P < 0.001),
      height (beta = +0.25, P < 0.01), and arterial blood pressure (beta = -0.19, P <
      0.01) were independent predictors of RPF, but that weight or body mass index was
      not. When related to body surface area, RPF appeared to decline with increasing
      obesity as follows: normal weight, 609 +/- 153 mL/min per 1.73 m2; overweight,
      572 +/- 149 mL/min per 1.73 m2; severely overweight, 530 +/- 145 mL/min per 1.73
      m2 (P < 0.012). In contrast, RPF related to height reflected a pattern concordant
      with the multiple regression analysis: normal weight, 3.76 +/- 0.9 mL/min per
      meter; overweight, 3.86 +/- 1.0 mL/min per meter; and severely overweight, 3.86
      +/- 1.0 mL/min per meter (not significant). A separate repetition of the whole
      analysis for both normotensive (N = 55) and hypertensive subjects (N = 160)
      revealed a result similar to that found for the whole group. Thus, our results
      show that obesity was not a determinant of RPF, and when related to body surface
      area, inappropriately low values of RPF were calculated for obese patients. It
      was concluded that RPF values correlate with height and not with surface area in
      obese subjects.

PMID- 7780062
TI  - Autosomal recessive Alport syndrome: mutation in the COL4A3 gene in a woman with
      Alport syndrome and posttransplant antiglomerular basement membrane nephritis.
AB  - Autosomal recessive Alport syndrome can arise from a mutation in either of the
      genes COL4A3 and COL4A4 on chromosome 2, which encode, respectively, the alpha 3
      and alpha 4 chains of Type IV collagen. This report describes a mutation in
      COL4A3 in a girl who presented at age 5 with hematuria and proteinuria, lacking
      any family history of renal disease. Renal biopsy at age 8 showed immunoglobulin
      A nephropathy and Alport syndrome. Sensorineural deafness developed during
      adolescence, and the patient's renal disease progressed to terminal renal failure
      by age 20. She received a living related donor renal allograft at age 20 and
      developed antiglomerular basement membrane nephritis of the allograft 8 months
      after transplantation. Amplification and sequencing of exon 5 of COL4A3 (counting
      from the 3' end of the gene) revealed a 7-base-pair deletion, producing a shift
      of the reading frame and the creation of a premature stop codon. Each parent was
      heterozygous for the normal and mutant exon 5 sequences. This mutation in COL4A3
      would result in the loss of 222 amino acids from the carboxy-terminal
      noncollagenous domain of the alpha 3(IV) chain. The mutant chain would be unable
      to form trimers with other Type IV collagen alpha chains. In addition, the mutant
      chain would lack the Goodpasture epitope, which resides in the carboxy-terminal
      noncollagenous domain of the alpha 3(IV) chain. The absence of this epitope may
      underly the subsequent development of anti-glomerular basement membrane nephritis
      in the allograft.

PMID- 7780063
TI  - Endothelin A receptor mediates functional but not structural damage in chronic
      cyclosporine nephrotoxicity.
AB  - Chronic treatment with cyclosporine (CsA) is limited not only by glomerular
      hypofiltration but also by structural damage. The pathogenesis of these
      nephrotoxicities was studied in a model of chronic CsA-induced renal damage. Salt
      depleted rats were treated with daily CsA (15 mg/kg sc) for approximately 3
      weeks, at which time renal function was measured and kidneys were harvested for
      morphologic assessment. A separate group of rats (CsA + BQ123) were identically
      treated with CsA but in addition also received simultaneous treatment with a
      specific endothelin A (EtA) receptor antagonist, BQ123, which was continuously
      delivered via sc osmotic pump (1 mg/kg per hour) and maintained throughout the
      study. Chronic CsA treatment caused profound functional and structural damage,
      although blood pressure was normal (102 +/- 6 mm Hg); GFR was 0.05 +/- 0.02
      mL/min per 100 g body wt, and RPF was 0.15 +/- 0.06/100 g body wt. Renal injury
      was scored on a scale of 0 to 4 and showed dilation/vacuolization of 1.07 +/-
      0.29 and tubulointerstitial fibrosis of 0.78 +/- 0.17. Arteriolopathy was present
      in 78 +/- 4% of arterioles. Chronic antagonism of the EtA receptor preserved
      renal function: GFR was 0.15 +/- 0.03 mL/min per 100 g body wt, and RPF was 0.32
      +/- 0.08/100 g body wt (P < 0.05 for GFR versus CsA). Blood pressure was not
      affected: 104 +/- 8 mm Hg.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780064
TI  - Choosing the appropriate double-lumen tube: a glimmer of science comes to a dark
      art.

PMID- 7780065
TI  - The relationship between left mainstem bronchial diameter and patient size.
AB  - Knowledge of a patient's left mainstem bronchial diameter would provide a useful
      guide to choosing the appropriate double-lumen tube (DLT) size for that patient.
      Therefore, the authors investigated the possibility that left bronchial diameter
      could be predictably estimated from a patient's size and sex. The routine
      preoperative chest X-rays of 100 adult male and female patients of known age,
      height, and weight were examined. The left bronchial diameter was measured on the
      posteroanterior (PA) chest x-ray, and a formula was used to correct for the
      magnification of intrathoracic structures encountered on the PA view. Multiple
      linear regression analysis was used to determine whether one or more of the
      variables (age, sex, height, weight, and body surface area) had a predictable
      relationship to the left bronchial diameter. The left mainstem bronchial diameter
      in men and women (mean +/- SD/range) was 12.4 +/- 1.5 mm/9.5 to 15.5 mm, and 10.7
      +/- 1.0 mm/9.0 to 14.0 mm, respectively. In female patients, none of the
      variables was significantly correlated with bronchial diameter. In male patients,
      age (p = 0.013) and height (p = 0.008) individually produced a statistically
      significant prediction of endobronchial diameter. The following formula was best
      predictive of left bronchial diameter in men: diameter (mm) = 0.032 x age (year)
      + 0.072 x height (cm) -2.043. Applying this formula to mean age 50 who are 158,
      172, and 185 cm in height, the predicted left bronchial diameters are 11.0, 12.0,
      and 13.0 mm, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780066
TI  - Incidence of malposition of polyvinylchloride and red rubber left-sided double
      lumen tubes and clinical sequelae.
AB  - Currently, fiberoptic bronchoscopy (FB) is recommended for correct positioning of
      double-lumen endobronchial tubes (DLTs) because of the high incidence of
      malpositions not appreciated by clinical signs. The aims of this study were to
      assess whether clinical signs allow accurate confirmation of adequate positioning
      with left red rubber (RR) or polyvinyl-chloride (PVC) double-lumen tubes and to
      compare the incidence of malpositions between the two tubes. Another goal was to
      assess whether these malpositions, not appreciated by clinical assessment,
      adversely affected outcome. Twenty-one adult patients scheduled for elective
      thoracic surgery were randomly assigned to the RR (11 patients) or PVC group (10
      patients). After endobronchial intubation, the position of the tubes was adjusted
      until clinically satisfactory lung separation had been achieved. A single
      investigator performed all the FB assessments were performed in the supine (SUP)
      and lateral positions. The anesthesiologists responsible for the clinical
      evaluation were "blinded" to the bronchoscopic findings. While in the SUP
      position, the tube was "too deep" to permit visualization of the carina during
      tracheal bronchoscopy in 5 patients (2 RR, 3 PVC). In 17 of 21 (10 RR, 7 PVC),
      the bronchial cuff could not be visualized, although in 1 patient (RR group), the
      cuff was overinflated and bulged out to partially obstruct the right main
      bronchus orifice. Bronchial bronchoscopy showed 4 of 11 patients in the RR group
      in whom the left upper lobe orifice was occluded compared with 1 only in the PVC
      group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780067
TI  - Postthoracotomy pulmonary function: a comparison of epidural versus intravenous
      meperidine infusions.
AB  - It has remained unclear whether epidural opioid analgesia permits better recovery
      of postthoracotomy pulmonary function than an optimal method of systemic opioid
      administration. Lumbar epidural meperidine infusions were compared with
      intravenous patient-controlled analgesic (PCA) meperidine infusions in a
      prospective randomized unblinded study for 72 hours postthoracotomy. Before
      induction of general anesthesia, patients received a bolus of meperidine, 1
      mg/kg, and an infusion of meperidine, 0.33 mg/kg/hr, was started via either a
      lumbar epidural or intravenous catheter. Postoperatively, the meperidine infusion
      rates were titrated as needed for analgesia. In addition, the intravenous group
      received meperidine, 10 mg per dose, as required, from a patient-controlled
      analgesia pump. No other opioid was administered during the study period.
      Patients were studied for recovery of spirometric tests of pulmonary function,
      visual analog pain scores, sedation, arterial blood gases, meperidine dose
      requirements, radiographic pulmonary complications, and neurologic signs and
      symptoms. A subgroup of 10 patients (5 from each group) had venous blood samples
      drawn every 24 hours for 96 hours and assayed for serum meperidine and
      normeperidine concentrations. Epidural meperidine analgesia was associated with
      improved postthoracotomy pulmonary function, better analgesia scores, and lower
      meperidine dose requirements than intravenous PCA meperidine. There were no
      differences between the epidural versus intravenous PCA subgroups with respect to
      serum meperidine or normeperidine levels. Normeperidine levels greater than 300
      ng/mL were associated with an increased incidence of shakiness and/or tremors.
      Meperidine provides satisfactory postthoracotomy analgesia via a lumbar epidural
      infusion. This analgesia is associated with improved recovery of postoperative
      pulmonary function when compared with an intravenous PCA meperidine infusion.

PMID- 7780068
TI  - Retrograde-delivered cardioplegia is not distributed equally to the right
      ventricular free wall and septum.
AB  - Right ventricular myocardial protection during cardiac surgery continues to be a
      challenge. Retrograde delivery of cardioplegia has been shown to perfuse left
      ventricular regions subtended by critical coronary stenosis and not adequately
      protected by antegrade delivery. However, the distribution of cardioplegia from
      the coronary sinus to the right ventricle remains in question. A reliable means
      for assessing such flow distribution intraoperatively is provided by contrast
      echocardiography. It was hypothesized that conventional use of coronary sinus
      catheters for retrograde cardioplegia delivery does not reliably perfuse the
      myocardial region subtended by the right coronary artery. Six patients scheduled
      to undergo elective coronary artery bypass surgery were evaluated with contrast
      echocardiography to determine the distribution of retrograde-delivered
      cardioplegia into the right ventricle. Sonicated Renografin-76 (Squibb
      Diagnostics, Princeton, NJ) was injected during retrograde delivery of cold
      crystalloid cardioplegia solution and continuous two-dimensional ultrasound
      imaging of the heart. On-line videodensitometric analysis was performed with a
      digital ultrasound system. The area under the curve and peak pixel intensity were
      determined for the anterior septum, the posterior septum, and the right
      ventricular free wall for each contrast injection. Recorded VHS videotape images
      of contrast-enhanced perfusion patterns were also reviewed and scored. On-line
      acoustic-densitometric analysis showed that right ventricular posterior and
      anterior septal peak pixel intensities were 4.8 +/- 3.2 and 7.3 +/- 1.5,
      respectively, compared with only 1.6 +/- 1.2 (p < or = 0.05) in the right
      ventricular free wall.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780069
TI  - Comparison of vecuronium and meperidine on the clinical and metabolic effects of
      shivering after hypothermic cardiopulmonary bypass.
AB  - The use of vecuronium and meperidine on the clinical and metabolic effects of
      shivering in mechanically ventilated patients after hypothermic cardiopulmonary
      bypass (CPB) was compared. Twenty adult male patients undergoing cardiac surgery
      were randomized to meperidine, 25 to 75 mg (n = 10), or vecuronium, 0.1
      microgram/kg (n = 10), for the treatment of shivering during postoperative
      rewarming. Vecuronium was continued as an infusion at 1.0 microgram/kg/min for 4
      hours. Meperidine abolished shivering in 50% of patients with a 60% recurrence
      within 2 hours and did not correct acute respiratory acidosis when it occurred.
      Vecuronium uniformly abolished shivering, corrected acute respiratory acidosis,
      and improved mixed venous oxygen saturation (20% v 4%), decreased oxygen
      consumption (-32% v -7%) and decreased end-tidal carbon dioxide (-21% v -5%)
      significantly more than meperidine (p < 0.005). Meperidine administration caused
      a significant decline in systolic blood pressure (121.9 +/- 10.6 mmHg to 106.9 +/
      8.5 mmHg, p = < 0.02). The authors conclude that, during rewarming after
      hypothermic CPB, muscle relaxation with vecuronium reverses both the clinical and
      metabolic effects of shivering more reliably and effectively than repeated
      boluses of meperidine, and with greater hemodynamic stability. Control can be
      maintained by continuous infusion of vecuronium with concomitant sedation for up
      to 4 hours without prolonging intubation time.

PMID- 7780070
TI  - Determinants of postoperative hypothermia after normothermic cardiopulmonary
      bypass.
AB  - Inadvertent postoperative hypothermia in the cardiac surgical patient can have
      various adverse physiologic effects. Previous studies have investigated the
      relationship of patient, surgical, and anesthetic factors with postoperative
      hypothermia in patients undergoing noncardiac surgery. This study was designed to
      assess the relationship between postoperative hypothermia after normothermic
      cardiopulmonary bypass (CPB) for cardiac surgery and a variety of perioperative
      and patient factors. Fifty-six patients undergoing daytime elective or urgent
      cardiac surgery with warm (37 degrees C) CPB were studied. The following patient
      variables were included: age, weight, height, sex, history of previous cardiac
      surgery, and prebypass temperature. The following treatment factors were
      recorded: type of surgery, type and dose of anesthetic, use of airway humidifier,
      use of an intravenous (i.v.) fluid warmer, total volume of i.v. fluid
      administered during surgery, net fluid volume administered via CPB, total time
      spent on CPB, use of nitroglycerin, use of alpha-agonists during surgery, and
      elapsed time from end of CPB to end of surgery. Core temperature readings, as
      measured by a pulmonary artery catheter thermistor, were noted as follows: (1) on
      insertion of the pulmonary artery catheter; (2) after the patient was weaned from
      CPB; (3) within 30 minutes of intensive care unit (ICU) arrival; (4) 3 to 5 hours
      after ICU arrival; (5) 7 to 9 hours after ICU arrival; and (6) 11 to 13 hours
      after ICU arrival. Multiple linear regression and logistic regression for
      categorical variables with backward elimination were employed to determine the
      impact of all variables on lowest postoperative temperature. The lowest mean
      temperature occurred during CPB.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780071
TI  - Modification of the diuretic and natriuretic effects of a dopamine infusion by
      fluid loading in preoperative cardiac surgical patients.
AB  - An intravenous infusion of dopamine at 2.5 microgram/kg/min was administered for
      40 minutes to anesthetized cardiac surgical patients, and their renal function
      was measured. Five patients had the usual preoperative regimen of reduced fluid
      intake for the night and morning before surgery (nonhydrated), and five patients
      received normal saline, 2 mL/kg/hr intravenously, for 6 hours before anesthesia
      (hydrated). Renal function (measured by urine output, sodium excretion, free
      water clearance, and fractional excretion of sodium) was similar immediately
      before starting the dopamine infusion. All four variables were significantly
      higher in the hydrated group after 10 minutes; this difference becoming maximal
      after 40 minutes. Twenty minutes after stopping the dopamine infusion, renal
      function was similar in the two groups. This study indicates that preoperatively
      fluid-restricted patients demonstrate powerful salt and water conservation with
      reduced natriuretic and diuretic responses to a low-dose dopamine infusion when
      compared with hydrated patients. Patients with adequate fluid loading and
      intravascular volume will demonstrate a marked natriuresis and diuresis in
      response to low-dose dopamine infusion.

PMID- 7780072
TI  - Oxygen transport and hemodynamics during retrograde whole-body perfusion.
AB  - The changes in oxygen transport and hemodynamics during retrograde whole-body
      extracorporeal perfusion (retro-ECC) were studied in six mongrel dogs. Oxygen
      consumption during retro-ECC, in which the blood flow rate was set at 25% and 50%
      of the flow during antegrade extracorporeal perfusion (ante-ECC), respectively,
      was relatively high compared with that during ante-ECC. These changes were caused
      by an increase in the oxygen extraction ratio to 71.5% +/- 8.2% and 51.2% +/-
      12.4% during retro-ECC/25% and retro-ECC/50%, respectively. Thus, tissue
      perfusion was apparently well maintained by retrograde perfusion on the basis of
      the oxygen transport data. However, central venous pressure increased markedly to
      29.5 +/- 11.6 mmHg and 56.2 +/- 24.5 mmHg during retro-ECC/25% and retro-ECC/50%,
      respectively, because of massive venous congestion caused by insufficient
      arterial return of perfused blood. The great venous compliance and increased
      systemic vascular resistance were the main causes of circulatory failure during
      retro-ECC. The risk of serious complications owing to the venous congestion must
      be considered during retrograde perfusion, especially during the clinical
      application of retrograde cerebral perfusion.

PMID- 7780073
TI  - Changes in transfusion therapy and reexploration rate after institution of a
      blood management program in cardiac surgical patients.
AB  - A retrospective study was performed to determine the impact of a coagulation and
      transfusion management program on blood utilization in 1,079 sequential patients
      for myocardial revascularization and open ventricle or combined procedures. Four
      hundred and eighty-eight patients (group 1) before, and 591 patients (group 2)
      after institution of thromboelastography (TEG)-guided coagulation were studied
      and compared for transfusion requirements, donor exposure, and the incidence of
      reoperation for hemorrhage. Group 2 patients had a significantly lower incidence
      of overall transfusion (78.5% v 86.3%) during hospitalization and in total
      transfusion in the operating room (57.9% v 66.4%). The incidence of each
      transfusion subtype was also significantly lower in group 2 patients. Actual
      total median donor exposure was 8 in group 1 patients and 6 exposures in group 2
      patients. Mediastinal reexploration for hemorrhage was 5.7% before institution of
      TEG-based coagulation monitoring and 1.5% in TEG-monitored patients. Use of TEG
      monitoring before reexploration has decreased the cost and potential risk for
      patients undergoing CABG surgery.

PMID- 7780074
TI  - The use of thoracic epidural anesthesia in repair of an aortic coarctation.

PMID- 7780075
TI  - The use of halothane to treat severe bronchospasm after a unifocalization
      procedure.

PMID- 7780076
TI  - The Univent tube for airway management in combined ascending and descending
      thoracic aortic surgery.

PMID- 7780077
TI  - Drug management for coronary revascularization without cardiac standstill: the
      use of high-dose esmolol.

PMID- 7780078
TI  - Kearns-Sayre syndrome and cardiac anesthesia.

PMID- 7780079
TI  - Respiratory muscle loading and the work of breathing.

PMID- 7780080
TI  - Case 2--1995. Continuous retrograde cerebral perfusion as an adjunct to brain
      protection during deep hypothermic systemic circulatory arrest.

PMID- 7780081
TI  - Pro: pH-stat management of blood gases is not preferable to alpha-stat in
      patients undergoing brain cooling for cardiac surgery.

PMID- 7780082
TI  - Con: pH-stat management of blood gases is preferable to alpha-stat in patients
      undergoing brain cooling for cardiac surgery.

PMID- 7780083
TI  - An unusual transesophageal echocardiogram.

PMID- 7780084
TI  - Pediatric pain in the nineties.

PMID- 7780085
TI  - Is it possible to improve the shape of right double-lumen endobronchial tubes?

PMID- 7780086
TI  - Fibroblast growth factors and their receptors: an information network controlling
      tissue growth, morphogenesis and repair.
AB  - The stimulation of cellular metabolism by the nine fibroblast growth factors
      (FGFs) is mediated by a dual-receptor system. This comprises a family of four
      receptor tyrosine kinases (FGFR) and heparan sulphate proteoglycans (HSPG). The
      stimulation of cell division by FGFs has an obligate requirement for both
      partners of the dual-receptor system. The binding of the nine FGFs to the FGFRs
      is marked by a pattern of overlapping specificity despite alternative splicing
      events generating a large number of FGFR proteins. Thus many of the FGFR isoforms
      bind several FGFs. It is likely that each FGF requires a different pattern of
      sulphation within the heparan sulphate chains for binding. Therefore, the HSPG
      receptors may provide additional specificity, allowing a cell to fine tune its
      response to the FGFs present in the extracellular milieu. The HSPG receptors also
      control the availability of FGFs and hence regulate the transport of FGFs within
      a tissue. FGF-stimulated cell division would appear to have a mandatory
      requirement for the FGFs to be translocated to the nucleus via the cytosol after
      interacting with the dual-receptor system. The consequences of the potential
      direct action of FGFs in stimulating cell division are examined in the light of
      current models of signal transduction.

PMID- 7780088
TI  - Bibliographic update: hepatocyte growth factor.

PMID- 7780087
TI  - Growth factors in CNS repair and regeneration.
AB  - Traumatic central nervous system (CNS) injury is a significant clinical problem
      in the developed world. After injuries that penetrate into either the mature
      brain or spinal cord, damaged neurons initially begin to regrow, but this
      regeneration is aborted as a fibrotic scar is laid down within the wound.
      Reconnection of several neuronal pathways does not occur. Functional recovery
      from such injuries is therefore poor and morbidity severe, particularly for those
      patients with spinal cord damage. Although palliative measures are available to
      improve the quality of life, there is no accepted treatment to restore impaired
      sensory or motor function, so patients remain significantly and permanently
      debilitated. However, the rapid recent advances that have been made in our
      understanding of the underlying cellular and trophic pathology of such injuries
      offer the potential for development of novel therapies to control scarring,
      enhance neuron survival and stimulate axon regeneration, thereby promoting
      functional recovery.

PMID- 7780089
TI  - Trend of initial drug resistance of tubercle bacilli isolated from new patients
      with pulmonary tuberculosis and its correlation with the tuberculosis programme
      in Beijing.
AB  - SETTING: The tuberculosis control programme of Beijing. OBJECTIVE: To observe the
      trend of initial drug resistance of tubercle bacilli and to try to correlate it
      with the Beijing tuberculosis control programme. DESIGN: Susceptibility testing
      of randomly collected isolates of positive sputum culture from new patients with
      pulmonary tuberculosis without a history of prior antituberculosis therapy, in
      1962 and continuously since 1978. Collection of treatment data from the Beijing
      tuberculosis control programme. RESULTS: The trend of initial drug resistance in
      Beijing began to decline in 1978. The Beijing tuberculosis treatment programme
      has been very successful, resulting in rapid reduction of prevalence of smear
      positive cases. CONCLUSION: It appears that the trend of initial drug resistance
      correlates with progress made in the implementation of the successful
      tuberculosis programme in Beijing. It is recommended that continuous observation
      of initial drug resistance be one of the indices of tuberculosis surveillance.

PMID- 7780090
TI  - Treatment of pulmonary disease caused by Mycobacterium kansasii: results of 18 vs
      12 months' chemotherapy.
AB  - SETTING: Chest Clinic, Sant Pau Hospital, Barcelona, Spain. OBJECTIVE: To assess
      the therapeutic response of pulmonary disease due to Mycobacterium kansasii to 12
      and 18 months of chemotherapy. DESIGN: 28 patients with criteria of pulmonary
      disease caused by M. kansasii not associated with HIV-infection were identified
      in our department in the period 1985-91 (24 male, 4 female, mean age 56 +/- 12
      years). 14 patients were treated with rifampicin-isoniazid-ethambutol daily for
      12 months (ethambutol only for the first 6 months), and 14 with the same regimen
      for 18 months. The follow-up after treatment was 12-30 months. RESULTS: All
      patients showed improvement of radiographic manifestation of disease and sputum
      conversion (mean time: 4.5 +/- 2 months). The adverse drug effects were minimal.
      No failures were detected, and only one patient (3.5%), in the group of 12-month
      chemotherapy, relapsed after finishing the treatment. CONCLUSIONS: Our findings
      suggest that pulmonary disease due to M. kansasii has an effective response to 12
      month chemotherapy regimen and that it is not necessary to prolong the
      administration of ethambutol for more than 6 months.

PMID- 7780091
TI  - Study of the effect of concomitant food on the bioavailability of rifampicin,
      isoniazid and pyrazinamide.
AB  - SETTING: Concomitant feeding and administration of antituberculosis medication
      has been proposed to increase compliance (by decreasing pyrazinamide associated
      nausea) and improve nutritional status. Food may however decrease the oral
      bioavailability of rifampicin and isoniazid. OBJECTIVE AND METHODS: A triple
      crossover pharmacokinetic study in 27 patients with tuberculosis (15 males and 12
      females) compared the bioavailability of rifampicin, isoniazid and pyrazinamide
      without food (control) with that when taken with a high carbohydrate (CHO) or
      high lipid (LIPID) diet. RESULTS: the CHO diet decreased isoniazid
      bioavailability. The maximum measured drug concentration (Cm) was decreased by
      20% (P = 0.0002) and the area under the concentration-time curve to 8 h (AUC8) by
      19% (P = 0.01). The CHO diet increased the time to maximum measured drug
      concentration (Tmax) for rifampicin by 21% (P = 0.03). The LIPID diet decreased
      the Cm of isoniazid by 9% (P = 0.03). Individual patient bioavailability on each
      meal was compared to the no-food control. A decrease of Cm or AUC8 of greater
      than 20% was considered significant. The bioavailability of isoniazid and
      rifampicin was decreased by food in a high percentage (33-56%) of patients.
      CONCLUSION: Concomitant feeding may thus have an important adverse effect on the
      therapy of tuberculosis and the desirability of this practice is called into
      question.

PMID- 7780092
TI  - Methodological issues in the estimation of the tuberculosis problem from
      tuberculin surveys.
AB  - SETTING: National tuberculin skin test surveys. OBJECTIVES: To review the
      operating characteristics of the tuberculin skin test, to ascertain the validity
      of estimating prevalence and risk of infection from tuberculin skin test surveys
      under various conditions, and to review constraints in the estimation of the
      magnitude of the tuberculosis problem in the community from such surveys.
      METHODS: This report utilizes hypothetical and selected real data obtained in
      regional and national surveys at various points in time to exemplify
      methodological issues. RESULTS: Risk of infection, the essence to be abstracted
      from tuberculin skin test surveys, theoretically allows for a comparison of the
      extent of transmission of tubercle bacilli in various populations. However, the
      conduct of tuberculin skin test surveys and the analysis and interpretation of
      their results are not free from important technical problems. Accurate estimation
      of infection prevalence is particularly vulnerable to the great variability of
      the test's specificity under various circumstances. Furthermore, the annual risk
      of infection has averaging characteristics that preclude a rapid assessment of
      changes in transmission patterns. Finally, estimates of infection risk do not
      necessarily provide a standardized parameter to derive incidence of infectious
      cases, because of variations in the quality of intervention and varying risks of
      progression from latent infection to overt tuberculosis. CONCLUSIONS: While
      tuberculin skin test surveys provide the currently most widely used means of
      assessing tuberculosis transmission patterns over prolonged periods of time in a
      community, results from such surveys must be interpreted with caution when
      accurate estimates of the tuberculosis problem are sought.

PMID- 7780093
TI  - Tuberculin sensitivity and the BCG scar in tuberculosis contacts.
AB  - SETTING: Tuberculosis clinic, St Vincents Hospital, Dublin. OBJECTIVE: To
      determine the influence of past BCG vaccination on tuberculin sensitivity in
      tuberculosis contacts. DESIGN: Prospective cohort study of tuberculin sensitivity
      using the Mantoux technique (5 TU). RESULTS: In 1050 contacts of 96 cases of
      tuberculosis, BCG scars were noted in 76% of the contacts. Approximately 50%, 30%
      and 20% of the contacts respectively had negative (0-4 mm), positive (5-14 mm)
      and strongly positive (15+ mm) Mantoux responses. The presence of a BCG scar was
      not found to significantly influence the degree of tuberculin sensitivity. The
      degree of tuberculin sensitivity increased after 20 years and decreased after 60
      years of age. Contacts of sputum-positive cases of tuberculosis had larger
      Mantoux responses. CONCLUSIONS: The study suggests that age of the contact and
      sputum status of the index case are important determinants of the degree of
      tuberculin sensitivity. Attributing a 'positive' Mantoux response to past BCG
      vaccination may be encouraging a false sense of security in contacts recently
      exposed to an infectious case of tuberculosis. Contact management guidelines may
      need to be reviewed and perhaps modified to reflect this finding.

PMID- 7780094
TI  - Tuberculin sensitivity trends in Hellenic army recruits during the period 1981
      91.
AB  - SETTING: The tuberculin skin test is widely used to define the tuberculous
      infection in the community. Serial representative tuberculin surveys demonstrate
      the trend of the risk of tuberculous infection. OBJECTIVE: The study of
      tuberculous infection in Hellenic army recruits for the purposes of BCG
      vaccination, which with chemoprophylaxis and early case-finding are the major
      strategies used for preventing tuberculosis (TB). DESIGN: We investigated
      tuberculin skin sensitivity on 544210 Hellenic Armed Forces recruits during 1981
      91. The age of the subjects ranged between 18-28 years (mean 21 +/- 1.5 years).
      We used the Mantoux technique with tuberculin PPD-RT 23 with Tween 80, dose 2 IU
      (1/5000) of the Hellenic Pasteur Institute. Tuberculin skin reactions were
      examined by two experienced readers after 48 hours. Indurations < 5 mm were
      considered as negative reactions, > or = 10 mm as positive, and 5-9 mm as
      doubtful reactions. RESULTS: The results of the present study were compared to
      other studies undertaken in recruits during the period 1934-80. We found a
      decrease of positive reactions from 14.2% in 1981 to 6.8% in 1991. The mean
      annual reduction was 0.74%. The decline has continued since 1947, as previous
      studies during the period 1934-80 have shown. CONCLUSION: We conclude that the
      tuberculin reactivity in recruits of the Hellenic army, although still high in
      relation to other European countries and North America, is declining steadily. We
      predict that the number of positive reactions will fall to about 1% by the year
      2000, assuming that the same trend continues.

PMID- 7780095
TI  - Serum soluble interleukin-2 receptor: a useful indicator of the clinical course
      in pulmonary tuberculosis.
AB  - SETTING: In tuberculosis both host protection and most pathogenic mechanisms
      depend on T lymphocytes. After activation by mycobacterial antigens, T cells both
      secrete interleukin-2 (IL-2) and express a high affinity receptor for this
      molecule (IL-2R) on their own surface. A soluble fraction of IL-2 receptor (sIL
      2R), released from cell membrane, is detectable in serum and its concentration is
      known to be elevated in tuberculosis. OBJECTIVE: To ascertain the role of sIL-2R
      as an indicator of clinical evolution and response to antituberculosis treatment.
      DESIGN: A prospective study, in which we have measured serum sIL-2R in 52
      patients (42 with active and 10 with inactive pulmonary tuberculosis) and in 36
      healthy controls. In 20 patients, serum sIL-2R levels were measured serially
      throughout the treatment. Levels of sIL-2R were correlated to clinical and
      radiological parameters. RESULTS: Serum sIL-2R was significantly increased in
      patients with tuberculosis as compared to healthy subjects. Both the radiological
      findings and the clinical state of patients showed a good correlation with sIL
      2R. All patients with normal values of sIL-2R 6 months after starting therapy had
      a favourable clinical evolution. CONCLUSION: Serum sIL-2R is a useful marker of
      the clinical state and evolution of patients with pulmonary tuberculosis. The
      detection of permanently high values beyond 3-6 months of treatment suggests that
      additional drugs or prolonged administration would be advisable in order to
      ensure full recovery.

PMID- 7780097
TI  - Distribution and characterization of beta-lactamases of mycobacteria and related
      organisms.
AB  - SETTING: The detailed distribution and precise features of mycobacterial beta
      lactamases urgently need to be elucidated. OBJECTIVE: To study the distribution
      pattern of beta-lactamases among mycobacteria, their enzymatic profiles and
      degree of contribution to the expression of drug resistance of some mycobacteria
      to beta-lactam antibiotics. DESIGN: Cell-associated beta-lactamase was measured
      by nitrocefin disc method. beta-lactamases obtained from some mycobacteria were
      studied for their substrate specificity, metal ion-dependency and isoelectric
      focusing (IEF) patterns. Changes in the minimum inhibitory concentrations (MICs)
      of beta-lactams for rapidly growing mycobacteria due to the combined use of
      tazobactam were measured. RESULTS: In slow growers, Mycobacterium tuberculosis
      complex possessed strong and M. kansasii showed strong to intermediate beta
      lactamase activity, while M. avium complex lacked such an activity. All the rapid
      growers possessed strong to intermediate activity. The beta-lactamases of test
      organisms including M. tuberculosis, M. kansasii, M. fortuitum etc, exerted both
      penicillinase and cephalosporinase activities and were not metalloenzymes. M.
      tuberculosis, M. kansasii, and M. smegmatis exhibited the species-specific IEF
      patterns of beta-lactamases. Tazobactam potentiated the in vitro antimicrobial
      activities of some beta-lactams against M. fortuitum and M. chelonae. CONCLUSION:
      Many mycobacteria possessed peculiar beta-lactamases and the enzymes were partly
      attributable to their drug resistance to certain beta-lactam antibiotics.

PMID- 7780098
TI  - Tracing as part of tuberculosis control in a rural Cambodian district during
      1992.
AB  - SETTING: The rural Cambodian district of Banteay Meas, population 74,464.
      OBJECTIVE: To evaluate the effectiveness of a district based tracing program
      developed to improve tuberculosis control program treatment results.
      Specifically, to assess factors affecting patient non-adherence to therapy and
      return of patients to treatment. DESIGN: All patients started on treatment during
      1992 were included. Standardized cohort analysis methods were applied to assess
      treatment outcome for all tuberculosis cases registered during Trimesters I-III.
      Absconders for the year were traced and followed as a separate cohort. Those
      returning to therapy were followed until the end of the study period in October
      1993. RESULTS: Activity in 1992 included 171 admissions and 46 absconders. Of the
      46, 57% were met at home. Among those met, 81% returned to treatment. Males
      absconded more than females even though females accounted for a majority of
      admissions. Socioeconomic factors (68%) were cited most often as the reason for
      non-adherence. Distance was not a factor. Cohort analysis showed improvement in
      the treatment completion rate (54.8% vs 69.2% vs 64%) coupled with a drop in the
      absconding rate (35.5% vs 25% vs 20%). Of the 21 patients returning, 76% have
      either completed or nearly completed treatment. CONCLUSION: These results support
      tracing as an effective means to improve patient adherence in rural Cambodia,
      thereby strengthening tuberculosis control programs at district level.

PMID- 7780096
TI  - In vitro activities of 2,2'-bipyridyl analogues against Mycobacterium avium and
      M. tuberculosis.
AB  - SETTING: Because of widespread emergence of resistant Mycobacterium tuberculosis
      and the high incidence of opportunistic infection caused by M. avium (MAC) in
      AIDS patients, there is an urgent need for new drugs against these organisms.
      OBJECTIVE: To evaluate the activity of newly synthesized 2,2'-bipyridyl analogues
      against MAC and M. tuberculosis. DESIGN: Susceptibility of MAC and M.
      tuberculosis to VUF-8514 and VUF-8842 were determined by both tube dilution
      method using 7H9 broth and radiometric (BACTEC) method using 14C-palmitic acid.
      RESULTS AND CONCLUSIONS: The MICs of 8514 against MAC and M. tuberculosis wee 1
      microgram/ml and 0.5 microgram/ml respectively, while for 8842 the respective
      values were 8 micrograms/ml and 2 micrograms/ml. In general, the MBC values for
      both drugs were two-fold higher than their corresponding MIC values. However,
      both drugs exhibited high bactercidal activities against both organisms. The MICs
      of clinical isolates of both organisms were in the same range as reference
      strains; furthermore, two isolates of M. tuberculosis that showed resistance to
      rifampicin were found to be susceptible to 8514. Thus, these two bipyridyl
      analogues show great promise in chemotherapy of tuberculosis and M. avium
      infection.

PMID- 7780099
TI  - Isolation of Mycobacterium malmoense from the environment in Zaire.
AB  - Two strains of mycobacteria isolated from water and soil in Zaire were identified
      as Mycobacterium malmoense by biochemical tests and lipid analysis. Apart from
      the previously reported fatty acids characteristic of this species, both strains,
      as well as 5 clinical isolates of M. malmoense, contained 2,4-dimethyl-docosanoic
      acid. One of the environmental strains, with a glycolipid pattern II,
      additionally contained 2-methyltetradecanoic acid. The results confirm that M.
      malmoense may be subdivided in 2 sub-groups according to its lipid patterns. They
      also show that M. malmoense can be isolated from the environment which may be the
      source of the infection.

PMID- 7780100
TI  - Isolation of Mycobacterium chelonae in a bronchoscopy unit and its subsequent
      eradication.
AB  - SETTING: Contamination events with Mycobacterium chelonae in 7 patients
      undergoing bronchoscopy, out of a total of 100 patients in a 5-month period, were
      analysed. OBJECTIVE: To identify and assess the importance of factors thought to
      be relevant in the aetiology of these contamination events and by removing these
      factors, to eradicate the problem of continuing M. chelonae contamination.
      DESIGN: A retrospective analysis of the frequency of M. chelonae isolates from
      bronchoalveolar fluid, assessing the contribution of the following measures to
      the eradication of M. chelonae: (1) changes to the bronchoscopy unit's water
      supply; (2) insertion of bacterial filters; (3) installation of a new semi
      automated cleaning machine incorporating an ultrasound cycle; (4) staff training
      in correct use of the new equipment. RESULTS: Following the discontinuation of
      using tapwater in the cleaning process, the above changes resulted in complete
      eradication of contamination events, with no further events occurring in the
      following 12 months. CONCLUSION: Insertion of bacterial filters into the water
      supply, with the addition of a more sophisticated semi-automatic cleaning machine
      involving an ultrasound cycle in addition to conventional cleaning methods
      currently used, will help reduce or eradicate contamination events with M.
      chelonae in bronchoscopy units.

PMID- 7780101
TI  - Disseminated Mycobacterium genavense infection in Canadian AIDS patients.
AB  - Mycobacterium genavense is a recently described mycobacterial species which thus
      far has been identified only in persons with advanced HIV disease. It appears to
      be a rare pathogen with an undefined reservoir. We describe the first two cases
      of M. genavense infection in Canadian AIDS patients. The clinical presentation of
      fever and wasting with extremely low CD4 lymphocyte counts was indistinguishable
      from disseminated M. avium complex (MAC) infection. However, blood cultures in
      BACTEC 13A medium required a mean of 58 days (range 41-87) to detect growth of M.
      genavense in contrast to a mean of 10 days for MAC in our laboratory. M.
      genavense infection is underdiagnosed due to the lack of universal use of BACTEC
      liquid medium and the use of relatively short incubation times (only 6 weeks) by
      some laboratories. The value of antimycobacterial therapy for M. genavense is
      unknown, but anecdotal data suggest that treatment with a regimen appropriate for
      MAC may be beneficial.

PMID- 7780102
TI  - Mycobacterium malmoense in Italy.
AB  - A case of mycobacterial lymphadenitis due to Mycobacterium malmoense was recently
      diagnosed in a 5-year-old girl. The organism was isolated from pus and tissue
      fragments obtained by surgical excision of the affected nodes. This is the first
      documented case of human infection due to this organism in Italy.

PMID- 7780103
TI  - Ciprofloxacin-induced renal dysfunction in patients with mycobacterial lung
      infections.
AB  - 3 patients with mycobacterial lung infections, one due to Mycobacterium avium
      intracellulare and 2 due to M. tuberculosis, developed ciprofloxacin-induced
      acute renal dysfunction while receiving the drug together with other
      antimycobacterial agents. These episodes took place 8-10 days after commencement
      of therapy and recovered spontaneously after cessation of all antimycobacterial
      drugs for 2-8 weeks. No recurrence was noted when patients were restarted on
      regimens that did not contain ciprofloxacin.

PMID- 7780104
TI  - Oral tuberculosis: primary localisation in an elderly non-immunodepressed
      patient.
AB  - We report a case of oral tuberculosis in an elderly non-immunodepressed patient.
      We emphasize and discuss the main epidemiological and clinical aspects as
      compared with the more common pictures of the past.

PMID- 7780105
TI  - An unusual presentation: primary tuberculosis of the middle ear cleft.
AB  - Tuberculosis rarely affects the middle ear cleft; therefore, except for those
      working in close association with respiratory physicians, the disease is a
      curiosity and not often considered in the differential diagnosis of otorrhea. The
      diagnosis is thus made too late, with resulting complications such as
      irreversible hearing loss and facial nerve paralysis. A case report and review of
      the literature are presented, emphasizing that tuberculosis should be considered
      in the differential diagnosis of chronic ear infection.

PMID- 7780106
TI  - Compliance with tuberculosis treatment in a rural district.

PMID- 7780107
TI  - Hypersensitivity to multiple drugs streptomycin, rifampicin and ethambutol: an
      unusual presentation.

PMID- 7780108
TI  - The International Union Against Tuberculosis and Lung Disease model National
      Tuberculosis Programmes.

PMID- 7780109
TI  - The relationships between erythroblast denucleation and the nuclear matrix-
      intermediate filaments.
AB  - We present a novel approach for making cybrids. By introducing neo gene
      expression plasmids into rabbit reticulocytes, fusing the gene transferred
      reticulocytes with K562 cells and selecting in G418 selection medium, a cybrid
      strain K-RRneo was established. Whole mount TEM study demonstrated that after
      cybridization, there was a reorganization of the intermediate filaments which
      showed a tendency to differentiate towards reticulocytes. SDS-PAGE and western
      blot analysis verified the above observation, in which the vimentin blot pattern
      of the cybrids was similar to that of reticulocytes, but totally different from
      that of K562 cells. Using this model, we reaffirmed the hypothesis that the
      erythroid differentiation factor (EDF) might be responsible for erythroid
      differentiation as well as the initiation of denucleation.

PMID- 7780110
TI  - P-glycoprotein expression in primary breast cancer.
AB  - In a retrospective study, liquid nitrogen preserved specimens from 50 women with
      primary breast cancer, who underwent surgery at the Beijing Institute for Cancer
      Research between June, 1986 and September, 1988, were investigated. All patients
      under this study were staged in TNM II or later, involved with axillary lymph
      node metastasis, and treated with systemic postoperative adjuvant chemotherapy.
      The median length of follow-up was 69 months. The expression of P-glycoprotein
      was investigated by means of immunohistochemistry, using a monoclonal antibody
      C219 specifically against P-glycoprotein and avidin-biotin peroxidase method.
      Positive staining for P-glycoprotein was found in 23 (46%) of the 50 patients.
      The P-glycoprotein expression negative group fared better than the group that was
      P-glycoprotein positive in overall survival curves (p = 0.0008, by the
      generalized Wilcoxon test). The prognostic effect of P-glycoprotein expression
      remained statistically significant (p = 0.0007) after adjustment by multivariate
      analysis (Cox's model) for other prognostic factors. It is demonstrated that P
      glycoprotein expression is a significant and independent predictor of
      postoperative survival in breast cancer patients. The results of the present
      study suggest that P-glycoprotein expression might also influence the biological
      behavior of breast cancers.

PMID- 7780111
TI  - Effect of glycyrrhetinic acid on DNA damage and unscheduled DNA synthesis induced
      by benzo(a)pyrene.
AB  - Glycyrrhetinic acid (GA) is an active component of Glycyrrhiza uraleusis fisch.
      In this study, GA was found to inhibit ear edema and ornithine decarboxylase
      (ODC) activity induced by croton oil in mice. GA could also protect rapid DNA
      damage and decrease the unscheduled DNA synthesis induced by benzo(a)pyrene. The
      results demonstrate that GA has a potential cancer chemopreventive activity.

PMID- 7780112
TI  - The use of a shuttle plasmid to study nontargeted mutagenesis and its sequence
      specificity.
AB  - Intact pZ189 DNA was replicated in monkey kidney vero cells which had been
      pretreated with N-methyl-N'-nitro-N-nitrosoguanidine (MNNG). The mutants were
      selected in E. coli MBM7070 and the mutation frequencies involving mutants with
      unchanged electrophoretic mobility of their plasmid DNA were scored. When
      compared to the spontaneous mutation frequency, the mutation frequencies were
      increased by 5.8 and 2.9-fold in cells pretreated with 0.2 and 2 mumol/L MNNG,
      respectively. The supF genes of these mutants were sequenced, and it was found
      that the types of base substitution and the sites of frameshifts differed from
      findings in studies of spontaneous and targeted mutagenesis. The results suggest
      that nontargeted mutagenesis occurs in mammalian cells and may have a sequence
      specificity.

PMID- 7780113
TI  - The regulatory effect of nucleoside diphosphate kinase on G-protein and G-protein
      mediated phospholipase C.
AB  - The effect of nucleoside diphosphate kinase (NDPK) on the activity of guanine
      nucleotide regulatory protein (G-protein) mediated phospholipase C (PLC) and on
      the [35S] GTPT tau S binding of G-protein was investigated in this work in order
      to demonstrate the mechanism behind the regulation of G-protein and its effector
      PLC by NDPK. The stimulation of PLC in turkey erythrocyte membrane by both GTP
      and GTP tau S indicated that the PLC stimulation was mediated by G-protein. NDPK
      alone stimulated PLC activity, as well as the stimulation in the presence of GTP
      and GDP, in a dose-dependent manner. However, NDPK inhibited GTP tau S-stimulated
      PLC. Furthermore, NDPK inhibited [35S]GTP tau S binding of purified Gi-protein in
      a non-competitive manner. A hypothesis implying an important role of direct
      interaction of G-protein and NDPK in the regulation of their functions is
      suggested and discussed.

PMID- 7780114
TI  - The measurement and application of TSH-IRMA levels among different age groups in
      areas with iodine deficiency disorders.
AB  - Using immunoradiometric TSH assay (TSH-IRMA) to measure whole blood TSH levels
      spotted onto filter paper, we compared TSH levels among different age groups
      (neonates, < 1 yr infants, schoolchildren aged 7 to 14 yrs, adults, pregnant
      women and reproductive-age women) in Guiyang, where iodine deficiency has long
      been a problem. The results showed: 1) The percentage of subjects with TSH levels
      equal to or greater than 5 mIU/L in the neonate group was 38.9% while the
      percentages in the other groups were 0-3.3% (P < 0.01); 2) The TSH levels of the
      neonates were inversely related to the urinary iodine values of their mothers
      (pregnant women). (r = -0.5, P < 0.01); 3) 97.6% of the inhabitants in Guiyang
      ingested salt with less than 20 mg/kg iodine. The results indicate that iodine
      deficiency remains a problem in Guiyang. Neonates are the only ideal population
      for monitoring iodine deficiency.

PMID- 7780115
TI  - Rapid HLA-DRB1 generic typing by PCR-SSP method.
AB  - We report a simple and rapid HLA-DRB1 generic typing method, PCR-SSP, which is
      practical and inexpensive. We use 9 sequence-specific primers and 2 group
      specific primers to define the HLA-DRB1 specificities DR1, DR2, DR3, DR4, DR5,
      DR6, DR7, DR8, DR9 and DR10. The HLA DR3, DR5, DR6 and DR8 can be amplified by
      the two primers of DR3568 and DRB1. The DR6 specificity can be identified by
      excluding the DR3, DR5 and DR8 when the DR3568 are positive. Any individuals can
      be typed with some exception: the three pairs of phenotype DR3/DR3 and DR3/DR6,
      DR5/DR5 and DR5/DR6, DR8/DR8 and DR8/DR6 cannot be discriminated from each other.
      We typed 106 unrelated healthy people from Beijing locations in two weeks. We
      think this typing method is suitable to replace the error-prone serologic HLA-DR
      tests in routine clinical practice, including the prospective typing of cadaveric
      organ donors.

PMID- 7780116
TI  - Significance of flow cytometry in the diagnosis and treatment of bladder tumors.
AB  - The results of application of flow cytometry (FCM) in analysis of 139 bladder
      irrigations of DNA contents in tumor cells from 52 cases of bladder tumors are
      reported. A comparison was made between this assay and cytological examinations
      as well as pathological grading. The results suggested that the accuracy of
      cytological analysis was apparently lower than the cell DNA measurement by flow
      cytometry, the higher the tumor pathological grading and the deeper the
      infiltration, the higher the heteroploid DNA contents in the tumor cells.
      Treatment of high heteroploid bladder tumor required radical cystectomy while the
      efficiency of simple electrosection or partial cystectomy appeared inferior. When
      FCM and the bladder tumor pathological grading had a high degree of correlation,
      especially in the high grading tumor, recurrence was high even when chemical
      treatment with bladder instillation of BCG was adopted. However, FCM cannot
      substitute for cystoscopy.

PMID- 7780117
TI  - Senile osteoporosis and hip fracture.
AB  - A randomized block design was used to compare the Singh index, the cortical index
      of the femoral neck and the lateral cortical width of the femur of a group of
      patients with femoral neck fracture, a group with intetrochanteric fracture, and
      a normal control group among a total of 102 postmenopausal women. The three
      indices in fracture group were very significantly (P < 0.01) or significantly (P
      < 0.05) different from those in the normal control subjects. The importance of
      osteoporosis in hip fracture of the aged is confirmed. Radiographic measurement
      of bone mass was found to have some predictive value for the risk of hip
      fracture.

PMID- 7780118
TI  - Mosaicism confined to placenta in pregnancies with adverse outcome.
AB  - Chorionic villi and fetal tissues from 50 pathological human conceptions at
      gestational weeks 9-40 were cultured and cytogenetically analyzed to explore the
      existence of chromosomal mosaicism confined to the extraembryonic tissues and to
      clarify the relationship between confined placental mosaicism and adverse outcome
      of pregnancy. Chorionic villi and fetal tissues from 12 second trimester
      gestations terminated for social reasons served as a control group. In two
      pathological gestations, true mosaicism was found exclusively in chorionic cells
      and could not be confirmed in cells derived from the fetal tissues. One of these
      was severely growth retarded. Concordant results were obtained in all other
      cases.

PMID- 7780119
TI  - Pre-exposure of mice to low dose or low dose rate ionizing radiation reduces
      chromosome aberrations induced by subsequent exposure to high dose of radiation
      or mitomycin C.
AB  - The phenomenon of cytogenetic adaptive and cross-adaptive response induced by low
      dose irradiation and chemical mutagen in mice is described. We found, firstly,
      that adaptation can be induced by acute low dose X-irradiation (0-100 mGy).
      Secondly, a cross-adaptation can occur between X-irradiation and mitomycin C
      (MMC). And finally, mice pre-exposed to chronic low dose rate 60Co-Gamma
      irradiation (0-226.0 mGy/day) are less susceptible to chromosome aberration
      induced by subsequent acute higher X-irradiation. Therefore, our data suggest
      that radioadaptive response depends on dose, dose rate and time interval.
      Possible mechanisms are also discussed.

PMID- 7780120
TI  - Experience in treating secondary systemic mycotic infection after severe burns
      associated with electric injury.

PMID- 7780121
TI  - A comparative study of imovane and estazolam treatment on sleep disturbances.
AB  - Twenty-six patients with sleep disturbances who had completed therapy with
      hypnotics were observed under single-blind and self-comparable method for 7 days
      each. We found that patients treated with imovane or estazolam had no statistical
      differences with respect to sleep time onset, total sleep time, nocturnal
      awakening, feeling after awakening, dream, drug side effects and sleep quality.
      Imovane performed better than estazolam in sleep time onset and total sleep time.
      From this study, imovane can be recommended as a new hypuotic to treat patients
      with sleep disturbances.

PMID- 7780123
TI  - The interrelationship between tumor cells' electrophoretic mobility, adhesive and
      invasive abilities, and their metastatic potential.
AB  - Investigations on the relationship between some tumor cell properties and their
      metastatic potential using different clones from two tumor cell lines are
      reported. CNE2L2 (highly metastatic) and CNE2L4 (low metastatic) clones were
      isolated from human nasopharyngeal carcinoma CNE-2Z cell line. LA1, LAD and LA5
      clones were isolated from mouse pulmonary adenocarcinoma offLA795 cell line with
      different metastatic potentials. The results from both cell lines showed that the
      metastatic potential of tumor cells positively correlated with electrophoretic
      mobility rate, adhesion with endothelial cells and in vitro and in vivo
      invasiveness, and negatively correlated with self-adhesion and adhesion to
      fibroblast cells. The data further confirmed the relationship between these
      factors and the metastatic potential of tumor cells.

PMID- 7780122
TI  - Analysis of C-Ha-ras gene amplification and mutation in laryngeal carcinoma.
AB  - In order to study the altered molecular events during laryngeal carcinogenesis
      and elucidate the role of Ha-ras oncogene amplification and mutation, we have
      examined their profile by polymerase chain reaction (PCR) and selective
      oligonucleotide hybridization. We analyzed the mutational status of codon 12 of
      Ha-ras in 22 laryngeal carcinomas and 10 normal tissues, and found that 7 of 22
      laryngeal carcinomas contained a Ha-ras mutation at codon 12. The frequency of
      mutation was 32%. None of the normal tissues revealed mutation. Moreover, no
      amplification was found in cancers when compared to the normal. Our findings
      indicated that the activated Ha-ras gene existed in laryngeal carcinoma, and
      activation of the Ha-ras gene by mutation at codon 12 might play a key role in
      laryngeal carcinogenesis.

PMID- 7780124
TI  - Diagnosis and surgical treatment of bronchogenic cysts.
AB  - Between 1974 and 1993, 22 patients with bronchogenic cysts were operated on in
      our hospital; there were 14 men and 8 women, ranging in age from 11 to 62 years.
      The cyst locations were mediastinal in 13 (59.1%) and intrapulmonary in 9
      (40.9%). There were symptoms (chest pain and recurrent bronchiolitis) in 20
      patients (91%). The preoperative complications included infection in the lung and
      in the cyst and dysphagia due to esophageal compression. Chest pain was the main
      symptom in mediastinal cyst and recurrent infection of lung in intrapulmonary
      cyst. Plain chest radiograms showed that a round shadow, occasional air-fluid
      levels, and peripheral calcification may be found in cysts. An operation is the
      best treatment for cysts. All cysts were completely excised. No postoperative
      complications, late complications, or recurrence developed in our patients.

PMID- 7780125
TI  - The treatment of severe acquired aplastic anemia.

PMID- 7780126
TI  - Tumor necrosis factor ligand superfamily: involvement in the pathology of
      malignant lymphomas.
AB  - The TNF receptor superfamily members are all type I membrane glycoproteins with
      typical homology in the extracellular domain of variable numbers of cysteine-rich
      repeats (overall homologies, 25% to 30%). In contrast, the TNF ligand superfamily
      members (with the exception of LT alpha) are type II membrane glycoproteins with
      homology to TNF in the extracellular domain (overall homologies, 20%). TNF and LT
      alpha are trimeric proteins and are composed of beta-strands forming a beta
      jellyroll. The homology of the beta-strand regions for the TNF ligand superfamily
      members suggest a similar beta-sandwich structure and possible trimeric or
      multimeric complex formation for most or all members. A genetic linkage, as
      evidence for evolutionary relatedness, is found by chromosomal cluster of TNFR
      p80, CD30, 4-1BB, and OX40 for 1p36; TNFR p60, TNFR-RP, and CD27 for 12p13; TNF,
      LT alpha, and LT beta for 6 (MHC locus); CD27L and 4-1BBL for 19p13; and FASL and
      OX40L for 1q25. Of the TNF ligand superfamily, TNF, LT alpha, and LT beta and
      their receptors (TNFR p60, TNFR p80, and TNFR-RP) interact in a complex fashion
      of cross-binding. However, the other family members presently have a one
      ligand/one receptor binding principle (CD27/CD27L, CD30/CD30L, CD40/CD40L, 4
      1BB/4-1BBL, OX40/gp34, and FAS/FASL). In general, the members of the TNF ligand
      superfamily mediate interaction between different hematopoietic cells, such as T
      cell/B cell, T cell/monocyte, and T cell/T cell. Signals can be transduced not
      only through the receptors but also through at least some of the ligands. The
      transduced signals can be stimulatory or inhibitory depending on the target cell
      or the activation state. Taken together, TNF superfamily ligands show for the
      immune response an involvement in the induction of cytokine secretion and the
      upregulation of adhesion molecules, activation antigens, and costimulatory
      proteins, all known to amplify stimulatory and regulatory signals. On the other
      hand, differences in the distribution, kinetics of induction, and requirements
      for induction support a defined role for each of the ligands for T-cell-mediated
      immune responses. The shedding of members of the TNF receptor superfamily could
      limit the signals mediated by the corresponding ligands as a functional
      regulatory mechanism. Induction of cytotoxic cell death, observed for TNF, LT
      alpha, CD30L, CD95L, and 4-1BBL, is another common functional feature of this
      cytokine family. Further studies have to identify unique versus redundant
      biologic and physiologic functions for each of the TNF superfamily
      ligands.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7780127
TI  - Activated protein C resistance: molecular mechanisms based on studies using
      purified Gln506-factor V.
AB  - Gln506-factor V (FV) was purified from plasma of an individual homozygous for an
      Arg506Gln mutation in FV that is associated with activated protein C (APC)
      resistance. Purified Gln506-FV, as well as Gln506-FVa generated by either
      thrombin or FXa, conveyed APC resistance to FV-deficient plasma in coagulation
      assays. Clotting assay studies also suggested that APC resistance does not
      involve any abnormality in FV-APC-cofactor activity. In purified reaction
      mixtures, Gln506-FVa in comparison to normal FVa showed reduced susceptibility to
      APC, because it was inactivated approximately 10-fold slower than normal Arg506
      FVa. It was previously reported that inactivation of normal FVa by APC involves
      an initial cleavage at Arg506 followed by phospholipid-dependent cleavage at
      Arg306. Immunoblot and amino acid sequence analyses showed that the 102-kD heavy
      chain of Gln506-FVa was cleaved at Arg306 during inactivation by APC in a
      phospholipid-dependent reaction. This reduced but measurable susceptibility of
      Gln506-FVa to APC inactivation may help explain why APC resistance is a mild risk
      factor for thrombosis because APC can inactivate both normal FVa and variant
      Gln506-FVa. In summary, this study shows that purified Gln506-FV can account for
      APC resistance of plasma because Gln506-FVa, whether generated by thrombin or
      FXa, is relatively resistant to APC.

PMID- 7780128
TI  - Molecular detection of the (2;5) translocation of non-Hodgkin's lymphoma by
      reverse transcriptase-polymerase chain reaction.
AB  - The t(2;5)(p23;q35) translocation was initially identified in cases of anaplastic
      large-cell lymphoma (ALCL) that expressed the Ki-1 (CD30) antigen. We have
      recently cloned this translocation and shown it to encode a chimeric product
      consisting of the N-terminal portion of a nonribosomal nucleolar phosphoprotein,
      nucleophosmin (NPM), from chromosome 5, fused to the kinase domain of a novel
      transmembrane tyrosine-specific protein kinase, anaplastic lymphoma kinase (ALK),
      from chromosome 2. To better define the spectrum of lymphomas that contain this
      translocation, we have analyzed 70 cases of non-Hodgkin's lymphoma (NHL) for
      expression of the t(2;5)-derived NPM/ALK chimeric message by reverse
      transcriptase-polymerase chain reaction (RT-PCR). Using a previously described
      set of oligonucleotide primers, NPM/ALK chimeric transcripts were detected in 21
      of 22 cases that contained the t(2;5) by cytogenetic analysis and in 10 of 48
      cases that either lacked evidence of the t(2;5) or had unsuccessful cytogenetics.
      In all but 1 case, the NPM/ALK PCR products were of identical size and sequence,
      suggesting that the genomic chromosome breaks are clustered in a single intron in
      both NPM and ALK. The NPM/ALK-expressing cases were not confined to NHLs with
      anaplastic morphology and included 15 ALCLs, 6 immunoblastic lymphomas, and 10
      diffuse large-cell lymphomas. Moreover, only slightly greater than half of the
      cases with anaplastic morphology and 59% of CD30-expressing cases were NPM/ALK
      positive. Thus, neither anaplastic morphology nor the expression of CD30
      accurately predicted the presence of this molecular genetic subtype of lymphoma.

PMID- 7780129
TI  - Interleukin-10 is an autocrine growth factor for acquired immunodeficiency
      syndrome-related B-cell lymphoma.
AB  - Interleukin-10 (IL-10) is an acid-sensitive protein of 35 kD that has pleiotropic
      effects including inhibition of cytotoxic T-cell response, induction of major
      histocompatibility complex type II in B lymphocytes, induction of B-cell growth
      and differentiation, and autocrine growth factor activity in monocytes. We and
      others have shown that IL-10 is produced spontaneously by blood mononuclear cells
      from human immunodeficiency virus-seropositive patients. In an attempt to
      ascertain the potential role of IL-10 in acquired immunodeficiency syndrome
      (AIDS)-related B-cell lymphoma, we evaluated the expression of human IL-10 in
      both tumor-derived B-cell lines and primary tumor cells. Expression of human IL
      10 (hIL-10) mRNA and protein was detected in four of five cell lines examined. An
      IL-10 antisense oligonucleotide inhibited IL-10 mRNA expression and IL-10 protein
      production. The proliferation of all B-cell lines was inhibited by an antisense
      oligonucleotide in a dose-dependent manner that was abrogated by the addition of
      recombinant hIL-10 protein. No effect of antisense oligonucleotide was observed
      in the B-cell line not producing hIL-10. Evaluation of primary tumor cells from
      patients with AIDS-lymphoma cells showed similar production and response to IL
      10. These data suggest an autocrine growth mechanism for IL-10 in AIDS-related
      lymphoma cells and that IL-10 may be important in its pathogenesis.

PMID- 7780130
TI  - p15ink4B and p16ink4 gene inactivation in acute lymphocytic leukemia.
AB  - Malignant cells from 52 children with acute lymphocytic leukemia (ALL) were
      investigated for inactivation of the p15ink4B and p16ink4 genes and other genetic
      alterations on chromosome 9p21. Homozygous deletions of the p15ink4B and/or the
      p16ink4 genes were detected in 16 cases and a further 9 cases showed evidence of
      allelic loss either by hemizygous deletion or loss of heterozygosity (LOH) for
      9p21 markers. Most cases had loss of both genes, but 5 patients had lost only
      p16ink4 and 2 cases had homozygous loss of p15ink4B only. Sequence analysis of
      all exons of p15ink4B and p16ink4 was performed in patients with hemizygous
      deletions or LOH for 9p21 markers. A frame shift mutation of p16ink4 exon 1 was
      shown in 1 case, whereas all other clones carried the wild-type sequence of
      p15ink4B and p16ink4 in the remaining allele. The data suggest that both the
      p15ink4B and p16ink4 genes can be inactivated in ALL. The existence of a hitherto
      undefined tumor-suppressor gene on chromosome 9p cannot be ruled out.

PMID- 7780131
TI  - Inhibition of endotoxin-induced activation of the coagulation and fibrinolytic
      pathways using a recombinant endotoxin-binding protein (rBPI23).
AB  - A recombinant endotoxin-neutralizing protein, rBPI23, was shown to partially
      prevent endotoxin-induced activation of the fibrinolytic and coagulation systems
      in experimental endotoxemia in humans. In a placebo-controlled, blinded crossover
      study, eight volunteers were challenged twice with an intravenous bolus injection
      of endotoxin (40 EU/kg of body weight) and concurrently received either rBPI23 (1
      mg/kg) or placebo (human serum albumin, 0.2 mg/kg). rBPI23 treatment
      significantly lowered the endotoxin-induced fibrinolytic response, ie, reduced
      the release of tissue-type plasminogen activator, urokinase-type plasminogen
      activator, plasminogen activator inhibitor antigen, and complex formation of
      plasmin alpha 2-antiplasmin (P = .0078 for each). Plasminogen activator inhibitor
      activity was also reduced, but not significantly according to the Hochberg method
      (P = .0304). The endotoxin-induced activation of the procoagulant state as
      reflected by increase in F1 + 2 fragments and TAT complexes was blunted by rBPI23
      infusion (P = .0391 [not significant according to the Hochberg method] and .0078,
      respectively). These results indicate that rBPI23 is capable of reducing both the
      activation of the fibrinolytic and the coagulation systems after low-dose
      endotoxin infusion in humans.

PMID- 7780132
TI  - Thrombopoietin induces tyrosine phosphorylation and activation of the Janus
      kinase, JAK2.
AB  - Thrombopoietin (TPO) is a recently characterized growth and differentiation
      factor for megakaryocytes and platelets that exerts its effects via the receptor,
      c-MpI. This receptor is a member of the hematopoietin receptor superfamily and is
      essential for megakaryocyte maturation; however, the molecular mechanisms of TPO
      and c-MpI action have not been elucidated. Recently, the Janus kinases have
      emerged as important elements in signaling via this family of receptors. In this
      report, we show that, in the M07e megakaryocytic cell line, which expresses c-MpI
      and proliferates in response to TPO, TPO induces phosphorylation of a number of
      substrates between 80 and 140 kD. Specifically, we show that stimulation with TPO
      induces the rapid tyrosine phosphorylation of a 130-kD protein that we identify
      as the Janus kinase, JAK2. However, no detectable tyrosine phosphorylation of
      JAK1, JAK3, or TYK2 was observed. TPO also induced activation of JAK2
      phosphotransferase activity in vitro. Taken together, these data indicate that
      JAK2 likely plays a key role in TPO-mediated signal transduction.

PMID- 7780133
TI  - Continuous infusion of the anti-CD22 immunotoxin IgG-RFB4-SMPT-dgA in patients
      with B-cell lymphoma: a phase I study.
AB  - IgG-RFB4-SMPT-dgA consists of deglycosylated ricin A chain (dgA) coupled to the
      monoclonal antihuman CD22 antibody, RFB4. This study determined the maximally
      tolerated dose (MTD) of this immunotoxin (IT) administered as a continuous 8-day
      infusion to 18 patients with B-cell lymphoma (30% CD22+ tumor cells) over 8 days.
      The MTD was 19.2 mg/m2/192 h (maximum toxicity grade 1), with vascular leak
      syndrome (VLS) as dose-limiting toxicity (DLT) at 28.8 mg/m2/192 h (grades 3
      through 5 in 7 of 11 patients). Predictors of severe VLS included serum IT
      concentrations greater than 1,000 ng/mL and the absence of circulating tumor
      cells. Decreased urine sodium excreted in 24 hours provided evidence for mild VLS
      without notable changes in serum albumin. Four partial responses, 3 minor
      responses, 6 stable disease, and 3 progression of disease were observed. The mean
      maximal serum concentration (Cmax) in initial courses at the MTD (19.2 mg/m2) was
      443 +/- 144 ng/mL (n = 3; range, 326 to 604). At 28.8 mg/m2/192 h, the Cmax was
      highly variable (n = 11; mean, 1,102 +/- 702; range, 9.6 to 2,032 ng/mL). Human
      antimouse or antiricin antibodies developed in 6 of 16 (37.5%) patients after one
      course of IT. However, 10 eligible patients received multiple courses of IT.
      Changes in serum cytokines and cytokine receptors did not correlate with toxicity
      but decreased soluble interleukin-2 receptor concentrations correlated with
      clinical response. Comparison to a prior study with the same IT administered by
      intermittent bolus infusions (Amlot et al, Blood 82:2624, 1993) suggests similar
      clinical response, toxicity, and immunogenicity.

PMID- 7780134
TI  - Cloning and expression of unique murine macrophage colony-stimulating factor
      transcripts.
AB  - Cocultivation of cells from the gamma-irradiated D2XRII murine bone marrow
      stromal cell line with an interleukin-3/granulocyte-macrophage colony-stimulating
      factor (GM-CSF)-dependent hematopoietic progenitor cell line FDC-P1JL26
      stimulates the emergence of factor-independent hematopoietic cell sublines.
      Several lines of evidence suggested that M-CSF or a protein antigenically related
      to M-CSF, termed leukemogenic stromal factor (LSF), that was expressed by D2XRII
      cells may have played a role in the emergence of the factor-independent sublines.
      In an effort to isolate a factor antigenically related to M-CSF, molecular clones
      were isolated from a D2XRII cDNA library that hybridized to a mouse M-CSF genetic
      probe. Two of these molecular clones, designated 60.8.2 and 6452, contained an
      885-bp deletion in the M-CSF coding region. Such a cDNA clone has not been
      previously described in the mouse, but a cDNA clone homologous to it has been
      isolated from a human pancreatic tumor cell line, MIA-PaCa-2. Three transcripts
      (4.8, 3.4, and 1.8 kb) were detected that hybridized to an oligonucleotide probe
      that was specific to RNA transcripts containing the 60.8.2 deletion. The level of
      the 1.8-kb transcript was not detectably induced by ionizing irradiation;
      however, the levels of the 4.8-kb and 3.4-kb transcripts and two other M-CSF
      transcripts of sizes to 4.4 kb and 2.3 kb showed a 1.4- to 2.2-fold increase
      after gamma irradiation. Reverse transcription-polymerase chain reaction showed
      that the deletion-specific transcript(s) was detected in multiple mouse bone
      marrow stromal cell lines and in normal mouse tissues. The present studies
      establish the existence of an increased spectrum of murine M-CSF transcripts in
      bone marrow stromal cells and other tissues. This complexity of transcripts along
      with their increased accumulation after irradiation provides additional evidence
      for a role of proteins encoded by M-CSF transcripts in the response of bone
      marrow stromal cells to ionizing irradiation.

PMID- 7780135
TI  - Interleukin-13 selectively suppresses the growth of human macrophage progenitors
      at the late stage.
AB  - Interleukin-13 (IL-13) is a pleiotropic cytokine that inhibits the production of
      inflammatory cytokines of monocytes. We investigated the effects of IL-13 on the
      clonal growth of human hematopoietic progenitors. IL-13 alone did not support any
      colony formation. IL-13 markedly suppressed macrophage colonies that were formed
      in the presence of IL-3 and erythropoietin, granulocyte-macrophage colony
      stimulating factor, or macrophage colony-stimulating factor. Macrophage colony
      cells showed dendritic cell-line morphology and cellular aggregates. IL-13 did
      not affect granulocyte colony and erythroid burst formation. Delayed addition of
      IL-13 and replating onto the culture dishes with IL-13 showed that macrophage
      colony formation was suppressed during days 8 and 14 of culture. These results
      indicate that IL-13 affects the growth of the late stage of committed macrophage
      progenitors. Single-cell culture of isolated CD34+CD33+ cells with IL-13
      confirmed that macrophage colony formation was significantly suppressed. These
      results show that IL-13 directly suppresses the proliferation of differentiating
      macrophages. In addition, these suppressive effects of IL-13 were synergistic
      with IL-4. Furthermore, in the liquid culture of bone marrow cells in the
      presence of IL-13, the number of CD14 (monocyte-macrophage antigen)-positive
      cells decreased and CD18 (LFA-1 beta)-positive cells increased. It is concluded
      that IL-13 affects the growth of the late stage of macrophage precursors as well
      as mature monocytes. Induction of differentiation of human monocytes may be
      correlated with the suppression of their progenitors.

PMID- 7780136
TI  - Purification and characterization of a C5a-inactivating enzyme from human
      peritoneal fluid.
AB  - Earlier work has suggested that familial Mediterranean fever, an inherited
      disorder characterized by sporadic episodes of inflammation involving the pleural
      and peritoneal cavities and the joints, is caused by the lack of a C5a
      inactivator normally found in serosal fluid. We have purified this inactivator
      from ascites fluid and obtained a protein of molecular weight 53 to 56 kD with a
      specific activity 10,000-fold greater than the crude material. On Western blot,
      an inhibitory antibody recognized a single antigenic species at the same
      molecular weight. The enzyme had no activity against denatured bovine serum
      albumin. With recombinant C5a as substrate, the Km and Vm were 3.4 mumol/L and 52
      nmol C5a/min/mg protein, respectively.

PMID- 7780137
TI  - Studies on the acute release of tissue-type plasminogen activator from human
      endothelial cells in vitro and in rats in vivo: evidence for a dynamic storage
      pool.
AB  - The process of acute release of tissue-type plasminogen activator (tPA) is
      important in locally speeding up fibrinolysis. Using a sensitive enzyme-linked
      immunosorbent assay for tPA, we investigated the acute release of tPA from
      cultured human umbilical vein endothelial cells. The addition of thrombin (0.003
      to 3 NIH U/mL) caused the dose-dependent release of noncomplexed, enzymatically
      active tPA into the medium. The amount of tPA released into the medium by
      thrombin was similar to the difference in the amounts of tPA present in extracts
      from thrombin-treated cells and control cells. The process of acute release of
      tPA was complete in 1 minute, whereas the concomitant release of von Willebrand
      factor into the medium was slightly slower (maximum after 3 minutes). By
      increasing (c.q. decreasing) tPA synthesis, it was found that the amount of tPA
      constitutively secreted, the amount acutely released, and the amount in cell
      extracts were increased (c.q. decreased) to the same extent. The same relation
      was found in vivo. When rats were pretreated with cholera toxin or retinoic acid
      to increase tPA synthesis, plasma levels of tPA were increased, whereas acute
      release of tPA, as induced by bradykinin, was increased to the same extent.
      Acutely released tPA and constitutively secreted tPA were liberated from
      different pathways in human umbilical vein endothelial cells; tPA had, relative
      to the in vivo situation, a short residence time in the acutely releasable
      pathway.

PMID- 7780138
TI  - Resistance to activated protein C as an additional genetic risk factor in
      hereditary deficiency of protein S.
AB  - Inherited resistance to activated protein C (APC), which is caused by a single
      point mutation in the gene for factor V, is a common risk factor for thrombosis.
      In this study, the prevalence of APC resistance in 18 unrelated thrombosis-prone
      families with inherited protein S deficiency was investigated to determine its
      role as additional genetic risk factor for thrombosis. In addition, a detailed
      evaluation of the clinical manifestations in these families was performed. Venous
      thrombotic events had occurred in 47% of the protein S-deficient patients
      (64/136) and in 7% of relatives without protein S deficiency (14/191). As
      estimated from Kaplan-Meier analysis, 50% of protein S-deficient family members
      and 12% of those without protein S deficiency had had manifestation of venous
      thromboembolism at the age of 45 years. The age at the first thrombotic event
      ranged from 10 to 81 years (mean, 32.5 years) and a large intrafamilial and
      interfamilial variability in expression of thrombotic symptoms was seen. The
      factor V gene mutation related to APC resistance was present in 6 (38%) of 16
      probands available for testing; in total, the mutation was found in 7 (39%) of
      the 18 families. In family members with combined defects, 72% (13/18) had had
      thrombosis as compared with 19% (4/21) of those with only protein S deficiency
      and 19% (4/21) of those with only the factor V mutation. In conclusion, APC
      resistance was found to be highly prevalent in thrombosis-prone families with
      protein S deficiency and was an additional genetic risk factor for thrombosis in
      these families. The results suggest thrombosis-prone families with protein S
      deficiency often to be affected by yet another genetic defect.

PMID- 7780139
TI  - Evaluation of the relationship between protein S and C4b-binding protein isoforms
      in hereditary protein S deficiency demonstrating type I and type III deficiencies
      to be phenotypic variants of the same genetic disease.
AB  - Type III protein S deficiency is characterized by a low plasma level of free
      protein S, whereas the total concentration of protein S is normal. In contrast,
      both free and total protein S levels are low in type I deficiency. To elucidate
      the molecular mechanism behind the selective deficiency of free protein S in type
      III deficiency, the relationship between the plasma concentrations of beta-chain
      containing isoforms of C4b-binding protein (C4BP beta+) and different forms of
      protein S (free, bound, and total) was evaluated in 327 members of 18 protein S
      deficient families. In normal relatives (n = 190), protein S correlated well with
      C4BP beta+, with free protein S (96 +/- 23 nmol/L) being equal to the molar
      excess of protein S (355 +/- 65 nmol/L) over C4BP beta+ (275 +/- 47 nmol/L). In
      protein S-deficient family members (n = 117), the equimolar relationship between
      protein S (215 +/- 50 nmol/L) and C4BP beta+ (228 +/- 51 nmol/L), together with
      the high affinity of the interaction, resulted in low levels of free protein S
      (16 +/- 10 nmol/L). Free protein S levels were distinctly low in protein S
      deficient members, whereas in 47 of the protein S-deficient individuals, the
      concentration of total protein S was within the normal range, which fulfils the
      criteria for type III deficiency. The remaining 70 had low levels of both total
      and free protein S and, accordingly, would be type I deficient. Coexistence of
      type I and type III deficiency was found in 14 families, suggesting the two types
      of protein S deficiency to be phenotypic variants of the same genetic disease.
      Interestingly, not only protein S but also C4BP beta+ levels were decreased in
      orally anticoagulated controls and even more so in anticoagulated protein S
      deficient members, suggesting that the concentration of C4BP beta+ is influenced
      by that of protein S. In conclusion, our results indicate that type I and type
      III deficiencies are phenotypic variants of the same genetic disease and that the
      low plasma concentrations of free protein S in both types are the result of an
      equimolar relationship between protein S and C4BP beta+.

PMID- 7780140
TI  - Autocrine interleukin-1 beta regulates both proliferation and apoptosis in EL4
      6.1 thymoma cells.
AB  - We demonstrate here that EL4-6.1 cells, a mouse thymoma that expresses high
      levels of membrane interleukin (IL)-1 receptors, produce IL-1 beta as an
      autocrine regulatory factor. Endogenous IL-1 beta sustains both proliferation and
      apoptosis: during the exponential phase, it mainly promotes proliferation, while
      during the plateau phase of cell growth, it induces death by apoptosis.
      Additionally, we show that exogenous IL-1 beta added to EL4-6.1 cells in lag
      phase induces apoptosis in a portion of the cells and proliferation in the
      remaining cells. Therefore, IL-1 beta can exert two completely opposite effects
      on a single cell type, depending on the state of the target cell.

PMID- 7780141
TI  - Retinoids downregulate both p60 and p80 forms of tumor necrosis factor receptors
      in human histiocytic lymphoma U-937 cells.
AB  - Because retinoids are known to modulate the growth and differentiation effects of
      tumor necrosis factor (TNF), we investigated the effect of all-trans-retinoic
      acid (RA) on the cell surface expression of TNF receptors in human histiocytic
      lymphoma U-937 cells. RA decreased the specific binding of 125I-labeled TNF to
      these cells in a dose- and time-dependent manner. The maximal decrease occurred
      when cells were treated with 1 mumol/L RA for 24 hours at 37 degrees C. Scatchard
      analysis of the binding indicated that the decrease by RA was caused by a
      decrease in receptor number and not by a decrease in affinity. The downmodulation
      of TNF receptors was also confirmed by covalent receptor-ligand cross-linking
      studies. Receptor-mediated internalization of the ligand was also found to be
      decreased on treatment of cells with RA. Northern blot analysis also indicated a
      decrease in the transcript of the receptor. By using antibodies specific to
      either the p60 or p80 form of the TNF receptor, we found that both receptors were
      downregulated by RA. RA treatment also decreased TNF receptors on acute monocytic
      leukemia cell line THP-1. Other analogues of RA, specifically 9-cis-RA, (E)-4-[2
      (5,6,7,8- tetrahydro-2-naphthalenyl)-1-propenyl]-benzoic acid (TTNPB), and 3
      methyl-TTNPB, which differ in their specificity towards different RA receptors,
      were also active in downregulating TNF receptors. 3-Methyl-TTNPB, which is more
      specific for the RXR form of the RA receptor, was found to be most potent. The
      downregulation of TNF receptors by RA correlated with the downmodulation of the
      antiproliferative effects of TNF against U-937 cells. Overall, our results
      indicate that RA downmodulates both the p60 and p80 form of the TNF receptor on
      cells of myeloid origin, which correlates with the cellular response.

PMID- 7780142
TI  - Cytokine activation during attacks of the hyperimmunoglobulinemia D and periodic
      fever syndrome.
AB  - The hyperimmunoglobulinemia D and periodic fever (hyper-IgD) syndrome is typified
      by recurrent febrile attacks with abdominal distress, joint involvement
      (arthralgias/arthritis), headache, skin lesions, and an elevated serum IgD level
      (> 100 U/mL). This familial disorder has been diagnosed in 59 patients, mainly
      from Europe. The pathogenesis of this febrile disorder is unknown, but attacks
      are joined by an acute-phase response. Because this response is considered to be
      mediated by cytokines, we measured the acute-phase proteins C-reactive protein
      (CRP) and soluble type-II phospholipase A2 (PLA2) together with circulating
      concentrations and ex vivo production of the proinflammatory cytokines
      interleukin-1 alpha (IL-1 alpha), IL-1 beta, IL-6, and tumor necrosis factor
      alpha (TNF alpha) and the inhibitory compounds IL-1 receptor antagonist (IL-1ra),
      IL-10, and the soluble TNF receptors p55 (sTNFr p55) and p75 (sTNFr p75) in 22
      patients with the hyper-IgD syndrome during attacks and remission. Serum CRP and
      PLA2 concentrations were elevated during attacks (mean, 213 mg/L and 1,452 ng/mL,
      respectively) and decreased between attacks. Plasma concentrations of IL-1 alpha,
      IL-1 beta, or IL-10 were not increased during attacks. TNF alpha concentrations
      were slightly, but significantly, higher with attacks (104 v 117 pg/mL).
      Circulating IL-6 values increased with attacks (19.7 v 147.9 pg/mL) and
      correlated with CRP and PLA2 values during the febrile attacks. The values of the
      antiinflammatory compounds IL-1ra, sTNFr p55, and sTNFr p75 were significantly
      higher with attacks than between attacks, and there was a significant positive
      correlation between each. The ex-vivo production of TNF alpha, IL-1 beta, and IL
      1ra was significantly higher with attacks, suggesting that the
      monocytes/macrophages were already primed in vivo to produce increased amounts of
      these cytokines. These findings point to an activation of the cytokine network,
      and this suggests that these inflammatory mediators may contribute to the
      symptoms of the hyper-IgD syndrome.

PMID- 7780143
TI  - Early human thymocyte proliferation is regulated by an externally controlled
      autocrine transforming growth factor-beta 1 mechanism.
AB  - Early thymocytes undergo extensive proliferation after their entry into the
      thymus, but cellular interactions and cytokines regulating this intrathymic step
      remain to be determined. We analyzed the effects of various T-cell growth factors
      and cellular interactions on in vitro proliferation of early CD2+CD3/TCR-CD4-CD8-
      (triple negative [TN]) human thymocytes. Freshly isolated TN cells were then
      assayed for their growth capacity after incubation with CD2I+III-monoclonal
      antibody (MoAb), recombinant human interleukin-2 (IL-2), IL-7, and/or IL-4. These
      cells displayed significant proliferative responses with IL-4, IL-7, or CD2
      MoAb+IL-2. The addition of recombinant transforming growth factor beta (TGF beta)
      or autologous irradiated CD3+CD8+CD4- cells to TN cell cultures dramatically
      decreased their growth responses to IL-2 and IL-7, whereas IL-4-induced
      proliferation was less sensitive to growth inhibition. We thus asked whether the
      CD8+ cell-derived inhibitory effect was due to TGF beta. The addition of
      neutralizing anti-TGF beta MoAb completely abolished CD8+ cell-derived inhibition
      of TN cell growth. Analysis of CD8+ cell-derived supernatants indicated that
      these cells had low TGF beta 1 production capacity, whereas TN cells secrete
      significantly high levels of TGF beta 1. Cell fixation studies showed that TN
      cells were the source of the TGF beta. TGF beta 1 released from TN cells was in
      the latent form that became the active inhibitory form through interaction of TN
      cells with CD8+ cells. Together, these data suggest a role for TGF beta 1 as an
      externally controlled, autocrine inhibitory factor for human early thymocytes,
      with a regulatory role in thymic T-cell output.

PMID- 7780144
TI  - Inhibition of CD26 enzyme activity with pro-boropro stimulates rat
      granulocyte/macrophage colony formation and thymocyte proliferation in vitro.
AB  - CD26 dipeptidyl peptidase (DPPIV) is involved in the regulation of proliferation
      of some hematopoietic and T-lineage cells. Here, we show that Pro-boropro a
      potent inhibitor of DPP activity has a costimulating effect in hematopoietic
      colony assays for macrophage and, to a lesser extent, for granulocyte colonies
      and has a stimulating effect in organ cultures of immature thymocytes. Based on
      these and other evidences, we propose that the mechanism by which CD26 regulates
      proliferation is associated with its DPP activity.

PMID- 7780146
TI  - All-trans retinoic acid and cyclic adenosine monophosphate cooperate in the
      expression of leukocyte alkaline phosphatase in acute promyelocytic leukemia
      cells.
AB  - Treatment of acute promyelocytic leukemia (APL) blasts with cyclic adenosine
      monophosphate (cAMP) analogs, in combination with all-trans retinoic acid (ATRA),
      results in the upregulation of the expression of leukocyte alkaline phosphatase
      (LAP), a marker for the differentiation of the granulocyte. The synergistic
      interaction between the cyclic nucleotide analogs and the retinoid is not unique
      to APL cells, as it is observed also in the peripheral granulocytes of chronic
      myelogenous leukemia (CML) patients. The molecular mechanisms underlying LAP
      induction were studied in NB4, an immortalized APL cell line. Induction of LAP
      enzymatic activity is dependent on the time of exposure and on the concentrations
      of dibutyryl-cAMP or 8-bromo-cAMP and ATRA, two factors that influence the
      kinetics of appearance of detectable levels of the enzyme. Augmentation of LAP
      levels by ATRA and cAMP is the result of both transcriptional and early
      posttranscriptional events and requires de novo protein synthesis. LAP induction
      correlates with augmentation in the levels of the type I catalytic subunit of
      cAMP-dependent protein kinase transcript and with granulocytic differentiation.
      The transcriptional component of the process leading to increased LAP gene
      expression was reproduced in its main features by transient transfection
      experiments performed in COS-7 cells using the normal retinoic acid receptor type
      alpha (RAR-alpha) or the APL-specific aberrant form (PML-RAR) and the upstream
      promoter of the liver/bone/kidney (L/B/K)-type alkaline phosphatase gene. The
      promoter is upregulated by treatment with ATRA, and this upregulation is further
      increased by cAMP analogs.

PMID- 7780145
TI  - Comparative genomic hybridization in chronic B-cell leukemias shows a high
      incidence of chromosomal gains and losses.
AB  - In chronic B-cell leukemias, fluorescence in situ hybridization has greatly
      improved the ability to detect certain chromosomal aberrations, as cells in all
      phases of the cell cycle are analyzed. To obtain a comprehensive view of
      chromosomal gains and losses, we applied the recently developed technique of
      comparative genomic hybridization (CGH) to 28 patients with chronic B-cell
      leukemias. CGH results were compared with those obtained by chromosome banding
      analysis and interphase cytogenetics. In 19 of the 28 cases, chromosomal
      imbalances were detected, including amplified DNA sequences in three instances.
      The most common aberrations included gains of chromosomal material on 8q and 12
      as well as losses of 6q, 11q, 13q, and 17p. In 13 cases, CGH revealed chromosomal
      gains and losses not detected by banding analysis. In 8 of these 13 cases,
      discrepancies were further investigated using other methods, and in all
      instances, the CGH findings were confirmed. A limitation of detecting small
      deleted regions by CGH was found in one example of 18p. In conclusion, our data
      show that the results of banding analysis in chronic B-cell leukemias often do
      not reflect the chromosomal changes in the predominant cell clone. This may be
      one explanation for the as yet poor correlation between cytogenetic findings and
      clinical course in this group of neoplasms.

PMID- 7780147
TI  - Abnormal function of the bone marrow microenvironment in chronic myelogenous
      leukemia: role of malignant stromal macrophages.
AB  - The bone marrow microenvironment supports and regulates the proliferation and
      differentiation of hematopoietic cells. Dysregulated hematopoiesis in chronic
      myelogenous leukemia (CML) is caused, at least in part, by abnormalities in CML
      hematopoietic progenitors leading to altered interactions with the marrow
      microenvironment. The role of the microenvironment itself in CML has not been
      well characterized. We examined the capacity of CML stroma to support the growth
      of long-term culture-initiating cells (LTC-IC) obtained from normal and CML
      marrow. The growth of normal LTC-IC on CML stroma was significantly reduced
      compared with normal stroma. This did not appear to be related to abnormal
      production of soluble factors by CML stroma because normal LTC-IC grew equally
      well in Transwells above CML stroma as in Transwells above normal stroma. In
      addition, CML and normal stromal supernatants contained similar quantities of
      both growth-stimulatory (granulocyte colony-stimulating factor (CSF), interleukin
      6, stem cell factor, granulocyte-macrophage CSF, and interleukin-1 beta) and
      growth-inhibitory cytokines (transforming growth factor-beta, macrophage
      inflammatory protein-1 alpha, and tumor necrosis factor-alpha). The relative
      proportion of different cell types in CML and normal stroma was similar. However,
      polymerase chain reaction and fluorescence in situ hybridization studies showed
      the presence of bcr-abl-positivo cells in CML stroma, which were CD14+ stromal
      macrophages. To assess the effect of these malignant macrophages on stromal
      function, CML and normal stromal cells were separated by fluorescence-activated
      cell sorting into stromal mesenchymal cell (CD14-) and macrophage (CD14+)
      populations. CML and normal CD14- cells supported the growth of normal LTC-IC
      equally well. However, the addition of CML macrophages to normal or CML CD14-
      mesenchymal cells resulted in impaired progenitor support. This finding indicates
      that the abnormal function of CML bone marrow stroma is related to the presence
      of malignant macrophages. In contrast to normal LTC-IC, the growth of CML LTC-IC
      on allogeneic CML stromal layers was not impaired and was significantly better
      than that of normal LTC-IC cocultured with the same CML stromal layers. These
      studies demonstrate that, in addition to abnormalities in CML progenitors
      themselves, abnormalities in the CML marrow microenvironment related to the
      presence of malignant stromal macrophages may contribute to the selective
      expansion of leukemic progenitors and suppression of normal hematopoiesis in CML.

PMID- 7780148
TI  - The PML gene encodes a phosphoprotein associated with the nuclear matrix.
AB  - The t(15;17)(q22;q12) translocation is the cytogenetic hallmark of acute
      promyelocytic leukemia (APL). The PML and retinoic acid receptor-alpha (RAR
      alpha) transcription factor genes are involved at translocation breakpoint. To
      elucidate the biologic function of PML, antipeptide antibody against PML protein
      was raised in rabbits. This antibody was able to detect a 90-kD PML protein and a
      110-kD PML-RAR alpha fusion protein by Western blotting and a nuclear speckled
      pattern in all cell lines by immunofluorescent staining. In K562 and NIH/3T3
      cells transfected with a PML expression plasmid, we found PML to be associated
      with the nuclear matrix. Our results also showed that PML is a phosphorprotein. A
      weak signal was detected in a Western blot containing the immunoprecipitated PML
      protein using the phosphotyrosine-specific monoclonal antibody. Therefore, at
      least one of the sites was phosphorylated by a tyrosine kinase. From our analysis
      of the phosphoamino acids of the PML protein by complete hydrolysis and thin
      layer chromatography, we concluded that both tyrosine and serine residues of PML
      are phosphorylated. To investigate whether expression of the PML protein is cell
      cycle related, HeLa cells synchronized at various phases of the cell cycle were
      analyzed by immunofluorescence staining and confocal microscopy for PML
      expression. We found that PML was expressed at a lower level in S, G2, and M
      phases and at a significantly higher level in G1 phase. Our study showed that PML
      has many similar properties compared with the tumor suppressor, eg, Rb. These
      findings further support the important role of PML in APL pathogenesis.

PMID- 7780149
TI  - Quercetin inhibits the growth of leukemic progenitors and induces the expression
      of transforming growth factor-beta 1 in these cells.
AB  - We previously showed that quercetin (3,3',4',5,7 pentahydroxyflavone) inhibits in
      a dose-dependent manner the growth of acute leukemias and is able to enhance the
      antiproliferative activity of cytosine arabinoside. We show here that quercetin
      inhibits the clonogenic activity of 20 of 22 acute leukemias (AL; 4 M1-AML, 3 M2
      AML, 2 M3-AML, 3 M4-AML, 3 M5-AML, and 7 ALL). In the present report, we show
      that the induction of transforming growth factor-beta 1 (TGF-beta 1) in leukemic
      blasts is one of the growth-inhibitory mechanisms of quercetin in these cells.
      This observation was supported by the following data. (1) Quercetin-sensitive
      leukemic blasts, when treated with quercetin, secrete large amounts of TGF-beta 1
      in the medium and show positivity for TGF-beta 1-immunoreactive material in the
      cytoplasm. (2) At a concentration of 8 mumol/L, antisense TGF-beta 1
      oligonucleotides prevent the growth-inhibitory action of quercetin. (3) Anti-TGF
      beta 1 neutralizing monoclonal antibodies can prevent almost completely the
      growth-inhibitory activity of quercetin. The analysis of quercetin-resistant
      cases confirmed as well the central role of TGF-beta 1 in the growth-inhibitory
      activity of quercetin. In conclusion, quercetin can act as a cytostatic agent for
      leukemic cells by modulating the production of TGF-beta 1.

PMID- 7780150
TI  - The t(12;21) of acute lymphoblastic leukemia results in a tel-AML1 gene fusion.
AB  - Analysis of a growing number of chromosomal translocations in human tumors have
      shown that they frequently result in gene fusions encoding chimeric proteins. We
      have characterized the recurrent t(12;21)(p12;q22) translocation present in human
      B-lineage acute leukemias. This translocation fused two genes, tel and AML1, that
      have previously been described in chromosomal translocations specific for myeloid
      malignancies. These two genes therefore belong to an increasing number of human
      genes that are involved in a variety of hematopoietic malignant disorders and can
      be rearranged with numerous partners. Interestingly, in these acute leukemias,
      deletion of the other tel allele from the normal chromosome 12 was associated
      with the tel rearrangement, whereas both tel alleles were present in the chronic
      leukemias bearing a t(5;12) that we have tested.

PMID- 7780151
TI  - Prognostic value of cellular proliferation and histologic grade in follicular
      lymphoma.
AB  - The clinical usefulness of histologic grading in follicular lymphoma (FL) is
      controversial and is further compromised by the subjective nature and poor
      reproducibility of most systems in current use. Therefore, we decided to
      objectively evaluate the importance of cellular proliferation in FL, along with
      the current grading systems. We studied 106 patients with FL who were uniformly
      staged and aggressively treated. A proliferative index (PI) was determined
      quantitatively using an automated image analyzer and a new Ki-67 antibody that
      stains archival paraffin tissues. The cases were also subclassified according to
      the Berard, Rappaport, Luke-Collins, and Jaffe methods, and survival analysis was
      performed. Patients with a low PI (< 40%) had a significantly longer overall
      survival (OS) than those with a high PI (> or = 40%), but the PI did not predict
      failure-free survival (FFS). The mean PI correlated well with the subgroups in
      each of the various classifications. All four of the classification methods were
      predictive of OS, but only the Berard method appeared to predict FFS and suggest
      that a proportion of patients with FL may be curable. In multivariate analysis,
      histologic classification was the only independent predictor of OS (Berard
      method: relative risk, 3.1) and the International Prognostic Index was the only
      independent predictor of FFS (relative risk, 2.3). We conclude that the Berard
      method for grading of FL is clinically useful and, along with the International
      Prognostic Index, should be included in future clinical studies of FL. The
      measurement of cellular proliferation does not appear to add additional useful
      information in FL.

PMID- 7780152
TI  - Cytogenetic profile of minimally differentiated (FAB M0) acute myeloid leukemia:
      correlation with clinicobiologic findings.
AB  - Cytogenetic data were studied in 26 patients with de novo acute myeloid leukemia
      (AML) with minimal myeloid differentiation, corresponding to the M0 subtype of
      the French-American-British classification, in correlation with cytoimmunologic
      and clinical findings. Clonal abnormalities were detected in 21 cases (80.7%), 12
      of which had a complex karyotype. Partial or total monosomy 5q and/or 7q was
      found, either as the sole aberration or in all abnormal metaphases, in 11
      patients; in 8 cases, additional chromosome changes were present, including
      rearrangements involving 12p12-13 and 2p12-15 seen in 3 cases each. Five patients
      had trisomy 13 as a possible primary chromosome change; in 5 cases, nonrecurrent
      chromsome abnormalities were observed. Comparison of these findings with
      chromosome data from 42 patients with AML-M1 shows that abnormal karyotypes,
      complex karyotypes, unbalanced chromosome changes (-5/5q- and/or -7/7q- and +13)
      were observed much more frequently in AML-M0 than in AML-M1. Patients with
      abnormalities of chromosome 5 and/or 7 frequently showed trilineage
      myelodysplasia and low white blood cell count. Despite their relatively young
      age, complete remission was achieved in 4 of 11 patients only. Patients with +13
      were elderly males with frequent professional exposure to myelotoxic agents.
      Unlike patients with clonal abnormalities, most AML-M0 patients with normal
      karyotype showed 1% to 2% peroxidase-positive blast cells at light microscopy and
      frequently achieved CR. It is concluded that (1) AML-M0 shows a distinct
      cytogenetic profile, partially recalling that of therapy-related AML, (2)
      different cytogenetic groups of AML-M0 can be identified showing characteristic
      clinicobiologic features, and (3) chromosome rearrangements may partially account
      for the unfavorable outcome frequently observed in these patients.

PMID- 7780154
TI  - Expression of CD21 antigen on myeloma cells and its involvement in their adhesion
      to bone marrow stromal cells.
AB  - The mature myeloma cells express very late antigen 5 (VLA-5) and MPC-1 antigens
      on their surface and adhere to bone marrow (BM) stromal cells more tightly than
      the VLA-5-MPC-1- immature myeloma cells in vitro. The VLA-5 and MPC-1 antigens
      possibly function as two of the molecules responsible for interaction of mature
      myeloma cells with BM stromal cells. However, the immature myeloma cells do
      interact with BM stromal cells, and it is unclear which adhesion molecules
      mediate their interaction. In this study, we found that both immature and mature
      myeloma cells expressed CD21, an adhesion molecule known to bind to CD23. CD21
      was also detected on normal plasma cells. To evaluate the role of CD21 expression
      on myeloma cells, two myeloma cell lines, NOP-2 (VLA-5-MPC-1-) and KMS-5 (VLA
      5+MPC-1+), were used as representatives of immature and mature myeloma cell
      types, respectively, and an adhesion assay was performed between the myeloma cell
      lines and BM stromal cells. Antibody-blocking results showed that adhesion of the
      mature type KMS-5 to KM102, a human BM-derived stromal cell line, or to short
      term cultured BM primary stromal cells was inhibited by monoclonal antibodies
      (MoAbs) against CD21, VLA-5, and MPC-1, and inhibition of adhesion of the
      immature type NOP-2 to KM102 by the anti-CD21 MoAb was observed as well.
      Furthermore, CD23 was detected on KM102. Treatment of KM102 with an anti-CD23
      MoAb also inhibited adhesion of either KMS-5 or NOP-2 to KM102. Therefore, we
      propose that CD21 expressed on myeloma cells likely functions as a molecule
      responsible for the interaction of immature myeloma cells as well as mature
      myeloma cells with BM stromal cells, and CD23 may be the ligand on the stromal
      cells for the CD21-mediated adhesion.

PMID- 7780153
TI  - Heterogeneity in CBF beta/MYH11 fusion messages encoded by the inv(16)(p13q22)
      and the t(16;16)(p13;q22) in acute myelogenous leukemia.
AB  - Inv(16)(p13q22) is one of the most frequent chromosomal rearrangements found in
      acute myelogenous leukemia (AML), representing approximately 16% of documented
      karyotypic abnormalities. The inv(16) breakpoints have been cloned and shown to
      involve the non-DNA binding component of the AML-1 transcription factor complex
      termed core binding factor beta gene (CBF beta) on 16q and the smooth muscle
      myosin heavy chain gene (MYH11) on 16p. In this study, we analyzed 37 cases of
      inv(16)-containing AML and 4 cases with t(16;16)(p13;q22) for expression of the
      CBF beta/MYH11 chimeric message by reverse transcription-polymerase chain
      reaction (PCR) analysis. CBF beta/MYH11 chimeric messages were detected in 33 of
      37 cases with the inv(16) and in the 4 t(16;16)-containing cases. Sequence
      analysis of PCR products showed extensive breakpoint heterogeneity in both CBF
      beta and MYH11. In addition to the previously described breakpoint in CBF beta at
      nucleotide (nt) 495 (amino acid 165), we have identified a second novel fusion
      point at nt 399 (amino acid 133) in 7% of the cases. Similarly, a unique
      breakpoint site was identified in MYH11 at nt 1098, as well as at three
      previously characterized sites at nts 994, 1201, and 1921. Of the 4 PCR-negative
      cases, 2 of 3 tested lacked CBF beta rearrangements by Southern blot analysis,
      suggesting the possible involvement of a different genomic locus in some cases
      with cytogenetic evidence of inv(16). To assess whether the portions of CBF-beta
      contained within the CBF beta/MYH11 chimeric products retain the ability to
      interact with their heterodimeric DNA-binding partner AML-1, we performed in
      vitro DNA-binding analysis. Recombinant CBF-beta polypeptides consisting of the N
      terminal 165 amino acids retained their ability to interact with AML-1, whereas
      mutants containing only the N-terminal 133 amino acids interacted with AML-1 less
      efficiently. These data suggest that different CBF beta/MYH11 products may vary
      subtly in their biologic activities.

PMID- 7780155
TI  - Ecotropic virus integration site-1 gene preferentially expressed in post
      myelodysplasia acute myeloid leukemia: possible association with GATA-1, GATA-2,
      and stem cell leukemia gene expression.
AB  - We investigated expression of the human ecotropic virus integration site-1 (EVI1)
      gene in patients with leukemia and myelodysplastic syndrome (MDS) using the
      reverse transcriptase-polymerase chain reaction (RT-PCR) method. The EVI1
      transcripts were detected in 5 (10.0%) of 50 patients with de novo acute myeloid
      leukemia (AML), including two AML patients with trilineage myelodysplasia, and in
      8 (34.8%) of 23 patients with post-myelodysplastic syndrome AML (post-MDS AML).
      EVI1 expression was also detected in 6 (35.3%) of 17 MDS patients and three of
      six patients with chronic myeloid leukemia (CML) in myelomegakaryoblast crisis.
      No EVI1 transcripts were detected in patients with acute lymphoid leukemia (n =
      15) or CML in lymphoid blast crisis (n = 4). Chromosomal abnormalities at the
      3q26 region, where the EVI1 gene is located, were found in one patient with MDS
      and two patients with CML myelomegakaryoblast crisis who had EVI1 expression. Our
      results showed that EVI1 expression was frequent in patients with post-MDS AML
      and AML with trilineage myelodysplasia, regardless of the presence or absence of
      3q26 abnormalities. EVI1 expression was accompanied by expression of GATA-1 and
      GATA-2, and often by stem cell leukemia (SCL) gene expression. In patients with
      post-MDS AML, EVI1 expression was not always associated with a 3q26 abnormality,
      whereas EVI1 expression in CML myelomegakaryoblast crisis was often linked to a
      3q26 abnormality. Our results suggest that the leukemogenic role of EVI1
      expression may differ between post-MDS AML and leukemia, with EVI1 expression
      associated with a 3q26 abnormality.

PMID- 7780156
TI  - Granulocyte-macrophage colony-stimulating factor increases 5-lipoxygenase gene
      transcription and protein expression in human neutrophils.
AB  - The complex process of neutrophil activation and accumulation is orchestrated by
      a cascade of cytokines and bioactive lipids produced at the site of inflammation.
      Neutrophils are a rich source of the potent inflammatory lipid leukotriene
      B4(LTB4). Granulocyte-macrophage colony-stimulating factor (GM-CSF) can activate
      neutrophils for an exponential increase in LTB4 production in response to a
      number of subsequent stimuli. In this report, we examined the temporal
      regulation, by GM-CSF, of the gene and protein expression of 5-lipoxygenase (5
      LOX), a key enzyme of the LTB4 production pathway. Human neutrophils were exposed
      to 10 ng/mL of GM-CSF for various periods of time and 5-LOX mRNA was measured by
      Northern blot analysis. We observed no change in 5-LOX mRNA at early time points
      (0.25 to 3 hours); however, by 18 hours we observed a significant augmentation of
      5-LOX-specific message (4.3 +/- 1.7-fold increase; n = 6). Nuclear transcription
      assays indicated that the rate of 5-LOX gene transcription was augmented
      threefold in neutrophils incubated with GM-CSF, whereas the half-life of the
      message was not markedly changed. Parallel experiments indicated that the levels
      of 5-LOX protein were also increased by GM-CSF. The augmentation was observed
      within 30 minutes after stimulation and was maximal (5.23 +/- 2.6; n = 4) at 18
      hours. Incubation of GM-CSF-stimulated neutrophils with protein synthesis
      inhibitors resulted in a time-dependent impairment of their ability to produce
      LTB4, with no inhibition seen during the first hours, a 75% decrease seen by 12
      hours, and greater than 95% inhibition seen at 18 hours. Collectively, our data
      imply that GM-CSF can regulate LTB4 production by two distinct mechanisms: a
      short-term increase that is not related to increased 5-LOX mRNA expression and is
      independent of protein synthesis, and a sustained increase in LTB4 production
      that is associated with the transcriptional activation of the 5-LOX gene,
      increase in 5-LOX mRNA levels, and dependence on protein synthesis. Such
      transcriptional modulation of 5-LOX enzyme expression may provide new approaches
      for therapeutic intervention in protracted inflammatory conditions.

PMID- 7780157
TI  - Inhibition by interleukin-10 of inducible cyclooxygenase expression in
      lipopolysaccharide-stimulated monocytes: its underlying mechanism in comparison
      with interleukin-4.
AB  - Both interleukin-10 (IL-10) and IL-4 inhibited the prostanoid synthesis of
      lipopolysaccharide (LPS)-stimulated human monocytes, and their inhibition was
      shown to be based on a common mechanism to suppress the gene expression of
      inducible cyclooxygenase (COX). COX has been shown to exist in at least two
      distinct isoforms, designated COX-1 and COX-2, and their gene expressions exhibit
      different profiles. At both the protein and mRNA levels, the expression of COX-1
      was constitutive and was not modulated by treatments with LPS, IL-10, or IL-4. In
      contrast, the expression of COX-2 was observed only after stimulation with LPS.
      IL-10 and IL-4 significantly inhibited LPS-induced COX-2 expression. Kinetic
      studies showed that they inhibited COX-2 mRNA expression within 1 hour after
      stimulation and that maximal inhibition was consistently observed at 5 hours.
      Moreover, the addition of cycloheximide (CHX) to LPS-stimulated monocytes
      resulted in a superinduction of COX-2 mRNA, whereas CHX almost abrogated the
      abilities of IL-10 and IL-4 to inhibit this gene expression. Experiments with
      actinomycin D showed that both cytokines accelerated the degradation of COX-2
      mRNA. Furthermore, nuclear run-on experiments showed that both cytokines modestly
      inhibited LPS-induced COX-2 gene transcription. Thus, both cytokines seemed to
      regulate the COX-related pathway in a similar manner, although their receptor
      systems did not show any structural similarities. Considering recent findings
      showing that the drugs that exhibit a selective effect on COX-2 may be more
      preferable in inflammatory conditions, such biologic activities of IL-10 and IL-4
      described above may offer useful tools in controlling inflammatory disorders in
      the future.

PMID- 7780158
TI  - Sustained long-term hematopoiesis after myeloablative therapy with peripheral
      blood progenitor cell support.
AB  - A retrospective analysis of long-term hematopoiesis was performed in a group of
      145 consecutive patients who had received high-dose therapy with peripheral blood
      progenitor cell (PBPC) support between May 1985 and December 1993. Twenty-two
      patients had acute myelogenous leukemia, nine had acute lymphoblastic leukemia,
      43 had Hodgkin's disease, 57 had non-Hodgkin's lymphoma, and 14 patients had
      multiple myeloma. Eighty-four patients were male and 61 female, with a median age
      of 37 years (range, 16 to 58 years). In 46 patients, PBPC were collected after
      cytotoxic chemotherapy alone, while 99 patients received cytokines either during
      steady-state hematopoiesis or post-chemotherapy. Sixty patients were treated with
      dose-escalated polychemotherapy, and 85 patients had a conditioning therapy
      including hyperfractionated total body irradiation at a total dose of 14.4 Gy.
      The duration of severe pancytopenia posttransplantation was inversely related to
      the number of reinfused granulocyte-macrophage colony-forming units (CFU-GM) and
      CD34+ cells. Threshold quantities of 2.5 x 10(6) CD34+ cells per kilogram or 12.0
      x 10(4) CFU-GM per kilogram became evident and were associated with rapid
      neutrophil and platelet recovery within less than 18 and 14 days, respectively.
      These numbers were also predictive for long-term reconstitution, indicating that
      normal blood counts are likely to be achieved within less than 10 months after
      transplantation. Conversely, 12 patients were autografted with a median of 1.75 x
      10(4) CFU-GM per kilogram resulting in delayed recovery to platelet counts of
      greater than 150 x 10(9)/L between 1 and 6 years. Our study includes bone marrow
      examinations in 50 patients performed at a median follow-up time of 10 months
      (range, 1 to 85 months) posttransplantation. A comparison with normal volunteers
      showed a 3.2-fold smaller proportion of bone marrow CD34+ cells, which was
      paralleled by an even more pronounced reduction in the plating efficiency of CFU
      GM and burst-forming unit-erythroid. No secondary graft failure was observed,
      even in patients autografted with relatively low numbers of progenitor cells.
      This suggests that either the pretransplant regimens were not myeloablative,
      allowing autochthonous recovery, or that a small number of cells capable of
      perpetual self-renewal were included in the autograft products.

PMID- 7780159
TI  - Association of gastroesophageal reflux with obstructive lung disease in children
      after allogeneic bone marrow transplantation.

PMID- 7780160
TI  - Transient disappearance of sickle hemoglobin after transfusion.

PMID- 7780161
TI  - Glucose-6-phosphate dehydrogenase (G6PD) mutations associated with F8C/G6PD
      haplotypes in Chinese.

PMID- 7780162
TI  - All-trans retinoic acid for advanced multiple myeloma.

PMID- 7780163
TI  - Levels of activated factor VII in patients with disseminated intravascular
      coagulation.

PMID- 7780164
TI  - Spinocerebellar ataxia 1 (SCA1) in the Japanese: analysis of CAG trinucleitide
      repeat expansion and instability of the repeat for paternal transmission.
AB  - SCA1 is caused by expansion of an unstable CAG triplet repeat in a novel gene
      located on the short arm of chromosome 6. In 126 Japanese individuals from 12
      pedigrees with SCA1, studies were done to determine if they carried this mutant
      gene. All the affected and pre-symptomatic individuals, determined by haplotype
      segregation analyses, carried an abnormally expanded allele with the range of 39
      63 repeat units. This repeat size inversely correlated with the age at onset.
      However, contrary to reported results, size of the repeat did not correlate with
      gender of the transmitting parent. Therefore, the CAG triplet repeat instability
      on paternal transmission is not likely to be fundamental to SCA1.

PMID- 7780165
TI  - Reexamination of chromosomal loci of human muscle actin genes by fluorescence in
      situ hybridization.

PMID- 7780166
TI  - A novel sequence polymorphism in exon 8 of the human vitamin D-binding protein
      (GC) gene in an African population.
AB  - A novel sequence polymorphism due to a T to C transition at the third nucleotide
      of the codon for Cys283 of the vitamin D-binding protein (GC) gene assigned to
      chromosome 4q13-4q21.1 was revealed by sequence analysis. Population studies by
      single strand conformation polymorphism (SSCP) analysis showed this GC-283.3 site
      was polymorphic in a Black African population but monomorphic in a European
      population.

PMID- 7780167
TI  - [Lifestyles and renal damage--association of smoking, drinking and physical
      activity with subsequent proteinuria].
AB  - To examine the role of lifestyles in the subsequent development of renal damage,
      the association of smoking, drinking and physical activity with subsequent
      proteinuria was investigated utilizing a longitudinal study. The subjects were
      7,701 males aged 20-84 years, who participated in health examinations at Aichi
      Prefectural Center of Health Care, Nagoya, Japan, both in 1989-1990 and 1992
      1993, and who showed no proteinuria at the first examination. Lifestyles at the
      first examination were compared between 140 men with, and 7,561 men without,
      newly developed proteinuria at the second examination. Age-adjusted odds ratios
      (ORs) of lifestyle factors for proteinuria were computed, and further the ORs
      were adjusted for age, systolic blood pressure, fasting plasma glucose level and
      other covariates obtained using multiple logistic regression analysis. Major
      significant findings which emerged from the present study were as follows. (a)
      The greater the consumption of alcohol per day, the higher the risk of subsequent
      proteinuria (trend p = 0.003). Heavy drinkers who consumed more than 58 g of
      alcohol per day experienced an increased risk (OR relative to non-drinker: 2.52).
      (b) Those who exercised less than once a week, and those who avoided walking even
      a short distance were at an increased risk (OR: 1.46, 1.55, respectively). Heavy
      drinking and low physical activity were found to be significantly associated with
      an increased risk of subsequent proteinuria even after adjusting for the
      covariates. An increasing risk of subsequent proteinuria with number of cigarette
      smoked per day was observed by univariate and multivariate analysis but without
      statistical significance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780168
TI  - [Feasibility of "well-aging facility" of "well-aging community promotion
      program"].
AB  - The government "Well-Aging Community Promotion Program" (WAC) defines a "Well
      Aging Facility" (WAF) consisting of a gymnasium for the elderly, an education
      center for the elderly, a service-center for handicapped elderly and their
      families, and a fee-for-service nursing home, and incorporated funding provisions
      for WAF. Because of economic reasons, with the exception of fee-for-service
      nursing home, there is only one WAF at present. An economic-feasibility study of
      WAF was conducted based on regional analysis of existing public facilities and
      the needs of the elderly, and proposals for promoting WAF and WAC were made. The
      results are as follows: 1. In large and middle-size cities, many types of public
      facilities exist within walking distance, but the number per capita of elderly is
      low. In small-size cities and towns the number per capita of elderly is high, but
      are rarely within walking distance. 2. Rather than investment in facilities, the
      role of private business in WAC can be described as investment in services such
      as management-services for public facilities and transportation among facilities.
      3. As for economic feasibility of WAF, in large and middle-size cities the
      education-center is viable, but for the gymnasium facility it would be based on
      utilization of facilities not only for elderly but multi-generational. The
      feasibility for the service-center will be high in large cities but low in middle
      size cities. 4. For small-size cities and towns, the management of the gymnasium,
      and the education-center will be feasible, but the service-center will be
      difficult. 5. To promote WAC in small-size cities and towns, the following will
      be needed. a. The development of transportation systems between homes and
      facilities. b. The promotion of multi-purpose use of facilities beyond the
      established purpose of each WAC public facility. c. The establishment of new
      multi-sectional management entities by both the public and private sectors to
      manage existing public facilities. d. Development of financial support program by
      the government for upgrading and remodeling of existing facilities to function as
      an alternative of the WAF.

PMID- 7780169
TI  - [Relationship between daily high temperature and mortality in Kyushu, Japan].
AB  - We analyzed the relationship between daily high temperature and mortality in
      Kyushu, Japan, 1972-1990. Mortality rate was obtained by dividing the number of
      deaths in a certain daily high temperature category by person-days in the same
      category. The results were as follows: (1) With daily high temperature on the x
      axis and mortality rate on the y-axis, the relationship between the two variables
      appeared to be V-shaped. The minimum mortality rate was observed at the 28
      degrees C-33 degrees C level. (2) Among all deaths at 33+ degrees C level, the
      proportion of deaths from "excessive heat" never exceeded 0.4%. This suggested
      that heat stroke is not a major contributor to the V-shape formation. (3) The V
      shape was observed even in 1990, suggesting that the rapid spread of air
      conditioners did not alter the relationship between daily high temperature and
      mortality rate. (4) For the 0-4 years age group, mortality was not temperature
      dependent. However, the 5-14 years age group showed high mortality rates at 33+
      degrees C. This may be attributed to outdoor activities during summer. After 30
      years of age, the overall mortality rates rose with age, with greater increases
      at lower ambient temperature levels. As a result, the 65+ years age group had the
      greatest temperature dependence. (5) Deaths from respiratory diseases,
      circulatory diseases, and senility were highly temperature dependent, whereas
      death from cancer was not temperature dependent. Deaths from digestive diseases,
      infectious diseases, and accidents showed moderate temperature dependence.

PMID- 7780170
TI  - [AIDS/HIV related knowledge, attitude and behavior of acupuncture therapists in
      Aichi Prefecture].
AB  - To promote AIDS prevention measures in Japan, the actual state of knowledge,
      attitudes and behaviors (KAB) of workers at risk for HIV infection requires
      clarification. In the present study, acupuncture therapists in Aichi Prefecture
      were evaluated for level of their KAB. By using a self-administered
      questionnaire, the KAB condition of 500 acupuncture therapists was surveyed from
      September-November in 1993. Responses from 494 (98.8%) were available for
      analysis. Results showed that knowledge level on general issues regarding HIV
      epidemics was good. The main sources for information on AIDS/HIV were TV, general
      lectures, public reports and magazines. More than 80% of acupuncture therapists
      sterilize their needles by autoclave or boiling and 60% of them use disposable
      needles. Furthermore, 97% of the therapists reported utilizing one or the other
      of these methods. More than a half of them have participated in AIDS education
      programs. While about 30% of them responded that they are able to accept HIV
      carriers as clients, 20% of them expressed negative responses. There appears to
      be a discrepancy between their level of knowledge of HIV transmission routes and
      their practical attitude towards clients with AIDS and/or HIV carriers. A more
      appropriate education program based on behavioral science is desirable to lessen
      discrepancy distance between general knowledge and preferable behavior regarding
      AIDS/HIV.

PMID- 7780171
TI  - [Sociomedical concerns of physically handicapped persons using wheelchairs and
      living in the community--a preliminary study on patients suffering from spinal
      cord injuries].

PMID- 7780172
TI  - Transient and continuous expression of NADPH diaphorase in different neuronal
      populations of developing rat spinal cord.
AB  - Nitric oxide is a novel intercellular messenger whose role in neuronal
      development is not yet known. As a first step toward elucidating its
      developmental function, we examined the pattern of NADPH diaphorase histochemical
      staining, an indicator of the presence of nitric oxide synthase, in the rat
      spinal cord at pre and postnatal ages. Some types of neurons expressed diaphorase
      activity transiently during development. For example, a subset of somatic motor
      neurons, located in the ventrolateral corner of a few caudal segments of the
      cervical spinal cord, were diaphorase-positive beginning on E15, but gradually
      became diaphorase-negative by birth. In contrast, other spinal neurons expressed
      diaphorase activity continuously from development into adulthood. Preganglionic
      autonomic motor neurons became diaphorase-positive early in their development, as
      they were migrating toward their adult positions. Other spinal neurons, such as
      those in superficial dorsal horn, first expressed diaphorase relatively late in
      their development, after reaching their final location. The transient expression
      in some cell types, as well as the early expression in others, suggest that
      nitric oxide may have an important role(s) during development, which may differ
      from its functions in the adult nervous system.

PMID- 7780173
TI  - Collagen fibrillogenesis in situ: fibril segments undergo post-depositional
      modifications resulting in linear and lateral growth during matrix development.
AB  - Elucidating how collagen fibril growth is regulated is important in determining
      how tissues are assembled. Fibrils are deposited as segments. The growth of these
      segments is an important determinant of tissue architecture, stability, and
      mechanical attributes. Fibril segments were isolated from developing tendons and
      their structure characterized. The post-depositional changes leading to linear
      and lateral growth of fibrils also were examined. Segments extracted from 14-day
      chicken embryo tendons had a mean length of 29 microns. The segments were
      asymmetric, having a short and a long tapered end. Most of the segments were
      centrosymmetric with respect to molecular packing. Segments extracted from 12- to
      16-day tendons had the same structure, but mean segment length increased
      incrementally due to the addition of an increasingly large population of longer
      segments. At 17 days of development there was a precipitous increase in segment
      length. The morphological data indicate that the increase in length was the
      result of lateral associations among adjacent segments. Analysis demonstrated
      that this fibril growth was associated with a significant decrease in fibril
      associated decorin. Using immunoelectron microscopy, decorin was seen to decrease
      significantly at 18 days of development. When decorin content was biochemically
      determined, a decrease also was observed. Decorin mRNA also decreased relative to
      fibrillar collagen mRNA during the same period. These data support the hypothesis
      that a decrease in fibril-associated decorin is necessary for fibril growth
      associated with tissue maturation. Growth through post-depositional fusion allows
      for appositional and intercalary growth and would be essential for normal
      development, growth, and repair.

PMID- 7780174
TI  - MyoD protein accumulates in satellite cells and is neurally regulated in
      regenerating myotubes and skeletal muscle fibers.
AB  - MyoD belongs to a family of helix-loop-helix proteins that control myogenic
      differentiation. Transfection of various non-myogenic cell lines with MyoD
      transforms them into myogenic cells. In normal embryonic development MyoD is
      upregulated at the time when the hypaxial musculature begins to form, but its
      role in the function of adult muscle remains to be elucidated. In this study we
      examined the cellular locations of MyoD protein in normal and abnormal muscles to
      see whether the presence of MyoD protein is correlated with a particular cellular
      behaviour and to assess the usefulness of MyoD as a marker for satellite cells.
      Adult rats were anaesthetised and their tibialis anterior or soleus muscles
      either denervated, tenotomised, freeze lesioned, lesioned and denervated, or
      lesioned and tenotomised. At various intervals after the operations the rats were
      killed and their muscles removed, snap frozen, and sectioned with a cryostat
      along with muscles from unoperated neonatal and adult rats. The sections were
      processed for immunohistochemistry using a rabbit affinity-purified antibody to
      recombinant MyoD. MyoD proved to be an excellent marker for active satellite
      cells; satellite cells in neonatal and regenerating muscles contained high levels
      of MyoD protein. MyoD positive cells were not observed in the muscles of old
      adults, in which the satellite cells are fully quiescent. MyoD immunoreactivity
      was rapidly lost from satellite cell nuclei after they fused into myotubes and
      was not detected in either sub-synaptic or non-synaptic nuclei of mature fibers.
      Denervation, and to a lesser extent tenotomy, of lesioned muscles induced
      expression of MyoD in myotubal nuclei. Denervation of normal muscles also
      upregulated MyoD in muscle fiber nuclei, an effect which was maximal after 3
      days. We conclude that MyoD protein is neurally regulated in both myotubes and
      muscle fibers.

PMID- 7780175
TI  - Cyclopamine, a steroidal alkaloid, disrupts development of cranial neural crest
      cells in Xenopus.
AB  - Cyclopamine is a steroidal alkaloid which causes limb and craniofacial defects in
      many vertebrate species. We have used Xenopus laevis as a model system to
      characterize the defects caused by cyclopamine at the cellular level. The most
      dramatic consequence of cyclopamine treatment in the Xenopus embryo is a defect
      in formation of craniofacial cartilage. Much of this cartilage is absent in
      treated animals. As in avian and mammalian species, Xenopus craniofacial
      cartilage is derived primarily from cells of the cranial neural crest. Grafting
      experiments show that development of the cartilaginous derivatives of the cranial
      neural crest is impaired after cyclopamine treatment, and this is at least
      partially due to a direct effect on presumptive crest cells. A culture system was
      used to determine the cellular response to the drug. Cyclopamine did not block
      the initial emigration of cells from a neural plate explant. However, cell death
      is seen in treated cultures after 4 days. Trunk neural crest cells and
      transformed cell lines are resistant to cyclopamine. We therefore conclude that
      cyclopamine specifically causes death of cranial neural crest cells and that
      lethality is likely to account for the teratogenic effects of this compound.

PMID- 7780176
TI  - Retinoic acid-induced cell death in the wound epidermis of regenerating zebrafish
      fins.
AB  - Previous work has shown that treatment with retinoic acid (RA) can induce
      malformations in regenerating pectoral and caudal fins. RA-treated regenerates
      are narrower than unamputated and regenerated control fins because of a decrease
      in the distance between rays, and either partial or total fusion of some of them.
      In order to tackle the issue of how RA induces its teratogenic effects on
      regenerating fins, and which cell types may be specifically affected by RA, we
      have examined the cellular changes occurring in early regenerates following
      treatment with retinoids. The work presented here shows for the first time that
      RA induces significant apoptosis in the wound epidermis, but not in the
      mesenchyme, of a regenerating appendage, besides inhibiting blastema development
      as reported in other species. We also show that RA does not retard regeneration
      by inhibiting accumulation of blastemal cells, but probably by impairing their
      ability to migrate distal to the amputation plane. This effect is rapidly
      reversed by discontinuing the treatment, and within 24 hr of removing the drug,
      blastema development is well advanced. By this time the teratogenic effects
      induced by RA are already apparent. A correlation between the length of the
      apical ectodermal ridge (AER) and the number of digits formed has been
      demonstrated in developing limb buds. We therefore suggest that RA-induced
      patterning abnormalities in regenerating fins are the consequence of a reduction
      in the size of the wound epidermis, due to increased cell death, which would
      affect patterning of the underlying mesenchyme.

PMID- 7780177
TI  - Basal lamina development in chicken muscle spindles.
AB  - The development of basal laminas was examined in immunohistochemical sections of
      chicken leg muscle spindles from embryonic day (E) 13 to 8 weeks postnatal.
      Fragments of basal laminas as seen with immunostaining for isoforms of laminin
      were already observed in E6 muscles. When clusters of intrafusal myotubes were
      first recognized at E13-14, they were surrounded by basal laminas which were
      incomplete both in terms of coverage and molecular composition. More mature basal
      lamina tubes individually enclosed young myofibers at E18. After afferents made
      contact with myotubes, synaptic portions of basal laminas at myosensory junctions
      reacted strongly with antibodies against s-laminin and chondroitin sulfate
      proteoglycan, while extrasynaptic portions were negative or reacted only weakly.
      At synaptic basal laminas of neuromuscular junctions heparin sulfate proteoglycan
      and s-laminin became prominent after E16. Contrary to the early presence of basal
      lamina proteins around intrafusal fibers, initial deposition of basal lamina
      proteins in the outer spindle capsule was not recognized until E17-18, and
      significant amounts were not detected until postnatal week 1. Unlike intrafusal
      basal laminas, capsular basal laminas developed no distinct specialized regions;
      however, molecular compositions of intrafusal and capsular basal laminas were
      similar.

PMID- 7780178
TI  - Clusterin expression within skin correlates with hair growth.
AB  - Clusterin/TRPM-2 is a sulfated glycoprotein that is expressed in many tissues.
      Independently cloned and isolated by several laboratories, it bears many names,
      and has been shown to be involved in many processes. These include cell-cell
      adhesion and aggregation, inhibition of complement cytolysis, programmed cell
      death and apoptosis, tissue remodeling, and terminal differentiation. The hair
      follicle undergoes cycles of growth, regression, and rest, which involve both
      tissue remodeling and programmed cell death. To identify whether clusterin
      expression is involved in hair growth and cycling, we studied the expression of
      clusterin throughout the hair cycle. We demonstrate that clusterin is expressed
      during the growth phase of the hair cycle. We found no correlation between
      clusterin expression and the apoptotic regression of the hair follicle. Using
      immunohistochemistry we localized clusterin to the inner root sheath of the
      follicle. This suggests that clusterin might be involved in the morphogenesis and
      differentiation of the hair follicle. We propose that clusterin has a role in the
      maintenance of the layered structure of the hair follicle, and in the
      interactions between the inner root sheath and both the outer root sheath and the

PMID- 7780179
TI  - Expression of two new protein isoforms of the neurofibromatosis type 1 gene
      product, neurofibromin, in muscle tissues.
AB  - The neurofibromatosis type 1 (NF1) gene encodes a tumor suppressor protein,
      termed neurofibromin, which is expressed predominantly in neurons, Schwann cells,
      oligodendrocytes, and leukocytes. There are at least three isoforms of
      neurofibromin produced by the alternative use of exons 23a and 48a. Previously we
      described the identification of an NF1 mRNA isoform containing an additional 54
      nucleotides from exon 48a (type 3 NF1) in human skeletal, cardiac and smooth
      muscle tissues by reverse-transcribed (RT)-PCR. To extend our initial
      observations, we have produced high titer chicken IgY antibodies which
      specifically recognize this muscle-specific neurofibromin isoform. An NF1 cDNA
      was generated containing human exon 48a sequences and expressed as a fusion
      protein in bacteria. The muscle-specific neurofibromin antibodies detected this
      exon 48a fusion protein by Western immunoblotting. Immunoprecipitation using
      these type 3 neurofibromin antibodies also specifically detected a 250 kDa
      protein in human and rat muscle tissues. Type 3 neurofibromin was found in rat
      heart and muscle, but not in liver brain, kidney or spleen with levels of
      expression declining after postnatal day 7. Expression of total NF1 RNA during
      rat embryonic development was detected at high levels in E15 heart, tongue, and
      limb bud. In addition, using type 2 neurofibromin-specific antibodies, the
      existence of a fourth isoform of neurofibromin (type 4 neurofibromin) containing
      both exon 23a and 48a sequences was demonstrated in rat heart muscle tissues. The
      identification of two muscle-specific isoforms of neurofibromin expands our
      definition of this important tumor suppressor protein and suggests additional
      roles for neurofibromin in muscle development and differentiation.

PMID- 7780180
TI  - Endogenous distribution of retinoids during normal development and teratogenesis
      in the mouse embryo.
AB  - We have analysed the endogenous retinoids present in whole mouse embryos from day
      9 to day 14 of development and in individual components of the embryo at two
      stages, day 10.5 and day 13, by HPLC. We can only detect two retinoids, all-trans
      RA (tRA) and all-trans-retinol (t-retinol), and t-retinol is 5-10-fold in excess
      over tRA. We cannot detect 9-cis-RA or any didehydroretinoids; thus mammalian
      embryos seem to differ in their retinoid content from other embryos such as
      chick, Xenopus, and fish. The levels of tRA do not change significantly over the
      6 days of development analysed, whereas t-retinol rises sharply as the liver
      develops. Within the embryo, tRA is present at high levels in the developing
      spinal cord and at very low levels in the forebrain; indeed there is a gradient
      of endogenous tRA from the forebrain to the spinal cord. Other parts of the
      embryo had intermediate levels of tRA. When a teratogenic dose of RA was
      administered to day 10.5 embryos, the levels of tRA present in individual tissues
      of the embryo rose dramatically--from 175-fold to 1,400-fold--and the levels rose
      in all tissues not in any exclusive areas. We then determined which areas of the
      embryo were malformed by such a teratogenic dose. The lower jaw, palate,
      vertebrae, tail, and limbs were consistently abnormal, and since these areas
      received a dose of tRA no higher than any other it was concluded that cell
      specific factors must determine the teratogenic response of these tissues. We
      then considered whether cellular retinoic acid-binding protein I or II (CRABP I
      or II) played any role in this response by determining their relative levels in
      each of the tissues analysed. There was no correlation between the presence of
      CRABP I and II and the distribution of administered RA. Neither was there a clear
      correlation in detail between the presence of CRABP I and II and the sites of
      teratogenesis. We therefore conclude that other factors, for example, nuclear
      factors, must be responsible for the teratogenic response to RA.

PMID- 7780181
TI  - Tracking genetically engineered microorganisms in nature.
AB  - The past year has seen the continued development of methods for tracking
      genetically engineered microorganisms in nature, with an emphasis on increased
      sensitivity, specificity and quantitative ability. In addition, novel methods
      have been developed for tagging bacteria targeted for environmental release.
      Nevertheless, the limited number of field trials published to date have primarily
      relied on conventional monitoring methods, despite the availability of better and
      theoretically safer methods.

PMID- 7780182
TI  - Further development of recombinant baculovirus insecticides.
AB  - On the basis of recent laboratory and field experiments, recombinant
      baculoviruses expressing insect-specific neurotoxin genes show an increased speed
      of insect killing compared with natural baculoviruses. They can also induce
      symptoms similar to those induced by chemical insecticides and have the potential
      for widespread use in agriculture. Current studies of the ecology and molecular
      biology of baculoviruses should further improve efficacy and better define
      safety.

PMID- 7780183
TI  - Environmental biotechnology.

PMID- 7780184
TI  - Renal function conscious one kidney-one clip hypertensive rats. Effect of
      indomethacin.
AB  - These experiments have analyzed: a) Blood pressure (BP) and renal function in one
      kidney-one clip rats two weeks after clipping; b) The effect of cycloxygenase
      (CO) inhibition on BP and renal function regulation during the hypertensive
      period. Using the unanaesthetized, unrestrained and chronically instrumented
      animal, three groups of rats were studied: Sham, Clip 0.31 mm lumen and Clip 0.29
      mm lumen. The animals were examined before (Control period) and during the
      infusion of indomethacin (IND, 5 mg/kg via aortic cannula, n = 11 for each group)
      or the buffer vehicle solution (BUF, n = 7 for each group). Effective inhibition
      of CO by IND was confirmed using radioimmunoassay of prostaglandin E2 (PGE2) in
      urine. Control BP (mmHg, mean +/- SE) differed significantly among the groups (p
      < 0.001): Sham, 114 +/- 3; Clip 0.31, 135 +/- 2; Clip 0.29, 154 +/- 4 and did not
      change by IND infusion. Along with the BP, Control Glomerular Filtration Rate and
      Renal Plasma Flow did not change by IND infusion, which suggests that CO
      eicosanoids, particularly PGG2, contribute little to basal renal hemodynamics in
      sham and hypertensive rats. Sodium excretion was lower in the Control period of
      Clip 0.29 rats (p < 0.01). A significant natriuretic effect observed in this Clip
      0.29 group by the infusion of IND suggests the contribution of an AA related
      metabolite in renal handling of sodium in more severe renovascular hypertension.

PMID- 7780186
TI  - [Argentine Society of Experimental Pharmacology, XXV annual meeting. Mar del
      Plata, 1993. Abstracts].

PMID- 7780185
TI  - [Identification of antibodies against cardiac muscarinic cholinergic receptors
      (CMCR) in blood from chagasic patients. Pathogenic implications].

PMID- 7780187
TI  - 1-Deoxymannojirimycin is a non-competitive inhibitor of mannosidase II.

PMID- 7780188
TI  - Expertise in glycobiology--the invisible category.

PMID- 7780189
TI  - Structure and function of laminin 1 glycans; glycan profiling.

PMID- 7780190
TI  - Cell surface components of Leishmania: identification of a novel parasite lectin?
AB  - Protozoan parasites of the genus Leishmania have a glycoconjugate surface coat
      (the glycocalyx) that acts as the interface between the parasite and its external
      environment. The principal components of the glycocalyx, the lipophosphoglycans
      and the glycoinositolphospholipids, have a variety of functions that facilitate
      parasite survival in both the extracellular and the intracellular stages of the
      life cycle. Recently, a novel hydrophilic Leishmania protein, the Gene B protein,
      has been identified on the surface of infective parasite stages. Attachment to
      the surface appears to be by association between a region of repeated amino acids
      in this molecule and components of the glycocalyx. As a consequence, the Gene B
      protein is exposed on the parasite surface while other peptides are buried
      beneath the glycocalyx. The putative functions of this unusual molecule are
      discussed.

PMID- 7780191
TI  - Tritium labelling of amino sugars at C-2 by alkaline epimerization in tritiated
      water.
AB  - N-Acetyl-D-[2-3H]glucosamine was synthesized from N-acetyl-D-mannosamine by
      alkaline 2-epimerization in pyridine containing 3H2O and nickelous acetate. The
      reaction involves reversible formation of an enol intermediate and therefore also
      resulted in incorporation of tritium into N-acetylmannosamine. After completed
      reaction, the two N-acetylhexosamines were separated from other radioactive
      products and Morgan-Elson chromogens by chromatography on a column of Sephadex G
      10, which was eluted with 10% ethanol, and were then separated from each other by
      chromatography on Sephadex G-15 in 0.27 M sodium borate (pH 7.8). The location of
      the incorporated tritium was established by treatment of the N-acetylhexosamines
      with borate under the conditions of the Morgan-Elson reaction, which converts the
      sugars to Kuhn's chromogen I with concomitant loss of the C-2 hydrogen. As
      expected, this treatment resulted in the formation of 3H2O, indicating that the
      tritium was located at C-2. [2-3H]Glucosamine was prepared by acid hydrolysis of
      the labelled N-acetylglucosamine and was converted to [2-3H]glucosamine 6
      phosphate by incubation with hexokinase and ATP. The sugar phosphate was used as
      a substrate for glucosamine 6-phosphate deaminase (isomerase, EC 5.3.1.10) in a
      simple 3H2O release assay.

PMID- 7780192
TI  - Characterization of the glycosylation of a human IgM produced by a human-mouse
      hybridoma.
AB  - We analysed the oligosaccharides of a human IgM produced by a human-human-mouse
      hybridoma at each of its five conserved heavy chain glycosylation sites.
      Consistent with previous reports, this IgM possesses sialylated oligosaccharides
      at Asn171, Asn332 and Asn395, and high-mannose-type oligosaccharides at Asn402.
      In contrast to previous reports for human IgMs, we find that Asn563 is not
      occupied by oligosaccharide on perhaps 25% of IgM heavy chains, while occupied
      Asn563 sites contain both high-mannose-type and sialylated oligosaccharides.
      These latter results are consistent with the glycosylation at Asn563 previously
      reported for the mouse MOPC 104E IgM. We demonstrate that both the human
      hybridoma IgM and the mouse MOPC 104E IgM are mixtures of pentamers and hexamers,
      raising the possibility that the unique findings concerning the glycosylation at
      Asn563 in this study and the previous study of the MOPC 104E IgM could be
      related, at least in part, to the different packing requirements of the hexameric
      geometry and the accessibility of oligosaccharides in the hexameric geometry for
      processing to complex type. In addition, we used high-pH anion-exchange (HPAE)
      chromatography, neutral anion-exchange chromatography, fluorophore-assisted
      carbohydrate electrophoresis and Western blots to compare the oligosaccharide
      compositions of the human hybridoma IgM, pooled human serum IgM and two mouse
      monoclonal IgMs (MOPC 104E and TEPC 183). Of note is the presence of N
      glycolylneuraminic acid (NeuGc) and N-acetylneuraminic acid (NeuAc) at a 2:1
      ratio in the oligosaccharides of the human hybridoma IgM. The presence of both
      NeuGc and NeuAc complicates the interpretation of HPAE chromatographs.

PMID- 7780193
TI  - Localization of neutral and acidic glycosphingolipids in rat lens.
AB  - Rat lens was found to contain several neutral and acidic glycosphingolipids in
      lens epithelia, cortex and nucleus, and showed developmental changes in their
      content and localization. TLC-immunostaining of gangliosides revealed the
      enrichment of some ganglio-series gangliosides (GM3, GM1, GD3 and GD1b) in lens
      epithelia and the presence of GM3 and GD3 in the lens nucleus.
      Immunohistochemical studies confirmed the distribution of GM3 and GM1 in anterior
      lens epithelial cells and the cortex, with expression decreasing toward the lens
      nucleus. Immunoreaction to GD3 was more intense in the lens nucleus than in
      epithelial cells. In contrast, the expression of neolacto-series
      glycosphingolipids was restricted to the lens nucleus. In order to investigate
      the pathological changes of glycosphingolipids in cataract, galactose-induced
      cataractous lenses were examined. However, no significant changes were observed
      in the content and composition of glycosphingolipids. In addition, Lewisx
      epitopes found in human cataractous lenses were not detected in the cataractous
      lenses of galactosaemic rats and hereditary cataractous Emory mice.

PMID- 7780194
TI  - The saccharides of the MUC 1 mucin-type glycoprotein, epitectin, produced by
      H.Ep.2 cells in the presence of aryl-N-acetyl-alpha-galactosaminides.
AB  - The treatment of H.Ep.2 cells with 4 mM aryl-N-acetyl-alpha-galactosaminide, an
      inhibitor of the elongation of O-linked saccharides of glycoproteins, resulted in
      a 70-80% decrease in the incorporation of [3H]glucosamine into epitectin (a MUC 1
      mucin-type glycoprotein). Gel electrophoresis of the partially glycosylated
      epitectin immunoprecipitated from the extracts of treated cells showed two bands
      of apparent mol. wts 420 and 460 kDa on SDS-PAGE, compared to bands of 350 and
      390 kDa for the native epitectin. Analysis of the saccharides released by beta
      elimination from the partially glycosylated epitectin showed the presence of
      substantial levels of beta 1-->3 galactosylated and sialylated saccharides. The
      data indicate that the inhibition of elongation of Ser/Thr-linked N-acetyl
      galactosamine in epitectin by aryl-N-acetyl-alpha-galactosaminides is only
      partial.

PMID- 7780195
TI  - Effect of metal ions on sucrose synthase from rice grains--a study on enzyme
      inhibition and enzyme topography.
AB  - The inhibition of the plant glycosyltransferase sucrose synthase from rice grains
      by free metal ions was studied. Decreasing sucrose synthase activities in the
      order of metal ions (Cu2+ >> Zn2+ > or = Ni2+ > Fe2+; 15.4% residual activity
      with 30 microM Cu2+) as well as inhibition by diethyl pyrocarbonate (27% residual
      activity at pH 7.2 and 43 microM diethyl pyrocarbonate) provided evidence that
      histidyl residues are important for sucrose synthase activity. Chelated metal
      ions, due to the geometric restriction of the reagent, gave a less pronounced
      inhibitory effect (11.7% residual activity with 100 microM Cu2+), but suggested
      that surface-accessible histidine residues are probably involved. Inhibition of
      sucrose synthase could always be prevented by metal ion scavengers [ethyl
      enediaminetetra-acetic acid (EDTA), dithiothreitol (DTT), mercaptoethanol,
      reduced glutathione, imidazole and histidine]. Sucrose synthase inhibited by free
      and chelated Cu2+, respectively, could be partly (60%) reactivated by EDTA. These
      results led to a topographical analysis of histidines on the surface of the
      homotetrameric protein by immobilized metal ion chromatography (IMAC). From the
      order by which sucrose synthase was bound to immobilized chelated metal ions in
      the presence of 1 mM imidazole (Cu2+ > Ni2+ > Zn2+ = Co2+), it could be concluded
      that the enzyme has at least 5-7 surface-accessible histidines. Sucrose synthase
      could not be eluted from a Cu2+ column by an increasing imidazole gradient. These
      results are of particular interest for the further purification of sucrose
      synthase(s), as well as for the evaluation of cloning and expression strategies
      using polyhistidine tails.

PMID- 7780196
TI  - High alpha-2,6-sialylation of N-acetyllactosamine sequences in ras-transformed
      rat fibroblasts correlates with high invasive potential.
AB  - Through cloning experiments with the FRras EJ4 cell line, previously described to
      exhibit a Sambucus nigra agglutinin (SNA)+ phenotype, three clones with a SNA-
      phenotype were isolated. All the selected SNA+ and SNA- clones expressed the ras
      oncoprotein and cloned in soft agar with the same efficiency. We were interested
      in studying the adhesion and invasion properties of the FRras cells presenting a
      SNA + or - phenotype. They were first compared in their biochemical properties
      and we found that FRras SNA- were characterized by a low alpha-2,6-sialylation of
      their cell surface glycoproteins and a low beta-galactoside alpha-2,6
      sialytransferase activity. Using in vitro invasion assays, FRras cells exhibiting
      a low alpha-2,6-sialylation on their surface were found to have a low invasive
      potential compared to their counterpart SNA+. FRras SNA-clones exhibit a
      different morphology from that of FRras SNA+ clones. Moreover, homotypic
      aggregation assays indicated that FRras SNA- were more cohesive with each other
      and adhesion assays showed that they were more adhesive to fibronectin.

PMID- 7780197
TI  - The critical glycosylation site of human transferrin receptor contains a high
      mannose oligosaccharide.
AB  - The human transferrin receptor (TfR) contains three N-linked oligosaccharides and
      glycosylation is required for the proper folding and function of the molecule.
      Earlier studies demonstrated that the oligosaccharide at Asn-727 is vital for the
      production of fully active TfR. The oligosaccharide(s) present at this site have
      been analysed using a combination of site-directed mutagenesis and chemical
      analysis. Wild-type TfR and mutants containing only the Asn-727 site or missing
      all three sites were transfected into mouse 3T3 cells and receptors were analysed
      by endo-N-acetylglucosaminidase H (Endo-H) digestion, SDS-PAGE and
      immunoblotting. These studies suggested that the Asn-727 site contains high
      mannose or Endo-H-sensitive hybrid oligosaccharides. Glycosylation of Asn-727
      found in the TfR purified from human placentae was analysed by high-pH anion
      exchange chromatography with pulsed amperometric detection (HPAE-PAD) and mass
      spectrometry following tryptic digestion, peptide purification via reverse-phase
      high-performance liquid chromatography (RP-HPLC) and peptide sequencing. HPAE-PAD
      showed the presence of a series of high-mannose oligosaccharides. Mass
      spectrometry confirmed these observations, but also showed the presence of an 80
      Da anionic moiety on a fraction of the oligosaccharides.

PMID- 7780198
TI  - Rhizobial lipo-oligosaccharide nodulation factors: multidimensional
      chromatographic analysis of symbiotic signals involved in the development of
      legume root nodules.
AB  - Nod factors are a group of biologically active oligosaccharide signals that are
      secreted by symbiotically competent bacteria of the family Rhizobiaceae. Their
      biosynthesis is determined by rhizobial nodulation (nod) genes, and is
      specifically induced in response to flavonoids secreted from the roots of host
      leguminous plants. The biological activity of Nod factors on these host legumes
      dramatically mimics the early developmental symptoms of the Rhizobium-legume
      symbiosis including, amongst other effects, root hair deformations and nodule
      initiation. Structurally, all Nod factors are short oligomers of beta-1,4-linked
      N-acetylglucosamine residues [usually degree of polymerization (dp) 4 or 5] that
      are N-acylated on the distal glucosamine. This common 'core' structure may be
      modified by a number of species-specific substituents on the distal or reducing
      sugars. These modifications are governed by rhizobial host specificity nod genes.
      The biological activity of purified Nod factors mirrors this host specificity,
      indicating that the symbiotic host range of individual Rhizobium species is, at
      least partially, determined by the variety of Nod factors they are able to
      produce. Here we describe techniques that are universally applicable to the
      extraction, chromatographic separation and identification of Nod factors. We have
      applied these techniques to Nod factors from the broad-host-range species
      Rhizobium fredii USDA257 and Rhizobium spp. NGR234, and the more narrow-host
      range Bradyrhizobium japonicum USDA110, and have identified a group of novel,
      relatively hydrophilic Nod factors from the NGR234 species that may have
      implications for Nod factor biosynthesis.

PMID- 7780199
TI  - Treatment with the alpha-glucosidase 1 inhibitor 6-O-butanoyl castanospermine
      reduces the detection of LFA-1 (CD18/CD11a) by monoclonal antibodies.
AB  - The antiviral clinical candidate 6-O-butanoyl castanospermine (MDL 28,574), an
      alpha-glucosidase 1 inhibitor, was examined for its effect on elementary
      parameters of immune function. It did not affect the mitogenic response of
      uninfected human mononuclear leukocytes or the detection of a range of cell
      surface markers, with the exception of the integrin LFA-1 (CD18/CD11a), which was
      reduced, after cell growth in vitro. The detection of LFA-1 was also reduced on
      both human and murine cells after oral administration of the compound to
      xenochimaeric or normal mice, respectively. Altered LFA-1 expression or function
      may contribute to reduced cell adhesion and the observed reduction in the in
      vitro allogeneic response by uninfected cells, as well as the previously
      described prevention of cell conjugate and HIV-induced syncytium formation.

PMID- 7780200
TI  - The effect of oral treatment with 6-O-butanoyl castanospermine (MDL 28,574) in
      the murine zosteriform model of HSV-1 infection.
AB  - Oral treatment of mice, cutaneously infected with herpes simplex virus type 1
      (HSV-1) (strain SC16), with the alpha-glucosidase 1 inhibitor 6-O-butanoyl
      castanospermine (MDL 28,574) produced a significant delay in lesion development
      and reduced the amount of virus recovered from the brain. Virus load in the
      brains of mice, whose treatment started 2 days prior to infection, was reduced
      approximately 100-fold when compared to untreated controls. Treatment initiated
      at the time of infection, while less effective than pre-treatment, nevertheless
      reduced virus recovery from the brain by 10-fold. Consistent with its antiviral
      activity, orally administered MDL 28,574 was rapidly incorporated by brain tissue
      and mice fed with compound over extended periods maintained relatively high
      levels of drug at this site.

PMID- 7780201
TI  - Tissue fibronectin is an endogenous ligand for galectin-1.
AB  - A 14K beta-galactoside-binding lectin (galectin-1) is present in many animal
      tissues. In a search for endogenous ligands, we surveyed galectin-1-binding
      proteins in human placenta. Extract of human placenta with 2 M urea was applied
      to a Sepharose 4B column conjugated with galectin-1 purified from frog (Rana
      catesbeiana) eggs. Two major proteins eluted with 100 mM lactose from the column
      bound fraction showed apparent molecular masses of 220 and 180 kDa on SDS-PAGE
      under reducing conditions. Western blotting analysis using monoclonal antibodies
      indicated that these proteins were fibronectin and laminin, respectively. Most
      placental and amniotic fibronectins bound strongly to the column, whereas almost
      all plasma fibronectin passed through the column. The galectin-1, fibronectin and
      laminin were immunohistochemically shown to be co-localized in the extracellular
      matrix of placental tissue. In a cell attachment assay, rhabdosarcoma cells
      adhered to a plate coated with placental fibronectin, even in the presence of
      GRGDS peptide, if galectin-1 were also present. This adhesive effect of galectin
      1 was inhibited by lactose. These results indicate that tissue fibronectin, as
      well as laminin, serve as endogenous ligands for galectin-1, suggesting that
      galectin-1 may play a role in assembly of the extracellular matrix, or in the
      control of cell adhesion based on lectin-extracellular matrix interaction.

PMID- 7780203
TI  - Pleiotropic effect of fluoranthene on anthocyanin synthesis and nodulation of
      Medicago sativa is reversed by the plant flavone luteolin.

PMID- 7780204
TI  - Measurement of total polychlorinated biphenyls (PCBs) in catalytic combustion
      effluents using a simple HPLC procedure.

PMID- 7780202
TI  - Dodecyl-beta-D-maltoside as a substrate for glucosyl and xylosyl transfer by
      glycogenin.
AB  - Glycogenin is the core protein of glycogen proteoglycan and is, at the same time,
      a self-glucosylating enzyme which catalyses early glucosyl transfer steps in the
      biosynthesis of glycogen. In the course of this process, glycogenin is
      glucosylated progressively until an oligosaccharide containing 8-11 glucose
      residues has been formed. Although glycogenin, under physiological conditions, is
      both enzyme and acceptor in the glucosyl transfer reactions, it is also capable
      of utilizing p-nitrophenyl-linked malto-oligosaccharides as exogenous acceptors.
      In view of the potential usefulness of exogenous acceptors in the study of the
      mechanism of the glycogenin reaction, we have expanded the search for such
      compounds and report here that several alkyl glucosides and alkyl maltosides may
      serve as acceptors in glucosyl transfer by beef kidney glycogenin. Dodecyl-beta-D
      maltoside (Km approximately 100 microM) was the most effective acceptor among the
      compounds tested and yielded 30 times as much product as p-nitrophenyl-alpha
      maltoside. Substantial product formation was also observed with tetradecyl-beta-D
      maltoside and octyl-beta-D-maltoside (39 and 22%, respectively, of the value
      measured for dodecyl-beta-D-maltoside). It was further demonstrated that dodecyl
      beta-D-maltoside served as an acceptor in the transfer of xylose from UDP-xylose,
      indicating that the exogenous substrate behaved similarly to glycogenin itself in
      this regard. Dodecyl-beta-D-maltoside has already proven useful in the
      development of a simple glycogenin assay, and it is further suggested that this
      and related compounds may be active in vivo and in cell culture as artificial
      initiators of glycogen synthesis.

PMID- 7780205
TI  - Polyclonal antibody-based ELISA for triasulfuron.

PMID- 7780206
TI  - 32P-postlabeling determination of DNA adducts in the earthworm Lumbricus
      terrestris exposed to PAH-contaminated soils.

PMID- 7780207
TI  - Developmental hazard assessment with FETAX: aerobic metabolites in bacterial
      transformation of naphthalene.

PMID- 7780208
TI  - Effects of sterilization methods on the physical characteristics of soil:
      implications for sorption isotherm analyses.

PMID- 7780209
TI  - Use of toxicity identification evaluation procedures in the assessment of
      sediment pore water toxicity from an urban stormwater retention pond in Madison,
      Wisconsin.

PMID- 7780210
TI  - Exposure and effects of oilfield brine discharges on western sandpipers (Calidris
      mauri) in Nueces Bay, Texas.

PMID- 7780211
TI  - Acute and chronic toxicity of the thiocarbamate herbicide, molinate, to the
      cladoceran Moina australiensis Sars.

PMID- 7780213
TI  - Organochlorine compounds in fish from a farming station in the municipality of
      Paez, state of Zulia, Venezuela.

PMID- 7780212
TI  - Salt induced changes in the growth of Chlorococcum humicolo and Scenedesmus
      bijugatus under nutrient limited cultures.

PMID- 7780214
TI  - In vivo metabolism of pentachlorophenol and aniline in Arctic charr (Salvelinus
      alpinus L.) larvae.

PMID- 7780215
TI  - Relative sensitivity of some selected aquatic organisms to phenol.

PMID- 7780216
TI  - Tissue distribution and histopathological effects of dietary methylmercury in
      benthic grubby Myoxocephalus aenaeus.

PMID- 7780217
TI  - Ultrastructural and biochemical effects of 3-methylcholanthrene in rainbow trout.

PMID- 7780219
TI  - Excretion of intracorporeal cadmium with S-benzoylthiamin monophosphate.

PMID- 7780218
TI  - Metabolism of 3,5-di-t-butyl-4-methylphenyl N-methylcarbamate, Terbucarb, on
      isolated rat hepatocytes.

PMID- 7780220
TI  - Effect of pre-exposure to cadmium and silver on nickel induced toxic
      manifestations in mice: possible role of ceruloplasmin and metallothionein.

PMID- 7780221
TI  - Effect of dietary phytic acid and cadmium on the availability of cadmium, zinc,
      copper, iron, and manganese to rats.

PMID- 7780222
TI  - Suppression of cellular immune responses in BALB/c mice following oral exposure
      to permethrin.

PMID- 7780223
TI  - Cadmium contamination of wood ash and fire-treated coniferous humus: effect on
      soil respiration.

PMID- 7780224
TI  - Lead uptake from beer in India.

PMID- 7780225
TI  - Postoperative changes in plasma tissue-type plasminogen activator and type 1
      plasminogen activator inhibitor.
AB  - To clarify the changes which occur postoperatively in intravascular fibrinolysis,
      plasma levels of tissue-type plasminogen activator (t-PA) antigen, the total
      plasminogen activator inhibitor type-1 (PAI-1) antigen, and the t-PA-PAI-1
      complexes were assayed in this study. Blood samples were taken the morning before
      surgery, then at 0, 12, 24, 36, 60, 108, and 156 h postoperatively in ten
      patients who underwent radical surgery for thoracic esophageal cancer. The plasma
      levels of the t-PA and total PAI-1 antigens, and the t-PA-PAI-1 complexes were
      then measured by enzyme immunoassay. The plasma t-PA and total PAI-1 levels
      increased significantly in the immediate postoperative period, the percent
      increase of the latter being much greater than that of the former. Moreover, the
      calculated free t-PA antigen level was decreased throughout the postoperative
      period, suggesting postoperative hypofibrinolysis. The platelet count and
      neutrophil elastase level were significantly correlated with the free t-PA
      antigen level at r = 0.630, P < 0.001, and r = -0.447, P < 0.01, respectively.
      The results of this study indicated that post-operative hypofibrinolysis caused
      by the increased synthesis of PAI-1 may enhance postoperative hypercoagulability,
      and this may lead to the development of organ damage. Thus, the concentration of
      the PAI-1 antigen may be a potentially important index for the prediction of
      postoperative illness.

PMID- 7780226
TI  - A comparative histological and immunohistochemical study of thymomas with and
      without myasthenia gravis.
AB  - Because myasthenia gravis (MG) is frequently associated with thymoma, in this
      study the histological patterns of thymomas from 11 patients with MG (group A)
      were compared with those from 8 patients without MG (group B). An
      immunohistochemical examination was also conducted to determine whether the
      thymoma associated with MG is the site where autoantibodies are produced or
      secreted. Lymphoid follicles (LFs) and medullary differentiation (MD) were
      histologically evident only in group A in 4 and 5 patients, respectively, but
      were completely absent in group B. Moreover, an elevated serum antiacetylcholine
      receptor antibody titer was found in group A. Typical LFs were histologically and
      phenotypically similar to the lymph follicles seen in reactive lymph nodes. The
      number of cells expressing the B-cell antigen differed between groups A and B in
      terms of IgM- or IgD-bearing cells in the mantle zones and LN1-positive cells in
      the germinal centers of LFs. Thus, it is thought that LFs consist of B cells
      under stimulatory conditions and that these B cells may have the potential to
      produce autoantibodies in MG; however, since the differentiation of these Ig
      bearing cells to plasma cells was hardly evident, the thymoma itself is possibly
      not the site of autoantibody production or secretion in patients with MG.

PMID- 7780227
TI  - Pathophysiology of dogs after 84% hepatectomy with emphasis on prostaglandin
      metabolites and the effect of a thromboxane A2 synthesis inhibitor and a
      prostaglandin I2 analog.
AB  - The pathophysiological conditions following 84% hepatectomy were examined in
      terms of the changes in thromboxane A2 (TxA2) and prostaglandin I2 (PGI2) in a
      canine model. OKY-046, a TxA2 inhibitor, and OP-2507, a PGI2 analog, were
      administered to evaluate the possibility of extending hepatic resection. The 2
      week survival rate following 84% hepatectomy significantly improved after the
      administration of OKY-046 and OP-2507, from 12.5% to 58.3% and 75.0%,
      respectively. Furthermore, OP-2507 significantly improved impaired hepatocyte and
      sinusoidal endothelial cell function after 84% hepatectomy, resulting in a
      satisfactory recovery to the preoperative levels. Within 24 h after 84%
      hepatectomy, the plasma levels of thromboxane B2 (TxB2) increased significantly,
      and the 6-keto-prostaglandin F1 alpha (6-KF) levels became slightly elevated. OKY
      046 and OP-2507 decreased TxB2 and increased 6-KF in the plasma, resulting in the
      maintenance of sufficient blood flow in the portal vein and hepatic tissue and
      the mitigation of microcirculatory disorders. Moreover, the cytoprotective
      effects of the two drugs inhibited functional impairment of the residual liver.
      In conclusion, abnormal prostaglandin metabolites were produced after 84%
      hepatectomy, being involved in residual liver disorders. However, the
      administration of either an inhibitor of TxA2 synthesis or a PGI2 analog
      ameliorated the functional impairment of the residual liver, which suggests their
      potential value for extending the resectability of the liver from what is
      presently feasible.

PMID- 7780228
TI  - Experimental study on chemotherapy using adsorbent charcoal with CDDP
      administered directly into the mediastinum following esophagectomy.
AB  - In this study, 1500AA, an activated charcoal with a strong affinity for the
      lymphatic system, was examined for its ability to deliver chemotherapy to
      metastatic lymph nodes. First, the anticancer effect on metastatic lymph nodes
      was assessed in an experiment using the mouse mammary tumor, MM48. Pathological
      examination of the inguinal lymph nodes revealed a metastatic rate of 50% in the
      group given cisplatin (CDDP)-saline, but 20% in the group given CDDP-charcoal.
      Next, in a canine model, CDDP dissolved in normal saline was administered
      directly into the mediastinum, and CDDP was given with fine particles of
      activated charcoal in the same manner in the other group. The concentration of
      CDDP in the lymph nodes and the plasma rapidly increased to peak in 10 min in the
      CDDP-saline group, whereas it increased slowly to peak in 20-30 min in the CDDP
      charcoal group. Moreover, the CDDP-charcoal group was found to have a much higher
      concentration of CDDP in the lymph nodes than the CDDP-saline group.

PMID- 7780229
TI  - The effects of calcium antagonists and prostaglandin E1 on isolated canine
      coronary arterial tension.
AB  - The effects of calcium antagonists (nifedipine, nicardipine, diltiazem, and
      verapamil) and prostaglandin E1 (PGE1) on the tension of isolated canine coronary
      arterial strips were studied. In a solution containing 20 mEq/L of K+, 127 mEq/L
      of Na+, the tension was increased by 500-1,000 mg with 4 mEq/L of Ca2+. This
      increase in tension was suppressed by Ca-antagonists and PGE1 dose-dependently.
      Nifedipine 10(-5) M, nicardipine 3 x 10(-7) M, diltiazem 3 x 10(-6) M, and
      verapamil 3 x 10(-6) M completely suppressed the increased tension. The maximal
      suppression of the tension produced by PGE1 was about 40% at 10(-10) M. In 20
      mEq/L K+ solution (0 mEq/L Ca2+, 37 degrees C), the reduction of the Na+
      concentrations from 127 mEq/L to 12 mEq/L increased the tension by 50 to 100 mg.
      This increase in tension was not suppressed by Ca-antagonists or PGE1. In
      conclusion, this study demonstrated that Ca-antagonists and PGE1 suppressed an
      increase in the tension caused by Ca2+ but did not suppress an increase in the
      tension caused by Na+ reduction.

PMID- 7780230
TI  - The development of a small bowel volvulus in the early postoperative period
      following a distal gastrectomy: report of a case.
AB  - A 51-year-old Japanese man who underwent a standard distal gastrectomy for cancer
      of the stomach developed abdominal pain when oral intake was commenced on the 6th
      postoperative day after an uneventful postoperative course. Complete obstruction
      of the jejunum led to a sudden deterioration in his general condition and a
      laparotomy was performed, revealing counterclockwise rotation of the mesenterium.
      The necrotic portion of the small intestine was removed, while 10 cm of the upper
      jejunum and 100 cm of the terminal ileum were preserved. His second postoperative
      course was uneventful apart from the development of "intestinal hurry," which is
      now under medical control 9 months after his second laparotomy.

PMID- 7780231
TI  - Pediatric spigelian hernia: reports of three cases.
AB  - We herein report three pediatric cases of spigelian hernia involving a 6-month
      old girl, an 8-month-old girl, and a 3-year-old boy. This is a rare condition
      with only 20 children (12 boys and 8 girls) younger than 15 years of age
      previously reported in the literature. Their ages ranged from 6 days to 15 years.
      The hernia was situated on the right side in six cases, on the left side in nine,
      and was bilateral in four (with one case unreported). Among these, four cases
      were caused by trauma and one case by a postoperative complication. Our first and
      third cases were spontaneous, while the second case was a postoperative lateral
      ventral hernia. The first and second cases were associated with ipsilateral
      mediastinal neuroblastoma. No previous report of spigelian hernia has been
      associated with mediastinal neuroblastoma. We suspected that muscle atrophy
      caused by the neuropathy of the ninth to twelfth intercostal nerves may have been
      the cause of the hernia. These two cases are thus believed to be the first such
      cases to be reported.

PMID- 7780233
TI  - Multiple pulmonary hamartomas: report of a case.
AB  - Among lung tumors, multiple hamartomas are uncommon while multiple chondromatous
      hamartomas are extremely rare, with only 12 cases having been previously
      reported. A case of multiple pulmonary chondromatous hamartomas in a 58-year-old
      Japanese man who has been followed up for 28 years is herein presented.

PMID- 7780232
TI  - Gastrocolic fistula originating from transverse colon cancer: report of a case
      and review of the Japanese literature.
AB  - A 72-year-old woman was admitted to our hospital complaining of loss of weight,
      general fatigue, and upper abdominal pain. Barium studies suggested that a
      fistula was present between the proximal transverse colon and the stomach which
      originated from a carcinoma of the colon. A plain computed tomography (CT) scan
      confirmed the presence of a gastrocolic fistula. A two-thirds distal gastrectomy
      and right hemicolectomy with a resection of a bulky tumor in the mesocolon were
      performed en bloc. Histological examination revealed a well-differentiated
      adenocarcinoma of the transverse colon which was involved with the wall of the
      stomach. We were able to obtain information on 14 previous cases of gastrocolic
      fistula originating from transverse colon cancer in the Japanese literature,
      including the present case. The most common symptom was abdominal pain (64%). A
      preoperative diagnosis of fistula was confirmed in 10 of the 11 cases examined by
      barium studies. A plain CT and a CT scan after the barium studies may also be
      helpful in detecting fistula formation. A fistula between the carcinoma of the
      middle or distal transverse colon and the stomach was found in 13 of 14 cases,
      but not in our case. Only one case lived longer than 9 years, even though a
      surgical resection was possible in 9 of 11 cases.

PMID- 7780234
TI  - Isolated dissecting aneurysm of the common iliac artery: report of a case.
AB  - Isolated dissecting aneurysms of the peripheral arteries which are not
      accompanied by a dissecting aneurysm of the aorta are rarely observed. We report
      herein the unusual case of a 54-year-old man in whom an isolated common iliac
      aneurysm was found to be caused by isolated dissecting aneurysms of the left
      common iliac artery.

PMID- 7780235
TI  - Clostridial gas gangrene associated with congenital generalized lipodystrophy:
      report of a case.
AB  - Congenital generalized lipodystrophy (CGL) is a rare disease, the main symptoms
      of which are a reduction of systemic subcutaneous fat, characteristic facial
      features, hypertrichosis, and insulin-resistant diabetes. We report herein the
      unusual case of a 25-year-old man with CGL in whom gas gangrene developed, an
      association which has never before been encountered.

PMID- 7780236
TI  - Anal metastasis from carcinoma of the lung: report of a case.
AB  - We report herein the case of a 75-year-old man who developed anal canal
      metastasis from squamous cell carcinoma of the lung. Initially, he underwent a
      right middle and lower lobectomy combined with left atrial wall resection under
      cardiopulmonary bypass. He presented 3 months later with an anal polyp which had
      prolapsed and bled, for which he underwent a transanal polypectomy.
      Histologically, the polyp was classified as squamous cell carcinoma and
      considered to be a metastasis from the primary lung cancer. He is presently well
      with no signs of recurrence 9 months after his initial operation. To our
      knowledge, there has been no other case of anal metastasis from lung cancer ever
      reported.

PMID- 7780237
TI  - Obstructive jaundice caused by a cholesterol polyp of the gallbladder: report of
      a case.
AB  - We present herein the case of a 34-year-old man in whom obstructive jaundice was
      found to be caused by an impacted detached cholesterol polyp. A cholecystectomy
      with exploration of the common bile duct was performed after ultrasonography
      showed cholesterol polyps and stones in the gallbladder. Intraoperative
      cholangioscopy demonstrated an impacted cholesterol polyp at the distal end of
      the common bile duct which appeared to be detached from the gallbladder. To our
      knowledge, this is the first report of an impacted detached cholesterol polyp
      causing obstructive jaundice.

PMID- 7780238
TI  - Distal arterial reconstruction using Esmarch's bandage technique to salvage upper
      extremity function in thoracic outlet syndrome caused by cervical ribs: a report
      of two cases.
AB  - We present herein the cases of two patients with thoracic outlet syndrome (TOS)
      who required arterial reconstruction due to gangrene of the fingers and/or hand.
      In both patients, the cervical ribs had produced intimal injury of the subclavian
      arteries, and the successive distal arterial embolism brought about severe
      ischemia of the affected upper extremity. To treat the TOS, the cervical ribs
      were resected through a supraclavicular incision. In the first patient, arterial
      reconstruction was performed from the subclavian artery to the radial collateral
      artery, a branch of the deep brachial artery, which resulted in minimizing
      amputation of the gangrenous hand. In the second patient, resection and direct
      anastomosis of the injured subclavian artery were performed, and bypass surgery
      from a brachial artery to an interosseous artery was carried out, preserving
      finger function. Reversed saphenous vein grafts were utilized and Esmarch's
      bandage technique was applied as a substitute for a vascular clamp in both
      patients. Following these case reports, we discuss the technique of performing
      distal bypass in the upper extremities and comment on the usefulness of Esmarch's
      bandage technique for preserving upper extremity function.

PMID- 7780239
TI  - Idiopathic portal hypertension in renal transplant recipients: report of two
      cases.
AB  - We present herein the cases of two patients who developed idiopathic portal
      hypertension (IPH) following renal transplantation. Both patients had been
      treated with azathioprine and prednisolone for 6 years and 4 months and for 4
      years and 7 months, respectively, and presented with splenomegaly and
      thrombocytopenia suggesting hypersplenism. Celiac angiography showed a dilated
      splenic artery and vein in both patients. When the splenic artery was obliterated
      with a balloon catheter in case 1, the portal venous pressure decreased from 51
      cmH2O to 36 cmH2O, and the direction of the superiomesenteric venous blood flow
      became hepatopetal rather than hepatofugal. These results suggested that the
      spleen might have played an important role in the development of IPH in these two
      patients. A splenectomy was therefore performed, immediately following which the
      portal venous pressure decreased remarkably, and the esophageal varices
      disappeared during the postoperative follow-up period. Microscopic examination of
      liver biopsies taken at the operation revealed lymphoplasmacytic infiltration
      with bile duct hyperplasia but no evidence of periportal fibrosis, and electron
      microscopy demonstrated very mild perisinusoidal fibrosis. Thus, the histological
      changes seen in the livers of these patients seemed not to have caused the portal
      hypertension. In conclusion, although few patients develop IPH after renal
      transplantation, we should be aware of its possibility and consider splenectomy
      as the treatment of choice.

PMID- 7780241
TI  - Interleukin-1 receptor antagonist in the fetomaternal compartment.
AB  - Interleukin-1 (IL-1) is a major mediator in infections and inflammation.
      Interleukin-1 receptor antagonist (IL-1ra) opposes the actions of IL-1. IL-1ra is
      present in exceptionally high concentrations in third trimester amniotic fluid.
      We studied IL-1ra in amniotic fluid, fetal serum and newborn urine. The
      concentrations of IL-1ra in amniotic fluid at mid-trimester and at 25-41
      gestational weeks were 6.6 +/- 0.5 ng/ml (n = 30) and 100 +/- 4 ng/ml (n = 202),
      respectively. At mid-trimester, amniotic fluid IL-1ra was not dependent on fetal
      gender, whereas during the third trimester IL-1ra was higher in female- than in
      male-bearing gestations. Urine of normal term newborns during the first day of
      life contained a very high concentration of IL-1ra (125 +/- 16 ng/ml, n = 50).
      Urinary concentration in female newborns was significantly higher than that in
      male newborns (202 +/- 19 ng/ml, n = 25 versus 49 +/- 14 ng/ml, n = 25). IL-1ra
      concentration in fetal serum at 22-36 gestational weeks was 0.50 +/- 0.07 ng/ml
      (n = 31) and at term 1.5 +/- 0.3 ng/ml (n = 17). Serum concentrations were not
      gender-dependent. The gender differences in IL-1ra concentrations may in part
      explain the lower susceptibility of female fetuses to infection.

PMID- 7780242
TI  - Breast milk beta-glucuronidase and prolonged jaundice in the neonate.
AB  - Breast milk samples from mothers of breast-fed, healthy, term newborns with
      unexplained prolonged jaundice were analyzed for beta-glucuronidase activity.
      Mean enzyme activity was 75.7 +/- 34.5 modified Sigma units/ml in the breast milk
      samples ingested by the study group of jaundiced babies (n = 25) and 82.2 +/-
      40.1 modified Sigma units/ml in the samples ingested by the control group of non
      jaundiced babies (n = 20) (p > 0.05). Enzyme activities at 2, 3 and 4 postnatal
      weeks were 101.0 +/- 39.9, 66.0 +/- 20.7 and 57.0 +/- 22.4 modified Sigma
      units/ml in the study group and 87.9 +/- 36.1, 58.5 +/- 15.0 and 88.3 +/- 49.1
      modified Sigma units/ml in the controls. The differences were not statistically
      significant (p > 0.05). We conclude that breast milk beta-glucuronidase activity
      may be a contributory factor, in the presence of other variables, in
      hyperbilirubinemia but it is neither the main nor the only cause of prolonged
      jaundice in neonates.

PMID- 7780243
TI  - Fecal cholesterol excretion in preterm infants fed breast milk or formula with
      different cholesterol contents.
AB  - In 44 very low-birth-weight infants, fecal cholesterol excretion was measured and
      in 29 other infants serum total cholesterol concentrations in response to
      different cholesterol intakes were studied. The infants received fortified breast
      milk (mean cholesterol content 15.3 mg/dl) or were fed either a standard preterm
      formula (cholesterol content 5.5 mg/dl) or the same formula but with a modified
      lipid composition (long chain polyunsaturated fatty acid concentration closely
      related to breast milk fat) and 30 mg of cholesterol/dl. In the group fed the
      high cholesterol formula, fecal cholesterol excretion was significantly higher
      (35.5 mmol/kg/day) than in the groups fed breast milk or the standard formula
      (20.1 and 18.2 mmol/kg/day). Cholesterol balance in the group fed the high
      cholesterol formula (21.8 mg/kg/day) was significantly higher than in the group
      fed breast milk (+8.6 mg/kg/day). In the infants fed the low cholesterol formula
      the balance was negative (-7.7 mg/kg/day). Serum concentrations of total
      cholesterol were similar in the groups fed breast milk or the high cholesterol
      formula (3.47 and 3.51 mmol/l), but significantly higher than in the group fed
      the low cholesterol formula (3.15 mmol/l). The data suggest that preterm infants
      are able to regulate a higher cholesterol intake than during breast feeding by
      increasing fecal cholesterol excretion as well as decreasing endogenous
      synthesis.

PMID- 7780240
TI  - Quadruple cancer including Bowen's disease after arsenic injections 40 years
      earlier: report of a case.
AB  - This report describes the successful treatment of quadruple cancer including
      Bowen's disease in a 71-year-old man who had been given injections of salvarsan,
      an arsenic compound, for syphilis more than 40 years earlier. Resection of a skin
      lesion on his chest subsequently confirmed a diagnosis of Bowen's disease, 3
      years after which he was operated on for concurrent gastric cancer and sigmoid
      colon cancer. A fourth cancer was discovered on his left vocal cord 2 weeks after
      this operation; it was resected 2 years later. A discussion of multiple malignant
      neoplasms and the possible relationship between arsenic and cancer is presented
      following this case report.

PMID- 7780244
TI  - Developmental maturation of gastro-oesophageal reflux in preterm infants.
AB  - The frequency and duration of gastro-oesophageal reflux were examined in 40
      preterm infants and compared with a previously published healthy cohort of 74
      term infants. Selection required that the infants were born between 24 and 32
      weeks' gestation, had a normal head ultrasound and were studied at term post
      menstrual age. Multi-channel pen recordings of sleep state, movement, breathing
      and acid reflux were made. In term and preterm infants the frequency and duration
      of reflux were greatest in active sleep, rare in quiet sleep and significantly
      less in preterm than term infants in wakefulness and active sleep (p < 0.05). The
      fewer and shorter episodes in preterm infants could not be explained by sleep
      state movement, gestational or postnatal age, days intubated, days on oxygen or
      the lowest pH of reflux episodes.

PMID- 7780245
TI  - Neonatal herpes simplex: clinical findings and outcome in relation to type of
      maternal infection.
AB  - In 39 mothers of children with neonatal herpes simplex virus infection, maternal
      infection was serologically characterized retrospectively and was related to
      maternal clinical symptoms and to the clinical findings and outcome in the child.
      Thirteen mothers had a primary infection (six type 1, seven type 2), mostly with
      clinical symptoms. The mean age of onset of the disease of the infants was 7 days
      and a disseminated disease was most commonly found. Most of the type 1-infected
      children recovered completely, whereas all but one of the type 2-infected
      children died. Twenty mothers had a recurrent (2 type 1, 18 type 2) and 4 an
      intermediate infection (primary type 2, prior infection with type 1), mostly
      asymptomatic. Their children had a localized disease (of the skin-eye-mouth or
      the central nervous system) with onset at a mean age of 14 or 13 days,
      respectively. The frequency of neurological sequelae was high. Two mothers had no
      serological signs of herpes infection.

PMID- 7780247
TI  - Severe mental retardation in 2 to 24-month-old children in Lahore, Pakistan: a
      prospective cohort study.
AB  - Severe mental retardation (developmental quotient (DQ) < 50) was investigated in
      1303 children from 2 to 24 months of age, born during 1984-87 in four population
      groups representing different socio-economic levels in and around Lahore,
      Pakistan. The incidence per 1000 live births was 22 in the periurban slum, 9 in
      the urban slum, 7 in the village and 4 in the upper middle class group. The
      aetiology was prenatal in 79%, perinatal in 14% and untraceable in 7% of cases.
      Down's syndrome was the most common cause of severe mental retardation (36%).
      Impairments were studied at 2 years of age. Impairment of language was present in
      all, while locomotor dysfunction was seen in 89% of cases. Epilepsy and cerebral
      palsy were each present in 22% of cases. Mortality among these severely mentally
      retarded children was 36%.

PMID- 7780248
TI  - A nutrition study in juvenile elite gymnasts.
AB  - Twenty-two female teenagers engaged in elite gymnast training and 22 healthy
      girls of comparable age were studied with regard to nutritional intake. The mean
      daily intakes of most nutrients in both groups were in accordance with the
      Swedish Nutritional Recommendations; exceptions were iron and dietary fibre which
      were too low in both groups. The individual variation was large in both groups
      and many subjects had an intake below the nutritional recommendations. Both the
      gymnasts and the reference group had an energy intake significantly below the
      estimated energy need. The mean daily energy intake was 725 kcal less than the
      energy need in the gymnast group and 450 kcal less in the reference group. The
      clinical investigation revealed that several gymnasts had delayed menarche or
      irregular menstruation as well as less body fat than the reference group. Among
      the gymnasts, girls with a regular menstrual pattern had more body fat than those
      who had not started to menstruate. The higher energy expenditure of the gymnasts
      could partly explain their smaller amounts of body fat, late pubertal development
      and menstrual patterns.

PMID- 7780246
TI  - A population-based study on the causes of mild and severe mental retardation.
AB  - The causes of mental retardation (MR) were studied as part of a multidisciplinary
      epidemiological case-control study in 151 mentally retarded patients identified
      by screening four age cohorts (12,882 children) at 8-9 years of age in the
      province of Kuopio, Finland. The causes of MR in 77 severely retarded (SD < or = 
      3 SD) and 74 mildly retarded (-2 > SD > -3) children were divided into pre-, peri
      , postnatal and unknown groups according to the probable time of onset. The
      causes were pre-, peri-, postnatal and unknown in 60%, 9%, 8% and 23%, and 22%,
      1%, 3% and 74%, in the two populations, respectively. Genetic causes were found
      in 28% of all 151 cases; the three most common subgroups were trisomy 21, fragile
      X syndrome and aspartylglycosaminuria (13%, 4% and 2% respectively). The study
      design used provided reliable information on the causes of MR and also
      demonstrated those forms of genetic metabolic diseases typical of Finnish
      inheritance.

PMID- 7780249
TI  - Normative developmental behavior with implications for health and health
      promotion among adolescents: a Swedish cross-sectional survey.
AB  - I describe behavior with impact on health in adolescents against the background
      of characteristics of the Swedish society and analyse possible areas for
      improvement. A total of 4500 adolescents, aged 13-18 yr, in seven areas answered
      an anonymous questionnaire. Their socioeconomic backgrounds reflected mainstream
      adolescents. The response rate was 80-85%. Questions concerned health habits,
      exploratory behaviors regarding sexuality, use of alcohol and tobacco, problem
      behaviors, such as getting drunk, and life quality. There was very little
      experimentation with regard to health habits learned in childhood. Rapid
      adaptation to adult life-styles occurred, which was similar in both sexes in the
      younger age groups, but there were significant differences among older students.
      Alcohol use is of considerable concern. Adolescent prediction of future behavior
      indicated that negative behaviors require intervention. Parental influence on
      adolescent behavior needs to be explored. Peer groups could be an additional area
      for intervention.

PMID- 7780250
TI  - Hypotonic oral rehydration solution in acute diarrhoea: a controlled clinical
      trial.
AB  - In a controlled trial, a hypotonic oral rehydration solution (ORS) (Na+67, K+20,
      Cl-66, citrate 7, glucose 89 mmol/l osmolality 249 mosmol/kg) was compared with a
      standard WHO-ORS (Na+90, K+20, Cl-80, citrate 10, glucose 111 mmol/l, osmolality
      311 mosmol/kg) in 60 children aged 5-24 months with acute watery diarrhoea. In
      the hypotonic ORS group, stool frequency, proportion of children who vomited, ORS
      requirements and purging rate over 24-48 h were reduced by 33% (p = 0.01), 30% (p
      = 0.02), 21% (p = 0.067) and 21% (p = 0.03), respectively. The proportion of
      children who vomited and the purging rate over 48 h were reduced by 23% (p =
      0.03) and 10% (p = 0.097), respectively. Serum electrolytes after 48 h were
      comparable. The beneficial effect of hypotonic ORS was most marked in, and
      largely contributed by, the subgroup negative for rotavirus.

PMID- 7780251
TI  - Anti-endomysium and anti-gliadin antibodies as serological markers for coeliac
      disease in childhood: a clinical study to develop a practical routine.
AB  - Anti-gliadin and anti-endomysium antibodies were analyzed in 174 children with
      suspected or verified coeliac disease with the aim of developing a practical
      routine. The biopsy was performed without knowledge of the antibody levels. To
      screen for coeliac disease is children younger than 2 years, we suggest the use
      of IgA anti-gliadin antibodies, giving a sensitivity of 100% and a specificity of
      86%. In older children both tests should be used in parallel, i.e. a biopsy
      should be performed if at least one of the tests is positive, giving a
      sensitivity of 98% and a specificity of 81%. To avoid unnecessary biopsy before
      mucosal relapse can be demonstrated during gluten challenge in a child without
      clinical symptoms, we suggest that the tests are used as serial testing, i.e. a
      biopsy should be performed if both tests are positive.

PMID- 7780252
TI  - Effect of combined treatment with gonadotropin releasing hormone analogue and
      growth hormone in patients with central precocious puberty who had subnormal
      growth velocity and impaired height prognosis.
AB  - Growth hormone-insulin-like growth factor-I status and response to growth hormone
      therapy (0.6 IU/kg/week sc, six times a week for 12 months) were evaluated in 12
      girls (chronological age 9.4 +/- 1.6 years) suffering from central precocious
      puberty with growth velocity less than 4 cm/year and no substantial increase or
      decrease in predicted adult height during gonadotropin releasing hormone Bn-RH)
      analogue treatment (D-Trp6-LH-RH, 60 micrograms/kg im/28 days). At baseline,
      large variations were observed in nocturnal growth hormone (GH) means
      (pathological values stimulated levodopa GH peaks (pathological values (< 10.0
      micrograms/l) 28.6%) and serum insulin-like growth factor-I (IGF-I) levels.
      Neither GH-nor IGF-I levels were correlated with growth velocity. During
      recombinant GH therapy, growth velocity increased significantly (baseline 3.0 +/-
      0.9 cm/year; 6 months 6.4 +/- 1.9 cm/year, p < 0.001 versus baseline; 12 months
      6.0 +/- 1.3 cm/year, p < 0.0001 versus baseline). There was a significant
      increase in height SDS for bone age (baseline -1.6 +/- 0.5 SDS; 12 months -1.04
      +/- 0.6 SDS; p < 0.002) and in predicted adult height (baseline 152.0 +/- 3.6 cm;
      12 months 155.9 +/- 3.4 cm; p < 0.002). Our results suggest that combined therapy
      with Gn-RH analogues and recombinant GH can improve growth velocity and predicted
      adult height in girls with central precocious puberty and impaired height
      prognosis during Gn-RH analogue treatment.

PMID- 7780253
TI  - Acute asthma, salbutamol and hyperglycaemia.
AB  - The effects of frequent high-dose nebulized salbutamol on plasma glucose
      concentrations were studied in 12 children (mean age 60 months) with acute severe
      asthma. There was a significant difference between mean initial glucose levels
      and peak levels. We conclude that hyperglycaemia can be produced in children as a
      result of nebulized salbutamol.

PMID- 7780254
TI  - Spinal posture during pubertal growth.
AB  - A cohort of children was followed-up annually from a mean age of 10.8-13.8 years
      to determine the development of their posture. Of the sample of 1060 children,
      847 (79.9%) participated in the final examination. Thoracic kyphosis and lumbar
      lordosis were measured annually with a spinal pantograph. Those children whose
      thoracic kyphosis in pantography was more than 35 degrees at entry and 45 degrees
      or more at the final examination underwent a lateral standing radiograph. The 3
      year incidence of Scheurermann's disease was 0.4%. The mean thoracic kyphosis
      increased and the mean lumbar lordosis decreased with age in both sexes, but
      these changes were not constant. Thoracic kyphosis was most pronounced at a mean
      age of 12.8 years and lumbar lordosis was least pronounced at a mean age of 13.8
      years. In accordance with the literature, the wide individual variation found in
      this study for both thoracic kyphosis and lumbar lordosis during the pubertal
      growth period was mainly physiologic.

PMID- 7780256
TI  - Trends in survival after childhood cancer in Denmark, 1943-87: a population-based
      study.
AB  - Survival from cancer in childhood and adolescence was studied in a population
      based series of 8312 cases in children aged 0-19 years notified to the Danish
      Cancer Registry during 1943-87. During the first period (1943-72), 5-year
      survival rates from all malignant neoplasms increased from 23% (1943-52) to 33%
      (1963-72). The greatest improvement was seen during the period 1973-87 when 5
      year survival rates reached 64% (1983-87). Between 1973-77 and 1983-87, 5-year
      survival rates increased from 32% to 62% for leukaemia, from 40% to 70% for acute
      lymphoblastic leukaemia, from 35% to 54% for non-Hodgkin's lymphoma, from 50% to
      66% for central nervous system neoplasms and from 25% to 49% for bone tumours. An
      improvement in 5-year survival rates from Wilms' tumour was seen between 1960
      (19%) and 1980 (81%). Up to 1972, the 5-year survival rate from germ-cell
      neoplasms was approximately 40%; among patients diagnosed in 1983-87, 76%
      survived for 5-years. Annual lethality decreased by 2.5% for all malignant
      neoplasms in 1943-72 and by 4.4% in 1972-87. Lethality was similar for boys and
      girls during the period 1943-72, but was significantly lower for girls
      subsequently. A marked effect of age at diagnosis was seen in the early
      registration period, where lethality rate for the age group 0-9 years was
      substantially higher compared with that in the age group 10-19 years. This
      inequality persisted only for children less than 2 years of age at the time of
      diagnosis in the later period.

PMID- 7780255
TI  - Study of lumbar spine bone mineral density in obese children.
AB  - Bone mineral density (BMD) was studied in 59 obese children (mean (+/- SD) age
      11.8 +/- 2.7 years) at the start of dietary treatment and compared with a control
      group, matched for sex, age and body height. Determinations of BMD were made at
      the level of the lumbar spine (L2-4) by a commercial dual photon absorptiometer
      (Novolab 22A). Mean (+/- SD) BMD of the obese children (0.68 +/- 0.12 g hydroxy
      appetite/cm2 (gHA/cm2)) was similar to that of the control group (0.70 +/- 0.16
      gHA/cm2). As in normal children, BMD of obese children was highly correlated with
      age (r = 0.70), body height (r = 0.65) and body weight (r = 0.55). The highest
      values for BMD were found in obese adolescents with the most advanced pubertal
      status. No sex difference in BMD was seen in the obese children when pubertal
      stage was taken into account. Lumbar spine BMD corrected for age, was not related
      to the degree or duration of obesity. No influence of physical activity on spinal
      mineralization could be demonstrated in the obese group. In conclusion, obese
      children present with normal lumbar spine BMD.

PMID- 7780257
TI  - Total body irradiation: a neuropsychological risk factor in pediatric bone marrow
      transplant recipients.
AB  - Bone marrow transplantation (BMT) involves conditioning with cyclophosphamide
      and, for leukemic patients, total body irradiation (TBI). Based on the concern
      that this may lead to later neuropsychologic impairment in children, a
      longitudinal study was conducted. Thirty pediatric bone marrow transplant
      recipients, treated for leukemia or severe aplastic anemia (SAA), and their
      sibling donors, were given a neuropsychological examination in 1986 and 1988. A
      third follow-up study of patients treated before 12 years of age was undertaken
      in 1990-91. We present longitudinal data on patients treated with BMT when 3-11
      (n = 15) and 12-17 (n = 11) years old. No neuropsychological deficits were found
      in the older group, or among non-irradiated SAA patients. In the first follow-up,
      children treated with BMT, including TBI at 3-11 years of age, performed less
      well than donors on tasks involving perceptual and fine-motor speed. In the
      second follow-up, this group of patients also demonstrated a slight deficit in
      non-verbal problem solving. An additional relative decline in verbal reasoning
      was noted in the third follow-up, 5.5-10 years after treatment. Alertness to
      signs of developmental difficulties in children treated with BMT, including TBI,
      is recommended.

PMID- 7780258
TI  - Automatic needle insertion diminishes pain during growth hormone injection.
AB  - Non-compliance in children receiving growth hormone (GH) treatment is often
      caused by pain on injection and difficulties in administration of GH. It has been
      suggested that automatic needle insertion diminishes pain perception. We
      quantitatively measured pain intensity on injection with two prototype pens for
      GH administration, providing either manual or automatic sc needle insertion,
      using a combined visual analogue/facial scale and a five-item scale in 18
      children. With the automatic pen there was a significantly lower maximum pain
      score compared with the manual pen (median 28.5 versus 52.0 mm) as well as a
      lower mean pain score (mean 13.7 versus 23.5 mm). The five-item scale revealed
      that automatic needle insertion was significantly less painful than manual
      insertion and 13 patients chose to continue treatment with the automatic pen. In
      conclusion, pain during GH injection can be significantly diminished by automatic
      needle insertion, which may improve compliance in long-term GH treatment.

PMID- 7780259
TI  - Detection of resistance to thyroid hormone by cord blood screening.

PMID- 7780260
TI  - The presenting features of mucopolysaccharidosis type IH (Hurler syndrome).
AB  - The presenting features of 39 patients with mucopolysaccharidosis (MPS) type IH
      are described. The mean age at diagnosis was approximately 9 months and it is
      difficult to see how this can be reduced without consideration of newborn
      screening. An earlier age at diagnosis is likely to lead to better results
      following therapy such as bone marrow transplantation. Clinical features which
      should arouse suspicion of MPS IH include frequent ENT surgery and recurrent
      herniae. Clinical vigilance is needed for early diagnosis.

PMID- 7780261
TI  - Ganciclovir therapy of congenital human cytomegalovirus hepatitis.

PMID- 7780262
TI  - Recrudescence and relapse of meningococcal meningitis and septicaemia.
AB  - Three cases of recrudescence and relapse of Neisseria meningitidis group B
      meningitis and septicaemia are reported. The recrudescence and relapses could not
      be explained by infectious foci, increased bacterial penicillin resistance or
      immunological defects. As a supplement to antibiotic treatment, all three
      patients received corticosteroids for the initial 2 days of treatment, and this
      may have contributed to the unusual course of the disease in our patient.

PMID- 7780263
TI  - Persistent non-familial asymptomatic hyperphosphatasemia: a report on three
      cases.
AB  - Three male children, aged 9 days, 2 years and 13 years, were found to have
      elevated serum alkaline phosphatase (ALP) activity (hyperphosphatasemia) in the
      absence of disease. In these three cases, elevation of ALP activity had persisted
      for 6-10 years. These patients did not inherit the disease from their parents.
      Isoenzyme determination revealed a skeletal origin of the elevated ALP in the
      three patients. They were diagnosed as having persistent non-familial
      asymptomatic hyperphosphatasemia (PNAH) which differs from transient and
      persistent asymptomatic familial hyperphosphatasemia. Reviewing the literature,
      although the term PNAH had not been used, two similar cases have been reported in
      a 24-year-old female and in a 27-year-old female. PNAH may be another type of
      benign hyperphosphatasemia.

PMID- 7780264
TI  - Congenital misalignment of pulmonary vessels: an unusual syndrome associated with
      PPHN.
AB  - We report a case of misalignment of pulmonary vessels and review the clinical
      features of all 13 cases reported to date. All were term infants dying from
      severe persistent pulmonary hypertension of the newborn. We have identified a
      triad of features that will alert neonatal clinicians to the possibility of this
      diagnosis: association with other non-lethal congenital malformations; delayed
      onset of presentation (especially after 12h); and severe hypoxaemia refractory to
      conventional therapy. We recommend that any autopsy on newborn infants include a
      specific search for misalignment of pulmonary vessels to outline the
      pathophysiology and clinical significance of this disorder.

PMID- 7780265
TI  - Why must Indian diabetic children continue to have retarded growth?

PMID- 7780266
TI  - Plasma exchange in childhood Guillain-Barre syndrome.

PMID- 7780268
TI  - [Psychometric function of stereo disparity in normal persons].
AB  - The accuracy and efficiency of threshold estimation depend on a priori knowledge
      of the shape of the psychometric function. Such knowledge is available for
      contrast detection and visual acuity, but not for disparity detection. METHODS:
      We studied the psychometric function for disparity detection in 26 visually
      normal, untrained observers by measuring detection rates over a wide range of
      disparities. In a two-alternative forced-choice (2AFC) task the subject had to
      decide whether the right or left of two vertical bars, differing in depth, was
      closer to them. An S-shaped Weibull function was fitted to each subjects's data
      using the maximum-likelihood procedure. RESULTS: In 21 of the 26 subjects the
      psychometric function rose with increasing disparities up to a level of about
      100%. Five of the 26 subjects only reached hit rates clearly below 100% (66% to
      82%), even at disparities well above the threshold. The mean slpe of the S-shaped
      psychometric function of disparity detection was much lower (1.2 Weibull units)
      than that known for visual acuity and contrast detection (about 3.0 Weibull
      units). The slope differed widely among subjects, but was not related to stereo
      acuity. CONCLUSION: For accurate and efficient estimation of stereo acuity, the
      shallow slope of the psychometric function requires more than 100 single trials
      around the threshold if a 2AFC procedure is used. In addition, several
      disparities well above the threshold must be presented in order to detect
      subjects who do not reach a hit rate of 100% at any disparity. Otherwise, stereo
      acuity would be underestimated in these subjects.

PMID- 7780267
TI  - [Experimental studies of locally generated focal VECP within the 30 degree visual
      field with LED].
AB  - Measuring and evaluating locally generated VECP present a chance to overcome
      methodical restriction in conventional subjective perimetry. To achieve this,
      stimuli are required which ensure the generation of detectable responses under
      controlled scattered light influence. The suitability of LED for this task was
      studied. LED stimuli (lambda = 560 nm) were moved in steps of 3 degrees from 0
      degree to 30 degrees on the horizontal meridian within a perimeter sphere. The
      stimuli were 0.8 degree and 1.7 degrees in size, 20 ms in duration and 0.5 Hz in
      frequency. The background illumination was 10 cd/m2. A total 467 responses
      recorded from 20 volunteers (age 26 +/- 2) known to be free of any visual field
      defect have been evaluated. Using only one LED (size 0.8 degree) VECPs are
      detectable in the visual field < 9 degrees exclusively. An increase of stimuli
      size to 1.7 degrees made the generation of detectable VECP within the peripheral
      visual field possible. Statistical evaluation (sign test) proved significantly
      that VECP can be reliably elicited under LED stimulation. LED (lambda = 560 nm)
      are suitable for the generation of localized VECP in the visual field up to an
      eccentricity of 30 degrees.

PMID- 7780270
TI  - [Aniseikonia reduces binocular summation in the VECP].
AB  - The binocular summation effect of human VECP (increase in amplitude from about
      4.0 microV to about 5.4 microV) was proved and optimized in 32 subjects. Stimulus
      parameters: TV steady-state pattern reversal (7.0 Hz); pattern size 1 degree;
      stimulus contrast 5% (higher stimulus contrasts reduced considerably the
      selectivity of the binocular summation effect); 96 sweeps averaging (Nicolet
      Compaq Four); position of electrodes: 10% and 30% above Protuberantia occipitalis
      externa of nasioninion distance. Aniseikonia of 7 to 52% was generated by means
      of small Galilei telescopes. Because of comparatively large interindividual
      variance within the series of subjects, no decrease in binocular VECP amplitude
      could be demonstrated at an aniseikonia less than 52%. On one woman subject, a
      significant reduction in amplitude (5% level) at 14%, 26% and 52% aniseikonia was
      apparent, but not at 7%. Thus, for this subject, it was possible to correlate the
      results with the clinically known limits of toleration for aniseikonia. This
      result was confirmed by more than 60% of the subjects in the test group.

PMID- 7780269
TI  - [Photo- and videographic determination of the dilatation deficit in differential
      diagnosis of Horner syndrome].
AB  - Physiological anisocoria, a very frequent condition among normal subjects, must
      be differentiated from Horner's syndrome. Aside from a history including
      evaluation of older photographs, pharmacological pupil testing with cocaine eye
      drops has been the "gold standard". Measurement of dilation lag, occurring in
      Horner's syndrome, is much less common and normal values are missing. Therefore,
      we evaluated various photographic parameters for testing for the best parameter
      to discriminate Horner's syndrome (22 patients) from physiological anisocoria (16
      patients). Additionally, we tested whether a commercially available camcorder is
      sufficient to record pupillary dilatation lag. An anisocoria of 0.6 mm or more 4s
      after switching off the illumination discriminates physiological anisocoria from
      Horner's syndrome with a sensitivity of 82% and a specificity of 69%. A
      dilatation speed of 1.1 mm/4 s shows the same ability to differentiate in
      anisocoria and does not provide any better results. Because of the good
      correlation between post-cocaine anisocoria and anisocoria after 4 s in darkness,
      photographic or videographic measurements of the pupillary dilatation lag may
      complete or in some cases even replace cocaine testing.

PMID- 7780272
TI  - [Effect of induced hyperglycemia on contrast sensitivity function in insulin
      dependent diabetic patients].
AB  - Acute hyperglycemia in diabetes mellitus is often associated with transient
      subjective visual disturbances that have not yet been objectively evaluated. We
      used a contrast sensitivity (CS) test to assess functional visual disturbances in
      provoked hyperglycemia in 20 patients with well-controlled insulin-dependent
      diabetes (40 eyes) with no evidence of diabetic retinopathy and with intact
      visual acuity (age: 32 +/- 8.2 years, duration of diabetes: 11.4 +/- 7.3 years).
      The CS function was measured by using the CSV-1000 CS test, which is rapid and
      easily comprehended by the patient and encompasses four spatial frequencies, 3
      (A), 6 (B), 12 (C) and 18 (D) cycles/degree. At each frequency, eight pairs of
      circular targets differing stepwise in contrast were presented simultaneously.
      The number of targets seen by each patient in the four spatial frequencies at
      euglycemic (116 +/- 14.7 mg/dl) and hyperglycemic (274 +/- 52 mg/dl) levels,
      expressed as the CS score, was recorded and afterwards analyzed. The differences
      in mean CS scores at the individual frequencies at euglycemic versus
      hyperglycemic levels were statistically significant (p < 0.001). Visual acuity
      remained stable during hyperglycemia. There was no significant difference in the
      amount of CS reduction between the group of patients that had had diabetes for a
      duration of more than 10 years and the group who had had diabetes for less than
      10 years.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780271
TI  - [Contrast sensitivity of visually handicapped patients].
AB  - The contrast sensitivity of 41 patients with low visual acuity, as a result of
      age-related maculopathy, diabetic retinopathy or open-angle glaucoma, in most of
      them, was studied by means of the VISTECH test and the Buser LCS-test. The
      VISTECH test revealed reduced contrast sensitivity, especially at high
      frequencies. This reduction was marked in patients with diabetic retinopathy.
      Contrast on the color TV monitor was adjusted by the subjects. Yellow and green
      monitors were chosen equally often by the patients. A positive contrast (black
      text with light background) was preferred. The contrast required was noticeably
      higher than that required by subjects with normal eyes.

PMID- 7780273
TI  - [Glare adaptation for inhomogeneous glare distribution with respect to the
      dynamic components of the vision task].
AB  - Basic investigations in the field of adaptation luminance were carried out using
      Holladay's visual threshold criterion. The connection between adaptation
      luminance LA, illumination at the spot in the eye EB1 and the angle of glare
      theta is LA = 9.2 x EB1 x theta -2 LA in cd/m2, Eb1 in 1x, theta in degrees. In
      most cases the investigations of adaptation luminance were also carried out under
      conditions of fixed view and static visual tasks. It is however, important to
      take into account the dynamic visual task and the adaptation process by
      determining the adaptation luminance, but very few measurements have been carried
      out under these conditions. For the results represented here the visual threshold
      was replaced by the readaptation time necessary for perception of movement
      direction of a striped pattern (dynamic) and with the idea of also comparing the
      perception of the slot location in a ring in the Landolt rings (static). The
      method of investigations was as follows: The subject adapts to the inhomogeneous
      field of luminance for which the adaptation luminance must be determined. Then in
      a dark surrounding field for comparison, the visual task is offered, and the
      readaptation time necessary for the fulfillment of the visual task is measured.
      This procedure is repeated with a homogeneous field of luminance. The luminance
      of a homogeneous field is equal to the adaptation luminance. If the readaptation
      times are equal, the inhomogeneous distribution of luminance has the adaptation
      luminance LA. The important difference in comparison to previous investigations
      is the inclusion of dynamic components (readaptation time and dynamic visual
      task).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780274
TI  - [Sensitivity and specificity of masked field campimetry].
AB  - Patients with circumscribed visual field defects are able to perceive the
      scotomata immediately while looking at randomly distributed black and white
      squares (12' x 12') flickering on a VDU with a high frequency (approximately 30
      Hz), resulting in a stimulus field comparable to the white-noise field on a TV
      screen without reception. In 368 eyes of 368 patients with varying lesions of the
      visual pathway the results of white-noise field campimetry were compared with
      those of conventional threshold-related, slightly suprathreshold automated grid
      perimetry. Rate of detection (sensitivity) was 84.2% in conventional perimetry
      and 80.7% in white-noise field campimetry, respectively. The results are not
      significantly different (p > 0.1; McNemar test). Examinations in 198 eyes of 198
      persons without any indication of a visual pathway defect allowed a definition of
      the normal range of white-noise field campimetry to be made. The specificity of
      this new method was 82.3%. The outcome of this most extensive study on
      sensitivity and specificity of noise field campimetry is compared with other
      publications. The results presented emphasize the capabilities of this new method
      as a screening test. They encourage the initiation of a field study using the
      noise field stimulus broadcasted to home TV sets.

PMID- 7780276
TI  - [The Freiburg Vision Test. Automated determination of visual acuity].
AB  - The Freiburg Visual Acuity Test is an automatic computerized procedure for self
      administered measurement of visual acuity. Landolt-Cs are presented on a monitor
      in one of eight orientations. The subject presses one of eight buttons, which are
      spatially arranged according to the eight possible positions of the Landolt-C's
      gap. To estimate the acuity threshold, a best-PEST procedure is employed,
      assuming a psychometric function with a constant slope on a logarithmic acuity
      scale. The discreetness artifacts in computer monitors limit the presentation of
      small stimuli. By anti-aliasing (smoothing of contours by gray-shading), the
      spatial resolution was improved by a factor of four, such that the shape of
      Landolt-Cs with oblique gaps is adequate and visual acuities from 0.06 up to 3.6
      can be tested at a distance of 5 m.

PMID- 7780275
TI  - [A new method for objective vision assessment using infrared nystagmography].
AB  - Objective assessment of visual acuity (VA) is necessary in cases of malingering
      or poor cooperation in subjective VA evaluation. Based on Ohm's idea of the
      suppression of experimentally evoked optokinetic nystagmus (OKN), a new objective
      visual acuity test is presented. A commercially available system for monitoring
      eye movement (OBER2) allows the test to be performed on a standard PC with a
      minimum amount of time. A grating pattern moving horizontally on the screen
      evokes OKN, which is recorded by infrared nystagmography. Superimposed black
      optotypes of increasing size (brake marks) suppress OKN as soon as they are
      recognized. Eighty-two normal eyes with VA artificially reduced by different
      Bangerter dispersion foils (VA 0.04-1.6) and 152 eyes with visual disturbances
      (VA 0.04-1.0) of various etiologies were examined. The test allowed estimation of
      the least VA in steps of > or = 1.0, > or = 0.25, > or = 0.1, > or = 0.05. None
      of the eyes examined had a VA below these values when the OKN was suppressed by
      the referring brake mark.

PMID- 7780277
TI  - [Dapiprazol antagonizes tropicamide- and phenylephrine-induced mydriasis in the
      elderly].
AB  - Dapiprazole eye drops were applied 1 h after topical tropicamide or phenylephrine
      instillation in 30 elderly subjects. Pupil diameter normalized much earlier than
      in controls receiving placebo. Dapiprazole constricted the tropicamide-dilated
      pupil by 1 mm after 1 h and normalized the pupil diameter of the phenylephrine
      dilated pupil within 1 h, whereas the pupils of the patients receiving placebo
      remained dilated. Intraocular pressure did not change; no major side effects were
      seen.

PMID- 7780278
TI  - [Sensitive physiologic perceptual tests for ocular side effects of drugs
      exemplified by various anticonvulsants].
AB  - Advanced psychophysical tests, performed in 42 patients who have seizures, showed
      that the widely used antiepileptic drugs, diphenylhydantoin and carbamazepine,
      can specifically affect retinal function, while valproic acid and the epileptic
      seizures do not. The Farnsworth-Munsell 100-Hue and Panel D-15 desature tests
      revealed an accumulation of errors along the tritan/tetartan axis and a high
      total error score. As shown by measurement of the so-called transient tritanopia
      and by determination of the spectral sensitivity, this blue vision defect is not
      only due to loss of postreceptoral interaction between long- and short-wavelength
      sensitive cones, but is also based on a disturbance in the receptor mechanism
      itself. The dark adaptation curve was not affected. As determined by cone flicker
      thresholds during dark adaptation, the inhibitory action of rods on cones is
      reduced. The results obtained for mesopic vision and especially glare sensitivity
      measured by nyktometry were markedly affected in these patients compared to the
      normal population. The psychophysical methods provide a very sensitive test for
      early detection of drug-induced retinal dysfunction and allow clear
      differentiation between the loss of a receptor mechanism and a defect in the
      neuronal interaction between photoreceptors in the human visual system induced by
      antiepileptics.

PMID- 7780279
TI  - [Binocular photometer for measuring light perception in diseases of the visual
      pathway].
AB  - In patients with a reduction in visual function because of optic nerve neuritis,
      light sensitivity is tested to detect differences between the right and left eye
      in combination with the swinging flashlight test and visual evoked potential
      (VEP). A binocular Zeiss microscope was modified to use integrated photometer
      controlled binocular stimulus fields and a central light system for fixation and
      variation of the contrast (background illumination). For exact binocular
      measurements of light sensitivity on both eyes, electronically controlled test
      fields (visual angle 5 degrees-20 degrees) guarantees only macular or
      overfoveolar stimulation. In addition, splitting the light for each stimulus
      field from only one halogen lamp guarantees wave-length-independent testing.
      Patients with various retinal diseases and neuritis nervi optici pathology were
      examined using pattern VEP, testing of the absolute lower threshold of light
      sensitivity, and binocular comparison over the range of luminous density. This
      binocular optical photometer system allowed minimal differences to be identified
      in the present visual function and after the eye had recovered from optic nerve
      neuritis.

PMID- 7780280
TI  - [Balloon dilatation of relative postsaccal lacrimal duct stenoses].
AB  - In ten patients with incomplete postsaccal stenosis radiology examined by digital
      subtraction dacryocystorhinography, an overpressure ballooning was done with a
      small foot vessel balloon with hydrophilic surface under image intensiver
      control. The balloon was inflated with a diluted suspension for visualization of
      the balloon and widening of the stenosis. In eight patients recovery was
      continuous without any treatment, in one with topical application of
      vasoconstrictor eye drops. In one patient there was a recurrence. Balloon of
      incomplete postsaccal lacrimal pathway dilatation stenosis is an adequate and
      minimally invasive therapy.

PMID- 7780281
TI  - [Prevention of postenucleation syndrome: the hydroxylapatite silicone implant.
      Preliminary experimental studies and initial clinical experiences].
AB  - An orbital implant after enucleation compensates for volume deficiency and
      increases prosthesis motility. In the literature, however, an extrusion rate of
      orbital implant between 10 and 25% is reported. Since the introduction of
      hydroxylapatic ceramics (HAC), these numbers have been reduced considerably. The
      HAC, which is derived from corals, has a rough surface and requires a scleral
      covering for implantation. The HAC, which is made in the laboratory, can be
      produced with smoother surfaces, so that a homoplastic covering is no longer
      mandatory. A composite implant was developed to improve prosthesis motility
      further. This consists of artificial HAC at its anterior surface to guarantee
      safe tissue integration; the posterior part of the implant is manufactured from
      silicon rubber to create a jointlike structure in Tenon's capsule. Integration of
      the porous HAC in the orbital soft tissues has been tested and confirmed by
      animal experiments. After 30 full HAC implants and 25 composite implants, only
      one extrusion occurred. In all other cases, compatibility proved to be excellent;
      transmission of the motility to the prosthesis was moderate to good. Examinations
      comparing prosthesis motility and computer tomographically evaluated implant
      motility enabled the analysis of deficits in motility transmission of the implant
      for the artificial eye.

PMID- 7780282
TI  - [Changes in orbital hemodynamics caused by nitroglycerin and nifedipine. A study
      using color duplex ultrasound].
AB  - Color Doppler imaging has demonstrated orbital hemodynamic changes in diseases
      such as central vein occlusion, the ocular ischemic syndrome and diabetic
      retinopathy. Reports of pharmacologically induced changes are, however, rare and
      inconsistent. In order to verify the sensitivity of color Doppler imaging to
      demonstrate pharmacologically induced changes in orbital hemodynamics,
      nitroglycerin and nifedipine served as vasoactive agents with a clear
      pharmacological spectrum. Twelve healthy volunteers were examined before and
      after drug application. After the administration of 0.8 mg nitroglycerin, the end
      diastolic bloodflow velocity was increased in the central retinal artery (before:
      Vdiastolic 2.2 +/- 1.0 cm/s, after: Vdiastolic 3.1 +/- 1.1 cm/s) as well as the
      ophthalmic artery (before: Vdiastolic 5.8 +/- 1.7 cm/s, after: Vdiastolic 7.4 +/-
      1.8 cm/s). The resistance index of orbital blood flow decreased in all three
      vessels. After sublingual administration of 10 mg nifedipine, peak systolic blood
      flow velocity was slightly higher in the ciliary arteries and in the ophthalmic
      artery (before: Vsystolic 34.7 +/- 4.6 cm/s, after: Vsystolic 37.8 +/- 3.6 cm/s).
      Blood-flow velocity in the central retinal vein was elevated as well (before:
      Vmax 3.81 +/- 0.66 cm/s, after: Vmax 4.66 +/- 0.83 cm/s). Those slightly
      divergent results may be due to the different pharmacological spectrum of the two
      drugs investigated While nitroglycerin leads to dilatation of venous vessels,
      nifedipine acts primarily on small arteries. As nifedipine and other calcium
      channel blockers have been tested in patients with low-tension glaucoma, future
      color Doppler studies of such a population seem to be promising.

PMID- 7780283
TI  - [Coronal incision as the surgical approach to the orbits].
AB  - The coronal incision of the skin extends from the ipsilateral preauricular region
      to the other side parallel to the coronal suture. The skin flap can then be
      mobilized down to nearly the floor of the orbits. We routinely use this incision
      in the following diseases and surgical procedures of the orbit: (1) osteo- and
      orbitotomies in premature synostosis of skull bones and craniofacial dysplasias;
      (2) frontobasal midface traumatology involving the orbit; (3) removal of fronto
      ethmoidal mucoceles and tumors with orbital involvement; (4) bilateral medial
      three-wall and lateral one-wall decompression in Graves' disease; (5) removal of
      tumors from the upper and medial level of the orbit via a transperiostal incision
      or an extended supraorbital resection. The major advantages of the coronal
      incision are the excellent exposure of normal and pathological structures of the
      (peri-)orbital region and the highly satisfying late cosmetic results.

PMID- 7780284
TI  - [Rhegmatogenic retinal detachment].

PMID- 7780285
TI  - Orthostatic intolerance and orthostatic tachycardia: a heterogeneous disorder.
AB  - A series of autonomic function tests were performed in eight patients who had
      orthostatic intolerance and orthostatic tachycardia (> 36 bpm). All eight had an
      abnormal tilt-table test (mean tachycardia 50 bpm compared with 22 +/- 7 bpm in
      31 normal subjects). Plasma volume was low in four out of six patients. There was
      a subnormal response to the cold pressor test in three out of eight patients.
      Intravenous atropine-induced tachycardia was subnormal in two out of eight
      patients. A segmental or patchy anhidrosis was present in six out of eight
      patients. Pilocarpine (0.0625%) induced miosis (three out of six) and exaggerated
      Valsalva ratio (one out of eight) were observed. A follow-up of six patients, 8
      17 years after the autonomic evaluation, showed spontaneous and complete
      improvement in two out of six, partial improvement in one out of six, and
      persistence of symptoms in three out of six patients. A repeat autonomic
      evaluation in two patients with persistent symptoms, 2 and 5 years after the
      initial assessment, showed mild progression of sympathetic and parasympathetic
      dysfunction. This syndrome appears characterized by orthostatic tachycardia, low
      plasma volume, lack of adrenergic supersensitivity, and sudomotor abnormalities.
      A longitudinal follow up demonstrates patients with and without recovery. The
      syndrome appears heterogeneous in terms of onset, clinical manifestations,
      laboratory studies and outcome.

PMID- 7780286
TI  - Variation of aortic blood velocity with age at rest and during exercise in normal
      subjects.
AB  - The effect of age on aortic blood velocity signal and its derived indices of left
      ventricular function namely peak velocity, stroke distance (the velocity-time
      integral) and minute distance (stroke distance x heart rate) was studied at rest
      and at maximal-tolerated supine exercise using a 2-mHz continuous-wave Doppler
      ultrasound applied via the suprasternal notch in 66 normal healthy volunteers.
      The peak velocity, stroke distance and the minute distance, both at rest and at
      maximal exercise decreased with advancing age by 1-1.1% per annum between the
      ages of 20 and 70 years. Accordingly a method for age-adjustment of the peak
      velocity, stroke and minute distances was introduced for clinical use in
      assessing individual subjects. These results indicate that age is an important
      variable affecting aortic blood velocity and its derived variables as non
      invasive measures of left ventricular function both at rest and with exercise.
      The relationship with age is an important consideration when assessing individual
      subjects.

PMID- 7780287
TI  - The effect of severe brainstem injury on heart rate and blood pressure
      oscillations.
AB  - To determine whether an intact brainstem is essential for the generation of
      neurogenically mediated fluctuations of R-R intervals and blood pressure, three
      patients with cerebellar lesions causing severe brainstem compression or death,
      one patient with a large pontine infarct and one patient with a pontine
      haemorrhage, were studied. Time-frequency maps (based on a modified Wigner
      distribution) were constructed from blood pressure and R-R interval signals in
      these patients with brainstem injury and were compared with maps of normal
      control subjects. Low frequency sympathetically mediated rhythms (0.01-0.12 Hz)
      in systolic and diastolic pressure remained detectable but attenuated in patients
      with brainstem injury whereas there was an almost complete loss of normal R-R
      intervals rhythmicity over 0.01 to 0.5 Hz range. These data suggest that
      fluctuations in R-R intervals require an intact brainstem, whereas low frequency
      approximately 0.06 +/- 0.02 Hz blood pressure rhythms may be preserved by spinal
      sympathetic circuitry.

PMID- 7780288
TI  - Smoking induced differences in autonomic responses in military pilot candidates.
AB  - The effects of smoking on autonomic function, the renin-angiotensin-aldosterone
      system, plasma catecholamine and 11-dehydro-thromboxane B2 values were studied in
      37 young male military pilot candidates, 19 smokers and 18 non-smokers. There was
      a higher diastolic blood pressure at rest and higher systolic blood pressure
      after 5 min during the orthostatic test in smokers. Smokers also had higher
      diastolic blood pressure levels after exercise in the hand-grip test. Smokers had
      a lower Valsalva ratio and higher tachycardia ratio in the modified Valsalva
      manoeuvre, suggesting a degree of autonomic dysfunction. Plasma renin levels at
      rest and plasma noradrenaline levels after hand-grip test were significantly
      higher in smokers, implying increased sympathetic activity and enhanced
      activation of the renin-angiotensin system. Our findings indicate that smoking in
      fit young men increases sympathetic activity and changes physiological responses
      to autonomic tests.

PMID- 7780289
TI  - Assessment of noninvasive tests of cutaneous vascular control in the forearm
      using a laser Doppler meter and a Finapres blood pressure monitor.
AB  - The control of human forearm cutaneous vascular resistance was examined using a
      combination of laser Doppler perfusion measurement and continuous Finapres blood
      pressure measurement. Tests which provoke changes in blood flow via different
      control mechanisms (local and neural) were applied in a group of ten healthy
      subjects. The purpose was to select from them a suitable (i.e. statistically
      significant) group to apply in cases where a disease process is suspected of
      interfering with the control of the skin circulation. Deep inspiration, immersion
      of the feet in water at 15 degrees C (both eliciting sympathetic vasoconstrictor
      nerve activity) and arm dependency (eliciting the local veni-arteriolar response)
      produced statistically significant, symmetrical increases in cutaneous vascular
      resistance in both arms (p < 0.05, Wilcoxon's test for paired differences).
      Similarly, post-ischaemic reactive hyperaemia (mediated by local vasodilator
      mechanisms) and indirect heating of the body (eliciting increased sympathetic
      vasodilator nerve activity) resulted in significant decreases in cutaneous
      vascular resistance (p < 0.01). When deep inspiration was repeated from a
      vasodilated baseline after indirect heating, the increases in cutaneous vascular
      resistance were smaller than those obtained before heating. Isometric handgrip
      exercise failed to produce a significant change in contralateral cutaneous
      vascular resistance (p > 0.05). There were no differences between right and left
      arms for any test (p > 0.05). The successful tests were subjected to power
      analysis in order to predict likely patient sample sizes required to demonstrate
      altered responsiveness at sites of microcirculatory disturbance compared with
      normal skin.

PMID- 7780290
TI  - Autonomic neuropathy and prolongation of QT interval in human immunodeficiency
      virus infection.
AB  - Autonomic neuropathy has been reported in human immunodeficiency virus positive
      (HIV+) patients. Since alterations in cardiac innervation may determine QT
      interval prolongation, this interval was studied in a group of HIV+ subjects to
      evaluate if it is prolonged and to compare this measurement with other diagnostic
      tests for autonomic neuropathy. Fifty-seven HIV+ and 23 human immunodeficiency
      virus negative (HIV-) subjects were studied. Autonomic function was tested by
      noninvasive cardiovascular reflex tests, and the QT interval on the
      electrocardiogram was measured at rest, at maximum tachycardia during Valsalva
      manoeuvre, and afterwards at maximum bradycardia. QT intervals were corrected for
      heart rate according to Bazzett's formula (QTc). Autonomic neuropathy was found
      in 37 HIV+ subjects: 25 had moderate autonomic neuropathy (HIV+/mAN) and twelve
      had severe autonomic neuropathy (HIV+/sAN). The 23 HIV- and 20 HIV+ (HIV+/AN-)
      patients did not have autonomic neuropathy. QTc intervals were significantly
      longer in HIV+/sAN and HIV+/mAN than in HIV- at rest; in HIV+/sAN than in HIV- at
      maximum tachycardia; in HIV+/sAN and HIV+/mAN than in HIV+, in HIV+/sAN and
      HIV+/mAN than in HIV+/AN- and in HIV+/sAN than in HIV+/mAN at maximum
      bradycardia. QTc was > or = 440 ms in 24 out of 37 (64.8%) patients with
      autonomic neuropathy and in five out of 20 (25%) HIV+/AN- patients (sensitivity
      65%, specificity 75%). A significant correlation was observed between scores of
      autonomic involvement and QTc interval prolongation. This study confirms that the
      QTc measurement is a reliable parameter indicating the presence of autonomic
      neuropathy. Since QT prolongation may determine ventricular arrhythmias, such
      patients must be followed because they may be at increased risk of sudden death.

PMID- 7780291
TI  - The effect of graded calcium infusions on rhythmic blood pressure oscillations in
      normal man.
AB  - This study was designed to determine whether calcium contributes to the
      regulation of rhythmic oscillations in blood pressure. Six normal subjects
      received sequential 1-h infusions of calcium gluconate (1.5, 3.0 and 4.5 mg
      calcium/kg/h) during continuous blood pressure (Finapres) monitoring. The plasma
      ionized calcium ([Ca2+]) concentration increased from 4.6 +/- 0.07 mg/dl to 5.97
      +/- 0.20 mg/dl (p < 0.01) with infusion. The mid-frequency (0.07-0.14 Hz, Mayer
      wave) power spectrum of diastolic blood pressure was depressed slightly following
      the first dose but increased significantly following the final dose (p < 0.05).
      The high-frequency (0.15-0.40 Hz) power spectrum of systolic blood pressure
      decreased following the first dose (p < 0.05) and subsequently remained low. The
      low-frequency (0.02-0.6 Hz) power spectrum was not affected. These results
      demonstrate that graded hypercalcaemia affects blood pressure oscillations in
      man. Our data suggest that the amplitude of the Mayer wave, a clinical marker of
      sympathetic vascular tone, is modulated in part by calcium.

PMID- 7780292
TI  - Muscle sympathetic nerve activity during postural change in healthy young and
      older adults.
AB  - Recent evidence suggests that during orthostatic stress the reflex increase in
      muscle sympathetic nerve activity may be diminished in older adults. To test this
      hypothesis, we measured muscle sympathetic nerve activity, plasma noradrenaline
      concentrations, heart rate, and arterial blood pressure in twelve young (mean, 25
      years; range, 19-29 years) adults and 14 older (mean 64 years; range, 60-74
      years) healthy adults, while supine and during upright sitting. Supine control
      levels of muscle sympathetic nerve activity were higher in the older subjects (35
      +/- 1 vs. 25 +/- 1 bursts/min, p < 0.05), but there were no differences in plasma
      noradrenaline concentrations, heart rate or arterial pressure. Despite higher
      supine control levels in the older group, the absolute unit increases in muscle
      sympathetic nerve activity in response to upright sitting (p < 0.05 vs. control)
      were not different in the two groups (7 +/- 1 vs. 7 +/- 1 bursts/min), nor were
      the increases in plasma noradrenaline concentrations. Heart rate did not increase
      above supine control in response to sitting in either group. Arterial pressure
      increased slightly (p < 0.05, supine vs. control), but there were no age-related
      differences. These results indicate that, contrary to recent findings, the reflex
      increases in muscle sympathetic nerve activity and plasma noradrenaline
      concentrations and regulation of arterial pressure during this natural
      orthostatic stress are well preserved in older healthy men and women.

PMID- 7780293
TI  - Clinical significance of the resting heart rate in the assessment of autonomic
      function by cardiovascular reflex tests.
AB  - The effect of the resting heart rate on heart rate responses in standard
      cardiovascular autonomic function tests was studied in a sample of 845 subjects.
      The responses, which were calculated using instantaneous heart rate changes and R
      R interval ratios, were divided into quantiles according to their absolute
      values. The effect of resting heart rate on each cardiovascular index was studied
      by linear regression analysis, first in the whole group and then in the group
      with responses belonging to the lowest quantile. As regards the whole group,
      eight out of ten indices diminished significantly with increasing resting heart
      rate. However, no response-attenuating effect of increasing resting heart rate
      could be found among the responses in the lowest quantile. Since particularly low
      heart rate responses in cardiovascular reflex testing are of clinical importance
      when autonomic neuropathy is diagnosed, it can be concluded that the usefulness
      of standard cardiovascular reflex test based on heart rate changes is not limited
      by the level of the resting heart rate.

PMID- 7780294
TI  - Impulsiveness and subjective effects of intravenous cocaine administration in the
      laboratory.
AB  - Cardiovascular and subjective responses to placebo and 40-mg intravenous (iv)
      cocaine injections were measured in 29 male iv cocaine users: most subjects
      received each of these injections on two separate occasions. Most of the subjects
      also completed various measures of psychopathology and personality. Although the
      small sample size made any conclusions tentative, an expected significant
      association between impulsivity and subjective euphoria following 40-mg cocaine
      administration was obtained, whereas associations of personality measures with
      cardiovascular responses to cocaine administration were inconsistent.

PMID- 7780295
TI  - Determinants of early alcohol and drug use among young women in alcoholism
      treatment.
AB  - Substance abuse experimentation may be one of several types of problem behaviors.
      Data from 99 Caucasian women interviewed in alcoholism treatment (19-29 years
      old) were used to test a developmental model of substance experimentation.
      Respondents were classified into three groups based on their use prior to age 15:
      nonusers, users of alcohol only, and users of alcohol and other drugs. Family
      history of alcoholism was not related to childhood anxiety and impulse control
      problems. Childhood anxiety and impulse control problems predicted adolescent
      emotional and impulse control problems but did not differentiate early
      experimenters. Whereas adolescent emotional problems were not related to early
      experimentation, early drug and alcohol users were significantly more likely to
      have engaged in other impulsive behaviors (e.g., running away from home, trouble
      with school authorities) than were nonusers or users of alcohol only. Alcoholism
      prevention programs, therefore, would do well to target youth who exhibit acting
      out behaviors as a high-risk group for early alcohol and drug use.

PMID- 7780296
TI  - A study of the gender differences in morbidity among individuals diagnosed with
      alcohol abuse and/or dependence.
AB  - The majority of studies on medical consequences of excessive alcohol consumption
      have been carried out with male subjects, mostly from clinical or hospitalized
      samples. The purpose of this report was to study differences in morbidity
      outcomes of men and women among respondents diagnosed with alcohol abuse and/or
      dependence. Utilizing data from the 1988 National Health Interview Survey, this
      study compared several indicators of physical morbidity among male and female
      respondents meeting the criteria for Diagnostic and Statistical Manual of Mental
      Disorders (DSM-III-R; American Psychiatric Association, 1987) alcohol abuse
      and/or dependence. The results revealed complex gender differences, not all of
      which can be explained by differences in sociodemographic characteristics or
      drinking practices. Moreover, the results indicated that it is inadequate to
      generalize results based on morbidity data of men with alcohol abuse and/or
      dependence to their female counterparts or female drinkers. Implications of these
      findings are discussed.

PMID- 7780297
TI  - Node-link mapping for counseling cocaine users in methadone treatment.
AB  - Treatment engagement problems associated with cocaine-using opioid addicts were
      addressed using a cognitively enhanced counseling strategy. Analysis of client
      urines, participation, and counselor ratings of clients over a 6-month period
      during treatment indicated that the use of node-link mapping--a multipurpose
      visual representation strategy for communication--produced better results for
      both low and high cocaine-using opioid addicts in methadone maintenance than
      those treated without this enhancement.

PMID- 7780299
TI  - Total body water adjustment of mean alcohol intakes.
AB  - Total body water volume (TBW) is one factor that determines the functional effect
      of a standard dose of alcohol. Because women and the elderly generally have lower
      TBW values than men and younger persons, respectively, less alcohol needs to be
      consumed by women and elders to achieve the same or higher blood alcohol levels
      compared to men and younger persons. An existing data set on elderly drinkers was
      analyzed with and without TBW adjustment of intakes using mean TBW estimates per
      decade for each gender. The estimates were obtained from a published report that
      pooled cross-sectional data to produce mean TBW values and TBW prediction
      equations applicable to Western populations. As the analyses confirm, the use of
      cutoff points of alcohol intake not adjusted for TBW results in drinking-level
      misclassification and findings biased towards younger males. This report supports
      the standard use of TBW-adjusted alcohol intakes in analyses of samples with both
      genders and/or a wide age range.

PMID- 7780298
TI  - Caffeinated coffee and tea intake and its relationship to cigarette smoking: an
      analysis of the Second National Health and Nutrition Examination Survey (NHANES
      II).
AB  - Recent studies have shown that smokers' intake of caffeine is higher than
      nonsmokers. This investigation evaluated the relationships between smoking status
      and self-reported caffeine intake from both coffee and tea. Subjects were adults
      who participated in the Second National Health and Nutrition Examination Survey
      (NHANES II). Results indicated that subjects who ingested caffeine from tea were
      more likely to be female, less educated, younger, non-Caucasian, and lighter
      drinkers. In contrast, those who ingested caffeine from coffee were more likely
      to be older, Caucasian, heavier drinkers, and have higher incomes. Smokers were
      not more likely to drink caffeinated tea. In contrast, smokers were much more
      likely to drink caffeinated coffee, and a dose-response relationship between
      caffeine from coffee and smoking intake was observed. These results clarify the
      relationship between smoking and caffeine intake. Implications for intervention
      efforts are discussed.

PMID- 7780300
TI  - A computer-directed program for smoking cessation treatment.
AB  - This report describes a computer-directed cigarette smoking cessation program
      that individualizes nicotine fading schedules for smokers based upon their daily
      smoking behavior. Previous outcome data from minimal intervention and intensive
      stop-smoking treatment studies are presented. Preliminary urinary cotinine data
      also are presented to validate the program's underlying assumption that computer
      directed nicotine fading results in across-treatment reductions in biological
      levels of nicotine.

PMID- 7780301
TI  - Gender differences in prospectively versus retrospectively assessed smoking
      withdrawal symptoms.
AB  - Investigations of gender differences in the frequency and/or intensity of smoking
      withdrawal symptomatology have yielded conflicting findings. Several studies
      using measures collected both before abstinence and at the peak of symptomatology
      have failed to find gender differences. Yet, when asked to rate symptomatology
      experienced during past quit attempts, women have repeatedly been shown to
      endorse significantly more symptomatology than men. A possible explanation is
      that, although men and women show no differences when rating symptoms
      prospectively, women remember their past withdrawal symptoms as being more severe
      than do men, either because women exaggerate the difficulties they experience or
      because men downplay them. To test this hypothesis, and to determine whether men
      or women were more accurate in their recollections, we combined data from two
      studies in which subjects were asked to assess symptoms prospectively following 2
      days of abstinence, and also to rate withdrawal during past quit attempts. As
      predicted, we found the effects of abstinence to be similar when assessed
      prospectively but different when assessed retrospectively, with women reporting
      more symptomatology than men. Men whose retrospective and prospective responses
      were discordant consistently underestimated the likelihood of experiencing
      symptomatology; women showed no consistent trends. The total number of symptoms
      reported retrospectively by women was similar to the total number reported
      prospectively, whereas men significantly underestimated the number of symptoms
      that they actually experienced. These findings may suggest ways in which
      treatment strategies can be tailored to the differences between male and female
      styles in recalling past experiences with abstinence from smoking.

PMID- 7780302
TI  - Case management of pregnant and parenting female crack and polydrug abusers.
AB  - The increasing use of crack-cocaine among addicted women and subsequent births of
      polydrug-exposed infants prompted the State of Florida to undertake initiatives
      to seek solutions to these problems. This study, focused on one of these
      initiatives, explored the relationship between service components of a
      comprehensive treatment program and substance-free time among 120 African
      American and Caucasian crack-cocaine addicted women. Findings from a multiple
      regression analysis indicated that aftercare management (p < .0001), vocational
      services (p < .02), and residential treatment (p < .03) were statistically
      significant services associated with substance-free time. Although these findings
      are not conclusive, they are supportive of a growing body of literature that
      suggests that crack-using and polydrug-using women can be responsive to treatment
      when it is tailored to their individual needs and includes long-term community
      support.

PMID- 7780303
TI  - Circulatory response of young adult trauma victims with alcohol intoxication.
AB  - Young adults are a subgroup particularly susceptible to traumatic injury; alcohol
      intoxication is a major risk factor for trauma in young adults. During the first
      hours following multiple trauma, however, little is known about the specific
      effects of alcohol intoxication on the circulatory response of critically injured
      young adults. The purpose of this prospective study was to compare the
      circulatory response of 5 severely injured young adults (15-40 years old) with
      acute alcohol intoxication to the circulatory response of 5 severely injured,
      nonintoxicated young adults. Data were collected every hour for the first 8 hours
      after admission to a surgical intensive care unit. Subjects with alcohol
      intoxication had significantly higher heart rates (t = 2.8176, p < .05) than
      their nonintoxicated counterparts. Heart rate and blood pressure, however, showed
      no statistically significant (p < .05) Group x Time interaction between the two
      groups. Subjects with alcohol intoxication also had injuries that caused more
      blood loss, more invasive monitoring, more operative procedures, more fluid
      replacement, and higher oxygen requirements.

PMID- 7780304
TI  - Functional interaction between the homeotic genes fbp1 and pMADS1 during petunia
      floral organogenesis.
AB  - The petunia MADS box floral binding protein (fbp) gene 1 represents a class B
      homeotic gene determining the identity of second and third floral whorl organs.
      Suppression of fbp1, which is highly homologous to the Antirrhinum gene globosa
      and Arabidopsis gene pistillata, results in the conversion of petals to sepals
      and stamens to carpels. In contrast to fbp1, the petunia homeotic gene pMADS1,
      encoding a protein homologous to the Antirrhinum protein DEFICIENS, has been
      shown to be involved in the formation of petals only. We demonstrated that the
      induction of fbp1 is established independent of pMADS1, whereas at later
      developmental stages, fbp1 is up-regulated by pMADS1 in petals. On the other
      hand, the induction and maintenance of pMADS1 expression are not affected by
      fbp1. To obtain information about the functional interaction between fbp1 and
      pMADS1, an fbp1 cosuppression mutant with mild phenotypic alterations was crossed
      with a green petals mutant in which pMADS1 expression was abolished. Progeny
      plants, heterozygous for the pMADS1 gene, had flowers with a more pronounced
      reversion from petals into sepals than was observed for the parent fbp1 mutant.
      The morphology of the third whorl organs was not changed. These observations,
      together with expression levels of pMADS1 and fbp1 in mutant flowers, provide
      evidence for functional control of fbp1 by PMADS1 in vivo.

PMID- 7780305
TI  - Expression of the Arabidopsis HMG2 gene, encoding 3-hydroxy-3-methylglutaryl
      coenzyme A reductase, is restricted to meristematic and floral tissues.
AB  - The synthesis of mevalonate, which is considered the first rate-limiting step in
      isoprenoid biosynthesis, is catalyzed by the enzyme 3-hydroxy-3-methylglutaryl
      coenzyme A reductase (HMGR; EC 1.1.1.34). In Arabidopsis, HMGR is encoded by two
      differentially expressed genes (HMG1 and HMG2). The transcriptional activity of
      the HMG2 gene was studied after fusing different regions of its 5' flanking
      region to the beta-glucuronidase (GUS) reporter gene and transforming the
      resulting constructs into tobacco plants. The spatial and temporal expression
      directed by the HMG2 promoter in the transgenic plants is consistent with the
      expression pattern previously established by RNA analysis using an HMG2-specific
      probe. HMG2 expression is restricted to meristematic (root tip and shoot apex)
      and floral (secretory zone of the stigma, mature pollen grains, gynoecium
      vascular tissue, and fertilized ovules) tissues. Deletion analysis of the HMG2 5'
      flanking region was conducted in transgenic plants and transfected protoplasts.
      The region containing nucleotides -857 to +64 of the HMG2 gene was sufficient to
      confer high levels of expression in both floral and meristematic tissues,
      although deletion to nucleotide -503 resulted in almost complete loss of
      expression. Sequences contained within the 5' transcribed, untranslated region
      are also important for gene expression. The biological significance of the
      restricted pattern of expression of HMG2 is also discussed.

PMID- 7780306
TI  - UFO: an Arabidopsis gene involved in both floral meristem and floral organ
      development.
AB  - We describe the role of the UNUSUAL FLORAL ORGANS (UFO) gene in Arabidopsis
      floral development based on a genetic and molecular characterization of the
      phenotypes of nine ufo alleles. UFO is required for the proper identity of the
      floral meristem and acts in three different aspects of the process that
      distinguishes flowers from shoots. UFO is involved in establishing the whorled
      pattern of floral organs, controlling the determinacy of the floral meristem, and
      activating the APETALA3 and PISTILLATA genes required for petal and stamen
      identity. In many respects, UFO acts in a manner similar to LEAFY, but the ufo
      mutant phenotype also suggests an additional role for UFO in defining boundaries
      within the floral primordia or controlling cell proliferation during floral organ
      growth. Finally, genetic interactions that prevent flower formation and lead to
      the generation of filamentous structures implicate UFO as a member of a new,
      large, and diverse class of genes in Arabidopsis necessary for flower formation.

PMID- 7780307
TI  - Long-distance movement factor: a transport function of the potyvirus helper
      component proteinase.
AB  - Transport of viruses from cell to cell in plants typically involves one or more
      viral proteins that supply dedicated movement functions. Transport from leaf to
      leaf through phloem, or long-distance transport, is a poorly understood process
      with requirements differing from those of cell-to-cell movement. Through genetic
      analysis of tobacco etch virus (TEV; potyvirus group), a novel long-distance
      movement factor was identified that facilitates vascular-associated movement in
      tobacco. A mutation in the central region of the helper component proteinase (HC
      Pro), a TEV-encoded protein with previously described activities in aphid
      mediated transmission and polyprotein processing, inactivated long-distance
      movement. This mutant virus exhibited only minor defects in genome amplification
      and cell-to-cell movement functions. In situ histochemical analysis revealed that
      the mutant was capable of infecting mesophyll, bundle sheath, and phloem cells
      within inoculated leaves, suggesting that the long-distance movement block was
      associated with entry into or exit from sieve elements. The long-distance
      movement defect was specifically complemented by HC-Pro supplied in trans by a
      transgenic host. The data indicate that HC-Pro functions in one or more steps
      unique to long-distance transport.

PMID- 7780308
TI  - Small cysteine-rich antifungal proteins from radish: their role in host defense.
AB  - Radish seeds have previously been shown to contain two homologous, 5-kD cysteine
      rich proteins designated Raphanus sativus-antifungal protein 1 (Rs-AFP1) and Rs
      AFP2, both of which exhibit potent antifungal activity in vitro. We now
      demonstrate that these proteins are located in the cell wall and occur
      predominantly in the outer cell layers lining different seed organs. Moreover, Rs
      AFPs are preferentially released during seed germination after disruption of the
      seed coat. The amount of released proteins is sufficient to create a
      microenvironment around the seed in which fungal growth is suppressed. Both the
      cDNAs and the intron-containing genomic regions encoding the Rs-AFP preproteins
      were cloned. Transcripts (0.55 kb) hybridizing with an Rs-AFP1 cDNA-derived probe
      were present in near-mature and mature seeds. Such transcripts as well as the
      corresponding proteins were barely detectable in healthy uninfected leaves but
      accumulated systemically at high levels after localized fungal infection. The
      induced leaf proteins (designated Rs-AFP3 and Rs-AFP4) were purified and shown to
      be homologous to seed Rs-AFPs and to exert similar antifungal activity in vitro.
      A chimeric Rs-AFP2 gene under the control of the constitutive cauliflower mosaic
      virus 35S promoter conferred enhanced resistance to the foliar pathogen
      Alternaria longipes in transgenic tobacco. The term "plant defensins" is proposed
      to denote these defense-related proteins.

PMID- 7780309
TI  - Post-transcriptional regulation of nitrate reductase by light is abolished by an
      N-terminal deletion.
AB  - Higher plant nitrate reductases (NRs) carry an N-terminal domain whose sequence
      is not conserved in NRs from other organisms. A gene composed of a full-length
      tobacco NR cDNA with an internal deletion of 168 bp in the 5' end fused to the
      cauliflower mosaic virus 35S promoter and appropriate termination signals was
      constructed and designated as delta NR. An NR-deficient mutant of Nicotiana
      plumbaginifolia was transformed with this delta NR gene. In transgenic plants
      expressing this construct, NR activity was restored and normal growth resulted.
      Apart from a higher thermosensitivity, no appreciable modification of the kinetic
      parameters of the enzyme was detectable. The post-transcriptional regulation of
      NR by light was abolished in delta NR transformants. Consequently, deregulated
      production of glutamine and asparagine was detected in delta NR transformants.
      The absence of in vitro delta NR activity modulation by ATP suggests the
      impairment of delta NR phosphorylation and thereby suppression of delta NR post
      translational regulation. These data imply that post-transcriptional control of
      NR expression is important for the flow of the nitrate assimilatory pathway.

PMID- 7780310
TI  - Two copper-responsive elements associated with the Chlamydomonas Cyc6 gene
      function as targets for transcriptional activators.
AB  - In Chlamydomonas reinhardtii, cytochrome c6 (cyt c6) is synthesized only under
      conditions of copper deficiency when plastocyanin cannot be synthesized. In
      previous work, the copper-responsive regulation of cyt c6 synthesis was
      demonstrated to occur by control of transcription, with no contribution from post
      transcriptional processes. To understand the mechanism underlying its regulation,
      the genomic DNA encoding cyt c6 (Cyc6) was analyzed for the presence of copper
      responsive elements. Sequences lying between positions -127 and -7 with respect
      to the start site of transcription were found to be sufficient to confer copper
      responsive expression on either a promoterless or a minimal beta-tubulin promoter
      driven (arylsulfatase-encoding) reporter gene. Analysis of this 120-bp fragment
      indicated that copper-responsive elements lie in two distinct regions (between 
      110 to -56 and -127 to -109). ATG fusions between copper-insensitive promoters
      and the coding plus 3' untranslated region of the Cyc6 gene resulted in the
      accumulation of cyt c6 in copper-supplemented medium; this confirms earlier
      studies indicating a lack of post-transcriptional control in this copper
      responsive pathway. In the context of a constitutive promoter (derived from the
      beta-tubulin gene), each region was found to function as an activator of
      transcription in copper-deficient cells, and the metal specificity of the
      response of reporter genes containing either one or both regions was identical to
      that of the endogenous Cyc6 gene. The copper-responsive synthesis of cyt c6 is
      thus attributed to these two 5' upstream sequences.

PMID- 7780311
TI  - Inactivation of a Synechocystis sp strain PCC 6803 gene with homology to
      conserved chloroplast open reading frame 184 increases the photosystem II-to
      photosystem I ratio.
AB  - A gene of the unicellular cyanobacterium Synechocystis sp strain PCC 6803 that is
      homologous to the conserved chloroplast open reading frame orf184 has been cloned
      and sequenced. The nucleotide sequence of the gene predicts a protein of 184
      amino acids with a calculated molecular mass of 21.5 kD and two membrane-spanning
      regions. Amino acid sequence analysis showed 46 to 37% homology of the
      cyanobacterial orf184 with tobacco orf184, rice orf185, liverwort orf184, and
      Euglena gracilis orf206 sequences. Two orf184-specific mutants of Synechocystis
      sp PCC 6803 were constructed by insertion mutagenesis. Cells of mutants showed
      growth characteristics similar to those of the wild type. Their pigment
      composition was distinctly different from the wild type, as indicated by an
      increase in the phycocyanin-to-chlorophyll ratio. In addition, mutants also had a
      two- to threefold increase in photosynthetic electron transfer rates as well as
      in photosystem II-to-photosystem I ratio-a phenomenon hitherto not reported for
      mutants with altered photosynthetic characteristics. The observed alterations in
      the orf184-specific mutants provide strong evidence for a functional role of the
      orf184 gene product in photosynthetic processes.

PMID- 7780312
TI  - Alternative medicine and general practitioners. Opinions and behaviour.
AB  - OBJECTIVE: To describe general practitioners' opinions and behaviour regarding
      alternative medicine. DESIGN: Cross-sectional survey of a random sample of
      Ontario and Alberta general practitioners. SETTING: General practices in Ontario
      and Alberta. PARTICIPANTS: A questionnaire was mailed to 400 general
      practitioners. Of the 384 eligible physicians, 200 completed the questionnaire.
      MAIN OUTCOME MEASURES: Reported beliefs and practices concerning alternative
      medicine. RESULTS: Acupuncture, chiropractic, and hypnosis were considered most
      useful and reflexology, naturopathy, and homeopathy least useful. Results showed
      56% of general practitioners believed that alternative medicine has ideas and
      methods from which conventional medicine could benefit, 54% referred to
      alternative practitioners, and 16% practised some form of alternative medicine.
      Province of practice, place of graduation, training in alternative approaches,
      number of alternative approaches perceived useful, and attitude toward
      alternative medicine were clearly related to referring to alternative
      practitioners. Sex, age, type of practice, training in alternative medicine,
      referring to alternative practitioners, number of alternative approaches
      perceived useful, and attitude toward alternative medicine were related to
      practicing alternative medicine. CONCLUSION: Although acceptance and integration
      of alternative medicine extend only to certain approaches, alternative medicine
      cannot be discounted in general practice. A study encompassing all Canadian
      provinces could help in planning medical education and developing policies to
      guide physician behaviour.

PMID- 7780313
TI  - New tuberculosis epidemic. Controversies in screening and preventive therapy.
AB  - The incidence of tuberculosis is increasing in many regions of Canada and the
      world. Accurate and current knowledge of screening and prevention is of utmost
      importance for family physicians caring for patients who might be at risk. This
      article presents guidelines on screening, skin testing, interpretation of
      results, and preventive therapy.

PMID- 7780314
TI  - Mantoux tests. Performing, interpreting, and acting upon them.
AB  - Interpreting and acting upon results of the tuberculin skin test (Mantoux test)
      can be confusing because the test is inherently ambiguous and published
      recommendations for investigation and prevention of tuberculosis are complex.
      This article presents a step-by-step guide to enable family physicians to make
      effective use of the Mantoux test.

PMID- 7780316
TI  - Clerkship rotation in rural family practice.
AB  - Every medical student at Memorial University of Newfoundland must do a rotation
      in rural family practice. This paper describes the organization of this clerkship
      learning experience and discusses its possible influence upon career choice.

PMID- 7780315
TI  - Tuberculosis in the 1990s. Issues for primary care physicians.
AB  - After declining for many years, tuberculosis rates have begun to level off in
      Canada. Groups at particularly high risk include aboriginal Canadians, immigrants
      from high-prevalence countries, HIV-infected people, and elderly men. If disease
      is suspected, appropriate investigations, including sputum tests for bacteriology
      and chest x-ray examinations, should be done. Response to treatment is excellent.
      Chemoprophylaxis is recommended for certain patients. Vaccination with BCG has a
      limited but important role, especially for aboriginal Canadians.

PMID- 7780317
TI  - Rural home care of a technology-dependent infant.
AB  - A multidisciplinary approach is necessary to prepare for home care of technology
      dependent infants. The environment must protect, support, and promote the
      physical, cognitive, and social growth and development of these infants. Parents
      and caregivers of technology-dependent infants should be taught cardiopulmonary
      resuscitation and should be helped to develop a plan for obtaining emergency
      medical assistance.

PMID- 7780320
TI  - Don't worry about the label. Diagnose underlying perpetuating factors in chronic
      fatigue syndrome.

PMID- 7780319
TI  - Promoting Canada's involvement in international health.

PMID- 7780318
TI  - Health care system awry in Hong Kong.

PMID- 7780321
TI  - Gatekeeping. Part 2: Who and how?

PMID- 7780322
TI  - Health of Canada's children. A family physician's view.

PMID- 7780323
TI  - Higher dose increases addiction potential.

PMID- 7780324
TI  - Should x-rays be taken?

PMID- 7780325
TI  - Hospital privileges and family physicians.

PMID- 7780326
TI  - Rural medicine needs help.

PMID- 7780327
TI  - Green medicine. Environmental impact of health care.

PMID- 7780328
TI  - Radiology rounds. Osteochondritis dissecans.

PMID- 7780329
TI  - Dermacase. Papular acrodermatitis of childhood.

PMID- 7780330
TI  - Which one of the following statements about the use of paracentesis in the
      management of ascites is true?

PMID- 7780331
TI  - Rural family medicine training in Canada.
AB  - OBJECTIVE: To examine the status of postgraduate family medicine training that
      occurs in rural family practice settings in Canada and to identify problems and
      how they are addressed. DESIGN: A retrospective questionnaire sent to all 18
      Canadian family medicine training programs followed by a focus group discussion
      of results. SETTING: Canadian university family medicine training programs.
      PARTICIPANTS: Chairs or program directors of all 18 Canadian family medicine
      training programs and people attending a workshop at the Section of Teachers of
      Family Medicine annual meeting. MAIN OUTCOME MEASURES: Extent of training
      offered, educational models used, common problems for residents and teachers.
      RESULTS: Nine of 18 programs offer some family medicine training in a rural
      practice setting to some or all of their first-year family medicine residents,
      and 99 of 684 first-year family medicine residents did some training in a rural
      practice. All programs offer some training in a rural practice to some or all of
      the second-year residents, and 567 of 702 second-year residents did some training
      in a rural setting. In 12 of 18 programs, a rural family medicine block is
      compulsory. Education models for training for rural family practice vary widely.
      Isolation, accommodation, and supervision are common problems for rural family
      medicine residents. Isolation and faculty development are common problems for
      rural physician-teachers. Programs use various approaches to address these
      problems. CONCLUSIONS: The variety of postgraduate training models for rural
      family practice used in the 18 training programs reflects different regional
      health care needs and resources. There is no common rural family medicine
      curriculum. Networking through a rural physician-teachers group or a faculty of
      rural medicine could further the development of education for rural family
      practice.

PMID- 7780333
TI  - [Phenomenon of tumor growth stability in the host's body. New approach to growth
      and treatment of tumors].
AB  - The impact of surgical treatment of Ehrlich's carcinoma on animals' survival was
      studied. Tumour removal on posttransplantation day 30 was shown to cause no
      increases in the longevity of the animals operated on as compared with those non
      operated on (mean longevity was 59.9 and 62.2 days, respectively). The death
      causes of the animals operated on were metastases and relapses. On day 7 after
      transplantation, cyclophosphanum therapy of Ehrlich's carcinoma failed to prolong
      the animals' life. While 24 hours after tumour transplantation the longevity
      increased from 61.8 to 93.4 days. No therapeutical effects were shown to be
      associated with the influence of humoral factors of the host body on tumor
      growth. It was shown that the lack of these humoral factors resulted in
      interrupting tumor growth.

PMID- 7780332
TI  - [Tumor markers CEA, CA 15-3, MCA, TPA, ferritin and PTH in the diagnosis and
      monitoring of primary breast cancer].
AB  - Sera from 254 females were assayed for markers of tumor growth, such as cancer
      embryonal antigen (CEA), breast cancer-associated antigen (CA 15-3), mucinoid
      cancer antigen (MCA), ferritin, tissue polypeptide antigen (TPA), parathyroid
      hormone (PTH) by means of monoclonal antibody kits by using radioimmunoassay and
      enzyme immunoassay. Forty nine patients were diagnosed as having benign breast
      neoplasms, 171 patients were admitted to the clinic for primary breast cancer of
      varying severities, 34 patients without any breast abnormalities and somatic
      diseases comprised a control group. There was a close correlation between the
      higher levels of markers and the stage of a tumorous process. Various therapies
      induced decreases in the levels of the markers serve as an objective criterion
      for the efficiency of the latter. Steady increases in the mean concentrations of
      tumor markers in the intra- and post-therapeutical periods are indicative of an
      extremely poor prognosis in this group of patients.

PMID- 7780334
TI  - [Comparison of the effectiveness and toxicity of parenteral and oral vepesid in
      the treatment of disseminated breast cancer].

PMID- 7780336
TI  - [Characteristics of the effects of artificial alkalosis on electrical activity of
      the brain and ultrastructure of blood cells in oncologic patients].
AB  - The authors examined 40 patients with malignant tumors of various histogenesis,
      sites and extent, as well as 5 patients with benign tumors and other non-tumorous
      diseases. They also studied their electroencephalography and peripheral blood
      lymphocytic and erythrocytic ultrastructure in metabolic alkalosis temporarily
      induced by intravenous sodium hydrogen carbonate. In cancer patients without late
      metastases, alkalosis caused a transient normalization of previously altered
      electroencephalography, erythrocyte disaggregation and substantially reduced the
      count of killer cells in small and middle lymphocytes. These findings suggest
      that patients with malignant neoplasms have a generalized intracellular acidosis
      which can be temporarily abolished by plasma alkalinization.

PMID- 7780335
TI  - [Evaluation of the effectiveness of tamoxifen in malignant breast tumors: new
      approaches].
AB  - It has been shown that 17 beta-estradiol stimulates the cycle of phospholipid
      conversion in the breast tumor cells. The action of tamoxifen on antiestrogen
      cells is not limited by weakening the stimulating effect of 17 beta-estradiol on
      the exchange of intracellular phospholipids, but gives rise to a more complicated
      pattern of changes: inhibited incorporation of 32-P-phosphatidylcholine (PC) and
      activated exchange of phosphoinositides (PI). The experimental findings of 53
      breast tumors have indicated that in 47.2% of cases Tamoxifen alters the PC/PI
      ratio and causes its 2-fold increase. Such alterations have been found to be
      induced by the ability of Tamoxifen to suppress the activity of protein kinase C
      that regulates the synthesis of PC and PI. It is suggested that the revealed
      capacity of Tamoxifen to change the rate of intracellular phospholipid conversion
      might be used for evaluating the efficiency of this agent on malignant tumors.

PMID- 7780338
TI  - [Public health and military medicine during the Great Patriotic War, 1941-1945].

PMID- 7780337
TI  - [Several aspects of broncho-angioplastic surgery in onco-pulmonology].

PMID- 7780340
TI  - [Use of histocompatibility class I molecule peptides for in vivo induction of
      specific T-suppressors in allogenic systems and prolongation of mouse skin graft
      life].
AB  - Six synthetic peptides were selected for the individual molecule H-2Kb of the
      major histocompatibility complex class 1. Optimum conditions were elaborated for
      the induction of specific suppressor T cells in vivo by peptide 6 (alpha 2
      domain) in an intravenous dose of 33 micrograms to the tail vein or 100
      micrograms to the orbital sinus, followed by testing the suppressor activity in
      inhibiting in vitro proliferation in the three-cell MLC in response to irradiated
      cells of the stimulator Kb (BL/6) in the absence of suppressed response to the
      foreign stimulator Kk (B10.BR). Out of 6 different peptides of the same molecule
      H-2Kb, suppressor T cells were induced effectively by peptides 2 (alpha 2
      domain), 5 and 6 (alpha 2-domain), while the high efficiency of suppressors is
      realized by memory cells along with peptides 2. Under the same conditions, in
      vivo peptide immunization did not induce cytotoxic T lymphocytes at all. In
      contrast, CTL were specific in their high efficiency where memory cells were in
      vitro pretreated with stimulators of warmed BL/6 cells. Intravenous
      administration of peptide 6 to mice gave rise to prolongation of Kb (BL/6 or
      B10.MBR)-induced skin transplantation during the transfer from allogenic murine
      R101 and B10.AKM, respectively, but without the terms of skin prolongation at all
      with the stranger donors Kk (B10.BR) or Kd (DBA/2).

PMID- 7780339
TI  - [Reconstructive surgery and organ-sparing methods in the treatment of patients
      with laryngeal and oral cavity tumors].
AB  - Some advances have been recently made to improve survival rates among patients
      with common advanced larynx and oropharyngeal cancer. In this connection, it is
      essential to improve the quality of such patients' life. A total 382 patients
      with Degrees III-IV laryngeal and oral cancers were followed up. New approaches
      to treating these patients by combining various radiation, chemoradiation and
      surgical treatments, as well wide application of various primary plastic
      surgeries have yielded good functional and cosmetic results in most patients.

PMID- 7780341
TI  - [Synthesis of arachidonic acid cascade eicosanoids in tumors of various
      histogenesis in mice].
AB  - The investigation was undertaken to characterize the profile of arachidonic acid
      metabolites in different spontaneous and transplantable tumors in mice. The five
      metabolites via the cyclooxygenase pathway (PGE2, PGF2 alpha, PGD2, TxB2, 6-keto
      PGF1 alpha), as well as the three lipoxygenase products (5-HETE, 12-HETE, and 15
      HETE) were monitored by thin layer chromatography and high performance liquid
      chromatography after "ex vivo" metabolism of exogenous [1-C14]-arachidonic acid
      by homogenates of tumor tissues. It was shown that all tumors had a unique
      profile of eicosanoids. The most cyclooxygenase activity along with the
      significant synthesis of PGE2, PGF2 alpha, and 6-keto-PGF1 alpha was noted in
      lung tumors. The antitumor effect of indomethacin was directly related to the
      ability of tumors to produce PGE2. On the other hand, there were varying
      lipoxygenase activities in tumors. In some cases, the extremely high levels of 15
      and 12-HETE synthesis in neoplastic tissue could indicate that there was a basic
      possibility of using lipoxygenase inhibitors for suppressing malignant tumors.

PMID- 7780342
TI  - [DNA ploidy of tumor cells in prognostication of the course of malignant
      neoformations].
AB  - DNA flow cytometry (FCM) was used for the clinical prognosis in patients
      undergone surgical removal of a tumor. The relationship between the structure of
      the tumor cell population (ploidy) and the frequency, time of a relapse onset
      (recurrence, metastasis), and the survival length were analyzed. All the patients
      had presurgical treatment (chemo- and/or radiotherapy). The patients were
      followed up for 5 to 9 years after surgery. The groups under study included 177
      cases of breast cancer, 81 cases of larynx cancer, and 62 cases of colon cancer.
      Among the patients, the onset of a relapse was earlier and occurred more
      frequently in cases of aneuploid tumors among the patients regardless of the
      tumor type. In patients with aneuploid tumors, the most unfavorable prognosis was
      inherent in the hyperdiploid and multiclonal ones. The probability of 5-year
      survival for patients with aneuploid tumors appeared to be 20-30% lower than that
      in cases of diploid ones.

PMID- 7780343
TI  - [Preoperative hypoxia-radiotherapy in multimodal treatment of patients with stage
      III colonic cancer].
AB  - The paper analyzes the results of surgical and multimodality therapies for 237
      patients with Stage III colonic cancer, which were divided into 3 groups. Group 1
      included 119 patients undergone only surgical management, Group 2 comprised 43
      who were additionally treated with intensive radiation (4 Gy daily for 5 days)
      and Group 3 consisted of 75 patients who were irradiated in the presence of
      overall hypoxia evoked by breathing a gaseous mixture containing 9% oxygen. A
      five-year follow-up has indicated that there are significantly higher survival
      rates among those who have received a multimodality therapy rather than those
      merely operated on (82 +/- 5 and 53 +/- 9%, respectively). A short-term gaseous
      hypoxia has been found to reduce the incidence of systemic radiation reactions in
      patients during preoperative radiation and to fail to lower the efficiency of
      multimodality therapy.

PMID- 7780344
TI  - [Indicators of the state and effectiveness of cancer control in Russia].
AB  - The paper analyses mortality rates due to malignant neoplasms and resultant
      socioeconomic losses, the risk of having and dying of these diseases throughout
      the coming life, the average longevity among cancer patients. These summarized
      indicators are considered by the authors as criteria for planning, managing, and
      implementing anticancer measures in the community.

PMID- 7780345
TI  - [Basic characteristics of macrophage as an effector cell].

PMID- 7780346
TI  - [Role of outdoor and indoor air pollution in the etiology of lung cancer].
AB  - The results of a case-control study of lung cancer risk in female non-smokers in
      Moscow are presented in the paper. The increase in a risk of lung cancer was
      found to be associated with outdoor pollution, the closure of the residence to
      chemical industry and ferrous and non-ferrous smelters, environmental tobacco
      smoke from husbands and exposure to radon (Rn) at home. The relative risk of lung
      cancer (RR) for those living in high air polluted versus relatively pure areas
      was 2.6 (95% CI = 1.2-5.6). RR of lung cancer related to the closure of the
      residence to chemical industry and ferrous and non-ferrous smelters were 2.0 (95%
      CI = 1.0-3.9) and 1.75 (95% CI = 1.0-3.1). The analysis has shown that there is
      an increase in lung cancer risk in women whose husbands smoke, which is as high
      as 1.9 (95% CI = 1.3-2.9). Lung cancer risk is associated with levels of exposure
      to Rn in the dwellings: RR was 2.48 (95% CI = 1.4-4.3) for the Rn concentration
      of > 24.3 Bq/m3 versus < 13 Bq/m3.

PMID- 7780347
TI  - Meditation and hypertension.

PMID- 7780348
TI  - Parasite molecules in cerebral malaria.

PMID- 7780349
TI  - Balloon angioplasty of the femoro-popliteal segment: follow up results from
      southern India.
AB  - BACKGROUND: Disease of the femoral and popliteal arteries, though one of the
      commonest manifestations of atherosclerosis, is under-recognized because the
      morbidity it produces is less catastrophic than coronary or cerebrovascular
      arterial involvement. Percutaneous transluminal angioplasty is performed for
      femoro-popliteal lesions at different centres in India, but post-angioplasty
      follow up data are scarce. We present our results after femoro-popliteal balloon
      angioplasty in 140 lesions. METHODS: Between 1986 and 1993, 140 femoro-popliteal
      angioplasties were performed in 119 patients with symptomatic limb ischaemia.
      Seventy-one per cent of patients had claudication and the others also had tissue
      loss. Eighty-two per cent of the lesions were occlusions. The average length of
      the lesions was 10.7 cm. Conventional wire-balloon angioplasty was performed in
      128 lesions; in 12 others, laser-assisted balloon angioplasty was performed using
      an Nd-YAG laser thermal probe. Patients were followed up at regular intervals for
      any recurrence of symptoms and for objective evidence of restenosis or re
      occlusion. RESULTS: Despite a technical success in 83% of the lesions, cumulative
      primary patency calculated by the life-table method showed a slow decline which
      plateaued at 40% after 36 months. Long occlusions and multifocal stenoses showed
      shorter cumulative patency following angioplasty (27 months and 5.8 months
      respectively). Extensive luminal irregularity due to post-angioplasty intimal
      flaps was reduced by using warm contrast for balloon dilatation in 16 patients.
      In 14 patients who had repeat angioplasty for restenosis, the secondary patency
      showed a satisfactory figure of 84% at 60 months. CONCLUSION: Percutaneous
      transluminal angioplasty is a satisfactory alternative to surgery in femoro
      popliteal stenotic or occlusive disease. Regular follow up of such patients is
      essential in the first three years because re-occlusion can occur. We found that
      patency remained fairly constant after 36 months. Repeated angioplasty can
      maintain patency in patients with restenosis.

PMID- 7780351
TI  - Magnesium levels in serum and erythrocytes of children from Kerala.
AB  - BACKGROUND: Magnesium is required in higher quantities, during the phase of rapid
      growth, in children. Its level in the ground water in Kerala is low. This can
      cause magnesium deficiency especially in children from the lower socio-economic
      groups who also suffer from nutritional insufficiency. METHODS: We compared the
      serum and erythrocyte magnesium levels of school children from high and low
      (agricultural labourers and fisherfolk) socio-economic groups. These levels were
      determined using atomic absorption spectrophotometry. Body mass indices and
      haemoglobin levels were used as indirect measures of nutritional status. RESULTS:
      Serum and erythrocyte magnesium levels were significantly lower in both boys and
      girls from low socio-economic groups who also had lower body mass indices.
      CONCLUSION: Nutritional insufficiency is prevalent in children from the low socio
      economic groups and is associated with low serum and erythrocyte magnesium
      levels.

PMID- 7780350
TI  - Infection rates in single- and double-lumen central venous catheters in
      critically ill patients.
AB  - BACKGROUND: Catheter-related sepsis is a well known complication in critically
      ill patients receiving total parenteral nutrition. Micro-organisms may travel
      from the skin puncture wound along the external surface of the catheter or from
      the hub through the lumen of the catheter, to be shed into the circulation
      causing bacteraemia and sepsis. The incidence of sepsis is said to be about three
      times greater with multiple-lumen catheters than with single-lumen catheters.
      METHODS: Fifty patients admitted to our intensive care unit were randomly
      assigned to have either a single-lumen (Group I, 25 patients) or double-lumen
      (Group II, 25 patients) hydromer-coated, polyurethane central venous catheters of
      the same gauge and length, placed through the infraclavicular subclavian approach
      using the Seldinger technique. A sterile dry gauze dressing at the skin puncture
      site was changed every day. Skin swabs were taken for semi-quantitative culture
      studies before catheter insertion and removal, from the proximal 3 cm (lying
      subcutaneously) and distal 5 cm of the catheter segments on removal of the
      catheter, and venous blood was drawn from a peripheral vein before removal of the
      catheter. RESULTS: The most common isolate was coagulase negative Staphylococcus.
      No significant difference was found between the two groups in the incidence of
      catheter-related infection and catheter-related sepsis. CONCLUSION: Double-lumen
      central venous catheters placed in critically ill patients do not cause more
      sepsis than single-lumen catheters.

PMID- 7780352
TI  - Paternal leucocyte immunotherapy for recurrent pregnancy loss.
AB  - The defective recognition of foetal alloantigens by the maternal immune system is
      associated with recurrent pregnancy failure and may be prevented by boosting the
      maternal immune response with paternal or third party leucocyte immunization. The
      mechanism by which this process achieves success is not known. Clinical trials on
      recurrent spontaneous abortion have shown an up to 70% successful pregnancy rate
      after immunotherapy but the importance of this is unclear because there have been
      success rates of between 29% and 76% even in the control population. These
      variations could be due to small sample sizes and heterogeneity in the
      populations studied as well as co-intervention by the placebo. This article
      reviews the state-of-the-art for immunotherapy and discusses its mechanism of
      action in the prevention of recurrent foetal loss.

PMID- 7780353
TI  - Rational drug use in developing countries.

PMID- 7780354
TI  - DRD2 Ser311/Cys311 polymorphism in schizophrenia.

PMID- 7780355
TI  - Living related liver transplantation.

PMID- 7780356
TI  - AIDS.

PMID- 7780357
TI  - Poliomyelitis in Indian adults.

PMID- 7780358
TI  - Medical Council of India and the General Medical Council, United Kingdom.

PMID- 7780359
TI  - Stress and medical practice.

PMID- 7780360
TI  - Cost analysis of blood surveys for the detection of microfilaria carriers in
      rural areas.

PMID- 7780361
TI  - HLA phenotypes in Asians developing tuberculosis on dialysis or after renal
      transplantation.

PMID- 7780362
TI  - Astropathy for cure.

PMID- 7780363
TI  - Medicine and the Indian media.

PMID- 7780364
TI  - Safe disposal of disposables.

PMID- 7780365
TI  - Fluoroquinolones should be used rationally.

PMID- 7780366
TI  - Responsible reporting on epidemics.

PMID- 7780367
TI  - Induction of ovulation and multiple pregnancies.

PMID- 7780368
TI  - [Molecular mechanisms of the toxic action of the mycotoxin zearalenone on
      phospholipid metabolism, peroxide formation processes in membranes of brain
      mitochondria and erythrocytes, resistance of the latter to peroxide hemolysis in
      white rats and effects of sodium thiosulfate under these conditions].

PMID- 7780369
TI  - [Trophic effect of neurotransplants on suppression of seizure activity in rats
      with hereditary epilepsy].

PMID- 7780371
TI  - [Features of the contractile reaction of the chick embryo amnion upon action of
      acetylcholine on its inner and outer surface].

PMID- 7780370
TI  - [Dynamics of spontaneous contractions of an isolated cardiomyocyte in vitro].

PMID- 7780372
TI  - [Embryogenesis of the olfactory bulb in cats].

PMID- 7780374
TI  - [Survival and distribution of genetically engineered microorganisms in laboratory
      water microecosystems].

PMID- 7780373
TI  - [Mediators of synaptic transmission in ganglia of the tracheal plexus].

PMID- 7780375
TI  - Photolabeling of human serum albumin by 4-azido-2-([14C]-methylamino)
      trifluorobenzonitrile. A high-efficiency, long wavelength photolabel.
AB  - N-alkyl derivatives of perfluoroarylazides are excellent candidates for
      photolabeling of proteins since they have absorption spectra in the 340-350 nm
      range permitting photolabel absorption without direct protein photolysis. The
      [14C]-N-methylamino derivative of 4-azido-tetrafluorobenzonitrile has been used
      to demonstrate that 80% of the photo-induced nitrene transient becomes covalently
      attached to HSA during photolysis. Multiwavelength detection of the photoprobe
      protein separation by size exclusion chromatography is shown to be an effective
      tool for assessing the conjugation of the photoprobe to the protein.

PMID- 7780376
TI  - Synthesis and in vivo disposition studies of 18F-labeled HFA-134a.
AB  - A rapid synthesis of the chlorofluorocarbon replacement compound 1,1,1,2
      tetrafluoroethane (HFA-134a) was identified and utilized to prepare 99+%
      radiochemically pure [18F]HFA-134a in 20-35% radiochemical yield. Four rats were
      then exposed to no-carrier-added (NCA) [18F]HFA-134a, and monitored via
      coincidence detection. Following withdrawal of the test atmosphere of [18F]HFA
      134a, the mean half-life of [18F]HFA-134a in four rats was determined to be 7.8
      +/- 1.5 min following a 10 s exposure and 8.1 +/- 1.7 minutes following a 10 min
      exposure.

PMID- 7780377
TI  - Prompt-gamma neutron activation facility for measuring body nitrogen in vivo in
      small animals.
AB  - We have designed a prompt-gamma neutron activation facility for in vivo
      measurements of total body N in small animals. The facility incorporates a 252C
      neutron source with an emission rate of 3.2 x 10(8) n s-1 (140 micrograms), and a
      heavy-water neutron collimator-moderator assembly, together providing an optimum
      thermal flux-to-dose ratio for a 0.25-0.5 kg animal. Using two NaI(Tl) detectors
      we can attain a fractional statistical error of measurement of 3.5% for a dose
      equivalent of approx 50 mSv, sufficiently low that serial measurements can be
      made on the same animal.

PMID- 7780378
TI  - Comparison of the psychometric characteristics of three quality of life measures
      in intractable epilepsy.
AB  - Understanding how epilepsy affects an individual's quality of life (QOL) requires
      reliable and valid QOL measures. Analyses of reliability and validity rarely
      examine measures obtained in the same sample, making comparisons among measures
      difficult. We report analyses of internal consistency reliability, face, content,
      construct and criterion validity for the Epilepsy Surgery Inventory-55 (ESI-55, a
      measure based on the SF-36 Health Survey), the Sickness Impact Profile (SIP) and
      the Washington Psychosocial Seizure Inventory (WPSI) administered concurrently in
      the same sample of intractable epilepsy patients. Results generally support the
      validity of all three measures in assessing the aspects of QOL they were designed
      to address. The ESI-55 and SIP assess a broad, multi-dimensional construct of QOL
      in epilepsy, compared with the more specific focus of the WPSI on psychological
      and social adjustment. Judged by objective psychometric criteria, the ESI-55 and
      SIP are preferred over the WPSI in studies of the broad impact of epilepsy on
      quality of life.

PMID- 7780379
TI  - Advances in methods for assessing the impact of epilepsy and antiepileptic drug
      therapy on patients' health-related quality of life.
AB  - We studied 31 previously validated and newly developed generic and epilepsy
      specific scales to evaluate their usefulness for assessing the impact of epilepsy
      and anti-epileptic drug (AED) therapy on health-related quality of life (HRQOL).
      Included were the MOS SF-36 Health Survey, additional measures of mental health,
      cognition, epilepsy-specific perception of control, behavioural problems,
      distress, worries and experiences, the Liverpool Epilepsy Impact and Seizure
      Severity scales, and a patient-completed symptom checklist. Questionnaires were
      completed twice by 136 patients on AED therapy in a multicentre study in the UK.
      Validity was assessed in relation to disease severity, defined as time since last
      seizure, and to patient-reported symptoms. Statistical analyses to estimate the
      contribution of HRQOL information of each scale relative to that of others were
      conducted. The 171-item questionnaire could be completed by out-patients with
      epilepsy with good data quality. With few exceptions, generic and epilepsy
      specific measures satisfied psychometric tests of hypothesized item groupings and
      scale score reliability (internal consistency and test-retest reliability) and
      differentiated well between groups of patients differing in time since last
      seizure and in symptom impact, regardless of time since last seizure. However,
      scales differed widely in their validity in discriminating between groups of
      patients known to differ clinically. The SF-36 Role Physical scale best
      discriminated among groups differing in disease severity. The epilepsy-specific
      Mastery, Impact, Experience, Worry, Distress, and Agitation scales were among the
      10 best measures in discriminating among groups differing in disease severity.
      Generic measures, especially measures of social and role functioning and mental
      health, were best at differentiating groups of patients differing in symptom
      impact. Recommendations are offered for concepts and specific scales most likely
      to be useful in future studies of the HRQOL burden of epilepsy and the HRQOL
      benefits of AED therapy.

PMID- 7780380
TI  - The Q-TWiST approach to assessing health-related quality of life in epilepsy.
AB  - We propose to develop a methodology for evaluating clinical interventions for
      epilepsy in terms of their effects on disease-related outcomes, social cost and
      quality of life, while incorporating patient preference. The technique represents
      an extension of the 'quality-adjusted time without symptoms and toxicities' (Q
      TWiST) method, which has been previously used to evaluate treatments for cancer
      and AIDS with respect to their costs in terms of toxicities, and benefits in
      terms of improved progression-free and overall survival. The extensions we
      propose to develop allow additional dimensions of quality of life relevant to
      epilepsy to be included in the analysis. We demonstrate a possible application of
      the proposed Q-TWiST method with a hypothetical example comparing surgery vs
      antiepileptic medication management alone for seizure control. The trade-offs
      between these alternative treatments are highlighted, along with patient
      importance weightings regarding various dimensions of quality of life. We
      describe further research needed to develop the methodology fully and comment on
      its potential usefulness.

PMID- 7780381
TI  - The contribution of the measurement of seizure severity to quality of life
      research.

PMID- 7780382
TI  - Agreement between self reports and proxy reports of quality of life in epilepsy
      patients.
AB  - Agreement between self reports and proxy reports of quality of life was examined
      in a sample of 292 patients with epilepsy and their designated proxies. Patients
      and proxies completed an 89-item Quality of Life Inventory (QOLIE-89), with the
      items rephrased for the proxy. Results reveal moderate correlations (product
      moment r ranging from 0.29 to 0.56 for 17 multi-item scales) between self reports
      and proxy reports. Agreement was good for measures of function that are directly
      observable and relatively poor for more subjective measures. Mean scale scores
      were significantly different between patients and proxies for only five of 17
      multi-item scales. Proxy respondents systematically reported better functioning
      than did patients in three scales assessing cognitive functioning (all p <
      0.001). By contrast, patients reported more positive health perceptions and less
      seizure distress than proxies. Patient educational attainment correlated
      inversely with degree of disagreement between patient and proxy reports for six
      of the 17 QOL scales and for the overall score. In addition, proxy educational
      attainment correlated positively with agreement for four scales. This study
      indicates that for group level comparisons, proxy respondents can be substituted
      for adults with epilepsy having low to moderate seizure frequency. However, for
      individual level assessments proxies should be used with caution.

PMID- 7780384
TI  - Directions for future research. Health related quality of life in epilepsy.

PMID- 7780383
TI  - The routine use of health-related quality of life measures in the care of
      patients with epilepsy: rationale and research agenda.
AB  - Reliable and valid patient-completed questionnaires to assess the health related
      quality of life (HRQOL) of people with epilepsy are becoming increasingly
      available. At present, however, they are not routinely used in epilepsy patients'
      care. The use of HRQOL measurement in clinical practice settings may improve the
      quality of care for people with epilepsy through (1) increasing the detection of
      patients' problems with daily functioning and well-being: (2) guiding therapeutic
      management; and (3) leading to improvements in patients' HRQOL and satisfaction
      with care. To realize the potential benefits of HRQOL assessment in the care of
      people with epilepsy, research into the feasibility of the office-based use of
      HRQOL questionnaires, measurement quality, and the impact of routine HRQOL
      assessment on the quality of epilepsy patients' care needs to be undertaken. The
      transfer of HRQOL questionnaires from research tools into clinical tools requires
      the collaboration of social scientists, health services researchers, and
      clinicians. HRQOL questionnaires have the potential to become a new clinical tool
      which could enhance the quality of care physicians are able to provide for their
      patients with epilepsy.

PMID- 7780385
TI  - Advances in the measurement of health-related quality of life in epilepsy.

PMID- 7780386
TI  - The evolution of health-related quality of life assessment in epilepsy.
AB  - The purpose of this article is to review the ways in which quality of life has
      been assessed in patients with epilepsy. It is specifically proposed that there
      have been three phases or types of studies examining the effects of epilepsy on
      cognitive, behavioural, social and physical function. The first and oldest phase
      was characterized by the use of traditional forms of clinical evaluation and
      available generic measures of cognitive, behavioural and psychosocial function to
      study the general effects of epilepsy, effects of epilepsy-specific clinical
      variables (e.g. seizure type, age at onset), and the consequences of treatment
      with antiepileptic medications on patients' lives. The second phase of research
      was characterized by the development of epilepsy-specific measures of cognitive
      ability, psychological status and psychosocial status, which were designed to
      meet the special research and clinical needs not provided by previous generic
      measures (e.g. Washington Psychosocial Seizure Inventory, Fear of Seizures
      Scale). The third and most recent phase is characterized by the use of models,
      techniques, and measures developed from the health services research field to
      assess formally contemporary definitions of health-related quality of life
      (HRQOL) (e.g. ESI-55, QOLIE-89, Seizure Severity Scale) and develop models of the
      effects of epilepsy on HRQOL. Thus, concern regarding the impact and consequences
      of epilepsy is not a new development, but has evolved over the years, resulting
      in new models and methods of assessment of disease impact on well-being and
      functional status.

PMID- 7780387
TI  - Flap coverage of a chronic hallux ulcer.
AB  - For nonhealing, noninfected plantar ulcerations of toes, flap coverage can be a
      viable alternative, providing there is adequate vascular supply to the digit.
      This article presents an interesting case, wherein the digital ulcer was covered
      with a flap from the same toe. The flapped area was then covered with a skin
      graft.

PMID- 7780388
TI  - The role of endoscopy in treatment of stenosing posterior tibial tenosynovitis.
AB  - Some foot and ankle pathologic conditions can be treated by an endoscopic
      approach. Its effectiveness has been reported in the treatment of plantar
      fasciitis. The authors have used an endoscopic approach in the treatment of
      posterior tibial tenosynovitis resistant to nonsurgical treatment. A review of
      the pathology, terminology and the diagnosis of tenosynovitis is provided. The
      case report demonstrates a technique using an endoscope to incise the posterior
      tibial tendon sheath.

PMID- 7780389
TI  - Protocol for lower extremity trauma.
AB  - Trauma to the lower extremity has been treated in the past by many specialties
      and subspecialties of medicine. No specialty, however, should be better qualified
      or trained in treating lower extremity trauma than the podiatrist. This study
      reviews some critical principles of acute trauma management and treatment. A
      simple algorithm is suggested. Three representative case studies are presented,
      demonstrating the importance and value of an established protocol.

PMID- 7780390
TI  - Elective foot and ankle surgery in the diabetic patient.
AB  - The philosophy of treating diabetic foot pathology has changed dramatically
      throughout the years. No longer are old, unfounded fears considered the standard
      of care. The authors enumerate on their indications and goals of treating this
      complex entity. Clinical aids, as well as patient evaluations are discussed.

PMID- 7780391
TI  - Forefoot postoperative continuous pain control by nonelectronic device.
AB  - The authors present a system against postoperative pain in forefoot operations,
      which functions by continuous infusion of anesthetic in the malleolar internal
      space. The system (Single-Day Baxter Infusor) was utilized in 145 patients who
      had undergone forefoot surgery. The effectiveness of the method was evaluated by
      means of a numeric scale (0 to 5) reflecting pain level. The method was effective
      in controlling postoperative pain in 110 cases (score 0 to 1); 25 cases (score 2)
      reported pain in the dorsal hallux, in the deep peroneal area, whereas in 10
      cases (score 4 to 5 on the scale), nonsteroidal anti-inflammatory drugs had to be
      administered.

PMID- 7780392
TI  - Ancient schwannoma of the foot.
AB  - Ancient neurilemoma (schwannoma) is an uncommon variant of neurilemoma. On the
      basis of histology, this slow-growing, benign neoplasm has often been confused
      with sarcoma, and this confusion has resulted in overzealous resection. The
      authors report a case of this lesion affecting the plantar aspect of the foot. A
      discussion of the clinical and histological findings that emphasizes diagnosis
      and treatment is included.

PMID- 7780393
TI  - Endoscopic heel anatomy: analysis of 200 fresh frozen specimens.
AB  - The authors radiographed and dissected 200 fresh frozen cadaveric specimens
      selected randomly from the general United States population. A 21% incidence of
      inferior calcaneal exostosis formation was identified. Of those specimens
      identified as having an inferior calcaneal exostosis, there was a 52.4% incidence
      of heel spurs that were in the plantar fascia and a 47.6% incidence of heel spurs
      that were identified superior to the plantar fascia. After dissection of the
      specimens, the mean width and thickness of the medial, central and lateral bands
      of the plantar fascia, and the width of the medial and lateral subcutaneous fat
      were calculated. The presence of an inferior calcaneal bursa was identified in
      one specimen, and the presence of a heel neuroma was identified in 0 specimens of
      the 200 examined. The results of this study will assist the practitioner in
      performing the endoscopic plantar fasciotomy by providing the surgeon with
      quantitative averages of fascial dimensions. By knowing these fascial
      measurements, the practitioner will be aided intraoperatively in determining what
      level of fasciotomy to perform. This could help obviate some of the postoperative
      biomechanical sequelae that can occur with total releases, and immediate
      postoperative excessive ambulation by the patient. This study may help to gain
      insight into the true etiology of heel spur syndrome/plantar fasciitis.

PMID- 7780395
TI  - Microbiology of osteomyelitis in diabetic foot infections.
AB  - The objective of this report is to describe the bacterial pathogens in diabetic
      patients with osteomyelitis due to neuropathic foot ulcerations. The authors
      reviewed the records of 36 diabetic patients with osteomyelitis of the foot due
      to neuropathic ulceration. Intraoperative deep soft tissue and bone specimens
      were obtained from each patient. The mean age of patients was 56.7 years, and the
      mean duration of diabetes was 14.9 years. Streptococcus species (61%) and
      Staphylococcus aureus (47%) were the most common organisms identified. Gram
      negative aerobes were found in 18 cultures (50%). Only five patients' cultures
      (14%) were identified with anaerobic pathogens. The average number of pathogens
      per patient was 2.25. The most common bacterial pathogens in bone infections in
      diabetics were Streptococcus species and Staphylococcus aureus. Anaerobes were
      uncommon.

PMID- 7780394
TI  - Ganglion cyst of the hallux: an aberrant presentation.
AB  - Ganglion cysts are benign, thin walled, fluid-filled lesions commonly occurring
      in the distal extremities. Although widely debated in the literature, a true,
      identifiable etiology has remained elusive. The authors report on a ganglion cyst
      with a unique presentation on the hallux, and a review of the literature.

PMID- 7780396
TI  - Evaluation of Wagdy's technique for treatment of hallux valgus by double-V
      osteotomy.
AB  - Seventy-nine feet in 71 patients with hallux valgus were treated by double-V
      Wagdy osteotomy of the first metatarsal head. Sixty-eight per cent were totally
      free of pain with acceptable cosmetic appearance. Excellent and good results were
      obtained in 97.5% of the cases. The mean postoperative decrease of the
      intermetatarsal angle was 1.8 degrees and of the hallux valgus angle 22 degrees.
      The operation is technically simple and stable without internal fixation. It
      restores the length of the hallux and reduces the possible complications of
      nonunion, avascular necrosis, shortening of the first metatarsal, and appearance
      of new bone formation at the medial aspect of the osteotomy site.

PMID- 7780397
TI  - Identification and treatment of the diabetic neuropathic foot.
AB  - The authors discuss neuropathic osteoarthropathy in the diabetic foot, often
      associated with Charcot joints. Identification of this malady as well as
      indications for treatment are reviewed. Representative cases are illustrated.

PMID- 7780398
TI  - Enchondroma of the proximal phalanx.
AB  - Enchondromas are the most commonly seen benign tumors of the small bones of the
      foot. If symptomatic, these tumors often require surgical excision. Foot surgeons
      must weigh the surgical alternatives with respect to relief of symptoms,
      prognosis, cosmesis, and function. The authors present a typical case
      presentation of a solitary enchondroma in a phalanx.

PMID- 7780399
TI  - Biodegradable internal fixation.
AB  - The objective of this article was to assess the value of the use of biodegradable
      materials in internal fracture fixation according to the current literature.
      Research methods included a computerized Medline search and a hand check of
      references of identified articles. Also, a complete reference list was obtained
      from the manufacturer of Biofix (Bioscience Ltd., Tampere, Finland). The
      reviewers abstracted descriptive information about population, materials,
      complications, follow-up times in clinical trials and strength of fixation,
      complications, and population for animal experiments. Results indicated that
      sterile sinus formation is mostly associated with polyglycolic acid, with rates
      up to 25%, and to a lesser extent, polylactic acid. Volume of implanted material
      and vascularity of bone appeared to affect the rate of sinus formation.
      Absorbable fixation was equivalent to or better than steel fixation for
      functional outcome refracture rate, and in transepiphyseal femoral and humoral
      fractures. Polyglycolic acid and polylactic acid both became toxic between 10
      days and 4 weeks of hydrolysis. Polyglycolic acid had the highest initial
      strength at 370 MPa compared with other polymers.

PMID- 7780400
TI  - A simplified technique for bending Kirschner wires.
AB  - Kirschner wires are extremely popular in foot surgery for fixation of osteotomies
      and digital procedures. Bending the protruding portion of a Kirschner wire used
      for fixation in foot surgery can sometimes be troublesome. A simplified technique
      is presented for bending protruding Kirschner wires using a Frazier size 3
      suction tube.

PMID- 7780401
TI  - An unusual case of diabetic cellulitis due to Pasturella multocida.
AB  - Pasturella multocida is a well known potential cause of infection following bites
      or scratches by animals. The organism causes the usual clinical manifestations of
      a rapidly developing cellulitis at the site of injury. The resultant infection is
      dangerous and can progress on to a deep infection, osteomyelitis, and septicemia.
      In compromised patients, the source and etiology of the infection may be obscure
      making definitive diagnosis difficult. This paper reviews a very unusual case of
      a foot infection in a diabetic patient that was due to a domestic pet licking an
      excoriation on the foot.

PMID- 7780402
TI  - Subungual exostosis.
AB  - The author describes subungual exostoses as well as their differential diagnoses.
      Clinical and radiologic features are illustrated. Surgical excision is
      recommended, following partial toenail avulsion, in the majority of symptomatic
      cases.

PMID- 7780403
TI  - The barbarians are at the gate.

PMID- 7780405
TI  - Advanced perioperative nursing: selected physiological effects of trauma.
AB  - This article reviews selected physiological responses to trauma. These responses
      help the person to partly meet the challenge of the trauma by changing endocrine
      and metabolic functioning with the release of endogenous chemicals.

PMID- 7780404
TI  - Coordination and collaboration of violent trauma care.
AB  - The STC has the luxury of an all RN staff, capable of functioning in any of the
      surgical specialities. The PTN is a specialitist at being a generalist to provide
      care to a critically injured population. The role of the PTN is multifaceted and
      varied; it can be best described as functioning as a multidisciplinary
      coordinator and case manager in meeting the demands of the violent trauma
      patient. The patient often enters the OR severely injured, intubated, and
      incapable of self-protection or determination. The most important function of
      perioperative nursing is that of patient advocate. No other member of the trauma
      team is as focal to the patient's safety and comfort as the nurse. Passage from
      the scene of violent trauma to the OR requires dynamic assessment skills,
      critical thinking, and organizational capabilities. As long as interpersonal
      altercation results in intentional trauma, there will be a need for perioperative
      trauma nurses with the committement and expertise to mend the wounds of violent
      trauma victims.

PMID- 7780406
TI  - Notes from the field: interview with a perioperative trauma night nurse.
      Interview by Julie A. Meador.
AB  - Trauma has significantly impacted our operating rooms with increases in care
      costs, staffing, and procedural needs. This article presents an interview with a
      frontline player in perioperative trauma, a night perioperative care coordinator.
      The coordinator provides a look into what it is like to plan, coordinate, and
      give perioperative trauma care on the night shift of a level I trauma center.

PMID- 7780407
TI  - Blood products replacements processed in the surgical field.
AB  - This article summarizes the main blood products that can be gathered from,
      treated, and returned to the trauma patient in the operating room. A brief
      description of the physiology of blood and clotting mechanisms is given. A focus
      on plasma pheresis is provided, as well as a suggested procedure for plasma
      collection.

PMID- 7780408
TI  - Safety in intraoperative trauma care.
AB  - Care of patients with penetrating trauma is risky because of increased prevalence
      of blood borne disease. Perioperative nurses have constant exposure to body
      fluids so they are at an increased risk of exposure. Personal safety has emerged
      as one of the primary workplace concerns of nurses. This report reviews
      intraoperative safety, Association of Operating Room Nurses and Occupational
      Safety and Health Administration standards, and universal precautions in
      practice.

PMID- 7780409
TI  - Perioperative considerations of firearm injuries.
AB  - The trauma patient who presents to the operating room averages three to six
      separate surgical procedures initially. Almost half of all trauma is because of
      penetrating injuries and, more often than not, is the result of injury by
      firearms. Successful intervention during the perioperative phase is a result of
      critical thinking and planning by the perioperative nurse based on familiarity
      with the mechanism of injuries produced by firearms. An understanding of the
      types of weapons and ballistics will give the perioperative nurse a basis for
      assessment and care planning.

PMID- 7780410
TI  - Pharmacological resuscitation in trauma.
AB  - With every patient who is involved in a traumatic event, the potential for
      catastrophe is hanging over the heads of everyone on the initial care team. There
      is a need to develop protocols and routines to provide care during these high
      stress periods. This article discusses the role of team members in the care of
      the trauma patient. It is also important to have a quick overview of the
      medications used in the resuscitation of the patient. The article discusses
      pharmacological adjuncts to the resuscitation and management of the trauma
      patient. This review of cardioactive and supportive medications can provide a
      review of medications commonly used in the initial treatment of the trauma
      patient. Whether the patient experiences cardiac arrest or not the potential
      exists at any time treatment period for the problem to develop. Constant review
      of needed medications and protocols will assist in the management of the patient.

PMID- 7780411
TI  - Another routine case: gunshot trauma.
AB  - This case study describes the surgical repair of noncomplicated gunshot wounds in
      a young man. The preoperative assessment and surgical procedures, including
      bullet retrieval, is given. A systematic routine for handling emergency gunshot
      wound patients is shared as intraoperative nursing is described. Direct cost of
      this surgery to the operating room is explored.

PMID- 7780412
TI  - Selection of regional anesthesia for trauma.
AB  - The type of trauma, the desires of the patient, and the skills of the
      practitioner dictate the type of anesthesia for any surgical procedure. This
      article briefly reviews physiological and contiguous considerations of choosing
      and administering regional anesthesia technique for the trauma patient. Selected
      potential complicating factors present in the emergency trauma patient are also
      briefly discussed.

PMID- 7780413
TI  - Bullet retrieval in the operating room.
AB  - Valuable trace evidence is often lost or destroyed because of faulty collection
      and preservation techniques during surgical management of gunshot wounds. An
      experiment was conducted to show the importance of proper collection techniques
      and preservation of forensic evidence. Results are noted, a discussion is given,
      and a protocol for the surgical retrieval of bullets is presented.

PMID- 7780414
TI  - Positioning of infants and children for surgery.
AB  - The positioning of infants and children for surgical intervention must have the
      same goals and outcomes as that for adults, ie, no risk of nerve damage, adequate
      tissue perfusion without compromise of respirations, and optimal exposure for the
      surgical team. The difference between treating infants and children is in the
      positioning aids use, which are related to height and weight rather than age.

PMID- 7780415
TI  - Pediatric anesthesia.
AB  - Pediatric anesthesia differs from that of adults in many critical ways. Patients
      in the pediatric group are not required to fast for long periods before surgery.
      Induction of anesthesia is usually accomplished via inhalation agents. The
      pediatric airway and its anatomical differences are of special concern to the
      anesthesia provider and the postanesthesia nursing staff.

PMID- 7780416
TI  - The pain experience in infants, children, and adolescents.
AB  - Postoperative pain in adults has become a subject that has seen increasing
      research. The result of that research has been an increase in the type and
      quality of interventions available for pain relief. Although infants, children,
      and adolescents also experience postoperative pain, the research and
      interventions have been slower in arriving. Perhaps this is caused, in part, by
      the inability of this population to express the pain experience. It may also be
      because of the reluctance of health care providers to objectively assess and
      intervene in the pain experience of infants, children, and adolescents. The
      purpose of this article is to explore the pain experience of infants, children,
      and adolescents so the perioperative nurse will be better equipped to handle this
      experience with the patient and the family.

PMID- 7780417
TI  - Ross-Konno procedure: a case study of a newborn.
AB  - The objective is to present a case study of a 2-day-old infant who undergoes a
      Ross-Konno procedure for correction of severe congenital aortic stenosis. This
      procedure involves replacing the stenosed aortic valve with a pulmonary
      autograft. The perinatal history, diagnostic data, and the operative procedure
      are described. Preoperative and postoperative nursing management is addressed
      including normal pediatric intensive care protocols. The infant's postoperative
      hospital course was 37 days. Mitral regurgitation and pulmonary hypertension are
      being managed with lisinopril.

PMID- 7780418
TI  - Advanced practice case study: congenital hemangiomas.
AB  - Congenital hemangioma is the most common tumor of infancy. Usually it occurs
      singly in the skin. Occasionally multiple tumors are present and can involve
      other body organs. Congenital subglottic hemangioma is considered rare, but when
      it occurs can be life threatening. This article discusses the different options
      available for treatment of subglottic hemangioma and the course of treatment
      chosen for Baby S. taking into consideration her diagnosis, family situation, and
      the availability of an experimental drug therapy.

PMID- 7780419
TI  - Repair of a recto-vaginal fistula as a result of sexual assault.
AB  - A thorough and careful examination should always be performed for a child with a
      presenting complaint of sexual abuse. Rarely will a child suffer extensive
      injuries requiring surgical repair. This case study is of a 4-year-old girl who
      sustained severe penetrating trauma of the vagina and rectum resulting in a recto
      vaginal fistula. She presented 2 months after the assault and required anogenital
      reconstruction with a temporary colostomy. Initial and long-term surgical
      management of this case is discussed.

PMID- 7780420
TI  - Laparoscopy and thoracoscopy in infants and children.
AB  - The recent revolution in adult laparoscopic and thoracoscopic surgery is gaining
      momentum in the pediatric surgery arena. Pediatric general surgeons, urologists,
      and thoracic surgeons have all reported successes in performing minimally
      invasive surgery. This article presents a review of the current literature and a
      status report on current pediatric laparoscopic and thoracoscopic procedures.

PMID- 7780421
TI  - Psychosocial factors affecting a child's capacity to cope with surgery and
      recovery.
AB  - Medical stressors associated with illness and surgery make extraordinary
      psychological demands on children. A child's coping abilities, both emotional and
      cognitive, are at the heart of adjustment to these demands. Social support is
      also an important element in the child's ability to recover psychologically.
      Finally, a child's previous medical experiences, psychiatric problems, and
      learning disabilities may affect the child's behavior.

PMID- 7780422
TI  - Child-focused perioperative education: helping children understand and cope with
      surgery.
AB  - It is essential for all health care providers to remember that children
      experience hospitalization and perioperative experiences differently than adults
      because of their development stage and personal life experiences. Advocating for
      preparatory and concurrent perioperative education and support continues to be
      supported in the literature. Therapeutically based play and support can be
      adapted throughout the perioperative setting, from start to finish. It can also
      promote understanding, compliance, and satisfaction for both the child and
      family, and can provide the health care worker with a more satisfying patient
      focused plan of care.

PMID- 7780423
TI  - Preoperative assessment of the infant, child, and adolescent.
AB  - The preoperative nursing assessment is a valuable tool for perioperative nurses.
      This article describes the pediatric history, approach to pediatric physical
      examination, methods of examination, and a system-by-system review of important
      considerations for the pediatric patient.

PMID- 7780424
TI  - Blood pressure measurement in children: a brief review.
AB  - Blood pressure measurement in children is difficult and many inaccuracies are
      seen because of the method of measurement of the blood pressure cuff and the
      choice of apparatus with which to measure the blood pressure. This article will
      briefly review the ways in which blood pressures are measured in children and the
      accuracy of these different measures. Perioperative nurses should be acutely
      aware of the confusion in literature concerning blood pressure measurement in
      children. It is hoped that this discussion will help the perioperative nurse to
      choose the appropriate size cuff and the most accurate method of measurement.

PMID- 7780425
TI  - Model of human transitional cell carcinoma: tumor xenografts in upper urinary
      tract of nude rat.
AB  - An in vivo model for the study of human transitional cell carcinoma (TCC) in the
      urinary tract is desirable. Orthotopic xenografts are useful in order to
      approximate better the behavior of human tumor cells in situ. Prior models have
      been described in the urinary bladder of the nude mouse and rat. We have
      developed the first model of implantation of human TCC in the upper urinary tract
      of an experimental animal. The kidneys of homozygous nude rats 4 weeks of age
      were inoculated with 1-5 x 10(6) cells of the RT4 well-differentiated papillary
      human TCC line through bilateral flank incisions, with transparenchymal injection
      of tumor cells into either the collecting system (renal pelvis) or the
      parenchyma. The overall implantation rate was 92% (54/59 kidneys). However,
      implantation into the collecting system occurred in only 45% (18/45) of the
      group. Ligation of the ureter prior to inoculation to produce urine stasis
      improved the mucosal implantation rate. Despite suspect urine cytology findings
      in the renal pelvis injection group, no distal seeding of the urinary tract was
      seen. Intraparenchymal tumor growth was less differentiated and had a higher
      fraction of mitotic cells than mucosal tumors. Vascular and lymphatic invasion
      were commonly seen; however, distant metastasis was not observed. This model will
      prove useful in determining the role of seeding in recurrent disease and in
      developing less invasive modalities for the treatment of upper tract TCC.

PMID- 7780426
TI  - Evaluation of optimal stent size after endourologic incision of ureteral
      strictures.
AB  - The stent size necessary to promote optimal ureteral healing after an
      endoureterotomy is not known. We compared healing of an endoureterotomy over a 7F
      indwelling ureteral stent with healing over a 14F endopyelotomy stent. A
      midureteral stricture was created in each of 25 anesthetized female minipigs
      using an electrified stone basket passed retrograde. Six weeks later, the
      stricture was incised with a 24F cutting balloon device. Twenty pigs were
      randomized to receive a 7F or a 14F stent; four control pigs received neither
      incisions nor stents. At 1 week, a radiograph was performed to confirm proper
      stent position, and the stents were removed. At 3 months, a retrograde
      ureterogram was performed, and the ureters were examined grossly and harvested
      for histologic studies. Two of the ten pigs in each study group developed a
      recurrent stricture. The use of a 14F stent provided no advantage over the use of
      a smaller, more easily positioned 7F stent.

PMID- 7780427
TI  - Nephron-sparing laparoscopic surgery: techniques to control the renal pedicle and
      manage parenchymal bleeding.
AB  - Laparoscopic nephron-sparing surgery has been limited by several factors,
      including problems in the control of the vascular pedicle and the management of
      parenchymal bleeding. In an effort to improve the efficacy of laparoscopic
      nephron-sparing surgery, we developed and tested several techniques to control
      and manage intraoperative renal bleeding while performing 30 laparoscopic
      anatrophic nephrolithotomies using the porcine model. Control of the renal
      pedicle and management of bleeding included the use of the following: (1)
      extracorporeally applied atraumatic vascular pedicle clamp; (2) Argon Beam
      Coagulator to perform the capsulotomy; (3) electrocautery scissors to perform the
      nephrotomy; (4) Gelfoam welded to the cut surface of the parenchyma with the
      argon beam coagulator; (5) Surgicel welded to the outer surface of the kidney
      with the Coagulator; and (6) laparoscopically applied bolster sutures to further
      stabilize the renal unit. All animals tolerated the procedure well and survived
      to their appointed date of sacrifice. We conclude that these techniques may
      improve the efficacy of laparoscopic renal surgery, including nephron-sparing
      procedures.

PMID- 7780428
TI  - Alternative endoscopic management in the treatment of urethral strictures.
AB  - Advances in endoscopic instrumentation and techniques have expanded our
      armamentarium for safe and effective treatment of urethral strictures. Endoscopic
      incision or dilation should remain the preferred treatment for uncomplicated
      primary strictures. Balloon dilation can be useful in the treatment of dense
      strictures. Incision using laser energy has yet to provide better results than
      procedures employing a cold knife. As such, it would be difficult to justify the
      added expense of laser urethrotomy. Endoscopic placement of free skin grafts into
      the bed of the urethra after transurethral resection or deep incision of the
      stricture is a novel approach that has shown a great deal of promise.
      Endourethroplasty is a reasonable alternative to open urethroplasty when treating
      long strictures, as more than 90% of the reported patients have had a successful
      outcome with no recurrence. However, larger experience with this procedure is
      necessary to verify its efficacy and for greater acceptance. The placement of
      indwelling stents is another new promising treatment option. Overall short-term
      success rates range from 75% to 100%, but the follow-up period is short, and
      little is known about the long-term risks of an indwelling foreign body in the
      urethra. Endoscopic incision via "cut-to-the-light" or "core-through" procedures
      is an excellent alternative in patients with obliterative strictures. Data from
      several centers reveal that the majority of patients gain relief of obstruction
      while maintaining continence and erectile potency. However, at least 25% of these
      patients will need further endoscopic management to maintain urethral patency.

PMID- 7780429
TI  - Use of continuous-infusion alfentanil for analgesia during spark-gap lithotripsy.
AB  - The painful stimuli produced by a new generation of
      electrohydraulic/electromagnetic lithotripters are such that continuous infusion
      analgesia rather than general or regional anesthesia is appropriate. We describe
      our experience with continuous alfentanil infusion supplemented with intravenous
      bolus midazolam in caring for patients treated with an unmodified Medstone STS
      1050 lithotripter. Ninety consecutive treatments using this technique averaged 63
      minutes, compared with 69 minutes for 14 treatments done with general anesthesia
      and 88 minutes for 58 treatments done with epidural anesthesia. The stone burden,
      kilovoltage, and number of shocks were similar for the three groups, as was the
      immediate stone fragmentation rate. Only 2 of 90 patients received inadequate
      analgesia with the intravenous technique and required the induction of general
      anesthesia. Continuous-infusion analgesia appears sufficient to blunt the
      stimulus provided by the unmodified spark-gap lithotripters still in common use.

PMID- 7780430
TI  - Functional and histologic alterations in growing solitary rat kidney as result of
      extracorporeal shockwaves.
AB  - The long-term effects of extracorporeal shockwave lithotripsy (SWL) on children
      treated for renal calculi are unclear. To study the effects on the immature
      animal, we evaluated 31 Wistar white rats that underwent right nephrectomy at 30
      days of age. At 40 days of age they were divided into three groups: a control
      group of 10 rats that received no shockwaves; Group I (9 rats) that received 1000
      shockwaves at 16.0 kV, and Group II (12 animals) that received 1000 shock waves
      at 17.2 kV. Six months later at maturity (7 months and 10 days of age), the
      following parameters were measured: (1) body and renal weight; (2) blood lithium,
      sodium, potassium, and creatinine; (3) fractional lithium, sodium, and potassium
      excretion; and (4) clearances of lithium and creatinine. The kidneys were studied
      grossly and histologically. We found no significant changes in overall animal and
      renal growth between the post-SWL and control groups. However, there were
      significant changes in renal function. The animals in Groups I and II presented
      significant increases in blood potassium compared with the control group.
      Furthermore, the 1000 x 17.2 kV group showed permanent histologic renal changes,
      including red cells in Bowman's capsule and glomerular congestion. The disorders
      caused by SWL are compatible with hyporeninemic hypoaldosteronism,
      inappropriately low plasma renin activity, and aldosterone deficiency.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7780431
TI  - Metabolic evaluation of infected renal lithiasis: clinical relevance.
AB  - Complete metabolic evaluation was performed in 21 patients with infected renal
      lithiasis. Patients with pure struvite stones (struvite +/- carbonate apatite)
      were significantly less likely to have metabolic abnormalities than patients who
      had struvite +/- carbonate apatite+calcium oxalate (2 of 14 v 7 of 7, P =
      0.0003). Urine calcium excretion was markedly higher in the mixed stone group
      than the pure struvite group (342 +/- 98 mg/24 h v 136 +/- 82 mg/24 h; P <
      0.0001). The differing opinions among researchers regarding the likelihood of
      finding metabolic abnormalities in patients with urolithiasis and infection
      probably reflect differences in the definitions of the populations studied. If
      patients with calculi containing only struvite +/- carbonate apatite are
      evaluated, we believe that few significant metabolic abnormalities will be
      identified.

PMID- 7780432
TI  - Laparoscopic unroofing of symptomatic renal cysts: three distinct surgical
      approaches.
AB  - Although they are rarely associated with complaints, benign renal cysts may be
      the cause of pain, hypertension, or other problems. Simple aspiration is rarely
      definitive treatment. We have had good results with three laparoscopic approaches
      to cyst unroofing: transperitoneal, with reflection of the colon medially or
      dissection through the mesocolon and direct retroperitoneoscopy. We recommend
      initial percutaneous aspiration with cytology study both to rule out malignancy
      and to identify those cysts clearly in need of unroofing.

PMID- 7780433
TI  - Laparoscopic cystectomy and ileal conduit: case report.
AB  - A completely new combined laparoscopic cystectomy and ileal conduit technique for
      removal of an infiltrating bladder cancer was carried out on a 64-year-old woman.
      The bladder was dissected free and extracted whole through the right flank. The
      right ureter and a loop of intestine were withdrawn through the same incision. An
      ileal segment was isolated and intestinal continuity restored. The right ureter
      was anastomosed to one extreme of the segment that was then reintroduced into the
      abdomen, taken across to the left side, withdrawn with the left ureter,
      anastomosed extracorporeally, and reintroduced. The stoma was constructed in the
      left flank at the patient's request. Recuperation was unusually fast and
      painless, and little postoperative analgesia was required. Further experience and
      a two-team approach could reduce the operation time to 3 or 4 hours. We are now
      convinced that combining the two procedures was better for the patient, even
      though it prolonged the time in the operating room.

PMID- 7780434
TI  - Intraperitoneal versus extraperitoneal insufflation of carbon dioxide as for
      laparoscopy.
AB  - In order to compare the effects of intraperitoneal and extraperitoneal
      insufflation of CO2, we obtained blood gas measurements and chest radiographs in
      dogs during insufflation into three sites: the peritoneal cavity alone, the
      retroperitoneal space with communication into the peritoneal cavity, and the
      retroperitoneal space alone. The blood pH fell a mean of 0.11 +/- 0.03 and the
      PaCO2 rose a mean of 16.0 +/- 3.7 mm Hg when insufflation included the peritoneal
      cavity, whereas when insufflation was limited to the retroperitoneum, the pH fell
      a mean of 0.05 +/- 0.03 and the PaCO2 rose a mean of 7.5 +/- 2.8 mm Hg.
      Extrapleural thoracic dissection of gas was noted in one animal after
      insufflation limited to the retroperitoneal space. These findings confirm that
      there is significant absorption of CO2 from the peritoneal cavity during
      laparoscopy with CO2 insufflation, whether the pneumoperitoneum is primary or
      occurs secondary to retroperitoneal insufflation. If the insufflated gas is
      limited to the retroperitoneal space, however, the absorption of CO2 appears to
      be reduced in this animal model. The risk of thoracic dissection of gas may be
      greater during extraperitoneal insufflation than during intraperitoneal
      insufflation.

PMID- 7780435
TI  - Retroperitoneoscopy: effects of insufflation media on surrounding tissue during
      balloon rupture.
AB  - There has been recent interest in using balloon dilation to create an
      extraperitoneal working space to perform retroperitoneoscopy. Balloon dilation is
      not without risk, and incorrect placement or rupture can result in tissue damage.
      We developed an ex vivo model to assess the effect of various filling media on
      tissue injury during balloon rupture. As would be expected from theoretical
      considerations, greater energy was released during rupture of the gas-filled
      balloon than a liquid-filled balloon. These data indicate that liquid filling
      medium is preferable to gas when creating an extraperitoneal working space.

PMID- 7780436
TI  - Outcome of extracorporeal shockwave lithotripsy monotherapy for large renal
      calculi: effect of stone and collecting system surface areas and cost
      effectiveness of treatment.
AB  - The treatment options for large renal calculi are controversial. We report on our
      experience with 65 treatments of renal calculi > 3 cm using extracorporeal
      shockwave lithotripsy (SWL) monotherapy. We stratified our results according to
      stone and collecting system surface areas (measured by computer image analyses),
      stone location, and stone type. The overall success rate of SWL monotherapy was
      27% at 3 months. The best stone-free rate (60%) was obtained for stones < 500 mm2
      and located primarily within the renal pelvis. The stone-free rate for stones
      with surface areas > 1000 mm2 was only 8%. None of the cystine stones was treated
      successfully, whereas 80% of patients with uric acid stones became stone free. We
      estimated an average cost of $67,048 to render a patient with a large renal
      calculus stone free using SWL monotherapy. We recommend that other treatment
      options, such as percutaneous nephrolithotomy, be considered as first-line
      therapy for large renal calculi.

PMID- 7780437
TI  - Noninvasive quantitative method for measuring isovolumetric bladder pressure and
      urethral resistance in the male: I. Experimental validation of the theory.
AB  - Noninvasive measurement of intravesical pressure, impulsive flow rate, and
      localized urethral resistance is achieved by clamping the penis immediately above
      the glans with a pneumatic cuff and then instructing the patient to initiate
      voiding. The cuff is then deflated slowly until urinary flow of at least 1 ml/s
      is detected and is then released rapidly to permit unimpeded flow. Cuff pressure,
      voided volume, and flow rate are recorded as functions of time. From the
      resulting tracings it is possible to determine the isovolumetric bladder
      pressure, the impulsive flow rate, and the flow pattern specific to the test. We
      studied 53 male patients demonstrating that data thus obtained are reproducible
      and that the cuff pressure at the initiation of voiding does measure the bladder
      pressure at this moment. We then modeled the lower urinary tract by an analog
      electrical circuit which facilitated the analysis of the urodynamic data. This
      analysis suggests that it is possible to separate the effects of bladder
      dysfunction from the effects of urethral resistance and to localize the
      resistance to the proximal or distal urethra without invasive testing.

PMID- 7780438
TI  - Passive urethral resistance to dilation in healthy women: an experimental
      simulation of urine ingression in the resting urethra.
AB  - The dynamic urethral pressure response to a simulated urine ingression was
      studied at the bladder neck, in the high pressure zone, and in the distal urethra
      in 10 healthy female volunteers. The pressure response was characterised by a
      steep pressure increase simulataneous with the urethral dilation, followed by a
      decay during the next seconds until a new equilibrium pressure was reached. The
      pressure decay could be described by a double exponential function in the form Pt
      = Pequ + P alpha e-t/tau alpha + P beta e-t/tau beta, where Pt represents the
      pressure at the time t, Pequ represents the pressure at equilibrium, P alpha and
      P beta express the decline in pressure, and tau alpha and tau beta are time
      constants. The size of the pressure response proved highly dependent on velocity
      and size of dilation as well as urethral site of measurement, with the maximum
      values in the high pressure zone. The time constants, on the other hand, were
      uninfluenced by these factors. The pressure response represents an integrated
      stress response from the surrounding tissues which may reflect the visco-elastic
      properties of the structures involved. The findings indicate that striated muscle
      fibres are of dominating significance for the pressure response, and the varying
      size of the response along the urethra is in accordance with the localization of
      the horseshoe-shaped rhabdosphincter, which quantitatively is the dominating
      circularly arranged structure around the female urethra. Functionally, the stress
      response will oppose any dilation, and increasingly with rising size or velocity
      of dilation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780439
TI  - Exercise pad testing in continent exercisers: reproducibility and correlation
      with voided volume, pyridium staining, and type of exercise.
AB  - This study was undertaken to determine normal values for a modified pad test to
      be used for testing outcomes of studies addressing therapy for exercise
      incontinence. Fourteen asymptomatic volunteers who were continent by history
      completed three similar exercise sessions wearing pre-weighed pads after
      ingesting phenazopyridine hydrochloride (Pyridium, Parke-Davis, Sandy, UT). The
      mean pad weight gain for all exercise sessions combined was 3.19 +/- 3.16 g
      (range 0.1-12.4). The mean area of pyridium staining was 2.66 +/- 3.14 mm. Mean
      volume voided after the exercise sessions was 193 +/- 108 cc (range 10-625). The
      Kendall coefficient of concordance used to test the interest reliability was 0.96
      for pad weight gain, 0.76 for area of stain, and 0.60 for volume voided. All but
      one of the subjects had at least one spot of pyridium stain on at least one of
      the three pads. The increase in pad weight attributable to sweat and vaginal
      moisture is reproducible in a given individual performing the same exercise
      routine, but due to the large variation between subjects, we were unable to
      establish a cut-off value separating continence from incontinence. Adding
      pyridium did not improve the specificity of the test, despite instructing
      subjects to milk the urethra and blot before applying the pad.

PMID- 7780440
TI  - Short forms to assess life quality and symptom distress for urinary incontinence
      in women: the Incontinence Impact Questionnaire and the Urogenital Distress
      Inventory. Continence Program for Women Research Group.
AB  - This article describes short form versions of the Incontinence Impact
      Questionnaire (IIQ) and the Urogenital Distress Inventory (UDI). These
      instruments assess life impact and symptom distress, respectively, of urinary
      incontinence and related conditions for women. All subsets regression analysis
      was used to find item subsets that best approximated scores of the long form
      versions. The approach succeeded in reducing the 30-item IIQ and the 19-item UDI
      to 7- and 6-item short forms, respectively. The short form versions may be more
      useful than the long form versions in many clinical and research applications.

PMID- 7780441
TI  - Autonomic dysreflexia in a rat model spinal cord injury and the effect of
      pharmacologic agents.
AB  - The object of this study was to develop a spinal cord injury (SCI) rat model for
      autonomic dysreflexia (AD), assessing the effect of alpha-adrenergic and calcium
      channel blockade and to determine the relationship of detrusor-external sphincter
      dyssynergia (DESD) to the development of AD. A laminectomy was performed in male
      rats at the T4 or T10 level and a controlled 50 g cm blunt SCI was induced using
      an impounder. Four weeks after injury, changes in arterial blood pressure and
      heart rate were monitored while simultaneous cystometry (CMG) and pelvic floor
      electromography (EMG) were performed in vivo in sham (control) and spinal cord
      injured rats. The effects of terazosin (0.1 mg/kg), diltiazem (0.5 mg/kg), and
      oxybutynin chloride (0.1 mg/kg) on hemodynamic changes were assessed
      independently. Both T4 and T10 SCI rat displayed evidence of DESD (enhanced
      pelvic floor EMG activity at cystometric capacity) while control rats did not.
      Only T4 injured rats exhibited evidence of AD, with mean blood pressure
      elevations from 82.9 +/- 13.6 to 93.9 +/- 11.3 mm Hg (P < 0.01) and a mean heart
      rate decrease from 332.2 +/- 56.5 to 311.1 +/- 54.5 beats/min (P = 0.02) at
      cystometric capacity. The intravenous administration of terazosin or diltiazem
      abolished the AD response during CMG. The administration of oxybutynin exhibited
      the ability to increase bladder capacity and improve compliance in all 3 groups
      but did not blunt AD. The rat model of SCI effectively reproduced hemodynamic
      changes consistent with the AD complex in T4 level SCI but not T10 level SCI
      animals, despite incomplete lesions. Blockade with either an alpha-1 or a calcium
      channel antagonist effectively ablated the AD response to bladder distention.
      Anticholinergic agents had no effect on AD. DESD frequently accompanies autonomic
      dysreflexia, although the development of AD is not a prerequisite for DESD.

PMID- 7780443
TI  - Blood flow rate and total blood flow related to length density and total length
      of blood vessels in mini-pig urinary bladder after chronic outflow obstruction
      and after recovery from obstruction.
AB  - Chronic partial bladder outlet obstruction was created in mini-pigs by implanting
      a 6-7 mm ring around the proximal urethra. After a median obstruction period of
      63 days the ring was removed, and after a median recovery period of 60 days the
      animals were sacrificed. At each study occasion the blood flow rate (ml per 100 g
      per min) was measured by washout of locally injected 133Xe in the bladder wall
      and the washout curves analyzed by the corrected initial slope method.
      Stereological estimation of length density and total length of blood vessels in
      the bladder were performed. The results can be summarized as follows: (1) no
      differences in the blood flow rate at the time of ring implantation, obstruction,
      or recovery, (2) no decrease in the blood flow rate in normal bladders after
      bladder distension, (3) a significant decrease in blood flow rate in obstructed
      bladders after distension, (4) a 6-fold increase in total bladder blood flow
      after obstruction, (5) an unchanged blood flow per length of blood vessels per
      min during the study, (6) no changes in length densities of blood vessels during
      the study, and (7) a 7-fold increase in total length of blood vessels after
      obstruction and reversion to control level after recovery. The unchanged blood
      flow per length of vessels implies that capillary proliferation matched the
      increased bladder mass during the study.

PMID- 7780442
TI  - Effects of diuresis on micturition.
AB  - Micturition can be characterized experimentally by monitoring both the frequency
      and volume of micturition. Previous studies demonstrated that the functional
      capacity of the rat and rabbit bladder, as determined by cystometry, is
      approximately equal to the maximal single micturition volume as recorded over a
      24 hour period. Studies in many laboratories have demonstrated that chronic
      increases in diuresis induce increases in micturition frequency and capacity, and
      an increase in bladder mass. The current study compares the temporal relationship
      among these parameters in three models of diuresis: streptozotocin-induced
      diabetes in rats, sucrose-induced diuresis in rats, and furosemide-induced
      diuresis in rabbits. In both sucrose diuresis in rats and furosemide diuresis in
      rabbits there were immediate increases in both the frequency and volume of
      micturition. The magnitude of the increases in micturition frequency and
      micturition volume paralleled the increase in the total volume of urine excreted.
      Bladder mass increased progressively over the time course of the study.
      Streptozotocin-induced diabetes resulted in a more gradual (but parallel)
      increase in micturition frequency and volume, and again a more gradual increase
      in bladder mass. These studies demonstrate that functional bladder capacity is
      increased immediately upon the initiation of diuresis with sucrose or furosemide,
      as is the frequency of micturition. This indicates that functional bladder
      capacity is probably under neuronal regulation and the change in capacity is not
      a function of the increased bladder mass which occurs at a later time
      period.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780444
TI  - Total hip replacement.
AB  - OBJECTIVE: To provide physicians with a current consensus on total hip
      replacement. PARTICIPANTS: A non-Federal, nonadvocate, 13-member consensus panel
      representing the fields of orthopedic surgery, rehabilitation and physical
      medicine, biomechanics and biomaterials, internal medicine, public health,
      geriatrics and biostatistics, and a public representative. In addition, 27
      experts in orthopedic surgery, rehabilitation and physical medicine, biomechanics
      and biomaterials, rheumatology, geriatrics, and epidemiology presented data to
      the consensus panel and a conference audience of 425. EVIDENCE: The literature
      was search through Medline and an extensive bibliography of references was
      provided to the panel and the conference audience. Experts prepared abstracts
      with relevant citations from the literature. Scientific evidence was given
      precedence over clinical anecdotal experience. CONSENSUS: The panel, answering
      predefined consensus questions, developed their conclusions based on the
      scientific evidence presented in open forum and the scientific literature.
      CONSENSUS STATEMENT: The panel composed a draft statement that was read in its
      entirety and circulated to the experts and the audience for comment. Thereafter,
      the panel resolved conflicting recommendations and released a revised statement
      at the end of the conference. The panel finalized the revisions within a few
      weeks after the conference. CONCLUSIONS: Total hip replacement is an option for
      nearly all patients with diseases of the hip that cause chronic discomfort and
      significant functional impairment. Most patients have an excellent prognosis for
      long-term improvement in symptoms and physical function. At this time, a cemented
      femoral component using modern cementing techniques, paired with a porous-coated
      acetabular component, can give excellent long-term results. Revision of a total
      hip replacement is indicated when mechanical failure occurs. Continued periodic
      follow-up is necessary to identify early evidence of impending failure so as to
      permit remedial action before a catastrophic event.

PMID- 7780445
TI  - Cloning and expression of two genes from Babesia equi merozoites and evaluation
      of their diagnostic potential.
AB  - High-titre equine immune sera were used to screen a lambda gt 11 expression
      library of Babesia equi cDNA fragments. Two cDNA clones which did not cross
      hybridize to each other were studied. Both clones hybridized specifically to DNA
      from B. equi but not to DNA from B. caballi, B. divergens or B. ovis. Recombinant
      proteins were expressed as glutathione S-transferase (GST) fusion proteins with
      apparent molecular weights of 40 kDa and 75 kDa. Polyclonal antibodies directed
      against the 40 kDa and 75 kDa recombinant proteins detected native antigens of 55
      kDa and 50 kDa respectively in crude lysates of B. equi merozoites indicating
      that neither cDNA clone was full length (GST = 26 kDa). In Western blotting
      experiments the 75 kDa protein showed cross-reactivity with sera from horses
      infected with B. caballi and was not further investigated. The 40 kDa protein was
      additionally tested in an enzyme-linked immunosorbent assay (ELISA). A test was
      developed which had a calculated specificity of 99% and a sensitivity of 88% with
      sera from horses infected with the homologous strain of B. equi. The ELISA did
      not recognize sera from horses infected with B. equi strains from Brazil and
      Morocco.

PMID- 7780446
TI  - Significance of moisture content of dung pats for colonisation and degradation of
      cattle dung.
AB  - The moisture content of freshly voided cattle faeces is important with regard to
      colonisation by fauna and the rate of degradation of dung pats. This paper
      reports five trials designed to clarify the influence of small changes in
      moisture content of dung pats on dung breeding Coleoptera, Diptera, nematodes and
      earthworms and on degradation of the pats. Surface area, wet weight and organic
      substance content were used as parameters for measurement of degradation. Special
      attention was given to a trial which compared naturally voided pats with pats
      formed artificially from faeces of the same animals. Results indicate that small
      differences in moisture content of 1-2%, which may not be distinguishable by
      visual inspection, may have an impact on the development of Diptera, Coleoptera
      and earthworms and on dung degradation.

PMID- 7780447
TI  - Acanthocheilonema viteae: rational design of the life cycle to increase
      production of parasite material using less experimental animals.
AB  - The maintenance of the life cycle of Acanthocheilonema viteae is described with
      the aim to increase the production of parasite material using less experimental
      animals. The filaria was maintained in jirds (Meriones unguiculatus) and in soft
      ticks (Ornithodoros moubata). The optimal infection dosis for jirds was 80
      infective larvae (L3). The mean worm number in groups of animals varied between
      18 and 30 adult worms. A stable microfilaremia developed and only few animals
      developed pathological alterations as a consequence of the infection. A simple
      membrane feeding apparatus allowed mass feeding of ticks. Infection of ticks with
      microfilariae (mf) using this technique resulted in a mean no. of 594 +/- 527.2
      L3/tick. L3 and mf were cryopreserved in liquid N2 with a simple technique. The
      described maintenance of the life cycle reduced the amount of required
      experimental animals to 30-40% of the originally needed numbers.

PMID- 7780449
TI  - The in vitro culture of Onchocerca spp.: I. Preliminary observations on the
      development of the second to the third stage larvae.
AB  - Second stage larvae of Onchocerca lienalis and O. gutturosa were induced to moult
      successfully to the third stage in vitro. Following development in their vectors
      Simulium ornatum s.l. and Culicoides nubeculosus the second stage larvae were
      kept in a cell free culture system. At least 25% of the second stage larvae of
      either Onchocerca species completed the moult successfully although no feeder
      layers had been used. In the absence of CO2 (5% in air) the number of the second
      stage larvae moulting successfully to the infective stage dropped to 6 and 9%
      respectively.

PMID- 7780448
TI  - Urinary schistosomiasis among school children in an endemic community in south
      eastern Nigeria.
AB  - Studies were carried out on urinary schistosomiasis among school children aged 6
      to 21 in Abia State, Nigeria. Of the total 1,165 children examined for eggs of S.
      haematobium in their urine, 245 (21.03%) were infected. Male children had
      significantly (P < 0.05) higher infection (64.08%) than their female counterparts
      (35.92%). Age-related infection rate showed significant difference (P < 0.05)
      with the highest infection rate (46.94%) recorded among children between the ages
      of 12 and 14 years. As with infection rate, the intensity of infection was
      significantly higher (P < 0.05) in males (35.50 eggs/10 ml urine) then in females
      (28.73 eggs/10 ml urine). 4 (1.63%) of the infected individuals had heavy
      infection (400 eggs/10 ml urine). There was a gradual increase of mean egg count
      with age up to 12-14 years after which there was a decrease. Viability test
      showed that of the 245 children infected 151 (61.63%) had viable eggs in their
      urine sample. The number of males with viable eggs (62.25%) was significantly
      higher (P < 0.05) than the females (37.74%). Also in the number of infected
      individuals with viable eggs a significant difference among age groups was
      observed. It was significantly higher (P < 0.05) among the age group 12-14 years
      than in any other group. Among the infected children 38 (15.51%) had haematuria
      (which represents 95% of the 41 individuals with trace of blood in their urine).
      There was a significant association (P < 0.05) between haematuria and infection
      rate/intensity.

PMID- 7780450
TI  - Effect of temperature and humidity on egg hatch, moulting and longevity of larvae
      and nymphs of Dermacentor reticulatus (Ixodidae).
AB  - Larvae of Dermacentor reticulatus hatched at a temperature range of 20-34 degrees
      C, but a high egg hatch success of > 90% was only achieved at 20 degrees C and 27
      degrees C and 100% r.h. The developmental capability of the eggs at low or
      freezing temperatures persisted up to 3 weeks at -10 degrees C and up to 8 weeks
      at 5 degrees C. The 50% mortality period of unfed larvae and nymphs increased
      with rising humidity and was longest at 5 degrees C and 100% r.h., amounting to
      83.5 days for larvae and 108 days for nymphs. Engorged larvae and nymphs only
      moulted in the temperature range of 10-27 degrees C. The percent moulting success
      was low at 10 degrees C and increased with rising ambient humidity at 20 degrees
      C and 27 degrees C reaching more than 90% at 100% r.h. After incubation at low or
      freezing temperatures and subsequent transfer to 20 degrees C and 100% r.h.
      engorged larvae did not moult after exposure to -10 degrees C, but they tolerated
      0 degrees C and 5 degrees C up to 3 and 10 weeks, respectively, and developed
      into nymphs. Engorged nymphs moulted into adults even after preceding incubation
      at -10 degrees C, their metamorphosis capability persisted for a maximum of 4 and
      17 weeks at 0 degrees C and 5 degrees C, respectively.

PMID- 7780451
TI  - [Evidence of Cryptosporidium in children with symptomatic enteritis from the
      Leipzig administrative area 1987-1992].
AB  - From 1987 to 1992 stool samples of 3235 diarrheic children at the age from 1 to
      14 years in the Leipzig district were examined for Cryptosporidium spp. In 58
      patients (= 1.8%) oocysts have been detected. Most of the positive children (=
      81%) were less than 7 years old. A seasonal increasing of prevalence was observed
      in August and in the following months. According to anamnestic informations of
      treating physicians all patients were immunocompetent. The clinical
      symptomatology comprised diarrhoea, vomiting, fever and stomach ache. Animal
      contacts were known in 52% of the patients. Stool examinations for diagnosis of
      Cryptosporidium are recommended in unclear diarrhoeas, also in immunocompetent
      patients. The role of Cryptosporidium spp. as opportunists in immunodeficiency is
      especially commented.

PMID- 7780452
TI  - Managed care ... new study of 1,200 U.S. hospitals.

PMID- 7780453
TI  - On-line claims info comes to Los Angeles.

PMID- 7780454
TI  - Hospital group calls proposed Medicare cuts "devastating".

PMID- 7780455
TI  - The measure of Medicare services.
AB  - Trying to make managed care more responsive to the demands of employers and
      consumers is a challenge. More and more HMOs are providing financial incentives
      for doctors to deliver better quality and service. But critics contend that
      bonuses can weaken quality.

PMID- 7780456
TI  - Cutting off care. California's drastic reaction to illegal immigrants doesn't
      play well in other states.

PMID- 7780457
TI  - Fifth annual contract management survey. Value-driven.

PMID- 7780458
TI  - No breathing room in the anesthesia turf battle.
AB  - Anesthesiologists and nurse anesthetists have always jostled each other for work,
      but managed care and policy changes have brought tensions to a boil. Is the
      anesthesia battle a harbinger of the future?

PMID- 7780459
TI  - Research Triangle, NC. New competition hits the old 'Tobacco Road'.

PMID- 7780460
TI  - Profiles in service (1986-1995). 1992 Foster G. McGaw Prize winner. Mount Sinai
      Hospital Medical Center, Chicago, Illinois.

PMID- 7780461
TI  - Construction. Resurrection's renewal.

PMID- 7780462
TI  - Tax-exemption. Ready for a rumble.

PMID- 7780463
TI  - No smoking. Ways to clear the haze.

PMID- 7780464
TI  - Art therapy. Treads on threads.

PMID- 7780465
TI  - Teamwork. Quality converts.

PMID- 7780466
TI  - Homefront. When stress is relative.

PMID- 7780467
TI  - The faces of Medicaid.

PMID- 7780468
TI  - Recognizing change.

PMID- 7780469
TI  - Guardians and gatekeepers.

PMID- 7780470
TI  - Hepatitis C: past, present, and future.
AB  - Hepatitis C, the leading cause of chronic hepatitis in the United States, is
      difficult to diagnose and treat. It is vital that medical-surgical nurses
      understand the historical background and current information regarding prevention
      of hepatitis C, serological diagnosis, epidemiology and transmission, sequelae,
      and treatment. Issues of safety in the workplace and risks of transfusion must
      also be clearly understood to protect health care workers and patients receiving
      transfusions from infection.

PMID- 7780472
TI  - Current nursing practices in fever management.
AB  - Data regarding fever management were obtained through a retrospective or
      concurrent review of the medical records of 150 patients. For 41% of the patients
      studied, nurses notified physicians of the fever episode. The decision to treat
      fever was significantly influenced by fever intensity and the drawing of blood
      cultures, but not by age, length of hospital stay, or the duration of the fever
      episode. Despite recent evidence of the protective value of fever, the majority
      of fever episodes were treated. Acetaminophen alone, and acetaminophen in
      combination with physical cooling methods, were effective in lowering fever.

PMID- 7780471
TI  - Rationing trauma care to the elderly: an ethical dilemma.
AB  - It is estimated that by 2025, 25% to 35% of the people in this country will be
      older than 65 years. One of the hazards facing the elderly is the risk of trauma.
      Currently, one third of the total resources spent on trauma care are expended on
      the elderly, and this number will increase as the elderly segment of the U.S.
      population continues to grow. Despite aggressive care, the elderly trauma
      patient's chances of a good outcome are slim. However, is it ethical to ration
      trauma care on the basis of age? A case study of an elderly trauma patient
      provides an opportunity to apply an ethical decision-making model to the
      question.

PMID- 7780473
TI  - Research utilization: the development of a preoperative teaching protocol.
AB  - A research-based preoperative teaching protocol was designed for use with
      surgical patients at a rural midwestern hospital. A strong research base
      supported the development of a protocol which included an individual teaching
      plan adapted to the patient's fear/anxiety level. A practice-level model was
      designed to guide the staff nurse through the preoperative teaching process.
      Expected outcomes were established and an evaluation tool developed. This
      research utilization project improved patient outcomes and benefitted nurses and
      the organization.

PMID- 7780474
TI  - Intravenous methylprednisolone for exacerbations in multiple sclerosis.
AB  - Multiple sclerosis remains one of the most difficult neurological diseases to
      treat. It is important for medical-surgical nurses to understand the
      pathophysiology of multiple sclerosis, as well as recent evidence suggesting that
      intravenous methylprednisolone treatment may be effective for treating
      exacerbations of the disease. Indications and criteria for treatment, side
      effects, and patient teaching issues are discussed.

PMID- 7780476
TI  - Promoting health.

PMID- 7780477
TI  - Pressure ulcers: assessment to evaluation.

PMID- 7780475
TI  - Patient and nurse criteria for heart transplant candidacy.
AB  - The criteria nurses and patients believe should be used to allocate hearts for
      transplantation were explored and compared in a descriptive study. Although the
      majority of both groups agreed that patients with AIDS or who are HIV positive
      should not receive a transplant, the two groups agreed very little on the other
      criteria. This research has implications for clinical care and ethical decision
      making.

PMID- 7780478
TI  - The eggs and us.

PMID- 7780479
TI  - Depression and stroke patients: the keys to successful adaptation.

PMID- 7780480
TI  - The Internet: legal rights and responsibilities.

PMID- 7780481
TI  - Metformin [Glucophage]: new treatment for NIDDM.

PMID- 7780482
TI  - Interleukin-15 and the growth of tumor derived activated T-cells.
AB  - Interleukin-15 was tested to determine whether this recently discovered cytokine
      was capable of stimulating the growth of tumor derived activated T cells in
      culture (TDAC, also referred to as tumor infiltrating lymphocytes). When
      established cultures of IL-2 induced, IL-2 dependent TDAC were tested, IL-15
      stimulated growth in a dose dependent manner, alone or in the presence of IL-2.
      One established TDAC was cultured with IL-15 alone for 18 passages over a 10 week
      period. Comparing IL-2 and IL-15 treated cultures, growth rate with IL-15 was
      slower. IL-15 doubled the secreted interferon alpha and granulocyte-macrophage
      colony stimulating factor. IL-15 and IL-2 were compared in primary TDAC cultures.
      IL-15 induced TDAC outgrowth in 3 of 6 cultures. IL-2 induced outgrowth in all 6.
      Tumor cells were eliminated as TDAC grew out in both IL-2 and IL-15 treated
      cultures. These results suggested that IL-15 like IL-2, is capable of stimulating
      the growth of TDAC with antitumor activity, but with certain distinct effects
      which may be of interest therapeutically.

PMID- 7780483
TI  - Interferon-alpha/5-fluorouracil: a novel outpatient chemo/immunotherapy for
      progressive metastatic renal cell carcinoma.
AB  - In metastatic renal cell carcinoma, most conventional antineoplastic drugs have
      yielded no or little efficacy. To evaluate the tolerance and therapeutic efficacy
      of second line chemo/immunotherapies, we treated patients with advanced
      metastatic renal cell carcinoma upon progression after previous antineoplastic
      therapy employing an outpatient combination of subcutaneous (SC) recombinant
      interferon-alpha (rIFN-alpha) and intravenous (IV) 5-fluorouracil(5-FU). Thirty
      three patients with metastatic renal cell carcinoma received SC doses thrice
      weekly of rIFN-alpha at 10 million U/m2 over 8 consecutive weeks. Additionally,
      patients received IV 5-FU at 750 mg/m2 in weeks 1-3 and 5-7; treatment cycles
      were repeated until disease progression. Of 33 patients, one achieved a complete
      remission (response duration, 24 months) and two patients presented with partial
      remissions (median response duration, 7 months) of pulmonary metastases upon rIFN
      alpha/5-FU after failing SC recombinant interleukin-2 (rIL-2) and rIFN-alpha. The
      present chemo/immunotherapy regimen was overall well tolerated with low to
      moderate systemic toxicity and predominantly constitutional symptoms i.e., fever,
      chills, and malaise. In summary, the second line outpatient chemo/immunotherapy
      regimen of SC rIFN-alpha/IV 5-FU demonstrated a limited albeit significant
      efficacy in pretreated patients with progressive metastatic renal cell cancer.

PMID- 7780484
TI  - The integration of high-dose chemotherapy and biotherapy: initial 5-year
      experience with autologous bone marrow transplantation in a comprehensive
      community cancer center.
AB  - Perhaps the best example of the integration of chemotherapy and biotherapy is
      autologous stem cell rescue following high dose chemotherapy. This analysis was
      undertaken to determine the outcome for patients treated in an autologous bone
      marrow transplant program, which was initiated in January 1989, and to illustrate
      the impact which biological response modifiers have had on the toxicity,
      survival, and costs associated with this aggressive treatment approach. Patients
      with metastatic cancer and good performance status were treated according to
      disease-specific treatment protocols. Peripheral blood stem cells [PBSC] came
      into use in 1990, hematopoietic colony stimulating factors [CSFs] in 1991.
      Outcome was monitored prospectively from the inception of the program. Five years
      after the program's inception, 75 patients had undergone 96 intensive
      chemotherapy treatments followed by autologous PBSC rescue. This included 35
      patients with breast cancer, 15 with lymphoma or Hodgkin's Disease, five ovary,
      four melanoma, three sarcoma, three lung cancer, three leukemia, three
      testicular, two myeloma, one non-lung small cell carcinoma, and one
      medulloblastoma. Twenty-one patients underwent back-to-back cycles of intensive
      therapy and rescue; 14 of whom had breast cancer. Twelve patients were treated in
      1989, 14 in 1990, 18 in 1991, 14 in 1992, and 17 in 1993. While four of the first
      12 patients died within 60 days of reinfusion of cells in 1989, no patients have
      died within this time frame as a direct result of therapy during the subsequent
      four years. No patients have been lost to follow-up. Median survival was only
      eight months in 1989, but has not been reached for subsequent years. For all
      patients, median failure-free survival (FFS) is 17.2 months; 1-year FFS is 57%, 2
      year 36%, and 3-year 29%. Median overall survival (OS) is 30.4 months; 1-year OS
      66%, 2-year 52%, and 3-year 42%. From 1990-1993, for patients with metastatic
      breast cancer (21), and recurrent lymphoma (15), FFS and OS are comparable to the
      best results published from academic teaching hospitals. Twenty-one patients have
      survived over two years, 18 of whom continue in remission. Patients were
      hospitalized for an average of 31 days in 1989, 28.9 in 1990, 24.5 in 1991, and
      only 13.0-14.0 days in 1992-1993. Two patients were treated entirely as
      outpatients. Average hospital charges for the 96 treatments have been $120,000
      with a range of $15,000 to $461,000, and currently average around
      $100,000.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780485
TI  - Augmentation of specific tumor killing activity by tumor-infiltrating lymphocytes
      (TIL) in the presence of TNF-SAM2.
AB  - The effect of TNF-SAM2 on cytotoxic activity of tumor-infiltrating lymphocytes
      (TIL) was investigated. TIL were prepared from 11 human cancer patients. They
      were propagated by double in vitro stimulation with anti-CD3 monoclonal antibody
      and interleukin-2, and cultured for 3 weeks. The cytotoxic activity of TIL was
      tested with standard 4h 51Cr-release assays in the presence or the absence of TNF
      SAM2. In the presence of TNF-SAM2 (500U/ml), the mean cytotoxic activity against
      autologous tumor cells was significantly augmented compared to that in its
      absence. However, the fact that cytotoxic activity against K562 and Daudi showed
      no difference whether substance was present or not, indicates that LAK and NK
      activity were not affected by TNF-SAM2. Direct cytotoxicity by exogenously added
      TNF-SAM2 to tumor cells was measured in 9 out of 11 cases and this revealed that
      cytotoxicity solely by TNF-SAM2 was seen in 3 tumors. However, there was no
      correlation between the augmentation of cytotoxicity by TIL in the presence of
      TNF-SAM2 and the cytotoxicity shown by TNF-SAM2 alone. These results suggested
      that TIL therapy combined with administration of exogenous TNF may exert a
      synergistically stronger therapeutic effect on cancer.

PMID- 7780486
TI  - Diabetes mellitus in cancer patients treated with combination interleukin 2 and
      alpha-interferon.
AB  - Diabetes mellitus is thought to be an autoimmune disease caused by destruction of
      beta cells in pancreatic islets. Insulin resistance in the peripheral tissues may
      also play a role. Both interleukin 2 (IL-2) and alpha interferon can enhance
      immune function by stimulating formation of cytolytic T cells and/or antigen
      expression on both normal and tumor cells. This report describes three patients
      with advanced malignancy who were treated with combination IL-2 and alpha
      interferon who had the onset or worsening of diabetes mellitus. One patient died
      as a result. There is evidence that interferon can increase insulin resistance
      and it is likely that both agents can initiate or enhance an ongoing autoimmune
      process. Physicians using this combination of drugs should be aware of this
      potential serious toxicity.

PMID- 7780487
TI  - Subcutaneous interleukin-2 and alpha-interferon in advanced colorectal carcinoma.
      A phase II study.
AB  - Subcutaneous administration of low doses of recombinant interleukin-2 (IL-2) and
      interferon-alpha (IFN-alpha) on an out-patient basis has been reported not to
      significantly compromise the response frequency compared to intravenous IL-2 in
      patients with renal cell carcinoma and melanoma. As part of an ongoing program to
      develop a biotherapeutic concept in patients with colorectal carcinoma (CRC) we
      studied the clinical effects of such a regimen in 15 patients with metastatic
      CRC. The daily dose of IL-2 varied between 4.8-14.4 x 10(6) U/m2 and of IFN-alpha
      between 3-6 x 10(6) U/m2. The cycle length was 6 weeks. The course was repeated
      every 8 weeks until disease progression. Maximum 4 cycles were administered.
      Maintenance therapy was given to responding patients once a week every month. No
      patient showed a major response (CR or PR). Six patients had a stable disease
      ranging from 3 months to 18 months with a median duration time of 5 months. The
      median survival of all patients was 13 months. The main adverse reactions were
      fever, chills, anorexia and shortness of breath. No treatment related deaths
      occurred. 6/14 patients developed abnormal concentration of serum levels of
      thyroid hormones. It is concluded that the present treatment schedule using IL-2
      and IFN-alpha in advanced CRC seemed not to be of clinical benefit.

PMID- 7780488
TI  - Correlation between malignancy level of AKR lymphoma variants and sensitivity to
      hyperthermia.
AB  - The tumor progression process has been found to be accompanied by various cell
      membrane modifications. This cell organelle may therefore be considered as a
      target for drugs directed against tumor cells of advanced cancer. Hyperthermia
      acts on tumor cells largely, although not only, via an effect on the cell
      membrane. In the present study, the in vitro effect of hyperthermia on the
      tumorigenicity of cells derived from two AKR lymphoma variants of malignancy, TAU
      39 of low (LM) and TAU-38 of high-malignancy (HM), was compared. The cells of the
      HM variant were markedly more sensitive to hyperthermic treatment than those of
      the LM one. Pretreatment of cells at 41 degrees C or 43 degrees C resulted in a
      more marked delay in tumor appearance in mice injected with the HM than in those
      inoculated with the LM variant. Moreover, in mice inoculated with cells
      pretreated at 45 degrees C, long term survivors were found only in those
      inoculated with the HM variant. These results corroborate our previous data
      regarding the effect of hyperthermia on metastatic and primary tumor cells of AKR
      lymphoma as well as the F1 and F10 variants of B16 melanoma.

PMID- 7780489
TI  - Can the Year 2000 objective for reducing overweight in the United States be
      reached?: a simulation study of the required changes in body weight.
AB  - AIM: The purpose of this analysis was to estimate the magnitude of weight change
      required in the six-year period between 1994 and the Year 2000 if Americans are
      to reach the Healthy People 2000 goal for reduction of overweight among those
      ages 20-74 to no more than 20% among all adults and no more than 30% among black
      women. Prevention of weight gain among the non-overweight is compared with that
      of weight loss among the overweight as strategies for reaching this goal. DESIGN:
      Data from the First National Health and Nutrition Examination Survey (NHANES I)
      and the Nutrition Examination Survey Epidemiologic Follow-up Study (NHEFS) were
      used to estimate 6-year weight change of persons aged 20 to 72 at the Year 2000.
      Men, white women, and black women were examined in addition to the overall
      population. Given a baseline prevalence of 24.7%, overweight in the year 2000 was
      projected for three simulated interventions: no weight gain among non-overweight
      persons (prevention-only), weight loss among overweight persons (weight-loss
      only), and prevention-plus-weight-loss. In addition, the Year 2000 overweight
      prevalence was projected under different baseline prevalence scenarios of 26% and
      34%. OUTCOME MEASURE: Prevalence of overweight; overweight determined by body
      mass index (> or = 27.3 kg/m2 for women and > or = 27.8 kg/m2 for men). RESULTS:
      Prevention-only was successful in reducing the overall prevalence of overweight
      from 24.7% to 20%. Weight-loss-only required a 5.3 kg weight loss to achieve the
      overall goal of 20% and 8.4 kg weight loss to achieve the goal within all three
      race-sex strata. Prevention-plus-weight-loss required only 3.8 kg of weight loss
      to achieve the goals within the three race-sex strata. Prevention-only was not
      successful in reducing the overall prevalence of overweight to 20% when the 26%
      and 34% baseline scenarios were used. Weight-loss-only required 6.3 and 11.2 kg;
      prevention-plus-weight-loss required 1.2 and 6.6 kg of weight loss using the 26%
      and 34% baselines, respectively. CONCLUSIONS: Prevention of weight gain among
      those who are not already overweight could achieve substantial changes in the
      prevalence of overweight, even in a 6-year time period. However, given the
      increasing trend in overweight, the Year 2000 goal for the reduction in
      prevalence of overweight will not be reached.

PMID- 7780490
TI  - Modernity and obesity in coastal and Highland Papua New Guinea.
AB  - OBJECTIVE: To investigate the association between individual degree of
      modernization and obesity in Papua New Guineans using a score of relative
      'modernity'. DESIGN: Cross-sectional survey in six populations with varying
      degrees of modernity. Independent effects of modernity score, components of
      modernity score, age and physical activity were assessed in relation to general
      obesity (body mass index (BMI)) and body fat distribution (waist-hip ratio
      (WHR)). A sub-study of the relationship between diet and modernity was also
      performed. SETTING: Population-based samples of subjects in three Highland and
      three coastal locations in the developing country of Papua New Guinea (PNG).
      SUBJECTS: 1877 subjects > or = 25 years of age attended the survey. MEASUREMENTS:
      Age, physical activity, BMI, WHR, 2-h oral glucose tolerance test, and modernity
      score, based on area of origin, father's employment, type and duration of
      individual's employment, education, years in an urban centre, housing type and
      spouse score. RESULTS: More modern subjects had higher mean BMI and lower levels
      of physical activity, and mean WHR also varied with modernity in men but not
      women. In linear regression analysis, total modernity score was significantly
      associated with both BMI and WHR in men and women, independently of age and
      physical activity. When components of the modernity score were examined, younger
      age, more sophisticated housing and increasing number of years in an urban centre
      were independently associated with BMI in men and women, while education level
      and reduced physical activity were also significant predictors in men.
      Associations with WHR were weaker. Results of the dietary sub-study suggested
      that the lowest energy and nutrient intakes occurred in the least modern men and
      women. CONCLUSION: Aspects of modernity, such as more sophisticated housing and
      greater number of years spent in an urban centre, may be markers of higher income
      and increasing adoption of Western ways, which in turn are associated with
      physical inactivity and increased availability of energy-dense Western food, thus
      promoting obesity in this rapidly developing Pacific nation.

PMID- 7780491
TI  - Effect of dexfenfluramine on energy expenditure in obese patients on a very-low
      calorie-diet.
AB  - AIM: To investigate the effect of dexfenfluramine (dF) on Energy Expenditure
      (EE). DESIGN: 20 obese females were studied in a double-blind design. Pre-diet
      and at 14 and 28 days of VLCD and dF treatment (30 mg/d) or placebo, Resting
      Metabolic Rate (RMR), 3 h-Thermic Effect of Food (3 h-TEF) and body composition
      were determined. EE and body composition were measured by indirect calorimetry
      and bioelectrical impedance, respectively. RESULTS: No differences between groups
      were observed in relation to weight loss, body composition changes or RMR. At 3 h
      postprandial, the EE was still elevated in both groups. No changes on TEF were
      observed in the placebo group during VLCD. In contrast, TEF decreased in dF group
      during VLCD (P < 0.05). No significant differences in TEF at the end of the study
      were observed between groups. CONCLUSION: These results suggest that dF modifies
      3 h-TEF but not RMR in obese patients during VLCD administration.

PMID- 7780492
TI  - Associations between different anthropometric measurements of fatness and
      metabolic risk parameters in non-obese, healthy, middle-aged men.
AB  - OBJECTIVE: To investigate whether body fatness influences the metabolic risk
      profile in a group of healthy, normal-weighted men and to determine which
      anthropometric measurements that are most closely associated with the risk
      profile in this group of men. DESIGN: A cross-sectional study where total fatness
      and abdominal fatness were determined by older (BMI, WHR, impedance) and more
      recent anthropometric indices (sagittal diameter (SD) and conicity index (Valdez
      et al., Int. J. Obes. 1993; 17: 955)). The metabolic risk profile was determined
      by lipoproteins, insulin, glucose and blood pressure. SUBJECTS: The study
      comprised a homogeneous group of 58 men who were all healthy and normal-weighted
      (BMI = 24.2 +/- 1.8) and were all 44 years old. RESULTS: In relation to total
      fatness, BMI was more closely correlated to the various risk parameters than the
      fat mass determined by bioelectrical impedance independent of using several
      different equations in estimating the fat mass. From simple comparison of
      correlation coefficients, SD and SDH (SD/height) seemed to be the best indices of
      abdominal fatness in predicting an enhanced metabolic risk profile. The conicity
      index was considerably inferior in comparison to the other indices of abdominal
      fatness. In multiple regression analysis abdominal fatness as determined by SD or
      SDH explained most of the variation in the metabolic risk profile and no
      significant influence of total fatness (BMI) was found when taking the influence
      of abdominal fatness into account. The most pronounced effect of abdominal
      fatness in these non-obese men was a reduction of HDL-cholesterol, an elevation
      of the triglycerid level and an elevation of the insulin level. CONCLUSION: Thus,
      even a minor accumulation of adipose tissue in the abdominal region in these
      otherwise non-obese men was associated with a considerably adverse metabolic risk
      profile. SD or SDH seemed to be slightly more correlated to the risk profile than
      other anthropometric indices of abdominal adipose tissue mass (e.g. WHR). The new
      conicity index was inappropriate for predicting the risk profile associated with
      abdominal fatness in these non-obese men.

PMID- 7780494
TI  - Dexfenfluramine treatment of obesity: a double blind trial with post trial follow
      up.
AB  - OBJECTIVE: As successful weight management demands a long term approach, a better
      understanding of weight changes during and for significant periods after
      cessation of dexfenfluramine therapy is essential to the evaluation of the drug's
      effectiveness in clinical practice. This study aimed to investigate additional
      benefits to weight loss during 6 months treatment with dexfenfluramine in 60
      patients enrolled in a weight loss programme. DESIGN: Sixty obese subjects (21
      males; 39 females) were randomised to dexfenfluramine (15 mg twice daily) or
      placebo for six months. Fifty one (27 dexfenfluramine; 24 placebo) subjects
      completed the double blind, randomised, placebo controlled clinical trial.
      RESULTS: After a one month 'run in' phase and six months treatment, weight loss
      in the dexfenfluramine group was significantly greater than placebo, 9.7 +/- 1.1
      kg vs 4.9 +/- 0.9 kg (mean +/- s.e.m.); P = 0.002. Reduction in body fat, 5.0 +/-
      0.7 kg vs 1.0 +/- 0.9 kg; P = 0.002 and waist circumference, 10.5 +/- 1.9 cm vs
      5.7 +/- 1.1 cm; P = 0.04 was also greater in the dexfenfluramine group. Despite
      significant weight loss, waist to hip ratio (WHR) did not change in either group.
      The dexfenfluramine group reported a significantly greater incidence of nausea,
      dry mouth and dizziness which tended to decrease as treatment progressed. No
      subjects withdrew due to drug induced side effects. Reduction in serum
      triglyceride levels and an increase in HDL cholesterol (in female subjects) in
      conjunction with a reduction in fasting insulin, collectively support an improved
      cardiovascular risk profile in the dexfenfluramine group. Despite significant
      weight loss, these risk factor measurements worsened in the placebo group. After
      cessation of dexfenfluramine therapy, there was a significantly greater weight
      regain indicating a loss of treatment effect. By 5 months after cessation of
      dexfenfluramine, the treatment effect was negated with weight loss in the
      dexfenfluramine (6.0 +/- 1.6 kg) and placebo (6.2 +/- 1.3 kg) group, similar.
      CONCLUSION: The results of this study support the longer term use of
      dexfenfluramine therapy for patients with chronic obesity.

PMID- 7780493
TI  - High fasting insulin levels associated with lower rates of weight gain in persons
      with normal glucose tolerance: the San Luis Valley Diabetes Study.
AB  - OBJECTIVE: to investigate whether increased insulin resistance is associated with
      a reduced risk of weight gain among Hispanic and non-Hispanic white persons in
      Colorado. DESIGN: measurements were taken at baseline and after an average of 4.3
      years. SUBJECTS: 789 normal glucose tolerant subjects 20 to 74 years of age were
      studied. MEASUREMENTS: fasting insulin levels were used as an indirect marker of
      insulin resistance. RESULTS: the average baseline body mass index (BMI) was 26.1
      (+/- 3.6 s.d.) in men and 25.2 (+/- 4.4 s.d.) in women. The average weight change
      at follow-up was 0.8 kg (+/- 4.3 s.d.) in men and 1.3 kg (+/- 5.0) in women. A
      doubling in initial fasting insulin was associated with a reduced risk of gaining
      5 kg (n = 134) and 10 kg (n = 24) of weight in logistic regression models (OR5kg
      = 0.76, 95% CI: 0.59, 0.99 and OR10kg = 0.61, 95% CI: 0.36, 1.02). Similarly, a
      doubling of initial fasting insulin was associated (P = 0.006) on average with a
      6.3 kg less weight gain in linear regression models, independently of initial
      body weight, age, sex, ethnicity and BMI. The relation was consistently observed
      in men and women and in both ethnic groups. CONCLUSION: higher initial fasting
      insulin decreases the risk of subsequent weight gain in both Hispanic and non
      Hispanic white normal glucose tolerant individuals similar to Pima Indians. This
      appears to be a common biologic characteristic in moderate to low as well as high
      risk populations for NIDDM.

PMID- 7780495
TI  - Child's home environment in relation to the mother's adiposity.
AB  - OBJECTIVE: There are conflicting findings regarding the role of non-genetic
      family factors on obesity in children, but specific characteristics of the family
      environment that may influence childhood obesity have not been identified. The
      purpose of the present study was to explore the association between mother's
      adiposity and family environment factors that could influence the child's risk of
      obesity, primarily through effects on eating and physical activity behaviors.
      DESIGN AND MEASURES: Cross-sectional, correlational study. Adiposity was
      estimated by the sum of mothers' triceps and subscapular skinfolds. Family
      environment measures were assessed by direct observation and by structured
      interviews with mothers. SUBJECTS: A sample of 347 mothers of preschool children
      were assessed. RESULTS: Mother's adiposity was related to marital status, with
      married mothers having thicker skinfolds. Only two of 23 family environment
      variables were significantly correlated with mother's adiposity, and both of
      these variables were related to television. The demographic and family
      environment variables accounted for only 4% of the variance in mothers'
      skinfolds. CONCLUSION: The present study identified few characteristics of the
      family environment that were related to mother's adiposity.

PMID- 7780496
TI  - No evidence for a chronic effect of smoking on energy expenditure.
AB  - OBJECTIVE: To investigate whether effects of smoking on energy expenditure (EE)
      extend chronically beyond smoking the last cigarette. DESIGN: Eight subjects
      (5M,3F) were studied over three consecutive months, after smoking as normal (S)
      on 1-3 occasions, and after not smoking for 4-8 weeks (NS) on 1-2 occasions. On
      each occasion subjects underwent one 32-h measurement of EE in a respiration
      chamber (8-h overnight plus a 24-h day, with no smoking in the chamber) and one
      measure of basal metabolic rate (BMR) on exit from the chamber. Statistical
      differences were determined using paired t-tests. RESULTS: There were no
      differences between S and NS for any of the EE measures, either including (n = 8)
      or excluding (n = 5) three subjects whose urinary cotinine excretions suggested
      failure to stop smoking during NS. For S and NS (N = 5) respectively, overnight
      EEs during the first night in the respiration chamber were 2.08 +/- 0.38 and 2.10
      +/- 0.42 MJ/8-h; 24-h EEs during 12-36 hours after the last cigarette were 8.38
      +/- 1.6 and 8.24 +/- 1.34 MJ/day, and BMRs were 6.51 +/- 1.21 and 6.50 +/- 1.07
      MJ/day. CONCLUSION: We found no evidence for a chronic effect of smoking on EE.

PMID- 7780497
TI  - Breast size as a determinant of breast cancer.
AB  - OBJECTIVE: To determine whether breast size as reflected in cup size is
      independently associated with Wolfe's mammographic patterns. DESIGN: Univariate
      and multivariate associations between the waist/hip ratio (WHR), body mass index
      (BMI), cup size, age, parity, age at menarche menopausal status and Wolfe's
      mammographic parenchymal patterns were determined by (multiple) linear logistic
      regression. SETTING: Population based mammographic breast cancer screening
      project. SUBJECTS: 7819 women between 39 to 52 years of age. RESULTS: The
      univariate analysis demonstrated that women in the lowest tertile with respect to
      BMI and WHR when compared to women in the upper tertile were significantly more
      likely to display the high risk P2, Dy breast patterns. Cup size showed a similar
      inverse relation with the P2, Dy patterns. When age, WHR and BMI are entered
      together in the multivariate model the relation between cup size and the P2 Dy
      patterns is no longer significant in the upper tertile. CONCLUSION: Breast size
      is not a major independent determinant of the high risk P2, Dy parenchymal breast
      patterns when the WHR and BMI are taken into account.

PMID- 7780498
TI  - The effect of standardising the body mass index for relative sitting height.
AB  - The body mass index (BMI) has become a universal index of energy nutritional
      status in adults even though it is influenced by many factors other than energy
      stores. One of these is variation in height caused by variation in the length of
      the trunk and legs. Such variations occur between and within populations. In the
      British population, with a sitting height/stature (SH@S) ratio at the mode of
      population values, adjustment of BMI for SH/S ratio caused BMI to change by 1
      kg/m2 or more in 33% of women and 10% of men and by 2 kg/m2 in 5% of women and 1%
      of men. The possible effects of shape, as evinced by SH/S ratios should be borne
      in mind when describing individuals or populations as overweight or obese in
      epidemiological studies and in decisions of clinical management.

PMID- 7780499
TI  - Professor Vladimir Dilman.

PMID- 7780500
TI  - In vitro reconstitution of progesterone-dependent RNA transcription in nuclear
      extracts of human breast carcinoma cells.

PMID- 7780501
TI  - Plastid in vitro transcription.

PMID- 7780502
TI  - Microinjection of in vitro transcribed RNA and antisense oligonucleotides in
      mouse oocytes and early embryos to study the gain- and loss-of-function of genes.

PMID- 7780503
TI  - mRNA translation in Xenopus oocytes.

PMID- 7780504
TI  - Transcription system using a HeLa cell mitochondrial lysate.

PMID- 7780505
TI  - The Xenopus egg extract translation system.

PMID- 7780506
TI  - In vitro translation using rabbit reticulocyte lysate.

PMID- 7780507
TI  - Translation using a wheat-germ extract.

PMID- 7780508
TI  - In vitro transcription and translation in a cell-free system from Clostridium
      tetani.

PMID- 7780509
TI  - Preparation and use of E. coli S-30 extracts.

PMID- 7780510
TI  - Posttranslational transport and in Thylakoido integration of plastid protein.

PMID- 7780511
TI  - Import into isolated yeast mitochondria of radiolabeled proteins synthesized in
      vitro.

PMID- 7780512
TI  - Quantitative measurement of mRNA using the RNase protection assay.

PMID- 7780513
TI  - Structure-function studies based on in vitro expression.

PMID- 7780514
TI  - Sigma-like plastid transcription factors.

PMID- 7780515
TI  - Preparation of HeLa nuclear extracts.

PMID- 7780516
TI  - Purification of the human TATA-binding protein, TBP.

PMID- 7780517
TI  - DNA-binding studies using in vitro synthesized Myb proteins.

PMID- 7780519
TI  - Gene isolation by screening lambda gt11 expression libraries with DNA-binding
      site probes.

PMID- 7780518
TI  - DNase I footprinting using PCR-generated end-labeled DNA probes.

PMID- 7780520
TI  - Transcriptional activation analysis by the chloramphenicol acetyl transferase
      (CAT) enzyme assay.

PMID- 7780522
TI  - Antisense affinity depletion of RNP particles. Application to spliceosomal
      snRNPs.

PMID- 7780521
TI  - Assembly and transcription of chromatin templates using RNA polymerase III.

PMID- 7780523
TI  - In vitro mRNA editing using S100 extracts.

PMID- 7780524
TI  - The role of quantitative modelling in health care.

PMID- 7780525
TI  - Should you eat breakfast? Estimates from health production functions.
AB  - This paper uses an econometric specification based on the health production
      function approach to examine the importance of lifestyles for adult health. The
      approach treats health practices such as eating breakfast, smoking, and exercise
      as inputs into the production of good health; several output measures are
      explored. The econometric models estimated with data from the 1985 Health
      Interview Survey show broad agreement with conventional wisdom about the
      importance of healthy lifestyles. This paper also investigates the role schooling
      plays in the production of good health. Schooling is found to be related to good
      health even after controlling for differences in observable health inputs.
      However, lack of support for a plausible specification of the productive
      efficiency hypothesis casts some doubt on the interpretation that schooling
      increases the efficiency of the household production of health.

PMID- 7780527
TI  - An economic model of the market for hospital treatment for non-urgent conditions.
AB  - This paper develops an economic model of the market for treatment of waiting list
      conditions, in which complainants choose between private treatment, NHS treatment
      and no hospital treatment. This choice depends on a number of clinical and non
      clinical factors, which enter the demand functions for private and NHS treatment.
      Among the key influences are the price of private treatment and the expected
      duration of wait for NHS treatment, both of which are endogenous variables in the
      model. Given a pair of private sector and NHS supply functions, expressions are
      obtained for the price and expected wait at which demand and supply are
      simultaneously equated in both the private sector and the NHS. The paper
      concludes by exploring the responsiveness of the equilibrium to various demand
      side and supply side shocks.

PMID- 7780526
TI  - On approximations in treatment costing.
AB  - As detailed costing may be a time-consuming and expensive exercise within an
      evaluation, economists will be conscious of the possibilities of taking short
      cuts. To explore the viability of such approaches in the context of acute care
      (the surgical treatment for colorectal cancer), we compare the results of a
      detailed costing study with reduced list costing and econometric estimation. We
      conclude, first, that use of a reduced list is likely to generate substantial
      research economies only at the expense of inaccuracy. Second, crude costing,
      based upon average costs of the specialty, is acceptable when the frame of
      reference is the aggregate. Such crude costing, however, is vulnerable to bias
      when specific sub-samples of patients are to be considered. Finally, total costs
      are predictable from a restricted list of cost and event variables, and with a
      high degree of accuracy, although ex ante specification of the functional form is
      problematic.

PMID- 7780528
TI  - The impact of nursing grade on the quality and outcome of nursing care.
AB  - The large industry which has grown up around the estimation of nursing
      requirements for a ward or for a hospital takes little account of variations in
      nursing skill; meanwhile nursing researchers tend to concentrate on the
      appropriate organisation of the nursing process to deliver best quality care.
      This paper, drawing on a Department of Health funded study, analyses the relation
      between skill mix of a group of nurses and the quality of care provided. Detailed
      data was collected on 15 wards at 7 sites on both the quality and outcome of care
      delivered by nurses of different grades, which allowed for analysis at several
      levels from a specific nurse-patient interaction to the shift sessions. The
      analysis shows a strong grade effect at the lowest level which is 'diluted' at
      each succeeding level of aggregation; there is also a strong ward effect at each
      of the lower levels of aggregation. The conclusion is simple; you pay for quality
      care.

PMID- 7780529
TI  - The demand for cigarettes in California and behavioural risk factors.
AB  - This study contributes to the understanding of the demand for cigarettes by
      taking into account the interdependence of smoking and other behavioural risk
      factors. Information on smoking and other behavioural risk factors including
      drinking, alcohol use, and obesity were obtained from the California Behavioural
      Risk Factor Survey for the period 1985-91. A monthly cigarette price index for
      California was constructed based on data obtained from the Bureau of Labor
      Statistics. A two-part model was used to examine separately the effect of price
      on the decision to be a smoker, and on the amount of cigarettes smoked by
      smokers. The overall price elasticity of cigarettes was estimated at -0.46, with
      a price elasticity of -0.33 for smoking participation and of -0.22 for the amount
      of cigarettes consumed by smokers. The inclusion of other behavioural risk
      factors reduced the estimated price elasticity for smoking participation
      substantially, but had no effect on the conditional price elasticity for the
      quantity of cigarettes smoked.

PMID- 7780530
TI  - Report cards or instrument panels: who needs what?
AB  - BACKGROUND: The report card movement in health care is a positive response to
      legitimate customer needs and requirements for comparative information on quality
      and costs. At the same time, providers have a legitimate concern about potential
      problems with gathering and using valid data in a prudent manner. Report cards
      have problems that often detract from their potentially constructive uses. In
      response to this concern, the authors propose that instrument panels--a newer
      concept in health care--compared to the static, judgmental image of report cards
      project an action-oriented, decision-making image. EXAMPLES: Descriptions are
      given of three types of instrument panels based on work in progress in the
      Dartmouth-Hitchcock health care system, a regional, integrated delivery system
      that serves the population of New Hampshire and parts of Vermont and
      Massachusetts: a 450-physician group practice (The Hitchcock Clinic), which
      provides more than one million visits per year in more than 25 locations; a
      tertiary health care facility (Mary Hitchcock Memorial Hospital) with more than
      300,000 patient days; and prepaid health plan (Matthew Thornton Health Plan) with
      approximately 120,000 members. SUMMARY: It would be wise and efficient for
      providers to design instrument panel data collection systems that can feed
      directly into report cards, leading to the triple benefit of enhancing accuracy,
      reducing total costs, and increasing overall utility to both providers and their
      customers.

PMID- 7780532
TI  - Interdisciplinary integration for quality improvement: the Cleveland Veterans
      Affairs Medical Center Firm System.
AB  - BACKGROUND: Many of the characteristics of Firm Systems lend themselves to the
      application of principles of continuous quality improvement (CQI). A Firm System
      is defined as two or more parallel practices organized on the principle of
      continuity of relationships between patients and an interdisciplinary group of
      health care professionals and trainees. Firm Systems are organized around the
      care of the patient or customer and emphasize access, continuity, and quality of
      care. CASE STUDY: The Firm System was implemented at the Cleveland Veterans
      Affairs Medical Center (VAMC) not as a CQI initiative per se, but as an effort to
      coordinate the processes involved in the delivery of patient care. The primary
      goals of this implementation were to improve the quality of patient care, medical
      education, and health care research. The main strategy to deal with problems
      caused by uncoordinated care were to move from a departmental approach to an
      integrated interdisciplinary approach. This approach represented a paradigm shift
      within the organization that extended to planning, documentation, and the general
      work environment. Most important, the institution had leaders who were committed
      to the Firm System and willing to authorize resources to ensure its success.
      CONCLUSION: VA hospitals are ideal settings for Firm Systems because they provide
      longitudinal, comprehensive care with a centralized, prepaid payment mechanism,
      and they have well-developed information systems that allow the random assignment
      of patients to Firms. Recommendations to others interested in implementing Firm
      Systems include creation of a written plan that can gain general support;
      identification of resources needed for successful implementation; remembering
      that the patient is the most important customer, as well as that complex systems
      have many customers; monitoring of performance; and the importance of randomizing
      patients and providers.

PMID- 7780533
TI  - "Pathways to Performance": an interview with Jim Clemmer. Interview by Steven
      Berman.

PMID- 7780534
TI  - [Helicobacter pylori in children: many questions, few answers].

PMID- 7780535
TI  - [Fetal growth deficiency: a hope!].

PMID- 7780531
TI  - Reporting and using health plan performance information in Massachusetts.
AB  - BACKGROUND: In 1993, 27 corporate and government health care purchasers formed
      the Massachusetts Healthcare Purchaser Group (MHPG). Sixteen health plans
      submitted 1992 data on six clinical indicators-mental health inpatient days per
      patient and inpatient readmission, blood pressure screening, prenatal care,
      mammography screening, cesarean section (C-section) rates, and asthma admission
      rates-developed in an earlier pilot effort in response to the quality portion of
      MHPG's "Cost/Quality Challenge." DATA COLLECTION AND ANALYSIS: Detailed data
      specifications developed in the pilot to ensure uniform data collection were
      used, with a requested sample size for chart-reviewed measures of 220. A
      "clinically significant average range" was defined. Health plan performance was
      summarized for each indicator in a report released in March 1994. REPORTING OF
      CLINICAL INDICATOR RESULTS: For the six indicators, each plan had a unique
      pattern of variation from the average range. For prenatal care, mammography, and
      hypertension, many plans had opportunities for improvement. SURVEY OF PURCHASERS:
      Most of the purchasers MHPG surveyed in October 1994 about their assessment and
      use of the Cost/Quality Challenge Report found it useful. RESPONSES TO THE
      REPORT: To promote quality improvement activities among health plans, MHPG showed
      purchasers how to pursue performance issues with health plans, held a Best
      Practice Forum on C-section, and created a follow-up endeavor, the Coordinated
      Purchasing Initiative. SUMMARY AND CONCLUSIONS: In spite of potential problems
      posed by technical deficiencies, costs of data acquisition and quality efforts,
      and unintended effects of public reporting, purchaser/plan initiatives such as
      the Cost/Quality Challenge can provide valuable information to purchasers.

PMID- 7780536
TI  - [Genetics of epilepsy in children].

PMID- 7780537
TI  - [Helicobacter pylori gastritis in children].
AB  - BACKGROUND: The role of Helicobacter pylori in chronic gastric and duodenal ulcer
      disease has now been proven in adults as well as in children. MATERIAL AND
      METHODS: H pylori has been looked for during endoscopy in 130 children suffering
      from recurrent abdominal pain (78 patients) or other symptoms (52 patients).
      Biopsy samples were taken from the antrum and the fundus, and were examined for
      histology and bacteriology (Gram staining, urease test, culture). RESULTS: H
      pylori was found in 30 cases (H pylori+ group, medium age: 12 years) and was
      absent in the 100 other cases (H pylori- group, medium age: 6 years). H pylori
      was present in 27% of children suffering from recurrent abdominal pain and 17% of
      children with other symptoms. Epigastric location of the pain and vomiting were
      equally frequent in both groups. Endoscopic gastritis, often nodular, was noted
      in 60% of the cases in the H pylori+ group and in 46% in the H pylori- group
      (NS). Chronic gastritis was noted in 90% of the cases in the H pylori+ group, and
      in 32% of the cases in the H pylori- group (p < 0.01). Culture was positive in 27
      out of 28 cases (97%) in the H pylori+ group, including 3 cases with negative
      histologic examination. Twenty-two children in the H pylori+ group were treated
      with amoxicillin and metronidazole. Endoscopy performed about 2 months later
      showed eradication of H pylori in 63% of the cases, associated with disappearance
      of histologic lesions in 6 out of 14 cases and of symptoms in 5 out of 7 cases.
      CONCLUSIONS: H pylori is associated with some pediatric cases of antral
      gastritis. Further studies are needed to determine the influence of its
      eradication on symptoms and the interest to search this pathology (by serology)
      in children suffering from chronic abdominal pain.

PMID- 7780539
TI  - [Measurement of peak expiratory flow in young children: comparison of four
      portable equipments].
AB  - BACKGROUND: Peak expiratory flow (PEF) monitoring is seldom used in young
      children because peak flow meter normal values are needed for children less than
      7 years old. POPULATION AND METHODS: PEF was measured in 152 non asthmatic school
      children, aged 2.9 to 14.5 years with four peak flow meters (Assess, DHS,
      Vitalograph, MiniWright). Calibration of these peak flow meters were performed
      with flows ranging from 100 to 700 l/min with a calibration syringe. RESULTS:
      Calibration demonstrated the excellent linearity of each device but there was a
      slight overestimation by DHS and MiniWright, and a slight underestimation by
      Vitalograph and Assess. PEF measured with the four devices was better linearly
      correlated with height (r = 0.72 to 0.77) than with age. Differences similar to
      calibration have been found between the four linear regressions. CONCLUSION:
      These results indicate that PEF can be used in young children less than 7 years
      old. It is necessary to always use the same peak flow meter for a child.

PMID- 7780538
TI  - [Failure of the treatment with antibiotics in severe Salmonella infections in
      children and use of quinolones].
AB  - BACKGROUND: Quinolone antibiotics are effective in the treatment of Salmonella
      infections in adults. Their use in children is limited by their side-effects.
      POPULATION AND METHODS: Forty-two patients (21 girls and 21 boys), aged 1 month
      to 12 years (mean 3.3 yrs) were admitted from September 1991 to June 1993 for
      severe Salmonella infections. Criteria of severity were persistent diarrhea and
      fever for more than 3 days. Thirty-one of these patients were less than 5 years
      of age. Blood culture was positive in 7 out of 35 patients: culture of the stools
      was positive in all patients. Five of the 42 patients had presented an acute
      episode of Salmonella infection a few weeks earlier and had remained asymptomatic
      carriers until the new acute and severe episode of diarrhea. All patients were
      given usual antibiotics, mainly ampicillin, amoxicillin, trimethoprime
      sulfamethoxazole. Twenty-five of these patients were then given pefloxacin, 12
      mg/kg/day, since the 5th day, for 7 days, because persistence of diarrhea and
      fever. RESULTS: Diarrhea and fever disappeared within less than 2 days in the
      group of patients given pefloxacin, even though in 6 patients the infecting
      Salmonella was in vitro resistant to beta-lactamins. Twenty % of patients
      remained asymptomatic carriers of Salmonella in the group treated by pefloxacin
      vs 47% in the group without it. There was no difference in species of Salmonella
      between both groups. None of the patients treated by pefloxacin developed side
      effects during the six months following its administration. CONCLUSIONS: Short
      treatment by pefloxacin may be an alternative choice for treating severe
      Salmonella infections in children.

PMID- 7780540
TI  - [Efficacy of oral administration of a micellaar solution of vitamin K during the
      neonatal period].
AB  - BACKGROUND: Oral administration of vitamin K to neonates is quite satisfactory
      for preventing hemorrhagic disease of the newborn. The aim of this study is to
      test efficacy of a micellar solution of vitamin K at birth. POPULATION AND
      METHODS: Thirty full term infants, exclusively breast-fed during the first month
      of life, were included in this study. Seven of them (control group Cos) were
      given oral supplementation with 5 mg vitamin K1, cremophor; 15 other infants were
      given oral supplementation with 3 mg micellar solution of vitamin K1 (group MMos)
      and 7 were given an intramuscular injection of 1.5 mg micellar solution of
      vitamin K1 (group MMim). Prothrombin time activity and plasma vitamin K
      concentration were measured in the cord blood, 24 +/- 12 hours and 1 month after
      supplementation. RESULTS: No hemorrhage was seen and tolerance to vitamin K was
      good in the 3 groups. Mean prothrombin time activity was 54% in the cord blood,
      around 55% and 75%, 24 hrs and 1 month after supplementation, respectively; only
      one infant had low value (41%) by 1 month despite normal plasma vitamin K
      concentration. Two infants had low plasma vitamin K1 concentration by the second
      control despite normal prothrombin time activity; one belonged to the MMos group
      and the other to the Cos group. Mean values of plasma vitamin K1 concentration
      were higher by 1 month in the MMos group. CONCLUSION: A unique dose of micellar
      solution of vitamin K given orally at birth seems effective to prevent
      hemorrhagic disease.

PMID- 7780541
TI  - [Superior mesenteric artery syndrome].
AB  - BACKGROUND: Early diagnosis of superior mesenteric artery syndrome, less frequent
      in children than in young adults, is improved by the use of ultrasonography and
      CT scan. CASE REPORT: An eleven year-old boy was admitted because he suffered
      from bilious vomiting for 24 hours. A diagnosis of superior mesenteric artery
      syndrome was made from the results of plain films of the abdomen, ultrasonography
      and roentgenograms after instillation of dilute barium solution. Diameter of the
      left renal vein appeared increased. The patient was given fractionated meals and
      placed in left lateral position. The CT scan performed 5 days later confirmed the
      diagnosis but did not show dilatation of the left renal vein. The patient is well
      one year later without treatment. Ultrasonography performed 3 hours after a meal
      showed similar findings to those seen in the acute phase. CONCLUSION: Abdominal
      scanning and ultrasound are valuable tools for diagnosis of such a syndrome. The
      diagnostic value of dilatation of the left renal vein remains to be determined.

PMID- 7780542
TI  - [Intraosseous infusion in children].
AB  - BACKGROUND: Intravenous access in critically ill patients may be very difficult
      to obtain. The intraosseous route is an alternate way to administer fluids and
      drugs. CASE REPORT: A five month old infant was brought to the emergency
      department in profound hypovolemia requiring immediate tracheal intubation. A
      peripheral venous access was established and 35 ml of colloid were rapidly
      infused. Unfortunately, fluid extravasated and the intravenous line had to be
      removed. As further attempts to gain intravenous access were unsuccessful, an
      intraosseous needle was inserted into the left tibia 1 cm below the tibial
      tuberosity, and colloid and human albumin solution were infused rapidly, followed
      by 1.4% sodium bicarbonate. After ninety minutes of intraosseous rehydration, 2
      peripheral venous lines were inserted, and the intraosseous needle was removed.
      Bacteriological and viral cultures were negative. Four days after admission, the
      child was discharged in good condition. CONCLUSIONS: Intraosseous infusion
      provides safe, rapid and reliable access to the circulation for administration of
      fluids and drugs in the critically ill child or during cardiac arrest.

PMID- 7780543
TI  - [Benign cutaneous lymphocytoma of the breast areola and Erythema chronicum
      migrans: a pathognomonic association of Lyme disease].
AB  - BACKGROUND: Clinical manifestations of Lyme disease are mainly cutaneous,
      neurologic, cardiac and/or located joints. Some dermatologic manifestations are
      more specific. CASE REPORT: An eight year-old-girl was examined because she
      suffered from a nodular lesion located on the left breast areola which appeared 3
      months earlier. This lesion was associated with an expanding erythematous annular
      lesion located on the anterior face of thorax and left axillary area, without any
      lymphadenopathy. The association of this cutaneous lymphocytoma and erythema
      chronicum migrans was suggestive of Borellia infection despite absence of
      previous tick bite. Serologic tests (indirect immunofluorescence) were negative,
      but both lesions disappeared within 2 weeks with ceftriaxone, 50 mg/kg/day.
      CONCLUSIONS: This association is pathognomonic of Lyme disease; serologic tests
      may be found negative in the early stages of disease.

PMID- 7780544
TI  - [Scimitar syndrome with anatomical or functional absence of the right pulmonary
      artery. Apropos of 4 cases].
AB  - BACKGROUND: Scimitar syndrome is characterized by an anomalous pulmonary vein
      draining into the inferior vena cava and visible roentgenographically as a
      crescentic shadow of vascular density along the right border of the cardiac
      silhouette. The aim of this study is to report four cases associated with
      anatomical or functional absence of the right pulmonary artery. CASE REPORTS:
      Diagnosis of scimitar syndrome had been made in 4 patients aged 3, 10, 23 and 33
      years. Pulmonary scintigraphy and/or CT scan detected the scimitar syndrome and
      the type of pulmonary and systemic vascularization. In all cases, the
      vascularization of the right lung did not originate from the pulmonary artery
      trunk but was supplied by systemic vessels arising from the abdominal aorta. The
      right pulmonary artery was vascularized a retro, against the stream, by the
      systemic vessels (two cases); alternatively, circulation into the right pulmonary
      artery resulted directly from the systemic vessels, this pulmonary artery being
      anatomically absent (two cases). Pulmonary arterial pressures were normal in all
      four cases and functional tolerance was good in three cases; repeated and severe
      hemoptysis required right pneumonectomy in the last patient. CONCLUSIONS: These
      four cases are compared to six other similar cases in the literature. Elegant and
      non invasive methods are now disposable to detect such a syndrome and to assess
      the type of pulmonary vascularization.

PMID- 7780545
TI  - [Corticosteroids: pharmacology and indications of short courses in pediatrics].
AB  - The principle of short courses of corticosteroids (SCC), ie, courses of less than
      2 weeks, is to use the potent anti-inflammatory effect of corticosteroids. The
      pharmacological and pathophysiological basis of this anti-inflammatory effect are
      presented. Because they represent a very peculiar strategy of treatment,
      intravenous bolus dosages of methylprednisolone are not discussed. As compared to
      cortisol, the synthetic corticosteroids used in SCC (ie, mainly prednisone,
      prednisolone and betamethazone) have a more potent anti-inflammatory activity, a
      reduced mineralocorticoid effect and a longer biological half-life. The main
      indications of SCC are laryngitis and acute asthma. SCC are also indicated in
      bacterial meningitis, in addition to antibiotherapy. Other indications are Henoch
      Schonlein purpura and intestinal inflammatory diseases. Adverse effects of SCC
      are uncommon. There are possible immunoallergic manifestations presenting mainly
      as skin reactions and sometimes as anaphylaxis. Abnormal psychological behaviour
      may be observed during the first 10 days of treatment. Few cases of ocular
      complications have been reported in adults, related to an increased intraocular
      pressure in patients with myopia or glaucoma. However, there is no evidence that
      SCC may cause gastric ulcer, nor that they may induce suppression of the adrenal
      function so that there is no need for a progressive decrease of the dosage when
      discontinuing the treatment.

PMID- 7780546
TI  - [Treatment of growth hormone deficiencies with growth hormone releasing hormone.
      Current status and perspectives].
AB  - Results of clinical trials performed with human hypothalamic growth hormone
      releasing factor (GRF) are conflicting, but rather disappointing for most of
      them. Pulsatile administration of GRF has been found to increase growth hormone
      secretion as well as growth velocity, but is not convenient for practical use.
      All other routes and rhythms of administration lead only to sub-optimal results,
      and generally does not seem to procure an appropriate GRF bio-availability.
      Improvements are possible, particularly the development of agonists and new
      galenic forms with sustained release. Therapeutic approach with hexapeptides, or
      hexapeptides analogs, looks promising, but could be more complementary than
      competitive.

PMID- 7780547
TI  - [Vitamin D supplementation in pregnancy: a necessity. Committee for Nutrition].
AB  - In septentrional countries without vitamin D supplementation of milk and dairy
      products, many pregnant women are vitamin D deficient. Consequently vitamin D
      deficiency is present in many newborn infants, which may lead to neonatal
      hypocalcemia and vitamin D deficient rickets. A prevention of vitamin D
      deficiency is therefore a necessity in pregnant women through a vitamin D
      supplementation. This can be done either by a daily supplementation of 400 IU
      during all pregnancy, or a daily supplementation of 1,000 IU during the third
      trimester, or by giving a unique dose of 100,000 to 200,000 IU during the seventh
      month of pregnancy.

PMID- 7780548
TI  - [Percutaneous endoscopic gastrostomy in pediatric practice].
AB  - Percutaneous endoscopic gastrostomy (PEG) has become a good alternative to
      nasogastric tube feeding and surgical gastrostomy. The procedure requires two
      practitioners, one of them being an endoscopist. The technique can be performed
      either under local or general anesthesia, at bedside or in an operating room or
      endoscopic room, using a one step button or first setting of a catheter and
      secondly a button, by pull technique in which the button is pulled through
      esophagus or push technique were the button is pushed through the parietal wall.
      Its is used to deliver enteral nutriments in patients who need tube feeding. In
      paediatrics practice, morbidity rate related to PEG is less than 1% and morbidity
      less than 10%. PEG appears as a simple, safe, practical, esthetic and cheap
      procedure.

PMID- 7780549
TI  - [Myxedematous pericarditis in a child].

PMID- 7780550
TI  - [Treatment of Streptococcus pneumoniae meningitis in infants].

PMID- 7780551
TI  - [tPA thrombolytic treatment of aortic thromboses due to umbilical arterial
      catheterization in newborn infants].

PMID- 7780552
TI  - [Exanthema in infants and children].

PMID- 7780553
TI  - [Salivary cyst and gastroesophageal reflux in a newborn infant with syncope].

PMID- 7780554
TI  - [Risks of drugs in pediatrics].

PMID- 7780555
TI  - [Examination of children before entering elementary school].

PMID- 7780556
TI  - [Histiocytosis in pediatrics].

PMID- 7780557
TI  - [Mental retardation].

PMID- 7780558
TI  - [Emergencies in infectious and parasitic pathology].

PMID- 7780559
TI  - [Dermatology].

PMID- 7780560
TI  - [Phakomatosis].

PMID- 7780561
TI  - [The indications for LHRH analogs].

PMID- 7780562
TI  - [Imaging in nephro-urology].

PMID- 7780563
TI  - [Surveillance of premature infants during the first year].

PMID- 7780565
TI  - Monocular elevation paresis caused by an oculomotor fascicular impairment.
AB  - A 54-year-old man developed an acquired monocular elevation paresis. Forced lid
      closure or oculocephalic reflexes failed to elevate the affected eye in contrast
      to the contralateral eye, which turned fully upward using either maneuver. A mass
      lesion compressing the lateral aspect of the right oculomotor nerve at the exit
      of the brainstem was found. The monocular elevation paresis in this patient
      reflects damage of the oculomotor nerve fascicles that supply the inferior
      oblique and superior rectus muscles. This case supports the accepted
      topographical fascicular arrangement of the oculomotor nerve, with the inferior
      oblique and superior rectus being the most lateral and caudal, and the
      pupilloconstrictor fibers and the inferior rectus being most medial and rostral.

PMID- 7780564
TI  - Microangiopathy of brain, retina, and inner ear.
AB  - Microangiopathy of brain, retina, and inner ear is a rare syndrome manifesting as
      arteriolar occlusions of the brain, retina, and inner ear, with resultant
      encephalopathy, visual, and hearing loss. Despite exhaustive laboratory
      examinations in these patients, no evidence of a systemic disease can be found.
      We treated and followed an adolescent with this disorder who initially presented
      with a branch retinal artery occlusion. A unique finding in this case was retinal
      vessel wall hyperfluorescence noted five days prior to retinal infarction. The
      patient developed recurrent branch artery occlusions, sensorineural hearing loss,
      and central nervous system infarctions despite anticoagulation and
      immunosuppressive treatment.

PMID- 7780566
TI  - Lack of differences among mitochondrial DNA in family members with Leber's
      hereditary optic neuropathy and differing visual outcomes.
AB  - Investigation of a maternal family of three generations of Leber's hereditary
      optic neuropathy (LHON) showed four affected and three unaffected individuals.
      Two of the four patients had recovered near-normal vision, one spontaneously, and
      one following treatment with idebenone, a quinol compound. One patient whose
      visual impairment persisted was a heavy consumer of alcohol and tobacco.
      Molecular genetic analysis of 12 known primary or secondary mutations in
      mitochondrial DNA (mtDNA) associated with LHON revealed only the 11778 mutation
      in a homoplasmic fashion with no secondary mutations. The variations in clinical
      outcome thus could not be explained by synergistically interacting secondary
      mutations in mtDNA. Environmental factors may play an etiologic role in the
      development of optic atrophy.

PMID- 7780568
TI  - Possible mechanisms for horizontal gaze deviation and lateropulsion in the
      lateral medullary syndrome.
AB  - We report a patient who developed conjugate horizontal gaze deviation and
      ipsipulsion of saccades from a lateral medullary infarction. Recent evidence
      suggests that the gaze deviation may result from increased inhibition of the
      ipsilateral vestibular nucleus and ipsipulsion of saccades from decreased
      excitation of the contralateral ocular premotor areas of the brainstem reticular
      formation. Interruption of the olivocerebellar pathways may account for both of
      these ocular motor abnormalities.

PMID- 7780567
TI  - Supranuclear eye movement dysfunction in mitochondrial myopathy with tRNA(LEU)
      mutation.
AB  - A patient with multiple neurological deficits and biopsy-proven mitochondrial
      myopathy with mutation of tRNA(LEU) at nucleotide 3243 was referred for eye
      movement evaluation. He had restricted range of voluntary motions in all
      directions and full range of eye movements on passive rotation of head while
      fixating a visual target. Eye movement recordings revealed decreased horizontal
      and vertical saccadic velocities and markedly decreased smooth pursuit gain in
      both directions. The vestibulo-ocular reflex showed gain abnormalities with many
      saccadic intrusions on the smooth reflex response. His brother, with similar
      mutation, was clinically asymptomatic. However, his eye movement recordings
      revealed slow horizontal saccadic velocities leftward and normal saccadic
      velocities rightward in both eyes as well as in upward and downward direction.
      Smooth pursuit and vestibulo-ocular reflexes were within normal limits. Although
      eye movement abnormalities are seen commonly in mitochondrial myopathies, the
      exact mechanism is not known. Our cases suggest supranuclear dysfunction as one
      of the mechanisms for ophthalmoparesis.

PMID- 7780569
TI  - Left dural to right cavernous sinus fistula. A case report.
AB  - Direct carotid-cavernous sinus fistulas that present with signs and symptoms
      contralateral to the arterial supply of the fistulas are not uncommon. We present
      a thoroughly documented case of a dural-cavernous sinus fistula with symptoms
      exclusively contralateral to the arterial source, a rarer entity. The patient
      presented with a red, proptotic right eye and a history of transient horizontal
      diplopia and a "feeling of fullness" in that eye. Magnetic resonance imaging
      (MRI) of the brain and orbits performed at another hospital had shown no
      abnormalities. Carotid angiography performed on the right side was normal;
      carotid angiography performed on the left side showed a dural-cavernous sinus
      fistula, with shunting from branches of the left external carotid artery directly
      to the right cavernous sinus. Orbital duplex color-flow sonography showed reverse
      flow in a dilated right superior ophthalmic vein. This unusual manifestation of a
      dural-cavernous sinus fistula offers insight into the pathophysiology of
      arteriovenous fistulas involving the cavernous sinus, and is a reminder that
      bilateral injections are required when performing carotid angiography to
      characterize these disorders.

PMID- 7780570
TI  - Invasive aspergillosis. A complication of treatment of temporal arteritis.
AB  - Temporal arteritis is a systemic necrotizing vasculitis for which the only
      effective treatment is systemic corticosteroids. A review of the literature
      suggests that there is a significant mortality rate in untreated patients but
      that those patients who receive adequate corticosteroid treatment rarely
      experience a reduced life expectancy. I had the opportunity to evaluate a patient
      with temporal arteritis who eventually died from disseminated aspergillosis 6
      weeks after beginning corticosteroid treatment. A high index of suspicion for
      infections with opportunistic organisms should be maintained in patients with
      temporal arteritis receiving corticosteroids.

PMID- 7780571
TI  - Transient ictal cortical blindness during middle age. A case report and review of
      the literature.
AB  - We report a case of transient ictal cortical blindness in a 63-year-old woman. We
      reviewed the literature of all seizure-induced bilateral blindness. After careful
      evaluation of 44 cases, it was evident that the cases could be categorized into
      three groups with different etiologies, duration of blindness, and probable
      visual prognosis. Transient cortical blindness may occur with unilateral focal
      seizure or with bilateral seizure activity of the primary generalized type.
      Seizure-induced blindness may be ictal or postictal (Todd's) phenomenon or a
      permanent consequence following status epilepticus. Its duration varies between
      less than 1 minute to 4 months, or can be permanent. Our case of cortical
      blindness is related to new onset occipital epilepsy from a left occipital focus,
      and adds to the evidence that cortical blindness occasionally occurs as an
      uncommon manifestation of seizure.

PMID- 7780572
TI  - Adie's tonic pupil secondary to migraine.
AB  - A 46-year-old woman observed transient unilateral mydriasis during a classic
      migraine attack. One week later she experienced a similar episode after which
      anisocoria was persistent. Subsequent examination showed the clinical and
      pharmacologic features of a postganglionic parasympathetic paresis (Adie's tonic
      pupil). This case confirms the hypothesis that transient mydriasis accompanying
      migraine is due to interruption of parasympathetic innervation rather than
      sympathetic overactivity.

PMID- 7780573
TI  - Acute bilateral ophthalmoplegia secondary to metastatic prostatic carcinoma.
      Demonstration on magnetic resonance imaging.
AB  - We report an unusual case of acute bilateral ophthalmoplegia secondary to
      bilateral cavernous sinus metastasis from prostatic adenocarcinoma. The lesion
      was demonstrated with magnetic resonance imaging.

PMID- 7780574
TI  - The retrogeniculate sensory visual system and higher cortical function, 1993.

PMID- 7780575
TI  - Pain in anterior ischemic optic neuropathy.
AB  - PURPOSE: The diagnoses of both anterior ischemic optic neuropathy (AION) and
      optic neuritis are clinical ones with significant overlap of symptoms and signs.
      This study investigates the presence and character of pain at the onset of AION,
      in order to evaluate this symptom as a differentiating diagnostic feature between
      optic neuritis and AION. METHODS: Forty-one consecutive patients over 45 years of
      age with a clinical syndrome consistent with AION were questioned about the
      presence and character of associated pain. RESULTS: Pain was reported by 12% (5
      of 41) of the patients with AION. This is contrasted with data compiled on 448
      patients in the optic neuritis treatment trial, of whom 92.2% complained of pain.
      CONCLUSION: While there is overlap in the incidence and character of pain in AION
      and optic neuritis, its presence/absence remains a useful differentiating
      feature.

PMID- 7780576
TI  - High-performance liquid chromatography comparison of supercritical-fluid
      extraction and solvent extraction of microbial fermentation products.
AB  - The use of supercritical fluids for the extraction of biologically active
      compounds from the biomass of microbial fermentations has been compared with
      extraction using the organic solvents methanol and dichloromethane. Compounds
      representing a range of structural types were selected for investigation. All the
      extracts obtained were examined using reversed-phase high-performance liquid
      chromatography. The extractability of metabolites using unmodified and methanol
      modified supercritical-fluid carbon dioxide was examined in particular detail for
      six microbial metabolites: chaetoglobosin A, mycolutein, luteoreticulin, 7,8
      dihydro-7,8-epoxy-1-hydroxy-3-hydroxymethyl-xanthone-8-carboxyl ic acid methyl
      ester, sydowinin B and elaiophylin. The extraction strength of supercritical
      fluid carbon dioxide alone appeared to be lower than that of dichloromethane. All
      the components of interest that were extractable with dichloromethane and
      methanol were also extractable with methanol-modified carbon dioxide.

PMID- 7780577
TI  - High-performance frontal analysis for the study of protein binding of
      troglitazone (CS-045) in albumin solution and in human plasma.
AB  - An on-line frontal analysis HPLC system was developed for the determination of
      the unbound concentration of troglitazone (CS-045), a new oral antidiabetic
      agent, in human serum albumin (HSA) solution and in human plasma. This system
      consists of a high-performance frontal analysis (HPFA) column, an extraction
      column, and an analytical column, which are connected via two switching valves.
      After the direct injection of the sample solution into the HPFA column, the drug
      was eluted as a zonal peak with a plateau region. The unbound drug concentration
      was determined as the drug concentration in the plateau. As low as 0.3 nM unbound
      CS-045 was determined with good reproducibility. It was found that CS-045
      strongly binds with HSA, and the bound fraction in the 550 microM HSA solution
      was 99.93%, which was very close to that in human plasma (99.89%). The bound
      fractions were constant within the total drug concentration range of 1-10 microM
      in the HSA solution and 250 nM-10 microM in human plasma.

PMID- 7780578
TI  - Sensitive determination of the benzene metabolite S-phenylmercapturic acid in
      urine by high-performance liquid chromatography with fluorescence detection.
AB  - A method was developed for the determination of the specific benzene metabolite S
      phenylmercapturic acid in urine. The analyte is determined by HPLC with
      fluorescence detection after solid-phase extraction of urine with C18 material
      and hydrolysis followed by precolumn derivatization. The samples are separate by
      a column-switching method with a dual column system. As the method is highly
      sensitive (detection limit ca. 1 microgram/l), urinary S-phenylmercapturic acid
      concentrations for non-exposed persons (e.g., non-smokers) can also be measured
      precisely.

PMID- 7780579
TI  - Automated analysis of urinary catecholamines by high-performance liquid
      chromatography and on-line sample pretreatment.
AB  - A simple and automated solid-phase extraction for the selective and quantitative
      HPLC analysis of free catecholamines in urine is described. The urinary
      catecholamines react with diphenylboric acid, giving a complex at pH 8.5 which is
      strongly retained on a PLRP-S cartridge; elution is accomplished with the same
      mobile phase used for HPLC analysis. Separation is performed by ion-pair reversed
      phase HPLC, with sodium heptanesulphate as counter-ion, and a totally end-capped
      C18 analytical column. Quantitation is achieved with an electrochemical detector.
      A Spark Holland Prospekt system controls the on-line solid-phase extraction,
      preconcentration and direct elution to the LC column. Chromatography run-time is
      10 min and the total time to process one urine sample is ca. 12 min.

PMID- 7780580
TI  - Complementary use of counter-current chromatography and hydroxyapatite
      chromatography for the separation of three main classes of lipoproteins from
      human serum.
AB  - High-density, low-density and very-low-density lipoproteins (HDLs, LDLs and
      VLDLs) were purified from human serum by the combined use of counter-current
      chromatography (CCC) and hydroxyapatite chromatography. Polymer-phase CCC of
      human serum using the cross-axis coil planet centrifuge yielded two lipoprotein
      fractions, one containing HDLs and LDLs and the other VLDLs and serum proteins.
      Each fraction was concentrated and subjected to hydroxyapatite chromatography to
      obtain three lipoprotein fractions, all free from serum proteins. Each
      lipoprotein was confirmed by agarose gel electrophoresis.

PMID- 7780581
TI  - Chromatography in DNA radiolabeling: hands-off automation using a robotic
      workstation.
AB  - The experiments described in the present paper were performed in order to
      determine whether the Biomek-1000 (Beckman Instruments, Fullerton, CA, USA)
      automated laboratory workstation can be used in a fully automated DNA labeling
      method followed by automated gravity-driven size exclusion purification of
      molecular probes. To this aim, we performed random oligodeoxyribonucleotide
      priming of a HIV-1 LTR probe that was used for molecular hybridization to
      Southern blotted polymerase chain reaction products. The results obtained
      demonstrate that the automatically labeled probe can be efficiently purified by
      automated and gravity-driven Sephadex G-50 chromatography, without any major
      changes in hybridization property. This robotic methodology can be used in
      several procedures employing radioisotope labeling.

PMID- 7780582
TI  - Analysis of all stratum corneum lipids by automated multiple development high
      performance thin-layer chromatography.
AB  - An optimized gradient enabling the separation of all stratum corneum lipids by
      automated multiple development on HPTLC plates is presented. An initial isocratic
      step separates sebum lipids. This is followed by a 25-step development using a
      gradient with a polarity range of methanol-water to hexane. Application to in
      vivo extracted and isolated stratum corneum lipids demonstrates the possible
      quantification of the lipid classes with a "one-experiment" separation.

PMID- 7780583
TI  - Influence of the injection technique on the thermal degradation of cocaine and
      its metabolites in gas chromatography.
AB  - Thermal degradation of some substances due to high temperature at the injection
      port and/or the type of injection technique used may limit the usefulness of gas
      chromatography with conventional detectors or coupled to mass spectrometry. To
      minimize thermal degradation of cocaine and its metabolites, chromatography was
      performed using two different insert liners and a cool on-column inlet. When
      using a packed liner, marked degradation of all compounds was observed. The
      degradation process was reduced by the use of an open liner and, when the cool on
      column inlet was employed, essentially no degradation occurred.

PMID- 7780584
TI  - High-performance liquid chromatographic-electrospray mass spectrometric
      determination of morphine and its 3- and 6-glucuronides: application to
      pharmacokinetic studies.
AB  - A rapid and selective assay of morphine and its 3- and 6-glucuronides in serum,
      based on high-performance liquid chromatography-electrospray mass spectrometry
      has been developed. The analytes and the internal standard, codeine or
      naltrexone, were subjected to solid-phase extraction, using ethyl solid-phase
      extraction columns, prior to chromatography. A reversed-phase column and a
      gradient mobile phase consisting of water and methanol were used. The mass
      spectrometer was operated in the selected-ion monitoring mode. The following ions
      were used: m/z 286 for morphine, m/z 300 for codeine, m/z 342 for naltrexone, and
      m/z 462 for morphine 3- and 6-glucuronides. The limit of quantitation observed
      with this method was 10 ng/ml morphine, 50 ng/ml morphine-6-glucuronide and 100
      ng/ml morphine-3-glucuronide. The present method proved useful for the
      determination of serum levels of the parent drug and its metabolites in pain
      patients, heroin addicts and in morphine-treated mice.

PMID- 7780585
TI  - Simultaneous determination of ampicillin and metampicillin in biological fluids
      using high-performance liquid chromatography with column switching.
AB  - A new high-performance liquid chromatographic method with column switching has
      been developed for the simultaneous determination of metampicillin and its
      metabolite ampicillin in biological fluids. The plasma, urine and bile samples
      were injected onto a precolumn packed with LiChrosorb RP-8 (25-40 microns) after
      simple dilution with an internal standard solution in 0.05 M phosphate buffer (pH
      7.0). The polar plasma components were washed out using 0.05 M phosphate buffer
      (pH 7.0). After valve switching, the concentrated drugs were eluted in the back
      flush mode and separated by an Ultracarb 5 ODS-30 column with a gradient system
      of acetonitrile-0.02 M phosphate buffer (pH 7.0) as the mobile phase. The method
      showed excellent precision, accuracy and speed with a detection limit of 0.1
      microgram/ml. The total analysis time per sample was less than 40 min and the
      coefficients of variation for intra- and inter-assay were less than 5.1%. This
      method has been successfully applied to plasma, urine and bile samples from rats
      after intravenous injection of metampicillin.

PMID- 7780586
TI  - Screening and determination of beta-blockers, narcotic analgesics and stimulants
      in urine by high-performance liquid chromatography with column switching.
AB  - A fast method is described for the screening of eleven beta-blockers, two
      narcotic analgesics and two stimulants in urine by HPLC with column switching.
      The urine sample (100 microliters), buffered to pH 9-9.5, is injected onto a
      short extraction column packed with CN stationary phase. The extraction column is
      flushed with water for 2.5 min to elute polar matrix components to waste. The
      retained components are then backflushed by means of a six-port valve onto the
      ODS analytical column where they are separated. Phosphate buffer pH 3.0 and
      acetonitrile were used as mobile phase. Gradient elution was applied in the
      screening method to improve separation. Detection was performed with a diode
      array detector at 220, 235 and 300 nm. Recoveries were near 100%, precision was
      excellent and sensitivity about 0.25 micrograms/l. To speed up the quantitative
      analysis, the same method but with isocratic elution was successfully applied to
      the determination of acebutolol and metoprolol in urine samples collected 4 h
      after administration of the compounds as single doses.

PMID- 7780587
TI  - Simultaneous determination of terbinafine (Lamisil) and five metabolites in human
      plasma and urine by high-performance liquid chromatography using on-line solid
      phase extraction.
AB  - The antimycotic agent terbinafine (Lamisil) and five of its main metabolites were
      determined simultaneously in human plasma and urine samples by an isocratic HPLC
      method. The compounds were separated on a phenyl column following on-line solid
      phase sample clean-up with a column-switching device. Terbinafine and its
      metabolites were detected by monitoring the column effluent with UV light at a
      wavelength of 224 nm. The linear range in plasma was assessed between 0 and 2500
      ng/ml for the parent drug and metabolites V, IV and I. The linear response of
      metabolites III and II was assessed between 0 and 1250 ng/ml. In urine, linearity
      was assessed between 0 and 10,000 ng/ml for metabolites V, IV, III, II and
      between 0 and 1000 ng/ml for the parent drug and metabolite I. Quantification
      limits based on a C.V. < or = 20% and a bias < or = +/- 20% ranged from 20 to 500
      ng/ml depending on the compound and the matrix. Inter-day and intra-day
      variations were similar indicating the ruggedness of the two methods. Due to the
      considerable differences in hydrophobicity between the compounds, extraction
      efficiencies ranged from 55 to 100%. Both methods were found to be reproducible
      and sufficiently sensitive for the evaluation of metabolite pharmacokinetics.

PMID- 7780588
TI  - Manual and automated determination of 1-beta-D-arabinofuranosyl-E-5-(2
      bromovinyl)uracil and its metabolite (E)-5-(2-bromovinyl)uracil in urine.
AB  - This paper describes the determination of 1-beta-D-arabinofuranosyl-E-5-(2
      bromovinyl)uracil in urine. The method involves sample clean-up by liquid-liquid
      extraction with ethyl acetate followed by high-performance liquid chromatographic
      (HPLC) analysis. The sample preparation may be performed either manually or
      automatically using a Zymark Py-robotic system. The chloro analog of the parent
      compound, CV-araU, is used as the internal standard. As low as 0.1 microgram of
      analyte per ml of urine can be measured. This sensitivity is adequate for
      pharmacokinetic studies but could be improved quite easily if necessary.

PMID- 7780589
TI  - High-performance liquid chromatographic assay for 3'-amino-3'-deoxythymidine in
      plasma, with 9-fluorenyl methyl chloroformate as the derivatization agent.
AB  - We have developed a sensitive high-performance liquid chromatographic assay for
      the determination of the zidovudine metabolite 3'-amino-3'-deoxythimidine (AMT)
      using fluorescence and sensitivity in the picomolar range. Plasma was diluted
      with 0.05 M sodium phosphate buffer pH 7.2 and subsequently prepared for analysis
      using solid-phase extraction. AMT was derivatized with 9-fluorenyl
      methylchloroformate and chromatographed using a reversed-phase system. The mobile
      phase consisted of acetonitrile-0.01 M potassium phosphate buffer (pH 7) (32.68,
      v/v). The fluorescence of the column effluent was monitored at 262 nm
      (excitation) and 306 nm (emission). Good resolution of AMT from endogenous plasma
      components was obtained. Within- and between-day variability was less than 10%.
      The limit of quantitation was 0.9 microgram/l. The assay was successfully applied
      to the determination of AMT in human plasma and in plasma of mice treated with
      zidovudine.

PMID- 7780590
TI  - High-performance liquid chromatographic procedures for the quantitative
      determination of paclitaxel (Taxol) in human urine.
AB  - A reversed-phase high-performance liquid chromatographic (RP-HPLC) method has
      been developed and validated for the quantitative determination of paclitaxel in
      human urine. A comparison is made between solid-phase extraction (SPE) and liquid
      liquid extraction (LLE) as sample pretreatment. The HPLC system consists of an
      APEX octyl analytical column and acetonitrile-methanol-0.2 microM ammonium
      acetate buffer pH 5 (4:1:5, v/v) as the mobile phase. Detection is performed by
      UV absorbance measurement at 227 nm. The SPE procedure involves extraction on
      Cyano Bond Elut columns. n-Butylchloride is the organic extraction fluid used for
      the LLE. The recoveries of paclitaxel in human urine are 79 and 75% for SPE and
      LLE, respectively. The accuracy for the LLE and SPE sample pretreatment
      procedures is 100.4 and 104.9%, respectively, at a 5 micrograms/ml drug
      concentration. The lower limit of quantitation is 0.01 microgram/ml for SPE and
      0.25 microgram/ml for LLE. Stability data of paclitaxel in human urine are also
      presented.

PMID- 7780591
TI  - Determination of paclitaxel and metabolites in mouse plasma, tissues, urine and
      faeces by semi-automated reversed-phase high-performance liquid chromatography.
AB  - We have developed and validated a sensitive and selective assay for the
      quantification of paclitaxel and its metabolites 6 alpha, 3'-p
      dihydroxypaclitaxel, 3'-p-hydroxypaclitaxel and 6 alpha-hydroxypaclitaxel in
      plasma, tissue, urine and faeces specimens of mice. Tissue and faeces were
      homogenized (approximately 0.1-0.2 g/ml) in bovine serum albumin (40 g/l) in
      water, and urine was diluted (1:5, v/v) in blank human plasma. Sample
      pretreatment involved liquid-liquid extraction of 200-1000 microliters of sample
      with diethyl ether followed by automated solid-phase extraction using cyano Bond
      Elut columns. 2'-Methylpaclitaxel was used as internal standard. The overall
      recovery of the sample pretreatment procedure ranged from 76 to 85%. In plasma,
      the lower limit of detection (LOD) and the lower limit of quantitation (LLQ) are
      15 and 25 ng/ml, respectively, using 200 microliters of sample. In tissues,
      faeces and urine the LLQs are 25-100 ng/g, 125 ng/g and 25 ng/ml, respectively,
      using 1000 microliters (faeces: 200 microliters) of homogenized or diluted
      sample. The concentrations in the various biological matrices, for validation
      procedures spiked with known amounts of the test compounds, are read from
      calibration curves constructed in blank human plasma in the range 25-100,000
      ng/ml for paclitaxel and 25-500 ng/ml for the metabolites. The accuracy and
      precision of the assay fall within the generally accepted criteria for bio
      analytical assays.

PMID- 7780592
TI  - Stereospecific high-performance liquid chromatographic determination of an S(-)
      benzopyran methyl ester derivative (CGP 50 068), its (-)-carboxylic acid
      metabolite (CGP 55 461) and the related (+)-enantiomer (CGP 54 228) in human and
      dog plasma.
AB  - The simultaneous determination of CGP 50 068, S(-)-enantiomer (I), its (-)
      carboxylic acid metabolite CGP 55 461 (II) and the related (+)-enantiomer CGP 54
      228 (III) by stereospecific high-performance liquid chromatography, in human
      plasma, is described. The three compounds and racemic acebutolol, used as
      internal standard, were isolated from plasma by liquid-solid extraction on
      disposable C18 columns. The resolution and determination of I and the two
      carboxylic acid enantiomers were achieved by direct chromatography using a Chiral
      AGP column refrigerated at 5 degrees C. The mobile phase was tetrabutylammonium
      iodide in a pH 7 phosphate buffer solution used at a constant flow-rate of 0.5
      ml/min. The UV detection wavelength was set at 270 nm. The reproducibility and
      accuracy of the method were found to be suitable over the concentration range
      0.56-28.0 mumol/l for II and III and 2.0-26.7 mumol/l for I.

PMID- 7780593
TI  - Determination of a new fluoroquinolone antimicrobial agent, (S)-10-[(S)-(8-amino
      6-azaspiro d3,4]octan-6-yl)]-9-fluoro-2, 3-dihydro-3-methyl-7-oxo-7H-pyrido[1,2,3
      de][1,4]benzoxazine-6- carboxylic acid hemihydrate, DV-7751a, in human serum and
      urine using solid-phase extraction and high-performance liquid chromatography
      with fluorescence detection.
AB  - A high-performance liquid chromatographic method for the determination of a new
      fluoroquinolone antimicrobial agent, (S)-10-[(S)-(8-amino-6-azaspiro[3,4]octan-6
      yl)]-9-fluoro-2,3- dihydro-3-methyl-7-oxo-7H-pyrido[1,2,3-de][1,4]benzoxazine-6
      carboxylic acid hemihydrate (DV-7751a, I) in human serum and urine has been
      developed. Compound I and the internal standard were extracted from serum and
      urine by means of Bond Elut C8 LRC column. The extracts were chromatographed on a
      reversed-phase Inertsil ODS-2 column using tetrahydrofuran-50 mM KH2PO4 (pH2)-1 M
      ammonium acetate (19:81:1, v/v) as the mobile phase at a flow-rate of 1.0 ml/min.
      Fluorescence detection at an excitation wavelength of 305 nm and an emission
      wavelength of 530 nm resulted in a limit of quantitation of 0.0098 microgram/ml
      for serum and 0.098 microgram/ml for urine. The method showed satisfactory
      sensitivity, precision, accuracy, recovery and selectivity. Stability studies
      showed that I was stable in serum and urine for at least 1 month at -20 degrees C
      and for at least 48 h at room temperature.

PMID- 7780594
TI  - High-performance liquid chromatographic assay for the determination of the novel
      etoposide derivative dimethylaminoetoposide (NK611) and its metabolites in urine
      of cancer patients.
AB  - A simple, reproducible and specific urine assay for the novel epipodophyllotoxin
      derivative dimethylaminoetoposide (NK611, I) its picro form (III), the N-demethyl
      metabolite (II) and its picro form (IV) is reported. The method involves the
      addition of Pr-NK611 as internal standard, chloroform extraction and HPLC
      separation on a Nova-Pak C18 column with a mobile phase of acetonitrile-0.05 M
      KH2PO4 (pH 6.4) (23:77, v/v). UV detection was used with absorbance monitored at
      205 nm and the limit of quantification was 100 ng/ml. The intra- and inter-day
      precisions were within the ranges 1.1-3.4% and 1.9-2.4% for all analytes and the
      accuracy was 101-107%. The extraction recovery was more than 88% for I, II and IV
      and more than 83% for III. The assay is applicable to the urinary monitoring of I
      IV in clinical pharmacokinetic investigations.

PMID- 7780596
TI  - Determination of total plasma homocysteine and related aminothiols by gas
      chromatography with flame photometric detection.
AB  - A selective and sensitive method for the determination of total homocysteine
      (Hcy) and related aminothiols, such as cysteine (Cys) and cysteinylglycine
      (CysGly), in plasma samples by gas chromatography (GC) has been developed. After
      reduction of the sample with sodium borohydride, the liberated Hcy and other
      aminothiols were converted to their N,S-diisopropoxycarbonyl methyl ester
      derivatives and measured by GC with flame photometric detection using a DB-17
      capillary column. The calibration curves were linear over the range 0.5-10 nmol
      for Hcy and CysGly, and over the range 5-100 nmol for Cys, and the correlation
      coefficients were above 0.996. Using this method, total plasma Hcy, Cys and
      CysGly could be directly analysed without prior clean-up of the sample and
      without any interference from coexisting substances. Overall recoveries of Hcy
      and other aminothiols added to plasma samples were 95-106%. Analytical results
      for the determination of total plasma Hcy, Cys and CysGly from normal subjects
      are presented.

PMID- 7780595
TI  - Determination of portal short-chain fatty acids in rats fed various dietary
      fibers by capillary gas chromatography.
AB  - A simple, rapid and sensitive capillary gas chromatographic method was
      investigated to measure portal short-chain fatty acids (SCFAs). A 20-microliters
      sample of portal plasma was denatured with sulfosalicylic acid and then extracted
      with diethyl ether before the removal of protein precipitate. The resultant
      extract was concentrated by a transfer to 50 microliters of 0.2 M NaOH, thus
      avoiding tedious further concentration steps. This reduced the sample volume to
      one-fourth. Since the ratio of acetic acid, a major SCFA, to other acids varies
      widely, ranging from 10-fold to 100-fold, acrylic and methacrylic acids were used
      as internal standards to simultaneously measure SCFAs having a carbon number of 2
      6. As a result, good recovery (90.38-103.17%) and reproducibility (coefficient of
      variation 0.83-8.85%) were observed over a wide range. Furthermore, portal SCFAs
      in rats fed various dietary fibers were determined by the present method. We
      showed that the amounts not only of the major acids such as acetic acid and
      propionic acid, but also of the minor fermented products such as n-valeric acid
      and n-caproic acid, could be significantly changed by dietary manipulation. Thus,
      the present method is simple and reliable, and requires only a small amount of
      sample.

PMID- 7780597
TI  - Capillary liquid chromatography-fast atom bombardment mass spectrometry using a
      high-resolving cation exchanger, based on a continuous chromatographic matrix.
      Application to studies on neuropeptide peptidases.
AB  - Hyphenated mass spectrometric techniques such as LC-MS are advantageous over
      standard MS methods, because they provide increased sensitivity and minimize
      signal suppression by other compounds present in the reaction mixture. Recently,
      we have introduced so-called continuous beds, and applied this technique to
      prepare a 0.32 mm I.D. cation-exchange capillary column, in order to separate the
      reaction product substance P(1-7) after proteolytic cleavage of substance P by an
      endopeptidase recovered from human cerebrospinal fluid. The use of a volatile
      buffer for elution provides very good flow stability. Ion-exchange microcolumns
      may be particularly useful for the separation of those peptides that co-elute in
      reversed-phase chromatography because the separation mechanisms of these two
      methods are different.

PMID- 7780598
TI  - Analysis of bile acids and their conjugates using high-pH anion-exchange
      chromatography with pulsed amperometric detection.
AB  - Bile acids and their conjugated forms may be separated by anion-exchange
      chromatography in alkaline media (0.9 M sodium acetate, 0.1 M sodium hydroxide,
      15% v/v acetonitrile) on a CarboPac PA-100 column. The effluent was monitored at
      high sensitivity, with detection limits of less than 10 microM, using a pulsed
      amperometric detector. Free bile acids and their glyco- and tauro-conjugated
      forms were separated and detected within 40 min under isocratic conditions.

PMID- 7780599
TI  - Rapid determination of dabsylated hydroxyproline from cultured cells by reversed
      phase high-performance liquid chromatography.
AB  - A high-performance liquid chromatographic method was modified for the
      determination of hydroxyproline in cultured cells derived from rat liver. First,
      the primary amino group in the cell hydrolysate was blocked with o
      phthalaldehyde, then the secondary amino group was derivatized with 4
      dimethylaminoazobenzene-4'-sulfonyl chloride (dabsyl chloride). The dabsylated
      sample was treated with ethyl acetate to obtain a simple chromatographic elution
      profile of the cell hydrolysate. Dabsylhydroxyproline and proline were separated
      from other compounds by high-performance liquid chromatography in the gradient
      elution mode, and eluted at 4.71 and 8.00 min, respectively. The method was
      applied to the determination of hydroxyproline contained in cultured cells, the
      result being 25.4 +/- 3.6 pmol/microgram.

PMID- 7780600
TI  - Rapid and specific high-performance liquid chromatographic method for the
      determination of iodide in urine.
AB  - A rapid and specific method for the determination of iodide in urine by high
      performance liquid chromatography on an anion-exchange column with
      electrochemical detection is described. The assay is reproducible as judged by
      the coefficient of variation of less than 4% at all concentrations used. The
      limit of detection was 0.1 mumol, and the calibration graph was linear for
      concentrations between 0.1 and 200 mumol. Using this method, healthy volunteers
      were found to excrete 69 +/- 39 mumol of iodide per mole of creatinine.

PMID- 7780601
TI  - Selective elution and purification of living Trichomonas vaginalis using
      gravitational field-flow fractionation.
AB  - Gravitational field-flow fractionation is one of the simplest separation methods
      for biological materials. Its potential in parasitology is demonstrated for
      Trichomonas vaginalis, a parasite responsible for one of the most widespread
      sexually transmitted diseases. It was observed that this unicellular parasite can
      be purified in a culture medium with a recovery of 85% for the living
      trophozoites. The parasite retention characteristics were different when motile
      living and non-motile dead cells were eluted, motile cells being less retained
      than the non-motile cells.

PMID- 7780602
TI  - Gas chromatographic determination of methamphetamine and its metabolite
      amphetamine in human plasma and urine following conversion to N-propyl
      derivatives.
AB  - A gas chromatographic method for the simultaneous determination of
      methamphetamine and its metabolite amphetamine in human plasma and urine is
      described. The method utilizes reductive alkylation with propionaldehyde and
      sodium borohydride to produce N-propyl derivatives, which have excellent
      chromatographic properties. Structural analogs of the analytes, p
      methylmethamphetamine and p-methylamphetamine, are used as internal standards.
      The method has good precision and accuracy for concentrations ranging from less
      than 10 ng/ml to 5000 ng/ml and has been used to measure plasma concentrations as
      part of a pharmacokinetic/pharmacodynamic study of methamphetamine in humans.

PMID- 7780603
TI  - Rapid identification of 4-hydroxy-2-alkylquinolines produced by Pseudomonas
      aeruginosa using gas chromatography-electron-capture mass spectrometry.
AB  - The 4-hydroxy-2-alkylquinolines and their N-oxides are secondary metabolites
      produced by Pseudomonas aeruginosa which inhibit the growth of a number of Gram
      positive organisms including Staphylococcus aureus. To facilitate the
      identification of these compounds in biological fluids, we have developed a rapid
      profiling system based on gas chromatography-electron-capture mass spectrometry
      of the O-bistrifluoromethylbenzoyl derivatives. Using the technique, over twenty
      hydroxyalkylquinolines have been identified from a culture obtained from a strain
      of P. aeruginosa obtained from a patient with severe bronchiectasis.

PMID- 7780604
TI  - High-performance liquid chromatographic method for the determination of
      budesonide in bronchoalveolar lavage of asthmatic patients.
AB  - A simple, sensitive and selective method for the determination of budesonide in
      bronchoalveolar lavage (BAL) using high-performance liquid chromatography (HPLC)
      with UV detection was developed. BAL samples were extracted twice with methylene
      chloride, the extracts were centrifuged and the organic layer separated and dried
      under nitrogen. The samples were reconstituted in the mobile phase and 80
      microliters were injected on to a Spherisorb ODS column with UV absorbance
      detection at 250 nm. The mobile phase was methanol-aqueous buffer (69:31, v/v).
      Inter-assay coefficients of variation were measured at 7.81 and 500 ng/ml with
      ranges of 0.89-7.31%. Average recoveries were 97% or greater. This method was
      successfully implemented for the analysis of BAL from asthmatics, in order to
      establish the amount of budesonide available to the lung and to investigate the
      efficacy of inhaler systems. Patients (n = 9) inhaled four puffs of 200
      micrograms of budesonide and BAL was performed 10 min after the last inhalation.
      Only four BAL out of the nine presented detectable amounts of budesonide. The
      concentrations in BAL in these four patients were 13.44-84.18 ng/ml,
      corresponding to total amounts of 0.847-7.997 micrograms.

PMID- 7780605
TI  - Reversed-phase high performance liquid chromatographic determination of
      cyproheptadine from urine by solid-phase extraction.
AB  - A simple, sensitive and reliable high-performance liquid chromatographic method
      for the determination of cyproheptadine in urine by solid-phase extraction (SPE)
      has been developed. The sample matrix was passed through a pre-conditioned C18
      cartridge, washed with methanol-water solution (4:1) and eluted with methanol.
      The methanolic solution was evaporated to dryness, reconstituted with methanol
      and chromatographed using a C18 reversed-phase column. The mobile phase consisted
      of acetate buffer (constant ionic strength of 0.005 I)-methanol (56:44, v/v).
      Detection was performed at 254 nm with the sensitivity set at 0.002 AUFS.
      Concentrations as low as 50 ng/ml could be quantitatively determined by an
      external standard method and the overall recovery was found to be 76.16%, whereas
      the limit of detection was estimated as 15 ng/ml.

PMID- 7780606
TI  - Sensitive high-performance liquid chromatographic method for the determination of
      methyl N-[5-[[4-(2-pyridinyl)-1-piperazinyl]carbonyl]-1H-benzimidazol-2-yl d
      carbamate in rat blood.
AB  - A sensitive high-performance liquid chromatographic assay has been developed and
      validated for the determination of methyl N-[5-[[4-(2-pyridinyl)-1
      piperazinyl]carbonyl]-1H-benzimidazol-2-y l d carbamate (CDRI compound 81/470) in
      normal rat blood. The method described herein is simple, with improved
      selectivity and sensitivity over a previously reported HPLC method. The limit of
      quantitation is 10 ng/ml (method 1) and 2.5 ng/ml (method 2) in blood, as
      compared with 40 ng/ml for the previous method. The standard curve in blood is
      linear over the concentration range 10-1000 ng/ml in method 1 and 2.5-1000 ng/ml
      in method 2 and the extraction recovery is higher than 80% for both methods.

PMID- 7780607
TI  - Evolving strategies for the management of non-palpable breast abnormalities.
AB  - Increased public and professional awareness has resulted in more women obtaining
      mammograms. As a result, the surgeon is often called on to diagnose and treat
      occult breast lesions. The development of new diagnostic modalities has changed
      the way such breast lesions are approached. Management decisions are made in the
      context of new pressures applied by the growing managed care imperative and
      increased mediocolegal exposure. In this review, we establish guidelines for the
      management of non-palpable breast abnormalities that place the welfare of the
      patient first.

PMID- 7780608
TI  - The value of endorectal ultrasonography in the follow-up of intracavitary
      radiation treated early rectal cancer.
AB  - In selected patients with early rectal cancer, intracavitary radiation is a
      successful treatment. Endorectal ultrasound has proved an accurate method for
      staging and selecting such cancers for treatment. The value of endorectal
      ultrasound in the follow-up of patients with intracavitary radiation has not been
      previously assessed. Between 1989 and 1991, 30 patients treated at the Hamilton
      Regional Cancer Centre with intracavitary radiation were assessed by endorectal
      ultrasound. The mean age was 65 +/- 12 years with a range of 37-78 years. There
      were 17 males and 13 females. All patients were treated with curative intent. The
      dose of radiation administered was 8963 +/- 1506 cGy over 3.5 +/- 0.7 fractions.
      No patient received supplemental iridium implantation. Thirty-seven endorectal
      ultrasounds were carried out in 30 of the intracavitary radiation treated
      patients. Clinical findings (digital, sigmoidoscopic, and histology) were
      compared with the radiologist's interpretation of the endorectal ultrasounds.
      Using a 2 x 2 table accepting the clinical findings as the 'Gold Standard', the
      sensitivity of endorectal ultrasound was 71%, the specificity 61%, the positive
      predictive value 53%, the negative predictive value 78% with an overall accuracy
      of 75%. We conclude that endorectal ultrasound in the routine follow-up of
      patients treated with intracavitary radiotherapy for carcinoma of the rectum is
      questionable.

PMID- 7780609
TI  - The distribution of matrix metalloproteinases and tissue inhibitor of
      metalloproteinases in colorectal cancer.
AB  - Studies suggest that the interplay between matrix metalloproteinases (MMPs) and
      their inhibitors, tissue inhibitor of metalloproteinases (TIMPs), is an important
      mediator of tumour invasion and metastasis. Using immunohistochemistry, 40
      specimens of colorectal cancer were examined for the presence of TIMP-1 and the
      MMPs, stromelysin, gelatinases A and B and interstitial collagenase. Neither
      enzyme nor TIMP-1 was detected in histologically normal mucosa. Within malignant
      tissue, stromelysin and gelatinase A were conspicuously absent in tumour cells
      but were immunolocalized to the extracellular matrix and for gelatinase A also to
      peritumoural fibroblast-like cells. Gelatinase B was confined to
      polymorphonuclear leucocytes. Interstitial collagenase was not identified. TIMP-1
      was present in only three of the 40 tumours within the malignant stroma. These
      observations suggest that the mesenchymal elements of colorectal carcinomas, by
      acting as a source of MMPs and TIMPs, may modulate tumour invasion.

PMID- 7780611
TI  - Symptomatic outcome following resection of gastric cancer.
AB  - The extent to which the different resections relieve the symptoms of gastric
      cancer is poorly defined. The symptoms of 57 consecutive patients undergoing
      standard resection of gastric adenocarcinoma by oesophagogastrectomy (n = 19),
      total gastrectomy [16] or partial gastrectomy [22] were studied prospectively.
      Common symptoms were relieved in 80% of cases and this was independent of tumour
      stage. Symptoms were significantly more frequent after total gastrectomy than
      after partial gastrectomy or oesophagogastrectomy, the difference being
      attributable principally to the development of new symptoms after total
      gastrectomy. While abdominal pain, nausea and vomiting were largely relieved by
      resection, dyspepsia or dysphagia worsened in 31% of patients following surgery,
      especially total gastrectomy (P < 0.05). Resection relieves the symptoms of
      gastric cancer adequately but outcome is influenced by operation type. As total
      gastrectomy gives a poorer symptomatic outcome, it should be avoided when the
      performance of an alternative procedure does not compromise established
      principles of resection.

PMID- 7780610
TI  - Protective role of lactulose in intestinal carcinogenesis.
AB  - Primary bile acids are converted to carcinogenic secondary bile acids by colonic
      bacteria when the colonic pH is high. Therefore acidification of the luminal
      contents may reduce the cancer risk. The ability of lactulose to reduce colonic
      pH, secondary bile acid production, mucosa crypt cell production rate and tumour
      formation was measured in a rat model of intestinal carcinogenesis. Eighty Wistar
      rats were divided into four groups receiving normal diet alone or with lactulose,
      azoxymethane or both azoxymethane and lactulose. The addition of lactulose was
      associated with a significant fall in small intestinal and colonic pH. Lactulose
      was associated with a sharp rise in the secondary to primary bile acid ratio. The
      crypt cell production rate fell significantly with lactulose. The addition of
      lactulose was associated with a significantly reduced tumour yield in small
      intestine but not in colon. Lactulose therefore can reduce this is of no value in
      humans at risk of developing colorectal carcinoma.

PMID- 7780612
TI  - In vitro stimulation of ovarian tumour-associated lymphocytes with a peptide
      derived from HER2/neu induces cytotoxicity against autologous tumour.
AB  - The proto-oncogene HER2/neu encodes for a 185 kDa transmembrane protein with
      extensive homology to the epidermal growth factor (EGF) receptor. We have
      previously shown a correlation between HER2/neu expression and the level of in
      vitro cytotoxicity of tumour-associated lymphocytes (TAL) versus autologous
      tumour. In addition, we have recently demonstrated that tumour-associated
      cytotoxic T-lymphocytes (CTL) from ovarian and breast cancer patients can
      recognize a HER2/neu derived peptide epitope when presented in the context of HLA
      A2. Since repeated tumour stimulation of CTL enhances both proliferation and
      cytotoxicity against autologous tumour, we hypothesized that repeated peptide
      antigen stimulation would have a similar effect. To be therapeutically useful,
      the peptide antigen must meet the following conditions: (1) the peptide must be
      immunogenic and cause a proliferation of CTL to adequate therapeutic numbers, and
      (2) the peptide-specific CTL which are generated must be cytotoxic against
      autologous tumour. To test our hypothesis, T-lymphocytes isolated from the
      ascites of four consecutive HER2/neu+ ovarian cancer patients were initially
      stimulated with solid phase anti-CD3 antibody and divided into three groups: (1)
      treatment with recombinant interleukin-2 (IL-2) alone, (2) IL-2 plus weekly
      stimulation with irradiated autologous tumour cells, and (3) IL-2 plus weekly
      stimulation with a HER2/neu derived peptide. Peptide-stimulated and tumour
      stimulated CTL showed similar increases in proliferation with both groups
      consistently reaching therapeutic numbers. Peptide-stimulated CTL demonstrated
      significantly enhanced cytotoxicity against autologous tumour in 4-h chromium
      release assays as compared to the IL-2 alone group.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7780613
TI  - The relationship between the immunodetection of transforming growth factor-beta
      in lung adenocarcinoma and longer survival rates.
AB  - We immunohistochemically examined the expression of transforming growth factor
      beta (TGF-beta) on tissue specimens from primary 124 human lung adenocarcinoma,
      using a polyclonal antibody. The overall mean immunoreactivity of TGF-beta was
      25.7 +/- 22.9, therefore we separated patients into two groups according to their
      mean immunoreactivity. There were 59 (48%) with a high TGF-beta and 65 (52%) with
      a low TGF-beta. No correlation was observed between the expression of TGF-beta
      and clinicopathological factors except for degree of differentiation. The 5-year
      survival rates of patients with high and low TGF-beta were 71% and 37%,
      respectively (P < 0.05). A multivariate analysis using the Cox life table
      regression model showed TGF-beta to be a significantly independent factor. We
      thus concluded, based on our findings, that the expression of TGF-beta was found
      to be related to a better prognosis. Therefore, estimating the negative cell
      proliferation activity induced by TGF-beta on immunohistochemical technique is
      considered to be useful for determining the patients' prognosis in cases of lung
      adenocarcinoma.

PMID- 7780614
TI  - Electrophysiology of atrial fibrillation.

PMID- 7780615
TI  - Therapy for atrial fibrillation: control of the ventricular response and
      prevention of recurrence.

PMID- 7780617
TI  - Surgery for atrial fibrillation.

PMID- 7780616
TI  - Radiofrequency catheter ablation for atrial fibrillation.

PMID- 7780618
TI  - Anticoagulation/platelet inhibition for atrial fibrillation.

PMID- 7780619
TI  - Determinants of transmitral inflow pattern 10-14 days after acute myocardial
      infarction.
AB  - AIM: The administration of thrombolytic therapy after an acute myocardial
      infarction can reduce the size of the infarct and improve left ventricular
      function. We used pulsed Doppler to assess left ventricular diastolic function
      after an acute myocardial infarction in patients treated with recombinant tissue
      plasminogen activator (rTPA). PATIENTS AND METHODS: We studied 104 patients after
      an acute myocardial infarction, 48 treated with a placebo and 56 with rTPA. They
      were compared with 36 age-matched controls. The Doppler parameters measured
      included the early peak in diastolic flow velocity, the peak during atrial
      contraction, the atrial: early ratio, mean deceleration, deceleration time, and
      half-filling fraction. Doppler parameters for large and small infarct sizes were
      compared. RESULTS: The Doppler parameters did not differ between treatment
      groups. Compared with the normal controls, significant differences were observed
      in both treatment groups for the early peak (placebo P < 0.05; rTPA P < 0.001),
      the atrial: early ratio (placebo P < 0.05; rTPA P < 0.01), and the half-filling
      fraction (P < 0.001 for both). In patients with large infarcts, the atrial peak
      was depressed (P = 0.008). Multivariate analysis showed that end-diastolic
      pressure, age, end-systolic volume, and regional wall motion parameters were
      major predictors of Doppler parameters.

PMID- 7780620
TI  - Psychosocial factors predict medical outcome following a first myocardial
      infarction. Working Group on Cardiac Rehabilitation of the Swiss Society of
      Cardiology.
AB  - BACKGROUND: The aim of this study was to identify psychosocial variables that, in
      addition to known medical factors, predict the long-term outcome after a first
      myocardial infarction. PATIENTS AND METHODS: The study population consisted of
      222 men aged 30-60 years who entered an inpatient rehabilitation program a mean
      of 7 weeks after a first myocardial infarction. Medical data and completed
      questionnaires for psychosocial variables were obtained from the patients and
      their family physicians at entry to the rehabilitation center and 1 year later.
      Further data, including answers to a detailed questionnaire, were collected at
      the beginning of rehabilitation and after one year; this follow-up was 99%
      complete. RESULTS: The 1-year mortality was 2.2%, the reinfarction rate 1.8%,
      hospital readmissions for cardiac reasons occurred in 25%, and 13% of the
      patients underwent a subsequent revascularization procedure. At baseline and
      after 1 year, respectively, 84 and 83% of the patients were asymptomatic. A poor
      medical outcome, defined as death, reinfarction, severe symptoms or poor exercise
      capacity, was seen in 9% of the patients. The most important physiological
      predictors for an unfavourable medical outcome, found in bivariate and
      multivariate analyses, were age, severity of infarction, and major coronary risk
      factors. In addition, some of the psychosocial variables were significantly
      related to a poor medical outcome: lack of a stable partnership, high work load,
      poor general well-being with multiple chronic non-specific health complaints, and
      a low external locus of control (failure to identify disease-promoting factors
      within own surroundings or lifestyle). CONCLUSIONS: The medical course of
      coronary artery disease was predicted not only by medical variables but also by
      psychological and social variables. As well as being addressed directly, these
      factors may help to identify patients who need to be followed more closely, so
      that medical complications can be reduced by treating early signs of disease
      progression more aggressively.

PMID- 7780621
TI  - Sequential changes in the distribution of type I and III collagens in the infarct
      zone: immunohistochemical study of experimental myocardial infarction in the rat.
AB  - AIM: Ventricular remodeling following acute myocardial infarction is an important
      factor in prognosis. The healing process, involving changes in type I and III
      collagens, is one of the major factors in remodelling. We therefore examined
      sequential changes in type I and III collagens after experimental myocardial
      infarction. MATERIALS AND METHODS: Hearts were excised from 1 day to 10 weeks
      after permanent left coronary ligation in rats. Immunohistochemical staining with
      a polyclonal antibody to each collagen was performed by the avidin-biotin
      peroxidase method. RESULTS: Type I collagen initially appeared in the peripheral
      zone of the infarct from 3 days after ligation, the extent of staining gradually
      increasing until it reached a maximal level on days 21-28, after which the
      distribution remained unchanged. Type III collagen appeared in the peripheral
      zone of the infarct from 3 days after ligation; the extent of staining reached
      the maximal level after 11-28 days, after which a slight decrease in the
      distribution was observed, although the staining did not entirely disappear.
      CONCLUSIONS: Type I collagen was a major factor in collagen matrix formation,
      especially in the relatively late phase. Type III collagen, however, contributed
      particularly to collagen matrix formation in the relatively early phase. This
      study improves current understanding of the time-dependent alterations in type I
      and III collagens involved in the healing process after coronary artery
      occlusion.

PMID- 7780624
TI  - Bibliography of the current world literature.

PMID- 7780623
TI  - Effects of delayed recanalization of an occluded acute myocardial infarction
      related artery using coronary angioplasty on late potentials.
AB  - BACKGROUND: Recent evidence suggests that late reperfusion of an occluded infarct
      related artery after an acute myocardial infarction may reduce the frequency of
      subsequent arrhythmic events. Late mechanical reperfusion by percutaneous
      transluminal coronary angioplasty (PTCA) under these circumstances has a high
      success rate. The present study was performed to test the hypothesis that the
      late mechanical restoration of anterograde flow in an occluded infarct artery
      after an acute myocardial infarction causes a resolution of late potentials.
      METHODS: Twenty subjects (10 men, one woman; aged 32-77 years) suffering a first
      acute myocardial infarction, with signal-averaged electrocardiographic (ECG)
      recordings and a severely occluded infarct-related artery, were prospectively
      identified. RESULTS: Eighteen patients underwent successful PTCA of the occluded
      artery 6-32 days after a first acute myocardial infarction. Late potentials were
      observed in 14 patients 5-22 days after the infarction. A follow-up signal
      averaged ECG was performed 1-8 days later. In the subgroup of 12 patients with
      successful reperfusion and an abnormal signal-averaged ECG before PTCA, seven
      (58.3%) showed resolution of the late potentials at follow-up; in these patients
      the filtered QRS duration showed a significant reduction (112.1 +/- 14.2 to 96.7
      +/- 12.7 ms, P = 0.02), the root-mean-square voltage increased (9.8 +/- 6.5 to
      33.1 +/- 15.5 microV, P = 0.017), and the duration of low-amplitude signals < 40
      microV decreased after angioplasty (46.3 +/- 11.0 to 28.5 +/- 6.5 ms, P < 0.022).
      In contrast, two patients with late potentials before PTCA and unsuccessful
      reperfusion had no significant changes in signal-averaged ECG. CONCLUSIONS: In
      some patients with an acute myocardial infarction, late mechanical reperfusion of
      the culprit vessel may reduce the incidence of abnormalities on the signal
      averaged ECG. Whether this will improve long-term survival has yet to be
      confirmed in a large trial.

PMID- 7780622
TI  - Acute and long-term results of coronary stents and atherectomy in women and the
      elderly.
AB  - AIM: To determine the efficacy of new coronary interventions in women and the
      elderly. PATIENTS AND METHODS: We studied 504 patients who underwent a total of
      567 procedures, comprising 275 directional coronary atherectomy and 292 Palmaz
      Schatz stents over a 2 1/2 year period; 18% were women and 23% were aged > or =
      70 years (elderly). RESULTS: High rates of success were obtained with these
      procedures in women and the elderly, although the rates were lower in women than
      in men (89 versus 96%, P = 0.005), and similarly lower in the elderly than in
      younger patients (91 versus 96%, P = 0.06). In addition to the lower success
      rates, there was a higher incidence of procedure-related non-Q myocardial
      infarction and vascular complications in both the women and the elderly,
      independently. The degree of angiographic restenosis (> or = 50% diameter
      stenosis), however, was similar in women (36 versus 28% in men, P = 0.22) and in
      the elderly (28 versus 29% in patients ages < 70 years, P = 0.8). There were no
      sex-related differences in survival, late myocardial infarction, or repeat
      revascularization. In the elderly, although the incidence of repeat
      revascularization was not increased, there was a decrease in late survival (P <
      0.001) and an increase in the incidence of late myocardial infarction (P = 0.02),
      probably reflecting the presence of other co-morbid variables. CONCLUSION: Both
      directional coronary atherectomy and coronary stenting can be performed safely
      and effectively in women and the elderly with good long-term clinical results,
      despite a somewhat lower rate of success and similarly higher rates of acute
      complications.

PMID- 7780625
TI  - The epidemiology of atrial fibrillation.

PMID- 7780626
TI  - Modulation of connexin43 expression: effects on cellular coupling.
AB  - INTRODUCTION: Gap junctions connect cardiac myocytes allowing propagation of
      action potentials. They contain intercellular channels formed by multiple
      different connexin proteins. The arrangement and type of gap junctions and the
      types, function, and interaction of connexin proteins determine intercellular
      resistance and can thereby influence conduction velocity and the potential for
      reentrant arrhythmias. Our goal was to develop genetically manipulable models to
      test the effects of altering expression of a major cardiac connexin (connexin43)
      on intercellular coupling and expression of other connexin proteins. METHODS AND
      RESULTS: BHK cells that are poorly coupled and BWEM cells that are well coupled
      were stably transfected with plasmids containing connexin43 cDNA in antisense and
      sense orientations. RNA blots confirmed expression of the transfected
      transcripts. Immunoblots showed that connexin43 protein was reduced in the BHK
      antisense transfectants and increased in the BHK sense transfectants compared to
      the parental cells. It was not detectably changed in the BWEM antisense
      transfectant line compared to the BWEM parental cells. Transfection of connexin43
      cDNA did not affect production of connexin45 mRNA and protein nor did
      transfection induce expression of other previously unexpressed connexin mRNAs.
      Cell coupling was assessed by intercellular diffusion of microinjected Lucifer
      yellow in confluent cell populations. Lucifer yellow passed to a mean of 3 +/- 3
      neighboring parental BHK cells, to 8 +/- 8 neighbors in the sense connexin43
      transfected BHK cells, and to only 2 +/- 2 neighbors in the antisense connexin43
      transfected BHK cells (P < 0.05). In contrast, dye transfer did not differ
      significantly between the parental BWEM cells (mean transfer = 19 +/- 14 cells)
      and the BWEM connexin43 antisense transfectants (mean transfer = 15 +/- 12 cells)
      (P = 0.20). CONCLUSIONS: These data demonstrate that stable transfection with
      connexin43 cDNA constructs can result in detectable changes in connexin43
      expression and cellular coupling without inducing compensatory changes in the
      cell's connexin phenotype and, therefore, may provide a basis for future attempts
      at specifically modulating connexin expression and intercellular resistance in
      cardiac tissues.

PMID- 7780627
TI  - The vulnerable window for unidirectional block in cardiac tissue:
      characterization and dependence on membrane excitability and intercellular
      coupling.
AB  - INTRODUCTION: Unidirectional block is a requisite event in the initiation of
      reentry in cardiac tissue, but its initiation and behavior in the presence of
      tissue pathologies remain poorly understood. Previous experimental and
      theoretical reports on vulnerability to unidirectional block under conditions of
      reduced cellular coupling and reduced membrane excitability have varied due to
      differences in experimental and simulation protocols. METHODS AND RESULTS: We
      have addressed the issue of vulnerability to unidirectional block using the
      recent Luo-Rudy membrane model and computer simulations of propagation in a one
      dimensional cardiac fiber. The vulnerable window (VW) of unidirectional block
      from premature stimulation is expressed in units of time, VWtime, and as a range
      of membrane potentials at the stimulus site, VWpot. VWpot and VWtime were
      quantified over a range of membrane excitability and gap junction resistances
      (intercellular coupling). With normal membrane excitability and intercellular
      coupling, VWpot and VWtime were small (VWpot = 0.44 mV, VWtime = 0.39 msec). A
      uniform reduction (0.25x) in the degree of intercellular coupling increased
      VWtime and VWpot by factors of 3.6 and 4.7, respectively, whereas a uniform
      decrease (0.25x) in membrane excitability (same resulting velocity) increased
      VWtime by only a factor of 0.4 and decreased VWpot to negligible levels. When
      inhomogeneities in fiber properties were introduced (intercellular coupling and
      membrane excitability), VWtime increased more due to inhomogeneity in membrane
      excitability (VWtime = 4.5 msec) than to inhomogeneity in intercellular coupling
      (VWtime = 1.5 msec). The simulations also clarify the dependence of the VW on the
      dimensions of the stimulating electrode. The length of the stimulating electrode
      added a factor, equal to the propagation time across the electrode length, to the
      intrinsic VW of the fiber. CONCLUSIONS: VWpot and VWtime are both important
      parameters for quantifying vulnerability to unidirectional block. In an
      environment with uniform distribution of fiber and membrane properties, reduced
      intercellular coupling has a greater effect on the VW than reduced membrane
      excitability. Inhomogeneous reduction of membrane excitability can significantly
      enhance vulnerability to unidirectional block, much more so than inhomogeneous
      reduction of intercellular coupling. Theoretically, stimulation at a point should
      be used to define the VW. Finite electrode dimensions introduce a geometrical
      factor that affects the measurement of the VW.

PMID- 7780628
TI  - Wolff-Parkinson-White syndrome presenting as the permanent form of junctional
      reciprocating tachycardia.
AB  - The substrate of the permanent form of junctional reciprocating tachycardia is an
      accessory pathway with no spontaneous anterograde conduction, usually located in
      the posteroseptal area. We report a case of this type of tachycardia with overt
      anterograde ventricular preexcitation. Electrophysiologic study confirmed that
      tachycardia was due to an accessory pathway with long retrograde conduction time;
      electrophysiologic findings suggested longitudinal dissociation of the accessory
      pathway. Radiofrequency application at the coronary sinus os resulted in
      disappearance of preexcitation and cure of the tachycardia.

PMID- 7780629
TI  - Heterogeneity in the inherited long QT syndrome.
AB  - Heterogeneity is present in the inherited long QT syndrome and affects the
      diagnosis of patients. The evidence of genetic heterogeneity is clear, with at
      least five genetic loci responsible for the syndrome. Phenotypic heterogeneity is
      less well defined, but differences in QT prolongation, T wave morphology, and the
      risk and frequency of syncope and sudden death are very likely. Of particular
      importance, it is likely that there are differences in the molecular
      pathophysiology of the syndrome, which are dependent on the genetic substrate
      present. Elucidation of the specific molecular physiology of each of the genetic
      subtypes of long QT syndrome will not only allow precise diagnosis and,
      potentially, treatment of patients with the syndrome, but will enhance our
      understanding of the pathophysiology of arrhythmias in general, which will extend
      the benefit of more precise therapy to many patients in addition to those with
      the long QT syndrome.

PMID- 7780630
TI  - Description and evaluation of the Res-Q Arrhythmia Control Device.
AB  - The Res-Q Arrhythmia Control Device (Intermedics Inc.) is one of the latest
      entries into the growing implantable cardioverter defibrillator (ICD) market.
      Dysrhythmias are classified according to their zone of detection, with a
      bradycardia zone, up to 3 tachycardia zones, and a fibrillation zone. Detection
      criterion, therapies, and redetection criterion within each zone are
      independently programmable, tailoring the setup to each individual's needs. In a
      hierarchical manner, this allows efficacy, urgency, and patient comfort to be
      appropriately balanced. Tachycardia therapy options include antitachycardia
      pacing (ATP), low-energy cardioversion, and high-energy shock, while VVI pacing
      provides bradycardia therapy. ATP programming is extremely flexible. Biphasic
      waveform and a maximum output of 700 V have yielded a high rate of successful
      implantation. Unique features include the multiprogrammable sensing autogain,
      which tracks evoked T waves during pacing, as well as the use of the pulse
      generator to perform implant testing. Major strengths include programming
      flexibility and individualized therapy for multiple dysrhythmias. The major
      shortcoming relates to a lack of stored electrograms. Although long-term follow
      up is not yet available, the Res-Q appears to be a capable challenger to a peer
      group of advanced generation ICDs.

PMID- 7780631
TI  - The effect of radiofrequency catheter ablation on myocardial creatine kinase
      activity.
AB  - INTRODUCTION: The primary mechanism of myocardial injury during radiofrequency
      (RF) catheter ablation in the heart is presumed to be thermal. Creatine kinase
      has been measured in serum to assess the volume of myocardial injury after
      ablation. However, its thermal inactivation by RF ablation could lead to
      underestimation of the true volume of injury. METHODS AND RESULTS: Serial RF
      lesions were created in 10 canine left ventricles in vivo, and serial serum
      creatine kinase activities were measured and compared to lesion volume. To assess
      the stability of myocardial creatine kinase during RF catheter ablation, 29 RF
      ablations were made on the epicardial surface of porcine left ventricle in vivo
      and a 2-mm core biopsy was rapidly removed. The cores were rapidly frozen,
      sectioned longitudinally in 1-mm slices, and homogenized in 0.3 M Tris buffer
      solution containing EDTA and dithiothreitol for subsequent analysis of creatine
      kinase activity. An additional 19 tissue cores from RF lesions were stained and
      used to determine mean lesion depth. Normal tissue biopsies were exposed to 60
      seconds of hyperthermia (37 degrees to 85 degrees C, n = 190), or high-density RF
      current at 50 degrees C (0 to 100 mA/mm2, n = 50), and tissue creatine kinase
      activity was measured. There was no evidence of creatine kinase washout within
      the first 2 hours, and peak values were measured 5 to 7 hours postablation.
      Tissue creatine kinase activity in the first mm depth of RF lesions averaged 10%
      of control values and increased over the first 5 mm of lesion depth. The mean
      creatine kinase activity within the hemisphere of ablated myocardium was
      calculated to be 31% of control. Creatine kinase activity declined significantly
      at temperatures above 65 degrees C, but no difference in tissue creatine kinase
      activity was observed among differing levels of RF current exposure in the
      absence of significant heating. CONCLUSIONS: Creatine kinase activity in
      myocardial tissue is significantly diminished within the RF lesion. Creatine
      kinase activity is not stable at temperatures above 65 degrees C, which are
      routinely achieved within the central zone of RF ablation, and is unaffected by
      RF current in the absence of hyperthermia. Measurements of serum creatine kinase
      activity after RF catheter ablation may significantly underestimate the volume of
      myocardial injury.

PMID- 7780632
TI  - Characteristics of multiple-shock defibrillation.
AB  - INTRODUCTION: A new method for defibrillation allows two shocks to be combined to
      defibrillate with reduced current by adjusting their separation according to the
      cycle length of the fibrillation event. We investigated various aspects of this
      new method to better understand its characteristics and applicability to
      defibrillation. METHODS AND RESULTS: In 48 pentobarbital-anesthetized dogs, we
      measured the current for 50% defibrillation success using the new method with
      sequences of rectangular shocks. Group 1 studied the role of shock total duration
      and found that two-shock sequences followed a strength-duration curve similar to,
      but below, that for single shocks. Group 2 studied the role of amplitude and
      duration balance between shocks and found that two-shock sequences with equal
      shocks performed best. Group 3 studied whether the new method could be used with
      either biphasic waveforms or sequential shock pathways. Current reduction for the
      combined methods equaled the product of current reduction by each method,
      demonstrating that these methods can be effectively combined. Group 4 extended
      the method to include three-shock and four-shock sequences and found that a
      fourth shock did not further improve defibrillation. The optimum three-shock
      sequence required 33% lower current (P < 0.002) and 34% greater energy (P < 0.095
      = NS) than a single shock. CONCLUSIONS: The new method allows defibrillation to
      be distributed over several fibrillatory cycles and has an improved strength
      duration relationship. Two- or three-shock sequences using equal shocks permit a
      substantial reduction of defibrillation current that can be combined with the
      reduction for biphasic and sequential methods. Thus, the method may have
      application in low-current defibrillation devices.

PMID- 7780633
TI  - Involvement of B1 and B2 receptors in bradykinin-induced rat paw oedema.
AB  - 1. The mechanisms involved in bradykinin (BK)-induced oedema in the rat paw as
      well as the interactions between BK and several inflammatory mediators, have been
      investigated. 2. Intraplantar injection of BK (1 nmol/paw) in rats pretreated
      with captopril (5 mg kg-1, s.c.) caused a small amount of oedema formation (0.17
      +/- 0.05 ml). Des-Arg9-BK (DABK, a selective B1 receptor agonist) up to 300
      nmol/paw caused minimal oedema (0.03 +/- 0.01 ml). 3. Co-administration of
      prostaglandin E2 (PGE2), prostaglandin I2 (PGI2), calcitonin gene-related peptide
      (CGRP), 5-hydroxytryptamine (5-HT), substance P (SP) or platelet activating
      factor (PAF) (1 pmol-1 nmol/paw) with BK (1 nmol/paw) dose-dependently
      potentiated BK-induced paw oedema. The rank order of potency (mean ED50,
      pmol/paw) for this effect was: SP (8.1) > PAF (13.7) > PGI2 (20.5) > 5-HT (23.8)
      > CGRP (25.7) > PGE2 (52.0). Co-administration of BK with the various
      inflammatory mediators resulted in maximal paw oedemas (ml) of: PGE2 (0.71 +/-
      0.02); PGI2 (0.66 +/- 0.02); 5-HT (0.65 +/- 0.01); SP (0.63 +/- 0.05); CGRP (0.60
      +/- 0.05) and PAF (0.47 +/- 0.02) ml. Histamine (up to 1 nmol/paw) was
      ineffective in potentiating the response to BK. 4. Hoe 140 or NPC 17731 (two
      selective B2 receptor antagonists, 0.1-3 nmol/paw) produced dose-dependent
      inhibition of paw oedema potentiation induced by co-injection of BK with other
      mediators with the following mean ID50s (nmol/paw): Hoe 140-1.4; 1.3; 1.5 and 1.1
      and NPC 17731-1.0; 1.0; 0.9 and 0.7; in the presence of PGE2, PGI2, CGRP and SP,
      respectively. The selective B1 receptor antagonist des-Arg9 [Leu8]-BK (DALBK, up
      to 300 nmol/paw) had no effect.5. Daily intraplantar injections of BK (10
      nmol/paw) once a day for 7 consecutive days caused a progressive and complete
      desensitization of the paw oedema, which was specific for BK, since paw oedema
      induced by PAF, PGE2, SP or histamine was not affected. In addition, the oedema
      caused by BK in the paw desensitized to the peptide was almost completely
      reversed if BK was co-injected with PGE2, PGI2 or SP (1 nmol/paw). Injection of
      PGE2 or SP (10 nmol/paw) together with the first BK injection (1O nmol/paw),
      partially prevented BK-induced desensitization.6. When animals were completely
      desensitized to BK, DABK (100nmol/paw) caused paw oedema(0.25 +/- 0.03 ml) which
      was consistently blocked by the B1 receptor antagonist, DALBK (100 nmol/paw).7.
      Treatment of animals with dexamethasone (0.5 mg kg-1, s.c., 24 h previously)
      antagonized paw oedema induced by DABK (100 nmol/paw) in desensitized paws, but
      not that induced by BK (3 nmol/paw) in naive paws. The steroid also prevented the
      recovery of oedema seen after co-injection of BK with PGE2 or PGI2 (1 nmol/paw)
      in desensitized paws.8. These results suggest that both B, and B2 receptors are
      involved in BK-induced rat paw oedema. The B2 receptors are constitutive, but
      induction of expression of B, receptors seems to occur only after complete
      desensitization of the paw to BK. In addition, very low doses of inflammatory
      mediators markedly potentiate BK-induced paw oedema and can attenuate BK-induced
      paw oedema desensitization.Such mechanisms may be relevant for the manifestation
      of acute and chronic inflammatory processes.

PMID- 7780634
TI  - Sensitization by calyculin A of brain capillary endothelial cells to endothelin
      1.
AB  - 1. Cultured brain capillary endothelial cells of the rat respond to endothelin-1
      (ET-1) by an increased activity of the Na+,K+,2Cl-, cotransporter and a
      mobilization of intracellular Ca2+ stores. 2. Calyculin A (1-30 nM), but not
      okadaic acid, sensitizes up to 100 fold the Na+,K+,2Cl- cotransporter to the
      action of ET-1. 3. Calyculin A (30 nM) does not modify the binding properties of
      ET-1 to ETA receptors. 4. Calyculin A (30 nM) inhibits ET-1 induced intracellular
      Ca2+ mobilization. 5. It is concluded that inhibition of protein phosphatase 1
      selectively modifies the repertoire of intracellular actions of ET-1 and favours
      actions that are unrelated to the phospholipase C signalling cascade.

PMID- 7780635
TI  - The interaction of antidepressant drugs with central and peripheral (enteric) 5
      HT3 and 5-HT4 receptors.
AB  - 1. A combined study of receptor binding in central neuronal cell membranes and
      functional responses in isolated segments of guinea-pig small intestine allowed
      characterization of the interaction of four antidepressant drugs with central and
      peripheral 5-HT3 and 5-HT4 receptors. 2. Clomipramine, paroxetine and fluoxetine
      inhibited [3H]-DAU 6215 binding to 5-HT3 recognition sites in NG 108-15 cells
      with IC50 values in the range 1.3-4 microM. Litoxetine had an IC50 of 0.3 microM.
      The specific binding of [3H]-GR 113808 to 5-HT4 recognition sites in pig striatal
      membranes was inhibited by all four antidepressants with negligible potency (IC50
      values > or = 20 microM). 3. In whole ileal segments, concentration-response
      curves to 5-HT were biphasic, with the high- and low-potency phases involving 5
      HT4 and 5-HT3 receptors, respectively. Curves to 2-methyl-5-hydroxytryptamine (2
      methyl-5-HT: a 5-HT3 receptor agonist) and 5-methoxytryptamine (5-MeOT: a 5-HT4
      receptor agonist) were monophasic. All antidepressants were used at
      concentrations lacking anticholinoceptor properties, as demonstrated in both
      electrically stimulated longitudinal muscle-myenteric plexus preparations (LMMPs)
      and in unstimulated LMMPs following addition of acetylcholine (100 nM). 4.
      Fluoxetine (0.1-1 microM) and litoxetine (0.3-3 microM) antagonized both the high
      and low-potency phases of the 5-HT curve. Schild analysis for the low-potency
      phase yielded pA2 estimates of 6.6 +/- 0.3 (Schild slope of 1.1) and of 6.6 +/-
      0.1 (Schild slope of 1.1), respectively. At higher concentrations (3 microM),
      fluoxetine markedly inhibited the 5-HT response maximum. Clomipramine (10-300 nM)
      inhibited, by a mechanism independent of concentration, both phases of the 5-HT
      curve with a reduction of the maximum response. Paroxetine (1 microM) was
      ineffective on the high-potency phase, but caused a rightward shift of the low
      potency phase (pKB: 6.1 +/- 0.01). 5. Responses to 2-methyl-5-HT were inhibited
      by 1 microM fluoxetine (pKB: 5.4 +/- 0.02). Like clomipramine(30 and 100 nM),
      litoxetine (1 and 3 microM) produced rightward displacements of 2-methyl-5-HT
      induced contractions, which were virtually independent of antidepressant
      concentration (pKB values: 6.0 +/- 0.02 and 5.5 +/- 0.01, respectively). At
      higher concentrations, fluoxetine (3 microM) and clomipramine (300 nM)markedly
      reduced the 2-methyl-5-HT response maximum. Paroxetine (1 micro M) was
      ineffective.6. Responses to 5-MeOT were shifted to the right by fluoxetine (0.1-1
      micro M) and litoxetine (1 and 3 microM)in a concentration-dependent manner. At
      higher concentrations, fluoxetine (3 microM) markedly reduced the 5-MeOT response
      maximum, an effect also observed with 100 and 300 nM clomipramine. Paroxetine(1
      microM) was ineffective.7. In unstimulated LMMPs, the excitatory effects evoked
      by 5-HT, 2-methyl-5-HT and 5-MeOT and the antagonism produced by 300 nM
      clomipramine were comparable to those obtained in whole ileal segments. This
      suggests that 5-HT contained in the mucosa of whole preparations does not
      interfere with agonist-induced contractile responses and with the inhibitory
      effect of antidepressant drugs.8. In conclusion, our results show that
      clomipramine, fluoxetine, paroxetine and litoxetine possess low to moderate
      potency/affinity at both central and peripheral (enteric) 5-HT3 receptors. In
      contrast, all four antidepressants are virtually ineffective at central 5-HT4
      receptors. Inhibition of 5-HT4 receptor mediated ileal contractions by
      fluoxetine, litoxetine and clomipramine may result from allostericant agonism or,
      more likely, from post-receptor blockade of second messenger generation. The
      interaction of antidepressants with central and peripheral 5-HT3 and 5-HT4
      receptors may be relevant for both potential therapeutic action and adverse
      effects at gastrointestinal level.

PMID- 7780636
TI  - Pharmacological characterization of alpha 1-adrenoceptor subtypes in rat heart: a
      binding study.
AB  - 1. The alpha 1-adrenoceptor subtypes of rat heart were characterized in binding
      experiments performed with [3H]-prazosin as the radiolabel. The specific binding
      to the alpha 1-adrenoceptors was determined with 0.3 microM prazosin, because
      phentolamine (10 microM) was insufficient to inhibit completely the specific
      binding of high concentrations of [3H]-prazosin. 2. In saturation experiments,
      [3H]-prazosin bound to two distinct affinity sites (pKD = 10.39 and 8.19). The
      proportion of the low affinity sites was approximately 84% of total specific
      binding. Membranes pretreated with chloroethylclonidine (CEC, 10 microM) also
      showed two distinct affinity sites for [3H]-prazosin, although the maximum
      numbers of high and low affinity sites were reduced by 86 and 64%, respectively.
      3. In competition experiments, [3H]-prazosin (100 pM) binding was inhibited by
      WB4101 (2-(2,6-dimethoxy-phenoxyethyl)aminomethyl-1,4-benzodioxane) and 5
      methylurapidil. The inhibition curves displayed shallow slopes which could be
      subdivided into high and low affinity components (pKi = 10.43 and 8.36 for
      WB4101, 8.62 and 6.61 for 5-methylurapidil). However, unlabelled prazosin or
      HV723 (alpha-ethyl-3,4,5-trimethoxy-alpha-(3-((2-(2-methoxyphenoxy)-ethyl)amin o)
      propyl)benzeneacetonitrile fumarate) competed for [3H]-prazosin binding
      monophasically (pKi = 10.34 and 8.28, respectively). In CEC-pretreated membranes,
      prazosin, WB4101, 5-methylurapidil and HV723 antagonized the [3H]-prazosin (100
      pM) binding monophasically (pKi = 9.70, 9.56, 8.60 and 8.82, for each
      antagonist). 4. On the other hand, 1000 pM [3H]-prazosin binding was inhibited by
      unlabelled prazosin biphasically (pKi = 10.49 and 8.49). HV723 did not
      discriminate both prazosin-high and low affinity sites (pKi = 8.18). 5. These
      results suggest the presence of at least three distinct alpha1-adrenoceptor
      subtypes in rat hearts(two prazosin-high affinity sites and one prazosin-low
      affinity site). According to the recent alpha l-adrenoceptor subclassifications,
      one of the former two sites corresponds to the alpha 1B subtype with low
      affinities for WB4101 and 5-methylurapidil and sensitive to CEC, while another
      site with relatively high affinities for WB4101 and 5-methylurapidil may be
      classical alpha 1A, cloned alpha 1c, alpha 1D subtypes or their mixture. The
      prazosin-low affinity site corresponds to putative alpha 1L subtype with low
      affinity for HV723,which may be predominantly involved in the positive inotropic
      response to phenylephrine.

PMID- 7780638
TI  - Interaction of beta-carboline inverse agonists for the benzodiazepine site with
      another site on GABAA receptors.
AB  - 1. We examined the effects of methyl 6,7-dimethoxy-4-ethyl-beta-carboline-3
      carboxylate (DMCM), a beta-carboline inverse agonist for the benzodiazepine site,
      on gamma-aminobutyric acid (GABA)-induced Cl-currents in several cloned rat GABAA
      receptor subtypes expressed in human embryonic kidney cells. The Cl- currents
      were measured in the whole cell configuration of patch clamp techniques. 2. DMCM
      at low concentrations (< 0.5 microM) occupying only the benzodiazepine site
      decreased GABA-induced Cl currents in the alpha 1 beta 2 gamma 2 and alpha 3 beta
      2 gamma 2 subtypes as expected from an inverse agonist, but produced no change in
      the alpha 6 beta 2 gamma 2 subtype (perhaps a neutral antagonist). The drug at
      higher concentrations (> 0.5 microM) enhanced Cl- currents in all the subtypes
      with a half maximal concentration of 6 to 20 microM, depending on the alpha
      isoform. In the alpha 1 beta 2 subtype, which is without the benzodiazepine site,
      DMCM monophasically increased Cl- currents with a half maximal concentration of
      1.9 microM. 3. Ro 15-1788 (a classical benzodiazepine antagonist) had no effect
      on Cl- current enhancement by DMCM and, in fact, increased the current level
      through blocking current inhibition by DMCM via the benzodiazepine site. Also, Cl
      current enhancement by pentobarbitone or by 3 alpha, 21-dihydroxy-5 alpha
      pregnan-20-one was additive to that by DMCM at saturating doses. It appears that
      the agonist site for DMCM is distinct from those for benzodiazepines,
      barbiturates and neurosteroids. 4. Among beta-carboline analogues, methyl-beta
      carboline-3-carboxylate and propyl-beta-carboline-3-carboxylate markedly enhanced
      GABA-induced Cl currents in the alpha 1 beta 2 gamma 2 subtype, while N-methyl
      beta-carboline-3-carboxamide and 1-methyl-7-methoxy-3,4-dihydro-beta-carboline
      did not. It appears that the 3-carboxyl ester moiety is necessary for beta
      carbolines to interact with a novel site on GABAA receptors as agonists.

PMID- 7780637
TI  - Inhibition of morphine withdrawal by the association of RB 101, an inhibitor of
      enkephalin catabolism, and the CCKB antagonist PD-134,308.
AB  - 1. The effects induced in rats on naloxone-precipitated morphine withdrawal
      syndrome by the new mixed inhibitor of enkephalin catabolism able to cross the
      blood-brain barrier RB 101 (N-((R,S)-2-benzyl-3[(S)(2-amino-4-methylthio)butyl
      dithio]-1-ox-opropyl-L-phenylalanine benzyl ester) given alone or associated with
      the selective CCKB antagonist, PD-134,308, were investigated. 2. The systemic
      administration of RB 101 (5, 10 and 20 mg kg-1, i.v.) elicited a significant
      decrease in 8 of the 14 withdrawal signs evaluated. PD-134,308 (3 mg kg-1, i.p.)
      did not modify the expression of morphine abstinence when given alone, but
      induced a strong facilitation of RB 101 responses (12 of 14 withdrawal signs were
      decreased). This potentiation was particularly intense in peripherally mediated
      withdrawal signs. 3. In order to clarify the biochemical mechanisms implicated in
      these responses, the effects induced by the association of RB 101 and PD-134,308
      on the occupation of brain opioid receptors by endogenous enkephalins were also
      investigated in mice. PD-134,308, as well as RB 101, inhibited [3H]-diprenorphine
      binding to opioid receptors. These results suggest that an increase in endogenous
      enkephalin levels induced by PD-134,308 could participate in the facilitation of
      RB 101 behavioural responses. 4. RB 101 has a promising potential role in the
      management of the opiate withdrawal syndrome. CCKB antagonists, such as PD
      134,308 may be useful in potentiating this anti-withdrawal effect.

PMID- 7780640
TI  - Evidence for the involvement of different receptor subtypes in the pre- and
      postjunctional actions of angiotensin II at rat sympathetic neuroeffector sites.
AB  - 1. The effects of the nonpeptide angiotensin II receptor (AT) antagonists
      losartan and PD 123319 on actions of angiotensin II in the rat caudal artery and
      rat vas deferens preparations were investigated. 2. Angiotensin II (1.0 microM)
      increased perfusion pressure in isolated segments of the rat caudal artery. This
      increase in perfusion pressure was prevented by the AT1-antagonist, losartan (0.1
      microM) but was not affected by the AT2-antagonist, PD 123319 (0.1 microM). 3.
      Angiotensin II (0.1-3.0 microM) produced a concentration-dependent enhancement of
      the stimulation-induced (S-I) efflux of [3H]-noradrenaline from isolated segments
      of rat caudal artery in which the noradrenergic transmitter stores had been
      labelled with [3H]-noradrenaline. The maximum enhancement of S-I efflux was
      approximately 60% with 1.0 microM angiotensin II. 4. Losartan (0.01 and 0.1
      microM) reduced the enhancement of S-I efflux produced by 1.0 microM angiotensin
      II in the caudal artery. 5. PD 123319 (0.01 microM) did not affect the
      enhancement of S-I efflux produced by angiotensin II (1.0 microM) in the caudal
      artery. However, in a higher concentration (0.1 microM), PD 123319 reduced the
      enhancement of S-I efflux produced by 1.0 microM angiotensin II. 6. Angiotensin
      II produced concentration-dependent enhancement of the purinergic twitch
      responses (1 pulse/60 s) in the rat vas deferens. 7. Losartan (0.03 microM) and
      PD 123319 (0.03 microM) each reduced the angiotensin II-induced enhancement of
      the twitch responses in the rat vas deferens. 8. These findings indicate that the
      enhancement of sympathetic neuroeffector transmission in both the caudal artery
      and vas deferens of the rat involves angiotensin receptor subtype(s) sensitive to
      both losartan and PD 123319. In contrast, the direct vasoconstrictor effect of
      angiotensin II in the rat caudal artery involves activation of a receptor subtype
      sensitive only to losartan.

PMID- 7780639
TI  - Functional effects of long-term activation on human beta 2- and beta 3
      adrenoceptor signalling.
AB  - The functional effects of long-term activation of beta-adrenoceptors were
      investigated by measuring adenylyl cyclase activity, cyclic AMP accumulation and
      cyclic AMP-dependent protein kinase activity in CHW and L cells expressing either
      human beta 2- or beta 3-adrenoceptors. Pre-incubation of CHW and L cells
      expressing beta 2-adrenoceptors with 10 microM isoprenaline for 24 h produced a
      marked reduction in the total receptor number and dramatically reduced the
      capacity of the receptor to stimulate adenylyl cyclase maximally. In contrast,
      the ability of beta 3-adrenoceptors number was observed in L but not in CHW
      cells. Maximal levels of intracellular cyclic AMP concentrations were reached
      during the first hour of receptor activation with isoprenaline in all four cell
      lines. In the absence of phosphodiesterase inhibitors, cyclic AMP decreased to
      basal levels within 24 h of continuous stimulation. This phenomenon occurred more
      rapidly in cells expressing the beta 2- than the beta 3-adrenoceptors. These
      results confirm that, at the level of adenylyl cyclase stimulation and cyclic AMP
      accumulation, the beta 3-adrenoceptor is more resistant than the beta 2
      adrenoceptor to long-term desensitization. However, when cyclic AMP-dependent
      protein kinase activity was considered, a 24 h stimulation of beta 2- and when
      cyclic AMP-dependent protein kinase activity was considered, a 24 h stimulation
      of beta 2- and beta 3-adrenoceptor expressing cells led to the desensitization of
      the kinase in L but not in CHW cells. In conclusion, long-term desensitization
      may have distinct functional effects on cell signalling depending on the receptor
      subtype and the cell type considered. These findings might have practical
      implications for future strategies involving long-term therapies with receptor
      agonists.

PMID- 7780641
TI  - Evidence for lack of modulation of mu-opioid agonist action by delta-opioid
      agonists in the mouse vas deferens and guinea-pig ileum.
AB  - 1. There is evidence from in vivo studies for an interaction of mu- and delta
      opioid ligands. In the present work this concept has been investigated using the
      mouse vas deferens and guinea-pig ileum myenteric plexus-longitudinal
      preparations. 2. In field stimulated vasa deferentia of the mouse, co
      administration of sub-effective concentrations of the delta-opioid agonist [D
      Pen2,D-Pen5]enkephalin (DPDPE) and [Met5]- or [Leu5]enkephalin had no effect on
      the dose-response curves of the mu-agonists [D-Ala2,MePhe4, Gly-ol5]enkephalin
      (DAMGO) and morphine. Similarly, the delta-opioid agonists did not alter the
      potency of morphine and DAMGO when added at different times prior to the mu
      opioid agonists, or when EC50 concentrations of delta-opioid ligands were co
      administered. Compounds with preferred activity for the putative delta 1-(DPDPE)
      or delta 2-([D-Ala2,Glu4]deltorphin II (Delt II)) opioid receptors were
      ineffective in this respect. 3. The guinea-pig ileum contains delta-opioid
      receptors. No function of these receptors in mediating blockage of field
      stimulated contractions was observed with ligands having affinity for the
      putative delta 1 or delta 2 subtypes nor were the agonists able to modulate
      responses to mu-opioid ligands in this tissue. 4. The results demonstrate the
      modulation of mu-opioid agonists by delta-opioid agonists does not occur in the
      isolated peripheral tissues examined. Thus the findings do not support the
      concept of a functional coupling of opioid receptors, though the results may be
      explained by differences between opioid systems in the brain and peripheral
      tissues examined.

PMID- 7780642
TI  - The effect of morphine on formalin-evoked behaviour and spinal release of
      excitatory amino acids and prostaglandin E2 using microdialysis in conscious
      rats.
AB  - 1. In the present study, the object was to examine the effects of morphine on
      spinal release in vivo of excitatory amino acids (EAA), prostaglandin E2 (PGE2),
      and a marker for nitric oxide (NO) synthesis, citrulline (Cit), evoked by a
      protracted noxious stimulus produced by the injection of formalin into the paw.
      Spinal release was monitored in conscious rats using a microdialysis probe
      implanted into the subarachnoid space with the active site placed at the level of
      the lumbar enlargement. In split dialysate samples. EAAs were measured by high
      performance liquid chromatography (h.p.l.c.) and PGE2 was determined by
      radioimmunoassay. 2. Resting concentrations in nmol ml-1 for the amino acids
      (mean +/- s.e.mean, n = 21) were: 4.8 +/- 0.4 for glutamate (Glu), 0.8 +/- 0.1
      for aspartate (Asp), 8.8 +/- 0.8 for taurine (Tau), 24 +/- 3 for glycine (Gly),
      19 +/- 3 for serine (Ser), 5.2 +/- 0.8 for asparagine (Asn), 64 +/- 4 for
      glutamine (Gln) and 5.2 +/- 0.4 for Cit. Mean basal release for PGE2 was 12 +/- 1
      pmol ml-1. 3. Subcutaneous (s.c.) injection of 5% formalin evoked a biphasic
      flinching behaviour (phase 1: 0-9 min and phase 2: 10-60 min) of the injected
      paw. Corresponding to phase 1 behaviour, there was a significant increase (50
      100%) in spinal levels of Glu, Asp, Tau, Gly, Cit and PGE2, but not Ser, Asn and
      Gln. A significant (P < 0.01) second phase increase in release was observed only
      for Cit and PGE2. However, Glu and Asp levels were increased by approximately
      45%. 4. Injection of morphine sulphate (3 mg kg-1, s.c.) had no effect on resting
      release, but produced a significant suppression of the formalin-evoked behaviour
      and release of Glu, Asp, Tau, Gly, Cit and PGE2. The effect of morphine was
      reversed by pretreatment with 1 mg kg-1 naloxone. Naloxone by itself did not
      change the release or behaviour of the formalin test.5. This study demonstrates
      that both spinal EAA and PGE2 release patterns correlate with behavioural
      nociceptive responses in the formalin test and that morphine suppresses the
      formalin-evoked behaviours and spinal release. The reversal by naloxone of the
      morphine effect indicates mediation via an opioid receptor.

PMID- 7780644
TI  - Differential effects of OPC-18790, amrinone and dobutamine on cardiac function
      and energy metabolism in the guinea-pig isolated ischaemic heart.
AB  - 1. The effects of OPC-18790, a novel positive inotropic agent, on cardiac
      function and myocardial energy metabolism in the guinea-pig isolated heart with
      ischaemia were studied by 31P-magnetic resonance spectroscopy (MRS) and compared
      with those of amrinone and dobutamine. 2. Cardiac ischaemia was induced by
      intracoronary infusion of 15 microns microspheres to reduce coronary perfusion
      flow (CPF) by 50%. Microsphere embolisation caused a 40% decrease in left
      ventricular systolic pressure (LVSP), cardiac contractility measured by peak of
      ventricular pressure development (LVdP/dt) and slightly reduced heart rate. There
      was also a decrease in ATP and creatine phosphate (PCr) by 20%, an increase in
      inorganic phosphate (Pi) by 25% and an acidic shift of intracellular pH in the
      ischaemic heart. 3. In the ischaemic heart, OPC-18790, amrinone and dobutamine
      were applied at concentrations which increased LVdP/dt by about 60%. These
      compounds increased LVP by 15% to 30% and increased CPF by about 10%. Amrinone
      and dobutamine but not OPC-18790 increased heart rate. When these drugs produced
      the haemodynamic changes described above, amrinone and dobutamine reduced ATP and
      PCr, increased Pi and produced further intracellular acidosis, whereas, OPC-18790
      did not change these parameters. 4. Cardiac pacing at 285 beats min-1 produced
      decreases in LVP, LVdP/dt and CPF by about 30%, 20%, 5%, respectively and an
      increase in Pi, decreases in PCr and ATP, and intracellular acidosis. 5. These
      results suggest that degradation of high energy phosphate compounds closely
      relates to increase in heart rate in the ischaemic heart. Positive inotropic
      agents without chronotropic action seem to be beneficial in support of the
      ischaemic heart.

PMID- 7780643
TI  - Copper chelation-induced reduction of the biological activity of S-nitrosothiols.
AB  - 1. The effect of copper on the activity of the S-nitrosothiol compounds S
      nitrosocysteine (cysNO) and S-nitrosoglutathione (GSNO) was investigated, using
      the specific copper chelator bathocuproine sulphonate (BCS), and human washed
      platelets as target cells. 2. Chelation of trace copper with BCS (10 microM) in
      washed platelet suspensions reduced the inhibition of thrombin-induced platelet
      aggregation by GSNO; however, BCS had no significant effect on the anti
      aggregatory action of cysNO. BCS inhibited cyclic GMP generation in response to
      both cysNO and GSNO. 3. The effect of BCS was rapid (within 30 s), and could be
      abolished by increasing the platelet concentration to 500 x 10(9) l-1. 4. In BCS
      treated platelet suspensions, the addition of Cu2+ ions (0.37-2.37 microM) led to
      a restoration of both guanylate cyclase activation and platelet aggregation
      inhibition by GSNO. 5. The anti-aggregatory activity of GSNO was reduced in a
      concentration-dependent manner by the copper (I)-specific chelators BCS and
      neocuproine, and to a smaller extent by desferal. No effect was observed with the
      copper (II) specific chelator, cuprizone, the iron-specific chelator,
      bathophenanthroline sulphonate, or the broader-specificity copper chelator, D
      penicillamine. 6. In both BCS-treated and -untreated platelet suspensions, cys NO
      was more potent than GSNO as a stimulator of guanylate cyclase. In BCS-treated
      platelet suspensions there was no significant difference between the anti
      aggregatory potency of cysNO and GSNO; however, in untreated suspensions, GSNO
      was significantly more potent than cysNO. Thus, when copper was available, GSNO
      produced a greater inhibition of aggregation than cysNO, despite being a less
      potent activator of guanylate cyclase. 7. The breakdown of cysNO and GSNO was
      measured spectrophotometrically by decrease in absorbance at 334 nm. In Tyrode
      buffer, cysNO (10 microM) broke down at a rate of 3.3 microM min-1. BCS (10
      microM)reduced this to 0.5 microM min-1. GSNO, however, was stable, showing no
      fall in absorbance over a period of 7 min even in the absence of BCS.8. We
      conclude that copper is required for the activity of both cysNO and GSNO,
      although its influence on anti-aggregatory activity is only evident with GSNO.
      The stimulatory effect of copper is unlikely to be explained solely by catalysis
      of S-nitrosothiol breakdown. The enhancement by copper of the anti-aggregatory
      activity of GSNO, relative to cysNO, suggests that copper may be required for
      biological activity of GSNO which is independent of guanylate cyclase
      stimulation.

PMID- 7780645
TI  - Effect of the NMDA-antagonist, MK 801, on benzodiazepine-opioid interactions at
      the spinal and supraspinal level in rats.
AB  - 1. Benzodiazepines potentiate morphine antinociception at the spinal level via
      GABAergic mechanisms. At the supraspinal level, the inhibitory effect of
      midazolam on morphine antinociception cannot be easily explained by GABAA
      receptor activation. Since excitatory amino acids play a role in central
      transmission, we investigated the effect of dizocilpine (MK 801) on this
      interaction in spinal cord and brain. 2. In rats with an intrathecal or
      intracerebroventricular catheter, the mechanisms of the antinociceptive effect of
      benzodiazepine-morphine combinations were tested during thermal nociceptive
      tests. 3. The principal findings of this study were that at the spinal level,
      midazolam potentiation of morphine antinociception can be antagonized by the NMDA
      antagonist, MK 801 (10 micrograms), as assessed by hot-plate and tail-flick
      tests. When drugs were administered supraspinally, midazolam inhibited morphine
      antinociception only in the hot-plate test, an effect also inhibited by MK 801.
      In the tail-flick assay, midazolam failed to influence the morphine response. 4.
      The NMDA antagonist significantly affected midazolam antinociception at the
      spinal level, but was not effective following i.c.v. administration of the drugs.
      MK 801 had no effect on morphine antinociception after i.t. and i.c.v.
      administration of the drugs. 5. The paradoxical effect of midazolam on morphine
      antinociception and its reversal by MK 801 might be due to modulation at various
      levels of the neuraxis and/or modulation of different pathways mediated via both
      GABAA and NMDA receptor mechanisms.

PMID- 7780646
TI  - Role of endothelin-1 and the ETA receptor in the maintenance of
      deoxycorticosterone acetate-salt-induced hypertension.
AB  - 1. To search for a possible role for endothelin-1 (ET-1) in deoxycorticosterone
      acetate (DOCA)-salt-induced hypertension, we examined changes in concentration of
      ET-1 in vascular and renal tissue in DOCA-salt hypertensive rats and evaluated
      the antihypertensive effect of the ETA receptor antagonist, FR139317. 2. There
      was an increase in aortic immunoreactive-ET (IR-ET) concentrations in association
      with hypertension-induced treatment. There were no significant changes in ET-1
      levels in the kidney with DOCA-salt treatment. 3. In DOCA-salt hypertensive rats,
      a significant correlation (r = 0.83, P < 0.01) was found between aortic IR-ET
      concentrations and systolic blood pressure. 4. High-performance liquid
      chromatography analysis of the aortic extract from DOCA-salt rats revealed one
      major component corresponding to the elution position of synthetic ET-1. 5. The
      intravenous bolus injection of FR139317 (10 mg kg-1) produced a slight decrease
      in blood pressure in the control rats and in the DOCA-salt hypertensive rat,
      FR139317 had a more pronounced hypotensive effect. 6. We propose that ET-1
      production in vascular tissues is increased in DOCA-salt hypertensive rats. In
      addition, our study indicates the pathophysiological importance of increased
      endogenous ET-1 in the maintenance of DOCA-salt-induced hypertension, through
      interaction of the peptide with ETA receptors.

PMID- 7780647
TI  - Blockade of motion- and cisplatin-induced emesis by a 5-HT2 receptor agonist in
      Suncus murinus.
AB  - 1. The effects of (+/-)-1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOl), a 5
      hydroxytryptamine 5-HT2A/5-HT2C receptor agonist, on motion- and cisplatin
      induced emesis were studied in Suncus murinus. Subcutaneous injection of DOl, 30
      min prior to the emetic stimuli, dose-dependently blocked the emesis induced by
      motion sickness and cisplatin (20 mg kg-1, i.p.) with estimated ID50 values of
      640 and 780 micrograms kg-1, respectively. 2. alpha-Methyl-5-hydroxytryptamine
      (alpha-Me-5-HT), a peripheral 5-HT2A/5-HT2C receptor agonist, had no effect on
      motion- and cisplatin-induced emesis. 3. The antiemetic effects of DOl on motion-
      and cisplatin-induced emesis were attenuated by preadministration of ketanserin,
      a selective 5-HT2A receptor antagonist. 4. The present results suggest an
      inhibitory role for central 5-HT2 receptors in the emetic reflex mechanism and
      that a 5-HT2 receptor agonist may be a useful tool to investigate the involvement
      of 5-HT receptors in the emetic reflex.

PMID- 7780648
TI  - Effects of beta 2-adrenoceptor agonists on anti-IgE-induced contraction and
      smooth muscle reactivity in human airways.
AB  - 1. The beta 2-adrenoceptor agonists, salbutamol, salmeterol and RP 58802 relaxed
      basal tone of human isolated bronchial smooth muscle. Salmeterol- and RP 58802
      induced relaxations persisted for more than 4 h when the medium was constantly
      renewed after treatment. 2. Salbutamol, salmeterol and RP 58802 reversed
      histamine-induced contractions in human airways (pD2 values: 6.15 +/- 0.21, 6.00
      +/- 0.19 and 6.56 +/- 0.12, respectively). 3. Anti-IgE-induced contractions were
      significantly inhibited immediately after pretreatment of preparations with beta
      2-adrenoceptor agonists (10 microM). However, when tissues were treated with beta
      2-agonists and then washed for a period of 4 h, salmeterol was the only agonist
      which significantly inhibited the anti-IgE response. 4. Histamine response curves
      were shifted to the right immediately after pretreatment of tissues with the beta
      2-adrenoceptor agonists (10 microM; 20 min), but maximal contractions were not
      affected. After a 4 h washing period, the histamine curves were not significantly
      different from controls. Concentration-effect curves to acetylcholine (ACh) or
      leukotriene C4 (LTC4) were not significantly modified after beta 2-agonist
      pretreatment. 5. These results suggest that beta 2-adrenoceptor agonists may
      prevent anti-IgE-induced contraction by inhibition of mediator release rather
      than alterations of those mechanisms involved in airway smooth muscle
      contraction.

PMID- 7780649
TI  - Pharmacology of a non-selective ETA and ETB receptor antagonist, TAK-044 and the
      inhibition of myocardial infarct size in rats.
AB  - 1. The aims of the present study were to characterize the pharmacological profile
      of a new endothelin (ET) receptor antagonist, TAK-044 and to consider whether it
      limits the extension of myocardial infarct size in rats. 2. Binding of [125I]-ET
      1 to ET receptors on rabbit ventricular and cerebellar membrane fractions was
      inhibited by TAK-044 with IC50 values of 3.8 nM and 130 nM, respectively. 3. It
      inhibited ET-1, ET-2 and ET-3-induced vasoconstriction of porcine isolated
      coronary arteries in a competitive (ET-1, ET-2) and a non-competitive (ET-3)
      manner. 4. In the rat in vivo, the ET-1-induced blood pressure changes including
      transient hypotension followed by sustained hypertension, were inhibited by TAK
      044 (0.1-10 mg kg-1, i.v.) in a dose-dependent manner. 5. Acute myocardial
      infarction induced by 1 h coronary occlusion followed by 24 h reperfusion in rats
      caused an infarct size of 60 +/- 2% (n = 12) of the area-at-risk by weight. 6.
      Intravenous injection of TAK-044 10 min before coronary occlusion reduced the
      infarct size in a dose-dependent manner: 32% and 54% reductions at 1 and 3 mg kg
      1, respectively. 7. TAK-044 administered 10 min before or 1 h after reperfusion
      (1 mg kg-1, i.v.) showed similar inhibitory effects: 34% and 23% reductions,
      respectively. 8. We conclude that TAK-044 is an ETA/ETB receptor antagonist which
      shows strong inhibitory effects on the extension of myocardial infarct size after
      coronary artery occlusion-reperfusion in rats.

PMID- 7780651
TI  - Vascular 5-HT1-like receptors mediating vasoconstriction and vasodilatation:
      their characterization and distribution in the intact canine cardiovascular
      system.
AB  - 1. In anaesthetized dogs, intra-left atrial administration of 5-hydroxytryptamine
      (5-HT) and selected tryptamine analogues (5-carboxamidotryptamine, 5-CT; 5-methyl
      tryptamine, 5-MT; alpha-methyl 5-hydroxytryptamine, alpha-HT; sumatriptan, Sum)
      in the presence of ketanserin and MDL72222 (5-HT2 and 5-HT3 receptor antagonists,
      respectively), produced dose-related changes in carotid, coronary and renal
      vascular conductance mediated by vascular 5-HT1-like receptors. 2. In the carotid
      vascular bed, 5-HT, 5-MT, alpha-HT and Sum were vasoconstrictors with a rank
      order of potency (comparing ED50 values) of 5-HT = Sum > 5-MT > alpha-HT. By
      contrast in this vascular bed, 5-CT was a potent vasodilator. 3. In the coronary
      vascular bed, 5-HT, 5-CT, 5-MT and alpha-HT were vasodilators with a rank order
      of potency (comparing ED50 values) of 5-CT > 5-HT > 5-MT > alpha-HT. In this
      vascular bed, Sum was without effect. 4. In the renal vascular bed, 5-HT, 5-CT, 5
      MT, alpha-HT and Sum were vasoconstrictors with a rank order of potency
      (comparing ED50 values) of 5-CT > 5-HT > Sum > 5-MT > alpha-HT. 5. The coronary
      (and carotid) vasodilator responses to 5-CT were antagonized by the 5-HT1-like
      receptor antagonists, spiperone (1 mg kg-1) and methiothepin (0.1 mg kg-1),
      whereas the renal vasoconstrictor responses to this tryptamine analogue were
      antagonized only by methiothepin. 6. It is concluded from these studies that
      agonist finger-printing in vivo, using tryptamine analogues,identifies and
      confirms the functional presence of at least two pharmacologically distinct
      subtypes of the 5-HT1-like receptor in the intact canine cardiovascular system.
      These two subtypes are located on the vascular smooth muscle and mediate direct
      vasoconstriction and vasodilatation responses in vivo.7. In addition, these
      studies confirm that the distribution of these subtypes within the major vascular
      beds, shows a marked heterogeneity. The carotid vascular responses to the
      tryptamine analogue sindicate the presence of both the vasodilator and the
      vasoconstrictor subtypes. The coronary vascular responses to these analogues are,
      however, consistent with presence of the vasodilator subtype, only. By contrast,
      the renal vascular responses to these analogues indicates only the presence of
      the vasoconstrictor subtype.

PMID- 7780650
TI  - The role of nitric oxide in the altered vascular reactivity of pregnancy in the
      rat.
AB  - 1. Pregnancy is characterized by a decrease in systemic vascular resistance and a
      blunting of the angiotensin II (AII) pressor response. We studied the role of
      nitric oxide (NO) and prostanoids in these vascular changes of pregnancy in
      anaesthesized, ganglion blocked non-pregnant and pregnant rats. 2. Inhibition of
      NO synthesis with NG-nitro-L-arginine methyl ester (L-NAME) led to an increase in
      mean arterial pressure (MAP) which was of a significantly greater magnitude in
      pregnant rats in late gestation than in non-pregnant rats, or rats in mid
      gestation. 3. The pressor response to varying doses of AII was attenuated during
      late pregnancy, and this attenuation was partially reversed by L-NAME. 4. The
      pressor response to varying doses of a vasoconstrictor, phenylephrine (PE), was
      also attenuated in late pregnancy. However, this attenuation was not reversed by
      L-NAME. 5. Inhibition of prostanoid biosynthesis with meclofenamate did not alter
      basal MAP, nor the pressor response to varying doses of AII or PE in pregnant and
      non-pregnant animals. 6. It is concluded that (a) increased NO synthesis occurs
      during late gestation and contributes both to the decrease in systemic vascular
      resistance, as well as the blunting of the pressor response to AII during
      pregnancy, and (b) prostaglandins are not important in the maintenance of basal
      vascular tone, or the blunting of the pressor response to AII during pregnancy.

PMID- 7780652
TI  - Canine renovascular responses to sumatriptan and 5-carboxamidotryptamine:
      modulation through endothelial 5-HT1-like receptors by endogenous nitric oxide.
AB  - 1. In anaesthetized dogs, intra-left atrial (i.l.a.) administration of the 5-HT1
      like receptor agonists, sumatriptan (1-10 micrograms kg-1) and 5
      carboxamidotryptamine (0.03-0.3 micrograms kg-1) produced dose-related reductions
      in renal blood flow and vascular conductance, which were characterized by their
      rapid onset and recovery. 2. In these animals, i.v. administration of the
      inhibitor of nitric oxide (NO) synthase, NG-nitro-L-arginine methyl ester (L
      NAME; 10 mg kg-1) significantly augmented the renal vasoconstrictor responses to
      i.l.a. sumatriptan and 5-carboxamidotryptamine. 3. The effects of L-NAME upon
      these responses to sumatriptan and 5-carboxamidotryptamine were significantly
      reversed by subsequent i.v. administration of L-arginine (1000 mg kg-1). 4. L
      NAME significantly attenuated the systemic hypotensive responses to i.v.
      acetylcholine (0.3-3 micrograms kg-1) and this effect was also reversed by L
      arginine. 5. L-NAME had no effect upon the renal vasoconstrictor response to
      i.l.a. administration of angiotensin II, nor did it affect the renal vascular
      conductance recovery response to brief mechanical occlusion of the renal artery.
      6. These data suggest that sumatriptan and 5-carboxamidotryptamine stimulate the
      release of NO through the activation of a 5-HT1-like receptor located on the
      endothelial cells. 7. It is concluded that in canine renal vasculature, 5-HT1
      like agonists (and presumably endogenous 5-hydroxytryptamine) can cause
      simultaneous activation of a 5-HT1-like receptor on both vascular smooth muscle
      and endothelial cells. The net renal vascular response to these agonists is
      therefore a function of both the vascular smooth muscle vasoconstriction and the
      concurrent vasodilator influence of NO released from the endothelium.

PMID- 7780653
TI  - Haemostatic mechanism in the endometrium: role of cyclo-oxygenase products and
      coagulation factors.
AB  - 1. The primary mechanism of haemostasis in the endometrium of rat was studied and
      results were compared to that in the mesenteric artery. 2. The bleeding time of
      the rat endometrium as assessed by haemoglobin output was significantly decreased
      after pretreatment of the animals with either indomethacin (5 mg kg-1, i.v.) or
      meclofenamate (3 mg kg-1, i.v.) whereas the bleeding time was significantly
      increased in the rat mesenteric artery. 3. The bleeding time of the rat
      endometrium was unchanged from control values following treatment with
      prostacyclin (0.5 microgram kg-1 min-1, i.v.) or 1-benzylimidazole (50 mg kg-1,
      i.v.) whereas the bleeding times were increased in the rat mesentric artery. 4.
      Administration of heparin (100 units kg-1) increased the bleeding time in the rat
      mesenteric artery but had no effect on the bleeding time of the endometrium. 5.
      Superfusion of the endometrium with 16, 16-dimethyl PGE2 (1 microgram ml-1) a
      vasodilator, increased the bleeding time of the endometrium but superfusion of
      PGE2 over the mesenteric artery did not affect the bleeding time from this site.
      6. Histological studies of the mesenteric artery and the endometrium following
      haemostatis revealed that the haemostatic plug in the mesenteric artery was
      mainly composed of platelets and fibrin whereas in the endometrium it was mainly
      composed of fibrin. 7. These findings suggest that haemostasis in the endometrium
      may be mediated by the vascular tone and fibrin whereas formation of the platelet
      plug may be primary mechanism for haemostasis in the mesenteric artery.

PMID- 7780654
TI  - Angiotensin-converting enzyme (ACE) inhibitor transport in human intestinal
      epithelial (Caco-2) cells.
AB  - 1. The role of proton-linked solute transport in the absorption of the
      angiotensin-converting enzyme (ACE) inhibitors captopril, enalapril maleate and
      lisinopril has been investigated in human intestinal epithelial (Caco-2) cell
      monolayers. 2. In Caco-2 cell monolayers the transepithelial apical-to-basal
      transport and intracellular accumulation (across the apical membrane) of the
      hydrolysis-resistant dipeptide, glycylsarcosine (Gly-Sar), were stimulated by
      acidification (pH 6.0) of the apical environment. In contrast, transport and
      intracellular accumulation of the angiotensin-converting enzyme (ACE) inhibitor,
      lisinopril, were low (lower than the paracellular marker mannitol) and were not
      stimulated by apical acidification. Furthermore, [14C]-lisinopril transport
      showed little reduction when excess unlabelled lisinopril (20 mM) was added. 3.
      pH-dependent [14C]-Gly-Sar transport was inhibited by the orally-active ACE
      inhibitors, enalapril maleate and captopril (both at 20 mM). Lisinopril (20 mM)
      had a relatively small inhibitory effect on [14C]-Gly-Sar transport. pH-dependent
      [3H]-proline transport was not inhibited by captopril, enalapril maleate or
      lisinopril. 4. Experiments with BCECF[2',7',-bis(2-carboxyethyl)-5(6)
      carboxyfluorescein]-loaded Caco-2 cells demonstrate that dipeptide transport
      across the apical membrane is associated with proton flow into the cell. The
      dipeptide, carnosine (beta-alanyl-L-histidine) and the ACE inhibitors enalapril
      maleate and captopril, all lowered intracellular pH when perfused at the apical
      surface of Caco-2 cell monolayers. However, lisinopril was without effect. 5. The
      effects of enalapril maleate and captopril on [14C]-Gly-Sar transport and pHi
      suggest that these two ACE inhibitors share the H(+)-coupled mechanism involved
      in dipeptide transport. The absence of pH-dependent [14C]-lisinopril transport,
      the relatively small inhibitory effect on [14C]-Gly-Sar transport,and the absence
      of lisinopril-induced pHi changes, all suggest that lisinopril is a poor
      substrate for thedi/tripeptide carrier in Caco-2 cells. These observations are
      consistent with the greater oral availability and time-dependent absorption
      profile of enalapril maleate and captopril, compared to lisinopril.

PMID- 7780655
TI  - Suppression by the sumatriptan analogue, CP-122,288 of c-fos immunoreactivity in
      trigeminal nucleus caudalis induced by intracisternal capsaicin.
AB  - 1. The effects of an intravenously administered sumatriptan analogue were
      examined on c-fos-like immunoreactivity (c-fos-LI), a marker of neuronal
      activation, evoked within trigeminal nucleus caudalis (TNC) and other brain stem
      regions 2 h after intracisternal injection of the irritant, capsaicin (0.1 ml,
      0.1 mM), in pentobarbitone-anaesthetized Hartley guinea-pigs. 2. C-fos-LI was
      assessed in eighteen serial sections (50 microns) using a polyclonal antiserum. A
      weighted average, reflecting total expression within lamina I, IIo of TNC was
      obtained from three representative levels (i.e., at -0.225 mm, -2.475 mm and 
      6.975 mm.). 3. Capsaicin caused significant labelling within lamina I, IIo, a
      region containing axonal terminations of small unmyelinated C-fibres, as well as
      within the nucleus of the solitary tract, area postrema and medial reticular
      nucleus. A similar distribution of positive cells was reported previously after
      intracisternal injection of other chemical irritants such as autologous blood or
      carrageenin. 4. Pretreatment with a conformationally restricted sumatriptan
      analogue (with some selectivity for 5-HT1B and 5-HTID receptor subtypes) CP
      122,288, reduced the weighted average by approximately 50-60% (P < 0.05) in
      lamina I, IIo at > or = 100 pmol kg-1, i.v., but did not decrease cell number
      within area postrema, nucleus of the solitary tract or medial reticular nucleus.
      A similar pattern was reported previously following sumatriptan,
      dihydroergotamine or CP-93,129 administration after noxious meningeal
      stimulation. 5. We conclude that modifications at the amino-ethyl side chain of
      sumatriptan dramatically enhance the suppression of c-fos expression within TNC,
      a finding consistent with its remarkable potency against neurogenic plasma
      protein extravasation within dura mater. CP-122,288 and related analogues may
      serve as an important prototype for drug development in migraine and related
      headaches.

PMID- 7780656
TI  - 5-Hydroxytryptamine (5-HT)4 receptors in post mortem human brain tissue:
      distribution, pharmacology and effects of neurodegenerative diseases.
AB  - 1. The distribution, pharmacology and effects of neurodegenerative diseases on 5
      HT4 receptors in human brain have been characterized in vitro. 2. The 5-HT4
      receptor in post mortem human brain tissue was specifically labelled with [3H]-GR
      113808. In human putamen, this ligand labelled a homogeneous population of sites,
      with an apparent affinity (-log Kd) of 10.1 and a density (Bmax) of 5.73 fmol mg
      1 tissue. The pharmacology of this site was characterized by use of a series of
      displacing ligands, and the following rank order of apparent affinities (with
      mean +/- s.d. -log Ki values in parentheses) was generated: GR113808 (10.05 +/-
      0.04) > SDZ 205,557 (8.65 +/- 0.08) > DAU 6285 (7.95 +/- 0.04) > BIMU-1 (7.81 +/-
      0.06) > DAU 6215 (7.42 +/- 0.23) > tropisetron (7.39 +/- 0.23) > 5-HT (7.32 +/-
      1.00) > BIMU-8 (7.25 +/- 0.04) > (R)-zacopride (5.82 +/- 0.04). The Hill
      coefficients were not significantly different from unity, consistent with an
      interaction at a single site. A comparison of the affinities of these compounds
      with those obtained from guinea-pig striatum indicated no evidence of species
      differences. 3. The regional distribution of 5-HT4 receptors was assessed by
      determining the density of binding sites for [3H]-GR 113808. The distribution
      were as follows (with mean +/- s.d. Bmax values, fmol mg-1 tissue, in
      parentheses): caudate nucleus (8.7 +/- 1.5), lateral pallidum (8.6 +/- 5.5),
      putamen (5.7 +/- 3.0), medial pallidum (3.8 +/- 0.9), temporal cortex (2.6 +/-
      0.6), hippocampus (2.4 +/- 0.8), amygdala (2.3 +/-1.1), frontal cortex (1.7 +/-
      0.5), cerebellar cortex (<1.0). In these studies, the affinities of GR 113808
      were not significantly different.4. The density of 5-HT4 receptors selected from
      regions of post mortem brains of patients with Parkinson's disease, Huntington's
      disease and Alzheimer's disease were compared to age-matched controls. In
      Parkinson's disease, there was no significant difference between control or
      patient values(mean +/- s.d. Bmax values, fmol mg-1 tissue; putamen, control 4.74
      +/- 0.07, patient 5.86 +/- 1.48; substantia nigra, control 4.21 +/- 2.56, patient
      5.57 +/- 0.10). In Huntington's disease, there was a significant decrease in
      putamen (control 5.33 +/- 1.08, patient 2.68 +/- 1.08), while in Alzheimer's
      disease, there was a marked loss of receptors in hippocampus (control 2.34 +/-
      0.62, patient 0.78 +/- 0.61), in frontal cortex (control,1.76 +/- 0.19, patient
      1.30 +/- 0.22). Receptor density in temporal cortex showed a decrease, but did
      not achieve statistical significance (control 2.06 +/- 0.21, patient 1.44 +/-
      0.64).5. These data suggest a heterogeneous distribution of 5-HT4 receptors in
      human brain, with high to moderate densities in basal ganglia and limbic
      structures. These receptors may not be principally co-localized on dopaminergic
      cell bodies or terminals, given the lack of change observed in Parkinson's
      disease. The loss of 5-HT4 receptors in the putamen in Huntington's disease
      raises the possibility of their presence on intrinsic striatal GABAergic or
      cholinergic neurones. The marked loss of receptors in hippocampal and cortical
      regions in the brains from patients with Alzheimer's disease is consistent with a
      role for the 5-HT4 receptor in cognitive processing.

PMID- 7780657
TI  - Further investigations into adenosine A1 receptor-mediated contraction in rat
      colonic muscularis mucosae and its augmentation by certain alkylxanthine
      antagonists.
AB  - 1. The alkylxanthine antagonists, 8-phenyltheophylline (8-PT), 8-p
      sulphophenyltheophylline (8-SPT) and 1,3,7-trimethylxanthine (caffeine) produced
      rightward displacements of contractile concentration-effect curves to 5'-N
      ethylcarboxamidoadenosine (NECA) in rat isolated colonic muscularis mucosae
      (RCMM) with concentration-ratios consistent with adenosine receptor blockade. The
      non-xanthine antagonist, 9 fluro-2-(2-furyl)-5,6-dihydro [1,2,4] triazo to [1,5
      c]-quinazin-imine (CGS15943A) also antagonized contractions to NECA with an
      affinity (pKB8.1-8.5) consistent with adenosine A1 receptor blockade. 2. In
      addition to producing rightward shifts of the concentration-response curves, the
      maximum contractions to 5'-N-ethylcarboxamidoadenosine (NECA) were also markedly
      increased in the presence of 8-PT (by 83 +/- 16% at 1 microM), 8-SPT (by 37 +/-
      7% at 10 microM) and caffeine (by 45 +/- 5% at 100 microM) but were unaffected by
      CGS15943A (at 0.01 and 0.03 microM). 3. As with NECA, the maximum contractions to
      the adenosine A1 receptor agonists R-phenylisopropyladenosine (R-PIA) and N-[(1S,
      trans)-2-hydroxyclopentyl] adenosine (GR79236) were both antagonized and
      augmented by 8-PT. In addition, the contractions to NECA in the presence of 8-PT
      (1 microM) were inhibited by nanomolar concentrations of 8-cyclopentyl-1,3
      dipropylxanthine (DPCPX). 4. The non-selective phosphodiesterase (PDE) inhibitor,
      3-isobutyl-1-methylxanthine (1 microM) produced a marked increase in the NECA
      maximum without producing a rightward shift in the NECA curve, whereas a higher
      concentration (10 microM) virtually abolished responses. The PDE type III
      inhibitor,milrinone (1 microM), the type IV inhibitor, rolipram (10 microM), and
      the type V PDE inhibitor, zaprinast(3 microM), were all without effect on NECA
      responses in RCMM.5. Partial inhibitions of contractions to NECA were produced by
      indomethacin (at 3 or 10 micro M) or piroxicam (at 3 microM). Responses to
      GR79236 were also partially inhibited by indomethacin. In the presence of
      indomethacin, 8-PT was still able to enhance markedly the maximum contractions
      obtained to NECA in RCMM.6. The present study has shown that certain
      alkylxanthine antagonists (but not the non-xanthineCGS15943A) produced a marked
      augmentation of adenosine Al receptor-mediated contractions inRCMM. The mechanism
      of this augmentation is, as yet, not known but is unlikely to result from
      inhibition of PDE. This study has also shown that adenosine Al receptor-induced
      contractions inRCMM are mediated, in part, via products of the cyclo-oxygenase
      pathway.

PMID- 7780658
TI  - Karyotype evolution in holocentric chromosomes of three related species of
      triatomines (Hemiptera-Reduviidae).
AB  - C-banded karyotypes, DNA content and the male meiiotic process of Triatoma
      platensis and Triatoma delpontei are compared with those of Triatoma infestans,
      the main vector of Chagas disease in South America. These three species present
      the same diploid chromosome number 2n = 22 (20 autosomes + XX male/XY female).
      They also have several cytogenetic traits that differ from all other triatomines:
      large autosomes, C-heterochromatic blocks and meiotic heteropycnotic
      chromocenters formed by autosomes and sex chromosomes. In spite of these
      similarities, each species presents different chromosomal behavior during male
      meiosis, distinct DNA content and a specific amount and localization of the C
      heterochromatin. The differences in DNA content are mainly due to the variation
      in C-heterochromatin amount, which may be interpreted as loss and/or gain of C
      regions. This interpretation is supported by the presence of meiotic and mitotic
      chromocenters that facilitate the transference of C-positive material. The
      cytogenetic data presented in this work suggest that T. infestans and T.
      platensis are more closely related to each other than to T. delpontei. It can
      also be inferred that the differences in distribution and amount of
      heterochromatin do not play a direct role in speciation in this group.

PMID- 7780659
TI  - Do chiasmata disappear? An examination of whether closely spaced chiasmata are
      liable to reduction or loss.
AB  - The questions of whether closely spaced crossovers could be misidentified as
      single chiasmata or could cancel out each other and whether exchange could occur
      without chiasma formation were examined in Locusta migratoria. Monochiasmate
      bivalents that showed differential sister chromatid staining following
      bromodeoxyuridine incorporation were screened for their patterns of label
      distribution. Half of the chiasmata were associated with an exchange between dark
      and lightly stained chromatids, as expected if recombination involved any two non
      sister chromatids chosen at random. Two variant types of label distribution were
      also seen: approximately 10% of all monochiasmate bivalents had an anomalous
      distribution of dark and light chromatids around the chiasma, and in three of the
      1365 bivalents screened a second type of anomalous pattern was observed for the
      first time, in which all four chromatids had a label exchange at the chiasma. The
      observed incidence of the latter was considerably less than expected if they
      originated through a four-strand double crossover with closely positioned
      exchanges. Analysis of label distribution patterns in monochiasmate bivalents did
      not produce evidence of the other configurations expected if two closely spaced
      exchanges could be misidentified as single chiasmata or could cancel one another
      out so as not to form a chiasma. We conclude that analysis of chiasma frequencies
      and distributions offers an accurate means of assessing recombination in
      organisms with favourable cytology.

PMID- 7780660
TI  - The developmental stage of inactivation of rye origin rRNA genes in the embryo
      and endosperm of wheat x rye F1 hybrids.
AB  - To identify the developmental stage during which the preferential inactivation of
      rRNA genes from the rye parent occurs in wheat x rye hybrids, nucleolar activity
      was evaluated in the embryo and endosperm of developing seeds of the hybrids. The
      hybrids were obtained from crosses of euploid and aneuploid lines of hexaploid
      wheat, Triticum aestivum cv. Chinese Spring, with rye, Secale cereale cv. Centeio
      do Alto. The number of nucleolar organizing regions (NORs) and nucleoli present
      in the embryo and endosperm cells of wheat, and wheat x rye F1 hybrids, at
      different times after fertilization was scored by silver staining. The
      inactivation of rDNA of rye origin in F1 hybrids occurs simultaneously in the
      embryo and in the endosperm between 4 and 5 days after fertilization, when these
      have been through six and 10 cell cycles respectively. We conclude that the
      genomic interactions leading to the inactivation of the rye origin rDNA is a time
      dependent process, related to the developmental stage and independent of the
      number of cell cycles (DNA replication rounds) they have been through.

PMID- 7780661
TI  - Identification of highly conserved loci by genome painting.
AB  - Fluorescence in situ hybridization was used to identify patterns of DNA
      similarity among the genomes of several rodent taxa. Total genomic or Cot-1 DNAs
      were used as hybridization probes against metaphase preparations across different
      taxonomic levels, including three species of Microtus (suborder Sciurognathi),
      three species of Microtus (suborder Sciurognathi), Mus musculus (suborder
      Sciurognathi) and Ctenomys steinbachi (suborder Hystricognathi). The
      hybridization patterns of Mus or Peromyscus (sciurognath) DNA to Mus metaphases,
      which were consistent with what is known of the satellite sequences in these
      species, demonstrated the efficacy of this approach for molecular cytogenetics
      and evolutionary biology. Additional hybridizations to chromosomes of Ctenomys or
      Microtus identified loci consisting of highly conserved DNA sequences. This
      approach has proved useful in investigating genome homologies across divergent
      rodent lineages. Chromosome microdissection can be used to characterize these
      regions further.

PMID- 7780662
TI  - Synaptonemal complex analysis in spermatocytes and oocytes of rainbow trout,
      Oncorhynchus mykiss (Pisces, Salmonidae): the process of autosome and sex
      chromosome synapsis.
AB  - The surface-spreading synaptonemal complex (SC) technique was employed to analyze
      spermatocytes and oocytes of rainbow trout in order to visualize the process of
      autosome and sex chromosome synapsis in this species. The structure of lateral
      elements (LEs) of the SC and the chromosome synapsis process at the stages of
      leptotene, zygotene and pachytene are described. Comparative analysis of SCs of
      spermatocytes and oocytes showed a difference in the synaptic process, i.e. in
      spermatocytes all LEs were synapsed before the appearance of centromeric regions
      in the biarmed elements, while in the oocytes some fully synapsed LEs, including
      the centromeric region of the biarmed elements, were found together with fully or
      partially unsynapsed LEs. In males the sex chromosome synapsis starts only after
      all autosomes have synapsed. Irregular synapses involving three or four LEs were
      found in 3.4% of the cells analyzed in mid or late zygotene. Multivalents were
      found in males and females. Some aspects of initial meiotic development and their
      implications in rainbow trout cytogenetics, genetics and evolution are discussed.

PMID- 7780663
TI  - General characteristics of the polytene chromosome from ovarian pseudonurse cells
      of the Drosophila melanogaster otu11 and fs(2)B mutants.
AB  - Polytene chromosomes of good cytological quality from pseudonurse cells (PNCs) of
      fs(2)B and otu11 mutants were obtained, photomaps for otu11 mutants were
      constructed and the general characteristics of polytene chromosomes from salivary
      glands (SGs) and PNCs were compared. Three conditions were found to improve the
      cytological quality of PNC chromosomes: temperature below 18 degrees C, a protein
      rich medium and presence of the Y-chromosome. Detailed comparison of the
      chromosome banding pattern from SGs and PNCs has shown only minor differences
      between them. The frequency of asynapsis appeared to be 10 times higher for PNC
      chromosomes. Despite previous reports, features such as breaks and ectopic
      contacts turned out to be also typical for PNC chromosomes, but with remarkably
      lower frequencies.

PMID- 7780666
TI  - [Bibliography. Writing rules for references].
AB  - Scientific authors and editors have some years ago established some international
      rules concerning the presentation of the references. This paper describes the
      principles of these rules and gives explanations for their use, particularly in
      the most common types of publication: journal articles, books, book chapters,
      theses, and abstracts in conference proceedings.

PMID- 7780665
TI  - [Evaluation of a training program for nurses specializing in anesthesia and
      resuscitation in Cambodia].
AB  - Following the signing of a treaty drafted between the Cambodian Ministry of
      Health, Medecins Sans Frontieres, and the universities of Paris Nord and Bordeaux
      II, the first class of sixteen nurses completed the training in anesthesia and
      resuscitation, between September 1991 and June 1993. The training course took
      into account the special context in which the course was planned and organized.
      By bringing together the specific skills of non-government organizations and
      universities, the students obtained high quality professional skills which have
      become extremely rare in Cambodia, where almost all competent health-care
      professionals have disappeared. The results of the program were evaluated several
      months after the graduation. Using quantitative and qualitative methods,
      evaluators tried to assess if the nurses were able to apply what they had
      learned, if the course material was relevant, and how well the nurses adapted in
      terms of actual work, and professional recognition and development. Eight months
      after graduation, the nurse anesthetists' activities represented approximately
      24% of the total activity of the departments in which they worked. Thirteen of
      the sixteen nurses received significant professional recognition for their
      responsibilities in the departments, and for their independence in administering
      anesthesia. The working conditions were satisfactory, and the nurses were able to
      correctly apply what they had learned and solve many problems. However, because
      the anesthesia and resuscitation departments were being set up at the time of
      their arrival, the nurses were not able to fully care for the patients during the
      pre- and post-operation periods. Objectives for improving the training courses
      were defined, following a detailed analysis of the results of the study. However,
      proper supervision of the newly trained nurses remains an essential element in
      maintaining their competencies and motivation. By 1997, fifty-four people (fourty
      five nurses and nine doctors) should be trained in anesthesia and resuscitation.
      The continuation of the school depends on the possibility of the Cambodians to
      take charge of the program. For this purpose, two of the graduate nurses began
      training as teachers in November 1993.

PMID- 7780664
TI  - Yeast artificial chromosome cloning of the beta-catenin locus on human chromosome
      3p21-22.
AB  - beta-Catenin has emerged as an important component of the adherens junctions
      between epithelial cells. As a result of studies of its interaction with the APC
      gene product, it has been implicated in the development of colorectal cancer.
      alpha-Catenin, beta-catenin, E-cadherin and APC appear to mediate contact
      inhibition in epithelia. As part of the study of the organization of the beta
      catenin gene, we have isolated yeast artificial chromosomes (YACs) to
      characterize its intron/exon structure. YAC fluorescence in situ hybridization
      analysis and polymerase chain reaction analysis of somatic cell hybrid DNAs show
      that beta-catenin maps in the 3p21-22 region, the location of tumour-suppressor
      genes deleted in small-cell lung cancer (SCLC) and other disorders. beta-Catenin
      YACs will provide a source of microsatellite markers useful in loss of
      heterozygosity studies to assess the importance of beta-catenin deletions in
      SCLC.

PMID- 7780667
TI  - ["Silence, people are dying..." The Damergou famine, an examination of the
      facts].
AB  - This study illustrates the importance of rapid and rigorous nutritional surveys
      to evaluate precarious nutritional situations in the context of media uproar. It
      was performed in July 1993 in the Damergou district of Tanout in the Zinder
      department of Niger. In October 1992, the early warning system (SAP for Service
      d'alerte precoce) in the department reported and evaluated the food production
      deficit in the district. A food aid strategy was implemented according to these
      findings, and food was distributed from May. During June, 1993, a non
      governmental organisation (NGO) used a tabloid press report to dramatise the
      situation, and declare that 75% of the children were malnourished, and that there
      were 56,000 people starving and unable to move to look for food. An international
      aid spiral of bidding and outbidding followed, based on simple presumption,
      probably justified, but not verified. The first surveys sent from the
      headquarters were unable to make any reliable evaluations or pertinent
      recommendations. The departmental health office then performed a rapid
      anthropometric nutritional survey (RANS) using a representative sample of the
      population. The survey was a cluster survey involving 29 villages and including
      1,088 children between the ages of 6 months and 6 years old and their mothers.
      The 29 villages account for 10% of the population of the district. The findings
      were as follows: 2.8% of the families had emigrated since the harvest. The
      average price of a tiya (approximately 2.5 kg) of millet was 183 FCFA (French
      African Francs), the normal price at this time of year. The reserve of animal
      stock was 8.6 heads per family, inconsistent with massive destocking.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7780669
TI  - [The difficult dialogue between researchers and health development planners.
      Whose domain is health?].

PMID- 7780668
TI  - [Street children and AIDS in Haiti].
AB  - This study is a qualitative inquiry KAP about sexuality, and adoption and
      preservation of safe sexual behaviors, among the children of the street in Port
      au-Prince, Haiti. Three groups of participating children of the street were
      observed in Port-au-Prince for three months, during June through August 1991. The
      information was collected with the use of pre-tested charts for each theme
      chosen. Then, individual interviews were conducted with leaders identified among
      the educators and children of the street. One of the main goals of Aids
      educational programs of street children should be to make them believe in the
      existence of the disease, and the real risk it poses for death. The strategies
      that we will use to convince them should deal with the different social,
      psychological, economical, and environmental factors that characterized the
      children as follows: 1) their adherence to a peer group and the relationship of
      power between the older and younger children; 2) the fundamental importance of
      money in their life, and that all relationships that they have are based on the
      capacity of people to give them something, such as money; 3) the role of their
      social appearance and their need to behave like other children for even one day;
      4) their low self-esteem; 5) their feeling of powerlessness and resignation
      related to their living conditions; 6) the influence of the street culture; and
      7) their understanding of sexuality as an immediate pleasure.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7780670
TI  - [Vitamin A deficiency and food consumption of children aged 6 to 84 months in a
      Mali rural area].
AB  - A cross-sectional study was carried out during the dry season, within the
      framework of an extension of an existing sanitary program. In December 1991, a
      cluster sample of 2,631 children was selected in a rural district of Mali, in the
      district of Koutiala, with good agricultural conditions. A sub-sample of 262
      mothers was selected for interviews concerning their knowledge and attitudes
      about vitamin A deficiency symptoms. Prevalence of clinical symptoms was 2% for
      night blindness, 0.3% for Bitot's spots and 0.2% for corneal scars. Night
      blindness was more common after 3 years. The study of weekly consumption of
      vitamin A rich foods, made on a sample of 519 children, revealed that only 3.3%
      ate vitamin A rich foods less than seven times a week and 2.7% never ate any.
      According to the recommended dietary allowances, vitamin A deficiency was not a
      public health problem in this region. However, these results do not agree with
      those of the clinical study. It should be noted also that protein energy
      malnutrition is scarce among the children. These results allowed an estimate of
      the prevalence of vitamin A deficiency, but were insufficient for the design of
      strategies to reduce this prevalence. Simple and relatively cheap epidemiological
      methods like case-control studies are not commonly used in developing countries.
      These methods could be used to obtain a better estimate of social, cultural and
      biological risk factors, and therefore, better targeting interventions.

PMID- 7780671
TI  - [Effectiveness of coils and mats for protection against malaria vectors in
      Cameroon].
AB  - The evaluation of the effectiveness of coils and mats on mosquitoes, especially
      malaria vectors was carried out in the Southern Cameroon. The study was performed
      in the Nsimalen village from November 1993 to August 1994. Two brands of coils:
      Timor and Moon Tiger containing 0.15% W/W of esbiothrin and two brands of mats:
      ARS MATS (containing d-allethrin) and Moon Tiger (with S biothrin and diethyl
      toluamide) were tested. The evaluation was based on night catches on human bait
      inside houses. A catcher was sitting at two meters of a coil or a mat. Mosquitoes
      were caught during five consecutive nights per month in five houses. Two of the
      five houses were protected with the coils, two others with the mats and the fifth
      was used as control. Each night, coils and mats were rotated in such a way that
      at the end of the five nights, each house has been protected twice with coils,
      twice with mats and had served once as control. The composition of the mosquito
      samples collected was analysed and the reduction rate of bites was calculated for
      each method. A thousand and twenty nine mosquitoes were caught in all. Two
      hundred and fifty nine mosquitoes in houses with coils, 180 in those with mats
      and 590 in the houses which served as control. Anopheles moucheti and Mansonia
      s.p. accounted more than 90% of the samples; Anopheles gambiae s.s. represented 4
      to 9%. Coils reduced malaria vectors bites by 82.8% and mats by 90.5%. Mansonia
      bites were reduced by 66% only.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780672
TI  - [The recycling of waste water and mosquitoes].
AB  - Recycling waste water in the Acheres complex (North-West Paris) is based on both
      sophisticated industrial techniques and simple agricultural methods. The sewage
      farms and settling pools provide suitable breeding sites for more than ten
      mosquito species. Aedes caspius is the major pest for the local population.
      Moreover Culex pipiens (anthropophilic form) breeds in the sewers of the
      neighbouring towns. Mosquito control is based early ground treatment of breeding
      sites. Temephos and fenotrothion are used against A. caspius. Spherimos (Bacillus
      sphaericus) is used to control C. pipiens. The two insecticides have no adverse
      effect on humans or the environment and Spherimos is harmless. Aedes pest have
      been virtually eliminated. Urban Culex control is generally good despite being
      performed by less well trained municipal employees. In the areas treated by the
      specialized team of the SIAAP, pest mosquitoes have disappeared. The techniques
      used in the Acheres complex do not require sophisticated equipment. Thus, if
      adapted to local ecological, epidemiological and financial conditions they could
      be transferred to developing countries.

PMID- 7780673
TI  - [Lipid profile during specific malaria therapy in Gabonese children].
AB  - We report specific dyslipidemia in Gabonese children aged 18 months to 4 years
      old treated with Halfan for malaria. This is observed in addition to the
      hypoglycemia typically associated with malaria. C-HDL (high density lipoprotein)
      fell on day 0 (D0), then increased during the treatment. Triglycerides (TG),
      total cholesterol (TC) and non-esterified fatty acids (NEFA) rose on D0. CT
      continued to rise evenly throughout the treatment, whereas TG declined. The
      differences with respect to normal values are significantly different as assessed
      by the Student test. We report metabolic variation and tolerance to Halfan.

PMID- 7780674
TI  - Efficacy and gastroduodenal safety of a fixed combination of diclofenac and
      misoprostol in the treatment of arthritis.
AB  - Non-steroidal anti-inflammatory drugs (NSAIDs) are an effective therapy for the
      management of arthritis, but their use is restricted by the risk of
      gastrointestinal complications from NSAID-induced ulceration. The elderly, in
      particular, are vulnerable to such damage and complications. Misoprostol is the
      only cytoprotective drug found to be effective in the prevention of both gastric
      and duodenal ulcers associated with NSAIDs. A fixed-combination of diclofenac 50
      mg/misoprostol 200 micrograms has been evaluated for efficacy and safety in the
      treatment of arthritis. Pharmacokinetic studies of the fixed combination have
      found that no drug-drug interaction occurs between misoprostol and diclofenac
      after either single or multiple doses, and the bioavailability of misoprostol and
      diclofenac are comparable with that of misoprostol and diclofenac given alone.
      This fixed combination was found to be equivalent to other NSAIDs in the control
      of symptoms and other parameters of arthritis. The fixed combination was
      generally well tolerated, although the occurrence of abdominal pain and diarrhoea
      was slightly more frequent than with other NSAIDs. This contrasts with a 2- to 3
      fold reduction in the rate of gastroduodenal damage with the fixed combination
      compared with the rate associated with other NSAIDs. These results indicate that
      the diclofenac 50 mg/misoprostol 200 micrograms combination should be considered
      in preference to other NSAIDs when treating patients at risk of ulcer
      complications.

PMID- 7780675
TI  - The iatrogenic cost of non-steroidal anti-inflammatory drug therapy.
AB  - The secondary gastrointestinal effects associated with the use of non-steroidal
      anti-inflammatory drugs (NSAIDs) are well documented in the medical literature.
      Less addressed is the 'iatrogenic' cost due to the treatment of these secondary
      effects. Epidemiologic and clinical studies report that the cost of NSAIDs is
      multiplied by a coefficient that ranges from 1.45 to 3, if the cost of treating
      the induced gastrointestinal complications is considered. A simple methodology
      incorporating the direct medical cost of treating complications has been
      developed to calculate a 'shadow price' of an NSAID, thus reflecting the real
      cost to the payer of NSAID therapy. The model has been used to compare three
      NSAIDs on the basis of their relative prices and gastroduodenal toxicity.

PMID- 7780676
TI  - Historical overview of non-steroidal anti-inflammatory drugs.
AB  - Non-steroidal anti-inflammatory drugs (NSAIDs) are efficacious in the control of
      arthritis symptoms and have become the mainstay of arthritis therapy. While
      NSAIDs' chief mechanism of action has long been assumed to be the inhibition of
      prostaglandin synthesis, further investigation has implicated additional
      mechanisms, and shed light upon additional side-effects. Adverse renal effects
      and effects on bone and cartilage metabolism are counted among worrisome NSAID
      induced side-effects, but gastrointestinal side-effects represent the greatest
      threat to chronic NSAID users. It is important that we combine documented
      experience of side-effect risk with our growing knowledge of potential risk to
      frame a prescriptive approach to the arthritis patient that encompasses symptom
      management as well as patient protection.

PMID- 7780677
TI  - Non-steroidal anti-inflammatory drugs and renal function.
AB  - The use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with a
      range of renal effects, including interference with fluid and electrolyte
      homoeostasis. Common adverse effects are generally mild and transient; less
      common but more severe effects include reversible renal insufficiency,
      interstitial nephritis and papillary necrosis. Any of these effects can influence
      the clinical course of patients at risk because of illness, debility or age.
      Acute renal failure associated with NSAID use has been reported to account for up
      to 15.6% of cases of drug-induced renal failure. NSAID-induced haemodynamic renal
      failure is virtually always reversible with appropriate management; the
      relatively rare complications of interstitial nephritis and papillary necrosis
      are more often irreversible. NSAID-related impairment of kidney function is
      probably due in large part to inhibition of prostaglandin synthesis. Use of a
      prostaglandin E1 (PGE1) analogue has been suggested to prevent some of the
      adverse renal effects of NSAIDs in patients at high risk, an interesting
      possibility that deserves further evaluation.

PMID- 7780678
TI  - Quantitative cartilage imaging.

PMID- 7780679
TI  - Epidemiology and prevention of non-steroidal anti-inflammatory drug effects in
      the gastrointestinal tract.
AB  - Lesions of the gastric, duodenal and intestinal mucosae are found in large
      numbers of patients using non-steroidal anti-inflammatory drugs (NSAIDs);
      however, no markers have yet been isolated to identify patients at risk for
      developing gastrointestinal problems or to predict which patients with lesions
      are at risk for developing catastrophic complications. There appears to be a poor
      correlation between the presence of ulcer disease and the appearance of symptoms
      while patients are using NSAIDs. The ideal treatment--namely, withdrawal from
      NSAIDs--may not always be practicable in patients who require the analgesic
      benefit of these otherwise generally innocuous agents. It is incumbent on the
      clinician to identify the agent most appropriate for the needs of the individual,
      and to supplement NSAID therapy, where appropriate, with a means of preventing or
      minimizing adverse effects. Four classes of drugs are used to prevent NSAID
      related gastric mucosal damage: histamine (H2)-receptor antagonists (ranitidine,
      cimetidine, nizatidine, famotidine); gastric acid-pump inhibitor (omeprazole);
      barrier agent (sucralfate); and prostaglandin analogue (misoprostol). The current
      therapies (H2 antagonists and barriers) have not lived up to their promise for
      preventing gastroduodenal erosion. Moreover, such protection as they provide is
      limited to the duodenal mucosa; they afford no protection to the gastric mucosa.
      Preliminary data indicate that an acid pump inhibitor may be useful, but large
      scale studies have yet to be reported. Acute and long-term studies of the
      prostaglandin analogue misoprostol have shown that this agent has an important
      role as an adjunctive therapy to prevent both gastric and duodenal ulceration due
      to NSAIDs.

PMID- 7780680
TI  - Involvement of thiol groups in the impairment of cardiac sarcoplasmic reticular
      phospholipase D activity by oxidants.
AB  - Considerable phospholipase D (PLD) activity is localized in myocardial
      sarcoplasmic reticular (SR) membranes, where it may take part in the regulation
      of Ca2+ movements. In this study, we examined thiol group dependence as a
      possible regulatory mechanism for SR PLD. SR membranes isolated from rat heart
      were exposed to four types of thiol group modifiers, which all induced a decrease
      in SR PLD activity that was prevented by dithiothreitol. Furthermore, since
      abnormalities in thiol status and Ca2+ homeostasis are characteristic for the
      myocardial cell damage induced by oxidative stress, we also studied the effects
      of oxidants on the SR PLD activity. The enzyme was not affected by xanthine
      xanthine oxidase, but was depressed by hydrogen peroxide and by hypochlorous
      acid. These inhibitory effects were prevented by catalase as well as by
      methionine and dithiothreitol, respectively. Furthermore, reduced glutathione
      protected against the hydrogen peroxide-induced depression, whereas oxidized
      glutathione inhibited SR PLD. The results indicate that SR PLD activity is
      inhibited by nonradical oxidants, hydrogen peroxide and hypochlorous acid,
      through reversible modification of associated thiol groups. Thus, the enzyme may
      be controlled by the glutathione redox status of the cardiac cell.

PMID- 7780681
TI  - Modulation of the endogenous leukotriene production by fish oil and vitamin E.
AB  - We investigated the effects of fish oil and vitamin E on the endogenous
      leukotriene production. 10 healthy volunteers were supplemented for 1 week with
      fish oil (containing 40 mg/kg body weight per day of eicosapentaenoic and
      docosahexaenoic acid), vitamin E (540 mg, i.e., 800 IU of D-alpha-tocopherol per
      day), or with both agents. Treatment resulted in a significant increase in the
      eicosapentaenoate concentration in red blood cell membranes and/or in the vitamin
      E concentration in serum. In addition, nine obese patients were investigated who
      were on a hypocaloric diet including 10 mg vitamin E/day for 8 weeks. This diet
      was associated with a significant decrease in serum vitamin E concentration. The
      urinary concentration of leukotriene E4 plus N-acetylleukotriene E4 served as a
      measure for the endogenous leukotriene production. Fish oil reduced leukotriene
      production in eight of the 10 healthy individuals. After vitamin E
      supplementation, urinary leukotrienes were significantly reduced in all of the
      healthy volunteers. The combination of vitamin E plus fish oil had no synergistic
      effect on leukotriene production in the individuals tested. The decrease in serum
      vitamin E concentration during the hypocaloric, 10 mg vitamin E/day diet was
      associated with an increase in urinary leukotrienes in 8 of the 9 obese patients.
      Urinary prostaglandin metabolites, determined as tetranorprostanedioic acid,
      increased or decreased in parallel with urinary leukotrienes in most individuals;
      however, changes were less pronounced than those observed with leukotrienes. We
      conclude that the endogenous leukotriene production can be reduced effectively by
      high doses of fish oil or vitamin E, whereas vitamin E depletion is associated
      with an increase in leukotriene generation.

PMID- 7780682
TI  - Lyso-PAF:acetyl-CoA acetyltransferase and CDP-choline cholinephosphotransferase
      activities in the rabbit endometrium.
AB  - Endometrial platelet-activating factor (PAF, 1-O-alkyl-2-acetyl-sn-glycero-3
      phosphorylcholine) levels change significantly during the pre-implantation period
      in the rabbit uterus, but under in vitro culture conditions, constitutive PAF
      biosynthesis by isolated endometrial tissues is not easily demonstrable. Rapid
      metabolism of PAF relative to its synthesis may account for this disparity
      because we have recently shown that in stromal cells there is a significant build
      up of lyso-PAF suggesting that lyso-PAF-acetyl-CoA acetyltransferase might be a
      limiting factor. In the glandular epithelial cells however, the lyso-PAF build-up
      was replaced by a significant accumulation of a neutral lipid which was
      tentatively identified as 1-O-hexadecyl-2-acetylglycerol. It was hypothesized
      that, during endometrial growth and development, this lipid might serve as the
      substrate for the alkylacetylglycerol CDP-choline cholinephosphotransferase
      enzyme for PAF synthesis via the de novo pathway. We have therefore examined the
      activities of lyso-PAF:acetyl-CoA acetyltransferase and the CDP
      cholinephosphotransferase enzymes. Microsomal preparations containing lyso
      PAF:acetyl-CoA acetyltransferase activity catalyzed the incorporation of
      [3H]acetyl-CoA lyso-PAF into two distinct lipid products. One co-migrated with
      authentic PAF and the other with 1-O-hexadecyl-2-acetylglycerol, the latter being
      formed subsequent to PAF formation. The alkylacetylglycerol CDP-choline
      cholinephosphotransferase enzyme, which would potentially utilize the
      alkylacetylglycerol synthesized via the remodeling pathway, was also
      demonstrable. Unlike the species present in other tissues however, it was found
      to be sensitive to the presence of 10 mM DTT. The diacylglycerol CDP-choline
      cholinephosphotransferase species was also demonstrable and supported the
      synthesis of both PAF and phosphatidylcholine, in the absence of DTT, when only
      the synthesis of phosphatidylcholine was expected. It is hypothesized that the
      rabbit endometrium possesses active enzymes which may catalyze PAF synthesis via
      both the de novo and 'remodeling' pathways.

PMID- 7780683
TI  - Bimodal action of fatty acids on PMA-stimulated O2.- production in human adherent
      monocytes.
AB  - Not only unsaturated linear fatty acids, but also saturated monomethyl-branched
      fatty acids (MMBFAs), are provided by food. They are capable of penetrating into
      the membrane lipids and promoting lipid disorder. Both NADPH oxidase and protein
      kinase C (PKC) are bound to cell cytoplasmic membranes and are responsive to
      unesterified fatty acids (UEFAs). We found that the O2.- NADPH oxidase-mediated
      production of human adherent monocytes was modified by unsaturated linear and
      saturated branched UEFAs only in the presence of phorbol myristate acetate. This
      result together with our inhibition data indicated an action strictly linked to
      PKC activity. The type and intensity of action depended on the UEFA
      concentrations and chain structure. Nanomolar concentrations showed potentiating
      effects whereas micromolar (< CMC) concentrations displayed depressant influences
      MMBFAs were generally more active than the other FAs. With respect to the
      micromolar depressant effect, oleate and linoleate were as active and
      docosahexaenoate nearly as active as MMBFAs. As assessed by iso-15:0 or
      arachidonate action, such bimodal alteration did not occur in non-adherent
      monocytes and neutrophils. Certain UEFAs could be considered as 'cellular' anti
      oxidants on the sites of adherent-monocyte recruitment.

PMID- 7780684
TI  - Effect of a 5-lipoxygenase inhibitor, AL-3264, on propranolol-induced
      bronchoconstriction in guinea-pigs.
AB  - The administration of propranolol can provoke bronchoconstriction in asthmatic
      patients. We hypothesized that such bronchoconstriction may result from the
      inflammatory mediators released by an allergic reaction. We investigated the
      effect of AL-3264, a 5-lipoxygenase inhibitor, on propranolol-induced
      bronchoconstriction (PIB) after antigen inhalation in passively sensitized and
      artificially ventilated guinea-pigs. Our goal was to determine whether products
      of arachidonate 5-lipoxygenase are involved in such PIB. Bronchoconstriction
      occurred when 10 mg/ml of propranolol was inhaled 20 min after antigen challenge.
      Pretreatment with AL-3264 given in intravenous doses of 0.01 and 0.1 mg/kg 15 min
      after the antigen challenge significantly reduced PIB in a dose-dependent manner.
      Pretreatment with 0.1 mg/kg of AL-3264 10 min before antigen challenge
      significantly inhibited both the immediate allergic bronchoconstriction and PIB,
      although the effect was minimal. Results suggest that arachidonate 5-lipoxygenase
      products (such as leukotriene B4, C4, D4 or E4) are involved in the
      pathophysiology of PIB but their contribution may be small. Further studies using
      selective antagonists for each of these leukotrienes are needed to clarify their
      role.

PMID- 7780686
TI  - T-cell depletion and manipulation in allogeneic hematopoietic cell
      transplantation.
AB  - Graft-vs-host disease (GVHD) in allogeneic hematopoietic transplantation can be
      abrogated by T-cell depletion (TCD) of the graft. Researchers have sought the
      optimal TCD procedure, which would alter the activity, number, and/or
      subpopulation profile of T cells to acceptable levels, while retaining sufficient
      engraftment potential of the harvested hematopoietic stem cells. The techniques
      that have successfully survived the translation from research studies into
      practical clinical application may be analyzed by their effectiveness,
      efficiency, ease of application, and cost. The predominant techniques rely on
      either physical separation of the T cell (binding to erythrocytes, lectins,
      centrifugation) or reaction with monoclonal antibodies (immunomagnetic, panning,
      complement-mediated cytotoxicity, immunotoxins). Comparative trials between the
      various techniques are few, making comparisons difficult. However, all of the
      techniques, whatever their relative advantages and disadvantages, must meet the
      same challenges.

PMID- 7780685
TI  - Inhibition of human group II phospholipase A2 by C-reactive protein in vitro.
AB  - Endotoxin or cytokine-induced expression of a secretory non-pancreatic
      phospholipase A2 (sPLA2) has been implicated in the pathogenesis of multisystem
      organ dysfunction or failure in patients with septic shock. Circulating sPLA2
      levels increase as much as 1000-fold during the course of septic shock. However,
      the mode of regulation of the activity of this lipolytic enzyme is unknown, since
      circulating inhibitors have not been identified. We investigated the potential
      inhibitory activity of the acute phase reactant, C-reactive protein (CRP), a
      phospholipid-binding protein whose expression increases as much as 1000-fold
      during severe infections. Serum CRP and sPLA2 profiles were highly concordant in
      patients with septic shock. In studies in vitro, human CRP inhibited hydrolysis
      of PC-lyso-PC (2:1) multilamellar liposomes by human recombinant sPLA2 in a dose
      dependent manner, with an apparent IC50 of 50 micrograms/ml CRP and maximal
      inhibition at 100 micrograms/ml. Inhibition of sPLA2 activity by CRP was
      substrate concentration-dependent, and increasing substrate concentrations
      reversed the inhibitory effect of CRP using the PC-lyso-PC system. Preincubation
      of CRP with phosphorylcholine led to a concentration-dependent loss of CRP
      induced inhibition of substrate hydrolysis. These observations are consistent
      with a substrate-depletion model of inhibition of sPLA2 activity by CRP.

PMID- 7780687
TI  - Genetic marking and manipulation of hematopoietic progenitor cells using
      retroviral vectors.
AB  - In the 5 years since the first human gene therapy studies began, more than 70
      clinical protocols have been approved, and over 200 patients have received
      genetically modified cells. A high proportion of these protocols have made use of
      hematopoietic progenitor cells or their mature progeny. In this review, we
      discuss the progress and limitations of current clinical gene transfer studies
      using marrow-derived progenitor cells and describe how the technique is being
      applied to the treatment of single-gene disorders and to augment cancer
      immunotherapies. We also discuss the contribution made by gene marking studies.

PMID- 7780689
TI  - Detection of minimal residual disease in autologous grafts.
AB  - There is increasing evidence that the presence of tumor cells within autologous
      hematopoietic cell grafts may increase the risk of relapse of disease post
      transplant. The sensitive detection of minimal residual disease is therefore
      central to improving the outcome of autologous transplantation, irrespective of
      the source of the graft. This review presents a comparative evaluation of the
      sensitivity and specificity of the currently available methods for tumor
      detection.

PMID- 7780688
TI  - Peripheral blood progenitor cell transplantation for hematological malignancies.
AB  - It has been demonstrated that it is possible to mobilize hematopoietic progenitor
      cells from the bone marrow into the peripheral blood, from which they can be
      collected by apheresis and used for transplantation. Although the clinical
      results obtained using this approach have not been compared in a randomized trial
      to those obtained using bone marrow, it appears that this method has certain
      advantages. These, together with future developments, are discussed in this
      review.

PMID- 7780690
TI  - Immunologically based methods for the elimination of tumor cells from autologous
      stem cell grafts.
AB  - There is currently renewed interest in the potential of tumor cells within
      autologous hematopoietic grafts to contribute to relapse of cancer post
      transplant. This has prompted the development of a wide variety of techniques for
      the ex vivo removal or purging of malignant cells from bone marrow and peripheral
      blood progenitor cell grafts. Both negative selection, in which tumor cells are
      eliminated, and positive selection, in which hematopoietic stem cells are
      enriched, are under examination as purging modalities. This review describes the
      use of immunologically based methods for autologous graft engineering.

PMID- 7780691
TI  - Cathepsin D in invasive ductal NOS, medullary, lobular and mucinous breast
      carcinoma. An immunohistochemical study.
AB  - Cathepsin D expression was determined by immunohistochemistry in 445 formalin
      fixed, paraffin embedded primary invasive breast carcinomas. We found: 1. a
      relationship between cathepsin D expression and histological type of tumour, 2. a
      negative correlation between cathepsin D expression and histological grade, 3. a
      negative correlation between cathepsin D expression and tumour diameter, 4. a
      relationship between the morphology of cathepsin D granules and histological type
      of the tumour.

PMID- 7780692
TI  - Flow cytometric evaluation of Ki67 proliferative antigen in primary breast
      cancer.
AB  - In the group of forty five primary mammary carcinomas Ki67 reactivity was
      evaluated with flow cytometry and immunohistochemistry. The expression of
      proliferative antigen, evaluated with both methods did not correlate with other
      indicators of proliferative activity. This result is probably associated with the
      physicochemical properties of breast cancer cells.

PMID- 7780693
TI  - Relationship of histology, DNA-values and proliferative activity in unselected
      breast cancer patients (a preliminary study).
AB  - Based upon a group of 108 consecutive mammary carcinomas a comparative analysis
      of morphological parameters, DNA-ploidy and indicators of proliferation activity
      was made. A correlation between Bloom-Richardson scale, mitotic index, PCNA
      labeling index and DNA-index was shown. The ploidy of mammary carcinomas was
      significantly related to the values of proliferative fraction, as well as to PCNA
      labeling index. Among patients with axillary metastases the tumor size and the
      value of PCNA-labeling index were significantly higher than those in patients
      with negative lymph nodes.

PMID- 7780694
TI  - Expression of synaptophysin and neurofilament protein confirms predominantly
      neuroblastic differentiation of primitive neuroectodermal tumors (PNET).
AB  - We report here that neuronal and glial differentiation is easily detected using
      synaptophysin (SF) and neurofilament protein (NFP) immunohistochemistry in
      primitive neuroectodermal tumors (PNET). Thus, for all practical reasons, every
      PNET should be regarded as PNET with "hidden" multipotential or bipotential
      differentiation.

PMID- 7780695
TI  - [The usefulness of morphologic methods for prognosis and treatment of breast
      carcinoma].
AB  - Numerous parameters of prognostic and therapeutic importance can be assessed on
      the base of the morphological methods. Apart from the classic methods of
      examination, the immunomorphologic technics, cytometry and, recently, molecular
      biology technics, can be employed. The diameter of the primary tumor, as a basic
      parameter in assessment of the prognosis and therapy of breast cancer, can be
      linked with the group of attributes, defining differentiation, invasiveness,
      aggressiveness and a heterogeneous set of the other features. These parameters
      gain particular importance, when studied together with the clinical presentation
      of the disease.

PMID- 7780696
TI  - Reappraisal of ultrastructural diversity of amyloid plaques in Gerstmann
      Straussler-Scheinker syndrome.
AB  - Gerstmann-Straussler-Scheinker (GSS) syndrome is one of the most rare human
      neurodegenerative disease. In this report I summarise the ultrastructural
      pathology of amyloid plaques in two cases of this rare disease. The first type,
      unicentric "kuru" plaques consisted of stellate arrangements (stars or cores) of
      amyloid bundles emanating from a densely interwoven centre. Amyloid stars were
      surrounded by astrocytic processes and invaded by microglial cells. The amyloid
      bundles were attached to microglial cell membranes. Of note, robust basement
      membranes lined with electron dense astrocytic anchorages material were observed
      at the periphery of almost all amyloid plaques. Dystrophic neurites (DN) were
      seen only rarely. Occasionally, clusters composed of several kuru plaques were
      found; those are interpreted as intermediate forms to multicentric plaques which
      consisted of several merging stellate cores. In contrast to kuru plaques
      associated with a limited number of DN, numerous such structures were seen at the
      periphery of multicentric plaques. Identical DN were observed not associated with
      any plaques. The last and the rarest type of plaques, were purely neuritic
      plaques. These consisted of large areas filled with DN of different sizes and
      shapes (sometimes bizarre) but not amyloid bundles. Analogously to kuru and
      multicentric plaques, astrocytic processes were observed at the periphery.

PMID- 7780697
TI  - Diagnosis of Alzheimer's disease with commercially available anti-beta peptide
      (beta A4) antibodies following microwave oven pretreatment.
AB  - Alzheimer's disease (AD), the most common presenile dementia is underdiagnosed in
      Poland, thus every attempt to make the frequency of this diagnosis approaching
      standards of Western countries should be recommended. Deposits of beta A4 amyloid
      in a form of amyloid (senile) plaques, diffuse amyloid deposits and congophilic
      angiopathy is central to the pathogenesis of AD. These amyloid deposits are
      virtually invisible in routine pathological stainings like HE but may be
      visualized with Bielschowsky silver impregnation, other metallic impregnations,
      and following Thioflavine S or Congo red stainings. We report here that amyloid
      deposits are as easily immunolabeled with commercially available antibodies
      against beta A4 (DAKO) and such a staining was greatly enhanced by microwave oven
      pretreatment. In all cases of AD, the diagnosis could be easily made using either
      4GM or commercial DAKO anti-beta A4 antibodies following pretreatment with formic
      acid or processing in microwave oven. Pretreatment in microwave oven even for
      only one second was already sufficient to visualize beta A4-immunopositive
      plaques while after 5 second the intensity of staining approached that obtained
      after formic acid pretreatment.

PMID- 7780698
TI  - Glycol methacrylate embedding of bone marrow cores.
AB  - The objective of the present study was to assess the use of glycol methacrylate
      (GMA) as an embedding medium for bone marrow biopsies. Paraffin-embedded bone
      marrow trephines, which are most widely used for diagnostic purposes, need to be
      decalcified prior to sectioning. This process has a number of effects, and
      results in interference with the evaluation of the bone marrow. Differentiation
      of some cases of hematological malignancies may be difficult in decalcified,
      paraffin-embedded bone marrow biopsy specimens, because of the reported inability
      to obtain reproducible blast counts, and because a considerable percentage of
      cells cannot be easily recognized. On the other hand, GMA-embedding of marrow
      cores, which obviates the need for decalcification, shows structural organization
      of the marrow and gives excellent cellular details. The simplicity of GMA
      embedding, short processing time and reproducibility, makes this method highly
      suitable for routine work in the hematology laboratory.

PMID- 7780699
TI  - Malignant blue nevus with neurosarcoma-like lymph node metastases.
AB  - We report a case of malignant blue nevus (MBN) of the foot with unusual
      morphologic presentation of nodal metastases. Their structure resembled
      neurosarcoma, and differed from the appearance of the primary tumor. This case
      confirms the mutual close histogenic relationship between MBN and neurosarcoma,
      both tumors originating from the structures of the neural crest. We also discuss
      the problem of so-called "benign" metastases of malignant melanoma.

PMID- 7780700
TI  - Chondrolipoma of the lip. A case report.
AB  - Chondrolipoma of the lip has been described. Only one case of the lesion in this
      region had been previously reported.

PMID- 7780701
TI  - Cardiac transplantation: a review.
AB  - Cardiac transplantation is currently a highly successful treatment for selected
      patients with end-stage cardiac failure. The long-term results are limited by the
      development of coronary artery vasculopathy, infection and malignancy. The
      activity of transplantation programmes worldwide is severely limited by the
      availability of donor organs. Further refinements of immunosuppressive agents are
      likely to result in improved prevention of both acute and chronic rejection. The
      donor pool is unlikely to be significantly extended as a result of measures to
      increase donor organ supply. Alternative methods to allograft transplantation
      need further investigation to increase the number of therapeutic options
      available for those patients with end-stage heart failure.

PMID- 7780703
TI  - Surgical treatment of thoracic aneurysm: a 5-year experience.
AB  - The surgical results of 77 patients with an aneurysm of the thoracic or
      thoracoabdominal aorta who were surgically treated during a 5-year period were
      retrospectively evaluated. Eighty-four operations were performed. The aneurysm
      was located on the ascending aorta in 20 patients, on the arch in nine, and on
      the arch and ascending aorta in eight. Sixteen aneurysms involved the descending
      thoracic aorta and 27 were thoracoabdominal. Associated surgery was performed in
      12 patients. Deep hypothermia and circulatory arrest were employed in 30
      patients. Partial cardiopulmonary bypass was used in 15 patients. Mortality was
      significantly higher if operation was performed under emergency conditions: the
      early mortality rate was 11.7%. Aggressive surgical management of untreated
      aneurysm is justified, as rupture of such lesions is the most common cause of
      death and associated mortality is high, with a 5-year survival rate of less than
      20%.

PMID- 7780702
TI  - Arterial injuries associated with lower-extremity fractures.
AB  - The records of 110 patients with arterial injuries of the lower extremities
      associated with bone fractures, and managed in the authors' vascular surgery
      clinic, were reviewed. The majority (72%) were young men; 66 had blunt and 44
      penetrating arterial injuries. A total of 92 patients were treated by saphenous
      vein interposition grafting, 12 with composite grafts and six with
      polytetrafluoroethylene grafts. The limb salvage rate was 93%. All eight
      amputations were in neglected cases with arterial injury at the popliteal or
      infrapopliteal level and associated with muscle loss.

PMID- 7780704
TI  - Results of an exclusion technique for treatment of abdominal aortic aneurysm.
AB  - An exclusion technique for the treatment of abdominal aortic aneurysm was used in
      six patients considered to be at high operative risk mainly because of chronic
      pulmonary disease. There were no deaths or immediate major complications.
      Thrombosis of the aneurysm was achieved in four of the six patients. However, in
      three cases, repeated percutaneous embolization was required to produce
      thrombosis. One patient developed a secondary rupture of a persisting infrarenal
      sac resulting from a patent inferior mesenteric artery. This patient was
      successfully managed by ligature of the infrarenal portion of the abdominal aorta
      through a median laparotomy. This study emphasizes the limits and the risks of
      the exclusion technique.

PMID- 7780705
TI  - Incidence of rupture of aortic aneurysms after coincidental operation.
AB  - The clinical course of 76 patients with aortic aneurysmal disease undergoing 107
      coincidental surgical procedures was analysed in order to examine the
      relationship between aortic aneurysmal rupture and coincidental treatment.
      Additionally the incidence of aneurysmal rupture was assessed following 82
      endoscopic procedures in 42 patients with aortic aneurysms. Two patients ruptured
      an aortic aneurysm after operation, one after colonoscopy (maximal transverse
      diameter 7 cm) and one after coronary artery bypass grafting (maximal transverse
      diameter 5.6 cm). The mean maximal transverse diameter of aneurysms in 76
      patients was 5.08 cm (95% confidence interval 4.7-5.4 cm). Both patients with
      ruptured aortic aneurysm were outside these confidence limits and were known
      hypertensives whose perioperative control of hypertension was questionable. The
      present series of patients is discussed with reference to induction of
      collagenase activity as a precipitating cause for postoperative rupture of aortic
      aneurysms, perioperative control of hypertension, transverse aneurysm diameter as
      a predictor of postoperative rupture and conduct of coincidental procedures in
      the presence of aneurysmal disease.

PMID- 7780706
TI  - Management of neglected embolic occlusions in lower-limb arteries using arterial
      lavage.
AB  - Fourteen patients (seven males and seven females aged between 8 months and 100
      years) with embolic lower-limb arterial occlusions of 1 to 6 days' duration were
      treated at Assir Central Hospital, Abha, Saudi Arabia over a 27-month period. On
      admission, the limbs were ischaemic up to mid-thigh and peripheral pulses were
      absent. Doppler studies showed absence of blood flow. The anatomical block was
      localized by angiography and ultrasonography. Fogarty catheter embolectomy was
      performed in all patients followed by rapid positive-pressure lavage of the
      vascular tree with 4-61 Ringer's lactate solution containing mannitol in an
      attempt to remove free radicals. Three patients died; one transmetatarsal
      amputation was performed. The remaining 11 limbs were salvaged and these patients
      remain ambulatory 21 to 42 months after surgery.

PMID- 7780708
TI  - Treatment plan used for vascular injuries in the Afghanistan war.
AB  - The outcome of 961 patients with vascular injuries received in the Afghanistan
      war is reported. Some 755 (78.6%) patients had to have a primary amputation while
      only 206 (20.9%) had restorative surgery. The vessels were simply ligated in 85
      cases and reconstructive surgery was performed in 121. Ligation resulted in 46
      (54%) cases of limb salvage and functional restoration; 30 (35%) went on to
      amputation and nine (11%) died. Of the 121 patients treated by reconstructive
      surgery, 83 (68.5%) had completely patent vessels, 19 (15.7%) collateral
      compensation, 13 (10.7%) proceeded to subsequent amputation and six (4.9%) died.
      Although the location of the injury and the duration of the ischaemic period are
      important in deciding how to treat the vascular injuries of war, the decisive
      factor appears to be the pre-existing severity of regional ischaemia.

PMID- 7780707
TI  - Iatrogenic vascular injuries in western Saudi Arabia.
AB  - A group of 30 consecutive patients with iatrogenic vascular injury were studied
      to determine the aetiology of the condition and to investigate its possible
      prevention. Of the patients, 18 were males and 12 females; mean age was 37.0
      years (range 2 weeks to 70 years). Most injuries (n = 25) involved the arterial
      system; eight cases (27%) were recognized during the operative procedure. The
      most common presentations were bleeding and chronic ischaemia. Cannulation of
      vessels was the cause of injury in 14 cases (47%); two-thirds of these were
      iatrogenic in nature. A conservative policy was adopted in nine patients; surgery
      was planned but not performed in two. A total of 19 patients were operated on (17
      reconstructions, one ligation, one fasciotomy); two died from causes related to
      their original condition. In order to reduce the incidence of iatrogenic injury,
      medical personnel should be informed of possible vessel damage, especially during
      cannulation. All surgical and radiological procedures should be carefully
      audited.

PMID- 7780709
TI  - Infrainguinal arterial reconstruction in end-stage renal disease.
AB  - A total of 14 infrainguinal revascularizations in 11 patients with end-stage
      renal disease resulting from diabetes mellitus were reviewed. Indications for
      surgery comprised gangrene or non-healing ulcerations in eight patients (11
      limbs), ischaemic rest pain in two (two limbs) and disabling claudication in one
      (one limb). No graft failures occurred during the period of observation. There
      were two immediate postoperative deaths, one amputation, and four persistent non
      healing foot ulcers. The remaining four patients showed improvement. Six deaths
      occurred, including two perioperative deaths. Four patients with non-healing
      ulcers died within 1 year and 10 months after revascularization, but their deaths
      were not associated with the foot ulcers. The cumulative patient survival rate
      was 42% at 1 year. Infrainguinal revascularization in patients with end-stage
      renal disease caused by diabetes mellitus is feasible when meticulous
      preoperative assessment and careful perioperative management are employed to
      minimize operative risk.

PMID- 7780710
TI  - Short-term and long-term outcome following renovascular reconstruction.
AB  - Experience with renovascular reconstruction at the authors' institution over the
      past 16 years has been reviewed. A total of 76 patients underwent surgical
      intervention for renovascular disease during that time. This included 62 patients
      with atherosclerosis and 11 with fibromuscular hyperplasia. Indications for
      intervention were uncontrolled hypertension in 42 patients and to restore renal
      impairment in eight. The procedure was performed for both indications in 26
      patients. Ten patients (13%) died in the perioperative interval, which correlated
      strongly with comorbidity. With the exception of one patient, all deaths occurred
      in the elderly (> 65 years). While an increased mortality rate (P < 0.05) was
      observed in those undergoing concomitant surgical procedures (20%) as opposed to
      those undergoing renovascular reconstruction alone (6%), this was not an
      independent risk factor. Both the short term and long term response of
      hypertension control to renovascular reconstruction were favourable, with age <
      60 years, shorter duration of hypertension (< 5 years) and diagnosis of
      fibromuscular hyperplasia predictive of a better response. Renovascular
      reconstruction, while successful in stabilizing or even improving renal function
      in the short term, was poor at restoring function long term, especially in the
      subgroup of patients whose serum creatinine was > 200 mumol/l at the time of
      reconstruction.

PMID- 7780712
TI  - Anomalous carotid vertebral anastomoses and carotid endarterectomy.

PMID- 7780714
TI  - Doppler analysis of the left venting line: an effective and simple technique to
      control heart de-airing.
AB  - Air embolism is still a major risk of open-heart surgery. Different techniques of
      air removal have been established, even though none is completely effective.
      Since 1989 the authors have used a new technique to avoid air passage into the
      left vent line when the left heart cavities are open. A specially designed probe
      attached to a vascular Doppler analyser is fixed to the left vent tubing. Air
      passage is detected by a characteristic acoustic signal. Air removal procedures
      are continued until no audible signals are detected. This technique was carried
      out in 150 open left heart operations in which there were no clinical signs of
      air embolism. To validate this procedure, simultaneous assessment of air removal
      was made using transoesophageal echocardiography (TEE) and carotid Doppler (CD)
      in six patients. When Doppler signs of air in the left vent disappeared, TEE
      revealed that a small amount of air was still present in two patients; carotid
      Doppler showed only minimal passage of air bubbles in three patients after left
      vent removal while the heart was freely ejecting. These results demonstrate that
      this technique is a reliable method of assessing air removal, which is especially
      useful when de-airing is difficult during reoperation.

PMID- 7780713
TI  - Congenital aneurysm of the internal jugular vein in a pregnant woman.
AB  - A pregnant woman with a symptom-free congenital aneurysm of the internal jugular
      vein (IJV) is described. A color duplex scan revealed an aneurysm (2.4 cm in
      diameter) of the right IJV in the mid-neck without evidence of thrombus. To the
      authors' knowledge, this is the first reported case demonstrating that such a
      lesion in a pregnant woman can be safely managed without excision.

PMID- 7780711
TI  - Diffuse arterial thrombosis in a young man with elevated lipoprotein(a) and
      minimal atherosclerosis.
AB  - An increased incidence of premature atherosclerotic arterial occlusive disease
      was recently reported in young adults. This condition is characterized by early
      occurrence of severe symptoms, lower incidence of typical cardiovascular risk
      factors for atherosclerosis, different natural course of arterial disease vis-a
      vis older population, and poor outcome of a standard treatment. This report
      describes a young man with aggressive arterial occlusive disease in the lower
      extremities and symptom-free occlusions of coronary and renal arteries in
      association with high levels of lipoprotein(a). Microscopic early atherosclerotic
      changes were noted in the occluded arteries of the amputated leg. Premature
      atherosclerotic arterial occlusive disease in young adults has different clinical
      and pathological patterns, necessitating a different approach for evaluation and
      treatment.

PMID- 7780717
TI  - Concomitant repair of complete atrioventricular canal defect and transposition of
      the great arteries in an infant.
AB  - The case of an infant who was born with the rare presentation of complete
      atrioventricular canal defect and transposition of the great arteries is
      described. The patient underwent pulmonary banding at the age of 2 months,
      followed by concomitant arterial switch and repair of the atrioventricular canal
      defect at 20 months. Palliative banding allowed for the infant to grow and thus
      facilitated the later successful repair of these congenital defects.

PMID- 7780716
TI  - Left aortic arch and right descending aorta--interruption or severe coarctation
      of the aortic arch in the newborn.
AB  - Three consecutive neonates (aged 7, 14 and 30 days, body-weight 2980 g, 3000 g
      and 3400 g respectively) with interruption of the aorta (n = 2) and severe
      coarctation (n = 1) in the presence of left aortic arch and right descending
      aorta are reported. Associated lesions were an aortopulmonary window in the first
      case and an unrestrictive ventricular septal defect in the two others.
      Intractable heart failure and the complexity of the malformation led to the
      decision of a staged operation. A prosthetic graft was interposed between the
      ascending and descending aorta via a right thoracotomy in order to bridge the
      atretic or hypoplastic segment without using extracorporeal circulation. There
      was no intraoperative complication. One patient developed a thrombocytopenia
      within the frame of a sepsis syndrome and died on day 5 after operation, death
      being caused by a massive bleeding into the left thoracic cavity, although the
      operation was carried out via a right thoracotomy. Angiography 1 year after
      operation revealed a good flow through the grafts and no stenosis at the site of
      the anastomoses. The two surviving infants are clinically well without any
      medication. The reported operative technique provides an alternative palliative
      possibility to manage critically ill neonates without any obstacle to later
      definitive repair.

PMID- 7780715
TI  - Balloon angioplasty before Wheat's operation in a patient with Turner's syndrome.
AB  - The case of a 19-year-old woman with Turner's syndrome, dissecting aneurysm of
      the ascending aorta, coarctation of the aorta and bicuspid aortic valve stenosis
      is presented. Balloon angioplasty was performed before surgery to relieve the
      pressure gradient caused by coarctation of the aorta. Successful surgical
      treatment was carried out using Wheat's method. Four-year follow-up has revealed
      no signs of complications such as restenosis or aneurysm formation.

PMID- 7780718
TI  - Anomalous origin of the right coronary artery from the pulmonary artery: an
      unusual cause of angina.
AB  - Origin of the right coronary artery from the pulmonary trunk rather than the
      aorta is a rare congenital anomaly. Only five cases of this anomaly have
      presented with signs and symptoms of ischemia. One of these cases, along with
      objective evidence for the cause of the ischemia and recommendations regarding
      surgical repair, is presented here.

PMID- 7780720
TI  - Acute postoperative obstruction of the ascending aorta following replacement with
      an intraluminal graft.
AB  - A fourth case of displacement of one ring of an intraluminal graft is reported.
      This occurred in a woman who was operated on for acute dissection of the aorta.
      The displacement happened 8 h after surgery and produced acute obstruction of the
      ascending aorta. Restoration of the proximal ring of the graft into its correct
      position was successful.

PMID- 7780719
TI  - Prevention of left ventricular thrombus formation during pneumatic pump assist.
AB  - A postcardiotomy patient with a pneumatic pulsatile pump for left ventricular
      assist showed a smoke-like swirling echo within the left ventricle during pump
      assist. The image disappeared partially during intra-aortic balloon pumping,
      which was performed as usual. Subsequently, three pumps (native left ventricle,
      pneumatic and intra-aortic balloon) were driven synchronously; that is, the
      ventricular assist pump ejected the blood in the first half of the diastole of
      the native heart beat, and the intra-aortic balloon was inflated during the
      second half. With this bisected diastolic driving, the abnormal echo disappeared
      completely. The patient died 52 days after operation, but no thromboembolic
      episode was observed during the course, and no fresh thrombus was found within
      the left ventricle at autopsy. The bisected diastolic driving method served as an
      aid to prevent stagnation of blood and thrombus formation within the native left
      ventricle in this patient with a left ventricular assist device.

PMID- 7780721
TI  - Comparative investigations among meteorological conditions, air chemical-physical
      pollutants and airborne particulate mutagenicity: a long-term study (1990-1994)
      from a northern Italian town.
AB  - The findings of a continuos monitoring (Apr90-Mar94) on urban air quality of a Po
      Valley town are reported. Chemical-physical and genotoxicity data were detected.
      The results show the presence of mutagenic agents during the whole investigated
      period. Short term mutagenesis tests together with chemical-physical parameters
      analysis are able to better assess air quality and genotoxic risk for the
      population.

PMID- 7780722
TI  - The use of in vitro DNA adduct formation to estimate the genotoxicity of residues
      at contaminated sites.
AB  - Genotoxic carcinogens such as polycyclic aromatic hydrocarbons (PAHs) covalently
      bind to the bases in DNA to form adducts. The formation of DNA adducts is
      significant with respect to chemical carcinogenesis. Many contaminated sites
      contain quantities of carcinogens such as PAHs, and the evaluation of the
      genotoxicity of these soils has important implications for human risk assessment.
      DNA adducts can be formed using an in vitro system incorporating extracts from
      contaminated soils. The 32P-postlabelling assay is a sensitive technique for the
      detection of DNA adducts from complex mixtures of environmental carcinogens.
      These techniques have been used to form and detect DNA adducts using soils from a
      number of coal gasworks sites. The results show that the extent of adduct
      formation depends partially on the petroleum hydrocarbon content of samples, but
      also on other undetermined factors related to composition. While environmental
      weathering has been shown to effect the PAH composition of samples, this is not
      an important factor in controlling the genotoxicity of samples as estimated by
      DNA adduct formation.

PMID- 7780724
TI  - Learning. A mechanism of learning found?
AB  - Synaptic plasticity in the cerebellar cortex is abolished and cerebellum
      dependent motor learning is decreased in mice lacking a metabotropic glutamate
      receptor. Is the receptor involved in learning?

PMID- 7780725
TI  - Cartilage disorders. The importance of being sulphated.
AB  - Mutations within a gene encoding a novel sulphate transporter cause diastrophic
      dysplasia. This finding has implications for the management of the disorder and
      for understanding the structure and function of cartilage.

PMID- 7780726
TI  - Intercellular signaling. A kinase for cell-fate determination?
AB  - GSK-3, a ubiquitous kinase regulated by tyrosine phosphorylation, controls cell
      fate decisions in both Drosophila and Dictyostelium; genetic analysis of its
      interactions with other signaling pathways is now possible.

PMID- 7780723
TI  - Congener specific analysis of polychlorinated biphenyls (PCBs) in serum using
      GC/MSD.
AB  - A new congener specific method has been developed for extraction and quantitative
      determination of PCB contaminants of serum. After liquid-liquid extraction and
      chromatographic fractionation with Carbopack-C/florisil column, the analytes were
      identified and quantified utilizing gas chromatography/mass spectrometry (GC/MSD)
      using selected ion monitoring (SIM) technique. Recoveries of 35 non-planar PCB
      congeners (#18, 28, 31, 44, 49, 52, 60, 66, 74, 82, 87, 99, 101, 105, 110, 114,
      118, 128, 138, 141, 146, 151, 153, 156, 157, 158, 167, 170, 171, 180, 183, 185,
      187, 189 and 194) and 5 non-ortho (coplanar) congeners (#37, 77, 81, 126 and 169)
      from spiked serum were between 55-115%.

PMID- 7780727
TI  - Neural development. Brain stems.
AB  - The discovery of stem cells in adult nerve tissue makes the repair of brain
      damage a realistic possibility.

PMID- 7780728
TI  - Superantigens. Gazing into the crystal ball.
AB  - The recently determined crystal structures of complexes between bacterial toxin
      'superantigens' and MHC class II molecules shed light on the nature of the
      interactions between these two molecules.

PMID- 7780730
TI  - Regulated secretion. Helper proteins for neuroendocrine secretion.
AB  - The granins, known to be general constituents of neuroendocrine secretory
      granules, are regulators of the proteolytic processing of peptide precursors and
      promote their aggregation-mediated sorting into secretory granules.

PMID- 7780732
TI  - Intraepithelial lymphocytes. Scratching the surface.
AB  - The epithelial surface is the site at which we first encounter pathogens. Two
      recent advances indicate that intraepithelial lymphocytes use specialized tools
      to help protect this surface.

PMID- 7780731
TI  - Emotional learning. Fear and loathing in the amygdala.
AB  - The amygdala in the brain plays a critical role in learning emotional components
      of experience, such as conditioned fear; these processes in turn affect many
      other aspects of memory and cognition.

PMID- 7780729
TI  - Chromatin. Ga-ga over GAGA factor.
AB  - Recent results suggest that the Drosophila transcriptional activator known as
      GAGA factor functions by influencing chromatin structure.

PMID- 7780733
TI  - Molecular evolution. Retroposon revivals.
AB  - Phylogenetic studies of the mouse L1 retroposon family show that the elements
      evolve through successively active subfamilies, which differ from each other by
      complete replacements of their promoter sequences.

PMID- 7780734
TI  - Neural transmission. Synaptotagmin is just a calcium sensor.
AB  - Ligand-binding studies have suggested many functions for the synaptic vesicle
      protein, synaptotagmin. But genetic elimination of the protein supports only one
      role: translating arriving Ca2+ signals into vesicle release.

PMID- 7780735
TI  - Genetic hypertension. A direct link to salt.
AB  - The basis of one type of inherited hypertension has been discovered-it is caused
      by mutations in the gene for the beta subunit of a renal sodium channel.

PMID- 7780736
TI  - Green fluorescent protein. The green revolution.
AB  - Green fluorescent protein allows gene expression and protein localization to be
      observed in living cells.

PMID- 7780737
TI  - Structural characterization of viral fusion proteins.
AB  - Infection by enveloped viruses is initiated by the fusion of viral and cellular
      membranes. In many cases, the viral membrane proteins that mediate fusion must
      undergo conformational changes to become active. Influenza hemagglutinin, for
      example, is activated by a dramatic conformational rearrangement, triggered by
      the low pH of the intracellular compartment in which fusion occurs. Structural
      characterization of this rearrangement has led to a reconsideration of how
      hemagglutinin mediates membrane fusion.

PMID- 7780738
TI  - A small peptide inhibitor of DNA replication defines the site of interaction
      between the cyclin-dependent kinase inhibitor p21WAF1 and proliferating cell
      nuclear antigen.
AB  - BACKGROUND: p21WAF1 is a potent inhibitor of the cell-cycle regulatory cyclin
      dependent kinases (Cdks). It acts on Cdks in the G1 and S phases of the cell
      cycle, and also binds to proliferating cell nuclear antigen (PCNA), blocking DNA
      replication in vitro. Transcription of p21WAF1 can be induced by the human tumour
      suppressor protein p53, suggesting that the action of p21WAF1 may be important in
      cancer prevention. We have investigated the interaction between p21WAF1 and PCNA
      using a genetic two-hybrid screen and with arrays of synthetic peptides derived
      from the p21WAF1 protein sequence. RESULTS: We have established that the carboxy
      terminal region of p21WAF1 interacts with PCNA in a yeast two-hybrid screen.
      Interaction with p21WAF1 involves the central loop of PCNA, which connects the
      two domains of the PCNA monomer. The interaction was finely mapped using peptides
      derived from the entire sequence of the p21WAF1 protein, and the critical
      residues were found to be QTSMTDFY (amino acids 144-151 of p21WAF1). Remarkably,
      a 20-residue peptide containing this sequence inhibited replication of simian
      virus 40 (SV40) DNA in vitro and could capture PCNA from whole cell extracts,
      demonstrating that small molecules can retain the biological activity
      characteristic of the whole protein. Sequential alanine-scan mutations of the
      peptide demonstrated that its ability to block replication correlates with its
      affinity for binding PCNA. CONCLUSIONS: We have shown that PCNA and the cell
      cycle regulator p21WAF1 interact in vivo, and that this interaction requires the
      central loop of PCNA and an eight amino-acid motif from the carboxyl terminus of
      p21WAF1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780740
TI  - Evidence that SH2 domains promote processive phosphorylation by protein-tyrosine
      kinases.
AB  - BACKGROUND: Non-receptor protein-tyrosine kinases often contain at least one Src
      homology 2 (SH2) domain, a protein module that binds with high affinity to
      tyrosine-phosphorylated peptides. Because SH2 domains would be predicted to bind
      with high affinity to proteins phosphorylated by the kinase, but not to the
      unphosphorylated substrate, their presence in tyrosine kinases has been puzzling.
      An important role for the SH2 domain of the Abl tyrosine kinase was suggested by
      work showing that Abl requires an intact SH2 domain in order to malignantly
      transform cells, and that replacement of the Abl SH2 domain with heterologous SH2
      domains alters the spectrum of proteins phosphorylated detectably by Abl in vivo.
      RESULTS: We have used purified wild-type and mutant Abl kinases to examine the
      roles of the Abl's SH2 and catalytic domains in phosphorylation of p130CAS, a
      model substrate that has multiple potential phosphorylation sites. We find that
      an SH2 domain is required for efficient hyperphosphorylation of p130 in vitro. We
      use chimeric mutants with heterologous SH2 domains to demonstrate that the SH2
      domain of the oncogenically transforming adaptor protein Crk, which is the SH2
      domain predicted to bind with highest affinity (of those tested) to potential
      phosphorylation sites in p130, is best able to facilitate hyperphosphorylation.
      This is the case whether the catalytic domain of the kinase is derived from Abl
      or from its distant relative, Src. These studies also reveal a role for binding
      of Crk to Abl in mediating phosphorylation by the kinase. Using purified
      proteins, we demonstrate that association with Crk strikingly enhances the
      ability of Abl to hyperphosphorylate p130. There is an excellent correlation
      between the ability of mutant Crk proteins to promote hyperphosphorylation of
      p130 by Abl and their ability to transform rodent fibroblasts. CONCLUSION: Our
      data suggest that, ultimately, the substrate specificity of a non-receptor
      tyrosine kinase is dependent on the binding specificity of its associated SH2
      domain. The SH2 domain binds tightly to a subset of proteins phosphorylated by
      the catalytic domain, leading to processive phosphorylation of those proteins.
      Substrate specificity can be broadened by an association between the kinase and
      proteins, such as Crk, that contain additional SH2 domains; this may play a role
      in malignant transformation by Crk.

PMID- 7780741
TI  - Heat-shock proteins Hsp104 and Hsp70 reactivate mRNA splicing after heat
      inactivation.
AB  - BACKGROUND: The heat-shock protein Hsp104 plays a crucial role in the survival of
      cells exposed to high temperatures and other severe stresses, but its specific
      functions and the biological pathways on which it operates have been unclear.
      Indeed, very little is known about the specific cellular processes in which any
      of the heat-shock proteins acts to affect thermotolerance. One essential process
      that is particularly sensitive to heat in many organisms is the splicing of
      intervening sequences from mRNA precursors. RESULTS: We have examined the role of
      Hsp104 in the repair of splicing after disruption by heat shock. When splicing in
      the budding yeast Saccharomyces cerevisiae was disrupted by a brief heat shock,
      it recovered much more rapidly in wild-type strains than in strains containing
      hsp104 mutations. Constitutive expression of Hsp104 promoted the recovery of heat
      damaged splicing in the absence of other protein synthesis, but did not protect
      splicing from the initial disruption, suggesting that Hsp104 functions to repair
      splicing after heat damage rather than to prevent the initial damage. A modest
      reduction in the recovery of splicing after heat shock in an hsp70 mutant
      suggested that Hsp70 may also function in the repair of splicing. The roles of
      Hsp104 and Hsp70 were confirmed by the ability of the purified proteins to
      restore splicing in extracts that had been heat-inactivated in vitro. Together,
      these two proteins were able to restore splicing to a greater degree than could
      be accomplished by an optimal concentration of either protein alone. CONCLUSIONS:
      Our findings provide the first demonstration of the roles of heat-shock proteins
      in a biological process that is known to be particularly sensitive to heat in
      vivo. The results support previous genetic arguments that the Hsp104 and Hsp70
      proteins have different, but related, functions in protecting cells from the
      toxic effects of high temperatures. Because Hsp104 and Hsp70 are able to function
      in vitro, after the heat-damaged substrate or substrates have been generated,
      neither protein is required to bind to its target(s) during heating in order to
      effect repair.

PMID- 7780739
TI  - Inactivation of p42 MAP kinase by protein phosphatase 2A and a protein tyrosine
      phosphatase, but not CL100, in various cell lines.
AB  - BACKGROUND: Mitogen-activated protein (MAP) kinase is central to a signal
      transduction pathway that triggers cell proliferation or differentiation.
      Activation of the p42mapk isoform requires its phosphorylation at two residues,
      Thr 183 and Tyr 185, and this phosphorylation is catalysed by MAP kinase kinase
      (MAPKK). Relatively little is known, however, about the enzymes that
      dephosphorylate these residues, thereby inactivating the pathway. Recently, the
      CL100 phosphatase has been shown to inactivate p42mapk in vitro by
      dephosphorylating Thr 183 and Tyr 185 at similar rates. CL100, the product of an
      immediate early gene, is synthesized within one hour of stimulating cells with
      growth factors or exposure to oxidative stress or heat shock. Incubation of NIH
      3T3 fibroblasts with cycloheximide prevents both synthesis of CL100 and
      inactivation of p42mapk after stimulation with serum. RESULTS: Depleting cells of
      CL100 and preventing its induction using cycloheximide stopped the inactivation
      of p42mapk in Swiss 3T3 fibroblasts following stimulation with epidermal growth
      factor (EGF), but had no effect on the rapid inactivation of p42mapk in response
      to EGF in adipose (3T3-L1) or chromaffin (PC12) cells or in response to platelet
      derived growth factor (PDGF) in endothelial (PAE) cells. Moreover, maximal
      induction of CL100 mRNA and a CL100-like activity did not trigger inactivation of
      p42mapk, which was sustained at a high level after stimulation of PC12 cells with
      nerve growth factor, PAE cells with serum, or Swiss 3T3 cells with PDGF.
      Dephosphorylation of Tyr 185 but not Thr 183 of p42mapk was suppressed by
      vanadate in EGF-stimulated PC12 cells; dephosphorylation of Thr 183, by contrast,
      was elicited by a vanadate-insensitive activity. Protein phosphatase-2A was the
      only vanadate-insensitive phosphatase acting on Thr 183 of p42mapk or on MAPKK to
      be detected in PC12 cell extracts. Phosphorylation of Thr 183 also inhibited the
      dephosphorylation of Tyr 185 in vitro by the major vanadate-sensitive Tyr 185
      specific phosphatase, explaining why dephosphorylation of Thr 183 is rate
      limiting for p42mapk inactivation in PC12 cells after stimulation with EGF.
      CONCLUSIONS: The rapid inactivation of p42mapk initiated five minutes after
      stimulation of endothelial, adipose and chromaffin cells with growth factor is
      not catalysed by CL100, but rather by protein phosphatase 2A and by a protein
      tyrosine phosphatase distinct from CL100. Induction of CL100 is not accompanied
      by the inactivation of p42mapk in a number of situations.

PMID- 7780742
TI  - Function and characteristics of repetitive calcium waves associated with meiosis.
AB  - BACKGROUND: Internal calcium waves and oscillations are now recognized as
      universal features of cellular activation, but their exact role remains
      uncertain. In mammalian and ascidian eggs, a large, sperm-triggered calcium
      activation wave crosses the egg at fertilization, followed by a series of
      periodic increases in intracellular calcium concentration ([Ca2+]i). We have
      previously shown that, in eggs of the ascidian Phallusia mammillata, these
      periodic, post-activation [Ca2+]i increases are in the form of waves, the origin
      of which relocalizes to a pacemaker region, and that they stop seconds before the
      completion of meiosis. RESULTS: We show here that the origin of the first one to
      four post-activation calcium waves in P. mammillata eggs transfers progressively
      from the site of sperm entry, usually in the animal hemisphere, towards an
      endoplasmic reticulum (ER)-rich contraction pole in the vegetal hemisphere, a
      process that takes about five minutes. Once the origin of these repetitive post
      activation calcium waves has reached the contraction pole, all subsequent calcium
      waves originate from the domain of ER concentrated there, which acts as a
      pacemaker. The first few post-activation calcium waves are faster than the
      activation wave and, like the activation wave, they propagate homogeneously
      throughout the cytoplasm. Approximately five to ten minutes after fertilization,
      the post-activation calcium waves begin to propagate preferentially in the egg
      cortex. By manipulating intracellular calcium levels with caged inositol 1,4,5
      trisphosphate (InsP3) and a competitive inhibitor of InsP3-induced calcium
      release, we show that the activation wave induced by the sperm is sufficient to
      induce extrusion of the first polar body, but that additional [Ca2+]i increases
      are necessary for completion of the second meiotic division. However, periodic
      calcium waves per se do not seem to be strictly necessary for the completion of
      meiosis, as a persistent and homogeneous increase in calcium, induced by the
      calcium ionophore ionomycin, is sufficient to cause second polar body formation
      and allow completion of meiosis on time. CONCLUSION: These results clearly show
      that, in the ascidian egg, post-activation calcium waves are required to complete
      meiosis. They also show that following a period of progressive relocalization of
      the wave origin, which lasts approximately five minutes, an ER-rich domain at the
      contraction pole finally becomes a pacemaker from which the calcium waves
      originate. Once their origin becomes stably localized, the calcium waves begin to
      propagate preferentially around the cortex of the egg rather than throughout the
      egg cytoplasm.

PMID- 7780743
TI  - Loose ends.

PMID- 7780745
TI  - PDA comments. "Review of general biologics licensing regulations". Parenteral
      Drug Association.

PMID- 7780744
TI  - Elaborate decision criteria for media fill tests.

PMID- 7780746
TI  - PDA response. "Guideline for submitting documentation for sterilization process
      validation in applications for human and veterinary drug products". Parenteral
      Drug Association.

PMID- 7780747
TI  - Microbial retention characteristics of 0.2-microns-rated nylon membrane filters
      during filtration of high viscosity fluids at high differential pressure and
      varied temperatures.
AB  - Regulatory guidelines for aseptic manufacture of pharmaceuticals recommend
      validation of sterilizing filters by bacterial challenge under "worst case"
      conditions. The microbial retention characteristics of a sterilizing grade, 0.2
      microns-rated Nylon 66 membrane filter were evaluated for filtration of high
      viscosity fluids. Glycerol (80%) was used as the carrier fluid and Pseudomonas
      diminuta ATCC 19146 as the challenge organism. Testing was carried out at a
      constant differential pressure of 60 psig over a six-hour test period. Test runs
      were undertaken at three different temperature conditions (25 +/- 5 degrees C, 42
      +/- 1 degree C, and 50 +/- 1 degree C). Under the test conditions, the Nylon 66
      membranes provided total retention of P. diminuta. The results demonstrated that
      a high pressure differential challenge using a high viscosity fluid over a six
      hour test period at ambient and elevated temperatures did not alter the retention
      characteristics of the membrane filter.

PMID- 7780748
TI  - Particle size reduction of emulsions by formulation design-II: effect of oil and
      surfactant concentration.
AB  - The objective of this study was to investigate the effect of the concentration of
      surfactant and oil on particle size reduction and stability of oil-in-water
      emulsion formulations containing polyhydroxy alcohols. Emulsions were prepared
      using an emulsifier system consisting of Tween 80 and Span 80 with 5%, 10%, 15%
      and 20% soybean oil and containing 50% w/w of either propylene glycol (PG) or
      glycerol (GLY) in the external phase. At each oil concentration, four emulsions
      were formulated with increasing surfactant concentration to provide emulsions
      with surfactant to oil (S/O) ratios of 0.1, 0.2, 0.3 and 0.4. Three parameters
      were evaluated, particle size reduction, particle size stability upon dilution,
      and viscosity. It was found that increase in S/O ratio resulted in substantial
      decrease in particle size in all cases. But there was a difference in the
      particle size reduction pattern between PG and GLY. Increase in oil concentration
      at the same S/O ratio caused particle size reduction for emulsions with PG but
      not for emulsions with GLY. The reduction in particle size was also greater for
      emulsions containing PG. Further, particle size of emulsions containing PG was
      found to be stable over 24 hours after dilution. However, a slight increase in
      particle size was observed in emulsions containing GLY. It was also found that
      the viscosity of emulsions increased with an increase S/O ratio as well as the
      concentration of the oil.

PMID- 7780749
TI  - The effect of aggregation inhibitors and antioxidants on the stability of hemin
      solutions.
AB  - Despite their importance as infusions for the treatment of porphyrias, aqueous
      solutions of hemin can be quite unstable, with a reported half-life of a few
      hours. We have examined factors which affect the stability of hemin solutions in
      order to identify possible excipients and conditions which would increase the
      stability. In agreement with previous reports, we have found that human serum
      albumin leads to stabilization of hemin solutions; polyvinylpyrrolidone is also
      an effective stabilizer of hemin. Imidazole, caffeine, and niacinamide were also
      found to stabilize hemin, apparently by complexing to hemin and preventing the
      formation of hematin dimers. Addition of certain antioxidants, e.g., butylated
      hydroxyanisole and N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid (HEPES),
      led to stabilization of hemin, suggesting that radicals are involved in the
      degradation process. A comparison was also made by HPLC analysis of the hemin
      autooxidation products with those from the reaction of hemin with hydrogen
      peroxide; the results indicate that the products are similar but not identical.
      The implications of the results for clinical use of hemin solutions are
      discussed.

PMID- 7780750
TI  - Gamma processing technology: an alternative technology for terminal sterilization
      of parenterals.
AB  - This paper will outline the advantages of utilizing gamma radiation as a means
      for terminally sterilizing parenterals and other pharmaceutical products. The
      factors which must be evaluated in order to qualify a product for radiation
      sterilization will be detailed. It will also compare the characteristics of this
      method with other technologies currently available. The highest SAL can be
      achieved by combining a knowledge of the microbial quality of the raw materials,
      and the manufacturing environment with a formulation designed to promote the most
      radiation stable form of the product.

PMID- 7780751
TI  - What do we mean by "sterility"?
AB  - In a "President's Comment" (PDA Newsletter, August 1993) James Akers referred to
      such numbers, and numerical statements, as: 10(-3), 10(-6), 1cfu/m3, 3cfu/Rodac
      plate, 90 feet per minute, 0.005 inches of water, 80 degrees C, 20 air changes
      per hour, and 0.1% with 95% level of confidence. He posed the question "Where did
      all these numbers come from?" These are, of course all numbers instantly
      recognisable by those acquainted with the art and science of parenteral
      manufacture. They are accepted (essential?) parameters of various aspects of this
      process. But Akers's question carries with it the implicit answer: "They just
      seemed like a good idea at the time." One might similarly add: 100, 10,000,
      100,000, 115 degrees C for 30 minutes, 121 degrees C for 15 minutes, and so on.

PMID- 7780753
TI  - Travelling with your baby.

PMID- 7780752
TI  - Qualification of weighing station for pharmaceutical substances.
AB  - Work at weighing stations in pharmaceutical industries can cause risk situations
      to the operators as well as to the product. When working at a station, the
      operators' movements and the interaction between air movements and dispersion of
      contaminants play a vital role. A newly designed ventilated weighing station with
      HEPA-filters and how it can be evaluated with tracer gas will be discussed.

PMID- 7780754
TI  - How do women choose to breastfeed?
AB  - Midwives generally rely on client education to get the message across that
      'breast is best'. Research tends to ask why women bottlefeed rather than trying
      to find out how the decision to breastfeed is reached. The psychological theory
      of personal constructs might help to shed light on this difficult and frustrating
      area of midwifery.

PMID- 7780755
TI  - The principles of antenatal screening.

PMID- 7780756
TI  - Is active management always necessary?
AB  - There is a conflict between the active management (AM) of labour and the woman
      centred approach advocated by Changing Childbirth. AM assumes that all births are
      abnormal until proved normal, whereas midwives usually assume the opposite. There
      is evidence that AM can be ineffective in shortening labour. Midwives should
      consider alternative, non-medical approaches to active management.

PMID- 7780757
TI  - Our best chance ever. Interview by Alison Turnbull.

PMID- 7780758
TI  - Ethical issues in qualitative studies.
AB  - Research interviews can expose individuals' inner thoughts and beliefs. The
      researcher must consider the participants' interests. Those interests might be
      best served by a well thought-out scheme for ensuring anonymity. The researcher
      must guard against inadvertent clues to participants' identity, through well
      known individual views or language idiosyncrasies. Ownership of data must be
      considered. Ethically speaking, permission to undertake research does not
      automatically grant permission to publish the results.

PMID- 7780759
TI  - A midwifery team for high-risk pregnancies.
AB  - A midwifery group practice approach has been developed for the care of high-risk
      mothers at the Chelsea & Westminster Hospital. The team of six midwives working
      with the professor of obstetrics, the consultant obstetrician and a physician
      cares for a caseload of 200 high-risk women a year. Midwives are able to acquire
      and maintain the skills necessary to care for high-risk mothers. Audit of the
      scheme is essential and will be complemented by a satisfaction survey completed
      by clients, midwives and doctors.

PMID- 7780760
TI  - Hopes for the future of midwifery care.

PMID- 7780762
TI  - Only plumbers?

PMID- 7780761
TI  - Shortchanging childbirth.

PMID- 7780763
TI  - Bournemouth puts breastfeeding first.

PMID- 7780764
TI  - Six-point plan for supervision.

PMID- 7780765
TI  - The clinical and statistical significance of using norm- versus criterion
      referenced measures.

PMID- 7780766
TI  - Use of the cognitive assessment method to evaluate the adequacy of sexually
      transmitted disease history questions.
AB  - Cognitive assessment is an approach used to evaluate questions in survey
      interviews. This approach is useful in delineating measurement error due to
      participants' understanding of terms and interpretation of questions. The purpose
      of this study was to evaluate the quality of questionnaire items designed to
      evaluate history of sexually transmitted diseases (STDs) using a cognitive
      assessment approach. Participants recruited from an STD clinic were asked up to
      six questions to assess their history of STDs. Verbal probes were used after each
      question in an attempt to evaluate the participants' understanding of the
      questions and methods they used to recall episodes of having STDs. The findings
      revealed that respondents did not understand the medical terms for some STDs,
      that the wording of one question potentially interfered with respondents'
      comprehension of the question, and that respondents used an episodic recall
      method to determine their number of previous STD infections. Cognitive assessment
      is a useful method for identifying potential sources of respondent-induced
      measurement error.

PMID- 7780767
TI  - Cognitive appraisal of stress events: measuring the personal schema of
      childbirth.
AB  - The purpose of this study was to theoretically base, develop, and test items for
      the Childbirth Schema Scale. The scale was designed to obtain an understanding of
      schema formation and revision with the known stressor of childbirth. The
      psychometric properties of the instrument were assessed using a sample of
      childbearing women, surveyed before and after birth. A principal components
      analysis with varimax rotation resulted in a four-factor solution supporting the
      theoretical factors of emotions of outcome, sensations of work, time, and
      preparation for control. Construct validity was assessed by hypothesis testing
      that women whose prebirth schemas were least like their real experience would use
      more review than women whose schemas were closer. A significant t test between
      the two groups provided some evidence of validity. The factors were used to form
      subscales. Internal consistency scores for each subscale were .73, .70, .84, and
      .65, respectively.

PMID- 7780768
TI  - A questionnaire to measure mother-to-infant attachment.
AB  - The Maternal Attachment Inventory (MAI) was developed and tested to provide a
      practical measure of maternal affectionate attachment. MAI items were identified
      from the literature, and their construct validity was assessed by experts who
      numerically rated them for relevance. The MAI, two other indicators of maternal
      attachment, and a measure of maternal adjustment were completed by 196 women
      approximately 1 month after the birth of their infants. Two subgroups of women
      completed the research instruments when their infants were 4 (Group A) or 8
      (Group B) months old. The MAI demonstrated evidence of validity through
      significant correlations with other indicators of maternal attachment (the How I
      Feel About the Baby Now Scale and the Maternal Separation Anxiety Scale) at all
      time points and a correlation with maternal adjustment as measured by the
      Maternal Attitudes and Maternal Adjustment Scale. The MAI also demonstrated
      evidence of acceptable internal consistency reliability at all three time points.

PMID- 7780769
TI  - The Index of Readiness: development and psychometric analysis.
AB  - This article describes the development and initial psychometric evaluation of a
      measure of individual appraisal of readiness to initiate health behavior change.
      Items were developed from inductively generated data to index dimensions of
      individual appraisal of readiness. Quantification of Index of Readiness content
      validity was established through the ratings of 10 experts, following criteria
      established by Imle and Atwood (1988). The instrument was tested in successive
      steps with 146 individuals who were participating in an outpatient cardiac
      rehabilitation program, for reliability and validity, including internal
      consistency reliability, and three forms of validity assessment (content
      validity, criterion-related validity, and construct validity). The three
      subscales of Reevaluation of Lifestyle, Identification of Barriers, and Goal
      Commitment demonstrated internal consistency. Criterion-related and construct
      validity were substantiated. With refinement, this measure will provide a basis
      for nursing interventions designed to enhance individual motivation in relation
      to specific health behaviors.

PMID- 7780770
TI  - Development of the Multidimensional Hope Scale.
AB  - In this psychometric study, a scale to measure hope in chronically ill patients
      was developed and evaluated. Four hundred fifty participants with a variety of
      chronic diagnoses completed two forms of the Multidimensional Hope Scale (MHS)
      (state and trait) and the Beck Hopelessness Scale (BHS). High levels of internal
      consistency (alpha = .95) and test-retest reliability (r = .82, p < .001) were
      estimated for the state form. Good concurrent validity was also indicated with a
      significant negative correlation between the MHS and the BHS (r = -.45, p <
      .001). Factor analysis using principal axis factoring and oblimin rotation
      identified six factors: Resource to Others, Civic Interest, Spirituality, Health,
      Social Support, and Self-Actualization. The psychometric data suggest a promising
      tool for measuring hopefulness in physically ill individuals.

PMID- 7780771
TI  - The Maturation Index of Colostrum and Milk (MICAM): a measurement of breast milk
      maturation.
AB  - A biological marker, the Maturation Index of Colostrum and Milk (MICAM), was
      developed using filter paper chromatography. The MICAM consists of five patterns
      used to measure the individual rate of breast milk maturation among mothers. This
      article documents the biological basis of MICAM patterns as a gradual breakdown
      of an emulsion of breast milk that is dependent on the ratio of sterols plus
      phospholipids to fat content of the milk. Frequencies of MICAM patterns by day,
      timing of the milk collection, and inter-rater reliability are addressed and the
      construct validity is explored. This was a partial replication of the original
      tool development reported by Humenick in 1987. In both studies, the variables of
      timing of breast-feeding initiation, frequency, and cumulative length of breast
      feeding episodes were significantly correlated as predictors of early milk
      maturation as measured by the MICAM. Milk maturation rate was also significantly
      correlated as a predictor of infant weight gain, weeks of sustained breast
      feeding, and maternal-infant breast-feeding satisfaction. The MICAM can be used
      as a clinical screening tool to assess the progress of milk maturation in cases
      where breast-feeding has had a difficult or delayed initiation, and to evaluate
      interventions designed to support lactation.

PMID- 7780772
TI  - Ending batting slumps in baseball: a qualitative investigation.
AB  - This study used a qualitative method of inquiry to examine how baseball players
      cope with batting slumps. Players from one national junior (n = 30) and several
      semi-professional teams (n = 35) made up the sample. Through the use of an open
      ended question, each subject was asked to provide advice to players experiencing
      a batting slump. Inductive content analysis procedures were used to analyse the
      quotes from the open-ended question. Six major categories of coping strategies
      emerged from the data: focusing on the task, returning to basics, being actively
      positive, avoiding negativism, increasing effort, and seeking coaching. These
      findings contribute to the suggestion that baseball players use a variety of
      coping strategies to deal with batting slumps. Results also showed that national
      junior and semi-professional players differed on some of the coping strategies
      they considered to be most helpful. How this information can be used by coaches
      and sport psychologists is discussed.

PMID- 7780773
TI  - The efficacy of isokinetic, isometric and vertical jump tests in exercise
      science.
AB  - This research examined the efficacy of several tests of muscular strength and
      power in their capacity to be related to performance, their ability to
      effectively discriminate between individuals of different performance levels and
      their sensitivity in detecting training induced changes to performance. Thirty
      healthy active subjects performed the following maximal tests of muscular
      function: (1) Vertical jump; (2) Isokinetic knee extension at 1.05, 3.14 and 5.24
      rads s-1; and (3) Isometric rate of force development. Performance was assessed
      by the peak power output achieved on a cycle test. In addition, subjects
      participated in a 10 week resistance training program. The isokinetic and
      vertical jump tests were significantly related to performance (r = 0.5-0.73) and
      could be used to discriminate between subjects of differing performance levels.
      However, the isometric rate of force development test was an ineffective
      assessment modality. None of the tests were able to effectively monitor training
      induced changes in performance, as evidenced by non-significant correlations
      between the pre- to post-percentage changes in cycling performance and the test
      variables. Consequently, alterations to training programs for athletes should be
      based on changes in actual performance, as opposed to muscular function tests.

PMID- 7780774
TI  - Gastrointestinal blood loss in triathletes: it's etiology and relationship to
      sports anaemia.
AB  - Twenty male triathletes (R 18-39 mean = 27.5 yrs) provided blood and faecal
      samples during intense training, pre-race taper and post-competition. All
      answered a closed-end questionnaire on intake of aspirin, NSAIDS, Vitamin C, iron
      and red meat. History of GIT blood loss and training distances were also
      obtained. Blood samples were taken on three occasions and analysed for
      Haemoglobin(Hb) and Serum Ferritin concentrations. Faecal specimens were
      collected on five occasions and assessed for blood loss using Haemoccult II and
      Monohaem (a monoclonal antibody test specific for human haemoglobin). Mean Hb and
      95% confidence intervals at the three stages were 14.53gm/l (13.95-15.10),
      14.9gm/l (14.46-15.34), 14.57gm/l (14.18-14.97) respectively. There was a small,
      but statistically significant, increase in Hb during the pre-race taper period
      (paired t = 2.65, p < 0.05), and a non-significant drop in Hb post-event (paired
      t = 1.89, p = 0.075). Mean ferritin, MCV and haematocrit values did not
      significantly change. Eighty percent of the group exhibited faecal blood loss on
      one or more of the tests used. There were significant increases in both
      Haemoccult (chi 2 = 5.44, p < 0.04) and Monohaem (chi 2 = 7.36 p < 0.02).
      Regression analysis demonstrated a significant relationship between training Hb
      and total training intensity (R = -0.61, F1,l5 = 8.98, p < 0.009) and training
      run intensity (R = -0.55, F1,l5 = 6.17, p < 0.026), as estimated using Coopers
      aerobic points system. These results confirm that GIT blood loss is common in
      endurance athletes, and appears to be related to exercise intensity. The possible
      mechanisms of blood loss are discussed.

PMID- 7780775
TI  - Biomechanical responses of elite swimmers to staleness and recovery.
AB  - Tethered swimming forces (TSF), average distance achieved per stroke (D/S) during
      a submaximal effort swim, and time and D/S for a maximal effort swim were
      measured to determine changes occurring with staleness and recovery. Fourteen
      nationally ranked male and female swimmers were studied five times (i.e. early-,
      mid-, and late-season, during tapering, and after competition). ANOVA and Newman
      Keuls post-hoc tests were used to assess changes during the season. Three
      swimmers were classified as stale and showed a deterioration (0.7%) in maximal
      performance time from early- to late-season which was significantly different (P
      < 0.05) from the improvement (3.1%) demonstrated by the non-stale swimmers. Daily
      self-ratings of fatigue, kept by the swimmers in log books during the season,
      were significantly higher (P < 0.001) for the stale compared with the non-stale
      swimmers. No significant differences were established between the stale and non
      stale swimmers in TSF or D/S during the season or in the response to tapering. A
      significant improvement (P < 0.05) in TSF was observed from before to after
      tapering. It was concluded that TSF and D/S may not change significantly with
      staleness and that the recovery period of tapering prior to competition allows
      swimmers to generate greater forces in the water.

PMID- 7780776
TI  - Victimization prevention programs: a national survey of children's exposure and
      reactions.
AB  - The National Youth Victimization Prevention Study interviewed a representative
      sample of 2,000 U.S. children and their caretakers about the children's
      experience with child abuse and victimization prevention programs. Two-thirds of
      the children reported being exposed to at least one program at some time, 37%
      within the last year. Programs that gave children a chance to practice, that
      prompted discussions with parents, and that included information on dealing with
      bullies were more likely to result in utilization of the program skills. Although
      satisfaction levels were generally high for all groups, girls, black children,
      and children from lower socioeconomic status families, as well as their parents,
      had more positive reactions and reported more skill utilization. Some children
      did report, and their parents confirmed, more worry about abuse and fear of
      adults. However, the children with increased worry and fear were also the
      children who themselves and their parents reported the most positive feelings
      about the programs and the most skill utilization. This suggests that the level
      of worry and fear induced by the programs was appropriate to the subject.

PMID- 7780777
TI  - The effectiveness of victimization prevention instruction: an evaluation of
      children's responses to actual threats and assaults.
AB  - This study examined whether instruction in school and at home about how to
      prevent victimization has any impact on children's behavior in situations of real
      victimization threat. Telephone interviews were conducted in 1992 with a
      nationally representative sample of 2,000 youths age 10 to 16 and their
      caretakers. More comprehensive school programs had mixed, small but overall
      positive effects. Children exposed to such school-based prevention programs
      performed better on a short test of knowledge about sexual victimization; when
      victimized or threatened were more likely to use the self-protection strategies
      recommended by prevention educators; were more likely to feel that they had been
      successful in protecting themselves; and were more likely to disclose to someone
      about the victimization attempts. They were not better able to limit the
      seriousness of the assaults and, in fact, they experienced more injuries in the
      course of sexual assaults. Comprehensive parental instruction also had positive
      effects on knowledge, the use of preferred self-protection strategies and the
      likelihood of disclosure. Children with comprehensive parental instruction were
      more likely to limit the seriousness of assaults.

PMID- 7780778
TI  - Emotional, behavioral, and physical symptoms reported by parents of sexually
      abused, nonabused, and allegedly abused prepubescent females.
AB  - There have been few studies that have examined emotional, behavioral, and
      physical symptoms that discriminate between well-defined groups of sexually
      abused and nonabused children. This study examined the results of a structured
      parent interview (SASA) completed on three matched samples of prepubescent
      females: 68 who were selected for nonabuse (NA Group), 68 from a sexual abuse
      clinic in which a perpetrator confessed (SA Group) and 68 seen at the same clinic
      who did not have a perpetrator confession (AA Group). Parents of girls in both
      the SA and AA groups reported increased sleep problems, fearfulness, emotional
      and behavioral changes, concentration problems, and sexual curiosity and
      knowledge. When contrasting the known (SA) with the allegedly abused sample (AA),
      self-consciousness, nightmares, and fearfulness of being left alone emerged
      significantly more frequently in the SA sample.

PMID- 7780779
TI  - Characteristics of childhood sexual abuse in a predominantly Mexican-American
      population.
AB  - Little has been written about the characteristics of childhood sexual abuse among
      Mexican Americans. In addition, certain aspects of the epidemiology of reported
      sexual abuse in the United States have changed significantly over the past 12
      years. To better understand how characteristics of sexual abuse vary with
      ethnicity, race, gender, and age, we reviewed the records of 2,130 children under
      age 18 who were evaluated at our university-based facilities for possible sexual
      abuse from 1987 to 1989. The demographic, historical, and physical findings of
      the cases from our predominantly Mexican-American population were analyzed. T
      test, analysis of variance, and chi-square analyses were used to test for
      differences related to ethnicity, race, gender, and age. Significant differences
      in these factors were found with respect to the relationship of the perpetrator
      to the child, the number of perpetrators, the interval from the abuse to the
      evaluation, the types of abuse, and the findings of the physical examination.
      This study demonstrates the important influences of ethnicity, race, gender, and
      age on characteristics of childhood sexual abuse. Awareness of these influences
      can be helpful in understanding factors that contribute to childhood sexual
      abuse, preparing for legal proceedings, and designing appropriate prevention
      programs.

PMID- 7780780
TI  - Comparative psychopathology of women who experienced intra-familial versus extra
      familial sexual abuse.
AB  - The Diagnostic Inventory of Personality and Symptoms (DIPS) was used to assess
      psychopathology in a clinical sample of 30 women with histories of intra-familial
      sexual victimization, 22 women with histories of extra-familial sexual
      victimization, and 30 women with no victimization experiences. The present study
      examines whether the relative/nonrelative issue is significant to the impact of
      sexual victimization experiences. A clinical comparison of two point code types
      indicated that both sexually abused groups could be characterized as suffering an
      Affective Depressed-Dissociative Disorder. However, profile shapes produced for
      the intra- and extra-familial abused groups differed. A discriminant function
      developed via step wise selection procedures incorporated 12 of the 14 scales,
      correctly classifying 94% of the individuals (49 of 52) as members of the extra
      or intra-familial groups. Profile analyses, discriminant analyses, clinically
      descriptive comparisons, and post hoc analyses of individual scales all revealed
      that psychopathology is much more evident in those who have experienced sexual
      abuse. Methodological considerations are highlighted and implications for
      treatment and research are addressed.

PMID- 7780782
TI  - The maltreatment of intellectually handicapped children and adolescents.
AB  - Eleven and a half percent of intellectually handicapped children in Castilla-Leon
      are subjected to maltreatment; in these, physical neglect is the most frequent.
      These findings come from a questionnaire (CEMND) specifically designed to detect
      and discover the prevalence of maltreatment in a sample of 445 mentally retarded
      children. It was discovered that problems between the child's parents, the
      child's behavior and the interaction between both aspects were significant
      factors in situations of maltreatment.

PMID- 7780781
TI  - Risk factors for behavioral dysfunction: the relative impact of maltreatment,
      SES, physical health problems, cognitive ability, and quality of parent-child
      interaction.
AB  - An analysis to identify risks for behavioral dysfunction is described in which
      maltreatment is viewed as one of multiple factors putting behavioral outcome at
      risk. Based on a study of physically abused and neglected, and nonabused, non
      neglected children (n = 206) assessed at two points in time--preschool age and
      school age--variables representative of several domains (parenting, family
      environment, and child characteristics) were identified as significantly
      affecting children's behavioral functioning. Based on teachers' ratings, the
      children were assigned to one of three groups: high, medium, and low functioning.
      Discriminant analysis was used to determine which factors discriminated among the
      three groups. Results indicated that behavioral functioning is most strongly
      differentiated by the sociocultural and family climate in which the child is
      raised with physical and emotional maltreatment being significant but less
      powerful influences.

PMID- 7780783
TI  - Child abuse by the middle class? A study of professionals in India.
AB  - The purpose of this study was to determine if the abuse of children was prevalent
      among middle-class professionals in India. Face-to-face interviews were conducted
      with a stratified random sample of 319 subjects, in three cities in India, to
      assess their attitudes toward child rearing and their expectations about child
      development. These were then correlated with the methods of conflict resolution
      which had been used with children in the past year. Of the subjects who
      participated in the study, 56.9% reported having used "acceptable" violence,
      while 41.9% revealed that they had engaged in "abusive" violence. Interestingly,
      2.9% admitted to having employed "extreme" violence toward their children. The
      correlations between parental attitudes and/or expectations and the use of
      different methods of conflict resolution did not occur as frequently as
      anticipated, suggesting that violence against children in India may well be the
      result of social sanction. Implications for intervention are suggested.

PMID- 7780784
TI  - The measurement of maltreatment: a comparison of approaches.
AB  - This study examined the comparability and predictive validity of three approaches
      to the measurement of child maltreatment. Adolescents (N = 160, aged 11-17) were
      randomly selected from the open caseload of a child protection agency. Global
      ratings of maltreatment severity were made by three reporting sources:
      researchers on the basis of protection agency case files, protection agency
      social workers, and the adolescents themselves. Ratings were made of five types
      of maltreatment: physical, sexual, emotional, neglect, and exposure to family
      violence. Self-reported (YSR) and caretaker-reported (CBCL) adjustment measures
      were also obtained for each subject. Results indicated that over 90% of the
      sample had experienced more than one type of maltreatment. Comparison of ratings
      across sources indicated considerable disagreement with respect to judgments of
      maltreatment occurrence and severity. Relative to professional ratings,
      adolescent ratings were better predictors of externalizing and internalizing
      symptomatology in both univariate and multivariate analyses.

PMID- 7780785
TI  - Judicial decision-making in contested custody cases: the influence of reported
      child abuse, spouse abuse, and parental substance abuse.
AB  - This study examined the relationship between allegations of maltreatment and
      substance abuse, and custody awards in Florida. Information concerning the
      presence, or absence, of these reports was collected on 60 contested initial
      disposition, or disposition modification cases, and was used to model judicial
      decision-making. Substantiated reports of child and spouse abuse occurred very
      infrequently in our sample. Conversely, substance abuse allegations occurred much
      more frequently. Judges appeared responsive to allegations of abuse with regard
      to awards of primary physical residence, despite the lack of substantiated
      evidence. Maltreatment allegations had no apparent impact, however, on awards of
      shared, versus sole, custody. Additionally, reports of parental substance abuse
      also had no apparent impact on judicial decision-making. Implications of these
      results are discussed.

PMID- 7780786
TI  - Child abuse prevalence in Russian urban population: a preliminary report.
AB  - Self-reported data from 375 early and mid-adolescent school children in a
      Siberian city estimated a prevalence of child abuse at 28.9%. Of these children,
      3.8% suffered injuries that required medical attention. This prevalence of child
      abuse indicates the need for additional research and development of a system to
      identify and manage child abuse in Russia.

PMID- 7780787
TI  - Pediatric gonococcal infection: case report demonstrating diagnostic problems in
      remote populations.
AB  - The inability of Neisseria gonorrhoeae to survive prolonged transit times and
      hostile ambient temperatures has made its detection at referral laboratories by
      cultural methods untenable. In this situation, reliance upon antigen detection
      systems is attractive but when these tests are performed on vaginal specimens
      from children, false positive results are a significant concern. Some of the
      difficulties associated with the investigation of a gonococcal infection
      resulting from sexual abuse of a child in an isolated community are illustrated
      in this report.

PMID- 7780788
TI  - [Long term potentiation of the synaptic efficacy: mechanisms, functional
      properties and role in learning and memory].
AB  - It is widely assumed that information is stored in the brain as changes in the
      efficacy of synaptic connections on those neurons which are activated during
      learning. In the past decade, long-term potentiation (LTP) of synaptic efficacy
      has become the dominant model in the search for the cellular bases of learning
      and memory. Today, considerable progress has been made in understanding the
      synaptic events underlying LTP and in identifying the neural systems which
      express LTP. In parallel, the hypothesis that the mechanisms underlying LTP are
      activated during learning and actually serve learning and memory has gained much
      empirical support. This article summarizes present knowledge about the properties
      and mechanisms of LTP and reviews the major experimental strategies that have
      been pursued to elucidate its functional significance in learning and memory. The
      data provide a working framework within which the dynamics of cellular mechanisms
      of learning and memory is profiled.

PMID- 7780789
TI  - [Hippocampus as interaction sites between cerebral memory systems].
AB  - Most of the current theories assume that there are multiple forms of memory that
      are supported by separate brain systems and have different characteristics.
      Animals studies on the various dual-memory theories have been carried out mainly
      on the basis of hippocampal system function. Specifically, they have focused on
      aspects of learning and memory that are impaired (vs. spared) by lesions of the
      hippocampal formation. However, there are several instances in the animal
      literature showing that hippocampal lesions actually produced enhanced learning
      and memory function. Moreover, the acquisition of tasks that are facilitated by
      hippocampal lesions (or dysfunction) is nevertheless associated, in intact
      subjects, with specific neurobiological alterations in the hippocampus. This
      problem has been analysed using two different tasks in mice: a bar-press
      conditioning and a spatial discrimination task. Results showed that, depending on
      the task considered, the same pharmacological treatment produced either a
      facilitation or an impairment of acquisition. Moreover, each task induced
      significant alterations in hippocampal adenylate cyclase activity but in opposite
      directions. Together with previous findings, these results suggest that the
      hippocampus is involved in both the so-called "hippocampal-dependent" and
      "hippocampal-independent" forms of memory. It is postulated that some of the
      observed training-induced neurobiological alterations might reflect the
      interaction between two (or more) competing memory systems at the hippocampal
      level. Thus, in addition to its proposed specific information processing
      functions (i.e., relational), the hippocampus would play a role in addressing
      information to the brain memory system that, in a given situation, has the best
      adaptive value.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780791
TI  - [From positional cloning to gene identification and its function in genetic
      diseases].
AB  - The huge development of genetic tools, together with the availability of powerful
      computers have enabled the mapping of several loci responsible for genetic
      diseases by the positional cloning technique, also called reverse genetics. The
      step consisting of identifying the gene itself remains a difficult step and the
      function of the gene identified may remain difficult to establish. In this
      chapter, we will examine the various steps allowing the identification of the
      gene, techniques allowing the creation of animal models of human diseases and the
      recent progresses of these techniques.

PMID- 7780790
TI  - [Aging of memory mechanisms].
AB  - Human amnesia cases (after surgical removal of the hippocampi or brain anoxia)
      have clearly established the critical role of the hippocampal formation in
      anterograde amnesia. Other parts of the brain may also contribute to anterograde
      amnesia (mammillary bodies, medial thalamus). In neurodegenerative diseases (and
      specially in Alzheimer's disease) amnesia is often the prominent symptom, but the
      brain lesions are not restricted to the hippocampal formation. In Alzheimer's
      disease they involve also the cerebral cortex and several subcortical nuclei.
      Physiological brain aging is also associated with some degree of memory
      impairment, but much less severe than in Alzheimer's disease. The issue of the
      nature and the mechanisms of the memory impairment associated with age and with
      Alzheimer's disease is very important, because the frequency of these problems
      increases dramatically as the populations of the world is growing older. There is
      some evidence that neuronal loss and alterations in neurotransmitter systems
      occur in the aged subject, but the relationship between such changes and the age
      related memory deficit is far from being clear. In Alzheimer's disease, the loss
      of memory is likely to be due to neuronal loss in cerebral cortex and hippocampal
      formation, along with alterations in neurotransmitter systems (specially
      cholinergic, monoaminergic and aminoacidergic systems). The work in experimental
      animals has largely confirmed the critical role of the hippocampal formation, as
      well as identified other critical structures. The mechanisms of the age-related
      memory impairment can be to some extent investigated in aged animals. In the aged
      rat there is evidence that several neurotransmitter networks are altered.
      Alteration in the dopaminergic and cholinergic systems have been extensively
      studied, but the involvement of other systems is likely. Learning and memory
      deficits are consistently observed in a sub-population of aged rodents (as well
      as in other species including non-human primates). For instance some aged rats do
      have a deficit in the performance of a spatial learning task such as the "water
      maze". There is some evidence that this deficit is due, at least in part, to
      alterations in the functions of the hippocampal formation. In other words, if
      aged rats have a spatial memory deficit, it might be due to changes in
      hippocampal neuronal circuitry. The study of age-related alterations in
      hippocampal neuronal networks, using electrophysiological techniques have shown
      that several neuronal properties such as resting membrane potential, membrane
      resistance or sodium spike amplitude are not altered in the aged rat
      hippocampus.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7780792
TI  - [Physical study of big fragments and search strategy of genes. Application to
      locus of infant spinal muscular atrophies].
AB  - Spinal muscular atrophies (SMA) represent the second most common fatal autosomal
      recessive disorder after cystic fibrosis. Childhood SMAs are divided into severe
      (type I) and mild forms (types II and III). By a combination of genetic and
      physical mapping, a YAC contig of the 5q13 region spanning the disease locus was
      constructed that showed the presence of low copy-repeats in this region. Allele
      segregation was analyzed at the closest genetic loci detected by markers C212 and
      C272 in 201 SMA families. Inherited and de novo deletions were observed in 10 SMA
      patients. Moreover, deletions were strongly suggested in at least 18% of SMA type
      I patients by the observation of marked heterozygosity deficiency for the loci
      studied. These results indicate that deletion events are statistically associated
      with the severe form of SMA.

PMID- 7780793
TI  - [Identification of mutation of RET proto-oncogene in Hirschsprung disease].
AB  - Hirschsprung's disease is a frequent congenital malformation of the hindgut. The
      existence of Hirschsprung's families favors the role of an autosomal dominant
      gene with a reduced penetrance. We have successively localized and identified the
      RET proto-oncogene as the gene responsible for familial Hirschsprung's disease.
      Interestingly, other mutations of the RET proto-oncogene have been described in
      inherited predisposition to endocrine cancers. This observation shows that,
      depending on their nature, mutations of the RET proto-oncogene could lead either
      to early developmental defects or to tumor predisposition.

PMID- 7780794
TI  - [Cell adhesion and development of skeletal muscle].
AB  - Cell adhesion is a cell autonomous property of pluricellular organisms at the
      basis of tissues and organs formation. Thus, adhesive processes must be
      considered as key features of the development of skeletal muscle as well as of
      other tissues. We present here the actual knowledge on cell adhesion molecules in
      skeletal muscle morphogenesis. The spatio-temporal expression patterns of N-CAM,
      N-cadherin, M-cadherin, VLA-4 and VCAM-1 during chicken and mouse myogenesis
      suggest that these cell adhesion molecules are differentially involved in
      myoblast-myoblast, myoblast-myotube and myotube-myotube interactions. These
      molecules link myogenic cells before they are separated by their basal laminae.
      They can potentially induce preferential cell adhesion and sorting-out as it has
      been described by Holtfreter. This differential adhesion may lead either to
      myoblast fusion or to preferential association between primary and secondary
      myotubes.

PMID- 7780795
TI  - [Analysis of the diversity of tropomyosin isoforms].
AB  - Tropomyosins are a family of actin filament binding proteins. Like many
      structural proteins, tropomyosin isoform expression involves the use of multiple
      genes, but diversity is to a large extent generated by alternative processing of
      RNA. The tropomyosin family consists of 15 to 20 different protein isoforms which
      are coded by four genes. Each of these genes code for multiple proteins ranging
      from two up to as many as nine different isoforms. These genes have been named
      alpha CTM, alpha FTM, alpha STM and beta TM after to the striated muscle specific
      subunit of tropomyosin which they code. Their multiple coding potential is based
      upon the existence of multiple exons associated with initiation of transcription,
      multiple exons associated with polyadenylation signals and multiple mutually
      exclusive internal exons which are alternatively spliced. The regulation of this
      process of alternative splicing have been extensively studied both in the case of
      exons 2a/2b of the alpha FTM gene and in the case of exons 6a/6b of the beta TM
      gene. In both cases, one exon is specifically used in one type of muscle tissue,
      exon 2a is smooth muscle specific and exon 6b is skeletal muscle specific. In
      both cases, alternative splicing involves a combination of negative regulation,
      on exon 2b in smooth muscle and on exon 6b in non muscle tissues, and of
      competition in the alternative situation.

PMID- 7780796
TI  - [Serine proteases and their inhibitors: their role in the differentiation in
      neuromuscular system].
AB  - It is now well established that some serine proteases, such as plasminogen
      activators and thrombin, as well as their inhibitors, have roles in the
      development of both central and peripheral nervous systems. We have shown that
      muscle plasminogen activators, activated after denervation, were able to digest
      some components of the muscle basement membrane. We have also shown that several
      inhibitors of serine proteases were concentrated at the neuromuscular junction.
      These are protease nexin, I, also called glia-derived nexin, protease nexin II, a
      secreted form of the beta-amyloid precursor protein (APP), and alpha 1
      antichymotrypsine (ACT). These results leads us to propose a model in which
      serine proteases would favor plasticity of motor nerve endings during
      neuromuscular development. On the contrary, the inhibitors of serine proteases
      would act to provide and secure maintenance of the synaptic contact. A
      dysequilibrium between serine proteases and their inhibitors might underlie one
      or more motor neuron diseases.

PMID- 7780797
TI  - [Muscular reconstruction by myogenic cell graft].
AB  - We have developed an experimental model to test the ability of cultured satellite
      cells to form new muscle fibers when grafted in an irreversibly injured muscle.
      Association of X-irradiation to autotransplantation reduced extensor digitorum
      longus muscles of adult rats to a cystic structure formed by a peripheral rim of
      surviving muscle fibers surrounding a central space devoid of myofibers. Grafting
      autologous satellite cells, multiplied and labelled in vitro, into this central
      space gave rise to new myotubes which developed and matured to form fully
      differentiated myofibers. Mecanophysiological recordings confirmed the
      improvement of functional parameters particularly a 4 fold increase of twitch and
      tetanic tensions in grafted muscles. Furthermore, we examined the role of old
      basal lamina in architectural organisation of the reconstituted muscle by
      electron microscopy and immunofluorescence using antibodies to laminin,
      fibronectin, type IV collagen and heparan sulfate proteoglycan. We observed the
      persistence of immunoreactivity to all components; anti-laminin antibodies for
      example, evidenced a clear fascicular organization of ghost basal lamina which
      are progressively repopulated by the grafted cells. We finally investigated in
      vivo proliferation of the grafted cells by an autoradiographic study of H3
      thymidine incorporation in the regenerated fibers and demonstrate that grafted
      cells proliferate for, at least, 1 week after cell grafting.

PMID- 7780798
TI  - [Expression and localization of dystrophin during human skeletal, cardiac and
      smooth muscle development].
AB  - Dystrophin, the Duchenne muscular Dystrophy gene product, is a large cytoskeletal
      protein associated with a complex of membrane proteins, the Dystrophin
      Glycoprotein Complex (DGC). Dystrophin is localized to the sarcolemmal membrane
      of all normal muscle types, but is absent from muscles of DMD patients. Using
      monoclonal antibodies raised against distinct regions of the dystrophin, we
      studied its expression and subcellular localization during human skeletal,
      cardiac and smooth muscle development. We have shown that the expression and the
      association of dystrophin with the plasma membrane take place earlier in cardiac
      and smooth muscles (8 weeks of gestation) than in skeletal muscles. In skeletal
      muscles, dystrophin is first observed in the cytoplasm, and is progressively
      localized to the plasma membrane from 10 weeks onwards. We obtained differences
      in staining when using antibodies against either the central part of the protein
      or the carboxy-terminal domain, and we suggested that isoforms of dystrophin,
      probably differing in their carboxy-terminal end and their capacity to associate
      with the plasma membrane were differentially expressed during development and in
      different tissue-types (7). These findings are discussed in the context of the
      pathology of Duchenne Muscular Dystrophy.

PMID- 7780799
TI  - [Main steps in the skeletal myogenesis in man].
AB  - During the metabolic differentiation of developing human skeletal muscle fibers,
      two different generations of fibers can be characterised by their profiles of
      protein expression (in particular of the myosin heavy chains). This
      differentiation is regulated by both genetic and epigenetic factors (motor
      innervation, levels of thyroid hormone). The anomalies in different muscle
      pathologies can be better understood by comparison with the modifications
      occurring during normal skeletal muscle development.

PMID- 7780800
TI  - [Induction of prostatic buds in the absence of androgens].
AB  - We have investigated the non-androgenic factors that induce the prostatic buds
      from the sinus epithelium. The buds were found to be induced in the explants
      cultured in the androgen-deficient medium containing 20 ng/ml rat keratinocyte
      growth factor (KGF) irrespective of the sex of the sinus.

PMID- 7780801
TI  - Transcription factors 1: bZIP proteins.

PMID- 7780802
TI  - [The geriatric team in ambulatory (mobile) rehabilitation. Results of a
      longitudinal study on the effects of ambulatory rehabilitation].
AB  - This article describes the experiences obtained in a study of ambulatory (mobile)
      rehabilitation with stroke patients. The patients had been treated in a
      rehabilitation clinic before. The ambulatory rehabilitation, which lasted 18
      months, served to maintain and further develop the previous success of in-patient
      rehabilitation. On the one hand, the research project provided empirical evidence
      for the success of ambulatory rehabilitation. On the other hand, the experiences
      obtained through this research project indicate that the success of an ambulatory
      rehabilitation concept is dependent on optimal co-operation among members of the
      rehabilitation team (physicians, psychologists, physical therapists, occupational
      therapists, speech therapists, and nursing staff). In relation, the institutional
      conditions for effective ambulatory rehabilitation are only met when physicians
      in private practice, who are responsible for the co-ordination of rehabilitation
      services, are supported by physicians in regard to time-consuming home visits,
      and when sufficient numbers of physical therapists, occupational therapists, and
      speech therapists in private practice are available. Unfortunately, these
      conditions are not fulfilled in many regions of Germany.

PMID- 7780803
TI  - [The geriatric team in the memory clinic].
AB  - The early and differential diagnosis of senile dementia is still a problem. The
      work of a multiprofessional team in the Memory Clinic Essen is reviewed. the
      combination of qualifications of the team corresponds with the diagnostic
      algorithms of DMS-III R and ICD 10. Members of the team are a geriatrician, a
      psychiatrist, a geragoque, and a psychologist. Every specialist examines the
      patient using his specialized method. The results are discussed in a diagnostic
      conference. Out of the different methods and views of the specialists a
      comprehensive image of the patient takes shape and allows a better understanding
      of the dementia.

PMID- 7780804
TI  - [The geriatric team in transitional patient management].
AB  - The transition team has its place in pre- and postdischarge nursing and
      therapeutic care, on the basis of a geriatric assessment. Core members of the
      team are, in the sequence of the scheduled performance in-hospital, nurse,
      occupational therapist, physiotherapist and social worker, supplemented by a team
      physician. Two-thirds of all treatments were in the hospital, one-third in an
      outpatient setting up to 4 weeks after discharge. Cooperation with outpatient
      services has been good.

PMID- 7780805
TI  - [The gerontopsychiatric team in the specialized department].
AB  - People 65 years and older constitute a group with high risk for psychiatric
      disease, and their numbers are increasing. At the same time familial networks and
      financial resources are weakening. In order to improve psycho-geriatric therapy,
      we developed teamwork within our department. In the present work we describe the
      psycho-geriatric ward and the special functions of team members. It seems to be
      important that there are enough staff members who are well trained and motivated;
      it should be guaranteed that members regularly meet in conferences and have
      regular supervision; work hours should be favorable. Team process is described as
      consisting of imaging a comprehensive idea of the personality and the problems of
      the patient; agreeing on a therapeutic proceeding and-as a result-translating
      into action. Finally, it focuses on the necessity for further development and
      research.

PMID- 7780806
TI  - [Age differences versus aging--a cross-sectional and longitudinal analysis on the
      development of memory in advanced age].
AB  - This study examines the development of episodic memory in later adulthood and old
      age in a combined cross-sectional and longitudinal design. 124 normal aging
      subjects, aged 50-87 years, representing four age groups (M1 = 53.65 years, M2 =
      60.60 years, M3 = 68.44 years, M4 = 75.83 years) participated in a cross
      sectional study. Seven years later a retest was done in which 70% of the original
      sample again participated. Significant differences between the cross-sectional
      and the longitudinal results were found, with the latter showing the more severe
      decline in memory performances. Moreover, the age decline occurred earlier in the
      longitudinal study. Cohort differences account for these differences between the
      cross-sectional and longitudinal findings, favoring subjects of earlier-born
      cohorts.

PMID- 7780807
TI  - [The role of the medial services of health insurance in expert evaluation of
      disability in social insurance (SGB XI)].

PMID- 7780808
TI  - [The geriatric team].

PMID- 7780810
TI  - [The team of the geriatric day clinic].
AB  - Composition of staff and therapeutic offers of day-hospitals principally are
      identical with those of geriatric hospitals. But there are peculiarities in their
      working: They offer a well balanced combination of somato-, physio-, psycho- and
      sociotherapy which individually must be planned, perpetually controlled and if
      necessary changed corresponding to the given situation of the particular patient.
      This so called therapeutic milieu is only to be preserved by a close cooperation
      and interchange of information within the team and an intensive motivation of the
      patient to cooperate with the therapists.

PMID- 7780809
TI  - [The geriatric university clinic].
AB  - The very old are the fastest growing population group. Medical progress allows
      more autonomy and better quality of life for the elderly. Traditional medical
      concepts are, however, only partly suited for dealing with age-associated
      problems. Medical education responds to these new requirements in a limited way.
      Interdisciplinary teamwork is a prerequisite in treating the multimorbid, acutely
      ill elderly patient. The task of the university is not only the development and
      implementation of high-tech medicine, but first of all a comprehensive training
      in medicine, including geriatrics. The Geriatric University Clinic therefore
      offers pre- and postgraduate training in geriatrics, but also in related
      disciplines by promoting teaching and research. In order to attain these goals,
      the geriatric acute ward was created for acutely ill, very old, multimorbid,
      frail elderly patients. A geriatric ward for rehabilitation complements this
      ward. A consultation service offers geriatric know-how to all other services. A
      special task is the early diagnosis and treatment of dementia in an outpatient
      service. The aim is to prevent chronification by early intervention and to
      reestablish satisfactory function and autonomy.

PMID- 7780811
TI  - [The interdisciplinary team on the assessment unit].
AB  - Comprehensive geriatric assessment is usually accomplished by multidisciplinary
      teams in order to meet the complexity of patients' needs. An implementation of
      information exchange, case reporting and planning of treatment in a systematic
      manner is a prerequisite for interdisciplinary team work. This report gives the
      results from a series of 54 patients consecutively admitted to an assessment
      unit. Assessment was predominantly accomplished by a core team (physician, nurse,
      social worker), and was supplemented by additional disciplines, if needed. The
      process of assessment and treatment resulted in functional improvement as
      assessed by an increase in the Barthel-Index score, 14 days after admission and
      at hospital discharge. More than 70% of patients surviving were discharged back
      to their homes. Geriatric assessment revealed a great need for additional
      ambulatory professional care although some patients used such health care
      services, already.

PMID- 7780812
TI  - [Surgical diagnosis of pancreatic diseases].

PMID- 7780813
TI  - [Current status and prospectives of combating addiction of heroin].

PMID- 7780814
TI  - [The role of tumor necrosis factor in acute pancreatitis and associated multiple
      organ failure].
AB  - In 32 patients with acute pancreatitis (AEP = 15, ANP = 17), tumor necrosis
      factor (TNF) activity, oxygen-derived free radicals (OFR) and endotoxin contents
      were determined by L929 cell bioassay, Tetrabarbituric acid fluorometry and
      Limulus test respectively. The results showed that TNF and OFR elevated in
      patients with AP at the admission (P < 0.05 vs normal). The change of TNF and OFR
      responded to the clinical symptoms. TNF correlated to early multiple organ
      failure (MOF). In patients with late MOF, TNF and OFR were both the important
      factors. By measuring endotoxin, we found that endotoxemiae were not so important
      in early phase of the disease as in late phase, in which they made TNF and OFR
      released profusely.

PMID- 7780815
TI  - [Cryosurgery of acute hemorrhagic necrotizing pancreatitis].
AB  - Acute hemorrhagic necrotizing pancreatitis (AHNP) was induced by introduct
      retrograde injection of the autologous bile in canine. The cryoprobe was under
      the influence of temperature ranging from -160C to -190C for fifteen to eighteen
      seconds, and the frozen areas were about 80% surface of pancreas. Cryotherapy of
      AHNP strongly inhibited the development of the inflammation in pancreatic
      parenchyma. Postcryotherapy 24hr for remarkably decreased the activities of
      pancreatic enzymes. The activities of phospholipase A, lipase and amylase in
      serum decreased by 502.1%, 355.8%, 502.5% respectively in 7 days. The level of
      blood glucose decreased. At the second week, the fibroblasts were growing around
      the residual pancreatic aciner cells and insular cells rich in intact zymogen
      granules. The mortality (6.89%) of the treatment group within 48 hours was
      significantly lower than that of the control group (100%).

PMID- 7780816
TI  - [The role of platelet activating factor in mesenterioangial microcirculatory
      disturbance complicated with acute pancreatitis in rats].
AB  - To study shock in early acute pancreatitis (AP), we observed the change of
      mesenterio-angial microcirculation in the rat with AP induced by sodium
      taurocholate infused into the pancreatic duct. Meanwhile, the effect of platelet
      activating factor (PAF) receptor antagonist BN52021 upon the animal with AP was
      also investigated. 18 Sprague-Dawley rats were divided into three groups:
      pancreatitis group pan + BN52021 group and control group. pan + BN52021 group was
      injected BN52021 (10mg/kg) intravenously 5 minutes and 180 minutes after AP
      induction. The other groups were injected normal saline. We also studied the
      survival times of rats. The results showed slow mesenterio-angial small
      arteriolar and venular blood flow velocity and dilated meseaterio-angial small
      venular diameter during the early phase of AP. An protective effect of BN52021 on
      mesenterio-angial microcirculation injuries accompanied by AP was confirmed
      Animals treated with BN52021 survived 458.3 +/- 9.5 minutes whereas death
      occurred 243.3 +/- 2.3 minutes after AP induction in untreated rats (P < 0.01).

PMID- 7780817
TI  - [Application of transcranial color Doppler flow imaging in the carotid cavernous
      sinus fistulae].
AB  - Transcranial color Doppler flow imaging (TCCDFI) allows for simultaneous two
      dimensional structural imaging and Doppler evaluation of blood flow through
      intact skull. With this technique, we evaluated 10 patients with carotid
      cavernous sinus fistulae (CCSF) and 35 normal volunteers. Each of them was
      confirmed by angiography. TCCDFI showed that patients with CCSF had typical signs
      in the affected part. The cavernous sinus had mosaic color shade. Pulse-Doppler
      showed disorderly polydirection vortex blood flow spectra in the mosaic color
      shade associated with murmur. Two-dimensional sonography and color Doppler
      imaging demonstrated a dilated superior ophthalmic vein (SOV) with arterialized
      blood flow. The Vmax of MCA and ACA in the affected side were lower than the
      healthy and normal side. The RI was lower than that of the healthy side and PCA
      of both sides was lower than that in normal volunteers. Two patients were
      examined after tubolization. Mosaic color shade disappeared and SOV returned to
      normal venous flow in patients completely occluded. Mosaic color shade reduced
      and SOV still aterialized blood flow in partly occluded patients. This technique
      helps to confirm the clinical diagnosis and to track the hemodynamics of CCSF
      patients and evaluate the effect of therapy.

PMID- 7780818
TI  - [Expression of c-myc, c-erbB-2, insulin-like growth factor II andepidermal growth
      factor receptor in hepatitis B, cirrhosis and hepatocellular carcinoma].
AB  - In order to get a better understanding of expressions of multiple oncogenes and
      their possible roles in human hepatocarcinogenesis, 379 cases of liver tissues
      were investigated immunohistochemically. EGF receptors were immunolocalized
      mainly in the sinusoidal endothelial cells. They might not take part in the
      development of hepatocellular carcinoma (HCC), c-myc protein was showed to be
      expressed in cancer cells and the hepatocytes in the so-called "large-cell
      dysplasia" and in ductular metaplasia (DM). Its expression was also observed in
      some zone II hepatocytes of hepatic accini in 21% of normal liver tissues, which
      indicated that c-myc expression might also be related to the proliferation of
      mature hepatocytes. The positivity rate of c-erbB-2 product was shown to be
      highest among the oncogenic genes examined in this study. The positivity was
      observed in small polygonal liver cells (SPLCs) and the hepatocytes were observed
      in SCD and in DM. The expression level of c-erbB-2 oncogene in HCC cells was
      higher significantly than in normal hepatocytes, but lower than in SPLCs, the
      hepatocytes in SCD and in DM. We suggest that c-erbB-2 gene activation may play
      an important role not only in HCC genesis, but also in DM. Insulin-like growth
      factor II (IGF II), an oncofetal hepatocellular growth factor, was
      immunolocalized in the cancer cells, SPLCs and the hepatocytes in SCD, which
      indicated that activation and hyperexpression of IGF II gene might be responsible
      for the prominent proliferation of SPLCs and SCD, a crucial step in malignant
      transformation of hepatocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780819
TI  - [A light-microscopic and immunohistochemical study in testis tissue from
      hemorrhagic fever with renal syndrome autopsies].
AB  - Testis tissues from 13 cases of hemorrhagic fever with renal syndrome (HFRS) were
      studied by light-microscopy and immunogold-silver staining (IGSS). Under routine
      light microscopy, the pathological lesions were found frequently in the
      spermatogenic epithelia, the basement membrane in the seminiferous tubules, and
      the mesenchyme around the tubules. Immunohistochemical studies showed that there
      were immune complexes (IgG) deposited mainly in the basement membrane in the
      tubules and interstitial cells, endothelial cells, and red cells of the small
      vessels around tubules mesenchyme. The injury mechanism is that the immuno
      complexes (IgG) are deposited in testis tissues from HFRS autopsies.

PMID- 7780820
TI  - [Apolipoprotein (a) phenotypes of patients with myocardial infarction].
AB  - We studied apolipoprotein (a) (apo(a)) phenotypes of 69 myocardial infarction
      survivors and 56 stroke patients, and compared them with those of 190 healthy
      Chinese. The distribution of apo(a) phenotype frequency in cardio-cerebrovascular
      disease patients was different from those of controls. The frequency of the
      phenotypes B, S1 and S2 in patients was remarkably higher than that in controls
      within the same single-band apo(a) phenotype. Moreover, the Lp(a) serum
      concentrations in CCVD patients were significantly higher than those in controls
      within the same single-band apo(a) phenotype.

PMID- 7780821
TI  - [Interleukin-1 beta, interleukin-1 receptor antagonist mRNA expression of
      peripheral blood mononuclear cells (PBMC) in idiopathic nephrotic syndrome (INS)
      detected by biotin-labelled probe in situ hybridization].
AB  - The pathogenesis of INS is related to the disorder of cellular immunity. Using
      the in situ hybridization of biotin-labeled probe and streptavidin -alkaline
      phosphatase conjugate detection system, we quantitatively analysed by true colour
      medical image analysis system the expression of IL-1 beta, IL-1ra mRNA of
      peripheral blood mononuclear cells (PBMC) from 4 cases of idiopathic nephrotic
      syndrome. IL-1 beta IL-1ra mRNA expression of PBMC in INS were significantly
      lower than those of the normal control (107.63 +/- 20.80 vs 195.56 +/- 31.14;
      144.45 +/- 11.42 vs 370.38 +/- 100.48, respectively, P < 0.05). The expression of
      IL-1 beta mRNA was significantly lower than the IL-1ra mRNA expression of PBMC in
      INS (107.63 +/- 20.80 vs 144.45 +/- 11.42, P < 0.05). There existed dysregulation
      of IL-1 beta, IL-1ra mRNA expression in INS. The advantages of biotin-labelled
      probe in situ hybridization were also discussed.

PMID- 7780822
TI  - [3 retinoic acid isomers on proliferation and differentiation properties of APL
      cell line-NB4].
AB  - We examined the effect of three RA isomers, including ATRA, 13C-RA and 9C-RA, on
      the proliferation and differentiation properties of NB4 cells, a cell line
      established from APL patient and carrying the typical translocation t (15;17).
      Standard parameters such as cell morphology, cell growth curve, dynamics of cell
      cycle, expression of clusters of differentiation and reduction of nitro blue
      tetrazolium (NBT) were used to evaluate the effects of the three isomers. During
      the first 48 hours of RA treatment, the APL cell maturation was coupled with the
      cell proliferation. Moreover, significant differences of differentiation-induced
      effect among RA isomers were observed. ATRA showed better results than 13C-RA
      while 9C-RA functioned even better than ATRA. These data are helpful to
      understand the mechanisms, by which RAs induce promyelocytic leukemia cell
      differentiation and open a new prospect for the clinical use of novel retinoic
      acid isomers.

PMID- 7780823
TI  - [Establishment of hybridoma lines and protective study of monoclonal antibodies
      against lipid A of endotoxins].
AB  - For developing monoclonal antibodies (MAb) that bound to lipid A of the LPS
      molecule, we established several hybridomas cell lines by fusion of SP2/0 and
      spleen cells from BALB/c mice immunized by J5 mutant strain of E. coli 0111:B4.
      Each MAb exhibited a high titer by ELISA assay. Six of MAb were of immunoglobulin
      G isotype and another one immunoglobulin M. All of these MAb demonstrated
      different capacity to cross-react with several gram-negative bacteria and their
      endotoxins. Among them, 9G6 MAb improved the survival rate of mice significantly
      when administered 2 hours before the challenge by pseudomonas A and E. coli.
      These findings suggest that MAb will probably be useful in the treatment of
      sepsis caused by a wide variety of gram-negative bacteria.

PMID- 7780824
TI  - [Effect of NG-nitro-L-arginine methylester on the secretion of endothelin-1 in
      vivo and in cultured endothelial cells].
AB  - We investigated the effect of nitric oxide, derived from L-arginine on the
      production of endothelin-1 in vivo and in cultured endothelial cells. In
      mechanically ventilated anesthetized dogs (n = 5), mean pulmonary arterial
      pressure (mPAP), pulmonary vascular resistance (PVR) and plasma endothelin-1
      level of the femoral artery during hypoxic ventilation (FIO2 = 0.10) were 3.3 +/-
      0.4kPa, 68.7 +/- 10.2kPa.s-1/L and 47.2 +/- 17.4ng/L respectively. NG-nitro-L
      arginine methylester (L-NAME), an inhibitor of nitric oxide synthase, increased
      the peak value of mPAP and PVR during hypoxic ventilation to 4.9 +/- 0.6 kPa and
      160.9 +/- 34.6kPa. s/L and its effect lasted for 3 hours. Meanwhile, plasma
      endothelin-1 level in the femoral artery was increased to 68.2 +/- 20.6, 72.8 +/-
      20.9, 75.8 +/- 22.7 ng/L at 60, 120, 180 minutes respectively after the injection
      of L-NAME (P < 0.05 vs hypoxic control before the injection). In cultured
      endothelial cells from human umbilical veins, endothelin-1 level of culture
      medium increased significantly in 10(-11) and 10(-7) mol/L L-NAME group (n = 9, P
      < 0.05 vs control group). These findings indicate that endogenous nitric oxide is
      an inhibitory modulator of hypoxic pulmonary vasoconstriction and that nitric
      oxide inhibits the production of endothelin-1 in vivo and in cultured vascular
      endothelial cells.

PMID- 7780825
TI  - [Effects of alveolar macrophage conditioned media from interstitial lung disease
      patients on the procollagen mRNA expression in human lung fibroblasts].
AB  - We investigated the effects of alveolar macrophage (Am) conditioned media from
      interstitial lung disease (ILD) patients on lung fibroblast proliferation and
      procollagen mRNA expression in cells. 13 patients with ILD and 8 patients with
      bronchial carcinoma (BC) received bronchoalveolar lavage (BAL). The BAL fluid was
      collected and centrifuged to obtain cells of two groups. The cells were washed
      and incubated at 37 degrees C and 5% CO2 for 2 hours in DMEM with 10% FCS. Then
      the adherent Am was added with DMEM with 0.1% FCS. (2ml/10(6) cells), and
      cultured at 37 degrees C and 5% CO2 for 24 hours. The supernatant was obtained by
      centrifugation and stored in -20 degrees C for experiment. Lung fibroblasts were
      planted in 96 well microtitle plate and cultured to confluence. Each well was
      added 100 microliters Am conditioned medium and incubated for 16 hours, then
      added 5 uci 3H-TdR for measuring the fibroblast proliferation and incubated till
      24 hours. The cells were collected and counted. The DMEM with 0.1% FCS was used
      as control. When stimulated with Am conditioned media from ILD patients,
      fibroblast proliferation increased 71%, but for media from BC patients, it just
      increased 14% (P < 0.05). After stimulated with conditioned media for 24 hours,
      the cells were trypzied, collected, ashed and isolated total RNA with guanine
      method. Several samples' total RNA was subjected to electrophoresis in 1%
      agaroseformaldehyde gel to test specificity of procollagen al (I) and al (III)
      cDNA probes. 10 micrograms total RNA of each sample was bloted to nitrit membrane
      and baked at 80 degrees C for 2 hours.

PMID- 7780826
TI  - [Progress in the exogenous pulmonary surfactant replacement therapy for the adult
      respiratory distress syndrome].

PMID- 7780827
TI  - The structure and the mechanism of action of pyruvate carboxylase.
AB  - Pyruvate carboxylase plays an important role in intermediary metabolism,
      catalysing the formation of oxaloacetate from pyruvate and HCO3-, with
      concomitant ATP cleavage. It thus provides oxaloacetate for gluconeogenesis and
      replenishing tricarboxylic acid cycle intermediates for fatty acid, amino acid
      and neurotransmitter synthesis. The enzyme is highly conserved and is found in a
      great variety of organisms including fungi, bacteria and plants as well as higher
      organisms. It is a member of a group of biotin-dependent enzymes and the biotin
      prosthetic group is covalently bound to the polypeptide chain of the enzyme,
      there normally being four such chains in the native, tetrameric enzyme. The
      overall reaction catalysed by pyruvate carboxylase involves two partial reactions
      that occur at spatially separate subsites within the active site, with the
      covalently bound biotin acting as a mobile carboxyl group carrier. In the first
      partial reaction, biotin is carboxylated using ATP and HCO3- as substrates whilst
      in the second partial reaction, the carboxyl group from carboxybiotin is
      transferred to pyruvate. The chemical mechanisms of the partial reactions and
      some of the roles played by amino acid residues of the enzyme in catalysing the
      reaction have been elucidated. The domain structure of the yeast enzyme has been
      deduced by comparing its amino acid sequence with those of enzymes that have
      similar catalytic functions. The quaternary structures of the pyruvate
      carboxylases studied so far, all involve a tetrahedron-like arrangement of the
      subunits. The major regulator of enzyme activity, acetyl CoA, stimulates the
      cleavage of ATP in the first partial reaction and in addition it has been shown
      to induce a conformational change in the tetrameric structure of the enzyme. In
      the past, the lack of any detailed structural information on the enzyme has
      hampered efforts to fully understand how this and other biotin-dependent enzymes
      function and are regulated. With the recent cloning of the enzyme from a variety
      of sources and the performance of three-dimensional structural studies, the next
      few years should see much progress in our understanding the mechanism of action
      of this enzyme.

PMID- 7780828
TI  - The effect of lipid peroxidation on the activity of various membrane-bound
      ATPases in rat kidney.
AB  - Peroxidation of membrane phospholipids is accompanied by alteration of the
      structural and functional characteristics of membranes. Lipid peroxidation
      changes the activities of various enzymes. The present study evaluates the effect
      of lipid peroxidation on the activity of various ATPases localized on kidney
      membranes. Our experiments were performed on crude preparation of rat kidney
      membranes which were exposed to Fe2+.ADP/NADPH-induced lipid peroxidation. The
      extent of peroxidation was estimated by measuring the thiobarbituric acid
      reactive substances. Simultaneously the activities of different ATPases were
      determined and divided according to their ouabain sensitivity and Mg2+
      dependency. We found that 10 min incubation of isolated rat kidney membranes at
      37 degrees C with inductors of lipid peroxidation increased the production of
      thiobarbituric acid-reactive substances from 1.10 +/- 0.26 to 7.72 +/- 2.55 nmol
      malondialdehyde/mg prot. (+/- SD, n = 4). Under these conditions total ATPase
      activity was decreased from 681 +/- 77 to 507 +/- 82, ouabain-sensitive Mg(2+)
      dependent ATPase (Na+,K(+)-ATPase) activity from 249 +/- 54 to 81 +/- 21 and
      ouabain-insensitive Mg(2+)-dependent activity from 287 +/- 48 to 173 +/- 58
      whereas apparently Mg(2+)-independent ATPase activity was increased from 145 +/-
      37 to 253 +/- 42 nmoles P/min/mg prot. (+/- SD, n = 4). The study indicates
      different mechanisms by which lipoperoxides affect the function of membrane-bound
      ATPases activities. It is concluded that the ATPases activities are changed
      during lipid peroxide formation.

PMID- 7780829
TI  - Changes in apoprotein distribution between lipoprotein classes of
      hypercholesterolemic rats treated with ascorbate.
AB  - It is known that ascorbate has a lipid lowering effect, accompanied by a drop of
      apo B, in rats fed a diet enriched with 1.5% of cholesterol (Nath diet). In order
      to better clarify the role exerted by ascorbate in lipid metabolism, the effect
      of ascorbate administration on apolipoprotein pattern in rats fed the Nath diet
      was investigated. Wistar male rats fed for two months the Nath diet were treated
      i.p. with 60 mg/kg of body weight of ascorbate for 10 days. Blood collection
      before and after the treatment was performed by intracardiac puncture.
      Lipoproteins were prepared by preparative ultracentrifugation and their
      apoprotein content was obtained by densitometric scanning of the apoprotein
      electhrophoretic pattern. The decrease of total plasma cholesterol and
      triglycerides and of cholesterol, triglycerides and protein content of all plasma
      lipoproteins observed in ascorbate treated rats, is accompanied by a marked
      modification of the apolipoprotein pattern of all lipoprotein classes studied,
      with an increase of apo E content in VLDL-IDL and LDL fractions (135 and 44%
      respectively), and a decrease of C (37%), AI (70%) and B (37.5%) apoproteins in
      VLDL-IDL and of apo C (36%) in LDL. On the contrary, in HDL fraction ascorbate
      induces an increase of C apoproteins (26%) and a decrease of E and B apoproteins
      (47% and 71% respectively). The data reported clearly show that in
      hypercholesterolemic rats the lipid lowering effect of ascorbate administration,
      is accompanied by a marked modification of the apoprotein pattern of all
      lipoprotein classes studied.

PMID- 7780830
TI  - Heat stress stimulates high affinity GTPase in cervical carcinoma cells.
AB  - A primary cellular site involved in heat shock response of eukaryotic cells is
      located in plasma membranes. The mechanism by which heat shock is sensed and the
      signals that trigger heat shock response remain an enigma. We aim to determine
      the role of guanine-nucleotide binding proteins (G)-proteins in mediating heat
      shock response in eukaryotic cells. The effect of heat shock on high affinity
      GTPase activity in presence or absence of modulators of G-proteins, such as
      pertussis toxin was studied by measuring GTPase catalyzed release of 32[Pi] from
      gamma-32[P]GTP. The effect of pertussis toxin on induction of heat shock proteins
      in cells subjected to thermal stress was studied by SDS-PAGE analysis of 35[S]
      methionine labelled cellular proteins. Exposure of cultured human malignant cells
      to thermal stress (43 degrees C) resulted in a significant increase in activity
      of high affinity GTPase in the membranes (P < 0.001). This response to heat shock
      was inhibited by prior exposure of the cells to nanogram concentrations of
      pertussis toxin, suggesting the involvement of G-proteins in mediating heat shock
      response. To characterize this G-protein dependence further, we assayed thermal
      stress stimulated high affinity GTPase activity in cells pretreated with antisera
      (AS/7) raised against a synthetic peptide corresponding to the last 10 amino
      acids of alpha-subunit of inhibitory G-protein (Gi). A partial reduction in heat
      shock induced stimulation of GTPase activity was observed in the presence of this
      antisera. The pertussis toxin treated cells did not show induction of heat shock
      proteins in response to thermal stress.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780831
TI  - Alteration of glutathione, glutathione S-transferase and lipid peroxidation in
      mouse skin and extracutaneous tissues after topical application of gasoline.
AB  - The skin is the major environmental interface of the human body and is repeatedly
      exposed to a broad array of exogenous chemicals potentially capable of causing
      toxicity. In the present study we have applied 3, 6 or 12 ml leaded gasoline/kg
      body weight to the skin of adult male Swiss mice for 7 consecutive days and then
      sacrificed the animals on 8th day after an overnight fast. Glutathione (GSH)
      concentration, lipid peroxidation and other GSH-dependent enzyme activities were
      measured in skin, liver, brain and blood tissues of the mice. Topical application
      of 12 ml/kg gasoline caused a significant increase in water consumption by the
      animals, although, their body weight and food consumption was not significantly
      affected. A 40-60% decrease in blood concentration of glucose, triglyceride, and
      cholesterol was also observed after the treatment. The hemoglobin concentration,
      GSH content, lipid peroxidation and glucose 6-phosphate dehydrogenase activity of
      erythrocytes were not significantly affected by the gasoline treatment. However,
      a decrease in GSH concentration (16-21%), lipid peroxidation (30-60%) and
      glutathione S-transferase (GST) activity (30-40%) was observed in skin, liver and
      brain after gasoline application. Western blot analysis of tissues using
      antibodies against GST isoenzymes demonstrated an alteration in the expression of
      various GST isoenzymes after gasoline treatment. Our results suggest that topical
      exposure of gasoline causes some deleterious effects on skin and extracutaneous
      tissues.

PMID- 7780832
TI  - Induction of cytochrome P-450 isoenzymes in cultured monkey hepatocytes.
AB  - The effect of phenobarbital (PB), beta-naphthoflavone (beta-NF) and rifampicin
      (Rif) on the drug-metabolizing activity of cultured squirrel monkey hepatocytes
      was examined. The drug metabolizing activity (e.g. alkoxycoumarin dealkylase or
      steroid hydroxylase) gradually decreased during the culture period with 40-70%
      activity remaining at 72 hr. When 0.5 mM PB was added to the culture, the
      activities of 7-methoxycoumarin O-demethylase (MCOD) and 7-ethoxycoumarin O
      deethylase (ECOD) increased to 6-7 fold higher level than those of control at 72
      hr. Testosterone 6 beta-hydroxylase (6 beta-OH-T) and testosterone 16 beta
      hydroxylase (16 beta-OH-T) activities were approx. 3-fold higher than those of
      the control. Addition of beta-NF significantly increased the activities of 7
      ethoxyresorufin O-deethylase (EROD) and ECOD. Though statistically insignificant,
      Rif slightly increased 6 beta-OH-T activity. Western blot analysis indicated PB
      induced production of the CYP 2B and 3A subfamilies, while beta-NF and Rif
      induced that of the CYP 1A and the CYP 3A subfamily, respectively.

PMID- 7780834
TI  - Comparison of the effects of a range of dietary lipids upon serum and tissue
      lipid composition in the rat.
AB  - Since the type of fat consumed in the diet may play a role in the development of
      several disorders, it is important to ascertain the effects of different dietary
      fats upon parameters such as serum lipid levels and adipose deposition. The aim
      of this study was to determine the effects of feeding rats a range of fats with
      differing fatty acid compositions. Weanling male rats were fed for 10 weeks on a
      low fat (LF) diet or on one of five high fat diets, which contained 20% by weight
      of either hydrogenated coconut oil (HCO), olive oil (OO), safflower oil (SO),
      evening primrose oil (EPO) or menhaden (fish) oil (MO). Food intake, animal
      growth, tissue weights at sacrifice, serum and liver lipid concentrations and
      serum, heart, brain and adipose tissue fatty acid compositions were studied. The
      food intake of the LF-fed animals was greater than that of animals fed on the
      high fat diets; there were no differences in food intake between animals fed the
      high fat diets. The total energy intake was lower for animals fed on the HCO diet
      than for those fed on the LF, OO, EPO or MO diets; there were no other
      differences in energy intake between the groups. Animals fed the different diets
      had almost identical rates of weight gain up to 5 weeks; after this period of
      rapid growth, the increase in weight was slower in all groups but especially in
      the LF-fed animals. The LF-fed rats had a lower total weight gain and smaller
      final weights than rats fed on the high fat diets. Animals fed on the MO diet had
      a greater weight gain than those fed on the OO or EPO diets and their final
      weights were greater. The MO diet resulted in greatly increased liver weight
      compared with each of the other diets. The HCO, OO and EPO diets also increased
      liver weight compared with the LF diet. The total lipid content of the livers
      from rats fed the high fat diets was greater than that of those from rats fed the
      LF diet; the livers from animals fed the MO diet contained more lipid than those
      from animals fed each of the other diets. MO feeding increased the free
      cholesterol, cholesterol ester and triacylglycerol contents of the
      liver.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7780833
TI  - Arginine and ornithine metabolizing enzymes in testosterone-induced hypertrophic
      mouse kidney.
AB  - Administration of testosterone to female mice causes hypertrophy of their kidneys
      with spectacular induction of ornithine decarboxylase and significant increase in
      the level of putrescine. We tried to find out whether testosterone treatment
      affects also the renal activities of enzymes participating in the formation and
      utilization of ornithine, specifically arginase and ornithine aminotransferase,
      and whether they are dependent on putrescine level. Swiss, CFW, DBA2 or F1 (CFW x
      DBA2) female and male mice were injected with testosterone (125 mg/kg) or CB 3717
      (100 mg/kg). DFMO was applied in the drinking water. The activities of the
      enzymes were determined 24 hr or 5 days after administration of CB 3717 or
      testosterone, respectively. Renal activities of ornithine decarboxylase (ODC),
      arginase and ornithine aminotransferase (OAT) were found to be sex
      differentiated. The highest activity of ODC was characteristic for the kidneys of
      males, whereas those of arginase and OAT for the kidneys of females. In the
      kidneys of testosterone-treated female mice a decrease (50%) of OAT, and a
      significant increase of arginase activities (up to 200%), were observed. In the
      males these changes were less pronounced. DFMO, which completely inhibited the
      activity of renal ODC, did not influence significantly the testosterone-induced
      arginase and the testosterone-decreased OAT. Arginase and OAT, in contrast to
      ODC, were not changed in CB 3717-induced hyperplastic kidney. The study showed
      testosterone-induced differential changes in the activity of two enzymes involved
      in ornithine biosynthesis and catabolism which accompanied ODC induction in
      female mouse kidney.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7780835
TI  - Factors affecting the stability of the renal sodium/phosphate symporter during
      its solubilization and reconstitution.
AB  - Phosphate is reabsorbed across the brush-border membrane of the proximal tubule
      by a specific sodium-dependent symporter. Like the other brush-border membrane
      transport proteins of the kidney, the phosphate carrier remains to be isolated in
      a functional state. To establish a set of parameters that allow to preserve its
      biological activity, the phosphate carrier was solubilized under systematically
      varied conditions and reconstituted into proteoliposomes. Successful
      reconstitution was achieved only when the extraction buffer contained lipids
      extracted from the renal brush-border membrane. Glycerol, an osmolyte which
      reduces the water activity of the solution, was also required. It could however
      be replaced by 150 mM sodium or potassium phosphate. Below this concentration and
      in the presence of glycerol, the ionic strength of the solution had little effect
      on the stability of the transporter, but sodium phosphate could not be replaced
      by sodium chloride. Phosphate transport in reconstituted vesicles depended on the
      concentration of detergent and pH of the extraction buffer. Finally, transport
      activity was increased when solubilization was carried out in the presence of a
      reducing agent, dithiothreitol. These results should be helpful during the
      purification and further characterization of the renal phosphate symporter.

PMID- 7780836
TI  - Presence of Vicia graminea lectin- or Vicia unijuga lectin-binding (Vgu)
      glycoproteins, Vgu glycoproteins with Thomsen-Friedenreich (T) activity and T
      active glycoproteins in human meconium.
AB  - Perchloric acid-soluble fraction prepared from a mixture of meconiums of 22
      newborn babies was subjected to a systematic affinity chromatography using Vicia
      unijuga lectin-Cellulofine column and Arachis hypogaea lectin-Agarose column and
      separated into four fractions, Vgu glycoprotein, Vgu glycoprotein with T
      activity, T-active glycoprotein and another glycoprotein fractions. HPLC analysis
      showed that the first fraction contained three glycoproteins with molecular
      weight (Mw) of about 19,400 kDa, 5500 kDa and 1900 kDa, the second fraction
      consisted of two glycoproteins with Mw of about 460 kDa and 150 kDa and the third
      fraction composed of several glycoproteins including the main glycoprotein with
      Mw of about 11,700 kDa.

PMID- 7780837
TI  - Nursing challenges in the care of very low birth weight infants (< 1,000 grams).
AB  - It is not unusual for neonates to be born before the 24th week of gestation and
      weigh less than 1,000 g. These neonates are surviving to be transferred to a
      tertiary care center, and many are discharged eventually to home. When one
      considers that these infants are only "half developed" by the standard 40-week
      gestational period, it is understandable that the challenges for nurses caring
      for them are enormous. In this article, the authors review gestational
      development and the critical care needs of this special neonatal population.

PMID- 7780838
TI  - Consequences of perinatal asphyxia.
AB  - Perinatal asphyxia occurs in 3-9 of every 1,000 births. The risk for perinatal
      asphyxia is present in every pregnancy. When asphyxia is diagnosed in a newborn,
      the effects on the infant are potentially life-threatening. Management of the
      asphyxia focuses on initial stabilization and support based on identified organ
      system dysfunction as well as support for the infant's family. Long-term outcome
      for the asphyxiated infant is related to the degree, duration, and resolution of
      organ system dysfunction.

PMID- 7780839
TI  - Liquid ventilation: it's not science fiction anymore.
AB  - Liquid ventilation is, by all initial considerations, an unconventional concept.
      Decades of research, however, have found that by using perfluorocarbons, which
      are capable of holding high concentrations of critical gases such as oxygen and
      carbon dioxide, gas exchange optimal enough to support life is possible with no
      known toxic effects. The earliest method of liquid ventilation, tidal liquid
      breathing, involved infusion and active removal of tidal volumes of
      perfluorocarbons by a liquid ventilator for gas exchange. Recently, a new method
      of partial liquid breathing, called perfluorocarbon-associated gas exchange,
      makes the process of liquid ventilation simpler by using conventional gas
      ventilators. Current research is showing great promise in the use of liquid
      ventilation for patients with pulmonary pathology. Critical care nurses should
      become knowledgeable of this new mode of ventilation and be prepared to meet the
      special needs of this unique population.

PMID- 7780840
TI  - Perioperative management of pulmonary circulation in children with congenital
      cardiac defects.
AB  - Congenital cardiac defects and the clinical symptoms they exhibit are affected
      intimately by the relation they have with pulmonary circulation. Cardiac lesions
      that increase pulmonary blood flow often occur clinically with signs and symptoms
      of congestive heart failure, including hepatomegaly, tachycardia, diaphoresis,
      and feeding difficulties. However, in the neonatal period, pulmonary vascular
      resistance often remains elevated, decreasing the pulmonary blood flow and,
      therefore, severity of symptoms. Cardiac lesions that reduce pulmonary blood flow
      often manifest early in life with clinical signs and symptoms of cyanosis,
      tachypnea, and acidosis. Finally, cardiac lesions that result in isolated
      pulmonary blood flow manifest immediately in the neonatal period, with profound
      cyanosis and acidosis. In all three groups of cardiac anomalies, critical care
      nurses play a key role in the control of pulmonary vascular resistance and blood
      flow by collaborating in therapies designed to increase, decrease, or promote
      mixing to reduce morbidity and mortality.

PMID- 7780841
TI  - Current controversies in pediatric transplantation.
AB  - Transplantation in children has become a therapeutic option for several end stage
      organ diseases. The kidney, liver, and heart are the most common organs'
      transplanted; however, an increasing number of children are undergoing successful
      intestine, lung, and multiple organ transplant combinations. Through case study
      reports, emerging transplant options for the child experiencing end stage liver,
      intestine, heart, and lung failure are described. Critical care nurses play a
      crucial role in the postoperative recovery of these patients. An understanding of
      the transplant process and consequences of immunosuppression will help the
      critical care nurse identify signs of rejection, infection, and posttransplant
      lymphoproliferative disease.

PMID- 7780842
TI  - Meningococcemia: recognizing and reducing complications in pediatric patients.
AB  - Meningococcemia is a true infectious emergency that requires tremendous skill and
      collaboration among health-care professionals to reduce the high morbidity and
      mortality associated with this disease. Complications and sequelae may effect
      virtually every body system with meningococcal disease. The critical care nurse
      plays a crucial role in preventing and recognizing complications to reduce
      serious consequences, including respiratory distress syndrome, myocarditis,
      cardiovascular collapse, coagulopathies, major skin loss, and limb amputations.

PMID- 7780843
TI  - Visitation in the pediatric intensive care unit: controversy and compromise.
AB  - Much controversy has arisen in the last few decades regarding parental and family
      visitation in the intensive care setting. The greatest needs of parents while
      their child is in an intensive care unit include: to be near their child, to
      receive honest information, and to believe their child is receiving the best care
      possible. The barriers that exist to the implementation of open visitation mostly
      are staff attitudes and misconceptions of parental needs. Open visitation has
      been found in some studies to make the health-care providers' job easier,
      decrease parental anxiety, and increase a child's cooperativeness with
      procedures. To provide family-centered care in the pediatric intensive care unit,
      the family must be involved in their child's care from the day of admission. As
      health-care providers, the goal is to empower the family to be able to advocate
      and care for their child throughout and beyond the life crisis of a pediatric
      intensive care unit admission.

PMID- 7780844
TI  - AACN--SCCM Health Care Ethics Forum '94. Arlington, Virginia, March 1994.
      Proceedings.

PMID- 7780845
TI  - HealthCare Ethics Forum '94: health-care reform and clinical ethics: old values
      for new times.

PMID- 7780846
TI  - HealthCare Ethics Forum '94: ethical care from the patient's perspective.

PMID- 7780847
TI  - HealthCare Ethics Forum '94: ethics committees: living up to your potential.

PMID- 7780848
TI  - HealthCare Ethics Forum '94: organ transplantation and donation.

PMID- 7780849
TI  - HealthCare Ethics Forum '94: ethical challenges in the critically ill: use of
      restraints.

PMID- 7780850
TI  - HealthCare Ethics Forum '94: euthanasia and assisted suicide: critical care
      perspectives.

PMID- 7780852
TI  - HealthCare Ethics Forum '94: caregiver distress: if it is so ethical, why does it
      feel so bad?

PMID- 7780851
TI  - HealthCare Ethics Forum '94: advance directives: the critical challenges.

PMID- 7780853
TI  - HealthCare Ethics Forum '94: perspectives on withholding and withdrawal of life
      support.

PMID- 7780854
TI  - HealthCare Ethics Forum '94: pain management and sedation in the terminally ill.

PMID- 7780855
TI  - HealthCare Ethics Forum '94: medical futility: a bedside perspective.

PMID- 7780856
TI  - The midlevel practitioner role: one medical center's experience.
AB  - Numerous trends in the current health-care environment have converged to produce
      an increased emphasis on the role of the midlevel practitioner. Financial
      constraints head the list, including a mandate for the best care at the lowest
      rates and a resulting shift from costly specialists to primary care providers.
      The desire to conserve human and technologic resources requires a practitioner
      with advanced knowledge and skills to serve as gatekeeper in terms of
      facilitating access to health care, establishing efficient referral patterns, and
      developing a holistic care plan. The midlevel practitioner also is prepared to
      facilitate the transition from the intensive care unit to the less costly general
      care areas. In addition, the inevitable reduction in funds for graduate medical
      education and the dwindling number of first-year medical students choosing
      internal medicine as a specialty threaten the ability of academic medical centers
      in particular to provide adequate housestaff coverage to full-time and voluntary
      faculty members. Physicians eager to provide efficient, seamless care to patients
      in the acute care setting, while maintaining an office practice and caseloads at
      several hospitals, find the support provided by a midlevel practitioner an
      enhancement to their clinical practice and a solution to the continuous
      management of acute and chronically ill patients. In this article, the authors
      describe one medical center's experience in implementing the midlevel
      practitioner role.

PMID- 7780857
TI  - Implementation of the acute care nurse practitioner role.
AB  - In this article, the experiences of two new acute care nurse practitioners
      working at the University of Pittsburgh Medical Center are described. Included
      are the experiences they encountered in initiating the role and some of the
      responsibilities they assumed.

PMID- 7780858
TI  - No-effect level of subacute tetraethoxysilane inhalation on the mouse kidney.
AB  - To determine safe exposure levels of tetraethoxysilane (TEOS) in the kidney,
      groups of male ICR mice (SPF grade) containing 10 animals each were exposed to
      TEOS, 100 ppm or 50 ppm, for 6 hours/day, 5 days/week, for 2 or 4 weeks. Tubulo
      interstitial nephritis developed in mice exposed to 100 ppm for 2 and 4 weeks,
      but no kidney lesions or renal function changes were observed in mice exposed to
      50 ppm. However, histopathological changes were detected in the nasal mucosa of
      mice exposed to 50 ppm TEOS. These results indicate that the occupational
      exposure level for TEOS should be strictly maintained below the current
      recommended exposure limit, 10 ppm, set by many countries and academic
      associations, and that renal tubular function of TEOS-exposed workers should be
      assessed and monitored for a long period.

PMID- 7780859
TI  - Influence of different doses of methyl ethyl ketone on 2,5-hexanedione
      concentrations in the sciatic nerve, serum, and urine of rats.
AB  - Rats were injected subcutaneously with 2,5-hexanedione (2,5-HD 2.6 m mol/kg)
      alone (HD group) or with 2,5-HD and methyl ethyl ketone (MEK) (2.6 m mol/kg of
      each agent, HD&MEK group) or with 2,5-HD 2.6 m mol/kg and 5 times that dose (13.0
      m mol/kg) of MEK (HD&5MEK group). The concentration of 2,5-HD in serum and in the
      sciatic nerve was determined 0.5, 1, 2, 4, 8, and 16 h after administration.
      Urinary 2,5-HD concentration was determined from the beginning of administration
      up to 16 h afterward. 1) The concentration of 2,5-HD in the serum, the sciatic
      nerve, and the urine was increased significantly (p < 0.05) in the co
      administered groups; the higher the MEK doses were, the greater was the increase.
      2) The clearance of 2,5-HD from both the serum and the sciatic nerve was delayed
      in the co-administered groups. The highest concentration in serum and the sciatic
      nerve appeared at 1 and 2 h respectively. After administration, the biological
      halflife (t1/2) of 2,5-HD from 1 to 8 h in serum was 6.5, 5.8 and 12.0 h for the
      HD, HD&MEK, and HD&5 MEK groups respectively. From 8 to 16 h, the t1/2 in serum
      was 1.2, 3.2 and 16.6 h for the HD, HD&MEK, and HD&5MEK groups, respectively. In
      nerve tissue, the prolongation of clearance in the co-administered groups was
      greater than that in serum, the t1/2 from 2 to 8 h being 5.2, 9.6 and 19.9 h for
      the HD, HD&MEK, and HD&5MEK groups, respectively.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7780861
TI  - [The study of the relation between the working conditions and the prevalences of
      obesity, liver disorder and hyperlipidemia: evaluation of physiological
      examination data during the terms of car manufacturing work and car sales work].
AB  - To evaluate the relation between the working conditions and the workers' health,
      particularly the prevalences of obesity, liver disorder and hyperlipidemia, we
      analyzed physiological examination data and the questionnaire survey about life
      behaviors and working conditions during the terms of car manufacturing work and
      car sales work among 61 male subjects. In the physiological examination data,
      compared with the term of car manufacturing work, the values of body weight, body
      mass index (BMI), GOT, GPT, gamma-GTP, TG and T-CHO elevated and the prevalences
      of obesity and liver disorder increased during the term of car sales work. During
      the term of car sales work, the prevalences of alcohol drinkers and cigarette
      smokers increased and the changes of food intake behaviors were noted. It was
      estimated that the changes of food intake behaviors associated with the
      differences of working conditions contributed increasing number of obesity and
      liver disorder that was based on fatty liver caused by hyperlipidemia. These
      results of this study suggested that working conditions associated with the
      prevalences of obesity, liver disorder and hyperlipidemia were important to
      conduct the effective health education in the present occupational health
      administration.

PMID- 7780860
TI  - [Effectiveness of continuous good dental health cares contributing to 20 teeth
      retained].
AB  - This study was made to demonstrate what kinds of continuous care for dental
      health have teeth remained even at the elderly time. Questionnaires were mailed
      to 632 men retired from a company at the age of 60s or more, September-October in
      1992. Of 424 cases recovered (67.1%), 414 (97.6%) i.e., 185 cases at the age of
      60s, 172 of 70s, and 57 of over 80s, were subjected to analysis. All the subjects
      were classified into two groups. One is the group who has 20 teeth or more, the
      other having 19 teeth or less. Furthermore, each group was classified into three
      groups. The first group was no dental health care [DHC] group (group 1), the
      second one was starting DHC at the age of 20s or 30s (group 2), the third one was
      doing at the age of 40s or 50s (group 3). These groups were compared with each
      other group. Items related to dental health were developed by ourselves. Chi
      square test was done to prove the relationship between the starting time of
      continuous DHC and retention teeth of 20 teeth or more in the three age groups.
      The following three items related to dental health care may contribute
      significantly to retention teeth of 20 teeth or more at each age group, 1)
      changing to new brush every 2 or 3 months (p < 0.01), 2) making an effort to have
      hard foods (p < 0.01), 3) having calcium-rich foods (p < 0.05).

PMID- 7780862
TI  - [The effect of fixed night work on blood pressure of male bakery workers in a
      processing plant].
AB  - The effect of fixed night work on blood pressure was investigated for the 13 male
      bakery workers. All were on the fixed night duty for the first 5 years. The mean
      BP values of the subjects began to rise significantly from the 4th year. At the
      6th year, half of the subjects switched to working in shifts. After that, no
      increase in the mean BP values was seen in this group. Further increase in the
      values was observed in the other group on the night duty. However, a two-hour nap
      late at night prevented the rise of the mean BP values.

PMID- 7780863
TI  - Effect of pyrethroid (allethrin and fenvalerate) on excitability changes
      following nerve impulse.
AB  - Pyrethroid insecticides induce two different clinical symptoms. The difference
      has been reported to depend on the effect on the sodium channel opening time. We
      performed the present study to confirm this report by a double stimulation
      method. Allethrin (type I) 5 mg/kg and fenvalerate (type II) 1.5 kg/mg were
      injected into pentobarbital anesthetized rats. Tail nerve excitability was
      examined by a double stimulation method at from 4 msec to 40 msec intervals. The
      excitability was expressed as a percentage of the response to conditioned stimuli
      following supernormal stimuli to response to unconditioned stimuli. In control
      rats, the largest excitability was 94.6 +/- 19.2% at an 8 msec stimulus interval.
      After allethrin injection, we obtained two types of excitability changes. In some
      rats, supernormal excitability was present from 4 msec to 15 msec up to 120%. In
      other rats, the excitability was lower than that in the control from 4 msec to 15
      msec. In fenvalerate treated rats, there was supernormal excitability from 4 msec
      to 40 msec. The peak of excitability was 122.4 +/- 35.3% at 10 msec. By double
      stimulation methods, we obtained characteristic nerve excitability changes in
      allethrin and fenvalerate treated rats after symptoms disappeared. These results
      showed that it should be possible to detect human nerve subclinical changes
      following lower doses or during chronic exposure.

PMID- 7780864
TI  - A study on indices of body fat distribution for screening for obesity.
AB  - In order to screen high risk obesity groups for coronary heart disease, the
      relationships between certain body fat distribution indices and coronary risk
      factors (CRFs) were analyzed. Body circumference at various measuring points and
      skinfold thickness were measured in 938 male clerical workers, and some indices
      of body fat distribution were calculated. The results are as follows: (1) The
      body mass index (BMI) showed the highest correlation with systolic blood
      pressure, and skinfold thickness showed a high correlation with serum total
      cholesterol (TC) and LDL-cholesterol. (2) In body fat distribution indices, the
      waist/stature ratio (WSR) showed the highest correlation with CRF measurements,
      especially with serum triglyceride (TG) and diastolic blood pressure (DBP). (3)
      WSR showed the highest sensitivity and specificity for screening for abnormal
      hypertension groups TG and TC. (4) There were significant differences in the mean
      value for all CRF measurements between the high WSR group (> = 0.49) and the low
      WSR group (< 0.49), and the rates for high CRF persons in the high WSR group were
      almost twice those of the low WSR group. These results show that WSR is useful
      for the screening for obesity to prevent coronary heart disease.

PMID- 7780865
TI  - Have typewriter--will travel.

PMID- 7780866
TI  - The consensus report: is it ever the last word?

PMID- 7780867
TI  - From thrombolytic megatrials to clinical policy-making: facing the facts.

PMID- 7780868
TI  - Management of the postmyocardial infarction patient: a consensus report--revision
      of 1991 CCS guidelines.

PMID- 7780869
TI  - Can practice patterns and outcomes be successfully altered? Examples from
      cardiovascular medicine. The Clinical Quality Improvement Network (CQIN)
      Investigators.
AB  - OBJECTIVE: To offer an attributive opinion of recent improvements in acute
      myocardial infarction (AMI) practice patterns and patient outcomes in the culture
      of an active health care research program. DATA SOURCES: Review of original
      clinical data from five sequential, consecutively enrolled, AMI patient cohorts
      at the University of Alberta Hospitals from 1987-93. DATA SYNTHESIS: Early
      cohorts had low use of trial-proven efficacious therapies for AMI, particularly
      among high risk older and female patients. Over time, there were continuous and
      marked increases in the use of efficacious therapies and decreased use of
      nonefficacious therapies, with a parallel decrease in mortality among high risk
      patients. CONCLUSIONS: In a large tertiary care hospital between 1987 and 1993
      the use of evidence-based AMI therapy and survival in high risk patients
      significantly increased. The continuity and large size of these improvements in
      AMI practice patterns, compared with similar populations reported in the
      contemporary literature, suggest it is unlikely they were due to chance. Rather,
      intercurrent repeated measurement and reporting of key health care performance
      indicators, and initiation of explicit critical path AMI practice guidelines
      provide a more likely explanation. Future studies by a network of community and
      university investigators will test whether these findings are true for a broad
      AMI population and whether similar practice definition and improvement tools are
      effective for other cardiac problems, including the management of congestive
      heart failure.

PMID- 7780870
TI  - Evaluation of the reproducibility and accuracy of apex beat measurement in the
      detection of echocardiographic left ventricular dilation.
AB  - OBJECTIVE: To develop a standardized method for measuring the width of the apex
      beat and to determine its precision and accuracy in detecting
      echocardiographically determined left ventricular dilation. DESIGN: In the
      reproducibility study, two cardiologists blinded to each other's findings
      measured the apex beat. To determine accuracy, blind, independent assessment of
      apex beat measurement was compared with left ventricular enlargement determined
      by echocardiogram. PATIENTS: One hundred and four patients referred for
      echocardiogram for a wide variety of suspected cardiac abnormalities.
      MEASUREMENTS: The apex beat was measured with patients in a 45 degrees left
      lateral decubitus position; medial and lateral aspects of the impulse and the
      width were identified using electrocardiographic callipers. Echocardiographic
      left ventricular dilation was defined as a measure exceeding the 95% prediction
      limits as determined for the patient's age and body surface area. RESULTS: The
      intraclass correlation measuring agreement on apex beat size between two
      cardiologists in 13 patients was 0.95. Of the 104 patients, 57 had a measurable
      apex beat of whom 50 had a technically adequate echocardiogram. The sensitivity
      of the measurement, using a cut-point of 40 mm, was 0.48 and the specificity
      0.96.

PMID- 7780871
TI  - Nonrheumatic atrial fibrillation: a brief overview.
AB  - OBJECTIVE: To review the effectiveness of current approaches in the treatment of
      patients with nonrheumatic atrial fibrillation (NRAF). DESIGN: Review of the
      available English-language articles on the epidemiology, clinical consequences,
      management and prevention of stroke in patients with NRAF. RESULTS: The incidence
      of atrial fibrillation increases steadily in both sexes in relation to age. The
      clinical independent risk factors for NRAF are diabetes mellitus, hypertension,
      recent heart failure, valvular heart disease and myocardial infarction. The
      echocardiographic predictors are left atrial enlargement, reduced left
      ventricular function and left ventricular wall thickness. The clinical
      consequences of NRAF are increased risk of stroke, mortality and left ventricular
      dysfunction. The management of NRAF includes correction of cause, termination of
      acute episode, maintenance of sinus rhythm, ventricular rate control and
      prevention of systemic embolism. CONCLUSION: NRAF is a common cardiac arrhythmia
      that is associated with high incidence of mortality and systemic embolism.
      Anticoagulation is effective in preventing embolism with acceptable risk of major
      bleeding. Acetylsalicylic acid is less effective but a reasonable alternative
      when anticoagulation is contraindicated.

PMID- 7780872
TI  - 2,3-Butanedione monoxime preserves coronary artery endothelium-dependent
      relaxation during myocardial ischemia in the isolated rat heart.
AB  - OBJECTIVE: To evaluate the potential benefit of 2,3-butanedione monoxime (BDM) in
      preserving endothelium-dependent coronary artery relaxation during myocardial
      ischemia. MATERIALS AND METHODS: Langendorff-perfused rat heart model.
      Endothelium-dependent and independent relaxations were tested with infusion of 5
      hydroxytryptamine (10(-6) mol/L) and sodium nitroprusside (10(-5) mol/L),
      respectively. Four groups of hearts (n = 6) were used. Group 1 was perfused with
      BDM (25 mmol/L) without ischemia for 30 mins. Group 2 was perfused for 10 mins
      with BDM and exposed to 30 mins of no flow ischemia (37 degrees C). Group 3 was
      perfused with cold (4 degrees C) nonoxygenated BDM (30 mins) and group 4
      (control) was exposed to 30 mins of no flow ischemia alone. Left ventricular
      pressure (LVP), left ventricular pressure first derivative (dP/dt) and coronary
      basal flow were evaluated before treatment and after 30 mins of reperfusion.
      RESULTS: BDM perfusion alone (group 1) did not affect coronary reactivity.
      Preservation of endothelium-dependent and -independent relaxation was
      significantly enhanced after ischemia in groups 2 and 3 (BDM-treated) compared
      with group 4 (control). No significant benefit was found regarding LVP and dP/dt
      in all groups. Postreperfusion coronary flow was decreased in all hearts except
      the controls (group 4), suggesting a residual BDM intrinsic effect on coronary
      flow. CONCLUSION: These experiments suggest that BDM can enhance preservation of
      coronary artery endothelium-dependent and -independent relaxation during
      myocardial ischemia in the isolated rat heart.

PMID- 7780874
TI  - Evaluation of MI therapy at a Canadian tertiary hospital.

PMID- 7780875
TI  - World Conference on Hypertension Control. Ottawa, Canada, June 21-24, 1995.
      Abstracts.

PMID- 7780873
TI  - Successful treatment of heparin-associated thrombocytopenia and thrombosis using
      Hirulog.
AB  - Heparin-associated thrombocytopenia is a serious medical problem, especially when
      the patient requires continued anticoagulation. Hirulog is an immediate-acting
      intravenous anticoagulant that can be substituted for heparin. A new use of
      Hirulog in the treatment of life-threatening heparin-associated thrombocytopenia
      with thrombosis (HATT) is presented. Two patients suffering from the HATT
      syndrome were successfully treated with Hirulog to prevent further thrombosis. A
      third patient had developed heparin-associated thrombocytopenia after coronary
      artery bypass surgery in the past and was subsequently treated with Hirulog
      during a peripheral angioplasty procedure. Hirulog was an effective and
      predictable anticoagulant for these patients and was free from adverse effects.

PMID- 7780876
TI  - How to reduce the risk factors of osteoporosis in Asia.
AB  - Osteoporosis can be predicted to be a new burden to public health in Asia.
      Currently, the incidence of osteoporosis-related fractures is lower there than in
      most western communities. By the year 2050, however, 50% of the 6.3 million hip
      fractures which occur worldwide will be in Asians as a result of an aging
      population, a decrease in physical activity and westernization of lifestyles. The
      cost of treatment and cure of these patients will be enormous, a sufficient
      financial burden to consume current economic gain and cripple the future
      advancing development of Asian countries. Individual risk factors for
      osteoporosis have been identified by the extensive Mediterranean Osteoporosis
      Study (MEDOS). Fortunately, Asians, the rural population and farmers in
      particular, have the favorable lifestyle identified by the study, including high
      physical activity and exposure to sunlight. Strikingly, tea drinking, a daily
      habit in Asia, is also identified as a protective factor against osteoporosis. In
      addition, bioflavonoids and phytoestrogen-rich soybeans and vegetables are
      consumed in large quantities by Asians. A soy diet reduces mortality in breast
      and prostate cancer because it contains weak estrogens. The weakly estrogenic
      phytoestrogens require further study to demonstrate their pharmacological effect
      in reducing the rate of osteoporosis. Public health education, however, is needed
      to encourage the Asian population to maintain their traditionally good lifestyle
      and to reduce the risk factors for osteoporosis. In turn, these steps may reduce
      the public health burden by 2050.

PMID- 7780877
TI  - Detection of antibody to M2 mitochondrial antigen in Chinese patients with
      primary biliary cirrhosis.
AB  - BACKGROUND: Antimitochondrial antibodies (AMA) are present in more than 90% of
      patients with primary biliary cirrhosis (PBC). However, AMA are not specific for
      PBC; they can be observed in nonhepatic disease. It has been reported that
      antibody of M2 mitochondrial antigen (anti-M2) is specific for PBC. The aim of
      the present study is to clarify the role of anti-M2 in the diagnosis of PBC.
      METHODS: Sera from 27 patients with PBC, 62 normal subjects, 18 patients with
      chronic hepatitis B and 30 patients with chronic hepatitis C were obtained for
      the detection of anti-M2 and AMA. The anti-M2 assay was performed by enzyme
      immunoassay (EIA) and the AMA test was performed by indirect immunofluorescent
      method. RESULTS: Twenty-four (88.9%) of the serum specimens from the patients
      with PBC and one (0.9%) of the 110 serum specimens from the non-PBC groups were
      positive for AMA. In contrast, twenty-five (92.6%) of the 27 PBC sera and five
      (4.5%) of the 110 non-PBC sera were positive for anti-M2. Most of the PBC sera
      contained high titers of anti-M2 and all the false-negative specimens disclosed
      low titers of anti-M2. CONCLUSIONS: Although the anti-M2 assay used in the
      present study seemed not superior to the conventional AMA test in the sense of
      specificity, it had the advantage of being able to provide quantitative results.
      Since the presence of high titer anti-M2 is very specific for PBC, this assay may
      have a role in the diagnosis of equivocal PBC.

PMID- 7780879
TI  - An appraisal of dipyridamole thallium imaging-detected ischemia in Chinese
      following acute myocardial infarction.
AB  - BACKGROUND: The detection of objective myocardial ischemia is an important work
      up of risk stratification for survivors of acute myocardial infarction (MI).
      Intravenous dipyridamole thallium scintigraphy was used to identify the
      prevalence and prognostic value of silent myocardial ischemia (SI) at the early
      stage in patients after MI. METHODS: Ninety patients (male/female = 87/3; aged
      from 36 to 70 years) who succumbed to an episode of MI was recruited in this
      prospective study. Thallium imaging with reversible or combined defect was
      defined as presence of SI (Group I), while those with fixed defects or normal
      images were defined as absence of SI (Group II). Correlation between the patterns
      of thallium images for postinfarct ischemia and the angiographic lesions was
      investigated. Also, versatile clinical variables and indexes of adverse cardiac
      events: unstable angina, CHF, reinfarction, ventricular tachyarrhythmia and
      sudden death, were evaluated for their influence on patients' prognosis. The
      average follow-up was 11.6 months. RESULTS: There were 61 patients in the Group I
      as compared with 29 patients in the Group II. The difference of Killip functional
      classification between Group I and Group II patients was not significant (1.33 +/
      0.72 versus 1.07 +/- 0.59). Adverse cardiac event occurred in 30% (27/90) of the
      patients during follow-up. Cardiac death occurred in 6 cases (7%) and were
      distributed evenly (3 versus 3) in both groups. Group I patients showed a higher
      number of nonfatal reinfarctions (8 versus 5) and had more cases of percutaneous
      coronary angioplasty (11 versus 8) than Group II patients. Only two cases in
      Group I underwent bypass graft surgery. There was no statistic difference among
      four patterns of thallium image in the cumulative event-free survival curve.
      Prior history of CHF, prior MI and higher score index of proximal arterial
      stenosis were the three significant prognostic predictors for late cardiac
      events. CONCLUSIONS: Dipyridamole thallium imaging-detected SI was frequently
      seen in the Chinese patients following AMI. It was less valuable than prior
      histories of CHF, prior MI and higher index of proximal arterial stenosis scores
      in predicting the short-term unfavorable cardiac events in these patients. A
      large scale analysis and longer follow-up might be required to more accurately
      determine the role of this exam for the Chinese victims of myocardial infarction.

PMID- 7780878
TI  - Polyethylene glycol method is superior to ammonium sulfate and protein-A
      sepharose-4B method in fractionating thyroid stimulating immunoglobulin in
      Graves' disease.
AB  - BACKGROUND: The purpose of this study is to compare the performance of three
      methods, i.e., ammonium sulfate, polyethylene glycol (PEG) and protein A
      sepharose 4B in fractionation of thyroid stimulating immunoglobulin. METHODS:
      Twelve patients with Graves' disease and twelve age-, sex-matched normal controls
      were recruited. 0.9 ml of saturated ammonium sulfate was added slowly to 1.1 ml
      of sera of all subjects and was stirred until reaching 45% saturation. The
      precipitation was allowed to form at 4 degrees C overnight. The solution was
      centrifuged at 10,000 x g for 5 minutes. The precipitate was washed twice with
      45% ammonium sulfate, dissolved in 0.55 ml of distilled water equal to half of
      the initial volume of the serum and dialyzed against 200 volumes of phosphate
      buffered saline (PBS) for 48 hours. Another 0.5 ml of serum sample from the same
      patients was mixed with 1.5 ml of 20% polyethylene, followed by centrifugation at
      2,800 g for 20 minutes. The pellet was dissolved in 0.6 ml of Hanks' medium
      without NaCl containing 1.5% bovine serum albumin, 20mM HEPES: 1 ml of sera was
      applied to 0.75 g of protein A sepharose-4B in PBS buffer and eluted with
      glycine, pH 2.3. By adding immunoglobulin (Ig) from the different methods to the
      FRTL-5 tissue culture, we determined the cAMP generation. RESULTS: Patients with
      Graves' disease were found to have higher serum thyroxine and triiodothyronine
      concentrations (p < 0.001) and significantly higher free thyroxine concentration
      than normal subjects. Ig elicited stronger response in cyclic AMP generation when
      prepared with PEG method, as compared with the other two methods (p < 0.001).
      With sepharose-4B Ig preparation, 10 out 12 patients (83.33%) showed positive
      thyroid stimulating immunoglobulin (TSI) while with ammonium sulfate
      precipitation, nine out 12 patients (75%) showed positive TSI. On the other hand,
      all patients showed positive TSI with PEG precipitation. When the degree of
      thyrotoxicosis was classified in terms of thyroid hormone concentrations, there
      was no correlation between TSI titers and thyroid hormone concentration.
      CONCLUSIONS: Polyethylene glycol is superior to both ammonium sulfate and protein
      A sepharose-4B in fractionating TSI in terms of sensitivity and convenience in
      operation.

PMID- 7780880
TI  - Use of a low profile Doppler angioplasty guidewire to evaluate the effect of
      percutaneous coronary angioplasty on coronary artery flow velocity.
AB  - BACKGROUND: The intracoronary Doppler flow velocity measurement is widely used.
      The Doppler flow catheter, used in many studies, still cannot always measure
      distal portions of coronary artery stenosis. However, three years ago, a low
      profile Doppler angioplasty guide wire (0.018-inch) was started by apply for
      measurement of changes in proximal and distal flow velocity during coronary
      angioplasty. METHODS: Blood flow velocity and diastolic/systolic velocity ratio
      (DSVR) on both proximal and distal portions of the coronary artery were measured
      with a low profile Doppler angioplasty guide wire in 13 patients with stenosis of
      the left anterior descending artery (LAD) during coronary angioplasty. RESULTS:
      Non-significant improvement in maximal peak velocity was noted in the distal
      portion of the coronary artery immediately after angioplasty (before, 36 +/- 12
      cm/s; after, 41 +/- 12 cm/s; p > 0.05); but significant improvement was found
      after removal of the balloon (from 41 +/- 12 cm/s to 49.5 +/- 15 cm/s, p < 0.01).
      Increases in proximal maximal peak velocity after angioplasty were less
      remarkable (before, 38.5 +/- 15 cm/s; after, 45 +/- 13 cm/s; p > 0.05), and there
      was a significant increase of DSVR on the distal portion of the left anterior
      descending artery after angioplasty (before, 2.18 +/- 0.51; after, 2.98 +/- 0.44;
      p < 0.05). However, there was no significant increase of DSVR on the proximal
      portion of LAD (before, 2.19 +/- 0.16; after, 2.44 +/- 0.1; p > 0.05). The
      coronary flow reserve ratio showed no significant increase on the distal portion
      of the LAD (before, 1.03 +/- 0.3; after, 1.02 +/- 0.3) and proximal portion of
      LAD (before, 1.05 +/- 0.2; after, 1.03 +/- 0.3). CONCLUSIONS: Increase in peak
      velocity and DSVR of the distal portion of the coronary artery after angioplasty
      was more significant after removal of the balloon catheter than as if it were
      assessed immediately, without removing the balloon catheter. No significant
      increase in flow velocity of the proximal portion of the coronary artery after
      angioplasty was observed. No significant increase of the coronary flow reserve of
      the distal and proximal portion of the coronary artery occurred after successful
      angioplasty.

PMID- 7780881
TI  - Does coronary artery disease with stressed myocardial ischemia alter heart rate
      variability?
AB  - BACKGROUND: Research has shown that decreased heart rate variability (HRV) is
      independently associated with increased mortality after acute myocardial
      infarction. However, the relationship between HRV and myocardial ischemia still
      remains controversial. The purposes of this study were (1) to determine the
      relationship between HRV and atherosclerosis of the coronary artery; and (2) to
      determine the relationship between HRV and the extent of coronary stenosis in
      patients with stressed myocardial ischemia. METHODS: Forty-six patients, 41 males
      and 5 females, were included in this study. Ages ranged from 50 years to 79
      years. Seventeen volunteers served as the control group, which was comprised of
      15 males and 2 females of ages ranging from 40 years to 74 years. For each
      patient a left ventriculogram and a coronary angiogram were performed. According
      to their coronary angiograms, patients were divided into normal coronary artery
      group, atherosclerotic coronary artery group and significant coronary artery
      disease group. An ambulatory EKG was performed on each patient and volunteer.
      Heart rate variability was defined as SDNN, SDANN, rMSSD, and pNN50 in time
      domain measures; and low and high frequency in frequency domain measures.
      RESULTS: There were no significant differences in all variables of heart rate
      variability between the atherosclerotic coronary artery group and normal coronary
      artery group. In addition, there were no significant differences in all variables
      between the significant coronary artery disease group and the control group or
      between the significant coronary artery disease group and the normal coronary
      artery group. CONCLUSIONS: These studies have shown that atherosclerotic or
      significant coronary artery disease with stressed myocardial ischemia does not
      impair 24-hour heart rate variability.

PMID- 7780882
TI  - Clinical distinction between acute hemorrhagic and acute ischemic stroke by
      Siriraj stroke score.
AB  - BACKGROUND: The clinical distinction between hemorrhagic and ischemic stroke
      cannot be achieved by simple clinical evaluation, and it is impossible to submit
      all stroke patients to computed tomography. A simple, reliable, and safe
      diagnostic tool for acute stroke syndrome is needed. This study tested the
      Siriraj stroke score to verify its accuracy for distinguishing among the
      pathological subtypes of stroke. METHODS: This study included the one hundred and
      seventy-one patients with acute supratentorial stroke syndromes consecutively
      admitted to the Emergency Room of the Taichung Veterans General Hospital from
      April 1 to September 30, 1993. The Siriraj stroke score was calculated, then
      compared with results of computed tomography. The Siriraj stroke score was
      calculated as (2.5 x level of consciousness) + (2 x vomiting) + (2 x headache) +
      (0.1 x diastolic blood pressure) - (3 x atheroma markers) - 12. A score above 1
      indicates supratentorial intracranial hemorrhage, while a score below -1
      indicates infarction. The score between 1 and -1 represents an equivocal result
      needing further evaluation to verify diagnosis. RESULTS: The diagnostic
      sensitivities of the Siriraj stroke score for intracranial hemorrhage and
      infarction were 85% and 90% respectively, with an overall predictive accuracy of
      88.5%. When three cases with subarachnoid hemorrhage whose scores were all above
      1 were excluded, the sensitivities for cerebral hemorrhage and infarction were
      83.8% and 90% respectively, with an overall predictive accuracy of 88.2%.
      CONCLUSIONS: The Siriraj stroke score can be used as a reliable bedside method
      for diagnosing acute stroke and for deciding which patients should have priority
      for computed tomography, it is also a valuable tool for epidemiology studies of
      stroke incidence and outcome.

PMID- 7780883
TI  - Fingertip reconstruction by the reverse digital artery island flap.
AB  - BACKGROUND: Fingertip injuries remain as one of the most common injuries in the
      hand. The ideal reconstruction for such injuries is to provide abundant tissue
      with similar qualities, preserve the length, maintain joint motion and restore
      fingertip sensation. Although many reconstructive methods are described in the
      literature, many disadvantages can be associated with these procedures. METHODS:
      An island skin on the side of the proximal phalanx, based on the ipsilateral
      digital artery, was elevated to resurface the defect of the fingertip. Six male
      patients with fingertip injuries were treated by using this flap from August 1993
      to January 1994. Their ages ranged from 20 to 55 years. The average follow-up
      time was 8.5 months. RESULTS: Three of the six flaps were involved the middle
      fingers; two, for the index fingers and one, for the small finger. The sizes of
      the flaps varied from 1.5 by 2.0 to 2 by 3;. all the flaps survived. There was no
      vascular disturbance nor neurological deficit, and no limitation of joint motion.
      All the patients were pleased with the results. CONCLUSIONS: The advantages of
      the reverse digital artery island flap include using a single operative field on
      the injured digit, allowing for treatment of single or multiple fingertip
      injuries, providing abundant tissue with similar qualities and aesthetic
      improvement.

PMID- 7780884
TI  - Successful percutaneous transluminal angioplasty in native coarctation of aorta
      in young adult: a case report.
AB  - Coarctation of aorta is a rare cause of secondary hypertension, premature death
      will occur if no appropriate treatment is given. Before 1980, the only effective
      treatment was surgery, and recurrent stenosis was frequent. After then several
      works on percutaneous transluminal angioplasty of this disease were reported,
      with promising short-term and long-term results, especially in children and young
      adults. This report concerns a 19-year-old male who had hypertension for four
      years; the hypertension was caused by coarctation of the aorta, confirmed by
      cardiac catheterization and angiography. Average blood pressure (BP) of his upper
      extremities was 200/110 mmHg which dropped to 150/90 mmHg immediately, and still
      two years, after angioplasty, whereas BP of the lower extremities maintained at
      about 150/80 mmHg measured by Korotkoff technique. Follow-up transesophageal
      echocardiography found no coarctation or aneurysm at the dilatation site one year
      later. Magnetic resonance imaging, performed two years later, showed an almost
      normal aortic wall at the coaxctation. The postoperative course was uneventful,
      and patient follow-up at the cardiology clinic has regularly shown an average BP
      around 150/80 mmHg.

PMID- 7780885
TI  - Effect of calcitriol treatment on psoriasis in hemodialysis patient: a case
      report.
AB  - The case of a 67-year-old man who has had psoriasis with multiple joints
      involvement for 30 years and renal failure for 1 year is described. He was
      admitted because of uremic symptoms and exacerbation of psoriasis. Hypocalcemia
      and low serum active 1.25(OH)2D3 were also observed. Hemodialysis, oral
      1.25(OH)2D3 and CaCO3 supplement were employed. Interestingly, the psoriasis
      strikingly improved. The relationships among psoriasis, renal failure,
      1.25(OH)2D3, serum calcium level and dialysis are discussed.

PMID- 7780886
TI  - Cardiotoxicity related to 5-fluorouracil chemotherapy: a report of two cases.
AB  - 5-Fluorouracil (5-FU) is a chemotherapeutic agent which has been used to treat
      many solid tumors including cancers of the breast, ovary, cervix, bladder,
      prostate gland and gastrointestinal tract. Side effects related to the drug
      include bone marrow suppression, stomatitis, nausea, vomiting and diarrhea.
      However another less frequent but lethal event cardiotoxicity--appears to have
      been ignored by physicians. Recently, two cases of cardiac toxicity induced by 5
      FU have been encountered here. One patient developed supraventricular tachycardia
      and the other illustrated silent myocardial infarction with congestive heart
      failure. Since these side effects may result in death when 5-FU is prescribed to
      those patients who have had previous heart disease or are concomitantly receiving
      inevitable radiotherapy over the cardiac region, it should be recommended with
      extreme caution.

PMID- 7780887
TI  - Elevated serum CK-MB and CK-BB isoenzymes in a patient with small cell lung
      cancer: a case report.
AB  - An increase in serum creatine kinase-MB (CK-MB) isoenzyme is regarded as a
      specific indication of acute myocardial infarction. Recently, increased
      concentrations of various types of creatine kinase isoenzymes (mostly CK-BB and
      macro CK type 2 isoenzymes) have been found in the blood of some patients with
      malignancies. However, highly elevated serum CK-MB isoenzyme associated with
      malignancy has rarely been reported previously. Herein a case of extensive small
      cell lung cancer is presented in which the elevated serum levels of CK were
      detected throughout the three weeks of hospitalization. Fractionation of its
      isoenzymes by gel electrophoresis displayed elevated CK-MB and CK-BB isoenzymes.
      The proportion of serum CK-MB and CK-BB isoenzyme activities was persistently
      above normal (CK-MB 50-53%, normal < 5%). Clinical examination showed no evidence
      of myocardial infarction or injury, or tumor involvement of the heart. The tumor
      was the probable source of most circulating CK-MB isoenzyme. In clinical
      practice, markedly elevated levels of CK-MB, or increased levels of CK-MB in
      combination with CK-BB may point away from a myocardial origin and toward the
      existence of a malignancy.

PMID- 7780888
TI  - Insufficiency fracture of acetabulum: a case report.
AB  - Most stress fractures of the hip joint occur on the femoral side. A review of the
      English literature showed that only eight cases of stress fracture of the
      acetabulum had been reported. Another insufficiency fracture of the acetabulum in
      an osteoporotic bone is reported.

PMID- 7780890
TI  - Update in cataract and refractive surgery.

PMID- 7780889
TI  - Torsion of an ovarian borderline tumor with extreme serum tumor markers: a case
      report.
AB  - A postmenopausal woman with torsion of the left ovarian mucinous cystadenoma with
      borderline malignancy is reported. Extremely elevated serum tumor markers such as
      carcinoembryonic antigen (CEA) (398.0 ng/mL, normal < 3.0 ng/mL), carbohydrate
      antigen 19-9 (CA 19-9) (240 U/mL, normal < 37 U/mL) and tissue polypeptide
      antigen (TPA) (1,918 U/L, normal < 110 U/L) were found preoperatively. Imaging
      studies such as ultrasound and computed tomogram favored a diagnosis of ovarian
      malignancy, and advanced ovarian cancer was suspected prior to operation.
      Diagnosis of borderline malignancy was first made by frozen section during
      laparotomy. The patient recovered following simple total hysterectomy and
      bilateral salpingo-oophorectomy. Serum levels of the tumor markers became normal
      gradually following operation. To present knowledge, this is the first reported
      case with extremely high serum tumor markers in a postmenopausal woman with
      torsion of a stage-Ia ovarian mucinous cystadenoma of borderline malignancy.
      Rapid release of these tumor markers into circulation secondary to necrosis and
      degeneration of the tumor cells following torsion might account for such an
      unusual finding.

PMID- 7780892
TI  - Natural course of perfused central retinal vein occlusion.
AB  - OBJECTIVE: To investigate the visual prognosis in perfused (nonischemic) central
      retinal vein occlusion (CRVO), to determine the frequency of conversion from
      perfused to nonperfused CRVO, and to identify risk factors for poor visual
      outcome. DESIGN: Case series. SETTING: Retina referral centre in Portland, Ore.
      PATIENTS: Fifty-eight patients (59 eyes) with perfused CRVO followed for at least
      1 year (average 2.5 years). MAIN OUTCOME MEASURES: Visual acuity, progression to
      nonperfused CRVO. RESULTS: At the final follow-up visit the visual acuity had
      improved by two or more lines in 9 eyes (15%), remained the same in 33 eyes (56%)
      and decreased by two or more lines in 17 eyes (29%). Factors significantly
      related to visual outcome were initial visual acuity (p = 0.0001) and age, older
      patients having a worse visual outcome (p = 0.0029). Nine eyes (15%) progressed
      to nonperfused CRVO. None of the factors analysed, including age, sex, duration
      of symptoms and initial visual acuity, were predictive of progression.
      CONCLUSIONS: Perfused CRVO frequently results in significant, permanent visual
      loss, and a poor visual outcome is most likely in older patients and those with
      poor initial visual acuity.

PMID- 7780891
TI  - Perioperative ofloxacin vs. tobramycin: efficacy in external ocular adnexal
      sterilization and anterior chamber penetration.
AB  - OBJECTIVE: To compare the efficacy of two treatment regimens, tobramycin drops
      erythromycin ointment and ofloxacin drops-placebo ointment, in sterilizing the
      external ocular adnexa when given perioperatively. A second objective was to
      determine the aqueous humour concentration of ofloxacin and tobramycin. DESIGN:
      Randomized double-blinded clinical trial. SETTING: University-affiliated
      hospital. PATIENTS: Patients aged 18 years or more scheduled to undergo planned
      cataract surgery who were judged likely to complete the trial. NUMBERS: Of 55
      patients enrolled 6 were disqualified and 49 completed the trial. INTERVENTIONS:
      Preoperative instillation of 10 drops of a 0.3% solution of ofloxacin (26 eyes)
      or tobramycin (23 eyes) in the operative eye, starting the evening before
      surgery. Tobramycin-treated eyes received erythromycin ointment after surgery;
      ofloxacin-treated eyes received petrolatum ointment. Lid and conjunctival swabs
      were obtained from both eyes on the day before surgery (visit 1), at surgery
      (visit 2) and on the first postoperative day (visit 3). Aqueous humour samples
      were obtained from the study eyes at surgery. MAIN OUTCOME MEASURES: Threshold
      growth of bacteria on culture, aqueous humour concentration of ofloxacin or
      tobramycin. RESULTS: At visit 1, 96% of all eyes had positive cultures; this
      result persisted at visits 2 and 3 for the control eyes. For the treated eyes the
      incidence of positive cultures decreased from visit to visit. By visit 3 lid
      cultures were positive for 7 (27%) of the ofloxacin-treated eyes and 7 (30%) of
      the tobramycin-treated eyes; conjunctival cultures were positive for 0 (0%) of
      the ofloxacin-treated eyes and 1 (4%) of the tobramycin-treated eyes. No
      significant differences were seen in culture positivity between the treatment
      groups at any visit. The mean aqueous humour concentration of ofloxacin was
      significantly higher than that of tobramycin (0.4084 vs. 0.0279 microgram/mL) (p
      < 0.001). CONCLUSIONS: Both ofloxacin-placebo treatment and tobramycin
      erythromycin treatment were more effective than no treatment in sterilizing the
      external ocular adnexa. The two treatments were equally efficacious in
      eliminating bacteria, more successfully in the conjunctiva than the lids.
      Topically administered ofloxacin demonstrated significantly greater anterior
      chamber penetration than topically administered tobramycin.

PMID- 7780893
TI  - Correction of night myopia and glare for night driving.
AB  - OBJECTIVE: To assess the effectiveness of treating night myopia. SETTING:
      Ophthalmic practice in Toronto. PATIENTS: Sixty-one patients aged 18 to 60 years
      with night myopia and no ocular disease followed for 1 to 14 months (phase 2).
      Phase 1 (32 patients) was abandoned because of problems with the tint chosen.
      INTERVENTIONS: Assessment of night myopia with a laser speckle generator,
      prescription of minus lenses with or without a tint. MAIN OUTCOME MEASURES:
      Magnitude of night myopia, subjective change in symptoms of night myopia.
      RESULTS: Nineteen patients (31%) could not benefit from minus or tinted lenses,
      and eight were lost to follow-up. Of the remaining 34 patients 22 (65%) reported
      marked improvement in night driving, 9 (26%) had moderate improvement and 3 (9%)
      had minimal improvement. CONCLUSIONS: Many patients with night driving
      difficulties can be helped with an increased myopic correction worn at night.

PMID- 7780894
TI  - Decreased retinal blood flow in retinitis pigmentosa.
AB  - OBJECTIVE: To determine alterations in retinal blood flow in retinitis pigmentosa
      (RP). DESIGN: Case-control study. SETTING: Ophthalmology department of a
      university-affiliated hospital in Elazig, Turkey. SUBJECTS: Ten patients (20
      eyes) with typical RP and 22 age-matched volunteer subjects (22 eyes) with no
      history of ocular or systemic disease. MAIN OUTCOME MEASURES: Central retinal
      artery peak systolic and diastolic blood flow velocity (measured by means of
      colour Doppler imaging), resistance index and pulsatility index. RESULTS: The
      mean peak systolic and diastolic flow velocity values were significantly lower in
      the study group than in the control group (4.96 +/- 1.3 vs. 11.11 +/- 1.5 cm/s [p
      < 0.00001] and 2.15 +/- 0.4 vs. 3.40 +/- 0.9 cm/s [p < 0.0001] respectively). The
      mean resistance index value was significantly lower in the study group (0.55 +/-
      0.05) than in the control group (0.71 +/- 0.06) (p < 0.0001), as was the mean
      pulsatility index value (0.94 +/- 0.18 vs. 1.45 +/- 0.36) (p < 0.00001).
      CONCLUSIONS: Decreased retinal blood flow is an important feature of RP.

PMID- 7780895
TI  - Acanthamoeba keratitis: increasing the index of suspicion.

PMID- 7780897
TI  - Functional visual loss and the duochrome test.

PMID- 7780896
TI  - Viscoelastic dissection for relocation of off-axis intraocular lens implant: a
      new technique.

PMID- 7780898
TI  - A survey of intraocular schwannoma with a case report.

PMID- 7780900
TI  - Excimer laser photorefractive keratectomy.

PMID- 7780899
TI  - Effects of cytoskeleton-reactive agents on aqueous outflow facility in a porcine
      ocular anterior segment preparation.
AB  - OBJECTIVE: To assess the effect of three agents known to react with cytoskeletal
      components--acrylamide (a vinyl monomer), demecolcine (a colchicine derivative)
      and stypoldione (an ichthyotoxic metabolite derived from the tropical marine alga
      Stypopodium zonale)--on facility of aqueous humour outflow in order to increase
      the understanding of the role of the cytoskeleton in the biology of aqueous
      outflow. DESIGN: Constant-pressure perfusion experiments with various
      concentrations of the agents using a porcine ocular anterior segment preparation.
      NUMBERS: Eighteen experimental eyes (six with each agent) and 18 control eyes.
      MEAN OUTCOME MEASURES: Aqueous outflow facility, determined after 1, 2 and 24
      hours of perfusion. RESULTS: The mean baseline outflow facility was 0.10
      (standard error of the mean 0.045) microL/min per mm Hg. There was no significant
      difference in mean baseline outflow facility between the experimental and control
      eyes. Perfusion of 0.01 to 1.0 mM demecolcine did not produce any consistent
      alteration in outflow facility. A mild to moderate dose-related experimental
      effect was noted after 2 hours of perfusion with 1.0 to 100 mM acrylamide.
      Perfusion with 0.10 mM stypoldione produced a moderate increase in outflow
      facility; the effect was greatest after 1 hour of perfusion. CONCLUSIONS: Our
      preliminary results do not support a central role for the cytoskeleton in the
      regulation of aqueous outflow resistance.

PMID- 7780901
TI  - Defining physician-assisted suicide and euthanasia.

PMID- 7780902
TI  - Misuse of asthma-medication inhalers.

PMID- 7780903
TI  - Sex differences in psychologic symptoms among patients with newly diagnosed lung
      cancer.

PMID- 7780905
TI  - Orthopractic organization seeking to usurp chiropractors?

PMID- 7780904
TI  - Orthopractic organization seeking to usurp chiropractors?

PMID- 7780906
TI  - Prevention and control of high blood pressure: challenges and opportunities.
AB  - Cardiovascular disease is still the leading cause of death in developed countries
      and is becoming more common in the developing world. The reduction in incidence
      of many cardiovascular diseases in the last few decades may be attributed in part
      to extensive programs to reduce and manage risk factors such as hypertension.
      Nevertheless, untreated, uncontrolled and undiagnosed hypertension remains a
      significant concern. Many nations have adopted policies and programs for
      hypertension control. An international sharing of knowledge and experience could
      lead to improvements in the prevention and treatment of hypertension and to lower
      rates of cardiovascular disease. In keeping with Canada's leadership in
      hypertension and cardiovascular disease prevention, Ottawa will host the World
      Conference on Hypertension Control from June 21 to 24, 1995. This conference will
      give participants the opportunity to review current programs and develop improved
      strategies for hypertension control and cardiovascular disease reduction.

PMID- 7780907
TI  - Monitoring clinical research: an obligation unfulfilled.
AB  - The revelation that data obtained for the US-based National Surgical Adjuvant
      Breast and Bowel Project (NSABP) from subjects enrolled at Hopital Saint-Luc in
      Montreal was falsified has eroded public trust in research. Institutions can
      educate researchers and help prevent unethical research practices by establishing
      procedures to monitor research involving human subjects. Research monitoring
      encompasses four categories of activity: annual reviews of continuing research,
      monitoring of informed consent, monitoring of adherence to approved protocols and
      monitoring of the integrity of data. The authors describe characteristics of
      research projects that may call for monitoring procedures in each category. The
      form taken by such monitoring depends on the nature of the protocol. Although
      appropriate research monitoring requires substantial investment of personnel and
      financial resources, it is required under guidelines regulating research
      involving human subjects in Canada. Research monitoring is a step forward in re
      establishing public confidence in medical research.

PMID- 7780909
TI  - Community surveillance for wild poliovirus in Ontario, 1993.

PMID- 7780908
TI  - New directions in research: report from the 10th International Conference on
      AIDS.
AB  - Research findings presented at the 10th International Conference on AIDS, held in
      Yokohama, Japan, in August 1994, indicate that few advances have been made in
      standard antiretroviral therapy for HIV infection. The perinatal administration
      of AZT (zidovudine) was reported to reduce transmission of HIV from mother to
      child, and its use in combination with acyclovir appears to improve survival
      among patients with advanced disease. Other research has focused on asymptomatic
      patients with long-standing HIV infection. Their survival may be related to the
      activity of cell antiviral factor, a cytokine produced by CD8+ cells. In gene
      therapy research, one approach involved the genetic alteration of target cells to
      enable them to render the virus harmless. A second approach consisted of
      enhancing the function of CD8+ cells to allow them to compensate for
      dysfunctional CD4+ cells. The author believes that gene therapy may offer the
      greatest hope of an effective treatment for HIV infection.

PMID- 7780910
TI  - Physicians among many participants in midst of Canada's emotional gun-control
      debate.
AB  - Because they are seen as advocates for public health and safety, physicians are
      also widely believed to be supporters of aggressive gun-control measures, but in
      reality there are strong feelings on both sides of the issue. "People assume that
      more gun control will mean less violence, but there are no hard data to support
      that," says Vancouver psychiatrist Joseph Noone, who argues that Canada already
      has highly restrictive firearms laws. Other physicians are puzzled by colleagues'
      opposition to the changes. "I don't understand why it's such a big deal," says
      Dr. Stephen Corber, medical officer of health for the Ottawa-Carleton region. He
      argues that registration would not be a deterrent to responsible gun use and
      ownership.

PMID- 7780911
TI  - It's 210 transplants and counting at the University of Ottawa Heart Institute.
AB  - The Ottawa Heart Institute, the site of more than 200 heart-transplant procedures
      since 1984, is preparing for the retirement of its founder, Dr. Wilbert Keon, in
      2001. The institute has developed a national and international reputation, but
      also faces the same funding challenges as other Canadian health care facilities.
      Although the cost of the institute's high-tech procedures is challenged by some,
      Keon makes no apologies. "I haven't the slightest problem rationalizing what we
      do here," he says. "There are many areas in our health care system that should be
      tightened up before we cut services with demonstrable benefits." He also thinks
      there might be room for private care within Canada's publicly funded system.

PMID- 7780912
TI  - Is the issue the price of a child's life, or the futility of heroic measures?
AB  - Britain's High Court has been asked to rule whether a $160,000 experimental
      treatment with a 1% chance of saving the life of a 10-year-old girl should be
      paid for by the National Health Service. Child B, who has had one bone-marrow
      transplant, has had acute myeloblastic leukemia for a year and is near death.
      However, after her Cambridge doctors advised that further treatment would not be
      beneficial, her family found a hematologist willing to try an experimental
      treatment and a second transplant. The media debate in Britain has focused on
      financial aspects of the situation, not on the usually futile use of heroic
      measures.

PMID- 7780913
TI  - Altered keratinocyte growth and differentiation in psoriasis.

PMID- 7780914
TI  - T lymphocytes in psoriasis.

PMID- 7780915
TI  - The inflammatory infiltrate in psoriasis.

PMID- 7780916
TI  - Inflammatory mediators and chemoattractants.

PMID- 7780919
TI  - Pathogenic aspects of psoriasis. Introduction.

PMID- 7780918
TI  - Signal transduction pathways in epidermal proliferation and cutaneous
      inflammation.

PMID- 7780920
TI  - The puzzling genetics of psoriasis.

PMID- 7780917
TI  - Cell trafficking and role of adhesion molecules in psoriasis.

PMID- 7780921
TI  - Developmental care: making your NICU a gentler place.
AB  - Over the years, the nursing care provided at Women's College Hospital in Toronto
      has broadened to become increasingly holistic. Our neonatal intensive care unit
      (NICU) has kept pace. Seven years ago we introduced the philosophy of
      developmental care in the NICU, and it has continued to evolve ever since. This
      framework of care not only makes us more effective in meeting the
      neurodevelopmental needs of preterm infants, it also leads to enhanced
      relationships between parents and their babies.

PMID- 7780922
TI  - Latex allergy alert.
AB  - Reports of children and adults having allergic reactions after latex exposure are
      appearing in the literature in increasing numbers. The reactions have ranged from
      rashes, hives and swelling to respiratory distress and even death. Unfortunately,
      although latex is a common component in many hospital and household products,
      many health care workers remain unaware of the potential implications of latex
      allergy on their work and on the health and safety of their patients.

PMID- 7780923
TI  - The silicone breast implant controversy.
AB  - Feminists call it objectification. Consumer advocates call it victimization.
      Medical personnel call it augmentation. Women, implantation. Whatever the term,
      media hype and the increasing number of lawsuits against U.S. manufacturers of
      silicone breast implants has caused widespread concern among women and raised
      serious questions about the long term health risks and safety of breast implant
      devices.

PMID- 7780924
TI  - Breast implants: a gender issue?
AB  - Breast implants have been in use in Canada for more than 30 years. Between
      100,000 and 200,000 Canadian women have them as well as one to two million women
      in the United States. Oddly, despite those numbers, inadequate data are available
      on the safety and side effects of these prosthesis.

PMID- 7780925
TI  - [Facing perinatal bereavement].
AB  - Pregnancy and childbirth are, for most women, wonderful and memorable
      experiences. Yet, without warning, they can have a heartbreaking outcome.
      Regardless of the stage of pregnancy at which a baby is lost, the family grieves
      the death. The authors of this article suggest how nurses can best support the
      couple, siblings, grandparents and significant others through their time of
      sorrow. The article highlights key points from the 1992 the Hopital de Chicoutimi
      (Quebec) reference guide entitled "Guide d'accompagnement des familles devant un
      deuil perinatal." The guide includes the types of grief and the six phases of
      grief resolution. It outlines specific nursing interventions and recommends
      various strategies for the nurse to help these families grieve their loss. Some
      strategies include the holding and cuddling of the baby by the parents, post
      partum follow-up by nursing personnel and family therapy sessions. The authors
      suggest that nurses who are knowledgeable about the grief experiences of these
      parents will be better equipped to help other parents cope with similar grief.
      The increased knowledge will also assist nurses to sort out and deal with their
      own feelings on this subject. Nurses who are able to effectively care for these
      grieving families can often enhance their personal and professional self-esteem.

PMID- 7780926
TI  - [How to intervene effectively with a dying patient].
AB  - Nurses are in a strategic position to meet the needs of the dying patient.
      However, when confronted with death, nurses often utilize avoidance behaviors,
      such as: tending to the dying patient only if a technique is required; initiating
      conversations on casual topics or directing the conversation towards the
      patient's "health"; requesting consults to avoid talking about dying; and
      unnecessarily overmedicating the patient. This paper explains the rights and
      needs of the dying patient and describes associated nursing interventions. For
      example, the dying patient has the primordial right to choose whether or not to
      receive treatment. For nurses to intervene effectively, they must learn to manage
      their own emotions relating to death. A strong theoretical understanding of the
      dying process must be acquired. They must also develop internal strengths and
      receive help from various resources. By doing so, nurses reinvest their shared
      life experiences and apply them to other dying patients continuously refining
      their conceptual model of loss. Through verbal and non-verbal cues, nurses
      transmit profound messages to their patients. Some efficient nursing
      interventions consist of: providing basic care and medications to prevent
      terminal suffering; offering an attentive and reassuring presence; respecting the
      contemplative phases; listening for latent messages in conversations;
      understanding symbolic language; respecting family dynamics; allowing family
      members to choose physical and psychosocial interventions to improve the
      patient's comfort; frequently visiting the patient and intensifying their
      presence; permitting the dying patient to verbalize fears and anxieties; and
      consistently offering tenderness, empathy, acceptance, warmth and respect. As
      death nears, scientific and technological aspects of nursing become less
      important for the patient, and the art of sincere human empathy becomes
      paramount.

PMID- 7780927
TI  - The body reality.

PMID- 7780928
TI  - Seeing deafness in a new light.

PMID- 7780929
TI  - The glass box.

PMID- 7780931
TI  - Recovery's limitations.

PMID- 7780930
TI  - Suspicious death.

PMID- 7780932
TI  - From vision to reality.

PMID- 7780933
TI  - Nursing in Nepal.
AB  - In 1991 and '92 I developed and implemented a research project that was a case
      study of nurses and primary health care in Nepal. Data were gathered from a
      variety of sources, but what I found particularly interesting were the interviews
      with nurses and my observations of them at work.

PMID- 7780934
TI  - "Wish you were here...".
AB  - Camp is one of the most popular summer destinations for children and youth. Their
      enthusiasm is infectious; more and more adults are now taking part. Summer camp
      offers a change of pace (not always slower); a change of environment (not always
      outdoors); and, a change of expectations (where else could you wear the same
      clothes for a whole week?). It's also a chance to be accepted as you are, or try
      new roles with no expectation of perfection. Little wonder that camp appeals to
      all ages.

PMID- 7780935
TI  - Alcohol home detoxification.
AB  - Traditional inpatient treatments for alcohol-related problems often prevent the
      problem drinker from seeking early intervention. Inpatient treatment may be
      particularly difficult for women because of stigma, labelling and family
      commitments. An alternative, home-based program initiated in the United Kingdom
      (U.K.) in the late 1980s and currently being trialed by many health districts,
      may be of interest to Canadian nurses. In addition to improved client outcomes
      and cost-effectiveness, the program offers nurses a higher public and medical
      profile. Clinical nurse specialists in particular may want to consider whether
      the expanded role of their British colleagues might be appropriate for Canadian
      adaptation.

PMID- 7780936
TI  - [The nurse manager in oncology].
AB  - Several nursing studies have described the important role of the oncology nurse
      manager in managing nursing staff. A 1987 study by Vachon, outlined stressors
      identified by 581 health professionals working in oncology units. It identified
      the fact that nursing personnel face a workplace filled with pain and suffering
      on a daily basis. The study concluded that the oncology nurse manager is the key
      individual to encourage a climate of sharing and support among nursing staff.
      Oncology nurse managers are role models and mentors who transmit to their staff
      the desire for a caring and holistic approach to excellence in patient care.
      Professional, educational and personal responsibilities rest with them. They must
      maintain a dynamic presence with all members of the health care team. Their
      knowledge of the most current medical breakthroughs, as well as strong leadership
      qualities, inspire nursing staff to strive for high standards of care.

PMID- 7780937
TI  - Reform and primary care.
AB  - The success of Canada's health care reform depends on nurses' participation. No
      one can dispute that nurses are the largest single group of health care
      providers. Nurses are also experienced players in primary health care-health
      care's new direction.

PMID- 7780938
TI  - Clearer images in pediatric MRI.
AB  - Pediatric outpatient magnetic resonance imaging (MRI) was a frustrating
      experience for both patients and staff at London, Ontario's University Hospital
      until nurses, the child-life specialist, physicians and technicians got together
      and developed the Pediatric MRI Sedation Program.

PMID- 7780940
TI  - One strong voice.

PMID- 7780939
TI  - Standard of care.
AB  - Did you know that a nurse may be held to the same standard of care as a
      physician? In a 1989 Indiana case, Planned Parenthood of Northwest Indiana, Inc.
      v. Vines 543 N.E. 2d 654 (Ind. App. 3 Dist. 1989), a patient and her husband sued
      a clinic and a nurse for negligence in the insertion of an intrauterine device.
      The Indiana Court of Appeals upheld a lower court's finding that the nurse
      practitioner be held to the standard of care of a physician in performing this
      procedure.

PMID- 7780941
TI  - The power of hope.
AB  - What would it be like to know the day of our death? How would that feel, knowing
      that each passing day brought you closer to that final day? I hope may last day
      comes as a surprise.

PMID- 7780942
TI  - Long term care in acute care facilities.

PMID- 7780943
TI  - Rationing health care.
AB  - What health services should governments pay for? Who should receive transplants
      or expensive procedures? What services should be available through private
      insurance? Should there be a two-tiered system? And, how do we decide on what
      services to publicly insure/fund? Many governments around the world are facing
      such questions. In Canada, the Government of Alberta and the Reform Party of
      Canada have recently expressed the need to re-think which health services are
      publicly funded, or the "comprehensiveness" of Canada's health care system.

PMID- 7780944
TI  - Segmentation and visualization of brain lesions in multispectral magnetic
      resonance images.
AB  - In this study we focus on the problem of segmentation and visualization of soft
      tissue structures in three-dimensional (3D) magnetic resonance (MR) imaging. We
      introduce a classification method which is a combination of a recently proposed
      contour detection algorithm and Haslett's contextual classification method
      extended to 3D. This classification method is used in the classification step of
      a rendering model suggested by Drebin et al. for visualizing normal and
      pathological tissue structures in the brain. We evaluate the combination of these
      two methodologies, and identify some problems which have to be solved in order to
      develop a clinical useful tool.

PMID- 7780945
TI  - Rapid automatic brain volumetry on the basis of multispectral 3D MR imaging data
      on personal computers.
AB  - Fast magnetic resonance imaging sequences are an excellent basis for the
      volumetry of the human brain. We present a concept for an automatic three
      dimensional (3D) segmentation and volumetry which provides rapid image processing
      along with minimal requirements of manual interaction on low-end hardware
      platforms. The concept is based on standard image segmentation techniques and
      provides for the determination of the total brain tissue and cerebrospinal fluid
      volumes from the input data base, a T1- and a T2-weighted 3D image data cube. We
      used a 3D MPRAGE sequence for the T1- and a 3D PSIF sequence for the T2-weighted
      images; both 3D image data cubes consisted of 128 sagittal image slices with a
      voxel size of 1.0 x 1.0 x 1.2 mm3. The segmentation and volumetry tool was
      applied to clinical image data of volunteers and Alzheimer patients in order to
      prove its stability.

PMID- 7780946
TI  - Three-dimensional densitometric reconstruction and visualization of stenosed
      coronary artery segments.
AB  - In this paper we report results from an ongoing study about the diagnostic
      benefits of three-dimensional (3D) visualization and quantification of stenosed
      coronary artery segments. Biplane angiographic images do not provide enough
      information for the exact reconstruction of the coronary arteries. Therefore, a
      priori information about the 3D shape to be reconstructed must be incorporated
      into the reconstruction algorithm. One approach is to assume a circular cross
      section of the coronary artery. Hence, the diameter is estimated from the
      contours of the vessel in both projections. Another approach is based on
      densitometry and searches for a solution of the reconstruction problem close to
      the previously reconstructed adjacent slice. In this paper we apply contour
      information as well as the densitometrical profiles of the two orthogonal vessel
      projections. We present a new probabilistic densitometric reconstruction
      algorithm, which extends the correct handling of the stochastic properties of the
      density profiles into the network flow based reconstruction algorithm. The
      reconstructed coronary segment is visualized in three dimensions. In order to
      assess the accuracy of the reconstruction, the method is applied to tubes with
      artificial obstruction of known geometry, modeling coronary artery stenoses.
      These catheter tubes are filled with normal iodine contrast material. The results
      of the reconstruction and visualization are discussed with respect to clinical
      usefulness.

PMID- 7780947
TI  - MR relaxometry: estimating overhydration in renal failure.
AB  - An MR method is described for estimating overhydration in patients suffering from
      renal failure. In 29 healthy volunteers, the fat content of a selected slice of
      the lower limb was correlated to the overall T1-relaxation time (r = -0.97, p <
      0.000001). When compared with the normal T1 of the voluntary group, delta T1 was
      calculated having regard to the individual fat content in 74 MR studies of 22
      overhydrated patients. MR results were correlated with the difference between
      clinically estimated dry and the actual body weight (r = 0.6, p < 0.000001). In
      an intraindividual follow-up (11 studies) MRI was shown to provide good
      correlation to the actual body weight (r = 0.9, p < 0.0005) and fluid balance (r
      = 0.87, p < 0.001).

PMID- 7780948
TI  - Light photon equalization and its application to X-ray film digitization.
AB  - The principle of light photon equalization (LPE) is to modulate the light source
      during X-ray film digitization so that the dynamic range of the transmitted light
      into a photo-detector can be precisely controlled to obtain improved signal-to
      noise ratio (SNR). The modulation of the light source is derived from a smoothed
      image of the original digitized image. The final output digital image is
      reconstructed by convoluting the modulation function with the resultant LPE
      image. The LPE was implemented in a laser film digitizer as a prototype. The
      results shows that, although the dynamic range of X-ray films is about 10(4):1,
      the range of the transmission light into a photo detector was reduced to 10(2):1
      with this technique. Also the SNR improved by a maximum factor of five in the
      lung area of a digitized chest radiograph.

PMID- 7780950
TI  - Unruptured interstitial pregnancy: a pitfall of MR imaging.
AB  - We report two cases with interstitial pregnancy, which showed completely
      different MR appearances. In case 1, a gestational sac was demonstrated and the
      diagnosis of ectopic pregnancy was straightforward. In case 2, a hypervascular
      mass was shown without demonstration of a gestational sac, the findings usually
      seen in gestational trophoblastic disease (GTD). MR imaging may play some role in
      the diagnosis of interstitial pregnancy when sonography is insufficient or
      equivocal. If GS is visualized, diagnosis is easy. However, if not, the
      appearance may have a spectrum and can be similar to GTD.

PMID- 7780949
TI  - Solitary muscular involvement by tuberculosis: CT, MRI, and scintigraphic
      features.
AB  - The authors reported computed tomography (CT), magnetic resonance imaging (MRI)
      and scintigraphic findings of a patient with solitary muscular tuberculosis in
      the forearm. All these findings resembled those of other granulomatous
      inflammatory lesions in the soft tissue such as muscular sarcoidosis.

PMID- 7780951
TI  - MR findings in hereditary spherocytosis.
AB  - The magnetic resonance findings of intrathoracic extramedullary hematopoiesis
      associated with bone marrow reconversion, and reticuloendothelial hemosiderosis
      in a 50-years-old are reported. Radiologic finding of extramedullary
      hematopoiesis was the first step to the diagnosis of previously unknown
      hereditary spherocytosis.

PMID- 7780953
TI  - Expression of manganese superoxide dismutase reduces tumor control radiation
      dose: gene-radiotherapy.
AB  - This study investigated the in vitro and in vivo radiation response of tumor
      cells transfected with human manganese superoxide dismutase (MnSOD) cDNA. A major
      objective was to test the potential tumor suppressive effect of MnSOD in vivo.
      Tumor cells studied were an in vitro line derived from a murine spontaneous
      fibrosarcoma, FSa-II, which expressed an undetectable MnSOD activity. These cells
      were transfected with pSV2-NEO plasmid (NEO line) or cotransfected with MnSOD
      plasmid plus pSV2-NEO plasmid (SOD lines) as described previously. The cell lines
      used were SOD-L and SOD-H, which expressed, respectively, low and high MnSOD
      activities after transfection, and NEO and parental FSa-II controls. Both SOD-L
      and SOD-H cell lines were slightly more resistant to ionizing radiation than were
      the two control cell lines when irradiated in vitro in the presence of oxygen.
      The dose-modifying factors calculated at the survival level of 0.01 were 1.13 and
      1.15 for the SOD-L and SOD-H cells, respectively. To investigate potential tumor
      suppressive effects, animal tumors of 4 mm diameter were irradiated in vivo under
      hypoxic conditions, and the radiation dose to control one-half of the irradiated
      tumors (TCD50) was determined for each tumor. The TCD50S obtained on the basis of
      the tumor control rate in 120 days after irradiation were substantially lower for
      the SOD-H and SOD-L tumors compared to the NEO tumors. They were 22.9, 28.6, and
      47.5 Gy for SOD-H, SOD-L and NEO tumors, respectively. To analyze these data,
      survival curves were obtained for hypoxic cells by irradiating NEO and SOD-H
      tumors under hypoxic conditions in vivo and assaying in vitro. Analysis of these
      curves suggests that the decrease in the TCD50S of SOD tumors is attributable to
      the reduced tumorigenicity in these tumors. The hypoxic cell survival curves also
      showed that SOD did not protect cells from radiation in the absence of oxygen.
      Electron microscopy showed no morphological differences between these cells.
      These results suggest that the fraction of tumorigenic cells could be reduced by
      expression of MnSOD, resulting in a substantial decrease in the TCD50.

PMID- 7780954
TI  - A defined region of loss of heterozygosity at 11q23 in cutaneous malignant
      melanoma.
AB  - Karyotypic and molecular data indicate that genetic alterations of the long arm
      of chromosome 11 (11q) may be involved in malignant melanoma. To test this we
      analyzed 5 polymorphic microsatellite repeats on 11q using a PCR-based assay for
      loss of heterozygosity in normal and tumor tissues from 24 individuals with
      cutaneous malignant melanoma of various stages. Our findings indicate that a
      tumor suppressor gene that plays a role in malignant melanoma is located on the
      long arm of chromosome 11, likely within a 51 cM region at 11q23. Its loss
      appears to be a late event in tumor progression and may serve as an indicator for
      a less favorable clinical outcome.

PMID- 7780952
TI  - Effects of estrogen on apoptotic pathways in human breast cancer cell line MCF-7.
AB  - We utilized a reverse transcription-PCR method to examine the effect of estrogen
      on the expression of mRNA for Bcl-2 and Bax, two modulatory proteins in the
      apoptotic pathway, in human breast cancer cell line MCF-7. We found that the bcl
      2 mRNA levels in the cells exposed to 17 beta-estradiol were higher than those of
      control cells. Although the relative bax mRNA levels remained unchanged, the
      changes in bcl-2 mRNA level occurred in a time- and concentration-dependent
      fashion. In addition, pretreatment with 17 beta-estradiol protected MCF-7 cells
      from apoptosis. Our study provides evidence that responses of breast epithelial
      cells toward a steroid sex hormone involve regulation of the apoptotic pathway.

PMID- 7780955
TI  - Molecular characterization of 12q14-15 rearrangements in three pulmonary
      chondroid hamartomas.
AB  - Chromosomal aberrations involving the chromosomal breakpoint region 12q14-15 are
      frequently seen in a variety of mesenchymal tumors as uterine leiomyomas,
      lipomas, myxoid liposarcomas, enchondromas, or hemangiopericytomas. Therefore,
      this breakpoint region seems to be one of the most frequent chromosomal
      abnormality associated with the initiation of human mesenchymal neoplasms. To
      narrow down the breakpoint region on a molecular level in cells of three
      pulmonary chondroid hamartomas with 12q14-15 aberrations, we performed
      fluorescence in situ hybridization analysis with different cosmid clones
      originating from a YAC and cosmid contig overspanning parts of the region 12q14
      15. We were able to narrow down the breakpoint to a region of 175 kb belonging to
      an area designated multiple aberration region because it also includes the
      breakpoints of leiomyomas, lipomas, and pleomorphic adenomas with 12q14-15
      abnormalities. Our molecular and cytogenetic data suggest that hamartomas of the
      lung molecularly belong to the benign group of mesenchymal tumors showing
      multiple aberration region involvement.

PMID- 7780956
TI  - p21CIP1 is not required for the early G2 checkpoint response to ionizing
      radiation.
AB  - We have previously reported that the immediate G2 checkpoint delay of normal
      human fibroblasts in response to ionizing radiation is correlated with inhibition
      of p34CDC2/cyclin B kinase activity. Here, we observed increased amounts of the
      cyclin-dependent protein kinase inhibitor p21CIP1 associated with p34CDC2/cyclin
      B protein complexes from irradiated normal human fibroblasts. Since wild-type p53
      function is not required for the early G2 checkpoint response to ionizing
      radiation, we investigated whether a p53-independent induction of p21CIP1 was
      required for the G2 checkpoint. Early passage human fibroblasts expressing the E6
      oncoprotein of human papilloma virus-type 16 (NHF4 E6) were analyzed. It has been
      demonstrated earlier than inactivation of wild-type p53 function in these cells
      by E6 protein does not alter their intact early G2 checkpoint response to gamma
      rays. p21CIP1 was found to be undetectable in p34CDC2/cyclin B protein complexes
      and in total extracts from the E6-expressing cells, with or without exposure to
      ionizing radiation. These data indicate that p21CIP1 is not required for the
      immediate G2 checkpoint response and is not induced by a p53-independent pathway
      in G2 phase following exposure to gamma-rays.

PMID- 7780957
TI  - Mutational effects on the p16INK4a tumor suppressor protein.
AB  - Several point mutations of p16INK4a were studied by site-specific mutagenesis and
      functional analysis to assess the effects of these mutations on the function of
      the protein. These mutations were reported in several malignancies. Three
      deletional mutants of p16INK4a were also analyzed to reveal the relationship
      between p16INK4a and p15INK4b and to test the importance of the ankyrin repeats
      observed in both proteins. We studied the activity of these mutants using the
      yeast two-hybrid system and an in vitro kinase assay. Our results suggest that
      point mutations in the conserved ankyrin consensus affect the activity of
      p16INK4a. However, not all of the point mutations observed in tumors have a
      detectable effect on the activity. The COOH-terminal region of p16INK4a is not
      required for the protein to bind and to inhibit CDK4, but the deletion of the 4th
      ankyrin repeat abolished the activity completely.

PMID- 7780958
TI  - Overexpression of Bcl-XS sensitizes MCF-7 cells to chemotherapy-induced
      apoptosis.
AB  - Resistance to apoptosis plays an important role in tumors that are refractory to
      chemotherapy. We report that Bcl-XL, which functions like Bcl-2 to inhibit
      apoptosis, is highly expressed in MCF-7 human breast carcinoma cells. We used Bcl
      XS, a dominant negative inhibitor of Bcl-2 and Bcl-XL, to demonstrate the role of
      these genes in modulating chemotherapy-induced apoptosis. Bcl-XS overexpressed in
      MCF-7 cells by stable transfection does not affect viability by itself but
      induces a marked increase in chemosensitivity to VP-16 or taxol. Using an ELISA
      assay which quantitates DNA damage, we demonstrate that this sensitization is due
      to apoptosis, suggesting the therapeutic utility of targeting this pathway.

PMID- 7780959
TI  - Allele-specific mutations involved in the pathogenesis of endemic gallbladder
      carcinoma in Chile.
AB  - Although gallbladder carcinoma is one of the most frequent neoplasms in Chile,
      there is limited information about the molecular changes involved in its
      pathogenesis. We investigated the incidence of ras gene mutations and loss of
      heterozygosity (LOH) at the following genes/loci: p53, DCC, rb, 5q 3p, 8p, and
      9p. We precisely microdissected 194 relevant areas from paraffin-embedded
      microslides from 25 gallbladder carcinomas and their accompanying nonneoplastic
      lesions (which were present in 15 cases) from patients in Chile. The specimens
      were analyzed by PCR-based assays for LOH, and we designed a RFLP method for ras
      mutations and immunohistochemistry for p53 protein overexpression. We determined
      that LOH at p53 (91%), 9p (50%), 8p (44%) and DCC (31%) are frequent events and
      that LOH at p53, 9p, and DCC are early events, while ras mutations and LOH at 3p,
      rb, and 5q occurred occasionally. LOH at p53 occurred more frequently and earlier
      than protein overexpression. The mean number of mutations present in invasive
      carcinomas was 2.1, and in six cases, LOH at the p53 gene was the sole mutation
      detected. The same allele was lost in 61 (93%) of 71 nonneoplastic foci as in the
      corresponding invasive carcinomas for all four mutations studied. The odds of
      this occurring by chance are approximately 4 x 10(-15). Although clonality cannot
      be excluded, allelic loss appears to be highly directed, but the mechanism for
      allele-specific mutations remains to be determined.

PMID- 7780960
TI  - Selective cell culture of primary breast carcinoma.
AB  - We have used culture conditions which simulate the microenvironment of breast
      tumors for the isolation and propagation of primary breast tumor cells in vitro.
      In this monolayer setup, the mixture of cells dissociated from primary breast
      tumors is subjected to self-created gradients of oxygen and nutrients as well as
      metabolic waste and extracellular pH. The tumor populations isolated under these
      novel conditions have displayed phenotypic properties characteristic of breast
      carcinomas, including homogeneous expression of cytokeratin 19, and increased
      mitochondrial retention of the cationic dye rhodamine 123. Nonmalignant cultures
      from reduction mammoplasty were unable to survive these conditions. One tumor
      population which reached passage 10 was aneuploid for chromosomes 15 and 17, and
      displayed a p53 mutation in exon 8. These studies strongly suggest that the
      culture conditions described here can suppress the growth of normal breast cells,
      thereby allowing selective isolation of some populations of slow-growing primary
      tumor cells in vitro.

PMID- 7780961
TI  - Fate of melanoma cells entering the microcirculation: over 80% survive and
      extravasate.
AB  - Metastasis is an inefficient process; only a few cancer cells are able to form
      tumors after being released into the circulation. We studied the fate of cancer
      cells after injection into the circulation, quantifying their survival and
      ability to extravasate by 1 day later. B16F10 cells, parental or transfectants
      overexpressing tissue inhibitor of metalloproteinases 1, were injected i.v. into
      chorioallantoic membrane of chick embryos and analyzed by intravital
      videomicroscopy. Cell survival was quantified in two ways: (a) 15-microns
      microspheres were injected with cancer cells, and proportions of viable cells to
      microspheres were compared before and after injection; and (b) individual cancer
      cells were monitored continuously for 0.5-8-h intervals covering the first 24 h.
      Both methods showed virtually no destruction of cells. Greater than 80% of
      injected cells survived and extravasated by 24 h, indicating that growth after
      extravasation is a key stage of metastatic control.

PMID- 7780962
TI  - Cytokine-producing mammary carcinomas in transgenic rats carrying the pX gene of
      human T-lymphotropic virus type I.
AB  - In two lines of transgenic rats (pX rats) from WKAH and F344 strains and carrying
      the human T-lymphotropic virus type I pX gene, undifferentiated mammary
      carcinomas developed predominantly in females starting at about 5 months of age,
      and there was massive infiltration of granulocytes in the tumor tissue. The
      incidence of the tumor reached about 40% when the rats were 12 months old. mRNAs
      of both pX and host genes Gro and MIP-2, which are granulocyte chemoattractants
      of the interleukin 8 family, were highly expressed in the tumor tissue. Since
      expression and point mutation of several oncogenes and the antioncogene were not
      demonstrated, hitherto unidentified novel oncogenic pathways may be
      transactivated by the pX transgene in these pX rats.

PMID- 7780963
TI  - Protein B61 as a new growth factor: expression of B61 and up-regulation of its
      receptor epithelial cell kinase during melanoma progression.
AB  - Epithelial cell kinase (ECK) is a receptor protein tyrosine kinase, the role of
      which in melanoma biology is unclear. Here we studied the role of ECK during
      melanoma progression. ECK mRNA was overexpressed in virtually all melanoma lines
      tested, and levels were significantly higher in cell lines from distant
      metastases than primary melanomas; melanocytes were negative. Gene amplification
      was not detected in melanomas. Levels of ECK protein corresponded well with mRNA
      levels. B61 or LERK-1, recently identified as an ECK ligand, stimulated the
      growth of ECK-expressing melanoma cell lines, its first identified biological
      activity. Melanoma chemotaxis and chemoinvasion were not affected by B61. Growth
      of normal melanocytes was not affected. mRNA for B61 was detected in both
      melanoma cell lines and normal melanocytes. B61 was also identified by Western
      blotting and ECK binding activity with the use of a BIAcore binding assay in
      melanoma cell-conditioned media. These results suggest that B61 is an autocrine
      growth factor for melanomas but not normal melanocytes.

PMID- 7780964
TI  - Telomerase activity associated with acquisition of malignancy in human colorectal
      cancer.
AB  - Shortening of telomeres may contribute to the control of the proliferative
      capacity of normal cells, and telomerase, the enzyme that elongates telomeric
      DNA, may be essential for unlimited cell proliferation. We have shown previously
      that telomerase activity is present in human cells immortalized in vitro and in
      metastatic ovarian carcinoma cells but is undetectable in normal cultured cells
      or normal tissues. We have determined the temporal pattern of telomerase activity
      during colorectal carcinogenesis in man. We report that telomerase activity is
      associated with acquisition of malignancy as it is detectable in colorectal
      carcinoma but not in adenomatous polyps. Mutations leading to reactivation or
      upregulation of the enzyme may represent an additional required event in the
      multistep development of colorectal cancer.

PMID- 7780965
TI  - Differential expression of elafin in human normal mammary epithelial cells and
      carcinomas is regulated at the transcriptional level.
AB  - Elafin is an elastase inhibitor with a unique structure, not related to the
      serpin family, which includes the neutrophil elastase inhibitor. The gene was
      identified in this laboratory by subtractive hybridization between RNAs from
      human mammary tumor-derived cells and cDNAs from normal human mammary epithelial
      cells. Elafin is consistently expressed in normal mammary epithelial cells, but
      is down-regulated in most breast tumor cell lines. Restriction fragment analysis
      detected no gross deletions or rearrangement of the gene in any of the tumor cell
      lines examined. The elafin gene was cloned, and both the cDNA and the promoter
      region were sequenced. A major positive upstream promoter element was identified
      by chloramphenicol acetyltransferase assay and deletion analysis, active in
      normal cell extracts but not in extracts of tumor cells. These results
      demonstrate that differential expression of elafin in normal mammary epithelial
      cells and breast tumor cells is regulated at the transcriptional level. Cell
      synchronization experiments demonstrated that elafin mRNA is down-regulated in S
      phase in normal cells. These results suggest that elafin may act as an inhibitor
      of cell cycle progression.

PMID- 7780966
TI  - An alternatively spliced form of NQO1 (DT-diaphorase) messenger RNA lacking the
      putative quinone substrate binding site is present in human normal and tumor
      tissues.
AB  - DT-diaphorase is a ubiquitously expressed flavoenzyme responsible for the two
      electron reduction of a number of quinone and other anticancer drugs. The
      majority of DT-diaphorase enzyme activity in human tissues is the product of the
      NQO1 gene. We have now identified a novel alternatively spliced form of human
      NQO1 mRNA lacking exon 4 at levels equal to or exceeding those of wild-type NQO1
      mRNA. Exon 4 codes for the putative quinone substrate binding site of DT
      diaphorase derived from NQO1 and the recombinant protein from alternatively
      spliced NQO1 mRNA lacking exon 4 has minimal enzyme activity with quinoid and
      other known substrates of DT-diaphorase. The physiological substrate of DT
      diaphorase is unknown, and it is possible that the protein derived from the
      alternatively spliced NQO1 mRNA could have enzyme activity with an appropriate
      substrate. We found full-length DT-diaphorase protein but could not detect
      expression of an appropriately smaller form of DT-diaphorase in human tissues
      using polyclonal antibody to DT-diaphorase, suggesting that alternatively spliced
      NQO1 mRNA lacking exon 4 may not be translated or that the protein product is
      rapidly degraded. Alternative splicing of NQO1 RNA could provide an important
      mechanism for regulating NQO1 gene expression.

PMID- 7780967
TI  - Activation of progelatinase B (MMP-9) by gelatinase A (MMP-2).
AB  - The M(r) 72,000 (MMP-2; gelatinase A) and M(r) 92,000 (MMP-9; gelatinase B)
      gelatinases are two members of the family of matrix metalloproteinases (MMPs).
      These proteinases are thought to play a critical role in tumor cell invasion and
      are frequently coexpressed in human cancers. Gelatinases are secreted in a latent
      inactive form, and their conversion to the active species can be accomplished by
      other proteolytic enzymes, including other MMPs. We report herein that
      organomercurial or plasma membrane-activated M(r) 72,000 gelatinase A activates
      progelatinase B to an M(r) 82,000 active form in a process inhibited by tissue
      inhibitor of metalloproteinase (TIMP)-1 and TIMP-2. Progelatinase B activation
      was accomplished by the two active species of gelatinase A, the M(r) 62,000 and
      M(r) 45,000 forms, generated after plasma membrane or organomercurial activation
      of TIMP-2-free progelatinase A. The M(r) 45,000 species of gelatinase A lacks
      both the NH2-terminal profragment and the COOH-terminal domain known to play a
      role in plasma membrane activation and the regulation of TIMP-2 inhibition. These
      results suggest a novel mechanism of activation of progelatinase B mediated by
      gelatinase A species that may be localized in the surface of tumor cells and
      enhance matrix degradation during cancer metastasis.

PMID- 7780968
TI  - Expression of prostaglandin G/H synthase-1 and -2 protein in human colon cancer.
AB  - Prostaglandin G/H synthase (PGHS), a key enzyme leading to the formation of
      prostaglandins, is the target of nonsteroidal antiinflammatory drugs. Two forms
      of the enzyme have been identified, PGHS-1 and PGHS-2. Epidemiological evidence
      has suggested that aspirin and other nonsteroidal antiinflammatory drugs may
      reduce the risk of colorectal cancer. We examined by immunoblot analyses the
      expression of human PGHS-1 and PGHS-2 protein in 25 matched colon cancer and
      nontumor tissues, 4 premalignant polyps, 5 control colon tissues from noncancer
      patients, and 3 matched normal and cancerous breast tissue samples. PGHS-1 was
      detected in all normal and tumor tissue. In contrast, PGHS-2 was not detected in
      23 of 25 normal colon tissues but was detected in 19 of 25 colon tumors. PGHS-2
      protein was not observed in four human premalignant polyp samples, control colon
      from noncancer patients, or matched normal or cancerous breast tissues. These
      results suggest that the beneficial effects of nonsteroidal antiinflammatory
      drugs in colon cancer may be mediated by inhibition of PGHS-2.

PMID- 7780970
TI  - A mutator phenotype characterizes one of two complementation groups in human
      cells tolerant to methylation damage.
AB  - Sixty % of clones isolated from HeLa cells treated with toxic concentrations of a
      methylating carcinogen showed increased resistance to the cytotoxicity of N
      methyl-N-nitrosourea. D37 values were 6- to 100-fold higher than in the parental
      cell population. The absence of detectable levels of the repair enzyme O6
      methylguanine-DNA methyltransferase indicated that the resistant clones were able
      to tolerate the presence of O6-methylguanine in their DNA. Analysis of N-methyl-N
      nitrosourea survival in the hybrids between tolerant clones and HeLa cells showed
      that tolerance can be either recessive or codominant. Fusion between tolerant
      clones indicated two complementation groups. We measured spontaneous mutation
      rates at microsatellites and at the hypoxanthine-guanine phosphoribosyl
      transferase (hprt) locus in several tolerant clones. All the clones of
      Complementation Group I showed unstable microsatellites and 4-8-fold increases in
      mutation rates at hprt. No significant alterations in spontaneous mutation rates
      were found in clones of Complementation Group II. The data indicate that
      tolerance to methylation damage can be conferred by alterations in at least two
      different gene products and that one of the two groups has the mutator phenotype
      typical of mismatch correction defective cells.

PMID- 7780969
TI  - Multiple genetic alterations in hamster pancreatic ductal adenocarcinomas.
AB  - Pancreatic ductal adenocarcinomas induced in the Syrian golden hamster (SGH) by N
      nitrosobis(2-oxopropyl)amine share many similarities with the human disease,
      including mutations of the K-ras oncogene. In vitro carcinogenesis studies with
      immortal SGH pancreatic duct cells indicate that neoplastic transformation in
      this system can occur without mutational inactivation of p53 suppressor gene. In
      this study we extend the genetic analysis of the in vivo SGH model to increase
      the number of cases analyzed for the status of K-ras and to determine further the
      spectrum of alterations involved; we have studied the status of the p53, DCC, and
      Rb-1 suppressor genes and the status of the mdm2 oncogene, which can involve p53
      indirectly. The partial SGH-coding sequence of mdm2 and DCC was determined. K-ras
      mutation in the second position of codon 12 was present in 17 of 19 (90%) of
      tumors. Immunohistochemistry and single strand conformation polymorphism analysis
      showed no evidence of p53 mutation in 21 tumors. RNase protection assays showed
      overexpression of mdm2 in 5 of 19 (26%) tumors. Semiquantitative reverse
      transcription-PCR analysis showed a complete or partial loss of DCC expression in
      10 of 19 (53%) neoplasms and of Rb-1 (42%) expression in 8 of 19 tumors when
      compared to matched controls. Deregulation of these genes appears to be
      significant in SGH pancreatic carcinogenesis as indicated by their frequencies.
      However, the fact that 6 tumors showed either only a K-ras mutation or the
      absence of alterations of the 5 genes analyzed indicates that additional as yet
      unstudied or unknown genes are also involved in SGH pancreatic duct
      carcinogenesis.

PMID- 7780971
TI  - Bcl-xL is expressed in neuroblastoma cells and modulates chemotherapy-induced
      apoptosis.
AB  - bcl-x is a new member of the bcl-2 gene family and is highly expressed in neural
      tissues. The present study was designed to determine the expression of the bcl-x
      gene products in neuroblastoma (NB) and their role in the modulation of
      chemotherapy-induced apoptosis. Twenty-seven NB cell lines were screened by
      quantitative immunoprecipitation for Bcl-xL, Bcl-xS, and Bcl-2 expression. None
      of the cell lines expressed Bcl-xS. Twenty-four of 27 (88%) of the NB cell lines
      expressed Bcl-xL and 21 of 27 (78%) were positive for Bcl-2. The level of Bcl-xL
      and Bcl-2 expression was variable among the lines analyzed. Bcl-2 expression was
      restricted to cells of chromaffin lineage, whereas Bcl-xL was seen in both
      chromaffin and nonchromaffin lines. To determine whether Bcl-xL could mediate
      chemotherapy resistance, a NB cell line expressing negligible levels of Bcl-xL
      was transfected with a bcl-xL expression vector, and unique clones were generated
      expressing variable levels of Bcl-xL. Cells were treated either with cisplatinum
      (CP), 4-hydroperoxy-cyclophosphamide (4-HC), or etoposide (VP-16) to induce
      apoptosis, and cell viability and DNA degradation were determined. Following
      treatment with CP or 4-HC, Bcl-xL-expressing cells showed significantly increased
      viability as compared to vector-transfected controls (P < 0.005). Flow cytometric
      analysis of propidium iodide-stained nuclei following CP or 4-HC treatment
      revealed significantly increased DNA degradation in controls as compared to Bcl
      xL-expressing lines (P < 0.004). DNA analysis by pulsed-field gel electrophoresis
      revealed high molecular weight (approximately 40 kb) DNA degradation in controls,
      whereas the DNA in cells expressing Bcl-xL was largely intact. In contrast to CP
      and 4-HC, results with VP-16 revealed a short-term delay in the onset of
      apoptosis in Bcl-xL-expressing cells with no long-term survival advantage. The
      results of these studies indicate Bcl-xL is expressed in NB cells and functions
      in a manner analogous to Bcl-2 by inhibiting chemotherapy-induced apoptosis.

PMID- 7780972
TI  - An estrogen-independent MCF-7 breast cancer cell line which contains a novel 80
      kilodalton estrogen receptor-related protein.
AB  - Long-term growth of estrogen-responsive human breast cancer cell lines in
      estrogen-free media leads inevitably to the development of estrogen-independent
      growth. We have identified and characterized a unique subclone of the MCF-7 human
      breast cancer cell line, named MCF-7:2A, which grows maximally in the absence of
      endogenous estrogens but whose growth is inhibited by the antiestrogens 4
      hydroxytamoxifen and ICI 164,384. The MCF-7:2A cells express high levels of
      estrogen receptor (ER; 477 fmol/mg protein), which can be reduced by growth in 10
      nM 17 beta-estradiol (201 fmol/mg protein). Basal progesterone receptor synthesis
      is very low in the 2A cells (< 1 fmol/mg protein) but can be dramatically
      increased by 10 nM 17 beta-estradiol (384 fmol/mg protein). Clearly, the pathways
      that control growth and estrogen-regulated genes such as the progesterone
      receptor are now dissociated in these cells. MCF-7:2A cells also possess two
      unique characteristics. First, the MCF-7:2A cells constitutively activate an ER
      responsive luciferase reporter construct in the absence of any estrogens, and
      this activation can be blocked by either 4-hydroxytamoxifen or ICI 164,384. This
      constitutive activity is not observed in the parental MCF-7 cells. Second, they
      express an 80-kDa protein that cross-reacts with three distinct antibodies to the
      ER. The MCF-7:2A cells were subjected to an additional round of limiting dilution
      subcloning, and 10 independent clones were all shown to express both the 66- and
      80-kDa ERs as observed in the MCF-7:2A line. This confirms that both ERs are
      being expressed in each cell and are not the result of a mixed population of
      cells. While numerous ER variants have been reported previously, no ER has until
      now been described that is larger than the wild-type 66-kDa ER. The MCF-7:2A
      cells provide a unique model to use in the study of ER action and the development
      of estrogen-independent growth in human breast cancer cells.

PMID- 7780973
TI  - Prolactin synthesis and secretion by human breast cancer cells.
AB  - A possible autocrine function of prolactin (Prl) in human breast cancer was
      explored by the addition of a panel of anti-human Prl mAbs to T47Dco and MCF7
      human breast adenocarcinoma cells. mAb 631 and mAb 390 inhibited cell growth by
      86 and 68%, respectively, in the estrogen receptor-negative T47Dco cells and by
      20 and 71%, respectively, in the estrogen receptor-positive MCF7 cells.
      Conditioned medium prepared from T47Dco cells was assessed for the presence of
      Prl-like molecules by its ability to stimulate growth of Prl-responsive Nb2 rat
      lymphoma cells. Growth of Nb2 cells under the influence of human Prl or
      conditioned medium was abolished when either solution was pretreated with mAb
      390, followed by Immunobead precipitation (Bio-Rad, Melville, NY). T47Dco cells
      secrete 0.7 microgram lactogen/ml over a 24-48-h period. With the use of reverse
      transcription-PCR, an expected 612-bp band was detected by ethidium bromide
      staining, and its similarity to pituitary Prl was confirmed by Southern blot
      analysis with the use of human Prl cDNA as a probe. A single M(r) 22,000 band,
      the dominant size of monomeric pituitary Prl, was found in immunoprecipitates of
      both cell extracts and conditioned medium from T47Dco cells labeled metabolically
      with [35S]cysteine. These data suggest that human breast cancer cells synthesize
      and secrete biologically active Prl.

PMID- 7780974
TI  - Modulation of transforming growth factor beta 1 effects on prostate cancer cell
      proliferation by growth factors and extracellular matrix.
AB  - Poorly differentiated MATLyLu rat prostate cancer cells are resistant to the
      growth inhibitory effect of transforming growth factor (TGF) beta 1 in vivo, but
      are inhibited by TGF-beta 1 in vitro. However, TGF-beta 1 inhibited proliferation
      only when the cells were plated at low density in serum-free medium
      (concentration for 50% of maximum inhibition, 0.1 ng/ml). TGF-beta 1 was not
      growth inhibitory when cells were plated at high density, or at low density in
      0.5% serum. At low cell density in serum-free medium, 0.5 ng/ml TGF-beta 1 caused
      maximum inhibition. In the presence of basic fibroblast growth factor (10 ng/ml),
      TGF-beta 1 did not inhibit proliferation. In the presence of epidermal growth
      factor (50 ng/ml), TGF-beta 1 inhibited proliferation by only 18%. Growth
      inhibition by TGF-beta 1 was less effective on extracellular matrix than on
      plastic. The ability of high cell density, serum, growth factors, or
      extracellular matrix to prevent or blunt the growth inhibitory effect of TGF-beta
      1 in vitro probably explains why TGF-beta 1 does not inhibit tumor growth in
      vivo. Thus, prostate cancer cells express high levels of TGF-beta and retain
      exquisite sensitivity to the growth inhibitory effect of TGF-beta, but have
      devised a way to protect themselves from growth inhibition by TGF-beta in vivo.
      TGF-beta 1 stimulated MATLyLu cell motility even at high cell density, suggesting
      that TGF-beta 1 might affect motility even in vivo and contribute to the
      aggressiveness of the tumor, without affecting proliferation.

PMID- 7780975
TI  - Antimelanoma effect of 4-S-cysteaminylcatechol, an activated form of 4-S
      cysteaminylphenol.
AB  - Rational chemotherapy of malignant melanoma could be developed by taking
      advantage of the presence of melanogenic enzymes in melanoma cells. 4-S
      Cysteaminylphenol (4-S-CAP) has been evaluated for melanocytotoxicity and
      antimelanoma effect. Although 4-S-CAP is selectively toxic to pigmented melanoma
      cells, it is not potent enough when applied as a single agent. To increase the
      efficacy of 4-S-CAP, we synthesized 4-S-cysteaminylcatechol (4-S-CAC), an
      activated form of 4-S-CAP, and compared its biochemical properties and
      antimelanoma effects with those of the isomers 3-S-cysteaminylcatechol (3-S-CAC)
      and 2-S-cysteaminyl-hydroquinone (2-S-CAH). 4-S-CAC was found to be a better
      substrate for melanoma tyrosinase than was L-3,4-dihydroxyphenylalanine, the
      natural catecholic substrate. 3-S-CAC was a poor substrate, whereas 2-S-CAH was
      not a substrate. 4-S-CAC was the most cytotoxic to three lines of melanoma cells
      in vitro, followed by 2-S-CAH and 3-S-CAC. When applied i.p. for 9 days at a dose
      of 100 mg/kg, 4-S-CAC.HCl, increased by 46-52% the life span of C57BL/6 mice
      inoculated i.p. with B16 melanoma; this effect was comparable to that of a 50
      mg/kg dose of 5-(3,3-dimethyltriazenyl)-1H-imidazole-4-carboxamide. 3-S-CAC was
      marginally effective, whereas 2-S-CAH was toxic to the host. This systemic
      toxicity of 2-S-CAH reflected its susceptibility to autoxidation. Growth of B16
      melanoma cells inoculated s.c. was significantly inhibited by i.p. administration
      of 4-S-CAC.HCl (200 mg/kg) for 5 days (P < 0.05). These results suggest that 4-S
      CAC is a potent antimelanoma agent, the effect of which is mostly mediated
      through tyrosinase oxidation.

PMID- 7780976
TI  - Retrovirus-mediated expression of a DNA repair protein in bone marrow protects
      hematopoietic cells from nitrosourea-induced toxicity in vitro and in vivo.
AB  - Severe and delayed myelosuppression is a major side effect encountered with the
      clinical use of nitrosourea-type chemotherapeutic drugs. The DNA repair protein
      O6-methylguanine DNA methyltransferase (MGMT) has been shown to repair
      nitrosourea-induced DNA damage. We therefore investigated the effect of
      expressing MGMT in hematopoietic cells (via retrovirus-mediated gene transfer) on
      nitrosourea-induced toxicity. A retroviral vector (N2/ZipPGK-MGMT) expressing the
      human MGMT cDNA from the phosphoglycerate kinase promoter was constructed.
      Infection of murine bone marrow with the N2/ZipPGK-MGMT retrovirus significantly
      increased the survival of murine bone marrow-committed progenitor cells following
      in vitro exposure to N-N'-bis(2-chloroethyl)-N-nitrosourea (BCNU, carmustine).
      MGMT gene transfer also protected murine hematopoietic cells in vivo in a murine
      model of BCNU-induced myelosuppression. The infusion of 4-6 x 10(6) N2/ZipPGK
      MGMT-transduced bone marrow cells into mice every 2 weeks significantly increased
      peripheral leukocyte counts, platelet counts, and hematocrits compared to
      infusions of mock-infected bone marrow cells. In addition, bone marrow-committed
      progenitor cells from some recipient animals demonstrated increased resistance to
      BCNU in vitro when analyzed 2.5 months after initial treatment. The integration
      of the N2/ZipPGK-MGMT provirus in the spleen DNA from these animals correlated
      with committed progenitor cell resistance to BCNU. These data suggest that MGMT
      expression in hematopoietic progenitor and precursor cells protects against
      nitrosourea-induced toxicity and that gene transfer may prove useful in attempts
      to reduce nitrosourea-induced myelosuppression in the clinical setting.

PMID- 7780977
TI  - Inhibition of the growth of various human and mouse tumor cells by 1,15
      bis(ethylamino)-4,8,12-triazapentadecane.
AB  - Effects of 1,15-bis(ethylamino)-4,8,12-triazapentadecane (BE3333), the least
      toxic bis(ethyl)pentaamine, on the growth of tumor cells were studied in in vitro
      systems and with tumor xenografts in mice. BE3333 suppressed ornithine
      decarboxylase and S-adenosylmethionine decarboxylase, induced spermidine/spermine
      N1-acetyltransferase, and thus decreased the amount of polyamines. BE3333
      accumulated in cells at a concentration 3-5-fold that of spermine in control
      cells through the polyamine transport system. The accumulated BE3333 inhibited
      protein synthesis, especially mitochondrial protein synthesis, and decreased the
      amount of ATP. The inhibition of protein synthesis was correlated with the
      subsequent inhibition of cell growth. BE3333 showed inhibitory effects in in
      vitro systems against the growth of mouse FM3A mammary carcinoma cells, human
      SW480 and SW620 colon tumor cells, Lu-65A and A549 lung tumor cells, MCF-7 breast
      tumor cells, and MALME-3M and A375 melanoma cells at a range of 0.5-10 microM.
      Intravenous (30 mg/kg) or i.p. (50 mg/kg) daily injections of BE3333 for 5 or 7
      days greatly suppressed the growth of human colon tumor SW620 xenotransplanted
      into nude mice. Similar antitumor activity was obtained with continuous infusion
      of BE3333 into the peritoneal cavity (80 mg/kg), but not with p.o. administration
      (200 mg/kg). BE3333 also showed inhibitory effects against the growth of lung
      tumors (Lu-65, Lx-1, Lc-1, and Lu-61), stomach tumors (Sc-6 and St-15), and
      melanoma (SEKI) xenotransplanted into nude mice. The results indicate that BE3333
      is effective against both rapid- and slow-growing tumors, with reasonable short
      term host toxicity.

PMID- 7780978
TI  - Uptake, localization, and photodynamic effect of meso
      tetra(hydroxyphenyl)porphine and its corresponding chlorin in normal and tumor
      tissues of mice bearing mammary carcinoma.
AB  - By using a chemical extraction assay and confocal laser scanning fluorescence
      microscopy, the kinetic patterns of uptake, elimination, and localization of meso
      tetra(hydroxyphenyl)porphine (m-THPP) and its corresponding chlorin (m-THPC) in
      tumors and various normal tissues of female C3D2/F1 mice bearing CaD2 mammary
      carcinoma were studied after an i.p. injection of either 5 mg/kg body weight of m
      THPP or 1 mg/kg body weight of m-THPC. Moreover, the histological and
      ultrastructural alterations of the tumors were evaluated after photodynamic
      therapy (PDT) with m-THPP or m-THPC. The PDT efficacy with m-THPP and m-THPC was
      also compared. Both m-THPP and m-THPC had a similar kinetic pattern of
      distribution in the tumors and most normal tissues examined. The concentrations
      of the dyes in the tissues peaked at 24-48 h after injection. The peak values of
      the uptake of m-THPP by the tissues were found to decrease in the following
      order: spleen > urinary tract > kidney > liver > lung > tumor > heart > skin >
      muscle > brain. However, higher concentrations of m-THPC were taken up by the
      tumors than by most of the normal tissues studied except for the liver, urinary
      tract, and skin. m-THPP was mainly localized in the stroma of the tumors, whereas
      m-THPC was distributed in both vascular interstitium and neoplastic cells of the
      tumors. Morphological studies showed that PDT with m-THPP resulted in destructive
      changes in the microvasculature of the tumors, whereas m-THPC-based PDT destroyed
      both vascular walls and tumor cells of the tumors. The m-THPP-PDT of the tumors
      was much less efficient than m-THPC-PDT of the tumors, although the dose of m
      THPP used was five times higher than that of m-THPC. m-THPP and m-THPC have
      different efficiency of sensitizing tumors to photodestruction, although they are
      similar with respect to hydrophobicity. This is likely due to the differences in
      their intratumoral localization patterns and in their absorption spectra.

PMID- 7780979
TI  - Suppressive role of the metastasis-related nm23-H1 gene in human ovarian
      carcinomas: association of high messenger RNA expression with lack of lymph node
      metastasis.
AB  - The nm23-H1 gene has been proposed as a metastasis suppressor gene. It is located
      on the long arm of chromosome 17, which is frequently deleted in ovarian cancer,
      and shows altered expression and structure in some advanced neoplasms. To
      evaluate the role of nm23-H1 in ovarian carcinogenesis, we have analyzed this
      gene in 66 primary human ovarian carcinomas at both the DNA and RNA levels.
      Despite the high frequency (76%) of nm23-H1 loss of heterozygosity (LOH), the
      complete absence of gene mutations in the coding portions of the retained allele
      clearly indicated that, in ovarian carcinomas, this gene does not function in the
      same way as do classic oncosuppressor genes. The relationship of
      clinicopathological parameters with nm23-H1 gene deletions and expression levels
      was also investigated. LOHs were more common in the serous and endometrioid
      histotypes (85 and 93%, respectively), and the highest LOH frequency was detected
      in poorly differentiated tumors (89%). A significant relationship between nm23-H1
      mRNA expression and lymph node metastasis was observed in high-grade tumors,
      which are intrinsically more invasive than are low-grade tumors. In particular,
      among the poorly differentiated tumors showing areas of undifferentiated solid
      carcinoma (classified as G3/G4), lymph node-negative tumors displayed expression
      levels that were significantly higher than those of lymph node-positive tumors (P
      < 0.001). In conclusion, our data suggest that the nm23-H1 gene product may exert
      an inhibitory effect on the lymphatic dissemination of human ovarian tumors.
      However, several other factors, biological or time and patient dependent,
      influence the complex metastatic progression of ovarian tumors and may cooperate
      with nm23-H1 in the promotion or inhibition of this process.

PMID- 7780980
TI  - Identification of an enhancer responsible for tumor marker gene expression by
      means of transgenic rats.
AB  - The glutathione transferase P (GST-P) gene is known for its specific expression
      during chemical hepatocarcinogenesis of the rat and is used as a tumor marker for
      hepatocellular carcinoma. We have shown recently that the upstream 2.9-kb region
      of the GST-P gene is sufficient for conferring tumor-specific expression of the
      gene in vivo (S. Morimura et al., Proc. Natl. Acad. Sci. USA, 90: 2065-2068,
      1993). To further identify crucial sequence elements regulating the unique
      expression of this gene, we have established six independent lines of transgenic
      rats bearing distinct areas of the GST-P gene that are connected to the
      chloramphenicol acetyltransferase coding region and analyzed changes of the
      chloramphenicol acetyltransferase activity during the course of chemical
      hepatocarcinogenesis. We demonstrate here that the enhancer, glutathione
      transferase P enhancer I, that is located 2.5 kb upstream of the GST-P gene is
      required and sufficient for its tumor-specific expression of the gene among other
      controlling elements. This approach to transgene expression could be used to
      define other enhancers, the activity of which is dependent on cellular changes
      such as carcinogenesis, development, and differentiation.

PMID- 7780981
TI  - Sequential loss of heterozygosity at microsatellite motifs in preinvasive and
      invasive head and neck squamous carcinoma.
AB  - Studies of sequential molecular alterations in noninvasive and invasive head and
      neck squamous carcinoma are few in number. Consequently, the genetic changes
      associated with the neoplastic transformation of these carcinomas have not been
      defined. To identify chromosomal alterations in preinvasive and invasive head and
      neck squamous carcinoma, we analyzed DNA from microdissected normal squamous
      epithelium, severe dysplasia, and invasive carcinoma samples from 20 patients for
      loss of heterozygosity (LOH) at microsatellite loci by multiplex PCR. Twenty-five
      microsatellite repeats on chromosomes 3p, 5q, 8p, 9p and 9q, 11q, 17p, 17q, and
      18p and 18q regions were used. In informative cases, LOH in noninvasive lesions
      was observed in 9p (28%), 9q and 18q (10%), 11q and 17p (7%), and 3p and 18p
      (5%). A high incidence of LOH in invasive carcinoma was observed at 9p (72%), 8p
      (53%), 3p (47%), 9q (35%), and 11q (33%). LOH was also associated with DNA
      aneuploidy, high tumor stage, and poor histological differentiation. Our results
      indicate that: (a) the high incidence of LOH at loci on chromosomes 9p, 8p, 3p,
      9q, and 11q implicate these regions in head and neck squamous carcinoma
      tumorigenesis; (b) 9p loci alterations are manifested in the early development of
      these tumors; (c) LOH is correlated with poor prognostic clinicopathological
      factors; and (d) LOH at 8p loci appears to be associated with the tumor's
      aggressive features.

PMID- 7780982
TI  - Loss of heterozygosity for chromosome 11 in primary human breast tumors is
      associated with poor survival after metastasis.
AB  - A common feature of the malignant progression of human tumors is loss of
      heterozygosity (LOH) for various regions of their genomes. Such events
      encompassing chromosomes 11p15 and 11q23 are frequent in human breast tumors.
      Here, we have analyzed genetic and clinical characteristics of a series of
      primary breast tumors in order to determine: (a) a more finely mapped estimate of
      the involved regions; (b) whether there is a relationship in the presentation of
      LOH between the two regions; and (c) whether a correlation exists between such
      LOH and any of the clinical parameters pertaining to each patient. We found that
      LOH for 11p15.5 and 11q23 occurred in 35 and 46% of the 86 primary breast
      carcinomas, respectively, but in none of the 10 benign tumors examined. The
      minimal region of LOH for 11p15 was in the approximately 2-megabase region
      between loci TH and D11S988. Twenty-nine % of the tumors showed LOH
      simultaneously at both 11p15 and 11q23, 5% had LOH only at 11p15.5, and 15% had
      LOH only at 11q23. Among these genetic groups, clinical features such as tumor
      size, involvement of auxiliary nodes, histological subtype, tumor grade,
      estrogen/progesterone receptor status, and patient age were not markedly
      different. However, LOH of 11q23 (either alone or in conjunction with LOH of
      11p15) in the primary tumor was found to be highly predictive of aggressive
      postmetastatic disease course with substantially reduced survival (P = 0.0004;
      log rank test). We also observed a slight trend toward a more rapid development
      of metastatic lesions, without obvious site specificity, in patients with primary
      tumors showing LOH for chromosome 11 in the pathogenesis of human breast cancer;
      we suggest that its effects are late in the progression of this disease.

PMID- 7780983
TI  - Mutations of the K-ras and p53 genes in gastric adenocarcinomas from a high
      incidence region around Florence, Italy.
AB  - K-ras and p53 gene mutations in intestinal-type gastric carcinomas from a high
      incidence area around Florence, Italy, were studied by single strand conformation
      polymorphism and DNA sequencing analysis. Single-strand conformation polymorphism
      analysis of K-ras indicated aberrant bands in 13 of 34 cases. Sequencing revealed
      point mutations in 7 (including two at a previously unreported site in codon 11),
      a significantly higher frequency than reported in countries other than Japan. No
      K-ras mutations were identified in stage III tumors. Single-strand conformation
      polymorphisms in p53 exons 5-8 occurred in 30 of 34 cases, with mutations
      identifiable by direct sequencing in 65% of the cases. Of these, 91% were base
      substitutions, a value similar to that usually reported, but the percentage of
      G:C to A:T transitions (90% in this study, 89% in all published European cases
      combined) differed significantly from that in Oriental cases (48%). The
      percentage of A:T to G:C transitions was greater in Oriental (22%) than European
      cases (2%), as was also true for transversions (30% in Oriental tumors, 9% in
      European tumors). The frequency of mutations at CpG sites (14%) varied
      significantly from the 67% in cases from a neighboring region in Italy.
      Helicobacter pylori infection was established in 19 cases and was somewhat more
      common in cases lacking a p53 mutation.

PMID- 7780984
TI  - Identification of a monoclonal antibody, TV-1, directed against the basement
      membrane of tumor vessels, and its use to enhance the delivery of macromolecules
      to tumors after conjugation with interleukin 2.
AB  - mAbs reactive with epitopes expressed on tumor vessels were evaluated as
      universal delivery agents of peptides with vasoactive properties to enhance the
      uptake of macromolecules in tumors. Unlike other reported approaches to target
      tumor vessels, a mAb designated TV-1 targets a basement membrane antigen that is
      found in all tissues but that is accessible only in tumor vessels, making it an
      alternative vehicle for the delivery of biologically active peptides to tumors. A
      panel of 30 monoclonal and polyclonal antibodies was screened by
      immunohistochemistry on sections of human tumors, normal vascular endothelium,
      and connective tissues. Five antibodies were chosen for in vivo evaluation,
      including two antifibronectin antibodies (TV-1, HFN 7.1), one anti-basic
      fibroblast growth factor antibody (anti-BFGF), and two antibodies reactive with a
      mesenchymal cell antigen (TP-1, TP-3). Three nude mouse tumor models
      characterized by varying degrees of vascularization (low to high) were used.
      After chemical conjugation to interleukin 2 (IL-2), these antibodies were used to
      pretreat tumor-bearing nude mice 3 h before injection with a radiolabeled mAb
      directed to the transplanted tumors. Pretreatment with TV-1/IL-2 or HFN 7.1/IL-2
      produced a 3-fold higher tumor uptake of radiolabel compared to control mice
      pretreated with mAb alone. The other three vasoactive immunoconjugates failed to
      show significant increases in these tumor models. When TV-1/IL-2 was compared
      with the specific vasoconjugate (Lym-1/IL-2) as a pretreatment in the Raji
      lymphoma model, which has low vascularization, TV-1/IL-2 yielded approximately
      60% of the tumor uptake seen with Lym-1/IL-2. In comparison, pretreatment with TV
      1/IL-2 in the LS174T colon carcinoma model, which has high vascularization,
      yielded approximately the same tumor uptake seen with the B72.3/IL-2
      vasoconjugate, which directly targets the tumor cells. These studies demonstrate
      that a mAb directed against fibronectin in the endothelial subcellular matrix can
      be used to deliver vasoactive agents to tumors.

PMID- 7780985
TI  - Mucin gene expression in normal, preneoplastic, and neoplastic human gastric
      epithelium.
AB  - Mucins synthesized by malignant cells may contribute (via decreased cellular
      adhesion and immune recognition) to cancer invasion and metastases. Human mucins
      are derived from a heterogeneous family of genes, labeled MUC1-6. Our aim was to
      determine the pattern of mucin gene expression in normal, preneoplastic
      (intestinal metaplasia), and malignant gastric specimens. Probes and antibodies
      for specific mucin tandem repeat sequences were used for RNA and
      immunohistochemical analysis. Normal stomach mucosa was characterized by
      expression of MUC1, MUC5, and MUC6 mRNA and immunoreactive protein, without MUC2,
      MUC3, and MUC4 gene expression. In contrast, high levels of MUC2 and MUC3 mucin
      mRNA and immunoreactive protein were found in specimens with intestinal
      metaplasia. Gastric cancers exhibited markedly altered secretory mucin mRNA
      levels compared with adjacent normal mucosa, with decreased levels of MUC5 and
      MUC6 mRNA and increased levels of MUC3 and MUC4 mRNA. Overall, immunoreactive
      MUC1 mucin was detected in 72% of 33 gastric cancers, and secretory mucin core
      peptides were expressed in 34% (MUC2), 45% (MUC3), 19% (MUC5), and 57% (MUC6) of
      these specimens. Coexpression of multiple (three or more) mucin core proteins
      occurred in 15 of 25 (60%) advanced (stages III and IV) cancers compared with 1
      of 8 (12.5%) early (stages I and II) cancers (P < 0.048). We conclude that human
      gastric epithelium has a unique mucin gene pattern, which becomes markedly
      altered in preneoplastic and neoplastic specimens. Increased mucin gene
      heterogeneity in gastric adenocarcinomas is associated with advanced cancer
      stage.

PMID- 7780986
TI  - Expression of peripheral-type benzodiazepine receptor and diazepam binding
      inhibitor in human astrocytomas: relationship to cell proliferation.
AB  - The expression of peripheral-type benzodiazepine receptor (PBR) and diazepam
      binding inhibitor (DBI) were studied in human astrocytic tumors using
      immunocytochemistry and in situ hybridization. Both PBR and DBI were prominently
      expressed in neoplastic cells, whereas in normal brain their amount was low or
      undetectable. Immunocytochemical double staining demonstrated that PBR and DBI
      were present in the same cells, suggesting that DBI may act in an autocrine
      manner in these cells. Analysis of 86 cases showed that PBR expression was
      statistically significantly associated with tumor malignancy grade (P = 0.004)
      and the proliferative index as determined by immunocytochemistry with the MIB-1
      antibody (P = 0.004). Patients having tumors with high levels of PBR
      immunoreactive cells had a shorter life expectancy than patients whose tumors
      showed lower PBR contents (P = 0.024). In conclusion, these results show that PBR
      expression is higher in neoplastic cells than in normal brain tissue. They also
      suggest that PBR immunocytochemistry might be useful in evaluating malignancy in
      brain tumors.

PMID- 7780987
TI  - Glutathione S-transferase pi in colorectal tumors is predictive for overall
      survival.
AB  - Glutathione S-transferases (GSTs) are enzymes involved in the detoxification of
      xenobiotics and are divided into four subclasses, alpha, mu, pi, and theta, with
      different although overlapping substrate specificities. Most human
      gastrointestinal tumors contain increased amounts of GST-pi and GST enzyme
      activity. The relationship between GST parameters and tumor and patient
      characteristics, including overall survival, were studied retrospectively in 100
      primary colorectal adenocarcinomas. Levels of GST-alpha, GST-mu, GST-pi, and GST
      enzyme activity were not related to the Dukes stage, differentiation grade,
      localization, histological type and diameter of the tumor, or gender and age of
      the patient. Fifty-seven patients died (median survival, 21 months; range, 1-65
      months) during follow-up, and 43 patients were still alive at the closing date of
      the study (median follow-up, 68 months; range, 60-87 months). Optimal
      dichotomization and uni- and multivariate analyses were done with the Cox
      proportional hazard model. Multivariate analysis with all clinicopathological
      parameters revealed higher Dukes stage (hazard ratio, 2.7; P < 0.001) and older
      age (hazard ratio, 2.8; P = 0.001) to be the only independent prognostic
      variables for overall survival. In contrast to GST-alpha and GST-mu, high levels
      of GST-pi (hazard ratio, 3.1; P = 0.002) and GST enzyme activity (hazard ratio,
      2.0; P = 0.020) in the tumors were found to have a significant prognostic value
      independent from the clinicopathological parameters when added separately to this
      Cox model. Thus, this study indicates that GST subclass levels in colorectal
      adenocarcinomas are not related to clinicopathological parameters and that the
      GST-pi level and GST enzyme activity have a prognostic value for the overall
      survival of the patients.

PMID- 7780989
TI  - Synthesis of 3,4-di-O-acetyl-2,5-anhydro-1,6-dideoxy-1,6-diiodo-D-mannitol.
      Comparison of NMR spectral results for the solid state and solution with those of
      the X-ray structural determination.
AB  - 3,4-Di-O-acetyl-2,5-anhydro-1,6-dideoxy-1,6-diiodo-D-mannitol (3) is prepared
      from 2,5-anhydro-D-mannitol (1) in three steps. The solution and solid-state NMR
      spectra of 3 indicate considerable variation in conformation. In solution, it
      adopts, on average, a symmetric 4T3 conformation, whereas in the solid state it
      adopts an asymmetric conformation as revealed by 13C NMR cross polarization and
      magic angle spinning techniques. A single-crystal X-ray structure analysis
      confirmed the asymmetric conformation of 3 in a monoclinic crystal, space group
      P2(1) with a = 8.9608(4), b = 8.6348(5), c = 9.6468(4) A, beta = 96.139(4)
      degrees, V = 742.1(1) A3, Dc = 2.085 g cm-3, mu (MoK alpha) = 4.2 mm-1, and Z =
      2. The structure was refined to R = 0.039 and Rw = 0.047 for 5181 observed
      reflections. The furanoid ring of 3 adopts an envelope E5 conformation slightly
      distorted towards 4T5, with puckering parameters psi = 313.49 degrees and q =
      0.37 A. The asymmetric conformation is rationalized in terms of the weak packing
      forces in the crystal.

PMID- 7780988
TI  - Expression of platelet-derived growth factor B-chain and the platelet-derived
      growth factor receptor beta subunit in human breast tissue and breast carcinoma.
AB  - Breast carcinomas are known to express platelet-derived growth factor (PDGF), a
      known connective tissue mitogen. In order to further evaluate the potential role
      of PDGF in these epithelial tumors, expression of the PDGF B chain (PDGF-B) and
      the PDGF receptor beta subunit (PDGFR) was analyzed by immunocytochemistry and in
      situ hybridization in 49 benign and malignant breast tissues. PDGF-B expression
      was analyzed with respect to the expression of the proliferating cell nuclear
      antigen, as well as tumor grade, p53 overexpression, estrogen receptor,
      progesterone receptor, and c-erbB-2 expression. Expression of PDGF-B protein and
      mRNA was restricted to the breast epithelium and tumor cells except for scattered
      tissue macrophages. A strong correlation was found between increasing
      proliferating cell nuclear antigen indices and PDGF-B expression in both
      nonmalignant (P = 0.01) and malignant (P = 0.02) breast specimens. Decreased PDGF
      B expression was found in postmenopausal atrophic breast tissue compared with
      normal breast tissue (P = 0.04). Within the subgroup of malignant tumors, no
      correlations were found between PDGF-B expression and tumor grade or p53
      overexpression. In 16 of the malignant tumors evaluated for estrogen/progesterone
      receptor status and c-erbB-2 overexpression, no correlations with PDGF-B
      expression were found. Membranous PDGFR immunostaining was present within the
      fibroblastic cell population in all of the tissues examined but not in the
      nonmalignant breast epithelium. Six malignant specimens had detectable
      cytoplasmic expression of PDGFR. There was no correlation between this PDGFR
      expression and proliferating cell nuclear antigen indices, but a correlation was
      noted between increasing estrogen receptor expression and PDGFR cytoplasmic
      expression (P = 0.04). The results support a paracrine role for PDGF-B in
      malignant and benign breast epithelial cell proliferation.

PMID- 7780990
TI  - Solid-phase synthesis of a glycosylated hexapeptide of human sialophorin, using
      the trichloroacetimidate method.
AB  - A hexapeptide containing a beta-D-Gal p-(1-->3)-alpha-D-Gal pNAc-(1-->O)-L
      threonine unit was synthesized using glycosylated pentafluorophenyl esters in an
      Fmoc-based strategy. In all of the glycosylation reactions, trichloroacetimidates
      were successfully employed. The disaccharide moiety was prepared from tetra-O
      acetyl-alpha-D-galactopyranosyl trichloroacetimidate and tert-butyldimethylsilyl
      2-azido-6-O-benzoyl-2-deoxy-beta-E-galactopyranoside with boron trifluoride
      etherate as a catalyst. The glycosylated active esters were obtained in the
      reaction of alpha and beta 2,3,4,6-tetra-O-acetyl-beta-D-galactopyranosyl-(1-->3)
      4-O-acetyl-2-azid o-6- O-benzoyl-2-deoxy-D-galactopyranosyl trichloroacetimidates
      with Fmoc-protected pentafluorophenyl esters of L-serine and L-threonine in the
      presence of trimethylsilyl trifluoromethanesulfonate as Lewis acid. The
      glycosylated pentafluorophenyl ester of L-threonine was transformed into
      glycopeptides via a solid-phase synthesis. Azide reduction and N-acetylation were
      performed on the solid phase with a thioacetic acid-pyridine mixture. The
      glycopeptide was then cleaved from the resin with strong acid, also removing the
      acid-labile protecting groups of the peptide chain. Finally, the acyl groups used
      for sugar protection were cleaved with sodium methoxide, affording the completely
      deprotected N-acetyl-L-leucyl-L-glutamyl-O-[beta-D-galactopyranosyl-(1-->3)-2-
      acetamido-2-deoxy-alpha-D-galactopyranosyl]-L-threonyl-L-seryl-L-threony l-
      glycinamide (1) in high purity.

PMID- 7780991
TI  - Stereoselective synthesis of a blood group A type glycopeptide present in human
      blood mucin.
AB  - N,N-Dimethyl-O-(2-acetamido-2-deoxy-alpha-D-galactopyranosyl)-(1-->3)-O- [(alpha
      L-fucopyranosyl)-(1-->2)]-O-(beta-D-galactopyranosyl)-(1-->3)-O- (2-acetamido-2
      deoxy-alpha-D-galactopyranosyl)-(1-->3)-L-serine, a core I glycotetraosyl peptide
      structure and a predominant substructure in complex glycan-glycoproteins present
      in human blood group A ovarian mucin, was synthesized for the first time. The
      title compound was synthetically accomplished via the following key manoeuvres:
      regio- and stereo-controlled construction of the alpha-GalNAc-(1-->3)-Gal
      synthon, stereoselective glycosylation generating a alpha-GalN3-(1-->3)-Ser
      glycopeptide synthon and alpha-selective fucosylation towards an acceptor which
      was derived from glycosylation of the latter two synthons. An alternative route
      to that of the latter, to synthesize a fully protected equivalent of the title
      compound, involving the coupling of a alpha-GalNAc-(1-->3)-beta-Gal-(1-->3)
      GalN3X synthon to an aglycon serine derivative, is described herein.

PMID- 7780992
TI  - Synthesis of N-beta-D-glucopyranosyluronate derivatives of barbital,
      phenobarbital, metharbital, and mephobarbital.
AB  - The synthesis and characterization of barbital, phenobarbital, metharbital, and
      mephobarbital glucuronides is reported. The condensation of per(trimethylsilyl)
      barbital and -phenobarbital with methyl 1,2,3,4-tetra-O-acetyl-beta-D
      glucopyranuronate in the presence of trimethylsilyl trifluoromethanesulfonate
      gave moderate yields of the N1-(beta-D-glucopyranosyluronate) barbiturate
      derivatives. The diastereomers of the phenobarbital derivatives were resolved by
      use of C18 reversed-phase HPLC. The homologous N3-methyl barbiturate N1
      glucuronates were prepared by reaction of the barbital and phenobarbital N1
      glucuronate derivatives with diazomethane. The absolute configuration of the
      phenobarbital N1-beta-D-glucopyranuronate epimers was determined by oxidative
      removal of the glycon from the mephobarbital N1-beta-D-glucopyranuronate epimers
      to give the optical isomers of mephobarbital. The spectroscopic data for this
      series of compounds will facilitate the characterization of N-glycosylated imide
      xenobiotics that may be detected as mammalian metabolites in biodisposition
      studies.

PMID- 7780993
TI  - Enzymic transfer of 6-modified D-galactosyl residues: synthesis of biantennary
      penta- and hepta-saccharides having two 6-deoxy-D-galactose residues at the
      nonreducing end and evaluation of 6-deoxy-D-galactosyl transfer to glycoprotein
      using bovine beta-(1-->4)-galactosyltransferase and UDP-6-deoxy-D-galactose.
AB  - UDP-6-Deoxy-D-galactose and UDP-6-deoxy-6-fluoro-D-galactose were synthesized and
      their transfer to 2-acetamido-2-deoxy-D-glucose (N-acetyl-D-glucosamine) by beta
      (1-->4)-galactosyltransferase was examined. The transfer rates of 6-deoxy-D
      galactose and 6-deoxy-6-fluoro-D-galactose were 1.3 and 0.2% of that of D
      galactosyl transfer, respectively. The 2-acetamido-4-O-(6-deoxy-beta-D
      galactopyranosyl)-2-deoxy-D-glucopyranose (6'-deoxy-N-acetyllactosamine) and
      methyl 2-acetamido-4-O-(6-deoxy-6-fluoro-beta-D-galactopyranosyl)-2-deoxy-D-
      glucopyranoside (6'-deoxy-6'-fluoro-N-acetyllactosamine) were synthesized
      enzymatically in 30 and 59% yields, respectively. Further, 6-deoxy-D-galactose
      could be completely transferred to N-linked type biantennary oligosaccharides
      having two N-acetyl-D-glucosaminyl residues at the nonreducing end to give the
      corresponding penta- and hepta-saccharides in 55 and 57% yields, respectively. An
      assay of 6-deoxy-D-galactosyl transfer using asialo agalacto alpha 1-acid
      glycoprotein as an acceptor suggested that 6-deoxy-D-galactose was transferred to
      about 30% of the N-acetyl-D-glucosaminyl residues in the N-linked
      oligosaccharides of the glycoprotein.

PMID- 7780994
TI  - The structure of the capsular polysaccharide of Escherichia coli O8:K43:H11.
AB  - The primary structure of the acidic capsular polysaccharide of Escherichia coli
      08:K43:H11 was shown by monosaccharide analysis, methylation analysis, beta
      elimination, and by 1D and 2D 1H and 13C NMR spectroscopy to be composed of
      branched pentasaccharide repeating units with the structure.

PMID- 7780995
TI  - The structure of a novel polysaccharide produced by Bradyrhizobium species within
      soybean nodules.
AB  - Certain strains of Bradyrhizobium japonicum and B. elkanii produce a
      polysaccharide within the root nodules of their legume host, soybean. These
      nodule polysaccharides (NPSs) were isolated and characterized. The NPS produced
      by B. elkanii strains proved to be identical in glycosyl composition and linkages
      to the extracellular polysaccharide (EPS) of this species indicating that the NPS
      and EPS for B. elkanii have identical structures (W.F. Dudman, Carbohydr. Res.,
      66 (1978) 9-23), [formula: see text] However, the structure of the NPS from B.
      japonicum proved to be quite different from that of its EPS. Methylation analysis
      of this NPS showed that it consists of 3-linked Gal, 3-linked Rha, 2,4-linked
      Rha, 4-linked Rha, and terminal 2-O-methyl GlcA in a 1:1:1:1:1 ratio.
      Stereochemical configurations of the glycosyl residues were determined by the
      preparation and analysis of trimethylsilyl (Me3Si) (-)-2-butyl glycosides. NMR
      spectroscopy (both 1H and 13C) showed that the Gal residue is alpha-linked, while
      all the other glycosyl residues are beta-linked. Oligosaccharides produced by
      periodate oxidation-Smith degradation were purified, as were oligosaccharides
      produced by partial acid hydrolysis. Characterization of the Smith degradation
      products by methylation analysis. NMR spectroscopy, electrospray-mass
      spectrometry, and characterization of the partial acid hydrolysate
      oligosaccharides showed that the repeating oligosaccharide unit of the NPS has
      the structure, [formula: see text]

PMID- 7780996
TI  - NMR studies of acetan and the related bacterial polysaccharide, CR1/4, produced
      by a mutant strain of Acetobacter xylinum.
AB  - Acetan is a bacterial polysaccharide produced by Acetobacter xylinum NRRL B42.
      Chemical mutagenesis of A.xylinum allowed selection of a mutant strain which
      produced a new polysaccharide, CR1/4. 2D NMR methods have been used to assign the
      1H and 13C spectra of the two polysaccharides and to determine that CR1/4 has the
      structure shown below. The total number of O-acetyl groups is slightly less than
      two per repeating unit. [formula: see text] The pentasaccharide side chain of
      acetan is truncated to a disaccharide unit in CR1/4, but the structures are
      otherwise identical. In particular, the degree of acetylation is about the same
      and the O-acetyl groups are located at the same position in both polysaccharides.

PMID- 7780998
TI  - [On the meaning of life and death, today].

PMID- 7780997
TI  - The preparation of sucrose monophosphates from dried mixtures of sucrose and
      sodium phosphate.

PMID- 7780999
TI  - [The role of the cardiologist in the emergency department].

PMID- 7781000
TI  - [Myocardial infarct with normal coronary vessels: an association with dysfunction
      of the coronary microcirculation].
AB  - The association of acute myocardial infarction (AMI) with normal coronary
      arteries was analyzed prospectively. A series of 128 consecutive patients
      underwent coronary angiography within 1 week from AMI. Seven patients, all
      females, had no coronary artery lesions and were considered eligible for the
      study. All 7 patients underwent atrial pacing (10 g/min increments every 2 min),
      ergonovine testing (E; total dose 0.650 mg i.v.). Great cardiac vein flow (GCVF;
      thermodilution technique), mean aortic pressure (MAP), anterior coronary
      resistance (ACR) and myocardial lactate extraction [(Lac art-Lac gcv)/Lac art]
      were measured at baseline and during testing. Pacing-induced typical chest pain
      occurred in 5 patients: 4 of them showed concurrent significant (> or = 0.15 mV)
      ST downsloping. At peak pacing, GCVF increased only by < 50%, or even decreased,
      in all patients. Baseline lactate extraction (0.13 +/- 0.11) changed to lactate
      production (-0.15 +/- 0.10) in 7/7 patients. None of the patients showed focal
      epicardial coronary artery spasm following E. During testing, however, all 7
      patients showed decrease in GCVF (110 +/- 47 versus 74 +/- 21; p < 0.005),
      increase in ACR (0.92 +/- 0.29 versus 1.43 +/- 0.20; p < 0.001), and significant
      coronary lactate production (-0.18 +/- 0.12). Six patients referred slight to
      moderate chest pain, which was accompanied by ST downsloping in 4.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7781001
TI  - [The noninvasive demonstration of functional reinnervation after heart
      transplantation].
AB  - Although RR interval variability appears to be an ideal method for assessing
      reinnervation after heart transplantation, it has been shown that respiratory
      sinus arrhythmia is caused by the mechanical effect of respiration on the right
      atrium. The neck-suction induces heart rate changes only by means of nervous
      reflex and its hemodynamic effect is local and hence appears as a useful method
      for assessing reinnervation. We tested the presence of autonomic reinnervation in
      18 heart transplant recipients, compared to 12 donor-age-matched controls. We
      measured the power of RR interval low- (LF, around 0.1 Hz) and respiratory
      fluctuations (HF) before and during rhythmic neck-suction stimulation at 0.1 Hz
      and at a frequency (0.20 Hz) similar to, but distinct from, that of respiration
      (controlled at 0.25 Hz), before and during 0.04 mg/kg atropine infusion, using
      autoregressive spectral analysis of RR interval, respiration and neck pressure
      signals. The relationship between pairs of signals at each frequency was
      quantitatively assessed by bivariate coherence function. All transplanted
      subjects showed low-amplitude HF, related to respiration. Detectable LF (whose
      power was lower than in controls: 1.15 +/- 0.39 versus 6.08 +/- 0.27 1n-ms2, p <
      0.001), non coherent with respiration, were present in 11/18 transplanted
      subjects, and correlated with months since transplantation (r = +0.59, p < 0.05).
      HF neck suction induced the presence of a 0.20 Hz fluctuation in 12/12 controls,
      distinct from and greater than the 0.25 Hz respiratory component (7.28 +/- 0.26
      versus 6.69 +/- 0.74 1n-ms2, p < 0.01); this was not seen in any of the
      transplanted subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781003
TI  - [Recent large studies of the elderly hypertensive: results and indications].

PMID- 7781002
TI  - [Gene therapy for the treatment of restenosis after coronary angioplasty].
AB  - Accumulation and proliferation of vascular smooth muscle cells are associated
      with atherosclerosis and hypertension. Proliferation of smooth muscle cells
      constitutes a major pathological event responsible for long-term failure of
      coronary and peripheral arterial bypass graft as well as the development of
      restenosis after percutaneous transluminal coronary angioplasty (PTCA). The
      incidence of restenosis after PTCA has been reported to be as high as 40-45%
      within 3-6 months. Major advantages in recombinant deoxyribonucleic acid (DNA)
      technology and eukaryotic gene regulation allow to hypothesize gene therapy as a
      potential treatment for inherited and acquired diseases. Gene therapy is the
      introduction of genes into somatic cells to correct an inherited or acquired
      disorder through the synthesis of missing or defective protein. Although no
      disease has yet been treated by gene therapy, several gene transfer protocols
      have recently been undertaken. We have studied the expression of foreign DNA that
      has been introduced into smooth muscle cells after balloon carotid injury in a
      rat model of angioplasty. The effects of different degree of balloon injury on
      neointima formation and c-fos expression was also assessed. Our data demonstrate
      that site-specific gene expression can be achieved by direct gene transfer in
      vivo and could be applied to the treatment of restenosis after PTCA.

PMID- 7781004
TI  - [Mental stress and cardiopathies].

PMID- 7781005
TI  - Severe calcific pulmonic valve stenosis and restrictive ventricular septal defect
      in a 64-year-old man. Results of percutaneous double balloon valvuloplasty.
AB  - The clinical and hemodynamic features of a 64-year-old symptomatic man with
      severe calcific pulmonic valve stenosis and restrictive ventricular septal defect
      are reported. Successful double balloon percutaneous pulmonic valvuloplasty
      immediately produced excellent symptomatic benefit and introduced expected and
      well tolerated hemodynamic changes. The transpulmonic valve peak systolic
      pressure gradient was reduced from 130 to 30 mmHg and pulmonary artery pressure
      increased to top normal levels acquiring normal pulse wave configuration. A left
      to-right shunt, negligible prior to valvuloplasty, increased appreciably
      producing a pulmonary to systemic flow ratio of 1.7. Reevaluation at 5 months
      revealed sustained hemodynamic profile. Symptomatic benefit and tolerance to
      ordinary physical activities have remained excellent at 1 year follow-up.

PMID- 7781006
TI  - Lipoprotein oxidation as a mediator of atherogenesis: insights from
      pharmacological studies.

PMID- 7781007
TI  - Neurocardiology update: role of the nervous system in coronary vasomotion.

PMID- 7781008
TI  - Stroma and the search for common ground. Plumbism or promiscuity?

PMID- 7781009
TI  - Abnormal ATP turnover in rat leg muscle during exercise and recovery following
      myocardial infarction.
AB  - OBJECTIVE: Clinical and animal studies show increased acidification of skeletal
      muscle during exercise in heart failure, implying increased anaerobic metabolism,
      and impaired recovery from exercise, implying defective oxidative function. This
      study aimed to define the quantitative relationship between these changes in
      exercise and recovery and relate skeletal muscle bioenergetics to cardiovascular
      function. METHODS: Wistar rats were studied four weeks after myocardial
      infarction or a sham operation. 31P magnetic resonance spectroscopy of the hind
      leg muscle was used to estimate rates of oxidative and non-oxidative ATP
      synthesis from changes in pH and phosphocreatine concentration during sciatic
      nerve stimulation and to estimate the maximum rate of mitochondrial ATP synthesis
      from the kinetics of phosphocreatine recovery after stimulation. RESULTS:
      Following myocardial infarction, cardiac function was abnormal, with evidence of
      left ventricular hypertrophy, failure, and diminished arterial pressure. There
      was impaired phosphocreatine recovery, suggesting an approximate halving of the
      maximum rate of mitochondrial ATP synthesis. CONCLUSIONS: The response to
      exercise of the infarct group was abnormal and was quantitatively consistent with
      the reduced maximum rate of mitochondrial ATP synthesis inferred from recovery,
      the oxidative deficit during exercise being made up by increased glycogenolysis,
      causing sufficient acidification to prevent an appropriate increase in [ADP].

PMID- 7781010
TI  - Differential effects of lignocaine and hypercalcaemia on anisotropic conduction
      and reentry in the ischaemically damaged canine ventricle.
AB  - OBJECTIVE: Anisotropic conduction characteristics, which may be expressed as the
      ratio of conduction velocities in the longitudinal (Vlong) and transverse
      (Vtrans) fibre directions, have been shown to stabilise reentry and favour the
      induction of sustained, uniform ventricular tachycardia. The aim of this study
      was to investigate whether interventions affecting either excitability
      (lignocaine) or both excitability and cell coupling (hypercalcaemia) might
      produce differential effects on the Vlong/Vtrans ratio, and whether an
      intervention reducing this ratio might prevent the induction of sustained
      reentrant ventricular tachycardia. METHODS: The effects of hypercalcaemia [8.2(SD
      3.8) mmol.litre-1] and lignocaine infusion [to 24.4(19) and 42.3(29) mumol.litre
      1] on Vlong and Vtrans were determined from 127 electrograms recorded with a
      plaque electrode on the anterior left ventricular wall of healthy dogs or 3 d
      after occlusion of the left anterior descending coronary artery. Vlong and Vtrans
      were computed from isochronal maps displaying ellipsoid patterns with a long axis
      corresponding to longitudinal conduction and a short axis corresponding to
      transverse conduction, as determined during basic (S1) and premature (S2)
      stimulation from the centre of the plaque electrode. Infarcted heart preparations
      were subjected to programmed stimulation for induction of reentrant ventricular
      tachycardias. RESULTS: Hypercalcaemia reduced both Vlong and Vtrans (P < 0.05)
      but did not modify either the Vlong/Vtrans ratio or the induction and patterns of
      ventricular tachycardias. Lignocaine reduced Vlong and the Vlong/Vtrans ratio
      during premature stimulation (S2) of infarcted heart preparations (P < 0.05) and
      stabilised reentrant ventricular tachycardias in preparations in which only
      nonsustained, multiform ventricular tachycardias were induced under control
      conditions. CONCLUSIONS: Conduction velocities in the longitudinal and transverse
      directions can be differentially affected by selected pharmacological
      interventions, but the Vlong/Vtrans ratio is not a representative index of the
      facilitating influence of tissue anisotropy on reentry. Therefore, the role of
      anisotropy in this model of reentry is not confined to establishing disparity of
      a functional character between conduction velocities in the longitudinal and
      transverse directions.

PMID- 7781011
TI  - L-carnitine increases glucose metabolism and mechanical function following
      ischaemia in diabetic rat heart.
AB  - OBJECTIVE: Stimulation of glucose oxidation by L-carnitine improves mechanical
      recovery of ischaemic hearts from non-diabetic rats perfused with high levels of
      fatty acids. The aim of this study was to determine whether L-carnitine also
      increases glucose oxidation and function in diabetic rat hearts, which have
      suppressed glucose metabolism. METHODS: Isolated working hearts from six week
      streptozotocin diabetic and control rats were perfused with 11 mM (5-3H/U-14C)
      glucose, 1.2 mM palmitate. Hearts were paced at 260 beats.min-1 during 60 min of
      low flow ischaemia, and were then subjected to 30 min of aerobic reperfusion.
      Total myocardial carnitine content in these hearts was first increased by a 60
      min aerobic perfusion with 10 mM L-carnitine. RESULTS: Steady state glucose
      oxidation rates (measured as 14CO2 production) were depressed in diabetic rat
      hearts compared to control hearts during the initial aerobic period. However, L
      carnitine treatment dramatically increased glucose oxidation rates in the
      diabetic rat hearts, as well as in control hearts. Glycolysis was also lower in
      diabetic rat hearts compared to control hearts, although L-carnitine treatment
      significantly increased glycolysis only in the diabetic animals. During
      reperfusion, steady state rates of glucose oxidation and glycolysis returned to
      preischaemic values in both the control and diabetic groups. L-carnitine
      treatment stimulated glucose oxidation during reperfusion in control and diabetic
      rat hearts. Mechanical function of control hearts returned to 38(SEM 9)% of
      preischaemic values, whereas in L-carnitine treated hearts function returned to
      90(7)% of preischaemic values. Recovery of function was 80(15)% of preischaemic
      in the diabetic rat hearts, and was increased to 100% of preischaemic function
      with L-carnitine. CONCLUSIONS: Carnitine improves recovery of function of
      ischaemic non-diabetic rats by stimulating glucose oxidation during reperfusion,
      whereas it may be beneficial in diabetic rat hearts by stimulating both
      glycolysis during ischaemia and glucose oxidation during reperfusion.

PMID- 7781012
TI  - Transient downregulation of glomerular atrial natriuretic factor receptors in
      high output heart failure in the rat.
AB  - OBJECTIVE: The renal response to exogenous atrial natriuretic factor (ANF) is
      blunted in chronic heart failure. The aim of the present studies was to
      investigate whether renal ANF receptor regulation in chronic heart failure is a
      time related event. METHODS: Glomerular ANF receptors were analysed in
      radioligand binding experiments at 0, 1, 2, 6, 12, 24, and 48 h, as well as at 1,
      2, 4, and 8 weeks after the induction of an aortocaval shunt. RESULTS: Rats with
      aortocaval shunts had lower packed cell volume and body weight and higher
      relative heart weight than sham operated controls. Plasma ANF C and N terminal
      levels were increased in shunt rats as early as 5 min after establishment of the
      shunt. Right and left atrial ANF concentrations were decreased and ventricular
      ANF concentration was increased in shunt rats at 6 and 12 h respectively.
      Competitive inhibition of 125I-ANF binding showed that at 6 h the density (Bmax)
      of glomerular ANF receptors was significantly lower than in the controls [518(SEM
      10) v 759(12) fmol.mg-1 protein] without differences in their affinity (Kd). The
      low Bmax in shunt animals persisted at 12, 24, and 48 h, even at 1 week [Bmax:
      400(29) and 713(28) fmol.mg-1 protein; Kd: 80(2) and 70(4) pM, for AC rats and
      controls, respectively]. Bmax values were not significantly different at 2, 4,
      and 8 weeks. In 24 h animals, C-ANF displaced 65% of total binding, with both
      total and C ANF binding sites being 38% lower in shunt animals. CONCLUSION:
      Downregulation of glomerular ANF receptors is a transient event during the
      development of high output heart failure in the rat. Thus the blunted renal
      response to ANF during chronic heart failure is not likely to be due to a
      decrease in renal ANF receptor density or affinity.

PMID- 7781013
TI  - Effects of inorganic phosphate and ADP on calcium handling by the sarcoplasmic
      reticulum in rat skinned cardiac muscles.
AB  - OBJECTIVE: The aim was to investigate whether, and how, increases in inorganic
      phosphate (Pi) and ADP, similar to those occurring intracellularly during early
      myocardial ischaemia, affect the calcium handling of the sarcoplasmic reticulum.
      METHODS: Rat ventricular trabeculae were permeabilised with saponin. The
      physiological process of calcium induced calcium release (CICR) from the muscle
      sarcoplasmic reticulum was triggered via flash photolysis of the "caged Ca2+",
      nitr-5. Alternatively, calcium release was induced by rapid application of
      caffeine to give an estimate of sarcoplasmic reticular calcium loading. The
      initial rate of sarcoplasmic reticular calcium pumping was also assessed by
      photolysis of caged ATP at saturating [Ca2+]. Myoplasmic [Ca2+] (using fluo-3)
      and isometric force were measured. RESULTS: Pi (2-20 mM) significantly depressed
      the magnitude of CICR and the associated force transient. Sarcoplasmic reticular
      calcium loading was inhibited even more than CICR by Pi, suggesting that reduced
      calcium loading could account for all of the inhibitory effect of Pi on CICR and
      that Pi may slightly activate the calcium release mechanism. The reduced
      sarcoplasmic reticular calcium loading seemed to be due to a fall in the free
      energy of ATP hydrolysis (delta GATP) available for the calcium pump, since equal
      decreases in delta GATP produced by adding both Pi and ADP in various ratios
      caused similar falls in the calcium loading of the sarcoplasmic reticulum. The
      caged ATP experiments indicated that Pi (20 mM) did not affect the rate constant
      of sarcoplasmic reticular calcium uptake. ADP (10 mM) alone, or with 1 mM Pi,
      inhibited calcium loading. In spite of this, ADP (10 mM) did not alter CICR and,
      when 1 mM Pi was added, ADP increased CICR above control. CONCLUSIONS: An
      increase in intracellular Pi reduces sarcoplasmic reticular calcium loading and
      thus depresses the CICR. This could be an important contributing factor in the
      hypoxic or ischaemic contractile failure of the myocardium. However the
      detrimental effect of Pi may be offset to some extent by a stimulatory action of
      ADP on the calcium release mechanism of CICR.

PMID- 7781014
TI  - Ischaemic preconditioning is protein kinase C dependent but not through
      stimulation of alpha adrenergic or adenosine receptors in the isolated rat heart.
AB  - OBJECTIVE: The aim was (1) to clarify whether alpha adrenoceptor and adenosine
      receptor stimulation is involved in the anti-infarct effect of ischaemic
      preconditioning in the rat heart, and (2) to test the hypothesis that signal
      transduction through membrane bound protein kinase C is essential for the
      protection. METHODS: Isolated, buffer perfused rat hearts were subjected to 30
      min of regional ischaemia and 120 min of reperfusion. The risk zone was
      determined by fluorescent particles, and infarct size was determined by staining
      with triphenyltetrazolium chloride. RESULTS: Ischaemic preconditioning with three
      cycles of 5 min ischaemia plus 5 min of reperfusion significantly reduced infarct
      size as compared to non-preconditioned group [4.5(SEM 0.6)% of the risk zone v
      45.5(5.7)%, P < 0.001]. Blockade of alpha adrenoceptors alone and simultaneous
      blockade of alpha adrenoceptors with phenoxybenzamine (10 microM) and adenosine
      receptors with sulphophenyltheophylline (100 microM) did not prevent the
      protective effect of ischaemic preconditioning [infarct size = 2.4(0.4) and
      5.6(1.9)% respectively, NS v the non-treated preconditioned group]. Blocking
      either the membrane binding of protein kinase C with polymyxin B (1 microM) or
      direct inhibition of protein kinase C activity with chelerythrine (2 microM)
      completely abolished the infarct size reducing effect of ischaemic
      preconditioning [32.4(3.3)% and 48.2(4.0)% respectively, P < 0.005 v non-treated
      preconditioned group: NS v the non-preconditioned group]. CONCLUSIONS: In the rat
      heart infarct model the protective effect of ischaemic preconditioning is not
      mediated through stimulation of alpha adrenoceptors alone or the combined
      stimulation of alpha adrenergic and adenosine receptors, and it is dependent on
      activation of membrane bound protein kinase C.

PMID- 7781016
TI  - Effect of intraluminal application of tissue-type plasminogen activator on the
      fibrinolytic activity of experimental vein grafts.
AB  - OBJECTIVE: The aim was to quantify the effect of intraluminally applied tissue
      type plasminogen activator (tPA) on the fibrinolytic activity of experimental
      vein grafts and assess the effect of pretreatment of the vein on early platelet
      and thrombus formation using histological techniques. METHODS: A pig model of
      bilateral saphenous venin-carotid artery grafts was used. In each animal one side
      of the neck was grafted using vein distended to 230 mm Hg and pretreated with tPA
      (1 mg.ml-1) for a period of 15 min before grafting (treated graft). The perfused
      in situ for 2 h after implantation and before analysis. Changes in local
      fibrinolytic activity were quantified using fibrin plate techniques and specific
      chromogenic assays for tPA and urokinase (uPA) in tissue extract (n = 6 animals).
      Histological assessment was made using light and scanning microscopy (n = 4
      animals). RESULTS: Surgical preparation and distention significantly reduced the
      fibrinolytic activity of pig saphenous vein in terms of areas of lysis produced
      on fibrin plates (P < 0.05), tPA activity (P < 0.05), and uPA activity (P <
      0.05). Pretreatment of distended vein with tPA before grafting significantly
      enhanced its fibrinolytic activity after 2 h perfusion compared to control
      (untreated) grafts, as assessed by areas of lysis on fibrin plates (P < 0.05) and
      specific tPA activity (P < 0.05). Treated grafts also showed qualitatively less
      platelet and thrombus formation on histological examination. CONCLUSIONS:
      Pretreatment of surgically harvested vein by intraluminal application of tPA
      before grafting enhances its fibrinolytic activity after exposure to 2 h
      perfusion in vivo. This technique requires further investigation to validate its
      potential as a means of providing local anticoagulation to veins implanted as
      arterial grafts thereby reducing the incidence of early graft thrombosis.

PMID- 7781015
TI  - Central vasopressin in experimental aortic stenosis in the rat.
AB  - OBJECTIVE: In several forms of heart disease characterised by low cardiac output,
      activated neurohumoral systems including increased vasopressin plasma levels play
      a key role in the changes in cardiovascular function. The aim of this study was
      to test the hypothesis that under such conditions the central vasopressin system
      might also be altered, which could contribute to deranged cardiovascular control.
      METHODS: Aortic stenosis was produced in 22 rats by placing a Silver clip (inner
      diameter 0.6 mm) on the ascending aorta. After 12 weeks, haemodynamic and
      hormonal measurements were performed, and vasopressin content was determined in
      20 microdissected brain areas (micropunch technique). Twenty two sham operated
      rats served as controls. RESULTS: Twelve weeks after placing the supravalvular
      clip, significant aortic stenosis was documented by left ventricular myocardial
      hypertrophy. Cardiac index was significantly reduced and the peripheral vascular
      resistance index was increased, while poststenotic aortic pressure was non
      significantly decreased. Plasma renin concentration [6.8(SEM 0.9) v 2.1(0.2)
      ngAI.ml-1.h-1 in controls] and plasma vasopressin [32.9(12.5) v 18.4(6.0) pg.ml
      1] were significantly increased, while plasma and urinary noradrenaline remained
      unaltered. The vasopressin content was significantly altered in eight out of 20
      brain areas investigated. Concerning the vasopressin producing hypothalamic
      nuclei, concentrations were increased in the paraventricular [7494(360) v
      4744(237) pg.mg-1 protein, P < 0.05] and suprachiasmatic [3613(170) v 1784(197)
      pg.mg-1 protein, P < 0.01], but not in the supraoptic nuclei. Rats with aortic
      stenosis showed significantly raised vasopressin concentrations in the median
      eminence [25 186(1682) v 37 367(1345) pg.mg-1 protein, P < 0.01], where the
      hormone is mainly concentrated in the hypothalamo-hypophysial tract. Vasopressin
      content was significantly decreased in locus coeruleus [49(5) v 89(6) pg.mg-1
      protein], which is known to be involved in modulation of sympathetic activity.
      CONCLUSIONS: As well as showing increased secretion of vasopressin into the blood
      with consecutive peripheral antidiuretic and vasoconstrictive effects, these data
      suggest an alteration in the central vasopressin system in aortic stenosis which
      might transmit cardiovascular effects by neuromodulation and neuroregulation.

PMID- 7781017
TI  - Mechanical efficiency of stunned myocardium is modulated by increased afterload
      dependency.
AB  - OBJECTIVE: Oxygen consumption (MVO2) of stunned myocardium is relatively high
      compared to, and poorly correlated with, systolic contractile function. The aim
      of this study was to investigate whether an increased afterload dependency,
      induced by the decreased contractility of the stunned myocardium, contributes to
      the large variability in the mechanical efficiency data. METHODS: In 13
      anaesthetised open thorax pigs undergoing two cycles of 10 min occlusion of left
      anterior descending coronary artery and 30 min reperfusion, segment shortening,
      the slope of end systolic pressure segment length relationship (Ees), external
      work (EW, derived from the area inside the left ventricular pressure segment
      length loop), the efficiency of energy conversion (EET, = EW/PLA x 100%, where
      PLA = total pressure-segment length area), mechanical efficiency (EW/MVO2), and
      their dependency on left ventricular end systolic pressure (Pes) were determined
      before and after induction of stunning, and during subsequent inotropic
      stimulation with dobutamine (1 and 3 micrograms.kg-1.min-1 over 15 min). RESULTS:
      The stunning protocol not only caused significant decreases in segment
      shortening, external work, energy conversion efficiency, and EW/MVO2 but also
      increased the afterload dependency of these variables. Before stunning an
      increase in Pes from 100 to 160 mm Hg decreased segment shortening from 18(SEM
      1)% to 14(2)% (P > 0.05) and increased external work from 206(18) to 254(32) mm
      Hg.mm (P < 0.05). After induction of stunning the same increase in Pes caused a
      decrease in segment shortening from 9.5(1.8)% to -4.6(2.1)% (P < 0.05) and in
      external work from 149(21) to -11(10) mm Hg.mm (P < 0.05). The afterload
      dependency of the PLA was not altered by stunning, but the afterload dependency
      of energy conversion efficiency increased, since efficiency decreased from 67(3)%
      to 59(5)% as Pes was increased from 100 to 160 mm Hg before stunning, but from
      57(5) to -7(5)% after induction of stunning (P < 0.05). Furthermore, the same
      increase in Pes resulted in an 8% decrease of EW/MVO2 before stunning and 107%
      after induction of stunning. Infusion of dobutamine not only restored segment
      shortening, external work, energy conversion efficiency, and EW/MVO2 of the
      stunned myocardium, but also attenuated their afterload dependency to pre
      stunning levels. CONCLUSIONS: Myocardial stunning increases the afterload
      dependency of segment shortening, external work, energy conversion efficiency,
      and mechanical efficiency, which can be attenuated by inotropic stimulation with
      dobutamine. However, the decrease in left ventricular end systolic pressure,
      which accompanies the induction of stunning, counteracts the decrease in these
      variables. These two mechanisms can explain most of the reported scatter in
      mechanical efficiency.

PMID- 7781018
TI  - Increased intracellular magnesium contributes to impairment of postischaemic
      cardiac function.

PMID- 7781019
TI  - High magnesium improves the postischaemic recovery of cardiac function.

PMID- 7781020
TI  - Differential expression of type 2 and type 3 inositol 1,4,5-trisphosphate
      receptor mRNAs in various mouse tissues: in situ hybridization study.
AB  - The inositol 1,4,5-trisphosphate receptor (IP3R) is an intracellular Ca2+ release
      channel responsible for mobilizing stored Ca2+. Three different receptor types
      have been molecularly cloned, and their genes have been classified into a family.
      The gene for the type 1 receptor (IP3R1) is predominantly expressed in cerebellar
      Purkinje neurons, but its gene product is localized widely in a variety of
      tissues; however, there is little information on what types of cells express the
      other two receptor types, type 2 and type 3 (IP3R2 and IP3R3, respectively). We
      studied the expression of the IP3R gene family in various mouse tissues by in
      situ hybridization histochemistry. Compared with IP3R1, the levels of expression
      of IP3R2 and IP3R3 mRNAs were low in all of the tissues tested. IP3R2 mRNA was
      localized in the intralobular duct cells of the submandibular gland, the urinary
      tubule cells of the kidney, the epithelial cells of epididymal ducts and the
      follicular granulosa cells of the ovary, while the IP3R3 mRNA was distributed in
      gastric cells, salivary and pancreatic acinar cells and the epithelium of the
      small intestine. All of these cells which express either IP3R2 or IP3R3 mRNA are
      known to have a secretory function in which IP3/Ca2+ signalling has been shown to
      be involved, and thus either IP3R2 or IP3R3 may be a prerequisite to secretion in
      these cells.

PMID- 7781021
TI  - Resolution of sensory and mucoid glycoconjugates with terminal alpha-galactose
      residues in the mucomicrovillar complex of the vomeronasal sensory epithelium by
      dual confocal laser scanning microscopy.
AB  - The organization of the mucomicrovillar complex of the vomeronasal sensory
      epithelium of adult rats was examined using confocal laser scanning microscopy.
      In specimens labeled with the FITC-conjugated isolectin B4 of Bandeiraea
      simplicifolia, which recognizes terminal alpha-galactose sugar residues of
      glycoconjugates, we demonstrated that the mucomicrovillar complex was composed of
      islet-like structures with a high-density alpha-galactose core. The
      mucomicrovillar complex was further resolved into sensory and mucoid components
      in double-labeling and dual scanning experiments. The sensory component, which
      consists of the dendritic terminals of olfactory marker protein-immunoreactive
      vomeronasal receptor neurons, contained cytosolic glycoconjugates with terminal
      alpha-galactose sugar residues. The extracellular mucoid component consisted of
      glycoconjugates containing terminal alpha-galactose derived from the glands
      associated with the vomeronasal organ. These results demonstrated the complex
      microchemical organization of the sensory and mucoid components of the
      mucomicrovillar complex.

PMID- 7781022
TI  - Experimental analyses of the rearrangement of ectodermal cells during
      gastrulation and neurulation in avian embryos.
AB  - The rearrangement of ectodermal cells was studied in chimeras in which grafts
      were transplanted during late gastrula and early neurula stages to heterotopic
      locations in avian embryos. Three types of experiments were done. In all
      experiments, Hensen's node was extirpated completely and replaced with an
      epithelial plug derived from 1 of 3 regions of the prospective ectoderm. In type
      1 experiments, Hensen's node was replaced with a plug consisting of precursor
      cells of the floor plate of the neural tube. In type-2 experiments, Hensen's node
      was replaced with a plug consisting of precursor cells of the lateral wall of the
      neural tube. In type-3 experiments, Hensen's node was replaced with a plug
      consisting of precursor cells of the epidermal ectoderm. In all experiments, the
      amount and direction of cell rearrangement that occurred in the transplanted
      ectodermal plug was essentially typical for prospective ectodermal cells normally
      residing within Hensen's node. That is, transplanted ectodermal cells underwent
      lateral-to-medial cell-cell intercalation and contributed to the ventral midline
      of the neural tube along its entire rostrocaudal extent. In most embryos, a
      notochord was reconstituted from host cells, despite the fact that Hensen's node-
      the prime source of prospective notochordal cells in intact embryos--was
      extirpated completely; however, a few embryos had long notochordal gaps. In such
      essentially notochordless embryos, the ventral midline of the neural tube still
      derived from grafted cells, but it failed to form a floor plate, providing
      further confirmation of the results of several previous studies that the
      notochord is required to induce the floor plate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781023
TI  - Immunocytochemical localization of ribonuclease in yolk granules of adult Rana
      catesbeiana oocytes.
AB  - To determine the localization of the pyrimidine-guanine sequence-specific
      ribonuclease in Rana catesbeiana (bullfrog) oocytes, the RNase was first isolated
      and used to prepare a specific rabbit antiserum. Only one protein of similar
      molecular size to the RNase was immunoprecipitated from ovary homogenate by the
      antiserum, but two bands were observed by Western blotting analysis. These two
      proteins were shown by further purification of antibody and Western blotting
      analysis to have similar antigenicity. Immunoprecipitation and Western blotting
      of tissue homogenates showed that the RNase was found predominantly in the ovary,
      but not in other tissues. The specific localization of the RNase was determined
      by immuno-electron microscopy of oocyte sections incubated with the specific
      antiserum; the yolk granules, but not other organelles, were found to contain the
      RNase. Most of the RNase was evenly distributed in the lateral amorphous area of
      the yolk granule but not in the central yolk crystal area which contains stored
      vitellogenin proteins. Our results indicate that the RNase is compartmentalized
      in the yolk granules of oocytes, which might prevent damage to cellular RNAs.

PMID- 7781024
TI  - Localization and coexistence of atrial natriuretic peptide (ANP) and neuropeptide
      Y (NPY) in vertebrate adrenal chromaffin cells immunoreactive to TH, DBH and
      PNMT.
AB  - Antisera specific for mammalian atrial natriuretic peptide (ANP) and neuropeptide
      Y (NPY) were applied to examine, in immunofluorescence, the occurrence of cells
      immunoreactive to ANP and NPY in the adrenal organs of mammals, birds, reptiles,
      amphibians, and bony fish. Catecholamine-containing cells were identified using
      antisera against tyrosine-hydroxylase, dopamine-beta-hydroxylase, and
      phenylethanolamine-N-methyl-transferase. In all vertebrates studied,
      immunoreactivities to ANP and NPY occurred in adrenal chromaffin cells but were
      absent from the cortex or its homolog, the interrenal. The majority of
      immunoreactivities to ANP and NPY was confined to the adrenaline cells. In
      mammals, the number of ANP-immuno-reactive cells (60%-80% of the total cell
      population) exceeded that of the NPY-immunoreactive cells (35%-45%). In birds,
      reptiles, and Amphibia, the numbers of ANP-immunoreactive (35%-40%) and NPY
      immunoreactive (30%-35%) cells were in a similar range. The bony fish showed a
      density of both ANP-immunoreactive (80%-90%) and NPY-immunoreactive (35%-40%)
      cells. In all species studied, immunoreactivities to ANP and NPY partially
      coexisted. Generally, 30%-55% of the ANP-immunoreactive cells also contained NPY
      immunoreactivity. In rat, coexistence amounted to almost 100% and in quail to
      95%. Except for the rat, three subpopulations of chromaffin cells seemed to
      occur: ANP-immunoreactive non-NPY-immunoreactive, ANP-immunoreactive+NPY
      immunoreactive, and NPY-immunoreactive non-ANP-immunoreactive cells. Thus,
      adrenal ANP and NPY share a conservative history and coexist as early as at the
      level of bony fish. The endocrine actions of ANP and NPY derived from medullary
      cells on cortical cells as found in mammals might be based on an ancestoral
      paracrine system. In submammalians, ANP and NPY may not only act as endocrine
      hormones, but also influence steroid-producing interrenal cells in a paracrine
      manner, and act as modulators on chromaffin cells.

PMID- 7781025
TI  - Retarded myogenic cell replication in regenerating skeletal muscles of old mice:
      an autoradiographic study in young and old BALBc and SJL/J mice.
AB  - The patterns of skeletal muscle precursor cell replication after crush injury
      were compared by the use of autoradiographic techniques, in young (4-week-old)
      and old (39-week-old) BALBc and SJL/J mice. Similar comparisons were made between
      cut and crush lesions in old BALBc muscle. Muscle precursor cell replication
      commenced at 18-24 h after injury in both young and old muscles from both strains
      of mice. In young BALBc muscle the peak of myogenic activity at 60 h was 36 h
      earlier than in old mice. SJL/J muscle responded more rapidly than did BALBc: in
      young SJL/J the peak myogenic activity was at 46 h (14 h earlier than in young
      BALBc muscle), and in old SJL/J muscle the peak activity at 72 h was 24 h earlier
      than in old BALBc muscle. In all mice (both young and old) myogenic cell
      replication was substantially reduced by 120 h after injury. A comparison of the
      timing of muscle precursor cell replication in cut and crush lesions in old BALBc
      mice revealed a more rapid response in the cut lesion; this difference between
      the lesions is comparable with data from identical lesions in 6-8-week-old BALBc
      mice (McGeachie and Grounds 1987). However, the peak of myogenic replication in
      the older mice in the present study was some 26-36 h later than in the younger 6
      8-week-old mice. These experiments show that, whilst muscle precursor cell
      replication commences at approximately the same time (about 24 h) after injury in
      young and old mice, the peak level of activity is delayed by some 24-36 h in old
      mice. In addition, the SJL/J mouse strain responds more rapidly and prolifically
      to muscle injury than does the BALBc strain.

PMID- 7781026
TI  - The expression of the gene coding for parathyroid hormone-related protein (PTHrP)
      during tooth development in the rat.
AB  - By means of in situ hybridisation studies, it is shown that parathyroid hormone
      related protein (PTHrP) mRNA is strongly expressed in the developing enamel
      organs of rat teeth. In particular, the cervical loop hybridises strongly with
      the PTHrP probe and expression is maintained at this site throughout life in the
      permanently erupting incisor teeth. In mature molar teeth, expression is
      downregulated to low levels and confined to the epithelial cell rests of Malassez
      and/or cementoblasts which may derive from these. The gene is also expressed at
      low levels in the tissue overlying the erupting molars and, thereafter, in the
      junctional epithelia and connective tissue cells of the epithelial attachment on
      all tooth surfaces. The premise that PTHrP may undergo post-translational
      processing and that the resultant products could act in different ways raises the
      possibility of its exerting multiple paracrine actions during tooth development.
      These could include the control of cell division and local vascular dilation
      during development.

PMID- 7781027
TI  - Colocalization of neuropeptides and NADPH-diaphorase in the intra-adrenal
      neuronal cell bodies and fibres of the rat.
AB  - Colocalization of vasoactive intestinal peptide, neuropeptide Y, calcitonin gene
      related peptide, substance P, and tyrosine hydroxylase, respectively, with NADPH
      diaphorase staining in rat adrenal gland was investigated using the double
      labelling technique. All vasoactive intestinal peptide- and some neuropeptide Y
      immunoreactive intrinsic neuronal cell bodies seen in the gland were double
      stained with NADPH-diaphorase. Double labelling also occurred in some nerve
      fibres immunoreactive to vasoactive intestinal peptide and neuropeptide Y in the
      medulla and cortex. No colocalization of calcitonin gene-related peptide,
      substance P or tyrosine hydroxylase immunoreactivity with NADPH-diaphorase
      staining was observed. However, nerve fibres with varicosities immunoreactive for
      all the neuropeptides examined were closely associated with some of the NADPH
      diaphorase-stained neuronal cell bodies. Thus, in rat adrenal gland, nitric oxide
      is synthesized in all ganglion cells containing vasoactive intestinal peptide and
      in some containing neuropeptide Y, but not in those containing calcitonin gene
      related peptide, substance P or tyrosine hydroxylase.

PMID- 7781028
TI  - Distribution of immunoreactive neuropeptides in the pancreas of the bullfrog,
      Rana catesbeiana, demonstrated by immunofluorescence.
AB  - Indirect double immunofluorescence labelling for eight neuropeptides in the
      pancreas of the bullfrog, Rana catesbeiana, demonstrated the occurrence,
      distribution, and coexistence of certain neuropeptides in the exocrine and
      endocrine pancreas. Immunoreactivity of substance P (SP), calcitonin gene-related
      peptide (CGRP), vasoactive intestinal polypeptide (VIP), neuropeptide Y (NPY),
      FMRFamide (FMRF), and galanin (GAL) was localized in nerve fibers distributed
      between the acini and around the duct system and vasculature of the exocrine
      pancreas. In these regions, CGRP-immunoreactive fibers were more numerous than
      those containing the other five peptides. Almost all SP fibers showed coexistence
      of SP with CGRP, and about one third of fibers also showed coexistence of SP with
      VIP, NPY, FMRF, and GAL. In the endocrine pancreas, SP, CGRP, VIP, and GAL were
      recognized in the nerve fibers around and within the islets of Langerhans, and
      VIP and GAL fibers were more numerous than SP and CGRP fibers. All CGRP fibers,
      and about half of the VIP and GAL fibers were immunoreactive for SP. NPY- and
      FMRF-immunoreactive cells were found at the periphery of the islets. These
      findings suggest that the exocrine and endocrine pancreatic functions of the
      bullfrog are under the control of peptidergic innervation.

PMID- 7781029
TI  - Structural organization and epithelial cells types of the intestinal diverticula
      (protopancreas) of ammocoetes of southern hemisphere lampreys: functional and
      phylogenetic implications.
AB  - Larvae of the two southern hemisphere lamprey genera, Mordacia and Geotria,
      possess one and two intestinal diverticula, respectively, each originating at the
      oesophageal-intestinal junction. These diverticula comprise an inner layer of
      simple columnar epithelium composed solely of zymogen and mucous cells, a middle
      layer consisting mainly of a blood sinus, and an outer serosa layer covered by a
      simple squamous epithelium (mesothelium). The inner surface is highly folded only
      in Mordacia. The secretion of mucus probably protects the epithelium from the
      effects of digestive enzymes secreted by the zymogen cells and/or bile, which
      enters the diverticulum at its tip. Unlike the situation in southern hemisphere
      lampreys, the zymogen cells of the larvae of holarctic lampreys are located in
      the anterior intestine, a condition considered to be "primitive". It is thus
      proposed that intestinal diverticula were developed during the evolution of
      southern hemisphere lampreys. The relocation of zymogen cells in the diverticula
      increases the area for these cells, and thus the capacity for the synthesis and
      secretion of digestive enzymes, particularly in Mordacia where the inner surface
      is folded.

PMID- 7781030
TI  - GABA and glutamate-like immunoreactivity at synapses received by dorsal unpaired
      median neurones in the abdominal nerve cord of the locust.
AB  - Dorsal unpaired median (DUM) neurones in the abdominal ganglia of the locust were
      impaled with microelectrodes and some were injected intracellularly with
      horseradish peroxidase so that their synapses could be identified in the electron
      microscope. Simultaneous recordings from DUM neurones in different abdominal
      ganglia revealed that they received common postsynaptic potentials from
      descending interneurones. Post-embedding immunocytochemistry using antibodies
      against GABA and glutamate was carried out on ganglia containing HRP-stained
      neurones. GABA-like immunoreactivity was found in 39% (n = 82) of processes
      presynaptic to abdominal DUM neurones and glutamate-like immunoreactivity in 21%
      (n = 42) of presynaptic processes. Output synapses from the DUM neurites were
      rarely observed within the neuropile. Structures resembling presynaptic dense
      bars but not associated with synaptic vesicles, were seen in some large diameter
      neurites.

PMID- 7781031
TI  - Distribution of catch-relaxing peptide (CARP)-like immunoreactive neurons in the
      central and peripheral nervous system of Helix pomatia.
AB  - Immunocytochemistry was performed on the nervous system of Helix by the use of an
      antibody raised against a myotropic neuropeptide, the catch-relaxing peptide
      (CARP), isolated from Mytilus edulis. In each ganglion of the central nervous
      system of Helix pomatia, numerous CARP-immunoreactive cell bodies and a dense
      immunoreactive fiber system could be observed with a dominancy in the cerebral
      and pedal ganglia. The majority of the immunoreactive neurons are unipolar,
      although multipolar neurons also occur. In the neuropil areas, CARP
      immunoreactive fibers show extensive arborization, which may indicate a central
      role of CARP. CARP-immunoreactive elements could be observed in each investigated
      peripheral nerve and peripheral areas, namely in the intestine, heart, aorta,
      buccal mass, lips, and foot. However, CARP-immunoreactive cell bodies could only
      be demonstrated in the intestine and the foot musculature. Thin varicose CARP
      immunoreactive fibers were observed over both muscle and gland cells in the
      different peripheral organs, suggesting a peripheral role of CARP. In vivo CARP
      injection into the body cavity (10(-3), 10(-4), 10(-5) M) altered the general
      behavioral state of the animals and induced the relaxation of the musculature of
      the whole body wall indicating that CARP has a significant role in the regulation
      of muscle contraction.

PMID- 7781032
TI  - Areas of asbestoid (amianthoid) fibers in human thyroid cartilage characterized
      by immunolocalization of collagen types I, II, IX, XI and X.
AB  - The distribution of type I, II, IX, XI and X collagens in and close to areas of
      asbestoid (amianthoid) fibers in thyroid cartilages of various ages was
      investigated in this study. Asbestoid fibers were first detected in thyroid
      cartilage from a 3-year-old male child. Areas of asbestoid fibers functionally
      appear to serve as guide rails for vascularization of thyroid cartilage. Alcian
      blue staining in the presence of 0.3 M MgCl2 revealed a loss of
      glycosaminoglycans in areas of asbestoid fibers. In addition, the fibers reacted
      positively with antibodies against collagen types II, IX and XI, but showed no
      staining with antibodies to collagen types I and X. Territorial matrix of
      adjacent chondrocytes showed the same staining pattern. In addition to staining
      for type II, IX and XI collagens, asbestoid fibers showed strong immunostaining
      for type I collagen after puberty but not for type X collagen. However, groups of
      chondrocytes within areas of asbestoid fibers reacted strongly with antibodies to
      type X collagen, suggesting that this collagen plays an important role in matrix
      of highly differentiated chondrocytes. The finding that these type X collagen
      positive chondrocytes also revealed immunostaining for type I collagen confirms
      previous studies showing that hypertrophic chondrocytes can further differentiate
      into cells that are characterized by the synthesis of type X and I collagens.

PMID- 7781033
TI  - Leu-callatostatin gene expression in the blowflies Calliphora vomitoria and
      Lucilia cuprina studied by in situ hybridisation: comparison with Leu
      callatostatin confocal laser scanning immunocytochemistry.
AB  - In situ hybridisation studies using a digoxigenin-labelled DNA probe encoding the
      Leu-callatostatin prohormone of the blowflies Calliphora vomitoria and Lucilia
      cuprina have revealed a variety of neurones in the brain and thoracico-abdominal
      ganglion, peripheral neurosecretory neurones, and endocrine cells of the midgut.
      With two exceptions, the hybridising cells are the same as those previously
      identified in immunocytochemical studies of sections and whole-mounts using Leu
      callatostatin COOH-terminal-specific antisera. Within the brain and
      suboesophageal ganglion, there is a variety of neurones ranging from a single
      pair of large cells situated in the dorsal protocerebrum, to the several pairs of
      neurones in the tritocerebrum, some of which, in immunocytochemical preparations,
      can be seen to project via axons in the cervical connective to the thoracico
      abdominal ganglion. In the medulla of the optic lobes, numerous small
      interneurones hybridise with the probe, as do clusters of similar-sized neurones
      close to the roots of the ocellar nerves. These results indicate that the Leu
      callatostatin neuropeptides of the brain play a variety of roles in
      neurotransmission and neuromodulation. There are only three pairs of Leu
      callatostatin-immunoreactive neurones in the thoracico-abdominal ganglion, at
      least two pairs of which project axons along the median abdominal nerve to
      provide extensive innervation of the hindgut. The Leu-callatostatin peripheral
      neurosecretory cells are located in close association with both nerve and muscle
      fibres in the thorax. In addition to neuronal Leu-callatostatin, the presence of
      the peptide and its mRNA has been demonstrated in endocrine cells in the
      posterior part of the midgut. These observations provide an example of a named
      brain/gut peptide in an insect.

PMID- 7781034
TI  - Reversible histochemical modifications of endoplasmic reticulum following
      arginine vasopressin stimulation of granular cells of toad bladder.
AB  - The endoplasmic reticulum is generally absent from schematic representations of
      transport phenomena, although it shows a well-organized network in most transport
      epithelial cells. In order to examine the correlation between this organelle and
      cellular activity, bladders of Bufo marinus were studied under different
      experimental conditions and fixed by immersion in glutaraldehyde, followed by
      OsO4 impregnation for 3 days. Normal granular and mitochondria-rich cells showed
      a rich cytoplasmic network of canaliculi, well-impregnated by osmium deposits.
      Following a 2 to 15-min stimulation (serosal bath) with arginine vasopressin, the
      V2 receptor agonist dD-arginine-vasopressin or cyclic AMP (cAMP), the staining of
      endoplasmic reticulum in granular cells disappeared. After washing out of the
      hormone or the agonist, impregnation of the endoplasmic reticulum could be
      observed once again. Arginine vasopressin did not modify the impregnation of
      endoplasmic reticulum of either mitochondria-rich or basal cells. Our data
      indicate a correlation between the reactivity of endoplasmic reticulum to osmium,
      and a cAMP-dependent effect of arginine vasopressin through its V2 receptors.
      Incubation of arginine vasopressin through its V2 receptors. Incubation of toad
      bladders carried out with agents interfering with cellular calcium (calcium
      ionophores, high or low bath calcium) or with calcium release from the
      endoplasmic reticulum (TMB-8, thapsigargin) suggested that an early step in the
      cAMP-dependent effect of arginine vasopressin must involve the release of
      intracellular calcium from the endoplasmic reticulum. However, calcium ATPases in
      this organelle do not seem to participate in the hormonal effect.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7781035
TI  - Ovarian and uterine lymphatic drainage in Australian flying-foxes (genus
      Pteropus, suborder Megachiroptera).
AB  - Ovarian lymphatics of flying-foxes were traced to determine if they could
      transport hormones directly from ovary to ipsilateral uterine horn, thereby
      stimulating the localised endometrial growth which is characteristic of these
      animals. Intra-ovarian injections of ink and serial histological sections did not
      reveal any such connection. All major ovarian lymphatics and those from the
      cranial tip of each uterine horn drain cranially, terminating in 1 or 2 lymph
      nodes lying caudal to the ipsilateral kidney. For much of their course, the major
      ovarian lymphatics run in the adventitia of the ovarian venous sinus. This sinus
      encloses the coiled ovarian artery, which provides the major blood supply to the
      cranial end of the ipsilateral uterine horn. Some fine ovarian lymphatics run in
      the adventitia of the coiled ovarian artery. The enclosure of the coiled ovarian
      artery by the ovarian venous drainage is thought to provide the main route for
      transfer of steroids from ovarian vein to ovarian artery and thence to
      ipsilateral uterine horn. The ovarian lymphatics described here do not bypass the
      vascular pathway but provide an additional route for counter- or cross-current
      transfer of ovarian steroids to the ovarian arterial supply to the uterus.

PMID- 7781036
TI  - Reflective organelles in the anterior pigment epithelium of the iris of the
      European starling Sturnus vulgaris.
AB  - The ultrastructure and chemical composition of reflective organelles in the
      anterior pigment epithelium of the iris of the European starling Sturnus vulgaris
      were examined. The reflective organelles produced a diffuse white reflectance at
      the iris mid-section which was visible only when the stroma was removed. The
      pigment granules were clear, angular, and birefringent under the light
      microscope. In electron micrographs the granules were irregular in shape and
      density, sometimes crystalline in appearance, but more often they were lost
      during sectioning or staining. Guanine was abundant in the modified pigment
      epithelium of the starling, but not in the pigment epithelia of other birds that
      lacked birefringent granules. Pteridines, such as xanthopterin and leucopterin,
      were present in small amounts. Pteridines were also present in the iris stroma
      which had no reflective organelles. The reflective organelles in the starling
      pigment epithelium resemble both the reflecting platelets of lower vertebrate
      chromatophores and the reflective granules in the tapeta of various vertebrates.
      Possible derivation of the organelles from these sources is discussed.

PMID- 7781037
TI  - The genotype of bone marrow-derived inflammatory cells does not account for
      differences in skeletal muscle regeneration between SJL/J and BALB/c mice.
AB  - This study determined whether the genotype of bone marrow-derived inflammatory
      cells contributes to the more pronounced leukocytic exudation and extensive new
      muscle formation seen in SJL/J compared with BALB/c mice after a crush-injury
      (Mitchell et al. 1992). Female SJL/J mice were whole-body irradiated and
      reconstituted with male bone marrow from the BALB/c strain, and irradiated BALB/c
      females reconstituted with male SJL/J bone marrow. The mice were allowed to
      recover for 3 weeks and the tibialis anterior muscle (in a leg which had been
      protected from irradiation) was injured by crushing. At 3 and 10 days after
      injury the extent of necrotic debris, mononuclear leukocytic infiltration and new
      muscle formation was assessed in the muscles. The SJL/J mice reconstituted with
      BALB/c bone marrow showed extensive mononuclear leukocytic infiltration and
      clearance of necrotic debris when compared with BALB/c mice reconstituted with
      SJL/J bone marrow, and these strain-specific differences mirrored those seen with
      control bone marrow reconstituted hosts and non-irradiated hosts. The results
      show that the genotype of the bone marrow-derived macrophages is not responsible
      for the superior regeneration of crush-injured skeletal muscle in SJL/J mice, and
      it appears that factors intrinsic to the muscle tissue may be of central
      importance.

PMID- 7781038
TI  - Immunocytochemical localisation of some lysosomal hydrolases, their presence in
      luminal fluid and their directional secretion by human epididymal cells in
      culture.
AB  - The way in which the human epididymis modifies spermatozoa during their sojourn
      in this structure might be clarified by knowledge of the nature of its
      secretions. We have examined the presence of several lysosomal hydrolases in
      human epididymal tissue and fluids, and their synthesis and secretion by
      monolayer cultures. Tissues were obtained from men undergoing orchidectomy for
      prostatic carcinoma. The enzymes cathepsin D and acid alpha-glucosidase were
      localised in the lysosomes of epithelial cells from the corpus epididymidis, by
      an immunocytochemical technique. Cathepsin D was also found in epithelial cells
      of the efferent ducts within lysosomes, apical vesicles and multivesicular
      bodies. No immunolocalisation of acid glucosidase in the efferent ducts or on the
      microvilli of the corpus was demonstrable. Cathepsin D, beta-hexosaminidase (N
      acetylglucosaminidase) and alpha-glucosidase were measurable in the luminal fluid
      from the human corpus epididymidis; beta-hexosaminidase was secreted into the
      culture medium by confluent monolayers of epididymal and efferent duct cells.
      Immunoprecipitation of cell extracts and culture medium of these cultures
      incubated with 35S-methionine revealed that the precursors of cathepsin D and
      beta-hexosaminidase were synthesized and secreted by such monolayers. Thus,
      active lytic enzymes are secreted by the human epididymis and could modify sperm
      membranes.

PMID- 7781039
TI  - A histochemical study of the distribution of lectin binding sites in the
      developing oocytes of the lancelet Branchiostoma belcheri.
AB  - The distribution of carbohydrate moieties in lancelet (Branchiostoma belcheri)
      oocytes has been studied at different stages of development, using a peroxidase
      labeled lectin incubation technique, the PAS-reaction and Alcian Blue staining.
      Binding sites of 5 lectins, indicating the presence of different sugar moieties
      (Wheat germ agglutinin (WGA) for N-acetylglucosamine, Concanavalin A (Con A) for
      glucose/mannose, Helix pomatia agglutinin (HPA) for N-acetyl-D-galactosamine,
      Ricinus communis agglutinin (RCA-I) for galactose and Ulex europaeus agglutinin
      (UEA-I) for fucose), were identified and were shown to undergo considerable
      variation during oocyte development. In the previtellogenic stage, HPA, RCA-I and
      UEA-I were not identified on the oocyte surface, but WGA and Con A gave strongly
      positive reactions at this site. In the cytoplasm, 4 lectins (Con A, HPA, RCA-I
      and UEA-I) gave a weak or moderate reaction, and Con A was also observed in the
      perinuclear region. In vitellogenic oocytes, these 4 lectins were found to also
      bind to the nuclear envelope, karyoplasm and nucleolus, and, with the exception
      of Con A, could also be found in the nuclei of more mature stages. The
      cytoplasmic yolk granules and Golgi vesicles of the vitellogenic oocyte, were
      moderately positive for Con A, HPA, RCA-I and UEA-I, but HPA, RCA-I and UEA-I
      were only weakly bound at the oocyte surface. In mature oocytes, all 5 lectins
      bound moderately or strongly to yolk granules and cell surface. HPA, RCA-I and
      UEA-I bound moderately or strongly to various nuclear compartments.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7781040
TI  - Tissue- and cell-specific distribution of creatine kinase B: a new and highly
      specific monoclonal antibody for use in immunohistochemistry.
AB  - A synthetic 17-mer peptide corresponding to an unique sequence in the amino
      terminal region of human creatine kinase B was used to raise a new and highly B
      subunit-specific monoclonal antibody, CK-BYK/21E10. We show here that the
      monoclonal antibody is suitable for immunohistochemistry of unfixed frozen
      sections as well as formaldehyde- or Bouin-fixed, paraffin-embedded sections of
      human, rabbit, and mouse tissues. Moreover, in the study of cell- and tissue
      specific distribution patterns, parallel Western blot analysis and immunoelectron
      microscopy is possible using this antibody. Our analyses demonstrate that
      creatine kinase B expression is restricted to a specific subset of cell types in
      various tissues. In brain, the B-subunit was found only in neurocytes, but not in
      glia cells. High expression was also observed in inner segments of photoreceptor
      cells and the outer plexiform layer of the retina, in the parietal cells of the
      stomach and in gut enterocytes, gallbladder and epithelial cells of the
      urogenital system. The possible roles of the creatine kinase/phosphocreatine-ATP
      system in these tissues are discussed.

PMID- 7781041
TI  - Adherence, proliferation and collagen turnover by human fibroblasts seeded into
      different types of collagen sponges.
AB  - We describe an in vitro model that we have used to evaluate dermal substitutes
      and to obtain data on cell proliferation, the rate of degradation of the dermal
      equivalent, contractibility and de novo synthesis of collagen. We tested three
      classes of collagenous materials: (1) reconstituted non-crosslinked collagen, (2)
      reconstituted collagen that was chemically crosslinked with either
      glutaraldehyde, aluminium alginate or acetate, and (3) native collagen fibres,
      with or without other extracellular matrix molecules (elastin hydrolysate,
      hyaluronic acid or fibronectin). The non-crosslinked reconstituted collagen was
      degraded rapidly by human fibroblasts. The chemically crosslinked materials
      proved to be cytotoxic. Native collagen fibres were stable. In the absence of
      ascorbic acid, the addition of elastin hydrolysate to this type of matrix reduced
      the rate of collagen degradation. Both elastin hydrolysate and fibronectin
      partially prevented fibroblast-mediated contraction. Hyaluronic acid was only
      slightly effective in reducing the collagen degradation rate and more fibroblast
      mediated contraction of the material was found than for the native collagen
      fibres with elastin hydrolysate and fibronectin. In the presence of ascorbate,
      collagen synthesis was enhanced in the native collagen matrix without additions
      and in the material containing elastin hydrolysate, but not in the material with
      hyaluronic acid. These results are indicative of the suitability of tissue
      substitutes for in vivo application.

PMID- 7781044
TI  - Dissociation of photoreceptors from whole heads of the fruit fly, Drosophila
      melanogaster.
AB  - Photoreceptor cells that were mostly free of extracellular material and suitable
      for most electrophysiological study procedures were dissociated from whole heads
      of the fruit fly, Drosophila melanogaster, by a simple "smash" technique
      employing gentle chopping by a razor blade through Parafilm sheets. A variety of
      commonly available proteolytic and glycolytic digestion enzymes were tested as
      additions to the basic dissociation procedure described. With the aid of Nomarski
      interference contrast optics, periodic acid-Schiff staining, and fluorescent
      labeling and microscopy methods, it was determined that proteolytic enzymatic
      digestion does little to enhance the dissociation procedure, and instead, often
      damages the cells that one is attempting to recover. Unexpectedly, certain
      glycolytic enzymes, when added to the basic procedure, appear to enhance the
      recovery of intact viable Drosophila photoreceptors that are stripped of most
      extracellular material. Based on these results, a hypothesis concerning the
      biochemical nature of the extracellular matrix of the Drosophila retina is
      proposed. Drosophila photoreceptors are an interesting model system for the study
      of invertebrate phototransduction and photoreceptor cell biology because of their
      many well-characterized mutant strains. The technique described here should
      produce clean viable photoreceptors or ommatidia that respond to light, and that
      are suitable for patch clamping or cell culture.

PMID- 7781043
TI  - Expression of neural cell adhesion molecules, NCAMs, and their polysialylated
      forms, PSA-NCAMs, in the developing rat pituitary gland.
AB  - Neural cell adhesion molecules (NCAMs) can undergo post-translational
      modifications, such as the addition of polysialic acid chains, thus generating
      PSA-NCAMs, which are expressed mainly during development. Since polysialylation
      considerably modifies NCAM adhesivity, expression of NCAMs and PSA-NCAMs has been
      investigated in the developing hypophysis by immunohistochemistry. At embryonic
      day 13 (E13), an antibody against NCAM outlined all cellular profiles in the
      entire Rathke's pouch; this labelling persisted until adulthood. NCAM expression
      increased in all lobes during development and concerned all pituitary cell types.
      In contrast, at E13, PSA-NCAMs were only detected in the neural lobe, solely
      constituted of pituicytes at this stage, and the tuberal lobe, the only lobe
      expressing hormonal mRNA at the same stage. PSA-NCAMs expression increased in the
      neural lobe at E17 with the arrival of the neurosecretory fibres and persisted
      into adulthood. In the anterior lobe, PSA-NCAMs appeared at E15 where their
      distribution was similar to that of the differentiating corticotrophic cells; at
      subsequent stages, their expression extended to the whole anterior lobe. Only two
      cell types, corticotrophic and somatotrophic cells, remained labelled in the
      adult gland. In the intermediate lobe, melanotrophic cells never expressed PSA
      NCAMs but these were expressed on folliculo-stellate cells at birth, preceding
      the onset of innervation. These results suggest that NCAMs and PSA-NCAMs play a
      role in pituitary histogenesis, cell differentiation and neurointermediate lobe
      innervation.

PMID- 7781045
TI  - [A study on the relationship between malignant tumour mortality and environmental
      pollution in Beicun countryside of Datong City].
AB  - The paper reports investigations on malignant tumor mortality in Beicun
      countryside of Datong city, with Hua yuan tun countryside as the control group.
      The result showed that malignant tumor mortality (117.04/10(5)) in Beicun
      countryside was significantly higher than that in the control group
      (61.06/10(5)). The nitrate and nitrite in drinking water and five kinds of
      vegetables in Beicun countryside were significantly higher than those in the
      control group (P < 0.05 - P < 0.001). Serum Cu and Cu/Zu levels in the
      inhabitants of Beicun countryside were significantly higher than those in the
      control group (P < 0.001 and P < 0.01). The benzo (a) pyrene and airborne
      particulates in Beicun countryside area were higher than those in the control
      group area. The results showed that the malignant tumor mortality was strongly
      correlated with severe pollution of vegetables, drinking water and air.

PMID- 7781042
TI  - Intermediate filament typing of the human embryonic and fetal notochord.
AB  - In order to characterize human notochordal tissue we investigated notochords from
      32 human embryos and fetuses ranging between the 5th and 13th gestational week,
      using immunohistochemistry to detect intermediate filament proteins cytokeratin,
      vimentin and desmin, the cytokeratin subtypes 7, 8, 18, 19 and 20, epithelial
      membrane antigen (EMA), and adhesion molecules pan-cadherin and E-cadherin.
      Strong immunoreactions could be demonstrated for pan-cytokeratin, but not for
      desmin or EMA. Staining for pan-cadherin and weak staining for E-cadherin was
      found on cell membranes of notochordal cells. Also it was demonstrated that
      notochordal cells of all developmental stages contain the cytokeratins 8, 18 and
      19, but not 7 or 20. Some cells in the embryonic notochord also contained some
      vimentin. Vimentin reactivity increased between the 8th and 13th gestational week
      parallel to morphological changes leading from an epithelial phenotype to the
      chorda reticulum which represents a mesenchymal tissue within the intervertebral
      disc anlagen. This coexpression reflects the epithelial-mesenchymal
      transformation of the notochord, which also loses E-cadherin expression during
      later stages. Our findings cannot elucidate a histogenetic germ layer origin of
      the human notochord but demonstrate its epithelial character. Thus, morphogenetic
      inductive processes between the human notochord and its surrounding vertebral
      column anlagen can be classified as epithelial-mesenchymal interactions.

PMID- 7781046
TI  - [Evaluation of segregation ratio and hereditability of esophageal cancer--a
      comparative epidemiologic study in Huai'an County].
AB  - A genetic epidemiologic case-control study including 407 pedigrees (249 cases and
      158 controls) was carried out to estimate the segregation ratio and the
      hereditability (h2) of esophageal cancer by using the method of Li-Mantel-Gart
      and Falconer, respectively, and to compare the genetic epidemiologic features
      from the other cancers. The results showed that the segregation ratio of
      esophageal cancer was 0.1347, significantly less than 0.25 and the genetic model
      belonged to polygenetics. The h2 of esophageal cancer was 21.41%, 20.23% for
      female and 13.57% for male. It is concluded that genetic factor is one of the
      risk factors for esophageal cancer and specially of importance for female, but it
      is not a main risk factor for esophageal cancer. The results of comparative
      epidemiologic study among the cancers of lung, stomach, liver and large bowel
      showed that the segregation ratios of the cancers (except stomach, no data) were
      all less than 0.25, and the h2 of gastric and liver cancers were higher, which
      were 52.40% and 51.85%, respectively.

PMID- 7781047
TI  - [Investigation on scoliosis incidence among 24,130 school children].
AB  - Through the screening on scoliosis among 24,130 school children in Hu Guan
      County, Shanxi Province, it showed that the forward-bending test was positive in
      1,794 children (7.4 per cent), with male 3.64 per cent and female 3.8 per cent.
      The hump inclination angles that were more than 4 degrees were found in 665
      children (2.75 per cent). The Cobb angles that were more than 10 degrees were
      found in 347 children. The incidence rate was 1.44 per cent, with a male to
      female ratio of 1:1.17. Most of them were idiopathic scoliosis.

PMID- 7781048
TI  - [Detection of human cytomegalovirus in urine by polymerase chain reaction].
AB  - Polymerase chain reaction (PCR) amplification was set up with double primer pairs
      of major immediate-early and late gene in order to detect human cytomegalovirus
      (HCMV) from urine. This method was applied to the detection of HCMV in clinical
      samples of urine from renal transplant recipients. The result indicated that the
      primers did not cross react with other members of the herpes family of virus and
      human genomic DNA; that the HCMV AD169 tissue culture mixture used and the
      dilutions to estimate the sensitivity of PCR relative to tissue culture, 2.5
      microliters of a 10(-3) dilution of the culture (625fg HCMV DNA) assayed were
      detected by direct gel analysis; that 25 of 30 samples of urine from the renal
      transplant recipients (serum HCMV IgM positive) were positive. It is conclude
      that PCR amplification is a valuable tool for diagnoses of HCMV infection in
      renal transplant recipients.

PMID- 7781049
TI  - [Application of biological markers in epidemiologic studies].

PMID- 7781050
TI  - [A cohort study and KAP investigation of HIV infected persons in Ruili, and other
      counties in Yunnan, 1994].
AB  - In 1994, an cohort study of drug users had continued in Longchuan and Luxi
      counties, Ruili city. The cohort study for drug users had been established since
      1992 and total 522 drug users were investigated. Sixty five sera samples were
      collected, including 26 HIV negatives intravenous drug users in 1992 and 39 of
      them in 1993. The result shown that 10 sera samples are positives. Of sixty five
      samples tested, the rate of HIV infectious for IVDU in Ruili, Longchuan and Luxi
      were 25.0%, 16.3% and 0.0% respectively. Total of 46 HIV positives samples were
      found from 105 blood samples among the IVDU who were newly included in the cohort
      study in 1994. Of these samples, the rates of HIV infection in Ruili, Longchuan
      and Luxi were 61.8%, 38.5% and 0.0% respectively. The result of KAP investigation
      from 522 drug users has shown that there is a marked difference of the rate of
      HIV infections in the nationalities, occupations, education (P < 0.01). The main
      reason contributing the low rate of HIV infections in Luxi county is that the
      IVDU mainly are the Han nationality with higher education level, as well as
      travelling less to Burma.

PMID- 7781051
TI  - [Investigation of mortality among HIV-infected intravenous drug users in Ruili
      region of Yunnan province].
AB  - The investigation of death condition of HIV infected intravenous drug users
      (IVDU) was conducted with a retrospective cohort study in Ruili city of Yunnan
      province from 1989-Oct to 1993-Oct, the deaths among 395 HIV+ IVDUs add up to 61
      and the mortality is 15.4%, which has significant difference compared to the
      death level of control cohort composed by 192 HIV- IVDUs (add up to 18). The
      relative risk of death is 1.6 (95% confidence interval 1.0-2.5). After classified
      by the cause of death, it was found that both maintain high accidence mortality
      caused mainly by narcotism, violence and suicide. But in death group caused by
      diseases, the mortality of HIV+ IVDU (8.4%) is much higher than HIV- IVDU (3.1%)
      (95% confidence interval 1.2-6.1). We also compared non-AIDS mortality between
      HIV+ and HIV- IVDU according to data of HIV/AIDS surveillance which showed 2
      patients died of AIDS in HIV+ IVDU. The difference is also significant (13.8% in
      HIV+, but 7.9% in HIV- IVDU) and the relative risk is 1.7 (95% confidence
      interval 1.0-2.8). The results indicated that the lever of reported AIDS cases
      were probably lower than that of actual AIDS cases existing.

PMID- 7781052
TI  - [Cost-benefit analysis on immunization of newborns with hepatitis B vaccine in
      Jinan City].
AB  - The decision tree model cost-benefit analysis method was used to analyse the
      strategies and economic benefits of immunization of newborns with hepatitis B
      vaccines in Jinan City. The results showed that all the three vaccination
      strategies could all produce positive benefits. Their BCR were 42.41 to 48.01.
      Through the decision analysis, it concluded that stress should be laid on the
      blocking of mother-to-infant transmission, and that if there are sufficient HB
      vaccines, all newborns should be vaccinated. In addition, the results of
      sensitivity analysis indicate that the benefits of HB vaccination are outstanding
      and quite stable.

PMID- 7781053
TI  - [A seroepidemiologic survey on HCMV infection in pregnant women].
AB  - A survey on antibodies to HCMV-IgM was carried out with the solid-phase ELISA in
      6,428 pregnant women who were given perinatal medical care in six regions of
      Henan Province. The positive rate was 1.1%. It was found that women of different
      ages, stages and numbers of pregnancy had the same positive rate. And the rate in
      autumn was slightly higher than those in other seasons.

PMID- 7781054
TI  - [A study on the risk factors of Legionella infection in children].
AB  - In order to understand the risk factors of legionella infection in children a
      case-control study with two kinds of controls was conducted. The stepwise
      regression analysis included age, sex, season and immunosuppressive therapy in
      regression equation. The non-conditional logistic regression analysis showed that
      age, passive smoking and touching soil were associated with legionella infection.
      The statistics analysis also showed that there were dose-response relationship
      between age, passive smoking and immunosuppressive therapy and the frequency of
      legionella infection in children. It was suggested that age, season,
      immunosuppressive therapy, passive smoking and touching soil were risk factors
      for legionella infection.

PMID- 7781055
TI  - [Study on carboxylated latex agglutination test for serodiagnosis of human and
      animal brucellosis].
AB  - A carboxylated latex agglutination test was developed for detecting antibodies in
      sera from 372 human and animal brucellosis. Of which 94 sera from human was
      detected by ELISA. The latex was chemical-linked with B. melitensis 16M and
      extracted with 5% NaCl. Comparing with RBPT in detecting antibodies with
      brucellosis, the LAT was more stable and specific; the positive or negative
      results detected by LAT were consistent with those by SAT and ELISA. LAT may
      detect both IgG and IgM antibodies to Brucella in Human and animal. It is
      concluded that LAT is stable, specific, sensitive and practicable for the
      serodiagnosis of brucellosis.

PMID- 7781056
TI  - [A report of epidemiology investigation on 222 infants with tetanus in
      Pingdingshan City from 1990 to 1991].
AB  - A total of 222 in-patients with tetanus had been investigated in Ping Ding Shan
      City (including 4 counties) from 1990 to 1991. The incidence in 1990 was
      62.8/10(5), the special incidence was 2.44/1000. But in 1991, they were
      48.1/10(5) and 1.97/1000, respectively. The male-to-female ratio was 3:1. 89.64%
      infants came from the countryside, and 99.6% infants were delivered in an old
      way.

PMID- 7781057
TI  - [The prevalence of Toxoplasma infection among pregnant women and their newborn
      infants in Chengdu].
AB  - Purpose of the study was to determine the prevalence of toxoplasma infection
      among the pregnant women and their newborn infants in Chengdu and to identify
      risk factors of acquiring toxoplasma infection. The Maternal and Child Health
      Hospital was selected by random cluster sampling method in the study. Each
      pregnant women admitted to the above hospital consecutively and her surviving
      newborn at birth were included in this survey. History, physical examination and
      blood specimens were obtained from 1,211 pairs of mother-newborns. ELISA was used
      to detect toxoplasma IgG and IgM antibodies. Results revealed that sera
      prevalence of toxoplasma IgG antibodies and IgM antibodies of pregnant women were
      39.14% and 4.21% respectively. Seraprevalence of toxoplasma IgM antibodies of
      newborn infants was 1.07%. Congenital malformation of newborn infants may be
      associated with congenital toxoplasma infection (P < 0.05, OR = 6.32).

PMID- 7781059
TI  - No end yet to messenger RNA 3' processing!

PMID- 7781058
TI  - Qualifying for the license to replicate.

PMID- 7781060
TI  - Sense from nonsense: RNA editing in mitochondria of kinetoplastid protozoa and
      slime molds.

PMID- 7781061
TI  - Arrestin binding determines the rate of inactivation of the G protein-coupled
      receptor rhodopsin in vivo.
AB  - G protein-coupled receptor inactivation is a crucial feature of cellular
      signaling systems; this process determines the catalytic lifetime of the
      activated receptor and is necessary for response termination. Although previous
      work has indicated a class of models in which several sequential steps are
      required for receptor inactivation, the rate-limiting event is still unclear. In
      this paper, we develop a theory that describes the kinetics of inactivation of
      the G protein-coupled receptor rhodopsin based on the rate of arrestin binding
      and test the theory using a combination of genetic and electrophysiological
      techniques in Drosophila photoreceptors. The theory quantitatively describes the
      inactivation kinetics of activated rhodopsin in vivo and can be independently
      tested with molecular and spectroscopic data. The results demonstrate that the
      rate of arrestin binding determines the kinetics of receptor inactivation in vivo
      and thus is the event that controls signal amplification at the first step of
      this G protein-coupled transduction cascade.

PMID- 7781062
TI  - Rac mediates growth factor-induced arachidonic acid release.
AB  - Growth factor-induced stress fiber formation involves signal transduction through
      Rac and Rho proteins and production of leukotrienes from arachidonic acid
      metabolism. In exploring the relationship between these pathways, we found that
      Rac is essential for EGF-induced arachidonic acid production and subsequent
      generation of leukotrienes and that Rac V12, a constitutively activated mutant of
      Rac, generates leukotrienes in a growth factor-independent manner. Leukotrienes
      generated by EGF or Rac V12 are necessary and sufficient for stress fiber
      formation. Furthermore, leukotriene-dependent stress fiber formation requires Rho
      proteins. We have therefore identified elements of a pathway from growth factor
      receptors that includes Rac, arachidonic acid production, arachidonic acid
      metabolism to leukotrienes, and leukotriene-dependent Rho activation. This
      appears to be the major pathway by which Rac influences Rho-dependent
      cytoskeleton rearrangements.

PMID- 7781063
TI  - Yan functions as a general inhibitor of differentiation and is negatively
      regulated by activation of the Ras1/MAPK pathway.
AB  - Drosophila yan has been postulated to act as an antagonist of the proneural
      signal mediated by the sevenless/Ras1/MAPK pathway. We have mutagenized the eight
      MAPK phosphorylation consensus sites of yan and examined the effects of
      overexpressing the mutant protein in transgenic flies and transfected S2 cultured
      cells. Our results suggest that phosphorylation by MAPK affects the stability and
      subcellular localization of yan, resulting in rapid down-regulation of yan
      activity. Furthermore, MAPK-mediated down-regulation of yan function appears to
      be critical for the proper differentiation of both neuronal and nonneuronal
      tissues throughout development, suggesting that yan is an essential component of
      a general timing mechanism controlling the competence of a cell to respond to
      inductive signals.

PMID- 7781064
TI  - Expression of msl-2 causes assembly of dosage compensation regulators on the X
      chromosomes and female lethality in Drosophila.
AB  - Male-specific lethal-2 (msl-2) is a RING finger protein that is required for X
      chromosome dosage compensation in Drosophila males. Consistent with the formation
      of a dosage compensation protein complex, msl-2 colocalizes with the other MSL
      proteins on the male X chromosome and coimmunoprecipitates with msl-1 from male
      larval extracts. Ectopic expression of msl-2 in females results in the appearance
      of the other MSL dosage compensation regulators on the female X chromosomes and
      decreased female viability. We suggest that msl-2 RNA is the primary target of
      SxI regulation in the dosage compensation pathway and present a speculative model
      for the regulation of two distinct modes of dosage compensation by SxI.

PMID- 7781065
TI  - Visualization of chromosomal domains with boundary element-associated factor BEAF
      32.
AB  - We have purified two proteins from Drosophila that bind to the scs' boundary
      element of the hsp70 domain at locus 87A7. Their palindromic binding sites (CGATA
      TATCG) symmetrically abut the previously mapped hypersensitive site of scs'. We
      have cloned a cDNA for one of these proteins, BEAF-32 (boundary element
      associated factor of 32 kDa). It encodes a novel protein that is bound to scs'
      but not scs in vivo. Immunostaining localizes BEAF to hundreds of interbands and
      many puff boundaries on polytene chromosomes, suggesting that a chromosomal
      domain consists of a band (or puff) and part of the flanking interbands. Enhancer
      blocking assays implicate the palindromic binding site in boundary function. The
      lack of enhancer blocking in transiently transfected cells suggests an
      involvement of chromatin, nuclear structure, or both in boundary function.

PMID- 7781066
TI  - CaMKII regulates the frequency-response function of hippocampal synapses for the
      production of both LTD and LTP.
AB  - To investigate the function of the autophosphorylated form of CaMKII in synaptic
      plasticity, we generated transgenic mice that express a kinase that is Ca2+
      independent as a result of a point mutation of Thr-286 to aspartate, which mimics
      autophosphorylation. Mice expressing the mutant form of the kinase show an
      increased level of Ca(2+)-independent CaMKII activity similar to that seen
      following LTP. The mice nevertheless exhibit normal LTP in response to
      stimulation at 100 Hz. However, at lower frequencies, in the range of 1-10 Hz,
      there is a systematic shift in the size and direction of the resulting synaptic
      change in the transgenic animals that favors LTD. The regulation of this
      frequency-response function by Ca(2+)-independent CaMKII activity seems to
      account for two previously unexplained synaptic phenomena, the relative loss of
      LTD in adult animals compared with juveniles and the enhanced capability for
      depression of facilitated synapses.

PMID- 7781068
TI  - Crystal structure of the cys2 activator-binding domain of protein kinase C delta
      in complex with phorbol ester.
AB  - Protein kinase Cs (PKCs) are a ubiquitous family of regulatory enzymes that
      associate with membranes and are activated by diacylglycerol or tumor-promoting
      agonists such as phorbol esters. The structure of the second activator-binding
      domain of PKC delta has been determined in complex with phorbol 13-acetate, which
      binds in a groove between two pulled-apart beta strands at the tip of the domain.
      The C3, C4, and C20 phorbol oxygens form hydrogen bonds with main-chain groups
      whose orientation is controlled by a set of highly conserved residues. Phorbol
      binding caps the groove and forms a contiguous hydrophobic surface covering one
      third of the domain, explaining how the activator promotes insertion of PKC into
      membranes.

PMID- 7781067
TI  - Impairment of spatial but not contextual memory in CaMKII mutant mice with a
      selective loss of hippocampal LTP in the range of the theta frequency.
AB  - We assessed hippocampal-dependent memory in mice with a Ca(2+)-independent form
      of CaMKII generated by the introduction of an aspartate at amino acid 286. The
      CaMKII-Asp-286 mice show normal LTP at high frequency stimulation, but in the 5
      10 Hz range, they show a shift in the frequency-response curve favoring LTD. This
      range of frequencies is similar to the theta rhythm, which is associated with
      exploration in rodents. Using the Barnes maze to assess spatial memory, we found
      the transgenic mice could not learn to navigate to a specific location using
      spatial cues. In contrast, one line of transgenic mice performed normally in
      contextual fear conditioning, a task that is also hippocampal dependent. This
      dissociation between spatial and contextual memory suggests that even though both
      require the hippocampus, they may be mediated by different synaptic mechanisms.

PMID- 7781069
TI  - Initiation of V(D)J recombination in a cell-free system.
AB  - Cells performing V(D)J recombination make specific cuts in DNA at recombination
      signal sequences. Here, we show that nuclear extracts of pre-B cell lines carry
      out this specific cleavage. The products of cleavage are the same as found
      previously in thymocytes: full-length, blunt, 5'-phosphorylated signal ends, and
      covalently sealed (hairpin) coding ends. A complete signal sequence is required.
      Recombinant RAG1 protein greatly increases activity and complements an inactive
      extract from a RAG1 (-/-) pre-B cell line. When the extracts are fractionated,
      cleavage activity correlates with the presence of RAG2 protein. These results
      suggest that RAG1 and RAG2 are components of the V(D)J recombinase.

PMID- 7781070
TI  - A role for recombination junctions in the segregation of mitochondrial DNA in
      yeast.
AB  - In S. cerevisiae, mitochondrial DNA (mtDNA) molecules, in spite of their high
      copy number, segregate as if there were a small number of heritable units. The
      rapid segregation of mitochondrial genomes can be analyzed using mtDNA deletion
      variants. These small, amplified genomes segregate preferentially from mixed
      zygotes relative to wild-type mtDNA. This segregation advantage is abolished by
      mutations in a gene, MGT1, that encodes a recombination junction-resolving
      enzyme. We show here that resolvase deficiency causes a larger proportion of
      molecules to be linked together by recombination junctions, resulting in the
      aggregation of mtDNA into a small number of cytological structures. This change
      in mtDNA structure can account for the increased mitotic loss of mtDNA and the
      altered pattern of mtDNA segregation from zygotes. We propose that the level of
      unresolved recombination junctions influences the number of heritable units of
      mtDNA.

PMID- 7781071
TI  - The secretory phospholipase A2 gene is a candidate for the Mom1 locus, a major
      modifier of ApcMin-induced intestinal neoplasia.
AB  - Mutations in the APC gene are responsible for various familial and sporadic
      colorectal cancers. Min mice carry a dominant mutation in the homolog of the Apc
      gene and develop multiple adenomas throughout their small and large intestine.
      Quantitative trait loci studies have identified a locus, Mom1, which maps to the
      distal region of chromosome 4, that dramatically modifies Min-induced tumor
      number. We report here the identification of a candidate gene for Mom1. The gene
      for secretory type II phospholipase A2 (Pla2s) maps to the same region that
      contains Mom1 and displays 100% concordance between allele type and tumor
      susceptibility. Expression and sequence analysis revealed that Mom1 susceptible
      strains are most likely null for Pla2s activity. Our results indicate that Pla2s
      acts as a novel gene that modifies polyp number by altering the cellular
      microenvironment within the intestinal crypt.

PMID- 7781073
TI  - [Principles of ontogenetic research on the central nervous system].

PMID- 7781072
TI  - [Membrane transport of macromolecules and particles: exocytosis and endocytosis].

PMID- 7781074
TI  - [The role of GTP-binding proteins in hormone signal transfer].

PMID- 7781075
TI  - [Pathophysiology of calcium metabolism regulation].

PMID- 7781076
TI  - [Mechanisms of learning, memory and their development].

PMID- 7781078
TI  - [Ion channels].

PMID- 7781079
TI  - [Role of the central cholinergic system in behavior during stress].

PMID- 7781077
TI  - [Functional hemispheric asymmetry in man].

PMID- 7781081
TI  - [Hormonal thermogenesis].

PMID- 7781080
TI  - [Present findings on the interrelation between the immune and the endocrine
      systems].

PMID- 7781082
TI  - [The importance of nutrition for the developing organism].

PMID- 7781084
TI  - [Basics of hemodynamic values and their regulation].

PMID- 7781083
TI  - [Mechanisms of oxygen transport].

PMID- 7781085
TI  - [Humoral regulation and endocrine function of the cardiovascular system].

PMID- 7781086
TI  - The prevalence of hepatitis B surface antigen in the Gampaha district.
AB  - OBJECTIVE: To assess the prevalence and some epidemiological features of
      hepatitis B surface antigen (HBsAg) status in the Gampaha district. DESIGN:
      Community based survey. SETTING: The district of Gampaha. SUBJECTS: All
      individuals over six months of age who were resident in the Gampaha district for
      a period over one month at time of survey. RESULTS: The HBsAg positivity rate in
      the Gampaha district was estimated to be 2.5% (95% C.I. 2% to 3%). This places
      the area in the intermediate endemicity zone as classified by WHO. The
      epidemiology indicates horizontal intrafamilial spread being more important in
      the population studied, than vertical, parenteral or sexual routes of
      transmission. CONCLUSIONS: The study suggests that immunisation in early
      childhood is an important measure in prevention of the infection in this
      district.

PMID- 7781087
TI  - Raised serum IgE levels in chronic inflammatory lung diseases.
AB  - OBJECTIVE: To study the serum IgE response in nonallergic subjects with chronic
      inflammatory lung diseases. SETTING: Christian Medical College Hospital, Vellore.
      SUBJECTS: Twenty six patients with bronchiectasis, five with pulmonary mycosis
      referred from all over India and 30 healthy subjects. MAIN OUTCOME MEASURES:
      Serum IgE value (determined by radioimmuno assay) above the upper limit of normal
      control range (136 to 948 iu/ml) was considered as raised level. RESULTS: Of the
      26 patients with bronchiectasis 13 had pyogenic infections, six had pulmonary
      tuberculosis; in six patients sputum culture was sterile while another patient
      had herpes zoster. Five cases of mycosis included one each of actinomycosis,
      aspergillosis, blastomycosis, cryptococcosis and nocardiasis. The serum IgE
      levels were raised in 20 (65%) of the 31 patients. CONCLUSION: Associated
      bacterial, fungal and parasitic infections were probably responsible for inducing
      an hyper-IgE response in these non-allergic subjects.

PMID- 7781088
TI  - Unvisited vistas of the nervous system.

PMID- 7781089
TI  - The case for a national integrated diabetes service.

PMID- 7781090
TI  - Some doctors celebrated for their non-medical achievements.

PMID- 7781091
TI  - Endemic multinodular goitre--management strategies.

PMID- 7781092
TI  - Decompression sickness: recovery after delayed recompression.
AB  - Two patients with Type II decompression sickness with good recovery following
      delayed recompression therapy are described. These are the first two cases of
      successful recompression therapy for this diving hazard to be reported in Sri
      Lanka. The risks taken by Sri Lankan divers and prevention of diving related
      medical disorders are discussed.

PMID- 7781093
TI  - Idiopathic thrombocytopaenic purpura presenting as post-partum haemorrhage.
AB  - We describe a patient with idiopathic (immune) thrombocytopaenic purpura who
      presented with postpartum haemorrhage. The patient did not have any external
      manifestations of idiopathic thrombocytopaenic purpura on admission but the
      diagnosis was suspected after examination of the baby.

PMID- 7781094
TI  - Congenital nephrotic syndrome.
AB  - A six week old baby girl from a closed Malay community in Hambantota presented
      with gradually increasing oedema since two weeks of age. She was oedematous, with
      gross non selective proteinuria, hypoproteinaemia and hypercholesterolaemaia.
      Congenital nephrotic syndrome is extremely rare and has not been reported
      previously in Sri Lanka.

PMID- 7781095
TI  - Chediak-Higashi syndrome.

PMID- 7781096
TI  - The intermediate rainfall zone as a source of malaria epidemics in Sri Lanka.

PMID- 7781097
TI  - Atypical presentations of malaria associated with chloroquine resistance.

PMID- 7781098
TI  - Unidentified snake bite with "pure" nephrotoxicity.

PMID- 7781099
TI  - Kikuchi's disease--a recognised cause for benign lymphadenopathy.

PMID- 7781101
TI  - Tumour of the pancreas with unusual clinicopathological features.

PMID- 7781100
TI  - Abuse of paracetamol in childhood fever.

PMID- 7781102
TI  - Pure choriocarcinoma of ovary, probably non-gestational in origin.

PMID- 7781103
TI  - Prevention of AIDS in Sri Lanka: are we doing the best for our people?

PMID- 7781104
TI  - A Sri Lankan family with lipoid proteinosis.

PMID- 7781105
TI  - Two children with acute leukaemia presenting with renal masses.

PMID- 7781106
TI  - [Current status and perspective of researches in cardiovascular pathology].

PMID- 7781107
TI  - [Immunohistochemical observations on production and distribution of endothelin in
      atherosclerosis plaques].
AB  - An analysis of endothelin in atherosclerotic plaques using immunohistochemical
      methods showed that endothelin not only existed in endothelial cells, large
      amounts were also found in the proliferating intimal vascular smooth muscle cells
      (VSMC). In the de-endothelized thoracic aorta of rats, significant amounts of
      endothelin could be produced by proliferating intimal VSMC. Radio-immunological
      studies demonstrated that the extent of VSMC proliferation was in direct ratio to
      endothelin content, which suggests that production of endothelin is related to
      proliferation of VSMC in atherosclerotic plaques.

PMID- 7781108
TI  - [Expression and significance of HBV DNA and its 5 antigens in liver cirrhosis].
AB  - Hepatitis B virus (HBV) DNA and its 5 antigens were studied in 225 cases of
      paraffin-embedded sections of human liver cirrhosis obtained by biopsy. HBxAg,
      pre-S1 and pre-S2 antigens were detected by immunohistochemical ABC method, HBsAg
      and HBcAg by PAP method. HBV DNA by in situ hybridization, and both HBV DNA and
      HBsAg, HBxAg or HBcAg by double labelling technique of immunohistochemistry and
      in situ hybridization respectively. The results showed that the positive rates
      were 70.0% (128/183) for HBsAg, 64.4% (85/132) for pre-S1 antigen, 61.4% (81/132)
      for pre-S2 antigen, 75.3% (113/150) for HBxAg, 22.4% (39/174) for HBcAg and 62.4%
      (58/93) for HBV DNA respectively. The double labelling positive rates were 37.3%
      (19/51) for both HBV DNA and HBsAg, 86.3% (44/51) for both HBV DNA and HBxAg and
      39.2% (20/51) for both HBV DNA and HBcAg respectively. More than 80% of the cases
      with positive sections for HBV DNA and its 5 antigens were associated with liver
      cell dysplasia (LCD). The results of this study suggest that the occurrence and
      development of liver cirrhosis were closely related to chronic infection of HBV
      in China.

PMID- 7781109
TI  - [Detection of HBV DNA and HBsAg in HCC and pericarcinomatous tissues using double
      labelling technique].
AB  - 40 cases of hepatocellular carcinoma (HCC) and their surrounding tissues were
      studied on paraffin-embedded sections by in situ hybridization and
      immunohistochemical double labelling techniques. The positive rates of HBV DNA
      and HBsAg were 65% and 82.5% respectively, suggesting that HBV infection is a
      significant cause of HCC. HBV DNA and HBsAg signals in the pericarcinomatous
      tissues were stronger than that in cancer cells. Reduced replication caused by
      integration of HBV DNA in HCC may explain this phenomenon. We found that the
      small "piece-meal like" inclusions which existed only in HCC may be a special
      cancer related pattern of HBsAg. There were stronger signals of HBsAg in the
      small cell LCD than in other pericarcinomatous lesions, supporting the theory
      that the small cell LCD is more likely to be a precarcinomatous lesion.

PMID- 7781110
TI  - [Iron overload and iron deficiency regulate ED1 and ED2 expression in spleen
      macrophages of rats].
AB  - Monoclonal antibodies ED1 and ED2 can recognize epitopes on the spleen macrophage
      related with its antigen presenting activity. Immunohistochemical and
      histochemical methods were used to show the influence of iron overload and iron
      deficiency on the expression of ED1, ED2 and phagocytic functions of the
      macrophages in the spleen. We found that iron overloaded rats had large amounts
      of hemosiderin deposits in the macrophages of red and white pulp with reduced
      expression of ED1, ED2 and phagocytic function. It is suggested that iron
      concentration can regulate the expression of ED1, ED2 and phagocytic activity of
      the macrophage, which may in turn influence its antigen presentation and anti
      infection functions.

PMID- 7781111
TI  - [Gene expression of growth factors, growth factor receptor and oncogenes in human
      lung cancer cell lines].
AB  - Gene expression of growth factors including epidermal growth factor (EGF),
      transforming growth factor alpha (TGF alpha), epidermal growth factor receptor
      (EGFR), oncogenes such as c-myc, N-ras, c-erbB2 and tumor suppressor gene P53
      were studied in 4 human lung cancer cell lines using Northern blot technique.
      Among these cell lines were 2 adenocarcinoma cell lines, one large cell carcinoma
      cell line and one small cell carcinoma cell line. Expression of EGF and TGF alpha
      mRNAs were found in all 4 cell lines and EFGR mRNA was seen in 3 out of 4 cell
      lines. Among these cell lines, 2 cell lines with weaker expression of EGF and TGF
      alpha, expressed c-myc mRNA. Another 2 cell lines had no c-myc but expressed
      large amounts of EGF and TGF alpha mRNA. No expression of N-ras, c-erbB2 and p53
      were found in these cell lines. The results indicate the presence of autocrine
      loop of growth factors in these cancer cells. The autostimulation of growth
      factors may be the main cause for the uncontrolled growth of cancer cells. After
      treating the cancer cells with EGF, anti-EGF and anti-EGFR antibodies, EGF was
      found to exert a mild stimulating effect on the growth of one cell line, but no
      effect on the other cell lines. Anti-EGF and anti-EGFR antibodies inhibited the
      cell growth on all cell lines. These results provided further evidence for the
      presence of autocrine loop of growth factors in these lung cancer cell lines.

PMID- 7781112
TI  - [The detection of p53 gene and HPV16 oncogene in cervical carcinoma].
AB  - Special primers of HPV16 E6 and E7 ORFs as well as p53 exon 7 were used with PCR,
      PCR-SSCP technique to study 35 cervical carcinoma specimens. The results were as
      follows: (1) HPV16 E6 and E7 DNA were found in 25/35 specimens (71.42%). However,
      only 11/35 (31.42%) had E6, E7 ORFs Simultaneously; 3/35 (8.57%) had E6 ORFs and
      11/35 (31.42%) had E7 ORFs, indicating that the distribution of E6 E7 genes were
      heterogeneous in cervical carcinoma. (2) No mutation and loss of heterogeneity of
      p53 exon 7 was found in any of the 35 specimens, indicating that the alteration
      of p53 exon 7 in cervical carcinoma was uncommon.

PMID- 7781113
TI  - [Pathological research on isolated microcallus formation in 576 vertebrae].
AB  - 576 vertebrae specimens obtained from 24 autopsy cases were studied for
      microcallus. Microcallus consisted of osteocytes which originated from
      osteoblasts located on the surface of trabeculae and from medullary reticulum
      cells. In the early stage, microcallus is immature woven bone which later
      transforms into mature lamellar bone. The incidence of microcallus is related to
      stress on the vertebral body and to the age of the patient, therefore, most
      microcallus were found in the lumbar vertebrae and in the elderly.

PMID- 7781114
TI  - [A study on human dental embryology in an endemic high fluorosis region].
AB  - In a high endemic fluorosis area in Guizhou, China, 40 human fetuses delivered by
      induced abortion during the 5th-8th month of gestation were utilized to study
      dental embryonic samples under transmission electron microscope (TEM). Compared
      with normal controls, ultrastructure findings in the ameloblast cell organs
      include swelling of mitochondria, enlargement of SER, increase in RNA granules
      and RER. This study suggests that the irregularities of the collagenous fibers
      and crystallites are due to the maldevelopment of the ameloblast Tome's
      processes, which explains the mechanism of motteled enamel.

PMID- 7781115
TI  - [Olfactory neuroblastoma: a histopathological ultrastructural and
      immunohistochemical study of 11 cases].
AB  - Eleven cases of olfactory neuroblastoma (ONB) were studied histopathologically,
      ultrastructurally and immunohistochemically. Light microscopical examination
      showed the tumor cell nests separated by fibrous connective tissue (present in
      10/11 ONB), Homer-Wright rosette and/or Flexner rosette (9/11 ONB) and
      acidophilic fibrillary background (8/11 ONB). Ultrastructurally, there were
      neurosecretory granules (2/2 ONB) and neurofibrils (1/2 ONB) in cytoplasm of
      tumor cells. A panel of antibodies were used to characterize the
      immunohistochemical staining profile of ONB. The following results were obtained
      for the 11 neoplasms that were immunostained: NSE 11/11 (+), S-100 3/11 (+),
      Vimentin 4/11 (+), Keratin 1/11 (+) and NF, EMA, CEA, LCA all negative
      respectively. The significance of the morphological and immunohistochemical
      features of ONB in diagnosis and differential diagnosis were discussed.

PMID- 7781116
TI  - [Detection and quantification of lipoprotein (a) in atherosclerotic lesions of
      human aorta].
AB  - Lipoprotein(a) [Lp(a)] represents an independent risk factor for atherosclerotic
      disease. In the present study, the extent to which Lp(a) accumulated in normal
      and various degrees of atheromatous lesions and the distribution pattern of Lp(a)
      in these lesions have been studied in thoracic aorta from the autopsy tissues by
      means of immunohistochemistry, immunoelectronic microscopy, enzyme-linked
      immunosorbent assay and computer-assisted image processing. Lp(a) was found to be
      localized preferentially in lesion areas and had its own distribution pattern in
      each kind of lesion. Lp(a) associated primarily with extracellular matrix and was
      detected in only a small number of foamy cells. Apolipoprotein B was also
      detected, whose staining pattern was always found to be congruent with that of
      Lp(a). This suggests that the immunoreactivity of apoB is related to the presence
      of Lp(a) at least in part, since Lp(a) possesses apoB in addition to apo(a). It
      was concluded that both low density lipoprotein and lipoprotein(a) play an
      important role in the pathogenesis of atherosclerosis.

PMID- 7781117
TI  - [Studies on the histological classification of proliferative disease of breast
      and its relation with breast carcinoma].
AB  - According to the degree of fibroplastic proliferation, proliferative disease of
      breast can be divided into three types: lobular hyperplasia type, fibroadenosis
      type and fibrosclerosis type. Each type could have simple or compound lesions.
      The latter include: atypical hyperplasia of duct epithelial cells, large sweat
      gland metaplasia, cyst and fibroadenoma formation. The progress of lesions
      coincided with the increase of age. The age of fibrosclerosis patients were close
      to that of patients with breast carcinoma accompanied with proliferative breast
      disease. The level of PCNA expression in the three types of proliferative breast
      disease increased progressively and the level of PCNA expression in
      fibrosclerosis and breast carcinoma being similar. It is emphasized that in the
      fibrosclerosis type hyperplasia, the presence of twisting, fragmentation or
      incomplete encirclement of the periductal myoepithelial cells as well as the
      basement membrane of the tubules may be considered as a warning to call one's
      attention to follow up patients closely.

PMID- 7781118
TI  - [Detection of human papillomavirus in condyloma acuminata tissues].
AB  - We used immunohistochemical technique, in situ hybridization and polymerase chain
      reaction to detect HPV capsid antigen (HPV-Ag) and HPV-DNA sequences in genital
      condyloma and pseudocondyloma of vulvae tissues. We also observed the relation
      between HPV distribution in condylomas and their histological changes. RESULTS:
      71.4% of condylomas were positive for HPV-Ag with IMHC, 96.5% of condylomas were
      positive for HPV6/11 DNA with ISH, and 100% of condylomas were positive for
      HPV6/11/16/18DNA with PCR. Only 21.4% of pseudocondylomas of vulvae were positive
      for HPV6/11/16/18DNA with PCR. By observing the distribution of labelled HPV-Ag
      and HPV-DNA, we found a close relation between HPV proliferative infection and
      the specific changes of condylomas.

PMID- 7781119
TI  - [Effects of retinoids on the invasiveness and metastasis of neoplastic cells and
      related mechanism].

PMID- 7781120
TI  - [Apolipoprotein A-IV and transportation of cholesterol from smooth muscle cells
      in experimental hyperlipidemia].
AB  - The effects of apolipoprotein (apo) A-IV and apoA-IV/phosphatidylcholine (PC)
      liposome on cholesterol efflux from the smooth muscle cells originating from the
      aorta of hypercholesterolemic rabbit model and control rabbits, and on the
      activation of lecithin cholesterol acyltransferase (LCAT) were studied
      respectively. Both apoA-IV/PC and apoA-I/PC liposomes have similar efficiency as
      the HDL's, i.e. a strong ability to clear intracellular cholesterol and the
      ability to activate LCAT. There were no differences noticed on the clearance
      ability between apoA-IV and apoA-I or between apoA-IV/PC and apoA-I/PC liposomes.
      These results suggest that apoA-IV may play an important role in the process of
      reverse cholesterol transport and apoA-IV/PC liposome may be effectively used
      instead of natural HDL to prevent the development of atherosclerosis.

PMID- 7781122
TI  - [Isolation and identification of enteric adenovirus in China].
AB  - Enteric adenovirus type 40/41 is considered to be the second major cause of
      gastroenteritis in young children. In this study fecal specimens 86-123 from
      diarrhea patients were isolated and examined in Grahm 293 cells. This induced
      cytopathic effect (CPE) at this cells. Viral particles were also found in fecal
      specimens and by electron microscopy. Examination of the isolate with Cambridge
      Biotech Adenoclone-Type 40/41 test kit indicated that it contained EAd. On the
      basis of the above studies, one strain of EAd was the first isolated virus in
      China.

PMID- 7781123
TI  - [Photorefractive keratectomy for myopia: 6 month results].
AB  - The argon fluoride excimer laser is able to ablate the superficial cornea and to
      correct refractive problems. Photorefractive keratectomy (PRK) was performed on
      103 myopic eyes ranging from -0.75D to -6.00D. We prospectively evaluated visual
      and refractive results that were followed for more than 6 months. Uncorrected
      visual acuity of 1.0 or better was achieved in 88.35%. The difference between
      attempted and achieved refractive correction was within +/- 1.00D in 94.17%. 10
      eyes (9.71%) had trace to mild subepithelial hare and 19 eyes (18.45%) had loss
      of one line of best spectacle corrected visual acuity. The excimer laser PRK
      appears to be a predictable and effective method to correct myopia under -6.00D.

PMID- 7781121
TI  - [Effect of NMBzA on the oncogene and multiple tumor suppressor genes in monkey
      esophageal epithelium].
AB  - Mutations of ras oncogene and multiple tumor suppressor genes p53, Rb and APC in
      esophageal epithelium of rhesus monkey fed with one dose of N-methyl-N
      benzylnitrosamine (NMBzA 30mg/kg), which was found in high incidence areas of
      esophageal cancer in China, were analysed by PCR and direct sequencing. Mutation
      at codon 12 of Ha-ras gene was not found in esophageal epithelium of monkey fed
      with NMBzA. Some mutations of p53 gene were found in esophageal epithelium of
      monkey after being fed with NMBzA for 24-48 hours. Some mutation of Rb and APC
      were found in esophageal epithelium of monkey after being fed with NMBzA for 48
      hours. The mutation fingerprints of these genes disappeared in esophageal
      epithelium of monkey after being fed with NMBzA for 5 days. The results
      demonstrated that chemical carcinogen NMBzA can induce mutations of multiple
      tumor suppressor genes in monkey (in vivo) and indicated that the alteration of
      tumor suppressor genes in the initial stage of carcinogenesis needs many hits by
      chemical carcinogen. These alterations of p53, Rb, APC genes were similar to the
      changes of these genes in some reported previously primary esophageal cancer.

PMID- 7781125
TI  - [Oscillatory potentials in retinitis pigmentosa with TCM treatment].
AB  - Computer-averaged oscillatory potentials (OPs) of electroretinogram (ERG) were
      recorded in 54 patients affected by different hereditary forms of retinitis
      pigmentosa (RP) before and after three-months of traditional Chinese medicine
      (TCM). This study was conducted in order to investigate the alterations of
      physiological function in inner part of the retina affected by RP. The results
      showed that OP waveforms were recordable in 22 and 27 patients before and after
      TCM treatment, respectively. The amplitudes of summed OPs (sigma OPs) were
      increased significantly in patients with different hereditary modes of RP, and
      also in those by clinical TCM classification after the treatment. The component
      specific amplitudes of OPs were observed. In particular, OP2 showed an elevation
      in both dominant and nondominant patient groups, while OP3 only showed an
      elevation in the dominant group. The results suggest that OP2, which represents
      mainly cone OP activity, could be improved in the patients extensively; and OP3,
      which represents mainly rod OP activity, could be improved only in the patients
      with less advanced retinal degeneration. These data provide evidence that visual
      function in the inner retina of patient with RP could be improved to a certain
      extent with TCM treatment.

PMID- 7781124
TI  - [Apoptosis of mouse MS-2 fibrosarcoma cells induced by photodynamic therapy with
      LDL-administered zinc-phthalocyanine].
AB  - Photodynamic destruction of MS-2 fibrosarcoma cells in mice induced by LDL
      administered Zinc-phthalocyanine and red light irradiation was studied by
      electron microscopy. The pronounced structural changes such as chromatin
      condensation, disappearance of nuclear pores, karyopyknosis, karyorrhexis,
      leakage of chromatin aggregates, autophagocytosis, bleb formation on the cell
      surface, cytoplasmic vacuolization and cell fragmentation suggest that the tumor
      cell death was induced by apoptosis. However, its exact mechanism and regulating
      pathways remain to be further investigated.

PMID- 7781126
TI  - [High purification of human thrombin].
AB  - A highly purified human thrombin was prepared from plasma. The procedure involved
      the adsorption of prothrombin from human plasma by barium chloride and
      precipitation by using ammonium sulfate. The partially purified prothrombin was
      activated by tissue thromboplastin and followed by chromatography on Amberllte
      and SP-Sephadex. The purified enzyme is homogeneous on SDS-PAGE and has a
      specific activity toward fibrinogen of 2000 NIH U/mg. The recovery is about 30%
      approximately 40%. This highly purified human thrombin can be used as a tool
      enzyme in the downstream procedure of fused recombinant proteins expressed by
      genetic engineering.

PMID- 7781127
TI  - [Inhibitory effect of anti-motoneuron serum on the neurite outgrowth of spinal
      cord explants (in vitro) and the cross-reactivity of serum to human and rat
      motoneurons].
AB  - The effects of rabbit anti-swine motoneuron serum (RAS), normal rabbit serum
      (NRS), skeletal muscle extracts (MET, 50 and 100 micrograms/ml) and brain
      extracts (BET, 50 and 100 micrograms/ml) on neurite outgrowth of neonatal rat
      spinal cord explants (in vitro) were studied after 5 days of treatment. In
      comparison with NRS (explants possessing neurite outgrowth accounted for 36.7%, n
      = 30), the neurite outgrowth of spinal cord explants was significantly
      accelerated by MET (96.7% of explants had neurite outgrowth), but inhibited by
      RAS (only 13.3% of the explants had neurite outgrowth). The cross-reactivity of
      RAS to the spinal motoneuron of swine, humans and rats were also demonstrated by
      immunocytochemical techniques.

PMID- 7781129
TI  - [Establishment of a human fetal thymocyte cell line and observation of its
      biological properties].
AB  - Thymocytes were isolated from a five month fetus after caesarean section and
      cultured in vitro. A cell line named human fetal thymocyte 8810 (HFT8810) was
      established and cultured continuously for 2 years in our lab, and grew well after
      recovery from the state of being frozen in liquid nitrogen. The HFT 8810 cells
      retained their ability to secrete thymosin after many generations in vitro
      culture.

PMID- 7781128
TI  - [Detection of hypermethylation in affected males with fragile X syndrome by PCR
      assay].
AB  - PCR technique was applied to detect hypermethylation at BssH II recognition sites
      within CpG island of FMR-1 gene in normal, affected, and clinically suspected
      males with fragile X syndrome. Hypermethylation was found to occur in all 7
      affected and 5 of 26 suspected, but none of 15 normal males. The results of PCR
      assay are in good coincidence with those of Southern blot and cytogenetic assays.
      This PCR assay will be a promising method in the diagnosis of fragile X syndrome
      in males with mental retardation.

PMID- 7781130
TI  - [Use of high-performance liquid chromatography electrochemical detection to
      detect hydroxy radicals].

PMID- 7781131
TI  - [Clinical observation of labor of induction with nutritional food].
AB  - 386 pregnant women in 3rd trimester having indications of induction labor were
      induced with nutritional food. The success rate was 77.92% (301/386) and
      correlated with the cervical Bishop score. Furthermore the success rate increased
      significantly in term with premature rupture of the membrane (90.54%). This
      method, which was found to be safe and effective can significantly shorten the
      first and total stage of labor.

PMID- 7781132
TI  - [Flow cytometry used to distinguish between complete and partial hydatidiform
      moles].
AB  - The nuclear ploidy of 14 placentas was determined by flow cytometry. All
      histologically classified complete moles (4 cases), hydropic villi (4 cases) and
      control placentas (3 cases) were diploid; whereas two of three histologically
      classified partial moles were triploid. The remaining case classified as partial
      mole was diploid, most likely a complete mole. It was concluded that DNA flow
      cytometric analysis offers an informative supplement to the histological
      interpretation of hydropic placentas.

PMID- 7781133
TI  - [Experimental study on acute hypoxia in newborn rabbits].
AB  - To investigate the hypoxic-ischemic damage of perinatal asphyxia, the acute
      hypoxic models of newborn rabbits were established and the effects of
      ligustrazine and anisodamine on pulmonary arterial pressure (PAP), dural blood
      flow (DBF) and blood gas of the hypoxia rabbits were observed. Acute hypoxia was
      caused by inhalation of 10% O2 + 90% N2 mixture. PaO2 was obviously reduced, PAP
      and DBF were obviously increased. But PAP in ligustrazine group did not increase
      and the elevated level of PAP in the anisodamine group was lower than the
      control. DBF and PaO2 was not affected by using both of the drugs. Ligustrazine
      and anisodamine might be effective for preventing and treating newborn persistent
      pulmonary hypertension.

PMID- 7781134
TI  - [Patella resurfacing and patellofemoral resurfacing].
AB  - Since 1983 isolated polyethylene patellar prosthesis was used for patella
      resurfacing of 19 patients with patellofemoral osteoarthritis. After an average
      of 44.9 months follow-up, the treatment was found to be not as satisfactory as
      earlier trials. The main reason was the wide erosion of femoral condyle caused by
      the polyethylene patella. To overcome this shortness, a new type of
      patellofemoral prosthesis was designed by the authors, which was named Y-L-Q.
      From January, 1991 to November, 1993, this prosthesis was used to treat 16 knees
      of 13 patients with patellofemoral osteoarthritis. Most of those patients
      improved both symptomatically and functionally. The good to excellent results
      rate was 87.5% (14/16 knees) at the time of an average 10 month follow-up. The
      early results of our experience with patellofemoral resurfacing are encouraging,
      and extended follow-ups are in progress.

PMID- 7781135
TI  - [Recent advances in the screening of target genes with monoclonal antibody
      probes].

PMID- 7781136
TI  - Fludarabine- and gemcitabine-induced apoptosis: incorporation of analogs into DNA
      is a critical event.
AB  - The nucleoside analogs fludarabine and gemcitabine inhibit cellular DNA synthesis
      by two different mechanisms: (1) direct termination of DNA strand elongation
      after the triphosphate of each drug is incorporation into DNA; and (2) indirect
      inhibition of DNA synthesis by decreasing cellular dNTPs through inhibition of
      ribonucleotide reductase. The present study demonstrated that incorporation of
      the analogs into DNA is critical for the cytotoxic action of these drugs in human
      T lymphoblastoid CEM cells. S phase cells, which actively incorporated the
      analogs into DNA, were most sensitive to the cytotoxic action of these compounds.
      A relatively short-term (5-24 h) cessation of cellular DNA synthesis without
      analog incorporation was not sufficient to cause cell death. The drug-treated
      cells died through apoptosis characterized by generation of internucleosomal DNA
      fragmentation and apoptotic morphology. Induction of high molecular mass (50-500
      kb) DNA fragmentation was also observed in cells undergoing apoptosis; this type
      of DNA degradation was strongly correlated with the analog-induced cell death
      process. Inhibition of the analog incorporation into DNA by aphidicolin blocked
      both types of DNA fragmentation and apoptotic morphology, indicating the
      essential role of analog incorporation into DNA in drug-induced cell death.

PMID- 7781137
TI  - Phase I study of NKT-01.
AB  - A phase I study of NKT-01 (deoxyspergualin), which is a derivative of an
      antitumor antibiotic, spergualin, was performed by a cooperative study group. NKT
      01 was given intravenously by 3-h infusion. The effect of single administration
      was studied prior to evaluation of daily administration for 5 consecutive days.
      In all, 5 and 33 patients with various malignancies, including leukemia, were
      entered into the trials of single and daily administration, respectively. In the
      single-administration study, all patients were evaluable and no clear adverse
      effect was observed at doses ranging from 20 to 320 mg/m2. In the daily
      administration study, 28 evaluable patients (16 men and 12 women; median age,
      55.5 years) were treated with a daily dose of 20-500 mg/m2. Toxicities such as
      myelosuppression, mild nausea/vomiting, anorexia, alopecia, tongue and perioral
      numbness, and hypotension were observed dose-dependently during or after the
      treatment. Grade 2 leukopenia, thrombocytopenia, and anemia were experienced at a
      dose of 500 mg/m2. These usually recovered to normal values by approximately 3
      weeks after treatment. A pharmacokinetic analysis of single administration
      revealed rapid plasma clearance, with mean half-lives for the alpha and beta
      phases being 28 min and 6.9 h, respectively. Approximately 12% of the infused
      dose was excreted into the urine in unmetabolized form. The pharmacokinetic
      parameters obtained after 5-day administration were similar to those recorded
      after single administration. Concerning treatment response, a transient but
      significant reduction in the number of leukemic cells was observed in one patient
      with adult T-cell leukemia. In this study, perioral numbness, hypotension, and
      hematological toxicity were concluded to be dose-limiting, with the maximal
      acceptable dose being 500 mg/m2. The recommended dose for a phase II study of NKT
      01 against solid tumors was judged to be 400 mg/m2 given daily by 3-h infusion
      for 5 days, every 3 weeks. In hematological malignancies, however, higher
      myelosuppressive schedules of administration should be investigated.

PMID- 7781138
TI  - In vitro activity of S 9788 on a multidrug-resistant leukemic cell line and on
      normal hematopoietic cells-reversal of multidrug resistance by sera from phase I
      treated patients.
AB  - The triazinoaminopiperidine derivative S 9788 is a new multidrug-resistance
      modulator that is currently being evaluated in phase I clinical trials. In this
      study, the reversal effect of S 9788 in comparison with verapamil was shown in
      vitro in human T-leukemic CCRF-CEM/VLB cells expressing the multidrug-resistance
      (MDR) phenotype. S 9788 increased in a dose-dependent manner the cytotoxic
      activity of doxorubicin or vinblastine, with complete reversal of resistance
      occurring at 2 microM for a concomitant continuous exposure (96 h) to the
      cytotoxic drugs. At respective concentrations equivalent to the IC10 value (the
      concentration inhibiting 10% of cell growth), S 9788 was 44 times more potent
      than verapamil in CCRF-CEM/VLB cells. S 9788 at 2 microM did not enhance the in
      vitro toxicity of doxorubicin or vinblastine in the human normal bone-marrow
      erythroid (BFU-E) and myeloid (CFU-GM) progenitors. The effect of exposure
      duration and concentrations on the synergistic action of modulator and cytotoxic
      agent closely depended on the cytotoxic agent studied. Post-incubations with S
      9788 alone after a 1-h coadministration with vinblastine and S 9788 dramatically
      increased the reversal effect (4-41 times) in proportion to both the duration of
      postincubation and the concentration of S 9788. In contrast, for doxorubicin
      resistance, post-incubation with S 9788 alone induced a maximal 2-fold increase
      in the reversal effect that was not proportional to the post-incubation duration.
      In patients treated with S 9788 as a 30-min intravenous infusion during phase I
      trials, a good correlation was found between the serum levels of S 9788 and the
      ability to reverse MDR in CCRF-CEM/VLB cells. The reversal effect was dose
      dependent and was effective beginning at a plasma concentration of 0.25 microM.
      These data form a basis for the design of phase II trials using a combination of
      a loading dose of S 9788 given before vinblastine or doxorubicin administration
      followed by a maintenance infusion of S 9788 alone for a period of 2-24 h.

PMID- 7781139
TI  - Encephalopathy is the dose-limiting toxicity of intravenous hepsulfam: results of
      a phase I trial in patients with advanced hematological malignancies.
AB  - Hepsulfam is a bisulfamic ester which is similar in structure to busulfan and is
      believed to act as a bifunctional alkylator inducing both DNA-DNA and DNA-protein
      crosslinks. Prior studies in patients with refractory solid tumors have
      identified the dose-limiting toxicity of hepsulfam to be cumulative
      myelosuppression resulting in prolonged leukopenia and thrombocytopenia. This
      phase I trial was designed to determine the maximally tolerated dose of hepsulfam
      administered intravenously in patients with refractory leukemias and other
      advanced hematologic malignancies. Hepsulfam was administered as a 30-min or 2-h
      intravenous infusion to 21 patients with advanced leukemia or multiple myeloma.
      All patients had been extensively treated and had progressive disease. Cycles
      were repeated every 5 weeks. Cohorts of patients were treated at 360, 480, 640,
      and 800 mg/m2. The dose-limiting toxicity of intravenous hepsulfam was severe
      encephalopathy. The single patient treated at 800 mg/m2 became comatose within 48
      h and required 3 weeks for his mental status to return to baseline. There were,
      however, no irreversible neurological sequelae. Several patients treated at 640
      mg/m2 had clinical evidence of toxic deliriums and slowing of alpha rhythm waves
      on electroencephalograms indicative of a gray-matter encephalopathy. When
      hepsulfam was infused over 30 min, patients complained of uncomfortable
      parasthesias, but when the drug was administered over 2 h, these acute symptoms
      were less common. Myelosuppression was observed in most patients. Among those
      patients who had some suppression of their leukemia, peripheral blood counts
      recovered to pretreatment levels after 3-5 weeks. Apart from CNS toxicity, non
      hematologic toxicity was minimal. Pharmacokinetic studies demonstrated rapid
      clearance of hepsulfam so that the drug was not reliably detected in the plasma
      after 24 h. The recommended phase II dose of hepsulfam as a single 2-h
      intravenous infusion is 480 mg/m2, but this dose provided relatively little
      clinical benefit for patients with refractory leukemia. The dose-limiting
      toxicity is CNS toxicity with increasingly severe encephalopathy at doses > or =
      640 mg/m2. It would be reasonable to investigate further dose escalation of
      hepsulfam in a divided dose schedule to minimize the peak concentrations which
      may be related to the encephalopathy. EEG monitoring is recommended for early
      detection of slowing of alpha rhythm waves. Hematopoietic stem cell support will
      probably be required at total doses exceeding 800 mg/m2.

PMID- 7781140
TI  - Safety and efficacy of intraperitoneal injection of etoposide in oil suspension
      in mice with peritoneal carcinomatosis.
AB  - We compared the safety and efficacy in mice with peritoneal carcinomatosis of two
      etoposide formulations: an aqueous solution (Etp-sol) and particles suspended in
      oil (the addition products of iodine and the ethyl esters of the fatty acids
      obtained from poppy-seed oil (Lipiodol) or sesame oil; Etp-oil). We also
      investigated tissue distribution of etoposide in rats treated with Etp-oil and
      Etp-sol. Etoposide was injected intraperitoneally at concentrations ranging from
      52 to 392 mg/kg (increasing geometrically by a factor of 1.4). The 50% lethal
      dose (LD50), determined over a 2-week period of observation, was 135 mg/kg for
      Etp-oil and 108 mg/kg for Etp-sol. Autopsy findings included macroscopic
      intestinal bleeding, necrosis of the intestinal mucosa, and pulmonary congestion
      in mice from both treatment groups. In the efficacy trials. 10(6) P388 leukemia
      cells were transplanted into CDF1 male mice, and Etp-oil and Etp-sol were
      injected at doses of 20 mg/kg and 80 mg/kg. In the groups receiving the 20 mg/kg
      dose, 11 of 19 mice in the Etp-oil group survived to day 60 compared with 3 of 20
      mice in the Etp-sol group. Toxicity-related deaths occurred in 1 of 20 mice
      treated with 80 mg/kg Etp-oil and in 8 of 20 mice treated with 80 mg/kg Etp-sol.
      No cancer-related deaths were associated with the 80 mg/kg dose in either
      treatment group. Our findings showed that the Etp-oil was associated with a lower
      toxicity and a higher efficacy than the Etp-sol. To evaluate tissue distribution,
      rats were injected intraperitoneally with 5 mg/kg body weight of Etp-sol or Etp
      oil. The tissue distribution of etoposide was subsequently analyzed by high
      performance liquid chromatography. Compared with Etp-sol, Etp-oil delivered
      significantly greater amounts of etoposide and for a longer period to the
      omentum, taken as representative of the intraperitoneal tissue, and the etoposide
      concentration in blood plasma was increased more slowly and decreased more
      gradually.

PMID- 7781142
TI  - Comparative resistance of idarubicin, doxorubicin and their C-13 alcohol
      metabolites in human MDR1 transfected NIH-3T3 cells.
AB  - The anthracycline analog idarubicin (ID) is useful in the treatment of leukemias,
      and is of further interest because of the unique activity of its major
      circulating metabolite idarubicinol (IDOL). In vitro studies have shown that ID
      retains activity against tumor cells made resistant by prolonged exposure to
      substrates of the p-glycoprotein energy-dependent efflux pump. To selectively
      investigate multidrug resistance to ID in tumor cells, ID, IDOL, doxorubicin (DX)
      and doxorubicinol (DXOL) were evaluated for growth inhibitory activity when
      incubated with NIH-MDR1-G185 (MDR) cells or with the parent NIH-3T3 (3T3) cells.
      The MDR cells are transfected with the human multidrug gene mdr1, and express a
      functional p-glycoprotein. ID growth inhibitory activity was much less affected
      by p-glycoprotein-mediated efflux than was DX. ID IC50 values were only 1.8-fold
      greater in the MDR cell line than in the parental 3T3 cell line, while the IC50
      value for DX was 12.3-fold greater in the transfected cell line. Verapamil (VRP)
      fully restored drug sensitivity of the MDR cell line to ID and DX. In studies
      with the alcohol metabolites, IDOL and DXOL IC50 values were 7.8- and 18.9-fold
      greater, respectively, for the MDR cell line than for the parental cell line.
      Intracellular concentrations of DX and DXOL, but not ID and IDOL, were
      substantially increased in the MDR cells when VRP was present in the incubation
      mixtures. ID and IDOL retain substantial growth inhibitory activity in mdr1
      transfected cells, and ID may be of value in clinical settings where multidrug
      resistance mediated by p-glycoprotein is a potential limitation of therapy.

PMID- 7781141
TI  - Antitumor activity of FCE 26644 a new growth-factor complexing molecule.
AB  - FCE 26644, or 7,7'-(carbonyl-bis[imino-N-methyl-4, 2 pyrrole carbonyl-imino(N
      methyl-4,2-pyrrole)carbonyl-imino])-bis-(1,3- naphthalene)disulfonic acid,
      belongs to the newly synthesized class of sulfonated derivatives of distamycin A.
      FCE 26644 is a noncytotoxic molecule capable of inhibiting the binding of basic
      fibreblast growth factor (bFGF), platelet-derived growth factor (PDGF beta) and
      interleukin 1 (IL-7) to their receptors and to block bFGF-induced vascularization
      in vivo as well as neovascularization in the chorioallantoic membrane. FCE 26644
      and suramin, a compound possessing the same terminal half-life (t1/2) in mice
      and, presumably, the same mode of action, inhibit the growth of solid murine
      tumors, M5076 reticulosarcoma, and MXT and S180 fibrosarcoma and are inactive
      against B16F10 melanoma. The activity of FCE 26644 was constantly observed at
      nontoxic doses, at variance with suramin. FCE 26644 was also found to maintain
      activity against M5076 resistant to cyclophosphamide and to be equally active
      against UV 2237 and UV 2237/ADR fibrosarcoma.

PMID- 7781143
TI  - Pretreatment H2 receptor antagonists that differ in P450 modulation activity:
      comparative effects on paclitaxel clearance rates and neutropenia.
AB  - Histamine-2 receptor antagonists (H2RAs) are principal components of the
      premedication regimen used to prevent major hypersensitivity reactions in
      patients receiving paclitaxel. Several different H2RAs, including cimetidine,
      ranitidine and famotidine, have been used in clinical trials of paclitaxel, as
      well as by clinicians in different geographic regions and hospitals primarily
      because of differences in the availability of the various H2RAs. However, H2RAs
      have highly variable cytochrome P450-modulating capabilities, and the P450 system
      appears to play a major role in paclitaxel metabolism and disposition. Therefore,
      the use of different H2RAs may result in different pharmacologic, toxicologic and
      antitumor profiles due to differential effects on paclitaxel metabolism. This
      study evaluated whether cimetidine and famotidine, which possess disparate P450
      modulating capabilities, differentially affect paclitaxel clearance rates and the
      agent's principal toxicity, neutropenia. Women with advanced, platinum-refractory
      ovarian carcinoma received two courses of treatment with 135 mg/m2 paclitaxel
      over 24 h while participating in the National Cancer Institute's Treatment
      Referral Center Protocol. A crossover design was employed in which consecutive
      patients received either 300 mg cimetidine i.v. or 20 mg famotidine i.v. before
      their first course of paclitaxel and the alternate H2RA before their second
      course. In order to evaluate the differential effects of cimetidine and
      famotidine on pertinent pharmacologic and toxicologic parameters in the same
      individual, paclitaxel concentrations at steady-state (Css), paclitaxel clearance
      rates, and absolute neutrophil counts (ANCs) were obtained during both courses.
      Paclitaxel Css values were not significantly different in individual patients
      when either cimetidine or famotidine preceded paclitaxel (p = 0.16). Mean
      paclitaxel clearance rates were 271 and 243 ml/min per m2 following cimetidine
      and famotidine, respectively. These clearance rates were not significantly
      different in paired analysis (p = 0.30). The likelihood of subsequently requiring
      granulocyte-colony stimulating factor (G-CSF) for severe neutropenia during
      course 1 did not differ significantly between the two H2RAs (p = 0.9). Among
      patients who did not require G-CSF, mean percentage decreases in ANC were 87.7%
      and 84.2% after paclitaxel cycles preceded by cimetidine and famotidine,
      respectively. These measures of neutropenia did not differ significantly in
      paired analysis (p = 0.13). These results show that the H2RAs cimetidine and
      famotidine do not differentially affect the pharmacologic and toxicity profiles
      of paclitaxel when used in the premediation regimen to prevent major
      hypersensitivity reactions, and may be interchanged.

PMID- 7781144
TI  - A limited sampling strategy for the study of pirarubicin pharmacokinetics in
      humans.
AB  - Pirarubicin (4'-O-tetrahydropyranyldoxorubicin, THP-Adriamycin) is a new
      anthracycline antibiotic that has recently been developed because its reduced
      cardiac toxicity is associated with an antitumour efficacy similar to that of
      doxorubicin. Pirarubicin is characterised by strong haematological toxicity,
      which has been shown to be correlated with pharmacokinetic parameters, especially
      the area under the time-concentration curve. To obtain routine pharmacokinetic
      evaluations of pirarubicin for dose monitoring we developed a limited sampling
      strategy relying on three blood samples taken at the end of the infusion and at
      12 and 24 h post-infusion. The characteristics of interindividual variability
      were assessed on the first courses of treatment performed in 18 patients; the
      model was then validated on 10 independent first courses of treatment performed
      in 10 other patients. The main pharmacokinetic parameters (half-lives, total
      volume of distribution, total plasma clearance) were estimated in the test group
      by maximum-likelihood estimation using all samples and by Bayesian estimation
      using three samples. The concordance between the two estimates was correct (the
      bias and precision for clearance were 2.3% and 12.1%, respectively), which shows
      that this limited sampling strategy can be used in routine drug monitoring.

PMID- 7781145
TI  - Pharmacokinetics and metabolism of pirarubicin in humans: correlation with
      pharmacodynamics.
AB  - The pharmacokinetic monitoring of anthracycline-containing regimens is warranted
      because of the important toxicity of these drugs and because pharmacokinetic
      pharmacodynamic relationships have been clearly established. We studied the
      pharmacokinetics of the new anthracycline pirarubicin in 80 courses of treatment
      performed in 27 patients, using a limited sampling protocol we had previously
      validated. We observed (for 47 of these courses) a significant correlation
      between the leucocyte cell kill and the pirarubicin area under the time x
      concentration curve, but the most significant correlation was obtained using the
      plasma concentration of doxorubicin, a metabolite of pirarubicin, at the end of
      the infusion. On the basis of this value, it is possible to predict for
      pirarubicin haematological toxicity in a way that can help the clinician in
      identifying patients at risk for toxicity.

PMID- 7781146
TI  - Experimental solid tumour activity of N-[2-(dimethylamino)ethyl]-acridine-4
      carboxamide.
AB  - N-[2-(Dimethylamino)ethyl]acridine-4-carboxamide (DACA), a DNA intercalator that
      exerts its antitumour action through the enzyme topoisomerase II, has previously
      been shown to be curative against the transplantable Lewis lung adenocarcinoma
      growing as lung tumour nodules in mice. On the basis of this finding as well as
      its high in vitro activity against multidrug-resistant cell lines, DACA has been
      chosen for clinical trial under the auspices of the Cancer Research Campaign,
      United Kingdom. In the present study the activity of DACA was assessed against
      advanced (5-mm diameter) s.c. colon 38 adenocarcinomas in BDF1 mice using tumour
      growth delay as an end point. Its activity was found to be related positively to
      the total dose given and negatively to the total duration of the dose schedule.
      Adoption of a split-dose i.p. administration schedule or slow i.v. infusion
      allowed the administration of large doses without toxicity. The activity of DACA
      was comparable with that of 5-fluorouracil and superior to that of doxorubicin,
      cyclophosphamide and the experimental amsacrine analogue CI-921. Mitoxantrone,
      amsacrine, etoposide, teniposide and daunorubicin showed minimal activity. DACA
      also demonstrated significant activity against the NZM3 melanoma human cell line
      growing as a xenograft in athymic mice.

PMID- 7781147
TI  - The effects of oral 4-hydroxyandrostenedione on peripheral aromatisation in post
      menopausal breast cancer patients.
AB  - This study investigated the influence of the aromatase inhibitor 4
      hydroxyandrostenedione (4OHA, formestane), given orally, on peripheral aromatase
      activity and plasma oestradiol (E2) levels in post-menopausal women with advanced
      breast cancer. The aim was to establish whether an optimal dose could be
      identified that had a pharmacological effectiveness comparable with that of
      parenteral 4OHA. A total of 13 post-menopausal women were studied before
      treatment and after a minimum of 4 weeks on treatment with one or more of the
      following doses: 125 mg once daily (od), 125 mg b.i.d. (bd) and 250 mg od. In
      all, seven aromatase studied were performed at 125 mg od; four, at 125 mg bd; and
      ten, at 250 mg od. Three patients were studied at all doses. E2 was measured
      concurrently and was available at all dose increments for seven patients. Given
      at doses of 125 mg od, 125 mg bd and 250 mg od, treatment with formestane
      inhibited in vivo aromatisation by 62.3% +/- 9.5%, 70.0% +/- 5.1% and 57.3% +/-
      5.3%, respectively (mean +/- SEM). Corresponding values for plasma E2 suppression
      were 30.7% +/- 6.5%, 43.4% +/- 4.5% and 42.9% +/- 6.7%, respectively. Thus, apart
      from a somewhat better suppression of plasma E2 levels by the two higher doses as
      compared with 125 mg od, no significant difference in the degree of aromatase
      inhibition or plasma E2 suppression was observed. The suppression of E2 by oral
      4OHA at 125 mg bd or 250 mg od approaches that achieved by the recommended
      parenteral schedule of 250 mg fortnightly, but inhibition of aromatase at this
      dose was substantially inferior. The findings are consistent with a hypothesis
      that 4OHA given orally may cause substantial plasma oestrogen suppression during
      part of the day, but neither the od nor the bd regimens investigated in the
      present study were capable of producing optimal aromatase inhibition.

PMID- 7781148
TI  - Treatment of advanced gastric cancer with the combination fluorouracil,
      leucovorin, etoposide, and cisplatin: a phase II study of the ONCOPAZ Cooperative
      Group.
AB  - A phase II study was performed to assess the efficacy and toxicity of the
      combination of 5-fluorouracil (5-FU), leucovorin (LV), etoposide, and cisplatin
      (FLEP) in patients with advanced gastric carcinoma. A total of 46 consecutive,
      previously untreated patients with unresectable, measurable gastric carcinoma
      were treated with 300 mg/m2 LV, 100 mg/m2 etoposide, 500 mg/m2 5-FU, and 30 mg/m2
      cisplatin on days 1-3 every 28 days. All courses were given on an outpatient
      basis. A total of 169 courses of treatment were given. In all, 18 of the 46
      patients (39%) had an objective response [95% confidence interval (CI), 25%-54%]
      and 2 (4%) patients experienced a clinical complete response. The median duration
      of response was 5 months. The main side effects were hematological and
      gastrointestinal. Grade 3-4 toxicity was encountered as follows: leukopenia, in
      9.5% of the courses; anemia, in 3%; thrombocytopenia, in 3%; nausea/vomiting, in
      4%; and diarrhea, in 5%. Hospitalization due to fever and granulocytopenia was
      required in 5 patients, 3 of whom died of sepsis. In conclusion, FLEP shows
      moderate activity in patients with advanced gastric carcinoma, albeit at the cost
      of a high degree of toxicity. For this reason we do not recommend its use.

PMID- 7781149
TI  - Oral trofosfamide: an active drug in the treatment of soft-tissue sarcoma.
AB  - A total of 23 patients with metastatic sarcomas were treated with continuous oral
      trofosfamide, an alkylating agent structurally related to cyclophosphamide and
      ifosfamide. In all, 12 of the patients were chemotherapy-naive. Doses were
      escalated every 3rd week until the development of leukopenia of WHO grade 2. The
      treatment was well tolerated and produced little subjective toxicity. Leukopenia
      was the dose-limiting toxicity. The daily dose that produced grade 2 leukopenia
      was 200-250 mg in 65% of the patients. Three patients responded, all of whom had
      been treated with trofosfamide as first-line treatment.

PMID- 7781150
TI  - Development and validation of a sensitive solid-phase-extraction and high
      performance liquid chromatography assay for the bioreductive agent tirapazamine
      and its major metabolites in mouse and human plasma for pharmacokinetically
      guided dose escalation.
AB  - A sensitive solid-phase-extraction and high-performance liquid chromatography
      (HPLC) method has been developed to investigate the pharmacokinetics and
      metabolism of the hypoxic-cell cytotoxic agent tirapazamine (1,2,4-benzotriazine
      3-amine 1,4-di-N-oxide; WIN 59075, SR 4233), currently in phase I/II studies in
      the United Kingdom and United States. A sample extraction and concentration
      process was devised using strong cation-exchange Bond Elut cartridges.
      Tirapazamine, the mono and zero-N-oxide metabolites (WIN 64012, WIN 60109) were
      isocratically resolved using a microBondapak phenyl HPLC column and measured
      using photodiode-array detection. The minimal quantifiable level (MQL) of
      tirapazamine was 40 ng/ml in mouse plasma and 20 ng/ml in human plasma. Recovery
      was consistently greater than 80% for all compounds over the concentration range
      of 20 ng/ml to 20 micrograms/ml. No significant decomposition was observed
      following up to three freeze/thaw cycles and storage at -70 degrees C for 52
      days. The assay was accurate and reproducible, with measured values lying within
      the limits of defined acceptance criteria. Additional studies to investigate the
      degree of plasma protein binding showed that tirapazamine did not bind
      extensively to plasma proteins (binding, 9.7% +/- 0.1% and 18.7% +/- 1.3% in
      mouse and human plasma, respectively). These small species differences in protein
      binding are unlikely to have any major impact on the extrapolation of
      pharmacokinetic data from mice to humans. The assay has now been successfully
      applied to investigate the pharmacokinetics and metabolism of tirapazamine in
      mice and patients as part of a pharmacokinetically guided dose-escalation
      strategy for phase I clinical trials.

PMID- 7781151
TI  - Usher syndrome: increasing awareness in Scotland.
AB  - In July 1993, professionals from a number of European countries met at the 7th
      European Usher Syndrome Study Group. The purpose of the Study Group (which meets
      on a biannual basis) is to give professionals working in this specialized field
      the opportunity to share ideas and examples of their work. People attending
      included medical practitioners, social service workers, representatives from
      voluntary bodies and individuals with Usher. The following article is an expanded
      version of a paper presented at the Study Group. It describes the development of
      a 3 hour workshop for the wide range of practitioners a child or young person
      with Usher syndrome may meet. Through group work, positive approaches to working
      through the personal and practical implications of Usher syndrome are explored.

PMID- 7781152
TI  - Language and motor development in pre-term children: some questions.
AB  - A cohort of 37 pre-term children was assessed for both morphosyntactical and for
      vocabulary skills at the age of 2 and again at the age of 3 years and 6 months.
      They were compared with two comparison groups of full-term children (adjusted age
      and chronological age). The results indicated (1) a clear asynchrony between the
      two components of language production assessed at both ages, (2) an accurate
      prediction of language delay at age 2 for pre-term children (35% of pre-term
      children were detected for morphosyntax as measured by Mean Length of Utterance
      and 27% of pre-term children were detected for vocabulary as measured by the
      number of different words) and, (3) no evidence on the relationship of language
      and motor development as measured by formal tests. Such findings strongly
      challenge the validity of standardized developmental tests and support to a
      certain extent the hypothesis that language development is independent of motor
      skills. A neurodevelopmental assessment is suggested.

PMID- 7781153
TI  - Parents, partnership and education officers: a study of attributions.
AB  - Thirty-five parents of children with special educational needs were interviewed
      to ascertain their experiences of dealing with education officers involved in the
      assessment and placement of their children. They were found predominantly to make
      internal attributions for negative behaviours, and external attributions for
      positive behaviours. The implication of these results for new United Kingdom
      government initiatives to reduce conflict between parents and education
      authorities are examined.

PMID- 7781154
TI  - Children in medical research: Australian ethical standards.
AB  - This paper examines standards for the use of children as research participants in
      medical research which are relevant to Australia and relates the standards to
      pivotal ethical issues. The standards include the National Health and Medical
      Research Council's NHMRC Statement and Supplementary Notes, professional codes of
      ethics, international human rights conventions, United Kingdom and United States
      codes of ethics, and statute and case law. The key ethical issues of potential
      risk and benefit to the child, and consent to research participation are
      discussed. Suggestions for the improvement of the NHMRC Statement are made.

PMID- 7781155
TI  - The development of communication in blind and in deaf infants--similarities and
      differences.
AB  - Results from two longitudinal studies of blind infant--sighted mother and of deaf
      infant-hearing mother/deaf mother interaction, are summarized in this paper. The
      aim is to shed light on the role of visual and auditory stimulation in the
      development of communication. Video-recorded interactions taken during infancy
      were transcribed in a systematic, objective and detailed way. The development of
      communication is described with a focus on pre-verbal abilities, exploration of
      toys, social and symbolic play, communicative intent and sharing of experiences.
      The results show a delay in the development of communication in the blind infants
      compared with the deaf infants, indicating a more critical role of visual
      stimulation compared with auditory stimulation during the infancy period to this
      development.

PMID- 7781156
TI  - Alterations in responsiveness to ethanol and neurotrophic substances in fetal
      septohippocampal neurons following chronic prenatal ethanol exposure.
AB  - Pregnant Long-Evans rats were maintained on three diets: a liquid diet in which
      ethanol accounted for 35-39% of the total calories, a similar diet with the
      isocaloric substitution of sucrose for ethanol, and a lab chow control diet. At
      gestation day 18, the fetuses were taken and cultures of septal and hippocampal
      neurons prepared. Neuronal survival and neurite outgrowth were compared in
      cultures from the three diet groups, using the following media supplements:
      ethanol (1.2, 1.8 or 2.4 g/dl), neurotrophic factors (nerve growth factor [NGF]
      with the septal cultures, basic fibroblast growth factor [bFGF] with the
      hippocampal cultures), or ethanol plus neurotrophic factors. Both the septal and
      hippocampal neurons responded to ethanol in a dose-dependent manner. The neurons
      from both populations from fetuses which had been exposed prenatally to ethanol,
      however, tolerated considerably higher ethanol concentrations before decreases in
      survival or outgrowth were seen. These ethanol-exposed neuronal populations were
      also less responsive to neurotrophic factors: in hippocampal cultures, process
      outgrowth was significantly enhanced by bFGF in control but not ethanol-derived
      cultures, and in septal and hippocampal cultures, the neurotrophic factors
      significantly ameliorated ethanol neurotoxicity in control cultures, but not in
      those from the ethanol-exposed fetuses. The possible relevance of these
      observations to the fetal alcohol syndrome is discussed.

PMID- 7781157
TI  - Postnatal development of inositol 1,4,5-trisphosphate receptors: a disparity with
      protein kinase C.
AB  - Ligand-stimulated phosphoinositide hydrolysis activates a bifurcating second
      messenger system, releasing inositol 1,4,5-trisphosphate (IP3) and diacylglycerol
      (DG), which activates protein kinase C (PKC). Yet, in developing cat visual
      cortex and hippocampus, high levels of [3H]PDBu binding (labelling PKC) appear
      much earlier than do [3H]IP3 labelled sites. Binding distributions for the two
      ligands also appear to be complimentary in both brain regions. Moreover, early
      surgical removal of input to the visual cortex increases [3H]PDBu binding without
      affecting that of [3H]IP3. Our results suggest that, (1) at certain developmental
      stages, IP3 and PKC may act individually or complimentarily rather than
      synergistically in the visual cortex and hippocampus; (2) in neonatal cortex, IP3
      metabolites rather than IP3 itself may act as second messengers; (3) although
      both IP3 receptors and PKC are localized in intracortical cells, their expression
      is regulated by different mechanisms during development.

PMID- 7781158
TI  - The intensity of a fetal taste aversion is modulated by the anesthesia used
      during conditioning.
AB  - Rat fetuses (E18) can learn a taste aversion in utero if experience with a sweet
      flavor (saccharin = Sac) is followed by a malaise-producing injection of lithium
      chloride (LiCl). Here we report that this phenomenon can be significantly
      modulated by the type of anesthesia administered to the pregnant dam before the
      conditioning procedure. Dams were anesthetized with one of the following drugs or
      drug combinations: (1) sodium pentobarbital; (2) ketamine hydrochloride and
      xylazine; or (3) sodium pentobarbital and ketamine hydrochloride. While under the
      influence of these anesthetics, rat fetuses received pairings of Sac + LiCl or
      one of the following sets of oral and systemic (i.p.) control injections: Sac +
      Saline, H2O + LiCl; H2O + Saline. At age 15 days neonatal rats were given a taste
      preference test by allowing them to select nipples painted with either saccharin
      or vehicle (H2O). After weaning, rats were given an additional taste preference
      test where they were allowed to drink from bottles filled with either 0.30%
      saccharin or water. Neonates that received Sac + LiCl injections avoided
      saccharin-painted nipples while neonates that received control injections in
      utero preferred saccharin-painted nipples. Rats that acquired the taste aversion
      under the influence of ketamine showed a significantly stronger conditioned taste
      aversion on the nipple preference test than did those from dams injected with
      sodium pentobarbital. The conditioned taste aversion was not detectable later
      during the bottle preference test. Since ketamine blocks N-methyl-D-aspartate
      (NMDA) glutamate receptors, and these receptors have been implicated in neural
      plasticity during development, our data suggest that NMDA antagonism can
      potentiate fetal learning. Ketamine has been used as an obstetrical and pediatric
      anesthetic.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781159
TI  - Effects of chronic activation of dopamine D-2 receptors in cultures of rat fetal
      dopaminergic neurons: indications for alterations in functional activity.
AB  - In Parkinsonian patients, previously subjected to neuronal grafting therapy, the
      survival and functional status of dopaminergic grafts might be impaired by the
      concurrent pharmacotherapy with L-DOPA and/or dopamine (DA) D-2 receptor
      agonists. To test this hypothesis in vitro, we studied the effects of chronic DA
      D-2 receptor activation on the functional capacity of cultured fetal rat
      mesencephalic DA neurons, using the activity of tyrosine hydroxylase (TH) and the
      intracellular dopamine content as neurochemical parameters. In cellular extracts
      prepared from our cultures, TH activity (as determined by the release of 3H2O
      from 3H-[3,5] tyrosine) appeared to be tetrahydrobiopterin-, Fe2+, and
      temperature sensitive, while in intact cells, the catalytic activity of TH could
      be induced by K(+)-evoked depolarization in a Ca(2+)-dependent way. In contrast,
      no acute DA D-2 receptor mediated inhibitory effects could be demonstrated in
      intact cells, either when tested under basal or depolarizing conditions.
      Nevertheless, after chronic exposure to DA D-2 receptor agonists for 14 days
      clear differences were observed in the functional status of cultured fetal
      dopaminergic neurons. Thus, whereas the overall survival and basal TH activity of
      cultured fetal dopaminergic neurons remained virtually unaltered, the
      depolarization induced activation of TH was enhanced in agonist-treated cultures.
      Moreover, after long-term treatment for 14 or 21 consecutive days, the
      intracellular DA content of agonist treated cultures appeared to be higher, as
      compared to untreated controls. It is concluded that chronic activation of DA D-2
      receptors may induce adaptive alterations in the functional activity of cultured
      fetal dopaminergic neurons.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781160
TI  - Repeated intracerebroventricular administration of taurine lowers LH levels and
      postpones vaginal opening in peripubertal female rats.
AB  - We investigated the effect of repeated intracerebroventricular injections of
      taurine (Tau, 0.15 mumol/3 microliters distilled water), administered during
      postnatal days 23-29, on serum LH levels, and on the hypothalamic content of LHRH
      and amino acid neurotransmitters (measured by HPLC and electrochemical detection)
      in 30-day-old female rats (n = 18). Treatment with Tau lowered serum LH (Tau:
      0.20 +/- 0.04; CONTROLS: 1.04 +/- 0.21 ng/ml RP3; mean +/- S.E.M.; P < 0.05) as
      well as hypothalamic LHRH levels (Tau: 82.6 +/- 9.5; controls: 128.7 +/- 14.1
      pg/mg wet tissue, P < 0.05). Tau treatment doubled hypothalamic GABA levels (Tau:
      31.3 +/- 2.9; CONTROLS: 15.6 +/- 1.2 nmoles/mg wet tissue, P < 0.001). In a
      second group of animals (n = 13), Tau treatment delayed vaginal opening by more
      than 2 days (P < 0.05 vs. controls). It is concluded that supplementation with
      Tau during the fourth postnatal week reduces LHRH/LH secretion and postpones
      sexual development, perhaps by increasing the activity of the hypothalamic
      GABAergic system.

PMID- 7781161
TI  - The developmental emergence of the representation of auditory azimuth in the
      external nucleus of the inferior colliculus of the guinea-pig: the effects of
      visual and auditory deprivation.
AB  - A topographic representation of the auditory azimuth has been described in the
      external nucleus of the inferior colliculus (ICX) of the guinea-pig [3]. This
      representation is characterized by directional multi-unit responses, at threshold
      stimulation intensities, with directional preferences organized in such a way as
      to represent the auditory azimuth along the rostro-caudal axis of the ICX. The
      following paper considers the emergence of that map and the role of developmental
      experience in its elaboration. Multi-unit responses to free-field broad-band
      auditory stimuli were recorded in the ICX. At threshold stimulation intensities,
      multi-unit receptive fields (MURFs) obtained from younger animals showed the same
      discrete spatial tuning as found in MURFs from animals older than 35 DAB (days
      after birth). However, a normal adult topographic representation was not present
      until animals were at least 30-32 DAB. Visual deprivation, by dark-rearing from
      birth until mapping (at 35-43 DAB), had no obvious detrimental effects on
      auditory receptive field size or topographic order in the ICX. Auditory
      deprivation was achieved by rearing animals in an environment of continuous
      omnidirectional noise from birth until mapping (47-53 DAB). Following auditory
      deprivation, receptive fields remained relatively discrete, but no correlation
      between rostro-caudal position of the recording site and the angle of the best
      response was observed. Thus, the representation of auditory azimuth in the ICX
      appears to be unperturbed by developmental visual deprivation but is susceptible
      to developmental auditory deprivation.

PMID- 7781162
TI  - Cyclic remodelling of growth cone lamellae and the effect of target tissue.
AB  - We report the existence of cyclical fluctuations in the total size of growth cone
      lamellae, represented by membrane protrusions and retractions, and show that
      aspects of this behavior can be regulated by the target tissue for the nerve
      fibers. The transition of the growth cone from a high to a less motile state,
      which occurs in the presence of the target tissue, has implications for the
      mechanisms that underlie nerve fiber elongation during development.

PMID- 7781163
TI  - Developmental change of mu opioid receptors in neonatal guinea pig brain stem.
AB  - Opioid receptor binding of morphine-6-beta-D-glucuronide (M6G), morphine and
      [3H][D-Ala2,N-methylPhe4-Glyol5]enkephalin (DAMGO) were determined in neonatal
      guinea pigs. Pontomedullary membranes specifically bound [3H]DAMGO, which was
      displaced by M6G and morphine. The KI for M6G and morphine were 15.1 nM and 5.0
      nM, respectively, and did not change between day 3 and day 7 after birth. KD for
      [3H]DAMGO binding was constant (1.1nM), however Bmax increased from 62.2 to 88.3
      fmol/mg protein between days 3 and 7 (P < 0.01). This 42% increase in mu
      receptors may play a role in the increased potency of M6G respiratory effects for
      guinea pigs during the first week after birth.

PMID- 7781164
TI  - Midkine is present in the early stage of cerebral infarct.
AB  - Expression of midkine (MK), a growth factor with neurotrophic activities, was
      examined immunohistochemically in experimental cerebral infarct of rats. From
      postoperative day 1 to day 7 after the onset of infarct, anti-MK immunoreactivity
      was observed in the surrounding ischemic zone of the infarct but not in the
      necrotic lesion. The immunoreactive material was identified to be MK by Western
      blotting. On day 14, anti-MK immunoreactivity became negative. Absence of MK in
      the normal brain was verified both by immunohistochemical staining and Western
      blotting. The induced expression of MK is an early event: increased expression of
      glial fibrillary acidic protein (GFAP), a marker of astrocytes, started on day 4
      and continued to day 14. These findings suggest that MK is produced around the
      site of nerve damage and plays a role as a reparative neurotrophic factor during
      the early phase of cerebral infarct.

PMID- 7781165
TI  - Molecular characterization of EAP-300: a high molecular weight, embryonic
      polypeptide containing an amino acid repeat comprised of multiple leucine-zipper
      motifs.
AB  - In this study we report the biochemical and initial molecular characterization of
      EAP-300, a developmentally regulated embryonal protein that has been shown
      previously to be expressed by radial glia in various regions of the CNS,
      including putative glial barriers. In the present study we have shown that the
      300 kDa EAP-300 polypeptide is developmentally regulated in all tissues
      expressing the protein, which include various PNS and CNS tissues and muscle. In
      neural tissue the protein is readily detected during early embryogenesis,
      subsequently down-regulated at later stages, and is not detected in the adult. In
      contrast to neural tissue, small amounts of the protein are expressed in heart,
      consistent with earlier studies which showed that EAP-300 expression was
      maintained in the Purkinje cells of the heart conduction system. Metabolic
      labeling demonstrates that EAP-300 is a phosphoprotein, and is fatty acylated
      based on incorporation of [3H]palmitate. We also show that the normal
      developmental down-regulation of EAP-300 by glia does not occur in vitro, and
      these data therefore suggest that the signal(s) that regulates EAP-300 gene
      expression during development in vivo is absent in dissociated cell cultures. We
      have also initiated molecular studies of EAP-300 by screening embryonic brain
      cDNA expression libraries with a mixture of EAP-300 monoclonal antibodies.
      Sequence analysis of partial EAP-300 cDNAs indicate that the protein is related,
      if not identical, to IFAPa-400, a developmentally regulated intermediate filament
      associated protein in chick that is proposed to participate in cell
      differentiation. These studies also indicate that EAP-300 mRNA is developmentally
      regulated and is expressed by glial cells in putative CNS barrier structures. Our
      studies also suggest that two pools of EAP-300 may exist in cells, implying that
      unlike IFAPa-400 the EAP-300 protein may not always be associated with
      intermediate filaments. Interestingly, our studies demonstrate that EAP-300
      contains a novel repeat amino acid domain comprised of multiple leucine-zipper
      motifs, which may contribute to its function during glial differentiation.

PMID- 7781166
TI  - Cocaine inhibits central noradrenergic and dopaminergic activity during the
      critical developmental period in which catecholamines influence cell development.
AB  - Cocaine produces neurobehavioral damage in the fetus and neonate both through its
      ischemic actions and through direct effects mediated by the drug within the
      developing brain. The replication and differentiation of catecholaminergic target
      cells are controlled in part by neurotransmitter input and the current study
      assess whether cocaine modifies the function of these neurons during the critical
      periods in which target cell programming occurs. Neonatal rats (1, 7, 14 and 21
      days old) were given cocaine (30 mg/kg) acutely and the turnover of
      norepinephrine and dopamine, a measure of synaptic activity, was evaluated in
      vivo in three different brain regions known to be adversely affected by cocaine.
      For norepinephrine, cocaine suppressed transmitter turnover in the immediate
      postnatal period in all regions, reaching a maximal effect within the first 2
      postnatal weeks; at subsequent ages, the inhibitory actions were no longer
      evident. For dopamine, an inhibitory effect also appeared during the first
      postnatal week, but by 14 to 21 days the effect was replaced by the excitatory
      response that is characteristic of mature brain; effects on dopamine turnover
      were restricted to the forebrain. The inhibitory effects of cocaine on immature
      brain could not be attributed to localized actions at the nerve terminal itself
      (blockade of reuptake, autoreceptor activation, local anesthesia), but instead
      are likely to represent reductions in nerve impulse activity. Brain development
      in the neonatal rat corresponds to fetal stages in man, and thus the transient
      ability of cocaine to interfere with noradrenergic and dopaminergic activity
      during the period in which differentiation is being patterned by neurotransmitter
      input, may be important in the neurobehavioral teratology of cocaine.

PMID- 7781167
TI  - Alteration of PFK subunit protein, synthesis, and mRNA during neonatal brain
      development.
AB  - During neonatal maturation of rat brain, a similar biphasic relationship exists
      between the previously reported pattern of glucose utilization and levels of each
      type of 6-phosphofructo-1-kinase (PFK) subunit protein, relative synthesis, and
      mRNA. The increasing amounts of each subunit isoform generally correlated with
      elevated protein synthesis which was promoted by greater amounts of each type of
      subunit mRNA. For each parameter, the early phase, 1 to 10 days after birth, was
      characterized by small increases, and the subsequent period from ten to thirty
      days postpartum was characterized by a much greater rate of increase. By 30 days
      after birth, adult values were observed. The apparent efficiency of translation
      of each type of PFK subunit mRNA in brain suggests that the M-type subunit mRNA
      is the most efficient and that the L-type subunit mRNA is the least. The greatest
      relative increases in subunit protein, mRNA, and synthesis were observed for the
      C-type subunit. Since enhanced translation apparently makes little, if any,
      contribution, a possible explanation of these phenomena could be increased
      transcription of the PFK genes. These neonatal changes could involve age
      dependent alteration of methylation of the PFK gene promotor(s) and/or activity
      of effectors of the transcription of the PFK genes.

PMID- 7781168
TI  - Arg-vasopressin content in the suprachiasmatic nucleus of rat pups: circadian
      rhythm and its development.
AB  - To investigate the development of Arg-vasopressin (AVP) content and its diurnal
      rhythm in the suprachiasmatic nucleus (SCN), AVP was measured by enzyme
      immunoassay in the rat pup SCN punched out from tissue slices obtained at
      postnatal day (PD) 1, 5, 10, 12 and 20 from animals maintained under a light-dark
      cycle (LD). The AVP levels, measured at a restricted time of day, increased from
      PD1 reaching the adult level at PD10-12. Diurnal rhythm similar to that in adults
      was evident at PD10-12 under the LD conditions used. The peak value of AVP was
      observed at the earlier light period, and its trough occurred at the end of the
      light period. The circadian rhythm remained for 7 days under constant dark (DD)
      or constant light (LL) conditions. These results indicate that the AVP, one of
      the output signals from the SCN, starts to oscillate after PD10-12, and shows a
      free-running rhythm during the nursing period.

PMID- 7781169
TI  - Epileptogenesis in immature neocortical slices induced by 4-aminopyridine.
AB  - The laminar site of onset of 4-aminopyridine (4AP)-induced epileptiform
      discharges in immature neocortical brain slices was localized to layer V using
      conventional extracellular field electrodes, current source-density analysis
      (CSD), and subdivided slices. Intracellular patch-electrode recordings in
      immature layer V neurons confirmed that intrinsically bursting (IB) neurons were
      not present at the ages studied or with bath application of 50-200 microM 4AP. IB
      properties were not being masked in the younger animals by the patch electrodes
      because typical IB neurons in layer V were seen in older rats when the same
      intracellular techniques were used. These results demonstrate that epileptiform
      activity can be initiated in the absence of IB neurons, and suggest that other
      factors are responsible for the preferential onset in layer V.

PMID- 7781170
TI  - A study of double-labeled retinal ganglion cells from the superior colliculus in
      the developing albino rat.
AB  - We studied the distribution pattern and percentage of bilaterally projecting,
      double-labeled retinal ganglion cells in the albino rat by the retrograde
      fluorescent double labeling. Forty-five albino (Wistar, Japan Clea) rats of
      either sex and of different stage of development ranging in age from the day of
      birth (Day 0) to Day 30, were used. With the rats under deep anesthesia, we
      pressure injected 0.02 microliter of 15% Evans blue (EB) and 0.02 microliter of
      4% Fluoro-gold (FG) into the right and left superior colliculi, respectively; for
      rats older than 5 days, the volume of each tracer was 0.04 microliter. The
      animals were perfused with formol-saline 48 to 72 h later and the brain and
      eyeballs were excised and sectioned. Double-labeled cells were found over almost
      the entire retina, with the concentration in the lower temporal crescent in rats
      up to day 1; concentration gradually shifted to the ventral half between days 5
      and 10. After day 15, double-labeled cells were found only in the ventral
      temporal crescent of the retina, which is the pattern in the adult rats. The
      percentages of retinal ganglion cells that were double-labeled at days 0, 1, 5,
      7, 10, 15, 20, 25 and 30 were 60.2, 51.6, 60.5, 57.6, 62.2, 60.7, 55.7, 45.2, and
      39.1, respectively. After day 10, the percentage of such cells decreased
      steadily.

PMID- 7781171
TI  - Ontogeny and distribution of glial cell line-derived neurotrophic factor (GDNF)
      mRNA in rat.
AB  - Glial cell line-derived neurotrophic factor (GDNF) is a member of the
      transforming growth factor-beta family isolated from the rat glial tumor cell
      line, B49. In embryonic dopaminergic (DA) neurons in vitro, GDNF promotes
      survival, high-affinity dopamine uptake, and neurite outgrowth. We have used a
      semi-quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) with
      primers specific to GDNF to study the developmental expression of GDNF mRNA in
      central nervous system (CNS) and peripheral organs of embryonic rat on
      gestational days E11.5, E13.5 and E18, neonatal rat on postnatal days P0 and P10,
      and adult rat. GDNF mRNA is expressed throughout the CNS, with highest levels in
      P0 spinal cord and in P0 and P10 striatum. Lower levels are present in the
      brainstem (including the ventral mesencephalon, which contains the DA neurons of
      the substantia nigra), cerebellum, diencephalon, and telencephalon, as well as in
      primary cultures of cerebellar granule cells prepared from P7 cerebellum and
      astrocytes prepared from P1 cortex. The cerebellum has an unusual temporal
      pattern of expression, high at birth and in the adult, but undetectable at P10.
      GDNF mRNA is also expressed in many peripheral tissues at higher levels than in
      brain. These include embryonic limb bud, kidney and gut; neonatal kidney, gut,
      lung and testis; and adult lung, liver and ovary. In addition to the predicted RT
      PCR product, we also observed a minor band which was shown to be identical to
      GDNF in the mature peptide sequence, but which has a 78 base pair deletion in the
      preproprotein sequence.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781172
TI  - Effect of transient neonatal muscle paralysis on the growth of soleus
      motoneurones in the rat.
AB  - The postnatal growth of soleus motoneurones was studied during normal development
      and following transient paralysis of the soleus muscle in neonatal rats.
      Paralysis was achieved by implanting a silicon strip containing alpha
      bungarotoxin alongside the soleus muscle in rat pups within 3-6 h of birth. The
      soleus muscle was completely paralysed for at least 24 h, and by 9 days
      neuromuscular transmission was fully restored. The soma size of normal and target
      deprived soleus motoneurones was compared at intervals during the first 3
      postnatal weeks and in adults, using the retrograde horseradish peroxidase
      technique. There was a four-fold increase in the soma area of normal motoneurons
      during the first 3 postnatal weeks, with the greater part of the increase
      occurring between 7 and 14 days. At 3 days, the distribution of soma areas was
      unimodal and became bimodal by 21 days. Paralysis during the first postnatal week
      did not significantly affect the developmental changes in motoneurone soma area
      or their distribution up to 3 weeks of age. Thus, motoneurones deprived of
      functional neuromuscular contact appear to grow normally during the early
      postnatal period, although previous results show that at later stages (2-3 months
      of age), many of these motoneurones die and the remaining cells are smaller than
      normal.

PMID- 7781173
TI  - The effect of mercury vapour on cholinergic neurons in the fetal brain: studies
      on the expression of nerve growth factor and its low- and high-affinity
      receptors.
AB  - The effects of mercury vapour on the production of nerve growth factor during
      development have been examined. Pregnant rats were exposed to two different
      concentrations of mercury vapour during either embryonic days E6-E11 (early) or
      E13-E18 (late) in pregnancy, increasing the postnatal concentration of mercury in
      the brain from 1 ng/g tissue to 4 ng/g tissue (low-dose group) or 11 ng/g (high
      dose group). The effect of this exposure in offspring was determined by looking
      at the NGF concentration at postnatal days 21 and 60 and comparing these levels
      to age-matched controls from sham-treated mothers. Changes in the expression of
      mRNA encoding NGF, the low- and high-affinity receptors for NGF (p75 and p140
      trk, respectively) and choline acetyltransferase (ChAT) were also determined.
      When rats were exposed to high levels of mercury vapour during early embryonic
      development there was a significant (62%) increase in hippocampal NGF levels at
      P21 accompanied by a 50% decrease of NGF in the basal forebrain. The expression
      of NGF mRNA was found to be unaltered in the dentate gyrus. The expression of p75
      mRNA was significantly decreased to 39% of control levels in the diagonal band of
      Broca (DB) and to approximately 50% in the medial septal nucleus (MS) whereas no
      alterations in the level of trk mRNA expression were detectable in the basal
      forebrain. ChAT mRNA was slightly decreased in the DB and MS, significantly in
      the striatum. These findings suggest that low levels of prenatal mercury vapour
      exposure can alter the levels of the NGF and its receptors, indicating neuronal
      damage and disturbed trophic regulations during development.

PMID- 7781174
TI  - Induction of labor using prostaglandin E2 (PGE2) vaginal gel in triacetin base.
      An efficacy study comparing two dosage regimens.
AB  - OBJECTIVE: To compare two dosage regimens for the administration of vaginal
      prostaglandin gel in triacetin base for induction of labor. METHODS: Seventy
      subjects planned for elective induction of labor at term were randomized to
      treatment with PGE2 vaginal gel every 6 or 12 hours. The 6-hourly group received
      an initial dose of 1 mg, followed by 2 mg at 6 hour intervals for a maximum of
      two additional doses if not in active labor. The 12-hourly group had an initial
      dose of 2 mg followed by two additional doses at 12 hour intervals if not in
      active labor. RESULTS: Successful induction rate was higher in the 12-hourly as
      compared to 6-hourly gel regimen (100% vs. 91%, P > 0.05). Twelve hours after the
      initial dose, delivery occurred in 34% delivery had occurred in 57% and 37%
      respectively (P < 0.01). We found no difference in the induction-active labor
      interval (P > 0.05), and the induction-delivery interval (P > 0.05) between the
      two groups. Active labor followed a single dose of gel in 66% of the 12-hourly
      group compared to 40% of the 6-hourly group (P < 0.01). Syntocinon augmentation
      was needed in 6% of subjects in the 12-hourly group as compared to 26% in the 6
      hourly group (P < 0.01). The cesarean section rate was similar in both groups.
      Uterine hyperstimulation occurred less frequently in the 12-hourly group (P <
      0.05). The perinatal outcome was similar in both groups. CONCLUSIONS: The 12
      hourly regimen was more effective than the 6-hourly regimen in initiating labor.
      The majority of the subjects in the 12 hourly group achieved labor following a
      single dose of gel. Induction delivery interval, however, was similar in both
      groups.

PMID- 7781175
TI  - Pregnancy in heart transplant recipients. Case report and review.

PMID- 7781176
TI  - Anatomo-clinical considerations on the ovarian fibroma.
AB  - The Authors analysed from an anatomo-clinical point of view, 17 cases of ovarian
      fibroma, observed during the period between 1968 and 1992. The incidence of
      ovarian fibroma in this study was 2.52% and it affected women in different age
      groups, though with greater frequency those above 50 years. Even the
      symptomatology was variable and was characterized by pain in the hypogastric
      quadrant (47.1%); alteration of the menstrual cycle (17.6%); metrorrhagic
      episodes (17.6%); sterility (5.9%). Due to the fact that the ovarian fibroma can
      appear at any age, this suggests different surgical approaches according to age,
      general conditions of the patient and fertility.

PMID- 7781177
TI  - The wording of the informed consent in gynecology.
AB  - In many western States medical activity is characterized by legal difficulties
      regarding the patients' consent. In this paper we have confronted the medical and
      legal problems connected to the wording of the informed consent in diagnostic and
      therapeutic practice in gynecology and obstetrics. In this area the role of
      Scientific Societies seems ever more important in that they could carry-out an
      important task by having the possibility of acquiring and coordinating the
      maximum amount of knowledge in both the specialistic medical field and the
      judiciary field. Here, we discuss the various aspects of the preparation of
      appropriate forms for correct patient information and the valid acquisition of
      the patient's consent for medical records.

PMID- 7781179
TI  - Menstrual patterns, pain symptoms, body mass index and smoking habits in women
      with endometriosis.
AB  - Epidemiologic studies have investigated the risk factors for endometriosis, but
      currently the results are still controversial. The aim of this study is to
      evaluate the incidence of some of the risk factors that have been involved with
      endometriosis to better understand the natural history and evolution of this
      disease. The medical records of 186 women with laparoscopic diagnosis of
      endometriosis were studied. We analysed the characteristics of the menstrual
      cycle, the presence of pain symptoms and the familiarity for endometriosis.
      Moreover, the body mass index of all patients and the average cigarettes smoked
      per day were calculated. Despite the fact that some of the data collected
      resulted to be statistically significant when compared among the four stages of
      endometriosis, the roles of the many factors that have been associated with the
      risk or the evolution of pelvic endometriosis still remain unknown.

PMID- 7781178
TI  - The management of persistent occipito-posterior position.
AB  - Persistent occipito-posterior position (POP) is found in about 1% of labors, and
      its management is still controversial. A study group of 319 patients with POP
      deliveries were screened and analyzed for prepartum, intrapartum and postpartum
      parameters. A control group of the same size was matched for maternal age (mean
      27-28 +/- 5.22 yrs), gravidit (mean 2.52 +/- 1.95) and parity (mean 1.13 +/-
      1.67). Statistically significant differences were found between the study and the
      control groups regarding the incidence of instrumental (forceps/vacuum)
      deliveries, prolonged second stage, pregnancy-induced hypertension, prostaglandin
      E2 induction, premature rupture of membranes and episiotomy. A discussion is
      presented evaluating the possible significance of these findings. Although the
      high rate of instrumental deliveries encourages active management of POP labors,
      the authors advocate a more conservative approach.

PMID- 7781181
TI  - Substitutive hormonal treatment in postmenopause.
AB  - The social impact of menopause is stressed by the actual life expectancy of
      women. One of the most important post-menopausal alterations--"osteoporosis"--is
      considered. Particular attention is focussed on therapeutical aspects.

PMID- 7781180
TI  - Transvaginal Doppler ultrasound with colour flow imaging in benign and malignant
      ovarian lesions.
AB  - Since early detection of ovarian cancer is difficult, most cases are diagnosed at
      advanced stages. The imaging diagnosis is based on pattern classification and is
      limited with respect to the precise determination of malignancy. High-frequency
      transvaginal sonography improves the ability to detect malignant ovarian tumors
      over that of transabdominal route, however, the predictive values are
      unsatisfactory because of inability to distinguish between malignant and benign
      tumors that have similar morphologic characteristics. The introduction of
      transvaginal colour flow imaging has allowed detection of low-resistance
      intratumoral blood vessels, characteristic of malignant tumors, and visually
      reflected the state of blood flow of an ovarian tumor. These two ultrasonographic
      methods were used for diagnosis of ovarian tumors in 65 women treated in our
      Department of Obstetrics and Gynecology. Waveforms of the parenchymal tumor
      arteries or tumor surface arteries were compared using value of the resistance
      index (RI). The sensitivity, specificity and accuracy of the preoperative RI in
      detecting malignant ovarian tumors were 100%, 94%, 95.4% respectively. The
      sensitivity, specificity and accuracy of preoperative suspicious sonographic
      findings in detecting malignant ovarian tumors were 100%, 61% and 71%. Positive
      and negative predictive values of colour flow imaging were 85% and 100%, whereas
      for grey-scale transvaginal ultrasonography they were 46% and 100% respectively.
      The findings of this study suggest that transvaginal colour Doppler is a method
      which is superior to the other methods for preoperative evaluation of ovarian
      malignancy.

PMID- 7781182
TI  - Pregnancy and myasthenia gravis. A case report.
AB  - Myasthenia gravis in pregnancy is seen very rarely. We present such a case who
      was diagnosed and treated in our department.

PMID- 7781183
TI  - Histochemical aspects of nucleoproteidic metabolism of human embryos. A
      histofluoroscopic study.
AB  - The Author, after stressing the importance of proteic syntheses in the vital
      processes of each cell and the role played by nucleic acids in such metabolic
      processes, underlines the importance of histochemical studies on nucleoproteidic
      metabolic in the embryo, and briefly illustrates the most important features of
      the fluorescent method. The Author further relates the results of his personal
      research conducted by means of microfluoroscopy after acridine orange
      chromization on histological sections of human embryos. The results are
      documented by the enclosed photographs, and their significance is briefly
      discussed.

PMID- 7781184
TI  - Pregnancy in adolescents. A case-control study.
AB  - OBJECTIVE: to investigate pregnancy outcome and incidence of pregnancy-related
      disorders in the adolescent. DESIGN: a matched control retrospective study.
      SUBJECTS: pregnant adolescents aged 14 to 19 years admitted to the Departments of
      Obstetrics and Gynecology--Policlinico Umberto I, between the years 1984 and
      1993; a comparable number of pregnancies aged 20 to 24 years was considered as a
      control group. RESULTS: In the 10 yrs. period a total of 304 pregnancies in
      adolescents were considered. Preterm deliveries were 9.5% in the adolescent group
      vs 5.9% in control (P > 0.05). A higher incidence was found in number of cesarean
      section (P < 0.001), spontaneous abortion (P = 0.003), intrauterine growth
      retardation (P = 0.04) and fetal distress (P = 0.04) in the adolescent group vs
      matched controls. Also mean birth weight was significantly lower in the
      adolescent group when compared with normal group (P < 0.001). CONCLUSION: we
      found a higher incidence of obstetric complications, such as IUGR, acute fetal
      distress in labor and lower birth weight, in the adolescent group, resulting in a
      higher number of cesarean sections. We hypothesise that the relative state of
      "hypoarterialisation" characteristic of the adolescent uterus may be involved in
      the afore-mentioned complications.

PMID- 7781185
TI  - High risk pregnancy in a patient with angioma of the corpus callosum.
AB  - Literature data indicate that rupture of arterovenous malformations is 4 times
      more frequent in pregnant women. The Authors present a case of cerebral
      hemangioma of the third medium anterior of the corpus callosum diagnosed in a
      patient at the 28th gestational week by Magnetic Resonance scan. The patient
      underwent elective caesarean section under peripheral anesthesia (peridural and
      spinal block by Bupivacaine) and delivered a male infant 4560 gr, 52 cm. The
      postoperative course was uneventful. The arterovenous malformation constituted an
      important anesthesiologic risk factor but the Authors conclude that caesarean
      section can be safely performed with a very careful anesthesiological time
      schedule and a reliable haemodynamic monitoring.

PMID- 7781187
TI  - Re: Board certified in QEEG???

PMID- 7781186
TI  - Leiomyoma of the female urethra. A case report and review.
AB  - A case of urethral leiomyoma in a 39 year old woman is reported. It is always a
      benign neoplasia, frequently hormone-dependent, rarely relapsing after excision.
      An accurate review of the literature has found over 110 cases up to date, in
      opposition to a recent publication in the Journal of Urology in 1992, which
      reported only 36 cases up to that year.

PMID- 7781188
TI  - Topographic analysis of EEG photic driving in normal and schizophrenic subjects.
AB  - In a 19-channel EEG photic driving paradigm the steady-state evoked response was
      studied in schizophrenic patients and normal controls. Seventeen drug-free
      patients and 15 normal controls were compared. Schizophrenic patients had lower
      EEG photic driving in the alpha range, particularly in the high alpha frequency
      band (p = 0.08). Topographic analysis revealed that the group differences were
      primarily located in the mid-frontal, central and parietal areas (p < 0.05).
      Temporal and lateral frontal lobe alpha remained the same in the two groups.
      Separate analysis of eye movement (EM) showed an opposite effect on the alpha
      frequency photic driving as compared to that on the resting alpha EEG. EM
      decreased the resting alpha EEG and increased the photic driving. This finding
      suggested that the lower EEG photic driving in the schizophrenic patients could
      not be explained by the eye movement artifact. We hypothesize that the 10 Hz
      range photic driving that reflects the intrinsic EEG spindle generation in the
      thalamus may play an important role in the psychophysiology of schizophrenia.

PMID- 7781189
TI  - Sleep onset: scoring criteria in patients with sleep apnea syndrome.
AB  - It has been suggested that in patients with sleep apnea syndrome (SAS) modified
      scoring criteria may improve accuracy in the determination of sleep onset in the
      Multiple Sleep Latency Test (MSLT). Scoring in 30-sec epochs according to the
      standard criteria requires more than 50% of the epoch asleep to score sleep
      latency (SL). In patients with SAS, short apneas with arousals could prevent the
      accurate determination of SL. This study compared three time-duration epochs (5
      sec, 10-sec, 30-sec) for scoring SL in patients with SAS. Sleep onset during a
      single sleep latency test, the morning subsequent to a nocturnal polysomnogram,
      was determined by the criterion of at least 50% of the epoch asleep.
      Neuropsychological evaluation was performed immediately after the single sleep
      latency test. There was no statistically significant difference in time to fall
      asleep as defined by 10-sec and 30-sec epochs, but SL defined by 5-sec epochs was
      significantly shorter than SL defined by 10-sec and 30-sec epochs. Wilkinson
      Addition Test correct score correlated better with SL as defined by 30-sec
      epochs. The results imply that the level of sleepiness measured by 30-sec epochs
      may be more useful to appreciate behavior and performance.

PMID- 7781190
TI  - Effects of antiepileptic drugs on EEG background activity in children with
      epilepsy: initial phase of therapy.
AB  - The effects of antiepileptic drugs (AED) on EEG background activity were
      evaluated in 37 newly treated children with epilepsy, compared with 46 age
      matched healthy controls. Before AED therapy, the children with epilepsy, both
      partial (treated with carbamazepine, CBZ group) and generalized seizures (treated
      with valproic acid, VPA group), already exhibited significant slowing of EEG with
      increased delta and decreased alpha power. Following 3 to 6 months of AED
      therapy, this EEG slowing was enhanced in the CBZ group and reduced in the VPA
      group. Following 1 year of AED therapy, an increase in frequency was recognized
      in the CBZ group. These results suggest that 1) most children with epilepsy
      already exhibit slowing of the EEG at the onset of seizures, which may reflect
      CNS developmental deficit, 2) the short-term effects on EEG are different between
      CBZ and VPA, and 3) EEG development with age continues under continuous AED
      administration. The EEG background activity in children with epilepsy is affected
      by many factors, which include the underlying CNS dysfunction of the epilepsy
      itself and also AED therapy (type of AEDs, duration of therapy, etc).

PMID- 7781191
TI  - Effects of zonisamide on BAEP, SSEP and P300.
AB  - The effects of zonisamide on BAEP, SSEP and P300 were studied. The subjects were
      12 patients (4 men and 8 women) with untreated epilepsy. Their ages ranged from
      16 to 59 years, with a mean of 26.3 +/- 12.0 years. The daily dose of zonisamide
      was between 200 mg. to 600 mg. (2 to 6 tablets, 2.9 +/- 1.1 tablets on average).
      The serum concentrations of zonisamide ranged from 11.4 to 32.5 micrograms/ml,
      with a mean of 18.7 +/- 8.5 micrograms/ml 1 year after administration. Central
      conduction time and latency in BAEP and SSEP and amplitude, response time and
      latency in P300 were investigated. There were no significant differences in any
      of the tests. Zonisamide did not affect any of these evoked responses and may be
      less toxic to the central nervous system than other antiepileptic drugs.

PMID- 7781192
TI  - Late onset absence seizures in multiple sclerosis: a case report.
AB  - A 38-year-old woman was admitted to hospital because of generalized tonic-clonic
      attacks and late onset absence seizures. EEG and Video-EEG showed 3-4 hz
      generalized spike and wave discharges lasting 1-8 seconds, which were associated
      with impairment of consciousness and unresponsiveness. MR scan revealed multiple
      demyelinating lesions, including the most prominent one in the mesial frontal
      region that we suppose might be responsible for electroclinical absence seizures.
      After investigation the diagnosis of multiple sclerosis was made. Possible
      pathophysiological mechanisms and differential diagnosis of tonic-clonic and
      absence seizures in MS are discussed.

PMID- 7781193
TI  - Study of the alpha frequency band of healthy adults in quantitative EEG.
AB  - The qEEG of the alpha band in 115 healthy adults, and for comparison the SPM of
      244 patients, were studied. The alpha band was divided into three subgroups:
      alpha 1 (8-8.9Hz), alpha 2 (9-10.9Hz) and alpha 3 (11-12.9Hz). This method could
      both demonstrate the dominant rhythm of healthy adults and discover alpha
      slowing. The distribution of the level of power and percentage of frequency in
      alpha 1, 2 and 3 varied on different head regions. While the distribution of
      alpha 1 was the same as the theta and delta bands, there was a trend toward
      abnormally high power of alpha 1 and theta bands in patients.

PMID- 7781194
TI  - Neurometric subgroups in attentional and affective disorders and their
      association with pharmacotherapeutic outcome.
AB  - To determine if quantitative electrophysiologic measures correlate with
      pharmacotherapeutic response, we conducted a retrospective analysis of treatment
      outcomes in sequential patients with attention deficit disorder and affective
      disorders. One hundred medication-free patients meeting DSM-III-R criteria for
      attentional and affective disorders underwent pretreatment EEG, quantitative
      Neurometric EEG, and physical/laboratory examinations. Attention-disordered
      patients were first treated with a stimulant, secondarily with an antidepressant,
      and tertially with an anticonvulsant. Affectively disordered patients were
      treated initially with antidepressant, and secondarily augmented with
      anticonvulsant or lithium. Tertiary treatment was a stimulant. Patients were
      assessed up to 6 months. A Clinical Global Improvement score was assigned.
      Similar Neurometric subgroups were identified within both the attentional and the
      affectively disordered patients. Subgroups were relative alpha frequency excess,
      relative theta frequency excess, and/or inter-hemispheric hypercoherence. Without
      regard to DSM-III-R diagnosis, there were robust correlations between Neurometric
      subgroup membership, responsivity to selected pharmacologic agent class(es), and
      clinical outcome. The frontal alpha excess subgroup was 87% responsive to
      antidepressants. The frontal theta excess subgroup was 100% responsive to
      stimulants. The frontal alpha excess/hypercoherent subgroup was 85% or more
      responsive to anticonvulsants/lithium. The frontal theta excess/hypercoherent
      subgroup was 80% responsive to anticonvulsants. Patients with similar Neurometric
      features responded to the same class(es) of psychopharmacologic agent(s) despite
      their DSM-III-R classification.

PMID- 7781195
TI  - QEEG in hemophiliacs with HIV infection.
AB  - Conventional visual analysis of the EEG was performed on 320 hemophiliacs
      infected with HIV, who spanned the range of the Walter Reed (WR) system for
      classifying clinical stage of HIV infection, and on 50 HIV seronegative
      hemophiliac controls. Intermittent or paroxysmal slowing was the conventional EEG
      abnormality most commonly seen in early stages of HIV infection (stages WR1 and
      2), with increased focal epileptiform activity and generalized slowing appearing
      in patients with the full clinical syndrome of AIDS (WR6). Slowing of the
      manually measured alpha rhythm was noted in stages WR2 and above. Quantitative
      EEG (qEEG) was obtained in a subset of 103 male HIV seropositive male
      hemophiliacs and 35 male HIV seronegative hemophiliac controls. The principal
      findings were a progressive relative increase in theta power with a tendency
      towards an anterior topographic distribution, and a progressive decline of
      spectral power in fast alpha relative to slow alpha with increasing severity of
      HIV disease. Significant qEEG differences from controls were apparent in WR2
      subjects (seropositive with lymphadenopathy and without other constitutional
      symptoms), and were relatively greater in WR3-6 subjects. These results suggest
      sensitivity of qEEG to early CNS involvement with HIV infection.

PMID- 7781196
TI  - The EEG in psychiatry: an outline with summarized points and references.

PMID- 7781197
TI  - Selected papers presented at the Nephropharmacology 3 meeting. Ulm, 1994.

PMID- 7781198
TI  - Endothelin (ET-1) is involved in the contrast media induced nephrotoxicity in
      children with congenital heart disease.
AB  - In 77 children with congenital heart disease urinary endothelin-1 (ET-1), an
      indicator of intrarenal endothelin release, was compared to urinary excretion of
      total protein, albumin, immunoglobuline G (IgG), alpha 1-microglobuline (alpha 1
      MG), N-acetyl-beta-D-glucosaminidase (NAG) and villin. Urine samples were
      collected the day before and immediately after cardiac angiography with high
      (Conray 70; n = 56; CON) or low osmolality contrast media (Solutrast 300; n = 21;
      SOL) to assess the relationship between urinary endothelin and glomerular and
      tubular nephrotoxicity of contrast media. The children were further subdivided
      according to age: less than 1 year-CON 1 (n = 20); SOL 1 (n = 12) and 1-18 years
      CON 2 (n = 36); SOL 2 (n = 9). Results (median): 1. There are no significant
      changes in total protein-, albumin- and IgG-excretion as parameters of glomerular
      toxicity. 2. Tubular toxicity of contrast media is shown by significant increase
      of alpha 1-MG-(10.0 to 23.2 mg/g Crea; p < 0.001), NAG-(5.9 to 9.6 mg/g Crea; p <
      0.001) and Villin-excretion (1.0 to 2.0 STS, p < 0.001) in all children. 3.
      Endothelin excretion (101.0 to 163.0 ng/g Crea, p < 0.001) and concentration
      (42.5 to 56.0 pg/ml; p < 0.001) were elevated after angiography in all children.
      4. The changes in endothelin excretion are correlated to the changes in alpha 1
      MG (r = 0.65; p < 0.001) and NAG (r = 0.43, p < 0.001) in all children.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7781199
TI  - Methylprednisolone pharmacokinetics and pharmacodynamics in chronic renal
      failure.
AB  - Methylprednisolone (MP) pharmacokinetics and its directly suppressive effects on
      cortisol secretion and cell trafficking were compared in 6 chronic renal failure
      (CRF) subjects and 6 healthy controls. After IV administration of MP 0.6 mg/kg as
      Solu-Medrol, the pharmacokinetics of methylprednisolone were similar. The
      clearance was about 280 ml/hr/kg, volume of distribution was 1.1 l/kg, t1/2 was
      2.7 hr, and fraction unbound was 0.2. Physiologic pharmacodynamics models were
      applied for the suppression of cortisol secretion and recirculation of basophils,
      T-helper cells, and T-suppressor cells. The net response (area under the curve)
      and inhibitory concentrations (IC50) of methylprednisolone for each
      pharmacodynamic parameter were similar in both groups. As the pharmacokinetics of
      other corticosteroids are altered in CRF, the lack of pharmacokinetic/dynamic
      changes of methylprednisolone may offer a therapeutic advantage for CRF patients.

PMID- 7781200
TI  - Single dose kinetics of piperacillin during continuous arteriovenous hemodialysis
      in intensive care patients.
AB  - Piperacillin (Pi) kinetics in patients with acute renal failure treated by
      continuous arteriovenous hemodialysis (CAVHD) are not known. Therefore, dosing
      regimens have been based on kinetic data derived from patients with chronic renal
      failure and principal pharmacokinetic considerations [Reetze-Bonorden et al.
      1993]. From these estimations it has been predicted that approximately 30% of the
      dose of Pi is removed by CAVHD (dialysate/ultrafiltrate (D/UF) flow rate 1.5
      liter/hour). To confirm this estimate single dose (4g i.v.) Pi kinetics were
      studied in 12 intensive care patients with anuric acute renal failure due to
      septicemia treated by CAVHD. Pi plasma and D/UF levels were measured by HPLC.
      Sieving/Saturation of Pi in the D/UF was 0.71 +/- 0.21 (+/- SD). With a mean D/UF
      flow rate of 20.4 +/- 1.5 ml/min, the mean extracorporal clearance (Clextra) was
      12.2 +/- 1.0 ml/min and accounted for 29% (range 14-48%) of total body clearance
      (ClB = 47.1 +/- 22.3 ml/min). In 7 out of 12 patients the fraction of the dose
      eliminated by CAVHD reached a significant value above 25%. The mean volume of
      distribution (Vd) and elimination half life (t1/2) were 25.8 +/- 3.8 liter and
      7.4 +/- 2.9 hours, respectively. In conclusion the extent of extracorporal
      elimination of Pi by CAVHD was well in agreement with the estimation previously
      published. In intensive care patients with acute renal failure on continuous
      hemodialysis Pi dosing should take into account the possibly significant
      elimination of Pi. The usual dose for anuric patients may be increased by 50% to
      avoid underdosing in these critically ill patients.

PMID- 7781201
TI  - Saturable first-pass kinetics, plasma protein binding, and the furosemide
      intricacies.
AB  - An equation for saturable nonlinear first-pass kinetics is presented to discuss
      some contra-intuitive findings encountered with furosemide bioavailability. The
      diverging effects on steady-state bioavailability (Fss) are simulated for changes
      in maximal metabolic capacity (Vm), volume of distribution (Vd), Michaelis
      constant (Km), steady-state plasma concentration (Css), repetitively administered
      drug dose (Dss), dosage interval (Tau), liver plasma flow (Ql), absorption rate
      constant (Ka), and free plasma fraction (fp), where (Cssf = fp Css = const.) and
      (Kmf = fp Km = const.). [Formula: see text] The present concept is in line with
      observations indicating that furosemide bioavailability decreases from 60 to 45%
      in nephrotic syndrome patients whose plasma protein binding is reduced and
      hepatic clearance increased. These observations and our equation-based
      simulations show that furosemide must have a first-pass effect. Hepatic
      extraction of furosemide is not facilitated by albumin, and saturable first-pass
      kinetics can not be used to explain an albumin paradox.

PMID- 7781202
TI  - Clinical experience transferring kidney transplant patients from Sandimmun to
      Sandimmun Neoral--results after 3 months.
AB  - The new galenic formulation of cyclosporine prepared as microemulsion (Sandimmun
      Neoral, SN) shows a significantly improved correlation between both trough level
      (Cmin) and dose. Moreover, since the bioavailability is increased by 20 to 30% on
      average, it may lead to a drug overexposure in so far malabsorbing patients. In
      order to assess safety and to establish an appropriate procedure to switch
      patients safely from conventional Sandimmun to SN, we initialized an open,
      stratified (transplant age) clinical trial enrolling 302 patients of our
      outpatient clinic. We used a simple 1:1 conversion of the patient's total daily
      dose. Trough drug levels, as well as serum creatinine, liver enzymes, uric acid,
      and blood pressure values were measured at baseline, at days 4, 8, 15, 29, and at
      month 3 after drug substitution. Within the three month observation period, the
      cyclosporine dose was reduced by 14.2% (204 +/- 60 mg/day baseline vs. 175 +/- 54
      mg/day after conversion, p < 0.05). By day 8, the 1:1 dosage conversion resulted
      in a modest mean increase in drug trough levels (114 ng/ml baseline vs. 120
      ng/ml, p < 0.05). This increase was accompanied by a slight increase in mean
      serum creatinine concentration, a decrease in calculated creatinine clearance,
      and an increase in mean uric acid values (p < 0.05). Liver enzymes remained
      unchanged while systolic and mean arterial blood pressure decreased (p < 0.05).
      Parallel to dosage reduction, drug trough levels had decreased after 1 month to
      baseline (112 ng/ml) and remained there for the remainder of the study.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7781203
TI  - Therapeutic use of theophylline to antagonize renal effects of adenosine.
AB  - Experiments in laboratory animals clearly show that adenosine acts as a
      vasoconstrictive metabolite in the kidney. Adenosine receptor antagonists like
      theophylline can inhibit renal vasoconstriction in response to exogenous and
      endogenous adenosine. Based on these findings a number of experiments have been
      performed to test whether the vasoconstrictive action of adenosine in the kidney
      might be important also in pathophysiological states. In various animal models
      theophylline and other methylxanthine derivatives have been successfully employed
      to improve renal function after induction of acute renal failure. Clinical
      implications of these experimental findings comprise the prevention of acute
      renal failure following the administration of radio contrast media by
      theophylline. Another therapeutic aspect derives from experimental and clinical
      data showing that theophylline controls erythropoietin production in
      erythrocytosis after renal transplantation.

PMID- 7781204
TI  - Determinants of furosemide delivery to its site of action.
AB  - We have investigated the pharmacokinetic determinants of delivery of furosemide
      to its site of action in the renal tubules in patients and healthy volunteers.
      The bioavailability of furosemide is low and variable. Patients with renal
      disease may also have a low renal extraction of furosemide. In clinically
      relevant concentrations the free fraction of furosemide is inversely proportional
      to the plasma albumin concentration. A change in the free fraction of furosemide
      will change Clr, Clnr, and Vd in the same direction and that will cause minimal
      changes in the excretion rate of furosemide and its t1/2. A change in RBF will
      change the secretory clearance of furosemide to the same proportion and
      consequently also the excretion rate and its t1/2.

PMID- 7781205
TI  - Does L-arginine alter proteinuria and renal hemodynamics in patients with chronic
      glomerulonephritis and hypertension?
AB  - Endogenous nitric oxide (EDRF) plays an important role in the regulation of
      systemic and renal blood pressure by an alteration of vascular tone. To assess
      the effect of L-arginine (160 mumol/min i.v. for 3 hours), the precursor of EDRF,
      on blood pressure, protein-excretion and renal function (GFR = glomerular
      filtration rate, RPF = renal plasma flow) we performed a prospective, double
      blind, placebo controlled study. 18 patients with chronic glomerulonephritis
      (51.3 +/- 11.5 years), renal insufficiency (GFR < 65 ml/min) and hypertension
      were investigated for changes in GFR and RPF by continuous inulin- and PAH
      clearances and for changes in permselectivity by determination of protein
      excretion. L-arginine infusion results in a reduction of proteinuria (p < 0.05, t
      test). There is no significant effect on renal hemodynamics and mean arterial
      pressure (MAP). Comparing the excretion of the endogenous proteins, only
      albuminuria is decreased significantly (p < 0.01), whereas IgG-excretion is
      reduced slightly (p < 0.05). This can be considered as an indicator of a special
      influence on the mesangial cells or the basement membrane of the glomerulum
      itself by EDRF. In conclusion L-arginine reduces protein-excretion without
      significant alterations in renal hemodynamics and so might prevent a decline in
      renal failure.

PMID- 7781206
TI  - Renal hemodynamics in essential hypertensives treated with losartan.
AB  - ACE-inhibitors are known to have special renal effects, i.e. they increase ERPF,
      decrease the filtration fraction and lower proteinuria. These effects can be due
      to a decrease in angiotensin II (AII) levels as well as an increase in
      bradykinin. New and more specific AII-receptor antagonists may help to
      distinguish between effects exerted by angiotensin II and those exerted by
      bradykinin. We investigated the effects of losartan in 9 patients with essential
      hypertension (sitting mean diastolic blood pressure 95-120 mmHg). Renal
      hemodynamics were measured by continuous inulin-and PAH-clearance (GFR and RPF)
      after stopping antihypertensive therapy for 1 week, followed by a 2-week placebo
      period and after a 4-week treatment phase with losartan (50 mg/die) followed by a
      therapy with an ACE-inhibitor (ramipril 5mg/die). Additionally, urine albumin
      excretion (UAE) was measured. Treatment of patients with essential hypertension
      with losartan resulted in a significant decrease of MAP after three weeks of
      treatment (121 +/- 8 mmHg under placebo and 114 +/- 10 mmHg under losartan; * = p
      < 0.05). MAP after four weeks of losartan treatment was 115 +/- 11 mmHg.
      Regarding changes in renal hemodynamics we could not demonstrate a significant
      change for neither losartan nor the ACE-inhibitor. Urine albumin excretion was
      reduced by both treatment regimens in correlation to the magnitude of blood
      pressure reduction. Our data indicate that losartan induced a significant
      reduction in MAP in patients with essential arterial hypertension with only
      moderate effects on renal hemodynamics.

PMID- 7781207
TI  - [Multiorgan abnormalities in myotonic dystrophy--correlation among endocrine
      disorders, central nervous system involvements and gene analysis].
AB  - Myotonic dystrophy (DM) is a disease involving multiple organs. To elucidate the
      extent of severity of the affected organs in a given individual, we performed an
      investigation of the Ellsworth-Howard test (EH test), intelligence quotient (IQ),
      apnea index (AI), and expanded DNA fragment (EF) size in 10 patients with DM. The
      EF size analyzed by standard Southern blot procedures using EcoRI digested
      genomic DNA extracted from the peripheral white blood cells and probed with
      cDNA25. In the EH test, these patients were divided into two groups according to
      the results of their phosphaturic responses (delta P). Of these, 5 patients
      (Group I) showed a positive delta P, while remaining 5 patients (Group II) showed
      a negative one. In both Groups I and II, their urinary cyclic AMP responses were
      positive. Group II showed a significantly low value in IQ (p < 0.02) and a
      significantly high value in AI (p < 0.02) as compared with Group I. EF size in
      Group II was found significantly larger than in Group I (p < 0.01). A positive
      correlation between delta P and IQ (p < 0.1), a significant negative one between
      delta P and AI (p < 0.01), and a negative correlation between EF size and delta P
      (p < 0.2) were observed. IQ was negatively (p < 0.05), and AI was positively (p <
      0.05) correlated with EF size, which were statistically significant. Our results
      suggest that the extent of disease severity of the central nervous system is
      almost the same as that of endocrine organs, and that EF size is correlated with
      disease severities in both affected organs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781208
TI  - [Mirror movement due to the medial frontal lobe lesion].
AB  - We reported a case with acquired mirror movement in upper limbs due to the lesion
      of right medial frontal lobe including supplementary motor area, and also
      discussed a possible mechanism underlying it. A 59-year-old right-handed woman
      developed left hemiparesis caused by cerebral hemorrhage in the right
      frontoparietal lobe, on April 5, 1981. She had right hemiparesis and right
      hemianopsia due to cerebral hemorrhage in the left parieto-occipital lobe, 13
      days later. As the patient was recovering from paresis, mirror movement appeared
      on upper limbs. The features of the mirror movement of this case are summarized
      as follows: (1) it appeared when using both proximal and distal region of upper
      limbs; (2) it appeared on left upper limb when the patient intended to move right
      upper limb or on right upper limb when intended to move left upper limb, while it
      appeared predominantly in the former; and (3) it was more remarkably found in
      habitual movement using gesture and pantomimic movement for the use of objects,
      and it was found in lower degree when actual object was used or when the patient
      tried to imitate the gesture of the examiner. The lesions in MRI were found in
      medial region of right frontal lobe (supplementary motor area, medial region of
      motor area, and cingulate gyrus), right medial parietal lobe, posterior region of
      right occipital lobe, and medial regions of left parietal and occipital lobes.
      There was no apparent abnormality in corpus callosum.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7781209
TI  - [Rest-activity and body-temperature rhythm disorders in elderly patients with
      dementia--senile dementia of Alzheimer's type and multi-infarct dementia].
AB  - We simultaneously monitored rest-activity and body temperature (BT) rhythm in
      demented patients with sleep and behavior disorders using ambulatory wrist-worn
      actigraph and long-term monitoring system for 5-7 consecutive days. Subjects
      consisted of 19 patients with senile dementia of Alzheimer's type (SDAT) (M/F =
      7/12, mean age = 71.7 years), 16 patients with multi-infarct dementia (MID) (M/F
      = 9/7, mean age = 75.2 years) and 9 normal controls (M/F = 4/5, mean age = 70.4
      years). Both dementia groups showed a significant increase in percentage of
      nighttime activity. In the SDAT group, a significant positive correlation between
      the degree of dementia and total activity was observed, but not observed in the
      MID group. A significant high amplitude of BT rhythm was observed in the SDAT
      group comparing that in the MID or the control group. These findings indicate
      that the SDAT patients had a disrupted rest-activity rhythm with the severity of
      intellectual deterioration and increased night activity, while the circadian BT
      rhythm was remarkably well preserved, i.e. there was a dissociation between rest
      activity and BT rhythms in the SDAT group. On the other hand, the disruption of
      the rest-activity and BT rhythm in the MID patients was characterized by a
      concomitant decrease of amplitude, which seems to have no relation with the
      severity of dementia. Different mechanisms could be involved in characteristic
      disruption of the circadian rhythms in the 2 dementia groups.

PMID- 7781210
TI  - [Clinical and biochemical analysis of 27 patients with myoglobinuria of unknown
      causes].
AB  - We examined the clinical and biochemical features of 27 cases with acute
      myoglobinuria who had been suspected of having metabolic myopathies. The
      systematic biochemical studies included the measurements of 13 glycolytic
      enzymes, mitochondrial respiratory chain enzymes, carnitine palmitoyltransferase
      (CPT) and 5 enzymes of fatty acid beta-oxidation. Enzyme defects were found in 9
      patients using muscle biopsy specimens: phosphorylase deficiency in 3, CPT
      deficiency in 4 and phosphoglycerate kinase deficiency in 2. One patient was
      diagnosed as MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis and
      stroke-like episodes) with the histopathological examination and clinical data. A
      suspicion of beta-oxidation disorder was entertained in some patients of which
      the activities were about 50% of control means. However, no evidence to
      substantiate its significance as the enzyme defects was obtained from our data.
      Sixteen of 17 undiagnosed cases could be divided into two groups according to
      precipitating factors as follows: one had exercise as the factors and the other
      had infection. These groups also showed some differences in clinical features. In
      the infection group, myoglobinuria tended to progress more rapidly and was
      occasionally followed by acute renal failure. And some cases had additional
      associated conditions such as mental retardation or epilepsy. On the other hand,
      the exercise group had only myopathic symptoms. The difference in these clinical
      features between the two groups suggested that they had the different pathogenic
      mechanisms respectively.

PMID- 7781211
TI  - [Paroxysmal dystonic choreoathetosis with chronic hemolytic anemia and
      morphologically abnormal erythrocytes].
AB  - A 38-year-old man was admitted to our hospital because of paroxysmal involuntary
      movement. He had a normal birth and normal development. No other members of his
      family had similar symptoms. He had attacks of choreoathetoic involuntary
      movement without loss of consciousness since about 11 years of age. Paroxysmal
      choreic movement occurred once or twice a month and lasted for 30 minutes to 4
      hours. The attacks were intractable with phenytoin, phenobarbital, valproic acid,
      etc. He had slight disturbance of visual acuity due to toxoplasmosis and low
      intelligence (IQ 59, WAIS-R test). There were no other abnormal findings on
      general and neurological examinations. He was diagnosed as paroxysmal dystonic
      choreoathetosis (PDC) because of the typical attacks of paroxysmal choreic
      movement. He had macrocytic anemia with elliptocytes (13%) and stomatocytes (12%)
      but no acanthocytosis. There were increased reticulocytosis and low level of
      haptoglobin. Bone marrow aspiration showed increased erythroblasts. However,
      other hemolytic findings including bilirubin levels, Coombs test, osmolality
      tolerance test were normal. Biochemical analyses of erythrocyte membrane proteins
      and lipids, glycolytic enzymes activities and intermetabolites contents showed no
      abnormality. EEG revealed slow waves without abnormal paroxysmal discharges, and
      CT revealed no abnormal calcification. T2 weighted MRI showed bilateral multiple
      high intensity spots in the subcortical area, but no atrophy of the caudate
      nucleus. The pathogenesis of PDC is still unknown. In the present case, we
      suspect that a biochemical defect which had not been disclosed might result in
      abnormal erythrocyte membrane and PDC.

PMID- 7781212
TI  - [A case of secondary carnitine deficiency due to anorexia nervosa and severe
      liver damage].
AB  - We reported an 18-year-old woman with anorexia nervosa and liver damage who
      showed carnitine deficiency. Her unbalanced diet had little carnitine, and
      severely damaged liver could not synthesize carnitine. Since total parenteral
      nutrition (TPN) and tube-feed formulas contain little or no carnitine, the
      patient had progressive weakness and muscle atrophy. Muscle biopsy revealed
      variability of fiber diameter, type 1 fiber atrophy and copious amount of lipid
      granules. Carnitine deficiency must be diagnosed in the early stage by muscle
      biopsy or muscle carnitine levels, and treated with oral intake of L-carnitine.

PMID- 7781213
TI  - [A case of localized hypertrophic neuropathy in the sciatic nerve].
AB  - A 26-year-old male patient gradually developed muscular atrophy of the right
      lower leg over a two-year period. Neurological examination revealed absent
      Achilles tendon reflex and muscular atrophy of the right lower leg and right
      hamstring muscles. Conduction velocity of the F waves was delayed in the right
      posterior tibial nerve. A computerized tomography scan and magnetic resonance
      imaging revealed a mass lesion along the proximal segment of the right sciatic
      nerve. Exploration revealed a fusiformly swollen sciatic nerve. Histological
      examination showed that a swollen segment of the sciatic nerve was filled with
      onion-bulb formations of perineurial cells, consistent with the diagnosis of
      localized hypertrophic neuropathy. This condition should be added to several
      etiologies of monomelic amyotrophy. Electrophysiological studies and neuroimaging
      techniques were useful in obtaining differential diagnosis.

PMID- 7781214
TI  - [A case of acute sensory neuropathy].
AB  - We report a 50-year-old man who developed sensory neuropathy of acute onset. It
      affected position and vibration senses very severely, and superficial sensations
      mildly. There were athetoid movements of the outstretched left arm when the eyes
      were closed. The upper limbs were more severely affected than the lower limbs.
      There was no weakness or atrophy in the limb muscles. Nerve conduction study and
      somato-sensory evoked potential showed normal function of motor nerves and
      axonopathy of the sensory nerves. Sural nerve biopsy disclosed fibrosis and
      marked loss of myelinated fibers, especially of large ones, and many fibers with
      myelin balls in teased preparations, indicating severe axonopathy.
      Electronmicroscopy confirmed severe degeneration and loss of myelinated axons
      with abundant myelin figures in schwann cells. There were no malignancy or other
      diseases that could cause sensory neuropathy, and he was diagnosed as having
      acute sensory neuropathy (ASN) of Windebank et al. ASN, a distinct syndrome
      characterized by axonal type neuropathy, should be segregated from acute and
      chronic inflammatory demyelinaiting neuropathies although the clinical features
      and CSF findings look alike.

PMID- 7781215
TI  - [Sequential neuroimaging in a patient with delayed post-hypoxic
      leukoencephalopathy].
AB  - We described a patient with delayed cerebral demyelination following a post
      operatively hypoxic encephalopathy. A 65-year-old man, with a history of exposure
      to the atomic bomb at Hiroshima in 1945, suffered from hypoxia, hypotension and
      respiratory acidosis and became unresponsive 10 hours after a laminectomy for
      lumbar disc herniation, in December 1993. Following an emergent resuscitation,
      the patient had gradually recovered and could walk 2 weeks later. Three weeks
      after the insult, however, the patient developed an apallic state with frontal
      lobe signs. Except an increased level of myelin basic protein in the CSF, there
      were no other abnormal laboratory findings. Brain CTs showed a leukoaraiosis. MRI
      one month post-operation, demonstrated extensive high signal intensity areas in
      the cerebral white matter on T2-weighted image, and a gadolinium-enhanced spotty
      lesion in the right globus pallidus on T1-weighted image. Three months after the
      operation, the high signal intensity on T2-weighted image became more intensive
      and extensive, while the enhanced spotty lesion in the globus pallidus
      disappeared. The corpus callosum and cerebellar white matter were spared
      throughout the observation. The SPECT using 123I-IMP showed a hypoperfusion in
      the frontal lobe at 1 month. Three months later, the hypoperfusion areas extended
      to the whole cerebral and cerebellar cortices, relatively less affected in the
      motor area and basal ganglia. The patient had improved slightly over the next few
      months. We speculate that subclinical vulnerability in the white matter secondary
      to exposure to the atomic bomb, in addition to the incomplete prolonged hypoxia,
      hypotension and acidosis, caused selective cerebral demyelination in this
      patient.

PMID- 7781216
TI  - [Acute leukoencephalopathy in Filipino women--report of two cases].
AB  - Two cases of acute leukoencephalopathy are reported. Both patients were Filipino
      women who had lived together in Japan for one month at the time of the onset. The
      first patient, 26 years old, suddenly developed right hemiplegia without fever.
      Small, high signal intensity lesions of the cerebral white matter were
      disseminated on T2-weighted magnetic resonance images. One week later, the
      patient became delirious, developed seizures, and lapsed into a comatose state
      with spastic quadriplegia. Corticosteroid was administered, resulting in
      improvement of consciousness levels. The patient was transferred to our hospital.
      Neurological examination disclosed severe pseudobulbar palsy and spastic
      quadriplegia without meningeal signs. Results of a cerebrospinal fluid
      examination were unremarkable. With magnetic resonance imaging, large irregularly
      shaped lesions were seen in both centrum semiovale as high signal intensity areas
      on T2-weighted images and low signal intensity areas on T1-weighted images.
      Concentric structures in the lesions were particularly observed on T1-weighted
      images. One year later, the patient improved from a bedridden state to a wheel
      chair bound state. The second patient, 23 years old, also developed right
      hemiplegia one week after the onset of the first case. MR imaging revealed small
      disseminated lesions in the cerebral white matter similar to those disclosed in
      the first case. From the onset, the patient was given corticosteroid, and
      experienced good recovery within one month. The clinical features, results of the
      laboratory examination, and MRI findings particularly in the first case suggest
      the diagnosis of so-called Balo's concentric sclerosis, despite the absence of
      pathological confirmation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781217
TI  - [MR imaging of the anterior spinal artery in a case of bilateral vertebral
      arterial occlusion].
AB  - A 66-year-old woman, who had been suffering from frequent episodes of vertebro
      basilar insufficiency for 10 years, was admitted because of brainstem ischemic
      symptoms. Magnetic resonance (MR) images were almost normal, but small flow voids
      were observed in front of the medulla oblongata and the upper cervical spinal
      cord. Cerebral angiography revealed that both of the vertebral arteries were
      completely occluded after branching off the respective posterior inferior
      cerebellar arteries. The basilar artery was fed only by a retrograde collateral
      flow via the anterior spinal artery which, arising from the left vertebral artery
      at the level of the fifth to sixth cervical vertebra, ascended the ventral aspect
      of the cord. These findings clarified that the flow voids on the MRI were from
      the anterior spinal artery, and were unusually prominent, as a collateral flow to
      the basilar artery. To the best of our knowledge, an anterior spinal flow void
      found on routine brain MR imaging has not been documented in the literature. Our
      case suggested that the flow void, a very small finding on the MRI, could be a
      useful sign in the diagnosis of serious vertebral arterial diseases.

PMID- 7781218
TI  - [Clinicopathological report of cisplatin encephalopathy].
AB  - A 61-year-old woman was treated with cisplatin and etoposide for ovarian
      carcinoma. After the second course of chemotherapy she developed acute
      encephalopathy which manifested itself as headache, fever, a partial seizure,
      confusion, and mild right hemiparesis, although no evidence of a central nervous
      system infection was found. Ten days after the onset of neurological symptoms,
      she experienced a sudden loss of vision in both eyes. Neurological findings were
      compatible with cortical blindness. Neurological symptoms subsided and visual
      acuity completely returned over the next months. The total cumulative dose of
      cisplatin was 325 mg/m2. She died of aspiration pneumonia on the 43rd day.
      Postmortem examination revealed severe nerve cell loss, gliosis and spongy
      changes in the bilateral occipital cortex including visual field, and slight to
      moderate demyelination in the subcortical white matter of the occipital cortex,
      Goll's tract, and dorsal root ganglia. As far as we know this encephalopathy is
      the second report in which the neuropathological changes associated with
      cisplatin therapy have been demonstrated by autopsy findings. The first was a
      case report of leukoencephalopathy, which differed significantly from our case in
      the primary lesions of the brain. We measured the platinum level in several parts
      of the cerebrum and cerebellum, optic nerve, spinal cord, and cauda equina by
      using an atomic absorption spectrophotometric technique. Platinum was detected in
      the bilateral occipital cortex, spinal cord, and cauda equina. These results were
      consistent with the distribution of pathological lesions. The mechanism of
      cisplatin-induced focal encephalopathy remains speculative.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7781219
TI  - [A case of facial diplegia in associated with reactivation of herpes simplex
      virus type I].
AB  - A 27-year-old Japanese man developed right peripheral facial palsy after
      suffering from a cold and low-grade fever for 7 days. Left peripheral palsy
      developed 4 days later. When he visited our hospital 3 days after that,
      neurological examination revealed no abnormalities except peripheral facial
      diplegia. Cerebrospinal fluid (CSF) was normal on admission and on hospital day
      12. On admission, the patient had a transient increase of serum titers of HSV
      type I IgM (fluorescence assay). Then, serum titers of HSV type I IgG (ELISA)
      continuously increased. A diagnosis of peripheral facial diplegia due to
      reactivation of HSV type I was made clinically and serologically. Steroid pulse
      therapy was performed and his facial diplegia disappeared completely after 2
      weeks. This case may support the hypothesis of virus etiology of Bell's palsy,
      and HSV type I should be considered as one of the possible causes of facial
      diplegia.

PMID- 7781220
TI  - [The relationship among hematocrit, platelet aggregation and the time of onset in
      patients with acute stage-cerebral infarction].
AB  - We evaluated time relation among hematocrit (Ht), platelet aggregation (PA) and
      the onset of acute stage-cerebral infarction in 221 patients. Lacunar infarctions
      were likely to occur in the evening or at midnight. The elevated Ht value was
      frequently found in patients with infarctions occurring at midnight, suggesting
      that the elevation of blood viscosity has an intimate etiology to the onset. The
      decrease of PA was often found in those who suffered from their stroke while
      awake in the morning or at midnight, and frequently had been associated with
      elevated Ht in the latter patients. Decrease of PA is often reported during acute
      stage-cerebral infarction. Our results indicate that increased platelet
      aggregation may play an important role in developing cerebral infarction,
      especially in those who had onset of illness in the morning.

PMID- 7781221
TI  - [Sensory nerve conduction velocity determined by somatosensory evoked potentials
      in patients with hereditary motor and sensory neuropathy type I].
AB  - We evaluated sensory nerve conduction velocity (SCV) determined by somatosensory
      evoked potentials (SEPs) components in 2 cases of hereditary motor and sensory
      neuropathy whose sensory nerve action potentials (SNAPs) were not evoked. SEPs
      elicited by median or ulnar nerve stimulation at the wrist or elbow were recorded
      from 5 scalp electrodes with ear reference. In both cases, no parietal N20 or
      frontal P20 component was identified, but a clear parietal P27 component was
      noted. The onset latency of the P27 component elicited by wrist or elbow
      stimulation was identified as the point where the superimposed 5 waves diverged.
      Then, the SCV was obtained by dividing the distance between the wrist and elbow
      by the onset latency difference. Tibial SCV was also determined by a similar
      method in one patient. The SCVs of the median, ulnar and tibial nerves were
      markedly decreased but 10-30% faster than the motor nerve conduction velocities
      measured concomitantly. We showed that a multichannel scalp recording of SEPs
      makes it possible to determine the onset latencies of the cortical components.
      So, SEP testing should be applied to obtain the SCVs in patients whose SNAPs were
      unrecordable.

PMID- 7781222
TI  - [Vasomotor impairment in patients with diabetic neuropathy--evaluation by laser
      Doppler flowmetry].
AB  - Using laser Doppler flowmetry, we evaluated cutaneous microcirculation in 28
      patients with diabetic neuropathy and 18 control subjects. Skin blood flow in the
      hand was significantly reduced in the patients compared with that in age-matched
      controls. Skin blood flow in the hand of the patients correlated significantly
      with the amplitude of sensory nerve action potential of the median nerve.
      Significant correlation was shown in the patients between skin blood flow in the
      hand and changes in systolic blood pressure on standing from a supine position.
      However, there was no correlation between skin blood flow in the hand and
      variation in the R-R interval. These results suggest that the skin blood flow may
      decrease with the progression of diabetic neuropathy, particularly sympathetic
      autonomic neuropathy, and that neural control may be an important factor in the
      regulation of skin blood flow. Cold water immersion test revealed that there was
      no significant difference in vasoconstrictive response during the cold challenge,
      while recovery time of vasodilatory response after withdrawal of the thermal
      challenge was significantly prolonged in the patients as compared with that in
      the controls. In addition, it is suggested that the patients with a small
      increase or normal in skin blood flow of the hand may possess abnormalities
      predominantly in vasoconstrictive tone, whereas the patients with a decrease in
      skin blood flow of the hand in vasodilatory tone. Consequently, microcirculation
      in skin of extremities changes under the balance of vasoconstrictive and
      vasodilatory tones in patients with diabetic neuropathy.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7781223
TI  - [A case of carpal tunnel syndrome caused by a ganglion cyst--diagnosis and follow
      up study with magnetic resonance imaging].
AB  - We report a case of carpal tunnel syndrome (CTS) caused by a ganglion cyst which
      was diagnosed by magnetic resonance (MR) imaging of the left wrist. MR images
      depicted a 10-mm ganglion cyst which pressed the median nerve toward the ulnar
      side. The ganglion cyst was punctured under direct endoscopic visualization in
      the carpal canal, subsequently the clinical and the electrophysiologic findings
      of CTS improved. The median nerve was delineated in its proper position. MR
      imaging of the wrist, a noninvasive means to observe median nerve, is useful for
      the diagnosis and the follow-up study of CTS.

PMID- 7781224
TI  - [Siblings of early onset cerebellar ataxia with hypoalbuminemia].
AB  - Recently, a new syndrome of early onset cerebellar ataxia with hypoalbuminemia
      (EOCA-HA) was reported in Japan. The clinical features of EOCA-HA overlap with
      those of Friedreich's ataxia (FA), and primary hypoalbuminemia is a
      characteristic laboratory finding of this syndrome. Genetic linkage analysis of
      EOCA-HA including this newly reported family revealed that the gene for EOCA-HA
      is located on the long arm of chromosome 9 as FA. However, several recombination
      events were observed between D9S15 in EOCA-HA, whereas no recombination events
      were seen in FA. We report on two siblings with EOCA-HA and discuss the clinical
      and laboratory features. The patients were a 25-year-old man (patient 1) and a 23
      year-old man (patient 2). Their parents marriage was non-consanguineous. The mode
      of inheritance is compatible with autosomal recessive mode. Clinically, they
      showed cerebellar ataxia as the initial symptom in the late infantile period and
      subsequently showed choreoathetosis and ocular motor apraxia at the age of
      approximately fifteen years. Deep tendon reflexes were reduced in late infancy
      and finally disappeared. Amyotrophy and sensory impairment of the legs developed
      at approximately twenty. Abnormal electrocardiogram and diabetes mellitus were
      not observed. On X-ray CT scan or MRI, the cerebella of both patients were mildly
      atrophic. Clinical features in these siblings were indistinguishable from those
      of ataxia telangiectasia, but immunodeficiency syndrome was absent.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7781225
TI  - [Hemorrhagic cerebral infarction at the old age in a case with familial
      antithrombin III (ATIII) deficiency].
AB  - An old woman had stroke at age 67. Cerebral CT scan disclosed the low-density
      lesion with high-density area in the left temporal lobe, but no empty delta sign
      in the superior sagittal sinus. Thereafter, she had sometimes panic attacks. At
      the age of 70, she was admitted because of loss of consciousness probably caused
      by the same attack. On admission, Brain CT scan showed no fresh lesions. During
      the stay in the hospital, she had an episode of deep vein thrombosis of her left
      leg. The patient was found to have not only reduced biochemical activity but also
      low immunological level of AT III. Her nephew had also the low plasma AT III
      antigen concentration. Transesophageal echocardiography showed no abnormality,
      but atherosclerotic change at the aortic arch. We speculated that hemorrhagic
      cerebral infarction in the territory of the branch of middle cerebral artery
      could be induced by the arterial thrombus which was related to the
      hypercoagulable state associated with familial AT III deficiency, although the
      possibility of cardiogenic embolic infarction or of cerebral vein thrombosis
      could not be ruled out. Familial AT III deficiency is one of the causes of
      cerebral infarction even in the elderly.

PMID- 7781226
TI  - [MRI study of degenerative process in multiple system atrophy].
AB  - The characteristic morphological changes of the brainstem and cerebellar regions
      of multiple system atrophy (MSA) were studied by MRI in varying subtypes, that is
      olivoponto cerebellar atrophy (OPCA: 23 cases), striatonigral degeneration (SND:
      7 cases) and Shy-Drager's syndrome (SDS: 9 cases). OPCA was characterized by
      atrophy of the entire regions of the brainstem and the cerebellum. SND and SDS
      tended to show atrophy similar in type but lessin extent to OPCA. The common
      lesions in MSA were atrophy of the pontine base and cerebellum, and dilation of
      the fourth ventricle. Atrophy of the pontine base was more dominant in the
      inferior part than in the superior part, and cerebellar atrophy was more dominant
      in the superior part than in the inferior part, indicating that degeneration of
      the pontocerebellar pathway proceeds principally along fibers connecting the
      inferior part of the pons and the superior part of the cerebellum. Dilation of
      the fourth ventricle indicated atrophy of the middle cerebellar peduncle. In
      almost all the cases of OPCA and about a half the cases of SND and SDS, the
      pontine base and the middle cerebellar peduncle appeared as high signal intensity
      on T2 weighted image and as low intensity on T1, suggesting degeneration and
      demylination. In a few cases of OPCA, the dorsolateral part of the putamen were
      demonstrated as low signal intensity on T2 weighted image.

PMID- 7781227
TI  - [Clinical subtypes of essential tremor and their electrophysiological and
      pharmacological differences].
AB  - We divided 19 patients with essential tremor into two subtypes according to
      clinical characteristics of the tremor. Ten patients had pure postural tremor
      distributed in the hand(s), head, and face (group A). Nine patients had tremor
      extending to the voice or leg(s), associated with resting tremor and/or
      hyperkinesie volitionnelle of the hand(s) (group B). Their ages, the age of
      onset, and the duration of illness were not different between the two groups.
      Electrophysiologically, the tremor of group A patients had higher frequencies
      than that of group B patients, and had synchronized activities for antagonistic
      muscles. Four of group B patients had reciprocal antagonistic activities of the
      tremor. Inactive phase of tremor induced by an electrically-evoked muscle twitch
      was invariably within the range of the physiological silent period for group A
      patients, and prolonged beyond the range for four of group B patients.
      Pharmacologically, 78% of group A patients responded well to beta-blocker, which
      was effective for 25% of group B patients. Sixty per cent of beta-blocker
      resistant group B patients responded well to phenobarbital. In conclusion, a
      peripheral mechanism, presumably beta-adrenergic drive, is important for the
      tremor in group A patients, while central pathogenic mechanisms are more
      important for the tremor of group B patients.

PMID- 7781228
TI  - [Scoliosis in the patients with both severe mental retardation and severe
      physical disability--computed tomography of paraspinal muscles].
AB  - Patients with both severe mental retardation and severe physical disability, so
      called "jushouji", often have scoliosis as one of the complications. The
      correlation between radiological findings of paraspinal muscles and progression
      of scoliosis was investigated by computed tomography (CT) in 15 patients. We took
      the CT of paraspinal muscles at the apical vertebral level in each patient, and
      measured the size of cross-sectional area and the CT value of paraspinal muscles
      of the both concave and convex side. There was no significant difference of the
      size of cross-sectional area of the muscles between the convex and concave side.
      The average CT value of the muscles was normal on the convex side, but abnormally
      lower on the concave side. Scattered low density areas were recognized in the
      fascicles of both sides like moth eaten appearance, which was speculated as fatty
      tissue. The CT value of remaining muscles was within normal range. The CT value
      on the concave side became lower as the degree of scoliosis progressed. The group
      who could not keep sitting position independently showed lower CT value on the
      concave side and had more severe scoliotic curves than the group who could sit
      independently or with slight support. From the above results, it may be concluded
      that the paraspinal muscles of the concave side become secondarily atrophic due
      to disuse, and may not be responsible for the progression of the scoliosis.

PMID- 7781229
TI  - [The "pseudo-polyneuropathy" type sensory disturbances in cervical spondylotic
      myelopathy].
AB  - We reported the pseudo-polyneuropathy type sensory disturbances in cervical
      spondylotic myelopathy. We defined this clinical type by objective superficial
      sensory deficits of all four distal limbs, and excluded the patients having only
      subjective sensory disturbances. Ten out of 61 patients with cervical spondylotic
      myelopathy had sensory disturbances of this type. Two patients noticed difference
      of the subjective sensations of the upper and lower limbs. Eight patients
      developed sensory symptoms initially in the upper limbs. Pin-prick sensation was
      diminished in the upper limbs more predominantly than in the lower limbs.
      Vibration sense was affected in the lower limbs predominantly. Motor functions
      were mildly impaired, and muscle stretch reflex of triceps brachii was preserved
      in all ten patients. Distribution of sensory disturbances of four patients
      changed in their course. Nerve conduction studies and F-wave latencies were
      normal. Electromyography showed mild chronic denervation of the C5-C7 innervated
      muscles. Somatosensory evoked potentials after median or ulnar nerve stimulation
      showed delayed latencies or attenuated waveforms of N13 as well as P14 peaks.
      Spinal cord was compressed mainly at C4/5 and C5/6 intervertebral level, shown by
      myelography, CT-myelography or magnetic resonance imagings. We conclude that the
      pseudo-polyneuropathy type sensory disturbance of cervical spondylotic myelopathy
      indicates the lesion at mid-to-low cervical vertebral level. The anatomical
      substrates for this type of sensory impairment could be caused by combination of
      the dorsal horn/anterior comissure lesions for the upper limbs, and the
      anterolateral funiculi lesions for the lower limbs.

PMID- 7781230
TI  - [Clinical difference between "proximal" and "distal" type of cervical spondylotic
      amyotrophy].
AB  - We studied 31 patients with cervical spondylotic amyotrophy. Weakness and atrophy
      without prominent sensory changes were started from the proximal muscles in 16
      patients (proximal type), and from the distal muscles in 15 patients (distal
      type). In both types, the age at onset of neurological symptom ranged from
      thirties to sixties, and men were more frequently affected than women. Distal
      type patients often presented cold paresis and/or postural finger tremor, which
      occasionally was the initial symptom. Two patients of proximal type had muscular
      atrophy extended to the distal end. None of distal type patients had extension of
      atrophy to the proximal muscles during a long course of their illness. Most
      patients of proximal type had neurogenic changes on electromyography extended to
      the distal muscles. Neuroradiologically, proximal type patients had a cord
      atrophy at C4/5 intervertebral level, and distal type had cord atrophy at
      C5/6,6/7. We assume that the responsible lesion for the cervical spondylotic
      amyotrophy is in anterior horn at C5-T1 cord level for the proximal type, and at
      C7-T1 for the distal type. Abnormal venous circulation within the cord may cause
      the selective involvement of the gray matter.

PMID- 7781231
TI  - [Analysis of gait disturbance in a patient with corticobasal degeneration].
AB  - A 64-year-old right-handed man was admitted because of increasing clumsiness of
      the right hand and difficulty in walking since 8 months earlier. The WAIS
      revealed verbal IQ 124, performance IQ 104 and full scale IQ 115. Neurological
      examination revealed slight dysarthria and normal eye movements. The right upper
      extremity showed Gegenhalten, tremor, dystonic elbow flexion, marked grasp
      reflex, grasping and groping behavior. Voluntary movements were slow and clumsy
      on the right side. However, neither ideational nor ideomotor apraxia was
      observed. Tendon reflexes were slightly exaggerated on the right side. Plantar
      responses were normal. The patient had difficulty in initiating forward walking
      and turning movements. Once started, he walked dragging his right foot ahead of
      the left with short steps. A line on the floor was of no benefit. He could not
      stride across the line on the floor in front of him. Analysis of gait with floor
      reaction force revealed that the single step rhythm of his frozen gait was about
      1.5 Hz, which contrasted with the high frequency seen in Parkinson's disease. MRI
      demonstrated atrophy of the frontal and parietal lobes on both sides. 123I-IMP
      single-photon emission CT demonstrated severe hypoperfusion of the left frontal
      and parietal lobes. Frozen or shuffling gait is a popular symptom as well as
      unsteady gait and tendency to fall in corticobasal degeneration. It may result
      from the frontal lobe dysfunction. Lack of improvement in freezing by the visual
      input contrasts with Parkinson's disease and may be related to dysfunction of the
      mesial part of the frontal lobe or the parietal lobe involved in corticobasal
      degeneration.

PMID- 7781232
TI  - [An autopsy case of intravascular malignant lymphomatosis with intracranial
      lymphomatous mass lesions].
AB  - A 50-year-old man was admitted to our hospital, because of weakness in his right
      leg. On admission, he had generalized hyperreflexia and positive Babinski signs
      bilaterally. After admission, weakness in his left leg and confusion developed. A
      cerebrospinal fluid examination revealed increases in cell counts and protein but
      was negative for malignant cells. Blood chemistry was normal except for elevated
      LDH. A bone marrow biopsy yielded lymphoma cells. Successive T2-weighted cranial
      MRI showed a progressively expanding high signal area in the right parieto
      occipital lobe. His confusional state improved after chemotherapy; however, two
      months later another cranial CT showed multiple enhanced mass lesions. The
      patient died 20 months after the onset of illness. Postmortem examination
      revealed widespread intravascular aggregates of malignant lymphomatous cells in
      the cerebrum, lungs and kidney, as well as multiple infarcts without
      atherosclerosis in the cerebrum. These pathological findings are compatible with
      those of intravascular malignant lymphomatosis. In addition, extravascularly
      expanding tumor cells formed multiple nodular lesions in the cerebral hemisphere.
      An immunohistochemical study showed that the tumor cells were positive for B-cell
      marker L26. Intracranial lymphomatous mass lesion rarely occurs in cases of
      intravascular malignant lymphomatosis. In the present case, tumor cells were
      presumably restricted to intravascular spaces, occluded them and resulted in
      ischemic lesions in the cerebrum in the early phase, but they expanded
      extravascularly and developed mass lesions in the terminal stages. In conclusion,
      intravascular malignant lymphomatosis is considered to be phenotypes of malignant
      lymphoma. This is the first case of intravascular malignant lymphomatosis
      associated with intracranial lymphomatous mass lesions in Japan.

PMID- 7781233
TI  - [A case of "apraxia of eyelid opening" secondary to right hemisphere infarction-
      assessment of various symptoms of the eye and eyelid].
AB  - A 68-year-old right-handed woman showed "apraxia of eyelid opening" during an
      acute phase of hemorrhagic infarction in the right middle cerebral artery
      distribution. She showed paradoxical contraction of the bilateral orbicularis
      oculi muscles both against our order to open her eyes and even against her hand
      movement to help her eyes open, although she could voluntarily open her eyes. She
      was diagnosed as "apraxia of eyelid opening". Her eyes kept closed in most of
      time. Spontaneous blepharospasm and a right conjugate gaze preference were also
      seen. These symptoms disappeared 2 weeks after the hemorrhagic infarction.
      Because most of cases in previous reports as well as this patient showed "apraxia
      of eyelid opening" after a right cerebral involvement, we propose that this
      symptom may attribute to right cerebral dysfunction.

PMID- 7781234
TI  - [Development of Wernicke's encephalopathy during the period of oral food intake
      after a subtotal colectomy for ulcerative colitis].
AB  - A 61-year-old woman was hospitalized because of ulcerative colitis which had
      caused fever, vomiting and diarrhea since June 16, 1992. Then she developed toxic
      megacolon, and was transferred to our hospital on the 1st of July and underwent
      subtotal colectomy the same day. After surgery, she received intravenous
      hyperalimentation (IVH) which contained 1,000 Kcal/day without vitamin
      supplementation. From the 8th to the 13th post-operative days, she took 3/4 or
      more of the liquid diet which contained 1,050 Kcal, protein 35 g, carbohydrate
      166 g and vitamin B1 0.59 mg per day. From the 14th to the 23rd post-operative
      days, she ate 4/5 or more of the oral diet which contained 1,700 Kcal/day,
      protein 68 g, carbohydrate 236 g and vitamin B1 0.93 mg per day. During the 7th
      to the 23rd day, the IVH was reduced to 800 Kcal and then 500 Kcal per day. She
      talked less on the 19th post-operative day, and in a few days, her level of
      consciousness began to decline progressively. On the 27th post-operative day,
      neurological examinations revealed the following: semi-coma, almost fixed pupils
      which were 3 mm in diameter, absent doll's eye movement to all directions,
      flaccid extremities with abolished deep tendon reflexes. Pertinent abnormalities
      on laboratory data at that time consisted of hemoglobin 7.8 g/dl and serum total
      protein 5.4 g/dl. Lumbar puncture revealed normal cerebrospinal fluid under
      normal opening pressure. Cranial magnetic resonance imaging (MRI) taken on the
      27th post-operative day demonstrated, on T2-weighted images, symmetrical high
      intensity lesions in the periventricular areas of the third and fourth
      ventricles, and periaqueductal area of the midbrain.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7781235
TI  - [Cerebral blood flow and metabolism in Lafora disease].
AB  - An 18-year-old male manifesting intellectual deterioration and negative myoclonus
      was diagnosed as Lafora disease by the demonstration of Lafora bodies in the skin
      and muscle biopsy. The cortical evoked potential to electric stimulation of the
      median nerve at wrist showed the giant SEP, suggesting hyperexcitability of the
      sensory motor cortex. Cerebral blood flow, and cerebral glucose and oxygen
      metabolism were investigated by positron emission tomography (PET) in order to
      clarify the pathophysiological process in Lafora disease. The result showed
      diffusely decreased cortical glucose metabolic rate and cerebral blood flow, and
      moderately lowered oxygen metabolic rate. There was no increase in blood flow or
      glucose and oxygen metabolism in the sensorimotor cortex in spite of the presence
      of giant SEP. The ratio of the glucose to oxygen metabolism was not different
      from the mean value obtained from nine normal subjects. Based on these findings
      and review of the literature, it is unlikely that there is a significant deficit
      in cortical energy metabolism in patients with Lafora disease and it would be
      less plausible to have some enzymatic deficits in glucose metabolic process.

PMID- 7781236
TI  - [Neuroleptic malignant syndrome associated with the syndrome of inappropriate
      secretion of antidiuretic hormone].
AB  - We reported a case of neuroleptic malignant syndrome (NMS) associated with the
      syndrome of inappropriate secretion of antidiuretic hormone (SIADH). A 71-year
      old woman, who had been diagnosed as hypertension and multiple cerebral
      infarction, was given sulpiride 150 mg daily for depressive state. Three days
      after started sulpiride, she developed fever, sweating, difficulty of movement
      and was admitted to the hospital. The white blood cell count rose to 16,300/mm3
      and serum creatine kinase (CK) to 3,063 IU/L. Two days later CK rose to 20,050
      IU/L regardless of stopping the drug, so she was transferred to our hospital for
      further investigation. On admission, it was the 6th day from the onset, she was
      mute and akinetic accompanied by muscle pain and rigidity in extremities. Serum
      CK was 1,831 IU/L, Na 122 mEq/L, osmolality 244 mOsm/kg, plasma antidiuretic
      hormone (ADH) level 6.5 pg/ml and urine Na was 101 mEq/L, osmolality 467 mOsm/kg.
      Renal and adrenal functions, plasma renin activity were normal. From the history,
      course and these data, diagnosis of NMS associated with SIADH was made.
      Intravenous sodium (130-200 mEq/day) and fluids (1,000-1,200 ml/day) were
      carefully infused. She became active, muscle pain disappeared and rigidity,
      akinesia decreased. CK, serum Na and osmolality gradually improved to normal.
      About the transient increase in ADH secretion, we considered that hypothalamic
      disturbance in NMS might induce leakage of stored ADH from neuroendocrine neurons
      in it.

PMID- 7781237
TI  - [Complete deficiency of adhalin (50 kDa DAG) in skeletal muscle of malignant limb
      girdle muscular dystrophy].
AB  - Malignant limb-girdle muscular dystrophy was first described by Miyoshi and co
      workers in 1966, and has clinical features similar to Duchenne muscular dystrophy
      but is inherited through an autosomal recessive trait. This paper describes a
      patient with malignant limb-girdle muscular dystrophy with complete deficiency of
      adhalin (50 kDa dystrophin-associated glycoprotein (DAG)) in skeletal muscle. The
      patient was an 11-year-old Japanese girl whose parents were cousin. She learned
      to walk at one year and 3 months of age. Her gait became unsteady at 3 years of
      age, and motor dysfunction in the lower extremities progressed thereafter. At 8
      years of age, she had difficulty in standing up from a sitting position, but
      could walk without assistance. At 11 years, she could walk with support, but
      could not stand up without assistance. Her intelligence was normal. Muscle
      atrophy was not apparent due to obesity, but her calves appeared hypertrophic.
      She had generalized muscle weakness, predominantly in the pelvic girdle muscle.
      Muscle tone was slightly hypotonic, and deep tendon reflexes of the legs were
      absent or hypoactive. Her sensory system appeared normal. Serum creatine kinase
      level was elevated to 30 times above the upper limit of the normal range in the
      patient and normal in her parents. EMG showed a mild myopathic pattern. CT scan
      of muscle revealed marked low density in the upper legs and mild in the lower
      legs. Muscle histology showed muscle fiber necrosis with a small number of
      regenerating fibers. Opaque fibers were occasionally observed, but not as many as
      in Duchenne type. Fiber splitting was seen frequently.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7781238
TI  - [A case of Kearns-Sayre syndrome whose asymptomatic mother had abnormal
      mitochondria in skeletal muscle].
AB  - The mode of inheritance of Kearns-Sayre syndrome (KSS) and chronic progressive
      external ophthalmoplegia (CPEO) have not yet been established, since most cases
      are sporadic. We studied skeletal muscle pathology and mitochondrial DNA (mtDNA)
      in a sporadic KSS patient (proband) and examined mitochondrial function of the
      muscle in his asymptomatic family members. The proband was a 56-year-old male
      with bilateral ptosis, external ophthalmoplegia, retinal degeneration and cardiac
      conduction disturbance. Biopsied deltoid muscle showed 9.7% of ragged red fibers
      without cytochrome oxidase (COX) activity and abnormal mitochondria on electron
      microscopy. Analysis of muscle mtDNA revealed a 4,977 bp deletion between nt.
      8,483 and 13,459. None of the family members had symptoms similar to those of the
      proband. However, an aerobic exercise test of 15W for 15 minutes with an
      ergometer induced a marked increase in serum lactate levels in the proband's
      mother. Histology of her biopsied deltoid muscle showed 0.3% of ragged red fibers
      without COX activity and morphologically abnormal mitochondria. These findings
      indicate that the abnormal mitochondria of the proband were transmitted from his
      asymptomatic mother. This also suggests that some of the sporadic KSS/CPEO cases
      are inherited one.

PMID- 7781239
TI  - [Oncogenic osteomalacic myopathy; a case report].
AB  - A 54-year-old man with oncogenic osteomalacic myopathy was reported. He presented
      with gradual onset of muscle weakness and painful cramp of the bilateral
      quadriceps femoris muscles, followed by low inorganic phosphorus, elevated
      alkaline phosphatase in the serum and hyperphosphaturia. The electromyogram (EMG)
      revealed myogenic change localized in the quadriceps muscle and nerve conduction
      study was normal. Muscle biopsy of right vastus lateralis muscle demonstrated non
      specific myopathic change with minimal neuropathic change: moderate variation in
      size, many centrally placed nuclei, a few small angulated fibers and pyknotic
      nuclear clump. The ratio of Type IIA fibers decreased to 5.5%. Serum 25
      hydroxyvitamin D and parathormone were normal, whereas 1, 25-dihydroxyvitamin D
      was above lower normal limit. High dose of 1,25-dihydroxyvitamin D and phosphorus
      were administered with partial response. CT scan demonstrated tumor in the left
      10th rib proximal to the vertebra, invading into the mediastinum. Partial
      resection of the tumor was performed in order to preserve the rib.
      Histologically, the tumor was characterized by high vascularity with cystic
      formation, many giant cells and tumor cells with oval-shaped nuclei.
      Histopathological diagnosis was primitive mesenchymal tumor (mixed connective
      tissue variant). Immediately after resecting the tumor, the patient's muscle
      weakness and painful cramp was prominently relieved and serum inorganic
      phosphorus and tubular reabsorption of phosphorus became normal, in addition, 1,
      25-dihydroxyvitamin D was elevated within normal limit. EMG findings revealed
      normal motor nerve unit with normal recruitment pattern. Mild myopathy is
      relatively a common manifestation in patients with osteomalacia. On the other
      hand, osteomalacia is sometimes caused by tumors, many of which are benign
      mesenchymal tumors of bone or soft tissue origin.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7781240
TI  - [A sporadic dentatorubral-pallidoluysian atrophy (DRPLA) diagnosed by gene
      analysis].
AB  - We report a 48-year-old woman with dentatorubral-pallidoluysian atrophy (DRPLA).
      She is the only patient in her 15 family members in two generations. She
      developed cerebellar ataxia and epilepsy at age 43. On admission at 48, she
      showed mild dementia and choreic movement in her face and extremities as well as
      truncal and limb ataxia. Routine laboratory examinations were normal. The point
      mutations in the tRNALys gene of mitochondrial DNA specific for MERRF were not
      found. A cranial CT scan and MRI showed mild atrophy of the cerebellum and
      prominent atrophy in the pons, especially in the tegmentum. Although she was
      thought to have DRPLA from the clinical point of view, absence of family history
      made the diagnosis difficult. Her parents were healthy until their 80's and died
      of cerebrovascular diseases and her 5 siblings had no symptoms. Hereditary DRPLA
      is known as an autosomal dominant disorder, with a high rate of penetrance and
      low rate of new mutation. According to our recent findings of a CAG repeat
      expansion in the DRPLA gene, this patient was diagnosed as a sporadic DRPLA.
      Considering the wide varieties of clinical manifestations, it is essential to
      examine this gene abnormality for diagnosing sporadic DRPLA.

PMID- 7781241
TI  - [A case of rigid spine syndrome with congenital cardiac abnormality of sinus
      venosus defect].
AB  - A 28-year-old male with a rigid spine syndrome who had congenital cardiac
      abnormality of sinus venosus defect was described. The patient was admitted to
      our hospital because of easy fatigability and palpitation. At the age of 4 years,
      he had an operation for his congenital cardiac abnormality and developed
      persistent atrial fibrillation thereafter. On neurological examination, he had
      average mentality, rigid spine with joint contractures, especially in the left
      elbow joint, and winged scapulae. He had marked muscle weakness and atrophy,
      predominantly in the left half of the extremities and trunk. Electromyographic
      studies demonstrated myopathic with partial neurogenic changes. Motor and sensory
      nerve conduction velocity was normal. A muscle biopsy specimen obtained from the
      right rectus femoris showed some marked hypertrophic and atrophic muscle fibers,
      with prominent internal nuclei, fiber splitting and pyknotic nuclear clump. ATP
      ase stain showed type 2B fiber deficiency, increased number of type 2C fibers and
      fiber type grouping.

PMID- 7781242
TI  - [Guillain-Barre syndrome associated with anti-GalNAc-GD1a antibody subsequent to
      Campylobacter jejuni enteritis].
AB  - We report a 15-year-old man with Guillain-Barre syndrome (GBS) following
      Campylobacter jejuni enteritis. Neurologic examination revealed distal muscle
      weakness and mild disturbance of superficial sense on right plantar area. Serial
      electrophysiologic studies indicated that the predominant process was axonal
      degeneration of motor nerves. Thin-layer chromatography with immunostaining
      revealed that serum IgG strongly reacted with GalNAc-GD1a and weakly with GM2,
      but did not react with GM1. This is the first report of GBS subsequent to C.
      jejuni enteritis associated with anti-GalNAc-GD1a antibody.

PMID- 7781244
TI  - [A case of spastic paraparesis, mental retardation and thinning of corpus
      callosum].
AB  - There are several reports of the patients who have peculiar clinical
      presentation, that is, spastic paraparesis, mental disturbance and thinning of
      corpus callosum. We presented a sporadic case with similar symptoms. He was born
      by normal vaginal delivery without problems from consanguineous parents. His
      development had delayed since his infantile period. He started to have spasticity
      of the legs at the age 13 years and it worsened with advancing age. On
      examination at age 19, he was mentally slow, his full-scale IQ being 35. The tone
      in the arms was slightly increased and marked in the legs. The finger to nose
      test caused mild dysmetria. Rest of the neurological examinations were normal.
      MRI demonstrated characteristic thinning of corpus callosum, dominant in anterior
      portion. In addition, it showed wide cavum vergae and cavum septi pellucidi, and
      abnormal high intensity in periventricular white matter. The findings of MRI were
      possibly suggestive of the static developmental disturbance of brain.

PMID- 7781243
TI  - [A case of radiation neuropathy following radiation therapy for metastasis of
      breast cancer].
AB  - We report a 49-year-old woman with radiation neuropathy, which occurred 7 years
      after radiation therapy for supraclavicular lymph node metastasis of breast
      cancer. The patient had noticed a hard induration in the right breast twelve
      years previously and had a radical operation for right breast cancer. After
      surgery, she remained well until 7 years ago when she noted a right
      supraclavicular mass. Based on a diagnosis of metastasis of breast cancer at the
      right supraclavicular lymph node, she received radiation therapy at 50 Gy in 25
      fractions to the lesion. Seven years after radiation therapy, the patient noted
      muscle weakness of II-V fingers of the right hand, followed by muscle atrophy of
      the right forearm. We diagnosed her condition as radiation neuropathy based on
      the absence of a mass lesion in the right supraclavicular region, no RI deposits
      in that region on Ga and bone scintigraphy, findings supportive of a lesion in
      the right brachial plexus on EMG and the history of radiation therapy for
      supraclavicular lymph node metastasis of breast cancer 7 years previously. We
      treated the patient with pulse therapy with high-dose oral prednisolone.
      Subsequently, the muscle weakness and atrophy of the right forearm and fingers
      have improved gradually. We suggest that pulse therapy with high-dose oral
      prednisolone for radiation neuropathy should be evaluated in a clinical trial,
      since few therapies are available for this condition.

PMID- 7781245
TI  - [Thalamic experiential hallucinosis].

PMID- 7781246
TI  - Nutritional therapy for pregnant women with a metabolic disorder.
AB  - Nutritional therapy is essential for a normal reproductive outcome in
      phenylketonuric women. In homocystinuria, fetal outcome is good in women whose
      disorder is responsive to vitamin B6 therapy and is poor in women whose disorder
      is unresponsive to therapy. Pregnancy in galactosemia is rare because of the
      almost universal ovarian dysfunction present in female patients with this
      disorder. Transplantation of the fertilized ovum is a promising possibility for
      these women. In women with MSUD, there has been only one case of pregnancy
      reported to date.

PMID- 7781247
TI  - Antenatal ultrasound and fetal Doppler. Diagnosis and outcome in intrauterine
      growth retardation.
AB  - Advances in ultrasonographic biometry and fetal Doppler technology enhance our
      ability to detect the presence of fetal growth retardation, expand our
      understanding of its pathophysiology, and improve the ability to predict certain
      outcome parameters. Further refinement of these methods will allow better
      definition of IUGR as well as a means to more accurately direct perinatal
      resources. As causes of fetal growth retardation become more precisely defined,
      improvements in outcome are likely for certain subsets of those populations.

PMID- 7781248
TI  - Recent advances in parenteral nutrition.
AB  - With the modifications described in this article, some of the precise elements in
      parenteral nutrition have been elucidated. With these changes, this form of
      nutrition has provided the essential calories and trace elements necessary for
      very-low-birthweight infants, as well as infants who have required surgery. As
      further research is done in this area, it is anticipated that even more
      adjustments to parenteral nutrition will be made, in order to provide optimal
      caloric vitamin, and trace element intake and establish the optimal manner in
      which these are administered.

PMID- 7781249
TI  - Metabolic substrates for fetal energy metabolism and growth.
AB  - This article reviews the basic aspects of fetal nutrition with emphasis on recent
      developments. Growth and energy requirements are first described, followed by a
      discussion about the contributions of main metabolic substrates for the fetus
      including amino acids, carbohydrates, and lipids. While the placenta is not the
      primary focus of this review, fetal and placental metabolism are intimately
      related. Current understanding of placental transport and metabolism is included
      where relevant. Lastly, a current review about the effects of nutrient
      deprivation on fetal growth and metabolism is presented.

PMID- 7781250
TI  - Nutritional role of omega-3 fatty acids during the perinatal period.
AB  - There is now clear evidence that dietary supplementation of omega-3 fatty acid is
      essential for normal eye and brain development. Corn oil-based diets induce omega
      3 deficiency in preterm infants, affecting retinal responses to light, cortical
      visual evoked potentials, and behavioral measures of visual acuity. Preterm
      infants require docosahexanoic acid (DHA) because they are unable to form
      sufficient quantities from precursors provided by soy oil-based formula products.
      Human milk provides an ideal source of essential fatty acids for premature
      infants. There is increasing evidence that premature infant formulas containing
      vegetable oils should be supplemented with long-chain EFAs to promote optimal
      retinal and cortical visual development.

PMID- 7781251
TI  - Metabolic balance studies in premature infants.
AB  - Many investigators over the past three decades have successfully conducted
      traditional metabolic balance studies in efforts to determine the retention rates
      of key nutrients important to the optimal growth of preterm infants. Differences
      in methodologies discussed in this review may explain the inconsistent results of
      balance studies reported for some nutrients, particularly calcium. These
      methodologic differences include (1) variability in nutrient intake and
      nutritional course prior to the balance period, (2) differences in the method of
      stool collection (with and without markers), (3) use of single versus repeated
      balance periods, and (4) different durations of balance periods. The data
      presented here suggest that the variability of net fat absorptions among VLBW
      infants was decreased when an acclimation period of nutrient intake supportive of
      growth was provided prior to a metabolic balance study. In addition, the use of
      markers affected the estimates of net calcium absorption but not fat absorption.
      Additional factors that may influence net calcium absorption and methods for the
      estimation of calcium absorption in VLBW infants warrant further investigation.
      This review describes the methods of specimen collection for metabolic balance
      studies in VLBW preterm infants that demonstrated reproducible data. The recent
      application of stable isotope methodology to metabolic balance studies can be
      extremely advantageous in identifying the rates of nutrient absorption versus
      endogenous secretion in the GI tract.

PMID- 7781252
TI  - Minimal enteral feedings.
AB  - The provision of early minimal enteral nutrition to the metabolically stable
      premature infant appears to result in multiple nutritional benefits and in a
      minimal risk of complications. Whereas benefits can be achieved with feeding
      volumes ranging from 0.1 to 4 mL/kg, future studies will need to address the
      responses of the immune system, the circulatory system, and motor activity of the
      intestine to various feeding regimens before pragmatic recommendations can be
      concluded.

PMID- 7781253
TI  - Suitability of human milk for the low-birthweight infant.
AB  - Information is emerging now that supports the use of human milk for low
      birthweight (LBW) infants. The nutritional benefits, in terms of protein
      digestion, amino and fatty acid patterns, fat absorption, and lactose digestion
      are recognized. Gastrointestinal function may be enhanced with human milk
      feeding. Profound effects on host defense, including a reduction in the rates of
      neonatal infection and necrotizing enterocolitis, recently have been
      acknowledged. To enable the LBW infant to continue to receive a mother's own
      milk, attention needs to be focused on specific nutrient limitations. Calcium and
      phosphorus require supplementation. Protein and sodium supplements may be needed.
      Commercial formulations are available that enable the fortification of human
      milk. Approaches that facilitate the feeding of a mother's own milk should be
      adopted by neonatal units.

PMID- 7781254
TI  - Trace elements in nutrition for premature infants.
AB  - Ten trace elements that are nutritionally essential include: zinc, copper,
      selenium, chromium, manganese, molybdenum, cobalt, fluoride, iodine, and iron.
      This article briefly reviews the biochemistry of these trace elements, describes
      clinical deficiency states, and provides a rationale for recommended enteral and
      parenteral intakes for preterm infants.

PMID- 7781255
TI  - Gastrointestinal motility in the neonate.
AB  - Although patterns of gastrointestinal movements have been recognized for nearly a
      century, only in the past 10 years have we had the diagnostic tools to
      characterize both normal and abnormal motility in the neonate. Parallel with
      these advances, over the past 25 years, we have seen an explosion in our
      understanding of the ENS and its independent regulation of gut motility. It is
      expected that, as we come to a better understanding of the microregulation of
      intestinal motor activity, we can develop more effective means to treat many of
      these heretofore refractory disorders of gastrointestinal motility.

PMID- 7781256
TI  - Nutritional care of the extremely premature infant.
AB  - In summary, the nutritional care of extremely premature babies includes special
      attention to glucose homeostasis and fluid and electrolyte balance in the
      immediate postnatal period. Parenteral nutrition should be started routinely on
      the 2nd or 3rd day of life, if the infant is metabolically stable, and continued
      until the infant is receiving sufficient enteral feedings to promote growth. If
      not clinically contraindicated, minimal enteral feedings should be started before
      the end of the first week of life. The decision to either advance or maintain
      minimal enteral feedings at a constant level should take into account the
      clinical status of the infant. Fortified preterm human milk is the preferred
      feeding and premature infant formulas, the best substitute. Multivitamin
      supplements may be necessary, depending on formula intake. Iron supplements can
      be initiated as early as 2 weeks of age and high levels of intake appear to be
      necessary during erythropoietin therapy.

PMID- 7781257
TI  - The effects of illness on neonatal metabolism and nutritional management.
AB  - In summary, careful attention to nutrient delivery in the IUGR infant is
      important to prevent and treat neonatal metabolic derangements and to improve
      postnatal growth. Carbohydrates are the essential fuel in the first days of life,
      to prevent hypoglycemia. Subsequent delivery of protein and fat helps rectify
      reduced muscle and fat stores and promotes weight gain. Calcium supplementation
      to prevent further bone demineralization and iron supplementation to replete iron
      stores may be necessary. Of special interest is that the neurologic outcome of
      these infants appears linked to the rate of catch-up growth. The rate of
      postnatal head growth depends on many perinatal and neonatal risk factors, and is
      a strong predictor of early developmental outcome in low-birthweight infants.
      Insufficient energy delivery beyond 2 weeks postnatal age in SGA premature
      infants results in failure to initiate subsequent catch-up head growth, with
      consequently smaller head circumferences at 1-year follow-up.

PMID- 7781258
TI  - Stable isotopes as metabolic probes for nutritional studies in neonates.
AB  - Metabolic and nutritional studies with stable isotope tracers have proved
      valuable in the human newborn. This technique is acceptable ethically, because it
      does not expose the infant to radioactivity, and it is sensitive enough for the
      analysis of very small samples. The stable isotope method has been especially
      applied to studies of neonatal carbohydrate, protein, and energy metabolism.

PMID- 7781260
TI  - Pharmacokinetics and pharmacodynamics of enantiomers of pimobendan in patients
      with dilated cardiomyopathy and congestive heart failure after single and
      repeated oral dosing.
AB  - Pharmacokinetics and pharmacodynamics of pimobendan were studied in eight
      patients with dilated cardiomyopathy and chronic congestive heart failure after
      single dosing and after 2-week repeated dosing of 5 mg racemic pimobendan.
      Enantiomers of pimobendan and its demethylated metabolite in plasma and in red
      blood cells were measured. In the single-dose study, the peak plasma levels of
      16.3 +/- 4.0 and 17.0 +/- 3.1 ng/ml of (+)- and (-)-pimobendan were observed at
      0.9 hour after dosing. The concentration-time curves followed a two-compartment
      model, with terminal half-lives of 2.56 +/- 0.35 and 2.93 +/- 0.33 hours for (+)-
      and (-)-pimobendan (p > 0.05), respectively. The oral volumes of distribution
      after equilibrium were 3.26 +/- 0.74 and 3.13 +/- 0.75 L/kg, and oral clearances
      were 28.6 +/- 7.0 and 21.9 +/- 4.1 ml/min/kg for (+)- and (-)-pimobendan (p >
      0.05), respectively. In red blood cells, the respective (+)- and (-)-pimobendan
      concentrations were 5.8 and 8.4 times higher than those in plasma, indicating a
      stereoselective partitioning of drugs between plasma and red blood cells. The
      pharmacodynamic effect of pimobendan was evaluated by echocardiography. The
      ejection fraction, mean velocity of circumferential fiber shortening, aortic flow
      peak velocity, cardiac index, and stroke volume index significantly increased 50%
      to 60%. The left ventricular end-systolic dimension, systolic blood pressure, and
      diastolic blood pressure significantly decreased 8% to 11%. These effects lasted
      for more than 8 hours. In a 2-week repeated-dose study, there was no significant
      dose accumulation in plasma and red blood cells. The pharmacokinetic parameters
      were similar to those in the single-dose study, except for significantly shorter
      absorption half-lives. The baseline levels of cardiac index and stroke volume
      index were significantly higher than the baseline levels in the single-dose
      study. This suggests an accumulation of pharmacodynamic effects despite a
      relatively short elimination half-life.

PMID- 7781259
TI  - Bioavailability, pharmacokinetics, and pharmacodynamics of torsemide and
      furosemide in patients with congestive heart failure.
AB  - The bioavailability, pharmacokinetics, and pharmacodynamics of torsemide (10 mg
      orally and intravenously) and furosemide (40 mg orally and 20 mg intravenously)
      were determined in a randomized crossover clinical trial in 16 patients with
      compensated congestive heart failure. Torsemide (time to reach maximum
      concentration [tmax], 1.1 +/- 0.9 hour) was more rapidly absorbed than furosemide
      (tmax, 2.4 +/- 2.5 hours), the absorption of which was delayed compared with that
      in healthy volunteers. Bioavailability of torsemide was also greater and less
      variable than that of furosemide. All four treatments yielded comparable changes
      from baseline in 24-hour electrolyte excretion. Based on the relationships
      between sodium excretion rate and fractional sodium and urinary drug excretion
      rate, response to both diuretic agents at the level of the nephron was decreased
      compared with previous studies with healthy subjects. Assessment of the clinical
      relevance, if any, of the difference in the variability of absorption warrants
      further study.

PMID- 7781261
TI  - Population pharmacokinetics of the active metabolite of nabumetone in renal
      dysfunction.
AB  - We determined the pharmacokinetics of 6-methoxy-2-naphythylacetic acid (6-MNA),
      the active metabolite of nabumetone, in normal subjects and in subjects with
      impaired renal function, including subjects requiring hemodialysis. Subjects
      received a 1000 mg oral dose of nabumetone either as a single dose or daily for
      15 days. We used a noncompartmental pharmacokinetic analysis and compared those
      results to a population pharmacokinetic analysis performed with nonlinear mixed
      effects modeling (NONMEM). The results of the two different analyses were
      similar. The elimination half-life increased with decreased renal function and
      ranged from 22 to 44 hours. The area under the curve decreased significantly at
      steady state, regardless of renal function. The apparent clearance determined by
      NONMEM analysis increased from 0.68 L/hr after a single dose to 1.13 L/hr at
      steady state. The apparent volume of distribution was directly proportional to
      the nonalbumin protein concentration and ranged from 23 to 60 L. We conclude that
      the pharmacokinetics of 6-MNA in this population are complicated by possible
      protein binding changes. However, the increased half-life in patients with renal
      failure is offset by changes in the apparent volume of distribution that prevent
      the accumulation of 6-MNA in the serum of patients with impaired renal function.
      Therefore dosage adjustments may not be necessary in patients with decreased
      renal function.

PMID- 7781262
TI  - Pharmacokinetics of the novel antiestrogenic agent toremifene in subjects with
      altered liver and kidney function.
AB  - OBJECTIVES: The pharmacokinetics of toremifene was investigated in an open study
      with four parallel groups of 10 subjects each. Subjects with impaired liver
      function (biopsy-proven liver disease), activated liver function (drug-induced),
      and impaired kidney function were compared with normal subjects. METHODS: A
      single oral 120 mg dose of toremifene was administered after an overnight fast,
      and blood samples were collected over 28 days. Serum levels of toremifene and its
      metabolites were determined; appropriate pharmacokinetic parameters were
      calculated and statistically evaluated. RESULTS: In normal subjects, the average
      peak level of 414 ng/ml toremifene was achieved at 3 hours after dosing, the
      terminal half-life was 6.2 days, apparent oral clearance was 5.1 L/hr, apparent
      volume of distribution was 958 L, and the fraction not bound to protein was 0.3%.
      The peak level (130 ng/ml) of the major metabolite, N-demethyltoremifene,
      appeared in serum with large variation in the time to peak level (median, 3 days)
      and a terminal half-life of 21.0 days. Low levels of deaminohydroxytoremifene
      were also measured, and two other metabolites could be quantified at some time
      points in some patients. The elimination rate of toremifene and the main
      metabolite was significantly increased in patients with activated liver function,
      resulting in decreased terminal half-lives (3.0 days and 4.5 days, respectively),
      and was decreased in patients with impaired liver function (10.9 days and 29.6
      days, respectively). The subjects with impaired kidney function showed normal
      elimination kinetics. CONCLUSION: Liver, but not kidney, function should be taken
      into account when toremifene is administered.

PMID- 7781263
TI  - Disposition and covalent binding of ibuprofen and its acyl glucuronide in the
      elderly.
AB  - Ibuprofen is an over-the-counter nonsteroidal anti-inflammatory drug with a low
      incidence of severe adverse reactions. It is metabolized by oxidation to
      carboxyibuprofen and hydroxyibuprofen and by conjugation to an acyl glucuronide.
      In vitro studies have indicated that ibuprofen glucuronide is labile and
      reactive, forming covalent adducts with proteins. To verify the formation of
      ibuprofen-protein adducts in vivo, the pharmacokinetics of ibuprofen glucuronide
      and its covalent binding to plasma proteins were studied in five elderly patients
      who received long-term administration of oral doses of ibuprofen. Plasma levels
      of ibuprofen glucuronide were low relative to those of ibuprofen; the ratio of
      area under the plasma concentration versus time curve for the glucuronide
      relative to the parent drug was only 4%. Covalent binding of ibuprofen to plasma
      protein was observed in all patients, correlating well with the area under the
      plasma concentration versus time curve of ibuprofen glucuronide (r = 0.966).
      Compared with reports for other nonsteroidal anti-inflammatory drugs that form
      acyl glucuronides, plasma levels of ibuprofen-protein adduct are low during long
      term administration. The observed lower reactivity in vivo is probably
      attributable to the greater stability of ibuprofen glucuronide relative to other
      acyl glucuronides.

PMID- 7781264
TI  - Interindividual variability of chlorzoxazone 6-hydroxylation in men and women and
      its relationship to CYP2E1 genetic polymorphisms.
AB  - Chlorzoxazone 6-hydroxylation is mediated by CYP2E1, and its measurement provides
      an in vivo probe of the enzyme's activity. To determine the population
      distribution of such activity, the disposition of chlorzoxazone and its 6-hydroxy
      metabolite was determined after oral administration to 70 white subjects (40 men
      and 30 women) residing in middle Tennessee. Both oral (330 +/- 111 ml.min-1, mean
      +/- SD) and fractional (213 +/- 86 ml.min-1) clearances varied fourfold to
      fivefold within the population and were unimodally distributed in a visually
      normal fashion. Clearance values were one-third greater in men than in women, but
      such differences were less striking after normalization according to body weight.
      Attempts to develop a single-time-point measure of 6-hydroxylating ability on the
      basis of plasma levels or urinary excretion of chlorzoxazone or its metabolite
      were unsuccessful. Genetic polymorphisms (Pst I and Rsa I restriction fragment
      length polymorphisms) in the 5'-flanking region of CYP2E1 deoxyribonucleic acid
      obtained from peripheral leukocytes were not associated with differences in the
      disposition of chlorzoxazone. Similarly, no major effects on 6-hydroxylation were
      associated with mutations in intron 6 associated with a Dra I restriction
      fragment length polymorphism. The interindividual variability in CYP2E1 activity
      as measured in vivo in healthy subjects appears to be considerably less than that
      expected based on in vitro studies. Whether such variability is associated with
      individual susceptibility to CYP2E1-mediated toxicity remains to be determined.

PMID- 7781265
TI  - Phenotyping and genotyping of S-mephenytoin hydroxylase (cytochrome P450 2C19) in
      a Shona population of Zimbabwe.
AB  - The S-mephenytoin hydroxylase has recently been identified as cytochrome P450
      2C19 (CYP2C19). This enzyme metabolizes mephenytoin, diazepam, omeprazole, and
      citalopram and has been shown to be polymorphically distributed. One clinical
      implication of CYP2C19-dependent drug metabolism for persons who reside in
      tropical regions is in the use of the antimalarial drug chloroguanide
      hydrochloride, which is apparently biotransformed to its active metabolite by
      this isozyme. In this investigation we studied mephenytoin metabolism in 103
      black Zimbabwean Shona subjects. Four were identified as poor metabolizers (4%).
      This prevalence is comparable to that in white subjects (2% to 5%) but lower than
      the 15% to 20% incidence of poor metabolizers among Oriental subjects. Of the
      subjects phenotyped, 84 were genotyped for the G-->A mutation in exon 5 of
      CYP2C19, which creates a cryptic splice site, causing the production of a
      nonfunctional protein. Three of the four poor metabolizers were homozygous for
      this mutation, whereas the fourth one was heterozygous. The G-->A mutation has
      been shown to predict the incidence more than 60% of poor metabolizers among
      white subjects and Japanese subjects, and in the current investigation we also
      obtained a similar relationship in the black population.

PMID- 7781266
TI  - The hydroxylation of omeprazole correlates with S-mephenytoin metabolism: a
      population study.
AB  - We compared omeprazole and mephenytoin as probes for the CYP2C19 metabolic
      polymorphism. Single oral doses of omeprazole (20 mg) or mephenytoin (100 mg)
      were administered at least 1 week apart to 167 healthy volunteers. Mephenytoin
      metabolism was measured using the amount of 4'-hydroxymephenytoin and the S/R
      ratio of mephenytoin in an 8-hour urine collection. Omeprazole hydroxylation was
      measured using the ratio of omeprazole to 5'-hydroxyomeprazole in serum 2 hours
      after dosing. All three methods separated poor- or extensive-metabolizer
      phenotypes with complete concordance. Omeprazole hydroxylation correlated with
      the S/R ratio of mephenytoin in extensive metabolizers (r2 = 0.681; p < 0.001).
      Genotyping tests showed that six poor metabolizers of omeprazole were homozygous
      for a single base pair mutation in exon 5 of CYP2C19. These results support the
      hypothesis that omeprazole 5'-hydroxylation cosegregates with the CYP2C19
      metabolic polymorphism.

PMID- 7781267
TI  - Moclobemide, a substrate of CYP2C19 and an inhibitor of CYP2C19, CYP2D6, and
      CYP1A2: a panel study.
AB  - The reversible monoamine oxidase A inhibitor moclobemide was given in single (300
      mg) and multiple doses (600 mg/day) to 11 male and four female healthy volunteers
      (age range, 23 to 27) who were either poor metabolizers of S-mephenytoin (n = 7)
      or extensive metabolizers of S-mephenytoin (n = 8). All were extensive
      metabolizers of sparteine. Poor metabolizers of S-mephenytoin had lower
      moclobemide clearance values (median, single dose: 16.1 versus 43.2 L.hr-1;
      steady state: 13.4 versus 22.1 L.hr-1) and longer moclobemide half-life values
      (median, single dose: 4.0 versus 1.8 hours; steady state: 5.1 versus 2.7 hours)
      than extensive metabolizers of S-mephenytoin. The plasma levels of a metabolite
      formed by C-hydroxylation (Ro 12-8095) were lower in poor metabolizers of S
      mephenytoin than in extensive metabolizers of S-mephenytoin. Moclobemide thus
      partially undergoes oxidative metabolism by way of the polymorphic CYP2C19. A
      combined mephenytoin, sparteine, and caffeine test performed before, during, and
      after multiple dosing of moclobemide showed changes in the metabolic indexes
      compatible with a reversible inhibition of oxidation by way of the corresponding
      CYP enzymes--CYP2C19, CYP2D6, and CYP1A2--during moclobemide treatment.

PMID- 7781268
TI  - Racial differences in sensitivity to the negative chronotropic effects of
      propranolol in healthy men.
AB  - OBJECTIVE: Dose-response studies in patients with hypertension have shown that
      black subjects are less responsive to beta-blocker therapy than white subjects,
      whereas studies in healthy volunteers suggest marginal or no racial differences
      in response. No concentration-response studies have been conducted in black
      subjects and white subjects. The purpose of this study was to characterize beta
      blocker pharmacodynamics in healthy black and white men. METHODS: Thirteen black
      and 13 white healthy men took 80 mg oral propranolol three times daily, for a
      total of 16 doses. Heart rate response to treadmill exercise was measured at
      various times over 24 hours. Serum propranolol samples were collected during the
      same 24-hour time period and were measured by chiral HPLC. The sigmoid maximal
      effect (Emax), Emax, and linear models were fitted to percentage reductions in
      exercise heart rate and S-propranolol concentrations. RESULTS: Black subjects had
      significantly lower values for serum concentration producing one-half the maximal
      effect (EC50) and unbound EC50 than white subjects (EC50: 10.2 ng/ml (4.4 to 28.0
      ng/ml) versus 24.4 ng/ml (14.3 to 64.1 ng/ml), blacks versus whites; unbound
      EC50: 1.29 ng/ml (0.686 to 4.91 ng/ml) versus 2.77 ng/ml (1.70 to 8.11 ng/ml),
      blacks versus whites). There was no statistical difference in Emax (33.3% [22.2%
      to 39.7%] versus 38.3% [30.7% to 45.1%], blacks versus whites). CONCLUSIONS:
      Healthy black men were more sensitive to beta-blockade than healthy white men.
      The results of this study in healthy volunteers suggest that the racial
      differences in response observed in patients with hypertension are related to
      hypertensive pathophysiology rather than normal physiology.

PMID- 7781269
TI  - Regional brain glucose metabolism after acute alpha 2-blockade by idazoxan.
AB  - BACKGROUND: Several classes of antidepressant drugs act on alpha 2-adrenergic
      receptors. Studies of patients with disorders responsive to treatment with these
      drugs report group differences in ex vivo measures of alpha 2-binding and in vivo
      responses mediated by alpha 2-receptors. Measurement of regional brain metabolic
      response to an alpha 2-antagonist may be a useful method for further definition
      of the role alpha 2-receptor regulation plays in the treatment of
      neuropsychiatric disorders. METHODS: Regional brain glucose metabolism was
      measured before and after infusion with 200 micrograms/kg idazoxan with use of
      18F-fluoro-2-deoxyglucose positron emission tomography in 13 healthy men.
      Arterial drug concentration, behavioral responses, and cardiovascular responses
      were also measured. RESULTS: The absolute and normalized glucose metabolic rate
      significantly increased in primary visual cortex. Significant increases and
      decreases occurred in normalized metabolic rates in prefrontal cortical regions.
      Measurement of metabolic effects occurred during the peak cardiovascular
      response. CONCLUSIONS: Our findings are consistent with regionally specific
      effects of alpha 2-blockade. This method may be useful for the study of alpha 2
      receptor function in humans.

PMID- 7781270
TI  - Pemoline-associated fulminant liver failure: testing the evidence for causation.
AB  - BACKGROUND: Pemoline is a central nervous system stimulant used in treating
      children with attention deficit-hyperactivity disorder. Hepatotoxicity has been
      commonly reported in association with pemoline; however, only two reports of
      cases of fatal liver failure have been published. OBJECTIVES: We report on a 14
      year-old boy who received concomitant pemoline and methylphenidate in whom
      fulminant liver failure occurred and for whom liver transplantation failed. Other
      causes of fulminant liver failure were ruled out, and the liver biopsy was
      suggestive of drug toxicity. We estimated the probability that these three cases
      represent an increased risk of fulminant liver failure associated with pemoline.
      RESULTS: Based on the three known cases of fatal liver failure associated with
      pemoline use, we calculated that a child receiving pemoline has a relative risk
      of development of fulminant liver failure of 45.3 (95% confidence interval, 4.1
      to 510). This highly significant association (p < 0.001) suggests causation.
      CONCLUSIONS: Because pemoline has been widely used in recent years, further
      studies are needed to better quantify this risk in children with attention
      deficit-hyperactivity disorder.

PMID- 7781271
TI  - Buspirone and electroencephalography.

PMID- 7781272
TI  - Laboratory evaluation of platelet dysfunction.
AB  - Platelet dysfunction, especially acquired forms, is a common cause of hemorrhage,
      especially when associated with trauma or surgery. Although the hereditary
      platelet function defects are generally rare, hereditary storage pool disease is
      common enough to be suspected in an individual, usually a child, with
      characteristic historical and clinical findings. The acquired platelet function
      defects, especially those resulting from drugs, are very common and should
      promptly be suspected in patients with easy and spontaneous bruising, mild-to
      moderate mucosal membrane hemorrhage, or unexplained bleeding associated with
      trauma or surgery. The template bleeding time is generally useful as a screening
      test of platelet function, but a normal template bleeding time, in the face of a
      suggestive history, suggestive clinical findings, or in the patient frankly
      bleeding, is not reliable, and platelet aggregation or lumi-aggregation should be
      done in applicable clinical situations. Prolongation of the template bleeding
      time is an unreliable predictor of clinical bleeding propensity. The mainstay of
      therapy for all of these defects, if bleeding is important, is the liberal
      infusion of suitable numbers of platelet concentrates. The acquired platelet
      function defects should also be managed by attempts to treat or control the
      underlying disease, if possible, and offending drugs or potentially offending
      drugs should immediately be stopped.

PMID- 7781273
TI  - Laboratory monitoring of unfractionated heparin treatment.
AB  - Laboratory monitoring is indicated when unfractionated heparin is used in the
      treatment of established thromboses. Special problems may be encountered in
      patients with antithrombin III alteration, thrombocytopenia, heparin resistance,
      or with an increased risk of bleeding.

PMID- 7781274
TI  - Contemporary laboratory monitoring of low molecular weight heparins.
AB  - Low molecular weight heparins are widely used in the prophylaxis and treatment of
      thromboembolic accidents. Laboratory monitoring seems restricted to the treatment
      of established thrombosis. Repeated controls of platelet count are mandatory.

PMID- 7781275
TI  - Blood protein defects associated with thrombosis. Laboratory assessment.
AB  - This review has stressed the common hereditary and acquired blood protein defects
      associated with thrombosis. The most common of the hereditary defects appear to
      be antithrombin, protein C, and protein S deficiency, and the most common
      acquired defects are anticardiolipin antibodies and the lupus anticoagulant.
      Therefore, these are the defects which should first be searched for in an
      individual with unexplained thrombosis. If these more common defects are not
      found, the rarer defects, including HC-II, plasminogen, or TPA deficiency,
      dysfibrinogenemia, elevated PAI-1, or heterozygous homocystinemia should be
      looked for. The incidence of activated protein C co-factor deficiency (APC
      resistance) is not yet clear but may also represent a common defect. PAI-1
      defects may, with time, be shown to be common. Finding these defects has
      important implications for therapy for the individual patient and for the
      institution of family studies to identify, inform, and possibly treat others at
      risk. It is expected that as knowledge of hemostasis expands, more hereditary and
      acquired defects, such as elevated lipoprotein(a) or defects of extrinsic (tissue
      factor) pathway inhibitor (EPI, TFPI), may be associated with enhanced risks for
      thrombosis.

PMID- 7781276
TI  - Laboratory monitoring of thrombolytic therapy.
AB  - The concept and strategy of thrombolytic therapy are absolutely correct. The
      obstructing intraluminal thrombus is in urgent need of resolution to permit
      reestablishment of blood flow. As investigative efforts in this area continue,
      more effective and more rapidly acting thrombolytic agents will be forthcoming.
      The thrombolytic agents available today are excellent and can definitely be used
      safely. However, a modicum of common sense must be employed in initiating their
      use. There must be frequent contact with the patient receiving such important and
      needed therapy. It is foolish for those individuals either not familiar with or
      not educated to utilize thrombolytic agents to make broad sweeping statements
      that such agents, whose efficacy has been demonstrated, should not be employed in
      the treatment of thrombosis. Such an attitude is an example of how not to proceed
      to further improvement in health care. To be content to remain in the past will
      never permit entrance into the future.

PMID- 7781277
TI  - Economic tools for the pathologist.
AB  - Whether or not it is generally accepted by medical care personnel within the
      hospital or the laboratory, the laboratory is a business within a hospital. If
      the laboratory is free-standing, with a corporate ownership, then a laboratory is
      a business by itself. Even if it is a part of a nonprofit organization (more than
      two thirds of American hospitals are nonprofit), a laboratory must be able to
      generate more gains (profits, assets, contribution margin) than losses
      (liabilities, costs). With the growing volume and complexity of laboratory tests
      in the United States, the onerous surge of regulatory restrictions, decreasing
      capital, decreasing physician's reimbursement, increasing salary and operating
      costs, it is now time for the pathologist to add new tools to his/her customary
      "tools of the trade," such as surgical knives, microtomes, analyzers, and
      microscopes. These new tools are the economic tools of cost analysis,
      productivity analysis, ratio analysis, utilization review, and capital asset
      analysis. The pathologist of the future must not only provide patient care
      diagnostic expertise, but must also be a successful manager of human, fiscal, and
      operational resources to survive in an economic environment that demands
      knowledge of the principles of successful laboratory management. In addition to a
      general review of economic and financial "tools," this article describes
      techniques that have been developed during the past several years by the
      Laboratory Fiscal Management Committee of the College of American Pathologists
      that analyze, condense, and interpret general macro-indicators of laboratory cost
      and operational functions. These indicators are generic and can be quickly
      understood and utilized by every pathologist practicing in a private, commercial,
      or public laboratory setting.

PMID- 7781279
TI  - The antiphospholipid and thrombosis (APL-T) syndromes. Clinical and laboratory
      correlates.
AB  - Anticardiolipin antibodies and the lupus anticoagulant are strongly associated
      with thrombosis and appear to be the most common of the acquired blood protein
      defects causing thrombosis. Although the precise mechanisms by which
      antiphospholipid antibodies alter hemostasis to induce a hypercoagulable state
      remain unclear, several theories have been advanced. The most common thrombotic
      events associated with anticardiolipin antibodies are deep venous thrombosis and
      pulmonary embolus (type I syndrome), coronary or peripheral artery thrombosis
      (type II syndrome), or cerebrovascular-retinal vessel thrombosis (type III
      syndrome); occasionally, patients present with mixtures (type IV syndrome). The
      relative frequency of anticardiolipin antibodies in association with arterial and
      venous thrombosis strongly suggests that these should be looked for in any
      individual with unexplained thrombosis; all three idiotypes (IgG, IgA, and IgM)
      should be measured. Also, the type of syndrome (I through V) should be defined,
      if possible, as this may dictate both the type and duration of both immediate and
      long-term anticoagulant therapy. Unlike patients with anticardiolipin antibodies,
      patients with primary lupus anticoagulant thrombosis syndrome usually sustain
      venous thrombosis. Because the aPTT is unreliable in patients with lupus
      anticoagulant (prolonged in approximately 40% to 50% of patients) and is seldom
      prolonged in patients with anticardiolipin antibodies, definitive tests (ELISA
      for anticardiolipin antibodies and the dRVVT for lupus anticoagulant) should be
      immediately ordered when antiphospholipid syndrome is suspected or when
      individuals present with otherwise unexplained thrombotic or thromboembolic
      events.

PMID- 7781278
TI  - Molecular markers of hemostatic activation. Implications in the diagnosis of
      thrombosis, vascular, and cardiovascular disorders.
AB  - Until recently, the diagnosis of thromboembolic disorders remained difficult to
      establish before the occurrence of a pathologic event. Clearly, thrombosis is the
      result of a progressive alteration of the blood and vasculature. Various
      molecular markers of hemostatic alteration are found in increased or decreased
      amounts predisposing to thrombosis or in increased circulating amounts during the
      activation process.

PMID- 7781280
TI  - Laboratory diagnosis of antiphospholipid syndromes.
AB  - The search for clinical outcomes associated with antiphospholipid antibodies
      (aPL) has been ongoing for a decade. This article focuses on the clinical use of
      tests for the detection of aPL. A review of the current thinking regarding the
      pathophysiology of antiphospholipid syndromes is relevant to the discussion of
      different aPL assays and methodologies. The value of aPL testing in specified
      patient populations is analyzed.

PMID- 7781281
TI  - Whose enlightenment? Medicine, witchcraft, melancholia and pathology.

PMID- 7781282
TI  - Sarah Stone: enlightenment midwife.

PMID- 7781283
TI  - Developing medical expertise: medical practitioners and the suspected murders of
      new-born children.

PMID- 7781284
TI  - Reflections on medical reform: Cabanis' Coup d'CEuil.

PMID- 7781285
TI  - The enlightenment encountered: the German Physicus and his world, 1750-1820.

PMID- 7781286
TI  - Conflicting attitudes towards inoculation in enlightenment Germany.

PMID- 7781287
TI  - Honeyed words: Bernard Mandeville and medical discourse.

PMID- 7781288
TI  - Shaping psychiatric knowledge: the role of the asylum.

PMID- 7781289
TI  - Vitalism, disease and society.

PMID- 7781290
TI  - The weight of evidence and the burden of authority: case histories, medical
      statistics and smallpox inoculation.

PMID- 7781291
TI  - Methodism and Dr George Cheyne's 'more enlightening principles'.

PMID- 7781293
TI  - An enlightenment science? Surgery and the Royal Society.

PMID- 7781292
TI  - Anti-Lockean enlightenment?: mind and body in early eighteenth-century English
      medicine.

PMID- 7781294
TI  - The politics of committal to early modern Bethlem.

PMID- 7781295
TI  - Medical reform, the enlightenment and physician-power in late eighteenth-century
      France.

PMID- 7781296
TI  - Microbiological assessment of denture hygiene among patients in longstay and
      daycare community places.
AB  - A simple, inexpensive microbiological assay for objective measurement of denture
      hygiene has been devised. Small individual filter paper discs were applied to the
      fitting surface of dentures for 20 seconds, eluted in phosphate buffered saline
      and bacterial counts on blood agar plates performed on the eluate. There was a
      strong positive correlation between denture cleanliness (graded on a scale of 0
      to 4) and both total anaerobic count (r = 0.829; P < 0.001) and total aerobic
      count (r = 0.786; P < 0.001) following logarithmic transformation. Yeasts in the
      eluted disc specimens could be used as an aid to diagnose oral candidiasis. The
      method provided an objective measure of denture hygiene among elderly patients in
      longstay hospitals and daycare community places. It may be applicable to audit
      studies following implementation of new oral health care policies.

PMID- 7781297
TI  - Changes in dental attitude and behavior among Dutch adults wearing complete
      dentures.
AB  - In 1992 a follow-up on the Dutch National Dental Survey of 1986 (DNDS) was
      performed. The main objective was to detect and analyze changes in oral self
      care, dental attendance, and oral health status. This paper will focus on the
      DNDS adults wearing complete dentures. Changes over a 6-yr period will be
      presented of: dental attendance, denture satisfaction and wearing of the complete
      dentures, and denture treatments. A postal questionnaire was used: 232 persons
      (64%) participated in the study. Analysis of Variance (ANOVA) was used to study
      the effect of dental and social variables on observed changes since 1986. Risk
      ratios (RR) were computed to clarify the actual effects of these variables. With
      respect to dental attendance, a shift towards visits for denture check-ups was
      found, thought to reflect the respondents' concern for their complete dentures
      (RR = 1.6). A small shift towards more visits because of denture problems was
      found. This was attributed to denture treatments that had taken place between
      1986 and 1992 (RR = 2.8). With respect to changes in denture satisfaction, no
      influence of denture treatments could be noted, but a relation was found with a
      variable indicating the imperfection of the complete dentures as felt by the
      respondents (RR = 2.8). In 31% of the respondents some denture treatment had been
      performed since 1986. No objective dental criteria of complete dentures and
      denture bearing areas had influenced these denture treatment decisions, but only
      respondents' subjective criteria (RR = 1.9-2.9).

PMID- 7781298
TI  - Characteristics of 5410 edentulous implant candidates and the treatment they
      receive.
AB  - Since 1989 implant dentistry in the Netherlands is a National Dental Insurance
      (NDI) benefit, thus reducing out-of-pocket expenditures for implant candidates
      considerably. A nationwide investigation was set up in order to evaluate
      quantitative, qualitative and financial effects of this new provision. The
      patient and treatment characteristics of 5410 edentulous implant candidates are
      discussed. Intensive monitoring of the usage of these new regulations facilitates
      health care policy making, including future planning. Over a 3 1/2 yr period, two
      out of every thousand totally edentulous NDI patients were treated in combination
      with dental implants. This number is being considered small, bearing in mind the
      number of edentulous patients in the Netherlands and the proportion of
      dissatisfied denture wearers. Demographic data, prosthetic and pre-prosthetic
      surgical history reveal that these patients, mostly female and middle-aged,
      experience severe denture-related problems. In the majority of cases the implants
      are placed by an oral surgeon and the suprastructure is made by a general dentist
      or at a centre for special dental care. The treatment itself mostly consists of
      an implant retained overdenture on two or four permucosal implants and a bar
      construction.

PMID- 7781299
TI  - General and local contraindications for endosseal implants--an epidemiological
      panoramic radiograph study in 65-year-old subjects.
AB  - In order to evaluate general and local contraindications for implantation for 65
      yr-old subjects from a medium-sized Finnish city, 431 such persons were examined
      anamnestically and by means of panoramic radiographs. The population represents
      61% of the total age group in the city (born in 1923). It was shown that several
      degrees of cardiac problems and increased blood pressure followed by pulmonary
      diseases and diabetes were the most commonly encountered relative
      contraindications for implantation. Eleven percent of the patients said that they
      smoked regularly and the bone quality was estimated to be less suitable for
      implantation in 21% of the cases. Implantation was evaluated according to the
      Bonefit system (implant lengths between 6 and 16 mm) in 10 regions in the maxilla
      and 6 regions in the mandible and was shown to be possible in 38% of the regions
      in the partially edentulous maxillae and 50% of those in the partially edentulous
      mandibles, the corresponding figures for the edentulous jaws were 55% in the
      maxilla and 61% in the mandible.

PMID- 7781301
TI  - Mutans streptococci, lactobacilli and caries experience in 12-year-old Icelandic
      urban children, 1984 and 1991.
AB  - In order to evaluate changes in salivary counts of cariogenic bacteria and relate
      these to trends in caries experience, stimulated saliva was collected from a 20%
      random sample of 12-yr-old residents of Reykjavik, Iceland (252 children) in 1991
      under conditions consistent with those of a survey conducted in 1984. The mean
      and median counts of salivary mutans streptococci and lactobacilli remained
      similar in the two studies. However, the frequency distribution at lower levels
      of mutans streptococci differed significantly between 1991 and 1984, e.g. in the
      present study 25.8% of the children had < 10(5) compared with 13.8% in the study
      1984. The mean caries prevalence in the permanent dentition (DFStot) was 11.0,
      which is significantly lower than in 1984 (mean DFStot 28.8). A significant
      difference in caries prevalence was found at various levels of salivary mutans
      streptococci. Strep. mutans (serotype c/e/f) was carried by all mutans
      streptococci-positive children, save one child, who carried only Strep. sobrinus.
      The proportion of 12-yr-olds who carried Strep. sobrinus had decreased
      significantly to 15.7% from 34.0% in 1984. Significantly more children with
      Strep. sobrinus showed high levels of total mutans streptococci than children
      with only Strep. mutans. As the case was in 1984 significantly more Strep.
      sobrinus carriers had a high level of salivary lactobacilli as well as higher
      caries prevalence than the children who did not carry this species.

PMID- 7781300
TI  - How is oral health education conducted in Finnish health centers?
AB  - The oral health education (OHE) given in Finnish health centers is mostly
      implemented by dental assistants and hygienists. However, there is no exact
      information concerning the distribution of OHE work and the working methods among
      individual health educators. The aims of this study were to assess 1) the time
      used for OHE by the dental professionals who bear most of the responsibility for
      OHE in health centers, and to evaluate 2) the collaboration between OH-educators
      and the parents of schoolchildren, school personnel and the other health care
      personnel and 3) the sources of the OHE knowledge and skills of these OH
      educators and their methods according to their work load. The data for this study
      were collected from 323 OH-educators. About one fourth (28%) of the OH-educators
      used 40% or more of their working time for group OHE and one third (33%) used 40%
      or more of their time for individual OHE. These workers were considered to be
      full-time OH-educators. The mean age of the OH-educators was 36 yr. The mean
      length of the OHE career was 8 yr. The most common OHE methods were a usual type
      of school lesson or a lesson in which the audience was questioned. Slides,
      models, transparencies and leaflets were the most general visual aids used.

PMID- 7781302
TI  - Dental caries and dental registration status in nursery school children in Newry,
      Northern Ireland.
AB  - 294 children aged 2-4 yr attending nursery schools in Northern Ireland were
      examined for dental caries and dental registration status under the capitation
      system in general dental practice. Their mean age was 3 yr 10 months. Sixty eight
      per cent were caries free, mean dmft was 1.10 and dt, mt and ft scores were 0.74,
      0.28 and 0.09, respectively. With increasing age the prevalence of caries
      increased, though the very low care index (d/dmft) did improve in the older
      children. Seventy per cent reported being registered for dental care and their
      levels of dental caries were significantly higher than those who were not yet
      enrolled (P < 0.001). For those not enrolled for dental care the main perceived
      barriers to seeking care related to lack of symptoms (33.6%) and apathy (31.6%)
      while few reported fear as a barrier (4.5%).

PMID- 7781303
TI  - Prevalence and distribution of developmental enamel defects in primary dentition
      of Chinese children 3-5 years old.
AB  - A total of 1344 children, 3-5 yr old, from two rural counties, Haidian and Miyun,
      close to Beijing, China, were examined in 1992. A modified DDE Index was employed
      in this study, and a pre-designed formula was used to calculate an enamel defect
      score (EDS) for each individual in the study. Oral examination was performed by
      one dentist under natural light using a standard mouth mirror and dental probe.
      Developmental enamel lesions were diagnosed without drying or cleaning the teeth
      prior to examination. Results from this study showed that primary teeth with
      defective enamel were seen in 23.9% of the children examined, opacity in 1.6%,
      and hypoplasia in 22.2%. Among the teeth, maxillary central and lateral incisors
      were affected by enamel hypoplasia most often (40.8% and 39.2%), followed by
      maxillary canines (25.7%), maxillary 1st molars (22.1%), and mandibular 1st
      molars (18.5%). The enamel defects occurred more frequently on the buccal
      surfaces of teeth than on any other surface. The study did not find a significant
      association of the children's age, family socioeconomic status, and
      anthropometric measurements with the distribution of enamel defects. However,
      there was a significantly higher prevalence of teeth with defects in males
      compared to females (P < 0.001), as well as mean tooth surfaces with defects (P <
      0.05), and mean EDS (P < 0.05). Children born prematurely were shown to have four
      times more enamel lesions than children who were full term (P < 0.01).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7781304
TI  - Evaluation of aesthetics for the different classifications of the Tooth Surface
      Index of Fluorosis.
AB  - The prevalence of dental fluorosis for children both from fluoridated and non
      fluoridated communities has increased dramatically in some regions of North
      America. This study evaluated the aesthetics of dental fluorosis for school-aged
      children from a reference population of 1131 children. The methodology from the
      Social Acceptability Scale of Occlusal Conditions (SASOC), part of the Dental
      Aesthetics Index (DAI), was used to assess fluorosis-related aesthetics. Pairs of
      semantic differentiated adjectives adapted from SASOC were used to rate fifty 35
      mm slides of anterior teeth. Sampling of children from the different categories
      of the Tooth Surface Index of Fluorosis (TSIF) on anterior permanent teeth was
      weighted to permit sufficient numbers of slides for the different classifications
      of the TSIF. Each slide was presented to a stratified random sample of pairs of
      parents and children who were participants in the original study. A convenience
      sample of dental professionals was also included. Analysis compared different
      classifications of "affected" slides (non-zero TSIF scores), with the mean
      aesthetic score computed from all "non-affected" slides (TSIF = 0). Results from
      children, parents, and professionals showed that there were highly significant
      differences between ratings of low and high TSIF scores. The only non-significant
      differences were between TSIF 4 and TSIF 5 & 6, which all three groups did not
      distinguish, as well as TSIF 1 versus TSIF 2 & 3, which children could not
      distinguish.

PMID- 7781305
TI  - Evaluation of screening for oral cancer and precancer in a company headquarters.
AB  - Oral cancer and precancer appear to fulfil many of the criteria for a disease
      suitable for mass screening. Several commercial organisations in the UK have
      introduced screening for their employees. One program has been formally evaluated
      over the course of 1 yr. Of 553 company headquarters staff aged > or = 40 yr, 292
      (53%) responded to the well-publicised screening invitation and received a simple
      clinical examination of the oral mucosa from one of two company dentists. In
      addition, 17 staff were screened from a separate company work-site. After
      screening, subjects were examined independently by an oral medicine specialist
      with access to the relevant diagnostic aids. The dentists' screening decisions
      were validated against the specialist's definitive diagnoses (the 'gold
      standard'). The true prevalence of subjects with lesions diagnosed as positive
      (white patch, red patch or ulcer of greater than 2 weeks' duration) was 17
      (5.5%). Overall, sensitivity was 0.71 and specificity, 0.99. The compliance rate
      to screening among headquarters subjects in seven occupational categories did not
      differ significantly from the occupational profile for all headquarters
      personnel. Estimates of relative risk of a positive diagnosis were calculated by
      logistic regression for five independent variables; gender, age, moderate
      smoking, heavy smoking, and smoking combined with greater than low risk alcohol
      consumption. Only heavy smoking (> or = 20 cigarettes per day) produced a
      significant odds ratio (3.43, P < 0.05).

PMID- 7781306
TI  - Opinions of different subgroups of dentists and patients about the ideal dentist
      and the ideal patient.
AB  - The aim was to study whether subgroups of lay people and dentists differ in their
      opinions about the ideal dentist and the ideal patient. This was done by
      analyzing further a data set containing responses on single statements regarding
      different aspects of dentist-patient relationship that have been reported
      previously. A questionnaire containing 124 five-class Likert scale statements and
      questions about the background of the respondents was sent in November 1988 to a
      representative sample of lay people and to all dentists in Kuopio and North
      Karelia Provinces in Finland. To extract areas of interdependence for both
      dentists and patients, factor analyses were applied to the data and factor scores
      were calculated for further analyses. Differences in the opinions were studied
      between dentists and patients as well as among subgroups of patients and
      dentists. The power of the selected factors in discriminating between dentists
      and patients, and different subgroups of dentists and patients was evaluated by
      means of logistic regression analyses. The expectations of dentists and patients
      were similar about the ideal patient. About the ideal dentist, dentists and
      patients agreed only on one of the five factors, i.e. communicativeness and
      informativeness. Differences, especially in the opinions about the ideal patient,
      were found between following subgroups of patients: non-regular and regular
      attenders, males and females, old and young, patients with low and high education
      and different occupational status; and between private practitioners and
      community dentists.

PMID- 7781307
TI  - Utilization of dental services in refugees in Sweden 1975-1985.
AB  - Prior to 1940 the population of Sweden was one of the most homogeneous in Europe,
      with only 0.5% foreign born. Fifty years later, in 1990, the proportion of
      immigrants was around 15%. In order to describe and analyze consumption of dental
      care in different refugee groups in Sweden, data registered by the Department of
      Immigration and the National Social Insurance Board, on a random sample of 2489
      refugees arriving in Sweden 1975-85, were merged. Information on nationality,
      date of arrival in Sweden, date of granting of permanent resident status and
      statistics on consumption of dental care were retrieved. During the period
      studied a total of 50,521 refugees arrived in Sweden. The average interval
      between arrival in Sweden and the first dental visit was 4.5 yr (95% < 1: 4.2
      4.7). The total treatment time during the first course of treatment was 165.5 min
      (95% < 1: 148.7-182.3). Consumption of dental care did not decrease with an
      increased number of treatments. Only 38% of the refugees had visited a dentist at
      all in Sweden. With increasing number of years in Sweden the number of courses of
      dental treatment increased, but 41% of the refugees who had visited the dentist
      in Sweden had done so only once. This study shows a low utilization of dental
      services among refugees in Sweden in general. Refugees with dental visits in
      Sweden, in particular, had a high dental consumption.

PMID- 7781308
TI  - Patterns of spatial functioning in Turner's syndrome.
AB  - This paper presents results from a study of task performance on a variety of
      spatial tasks in 9-11 year-old children with Turner's Syndrome (T.S.), divided
      into those with genotype 45XO and those with Mixed genotypes, including
      isochromosomes of X and mosaicism. There was a significant overall effect of
      group reflecting impaired spatial cognition in T.S. with greater decrement in the
      45XO group. Further investigation of the significant group by task interaction
      indicated that the group effects appeared on a visuo-perceptual task and on three
      visuo-constructional tasks but that there were no specific deficits in the T.S.
      groups on visuo-spatial or tactile-spatial tasks. In T.S., visuo-perceptual and
      visuo-constructive sub-systems of spatial skill may be more vulnerable than other
      components of spatial cognition, to the neuro-biological influences which
      contribute to the disorder. Such dissociation supports theories of modularity in
      the development of spatial skill. The spatial tasks which create difficulty
      overlap only partially with those for which there are sex differences amongst
      normal children and do not represent a simple exaggeration of normal male-female
      differences.

PMID- 7781309
TI  - Disorders of auditory identification in dementia of the Alzheimer type.
AB  - Fifteen patients with probable DAT and 18 matched controls were given tests that
      required the identification of verbal (phonemes and words) and non verbal (sounds
      and melodies) stimuli. In all tests, DAT patients made significantly more errors
      than controls. Errors predominated in non verbal tests in both groups. DAT
      patients (and, to a lesser degree, control subjects) made almost exclusively
      acoustic errors in word-identification, while errors in the identification of
      sounds and melodies could be either semantic or acoustic. Some categories of
      errors were observed predominantly in DAT patients. These results suggest that,
      in addition to their cognitive impairment, DAT patients have a specific
      deficiency of central auditory perception.

PMID- 7781310
TI  - Understanding impaired analysis of faces by patients with probable Alzheimer's
      disease.
AB  - The purpose of this study was to analyze the facial recognition skills of
      patients diagnosed with Probable Alzheimer's Disease (AD). The performance of 181
      AD patients was evaluated to address their ability to: analyze visual forms, to
      discriminate individual faces, and to recognize and name familiar famous faces.
      The results of the study demonstrate that the ability to analyze visual
      information is more vulnerable early in dementia than is the ability to
      discriminate individual faces. The inability to recognize familiar faces among
      the AD patients was related to impairments of their lexical/semantic system,
      rather than to a specific defect in facial discrimination. These data are fully
      consistent with existing models of face processing and recognition, and suggest
      that the recognition defect in AD is related to the naming component of face
      recognition, rather than the perceptual component.

PMID- 7781311
TI  - Impaired arithmetic facts but intact conceptual knowledge--a single-case study of
      dyscalculia.
AB  - We present the case of a young, highly educated patient who showed severe
      problems in basic arithmetic after a bone marrow transplant followed by extensive
      irradiation and chemotherapy. Despite his inability to resolve arithmetical fact
      problems (as 2 + 3), he showed intact processing of algebraic expressions and
      excellent understanding of complex arithmetic text problems. He perfectly knew
      arithmetic principles and applied them in various tasks. The performance of the
      patient suggests that conceptual knowledge (in addition to arithmetical fact
      knowledge and arithmetic procedures) is a functionally independent component of
      the calculation system.

PMID- 7781312
TI  - Psychoacoustical deficits related to bilateral subcortical hemorrhages. A case
      with apperceptive auditory agnosia.
AB  - We report a case of acute deafness secondary to bilateral hemorrhages involving
      the external capsule and extending to both temporal isthmi. The lesions probably
      disrupted both auditory radiations. Deafness disappeared within 2 weeks leading
      to a transient auditory agnosia for environmental and verbal sounds. Performance
      on audiological and neurolinguistic tests were consistent with the hypothesis of
      a deficit of non-specific auditory processes. Psychoacoustical deficits related
      to subcortical lesions are very rare and might differ from those due to cortical
      lesions by the lack of aphasia. The present case and both previous cases with
      subcortical lesions might suffer from auditory agnosia of apperceptive type. Its
      characteristics and the role of non-specific auditory processes are discussed
      using the data obtained from this third case.

PMID- 7781313
TI  - Selective deficit in processing double letters.
AB  - This paper reports a patient with a selective difficulty in spelling words and
      pseudowords with geminate (double) consonants. In all writing tasks, deletions of
      a geminate consonant occurred ten times more often than deletions of a consonant
      in a non-geminate cluster. In addition, the probability of substituting both
      geminate consonants was indistinguishable from the probability of substituting
      one consonant in a non-geminate cluster; and, the probability of substituting
      only one geminate consonant was close to zero, and significantly lower than the
      probability of substituting one consonant in a non-geminate cluster. This pattern
      of performance is consistent with the hypothesis that grapheme quantity and
      identity are separately represented in orthographic representations. The fact
      that these errors occurred in the absence of a significant number of geminate
      transpositions is interpreted as support for the hypothesis that letter
      gemination is specified by a "doubling feature."

PMID- 7781315
TI  - Reduplication of an event after head injury? A cautionary case report.
AB  - We report the case of a 69 year-old man who suffered head trauma in a road
      traffic accident. Subsequently, there was personality change, memory-impairment
      and the persisting 'delusion' that he had been involved in an earlier car
      accident. On the basis of detailed interviews with the patient (and his wife), we
      provide an explicit account of how the content of his reduplicative paramnesia
      could have arisen. We are concerned to stress that the patient's 'delusion' is a
      belief held on reasonable grounds.

PMID- 7781314
TI  - Unilateral somatoparaphrenia after right hemisphere stroke: a case description.
AB  - We report a case of somatoparaphrenia in a 41 year-old man after right temporo
      parietal stroke. An elaborate system of delusional beliefs was observed
      concerning the initially paralysed left leg, arm, and hand. The course of these
      beliefs is analysed as the patient progresses from a full-blown delusional state
      to having excellent insight into his condition. We outline the types of
      explantation that seem required to understand how somatoparaphrenic beliefs can
      arise.

PMID- 7781316
TI  - Personal name anomia: a single case study.
AB  - A case presenting an anomia specific for person proper names but no naming
      impairment either for other types of proper names or for common names is
      reported. The deficit was equally present both in face-naming and in naming upon
      definition and was not affected by the descriptiveness of the labels borne by the
      individuals. The patient had no semantic processing impairment either for faces
      or names. The results are discussed in terms of impaired access to intact
      phonological representations.

PMID- 7781317
TI  - The influence of neglected stimuli on free drawing in a patient with hemi
      inattention.
AB  - A patient with severe left hemi-inattention was found to be influenced by
      neglected stimuli in free drawing tasks. He was presented 64 sheets of paper: 32
      had geometric figures on the left side and 32 on the right side. The patient was
      asked what he saw and invited to draw a subject of his choice on the sheet of
      paper. The patient always denied seeing anything when the figures were on the
      left side, while he identified the figures on the right side. Four judges
      examined the patient's drawings and all of them agreed that 11 drawings were
      influenced by neglected stimuli and none by non-neglected ones. The drawings he
      made were similar but not the exact reproduction of neglected figures. This
      finding confirms that visual processing can proceed without awareness in a
      patient with hemi-inattention.

PMID- 7781318
TI  - Odor recognition memory is better under bilateral than unilateral test
      conditions.
AB  - Two odor memory tests were administered unilaterally (left and right) and
      bilaterally to the same set of 24 men and 24 women on two test occasions. These
      tests were (i) a "multiple-target" test (MTT) in which three target stimuli were
      selected, after 10-, 30-, and 60-sec retention intervals, from stimulus sets
      containing both target and distracter stimuli, and (ii) a 9-item "single-target"
      three-choice test (STT), in which single stimuli were selected from stimuli sets
      containing two distracters. Overall, odor memory scores were higher under
      bilateral than unilateral testing, and higher on the second than on the first
      test session. Unilateral testing resulted in a monotonic delay-related forgetting
      function. No differences were observed in the odor memory test scores of the left
      and right sides of the nose, and no significant correlations were present between
      these scores and scores on a battery non-olfactory memory tests. On the STT, the
      female, but not the male, subjects demonstrated better performance on the second,
      than on the first, test session. The results of this study imply that odor memory
      is facilitated centrally by bilateral activation, and that a memory system may
      exist for odors which is distinct from other memory systems.

PMID- 7781319
TI  - Familial sinistrality: the utility of calculating exact genotype probabilities
      for individuals.
AB  - Measures of familial sinistrality are frequently used in neuropsychological
      research. However they suffer from the problem that they are essentially a global
      measure of phenotypes in the family, whereas they are interpreted as an indicator
      of the genotype of the individual concerned. In this paper it is shown how to
      calculate a precise probabilistic estimate of a proband's genotype, given a
      particular genetic model of handedness, using all of the information available in
      a family tree. Example calculations are provided for a range of families with one
      or two sinistral relatives. Genotype probabilities are also calculated for a
      large population data set (the National Childhood Encephalopathy Study) and it is
      shown that familial sinistrality does not account for all of the variability
      present in the genotype probabilities, and that genotype probabilities provide an
      additional prediction of individual sinistrality after taking familial
      sinistrality into account, whereas all of the information in familial
      sinistrality is accounted for by the genotype probabilities. Finally it is shown
      how genotype probabilities can be used to assess whether there is heterozygote
      advantage for a characteristic, and using this method it is suggested that there
      is no support for heterozygotes having higher intellectual ability than
      homozygotes.

PMID- 7781320
TI  - A selective impairment of hand posture for object utilization in apraxia.
AB  - This study reports the case of an apraxic patient who was impaired in all aspects
      of gestural behavior following bilateral posterior parietal cortex lesions. The
      main impairment concerned manual prehension of objects during their utilization.
      The deficit contrasted with both normal movement trajectories of the arm during
      execution of such gestures, and with accurate manual prehension in the context of
      simple reaching movements. Although recognition of gestures and pantomimes made
      by the examiner was preserved, the patient showed a striking inability to
      visually discriminate or describe manual prehension associated with object
      utilization. We thus propose the existence of specialized cortical mechanisms for
      the representation and activation of the postural schemata of the hand required
      for complex actions.

PMID- 7781321
TI  - Evidence for the independence of recognition and recency memory in amnesic
      subjects.
AB  - The present study examined two groups of amnesic subjects (Korsakoff and Post
      Encephalitic) on tests of object recency. In the first test the subject tried to
      select the object that had been shown most recently from a pair of familiar
      objects. Compared with their respective controls both amnesic group were
      severely, and similarly, impaired. This impairment did not, however, appear to
      reflect a failure to engage specific rehearsal strategies. In the second test a
      dissociation was found between judgements of recency and recognition for the same
      item. This was consistent with the lack of correlation between recency
      performance and performance on a number of other memory tests. The present
      findings suggest that the underlying cause of the recency memory deficit in
      amnesia is different to that responsible for other memory losses. They also point
      to a dissociation between the processes involved in estimating recency and
      temporal duration.

PMID- 7781322
TI  - Task interruption in prospective memory: a frontal lobe function?
AB  - Prospective memory involves remembering an intention to do something as well as
      remembering the content of the task. It also shares common features with
      executive skills that are argued to be mediated by the frontal lobes. This paper
      describes performance on tests of prospective memory by a subject with bilateral
      frontal lobe infarcts and good retrospective memory but who displayed impairments
      of planning, initiation and inhibition of ongoing behaviour. The results lend
      some support to the suggestion that separate neuroanatomical pathways underly
      retrospective and prospective memory. They also indicate dissociable features
      within prospective memory that may reflect differences in utilisation of
      attentional resources and inhibitory control mechanisms.

PMID- 7781323
TI  - Activation of human hippocampal formation during memory for faces: a PET study.
AB  - Using positron emission tomography, we examined cerebral blood flow changes in
      human subjects whilst engaged in the visual processing of face stimuli. A task
      requiring anterograde memory of faces was compared with a control task involving
      simple gender classification--considered an automatic process that did not
      require any significant memory component. A second task requiring recognition of
      famous politicians' faces, and therefore involving long-term "semantic" memory,
      was also contrasted with the control task. To identify brain regions associated
      with primary visual processing of the face we compared all tasks against a
      control population scanned with eyes closed. Our results indicate--(1) The
      involvement of bilateral lingual/fusiform gyri and the right parahippocampal
      gyrus in addition to striate cortex in primary visual processing of the face; (2)
      the involvement of the left hippocampal gyrus in both types of memory; (3) a
      relative decrease in local cerebral blood flow in the inferior parietal lobules
      in long-term "semantic" memory. In addition, both memory tasks resulted in a
      suppression of cerebral blood flow in the left superior temporal cortex. We
      conclude that right hippocampal regions are involved in a largely automatic,
      primary processing of faces, while left hippocampal regions are additionally
      involved when explicit memory for faces is required.

PMID- 7781324
TI  - Adenine nucleotide depletion in cryopreserved human cardiac valves: the "stunned"
      leaflet interstitial cell population.
AB  - Preparation protocols for human cardiac valves are intended to minimize
      cytotoxicity because it has been thought that viable leaflet interstitial cells
      may enhance homograft durability. Preimplantation factors influencing the status
      of these cells at the time of transplantation include ischemia, disinfection, and
      cryopreservation freezing programs. In these experiments, adenine nucleotide
      quantitation was undertaken to assess metabolic consequences of preparation;
      preharvest ischemia served as an independent variable to examine the relationship
      between time of procurement (postmortem) and high-energy phosphate status of the
      cryopreserved leaflets at thaw. Nucleotides were measured using high-performance
      liquid chromatography performed on extracts of semilunar cusps from 25
      cryopreserved human valves with documented ischemic times. Results indicate total
      adenine nucleotides (TAN; [ATP] + [ADP] + [AMP], in nmol TAN/mg leaflet protein)
      are higher (P < 0.05) after < 2 h of harvest ischemia (1.16 +/- 0.36) than with
      ischemic times of 3-6 h (undetected), 7-12 h (0.18 +/- 0.07), and 13-20 h (0.06
      +/- 0.06). Depletion of ATP was similar, with many leaflets devoid of detectable
      levels. Net utilization of leaflet energy stores demonstrates time dependency
      when assayed after completed processing. However, relatively elevated
      catabolites, even with brief ischemia, and infrequently identified ATP, ADP, and
      AMP, suggest a consumption so accelerated that the following cryopreservation it
      is virtually independent of procurement-associated ischemia. We conclude
      resumption of a functional cell population obligates significant de novo
      phosphoanhydride boned reformation or a repopulation of dead/dying interstitial
      cells from a subset surviving the apparently severe rigors of valve preparation.

PMID- 7781325
TI  - Hepatic cryotherapy: double-freeze cycles achieve greater hepatocellular injury
      in man.
AB  - Hepatic cryotherapy is a relatively new technique used to treat both primary and
      secondary tumors. This paper concerns the changes in serum aspartate transaminase
      (AST) in 45 patients following both single and double freeze with partial thaw
      cycles. There was considerable elevation in serum AST, greatest on the day of
      operation, and there was a significantly higher peak AST following the double
      freeze cycles (1159; SE, 117.5) compared with single-freeze/thaw procedures (437;
      SE, 61.7). This finding indicates greater hepatocellular disruption which may be
      important both in planning clinical hepatic cryosurgery to achieve adequate
      destruction and also to avoid the morbidity of the cryoshock phenomenon.

PMID- 7781327
TI  - Membrane fluidity as a factor in production and stability of bacterial ice nuclei
      active at high subfreezing temperatures.
AB  - Detailed measurements were made of the rate of appearance of bacterial ice nuclei
      upon cooling of suspensions of Pseudomonas syringae cells and the disappearance
      of ice nuclei upon warming of the cells before assay for ice nucleation activity.
      While no substantial change in numbers of ice nuclei active at either -5 or at -9
      degrees C was observed in cells that were grown at temperatures lower than 24
      degrees C and cooled to 21 degrees C before assay, large increases in -5 but not 
      9 degrees C ice nuclei were observed in cells grown at temperatures greater than
      24 degrees C. Ice nucleation activity of cells subjected to a decrease in
      temperature before assay increased immediately upon temperature shift, but 8 to
      12 min was required before maximum rates of increase in numbers of ice nuclei
      were observed. The rate of appearance of ice nuclei in cell suspensions incubated
      at relatively cold temperatures prior to assay was substantially less than those
      incubated at temperatures approaching 24 degrees C. Cells rapidly lost ice
      nucleation activity when warmed to above 27 degrees C before assay; the rate of
      loss of ice nuclei in cells grown at a given temperature increased rapidly as the
      temperature to which they were warmed before assay increased. Ice nuclei
      disappeared most rapidly when cells grown at low temperatures were warmed before
      assay, suggesting that ice nucleus stability was lower in highly fluid membranes.
      The logarithm of the half-life of ice nuclei in cells was directly related to the
      concentration of the membrane fluidizing agent, 2-phenethyl alcohol, in which
      they were suspended.

PMID- 7781326
TI  - The temperature dependence in the hydraulic conductivity, Lp, of the mouse sperm
      plasma membrane shows a discontinuity between 4 and 0 degrees C.
AB  - Cryopreservation of sperm from transgenic mice would make possible the economical
      perpetuation of these genetic models. In order to design a protocol for this
      process, it was first necessary to determine the hydraulic conductivity, Lp, or
      water permeability, of the plasma membrane as a function of temperature to
      calculate its activation energy, Ea. This was done with sperm from the caudae
      epididymides of CD-1 mice, using the hyposmotic cell lysis method, in which the
      critical osmolality, Osmcrit, defined as the osmolality at which 50% of the cells
      lyse, was first determined, and then the time, t, to lysis of 50% of the cells in
      a medium of Osm < Osmcrit was obtained. Values (mean +/- SEM, n = 10) of Osmcrit
      at 37, 22, 4, and 0 degrees C were 32.1 +/- 2.7, 33.7 +/- 4.1, 30.8 +/- 3.4, and
      101.0 +/- 10.8 mOsm, and of t in 17 mOsm medium were 40.6 +/- 2.4, 33.8 +/- 5.7,
      25.0 +/- 4.4, and 4.7 +/- 1.2 s, respectively. Values of Lp were calculated from
      Osmcrit and t by two different algorithms, one based on the high-amplitude
      swelling model used with sperm from other mammalian species and the other based
      on a low-amplitude swelling model. Values of Lp in micron.min-1.atm-1 from the
      high-amplitude swelling model at 37, 22, 4, and 0 degrees C were 1.41 +/- 0.08,
      1.88 +/- 0.35, 2.12 +/- 0.19, and 1.13 +/- 0.1, respectively. From the low
      amplitude swelling model, the Lp values were 0.025 +/- 0.001, 0.040 +/- 0.008,
      0.082 +/- 0.029, and 1.66 +/- 0.23. Examination of mouse sperm in hyposmotic
      media by microscopy revealed little swelling of the cells, indicating that the
      low-amplitude swelling model may be the one more applicable to these cells. The
      temperature dependence, and hence Ea, of Lp shows a marked discontinuity between
      4 and 0 degrees C with values calculated from either model. This suggests a
      membrane phase transition to a more brittle structure in this temperature range,
      consistent with the observed marked increase in Osmcrit (P < 0.0003) and decrease
      in t (P < 0.0001) at 0 degrees C compared to the other temperatures. In the
      presence of 1 M glycerol, there was no discontinuity between 4 and 0 degrees C in
      the values of Osmcrit, consistent with the ability of glycerol to fluidize the
      membrane. Low hydraulic conductivity and low-temperature embrittlement of the
      plasma membrane are proposed as two factors leading to mouse sperm
      hypersensitivity to cryodamage.

PMID- 7781328
TI  - Regulation of internal Ca2+ by chilled bull and boar spermatozoa.
AB  - Intracellular Ca2+ in ejaculated spermatozoa from five bulls and five boars was
      determined with indo-1,AM in Ca(2+)-free medium. Aliquots of each ejaculate were
      then wrapped and held either on ice or at 25 degrees C for 20 min. At this time
      all samples were returned to 25 degrees C, either Ca(2+)-free medium or medium
      containing 1 mM Ca2+ was added, and intracellular Ca2+ was determined for an
      additional 120 min. Before and immediately after chilling, internal Ca2+ in bull
      spermatozoa did not differ. However, exogenous Ca2+ caused both control and
      chilled bovine spermatozoa to accumulate Ca2+ over the subsequent 120 min (P <
      0.01) with the control spermatozoal rate of Ca2+ intake being faster than that of
      the chilled (slopes, 29.531 vs 8.374 relative Ca2+ units/min; least squares means
      (lsmean) x 10(4) +/- 1.901 (pooled SE); P < 0.01). Viability of all spermatozoa
      was reduced after Ca2+ exposure, and the acrosomal morphology of chilled cells
      was adversely affected by Ca2+. For boar spermatozoa, chilling caused an
      immediate increase in internal Ca2+, confirming the greater sensitivity of boar
      spermatozoa to low temperatures. The presence of exogenous Ca2+ caused greater
      Ca2+ uptake by both control and chilled porcine cells relative to their Ca(2+)
      free analogues (0.939 vs 0.764 and 1.015 vs 0.836 Ca2+ units; lsmean +/- 0.166
      (pooled SE); P < 0.01 for control and chilled boar spermatozoa with and without
      Ca2+ at 150 min). Control spermatozoa, however, accumulated Ca2+ (P < 0.01) at a
      much greater rate (slope, 20.964 +/- 2.73 relative Ca2+ units x 10(4)/min; P < or
      = 0.001) than chilled cells, which only tended (P = 0.08) to accumulate Ca2+
      (slope, 4.782 +/- 2.73 relative Ca2+ units x 10(4)/min). This study suggest that
      chilling causes a species-specific effect on Ca2+ regulatory capabilities of
      spermatozoa that differs from cold shock and that spermatozoa may be able to
      compensate, at least partially, for such injuries.

PMID- 7781330
TI  - Is there room for the heart in CHEST?

PMID- 7781329
TI  - Fracture phenomena in an isotonic salt solution during freezing and their
      elimination using glycerol.
AB  - Thermal stress and consequent fracture in frozen organs or cell suspensions have
      been proposed to be two causes of cell cryoinjury. A specific device was
      developed to study the thermal stress and the fracture phenomena during a slow
      cooling process of isotonic NaCl solutions with different concentrations of
      glycerol (cryoprotectant) in a cylindrical tube. It was shown from the
      experimental results that glycerol significantly influenced the solidification
      process of the ternary solutions and reduced the thermal stress. The higher the
      initial glycerol concentration, the lower the thermal stress in the frozen
      solutions. Glycerol concentrations over 0.3 M were sufficient to eliminate the
      fracture of the frozen solutions under the present experimental conditions. To
      explain the action of glycerol in reducing the thermal stress and preventing the
      ice fracture, a further study on ice crystal formation and growth of ice in these
      solutions was undertaken using cryomicroscopy. It is known from previous studies
      that an increase of initial glycerol concentration reduced frozen fraction of
      water in the solution at any given low temperature due to colligative properties
      of solution, which reduced the total ice volume expansion during water
      solidification. The present cryomicroscopic investigation showed that under a
      fixed cooling condition the different initial glycerol concentrations induced the
      different microstructures of the frozen solutions at not only a given low
      temperature but also a given frozen fraction of water. It has been known that ice
      volume expansion during solidification is a major factor causing the thermal
      stress and the interior microstructure is critical for the mechanical strength of
      a solid. Therefore, functions of glycerol in reducing the total ice volume
      expansion during water solidification and in influencing interior microstructure
      of the ice may contribute to reduce the thermal stress and prevent the fracture
      in the frozen solutions.

PMID- 7781331
TI  - ICU scoring and clinical decision making.

PMID- 7781332
TI  - The disruptive ICU. An issue to lose sleep over?

PMID- 7781333
TI  - Should pulmonary metastases be resected?

PMID- 7781334
TI  - Pulmonary tuberculosis and steroids.

PMID- 7781335
TI  - Partial or total direct pulmonary venous drainage to right atrium due to
      malposition of septum primum. Anatomic and echocardiographic findings and
      surgical treatment: a study based on 36 cases.
AB  - The clinical and anatomic findings in 36 patients (21 postmortem cases and 15
      living patients) with partially anomalous (16 [44%]) or totally anomalous (20
      [56%]) pulmonary venous drainage directly to the right atrium constitute the
      material basis of this report. Displacement of septum primum--leftward in atrial
      situs solitus or rightward in atrial situs inversus--was present in all and
      appeared responsible for the anomalous pulmonary venous drainage. The pulmonary
      veins were connected with what normally constitutes the posterior wall of the
      left atrium, which became incorporated into the right atrium because of atrial
      septal displacement. This abnormality occurred predominantly in patients with
      visceral heterotaxy, usually with polysplenia, or rarely with asplenia or a
      normally formed spleen. Poor development or absence of septum secundum appeared
      responsible for the malposition of septum primum. Echocardiographic recognition
      of the displacement of septum primum facilitated surgical management.

PMID- 7781336
TI  - Neurohormonal activation and exercise function in patients with severe heart
      failure and patients with left ventricular assist system. A comparative study.
AB  - OBJECTIVES: The aim of this study was to evaluate the effects of implantation of
      a left ventricular assist system (LVAS) on the neurohormonal status, exercise
      capacity and symptomatic state in patients with severe congestive heart failure
      (CHF). BACKGROUND: Severe CHF is characterized by decreased exercise tolerance
      and activation of several neurohormonal systems. METHODS: Parameters of
      neurohormonal activation and exercise capacity in patients with LVAS (n = 7) were
      compared with those in groups of New York Heart Association (NYHA) class 3 (n =
      121) and class 4 (n = 81) patients. Plasma levels of norepinephrine (NE), plasma
      renin activity (PRA), and atrial natriuretic peptide (ANP) and maximal and
      submaximal exercise capacities were measured monthly in LVAS patients and
      compared with results in CHF patients. RESULTS: Plasma NE and PRA levels were
      significantly lower in LVAS patients than in NYHA class 4 patients, and plasma
      ANP levels in LVAS patients were significantly lower than those in NYHA class 3
      and 4 patients. The distance walked during submaximal exercise testing and peak
      oxygen consumption during maximal exercise testing were similar for the LVAS and
      NYHA class 3 patients. The class 4 patients were unable to exercise. CONCLUSIONS:
      We conclude that the LVAS lessens the neurohormonal activation and exercise
      intolerance characteristic of the CHF state and that the exercise capacity early
      after LVAS (< 4 months) is similar to that observed in NYHA class 3 patients.

PMID- 7781337
TI  - The incidence of patent foramen ovale in 1,000 consecutive patients. A contrast
      transesophageal echocardiography study.
AB  - STUDY OBJECTIVE: Patent foramen ovale (PFO) is present in 10 to 35% of people and
      has been reported to be an important risk factor for cardioembolic
      cerebrovascular accidents (CVAs) and transient ischemic attacks (TIAs),
      especially in younger patients. While contrast transthoracic echocardiography has
      been used to detect PFO, contrast transesophageal echocardiography (TEE) has a
      greater sensitivity. Prior studies reported the incidence of PFO in patients
      presenting with a CVA or TIA. DESIGN: To determine the incidence of PFO in a more
      general population, we reviewed 1,000 consecutive TEEs performed with contrast
      and color Doppler for the presence of PFO and other cardioembolic risk factors,
      including atrial septal aneurysm (ASA), aortic plaque, atrial fibrillation
      (AFib), and atrial thrombi. While imaging with monoplane or biplane TEE, multiple
      injections of agitated saline solution were injected during cough or Valsalva
      maneuver to detect flow through a PFO. PATIENTS: There were 482 male and 518
      female patients with mean age of 60 +/- 17 years (range 11 to 93 years). RESULTS:
      Patent foramen ovale was found in 9.2% of all patients and, though seen in all
      age groups divided by decade, the incidence in patients aged 40 to 49 years was
      greater than those aged 70 to 79 years (12.96% vs 6.15%, p = 0.03). Contrast TEE
      had a much higher detection rate than color Doppler alone. Importantly, there was
      no greater incidence of PFO in patients with CVA vs those without CVA, or in male
      vs female patients. Also, there was a very strong correlation between the
      presence of ASA and PFO (p < .001). CONCLUSION: Thus, PFO detected by TEE,
      frequently seen with ASA, is seen in all age groups and does not in itself
      present a risk factor for CVA. The association of PFO with peripheral thrombosis
      and CVA needs further study.

PMID- 7781338
TI  - Right ventricular function in patients with severe COPD evaluated for lung
      transplantation. Lung Transplant Group.
AB  - Right ventricular function was measured in ten patients with severe COPD (mean
      FEV1 = 0.48 +/- 0.2 L/s) as part of an evaluation for single lung transplant
      (SLT). Right ventricular ejection fraction (RVEF) was determined by two methods:
      first-pass radionuclide scan by multigated acquisition (MUGA) and by using a fast
      thermistor tipped RVEF/volumetric pulmonary artery catheter. None of the patients
      had clinical evidence of active right heart failure, although mild resting
      pulmonary hypertension (mean pulmonary artery pressure [PAP] = 24 +/- 4 mm Hg)
      that worsened with minimal exercise (mean PAP = 39 +/- 11 mm Hg) was present.
      There was a significant difference in RVEF measured by the two methods (mean MUGA
      RVEF = 57 +/- 10%, mean catheter RVEF = 27 +/- 8%; p < 0.00005). RVEF determined
      by both methods was correlated with hemodynamic and gas exchange variables
      obtained during rest and at maximal exercise. There were significant, yet
      inverse, correlations between RVEF measured by catheter and cardiac index
      measured during exercise (CIex), as well as with exercise pulmonary vascular
      resistance index (PVRI). There were no significant correlations found between
      MUGA RVEF and any gas exchange or hemodynamic variables. Significant correlations
      were found with the catheter-measured right ventricular end-diastolic volume
      (RVEDV) and CIex (r = 0.9 p < 0.005), with maximal oxygen consumption during
      exercise (VO2max) (r = 0.86 p < 0.0025), with exercise stroke volume index (SVI)
      (r = 0.76 p < 0.01), and exercise central venous pressure (CVP) (r = 0.62 p <
      0.05). Echocardiographic studies revealed right ventricular dilatation and mild
      tricuspid regurgitation (TR) in all patients. The strong correlation between
      RVEDV, CIex, and VO2max supports the concept that in these patients, as long as
      there is no clinical evidence of right heart failure (resting CVP still within
      normal limits), those with the largest RVEDVs use the Frank Starling principle to
      their best advantage to remain more functional.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7781339
TI  - Effect of acute allograft rejection on exercise hemodynamics in patients who have
      undergone cardiac transplantation.
AB  - The effect of acute allograft rejection on exercise hemodynamics was evaluated in
      8 consecutive cardiac allograft recipients (group 1) when the right ventricular
      endomyocardial biopsy showed evidence of allograft rejection (R), and when no
      evidence of rejection (NR) was present. A separate group of 10 cardiac transplant
      recipients (group 2) with no evidence of rejection on biopsy done at the end of
      the first and second year post-transplantation served as controls. The exercise
      hemodynamics were abnormal in both groups in both studies with a moderate
      increase of the pulmonary artery wedge pressure to a mean of 17.2 (NR) and 19.4
      mm Hg (R) in group 1 (p = not significant [NS]) and 20.1 and 21.2 mm Hg in group
      2 (p = NS), a mild increase of the mean right atrial pressure to a mean of 10 mm
      Hg (NR) and 10 mm Hg (R) in group 1 (p = NS), 11.9 mm Hg and 12.5 mm Hg in group
      2 (p = NS), and a moderate increase of the arteriovenous oxygen content
      difference to a mean of 8.5 (NR) and 8.4 vol percent (R) in group 1 and 8.3 and
      8.0 vol percent in group 2. No significant difference was observed between the
      two studies of the same group in any of the hemodynamic parameters except for the
      heart rate in group 1 (from 91 +/- 16 to 97 +/- 16 beats/min [p < 0.05] with and
      without evidence of allograft rejection, respectively). In conclusion, heart
      transplant recipients do not usually manifest further exercise hemodynamic
      deterioration during mild to moderate rejection.

PMID- 7781340
TI  - The role of the 'pericardial window' in AIDS.
AB  - BACKGROUND: The leading cause of pericardial effusion in urban hospitals is now
      AIDS-related pathologies. Clinically, these effusions are a diagnostic and
      management dilemma. In our institution, pericardial biopsy and operative drainage
      have become part of the diagnostic and management plan. Surgical intervention,
      however, has appeared to have little clinical impact. METHODS: A retrospective
      review was conducted of all patients (n = 29) diagnosed as having AIDS who
      underwent "pericardial window" for pericardial effusions from 1986 to 1994.
      RESULTS: Fluid cultures and pericardial biopsy were performed in all cases.
      Twenty-four percent of culture or biopsy specimens were diagnostic (7 of 29 = 2
      adenocarcinoma, 3 lymphoma, 1 Staphylococcus aureus, 1 Mycobacterium
      tuberculosis). In 94% of cases, there was no change in clinical management based
      on operative results. In 4 of 7 cases, the patients were ineligible for the
      indicated therapy based on underlying illness and in 1 of 7, the patient was
      receiving appropriate therapy for previously diagnosed disease. Ventilatory
      complications were noted in 17%. Three patients did not wean from the ventilator
      and died shortly after the operation. Sixty-nine percent mortality was noted at 8
      weeks post-operatively. One hundred percent mortality was noted at 22 weeks with
      86% follow-up. CONCLUSION: AIDS-related pericardial effusion is associated with a
      grave prognosis. Operations for diagnostic benefit provide little practical
      information and are not justified.

PMID- 7781341
TI  - Pulmonary resection for metastases of colorectal origin.
AB  - STUDY OBJECTIVE: To develop selection criteria for pulmonary metastasectomy in
      patients with metastases of colorectal cancer confined to the lungs. DESIGN: A
      retrospective study. SETTING: Medical records of all patients operated on for
      this condition in the Netherlands in the period 1982 to 1992 (n = 38).
      INTERVENTION: Evaluation by means of Cox's proportional hazards regression
      analysis of factors, which might relate to postthoracotomy disease-free survival
      and/or postthoracotomy survival. MEASUREMENTS AND RESULTS: The 5-year disease
      free survival was 31%, and the overall 5-year survival was 43% (Kaplan-Meyer).
      Multivariately, a number of three or fewer metastases (p = 0.012) and a short
      delay between detection of pulmonary metastases and resection (p = 0.05) related
      to a longer postthoracotomy disease-free interval. A longer interval between
      resection of the primary tumor and detection of lung metastases related to a
      longer postthoracotomy survival (p = 0.021). CONCLUSIONS: Patients with three or
      less pulmonary metastases of colorectal origin may benefit from resection; once
      metastases have been detected, resection should not be postponed.

PMID- 7781342
TI  - Empyema thoracis. Therapeutic management and outcome.
AB  - STUDY OBJECTIVE: We evaluated treatment and outcome of patients with thoracic
      empyema at a teaching institution. DESIGN AND SETTING: Retrospective chart review
      over a 44-month period at a university hospital. PATIENTS AND MEASUREMENTS:
      Charts of patients with a hospital discharge diagnosis of thoracic empyema were
      reviewed. Age, symptoms, alcohol use, empyema etiology, culture results, number
      of loculations, date and success of each procedure, length of hospital stay, and
      hospital discharge status were recorded for each patient. Success of procedure,
      recovery time, time between procedures, and total hospitalization time were
      compared between procedures and between subgroups. RESULTS: Charts from 43
      patients were reviewed. Twenty-four of 43 (56%) cases were parapneumonic
      empyemas. Forty of 43 (93%) patients had symptoms attributable to their empyema,
      with fever being the most common (65%). Seventy-nine procedures were needed to
      treat the 43 patients (1.84 procedures per patient). Success rates ranged from
      11% (3/27) for tube thoracostomy to 95% (21/22) for decortication (p = 0.0001).
      Delay between procedures averaged 6.2 +/- 1.1 (mean +/- SEM) days between the
      first and second procedure (n = 27), and 10.4 +/- 5.1 days between the second and
      third procedure (n = 8). Mean recovery after successful intervention ranged from
      9 to 19.3 days depending on the procedure (p = NS). Comparisons between
      multiloculated and uniloculated empyemas, parapneumonic and nonparapneumonic
      empyemas, and culture proven and biochemically proven empyemas showed no
      significant difference in procedure success rates or length of hospital stay.
      CONCLUSION: Multiple therapeutic options exist for the treatment of thoracic
      empyema. Optimal therapy requires selection of the most appropriate first
      procedure for each patient with early postprocedure imaging to avoid inordinate
      delays between interventions.

PMID- 7781344
TI  - Familial aggregates in obstructive sleep apnea syndrome.
AB  - Obstructive sleep apnea syndrome (OSAS) was diagnosed in157 subjects based on
      clinical symptoms, physical evaluation, cephalometric x-ray films, and
      polysomnography. These index cases identified 844 living first-degree relatives.
      Mailings were sent to 792 (94%). The mailing consisted of two identical
      questionnaires, one for the family member of the index case and one to be given
      to a friend (not a relative) of approximately the same age. In response, we
      received 531 (63%) questionnaires from relatives and 198 (25%) questionnaires
      from age-matched nonrelated friends, which were used as a control group. A more
      extensive investigation was performed on first-degree relatives of the index
      group living in the San Francisco Bay Area or vicinity. Two hundred seventy-nine
      relatives (100%) were identified. One hundred sixty-six subjects (59%) as well as
      69 age-matched friends (ie, 41% of the 166 relatives and 25% of the potential
      total group) agreed to participate in further studies. These subjects had
      interviews, clinical investigations, and nonattended ambulatory monitoring.
      Cephalometric x-ray films could be obtained on only 22 of 166 participating
      relatives and 6 of 69 friends. Body mass index was not a differentiating measure
      between relatives and friends. Odds ratios (ORs) were calculated from the
      questionnaiare data. The report of tiredness, fatigue, and sleepiness did not
      distinguish family members from friends. The OR, however, progressively increases
      when there is a positive history of near nightly loud snoring (OR = 1.78; 95%
      confidence interval [CI] 1.25-2.54) or a positive history of daytime sleepiness
      in conjunction with near nightly loud snoring (OR = 3.11; 95% CI = 1.94-4.99).
      The investigation in the Bay Area indicated that, when first-degree relatives
      were compared with friends, the complaint of daytime tiredness, sleepiness, or
      both with the presence of a high and narrow(ogival) hard palate sharply
      differentiated between friends and relatives (OR = 10.9, 95, CI = 5.31-22.5). An
      Epworth Sleepiness Scale score of 9 or greater with the presence of another
      symptom associated with OSAS, and a respiratory disturbance index greater than 5
      (number of apneas and hypopneas per hour of sleep > 5) gave an OR of 45.6 (95% CI
      = 18.8-11.0). Disproportionate craniofacial anatomy was common in familial groups
      with OSAS. Craniofacial familial features can be a strong indicator of risk for
      the development of OSAS.

PMID- 7781343
TI  - Cardiac hypertrophy in obstructive sleep apnea syndrome.
AB  - Fifty-one middle-aged male patients with obstructive sleep apnea syndrome (OSAS)
      were evaluated using two-dimensional echocardiography, 24-h blood pressure
      measurements, polysomnography, and plasma norepinephrine (NE) measurements. Among
      these patients, left ventricular hypertrophy (LVH) (left ventricular posterior
      wall thickness [LVPWT] or interventricular septal thickness [IVST] > or = 12 mm)
      and right ventricular hypertrophy (RVH) (right ventricular wall thickness [RVT] >
      or = 5 mm) were present in 41.2% (21/51) and 11.8% (6/51). LVH was present in
      50.0% of group 2 patients (apnea index > or = 20) and in 30.5% of group 1
      patients (apnea index < 20). All patients with LVH had hypertension. RVH was
      present in 21.4% of group 2 patients and none of the group 1 patients. IVST,
      LVPWT, LV mass, LV mass/body surface area (BSA), and obesity index were
      significantly greater in group 2 than in group 1. Apnea index and the duration in
      which nocturnal oxygen saturation was decreased under 90% (duration of SaO2 <
      90%), were significantly correlated with LV mass/BSA and 24-h mean blood
      pressure. Apnea index, number of apneas, duration of nocturnal oxygen saturation
      less than 90%, weight, and obesity index were significantly greater in patients
      with both LVH and RVH than in patients without LVH and RVH, or those with only
      LVH. Plasma NE after waking significantly increased compared with that before
      sleep (p < 0.05). The ratio of plasma NE levels after waking to those before
      sleep was significantly correlated with the duration of SaO2 < 90% (r = 0.83, p <
      0.05), but not with apnea index. These results suggest that frequent episodes of
      oxygen desaturation and/or arousal responses caused by apnea may contribute to
      the complication of LVH and RVH in the long term, and apnea-induced cyclical
      increases in blood pressure and the resulting sustained elevation in blood
      pressure associated with the increase in afterload and sympathetic activity may
      play a role in the development of LVH.

PMID- 7781345
TI  - Sleep fragmentation in kyphoscoliotic individuals with alveolar hypoventilation
      treated by NIPPV.
AB  - Intermittent positive pressure ventilation (IPPV) delivered via nasal access can
      normalize alveolar ventilation for individuals with chronic alveolar
      hypoventilation (CAH) due to neuromuscular disease, spinal cord injury, or
      skeletal deformity. The purpose of this study was to evaluate the effect of nasal
      IPPV (NIPPV) air leakage-associated oxyhemoglobin desaturations (dSATs) on the
      sleep efficiency of kyphoscoliotic individuals with severe pretreatment nocturnal
      dSATs. Only individuals using nocturnal NIPPV without supplemental oxygen therapy
      were studied. Seven such individuals were able to maintain PaO2 greater than 60
      mm Hg without supplemental oxygen therapy (five had been using oxygen therapy in
      the pretreatment period), had fewer hospitalizations, and had improvements in
      symptoms, arterial blood gas values, and nocturnal oxyhemoglobin saturation (SAT)
      by nocturnal NIPPV. This occurred despite polysomnographically observed sleep
      disruption and sleep stage changes associated with frequent transient dSATs and
      massive insufflation leakage. Arousals and dSATs were most frequent during rapid
      eye movement (REM) sleep with the latter occurring at a frequency of 10/h. The
      dSATs resulted in brief arousals or lightening of sleep stage 76% of the time.
      With or without arousal, central nervous system mediated reflex muscular activity
      occurred to diminish leak and normalize SAT. We conclude that the effectiveness
      of nocturnal NIPPV is dependent in part on central mediated muscular activity.

PMID- 7781346
TI  - A randomized comparison of 100-mg vs 500-mg dose of methylprednisolone in the
      treatment of acute asthma.
AB  - There have been conflicting reports comparing the effects of various doses of
      corticosteroids in the treatment of acute asthma. The purpose of this study was
      to compare 100 mg with 500 mg of methylprednisolone in the emergency department
      treatment of acute asthma. We studied 150 patients presenting to the emergency
      department with acute asthma. After baseline pulmonary function testing, patients
      were treated with oxygen and hourly administration of aerosolized albuterol.
      Patients were randomized to receive either 100 or 500 mg of methylprednisolone
      intravenously. Spirometry was repeated at 3 h, and again at 5 h for those
      patients whose dyspnea had not resolved after 3 h. There was no difference in the
      FEV1 between the 500-mg and 100-mg dose groups either before treatment (38.0% vs
      32.6% of predicted normal) or after treatment (55.3% vs 51.9% of predicted
      normal). There was no difference in the percentage improvement in FEV1 with
      treatment between the 500-mg and 100-mg dose groups (65.0% vs 71.2%). Twenty-five
      percent of the patients in the 500-mg dose group were admitted to the hospital
      compared with 28% of patients in the 100-mg dose group (not significant). We
      conclude that the administration of a 500-mg dose of methylprednisolone offers no
      advantages over a 100-mg dose in the emergency department treatment of acute
      asthma.

PMID- 7781347
TI  - Health-care utilization after near-fatal asthma.
AB  - Near-fatal asthma has been repeatedly associated with an increased risk of
      premature death. Despite a higher risk, death after near-fatal asthma remains
      infrequent. Few studies have examined the long-term outcome of those who
      experience a near-fatal event but do not succumb to asthma. We therefore
      contacted patients who had an episode of near-fatal asthma 5 to 10 years earlier
      and documented their use of health-care services for asthma. Each index case was
      compared with two age-matched controls who had been hospitalized for severe but
      not near-fatal asthma within 2 years of the index case admission. Thirty-seven
      index cases and 74 control subjects were assessed. Demographics did not
      distinguish the two groups. Availability of primary care physicians and asthma
      specialists were similar. There was no difference in the frequency of
      hospitalizations, emergency room visits, or visits to physicians for asthma
      between the two groups. ICU admissions were extremely infrequent. Although the
      mean number of ICU admissions per subject were similar in the year preceding our
      contact (0.03 +/- 0.16 in each group), there was a trend toward ICU admissions
      occurring more often in the near-fatal group (0.62 +/- 1.67 vs 0.31 +/- 0.91
      admissions/subject). Days away from work were more frequent in the control group
      (3.5 +/- 5.5 vs 1.6 +/- 3.3 d/yr) including days away from work in the year
      preceding our contact (8.9 +/- 43 vs 1.8 +/- 6.1 d). The data suggests that with
      regards to characteristics and health-care utilization, it may not be possible to
      distinguish people with near-fatal asthma from those who are hospitalized without
      a near-fatal event.

PMID- 7781348
TI  - The contribution of respiratory viruses to severe exacerbations of asthma in
      adults.
AB  - Viral infections are known to be associated with severe exacerbations of asthma
      in children. In contrast, there is limited data that viral infections evoke acute
      episodes of asthma that require emergency care in adults. To determine the role
      of viral infections in exacerbations of asthma in adults, we examined 33 patients
      who presented to the emergency room with 35 exacerbations of asthma between
      September 1990 and March 1991 for the presence of a viral infection. A nasal swab
      was obtained for virus isolation by culture and rapid antigen detection by
      fluorescent staining. In 16 patients, serum was collected at initial presentation
      and 3 to 4 weeks later for acute and convalescent viral antibody titers. All
      patients had acute episodes of asthma ascertained by medical history and physical
      examination. About 56% of the patients with asthma exacerbations had symptoms
      suggestive of viral illness. Rapid antigen detection and viral cultures for
      influenza A and B, parainfluenza-1, 2, 3, respiratory syncytial virus,
      adenovirus, and rhinovirus were negative on all patients. Likewise, in all 16
      patients tested, acute and convalescent serologic studies did not show a
      significant rise in titer by complement fixation test. Thus, despite symptoms
      consistent with viral infection, viral pathogens could not be shown by current
      virologic techniques. This study suggests that viral infection may not be as
      prevalent a precipitate of asthma in adults requiring emergency room treatment as
      is generally thought.

PMID- 7781349
TI  - Intravenous magnesium sulfate as an adjunct in the treatment of acute asthma.
AB  - STUDY OBJECTIVE: This study was conducted to determine whether intravenous
      magnesium sulfate (MgSO4), when used as part of a standardized treatment
      protocol, can improve pulmonary function and decrease admission rate in patients
      presenting to the emergency department with exacerbations of asthma. DESIGN: In
      this randomized double-blind placebo-controlled study, patients with acute asthma
      were treated with inhaled beta-agonists at regular intervals and intravenous (IV)
      steroids. At 30 min after entry, patients received either 2 g IV MgSO4 or IV
      placebo. Patients were monitored for up to 4 h with regular measurements of
      pulmonary function. Patients who were discharged from the emergency department
      were contacted at 1 day and 7 days for follow-up. SETTING: Emergency departments
      of a university-affiliated, voluntary hospital and municipal hospital.
      PARTICIPANTS: Asthmatics aged 18 to 65 years during acute exacerbation with FEV1
      less than 75% predicted both before and after a single albuterol treatment.
      INTERVENTIONS: Patients were given 2 g of MgSO4 or placebo as an adjunct to
      standardized emergency department procedure for acute asthma. MEASUREMENTS AND
      RESULTS: One hundred thirty-five patients were studied. Hospital admission rates
      were 35.3% for placebo-treated group and 25.4% for the magnesium-treated group (p
      = 0.21). FEV1 measured at 120 min was 56% predicted for the placebo-treated group
      and 55% predicted for the magnesium-treated group. (p = 0.92) For subgroup
      analysis, patients were divided into "severe" (baseline FEV1 < 25% predicted on
      presentation) or "moderate" (baseline FEV1, 25 to 75% predicted on presentation).
      For the severe group, admission rates were 78.6% (11/14) for the placebo-treated
      group and 33.3% (7/21) for the magnesium-treated group (p = 0.009). For the
      moderate patients, admission rates were 22.4% (11/49) for the placebo-treated
      group and 22.2% (10/25) for the magnesium-treated group (p = 0.98). There was no
      significant improvement in FEV1 in the moderate group for magnesium-treated
      patients. However, in the severe group, there was a significant improvement in
      FEV1 at 120 min and 240 min (p = 0.014 and 0.026, respectively). CONCLUSION:
      Intravenous MgSO4 decreased admission rate and improved FEV1 in patients with
      acute severe asthma but did not cause significant improvement in patients with
      moderate asthma.

PMID- 7781350
TI  - Nasal function and bronchial hyperresponsiveness to methacholine in children.
AB  - The objective of the present study was to investigate nasal function by active
      anterior rhinomanometry with respect to spirometric data and bronchial
      hyperresponsiveness to methacholine in 9-year-old children. The study population
      consisted of 300 children (ages 8 to 11 years; mean, 9.3 years; 161 male, 139
      female), who underwent basal rhinomanometry followed by a decongestion test and a
      lung function test consisting of spirometry and a methacholine provocation test.
      The flow values of the basal rhinomanometry showed a significant correlation with
      height and bronchial hyperresponsiveness. The consecutive decongestion test
      showed a marked increase in flow rates at each level, which was found to be
      significantly higher in children with bronchial hyperresponsiveness (p < 0.01).
      The spirometric data showed no influence on rhinomanometric values. These results
      suggest that nasal dysfunction and reactivity in terms of the decongestion test
      may be associated with bronchial hyperresponsiveness in children.

PMID- 7781351
TI  - Evaluation of the short-form 36-item questionnaire to measure health-related
      quality of life in patients with COPD.
AB  - STUDY OBJECTIVE: To evaluate the short-form 36-item questionnaire (SF-36) as an
      instrument for measuring health-related quality of life (HRQL) in patients with
      symptomatic COPD. DESIGN: Observational data at a single point in time. SETTING:
      Outpatient pulmonary clinic. PATIENTS: Fifty male patients with COPD and no
      significant comorbidity. MEASUREMENTS AND RESULTS: HRQL was assessed with the SF
      36, which consists of 36 questions that cover nine health domains. Clinical
      ratings of dyspnea were measured by the multidimensional baseline dyspnea index
      (BDI). Pulmonary function tests included forced vital capacity (FVC), forced
      expiratory volume in 1 s (FEV1), and maximal inspiratory mouth pressure (PImax).
      The mean (+/- SD) age of the patients was 72 +/- 8 years. The BDI focal score was
      5.6 +/- 2.3, FEV1 was 1.32 +/- 0.60 L (48 +/- 22% pred), and PImax was 62 +/- 23
      cm H2O. The BDI focal score was significantly correlated with seven of nine
      components of the SF-36 (range of r, 0.42 to 0.91; p < 0.05). The FEV1 percent of
      predicted and PImax were significantly correlated with five of nine health
      components (range of r, 0.30 to 0.65 and 0.31 to 0.61, respectively). Using
      linear regression model analysis with the different SF-36 components as the
      dependent variable and BDI, FVC, FEV1, and PImax as independent variables, the
      BDI score was the only significant predictor of social and physical functioning,
      role-physical, vitality, pain, health perceptions, and health transition (p <
      0.05). CONCLUSIONS: The SF-36 is a valid instrument to measure HRQL in patients
      with COPD. The severity of dyspnea but not respiratory function was a significant
      predictor of various components of HRQL.

PMID- 7781352
TI  - Reproducibility of Borg scale measurements of dyspnea during exercise in patients
      with COPD.
AB  - The purpose of this study was to evaluate the moderate term (5 weeks)
      reproducibility of Borg scale ratings of the effort to breathe (Borge) and the
      degree of discomfort evoked by breathing (Borgd) in patients with COPD during
      exercise. Six subjects with moderately severe COPD (FEV1, 1.42 +/- 0.50 L)
      underwent progressive incremental exercise (15 W/min) on a cycle ergometer to a
      symptom-limited maximum every week for 6 weeks (first week used as practice
      session). Minute ventilation (VE), oxygen consumption (VO2), and Borg ratings
      were obtained every minute during exercise. Borge and Borgd were highly
      correlated in each subject (r = 0.99 +/- 0.01). Borg scores were not
      significantly different across study days during both maximal and submaximal
      exercise. The within-subject coefficient of variation (CV) for Borge during
      maximal exercise was 13.9 +/- 9.0% (range, 6 to 31%) which was not significantly
      different from that observed for the physiological indices: 8.2 +/- 4.1% (range,
      4 to 15%) for VE and 5.2 +/- 3.4% (range, 1 to 10%) for VO2. In contrast, at 66%
      of the maximum workload, the within-subject CV for Borge was 25.0 +/- 13.6%
      (range, 12 to 50%) which was significantly greater than that observed for the
      physiologic indices: 5.8 +/- 2.0% (range, 3 to 9%) for VE and 4.6 +/- 1.1%
      (range, 3 to 6%) for VO2. In every subject, Borge was linearly correlated with
      VE, VO2, and workload. However, within an individual subject, the slope of these
      relationships varied between trials; within-subject CV for the slope of the
      Borge/VE relationship was 20.2 +/- 8.0% (range, 12 to 32%). In conclusion, during
      incremental exercise Borg ratings of dyspnea are not as reproducible as
      physiologic indices in patients with COPD.

PMID- 7781353
TI  - Diagnosis of pleural effusions. Experience with clinical studies, 1986 to 1990.
AB  - OBJECTIVES: To identify in patients with pleural effusion which procedures are
      most useful in separating malignant from nonmalignant pleural effusions and to
      identify which procedures most commonly lead to a definitive diagnosis. DESIGN:
      Prospective consecutive case series. SETTING: Pulmonary referral hospital in
      Prague, Czech Republic. PATIENTS: One hundred seventy-one adults between ages 18
      and 70 years with a pleural effusion and a Karnofsky score of 70 or above.
      INTERVENTIONS: All patients underwent history, physical, pleural fluid cytologic
      study, laboratory evaluation of serum and pleural fluid, pleural biopsy,
      bronchoscopy, and lung scan and/or pulmonary arteriogram. RESULTS: In this series
      in which 45% of the patients had malignant effusions, 19% had paramalignant
      effusions, and 36% had benign diseases, the pleural fluid cytologic study was the
      best for establishing a diagnosis. The pleural fluid carcinoembryonic antigen
      (CEA) levels above 10 had a high specificity (90%) for malignancy but had low
      sensitivity (37%). The pleural fluid CEA level was increased only in 19% of
      patients with paramalignant effusions. Although there were statistically
      significant differences in the mean results on several biochemical tests of
      pleural fluid, none were very accurate in separating malignant from benign
      disease. CONCLUSION: From this study, we conclude that patients with an
      undiagnosed pleural effusion should be evaluated in an individualized stepwise
      manner. If malignancy is strongly considered, the initial three steps should be
      relatively noninvasive and include clinical evaluation and cytologic study.

PMID- 7781354
TI  - Comparative analysis of the biochemical parameters used to distinguish between
      pleural transudates and exudates.
AB  - The differentiation between exudates and transudates is the initial step in the
      analysis of pleural effusions as it often gives an indication of the underlying
      pathophysiologic process, the differential diagnosis, and the need for further
      investigations. Four classifications have been suggested in the literature:
      Light's criteria, serum-effusion albumin gradient, effusion cholesterol
      concentration, and pleural/serum bilirubin concentration. AIM OF STUDY: To
      compare the various biochemical parameters used to identify exudates. PATIENTS
      AND METHODS: A study was carried out from February 1993 to March 1994 at
      Tygerberg Hospital, South Africa. Five hundred pleural effusions and serum
      specimens were analyzed. After discharge, the hospital records of all patients
      were reviewed for a diagnosis. RESULTS: A reliable diagnosis could be made in 393
      cases (270 exudates and 123 transudates). Using the criteria of Light and
      associates 93% of the effusions were correctly classified, yielding a sensitivity
      and specificity of 98% and 83%, respectively, to detect exudates. The serum
      effusion albumin gradient at a cutoff level of 12 g/L yielded the following
      results: accuracy, 89%; sensitivity, 87%; and specificity, 92%. Using a cutoff
      level of 1.55 mmol/L, the effusion cholesterol concentration yielded results of
      70%, 54%, and 92%, respectively. The results improved at lower cutoff levels for
      effusion cholesterol level. Use of the pleural/serum bilirubin ratio as a means
      for identifying exudates produced results of 75%, 81%, and 61%, respectively.
      CONCLUSION: The criteria of Light et al remain the best method for distinguishing
      exudates from transudates. The serum-effusion albumin gradient is useful when
      patients are receiving concurrent diuretic therapy.

PMID- 7781355
TI  - Changes in pulmonary mechanics and gas exchange after thoracentesis on patients
      with inversion of a hemidiaphragm secondary to large pleural effusion.
AB  - The present study was designed to test whether there was a significant
      improvement in pulmonary function and arterial blood oxygenation after
      therapeutic thoracentesis on patients with inversion of a hemidiaphragm due to
      pleural effusion. In 21 patients with inversion of a hemidiaphragm because of a
      pleural effusion, we studied the changes in pulmonary mechanics and gas exchange
      that occurred in 24 h after removal of 600 to 2,700 mL of fluid by thoracentesis.
      There was a small but significant increase in the forced expiratory volume in 1 s
      (FEV1) and forced vital capacity (FVC) (p < 0.001). The alveolar-arterial oxygen
      gradient (P[A-a]O2) and partial pressure of arterial oxygen (PaO2) showed a
      significant increase (p < 0.001), but there was no change in partial pressure of
      arterial carbon dioxide (PaCO2). In the present study, all patients with a large
      pleural effusion had inversion of a hemidiaphragm documented by chest sonography,
      and that was an important factor to observe significant improvement in pulmonary
      mechanics and gas exchange.

PMID- 7781356
TI  - Percutaneous needle biopsy of localized pulmonary, mediastinal, and pleural
      diseased tissue with an automatic disposable guillotine soft-tissue needle.
      Preliminary results.
AB  - Percutaneous needle biopsy (PNB) of localized thoracic disease has become a
      widespread procedure in many institutions. The development of special small
      caliber needles has increased the diagnostic yield of PNB partly by increasing
      the amount of tissue from biopsy, often enabling histologic examination.
      Nevertheless, in a significant number of patients only cytopathologic examination
      is possible on the retrieved biopsy fragments, necessitating the presence of a
      trained cytopathologist in the biopsy room. Furthermore multiple biopsy needle
      passages often are required, increasing the risk for complications such as
      pneumothorax. We have evaluated the use of a small-caliber tissue biopsy cutting
      needle, consistently yielding sufficient biopsy tissue for histologic
      examination. In 25 pleural and mediastinal lesions, which could be biopsied
      without passage through aerated lung, there was a 93% sensitivity (7% false
      negative results) for neoplasm and a 100% accuracy for benign disease. There were
      no complications. In 32 patients with lesions of 1 cm in diameter or more
      surrounded with aerated lung tissue, adequate histologic examination was feasible
      on every biopsy specimen after only one needle passage. There was an 87%
      sensitivity of PNB in neoplastic disease (13% false-negatives). In the patients
      with benign disease, there was a 100% accuracy. There was a 15.6% risk for
      pneumothorax. In only one patient (3%), however, was chest drainage necessary.
      One patient (3%) had mild hemoptysis. We conclude that percutaneous biopsy of
      localized pulmonary, pleural, and mediastinal lesions with a new small-caliber
      automatic guillotine cutting needle is safe and efficient, enabling recovery of
      sufficient tissue for histologic examination with a single-pass procedure, thus
      minimizing the risk for pneumothorax, eliminating the need for a cytopathologist
      in the biopsy room, and shortening the duration of the procedure.

PMID- 7781357
TI  - Prednisone as adjunctive therapy in the management of pulmonary tuberculosis.
      Report of 12 cases and review of the literature.
AB  - A retrospective chart review was conducted over a 5-year period (1988 to 1993) in
      a tertiary inpatient care center on the effects of the addition of prednisone to
      the treatment regimens of 12 patients with pulmonary tuberculosis who continued
      to spike high temperatures and lose weight while showing bacteriologic response
      to effective antituberculosis therapy. After exclusion of other causes of fever,
      all patients were treated with 20 to 60 mg of prednisone daily until
      normalization of temperature and clinical improvement. Analyzed data included
      twice weekly sputum bacillary count, temperature record every 4 h, weekly patient
      weight, serum albumin level, liver function tests, and chest roentgenogram. The
      patients continued to spike temperatures of 38.3 degrees C to 40.5 degrees C
      (mean +/- SD = 39.6 degrees C +/- 0.6 degrees C) even after 18 to 53 days (mean
      +/- SD = 33.9 +/- 9.8 days) of antituberculosis therapy. Within 24 h after the
      addition of oral prednisone, temperature decreased in all 12 patients from a
      daily highest spike mean of 39.6 degrees C +/- 0.6 degrees C (SD) to 38.1 degrees
      C +/- 0.6 degrees C (SD) (p = 0.0022). The duration of required prednisone
      therapy was 20.1 +/- 9 days (mean +/- SD). During this period patients' appetites
      improved, and their weight increased from a mean (+/- SD) of 53.6 +/- 5.7 kg to
      58.1 +/- 6.4 kg (p = 0.0022). The serum albumin level increased from a mean (+/-
      SD) of 2.51 +/- 0.4 g/dL to 3.21 +/- 0.4 g/dL (p = 0.0033). All the patients also
      showed clinical evidence of a decrease in toxic reactions associated with
      tuberculosis. There were no side effects from the addition of prednisone. This
      study shows the need for randomized controlled clinical trials to clarify the
      role of prednisone as adjunctive therapy in the management of pulmonary
      tuberculosis.

PMID- 7781358
TI  - The utility of polymerase chain reaction (PCR) in the diagnosis of pulmonary
      tuberculosis.
AB  - A fragment of DNA of 123 bp belonging to insertion sequence IS6110, specific of
      Mycobacterium tuberculosis complex, was amplified by polymerase chain reaction
      (PCR) of respiratory samples, for the diagnosis of pulmonary tuberculosis. A
      total of 314 samples (286 sputum and 28 bronchoalveolar lavages) from 242
      patients were evaluated by PCR, and the results were compared with the those
      obtained by acid-fast-stained smears, culture, and clinical diagnosis.
      Mycobacterium tuberculosis was detected by PCR in 102 of 105 patients with
      clinical diagnosis of pulmonary tuberculosis. All smear and culture-positive
      samples were PCR positive. The sensitivity of PCR, culture, and staining was 97%,
      88%, and 65%, respectively, and the specificity was 100% in all cases. In ten
      patients with old residual lesions, but no active disease, M tuberculosis genome
      was detected by PCR. In our experience, PCR proved to be a useful method for the
      rapid diagnosis of pulmonary tuberculosis.

PMID- 7781359
TI  - Elevated levels of soluble ICAM-1 in serum and BAL fluid in patients with active
      sarcoidosis.
AB  - Intercellular adhesion molecule-1 (ICAM-1), a member of the immunoglobulin
      superfamily of adhesion molecules, plays an important role in inflammatory and
      immune diseases. The soluble form of ICAM-1 (sICAM-1) shed from the cell surface
      may be a marker of inflammatory response and may reflect the disease activity. We
      measured the levels of sICAM-1 in serum and bronchoalveolar lavage fluid (BALF)
      in patients with sarcoidosis. Healthy volunteers were examined as controls. sICAM
      1 concentrations were measured using an enzyme-linked immunosorbent assay kit
      with two different monoclonal antibodies. Serum and BALF sICAM-1 levels in
      sarcoidosis were significantly higher than those in control. Serum sICAM-1 levels
      correlated with serum soluble interleukin-2 receptor levels (a marker of T
      lymphocyte activation) but not with serum angiotensin-converting enzyme levels.
      sICAM-1 levels in BALF correlated significantly with the percentage of
      lymphocytes in BALF. Some patients were examined twice during follow-up periods.
      In patients in whom the chest radiograph improved, serum and BALF sICAM-1 levels
      decreased. However, in patients in whom the radiograph worsened, sICAM-1 levels
      increased. These results suggest that measurement of sICAM-1 may be useful to
      investigate not only the pathogenic mechanisms, but also the clinical status and
      disease activity in patients with sarcoidosis.

PMID- 7781360
TI  - Human neutrophil collagenase (MMP-8), identified in bronchiectasis BAL fluid,
      correlates with severity of disease.
AB  - Collagenases in bronchoalveolar lavage fluid (BALF) of patients with
      bronchiectasis and healthy subjects were characterized using specific functional
      and immunologic assays. The BAL fluid contained interstitial collagenase and
      collagenolytic proteinases of bacterial origin. Collagenase activities, obtained
      after organomercurial activation, correlated with the severity of bronchiectasis.
      In severe cases, collagenase activities were 3.5 x 10(-7) IU/L/48 h or 4.8 x 10(
      6) IU/g/48 h (p < 0.01), in moderate ones 1.74 x 10(-7) IU/L/48 h or 3.35 x 10(
      6) IU/g/48 h (p < 0.05), and in mild cases 0.32 x 10(-7) IU/L/48 h or 0.7 x 10(
      6) IU/g/48 h (p < 0.05). The corresponding activities in healthy control subjects
      were 0.08 x 10(-7) IU/L/48 h or 0.13 x 10(-6) IU/g/48 h. The cellular origin of
      interstitial collagenase was assessed with doxycycline inhibition test utilizing
      the differential sensitivity of fibroblast-type collagenase/MMP-1 (IC50 = 280
      microM) and neutrophil-type collagenase/MMP-8 (IC50 = 26 microM) to the
      anticollagenolytic, nonantimicrobial doxycycline action. Interstitial
      collagenase, contained in BALF, was totally inhibited by 100 microM of
      doxycycline. It can therefore be concluded that most of mammalian collagenase
      presented in inflamed fluid of bronchiectasis originated from neutrophils. The
      molecular forms of neutrophil-type collagenase/MMP-8 were confirmed and analyzed
      by Western-blot, which showed evidence of the proteolytic conversion of the
      latent 85-kD MMP-8 proenzyme species into active 65-kD molecular weight species.
      These findings strongly suggest involvement of proteolytic activation pathway of
      proMMP-8, especially in severe and moderate forms of bronchiectasis. Furthermore,
      collagenolytic proteases of bacterial origins may also participate in tissue
      destruction of the lung.

PMID- 7781361
TI  - Pulmonary barotrauma and related events in divers.
AB  - Although pulmonary barotrauma (PBT) is a well-known clinical entity, its
      recognition in divers is sometimes delayed and its implications for future diving
      often are unappreciated. The pulmonary complications of diving activities range
      from mere discomfort from mediastinal emphysema or pneumothorax, or both, to life
      threatening gas embolization. In nine cases described here, only minor
      manifestations were associated with PBT which occurred at or close to the
      surface, but three of these four divers were found to have abnormal pulmonary
      function. More serious manifestations resulted from PBT which took place at
      depths of 16 to 120 ft. Even minor forms of PBT should be considered a
      contraindication to further diving, since they are prone to recur. Such
      recurrences--even at shallow depths--may cause serious complications.

PMID- 7781362
TI  - Cerebral air embolism in asthmatic scuba divers in a swimming pool.
AB  - Significant shallow-water injuries can occur in scuba divers, even in swimming
      pools. Two asthmatic patients are presented who sustained cerebral air emboli
      during Scuba classes in a swimming pool. Such injuries may be more common in
      asthmatics. Asthma is a contraindication to Scuba diving.

PMID- 7781363
TI  - Endotracheal intubation by paramedics during in-hospital CPR.
AB  - STUDY OBJECTIVE: To examine whether well-trained paramedics can perform emergent,
      successful, uncomplicated, endotracheal intubations during in-hospital
      cardiopulmonary resuscitation (CPR). DESIGN: Retrospective review of medical
      records of in-patients undergoing emergent, endotracheal intubations during in
      hospital, CPR over 8 months, with comparison of the performance of the paramedics
      against that of other hospital-based personnel. SETTING: A 437-bed Midwestern
      community teaching hospital. PATIENTS: Adult in-patients in general
      medical/surgical wards. MAIN OUTCOME MEASURES: The rapidity of response of
      paramedics and other medical personnel to a cardiorespiratory arrest (code 4)
      announcement, and reported difficulties, success rate, rapidity, and
      complications of endotracheal intubation. RESULTS: In the 47 cardiorespiratory
      arrests requiring intubation that we analyzed, the median response times (with
      values in parentheses representing interquartile range [IQR]) for paramedics,
      nurse anesthetists (CRNAs), anesthesiologists, and other physicians respectively,
      were 2.00 (4.25), 4.00 (2.0), 4.00 (15.0), and 7.00 (8.0) min, requiring a median
      of 1.0 attempt for all groups (mean values, 1.4, 1.125, 1.0, and 1.4
      respectively) to place an endotracheal tube. The paramedics were successful in 13
      of 15 instances. Median times (seconds) required for intubation by various groups
      (same order as response times, with IQR given in parentheses) were 60 (30), 150
      (270), 45 (30), and 60 (30). Difficulties were reported by all groups, including
      patients' resistance to intubation, airway obstruction by extraneous material,
      and difficulty in visualizing the glottis. Reported complications (4%) were
      confined to groups other than the paramedics. CONCLUSIONS: Paramedics can
      successfully, and without undue difficulty or complications, place endotracheal
      tubes during in-hospital CPR. Appropriately trained paramedics may be
      incorporated into hospital-based CPR teams in two contexts: (1) to provide an
      acceptable, long-term solution to the scarcity of personnel highly skilled in
      endotracheal tube placement during in-hospital CPR, and (2) to fulfill the need
      for hospitals to have on-site, qualified professionals to perform emergent
      endotracheal intubation during CPR. In the latter situation, personnel skilled in
      airway management could supplement the paramedics on demand. Further
      investigation in this area could be fruitful in view of the small sample size
      covered in this study.

PMID- 7781364
TI  - Evaluation of formulas for optimal positioning of central venous catheters.
AB  - OBJECTIVE: To evaluate the accuracy of formulas designed to estimate the optimum
      intravenous length of central venous catheters. DESIGN: A prospective study of
      catheter insertion sites to evaluate the accuracy of predetermined formulas that
      predict the intravascular insertion length required to avoid intracardiac
      catheter tip placement. SETTING: A 320-bed tertiary hospital. PATIENTS:
      Critically ill patients requiring central venous access for therapy or
      monitoring. MAIN RESULTS: The formulas accurately predicted required
      intravascular length of the central venous catheter in 217 of 228 (95%) cases.
      The formula for predicting catheter length was most accurate when the subclavian
      vein was used. It was least accurate when the right internal jugular vein was
      selected. CONCLUSIONS: The formulas can accurately predict the required length of
      catheters and thereby reduce the possibility of complications and save time and
      expense.

PMID- 7781365
TI  - Pressure support ventilation attenuates the cardiopulmonary response to an acute
      increase in oxygen demand.
AB  - Critically ill patients undergo interventions, such as chest physical therapy,
      that acutely increase metabolic rate. Previous observations revealed that chest
      physical therapy is accompanied by increases of 40 to 50% in oxygen consumption
      (Vo2) and 40% in minute ventilation contributes to the rise in Vo2 and its
      associated hemodynamic responses. This was done by increasing mandatory
      ventilatory support during the chest physical therapy session: In phase 1 the
      mandatory ventilation rate was increased by 35% and in phase 2 pressure support
      ventilation 15 cm h2O was added. In phase 1 (n = 12), the increase in mandatory
      rate did not attenuate the chest physical therapy induced rises in heart rate,
      arterial blood pressure and Vo2. The increase in minute ventilation when the
      mandatory rate was increased prevented a rise in PaCO2. In phase 2 (n = 15), no
      change in the increase in Vo2 with chest physical therapy was observed with the
      addition of pressure support. Yet the rises in heart rate and systemic and
      pulmonary artery pressures were attenuated, as was the increase in PaCO2.
      Respiratory rate did not increase as much with pressure support. There appears to
      be a role for pressure support ventilation in attenuating the pulmonary and
      hemodynamic responses to interventions that increase oxygen demand.

PMID- 7781366
TI  - Investigating the impact of age on outcome of mechanical ventilation using a
      population of 41,848 patients from a statewide database.
AB  - STUDY OBJECTIVE: To examine the impact of age on outcome from mechanical
      ventilation. DESIGN: Retrospective analysis of a statewide database. SETTING: All
      acute-care hospitals in New York State. PATIENTS: All patients, aged 18 years and
      over, requiring mechanical ventilation during 1990 who could be identified with a
      mechanical ventilation procedure code (93.92) were studied. Data were obtained in
      aggregate form (six or more cases) from the New York State Department of Health.
      This process required a detailed request letter to the Statewide Planning and
      Cooperative System (SPARCS). Transmission of confidential information was not
      desired or permitted. MEASUREMENTS AND RESULTS: Age and mortality rate (MR) fit a
      cuboidal regression model best (MR = -25.55 + 3.98Age - 0.072Age2 + 0.00043Age3,
      R2 = 0.85). Mortality rates vary significantly across various broad diagnostic
      groups (p < 0.01, analysis of variance [ANOVA]) and increase as a function of ICU
      duration (p < 0.01, ANOVA). CONCLUSIONS: Age has an important effect on outcome
      from mechanical ventilation. Other factors, such as ICU duration and diagnosis,
      also influence outcome, and age should not be used as a sole criterion in
      evaluating the potential benefit of mechanical ventilation to an individual
      patient. Large, existing databases, such as SPARCS, may be useful in studying the
      application of mechanical ventilation.

PMID- 7781367
TI  - Transferrin concentrations in serum and lower respiratory tract fluid of
      mechanically ventilated patients with COPD or ARDS.
AB  - Transferrin serves as the primary iron transport protein in serum, but it also is
      present in the lower respiratory tract where it has antioxidant and antibacterial
      properties. Prior studies indicate that patients with respiratory failure (RF)
      due to ARDS have increased concentrations of transferrin in the lower respiratory
      tract, which is attributed to increased lung vascular permeability. It is unclear
      whether mechanical ventilation contributes to increased lung transferrin content
      in patients with ARDS, although mechanical ventilation may increase lung
      microvascular permeability. To assess whether mechanical ventilation in patients
      with RF due to causes other than ARDS is also associated with increased
      respiratory tract concentrations of transferrin, we compared transferrin
      concentrations in serum and lung lavage fluid obtained from 12 mechanically
      ventilated patients with RF attributable to COPD, 6 patients with ARDS, and 15
      healthy volunteers. Serum transferrin concentrations in patients with RF due to
      COPD were variable, but mean concentrations were similar to those in control
      subjects (336 +/- 58 vs 307 +/- 9 [SE] mg/dL), whereas serum transferrin
      concentrations were decreased in patients with ARDS (182 +/- 68 mg/dL; p < 0.05).
      Compared with control subjects, lavage fluid recovered from patients with RF due
      to COPD contained significantly decreased concentrations of transferrin (1.56 +/-
      0.24 vs 4.27 +/- 0.44 micrograms/mL; p < 0.001), whereas transferrin
      concentrations in lavage fluid recovered from patients with ARDS were increased
      (15.72 +/- 2.01 micrograms/mL; p < 0.001). Transferrin concentrations of lavage
      fluid also were decreased in COPD patients when normalized for lavage fluid
      protein content (4.35 +/- 0.72 vs 19.96 +/- 3.13 micrograms/mg in control
      subjects, p < 0.001). These data indicate that mechanical ventilation of patients
      with COPD is associated with decreased lung transferrin concentrations, in
      contrast to an increased transferrin concentration found in patients with ARDS.
      Decreased transferrin concentrations in the lower respiratory tract may decrease
      defenses against oxidant injury and bacterial infection in patients with RF due
      to COPD.

PMID- 7781368
TI  - Enteral feeding tube placement success with intravenous metoclopramide
      administration in ICU patients.
AB  - OBJECTIVE: The purpose of this study was to determine if intravenous push
      metoclopramide would facilitate immediate transpyloric passage of a small-bore
      feeding tube without fluoroscopy or endoscopy. DESIGN: Prospective, randomized
      trial. PATIENTS: One hundred five medical and surgical ICU patients at a
      community teaching hospital. INTERVENTIONS: Patients were randomized to receive
      10 mg of metoclopramide 10 min before tube insertion or no medication.
      MEASUREMENT: Successful placement was stated as radiologically verified
      transduodenal tube location. RESULTS: A 54% success rate was shown with
      administration of the drug with 46% success for the control. Chi square analysis
      of the success rate showed no significant relationship between administration of
      metoclopramide and successful tube placement (p = 0.38). Increasing years of
      physician training was the only variable associated with successful placement (p
      = 0.003). No association was found between successful tube placement and presence
      of endotracheal tube, tracheostomy, or cervical immobility, nor any interaction
      of metoclopramide with these variables. CONCLUSION: Intravenous metoclopramide,
      10 mg, administered 10 min prior to intubation with a small-bore feeding tube
      (10F), was ineffective in facilitating transpyloric intubation.

PMID- 7781369
TI  - Intravenacaval membrane oxygenation and carbon dioxide removal in severe acute
      respiratory failure.
AB  - STUDY OBJECTIVE: To characterize the physiologic response to, and safety of,
      intravenacaval membrane oxygenation and carbon dioxide removal. DESIGN:
      Interventional before-after study. SETTING: University teaching hospital ICU.
      PATIENTS: Twenty-two patients with severe acute respiratory distress syndrome
      (ARDS). INTERVENTIONS: Implantation of a hollow-fiber membrane oxygenator (IVOX;
      CardioPulmonics; Salt Lake City, Utah) into the superior and inferior venae cavae
      by venotomy of the right femoral or right internal jugular vein for a duration of
      up to 20 days. MEASUREMENTS: Hemodynamic measurements using pulmonary artery and
      systemic artery catheters, ventilator settings (FIO2, minute ventilation, peak
      inspiratory pressure, and positive end-expiratory pressure), arterial and mixed
      venous blood gases (pH, PCO2, PO2, and measured saturation), and clinical
      laboratory determinations (CBC, fibrinogen, plasma hemoglobin, complement C3 and
      C5) were obtained. Calculations of PaO2/FIO2 ratio and PaCO2-VE product were used
      to assess gas exchange efficacy. Microbiologic cultures were obtained from the
      device and wound following explantation. Survival to ICU discharge and hospital
      discharge were recorded. RESULTS: Implantation was successful in 20 of 22
      patients. Gas exchange rates averaged 50.4 +/- 15.8 mL.min-1 for carbon dioxide
      and 71.1 +/- 20.2 mL.min-1 for oxygen. A reduction in FIO2 from 0.78 +/- 0.16 to
      0.63 +/- 0.21 and in VE from 177 +/- 94 mL.kg-1.min-1 to 127 +/- 58 mL.kg-1.min-1
      was possible within 4 h post-implantation. By 12 h, FIO2 was reduced to 0.57 +/-
      0.18. Indices of gas exchange improved significantly after implantation, with
      PaO2/FIO2 ratio increasing from 79 +/- 20 to 112 +/- 47 and PaCO2-VE product
      decreasing from 7.6 +/- 4.2 to 4.9 +/- 2.5 within 4 h. A significant reduction in
      peak inspiratory pressure was achieved (45 +/- 10 to 38 +/- 9 cm H2O). Major
      complications were blood loss during implantation requiring transfusion in 11
      patients, a retroperitoneal bleed in 1 patient, and femoral deep venous
      thrombosis in 4 patients, but there were no long-term sequelae or IVOX-related
      deaths. The ICU and hospital survival were 10/20 (50%) and 8/20 (40%),
      respectively. CONCLUSIONS: Intravenacaval membrane oxygen and carbon dioxide
      removal can provide partial respiratory support during severe respiratory failure
      and permit reductions in the level of mechanical ventilator support, with an
      acceptable safety profile.

PMID- 7781370
TI  - Hemodynamic and metabolic effects of rapid correction of hypophosphatemia in
      patients with septic shock.
AB  - STUDY OBJECTIVE: To examine the hemodynamic and metabolic short-term effects of
      hypophosphatemia correction in patients with septic shock receiving catecholamine
      therapy. DESIGN: Prospective, single cohort study. SETTING: ICU, university
      hospital. PATIENTS: Ten patients with septic shock and hypophosphatemia below 2
      mg/dL. INTERVENTIONS: Infusion of glucose-1-phosphate solution (20 mmol of
      elemental phosphorus) for 60 min. MEASUREMENTS AND RESULTS: Hemodynamic, oxygen
      derived, acid-base, and electrolyte parameters before and immediately after
      phosphate infusion. Left ventricular stroke work index increased significantly
      (22%) from a mean low value of 24 +/- 10 g/m2 without changes in filling
      pressures. Systolic arterial pressure improved by 12%. Arterial pH improved
      slightly but significantly. Ionized calcium level slightly decreased within the
      normal range values. Other parameters remained unchanged. CONCLUSIONS: Severe
      hypophosphatemia may be considered as a superimposed cause of myocardial
      depression, inadequate peripheral vasodilatation, and acidosis in septic shock. A
      rapid correction of hypophosphatemia is well tolerated and may have both
      myocardial and vascular beneficial effects. The magnitude of the response,
      however, is variable and unpredictable on the basis of serum phosphorus levels.

PMID- 7781371
TI  - Talc slurry is an effective pleural sclerosant in rabbits.
AB  - Insufflated talc is probably the most effective agent for creating a pleurodesis
      both in the clinical situation and in animals. However, the insufflation of talc
      requires an invasive procedure such as thoracoscopy or thoracotomy. Recently,
      there have been reports that talc in a slurry was effective in the clinical
      situation. The objective of this project was to determine whether talc in a
      slurry at varying doses is an effective sclerosant in an experimental model in
      rabbits. Talc, 50, 100, 200, and 400 mg/kg, in a 2-mL slurry was injected
      intrapleurally through a small catheter in male rabbits. Eleven rabbits received
      each dose. Twenty-eight days after the instillation, the animals were killed. The
      pleural spaces were assessed grossly for evidence of pleurodesis and
      microscopically for evidence of fibrosis and inflammation. The degree of
      pleurodesis (on a scale of 0 to 4) after the injection of 50, 100, 200, and 400
      mg/kg of talc was 1.1 +/- 0.9, 1.5 +/- 1.1, 2.7 +/- 0.6, and 3.4 +/- 0.5,
      respectively. The degree of microscopic fibrosis similarly increased with
      increasing doses of talc. These scores were similar to those we have reported
      with the tetracycline derivatives. In contrast to the results with tetracycline
      derivatives, none of the rabbits developed fibrothorax or hemothorax. From this
      study, we conclude that talc in a slurry is a very effective pleural sclerosant
      in rabbits and does not produce hemothoraces as do the tetracycline derivatives.

PMID- 7781373
TI  - Sleep in the intensive care unit.
AB  - The most critically ill patients in the hospital are located in the ICU. Due to
      intensive individualized care and monitoring, these patients often suffer from
      severe sleep deprivation. The amount and continuity of sleep as well as normal
      sleep architecture are all affected. Moreover, by impairing protein synthesis,
      cell division, and cellular immunity, sleep deprivation can affect the healing
      process and thus contribute to an increased morbidity and mortality. Reasons for
      sleep deprivation appear to be multifactorial and include the following: the
      patient's chronic underlying illness, an acute superimposed illness or surgical
      procedure, medications used in treatment of the primary illness, and the ICU
      environment itself. Therapeutic interventions need to address each of these
      potential causes, with an emphasis placed on providing an environment that is
      both diurnal and focused on the importance of uninterrupted sleep.

PMID- 7781372
TI  - Talc slurry pleurodesis. Pleural fluid and histologic analysis.
AB  - Although talc slurry pleurodesis is effective for control of malignant pleural
      effusions and recurrent pneumothorax, the mechanisms of pleurodesis remain
      incompletely defined. We instilled 70 mg/kg of sterile asbestos-free talc slurry
      into the pleural space of New Zealand white rabbits and studied the inflammatory
      response at 1, 2, 3, 7, 15, 30, 60, 90, and 120 days by observing pleural fluid
      and histologic characteristics. Talc slurry caused mesothelial denudement and an
      exudative neurotrophilic pleural effusion that resolved after 48 h. A transient
      mononuclear vasculitis was seen within the lung at 1, 2, and 3 days after
      instillation. Pleural adhesions were minimal and did not increase in number over
      time. Talc was found outside of the pleural space in mediastinal lymph nodes (4
      of 23 animals examined), kidney (1 of 6), and spleen (4 of 10). The predominant
      cause of pleurodesis with talc slurry instillation is an acute pleural injury
      similar to the tetracycline class agents.

PMID- 7781374
TI  - What is acute lung injury? What is ARDS?

PMID- 7781375
TI  - Review of the Kilburn and Warshaw Chest article--airways obstruction from
      asbestos exposure.

PMID- 7781376
TI  - Airways obstruction from asbestos exposure and asbestosis revisited.

PMID- 7781377
TI  - Acute myocardial infarction. Then and now.
AB  - Dramatic changes in the management of acute myocardial infarction (AMI) have
      occurred in the past decade. While previous management strategies were primarily
      supportive, current strategies focus on achieving and maintaining patency of the
      infarct-related artery restoring blood flow to jeopardized myocytes, preserving
      left ventricular function, and preventing recurrences and complications in
      addition to promoting healing. Restoration of blood flow can be achieved
      pharmacologically with thrombolytic agents or mechanically with percutaneous
      transluminal coronary angioplasty (PTCA). Early use of antiplatelet agents and
      anticoagulants helps maintain patency of the infarct-related arteries and
      prevents thromboembolic complications. Administration of beta-blockers and
      angiotensin enzyme inhibitors are more specific means of conserving myocardium
      and preserving ventricular function. Additionally, several strategies for
      preventing arrhythmias such as prophylactic lidocaine use and routine long-term
      suppression of premature ventricular contractions with antiarrhythmic drugs are
      no longer routinely advocated. Basically, in the era prior to the eighth decade
      of this century, the primary direction of the therapeutic strategy for AMI was to
      reduce the oxygen demands in the infarcted myocardium; whereas in the subsequent
      years, the emphasis shifts to improvement in oxygen delivery, via thrombolysis,
      PTCA, and coronary artery bypass graft surgery. These interventional changes,
      when added to greater sophistication in the use of drugs to reduce oxygen
      demands, resulted in significant lowering of myocardial mortality.

PMID- 7781378
TI  - Benign tumors of the tracheobronchial tree. Endoscopic characteristics and role
      of laser resection.
AB  - We conducted a review of all the bronchoscopies performed at our institutions for
      benign tumors from 1980 to 1991 to determine the endoscopic characteristics of
      these lesions. We reviewed the charts, the endoscopic characteristics from our
      video records, and finally the pathologic findings of these cases. We tried to
      identify the effectiveness of laser resections in each group. Of a total of 3,937
      patients, 185 (4.7%) were benign tumors. On these patients, 317 procedures were
      carried out. There were 3 myoblastomas, 53 papillomas, 1 adenoma, 8 chondromas, 4
      fibromas, 45 hamartomas, 15 hamartochondromas, 6 lipomas, 19 angiomas, 5
      leiomyomas, 4 schwannomas, 1 neurofibroma, and 21 amyloidomas. Results of laser
      resection were "very good" in 115 (62%) and "good" in 70 (38%). Complications
      were minimal: two mediastinal emphysemas, one pneumothorax, and one anesthesia
      related cardiac arrest leading to the single death in this series. In general,
      benign tumors of the proximal endobronchial tree responded well to laser
      resection when their endoscopic appearance is recognized and prognosis known.
      Even when recurrent, repeated procedures can be performed easily with good
      results. This series is probably the largest in the world's literature about
      endoscopic recognition and the role of laser resection in patients presenting
      with benign endobronchial tumors.

PMID- 7781379
TI  - Pneumonia and infraorbital abscess in a 29-year-old diabetic pregnant woman.

PMID- 7781380
TI  - A 21-year-old man with cystic fibrosis.

PMID- 7781381
TI  - Posterior mediastinal mass in a patient with chest pain.

PMID- 7781382
TI  - Occult hypercarbia. An unrecognized phenomenon during percutaneous endoscopic
      tracheostomy.
AB  - Bronchoscopy has been incorporated as a useful adjunct to increase the safety and
      effectiveness of percutaneous endoscopic tracheostomy (PET). Insertion of the
      bronchoscope, along with the intraluminal dilators of the PET set, into the
      airway potentially leads to hypoventilation and hypercarbia during the procedure.
      Using continuous in-line arterial blood gas monitoring, we documented profound
      hypercarbia in two patients undergoing PET in the surgical ICU. In a third
      patient, the rise in PaCO2 was accompanied by a marked rise in intracranial
      pressure (ICP), and a corresponding fall in cerebral perfusion pressure. While
      transient hypercarbia seems well tolerated by most patients, this phenomenon and
      its effect on cerebral blood flow should be strongly considered before performing
      PET on the critically ill patient with evidence of elevated ICP.

PMID- 7781383
TI  - Fluoxetine hydrochloride (Prozac)-induced pulmonary disease.
AB  - We describe a patient who developed progressive dyspnea, lung infiltrates, and
      restrictive lung disease in association with the antidepressant fluoxetine
      hydrochloride (Prozac). The pathologic findings were consistent with
      hypersensitivity pneumonitis. An associated pulmonary phospholipidosis was also
      noted.

PMID- 7781384
TI  - Acute myocardial infarction while using the nicotine patch.
AB  - A 39-year-old man developed an acute myocardial infarction 20 days after starting
      treatment with nicotine patches. He had not smoked while using the patches. He
      recovered without complications. Coronary angiography did not reveal coronary
      stenoses. He had no history of myocardial infarction, hypertension, or diabetes
      mellitus. Although coincidence cannot be excluded, it is recommended that all
      patients should be strongly advised not to smoke while using the nicotine patch
      and to consult a physician if chest pain develops.

PMID- 7781385
TI  - Independent ventilation and ECMO for severe unilateral pulmonary edema after SLT
      for primary pulmonary hypertension.
AB  - Single lung transplantation (SLT) is now accepted therapy for selected cases of
      severe pulmonary hypertension. A recognized complication is the postoperative
      development of reperfusion edema in the graft, a potentially fatal cause of
      respiratory failure. Because reperfusion edema may be a reversible process,
      temporizing support measures can be life-saving. We report the case of a 48-year
      old woman who developed severe reperfusion edema following right SLT for primary
      (unexplained) pulmonary hypertension. Extracorporeal membrane oxygenation (ECMO)
      was instituted. Independent lung ventilation was later begun and resulted in
      markedly improved oxygenation allowing withdrawal of ECMO. We conclude that
      reperfusion edema following SLT for pulmonary hypertension may be uniquely
      amenable to treatment with independent lung ventilation and ECMO if needed.

PMID- 7781386
TI  - Correlate clinical findings with hemodynamic findings.

PMID- 7781387
TI  - Inhaled drug consumption and asthma mortality in Greece.

PMID- 7781388
TI  - Occupational asthma caused by pea flour.

PMID- 7781389
TI  - Adenosine deaminase in pleural effusions.

PMID- 7781390
TI  - The tracheotomized patient. Tracheal toilet and speech.

PMID- 7781391
TI  - A matter of terminology. Alveolar-arterial oxygen gradient.

PMID- 7781392
TI  - Fistulas do not always cause pericardial effusion.

PMID- 7781393
TI  - Tuberculosis in young adults and the elderly.

PMID- 7781394
TI  - Pleural tuberculosis in HIV-infected patients.

PMID- 7781395
TI  - Multimodality Therapy of Chest Malignancies. Proceedings of a symposium. Boston,
      Massachusetts, April 7-9, 1994.

PMID- 7781396
TI  - A neoadjuvant approach to esophageal cancer.
AB  - Patients with symptomatic esophageal cancer represent a significant challenge to
      the thoracic clinician, whether medical oncologist, surgeon, or radiation
      therapist. Historically, cure has been rare and palliation has been a more
      realistic goal. Surgery was often viewed as radical or risky as limited long-term
      survival was weighed against expected operative morbidity and mortality.
      Epidermoid tumors were minimally responsive to available chemotherapy. Primary
      radiotherapy achieved similar overall survival; however, recurrent dysphagia
      limited its palliative benefit.

PMID- 7781397
TI  - Thoracoscopic staging and surgical therapy for esophageal cancer.
AB  - Esophageal cancer continues to be a major health problem with an associated poor
      prognosis. New technology is being applied to the staging of this cancer. The new
      staging system requires assessment of depth of wall penetration and lymph node
      status prior to resection. To determine penetration and node status with a high
      degree of accuracy generally requires some combination of chemotherapy, magnetic
      resonance imaging, endoesophageal ultrasound, and/or surgical staging. Several
      variables need to be considered in planning the surgical approach to the patient
      with esophageal cancer: the intent of the surgeon to either cure or palliate, the
      anatomic location of the tumor, and the method of reconstruction. Surgery is
      optimal for localized esophageal cancer. Neoadjuvant chemoradiation has increased
      survival in specific subgroups. Phase 2 trials have shown the safety and efficacy
      of chemoradiation. Randomized multi-institutional trials are needed to verify the
      encouraging results of recent phase 2 trials.

PMID- 7781398
TI  - Chemotherapy and combined-modality therapy for esophageal cancer.
AB  - Treatment of esophageal carcinoma with radiation alone or surgery alone has
      yielded unsatisfactory cure rates and has not had a major impact on survival. The
      failure to cure or prolong survival of patients with esophageal cancer is because
      of our inability to eradicate residual disease at the primary site and to early
      systemic dissemination of disease. Three neoadjuvant approaches involving
      chemotherapy have been studied in patients with apparently localized esophageal
      cancer: preoperative chemotherapy followed by surgery, chemotherapy and
      concurrent radiation therapy followed by surgery, and chemotherapy and radiation
      therapy without surgery. All of these approaches have shown potential in pilot
      trials. Large-scale trials comparing surgery alone with chemotherapy prior to
      operation are underway. For patients with local-regional epidermoid carcinoma who
      are not able to undergo or who refuse operation, chemotherapy plus concurrent
      radiation appears, in random assignment trials, to be superior to radiation
      alone.

PMID- 7781399
TI  - The role of radiation therapy in treating patients with potentially resectable
      carcinoma of the esophagus.
AB  - Radiotherapy (RT) in conjunction with surgery may have a number of roles in the
      treatment of patients with potentially resectable esophageal carcinoma. The use
      of RT alone either preoperatively or postoperatively can be expected to improve
      resectability rates only modestly. The risk of locoregional failure, a common
      problem in esophageal carcinoma, has been substantially reduced with preoperative
      or postoperative RT in trials with a duration of follow-up of 3 or more years,
      although this effect has not been seen in trials with shorter follow-up. Because
      of the high risk of distant failure associated with these tumors and perhaps
      because of the inadequate doses used, most trials of RT have not shown notable
      improvements in overall survival rates. The risk of severe complications
      following preoperative or postoperative RT is small, provided that very high
      doses or fraction sizes are avoided. Concurrent chemotherapy and RT
      administration have been shown to be superior to RT alone in patients who have
      medically or surgically inoperable conditions; randomized trials using this
      combined modality in patients with resectable disease have only recently begun.
      In addition to evaluating the efficacy of this approach, investigators hope to
      establish the optimal sequencing and timing of administration of these modalities
      with regard to each other and to surgery.

PMID- 7781400
TI  - Small cell lung cancer. Case report.
AB  - The selection of appropriate chemotherapeutic and/or radiation therapy for small
      cell lung cancer should be done after careful diagnosis and staging workup. A
      patient with small cell lung cancer is presented and explanation given for each
      step in diagnosis and staging.

PMID- 7781402
TI  - Thoracic and cranial radiotherapy for limited-stage small cell lung cancer.
AB  - Chemotherapy remains the mainstay of treatment for small cell lung cancer (SCLC).
      For patients with limited-stage disease, the addition of thoracic radiotherapy
      confers a moderate improvement in local control and a modest survival benefit,
      but these improvements come at the cost of increased toxic reactions. The optimal
      method for integrating chemotherapy and thoracic radiotherapy is unresolved.
      Concurrent and alternating strategies are appealing because they allow
      uninterrupted delivery of chemotherapy, but they have not been proven to be
      superior to conventional sequential approaches. Based on limited data, delivery
      of thoracic radiation early in the treatment course may be preferable to delivery
      later in the course. There is evidence of a radiation dose-response effect for
      SCLC, and, in standard regimens, thoracic radiation doses in the range of 50 to
      60 Gy are recommended. The use of limited radiation fields (to postchemotherapy
      tumor volumes) appears reasonable. Results for alternative thoracic radiation
      fractionation schedules such as accelerated hyperfractionation are promising and
      worthy of further investigation. The role of prophylactic cranial irradiation
      (PCI) is controversial and should be individualized. It should be considered for
      the favorable subgroup of patients with limited-stage disease who achieve a
      complete response to chemotherapy and thoracic radiotherapy. If given, we
      recommend a total dose of 30 to 36 Gy in 2-Gy fractions; PCI should not be
      delivered concomitantly with chemotherapy.

PMID- 7781401
TI  - Small cell lung cancer. State-of-the-art therapy 1994.
AB  - In the United States, small cell lung cancer (SCLC) accounts for about 20% of all
      cases of lung cancer. Without treatment, tumor progression in patients with SCLC
      is rapid, with a median survival of 2 to 4 months. Modern chemotherapy has
      yielded multifold increases in median survival, but only minimal improvements
      have occurred over the last decade. Combination chemotherapy with
      etoposide/cisplatin prolongs survival, especially in patients with limited
      disease. In patients at high risk of toxicity from standard combination
      chemotherapy, single-agent chemotherapy may have a viable role, but whether its
      efficacy is comparable to combination regimens must be established in clinical
      trials. Clearly, new, more effective drugs will be required for any major
      improvements in the treatment of SCLC. Combined-modality therapy employing
      chemotherapy and chest irradiation appears to produce excellent cytotoxic effects
      and is relatively well tolerated in patients with limited disease. A recent meta
      analysis of 13 randomized trials showed a modest but significant 14% reduction in
      the relative mortality rate of patients receiving chemotherapy/chest irradiation
      vs those receiving chemotherapy alone. Surgery as sole treatment can produce
      cures in highly selected patients with limited disease and can reduce the rate of
      local recurrence. The use of surgery after definitive treatment remains
      experimental and should not be considered other than in controlled clinical
      trials.

PMID- 7781403
TI  - Dose-intensive therapy for small cell lung cancer.
AB  - Enhancement of dose and dose intensity increases tumor response and may enhance
      long-term progression-free survival in patients with small cell lung cancer.
      Several strategies are identified to intensify therapy safely: a traditional
      induction/intensification mode, in which high-dose therapy with hematopoietic
      stem cell support is used to treat patients responding to conventional-dose
      therapy; and multicycle dose-intensive approaches, in which higher-dose therapy
      is administered over multiple cycles at initiation of therapy. This paper reviews
      some of the recently completed and activated trials (particularly those developed
      at the Dana-Farber Cancer Institute) exploring these concepts.

PMID- 7781404
TI  - Prognostic issues in non-small cell lung cancer.

PMID- 7781405
TI  - Chest X-ray screening improves outcome in lung cancer. A reappraisal of
      randomized trials on lung cancer screening.
AB  - It is believed that population-based screening for cancer should be advocated
      only when screening reduces disease-specific mortality. Four randomized
      controlled studies on lung cancer screening have been conducted in male cigarette
      smokers, and none has demonstrated reduced mortality. Accordingly, no
      organization that formulates screening policy advocates any specific early
      detection strategies for lung cancer. Yet, despite this public policy against
      screening, there is considerable evidence that chest x-ray screening is
      associated with earlier detection and improved survival. Two randomized trials,
      the Memorial Sloan-Kettering and Johns Hopkins Lung Projects, were specifically
      designed to evaluate the effectiveness of sputum cytologic study. Both evaluated
      the efficacy of the addition of sputum cytologic studies to annual chest
      radiographs, and both demonstrated that cytologic study did not favorably
      influence outcome. All individuals in experimental and control groups in both
      studies had annual chest radiographs. Because survival rates observed in both
      studies were about three times higher than predicted, based either on the
      National Cancer Institute's Surveillance Epidemiology and End Results database or
      based on the American Cancer Society's annual Cancer Statistics, raises the
      possibility that the periodic chest radiographs performed in all patients in both
      studies contributed to an improved outcome. In the Mayo Lung Project and in the
      Czechoslovak study on lung cancer screening, the experimental groups underwent a
      program of relatively intensive and regular rescreening with chest radiographs
      and sputum cytologic study, while the control groups underwent either less
      frequent rescreening or no rescreening. In both studies, the screened groups
      achieved meaningful improvements in stage distribution, resectability, and
      survival. However, increases in cumulative incidence of lung cancer in the
      experimental group in both studies (which in the Mayo Lung Project reached
      statistical significance) prevented significant improvements in survival from
      translating into corresponding reductions in mortality. The possibility that
      screening may be associated with lung cancer "overdiagnosis" has been widely
      postulated to account for higher survival and incidence rates and equivalent
      mortality rates. However, analysis of autopsy information and of disease outcome
      in individuals with screen-detected early stage lung cancer who do not undergo
      surgical resection strongly supports the conclusion that screening does not lead
      to overdiagnosis of lung cancer. Similarly, lead-time and length bias do not
      adequately account for the differences in cumulative incidence observed in the
      Mayo and Czech studies.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7781406
TI  - Molecular markers in early cancer detection. New screening tools.
AB  - Better early detection strategies for lung cancer are clearly needed. About 20
      years ago, cytomorphologic criteria were developed for use in staging bronchial
      epithelium carcinoma. Yet, when sputum cytology was added to chest radiograph in
      the largest early-screening-of-lung-cancer study carried out to date, the three
      arm trial sponsored by the National Cancer Institute, no major outcome benefit
      was shown. Sputum samples of participants in one of these trials, the Johns
      Hopkins Lung Project, have been archived. Currently, sputum immunostaining using
      two monoclonal antibodies directed at a difucosylated Lewis X epitope and a 31
      kilodalton protein show correlation between positive staining of these samples
      and eventual development of lung cancer in the sampled population. Strategies to
      neutralize the stimulation of growth factors like gastrin-releasing peptide,
      which are seen in small-cell disease, are also being explored. Development of an
      epithelial-directed diagnostic test is the most important goal in obtaining early
      detection tools for lung cancer. Several new tests await prospective trials to
      evaluate their utility. In developing an early detection test for lung cancer,
      due to the chronic nature of the risk and the vast at-risk population, cost and
      patient compliance are two major concerns.

PMID- 7781407
TI  - Biologic and molecular prognostic factors--impact on treatment of patients with
      non-small cell lung cancer.
AB  - A wide range of genetic and phenotypic abnormalities have been identified in lung
      cancer. However, only a few are known to have an impact on patient outcome and
      thus may influence choice of therapy. Biologic and molecular factors known in
      this regard include the epidermal growth factor family and its receptors, markers
      of neuroendocrine differentiation in non-small cell lung cancer, and mutations of
      the ras gene family. None of these factors, however, can be considered a standard
      for selection of patients for therapy until additional information is gleaned
      from ongoing prospective studies.

PMID- 7781408
TI  - Locally advanced lung cancer. Case presentation.

PMID- 7781409
TI  - Radiologic evaluation in chest malignancies. A review of imaging modalities.
AB  - Radiologic evaluation of the patient with non-small cell lung cancer (NSCLC)
      includes chest radiographs for detecting nodules, computed tomography (CT) for
      further characterizing them, CT and magnetic resonance imaging (MRI) to evaluate
      the mediastinum, and extrathoracic imaging of bones, the adrenal gland, the
      central nervous system, and liver. The current practice standards for each are
      reviewed. Asymptomatic solitary pulmonary nodules, which are usually detected on
      chest radiographs obtained for other indications, inevitably require a precise
      diagnosis. The radiologic characteristics that differentiate benign from
      malignant pulmonary lesions are given. Mediastinal CT is the preferred modality
      for examining the mediastinum in patients with NSCLC. Magnetic resonance imaging
      is used selectively, eg, in patients with superior sulcus tumors who are
      candidates for surgery. When evaluation for N2/N3 disease is requested,
      mediastinoscopy should replace CT using the latter as a "roadmap." The role of
      extrathoracic imaging in evaluating asymptomatic patients with NSCLC at initial
      presentation is equivocal. Computed tomographic scanning of the head is
      reasonable in most patients with lung cancer, given the significant incidence of
      occult brain metastases in this population and that solitary brain lesions may be
      resected in some protocol settings. Routine liver and adrenal gland scanning is
      similarly controversial. Bone scans do not appear to be useful in patients with
      NSCLC unless they have clinical signs, symptoms, or laboratory findings to
      indicate possible metastases. Although heavily affected by local practice,
      radiologic evaluation of the patient with NSCLC should attempt to provide
      accurate determination of local disease and a search for distant metastases.

PMID- 7781410
TI  - Thoracoscopy and video-assisted thoracic surgery in the treatment of lung cancer.
AB  - The contemporary surgical repertoire for the evaluation and treatment of patients
      with lung cancer includes the bronchoscope, mediastinoscope, thoracoscope, and
      standard surgical instrumentation. The recent advances in video optics and the
      development of endoscopic instruments have significantly expanded the surgical
      options for patients with lung cancer. Thoracoscopy, or the more inclusive term
      of video-assisted thoracic surgery (VATS), has been characterized as "minimally
      invasive" surgery. Thoracoscopy and VATS have decreased operative trauma and
      facilitated surgical staging prior to neoadjuvant therapy. An ancillary benefit
      to diminished surgical morbidity is shorter hospital stays with a concomitant
      reduction in costs to the patient and health-care system. These advantages make
      VATS ideal for elderly patients or patients with significant comorbidity.

PMID- 7781412
TI  - Benefits of aggressive perioperative management in patients undergoing
      thoracotomy.
AB  - With lung resection remaining the cornerstone of curative therapy in patients
      with lung cancer, aggressive perioperative management continues to play a
      critical role. This review summarizes the most important factors in successful
      perioperative management. These include patient selection, with an emphasis on
      which patient variables and hemodynamic assessments are most useful in
      determining operability. Postoperative management, in particular, patient
      controlled analgesia, and pulmonary toilet, are essential to facilitate early
      patient mobility and to minimize complications, respectively. Aggressive
      perioperative management can result in reduced postoperative morbidity and
      mortality, reduced length of hospital stay and expenditures for complications,
      and it expands the population that can receive potentially curative therapy.

PMID- 7781411
TI  - New chemotherapeutic agents for non-small cell lung cancer.
AB  - The identification of new chemotherapeutic agents for the treatment of non-small
      cell lung cancer should proceed in a structured, logical fashion. Agents should
      be evaluated on the basis of multiple objective and subjective end points. A 15%
      or greater major objective response rate, demonstrated in multiple single-agent
      phase II trials, is considered the lower limit for an agent to be deemed
      clinically active in this disease. A number of drugs previously have been
      identified in this category, including cisplatin, ifosfamide, mitomycin,
      paclitaxel, and the vinca alkaloids vinblastine and vindesine. Most of these
      conventional agents have been explored alone, in a variety of doses and
      schedules, and in combination. In the last several years clinical development has
      produced new agents, including chloroquinoxaline sulfonamide, docetaxel,
      edatrexate, gemcitabine, irinotecan, topotecan, and vinorelbine, which hold
      promise for more successful treatment of this lethal disease.

PMID- 7781413
TI  - Chemoprevention of lung cancer.
AB  - Treatment of lung cancer remains frustrating. Most patients with lung cancer are
      not candidates for curative therapy, and new therapies have not made a
      substantial impact on survival. Consequently, some clinical investigators have
      focused their efforts on developing prevention strategies. Chemoprevention, the
      administration of agents to block or reverse carcinogenesis, is being
      investigated in ongoing trials. Studies of chemoprevention in lung cancer have
      included trials to reverse premalignant lesions such as sputum atypia or squamous
      metaplasia of the bronchial epithelium. Clinical trials of lung cancer prevention
      have often studied groups of participants with tobacco or asbestos exposure.
      Other clinical trials are being conducted among patients who have been treated
      for an early-stage lung cancer. As the result of diffuse epithelial injury, these
      patients are at very high risk for developing second primary tumors,
      predominantly in the lungs and upper aerodigestive tract. It is our hope that
      these studies may establish a new strategy for preventing lung cancer.

PMID- 7781414
TI  - Pulmonary metastasectomy. Current indications.
AB  - Surgical resection remains an important form of treatment for pulmonary
      metastases from a variety of solid tumors. The most significant factors in
      selecting patients for operation include control of the primary tumor, ability to
      resect all metastatic disease, absence of extrathoracic metastases, lack of
      better alternative systemic therapy, and sufficient cardiopulmonary reserve for
      the planned resection. A solitary pulmonary nodule and long tumor doubling times
      and disease-free intervals usually define patients who experience better long
      term survival after pulmonary resection but do not constitute absolute criteria
      by which to select such patients. Complete surgical resection is critical to
      achieving long-term survival and is best accomplished via a standard or
      "clamshell" thoracotomy or a median sternotomy. The decision to proceed with the
      surgical resection of pulmonary metastases should be a multidisciplinary one,
      made jointly by the thoracic surgeon and the medical oncologist.

PMID- 7781415
TI  - Current approach to malignant mesothelioma of the pleura.
AB  - Malignant mesothelioma of the pleura occurs primarily in individuals who were
      exposed to asbestos either in the workplace or home. The incidence of malignant
      mesothelioma is rising and, reflective of the malignancy's long latency period,
      is expected to continue to increase into the next century. Current treatment
      measures, including surgery, radiation therapy, chemotherapy, intrapleural
      therapy, and combined-modality therapies, have had varying impacts on survival.
      This paper explores current trends in the treatment of malignant pleural
      mesothelioma.

PMID- 7781416
TI  - Mesothelioma and radical multimodality therapy: who benefits?
AB  - The incidence of malignant pleural mesothelioma is increasing. Untreated,
      patients with this disease experience a rapid and horrendous clinical decline.
      Surgery plays a role in the diagnosis, staging, and treatment of this malignancy.
      Surgery, chemotherapy, and radiotherapy alone have been unable to achieve major
      improvements in survival for most patients. More recent phase II trials suggest
      that surgery, at one time a purely palliative approach, may have a potentially
      curative role when used in combination with chemotherapy and radiotherapy.

PMID- 7781417
TI  - [Surgical treatment of traumatic cataract].
AB  - 140 cases and 142 eyes with traumatic cataracts treated by extracapsular cataract
      extraction (ECCE), ECCE and intraocular lens implantation (ECCE + IOL), and
      lensectomy were reported. The data showed that postoperative corrected visual
      acuities > or = 0.1-1.0 were in 89 eyes (70%) in one week and in 33 eyes of 44
      eyes (75%) followed up for more than 6 months. The 3 methods of operation were
      compared, the indications and the optimum time of operation for each method and
      the personal experiences of the authors in the operation were discussed.

PMID- 7781418
TI  - [An investigation on therapeutic results of extracapsular cataract extraction and
      intraocular lens implantation in diabetics].
AB  - 44 cases (50 eyes) with diabetes and cataract were followed up for 6-30 months
      after extracapsular cataract extraction (ECCE) with intraocular lens implantation
      (IOL). No severe intra- and post-operative complications were found and 84% of
      eyes obtained post-operative corrected visual acuities > or = 0.5. The results
      suggest that the pre-operative hyperglycemia alone be not a contraindication of
      the operation. Pre-operatively, if the diabetes of patients with cataract can be
      controlled by diet or hypoglycemic agent, their glucose level in the blood
      remains normal and stable for a period of time and there are no other systemic
      and ocular complications, ECCE with IOL can be performed on such patients and the
      therapeutic results of the operation can be safe and reliable.

PMID- 7781419
TI  - [Gonioscopic observation after posterior chamber intraocular lens implantation].
AB  - 6 months after senile extra-capsular cataract extraction and posterior chamber
      intraocular lens (IOL) implantation, Goldmann gonioscopy was performed on 30 eyes
      having undertaken the surgery. Peripheral anterior synechiae (PAS) were found in
      17 eyes (56%). PAS overlying the positions of 20 lens haptics were observed in 15
      eyes. It is easier to develop PAS in eyes with vertically fixed haptics than in
      eyes with horizontally fixed ones. The causes and the consequences of PAS were
      discussed. It is suggested that during the follow-up, routine gonioscopic
      observation after posterior chamber IOL implantation be necessary.

PMID- 7781420
TI  - [A comparison study of various anterior capsulectomies].
AB  - The incidences of anterior capsular radial tears occurring in different
      capsulectomies performed on rabbit eyes under standardized conditions were
      compared. The eyes were randomly divided into 4 technique groups: (1) can opener,
      (2) capsulopuncture, (3) linear capsulotomy and (4) continuous circular
      capsulorhexis (CCC). The results demonstrated that the CCC technique has more
      advantages in comparison with other three groups. With the nuclear expression
      technique used in this study, no radial tears occurred with the CCC technique,
      whereas radial tears occurred in 100% of cases treated with other three
      techniques.

PMID- 7781421
TI  - [A real-time analysis of 133 normal lens images by a computer].
AB  - According to the theory that the light scattering of the lens is correlated with
      the lens density, we designed a computerized system for the real-time analysis of
      the lens image. By measurement of the gray scale value of the lens optical
      section, the lens density is measured objectively and numerically. With the help
      of the system, 133 normal lens images were investigated. From the analysis of
      various age groups, we found that the grey scale values of the anterior cortex,
      posterior cortex and nucleus increase with the increase of age (P < 0.01), the
      grey scale values of the anterior and posterior cortex are significantly higher
      than the value of the nucleus (P < 0.05), but there is no significant difference
      between the values of the anterior and posterior cortex (P > 0.05), and there is
      also no significant difference in the comparisons of the grey scale values of the
      respective corresponding lens areas between the male and female.

PMID- 7781422
TI  - Nonaccommodative factors of refractive accommodative esotropia.
AB  - The clinical characteristics of 45 cases of refractive accommodative esotropia
      were compared with 31 cases of the control group who remained orthotropic in the
      presence of uncorrected same degree of hypermetropia. In addition to the general
      ophthalmologic and orthoptic examinations, the accommodative
      convergence/accommodation (AC/A) ratio, fusional vergences and random dot
      stereopsis were investigated. The hypermetropic patients without esotropia were
      found to have a lower AC/A ratio and normal fusional function, while in cases
      with refractive accommodative esotropia, their AC/A ratios were normal and their
      fusional functions were decreased, especially significant being the divergent
      fusional function. In both groups, their stereopsis was defective or absent. It
      is suggested that esotropia be not simply caused by excessive accommodation due
      to uncorrected hypermetropia, and the range of divergent fusional function and
      the level of AC/A ratio be the two factors which determine the causation of
      esotropia in cases with uncorrected hypermetropia.

PMID- 7781423
TI  - [Silicone oil removal in 31 cases].
AB  - Silicone oil removal was performed on 32 eyes of 31 cases after silicone oil
      injection for an average of 13.9 months. The reasons for the silicone oil removal
      are the complications such as cataract, glaucoma, emulsification of the silicone
      oil and so on. Complete retinal reattachment without any complications was found
      in 6 eyes of the 32 cases. Retinal reattachment remained in place in 24 eyes
      after the removal, and 24 eyes achieved postoperative visual acuities > or =
      0.02. After the removal, in 7 of 8 eyes with complication, retinal detachment
      reoccurred. The significance and the timing of the silicone oil removal were
      discussed in this paper.

PMID- 7781424
TI  - [An analysis of causes of post-operative shallow anterior chamber in glaucoma
      filtering surgery].
AB  - 131 eyes of 103 cases having undertaken glaucoma filtering surgeries were
      randomly selected to analyze retrospectively the causes of the post-operative
      shallow anterior chamber. The causes are choroidal detachment accounting for
      75.6%, excessive filtration 13.3% and malignant glaucoma 11.1%. As the rate of
      discovery of the choroidal detachment under a direct ophthalmoscope was quite
      low, the definite diagnosis depended primarily on B-ultrasonography. It is
      discovered that in the analysis of the possible factors leading to choroidal
      detachment, the plasma level of fibronectin is correlated to the development of
      the post-operative choroidal detachment of a glaucoma filtering operation,
      suggesting the impairment of microcirculatory function be investigated to
      approach the causes of the choroidal detachment following anti-glaucoma and other
      intraocular surgeries.

PMID- 7781425
TI  - [Studies on red blood cell-mediated immunity of patients with recurrent stromal
      herpes simplex keratitis].
AB  - Assays of red blood cell (RBC) C3b receptor rosette and RBC immune complex (IC)
      rosette of 67 cases with recurrent stromal herpes simplex keratitis (HSK) were
      carried out. The results show that the rosette rate of RBC C3b receptor is
      markedly lowered and that of RBC IC receptor is significantly increased in cases
      with stromal HSK. In comparisons with the corresponding rates in the control
      group, there are significant differences (P < 0.01). The roles of RBC-mediated
      immunity in the immunopathogenesis of HSK were preliminarily discussed.

PMID- 7781426
TI  - [An observation on pathological changes in retinal ultrastructure of rat with
      hypertension and after its life-long treatment with captopril].
AB  - The fundus and retinal ultrastructural changes of rats with hypertension and such
      rats having taken life-long captopril treatment were examined by funduscope,
      light and transmission electron microscopes. The normal rats were the controls.
      The results showed that in the hypertension group, the ratio of the diameter of
      the retinal artery to that of the vein was 1:2, the arteries were spastic and
      narrowed, their light reflexes were widened and their calibers of the lumens were
      uneven, the fundus appearances being consistent with grade I and II retinal
      changes of systemic hypertension. Under the light microscope, it was discovered
      that the basement membranes of the retinal capillaries were thickened and their
      lumens narrowed, resulting in retinal ischemia and anoxia. Under the transmission
      electron microscope, the main pathological changes involved the external segments
      of photoreceptors and ganglionic cells. The pathological changes were hazy
      renewed membranous discs at the basal portions of the external segments of
      photoreceptors, edematous ganglionic cells being the majority, their cytoplasm
      stained pale, mitochondrial vacuolization, enlargement of smooth endoplasmic
      reticula and degranulation of rough endoplasmic reticula. In the group of rats
      with hypertension having taken life-long captopril treatment, the fundi and blood
      pressure remained normal and no significant ultrastructural changes had taken
      place in their retinae.

PMID- 7781427
TI  - [A morphological study of experimental corneal neovascularization].
AB  - Corneal neovascularization (CNV) was induced by alkali burn injuries in 20 rabbit
      corneas. The process of CNV was observed with biomicroscopy in vivo and
      histologically by light and electron microscopy. At 8 hours after injury, an
      obvious acute inflammatory response as evidenced by infiltration of neutrophils
      had already occurred in the pericorneal limbal area. Many neutrophils in the
      extravascular space contained abundant intracytoplasmic phagolysosomes. The
      vascular sprouts appeared 2 days after injury. The infiltration of neutrophils
      and their debris were visible around newly formed blood vessels in the cornea.
      The results suggest that there be the participation and an inductive action of
      neutrophils in the pathogenesis of CNV.

PMID- 7781428
TI  - YAG laser resection for the membrane on anterior surface of intraocular lenses.
AB  - The results and methods of YAG laser resection for the membrane forming
      postoperatively on the anterior surface of intraocular lens (IOL) in 33 eyes (31
      cases) were reported. A monomode single pulse YAG laser was used to do a circular
      incision along the pupilar margin and blow it up. A multimode defocus burst was
      used to peel off the shrunk flap from the lens surface. The membrane in 27 eyes
      (81.8%) was completely removed in the first resection. The mean burst number was
      49.2 +/- 26.3. The average energy of each burst was 1.3 mJ and the average total
      energy of each treatment was 62.1 +/- 37.1 mJ. Except 3 eyes with little blood
      oozing from iris near the pupilar margin, 4 eyes having foggy spots on IOL
      surface and 2 eyes with mild transient increased intraocular pressure (IOP) after
      resection, there were no other complications. The resection is safe and
      effective, could be instead of the second operation for unabsorbable organized
      membranes or the membrane causing blockage glaucoma, could accelerate the
      recovery of visual acuity and shorten or substitute medical treatment for thick
      membranes.

PMID- 7781429
TI  - [Observations on damage and regeneration of corneal nerves of rabbit eyes with
      herpes simplex keratitis].
AB  - An experimental study on the damage and regeneration of the corneal sensory
      nerves in rabbit eyes with herpes simplex keratitis (HSK) was carried out by
      means of acetylcholine esterase staining and transmission electron microscopy.
      The results indicate that the diminution of the corneal sensitivity detected
      clinically in HSK is caused by the damage of the terminals of the sensory nerve
      plexus in the epithelial and subepithelial layers of the cornea and in the later
      stage of HSK, the corneal sensory nerves begin to regenerate, that is the basis
      of the restoration of corneal sensitivity.

PMID- 7781432
TI  - Clinical comparison of extracorporeal piezoelectric lithotripsy (EPL) and
      intracorporeal electrohydraulic lithotripsy (EHL) in difficult bile duct stones.
      A prospective randomized trial.
AB  - Today, nearly 90% of common bile duct stones are extracted endoscopically.
      Problems are encountered if there are large stones or a duct stenosis.
      Extracorporeal piezoelectric lithotripsy (EPL) as well as intracorporeal
      electrohydraulic lithotripsy (EHL) serve as an alternative to surgical
      intervention for those few patients in whom endoscopic measures have failed. A
      total of 35 patients with common bile duct stones in whom conventional endoscopic
      treatment had failed were selected on the condition that stone visualization
      through ultrasound was possible and that the papilla was within easy reach of the
      endoscope. Patients fulfilling the inclusion criteria were randomly treated
      either by EPL or EHL. The average age of our patients was 73 years. The main
      reasons for failure of conventional endoscopy were due to the large size of the
      stones (13 patients), impacted stones (16), or the presence of a biliary
      stricture (6). In the EPL group, visualization of the stones by ultrasound and
      ensuing treatment were possible in 16 of 18 patients (89%); stones could be
      fragmented in 15 patients. In 13 patients, the biliary tree could then be
      completely freed of calculi; the success rate was 72% for all the patients (13 of
      18). On average, the patients had 2.3 treatments on the lithotripter, and 3870
      shock waves were applied per treatment. In the EHL group stones were successfully
      fragmented in 13 of 17 patients (76.5%). The average number of treatments was
      1.4. Comparing both therapies, there was no difference in stone-free rates. In
      both groups, additional endoscopic interventions were necessary to clear the bile
      duct.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781431
TI  - Effect of extracorporeal shock-wave lithotripsy on gallbladder emptying in
      patients with solitary and multiple gallbladder stones.
AB  - In a prospective study, we investigated the effect of extracorporeal shock-wave
      lithotripsy (ESWL) on gallbladder contractility and on fasting and residual
      gallbladder volume in patients with solitary and multiple gallbladder stones with
      stone densities < 100 Hounsfield units (HU) and adequate gallbladder function.
      Twenty-five patients (seven males and 18 females, mean age 48.5 +/- 11.7 years)
      treated with ESWL were assigned to either group I, consisting of 13 patients with
      solitary stones < 20 mm diameter, or group II, including patients with two to
      three stones and maximum stone diameter of 30 mm. ESWL was performed with the MPL
      9000 lithotripter. Gallbladder ejection fraction was determined using the method
      of Dodds after a 12-hr fast and following application of a standard stimulative
      meal. Gallbladder volume was measured by ultrasound over 90 min at 10-min
      intervals before ESWL, then at 1, 30, 120, and 210 days after ESWL. At 24 hr
      after ESWL, residual gallbladder volume increased in group I from 7.4 ml to 13.9
      ml (P = 0.0567) and in group II from 6.5 ml to 20.2 ml (P = 0.0076). Thereafter,
      residual volumes returned to pre-ESWL levels. In group II, post-ESWL fasting
      volumes were significantly increased over initial values at all time intervals.
      Correspondingly, only at 24 hr after ESWL, ejection fractions decreased from
      73.1% to 64.9% in group I and from 76.5% to 62.7% in group II. No statistically
      significant differences in gallbladder contractility between the two groups were
      observed at any point of the follow-up period.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781430
TI  - Correlation between biliary alpha 1-acid glycoprotein concentration and
      cholesterol crystal nucleation time in gallstone disease.
AB  - A biliary form of the alpha 1-acid glycoprotein (AAG) promotes cholesterol
      crystallization in the lower-molecular-weight, concanavalin A-bound fraction of
      gallbladder bile. In addition, bile AAG concentration is higher in cholesterol
      gallstone patients with multiple stones than in control patients without
      gallstone disease. In this study we sought to determine whether the increased
      biliary concentration of AAG in cholesterol gallstone patients is accompanied by
      a more rapid nucleation time in patients with multiple stones. AAG concentration
      in native biles was measured by ELISA. Nucleation time was measured using a
      standard microscopy method. The concentration of biliary AAG was then related to
      nucleation time in biles from the same patients. Nucleation times were
      significantly shorter (< or = 5 days) in cholesterol gallstone patients with
      raised AAG concentrations (P < 0.03). There was a significant (P = 0.004)
      negative correlation (r = -0.53) between nucleation time and the AAG
      concentration in cholesterol gallstone patients with multiple stones. The
      concentration of biliary AAG appears to exert an important influence on the speed
      of cholesterol nucleation in bile in many patients with cholesterol gallstone
      disease.

PMID- 7781433
TI  - Conjugated bile salts regulate turnover of rat intestinal brush border membrane
      hydrolases.
AB  - The mechanisms whereby the conjugated bile salts regulate the activities of the
      brush border membrane hydrolases and its physiological significance were
      investigated in rat small intestine, and comparisons were made with the action of
      pancreatic protease. Rat brush border membrane proteins were metabolically
      labeled with [35S]methionine, and isolated brush border membrane was incubated
      with taurocholate or pancreatic elastase. The activity of solubilized hydrolases
      was assayed and the molecular forms of the hydrolases were examined by SDS-PAGE.
      The activity and protein bands of alkaline phosphatase and sucrase-isomaltase
      were solubilized by taurocholate, while alkaline phosphatase was not solubilized
      by elastase. Solubilized sucrase-isomaltase molecules were proteolytically
      degraded by elastase, whereas the intact molecule of sucrase-isomaltase was
      solubilized by taurocholate. Next the physiological role of bile salts in brush
      border membrane hydrolase turnover were investigated using metabolic labeling of
      brush border membrane hydrolase and immunoprecipitation in biliary diversion
      rats. After three days of biliary diversion, a significant increase in alkaline
      phosphatase activity was observed. Although synthesis of alkaline phosphatase in
      biliary diversion rats was similar to that observed in control rats, biliary
      diversion rats showed 1.5-fold slower turnover of alkaline phosphatase when
      compared with control rats. These results suggest that conjugated bile salts in
      the intestinal lumen may cause a rapid turnover of brush border membrane
      hydrolases, which may be increased by the enhanced enzyme degradation. The
      mechanisms for the enhanced degradation appeared to be solubilization of
      hydrolases caused by the detergent activity of bile salts. Therefore, conjugated
      bile salts may play an important physiological role in the regulation of
      expression of the protease-resistant enzymes such as alkaline phosphatase.

PMID- 7781434
TI  - Comparative effects of secretin (SEC) and cholecystokinin-octapeptide (CCK-8) on
      pancreatic microcirculation.
AB  - Using epifluorescent microscopy, we investigated the dynamic changes in
      pancreatic microcirculation in vivo after bolus administration of secretin (SEC)
      (0.1-10.0 micrograms/100 g body wt) and cholecystokinin-octapeptide (CCK-8)
      (0.005-1.2 micrograms/100 g body wt) in pentobarbital-anesthetized rats.
      Pancreatic capillary red cell velocity as a monitor for pancreatic capillary
      blood flow was measured in 1-min intervals from 2 min prior to 8 min following
      bolus infusion of SEC or CCK-8. Physiological concentrations of SEC did not
      increase pancreatic capillary blood flow. However, pharmacological SEC
      concentrations induced a dose-dependent increase in pancreatic capillary blood
      flow (to 162 +/- 19% of baseline; P < 0.05), due to an increase in blood flow
      velocity (to 153 +/- 18% of baseline; P < 0.05). In contrast, bolus
      administration of physiological CCK-8 concentrations, which have been proven to
      stimulate enzyme secretion, induced a transient and dose-dependent increase in
      pancreatic capillary blood flow (to 235 +/- 24% of baseline; P < 0.05), due to an
      increase in blood flow velocity (to 184 +/- 13% of baseline; P < 0.05) and
      capillary diameters (+0.63 +/- 0.15 micron; P < 0.05).

PMID- 7781435
TI  - Occurrence of antibody against rat hepatic sinusoidal endothelial cells in sera
      of patients with autoimmune hepatitis.
AB  - To determine whether an antibody against hepatic sinusoidal endothelial cells was
      present in sera of patients with autoimmune hepatitis (AIH) type 1, we measured
      the serum IgG bound to the glutaraldehyde-fixed cultured rat sinusoidal
      endothelial cells by enzyme-linked immunosorbent assay. IgG bound to the cells
      was detected significantly more in patients with autoimmune hepatitis type 1
      (97.1%) than in those with primary biliary cirrhosis (13.0%), chronic hepatitis C
      (5.9%) or B (7.9%), or healthy controls (0%). IgG-F(ab')2 fragments from
      autoimmune hepatitis patients also bound to the cells, and this binding was
      observed after absorption of the fragments with rat hepatoma cells, but not after
      absorption with bovine carotid endothelial cells. Culture of sinusoidal
      endothelial cells in the presence of IgG from AIH patients significantly reduced
      the number of viable attached cells. In conclusion, anti-sinusoidal endothelial
      cell antibody occurred in the sera from patients with autoimmune hepatitis type
      1.

PMID- 7781436
TI  - A role for chronic hepatitis C virus infection in a patient with cutaneous
      vasculitis, cryoglobulinemia, and chronic liver disease. Effective therapy with
      interferon-alpha.
AB  - A six-year history of repeated attacks of fatigue, fever, arthralgias, skin
      changes, Raynaud's phenomenon, and neuropathy is reported in a patient with
      chronic liver disease. The following diagnoses were made: (1) leukocytoclastic
      vasculitis; (2) acute urticaria; (3) cryoglobulinemia type II with Raynaud's
      phenomenon and low serum level of C4; (4) peripheral polyneuropathy; (5) sicca
      syndrome; and (6) chronic hepatitis C virus infection. Despite therapy with
      corticosteroids symptoms increased gradually over years. In the first PCR of the
      nested PCR analysis, HCV-RNA was exclusively detected in the cryoglobulin
      fraction but not in the serum supernatant, suggesting that antibodies bind HCV
      particles, forming circulating immune complexes. As diagnoses 1-5 are well-known
      organ manifestations of cryoglobulinemia, we speculated whether treatment of
      hepatitis C with IFN-alpha (3 million IU IFN-alpha 2b three times a week) would
      inhibit HCV replication, decrease the cryocrit level and thereby ameliorate organ
      manifestations such as neuropathy and vasculitis. During treatment with IFN-alpha
      only a very weak or no signal could be detected for HCV-RNA in the cryoglobulin
      fraction as well as in the serum supernatant. This held true also for the serum
      supernatant in the second PCR. In parallel, cryoglobulin level, immunoglobulins,
      and liver enzymes decreased substantially to normal or near normal levels.
      Clinical symptoms-leukocytoclastic vasculitis and neuropathy-disappeared. We
      conclude that chronic HCV infection is involved in the pathogenesis of
      cryoglobulinemia and that IFN-alpha might be an effective treatment in these
      patients.

PMID- 7781438
TI  - Treatment of chronically draining infected echinococcal cyst with repeated
      injection of 96% ethanol.

PMID- 7781437
TI  - Exacerbation of primary biliary cirrhosis during interferon-alpha 2b therapy for
      chronic active hepatitis C.
AB  - A 60-year-old woman with chronic active hepatitis C was treated with 6 million
      units of rIFN-alpha 2b daily for two weeks and subsequently three times weekly
      for several months. Histological examination proved a severe form of chronic
      active hepatitis C unexpectedly complicated with primary biliary cirrhosis (PBC).
      Before treatment, levels of serum alkaline phosphatase (ALP) or
      gammaglutamyltranspeptidase (GGT) had remained within normal limits over six
      months, although anti-mitochondrial antibody (AMA) was shown to be positive.
      After eight weeks of therapy, the daily dose of rIFN was reduced to 3 million
      units because of a marked increase of ALP and GGT, although the serum alanine
      aminotransferase (ALT) was normalized. Four months later, IFN treatment was
      suspended because of continuous elevation of the ALP and GGT levels, and
      administration of ursodeoxycholic acid was substituted. Two months later, the ALP
      and GGT levels returned to the normal range, although ALT was not normalized and
      HCV-RNA remained positive. This is the first report case that demonstrates IFN
      treatment potentially exacerbates PBC associated with chronic active hepatitis C.
      It is important for treating physicians to keep this association in mind.

PMID- 7781439
TI  - Autoimmune cholangitis: a variant of primary biliary cirrhosis. Clinicopathologic
      and serologic correlations in 200 cases.
AB  - The term "autoimmune cholangitis" is used for a disease with clinical and
      pathologic features of primary biliary cirrhosis (PBC) but with negative anti
      mitochondrial antibody (AMA) and positive anti-nuclear antibody (ANA) tests. In
      order to characterize autoimmune cholangitis and to determine whether this truly
      differs from PBC, we reviewed 200 cases morphologically consistent with PBC in
      which data on AMA and ANA status were available to us. Of these, 64 (32%) had a
      negative AMA, 114 (57%) had a positive ANA, and 40 (20%) had negative AMA and
      positive ANA (autoimmune cholangitis). The AMA-negative group was slightly
      younger on average (50 vs 55 years) than AMA positives (P < 0.05). There were no
      significant differences in gender (15.5% male overall), hepatic histopathology,
      or other laboratory tests between the groups of patients with any of the 4
      possible combinations of AMA and ANA. Since the only consistently distinguishing
      feature among these patients is the autoantibody (AMA and ANA) profile, and they
      otherwise have virtually identical clinical and histopathologic features,
      autoimmune cholangitis can be considered to be the same as AMA-negative PBC.

PMID- 7781440
TI  - Suprahepatic vein oxygen tension in alcoholics with severe and mild liver damage.
AB  - We measured suprahepatic vein and arterial partial oxygen pressure in 35
      alcoholics with severe (N = 7) or mild (N = 28) histological liver damage and
      without evidence of clinical liver failure. The suprahepatic vein was punctured
      with a fine needle, using a percutaneous approach. Suprahepatic vein partial
      oxygen pressure was lower and arterial-suprahepatic gradient higher in alcoholics
      with severe liver damage compared to those with mild damage (35.1 +/- 1.7 vs 44.1
      +/- 2.1 and 58.9 +/- 3.7 vs 45.9 +/- 2.4 mm Hg, respectively; P < 0.001).
      Suprahepatic puncture was well tolerated and devoid of complications. It is
      concluded that alcoholics with severe liver damage have lower oxygen tensions in
      the suprahepatic vein, a phenomenon that supports the hypoxic theory of alcoholic
      liver disease.

PMID- 7781441
TI  - Hepatic blood flow during reduced liver grafting in pigs. A comparison of
      controls and recipients of intact allografts.
AB  - Intraoperative changes in portal venous and hepatic arterial flow were compared
      in porcine recipients of reduced liver grafts with recipients of intact grafts
      and sham-operated controls. Control animals showed no significant changes in
      hepatic blood flow (measured with perivascular ultrasonic cuffs), heart rate,
      mean arterial pressure, cardiac output, acid/base balance, plasma sodium,
      potassium, glucose, or catecholamines. Recipients of intact or reduced grafts
      showed hypotension, reduced cardiac output, tachycardia, and increased systemic
      vascular resistance during the anhepatic phase, which lasted approximately 30
      min. These changes returned to normal in recipients of intact grafts but in
      recipients of reduced grafts, levels returned only to 50-60% of baseline. After
      intact grafting, total liver blood flow and the portal and arterial components
      returned to baseline within 2 hr of revascularization, but after reduced
      grafting, hepatic arterial flow values remained depressed to 50-60% of baseline.
      Plasma epinephrine and norepinephrine were unaltered during control operation but
      increased 4- to 20-fold in recipients of all grafts. These returned towards
      baseline in all except recipients of reduced grafts, in which norepinephrine
      levels remained significantly elevated for the 4 hr of postoperative study. These
      data highlight persistent elevation of plasma norepinephrine after reduced liver
      grafting, which may have contributed to the diminished hepatic arterial flow.
      These results need to be confirmed in adult recipients of split liver grafts in
      whom grafts are comparatively small. In such patients receiving donor livers
      which have undergone prolonged storage, the effects of increased plasma
      norepinephrine levels upon donor agonal arterial spasm may be significant.

PMID- 7781443
TI  - Fatal Vibrio parahemolyticus septicemia in a patient with cirrhosis. A case
      report and review of the literature.
AB  - Vibrio parahemolyticus has been well documented to cause outbreaks of infectious
      diarrhea, usually related to poor food handling; only rarely has it been reported
      to cause fetal septicemia. In contrast, Vibrio vulnificus is a well-known cause
      of septicemia, especially in patients with cirrhosis. A 31-year-old woman with
      cirrhosis who developed fatal V. parahemolyticus sepsis after ingesting raw
      seafood is described. We review the clinical syndromes associated with sepsis
      caused by these two organisms. Leg pain and bullous skin lesions may be a clue to
      the diagnosis. Febrile patients with cirrhosis should be questioned regarding
      recent seafood ingestion, and appropriate antibiotics chosen if this history is
      obtained. Physicians should inform patients at risk to avoid raw seafood in an
      attempt to prevent this potentially lethal syndrome.

PMID- 7781442
TI  - Small bowel bacterial overgrowth in patients with alcoholic cirrhosis.
AB  - A total of 89 patients with alcoholic cirrhosis and 40 healthy subjects were
      included in a study to assess the prevalence of intestinal bacterial overgrowth
      and to analyze its relationship with the severity of liver dysfunction, presence
      of ascites, and development of spontaneous bacterial peritonitis (SBP). Bacterial
      overgrowth was measured by means of a breath test after ingestion of glucose.
      Intestinal bacterial overgrowth was documented in 27 (30.3%) of the 89 patients
      with alcoholic cirrhosis and in none of the healthy subjects. The prevalence of
      intestinal bacterial overgrowth was significantly higher in cirrhotics with
      ascites (37.1%) than in those with no evidence of ascites (5.3%) and among
      patients with Pugh-Child class C (48.3%) than in patients with class A (13.1%) or
      B (27%). Twelve (17.1%) of the 70 patients with ascites developed an episode of
      SBP. The prevalence of spontaneous bacterial peritonitis was significantly higher
      in patients who had intestinal bacterial overgrowth (30.7%) than in patients who
      did not (9.09%). We conclude that intestinal bacterial overgrowth occurs in
      approximately one third of patients with cirrhosis secondary to alcohol,
      particularly in patients with ascites and advanced liver dysfunction. Moreover,
      bacterial overgrowth may be a condition favoring infection of the ascitic fluid.

PMID- 7781444
TI  - Differences in laser-induced autofluorescence between adenomatous and
      hyperplastic polyps and normal colonic mucosa by confocal microscopy.
AB  - Laser-induced autofluorescence has been used to discriminate normal from
      adenomatous colonic mucosa. However, few studies to date have studied the origin
      of colonic autofluorescence. Using confocal microscopy (excitation wavelength 488
      nm), we have shown that autofluorescence at this wavelength is present
      predominantly in the lamina propria of normal mucosa but in the epithelium in
      adenomatous and hyperplastic polyps. The intensity ratio of epithelial cell to
      lamina propria fluorescence was significantly lower (P < 0.0001) in normal mucosa
      (0.52 +/- 0.01) compared with either adenomatous (1.6 +/- 0.2) or hyperplastic
      polyps (1.7 +/- 0.15). However, the ratios were not significantly different
      between hyperplastic and adenomatous polyps. Thus, confocal microscopy enables
      the detection of the sites of autofluorescence within colonic mucosa and the
      quantitation of differences in fluorescence between different tissue types.

PMID- 7781445
TI  - Urinary N1-acetylspermidine and N8-acetylspermidine excretion in normal humans
      and in patients with colorectal cancer.
AB  - Urinary N1-acetylspermidine (N1SPD) and N8-acetylspermidine (N8SPD) were measured
      in 24-hr urine specimens from 42 patients with colon adenocarcinoma and 29
      healthy controls to assess their use as markers for colon cancer screening.
      Serial spot urines in four controls demonstrated significant fluctuations in
      these polyamine levels throughout the day without a distinct circadian pattern
      and therefore all subsequent analyses were performed on 24-hr collections. Both
      N1SPD and N8SPD were significantly increased in colon cancer patients compared to
      controls. Neither test correlated with tumor stage or location, but N8SPD was
      elevated in patients with poorly differentiated adenocarcinoma when compared to
      moderate or well-differentiated tumors. Using receiver operator characteristic
      (ROC) analysis, N1SPD had a higher information content than N8SPD, N1SPD + N8SPD,
      or the ratio of N1SPD/N8SPD and at a normal cut-off value of 4.0 nmol/mg
      creatinine, yielded a 95% specificity and 50% sensitivity for colon cancer.

PMID- 7781446
TI  - Fundic argyrophil carcinoid tumor in a patient with sporadic-type Zollinger
      Ellison syndrome.
AB  - In the Zollinger-Ellison syndrome, fundic argyrophil carcinoid tumors occur
      almost exclusively in the small subgroup of patients who also have multiple
      endocrine neoplasia type 1. In these patients, tumor development seems related to
      the same genetic alterations as those observed in other endocrine tumors related
      to multiple endocrine neoplasia type 1. We report here the second detailed case
      of a patient with sporadic Zollinger-Ellison syndrome who developed an argyrophil
      carcinoid tumor in nonatrophic fundic mucosa, suggesting that chronic
      hypergastrinemia may lead to fundic carcinoid development in nongenetically
      predisposed patients.

PMID- 7781447
TI  - Malignant schwannoma of the liver.
AB  - Malignant schwannoma is the most common soft tissue sarcoma in adults, but
      primary schwannoma of the liver is extremely rare. We report an autopsy case of
      malignant schwannoma of the liver in a 63-year-old man. The tumor involved almost
      the entire right lobe of the liver. Microscopically, it was composed of
      moderately pleomorphic spindle cells with hyperchromatic nuclei with mitotic
      figures. The spindle cells were stained positively with antibodies to both S-100
      protein and vimentin. Necrosis was found in the primary tumor. Only four other
      cases of malignant schwannoma of the liver were found in a review of the
      literature. Pertinent features of these tumors are discussed.

PMID- 7781448
TI  - Prospective evaluation of gastrointestinal tract in patients with iron-deficiency
      anemia.
AB  - Gastrointestinal bleeding is believed to cause iron-deficiency anemia (IDA). The
      information concerning ideal evaluation of the gastrointestinal tract and exact
      findings in patients with IDA is scant. The aim of this study was to
      prospectively evaluate patients with IDA for gastrointestinal lesions potentially
      causing IDA at a US Army Teaching Medical Center with Gastroenterology
      Fellowship. Seventy patients with IDA had esophagogastroduodenoscopy (EGD) and
      colonoscopy, and if this evaluation was unremarkable, then small bowel biopsy was
      obtained at EGD to evaluate for celiac disease. Enteroclysis was done if
      endoscopic evaluation was negative. At endoscopy, at least one lesion potentially
      accounted for the IDA in 50 (71%) patients. At colonoscopy, 21 (30%) patients had
      22 lesions (four colon cancer, seven adenoma > 1 cm, six vascular malformation,
      four severely bleeding hemorrhoids, one ileal Crohn's); at EGD, 39 (56%) patients
      had 43 lesions (11 gastric erosion, 10 esophagitis, four vascular malformation,
      four celiac disease, three gastric cancer, three gastric ulcer, three duodenal
      ulcer, two gastric polyp > 1 cm, one duodenal lymphoma, one esophageal cancer,
      and one duodenal Crohn's). Twelve (17%) patients had both upper and lower
      gastrointestinal tract lesions. Twenty-four of 32 (75%) patients with positive
      fecal occult blood test had potentially bleeding lesions compared to 24 of 38
      (63%) patients with negative fecal occult blood test (P > 0.05). Six of nine
      patients with malignancy had positive fecal occult blood test. Twenty patients
      with normal endoscopy and small bowel biopsy had normal enteroclysis.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7781449
TI  - Hydrogen peroxide injury to the colon.

PMID- 7781450
TI  - Free radical scavengers prevent reflux esophagitis in rats.
AB  - Free radical damage in reflux esophagitis of rats induced by 24-hr duodenojejunal
      ligation was studied. Oxygen free radicals were selectively blocked. Groups were:
      sham operation, reflux, reflux + superoxide dismutase (SOD), catalase,
      dimethylthiourea, allopurinol, and inactivated SOD or inactivated catalase alone
      or in the combination SOD + catalase or SOD + catalase + dimethylthiourea +
      allopurinol. Macroscopic esophagitis was inhibited only by SOD, alone or in
      combination with other agents. Esophageal mucosal lipid peroxidation was 10-fold
      increased in the reflux group compared to the sham group (P < 0.05). This
      response was damped by SOD > catalase (P < 0.05) but not by the inactivated
      enzymes, dimethylthiourea or allopurinol. SOD + catalase showed no significant
      improvement on SOD alone. Total inhibition of lipid peroxidation was achieved by
      combining all scavengers. Total glutathione (GSH) in the esophageal mucosa was
      stimulated by reflux. This response was inhibited by scavengers equivalent to
      their efficacy in preventing lipid peroxidation. It is concluded that reflux
      esophagitis is associated with free radical release with O2- being the main
      source. Free radicals appear to stimulate GSH production in this prolonged
      oxidative stress.

PMID- 7781451
TI  - Esophagitis in Sprague-Dawley rats is mediated by free radicals.
AB  - Free radical-mediated esophagitis was studied during duodenogastroesophageal
      reflux (mixed reflux) or acid reflux in rats. The influence of reflux on
      esophageal glutathione levels was also examined. Mixed reflux caused more gross
      mucosal injury than acid reflux. Gross mucosal injury occurred in the mid
      esophagus. Total glutathione (GSH) in the esophageal mucosa of control rats was
      highest in the distal esophagus. The time course of esophageal GSH in rats
      treated by mixed reflux showed a significant decrease 4 hr after initiation of
      reflux, followed by a significant increase from the 12th hour on. Mucosal GSH was
      increased in both reflux groups after 24 hr but significantly more so in the
      mixed than in the acid reflux group. The free radical scavenger superoxide
      dismutase (SOD) prevented esophagitis and was associated with decreased GSH
      levels. GSH depletion by buthionine sulfoximine (BSO) prevented esophagitis and
      stimulated SOD production in the esophageal mucosa. It is concluded that
      gastroesophageal reflux is associated with oxidative stress in the esophageal
      mucosa. The lower GSH levels in the mid-esophagus may predispose to damage in
      this area. Duodenogastroesophageal reflux causes more damage than pure acid
      reflux. Oxidative stress leads to GSH depletion of the esophageal mucosa in the
      first few hours following damage but then stimulates GSH production. GSH
      depletion by BSO does not worsen esophagitis since it increases the esophageal
      SOD concentration.

PMID- 7781452
TI  - Active oxygen species in formation of acute gastric mucosal lesions induced by
      thermal injury in rats.
AB  - Active oxygen species generated by circulating leukocytes and released from the
      gastric mucosa were measured in the process of acute gastric mucosal lesion
      formation after thermal injury in rats. Alterations of luminol-dependent
      chemiluminescence activities generated by leukocytes obtained from the gastric
      vein and the inferior vena cava were approximately same. A decrease in
      chemiluminescence activity 15 min after thermal injury and a significant increase
      in chemiluminescence activity 5 hr after thermal injury were observed in
      leukocytes from both veins. From 15 min to 12 hr after thermal injury, luciferin
      dependent chemiluminescence activities were significantly higher than that of the
      control group. Oral administration of rebamipide resulted in decreased mucosal
      lesion formation. Rebamipide, an antiulcer agent that protects the mucosa from
      damage in various animal models decreased chemiluminescence activities only
      released from the gastric mucosa but not from circulating leukocytes. These
      results suggest that two different pathways of active oxygen species formation
      may exist in the pathogenesis of acute gastric mucosal lesions after thermal
      injury.

PMID- 7781453
TI  - Velocity of peristaltic propagation in distal esophageal segments.
AB  - Recent studies of the peristaltic pressure wave have suggested the presence of
      two sequential but overlapping contraction segments in the distal esophageal
      body. In this report, propagation velocity of esophageal peristalsis was
      determined in these segments in normal subjects (N = 35) and in patients with
      high-amplitude peristalsis (nutcracker esophagus, N = 25) to see if intersegment
      differences were present in the normal or abnormal setting. Velocity measurements
      were made from conventional manometric tracings in two 4-cm regions representing
      the distal smooth-muscle segments. A novel method of velocity measurement was
      employed that used regression lines established from contraction onset times. In
      normal subjects, propagation velocity decreased significantly from the proximal
      to distal segment (4.9 +/- 0.5 cm/sec, vs 3.2 +/- 0.2 cm/sec, P < 0.01). Velocity
      also decreased across segments in nutcracker-esophagus patients (5.3 +/- 0.6
      cm/sec, vs 3.6 +/- 0.7 cm/sec, P = 0.06), but the difference reached statistical
      significance only when the subset with highest amplitudes (> or = 180 mm Hg) was
      analyzed separately. Greater variance in velocity in the distal smooth-muscle
      segment of nutcracker-esophagus patients (P < 0.01) was, in part, responsible for
      this statistical observation. We conclude that normal propagation velocity
      decreases across regions corresponding to the smooth-muscle contraction segments
      defined by recent studies of peristalsis, supporting the assumption that they
      represent separate neuromuscular units. The mechanisms responsible for
      contraction wave abnormalities in the nutcracker esophagus have a minimal effect
      on propagation velocity, an effect that is restricted to the distal smooth-muscle
      segment of the esophageal body.

PMID- 7781454
TI  - How well can quantitative 24-hour intraesophageal pH monitoring distinguish
      various degrees of reflux disease?
AB  - Twenty-four normal subjects and 64 symptomatic patients with various degrees of
      reflux disease (24 with reflux symptoms without esophagitis and 21 with mild and
      19 with severe esophagitis) underwent quantitative 24-hr intraesophageal pH
      monitoring. Various reflux parameters during supine, interprandial, and
      postprandial periods were examined by binary logistic regression and by CART
      analysis to determine the sensitivity and specificity to separate the various
      groups of subjects and patients. The distinction was excellent between
      asymptomatic controls and patients with severe erosive esophagitis (sensitivity
      and specificity both 100% by logistic regression and 95% and 88%, respectively,
      by CART), but discrimination was poor when asymptomatic controls were compared to
      symptomatic patients without esophagitis (71% and 79% by logistic regression and
      75% and 92% by CART), which is the most important indication for pH recording in
      clinical practice. A 3-hr postprandial pH recording was inadequate to distinguish
      the various groups. The acidity of the reflux episodes during the night appeared
      to be a crucial factor in the development of severe erosive esophagitis. The
      duration of esophageal acid exposure was another important factor in the
      development of reflux lesions.

PMID- 7781455
TI  - Increasing pain sensation to repeated esophageal balloon distension in patients
      with chest pain of undetermined etiology.
AB  - Previous studies have demonstrated lowered sensory thresholds to esophageal
      balloon distension in patients with chest pain of undetermined etiology. Whether
      this finding is specific to patients with chest pain or is simply related to an
      underlying esophageal motility disorder is unclear. In the present study,
      distension-induced pain-sensation scores and the effect of repeated balloon
      distension were compared in patients with chest pain, dysphagia secondary to
      esophageal dysmotility, and healthy controls. All subjects underwent standard
      esophageal manometry followed by mid-esophageal balloon distension. Volumes 2.5,
      5, 7.5, and 10 ml (each volume repeated three times) were applied in random order
      in a single-blind fashion, and the pain-sensation score was recorded after each
      distension. Pain-sensation scores varied directly with balloon volume. Mean pain
      scores were significantly higher (P < 0.001) in the chest pain group than in
      either the controls or dysphagia group. There was no significant difference
      between controls and the dysphagia group, and the motor response to distension
      was no different between groups. In the controls and dysphagia groups, pain
      sensation score was not significantly different between the first, second, or
      third distension at a given volume. However, in the chest pain group, pain
      sensation scores increased significantly with the second (P = 0.004) or third (P
      = 0.002) distension using the same balloon volume. These studies suggest that
      abnormal esophageal nociception in patients with chest pain of undetermined
      etiology is not simply related to underlying esophageal motor dysfunction. In
      addition, chest pain patients display a conditioning phenomenon, further
      supporting the presence of a visceral sensory abnormality.

PMID- 7781456
TI  - Mechanism of Helicobacter pylori-associated gastric mucosal injury.
AB  - Helicobacter pylori infection is associated with gastric mucosal damage and the
      infiltration of neutrophils. Myeloperoxidase from neutrophils produces
      hypochlorous acid, which yields monochloramine in the presence of ammonia
      produced by urease enzyme of Helicobacter pylori. The target cells of gastric
      mucosal damage are gastric mucosal cells and endothelial cells. We therefore
      tested the hypothesis that ammonium, hypochlorous acid, and monochloramine damage
      the target cells. We studied the in vitro cytotoxic effects of ammonium chloride,
      sodium hypochlorite, monochloramine, and activated neutrophils on the target
      cells. Cytotoxicity was measured by a 51Cr-release assay. Ammonium chloride,
      sodium hypochlorite, and monochloramine were toxic to labeled cells in a
      concentration dependent manner. The toxicity of these agents was in the order
      monochloramine > sodium hypochlorite >> ammonium chloride. Incubation of labeled
      cells with activated neutrophils, Helicobacter pylori, and urea resulted in
      cytolysis. These cytotoxicities were significantly inhibited by the scavenger of
      hypochlorous acid, taurine. Monochloramine is more toxic to the target cells than
      ammonium chloride. Although ammonium chloride at neutral pH by itself has little
      direct damaging effect on the gastric mucosa, it is damaging to the gastric
      mucosa through a reaction with hypochlorous acid, suggesting that it plays a role
      in Helicobacter pylori-associated gastric damage.

PMID- 7781457
TI  - Zinc deficiency delays gastric ulcer healing in rats.
AB  - Zinc is an important element in wound healing. Zinc compounds hasten the healing
      of gastric ulcers, by an unknown mechanism(s). We studied the effect of the
      induction of zinc deficiency on gastric ulcer healing. Rats were given a control
      or zinc-deficient diet for six weeks and then subjected to the induction of
      acetic acid-induced chronic gastric ulcers. Four days later, zinc-deficient rats
      were divided into two groups. In the first group, the zinc-deficient diet was
      continued. In the second group, the diet was changed to the control diet. Zinc
      deficient rats had a mean serum zinc concentration approximately 70% of that in
      controls. Zinc deficiency did not affect the formation of gastric ulcers;
      however, it reduced cell proliferation by day 4 and delayed ulcer healing. Zinc
      supplementation brought zinc to control levels within a week, but failed to
      reverse the delay in ulcer healing. We conclude that zinc is crucial for healing
      of gastric ulcers, especially at the early stage.

PMID- 7781459
TI  - Time course of mucosal cell proliferation following acute aspirin injury in rat
      stomach.
AB  - The time course of replicating cell proliferation in the gastric fundic mucosa
      following acute aspirin-induced injury was determined by BrdU labeling. Gastric
      erosions were produced in adult rats by gastric gavage using aspirin (200 mg/kg)
      suspended in 0.15 M HCl. Lesion scores indicated significant gross injury in the
      aspirin-treated rats at all times measured (from 2 to 48 hr). BrdU labeling was
      not elevated at 2 or 8 hr after gavage. A significant increase in labeling was
      observed at 15 hr, reached a maximum at 16 hr, and declined with a slight, but
      significant increase still present at 48 hr. Elevations in BrdU labeling were
      uniform and seen in areas adjacent to and distant from the gross injury. The BrdU
      labeling in the fasted control rats decreased during this same time period. The
      height of the proliferative zone was not altered from control in the aspirin
      treated rats despite the marked differences in proliferation activity. This study
      demonstrates the importance of the time course in the assessment of mucosal cell
      proliferation following injury.

PMID- 7781460
TI  - In vitro recovery of canine gastric mucosal surface hydrophobicity and potential
      difference after aspirin damage.
AB  - This study determined how the luminal surface hydrophobicity and transmucosal
      potential difference (PD) of canine gastric mucosa changed during the recovery
      period after the tissue was challenged with acidified aspirin. Luminal aspirin
      reduced both the contact angle and PD of mucosae incubated in Ussing chambers.
      After the removal of aspirin, surface hydrophobicity was found to recover before
      PD, and nutrient 16,16-dimethyl prostaglandin E2 accelerated the recovery of both
      parameters. Restoration of luminal surface hydrophobicity may be an important
      component of how the stomach reestablishes its barrier properties after exposure
      to a luminal damaging agent.

PMID- 7781458
TI  - Nonsteroidal antiinflammatory drugs and dyspepsia in the elderly.
AB  - Upper gastrointestinal tract symptoms are common in the elderly and, despite a
      paucity of data, nonsteroidal antiinflammatory drugs (NSAIDs) are believed to be
      important risk factors. We aimed to evaluate the association of NSAIDs with
      dyspepsia and heartburn in a population-based study. An age- and gender
      stratified random sample of Olmsted County, Minnesota, Caucasian residents aged
      65 years and older was mailed a valid self-report questionnaire; 74% responded (N
      = 1375). Age- and gender-adjusted (to 1980 US Caucasian population) prevalence
      rates for NSAID use, dyspepsia (defined as pain located in the upper abdomen or
      nausea), and heartburn (defined as retrosternal burning pain) were calculated.
      Logistic regression analysis was used to estimate the association of dyspepsia
      and heartburn with potential risk factors adjusting for age and gender. The age-
      and gender-adjusted annual prevalences (per 100) of aspirin and nonaspirin NSAID
      use were 60.0 (95% CI 57.2, 62.7) and 26.1 (95% CI 23.6, 28.7), respectively. The
      annual prevalences of dyspepsia and heartburn were 15.0 (95% CI 12.9, 17.0) and
      12.9 (95% CI 10.9, 14.8), respectively. Aspirin was associated with dyspepsia
      and/or heartburn (OR = 1.6, 95% CI 1.2, 2.2) as were nonaspirin NSAIDs (OR = 1.8,
      95% CI 1.3, 2.6), but smoking and alcohol were not significant risk factors.
      Aspirin and nonaspirin NSAIDs are associated with almost a twofold risk of upper
      gastrointestinal tract symptoms in elderly community subjects.

PMID- 7781461
TI  - A double-blind study of pantoprazole and ranitidine in treatment of acute
      duodenal ulcer. A multicenter trial. European Pantoprazole Study Group.
AB  - Pantoprazole is a new substituted benzimidazole, which is a potent inhibitor of
      gastric acid secretion by its inhibition of H+,K(+)-ATPase. Pantoprazole, 40 mg,
      was compared with the H2-receptor antagonist ranitidine, 300 mg, in the healing
      of acute duodenal ulcer. Two hundred seventy-six patients with endoscopically
      diagnosed duodenal ulcer were studied in this multicenter double-blind study.
      Patients were reendoscopied after two weeks of treatment, and those patients
      whose ulcers remained unhealed were also endoscoped after an additional two weeks
      of treatment. The primary end point was the complete healing of the ulcer.
      Demographic characteristics were comparable in both treatment groups. After two
      weeks of treatment, 90/124 (73%) patients in the pantoprazole group had healed
      ulcers compared with 57/126 (45%) patients in the ranitidine group (P < 0.001,
      per-protocol analysis). After four weeks, the cumulative healing rates were 92%
      and 84% in the pantoprazole and ranitidine groups, respectively (P = 0.073).
      Symptoms were also improved at week 2, with 84% and 72% of patients in the
      pantoprazole and ranitidine groups, respectively, reporting no ulcer pain (P <
      0.05, per-protocol analysis). Both treatments were well tolerated. This study has
      confirmed the superiority of pantoprazole compared with ranitidine in the healing
      of duodenal ulcers and pain relief after two weeks of treatment and has shown
      pantoprazole to be well tolerated in this indication.

PMID- 7781462
TI  - L-arginine/nitric oxide pathway modulates gastric motility and gallbladder
      emptying induced by erythromycin and liquid meal in humans.
AB  - There is recent evidence that nitric oxide, a soluble gas produced from L
      arginine, is released by the smooth muscle cells and neurons of the
      gastrointestinal tract where it exerts a myorelaxive action. However, little is
      known about the effects nitric oxide has on gastric and gallbladder motility
      during the inter- and postprandial phases in man. We therefore investigated the
      effects 200 mg/kg/hr L-arginine exerts on the gastric and gallbladder motility
      induced by 2 mg/kg erythromycin or a liquid meal in 21 subjects in a double
      blind, placebo-controlled study. Gastric and gallbladder emptying were evaluated
      by sonography. Fasting antral motility was expressed as antral motility index
      (MI). In fasting subjects, L-arginine administration determined a threefold
      increase in plasma nitrite concentrations. Administration of erythromycin caused
      a significant rise in the antral MI, which was inhibited by L-arginine (P <
      0.05). Ingestion of a liquid meal also significantly increased antral MI, but it
      returned to basal values 90 min after the end of the meal. Although L-arginine
      administration caused a significant reduction in the antral MI (P < 0.05), it did
      not inhibit gastric emptying. L-Arginine provoked an approximately 40% increase
      in basal gallbladder volume, completely blocked erythromycin-induced emptying,
      and partially, but significantly, prevented the emptying induced by a liquid meal
      (P < 0.01). Our study suggests that nitric oxide may be implicated in the
      physiological modulation of gastric and gallbladder motility during the inter-
      and postprandial phases in man.

PMID- 7781463
TI  - Influence of intestinal inflammation (IBD) and small and large bowel length on
      fecal short-chain fatty acids and lactate.
AB  - Treatment with short-chain fatty acids (SCFAs) seems promising in ulcerative
      colitis and changes in colonocyte oxidation of butyrate have been suggested to be
      of importance for the development of this disease. The influence of small and
      large bowel length after surgery on SCFAs is only partly known. SCFAs and lactate
      were measured in consecutive fecal samples from 300 patients with ulcerative
      colitis (103), Crohn's disease (127), and noninflammatory bowel disease (70); 205
      had had surgery, 52 had short bowels (< 200 cm). Lactate (mainly the L-isomer)
      was elevated in ulcerative colitis patients with pancolitis (mean +/- SEM, 17 +/-
      5 mmol/liter) and proctitis (12 +/- 3 mmol/liter) compared with quiescent
      ulcerative colitis (3 +/- 1 mmol/liter, P < 0.01), and correlated with the index
      of Truelove (R = 0.52, P < 0.0005). Lactate was also increased in Crohn's colitis
      (21 +/- 8 mmol/liter), but not in isolated ileitis (4 +/- 2 mmol/liter), compared
      with quiescent Crohn's disease (7 +/- 2 mmol/liter, P < 0.02), but did not
      correlate with the activity index (CDAI; R = 0.18, P = 0.12). In contrast to
      earlier reports, SCFAs (including butyrate) did not correlate with inflammatory
      activity or localization in either ulcerative colitis or Crohn's disease. The
      length of the small bowel had no influence on SCFAs and lactate in patients with
      either no colonic function (ileostomies), or with > 50% and < 50% preserved
      colorectal length, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781464
TI  - Response to intraluminal gas in irritable bowel syndrome. Motility versus
      perception.
AB  - Our aim was to evaluate the response to intraluminal gas in irritable bowel
      syndrome and to determine whether this response was consequent upon disordered
      motility or altered perception. We evaluated 10 patients who satisfied the
      clinical criteria for the diagnosis of irritable bowel syndrome and 10 healthy
      controls. An eight-lumen perfused catheter assembly was positioned to monitor
      motor activity in the duodenum and proximal jejunum; a separate side port in the
      distal duodenum permitted gas infusion. Subjects recorded symptoms of abdominal
      pain, bloating, and nausea throughout the study, using a visual analog scale.
      Following an overnight fast and a 60-min basal recording period in the fasted
      state, subjects ate a standard meal; 60 min later, "sham" gas was administered
      for 20 min, followed by the actual infusion of nitrogen gas at 40 ml/min.
      Subjects were randomized to receive atropine (7 micrograms/kg) or placebo
      intravenously during the period of actual gas infusion. Patients with irritable
      bowel syndrome described more pain (score, mean +/- SE, control versus irritable
      bowel: 0.22 +/- 0.16 vs 1.65 +/- 0.5, P < 0.01) and nausea (0.25 +/- 0.21 vs 1.45
      +/- 0.64, P < 0.04) during sham gas; motility indices were similar in both
      groups. During active gas, irritable bowel syndrome patients reported more pain
      (0.40 +/- 0.39 vs 2.94 +/- 1.16, P < 0.03); motility indices at all sites were
      similar in both groups. Symptom severity in irritable bowel syndrome subjects
      randomized to receive atropine was similar to control subjects during active gas
      infusion; motility indices were similar.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781466
TI  - Crohn's disease and factitious physical disorders.

PMID- 7781465
TI  - Functional and morphological changes in small bowel of Crohn's disease patients.
      Influence of site of disease.
AB  - Morphological and functional changes were examined in the upper jejunum and
      terminal ileum of 18 patients suffering from Crohn's disease. Intestinal
      permeability, biochemical determination of enzymatic activities, and morphologic
      evaluation of the severity of the lesions were evaluated. Ulcerative colitis and
      irritable bowel syndrome patients served as controls. We found abnormal lactulose
      mannitol tests in all patients with active Crohn's disease. Permeability changes
      correlated with increased crypt cell proliferation, as indicated by thymidine
      kinase activity. A significant reduction in brush border enzyme activities was
      seen in the terminal ileum, but no significant change was observed in the
      unaffected upper jejunum. The number of mast cells was increased in the diseased
      ileum. We conclude that the site of inflammation and the healing capacity of the
      epithelium are important in determining functional and biochemical abnormalities
      in active Crohn's disease. Changes may be dependent on the type and number of
      immune cells involved in the inflammatory process.

PMID- 7781467
TI  - Severe thrombotic complications in a postpartum patient with active Crohn's
      disease resulting in ischemic spinal cord injury.
AB  - This report describes a 33-year-old female patient who presented with severe
      neurological symptoms and signs during postpartum relapse of Crohn's ileocolitis.
      The cause of the neurological deficit was extensive major vessel thrombosis
      resulting in spinal cord ischemia. Etiologic factors involved in this exceptional
      thrombotic state are discussed with emphasis on the relationship between low
      levels of folic acid, homocysteine metabolism, and coagulation.

PMID- 7781468
TI  - Collagenous colitis. A treatable disease with an elusive diagnosis.
AB  - Collagenous colitis is associated with normal endoscopy examination and peculiar
      histopathological changes. The natural history and optimal treatment are not well
      defined. Our objectives were to analyze the symptomatology of collagenous
      colitis, determine the natural history, and response to treatment. All patients
      with collagenous colitis from 1978 to 1992 were studied. Demographic data,
      symptomatology, associated conditions, colonoscopic findings, and pathology
      specimens were reviewed. Clinical improvement was classified as none, partial, or
      complete. Nineteen patients were identified, mainly white females over age 50.
      Mean follow-up was 22.6 months. Symptom duration was 37 months (range 4 months to
      15 years). Symptoms were intermittent diarrhea (19), with a predominant nocturnal
      component (13); abdominal pain (15); and mild weight loss and incontinence (8).
      Colonoscopy was normal in 12 patients. Segmental mucosal edema and loss of
      vasculature pattern were present in seven. Antiperistaltic agents were used in 17
      patients with no improvement (15), partial resolution (1), and complete
      resolution (1). Eight nonresponders received sulfasalazine. Responses were none
      (6) or complete (2). Ten patients received steroids (10-20 mg/day). One failed to
      respond. Nine initially responded completely but two relapsed. Seven patients who
      did not respond to any type of treatment improved eventually, two partially and
      five completely. These patients were younger (54.3 vs 68.3 years, P = 0.04) and
      symptom duration was shorter (25.4 vs 44.5 months, P = 0.38) than the rest of the
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781470
TI  - Idiopathic perforation of sigmoid colon.

PMID- 7781469
TI  - Placebo controlled study randomizing leuprolide acetate.

PMID- 7781471
TI  - Cold versus warm cardioplegia: recognizing hemodynamic variations.
AB  - The use of warm blood cardioplegia during open-heart surgical procedures
      represents a marked departure from the traditional hypothermic approach used over
      the past 30 years. Current literature regarding the two techniques reveals
      interesting and sometimes confusing results. Nurses aware of the different
      hemodynamic responses from both techniques provide critical assessment skills,
      which help prevent or identify early complications for these patients.

PMID- 7781472
TI  - Caring for patients with acute myocardial ischaemia: the perhexiline maleate
      experience.
AB  - Perhexiline Maleate (Px) is a potent, oxygen-sparing agent used in the management
      of patients with acute myocardial ischaemia that is resistant to conventional
      pharmacological therapy. The critical care nurse plays an integral role in (1)
      maximizing the therapeutic benefits of Px and (2) ensuring that the patient
      reaches the point of correctional intervention with the minimum of ischaemic
      damage.

PMID- 7781474
TI  - Intravenous patient-controlled analgesia in critically ill postoperative/trauma
      patients: research-based practice recommendations.
AB  - PCA use is increasingly common in the Intensive Care Unit. The authors review
      current PCA research and make recommendations for the optimal use of PCA in the
      critically ill patient.

PMID- 7781473
TI  - Examining management of pain for infants following cardiothoracic surgery.
AB  - Pain management for infants continues to be inadequate despite evidence that
      infants do experience pain. Some health professionals fear that the risks of
      administering medication for pain outweigh the benefits. In caring for infants
      thought to be in pain, nurses often choose to administer a minimal dosage of
      analgesia; administer a sedative for its calming effects; or try to maximize
      relief by combining the analgesics and sedatives prescribed. Findings from this
      study indicate that the administration of analgesics and sedatives to relieve
      pain or calm an infant may be too conservative.

PMID- 7781475
TI  - "Preventing complications of PEG tubes".

PMID- 7781476
TI  - Escorting the family out of the ICU: ethical and legal issues.
AB  - This article presents an interesting case where nurses touched a family member to
      escort her out of the ICU against her wishes. In the case analysis, the nurse
      attorney author reviews the ethical and legal issues in this case.

PMID- 7781477
TI  - Battered women in the critical care setting: strategies for critical care nurses.
AB  - Nursing intervention with battered women can be a frustrating and discouraging
      experience, as battered women are trapped in a cycle of violence that is
      difficult to break. Research reveals an Open Window Phase within the cycle of
      violence. During this brief period, battered women are most receptive to
      interventions. The responsibility of the critical care nurse to intervene during
      this short period of time is particularly urgent. This article provides
      intervention strategies for nurses in critical care to use during the Open Window
      Phase.

PMID- 7781478
TI  - Morphological and pathogenetic aspects of proliferative vitreo-retinopathy. A
      histological and immunohistochemical study.
AB  - Proliferative vitreo-retinopathy (PVR) and subretinal membrane proliferation are
      the most common complication and cause of failure in retinal-detachment (RD)
      surgery. In this study, material withdrawn from 21 patients was observed. The
      vitreal taps of 16 bulbs affected by PVR and which had undergone vitrectomy,
      along with 5 bulbs obtained by enucleation, were stained with Hematoxylin Eosin
      and studied immunohistochemically. The cells involved in this proliferative
      tissue include macrophages, cellular elements of pigmented epithelium origin,
      fibroblasts and myofibroblasts. From the examination of enucleated bulbs, we can
      easily recognize that the cellular components of the membrane are represented by
      fibroblasts, capillaries, and occasional macrophages; meanwhile, PE cells remain
      at the base of the newly formed tissue.

PMID- 7781479
TI  - Morphometrical analysis of retinal arterial macroaneurysms.
AB  - Twenty-one macroaneurysms and related vessels of 19 patients were evaluated
      morphometrically. Macroaneurysms were classified into two groups as hemorrhagic
      and exudative in terms of their major clinical sign. Average diameters of the
      macroaneurysms were arranged in a Gaussian distribution curve (mean and standard
      deviation: 281.60 +/- 57.28 micrometers). Regarding the distribution curve based
      on this data macroaneurysm can be defined as being greater than 109.76
      micrometers. Macroaneurysms were most frequent on the superotemporal vessels
      (52.38%), followed by the inferotemporal (38.10%), inferonasal (4.76%) and
      superonasal vessels. Average diameter (r = +0.68, p = 0.0006) and area (r =
      +0.71, p = 0.0003) of the macroaneurysms were significantly correlated to the
      diameter of the relevant arterial segments. The distribution of the
      macroaneurysms in respect to arterial bifurcation (chi 2 = 18.762, p = 0.0003)
      and arteriovenous crossings (chi 2 = 8.286, p = 0.0405) were nonrandom with
      macroaneurysms clustering near this points. Hemorrhagic macroaneurysms were
      significantly closer to the optic disc (p < 0.01) and were located on relatively
      larger arterioles (p < 0.01). They were also more circular (p < 0.01) in shape
      and greater in area (p < 0.01) and diameter (p < 0.01) than the exudative ones.
      These findings suggest that the location of the macroaneurysm is closely related
      to its clinical appearance.

PMID- 7781480
TI  - Influence of existing retinal correspondence on the results of squint operations
      in alternating convergent strabism.
AB  - In our study we examined the influence of existing retinal correspondence on the
      result of squint operations for alternating convergent strabism. 157 patients
      under 10 years of age at the time of their first or only operation were included.
      They were divided into groups, depending on their age at the onset of squint and
      subgroups according to their type of retinal correspondence. The development of
      distance and near deviation was investigated separately. Covariance analysis
      demonstrated that the preoperative sensorial state is a predictor for the motor
      outcome of surgery with regard to postoperative distance deviation. Statistically
      we found at least noticeable results (p < 0.15) in all groups of patients--for
      acquired esotropia a significant result (p < 0.01). With regard to the
      postoperative near deviation we found a significant influence of the preoperative
      sensorial state only in the group of patients with a late onset of squint (p =
      0.05). For patients with an earlier onset (before the 30th month) of strabismus,
      the preoperative angle of near deviation proved to have a significant impact on
      the postoperative development of near deviation (p < 0.05). Sensorio-motorial
      adaptational phenomena in esotropia are presumed to be the major cause for this
      difference.

PMID- 7781482
TI  - Secondary hyperfunction of unoperated inferior oblique muscle after surgical
      treatment of strabismus.
AB  - Secondary hyperfunction of the inferior oblique muscle IO of one of the eyes is a
      frequent complication after unilateral recession of the overacting IO of the
      fellow's eye. It is often observed in cases with bilateral asymmetric
      hyperfunction of the IO's when these are surgically decreased. The pathogenesis
      of this secondary hyperfunction is not sufficiently explained yet. We evaluated
      the condition of unoperated IO in 42 children with unilateral hyperfunction of
      the IO. In all cases the operation we performed was recession combined with a
      fixed anteroposition. During the two years follow up period we found no secondary
      hyperfunction of the unoperated oblique muscle in 31 of the children, mild level
      of elevation in 7 of them, middle--in 2, and severe in 2 of the children. This
      observation confirmed our conviction of refraining from simultaneous surgical
      intervention on both IO muscles when there is hyperfunction of one of them.

PMID- 7781481
TI  - Fornix- vs. limbus-based flaps in combined phacoemulsification and
      trabeculectomy.
AB  - We studied prospectively the results of limbus-versus fornix-based flaps in
      patients undergoing combined trabeculectomy and phacoemulsification. We found no
      significant difference at six months postoperatively in the level of intraocular
      pressure between the limbus-(16.1 +/- 4.1 mm Hg) and fornix- (14.0 +/- 3.4 mm Hg,
      p = 0.161) based groups, or in the number of glaucoma medications (p = 0.0750).
      The highest intraocular pressure recorded within the first postoperative month
      was similar between groups (18.4 +/- 6.9 mm Hg for limbus and 18.5 +/- 5.5 mm Hg
      for fornix, p > 0.900). Postoperative bleb height, extent, and vascularity, as
      well as chamber depth were statistically similar between groups (p > 0.05).
      Postoperative complications were similar between groups. This study indicates
      that both fornix- and limbus-based flaps may be used safely and effectively when
      performing a trabeculectomy combined with phacoemulsification.

PMID- 7781483
TI  - The cytological, immunocytochemical and molecular genetic analysis in diagnosis
      of the neoplasms of the eye, eye adnexa and orbit.
AB  - The fine needle aspiration biopsy was performed in 91 patients including 57 cases
      of retrobulbar tumors done under CT control. All aspirates were cytologically
      examined. In 21 cases immunocytochemical examination was performed in order to
      distinguish poorly differentiated neoplasms. In 19 cases malignant lymphoma was
      distinguished from pseudolymphoma. Cytological diagnosis was confirmed by
      histopathological examination in 77 cases /84%/. One result was false positive, 3
      false negative. The value of immunocytochemical methods in differential diagnosis
      of poorly differentiated neoplasms was stressed.

PMID- 7781484
TI  - Spectral transmission of the optical media of the human eye with respect to
      keratitis and cataract formation.
AB  - The spectral transmissions of cornea, aqueous humour, lens and vitreous humour of
      human eyes were measured in the range from 250 nm to 800 nm in 1 nm steps using a
      high resolution double monochromator. Cornea and lens are good cut off filters;
      1% transmission was measured in various cornea samples between 291 and 298 nm,
      and in different lenses between 389 and 414 nm. Aqueous humour and vitreous
      humour showed high transparency (80%) at lambda > 320 nm. The wavelength range of
      keratitis effective irradiance was found to be completely within the wavelength
      range of absorption of the cornea, that of cataract effective irradiance was
      found to be at the short wavelength end partly outside the wavelength range of
      absorption of the lens. It may therefore be supposed that the action spectrum of
      cataract obtained by animal experiments is applicable to the human eye only with
      certain reservations.

PMID- 7781485
TI  - Persistent choroidopathy in systemic lupus erythematosus.
AB  - We report a case of a rare entity, choroidopathy in association with systemic
      lupus erythematosus (SLE), previously described in only twelve patients to our
      knowledge. It manifested by multiple focal serous elevations of the sensory
      retina and/or serous detachments of the retinal pigment epithelium bilaterally.
      No retinal vascular changes were observed. The probable pathogenesis is related
      to choroidal vascular disease due to systemic hypertension secondary to lupus
      nephritis, vasculitis, or a combination of these.

PMID- 7781486
TI  - Macular drusen and the sensitivity of the central visual field.
AB  - Macular drusen are one of the earliest signs of age-related macular degeneration
      but little information is available on the functional aspects of macular area in
      patients with drusen. To determine if drusen are associated with changes in
      central visual field sensitivity, one eye of each of 35 subjects (mean age 64.9
      years) with bilateral drusen and visual acuity of 1.0 (20/20) underwent automated
      static threshold perimetry of the central 10 degrees. 16 normal subjects (mean
      age 65.8 years) were used as controls. 30 degrees fundus photographs were graded
      in a masked fashion for the clinical characteristics of drusen: type, size and
      number. The mean sensitivity (MS) of the central 10 degrees was significantly
      lower in eyes with drusen compared to normal eyes (p = .0001). After grading
      drusen eyes for size (> or = 63 mu) and type (presence of soft drusen), MS
      significantly deteriorated when large and soft drusen were present. These results
      suggest that central visual field sensitivity is precociously affected in eyes
      with drusen and that testing central visual field sensitivity may be useful as
      functional parameter in long term studies on the evolution of age-related macular
      degeneration.

PMID- 7781487
TI  - Lubrithal (Leo viscous eye gel), precorneal residence time in normal and dry
      eyes.
AB  - In an open, right/left controlled study we compared the effects of topical
      carbomer gel Lubrithal (Leo viscous eye gel) and polyvinyl alcohol (Liquifilm,
      Allergan) in 20 patients with dry eyes and in 20 healthy subjects. The average
      precorneal residence time of carbomer gel in patients and healthy subjects was
      92.8 min (+/- 35.7) and 36.5 min (+/- 14.2), respectively, while it was 40.8 min
      (+/- 19.4) and 19.5 min (+/- 8.3) in the polyvinyl alcohol group. The tear break
      up time was 10 min after instillation significantly longer with the carbomer gel:
      23.0 seconds (+/- 5.5) in dry eye patients and 26.2 seconds (+/- 4.4) in healthy
      subjects compared to polyvinyl alcohol: 10.4 seconds (+/- 3.4) in dry eye
      patients and 16.5 seconds (+/- 7.1) in healthy subjects (p < 0.001). Seventy-five
      per cent of the dry eye patients preferred Lubrithal.

PMID- 7781488
TI  - Baroreflex function in streptozotocin (STZ) induced diabetic rats.
AB  - To determine whether the renal sympatho-inhibition and bradycardia in responses
      to acute increases in arterial pressure are altered in the diabetic state, the
      renal nerve discharge and heart rate were measured in streptozotocin (STZ)
      induced diabetic (DIA) rats. Integrated renal sympathetic nerve activity and
      heart rate were measured before and during an acute increase in blood pressure in
      anesthetized (Inactin 0.1 g/kg, i.p.) control (vehicle) and DIA rats (Sprague
      Dawley rats injected with STZ 65 mg/kg i.p.). Blood glucose levels were
      significantly elevated in the DIA group compared with the control group.
      Baroreflex changes in renal nerve activity and heart rate were not significantly
      different in the DIA rats compared with control rats at a time when the renal
      sympatho-inhibition in response to acute volume expansion was blunted in the
      diabetic rats. In addition, blocking the effect of elevated angiotensin II in
      diabetic rats with the converting enzyme inhibitor enalapril did not change the
      baroreflex function in DIA rats compared with control rats. However,
      administration of vasopressin failed to potentiate the baroreflex in diabetic
      rats as it did in normal control rats. This study demonstrates that (1) the
      baroreflex function is normal in STZ induced diabetic rats unlike the volume
      reflex during the early phase of the disease, (2) blockade of the AII system does
      not alter baroreflex function in diabetic rats and (3) vasopressin fails to
      potentiate the baroreflex in diabetic rats as it does in the euglycemic normal
      rats.

PMID- 7781489
TI  - Ascorbic acid supplementation prevents hyperlipidemia and improves myocardial
      performance in streptozotocin-diabetic rats.
AB  - The present study investigated the effects of ascorbic acid (AA) supplementation
      on the cardiac performance and the plasma levels of glucose, insulin,
      triglycerides, cholesterol and free fatty acid in diabetic and non-diabetic rats.
      Diabetes was induced by intravenous injection of streptozotocin (STZ) 55 mg/kg.
      AA was given in drinking water in concentrations of 1 g/l or 2 g/l for 8 weeks
      after STZ injection. Myocardial performance was determined using the isolated
      perfused working heart preparations. Following AA supplementation, there were no
      significant changes in any of the parameters measured in non-diabetic rats;
      however, the occurrence of polydipsia, hyperphagia, hyperlipidemia and myocardial
      dysfunction in STZ-diabetic rats was significantly alleviated in a dose-dependent
      manner. Nevertheless, the decreased body weight gain, hypoinsulinemia and
      hyperglycemia in diabetic animals were not affected. The data show that AA
      supplementation in STZ-diabetic rats improves both hyperlipidemia and cardiac
      function. However, the mechanisms of these effects and the correlation between
      these improvements are not clear.

PMID- 7781490
TI  - Lack of effect of CS-045, a new antidiabetic agent, on insulin secretion in the
      remnant pancreas after 90% pancreatectomy in rats.
AB  - We assessed the effect of CS-045, a new hypoglycemic agent, on B-cell function in
      partially pancreatectomized rats. At the age of 4 weeks, male Wistar rats were
      subjected to 90% pancreatectomy (Px). For 2 weeks starting at 6 weeks after
      surgery the Px rats were treated with CS-045 (CS rats) mixed with chow pellets in
      a proportion of 0.2% (w/w). To compare the efficacy of CS-045 with that of
      insulin therapy, an osmotic pump was implanted to release insulin (1.2 units/day)
      into the intraperitoneal cavity of the Px rats (Is rats). Plasma glucose levels
      in the CS and Is rats were significantly lower than in the control Px rats;
      however, no marked improvement in plasma glucose or insulin levels was observed
      in glucose tolerance test (2 g/kg, i.p.) in the CS rats. Insulin secretion by the
      isolated perfused pancreas in response to 16.7 mM glucose showed a biphasic
      pattern, but was slightly reduced in the Px and CS rats compared with the Is
      rats. Insulin secretion induced by 19 mM arginine was unaffected by the
      treatment. The insulin content of the CS rats was significantly greater than in
      the Px and Is rats. Histological observations suggested regranulation of the
      pancreatic islets of the CS rats. B-cell areas within the islet were restored to
      normal levels in the Cs and Is rats. These findings indicate that the
      hypoglycemic effect of CS-045, which is not mediated by insulin secretion from
      the residual pancreas, prevents destruction of the islet.

PMID- 7781491
TI  - Stimulation of insulin secretion and potentiation of glibenclamide-induced
      insulin release by the dimethyl ester of glutamic acid in anaesthetized rats.
AB  - The dimethyl ester of L-glutamic acid (GME) stimulates insulin release in
      isolated pancreatic islets and may represent a novel experimental tool in the
      study of non-insulin-dependent diabetes. In the present study, GME was found both
      to stimulate insulin secretion and to augment glibenclamide-stimulated insulin
      release in normal anaesthetized rats. A comparable hierarchy in the magnitude of
      the secretory response to GME and/or glibenclamide was found in control rats and
      animals injected with streptozotocin during the neonatal period. In the latter
      animals, however, the B-cell secretory response was invariably lower than in
      control animals. It is proposed that GME represents a novel tool to bypass
      anomalies of glucose transport and metabolism in the beta cell and, hence, to
      stimulate insulin release and enhance the insulinotropic action of hypoglycaemic
      sulphonylurea in animal models of non-insulin-dependent diabetes.

PMID- 7781493
TI  - Serum concentrations of basement membrane proteins in NIDDM as a prognostic
      marker for nephropathy.
AB  - Metabolic changes of basement membrane proteins, collagenous and non-collagenous,
      will be followed by morphological changes and develop into diabetic
      microangiopathy. In this study, serum concentrations of laminin and type IV
      collagen were measured in 87 cases o f non-insulin-dependent diabetes mellitus
      (NIDDM) and examined with the development of diabetic nephropathy and
      retinopathy. Serum type IV collagen was measured by two methods, assays of the 7S
      portion (7S-RIA) and of both the 7S and central triple helical domain (IV-EIA).
      IV-EIA showed more significant elevation with development of diabetic
      microangiopathy than 7S-RIA and laminin. After measurement of basement membrane
      proteins, 66 cases were followed clinically for 3 or 4 years. In 45 cases without
      worsening of diabetic nephropathy, IV-EIA and laminin concentrations in serum
      were significantly lower than those in 21 cases who showed worsening of diabetic
      nephropathy in the same period, Multivariate analysis revealed a good model
      including three dependent variables of serum values of laminin, IV-EIA and mean
      blood pressure for discriminating between the worsened group and the non-worsened
      group. High values of IV-EIA and laminin in serum may be useful in predicting the
      worsening of diabetic nephropathy.

PMID- 7781492
TI  - Immunogenetic heterogeneity in type 1 (insulin-dependent) diabetes among Japanese
      -class II antigen and autoimmune thyroid disease.
AB  - HLA-DQA1 and DPB1 alleles were examined in relation to autoimmune thyroid disease
      (AITD) in the Japanese type 1 diabetic patients. The subjects consisted of 14
      type 1 diabetic patients with Graves' disease, 12 patients with Hashimoto's
      thyroiditis and 32 type 1 diabetic patients without AITD. Comparisons were made
      with 35 normal controls. Among the type 1 diabetic patients with Graves' disease,
      the age at onset of diabetes was 31.8 +/- 14.6 years old, which was later than
      that of those without AITD (P < 0.01). DR9 was increased (57.1% vs. 25.9%, P <
      0.05, RR: 3.85, chi 2:4.36) in the patients with Graves' disease. DQA1*0301 was
      increased and DQA1*0103 was decreased in the patients with Graves' disease and
      those without AITD. HLA-DPB1*0501 was increased (92.9% vs. 54.3%, P < 0.05, RR:
      11.0, chi 2:6.57) in the patients with Graves' disease. These findings suggest
      the existence of a Graves' complicated subgroup characterized by the increasing
      association of DPB1*0501 and late onset of diabetes in Japanese type 1 diabetic
      patients. There exists a heterogeneity in Japanese type 1 diabetes.

PMID- 7781494
TI  - Effect of chronic vanadate administration in partially depancreatized rats.
AB  - The effects of vanadate on B-cell function and replication in rats after 90%
      partial pancreatectomy (Px) were compared with insulin therapy. At the age of 4
      weeks, male Wistar rats were subjected to sham operation or Px. Vanadate (0.2
      mg/ml) was given in drinking water for 3 weeks starting at 2 weeks after surgery.
      Regular insulin (2.4 units/day) was administered as a continuous subcutaneous
      infusion through an osmotic pump. Plasma glucose levels were significantly higher
      in the Px rats than in the sham rats from 1 week after surgery. Vanadate lowered
      plasma glucose levels to near normal values in the Px rats as early as 2 days.
      The effect was sustained throughout the experiment. The hypoglycemic effect of
      insulin was less than that of vanadate. During an i.p. glucose tolerance test,
      plasma glucose levels were decreased in the Px rats treated with vanadate or
      insulin, while plasma insulin levels were not affected. The insulin content in
      the Px rats treated with vanadate was significantly (P < 0.01) greater than in
      the insulin-treated Px rats. Histological examination showed fibrotic
      degeneration in the enlarged islets of Px rats, whereas the normal structure was
      retained in most islets of the Px rats treated with vanadate and insulin. In
      addition, B-cell areas within the islet were restored to normal levels not only
      in the insulin-treated Px rats but in the vanadate-treated Px rats. However, both
      vanadate and insulin failed to stimulate proliferative activity of the B-cells.
      These data suggest that vanadate is a new therapeutic option to ameliorate the
      diabetic state after Px.

PMID- 7781495
TI  - Long-term efficacy and tolerability of pravastatin in hypercholesterolemia in
      patients with non-insulin-dependent diabetes mellitus. Hyogo Pravastatin Study
      Group.
AB  - This study reports the result of a 12-month, open-label multicenter study of the
      efficacy and tolerability of pravastatin in the management of
      hypercholesterolemia associated with non-insulin-dependent diabetes mellitus.
      Pravastatin produced a decrease, in 138 diabetic and 51 non-diabetic patients, in
      total serum cholesterol by 19 and 20%, in low-density lipoprotein (LDL)
      cholesterol by 25 and 29%, in apolipoprotein B by 15 and 19% and in triglycerides
      by 8 and 5%, respectively. High-density lipoprotein cholesterol levels were
      increased by 9% in both groups. All of these changes were significant (P < 0.001)
      except for triglycerides changes in non-diabetic patients, where the change was
      not significant and no significant differences were observed between the two
      groups. These favorable effects on LDL cholesterol and apolipoprotein B were not
      influenced by gender, the type of diabetic therapy, baseline hemoglobin A1c
      levels and by the presence of hypertension or gross proteinuria, although a
      decrease in the two variables were less in those with body mass index > or = 26.4
      kg/m2 or in those with age < 60 years. Adverse experiences were similar between
      treatment groups and the drug was well tolerated. Only one diabetic patient was
      withdrawn from the study because of pruritus. Pravastatin produced no change in
      fasting plasma glucose concentrations and hemoglobin A1c levels in diabetic
      patients throughout the study. Pravastatin was generally effective in improving
      the serum lipids of hypercholesterolemic diabetic patients.

PMID- 7781496
TI  - Prevalence of hypertension and albuminuria in a teaching hospital diabetes
      clinic.
AB  - The prevalence of hypertension and its relationship to nephropathy were measured
      in a hospital-based diabetic clinic. Six hundred patients (300 insulin treated,
      300 non-insulin treated) were randomly selected from a clinic population of 1054
      insulin treated and 1039 non-insulin treated subjects. Eighty-three percent of
      patients with insulin treated diabetes and 72% of patients with non-insulin
      treated diabetes were studied. Blood pressure data from the Belfast MONICA
      project were used for the control group. In patients with insulin treated
      diabetes (age 25-64 years) the prevalence of a systolic blood pressure > 160 mmHg
      or a diastolic blood pressure > 95 mmHg or on treatment for hypertension (WHO
      criteria) was 19.1% in males (NS, vs. control group) and 17.8% in females (NS);
      the prevalence of a systolic blood pressure > 140 mmHg and diastolic blood
      pressure > 90 mmHg was 17.6% in males (NS, vs. control group) and 9.5% in females
      (NS). In patients with non-insulin treated diabetes (age 35-65 years) the
      prevalence of hypertension by WHO criteria (see above) was 26.8% in males (NS,
      vs. control group) and 28.9% in females (NS); the prevalence of a systolic blood
      pressure > 140 mmHg and diastolic blood pressure > 90 mmHg was 21.4% in males
      (NS, vs. control group) and 17.8% in females (NS).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7781497
TI  - Mortality from coronary heart disease and cerebrovascular disease and associated
      risk factors in diabetic patients in Osaka District, Japan.
AB  - Mortality from coronary heart disease (CHD) and cerebrovascular disease (CVD), as
      well as associated risk factors, were examined. The subjects studied were 1939
      non-insulin-dependent diabetic (NIDDM) patients and 503 deaths were observed
      during a mean follow-up period of 9.4 years. Of these deaths, 62 were CHD deaths
      and 84 were CVD deaths. The mortality rates per 1000 person-years from CHD were
      3.95 for males and 2.57 for females and those from CVD were 5.12 and 3.86 for
      males and females, respectively, showing a higher mortality for males and an
      increasing trend with age. The baseline factors associated with CHD mortality
      were age at entry into the study, hypertension, ischemic ECG changes, serum
      cholesterol level, diabetic retinopathy and albuminuria, while those associated
      with CVD were age at entry, hypertension, ischemic ECG changes, diabetic
      retinopathy, albuminuria and therapeutic regimen, all of which were found to be
      significant by univariate analysis. The relationships were further analyzed by
      the multiple logistic method. In addition, the baseline characteristics of the
      patients who died of CHD and CVD were compared with those of patients who died
      from other causes. The baseline characteristics in cases of deaths from CHD and
      CVD were significantly different from those of deaths from other causes in terms
      of obesity, ischemic ECG changes, serum cholesterol level and serum triglycerides
      level for deaths from CHD and in terms of age at onset, age at death and
      hypertension for deaths from CVD.

PMID- 7781498
TI  - [Stress reduction through listening to music: effects on stress hormones,
      hemodynamics and mental state in patients with arterial hypertension and in
      healthy persons].
AB  - Stress hormones, tissue-plasminogen activator (t-PA) antigen, left-ventricular
      diastolic function and mood immediately before and after listening to three
      different kinds of music (a waltz by J. Strauss, a piece of modern classic by H.
      W. Henze, and meditative music by R. Shankar) were measured in 20 healthy persons
      (10 women, 10 men; mean age 25 [20-33] years) and 20 hypertensives (8 women, 12
      men; mean age 57.5 [25-72] years). To recognise haemodynamic effects, mitral flow
      by Doppler ultrasound was used as a measure of left-ventricular diastolic
      function. Atrial filling pressure (AFF) was calculated from the flow integral
      (VTI) of the early E and the late A waves. The Zerssen scale was used to estimate
      the immediate mood of the subjects. In hypertensives the levels of cortisol (74
      vs 78 ng/ml; P < 0.05) and t-PA antigen (4.3 vs 4.5 ng/ml; P < 0.05) were lower
      after than before the Strauss waltz. The muscle by Henze lowered the
      concentrations of cortisol (70 vs 84 ng/ml; P < 0.05), noradrenaline (203 vs 224
      ng/l; P < 0.05) and t-PA antigen (4.1 vs 4.6 ng/ml; P < 0.05). After listening to
      the piece by Shankar the concentrations of cortisol (71 vs 78 ng/ml; P < 0.05),
      adrenaline 14.5 vs 24.5 ng/ml; P < 0.05) and t-PA antigen (4.2 vs 4.3 ng/ml; P <
      0.05) were lower. In healthy subjects AFF (29 vs 26%; P < 0.05) rose after the
      Strauss music, VTI-E fell (69 vs 73 mm; P < 0.05, while natriuretic peptide rose
      (63 vs 60 pg/ml; P < 0.05.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781499
TI  - [Tubulointerstitial nephritis-uveitis syndrome (TINU syndrome)].
AB  - For 10 weeks a 25-year-old man had been suffering from tiredness, fatigue, nausea
      and a 16 kg weight loss. Erythrocyte sedimentation rate (83/133 mm), serum C
      reactive protein (5.5 mg/dl) and creatinine (5.05 mg/dl) were all elevated. He
      also had proteinuria (1120 mg daily), sterile leukocytosis and a creatinine
      clearance of 10 ml/min. Renal biopsy showed interstitial nephritis and bone
      marrow biopsy revealed non-caseous epithelioid-cell granulomas. 14 days after
      admission he developed acute iritis in the right eye. Other causes having been
      excluded, the diagnosis of tubulo-intestinal nephritis with uveitis (TINU
      syndrome) was made. The clinical symptoms and laboratory findings improved within
      a few days of the start of glucocorticoid treatment (initially, 100 mg prednisone
      daily, reduced to 5 mg within 30 days). The patient was discharged after 8 days
      in good general condition.

PMID- 7781500
TI  - [Differential diagnosis of commonplace upper abdominal symptoms: hepatic
      echinococcosis].
AB  - A 17-year-old girl from Turkey had for 6 years been suffering from right-sided
      upper abdominal symptoms not usually related to food intake. Treatment of
      suspected gastritis remained ineffective. Laboratory tests were unremarkable,
      except for an accelerated erythrocyte sedimentation rate (12/30 mm), eosinophilia
      (6.4%) and albumin concentration of 52.6 g/l. Upper abdominal sonography revealed
      a cyst, about 10 cm in diameter, in the right liver lobe. Computed tomography
      showed the 8 x 8.5 cm cyst which was septated at its caudal portion and
      compressed the vena cava for 5.6 cm. The antibody titre against echinococcus
      antigen was 1:3200. At laparotomy the echinococcal cyst was found to have
      extended to the left adrenal gland, renal fat capsule and left part of the
      diaphragm. There was a pressure necrosis on the right lateral aspect of the vena
      cava. The affected parts were resected and the patient quickly recovered.
      Postoperative treatment consisted of the administration of mebendazole (1.5 g
      daily) for 18 months. The patient had come from an area where echinococcal
      infection is endemic. The disease could have been quickly and easily diagnosed
      and cured if sonography had been undertaken early, sparing the patient major
      surgery.

PMID- 7781501
TI  - [Substitution therapy with estrogens and gestagens].

PMID- 7781503
TI  - [Postsplenectomy sepsis (overwhelming postsplenectomy infection (OPSI)
      syndrome)].

PMID- 7781502
TI  - [Mesalazine].

PMID- 7781504
TI  - [Primary immunization and booster vaccination against polio].

PMID- 7781505
TI  - [Adjuvant therapy in colorectal carcinoma].

PMID- 7781506
TI  - [Adjuvant therapy in colorectal carcinoma].

PMID- 7781507
TI  - [Adjuvant therapy in colorectal carcinoma].

PMID- 7781508
TI  - [Pyrimethamine-sulfadiazine resistant cerebral toxoplasmosis in AIDS].

PMID- 7781509
TI  - [Nasal continuous positive airway pressure (nCPAP) therapy in obstructive sleep
      breathing disorders].
AB  - The therapeutic efficacy and the incidence of significant side effects of nasal
      continuous positive airway pressure (nCPAP) treatment was investigated in 1140
      patients with sleep-related apnoea (1089 men, 51 women; mean age 53.2 +/- 9.2 [16
      84] years). All had been treated for the condition with nCPAP at the Marburg
      University Medical Polyclinic between 1986 and 1992. The mean number of attacks
      of apnoea and/or hypopnoea per hour of sleep ("respiratory disturbance index",
      RDI) was 45.8 +/- 25.6 before treatment and 3.5 +/- 4.8 under nCPAP. 21.1% of
      patients had an apnoea index of no more than 10/h. 11.6% an RDI of no more than
      15/h. The average airway pressure was 8.7 (3-18) cm H2O. The treatment was
      successful in 1023 patients and these decided to continue the treatment long
      term. The RDI could not be lowered under 10/h in 63 patients, while 4 patients
      declined ambulant treatment despite the demonstrated efficacy of nCPAP. Three
      patients developed acute left ventricular failure in the initial phase of the
      treatment, while in another 16 patients long-persisting central hypoventilation
      was shown to occur. These data show that treatment with nCPAP can be employed for
      all degrees of severity of obstructive sleep apnoea. However, because of the
      potentially life-threatening side effects, the introduction of the treatment must
      be undertaken in the sleep laboratory under continuous monitoring.

PMID- 7781510
TI  - [The von Hippel-Lindau syndrome. Its differential diagnosis from cystic kidneys
      in adulthood].
AB  - A 51-year-old patient with severe back pain had undergone resection of a benign
      cerebellar tumour when aged 15 years. In addition, polycystic kidney disease was
      diagnosed 24 years ago, bilateral phaeochromocytoma 2 years ago, and for 4 months
      before the present admission he had been on haemodialysis. The family history
      indicated autosomal dominant inheritance of the polycystic renal disease. His
      general condition was found to have deteriorated, he had pain on pressure over
      the upper thoracic and lower lumbar vertebrae, and the kidneys were enlarged on
      palpation. There were increased concentrations of calcium (3.01 mmol/l),
      parathormone (2.0 ng/l), carcinoembryonic antigen (13.5 micrograms/l) and TPA (69
      U/l). Computed tomography demonstrated cystic and solid parts of much enlarged
      kidneys. Biopsy revealed a poorly differentiated clear-cell renal carcinoma.
      Further information concerning the previously removed brain tumour showed this to
      have been an haemangioblastoma of the cerebellar tonsils indicating the diagnosis
      of v. Hippel-Lindau disease. Nine other family members had been affected, but
      none had the full-blown picture of the disease. The patient died 3 weeks later
      from the rapidly advancing tumour. Autopsy showed the bilateral renal carcinoma,
      bilateral phaeochromocytoma and metastases to the sternum, femurs, vertebrae and
      liver.

PMID- 7781511
TI  - [Thrombosis of a prosthetic mitral valve in the anticardiolipin syndrome].
AB  - A 40-year-old woman in whom the mitral valve had to be replaced with a prosthetic
      one (St. Jude's) had to be reoperated 8 months later because of endocarditis on
      the second prosthetic valve (Carbo-Medics). Four months later her general
      condition deteriorated progressively with cough and dyspnoea, requiring
      hospitalization. Auscultation revealed moist rales over both lung bases; heart
      sounds were distant but otherwise normal. The "international normalized ratio"
      was 2.5, while erythrocyte sedimentation rate, white cell count and C-reactive
      protein were normal. Transthoracic echocardiography demonstrated a hardly moving
      mitral valve prosthesis with an opening area of 0.8 cm. Subsequently this
      decreased further and measurement of the anticardiolipin antibody titre revealed
      an IgG fraction of 37.9 U/ml (normal up to 12 U/ml). Within 48 hours thrombolysis
      with streptokinase had increased the valve's opening area to 1.8 cm. The patient
      made an uneventful recovery under strict anticoagulation. This case illustrates
      that the anticardiolipin syndrome can be a cause of an otherwise unclear genesis.

PMID- 7781512
TI  - [Dermatoscopy. A new method for the clinical diagnosis of malignant melanoma].

PMID- 7781513
TI  - [Nephropathy due to contrast media. Its pathogenesis and prevention].

PMID- 7781514
TI  - [A plea for clinical pancreas transplantation].

PMID- 7781515
TI  - [Bladder emptying disorder].

PMID- 7781517
TI  - [Xanthogranulomatous pyelonephritis with phlegmonous abdominal wall
      infiltration].

PMID- 7781516
TI  - [The therapy of Sjogren's syndrome].

PMID- 7781518
TI  - [Unilateral femur amputation and infrarenal abdominal aortic aneurysm--the facts
      from the viewpoint of the biometrician].

PMID- 7781519
TI  - [Pulmonary mucormycosis in an HIV-infected patient].

PMID- 7781520
TI  - [Homeopathic drugs in airway infections in childhood].

PMID- 7781521
TI  - [Vascular endothelial growth factor in the ocular fluid in diabetic retinopathy
      and other retinal diseases].

PMID- 7781523
TI  - [Restriction enzyme mismatch polymerase chain reaction in the demonstration of Ki
      ras-oncogene mutation in carcinoma of the pancreas].
AB  - A pilot study was undertaken to test whether combining the polymerase chain
      reaction with restriction fragment length polymorphism is suitable for the
      routine diagnosis of carcinoma of the pancreas. The method makes it possible to
      recognize point mutations in codon 12 of the Ki-ras oncogene. 60 cytological
      specimens from the pancreatobiliary tract, the bronchopulmonary system (by
      bronchoalveolar lavage or from pleural effusion) and ascites were tested. Results
      from nine pancreas carcinoma cell lines served as control. A PCR product was
      successfully amplified in all cell lines and 47 of the clinical specimens. In all
      eight samples in which a mutated Ki-ras oncogene was demonstrated, there was at
      least a suspicion of malignancy by cytological examination. A mutation was also
      found in four of five pancreas carcinomas. But no mutation was found in one,
      clinically certain, case of pancreas carcinoma. The described method is an
      elegant and, most of all, rapid means to complement and optimize any cytological
      diagnosis.

PMID- 7781522
TI  - [Ki-ras mutation as a molecular tumor marker for carcinoma of the pancreas].
AB  - More than 90% of tumours of the pancreas have mutations on codon 12 of the Ki-ras
      oncogene. Cellular DNA from pancreatic secretions and fine-needle biopsies,
      obtained from 69 patients (41 men, 28 women), were amplified by the polymerase
      chain reaction (PCR) to demonstrate this characteristic marker. All these
      patients had undergone endoscopic retrograde pancreatography for suspected
      pancreatitis or carcinoma of the pancreas. Two different methods were developed
      to demonstrate the mutations. With the aid of one of these methods, enrichment
      PCR with analysis of the restriction fragment length (FL), mutations on codon 12
      of the Ki-ras gene were demonstrated in unstimulated pancreatic secretions of 29
      of 33 patients with pancreatic carcinoma. All eleven fine-needle biopsies that
      had been cytologically examined showed the tumour-specific mutation. After direct
      sequencing of enrichment PCR a codon 12 mutation was demonstrated in pancreatic
      secretion from 21 of 24 patients and with the single strand conformation
      polymorphism analysis in 17 of 33 patients. In two of these 33 patients two
      different Ki-ras mutations were discovered. No mutations were found in acute
      inflammations or stone disease, while in five patients with chronic pancreatitis
      mutations were demonstrated only in those two patients in whom histological
      examination had revealed precancerous mucinous hyperplasia. This investigation
      indicates that codon 12 mutations of the Ki-ras gene, found after PCR in
      pancreatic secretion and biopsies, constitute a sensitive and specific tumour
      marker whose clinical value is being assessed.

PMID- 7781524
TI  - [Ki-ras mutation--a specific and sensitive tumor marker for carcinoma of the
      pancreas?].

PMID- 7781525
TI  - [Intra-aortic balloon counterpulsation as percutaneous therapy option in
      cardiogenic shock].
AB  - Six months after sustaining a posterior wall myocardial infarction a 40-year-old
      man had a further infarction in the anterior wall region. After thrombolysis
      treatment with recombinant tissue plasminogen activator the patient was at first
      symptom-free and haemodynamically stable, but 48 hours later another anterior
      wall re-infarction occurred with cardiogenic shock. Despite infusions of
      catecholamines at highest dosage and successful coronary angioplasty the
      circulation became critically unstable and percutaneously introduced intraaortic
      balloon counterpulsation (IABCP) was commenced. As the haemodynamics improved
      catecholamine dosage was markedly reduced and then discontinued over the
      subsequent 24-48 hours and inspiratory oxygen concentration of the ventilated
      patient was decreased from 100% to 40%. After a total of 5 days the IABCP
      catheter was removed without complication. The cardiac pump action showed further
      improvement in the following days. 6 months later the patient's condition was
      stable in grade II-III (New York Heart Association classification) heart failure.
      This case illustrates the place of IABPC as a highly effective treatment option
      in myocardial infarction with cardiogenic shock, especially when combined with
      interventional revascularisation procedures.

PMID- 7781527
TI  - [Methods in medicine: computerized tomography].

PMID- 7781526
TI  - [Urinary calculi analysis. Methods and relative value in the age of minimally
      invasive stone removal].

PMID- 7781529
TI  - [Therapy of arterial hypertension and coronary heart disease in coexisting aortic
      valve stenosis].

PMID- 7781528
TI  - [Intravascular ultrasonography in coronary heart disease. Current aspects in the
      pathogenesis].

PMID- 7781530
TI  - [Antibiotic prophylaxis in indwelling catheter of the bladder?].

PMID- 7781532
TI  - [Diagnosis of immune deficiency].

PMID- 7781531
TI  - [Fibrinogen levels in ultra-high dosage streptokinase lysis].

PMID- 7781533
TI  - [Continuous examination of sows with cystic, degenerating ovaries using
      sonography and serum hormone determination].
AB  - Ten sows with cystic ovaries have been examined periodically by transrectal
      sonography (2 days intervals) and analysis of serum-progesterone and estradiol (7
      days intervals). Estrus occurred in nine of the sows after a time up to 82 days.
      Estrus reappeared after an almost physiological interval of 22 to 24 days. The
      cysts on the ovaries regressed completely (4 sows) or diminished in size (5 sows)
      before estrus. The regression was preceded by increasing echoes from trabeculae
      like structures in the cysts and increase of serum progesterone concentration. In
      six sows cysts were again detectable after estrus. These increased in size and
      regressed again in the same manner as before. All nine sows were served by a boar
      during second estrus and seven became pregnant according to sonographic findings
      after 27 days. These results show that sows with cysts on there ovaries may
      maintain an ovarian cycle and even conceive. The regression of ovarian cysts is
      probably preceded by the formation of luteal tissue. Our results don't allow
      general conclusions concerning the role of ovarian cysts in sows as a cause of
      infertility due to the small number and the unknown anamnesis of our patients.
      However in only one of the ten sows, the cysts persistent beyond the observation
      time of 100 days.

PMID- 7781534
TI  - [The therapy of urinary tract infections in sows].
AB  - Fifteen sows spontaneously infected with Eubacterium suis were treated with
      enrofloxacin and, if necessary, with ampicillin. Before and after treatment
      different blood and urine parameters were determined with regard to renal
      function and the condition of the urinary bladder was examined by cystoscopy.
      Besides results of a controlled treatment in a breeding herd with a high
      frequency of urinary tract infections are referred. Duration of treatment with
      appropriate dosage should be at least 10 days. Even when a haemorrhagic
      inflammation was present therapy of infections with Eubacterium suis showed no
      problems, if the alterations were restricted to the bladder. In sows with renal
      insufficiency in case of ascending infection treatment is also possible on
      principle, but intensive infusion therapy is necessary in addition to antibiosis.
      Reliable estimation of the renal function can be obtained by measurement of
      creatinine and urea blood levels. Enrofloxacin treatment of urinary tract
      infections was successful in a breeding herd. An insufficient water supply and a
      high incidence of crystalluria were important predisposing factors.

PMID- 7781535
TI  - [Causes of pre- and perinatal piglet loss].
AB  - The main part of the extensive embryonic losses in swine is usually attributed to
      endogenous regulatory processes. Beyond that a lot of endogenous and exogenous
      noxae can induce embryonic and fetal death. 60-80% of the preweaning mortality
      occur during the perinatal period, i.e. the time direct before farrowing until
      the third day of life. Aetiology, which generally is due to noninfectious causes,
      and clinical symptoms of perinatal mortality are described.

PMID- 7781536
TI  - [Effects of different anemia prevention forms on the blood parameters of the
      suckling piglet].
AB  - The results of this trials confirmed the earlier experience that suckling piglets
      kept indoors, without iron supplementation, develop iron deficiency after 14 days
      postpartum. Piglets kept outdoors did not develop iron deficiency because of the
      daily iron supplementation from the ground. Principally, a single dose of iron
      either parenteral (injection) or oral (iron paste) would supply the iron
      requirements of the suckling piglets. However, iron injection provided even
      results than that of the oral supply where some piglets treated orally, developed
      anemia because oral treatment runs a greater risk of misapplication. Best results
      were obtained by use of an iron form which can be scattered on the ground during
      the whole period of suckling. The piglets would receive their iron requirement
      freely during this period. Another form of iron-electrolyte solution can be
      supplied through the drinking automate. However, the results were unfavorable and
      the piglets developed symptoms of anemia. This could be attributed to the fact
      that the piglets do not require extra fluids during the suckling period, when
      they receive enough dam milk.

PMID- 7781537
TI  - [The application of sonography for swine].
AB  - The application of sonography at pigs has hitherto been confined to gynecological
      questions. In this examination applicabilities of the ultrasonic method are
      examined from the internal point of view. The sonographical normal picture of
      organ structures and the value of this method as aid for diagnosis of clinically
      manifest changes are shown. A 5MHz linear-scanner and a 3.5 MHz convex-scanner
      (76 degrees) turned out to be suitable. 112 patients of the Clinic of Internal
      Medicine II and additional 35 healthy pigs were examined. Preliminary
      examinations were made with isolated organs, which were scanned in a water bath.
      The sonographical findings of pathological changes could be secured by the
      postmortem findings. Within the scope of the main examinations, manners of
      representation and sonographical appearance of liver, gall-bladder, kidneys,
      urinary-bladder, stomach, lungs, muscular system, spine and transponder were
      elaborated. The standardized measuring of liver and kidney proved statistically
      secured dependencies among the measuring data and were significantly related with
      the body-weight. The ultrasonic guided puncture of gall-urinary bladder and of
      liquor cerebrospinalis could be carried out successfully.

PMID- 7781538
TI  - [The immune response in edema disease of weaned piglets measured with a
      recombinant B subunit of shiga-like toxin II].
AB  - An outbreak of edema disease (ED) was monitored in 80 piglets after weaning over
      a period of 4 weeks. The shedding of Shiga-like toxin-IIe) producing Escherichia
      coli strains, the serum bactericidal activity (SBA) against SLTEC-IIe, and the
      antibody response against SLT-IIe were investigated. The antibody response was
      monitored by utilizing a glutathione-S-transferase (GST) + SLT-IIe B/SUB fusion
      protein (FRANKE et al., in press) for immunoblot assays. E. coli-strain GO15III
      (0141:K85ac) was diagnosed as SLT-IIe-producing E. coli by polymerase chain
      reaction, DNA hybridization and cytotoxicity assays. Maximum excretion of GO15III
      appeared between days 8 and 15 after weaning. On day 1 after weaning no piglet
      shed GO15III, while the number increased on day 8 to 53 (66.2%) and on day 15 to
      59 (73.8%) of the piglets. 4 week after weaning, GO15III was only isolated from
      23 (28.8%) of the piglets. In parallel, serum bactericidal activity against
      GO15III increased significantly in the sera of 73 (91.2%) piglets, reaching a
      stable maximum from day 15 on. During the first two weeks after weaning, no
      piglet yielded detectable SLT-IIe-IgG. However, the number of SLT-IIe-IgG
      positive piglets increased steadily from day 15. On day 15, 5 (6.2%) piglets were
      positive in SLT-IIe immunoblot analysis and 29 days after weaning the number
      increased to 31 (38.8%). These data represent the first serological monitoring of
      a natural outbreak of edema disease in piglets after weaning by using a
      recombinant fusion protein (GST+SLT-IIe B/SUB). The recombinant protein proved to
      be a useful diagnostical tool for monitoring the specific antibody status of
      piglets.

PMID- 7781539
TI  - [Treatment of swine with chronic pneumonia with chlortetracycline-medicated
      feed].
AB  - 26 fattening pigs with spontaneous severe chronic bronchopneumonitis were orally
      treated with feed containing 800 ppm chlortetracycline (CTC) over 3 weeks. With
      the help of clinical investigation, transcutaneous measurement of the oxygen
      saturation of the blood, X-ray of the thorax and bronchoalveolar lavage
      significant effects could be measured during and after finishing the treatment.
      In 19 spontaneous fallen ill untreated control animals recovery could not be
      detected by the used methods. After the end of the 3 weeks interval there were
      significant differences between treated and untreated animals detectable. By this
      investigations practical observations that oral treatment with 800 ppm in
      fattening pigs is effective was verified. But because of pharmacokinetic data
      higher concentrations would be recommendable. In the treated pigs a significant
      increase of the oxygen saturation of the blood occurred not before the 8th day of
      treatment. This underlines the importance of sufficient length of the treatment
      interval.

PMID- 7781540
TI  - [The metabolism of trichothecenes in swine].
AB  - Trichothecenes like T-2 toxin, diacetoxyscirpenol, and deoxynivalenol, which
      occur in feed, are metabolized preponderant in a biphasic way. Oxidation and
      hydrolysis are carried out in phase 1, while the transformation products are
      conjugated with glucuronic acid in phase 2; in addition, the epoxide ring is
      cleaved by the gut microflora. Metabolites of T-2 toxin are HT-2 toxin, 3'
      hydroxy-T-2 toxin, 3'-hydroxy-HT-2 toxin, neosolaniol, 4-deacetylneosolaniol, T-2
      triol, T-2 tetraol, and de-epoxide T-2 tetraol. Diacetoxyscirpenol is transformed
      to 15-monoacetoxyscirpenol, scirpenetriol, de-epoxide 15-moneacetoxyscirpenol,
      and de-epoxide scirpenetriol. Deoxynivalenol undergoes no extensive metabolism;
      only the production of deoxynivalenol glucuronide and de-epoxide deoxynivalenol
      is assumed. As trichothecenes are rapid metabolized, the diagnosis of an
      intoxication by the analysis of samples of pig origin should be hardly possible;
      for the same reason, the possibility of an enrichment of trichothecene
      metabolites in edible tissues is graded as low.

PMID- 7781541
TI  - [The mineral content of calcium, phosphorus and magnesium in the serum and bones
      and the serum activity of alkaline phosphatase in slaughtered fattening pigs].
AB  - The mineral content of serum and bones in 311 fattening pigs kept in a large
      scale farming operation was analyzed. Serum and metacarpal (III and IV) bone
      samples were obtained during slaughtering. The mean values of serum parameters as
      determined by automated dry-chemistry (Kodak Ektachem) were: Ca 2.80 +/- 0.20
      mmol/l, P 3.08 +/- 0.67 mmol/l, Mg 1.21 +/- 0.24 mmol/l and Alkaline Phosphatase
      211.25 +/- 56.91 U/l. Ash in bones was on average 62.85 +/- 2.07%. Ca- und Mg
      contents of bones were analyzed by atomic absorption spectrophotometry, the
      percentage found for Ca was 31.87 +/- 2.68%, and for Mg 0.64 +/- 0.05%. P in
      bones was determined spectrophotometrically by the vanadate-molybdate method and
      was 17.48 +/- 0.97%. The Ca/P-ratio in serum was 0.94 +/- 0.16, in bones 1.83 +/-
      0.19, Ca/Mg in serum 2.37 +/- 0.31 and in bones 50.05 +/- 5.00. The parameters
      tested (Ca, P, Mg, AP) and the Ca/P- and Ca/Mg-ratios of minerals in serum and
      bones did not differ between sexes. Between all serum parameters positive
      correlations were found as well as between Ca and Mg in bones. Ca, P and Mg in
      bones were negatively correlated to Ca, P and Mg in serum, respectively. All
      results of the parameters examined were within the normal range for healthy
      fattening pigs, with the only exception that Ca-values in bones were lower than
      normal. A new method for preparing the bone samples for the analyses of minerals
      was established and can be recommended for further investigations.

PMID- 7781542
TI  - [Isolation of the agent of European swine plague from imported frozen wild boar
      meat].
AB  - Since July 1993 imported frozen meat of wild boars has to be screened for the
      presence of HCV. The number of taken samples is given by the Ministry of health,
      sport and consumer protection. Until August 1994 the total number of 688 samples
      from different countries, have been examined. Three of them were found positive
      for HCV. The first one (November 1993) was from China, the other two positive
      samples were sent in one delivery from Romania in May 1994.

PMID- 7781543
TI  - [Fulminating malignant hyperthermia in swine--an alternative therapy concept].
AB  - An inexpensive therapeutic concept compared to the dantrolene-therapy to counter
      the malignant hyperthermia (MH) is to be discussed, using a case-study from swine
      anaesthesia. Hyperventilating the animals (with O2), administering metamizol,
      beta-blocker, bicarbonate and sufficiently cooling the patient can, if the
      symptoms are recognized early enough, arrest the hypermetabolic cascade in its
      track. All the animals that were treated according to this scheme survived the
      (MH) crisis without any lasting post operative damage.

PMID- 7781544
TI  - [Clinical kidney function studies in sheep. III. Pathologic function changes in
      nephropathies of sheep and in urolithiasis of rams and billy goats].
AB  - Examination of renal function have been carried out in sheep with acute prerenal
      (n = 6), renal (n = 15) or postrenal failure (n = 3), pyelocystitis (n = 4), and
      in cases of urolithiasis in rams (n = 16) and billy goats (n = 11) respectively.
      The calculation of parameters was done on the basis of the estimated weight
      dependent endogenous creatinine excretion. A control group of 56 healthy non
      pregnant or early pregnant (< 120th day of pregnancy) ewes have been used. The
      renal creatinine clearance was reduced and the absolute as well as the fractional
      renal water excretion was enhanced in all groups of sick animals. An elevated
      fractional excretion of sodium and phosphate could be seen as well. Functional
      disturbances could be observed in urolithiasis in like manner as in acute renal
      failure. There was proteinuria, glucosuria, excessive potassium excretion and
      often decreased plasma concentration of potassium in both syndromes. A
      hyperkalemia occurred only in the final state of urolithiasis. No clinical
      outcome of chronic nephropathies could be seen. Mortality of the described acute
      nephropathies was about 76%. The results of examination were suitable to control
      the course and restitution of renal function. They were not helpful for
      differential diagnosis and prognosis of acute renal failure.

PMID- 7781545
TI  - [Clinical findings in a lamb with congenital multiple abnormalities].
AB  - A case of multiple, congenital malformations, with special emphasis on cardiac
      malformations (atrial- and ventricle septum defect, Ductus Botalli persistens,
      bilateral ventricle and atrial dilatation) in a lamb are described. Clinical
      findings, X-ray, ultrasound examination, electrocardio- and phonocardiogram, as
      well as pathology are discussed.

PMID- 7781546
TI  - Genital prolapse as a problem in rural community.

PMID- 7781547
TI  - Some haematological parameters in Malawian neonates.
AB  - Studies of haematological parameters were performed on 366 (177 male and 189
      female) normal Malawian neonates with mean +/- s.d. birthweight of 2.99 +/- 0.37
      (range 2.1-4.0) kg using a Nova Cell Track, Model Nova CT11. Cord anaemia (Cord
      Hb < 13.5g dl-1) was detected in 100 (27.3%) of the neonates. It was also shown
      that although the male babies had a significantly higher erythrocyte
      protoporphyrin level (p < 0.001) than the females, there were no significant
      differences (p > 0.05) in the red cell, white cell and platelet indices between
      the two sexes. When the haematological parameters of the 266 (72.7%) non-anaemic
      (Cord Hb > 13.5g dl-1) neonates were analysed, the mean +/- s.d. values which may
      serve as local reference standards were: Hb 16.0 +/- 1.7 (range 13.5-21.3) g dl
      1, Hct 47.0 +/- 6.0 (range 36.5-67.5) percent, MCV 112.6 +/- 8.9 (range 72.2
      131.0) fl, MCH 31.9 +/- 5.5 (range 24.4-48.5) pg, MCHC 33.5 +/- 2.8 (range 29.1
      48.9) g dl-1 reticulocyte count 6.9 +/- 3.6 (range 1.2-25.0) percent, free
      erythrocyte protoporphyrin 3.3 +/- 0.9 (range 1.9-7.7) mgs ZPP gm-1 Hb, platelet
      count 269.9 +/- 57.7 (range 134.0-454.0) x 10(9) l-1 and total leucocyte count
      12.3 +/- 4.8 (range 5.5-35.3) x 10(9) l-1. Further analysis of the differential
      wbc count disclosed normal levels of eosinophils and neutrophils similar to those
      given in standard haematology textbooks for Caucasian neonates; thus
      strengthening the belief that eosinophilia and relative neutropenia previously
      reported in adult Africans is not of genetic origin, but rather an acquired
      phenomena.

PMID- 7781548
TI  - Rapid surveys in support of district health information systems: an experience
      from Uganda.
AB  - The role of rapid health assessment in generating data other than routine
      reporting for a multi-element primary health care information system is
      presented. Rapid surveys, based on the adaptation of the WHO/EPI cluster survey
      methodology, may generate reliable and valid results useful for the support of a
      managerial PHC information system. However, because of the limitations inherent
      to the method, so far, only few studies have investigated more than few PHC
      related issues. The experience of a household rapid survey conducted in Arua
      District, Uganda, using a modified EPI cluster survey methodology, is reported.
      Rapid appraisal methods were used to prioritize the information requirement and
      to identify the survey items. Fully supervised teams of primary school teachers
      were used as interviewers. Data processing, check and analysis were speeded up by
      a lap-top computer, in spite of problems of erratic power. Within a 10-day time
      span between the start of the survey and the publishing of results, data on
      health services' utilization, health seeking behaviour, coverage of PHC services,
      including immunization, and anthropometric data on the nutritional status of
      under-five children were obtained. Standard errors and 95% confidence intervals
      were calculated taking into account the variability of the parameters under
      investigation and true design effects were computed. The findings were utilized
      for the identification of health priorities and the monitoring of effectiveness
      of programmes, as well as to validate routine reporting. The methodological
      package was built up looking at the local context, so that it could become an
      operational tool for the district health management team.

PMID- 7781549
TI  - The haematological profile of urban black Africans aged 15-64 years in the Cape
      Peninsula.
AB  - A stratified probability sample (n = 986) with quotas was drawn from black
      residential areas in the Cape Peninsula, South Africa. Subjects (n = 819) aged 15
      64 years, participated in a coronary heart disease (CHD) risk factor survey, the
      BRISK Study. Nutritional status and prevalence of CHD was determined in this
      population undergoing rapid urbanization. Full blood and differential white blood
      cell counts provided data to calculate population reference values based on the
      95% reference limits of the haematological parameter. Mean haemoglobin
      concentrations (Hb) in men (14.0 g/dl) and women (12.4 g/dl) were +/- 1.5 g/dl
      lower than previous South African reports. Mean BRISK Hb values were very similar
      to the World Health Organization's Hb cutoff criteria (< 13 g/dl men; < 12 g/dl
      women), indicating a possible high prevalence of anaemia. Significantly higher (P
      < 0.05) mean values for red cell indices were confirmed in men, which also
      reflected equally higher red blood cell counts (RBC), haematocrit (HCT) and mean
      corpuscular haemoglobin (MCH) values. Mean Hb values were significantly lower in
      the younger (15-24 years) and older (55-64 years) men compared with 25-54 year
      olds (P < 0.05). Hypochromic microcytic anaemia was more prevalent in women,
      possibly due to iron deficiency (ID), while macrocytic anaemia was more prevalent
      in men. No significant differences were noted in mean total and differential
      white blood cell counts (WBC) between men and women.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7781551
TI  - Spectrum of childhood cancers in Malawi 1985-1993.
AB  - An analysis of seven hundred and ninety one children aged 0.2 to 14 years with
      confirmed malignant disease recorded by the Malawi National Cancer Registry over
      a period of 9 years is presented. Childhood cancer constituted 6.9% of all
      malignancies recorded during the study period. The top ten neoplasms in
      descending order of frequency were: non-Hodgkin's lymphoma 434 (54.9%),
      retinoblastoma 89 (11.3%), nephroblastoma 50 (6.3%), epithelial carcinoma 45
      (5.7%), Hodgkin's disease 38 (4.8%), soft tissue sarcoma (excluding Kaposi):
      34(4.3%), Kaposi's sarcoma 32 (4.0%), malignant tumours (not specified): 20
      (2.5%), acute leukaemias 18(2.3%) and osteogenic sarcoma 16 (2.0%). Some
      differences noted in the pattern of neoplasms in this study from those of
      developed and developing African countries are discussed. The findings highlight
      the most common childhood malignancies in Malawi where intense research should be
      directed so that meaningful and cost effective therapeutic intervention
      programmes can be planned and developed.

PMID- 7781550
TI  - Utero-vaginal prolapse: a rural disability of the young.
AB  - A study consisting of 156 and 195 patients admitted to Gondar College and Gandhi
      Memorial hospitals respectively, for surgical corrections of vaginouterine
      prolapses of second and third degrees was carried out from June 1989 to June
      1993. At Gondar, uterovaginal prolapses accounted for 19.9% of all major
      gynaecological operations in comparison to 17.2% at Gandhi. The mean ages for
      Gondar and Gandhi subjects were 38.09 +/- 11.52 and 42.17 +/- 13.16 years,
      respectively. In both centres there is statistically significant (p < 0.05)
      sequestration of especially third degree prolapse with increase in age. Mean
      parity of 5.6 +/- 2.7 children and 5.4 +/- 2.6 children have been obtained for
      Gondar and Gandhi groups, respectively. There is statistically significant
      increase (p < 0.05) of the second and more so of the third degree genito- urinary
      prolapse with increase in parity. Of the 125 housewives from the Gondar group,
      114 (92.2%) were from the rural areas. The results of Gandhi group revealed that
      143 (90.5%) out of 158 subjects were rural housewives. There is significant
      association of prolapse and occupation particularly with the rural housewives of
      both centres. The symptoms and signs of both centres were variable and dependent
      on degrees of prolapse; and the mean durations were 2.8 years +/- 2.9 years for
      Gondar and 2.4 years +/- 2.4 years for Gandhi, respectively. As a vaginal
      problem, vaginal surgical approaches yielded better results despite shortcomings
      of short term follow up. This paper based on two hospital records with similar
      results illustrates that it is mainly a rural problem and relatively of a younger
      population.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781553
TI  - Antistreptolysin O and antideoxyribonuclease B titres in blood donors and in
      patients with features of nonsuppurative sequelae of group A streptococcus
      infection in Tanzania.
AB  - Antistreptolysin O (ASO) and antideoxyribonuclease B (ADN B) titres were
      determined on sera from blood donors in Dar es Salaam, Tanzania and from Bergen,
      Norway and were compared with titres in patients with features of postgroup A
      streptococcal diseases in Dar es Salaam. The upper limit of normal ASO titres in
      Dar es Salaam was 200 mu/ml and for ADN B it was 300 u/ml while in Bergen the
      upper limit of normal ASO titre was 250 u/ml and that of ADN B was 100 u/ml.
      Titres of ASO in Dar es Salaam and Bergen were consistent with those from sub
      Saharan Africa and from other continents. Upper limit of normal ADN B titres in
      adults in Dar es Salaam were higher than those in Bergen probably due to higher
      frequencies of group A streptococcal skin infections in Dar es Salaam than in
      Bergen. Patients with features of postgroup A streptococcal diseases in Dar es
      Salaam had antibody titres above the upper limits of normal in 32.8% of the
      patients for ASO and in 45.9% for ADN B. ASO and ADN B titres or ASO and any
      other reliable test for antibody to group A streptococcus should be utilised
      together in providing strong evidence of recent infection with the group A
      streptococcus or of postgroup A streptococcal disease.

PMID- 7781552
TI  - Serologic markers for hepatitis B virus and hepatitis A virus in Bushmen in West
      Caprivi, Namibia.
AB  - A community based sero-epidemiological study was undertaken to determine the age
      specific prevalence rates of hepatitis A virus (HAV) and hepatitis B virus (HBV)
      infection in a band of Bushmen in the West Caprivi, Namibia. All children tested
      and all but two of the adults tested showed the presence of anti-HAV antibodies.
      Nineteen individuals (18%) were positive for HBsAg and 65 (61%) individuals had
      serologic evidence of past exposure to HBV infection.

PMID- 7781554
TI  - Coronary heart disease in black Africans: an overview.
AB  - Coronary heart disease is still rare representing only 6% of all cardiovascular
      diseases in black Africans despite its increased incidence in recent years.
      Myocardial infarction in black Africans shows similar characteristics as those
      seen in patients aged under 40 years in the west, particularly regarding the
      frequency of infarction as the first manifestation of the disease, low prevalence
      of coronary artery stenosis and relatively common finding of normal coronary
      arteriography. Risk factor profile is the same as in western countries, but the
      haemoglobin S or C trait could be a unique one. The long-term outcome of
      infarction is severe and influenced by myocardial sequelae of imprecise origin;
      delayed hospitalisation; absence of thrombolysis and angioplasty; and socio
      economic and literacy problems.

PMID- 7781555
TI  - Myelopathies in Ethiopia.
AB  - From December 1990 to December 1993, 130 patients who had a lesion localized to
      the spinal cord were admitted to the Tikur Anbessa Hospital, Department of
      Internal Medicine, Addis Ababa. These patients accounted for 18.0% of all
      neurological admission to this department. The male/male female ratio was 1:8:1;
      the mean age was 40 years for these patients; 52% were from Addis Ababa City and
      48% of them were coming from the rest of the country. Paraparesis or paraplegia
      (77%) and quadriparesis or quadriplegia (23%) were the commonest presenting
      complaints. Sensory level, sphincter dysfunction and bedsores were found in 70%,
      54% and 14% of the cases respectively. Tuberculous spondylitis was found to be
      the leading cause accounting for 35 (26.9%), and HIV-1 myelopathies was the
      second common type accounting for 22 (16.9%) of spinal cord disease. Metastatic
      cord compression, tropical spastic paraparesis, (progressive non compressive
      myelopathy), cervical spondylosis, primary cord tumours and transverse myelitis
      were also not uncommon. Death related to sepsis or other causes were documented
      in 14 (10.8%). Follow-up was arranged on discharge, and only 45 (38.8%) patients
      were able to attend at least once the neurology referral clinic. Myelopathy is an
      important neurological disease and currently HIV-1 associated myelopathy has
      become the second important presumed cause.

PMID- 7781556
TI  - Tuberculosis of the spine in children at Muhimbili Medical Centre, Dar es Salaam.
AB  - A retrospective study of 22 children with tuberculosis of the spine who were
      managed at Paediatric Surgical Unit (PSU) of Muhimbili Medical Centre (MMC), Dar
      es Salaam between 1988 and 1993 was done. There were 12 boys and 10 girls of ages
      ranging from 3-13 years. Majority of the patients presented with back pain and/or
      deformity and weakness in the legs associated with difficulty in walking. The
      diagnosis was based on radiological as well as haematological findings. Two
      patients had associated lung lesions and these gave AFB positive sputum. Majority
      (63.5%) were thoracolumbar T11-L2. All patients received chemotherapy and in
      addition two had simple drainage of paravertebral abscesses and two debridement
      and bone grafting. There was no formal immobilization except that they had to
      sleep on hard beds. All gave a history of BCG vaccination scars. Mantoux or Heaf
      test was done on 16/22, patients of whom 11/16 (68.8%) were positive. One patient
      ended up with paraplegia, one with marked paraparesis and in 17/22 the
      kyphosis/gibbus increased. Laxity in the tuberculosis control programmes and the
      widespread of HIV could play part in what seems to be a flare up of tuberculosis
      infection in the recent past.

PMID- 7781557
TI  - Bladder carcinoma in Ibadan Nigeria: a changing trend?
AB  - A review of cases of bladder carcinoma in Ibadan, Nigeria between 1979-1989
      suggest a changing trend with a rise in the frequency of transitional cell
      carcinoma (49.9%) relative to squamous cell carcinoma (SCC). Earlier reports from
      Ibadan indicated a preponderance of SCC. However, similar to other reports, SCC
      is more frequent amongst those aged 50 years and below (45.5%) compared to TCC
      (18%). This frequency has often been related to schistosomal infestation. Though
      the possibility of age-related factors are considered, the significance of
      changing environmental and socio-economic factors are highlighted. Whilst better
      public enlightenment and health education, may help in lowering the intensity of
      schistosomal infestation, increasing urbanization and industrialization may be
      increasing environmental factors that predispose to transitional (urothelial)
      cell carcinoma of the bladder.

PMID- 7781558
TI  - The effect on fibrinolytic system of blood plasma of Wister rats after feeding
      them with Coix mixed diet.
AB  - Experimental wister rats were fed on coix-mixed diet for 30 days in a view to
      study the effect of Coix feeding on the state of haemostatic mechanisms. Blood
      plasma which was obtained after cardiac puncture was analyzed for fibrinogen
      levels, euglobulin lysis time, fibrinolytic activity by protamin sulfate
      degradation and inhibitors of plasmin. These experimental models were set with a
      view to analyze situations mimicking processes associated with haemostasis and
      interpolate such situations in changes associated with the development of
      atherosclerosis. To study the plasma fibrinogen levels in experimental and
      control animals, spectrophotometric method was applied. Feeding the animals with
      coix-pellets mixed diet caused a decrease in fibrinogen levels as compared with
      controls. An overall decrease of this plasma protein was observed in both sexes.
      It was shown that euglobulin lysis time (ELT) was insignificantly changed in the
      experimental animals. However, fibrinolytic activity by degradation of protamin
      sulfate showed an increased fibrinolytic potential in experimental animals. In
      the same experimental models the analysis for the activity of inhibitors of
      plasmin showed no significant differences in mean values. It was found that coix
      has got vital nutritional value in lowering fibrinogen levels while at the same
      time creating a tendency of reducing fibrinolytic activity. More experiments
      should be conducted to show the possible mechanisms by which the observations can
      affect the development of atherosclerosis in man.

PMID- 7781559
TI  - Prescribing pattern of antibacterial drugs in a teaching hospital in Gondar,
      Ethiopia.
AB  - The prescribing pattern of antibacterial agents was analyzed by reviewing case
      notes of 407 patients discharged between October and November 1992 from a
      teaching hospital in Gondar, North-West Ethiopia. Seventy percent had received
      one or more antibacterials. Most exposure was in surgical ward (84%) followed by
      paediatric (82%), orthopaedic (78%), medical (72%), gynaecologic (58%) and
      obstetric (20%) wards. The antibacterials most frequently prescribed were
      penicillin G (25%), chloramphenical (24%), and ampicillin (20%). The total list
      numbered 13 and included no cephalosporines or quinoline derivatives. The
      preliminary survey indicated an inappropriate use of antibacterials and suggested
      the need to develop a policy on hospital antibacterial use.

PMID- 7781560
TI  - Analysis of caesarean delivery in Jimma Hospital, south-western Ethiopia.
AB  - In this prospective study, 100 mothers who have undergone caesarean section in
      Jimma Hospital from 23rd June 1992 to 24th September 1993 were analysed to
      determine the incidence, indications and post operative complications of
      caesarean delivery. During the study period, there were 1236 deliveries, of whom
      100 mothers were delivered by caesarean section; giving a caesarean birth rate of
      8%. The leading indications for caesarean section were cephalopelvic
      disproportion (44%), malpresentations and malpositions (21%), repeat caesarean
      section (16%), antepartum haemorrhage (8%) and foetal distress (6%), accounting
      for 95% of the indications for caesarean section. There was no maternal death,
      but the overall morbidity rate was 20%. The causes of morbidity were wound
      infection (27.1%), sepsis (21.4%), endometritis (33.3%), haemorrhage (8%) and
      wound dehiscence (10%). The gross perinatal mortality rate of 120 per 1000 live
      births was not significantly higher than the rate for all deliveries, which was
      92.5% per 1000 live births (P < 0.5). The single most important cause of
      perinatal death was prolonged and obstructed labour. In order to reduce the high
      perinatal mortality and maternal morbidity, there is a strong and urgent need to
      prevent prolonged and obstructed labour through effective antenatal care and
      referral system.

PMID- 7781561
TI  - Pneumocystis carinii: a review.
AB  - Pneumocystis carinii has been increasingly recognized as an important cause of
      opportunistic infection in immune-deficient hosts. The prevalence of pneumocystis
      pneumonia (PCP) in Africa used to be neglected and underestimated due to
      difficult methods of isolating the infection. In this review, the authors discuss
      the nature of the parasite, and methods of diagnosis.

PMID- 7781562
TI  - Cost consideration in renal replacement therapy in Kenya.
AB  - End stage renal disease requiring renal replacement therapy is a common
      complication of several renal diseases that are seen in the tropics. World over,
      the costs of the various modalities of therapy that constitute renal replacement
      therapy, including hemodialysis, continuous ambulatory peritoneal dialysis and
      renal transplantation, is prohibitive. All the above modes of therapy are
      provided in Kenya, unlike most countries with similar level of socioeconomic
      development. This article analyses the factors behind the limited success that
      renal replacement therapy enjoys in Kenya, which is faced with more pressing
      basic problems of malnutrition and infection.

PMID- 7781563
TI  - Urinary tract infection with proteus species in a teaching hospital.
AB  - This study was undertaken to assess the prevalence of urinary tract infection due
      to proteus species, the predisposing factors, age and sex distribution,
      complications and the extent of drug resistance. A total of 580 patients were
      studied. Proteus species comprised 33 (9%) of the total number of bacterial
      isolates causing urinary tract infection during a one year study period between
      June 1991-May 1992. Proteus urinary tract infection was found to be the most
      common from the age of 55 years upwards in males, while in females, they were
      more evenly distributed. All the proteus isolates were completely resistant to
      ampicillin, tetracycline and cotrimoxazole. Ofloxacin was the most potent
      antibiotic (94.4%) sensitive, followed by gentamicin (83.3%) sensitive. Majority
      of the cases occurred in surgical department with more cases being nosocomially
      acquired than community. All male patients had at least one predisposing factor
      with catheterization being the commonest. To help reduce morbidity and mortality
      associated with urinary tract infection due to proteus species, strict aseptic
      catheter techniques and more efficient infection control measures must be
      reinforced.

PMID- 7781564
TI  - Interaction between nifedipine and digoxin in rats.
AB  - Possible nifedipine-digoxin interaction was investigated in rats by comparing
      lethal doses of intravenously infused digoxin in control and experimental rats.
      In the experimental rats, nifedipine was administered intraperitoneally, 30
      minutes prior to infusing digoxin at a constant rate of 40mcg per minute. Results
      indicate that nifedipine administered within the dosage range 0.5-2.0mg per kg
      rat body weight, lowered the lethal dose of intravenously infused digoxin by 26
      38% compared with control rats, thus indicating a synergistic effect between the
      two drugs. There was very little dose dependence of this effect. It is concluded
      that concomitant administration of nifedipine and digoxin in humans may lead to
      drug interactions.

PMID- 7781565
TI  - Growth deficient fetuses with absent or reversed umbilical artery end-diastolic
      flow are metabolically compromised.
AB  - Controversy continues regarding the clinical relevance of absent or reversed
      umbilical artery blood flow during diastole. The purpose of this study was to
      characterize the blood gas and lactate measurements of growth deficient fetuses
      with absent (ADF) or reversed (RDF) umbilical artery (UA) diastolic flow. In a
      descriptive study from February 1988 through October 1991, 42 consecutive
      structurally and karyotypically normal growth deficient fetuses identified to
      have either ADF or RDF diastolic flow in the UA were studied. Heparinized blood
      specimens were obtained from them and the pH, PCO2, PO2 and lactate measured.
      Fourteen of these specimens were obtained from the umbilical vein by
      cordocentesis and 28 at the caesarean delivery of non-labouring patients.
      Statistical analyses were performed using Fisher's exact test, Student t-test and
      linear correlation. All measured parameters in fetuses with ADF or RDF undergoing
      cordocentesis were significantly abnormal compared to gestational age corrected
      norms. Both the mean venous and arterial pH of fetuses with RDF were
      significantly lower than that of fetuses with ADF. With few exceptions,
      preoperative maternal oxygenation failed to correct the fetal hypoxaemia
      associated with either ADF or RDF. In the setting of severe fetal growth
      deficiency secondary to uteroplacental dysfunction, ADF and RDF are clinically
      reliable indicators of fetal compromise as determined by the umbilical blood
      gases. RDF is associated with a greater impairment of placental gas exchange than
      ADF.

PMID- 7781566
TI  - Vagal response to feeding tube insertion in preterm infants: has the key been
      found?
AB  - We prospectively studied the vagal response to feeding tube insertion in eight
      healthy preterm infants, on three occasions in each infant during the first three
      weeks of life. Heart rate, oxygen saturation, respiration and cerebral blood flow
      velocities were assessed before, during and immediately after insertion of an
      orogastric feeding tube. The whole procedure was recorded on video. The duration
      and quality of tube insertion and the behaviour of the infant were evaluated from
      the recordings. Twenty-one measurements in eight infants were evaluated. The
      heart-rate decrease observed immediately after tube insertion correlated
      significantly with the duration of tube insertion, the quicker the manipulation,
      the greater the heart-rate decrease (P = 0.000). The maximal decrease of oxygen
      saturation after tube insertion correlated with the degree of heart rate
      deceleration (P = 0.009). Significant alterations of the flow velocities were
      observed only when the heart rate fell below 80 beats/min. We speculate that such
      episodes of bradycardia can be avoided by carefully inserting the feeding tube
      over a period of at least 15 s.

PMID- 7781567
TI  - Pulmonary hypoplasia and fetal breathing in preterm premature rupture of
      membranes.
AB  - Forty-eight patients with premature rupture of membranes prior to 24 weeks
      gestation (PPROM) were studied to investigate whether there was any difference in
      fetal breathing movements in those fetuses that did or did not develop pulmonary
      hypoplasia. The diagnosis of pulmonary hypoplasia was made on the basis of
      ultrasound measurement of fetal lung length. A control group of fetuses with
      intact membranes and normal pregnancies at the same gestation was also studied.
      The group that developed pulmonary hypoplasia had significantly less breathing
      movements than those that did not develop pulmonary hypoplasia and controls. This
      reduction in breathing movements may contribute to the development of pulmonary
      hypoplasia.

PMID- 7781568
TI  - Three-dimensional ultrasound image of the fetal stomach: congenital duodenal
      obstruction in utero.
AB  - To quantitatively characterize the stereographic stomach configuration in utero,
      11 fetuses (subject-group) with congenital duodenal obstruction, diagnosed
      antenatally, between 29 and 37 weeks' gestation were studied. Also included were
      879 uncomplicated fetuses between 20 and 40 weeks' gestation as a control-group.
      Applying the algorithm which we devised: "Modeling a three-dimensional shape from
      a silhouette by detecting symmetry", we reconstructed the three-dimensional
      stomach configuration from a two-dimensional ultrasound image for each case. The
      statistical differences in two parameters, stomach volume and sphericity, between
      subject- and control-group fetuses, were analyzed using the Grubbs-Smirnoff's
      test at corresponding gestational ages. From 29 to 37 weeks' gestation, the
      stomach volume in the subject-group fetuses was found to increase greatly with
      advancing gestation, having significantly higher values than the control-group
      fetuses, whereas the stomach sphericity remained unchanged with no significant
      differences from the control-group fetuses. These findings indicate that the
      fetal stomach with duodenal obstruction maintains almost the same three
      dimensional portrayal in utero as that seen in uncomplicated fetuses, although
      the stomach becomes extremely enlarged.

PMID- 7781569
TI  - Volume delivery during positive pressure inflation--relationship to spontaneous
      tidal volume of neonates.
AB  - Volume delivery by positive pressure inflation was determined in 20 premature
      infants and 10 infants born at term on days 1 and 2. The spontaneous tidal
      volume, respiratory rate and inspiratory to expiratory (I:E) ratio were measured
      daily in the first week of life in an additional group of 20 infants born
      prematurely. Measurements were made using a pneumotachograph only when the
      infants were stable and had acceptable blood gases for at least 2 h. There was
      variability between individuals but the median delivered volume by positive
      pressure ventilation ranged between 4.9 and 6.1 ml/kg on days 1 and 2 and within
      the groups of different maturity. There was no significant difference in the
      results of infants born prematurely or at term or when studied on days 1 or 2.
      The median spontaneous tidal volume during the first week of life varied between
      5.4 and 6.7 ml/kg; respiratory rate between 72 and 80 breaths/min and I:E ratio
      from 0.67 to 0.77. Postnatal age had no significant effect on the results. These
      results suggest volume delivery by positive pressure inflation during a stable
      period of ventilation is similar to the spontaneous tidal volume.

PMID- 7781570
TI  - Blood levels of vasoactive intestinal polypeptide in normal and growth retarded
      fetuses: relationship with acid-base and haemodynamic status.
AB  - The objectives of this study were (1) to detect vasoactive intestinal polypeptide
      in fetal blood obtained by cordocentesis (2) to examine possible changes in
      growth retarded fetuses and to establish relationships between its levels and
      fetal blood acid-base status as well as fetal haemodynamics as assessed by
      Doppler ultrasonography. Vasoactive intestinal polypeptide was measured in
      umbilical vein blood obtained at cordocentesis in 12 growth retarded fetuses and
      in 13 control fetuses. Umbilical vein pH and PO2 values were determined in all
      the cases. Before the procedure, Doppler indices were calculated from umbilical
      artery, middle cerebral artery, renal artery, cardiac outflow tracts and inferior
      vena cava. Simple and multiple stepwise regression analysis were performed to
      examine the relationships between Doppler indices, acid-base status and
      vasoactive intestinal polypeptide levels. In control fetuses, vasoactive
      intestinal polypeptide was always detectable in cord blood and its levels did not
      change with gestational age. In growth retarded fetuses, vasoactive intestinal
      polypeptide levels were higher and significantly related to umbilical vein PO2
      levels, Pulsatility Index in umbilical artery, middle cerebral artery and renal
      artery, while no relationship was found with umbilical vein pH, cardiac and
      venous Doppler indices. Stepwise multiple regression demonstrated middle cerebral
      artery Pulsatility Index to be the best explanatory variable for vasoactive
      intestinal polypeptide levels. In conclusion, vasoactive intestinal polypeptide
      blood levels are increased in growth retarded fetuses and this increase is
      inversely related to the Doppler measured impedance to flow in middle cerebral
      artery.

PMID- 7781571
TI  - Median nerve conduction tests and Phalen's sign in carpal tunnel syndrome.
AB  - Carpal tunnel syndrome (CTS) is associated with sensory and/or motor dysfunction
      of the hand's fingers. The syndrome is caused by a continuous or intermittent
      pressure on the median nerve (NM) at the patient's wrist. 82 patients suffering
      from recent CTS symptoms, and 24 matched asymptomatic controls were tested. In
      the present study we examined five electrophysiological parameters and their
      correlations with a most commonly used clinical test--the Phalen test. The Phalen
      measure is the time from initial provocation until positive sign. The
      electrophysiological measurements are: NM Onset Sensory Velocity, NM Peak Sensory
      Velocity, NM Motor Nerve Velocity, NM Distal Motor Velocity, NM Residual Latency.
      Most of the symptomatic hands exhibited pathological values of their clinical or
      electrophysiological parameters. Phalen and Residual Latency were the most
      sensitive parameters. Phalen times were not significantly correlated with any of
      the five electrophysiological parameters, yet sensory velocity tended to decrease
      in patients with pathological Phalen values.

PMID- 7781572
TI  - Comparison between median and ulnar sensitive action potential (SAP) obtained
      with two different stimulation methods.
AB  - We studied the sensory action potentials (SAP) of median and ulnar nerves in four
      groups of 20-30, 30-40, 40-50 and 50-60 years old healthy subjects. In each group
      ten sensitive ulnar and median nerves were examined stimulating respectively V
      and III hand digital nerves, with two compared methods. In the former stimulus
      intensity was 20 mA, with a duration 0.1 msec, and SAP was recorded with
      averaging technique after 20 stimuli; in the latter the stimulus intensity was
      supra maximal (100 mA), with a duration 0.1 msec and a single SAP was recorded.
      The SAP's recording was performed by bipolar surface electrodes at the wrist,
      following conventional techniques. There was not statistically significant
      difference between SAP's latencies obtained with the two methods in each group,
      even if there was a decrease of the latency value obtained with supra maximal
      stimulus. Otherwise there was a statistically significant increase of SAP's
      amplitude obtained with supra maximal stimulus, above all in elderly people for
      median (p < 0.001) and ulnar (p < 0.0005) nerve.

PMID- 7781573
TI  - H-reflexes in the upper extremity and the effects of voluntary contraction.
AB  - We report a simple technique for obtaining H-reflexes from the extensor carpi
      radialis (ECR) muscle. In 50 normal test subjects, above-elbow stimulation of the
      radial nerve evoked ECR H-reflexes, in all 100 arms with facilitation, and in
      only 8 without facilitation. H-waves were less common in extensor digitorum
      communis and rare in brachioradialis; these could have been volume-conducted ECR
      responses. Median-nerve stimulation at the elbow evoked H-reflexes in 92 of the
      100 flexor carpi radialis (FCR) muscles; 44 of these required no facilitation.
      Background EMG (facilitation) activity or an overlapping M-wave often obscured
      the H-wave onset: among the onsets considered reliable in FCR (67/92) and ECR
      (84/100), mean latencies were 16.2 msec and 16.5 msec respectively, and
      correlated well with subject height and arm length. There was no significant
      difference in latency obtained with and without facilitation for the FCR H
      reflexes and between techniques for the ECR H-reflexes. Right-left differences in
      latency ranged from 0 to 0.9 msec for ECR and 0 to 0.6 msec for FCR H-reflexes.

PMID- 7781575
TI  - Crossed R1 response of the blink reflex in peripheral facial palsy.
AB  - A patient with regenerated Bell's palsy showed a crossed R1 component of the
      blink reflex recorded from the healthy side while stimulating the affected side.
      Our observation supports the hypothesis that a short-circuit trigemino-facial
      pathway crossing the midline exists in normal subjects which is not activated
      under normal conditions, but may be engaged following peripheral facial nerve
      disease.

PMID- 7781574
TI  - Frequency of ulnar-to-median nerve anastomosis revisited.

PMID- 7781576
TI  - Electrophysiological studies in children with paralytic poliomyelitis.
AB  - H-reflex latency (H-RL) and H/M ratio were measured in normal children and
      children with paralytic poliomyelitis of 1-3 years of age. The H-RL was
      considerably increased in both the involved and uninvolved limbs of the patients,
      whereas the H/M ratio did not differ. The Mmax value in the involved limb was
      very low, and therefore, a corrected H/M ratio was calculated for that side only.
      The corrected H/M ratio was significantly less than the H/M ratio observed in the
      uninvolved and control limbs. The distal motor latency was also increased in the
      involved side.

PMID- 7781577
TI  - An analysis of VEP components in optic neuritis.
AB  - Various VEP parameters were analysed in 126 patients with multiple sclerosis,
      isolated optic neuritis or isolated myelopathy. The single most common deviation
      in eyes with clinical evidence of optic neuritis was a prolongation of the
      latency to P100. After the findings concerning P100 and N70 were combined two
      patterns of abnormalities emerged: 1) delayed P100 and delayed N70, 2) delayed
      P100 and absence of N70. In a few cases only one of the potentials was affected.
      Also in eyes without clinical evidence of optic neuritis the same patterns
      occurred but discrepancies between N70 and P100 were more common, especially the
      combination of normal P100 and delayed or absent N70. In about half of these
      cases the latency to P100 was close to the upper normal limit. It is concluded
      that in such cases the additional findings of an absent or delayed N70 is
      strongly suggestive of visual system dysfunction and that the inclusion of N70 in
      the analysis of VEP may increase the diagnostic yield of the examination.

PMID- 7781579
TI  - Prolonged brainstem auditory evoked potential latencies in tropical pancreatic
      diabetics with normal hearing.
AB  - Twenty patients with Tropical Pancreatic Diabetes (TPD) were evaluated by
      Brainstem Auditory Evoked Potentials (BAEP) in order to detect any possible
      subclinical involvement of auditory pathways. The latencies of BAEP Wave III (p <
      0.009) and V (p < 0.47) as well as the Interpeak Latencies I-III (p < 0.002), and
      I-V (p < 0.019) were significantly prolonged in patients with TPD when compared
      to age and sex matched healthy volunteers. There was correlation between the
      abnormalities of BAEP and duration of diabetes (p < 0.006), male sex of patients
      (p < 0.05), and the presence of retinopathy (p < 0.003) and nephropathy (p <
      0.38). There was no significant correlation with the age of the patients, type of
      treatment, blood sugar levels and presence of peripheral neuropathy. These
      changes suggest a subclinical involvement of the auditory pathways in TDP
      patients.

PMID- 7781578
TI  - Sacroiliac joint manipulation decreases the H-reflex.
AB  - Joint manipulation is widely utilized clinically to decrease pain and increase
      the range of motion of joints displaying limited mobility. Evidence of efficacy
      is based on subjective reports of symptom improvement as well as on the results
      of clinical trials. Experiments were designed to determine whether or not
      sacroiliac joint manipulation affects the amplitude of the Hoffman (H) reflex.
      Surface EMG recordings of the reflex response to electrical stimulation of the
      tibial nerve in the popliteal fossa were made from the soleus muscle. The
      averaged amplitudes of H-reflexes were compared on both legs before and after
      either sacroiliac joint manipulation or a sham procedure. H-reflex amplitude was
      significantly decreased (12.9%) in the ipsilateral leg (p < 0.001) following a
      sacroiliac joint manipulation while there was no significant alteration following
      the sham intervention. There was no significant alteration in reflex excitability
      in the contralateral leg to the sacroiliac joint manipulation. To further
      investigate the mechanism of these reflex alterations, the local anaesthetic
      cream EMLA (Astra Pharmaceuticals) was applied to the skin overlying the
      sacroiliac joint and the experiments were repeated on a different group of
      subjects. This was intended to determine if excitation of cutaneous afferents was
      responsible for the reflex excitability changes. There was still a significant
      decrease in reflex excitability (10.6%) following sacroiliac joint manipulation
      (p < 0.001). These findings indicate that joint manipulation exerts physiological
      effects on the central nervous system, probably at the segmental level. The fact
      that the changes persisted in the presence of cutaneous anaesthesia suggests that
      the reflex changes are likely to be mediated by joint and/or muscle afferents.

PMID- 7781580
TI  - Median sensory nerve conduction block during wrist flexion in the carpal tunnel
      syndrome.
AB  - A new method for diagnosing the carpal tunnel syndrome (CTS) is introduced. We
      have determined the time (T50) necessary to reach a 50% reduction in the
      amplitude of the median antidromic sensory nerve action potential during wrist
      flexion. Ten patients with anamnestic and neurophysiological evidence of CTS
      (group CTS) and 20 patients with CTS suspected on clinical grounds (group CTS?)
      were compared with 10 normal subjects. During wrist flexion the sensory
      conduction in the median nerve became partially blocked in all patients, and also
      in 8 out of 10 controls. The T50 value in 8 out of 10 CTS patients and in 14 out
      of 20 CTS? patients was below the lowest recorded value in the control group. It
      was shown that ischemia caused the blocking of the median nerve. Determination of
      T50 of the median nerve SNAP during wrist flexion has the potential to add to the
      sensitivity and specificity of the electrophysiological diagnosis of CTS.

PMID- 7781581
TI  - [Social adjustment and depression: value of the SAS-SR (Social Adjustment Scale
      Self-Report)].
AB  - The Social Adjustment Scale Self-Report (SAS-SR) is a simple and inexpensive
      method, which allows the routine assessment of the patient's social adjustment,
      especially in the case of depression. Compared with other scales based on an
      interview with the patient, the SAS-SR is more sensitive to change in the
      patient's clinical status. The SAS-SR is a useful method as part of the detection
      of even mild depressions, regular aftercare evaluation of out-patients or as an
      outcome measure in longitudinal studies. A French version of the SAS-SR is now
      available and is currently under evaluation in a large-scale randomized
      therapeutic trial.

PMID- 7781582
TI  - [Factorial structure and internal consistency of the French version of the twenty
      item Toronto Alexithymia Scale in a group of 183 healthy probands].
AB  - The factorial structure of the French version of the twenty-item Toronto
      Alexithymia Scale (TAS-20) was studied in a group of 183 healthy subjects. The
      TAS-20 represents the latest revised version of the TAS. His psychometric
      characteristics are clearly superior than the others alexithymia scales. Our
      subjects filled out the TAS whose 14 items are common with the TAS-20. We
      conducted our statistical analyses on these 14 items. A principal components
      analysis was carried out and yielded a two-factor solution where the items rating
      the ability to describe feelings and the items rating the ability to identify
      feelings constitute one sole factor. The second factor corresponds to the
      externally oriented factor. The internal consistency of the scale was also
      measured by the Cronbach alpha coefficient and by the correlation between each
      item and the total score. The value of the Cronbach alpha was 0.79 and the
      correlation between each item and the total score ranges from 0.19 (p < 0.05) to
      0.69 (p < 0.001) with a mean of 0.52. Our results confirm a previous work on a
      group of 263 normal students which showed a two-factor solution of the TAS-20.
      The French version of the TAS-20 seems to be reliable and constitutes a useful
      instrument to study alexithymia in psychopathology.

PMID- 7781584
TI  - [The benzodiazepine receptor: the enigma of the endogenous ligand].
AB  - The structure of the benzodiazepine receptor is nowadays well established and its
      potentialisation of GABA neurotransmission is known as the main action mechanism
      of benzodiazepinic drugs. Three categories of ligands have been also identified
      with radically different effects: the agonists (like diazepam and other
      anxiolytics), the antagonists (like flumazenil) and the inverse agonists which
      are anxiogenic, pro-convulsant and alerting (like beta-carbolines). By analogy
      with opiates system, the existence of a possible endogenous ligand has been
      proposed, and if such a substance really exists, it could be an important
      biological support of anxiety regulation. Many compounds with benzodiazepine
      receptor affinity have been extracted from the brain, the cerebrospinal fluid and
      the urine of animals but also of humans. Among these, some are artefacts, like
      ethyl-beta-carbolin, or their affinity are to low to be physiologically relevant.
      N-desmethyl-diazepam has been purified from the brain of never treated humans,
      but probably comes from diet or gut bacteria. An important candidate is the DBI
      (Diazepam Binding Inhibitor), which displays inverse agonist activity and is
      present in human organism. Its role as a modulator of GABAergic transmission is
      questioned. Likewise, the intervention of endogenous agonist compounds is
      possible during acquisition tasks with stress or anxiety in animals. There are
      also reasonable arguments to involve an agonist (sedative) ligand in the
      pathogenesis of hepatic encephalopathy. On the other hand, inverse agonists are
      not implicated in benzodiazepine withdrawal and panic disorder mechanisms.
      Lastly, probably indirect interactions between benzodiazepine receptor and
      cholecystokinin system are important to be considered, with possible consequences
      on anxiety regulations.

PMID- 7781583
TI  - [Central serotonin receptors and chronic treatment with selective serotonin
      reuptake inhibitors in the rat: comparative effects of fluoxetine and
      paroxetine].
AB  - The hypothesis that a dysfunction of serotonergic neurotransmission is implicated
      in depression is supported by the clinical efficiency of selective serotonin (5
      hydroxytryptamine, 5-HT) reuptake inhibitors (SSRIs) in the treatment of
      depressive disorders. These drugs, such as fluoxetine and paroxetine, exert their
      antidepressant activity by increasing 5-HT concentration in the synaptic cleft
      and thus enhancing serotonergic neurotransmission. However, two to three weeks of
      treatment are necessary to see the first signs of clinical efficiency. Several
      hypothetical mechanisms have been put forward to account for this delay, taking
      into account pharmacokinetic considerations, neurotransmitter metabolism, and/or
      adaptive regulation of pre and/or post-synaptic receptors. The aim of this study
      was to look for such adaptive changes in the course of a 3-week treatment with
      fluoxetine (5 mg/kg/day, i.p.) or paroxetine (5 mg/kg/day, i.p.) in adult rats.
      In vitro binding and quantitative autoradiographic studies showed that neither 5
      HT1A, 5-HT1B, 5-HT2A, nor 5-HT3 receptor binding sites in various brain areas
      were affected by these treatments. Furthermore, comparison of the specific
      binding of [3H]8-OH-DPAT to 5-HT1A receptors functionally coupled to G proteins
      with that of [3H]WAY 100635 to all 5-HT1A receptor binding sites (i.e. coupled
      and uncoupled with regard to G proteins) revealed no significant change in rats
      treated with either SSRI. Accordingly, the proportion of functional 5-HT1A
      receptors (i.e. those physically coupled to G proteins) appeared to remain
      unaltered all along a 3-week treatment with either fluoxetine or paroxetine.
      Nevertheless, in vitro electrophysiological recordings of serotonergic neurons in
      the dorsal raphe nucleus allowed the demonstration of a clearcut functional
      desensitization of somatodendritic 5-HT1A autoreceptors. Thus, the potency of the
      5-HT1A autoreceptor agonist, 8-OH-DPAT, to depress the firing of serotonergic
      neurons in brain stem slices was significantly reduced as soon as after a 3-day
      treatment with either SSRI. The proportion of recorded neurons showing
      desensitization of somatodendritic 5-HT1A autoreceptors then increased along the
      treatment, and was generally larger with fluoxetine than with paroxetine. As 5
      HT1A autoreceptor desensitization can contribute to facilitate serotoninergic
      neurotransmission, the remarkable efficiency of fluoxetine to trigger this
      adaptive regulatory mechanism might account, at least partly, for its potent
      antidepressant activity.

PMID- 7781585
TI  - [Carbamazepine-fluvoxamine interaction. Consequences for the carbamazepine plasma
      level].
AB  - The current practices concerning psychotropic drugs use plasma levels for the
      therapeutic adaptation and for the prevention of overdose and side effects. We
      observed, among two patients treated with constant dosages of carbamazepine
      (CBZ), that the addition of fluvoxamine (FLV) has increased significantly plasma
      levels of CBZ. The first patient, suffering of an affective bipolar trouble (ICD
      10), was hospitalized for major depression. His admission treatment was CBZ (800
      mg/day) and cyamemazine (75 mg/day). The introduction of the FLV (200 mg/day) was
      justified by the symptomatology. Then, plasma levels of CBZ increased
      progressively. No clinic or biological side effect was observed. Rapidly, CBZ
      oral dosages were decreased, but the plasma levels of CBZ reached the therapeutic
      window only when the FLV prescription was definitively stopped. The other patient
      was hospitalized for an acute exacerbation of a paranoiac disorder. He was
      treated with haloperidol for this episode. For five years, he received CBZ for
      neuralgia of the Trigeminus. The emergence of a depressive disorder justified a
      FLV treatment. From the introduction of FLV, plasma levels of CBZ were
      significantly increased. The reduction, then the stop of the FLV treatment, has
      allowed the standardization of plasma concentrations of CBZ. Three similar
      studies were found in the literature. The danger of this interaction was notified
      in two studies (one case each). Furthermore, in the third study (three cases) was
      put forward the hypothesis of a new therapeutic pathway. this hypothesis was
      suggested by the fact that these two medications were proposed independently to
      treat impulsive behaviors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781587
TI  - [Re-reading: Theodule Ribot's The Psychology of Sentiments].

PMID- 7781586
TI  - [Modification of cognitive functions by 2 anxiolytic treatments in patients
      suffering from generalized anxiety].
AB  - The aim of this randomized, double-blind, multicentric study was to assess and
      compare cognitive impairment in patients treated with either lorazepam or
      hydroxyzine, for generalized anxiety. Only non depressed patients were selected
      according to MADRS criteria. The cognitive assessment was performed with the BEC
      96 rating scale, the intensity of anxiety symptoms was evaluated through the
      Hamilton-anxiety and Covi scales. The level of relation, mood and sedation was
      assessed for each item with a visual analog scale (VAS). The patient's and
      investigator's opinion on the global efficiency of the treatment were also
      evaluated on VAS. After an 8-day wash-out period under placebo, the treatment was
      given in a double-blind way for 28 days: either hydroxyzine 25 mg at a daily
      dosage of 100 mg t.i.d. (25 mg - 25 mg - 50 mg), or lorazepam 1 mg at a daily
      dosage of 4 mg t.i.d. (1 mg - 1 mg - 2 mg). The results were as follows: after
      the 28-day treatment period, patients showed at the BEC 96 a cognitive
      improvement in both groups, but the improvement in the hydroxyzine group was
      significantly higher. Furthermore, the improvement appeared more quickly in the
      hydroxyzine group. The Hamilton-anxiety and Covi scales showed an improvement in
      the anxiety level in both groups with no significant difference. The visual
      analog scales assessing relation, mood and sedation improved in both groups as
      well as the patient's and investigator's opinion. The five assessments all showed
      a significant by higher improvement in the hydroxyzine group.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7781588
TI  - [Suicide attempts and panic disorder: a study of 62 hospitalized suicidal
      patients].
AB  - Suicidal behaviours are multifactorial behaviours. While, historically, anxiety
      has not been regarded as an important risk factor in suicidal behaviours, recent
      epidemiological studies carried out on general population or panic patients have
      evidenced the possible links between suicidal behaviours and the occurrence of
      panic attacks. The aim of our study was to validate the hypothesis which
      stipulates that panic disorder may contribute to an actualization of suicidal
      behaviour in trying to establish the prevalence of panic disorder in a population
      of suicidal attempters. The diagnoses were reached after an interview using the
      Schedule for Affective Disorders and Schizophrenia-Lifetime Version modified for
      the study of Anxiety disorders (SADS-LA). The medical seriousness of the suicide
      attempts was assessed with the Risk Rescue Rating Scale (RRRS) of Weissman and
      Worden and the suicidal intent with the Suicidal Intent Scale of Beck (SIS). In
      the 62 suicide attempters hospitalized after minor or slightly more serious
      suicide attempts, we found high current and life-time prevalence of panic
      disorder (17.7% and 22.6% respectively). Comorbidity with major depressive
      episodes and addictive behaviours in suicide attempters with panic disorder was
      high. Current comorbidity rates were 72.8% and 27.3% respectively; life-time
      comorbidity rates were 71.4% and 21.4%. Patients who suffered from major
      depressive disorder with related panic disorder were given to more impulsive
      suicide attempts, even if the difference with depressed patients without panic
      disorder was statistically insignificant.

PMID- 7781589
TI  - [Four year follow-up of social adjustment of a cohort of schizophrenic patients].
AB  - Sixty-seven first episode schizophrenic patients (PSE-Catego criteria) have been
      included in this study in order to evaluate their prognosis and the factors
      predictive of their evolution. Potential predictive factors consisted of
      anamnestic and demographic data, scores on the Disability Assessment Schedule
      (DAS-WHO) and relatives' Expressed Emotion index (EE), measured by the Camberwell
      Family Interview (CFI). The outcome was assessed monthly by the Global Assessment
      Scale (GAS/DSM III-R). At four years, 39 patients (58%) were still being
      followed. 33% of the patients presented a good evolution (EGF > or = 51) and 67%
      of the patients a bad evolution (EGF < 51). Four factors predictive of the
      psychosocial adaptation were extracted using regression analysis: premorbid
      psychosocial evolution, EE, sex and psychiatric family history. These 4 factors
      predicted correctly 85% of cases. Moreover, the monthly follow-up of these
      patients pointed to three types of evolution: the patients presenting a good and
      stable evolution (22%), those presenting a bad and stable evolution (33%) and
      those presenting an oscillating evolution which fluctuated between good and bad
      periods (44%). However, no predictive factors of the psychosocial adaptation of
      these oscillating patients could be identified through the statistical analysis.
      These results take all their importance regarding the treatment of schizophrenic
      patients, for whom the therapeutic plans which have to be settled should take
      into account their prognosis in the most precise manner. Moreover, the predictive
      value of EE on psychosocial adaptation for a 4 years period is confirmed.

PMID- 7781590
TI  - [Clinical study of a population of patients hospitalized for eating disorders.
      Discussion of DSM III-R diagnostic criteria].
AB  - Patients consecutively referred for a clinical diagnosis of eating disorders to
      the Unit for Addictive Disorders at the University Hospital of Nantes were
      included in the study. The sample contained 95 patients (94 females, 1 male; mean
      age +/- SD: 24.1 +/- 6.5). All the patients were evaluated with the Computerized
      Multiple Diagnostic Instrument for Eating Disorders, which assesses diagnostic
      criteria for eating disorders from different international diagnostic
      classifications. Seven (7%) patients fulfilled the DSM III-R criteria for
      anorexia nervosa (AN) and 42 (44%) the DSM III-R criteria for bulimia nervosa.
      Two subgroups of bulimic patients were distinguished according to Body Mass Index
      [anorexia-bulimia (AB) if BMI was < 18 (n = 11, 12%) and normal weight bulimia
      (NWB) if BMI was > 18 (n = 31, 33%)]. Most patients (n = 46, 48%) did not fulfill
      DSM III-R criteria for AN or bulimia, and were given the residual DSM III-R
      diagnosis of eating disorder not otherwise specified (EDNOS). A comparison was
      made of the frequencies of the different weight control strategies displayed by
      the patients of the 4 subgroups. Vigorous exercise was more frequently used by AN
      patients than by patients of the 3 other subgroups. Vomiting was more frequent in
      bulimic patients, although this symptom was displayed by 29% of the AN patients
      and 24% of the EDNOS. Abuse of laxatives or diuretics was similar in the four
      subgroups. Use of diuretics was infrequent in the total sample of
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781592
TI  - Cytokines as mediators of autoimmune diabetes and diabetic complications.
AB  - Over the last several years, there has been a considerable and rapid expansion in
      our understanding of the cytokines. Insights into cytokine functions gained from
      basic biological studies are currently being applied to the study of autoimmune
      diabetes. It has become clear that cytokines are critical regulating elements
      involved in the processes of initiating, promoting, and effecting beta-cell
      destruction. It is also evident that cytokine functions in IDDM are determined by
      timing of appearance and local synthesis, as well as the prevailing cytokine and
      cellular milieu. Elucidating individual cytokine responses in IDDM may offer new
      insights into mechanisms of disease pathogenesis and may lead to novel cytokine
      based therapies for the treatment of IDDM. It may also be possible that the
      intensity or character of a patient's cytokine response to islet injury or to the
      metabolic changes inherent to diabetes may influence the ultimate expression of
      IDDM or its complications. Clearly, this rapidly expanding field of study should
      have a major impact on our understanding of diabetogenesis, our ability to
      intervene in our understanding of diabetogenesis, our ability to intervene in the
      disease process itself, and ultimately our capacity to care for individuals with
      IDDM.

PMID- 7781591
TI  - Insulin action and the insulin signaling network.

PMID- 7781593
TI  - The role of corticotropin-releasing factor and interleukin-1 in the regulation of
      neurons controlling reproductive functions.

PMID- 7781594
TI  - Structure-function relationships in the vitamin D endocrine system.

PMID- 7781595
TI  - FXR1, an autosomal homolog of the fragile X mental retardation gene.
AB  - Fragile X mental retardation syndrome, the most common cause of hereditary mental
      retardation, is directly associated with the FMR1 gene at Xq27.3. FMR1 encodes an
      RNA binding protein and the syndrome results from lack of expression of FMR1 or
      expression of a mutant protein that is impaired in RNA binding. We found a novel
      gene, FXR1, that is highly homologous to FMR1 and located on chromosome 12 at
      12q13. FXR1 encodes a protein which, like FMR1, contains two KH domains and is
      highly conserved in vertebrates. The 3' untranslated regions (3'UTRs) of the
      human and Xenopus laevis FXR1 mRNAs are strikingly conserved (approximately 90%
      identity), suggesting conservation of an important function. The KH domains of
      FXR1 and FMR1 are almost identical, and the two proteins have similar RNA binding
      properties in vitro. However, FXR1 and FMR1 have very different carboxy-termini.
      FXR1 and FMR1 are expressed in many tissues, and both proteins, which are
      cytoplasmic, can be expressed in the same cells. Interestingly, cells from a
      fragile X patient that do not have any detectable FMR1 express normal levels of
      FXR1. These findings demonstrate that FMR1 and FXR1 are members of a gene family
      and suggest a biological role for FXR1 that is related to that of FMR1.

PMID- 7781596
TI  - Cloning and electrophysiological analysis of KST1, an inward rectifying K+
      channel expressed in potato guard cells.
AB  - Potassium uptake by guard cells represents part of the osmotic motor which drives
      stomatal opening. Patch-clamp measurements have identified inward rectifying K+
      channels capable of mediating K+ uptake in guard cells and various other plant
      cell types. Here we report the molecular cloning and characterization of a
      voltage-dependent K+ channel (KST1) from potato (Solanum tuberosum L.) guard
      cells. In situ hybridization shows expression of kst1 in guard cells. Two
      electrode voltage-clamp and patch-clamp studies of the gene product after cRNA
      injection into Xenopus oocytes identified KST1 as a slowly activating, voltage
      dependent, inward rectifying K+ channel. The single channel current voltage curve
      was linear in the range -160 to +20 mV, with a deduced single channel conductance
      of 7 pS in symmetrical 100 mM K+. This channel type, modulated by pH changes
      within the physiological range, required ATP for activation. In line with the
      properties of a K(+)-selective channel, KST1 was permeable to K+, Rb+ and NH4+
      and excluded Na+ and Li+. Cs+ at submillimolar concentrations blocked the channel
      in a voltage-dependent manner. Related studies on potato guard cell protoplasts
      confirmed the biophysical characteristics of the kst1 gene product (KST1) in the
      heterologous expression system. Therefore, KST1 represents a major K+ uptake
      channel in potato guard cells.

PMID- 7781597
TI  - Two independent targeting signals in the cytoplasmic domain determine trans-Golgi
      network localization and endosomal trafficking of the proprotein convertase
      furin.
AB  - Furin, a subtilisin-like eukaryotic endoprotease, is responsible for proteolytic
      cleavage of cellular and viral proteins transported via the constitutive
      secretory pathway. Cleavage occurs at the C-terminus of basic amino acid
      sequences, such as R-X-K/R-R and R-X-X-R. Furin was found predominantly in the
      trans-Golgi network (TGN), but also in clathrin-coated vesicles dispatched from
      the TGN, on the plasma membrane as an integral membrane protein and in the medium
      as an anchorless enzyme. When furin was vectorially expressed in normal rat
      kidney (NRK) cells it accumulated in the TGN similarly to the endogenous
      glycoprotein TGN38, often used as a TGN marker protein. The signals determining
      TGN targeting of furin were investigated by mutational analysis of the
      cytoplasmic tail of furin and by using the hemagglutinin (HA) of fowl plague
      virus, a protein with cell surface destination, as a reporter molecule, in which
      membrane anchor and cytoplasmic tail were replaced by the respective domains of
      furin. The membrane-spanning domain of furin grafted to HA does not localize the
      chimeric molecule to the TGN, whereas the cytoplasmic domain does. Results
      obtained on furin mutants with substitutions and deletions of amino acids in the
      cytoplasmic tail indicate that wild-type furin is concentrated in the TGN by a
      mechanism involving two independent targeting signals, which consist of the
      acidic peptide CPSDSEEDEG783 and the tetrapeptide YKGL765. The acidic signal in
      the cytoplasmic domain of a HA-furin chimera is necessary and sufficient to
      localize the reporter molecule to the TGN, whereas YKGL is a determinant for
      targeting to the endosomes. The data support the concept that the acidic signal,
      which is the dominant one, retains furin in the TGN, whereas the YKGL motif acts
      as a retrieval signal for furin that has escaped to the cell surface.

PMID- 7781598
TI  - A component of the chloroplastic protein import apparatus is targeted to the
      outer envelope membrane via a novel pathway.
AB  - A chloroplastic outer envelope membrane protein of 75 kDa (OEP75) was identified
      previously as a component of the protein import machinery. Here we provide
      additional evidence that OEP75 is a component of protein import, present the
      isolation of a cDNA clone encoding this protein, briefly describe its
      developmental expression and tissue specificity, and characterize its insertion
      into the outer envelope membrane. OEP75 was synthesized as a higher molecular
      weight precursor (prOEP75) which bound to isolated chloroplasts in an in vitro
      import assay and subsequently was processed to the mature form (mOEP75). During
      this import assay, two proteins intermediate in size between prOEP75 and mOEP75
      were detected. One of these intermediates was also detected in chloroplast
      envelopes isolated from young pea leaves. Binding and processing of prOEP75
      required ATP and one or more surface-exposed proteinaceous components, and was
      competed by prSSU, a stromal-targeted protein. We propose that the N-terminus of
      the prOEP75 transit peptide acts as a stromal-targeting domain and a central,
      hydrophobic region of this transit peptide acts as a stop-transfer domain. A
      complex route of insertion and processing of prOEP75 may exist to ensure high
      fidelity targeting of this import component.

PMID- 7781600
TI  - Contact of Shigella with host cells triggers release of Ipa invasins and is an
      essential function of invasiveness.
AB  - The invasion of colonic epithelial cells by Shigella, an early essential step for
      causing bacillary dysentery, is mediated by the IpaB, IpaC and IpaD proteins.
      Secretion of the Ipa proteins from Shigella requires functions encoded by the mxi
      and spa loci. In this study, we show that contact between the bacteria and
      epithelial cell triggers release of the Ipa proteins into the external medium,
      which results in a rapid decrease in levels of Ipa proteins presented on the cell
      surface. When the bacteria were used to infect polarized Caco-2 cells, release of
      Ipa proteins occurred efficiently from bacteria interacting with the basolateral
      surface rather than with the apical surface. Moreover, the interaction of
      bacteria with components of the extracellular matrix, such as fibronectin,
      laminin or collagen type IV, also stimulates the release of Ipa proteins. The
      release of Ipa proteins from Shigella required the surface-located Spa32 protein
      encoded by one of the spa genes on the large plasmid.

PMID- 7781599
TI  - Epitope mapping and direct visualization of the parallel, in-register arrangement
      of the double-stranded coiled-coil in the NuMA protein.
AB  - NuMA, a 238 kDa protein present in the nucleus during interphase, translocates to
      the spindle poles in mitosis. NuMA plays an essential role in mitosis, since
      microinjection of the NuMA SPN-3 monoclonal antibody causes mitotic arrest and
      micronuclei formation. We have mapped the approximate position of the epitopes of
      six monoclonal NuMA antibodies using recombinant NuMA fragments. The SPN-3
      epitope has been located to residues 255-267 at the C-terminus of the first
      helical subdomain of the central rod domain and several residues crucial for
      antibody binding have been identified. To gain insight into the ultrastructure of
      NuMA, several defined fragments, as well as the full-length recombinant protein,
      were expressed in Escherichia coli and purified to homogeneity. They were then
      characterized by chemical cross-linking, circular dichroism spectra and electron
      microscopy. The results directly reveal the tripartate structure of NuMA. A long
      central rod domain is flanked by globular end domains. The rod is 207 nm long and
      is at least 90% alpha-helical. It reflects a double-stranded coiled-coil with the
      alpha-helices arranged parallel and in register. The NuMA protein thus forms the
      longest coiled-coil currently known. Our analyses reveal no indication that
      recombinant NuMA assembles into filaments or other higher order structures.

PMID- 7781602
TI  - Activation of ZAP-70 kinase activity by phosphorylation of tyrosine 493 is
      required for lymphocyte antigen receptor function.
AB  - ZAP-70 is a protein tyrosine kinase (PTK) required for T-cell development and T
      cell antigen receptor (TCR) function. ZAP-70 is associated with the
      phosphorylated antigen receptor and undergoes tyrosine phosphorylation following
      receptor activation. We demonstrate here that tyrosine phosphorylation of ZAP-70
      results in an increase in its catalytic activity and that this activation is
      mediated by the phosphorylation of tyrosine residue 493 by the src family of
      PTKs. The activity of baculoviral expressed ZAP-70 was up-regulated 10-fold when
      ZAP-70 was co-infected and phosphorylated by the src family PTK, lck. Mutation of
      Y493 alone abrogated the ability of ZAP-70 to be activated by lck. Moreover, we
      demonstrate that phosphorylation of Y493 and activation of ZAP-70 is required for
      antigen receptor-mediated induction of interleukin-2 (IL-2) secretion in
      lymphocytes.

PMID- 7781601
TI  - Involvement of the MAP kinase cascade in Xenopus mesoderm induction.
AB  - Mitogen-activated protein kinase (MAPK) is activated by MAPK kinase (MAPKK) in a
      variety of signaling pathways. This kinase cascade has been shown to function in
      cell proliferation and differentiation, but its role in early vertebrate
      development remains to be investigated. During early vertebrate embryogenesis,
      the induction and patterning of mesoderm are thought to be determined by signals
      from intercellular factors such as members of the fibroblast growth factor (FGF)
      family and members of the transforming growth factor-beta family. Here we show
      that the microinjection of either mRNA encoding a constitutively active mutant of
      MAPKK or mRNA encoding a constitutively active form of STE11, a MAPKK kinase,
      leads to the induction of mesoderm in ectodermal explants from Xenopus embryos.
      Moreover, the expression of MAPK phosphatase-1 (MKP-1, also called CL100) blocks
      the growth factor-stimulated mesoderm induction. Furthermore, injection of CL100
      mRNA into two-cell stage embryos causes severe defects in gastrulation and
      posterior development. The effects induced by CL100 can be rescued by co
      injection of wild-type MAPK mRNA. Thus, the MAPK cascade may play a crucial role
      in early vertebrate embryogenesis, especially during mesoderm induction.

PMID- 7781603
TI  - Biochemical and genetic analysis of the Drk SH2/SH3 adaptor protein of
      Drosophila.
AB  - The Drk SH3-SH2-SH3 adaptor protein has been genetically identified in a screen
      for rate-limiting components acting downstream of the Sevenless (Sev) receptor
      tyrosine kinase in the developing eye of Drosophila. It provides a link between
      the activated Sev receptor and Sos, a guanine nucleotide release factor that
      activates Ras1. We have used a combined biochemical and genetic approach to study
      the interactions between Sev, Drk and Sos. We show that Tyr2546 in the
      cytoplasmic tail of Sev is required for Drk binding, probably because it provides
      a recognition site for the Drk SH2 domain. Interestingly, a mutation at this site
      does not completely block Sev function in vivo. This may suggest that Sev can
      signal in a Drk-independent, parallel pathway or that Drk can also bind to an
      intermediate docking protein. Analysis of the Drk-Sos interaction has identified
      a high affinity binding site for Drk SH3 domains in the Sos tail. We show that
      the N-terminal Drk SH3 domain is primarily responsible for binding to the tail of
      Sos in vitro, and for signalling to Ras in vivo.

PMID- 7781604
TI  - Tyrosine phosphorylation of an SH2-containing protein tyrosine phosphatase is
      coupled to platelet thrombin receptor via a pertussis toxin-sensitive
      heterotrimeric G-protein.
AB  - SH-PTP1 is a protein tyrosine phosphatase (PTP) predominantly expressed in
      haematopoietic cells and containing two src homology-2 (SH2) domains. Here we
      report that SH-PTP1 is phosphorylated on both serine and tyrosine residues in
      response to thrombin or phorbol myristate acetate (PMA), which increased by 60
      and 40%, respectively, SH-PTP1 activity. Thrombin-induced phosphorylation of SH
      PTP1 is an early signalling event (maximal within 10 s) involving neither
      integrin signalling, nor calcium, nor release of ADP or thromboxane A2. Moreover,
      in contrast with PMA, the effect of thrombin on the tyrosine phosphorylation of
      SH-PTP1 was hardly affected by GF109203X, a specific protein kinase C (PKC)
      inhibitor. Finally, phosphorylation of SH-PTP1 could be provoked in permeabilized
      platelets by thrombin or GTP gamma S. This was abolished by pertussis toxin, the
      specificity of this effect being verified with the megakaryocytic cell line Dami
      cell. Our data thus identify SH-PTP1 as an in vivo substrate of a putative
      protein tyrosine kinase linked to the thrombin receptor by a Gi protein. This
      might offer some clue to unravel the mechanism of thrombin not only in platelets
      but also in nucleated cells, where its mitogenic effect is known to involve
      pertussis toxin-sensitive G-proteins, tyrosine phosphorylation and the ras
      pathway.

PMID- 7781605
TI  - Interleukin 2 and erythropoietin activate STAT5/MGF via distinct pathways.
AB  - Signal transducers and activators of transcription (STAT) proteins play an
      important role in cytokine signal transduction in conjunction with Janus kinases
      (JAKs). MGF/STAT5 is known as prolactin regulated STAT. Here we demonstrate that
      interleukin 2 (IL-2) as well as erythropoietin (EPO) stimulate STAT5 and induce
      tyrosine phosphorylation of STAT5. These IL-2- and EPO-induced STATs have an
      identical DNA binding specificity and immunoreactivity. We also show that IL-4
      induces a DNA binding factor which possesses similar, but distinct, DNA binding
      specificity from that of STAT5 and is immunologically different from STAT5.
      Analysis of two EPO receptor (EPOR) transfected CTLL-2 cell lines discloses that
      IL-2 activates JAK1 and JAK3 as well as STAT5, while EPO stimulates STAT5 and
      JAK2 in EPO-responsive CTLL-2 cells (ERT/E2). On the contrary, EPO activates
      neither JAK2 nor STAT5 in other cell lines that failed to respond to EPO (ERT
      cells). EPOR and JAK2 associate with each other regardless of EPO presence in
      ERT/E2 cells, however, such an interaction is not present in ERT cells. Thus,
      EPOR and JAK2 association seems to be important for EPO responsiveness in CTLL-2
      cells.

PMID- 7781606
TI  - Proviral tagging in E mu-myc transgenic mice lacking the Pim-1 proto-oncogene
      leads to compensatory activation of Pim-2.
AB  - The Pim-1 proto-oncogene is one of the most potent collaborators of the myc proto
      oncogenes in inducing lymphomagenesis in mice. Contrary to the profound effects
      when overexpressed in vivo, Pim-1-deficient mice showed only subtle phenotypic
      alterations, which could indicate the presence of redundantly acting genes. In
      line with this, a PCR-based screen has led to the identification of a closely
      homologous gene, Pim-2. The X-linked Pim-2 gene is 53% identical to Pim-1 at the
      amino acid level and shares substrate preference and the usage of non-AUG
      initiation codons with Pim-1. We have used these data to test whether the strong
      synergistic interaction between Pim-1 and c-myc can be utilized to gain access to
      Pim-1 compensatory pathways. We reasoned that, upon proviral tagging in compound
      mutant mice (E mu-myc/Pim-1-/- mice), the selective advantage of cells carrying
      provirally activated genes, that act downstream from or parallel to Pim-1, would
      increase. We show here that this is the case. A dramatic increase (from 15 to
      80%) was found in the frequency of proviral activation of the Pim-2 gene. These
      data show that the described strategy of 'complementation tagging' represents a
      powerful new tool to identify components of pathways involved in processes as
      complex as multistep tumorigenesis.

PMID- 7781607
TI  - Silencing of Escherichia coli bgl promoter by flanking sequence elements.
AB  - Silencing of a transcriptional unit by flanking sequence elements has so far only
      been described for eukaryotic systems. Here, a similar system is described in
      bacteria. The Escherichia coli bgl operon (beta-glucoside utilization) is
      normally cryptic due to very low promoter activity. However, low activity is not
      attributable to the quality of the promoter itself but is caused by its
      chromosomal context. The bgl promoter is perfectly active when tested outside of
      its normal context of a stretch of a few hundred base pairs. In addition, other
      promoters become inactivated when placed into the bgl region. Both the deletion
      of an upstream sequence element and the replacement of sequences located
      downstream result in promoter de-repression, demonstrating that silencing of
      promoters within this stretch of DNA in vivo is an active process brought about
      by the combined action of upstream and downstream chromosomal elements.

PMID- 7781608
TI  - Escherichia coli FtsH is a membrane-bound, ATP-dependent protease which degrades
      the heat-shock transcription factor sigma 32.
AB  - Escherichia coli FtsH is an essential integral membrane protein that has an AAA
      type ATPase domain at its C-terminal cytoplasmic part, which is homologous to at
      least three ATPase subunits of the eukaryotic 26S proteasome. We report here that
      FtsH is involved in degradation of the heat-shock transcription factor sigma 32,
      a key element in the regulation of the E. coli heat-shock response. In the
      temperature-sensitive ftsH1 mutant, the amount of sigma 32 at a non-permissive
      temperature was higher than in the wild-type under certain conditions due to a
      reduced rate of degradation. In an in vitro system with purified components, FtsH
      catalyzed ATP-dependent degradation of biologically active histidine-tagged sigma
      32. FtsH has a zinc-binding motif similar to the active site of zinc
      metalloproteases. Protease activity of FtsH for histidine-tagged sigma 32 was
      stimulated by Zn2+ and strongly inhibited by the heavy metal chelating agent o
      phenanthroline. We conclude that FtsH is a novel membrane-bound, ATP-dependent
      metalloprotease with activity for sigma 32. These findings indicate a new
      mechanism of gene regulation in E. coli.

PMID- 7781609
TI  - Fate of linear and supercoiled multinucleosomic templates during transcription.
AB  - Electron microscopy was used to monitor the fate of reconstituted nucleosome
      cores during in vitro transcription of long linear and supercoiled
      multinucleosomic templates by the prokaryotic T7 RNA polymerase and the
      eukaryotic RNA polymerase II. Transcription by T7 RNA polymerase disrupted the
      nucleosomal configuration in the transcribed region, while nucleosomes were
      preserved upstream of the transcription initiation site and in front of the
      polymerase. Nucleosome disruption was independent of the topology of the
      template, linear or supercoiled, and of the presence or absence of nucleosome
      positioning sequences in the transcribed region. In contrast, the nucleosomal
      configuration was preserved during transcription from the vitellogenin B1
      promoter with RNA polymerase II in a rat liver total nuclear extract. However,
      the persistence of nucleosomes on the template was not RNA polymerase II
      specific, but was dependent on another activity present in the nuclear extract.
      This was demonstrated by addition of the extract to the T7 RNA polymerase
      transcription reaction, which resulted in retention of the nucleosomal
      configuration. This nuclear activity, also found in HeLa cell nuclei, is heat
      sensitive and could not be substituted by nucleoplasmin, chromatin assembly
      factor (CAF-I) or a combination thereof. Altogether, these results identify a
      novel nuclear activity, called herein transcription-dependent chromatin
      stabilizing activity I or TCSA-I, which may be involved in a nucleosome transfer
      mechanism during transcription.

PMID- 7781610
TI  - Poly(dA:dT), a ubiquitous promoter element that stimulates transcription via its
      intrinsic DNA structure.
AB  - Many yeast promoters contain homopolymeric dA:dT sequences that affect nucleosome
      formation in vitro and are required for wild-type levels of transcription in
      vivo. Here, we show that poly(dA:dT) is a novel promoter element whose function
      depends on its intrinsic structure, not its interaction with sequence-specific,
      DNA-binding proteins. First, poly(dA:dT) stimulates Gcn4-activated transcription
      in a manner that is length dependent and inversely related to intracellular Gcn4
      levels. Second, Datin, the only known poly(dA:dT)-binding protein, behaves as a
      repressor through poly(dA:dT) sequences. Third, poly(dG:dC), a structurally
      dissimilar homopolymer that also affects nucleosomes, has transcriptional
      properties virtually identical to those of poly(dA:dT). Three probes of chromatin
      structure including HinfI endonuclease cleavage in vivo indicate that poly(dA:dT)
      increases accessibility of the Gcn4 binding site and adjacent sequences in
      physiological chromatin. These observations suggest that, by virtue of its
      intrinsic structure, poly(dA:dT) locally affects nucleosomes and increases the
      accessibility of transcription factors bound to nearby sequences.

PMID- 7781611
TI  - A novel signal transduction pathway from the endoplasmic reticulum to the nucleus
      is mediated by transcription factor NF-kappa B.
AB  - The inducible, higher eukaryotic transcription factor NF-kappa B is activated by
      a variety of external stimuli including inflammatory cytokines, viral and
      bacterial infection and UV irradiation. Here we show that internal stress, caused
      by the accumulation of proteins in the endoplasmic reticulum (ER), also induces
      NF-kappa B DNA binding as well as kappa B-dependent gene expression. This was
      observed upon expression of immunoglobulin mu chains in the absence of light
      chains and by treatment of cells with several agents known to cause ER stress,
      such as tunicamycin, brefeldin A, 2-deoxyglucose and thapsigsargin. The
      transcription factor AP-1 was weakly induced under similar conditions.
      Overexpression of NF-kappa B subunits did not influence expression of the gene
      encoding grp78/BiP, a protein induced by various forms of ER stress. Likewise,
      the glucosidase inhibitor castanospermine, which induced grp78/BiP expression,
      failed to activate NF-kappa B, while the antioxidant dithiothreitol augmented
      grp78/BiP expression but prevented activation of NF-kappa B. Hence, NF-kappa B
      participates in a novel ER-nuclear signal transduction pathway distinct from the
      unfolded-protein-response described previously. We provide evidence that the ER
      can produce at least two distinct signals in response to a functional impairment.
      One is emitted by the presence of unfolded proteins, the other in response to
      overloading of the organelle, for example through the overexpression of secretory
      proteins.

PMID- 7781613
TI  - Codon-dependent conformational change of elongation factor Tu preceding GTP
      hydrolysis on the ribosome.
AB  - The mechanisms by which elongation factor Tu (EF-Tu) promotes the binding of
      aminoacyl-tRNA to the A site of the ribosome and, in particular, how GTP
      hydrolysis by EF-Tu is triggered on the ribosome, are not understood. We report
      steady-state and time-resolved fluorescence measurements, performed in the
      Escherichia coli system, in which the interaction of the complex EF-Tu.GTP.Phe
      tRNAPhe with the ribosomal A site is monitored by the fluorescence changes of
      either mant-dGTP [3'-O-(N-methylanthraniloyl)-2-deoxyguanosine triphosphate],
      replacing GTP in the complex, or of wybutine in the anticodon loop of the tRNA.
      Additionally, GTP hydrolysis is measured by the quench-flow technique. We find
      that codon-anticodon interaction induces a rapid rearrangement within the G
      domain of EF-Tu around the bound nucleotide, which is followed by GTP hydrolysis
      at an approximately 1.5-fold lower rate. In the presence of kirromycin, the
      activated conformation of EF-Tu appears to be frozen. The steps following GTP
      hydrolysis--the switch of EF-Tu to the GDP-bound conformation, the release of
      aminoacyl-tRNA from EF-Tu to the A site, and the dissociation of EF-Tu-GDP from
      the ribosome--which are altogether suppressed by kirromycin, are not
      distinguished kinetically. The results suggest that codon recognition by the
      ternary complex on the ribosome initiates a series of structural rearrangements
      resulting in a conformational change of EF-Tu, possibly involving the effector
      region, which, in turn, triggers GTP hydrolysis.

PMID- 7781612
TI  - Extensive interactions of PRP8 protein with the 5' and 3' splice sites during
      splicing suggest a role in stabilization of exon alignment by U5 snRNA.
AB  - Precursor RNAs containing 4-thiouridine at specific sites were used with UV
      crosslinking to map the binding sites of the yeast protein splicing factor PRP8.
      PRP8 protein interacts with a region of at least eight exon nucleotides at the 5'
      splice site and a minimum of 13 exon nucleotides and part of the polypyrimidine
      tract in the 3' splice site region. Crosslinking of PRP8 to mutant and duplicated
      3' splice sites indicated that the interaction is not sequence specific, nor does
      it depend on the splice site being functional. Binding of PRP8 to the 5' exon was
      established before step 1 and to the 3' splice site region after step 1 of
      splicing. These interactions place PRP8 close to the proposed catalytic core of
      the spliceosome during both transesterification reactions. To date, this
      represents the most extensive mapping of the binding site(s) of a splicing factor
      on the substrate RNA. We propose that the large binding sites of PRP8 stabilize
      the intrinsically weaker interactions of U5 snRNA with both exons at the splice
      sites for exon alignment by the U5 snRNP.

PMID- 7781614
TI  - Biogenesis, structure and function of the yeast 20S proteasome.
AB  - Intracellular degradation of many eukaryotic proteins requires their covalent
      ligation to ubiquitin. We previously identified a ubiquitin-dependent degradation
      pathway in the yeast Saccharomyces cerevisiae, the DOA pathway. Independent work
      has suggested that a major mechanism of cellular proteolysis involves a large
      multisubunit protease(s) called the 20S proteasome. We demonstrate here that Doa3
      and Doa5, two essential components of the DOA pathway, are subunits of the
      proteasome. Biochemical analyses of purified mutant proteasomes suggest functions
      for several conserved proteasome subunit residues. All detectable proteasome
      particles purified from doa3 or doa5 cells have altered physical properties;
      however, the mutant particles contain the same 14 different subunits as the wild
      type enzyme, indicating that most or all yeast 20S proteasomes comprise a uniform
      population of hetero-oligomeric complexes rather than a mixture of particles of
      variable subunit composition. Unexpectedly, we found that the yeast Doa3 and Pre3
      subunits are synthesized as precursors which are processed in a manner apparently
      identical to that of related mammalian proteasome subunits implicated in antigen
      presentation, suggesting that biogenesis of the proteasome particle is highly
      conserved between yeast and mammals.

PMID- 7781615
TI  - Initiation complex assembly at budding yeast replication origins begins with the
      recognition of a bipartite sequence by limiting amounts of the initiator, ORC.
AB  - Characterization of the proteins that interact with replication origins, as well
      as characterization of the mechanisms by which the levels and activities of these
      proteins are regulated during the cell cycle, is required to understand the
      initiation of chromosomal DNA replication in eukaryotic cells. We have previously
      shown that the first detectable step in the assembly of initiation complexes in
      vivo involves the binding of the multisubunit origin recognition complex (ORC)
      and the general transcription/replication factor ABF1 protein to origins. In this
      paper we show that ORC is present in cells at low levels, corresponding to little
      more than one complete complex per replication origin, indicating that in vivo
      origin recognition by ORC is extremely efficient. We show that this efficient
      recognition requires two sequence elements, the essential A element containing
      the ARS consensus sequence and the functionally important B1 element, both in
      vitro and in vivo. Moreover, we show that origin binding by ORC in vivo does not
      require any other functional sequence element, indicating that it occurs
      independently of the binding of other factors, such as ABF1. Our results suggest
      a model for the roles of the individual elements of yeast replication origins.

PMID- 7781617
TI  - Effects of Holliday junction position on Xer-mediated recombination in vitro.
AB  - Site-specific recombination mediated by XerC and XerD functions in the
      segregation of circular replicons in Escherichia coli. A key feature of most
      models of recombination for the family of recombinases to which XerC and XerD
      belong is that a Holliday junction forms at the position of the first pair of
      recombinase-mediated strand exchanges and then branch migrates 6-8 bp to the
      position of the second pair of strand exchanges. We have tested this hypothesis
      for Xer recombination by studying the effects of junction position on XerC
      mediated strand exchange in vitro. Recombination of synthetic Holliday junction
      substrates in which junction mobility was constrained to a region extending over
      or removed away from the normal cleavage and exchange point was analysed. All
      substrates undergo strand cleavage at the normal position. We infer that the
      Holliday junction need not be at this position during strand cleavage and
      exchange. With substrates in which the Holliday junction is constrained to a
      region away from the XerC-mediated cleavage point, strand exchange generates
      products with the predicted mispaired bases.

PMID- 7781618
TI  - McrB: a prokaryotic protein specifically recognizing DNA containing modified
      cytosine residues.
AB  - Restriction of DNA by the Escherichia coli K-12 McrBC restriction endonuclease,
      which consists of the two subunits McrB and McrC, depends on the presence of
      modified cytosine residues in a special constellation. From previous work by
      others it was known that restriction of 5-methylcytosine-containing DNA requires
      two methylated 5'-PuC sites separated by approximately 40-80 non-defined base
      pairs. Here we show that binding of the McrBC nuclease is mediated exclusively by
      the McrB subunit. McrB has a low affinity for non-methylated DNA, with which it
      forms low molecular weight complexes. The affinity for DNA is significantly
      increased, with variations depending on the sequence context, by hemi- or fully
      methylated 5'-PuC sites. Binding to such substrates yields high molecular weight
      complexes, presumably involving several McrB molecules. Methylation at unique 5'
      PuC sites can be sufficient to stimulate DNA binding by McrB. As such substrates
      are not cleaved by the nuclease, restriction apparently requires the coordinated
      interaction of molecules bound to neighbouring 5'-PumC sites. The binding
      properties of McrB exhibit some similarities to recently identified eukaryotic
      proteins interacting in a non-sequence-specific manner with DNA containing
      methylated 5'-CpG sequences and might point to a common molecular origin of these
      proteins. In addition to DNA, McrB also binds GTP, an essential cofactor in DNA
      restriction by McrBC. McrC neither binds to DNA nor modulates the DNA binding
      potential of McrB. As McrC is essential for restriction it appears to
      predominantly function in catalysis.

PMID- 7781616
TI  - Primosome assembly site in Bacillus subtilis.
AB  - A single-strand initiation site was detected on the Enterococcus faecalis plasmid
      pAM beta 1 by its ability to prevent accumulation of single stranded DNA of a
      rolling circle plasmid, both in Bacillus subtilis and Staphylococcus aureus. This
      site, designated ssiA, is located on the lagging strand template, approximately
      150 bp downstream from the replication origin. ssiA priming activity requires the
      DnaE primase, the DnaC replication fork helicase, as well as the products of the
      dnaB, dnaD and dnaI genes of B.subtilis, but not the RNA polymerase. The primase
      and the replication fork helicase requirements indicate that ssiA is a primosome
      assembly site. Interestingly, the pAM beta 1 lagging strand synthesis is
      inefficient when any of the proteins involved in ssiA activity is mutated, but
      occurs efficiently in the absence of ssiA. This suggests that normal plasmid
      replication requires primosome assembly and that the primosome can assemble not
      only at ssiA but also elsewhere on the plasmid. This work for the first time
      describes a primosome in a Gram-positive bacterium. Involvement of the B.subtilis
      proteins DnaB, DnaD and DnaI, which do not have any known analogue in Escherichia
      coli, raises the possibility that primosome assembly and/or function in
      B.subtilis differs from that in E.coli.

PMID- 7781620
TI  - Pituitary disorders during pregnancy.
AB  - A number of morphologic and physiologic changes accompany pregnancy such as an
      increase in lactotrophs and prolactin production, and a decrease in gonadotropins
      and GH. The hormonal milieu can affect patients with prolactinomas, especially
      macroadenomas, to cause an increase in size in a minority of patients.
      Complications are treated with bromocryptine. Enlargement of GH-secreting tumors
      with acromegaly may respond to bromocryptine and possibly to octreotide.
      Pituitary tumors causing Cushing's syndrome may need removal if major
      complications develop. Hypopituitarism during pregnancy may be the result of
      lymphocytic hypophysitis or antepartum pituitary necrosis, and in the postpartum
      period may be because of postpartum hemorrhage and pituitary necrosis. These
      abnormalities need prompt recognition and hormonal replacement therapy with
      neurosurgical decompression to avoid serious morbidity and mortality. Posterior
      pituitary problems in pregnancy usually manifest by diabetes insipidus, with a
      pregnancy-specific variety resulting from excessive degradation of AVP by
      placental vasopressinase. The condition is treated with an analogue dDAVP, which
      is resistant to vasopressinase.

PMID- 7781619
TI  - Sequence variability within the tobacco retrotransposon Tnt1 population.
AB  - Retroviruses consist of populations of different but closely related genomes
      referred to as quasispecies. A high mutation rate coupled with extremely rapid
      replication cycles allows these sequences to be highly interconnected in a rapid
      equilibrium. It is not known if other retroelements can show a similar population
      structure. We show here that when the tobacco Tnt1 retrotransposon is expressed,
      its RNA is not a unique sequence but a population of different but closely
      related sequences. Nevertheless, this highly variable population is not in a
      rapid equilibrium and could not be considered as a quasispecies. We have thus
      named the structure presented by Tnt1 RNA quasispecies-like. We show that the
      expression of Tnt1 in different situations gives rise to different populations of
      Tnt1 RNA sequences, suggesting an adaptive capacity for this element. The
      analysis of the variability within the total genomic population of Tnt1 elements
      shows that mutations frequently occur in important regulatory elements and that
      defective elements are often produced. We discuss the implications that this
      population structure could have for Tnt1 regulation and evolution.

PMID- 7781622
TI  - Adrenal disorders of pregnancy.
AB  - In normal pregnancy, the maternal adrenal gland adapts to the physiologic changes
      necessary to sustain gestation. These changes protect the fetus and the mother,
      allowing for increased shunting of nutrients to the fetus and protection of
      immunologic rejection. The adrenal disorders pertinent to pregnancy include
      overactive and underactive secretion of adrenocortical hormones and tumors that
      secrete too much catecholamine. In addition, iatrogenic hypercortisolemia may be
      necessary to treat the mother for underlying diseases. The impact of iatrogenic
      hypercortisolemia on the fetus is addressed also.

PMID- 7781621
TI  - Pancreatic disorders of pregnancy. Diagnosis, management, and outcome of
      gestational diabetes.
AB  - Gestational diabetes is one of the more common medical problems of pregnancy.
      This article reviews the literature regarding the diagnosis and treatment and the
      controversy that surrounds gestational diabetes. The need for stricter guidelines
      for diagnosis and treatment and the evidence supporting this need are presented.
      Long-term follow-up evaluation for women with gestational diabetes and for their
      children is discussed.

PMID- 7781623
TI  - Calcium disorders of pregnancy.
AB  - This article begins with a discussion on changes in the maternal calcium
      parathyroid axis in response to pregnancy, followed by calcium disorders that can
      take place during pregnancy. Hypercalcemia and its subsequent disorders,
      including hyperparathyroidism, hypocalciuric hypercalcemia, and thyroid disease,
      are reviewed. Also, hypocalcemia and its subsequent disorders, including
      hypoparathyroidism, vitamin D deficiency, and hypomagnesemia, are addressed.
      Concluding the article are discussions on bone status and osteoporosis, calcium
      metabolism in pregnancy-induced hypertension and preeclampsia, and
      nephrolithiasis in pregnancy.

PMID- 7781624
TI  - Ovarian disorders of pregnancy.
AB  - Hormonal ovarian disorders are uncommon during pregnancy and present primarily as
      ovarian masses. The two most common conditions are luteomas and hyperreactio
      luteinalis. The most common clinical manifestation is maternal virilization,
      which occasionally affects the fetus also. Rarely, an acute abdomen can result
      from hemorrhage or torsion of the mass. Because most of the entities regress
      spontaneously following delivery, a conservative management approach that
      includes preserving the ovaries is warranted.

PMID- 7781626
TI  - Immunologic response in pregnancy. Its role in endocrine disorders of pregnancy
      and influence on the course of maternal autoimmune diseases.
AB  - During gestation, the immune system is challenged with establishing tolerance to
      the partial allograft represented by the paternal contribution to the fetal
      genome. That fact that cell-mediated immunity is decreased while T-cell-dependent
      immunoglobin production remains intact or is increased is generally accepted.
      This latter phenomenon can be placed in teleological perspective in terms of
      providing passive immunity to the fetus. T-cell lineages that diverge based on
      function and cytokine production have been identified. Pregnancy is associated
      with a relative increase in Th2-associated immunity, characterized by increased
      production of the cytokines IL-4 and IL-10. These changes occur concomitantly
      with increased immunoglobulin production and decreased Th1 immunity. IL-2 and
      interferon secretion characterize Th1 immunity, facilitating allograft rejection.
      These changes in Th1 and Th2 have implications for the clinical course of a
      several autoimmune diseases that may complicate pregnancy and the postpartum
      period.

PMID- 7781625
TI  - Relaxin and its role in pregnancy.
AB  - Relaxin is a 6000-d polypeptide, structurally related to insulin and the insulin
      like growth factors. Unlike insulin, the structure of which is remarkably well
      conserved among the vertebrates, relaxin sequences can vary by more than 50%
      between different species. Despite these large sequence variations, relaxins
      (with few exceptions) have very similar biologic activities in animal test
      systems. The reason for this has recently come to light: the receptor binding
      region of the B chain, in contrast to the rest of the molecule, is highly
      conserved between species. Relaxin is measured by bioassays employing interpubic
      ligament formation in mice and guinea pigs, and by inhibition of uterine
      motility. A more sensitive and efficient bioassay is urgently needed. In women,
      the target organs for relaxin are the uterine cervix, myometrium, endometrium,
      and decidua. Other presumptive but unproven targets are the pubic symphysis and
      sacroiliac joints, mammary glands, and pituitary gland. Circulating relaxin is
      secreted by the corpus luteum. The placenta, decidua, or both also produce
      relaxin, which does not enter the circulation but may act in an autocrine or
      paracrine fashion. hCG is a stimulus to luteal relaxin secretion. Other
      regulatory factors are poorly defined. Aluteal women are hyporelaxinemic, and yet
      are capable of normal vaginal delivery of their infants. Local effects of
      placental or decidual relaxin cannot be discounted in such subjects.
      Hyperrelaxinemia may occur in women with multiple gestations and ovarian
      stimulation, and may be associated with increased premature births. Serum relaxin
      also is elevated in pregnant diabetics, but its role in this condition has not
      been defined. Clearly, further investigations are needed to delineate the precise
      role of relaxin in human pregnancy.

PMID- 7781628
TI  - Pancreatic disorders of pregnancy. Pregestational diabetes.
AB  - The outcome of pregnancies complicated by pregestational diabetes, both insulin
      dependent and non-insulin-dependent, has changed dramatically since the discovery
      of insulin in the early 1920s. Now, patients with pregestational diabetes can
      safely undergo a pregnancy and be assured that the infant will be healthy.
      Unfortunately, a finite risk of problems still may occur, including congenital
      malformations, spontaneous abortions, and diabetic fetopathy classically manifest
      as a macrosomic infant. Treatment strategies, although tedious and sometimes
      onerous, do minimize these risks.

PMID- 7781627
TI  - Thyroid disorders of pregnancy.
AB  - Practical aspects in the management of thyroid diseases in pregnancy are
      reviewed. Information on the hypothalamic-pituitary thyroid axis function in
      pregnancy and transplacental passages of thyroid hormones is discussed. Diagnosis
      and management of thyroid dysfunction in pregnancy are updated together with the
      management of women on thyroid replacement therapy at the time of conception. A
      practical evaluation of thyroid nodules in pregnancy is suggested. Finally, the
      syndrome of postpartum thyroid dysfunction is reviewed, stressing the importance
      of proper diagnosis and the need for long-term follow-up evaluation of these
      patients.

PMID- 7781629
TI  - Anaesthesia and microvascular surgery: clinical practice and research.

PMID- 7781630
TI  - Impact of ischaemia on diastolic function: clinical relevance and recent Doppler
      echocardiographic insights.

PMID- 7781631
TI  - The influence of preload on post-systolic shortening in ischaemic myocardium.
AB  - Post-systolic shortening is a wall motion abnormality defined as shortening of
      cardiac muscle after the end of ejection and usually regarded as a manifestation
      of ischaemia. This study was designed to determine whether changes in preload may
      alter the magnitude of ischaemia-induced post-systolic shortening. Eleven beagles
      were anaesthetized (halothane 0.8%) and instrumented for measurement of
      pressures, flows and dimensions in the apical subendocardium supplied by the left
      anterior descending coronary artery. Myocardial ischaemia was obtained by
      tightening a micrometer-controlled snare around the left anterior descending
      coronary artery. Post-systolic shortening, calculated as end-systolic length
      minus minimum length divided by end-systolic length, was measured at different
      levels of preload. Increasing the preload from 4 to 17 mmHg caused a significant
      reduction in post-systolic shortening (8.9% vs. 12.9%, P < 0.05, Student's paired
      t-test); post-systolic shortening was negatively correlated with coronary
      perfusion pressure (r = 0.35, P < 0.01) and positively correlated with systolic
      bulging. This study demonstrates that the amount of post-systolic shortening
      depends on the volume status, which therefore has to be taken into account in
      interpreting regional wall motion abnormalities, such as those detected by
      echocardiography.

PMID- 7781632
TI  - Continuous spinal anaesthesia versus single dosing. A comparative study.
AB  - Continuous and single dose spinal anaesthesia were compared in a prospective
      randomized fashion in 108 patients undergoing orthopaedic surgery. Continuous
      spinal anaesthesia was via a 20 gauge polyamide multiperforated catheter
      introduced through an 18 gauge Tuohy needle. Single-dose spinal anaesthesia was
      performed with a 24 guage x 103 mm Sprotte spinal needle. The mean local
      anaesthetic dose for the continuous technique was 38.4 (SD 16.5) mg as hyperbaric
      lignocaine 5%, and for the single-dose spinal anaesthesia 10.8 (SD 2.2) mg as
      hyperbaric bupivacaine 0.5%. Segmental levels reached with the initial dose did
      not differ significantly between the two groups. Mean time required to perform
      continuous spinal anaesthesia was 6.7 (SD 3.9) min, which was longer than for
      single dose 4.9 (SD 2.8) min (P < 0.05). The onset time and efficacy of
      anaesthesia, and the duration of the operation were similar in the two groups.
      Analgesia was inadequate in six patients who received continuous spinal
      anaesthesia (11%) and one patient who received single dose (2%) (P = 0.18).
      Hypotension was more frequent in those receiving single doses (P < 0.05). Caudal
      rotation of the outlet needle orifice to advance the catheter correlated with
      inadequate analgesia (P < 0.01, r = 0.38). There were no significant differences
      in the incidence of post-operative complications.

PMID- 7781633
TI  - The effects of thiopentone, etomidate, ketamine and midazolam on several
      bactericidal functions of polymorphonuclear leucocytes in vitro.
AB  - Polymorphonuclear leucocytes (PMNL) are an essential component of the defence
      system against invading bacteria. There is evidence that some anaesthetics are
      able to suppress PMNL functions, promoting, perhaps, perioperative infection. We
      studied the effects of thiopentone, etomidate, ketamine, and midazolam on the
      generation of bactericidal agents (superoxide anion, hydrogen peroxide, and
      myeloperoxidase) by PMNL in vitro. Thiopentone inhibited superoxide anion (P < or
      = 0.01) as well as hydrogen peroxide production (P < or = 0.001). However, there
      was no statistically significant effect on myeloperoxidase release. Neither
      etomidate nor ketamine influenced the PMNL functions tested to any extent.
      Midazolam suppressed superoxide anion generation (P < or = 0.01) but only if a
      concentration far beyond clinical relevance was used.

PMID- 7781636
TI  - New technique of sciatic nerve block in the popliteal fossa.
AB  - A new technique of sciatic nerve block in the popliteal fossa was evaluated in
      120 patients using an 18 s.w.g. cannula. Precise placement of the cannula was
      facilitated with the aid of a nerve stimulator. In addition to an initial dose of
      1% prilocaine with adrenaline 1: 200,000 (5 mg kg-1), 5 mL 0.5% bupivacaine was
      used for blockade of the saphenous nerve distal to the medial tibial condyle. One
      third or one-quarter of the initial dose was administered when required for
      augmentation of anaesthesia or post-operative pain relief. Satisfactory
      anaesthesia was achieved in 117 patients (97.5%); two patients required general
      anaesthesia, since repositioning of the cannula after initial application of
      local anaesthetic was strictly avoided. No post-operative complications relating
      to the nerve block were observed. This technique of sciatic nerve block in the
      popliteal fossa provides effective and safe anaesthesia of the lower leg.

PMID- 7781635
TI  - Nitrous oxide with fentanyl and droperidol minimizes lipid peroxidation in the
      liver.
AB  - We have studied the level of lipid peroxidation in the liver of rats exposed to
      nitrous oxide plus oxygen or injected with droperidol of fentanyl. The effect of
      nitrous oxide used in combination with droperidol and fentanyl was also
      investigated. All the tested anaesthetics caused lipid peroxidation in the rat
      liver. It seems likely, however, that the mechanism by which droperidol and
      fentanyl initiate lipid peroxidation differs from that which nitrous oxide uses.
      Free radical products and/or activated oxygen species are produced during
      fentanyl and droperidol metabolism in the liver. However, nitrous oxide is not
      metabolized in the liver and probably undergoes one electron reduction outside
      the liver thus producing free radical products and/or activated oxygen species
      which are able to diffuse and initiate lipid peroxidation in the liver. It was
      also found that the level of lipid peroxidation in the liver of rats injected
      with droperidol and fentanyl and then exposed to nitrous oxide was low and close
      to that of the control animals. We suggest that, when used in combination, the
      products generated outside the liver as a result of nitrous oxide metabolism are
      transported to the liver and take part in reactions with the products of the
      metabolism of droperidol and fentanyl, thus decreasing the concentration of the
      species able to initiate lipid peroxidation.

PMID- 7781637
TI  - Mid-latency auditory evoked potentials and wakefulness during caesarean section.
AB  - We investigated intra-operative wakefulness and mid-latency auditory evoked
      potentials (MLAEP) in 20 patients undergoing elective Caesarean section under
      general anaesthesia. Anaesthesia was induced with thiopentone 5 mg kg-1 i.v. and
      succinylcholine 1-1.5 mg kg-1 i.v. After delivery, a balanced anaesthetic
      technique was maintained using fentanyl 0.2-0.3 mg i.v., enflurane 0.4-1.0 vol%
      end-expired concentration and 50% N2O in oxygen. Purposeful movements were
      interpreted as signs of inadequate anaesthesia and intra-operative wakefulness.
      They were recorded as either spontaneous movements or in response to one of two
      audio tapes (tape A: sound of a crying baby; tape B: classical music). Post
      operatively, intra-operative dreams, hallucinations and detailed reports about
      intra-operative events were evaluated. Auditory evoked potentials were recorded
      online before and during general anaesthesia. Twenty spontaneous purposeful
      movements were observed in 12 patients, seven before or during delivery and 13
      after delivery. Four purposeful movements were observed after presentation of the
      sound of a crying baby but only one after classical music. Dreams and
      hallucinations were reported by nine patients. Two patients reported experiencing
      surgical manipulations. In the awake state MLAEPs had great peak-to-peak
      amplitudes and a periodic waveform. Under adequate levels of general anaesthesia
      MLAEPs showed a marked increase in latency and decrease in amplitude or were even
      suppressed completely. This increase in latencies and decrease in amplitude of
      MLAEP was absent in patients who reported intraoperative events and during
      spontaneous or provoked motor reactions.

PMID- 7781634
TI  - Spontaneous respiration versus controlled ventilation anaesthesia with halothane
      for intra-ocular surgery.
AB  - One hundred and thirty-seven patients were randomly allocated to receive
      halothane anaesthesia for intra-ocular surgery either by IPPV (n = 71) or
      breathing spontaneously (n = 66). Both techniques provided satisfactory operating
      conditions in 87% and 80% of procedures, respectively. Intra-ocular pressure was
      reduced in a similar majority of patients, rose in a similar percentage
      (spontaneous = 11%, controlled = 21%) and remained unchanged in a few. Surgeons'
      reports of good operative conditions correlated very well with intra-ocular
      pressure changes whether they rose or fell intra-operatively. The duration of
      anaesthesia and the time taken to achieve full recovery following the two
      techniques were similar. Post-operative vomiting, headache, sore throat and
      confusion occurred with similar frequency, and analgesic and antiemetic
      requirements were not influenced by the technique. Resumption of ambulation, oral
      intake and micturation occurred similarly. In both groups, patients with a low
      normal pre-operative intra-ocular pressure tended to show a rise in intra-ocular
      pressure during anaesthesia, and those with a high normal pre-operative intra
      ocular pressure tended to show a fall.

PMID- 7781638
TI  - Accidental intravenous administration of 50 mg of racemic adrenaline in a 2-year
      old boy.
AB  - A 2-year-old boy received, by mistake, 50 mg racemic adrenaline intravenously,
      equivalent to 1.8 mg kg-1 of L-adrenaline. The blood pressure increased to
      160/105 mmHg, the heart rate to 160 beats min-1, and pulmonary oedema developed
      over the next 2 h. He was treated with nitroprusside, nitroglycerin and
      digitoxin, and was intubated and ventilated. After 3 h a hypotensive phase
      occurred which required infusions of very high concentrations of catecholamines
      for 72 h. Renal failure required renal transplantation after which the child made
      an uneventful recovery.

PMID- 7781639
TI  - Caesarean section in chronic renal failure.
AB  - A 22-year-old woman presented for Caesarean section at 34 weeks' gestation. She
      had chronic renal failure, with a glomerular filtration rate of 14 mL min-1 and
      was treated with twice weekly dialysis. We describe the potential problems of the
      case including cardiovascular instability, fluid balance and some of the effects
      of uraemia. We also describe the anaesthetic management of the case.

PMID- 7781640
TI  - Emergency intubation with the Combitube in two cases of difficult airway
      management.
AB  - The airway was managed successfully in two cases of difficult intubation using
      the Combitube, a new device for emergency intubation, which combines the
      functions of an oesophageal obturator airway and a conventional endotracheal
      airway. One patient could not be intubated due to lockjaw; in the other patient,
      the vocal cords could not be seen because of continued vomiting. The cases
      illustrate the benefit of the Combitube during emergency intubation for different
      problems and its effectiveness as an alternative to traditional intubation
      techniques.

PMID- 7781641
TI  - Thromboxane A2 receptor antagonist (ONO 3708) protects from liver damage induced
      by cholestasis and ischemia-reperfusion.
AB  - The effect of a thromboxane (Tx) A2 receptor antagonist, ONO 3708, on cholestasis
      and injury related to ischemia and subsequent reperfusion (I-R) was investigated
      in the dog liver by assessing changes in insulin and glucagon metabolism. The
      left hepatic duct was ligated for 4 weeks to create a cholestatic lobe. Sixty
      minute ischemia was induced by Pringle's procedure. ONO 3708 (200
      micrograms/kg/min) was initiated 60 min before induction of ischemia and
      continued throughout the experiment. The rate of insulin metabolism was higher in
      the right noncholestatic lobe than in the left cholestatic lobe. There was no
      significant difference in the rate of glucagon metabolism between the right and
      left lobes. After induction of I-R, the rate of insulin metabolism, but not
      glucagon metabolism, decreased. The lipid peroxide level was higher and the
      glutathione level was lower in the cholestatic lobe than in the noncholestatic
      lobe. There was no significant difference in the alpha-tocopherol level between
      lobes. After induction of I-R, the lipid peroxide level increased and the alpha
      tocopherol level decreased. There was no change in the glutathione level. I-R
      accelerated the release of 6-keto-prostaglandin (PG) F1 alpha, a stable
      metabolite of PGI2, and of TxB2, a stable metabolite of TxA2, from the liver.
      After I-R, cholestasis accelerated the release of TxB2, but not 6-keto-PGF1
      alpha. I-R also increased the TxB2/6-keto-PGF1 alpha ratio. ONO 3708 reduced
      these metabolic changes in the cholestasis and after I-R. These findings suggest
      that ONO 3708 protects liver function, especially in the cholestatic lobe, from I
      R-related injury by reducing peroxidation of lipids and the TxA2/PGI2 ratio,
      which predicts cellular damage, and by increasing levels of alpha-tocopherol and
      glutathione.

PMID- 7781642
TI  - Effect of cyclosporine A on the demethylation of aminopyrine in rats in vivo.
AB  - Serial determinations of hepatic function by quantitative tests might provide
      clinically useful information following liver transplantation provided that the
      test result is not influenced by the immunosuppressive regimen. To investigate
      the effect of cyclosporine A with and without prednisolone on established
      quantitative tests of hepatic function, rats were fed cyclosporine A at a dose
      resulting in average through blood levels of 1,176 ng/ml, and the aminopyrine
      breath test which reflects microsomal function, the decarboxylation of
      ketoisocaproic acid which reflects mitochondrial function and the galactose
      breath test which reflects cytosolic function were performed at intervals.
      Cyclosporine A did not impair the demethylation of aminopyrine and the
      decarboxylation of ketoisocaproic acid in vivo. The metabolism of galactose was
      enhanced by 25%. The results indicate that in contrast to in vitro experiments,
      where cyclosporine A has been shown to markedly inhibit the demethylation of
      aminopyrine and to result in a decrease of cytochrome P-450, therapeutic
      concentrations of cyclosporine A and prednisolone do not impair aminopyrine
      demethylation in vivo. Thus, the aminopyrine breath test is a reliable index of
      hepatic function also in the presence of immunosuppressive treatment.

PMID- 7781644
TI  - Effect of bile obstruction on liver regeneration following major hepatectomy: an
      experimental study in the rat.
AB  - The regeneration of the liver following resection is regulated by a variety of
      factors and it might be expected that jaundice influences the process. We
      therefore evaluated the regenerative response to major hepatectomy in bile
      obstructed rats. Two weeks after ligation of the common bile duct, a standardized
      77% hepatectomy was undertaken. The jaundiced animals showed an augmented liver
      regeneration compared to nonjaundiced individuals (p < 0.01). However, blood
      clearance of radiolabelled Escherichia coli bacteria was impaired (p < 0.01) in
      animals with bile obstruction at 7 days after the hepatectomy, accompanied by
      reduced bacterial uptake in the liver as a sign of impaired reticuloendothelial
      system function.

PMID- 7781643
TI  - Effects of oxygen radicals on cysteinyl leukotriene metabolism and pulmonary
      circulation in young pigs.
AB  - The effects of oxygen radicals, generated by the hypoxanthine-xanthine oxidase
      (XO) system, on pulmonary circulation and release of cysteinyl-containing
      leukotrienes (LTs) were studied in pigs after XO infusion into the right atrium.
      A 2.3-fold increase in pulmonary vascular resistance (PVR) (p < 0.05 vs.
      baseline) and a 2.1-fold increase in LT release (p < 0.05 vs. baseline) was
      observed. Pretreatment with indomethacin and allopurinol attenauted the vascular
      response (p < 0.01 and p < 0.05 vs. XO), and the LT release was inhibited by
      allopurinol and catalase (p < 0.01 and p < 0.02 vs. XO). We conclude that oxygen
      radicals stimulate lipoxygenase metabolism. This coincides with the observed
      increase in PVR, however, no causal relationship can be derived from the data
      presented.

PMID- 7781645
TI  - Improved survival rate after portacaval shunt in the rat using a modified
      microsurgical technique.
AB  - It has been observed that portacaval shunt in the rat is accompanied by a high
      postoperative mortality rate and shunt patency is seldom optimal on long-term
      follow-up. The immediate postoperative mortality is directly related to the
      intraoperative duration of occlusion of the portal vein. In order to reduce the
      intraoperative occlusion time of the portal vein we devised a technique to
      construct half of the shunt without portal vein occlusion and the other half with
      occlusion. The total occlusion time was only 4-6 min. There was negligible
      postoperative mortality and shunt patency was 100% after 6-8 months' follow-up.
      The changes in body weight, organ weight and metabolic parameters were
      reproducible.

PMID- 7781646
TI  - Effect of allopurinol, folinic acid, SOD and cyclosporine A on ischemic liver
      regeneration.
AB  - Liver regeneration plays a key role in restoring the liver/body ratio after
      partial liver transplantation. However, hepatic ischemia hinders the
      proliferative response of the hepatocytes. In this study, different ways of
      improving the regenerating capacity of ischemic hepatocytes are tested. Following
      70% hepatectomy and 15 min of normothermic liver ischemia, the percentage of
      regenerating hepatocytes and the regenerative gradient are assessed. Cyclosporine
      A (hepatotrophic agent), superoxide dismutase and folinic acid (antioxidants),
      administered during the ischemic period, have significantly increased these
      indices. The later drug has restored the regenerative response to the levels of
      normoperfused livers.

PMID- 7781647
TI  - Deterioration of platelet energy metabolism following energy crisis of liver
      after hepatectomy.
AB  - The aim of this study is to investigate the relationship in energy metabolism
      between the platelet and the liver. The adenylate energy charge of human
      platelets and arterial ketone body ratio (AKBR:acetoacetate/3-hydroxybutyrate)
      were measured in 11 patients after hepatectomy. Hepatic energy crisis was defined
      as the decrease of AKBR below 0.7. The platelet energy charge was measured on the
      first (Day 1), the second (Day 2), third (Day 3) and sixth (Day 6) day during
      AKBR decreased and remained under 0.7. The values before AKBR decreased were
      employed as the control. The values of the platelet energy charge were 0.917 +/-
      0.008 in the control (n = 11) and 0.896 +/- 0.009 in all samples after AKBR
      decreased under 0.7 (n = 30). There was no significant difference between them.
      The values of energy charge were divided into four groups according to the
      periods of time after AKBR decreased and remained under 0.7 and compared. The
      energy charge was 0.923 +/- 0.006 (Day 1, n = 11), 0.907 +/- 0.008 (Day 2, n =
      10), 0.890 +/- 0.005 (Day 3, n = 5), and 0.815 +/- 0.012 (Day 6, n = 4). The
      energy charge of Day 3 was significantly lower than that of Day 1 (p < 0.01). The
      energy charge of Day 6 was significantly lower than that of Day 1, 2, 3 (p <
      0.001, p < 0.001, and p < 0.01, respectively). The 4 patients whose AKBR remained
      under 0.7 for more than 6 days had hemostatic disorder. The deterioration of the
      platelet energy charge metabolism lags behind that of the liver.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7781648
TI  - Haemoglobin saturation in the rat liver after ischaemia and reperfusion: study
      using a laser photometry technique and correlation with changes in liver tissue
      blood flow.
AB  - Tissue oxygenation depends on the volume of oxygen consumed by the tissue and the
      volume of oxygen supply. This is particularly important in the liver after
      ischaemia and reperfusion, due to the relatively low oxygen saturation of the
      portal blood flow, the main source of oxygen to the liver. In this study we
      established a correlation between the postischaemic liver blood flow and tissue
      haemoglobin saturation, measured by laser Doppler flowmetry and laser surface
      photometry, with the purpose of investigating the possible role of a
      postischaemic imbalance of oxygen delivery/uptake in reperfusion injury. The
      experimental procedure consisted of the temporary interruption of blood flow to
      the left lateral and medial lobes of the rat liver in vivo, and subsequent
      reperfusion after defined periods, recording the postischaemic liver blood flow
      and liver oxyhaemoglobin saturation. Changes were found in the postischaemic
      liver blood flow and haemoglobin saturation in all the groups when compared to
      control values, showing a correlation between the length of the period of
      ischaemia and the magnitude of the alteration in the reperfusion blood flow and
      oxygenation. These alterations may be considered as a prolongation of the
      metabolic condition of ischaemia and may be part of an additional tissue damage
      upon reperfusion.

PMID- 7781649
TI  - Effect of growth hormone on hepatic energy metabolism in normal rabbit liver.
AB  - Growth hormone (GH), which is well known as an anabolic agent in systemic protein
      metabolism but has catabolic effects on the carbohydrate metabolism in the liver,
      was administered to normal rabbit to investigate its effects on the hepatic
      energy metabolism. The changes in arterial ketone body ratio (AKBR:
      acetoacetate/3-hydroxybutyrate), which reflects the hepatic mitochondrial redox
      state ([NAD+]/[NADH]), after GH injection was studied as an indicator of the
      hepatic energy metabolism. GH was administered to normal rabbit at the doses of
      50 micrograms/kg (GH-50 group), 100 micrograms/kg (GH-100 group) and 200
      micrograms/kg (GH-200 group) by intravenous bolus injection. In the GH-50, GH-100
      and GH-200 groups, AKBR decreased significantly from 1.40 +/- 0.09 to 0.94 +/-
      0.05, from 1.19 +/- 0.11 to 0.83 +/- 0.14, and from 1.19 +/- 0.08 to 0.71 +/-
      0.15 at 90 min, respectively. The energy charge of the liver decreased
      significantly 90 min after 200 micrograms/kg GH injection from 0.872 +/- 0.003 to
      0.836 +/- 0.012 (p < 0.05). These results suggest that GH is associated with the
      deterioration of the hepatic energy metabolism, and that the administration of GH
      should be carefully weighed up in cases of damaged liver.

PMID- 7781650
TI  - Dynamic liver scintigraphy: a new way of measuring the function of the
      reticuloendothelial system of the liver.
AB  - The phagocytic function and biokinetics of the hepatic reticuloendothelial system
      (RES) were evaluated using a 25-nm diameter colloid (Nanocoll) and a
      scintillation camera technique in opossums with obstruction of the pancreatic
      duct (group I) and additional obstruction of the common bile duct (group II). The
      liver net uptake curve was analysed using natural log regression. The regression
      curves proved to fit very well (r > 0.93) and a parameter R was calculated to
      describe the curves. In group I there was a slight but significant decrease in
      the RES function and no morphological change in the pancreas. In group II, RES
      function was significantly more suppressed than in group I. The opossums
      developed severe haemorrhagic pancreatitis. The results show that the regression
      parameter R is well suited to described liver RES function, and suggest that a
      suppressed liver RES after biliary obstruction could be an important factor in
      the pathogenesis of biliary pancreatitis.

PMID- 7781651
TI  - Rapid determination of the membrane potential of mitochondria in small biopsy
      specimens of the liver.
AB  - In liver transplantation, graft viability is ideally to be determined before
      implantation. Integrity of mitochondria may be a prerequisite to a viable graft.
      A new method is presented, which allows for the determination of the membrane
      potential of mitochondria (MPM; mV) in state 4 respiration within 50 min in 40-mg
      specimens, employing rhodamine 123 as a probe. Normal control showed a MPM of
      239.2 mV. Storage in saline at 37 degrees C yielded an impaired MPM of 153.5 mV
      within 3 h. The cold storage at 1 degree C could preserve MPM at quasi-normal
      after 3 h but reduced it significantly after 24 h to 222.2 mV in saline (p <
      0.005 vs. control) and 231.0 mV in UW solution (p < 0.05 vs. control): the
      difference between the 24-hour values was significant (p < 0.05).

PMID- 7781652
TI  - Segmental organization of the pig liver: anatomical basis of controlled partition
      for experimental grafting.
AB  - Segmental anatomy has been investigated on 54 pig livers by bench-top radiology
      and ultrasonography of hepatic and portal vessels and bile ducts and dissection
      of suprahepatic veins. Eight segments were recognized, homologous to those of the
      human liver. Major variations were found only of arterial distribution. The
      inferior vena cava invariably ran within the parenchyma of the right lobe and
      close to the liver hilum; suprahepatic veins were also entirely intraparenchymal.
      Therefore, the pig liver can easily be divided into two halves, but only the
      right one can be used for reduced-size grafting into a recipient.

PMID- 7781653
TI  - Effect of pantothenic acid and ascorbic acid supplementation on human skin wound
      healing process. A double-blind, prospective and randomized trial.
AB  - This study aimed at testing human skin wound healing improvement by a 21-day
      supplementation of 1.0 g ascorbic acid (AA) and 0.2 g pantothenic acid (PA). 49
      patients undergoing surgery for tattoos, by the successive resections procedure,
      entered a double-blind, prospective and randomized study. Tests performed on both
      skin and scars determined: hydroxyproline concentrations, number of fibroblasts,
      trace element contents and mechanical properties. In the 18 supplemented
      patients, it was shown that in skin (day 8) Fe increased (p < 0.05) and Mn
      decreased (p < 0.05); in scars (day 21), Cu (p = 0.07) and Mn (p < 0.01)
      decreased, and Mg (p < 0.05) increased; the mechanical properties of scars in
      group A were significantly correlated to their contents in Fe, Cu and Zn, whereas
      no correlation was shown in group B. In blood, AA increased after surgery with
      supplementation, whereas it decreased in controls. Although no major improvement
      of the would healing process could be documented in this study, our results
      suggest that the benefit of AA and PA supplementation could be due to the
      variations of the trace elements, as they are correlated to mechanical properties
      of the scars.

PMID- 7781655
TI  - The backflow from the pulmonary circulation for identification of the aortic
      origin of the bronchial arteries in experimental left single lung
      transplantation.
AB  - The ideal solution to the bronchial healing problems in lung transplant would be
      the reconstruction of the bronchial arteries at time of transplantation. The
      problems with this approach are essentially technical being difficult to identify
      and preserve the bronchial arteries in humans. The purpose of this paper is to
      report our experience with an experimental model in dog to easily identify and
      preserve bronchial circulation in single lung transplantation. The technique is
      based on the preservation during harvesting of the aortic origin of the first
      five couples of arterial orifices. Identification of the orifice(s) connected
      with the bronchial circulation is carried out by the backflow which takes place
      from the pulmonary circulation after organ reperfusion is resumed. The identified
      orifice(s) is then anastomosed to the descending recipient aorta, tangentially
      clamped.

PMID- 7781654
TI  - Successful long-term cryopreservation of highly purified canine islets.
AB  - This study evaluated the ability of cryopreservation to store large quantities of
      canine islets for transplantation studies. Islets were isolated by automated
      screen methods and purified by Euro-Ficoll gradients. After overnight 37 degrees
      C incubation, islets were equilibrated with 2 M dimethylsulfoxide, cryopreserved
      at a cooling rate of 0.25 degree C/min and subjected to long-term storage in
      liquid nitrogen. Six months later, some islets were thawed at a rate of 180
      degrees C/min. The viability of cryothawed islets was determined in vitro by
      comparing islet count, total insulin content, morphology and perifusion studies
      in both control and cryothawed islets, and in vivo by transplantation into
      diabetic nude mice. The percentages of recovery of both islet count and total
      insulin content were 74.17 +/- 4.46 and 70.66 +/- 14.08, respectively. Islet
      morphology after cryothaw by light and electron microscopy revealed structurally
      intact islets with varying degrees of granulation. The results of perifusion
      indicated that there was no significant difference (p > 0.1) in both total
      stimulated insulin secretion and stimulation index response to high-dose glucose
      plus 3-isobutyl-1-methylxanthine and carbachol of isolated islets as compared to
      those of cryothawed islets. Transplantation into nude mice proved that grafted
      islets can successfully reverse diabetes. In conclusion, these findings indicate
      that the majority of purified canine islets can survive the frozen-thawed insult
      while maintaining their secretory function and permitting mass storage of canine
      islets for further transplant studies.

PMID- 7781656
TI  - Heparin effects on superoxide production by neutrophils.
AB  - Heparin is widely used in the treatment of various diseases, but the mechanisms
      of its biologic actions remain largely obscure. Recently, oxygen radicals, which
      are produced in a variety of conditions and cause tissue damage, have been
      implicated in the pathophysiology of various diseases. To investigate the
      relationship between heparin and oxygen radical production by neutrophils, we
      compared the effects of standard heparin (heparin sodium), which has been widely
      used, and a recently developed low molecular weight heparin (LMWH) which has
      potent anti-Xa activity, on neutrophil oxygen radical production in vitro.
      Standard heparin increased neutrophil oxygen radical production slightly at the
      low concentrations used clinically but reduced it at high concentrations, so that
      the effect of heparin on neutrophil oxygen radical production was biphasic. The
      effects of LMWH on neutrophil oxygen radical production were slight at both low
      and high concentrations. In disseminated intravascular coagulation (DIC) locally
      activated neutrophils produce oxygen radicals and have toxic effects in vivo.
      Thus we concluded that LMWH should be indicated for the treatment of DIC.

PMID- 7781657
TI  - Effect of allogeneic polymorphonuclear neutrophils on staphylococcal sepsis in
      mice.
AB  - The antibacterial and host-damaging properties of locally injected allogeneic
      polymorphonuclear neutrophils (PMN) were studied in vivo. Peritoneal PMN were
      obtained from donor mice 24 h after i.m. infection with sublethal (SD) and lethal
      (LD) dose of Staphylococcus aureus. These donor PMN were mixed with S. aureus and
      injected i.m. into normal recipient mice. Normal donor PMN and PMN obtained from
      SL-infected donor mice did not induce the mortality of SL-infected recipient mice
      but protected LD-infected recipients (5.8% mortality vs. 29.4%). PMN obtained
      from LD-infected donor mice caused ca. 77% mortality in SD-infected recipients.
      In survivors, during the first 3 h infection, serum tumor necrosis factor (TNF)
      concentrations were higher than those in nonsurvivors and then decreased. In
      contrast, TNF level in nonsurvivors continued to be increased until death. PMN
      from LD-infected donors had the highest spontaneous chemiluminescence response
      (CL), the shortest time of peak and the lowest level of intracellular CL against
      S. aureus. These donor PMN exhibited increased phagocytosis and decreased killing
      of S. aureus than that of PMN of SD-infected donor mice. Early stimulation of PMN
      functions such as bacterial internalization and respiratory burst may result in
      decrease of their tissue-damaging properties.

PMID- 7781658
TI  - Changes in intraosseous pressure at the distal femoral epiphysis induced by
      variations in knee-joint position and intracapsular saline infusion. An
      experimental study in dogs.
AB  - Hemodynamic changes at the distal femoral epiphysis measured by recording
      intraosseous pressure (IOP) were investigated in mature and juvenile dogs after
      changes in knee-joint position and intracapsular infusion of 3 ml isotonic saline
      solution. Juvenile and mature animals responded to infusion test with a similar 5
      fold increase in intracapsular pressure. A 2-fold increase in IOP was found when
      knee-joint flexion passed from 30 degrees to complete flexion. In juvenile dogs,
      IOP values were lower than in adults both in complete knee flexion and during
      infusion test. The similar response to joint hyperpressure tests observed in
      adult and juvenile dogs suggests that the barrier effect of the growth plate for
      epiphyseal venous drainage has no major influence in the hemodynamics of the
      distal femoral epiphysis.

PMID- 7781659
TI  - The lipoprotein composition of plasma and ascitic fluid in liver cirrhosis.
AB  - Lipoprotein particles were examined in plasma and ascitic fluid from nine
      patients (5 males and 4 females) with liver cirrhosis and in plasma from nine
      control subjects. LDL and HDL fractions were isolated by ultracentrifugation
      under rate flotation conditions in a zonal rotor. LDL size was analysed by non
      denaturing polyacrylamide gradient gel electrophoresis. Plasma lipids in
      cirrhotic patients were markedly reduced compared to controls. Free cholesterol
      represented 45.3% of the total cholesterol in plasma and 70.4% of the total
      cholesterol in the ascitic fluid. The total cholesterol-triglyceride ratio was
      three times higher in the plasma than in the ascitic fluid of cirrhotic patients.
      The LDL particles had the same flotation properties in plasma from cirrhotic
      patients as in that from controls. In cirrhotic patients the IDL concentration
      was higher than that in controls. In ascitic fluid the LDL particles had a higher
      flotation rate than in the plasma. The LDL diameter as measured by gradient gel
      electrophoresis was similar in both plasma and ascitic fluid of the cirrhotic
      patients as well as in the plasma of controls. In plasma and ascitic fluid of
      cirrhotic patients only a single HDL subclass (HDL1) could be identified. HDL1
      particles had a higher flotation rate than normal HDL particles. The plasma
      levels of all the apoproteins were reduced in cirrhotic subjects compared to
      controls, but to a variable degree; while apo CII level in cirrhosis represented
      only 9% of the control level, the apo E level represented 77% of the control
      level.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781660
TI  - Lipid peroxidation and susceptibility of low-density lipoprotein to in vitro
      oxidation in hyperhomocysteinaemia.
AB  - The pathobiochemical mechanism of arteriosclerosis in hyperhomocysteinaemia has
      not yet been elucidated. In vitro studies have shown that the cytotoxic
      properties of homocysteine can be ascribed to its generation of reactive oxygen
      species. We studied lipid peroxidation, both in vivo and in vitro, in 10
      homozygous cystathionine synthase-deficient (CSD) patients and in a control group
      of 10 healthy subjects of comparable age and sex. The susceptibility of low
      density lipoprotein (LDL) from hyperhomocysteinaemic patients to oxidation was
      determined in vitro by continuously measuring the conjugated diene production
      induced by incubation with copper ions. Oxidation resistance (expressed as lag
      time), maximal oxidation rate, and extent of oxidation (expressed as total diene
      production) of LDL from CSD patients were not significantly different from those
      of LDL from controls. Furthermore, the time needed to reach maximal diene
      production, i.e. t(max), was similar for LDL from patients and controls. In
      addition, the vitamin E concentrations in LDL of CSD patients and controls were
      similar. The mean concentration (+/- SD) of plasma thiobarbituric acid reactive
      substances (TBARS), an indicator of in vivo lipid peroxidation, was 2.2 +/- 0.7
      mumol L-1 in CSD patients, a lower value than that measured in the matched
      controls (5.0 +/- 2.0 mumol L-1). Investigation of in vivo and in vitro
      parameters of lipid peroxidation shows that the increased risk of
      arteriosclerosis in hyperhomocysteinaemia is unlikely to be due to increased
      lipid peroxidation.

PMID- 7781661
TI  - Phenotypic and immunoregulatory analysis of intestinal T-cells in patients with
      inflammatory bowel disease: evaluation of an in vitro model.
AB  - Although a disturbed immune response to constituents of the gut mucosa has been
      implicated in the pathogenesis of inflammatory bowel disease, the mechanisms are
      still unclear. Intestinal T-cells derived from gut biopsies were propagated in
      vitro as single and co-cultures under different experimental conditions prior to
      flow cytometry. Intestinal T-cell lines from inflamed mucosa (n = 69) showed a
      significant (P < 0.001) decrease in CD4+ T-cells compared to T-cells from normal
      (n = 49) and uninflamed (n = 29) tissue specimens. Co-culturing of inflamed and
      uninflamed mucosa led to a normalization of CD4+ T-cells in cultures derived from
      inflamed mucosa. Analysis of supernatants revealed a significantly (P < 0.001)
      increased secretion of IL-4 under co-culture conditions. Moreover, stimulation of
      cultures derived from inflamed mucosa with rIL-4 led to a significant (P < 0.001)
      increase in CD4+ T-cells, whereas anti-IL-4 antibodies or IFN-gamma
      supplementation of T-cells derived from uninflamed mucosa significantly (P <
      0.001) reduced the CD4+ subset. Treatment with IFN-gamma and anti-IL-4 antibodies
      did not affect the phenotype of T-cells derived from inflamed mucosa. These data
      suggest that IL-4 might play a key role in the intestinal immune response.
      Furthermore, this in vitro system allows the investigation of mucosal immune
      mechanisms in more detail under standardized conditions.

PMID- 7781663
TI  - Prolonged consumption of moderate doses of alcohol and in vitro gastro-duodenal
      and ileal contractility in the rat.
AB  - The effects of chronic feeding with moderate doses of ethanol (3% vol/vol in
      drinking water for 8 weeks), which do not induce tolerance, dependence and
      withdrawal, on the contractility of gastric, duodenal and ileal strips from rats
      were investigated. Only 50% of ethanol-treated specimens (as compared to 100% of
      saccharose-fed controls) exhibited antral phasic contractions (frequency
      decreased by 31% and 27% in the antrum and duodenum, respectively; P < 0.03 vs.
      controls). The depolarizing agent potassium chloride (KCl, 80 mM) produced less
      peak active tension in the fundus of ethanol-fed rats (P < 0.01). In alcoholic
      rats the sensitivity of the antrum to acetylcholine was fourfold less than that
      of control specimens. It is concluded that, in the rat, moderate doses of ethanol
      given chronically impair both spontaneous and tonic contractility of the stomach
      and duodenal muscle without affecting ileal contraction. It is possible that
      motility defects in the gut exposed to ethanol concentrations which do not cause
      tolerance, dependence or withdrawal in the rat may be due to a local rather than
      a systemic effect on the smooth muscle.

PMID- 7781662
TI  - Hormonal and renal responses to neutral endopeptidase inhibition in normal humans
      on a low and on a high sodium intake.
AB  - Hormonal and renal effects of candoxatril, a neutral endopeptidase 24.11
      inhibitor, were investigated in eight subjects equilibrated on a low sodium diet
      (10 mmol sodium per day) and a high sodium (350 mmol per day) diet. After
      candoxatril treatment, plasma ANP increased to a maximum at 2-4 h and declined to
      baseline within 24 h. The increases were relatively greater on the high sodium
      diet, which was also associated with increases in urinary sodium, with highest
      values at 4h. On the low sodium diet, the magnitude of the changes was
      significantly lower (24 h cumulative sodium excretion was 11.4 +/- 5.5 mmol on
      the low sodium diet and 73.1 +/- 25.6 mmol on the high sodium diet; P < 0.01).
      There were no significant effects on urinary potassium excretion, creatinine
      clearance or haematocrit. After candoxatril treatment there were reductions in
      PRA, especially on the low sodium diet. On either diet there were no effects on
      systemic blood pressure. These results demonstrate that dietary sodium intake is
      an important determinant of the renal and hormonal responses to neutral
      endopeptidase inhibition.

PMID- 7781665
TI  - Response of digital arteries to endothelium dependent and independent
      vasodilators in patients with Raynaud's phenomenon.
AB  - The cause of the digital artery spasm seen in Raynaud's phenomenon (RP) is
      unclear. A dysfunction of endothelium-dependent vasodilation might contribute to
      the development of this spasm. We studied the digital artery responses to
      endothelium-dependent and independent vasodilators in eight Raynaud's phenomenon
      patients and eight sex-matched controls. A sequential series of infusions
      alternating with physiological saline were administered at a rate of 1 mL min-1
      via the radial artery. The infusions contained acetylcholine chloride (ACh) 110
      nm mL-1 and 550 nm mL-1, L-arginine 50 mumol mL-1, prostacyclin (PGI2) 2.5 ng mL
      1 and glyceryl trinitrate (GTN) 4.5 nm mL-1. Digital artery diameter (DAD) and
      cutaneous temperature were measured. DAD was measured using a high frequency A
      mode ultrasound scanner. There was no significant difference in mean brachial
      artery pressure, digital cutaneous temperature and DAD between the two groups at
      the start of the study. Comparing responses in the groups, there was a
      significantly greater increase in DAD and cutaneous temperature to Ach
      (endothelium-dependent vasodilator) at both concentrations in controls. A
      significantly greater increase in DAD was obtained in response to GTN
      (endothelium-independent vasodilator) in the RP subjects. There was no
      significant difference in response to L-arginine and PGI2 between the groups.
      These results suggest that a dysfunction of endothelium-dependent vasodilation is
      present in RP patients.

PMID- 7781664
TI  - Hyperhomocysteinaemia and endothelial dysfunction in young patients with
      peripheral arterial occlusive disease.
AB  - Hyperhomocysteinaemia, defined as an abnormally high plasma homocysteine
      concentration after an oral methionine load, is common in young (< or = 50 years)
      patients with peripheral arterial occlusive disease. It is thought to predispose
      to atherosclerosis by injuring the vascular endothelium. Treatment with
      pyridoxine and/or folic acid may lower plasma homocysteine levels. In mildly
      hyperhomocysteinaemic patients with peripheral arterial occlusive disease, we
      studied the effect of daily treatment with pyridoxine (250 mg) plus folic acid (5
      mg) on homocysteine metabolism (i.e. plasma concentrations in the fasting state
      and after methionine loading, in 48 patients) and on endothelial function (in 18
      patients). Endothelial function was estimated as the plasma concentrations of the
      endothelium-derived proteins, von Willebrand factor (vWF), thrombomodulin (TM),
      and tissue-type plasminogen activator (tPA). At baseline, fasting homocysteine
      levels were above normal in 24 of the 48 patients (50%); post-load levels, by
      definition, were above normal in 100% of patients. After 12 weeks of treatment,
      fasting and post-load levels were normal in 98 and 100% of patients,
      respectively. Endothelial function was assessed in 18 patients who completed 1
      year of treatment. At baseline, median vWF (235%) and TM (57.1 ng mL-1) levels
      were above normal. At follow-up, vWF levels had decreased to 170% (P = 0.01) and
      TM levels had decreased to 49 ng mL-1 (P = 0.04). tPA levels were normal at
      baseline and did not change. Endothelial dysfunction is present in young patients
      with peripheral arterial occlusive disease and hyperhomocysteinaemia. Pyridoxine
      plus folic acid treatment normalizes homocysteine metabolism in virtually all
      patients, and appears to ameliorate endothelial dysfunction.

PMID- 7781666
TI  - Radioiodine therapy of Graves' hyperthyroidism: standard vs. calculated 131iodine
      activity. Results from a prospective, randomized, multicentre study.
AB  - The present prospective, randomized, multicentre study was performed to directly
      compare for the first time the effectiveness of a standard activity of 555 MBq
      131iodine vs. an activity calculated to deliver 100 Gy for treatment of Graves'
      thyrotoxicosis. Therapeutic success was defined as the elimination of
      hyperthyroidism 6 months after radioiodine application (range 4.5-8 months). A
      success rate of more than 90% in eliminating hyperthyroidism was reported for
      both approaches, but only in retrospective investigations. Investigated
      prospectively, hyperthyroidism was eliminated in only 71% of the patients
      receiving standard activity (70/98) and 58% of those randomized for calculated
      activity (62/107). In the patients with standard activity, therapeutic success
      was inversely related to thyroid size. The rate was 100% for thyroid volumes < or
      = 15 mL, 95% for 16-30 mL, 68% for 31-45 mL, 44% for 46-50 mL, 20% for 61-75 mL
      and 25% for > or = 75 mL. In those patients with an activity calculated to
      deliver 100 Gy (except in those with a volume < or = 15 mL) this size/outcome
      dependency was almost compensated. The rates were 86%, 65%, 45%, 61%, 41% and
      45%, respectively. Furthermore, detailed statistical analysis revealed a strong
      correlation between the success of therapy and the radiation dose actually
      absorbed by the thyroid. The rate was 11% for a target dose of 50 Gy, 50% for 100
      Gy, 67% for 150 Gy, 80% for 200 Gy, 84% for 250 Gy, 88% for 300 Gy, 90% for 350
      Gy and 93% for 400 Gy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781668
TI  - Veno-arterial carbon dioxide and pH gradients and survival in critical illness.
AB  - Recent studies have shown that the veno-arterial gradient for carbon dioxide
      (dVApCO2) is increased in the case of low cardiac index (CI). In order to further
      investigate this matter 220 haemodynamic measurements from 34 patients with
      septic shock and from 28 patients in the post-operative state without sepsis were
      evaluated. The arteriovenous gradient for pH (dAVpH) was also evaluated. CI was
      found to be inversely correlated to both dVApCO2 and dAVpH when the two groups of
      patients were analysed separately (r = -0.76 and r = -0.78, P < 0.001 for the
      relationship between CI and dVApCO2, r = -0.58 and r = -0.69, P < 0.001 for the
      relationship between CI and dAVpH). When volume loading over 2h was used to
      increase CI, 58-66% of the patients in the two groups showed a decline in dVApCO2
      > 10% when CI was increased by > 10%. The corresponding values for a reduction in
      dAVpH > 10% during volume loading was 36-52%. While dAVpH was found to be
      increased in non-survivors (n = 27) when compared to survivors (0.32 +/- 0.01 vs.
      0.24 +/- 0.1, P < 0.05) at the second day in the IUC, dVApCO2 was not a
      significant predictor of mortality despite the fact that CI was found to be
      decreased in the non-survivors (3.5 +/- 0.94 vs. 4.3 +/- 1.0 L min-1 m-2, P <
      0.01). In conclusion, the veno-arterial carbon dioxide gradient was found to be
      inversely correlated to cardiac performance in patients both in patients with
      septic shock and in non-septic post-operative patients.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7781667
TI  - Effect of insulin treatment on serum lipoprotein(a) in non-insulin-dependent
      diabetes.
AB  - In order to evaluate whether Lp(a), a lipoprotein that is potentially
      thrombogenic and atherogenic, is a potential risk factor for CAD in non-insulin
      dependent diabetes (NIDDM), we compared the Lp(a) and its distribution in 145
      NIDDM patients with that in 94 healthy control subjects. Furthermore, we studied
      the effect of insulin treatment on serum Lp(a) in 108 patients with NIDDM. Male
      and female NIDDM patients had similar Lp(a) concentrations to healthy controls
      (median value 167 mg L-1, range 15-1550 mg L-1 vs. 157 mg L-1, range 15-919 mg L
      1, NS and 92, range 15-1190 mg L-1 vs. 103 mg L-1, range 15-842 mg L-1, NS).
      Also, the cumulative distribution of Lp(a) did not differ between the NIDDM
      patients and healthy subjects. Insulin treatment increased Lp(a) in diabetics
      with a Lp(a) concentration of less than 300 mg L-1, but this effect was not
      related to the concomitant improvement in metabolic control (mean change (+/-
      SEM) of HbA1c from 9.80 +/- 0.15 to 8.00 +/- 0.12; P < 0.001). In subjects with
      elevated Lp(a) concentrations (> 300 mg L-1) the Lp(a) concentration was
      unaffected by insulin, despite a similar improvement in glycaemic control. These
      results suggest that insulin may modulate the concentration of Lp(a).

PMID- 7781670
TI  - CCK-A antagonists: which and how.

PMID- 7781669
TI  - Human neutrophil and plasma endopeptidase 24.11: quantification and respective
      roles in atrial natriuretic peptide hydrolysis.
AB  - Neutral endopeptidase 24.11 activities were quantified on human peripheral blood
      cell preparations (reflecting the enzyme concentration on the surface of
      neutrophils) and in the corresponding diluted plasmas by a spectrofluorimetric
      assay. Despite statistically identical values in both compartments, enzymatic
      activity towards atrial natriuretic peptide was not comparable. Indeed,
      incubation of the radiolabelled peptide in whole blood resulted in the thiorphan
      sensitive production of the labelled metabolites Phe-Arg-Tyr and the Cys-Phe bond
      cleaved peptide. A similar degradation pattern was observed for blood cells but
      not for plasma, providing evidence for the exclusive involvement of neutrophil
      endopeptidase in this peptide inactivation. In search for plasma component(s)
      susceptible to inhibit enzymatic activity, we observed that in the presence of
      alpha 2-macroglobulin at the physiological concentration of 3.5 mg mL-1,
      endopeptidase activity decreased from 100% to 51.2 +/- 8.9% (P = 0.002). Our data
      suggest that this protein could play a role in the endogenous inhibition of
      plasma endopeptidase activity.

PMID- 7781671
TI  - Definition and localization of histamine H2 receptors.

PMID- 7781672
TI  - In vitro effects of H2-receptor antagonists on the cardiovascular system.

PMID- 7781673
TI  - Cardiac effects of amthamine: a new histamine H2-receptor agonist.

PMID- 7781674
TI  - Value of different methods for characterizing cardiovascular drug effects.

PMID- 7781675
TI  - Systolic time intervals: a method to assess cardiovascular drug effects in
      humans.

PMID- 7781676
TI  - Haemodynamic profile of new H2-receptor agonists in congestive heart failure.

PMID- 7781677
TI  - Clinical aspects of cardiovascular effects of H2-receptor antagonists.

PMID- 7781678
TI  - Evan's blue dye blocks capsaicin-induced cough and bronchospasm in the guinea
      pig.
AB  - The influence of Evan's blue dye on capsaicin-induced bronchoconstrictor and
      cough responses was investigated in the guinea pig. Evan's blue (30 mg kg-1 i.v.)
      pretreatment shifted the bronchoconstrictor dose-response to capsaicin (0.3-100
      micrograms kg-1 i.v.) to the right by 10-fold, but had no effect on the
      bronchospasm elicited by neurokinin A (0.3-10 micrograms kg-1 i.v.). Evan's blue
      (0.3-30 mg kg-1 s.c.) also inhibited capsaicin-induced cough in a dose-dependent
      manner. Evan's blue blocked capsaicin responses by the intravenous, subcutaneous,
      or inhaled routes of administration. We conclude bronchoconstrictor responses and
      cough in vivo.

PMID- 7781680
TI  - Effects of methylnaltrexone on morphine-induced inhibition of contraction in
      isolated guinea-pig ileum and human intestine.
AB  - We investigated the effects of methylnaltrexone on morphine-induced inhibition of
      smooth muscle-strip contraction in isolated guinea-pig ileum and human small
      intestine. The longitudinal muscle-strip was immersed in a temperature-controlled
      (37 degrees C) bath containing a physiological solution of 95% O2 and 5% CO2 with
      pH 7.4. Muscle contraction was elicited by transmural electrical stimulation with
      a pulse duration of 0.5 ms at frequencies of 1-50 Hz for 5-10 s at 1-3-min
      intervals. Muscle contraction was blocked by tetrodotoxin or atropine in both
      preparations. When methylnaltrexone was applied to the bath, the force produced
      by muscle contraction was enhanced up to approximately 30%. Stimulation-elicited
      muscle contraction was inhibited by morphine, which decreased the force of
      contraction 42 +/- 9.5% (S.D.) in the human intestine preparation and 35 +/- 8.6%
      in guinea-pig ileum at the inhibitory concentration 70% (IC70). Methylnaltrexone
      effectively antagonized the effects of morphine-induced inhibition of muscle
      strip contraction. In the guinea-pig ileum preparation, methylnaltrexone at 30,
      100 and 300 nM blocked 25 +/- 10.5%, 74 +/- 7.2% and 89 +/- 9.9% of morphine
      induced (300 nM) inhibition, respectively. In the human intestine preparation,
      methylnaltrexone at the same concentrations blocked 57 +/- 10.9%, 74 +/- 12.9%
      and 92 +/- 7.2% of morphine-induced (100 nM) inhibition, respectively. The
      relative ratio of methylnaltrexone to morphine was higher in human intestine
      (1:1) than in the guinea-pig ileum preparation (1:3). These data provide
      preliminary information for clinical studies to evaluate the efficacy of
      methylnaltrexone in preventing or reducing morphine-induced antimotility and
      antitransit actions.

PMID- 7781679
TI  - 7-Oxo-prostacyclin affects the electrogenic Na+/K+ pump in mouse diaphragm
      fibers.
AB  - The effect of a stable prostacyclin derivative, 7-oxo-prostacyclin, on the
      electrogenic Na+/K+ pump in mouse diaphragm muscle was investigated. Resting
      membrane potentials of muscle cells were measured with glass microelectrodes. In
      fresh diaphragm preparations from 7-oxo-prostacyclin-pretreated mice (50
      micrograms.kg-1 7-oxo-prostacyclin i.p. 30-34 h prior to the experiment) resting
      membrane potentials were significantly higher (-83.86 +/- 1.40 mV, mean +/-
      S.E.M.) than in control preparations (-70.78 +/- 1.07 mV). Ouabain at a
      concentration of 10(-4) mol.l-1 abolished this hyperpolarization (P < 0.05). The
      electrogenic effect induced by addition of 5 mmol.l-1 K+ to Na(+)-loaded muscles
      from 7-oxo-prostacyclin-pretreated animals was also enhanced (delta resting
      membrane potential = 21.73 +/- 3.13 mV) compared with that of the controls (delta
      resting membrane potential = 18.36 +/- 1.29 mV). Ouabain antagonized the increase
      in electrogenicity of Na(+)-loaded diaphragms induced by 7-oxo-prostacyclin
      pretreatment (P < 0.05). In contrast to control preparations, no inhibition of
      the electrogenic effect induced by 10 mmol.l-1 Ca2+ ions in Na(+)-loaded muscles
      was observed in diaphragms from 7-oxo-prostacyclin-pretreated animals. In acute
      experiments with Na(+)-loaded muscles, where 10(-7) mol.l-1 7-oxo-prostacyclin
      was added to the bath, resting membrane potential reached up to -100 mV. The
      electrogenic pump-induced increase in resting membrane potential amounted to
      approximately 30 mV. This effect could be also abolished by 10(-4) mol.l-1
      ouabain (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781681
TI  - Evidence for atypical endothelin receptors and for presence of endothelin
      converting enzyme activity in the mouse isolated vas deferens.
AB  - The endothelin receptors controlling sympathetic neurotransmission and the
      presence of endothelin-converting enzyme were investigated in the mouse vas
      deferens. Endothelin-1 or endothelin-3 (0.01-100 nM) enhanced contractions evoked
      by field stimulation, yielding EC50 (geometric mean and 95% confidence limits) of
      0.7 nM (0.4-1.6) and 13.7 nM (10.2-14.1) and Emax (mean +/- S.E.M. increase in
      twitch tension, in mg/10 mg wet tissue) of 473 +/- 35 and 520 +/- 51,
      respectively. The selective endothelin ETB receptor agonists IRL 1620 (Suc
      [Glu9,Ala11,15]endothelin-1) and sarafotoxin S6c were inactive up to 100 nM.
      Responses to endothelin-3 were progressively inhibited by the selective
      endothelin ETA receptor antagonist BQ-123 (cyclo[D-Trp-D-Asp-Pro-D-Val-Leu]) (10,
      30 and 100 nM). At 100 nM, BQ-123 almost abolished the response to endothelin-3
      (100 nM). In contrast, at 100, 300 nM and 1 microM, BQ-123 shifted the curve to
      endothelin-1 to the right only 2-, 5- and 6-fold, respectively. The selective
      endothelin ETB receptor antagonist BQ-788 (N-cis-2,6-dimethylpiperidinocarbonyl-L
      gamma-methyl-leucyl-D-1-++ +methoxycarbonyltryptophanyl-D-norleucine) (100 nM)
      did not modify responses to endothelin-1 or endothelin-3 (0.01-100 nM). Big
      endothelin-1 (0.3-30 nM) was 10-fold less potent than endothelin-1 in increasing
      neurogenic responses (EC50 6.8 nM, 4.7-9.6; Emax 457 +/- 37 mg/10 mg wet tissue).
      Preincubation with phosphoramidon (100 microM) reduced responses to big
      endothelin-1, but not endothelin-1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781682
TI  - Antinociceptive effects of the selective non-peptidic delta-opioid receptor
      agonist TAN-67 in diabetic mice.
AB  - The antinociceptive potencies of 2-methyl-4 alpha alpha-(3-hydroxyphenyl)
      1,2,3,4,4a,5,12,12 alpha alpha-octahydro-quinolino[2,3,3-g]isoquinoline (TAN-67),
      a non-peptidic delta-opioid receptor agonist, were examined using the acetic acid
      abdominal constriction test and the tail-flick test in diabetic mice. TAN-67, at
      doses of 3-100 mg/kg, s.c. [corrected], produced a marked and dose-dependent
      inhibition of the number of acetic acid-induced abdominal constrictions in both
      non-diabetic and diabetic mice. The antinociceptive effect of TAN-67 in the
      acetic acid abdominal constriction test in diabetic mice was greater than that in
      non-diabetic mice. Indeed, the ED50 (95% confidence limits) value of TAN-67 for
      the inhibition of acetic acid-induced abdominal constrictions in diabetic mice
      (6.0 (3.5-10.5) mg/kg) was significantly lower than that in non-diabetic mice
      (31.4 (14.2-69.4) mg/kg). The antinociceptive effect of TAN-67 was not
      antagonized by pretreatment with either beta-funaltrexamine, a selective mu
      opioid receptor antagonist, or nor-binaltorphimine, a selective kappa-opioid
      receptor antagonist. When 7-benzylidenenaltrexone (0.3 mg/kg, s.c.), a selective
      delta 1-opioid receptor antagonist, was administered 10 min before treatment with
      TAN-67, the antinociceptive effect of TAN-67 was significantly antagonized.
      However, naltriben, a selective delta 2-opioid receptor antagonist, had no
      significant effect on the antinociceptive effect of TAN-67. Furthermore, in the
      tail-flick test, TAN-67 at doses of 3-30 mg/kg, s.c. [corrected], also produced a
      marked and dose-dependent antinociceptive effect in diabetic mice, but not in non
      diabetic mice. In conclusion, TAN-67 produced an antinociceptive effect through
      the activation of delta 1-opioid receptors. Furthermore, the results of this
      study support our hypothesis that mice with diabetes are selectively
      hyperresponsive to delta 1-opioid receptor-mediated antinociception.

PMID- 7781683
TI  - Effects of purinoceptor agonists on smooth muscle from hypertrophied rat urinary
      bladder.
AB  - Tension responses induced by the purinoceptor agonists ATP and the stable ATP
      analogue alpha, beta-methylene ATP were investigated in isolated muscle strips
      from normal and hypertrophic urinary bladders from the rat. Hypertrophy was
      induced by a partial ligation of the urethra giving an increase in mean bladder
      weight from 65 mg to 300 mg. Activation with ATP and alpha, beta-methylene ATP
      caused phasic, concentration-dependent, contractions. The sensitivity to ATP was
      about 100-fold lower than that for alpha, beta-methylene ATP. The force of the
      contractions induced by the purinoceptor agonists was significantly lower in the
      hypertrophied bladder compared to the controls. The kinetics of the ATP-induced
      responses was studied by photolytic release of ATP from caged-ATP in intact fibre
      bundles. The rate of contraction following photolytic release of ATP was slower,
      and the force amplitude lower, in the hypertrophic preparations compared to the
      controls. The results suggest changes in the purinoceptor function or in the
      responses of the contractile system to transient increases in intracellular Ca2+
      in the hypertrophic bladder.

PMID- 7781684
TI  - Benzodiazepines and peptides stimulate pregnenolone synthesis in brain
      mitochondria.
AB  - Mitochondria isolated from rat brain were found to cleave cholesterol to produce
      pregnenolone, the precursor for hormonal steroids, at a mean rate of 21.0 pmol
      pregnenolone.mg protein-1.min-1. This rate-limiting step in steroidogenesis was
      significantly stimulated by PK 11195 (1-(2-chlorophenyl)-N-methyl-(1
      methylpropyl)-3-isoquinoline carboxamide) and Ro5 4864 (4'-chlorodiazepam),
      ligands which bind to peripheral benzodiazepine receptors with high affinity. Low
      affinity ligands for the peripheral benzodiazepine receptor such as Ro15 1788
      (ethyl-8-fluoro-5,6-dihydro-5-methyl-6-oxo-4H-imidazo[1,5 alpha][1,4] benzo-3
      carboxylate) and clonazepam had no significant effect on the rate of pregnenolone
      synthesis. Furthermore, the rank order of potency of these compounds as
      inhibitors of [3H]Ro5 4864 binding was identical to the rank order for steroid
      production. Since the 86-amino acid peptide diazepam binding inhibitor is also
      thought to bind to the peripheral benzodiazepine receptor, four fragments of this
      peptide, a random sequence and steroidogenesis activator peptide were also
      evaluated for their ability to interact with peripheral benzodiazepine receptors
      and to stimulate steroidogenesis in rat brain mitochondria. Steroidogenesis
      activator peptide and two fragments of diazepam binding inhibitor significantly
      stimulated pregnenolone biosynthesis. In contrast to the peripheral
      benzodiazepine receptor ligands, no correlation between peptide potency in
      displacing [3H]Ro5 4864 binding and steroidogenesis was observed.

PMID- 7781685
TI  - Induction but not expression of behavioural sensitization to nicotine in the rat
      is dependent on glucocorticoids.
AB  - Behavioural sensitization has been implicated in the development of addictive
      behaviour, and several studies suggest that corticosteroids may be involved in
      this phenomenon. In the present study, the effects of adrenalectomy and steroid
      replacement treatments on the behavioural sensitization observed after daily
      injections of nicotine (0.4 mg/kg s.c.) were investigated in the rat.
      Adrenalectomy completely prevented sensitization to the locomotor stimulating
      effect of nicotine after repeated injections but did not influence the acute
      locomotor activating effect of the drug or an already established sensitization
      to nicotine. In adrenalectomized animals receiving replacement treatment with
      corticosterone or dexamethasone, but not aldosterone, repeated administration of
      nicotine produced behavioural sensitization. Repeated dexamethasone treatment per
      se failed, however, to sensitize rats to nicotine. Post mortem neurochemical
      studies showed that repeated administration of nicotine significantly increased
      homovanillic acid (HVA) levels, as well as the dihydroxyphenylacetic acid
      (DOPAC)/dopamine quotient, in the limbic forebrain. Adrenalectomy per se
      significantly increased HVA levels and tended to elevate the DOPAC/dopamine
      quotient. When repeatedly treated with nicotine, adrenalectomized rats displayed
      a higher DOPAC/dopamine quotient, but no significant difference in HVA levels,
      compared to nicotine-treated sham-operated controls. In the striatum and the
      cortex, no significant effects of nicotine treatment or adrenalectomy were
      observed on any of the neurochemical measures. The present results suggest that
      glucocorticoid (type II) receptor activation is required for induction of
      sensitization to the locomotor stimulatory effect of nicotine, whereas
      corticosteroids are not required for the expression of the behavioural
      sensitization once established. Provided that HVA levels and the DOPAC/dopamine
      quotient relatively well reflect the presynaptic dopamine activating effect of
      nicotine, it may be suggested that corticosteroid-related mechanisms associated
      with behavioural sensitization to nicotine are post- rather than presynaptically
      located in relation to mesolimbic dopamine neurons.

PMID- 7781686
TI  - Gastric mucosal protection by YM638, a novel leukotriene D4 receptor antagonist,
      in rats.
AB  - YM638 ([[5-[[3-(4-acetyl-3-hydroxy-2-propylphenoxy)propyl] thio]-1,3,4-thiadiazol
      2-yl]thio] acetic acid) is a novel leukotriene D4 receptor antagonist. We
      investigated the involvement of the leukotriene D4 receptor blocking activity of
      YM638 in the gastric mucosal protection of this drug in rats. YM638 significantly
      prevented gastric lesion formation induced by water-immersion restraint stress,
      indomethacin, absolute ethanol, 0.7 N HCl and the combination of 0.2 N HCl and
      hemorrhagic shock, with ED50 values of 26.4, 4.1, 4.7, 35.4 and 8.0 mg/kg p.o.,
      respectively. Cetraxate and sofalcone showed inhibitory effects on most of these
      gastric lesions, but the inhibitory effects of these compounds were much weaker
      than those of YM638. In contrast, YM638 had no effect on gastric acid secretion
      and gastric lesion formation in pylorus-ligated rats, or on duodenal lesion
      formation in cysteamine-administered rats. YM638 competitively antagonized
      leukotriene D4-induced contraction of the isolated stomach, with a pA2 value of
      7.63 +/- 0.18. In anesthetized rats, intravenous YM638 inhibited leukotriene D4
      induced aggravation of gastric lesions caused by HCl, and leukotriene D4 and HCl
      induced reduction of the potential difference. In addition, oral YM638
      significantly increased gastric mucosal blood flow and prevented ethanol-induced
      increase in gastric vascular permeability. Endogenous prostaglandins, sulfhydryls
      and nitric oxides were not involved in this inhibitory effect on absolute ethanol
      induced gastric lesion. YM638 did not react with the stable free radical 1,1
      diphenyl-2-picrylhydrazyl in vitro, indicating that YM638 does not have potential
      as free radical scavenger. These results suggest that the preventive effect of
      YM638 on gastric lesions is attributable not only to its leukotriene D4 receptor
      blocking activity but also to the activation of gastric mucosal defensive
      mechanisms such as mucosal blood flow and vascular permeability.

PMID- 7781687
TI  - Effect of JTP-2942, a novel thyrotropin-releasing hormone analogue, on
      pentobarbital-induced anesthesia in rats.
AB  - The effects of a novel thyrotropin-releasing hormone (TRH) analogue, N alpha
      ((1S,2R)-2-methyl-4-oxocyclopentylcarbonyl)-L-histidyl-L-pro linamide monohydrate
      (JTP-2942), on pentobarbital-induced anesthesia in rats were investigated and
      compared with those of TRH. Intravenous administration of both JTP-2942 and TRH
      caused a dose-dependent decrease in the recovery time from pentobarbital-induced
      anesthesia. The minimum effective doses of JTP-2942 and TRH were respectively
      0.03 and 1 mg/kg. The effect of JTP-2942 was antagonized by intraperitoneal
      scopolamine (0.5 mg/kg). Intraperitoneal JTP-2942 (1 mg/kg) caused an increase of
      acetylcholine release and a decrease of choline release in the frontal cortex and
      hippocampus of pentobarbital-treated rats. In addition, JTP-2942 ameliorated the
      decrease of hemicholinium-3-sensitive high-affinity choline uptake and the
      increase of acetylcholine in these brain regions. However, JTP-2942 had no effect
      on choline acetyltransferase activity or the choline content, which were also not
      changed by pentobarbital. Our results indicate that the effect of JTP-2942 on
      pentobarbital-induced anesthesia was about 30 times more potent than that of TRH,
      and suggest that JTP-2942 may act by accelerating acetylcholine turnover.

PMID- 7781688
TI  - 5-Carboxamidotryptamine attenuates the development of deoxycorticosterone acetate
      salt hypertension in rats.
AB  - The effect of chronic i.v. infusion of the 5-HT1 receptor agonist, 5
      carboxamidotryptamine (5-CT), was evaluated during the development of
      deoxycorticosterone acetate-salt (DOCA-salt) hypertension in rats over 4 weeks.
      Vehicle-treated (n = 10) Sprague-Dawley rats given DOCA (100 mg/kg, s.c.) and 1%
      saline as drinking fluid developed hypertension with systolic blood pressure
      reaching 194.6 +/- 8.99 mm Hg at 27 days. In DOCA-salt rats treated with 5-CT
      infusions (15.0 micrograms/kg per day, n = 10) for 4 weeks via osmotic
      minimpumps, systolic blood pressure was significantly lower by 41.7 mm Hg at day
      27 when compared to vehicle-treated DOCA-salt rats. Systolic blood pressure
      values on day 27 in 5-CT-treated DOCA-salt rats were however greater than those
      in vehicle-treated control rats which were not given DOCA. Systolic blood
      pressure in 5-CT-treated DOCA-salt rats was significantly lower by day 7 compared
      to vehicle-treated DOCA-salt rats and remained lowered for the rest of the
      observation period. Heart rate was significantly greater in 5-CT-treated DOCA
      salt rats on day 7 when compared to vehicle-treated DOCA-salt rats. Baroreflex
      sensitivity on day 28 was significantly greater in 5-CT-treated DOCA-salt rats as
      compared to vehicle-treated DOCA-salt rats. On day 28, hypotensive responses to
      hexamethonium (20 mg/kg) in 5-CT-treated DOCA-salt rats were markedly reduced
      compared to those in vehicle-treated DOCA-salt rats.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7781689
TI  - Cocaine promotes an apparent direct vasoconstrictor effect of neuropeptide Y in
      the rat tail artery.
AB  - Neuropeptide Y is a powerful vasoconstrictor in vivo; however, in vitro it shows
      weak constrictor effects. This discrepancy may have led to conflicting reports
      concerning the contractile effects of neuropeptide Y on isolated blood vessels.
      Using isolated rat tail and femoral artery segments neuropeptide Y (0.1-100 nM)
      did not induce any contractile response. However, if the catecholamine neuronal
      uptake blocker cocaine was added to the tissue bath, neuropeptide Y induced a
      contraction which could be fully blocked by prazosin (1000 nM). Furthermore, an
      age-dependent increase in the contraction to neuropeptide Y plus cocaine was
      observed. In conclusion, in the rat tail artery an apparent direct
      vasoconstrictor effect of neuropeptide Y occurs only in the presence of cocaine.
      Since this contraction can be fully blocked by prazosin, spontaneously released
      norepinephrine is an important component of the contraction. The discrepancy
      between in vivo and in vitro effects of neuropeptide Y may be explained in part
      by the presence of circulating vasoconstrictors.

PMID- 7781690
TI  - Minor alkaloids of tobacco release [3H]dopamine from superfused rat striatal
      slices.
AB  - In addition to S(-)-nicotine, several minor tobacco alkaloids ((+/-)-nornicotine,
      anabaseine, S(-)-anabasine, and S(-)-N-methylanabasine) are present in tobacco
      smoke. This study demonstrates that these alkaloids increase fractional 3H
      release in a concentration-dependent manner from rat striatal slices preloaded
      with [3H]dopamine, with desensitization of this response. The rank order of EC50
      values was S(-)-nicotine (3.0 +/- 2.2 microM) > (+/-)-nornicotine (6.7 +/- 2.1
      microM) > anabaseine (15.4 +/- 6.1 microM) = S(-)-N-methylanabasine (16.3 +/- 4.7
      microM) = S(-)-anabasine (19.3 +/- 3.2 microM). The alkaloids did not modulate
      fractional 3H release evoked by electrical-field depolarization. Thus, minor
      tobacco alkaloids may contribute to the apparent neuroprotective effects of
      smoking in neurodegenerative diseases.

PMID- 7781691
TI  - Analysis of responses of allicin, a compound from garlic, in the pulmonary
      vascular bed of the cat and in the rat.
AB  - Allicin, diallyl disulfide-oxide, an active ingredient released from garlic is a
      systemic vasodilator that acts by an unknown mechanism. In the present
      experiments, pulmonary vascular responses to allicin (0.1-1.0 mg) were studied in
      the intact-chest anesthetized cat and in the isolated lung of the rat under
      constant flow conditions. When baseline tone in the pulmonary vascular bed of the
      cat was raised with U46619 (11 alpha,9 alpha-epoxymethano-9 alpha,11 beta
      dideoxyprostaglandin F2 alpha), intralobar injections of allicin produced dose
      related decreases in pulmonary arterial pressure without changing left atrial
      pressure indicating that allicin had significant vasodilator activity in the
      pulmonary vascular bed when tone was increased experimentally. Allicin also
      decreased systemic arterial pressure in a dose-related manner. In terms of
      relative vasodilator activity in the cat, allicin was 100-fold less potent than
      sodium nitroprusside and many orders of magnitude less potent than isoproterenol.
      In the cat, vasodilator responses to allicin were unchanged by methylene blue or
      N omega-nitro-L-arginine methyl ester. Allicin also significantly diminished the
      pulmonary pressor response to ventilatory hypoxia in the isolated perfused rat
      lung. These data show that allicin has significant vasodilator activity in the
      pulmonary vascular bed of the cat and the rat. The present data suggest that
      pulmonary vasodilator responses to allicin are independent of the synthesis of
      endothelial-derived relaxing factor or the activation of soluble guanylate
      cyclase.

PMID- 7781693
TI  - Effects of adenosine receptor agonists and antagonists on physostigmine-induced
      yawning.
AB  - The effect of adenosine receptor agonists and antagonists on physostigmine
      induced yawning was investigated in intact or cannulated rats. Intraperitoneal
      (i.p.) or intracerebroventricular (i.c.v.) administration of physostigmine to
      rats induced yawning dose dependently. I.p. or i.c.v. treatment of the animals
      with atropine, theophylline, 5-N-ethylcarboxamidoadenosine (NECA) or N6
      cyclohexyladenosine reduced the yawning induced by i.p. injection of
      physostigmine. I.p. administration of theophylline decreased the yawning induced
      by i.c.v. injection of physostigmine. The inhibitory action of N6
      cyclohexyladenosine (i.p.) also was decreased by 8-phenyltheophylline (i.p.)
      pretreatment. It is concluded that yawning induced by a central cholinergic
      mechanism and a central adenosine mechanism interacts with the cholinergic
      induced behaviour.

PMID- 7781692
TI  - Selective inhibition of myosin phosphorylation and tension of hyperplastic
      arteries by the kinase inhibitor HA1077.
AB  - To examine possible alterations in myosin light chain phosphorylation in
      hyperplastic arteries, rabbit strips from right hyperplastic and left normal
      control carotid arteries were used for experiments 6 weeks after the ballooning
      procedure. When the hyperplastic artery was stimulated with various
      concentrations of K+ (10, 20, 30, 40 and 60 mM), the maximal tension in response
      to each concentration was significantly higher (P < 0.05) than that in the
      control artery. The maximal extent of myosin light chain phosphorylation induced
      by 60 mM K+ in the hyperplastic artery was also significantly higher than that in
      the control (55.1 +/- 4.1 vs. 45.1 +/- 3.2%, mean +/- S.D.). However, the [Ca2+]i
      response to elevated K+ in hyperplastic arteries was much the same as that in
      control arteries, when measured with fura-PE3. HA1077 (1-5-(isoquinolinesulfonyl)
      homopiperazine), a protein kinase inhibitor, was about 3-5 times more effective
      in inhibiting the tension and myosin light chain phosphorylation induced by 60 mM
      K+ in the hyperplastic artery than in the control artery. Nifedipine inhibited
      the tension and myosin light chain phosphorylation to the same extent in control
      and hyperplastic arteries. Thus, an alteration of the myosin light chain
      phosphorylation system, but not an alteration of Ca2+ mobilization, may be
      involved in the enhanced contraction of the hyperplastic artery. The enhanced
      phosphorylation of myosin light chain may be sensitive to HA1077.

PMID- 7781694
TI  - Antagonizing effect of morphine on the mobility and phagocytic activity of
      invertebrate immunocytes.
AB  - In the present study we have demonstrated that lipopolysaccharide (LPS) acts as
      an activator in the immunocytes of molluscs Planorbarius corneus, Mytilus edulis,
      and the insect Leucophaea maderae. This stimulatory effect, demonstrated by
      cellular conformational changes, is concentration- and time-dependent, and is
      antagonized by morphine. The inhibitory effect of morphine can be counteracted by
      naloxone. Morphine inhibitory action on immunocyte activity is also demonstrated
      by a decrease in the phagocytic activity. These data suggest that the
      downregulation of morphine is not limited to vertebrates but is also present in
      invertebrates.

PMID- 7781695
TI  - Discriminative stimulus effects of anandamide in rats.
AB  - Anandamide (arachidonylethanolamide), a putative endogenous ligand for the
      cannabinoid receptor, produces a tetrad of behavioral effects in mice
      characteristic of psychoactive cannabinoids including catalepsy, antinociception,
      hypothermia, and hypomobility. The present study examined the discriminative
      stimulus effects of anandamide in rats trained to discriminate delta 9
      tetrahydrocannabinol or the potent cannabinoid receptor ligand CP 55,940 [(-)-cis
      3-[2-hydroxy-4-(1,1-dimethylheptyl)-phenyl]-trans-4-(3-
      hydroxypropyl)cyclohexanol)] from vehicle. Intraperitoneal injections of
      anandamide substituted for delta 9-tetrahydrocannabinol and for CP 55,940;
      however, unlike substitution dose-effect curves with the training drugs,
      anandamide substitution occurred at a single dose (30 or 45 mg/kg) and was
      accompanied by severe decreases in response rates. The results of the present
      study suggest that, although systemic anandamide administration may have
      cannabimimetic effects similar to those of delta 9-tetrahydrocannabinol and CP
      55,940, some differences in the behavioral effects of anandamide and other
      psychoactive cannabinoids also are apparent.

PMID- 7781696
TI  - Acute effects of irradiation on the rat brain: protection by glutamate blockade.
AB  - Riluzole (2-amino-6-trifluorothethoxy benzothiazole), dizocilpine (MK-801; (+)-5
      methyl-10,11-dihydro-5H-dibenzo(a,d)-cyclohepten-5,10-imine maleate), and
      lamotrigine (3,5-diamino-6-(2,3-dichlorophenyl)-1,2-triazine), agents reported to
      have neuroprotective actions, and WR2721 (S-2-(3-aminopropylamino)
      ethylphosphorothioic acid), a radioprotector, were evaluated in 15-day-old rats
      that underwent a 2.5 Gray (Gy) irradiation from a cobalt 60 source. 20 min after
      irradiation, riluzole (0.5-8 mg/kg), dizocilpine (0.1-1 mg/kg), lamotrigine (25
      mg/kg), WR 2721 (75 mg/kg) or vehicle, were injected intraperitoneally. 6 h after
      irradiation, behavioural and histological evaluations revealed that exposure to
      2.5 Gy caused hypolocomotion, stumbling gait and somnolence, which was
      significantly reduced, from the dose of 4 mg/kg i.p. of riluzole. A dose
      dependent protection of neurones in the dentate gyrus, starting from the dose of
      1 mg/kg i.p. was also seen. Dizocilpine caused behavioral modifications but
      significantly reduced neuronal damage. Lamotrigine significantly increased
      neuronal damage while WR 2721 conferred no protection. In conclusion, two
      blockers of glutamatergic neurotransmission conferred significant protection
      against brain damage caused by ionizing irradiation when administered subsequent
      to exposure.

PMID- 7781697
TI  - The effect of opiates on the secretion of transmitter from amphibian motor nerve
      terminals.
AB  - The effects of dynorphin-A, dermorphine and morphine on the secretion of
      transmitter from the toad (Bufo marinus) motor nerve terminal have been
      determined. Intracellular recordings of miniature end plate potentials
      (m.e.p.p.s) and evoked end plate potentials (e.p.p.s) were used to estimate
      quantal content (m) and binomial parameters p and n. Dynorphin-A, and to a lesser
      extent morphine, decreased (m) while dermorphine had no significant effect on m.
      Dynorphin-A (ED50 = 24 microM) was 21 times more potent then morphine (ED50 = 510
      microM) in decreasing m. The decrease in m produced by dynorphin-A and morphine
      was accompanied by a greater decrease in the variance (S2) of number of quanta
      secreted per stimulation over the recording period. The decrease in m produced by
      dynorphin-A, and to a lesser extent by morphine, is probably mediated by the
      opiates acting on kappa-opioid receptors.

PMID- 7781698
TI  - Antihyperglycemic effects of M16209, a novel aldose reductase inhibitor, in
      normal and diabetic rats.
AB  - The effect of a single oral administration of M16209 (1-(3-bromobenzo[b]furan-2
      yl-sulfonyl)hydantoin), a novel aldose reductase inhibitor, on serum glucose was
      investigated. In normal rats, M16209 (100 mg/kg) had a weak hypoglycemic effect
      but markedly stimulated the disappearance of serum glucose in intravenous glucose
      tolerance tests. In diabetic rats, M16209 (100 mg/kg) significantly suppressed
      the hyperglycemia of streptozotocin-induced, mildly diabetic rats and stimulated
      serum glucose disappearance in neonatally streptozotocin-induced, non-insulin
      dependent diabetes mellitus (NIDDM) rats in glucose tolerance tests.
      Additionally, M16209 augmented insulin secretion in glucose-loaded, normal and
      NIDDM rats and restored the reduced serum insulin in streptozotocin-induced,
      mildly diabetic rats. M16209, however, showed no hypoglycemic effect in severely
      diabetic rats. In contrast, gliclazide, a sulfonylurea, showed a much more potent
      hypoglycemic effect in normal rats than in mildly diabetic rats. These results
      suggest that M16209 suppresses hypoglycemia through augmentation of glucose
      stimulated insulin secretion. The antihyperglycemic activity of M16209, combined
      with its potent aldose reductase inhibiting activity, is expected to be
      beneficial in the treatment of diabetic complications.

PMID- 7781700
TI  - Novel arylaminopyridazine-GABA receptor antagonists examined
      electrophysiologically in Ascaris suum.
AB  - The structure-activity relationships of 35 novel derivatives of 2-(carboxypropyl)
      3-amino-4-methyl-6-phenyl pyridazine (SR 95103) were examined as gamma
      aminobutyric acid (GABA) antagonists in the flap preparation of the parasitic
      nematode, Ascaris suum, using a two-microelectrode current-clamp technique. All
      but one of the potent antagonists displaced GABA dose-response curves to the
      right without reduction in the maximum response. The dissociation constants of
      the more potent competitive antagonists were described using a model which
      assumed that two molecules of GABA were required to open the ion channel but that
      only one molecule of antagonist acted on each ion channel. By exploring the
      structure-activity relationship, the potency of the antagonist was increased from
      a KB of 64 microM for SR 95103 to a KB of 4.7 microM for NCS 281-93 (2-(3
      carboxypropyl)-3-amino-4-phenylpropyl-6-phenyl pyridazine).

PMID- 7781699
TI  - Effects of M16209 on insulin secretion in isolated, perfused pancreases of normal
      and diabetic rats.
AB  - We investigated the stimulatory effect of M16209 (1-(3-bromobenzo[b]furan-2-yl
      sulfonyl)hydantoin), a novel aldose reductase inhibitor, on insulin secretion
      using isolated, perfused pancreases of rats. In the pancreases from normal rats,
      M16209 (100 microM) greatly augmented glucose-stimulated insulin secretion, but
      showed no effect on unstimulated insulin secretion at 2.8 mM glucose. In
      contrast, gliclazide (10 microM), a sulfonylurea, strongly enhanced both glucose
      stimulated and unstimulated insulin secretion. Sorbinil and epalrestat, potent
      aldose reductase inhibitors, had no stimulatory effect on insulin secretion.
      M16209 (100 microM) improved appreciably the decreased insulin response to 22.2
      mM glucose and enhanced slightly unstimulated insulin secretion in the pancreases
      of rats with neonatally streptozotocin-induced, non-insulin-dependent diabetes
      mellitus (NIDDM). Gliclazide (10 microM), however, failed to affect the
      pancreases of NIDDM rats. Furthermore, M16209 showed no appreciable effect on ATP
      sensitive K(+)-channels in pancreatic beta-cells. These results suggest that
      M16209, unlike sulfonylureas, selectively enhances glucose-stimulated insulin
      secretion in both normal and NIDDM rats through a direct action on the pancreas.
      The site of action remains unknown, but the inhibition of aldose reductase or the
      ATP-sensitive K+ channels is unlikely to be involved.

PMID- 7781701
TI  - Effect of MDL 73,745 on acetylcholine and biogenic amine levels in rat cortex.
AB  - We postulate that the effect of cholinesterase inhibitors to ameliorate the
      cholinergic deficit in Alzheimer's disease is related to their ability to
      maintain long-lasting, non-toxic steady-state levels of acetylcholine in cortex.
      We investigated the effect of the cholinesterase inhibitor, MDL 73,745 (2,2,2
      trifluoro-1-(3-trimethylsilylphenyl)ethanone), on the extracellular levels of
      acetylcholine, norepinephrine, dopamine and 5-hydroxytryptamine in the cerebral
      cortex of the rat by high-performance liquid chromatography coupled with
      electrochemical detection. The drug significantly increased acetylcholine levels
      above the baseline at 2 and 10 mg/kg s.c., but not at the 1 mg/kg dose. At both 2
      and 10 mg/kg there was a good correlation between cholinesterase inhibition and
      acetylcholine increase in cortex. At the 2 and 10 mg/kg doses, the maximal
      cholinesterase inhibition was 64% and 77%, respectively, and the increase in
      acetylcholine release was 481% and 1016%, respectively. Norepinephrine and
      dopamine, but not 5-hydroxytryptamine levels, were also significantly increased
      by the 10 mg/kg dose. The increases of norepinephrine and dopamine levels reached
      a maximum of 124% and 370%, respectively, and continued for a period of at least
      8 h. Cholinergic side-effects were most marked at the 10 mg/kg dose but were also
      noticeable at the 2 mg/kg dose in the form of fasciculations, tremor and splay.

PMID- 7781702
TI  - Alpha 1-adrenoceptor subtype selectivity of tamsulosin: studies using livers from
      different species.
AB  - The subtype selectivity of the alpha 1-adrenoceptor antagonist, tamsulosin, was
      tested using hepatocytes and liver membranes from guinea pigs and rabbits
      (expressing alpha 1-adrenoceptors with alpha 1A pharmacology) and rats (alpha 1B
      adrenoceptors). Tamsulosin blocked the alpha 1-adrenergic activation of
      phosphorylase with higher affinity in hepatocytes from guinea pigs and rabbits
      than in those from rats. [3H]Tamsulosin binding to liver membranes was rapid,
      reversible and saturable. The Kd values obtained also indicated higher affinity
      for alpha 1A-adrenoceptors (70 and 140 pM, for liver membranes obtained from
      guinea pigs and rabbits, respectively) than for those of the alpha 1B-subtype
      (510 pM). Chloroethylclonidine potently and completely inactivated [3H]tamsulosin
      binding sites in membranes from rabbit and rat livers, but not those in guinea
      pig liver membranes. Binding competition and inactivation experiments were
      performed to further characterize the receptor subtypes present in the livers of
      these animals. In summary, tamsulosin is a very potent alpha 1-adrenoceptor
      antagonist that has higher affinity for alpha 1A-adrenoceptors than for those of
      the alpha 1B-subtype.

PMID- 7781704
TI  - Thiomuscimol, a new photoaffinity label for the GABAA receptor.
AB  - Thiomuscimol inhibits [3H]muscimol binding to brain GABAA receptors. Exposure of
      Ag(+)-treated membrane preparations to UV radiation at 254 nm for 40 min in the
      presence of thiomuscimol (10(-5) M) produced a 20-30% irreversible decrease in
      high-affinity [3H]muscimol binding sites. The photoaffinity labeling of
      thiomuscimol was inhibited by GABA (10(-4) M) added prior to exposure to UV
      light. The data show that thiomuscimol can label the GABAA receptor site and that
      the ligand can be used as a photoaffinity label for purification and
      identification of GABA binding sites within the GABAA receptor complex.

PMID- 7781703
TI  - The role of carbon monoxide in lucigenin-dependent chemiluminescence of rat
      alveolar macrophages.
AB  - We have investigated the role of carbon monoxide (CO) in lucigenin-dependent
      chemiluminescence of alveolar macrophages from rat lungs. CO (10 nM to 1 microM)
      decreased chemiluminescence of alveolar macrophages in a concentration-dependent
      fashion. At a concentration of 1 microM, CO significantly increased intracellular
      cyclic GMP levels from a control value of 175 +/- 25 fmol/2 x 10(6) cells to 431
      +/- 49 fmol/2 x 10(6) cells. Pretreatment of alveolar macrophages with NG
      monomethyl-L-arginine (100 microM) failed to inhibit CO (1 microM)-induced
      decreases in chemiluminescence of alveolar macrophages (3.7 +/- 0.7 cpm x 10(3)
      in the presence of NG-monomethyl-L-arginine and 3.4 +/- 0.6 cpm x 10(3) in the
      absence of NG-monomethyl-L-arginine) and CO (1 microM)-induced increases in
      intracellular cyclic GMP levels (452 +/- 65 fmol/2 x 10(6) cells in the presence
      of NG-monomethyl-L-arginine and 419 +/- 58 fmol/2 x 10(6) cells in the absence of
      NG-monomethyl-L-arginine). Decreases in chemiluminescence of alveolar macrophages
      induced by CO (1 microM) were concentration-dependently inhibited by methylene
      blue (from 0.1 microM to 10 microM). Dibutyryl cyclic GMP (db cyclic GMP) (1 mM)
      also reduced chemiluminescence of alveolar macrophages (1.5 +/- 0.3 cpm x 10(3)
      in the presence of db cyclic GMP and 3.6 +/- 0.6 cpm x 10(3) in the absence of db
      cyclic GMP). In contrast to CO and db cyclic GMP, zinc protoporphyrin-9 (10nM to
      microM), an inhibitor of heme oxygenase potentiated chemiluminescence of alveolar
      macrophages in a concentration-dependent fashion.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7781705
TI  - Characterisation of an ATP receptor mediating mitogenesis in vascular smooth
      muscle cells.
AB  - Adenosine triphosphate (ATP), a co-transmitter in sympathetic nerves and released
      from platelets, has recently been shown to stimulate growth of vascular smooth
      muscle cells. It might therefore contribute to the development of vascular
      hypertrophy seen in hypertension and atherosclerosis. We aimed at characterising
      the receptor mediating this mitogenic effect in rat aorta smooth muscle cells.
      The potency of agonists indicates a P2 purinoceptor since ATP > or = ADP >> AMP,
      adenosine. The P2x-receptor subtype, which is responsible for ATP induced
      vasoconstriction in rat aorta, does not mediate the mitogenic effect since alpha,
      beta-methyleneATP had no effect and beta, gamma-methyleneATP had lower potency
      than ATP. The P2Y-receptor subtype was excluded since the selective agonist 2
      methylthioATP had weak effect with lower potency than ATP. When we studied the
      involvement of other nucleotides similar effects were seen of the purines ATP,
      GTP and ITP; also the pyrimidine UTP had powerful mitogenic effects (Emax = 52%
      of ATP) with similar potency. Nucleotides with fewer phosphate groups showed a
      stepwise fall in mitogenic effect. This indicates involvement of a nucleotide
      receptor (P2U). Ap4A were of equal potency and effect as ATP. There was strong
      correlation between the mitogenic effects of the nucleotides and analogues with
      both 45Ca(2+)-influx and inositol phosphate (IP) production, indicating that they
      may participate in mediating the mitogenic response. This is the first study
      describing the potencies for the mitogenic effects of the selective ATP-analogues
      and other nucleotides in vascular smooth muscle cells. The receptor
      characterisation indicates a nucleotide-receptor similar to the receptor which
      stimulates 45Ca(2+)-influx and inositol phosphate-formation in rat aorta smooth
      muscle cells. Substances related to ATP such as GTP, ITP, UTP and Ap4A which also
      can be released extracellularly in vivo stimulate mitogenesis of rat aorta smooth
      muscle cells through the same receptor.

PMID- 7781706
TI  - Pharmacological identity between somatostatin SS-2 binding sites and SSTR-1
      receptors.
AB  - Somatostatin (SRIF) SS-2 binding sites were originally defined in rat brain
      cerebral cortex membranes using [125I]Tyr11-SRIF-14 in the presence of 120 mM
      NaCl. These sites were characterized by their high affinity for SRIF-14 and SRIF
      28, but very low affinity for cyclic peptides such as octreotide (SMS 201-995)
      and seglitide (MK 678). The characteristics of SS-2 sites are reminiscent of
      125I]CGP 23996-labelled sites in rat brain which have been termed SRIF-2 sites.
      In the present study, the pharmacological profile of SS-2 sites was determined in
      radioligand binding studies performed in rat cortex membranes using [125I]SRIF-14
      in the presence of 120 mM NaCl and compared to that of human SSTR-1 receptors
      expressed in human embryonic kidney (HEK 293) cells, using [125I]SRIF-14. The
      rank orders of affinity of a variety of SRIF analogues and synthetic peptides for
      SS-2 binding sites and recombinant human SSTR-1 receptors were very similar and
      correlated highly significantly (r = 0.99). However, SS-2 binding correlated also
      with binding to recombinant SSTR-4 receptors (r = 0.91). Autoradiographic studies
      were performed using the radioligand [125I]CGP 23996 which has been claimed to
      label selectively SRIF-2 binding sites and compared with the distribution of SSTR
      1 receptor mRNA determined using in situ hybridization in rat brain. Although
      some overlap was observed between the distribution of SSTR-1 mRNA and [125I]CGP
      23996 binding sites, the latter were clearly more widespread, suggesting this
      ligand to label SSTR-1 and other sites. In addition, inhibition of forskolin
      stimulated adenylate cyclase was investigated in HEK 293 cells transfected with
      human SSTR-1 receptors; a variety of SRIF analogues and short synthetic peptides
      behaved as agonists at adenylate cyclase and displayed a rank order of potency
      highly similar to that observed for these compounds at SS-2 binding sites.
      Seglitide acted as an antagonist at SSTR-1 receptor mediated inhibition of
      adenylate cyclase activity with a pKB of 4.42. It is concluded that the
      pharmacological profile of SS-2 binding sites resembles most closely that of SSTR
      1 receptors (although similarities with SSTR-4 receptors were observed), that
      [125I]CGP 23996 labels presumably several SRIF receptors in rat brain, and that
      SSTR-1 receptors are negatively and efficiently coupled to adenylate cyclase
      activity.

PMID- 7781707
TI  - Characterization and distribution of somatostatin SS-1 and SRIF-1 binding sites
      in rat brain: identity with SSTR-2 receptors.
AB  - Somatostatin (SRIF) SS-1 binding sites were initially defined in radioligand
      binding studies performed in rat brain cerebral cortex membranes using [125I]204
      090 (a radiolabelled Tyr3 analogue of SMS 201-995, octreotide). SRIF-1
      recognition sites were defined in binding studies performed with [125I]MK 678
      (seglitide). Both SS-1 and SRIF-1 sites were characterized by their high affinity
      for SRIF-14, SRIF-28 and for cyclic peptides such as octreotide and seglitide, in
      marked contrast to SS-2 and SRIF-2 sites which have very low affinity for these
      synthetic SRIF analogues. In the present study, SS-1 and SRIF-1 radioligand
      binding studies were performed in rat cortex membranes and compared to results
      obtained in cloned Chinese hamster ovary cells expressing human SSTR-2 receptors
      using [125I]204-090 and/or [125I]MK-678. The rank orders of affinity of a variety
      of SRIF analogues and synthetic peptides for SS-1/SRIF-1 binding sites and
      recombinant SSTR-2 receptors were very similar and correlated highly
      significantly (r = 0.94-0.99); by contrast, correlation between SS-1 and SSTR-5
      (r = 0.44) or SSTR-3 binding (r = 0.07) was not significant. Autoradiographic
      studies were performed in rat brain using both radioligands [125I]204-090 and
      [125I]MK-678 and compared with the distribution of SSTR-2 receptor mRNA
      determined using in situ hybridization. A clear overlap was observed between the
      distribution of SSTR-2 mRNA and binding sites labelled with both radioligands.
      SSTR-2 receptor-mediated inhibition of forskolin-stimulated adenylate cyclase in
      Chinese hamster ovary cells by a variety of SRIF analogues and short synthetic
      peptides displayed a rank order of potency highly similar to their rank order of
      affinity at SS-1/SRIF-1 binding sites. It is concluded that SS-1 and SRIF-1
      binding sites respectively labelled with [125I]204-090 and [125I]MK 678, both
      display the pharmacological profile of SSTR-2 receptors, that the distribution of
      [125I]204-090 and [125I]MK-678 binding sites in rat brain is superimposable and
      largely comparable to that of SSTR-2 mRNA expression. It is also shown that
      neither [125I]204-090 nor [125I]MK-678 label SSTR-3 or SSTR-5 receptors in rat
      brain. Finally, it is demonstrated that SSTR-2 receptors can very efficiently
      couple to adenylate cyclase activity in an inhibitory manner.

PMID- 7781708
TI  - Calcitonin gene-related peptide selectively increases cAMP levels in the guinea
      pig ureter.
AB  - Calcitonin gene-related peptide (CGRP, 0.1 microM) and forskolin (10 microM) both
      produced a time-dependent accumulation of cAMP in homogenates of the guinea-pig
      ureter, while cromakalim (3 microM) was ineffective. Neither agent did increase
      the cGMP levels. cAMP accumulation induced by CGRP or forskolin was unchanged by
      glibenclamide (1 microM). In sucrose gap, the application of forskolin (1-10
      microM for 15 s) hyperpolarized the smooth muscle membrane and its effect was
      greatly enhanced when tested in a low-K+ medium (extracellular K+ reduced from
      5.9 to 1.2 mM). The hyperpolarization produced by 10 microM forskolin was reduced
      and abolished by 1 and 10 microM glibenclamide, respectively, in both normal and
      low-K+ medium. The present findings demonstrate that CGRP determines a selective
      cAMP accumulation in the guinea-pig ureter and suggest that elevation of cAMP may
      be involved in the opening of glibenclamide-sensitive K+ channels in the ureter
      smooth muscle.

PMID- 7781710
TI  - Inhibitory effect of sevoflurane on nitric oxide release from cultured
      endothelial cells.
AB  - We investigated the effect of sevoflurane (fluoromethyl-2,2,2-trifluoro-1
      (trifluoromethyl) ethylether) on intracellular calcium concentration ([Ca2+]i)
      and nitric oxide (NO) release from cultured porcine aortic endothelial cells
      using fura-2 fluorometry, and direct (ESR spectrometry with NO-trapping by 2-(4
      carboxyphenyl)-4,4,5,5-tetramiethylimidazoline-1-oxyl 3-oxide) or indirect
      (nitrite accumulation measured by Greiss reaction) NO measurement. Sevoflurane
      alone did not change resting [Ca2+]i, but diminished bradykinin-induced transient
      increase in [Ca2+]i in a concentration-dependent manner. The inhibitory effect of
      sevoflurane on bradykinin-induced transient rise in [Ca2+]i was larger than that
      of a non-selective Ca2+ channel blocker (CO2+). Application of sevoflurane
      following bradykinin-evoked [Ca2+]i transient diminished [Ca2+]i significantly,
      while bradykinin B2 receptor antagonist (D-Arg-[Hyp3, Thi5,8, D-Phe7] bradykinin)
      or CO2+ abolished it. Sevoflurane impaired nitrite accumulation stimulated by
      bradykinin, and reduced the amount of NO released from endothelial cells. Our
      results indicate that the negative effect of sevoflurane appears to be due to the
      inhibition of bradykinin-induced Ca2+ efflux from endoplasmic stores and Ca2+
      influx through membrane Ca2+ channels.

PMID- 7781709
TI  - LU52396, an inhibitor of the store-dependent (capacitative) Ca2+ influx.
AB  - The effects of 1-[2-(4-fluorophenyl)cyclohexyl]-2-[4-(3-phenylalkyl)-piperazin -1
      yl]- ethanol, LU52396, on a) Ca2+ influx across the plasma membrane and b) Ca2+
      mobilization from intracellular rapidly-exchanging Ca2+ stores were investigated
      in HeLa cells and in isolated microsomal fractions derived from the cerebellum
      and the skeletal muscle. LU52396 was found to be a potent inhibitor (Ki of about
      2 microM) of the Ca2+ influx activated by depletion of intracellular Ca2+ stores,
      a phenomenon referred to as store-dependent or capacitative Ca2+ influx. Such an
      effect, which was reversed by cell washing, was mediated neither by a
      depolarization of the cell, with decrease in the driving force for cation influx,
      nor by a change of the intracellular pH, and might therefore be due to a direct
      action of the drug on either the responsible channel in the plasma membrane or,
      less likely, on its regulatory mechanisms. Additional effects, i.e. inhibition of
      receptor-mediated Ca2+ influx, of Ca2+ release from intracellular stores via
      either inositol 1,4,5-trisphosphate or ryanodine receptors, and of Ca2+ reuptake
      into the stores via sarcoplasmic-endoplasmic reticulum Ca(2+)-ATPases, were also
      induced by the drug, however at concentrations 20-fold or more than those
      effective on the store-dependent influx. To our knowledge LU52396 is the first
      pharmacological tool that is found to be addressed with some preference to the
      store-dependent Ca2+ influx. It promises, therefore, to be useful for the
      characterization of the process, the identification of the responsible channel
      and, possibly, also of the molecular mechanisms through which these channels
      operate.

PMID- 7781711
TI  - Cyclic nucleotide phosphodiesterase isozymes in rat mesangial cells.
AB  - We characterized cyclic nucleotide phosphodiesterases isolated from rat mesangial
      cells and assessed their roles in regulating cellular cyclic nucleotide levels.
      Three peaks of phosphodiesterase activity were eluted by a linear sodium acetate
      gradient from a Q Sepharose column loaded with the mesangial cell extract. The
      first peak activity was stimulated by Ca(2+)-calmodulin and inhibited by
      calmodulin-stimulated phosphodiesterase inhibitors but not by a selective cGMP
      specific phosphodiesterase V inhibitor. The second, minor activity peak was
      stimulated by cyclic GMP and inhibited by EHNA [erythro-9-(2-hydroxy-3-nonyl)
      adenine], a selective inhibitor of cyclic GMP-stimulated phosphodiesterase II.
      The last peak activity was not inhibited by cyclic GMP but selectively inhibited
      by rolipram [4-(3-cyclopentyloxy-4-methoxyphenyl)-2-pyrrolidene] or Ro 20-1724 [4
      (3-butoxy-4-methoxybenzyl)-2-imidazolidinone], inhibitors of cyclic AMP specific,
      cyclic GMP insensitive phosphodiesterase IV. Based on their order of
      chromatographic elution, kinetic properties and sensitivity to allosteric agents
      and inhibitors, the peak 1, 2 and 3 correspond to phosphodiesterase I, II and IV.
      The basal cyclic GMP level was raised more effectively by selective inhibitor of
      phosphodiesterase I than phosphodiesterase II. In contrast, the atrial
      natriuretic factor-induced cyclic GMP elevation was potentiated more effectively
      by selective inhibitors of phosphodiesterase II than phosphodiesterase I. The
      forskolin-induced cyclic AMP increase was greatly potentiated by selective
      phosphodiesterase IV inhibitors but not by other phosphodiesterase inhibitors.
      These data suggest that phosphodiesterase I and II are responsible for cyclic GMP
      hydrolysis whereas phosphodiesterase IV is mainly responsible for cyclic AMP
      hydrolysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781712
TI  - Ca2+ handling mechanisms underlying neuropeptide Y-induced contraction in canine
      basilar artery.
AB  - The effects of neuropeptide Y on isometric tension simultaneously measured with
      cytosolic Ca2+ concentration ([Ca2+]cyt) and Ca2+ sensitivity of contractile
      elements were studied in isolated canine basilar arteries. Neuropeptide Y (1-100
      nM) increased [Ca2+]cyt and tension in a concentration-dependent and parallel
      manner, whereas 9,11-dideoxy-11 alpha,9 alpha-epoxymethano prostaglandin F2 alpha
      (U46619) (10-100 nM), a thromboxane A2 mimetic, produced a large contraction with
      a small increase in [Ca2+]cyt. Ca2+ channel antagonists such as d-cis-diltiazem
      (10 mM) abolished both [Ca2+]cyt and tension augmented by neuropeptide Y. In
      Ca(2+)-free solution containing 0.2 mM EGTA, neuropeptide Y did not change
      [Ca2+]cyt and tension, whereas U46619 transiently increased both of them.
      Furthermore, neuropeptide Y apparently did not affect the Ca2+ sensitivity when
      assessed in the artery permeabilized with Staphylococcus aureus alpha-toxin,
      whereas U46619 augmented it. These findings suggest that neuropeptide Y-induced
      contraction in the canine basilar artery is produced mainly by Ca2+ influx
      through L-type Ca2+ channels.

PMID- 7781713
TI  - Long-term haloperidol elevates dopamine D4 receptors by 2-fold in rats.
AB  - Chronic treatment of rats with neuroleptics results in elevated numbers of
      dopamine D2-like receptors. The present study was done to determine whether
      neuroleptics altered the density of one type of dopamine D2-like receptors,
      namely the dopamine D4 receptor. We here describe the effect of a one-month
      treatment with haloperidol on dopamine D4 receptor mRNA and protein levels in rat
      striatum. Endogenous levels of dopamine D4 receptor mRNA in rat striatum are very
      low and, therefore, reverse transcription and subsequent amplification were used
      for quantification. Dopamine D4 receptor density was, because of the absence of a
      dopamine D4 receptor specific [3H]ligand, determined by the difference between
      the number of binding sites for [3H]nemonapride and [3H]raclopride. Scatchard
      analysis of [3H]nemonapride and [3H]raclopride binding show that treatment for
      one month with halperidol elevates the density of dopamine D4 receptors in rat
      striatum by approximately 2-fold, whereas dopamine D2 and D3 receptors together
      show a 19% higher receptor density. Dopamine D4 receptor mRNA was also
      approximately increased by 2-fold.

PMID- 7781714
TI  - Characterization of the human liver alpha 1-adrenoceptors: predominance of the
      alpha 1A subtype.
AB  - The alpha 1-adrenoceptor subtype present in human liver membranes was studied
      using radioligand binding techniques. [3H]Prazosin binding was rapid, saturable
      and reversible. A kinetically derived Kd of 0.22 nM was obtained. Rosenthal
      analysis of saturation isotherms indicated a single class of binding sites with a
      Kd of 0.47 nM and a Bmax of 70 fmol/mg of protein. Membrane preincubation with
      chloroethylclonidine markedly decreased total binding (62% decrease) without
      altering the Kd for the radioligand. Binding competition experiments were
      performed and the order of potency for agonists was: oxymetazoline > epinephrine
      > or = norepinephrine > methoxamine. The binding affinity for epinephrine was
      modulated by the GTP analogue guanosine-5'-(beta,gamma-imido)triphosphate. For
      antagonists the potency order was: WB4101 > or = prazosin > or = (+)-niguldipine
      = 5-methylurapidil > or = benoxathian > or = phentolamine. The pharmacological
      profile of the [3H]prazosin binding sites of human liver membranes suggests that
      alpha 1A-adrenoceptors predominate (75%-85% of the alpha 1-adrenoceptors) in this
      tissue.

PMID- 7781715
TI  - Endogenous [3H]flunitrazepam binding in human embryonic kidney cell line 293.
AB  - Specific endogenous [3H]flunitrazepam binding sites were identified and
      characterized in membranes from the human embryonic kidney (HEK) cell line 293. A
      large part of these binding sites exhibited an intermediate affinity for
      [3H]flunitrazepam and a microM affinity for diazepam, clonazepam, 1-(2
      chlorophenyl)-N-methyl-N-(1-methylpropyl)-3-isoquinolinecarboxam ide (PK 11195)
      or 4'-chlorodiazepam (Ro 5-4864). These sites, thus, resembled neither gamma
      aminobutyric acidA (GABAA) receptor associated nor 'peripheral' benzodiazepine
      binding sites. A small part of the binding sites labeled by [3H]flunitrazepam
      seemed to belong to 'peripheral' benzodiazepine binding sites exhibiting a nM
      affinity for PK 11195, and another small part of the binding sites seemed to
      exhibit a high affinity for flunitrazepam and PK 11195. Although small amounts of
      mRNA for alpha 1-, beta 3- and gamma 2-subunits of GABAA receptors could be
      identified in HEK 293 cells, neither the actual expression of GABAA receptors in
      these cells nor a coassembly of endogenous subunits with transfected GABAA
      receptor subunits could be demonstrated by binding studies.

PMID- 7781717
TI  - Dizocilpine enhances striatal tyrosine hydroxylase and aromatic L-amino acid
      decarboxylase activity.
AB  - Dizocilpine administration enhances dopamine metabolism in the rat striatum,
      nucleus accumbens, olfactory tubercle, and prefrontal cortex. Concomitant with
      increased metabolism is enhanced tyrosine hydroxylase and aromatic L-amino acid
      decarboxylase activities in the striatum and increased mRNA for the two enzymes
      in the midbrain. Activation of dopaminergic neurons may, in part, explain
      increased locomotor activity in normal animals and the ability of dizocilpine to
      potentiate the antiparkinsonian action of L-3,4-dihydroxyphenylalanine in an
      animal model.

PMID- 7781716
TI  - In primary neuronal cultures muscarinic m1 and m3 receptor mRNA levels are
      regulated by agonists, partial agonists and antagonists.
AB  - The homologous regulation of the muscarinic m1 and m3 receptors mRNA was studied
      in rat corticostriatal neuronal cultures. In response to the full agonist
      carbachol the m1 and m3 receptor mRNA levels were modulated and showed different
      time-courses. The m1 receptor mRNA increased to 270% of prestimulation levels
      after 6 h, while the m3 receptor transcript transiently increased to 170% after 2
      h. Conversely, the muscarinic receptor partial agonist oxotremorine caused a
      rapid and sustained increase in both mRNA species as soon as after 1 h of
      exposure. A comparable increase in both receptor mRNAs was induced by the partial
      agonist [4-(m-chlorophenylcarbamoyloxy)-2-butynyltrimethyl-ammonium chloride]
      (McN-A-343). The observation that 1 h exposure to the non selective antagonist N
      methyl-scopolamine also enhanced the m1 and m3 receptor transcripts suggests that
      in corticostriatal neurons muscarinic receptor partial agonists exert an
      antagonist-like effect on the m1 and m3 receptor mRNAs.

PMID- 7781719
TI  - Natural head position and natural head orientation: basic considerations in
      cephalometric analysis and research.
AB  - Natural head position (NHP) provides the key for meaningful cephalometric
      analysis because an extracranial reference line is used instead of intracranial
      reference lines, known to be subject to considerable biological variation in
      their inclination. Although the principle of natural head position is being
      recognized in the orthodontic literature, its registration may contain an element
      of unavoidable error that requires correction. A new concept of natural head
      orientation (NHO) has been introduced to maximize the contribution of NHP to
      cephalometrics. It is defined as the head orientation of the subject perceived by
      the clinician, based on general experience, as the natural head position in a
      standing, relaxed body and head posture, when the subject is looking at a distant
      point at eye level. The present study was designed to determine the accuracy and
      validity of NHO, using lateral profile photographs cut in a circular shape,
      obtained from 27 orthodontic patients, 10-14 years old. Findings among four
      investigators showed a high correlation (r = 0.82-0.96), in orientating these
      profile photographs in estimated natural head position (NHP). Moreover,
      investigators showed good correlation (r = 0.57-0.84) in head orientation after a
      3-week interval. Mean differences for the same period varied between 0.1 and 2.9
      degrees. The validity of NHO was supported also by a panel investigation.
      Clinicians as well as auxiliary personnel can be trained to make a critical
      judgement of the recorded natural head position and correct head orientation,
      whenever indicated, to enhance the reliability of cephalometric analysis in
      clinical practice and research.

PMID- 7781720
TI  - Quantitative and qualitative assessment of enamel surface following five
      composite removal methods after bracket debonding.
AB  - The search for an ideal enamel surface finishing method following bracket
      debonding has met with equivocal response. In this study, four other methods were
      assessed to determine their effectiveness against the slow speed tungsten carbide
      bur which is regarded as the established method of removing residual composite.
      Orthodontic brackets were bonded on 50 premolar teeth extracted for orthodontic
      purpose. After debonding with a standardized technique, the teeth were randomly
      divided into five equal groups. Samples in each group were subjected to different
      finishing procedures: Group A--Ormco band removing plier. Group B--Komet slow
      speed tungsten carbide bur. Group C--High speed ultrafine diamond bur. Group D-
      Jet high speed tungsten carbide bur. Group E--High speed white stone finishing
      bur. For consistency, the finishing procedures were limited to 15 seconds with
      each particular method. The composite remnants which then remained on the enamel
      surface were graded by four independent raters using the Composite Remnant Index
      (CRI). Subsequent to this, the enamel surface was examined in a Scanning Electron
      Miscroscope at x203 magnification. The photomicrographs were then graded by the
      same four independent raters using the Surface Roughness Index (SRI). Statistical
      analysis with the Friedman test indicated that there was no significant
      difference in inter-examiner variability in both the CRI and SRI assessment, but
      there existed significant difference among groups (P < 0.01) for both the CRI and
      SRI. It was found that no single absolute method was considered to be ideal for
      composite removal.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781718
TI  - A photographic scale to measure facial aesthetics.
AB  - The aim of this study was to develop a measurement scale to quantify facial
      aesthetics. Four series of 36 standardized facial photographs (boys 11-13 years;
      girls 11-13 years; boys 14-16 years; girls 14-16 years) were judged twice by
      eight orthodontists, eight laymen, and eight children. This was undertaken by
      comparing each photograph with one reference photograph of a child of the same
      sex and age. Pearson's correlation coefficients were calculated to determine
      intra-observer agreement (median Pearson's correlation r = 0.78), and to assess
      the correlation between the scores of each judge and those of the others in that
      panel (median Pearson's correlation r = 0.71). Alpha coefficients were calculated
      as a measure for the reliability of the composed scores (median alpha coefficient
      alpha = 0.90). Finally, the correlation between the three jury panels was
      established (median Pearson's correlation r = 0.84). The results showed that the
      reproducibility of rating facial aesthetics is good. Moreover, a high level of
      agreement was found between the ratings of different panels. Therefore, a mean
      overall score for each judged photograph could be calculated. Finally, for each
      age and sex group a metric scale was composed, consisting of five photographs
      with their scores. These scales can be used to evaluate the results of
      orthodontic treatment with respect to facial aesthetics.

PMID- 7781721
TI  - The effect of a lip bumper on lower dental arch dimensions and tooth positions.
AB  - The effect of a lip bumper on the dimensions of the lower dental arch and on the
      inclination of the incisors and first molars was studied in 40 children, aged 9
      12 years. The children wore their lip bumper full time for 7-10 months. The
      effects of the lip bumper therapy were recorded on dental casts and profile
      cephalograms made before and after the treatment. The positions and stages of
      development of the lower second molars were determined on pretreatment intra-oral
      radiographs. The lip bumper treatment resulted in an increase of the dental arch
      widths between the molars, premolars, and canines. The arch length increased
      through proclination of the incisors and uprighting of the first molars. The
      stages of development and the positions of the second molars had no influence on
      the effect of the treatment. Simultaneous treatment in the maxilla with a
      headgear, a transpalatal arch or a removable plate had no influence on the
      outcome of the lip bumper therapy.

PMID- 7781722
TI  - Long-term evaluation after chincap treatment.
AB  - The purpose of this study was to investigate the skeletal changes occurring
      during and after chincap therapy. The subjects of this study, with a mean age of
      9 years 3 months, consisted of 27 patients; all of whom possessed an anterior
      crossbite. Of these patients, 15 had skeletal Class III and the remaining 12 had
      skeletal Class I malocclusions with anterior crossbites. The applied total force
      with the chincap was 600 grams and the mean treatment period was 12 months. The
      changes during and after treatment were analysed by using linear and angular
      cephalometric measurements. The result obtained in this investigation was that in
      skeletal Class I and Class III cases, successfully treated by a chincap
      appliance, where the necessary overjet and overbite relationship was obtained,
      the abnormality tended to return to the original position during the period
      following chincap removal.

PMID- 7781723
TI  - An in vitro comparison between a bonded retainer system and a directly bonded
      flexible spiral wire retainer.
AB  - Bonded lingual retainers are becoming more popular to stabilize the results of
      orthodontic treatment. The in vitro shear strength of a flexible spiral wire
      (FSW) retainer (Zachrisson, 1977, 1983) bonded with Prisma Fil was compared to
      the 'A'-Company bonded lingual retainer system, bonded with either Concise or
      Right-On, to human enamel. Statistical analysis of the results showed no
      significant differences between the 'A'-Company system when bonded with Concise
      or Right On, Concise having a greater mean bond strength, but also a greater
      range of bond strength values. All the materials tested gave bond strengths that
      were adequate for clinical practice and it is concluded that the choice of bonded
      retainer system can be made upon grounds of clinical convenience or cost.

PMID- 7781724
TI  - The prediction of distortion in formed orthodontic appliances.
AB  - The theoretical prediction of the onset of distortion within a retraction U-loop
      as derived from a knowledge of the maximum bending moment, the wire
      characteristics and the loop dimensions was found to be in good agreement with
      the experimental measurements carried out on large scale models of the U-loops.
      The ability to predict distortion in appliances should be of use in any
      comparison of the properties of the different designs of U-loop or in the
      evaluation of different designs of orthodontic appliance.

PMID- 7781725
TI  - Human dental pulp and gingival tissue after static magnetic field exposure.
AB  - The aim of this intra-individual study was to examine human dental pulp and
      gingival tissue after exposure to static magnetic fields generated by orthodontic
      samarium-cobalt magnets. In seven individuals, aged between 11.5 and 17.5 years,
      the maxillary first premolars and immediately adjacent gingival tissues were
      exposed to a static magnetic field from a bonded magnet on one side (test) and a
      demagnetized magnet was used as a control on the contralateral side. After a
      period of 8 weeks the test and control teeth were clinically examined regarding
      gingival conditions, then biopsies of the buccal gingival tissues were taken and
      the maxillary first premolars were extracted. The teeth and the tissue biopsies
      were examined histologically. The static magnetic field exposure (flux density)
      of the coronal pulp sections on the test sides ranged between 100 and 150 Gauss,
      and the exposure of the buccal gingival tissues ranged between 200 and 900 Gauss.
      The contralateral control tissues were exposed to flux density values at the
      level of the natural magnetic field on earth (0.3-0.6 Gauss). Static magnetic
      fields produced by orally placed orthodontic rare earth magnets did not result in
      any change in human dental pulp or gingival tissue adjacent to the magnets. There
      was no difference in clinical gingival conditions between test and control sites.

PMID- 7781726
TI  - Prevalence and severity of apical root resorption of maxillary anterior teeth in
      adult orthodontic patients.
AB  - The purpose of this study was to evaluate prevalence and severity of apical root
      resorption of maxillary anterior teeth in a large sample of adult orthodontic
      patients, to analyse any difference between subgroups of patients with and
      without a history of earlier orthodontic treatment, and to test the hypothesis
      that endodontically treated teeth are less likely to experience apical root
      resorption. Differences in tooth length measurements of standardized periapical
      radiographs made before and after treatment of 343 adults, representing groups of
      consecutively treated patients from four orthodontic practices, were calculated.
      Sample means of averaged root resorption of all six anterior teeth and of the
      most severely resorbed tooth per patient were 0.94 mm (SD 0.88) and 2.39 mm (SD
      1.43), respectively. Forty per cent of the adults had one or more teeth with 2.5
      mm resorption or greater. The subsample of 31 patients with a history of earlier
      orthodontic treatment had less root resorption than the remaining patients (P <
      0.001). Evaluation of the 39 contralateral pairs of teeth with and without
      endodontic treatment in 36 of the patients revealed less resorption of the
      endodontically treated teeth (P < 0.05).

PMID- 7781727
TI  - Epidemiology of Pseudomonas aeruginosa keratitis in contact lens wearers.
AB  - This study evaluated the epidemiology of Pseudomonas aeruginosa keratitis in
      contact lens (CL) wearers; the relationships between CL storage case
      contamination and CL hygiene practice and between CL hygiene and the development
      of keratitis. Sixteen CL wearers with keratitis were compared with 44
      asymptomatic controls. Lens hygiene practice was assessed and CL care materials,
      domestic water sites and endogenous sites were evaluated microbiologically. Poor
      CL hygiene was not associated with Ps. aeruginosa keratitis. There was an
      association between keratitis and bacterial contamination of the CL and storage
      case (P < 0.0005). Lens and storage case contamination were not significantly
      associated with poor hygiene. No domestic or endogenous source for Ps. aeruginosa
      was found. Causative organisms may be derived from other sources, but CLs and CL
      storage cases provide a favourable environment for Ps. aeruginosa colonization.
      Changing the CL care environment to one less favourable for Ps. aeruginosa may
      help to eliminate this problem.

PMID- 7781728
TI  - Correlation of change in phage type with pulsed field profile and 16S rrn profile
      in Salmonella enteritidis phage types 4, 7 and 9a.
AB  - Using pulsed-field gel electrophoresis (PFGE) and 16S rRNA (rrn) analysis
      (ribotyping), the in vivo derivation of strains of Salmonella enteritidis PTs 9a
      and 7 from a strain of S. enteritidis PT 4 has been demonstrated. All strains
      were isolated from a single patient over a 6-week period. Further studies have
      demonstrated that in terms of pulsed-field profile and ribotype, the genotypes of
      the patient-derived strains differed from those of the reference strains of the
      respective phage types. It is concluded that when used in combination, these
      methods can provide evidence of phylogenetic relationships in apparently
      unrelated S. enteritidis phage types isolated during pathogenesis of disease.

PMID- 7781729
TI  - Epidemiology of Campylobacter spp. at two Dutch broiler farms.
AB  - Broiler flocks on two Dutch poultry farms were screened weekly for the presence
      of campylobacter in fresh caecal droppings during eight consecutive production
      cycles. Hatchery and fresh litter samples were taken at the start of each new
      cycle. Water, feed, insects, and faeces of domestic animals, present on the farms
      were also included in the sampling. Penner serotyping of isolates was used to
      identify epidemiological factors that contribute to campylobacter colonization in
      the broiler flocks. Generally, broiler flocks became colonized with campylobacter
      at about 3-4 weeks of age with isolation percentages of 100%, and stayed
      colonized up to slaughter. A similar pattern of serotypes was found within the
      various broiler houses on one farm during one production cycle. New flocks
      generally showed also a new pattern of serotypes. Most serotypes isolated from
      the laying hens, pigs, sheep and cattle were different from those isolated from
      the broilers at the same time. Campylobacter serotypes from darkling beetles
      inside the broiler houses were identical to the ones isolated from the broilers.
      No campylobacter was isolated from any of the hatchery, water, feed or fresh
      litter samples. Conclusive evidence of transmission routes was not found, but
      results certainly point towards horizontal transmission from the environment.
      Horizontal transmission from one broiler flock to the next one via a persistent
      contamination within the broiler house, as well as vertical transmission from
      breeder flocks via the hatchery to progeny, did not seem to be very likely.

PMID- 7781730
TI  - Restriction fragment length polymorphisms among the flagellar genes of the Lior
      heat-labile serogroup reference strains and field strains of Campylobacter jejuni
      and C. coli.
AB  - Several typing systems have been described for Campylobacter jejuni and C. coli,
      to assess the complex epidemiology of these important enteric pathogens. In the
      present study two typing methods, slide agglutination according to the Lior
      scheme, and the demonstration of restriction-fragment length polymorphisms (RFLP)
      of flagellar genes, have been used in parallel on a set of 194 strains. This set
      comprised 118 sero-reference strains of C. jejuni and C. coli of the Lior scheme,
      as well as 76 clinical isolates. All isolates were serotyped and subjected to PCR
      for amplification of flagellar genes, and the PCR product was restricted with Alu
      I. Flagellar genes could be amplified in 152 strains. Among 85 seroreference
      strains, 74 different RFLP patterns were observed, and among 67 clinical
      isolates, there were 36 patterns. There was only limited correlation between
      flagellar RFLP and the Lior serogroup, and the variability of patterns in
      serogroups HL2 and HL4 were as marked as the variability between serogroups.
      Flagellar gene RFLP patterns are shown to be stable, highly discriminatory
      epidemiologic markers.

PMID- 7781731
TI  - Sporadic isolates of Escherichia coli O157.H7 investigated by pyrolysis mass
      spectrometry.
AB  - Thirty-six encoded isolates of Escherichia coli. 32 of which were of serotype
      O157, were examined by pyrolysis mass spectrometry (PyMS). Thirty-one of the
      serotype O157 isolates possessed the flagellar antigen H7 and produced
      Verocytotoxin (VT), the other isolate serotyped as H45 and was non-toxigenic.
      Eighteen of the VT-producing E. coli (VTEC) isolates were from sporadic disease
      in residents of the Northern Region. Standard principal component (PC) and
      canonical variate (CV) analysis of the data distinguished only the four non-O157
      isolates from the remainder which were indistinguishable by this approach. A
      similarity matrix based on differences between individual CV means distinguished
      a further ten isolates. The matrix correctly clustered 2 pairs of isolates from
      siblings and 4 isolates from an affected family. A further 5 clusters of 3 or
      more isolates and 6 pairs of isolates were defined. These groupings proved to be
      homogenous for toxin phenotype but occasionally entrained isolates of dissimilar
      phage type. However, in general, PyMS-derived clustering of apparently sporadic
      isolates accorded with geographical locations as determined by postcode. PyMS,
      which is a quick and high volume capacity phenotypic technique, may be a useful
      addition to existing methods in the investigation of the epidemiology of sporadic
      VTEC disease.

PMID- 7781732
TI  - Verotoxinogenic Citrobacter freundii associated with severe gastroenteritis and
      cases of haemolytic uraemic syndrome in a nursery school: green butter as the
      infection source.
AB  - A summer outbreak of severe gastroenteritis followed by haemolytic uraemic
      syndrome (HUS) and thrombotic thrombocytopenic purpura in a nursery school and
      kindergarten is described. Sandwiches prepared with green butter made with
      contaminated parsley were the likely vehicle of infection. The parsley originated
      from an organic garden in which manure of pig origin was used instead of
      artificial fertilizers. Clonally identical verotoxinogenic Citrobacter freundii
      were found as causative agents of HUS and gastroenteritis and were also detected
      on the parsley.

PMID- 7781733
TI  - The epidemiology of Haemophilus influenzae type b disease in the Republic of
      Ireland.
AB  - A 2-year case-control study was conducted to describe the epidemiology of
      Haemophilus influenzae type b (Hib) and investigate Hib disease risk factors in
      the Republic of Ireland. Between October 1991 and September 1993. 149 laboratory
      confirmed incident cases were matched with community controls. Annual Hib disease
      incidence was 25.4 per 100,000 children under 5 years, with peak incidence (65.8
      per 100,000) in the 6-11 months age-group. Meningitis was the predominant
      clincial condition. Twenty-four (16.1%) isolates were resistant to ampicillin.
      Creche or day-care attendance and the presence of chronic illness emerged as risk
      factors for Hib disease. Empirical first line treatment for suspected Hib
      infection warrants alternatives to ampicillin such as cefotaxime. Completed
      immunization with Hib conjugate vaccine by 6 months of age is required for
      maximum disease prevention. Until all children are receiving Hib vaccine on
      schedule, those who are creche or day-care attendees and those with chronic
      illness should be prioritized for timely immunization.

PMID- 7781734
TI  - High prevalence of antibodies to Chlamydia pneumoniae; determinants of IgG and
      IgA seropositivity among Jerusalem residents.
AB  - The prevalence of antibodies to Chlamydia pneumoniae was examined in a stratified
      random sample of 581 Jerusalem adult residents between August 1987 and March
      1989. IgG and IgA titres were measured by microimmunofluorescence, and
      associations with smoking and socio-demographic variables were assessed. IgG
      antibodies were found in 84.5% (95% confidence interval (CI): 80.4-87.9) of men
      and 68.7% (95% CI: 61.6-75.0) of women (P < 0.0001 for sex difference),
      indicating a very high rate of exposure in this population. IgA antibodies,
      postulated to represent persistent infection, were present in 45.1% (95% CI: 40.1
      50.2) of men and 23% (95% CI: 17.4-29.7) of women (P < 0.0001 for sex
      difference). Factors associated with IgG seropositivity included family size,
      education and social class. On the other hand age (in men) and smoking were
      associated with IgA seropositivity. These findings support the hypothesis that
      low socioeconomic status and household crowding may be predictive of exposure to
      or infection with this organism (IgG seropositivity), whereas they do not explain
      persistence of the infection putatively expressed as IgA seropositivity.

PMID- 7781735
TI  - Feasibility study for identifying adverse events attributable to vaccination by
      record linkage.
AB  - To investigate the feasibility of using a record linkage method for identifying
      vaccine attributable adverse events, computerized hospital admissions and
      vaccination records from South East Kent district were linked and checked for
      accuracy. Records for 90% of children under 2 years of age admitted to hospital
      over a 2-year period were matched with vaccination records using a computer
      algorithm based on name, date of birth, sex, and post-code supplemented by visual
      inspection. Relative to this gold standard, matching on date of birth, sex and
      postcode alone had a sensitivity of 60% and an incorrect match rate of 0.2% after
      matches to more than one vaccine recipient were excluded. Manual checking of a
      sample of admissions showed that only 4% had been assigned incorrect
      International Classification of Disease (ICD) codes. Routine record linkage of
      ICD admission codes to vaccination records therefore yields data of good quality
      which may be used for surveillance purposes.

PMID- 7781736
TI  - Isolation of epidemic poliovirus from sewage during the 1992-3 type 3 outbreak in
      The Netherlands.
AB  - To examine the extent of wild poliovirus circulation during the 1992-3 epidemic
      in the Netherlands caused by poliovirus type 3, 269 samples from sewage pipelines
      at 120 locations were examined for the presence of poliovirus. The epidemic virus
      strain was found in 23 samples, all from locations inside the risk area which
      contained communities that refuse vaccination for religious reasons. By sewage
      investigation, the wildtype virus was shown to be present in the early phase of
      the epidemic at two locations, one week before patients were reported from that
      area. The wild type 3 poliovirus was also detected retrospectively in a river
      water sample collected for other reasons three weeks before notification of the
      first poliomyelitis case, at a site a few kilometres upstream the home village of
      this patient. Oral poliovirus vaccine (OPV) virus was found at 28 locations
      inside or at the border of the risk area. Trivalent OPV was offered to
      unvaccinated or incompletely-vaccinated persons living in this region as part of
      the measures to control the epidemic.

PMID- 7781737
TI  - Sequence variation in the haemagglutinin-neuraminidase gene of human
      parainfluenza virus type 3 isolates in the UK.
AB  - The sequence variation in a 934 base-pair region of the gene encoding the
      haemagglutinin-neuraminidase of five human parainfluenza virus type 3 (HPIV3)
      isolates was determined together with that of a prototype UK strain. All of the
      clinical isolates were from the Manchester area of the UK and were obtained in
      1990, 1991 and 1993. The gene segment was amplified by the polymerase chain
      reaction using HPIV3-specific oligonucleotide primers. The nucleotide homology of
      the strains was high, around 99% and specific differences in the UK sequences
      when compared with that of the US prototype strain were identified. In addition,
      a number of isolate-specific differences were seen. No correlation was detected
      between the observed nucleotide mutations and the year of isolation, which
      supports the hypothesis that HPIV3 shows cocirculation of a heterogeneous
      population of viruses rather than varying with time in a linear fashion. However,
      the data suggested that geographically-defined genetic lineages of HPIV3 may
      exist.

PMID- 7781738
TI  - Serosurvey and laboratory diagnosis of imported sandfly fever virus, serotype
      Toscana, infection in Germany.
AB  - Of eight acute infections in German tourists caused by sandfly fever virus,
      serotype Toscana (TOS), and diagnosed clinically and serologically, seven were
      acquired during visits to Tuscany, Italy, and one to Coimbra, Portugal. An
      indirect immunofluorescence assay (IFA) using infected cells, and a newly
      developed enzyme-immunoassay (EIA) using crude virus antigen prepared from
      infected Vero-E6 cells was used to detect anti-TOS IgM and IgG. In a
      seroepidemiological survey of 859 health care workers and medical students, anti
      TOS IgG was detected in 1.0% by IFA, and in 0.7% by EIA. In 2034 German patients
      hospitalized for various diseases, 1.6% were positive for anti-TOS IgG by IFA,
      and 0.8% by EIA. Anti-TOS IgG was detected in 43 samples of commercial
      immunoglobulins at titres of 10-1000 by EIA. Although the seroprevalence of
      antibodies to TOS is low in Germany, TOS infection should be considered in
      patients returning from endemic areas who complain of fever, and headaches, and
      have symptoms of meningitis.

PMID- 7781739
TI  - Serological studies of influenza viruses in pigs in Great Britain 1991-2.
AB  - Samples from a sow serum bank representative of the pig population of Great
      Britain collected during 1991-2, were examined for antibodies to influenza A, B
      and C viruses, using viruses which had been isolated from a variety of hosts. For
      influenza A viruses there was evidence of the continued circulation of classical
      swine H1N1 virus (26%) seroprevalence), and human H3N2 viruses (39%) which are
      antigenically most closely-related to A/Port Chalmers/1/73 virus. In addition
      antibodies were detected to A/swine/England/201635/92 (8%), a strain of H3N2
      virus which appears to have arisen by antigenic drift from conventional H3N2
      swine strains. Specific antibodies (2%) were detected to an H1N1 virus
      (A/swine/England/195852/92) related most closely to avian H1N1 strains. In tests
      with human H1N1 and H3N2 viruses, excluding isolates from pigs, the highest
      seroprevalence was detected to the prevailing strains from the human population.
      Serological tests with avian H4 and H10, human H2, equine 1 and 2 influenza A
      viruses were all negative. Seven pigs seropositive by haemagglutination
      inhibition, virus neutralization and immunoblotting assays for antibody to
      influenza B virus, were randomly distributed geographically suggesting that
      influenza B viruses may be transmitted to pigs but fail to spread. The
      seroprevalence to influenza C viruses was 9.9% indicating that these viruses are
      widespread in pigs. These results provide further evidence that the pig can be
      infected by a number of influenza viruses, some of which may have significance in
      the epidemiology of human influenza.

PMID- 7781740
TI  - Acetylcholinesterase in the developing ferret retina.
AB  - The function of acetylcholinesterase (AChE) is to terminate the action of
      acetylcholine at the cholinergic synapse. Recent evidence suggests additional
      roles for acetylcholinesterase as a peptidase and/or a protease which is
      expressed by growing neurites as part of their invasion of developing neural
      structures. We report the localization of acetylcholinesterase in developing
      ferret retina. AChE histochemical staining is seen in the developing inner
      plexiform layer (IPL) of ferret retina at birth (post-natal day zero, PO), the
      earliest developmental stage examined. Transient expression is seen at the border
      between the ganglion cell layer and the nerve fiber layer at P14 and P21. A small
      amount of transient expression is seen in the outer plexiform layer (OPL) at this
      age as well. By P28, the transient expression in the OPL is at its peak, and is
      found at photoreceptor terminals and associated with apparent horizontal cell
      axons. Labeling is also seen intracellularly in the inner nuclear layer (INL), at
      the OPL/INL border, suggesting that horizontal cells are the source of the
      transient AChE expression in the OPL. Overt synaptic profiles also appear in the
      inner plexiform layer (IPL) at P21 and P28. About 2 days layer, the eyes open and
      the photoreceptor outer segments are fully developed. By 2 weeks later, at P42,
      the AChE staining pattern in the retina has taken on its adult appearance: no
      reaction product in the outer retina; intracellular reaction product in the Golgi
      apparatus of a subset of amacrine and displaced amacrine cells which manufacture
      AChE; and extracellular reaction product at both synaptic and non-synaptic sites
      in the IPL. These data are consistent with a role for AChE as a peptidase early
      in development, and as an enzyme essential in the termination of synaptic action
      at mature synapses.

PMID- 7781741
TI  - Structure and composition of the rodent lamina cribrosa.
AB  - To define the architecture and extracellular matrix composition of the lamina
      cribrosa in rodents, normal, adult pigmented rat and guinea pig eyes were frozen
      and sectioned for light microscopic immunohistochemistry. Antibodies specific for
      collagens I, III, IV and VI, laminin, elastin, and chondroitin and dermatan
      sulfate proteoglycans were exposed to longitudinal and cross-sections of optic
      nerve heads and their binding distributions observed with the avidin-biotin
      peroxidase complex technique. Cross-sections of the intraocular portion of the
      rat optic nerve head revealed a horizontally oval shape with distinct, vertically
      oriented, laminar beams. The guinea pig optic nervehead cross-section was
      circular, with randomly oriented beams. In both animals, collagens I, III and VI
      were found throughout the laminar beams, along with elastin fibrils. Collagen IV
      and laminin antibodies deposited along laminar beam margins and within the beams,
      representing astrocytic and vascular endothelial cell basement membranes. Both
      animals showed evidence for dermatan and chondroitin sulfate-containing
      proteoglycans in all connective tissue structures of the nerve head. In the rat,
      chondroitin-4 sulfate proteoglycans appeared localized to the sclera and laminar
      beams. The rat and the guinea pig optic nerve head possess an identifiable lamina
      cribrosa with structural proteins nearly identical to that of the primate. Both
      animals may provide affordable alternative animal models for in vivo studies on
      the role of the lamina cribrosa in glaucomatous optic nerve damage.

PMID- 7781742
TI  - Immunocytochemical study of cytochrome P450 (1A1/1A2) induction in murine ocular
      tissues.
AB  - C57BL/6 and DBA/2 mice were injected intraperitoneally with beta-naphthoflavone
      in corn oil and killed 48 hr later. Control animals received an injection of corn
      oil. The immunoreactivity of cytochrome P450 1A1/1A2 expressed in different
      ocular tissues and liver was examined with goat anti-P450 antibody (primary
      antibody) and gold-conjugated anti-goat antibody (secondary antibody). DBA/2
      mice, which are non-responsive to aryl hydrocarbon treatment, showed negligible
      levels of immunoreactivity toward anti-P450 1A1/1A2 antibody in all ocular
      tissues, whether or not the animals were treated with beta-naphthoflavone. In
      responsive C57BL/6 mice, however, the immunoreactivity of the uveal tissues,
      especially ciliary non-pigmented epithelium, was markedly increased by beta
      naphthoflavone treatment. The time course of induction of P450 1A1/1A2
      immunoreactivity was very similar for the liver and ciliary non-pigmented
      epithelium, although the maximum level of immunoreactivity of the ciliary
      epithelium reached in 48 hr after inducer treatment was about 25% of that of
      liver. The present results support our previous observations that the P4501A
      enzyme activities (e.g. aryl hydrocarbon hydroxylase) in the liver and eye of
      C57BL/6 mice are under the same genetic regulation. Further, this study is the
      first demonstration of P450 isoform induction in specific ocular tissues of the
      whole animal.

PMID- 7781743
TI  - Calcium cataract: a model for optical anisotropy fluctuations.
AB  - Young rat lenses were incubated in organ culture media enriched with 20 mM
      calcium. Lenses in the calcium rich medium developed cataracts and were
      characterized by the absence of vimentin in the urea soluble protein fractions.
      Sections from the same lenses were studied by polarized light scattering. The
      I+/Iparallel scattering intensity ratios were higher from the lenses in calcium
      rich media than from the control lenses. This indicated an increase in the
      optical anisotropy fluctuations during cataractogenesis. The turbidity that
      developed due to these fluctuations was caused partly by the disappearance of
      vimentin and which in turn caused the enhancement of birefringence of the lens.

PMID- 7781744
TI  - Frequency of glutathione-S-transferase 1 gene deletion and its possible
      correlation with cataract formation.
AB  - This experiment was conducted to investigate the possible association between an
      increased frequency of glutathione-S-transferase (GST)1 gene deletion and the
      presence of cataracts in elderly patients. Genomic DNA was isolated from blood
      samples obtained from 138 elderly patients who had undergone cataract surgery,
      and from 62 random blood donors. All subjects lived in the same geographic area
      (Ibaraki Prefecture, Japan). The DNA sequences among three different exon ranges
      (exons 3-5, exons 4-5 and exons 5-6) of the GST1 gene were amplified by the
      polymerase chain reaction (PCR) technique to determine if GST1 gene deletion
      occurred. Cataract patients had a significantly higher frequency of GST1 gene
      deletion than random controls did (P < 0.001, odds ratio = 2.91, 1.56-5.44; 95%
      of confidence interval). Mean age of cataract patients lacking GST1 gene was
      significantly younger (n = 101, mean age = 70.4, s.d. = 10.2) than that of
      patients possessing the GST1 gene (n = 37, mean age = 75.0, s.d. = 8.7) (P <
      0.02). These results show that the deletion of the GST1 gene may be one of
      determinants of genetic susceptibility to cataractgenic agents.

PMID- 7781745
TI  - Inflammation induced changes in adenosine 3',5'-cyclic monophosphate production
      by ciliary epithelial cell bilayers.
AB  - Despite extensive evidence implicating the cytokines interleukin-1 (IL-1) and
      tumor necrosis factor-alpha (TNF alpha) in the intraocular inflammatory response,
      little is known about their effects on signal transduction in anterior uveal
      tissue. Since these cytokines have been shown to alter the adenylyl cyclase
      system in nonocular tissues, we tested the hypothesis that IL-1 beta and TNF
      alpha affect the anterior uvea by altering production of the intracellular second
      messenger adenosine 3',5'-cyclic monophosphate (cAMP) in ciliary epithelial
      bilayers. This was accomplished by measuring the levels of cAMP in bilayers ex
      vivo, following intraocular inflammation induced by intravitreal injection of IL
      1 beta, TNF alpha or bacterial endotoxin, and in vitro, following exposure to IL
      1 beta, TNF alpha or bacterial endotoxin. Although cAMP production was enhanced
      in bilayers from IL-1 beta-, TNF alpha- or endotoxin-inflamed eyes, ex vivo,
      exposure of normal bilayers to IL-1 beta (15 U ml-1), TNF alpha (20 U ml-1), or a
      low concentration of endotoxin (0.01 microgram ml-1) for 4 hr, in vitro, had no
      effect on cAMP production. The inability of IL-1 beta, TNF alpha, or the low
      concentration of endotoxin to increase cAMP production by bilayers, in vitro,
      suggests that the enhanced cAMP production observed with inflamed bilayers, ex
      vivo, was not due to a direct action of these inflammatory agonists on the
      ciliary epithelial bilayer. Although direct exposure to cytokines or endotoxin
      did not change cAMP production, treatment with IL-1 beta, TNF alpha, or a higher
      concentration of endotoxin (1 microgram ml-1) did affect signal transduction
      mechanisms.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7781746
TI  - The late positive retinal potential in dogs.
AB  - The late positive potential of the mammalian electroretinogram has been called
      the 'PI' or the 'c-wave' potential. It is unusual among retinal potentials
      because its peak implicit time increases in response to increasing stimulus
      intensity and because it cannot be demonstrated consistently in small samples of
      normal humans or normal dogs. We recorded wideband (DC-1 kHz) responses from 34
      normal Beagles or dogs of similar size. Of the 34, 11 produced a late positive
      potential set that satisfied the criteria for c-waves. Multiple aspartate
      injections always increased c-wave amplitude and stimulus-response linearity in
      all 'producers'. Non-producers were never converted to producer status by
      aspartate blocking of the inner retina. Interaction of late positive and negative
      potentials and the possible influence of normal individual variations in the
      trans-epithelial potential are discussed. Individual mammal c-wave production is
      controlled by outer retinal phenomena which vary between individuals.

PMID- 7781747
TI  - In vitro studies on the assembly properties of the lens proteins CP49, CP115:
      coassembly with alpha-crystallin but not with vimentin.
AB  - A rapid one-step purification procedure for CP49, an intermediate filament
      protein found in the lens, is described using reverse-phase HPLC. This protein is
      one of the major intermediate filament proteins of the lens fibre cells and is
      found in both the water insoluble fraction (WIF) and the water soluble fraction
      (WSF) of the lens. In order to better understand the physiological role of CP49
      in lens transparency we have purified CP49 from both compartments and compared
      the in vitro assembly characteristics of both by electron microscopy and
      sedimentation assays. Our studies showed that CP49, when mixed with another lens
      intermediate filament protein, CP115, forms 10 nm intermediate filaments.
      Vimentin, another intermediate filament protein found in the lens, was unable to
      coassemble with CP115, thus demonstrating the specificity of the interaction of
      CP49 with CP115. CP49 isolated from either the WIF or the WSF formed 10-nm
      filaments with CP115 and indicated that CP49 from both these lens cell
      compartments had similar in vitro assembly characteristics. This also suggested
      that the post-translational modifications observed for CP49 from the different
      compartments was of little apparent consequence to filament formation. The
      inability to reconstitute beaded filaments from CP49 and CP115 suggested that
      other lens proteins may be needed in the reconstitution assay before these lens
      specific cytoskeletal elements could be repolymerised from their purified protein
      components. CP49 and CP115 were therefore assembled in the presence of alpha
      crystallins and a beaded filament structure was observed as has been seen with
      type III intermediate filament proteins assembled with alpha-crystallins.

PMID- 7781748
TI  - Characterization of neutral glycosphingolipids in rat lens.
AB  - Neutral glycosphingolipids were purified from non-cataractous lenses of Sprague
      Dawley rats by a combination of solvent extraction, Folch's partition, and column
      chromatography using DEAE-Sephadex and Iatrobeads. Six major GSLs from
      monohexosylceramide to pentahexosylceramide were identified by sugar composition
      analysis, methylation analysis and glycosidase digestion. Structural
      relationships among the six neutral glycosphingolipids revealed metabolic
      pathways leading to the synthesis of Gal alpha 1-3Gal beta 1-4GlcNAc beta 1-3Gal
      beta 1-4Glc beta 1-1 ceramide (IV3Gal alpha nLc4), instead of a Lewis(x)
      glycolipid (Gal beta 1- 4(Fuc alpha 1-3)GlcNAc beta 1-3Gal beta 1-4Glc beta 1-1
      ceramide, III3FucnLc4), from neolactotetraosylceramide (nLc4), together with
      isoglobotriaosylceramide (iGb3). The alpha-galactosyl epitope, Gal alpha 1-3Gal
      R, is evolutionarily conserved in many types of cells of non-primate mammals,
      prosimians and New World monkeys, but not in those of Old World monkeys or
      humans. This evolution-related difference in carbohydrate epitopes suggests
      different cell-to-cell attachments, which may be mediated through cell surface
      glycosphingolipids, between rat and human lenses.

PMID- 7781749
TI  - Tumour necrosis factor-induced uveitis in the Lewis rat is associated with
      intraocular interleukin 6 production.
AB  - Lewis rats were injected with recombinant murine tumour necrosis factor-alpha
      either intravitreally (0.08-50 ng) or intracardially (1 microgram). The
      intraocular inflammatory response induced by tumour necrosis factor was examined
      by slit-lamp and protein extravasation into aqueous humor was determined. The
      phenotype of the inflammatory cells in the eye was analysed by
      immunohistochemistry. In addition, the kinetics of intraocular interleukin 6
      production were determined. At 24 hr after intravitreal injection, a significant
      clinical uveitis was observed only in rats injected with 50 ng of tumour necrosis
      factor, when compared to saline-treated controls (P < 0.05). Maximal clinical
      uveitis and blood-aqueous barrier breakdown were already present at 4 hr after
      tumour necrosis factor injection. The uveitis was characterized by a massive
      cellular infiltrate in the anterior segment, consisting predominantly of
      polymorphonuclear cells and macrophages/monocytes, and to a lesser extent of T
      lymphocytes. Intraocular interleukin 6 mRNA expression and elevated levels of
      interleukin 6 in aqueous humor were detected 1 hr after tumor necrosis factor
      injection, reached a maximum at 3 to 4 hr after injection, and had declined again
      at 2 hr. Although intracardial injection of 1 microgram of tumour necrosis factor
      in Lewis rats induced a rise of circulating interleukin 6, it did not produce
      uveitis. The results obtained with intravitreally injected tumour necrosis factor
      indicate that intraocular TNF may play a pivotal role in the induction of uveitis
      in the rat. The transient intraocular production of interleukin 6 early during
      tumour necrosis factor-induced uveitis suggests that this cytokine may
      participate in the response induced by tumour necrosis factor.

PMID- 7781751
TI  - A study of phase separation in eye lens homogenate by means of speckle
      techniques.

PMID- 7781750
TI  - Evidence of retinoid metabolism within cells of inner retina.

PMID- 7781752
TI  - Effects of granulocyte-macrophage colony stimulating factor produced in Chinese
      hamster ovary cells (regramostim), Escherichia coli (molgramostim) and yeast
      (sargramostim) on priming peripheral blood progenitor cells for use with
      autologous bone marrow after high-dose chemotherapy.
AB  - Peripheral blood progenitor cells (PBPCs) were collected without prior
      association with chemotherapy but after the administration of granulocyte
      macrophage colony-stimulating factor (GM-CSF) produced in Chinese hamster ovary
      cells (CHO-GM, regramostim), Escherichia coli (E. coli-GM, molgramostim), or
      yeast (Yeast-GM, sargramostim) and used in conjunction with autologous bone
      marrow after high-dose chemotherapy in 69 patients with breast cancer or
      melanoma. The mean peripheral white blood cell (WBC) counts increased by 2.2 to
      2.7-fold after regramostim, 4.5 to 7.3-fold after molgramostim and 4.3-fold after
      sargramostim. All patients underwent three leukaphereses. The mean (+/- standard
      error) total nucleated pheresed cells per kg x 10(8) were 4.15 +/- 0.56, 15.10 +/
      1.77 and 7.24 +/- 1.00 for patients receiving regramostim, molgramostim or
      sargramostim respectively. The mean (+/- standard error) granulocyte-macrophage
      colony-forming units per kg x 10(4) mobilized into the PB were 8.75 +/- 3.63,
      71.03 +/- 17.85, and 65.11 +/- 18.74 for patients receiving regramostim,
      molgramostim, or sargramostim respectively. The total mean (+/- standard error)
      CD34+ cells per kg x 10(7) collected by three leukaphereses were 3.28 +/- 1.62,
      1.34 +/- 0.51 and 2.57 +/- 1.93, for patients receiving regramostim, molgramostim
      or sargramostim respectively. The use of either molgramostim- or sargramostim
      primed PBPCs led to complete elimination of absolute leukopenia with a WBC count
      under 100/mm3 in 64% and 77% of patients treated, respectively. Patients
      receiving molgramostim-primed PBPCs required fewer red blood cells transfusions
      than patients receiving regramostim-primed PBPCs (p = 0.0062). Our data indicate
      that PBPCs collected without prior association with chemotherapy but after either
      molgramostim or sargramostim with autologous bone marrow support and GM-CSF
      shorten the hematopoietic recovery after myeloablative chemotherapy in patients
      with breast cancer or melanoma.

PMID- 7781753
TI  - Three monoclonal IgG components, an IgG4(lambda), an IgG2(kappa) and an IgG1/IgG3
      (kappa) Gm(f,b) hybrid, in a single myeloma patient.
AB  - An unusual triclonal IgG combination in the serum of a 56-year old male with
      clinical stage IIIB multiple myeloma is reported. The patient initially had an
      IgG4(lambda) monoclonal protein in his serum and later developed an IgG2(kappa)
      and an IgG (kappa) which possessed the characteristics of both IgG1 and IgG3
      subclasses with an unusual combination of allotypic markers. Three M-proteins did
      not share idiotypic determinants. A rare class-switch recombination followed by
      mutation has been considered as a possible mechanism leading to this combination.

PMID- 7781754
TI  - Computerised method for recording platelet density distribution.
AB  - In the present study a computerized apparatus was employed for scanning light
      transmission variations along test tubes containing density-separated platelets.
      The device consists of a stepping motor, a stationary halogen lamp and a
      photopotentiometer connected to a personal computer. Anticoagulated whole blood
      was layered on a performed continuous Percoll gradient having a density span from
      1090 kg/l (bottom) to 1040 kg/l (top). After centrifugation at 3400g for 1.5
      hours, high-density cells (i.e. erythrocytes) pass through to the bottom of the
      test tube and the lighter platelets remain in the gradient. The test tube is
      moved by the computer between the halogen lamp and the photopotentiometer.
      Transmission variations along the gradient were recorded and registered in the
      computer. Density markers beads were used as an internal standard and platelet
      peak density was determined. After perforating the test tube the gradient was
      divided into 45 aliquots. In all fractions determination of platelet counts and
      mean platelet volume was carried out. In addition, in the aliquots having a
      platelet count > 20 x 10(12)/l the ratio beta-thromboglobulin per platelet was
      also determined. The platelet distribution in the gradient was illustrated
      graphically. A good agreement was found when comparing platelet distributions in
      the gradients and light transmission variations along the test tubes.

PMID- 7781755
TI  - Inversions of the factor VIII gene in Swedish patients with severe haemophilia A.
AB  - The series comprised 49 Swedish patients with severe haemophilia A [belonging to
      49 families (21 with known and 28 with sporadic haemophilia)], of whom 12 had
      developed F. VIII inhibitors. Using Southern blotting, 45% (22/49) were found to
      have inversions, i.e., intrachromosomal rearrangements of the tip of the X
      chromosome. Twenty patients had one or the other of the two variants of
      inversions recently published, whereas 2 patients manifested novel band patterns.
      Inversions were found in 50% of the families with sporadic haemophilia, and in
      38% of those with known haemophilia. Fourteen families with sporadic haemophilia
      A had inversions, the proband carrying the de novo mutation in 4 cases and the
      proband's mother in 10 cases. Six inversions derived from a male and five from a
      female X-chromosome meiosis, the origin of the remaining three was not
      established. Genetic counselling of patients with severe haemophilia A and their
      families will be considerably improved, as inversions occur in half the severe
      cases and can be detected by a simple Southern blotting procedure.

PMID- 7781756
TI  - Simultaneous measurements of megakaryocyte-associated IgG (MAIgG) and platelet
      associated IgG (PAIgG) in chronic idiopathic thrombocytopenic purpura.
AB  - We have simultaneously measured platelet-associated IgG (PAIgG) and megakaryocyte
      associated IgG (MAIgG) in 30 untreated patients with chronic idiopathic
      thrombocytopenic purpura (CITP). Megakaryocytes were purified from bone marrow by
      35% Percoll gradient centrifugation, followed by negative immunopanning using
      magnetic immunobeads. The normal range of MAIgG in 30 healthy donors was 15.5 +/-
      10.0 ng/10(5) megakaryocytes, whereas MAIgG in the 30 CITP patients was 140 +/-
      59.3 ng/10(5) megakaryocytes, although the values were widely distributed. From
      the PAIgG and MAIgG data, CITP patients were classified into three types; type I
      (PAIgG < 200 ng/10(7) platelets and MAIgG < 150 ng/10(5) megakaryocytes), type II
      (PAIgG > 200 ng and MAIgG > 150 ng), and type III (PAIgG < 200 ng and MAIgG > 150
      ng). Patients with types I and III had good clinical courses, but, in contrast,
      patients with type II responded poorly to steroid therapy followed by splenectomy
      or became refractory to treatment. In splenectomized patients, MAIgG of responder
      was promptly decreased to normal range and, in contrast, that of non-responder
      was persistently elevated. These results indicate that anti-platelet
      autoantibodies are able to bind with megakaryocytes in the bone marrow as well as
      with platelets in the peripheral blood, and the results also suggest that
      megakaryopoiesis in CITP is heterogeneous. Simultaneous measurement of PAIgG and
      MAIgG may predict the clinical outcome of CIPT.

PMID- 7781757
TI  - Correlation between soluble transferrin receptor and serum ferritin levels
      following bone marrow transplantation for thalassemia.
AB  - This study analyzes the serum transferrin receptor (sTfR) levels in a series of
      230 ex-thalassemics with a follow-up of 1 to 9 years after bone marrow
      transplantation (BMT) for homozygous beta thalassemia. Ex-thalassemics are
      individuals, cured of homozygous beta thalassemia by BMT, who maintain different
      degrees of iron overload acquired during the pretransplant period. Both in
      experimental and clinical conditions, sTfR concentrations have been shown to be a
      quantitative measure of body iron status. This study was carried out to assess
      whether the level of sTfR may be of help in determining the extent of iron
      overload in ex-thalassemics. Patients who received the marrow from their HLA
      identical sibling donor heterozygous for beta thalassemia, namely heterozygous ex
      thalassemics, displayed significantly higher levels of sTfR than patients
      transplanted from their normal sibling donors (normal ex-thalassemics). This
      finding suggests that increased erythropoiesis, albeit in part ineffective in
      heterozygous ex-thalassemics, is responsible for the sTfR increment. Both
      heterozygous and normal ex-thalassemics had significant lower sTfR levels than
      their heterozygous (p < 0.003) or normal (p < 0.0001) donors, respectively. These
      differences may be ascribed to the presence of iron overload in ex-thalassemics
      in comparison to their normal or heterozygous donors who did not present excess
      of iron in the body. A significant inverse correlation between sTfR and serum
      ferritin levels (r = -0.54, p < 0.0001) was found when normal ex-thalassemics
      were considered. In heterozygous ex-thalassemics, the lack of correlation between
      these two parameters may be explained by the enhanced erythropoietic activity of
      individuals with thalassemic trait. These results suggest that the level of sTfR
      may be a useful indicator of iron overload in normal ex-thalassemics.

PMID- 7781758
TI  - Fludarabine and plasma cell leukemia.

PMID- 7781759
TI  - Multilobated lymphoma presenting as primary spleen lymphoma.

PMID- 7781760
TI  - Effect of a negative regulatory element (NRE) on the human CYP1A1 gene expression
      in breast carcinoma MCF-7 and hepatoma HepG2 cells.
AB  - The expression of the cytochrome P4501A1 gene, CYP1A1, is induced by e.g. 2,3,7,8
      tetrachlorodibenzo-p-dioxin (TCDD) mainly by transcriptional mechanisms. The
      inducers mediate their effect upon binding and activation of the aryl hydrocarbon
      receptor (AHR) transcription-factor complex. Utilizing chimeric CYP1A1/CAT
      constructs transient gene expression experiments indicate that the putative
      negative regulatory element (NRE) of CYP1A1 influence the relative TCDD induced
      CAT activity in HepG2 cells, whereas this effect was not observed in MCF-7 cells.
      Differences in the formation of cell-specific protein-DNA complexes were
      demonstrated by gel retardation assays suggesting a functional difference of NRE
      in these two cell lines.

PMID- 7781761
TI  - Genomic structure of the mouse A-type lamin gene locus encoding somatic and germ
      cell-specific lamins.
AB  - Mouse A-type lamin genes were isolated. Structural analyses revealed that all the
      three known mouse A-type lamins (A, C and C2) were coded in a single genomic
      locus in a 22 kilobase DNA segment. The three lamins were coded in 12, 10 and 10
      exons for A, C and C2, respectively, and shared 8 exons among them. Primer
      extension analyses identified possible transcription start sites for both A/C and
      C2 genes suggesting that the locus is under the control of two separate
      promoters, that is a somatic cell-acting promoter (for A and C) and a testis
      specific promoter (for C2) which resides in the first intron of the A/C gene.
      Sequence characteristics of the possible promoter regions are discussed.
      Divergence of the two somatic cell-type lamins (A and C) is formally accounted
      for by differential selection of poly(A) sites together with lamin A-specific
      splicing.

PMID- 7781762
TI  - Almost the entire 5' non-translated region of hepatitis C virus is required for
      cap-independent translation.
AB  - To investigate which hairpin structures within the 5' untranslated region of
      hepatitis C virus (HCV) are necessary for cap-independent translation, mutants
      were constructed that lack one or more hairpin structures. Here we demonstrate,
      by constructing precisely defined hairpin deletion mutants, that with the
      exception of the most 5' located hairpin structure, which on deletion shows an
      increase on translation, each of the predicted hairpins is found to be essential
      for cap-independent translation. In addition, we demonstrate that HCV 5'UTR
      driven translation is stimulated by poliovirus 2Apro co-expression.

PMID- 7781763
TI  - Amyloid beta protein (25-35) stimulation of phospholipases A, C and D activities
      of LA-N-2 cells.
AB  - [3H]Myristic acid prelabeled LA-N-2 cells were exposed to varying concentrations
      of amyloid beta protein (25-35), from 20 to 250 micrograms/ml, and the activation
      of phospholipases A and D estimated. A progressive increase in
      phosphatidylethanol formation, a measure of phospholipase D activity, and of free
      fatty acid release, a measure of phospholipase A activity, was observed over a
      time-course of 60 min. [3H]Inositol prelabeled LA-N-2 cells were exposed to
      varying concentrations of A beta P, from 20 to 125 micrograms/ml, and
      phospholipase C activation was measured. There was an increased release of
      inositol phosphates in the presence of amyloid beta protein as a function of
      incubation time. The effects of adrenergic, metabotropic amino acid and bombesin
      antagonists on the A beta P mediated stimulation of phospholipase C activity was
      investigated. Propranolol, a beta adrenergic antagonist, 7-chloro-kynurenic acid,
      a metabotropic amino acid antagonist, and [Tyr4-D-Phe12]bombesin, a bombesin
      antagonist, blunted the A beta P stimulation of phospholipase C activity in
      [3H]inositol prelabeled LA-N-2 cells. This suggests that amyloid beta protein
      activation of phospholipase C may be receptor mediated. The phospholipase C
      inhibitor U 71322 prevented the activation of phospholipase C by A beta P.
      However, this activation was not effected by tocopherol, propylgallate, or
      vitamin C.

PMID- 7781764
TI  - Low nidogen affinity of laminin-5 can be attributed to two serine residues in EGF
      like motif gamma 2III4.
AB  - High affinity nidogen binding of laminin-1 (chain composition alpha 1 beta 1
      gamma 1) has been previously mapped to a single EGF-like motif gamma 1III4 of its
      gamma 1 chain. Two more isoforms, laminin-5 (alpha 3 beta 3 gamma 2) and laminin
      7 (alpha 3 beta 2 gamma 1), show low and high binding activity, respectively,
      indicating that the gamma 2 chain is of low affinity. This was confirmed by
      recombinant production of the homologous EGF-like motif gamma 2III4 of the gamma
      2 chain, which has a 100,000-fold lower binding activity than gamma 1III4. The
      crucial heptapeptide binding sequence Asn-Ile-Asp-Pro-Asn-Ala-Val of gamma 1III4
      is modified in gamma 2III4 by replacing both the central Asn and Val by Ser.
      Changing these replacements to Asn and Val by site-directed mutagenesis enhanced
      the activity of gamma 2III4 to a level which was only 5-fold lower than that of
      gamma 1III4. Despite their high sequence identity (77%) motifs gamma 1III4 and
      gamma 2III4 were also shown to differ considerably in immunological epitopes.
      This indicates distinctly different functions for laminins which differ in the
      gamma chain isoform.

PMID- 7781765
TI  - Temperature dependent chaperone-like activity of alpha-crystallin.
AB  - Alpha-crystallin, a multimeric protein present in the eye lens, is known to have
      chaperone-like activity in preventing the aggregation of enzymes and other
      crystallins. We have studied the chaperone-like activity of this protein towards
      the aggregation of insulin B chain, induced by reducing the interchain disulphide
      bond with dithiothreitol. At room temperature, there is no detectable protection
      (at a 1:1 (w/w) ratio of insulin: alpha-crystallin) against the aggregation of
      insulin B chain by alpha-crystallin, whereas it completely prevents this
      aggregation at 40 degrees C. We have monitored the temperature dependence of the
      protection of aggregation by alpha-crystallin; the protection increases sharply
      above 30 degrees C and reaches almost 100% by 41 degrees C. Probing the
      hydrophobic surfaces of alpha-crystallin with the hydrophobic fluorphore 8
      anilino-1 naphthalene sulfonate suggests that the hydrophobic surfaces of alpha
      crystallin are exposed to a greater extent above 30 degrees C. A complete
      prevention of the aggregation is achieved at 27.6 degrees C by increasing the
      concentration of alpha-crystallin by more than 8 fold. Similar temperature
      dependent chaperone-like activity of alpha-crystallin is observed towards the
      aggregation of zeta-crystallin, an enzyme crystallin from guinea pig. We have
      earlier shown that alpha-crystallin exposes hydrophobic surface(s) at
      temperatures above 30 degrees C. These results support our earlier hypothesis
      [Raman, B. and Rao, Ch.M. (1994) J. Biol. Chem. 269, 27264-27268] that the
      chaperone-like activity of alpha-crystallin is more pronounced in its
      structurally perturbed state.

PMID- 7781766
TI  - Effects of protein kinase modulators on transferrin receptor expression in human
      leukaemic HL-60 cells.
AB  - The mRNA of transferrin receptor (TfR) is constitutively expressed in
      proliferating human leukaemic HL-60 cells. Treatment of HL-60 cells with phorbol
      12-myristate 13-acetate (PMA), a protein kinase C (PKC) activator, or dibutyryl
      cyclic AMP (dbcAMP), a protein kinase A (PKA) activator, resulted in a 90%
      decrease in the level of TfR mRNA. Inhibition of TfR mRNA expression induced by
      10 nM PMA and 100 microM dbcAMP was abolished by prior incubation of cells with
      0.1-1.0 microM GF109203X, a PKC-specific inhibitor, and 1-10 microM H-89, a PKA
      specific inhibitor, respectively. The blocking effects of GF109203X and H-89 were
      dose-dependent and complete at the highest concentrations of the inhibitors used.
      Although treatment of cells with GF109203X or H-89 alone did not alter the
      constitutive expression of TfR mRNA, incubation of cells with 30-100 nM
      staurosporine, a wide-spectrum protein kinase inhibitor, resulted in suppression
      of the constitutive expression of TfR mRNA in a dose-dependent manner. These
      results suggest that (i) the down-regulation of TfR mRNA expression during the
      differentiation of HL-60 cells can be mediated by activation of either PKC or
      PKA; (ii) the constitutive expression of TfR mRNA in proliferating HL-60 cells is
      staurosporine-sensitive and is probably maintained by protein kinase(s) other
      than PKC and PKA.

PMID- 7781767
TI  - Preferential inhibition of phorbol ester-induced hydrolysis of
      phosphatidylethanolamine by N-acetylsphingosine in NIH 3T3 fibroblasts.
AB  - It has been reported that in rat fibroblasts cell-permeable ceramide analogs
      inhibit agonist-induced phospholipase D (PLD)-mediated hydrolysis of
      phosphatidylcholine (PtdCho). Here we demonstrate that relatively short (30 min)
      treatments of NIH 3T3 fibroblasts with 15-60 microM concentrations of N
      acetylsphingosine result in preferential, although not exclusive, inhibition of
      phorbol 12-myristate 13-acetate-induced PLD-mediated hydrolysis of
      phosphatidylethanolamine (PtdEtn). The results suggest that in different cell
      types the PtdEtn- and PtdCho-hydrolyzing PLD activities are differentially
      sensitive to the inhibitory effect of ceramide.

PMID- 7781768
TI  - A novel 27/16 kDa form of subtilisin cleaved actin: structural and functional
      consequences of cleavage between Ser234 and Ser235.
AB  - A new 27/16 kDa form of cleaved actin was prepared by subtilisin cleavage between
      Ser234 and Ser235 of F(MgADP)-actin complexed with BeFx. The cleavage had little
      effect on actin-actin interactions as probed in polymerization measurements and
      by electron microscopy. In circular dichroism melting experiments the
      thermostability of F-actin was reduced by about 10 degrees C by this cleavage.
      The in vitro motility and Vmax, but not Km, of actomyosin ATPase were decreased
      by about 20% upon 27/16 kDa cleavage of F-actin. The binding of tropomyosin to
      actin was unchanged by this modification.

PMID- 7781769
TI  - Nucleotide sequence encoding the di-haem cytochrome c551 peroxidase from
      Pseudomonas aeruginosa.
AB  - The nucleotide sequence of the gene encoding cytochrome c551 peroxidase from
      Pseudomonas aeruginosa is reported. The translated amino acid sequence differs
      from the sequence reported earlier by peptide mapping most significantly by the
      presence of a section containing an additional 20 residues. A number of minor
      differences are also evident. The new sequence translates to a protein containing
      346 amino acids, the first 23 being typical of a hydrophobic leader peptide with
      a characteristic protease cleavage site.

PMID- 7781770
TI  - Mutational analysis of a putative polyphosphoinositide binding site in
      phospholipase C-beta 2.
AB  - The phosphatidylinositol 4,5-bisphosphate (PtdIns-P2)-regulated actin-binding
      protein gelsolin and most phosphoinositide-specific phospholipases C (PLCs)
      comprise a basic amino acid motif ((K/R)xxxKxK(K/R); x denotes any amino acid)
      which was previously suggested to represent a PtdInsP2-binding site commonly
      present in these proteins. We have challenged this hypothesis for PLC beta 2 by
      replacing one or several residues of this motif (KILIKNKK; residues 457-464) and
      examining the functional consequences of these alterations. The results show that
      the integrity of the basic motif is important for PtdInsP2 hydrolysis by PLC beta
      2. Replacement of lysines 463 or 461 by arginine led to reduction or complete
      loss, respectively, of enzyme activity. The results provide further support to
      the concept that the function of the basic motif within the various PLCs is to
      bind the enzyme substrate PtdInsP2.

PMID- 7781771
TI  - Ecotin is a potent inhibitor of the contact system proteases factor XIIa and
      plasma kallikrein.
AB  - Ecotin, a serine protease inhibitor found in the periplasm of Escherichia coli,
      has been characterized as a potent reversible tight-binding inhibitor of the
      human contact activation proteases factor XIIa (FXIIa) and plasma kallikrein,
      having Ki values of 89 pM and 163 pM, respectively. Ecotin also inhibited human
      leukocyte elastase (HLE) with high affinity (Ki = 55 pM). The association rate
      constants kon for FXIIa and kallikrein were 5.3 x 10(5) M-1.s-1 and 2.9 x 10(5) M
      1.s-1, respectively. The dissociation rate constant koff for kallikrein, measured
      in the presence of HLE to prevent reassociation, was 6.3 x 10(-5) s-1; the koff
      for ecotin with FXIIa was 4.7 x 10(-5) s-1. Both FXIIa and kallikrein cleaved
      ecotin slowly at pH 5.0, identifying Met-84 as the P1 residue. The potent
      anticoagulant effect by ecotin is explained by the coincident inhibition of
      FXIIa, kallikrein, and FXa and suggests that it may be useful in the study of
      inflammatory or thrombotic disorders such as sepsis or cardiopulmonary bypass.

PMID- 7781772
TI  - Total antioxidant activity of low density lipoproteins and the relationship with
      alpha-tocopherol status.
AB  - A rapid method is described for measuring the antioxidant activity of low density
      lipoproteins. Studies were undertaken on individuals attending a hyperlipidaemia
      clinic, an unsupplemented group and a group after supplementation with 300 mg dl
      alpha-tocopherol acetate for nine weeks. The results show a positive correlation
      between the antioxidant activity and alpha-tocopherol content of LDL in the
      supplemented group.

PMID- 7781773
TI  - Calponin reduces shortening velocity in skinned taenia coli smooth muscle fibres.
AB  - Calponin (4.1-5.9 microM, pig stomach) inhibited maximal shortening velocity
      (Vmax) by 20-25% with only minor influence on force in skinned smooth muscle from
      guinea-pig taenia coli activated at different Ca2+ levels and with
      thiophosphorylation. Similar results were obtained with a fragment of the N
      terminal 1-228 amino acids engineered using a mouse cDNA construct (5.4 microM).
      Both the native calponin and the fragment inhibited actin filament sliding in a
      graded manner in an in vitro motility assay. We conclude that calponin influences
      the kinetics of the actin-myosin interaction in the organised smooth muscle
      contractile system and that engineered fragments of calponin can be used to probe
      its action in muscle fibres. The effects can be due to an introduction of an
      internal load during filament sliding, possibly by decreasing the detachment
      rates and increasing the cross-bridge time spent in the attached state.

PMID- 7781774
TI  - 1H and 13C NMR assignment and secondary structure of Chlorobium limicola f.
      thiosulfatophilum ferrocytochrome c555.
AB  - The 1H resonances of the ferrocytochrome c555 from the anaerobic green sulfur
      bacterium Chlorobium limicola f thio-sulfatophilum (strain Tassajara) have been
      assigned. Identification of spin systems and sequential assignment of 1H was
      accomplished by automated assignment computer programs followed by manual
      verification. In addition, 13C resonances have been extensively assigned by HSQC
      experiments at natural abundance. As determined by short-range NOE
      connectivities, 13C alpha chemical shifts, and HN exchange experiments, the
      secondary structure consists of 3 helices ranging from residues 3-13, 43-53 and
      70-86. Interestingly, the second helix is significantly longer than observed by X
      ray crystallography [1977, Proc. Natl. Acad. Sci. USA 74, 5244-5247]. A
      topological model of the cytochrome c555 is presented based on a small number of
      long-range NOE contacts. The helices are shown to pack onto the heme according to
      the pattern common to all class I cytochromes c.

PMID- 7781775
TI  - Boar spermadhesin PSP-II: location of posttranslational modifications,
      heterodimer formation with PSP-I glycoforms and effect of dimerization on the
      ligand-binding capabilities of the subunits.
AB  - Spermadhesin PSP-II was isolated from the non-heparin-binding fraction of boar
      seminal plasma; its disulphide bridge pattern, and the location of a single N
      glycosylation site were established. PSP-II forms a heterodimer with specific N
      glycoforms of PSP-I. Although both subunits possess heparin-binding capability,
      the PSP-I/PSP-II complex does not. The heterodimer contains binding sites for
      zona pellucida glycoproteins and soybean trypsin inhibitor located in the PSP-II
      subunit. However, the PSP-I/PSP-II heterodimer binds only loosely to the sperm
      surface and is easily removed during in vitro capacitation, suggesting that the
      zona pellucida binding activity may not be relevant for gamete interaction. Our
      results show that dimerization of spermadhesins PSP-I and PSP-II markedly affects
      their binding capabilities.

PMID- 7781777
TI  - Deletion mutagenesis of heparin cofactor II: defining the minimum size of a
      thrombin inhibiting serpin.
AB  - Heparin cofactor II (HCII) is a 66 kDa plasma glycoprotein that belongs to the
      serpin superfamily of protease inhibitors. Its natural target is thrombin. HCII
      inhibits thrombin in both a progressive reaction, and in an accelerated reaction
      catalyzed by a glycosaminoglycan, dermatan sulphate (DS). Both modes of
      inhibition result in the formation of a stable, denaturation-resistant complex.
      Using a cDNA clone encoding rabbit HCII recently isolated and characterized in
      our laboratory, we have employed deletion mutagenesis to identify amino-terminal
      regions of the molecular which are essential to the progressive reaction. PCR was
      employed to produce four deletion constructs: delta 58, delta 81, delta 106, and
      delta 169, all in an in vitro transcription vector plasmid background.
      Transcription of the full-length construct, and of the four deletion constructs,
      followed by in vitro translation in rabbit reticulocyte lysate, was used to
      produce the corresponding HCII-related polypeptides. The delta 106 and delta 169
      mutants failed to react with thrombin, even in the presence of DS. In contrast,
      the delta 58 and delta 82 mutants retained the ability to form complexes with
      thrombin, although the rate of complex formation was decreased for the latter
      mutant compared to the full-length recombinant HCII; no acceleration of complex
      formation in the presence of 20 micrograms/ml DS was noted for either truncated
      recombinant HCII. Alignment of the rabbit HCII primary structure with secondary
      structural elements found in alpha 1 antitrypsin and other serpins showed that
      the non-functional delta 106 mutant lacks helix A, while the functional delta 82
      mutant contains this element. Our results suggest that helix A is an essential
      part of a functional serpin, and define the limits of the amino-terminal region
      of HCII which is not essential for thrombin inhibition.

PMID- 7781776
TI  - Primary structure and expression of a novel human laminin alpha 4 chain.
AB  - The complete primary structure of a novel human laminin alpha 4 chain was derived
      from cDNA clones. The translation product contains a 24-residue signal peptide
      preceding the mature alpha 4 chain of 1792 residues. The domain structure is
      similar to that of the recently described alpha 3 chain [Ryan, Tizard, Van
      Devanter and Carter (1994) J. Biol. Chem. 269, 22779-22787]. Northern analysis of
      RNA from human fetal and adult tissues revealed developmental regulation of
      expression. In adult, strong expression was observed in heart as well as lung,
      ovary, small and large intestines, placenta and liver, whereas weak or no
      expression was detected in skeletal muscle, kidney, pancreas, testis, prostate or
      brain. In contrast, fetal lung and kidney revealed high expression. In situ
      hybridization analysis of human fetal and newborn tissues showed expression of
      the laminin in alpha 4 chain in certain mesenchymal cells in tissues such as
      smooth muscle and dermis.

PMID- 7781778
TI  - The tetracycline efflux protein encoded by the tet(K) gene from Staphylococcus
      aureus is a metal-tetracycline/H+ antiporter.
AB  - The tet(K) gene from Staphylococcus aureus was highly expressed in Escherichia
      coli by an alteration of its initiation codon from TTG to ATG and its ribosome
      binding sequence from GAGG to GGAGG [Noguchi, N. et al. (1994) Biol. Pharm. Bull.
      17, 352-355]. The inverted membrane vesicles prepared from the tet(K)-expressing
      cells showed respiration-dependent [3H]tetracycline transport comparable to the
      vesicles from the tet(B)-expressing cells. The affinity of Tet(K) vesicles to
      tetracycline was the same as that of Tet(B) vesicles, whereas the former Vmax
      value was about 60% of the latter one. Contrary to Tet(B) vesicles, Tet(K)
      vesicles showed no significant minocycline uptake, which was consistent with the
      low minocycline resistance of the Tet(K)-producing cells. The tetracycline
      transport mediated by Tet(K) vesicles was coupled with proton transport and the
      translocation of 60Co2+ ions as well as in Tet(B) vesicles. This observation
      indicates that the class K tetracycline resistance determinant from Gram-positive
      bacteria also encodes a metal-tetracycline/H+ antiporter that is functionally
      similar to that encoded by tet(B), although there is a considerable difference in
      the primary sequences and the putative topologies of these Tet proteins.

PMID- 7781780
TI  - Identification and structural characterization of a mannose-6-phosphate
      containing oligomannosidic N-glycan from human erythropoietin secreted by
      recombinant BHK-21 cells.
AB  - A sialidase resistant mono-charged N-glycan was isolated from glycosylation site
      I (Asn-24) of recombinant human erythropoietin expressed from baby hamster kidney
      (BHK-21) cells and constituted approximately 2-4% of the oligosaccharide material
      at this glycosylation site. Mass spectrometry and both 1- and 2-dimensional NMR
      techniques revealed a high mannose type structure (Man6) with a phospho
      diesterbridged N-acetylglucosamine as follows: [formula: see text]

PMID- 7781779
TI  - PTF1 encodes an essential protein in Saccharomyces cerevisiae, which shows strong
      homology with a new putative family of PPIases.
AB  - Complementation of a temperature sensitive mutant of the yeast Saccharomyces
      cerevisiae resulted in the isolation of PTF1 (processing/termination factor 1),
      an essential gene encoding a putative 3'-end processing or transcription
      termination factor of pre-mRNAs. Ptf1p shows significant homology to a newly
      discovered family of PPIases. This family is characterized by its insensitivity
      to immunosuppressive drugs and the lack of homology with cyclophilins and FK-506
      binding proteins [Rahfeld et al. (1994) FEBS Lett. 352, 180-184]. Should Ptf1p
      display PPIase activity, it would be the first characterized, eukaryotic member
      of this putative family, which is essential for growth.

PMID- 7781781
TI  - Relevance of histidine-84 in the elongation factor Tu GTPase activity and in
      poly(Phe) synthesis: its substitution by glutamine and alanine.
AB  - Substitution of His-84 (-->Gln and -->Ala), a residue of the switch II region of
      E. coli elongation factor (EF) Tu, hardly affected the binding of GTP or GDP. The
      activity in poly(Phe) synthesis and GTP hydrolysis of EF-Tu H84Q were both
      reduced to about 35%, as compared to EF-Tu wt, whereas EF-Tu H84A was inactive in
      poly(Phe) synthesis but still showed a 10% residual GTPase activity. Phe-tRNAPhe
      exerted a similar inhibitory effect on the GTPase activity of EF-Tu wt and EF-Tu
      H84Q while abolishing that of EF-Tu H84A. Ribosomes enhanced the GTPase activity
      of EF-Tu H84Q, but not that of EF-Tu H84A, on which they even seemed to exert an
      inhibitory effect. The one-round GTP hydrolysis associated with the EF-TuH84Q
      dependent binding of Phe-tRNAPhe to poly(U)-programmed ribosomes was less
      efficient than with EF-Tu wt. Kirromycin stimulated the GTPase activities of both
      mutants less than EF-Tu wt. The results of this work do not support a catalytic
      role of His-84 in the intrinsic GTPase of EF-Tu, but they emphasize the
      importance of its side-chain for polypeptide synthesis and GTP hydrolysis.

PMID- 7781783
TI  - Glucose responsiveness of a reporter gene transduced into hepatocytic cells using
      a retroviral vector.
AB  - An MMLV-based retroviral vector containing the chloramphenicol acetyl transferase
      reporter gene under the control of a glucose-dependent internal promoter derived
      from the L-type pyruvate kinase gene was constructed. After transfection into psi
      CRIP packaging cells, clones producing recombinant retrovirus were selected.
      These retroviruses were used to infect cultured established hepatocytic cells
      whose endogenous L-type pyruvate kinase gene is transcriptionally regulated by
      glucose. In the infected cells, the reporter gene was as responsive to glucose as
      the endogenous L-type pyruvate kinase gene, and the glucose gene activation was
      time- and concentration-dependent. The possibility to confer a glucose
      responsiveness on a transgene carried by a retroviral vector provides a powerful
      tool in the prospect of gene therapy for diabetes mellitus.

PMID- 7781782
TI  - Human thrombin variable region 1, including E39, is involved in interactions with
      alpha 1-antitrypsin M358R and protein C.
AB  - We used an antithrombin autoantibody (IgG D), the epitope of which encompasses
      ABE1 and amino acids located within variable region 1, to study thrombin
      interactions with R358 alpha 1-AT and protein C. IgG D inhibited the thrombin
      interaction with R358 alpha 1-AT, while hirugen had no effect, indicating that
      the interaction of R358 alpha 1-AT with thrombin may involve the VR1 subsite. We
      also obtained evidence that VR1 may be involved in the activation of protein C by
      thrombin in the absence of thrombomodulin. Moreover, IgG D attenuated the
      inhibitory effect of calcium ions during protein C activation by thrombin,
      probably by masking E39 within the VR1 site.

PMID- 7781784
TI  - Structure-activity study of a laminin alpha 1 chain active peptide segment Ile
      Lys-Val-Ala-Val (IKVAV).
AB  - The IKVAV sequence, one of the most potent active sites of laminin-1, has been
      shown to promote cell adhesion, neurite outgrowth, and tumor growth. Here we have
      determined the structural requirements of the IKVAV sequence for cell attachment
      and neurite outgrowth using various 12-mer synthetic peptide analogs. All-L- and
      all-D-IKVAV peptides showed cell attachment and neurite outgrowth activities. In
      contrast, all-L- and all-D-reverse-sequence peptides were not active. Some of the
      analogs, in which the lysine and isoleucine residues of the IKVAV peptide were
      substituted with different amino acids, promoted cell attachment, but none of the
      analog peptides showed neurite outgrowth activity comparable to that of the IKVAV
      peptide. These results suggest that the lysine and isoleucine residues are
      critical for the biological functions of the IKVAV peptide.

PMID- 7781785
TI  - Breast cancer--trials on conservative surgery.

PMID- 7781786
TI  - Open randomized trials in the management of primary breast cancer.

PMID- 7781787
TI  - Breast cancer: questions for future trials.

PMID- 7781788
TI  - Linkage analysis and the susceptibility gene (BRCA-1) in familial breast cancer.

PMID- 7781790
TI  - Lymph node metastases in gastric cancer invading the submucosal layer.
AB  - We investigated the incidence of lymph node metastasis in 80 patients with early
      gastric cancer invading the submucosal layer and the relation of metastasis to
      other clinicopathological variables. All patients underwent curative gastric
      resection with lymphadenectomy. Lymph node metastasis was detected histologically
      in 15 patients. The incidence of nodal involvement showed significant increase
      paralleling the depth of cancer invasion. There was no relation between nodal
      involvement and histological differentiation. No patients died of gastric cancer
      during the follow-up. We conclude that gastrectomy with R2 lymphadenectomy is an
      appropriate operative method for early gastric cancer in which precise diagnosis
      of cancer invasion cannot be confirmed preoperatively.

PMID- 7781789
TI  - Expression of p53 in oesophageal squamous cell carcinoma in Hong Kong Chinese.
AB  - We studied p53 overexpression in a series of 99 primary oesophageal squamous cell
      carcinomas (28 well-differentiated, 42 moderately-differentiated and 29 poorly
      differentiated squamous cell carcinomas) from Chinese patients using the p53
      protein specific mouse monoclonal antibody DO-7 on paraffin sections. The p53
      protein was detected in 30% (30 cases) of the tumours. A significantly higher
      positive rate was noted in the poorly-differentiated tumours (11% for the well
      differentiated, 31% for the moderately-differentiated and 48% for the poorly
      differentiated tumours). In addition, strong positive p53 staining was identified
      only in the less differentiated tumour cells in the periphery of the tumour cell
      nests in all the cases and the expression was weaker in the better differentiated
      foci. The central keratinizing areas and the immediately adjacent tumour cells
      were always negative for p53. The adjacent normal oesophageal mucosa was all
      negative for p53 protein but the non-invasive dysplastic epithelium next to the
      tumours could also be strongly positive for p53 protein (four out of 14 cases in
      which the dysplastic epithelium adjacent to the tumour was adequately sampled).
      In two out of these four cases, the dysplastic epithelium showed staining for
      p53; even the adjacent invasive tumour was negative for p53. It is concluded that
      there is a strong relationship between p53 overexpression and tumour cell
      differentiation in oesophageal squamous carcinoma and overexpression of p53 can
      occur in non-invasive tumour cells.

PMID- 7781791
TI  - Oncogenes in cancer of the pancreas.
AB  - A three-step immunoperoxidase staining technique was used in order to estimate
      the immunohistochemical expression of K-ras, c-fos, c-myc and c-erbB-2
      oncoproteins, in paraffin sections of 20 patients, with histologically proven
      adenocarcinoma of the pancreas. The two oncogenes that were found to be
      associated with pancreatic adenocarcinoma were K-ras and c-erbB-2. in 15 patients
      (75%) and four patients (20%), respectively. Positive immunostaining was intense,
      cytoplasmic and was noted in a great percentage of cancer cells. The same model
      of expression was observed in the examined cases of metastatic tissue from liver
      and lymph node metastases. The expression of myc and fos oncogenes was nuclear,
      weak and was observed in a small number of patients.

PMID- 7781793
TI  - Is an immunological faecal occult blood test better than Haemoccult? A cost
      benefit study.
AB  - Immunological faecal occult blood (FOB) tests have theoretical advantages over
      their guaiac counterparts in that they are specific for human haemoglobin.
      HemeSelect is a semi-quantitative immunological FOB text. Faecal material is
      eluted into test diluent and serial dilutions are performed. The manufacturers
      recommend that erythrocyte agglutination at 1:8 dilution is considered a positive
      reaction. However, further serial dilutions can be carried out and the highest
      dilution at which the test remains positive determined. At 1:8 dilution, the test
      has been shown to be more sensitive for symptomatic colorectal cancer than
      Haemoccult. The aim of this study is to compare the positive rates, neoplastic
      yield and costs of Haemoccult with HemeSelect at various dilutions in
      asymptomatic average risk subjects aged 50-74. 1489 subjects satisfactorily
      completed both tests, 145 (9.7%) returned positive Hemeselect tests (read at 1:8
      dilution, 38 patients with neoplasms > or = 1 cm) and 17 positive Haemoccult
      tests (1.1%). All positive Hemeselect tests were further serially diluted. As the
      Hemeselect dilution increased to 1:16, 1:32, 1:64 and 1:128 so the positive rate
      and yields of neoplasms > or = 1 cm progressively fell to 6.8% & 35, 3.6% & 20,
      2.7% & 18 and 1.5% & 12, compared with 1.1% and eight neoplasms > or = 1 cm for
      Haemoccult. In spite of the unit cost of the Hemeselect test being greater than
      Haemoccult, the cost per neoplasm > or = 1 cm was lower for Hemeselect at 1:8 and
      1:16 dilutions than Haemoccult. However, for an equivalent neoplastic yield,
      Haemoccult was cheaper. Hemeselect is a versatile test whose positive rate can be
      tailored according to the risk of the group being screened.

PMID- 7781792
TI  - Effect of essential fatty acids on natural cytotoxicity in patients with
      colorectal cancer.
AB  - Essential fatty acids (EFAs), have been shown to modulate lymphocyte reactivity
      and destroy various tumour cells in vitro. Natural cytotoxicity, mediated by NK
      and LAK cells, is believed to play an important anti-cancer role in vivo. The
      effect of EFAs, given orally as dietary supplementation, on NK and LAK cell
      cytotoxic activity in patients with localized (n = 10) and advanced (n = 20)
      colorectal cancer has been studied, using in-vitro 51Cr release cytotoxicity
      assays with K562 (NK) and DAUDI (LAK) cells. The activity of effector cells was
      expressed as lytic units. NK cell activity showed no significant change following
      15 days ingestion of EFAs in the group with localized cancer, but was
      significantly reduced in the group with advanced disease and continued to
      decline, reaching minimal levels following 6 months supplementation (P = 0.017).
      LAK cell activity showed no overall alteration after 15 days ingestion of EFAs in
      patients with localized cancer, but in the group with advanced disease, the
      reduction in the activity occurred at day 15 and steadily declined on prolonged
      intake, reaching significant minimal levels after 6 months of supplementation (P
      = 0.05). Cell surface marker analysis (FACS-CD MABs) revealed reduced absolute
      numbers of CD16+, CD56+ and CD57+ lymphocytes (P < 0.05) in the patients with
      advanced colorectal cancer. More importantly, the cytotoxicity of NK and LAK
      cells returned to the pre-supplementation values, 3 months after cessation of EFA
      intake. Furthermore, there was no alteration in the cytotoxic activity of NK and
      LAK cells in the control group (advanced colorectal cancer without EFA
      supplementation) during the 6 months period of evaluation. These results suggest
      that prolonged EFA supplementation, in the doses used in this study, may have
      detrimental effects on natural anti-cancer cytotoxic mechanisms in patients with
      malignant disease.

PMID- 7781794
TI  - Middle and lower third rectum carcinoma: sphincter saving or abdominoperineal
      resection?
AB  - Sphincter saving resections (SSR) are performed with increasing frequency in
      carcinoma of the lower and middle third of the rectum. In this retrospective
      study local and distant recurrence and survival were compared to abdominoperineal
      resection (APR). In 71 women and 71 men (mean age: 64 years) with a primary
      adenocarcinoma between 5 and 10 cm from the anal verge 89 SSR, and 53 APR, were
      performed (Dukes stages--SSR--A 19%; B 30.3%; C 50.7% vs APR--A 15%; B 45.3%; C
      39.6%). Patients have been followed up for a minimum of 24 months (mean time 62
      months). There were no differences in intraluminal diameters of the tumours in
      each operative procedure. The distal tumour-free distance was more than 6 cm in
      52% after APR (SSR: 10%) and less than 3 cm in 43% after SSR. Survival was not
      different between procedures in Dukes stages A and B. A survival advantage for
      patients with Dukes C carcinoma after APR did not reach statistical significance.
      No differences in distant spread were found for SSR (Dukes stage A 0%; B 7%; C
      18%) and APR (Dukes stage A 0%; B 8%; C 14%) for local recurrence in Dukes stages
      A and B after SSR (A and B 0%) and APR (A 0%; B 8%) whereas a significant
      increase in local recurrence rate was seen in Dukes stage C after SSR (24% vs,
      APR 5%). Although a further resection could be performed in almost all of these
      patients a negative effect of local recurrence on survival occurred (25.4 months
      with and 80 months without local recurrence). While SSR seems to be favourable in
      Dukes stages A and B, APR should be considered in carcinoma of the lower and
      middle third of the rectum with lymphatic spread. Effective preoperative staging
      determines selection of the appropriate operation.

PMID- 7781795
TI  - Expression of epidermal growth factor receptor messenger RNA in human colorectal
      carcinomas assessed by non-radioactive in-situ hybridization.
AB  - No consensus as to the involvement of the epidermal growth factor receptor (EGF
      R) in colorectal carcinomas has yet been attained, although they are assumed to
      play a role in the metastasis to lymph nodes and recurrence of breast carcinoma
      and bladder carcinoma invasion. Knowing that Dukes' classification of colorectal
      carcinoma is closely related to prognosis, we examined whether there is a
      correlation between Dukes' classification and the expression of EGF-R in
      colorectal carcinoma. If there is a positive correlation, the involvement of EGF
      R in the processes may be assumed and the expression of EGF-R may be used as a
      marker of their prognosis. To this end, the expression of EGF-R mRNA and protein
      by non-radioactive in-situ hybridization and immunohistochemistry, respectively,
      were determined on histological preparations of formalin-fixed paraffin-embedded
      colorectal surgical specimens. In 30 cases of colorectal carcinoma examined, mRNA
      and/or protein was detected in 33% (two of six) of Dukes' A, in 40% (four of 10)
      of Dukes' B, in 36% (four of 11) of Dukes' C, in 33% (one of three) of Dukes' D
      and in 0% of normal colon epithelial cells. Thus, there was no positive
      correlation between the Dukes' classification and the expression of EGF-R. It is
      concluded that the expression of EGF-R in colorectal carcinoma is not a promising
      marker of prognosis. However, the role of EGF-R in EGF-R positive tumours remains
      to be examined.

PMID- 7781796
TI  - Potential value of biliary CEA assay in early detection of colorectal
      adenocarcinoma liver metastases.
AB  - Elevation of the biliary CEA level in patients with liver metastases from
      colorectal carcinoma has been reported. The aim of this study is to determine the
      potential value of biliary CEA assay in the early detection of liver metastases.
      Biliary and serum CEA levels were determined in patients operated on for a
      colorectal cancer and in control groups. Among 13 patients with liver metastases
      from colorectal carcinomas, biliary CEA levels were markedly elevated (> 40
      ng/ml) in nine, moderately elevated (5-40 ng/ml) in two and normal (arbitrarily
      defined as < 5 ng/ml) in two. Of 28 patients with primary colorectal carcinoma
      without detectable hepatic secondaries, three had marked CEA elevation in the
      bile, 10 had moderate CEA elevation and 15 had normal levels. Among nine patients
      with non-malignant hepatobiliary pathology, there was one marked biliary CEA
      elevation, one moderate elevation and seven normal levels. None of the 13
      individuals with no identified hepatobiliary pathology had elevated biliary CEA
      levels. The follow-up of patients with a primary colorectal tumour, no evidence
      of hepatic secondaries and a biliary CEA elevation is of particular interest. If
      subsequent appearance of liver metastases is found in such cases, intra-operative
      biliary CEA assay could be considered a valuable diagnostic test. Further studies
      will then have to prove the possible benefit of a specific treatment for this
      group of patients.

PMID- 7781797
TI  - Positron emission tomography: 2-deoxy-2-[18F]-fluoro-D-glucose uptake in locally
      advanced breast cancers.
AB  - Fifteen patients with locally advanced breast cancers were studied using the
      radiopharmaceutical 2-deoxy-2-[18F]-fluoro-D-glucose (FDG) with positron emission
      tomography (PET). Five patients were sequentially imaged before and after two
      pulses of chemotherapy. In 14 of 15 tumours increased uptake of FDG was observed
      which correlated with the clinical site of the tumour. The PET images were
      compared with the mammographic and ultrasonomammographic appearances of the
      tumours in selected patients. In two patients with normal mammograms PET imaging
      detected the tumour and in a further four patients, with suspicious but not
      conclusively malignant mammographic changes, a well-defined area of increased FDG
      uptake was demonstrated by PET. In all five sequentially imaged tumours,
      following chemotherapy, there was a decrease of the FDG tumour: normal breast
      uptake ratio. In four patients who completed a full chemotherapeutic course this
      change preceded a pathological response of their tumours. These findings suggest
      that this technique may be of benefit in imaging carcinomas in the breasts of pre
      menopausal women which may appear dense on mammography and moreover, that
      sequential imaging may have a role in the prediction, at an early stage, of the
      response of locally advanced carcinomas to chemotherapy.

PMID- 7781799
TI  - Report of a symposium on diagnosis and treatment of adult soft tissue sarcomas in
      the head and neck.
AB  - A series of presentations and discussions was held during a symposium on the
      diagnosis and treatment of adult soft tissue sarcomas in the head and neck
      (HNSTS). The purpose of this meeting was to define guidelines on diagnosis and
      treatment of HNSTS. The results of this symposium are summarized and condensed in
      this report. Recommendations are made for diagnostic strategies and for
      treatment. Diagnostic efforts in PET scanning and dynamic MRI need to be expanded
      to detect early recurrences. Firm pathological diagnosis remains the basis for
      further treatment strategy. Wide surgical excision, if feasible, in combination
      with radiotherapy is the treatment of choice.

PMID- 7781798
TI  - The importance of the non-palpable lesion in women under 50, detected by
      mammography on self-referral for screening, symptoms or follow up.
AB  - Between 1.1.88 and 31.12.91, 349 consecutive patients had an x-ray localization
      excision of a non-palpable breast lesion less than 10 mm in diameter detected by
      2-view mammography performed as a result of self-referral for screening (133),
      breast symptoms (164), or follow-up for breast disease (52). All lesions greater
      than 11 mm were excluded. 250 had benign and 99 (28%) had malignant lesions. 37
      of 99 (37%) patients with malignancy were aged 49 or under. 133 patients
      requested screening, 33 (25%) had carcinoma of whom 11 (33%) were aged 49 or
      less. 164 patients presented with breast symptoms; 47 (29%) had cancer and 15
      (32%) of these were aged 49 or less. 52 patients requested follow up for breast
      diseases including previous cancers, 19 (37%) had carcinoma of which 11 were 49
      years or less (58%). 223 had microcalcifications, of which 68 (31%) were positive
      for cancer, and 126 had no microcalcification, of which 31 (25%) patients had
      cancer. The specific spiculate radiological lesions yielded 16 carcinomas in 31
      cases (52%). Microcalcification was seen in 110 patients under 49 with 27 (25%)
      carcinomas detected. Microcalcification was a significant diagnostic criterion in
      the patients aged 49 or less, accounting for 27/37 (73%) patients. Dutal
      carcinoma in situ accounted for 18/37 (49%) in patients aged 49 or less, and
      19/62 (31%) in patients over 50 years. Mammography should not be withheld from
      patients who are seeking screening, have symptoms, or who wish to be followed up,
      irrespective of age.

PMID- 7781800
TI  - The prevalence of different human papillomavirus types and p53 mutations in
      laryngeal carcinomas: is there a reciprocal relationship?
AB  - This study investigates whether a reciprocal association occurs between HPV
      infection and somatic mutation of the tumour suppressor gene p53 in laryngeal
      carcinomas. Using immunohistochemical techniques, 87 tumours were examined for
      expression of the mutant form of p53 phosphoprotein using the monoclonal antibody
      PAB 1801. The prevalence of different HPV types in these tumours was determined
      by using the polymerase chain reaction and restriction enzyme analysis. Over
      expression of p53 was noted in 50/87 (57.5%) of the tumours investigated but not
      in any of the non-neoplastic laryngeal mucosa (controls). There was no
      statistical correlation between p53 immunoreactivity and the clinicopathological
      parameters of laryngeal carcinomas. HPV DNA was detected in 8/36 (22.2%) of the
      tumours: HPV-6 in three, HPV-11 in one, HPV-16 in two, and unknown HPV type in
      two. In p53-mutant tumours, HPV was present in 4/20 tumours but none of these
      were high risk HPV types. In p53-normal tumours, on the other hand, HPV was
      present in 4/16 tumours but two of these were definitely high risk HPV-16. These
      results imply the reciprocal association between HPV and somatic mutations of p53
      found in the case of cervical carcinoma.

PMID- 7781801
TI  - Neuroendocrine tumours in various organ systems in a ten-year period.
AB  - Neuroendocrine cells are present in various organ systems. These widely
      distributed cells as well as their histogenetically related tumours can produce
      various peptides and peptide hormones. From 1984 to 1993, 349 neuroendocrine
      tumours were found among 511,382 histological diagnoses at the Institute of
      Pathology of the Medical School of the Karl Franzens University in Graz. In 30%
      carcinoid of the appendix was diagnosed, in 16% carcinoid of the colorectum, in
      9% carcinoid of the small intestine and in 2% duodenal carcinoid. Carcinoid of
      the stomach was detected in 14%. Seven of these cases showed microcarcinoidosis
      and five of them were combined with an adenocarcinoma. Carcinoid of the
      oesophagus was present in 1%, neuroendocrine pancreatic tumours in 6%.
      Neuroendocrine tumours of the bronchial system were found in 12%, medullary
      thyroid cancer in 5%. In 1% a Merkel-cell tumour was diagnosed. Other more rare
      localizations of neuroendocrine tumours were the uterus, ovary, breast, testes,
      epididymis, anal region and the upper respiratory tract.

PMID- 7781802
TI  - Is bladder conservation feasible? An Indian experience.
AB  - With the introduction of chemotherapy in the treatment of muscle invasive bladder
      cancers, endeavors at improving disease-free survival/overall survival are
      ongoing. As high objective response rates were seen with MVAC/CMV regimens (M
      methotrexate, V-vinblastine, A-adriamycin, C-cisplatin) organ conservation is
      being attempted. A phase II protocol was designed using MVAC as the initial
      therapy. Based on the response to two cycles all patients were evaluated and
      where possible the bladder was preserved. Twenty-nine patients completed the
      protocol and had a median follow-up of 24 months. Complete response (CR) was
      noted in 7/29 (24.1%) of patients, while 11/29 (38%) had partial response (PR)
      and 11/29 (38%) showed no response (NR). Bladder conservation was possible in
      15/29 (51.7%) patients initially with the use of radiation therapy after the
      initial chemotherapy. Ten of these patients are presently alive with their
      bladders intact. Three patients died of distant disease, two with normal bladders
      and one with local relapse. Two of the other patients required salvage cystectomy
      and are alive and disease-free. All complete responders 7/7 (100%) and 5/11 (45%)
      partial responders could have their bladders conserved. Three of 11 partial
      responders who refused radiotherapy and 11/11 non-responders underwent radical
      cystectomy after initial chemotherapy. Subset analysis indicates that low stage
      and grade tumours had the highest likelihood of bladder preservation, and there
      was no difference in overall survival in the groups according to response
      criteria. As our study consists of a small number of selected patients, it would
      be improper to draw firm conclusions. However, it seems that initial chemotherapy
      selects out a subset of patients with a good prognosis and the chance for bladder
      conservation.

PMID- 7781804
TI  - Update on urology--prostate cancer. 1--The molecular basis for prostatic cancer:
      how it may influence treatment choice.

PMID- 7781803
TI  - Membrane ruffling of cancer cells: a parameter of tumour cell motility and
      invasion.
AB  - Membrane ruffling of cells is a dynamic and rapid movement with irregular
      fluctuation of protrusion and withdrawal of the margin of the cell surface
      membrane. The ruffling can be seen in two major types: ruffling around the
      periphery and leading edge of an adherent cell and circular ruffling on the
      dorsal surface. A number of cytokines have been shown to increase membrane
      ruffling, and methods of decreasing ruffling are now being reported. Membrane
      ruffling has been shown to relate to metastatic status in tumour cells obtained
      by fine needle aspiration, while in-vitro and animal tumour studies show it to be
      an indicator of tumour cell motility and metastatic potential. If these latter
      findings can be confirmed as applicable to clinical tumours as well, the
      establishment of such a relationship may be useful in predicting invasion and
      metastasis in human tumours, as well as providing a model to study methods of
      inhibiting or reversing metastatic potential.

PMID- 7781805
TI  - Paediatric surgical oncology. 4--The management of soft tissue sarcomas in
      children.

PMID- 7781806
TI  - Combined therapeutic approach for extraorbital sebaceous carcinoma in a Torre's
      syndrome.
AB  - Extraocular sebaceous carcinomas are extremely uncommon neoplasms. More
      exceptional is their association with an internal malignancy as first described
      separately by Torre and Muir in 1967. We report the first use of combined
      adjuvant radio- and chemotherapy in a sebaceous carcinoma of the anal margin in a
      Torre's syndrome. An interesting partial response was attained before the patient
      died from general debility. The therapeutic approach is discussed.

PMID- 7781807
TI  - Haemangiopericytoma of the greater omentum.
AB  - A case of haemangiopericytoma of the greater omentum is reported here. We discuss
      the presentation, treatment and prognosis of these rare tumours.

PMID- 7781808
TI  - Change of flow cytometric DNA content in para-aortic lymph node showing
      recurrence after adjuvant chemotherapy for gastric cancer.
AB  - A para-aortic lymph node showing recurrence was resected from a patient who had
      received adjuvant chemotherapy after curative resection of an advanced gastric
      cancer. A flow cytometric analysis of DNA content was carried out for the primary
      lesion, a metastatic lymph node and the resected lymph node. A peri-diploid cell
      population in addition to diploid cells appeared in the recurrent lesion, whereas
      a major diploid cell population and a minor aneuploid cell population were found
      in the primary lesion and the metastatic lymph node, indicating that a clone of
      chemo-resistant tumor cells selectively multiplied after the cytotoxic therapy.
      The characters of a recurrent lesion may be changed by clonal selection following
      chemotherapy.

PMID- 7781809
TI  - Insulinoma: pitfalls in preoperative localization.
AB  - In patients with biochemical evidence of insulinoma, many techniques have been
      advocated as the procedures of choice for diagnostic localization without a clear
      cut consensus as to their utility. Despite the small size of insulinomas, 90% are
      solitary and nearly 100% are intrapancreatic. A commonly held belief is that once
      the diagnosis of autonomous hyperinsulinism is confirmed, it is necessary to
      secure as much information as possible about the precise location prior to
      surgery. Although frequently used, preoperative localization studies are
      expensive, potentially morbid, and worse yet, may be misleading. We present a
      case study in which the preoperative studies falsely localized the insulinoma to
      the pancreatic head. Since the introduction of intraoperative ultrasound (IOUS),
      it is now unusual not to identify and excise the insulinoma in patients
      undergoing exploration for functioning beta-islet cell lesions. Our experience,
      along with support from the literature, led us to recommend a simplified
      localization approach, namely IOUS combined with surgical palpation.

PMID- 7781810
TI  - Medullary cell carcinoma of the thyroid: metastases to the central nervous
      system.
AB  - We document a case of a patient who had been treated for a medullary cell
      carcinoma of the thyroid three years previously and who presented with a three
      month history of ataxia, weakness and headache. A CT scan showed contrast
      enhancing lesions in the posterior fossa. An MIBG uptake scan showed that there
      was some uptake in the cerebellar lesions; however, it was not sufficient to rely
      on this alone for treatment. The larger of these lesions was therefore surgically
      resected. Immunocytochemistry, using CAM 5.2, CEA and chromogranin, demonstrated
      a positive reaction which strongly favoured a diagnosis of metastases from a
      medullary cell carcinoma of the thyroid. However, absolute confirmation of the
      diagnosis was obtained using immunocytochemistry with calcitonin. Medullary cell
      carcinomas of the thyroid usually spread locally and metastasis to the brain has
      never before been reported.

PMID- 7781811
TI  - Sulphite analysis of food ingredients: false positive responses with butter
      flavourings in the optimized Monier-Williams method.
AB  - The analysis of commercial butter flavouring materials for sulphite by the
      optimized Monier-Williams method revealed detectable levels of apparent sulphur
      dioxide (1810 ppm for butter oil, 5760 ppm for butter flavour, and 14.5 ppm for
      butter derivative) even though the manufacturers claimed that no sulphites were
      used in processing these ingredients. The presence of volatile fatty acids in
      these ingredients may explain the anomalous results. Volatile fatty acids were
      found to interfere with the optimized Monier-Williams method for sulphite
      determination, detectable levels of titratable acid being found in the hydrogen
      peroxide trap with amounts of volatile fatty acids as low as 0.3 g. The levels of
      volatile fatty acids in foods would not be predicted to cause significant
      interference in the analysis of sulphite residues by the optimized Monier
      Williams method. However, this analytical procedure is not recommended for the
      analysis of sulphite residues in food ingredients containing substantial amounts
      of volatile fatty acids. Alternative methods for the detection of residual
      sulphite, such as the sulphite oxidase assay and the colorimetric para-rosaniline
      method, are not subject to interference by volatile fatty acids.

PMID- 7781812
TI  - 14C-sorbic acid distribution in the aqueous and non-aqueous extracts of cooked
      millet dough (fura).
AB  - Millet flour was used to prepare the West African food, fura, preserved with
      sorbic acid. The lipid and protein fractions which appeared to bind sorbic acid
      or its degradation products were identified with the help of 14C-sorbic acid.
      Fractionation of the lipids and proteins from fura showed the 14C to be
      associated with the petroleum spirit crude fat extract (28 +/- 5%), the water
      soluble (6.2 +/- 0.7%), the ethanol-soluble (4.5 +/- 0.7%), the salt-soluble (3.5
      +/- 0.6%) and the acetic acid-soluble components (0.9 +/- 0.3%). Dialysis of the
      ethanol-, salt- and acetic acid-soluble fractions suggested that 14C activity
      tended to be associated with the low molecular weight components of these
      fractions.

PMID- 7781813
TI  - Development of multi-residue methodology for the HPLC determination of veterinary
      drugs in animal tissues.
AB  - The application of solid-phase extraction and HPLC with UV-diode array detection
      to the multi-residue determination of veterinary drugs is described. A two-stage
      SPE clean-up was employed, using C18 and silica cartridges. HPLC analysis was
      carried out on a base-deactivated C8 column using gradient elution systems at two
      pH values. The procedure establishes the basis of a method for routine screening
      of pig kidney samples for some sulphonamides, benzimidazoles, nitroimidazoles and
      nitrofurans at concentrations at or below the UK Maximum Residue Limits (MRLs).
      Limits of detection of 2-18 micrograms/kg could be achieved for these analytes at
      recoveries of 40-70%. UV spectra measured on-line were used for confirmation of
      peak identities at these concentrations. The possibility of extension of this
      procedure to a wider range of analyses is discussed.

PMID- 7781814
TI  - Determination of quinoxaline carboxylic acid (metabolite of carbadox) in animal
      tissue by HPLC.
AB  - A method for the determination of residues of quinoxaline-2-carboxylic acid
      (QCA), the major metabolite of carbadox, in pig kidney has been developed. Tissue
      samples were subjected to alkaline hydrolysis, liquid-liquid extractions, ion
      exchange chromatography and further extraction to concentrate the analyte and
      purify the extract. Determination was by reverse phase HPLC with UV detection at
      320 nm. Validation exercises carried out on batches of six samples fortified with
      0.050 mg/kg QCA on three separate days gave mean recoveries ranging from 72 to
      79% with relative standard deviations ranging from 5.6 to 7.8%. Samples fortified
      with 0.010 mg/kg QCA gave a mean recovery of 100% with a relative standard
      deviation of 9.8%.

PMID- 7781815
TI  - The effect of cooking on veterinary drug residues in food: 2. levamisole.
AB  - The heat stability of levamisole was investigated. Results obtained indicated
      that the drug was stable in boiling water at 100 degrees C, but unstable at 260
      degrees C in cooking oil, with a half-life of about 5 minutes. The effect of
      cooking (microwaving, boiling, roasting, grilling and frying) on levamisole
      residues in a range of fortified and incurred tissue was studied. No evidence of
      instability was obtained in any of the cooking methods investigated. Most
      observed net changes fell within the limits of the precision of the method once
      allowance for weight loss during cooking was made to counter an apparent increase
      in concentration. Roasting was the only method of cooking where a net loss of
      levamisole was observed. Insufficient juices were produced to permit analysis in
      this instance. The net loss of levamisole in the cooked tissue was similar to
      that found with other cooking methods, where the levamisole lost was found in the
      cooking liquid or juices. An assessment of homogeneity of the incurred tissue
      used in the investigation was made. The pig muscle was found not to be
      homogeneous with larger differences seen between different areas of the animal
      than within the same muscle. The findings of this investigation showed that data
      obtained from measurements on raw tissue are suitable for use in consumer
      exposure estimates and dietary intake calculations.

PMID- 7781816
TI  - Evaluation of herbicide migration from water to gorgonzola and mozzarella cheeses
      in industrial processing.
AB  - The possibility of migration of atrazine, simazine, terbuthylazine, molinate and
      bentazon herbicides from contaminated water used in the manufacture of gorgonzola
      and mozzarella cheeses was verified in an industrial plant in an agricultural
      area in northern Italy. In a milk-processing plant, water samples were drawn from
      five wells; samples of milk, curd and finished products were collected from the
      respective production lines. In all samples, the herbicide residues were detected
      by gas chromatographic analysis. The results show that herbicide residues
      detected in water were not found in the finished products even if residues were
      found in the intermediate products (curd).

PMID- 7781817
TI  - Taste interaction of styrene/ethylbenzene mixtures in an oil-in-water emulsion.
AB  - Styrene and ethylbenzene are present in detectable amounts in polystyrene
      packaging materials and migration of these compounds may cause a taint of the
      packed food. The effect of mixtures of styrene and ethylbenzene on the detection
      threshold concentration in a 5% oil-in-water emulsion was investigated with the
      constant stimulus differences test. The detection threshold concentrations of the
      individual compounds in the emulsion were found to be 1.0 ppm for styrene and 3.0
      ppm for ethylbenzene. Linear regression of the percentages of correct answers and
      the logarithm of the sum of the concentrations of both compounds in the mixtures
      expressed as fractions of their threshold concentration gave the following
      relationship: % of correct answers = 42.5 x log (sum of threshold fractions)
      +74.8 (r = 0.87). Calculation of the sum of threshold fractions at the 75% point
      of correct answers gave a value of 1.0, which clearly indicates that the effect
      of mixing of styrene and ethylbenzene is additive at sub-threshold levels in a 5%
      oil-in-water emulsion.

PMID- 7781818
TI  - Identification of potential migrants from samples of dual-ovenable plastics.
AB  - The analysis of samples of dual-ovenable cookware articles has identified
      chemicals with the potential to migrate into food. Samples were analysed by
      dynamic headspace analysis at 200 degrees C using a Tenax TA trap cooled in ice,
      and/or solvent extraction, followed by gas chromatography/mass spectrometry.
      Plastics analysed were crystalline poly(ethyleneterephthlalate) (cPET), thermoset
      polyester, poly(ethersulphone) and poly (4-methyl-pent-1-ene) (TPX). The greatest
      number and quantity of chemicals with the potential to migrate were found in
      thermoset polyester.

PMID- 7781819
TI  - Compositional analysis of samples of thermoset polyester and migration of
      ethylbenzene and styrene from thermoset polyester into pork during cooking.
AB  - The levels of ethylbenzene, styrene, benzene and benzaldehyde in samples of
      thermoset polyester were determined by dynamic headspace/gas chromatography.
      Styrene was present at levels from 50 to 1400 mg kg-1, ethylbenzene up to 25 mg
      kg-1 and benzaldehyde up to 180 mg kg-1. Benzene levels were usually less than 1
      mg kg-1, but one article contained 19 mg kg-1. Levels of styrene dimers and
      trimers were estimated using size exclusion chromatography followed by gas
      chromatographic (GC) analysis and were present at approximately 100 mg kg-1 and
      700 mg kg-1 respectively. The principal identified constituents of solvent
      extracts were stearic and palmitic acids, present at a combined level of nearly
      1% by weight of the plastic. Styrene was shown to be produced by thermal
      depolymerization at temperatures of 175 degrees C and above. The migration of
      ethylbenzene and styrene into belly pork cooked in thermoset polyester dishes for
      1.5 h at 175 degrees C was measured by Likens-Nickerson extraction of the cooked
      meat and GC/MS analysis of the extracts. Migration ranged from 6 to 2400
      micrograms kg-1 for styrene and from < 6 to 34 micrograms kg-1 for ethylbenzene.

PMID- 7781821
TI  - PVC cling film in contact with cheese: health aspects related to global migration
      and specific migration of DEHA.
AB  - Following exposure to the food simulant olive oil for 10 days at 5, 20 or 40
      degrees C a global migration ranging from 20 to 30 mg/dm2 was detected from a
      common 'low migration' PVC film plasticized with a mixture of di
      (ethylhexyl)adipate (DEHA) and a polymeric plasticizer. In a laboratory
      experiment samples of cheese of the types most commonly consumed in Denmark were
      wrapped in this 'low migration' PVC film using a procedure simulating the actual
      pattern of use in retail shops. After a storage time of 2 h at 5 degrees C the
      level of DEHA was 45 mg/kg of cheese, which after 10 days increased to 150 mg
      DEHA per kg of cheese, corresponding to an estimated specific migration of 12 mg
      DEHA/dm2 of cheese surface. Based on statistics on dietary habits it is concluded
      that the retail packaging of small portions of cheese even in a 'low migration'
      PVC cling film may lead to consumer intakes of DEHA close to or above the
      tolerable daily intake of 0.3 mg/kg body weight as defined by the EEC Scientific
      Committee for Food. Furthermore, it is stressed that measurements of global
      migration followed by uncritical use of reduction factors may result in erroneous
      evaluation of the suitability of DEHA-plasticized cling film for the packaging of
      fatty foods.

PMID- 7781820
TI  - Migration studies on fatty acid amide slip additives from plastics into food
      simulants.
AB  - Specific migration studies, using food simulants, have been conducted on a range
      of polymers which are used in food packaging and contain commonly used fatty acid
      amide slip additives. Migration levels using the test conditions (10 days at 40
      degrees C) were found to depend primarily upon the food simulant and the polymer
      type, with the fat simulant and low density polyethylene giving the highest
      values in the range 1.8-3.1 milligrams of fatty acid amide per kilogram of
      simulant. Extremely low levels of migration, < 0.05 milligrams of fatty acid
      amide per kilogram of simulant, were found with aqueous food simulants for all
      plastics tested, and fat simulant with PVC and polystyrene plastics.

PMID- 7781822
TI  - Exposure of infants to aflatoxin M1 from mothers' breast milk in Abu Dhabi, UAE.
AB  - During a survey of the occurrence of aflatoxins in mothers' breast milk carried
      out in Abu Dhabi, involving 445 donors at the Cornich Hospital and the Al Nehyan
      Clinic for Maternity and Childhood, 99.5% of samples were found to contain
      aflatoxin M1 at concentrations ranging from 2 pg ml-1 to 3 ng ml-1. The mothers
      represented a wide range of nationalities, ages and health status and the
      opportunity was used to seek any correlation between these factors and the
      concentration of aflatoxin M1 in breast milk. The protein, fat and lactose
      contents of milk samples were also determined and the possibility of any
      correlation between any of these and aflatoxin M1 was studied.

PMID- 7781823
TI  - Lead and cadmium in some berries and vegetables on the Finnish market in 1991
      1993.
AB  - In order to determine the present contribution of vegetables and berries to the
      intake of lead and cadmium in Finland major vegetable groups as well as
      strawberries and blackcurrants were collected from wholesale distribution
      centres, orchards and the food industry. Pooled samples were mixed to represent
      wholesale distribution centres, exporting countries or geographical regions. Lead
      and cadmium were determined after wet digestion in concentrated HNO3 using ETAAS
      with Zeeman effect background correction and 0.1% palladium for lead and
      (NH4)H2PO4 for cadmium matrix modification. The method of standard additions was
      used for the quantification. The mean lead and cadmium contents found were:
      iceberg lettuce 1.1 and 20.9, butterhead lettuce 4.5 and 12.2, Chinese cabbage
      1.4 and 11.1, cauliflower 1.6 and 7.1, cucumber 0.7 and 0.6, carrot 5.9 and 24.6,
      tomato 1.5 and 1.5, leek 3.8 and 12.8, cabbage 1.3 and 3.1, paprika 3.1 and 5.3,
      potato 5 and 6 (domestic) or 5 and 31 (imported), strawberry 6.5 and 13.7,
      blackcurrant 12.7 and 1.4 micrograms/kg. The contents found in this study are the
      lowest reported so far in Finland and equal to or lower than those found
      elsewhere.

PMID- 7781824
TI  - Determination and confirmation of methyl p-hydroxybenzoate in royal jelly and
      other foods produced by the honey bee.
AB  - Methyl p-hydroxybenzoate (methyl paraben) in foods produced by the Honey Bee was
      determined by HPLC and confirmed by GC-MS. The compound was detected at a mean
      concentration of 22.3 +/- 6.8 mg/kg (between 14.2 and 31.9 mg/kg) in commercial
      royal jelly, but was not detected in honey, propolis or pollen lumps at the
      detection limit of 1 mg/kg. Fresh royal jelly collected from apiaries contained
      methyl p-hydroxybenzoate at a concentration of 20.3 +/- 4.7 mg/kg (between 12.5
      and 31.7 mg/kg). These results indicate that the methyl p-hydroxybenzoate in
      royal jelly is not added but is a natural component.

PMID- 7781825
TI  - Philosophy of occlusion: past and present.
AB  - Controversy in a field usually stimulates research to find answers and to promote
      clinical excellence. Thus, differing ideas about occlusion relative to centrics,
      gnathology, TMD, occlusal adjustment, and periodontal therapy have led to a
      controversial body of literature; however, I think also it has led to better
      treatment for patients, regardless of whether, for example, the concept of point
      centric or freedom-in-centric is advocated. No one can practice dentistry without
      some concept of occlusion whether it is applied to one or two teeth or to
      complete mouth restoration. Although the work of committees to clarify
      terminology is quite appropriate, common usage, semantics, avoidance of confusion
      in the literature, and the ideological nature of the bias in science must be
      carefully considered. At times we learn from history that all ideologies need
      constant revisions; too often the need leads to changes by fiat rather than by
      virtue of research on problems that may actually exist in communication.

PMID- 7781827
TI  - Occlusion and functional disorders of the masticatory system.
AB  - Understanding the relationship between occlusion and functional disorders of the
      masticatory system is no easy task. This article explores the static, functional,
      and dynamic relationships of the occlusal condition to the signs and symptoms of
      masticatory dysfunction. Some possible relationships are discussed.

PMID- 7781826
TI  - Biomechanics of occlusion and the articulator.
AB  - The evaluation of the occlusion is important in prosthodontics and restorative
      dentistry because the occlusal surfaces of the teeth to be restored must be
      functional units of the patient's stomatognathic system. Specifically, the
      morphology of the cusps, fossae, grooves, and marginal ridges should support the
      mandible in the intercuspal position and where appropriate, during eccentric jaw
      movements and in functional activities such as mastication. Restored teeth should
      not interfere with mandibular function in mastication, speech, and swallowing nor
      should they transmit excessive force to the attachment apparatus or the
      temporomandibular joint either in the intercuspal or eccentric jaw positions or
      during movement.

PMID- 7781828
TI  - Trauma from occlusion. Periodontal concerns.
AB  - Application of the chronic disease model to IPD suggests that to be most
      effective, programs of prevention and treatment include measures to address as
      many of the identified risk factors as is possible. It remains to be determined
      if TO is involved in the initiation of IPD, for example, if individuals with TO
      are at greater risk for the development of IPD. There is evidence that TO is a
      risk factor in the progression of IPD. Tooth mobility is associated with and is a
      risk factor for increased attachment loss and increased bone loss in patients
      with periodontitis. Tooth mobility can be reduced by occlusal treatment. Clinical
      trials involving patients with periodontitis clearly establish that a better
      clinical periodontal attachment level response to treatment is obtained when
      occlusal adjustment is included as part of the treatment plan. Patients with
      advanced periodontal involvement benefit from occlusal treatment in terms of
      increased stability for the teeth and also in terms of oral comfort. Finally,
      There is no evidence that without occlusal treatment, periodontal patients who
      are in careful maintenance programs are more likely to suffer recurrence of IPD.

PMID- 7781829
TI  - Occlusion and prosthodontics.
AB  - Occlusion in prosthodontics is extremely important. Muscle dysfunction can
      interfere with prosthodontic restoration of occlusion. Occlusal interferences are
      the primary cause of the hyperactivity that cause muscle dysfunction. Occlusal
      interference can also place adverse stress on restorations and result in
      premature failures. Lateral stresses on restorations can cause cement failures,
      porcelain fractures, and solder joint failures. Our goal in prosthodontics is to
      restore occlusion that is occlusal interference free. This article gave an
      overview of how this can be done in phases. In Phase I, a diagnosis is made as to
      the presence or absence of muscle dysfunction. If it is present, the OIs are
      hidden. Occlusal splint therapy is needed to get rid of the muscle dysfunction so
      the OIs can be found. The occlusal splint diagnosis whether OIs are the cause of
      the dysfunction. The cure is to correct the occlusion. The restoration of the
      occlusion should be OI free. The various factors to consider in design and
      restoration of the occlusion were presented. After successful restoration of the
      occlusion, the recall appointments should include an evaluation of the occlusion.
      The PRI, COS, and clinical examination can all be helpful in diagnosing whether
      muscle dysfunction is developing and whether OIs are developing again as a result
      of the normal changes that can occur. Suggestions were made on how to slow these
      changes. This article was not meant to cover every aspect of prosthodontic
      occlusion in detail. The goal was to present an overview for readers to make a
      self-evaluation as to what areas of their practice might need to be improved to
      improve the restoration of the occlusion. All was not taught in dental school. As
      one practices and improves in skill, more knowledge and abilities must be sought
      through graduate and postgraduate education. Occlusion is too important for a
      successful practice and happy patients to be ignored. Time will make this
      obvious; however, the failures may be costly. The best approach would be to
      anticipate the failures and prepare yourself to reduce the risks. Occlusal
      interferences are truly the plague of dentistry.

PMID- 7781830
TI  - Trauma from occlusion. Restorative concerns.
AB  - Trauma from occlusion and restorative concerns may affect the tooth itself, the
      supporting structures inside and around the tooth's immediate structures, and the
      total articulating system, which includes the neuromuscular system, the
      temporomandibular joints, and other systems such as the impairment of hearing or
      vision and many other peripheral conditions. A thorough examination and a
      differential diagnosis procedure is essential to restore the health of the
      articulating system and reverse peripheral condition. This includes the ability
      to restore the individual tooth in its best anatomic position as a complement to
      the articulating system using all individual disciplines of dentistry in the
      finest abilities of treatment and the ability to share and distinguish the
      possible parafunctional habits and the need for behavioral understanding,
      support, and management to limit or lessen the wear and destruction of the
      individual tissues and to restore a healthier physical support.

PMID- 7781832
TI  - Occlusal principles in orthodontics.
AB  - Morphologic and functional requirements of the orthodontically treated occlusion
      are discussed in this article. In the past, orthodontic treatment has been viewed
      as both a cause and a cure for temporomandibular disorders. This article reviews
      the literature, orthodontic implications of occlusal appliance therapy, and case
      reports.

PMID- 7781831
TI  - Occlusion and restorative materials.
AB  - Undoubtedly, the materials used in conjunction with restorative dentistry have
      been changing over the years. Although restorative systems before the early 1960s
      have changed only moderately, the last two to three decades have witnessed some
      fairly dramatic developments. Composite resins, mercury-free alloys, quartz-free
      ceramics, and gold-reduced or gold-free alloys represent some of the more obvious
      introductions. Considerable information has been made available concerning their
      physical and mechanical characteristics; however, little has been published
      concerning their effect on occlusion and equilibration of the teeth.

PMID- 7781833
TI  - Examination and occlusal analysis of the masticatory system.
AB  - Analysis of the occlusion and function of the masticatory system should be part
      of a thorough examination of the patient. This is especially important when signs
      or symptoms of functional disturbances are present or when planning extensive
      occlusal restorations. This article has strived to present (1) indications for
      occlusal analysis; (2) how to perform occlusal analysis and diagnostic aids that
      can be helpful in occlusal analysis; and (3) how information gained through
      occlusal analysis can be used in differential diagnosis of the three most common
      functional disturbancies of the masticatory system: trauma from occlusion,
      parafunction, and TM disorders.

PMID- 7781834
TI  - Principles of stabilization bite splint therapy.
AB  - The stabilization bite splint is discussed with regard to design, delivery, and
      clinical procedures that contribute to conservative appliance therapy.
      Indications for stabilization bite splint therapy and a clinical case report are
      presented.

PMID- 7781835
TI  - Laboratory procedures for the fabrication of maxillary occlusal bite plane
      splint.
AB  - Clear communication between the dentist and laboratory technician is important
      for the production of quality work and the saving of valuable chair time at
      delivery. This article discusses the laboratory procedures used in the
      fabrication of occlusal bite plane splint. Traditional heat curing, microwave
      heat processing, and visible light curing techniques are discussed.

PMID- 7781836
TI  - Occlusal adjustment.
AB  - Only an overview of the techniques for occlusal adjustment has been presented. A
      more thorough explanation can be found in the text Occlusion by Ramfjord and Ash,
      on which most of this material is based.

PMID- 7781838
TI  - [New Editor-in-Chief at Diabetes and Metabolism].

PMID- 7781837
TI  - Supportive conservative therapies for temporomandibular disorders.
AB  - Many modalities of conservative supporting therapies are available to dental
      professionals for the management of disorders of the masticatory system. This
      article discusses pharmacologic and physical agents useful in the management of
      masticatory dysfunction and external biofeedback.

PMID- 7781839
TI  - [Multicenter evaluation of the Nutri-Expert Telematic System in diabetic
      patients].
AB  - Nutri-Expert is a system for self-monitoring and dietetic education, accessible
      through Minitel. A preliminary randomised evaluation of one hundred diabetic
      patients in the Midi-Pyrenees region showed that Nutri-Expert improved dietetic
      knowledge, dietary habits and metabolic balance. The aim of the present study was
      to show that the system can be successfully prescribed to patients by physicians
      outside the center which originated it, indicating the benefit of a wider use of
      Nutri-Expert, among the diabetic population. One hundred and fifty-five patients,
      recruited by six French centres of diabetology, used Nutri-Expert from their
      homes for six months. Clinical examination, tests of dietetic knowledge and
      biological tests, including lipid fractions, were carried out before and after
      six months of use. After six months, there was a significant improvement in the
      patients' dietetic knowledge and in some biological parameters. Nutri-Expert is
      thus useful even when prescribed by a centre other than the hospital which
      devised the system. It is an additional beneficial tool in the ambulatory
      management of diabetic patients.

PMID- 7781841
TI  - [Prevalence of microalbuminuria in French type 2 diabetics followed by their
      general practitioner].
AB  - Microalbuminuria is a risk marker for cardiovascular morbidity and mortality in
      Type 2 diabetes. We studied microalbuminuria among French Type 2 diabetic
      patients in general practice, because we set-up a trial using cardiovascular
      events as end-points. Two thousand twenty four volunteer patients were studied
      for Urinary Albumin Concentration (UAC) during outpatient visit to general
      practitioners. The UAC was measured on first samples. If UAC was positive (> or =
      20 mg/l), a second sample was requested. If UAC was positive two times,
      persistently elevated UAC was identified (micro or macroalbuminuria). Clinical
      characteristic, cardiovascular antecedents and risk factors were studied. One
      hundred five first samples were excluded due to urinary infection; 1,217 others
      displayed normal UAC (< 20 mg/l); 63.4%; group N), 557 microalbuminuria (20-200
      mg/l; 29.0%, group mu), and 145 others macroalbuminuria (> 200 mg/l; 7.6%; group
      M). Among subjects with positive first sample, 26.5% had persistent albuminuria.
      There was no intergroup difference for age, but males were more frequent in
      groups mu or M than N (p < 10(-4)). Blood pressure and body mass index varied
      between groups. Smokers and alcoholic subjects were more frequent in groups mu
      and M than N (p = 0.037 and p = 0.0003 respectively), as were cases with
      myocardial infarction (p = 0.0026), lower limb arteritis (p < 10(-4)), and laser
      treated diabetic retinopathy (p = 0.0002). Antihypertensive treatments were taken
      by 61% of the subjects. Elevated UAC (micro or macroalbuminuria) is frequent
      among french Type 2 diabetic patients cared by their general practitioners, and
      is associated with a high cardiovascular risk profile.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7781840
TI  - Amylin/islet amyloid polypeptide: biochemistry, physiology, patho-physiology.
AB  - Amylin is a 37 amino-acid peptide mainly produced by the islet beta-cell.
      Aggregation of amylin is partly responsible for amyloid formation. Amyloid
      deposits occur both extracellularly and intracellularly and may contribute to
      beta-cell degeneration. Amylin is packed in beta-cell granules and cosecreted
      with insulin in response to the same stimuli but, unlike other beta-cell
      products, it is produced from specific a gene on chromosome 12. Basal, plasma
      amylin concentrations are around 5 pM, and increase fourfold after meals or
      glucose. Higher levels are found in cases of insulin resistance, obesity,
      gestational diabetes and in some patients with NIDDM. Low or absent levels are
      found in insulin-dependent diabetic patients. There are similarities between
      amylin and non beta-cell peptides such as calcitonin gene related peptides
      (CGRP). They may bind to the same receptor, determine similar post-receptor
      phenomena and qualitatively similar actions but with different degree of potency.
      The actions of amylin are multiple and mostly exerted in the regulation of fuel
      metabolism. In muscle, amylin opposes glycogen synthesis, activates
      glycogenolysis and glycolysis (increasing lactate production). Consequently,
      amylin increases lactate output by muscle and increases the plasma lactate
      concentration. In fasting conditions, this lactate may serve as a gluconeogenic
      substrate for the liver, contributing to replenish depleted glycogen stores and
      to increase glucose production. In non-fasting conditions, lactate can be
      transformed by liver in triglycerides. It is not clear at present whether amylin
      actions on the liver are direct or mediated by changes in circulating
      metabolites. A probably indirect effect of amylin in muscle is to decrease
      insulin- (or glucose)-induced glucose uptake, which may contribute to insulin
      resistance. Other actions include inhibition of glucose-stimulated insulin
      secretion and, in general, actions mimicking CGRP effects. Some of these actions
      are seen at supraphysiological concentrations. The physiopathological
      consequences of amylin deficiency, or excess are under active by investigated.

PMID- 7781842
TI  - Cardiovascular autonomic neuropathy in diabetic patients with macular oedema.
AB  - We performed a case-control study to investigate the determinants of macular
      oedema in patients with diabetes mellitus. Patients with macular oedema (n = 20)
      were selected for study, together with a random sample of subjects without
      macular oedema (controls, n = 21). Both groups were similar for sex, type of
      diabetes, treatment and glycaemic control. Patients with maculopathy had higher
      systolic and diastolic blood pressure than controls (P < 0.006 and P < 0.03,
      respectively). Impaired renal function was proportionally higher in patients with
      maculopathy than in controls (60% vs 47%). Vibratory perception was more impaired
      in the maculopathy group than the control group (P < 0.02), and maculopathy was
      associated with the presence of cardiovascular autonomic neuropathy. R-R
      variation and the brake index were significantly lower in patients than control
      subjects (P < 0.01 for both). Moreover, the group with maculopathy had a greater
      fall in systolic blood pressure after standing than did the control group (P <
      0.0001). Autonomic neuropathy may be associated with the development of
      maculopathy and retinopathy, although additional evidence is required to confirm
      this association. Conditions associated with high blood pressure may accelerate
      progression and aggravate maculopathy.

PMID- 7781843
TI  - Adjuvant therapy in recent onset type 1 diabetes at diagnosis and insulin
      requirement after 2 years.
AB  - Partial recovery of beta-cell function in type 1 diabetes is common after
      diagnosis by intensive insulin therapy. Residual beta-cell function can be
      improved by other therapies. Cyclosporin (CyA) and nicotinamide (NA), alone or in
      combination, can preserve this function, as indicated by the parameters of
      metabolic control (insulin dose, HbA1C). After suspension of CyA, insulin
      requirement returns to control values, suggesting loss of residual beta-cell
      function. The effects induced by withdrawal of NA after 1 year are not known. For
      the first time, we studied 27 type 1 diabetes patients treated with NA for 12
      months and then followed up for 1 year after discontinuance of NA. Another 25
      patients treated with NA + CyA and 28 control patients were followed up
      similarly. Insulin requirement doubled 12 months after discontinuance of NA or NA
      + CyA, becoming identical to that of controls. As patients showed HbA1C values
      similar to control subjects, it is likely that beta-cell function deteriorated
      after discontinuance of therapy. As NA is safer than other agents and its effects
      are beneficial, longer studies are warranted to investigate NA in prolonged
      treatments since this compound is also being considered for prevention of type 1
      diabetes.

PMID- 7781844
TI  - Adhered platelet morphology in diabetes mellitus.
AB  - We compared the morphology of platelets obtained from diabetic patients in
      various stages of retinopathy and nephropathy with those of control patients. The
      platelets were collected on to polyethylene films, processed and observed under
      scanning electron microscopy. Different platelet morphologies were observed
      within the diabetic group, correlating with the severity of complications,
      whereas platelets appeared normal in the control group. After more extensive
      follow-up and comparative studies, these preliminary observations could provide
      another diagnostic tool for detecting and evaluating severe complications
      associated with diabetes.

PMID- 7781845
TI  - Mefloquine-associated hypoglycaemia in a cachectic AIDS patient.
AB  - Quinine and its isomer quinidine are well-known causes of iatrogenic
      hypoglycaemia, due to excessive insulin secretion. The situation is less clear
      regarding other anti-malarial quinine analogues. In particular, this adverse
      effect has never been described with mefloquine (Lariam). We report a case of
      hypoglycaemia after mefloquine therapy (1,500 mg over two days) for severe
      gastrointestinal cryptosporidiasis in a cachectic AIDS patient with protracted
      diarrhoea. Blood glucose levels, which were normal before treatment, dropped to
      2.3 mmol/l within a few hours and were corrected by i.v. glucose infusion.
      Hypoglycaemia did not recur despite continued treatment. Rat islets of Langerhans
      exposed to mefloquine in vitro (10(-8) mol/l to 10(-3) mol/l) secreted
      significantly more insulin than control islets (up to 980 +/- 180 microU/ml/5
      islets incubated with mefloquine 10(-3) mol/l, vs 20 +/- 4 microU/ml/5 untreated
      islets). Mechanisms and triggering factors of hypoglycaemia induced by mefloquine
      and some other anti-malarial quinine analogues are discussed. Clinicians who
      manage cachectic patients, particularly those with protracted diarrhoea and/or
      receiving anti-malarial drugs including mefloquine, should be aware of the risk
      of severe hypoglycaemia.

PMID- 7781847
TI  - [Mechanisms of the intracellular effects of insulin].

PMID- 7781846
TI  - [Dyslipidemia in the diabetic patient. Recommendations of ALFEDIAM (French
      Language Association for the Study of Diabetes and Metabolic Diseases)].

PMID- 7781848
TI  - [Fear of hypoglycemia and/or pseudo-acceptance: what are the obstacles to control
      of insulin-dependent diabetes in the adult?].

PMID- 7781850
TI  - Endothelin--its possible role during pregnancy.

PMID- 7781849
TI  - Risk factors and their identification. First Part: What is a risk factor?
AB  - This series of three articles reviews the designs of studies which can be used to
      identify risk factors of a disease, here: diabetes or complications of diabetes.
      In the present issue of Diabete & Metabolisme, the first article of the series,
      we give the definition of a risk factor, along with measures of its force-
      relative risk and odds ratio, followed by the epidemiological definitions of the
      diseases: diabetes, coronary heart disease and hypertension. Risk factors are
      further discussed and we complete the discussion by some observations on the bias
      which can arise from a study or from its analysis, which can lead the researcher
      to the wrong conclusion. The three types of epidemiological studies which are
      used to determine whether factors are associated with a disease: observational or
      cross-sectional studies, cohort studies and case-cohort studies will be described
      in the second of the series in the next issue of the journal. Examples will be
      provided of each of these study types; their advantages and disadvantages will be
      discussed. In a third issue, the final paper will provide some examples of the
      study types and the identification of risk factors. The first examples involve
      diabetes and pancreatic cancer, the second birth weight and non-insulin dependent
      diabetes. Having found an association between a risk factor and diabetes, then we
      will discuss whether it can be considered to be a risk factor and if so and
      whether it is likely to be a cause of the disease.

PMID- 7781851
TI  - Fluorescent in-situ hybridization (FISH) as an aid to marker chromosome
      identification in prenatal diagnosis.
AB  - Five cases of supernumerary marker chromosomes were identified in prenatal
      diagnosis as derived from chromosomes 18, X, and Y. One unexpected finding was in
      a case where the PCR was positive for the SRY gene while fluorescence in situ
      hybridization was positive for two X centromeres. In another case with an X
      derived supernumerary marker the newborn was phenotypically normal. Two women
      with fetal mar(18) and mar(Xp) decided to terminate the pregnancy. The fifth
      pregnancy had a karyotype of 46,XX,-15,+der(15)t(Y:15)(q11,23;p13). A
      phenotypically normal girl was born at term.

PMID- 7781852
TI  - Turner's syndrome with sex chromosome mosaicism.
AB  - The increased risk of gonadal neoplasia in cases of Turner's syndrome with sex
      chromosome mosaicism and the presence of Y chromosome material emphasises the
      need for a diligent search and removal of the streak gonads. One such case is
      reported here.

PMID- 7781854
TI  - Shoulder dystocia and symphysiotomy.

PMID- 7781853
TI  - Successful term pregnancy after Mustard operation for transposition of the great
      arteries.
AB  - Transposition of the great arteries is a complex cardiac malformation with poor
      prognosis without surgical correction. Since the introduction of surgical
      procedures such as the intra-auricular reorientation of the venous return
      (Mustard procedure), an increasing number of patients may reach adulthood and
      experience pregnancy. Because long-term complications after the Mustard operation
      include systemic heart failure, arrhythmias, venous return stenosis and pulmonary
      edema, hemodynamic changes during pregnancy and delivery may potentially engender
      life-threatening complications in these patients. We report the case of a 24-year
      old primigravida who underwent a Mustard procedure at the age of 2 years for
      transposition of the great vessels, and who carried out a full-term pregnancy.
      The pregnancy was uneventful until the 34th week, when the woman developed signs
      of moderate right ventricular failure and frequent episodes of accelerated
      junctional rhythm. Digitalisation improved symptoms and elicited return to normal
      sinus rhythm. The patient delivered at term by elective cesarean section, under
      close hemodynamic monitoring.

PMID- 7781856
TI  - Fetal oxygenation at cordocentesis, maternal smoking and childhood neuro
      development.
AB  - OBJECTIVE: To assess the relationship between subsequent neuro-development and
      measurements in small for gestational age (SGA) fetuses, including oxygenation at
      cordocentesis. DESIGN: A longitudinal study of a cohort of SGA fetuses using
      those with normal oxygenation as controls. SUBJECTS: 65 chromosomally normal
      children aged 12-66 months who, as fetuses, had been small for gestational age,
      had undergone cordocentesis and had been delivered after 32 weeks' gestation.
      RESULTS: Griffiths' developmental quotient (DQ) was significantly associated with
      fetal blood pH (r = 0.41, P = 0.0008), PO2 (r = 0.25, P = 0.047) and PCO2 (r = 
      0.28, P = 0.027) at cordocentesis but not with the severity of growth retardation
      (r = 0.18, P = 0.17). However, the significant correlations between DQ and both
      PO2 and PCO2 were explained by their co-correlations with pH and neither remained
      significant after removing the effect of pH by analysis of variance. The
      association between DQ and pH was still significant after removing the effect of
      confounding variables. Maternal smoking during pregnancy was significantly
      associated with DQ (F to remove = 6.89, P = 0.011) even after allowing for the
      effects of possible confounding variables including fetal blood pH. CONCLUSIONS:
      Both fetal pH at cordocentesis and maternal smoking correlate significantly with
      subsequent neuro-development. Further investigation into the causes of these
      associations is required.

PMID- 7781855
TI  - Teenage pregnancy: are teenagers a high risk group?
AB  - OBJECTIVES: To study health profile of pregnant teenagers and their pattern of
      utilization of primary health care services in comparison with pregnant women
      aged 20-35 years in Abha, Saudi Arabia. STUDY DESIGN: A cohort of 1938 Saudi
      pregnant women (214 teenagers less than 20 years and 1724 aged 20-35 years) was
      selected by stratified random sampling technique. They were screened for anemia
      and hypertension using WHO criteria and followed until delivery to observe the
      method of delivery. RESULTS: The prevalence of anemia (9.6% and 12.0%,
      respectively) and hypertension (1.1% and 3.5%, respectively) was not
      significantly different among primigravida of both age groups. The same trend was
      observed among multigravida. Follow-up showed that the rate of abnormal
      deliveries among primigravida of both groups was not significantly different, and
      even lower among multigravida teenagers. Pregnant women in both groups had
      similar average prenatal visits (6.6 +/- 1.1 and 6.7 +/- 1.2 respectively, P <
      0.05) and the majority contacted the primary health care center early in
      pregnancy (87.4% and 88.9%, respectively, P < 0.05). CONCLUSION: These results
      indicate that pregnant teenagers are not a high risk group if good prenatal care
      is provided.

PMID- 7781857
TI  - Effect of a prostaglandin E1 analogue (gemeprost) on uterine and luteal
      circulation in normal first trimester pregnancies. A Doppler velocimetry study.
AB  - OBJECTIVE: To evaluate the effects of gemeprost on utero-placental and luteal
      circulation and on the embryo/fetus in normal first trimester pregnancies. STUDY
      DESIGN: Sixty-seven women with a normal first trimester pregnancy requesting
      termination of pregnancy for psychosocial reasons were randomly allocated to pre
      operative treatment with vaginal suppositories containing placebo or gemeprost.
      The women underwent transvaginal color and spectral Doppler ultrasound
      examination before the application of the suppository, 4 h after the application
      of the suppository but before the abortion, and on the seventh post-operative
      day. Blood flow velocities in the uterine and subchorionic arteries, the
      intrachorionic area and arteries in the wall of the corpus luteum and the
      embryonic/fetal heart rate were measured. RESULTS: The median value for
      pulsatility index (PI) in the dominant uterine artery was 2.4 before treatment
      with gemeprost and 8.5 4 h after treatment (P = 0.0006); the corresponding values
      for time-averaged maximum velocity (TAMXV) being 27 cm/s and 10 cm/s (P =
      0.0006). Four (14%) of 28 embryos/fetuses in the gemeprost group were dead 4 h
      after treatment with gemeprost and the median heart rate of those still alive was
      significantly lower than before treatment (130 vs. 163 bpm; P = 0.003). In the
      placebo group, the results for the uterine arteries and the embryonic/fetal heart
      rate did not differ significantly between the first and second ultrasound
      examinations. The median values for PI and TAMXV in the arteries of the corpus
      luteum wall at the first ultrasound examination were 0.71 and 18 cm/s,
      respectively, in the placebo group and 0.71 and 20 cm/s, respectively, in the
      gemeprost group. These values remained almost unchanged at the second and third
      ultrasound examinations in both groups. CONCLUSION: Gemeprost has profound
      effects on utero-placental circulation in the first trimester and can induce
      embryonic/fetal bradycardia and sometimes embryonic/fetal demise. It has no
      unequivocal effect on luteal circulation.

PMID- 7781858
TI  - Short-term results and long-term patients' appraisal of abdominal colposacropexy
      for treatment of genital and vaginal vault prolapse.
AB  - OBJECTIVE: To evaluate short-term results and long-term patients' satisfaction of
      abdominal colposacropexy performed for massive genital prolapse in our institute
      during a 14-year period. STUDY DESIGN: A retrospective analysis was performed of
      101 consecutive women who underwent abdominal colposacropexy. The procedure
      consisted of retroperitoneal interposition of a Mersilene mesh between a
      prolapsed vaginal vault or uterus and the anterior surface of the sacrum. A
      questionnaire was used to evaluate patients' satisfaction after surgery. RESULTS:
      In the short-term there was an acceptable rate of complications of surgery,
      comparable with that reported in the literature. Prolapse-related complaints
      evaluated by questionnaire were markedly diminished after surgery. Pain and
      functional complaints were only partly improved in a subgroup of patients. Only
      32% of the patients responded that they were fully cured after operation.
      CONCLUSIONS: Abdominal colposacropexy shows a particularly favorable result on
      prolapse-related complaints. Functional complaints and pain are not substantially
      relieved by this procedure. The complication rate of surgery is acceptable.

PMID- 7781859
TI  - Influence of hysterectomy on the fibrinolytic activity of plasma of women with
      intact ovarian function.
AB  - Hysterectomies are frequently required operations in gynecology. Several studies
      have reported an association between premenopausal hysterectomy and the risk of
      cardiovascular diseases. However, the pathophysiological linkages between these
      two conditions have not been elucidated. In recent years it has been shown that a
      decrease in plasma fibrinolytic activity is associated with increased risk of
      thrombosis. Furthermore, it has been known that the uterus is a very
      finbrinolytic active organ. In the present study we investigated the hypothesis
      that hysterectomy may lead to a decrease in plasma fibrinolytic activity, and
      thereby increase the risk for thromboembolic diseases. Fibrinolytic parameters of
      plasma were investigated in 26 women before and 6 weeks after premenopausal
      hysterectomy. Euglobulin lysis time (ELT), a global measure of plasma
      fibrinolytic activity, and the levels of tissue plasminogen activator (tPA) and
      plasminogen activator inhibitor type 1 (PAI-1) were not different before and
      after hysterectomy. The ELT difference before and after venous occlusion, which
      is a good indicator for the risk of thrombosis, was also not significantly
      changed after hysterectomy. Estradiol-17 beta, progesterone, LH, FSH and sex
      hormone binding globulin displayed no significant changes after hysterectomy.
      Furthermore, the hormone measurements also indicated that the women were
      premenopausal. There were no correlations between the hormone values and
      fibrinolytic parameters. These data indicate that premenopausal hysterectomy does
      not lead to changes in plasma fibrinolytic activity.

PMID- 7781860
TI  - Reverse correlation between P-glycoprotein expression and proliferative activity
      in endometrial adenocarcinoma.
AB  - Immunohistochemical study was employed using a monoclonal antibody (C219) to
      investigate P-glycoprotein expression in 23 normal endometria and 40 endometrial
      adenocarcinomas. P-glycoprotein immunopositivity was observed in the mid- to late
      proliferative phase and the whole secretory phase of normal endometrium. In
      contrast, no P-glycoprotein was detected in endometrium of early proliferative
      phase nor post-menopausal endometrium. We also investigated the expression of P
      glycoprotein in endometrial cancers to find 16 out of the 40 endometrial
      adenocarcinomas (40%) expressed P-glycoprotein. P-glycoprotein immunopositivity
      was often observed in gland growing parts but not in solid growing parts in a
      given tumor specimen. Proliferative activity of the tumor, as measured by PCNA
      labeling, was significantly higher in the P-glycoprotein-negative group than that
      in P-glycoprotein-positive group (P < 0.005). Thus, there was a strong reverse
      relation between P-glycoprotein expression and proliferative activity in
      endometrial adenocarcinomas.

PMID- 7781861
TI  - Calcium metabolism, calcium supplementation and hypertensive disorders of
      pregnancy.
AB  - In recent years growing attention has been directed towards the possible role of
      calcium in the development of pregnancy-induced hypertension and preeclampsia.
      Several studies describe calcium metabolism in normal and hypertensive pregnancy,
      but so far, they have shown discrepant and inconsistent results. Intracellular
      free calcium, which plays an important role in vascular smooth muscle
      contraction, has been claimed as a pathogenic factor in hypertensive disorders of
      pregnancy. Although there is discordance in the data, a possible role of
      intracellular calcium in the development of hypertensive disorders of pregnancy
      cannot be excluded. Observational studies in pregnant women suggest an inverse
      association between calcium intake and the incidence of hypertensive disorders of
      pregnancy. Despite large methodological differences, the results from the calcium
      supplementation trials support this finding. Although it is rather difficult to
      isolate the effect of calcium intake from the intake of other mineral elements,
      results from calcium supplementation trials are supportive for calcium being the
      most important. Proposed mechanisms by which calcium supplementation may lower
      blood pressure involve changes in parathyroid hormone (PTH) level, the renin
      angiotensin system and calcium as a modifier of vascular agent regulation, but
      none of these have yet been elucidated. At present, circumstantial evidence
      suggest a positive role for calcium in the prevention of hypertensive disorders
      of pregnancy, but definite evidence is lacking and further research is warranted.

PMID- 7781862
TI  - Ovarian carcinoma serum markers and ovarian steroid activity--is there a link in
      ovarian cancer? A correlation of inhibin, tetranectin and CA-125 to ovarian
      activity and the gonadotropin levels.
AB  - In a previous study, we have demonstrated that inhibin-production may be
      associated with improved survival and, also, that tetranectin (TN) is a valuable
      prognostic marker in ovarian epithelial cancer. We investigated the possible
      correlation between inhibin, tetranectin, CA-125, ovarian steroid activity and
      the gonadotropin levels. Preoperative serum levels of the tumor markers inhibin,
      tetranectin (TN) and CA-125 were measured and related to ovarian steroid function
      and the pituitary-gonadal axis (gonadotropin levels) in 28 postmenopausal ovarian
      cancer patients. The following median levels and 95% confidence limits were
      demonstrated for the tumor markers: Inhibin 0.4 U/l (0.2-0.9), TN 8.9 mg/l (6.8
      9.2), CA-125 160 kU/l (75-687). A significant inverse correlation was
      demonstrated between inhibin and the gonadotropins. The Spearman correlation
      coefficients showed a highly significant correlation of inhibin with the examined
      ovarian steroid hormones except DHEAS which also has a suprarenal component. This
      indicates a synthesis of inhibin and the steroid hormones from the same cell
      compartment as known from the normal ovary and an apparently intact negative feed
      back mechanism. Inhibin may be produced in the normal ovary as a defense
      mechanism against an elevated gonadotropin level and inhibin acts by lowering the
      gonadotropins or by altering their biological activity. Elevated values of the
      tumor markers TN and CA-125 due to gonadotropin stimulation could not be
      demonstrated but a significant inverse correlation between TN and CA-125 was
      confirmed.

PMID- 7781863
TI  - Hormone replacement therapy: compliance and cost after screening for
      osteoporosis.
AB  - OBJECTIVE: To assess HRT compliance and cost 1 year after population screening
      for low bone density. DESIGN: Postal questionnaire sent out to women 1 year after
      having a bone density scan. MAIN OUTCOME MEASURES: Compliance with HRT, type of
      HRT and cost. RESULTS: Compliance with HRT after screening for women with low
      bone density was 48% for postmenopausal women and 59% for women with a simple
      hysterectomy. The most often used form of HRT was Estraderm (49%) for women with
      a hysterectomy, whilst for women with an intact uterus Prempak-C (54%) was the
      most popular. The average annual cost of treating women who had had a
      hysterectomy was 67 pounds whilst for women with an intact uterus it was 61
      pounds, a non-significant difference. CONCLUSIONS: Approximately 50% of women
      with low bone density had started HRT within 1 year of having a densitometry
      examination. Previous reports of the cost advantage of treating women who had had
      a hysterectomy relative to those who had not has been overstated.

PMID- 7781864
TI  - A randomized, comparative trial of triptorelin depot (D-Trp6-LHRH) and danazol in
      the treatment of endometriosis.
AB  - To compare treatment efficacy and safety parameters a total of 55 premenopausal
      women with histologically proven endometriosis (stage II-IV) were randomized to
      receive the LHRH-analogue depot triptorelin (n = 30) or the steroid danazol (n =
      25) for a total of 24 weeks. Immediately after cessation of the endocrine therapy
      a second-look operation was performed. Four as well as 24 weeks after the end of
      treatment patients were seen for re-evaluation of clinical symptoms and safety
      parameters. Estradiol suppression was significantly more pronounced with
      triptorelin, while the free androgenic index rose with danazol. Both substances
      were equally effective in reducing endometriotic implants (58% and 51%,
      respectively). Dysmenorrhea was absent at the end of medical therapy in both
      treatment groups. Dyspareunia and pelvic pain decreased at least by 50%. Red
      blood count, thrombocytes, liver enzymes and the atherogenic index rose with
      danazol, while the urinary calcium/creatinine ratio showed a marked elevation
      with triptorelin. Adverse effects were mainly due to the hypoestrogenism of the
      LHRH analogue and the androgenic/anabolic properties of the steroid. Triptorelin
      and danazol are equally effective in treating endometriosis. Therefore, choice of
      treatment should be based on the patient's medical history and the
      pharmacological profile of each substance.

PMID- 7781865
TI  - Integrins and reproduction.
AB  - The integrins are a large family of cell adhesion receptors, involved in cell
      cell and cell-matrix interactions. At present, 20 different integrin heterodimers
      are known. They not only anchor cells to their proper locations, but also
      activately mediate the passage of information into the cell. They are involved in
      such diverse processes as immune response, lymphocyte homing, platelet
      aggregation, metastatic spread of certain malignancies, healing process of tissue
      injuries and, embryologic development. The role of integrins in reproduction had
      been only recently suggested. Several reasons make these molecules very
      attractive, due to their constant involvement from egg to birth. A normal
      expression of integrins can disrupt every reproductive stage. Most likely
      diagnostic tools and therapeutic propositions will emerge from the knowledge of
      these receptors. Integrins are a family of membrane glycoproteines that mediate
      cell-substratum or cell-cell adhesion. In respect of one fundamental principle of
      cellular biology consisting of 'what a cell touches has a major role in
      determining what a cell does', adhesion has a main part in many cell functions.
      Adhesion not only anchors cells to their proper locations, but also activately
      mediates the passage of information into the cell. Cellular adhesion is
      implicated in the immune response, lymphocyte homing, platelet aggregation,
      metastatic spread of certain malignancies, embryologic development and wound
      healing. The role of integrins in reproduction appears interesting. The aim of
      this review is to introduce these molecules, to outline their roles in cellular
      function and to consider their involvement in reproduction before foreseeing
      their potential implications for therapy.

PMID- 7781866
TI  - Secretory leukocyte protease inhibitor in the cervical mucus and in the fetal
      membranes.
AB  - OBJECTIVE: The purpose was to determine the concentration of leukocyte elastase
      and SLPI in the cervical mucus plug, cervical tissue, fetal membranes, amniotic
      fluid and serum from pregnant women. STUDY DESIGN: Samples were analysed using
      radioimmunoassay, immunodiffusion, immunohistological and enzyme assay
      techniques. Statistical comparisons were performed by the Mann-Whitney two-sample
      rank sum test. RESULTS: Concentrations of SLPI and elastase in cervical tissue
      are significantly increased during pregnancy and after delivery. Very high
      concentrations of SLPI and elastase were found in the cervical mucus plug. The
      concentrations of SLPI and elastase in human fetal membranes are highest at the
      rupture site. The concentration of elastase in amnion from preterm delivery was
      significantly higher than in amnion from term deliveries. CONCLUSION: The high
      molar ratio of SLPI/elastase in the cervical mucus plug suggests that inhibition
      of elastase is important during normal pregnancy. The role of SLPI may be
      protection of the fetal membranes and cervical tissue.

PMID- 7781867
TI  - Decrease in perinatal mortality and increase in cesarean section rates.
AB  - OBJECTIVES: To investigate the cesarean section (CS) rate in the Riyadh area, its
      trend and relationship to perinatal mortality (PNM). METHODS: Based on delivery
      data obtained from the Ministry of Health hospitals, Saudi Arabia, for a total of
      12 years, yearly rates of CS, PNM and the ratios of obstetricians and beds per
      10,000 population were computed for the Riyadh area and compared with the overall
      rates for Saudi Arabia. Correlation coefficients were used to investigate the
      relationship between the CS rate and each of the stated variables. RESULTS:
      Riyadh had significantly lower rates of CS and PNM than Saudi Arabia as a whole.
      The CS rate in Riyadh showed a positive trend (increasing from 4.4 to 6.7%) while
      the PNM rate revealed a significant decreasing trend (decreasing from 21.6/1000
      to 16/1000 live births). A negative association existed between the Riyadh rates
      of PNM and CS (r = -0.2375) and PNM and the availability of obstetricians (r = 
      0.8693). CONCLUSIONS: From our data it was not possible to establish a cause and
      effect relationship between the CS and PNM rates.

PMID- 7781868
TI  - Parity and the prevalence of overweight.
AB  - OBJECTIVE: To assess the association between previous term pregnancies and the
      prevalence of overweight in a group of urban women, controlling for the influence
      of age. METHODS: One thousand twelve women, living in middle and low
      socioeconomic areas of Mexico City, were interviewed at home and their
      reproductive histories studied. Height and weight were measured in a clinical
      setting using controlled procedures. Overweight (BMI > 25) was the dependent
      variable used to calculate odds ratios and to perform a multiple logistic
      regression analysis. RESULTS: Age and parity were significantly associated with
      the prevalence of overweight. Controlling for age, two or more previous
      pregnancies significantly increased the magnitude of the association. CONCLUSION:
      During the reproductive years parity seems to increase the risk of overweight in
      low and middle socioeconomic level urban women.

PMID- 7781869
TI  - Evaluation of combinations of procedures in cesarean section.
AB  - OBJECTIVE: To evaluate a procedure for cesarean section, consisting of a number
      of surgical techniques adopted from various sources and further developed.
      METHODS: The principal elements of the cesarean section procedure followed were:
      the Joel-Cohen method for opening the abdomen, suturing the uterus in one layer,
      and non-closure of the visceral and parietal peritoneal layers. The postoperative
      recovery of women who underwent this procedure (JCl--group) was compared with
      that of women who had undergone a Pfannenstiel incision, in which the uterus is
      sutured in two layers, and both peritoneal layers sutured (Pf2++ group). RESULTS:
      The incidence of postoperative febrile morbidity was 7.7% in the JCl--group
      compared with 19.8% in the Pf2++ group (P < 0.05). Adhesions were found in 6.3%
      of repeat operations after the JCl--operation compared with 28.8% after the Pf2++
      operation (P < 0.05), and there was a non-significant trend toward fewer
      postoperative analgesics in the JCl--group. CONCLUSION: The cesarean section
      procedure we have devised is not only safe, but has a lower risk of long- and
      short-term complications.

PMID- 7781870
TI  - Perinatal and maternal mortality associated with retained second twins.
AB  - OBJECTIVES: The aim of this study of retained second twins admitted to Korle-Bu
      Hospital between 1988 and 1993 was to identify the factors contributing to the
      mode of delivery, perinatal and maternal mortalities, and draw up recommendations
      to improve outcome. METHODS: The study consisted of a review of record cards,
      outpatient admission and discharge books, delivery books, and inpatient case
      notes of women admitted with retained second twins of 28 weeks' or more gestation
      during the study period. RESULTS: Of the 65 cases fully reviewed, 33
      (approximately 50%) were delivered by cesarean section due mainly to abnormal lie
      with or without shoulder impaction. The rest were assisted deliveries, mainly
      vertex deliveries or breech extractions. The perinatal mortality of the retained
      second twins was 38.5% compared with 12.3% for the first twins. Although in
      general the longer the interdelivery interval, the greater the second twin
      perinatal mortality risk, no clear direct correlation could be established. There
      was one perioperative maternal mortality due to anaphylactic reaction to
      intramuscular morphine injection. CONCLUSION: Irrespective of the antenatal
      course and early labor findings, twin delivery should be undertaken in a unit
      equipped for cesarean section and assisted delivery. The unacceptably high
      perinatal mortality of retained second twins could thus be significantly reduced.

PMID- 7781871
TI  - Efficacy of ipriflavone and 1 alpha vitamin D therapy for the cessation of
      vertebral bone loss.
AB  - OBJECTIVE: This study investigated whether a combined regimen of ipriflavone and
      1 alpha vitamin D is effective in stopping postmenopausal bone loss. METHODS:
      Ninety-eight postmenopausal women were recruited and randomly assigned to one of
      four groups: group 1, ipriflavone alone; group 2, 1 alpha vitamin D alone; group
      3, combined regimen of ipriflavone and 1 alpha vitamin D; group 4, no treatment.
      Vertebral bone mineral density, measured by dual energy X-ray absorptiometry,
      serum alkaline phosphatase, calcitonin, parathyroid hormone, osteocalcin, urinary
      calcium and hydroxyproline were measured before and at the 6th, 12th and 18th
      month of the study. All comparisons were made using Student's t-test of means.
      RESULT: There was a significant reduction in vertebral bone loss in the patients
      receiving the combined therapy (mean loss after 18 months 0.33% in the
      combination group vs. 2.37%, 1.15% and 3.70% in the ipriflavone alone, 1 alpha
      vitamin D alone, and control groups, respectively; P < 0.001). CONCLUSION: These
      findings suggest that the combined regimen could prevent postmenopausal bone
      loss.

PMID- 7781872
TI  - Chromocystoscopy in the urological monitoring of patients with cancer of the
      cervix.
AB  - OBJECTIVE: To determine whether chromocystoscopy could be used for the urological
      monitoring of cervical carcinoma. METHODS: The absolute ejaculation time (AET,
      the interval of time between the intravenous injection of dye and the ejaculation
      of dyed urine in the bladder from either of the ureters) and the relative
      ejaculation time (RET, the difference of time between the two ejaculations) were
      retrospectively studied in relation to intravenous urography (IVU) and
      radionuclide renography (RR) in 141 patients. RESULTS: A significant probability
      of normal IVU and RR was found when the AET was < or = 7 min or the RET < or = 4
      min and when no interval occurred between the two ejaculations. Pathological IVU
      and RR were found when there was no ejaculation from one or both ureters after 12
      min. CONCLUSIONS: Chromocystoscopy could be used for monitoring cervical cancer
      patients. An abnormal chromocystoscopy could indicate the need for further
      radiological examinations.

PMID- 7781873
TI  - Spontaneous resolution of fetal mediastinal cystic hygroma.
AB  - We present a case of prenatally diagnosed mediastinal cystic hygroma with
      spontaneous resolution. To our knowledge, this is only the second case report of
      mediastinal cystic hygroma diagnosed prenatally, and the first one with
      spontaneous resolution perinatally. Our case shows that, in the absence of
      hydrops fetalis, mediastinal cystic hygroma in a fetus with normal karyotype can
      be associated with a normal outcome. Therefore we recommend fetal karyotyping, a
      careful search for other anomalies and close sonographic follow-up in such cases.

PMID- 7781874
TI  - Adenosarcomas originating from sites other than uterine endometrium.
AB  - We report three cases of adenosarcomas arising from extraendometrium of the
      uterus: one arising from the ovary, one from the paracolpium and one from the
      endocervix of the uterus. Microscopically, they consisted of an admixture of
      benign-appearing epithelial and mesenchymal components with hypercellularity and
      minimal atypia. Two of the tumors were initially misdiagnosed as endometriosis
      and one was diagnosed as adenofibroma. One patient had several recurrences and
      died 7 years after the initial laparotomy and another patient had sarcomatous
      overgrowth which invaded the muscular tissues of the large intestine. Thus it
      appears that adenosarcoma occasionally shows grave clinical behavior, despite the
      benign or low-grade appearance of its microscopic features. Problems of diagnosis
      and management of this tumor are discussed. An aggressive therapeutic approach
      including wide surgical excision is recommended even in questionable cases.

PMID- 7781875
TI  - Endometrial mullerian carcinosarcoma after cessation of tamoxifen therapy for
      breast cancer.
AB  - The aim of this report is to draw the attention of clinicians to the possible
      occurrence of endometrial cancers of rare histological type among women currently
      undergoing or having in the past undergone tamoxifen therapy, in particular for
      breast cancer. We report a case of heterologous mixed malignant muller tumor
      occurring in an 80-year-old woman. At 69, she had been diagnosed with breast
      cancer and received tamoxifen for a total of 55 months over a 6-year period. In
      the 5th year after cessation of tamoxifen therapy, an endometrial carcinosarcoma
      was diagnosed. Although the association between tamoxifen use and endometrial
      cancer is recognized, only a few reports of occurrence long after cessation of
      therapy exist. We believe ours is the second for this particular histological
      type. Tamoxifen may have played a role in the occurrence of this tumor although
      it is also known that this type of tumor may arise de novo in elderly women. The
      etiologic hypothesis obtained from this case description will now be tested in a
      formal epidemiological investigation which hopefully will provide more definitive
      evidence.

PMID- 7781876
TI  - Women in difficult circumstances: war victims and refugees.
AB  - The majority of problems that women are confronting today originate from a lack
      of respect for human and reproductive rights. Escalating war crises are producing
      an enormous number of civilian victims, of whom women and children comprise the
      major part. Rape used as a war tactic in Bosnia has proven to be a very powerful
      tool. War in Bosnia has provided a tragic incentive to work on strategies and
      tactics for reaching the victims in such chaotic and unpredictable circumstances.

PMID- 7781878
TI  - Adenomyomatous polyp of the uterus.

PMID- 7781877
TI  - The treatment of Bartholin's cyst and abscess with silver nitrate.

PMID- 7781879
TI  - Metronidazole during pregnancy.

PMID- 7781880
TI  - Reducing postpartum endometritis by intraoperative cervical dilatation.

PMID- 7781881
TI  - Axillary cystic lymphangioma in pregnancy.

PMID- 7781882
TI  - Fetal intestine and pulmonary maturity tests.

PMID- 7781883
TI  - ACOG technical bulletin. Diabetes and pregnancy. Number 200--December 1994
      (replaces No. 92, May 1986). Committee on Technical Bulletins of the American
      College of Obstetricians and Gynecologists.

PMID- 7781884
TI  - ACOG committee opinion. Antenatal corticosteroid therapy for fetal maturation.
      Number 147--December 1994. Committee on Obstetric Practice. American College of
      Obstetricians and Gynecologists.

PMID- 7781885
TI  - In memoriam: a remembrance of Marcus Singer. (1914-1994).

PMID- 7781886
TI  - Epithelial hyperplasia of imaginal discs induced by mutations in Drosophila tumor
      suppressor genes: growth and pattern formation in genetic mosaics.
AB  - Lethal mutations in the giant discs (lgd) and fat (ft) tumor suppressor genes of
      Drosophila cause epithelial hyperplasia in all imaginal discs. By contrast,
      mutations in the vestigial (vg) gene adversely affect cell viability in the wing
      imaginal discs and consequently cause loss of pattern in the adult wings.
      However, combining homozygous lgd or ft mutations with homozygous vg1 increases
      the size of the wing imaginal discs and partially restores the bristle pattern in
      the wings of pharate adults. Comparable pattern restoration in vg1 wings is also
      induced by a newly isolated weak hypomorphic lgd3 allele. Further, mosaic
      analysis revealed that whereas lgd clones generated by the Minute technique
      display abnormal differentiation, those induced in a homozygous vg1 background
      exhibit autonomous restoration of wing pattern. These results suggest that
      pattern restoration in vg1 wings can serve as an assay for hyperplasia induced by
      mutations in Drosophila tumor suppressor genes.

PMID- 7781887
TI  - Bifunctional glyoxylate cycle protein of Caenorhabditis elegans: a
      developmentally regulated protein of intestine and muscle.
AB  - The reaction of an abundant 106-kDa polypeptide with a specific monoclonal
      antibody has been localized in intestinal and muscle cells of the nematode
      Caenorhabditis elegans. This protein was first detected in 4-6 cells of the
      clonal E lineage of 100-cell embryos. This lineage is committed to the intestinal
      cell fate. The antigen continued to be expressed in the differentiating gut and
      then appeared in early differentiating body wall muscle cells of 400- to 500-cell
      embryos. Molecular cloning and sequencing showed that the largest cDNA clone
      contained 3274 bp and encoded a sequence of 1005 amino acids. The predicted
      polypeptide of 112,799 MW contains separate domains for the glyoxylate cycle
      enzymes isocitrate lyase and malate synthase. Their enzymatic activities had been
      shown previously to be highest in embryos and L1 larvae (Khan, F. R., and
      McFadden, B. A. (1980). FEBS Lett. 115, 312-314; Khan, F. R., and McFadden, B. A.
      (1982). Exp. Parasitol. 54, 48-54; Wadsworth, W. G., and Riddle, D. L. (1989).
      Dev. Biol. 132, 167-173). The domain-specific sequences were shown to be
      contiguous in genomic DNA and are separated by an intron of 68 bp. A single
      polypeptide and both enzymatic activities are precipitated by the antibody, and
      peptide fragments resulting from limited proteolytic digestion contained amino
      acid sequences which overlap the predicted junctional region. The physical
      localization of the gene correlates with a small region of the left arm of
      Linkage Group V to which multiple embryonic lethal mutations have been mapped.

PMID- 7781888
TI  - Genetic regulation of shoot development in Arabidopsis: role of the EMF genes.
AB  - To investigate the genetic mechanism regulating Arabidopsis shoot maturation and
      development, we characterized eight emf mutants that bypassed the vegetative
      phase of the life cycle. Genetic complementation studies identified two EMF loci;
      both mapped to chromosome five. Double mutant analysis showed that the early- and
      late-flowering mutants, co, fb, elf1, elf2, and elf3, could not rescue vegetative
      development in the emf mutants, confirming the need for both EMF gene activities
      for rosette development. A series of phenotypes involving successive loss of
      reproductive organs was also observed in emf single mutants, in emf1-1/emf1-2
      transheterozygotes, and in emf1 emf2 double mutants, suggesting that the EMF
      genes not only specify the rosette (vegetative) but also are involved in
      inflorescence and flower (reproductive) development. Phenotypic analysis of
      double mutants between emf and tfl1, lfy, and ag indicated interactions between
      EMF and genes regulating inflorescence meristem development and floral organ
      identity. A model depicting the role of the EMF genes in regulating shoot
      maturation and their interaction with genes that affect phase transitions is
      presented.

PMID- 7781889
TI  - Changes in the structure and function of the multicatalytic proteinase
      (proteasome) during programmed cell death in the intersegmental muscles of the
      hawkmoth, Manduca sexta.
AB  - The intersegmental muscles (ISMs) of the tobacco hawkmoth Manduca sexta are a
      well-characterized model system for examining the biochemical changes that
      accompany programmed cell death during development. These giant muscles die
      during a 30-hr period in response to a decline in the circulating titer of the
      insect molting hormone 20-hydroxyecdysone. When the ISMs become committed to die,
      there are dramatic increases in both ubiquitin expression and ubiquitin-dependent
      proteolysis. Since the multicatalytic proteinase (MCP) is responsible for
      ATP/ubiquitin-dependent proteolysis in cells, we examined its composition and
      properties. The purified enzyme from whole larval integumentary tissues resembles
      MCPs isolated from other species with respect to subunit composition and general
      catalytic properties. However, when MCP was isolated from condemned ISMs, we
      observed an approximately ninefold increase in proteinase activity compared to
      MCP from precommitment muscles. This increase in proteolytic activity was
      correlated with an approximately eightfold increase in the absolute amounts of
      MCP protein as determined by Western blotting and densitometry. When purified MCP
      from condemned muscles was examined by two-dimensional polyacrylamide gel
      electrophoresis, four new subunits that were not detected in the precommitment
      muscles were present. Correlated with the addition of these new subunits was a
      dramatic increase in the levels of immunodetectable MCP throughout the cytoplasm
      and within the nuclei of dying muscles. These changes in MCP were regulated by
      the same hormonal signals that mediate cell death. These data are consistent with
      the hypothesis that when the ISMs become committed to die, more MCP accumulates
      in cells and new subunits are synthesized that change both the enzymatic
      properties and the conformation of MCP, which in turn participates in the
      dramatic proteolysis that accompanies cell death.

PMID- 7781890
TI  - Repression of gene expression at the beginning of mouse development.
AB  - The transition from maternal to zygotic gene expression in the mouse occurs in
      the 2-cell embryo. Previous studies in which DNA was injected into 2-cell embryos
      revealed that transcription promoters and origins of DNA replication are strongly
      repressed in cleavage stage embryos unless linked to an embryo-responsive
      enhancer. Repression also occurs when DNA is injected into the paternal
      pronucleus of a 1-cell embryo and the injected embryo subsequently undergoes
      mitosis, except that repression is no longer relieved by enhancers. Here we
      extend this observation to maternal pronuclei in 1-cell embryos and show that
      this repression could not be relieved either by linking the promoter to an embryo
      responsive enhancer or by inducing hyperacetylation of chromatin inorder to
      increase its accessibility to transcription factors. However, repression could be
      relieved by transplanting the injected pronucleus to a 2-cell embryo, even when
      the recipient cell subsequently underwent mitosis. Both the extent of promoter
      repression and the ability of enhancers to stimulate promoter activity increased
      as development proceeded from the early 2-cell stage to the 4-cell stage. Once
      repression was established in late 2-cell embryos, transplanting an injected 2
      cell embryo nucleus back to an early 1-cell embryo failed to restore activity to
      the injected promoter, even when it was linked to an enhancer. These and other
      data demonstrate that cytoplasmic factors appear during formation of a 2-cell
      embryo that can repress promoter activity and activate enhancer activity. These
      factors are absent from the paternal pronucleus and cytoplasm of early (S-phase
      arrested) 1-cell embryos. Moreover, the cytoplasm of early 1-cell embryos appears
      to lack the ability to reprogram expression of genes once they have progressed to
      the late 2-cell stage in mouse development.

PMID- 7781891
TI  - Coexpression and promoter function in two muscle actin gene complexes of
      different structural organization in the ascidian Halocynthia roretzi.
AB  - During embryogenesis of the ascidian Halocynthia roretzi, 42 unicellular striated
      muscle cells are formed in the tail of the tadpole larva. Isolation of cDNA
      clones demonstrated that multiple genes for larval muscle actin are expressed in
      this process. Among them, at least five muscle actin genes (HrMA2, HrMA4a,
      HrMA4b, HrMA5, and HrMA6) form a cluster (HrMA2/4 cluster) within about 30 kb of
      the genome. The 5' flanking sequences of the five actin genes resemble each
      other. When constructs in which 184 bp of the 5' flanking region of each of these
      genes fused with lacZ were introduced into fertilized eggs, the reporter gene was
      expressed in muscle cells of the tailbud embryo, suggesting that the 5' flanking
      region of each cluster gene has promoter activity. In addition, a pair of muscle
      actin genes, HrMA1a and HrMA1b (HrMA1 pair), was isolated from a genomic region
      different from that of the HrMA2/4 cluster. The HrMA1a and HrMA1b are linked in a
      head-to-head arrangement on opposite strands and share a 340-bp 5' flanking
      sequence containing two symmetrically located TATA boxes. HrMA1a showed basically
      the same expression pattern as that of HrMA4a. When constructs in which the
      shared upstream region of HrMA1 pair fused with lacZ in either direction were
      microinjected into eggs, the reporter gene was expressed in muscle cells of the
      larval tail, suggesting a bidirectional promoter that regulates muscle-specific
      transcription of the HrMA1 pair. The tandem cluster of HrMA2/4 genes and the
      bidirectional promoter of the HrMA1 pair could expedite utilization of muscle
      specific trans-acting factors. The organization of genes in the genome may play
      an important role in the synthesis of a large amount of actins during the process
      of rapid differentiation.

PMID- 7781892
TI  - Biogenesis of the posterior-tail plasma membrane domain of the mammalian
      spermatozoon: targeting and lateral redistribution of the posterior-tail domain
      specific transmembrane protein CE9 during spermiogenesis.
AB  - We used immunoperoxidase histochemistry and confocal immunofluorescence
      microscopy to examine the events involved in the compartmentalization of CE9 to
      the posterior-tail plasma membrane domain during spermatogenesis in the rat. We
      identified two major episodes of spermatogenesis during which CE9 appeared to
      accumulate in relatively large amounts intracellularly within elements of the
      secretory pathway. The first episode encompassed cells from preleptotene through
      early pachytene primary spermatocytes and was evident as intense intracellular
      labeling of the endoplasmic reticulum and the Golgi complex. The second episode
      encompassed spermatids in steps 8-12 of spermiogenesis and was evident as intense
      intracellular labeling of the Golgi complex and smaller vesicular structures
      observed within the cytoplasm of the spermatid. Between these two episodes, CE9
      was detected in considerably reduced amounts. Although present within the Golgi
      complex and the acrosomic system throughout much of the first half of
      spermiogenesis, CE9 was not detected on the tail of the spermatid until steps 8-9
      of spermiogenesis. Although detected initially in relatively small amounts along
      the entire length of the tail beginning at steps 8-9, there was no evidence for
      the presence of relatively large amounts of CE9 on the tail or anywhere else on
      the surface of the spermatid until after step 11 of spermiogenesis. Between step
      11 and steps 13-14 of spermiogenesis, CE9 was observed to accumulate in
      relatively large amounts on the whole tail coincident with its apparent loss from
      the Golgi complex. CE9 was observed to then undergo further compartmentalization
      to the posterior-tail domain sometime between steps 13-14 of spermiogenesis and
      spermiation. Our results suggest that CE9 is synthesized and enters the secretory
      pathway throughout much of spermatogenesis, but that the site of accumulation of
      CE9 varies considerably as a function of development. With respect to the
      biogenesis of the posterior-tail plasma membrane domain, our results suggest that
      CE9 is targeted from the Golgi complex to the plasma membrane of the whole tail
      during mid to late spermiogenesis and then redistributes laterally into the
      posterior-tail domain coincident with the caudal migration of the annulus late in
      spermiogenesis. This proposed pathway has a number of important implications for
      the logistical capabilities of the mammalian spermatid.

PMID- 7781893
TI  - Developmental regulation of troponin I isoform genes in striated muscles of
      transgenic mice.
AB  - The differentiation and diversification of striated muscle is a complex process
      involving numerous temporal and spatial alterations in the pattern of contractile
      protein isoform gene expression. In order to gain insight into the regulation of
      contractile protein isoform changes during skeletal and cardiac muscle formation,
      the expression of a transgene comprising a chloramphenicol acetyltransferase
      (CAT) reporter gene linked with sequences from -4200 to +12 of the human slow
      skeletal troponin I (TnIs) gene, and all three endogenous mouse troponin I (TnI)
      isoform genes, was investigated in embryonic, neonatal, and postnatal mice. The 
      4200 TnIsCAT transgene was properly activated in the limb and trunk skeletal
      muscle primordia and the early embryonic atrium and ventricle of the heart. Along
      with the endogenous mouse TnIs gene, expression of the CAT transgene began to
      segregate into the presumptive slow-twitch myofibers at late fetal stages and
      expression declined in the neonatal and postnatal heart except for the conductive
      tissues, in which expression persisted into adulthood. However, expression of the
      CAT transgene during development did not completely follow the endogenous mouse
      TnIs gene. The expression of the CAT transgene was aberrantly low in the
      embryonic cardiac outflow tract and the ventricles of the fetal heart. In
      addition to its expression in striated muscles, the transgene was expressed
      aberrantly in the primordial axial skeleton. We conclude that the upstream
      sequences from the human TnIs gene contain sufficient regulatory information to
      confer appropriate transgene expression during the early differentiation of
      skeletal muscles and during the establishment of fiber type upon the maturation
      of myofibers. However, additional regulatory elements are likely to be required
      for correct temporal and spatial regulation in the heart and somitic mesoderm
      during development. In vitro DNA transfection of cultured skeletal and cardiac
      muscle cells identified a cell type-specific enhancer element within the first
      intron of the TnIs gene whose absence in the transgene may account for the
      aberrant expression observed in vivo. In addition, we provide the first evidence
      that the fast-twitch skeletal muscle isoform of troponin I, TnIf, is transiently
      expressed during early cardiac muscle development.

PMID- 7781894
TI  - Epidermal growth factor ameliorates autosomal recessive polycystic kidney disease
      in mice.
AB  - C57BL/6J mice homozygous for the cpk gene exhibit an autosomal recessive (AR)
      form of polycystic kidney disease (PKD), similar to human ARPKD, with massive
      collecting duct cysts. These cysts are lined by epithelial with an immature
      phenotype. Since renal expression of epidermal growth factor (EGF) is also
      significantly decreased in affected mice, we hypothesized that renal EGF is
      necessary for normal developmental maturation of the collecting duct. To
      determine if the lack of EGF may be a decisive factor in the initiation and/or
      growth of collecting duct cysts, we administered exogenous EGF (1 microgram/g
      body wt subcutaneously) daily for Postnatal Days 3-9 (a critical period for
      collecting duct maturation) to C57BL/6J-cpk mice. EGF but not sham or albumin
      treatment retarded the development of PKD, reduced the degree of renal failure
      associated with the disease, and prolonged the survival of cystic mice. Sulfated
      glycoprotein-2 gene expression, a marker of immaturity in collecting duct cells,
      was reduced in cystic kidney by EGF treatment. This finding indicates that EGF
      treatment was associated with an increase in the maturation of the collecting
      duct epithelial cells. These findings support the view that decreased EGF may
      play a significant role in promoting the enlargement of collecting duct cysts in
      a hereditary model of ARPKD and that PKD involves defective and/or arrested
      collecting duct cell maturation.

PMID- 7781895
TI  - Expression and functional role of E- and P-cadherins in mouse mammary ductal
      morphogenesis and growth.
AB  - Mammary ducts, and the highly mitotic terminal end buds from which they are
      derived, consist of two layers of ectodermally derived epithelium, forming a tube
      within-a-tube structure. We investigated the role of Ca(2+)-dependent cell-cell
      adhesion molecules in maintaining the integrity of these layers. Immunostaining
      showed abundant E-cadherin on the lateral membranes of end bud body cells and
      ductal lumenal cells, but no P-cadherin. The basally located cap cells and their
      differentiated descendants, the ductal myoepithelial cells, displayed only P
      cadherin. We investigated the functional significance of this pattern of cadherin
      expression in situ by surgically implanting small, slow-release plastic implants
      releasing function-blocking antibodies. End buds exposed to a monoclonal antibody
      to E-cadherin showed disruption of the body epithelium, with epithelial cells
      floating freely in the lumen. Epithelial DNA synthesis, which is normally very
      high in these growth buds, abruptly declined. That this reduction in growth was
      not due to cell damage was shown by spontaneous reaggregation of the cells into a
      normal epithelium, with resumption of DNA synthesis, when the blocking antibody
      was depleted. A monoclonal antibody to P-cadherin had no effect on the lumenal
      layer but partially disrupted the basally located cap cell layer. These data
      indicate that spatially selective expression of E- and P-cadherins is required
      for mammary tissue integrity, which is in turn a prerequisite for normal rates of
      DNA synthesis.

PMID- 7781896
TI  - Two separate domains of laminin promote lung organogenesis by different
      mechanisms of action.
AB  - Laminin is a major component of basement membranes. We previously reported that
      the globular region of laminin B chain(s) and the cross region of the A chain
      play an active role in mouse lung branching morphogenesis. In this study, basic
      morphogenic cell behaviors modulated by laminin were analyzed in order to
      elucidate how this glycoprotein promotes lung development. Cocultures of
      epithelial and mesenchymal cells from mouse fetal lungs were used to determine
      the effect of site-specific monoclonal antibodies to laminin (AL-1, AL-2, AL-3,
      AL-4, and AL-5) on epithelial and mesenchymal cell adhesion, proliferation, and
      organotypic rearrangement. We found that monoclonal antibody AL-1, directed
      against the cross region of the laminin A chain, inhibited epithelial and
      mesenchymal cell attachment and had a selective antiproliferative effect on
      epithelial cells. In contrast, monoclonal antibody AL-5, directed against the
      globular region of the B chain(s), blocked epithelial cell polarity.
      Immunohistochemical studies on epithelial-mesenchymal cocultures exposed to
      monoclonal antibody AL-5 revealed the absence of laminin deposition at the
      epithelial-mesenchymal interface, whereas type collagen IV was present at this
      site. These findings suggest that each of the two laminin domains involved in
      lung development promotes morphogenesis by a different mechanism of action. The
      cross-region of the A chain mediates cell adhesion and epithelial cell
      proliferation, whereas the globular region of the laminin B chain(s) is critical
      for the process of basement membrane assembly and cell polarization. The combined
      effect of both laminin domains on epithelial and mesenchymal cells and on the
      interaction between them seems to be essential for normal lung branching
      morphogenesis.

PMID- 7781897
TI  - Characterization of two populations of ectopic cells isolated from the hearts of
      NGF transgenic mice.
AB  - We have observed sympathetic hyperinnervation and hyperplasia of an unknown cell
      population within the base of the hearts from transgenic mice in which nerve
      growth factor (NGF) expression was targeted to cardiac tissue (Hassankhani et
      al., 1993, 1995). To characterize this ectopic cell population, cells from the
      base of hearts of 3- to 4-week-old transgenic mice were dissociated and
      established in tissue culture, and their properties were analyzed using
      morphological, immunocytochemical, and physiological techniques. Morphological
      studies of the ectopic cells revealed the temporal expression of two different
      cellular phenotypes: (i) a spindle-shaped cell type, present by 1 to 2 days in
      vitro (DIV) and (ii) cells with a fiber-like morphology, detected by 7 DIV. In
      contrast to transgenic cardiac myocytes that express immunoreactivity to
      antibodies against sarcomeric myosin, beat spontaneously (approximately 60/min),
      and are electrically excitable, the ectopic cell types did not stain with an
      antibody against sarcomeric myosin, never showed contractile activity, and did
      not manifest membrane excitability. Moreover, these two types of ectopic cells
      demonstrated other distinctive characteristics. The spindle-shaped subpopulation
      typically formed small clusters of cells that were immunostained by antibodies to
      GFAP, vimentin, and low-affinity NGF receptor (LNGFR) and demonstrated a low
      incidence of dye coupling (30%), whereas the fiber-like cells aligned themselves
      along their long axes, immunostained for gp140trkA, LNGFR, and anti alpha-smooth
      muscle actin and showed extensive (100%) and diffuse dye spread to numerous other
      contiguous fiber-like cells. Dye spread was not observed between the adjacent
      fiber-like and the spindle-shaped cells and was reversibly blocked between
      homologous cells after treatment with halothane, a gap junction channel blocking
      agent. In comparison to cardiac myocytes, macroscopic junctional conductance of
      the spindle-shaped cells was more voltage-sensitive. At the single channel level,
      unitary junctional conductances of approximately 60 pS were predominant. Overall,
      these results indicate that these ectopic cells are likely derived from neural
      crest. The spindle-shaped cells appear to be immature Schwann cells, whereas the
      fiber-like cells may be related to the ectomesenchymal cells contributing to the
      morphogenesis of the cardiac outflow tract.

PMID- 7781898
TI  - Life stage and tissue-specific expression of the homeobox gene cnox1-Pc of the
      hydrozoan Podocoryne carnea.
AB  - We have isolated from the hydrozoan Podocoryne carnea a genomic clone and the
      corresponding cDNA of a homeobox gene. This gene, called cnox1-Pc, is most
      closely related to the lab class of homeobox genes. In the life cycle of P.
      carnea, which involves an asexually reproducing, sedentary polyp and a sexual
      planktonic medusa stage, we found cnox1-Pc transcripts specifically expressed in
      the medusa stage. Expression studies on isolated medusa organs and tissues
      indicate that the message is absent in the tentacles and the feeding and sexual
      organ of the medusa and present in the striated muscle cells. During medusa bud
      development, expression of cnox1-Pc can be correlated with the development of the
      striated muscle tissue, a cell type only found in the medusa. The results suggest
      that cnox1-Pc is involved in pattern formation of the medusa of P. carnea and
      might have a regulatory role in the differentiation of striated muscle.

PMID- 7781899
TI  - Induced premature G2/M-phase transition in pachytene spermatocytes includes
      events unique to meiosis.
AB  - Little is known about the control of events ending the lengthy prophase of
      meiosis I and leading to the G2/M-phase transition in mammalian spermatocytes,
      primarily because the relevant late pachytene, diplotene, and MI cells are
      present in low numbers in the testis and it is not possible to isolate them in
      significant numbers. We have utilized short-term cultures of pachytene
      spermatocytes from the mouse to study events of the G2/M cell-cycle transition
      induced by the protein phosphatase inhibitor okadaic acid (OA). Treatment of
      cultured pachytene spermatocytes with OA induced a rapid and premature onset of
      events leading to the M phase, visualized cytologically by nuclear envelope
      breakdown and chromosome condensation. After OA treatment, condensed chromosomes
      were seen as bivalents, not as univalents. Treatment with OA induced disassembly
      of synaptonemal complexes and resolution of crossovers as cytologically visible
      chiasmata. Chiasmata counts were similar in treated cells and control cells.
      Thus, surprisingly, even though the treated cells were in the pachytene substage
      of meiotic prophase, events of recombination were apparently completed to the
      point of chiasma formation in the majority of these cells. The sex chromosomes,
      forming the sex body of the pachytene spermatocyte, lagged behind the autosomal
      chromosomes in their condensation and progression toward the M phase. Treatment
      with OA induced an increase in histone H1 kinase activity, generally used as an
      indicator of metaphase-promoting factor (MPF) activity; furthermore, the OA
      induced cell-cycle transition does not require new protein synthesis. These
      results suggest that OA treatment overrides a cell-cycle checkpoint control that
      normally keeps pachytene spermatocytes in a lengthy prophase and that this
      control may be exerted by regulation of protein phosphorylation status.

PMID- 7781900
TI  - Drosophila midgut morphogenesis requires the function of the segmentation gene
      odd-paired.
AB  - Development of the Drosophila embryonic midgut is dependent on a number of genes,
      including tinman and bagpipe, which are required for formation of the visceral
      mesoderm, and the homeotic genes and their targets, which act locally in the
      visceral mesoderm to direct formation of specific midgut constrictions. Here we
      report the identification and characterization of another gene, odd-paired (opa),
      required for normal midgut development. opa, first identified by its pair-rule
      mutant phenotype in the larval cuticle, encodes a protein containing putative DNA
      binding domains and other hallmarks of transcriptional regulators. We have
      positively identified the cloned gene as opa by mapping two null mutations to the
      open reading frame of the putative opa transcript; these mutations disrupt the
      open reading frame and generate predicted proteins lacking the DNA binding
      domain. We demonstrate that opa function is required for formation of the three
      characteristic midgut constrictions. To understand the mechanisms by which opa
      contributes to constriction formation, we have analyzed the expression and
      function of opa throughout midgut development. In the cellular blastoderm, opa is
      expressed ubiquitously in the ectoderm and mesoderm precursors throughout the
      presumptive segmented region. As development proceeds, opa expression ceases
      briefly both in the ectoderm and in the underlying mesodermal cells that later
      become the visceral mesoderm. We show that in opa mutants the visceral mesoderm
      is interrupted, evidently due to abnormal expression of bagpipe, a homeodomain
      gene required for the formation of the visceral mesoderm. At early stages of
      development in opa mutants, interruptions in the visceral mesoderm are observed
      at many positions along the anterior-posterior axis. As development proceeds,
      interruptions are less frequently observed; however, one interruption, coincident
      with the Antennapedia expression and variability of Ultrabithorax expression in
      opa mutants. From these observations, we infer that the loss of at least the
      first and second midgut constrictions in opa mutants is the result of defects
      first evident in the early stages of visceral mesoderm development.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 7781901
TI  - Colocalization of bFGF and the myogenic regulatory gene myogenin in dystrophic
      mdx muscle precursors and young myotubes in vivo.
AB  - Tissue culture studies using muscle cell lines suggest that in addition to
      mitogenic effects, fibroblast growth factors (FGF) inhibit skeletal muscle
      differentiation and the expression of members of a family of muscle-specific
      regulatory genes including MyoD and myogenin. We examined the possible
      coexpression of bFGF and myogenin by tandem in situ hybridization (detecting
      mRNA) and immunocytochemistry studies (detecting protein) to determine whether
      myogenic cells in vivo endogenously produce bFGF. Mdx mouse muscle, which shows
      characteristic dystrophic damage and regeneration, demonstrated mononuclear cells
      containing myogenin and bFGF transcripts in similar regions of adjacent sections
      of focal degeneration and repair, particularly near recent segmental fiber
      damage. Using immunocytochemistry and in situ hybridization concurrently on the
      same sections, bFGF protein and myogenin mRNA were colocalized in both muscle
      precursors and new myotubes. The in vivo results were confirmed in vitro using
      primary explant cultures of mdx muscle. Approximately one-half of mononuclear
      cells in vivo were myogenic by the criterion of myogenin mRNA expression. Both
      myogenin and bFGF mRNAs were also colocalized with bFGF protein, indicating
      endogenous expression of bFGF in a subpopulation of myogenic cells. Small numbers
      of myogenic mononuclear cells were differentiated, as determined by the presence
      of developmental myosin heavy chain protein (DevMHC). These cells and new
      myotubes also colocalized myogenin, DevMHC, and bFGF. Since bFGF and myogenin are
      colocalized in mpec and myotubes in vivo and in vitro, endogenous expression of
      bFGF is not mutually exclusive of myogenic regulatory gene expression, either
      before or after differentiation of the skeletal muscle phenotype. Such features
      of coexpression suggest an important and complex role for bFGF in muscle
      regeneration in vivo.

PMID- 7781902
TI  - Laminin is required for heart, somatic muscles, and gut development in the
      Drosophila embryo.
AB  - Laminin, an extracellular matrix glycoprotein, has been implicated in a wide
      array of biological activities. Its specific roles during development, however,
      remain to be elucidated. In this report we describe the specific contribution of
      laminin to histogenesis and organogenesis during Drosophila embryogenesis. In
      particular, the function of laminin during mesoderm development and morphogenesis
      was dissected by analyzing embryos deficient in laminin A chain alone or in both
      laminin A and B2 chains. We show that laminin function is not required for the
      early phases of mesoderm patterning and morphogenesis in embryos at the extended
      germ band phase (stage 11). However, laminin function is required for the proper
      morphogenesis of the heart, somatic mesoderm, and the gut during later stages of
      embryonic development. In laminin A-deficient embryos, the heart is "broken" as a
      result of dissociation of the pericardial cells. The somatic myotubes are
      defective and do not extend properly, and the ventral oblique muscles never reach
      their proper attachment sites. Finally, during midgut formation, the endoderm
      fails to undergo the initial columnar polarization in the absence of functional
      laminin. These studies indicate that the primary function of laminin is to
      provide structural support for the various cell types, thereby enabling their
      proper organization into the various organs.

PMID- 7781903
TI  - Heart development in Drosophila requires the segment polarity gene wingless.
AB  - Mesoderm induction has been studied in many systems and some of the factors
      involved have been identified. Although the heart is mesodermal in origin, the
      molecular basis of heart development is essentially unknown. The Drosophila heart
      is a simple tubular structure similar to the early heart tube in vertebrates. The
      homeobox gene, tinman, has been shown to be crucial for heart formation in
      Drosophila. Several genes with considerable sequence similarities to tinman are
      expressed in cardiac primordial tissue of vertebrates and are likely to be
      required for heart development of higher organisms as well. In addition to
      transcriptional control factors, heart development might also depend on inductive
      signals. Here, we demonstrate that the gene wingless (wg), which is known to
      specify segmental polarity and neuroblast identity in Drosophila, has a novel
      role in mesoderm development: wg function is specifically required for heart
      development. A temperature-sensitive mutation of wg was used to inactivate wg
      function during precise developmental time periods. Elimination of wg function
      for a short time period after gastrulation results in the selective loss of heart
      precursors, without significantly affecting the formation of the body wall or
      visceral muscles, although some pattern defects are observed. This developmental
      requirement of wg for cardiac organogenesis is distinct from its function in
      segmentation and neurogenesis. We conclude that wg signaling is a crucial
      component of heart formation.

PMID- 7781904
TI  - The larval optic nerve is required for the development of an identified
      serotonergic arborization in Drosophila melanogaster.
AB  - The larval visual system in the fruitfly Drosophila melanogaster consists of two
      bilateral clusters of 12 photoreceptor cells. These neurons send their axons in a
      fascicle, the Bolwig's nerve, toward the target area in the ventral lateral
      region of the brain hemispheres. We describe the development of a serotonergic
      arborization originating in the central brain found in the larval optic center in
      association with the larval optic nerve. This arborization is formed by processes
      from larval neurons born during embryogenesis. However, these neuronal processes
      do not reach their final destination, the larval optic center, until late in
      larval development. Using mutations that disrupt the connectivity and/or
      development of the larval photoreceptor cells, as well as mosaic analysis, we
      demonstrate that the innervation of the larval optic center by this serotonergic
      arborization depends upon contact with the larval optic nerve.

PMID- 7781905
TI  - Cellular polarity in ciliates: persistence of global polarity in a disorganized
      mutant of Tetrahymena thermophila that disrupts cytoskeletal organization.
AB  - Much of the cell surface on the ciliate Tetrahymena thermophila is covered by a
      polarized lattice of cytoskeletal structures that are associated with basal
      bodies of the ciliary rows. Unique structural landmarks, including an oral
      apparatus and contractile vacuole pores, develop before cell division in
      localized domains located, respectively, posterior and anterior to the transverse
      fission zone. All of these structures can be visualized by specific monoclonal
      antibodies. A single-locus recessive mutation, disorganized-A (disA), primarily
      affects the striated rootlets of the ciliary-row basal bodies and brings about a
      severe disorganization in the positioning and orientation of these basal bodies
      and associated cytoskeletal elements. Nonetheless, the new oral apparatus,
      contractile vacuole pores, and other unique structures appeared at or near their
      normal sites along the anteroposterior axis of disA cells, indicating that the
      positioning of these localized structures is not dependent on the integrity of
      the ciliary rows. Abnormalities were present in the details of construction of
      some of the localized structures and in aspects of cell shape that may be
      influenced by these details. In the main, however, analysis of disA mutant cells
      indicates that intracellular domains near the cell poles develop independently of
      the vectorial polarity of the ciliary rows.

PMID- 7781906
TI  - An extracellular matrix protein of jellyfish homologous to mammalian fibrillins
      forms different fibrils depending on the life stage of the animal.
AB  - A monoclonal antibody generated against the isolated extracellular matrix (ECM)
      of the medusa Podocoryne carnea M. Sars (Coelenterata, Cnidaria, Hydrozoa) stains
      a fibrillar component of the Podocoryne ECMs in immunohistochemical preparations.
      The antigen shows a different staining pattern according to the type of ECMs from
      the animals life cycle. In ontogeny the epitope first appears after gastrulation
      in the planula larva as single widely dispersed small fibrils, which later
      accumulate to form a dense meshwork in the larval ECM. The distribution of the
      antigen strongly suggests an important role of the molecule to cover the
      biomechanical needs of the animal. In immunoblots one band with a size of 330 kDa
      is detectable in the polyp ECM, whereas in the outer ECM of the medusa a 340-kDa
      band is observed. Both the 330- and the 340-kDa bands appear when probed on the
      inner ECM of the medusa or on ECMs of the larva. The antibody was used to isolate
      a cDNA clone from an expression library. The deduced amino acid sequence of this
      cDNA fragment reveals a molecular structure composed of tandemly repeated
      epidermal growth factor-like repeats interrupted by a second cystein-rich motif
      first found in the latent transforming growth factor beta binding protein.
      Comparison of the sequence to the data bases indicates < 40% identity to human
      fibrillins. The presence of fibrillin-like beaded microfibrils in the ECM of P.
      carnea is furthermore demonstrated by electron microscopy after rotary shadowing.
      Our results demonstrate for the first time the existence of this noncollagenous
      interstitial ECM protein in invertebrates and suggest that the structure and the
      function of fibrillin have been conserved during evolution.

PMID- 7781907
TI  - Time- and concentration-dependent response of the Drosophila antenna imaginal
      disc to Antennapedia.
AB  - The response of the antenna imaginal disc to ectopic Antennapedia gene expression
      was explored in a heat shock Antennapedia (hsAntp) transgenic strain and in
      strains doubly transgenic for hsAntp and downstream enhancer trap targets. The
      distal to proximal changes in morphological transformation in response to
      Antennapedia product at different developmental stages were correlated with
      changing expression patterns of transgene targets from antenna to leg-like
      patterns. Dose-response studies indicated changing thresholds of response to
      Antennapedia. At particular stages and doses of Antennapedia product, cell
      differentiation of leg bristles was uncoupled from transformation of the third
      antennal segment to tarsus. The results suggest that determination for bristle
      type does not depend on a prior determination decision for organ type. The
      results also provide an avenue for exploring the nature of "competence" at
      cellular and molecular levels.

PMID- 7781908
TI  - Protein synthesis increases after fertilization of sea urchin eggs in the absence
      of an increase in intracellular pH.
AB  - We have reevaluated the presumed requirement for an elevated intracellular pH
      (pHi) in the acceleration of protein synthesis which follows fertilization of
      eggs of the sea urchin Lytechinus pictus. Zygotes were transferred to sea water
      at a low pH (6.8) containing a permeant weak acid at times ranging from 5 min to
      as early as 30 sec postinsemination, to reverse or prevent the rise in pHi that
      normally ensues upon fertilization. Using the fluorescent pH probe 2',7'
      bis(carboxyethyl)-5(6)-carboxyfluorescein (BCECF), we show that transfer of
      zygotes at 1 min or earlier after fertilization essentially blocks the rise in
      pHi. Under these conditions, both the incorporation of radiolabeled leucine into
      protein and the assembly of ribosomes into polysomes increase substantially (>
      50% of control values). We also assessed leucine incorporation during incubation
      of eggs and zygotes in sodium-free sea water or sea water containing amiloride,
      two additional treatments that block the pHi rise. In the presence of amiloride,
      leucine incorporation increased upon fertilization, whereas little or no increase
      was observed in sodium-free sea water. We provide evidence that the low rates of
      leucine incorporation in sodium-free sea water result from the tendency for this
      experimental condition to lower the pHi to values significantly lower than the
      pHi in unfertilized eggs. These findings call into doubt the belief that the pHi
      rise at fertilization is a necessary prerequisite for the acceleration of bulk
      protein synthesis. These observations support the view that pHi is only one of
      several signals involved in the turn on of protein synthesis at the time of
      fertilization of sea urchin eggs.

PMID- 7781909
TI  - Vascular endothelial growth factor (VEGF) and VEGF receptor 2 (flk-1) are
      expressed during vasculogenesis and vascular differentiation in the quail embryo.
AB  - Vasculogenesis, the de novo formation of embryonic blood vessels from their
      angioblastic precursors in situ, is supposed to be under the control of
      polypeptide growth factors and their receptors. The receptor tyrosine kinase flk
      1 and its high-affinity ligand vascular endothelial growth factor (VEGF)
      represent an endothelial specific signal transduction system expressed during
      embryonic vascular growth in the mouse. We have cloned the quail homologs of VEGF
      and flk-1 using PCR and have investigated their expression pattern in vivo. As
      shown by Northern analysis and reverse transcription PCR, VEGF and flk-1 mRNA
      (3.9 and 5.8 kb, respectively) were already present in the unincubated blastodisc
      at low levels and were largely upregulated during gastrulation at Embryonic Day
      1. As detected by in situ hybridization, flk-1 mRNA was initially present in the
      entire mesoderm of Day 1 embryos but from Day 2 on was restricted to endothelial
      cells. At Day 2 VEGF was ubiquitously expressed in the embryo proper and was
      mainly restricted to the vascularized part (area vasculosa) in the yolk sac.
      Later on VEGF expression was detected in all organs. In the kidney VEGF mRNA was
      mainly localized to the glomeruli. This pattern of expression is consistent with
      the pattern found during mouse embryogenesis. We have recently established an in
      vitro model of vasculogenesis in which hemangioblastic precursors are induced in
      cell cultures from the unincubated quail blastodisc by basic fibroblast growth
      factor (bFGF) and give rise to blood vessels in vitro. Taking advantage of this
      in vitro model we examined whether FGF and VEGF act in concert during
      vasculogenesis. We found that the flk-1 receptor mRNA is dramatically upregulated
      within 24 hr upon the addition of FGF to quail blastodisc cell cultures. This
      inducibility in response to FGF is confined to the first 24 hr of culture. The
      early expression of the flk-1 mRNA may characterize the differentiation of
      hemangioblastic precursors from pluripotent epiblast cells which in vivo is
      initiated during gastrulation. Thus, the time course and the pattern of
      expression during embryogenesis in different species suggest a major role for the
      VEGF/flk-1 signal transduction system in vasculogenesis and angiogenesis.

PMID- 7781910
TI  - SpGCF1, a sea urchin embryo DNA-binding protein, exists as five nested variants
      encoded by a single mRNA.
AB  - Several Strongylocentrotus purpuratus gene cis-regulatory regions contain
      asymmetric C4 sequences which are core elements of target sites for a specific
      DNA-protein interaction. Blastula stage nuclear extract contains five proteins
      which specifically bind to these target sites, resulting in a characteristic
      pattern of complexes in gel mobility shift assays. We used automated affinity
      chromatography to purify a protein which binds to these sites and have isolated
      the corresponding cDNA. This protein, SpGCF1, is a novel sea urchin DNA-binding
      protein with no overall homology to proteins reported in the databases currently
      available. The DNA-binding domain of this protein was identified by a deletion
      analysis. As demonstrated both for protein translated in vitro and for bacterial
      protein expressed from a cDNA clone, a single SpGCF1 mRNA serves as a template
      for the synthesis of five DNA-binding polypeptides. We show that these five
      polypeptides are most likely produced by differential usage of a nested set of
      AUG start codons in the SpGCF1 cDNA and thus contain variable amounts of a
      proline-rich N-terminal domain. Since proline-rich regions often serve as
      transcriptional activation domains, the five SpGCF1 proteins apparently possess
      different "activation potentials."

PMID- 7781911
TI  - Autonomous, erythroid-specific DNase I hypersensitive site formed by human beta
      globin locus control region (LCR) 5' HS 2 in transgenic mice.
AB  - The human beta-globin locus control region (LCR) is composed of four erythroid
      specific, DNase I hypersensitive (HS) sites that are located 6 to 18 kb upstream
      of the epsilon-globin gene. The beta-globin LCR appears to have two major
      functions. First, the sequences "open" a chromosomal domain that includes the
      epsilon-, gamma-, and beta-globin genes and, second, the LCR directs high-level,
      erythroid-specific expression of each globin gene family member. An LCR
      subfragment containing only 5' HS 2 can confer these properties on a linked beta
      globin gene. To determine whether 5' HS 2 can form an erythroid-specific, DNase I
      hypersensitive site in the absence of a linked globin gene, a 1.9-kb DNA fragment
      containing this site was injected into fertilized mouse eggs and DNase I
      hypersensitivity was analyzed in the animals that developed. In 9 of 10
      transgenic mouse lines, the human 5' HS 2 fragment formed a DNase I
      hypersensitive site in fetal liver but not in fetal brain. These results suggest
      that human 5' HS 2 can function autonomously to organize an open chromatin domain
      specifically in erythroid cells.

PMID- 7781912
TI  - The in vivo rate of glucose-6-phosphate dehydrogenase activity in sea urchin eggs
      determined with a photolabile caged substrate.
AB  - Some of the earliest metabolic changes after fertilization of sea urchin eggs
      center around the activity of the pentose phosphate shunt. We here report on the
      in vivo activity of glucose-6-phosphate dehydrogenase (G6PDH), the first enzyme
      of this shunt, as assayed with a photolabile (caged) analog of the substrate,
      glucose-6-phosphate (G6P). Caged G6P was synthesized from radiolabeled (5-3H or 1
      14C) glucose and loaded into unfertilized sea urchin eggs by transient
      electroporation. Irradiation of these eggs (either before or after fertilization)
      photolyses the caged G6P, thereby pulsing the cell with 3H- and 14C-labeled G6P.
      The fluxes of G6P into glycolysis and the pentose shunt are calculated from the
      rates of oxidation of labeled G6P to 3H2O and 14CO2; since the turnover of the 6
      phosphogluconate pool by 6-phosphogluconate dehydrogenase is nearly instantaneous
      (Swezey, R.R., and Epel, D. (1992) Exp. Cell Res. 201:366-372), the rate of 14CO2
      production by the pentose shunt is equal to the flux of G6P through G6PDH. The
      data indicate that G6PDH activity is very low in unfertilized eggs, increases 184
      to 427-fold by 2 min after fertilization, and then decreases to a value that is
      74 to 209 times the unfertilized level (maximally 0.005 x 10(-8) units per egg in
      unfertilized eggs, 2.14 x 10(-8) units per egg by 2 min after fertilization, and
      1.05 x 10(-8) units per egg by 20 min after fertilization). In spite of this
      substantial activation, the enzyme activity is considerably repressed; compared
      with activity in broken cell extracts, G6PDH at these developmental times
      operates in vivo at 0-0.003%, 0.52-1.21%, and 0.21-0.59%, respectively, of its
      potential activity. These results are discussed in terms of various hypotheses
      regarding the modulation of G6PDH activity by fertilization. These activity
      measurements relate well to other indices of in vivo activity. The major use of
      the NADPH shortly after fertilization is to produce H2O2, which is used as a
      substrate for fertilization membrane hardening; our data indicate that the NADPH
      that is produced by the pentose shunt activity is 30-70% of that required for
      this postfertilization generation of H2O2.

PMID- 7781913
TI  - Five Trk receptors in the zebrafish.
AB  - Using a homology-based cloning strategy we have identified five members of the
      Trk family in the zebrafish Danio rerio. They are homologous to the three
      mammalian Trk receptors in their conserved intracellular kinase regions and the
      organization of their extracellular regions. The five trk genes are
      differentially expressed in the developing brain, spinal cord, cranial ganglia,
      and retina. Full-length forms of three of the trk genes are expressed when
      neurons pioneer the major axon tracts, whereas the two other trk genes have a
      later onset of expression. Truncated transcripts and forms containing an
      extracellular juxtamembrane region insert were found. The degree of sequence
      variation and expression differences within the family suggest that each of the
      five zebrafish Trk receptors have a functionally distinct role. These findings
      demonstrate that the vertebrate Trk family is larger than previously appreciated.

PMID- 7781914
TI  - Early embryonic expression of XLPOU-60, a Xenopus POU-domain protein.
AB  - XLPOU-60 is a Xenopus POU-domain gene whose expression is tightly controlled
      during early development at transcriptional, post-transcriptional, translational,
      and post-translational levels. We report the expression pattern of the XLPOU-60
      protein; it is first detectable in the stage V oocyte and accumulates rapidly
      following fertilisation, reaching a peak at the time of the mid-blastula
      transition. In the blastula, XLPOU-60 protein translated from injected synthetic
      mRNA enters nuclei. During gastrulation, both transcript and protein are rapidly
      down-regulated in a cell-autonomous manner; down-regulation is not dependent on
      cell-cell contact or induction by activin in an animal cap assay. For the mRNA,
      this down-regulation correlates with changes in the length of its poly(A) tail
      and is dependent on sequences in the untranslated regions of the transcript. On
      the basis of its protein expression pattern and known DNA-binding properties, we
      speculate that XLPOU-60 may play a role in the control of early transcriptional
      events in the Xenopus embryo.

PMID- 7781915
TI  - Monitoring development and pathology of Drosophila indirect flight muscles using
      green fluorescent protein.
AB  - We describe the use of a green fluorescent protein (GFP) reporter construct to
      monitor indirect flight muscle development in normal and mutant Drosophila
      melanogaster strains. We used polymerase chain reaction to amplify a portion of
      the Act88F actin gene that includes 1420 nucleotides of flanking DNA, the
      transcription start, first intron, and initiator codon, incorporating the
      fragment into the Drosophila germ line transformation vector pCaSpeR. We fused
      the fragment to the gene encoding green fluorescent protein of the bioluminescent
      jellyfish Aequorea victoria. We could detect GFP protein in transgenic strains
      and found that its accumulation, conveniently visualized in living flies using
      epifluorescence microscopy, was limited to the indirect flight muscles. GFP
      fluorescence can be used to visualize all stages of flight muscle development
      subsequent to myoblast fusion nad facilitates the detection of morphological
      changes in fibers caused by particular mutations.

PMID- 7781916
TI  - Answering hard questions; asking for more!

PMID- 7781917
TI  - Advocacy for basic biomedical research.

PMID- 7781918
TI  - The origins of the clonal selection theory of immunity as a case study for
      evaluation in science.

PMID- 7781919
TI  - The actin fold.
AB  - X-ray structure analysis of actin and of the NH2-terminal domain of the heat
      shock cognate protein Hsc70 has revealed an unexpected extensive structural
      similarity between these two molecules. Despite the absence of significant
      similarity of their amino acid sequences, both proteins share the same core
      architecture and a common nucleotide binding site resembling the structure of
      hexokinase. All three are ATPases or kinases and bind ATP in association with
      Mg2+ or Ca2+. The common fold consists of two alpha/beta domains, which are
      connected by a putative hinge with an ATP-binding site situated between the
      domains. Each domain contains a five-stranded beta-sheet of identical topology,
      which suggests that the molecules may have evolved by gene duplication. From a
      comparison of the three aligned structures, a fingerprint sequence of the adenine
      nucleotide binding pocket was derived, which predicted that members of the
      glycerol kinase family should also have a similar fold of their nucleotide
      binding domain. This was later confirmed when the X-ray structure was published.
      Data base search with a refined consensus sequence has retrieved other sugar
      kinases, as well as the prokaryotic cell cycle proteins FtsA, MreB, and StbA, and
      two Escherichia coli phosphatases. These proteins are predicted to possess a
      structure similar to actin in the common core region. As exemplified for actin,
      Hsc70, and glycerol kinase, the diversity of biological function is provided by
      the polymorphism of the loops joining the beta-strands and helices in the core
      region and by inserted domains that show high variability.

PMID- 7781920
TI  - Protein kinases that phosphorylate activated G protein-coupled receptors.
AB  - G protein-coupled receptor kinases (GRKs) are a family of serine/threonine
      protein kinases that specifically recognize agonist-occupied, activated G protein
      coupled receptor proteins as substrates. Phosphorylation of an activated receptor
      by a GRK terminates signaling by that receptor, by initiating the uncoupling of
      the receptor from heterotrimeric G proteins. Six distinct mammalian GRKs are
      known, which differ in tissue distribution and in regulatory properties. The
      intracellular localization of GRKs to membrane-bound receptor substrates is the
      most important known regulatory feature of these enzymes. Rhodopsin kinase (GRK1)
      requires a post-translationally added farnesyl isoprenoid to bind to light
      activated rhodopsin. The beta-adrenergic receptor kinases (GRK2 and GRK3)
      associate with heterotrimeric G protein beta gamma-subunits, released upon
      receptor activation of G proteins, for membrane anchorage. The recently-described
      GRKs 4, 5, and 6 comprise a distinct subgroup of GRKs. These kinases utilize
      distinct mechanisms for membrane localization, which are just beginning to be
      defined. All GRKs appear to play the same general cellular role of desensitizing
      activated G protein-coupled receptors, but utilize distinctly individual means to
      the same end.

PMID- 7781921
TI  - The mechanism of acute hypoxic pulmonary vasoconstriction: the tale of two
      channels.
AB  - Hypoxia causes constriction in small pulmonary arteries and dilatation in
      systemic arteries. Hypoxic pulmonary vasoconstriction (HPV) is an important
      mechanism by which pulmonary blood flow is controlled in the fetus and by which
      local lung perfusion is matched to ventilation in the adult. HPV reduces the flow
      of desaturated blood through underventilated areas of lung. Even though many
      vasoactive substances have been examined as possible mediators of HPV, these
      appear more likely to be modulators than mediators. Hypoxic contraction has been
      demonstrated in single pulmonary vascular smooth muscle cells (PVSMC). The
      ability to sense changes in oxygen tension is observed in PVSMC and type 1 cells
      of the carotid body. In both cells, hypoxia has been shown to inhibit an outward
      potassium current, thus causing membrane depolarization and calcium entry through
      the voltage-dependent calcium channels. In both cells there is evidence to
      suggest that changes in the redox status of the oxygen-sensitive potassium
      channel or channels may control current flow, so that the channel is open when
      oxidized and closed when reduced. The redox status may be determined by the
      effects of hypoxia on mitochondrial/peroxisomal function or on the activity of an
      oxidase similar to NAD(P)H oxidase. More studies are needed to precisely define
      the individual potassium channels responsive to hypoxia and to confirm the gating
      mechanism. In systemic arteries hypoxia causes an increased current through ATP
      dependent potassium channels and vasodilatation, whereas in the pulmonary
      arteries hypoxia inhibits potassium current and causes vasoconstriction.

PMID- 7781922
TI  - Targeted vectors for gene therapy.
AB  - Successful gene therapy requires not only the identification of an appropriate
      therapeutic gene for treatment of the disease, but also a delivery system by
      which that gene can be delivered to the desired cell type both efficiently and
      accurately. Reductions in accuracy will inevitably also reduce efficiency since
      fewer particles will be available for delivery to the correct cells if many are
      sequestered into nontarget cells. In addition, the therapy will have net benefit
      to the patient only if gene delivery is sufficiently restricted such that normal
      cells are left unaffected by any detrimental affects of bystander cell
      transduction. Here we review how currently available delivery systems, both
      plasmid and viral, can be manipulated to improve their targeting to specific cell
      types. Currently, targeting is achieved by engineering of the surface components
      of viruses and liposomes to achieve discrimination at the level of target cell
      recognition and/or by incorporating transcriptional elements into plasmid or
      viral genomes such that the therapeutic gene is expressed only in certain target
      cell types. In addition, we discuss emerging vectors and suggest how gene therapy
      delivery systems of the future will be composites of the best features of diverse
      vectors already in use.

PMID- 7781923
TI  - The pathway of allosteric control as revealed by hemoglobin intermediate states.
AB  - The energetics of hemoglobin cooperativity has been analyzed through the use of
      stable, partially-ligated intermediates. These studies revealed that the two
      dimeric halves of the tetramer are autonomous, leading to a Symmetry Rule that
      governs the relationship between ligand-binding and the T-->R quaternary switch:
      the R structure is favored over T only when ligands are bound to both dimers
      within the tetramer. A major feature of the Symmetry Rule mechanism is the
      generation of cooperative free energy by tertiary conformational constraints,
      which are formed within one dimeric half of the T-tetramer and released during
      the quaternary structure change to R. These rules of tertiary and quaternary
      molecular switching also govern the roles of the heterotropic allosteric
      effectors (e.g. Bohr protons).

PMID- 7781924
TI  - Calcium-mediated cell injury and cell death.
AB  - The effect of intracellular ion deregulation, particularly of [Ca2+], on the
      events following acute cell injury and the progression of change from initiation
      (reversible) to maintenance (reversible-irreversible) phases and finally to cell
      death has been the major thrust of experimentation in our laboratory for over 20
      years. Cell death, which plays an important role in both normal and pathological
      phenomena, has been classified into two principal types, accidental and
      programmed. Recent exploration of programmed cell death (or apoptosis) has
      revealed extensive data showing it is an important mechanism for the normal
      maintenance and also differentiation of a variety of cell types and organs. From
      the results from our laboratory and those of others, we continue to expand and
      refine our working hypothesis: deregulation of [Ca2+] results in a number of
      phenomena from activation of signaling mechanisms and alterations in cellular
      structure to alterations in gene expression, all of which contribute to or play a
      critical role in cellular toxicity, including carcinogenesis and cell death.
      Therefore, although much more experimentation is needed to clarify some of these
      phenomena, the implications of such data for understanding the mechanisms and
      processes involved in carcinogenesis and the chemotherapeutic killing of cancer
      cells are extremely exciting. These relationships between [Ca2+], cell injury,
      and cell death are briefly reviewed here within the framework of our hypothesis.

PMID- 7781925
TI  - Retinoid-binding proteins: structural determinants important for function.
AB  - The transport and functions of biologically active naturally occurring retinoids
      (Vitamin A, retinol, and its metabolites) are mediated by extracellular,
      intracellular, and nuclear proteins. X-ray crystallographic studies to date on
      the extra- and intracellular proteins have helped to define distinct protein
      retinoid recognition mechanisms, each with a characteristic structural motif. The
      extracellular proteins (serum retinol-binding protein and a retinoic acid-binding
      protein from rat epididymis) bind retinoids with a hand-in-glove like fit in
      deep, hydrophobic-binding cavities. The intracellular proteins (cellular retinol
      binding proteins types I and II) encapsulate the ligand in an aqueous internal
      cavity. The details of the mechanisms of retinoid recognition, and how they
      result as a consequence of the different protein structures, are described in
      this review.

PMID- 7781927
TI  - Modulation of transcription factor NF kappa B activity by intracellular
      glutathione levels and by variations of the extracellular cysteine supply.
AB  - HIV-infected individuals and SIV-infected rhesus macaques have, on the average,
      decreased plasma cysteine and cystine concentrations and decreased intracellular
      glutathione levels. We now show that a depletion of intracellular glutathione in
      a human T cell line (Molt-4) inhibits the activation and nuclear translocation of
      the transcription factor NF kappa B, whereas incubation with increasing
      extracellular concentrations of cysteine inhibits the DNA-binding and
      transactivating activity of NF kappa B. Because inhibition of DNA-binding
      activity is associated with increasing intracellular glutathione disulfide levels
      and GSSG can be shown to inhibit the DNA-binding activity directly in cell-free
      systems, our studies suggest that GSSG is a physiologically relevant inhibitor in
      intact cells also. NF kappa B controls many immunologically important genes, so
      our studies suggest that the immune system may be sensitive not only against a
      cysteine and glutathione deficiency but also against an excess of cysteine.

PMID- 7781926
TI  - Nutritional impact on the final outcome of liver injury inflicted by model
      hepatotoxicants: effect of glucose loading.
AB  - Fifteen percent glucose in drinking water for 7 days increased lethality of four
      structurally and mechanistically different model centrilobular hepatotoxicants
      (acetaminophen, thioacetamide, chloroform, and carbon tetrachloride) in male
      Sprague-Dawley rats (n = 10/group). A nonlethal injection of thioacetamide was
      lethal in glucose loaded rats and therefore was chosen for further studies. Serum
      enzyme elevations and liver histopathology revealed that actual infliction of
      liver injury peaked between 36 to 48 h after thioacetamide injection; however,
      the liver injury progressed in rats receiving glucose, whereas it regressed in
      rats maintained on normal diet and drinking water without glucose supplement.
      Glucose loading did not increase the hepatic microsomal cytochrome P450.
      [3H]thymidine incorporation studies along with proliferating cell nuclear antigen
      immunohistochemical analysis of liver sections revealed inhibition of S-phase
      stimulation and decelerated cell cycle progression. These findings suggest that
      glucose loading inhibits cellular regeneration and tissue repair resulting in
      accelerated progression of liver injury inflicted by thioacetamide culminating in
      increased death of animals receiving a moderately hepatotoxic dose of
      thioacetamide.

PMID- 7781928
TI  - Morphogenesis of calcitic sponge spicules: a role for specialized proteins
      interacting with growing crystals.
AB  - Crystals formed in biological tissues often adopt remarkable morphologies that
      are thought to be determined mainly by the shapes of the confined spaces in which
      they grow. Another possible way of controlling crystal shape, demonstrated only
      in vitro, is by means of specialized proteins preferentially interacting with
      certain crystal faces. In so doing, they reduce the rate of growth in these
      directions and consequently change the overall crystal shape. In an X-ray
      diffraction study of the distribution of defects within the lattice of calcite
      crystals produced by certain sponges, we show that a remarkable correlation
      exists between the defect patterns or crystal texture and the macroscopic
      morphology of the spicules. This was observed in two cases in which proteins are
      present within the spicule crystal, but not in a third case where such
      intracrystalline proteins are absent. Furthermore, one of the spicules exhibited
      marked differences in texture even within families of structurally identical
      crystal planes, demonstrating that the organisms exert exquisite control over the
      microenvironment in which crystals grow. We conclude that highly controlled
      intercalation of specialized proteins inside the crystals is an additional means
      by which organisms control spicule growth.

PMID- 7781929
TI  - Preservation of the functional advantage of human time structure.
AB  - Upon exposure to sustained and synchronized diurnal activity, most human
      variables exhibit rhythms with a 24 h period. The best-fitting cosine curve to
      the data with a selected period (24 h) may yield parameters like acrophase
      (estimated peak time), amplitude, and mesor (rhythm adjusted mean). The
      sequential array of the rhythms' acrophases constructs the temporal order.
      Analyzing 168 different human rhythms revealed a time-dependent distribution with
      regard to the number of acrophases/h and to the clustering of variables according
      to function. Rhythms' amplitude/mesor ratios yielded a five modal distribution.
      The modes occurred at those clock times where repetitive habitual signals are
      anticipated. It is assumed that these specific features evolved to optimize the
      adaptive value of the temporal order.

PMID- 7781932
TI  - Gerontogenes: real or virtual?
AB  - The view that the life span of an organism is intrinsically limited and is
      largely species-specific necessarily involves certain notions of genetic elements
      of regulation. The term gerontogenes refers to any such genetic elements that are
      involved in the regulation of aging and life span. The existence of genes for
      programmed aging is generally discounted on the basis of evolutionary arguments
      against the notion of the adaptive nature of aging. It is suggested here that the
      concept of gerontogenes be linked with the idea of genes involved in homeostasis
      and longevity assurance, which is not contradictory to the nonadaptive nature of
      aging. Because these genes were not originally selected as real genes for aging,
      their involvement in aging is an emergent property making them virtual
      gerontogenes. Some experimental evidence is available that suggests that sets of
      genes involved in the maintenance and repair of various cellular functions are
      the primary candidates qualifying as virtual gerontogenes.

PMID- 7781931
TI  - Measurement of mRNA levels in tumor xenografts with quantitative autoradiography
      and in situ hybridization.
AB  - In situ methodologies allow qualitative and semi-quantitative analysis of spatial
      gene expression in whole organisms or tissues. We have applied quantitative
      autoradiography to in situ hybridizations of sections from human breast tumor
      xenografts to measure mRNA levels for ornithine decarboxylase, estrogen receptor,
      transforming growth factor alpha, and glyceraldehyde-3-phosphate dehydrogenase.
      Comparisons of control and tamoxifen-treated animals show significant decreases
      in MCF-7 tumor estrogen receptor mRNA levels in the drug-treated animals.
      Combining quantitative autoradiography with in situ hybridization allows
      measurement of absolute rather than relative mRNA levels for genes of interest,
      and to monitor effector-induced changes in these mRNAs in vivo.

PMID- 7781930
TI  - Skeletal muscle glycolytic and oxidative enzyme capacities are determinants of
      insulin sensitivity and muscle composition in obese women.
AB  - Regional fat distribution is an important determinant of insulin resistance in
      obesity. In the current study, the relationship between skeletal muscle insulin
      sensitivity, mid-thigh muscle composition, and the metabolic profile of muscle
      was investigated. Muscle composition was assessed by computed tomography of the
      mid-thigh, and by activities of marker enzymes of aerobic-oxidative and
      glycolytic pathways and muscle fiber typing using biopsies of the vastus
      lateralis muscle. Muscle with reduced Hounsfield attenuation on computed
      tomography scans was increased in proportion to obesity, and was strongly related
      to insulin resistance, reduced muscle oxidative capacity, and increased anaerobic
      and glycolytic capacities by muscle. These findings suggest that as part of its
      expression of insulin resistance, skeletal muscle of obese individuals is also
      poorly equipped for substrate oxidation and manifests increased storage of fat.

PMID- 7781933
TI  - The advent of paper chromatography.

PMID- 7781934
TI  - Authors and Editors of the world unite.

PMID- 7781935
TI  - [Acute alcoholic pancreatitis: an autonomous entity?].

PMID- 7781936
TI  - Antibiotic versus maintenance therapy in the prevention of duodenal ulcer
      recurrence. Results of a multicentric double-blind randomized trial.
AB  - OBJECTIVES: Reduction of gastric acid secretion by maintenance therapy and
      eradication of Helicobacter pylori by antibiotic treatment have been shown to
      reduce duodenal ulcer relapse. This study compared the effect of two regimens, a
      6-month maintenance on an H2 receptor antagonist versus a one-week antibiotic
      therapy, on the rate of duodenal ulcer relapse in duodenal ulcer patients with
      gastric H. pylori infection. METHODS: We conducted a 30-week, double-blind,
      double-dummy, multicentric clinical trial involving 119 patients (97 M, 22 F,
      mean age 39 +/- 14 years) randomly assigned to a daily dose of 40 mg famotidine
      for 6 weeks supplemented with, during the first week, either antibiotics (500 mg
      amoxicillin q.i.d. and 500 mg tinidazole t.i.d.-antibiotic group) or their
      placebo (maintenance group). Healed patients after 6 weeks entered the 6-month
      maintenance phase: the maintenance group received 20 mg famotidine at bedtime and
      the antibiotic group, a placebo. Endoscopy with antral biopsies was performed to
      allow a rapid urease test, culture and histological examination upon entry, after
      6 weeks, 3 months, and 6 months and, whenever symptoms recurred. H. pylori status
      was regarded as positive if any one of these three tests was positive, and
      negative if all tests were negative. RESULTS: The 2 treatment groups were well
      balanced for all baseline characteristics. After 6 weeks, H. pylori was
      eradicated in 25 (45%) patients in the antibiotic group, and in 1 (2%) in the
      maintenance group (P < 0.01). In term of intention-to-treat, there was no
      significant difference in the healing rate after 6 weeks (93 and 83% in the
      antibiotic and maintenance groups, respectively; P = 0.15) or in the relapse rate
      after 6 months (13 and 28% in the antibiotic and maintenance groups,
      respectively; P = 0.17 Log-rank test). However, the overall failure rate (absence
      of healing, relapse) was lower (P = 0.04, Log-rank test) in the antibiotic group
      in which all relapses but one were observed in H. pylori positive patients. The
      rate of ulcer relapse (1/20) in patients of antibiotic group who remained free of
      H. pylori during the study, was significantly (P < 0.01) lower compared with that
      of H. pylori positive patients in the maintenance group (11/44). During the first
      6-week period, more side effects were observed in the antibiotic group than in
      the maintenance group (4 vs 1 patient, respectively). CONCLUSIONS: Our results
      indicate no significant difference between ulcer relapse rates after 6 months
      following a one-week antibiotic therapy or long-term maintenance therapy. Short
      term antibiotic therapy should be considered as a valuable alternative to the
      long-term maintenance therapy.

PMID- 7781937
TI  - [Surgical treatment of severe ulcerous hemorrhages: predictive factors of
      operative mortality].
AB  - OBJECTIVES: Multivariate analysis of operative mortality in patients with
      bleeding peptic ulcer. METHODS: Seventy-eight consecutive patients, who underwent
      emergency surgical treatment for bleeding peptic ulcer were reviewed
      retrospectively. There were 49 males and 29 females, with a mean age of 64.3
      years, 2/3 of whom had associated medical disease. Surgical treatment was
      conservative in 63 cases: oversewing or ulcer excision, alone (n = 29) or
      associated with vagotomy (n = 34); and was radical in 15 cases:
      antrectomy+vagotomy (n = 10) or partial gastric resection (n = 5). RESULTS: There
      were 17 (21.8%) postoperative deaths and 19 (24.3%) bleeding recurrences. The
      causes of death included 9 bleeding recurrences, 7 organ failures and one
      duodenal leakage. On multivariate analysis, previous medical illness (cirrhosis
      or cardiac insufficiency (P < 0.001), shock at admission (P < 0.001), prolonged
      delay until surgery (P < 0.001), and bleeding recurrence (P < 0.001) were
      independently associated with increased mortality. In contrast, the type of
      surgical procedure did not influence postoperative mortality, whereas bleeding
      recurrence was more frequent in case of conservative surgery (P < 0.03) and
      anticoagulation therapy (P < 0.01). CONCLUSION: These results suggest that
      surgical treatment of bleeding peptic ulcer should be proposed early in high-risk
      patients. A radical procedure should be favoured since it reduces bleeding
      recurrence rate without increasing operative mortality.

PMID- 7781939
TI  - [Digestive visceral sensitivity. Methods of study in humans and
      physiopathological implications].

PMID- 7781938
TI  - [Does acute alcoholic pancreatitis always reveal chronic pancreatitis?].
AB  - OBJECTIVES: Whether acute alcoholic pancreatitis may occur without underlying
      alcoholic chronic pancreatitis is still a matter of debate. The aims of this
      study were to assess the frequency and delay of signs of alcoholic chronic
      pancreatitis in patients who had an alcoholic acute pancreatitis revealing a
      pancreatic disease. PATIENTS AND METHODS: From 1975 to 1993, all patients
      hospitalised for acute alcoholic pancreatitis as a first manifestation for a
      pancreatic disease and with follow-up > 2 years were included. Definite
      (pancreatic calcifications, mild to severe Wirsung duct abnormalities,
      histological or operative data) and probable (diabetes mellitus) diagnosis of
      chronic alcoholic pancreatitis was systematically searched for initially and
      during follow-up. RESULTS: Among 122 patients, 114 were included and 8 were
      excluded because of insufficient follow-up. A definite diagnosis of chronic
      pancreatitis was made in 101 patients (88.6%) (pancreatic calcifications: n = 71,
      mild to severe pancreatographic abnormalities: n = 19, histological data: n = 8,
      peroperative data: n = 3). In 61 patients, the diagnosis of chronic pancreatitis
      was made during the first year of follow-up and in 40 patients, the diagnosis was
      made after one year of follow-up. Diabetes mellitus occurred in 4 other patients
      (3.5%) in whom diagnosis of chronic pancreatitis was considered as probable. No
      signs of chronic pancreatitis were found in 9 patients (7.9%). CONCLUSION: Acute
      alcoholic pancreatitis is the hallmark of underlying chronic pancreatitis in
      92.1% of patients. Acute alcoholic pancreatitis without underlying chronic
      pancreatitis either does not exist or is extremely rare.

PMID- 7781940
TI  - [Intraoperative systematic cholangiography in celiopscopic cholecystectomy].
AB  - OBJECTIVES: Laparoscopic cholecystectomy has become the therapeutic gold standard
      in uncomplicated cases of cholelithiasis. This study evaluated the feasibility
      and the results of intra-operative cholangiography during laparoscopic
      cholecystectomy. METHODS: Intra-operative cholangiography was attempted in 126
      consecutive patients undergoing laparoscopic cholecystectomy. Common bile duct
      stones were detected according to the following criteria: a) clinically (history
      of jaundice or pancreatitis); b) biologically (aminotransferase > 2 N, alkaline
      phosphatase > 2 N, total bilirubin > 20 mumol/L); c) ultrasonographically
      (diameter of the common bile duct > 12 mm, presence of gallbladder stones < 10
      mm); d) calculation of the multifactorial score of Huguier. RESULTS: An
      intraoperative cholangiography was performed in 116 patients (92%), for a mean
      duration of 16 minutes (range: 9-25 min). Two anomalies of the biliary tree were
      detected. Ten common bile duct stones were detected (8.6% with 50% success of
      laparoscopic extraction). One false positive case had justified a surgical
      exploration of the common bile duct. The sensitivity of preoperative criteria was
      80%. No morbidity or postoperative biliary complications were related to the
      intraoperative cholangiography. CONCLUSIONS: Routine intraoperative
      cholangiography should be systematically performed during laparoscopic
      cholecystectomy, providing anatomical information of the biliary tree and
      detecting, in 1.7% of cases, unsuspected common bile duct stones which could be
      treated during the same operative procedure.

PMID- 7781941
TI  - [Interobserver concordance of echographic semiology in liver cirrhosis].
AB  - OBJECTIVES: The aim of this study was to evaluate the interobserver agreement of
      cirrhosis symptomatology. METHODS: Eight patients with cirrhosis (without
      ascites) and 23 patients with chronic liver disease without cirrhosis were
      included. Four observers (2 juniors and 2 seniors, with 1 specialist and 1
      general radiologist in each group) independently evaluated video recordings.
      Agreement of 18 variables was calculated by using kappa index (k), intraclass
      correlation coefficient (r) and agreement proportion. Observer bias and poorly
      trained observers were also investigated. RESULTS: Liver: surface: k = 0.68,
      homogeneity: k = 0.25, span: r = 0.87, caudate lobe: r = 0.4 to 0.57 according to
      3 dimensions, right lobe length: k = 0.33. Veins: portal diameter: r = 0.73,
      splenic diameter: r = 0.75; umbilical vein: presence: k = 0.19, diameter: r =
      0.5; left gastric vein: presence: k = 0, diameter: r = 0.18; spleno-renal shunt:
      k = 0.41. Spleen length: r = 0.93. Presence of cirrhosis: k = 0.53. The mean
      agreement for the 18 variables was not significantly different between juniors
      (0.53 +/- 0.32) and seniors (0.40 +/- 0.38) but was significantly better in
      specialists (0.61 +/- 0.22) than in general radiologists (0.43 +/- 0.40; P <
      0.05). CONCLUSIONS: Interobserver agreement of ultrasonography is good to
      excellent for the main characteristics of the liver, the main splanchnic veins
      and spleen but poor to fair for collateral vessels and the caudate lobe.
      Agreement for diagnosis of cirrhosis is good but should be improved by only
      selecting reliable signs or experienced echographists.

PMID- 7781942
TI  - [Mid-term failure of balloon dilatation treatment of antral stenosis induced by
      caustics].
AB  - We report the case of an antral stricture following lye ingestion. The patient
      was treated by 3 dilations using a through-the-scope balloon dilator, initially
      with good results. One year later, the recurrence of the symptoms led to 2 other
      sessions of dilation without success and a partial gastrectomy was performed. The
      intensity of the gastric wall fibrosis on the surgical specimen, probably
      responsible for major motor impairment, accounts for the discordance between the
      good endoscopic result and the clinical failure. Endoscopic dilation of lye
      induced gastric strictures could be a temporary alternative to surgical resection
      because the gastric wall fibrosis blemishes the long-term functional result.

PMID- 7781943
TI  - [Pneumatosis cystoides intestinalis associated with Steinert disease].
AB  - We report the case of a 63-year-old patient suffering from myotonic dystrophy,
      complicated with respiratory insufficiency, who presented a pneumoperitoneum
      without sign of peritonitis. Diagnosis of pneumatosis cystoides coli was based on
      CT scan evidence. Given oxygenotherapy and antibiotherapy, the patient rapidly
      improved. The association between the two affections has, to our knowledge, not
      been previously described.

PMID- 7781944
TI  - [Agenesis of the right lobe of the liver and portal hypertension].
AB  - A case of agenesis of the right lobe of the liver associated with portal
      hypertension is reported. This uncommon feature was diagnosed by computed
      tomography which excluded secondary liver atrophy due to cirrhosis or tumour. The
      main pathophysiological hypothesis for agenesis and portal hypertension,
      exceptionally associated, is arrest of hepatic development during foetal life.

PMID- 7781945
TI  - [Drug-induced toxicity: good practices for publication].

PMID- 7781946
TI  - [Drug-induced hepatotoxicity: ethics, pressures and publication].

PMID- 7781947
TI  - [Evaluation of celioscopic fundoplication by intraoperative esophageal
      manometry].

PMID- 7781948
TI  - [Eosinophilic ascites in cancer of the pancreas].

PMID- 7781949
TI  - [Acute intestinal intussusception in an adult treated by celioscopy].

PMID- 7781950
TI  - [Unusual lithiasis].

PMID- 7781951
TI  - [Chronic myelomonocytic leukemia and Crohn disease].

PMID- 7781952
TI  - Prevalence of irritable bowel syndrome in Motril (Spain)

PMID- 7781953
TI  - [Pseudoparasitism due to a small fluke in the liver].

PMID- 7781954
TI  - [Digestive hemorrhage caused by rupture of esophageal varices: emergency
      endoscopic sclerotherapy under general anesthesia].

PMID- 7781955
TI  - [The treatment of hepatitis B and C with interferon-alpha can induce or aggravate
      psoriasis].

PMID- 7781956
TI  - [Re-evaluation of risk of colonic cancer in Crohn disease].

PMID- 7781957
TI  - [Portal hypertension: value of combination of nitrate derivatives and beta
      blockers for better prevention?].

PMID- 7781958
TI  - Increases in gill cytosolic corticosteroid receptor abundance and saltwater
      tolerance in juvenile coho salmon (Oncorhynchus kisutch) treated with growth
      hormone and placental lactogen.
AB  - Juvenile coho salmon (Oncorhynchus kisutch) were injected with one of two
      recombinant bovine hormones, growth hormone (bGH; 5.0 and 0.5 micrograms.g-1 body
      wt) or placental lactogen (bPL; 5.0, 0.5, and 0.05 micrograms.g-1 body wt) to
      determine the effect on growth, plasma cortisol concentration, cytosolic
      corticosteroid receptors (CR) in the gills, and the development of
      hypoosmoregulatory ability. One week following a single injection or six weekly
      injections of bGH or bPL, the fish were measured and sampled for CR concentration
      and Na+,K(+)-ATPase activity in the gills. Fish were also challenged with salt
      water (salinity 25%) for 24 hr to determine saltwater tolerance at the end of the
      6-week treatment. Treatment with bPL and bGH significantly increased weight and
      length of the fish. The 0.05-micrograms bPL dose significantly elevated plasma
      cortisol concentration, whereas all other hormone treatments did not affect
      cortisol levels. bPL and bGH also significantly increased CR concentration and
      Na+,K(+)-ATPase activity in the gills. The perturbation in plasma sodium
      concentration was least in animals receiving the highest dose of bPL and the bGH
      treated animals following transfer to seawater. An increase in cytosolic CR by
      bGH and bPL may increase responsiveness of the gills to cortisol and partially
      account for the increase in Na+,K(+)-ATPase activity and greater ability to
      regulate plasma sodium in seawater as exhibited by the experimental groups.

PMID- 7781959
TI  - Vasotocin-sensitive adenylate cyclase in frog glomeruli.
AB  - Adenylate cyclase sensitivity to neurohypophyseal hormones was investigated in
      isolated glomeruli and in nephron segments microdissected from collagenase
      treated kidneys of Rana ridibunda. Vasotocin treatment increased adenylate
      cyclase activity in glomeruli and in collecting ducts and did not modify it in
      proximal convoluted tubules and in early and late distal tubules. In glomeruli,
      the hormonal stimulation resulted mainly in a decrease in the Km value for
      adenylate cyclase, which means a higher affinity for substrate (ATP) to the
      enzyme, whereas the response to forskolin was accounted for by increases both in
      affinity for substrate and in maximal adenylate cyclase velocity. The homologous
      neurohypophyseal hormones stimulated frog glomerular adenylate cyclase with the
      following rank order of affinities: hydrin 1 > or = AVT = AVP > or = hydrin 2 >
      OT > or = mesotocin > isotocin; structural analogs dDAVP, VDAVP, dVDAVP, and
      [Phe2,Orn8]VT had weak agonistic properties, [Thr4,Gly7]OT was inactive, and the
      antagonists OVTA, d(CH2)5Tyr(Et)2VAVP, and des-Gly9-d(CH2)5Tyr(Et)2VAVP inhibited
      hormone-induced enzyme activation with similar apparent inhibition constants. The
      vasotocin receptors triggering adenylate cyclase stimulation in frog glomeruli
      differ pharmacologically from V2 vasopressin receptors of mammalian kidneys and
      may also differ from V2-like vasotocin receptors of amphibian skin and urinary
      bladder.

PMID- 7781960
TI  - The stimulatory and inhibitory effects of dopamine on prolactin secretion in the
      turkey.
AB  - Dopamine (DA) was infused into the third ventricle of anesthetized laying turkey
      hens at various concentrations to determine its effect on both basal prolactin
      (PRL) levels and ongoing electrically induced PRL secretion. The infusion of DA
      at rates of 1.0 or 10.0 nmol/min resulted in dose dependent increases in plasma
      PRL. These infusions had no inhibitory effect on electrically stimulated PRL
      release. The infusion of DA at 100.0 or 500.0 nmol/min caused no stimulation of
      PRL secretion and totally inhibited the PRL response elicited by electrical
      stimulation of the medial preoptic nucleus. These results show that dopaminergic
      influences are involved in both stimulating and inhibiting avian PRL secretion
      and suggest possible biphasic actions of DA within the brain.

PMID- 7781962
TI  - Insulin-like growth factor-I in the plasma of two reptiles: assay development and
      validations.
AB  - Radioimmunoassays (RIAs) of insulin-like growth factor-I (IGF-I) in nonmammals
      are complicated by two problems: decreased specificity due to heterologous assays
      and assay interference from IGF binding proteins. We have developed and validated
      an RIA for the detection of IGF-I in reptilian plasma that circumvents these
      problems. Biochemical validations show parallelism between standard curves,
      plasma dilutions, and internal standards. Further, biological validations
      indicate that (1) plasma IGF-I levels are significantly reduced in
      nonreproductive, female American alligators (Alligator mississippiensis) with
      high plasma estradiol-17 beta concentrations compared to individuals with low
      plasma estradiol-17 beta concentrations and (2) plasma IGF-I concentrations are
      elevated in juvenile Trachemys scripta elegans turtles fed higher quality diets
      (defined by protein and energy content). These results provide impetus for future
      studies of IGF-I in reptiles.

PMID- 7781961
TI  - Abundant insulin-like growth factor-1 (IGF-1) receptor binding in fish skeletal
      muscle.
AB  - Insulin and insulin-like growth factor-1 (IGF-1) receptors were quantified in
      glycoprotein fractions prepared by wheat germ agglutinin-agarose affinity
      chromatography from skeletal muscle of several species of salmonid fish and carp.
      Insulin binding in fish skeletal muscle was lower than insulin binding found in
      rat. IGF-1-specific binding was two- to sixfold higher than insulin binding (16.0
      +/- 3.0 versus 5.8 +/- 0.75%/50 micrograms glycoprotein in brown trout, 15.5 +/-
      0.9 versus 2.2 +/- 0.5%/50 micrograms in coho salmon, and 39.7 +/- 7.6 versus
      16.0 +/- 3.0%/50 micrograms in carp muscle). Specific IGF-1 binding in fish
      skeletal muscle presented values similar to those in rat muscle. IGF-1 receptor
      binding was, in addition, highly specific. Cold IGF-1 displaced radiolabeled IGF
      1 binding in doses 100- to 1000-fold lower than cold insulin (ED50 of IGF-1
      binding to carp receptor preparations was 0.24 +/- 0.04 nM when displaced with
      cold IGF-1 and 368 +/- 83 nM when displaced with insulin). On the other hand,
      cold insulin displaced radiolabeled insulin binding at concentrations 10- to 100
      fold lower than cold IGF-1. Receptor tyrosine kinase activity was stimulated over
      basal values in a dose-dependent manner by both insulin and IGF-1, although IGF-1
      was more potent than insulin. Basal rates of phosphorus transferred to the
      artificial exogenous substrate poly(Glu4:Tyr1) were similar in all salmonid
      species (200-320 fmol P/micrograms protein) and higher in carp (1840 +/- 300 fmol
      P/micrograms protein). Maximum percentage of stimulation of tyrosine kinase
      activity by insulin and IGF-1 was in the same range in all salmonid species and
      carp (130-200% for insulin, 160-232% for IGF-1). Abundance of IGF-1 receptors in
      fish skeletal muscle contrasts with the pattern observed in higher vertebrates,
      in which insulin receptors prevail over IGF-1 receptors.

PMID- 7781963
TI  - Nature and distribution of gonadotropin-releasing hormone (GnRH) in the brain,
      and GnRH and GnRH binding activity in serum of the spotted dogfish Scyliorhinus
      canicula.
AB  - The distribution of different molecular forms of gonadotropin-releasing hormone
      (GnRH) in the brain and serum of the spotted dogfish, Scyliorhinus canicula, was
      investigated by an indirect immunofluorescence method, using antisera against
      salmon (s-), chicken-II (cII-) and mammalian (m-) GnRHs, and by reverse-phase
      high-performance liquid chromatography (RP-HPLC) coupled with radioimmunoassays.
      Five GnRH molecular forms were demonstrated on the basis of the retention time in
      the RP-HPLC system. The characteristics of four of these GnRH peptides are
      consistent with those of m-, cII-, dogfish (df-), and sGnRH. The fifth form
      appears to be novel. Immunoreactive sGnRH structures were confined to the
      diencephalon; whereas cIIGnRH and mGnRH were found in the telencephalon and
      diencephalon. cIIGnRH- and dfGnRH-like molecules were detected in the serum.
      Moreover, a specific, low-affinity GnRH binding protein (GnRH-BP) was found in
      the serum of the spotted dogfish. The binding of [125I]sGnRHA to the serum GnRH
      BP was dependent on incubation time, equilibrium being reached within 1 hr at 4
      degrees; binding was rapid and completely reversible. Scatchard analysis yielded
      a linear plot with a Kd of 7.9 x 10(-7) M. The presence of a GnRH-BP in spotted
      dogfish serum suggests a probable action of GnRH via the general circulation.

PMID- 7781964
TI  - Diurnal variation in alpha-melanocyte-stimulating hormone content of various
      brain regions and plasma of the Texas toad, Bufo speciosus.
AB  - We measured the concentrations of alpha-melanocyte-stimulating hormone (alpha
      MSH) in various brain regions as well as in the pituitary gland and plasma of the
      toad Bufo speciosus during a 24-hr light:dark cycle. There was significant
      diurnal variation of alpha-MSH concentrations in the hypothalamus and brainstem.
      In both areas alpha-MSH concentrations were highest during the scotophase. Peak
      alpha-MSH concentrations in the hypothalamus were observed at 21.00 and 05.00 hr,
      while a single peak in alpha-MSH concentrations was observed in the brainstem at
      21.00 hr. In contrast, peak alpha-MSH concentrations in the plasma were observed
      during the photophase at 17.00 hr, when brain concentrations of alpha-MSH were
      low. There was no significant diurnal variation observed in the pituitary content
      of alpha-MSH throughout the 24-hr light:dark cycle. These data suggest that
      different mechanisms control hypothalamic and pituitary alpha-MSH cells in the
      toad during the 24-hr light:dark cycle. The fact that peak alpha-MSH
      concentrations were observed in the hypothalamus during the activity period of
      the toad is consistent with the proposed role of alpha-MSH peptides in learning
      and memory processes.

PMID- 7781965
TI  - Evidence for functionally distinct subpopulations of steroidogenic cells in the
      domestic turkey (Meleagris gallopavo) adrenal gland.
AB  - A body of histological and functional evidence supports the hypothesis that there
      are functionally distinct subpopulations of steroidogenic cells comprising the
      avian adrenal gland. In the present study, we tested this hypothesis by
      evaluating the steroidogenic responses of density-dependent subpopulations of
      adrenal steroidogenic cells isolated from domestic turkeys fed either a high
      normal (control) sodium diet (0.4% Na+) or a Na(+)-restricted diet (0.04% Na+)
      for 8 days, the latter to stimulate the activity or appearance of possible zona
      glomerulosa-like cells. Subpopulations were visually yet reproducibly determined
      by their density-dependent separation on a continuous density gradient of Percoll
      (45%). The subpopulations were arbitrarily ascribed as being either low-density
      or high-density adrenal steroidogenic cells [LDAC (p = 1.0350-1.0585 g/ml) and
      HDAC (p = 1.0590-1.0720 g/ml), respectively]. LDAC and HDAC comprised 95.2 and
      4.8%, respectively, of the total number of adrenal steroidogenic cells isolated.
      The LDAC was further subdivided into three visually distinct subpopulations. The
      functional differences between the LDAC subpopulations is discussed but was less
      dramatic than the functional distinction between the HDAC subpopulation and the
      pooled LDAC subpopulations. Basal aldosterone production values between control
      LDAC and HDAC were equivalent. In addition, there were no differences in maximal
      aldosterone production between control LDAC and HDAC in response to
      [Ile5]angiotensin II (AII), the avian equivalent, [Val5]AII, K+ (as KCl), and
      that supported by exogenous corticosterone. However, maximal aldosterone
      production in response to human ACTH-(1-39) (ACTH) of the LDAC was 32% greater
      than that of the HDAC. Na+ restriction enhanced basal aldosterone production of
      the LDAC by 84% over the control LDAC. In addition, it enhanced maximal
      aldosterone production of the LDAC in response to AII peptides, K+, ACTH and that
      supported by corticosterone by 54, 164, 83, and 74%, respectively, over that of
      the control LDAC. However, Na+ restriction disproportionately enhanced basal
      aldosterone production of the HDAC by 348% over that of the control HDAC. In
      addition, with Na+ restriction, maximal aldosterone production of the HDAC in
      response to AII, K+, and ACTH and that supported by exogenous corticosterone was
      consistently greater than that of the LDAC. Moreover, with Na+ restriction,
      maximal aldosterone production of the HDAC in response to AII peptides and K+ was
      increased over that of the control HDAC to a greater extent than was maximal
      aldosterone production in response to ACTH and that supported by corticosterone
      (% enhancement over control was as follows: AII peptides, 502%; K+, 668%; ACTH,
      273%; corticosterone, 183%).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7781966
TI  - Melatonin rhythms in Atlantic salmon (Salmo salar) maintained under natural and
      out-of-phase photoperiods.
AB  - Diel changes in circulating melatonin were measured in juvenile Atlantic salmon,
      Salmo salar, maintained under natural and out-of-phase seasonal photocycles.
      Under natural daylengths of autumn, winter, spring, and summer circulating
      melatonin levels were inversely related to light intensity, with levels low
      during the day and high at night. The duration of the nocturnal increase in
      circulating melatonin was related to the duration of darkness, i.e., longer in
      winter than in summer. Under simulated seasonal photocycles circulating melatonin
      concentrations measured in August, October, and December were also elevated for
      the duration of darkness, irrespective of whether the photoperiods were
      synchronized or 6 months out-of-phase with the natural light and temperature
      cycles. Circulating melatonin also provided an accurate representation of the
      prevailing photoperiod in fish initially maintained on simulated natural
      photocycles, either synchronized or 6 months out-of-phase with the natural light
      cycle, and then held for 3 months on daylengths approximating the summer and
      winter solstices. Well-defined melatonin rhythms were always present,
      irrespective of time of year, photoperiod, and temperature. The amplitude of the
      nocturnal increase in circulating melatonin was similar in groups of fish
      maintained under simulated seasonal photoperiods 6 months out-of-phase with each
      other, but otherwise identical conditions, indicating that daylength per se did
      not influence the amplitude of the melatonin rhythm. The amplitude of the
      melatonin rhythm was slightly higher during the summer months, suggesting that
      temperature may modify circulating melatonin levels. These results demonstrate
      that circulating melatonin profiles always reflect the prevailing daylength and
      hence have the potential to provide the Atlantic salmon with accurate information
      on daily and calendar time, which could be utilised to time daily and seasonal
      events.

PMID- 7781967
TI  - Purification and structural characterization of vasoactive intestinal polypeptide
      from the trout and bowfin.
AB  - Vasoactive intestinal polypeptide (VIP) was purified from extracts of the
      stomachs of the rainbow trout, Oncorhynchus mykiss, and the bowfin, Amia calva.
      The primary structure of VIP from both species was the same: His-Ser-Asp-Ala-Ile
      Phe-Thr-Asp-Asn-Tyr10- Ser-Arg-Phe-Arg-Lys-Gln-Met-Ala-Val-Lys20-Lys-Tyr-Leu-Asn
      Ser-Val- Leu-Thr. This amino acid sequence shows only one amino acid substitution
      (Val5-->Ile) compared with the common sequence of VIP from the chicken,
      alligator, and European green frog. The structural identity of VIP from the trout
      and bowfin is consistent with the close phylogenetic relationship between the
      Salmoniformes and the Amiiformes and the data indicate that pressure to conserve
      the complete primary structure of VIP during vertebrate evolution has been very
      strong.

PMID- 7781968
TI  - Initial microbial adhesion is a determinant for the strength of biofilm adhesion.
AB  - This paper presents a hypothesis on the importance of initial microbial adhesion
      in the overall process of biofilm formation. The hypothesis is based on the
      realization that dynamic shear conditions exist in many environments, such as in
      the oral cavity, or on rocks and ship hulls. Recognizing that an entire biofilm
      is detached during high shear once the bond between the initially adhering
      organisms and a surface (often constituted through a so-called 'conditioning
      film') is broken, it becomes clear that research should focus on detachment
      rather than adhesion. Experiments were done in a parallel plate flow chamber in
      which attempts were made to detach adhering oral streptococci from glass by
      applying a high shear caused by the passage of a bubble, giving an air-liquid
      interface. Detachment of streptococci from bare glass and from an initially
      adhering actinomycete strain appeared not to occur. However, substantial
      detachment of adhering streptococci occurred when adhesion was mediated through a
      salivary conditioning film, presumably because of cohesive failure in the
      conditioning film.

PMID- 7781969
TI  - Induction and preliminary characterization of intracellular beta-glucosidases
      from a cellulolytic Streptomyces strain.
AB  - The cellulolytic actinomycete Streptomyces sp. QM-B814 possess an intracellular
      beta-glucosidase system which is induced by cellobiose and
      carboxymethylcellulose. Maximal beta-glucosidase activity was attained 8-10 h
      after inducer addition to exponential phase growing cultures. The induction is
      depressed in the presence of glucose. The system is composed of two
      electrophoretically different beta-glucosidases forms showing relative molecular
      masses of about 60 and 35 kDa, and pI values in the range 4.2-4.5. Both beta
      glucosidases are synthesized de novo. The enzymes share substrate preference and
      are both inhibited by delta-gluconolactone and p-chloromercuribenzoate. The
      induction pattern and glucose inhibition are similar for both enzymes.

PMID- 7781970
TI  - NtrBC-dependent expression from the Rhizobium meliloti dctA promoter in
      Escherichia coli.
AB  - Effects of the two-component sensor-regulator pairs DctBD and NtrBC upon the
      expression of a dctA::phoA fusion from Rhizobium meliloti were determined under
      excess and limiting nitrogen concentrations in Escherichia coli. Results
      indicated that NtrBC affected transcription from the dctA promoter on a number of
      regulatory levels and under different physiological conditions in the
      heterologous host. However, NtrBC-dependent cross-talk was not observed in free
      living R. meliloti under the conditions tested. Comparisons of the predicted
      amino acid sequences of DctD and NtrC from various sources indicated a specific
      region of the NtrC from rhizobia, which may have diverged from a consensus
      NtrC/DctD sequence to minimise interference between the two component systems,
      NtrBC and DctBD.

PMID- 7781971
TI  - Characterization of the superoxide dismutase gene and its upstream region from
      Methanobacterium thermoautotrophicum Marburg.
AB  - A gene (sod) encoding superoxide dismutase (SOD) was isolated from the strictly
      anaerobic archaeon Methanobacterium thermoautotrophicum Marburg. Its identify was
      confirmed by functional complementation of an Escherichia coli mutant strain
      lacking SOD activity and by DNA sequence analysis of a cloned fragment. Upstream
      of sod, separated by a 5-bp intergenic region, lies the open reading frame orfk
      which potentially codes for a protein of 209 amino acid residues. The amino acid
      sequence for this presumptive product had a similarity coefficient of 55.5% to a
      subunit of the alkyl hydroperoxide reductase (encoded by the ahpC gene) from
      Salmonella typhimurium.

PMID- 7781972
TI  - Construction and characterization of a Rhizobium leguminosarum biovar viciae
      strain designed to assess horizontal gene transfer in the environment.
AB  - An integration vector was developed which inserts cloned DNA in a non-essential
      site of the Rhizobium leguminosarum biovar viciae chromosome. The expression of
      integrated genes is under the control of the constitutive neomycin
      phosphotransferase II (nptII) promoter of transposon Tn5. The design of the
      vector ensures that loss of vector sequences can be detected, enabling selection
      of progeny containing only the requisite DNA. The newly constructed vector was
      employed to insert the Escherichia coli gusA gene conferring GUS activity into R.
      leguminosarum bv. viciae strain LRS39401 which is cured of its symbiotic plasmid
      (pSym). One GUS-positive transconjugant, strain CT0370, was shown to have lost
      all vector sequences. Conjugal transfer of pSym2004 (a Tn5-tagged derivative of
      symbiotic plasmid pRL1JI, which specifies pea nodulation and symbiotic nitrogen
      fixation) to CT0370, restored the GUS-positive strain's symbiotic proficiency.
      Strain CT0370 is presently being used in a field release experiment in order to
      assess the extent of pSym transfer in a natural R. leguminosarum bv. viciae
      population under environmental conditions.

PMID- 7781973
TI  - Cloning and sequencing of a novel hemolysis gene of Vibrio cholerae.
AB  - A hemolysis gene (hlx) which lyses sheep erythrocytes on blood agar plates when
      expressed in Escherichia coli was cloned from Vibrio cholerae. The cloned gene is
      predicted to encode a polypeptide of 92 amino acid residues with a deduced
      molecular mass of 10,451. E. coli transformed with this gene lysed sheep, goose,
      horse and chicken erythrocytes but not those of guinea pig and human. The hlx
      gene was observed in classical- and El Tor-biotype V. cholerae O1, V. cholerae
      non-O1, and V. mimicus, but not in V. parahaemolyticus.

PMID- 7781974
TI  - Glucosylation of cell wall proteins in regenerating spheroplasts of Candida
      albicans.
AB  - The cell wall of Candida albicans contains mannoproteins that are covalently
      associated with beta-1,6-glucan. When spheroplasts were allowed to regenerate a
      new cell wall, initially non-glucosylated cell wall proteins accumulated in the
      medium. While the spheroplasts became osmotically stable, beta-1,6-glucosylated
      proteins could be identified in their cell wall by SDS-extraction or beta-1,3
      glucanase digestion. At later stages of regeneration, beta-1,3-glucosylated
      proteins were also found. Hence, incorporation of proteins into the cell wall is
      accompanied by extracellular coupling to beta-1,6-/beta-1,3-glucan. The SDS
      extractable glucosylated proteins probably represent degradation products of wall
      proteins rather than their precursors. Tunicamycin delayed, but did not prevent
      the formation of beta-1,6-glucosylated proteins, demonstrating that beta-1,6
      glucan is not attached to N-glycosidic side-chains of wall proteins.

PMID- 7781975
TI  - Lack of lactate-proton symport activity in pck1 mutants of Saccharomyces
      cerevisiae.
AB  - Mutants of Saccharomyces cerevisiae without phosphoenolpyruvate carboxykinase
      activity showed no measurable lactate proton symport, while mutants without
      fructose-1,6-bisphosphatase had normal transport activity. Incubation of a pck1
      mutant, under derepression conditions in the presence of glycerol, restored the
      activity of the lactate-proton symport, with identical kinetic characteristics to
      that in the wild-type. For efficient lactate-proton symport activity, not only is
      an external inducer such as lactic acid needed, but also a molecule derived from
      the acid metabolism may be necessary.

PMID- 7781976
TI  - Targeted disruption of the PD78 gene (traF) reduces pheromone-inducible conjugal
      transfer of the bacteriocin plasmid pPD1 in Enterococcus faecalis.
AB  - Bacterial sex pheromone, cPD1, induces sexual aggregation of Enterococcus
      faecalis harboring the bacteriocin plasmid, pPD1, and enables pPD1 to transfer at
      high frequency in a liquid culture. PD78 is a cPD1-inducible cell surface protein
      encoded by pPD1. The PD78 gene, traF, was disrupted by homologous recombination
      between pPD1 and an artificial vector having a deletion in the middle portion of
      traF. The disruption of traF did not affect the cPD1-inducible aggregation but
      reduced the transfer frequency of pPD1 to 2% of the wild-type level.

PMID- 7781977
TI  - NAD(+)-glycohydrolase productivity of haemolytic streptococci assayed by a simple
      fluorescent method and its relation to T serotype.
AB  - The ability of haemolytic streptococci to produce NAD(+)-glycohydrolase was
      investigated by a fluorescent assay. Enzyme production was found in 31 (91%) of
      34 group A, 17 (61%) of 28 group C and eight (27%) of 30 group G isolates. The
      high producers were found in 22 (65%) of group A, one (4%) of group C and none of
      group G isolates. The high producers of the group A isolates belonged to T-1, T
      3, T-4 or T-12 serotype. These results suggest that NAD(+)-glycohydrolase
      productivity of streptococci is closely related to specific Lancefield's groups
      or T serotypes.

PMID- 7781978
TI  - Transposon mutagenesis in halophilic eubacteria: conjugal transfer and insertion
      of transposon Tn5 and Tn1732 in Halomonas elongata.
AB  - Molecular genetic studies of halophilic eubacteria have been limited by the lack
      of a suitable method for mutagenesis. To overcome this, we established a
      transposon mutagenesis procedure for the ectoine-producing, halophilic bacterium
      Halomonas elongata. We used suicide plasmids pSUP101 and pSUP102-Gm to introduce
      the transposons Tn5 and Tn1732 respectively into H. elongata via Escherichia coli
      SM10 mediated conjugation. Our finding that H. elongata is sensitive to
      aminoglycoside antibiotics at low salinity enabled us to apply transposons that
      mediate kanamycin resistance. The insertions of transposon Tn1732 occurred at
      different sites in the chromosome of H. elongata, as proved by Southern
      hybridization analysis. Phenotypic analysis revealed that different auxotrophic
      and salt sensitive mutants were generated by mutagenesis with transposon Tn1732.
      To our knowledge this is the first report of a successful application of a
      transposon for direct generalized mutagenesis in a halophilic eubacterium.

PMID- 7781979
TI  - Lack of involvement of merT and merP in methylmercury transport in mercury
      resistant Pseudomonas K-62.
AB  - To clarify whether the merT and merP genes play a role in the transport of
      methylmercury, we constructed a deletion plasmid, pMRD141 which lacked the genes
      conferring the organomercurial lyase and the mercuric reductase from plasmid,
      pMRA17 containing the entire broad-spectrum mercury resistance determinants of
      the 26 kb-plasmid from Pseudomonas K-62. Plasmid, pMRD141 showed hypersensitivity
      to Hg2+ but still expressed a normal sensitivity to methylmercury. The mercury
      induced hypersensitive cells carrying pMRD141 took up appreciably more 203Hg2+
      than the induced resistant cells with pMRA17 and the sensitive cells with cloning
      vector, Bluescript II SK(+) but no difference in the uptake of CH3(203)Hg2+ among
      these three strains was found. These results suggested that the merT and merP are
      only involved in the Hg2+ transport but do not participate in the transport of
      methylmercury.

PMID- 7781980
TI  - Plasmid and chromosomal DNA recovery by electroextraction of cyanobacteria.
AB  - High voltage electroporation has been investigated as a method for rapid recovery
      of plasmid and chromosomal DNA from the cyanobacteria Nostoc PCC 7121,
      Synechococcus PCC 7002, and Anabaena PCC 7120. Pulses of 18 kV/cm and higher
      applied to concentrated Nostoc cells carrying a shuttle plasmid (pRL25) resulted
      in copious release of nucleic acids and phycobiliproteins into the suspending
      medium. Small portions of these supernatants, when electroporated with
      Escherichia coli, gave rise to hundreds of E. coli transformants which contained
      pRL25. Electroporation of Synechococcus carrying plasmid pAQE19 did not cause
      detectable release of macromolecules but did reveal a low-level, voltage
      independent 'leakage' of pAQE19 into the medium. Electroextraction of Nostoc or
      Anabaena followed by addition of E. coli and delivery of a second high-voltage
      pulse permitted direct, one-cuvette transfer of shuttle plasmids from these
      cyanobacteria into E. coli. Electroextraction of single cyanobacterial colonies,
      as shown for Nostoc, also released sufficient chromosomal DNA for amplification
      of specific sequences by the polymerase chain reaction.

PMID- 7781981
TI  - Mycoplasma gallisepticum 16S rRNA genes.
AB  - The genome of Mycoplasma gallisepticum A5969 contains a truncated pseudogene for
      16S rRNA in addition to a single unsplit rRNA-operon and a second discontinuous
      set of rRNA genes. Other M. gallisepticum strains tested do not possess the
      truncated gene. This gene is almost identical to full-size isolated 16S rRNA gene
      starting from at least 500 nucleotides upstream of the coding sequence and ending
      at the 977th nucleotide within the structural part of 16S rRNA.

PMID- 7781983
TI  - Pore-forming bacteriocins of gram-positive bacteria and self-protection
      mechanisms of producer organisms.
AB  - Proteinaceous antimicrobial compounds are produced by a diversity of species
      ranging from bacteria to humans. This review focuses on the mode of action of
      pore-forming bacteriocins produced by Gram-positive bacteria. The mechanism of
      action of specific immunity proteins, which protect the producer strains from the
      lethal action of their own products (producer self-protection), are also
      discussed.

PMID- 7781982
TI  - Sucrose-derived exopolymers have site-dependent roles in Streptococcus mutans
      promoted dental decay.
AB  - We have constructed a panel of mutants of S. mutans V403 which are defective in
      one or more of the glucosyltransferase genes (gtfB, C or D) or the
      fructosyltransferase gene (ftf). These strains have been tested for virulence in
      a gnotobiotic rat caries model with reference to both buccal (smooth surface) and
      sulcal (pit and fissure) carious lesions. Our data suggest differing roles for
      degradable and non-degradable polymers at buccal and sulcal sites. Non-degradable
      polymers (made by products of the gtfB and C genes) contributed significantly to
      the severity of smooth surface lesions. However, our studies suggested their role
      in pit and fissure lesions was not as important as the role of degradable
      polymers. Specifically, a mutant deficient in the major insoluble glucan
      synthesizing activity (product of the gtfB gene) was 25% more cariogenic on
      sulcal surfaces than was the wild-type V403 strain. We propose that extracellular
      glucosyltransferases and fructosyltransferase compete for sucrose and that this
      competition influences pathogenicity at differing tooth sites.

PMID- 7781985
TI  - A novel dodecadepsipeptide, cereulide, is an emetic toxin of Bacillus cereus.
AB  - A vacuole-formation substance, cereulide of Bacillus cereus, is an emetic toxin
      in animals. Both oral administration and intraperitoneal injection of cereulide
      caused dose-dependent emesis in Suncus murinus, a new animal model of emesis.
      Vagotomy or a 5-HT3 receptor antagonist completely abolished this emetic effect.
      Therefore, cereulide causes emesis through the 5-HT3 receptor and stimulation of
      the vagus afferent. We also found that our purified cereulide caused swelling of
      mitochondria of HEp-2 cells.

PMID- 7781984
TI  - Intrinsic insensitivity to cadmium of the L-lactate oxidizing system in
      staphylococcoccus aureus.
AB  - Starved cells of cadmium-sensitive Staphylococcus aureus 17810S accumulated 109Cd
      via the Mn2+ porter energized by the membrane potential (delta psi) generated by
      L-lactate oxidation. However, Cd2+ accumulation did not result in inhibition of
      respiration and consequent generation of electrochemical proton gradient (delta
      muH+) via the respiratory chain. Thus, delta muH(+)-consuming processes, such as
      ATP synthesis and [14C]glutamate transport proceeded normally, despite the
      presence of Cd2+ in the cytoplasm. The mechanism of the intrinsic cadmium
      insensitivity of the L-lactate oxidizing system is discussed.

PMID- 7781987
TI  - Assignment of genes to Leishmania infantum chromosomes: karyotype and ploidy.
AB  - The use of various pulsed-field electrophoresis methodologies under different
      conditions allowed us to determine the Leishmania infantum karyotype. A total of
      25 chromosomal bands ranging in size from 375 to 3300 kb were resolved amounting
      to a minimum genomic DNA mass of about 2.6 x 10(7) pb. By molecular hybridization
      and on the basis of the karyotype, specific gene sequences could be assigned to
      particular chromosomes. A bias in the chromosomal distribution of different
      markers was found since 9 out of the 12 analysed gene markers hybridize with
      chromosomal bands XIXa and XIXb. We infer that chromosomal bands XIXa and XIXb,
      differing in about 30 kb, could be representing a pair of homologous chromosomes
      and that another pair of homologs may be also defined by chromosomal bands XVII
      and XVIII.

PMID- 7781986
TI  - Sequence of cDNA coding for a 65 kDa adhesive protein for the specific detection
      of Trichomonas vaginalis by PCR.
AB  - A Trichomonas vaginalis cDNA library was constructed and recombinant plaques were
      screened using rabbit immunoglobulins specific for P65, a protozoan protein
      involved in pathogenicity that we identified in a previous study. A 1.38
      kilobases cDNA fragment coding for the P65 protein was cloned in E. coli and then
      sequenced. On the basis of of the sequence obtained, six primers were synthesised
      and used to set up a Polymerase Chain Reaction. The presence of a specific
      amplicon in all 30 clinical isolates tested shows that P65 is a conserved and
      stable gene. The reaction is highly sensitive (as few as 5 to 10 parasites can be
      detected) and specific for Trichomonas vaginalis; the gene coding P65 adhesin can
      be therefore considered a very good molecular target for polymerase chain
      reaction-based diagnostic purposes.

PMID- 7781988
TI  - Kinetics of substrate oxidation by whole cells and cell membranes of Helicobacter
      pylori.
AB  - Oxygen uptake by Helicobacter pylori cells and membranes was determined. Cells
      from stirred broth cultures or agar plates, suspended in buffer, possessed a
      variable and apparently endogenous respiration which could be sustained for
      several hours. In contrast, oxygen consumption by cells from statically incubated
      broth cultures, in the absence of added substrate, was transient or undetectable.
      These latter cells, however, oxidised ethanol, fumarate, glucose, D-lactate,
      pyruvate and succinate, though glucose-oxidising ability declined rapidly. The
      Kms for D-lactate, pyruvate and succinate metabolism were low (< or = 20 microM)
      and oxygen uptake was approximately 1.5, 2 and 2 mol per mol substrate
      respectively, indicating metabolism beyond acetate plus CO2 and implying the
      presence of tricarboxylic acid cycle activity. Cell membranes oxidised fumarate,
      D-lactate, NADH, NADPH and succinate. NADPH oxidation was six times more rapid
      than that of NADH. Rates of oxygen uptake by cells suspended in buffer with
      metabolisable substrate were < 20% of those for cells suspended in a brain heart
      infusion medium. Uninoculated medium consumed significant quantities of oxygen.

PMID- 7781990
TI  - Luminometry and PCR-based monitoring of gene-tagged cyanobacteria in Baltic Sea
      microcosms.
AB  - The cyanobacterium Synechocystis 6803 was tagged by chromosomal integration of
      the firefly luciferase gene, luc, resulting in the modified strain Synechocystis
      6803-luc. The tagged cells were monitored in Baltic Sea microcosms both by
      detection of the luc gene by PCR amplification and by measurement of luc gene
      expression (bioluminescence) in total protein extracted from sediment and water.
      A new method was developed for isolation and concentration of total protein from
      sediment for optimization of luciferase quantitation. The detection limit for
      Synechocystis with a chromosomal luc insertion by bioluminescence was in the
      order of 4 x 10(3) cells per g sediment, a considerable improvement in
      sensitivity over previous methods. Another improvement was to use an internal
      luciferase standard to correct for quenching of light output by impurities in the
      samples. Baltic sea microcosms were inoculated with Synechocystis 6803-luc, and
      the luc DNA and luciferase protein specific to the tagged cells were monitored
      over time. A decrease in luminescence in the microcosm water was observed,
      simultaneously with an increase in luminescence in the sediment, suggesting
      settling of the luc-tagged cells in the sediment layer.

PMID- 7781989
TI  - Isolation and characterization of a bacterium which utilizes polyester
      polyurethane as a sole carbon and nitrogen source.
AB  - Various soil samples were screened for the presence of microorganisms which have
      the ability to degrade polyurethane compounds. Two strains with good polyurethane
      degrading activity were isolated. The more active strain was tentatively
      identified as Comamonas acidovorans. This strain could utilize polyester-type
      polyurethanes but not the polyether-type polyurethanes as sole carbon and
      nitrogen sources. Adipic acid and diethylene glycol were probably the main
      degradation products when polyurethane was supplied as a sole carbon and nitrogen
      source. When ammonium nitrate was used as nitrogen source, only diethylene glycol
      was detected after growth on polyurethane.

PMID- 7781991
TI  - Carbon dioxide regulated secretion of the EaeB protein of enteropathogenic
      Escherichia coli.
AB  - An eaeA mutant (intimin deficient) of enteropathogenic Escherichia coli
      stimulated phosphorylation of several host cell proteins, showing that intimate
      adherence is not required to activate signal transduction pathways in
      enteropathogenic E. coli-infected cells. Growth of enteropathogenic E. coli in
      tissue culture medium in 5% CO2, in the presence or absence of cultured cells,
      resulted in the secretion of several bacterial proteins. Two of these, 36 kDa and
      20 kDa in size, were expressed at significantly lower levels in air. N-terminal
      sequencing and analysis of secreted proteins of an eaeB mutant indicated that the
      36 kDa secreted protein was EaeB, previously implicated in the stimulation of
      signalling pathways in enteropathogenic E. coli-infected cells.

PMID- 7781992
TI  - Phylogenetic analysis by 16S ribosomal DNA sequence comparison reveals two
      unrelated groups of species within the genus Ruminococcus.
AB  - Phylogenetic analysis of the genus Ruminococcus based on 16S rDNA sequence data
      showed the genus to be phylogenetically heterogenous. Ruminococcus species fall
      within the radiation of the Bacillus/Clostridium subphylum of the Gram-positive
      line of descent. Two distinct and unrelated clusters are recovered. One group
      contains R. flavefaciens, R. albus, R. bromii, and R. callidus. The second group
      constitutes R. gnavus, R. hansenii, R. lactaris, R. obeum, R. productus and R.
      torques which together with some Clostridium species may constitute a new genus.

PMID- 7781993
TI  - Cloning and characterization of a gene from Pasteurella haemolytica A1 involved
      in lipopolysaccharide biosynthesis.
AB  - A Pasteurella haemolytica A1 gene involved in the biosynthesis of a moiety on the
      core of the lipopolysaccharide molecule has been cloned and characterized.
      Escherichia coli clones which carry this gene showed an alteration of its
      lipopolysaccharide migration profile on tricine SDS-PAGE and exhibited resistance
      to the core-specific phage U3. In addition, lipopolysaccharide extracted from the
      E. coli clones was recognized by an anti-corespecific antiserum, but not by
      antiserum specific for the O antigen of P. haemolytica A1 lipopolysaccharide.
      Nucleotide sequence analysis of the cloned DNA identified an open reading frame
      (lpsA) coding for a protein of 263 amino acids which showed significant homology
      with a Haemophilus influenzae type b lipooligosaccharide biosynthesis gene. PCR
      amplification of genomic DNA, using primers based on the P. haemolytica A1 lpsA
      sequence, yielded products from only the A biotypes of P. haemolytica.

PMID- 7781994
TI  - Intragenic suppression of a luxR mutation: characterization of an autoinducer
      independent LuxR.
AB  - The Vibrio fischeri luminescence genes are activated by the LuxR protein and a
      diffusible signal termed the autoinducer. LuxR consists of two domains, a C
      terminal transcriptional activator domain, and an N-terminal autoinducer-binding
      domain, which serves to regulate the function of the C-terminal domain. We have
      isolated and characterized an intragenic suppressor of a mutation that maps to
      the N-terminal domain and blocks autoinducer binding. The suppressor changes an
      alanine residue at position-221 in the C-terminal domain to a valine. In
      Escherichia coli, the suppressor allows partial activation of the V. fischeri
      luminescence genes although E. coli containing this protein remains unable to
      bind autoinducer. To further analyze the influence of the second-site mutation on
      luxR function, we constructed a luxR gene that coded for a protein with a wild
      type N-terminal domain and with the ala-221 to val substitution in the C-terminal
      domain. This protein activated the luminescence genes in the presence or absence
      of autoinducer, and it bound autoinducer at levels comparable to the wild-type
      LuxR protein. Apparently, the alanine to valine substitution at position-221
      allows activity of the C-terminal domain in a fashion independent of whether
      autoinducer is bound to the N-terminal domain.

PMID- 7781995
TI  - Linkage analysis of the gene encoding precursor protein of diapause hormone and
      pheromone biosynthesis-activating neuropeptide in the silkmoth, Bombyx mori.
AB  - We have determined the map position of the gene encoding a common precursor
      protein for diapause hormone and pheromone biosynthesis-activating neuropeptide
      (the DH-PBAN gene, Dh) in the silkmoth, Bombyx mori. First we compared the
      structure of introns in the DH-PBAN gene by the polymerase chain reaction, and
      found that the Dh locus carried three alleles, DhA1, DhA2 and DhB. The DhA1 and
      DhA2 alleles contained a fourth intron consisting of 740 bp, whereas DhB had a
      longer fourth intron of 770 bp. DhA1 and DhA2 contained a fifth intron consisting
      of 940 bp, whereas the fifth intron in DhB was much longer and consisted of 1700
      bp. DhA1 was distinguished from DhA2 by an RFLP in the fifth intron after
      digestion with Rsa I. Linkage analyses using these polymorphisms showed that Dh
      was linked to the bp gene on chromosome 11, and independent of markers on
      chromosomes 1, 2, 3, 4, 5, 6, 7 and 13. To determine the map position, we
      obtained F1 hybrids between the n501 strain (K DhA1) and the w30 strain (+K DhB),
      and backcrossed the F1 hybrid to females of the w30 strain. From the segregation
      of K and Dh in 864 individuals in the next generation, the recombination value
      was calculated as 25.5% between K and Dh. Similarly we obtained backcross progeny
      between the No. 744 strain (Bu DhA1) and the w30 strain (+Bu DhB), and calculated
      the recombination value between Bu and Dh as 30.4% from 487 progeny.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7781996
TI  - Accumulation of mutations affecting body weight in inbred mouse lines.
AB  - The variation from spontaneous mutations for 6-week body weight in the mouse was
      estimated by selection from a cross of two inbred sublines, C57BL/6 and C57BL/10,
      separated about 50 years previously from the same inbred line. Selection was
      practised high and low for 12 generations from the F2, followed by one generation
      of relaxation. The lines diverged by approximately 1.7 g or 0.7 sd. The additive
      genetic variance was estimated in the F2 by restricted maximum likelihood and
      from the selection response, and from this variance the mutational heritability
      hM2 was estimated using the number of generations since divergence. Estimates of
      hM2 range from 0.08 to 0.10% depending on the method of analysis. These estimates
      are similar to those found for other species, but lower than other estimates for
      the mouse. It is concluded that substantial natural and, perhaps, artificial
      selection operated during the maintenance of the sublines.

PMID- 7781997
TI  - Survey of genomic repeat sequence-PCRs that detect differences between inbred
      mouse strains.
AB  - We have developed molecular markers that distinguish between several inbred and
      congenic mouse strains using polymerase chain reaction (PCR) amplification of
      genomic DNA repeat sequences. Mouse genomic DNA, digested with four base
      recognition site-restriction endonucleases, was amplified by PCR using primers
      for the following repeat sequences: B1 (Alu homolog), LINE, LLR3, IAP, human Alu
      and myoglobin. Amplification products analysed by agarose gel electrophoresis and
      stained with ethidium bromide produced unique DNA fragments, some of which are
      specific for each of 12 strains tested. This method can be used for molecular
      analysis of the mouse genome, including genetic monitoring.

PMID- 7781998
TI  - Thirteen genes (Cebpb, E2f1, Tcf4, Cyp24, Pck1, Acra4, Edn3, Kcnb1, Mc3r, Ntsr,
      Cd40, Plcg1 and Rcad) that probably lie in the distal imprinting region of mouse
      chromosome 2 are not monoallelically expressed.
AB  - Seven imprinted genes are currently known in the mouse but none have been
      identified yet in the distal imprinting region of mouse Chromosome (Chr) 2, a
      region which shows striking linkage conservation with human chromosome 20q13.
      Both maternal duplication/paternal deficiency and its reciprocal for distal Chr 2
      lead to mice with abnormal body shapes and behavioural abnormalities. We have
      tested a number of candidate genes, that are either likely or known to lie within
      the distal imprinting region, for monoallelic expression. These included 3 genes
      (Cebpb, E2f1 and Tcf4) that express transcription factors, 2 genes (Cyp24 and
      Pck1) that are involved in growth, 5 genes (Acra4, Edn3, Kcnb1, Mc3r and Ntsr)
      where a defect could lead to neurological and probably behavioural problems, and
      3 genes (Cd40, Plcg1 and Rcad) that are less obvious candidates but sequence
      information was available for designing primers to test their expression. On/off
      expression of each gene was tested by reverse transcription-polymerase chain
      reaction (RT-PCR) analysis of RNA extracted from tissues of mice with maternal
      duplication/paternal deficiency and its reciprocal for the distal region of Chr
      2. None of the 13 genes is monoallelically expressed in the appropriate tissues
      before and shortly after birth which suggests that these genes are not imprinted
      later in development. This study has narrowed down the search for imprinted
      genes, and valuable information on which genes have been tested for on/off
      expression is provided. Since there is considerable evidence of conservation of
      imprinting between mouse and human, we would predict that the 13 genes are not
      imprinted in human. Five of the genes: E2f1, Tcf4, Kcnb1, Cd40 and Rcad, have not
      yet been mapped in human. However, because of the striking linkage conservation
      observed between mouse Chr 2 and human chromosome 20, we would expect these genes
      to map on human chromosome 20q13.

PMID- 7781999
TI  - Comparative population structuring of molecular and allozyme variation of
      Drosophila melanogaster Adh between Europe, west Africa and east Africa.
AB  - Restriction enzyme molecular variation in Drosophila melanogaster Adh was
      compared between three natural populations from Europe, West Africa and East
      Africa. The frequency distribution of silent variation in the slow allele was
      compatible with the neutral model in all three samples. The number of haplotypes
      in East Africa was significantly higher than in the other two populations. The
      largest divergence, as measured by Fst, was between the East African population
      and a group made up from the West African, the European, and previously studied
      American populations. We suggest that a split first occurred within African
      populations at least 44000 years ago. European populations separated from West
      Africa more recently, between the last glacial maximum and the post-glacial
      optimum, 18,000 to 8,000 years ago. We suggest that this species was domesticated
      recently relative to human evolution, possibly with the advent of agriculture.
      Population differentiation with respect to the two allozymes, fast and slow, does
      not follow the geographical pattern of silent variation. It opposes European to
      both African populations, and probably results from selection for adaptation to
      alcohol in recent temperate populations.

PMID- 7782000
TI  - Suicide risk in frail elderly people relocated to nursing homes.

PMID- 7782001
TI  - Relocation stress syndrome: a comprehensive plan for long-term care admissions.

PMID- 7782002
TI  - The resident: the heart of it.

PMID- 7782003
TI  - A profile of Pennsylvania nurse's aides.

PMID- 7782004
TI  - Carotid endarterectomy in elderly vascular patients: experience in a community
      hospital.

PMID- 7782005
TI  - Staffing and managing special care units for Alzheimer's patients.

PMID- 7782007
TI  - Another look at napping in older adults.

PMID- 7782006
TI  - Research utilization: meeting the challenge.

PMID- 7782008
TI  - Community partnerships: home health care for elderly minorities.

PMID- 7782009
TI  - Digestive dilemmas.

PMID- 7782010
TI  - Decisions about behavior-modifying medications for people with dementia.

PMID- 7782011
TI  - Professional issues and public concerns.

PMID- 7782012
TI  - Structure, occurrence, biosynthesis, biological activity, synthesis, and
      chemistry of aromadendrane sesquiterpenoids.

PMID- 7782013
TI  - The chemistry of melanins and melanogenesis.

PMID- 7782015
TI  - [Responsibilities and value of autopsy. Determining death--1].

PMID- 7782014
TI  - [Breast carcinoma--revision of after-care recommendations. 1: Results of many
      large studies from the literature are in agreement].
AB  - In the past, recommendations for the follow-up of women who had undergone primary
      treatment for local or locoregional breast cancer, were mostly concerned with
      "programmed" protocols in which the frequency of the follow-up appointments, and
      the examinations to be performed on the respective occasions (e.g. bone
      scintigraphy, chest X-ray, abdominal ultrasound, mammography and laboratory
      investigations) were rigidly fixed. Numerous new facts reported in the literature
      (including prospective randomized studies and meta-analyses) now appear to show
      that this formalized approach to follow-up brings the patient no advantage in
      terms of approved chances of being cured, longer survival or better quality of
      life. For this reason, for breast cancer follow-up, a strategy is proposed that
      is based on meticulous history-taking and clinical examination, and which also
      emphasizes psychosocial rehabilitation aspects. Examinations using technical
      equipment are carried out only when justified by clinical suspicion of recurrent
      disease.

PMID- 7782016
TI  - [Procedure for autopsy. 1: Responsibilities in autopsy--determining death].

PMID- 7782017
TI  - [Preventing imminent amputation by regional hyperthermic fibrinolytic drug
      perfusion. An intraoperative procedure for reopening thrombosed arteries in
      extremities].

PMID- 7782018
TI  - [Long-term therapy with a retard theophylline preparation].
AB  - The present study was conducted to investigate the therapeutic effect of long
      term treatment with a slow-release theophylline preparation on the pulmonary
      functions FEV1 and peak exspiratory flow (PEF). A total of 908 patients took part
      in this open multicenter study. Treatment with the slow-release theophylline
      resulted in an increase of FEV1 and PEF of about 20% in asthma and between 11%
      and 14% in COPD. Apart from theophylline itself, the galenic nature of the slow
      release formulation also contributed to the therapeutic effect.

PMID- 7782019
TI  - [The atypical neuroleptic clozapine (Leponex)--current knowledge and recent
      clinical aspects].
AB  - The dibenzoepine derivative clozapine is seen as a prototype of an atypical
      neuroleptic, because clozapine has good antipsychotic efficacy but only minimal
      dopamine antagonistic properties in common animal paradigms. The latter is
      reflected by the observation that extrapyramidal symptoms during clozapine are a
      rare phenomenon. Furthermore, recent studies in the USA demonstrated a superior
      efficacy of clozapine in schizophrenic patients who are nonresponsive to classic
      neuroleptics. Therefore, the introduction of clozapine in the USA was performed
      in 1990 despite the well-known risk of agranulocytosis (1-2% during the first
      year of treatment); however, under restricted conditions regarding the mandatory
      weekly control of the white blood cell count. For the use of clozapine in Europe,
      it should be underlined that in 1992 the indication was restricted to "acute and
      chronic forms of schizophrenia" whereas formerly it was permitted to treat
      several other neuroleptic resistant syndromes with clozapine, e.g. severe
      psychotic excitement, aggressive behavior or manic or atypical psychosis. The
      usage of clozapine in these indications is now only permitted under the
      restricted legal conditions of a "therapeutic trial" in selected patients.
      However, several indications for which clozapine has been used successfully in
      Europe are currently re-investigated in the USA, hopefully leading to a
      redefinition and extension of the indication spectrum. On the other hand, the
      American multicenter trials lead to the conclusion that the treatment with
      clozapine is not furthermore the treatment of last choice but a serious
      therapeutic alternative which should be available for all schizophrenic patient
      in case of neuroleptic resistance or of severe side effects of standard
      neuroleptics. Clozapine treatment leads to an improvement of the quality of life
      in one third of these schizophrenics and, moreover, results in a marked reduction
      of costs mainly by reducing the rehospitalisation rates. On the other hand, the
      list of well-known side effects of clozapine (e.g. agranulocytosis, increased
      risk of seizures, initial sedation) has to be extended (e.g. transient
      leucocytosis or eosinophilia, rare but severe complications like
      cardiorespiratory arrest and "sudden death" during combination with
      benzodiazepines, case reports of pericarditis, pancreatitis or polyserositis). On
      the background of possible cardiorespiratory complications we recommend to start
      the first treatment with clozapine in high risk patients (e.g. those in older age
      or in case of organic brain impairment) only in restricted indications and only
      in centers with sufficient clozapine experience.

PMID- 7782020
TI  - [Disorders of autonomic regulation in Parkinson syndrome].
AB  - Ever since the first description of Parkinson's disease, it has not only been
      associated with the classical triad of akinesia, rigor and tremor but also with
      autonomic regulation disorders. However, the studies published on this subject
      show differing and partly contradictory results. A large number of studies
      demonstrate a distinct autonomic disorder. On the other hand there are authors
      who question an affliction of the autonomic nervous system and others who
      attribute the autonomic disorder to Parkinson specific medication. To make
      matters worse, the various pathogeneses of Parkinson's syndrome within the
      patients collectives have not been sufficiently differentiated and nomenclature
      of the multisystem degeneration was handled in different ways. Taking our
      examinations of the various autonomic functions and the underlying literature
      into critical consideration, we come to the conclusion that regulation disorders
      of the cardiovascular system, gastrointestinal and urinary tract, as well as
      sweat and thermoregulation are often seen in the idiopathic Parkinson's disease.
      In our opinion the idiopathic Parkinson's syndrome must be attributed to the
      multisystem degenerations. Autonomic dysfunction occurs in different intensities
      in the disease.

PMID- 7782021
TI  - [Friedrich Holderlin's psychosis from the viewpoint of Karl Leonhard].

PMID- 7782022
TI  - [Parasitological research projects of Chagas disease in Paraguay].

PMID- 7782024
TI  - Hemodialysis patient regarded as a primary hyperoxaluria after long-term
      hemodialysis and renal transplantation.
AB  - Primary hyperoxaluria (PH) is a rare inborn error of oxalate metabolism resulted
      in autosomal recessive genetic defects. Clinical manifestations and end stage
      renal failure are developed during childhood in most cases, but occasionally they
      begin later in life. The diagnosis of PH is quite difficult due to diminished
      oxalate excretion after the renal function was declined. especially after
      initiation of hemodialysis therapy. We report here an adult case who was
      introduced into hemodialysis and subsequently regarded to have primary
      hyperoxaluria (PH). In clinical situations, this case had some peculiar clinical
      signs such as histories of frequent stone formations, impressive dental
      manifestations and destructive erosions of bones resembling renal osteodystrophy.
      There might be more PH patients among hemodialysis patients. PH should be
      considered in hemodialysis patients whenever curious bone changes and/or dental
      manifestations with history of frequent urolithiasis are recognized in the
      earlier course of hemodialysis therapy.

PMID- 7782023
TI  - A preliminary study of retreatment of chronic hepatitis C with interferon.
AB  - Nine patients with chronic hepatitis C virus (HCV) infection and no complete
      response to the first treatment with natural interferon (IFN)-alpha, were
      prescribed a second treatment with IFN. Five patients (Group A) with unsustained
      levels serum alanine aminotransferase (ALT) after the first treatment were
      administrated the same species of IFN but in a higher dose. The remaining four
      patients (Group B), with no normalization of ALT throughout the observation
      period of the first treatment, were administrated IFN-beta. HCV RNA was
      eliminated in three patients of group A and in two of group B patients during 6
      months follow up and ALT reverted to normal levels. These results suggest that
      retreatment with a higher dose of the same species of IFN-alpha can be effective
      in case of a relapse and that IFN-beta can be effective for those not responding
      to IFN-alpha.

PMID- 7782025
TI  - [Survey of using conditions of sterilized and non-sterilized disinfectants in
      Kyushu University Hospital].
AB  - We surveyed the using conditions of sterilized and non-sterilized disinfectants
      in Kyushu University Hospital by questionnaires and direct hearing. The kinds and
      concentrations of disinfectants used were generally proper for their respective
      purposes. However, there were also some inappropriate cases, such as the
      cleansing of mucosal membranes with chlorhexidine (Hibitane) gluconate and uses
      of the concentrations different from those described in the package insert. The
      present survey was very useful for proper uses of disinfectants.

PMID- 7782026
TI  - Hepatic resection under in situ hemihepatic hypothermic perfusion with
      hepatoprotective agents.
AB  - Hepatectomy was performed under in situ right lobar hypothermic perfusion
      combined with hepatoprotective agents in six patients who had hepatocellular
      carcinoma and coexisting liver disease. Following occlusion of the right hepatic
      vein and the right portal pedicle, in situ cold perfusion was initiated using
      chilled Ringer's lactate infused through a cannula placed in the right main
      portal vein. The right superior segments were resected in a bloodless field. The
      liver was cooled to 22-26 degrees C for 40 to 80 minutes with no significant
      changes in systemic hemodynamics or body temperature. Postoperative liver
      functions showed no marked derangement; the mean peak GPT was 221 U and the mean
      peak total bilirubin 2.3 mg d/l. Local cooling minimizes the risk of
      ischemia/reperfusion injury in this very vulnerable population, yet gives the
      surgeon adequate time to perform a challenging resection in a bloodless field.

PMID- 7782027
TI  - Changes in IL-6 and IL-8 after hepatectomy in patients with liver cirrhosis.
AB  - Changes in tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1
      beta), interleukin-6 (IL-6), and interleukin-8 (IL-8) were investigated before
      and after hepatectomy in patients with or without liver cirrhosis (5 cases
      without liver cirrhosis and 14 cases with liver cirrhosis). Both the IL-6 and IL
      8 values of the cirrhotic patients were significantly higher on the first
      postoperative day (POD) as compared with the non-cirrhotic patients. Overall, no
      significant correlation was found between peak values of IL-6 or IL-8 and blood
      loss or operating time. In the case of the cirrhotic patients, correlation of
      both IL-6 and IL-8 with operating time was significant at p < 0.05, gamma = 0.534
      and 0.586, respectively. No correlation was found between blood loss and the peak
      value of IL-6, but significant correlation (gamma = 0.647, p < 0.05) was found
      between them in cirrhotic patients. There was no consistent increase in TNF-alpha
      and IL-1 beta following hepatectomy. These findings indicate that procedures
      undertaken to reduce the excessive production of these cytokines may be useful
      for preventing complications after hepatectomy in cirrhotic patients.

PMID- 7782028
TI  - The interaction between hepatic arterial and portal venous blood flows;
      simultaneous measurement by transit time ultrasonic volume flowmetry.
AB  - Intra-operative measurement of the afferent circulation of the liver, namely
      hepatic artery and portal venous flow was carried out in 14 anesthetized patients
      with carcinoma of the splanchnic area, mainly in the head of the pancreas, by
      means of transit time ultrasonic volume flowmetry. The hepatic artery flow,
      portal venous flow and total hepatic flow were 0.377 +/- 0.10; 0.614 +/- 0.21;
      0.992 +/- 0.2761/min, respectively. The ratio of hepatic arterial flow to portal
      venous flow was 0.66 +/- 0.259. There was a sharp, significant increase in
      hepatic arterial flow (29.8 +/- 6.1%, p < 0.01) after the temporary occlusion of
      portal vein, while the temporary occlusion of the hepatic artery did not have any
      significant effect on portal venous circulation. The interaction between hepatic
      arterial flow and portal venous flow is much in dispute, but, as the data
      presented here show, there is no doubt that the decrease in portal venous flow
      immediately gives rise to a significant increase in hepatic artery circulation.

PMID- 7782029
TI  - Circulating enzyme activities of collagen turnover and undulin in patients with
      various degrees of schistosomiasis and alcoholic liver cirrhosis.
AB  - In contrast to alcoholic liver disease, schistosomiasis leads to presinusoidal
      hepatic fibrosis, which determines the prognosis of the disease. Since
      conventional liver function tests and liver biopsy provide little information
      about the dynamics of the fibrotic process, we measured the activities of two
      circulating enzymes of collagen turnover, namely serum galactosylhydroxylysyl
      glucosyl-transferase and plasma prolidase activity, together with undulin, a
      novel extracellular matrix glycoprotein. The study encompassed 15 healthy control
      subjects. 69 patients with various stages of Schistosoma mansoni/hematobium
      infection [28 with early active infection and no organ involvement, 27 with
      hepatosplenic involvement, and 14 with complications of portal hypertension] and
      16 patients with alcoholic liver cirrhosis. Liver biopsies were obtained from 30
      schistosomal patients for histopathological grading. Serum galactosylhydroxylysyl
      glucosyl-transferase was significantly increased in all clinical stages of
      schistosomiasis (p < 0.05), but normal in alcoholic cirrhosis. In contrast,
      plasma prolidase activity showed a significant increase only in early
      schistosomiasis (p < 0.01), but dropped to subnormal levels in advanced stages (p
      < 0.001). Undulin was highly elevated both in alcoholic patients and in all
      schistosomal groups (p < 0.001), and was capable of distinguishing between early
      and advanced schistosomal stages. We conclude that serum undulin may be a
      valuable non-invasive parameter for monitoring the course of schistosomal and
      alcoholic liver disease.

PMID- 7782030
TI  - Clinical significance of antiphospholipid antibodies in fulminant hepatic
      failure.
AB  - We examined the incidence of antiphospholipid antibodies (APA) in patients with
      fulminant hepatic failure (FHF) and various liver diseases using the enzyme
      linked immunosorbent assay (ELISA), and assessed possible correlations with the
      pathophysiology of these diseases. The APA assay employed cardiolipin (CL),
      phosphatidylserine (PS), and phosphatidylinositol (PI) as antigens. Anti-CL IgA
      antibody was detected in 13/14 (92.9%) patients with FHF. The incidence of anti
      CL-IgG, anti-CL-IgM, anti-PS-IgG, and anti-PI-IgG was 14.3%, 35.7%, 64.3%, and
      71.4%, respectively. Despite the high incidence of APA in FHF, these antibodies
      were not detected in most patients with acute or chronic hepatitis. There was a
      negative correlation between anti-CL-IgA and the platelet count, and a negative
      correlation between anti-PI-IgG and the amount of residual liver parenchyma. Our
      results suggest that APA develop secondarily to hepatocyte or sinusoidal cell
      damage and may aggravate both thrombocytopenia and liver failure.

PMID- 7782032
TI  - Lymph node metastasis and surgical management of gastric cancer invading the
      esophagus.
AB  - In 88 resected patients with esophagus-invading gastric cancer, the factors
      determining the prognosis of this disease were investigated by multivariate
      analysis. Neither, age, sex, macroscopic type, thoracotomy, nor histological type
      proved to be independent prognostic factors. The presence or absence of lymph
      node metastasis, serosal invasion, tumor size, and the extent of esophageal
      invasion were found to be significant independent prognostic factors. Among lymph
      node metastases, involvement of para-aortic lymph nodes was especially important.
      The prognosis was significantly better in cases in which these nodes were
      carefully dissected (R4 gastrectomy), than in cases in which selected dissection
      was performed (R2). However, no patient with mediastinal lymph node metastasis
      survived for any lengthy period, and thus the mediastinal lymph nodes seemed to
      be nodes, the dissection of which brought little effect. Postoperative results
      were very poor in cases in which the extent of the esophageal invasion was 3 cm
      or more. These patients should be treated with multi-modal therapy such as
      neoadjuvant chemotherapy.

PMID- 7782033
TI  - Changes in wound healing factors in liver cirrhosis after esophageal transection
      for esophageal varices.
AB  - Quantitative changes in plasma wound healing factors in cirrhotic patients after
      esophageal transection were evaluated and compared with those of non-cirrhotic
      esophageal cancer patients (controls) after esophageal resection. Serum total
      protein, albumin and fibronectin were maintained at the same levels as those in
      controls when multiple units of fresh frozen plasma and albumin products were
      employed. Nevertheless, the principle protease inhibitors including alpha-1
      antitrypsin and alpha-1-acid-glycoprotein showed little increase by the 3rd
      postoperative day, while those of controls increased as much as twofold at this
      time. Levels of complements C3 and C4 showed consistent depression, with little
      change during the study period. We conclude that the levels of some of the plasma
      proteins essential in wound healing are depressed in cirrhotic patients during
      the critical period after surgery.

PMID- 7782031
TI  - Recombinant a2 interferon (a-IFN) with chemo-hormonal therapy in patients with
      hepatocellular carcinoma (HCC).
AB  - Recent studies on HCC treatment reveal a tendency to use combined immuno-chemo
      therapy. Additionally, new agents have been suggested in this field. We therefore
      studied 7 patients with proven inoperable HCC who were treated in accordance with
      the following protocol, and 5 untreated patients used as controls. Therapeutic
      trial: 1) 1FNa (Roferon): 6 MU x 7 days consecutively every 3 weeks, 2)
      Adriamycin (doxorubicin): 60 mg/m2 i. v. once every 3 weeks (500 mg total dose),
      3) Tamoxifen: 10 mg p.o. twice daily continuously 4) Desferrioxamine (DFO): 500
      mg i.m. daily x 7 days consecutively every 3 weeks, 5) ascorbic acid: 300 mg p.o.
      daily 1 hour after DFO administration x 7 days consecutively every 3 weeks.
      Follow-up studies were performed monthly and comprised clinical, biochemical,
      radiological and immunological (T-cell subsets, NK cells, monocyte-macrophage
      function, IL-2r expression, HLA-DR expression) parameters. Compared with the
      control group, the treated group had a longer survival rate (p < 0.001),
      increased tumor regression and less progressive disease. Immunologically, the
      treated patients with the maintenance of a sufficient immune status were
      associated with a prolonged survival rate. No serious side effects of the regimen
      were observed. In conclusion, IFNa combined with chemohormonal therapy appears to
      be beneficial in HCC patients. In addition, a prolonged survival rate might
      correlate with the maintenance of an adequate immune status in the patients.

PMID- 7782034
TI  - Hepatopancreatoduodenectomy for squamous and adenosquamous carcinoma of the
      gallbladder.
AB  - The characteristics of squamous or adenosquamous cell carcinoma of the
      gallbladder differ quite markedly from those of adenocarcinoma, although the
      incidence is extremely low. Recently, we encountered both of the former types of
      gallbladder carcinoma: a 77-year-old man with squamous cell carcinoma and a 70
      year-old man with adenosquamous cell carcinoma of the gallbladder. Both had a
      large mass in the gallbladder fossa region with infiltration to the liver and
      invasion of the duodenum. Hepatopancreatoduodenectomy was performed on both of
      these patients. The TNM stage of the former was IV (T4N0M0) and of the latter IV
      (T4N0M0) and of the latter IV (T4N1bM0). The former has remained well without
      recurrence for about 1 year and 4 months after the operation, while the latter
      died of recurrent disease 6 months after operation. The true reason for the
      difference in the prognosis of these two patients was not known. However,
      hepatopancreatoduodenectomy is considered to be a most adaptable operative
      procedure for squamous or adenosquamous cell carcinoma of the gallbladder in view
      of their mode of spread, and the presence of lymph node metastasis might be a
      factor of poor prognosis.

PMID- 7782035
TI  - Significance of intraoperative measurement of liver consistency prior to hepatic
      resection.
AB  - The functional reserve of the liver should be estimated prior to hepatectomy.
      While the experienced liver surgeon often relies on the findings of manual
      palpation intra-operatively, this approach remains a subjective one. In 22 of our
      patients scheduled for hepatectomy, we measured intra-operatively hepatic
      consistency as well as the parameters of liver function. Hepatic consistency is
      augmented during progression from non-fibrosis to cirrhosis. We found a
      statistically significant correlation between liver consistency and the
      indocyanine green retention rate at 15 minutes (r = 0.682; p = 0.0009) and portal
      vein pressure (r = 0.733; p = 0.0008). Prothrombin time, the hepaplastin test,
      total bilirubin and glutamic pyruvic transaminase showed no significant
      correlation with hepatic consistency. The safety limits of the hepatic blood
      circulation for the performance of hepatectomy can be estimated using parameters
      of consistency in this organ.

PMID- 7782036
TI  - Ultrasound-guided percutaneous transhepatic gallbladder drainage followed by
      laparoscopic cholecystectomy: a new trial in the treatment of severe acute
      suppurative cholecystitis.
AB  - Seven cases of acute suppurative cholecystitis underwent percutaneous
      transhepatic gallbladder drainage followed by laparoscopic cholecystectomy at the
      Tainan Municipal Hospital. All the patients had frank septic phenomena
      clinically, including fever, jaundice, leukocytosis and unstable blood pressure.
      Organisms were cultured from both blood and bile specimens. Ultrasound-guided
      transhepatic puncture of the gallbladder was performed for bile drainage, and
      laparoscopic cholecystectomy was subsequently performed two to five days later
      after the patients had stabilized. No procedure-related complications from either
      percutaneous transhepatic gallbladder drainage or laparoscopic cholecystectomy
      were observed. All patients had early recovery, shortened hospital stay and good
      cosmetic results. These preliminary results show that laparoscopic
      cholecystectomy is a safe method and can be employed in those patients with
      symptomatic gallstone associated with suppurative cholecystitis after
      preoperative biliary drainage.

PMID- 7782037
TI  - Exocrine pancreatic function after recovery from necrotizing pancreatitis.
AB  - The aim of the present study was to investigate the exocrine pancreatic function
      after recovery from necrotizing pancreatitis. The exocrine function was analysed
      in 53 patients who had recovered from their first attack of necrotizing
      pancreatitis. In a group of 23 patients (Group A), three follow-up studies were
      performed between four weeks and 12 months after recovery from acute
      pancreatitis. A second group of 30 patients (Group B) was submitted to only one
      function test 18 months after recovery from acute necrotizing pancreatitis.
      Exocrine pancreatic function was observed after endogenous stimulation using the
      Lundh test meal. In Group A, after four weeks 74% of the patients had mild-to
      moderate insufficiency, while 26% suffered from severe impairment of pancreatic
      function. Twelve months after recovery, only 16% of the patients showed a normal
      pancreatic response, while 84% still had pancreatic insufficiency of variable
      severity. In Group B, 13% of the patients showed a normal pancreatic response,
      while mild-to-moderate insufficiency was observed in 81%. Severe pancreatic
      insufficiency was measured only in 6% of these patients. After recovery from
      necrotizing pancreatitis persistent global or dissociated functional
      insufficiency is found in 80-85% of the cases. Individual pancreatic enzyme
      secretion varies quiet considerably during the course of recovery in the follow
      up period.

PMID- 7782038
TI  - Duodenal variceal bleeding--successfully treated by mesocaval shunt after failure
      of sclerotherapy.
AB  - A 68-year-old male patient with liver cirrhosis and bilateral diffuse hepatoma
      presented with massive upper gastrointestinal bleeding caused by rupture of
      duodenal varices. Surgery had to be performed after sclerotherapy failed to stop
      the bleeding. A mesocaval shunt with graft interposition controlled the
      hemorrhage. Follow-up endoscopic examination showed complete disappearance of the
      varices. After surgery, the patient had two episodes of mild hepatic
      encephalopathy, which easily responded to treatment. There was no rebleeding, and
      he died of hepatic malignancy ten months after the shunt procedure.

PMID- 7782039
TI  - Multiparametric evaluation of functional outcome after pylorus-preserving
      duodenopancreatectomy.
AB  - The aim of the present study was to evaluate the clinical, morphological and
      functional results obtained in a group of patients previously submitted to
      Traverso-Longmire pylorus-preserving duodeno-pancreatectomy (PPDP). The study was
      performed as a clinical, endoscopic, radioisotopic and electro-manometric
      evaluation. An analysis of the results allowed us to conclude that: 1) most
      patients show good clinical features, and this becomes more evident as post
      operative time progresses; 2) bile reflux gastritis is an infrequent event; 3)
      gastric emptying times in patients overlap those seen in control subjects, and
      progressive normalization occurs postoperatively. The best clinical results
      coexist with normal gastric emptying times; 4) gastrojejunal interdigestive motor
      activity shows a reduction in phase 3 and a relative increase in phase 2. We
      argue that the motor activity of the upper gastrointestinal tract can restore,
      from a functional point of view, the new anatomical situation. On the basis of
      the good clinical and functional results, pyloric preservation seems to be the
      most physiological procedure for the restoration of alimentary continuity
      following duodenopancreatic resection.

PMID- 7782040
TI  - Liver involvement and its course in patients operated on for ulcerative colitis.
AB  - The prevalence of associated liver involvement in 214 patients with ulcerative
      colitis undergoing definitive surgery was evaluated, with special emphasis on the
      subsequent course of liver changes. At the time of colectomy or proctocolectomy
      45 patients (21%) had more than transient liver involvement, and 13 (6.1%)
      fulfilled the criteria of primary sclerosing cholangitis (PSC). Of the other 32
      patients with minor liver involvement four had steatosis, one chronic active
      hepatitis, one viral A hepatitis, and 14 possibly early sclerosing cholangitis or
      unspecific reactive hepatitis. During a mean follow-up of nine years, four
      patients with PSC (31%) showed clinical progression, but none of those with minor
      histological changes or those with no liver disease at surgery did so. Alkaline
      phosphatase levels showed a decreasing tendency, and minor histological changes
      improved after surgery, while repeated cholangiography mostly demonstrated
      progression or a static state. The results indicate that asymptomatic sclerosing
      cholangitis in association with ulcerative colitis is not always a progressive
      disease, and proctocolectomy may have a beneficial effect on the long-term course
      of sclerosing cholangitis in its early phase.

PMID- 7782041
TI  - The influence of age on the management of anal cancer.
AB  - The standard treatment for anal cancer is combination chemo-radiotherapy.
      Management decisions such as radical chemotherapy, resective surgery for poor
      response or relapse are frequently modified by age-associated comorbid factors.
      Between 1980 and 1990, our regional cancer center serving a population of 1.8
      million saw 78 patients with squamous carcinoma of the anus. We have compared
      patients who were younger than 65 years (n = 38) with those older than 65 years
      (n = 38). The mean +/- standard deviation age for the whole cohort was 65 +/- 12
      years, with a ratio of 2 females to each male presenting. Fewer of the elderly
      age group had major surgery (26% vs. 42%) (p = 0.03), and fewer suffered no
      toxicity (42% vs. 26%) (p = 0.03). However, 61% of the under-65-year age group
      are alive disease-free vs. 26% of the elderly group (p = 0.03). Similarly, only
      18% of the under-65-year group died with disease compared with 37% of the elderly
      group (b = 0.03). For the series as a whole, the crude mortality was 42%, with
      27% dying of their disease. The stage distribution, and the amount of
      radiotherapy or chemotherapy administered was not age-specific, but younger
      patients had more surgery and suffered more toxicity, with a greater proportion
      remaining alive and disease-free, and fewer dying of their disease. These data
      suggest that a more aggressive multi-modality approach in the elderly may improve
      disease response and survival.

PMID- 7782042
TI  - Spontaneous perforation of the left hepatic duct--a case report.
AB  - We report on a patient with spontaneous perforation of the left hepatic duct who
      presented with abdominal pain, jaundice and fever. The correct diagnosis was not
      established until extravasation of contrast medium from the left hepatic duct, as
      demonstrated by the cholangiogram, was observed. The patient developed two bile
      stained intraperitoneal encapsulated fluid collections, which were diagnosed by
      ultrasonography, and high bilirubin levels in the fluid aspirated from the
      encapsulations, which were also found at operation. Closure of the perforation
      with sutures, decortication of the encapsulations and choledocholithotomy for
      stone extraction with T-tube insertion were performed. Recovery was complete at
      follow-up examinations.

PMID- 7782043
TI  - Subulcerous fibrin gluing represents a further effective endoscopic therapy for
      the treatment of bleeding ulcer.

PMID- 7782044
TI  - Recurrence near the resection line of hepatocellular carcinoma in the
      anterosuperior subsegment of the liver--the effect of the argon beam coagulator.
AB  - The present paper examines the relationship between the patterns of intrahepatic
      recurrence after resections of hepatocellular carcinoma and surgical margins in
      cases located in the anterosuperior subsegment of the liver. In 95 curative
      resections of the liver for hepatocellular carcinomas less than 5 cm in size, 29
      tumors were located in the anterosuperior subsegment of the liver. The recurrence
      rates of tumors in the anterosuperior subsegment and other regions were 16/29
      (55.2%) and 39/66 (59.1%), respectively. Recurrences near the resection line were
      significantly more common in the anterosuperior subsegment (6/29) than in other
      regions (2/66) of the liver (P < 0.05). The surgical margin from the tumor edge
      to the resection line was significantly shorter in tumors of the anterosuperior
      subsegment (4.6 +/- 9.7 mm) than in those of other regions (9.7 +/- 10.6 mm) (P <
      0.01). The effect of an argon beam tissue coagulator was also examined in rat
      livers. Exposure to an argon beam tissue coagulator for 10, 30 and 60 seconds at
      a power setting of 100 watts was capable of burning out tissue to a depth of 6.0,
      10.5 and 13.3 mm from the resection line of the rat liver, respectively. An
      exposure of 10 seconds is thought to be sufficient to destroy any microscopic
      residues of malignant cells near the resection line. Thus, an argon tissue
      coagulator could potentially be of value for the prophylaxis of recurrence near
      the resected surface.

PMID- 7782045
TI  - Bone mineral density in children and adolescents with juvenile diabetes:
      selective measurement of bone mineral density of trabecular and cortical bone
      using peripheral quantitative computed tomography.
AB  - Bone mineral density (BMD) was studied in 21 children and adolescents with type I
      diabetes and in age- and sex-matched healthy controls. BMD was selectively
      measured in trabecular and total bone using peripheral quantitative computed
      tomography (pQCT). Cortical bone density was calculated. There was a decrease of
      trabecular bone density (-18.9%, p < 0.01), total bone density (-9.0%, NS) and
      cortical bone density (-5.1%, NS) in diabetes. Trabecular bone density was
      inversely correlated with the duration of diabetes and the concentration of
      glycosylated hemoglobin (HbA1) (r = -0.48, p = 0.027 and r = -0.63, p = 0.002,
      respectively). Total BMD correlated inversely with HbA1 (r = -0.52, p = 0.017).
      pQCT allows the selective measurement of metabolically active trabecular bone
      where changes of mineralization first occur. We conclude that pQCT is a useful
      method for investigating BMD in diabetes.

PMID- 7782046
TI  - Alcohol inhibits 11-beta-hydroxysteroid dehydrogenase activity in rat kidney and
      liver.
AB  - Male Wistar rats were treated with different ethanol concentrations diluted in
      drinking water in order to evaluate the effect of acute ethanol intoxication on
      11 beta-hydroxysteroid dehydrogenase (11 beta-OHSD) activity in liver and kidney
      tissue homogenates. Rats with the highest ethanol consumption (15% ethanol
      supplementation) showed a significant decrease in both hepatic and renal 11 beta
      OHSD activity as compared to the control group (p < 0.005). In the same group,
      aldosterone plasma levels were significantly lower than in controls (p < 0.01),
      while corticosterone (B) plasma levels were slightly higher, suggesting that the
      increase in intrarenal B concentrations, probably related to the acute ethanol
      consumption, might be responsible for a nonspecific B mineralocorticoid activity.

PMID- 7782047
TI  - Age-related changes in plasma corticosterone and aldosterone responses to
      exogenous ACTH in the rat.
AB  - Age related changes in the time courses of response of plasma corticosterone and
      aldosterone to exogenously applied ACTH were simultaneously studied in old
      (female and male) Long-Evans rats and compared to both young and adult
      pentobarbitone-anesthetized and dexamethasone-pretreated control rats. Acute
      intravenous injection of either 0.5 or 50.0 ng ACTH (1-24)/100 g body weight
      increased plasma concentrations of the two steroids with a similar time course in
      all groups of rats. However, we observed a significant age-related attenuation in
      the plasma corticosteroid response. Thus, in old as compared to young rats there
      was a decrease of approximately 45, 40 and 30% in plasma corticosterone levels
      respectively 8 min after the lower dose of ACTH in female and 45 min after the
      higher dose in female and male rats. Similarly, an attenuated (approximately 
      38%) response of plasma aldosterone levels, induced 45 min after the higher dose
      of ACTH, was observed both in old female and male rats. These results suggest
      that the previously reported age-related decreases of in vivo corticosterone and
      aldosterone secretion are, at least in part, due to a reduced capacity of
      adrenocortical cells for steroid biosynthesis and release in response to
      stimulation by ACTH.

PMID- 7782048
TI  - Efficacy of growth hormone replacement therapy in children with organic growth
      hormone deficiency after cranial irradiation.
AB  - We evaluated the growth response of 20 childhood cancer survivors who received
      growth hormone (GH) replacement therapy (0.3 mg/kg/week) for at least 12 months.
      In all subjects, GH deficiency was associated with cranial irradiation and was
      documented with growth charts, bone age, and somatomedin C levels; at least one
      GH stimulation test was available for 14 children. Pretreatment overall growth
      velocity was 3.3 +/- 0.5 cm/year (mean +/- SE) over a 3-year period. After GH
      replacement, growth velocity was 8.6 +/- 0.6 cm/year during the first year (n =
      20), 7.2 +/- 0.5 cm/year during the second year (n = 17), 5.9 +/- 0.6 cm/year
      during the third year (n = 11), and (6.1 +/- 0.6 cm/year during the fourth year
      (n = 7). Growth response, tabulated by age at onset of GH replacement, was
      compared with the response in GH-naive children with idiopathic GH deficiency
      (data obtained through the Genentech Inc. National Cooperative Growth Study
      Summary, September 1991); the growth velocity fell within the range described for
      idiopathic GH deficiency adjusted for either chronological or bone age. We
      conclude that children with GH deficiency after cranial irradiation for
      neoplastic diseases respond to GH replacement therapy as well as children with
      idiopathic GH deficiency.

PMID- 7782049
TI  - Enhanced nocturnal melatonin secretion in women with functional secondary
      amenorrhea: relationship to opioid system and endogenous estrogen levels.
AB  - The purpose of this study was to evaluate the role of the opioid system and the
      estrogen environment in the nocturnal secretion of melatonin in women with
      secondary amenorrhea (SA). Nocturnal melatonin concentrations in patients with SA
      were significantly higher than in normal women (p < 0.01 vs. women with normal
      menstrual cycles). There were significant negative correlations between
      cumulative melatonin levels (between 8 p.m. and 8 a.m.) and serum estradiol-17
      beta (r = -0.561, p < 0.01) and between peak serum melatonin values and serum
      estradiol-17 beta concentrations (r = -0.608, p < 0.01) in SA. Intravenous
      administration of a conjugated estrogen (Premarin 20 mg) significantly suppressed
      nocturnal melatonin secretion (p < 0.05), but a continuous intravenous infusion
      of naloxone (1.6 mg/h from 8 p.m. to 6 a.m.), an opiate antagonist, did not
      affect nocturnal melatonin secretion in SA. Our findings suggest that elevated
      nocturnal melatonin secretion may be related to low estrogen levels, but that it
      is not mediated by the opioid system.

PMID- 7782050
TI  - Auditory brainstem responses in thyroid diseases before and after therapy.
AB  - The aim of this study was to evaluate through the auditory brainstem responses
      (ABRs) the electrical events generated along the auditory pathway in 56 adult
      patients affected with hyper- and hypothyroidism. Twenty-four normal-hearing
      hyperthyroid patients affected with Graves' disease and 32 normal-hearing
      hypothyroid patients (9 with subclinical and 23 with overt hypothyroidism) were
      subjected to standard (clicks at 21 pps) and sensitized ABR with masking wide
      band (masking noise). In addition, thyroid scintiscan and ultrasonography, free
      T3 and T4, total T3 and T4, TSH, antimicrosomal and antithyroglobulin antibodies,
      audiogram and impedance tests were performed in all the patients. This study was
      repeated after 6-12 months of treatment in conditions of euthyroidism. The
      results showed changes of ABRs both in the standard procedure as well as in the
      sensitized test in 6 hyperthyroid (25%) and 8 hypothyroid patients (25%). All the
      patients with abnormal ABRs had overt hypothyroidism (8/23; 34.7%). The ABRs
      became normal in 5 out of 6 Graves' patients after 6-12 months of methimazole
      treatment. ABRs remained abnormal in all the hypothyroid patients despite their
      having been on L-thyroxine treatment for 6-12 months and were euthyroid for at
      least 5 months before the study was repeated. These findings suggest that ABR
      abnormalities are indicative only of a nonspecific injury in the bulbo-ponto
      mesencephalic centers. Alterations of ABRs in thyroid diseases are not specific
      in relation to hyper- or hypothyroidism. Lastly, there is a relationship between
      ABR abnormalities and the degree of hypothyroidism, even if ABR alterations are
      not always reversible after long-term therapy.

PMID- 7782051
TI  - Low serum levels of tumor necrosis factor-alpha in insulin-dependent diabetic
      children.
AB  - We measured serum levels of tumor necrosis factor-alpha (TNF-alpha) in 48
      children with insulin-dependent diabetes mellitus (IDDM), divided into two groups
      according to disease duration (group I < 6 months and group II > 3 years): group
      I 15 patients, aged 2.2-13.7 years, and group II 33 patients, aged 4.5-25.5
      years. Thirty-six age- and sex-matched healthy subjects served as controls. TNF
      alpha levels were measured by immunoradiometric assay. We found that TNF-alpha
      levels were lower in all IDDM patients (29.65 +/- 3.83 pg/ml) than in controls
      (74.74 +/- 10.17 pg/ml) (p < 0.0001), as well as in group I (24.07 +/- 3.65
      pg/ml) and group II (32.16 +/- 5.29 pg/ml) as compared to controls (p < 0.001).
      TNF-alpha levels were significantly lower in patients with antibodies than in
      those without antibodies and in controls. Similar results were found in
      longstanding IDDM patients. No correlation was found between serum TNF-alpha and
      chronologic age, duration of disease, metabolic control, insulin requirement and
      HLA typing. During a 1-year follow-up study in 12 group I patients no significant
      variations in TNF-alpha levels were observed. It has been reported that the
      administration of exogenous TNF suppresses the development of diabetes in
      nonobese diabetic mice, low producers of endogenous TNF. The results suggest that
      aberrant TNF-alpha synthesis may contribute to immune dysregulation thus favoring
      the development of autoimmune diseases.

PMID- 7782052
TI  - Alternation of hypo- and hypercalcemia in a parathyroidectomized patient with
      breast cancer.
AB  - We report the case of a 54-year-old female patient with postoperative
      hypoparathyroidism. Despite the fact that she was receiving calcitriol
      replacement therapy, following the appearance of bone metastases due to breast
      cancer she developed severe crises of hypo- and hypercalcemia.

PMID- 7782053
TI  - Hormonal, genetic and clinical findings in an XX male.
AB  - A 17-year-old XX male with constitutional delay of growth and development and
      genetic short stature is described. Testosterone levels were normal but
      luteinizing-hormone-releasing-hormone-stimulated gonadotropin concentrations were
      increased. Testicular biopsy showed atrophic tubuli seminiferi and hyperplasia of
      the Leydig cells, and the spermiogram indicated azoospermia. Molecular analysis
      demonstrated the SRY gene close to the centromere of the paternally derived X
      chromosome. Clinical data in addition to the cytogenetic and molecular aspects
      are discussed.

PMID- 7782054
TI  - Gonadotrophin control of follicular function.
AB  - It has been known for over 50 years that both follicle-stimulating hormone (FSH)
      and luteinizing hormone (LH) are required to stimulate both follicular
      development and oestradiol synthesis. However, previous experiments employing FSH
      and LH preparations (whether of pituitary or urinary origin) have not been able
      to answer unequivocally, whether an observed response was solely due to either
      FSH or LH because they were not pure preparations. In view of the recent
      availability of both 100% pure recombinant human FSH and recombinant human LH, we
      now have a unique opportunity to test their contribution in the regulation of
      ovarian function. Such experiments may have important clinical implications as
      they offer a means to interpret the effect of 'pure' FSH preparations when used
      to stimulate ovarian function in women undergoing different therapeutic regimens.
      To test the contribution of LH to optimize ovarian responsiveness to FSH, 21-day
      old hypophysectomized, immature, female rats were treated for a 2-day period with
      varying total doses of rec-FSH (30-72 IU and/or rec-LH at 12-hourly intervals. At
      48 h after the first injection, ovaries were removed, weighed and used to isolate
      granulosa and thecal interstitial cells for assessment of basal and gonadotrophin
      responsive steroidogenesis in vitro; homogenized to extract total RNA for
      Northern analysis of 17-hydroxylase/C17-20-lyase (cytochrome P-450C17); mRMA; or
      examined using in situ hybridization to determine the expression of P-450C17 in
      the rat graafian follicle. The experiments demonstrated the potential for rec-FSH
      to influence LH-responsive androgen synthesis (via a paracrine mechanism) which
      involves an up-regulation of thecal P-450C17 mRNA.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7782055
TI  - Follicle-stimulating hormone versus human menopausal gonadotropin for in vitro
      fertilization: results of a meta-analysis.
AB  - The observation of adverse effects of high-follicular-phase LH levels on
      fertilization, cleavage, embryo quality and pregnancy suggests that exogenous LH
      administration for ovarian stimulation in IVF may also be detrimental. The
      purpose of this study was to compare the use of FSH with hMG in IVF by conducting
      a systematic overview and meta-analysis of the evidence in the literature from
      randomized trials comparing the two gonadotropins. The data were extracted and
      pooled from eight studies that satisfied the inclusion criteria. The results show
      that FSH performs significantly better than hMG and is associated with at least
      50% higher clinical pregnancy rates.

PMID- 7782056
TI  - Experience using preparations of follicle-stimulating hormone alone to stimulate
      the ovaries for assisted conception after pituitary desensitisation and
      simplified management of treatment.
AB  - The results are reported of 2,204 cycles of treatment started for in vitro
      fertilisation and embryo transfer or gamete intrafallopian transfer, during 5
      years, 1990-1994, using only follicle-stimulating hormone (FSH) preparations to
      stimulate the ovaries following pituitary desensitisation, combined with greatly
      simplified scheduling and monitoring of treatment. The physiological principles
      underlying these choices are discussed. In all women under 40 years of age and
      men with normal sperm, the use of unpurified urinary FSH in 1990-1993 resulted in
      oocyte collection in 94% of cycles started, pregnancy in 29% and live births in
      23%. Using highly purified urinary FSH (uFSH-HP; Metrodin HP) during 1994, the
      rate for oocyte collection was 97% and pregnancy 25% (birth rates not yet
      available). The difference compared with previous years was not significant. A
      study of 93 first cycles using uFSH-HP showed that the dosage required was
      usually (expressed as medians) 24 ampoules over 12 days (2 ampoules/day)
      resulting in 9 oocytes (range 2-36) of which 93% were mature and 64% resulted in
      cleaving embryos. The results are comparable with the best using human menopausal
      gonadotropin or unpurified FSH and classical detailed monitoring.

PMID- 7782057
TI  - Results from in vitro fertilization and intracytoplasmic sperm injection with
      purified gonadotrophins (Metrodin HP).
AB  - Purified urinary follicle-stimulating hormone (uFSH-HP; Metrodin HP, Serono Ltd.)
      was compared with a combination of pure FSH and human menopausal gonadotrophin
      (hMG; Pergonal, Serono Ltd.) in patients undergoing standard in vitro
      fertilization (IVF) or intracytoplasmic sperm injection (ICSI). In standard IVF,
      pure FSH gave a significantly higher pregnancy rate per started cycle than did
      the combination with hMG (35 vs. 18%, p < 0.05). No differences between standard
      IVF and ICSI were seen which could be associated with hormonal stimulation in an
      open non-randomized series of patients. In 11 ICSI cycles, the use of recombinant
      FSH (Gonal F, Serono Ltd.) resulted in 4 ongoing pregnancies.

PMID- 7782058
TI  - The role of conditioned taste aversion in the hypophagia induced by
      intraperitoneal epinephrine and glucose.
AB  - It has been repeatedly shown that relatively high doses of epinephrine (E) and
      glucose (G) injected intraperitoneally (ip) produce hypophagia in fasted rats. In
      the present work we used a conditioned taste aversion (CTA) paradigm in order to
      test whether this effect could be due to "malaise." We determined the effect on
      food intake and saccharin preference with the following treatments: (a) E ip 100
      and 250 micrograms/kg; (b) E ip 250 micrograms/kg with or without previous alpha
      1 plus beta adrenergic blockade; (c) G ip 3.5 and 4 g/kg. Both doses of E
      significantly reduced food intake more than 75% but only the high dose produced a
      significant (50%) reduction in saccharin preference. Blockade of alpha 1 and beta
      adrenergic receptors completely suppressed the E-induced hypophagia but
      attenuated only slightly the taste aversivon effect. Both doses of G decreased
      food intake but only the high dose reduced saccharin preference; part of these
      effects would appear to be due to the high osmolarity of the solution. The
      present results indicate that E and G may induce CTA in our experimental
      conditions. However, their hypophagic and aversive effects seem to be elicited by
      different mechanisms.

PMID- 7782059
TI  - Gonadal hormone levels and spatial learning performance in the Morris water maze
      in male and female meadow voles, Microtus pennsylvanicus.
AB  - The present study examined the relationships between spatial learning and
      circulating levels of plasma estradiol and testosterone in adult male and female
      meadow vole, Microtus pennsylvanicus. Meadow voles are induced ovulators and most
      females that are housed with females or in isolation are in constant diestrus,
      whereas most females that are housed with males are in constant behavioral
      estrus. In this study sexually mature, adult male and female meadow voles housed
      with either females (constant diestrus) or males (constant behavioral estrus)
      were required to learn the spatial position of a hidden, submerged platform in
      the Morris water maze. Individual voles were tested using two blocks of four
      trials twice a day for 3 days for a total of six blocks. Task retention was
      examined with a probe trial 1 day after the last acquisition trial. Females were
      divided into two groups based on the median level of plasma estradiol [High
      Estradiol (15.79 +/- 1.20 pg/ml) and Low Estradiol (6.22 +/- 2.79 pg/ml)
      Females]. Males were similarly divided on the basis of median plasma testosterone
      levels [High (2.53 +/- 0.96 ng/ml) and Low Testosterone (0.45 +/- 0.08 ng/ml)
      Males]. High Estradiol females exhibited significantly longer latencies to reach
      the hidden platform, indicating poorer acquisition, than did either males (P =
      0.025) or Low Estradiol females (for Blocks, 2, 3, 4, and 6, P = 0.037). Male
      superiority in spatial learning performance was evident only when High Estradiol
      females were compared to males. There were no significant performance differences
      between High and Low Testosterone males. There were also no group differences in
      retention, with all voles displaying significant retention of the spatial task.
      There was, however, a significant correlation between plasma estradiol levels in
      females and retention, with higher estradiol levels being associated with poorer
      retention. These results suggest that levels of estradiol in adult female meadow
      voles are significantly related to spatial learning, with low levels of estradiol
      being associated with better spatial learning. There was no evidence that levels
      of testosterone were related to spatial performance in adult male meadow voles.
      The results suggest that estradiol may have activational effects on spatial
      learning in the adult meadow vole and that sex differences in spatial learning
      are evident only when High Estradiol females are compared to adult males.

PMID- 7782060
TI  - Hormonal correlates of breeding status, nest construction, and parental care in
      multiple-brooded northern mockingbirds, Mimus polyglottos.
AB  - Blood samples were taken from free-living male and female mockingbirds to
      determine correlations between plasma steroids and breeding behavior. Plasma
      levels of testosterone (T), estradiol (E2), progesterone (P), and corticosterone
      (B) were assessed during pre-breeding courtship, while males built nests, while
      females incubated, while parents fed young, and while males built new nests as
      pairs continued to care for dependent fledglings. Samples were also taken from
      unmated males holding spring territories. In males, T and P fluctuated with
      breeding phase, and in all groups, male T levels exceeded basal values measured
      in autumn. But, when mated males built nests in the absence of young, T levels
      were higher than in all other conditions, though only for early broods. In
      females too, T and P levels changed with breeding phase; T levels rose during
      courtship and while males built first nests and were intermediate during nest
      construction for later broods. Male and female P levels rose during courtship and
      when males built nests with young present. While feeding young in the nest, males
      showed significantly higher corticosterone levels than females, though in
      females, both P and B levels increased during incubation for replacement broods.
      These findings strengthen an earlier finding that T may activate male nest
      construction, and they suggest that breeding behavior may be related to T in
      females as well. Progesterone data raise the possibility that P too, may be
      linked to breeding behavior in male and female mockingbirds. Sex differences in
      corticosterone levels during the nestling period may reveal subtle costs
      associated with male mockingbirds' highly aggressive defense against predators.

PMID- 7782061
TI  - A comparison of LH secretion and brain estradiol receptors in heterosexual and
      homosexual rams and female sheep.
AB  - This study examined endocrine components of sexual orientation of male sheep.
      Sexual orientation of adult rams was identified through standardized sexual
      performance tests. Four rams that copulated with ewes, four rams that never
      mounted females and copulated with males, and eight ewes were used in the
      experiments. Exogenous estradiol benzoate (50 micrograms, i.m.) stimulated (P <
      .05) a preovulatory-like LH surge 16-22 hr after administration to females.
      Estradiol did not (P > .05) affect LH release of heterosexual or homosexual rams.
      Thirty days after the estradiol challenge, sheep were euthanized and areas of the
      amygdala (AMY), hypothalamus (HYP), anterior pituitary (AP), and preoptic area
      (POA) of the hypothalamus were collected. Occupied and unoccupied content of
      estradiol receptors (ER) was determined. The content of ER in the amygdala of
      both homosexual rams and ewes was similar, but less than (P < .05) the content of
      ER in heterosexual rams. The ER content measured in other brain regions did not
      differ by sex or orientation. In summary, results from these data show that the
      preovulatory LH surge mechanism that is a characteristic of the female does not
      occur in either homosexual or heterosexual rams. Conversely, the ER content of
      the AMY of homosexual rams is similar to that of ewes and differs from the
      heterosexual male. Differences in ER content between heterosexual and homosexual
      rams imply that the amygdala serves as a link for input from potential mates.
      These data suggest that the amygdala not only plays a role in sexual behavior but
      may be involved in sexual orientation of rams.

PMID- 7782062
TI  - Peripheral and intracerebroventricular administration of human chorionic
      gonadotropin alters several hippocampus-associated behaviors in cycling female
      rats.
AB  - Our recent demonstration of receptors for luteinizing hormone (LH)/human
      chorionic gonadotropin (hCG) in rat brain with the highest density within the
      hippocampus and dentate gyrus suggests novel functional roles for gonadotropic
      hormones within the brain. The present study investigated whether 125I-hCG can
      cross the blood-brain barrier and reach hippocampus and the possible role of hCG
      in the regulation of several behavioral activities associated with the
      hippocampal formation in the rat. About 1/100th of peripherally injected 125I-hCG
      crossed the blood-brain barrier in an intact form and was found in cerebrospinal
      fluid and in hippocampus. Intraperitoneal (IP) or intracerebroventricular (ICV)
      injections of highly purified hCG on the morning of proestrus of cycling female
      rats resulted in changes in several hippocampus-associated behaviors. hCG-treated
      animals were generally less active and showed less exploratory behavior as
      compared to saline-injected control animals. There was no difference, however, in
      latency to enter the open field between hCG-treated and control animals. Taste
      neophobia was dramatically decreased following IP as well as ICV injection of
      hCG. No differences were found in the memory component of T-maze performance;
      however, the hCG-treated rats exhibited decreased stereotypic behavior. In
      summary, hCG can cross the blood-brain barrier, and peripheral or central
      administration of hCG affects several hippocampus-associated behaviors suggesting
      that hippocampal LH/hCG receptors are most likely involved in mediating these
      effects. Some of the observed behavioral changes have parallels in pregnant
      women.

PMID- 7782063
TI  - Oxytocin changes in males over the reproductive cycle in the monogamous,
      biparental California mouse, Peromyscus californicus.
AB  - Levels of plasma oxytocin in male Peromyscus californicus were assessed across
      the reproductive cycle to provide a foundation for subsequent studies of the
      hormonal basis of paternal behavior and pair bonds. In Experiment 1, plasma
      oxytocin levels were significantly higher in expectant fathers than in virgin
      males or fathers. Plasma oxytocin increased in expectant fathers 1 day
      postcopulation and remained elevated for the first 15 days of gestation. Plasma
      oxytocin declined by Day 20 of gestation and oxytocin levels remained low in
      fathers throughout the lactational period. Oxytocin levels among expectant
      fathers did not differ between parental and nonparental males or between
      infanticidal and noninfanticidal males, suggesting that plasma oxytocin may not
      be involved in the prepartum onset of paternal behavior or the inhibition of
      infanticide. In Experiment 2, plasma oxytocin levels also did not differ between
      males that were parental or non-parental prepartum or postpartum. However, males
      separated from their mate and pups on the day of birth had elevated oxytocin
      levels on Day 3 postpartum compared to males that remained with their family,
      suggesting that disruption of the pair bond and/or absence of the young affects
      plasma oxytocin levels in males. This possibility remains to be determined.

PMID- 7782064
TI  - Central angiotensin II induces thirst-related responses in an amphibian.
AB  - Angiotensin II (A-II), a potent inducer of thirst-related behavior in many
      vertebrate species, was injected into the third ventricle of the brain of the
      spadefoot toad, Scaphiopus couchii. Following injection of 10 ng A-II the animals
      demonstrated a significant increase in water absorption response (WR) behavior,
      in which toads press their ventral skin to a moist surface and absorb water by
      osmosis. This increase in the frequency of WR behavior was positively correlated
      with an increase in water gain during a 2-hr period indicating that centrally
      injected A-II stimulates water intake by this amphibian species. We have
      previously demonstrated that WR behavior is also induced by intraperitoneal
      (i.p.) injections of A-II in several anuran species, including S. couchii. Thus,
      amphibians, like other vertebrates, demonstrate an increase in water intake in
      response to either centrally administered or circulating A-II. A second series of
      experiments was conducted to determine whether the above response to A-II might
      be secondary to increases in the circulating levels of aldosterone (ALDO) or
      antidiuretic hormone because the release of both of these hormones has been shown
      by others to be stimulated by A-II. Scaphiopus couchii injected i.p. with either
      ALDO or arginine vasotocin in dosages of 1, 10, and 100 micrograms/100 g body
      weight showed no increase in WR behavior relative to toads injected with saline
      alone. These results suggest that A-II acts directly on the brain of S. couchii
      to induce WR behavior.

PMID- 7782065
TI  - Hormonal responses to aggression vary in different types of agonistic encounters
      in male tree lizards, Urosaurus ornatus.
AB  - Hormonal responses to male-male interactions have been detected in some studies
      of vertebrates but not others. One hypothesis that may partially explain these
      discrepancies is that differences in the duration of male-male interactions cause
      different hormonal responses. In social systems based on dominance-subordinance
      hierarchies interactions often last longer than if exclusive territories are
      maintained. Tests of the hypothesis that encounter duration explains
      discrepancies in hormonal responses would be facilitated by a species that shows
      elements of both types of social systems, such as species in which males practice
      alternative reproductive tactics. We compared plasma levels of corticosterone and
      testosterone in males of the territorial morph of the tree lizard (Urosaurus
      ornatus) subjected either to short (15 min) male-male encounters or to long (7
      days) dominance interactions. In the long interactions, dominant males had lower
      levels of corticosterone than did subordinate males over the first day, but this
      difference subsequently disappeared. In sharp contrast, winners of short-term
      encounters had elevated plasma corticosterone levels which peaked the day after
      the encounter. Thus, males isolated after a short encounter experienced an
      increase in corticosterone that was apparently inhibited in males who continued
      interacting with other males. The delayed increase in corticosterone after a
      short encounter may facilitate metabolic recovery from the encounter, mobilize
      metabolic substrates useful in subsequent encounters, or may alter subsequent
      behavior. The response does not appear to be simply recovery from exercise
      because in a second experiment males exercised for 15 min did not show a similar
      delayed increase in corticosterone the following day. Testosterone levels were
      also monitored and did not change in any of these treatments. These results
      demonstrate that the duration and the outcome of male-male interactions may each
      independently influence hormone levels.

PMID- 7782066
TI  - Genomic organization of the human PAX3 gene: DNA sequence analysis of the region
      disrupted in alveolar rhabdomyosarcoma.
AB  - Mutations in the human PAX3 gene have previously been associated with two
      distinct diseases, Waardenburg syndrome and alveolar rhabdomyosarcoma. In this
      report we establish that the normal human PAX3 gene is encoded by 8 exons. Intron
      exon boundary sequences were obtained for PAX3 exons 5, 6, 7, and 8 and together
      with previous work provide the complete genomic sequence organization for PAX3.
      Difficulties in obtaining overlapping genomic clone coverage of PAX3 were
      circumvented in part by RARE cleavage mapping, which showed that the entire PAX3
      gene spans 100 kb of chromosome 2. Sequence analysis of the last intron of PAX3,
      which contains the previously mapped t(2;13)(q35;q14) translocation breakpoints
      of alveolar rhabdomyosarcoma, revealed the presence of a pair of inverted Alu
      repeats and a pair of inverted (GT)n-rich microsatellite repeats within a 5-kb
      region. This work establishes the complete structure of PAX3 and will permit high
      resolution analyses of this locus for mutations associated with Waardenburg
      syndrome, alveolar rhabdomyosarcoma, and other phenotypes for which PAX3 may be a
      candidate locus.

PMID- 7782067
TI  - The human archain gene, ARCN1, has highly conserved homologs in rice and
      Drosophila.
AB  - A novel human gene, ARCN1, has been identified in chromosome band 11q23.3. It
      maps approximately 50 kb telomeric to MLL, a gene that is disrupted in a number
      of leukemia-associated translocation chromosomes. cDNA clones representing ARCN1
      hybridize to 4-kb mRNA species present in all tissues tested. Sequencing of cDNAs
      suggests that at least two forms of mRNA with alternative 5' ends are present
      within the cell. The mRNA with the longest open reading frame gives rise to a
      protein of 57 kDa. Although the sequence reported is novel, remarkable similarity
      is observed with two predicted protein sequences from partial DNA sequences
      generated by rice (Oryza sativa) and fruit fly (Drosophila melanogaster) genome
      projects. The degree of sequence conservation is comparable to that observed for
      highly conserved structural proteins, such as heat shock protein HSP70, and is
      greater than that of gamma-tubulin and heat shock protein HSP60. A more distant
      relationship to the group of clathrin-associated proteins suggests a possible
      role in vesicle structure or trafficking. In view of its ancient pedigree and a
      potential involvement in cellular architecture, we propose that the ARCN1 protein
      be named archain.

PMID- 7782068
TI  - Localization of a murine recessive polycystic kidney disease mutation and
      modifying loci that affect disease severity.
AB  - We have used a novel method of chromosomal exclusion to map the recessive
      mutation juvenile cystic kidney (jck) to mouse chromosome 11 using an intercross
      between (C57BL/6J x DBA/2J) F1jck/ + mice. The severity of polycystic kidney
      disease (PKD) in the intercross progeny was significantly more variable than that
      found in the parental C57BL/6J strain, suggesting that a modifier locus or loci
      introduced from DBA/2J affects expression of jck. Two regions--one from DBA/2J on
      chromosome 10 and a second from C57BL/6J on chromosome 1--are associated with
      inheritance of a more severe PKD phenotype. The finding of a highly significant
      association of inheritance of a C57BL/6J-related locus with disease severity,
      with a maximal QTL analysis lod score of 16.8, was unexpected; this result
      suggests that inheritance of both this locus and at least one DBA/2J locus
      results in the more severe phenotype, presumably as a consequence of a direct or
      indirect interaction between their protein products.

PMID- 7782069
TI  - Construction of a YAC contig spanning the Xq13.3 subband.
AB  - The loci involved in several X-linked mental retardation syndromes have been
      linked to the pericentromeric region of the X chromosome long arm (Xq12-q21). To
      isolate candidate genes for these diseases, we set up the construction of YAC
      contigs spanning this region. Two of these syndromes (the Juberg-Marsidi syndrome
      and the alpha-thalessemia mental retardation syndrome) have been recently linked,
      with high lod scores, to polymorphic probes previously assigned to Xq13.3. We
      therefore constructed a first YAC contig, encompassing this band, from DXS441 to
      PGK1. The physical map, deduced from the isolated clones, extends over 2.1 Mb of
      genomic DNA. Restriction analysis of the YAC contig allowed us to map precisely
      the loci previously assigned to that chromosomal region and to define their
      relative order. The validity of this physical map has been checked by comparing
      Sfi I digests of the YACs to genomic fragments obtained with the same enzyme. A
      cDNA selection approach, already performed with a previous partial contig, has
      been extended to cover the whole region.

PMID- 7782070
TI  - Chromosomal assignment of the genes for proprotein convertases PC4, PC5, and PACE
      4 in mouse and human.
AB  - The genes for three subtilisin/kexin-like proprotein convertases, PC4, PC5, and
      PACE4, were mapped in the mouse by RFLP analysis of a DNA panel from a
      (C57BL/6JEi x SPRET/Ei)F1 x SPRET/Ei backcross. The chromosomal locations of the
      human homologs were determined by Southern blot analysis of a DNA panel from
      human-rodent somatic cell hybrids, most of which contained a single human
      chromosome each. The gene for PC4 (Pcsk4 locus) mapped to mouse chromosome 10,
      close to the Adn (adipsin, a serine protease) locus and near the Amh (anti
      mullerian hormone) locus; in human, the gene was localized to chromosome 19. The
      gene for PC5 (Pcsk5 locus) mapped to mouse chromosome 19 close to the Lpc1
      (lipocortin-1) locus and, in human, was localized to chromosome 9. The gene for
      PACE4 (Pcsk6 locus) mapped to mouse chromosome 7, at a distance of 13 cM from the
      Pcsk3 locus, which specifies furin, another member of this family of enzymes
      previously mapped to this chromosome. This is in concordance with the known close
      proximity of these two loci in the homologous region on human chromosome 15q25
      qter. Pcsk3 and Pcsk6 mapped to a region of mouse chromosome 7 that has been
      associated cytogenetically with postnatal lethality in maternal disomy,
      suggesting that these genes might be candidates for imprinting.

PMID- 7782071
TI  - Assignment of a Polycomb-like chromobox gene (CBX2) to human chromosome 17q25.
AB  - A human clone corresponding to the homologue of the murine Polycomb-like gene M33
      has been used to map this gene (CBX2) to human chromosomes. Both somatic cell
      hybrid panels and FISH on metaphase chromosomes have been used. These techniques
      gave a consistent localization, at the tip of the long arm of chromosome 17
      (17q25). This localization, as well as the potential role of a mammalian Polycomb
      like protein, suggests a potential involvement in two different pathologies: the
      campomelic syndrome, an inherited disorder, and neoplastic disorders linked to
      allele loss already described in this region.

PMID- 7782073
TI  - Cytosolic phospholipase A2 gene in human and rat: chromosomal localization and
      polymorphic markers.
AB  - We report the chromosomal localization and a simple sequence repeat (SSR) in the
      cytosolic phospholipase A2 (cPLA2) gene in both human and rat. A (CA)18 repeat in
      the promoter of the rat gene was determined to exhibit length polymorphism when
      analyzed using the polymerase chain reaction (PCR) in 19 different inbred rat
      strains. Genotyping for this marker in 234 F2 progeny of a SHR x BN intercross
      mapped the gene to rat chromosome 13. Using a PCR strategy, a fragment of the
      promoter for the human gene was isolated, and a (CA)18 repeat was identified.
      Since this marker displayed a low heterozygosity index, we also identified a
      mononucleotide repeat in the promoter for cPLA2 that displayed a polymorphism
      information content value of 0.76. The human gene was mapped using fluorescence
      in situ hybridization (FISH) to chromosome 1q25. Of interest, the gene encoding
      the enzyme prostaglandin-endoperoxide synthase 2 (cyclooxygenase-2), which acts
      on the arachidonic acid product of cPLA2, was previously localized to this same
      chromosomal region, raising the possibility of coordinate regulation.
      Identification of intragenic markers may facilitate studies of polymorphic
      variants of these genes as candidates for disorders in which perturbations of the
      eicosanoid cascade may play a role.

PMID- 7782072
TI  - A physical map of chromosome 20 established using fluorescence in situ
      hybridization and digital image analysis.
AB  - The physical locations of 46 cosmid clones and 21 P1 clones were determined along
      the chromosome 20 axis relative to the p terminus (FLpter) using fluorescence in
      situ hybridization (FISH) and digital image microscopy. The cosmid clones were
      selected from the chromosomally enriched library LA20NC01. Nine P1 clones were
      selected from a pooled DuPont genomic library using PCR with primer pairs
      selected to amplify genetically mapped sequence-tagged sites. This information
      was used to relate the physical map to the genetic map. Twelve P1 clones were
      selected from the same library using PCR primer pairs that amplified known genes.
      Two of these, E2F and BCLX, had not been mapped previously.

PMID- 7782074
TI  - Physical maps of human alpha (1,3)fucosyltransferase genes FUT3-FUT6 on
      chromosomes 19p13.3 and 11q21.
AB  - Sialyl Lewis x and related fucosylated glycans are differentially expressed in
      human cells and form ligands for selectin adhesion receptors.
      alpha(1,3)Fucosyltransferases (FUTs) that complete their biosynthesis also show
      tissue specificity. We have established physical maps of the FUT3-6 loci to study
      regulation of this gene family. FUT4 has previously been localized to chromosome
      11q21; FUT3, FUT6, and now FUT5 are localized to chromosome 19p13.3. Conventional
      and pulsed-field gel electrophoresis mapping of total genomic DNA and large
      genomic clones were used to generate a fine map of both loci, defining the order,
      orientation, and distances between FUTs. A P1 clone with all three 19p FUT genes
      in tandem orientation was isolated and used to study regions flanking FUT3, -5,
      and -6. Our studies provide preliminary information to study regulation of human
      FUT genes.

PMID- 7782075
TI  - Comparative mapping of DNA probes derived from the V kappa immunoglobulin gene
      regions on human and great ape chromosomes by fluorescence in situ hybridization.
AB  - Fluorescence in situ hybridization (FISH) of cosmid clones of human V kappa gene
      regions to human and primate chromosomes contributed to the dating of chromosome
      reorganizations in evolution. A clone from the kappa locus at 2p11-p12 (cos 106)
      hybridized to the assumed homologous chromosome bands in the chimpanzees Pan
      troglodytes (PTR) and P. paniscus (PPA), the Gorilla gorilla (GGO), and the
      orangutan Pongo pygmaeus (PPY). Human and both chimpanzees differed from gorilla
      and orangutan by the mapping of cos 170, a clone derived from chromosome 2cen
      q11.2; the transposition of this orphon to the other side of the centromere can,
      therefore, be dated after the human/chimpanzee and gorilla divergence.
      Hybridization to homologous bands was also found with a cosmid clone containing a
      V kappa I orphon located on chromosome 1 (cos 115, main signal at 1q31-q32),
      although the probe is not fully unique. Also, a clone derived from the orphon V
      kappa region on chromosome 22q11 (cos 121) hybridized to the homologous bands in
      the great apes. This indicates that the orphons on human chromosomes 1 and 22 had
      been translocated early in primate evolution.

PMID- 7782076
TI  - Characterization of a large population of mRNAs from human testis.
AB  - We present the results of single-pass sequencing of 779 expressed sequence tags
      from normal human testis cDNA clones. Of the sequences generated, 319 (41%)
      appeared to be completely unknown and are likely to represent new genes, and 289
      (37%) were identified based on exact or nonexact matches to sequences in public
      databases. In analyses of hybridization of four tissues, testis, brain, liver,
      and kidney, 6 of 12 cDNAs clones revealed testis-specific expression. This argues
      for the value of the combination of random sequencing and analysis of cellular
      expression for large-scale characterization of gene expression in the testis.

PMID- 7782077
TI  - Amelogenin signal peptide mutation: correlation between mutations in the
      amelogenin gene (AMGX) and manifestations of X-linked amelogenesis imperfecta.
AB  - Formation of tooth enamel is a poorly understood biological process. In this
      study we describe a 9-bp deletion in exon 2 of the amelogenin gene (AMGX) causing
      X-linked hypoplastic amelogenesis imperfecta, a disease characterized by
      defective enamel. The mutation results in the loss of 3 amino acids and exchange
      of 1 in the signal peptide of the amelogenin protein. This deletion in the signal
      peptide probably interferes with translocation of the amelogenin protein during
      synthesis, resulting in the thin enamel observed in affected members of the
      family. We compare this mutation to a previously reported mutation in the
      amelogenin gene that causes a different disease phenotype. The study illustrates
      that molecular analysis can help explain the various manifestations of a tooth
      disorder and thereby provide insights into the mechanisms of tooth enamel
      formation.

PMID- 7782078
TI  - Assignment of the human neuropeptide Y gene to chromosome 7p15.1 by nonisotopic
      in situ hybridization.

PMID- 7782079
TI  - The murine endoglin gene (Eng) maps to chromosome 2.

PMID- 7782080
TI  - Assignment of the human ubiquitous receptor gene (UNR) to 19q13.3 using
      fluorescence in situ hybridization.

PMID- 7782081
TI  - Human GTP-cyclohydrolase I gene and sepiapterin reductase gene map to region
      14q21-q22 and 2p14-p12, respectively, by in situ hybridization.

PMID- 7782082
TI  - Efficient pooling designs for library screening.
AB  - We describe efficient methods for screening clone libraries, based on pooling
      schemes that we call "random k-sets designs." In these designs, the pools in
      which any clone occurs are equally likely to be any possible selection of k from
      the v pools. The values of k and v can be chosen to optimize desirable
      properties. Random k-sets designs have substantial advantages over alternative
      pooling schemes: they are efficient, flexible, and easy to specify, require fewer
      pools, and have error-correcting and error-detecting capabilities. In addition,
      screening can often be achieved in only one pass, thus facilitating automation.
      For design comparison, we assume a binomial distribution for the number of
      "positive" clones, with parameters n, the number of clones, and c, the coverage.
      We propose the expected number of resolved positive clones--clones that are
      definitely positive based upon the pool assays--as a criterion for the efficiency
      of a pooling design. We determine the value of k that is optimal, with respect to
      this criterion, as a function of v, n, and c. We also describe superior k-sets
      designs called k-sets packing designs. As an illustration, we discuss a
      robotically implemented design for a 2.5-fold-coverage, human chromosome 16 YAC
      library of n = 1298 clones. We also estimate the probability that each clone is
      positive, given the pool-assay data and a model for experimental errors.

PMID- 7782083
TI  - Structure of the terminal 300 kb of DNA from human chromosome 21q.
AB  - The most distal 300 kb of human chromosome 21q was cloned and mapped using
      telomeric yeast artificial chromosomes (YACs). The region contains low-copy
      subtelomeric repeats at the telomeric end, chromosome 21-specific sequences more
      centromerically, and the S100B gene at a distance of 100-140 kb from the
      chromosome terminus. RecA-assisted restriction endonuclease cleavage of genomic
      DNA showed that the cloned fragments correspond to telomere-terminal genomic DNA,
      and restriction enzyme mapping of the YACs shows that the smaller clone (175 kb)
      corresponds exactly to the telomeric end of the larger one (300 kb). PCR assays
      for 21q-specific markers were used to show that COL6A1, COL6A2, and LA161 were
      all outside of the subtelomeric region spanned by the YACs and thus at least 300
      kb from the 21q terminus. The molecular probes provide telomeric closure for
      existing 21q maps.

PMID- 7782084
TI  - A high-resolution genetic linkage map of the pericentromeric region of the human
      X chromosome.
AB  - We generated a high-resolution genetic linkage map of the pericentromeric region
      of the human X chromosome from approximately Xp11.4 to Xq22. This map contains 41
      loci defined by 50 marker systems genotyped in the CEPH families. For this study
      we have generated 3 new markers (DXS1689, DXS1690, and DXS159) and 2 new primer
      sequences for previously described markers (PGK1P1 and AR). Using two different
      mapping algorithms based on genotype data alone, we developed two well-supported
      framework maps containing 15 and 18 markers with average interval sizes of 2.7
      and 1.7 cM. The 18 marker map is [DXS426, PFC]-2.0-DXS255-1.2-DXS991-1.6-AR-1.3
      DXS153-2.0-DX S106-1.5-DXS132-0.6- DXS1690-0.8-DXS453-1.4-DXS559-1.5-[PGK1,
      DXS56]-0.6-DXS1002-1.8-DXYS1X-2.0-DXS3-7.5-DX S458-2.8-DXS454, where the distance
      between adjacent loci is in centimorgans. As a third approach, we used physical
      mapping data to define bins for markers; this approach permitted us to place 26
      markers on our framework map. Finally, we constructed a map based on the physical
      order of 35 markers from the fifth international workshop on human X chromosome
      mapping. A comparison of the physical and genetic maps indicates a relationship
      of 2 cM per megabase in this region, with two regions of reduced recombination.
      The first is around the centromere (DXZ1), and the second is in the region around
      PGK1 (DXS441 to DXS995). Our maps should aid in the fine-mapping of the many
      disease loci that localize to this region of the X chromosome.

PMID- 7782085
TI  - Molecular cloning of the microfibrillar protein MFAP3 and assignment of the gene
      to human chromosome 5q32-q33.2.
AB  - Microfibrils having a diameter of 10-12 nm, found either in association with
      elastin or independently, are an important component of the extracellular matrix
      of many tissues, but characterization of these microfibrils is incomplete. To
      further our understanding of the gene structure of proteins composing the
      microfibrils and to identify their chromosomal location, we have cloned and
      characterized another microfibril protein, designated microfibril-associated
      protein-3 (MFAP3). The human gene encoding MFAP3 has a very simple structure,
      containing only two translated exons encoding a protein of 362 amino acids.
      Monospecific antibodies prepared against the recombinantly expressed protein
      reacted with the microfibrils found in ocular zonules. MFAP3 does not appear to
      share homology with any other known protein. The gene was found to be located on
      chromosome 5q32-q33.2, near the locus 5q21-q31 reported for the fibrillin gene,
      FBN2, which has been linked to congenital contractural arachnodactyly. MFAP3 is a
      candidate gene for heritable diseases affecting microfibrils.

PMID- 7782087
TI  - Cloning, sequence analysis, and chromosomal assignment of the mouse Apex gene.
AB  - APEX nuclease (Apex gene product) is a mammalian multifunctional DNA repair
      enzyme possibly involved in the repair of apurinic/apyrimidinic (AP) sites and
      single-strand DNA breaks with 3' termini blocked by nucleotide fragments and also
      in transcriptional regulation via redox activation of the AP-1 transcription
      factors. We cloned a 15-kb DNA fragment containing the Apex gene from a mouse
      leukocyte genomic library and determined a 4-kb stretch of its nucleotide
      sequence, including the complete sequence of the mouse Apex gene. The gene
      consists of 5 exons and 4 introns spanning 2.21 kb, and the boundaries between
      exons and introns follow the GT/AG rule. Two major and one minor transcription
      initiation sites were assigned to positions +1 and +24 and position +14,
      respectively, by a combination of ribonuclease protection, primer extension, and
      5' RACE analyses. Position +1 is located 312 nucleotides upstream from the ATG
      initiation codon. The translation initiation and termination sites are located in
      exon II and exon V, respectively. The sequenced 5' flanking region (1.32 kb)
      lacks a typical TATA box, but contains a CAAT box and putative binding sites for
      several transcription factors, such as ATF, NF-IL6, Sp1, and AP2. The 0.8-kb
      region from position -410 (5' flanking region) to position +386 (intron II)
      contains a CpG island. The Apex gene locus was mapped to mouse chromosome 14C2-D1
      using in situ hybridization.

PMID- 7782086
TI  - Structural organization of the human sorbitol dehydrogenase gene (SORD).
AB  - The primary structure of human sorbitol dehydrogenase (SORD) was determined by
      cDNA and genomic cloning. The nucleotide sequence of the mRNA covers 2471 bp
      including an open reading frame that yields a protein of 356 amino acid residues.
      The gene structure of SORD spans approximately 30 kb divided into 9 exons and 8
      introns. The gene was localized to chromosome 15q21.1 by in situ hybridization.
      Two transcription initiation sites were detected. Three Sp1 sites and a
      repetitive sequence (CAAA)5 were observed in the 5' noncoding region; no
      classical TATAA or CCAAT elements were found. The related alcohol dehydrogenases
      and zeta-crystallin have the same gene organization split by 8 introns, but no
      splice points coincide between SORD and these gene types. The deduced amino acid
      sequence of the SORD structure differs at a few positions from the directly
      determined protein sequence, suggesting allelic forms of the enzyme. High levels
      of SORD transcripts were observed in lens and kidney, as judged from Northern
      blot analysis.

PMID- 7782088
TI  - Characterization of the Xiphophorus fish (Teleostei: Poeciliidae) ERCC2/XPD
      locus.
AB  - We have cloned and sequenced the ERCC2/XPD locus of Xiphophorus maculatus. The
      human ERCC2/XPD gene is a nucleotide excision repair gene presumed to encode an
      ATP-dependent DNA helicase. The fish ERCC2/XPD gene is represented on 14.5 kb of
      genomic DNA and is composed of 23 exons. Within the coding regions, the overall
      nucleotide identity is 74% compared to the human cDNA. Of 760 amino acids
      compared between human and fish sequences, 127 differences are observed. Of these
      differences, 48 residues (38%) represent nonconservative amino acid changes,
      while 79 (62%) are conservative. The majority (73%) of nonconservative
      differences between the human and the fish amino acid sequences occur in eight
      distinct groups comprising only about 10% of the total protein. Overall, the fish
      and human sequences show 83% amino acid identity and 94% similarity when
      conservative amino acid substitutions are allowed.

PMID- 7782089
TI  - Gene duplication of the human peptide YY gene (PYY) generated the pancreatic
      polypeptide gene (PPY) on chromosome 17q21.1.
AB  - Neuropeptide Y (NPY), peptide YY (PYY), and pancreatic polypeptide (PP) are
      structurally related but functionally diverse peptides, encoded by separate genes
      and expressed in different tissues. Although the human NPY gene has been mapped
      to chromosome 7, we demonstrate here that the genes for human PYY and PP (PPY)
      are localized only 10 kb apart from each other on chromosome 17q21.1. The high
      degree of homology between the members of this gene family, both in primary
      sequence and exon/intron structure, suggests that the NPY and the PYY genes arose
      from an initial gene duplication event, with a subsequent tandem duplication of
      the PYY gene being responsible for duplication of the PYY gene being responsible
      for the creation of the PPY gene. A second weaker hybridization signal also found
      on chromosome 17q11 and results obtained by Southern blot analysis suggest that
      the entire PYY-PPY region has undergone a further duplication event.

PMID- 7782090
TI  - Genomic mapping by end-characterized random clones: a mathematical analysis.
AB  - Physical maps can be constructed by "fingerprinting" a large number of random
      clones and inferring overlap between clones when the fingerprints are
      sufficiently similar. E. Lander and M. Waterman (Genomics 2: 231-239, 1988) gave
      a mathematical analysis of such mapping strategies. The analysis is useful for
      comparing various fingerprinting methods. Recently it has been proposed that ends
      of clones rather than the entire clone be fingerprinted or characterized. Such
      fingerprints, which include sequenced clone ends, require a mathematical analysis
      deeper than that of Lander-Waterman. This paper studies clone islands, which can
      include uncharacterized regions, and also the islands that are formed entirely
      from the ends of clones.

PMID- 7782091
TI  - Localization of new genes and markers to the distal part of the human major
      histocompatibility complex (MHC) region and comparison with the mouse: new
      insights into the evolution of mammalian genomes.
AB  - We have refined and extended the map of the distal half of the human major
      histocompatibility complex. The map is continuous from HLA-E to 1000 kb telomeric
      of HLA-F and includes six new markers and genes. In addition, the corresponding
      sequences that were not previously mapped in the mouse genome have been located.
      The human and the mouse organizations have therefore been compared. This
      comparison allows us to demonstrate that the structure of the distal part of the
      MHC is similar in the two species. In addition, this comparison shows the
      presence of a breakpoint of synteny telomeric of the distal part of the H-2
      region. Indeed, the region telomeric of HLA in human is found on a chromosome
      different from that carrying H-2 in mouse. The mapping analysis of paralogous
      genes (structurally related genes) around the breakpoint shows that the human
      organization probably represents the putative human/mouse ancestral one. This
      evolutionary breakpoint was precisely mapped in human, and the surrounding region
      was cloned into yeast artificial chromosomes. Finally, we show that the region
      found around the breakpoint was involved several times in chromosome
      recombinations in the mouse lineage, as it seems to correspond also to the t
      complex distal inversion point.

PMID- 7782092
TI  - Promotion of macrophage-stimulated autoreactive T cell proliferation by
      interleukin-10: counteraction of macrophage suppressor activity during tumor
      growth.
AB  - CD4+ autoreactive T cells are a major cell population in regulating immune
      responses to altered autologous neoplastic cells. Normal autoreactive T cells
      recognize major histocompatibility complex (MHC) class II molecules in
      association with self-peptides on antigen-presenting cells, such as macrophages
      (M phi). Tumor-bearing hosts (TBH) have decreased autoreactivity partly because
      tumors increase M phi secretion of suppressor molecules like prostaglandin E2
      (PGE2) and decrease M phi MHC class II expression. Because interleukin (IL)-10, a
      cytokine produced by T cells, M phi, and tumor cells, inhibits production of most
      M phi suppressor molecules, we determined if IL-10 could reverse tumor-induced
      murine splenic M phi-mediated suppression of autoreactive T cell proliferation.
      Tumor growth enhanced activated M phi production of PGE2, nitric oxide, and tumor
      necrosis factor-alpha (TNF-alpha). IL-10 strongly reduced or inhibited M phi
      production of these molecules. When added to pure normal host (NH) CD4+ T cells,
      NH syngeneic splenic M phi stimulated autoreactive T cell proliferation more than
      did TBH splenic M phi. Exogenous IL-10 or M phi preincubation with IL-10 restored
      TBH M phi-stimulated autoreactivity to normal levels. IL-10 treatment had little
      or no effect on NH M phi-stimulated autoreactivity. IL-10 inhibited TBH M phi
      secretion of suppressor molecules in T cell proliferation assays because
      supernatants from IL-10-pretreated TBH M phi-syngeneic NH T cell cultures had
      decreased levels of suppressor molecules. When endogenous IL-10 activity was
      neutralized with anti-IL-10 monoclonal antibody, autoreactive T cell
      proliferation stimulated by NH or TBH M phi was slightly, but significantly
      decreased. Although IL-10 is known to inhibit M phi foreign antigen-presenting
      cell-dependent T cell proliferation, this study shows that IL-10 restores
      autoreactive T cell functions during tumor growth by counteracting M phi
      production of inhibitory molecules. These data suggest that IL-10 up-regulates
      anti-cancer autoreactive T cell responses by down-regulating suppressor M phi
      activity.

PMID- 7782093
TI  - A function of Ly-5 (CD-45) in the generation of lymphokine-activated killer cells
      defined by Ly-5 anti-sense oligodeoxyribonucleotides and Ly-5 monoclonal
      antibody.
AB  - The unique feature of the Ly-5 system is that it is a major cell surface
      glycoprotein, representing up to 10% of the total cell surface complement,
      confined to the hematopoietic cells as a family of isoforms generated by
      alternative splicing of a single Ly-5 gene. The cytoplasmic domain of Ly-5 has
      protein tyrosine phosphatase activity suggesting that Ly-5 is involved in signal
      transduction. We used Ly-5 anti-sense oligodeoxyribonucleotides (oligo) and Ly-5
      monoclonal antibody (mAb) to study the functional role of Ly-5 in the
      concanavalin A mitogenesis response by spleen cells, as well as in the generation
      of lymphokine-activated killer cells and the proliferative response by spleen
      cells induced by recombinant human interleukin-2 (rhIL-2). Our results indicate
      that the Ly-5 mAb could enhance these activities whereas the anti-sense oligo was
      inhibitory. These data clearly suggest that Ly-5 is involved in the IL-2 and IL-2
      receptor responsive circuit.

PMID- 7782094
TI  - Expression of MHC class II antigens on rat bone marrow cells and macrophages, and
      their modulation during culture with murine GM-CSF or M-CSF.
AB  - Flow cytometric analysis employing MRC OX 6 and MRC OX17 monoclonal antibodies
      recognizing determinants on RT1.B or RT1.D molecules, equivalent to murine I-A
      and I-E, respectively, was used to detect rat MHC class II antigen (Ag)
      expression. Approximately 5% of freshly isolated rat bone marrow cells (BMC)
      expressed RT1.B and over 30% displayed RT1.D molecules. The RT1.D+ cells were
      W3/13+, OX 7+, OX 19- and OX 22-. After one week culture of BMC with murine
      recombinant granulocyte/macrophage colony-stimulating factor (GM-CSF), regardless
      of concentrations, 90 to 95% of the cells were scored as bone marrow-derived
      macrophages (BMDM phi), and over 30% expressed both RT1.B and RT1.D Ag. GM-CSF
      increases the percentage of BMDM phi bearing MHC class II Ag in a concentration
      dependent manner. This effect seems to be specific because antibodies to
      interferon-gamma, tumor necrosis factor-alpha or interleukin-4 did not reduce the
      number of cells expressing RT1.B and RT1.D Ag. Furthermore, GM-CSF was able to
      trigger expression of class II molecules on rat peritoneal macrophages (M phi)
      and BMDM phi resulted from cultures of BMC with mouse M phi-CSF (M-CSF), and the
      RT1.B and RT1.D inducing effect of GM-CSF was opposed by M-CSF, and by anti-GM
      CSF antibodies. The induction of MHC class II Ag synthesis by GM-CSF on rat BMDM
      phi was confirmed at the mRNA level by Northern blot analysis employing cDNA
      probes encoding the RT1.B alpha.

PMID- 7782095
TI  - Antiproliferative effect of bone marrow cells on leukemic cells.
AB  - When normal murine bone marrow (BM) cells were cultured with either L1210
      lymphoma cells or P815 mastocytoma cells for 24 h, considerable tumor growth
      suppression without substantial tumor cell lysis was found. Under the same
      conditions, normal spleen cells also demonstrated the antitumor cytostatic
      activity, but not as significant as that characteristic of BM cells, whereas both
      normal thymus and lymph node cells had not any suppressive effect on tumor cell
      proliferation. The comparable cytostatic effects occurred in both syngeneic and
      allogeneic BM-tumor cell combinations. The cytostatic BM-effectors were distinct
      from T and B lymphocytes or mature macrophages. After being separated on a
      discontinuous Percoll density gradient, the cells active in suppressing tumor
      growth were recovered predominantly in 1.075 and 1.060 density fractions. The
      cytostatic BM effectors, at least in their part, were resistant to x-irradiation
      up to 2000 rad included. Collectively these results suggest that normal BM, being
      deficient in cell-mediated antitumor cytolytic activity, has a significant
      leukemia growth inhibitory potential; and that cytostatic BM effectors are
      similar in their characteristics to natural suppressor cells.

PMID- 7782096
TI  - Effect of bone marrow transplantation on antiphospholipid antibody syndrome in
      murine lupus mice.
AB  - The (NZW x BXSB)F1 (W/BF1) mouse is known to be an animal model of systemic lupus
      erythematosus (SLE) and immune thrombocytopenic purpura (ITP). These mice produce
      not only anti-DNA antibodies but also anti-platelet antibodies, resulting in
      decreased platelet counts. They show a high level of proteinuria, increased white
      blood cell (WBC) counts, hypertension, and myocardial infarction due to the high
      levels of anti-cardiolipin antibodies. When W/BF1 mice (4-5 months) were lethally
      irradiated and then reconstituted with T cell-depleted bone marrow cells of
      normal BALB/c mice (8 weeks), 60% of the mice survived more than one year. The
      WBC and platelet counts in the mice were normalized, and the levels of anti-DNA
      and anti-platelet antibodies decreased. The renal dysfunction was also
      ameliorated as indicated by a lower level of proteinuria, lower levels of serum
      creatinine (S-CRTN) and blood urea nitrogen (BUN), and by improved histology. The
      blood pressure (BP) of the treated W/BF1 mice decreased due to the improved renal
      functions. In contrast to the non-treated W/BF1 mice which died of myocardial
      infarction or renal failure by the age of 7 months, the treated W/BF1 mice showed
      no evidence of myocardial infarction even one year after BMT. This was due to the
      lower cardiolipin levels.

PMID- 7782097
TI  - Changes in the blood-thymus barrier of adult rats after estradiol-treatment.
AB  - The accessibility of the thymus parenchyma for relatively large Mw (+/- 150 Kd)
      proteins has been studied by the intravenous injection of monoclonal antibodies
      (mAbs) specific either for all T cells (His-17) or MHC class II molecules (His
      19) in control and estradiol benzoate (EB)-treated adult Wistar rats. In
      controls, the transcapsular route rather than cortical capillaries seems to be
      involved in the entry of molecules into the thymus. By contrast, a specific
      staining for either T cells (His-17) or MHC class II molecules (His-19 positive
      cells) disappears almost completely from the thymic cortex of EB-treated rats
      except in the immediate subcapsular epithelial cell layer. In these rats, T cells
      and epithelial cells intimately associated to blood vessels from both inner
      cortex and corticomedullary border showed additional staining with the respective
      mAbs confirmed by electron microscopy. The disappearance of the transcapsular
      route together with the increased vascular permeability of cortical blood vessels
      would be related to the reinforcement of the subcapsular epithelial cell layer
      and to direct effects of EB on vascular endothelia, respectively. These results
      are discussed in relationship to the cell migration into and out of adult thymus,
      as suggested by the changes in intrathymic T cell subsets evaluated by flow
      cytometry.

PMID- 7782098
TI  - Expression of ICAM-3 on human epidermal dendritic cells.
AB  - Three counter-receptors for LFA-1 of the immunoglobulin family have been
      discovered: ICAM-1, ICAM-2, and ICAM-3. Despite their homologies, their patterns
      of expression suggest specialized roles. The finding that ICAM-3 is much better
      expressed than other LFA-1 ligands on monocytes and resting T cells, and that
      this discovery may be important in the initiation of immune responses prompted us
      to search for the expression of ICAM-3 by human epidermal Langerhans cells (LC).
      Six out of eight different ICAM-3 monoclonal antibodies were found to be reactive
      with epidermal LC. Immunoelectron-microscopy staining revealed that 100% of
      freshly-isolated, typical Birbeck granules containing LC expressed ICAM-3. After
      one day and three days of culture, 100% of LC still expressed ICAM-3, but the
      staining intensity was decreased by 58% and 76% respectively. Immunoprecipitation
      of 125I surface-labeled LC with anti-ICAM-3 antibodies revealed a polypeptide
      with apparent M(r) of 122,000-125,000. To determine whether ICAM-3 was involved
      in LC function, mixed epidermal cell-lymphocyte reactions were performed with
      freshly isolated LC in the presence of various concentrations of different anti
      ICAM-3 antibodies. Among the different antibodies tested, HP2/19 and CBR-IC3/1
      were found to partially block the reaction in a dose-dependent manner, suggesting
      that ICAM-3 represents a new molecule involved in the initiation of the immune
      response driven by epidermal LC.

PMID- 7782099
TI  - Human nonspecific suppressor factor (hNSF): cell source and effects on T and B
      lymphocytes.
AB  - The human nonspecific suppressor factor (hNSF), the probable counterpart of the
      murine monoclonal nonspecific suppressor factor (MNSF), has been isolated from
      the ascitic fluid of a patient with systemic lupus erythematosus and
      characterized. hNSF presents an inhibitory activity on the proliferation and IgG
      production of mitogen stimulated human PBMC. In the present study, we demonstrate
      that hNSF can be isolated from the supernatants of ConA-activated T cells, but
      not from CD8-depleted T cells, indicating the CD8+ T cells are the major source
      of the factor. We also studied the effects of hNSF on purified human B and T
      cells; hNSF strongly inhibited the proliferation and Ig secretion by highly
      purified B cells induced by SAC plus IL-2, as well as the proliferation of T
      cells activated by Con A plus IL-2. These results indicate that hNSF is a CD8+ T
      cell product with strong antigen-nonspecific immunoregulatory action on both
      lymphocyte populations.

PMID- 7782100
TI  - Characterization of platelet antigen for CD45RA monoclonal antibodies.
AB  - CD45RA monoclonal antibodies recognize the higher molecular weight isoforms (220
      and 205 kDa) of leukocyte common antigen family (CD45), which are typically
      expressed on B cells and unstimulated T cells. We have found that there are at
      least three distinct CD45RA monoclonal antibodies which react with platelet 42
      kDa (P42) intracellular protein antigen, which seems to be different from any to
      date described platelet proteins with similar molecular weight. This platelet
      antigen is a single chain protein, very likely not a glykoprotein, with
      isoelectrical point between 6.8 and 7.5. P42 does not seem to be a membrane
      protein and is not associated with platelet cytoskeleton. Results of
      immunofluorescence assay suggest that P42 may be redistributed to platelet
      surface after platelet aggregation.

PMID- 7782101
TI  - Glial cell types, lineages, and response to injury in rat and fish: implications
      for regeneration.
AB  - Axons of the mammalian central nervous system do not regenerate spontaneously
      after axonal injury, unlike the central nervous system axons of fish and
      amphibians and the peripheral nervous system of mammals, which possess a good
      regenerative ability (Grafstein: The Retina: A Model for Cell Biology Studies,
      Part II, 1986; Kiernan: Biol Rev 54:155-197, 1979; Murray: J Comp Neurol 168:175
      196, 1976; Ramon y Cajal: Degeneration and Regeneration of the Nervous System,
      1928; Reier and Webster: J Neurocytol 3:591-618, 1974; Sperry: Physiol Zool
      23:351-361, 1948). It was previously believed that intrinsic differences between
      the central nervous system neurons of mammals and fish account for their
      differences in regenerative ability. The past decade, however, has seen an
      accumulation of evidence, indicating that mammalian central nervous system
      neurons are able to regenerate injured axons, at least to some extent. This was
      first demonstrated by Aguayo and colleagues (David and Aguayo: Science 214:931
      933, 1981; Kierstead et al: Science 246:255-257, 1989), who showed that injured
      mammalian central nervous system axons can grow for a considerable distance into
      an autograft of a peripheral nerve. It was also demonstrated that injured rabbit
      optic axons can regenerate into their own environment (i.e., into the distal part
      of the injured optic nerve), if the injured nerve is treated so as to make it
      conducive for growth (Lavie et al: J Comp Neurol 298:293-314, 1990; Eitan et al:
      Science 264:1764-1768, 1994).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782102
TI  - Differential Na+ channel beta 1 subunit mRNA expression in stellate and flat
      astrocytes cultured from rat cortex and cerebellum: a combined in situ
      hybridization and immunocytochemistry study.
AB  - Astrocytes have been shown to express voltage-sensitive Na+ channels, but the
      molecular structure of these channels is not yet known. Recent studies have
      demonstrated the expression of rat brain voltage-sensitive Na+ channel mRNAs in
      astrocytes. In this study, we used a combined non-radioactive in situ
      hybridization/immunocytochemistry method to investigate the expression of voltage
      sensitive Na+ channel beta 1 subunit (Na beta 1) mRNA in definitively identified,
      GFAP-positive astrocytes cultured from two different regions of the rat brain,
      cerebrum and cerebellum. In general, two morphologically distinct types of GFAP
      positive astrocytes were observed in culture: flat, fibroblast-like and stellate,
      process-bearing. We observed a differential expression of Na beta 1 mRNA in GFAP
      positive astrocytes: 1) stellate astrocytes expressed Na beta 1 mRNA, although
      the level of Na beta 1 mRNA expression was variable, and 2) flat astrocytes
      generally did not express Na beta 1 mRNA. Moreover, Bergmann-like cells from
      cerebellum did not express Na beta 1 mRNA, while the granule cells associated
      with Bergmann-like cell expressed Na beta 1 mRNA. These observations indicate
      that Na beta 1 mRNA is differentially expressed in rat astrocytes with various
      morphologies in vitro.

PMID- 7782104
TI  - The receptor for tumor necrosis factor on murine astrocytes: characterization,
      intracellular degradation, and regulation by cytokines and Theiler's murine
      encephalomyelitis virus.
AB  - Previous reports have shown that tumor necrosis factor (TNF) exerts a role on the
      physiology of astrocytes under inflammatory situations. The signalling for
      biological effects of this and other cytokines are usually exerted through cell
      surface receptors. In this study, we have demonstrated the presence of a surface
      TNF alpha receptor type I in murine astrocytes of both SJL/J and BALB/c origin,
      using 125I-labelled recombinant mouse TNF alpha. A linear Scatchard plot
      indicates the presence of only one type of receptor with a MW of 58 kDa (Type I
      TNF receptor) that binds the ligand with a Kd of 1 x 10(-9) M. There are 3,000
      copies of this receptor on untreated astrocytes. The results also indicate that
      receptor-bound TNF is rapidly internalized at 37 degrees C and degraded
      intracellularly to a principal molecular species which elutes from HPLC reverse
      phase columns at 38% acetonitrile rather than at 60%, as native TNF alpha does.
      The binding is up-regulated by increasing the number of receptors (but not its
      affinity) by treatments with Theiler's murine encephalomyelitis virus (TMEV), Con
      A and inflammatory cytokines such as IL-1 alpha, IL-6, and INF-gamma. It is not
      influenced by vaccinia virus, IL-2, or LPS. This receptor may contribute to the
      initiation of perpetuation of the immune response which mediates the
      demyelinating inflammation induced by Theiler's virus.

PMID- 7782103
TI  - Indicator expression directed by regulatory sequences of the glial fibrillary
      acidic protein (GFAP) gene: in vivo comparison of distinct GFAP-lacZ transgenes.
AB  - An increase in the expression of the glial fibrillary acidic protein (GFAP) gene
      by astrocytes appears to constitute a crucial component of the brain's response
      to injury because it is seen in many different species and features prominently
      in diverse neurological diseases. Previously, we have used a modified GFAP gene
      (C-339) to target the expression of beta-galactosidase (beta-gal) to astrocytes
      in transgenic mice (Mucke et al.; New Biol 3:465-474 1991). To determine to what
      extent the in vivo expression of GFAP-driven fusion genes is influenced by
      intragenic GFAP sequences, the E. coli lacZ reporter gene was either placed
      downstream of approximately 2 kb of murine GFAP 5' flanking region (C-259) or
      ligated into exon 1 of the entire murine GFAP gene (C-445). Transgenic mice
      expressing C-259 versus C-445 showed similar levels and distributions of beta-gal
      activity in their brains. Exclusion of intragenic GFAP sequences from the GFAP
      lacZ fusion gene did not diminish injury-induced upmodulation of astroglial beta
      gal expression or increase beta-gal expression in non-astrocytic brain cells.
      These results demonstrate that 2 kb of murine GFAP 5' flanking region is
      sufficient to restrict transgene expression primarily to astrocytes and to
      mediate injury-responsiveness in vivo. This sequence therefore constitutes a
      critical target for mediators of reactive astrocytosis. While acute penetrating
      brain injuries induced focal increases in beta-gal expression around the lesion
      sites in C-259, C-445, and C-339 transgenic mice, infection of C-339 transgenic
      mice with scrapie led to a widespread upmodulation of astroglial beta-gal
      expression. Hence, GFAP-lacZ transgenic mice can be used to monitor differential
      patterns of astroglial activation in vivo. These and related models should
      facilitate the assessment of strategies aimed at the in vivo manipulation of GFAP
      expression and astroglial activation.

PMID- 7782105
TI  - Effects of enhanced extracellular ammonia concentration on cultured mammalian
      retinal glial (Muller) cells.
AB  - Muller (glial) cells of the neonatal rabbit retina were cultured as confluent
      monolayers and exposed to enhanced concentrations of ammonia (0.25, 0.5, 1, 3, 7,
      and 10 mM) in medium for various periods (30 min to 10 d). This caused, in a time
      and dose-dependent manner, similar changes in the Muller cells as had previously
      been described in cultured astrocytes. The most conspicuous events were 1) an
      increasing size of cell nuclei, 2) an accumulation of phagocytotic vacuoles, and
      3) a rearrangement of intermediate filaments. 4) A considerable number of cells
      died when higher ammonia concentrations were applied for more than 1 h.
      Simultaneous application of dibutyryl-cyclic adenosine monophosphate (dBcAMP)
      prevented almost completely both the increase in cell nucleus size and the
      changes of intermediate filaments, but only partly the early cell death of a
      subpopulation of cells, and the accumulation of phagocytotic vacuoles. Further
      changes evoked by enhanced ammonia concentration were 5) an accumulation of
      lipofuscin-like material ("fatty degeneration") revealed by lipophilic stain, 6)
      reduced immunoreactivity for cathepsin D, and increased immunoreactivity for 7)
      glial fibrillary acidic protein, 8) glutamine synthetase, and 9) bcl-2
      protooncogene protein. These findings are discussed in respect to the possible
      underlying pathophysiological mechanisms.

PMID- 7782106
TI  - Estradiol promotion of changes in the morphology of astroglia growing in culture
      depends on the expression of polysialic acid of neural membranes.
AB  - Gonadal steroids are known to affect astroglial morphology in developing and
      adult animals. Earlier studies of mixed neuronal-glial cultures from fetal rat
      hypothalamus showed that glial fibrillary acidic protein (GFAP)-immunoreactive
      cells with a polygonal shape were transformed into process-bearing cells upon
      exposure to the ovarian hormone estradiol. This effect was dependent on a direct
      contact of astroglia with living hypothalamic neurons. The present study shows
      that somata and processes of neurons in such cultures were immunoreactive for
      polysialic acid (PSA); astroglia were immunonegative. PSA appears to participate
      in the estradiol-induced shape changes since treatment with endoneuraminidase, an
      enzyme that specifically removes PSA from the cell surface, abolished PSA
      immunostaining and prevented the 17 beta-estradiol-induced morphological changes
      of astroglia. In contrast, treatment with endoneuraminidase did not affect
      astroglial shape changes induced by basic fibroblast growth factor (bFGF), nor
      those induced by the addition of neurons to glial cultures. These results suggest
      that PSA on neuronal membranes, probably linked to the highly sialylated isoform
      of the neural cell adhesion molecule, is necessary for the expression of certain
      hormonally-regulated neuro-glial interactions.

PMID- 7782107
TI  - Disruption of the blood-brain interface in neonatal rat neocortex induces a
      transient expression of metallothionein in reactive astrocytes.
AB  - Exposure of the adult rat brain parenchyma to zinc induces an increase in the
      intracerebral expression of the metal-binding protein, metallothionein, which is
      normally confined to astrocytes, ependymal cells, choroid plexus epithelial
      cells, and brain endothelial cells. Metallothionein is expressed only in
      diminutive amounts in astrocytes of the neonatal rat brain, which could imply
      that neonatal rats are devoid of the capacity to detoxify free metals released
      from a brain wound. In order to examine the influence of a brain injury on the
      expression of metallothionein in the neonatal brain, PO rats were subjected to a
      localized freeze lesion of the neocortex of the right temporal cortex. This
      lesion results in a disrupted blood-brain interface, leading to extravasation of
      plasma proteins. From 16 h, reactive astrocytosis, defined as an increase in the
      number and size of cells expressing GFAP and vimentin, was observed surrounding
      the neocortical lesion site. Astrocytes and pial cells situated adjacent to the
      area of injury also became positively stained for metallothionein. At 3-6 days
      post-lesion, the highest level of reactive astrocytes expressing metallothionein
      was observed. Neo-Timm staining revealed that histochemically reactive zinc had
      disappeared from the lesion site. Extracellular albumin and metallothionein
      positive astrocytes were absent approximately 2 weeks after the lesion, whereas
      reactive astrocytosis was still observed. These results show that a lesion of the
      neonatal rat brain induces a transient expression of metallothionein in reactive
      astrocytes, probably as a response to metals released from the site of the brain
      injury.

PMID- 7782108
TI  - Expression of NMDA 2B receptor subunit mRNA in Bergmann glia.
AB  - N-methyl-D-aspartate (NMDA)-activated glutamate receptor subunits are invariably
      expressed in neurons, although NMDA-activated currents have been recently
      described in Bergmann glia. To date, the NMDA receptor subunit 2B (NMDAR2B) was
      thought not to be expressed in adult cerebellum. In the present study we provide
      evidence, from in situ hybridization histochemistry, that Bergmann glial cells in
      rat brain express mRNA encoding the NMDAR2B subunit, most probably co-expressed
      with the ubiquitous NMDAR1 subunit, while transcripts for other NMDAR2 subunits
      (A,C,D) were either not resolved or detected. Our findings suggest that Bergmann
      glial cells contain the molecular machinary to synthesize the NMDA receptor 2B
      subunit. The role of physiological NMDA receptors in the interaction between
      Bergmann glia and Purkinje neurons is not yet known.

PMID- 7782109
TI  - Clinical relevance of intracellular and extracellular concentrations of
      macrolides.
AB  - The serum levels of the three macrolides--roxithromycin, clarithromycin and
      azithromycin--vary considerably. The prediction of the antibacterial effect
      against extracellular pathogens is based on circulating concentrations of free
      drug, peak and trough levels, the rate of killing, and the presence of a post
      antibiotic effect. Intracellular activity depends on the distribution of the
      antibiotic and the localization of the bacteria, and is variable. Roxithromycin
      uptake is greater than that of erythromycin. The intracellular half-life may be
      long for some compounds (azithromycin > roxithromycin). The intracellular
      distribution is bimodal, both in the lysosomes and the cytoplasm, but the
      mechanisms of uptake have not yet been established. At low pH, accumulation is
      low and macrolides are less active in an acidic medium. Intracellular
      concentrations cannot readily be predicted on the basis of extracellular levels.
      Different models have shown that the greater the intracellular concentration, the
      better the clinical effect. In addition, the transport of macrolides by cells
      into the infected focus may play an important role in the therapeutic outcome.
      These factors influence the clinical indications for macrolides, their dosing
      regimens and breakpoints. In future, macrolides will be developed that are more
      selective for intracellular infections, while others, which will achieve
      significant serum levels, will be useful for a broader range of diseases.
      However, new compounds should be evaluated in different models of infection
      before clinical studies are instituted. The analysis of failures remains the most
      important approach in defining concentration/effect relationships.

PMID- 7782110
TI  - Roxithromycin 150 mg b.i.d. versus amoxycillin 500 mg/clavulanic acid 125 mg
      t.i.d. for the treatment of lower respiratory tract infections in general
      practice.
AB  - Two hundred and forty-two patients over 16 years of age with community-acquired
      lower respiratory tract infection (LRTI), matched for age and sex, were
      randomised to receive either roxithromycin 150 mg b.i.d. or amoxycillin 500
      mg/clavulanic acid 125 mg t.i.d. for 7 days, with a further 7 days if
      insufficient response was seen. Clinical efficacy at 7 days was 69% for
      roxithromycin and 56% for amoxycillin/clavulanic acid (p = 0.05) and at study end
      it was 91% for both antibiotics. There were fewer second treatment courses in the
      roxithromycin group (26% vs. 38%, p = 0.04) and a shorter treatment duration
      (8.29 days vs. 9.34 days, p > 0.05). Twelve patients (9.8%) treated with
      roxithromycin and 19 (17.1%) treated with amoxycillin/clavulanic acid had adverse
      effects possibly, or probably, related to the antibiotic. Roxithromycin appears
      to be a more appropriate choice than amoxycillin/clavulanic acid for the
      treatment of LRTI in the community given its more appropriate in vitro spectrum,
      efficacy against most common and atypical pathogens, greater cost-effectiveness,
      more convenient dosage regimen (b.i.d.), and superior tolerability profile.

PMID- 7782111
TI  - Pharmacoeconomic evaluation of roxithromycin versus amoxycillin/clavulanic acid
      in a community-acquired lower respiratory tract infection study.
AB  - A cost-effectiveness study of roxithromycin versus amoxycillin/clavulanic acid
      using data from a 242 patient multicentre trial in Australia and New Zealand was
      undertaken in the general practice treatment of infections of the lower
      respiratory tract (LRTI). Those patients assigned to roxithromycin required on
      average 1 day less of treatment, significantly fewer extended courses of
      treatment, and fewer patients experienced side effects considered to be related
      to the treatment. The cost benefit (difference between the two treatment costs)
      per clinical success was A$17.04*. By substituting roxithromycin for
      amoxycillin/clavulanic acid, Australia would save A$ 1.704 million per 100,000
      episodes of LRTI. The results demonstrate that savings in direct costs can be
      achieved by substituting roxithromycin for amoxycillin/clavulanic acid in the
      treatment of community-acquired LRTI.

PMID- 7782112
TI  - The overall safety of oral roxithromycin in paediatric clinical studies.
AB  - In two multicentre, non-comparative studies, a total of 477 children, aged 2
      months to 15 years, suffering from respiratory tract infections or skin and soft
      tissue infections were treated with roxithromycin (50 mg sachets). The mean
      duration of treatment was 9 days and the mean daily dose was 6 mg/kg/day
      administered b.i.d. The overall safety of roxithromycin was assessed by analysing
      the adverse events reported by the patients or investigators, the discontinuation
      of treatment because of adverse events, and the laboratory data. Adverse events
      reported by 20 (4%) children were considered to be possibly drug related. These
      adverse events were mainly digestive in nature and mild or moderate in severity.
      Treatment was discontinued because of adverse events in six (1%) children.
      Analysis of laboratory data revealed a few variations without any clinical
      significance.

PMID- 7782113
TI  - Potential role of roxithromycin against the Mycobacterium avium complex.
AB  - Until the recent experience with azithromycin and clarithromycin, macrolides were
      not considered to be important agents against mycobacteria. Clinical evidence is
      now growing that the newer 14 and 15 membered macrolide compounds have
      therapeutic activity against Mycobacterium avium, Mycobacterium chelonae and
      Mycobacterium leprae. Several years ago, when evaluating the activity of
      roxithromycin using one of the more virulent M. avium in our collection, the
      authors found that roxithromycin exerted a bacteriostatic effect in cultured
      human macrophages. However, in combination with tumour necrosis factor, which
      induces macrophage activation, roxithromycin caused enhanced intracellular
      killing. The significance of this finding is that tumour necrosis factor can be
      elaborated by activated macrophages during the course of infection. The
      roxithromycin doses that were chosen for these studies were less than achievable
      blood levels. More recently, the in vitro effect of roxithromycin against a panel
      of isolates from AIDS patients has been assessed and it was found that some (but
      not all) of the inhibitory concentrations, by the T-100 method of Inderlied, are
      within achievable serum levels. This, however, may not be the basis for
      anticipating in vivo activity since macrolide compounds are known to be
      concentrated within cells and particularly within phagolysosomes. Demonstration
      of effect in an in vitro test system is encouraging, but should be considered
      only as a preliminary step to careful assessments in experimental animals, such
      as the beige mouse, and studies in humans.

PMID- 7782114
TI  - Prevention of Pneumocystis carinii pneumonia and of cerebral toxoplasmosis by
      roxithromycin in HIV-infected patients.
AB  - The prevention of cerebral toxoplasmosis and of Pneumocystis carinii pneumonia is
      an essential objective in the management of patients infected with HIV. Given
      that roxithromycin is active in vitro against Toxoplasma gondii and that in 1989
      Dolermann reported the effective treatment of P. carinii respiratory infections
      with erythromycin, a randomized pilot study was undertaken in 52 patients
      infected with HIV. Patients were treated with either: a monthly dose of
      pentamidine aerosol (300 mg); roxithromycin once a week (300 mg t.i.d.); or a
      combination of pentamidine aerosol and roxithromycin. Intention to treat analysis
      was applied to these 52 patients, all of whom received at least one treatment
      dose. Five out of 18 patients treated with pentamidine aerosol, 1/17 patients
      treated with pentamidine aerosol + roxithromycin and none of the 17 patients
      treated with roxithromycin developed cerebral toxoplasmosis (p = 0.038). P.
      carinii pneumonia was diagnosed in one patient in the pentamidine aerosol-treated
      group, in one patient treated with roxithromycin and in none of the patients
      treated with pentamidine aerosol + roxithromycin (non-significant difference).
      Four cases of Mycobacterium tuberculosis and Mycobacterium avium-intracellulare
      infection were seen in the pentamidine aerosol-treated group (p = 0.028) and none
      in the roxithromycin groups. Adverse events leading to the discontinuation of
      treatment occurred in 5/34 (14.7%) patients treated with roxithromycin. Nausea,
      abdominal pain and raised transaminases occurred in four patients and a skin
      allergy in the final patient. Roxithromycin appears to be effective in the
      prevention of pulmonary pneumocystis infection and of cerebral toxoplasmosis in
      HIV-infected patients. However, these results require confirmation in a larger
      study.

PMID- 7782115
TI  - Roxithromycin in the treatment of Lyme disease--update and perspectives.
AB  - Spirochaetal infections have been successfully treated with penicillin; more
      recently, erythromycin has been used in cases with known penicillin allergy. The
      discovery of the spirochaete Borrelia burgdorferi and the elaboration of a new
      generation of macrolides with properties that differ from older macrolides have
      led to new ways of treating spirochaetal disease with these compounds. This paper
      presents data on the in vitro and in vivo efficacy of a combination of
      roxithromycin and co-trimoxazole against B. burgdorferi. In vitro (checkerboard
      technique; B. burgdorferi strain B31; modified BSK II medium) it was found that
      while roxithromycin showed excellent efficacy against B. burgdorferi (MIC 0.031
      mg/l), co-trimoxazole had no effect. However, the combination of both
      chemotherapeutics led to a minor synergistic effect, decreasing the MIC for
      roxithromycin by one dilution step at concentrations of co-trimoxazole from 256
      to 8 mg/l. In addition, a clearly reduced growth of microorganisms was seen at
      concentrations of roxithromycin as low as 0.015 mg/l in combination with 256 to 4
      mg/l co-trimoxazole, when compared to the positive controls. Most interestingly,
      however, the motility of B. burgdorferi was markedly reduced even when the two
      drugs were combined at very low concentrations. In an in vivo, non-randomised,
      open, prospective pilot study it was found that of 17 patients with confirmed
      late Lyme borreliosis (stage II/III), treated with combined roxithromycin (300 mg
      b.i.d.) and co-trimoxazole for 5 weeks, 13 (76%) recovered completely by the end
      of treatment, and four continued to have symptoms on follow-up at 6 and 12
      months. This success rate is similar to that seen with i.v. penicillin and
      ceftriaxone. It appears that the reduced motility of B. burgdorferi makes the
      pathogen more accessible to the immune system.

PMID- 7782116
TI  - Helicobacter pylori: the place of the new macrolides in the eradication of the
      bacteria in peptic ulcer disease.

PMID- 7782117
TI  - Pharmacokinetics of macrolides. Comparison of plasma, tissue and free
      concentrations with special reference to roxithromycin.
AB  - When macrolide antibiotics are administered according to the standard therapeutic
      regimens, the highest plasma concentrations of total drug, both during the first
      dosage interval and at steady state, are obtained with roxithromycin, followed by
      clarithromycin and azithromycin. The corresponding free plasma concentrations,
      calculated from published data on plasma protein binding for the three
      macrolides, are of the same order of magnitude and the highest values are again
      those of roxithromycin. With the use of improved analytical methodology, a stable
      and prolonged total elimination half-life of roxithromycin of about 19 h was
      demonstrated at steady state in healthy adults with a 300 mg once daily dosage
      regimen. Intra-group subject variations (adults, children, the elderly etc.) were
      smaller than anticipated. Roxithromycin is found in high and similar
      concentrations both in plasma and tissue, demonstrating a balanced
      pharmacokinetic behaviour.

PMID- 7782118
TI  - Monitoring exposure of hospital personnel handling cytostatic drugs and
      contaminated materials.
AB  - A study was undertaken to evaluate the urine mutagenicity of 63 individuals
      working in four hospital departments. The exposed group included 38 subjects who
      were exposed to various cytostatic drugs and/or contaminated material from
      treated patients. The control group included 25 individuals of the hospital
      personnel. Urine mutagenicity was monitored by the Ames test using tester strains
      TA 98 + S9 Mix and TA 102-S9 Mix. Urine samples were collected before and after
      the working periods. A total of 29/116 (25%) urine samples were mutagenic for
      either strain. Among the mutagenic samples, 24/29 were mutagenic for tester
      strain TA 98 exclusively. No significant correlation could be found between
      occupational exposure to cytostatic drugs and urine mutagenicity evaluated by the
      strain TA 98 + S9 Mix. Smoking was the main environmental factor that modulated
      urine mutagenicity with TA 98. Three subjects in the exposed group had mutagenic
      urine samples at the end of the working period with strain TA 102-S9 Mix. This
      mutagenicity was related to occupational exposure to cisplatin. In the control
      group, one individual had mutagenic samples before and after the working period.
      Assessing occupational exposure to cytostatic drugs with strain TA 102 requires
      additional studies to determine environmental mutagens which can be detected by
      this strain.

PMID- 7782120
TI  - A case-control study of psychological and psychosocial risk factors for shoulder
      and neck pain at the workplace.
AB  - Risk factors associated with work-related shoulder and neck myalgia were
      investigated in a case-control study with pairs matched for age, gender, and
      physical exposure. Guided interviews with standardized and self-constructed
      questionnaires were performed among manual (n = 15 pairs) and office (n = 24
      pairs) workers. Perceived general tension was the variable with the strongest
      association with shoulder and neck pain in both work groups. Otherwise, the
      results in the two groups were very different, indicating that different risk
      factors and mechanisms were associated with shoulder and neck pain in the two
      work groups. The study provides background information for future attempts to
      establish causal relationships between physical and psychosocial exposure and
      shoulder and neck pain, which can be more accurately investigated in a
      longitudinal rather than a cross-sectional experimental design.

PMID- 7782119
TI  - Dampness and molds in day-care centers as an occupational health problem.
AB  - To assess the occurrence of respiratory and other symptoms among workers in
      relation to dampness in day-care centers, a random sample of 30 day-care centers
      in the city of Espoo, Finland, was selected for the study. The study population
      consisted of 268 female day-care workers, who filled in a questionnaire. Dampness
      was found to be common: water damage had taken place in 70% of the centers, and
      workers perceived mold odor in 17% of them. Adjusted risk of work-related eye and
      respiratory symptoms was in general higher among the day-care workers exposed to
      both water damage and mold odor than among the unexposed. The prevalence of eye
      symptoms was statistically significantly higher. The results provide new evidence
      of the importance of dampness and mold problems in the work environment as
      determinants of respiratory and irritative symptoms.

PMID- 7782121
TI  - Subtle increase in leukocyte counts in association with drinking and smoking
      habits.
AB  - Peripheral leukocyte counts were examined in venous blood of more than 800 male
      workers exposed to toluene, xylenes, a combination of the two, or neither.
      Information on the social habits of smoking and drinking was obtained in an
      occupational health interview. The analysis showed that smoking (15
      cigarettes/day on average) induced a significant increase (by 7%) in leukocyte
      counts, and that an additional increase was induced when the drinking habit was
      coupled with smoking. Drinking alone tended to increase the leukocyte counts but
      the effect was statistically nonsignificant, possibly because the number of
      nondrinking smokers was limited. The study stresses the importance of paying
      attention to smoking and drinking habits when evaluating hematological parameters
      such as peripheral leukocyte counts in solvent-exposed workers.

PMID- 7782122
TI  - Neurotoxicity induced by lead levels: an electrophysiological study.
AB  - The object of the present study was to evaluate, with the aid of visual evoked
      potentials (VEPs), modifications induced in the optic nerve by lead, and to
      investigate the relationship between blood lead levels (PbB) and modification of
      the VEP. We studied a sample of 300 men with PbB values between 17 and 60
      micrograms/100 ml. Our study demonstrates that alterations in the latency of the
      VEP are dependent on PbB levels, though there is not a directly proportional
      relationship.

PMID- 7782123
TI  - Influence of power tool-related parameters on the response of finger flexor
      muscles.
AB  - Surface electromyography (EMG) and statistical analysis techniques were applied
      to investigate the response of finger flexor muscles to hand-transmitted
      vibration in all the three orthogonal directions. The trends in measured data
      were examined to derive the influence of variations in the tool-related
      parameters. Single-factor and multi-factor statistical analyses were performed to
      establish the significance of influence of different individual and coupled power
      tool-related parameters. The analysis of variance (ANOVA) results indicated that
      the vibration direction, acceleration and grip force influence the EMG of finger
      flexor muscles in a significant manner (P < 0.001), while the effect of vibration
      frequency was observed to be insignificant (P > 0.9). The electrical activity
      measured under different vibratory test conditions was observed to be 1.5-6.0
      times higher than that measured under the static loads. The increase in
      electrical activity of the finger flexor muscles with an increase in the grip
      force was observed to be most significant under static as well as dynamic loading
      conditions.

PMID- 7782124
TI  - Assessment of long-term styrene exposure: a comparative study of a logbook method
      and biological monitoring.
AB  - In a recent joint European research project "Biomonitoring of human populations
      exposed to genotoxic environmental chemicals: biomonitoring of styrene exposed
      individuals", a logbook method for assessment of long-term styrene exposure was
      applied in two Danish factories manufacturing glass fibre-reinforced polyester.
      The method was based on work process identification, assignment of work process
      concentrations and logbook keeping. Measures of exposure calculated by this
      method were compared with results from simultaneous measurements of styrene in
      blood and the metabolites mandelic acid and phenylglyoxylic acid in urine.
      Correlations were comparable with those obtained by use of personal samplers as
      published in the literature. Styrene in blood, however, only correlated with
      logbook concentrations at the time of sampling. Exposures were moderate to low.
      Mean personal 8-h time-weighted average concentration (8hTWAC) was 76 mg/m3
      styrene (SD 54 mg/m3, range 2-230 mg/m3). The Danish 8hTWAC threshold limit value
      for styrene in air, 105 mg/m3 (25 ppm), was exceeded on 17% of personal days. The
      summed urinary metabolites, mandelic acid and phenylglyoxylic acid, had a mean
      personal value of 138 mg/g creatinine (SD 84 mg/g creatinine) on the day of
      sampling. Blood styrene mean value was 129 micrograms/l (SD 74 micrograms/l,
      range 66-358 micrograms/l). It is concluded that the logbook method offers a
      technique for testing whether measurements are performed on representative days
      and may be recommended as a tool supplementary to biological monitoring in the
      assessment of long-term exposure.

PMID- 7782125
TI  - Immunological reactivity in ranitidine factory workers.
AB  - The involvement of immunological reactivity to ranitidine base (R-b) and
      ranitidine hydrochloride (R-HCl) in the development of occupationally related
      symptomatology was analyzed in 40 subjects employed in a pharmaceutical plant
      producing ranitidine and in 33 nonexposed controls, using a specific dose
      response lymphocyte proliferative test (lymphocyte transformation test: LTT). Of
      the 40 workers, 11 (28%) gave positive reactions to LTT: 3/11 to R-b, 4/11 to R
      HCl, and 4/11 to both compounds. None of the controls gave positive reactions.
      Cutaneous, oculonasal, or respiratory work-related symptoms were cited by 23 of
      the 40 (58%) subjects; ten of these 23 subjects (43%) were LTT positive. One
      asymptomatic case was LTT positive. The present results indicate that specific
      immune reactivity to ranitidine, analyzed by LTT, is associated with the presence
      of occupational symptomatology; R-HCl and R-b seem to share some antigenic
      determinants, because of the partial cross-reactivity shown by the examined
      compounds. Nonimmunological, probably irritative, mechanisms are also present in
      some of the symptomatic subjects.

PMID- 7782126
TI  - Evaluation of serum type III procollagen peptide as an exposure marker in retired
      coal workers.
AB  - Serum type III procollagen peptide (PIIIP), a degradation product of the type III
      collagen precursor, has been put forward as an exposure marker for mineral dust.
      We evaluated PIIIP levels as a marker of exposure to and effects of coal dust in
      retired coal miners (n = 104). To this end: (a) the individual cumulative dust
      exposure was calculated from job-exposure matrices, and (b) in addition to
      routine chest radiography (CR) of all miners according to the criteria of the
      International Labour Organisation (ILO), a subgroup (n = 46) was screened by high
      resolution computed tomography (HRCT). Profusion score (CR and HRCT) tended to
      increase with cumulative dust exposure, even in the absence of CR evidence for
      pneumoconiosis (i.e. CR < or = 0/1, n = 35). In contrast to our previous findings
      in active miners, PIIIP levels were not increased in miners as compared with non
      dust-exposed controls (n = 29), and no differences were observed between miners
      without (ILO = 0/0) and miners with coal workers' pneumoconiosis (CWP; ILO > or =
      0/1). No trend in PIIIP versus pneumoconiosis stage was present, either by CR or
      by the more sensitive HRCT score. PIIIP was also unrelated to any lung function
      parameter (FEV1, FVC, impedance, diffusion capacity). Age, medication, medical
      history and smoking habits had no significant effect on PIIIP levels. In the
      miners with CWP (i.e. ILO > 0/0, n = 28) a significant negative correlation was
      present between PIIIP values and (log) cumulative dust exposure. This decrease in
      serum PIIIP levels with increasing cumulative exposure may be due to chronic
      adaptive changes in type III collagen deposition and/or breakdown. Other
      relations between exposure and PIIIP were not observed. In conclusion, the
      present findings do not support the use of serum type III procollagen peptide as
      a marker of exposure to and (early) interstitial or respiratory effects of coal
      dust.

PMID- 7782128
TI  - The role of lactate dehydrogenase-C4 in testicular function and infertility.

PMID- 7782127
TI  - Blood toluene as a biological index of environmental toluene exposure in the
      "normal" population and in occupationally exposed workers immediately after
      exposure and 16 hours later.
AB  - Blood toluene was measured in a group of 100 workers occupationally exposed to a
      mean 8-h environmental toluene concentration of 128 micrograms/l (34 ppm), and in
      a group of 269 "normal" subjects without occupational exposure to toluene. The
      mean blood toluene of the workers at the end of the shift and the following
      morning, after 16 h, was 457 and 38 micrograms/l, respectively. The normal
      subjects had a blood toluene level of 1.1 micrograms/l. On the basis of the
      highly significant correlation between blood toluene and occupational exposure,
      it can be calculated that environmental toluene exposure of 188 and 377
      micrograms/l (50 and 100 ppm) gives end-of-shift blood toluene levels of 690 and
      1390 micrograms/l, respectively. The corresponding blood toluene levels on the
      following morning are 50 and 100 micrograms/l, respectively.

PMID- 7782129
TI  - Myoid cell proliferation in rat seminiferous tubules after ischaemic testicular
      atrophy induced by epinephrine. Morphometric and immunohistochemical (bromo
      deoxyuridine and PCNA) studies.
AB  - The proliferation of peritubular myoid cells in the testes of rats treated for 1
      11 weeks with intra-scrotal injections of epinephrine was investigated using
      immunohistochemistry and quantitative histology. The percentage of peritubular
      cells that were immunopositive for proliferating cell nuclear antigen (PCNA) or
      that were labelled with 5'-bromodeoxyuridine (BrdU) in the S-phase of the cell
      cycle, were calculated in control and treated rats after 1,3,5,8 and 11 weeks of
      treatment. In addition, the change in the number of peritubular cells per testis
      was calculated using two different stereological methods. The possible
      correlation between the changes observed using the two proliferation indices
      (PCNA immunoreaction and labelling of BrdU) in peritubular myoid cells was
      evaluated by regression analysis. The results of the study indicate that both
      proliferation indices increased in peritubular cells between the third and the
      eighth weeks of treatment, and that this increase was correlated with an increase
      in the number of these cells. From weeks 8-11 of treatment, both proliferation
      indices decreased and the same occurred with the number of peritubular cells. We
      hypothesize that proliferation of the peritubular cells occurs in order to
      increase their secretion of extracellular matrix components leading to
      enlargement of the lamina propria of the seminiferous tubule.

PMID- 7782130
TI  - Effect of seminiferous tubule size on hCG-induced regeneration of peritubular
      Leydig cells in hypophysectomized, EDS-treated rats.
AB  - Following their selective destruction 3 weeks previously by administration of
      ethane dimethanesulphonate (EDS) the regenerative capacity of Leydig cells was
      assessed in relation to seminiferous tubule morphology in hypophysectomized adult
      rats administered 7 daily injections of 100 iu hCG. Total Leydig cell volume per
      testis in hCG-treated rats (30.2 +/- 3.2 microliters, mean +/- SEM) was
      significantly (p < 0.01) greater than in the testes of rats at 3 and 4 weeks
      after EDS-treatment (7.6 +/- 0.7 and 22.7 +/- 1.4 microliters, respectively).
      Regeneration of Leydig cells in hCG-treated rats significantly (p < 0.05)
      favoured peritubular locations (18.6 +/- 2.8 microliters/testis) compared to
      central or perivascular sites of origin (11.6 +/- 1.2 microliters/testis).
      Partial restoration of spermatogenesis occurred in hCG-treated rats (tubule
      diameters usually > 250 microns) and a significant inverse correlation was found
      between peritubular Leydig cell percentage, or total volume per testis, and the
      volumetric proportion of seminiferous tubules (r = -0.94, p < 0.001) or the
      seminiferous epithelium (r = -0.73 to -0.79, p < 0.05-0.01). No significant (p >
      0.4-0.9) correlation existed between centrally-regenerated Leydig cells and these
      parameters. The results show that in response to hCG stimulation, Leydig cells
      are more likely to develop around smaller seminiferous tubules, suggesting that
      hCG alone cannot mimic the expected pattern of Leydig cell regeneration (central
      and peritubular origins) which occurs during normal sexual maturation or at 3-4
      weeks after EDS treatment. It is concluded that other factors, possibly FSH, are
      required for typical Leydig cell development which in turn may be influenced by
      local cellular growth factors originating from either the seminiferous tubules or
      the adjacent intertubular tissue.

PMID- 7782131
TI  - Temporal changes in sulphated glycoprotein-2 (clusterin) and ornithine
      decarboxylase mRNA levels in the rat testis after ethane-dimethane sulphonate
      induced degeneration of Leydig cells.
AB  - Short- (3-24 h) and long-term (4-50 days) changes in sulphated glycoprotein-2
      (SGP-2) and ornithine decarboxylase (ODC) mRNA levels in the adult rat testis
      were studied following a single dose of ethane-dimethane sulphonate (EDS), to
      destroy the Leydig cells. Distribution patterns of SGP-2 and ODC labelling were
      consistent with prevailing expression of the two transcripts in Sertoli cells and
      germ cells, respectively. This pattern did not show appreciable changes following
      EDS administration. No labelling of SGP-2 mRNA was noted in the interstitium of
      control and EDS-treated rats. This finding indicates that Leydig cell death
      induced by EDS is not associated with increased SGP-2 mRNA levels, a phenomenon
      related to apoptotic cell death in many tissues. Semi-quantitative densitometric
      analysis of the preparations demonstrated differential changes in SGP-2 and ODC
      mRNA levels in the tubular compartment following EDS treatment. At 6, but not at
      3 and 12, h following EDS administration, SGP-2 mRNA levels showed a significant
      increase, possibly secondary to a direct effect of the alkylating agent on
      Sertoli cells. A significant decrease in ODC mRNA levels was observed from day 7
      to day 28, matching degenerative changes in the seminiferous epithelium. In
      contrast, a decrease in SGP-2 transcript levels was observed from days 21-35
      after treatment. In conclusion, our findings demonstrate that SGP-2 mRNA, a
      putative marker of apoptosis, is not altered in the testicular interstitium
      during EDS-induced degeneration of Leydig cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782132
TI  - Insulin-like growth factor-I and transforming growth factor-alpha stimulate
      differentiation of type A spermatogonia in organ culture of adult mouse
      cryptorchid testes.
AB  - This study assessed the effect of growth factors on testicular germ cell
      differentiation in vitro. Testicular fragments of experimentally prepared
      cryptorchid testes of adult mice were cultured for 9 days in serum-free media
      containing various concentrations of IGF-I, TGF-alpha, FGF, and PDGF. Their
      histology was then examined under a light microscope. Each type of germ cell and
      mitotic cell in the seminiferous tubules was counted per 1000 Sertoli cells. IGF
      I at a concentration of 10 ng/ml induced maximal differentiation of type A
      spermatogonia. TGF-alpha at concentrations ranging from 1 to 10 ng/ml also
      stimulated differentiation, whereas FGF and PDGF did not show any stimulation of
      spermatogonial differentiation in this experimental system.

PMID- 7782133
TI  - Amiodarone effects on membrane organization evaluated by fluorescence
      polarization.
AB  - The effects of amiodarone (0-100 microM) on the physical state of synthetic and
      native membranes were investigated by fluorescence polarization of 1,6-diphenyl
      1,3,5-hexatriene (DPH), probing the bilayer core, and of its anionic propionic
      acid derivative (DPH-PA), probing the outer regions of the bilayer. In the gel
      phase of dimyristoylphosphatidylcholine (DMPC) bilayers, amiodarone broadens the
      transition profile and shifts the phase transition midpoint to lower temperature
      values, as evaluated by both probes. On the other hand, the drug orders the fluid
      phase of the lipid either in hydrophobic core or in the outer regions of the
      bilayer, as detected by DPH and DPH-PA, respectively. The effects of amiodarone
      on the thermotropic behaviour of DPPC confirm and extend data in DMPC.
      Cholesterol concentration modulates to a great extent the effects of amiodarone
      in the fluid phase of DMPC. Thus, both probes, DPH and DPH-PA, detect either
      ordering effects of amiodarone for low cholesterol concentrations (< or = 20
      mol%) or disordering amiodarone effects at higher cholesterol levels (> 20 mol%).
      In agreement with the results in models of synthetic lipids, the ordering effects
      of amiodarone in fluid native membranes of mitochondria and brain microsomes are
      depressed with the increase in intrinsic cholesterol. The ordering effects in
      mitochondria may induce bioenergetic dysfunctions and consequently disturbances
      in the electromechanic functioning of myocardium.

PMID- 7782134
TI  - Recombinant tissue-type plasminogen activator therapy in prosthetic mitral valve
      thrombosis: assessment by transthoracic and transesophageal echocardiography.
AB  - Prosthetic cardiac thrombosis is a life-threatening complication that needs
      prompt diagnosis and therapy. We used recombinant tissue-type plasminogen
      activator (rT-PA), followed by heparin, in three patients with mitral prosthetic
      thrombosis, which was evident in two and suspect in one. Transthoracic and
      transesophageal echocardiography were employed in the diagnosis of both
      thrombosis and its resolution. No complications occurred. Immediately after the
      end of treatment with rT-PA, clinical status and echocardiographic data improved
      in all cases: transthoracic echocardiography showed the normalization of
      prosthetic function and transesophageal echocardiography showed resolution of
      thrombosis. One patient needed reoperation for rethrombosis due to the presence
      of prosthetic fibrous clot. rT-PA, followed by heparin, led to a good clinical
      result without bleeding and embolic complications in selected patients with
      mitral prosthetic thrombosis. Transthoracic and transesophageal echocardiography
      are complementary diagnostic tools in the diagnosis and management of patients
      with prosthetic thrombosis.

PMID- 7782135
TI  - Surgical treatment of complete atrioventricular septal defect associated with
      tetralogy of Fallot.
AB  - The combination of complete atrioventricular septal defect (AVSD) and tetralogy
      of Fallot (TF) was reported to occur in less than 2% of patients undergoing
      repair of TF. From September 1981 to November 1989, five consecutive patients
      with such combination underwent total correction at National Taiwan University
      Hospital. Their age ranged from 3.8 years to 6.3 years. Two cases were associated
      with Down's syndrome. All interventricular communications were repaired by
      combined transatrial and transventricular approach and a separate pericardial
      patch was used to repair the interatrial communication. The transannular patch
      (TAP) was not used in one case; of the four cases with TAP, a pericardial
      monocusp was mounted in one of them. There was one hospital mortality, and one
      late death. Both were related to intractable right heart failure. We conclude
      that total repair of this anomaly could be accomplished after 3 years of age
      provided there is thorough awareness of anatomical features and avoidance of
      right heart failure.

PMID- 7782136
TI  - Influence of percutaneous transluminal coronary angioplasty on cardiac release of
      endothelin, neuropeptide Y and noradrenaline.
AB  - In the present study, the cardiac outflow of endothelin, noradrenaline and
      neuropeptide Y was investigated in 13 patients undergoing first time coronary
      angioplasty (PTCA) due to stenosis of the left anterior descending coronary
      artery. During PTCA there was an increase in the coronary sinus levels of
      endothelin but no detectable changes in neuropeptide Y or noradrenaline
      concentrations. It is therefore concluded that endothelial damage rather than
      myocardial ischaemia is the cause of endothelin release during PTCA.

PMID- 7782137
TI  - Mortality and clinical course of patients with acute myocardial infarction
      treated with streptokinase and antioxidants: mannitol and ascorbic acid.
AB  - There is increasing evidence that free radical scavengers limit reperfusion
      injury in animal experiments. We randomly administered 250 ml 20% mannitol
      infusion and 10.0 g ascorbic acid infusion, potent free radical scavengers to 42
      patients with acute myocardial infarction receiving streptokinase. A control
      group of 42 patients received only standard fibrinolytic therapy. We found that
      additional antioxidant treatment with ascorbic acid and mannitol decreased the
      number of some complications of acute myocardial infarction.

PMID- 7782139
TI  - Biochemical diagnosis of myocardial infarction within the thrombolytic time
      window.
AB  - A demonstrated temporal change in the total activity of creatine kinase or mass
      measurement of the cardio-specific isoenzyme creatine kinase MB is currently used
      as the biochemical diagnosis of myocardial infarction. The isoforms of creatine
      kinase MB may provide an earlier diagnostic marker of myocardial infarction than
      the currently available biochemical markers. We compare the sensitivity and
      specificity of total creatine kinase activity, creatine kinase MB mass
      measurement and the muscle and heart specific isoforms of creatine kinase in the
      early diagnosis of myocardial infarction. Using current methodologies, neither CK
      isoform offered any advantage over CK mass measurement as an early marker of
      ischaemic myocardial damage.

PMID- 7782138
TI  - The value of exercise electrocardiography testing in the identification of
      coronary restenosis: a probability analysis.
AB  - We studied by means of probability analysis the role of exercise ECG in
      identifying coronary restenosis. A total of 213 patients were independently
      evaluated by clinical history, conventional assessment of the exercise ECG ('yes
      or no' statement), D score (a discriminant function derived from exercise ECG),
      and coronariography, 5.4 +/- 2.8 months after successful coronary angioplasty.
      The initial probability of restenosis (30%), that is, the prevalence of the
      condition, was radically changed by the result of clinical history (77% for
      patients with angina vs. 17% for those without angina). By contrast, ECG binary
      assessment, due to its low accuracy (70% vs 82% of clinical history, P < 0.005),
      was unable to significantly change the established probabilities after
      symptomatic evaluation. Finally, D score, which greatly enhanced specificity (92%
      vs. 76% of bivariate assessment, P < 0.0001), proved to be useful in changing the
      probability (from 32% to 76% or to 25%) of patients (n = 34) with a discordant
      result (no angina/positive exercise ECG). When this stepwise approach was tested
      in 46 new patients, predicted and observed probabilities were actually very
      similar. We conclude that exercise ECG has a very limited role in identifying
      coronary restenosis if positive responses are not adjusted with a weighted score
      which takes into account other exercise derived factors.

PMID- 7782140
TI  - Effect of verapamil on the prognosis of patients with early postinfarction
      electrical or mechanical complications. The Danish Verapamil Infarction Trial II
      (DAVIT II).
AB  - The Danish Verapamil Infarction Trial II (DAVIT II) demonstrated from the second
      postinfarction week, that long term treatment with verapamil significantly
      improved reinfarction free survival after an acute myocardial infarction (AMI).
      The present post hoc analysis of DAVIT II was undertaken with the purpose of
      evaluating the effect of treatment with verapamil in patients with early
      electrical complications, i.e. ventricular or atrial fibrillation, ventricular
      tachycardia, or second or third degree atrioventricular block, with or without
      mechanical complication, i.e. heart failure, during the first post-AMI week. In
      the placebo group, the 18-month mortality rate was lowest (9.5%) in patients
      without electrical or mechanical complications, highest (24.6%) in patients with
      electrical events only, and in-between (17.5%) in patients with mechanical
      problems regardless of presence of electrical complications. Verapamil
      significantly reduced the 18-month mortality rate in patients with early
      electrical without mechanical complications (60% reduction, P = 0.02), and in
      patients without mechanical complications (35% reduction, P = 0.02). Verapamil
      did not change the mortality rate in patients with mechanical complications.

PMID- 7782141
TI  - Ventilation-perfusion matching in chronic heart failure.
AB  - BACKGROUND: The exercise limitation of patients with chronic heart failure is
      associated with an increased ventilatory response during exercise. This is
      thought to be due, at least in part, to excessive dead space ventilation.
      METHODS: To assess ventilation perfusion matching, 20 patients with chronic heart
      failure and eight controls with asymptomatic left ventricular dysfunction
      underwent symptom limited treadmill exercise with arterial blood sampling.
      Metabolic gas exchange was determined by expired gas analysis. Fractional dead
      space ventilation and the alveolar arterial oxygen difference were derived.
      RESULTS: There was a fall in fractional dead space ventilation (0.43 to 0.28; P <
      0.001), more marked in the controls (peak dead space fraction 0.19 (controls),
      0.32 (patients); P = 0.002). There was a rise in alveolar arterial difference in
      all patients (1.59 to 2.55 kPa; P = 0.006) with no difference between patients
      and controls. Arterial carbon dioxide tension fell during exercise (4.89 to 4.63
      kPa; P < 0.001), with no difference between patients and controls. There was no
      significant change in arterial oxygen tension. CONCLUSIONS: The fall in arterial
      carbon dioxide was the same in both patients and controls. The modest increase in
      alveolar-arterial oxygen difference tension was the same in both groups, which,
      coupled with the stable arterial oxygen tension makes it unlikely that a primary
      change in ventilation-perfusion matching is the cause of increased ventilatory
      response to exercise in chronic heart failure.

PMID- 7782142
TI  - Presentation and management of patients admitted with atrial fibrillation: a
      review of 291 cases in a regional hospital.
AB  - Two hundred and ninety one patients admitted with atrial fibrillation through the
      emergency room of a regional hospital in the year 1993 were reviewed to evaluate
      the presenting features and in-hospital treatment of patients with symptomatic
      atrial fibrillation. The incidence of atrial fibrillation increased with age
      (mean age was 73 +/- 12 years) and the ratio of female to male was 1.8:1. The
      commonest presenting features were palpitation (42.3%), dyspnoea (38.1%) and
      heart failure (16.4%). The most frequently associated cardiac conditions were
      hypertension (28.9%), atherosclerotic cardiovascular disease (24.7%) and
      rheumatic heart disease (17.5%). Pulmonary diseases (18.6%), diabetes mellitus
      (12.7%) and thyrotoxicosis (6.2%) were the principal associated non-cardiac
      conditions. Thromboembolic complications were found in 15 patients at
      presentation (5.2%). Cardiac enzyme assessment was investigated in two thirds of
      the patients (68.1%), while thyroid function test (59.5%) and echocardiography
      (29.6%) were less commonly investigated. Digoxin was still the most popular drug
      used for ventricular rate control, and cardioversion was performed in only 6.9%
      of patients. Antithrombotic therapy was used in 5.8% of patients only although it
      was clinically indicated in more than half of the patients (52%).
      Contraindications of anticoagulation were found in 23 patients (7.9%), including
      a history of gastrointestinal or cerebrovascular bleeding, active bleeding,
      chronic renal failure and poor drug compliance. The mean hospital stay was 5 +/-
      4 days, compared to a mean stay of 2.7 days for other medical patients. Fourteen
      patients (4.8%) died during hospitalisation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782143
TI  - The effects of sympathetic stimulation induced by mental stress on signal
      averaged electrocardiogram.
AB  - We evaluated the influence of sympathetic stimulation, induced by mental stress
      test, on signal-averaged ECG in 30 healthy subjects and in 30 patients with
      previous myocardial infarction. Both patient and control groups underwent three
      consecutive signal-averaged ECG: under basal conditions, during a continuous
      mental stress test, and 5 min after the mental stress test. The signal-averaged
      ECG parameters, analyzed by mean of a bandpass filter of 25-250 and 40-250 Hz,
      were: the filtered QRS duration, the duration of the low-amplitude high frequency
      signals in the terminal portions of the QRS complex below 40 microV (HFLA), and
      the root mean square voltage in the last 40 ms of the filtered QRS (RMS). The
      mathematical stress test was considered effective when the heart rate increased
      by at least 15 beats/min, remaining stable for the total duration of the signal
      averaged ECG acquisition. A significant reduction of the filtered QRS duration
      and HFLA with a simultaneous increase of RMS were found in control group, while
      no significant changes occurred in patient group. These results indicate that the
      sympathetic nervous system may affect the results of signal-averaged ECG,
      probably by influences on intraventricular conduction, in healthy subjects. On
      the contrary, myocardial alterations in ischemic heart disease induce
      modification of signal-averaged ECG not influenced by autonomic nervous system
      activity.

PMID- 7782144
TI  - Dietary fat purchasing habits in whites, blacks and Asian peoples in England-
      implications for heart disease prevention.
AB  - The mortality and morbidity from coronary heart disease (CHD) is higher in people
      of South Asian origin than in whites, but is significantly lower in the black
      (Afro-Caribbean origin) community in the United Kingdom. To investigate whether
      this may be related to differences in fatty food intake, we performed a
      questionnaire survey of the weekly food purchasing habits and preparation methods
      in white, black (Caribbean) and Asian households in Birmingham. We interviewed
      224 housewives from three ethnic groups (84 white, 76 black/Afro-Caribbean and 72
      Asian). The highest quantity of fat in foods purchased per week was found in the
      Asian population (median 1409 g/week per person, interquartile range (IQR) 850
      1952), which was significantly greater than black subjects, who had the lowest
      quantity of fat in foods purchased (1012 g/week per person, IQR 835-1388) (Mann
      Whitney test:median differences 300.5, 95% C.I. 23.3-600.4, P = 0.029). The
      median quantity of fat in foods purchased by the white households was
      intermediate, at 1186 g/week per person (IQR 861-1711). There was a higher
      quantity of fat in foods purchased in the lower social classes (IV and V) in both
      the white and Asian populations. Butter, egg and milk consumption was
      significantly greater in Asians; with ghee consumption almost exclusive amongst
      this group (98%). Amongst whites and blacks, the commonest food preparation
      methods were grilling, boiling or poaching; whilst amongst Asians, frying was
      more common (chi 2 = 81.25, d.f. = 4, P < 0.0001).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7782145
TI  - General practitioners' requirements from a hospital cardiology department.
AB  - The requirements of 500 general practitioners from a hospital department of
      cardiology were sought and assessed from a questionnaire. One hundred and twenty
      two general practitioners caring for 766,384 patients responded. The most
      important inpatient service requirement was that cardiologists should be
      responsible for the management of patients with acute myocardial infarction and
      other acute cardiac conditions. The expertise and reputation of the consultant
      cardiologist and the waiting time for an appointment were the two most important
      outpatient service requirements. The least important aspect was the time patients
      waited in clinic to see a doctor. Fundholders considered price of outpatient
      consultations to be unimportant. Waiting times for cardiac catheterisation and
      non-invasive cardiac investigations together with the quality of the
      investigation equipment and the technical staff were all considered to be
      important requirements. Most general practitioners wanted protocols for managing
      common cardiac conditions. The majority wanted an open access investigation
      service to reduce outpatient waiting times. Those who did not want an open access
      service explained that they would not be confident in interpreting the results or
      deciding subsequent management. An understanding of the requirements of general
      practitioners is helpful in planning and developing hospital services.

PMID- 7782146
TI  - Blood pressure response to stress tests does not reflect blood pressure
      variability and degree of cardiovascular involvement in young hypertensives.
AB  - The aim of the study was to assess the clinical value of blood pressure response
      to stress tests and to study its relationship with ambulatory blood pressure
      monitoring, daily blood pressure variability and hypertensive complications. Cold
      pressor test for 2 min, hand grip test at 25% of maximal voluntary contraction
      for 5 min and orthostatism were performed in 223 young men found hypertensive (BP
      systolic > 140 mmHg and/or diastolic > 90 mmHg) at the military service
      recruitment check-up. On the basis of ECG and fundoscopic examination, each
      patient was attributed a score of target organ damage. All patients underwent non
      invasive 24-h blood pressure monitoring and 169 patients underwent
      echocardiographic examination. Hypertension was confirmed in 54.2% of the
      subjects at ambulatory monitoring. No correlation was found between blood
      pressure response to stress tests and ambulatory blood pressure, daily blood
      pressure variability, target organ damage and left ventricular mass. Night-time
      ambulatory blood pressure were correlated with posterior wall
      thickness/ventricular diastolic internal diameter ratio (r = 0.26, P < 0.001). A
      negative correlation was found between the office-daytime blood pressure
      difference and systolic and diastolic response to orthostatic test (r = -0.309, P
      < 0.0001 for systolic blood pressure and r = -0.433, P < 0.0001 for diastolic
      blood pressure) and between supine office blood pressure and blood pressure
      response to orthostatism (r = -0.186. P = 0.013 for systolic blood pressure and r
      = -0.442, P < 0.0001 for diastolic blood pressure).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7782147
TI  - Influence of isolated diastolic hypertension identified by ambulatory blood
      pressure on target organ damage.
AB  - Clinical decisions and controlled studies in regard to hypertension have long
      emphasized the casual diastolic blood pressure (DBP). The influence of
      superimposition of high systolic blood pressure (SBP) on the target organ damage
      has been less studied. To assess the role of isolated diastolic hypertension
      without interference of superimposition of systolic hypertension, 171 subjects
      with normal blood pressure, isolated diastolic hypertension (SBP < 140 and DBP >
      or = 90 mmHg) isolated systolic hypertension (SBP > or = 140 and DBP < 90 mmHg)
      or combined hypertension (SBP > or = 140 and DBP > or = 90 mmHg) determined by
      mean 24-h ambulatory blood pressure were compared in relation to target organ
      damage including ECG abnormality related to hypertension, cardiac enlargement by
      chest X-ray, proteinuria and retinopathy. The incidence of target organ damage
      was lower in subjects with normal BP than in the other three groups. The
      incidence of target organ damage was almost significantly higher in patients with
      isolated systolic hypertension than in those with isolated diastolic
      hypertension. No significant difference in the incidence of complications existed
      between patients with isolated systolic and combined hypertension. These findings
      demonstrate that the severity of hypertensive complications is more closely
      related to mean ambulatory SBP than mean ambulatory DBP. The level of systolic BP
      is important for predicting the severity of target organ damage in patients with
      high diastolic BP, because there is a significant difference in the incidence of
      target organ damage between isolated diastolic hypertension and combined
      hypertension.

PMID- 7782148
TI  - Cardiomyopathic lentiginosis: an echo-Doppler report.
AB  - We report a case of a 64-year-old woman with cardiomyopathic lentiginosis. All
      the echocardiographic features of a hypertrophic obstructive cardiomyopathy were
      detected, with an accurate noninvasive measure of the left ventricle outflow
      gradient.

PMID- 7782149
TI  - Effect of cisplatin and FK565 on the activation of tumor-associated and bone
      marrow-derived macrophages by Dalton's lymphoma.
AB  - The present investigations were undertaken to study the effect of Dalton's
      lymphoma (DL) in situ on the functions of DL-associated macrophages (DL-AM) and
      bone marrow-derived macrophages (BMDM) in C3H/He mice. DL-AM showed enhanced
      production of reactive nitrogen intermediates (RNI) and tumor necrosis factor
      (TNF) compared with normal peritoneal macrophages (NMO). BMDM of DL mice also
      showed enhanced production of RNI compared with BMDM of normal mice. These
      observations suggest that the presence of DL in situ creates an environment which
      favours the activation of both DL-AM and macrophage progenitors located at a
      distant site. The effect of in vivo administration of chemotherapeutic drugs
      cisplatin and FK565 on the activation of DL-AM by DL cells was also investigated.
      Both cisplatin and FK565 augmented RNI production of NMO but differed in their
      effect on DL-AM. The production of RNI by DL-AM of cisplatin-treated mice was
      inhibited, whereas in the FK565 group it was up-regulated.

PMID- 7782150
TI  - Effects of triiodothyronine supplements on splenic natural killer cells in
      malnourished weanling mice.
AB  - The main purpose of this investigation was to determine whether exogenous
      triiodothyronine (T3) administered according to a protocol known to prevent
      depression in acquired immunity in weanling murine protein-energy malnutrition
      (PEM) would, likewise, influence the splenic natural killer (NK) cell in this
      disease. Weanling mice of disparate inbred strains, C57BL/6J and CBA/J, were
      subjected to wasting PEM produced by means of two low-protein diets (0.5% crude
      protein) identical in every respect except that one diet contained supplemental
      T3 (0.2 micrograms/g diet). NK cell lytic activity toward YAC-1 targets was
      assessed in vitro using suspensions containing 0.5 x 10(6) mononuclear spleen
      cells. Lytic activity in this assay was low in mice fed the unsupplemented low
      protein diet, but was not depressed in malnourished animals given exogenous T3.
      Surface marker analysis using the NK cell-specific antigen, NK 1.1 (PK 136),
      revealed no effect of the low-protein diet or of exogenous T3 on the proportion
      of splenic mononuclear cells exhibiting NK 1.1+ phenotype. Previous
      investigations have shown that acquired immune competence in PEM can be
      manipulated, by means of endocrine hormonal intervention, independently of
      continued wasting disease. The present results extend this fundamental new
      concept to include an innate immune function, namely NK cell lytic activity. In
      this system of experimental PEM, exogenous T3 prevented depression in NK cell
      lytic activity expressed on a per cell basis. The malnourished weanling rodent is
      a particularly powerful experimental system with which to investigate the
      mechanisms whereby thyroid hormones influence NK cells.

PMID- 7782151
TI  - Accelerated myelopoietic recovery in irradiated mice treated with Photofrin.
AB  - The porphyrin photosensitizer, Photofrin porfimer sodium (Photofrin), has been
      widely studied for its capacity to evoke destruction of malignant tissues. In
      addition to its photosensitizing properties, Photofrin may exert myelostimulatory
      effects in normal and immunosuppressed mice in the absence of activating light.
      In the present set of experiments, we examined the effect of Photofrin upon the
      immunohematopoietic axis of sublethally irradiated DBA/2 mice. Administration of
      Photofrin (10 mg/kg) 1 and 4 days following irradiation (4 Gy) significantly
      enhanced the recovery of spleen cellularity, spleen and bone
      granulocyte/macrophage progenitors (colony-forming units, CFU-GM) and peripheral
      blood leukocytes levels. Proliferative responses to the T-cell mitogen
      concanavalin A by spleen cells prepared from Photofrin-treated mice were
      significantly less than those of cells from irradiated control mice 8 and 15 days
      post-irradiation. Photofrin given 1, 4 and 7 days following irradiation elevated
      splenic CFU-GM 3 to 4-fold 10 days post-irradiation relative to the irradiated
      controls and mice given only two injections of Photofrin. In contrast to the
      effect of two injections, multiple (three or four) injections of Photofrin did
      not elevate bone marrow CFU-GM above control levels beyond 8 days post
      irradiation. In addition, splenic CFU-GM levels in animals receiving three or
      four injections of Photofrin were no different than those of the irradiated
      controls later than 10 days post-irradiation. These findings indicate that
      prolonged exposure to Photofrin in sublethally irradiated mice may induce
      regulatory factors which dampen the enhanced myelopoietic recovery stimulated by
      only two injections of the drug.

PMID- 7782153
TI  - In vivo and in vitro effects of macrophage colony-stimulating factor (M-CSF) on
      bronchoalveolar macrophages for antihistoplasmal activity.
AB  - The in vivo and in vitro effects of M-CSF on bronchoalveolar macrophages (BAM)
      activity against the intracellular fungal pathogen Histoplasma capsulatum (Hc)
      were studied. Three days after a single subcutaneous (s.c.) dose of M-CSF (2.5
      mg/kg), enhanced ex vivo antifungal activity of BAM was measured. BAM from M-CSF
      treated CD-1 mice significantly (P < 0.01) inhibited the intracellular
      multiplication of Hc yeast cells in 20 h assays compared to BAM from control
      mice. This effect was not observed at days 1, 7, 11 or 21 post-treatment. A dose
      of 5 mg/kg s.c., but not 1 mg/kg, induced similar antifungal activity in BAM by
      day 3. Peritoneal macrophages (PM) from M-CSF-treated mice did not have enhanced
      antifungal activity at days and doses tested. BAM could also be activated for
      antihistoplasmal activity by M-CSF in vitro. M-CSF at 10,000 U/ml for 24 h or
      5000 U/ml for 48 h induced significant (P < 0.01) inhibition of intracellular
      multiplication of Hc. Interferon-gamma (IFN) plus lipopolysaccharide (LPS)
      activated BAM and PM in vitro to inhibit intracellular multiplication of Hc (P <
      0.001); the antihistoplasmal activity was completely inhibited by NG-monomethyl L
      arginine (N-MMA), indicating that an L-arginine-dependent nitric oxide-producing
      mechanism was operative. N-MMA could not inhibit the antihistoplasmal activity of
      BAM or PM activated by M-CSF in vitro. The mechanism by which M-CSF-activated
      macrophages inhibit intracellular multiplication of Hc remains to be determined.

PMID- 7782152
TI  - Immunomodulating IL-6 activity by murine monoclonal antibodies.
AB  - The human anti-mouse immunoglobulin antibody (HAMA) response, which occurs
      frequently after injection of murine monoclonal antibodies (MAb) directed against
      cellular targets, has been reported extensively in several studies. We analysed
      here HAMA in 12 patients (six with multiple myeloma, MM, and six with metastatic
      renal cell carcinoma, MRCC) who were treated with B-E8, an IgG1 MAb against
      interleukin-6 (IL-6). Efficiency of the treatment was evidenced by the drop in
      the serum levels of C reactive protein (CRP), of which the in vivo production is
      under the control of IL-6. Three patients with MM and the six patients with MRCC
      became immunized to the injected MAb. HAMA appeared between days 7 and 15 after
      the beginning of the treatment. The nine patients made IgG antibodies; four also
      made IgM. All of immunized patients made anti-idiotype antibodies specific to B
      E8. Two of them also developed HAMA directed to murine IgG1 isotype; in these two
      patients B-E8 MAb cleared rapidly from the circulation with loss of treatment
      efficiency. In the patients who developed only anti-idiotype antibodies, serum
      levels of B-E8 remained unchanged and CRP production remained inhibited,
      indicating that treatment efficiency was not affected by the presence of HAMA.
      Circulating B-E8 MAb were still able to bind to IL-6 and to inhibit IL-6
      independent proliferation despite the presence of anti-idiotypic HAMA. Therefore,
      in contrast to HAMA against MAb directed against cellular targets, HAMA against
      anti-IL-6 MAb idiotopes led neither to clearance nor to functional inactivation
      of the injected MAb.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782154
TI  - Stimulatory effects of cocaine and its metabolites on IM-9 human B-lymphoblastoid
      cells.
AB  - This study examined the effect of cocaine and its metabolites benzoylecgonine,
      norcocaine, and cocaethylene on human B-cell proliferation using IM-9 cells.
      Cells were incubated with 0.01-10 micrograms/ml of cocaine or metabolite in serum
      free medium or medium containing 2% FBS for 24 and 48 h, and [3H] thymidine
      incorporation into DNA was measured using liquid scintillation counting. Results
      showed incubation with cocaine and metabolites significantly increased IM-9 cell
      proliferation. With cocaine, maximal stimulation of 148% (compared to drug-free
      control) occurred at 1.0 micrograms/ml in serum-free medium at 48 h.
      Benzoylecgonine and norcocaine showed maximal stimulation at 0.1 micrograms/ml
      with 170% and 150% stimulation, respectively. Cocaethylene showed maximal
      stimulation of 146% at 10 micrograms/ml. Drug stability was monitored under
      incubation conditions using high-performance liquid chromatography (HPLC). We
      have shown that cocaine and its major metabolites have an immunomodulatory effect
      on B-cell proliferation at concentrations equivalent to serum levels produced
      during cocaine use in humans. Since the cocaine metabolites also show an
      immunomodulatory effect, the immune consequences of cocaine use may be
      significantly prolonged.

PMID- 7782155
TI  - Liposomal adjuvanticity: effect of encapsulation and surface-linkage on antibody
      production and proliferative response.
AB  - The immunoadjuvanticity of liposomal antigens, namely encapsulated and surface
      linked conalbumin, was studied at different levels of an immune response
      including immunoglobulin production, blastogenic response and lymphokine
      production in sensitization conditions compatible with vaccine designs. The
      results demonstrated that both liposomal formulations stimulate all properties
      analyzed with respect to free antigen but significantly differ in some of their
      inductive capabilities, suggesting that they follow different routes in the
      immune network. Thus, although both liposomal antigens are capable of inducing
      potent humoral responses characterized by increased production of IgM and IgG2a,
      covalently linked antigen stimulates a quasi-polyclonal blastogenic response
      accompanied by the simultaneous secretion of IL-2 and IFN gamma, while
      encapsulated antigen which is less blastogenic mainly induces IL-2 secretion. We
      can conclude that: first, both antigenic formulations induce a Th1 type of
      activation and might therefore potentiate cell-mediated immunity, but surface
      linkage favors a more rapid maturation of the response and a much more intense
      help induction. Second, although a strong adjuvanticity can be observed whatever
      the route of sensitization, namely intraperitoneally, intravenously or
      subcutaneously, the intravenous injections induce the better potentiation. The in
      vitro data were all compared to those obtained with naive mice, allowing
      dissociation of the contribution of the in vitro rechallenge from that of the in
      vivo immunization. These differences observed between the liposomal antigens
      might be taken advantage of while formulating vaccines specifically suited to
      meet required needs and suggest that covalently linked antigen might be
      particularly useful in situations where induction of cell-mediated immunity is of
      prime importance.

PMID- 7782156
TI  - Conformation and structure of linear peptides with regularly alternating L- and D
      residues: structure of the blocked hexapeptide tert-butyloxycarbonyl-(D
      alloisoleucyl-L-isoleucyl)3 methyl ester monohydrate.
AB  - Peptides with a regular sequence of enantiomeric residues (L and D) along the
      chain have received considerable attention because of their accessibility to
      unique conformations and because they are model compounds for the naturally
      occurring peptide gramicidin A, which shows monovalent cation selective
      transmembrane transport. The solid-state structure of the linear hexapeptide t
      Boc-(D-alle-L-Ile)3-OMe has been determined by X-ray diffraction techniques and
      refined to a final R factor of 0.068. The molecule shows a bent U-shaped
      conformation stabilized by three intramolecular H-bonds of the N-H...O = C type:
      a type II beta-bend (4-->1 bend or C10 ring structure) with L-Ile2 and D-aIle3 at
      positions 2 and 3 of the bend, an alpha-turn (5-->1 bend or C13 ring structure)
      and a 1-->5 bend or C17 ring structure. The first two 10-membered and 13-membered
      bends are enclosed in the latter 17-membered hydrogen-bonded ring structure. This
      structural motif is common to hepta- and octa-peptide cyclic molecules, showing
      that ring closure is not required to achieve a particular topology in the
      molecular design of specific bended conformations.

PMID- 7782157
TI  - Synthesis of alpha-factor analogues containing photoactivatable and labeling
      groups.
AB  - Analogues of alpha-factor, Saccharomyces cerevisiae tridecapeptide mating
      pheromone (H-Trp-His-Trp-Leu-Gln-Leu-Lys-Pro-Gly-Gln-Pro-Met-Tyr-OH), containing
      both p-benzoyl phenylalanine (Bpa), a photoactivatable group, and 3-(mono- or di
      iodo-4-hydroxyphenyl)propanoic acid (iodinated HPP) or biotin as a tag, were
      synthesized using solid-phase methodologies on a [phenylacetamido]-methyl (PAM)
      resin. Bpa was introduced into the peptides using Bpa-hydroxybenzotriazole active
      ester during peptide chain assembly. Biotinylated alpha-factor analogues were
      prepared by assembling the desired peptide on the resin, and then reacting a
      specific amino group either with the symmetrical anhydride of biotin or with
      biotin using BOP as the activating agent prior to anhydrous hydrogen fluoride
      cleavage. Iodinated HPP was incorporated by acylating free peptides with Bolton
      Hunter reagent (3-[diiodo-4-hydroxyphenyl]propanoic acid hydroxysuccinimide
      ester) in N,N-dimethylformamide and borate buffer (pH 8.0) solutions.
      Purification of all peptides to 98% or greater homogeneity was accomplished by
      high-performance liquid chromatography on a reversed-phase mu-Bondapak C18 column
      with acetonitrile/water/trifluoroacetic acid as the mobile phase. All products
      were characterized by amino acid analysis and fast atom bombardment mass
      spectrometry. Two analogues, alpha-(diiodotyrosine)-His-Bpa-Leu-Gln-Leu-Arg-Pro
      Gly-Gln-Pro-Nle-Tyr-O H, and epsilon-(diiodo-HPP)-Lys-His-Bpa-Leu-Gln-Leu-Arg-Pro
      Gly-Gln-Pro-Nle-Tyr -OH, were one twentieth to one-fortieth as active as a alpha
      factor, and exhibited approximately one order of magnitude lower affinity to the
      alpha-factor receptor. The results suggest that these two analogues are alpha
      factor agonists and that they can be used as probes of the alpha-factor receptor.

PMID- 7782158
TI  - The 2,4-dinitrophenyl group for protection of hydroxyl function of tyrosine
      during solid-phase peptide synthesis.
AB  - The facile thiolytic cleavage of the O-2,4-dinitrophenyl (Dnp) tyrosine bound was
      applied to the solid-phase synthesis of the 22-amino acid residue peptide H-Asp
      Ala-Val-Tyr-Thr-Gly-Leu-Asn-Thr-Arg-Asn-Gln-Glu-Thr-Tyr-Glu-Thr-Le u-Lys- His-Glu
      Lys-OH, corresponding to positions 62-83 in the chain of the type 1 receptor for
      Fc epsilon domains expressed on the rat mucosal-type mast cells (line RBL-2H3). A
      method for the spectrophotometric determination of insoluble O-Dnp as well as of
      unprotected phenolic moieties of tyrosine was developed. It is based on
      monitoring S-Dnp-2-mercaptoethanol, produced upon O-Dnp thiolysis by 2
      mercaptoethanol.

PMID- 7782159
TI  - Mechanism of solvent-induced thermal stabilization of alpha-amylase from Bacillus
      amyloliquefaciens.
AB  - The transition temperature of irreversible thermal inactivation of alpha-amylase
      from Bacillus amyloliquefaciens was estimated to be 60 degrees C. At this
      temperature, the enzyme inactivation followed first-order kinetics, having a half
      life (t 1/2) of 12 min with a rate constant (k) of 0.06 min-1. Conformational
      change was a prerequisite for this thermal inactivation. This is governed by
      stepwise temperature-dependent phenomena. Among the solvent stabilizers tested,
      the enzyme was thermally stable in presence of DMSO and PEG 300 and the
      stabilizing efficiency of these cosolvents was concentration-dependent. The
      enzyme was partially stabilized by 5.0 M DMSO and 1.9 M PEG 300 up to 78 degrees
      C. However, above 78 degrees C the enzyme was inactivated in these cosolvents
      also. The mechanism of stabilization has been explained by preferential hydration
      of the enzyme in these structure stabilizing solvents by exclusion from the
      protein surface and interface by measurement of partial specific volume in these
      cosolvents. The data suggest a high value of preferential interaction parameter,
      (delta g3/delta g2)tau, mu 1, mu 3 being -0.606/g/g g/g in 40% DMSO and a low
      value of -0.025 g/g in 5% glycerol. The preferential interaction parameters in
      sucrose and glycerol suggests that (delta g3/delta g2)tau, mu 1, mu 3m is highest
      of -0.420 g/g in 10% glycerol than any other cosolvent.

PMID- 7782160
TI  - Peptide aggregates: a novel model system to study self-assembly of peptides.
AB  - Ordered aggregates of Val-Leu-Pro-Phe, tetrapeptide 1, have been found in aqueous
      solutions. Evidence for the formation of aggregates for the above peptide was
      obtained by conductometric, pH metric, UV and fluorescence spectroscopic
      techniques. Values of critical micelle concentration (CMC) for the above peptide
      obtained by these methods are in good agreement with each other. The formation of
      organized aggregates of the peptide is favoured upon increasing the temperature
      (viz. the process of aggregation is endothermic). The aggregation number has been
      determined at different temperatures. Values of delta G0m, delta H0m, delta S0m
      and delta C0p have also been estimated. Binding studies with the 8
      anilinonaphthyl sulfonic acid (ANS) and pyrene indicate that the interior of the
      aggregate is nonpolar. There are two processes with regard to the change of
      thermodynamical parameters like delta G0m, delta H0m, delta S0m, delta C0p and
      aggregation number (N). In the first process (from 5 degrees C to 40 degrees C)
      the driving force for aggregation seems to be the positive entropy because of
      water release due to intermolecular association of ionic moieties. The second
      process (from 40 degrees C and above) is due to intramolecular ionic interaction.
      The chemical shifts of the amide protons of the peptide have been presented in
      the light of inter- and intramolecular hydrogen-bond formation, and forces
      implicated in aggregation for both the first and second processes.

PMID- 7782161
TI  - Incorporation of thioamide linkages into a growing peptide under SPPS conditions
      improved by salt effects.
AB  - Amino acid methyl dithioesters may be coupled in the presence of DMAP and salts
      to a growing peptide chain on a polymeric resin with high coupling yields and low
      racemization.

PMID- 7782162
TI  - 'Tethered ligand' derived pentapeptide agonists of thrombin receptor: a study of
      side chain requirements for human platelet activation and GTPase stimulation.
AB  - Proteolytic action of alpha-thrombin on human thrombin receptor results in
      cleavage of a portion of the N-terminus, thereby generating a 'tethered ligand'
      at the newly exposed N-terminus, which then activates the receptor in an
      intramolecular fashion. Agonist peptides incorporating the amino acid sequence of
      the newly exposed N-terminal portion of the cleaved receptor cause receptor
      activation without requiring prior cleavage of the receptor by thrombin. The
      pentapeptide amide Ser-Phe-Leu-Leu-Arg-NH2, which retains the N-terminal sequence
      of the 'tethered ligand' of the receptor, has been shown to be the minimum
      sequence to cause receptor activation. To understand the importance of the side
      chains of various residues within the pentapeptide amide, we carried out an
      extensive structure-activity study of the ability of peptides to stimulate gel
      filtered platelet aggregation. In this study 106 pentapeptide amides were
      synthesized, utilizing naturally occurring L-amino acids, unnatural amino acids,
      D-amino acids and N-methyl amino acids for replacements. At position-1, charged
      residues (acidic or basic) were not tolerated, and the size and shape of the
      residue were important. Position-2 tolerated only aromatic residues. Position-3
      accommodated various residues. A significant finding of this study was that two
      very different residues, [3-(2-naphthyl)]-L-alanine and L-arginine, when
      substituted for leucine residue at position-3, resulted in more active agonists.
      At position-4 aromatic and aliphatic residues were well tolerated, whereas basic
      and acidic residues were less tolerated. Position-5 mimicked position-3 in its
      ability to tolerate a wide range of residues.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782163
TI  - Peptide synthesis using novel S-sulfocysteine derivatives.
AB  - New cysteine S-sulfonate derivatives, Boc-Cys(SO3Na)-ONa 2 and Fmoc-Cys(SO3Na)
      ONa 3, were prepared and their utility for peptide synthesis examined. The Fmoc
      derivative 3 was used in the solid-phase peptide synthesis of Arg8-vasopressin 9
      via the Bunte salt 7. Satisfactory S-sulfonate stability was observed when p
      cresol scavenged the cleavage from the resin. The intermediate 7 was purified by
      ion-exchange chromatography prior to S-sulfonate cleavage with tributylphosphine.

PMID- 7782164
TI  - Role of peptide hydrophilicity on determination of microsequencing efficiency.
AB  - The successful sequencing of short peptides on hydrophobic polyvinylidene
      difluoride membrane (PVDF-P) has been problematic. In this study the sequencing
      efficiency of various short synthetic peptides on charged-modified PVDF (PVDF-N)
      and chemically treated glass-fiber membranes or discs has been examined. These
      modified membranes provided better repetitive yields or sequencing efficiency
      than the unmodified PVDF-P. In contrast, there were no significant differences
      among the resulting initial yields for all the tested membranes, indicating that
      the modified membranes did not interfere with the coupling/cleaving reactions.
      Methanol at 1% increased the solubility of phenylisothiocyanate (PITC) in heptane
      for gas-phase delivery during the coupling reaction, whereas this addition of
      methanol failed to increase the coupling efficiency. Reduction of chemical
      background noise by replacing triethylamine (TEA) with diisopropylethylamine
      (DIPEA) also failed to increase the coupling efficiency. Polybrene strengthened
      the peptide binding to both PVDF-P and PVDF-N, but increased the amount of carry
      over of PTH-amino acid from the current cycle to the next. Nonetheless,
      hydrophilic peptides had higher sequencing recoveries and repetitive yields than
      hydrophobic peptides when sequenced on all the tested membranes. This
      relationship was further verified by testing a synthetic peptide with decreasing
      hydrophilicity by sequential deletions of 2 amino acid residues from its N
      terminus. A decreasing sequencing efficiency was observed, which correlated with
      the reduced hydrophilicity and peptide length. Similar results were obtained when
      testing peptide fragments with decreasing hydrophilicity by deletions of amino
      acids from the C-terminus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782166
TI  - Variability analysis of the T-cell receptors using three variability indexes.
AB  - In the absence of a three-dimensional structure for TCR molecules, several
      attempts to identify their hypervariable regions by variability methods have been
      made; this subjects is still troublesome. In this paper three different
      variability indexes were used: (i) the Kabat index, which is the classical
      measure of sequence variability, (ii) the modified Kabat index, successfully used
      in the beta-chain of T-cell receptors and (iii) an information-theoretical
      entropy concept, recently proposed as an improved measure of the variability. In
      order to identify the hypervariable regions in the TCR sequences, a Fourier
      filtering was applied on each variability profile. Results show that the three
      variability indexes have distinct resolutions for different levels of
      variability. Thus, the simultaneous use of these indexes compensates for the
      deficiency of any one of them in estimating variability. Applying the Fourier
      filtering, it is found that the hypervariable regions here identified, roughly
      coincide with the defined CDR-2 and CDR-3 in TCR by analogy with Ig. However, no
      hypervariable in the CDR-1 of alpha- and beta-chains was found. The study on the
      influence of sample size in variability analysis, indicates that results are
      independent of the sample size. Considering current structural models of TCR
      peptide-MHC interaction, one can suggest that the low-variability characteristics
      of these regions is inherently related to the interaction with relatively
      conserved region on the alpha-helices of MHC.

PMID- 7782165
TI  - Use of the 3-nitro-2-pyridine sulfenyl protecting group to introduce N epsilon
      branching at lysine during solid-phase peptide synthesis. I. Application to the
      synthesis of a peptide template containing two addressable sites.
AB  - TASPs (template-assembled synthetic peptides) are generated by the covalent
      attachment of linear peptides to a common peptide backbone, thus generating
      larger synthetic peptides/proteins with prefolded structure. In this work we
      present a strategy for the synthesis of a heterotemplate-assembled synthetic
      peptide containing two addressable sites. This orthogonal protection strategy
      would allow the selective introduction of different peptide chains via the
      epsilon-amino functions of template lysines being protected by either
      fluorenylmethoxycarbonyl (Fmoc) or 3-nitro-2-pyridine sulfenyl (Npys) groups. The
      N alpha-Boc-N epsilon-Npys-L-lysine required for solid-phase peptide synthesis
      (SPPS) is not readily available at a reasonable cost. To facilitate the more
      widespread use of this reagent we have compared the two published procedures for
      synthesizing this protected amino acid and evaluated the suitability of the
      products for SPPS. Two resin-bound peptides, a tripeptide Ac-G-K-Npys)-G-resin
      and an octapeptide template Ac-P1-K2-K3-L4-K5-K6-P7-G8-resin, were synthesized by
      SPPS. The epsilon-amino functions of lysines K2 & K6 and K3 & K5 of the
      octapeptide were protected by Fmoc and Npys groups, respectively. Secondly, these
      peptides were used to evaluate various reagents and reaction conditions for the
      deprotection of the epsilon-amino function of lysines bearing the N epsilon-Npys
      protecting group. A procedure for the optimized selective and quantitative
      deprotection of the Npys group from the epsilon-amino function of lysine in a
      resin-bound peptide using 2-mercaptopyridine-N-oxide is described.

PMID- 7782167
TI  - Single diastereomeric desaminotyrosylalanyl tetra- and heptapeptides with opioid
      antagonistic activity.
AB  - The N-terminal dipeptide Tyr-d-Ala of a mu-selective agonist, dermorphin
      tetrapeptide (DT, H-Tyr-D-Ala-Phe-Gly-NH2) and delta-selective agonist deltorphin
      C (DEL-C, H-Tyr-D-Ala-Phe-Asp-Val-Val- Gly-NH2) was changed into an aminodiacyl
      moiety. The relevant synthetic step is a nucleophilic substitution of bromine
      from a chiral 2-bromopropanamide by the amino group of tyrosine, with overall
      retention of configuration. The resulting pseudo tetra- and heptapeptides I-VI
      were characterized for mu- and delta-opioid receptor binding properties using
      [3H]DAGO and [3H]DPDPE, respectively, and in a bioassay using guinea pig ileum
      (GPI) and mouse vas deferens (MVD). As a result of chemical alteration of N
      terminal depeptide moiety, all synthesized analogs showed considerable reduction
      in opioid receptor affinity compared to mu- and delta-prototypes (500-fold on the
      mu-site, analog I, and 125-fold on the delta-site, analog IV). Interestingly,
      analogs I and IV showed moderate antagonist activity, respectively, on GPI and
      MVD, with pA2 values of 6.05 and 6.82. Analog IV did not exhibit the delta
      antagonist potency and delta-selectivity of TIPP peptides.

PMID- 7782168
TI  - Ras-dependent maturation of Xenopus oocytes is blocked by modified peptides of
      GTPase activating protein (GAP).
AB  - Guanosine triphosphatase activating protein (GAP) is an important modulator of
      p21ras (Ras)-dependent signal transduction in mammalian cells and in insulin
      induced maturation of Xenopus oocytes. A synthetic octapeptide from the catalytic
      domain of GAP, residues 899-906 (F899VFLRLIC906), inhibited GAP-stimulated
      hydrolysis of GTP to GDP by Ras in an in vitro biochemical assay (IC50 = 12
      microM). The peptide was assayed for its ability to block insulin- (Ras
      dependent) and progesterone- (Ras-independent) induced maturation of stage VI
      Xenopus laevis oocytes, marked by germinal vesicle breakdown (GVBD).
      Microinjection of 50 pmol of the peptide inhibited insulin- but not progesterone
      induced GVBD by 50%. A 7-residue peptide lacking F899, GAP(900-906)-NH2, failed
      to inhibit GAP-stimulated GTPase activity and did not block GVBD. Replacement of
      the cysteine residue at position 906 with methionine resulted in a peptide with
      prolonged inhibitory activity in the oocyte. Moreover, sequential replacement of
      specific L-amino acid residues with the corresponding D-amino acids produced a
      peptide with a two-fold increased half-life after injection into oocytes. None of
      the peptides tested affected progesterone induced GVBD, suggesting that the
      modifications did not result in loss of specificity. These studies show that (a)
      peptides that were able to inhibit GAP-stimulated Ras GTPase activity in vitro
      were also able to block Ras-dependent GVBD in oocytes, and (b) specific
      substitutions in these peptides can result in improved stability in oocytes.

PMID- 7782169
TI  - Probing the structure of human growth hormone by limited proteolysis.
AB  - Digestion of human growth hormone (hGH) with the Glu-specific protease from
      Staphylococcus aureus V8 was performed at 20-22 degrees C or 37 degrees C at a
      1:20 ratio (by weight) at pH 7.8 with or without 0.2% SDS. There are 14 Glu
      residues evenly distributed along the polypeptide chain of hGH as possible sites
      of proteolytic cleavage of V8-protease. The pattern of fragmentation of hGH was
      analyzed by electrophoresis and reversed-phase HPLC, and the identity of the
      proteolytic fragments isolated to homogeneity was established by their partial
      sequencing and amino acid analysis after acid hydrolysis. Kinetic analysis of the
      proteolytic digestion process allowed to establish that initial nicking of the
      protein occurs at Glu33 and subsequently at Glu56 and Glu66. Much slower
      cleavages occur at Glu30 and Glu186. These cleavage sites are located at chain
      loops in the hGH molecule, and in particular outside the helical segments of the
      four-helix bundle of the crystal structure of hGH. Fragments 1-33 and 67-191
      comprising entirely the N-terminal helix and the three C-terminal helices of hGH,
      respectively, were isolated to homogeneity in amounts useful for subsequent
      conformational and functional studies. The results of this study and of previous
      ones [Li, C.H. (1982) Mol. Cell. Biochem. 46, 31-41] describing limited
      proteolysis of hGH by various proteases have been interpreted on the basis of the
      three-dimensional structure and dynamics of hGH. Overall, it is shown that
      proteolytic enzymes preferentially cleave hGH at exposed and flexible loops only,
      thus emphasizing the fact that proteases can be used as reliable probes of
      protein structure and dynamics.

PMID- 7782170
TI  - Peritonsillar abscess in children. Is incision and drainage an effective
      management?
AB  - Debate continues concerning proper management of peritonsillar abscess (PA). We
      studied 189 children (mean age, 9 years) admitted in our department during the
      last 7 years with the diagnosis of PA. Management consisted of incision and
      drainage (performed in 92.5% of the children without general anaesthesia) and
      antibiotic therapy intravenously. There was resolution without complications in
      the overwhelming majority of the cases. After the initial episode, we further
      followed up 101 children. The recurrence rate was 15.8%. Forty-seven percent of
      the recurrences occurred 1 month after the children had been discharged. Probably
      some of these second PA should be considered as persistent and not as recurrent.
      Therefore, we propose that after their discharge, the children must take oral
      antibiotics (resistant to beta-lactamase) for more than 10 days. Cultures were
      taken from 58 cases. The predominant bacterial isolates were Streptococcus spp.
      (55%), anaerobes spp. (12%) and Staphylococcus aureus (6%). To our knowledge,
      this is the first survey that addresses exclusively a pediatric population and
      suggests that incision and drainage without general anaesthesia is an applicable
      and effective management in children with PA. Moreover, we believe that
      peritonsillar abscess is no longer a strong indication for tonsillectomy due to
      the relatively low rate of recurrence. We recommend close follow-up, mainly for
      the first months after the initial episode.

PMID- 7782171
TI  - Auditory brainstem responses in children with Cornelia de Lange syndrome.
AB  - Auditory brainstem evoked responses (ABRs) were recorded in 10 Japanese infants
      and children with Cornelia de Lange syndrome to determine the level of the lesion
      causing their poor response to sound. Behavioral audiometry showed severe
      threshold elevation compared to an age-matched control group. ABR thresholds,
      peak latencies of wave I and IV and the peak interval latency of waves I-V were
      measured. ABR abnormalities of 4 types: no ABRs following 85 dB clicks in both
      ears (4 cases), no ABRs in one ear but normal ABR in the other (2 cases), mild
      wave V threshold elevation of ABR with a markedly prolonged wave V (2 cases) and
      normal ABR pattern in the one side and abnormal ABR pattern in the opposite side
      suggesting brainstem immaturity for age (2 cases). Our results demonstrate a high
      prevalence of peripheral sensorineural hearing loss in Cornelia de Lange
      syndrome, but brainstem immaturity was not ruled out in 2 cases.

PMID- 7782172
TI  - Acute mastoiditis in pediatric age.
AB  - The object of the present paper is to review 39 cases of acute mastoiditis
      treated surgically at the 2nd and 4th ENT Clinics of the University of Rome 'La
      Sapienza'. The aetiological factors were investigated observing an association of
      the acute mastoid abscess with cholesteatoma. Moreover 5 patients developed
      mastoiditis after previous mastoid surgery. The rationale of surgical management
      is discussed.

PMID- 7782173
TI  - Role of anaerobic bacteria in chronic otitis media and cholesteatoma.
AB  - Otitis media (OM), a common infection in children, can cause significant
      morbidity. Selection of the most appropriate treatment regimen directed against
      the pathogens responsible for the OM can minimize complications. The most
      frequently isolated bacteria from chronic OM are Staphylococcus aureus,
      Pseudomonas aeruginosa and anaerobic bacteria. The predominant anaerobes are
      Peptostreptococcus spp., pigmented Prevotella and Porphyromonas spp., Bacteroides
      spp. and Fusobacterium spp. Many of the organisms causing OM can produce beta
      lactamase, which can contribute to the failure of penicillins therapy. The
      appropriate surgical and medical therapy for chronic OM is reviewed.

PMID- 7782174
TI  - The Usher syndrome type 2A: clinical findings in obligate carriers.
AB  - Ten obligate carriers of Usher syndrome type 2A from 5 different families with 2
      affected persons all underwent audiologic, vestibular and ophthalmologic
      examinations. They had a sensorineural hearing loss which was in excess of that
      expected for their age at all of the frequencies (0.25-8 kHz) tested, however,
      only a 10 dB (average) excess in hearing loss at 0.25-0.5 kHz proved to be
      significant. The speech discrimination scores obtained conformed with the hearing
      thresholds. Tympanometry, acoustic reflex and brain stem auditory-evoked
      potential findings were generally normal. Some vestibular abnormalities were
      found in a minority of the carrier sample, but not beyond the level of false
      positivity. Ophthalmologic findings were essentially normal, although in 5
      carriers there was a subnormal electrooculography (EOG). These findings are not
      sufficient specific for carrier detection.

PMID- 7782175
TI  - Screening for neonatal and infant deafness in Europe in 1992.
AB  - Many methods of screening for hearing impairment are available. The aim of our
      study was to determine which ones were really used in 1992. At the request of the
      British Audiology Society, we conducted an inquiry into the organization of
      screening for deafness in neonates and infants in Europe. In practice all 6-9
      month-old infants are tested with behavioural tests in every country. For the
      neonates, generally only those at risk for hearing-impairment (about 5%) were
      tested. The most widely used tests were behavioural ones. Only specialized
      centers used transient evoked otoacoustic emissions (TEOAEs). This last test
      assesses the active mechanical properties of the cochlea and allows detection of
      even mild or unilateral sensorineural deafness.

PMID- 7782176
TI  - Development of aerodynamic aspects in children's voice.
AB  - To determine the changes with increasing age in children this study measured the
      air flow and the acoustic signal in children aged 4-15 years. The subglottal
      pressure was estimated from the intraoral pressure during the phonation of the
      word 'ipipi'. From these parameters the glottal resistance and the glottal
      efficiency were calculated. Since these parameters depend on the sound pressure
      level, a linear regression of the parameters versus the sound pressure level was
      done, and the values for 75 dB SPL were taken for statistical analysis. The study
      found a subglottal pressure in younger children between 6 and 10 cm water column,
      which seemed to diminish with age. The phonatory flow rate was between 50 and 150
      ml/s in younger children, which seemed to increase with age. The glottal
      resistance did not depend on age, values of 20-250 Ns/m5 at a sound pressure
      level of 75 dB exceed those for adults given in the literature. The measurements
      for the glottal efficiency showed a broad variability between 20 ppm and 400 ppm.

PMID- 7782177
TI  - Word-initial voicing in the productions of stops in normal and preterm Italian
      infants.
AB  - It has been traditionally held that developmental anomalies in language
      acquisition are more frequent in neonatologically at-risk subjects. There is some
      suggestion that proficiency in phonology is correlated with motor control
      development. The purpose of this paper was to compare the patterns of acquisition
      of the control of the acoustic-phonetic cues for voicing in the speech of
      premature infants and controls. The measure studied was initial stop consonant
      voice onset time (VOT), which is known to be the most reliable acoustic cue for
      the distinction between voiced and voiceless stops. The total population of the
      study consisted of 7 infants born at less than 37 weeks gestation and a control
      group of 7 infants born full-term at normal weight; 7 adults, aged 24-26 years,
      also participated. Each child was recorded under standard recording conditions
      saying words contrasting labial, dental and velar voiced and voiceless initial
      stops. Elicited word productions were collected monthly from infants, at
      different age levels, ranging from 18 to 21 months. The results show that the
      subjects are more advanced in the acquisition of the appropriate VOT values for
      the voiceless than for the voiced consonants. This difficulty may be related to
      the increased neuromuscular control and more complex muscle activity necessary
      for maintaining voicing during the closure, especially for velar stops. It is
      important to recognize the possibility that increased variability in preterm
      children may be related to some neuromuscular immaturity.

PMID- 7782178
TI  - A prospective randomised trial of the use of sodium bicarbonate and hydrogen
      peroxide ear drops to clear a blocked tympanostomy tube.
AB  - This randomised prospective trial compared the efficacy of sodium bicarbonate and
      hydrogen peroxide ear drops in clearing a blocked tympanostomy tube. Tympanostomy
      tubes, 110 in number, obstructed with blood or inspissated secretions were
      randomised into treatment and control groups. Details of the operative procedure
      were retrospectively collected from the patients notes. The patients were
      reviewed after 2 weeks for both clinical and tympanometric evidence of clearance
      of the tube and evidence of complications of the drops. There was no significant
      therapeutic advantage between the two drops (P > 0.9), but in both treatment arms
      there was a significant therapeutic advantage over a period of observation (P <
      0.05 in both groups). Otorrhoea and pain on instilling the drops occurred with
      equal incidence in both treatment groups. As obstruction of tympanostomy tubes is
      a common occurrence which often prompts surgical reventilation, there is great
      potential for cost savings if conservative treatment can be used effectively. The
      treatments for obstructed tympanostomy tubes are reviewed and methods of
      prevention of this common occurrence are discussed.

PMID- 7782179
TI  - The effect of post-operative diet on recovery in the first twelve hours after
      tonsillectomy and adenoidectomy.
AB  - The effect of post-operative diet selection on the recovery rate of 100 children
      ages 3-17 years undergoing tonsillectomy and adenoidectomy (T & A) was studied.
      In the first 12 h after T & A children were allowed either a 'restricted' diet of
      only soft foods and liquids or a 'non-restricted' diet of foods preselected and
      usually eaten by the child. Parental evaluation of the child's general well
      being, pain level and nausea were evaluated. The number of episodes of emesis,
      doses of acetominophen and the list of foods and drinks consumed were also
      recorded. No significant differences in any aspect of recovery were noted between
      groups. However, a trend towards decreased nausea and parental perception of a
      more successful general recovery was noted at 12 h in the 'non-restricted' group.
      Children in the 'non-restricted' group were able to eat foods more often
      associated with their regular diet. No child from either group experienced any
      immediate or delayed complications. Implications for children and their families
      undergoing T & A are discussed.

PMID- 7782180
TI  - Children who could benefit from a cochlear implant: a European estimate of
      projected numbers, cost and relevant characteristics.
AB  - The incidence of profound hearing impairment by the age of 5, derived from a
      number of retrospective studies in the UK (population about 58 million; birth
      rate 14/1000), is estimated to be about 300 per annual birth cohort in the 1990s.
      This estimate includes 80 children who might be expected to acquire deafness in
      those first 5 years. Projected to Europe as a whole (population 511 million;
      birth rate 12/1000) this would mean a population who should be considered as
      potential cochlear implant patients of some 2268 children, given a variety of
      assumptions. At a take-up rate of 25% for both congenital and acquired cases of
      profound hearing impairment this would imply a European-wide expenditure of the
      order of 17 pounds m/p.a. on hardware and associated rehabilitation programmes.
      The need for such programmes is explored, in the context of strategies of early
      identification of hearing impairments.

PMID- 7782181
TI  - Airway obstruction in the Crouzon syndrome: case report and review of the
      literature.
AB  - Craniofacial dysostosis (Crouzon syndrome) is a syndrome characterized by
      premature closing of calvarial and cranial base sutures as well as those of the
      orbit and maxillary complex. Orofacial manifestations of this disease include
      maxillary hypoplasia, external nasal deformity, and prognathism. Airway distress
      is a well described feature of this syndrome, and both upper and lower airway
      obstruction may be present in the Crouzon syndrome. Obstructions in the upper
      airway have been reported secondary to septal deviation, midnasal and choanal
      abnormalities, and nasopharyngeal narrowing. This study presents a child with the
      Crouzon syndrome who required tracheotomy during the first 2 years of life for
      airway obstruction caused in the newborn period (first 6 months) by midnasal
      stenosis and laser (6 months to 2 years) compounded by soft palate obstruction at
      the level of the oro/hypopharynx. A review of the English language literature
      revealed one similar patient presentation but no comprehensive review of this
      subject. Previously reported airway anomalies are reviewed and airway management
      is discussed in patients with Crouzon syndrome.

PMID- 7782182
TI  - Alternatives in the management of aneurysmal bone cysts of the mandible.
AB  - Aneurysmal bone cyst (ABC) is an unusual expansile lesion of bone which may arise
      within the mandible on rare occasions. This lesion may arise with very few signs
      or symptoms. Surgical treatment consists of complete excision or curettage. The
      recurrence rate may be high in lesions which are incompletely excised. Three
      cases of aneurysmal bone cysts in children will be presented, demonstrating the
      wide variation of clinical presentation. One case required an extensive
      mandibular resection, necessitating the first reported microvascular mandible
      reconstruction for this entity in a pediatric patient.

PMID- 7782184
TI  - Congenital nasal pyriform aperture stenosis as a presenting feature of
      holoprosencephaly.
AB  - Congenital nasal pyriform apertures stenosis (CNPAS), a recently recognized
      uncommon cause of nasal airway obstruction, can be a life-threatening
      circumstance in the neonate. This study's experience with six cases confirmed the
      suggestion that CNPAS represents a manifestation of holoprosencephaly. Management
      of this condition depends firstly on the overall prognosis of the patient and
      secondly the severity of obstruction. Patients with poor overall prognosis should
      be managed conservatively with an oropharyngeal airway. In patients with a good
      outlook, the choice of treatment is conservative for those with less severe
      obstruction and surgical correction for those with complete obstruction. The
      ability to pass a No. 5Fr catheter (O.D. 1.67 mm) may be a guide to the choice of
      treatment. An increase in awareness among otolaryngologists on the nature of
      CNPAS is necessary to improve overall management of such patients.

PMID- 7782183
TI  - Recurrent respiratory papillomatosis in the larynx: re-emergence of clinical
      disease following surgery.
AB  - The treatment and aetiology of recurrent respiratory papillomatosis remains
      unclear. We report a case of laryngeal papillomatosis where repeated suction
      diathermy and later laser treatment led to the formation of a substantial glottic
      web, but a clinically papilloma-free state of the upper aerodigestive system.
      Division of the web led to widespread recurrence of the papillomas, which
      eventually resolved after the larynx had healed with the reformation of a limited
      anterior web. The role of surgical trauma and its effect on re-emergence of
      papillomas is discussed.

PMID- 7782186
TI  - Outcomes of ultrasound diagnosis of ectopic pregnancy. Dependence on observer
      experience.
AB  - BACKGROUND: The effect of examiner experience on the detection of ultrasound
      findings in ectopic pregnancy was assessed in a retrospective study. METHODS:
      Records and examinations of 267 consecutive patients with surgically proven
      ectopic pregnancy were reviewed. Patients were divided into two groups: (1) those
      who were examined by faculty during the day (182 examinations) and (2) those who
      were examined by resident physicians at night (85 examinations). RESULTS: A
      statistical difference was found in the incidence of adnexal mass, free fluid,
      sac within the mass, and corpus luteum cyst. CONCLUSION: Examiner experience has
      a strong effect on the diagnostic accuracy of ultrasound examination. Adnexal
      abnormalities may be difficult to identify because of confusion with loops of
      bowel or other pelvic structures. Faculty follow-up and review are important in
      patient management.

PMID- 7782185
TI  - Transcatheter occlusion of patent ductus arteriosus using a newly developed self
      expanding device. Evaluation in a canine model.
AB  - RATIONALE AND OBJECTIVES: A new occlusion device designed for use in a patent
      ductus arteriosus was tested in an animal model. METHODS: The device consists of
      a self-expanding conical-shaped stainless steel mesh, with hooks encircling the
      expanding end acting to secure the device within the ductus. A screw thread at
      the apex allows attachment to a stylet, and a 6 F delivery system is used.
      Placement of the device was attempted in 20 canines that previously had a
      vascular graft surgically inserted between the descending thoracic aorta and main
      pulmonary artery, creating the patent ductus model. Angiographic follow-up at
      regular intervals was performed over a 3-month period. RESULTS: Early cases
      resulted in device misplacement and migration because of inaccurate assessment of
      ductus position and size. In 15 canines the device was placed within the ductus
      and regularly assessed over the 3-month placement period. Ductus occlusion
      occurred within 1 week in 12 of 13 dogs (92%) when device placement was
      considered ideal. In two dogs where significant protrusion of the device from the
      ductus was evident (either into the aorta or main pulmonary artery) ductus
      closure was delayed but present by 3 months, resulting in a 93% overall closure
      rate at this time. In one dog, the ductus remained partially opened. CONCLUSIONS:
      This self-expanding patent ductus arteriosus occlusion device is promising. The 6
      F delivery system is advantageous over other devices currently available, making
      it more suited for use in the pediatric population. Accurate assessment of the
      ductus is imperative, however, to enable correct device sizing. The screw thread
      system allows the device to be repositioned if desired prior to deployment.

PMID- 7782187
TI  - Magnetization transfer magnetic resonance imaging of parenchymal lung disease.
AB  - RATIONALE AND OBJECTIVES: Magnetic resonance imaging with magnetization transfer
      (MT) contrast recently has been described as a method that may provide additional
      information about the macromolecular composition of tissue. Magnetization
      transfer contrast images were compared to conventional gradient-recalled echo
      images in a variety of pulmonary parenchymal diseases and normal lung. METHODS:
      Single-slice gradient echo images were obtained with and without an off-resonance
      radio frequency pulse on a 0.1T MR scanner. The change in signal intensity
      between identical regions of interest on non-MT and MT images was determined in
      13 patients with known lung disease, five healthy volunteers, and three
      postmortem atelectatic dog lungs. RESULTS: No significant change in signal
      intensity (MT effect) was observed in fat, flowing blood, normal lung,
      atelectatic lung, or in acute pulmonary edema. Chronic parenchymal lung disease
      showed the greatest MT effect, 37.7% +/- 7.5. Acute infectious lung disease
      showed an intermediate degree of MT effect, 19.5% +/- 3.0. CONCLUSIONS:
      Magnetization transfer contrast magnetic resonance imaging of pulmonary disease
      is feasible at low field strength and may be useful in the characterization and
      differentiation of pulmonary parenchymal abnormalities. Magnetization transfer
      contrast appears to be proportional to the amount of interstitial fibrosis in
      lung parenchyma, while acute inflammatory cell infiltration exhibits less MT
      effect and acute pulmonary edema exhibits very little.

PMID- 7782188
TI  - Comparison of gadolinium Cy2DOTA, a new hepatobiliary agent, and gadolinium HP
      DO3A, an extracellular agent, in healthy liver and metastatic disease.
AB  - RATIONALE AND OBJECTIVES: A new gadolinium (Gd) chelate with preferential
      hepatobiliary uptake, Gd Cy2DOTA, was compared in two animal species with Gd HP
      DO3A (gadoteridol), a clinically approved contrast agent with extracellular
      distribution. Liver enhancement was evaluated for these two contrast agents using
      magnetic resonance imaging, whereas an experimental model of metastatic disease
      was used to evaluate the agents' efficacy for liver-lesion delineation. METHODS:
      The two agents were compared in four healthy Rhesus monkeys (eight studies) and
      five New Zealand White rabbits with implanted VX-2 liver tumors (ten studies).
      The contrast dose was 0.1 mmol/kg, with the agents given in random order and at
      least 72 hours between contrast injections. Breathhold T1-weighted spin echo
      scans were obtained at 1.5 tesla (T) before and after contrast was administered.
      Postcontrast scans were obtained 1 to 90 minutes after injection in the monkeys
      and 1 to 240 minutes after injection in the rabbits. RESULTS: Prolonged hepatic
      enhancement, superior in degree to that with Gd HP-DO3A, was noted in both
      monkeys and rabbits after injection of Gd Cy2DOTA. Two minutes after contrast,
      liver SI was 1.94 +/- 0.05 with Gd Cy2DOTA compared with 1.51 +/- 0.05 with Gd HP
      DO3A in monkeys. Sixty minutes after contrast, liver SI was 1.60 +/- 0.09
      compared with 1.20 +/- 0.02. The difference between agents was significant at all
      times from 2 to 60 minutes after contrast injection (P < 0.01). Excretion of
      contrast into the gall bladder was observed in both animal species with Gd
      Cy2DOTA but not with Gd HP-DO3A. The maximum improvement in lesion conspicuity
      (rabbit) occurred 45 minutes after injection of Gd Cy2DOTA and 5 minutes after
      injection of Gd HP-DO3A. Sixty minutes after injection, liver-lesion contrast was
      246 +/- 61 with Gd Cy2DOTA and 106 +/- 28 with Gd HP-DO3A, with a significant
      difference (P < 0.02). CONCLUSIONS: Gd Cy2DOTA provides greater enhancement of
      the liver parenchyma on immediate and delayed magnetic resonance scans than does
      Gd HP-DO3A. On delayed scans, Gd Cy2DOTA provides superior delineation of
      metastatic liver lesions.

PMID- 7782189
TI  - Changes in the microcirculation of the intact rat heart after iodinated and
      gadolinium-containing contrast media.
AB  - RATIONALE AND OBJECTIVES: A new model was developed to study microcirculation in
      the intact heart of the anesthetized rat, and the effects of roentgenography and
      magnetic resonance imaging contrast media were investigated. METHODS:
      Roentgenography contrast media (600 mg iodine/kg), gadopentetate (0.25 mmol/kg),
      or physiological saline were injected intraarterially into anesthetized rats (N =
      10) whose chests had been opened in a pressurized container. The effects on
      arterial and venous vasomotion and microhemodynamics of the capillary network
      were determined in vivo by combined incidental light-fluoroscopic microscopy
      using continuous 35-mm cine film and video recordings from 5 minutes before until
      20 minutes after injection. The amplitude and frequency spectra were evaluated
      according to the Prony method and by Fourier analysis. Additionally, the number
      of perfused vessel bifurcations were counted. RESULTS: Gadopentetate exhibited no
      effects on microcirculation, and diatrizoate exhibited the largest ones. The
      deformation of the vasomotion spectrum reached 28%, and bifurcations were reduced
      by 21%. The effects were reversible within 10 minutes of injection. Iotrolan
      showed minimal disturbance. The other contrast media (iopromide, iopamidol,
      ioxaglate) fell between these two extremes. CONCLUSION: High-osmolar ionic
      roentgenography contrast media resulted in a transient deregulation of vasomotion
      and in a disturbed microcirculation in the rat heart. Isotonic or low-osmolar
      nonionic roentgenography contrast media or gadopentetate did not show this effect
      or showed it only to a minimal extent.

PMID- 7782190
TI  - Safety and efficacy of dotarem (Gd-DOTA) versus magnevist (Gd-DTPA) in magnetic
      resonance imaging of the central nervous system.
AB  - RATIONALE AND OBJECTIVES: Gd-DTPA is a well-characterized, safe contrast agent
      frequently used in magnetic resonance imaging (MRI) of the central nervous
      system. The purpose of this double-blind, comparative MRI study of brain, spine,
      trunk, and limbs was to evaluate the safety and efficacy of Gd-DOTA versus Gd
      DTPA in a large number of patients (n = 1038). METHODS: T1-weighted MRI was
      performed before contrast and after the administration of Gd-DOTA or Gd-DTPA (0.1
      mmol/kg). The MR images were scored for image quality, and the diagnostic
      efficacy also was assessed. Patients were questioned 1 hour after injection, and
      adverse reactions were recorded. RESULTS: Image quality of the T1-weighted MR
      images without contrast was good or excellent in 89.7% and 91.7% of the Gd-DOTA
      and Gd-DTPA groups, respectively (P > 0.2). After contrast, 85.8% (Gd-DOTA) and
      88.2% (Gd-DTPA) of the T1-weighted MR images were of good to excellent image
      quality (P > 0.2), significantly less than before contrast (P < 0.001, both
      groups). In 82.3% of the Gd-DOTA group and 83.5% of the Gd-DTPA group (P > 0.2),
      the information obtained was more accurate with the administration of contrast
      agents. In 82.4% (Gd-DTPA) and 81.9% (Gd-DOTA) of patients, confirmation was
      obtained of diagnosis without contrast, whereas in 17.0% and 17.3% of patients,
      therapy was modified as a result of the use of contrast (P > 0.2, both groups).
      The MRI investigation was reported as abnormal in 58.3% (Gd-DOTA) and 59.6% of
      patients (Gd-DTPA), indicating a similar prevalence of disease in each group.
      Patients responded that 97.8% (Gd-DOTA) and 98.5% (Gd-DTPA) of the investigations
      went well and adverse reactions, none of them serious, were encountered in 0.97%
      of Gd-DOTA and 0.77% of Gd-DTPA groups (P > 0.2, both groups). CONCLUSION: This
      double-blind, randomized, clinical trial comparing Gd-DTPA and Gd-DOTA revealed
      no serious adverse reactions, whereas minor adverse reactions were encountered in
      fewer than 1% of patients. Gd-DOTA is as safe a contrast agent as Gd-DTPA and has
      similar diagnostic efficacy.

PMID- 7782191
TI  - Radiation-induced lung injury using a pig model. Evaluation by high-resolution
      computed tomography.
AB  - RATIONALE AND OBJECTIVES: To assess the early phase of radiation-induced lung
      injury using high-resolution computed tomography (CT) under experimental
      conditions and to perform precise CT-pathologic correlation. METHODS: Five
      Yorkshire pigs received a single dose of 12.5 Gy to the right lower lung.
      Computed tomographic images were obtained at 2-week intervals. The animals were
      killed after follow-up periods of 4-16 weeks. The lungs were removed, inflated,
      fixed, dried, and sliced corresponding to the CT sections. Computed tomography,
      specimen radiography, and histologic findings were correlated. RESULTS: Various
      CT findings were observed during the first 16 weeks, including ground-glass
      opacity, discrete consolidation, patchy consolidation, thickened interlobular
      septum, and bronchovascular bundle. Ground-glass opacity was associated with
      thickened alveolar wall and scattered tiny fibrotic foci. Thickened interlobular
      septum and bronchovascular bundle were the results of fibrosis adjacent to these
      structures. Discrete consolidation correlated with intraalveolar edema with
      hemorrhage and infiltration of inflammatory cells. CONCLUSIONS: High-resolution
      CT correlated well with pathology of the lung due to radiation injury as verified
      by precise radiologic-pathologic correlation.

PMID- 7782192
TI  - Validation of right ventricular volume measurements by magnetic resonance imaging
      in small hearts using a fetal lamb model.
AB  - RATIONALE AND OBJECTIVES: Cine-magnetic resonance (MR) imaging is established as
      an accurate method of determining cardiac ventricular volumes in adults but has
      not been validated for the smaller ventricular volumes found in infants. The
      purpose of the authors study was to evaluate the accuracy and reproducibility of
      MR imaging to measure small ventricle volumes. METHODS: The volume of silicone
      rubber casts of the right ventricle of 11 fetal lamb hearts was measured by MR
      imaging using different imaging planes and slice section thicknesses and by water
      displacement. RESULTS: The ventricle volumes of the 11 hearts ranged from 0.45 to
      3.00 mL. Accurate and reproducible values for the right ventricle volumes were
      obtained by MR imaging. Thin sections (3 mm) in the axial plane produced the best
      results. CONCLUSIONS: Based on studies in the nonmoving heart, MR imaging can
      accurately measure the small ventricular volumes expected in infants.

PMID- 7782193
TI  - Flow cytometric evaluation of platelet activation by ionic or nonionic contrast
      media and modulation by heparin and recombinant hirudin.
AB  - RATIONALE AND OBJECTIVES: The purpose of this study was to investigate the
      platelet activation properties of ionic and nonionic contrast media in native
      heparinized or hirudinized human blood using flow cytometric analysis techniques.
      MATERIALS AND METHODS: Freshly drawn human blood samples were incubated at 37
      degrees C with ionic (Hexabrix and Angiovist) and non-ionic (Isovue and
      Omnipaque) contrast media for varying periods of time. Using fluorescent
      monoclonal antibodies to platelet surface receptors glycoprotein IIIa and with
      granule membrane protein-140, platelet activation was measured in whole blood
      using flow cytometry. Platelet factor 4 and thromboxane B2 levels also were
      measured. RESULTS: Dose- and time-dependent platelet activation was observed in
      nonionic, but not in ionic, contrast media (P < 0.05). Whole blood drawn into
      heparin or hirudin showed reduced platelet activation in the presence of contrast
      media compared with nonanticoagulated whole blood. Platelet factor 4 and
      thromboxane B2 levels showed similar results. Significant platelet activation was
      seen by flow cytometry in high (2000 mOsmol/kg), but not in lower osmolality (800
      mOsmol/kg) controls for ionic and nonionic contrast media, respectively (P <
      0.001). CONCLUSION: This study suggests that nonionic contrast media use is
      associated with significant levels of platelet activation, and that heparin or
      recombinant hirudin (where heparin is contraindicated) is preferable for use with
      nonionic contrast media, as these anticoagulants reduce contrast media induced
      platelet activation.

PMID- 7782194
TI  - Great moments. Parke, Davis and Company and the creation of medical art.

PMID- 7782195
TI  - The hospital-based attorney as patient advocate.

PMID- 7782196
TI  - Wrong necessity.

PMID- 7782197
TI  - Baby Ryan and virtual futility.

PMID- 7782198
TI  - Bethann's death.

PMID- 7782199
TI  - Two theories of modernity.

PMID- 7782200
TI  - Abandoning informed consent.

PMID- 7782201
TI  - Benign parotid adenomas: a review of the Princess Margaret Hospital experience.
AB  - BACKGROUND: The morbidity of treating benign parotid tumors is an important issue
      because the majority of patients are young. We therefore undertook this study to
      evaluate the outcome for these patients treated at the Princess Margaret
      Hospital. METHODS: A retrospective review was conducted on all patients
      registered with benign parotid tumors between 1970 and 1987. RESULTS: Seventy-six
      patients were included in this review; postoperative radiotherapy (XRT) was
      administered to 55 patients. Median follow-up time was 12.5 years. Postoperative
      XRT was particularly important for patients with recurrent disease. The risk of
      both temporary and permanent facial nerve paralyses increased with each
      operation. No patients in this study developed a malignancy. CONCLUSIONS: We
      recommend that all patients with benign parotid tumors be treated with a complete
      parotidectomy with preservation of the facial nerve. Consideration to
      postoperative XRT should be given to patients in whom there was tumor spillage,
      residual disease, or recurrences.

PMID- 7782202
TI  - Mucosal melanoma of the nasal cavity and paranasal sinuses.
AB  - BACKGROUND: Mucosal melanomas of the nasal cavity and paranasal sinuses are rare
      and do poorly. METHODS: Seventeen patients treated from 1981 to 1993 at a single
      referral center were retrospectively reviewed. RESULTS: Thirteen patients
      underwent surgical resection, with seven receiving postoperative radiotherapy.
      Eight had microscopically negative margins. The actuarial 2-year and 5-year
      survivals for this group of 13 were 67% (8 of 12) and 20% (2 of 10). The local
      recurrence rate was 85% (11 of 13) and distant metastases occurred in 31% (4 of
      13) patients. In the absence of metastatic disease, resection of recurrent tumor
      correlated with disease-free intervals ranging from 3 months to 40 months.
      CONCLUSIONS: Those who received postoperative radiotherapy appeared to have done
      better with increased disease-free intervals and prolonged survival. Negative
      surgical margins were not predictive of a more favorable outcome. Surgical
      resection followed by postoperative radiotherapy is appropriate and resection of
      recurrent tumor should be considered.

PMID- 7782203
TI  - Retropharyngeal adenopathy as a predictor of outcome in squamous cell carcinoma
      of the head and neck.
AB  - BACKGROUND: Little information about the incidence of retropharyngeal adenopathy
      and its impact on prognosis has been published. METHODS: For 774 patients with
      squamous cell carcinoma of the nasopharynx, oropharynx, hypopharynx, or
      supraglottic larynx, pretreatment CT and, in selected cases, MRI scans were
      reviewed to determine the presence of retropharyngeal adenopathy. Results were
      analyzed in 619 patients treated with curative intent to determine the prognostic
      impact of retropharyngeal adenopathy. RESULTS: The highest incidence of
      retropharyngeal adenopathy was seen in patients with nasopharyngeal (74%) and
      pharyngeal wall (19%) cancers. The number of cervical nodal groups involved was
      the most significant factor (p < .0001) relating to the incidence of
      retropharyngeal adenopathy. The rates of neck relapse (40% at 5 years) and
      distant metastasis were significantly higher in patients with retropharyngeal
      adenopathy, and the rates of 5-year relapse-free survival and absolute survival
      were significantly lower. CONCLUSIONS: Retropharyngeal adenopathy is a strong
      predictor of poor prognosis, particularly for patients with advanced neck
      disease.

PMID- 7782204
TI  - Extent of lymph node dissection in T3/T4 cancer of the alveolo-buccal complex.
AB  - BACKGROUND: Cancer of the alveolo-buccal complex even when locally advanced is
      amenable to curative resection. However, the extent of lymph node dissection
      remains controversial. METHODS: A total of 181 patients with T3/T4 cancer of the
      alveolo-buccal complex who underwent a radical neck dissection (RND) were
      analyzed retrospectively to determine the incidence and pattern of lymph node
      involvement and to define the extent of neck dissection required in these
      cancers. RESULTS: Lymph node involvement was as follows: level I (85%), II (51%),
      III (19%), IV (18%), V (5%). Levels I and II were most commonly involved (94%).
      Skip metastases occurred in 13%. Levels IV and V were involved in 2% and 20% when
      levels I, II, and III were uninvolved and involved, respectively. CONCLUSION: A
      supraomohyoid neck dissection (SOHD) should be performed and subjected to a
      frozen section evaluation in every patient. If lymph nodes are negative, then
      SOHD is adequate. If levels I, II, or III are positive, then a RND should be
      performed.

PMID- 7782206
TI  - Combined V figure-shaped scapular osteocutaneous and latissimus dorsi
      myocutaneous flap for composite mandibular reconstruction.
AB  - BACKGROUND: As early as 1981, the scapular crest was reported as a versatile
      donor site of vascularized bone flap. In our institute, much attention has been
      paid to applying a compound flap based on the subscapular vascular system for
      composite mandibular reconstruction. METHODS: The combined V figure-shaped
      scapular osteocutaneous and latissimus dorsi myocutaneous flap has been used for
      primary or secondary reconstruction of the mandible, intraoral mucosa and/or
      external skin following major ablation of the malignant tumors in seven patients.
      RESULTS: There was one total flap failure. Satisfactory results were obtained in
      the remaining patients. CONCLUSIONS: The V figure-shaped scapular bone flap
      supplied by the angular branch provides a long rotation arc of vascular pedicle,
      a long bony segment of more than 14 cm, and a good contour of mental
      protuberance. The combination of the scapular osteocutaneous flap with latissimus
      dorsi myocutaneous flap allows reliable reconstruction of massive and three
      dimensional composite mandibular defects.

PMID- 7782205
TI  - Mesenteric flap in free jejunal transfers: a versatile technique for head and
      neck reconstruction.
AB  - BACKGROUND: The technique of free jejunal transfers has been widely used for
      pharyngoesophageal reconstruction. However, secondary infectious and fistulous
      complications may develop in extensive and preoperatively high-dose irradiated
      cases. METHODS: A generous jejunomesenteric composite graft was harvested and the
      mesenterium was effectively applied for head and neck reconstruction. RESULTS:
      The mesenteric flap connected with the revascularized jejunum was used as means
      for obliterating dead space in the head and neck region, as a cover for the cover
      for the cervical vessels, as a vascularized bolstering for the vascular and
      enteral anastomoses, or as a vascularized bed for skin grafting when the skin
      flaps are deficient. Only one small fistula occurred in 10 patients who underwent
      the mesenteric flap. CONCLUSIONS: This versatile technique is expected to reduce
      the incidence of postoperative complications in pharyngoesophageal reconstruction
      using free jejunal transfers.

PMID- 7782207
TI  - Langerhans' cell histiocytosis: head and neck manifestations in children.
AB  - BACKGROUND: Langerhans' cell histiocytosis (LCH) is an uncommon, poorly
      understood granulomatous disease, characterized by the idiopathic proliferation
      of Langerhan's cells or their marrow precursors. In 1985, the Philadelphia Work
      shop adopted the term "Langerhans' cell histiocytosis" (LCH) to differentiate it
      from reactive and neoplastic causes of histiocytosis. METHODS: This study
      includes 73 pediatric patients diagnosed with this condition in Dublin, Ireland,
      and Nottingham, England, during a 34-year period (1959 to 1993). These patients
      are reviewed with respect to clinical presentation, difficulty with making a
      histological diagnosis, their management, and outcome. RESULTS: A total of 49
      patients (67%) had head and neck involvement. Bony involvement was the most
      frequent sign, most frequently located in the skull. There were 11 deaths (15%)
      in this series, all associated with multisystem disease, and nine of these deaths
      were in children younger than 2 years of age. CONCLUSIONS: The role of
      otolaryngologists is important in the early and accurate evaluation, staging, and
      diagnosis of LCH. It may mimic more common diseases, such as otitis externa,
      acute mastoiditis, skin rash, gingivitis, or cervical lymphadenopathy. Patients
      with multisystem disease may be so ill at presentation that the head and neck
      lesions may be overlooked. The current management of LCH has become increasingly
      conservative, and in the 1990s, fewer cases are given chemotherapy or
      radiotherapy. The prognosis is very good for single-system disease and poor for
      multisystem disseminated disease with early onset.

PMID- 7782208
TI  - Radical, modified, and selective neck dissection for cutaneous malignant
      melanoma.
AB  - BACKGROUND: The roles of modified and selective neck dissections in treating
      patients with clinical metastatic melanoma and the place of adjuvant radiotherapy
      are unclear. In the elective setting, the efficacy of various selective
      dissections also requires clarification. METHODS: The prospectively documented
      experience of the senior author (COB) was analyzed. A total of 175 patients had
      183 neck dissections and 92 parotidectomies in 6 years. There were 75 therapeutic
      and 108 elective operations. Modified or selective neck dissections were
      performed in 58% of patients with clinical neck metastases. Ali but two elective
      operations were modified or selective dissections. Postoperative radiotherapy was
      given to 27 dissected necks. Minimum follow-up was 12 months, and 86% of patients
      were followed up for 2 years or to neck recurrence. RESULTS: Nodes were
      histologically positive in 80 dissections. The cumulative rate of control of
      metastatic melanoma in the neck was 86% at 5 years. Neck recurrence developed in
      14% of radical dissections, 0% of modified, and 23% of selective dissections
      performed for clinical disease. Neck recurrence occurred after 5% of elective
      dissections. Recurrence was 7% among irradiated necks compared to 23% in
      nonirradiated (p-value not significant). The 5-year survival rate was 50%, and
      this was significantly worsened by increasing node involvement. CONCLUSIONS:
      Modified radical neck dissection is highly effective in controlling metastatic
      melanoma in selected patients. Selective dissections are less effective and need
      further study. Adjuvant radiotherapy appears to decrease the risk of neck
      recurrence. In the elective setting, recurrence is uncommon following the
      selective neck dissections described.

PMID- 7782209
TI  - The QT interval following carotid artery resection.
AB  - BACKGROUND: Right radical neck dissection has been shown to prolong the QT
      interval, reportedly caused by surgical trauma to the cervical autonomic system,
      which may result in malignant ventricular arrhythmias. Carotid artery resection
      would be expected to be more likely to cause dangerous arrhythmias. METHODS: We
      prospectively studied eight patients with electrocardiograms before and after
      carotid resection. Four patients had left-sided procedures and four patients had
      right-sided procedures. In addition, 11 patients were studied retrospectively. QT
      intervals were normal in all patients preoperatively. RESULTS: Preoperative
      corrected QT intervals (QTc) were in the normal range used by our institution for
      all eight patients in the prospective group. There were no significant QTc
      changes after either left-sided or right-sided carotid resection. However, the
      retrospective group did show significant changes in QTc following right carotid
      resection (n = 5), but not left resection (n = 6). CONCLUSIONS: EKG changes
      associated with carotid resection may not be uniform and may depend on surgical
      technique or specific anatomic factors. Controlled prospective studies are needed
      to confirm the prevalence of QT interval changes in radical neck surgery.

PMID- 7782210
TI  - Mandibular resection.

PMID- 7782211
TI  - Chronic sinusitis in a child.

PMID- 7782212
TI  - Primary ectopic meningioma of the maxillary sinus: case report and review of the
      literature.
AB  - METHODS: A case of a primary ectopic meningioma, arising within the right
      maxillary sinus, is presented. A review of English literature was also undertaken
      to determine the prevalence of these lesions in this specific anatomic location.
      RESULTS: A total maxillectomy was performed without complications and the
      surgical defect was covered with an immediate obturator. The patient is well and
      without evidence of disease 3 1/2 years postoperatively. A review of the English
      literature revealed four additional reports of primary ectopic meningiomas that
      were limited to the maxillary sinus. CONCLUSIONS: Primary ectopic meningiomas of
      the maxillary sinus are uncommon lesions which have a good prognosis when a
      complete resection of the neoplasm can be performed.

PMID- 7782213
TI  - Epiglottic abscess.
AB  - BACKGROUND: Epiglottitis is more commonly seen in children less than 6 years of
      age, although this entity has also been well described among adults. A
      coalescence of infection of the epiglottis, or epiglottic abscess, has been
      infrequently reported in series of epiglottitis. Risk factors for epiglottic
      abscess include adult age at onset, diabetes, and the presence of a foreign body.
      METHODS: Case study. RESULTS: We present a case of a woman with a 4-day history
      of febrile illness, odynophagia, and an altered voice. Clinical examination and
      computed tomography (CT) demonstrated an epiglottic abscess. The patient
      underwent direct laryngoscopy, intubation, drainage of abscess, and intravenous
      antibiotics. CONCLUSIONS: The diagnosis of epiglottic abscess should be
      considered in adult patients initially seen with odynophagia and dysphonia.
      Principles of treatment include airway management, antibiotics, and surgical
      drainage.

PMID- 7782214
TI  - Chemotherapy trials in head and neck cancer.

PMID- 7782215
TI  - Relationship between physician specialty and the selection and outcome of
      ischemic stroke patients.
AB  - OBJECTIVE: This study compares the initial characteristics, in-hospital
      treatment, and outcomes of stroke patients managed by neurologists versus non
      neurologists. DATA SOURCES/STUDY SETTING: An inception cohort of 146 patients
      hospitalized with their first stroke at a private, a university, or a Veterans
      Affairs hospital. STUDY DESIGN: A prospective, hospital-based, multisite cohort
      study design is used to ascertain the patients' initial 180-day in-hospital and
      postdischarge experience. DATA COLLECTION/EXTRACTION METHODS: Data were collected
      on patient demographics, disease severity, and risk factors for stroke;
      diagnostic tests and pharmacologic management; one-month and six-month all-cause
      and cause-specific mortality; and physical and functional impairment. PRINCIPAL
      FINDINGS: The 88 patients (60 percent) admitted to the neurology services of the
      study hospitals had better prognostic profiles, i.e., lower likelihood of having
      either completed stroke or cardiac comorbidity, and were less likely to die
      within one and six months of stroke onset. CONCLUSIONS: Substantial systematic
      differences in the types of patients managed by neurologists versus other
      specialists may preclude comparison of outcomes of care.

PMID- 7782216
TI  - Commentary: generalist and specialist care of stroke--is there a better way?

PMID- 7782217
TI  - Commentary: are differences in outcome due to differences in doctors or their
      patients?

PMID- 7782218
TI  - Small area variations in health care delivery in Maryland.
AB  - OBJECTIVE: Our purpose is a descriptive analysis of variations in hospital use
      among small areas of Maryland. DATA SOURCE: The data are Maryland patient
      discharge records from acute care hospitals for 1985-1987 and small area
      population estimates by age, gender, race, and income. FINDINGS: The common
      finding was excess geographic variability among Maryland's 115 areas. The
      hypothesis of uniform rates was rejected for most DRGs, including low-variation
      mastectomy and hernia repair. Clustering of high-use rates occurred in
      neighboring areas for orthopedic, vascular, and elective procedures. Admission
      rates for most nondiscretionary procedures and medical DRGs were reduced in
      affluent areas while discretionary surgery increased with income level. Elective
      procedures had extreme variation and were related to income. Coronary artery
      disease rates declined with income while coronary artery procedure rates
      increased, indicating that access and patient selection were factors in the use
      of coronary bypass and angioplasty. CONCLUSIONS: The issue is not the ubiquitous
      variation among small areas but its extent and identification of geographic
      patterns. Hospital use is related to demography, morbidity, medical resources,
      access, selection for care, and physician practice patterns. Heterogeneity of
      these factors ensures that uniform delivery of health care rarely holds. There is
      little evidence that incidence of surgical disease is the main source of
      variation in use of discretionary surgery. Rather, variations reflect differing
      medical opinion on appropriate use. Without evaluation, excessive use cannot be
      distinguished from underservice. Morbidity explains the variability of
      nondiscretionary surgery and conditions related to lifestyle. Access plays an
      important role for discretionary surgery. Geographic analysis can identify
      variation and relate incidence to socioeconomic and specific local effects.
      Hospital data do not permit direct assessment of appropriate care. Understanding
      the reasons for variation requires information beyond incidence data. The
      challenge is to identify and explain small area variations or to fix them.

PMID- 7782219
TI  - Mental health care utilization in prepaid and fee-for-service plans among
      depressed patients in the Medical Outcomes Study.
AB  - OBJECTIVE: We compare mental health utilization in prepaid and fee-for-service
      plans and analyze selection biases. DATA SOURCE: Primary data were collected
      every six months over a two-year interval for a panel of depressed patients
      participating in the Medical Outcomes Study, an observational study of adults in
      competing systems of care in three urban areas (Boston, Chicago, and Los
      Angeles). STUDY DESIGN: Patients visiting a participating clinician at baseline
      were screened for depression, followed by a telephone interview, which included
      the depression section of the NIMH Diagnostic Interview Schedule. Patients with
      current or past lifetime depressive disorder and those with depressed mood and
      three other lifetime symptoms were eligible for this analysis. We analyze mental
      health utilization based on periodic patient self-report. ANALYTIC METHODS: We
      use two-part models because of the presence of both nonuse and skewness of use.
      Standard errors are corrected nonparametrically for correlations across
      observations due to clustered sampling within participating physicians and
      repeated observations on the same individual. PRINCIPAL FINDINGS: The average
      number of mental health visits was 35-40 percent lower in the prepaid system,
      adjusted and unadjusted for observed differences in patient characteristics,
      including health status. Utilization differences were concentrated among patients
      of psychiatrists, with only minor differences among patients of general medical
      providers. Analyzing the effect of switches that patients make between payment
      systems over time, we found some evidence of adverse selection into fee-for
      service plans based on baseline utilization, but not based on utilization at the
      end of the study. In particular, after adjusting for observed patient
      characteristics and health status, patients switching out of prepaid plans had
      higher baseline use than predicted, whereas patients switching out of fee-for
      service had lower use than predicted. Switching itself appears to be related to
      an immediate decline in utilization and was not followed by an increase or "catch
      up" effect. CONCLUSIONS: The absence of the commonly found "catch-up" effect
      following switching and the significant decrease in utilization during the
      switching period suggests an interruption in care that does not occur for
      patients staying within a payment system. This finding emphasizes the need for
      integrating new patients quickly into a system, an issue that should not be
      neglected in the current policy discussion.

PMID- 7782220
TI  - The impact of prenatal exposure to cocaine on newborn costs and length of stay.
AB  - OBJECTIVE: Our intention is to determine newborn costs and lengths of stay
      attributable to prenatal exposure to cocaine and other illicit drugs. DATA
      SOURCES AND STUDY SETTING: All parturients who delivered at a large municipal
      hospital in New York City between November 18, 1991 and April 11, 1992. STUDY
      DESIGN: A cross-sectional analysis used multivariate, loglinear regressions to
      analyze differences in costs and length of stay between infants exposed and
      unexposed prenatally to cocaine and other illicit drugs, adjusting for maternal
      race, age, prenatal care, tobacco, parity, type of delivery, birth weight,
      prematurity, and newborn infection. DATA COLLECTION/EXTRACTION METHODS: Urine
      specimens, with linked obstetric sheets and discharge abstracts, provided
      information on exposure, prenatal behaviors, costs, length of stay, and discharge
      disposition. PRINCIPAL FINDINGS: Infants exposed to cocaine or some other illicit
      drug stay approximately seven days longer at a cost of $7,731 more than infants
      unexposed. Approximately 60 percent of these costs are indirect, the result of
      adverse birth outcomes and newborn infection. Hospital screening as recorded on
      discharge abstracts substantially underestimates prevalence at delivery, but
      overestimates its impact on costs.

PMID- 7782221
TI  - An integer programming model to limit hospital selection in studies with repeated
      sampling.
AB  - OBJECTIVE: We describe an integer programming model that, for studies requiring
      repeated sampling from hospitals, can aid in selecting a limited set of hospitals
      from which medical records are reviewed. STUDY SETTING: The model is illustrated
      in the context of two studies: (1) an analysis of the relationship between
      variations in hospital admission rates across geographic areas and rates of
      inappropriate admissions; and (2) a validation of computerized algorithms that
      screen for complications of hospital care. STUDY DESIGN: Common characteristics
      of the two studies: (1) hospitals are classified into categories, e.g., high,
      medium, and low; (2) the classification process is repeated several times, e.g.,
      for different medical conditions; (3) medical records are selected separately for
      each iteration of the classification; and (4) for budgetary and logistical
      reasons, reviews must be concentrated in a relatively small subset of hospitals.
      DATA COLLECTION/EXTRACTION METHODS. In each study, hospitals are ranked based on
      analysis of hospital discharge abstract data. CONCLUSIONS: The model is useful
      for identifying a subset of hospitals at which more intensive reviews will be
      conducted.

PMID- 7782223
TI  - ISO 9000 series standards: what healthcare facilities need to know.
AB  - With the recent trend toward implementing or improving quality systems and the
      increasing frequency with which vendors looking to secure a place in the world
      market have cited the International Organization for Standardization's (ISO) 9000
      Series quality system standards, healthcare facilities have been expressing
      increased interest in learning about these standards, especially ISO 9001, 9002,
      and 9003. In this article, we briefly discuss the ISO 9000 Series standards--what
      they are and what they mean--so that healthcare facilities can properly assess
      the significance of vendors' statements citing compliance with one or more of
      these standards.

PMID- 7782222
TI  - Assessing the impact of continuous quality improvement/total quality management:
      concept versus implementation.
AB  - OBJECTIVE: This study examines the relationships among organizational culture,
      quality improvement processes and selected outcomes for a sample of up to 61 U.
      S. hospitals. DATA SOURCES AND STUDY SETTING: Primary data were collected from 61
      U. S. hospitals (located primarily in the midwest and the west) on measures
      related to continuous quality improvement/total quality management (CQI/TQM),
      organizational culture, implementation approaches, and degree of quality
      improvement implementation based on the Baldrige Award criteria. These data were
      combined with independently collected data on perceived impact and objective
      measures of clinical efficiency (i.e., charges and length of stay) for six
      clinical conditions. STUDY DESIGN: The study involved cross-sectional examination
      of the named relationships. DATA COLLECTION/EXTRACTION METHODS: Reliable and
      valid scales for the organizational culture and quality improvement
      implementation measures were developed based on responses from over 7,000
      individuals across the 61 hospitals with an overall completion rate of 72
      percent. Independent data on perceived impact were collected from a national
      survey and independent data on clinical efficiency from a companion study of
      managed care. PRINCIPAL FINDINGS: A participative, flexible, risk-taking
      organizational culture was significantly related to quality improvement
      implementation. Quality improvement implementation, in turn, was positively
      associated with greater perceived patient outcomes and human resource
      development. Larger-size hospitals experienced lower clinical efficiency with
      regard to higher charges and higher length of stay, due in part to having more
      bureaucratic and hierarchical cultures that serve as a barrier to quality
      improvement implementation. CONCLUSIONS: What really matters is whether or not a
      hospital has a culture that supports quality improvement work and an approach
      that encourages flexible implementation. Larger-size hospitals face more
      difficult challenges in this regard.

PMID- 7782224
TI  - Hazard report. Failure of anti-free-flow mechanism in Baxter Flo-Gard 6201/6301
      infusion pumps.

PMID- 7782225
TI  - User experience network. Soldered medical gas piping.

PMID- 7782226
TI  - Holmium:YAG surgical lasers.
AB  - "Holmium:YAG (Ho:YAG)" is the shorthand name for a family of solid-state lasers
      that use the doping element holmium in a laser crystal (e.g., YAG [yttrium
      aluminum-garnet]) and that emit energy at approximately 2.1 microns. This
      wavelength is relatively new to medicine and has been used in laser surgery for
      only about the last six years. Like the carbon dioxide (CO2) laser when it was
      first used clinically, the Ho:YAG laser is poised for rapid and wide-spread use.
      Ho:YAG lasers, like CO2 lasers, offer precise cutting with minimal damage to
      adjacent tissue; however, unlike CO2 lasers, they also offer fiberoptic delivery
      (which is ideal for endoscopic use) and the ability to treat tissue in a liquid
      filled environment (e.g., saline, blood). The initial specialty for which the
      Ho:YAG laser was used was arthroscopic surgery, especially diskectomy. Today, it
      is effectively used in many surgical specialties, including general surgery,
      urology, laparoscopy, neurosurgery, lithotripsy, angioplasty, orthopedic surgery
      (which includes procedures such as meniscectomy, bone sculpting [may also be
      performed in plastic surgery], and some experimental surgery, such as cartilage
      shrinking to tighten loose joints), and dentistry. Because of its broad range of
      potential applications, it has been called the "Swiss Army Knife" of lasers. High
      powered Ho:YAG lasers, which enable surgeons to work more quickly and cut more
      smoothly, have been made available only within the last three years (units
      offering > 20 W) to 18 months (units offering > 60 W). Because of this rapid
      increase, high-powered units are still relatively expensive, and it is not yet
      clear whether maximum power outputs will continue to increase or whether the cost
      of higher-power units will begin to come down. Although low-power and high-power
      Ho:YAG lasers can be used for the same procedures, their different ranges of
      possible clinical techniques make them better suited to different applications:
      low-power units are preferable for small-joint and some head-and-neck surgeries
      or for office use, and high-power units are more suitable for use in major
      surgery, such as gastrointestinal surgery or surgery in large joints. This
      evaluation includes two units at both ends of the Ho:YAG power spectrum--one 10 W
      and one 60 W--and thus provides a guide to evaluating other Ho:YAG lasers that
      are currently available or that will be entering the market.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 7782227
TI  - Inside the beltway 1995. A veterinary view.

PMID- 7782228
TI  - More on the Andalusian goat rescue.

PMID- 7782229
TI  - Cross-reactivity between flea and housedust mite antigens?

PMID- 7782230
TI  - Clients with special needs.

PMID- 7782231
TI  - Thoughts on retroviruses.

PMID- 7782232
TI  - Question on classification of terbutaline.

PMID- 7782234
TI  - AVMA encourages input.

PMID- 7782233
TI  - Question cause of hypercalcemia in a rabbit.

PMID- 7782235
TI  - New direction for Center for Veterinary Medicine benefits animals and man.

PMID- 7782236
TI  - Treatment of perianal fistulas in dogs.

PMID- 7782237
TI  - Evaluation and dietary considerations in idiopathic hyperlipidemia in dogs.

PMID- 7782238
TI  - Veterinarians probe greyhound idiosyncrasies.

PMID- 7782239
TI  - What is your diagnosis? Osteomyelitis, septic arthritis.

PMID- 7782240
TI  - Urethral obstruction in a pup.

PMID- 7782241
TI  - Common law and statutory defenses to a veterinary medical malpractice action.

PMID- 7782242
TI  - Comparison of the efficacies of three heartworm preventives against
      experimentally induced infections with Ancylostoma caninum and Toxocara canis in
      pups.
AB  - Forty 11- to 12-week-old helminth-naive Beagles were categorized by sex and
      weight and randomly assigned to 4 treatment groups (group 1, ivermectin/pyrantel
      pamoate; group 2, milbemycin oxime; group 3, untreated control; group 4,
      diethylcarbamazine/oxibendazole). Each pup was inoculated PO with approximately
      100 infective Ancylostoma caninum larvae and 100 larvated Toxocara canis eggs on
      day 0, and repeatedly at 7-day intervals thereafter until day 56. Administration
      of anthelmintics also began on day 0, and subsequent treatments were administered
      according to label recommendations at 30-day intervals (groups 1 and 2) or daily
      (group 4) for a period of 90 consecutive days. Body weight and A caninum and T
      canis fecal egg counts were measured at weekly intervals, and clinical
      observations of health status were conducted twice daily. Pups were euthanatized
      on day 90, and total gastrointestinal worm burdens were determined. Compared with
      mean A caninum egg counts of group-3 control pups, egg counts in group-1 pups
      were significantly (P < or = 0.0001) lower on every sampling days 35, 42, 49, 63,
      70, 77, and 84, and were consistently the highest of all treated groups, and egg
      counts of group-4 pups were significantly (P < or = 0.0001) lower on every
      sampling date from day 14 to day 90, and were consistently the lowest of all
      treated groups. Compared with mean A caninum egg counts of group-3 pups, egg
      counts in group-1 and group-2 pups were lower by 97.8 and 90.8%,
      respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782243
TI  - Intraocular bacterial contamination during cataract surgery in dogs.
AB  - Prevalence of intraoperative contamination of the eyelids, conjunctival sac, and
      aqueous humor of 50 canine eyes that underwent elective cataract surgery was
      determined, and the short-term outcomes for contaminated and noncontaminated eyes
      were compared by scoring media clarity, pupil size and shape, and behavioral
      evidence of vision during the initial 30-day postoperative period. Results of
      bacteriologic culture of anterior chamber samples were positive for 12 of the 50
      (24%) eyes, but anterior chamber contamination was unrelated to results of
      bacteriologic culture of eyelids or conjunctival sac swab samples. Eyes
      undergoing phacoemulsification were less likely to be contaminated than were eyes
      undergoing intra- or extracapsular extraction. Eyes undergoing intra- or
      extracapsular extraction and eyes with anterior chamber contamination had a
      greater likelihood of developing glaucoma postoperatively. We did not detect an
      association between intraocular contamination and the surgeon performing the
      operation, the need for postoperative administration of tissue plasminogen
      activator, or the presence or absence of diabetes mellitus. Also, we did not
      detect any differences in outcome between eyes with and without intraocular
      contamination. Despite intraoperative bacterial contamination of the anterior
      chamber, bacterial endophthalmitis did not develop in any of the eyes.

PMID- 7782244
TI  - Seizure classification in dogs from a nonreferral-based population.
AB  - On initial evaluation for onset of seizure disorders at nonreferral veterinary
      practices, 50 previously healthy dogs were enrolled in a study to determine the
      probability of identifying a specific cause for the seizures. Treatment was not
      administered prior to entry of dogs in the study. On the basis of antemortem and
      postmortem test results, 22 dogs (44%) were classified as having primary
      epileptic seizures (PES; idiopathic or without identifiable cause), 23 (46%) had
      secondary epileptic seizures (SES; identifiable intracranial cause), and 5 (10%)
      had reactive epileptic seizures (RES; metabolic or transient noxious cause).
      Forty-one dogs (82%) had 2 or more seizures before evaluation, with 37 (90%) of
      these dogs classified as having epilepsy on the basis of an underlying chronic
      brain disorder. For these 41 dogs, 17 (41%) had PES, 20 (49%) had SES, and 4
      (10%) had RES. Among the 9 dogs (18%) with nonrecurring seizures, 5 had PES, 3
      had SES, and 1 had RES. Generalized seizures were the most common first-observed
      seizure type associated with all etiologic classifications in all dogs with
      recurring and nonrecurring seizures. Diagnosis of SES was statistically more
      probable when the dog was less than 1 or more than 7 years old at the first
      seizure, when the first seizure was a partial seizure, or when the first seizure
      occurred between midnight and 8 AM. A diagnosis of RES was statistically more
      probable only when the interval between the first and second seizure was brief (<
      or = 4 weeks).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782245
TI  - Effect of lente insulin for treatment of diabetes mellitus in 12 cats.
AB  - Ultralente insulin has replaced protamine zinc insulin as the treatment of choice
      in treatment of diabetes mellitus in cats. There is variability in effectiveness
      of ultralente insulin and problems with glycemic control develop in some cats.
      Alternative insulin preparations are sought when ultralente insulin is
      ineffective. Twelve cats with insulin-dependent diabetes mellitus were treated
      with lente insulin. Clinical signs improved in 8 cats given lente insulin every
      12 hours. Lente insulin was ineffective in 4 cats. Three of these cats were
      subsequently found to have an insulin resistant disorder. In 1 cat, lente insulin
      was ineffective because of short duration of action. Lente insulin is a viable
      treatment alternative when ultralente insulin is ineffective in achieving
      glycemic control. Ultralente insulin is still the insulin of choice for the
      initial treatment of diabetes in cats, because of the potential to establish
      glycemic control with once-a-day treatment.

PMID- 7782246
TI  - Noncardiogenic pulmonary edema in dogs and cats: 26 cases (1987-1993)
AB  - Medical records of 23 dogs and 3 cats treated for noncardiogenic pulmonary edema
      (NPE) resulting from airway obstruction (n = 8), cranial trauma (7), electric
      shock (7), or seizures (4) between 1987 and 1993 were reviewed. There were 18
      purebred dogs, 5 mixed-breed dogs, 2 domestic shorthair cats, and 1 Siamese.
      Sixteen animals were male, and 10 were female. All but 7 were less than 1 year
      old. Time between the inciting incident and onset of respiratory tract signs
      ranged from minutes to several hours. Respiratory distress was the primary
      clinical sign for all animals with NPE resulting from airway obstruction, cranial
      trauma, or seizures, and for 2 of the 7 animals with NPE resulting from electric
      shock. The only consistent clinicopathologic abnormality was hyperglycemia, which
      was detected in 12 animals. Arterial blood gas partial pressures were measured in
      11 animals; 10 were hypoxemic. On thoracic radiographs, the predominant pattern
      of pulmonary infiltration was alveolar. Symmetry of involvement, which was
      assessed by examining dorsoventral or ventrodorsal radiographic projections,
      could be determined for 23 animals. In 18, involvement was asymmetric, and in 13
      of those 18, the right side was predominantly involved. On lateral radiographic
      projections, the caudodorsal quadrant of the lung field was involved primarily or
      as part of a diffuse distribution in all but 1 animal. Generally, animals with
      NPE resulting from airway obstruction had the greatest degree of radiographic
      involvement, followed in decreasing order, by animals with NPE resulting from
      cranial trauma, animals with NPE resulting from seizures, and animals with NPE
      resulting from electric shock. Overall, 9 animals died.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7782247
TI  - Hepatic disease associated with administration of tetanus antitoxin in eight
      horses.
AB  - Seven horses developed clinical or subclinical hepatitis 48 to 87 days after
      administration of tetanus antitoxin. One horse had mildly high hepatic enzyme
      activity 120 days after inoculation with tetanus antitoxin. The first horse
      developed signs of depression, lethargy, and anorexia. During hospitalization,
      signs of hepatoencephalopathy were noticed, and laboratory data were consistent
      with hepatic disease. Another horse that was found dead had gross and histologic
      lesions compatible with serum hepatitis. Screening of serum gamma
      glutamyltransferase (GGT) and aspartate transaminase activities were used to
      investigate the remaining horses in the herd. High GGT activities (71 to 206
      IU/L) were detected in 5 additional herd members. These horses appeared
      clinically normal, apart from 2 reports of nasal photosensitization and an
      aborted fetus. In 3 horses, high serum GGT activity persisted over a 44-day
      testing period. All affected horses had been given tetanus antitoxin within 12
      hours of parturition, and a common source of vaccine was identified for 7 horses.
      Findings in this group of horses indicate that clinical and subclinical serum
      hepatitis can develop after administration of tetanus antitoxin.

PMID- 7782248
TI  - Arthroscopic findings in the carpal joints of lame horses without
      radiographically visible abnormalities: 41 cases (1986-1991).
AB  - Arthroscopy was performed in 1 carpal joint unilaterally in 27 horses and either
      in 2 carpal joints unilaterally or 1 carpal joint bilaterally in 7 horses. All
      horses were lame, but the cause of lameness could not be determined from
      radiographs. Twenty-seven carpi did not have radiographically visible
      abnormalities; the remaining 14 had only mild to moderate lucency or sclerosis of
      the radial facet of the third carpal bone. The primary abnormalities identified
      during arthroscopy included a crush fracture of the third carpal bone (7 carpi),
      an incomplete fracture of the third carpal bone in the frontal plane (13 carpi),
      an incomplete fracture of the third carpal bone in the sagittal plane (1 carpus),
      a crush fracture of the radial carpal bone (1 carpus), a chip fracture of the
      intermediate carpal bone (1 carpus), damage to the articular cartilage of the
      third carpal bone (12 carpi), tearing or fraying of the medial palmar intercarpal
      ligament (4 carpi), and synovitis (2 carpi). All of the horses in this study were
      racehorses (29 Standardbreds and 5 Thoroughbreds), and race records were used to
      evaluate performance before and after surgery. Twenty-four of 34 horses raced
      preoperatively, and 25 of 34 raced postoperatively. Twenty-three of the 27 (85%)
      horses in which a single joint was examined raced postoperatively.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7782249
TI  - Prevalence of antibodies to Toxoplasma gondii in swine in Illinois in 1992.
AB  - A serologic survey that tested for antibodies to Toxoplasma gondii was conducted,
      using the modified direct agglutination test, on 6,965 serum samples collected
      from swine in 179 herds in Illinois in 1992. In breeding swine, results for 1,057
      of 5,080 (20.8%) sera tested were positive. In growing/finishing swine, results
      for 59 of 1,885 (3.1%) sera tested were positive, which was substantially lower
      than the seroprevalence rate estimated in a serosurvey of pigs from abattoirs in
      Illinois in 1983 and 1984. Data in the survey reported here were summarized for
      herds having at least 28 samples/herd. Among all herds, the median, mean, and
      maximum seroprevalence rates were 6.7, 16.1, and 96.8%, respectively, for
      breeding swine in 172 herds, and 0.0, 2.8, and 20.0%, respectively, for
      growing/finishing pigs in 44 herds. Among the 172 herds with breeding swine, 61
      (35.5%) had no seropositive pigs. Among the 44 herds with growing/finishing
      swine, 28 (63.6%) had no seropositive pigs. A logistic regression model was used
      to estimate that the cumulative risk of T gondii infection for swine in herds
      containing seropositive pigs was 9.0% by 6 months of age for a herd that had the
      median seroprevalence rate. In contrast, for pigs in herds in the upper quartile
      of seroprevalence rates, risk of infection by 6 months of age was estimated to be
      greater than 20%. Analysis of these data would suggest that overall prevalence of
      T gondii infection in pigs from Illinois is low; nevertheless, there is a small
      proportion of farms for which the rate of T gondii infection in swine is
      moderately high.

PMID- 7782250
TI  - Use of a type II external skeletal fixator for repair of delayed union in three
      calves with forelimb fractures.
AB  - Three calves, 3 to 6 months old, were admitted for evaluation and treatment of
      fractures of the forelimb that had resulted from use of forced extraction at
      birth. Each of these calves had clinical and radiographic evidence of delayed
      union of a fractured metacarpus. All calves were treated, using a type II
      external skeletal fixator consisting of 0.25-inch-diameter transcortical pins and
      acrylic connecting bars. Two calves required open reduction of the fracture to
      obtain anatomic alignment of the limb. On the basis of the 3 calves described
      here, it would appear that type II external skeletal fixators may be adequate for
      treatment of selected calves with delayed union of a fracture.

PMID- 7782251
TI  - Stationary phase induction in Escherichia coli--new targets for antimicrobial
      therapy?

PMID- 7782252
TI  - Predicting the efficacy of antimicrobial agents in respiratory infections--is
      tissue concentration a valid measure?
AB  - Despite methodological and interpretive problems associated with studies of
      antibiotic concentrations in tissues, it is important to confirm the presence of
      a drug in significant concentrations in tissues and fluids at a particular site.
      For antibiotics used in the treatment of community-acquired respiratory
      infections, tissue distribution at sites of potential infection in the
      respiratory tree has been related to clinical outcome. Measurement of antibiotic
      concentrations achieved in lung parenchyma epithelial lining fluid, bronchial
      mucosa or bronchial secretions has indicated significant levels for beta-lactams
      and macrolides. Many respiratory infections are caused by obligate or facultative
      intracellular pathogens, which may be eradicated as a result of intracellular
      penetration and accumulation of macrolides, as shown in several models of
      phagocytic cells, and of intracellular antibacterial activities. For bacterial
      infections located in extracellular pulmonary sites, a knowledge of achievable
      concentrations of beta-lactam and of macrolides should be of value. For bacteria
      multiplying in alveolar macrophages the high concentrations of the new macrolides
      that can be achieved in extravascular and intracellular fluids should have
      clinical relevance, as shown in this review. Moreover with newer macrolides one
      may expect a better patient compliance due to prolonged persistence of drug in
      tissues and cells which results in shorter duration of treatment and once-daily
      dose administration. Finally, for some sites of infection and particularly in the
      human respiratory tree, there is a clear relationship between local
      concentrations and clinical efficacy.

PMID- 7782253
TI  - Evaluation of a broth microdilution antifungal susceptibility test with a pH
      indicator: comparison with the broth macrodilution procedures.
AB  - A broth microdilution antifungal susceptibility test with a pH indicator
      (bromocresol purple) in a synthetic medium was evaluated. This method measures
      cellular activity instead of simply a change in biomass. The variations of pH
      caused by fungal activity were measured by changes in optical densities at 450
      nm. The MICs50 obtained were compared with the MICs found by the classical broth
      macrodilution procedure. In most cases broth micro- and macrodilution MICs were
      in agreement for amphotericin B, fluconazole, flucytosine and nystatin.

PMID- 7782254
TI  - Enhancement of drug susceptibility of multi-drug resistant strains of
      Mycobacterium tuberculosis by ethambutol and dimethyl sulphoxide.
AB  - Strategies to augment conventional methods of drug delivery in treatment of
      multiple drug resistant tuberculosis are needed to achieve optimum results with
      available drugs. We have studied the effect of sub-minimum inhibitory
      concentrations (sub-MIC) of ethambutol and dimethyl sulphoxide on drug
      susceptibility of Mycobacterium tuberculosis strains both in vitro and in
      macrophages. At sub-MIC ethambutol between caused four and 64 fold increase in
      susceptibility to isoniazid rifampicin and streptomycin in four M. tuberculosis
      strains, resistant to these drugs. Incubation of the organisms with isoniazid and
      sub-MIC of dimethyl sulphoxide (2.5%) resulted in an eight-fold increase in
      susceptibility to the drug. Previous exposure of the organisms to sub-MIC of
      dimethyl sulphoxide also caused similar enhancement of susceptibility. Both
      ethambutol and dimethyl sulphoxide at the sub-MIC of sulphoxide also caused
      similar enhancement of susceptibility. Both ethambutol and dimethyl sulphoxide at
      the sub-MIC enhanced the activity of the anti-tuberculosis drugs against multiple
      drug resistant M. tuberculosis strains growing inside macrophages. Our data
      indicate that the agents which modify cell wall permeability can enhance the
      susceptibility of multiple drug resistant strains to drugs to which they were
      originally resistant. This could provide a new approach to treating drug
      resistant tuberculosis.

PMID- 7782255
TI  - The activity of halofuginone in immunosuppressed rats infected with
      Cryptosporidium parvum.
AB  - Halofuginone was evaluated for its activity against experimentally induced
      infection due to Cryptosporidium parvum in rats rendered immunosuppressed with
      dexamethasone. The drug's activity was dose-related and both prophylaxis and
      therapy reduced the rate and severity of infection in the small intestine and
      caecum. Prophylactic treatment reduced infection of the common bile duct, but
      therapeutic administration did not and neither form of treatment reduced the
      infection rate in the colon. Intestinal infection recurred at a level comparable
      to that of untreated controls when treatment was discontinued. Treatment with
      halofuginone may reduce the severity of acute cryptosporidiosis, but is less
      efficacious for chronic cryptosporidiosis involving the colon and extraintestinal
      tissues, a manifestation increasingly seen in the immunocompromised host.

PMID- 7782256
TI  - A double-blind, randomized, placebo-controlled clinical trial to evaluate the
      safety and efficacy of mupirocin calcium ointment for eliminating nasal carriage
      of Staphylococcus aureus among hospital personnel.
AB  - Sixty-eight health care workers were enrolled in a double-blind clinical trial
      and randomized to receive either mupirocin calcium ointment or placebo,
      intranasally bid for 5 days. Nasal cultures were taken immediately before
      starting treatment, 1 and 2 during treatment, at the end of treatment, 3 days
      later, weekly for 1-5 weeks and then monthly for 2-6 months after treatment.
      Mupirocin eliminated nasal carriage with Staphylococcus aureus in 58% of subjects
      within two days and 86.7% subjects by the end of therapy compared to 9.4%
      subjects at the end of treatment with placebo (P < 0.001). Post-treatment
      colonization rates of 43%, 56% and 67% were attained after 1 month, 2-4 and 6
      months treatment with mupirocin respectively and recolonisation with the same
      strain of S. aureus that had been isolated before treatment was noted in 32%, 40%
      and 48%. No resistance to mupirocin developed and the drug was well tolerated.
      Mupirocin is safe and effective in suppressing nasal carriage of S. aureus.

PMID- 7782258
TI  - Susceptibility of methicillin-resistant Staphylococcus aureus to the essential
      oil of Melaleuca alternifolia.
AB  - All 66 isolates of Staphylococcus aureus tested were susceptible to the essential
      oil of Melaleuca alternifolia, or tea tree oil, in disc diffusion and modified
      broth microdilution methods. Of the isolates tested, 64 were methicillin
      resistant S. aureus (MRSA) and 33 were mupirocin-resistant. The MIC and MBC for
      60 Australian isolates were 0.25% and 0.50%, respectively. Comparable results
      were obtained by co-workers in Britain using similar methods. These in-vitro
      results suggest tea tree oil may be useful in the treatment of MRSA carriage.

PMID- 7782257
TI  - Prevention of subsequent urinary tract infections in women by the use of anti
      adherence antimicrobial agents: a double-blind comparison of enoxacin with co
      trimoxazole.
AB  - A prospective, double-blinded crossover study was carried out to test whether a
      brief course of antibiotic therapy could eliminate bacteria adherent to
      uroepithelial cells and thus prolong the interval between urinary tract
      infections (UTIs). Thirty-two women with frequent Gram-negative urinary tract
      infections were randomized to receive either co-trimoxazole or enoxacin twice a
      day for 10 days to treat their UTI. Their urines were collected for 30 days after
      the onset of their UTI and quantitatively analyzed for bacteria, antibiotics, and
      bacteria adherent to uroepithelial cells (UECs). A subsequent infection caused
      the patient to be treated with the alternative antibiotic. A third infection
      terminated the study. Both regimens were indistinguishable in the rate of
      elimination of bacteria and in their inhibition of bacterial adherence to UECs
      for up to five days after stopping treatment. The interval between infections was
      inversely correlated with the number of adherent bacteria per UEC 30 days after
      the onset of the first UTI. Both regimens were equally effective in preventing
      subsequent UTI and the effect of 10 days therapy on the inhibition of bacterial
      adherence to UEC's did not extend beyond five days after stopping treatment.

PMID- 7782259
TI  - Comparing antimicrobial activity against resistant Pseudomonas aeruginosa using
      an index for the absence of cross-resistance.
AB  - We devised an index to estimate the degree cross-resistance between piperacillin,
      ceftazidime, sulbactam/cefoperazone, amikacin, tobramycin, carumonam and imipenem
      against 139 separate clinical isolates of Pseudomonas aeruginosa. A negative
      value of the index indicated the cross-resistance whereas a positive value
      suggested the converse making the device an index for the absence of cross
      resistance (ACR). Using the ACR index, we identified pairs of antibiotics
      exhibiting the least degree of cross-resistance and therefore the highest
      potential for treating infections due to P. aeruginosa.

PMID- 7782260
TI  - An enzymatic method for assaying sulbactam in human serum: comparison with high
      performance liquid chromatography.
AB  - An enzymatic method using nitrocefin as substrate was developed to assay
      sulbactam in human serum. Serum containing sulbactam was incubated with purified
      titrated TEM-1 beta-lactamase and nitrocefin was then added to the mixture to
      determine the remaining beta-lactamase activity and consequently the
      concentration of sulbactam. Assays were carried out on five patients with
      pulmonary infections receiving sulbactam plus amoxycillin iv. The values for
      serum sulbactam concentrations determined by the enzymatic method were compared
      with those determined by high performance liquid chromatography (HPLC). The
      correlation coefficient was 0.990 for serum sulbactam concentrations below 15
      mg/L.

PMID- 7782261
TI  - Amoxycillin-clavulanate versus methicillin or isoxazolyl penicillins for
      treatment of Staphylococcus aureus infections.

PMID- 7782262
TI  - Sensitivity to cefotaxime of pneumococci isolated in the UK.

PMID- 7782263
TI  - Concentration dependence of gentamicin post-bolus peak effect on Escherichia coli
      kill kinetics.

PMID- 7782265
TI  - Usefulness of femoro(ilio)-axillar bypass surgery for the treatment of subclavian
      steal syndrome caused by aortitis syndrome.
AB  - In two patients with subclavian steal syndrome associated with aortitis syndrome,
      retrograde bypass grafting from the femoral or common iliac artery to the
      axillary artery resulted in the disappearance of symptoms. One patient, a 37-year
      old female, was treated with a bypass from the left femoral artery to the left
      axillary artery with a 10-mm ring-supported double velour knitted Dacron graft.
      The other patient, a 54-year-old female, with the complication of moderate aortic
      regurgitation, was treated with a bypass from the left common iliac artery to the
      left axillary artery with an 8-mm EPTFE graft. These bypass grafts were
      angiographically confirmed to be patent after the operation. When changes in
      graft flow in different body positions (supine, sitting, and standing) were
      examined, using a transcutaneous Doppler flow meter, 5 years after the operation,
      resting graft flow to the upper extremities showed no consistent changes among
      the three different positions and was maintained in a stable condition,
      regardless of the patients' positions. Furthermore, graft flow increased while
      the left arm exercised. This finding, together with the clinical efficacy,
      indicates that this mode of retrograde bypass grafting may be effective in some
      selected patients with this complicated syndrome.

PMID- 7782264
TI  - Rheological significance of tandem lesions of the coronary artery.
AB  - It is not known whether the individual lesions that constitute tandem lesions of
      the coronary artery are developmentally or rheologically related. Luminal changes
      and their rheological significance were examined by percutaneous angioscopy in 44
      tandem lesions of 21 patients with ischemic heart disease. Angioscopically,
      individual narrowing of angiographically documented tandem lesions appeared only
      as a tangentially expressed prominent portion of an atherosclerotic spiral fold.
      The directions of the fold were counterclockwise in the proximal to middle
      segments and clockwise in the distal segment of the right coronary artery,
      clockwise in the proximal to middle segments and counterclockwise in the distal
      segment of the left anterior descending artery, and counterclockwise in the
      proximal to middle segments of the left circumflex artery. The bloodstream always
      ran along the spiral folds in the tandem lesions. The results suggest that
      angiographically documented tandem coronary lesions are merely a tangential
      expression of atherosclerotic spiral folds and that they may act to prevent blood
      turbulence by generating a spiral laminal flow.

PMID- 7782266
TI  - Cardiodynamic conditions for the linearity of preload recruitable stroke work.
AB  - Studies reported in the literature show that the stroke work (SW) versus end
      diastolic volume (Ved) relationship, namely, the preload recruitable stroke work
      relation (PRSW), is experimentally linear in closed-chest dog hearts and its
      slope reflects left ventricular contractility. We considered the theoretical
      cardiodynamic conditions necessary for the linearity of the SW-Ved relation by
      utilizing ventricular end-systolic elastance, Emax (ventricular contractility),
      and effective arterial elastance, Ea (arterial afterload). We simulated the SW
      Ved relation, using four theoretical models of the left ventricle, as follows: Ea
      is constant and the end-systolic pressure-volume relation (ESPVR) is linear
      (model 1), or nonlinear (model 2), and Ea is variable and ESPVR is linear (model
      3), or nonlinear (model 4). The results show that the SW-Ved relation can be
      linear in both linear and nonlinear ESPVR models (models 3 and 4) only when Ea is
      variable. In these models, end-systolic pressure (Pes) and Ea should gradually
      fall, maintaining the stroke volume (SV) relatively constant with decreases in
      Ved until the low end of the physiological Ved range. Then, Ea should rise
      sharply so that Pes does not fall below the critical level. These results suggest
      that the autoregulation mechanisms of an intact animal operate to adapt the
      arterial afterload against acute changes in LV preload, maintaining cardiac
      output and coronary artery pressure. Such mechanisms may thus produce a linear SW
      Ved relation over a wide range of conditions.

PMID- 7782267
TI  - Regional myocardial function curve of the ventricle.
AB  - To understand the pathophysiology of diseased hearts, we devised a new regional
      myocardial function curve and investigated its properties. Regional work per unit
      volume of the myocardium (RWM) was calculated by integrating mean wall stress
      (sigma) with respect to the natural logarithm of the reciprocal of wall thickness
      [ln(1/H)] over a cardiac cycle. Regarding the end-diastolic ln(1/H) as the
      preload for the region of concern on the assumption that the myocardium is
      incompressible, we defined the relation between RWM and end-diastolic ln(1/H) as
      the regional myocardial function curve. In ten mongrel dogs, we measured left
      ventricular pressure, left ventricular internal diameter, and wall thickness with
      a catheter-tip micromanometer and ultrasonic dimension gauges during volume
      loading to obtain the regional myocardial function curve. We examined the
      sensitivity of the regional myocardial function curve to changes in contractile
      state (isoproterenol, propranolol) and changes in afterload (pressure loading by
      a balloon-occlusion catheter). The linear fit to the data points of the regional
      myocardial function curve under each condition always achieved a very good
      correlation coefficient (greater than 0.62). Isoproterenol increased the slope of
      the regional myocardial function curve from 9.7 +/- 0.9 (SEM) mJ/cm3 to 14.4 +/-
      1.0 mJ/cm3 (P < 0.01), with no significant changes in the x-intercept, while
      propranolol decreased it to 5.6 +/- 1.2 mJ/cm3 (P < 0.01) with no significant
      changes in the x-intercept.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782268
TI  - Acute effects of amiodarone on membrane properties, refractoriness, and
      conduction in guinea pig papillary muscles.
AB  - Amiodarone has potent and complex antiarrhythmic effects associated with a rare
      incidence of proarrhythmia. For a comprehensive understanding of its
      antiarrhythmic mechanisms in the same preparations, amiodarone (50 microM) was
      employed as it would be in the clinical setting and applied to guinea pig
      papillary muscles impaled by microelectrodes, paced at different rates, and
      superfused with various concentrations of potassium ([K]e). Amiodarone exerted
      complex actions, as follows: (1) The maximum rate of rise (Vmax) of the fast
      action potential (i.e., [K]e = 5.4-9.0 mM) as well as that of the slow action
      potential (i.e., [K]e = 15.0 mM in the presence of 1.0 microM isoproterenol) was
      suppressed in a rate-dependent manner. (2) Amiodarone exhibited a rate- and [K]e
      dependent increase in the ratio of effective refractory period vs action
      potential duration at 90% repolarization (ERP/APD90), disclosing post
      repolarization refractoriness. (3) Amiodarone had no effect on passive cable
      factors, such as threshold current and tissue resistance, during propagation.
      These versatile electrophysiological effects of amiodarone may contribute to its
      unique antiarrhythmic effects, as well as the low incidence of proarrhythmia with
      this drug.

PMID- 7782269
TI  - Regional diastolic function in effort angina pectoris: assessment with biplane
      left ventriculography.
AB  - To investigate left ventricular (LV) regional diastolic function in effort angina
      pectoris (AP), we performed left ventriculography in 14 patients with AP and
      isolated left anterior descending artery disease and in 9 normal subjects (N). LV
      volume (V), regional area (S) [anterior, apex, and inferior], and the first
      derivative of V and S (dV/dt, dS/dt) were derived from analysis of the left
      ventriculogram. Normalized peak filling rate (nPFR) and peak atrial filling rate
      (nPAFR) were derived from dV/dt. The ratio of filling volume to stroke volume
      during rapid filling and atrial contraction were defined as rapid filling
      fraction (RFF) and atrial filling fraction (AFF). Similarly, peak area changing
      rate (PACR), peak area changing rate during atrial contraction (PACRac), rapid
      area changing fraction (RACF), and atrial area changing fraction (AACF) were
      derived from S and dS/dt. We also calculated the time constant of LV relaxation
      (T), and LV global and regional compliance during atrial contraction [(dV/VdP)ac,
      (dS/SdP)ac]. The LV global diastolic function (T increases, nPFR decreases) was
      impaired in the angina patients. LV regional diastolic function (nPACR decreases,
      RACF decreases) was also impaired in the affected region of the AP group. While
      their rapid filling was impaired, nPACRac was maintained and AACF was increased
      in the affected region. Furthermore, nPACR and RACF each showed a significant
      inverse correlation with AACF in the anterior region [r = -0.57 (P < 0.01), r = 
      0.92 (P < 0.001)]. In the affected region of the patients with AP, (dS/SdP)ac was
      increased, but not significantly. Thus, LV global and regional diastolic
      functions were simultaneously impaired in patients with isolated left anterior
      descending artery disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782271
TI  - The impact of health care reform on social phobia.
AB  - According to the National Comorbidity Survey, social phobia is the third most
      frequent psychiatric disorder in the United States. Its lifetime prevalence rate
      of 13.3% ranks behind only major depressive episode (17.1%) and alcohol
      dependence (14.1%). As was the case with depression 15 years ago, social phobia
      has often been trivialized and stigmatized. For example, some with social phobia
      may be dismissed as having mere "stage fright" or excessive shyness, while, in
      fact, social phobia is a serious mental illness associated with substantial
      psychosocial distress, comorbidity, and morbidity. Typical onset of social phobia
      is in the midteens and often continues throughout an individual's lifetime,
      leading to severe social and occupational impairment. Several excellent,
      efficacious treatments are available. Access to these treatments for social
      phobia may be more difficult in the future due to managed care initiatives and
      health care reform. Various proposals are now being considered as a part of
      health care reform that may have significant impact on the diagnosis and
      treatment of social phobia.

PMID- 7782272
TI  - Social phobia: a pharmacologic treatment overview.
AB  - Generalized and specific social phobias are common, chronic, and potentially
      debilitating conditions. In recent years, there have been major advances in the
      pharmacotherapy of social phobia; efficacy has become better established for a
      diverse group of medications. Controlled studies have shown substantial benefit
      from monamine oxidase inhibitors, both irreversible (phenelzine) and reversible
      (brofaromine and moclobemide). The serotonin selective reuptake inhibitor
      antidepressants have shown promise in case reports, uncontrolled studies, and
      double-blind trials (fluvoxamine and sertraline). The benzodiazepines have been
      extensively used to treat social phobia, although only recently has a controlled,
      double-blind study confirmed efficacy (clonazepam). The beta-adrenergic receptor
      blockers have been widely used on an as needed basis to treat specific social
      phobia (i.e., performance anxiety), although their value in generalized social
      phobia has not been convincing. Finally, pharmacologic approaches to social
      phobia must take into consideration the common coexistence of other psychiatric
      conditions.

PMID- 7782273
TI  - Advances in behavioral-cognitive therapy of social phobia.
AB  - Behavioral-cognitive therapy is a cost-effective treatment for social phobia. The
      doctor's role is to teach the patient how to do successful self-exposure. The
      clinician acts as a guide and monitor; there is no need to waste time
      accompanying the patient into the phobic situation. The patient first reads a
      self-exposure manual to learn how to confront panic-evoking social cues for
      prolonged period without avoidance until habituation sets in. This might require
      an hour daily of self-exposure over weeks or months. As patients habituate to
      social cues to which they have exposed themselves, they arrange exposure to fresh
      cues until they become used to all. The patient tracks progress by recording
      completed exposure-homework tasks in a daily diary. In instances where it is
      technically difficult to do regular exposure, the patient carries out imagined
      tape-recorded exposure in his/her own voice. The therapist can briefly help the
      patient role-play such exposure. Rational role-play enhances outcome of body
      dysmorphic disorder or delusional disorder somatic type with prominent social
      phobia. Cognitive therapy can be useful. Most social phobics improve with
      behavioral-cognitive treatment without medication. When patients have low mood,
      concurrent antidepressants can be synergistic.

PMID- 7782270
TI  - Sonicated X-ray contrast agents for quantitative myocardial contrast
      echocardiography--a critical approach.
AB  - Contrast echocardiography with sonicated radiographic contrast agents has been
      used for the qualitative and quantitative determination of myocardial blood flow.
      One major problem has been the size of the microbubbles since only bubbles
      smaller than 8 microns are expected to pass the capillary bed and larger bubbles
      may obstruct the capillaries and, thus, alter myocardial blood flow. These
      techniques have been used for several years, but their reliability has not yet
      been assessed accurately. Five different methods for the production of sonicated
      radiographic contrast agents (methods 1-3 from the literature, and 4 and 5 from
      our laboratory; M1-5) were evaluated for their use in quantitative contrast
      echocardiography. The sonication of non-ionic X-ray contrast media was performed
      with a standard titanium probe (20 kHz) for methods 1-4, with variation in the
      sonication time and the number of sonication jets used for each method. In M5, we
      used bubbles that were produced by the insufflation of oxygen in the X-ray
      contrast agent; large (> 8 microns) bubbles were destroyed by sonication at 380
      kHz (resonance method). Mean bubble size was determined by computerized
      videomicroscopy. The effect of bubble size on the backscatter of the ultrasonic
      signal was calculated for each method. Mean bubble size (+/- 1 SD) ranged between
      11.5 +/- 4 microns and 16.1 +/- 14 microns for M1-M5. The best values, i.e., the
      smallest bubbles, were found with M4 (prepressurized contrast medium). Assuming
      capillary passage for bubbles smaller than 8 microns, only 14%-48% of the bubbles
      were smaller than 8 microns (M1-M5). The best results with regard to bubble size
      (< or = 8 microns) were observed with M5 (48% < or = 8 microns). In regard to the
      influence of bubble size on the backscatter of the ultrasonic signal, 56%-98.5%
      of the signal was produced by bubbles larger than 15 microns (M1-5) but the best
      results were obtained with M4. It is concluded that capillary-passage of
      sonicated microbubbles (< or = 8 microns) can be expected in only 14%-48% of the
      bubbles for the five different sonication techniques. More than 50% of all
      microbubbles produced by these techniques are larger than the expected 8 microns.
      These large bubbles are responsible for the backscatter of the ultrasonic signal
      in the vast majority of cases. Thus, the sonication of radiographic contrast
      agents appears to be inappropriate for the production of uniformly small
      microbubbles and, thus, this method is not suitable for quantitative measurements
      of coronary blood flow.

PMID- 7782274
TI  - The diagnosis of social phobia.
AB  - Humans are social animals attuned to reactions of others; however, some are
      exquisitely sensitive to--and often misperceive--perceptions of those they
      encounter. The core feature of social phobia is marked and persistent fear of
      embarrassment or humiliation in social situations where the individual worries
      that others may judge his or her performance as too much or too little.
      Anticipatory anxiety and avoidance occur when the individual is under scrutiny
      while speaking or performing publicly, eating with others, writing in public, or
      using public bathrooms. Diagnosis of social phobia is based largely on history
      obtained from the patient. Onset is usually around puberty; its course is chronic
      with comorbid depression common and alcohol and other substances routinely abused
      in misguided attempts to minimize anxiety and depressive symptoms. At
      examination, patients often have a moist hand, averted gaze, blushing, and other
      manifest signs of anxiety. Slight shyness is familiar to most, but a substantial
      number suffer dysfunctional and distressing social anxiety to the point that they
      become phobic. A few patients satisfy criteria for avoidant personality disorder,
      which can be socially incapacitating.

PMID- 7782275
TI  - I-type lectins.

PMID- 7782276
TI  - Homophilic interactions mediated by receptor tyrosine phosphatases mu and kappa.
      A critical role for the novel extracellular MAM domain.
AB  - The receptor-like protein tyrosine phosphatases (RPTP) mu and RPTP kappa have a
      modular ectodomain consisting of four fibronectin type III-like repeats, a single
      Ig-like domain, and a newly identified N-terminal MAM domain. The function of the
      latter module, which comprises about 160 amino acids and is found in diverse
      transmembrane proteins, is not known. We previously reported that both RPTP mu
      and RPTP kappa can mediate homophilic cell interactions when expressed in insect
      cells. Here we show that despite their striking structural similarity, RPTP mu
      and RPTP kappa fail to interact in a heterophilic manner. To examine the role of
      the MAM domain in homophilic binding, we expressed a mutant RPTP mu lacking the
      MAM domain in insect Sf9 cells. Truncated RPTP mu is properly expressed at the
      cell surface but fails to promote cell-cell adhesion. Homophilic cell adhesion is
      fully restored in a chimeric RPTP mu molecule containing the MAM domain of RPTP
      kappa. However, this chimeric RPTP mu does not interact with either RPTP mu or
      RPTP kappa. These results indicate that the MAM domain of RPTP mu and RPTP kappa
      is essential for homophilic cell-cell interaction and helps determine the
      specificity of these interactions.

PMID- 7782277
TI  - A direct interaction between G-protein beta gamma subunits and the Raf-1 protein
      kinase.
AB  - Raf-1 is a serine/threonine protein kinase positioned downstream of Ras in the
      mitogen-activated protein kinase cascade. Using a yeast two-hybrid strategy to
      identify other proteins that interact with and potentially regulate Raf-1, we
      isolated a clone encoding the carboxyl-terminal half of the G beta 2 subunit of
      heterotrimeric G-proteins. In vitro, purified G beta gamma subunits specifically
      bound to a GST fusion protein encoding amino acids 1-330 of Raf-1 (Raf/330).
      Binding assays with truncation mutants of GST-Raf indicate that the region
      located between amino acids 136 and 239 is a primary determinant for interaction
      with G beta gamma. In competition experiments, the carboxyl terminus of beta
      adrenergic receptor kinase (beta ARK) blocked the binding of G beta gamma to
      Raf/330; however, the Raf-1-binding proteins, Ras and 14-3-3, had no effect.
      Scatchard analysis of in vitro binding between Raf/330 and G beta gamma revealed
      an affinity of interaction (Kd = 163 +/- 36 nM), similar to that seen between G
      beta gamma and beta ARK (Kd = 87 +/- 24 nM). The formation of native
      heterotrimeric G alpha beta gamma complexes, as measured by pertussis toxin ADP
      ribosylation of G alpha, could be disrupted by increasing amounts of Raf/330,
      with an EC50 of approximately 200 nM, in close agreement with the estimated
      binding affinity. In vivo complexes of Raf-1 and G beta gamma were isolated from
      human embryonic kidney 293-T cells transfected with epitope-tagged G beta 2. The
      identification and characterization of this novel interaction raises several
      possibilities for signaling cross-talk between growth factor receptors and those
      receptors coupled to heterotrimeric G-proteins.

PMID- 7782279
TI  - Rhodopsin phosphorylation and dephosphorylation in vivo.
AB  - Rhodopsin is an important member of the superfamily of G protein-coupled
      receptors. In vitro studies have suggested that multiphosphorylation of rhodopsin
      is a pivotal step in phototransduction. Because the in vitro biochemical
      experiments were conducted under nonphysiological conditions, we investigated the
      phosphorylation of mouse rhodopsin in vivo and determined the sites of
      phosphorylation and the time course of dephosphorylation. We found that a single
      phosphate group is incorporated into the rhodopsin molecule in a light-dependent
      manner, primarily at Ser338 after flashes and at Ser334 after continuous
      illumination. Dephosphorylation of these sites had different kinetics and spatial
      distribution in rod outer segments. Dephosphorylation of Ser338 was complete
      within 30 min, while Ser334 was dephosphorylated much slower (requiring up to 60
      min), correlating with the regeneration of rhodopsin. These results suggest that
      phosphorylation of Ser338 and Ser334 plays different roles in phototransduction.

PMID- 7782278
TI  - Inhibition of nuclear translocation of transcription factor NF-kappa B by a
      synthetic peptide containing a cell membrane-permeable motif and nuclear
      localization sequence.
AB  - To control agonist-induced nuclear translocation of transcription factor kappa B
      (NF-kappa B) in intact cells, cell-permeable synthetic peptides were devised.
      Their import into intact cells was dependent on a hydrophobic region selected
      from the signal peptide sequences and was verified by their inaccessibility to
      extracellular proteases and by confocal laser scanning microscopy. When a cell
      permeable peptide carried a functional cargo representing the nuclear
      localization sequence of NF-kappa B p50, it inhibited in a concentration
      dependent manner nuclear translocation of NF-kappa B in cultured endothelial and
      monocytic cells stimulated with lipopolysaccharide or tumor necrosis factor
      alpha. Synthetic peptide analogues with deleted hydrophobic cell membrane
      permeable motif or with a mutated nuclear localization sequence were inactive.
      Cell membrane-permeable peptides were not cytotoxic within the concentration
      range used in these experiments. These results suggest that cell-permeable
      synthetic peptides carrying a functional cargo can be applied to control signal
      transduction-dependent subcellular traffic of transcription factors mediating the
      cellular responses to different agonists. Moreover, this approach can be used to
      study other intracellular processes involving proteins with functionally distinct
      domains.

PMID- 7782280
TI  - A sphingomyelin-transferring protein from chicken liver. Use of pyrene-labeled
      phospholipid.
AB  - A phospholipid transfer protein was purified from chicken liver which, in
      addition to phosphatidylinositol (PI) and phosphatidylcholine (PC), carries
      sphingomyelin (SM) between membranes. For comparison, the PI-transfer protein
      from chicken liver only carries PI and PC. Specificity was established by use of
      phospholipids that carry a pyrene-labeled acyl chain. Based on the N-terminal
      sequence and Western blot analysis we conclude that this protein is an isoform of
      the PI-transfer protein. At increasing length of the pyrene-labeled acyl chain,
      the isoform expresses a high activity toward SM, a low activity toward PI, and
      virtually no activity toward PC.

PMID- 7782281
TI  - Import of the cytochrome oxidase subunit Va precursor into yeast mitochondria is
      mediated by the outer membrane receptor Mas20p.
AB  - Post-translational import of precursor proteins into yeast mitochondria is
      mediated by at least four protease-sensitive outer membrane proteins: Mas20p,
      Mas22p, Mas37p, and Mas70p. These "import receptors" recognize either the N
      terminal targeting signal or some other feature of mitochondrial precursor
      proteins. The only exception to this general rule appeared to be the precursor to
      subunit Va of cytochrome c oxidase (COXVa). Although this precursor carries a
      typical N-terminal mitochondrial targeting sequence, its import into mitochondria
      has been suggested to be independent of the known import receptors. Here we show
      that if import into isolated yeast mitochondria is assayed under conditions in
      which binding of the COXVa precursor to mitochondria is rate-limiting, import is
      strongly inhibited by protease pretreatment of the mitochondria or by antibodies
      against Mas20p. Post-translational import of the COXVa precursor can thus proceed
      by the general, receptor-mediated pathway.

PMID- 7782282
TI  - Molecular mapping of functional antibody binding sites of alpha 4 integrin.
AB  - Integrin alpha 4 beta 1 is a leukocyte receptor for fibronectin and vascular cell
      adhesion molecule-1 (VCAM-1). It is important in inflammatory recruitment of
      leukocytes, lymphopoiesis, and a number of development events. Here we have
      mapped a panel of functional monoclonal antibodies (mAbs) recognizing the
      integrin alpha 4 chain, using murine/human chimeric constructs expressed in COS7
      cells. We find that: 1) mAbs that induce homotypic aggregation (epitope A mAbs)
      map to the most N-terminal 100 amino acids of the human alpha 4 chain; 2) mAbs
      that block adhesion of alpha 4 beta 1 to VCAM-1 and fibronectin (epitope B mAbs)
      map to a 52-amino-acid region between residues 152 and 203 of human alpha 4; 3)
      epitope B mAbs that do or do not induce aggregation (epitope B2 and B1 mAbs,
      respectively) map to the same regions and are therefore indistinguishable by this
      analysis; 4) mAbs that neither induce homotypic aggregation nor block adhesion
      (epitope C mAbs) map to a distinct region of the molecule comprising amino acids
      422-606. The N-terminal region of the alpha 4 chain identified by functional A
      and B epitope mAbs does not correspond to ligand binding sites identified in
      other alpha subunits, such as cation binding sites or the "I-domain," which alpha
      4 lacks, and thus represents a novel site for epitope functionality among the
      integrins.

PMID- 7782283
TI  - Ligand-independent and -dependent functions of thyroid hormone receptor isoforms
      depend upon their distinct amino termini.
AB  - Isoform specificity likely plays a large role in the ability of the thyroid
      hormone receptor (TR) to specifically regulate gene expression in both the
      presence and absence of its cognate ligand, triiodothyronine. To investigate
      further the mechanism of isoform specificity of human TRs (TR alpha 1 and TR beta
      1), we have examined their functional effects on positive thyroid hormone
      response elements (TREs) both in the presence and absence of ligand. TR alpha 1
      was greater than 2-fold more potent than TR beta 1 on both TREs studied, in terms
      of both ligand-independent repression and ligand-dependent stimulation. By
      creating a number of chimeric and mutant receptors, we have established that the
      increased functional potency of TR alpha 1 is due to its unique amino terminus.
      Deletion or substitution of the TR alpha 1 amino terminus leads to a loss of both
      its ligand-independent and -dependent functions on positive TREs. Furthermore,
      the TR alpha 1 amino terminus antagonizes homodimer formation on the positive
      TREs studied. TR constructs, which contain the TR alpha 1 amino terminus, are
      unable to form homodimers and form exclusively heterodimers with RXR alpha on
      direct repeat and palindromic TREs. Deletion of the amino terminus from either TR
      isoform leads to preferential homodimer formation, which suggests that the TR
      amino terminus is important for relative heterodimerization capability. From
      these data, we conclude that TR alpha 1 isoform specificity on positive TREs
      resides predominantly in its amino terminus through its ability to favor
      heterodimerization with the retinoid X receptor or other nuclear proteins.

PMID- 7782284
TI  - A 30-amino acid truncation of the microsomal triglyceride transfer protein large
      subunit disrupts its interaction with protein disulfide-isomerase and causes
      abetalipoproteinemia.
AB  - The microsomal triglyceride transfer protein (MTP) is a heterodimer composed of
      the multifunctional enzyme, protein disulfide-isomerase, and a unique large, 97
      kDa, subunit. It is found as a soluble protein within the lumen of the
      endoplasmic reticulum of liver and intestine and is required for the assembly of
      very low density lipoproteins and chylomicrons. Mutations in MTP which result in
      an absence of MTP function have been shown to cause abetalipoproteinemia. Here,
      the gene encoding the MTP 97-kDa subunit of an abetalipoproteinemic subject,
      which we have previously demonstrated lacks MTP activity and protein (Wetterau,
      J. R., Aggerbeck, L. P., Bouma, M.-E., Eisenberg, C., Munck, A., Hermier, M.,
      Schmitz, J., Gay, G., Rader, D. J., and Gregg, R. E. (1992) Science 258, 999
      1001), was isolated and sequenced. A nonsense mutation, which predicts the
      truncation of the protein by 30 amino acids, was identified. To investigate if
      this apparently subtle change in MTP could explain the observed absence of MTP,
      protein disulfide-isomerase was co-expressed with either the normal or mutant MTP
      97-kDa subunit in Sf9 insect cells using a baculovirus expression system.
      Although there were high levels of expression of both the normal and mutant forms
      of the MTP 97-kDa subunit, only the normal subunit was able to form a stable,
      soluble complex with protein disulfide-isomerase. These results indicate that the
      carboxyl-terminal 30 amino acids of the MTP 97-kDa subunit plays an important
      role in its interaction with protein disulfide-isomerase.

PMID- 7782285
TI  - Characterization of the binding site for cyclothialidine on the B subunit of DNA
      gyrase.
AB  - The mechanism of inhibition of DNA gyrase by cyclothialidine, a novel gyrase
      inhibitor isolated from Streptomyces filipinensis NR0484, has been studied
      further by using [14C]benzoylcyclothialidine and a reconstituted Escherichia coli
      gyrase system consisting of the A subunit, the B subunit and relaxed ColE1 DNA.
      The mechanism of inhibition was also studied with the 43-kDa N-terminal fragment
      of the B subunit. The [14C]benzoylcyclothialidine could bind to the B subunit
      alone but not to the A subunit nor to the plasmid DNA alone. Furthermore, the
      compound also bound to the 43-kDa N-terminal fragment of the B subunit. Scatchard
      analysis of [14C]benzoylcyclothialidine binding to DNA gyrase showed that the
      binding affinity of the compound increased, depending on the assembly of the
      gyrase (A2B2). DNA complex. This suggests that the binding site of
      cyclothialidine on the B subunit or its vicinity causes a conformational change
      during the assembly of the gyrase.DNA complex (increase in affinity: B-->A2B2-
      >A2B2.DNA). Furthermore, displacement curves of [14C]benzoylcyclothialidine
      binding by nonlabeled cyclothialidine, ATP analogues, and coumarin antibiotics
      indicated that cyclothialidine, coumarins, and ATP share a common (or
      overlapping) site of action on the B subunit of DNA gyrase; however, the
      microenvironment of the binding sites may differ.

PMID- 7782286
TI  - Identification of the region within the neuroendocrine polypeptide 7B2
      responsible for the inhibition of prohormone convertase PC2.
AB  - The highly conserved polypeptide 7B2 and the subtilisin-related prohormone
      convertases PC1/PC3 and PC2 are broadly distributed in neurons and endocrine
      cells and are localized to secretory granules. We recently showed that
      recombinant 7B2 is in vitro a potent inhibitor of PC2 activity, but not of
      PC1/PC3, and that newly synthesized 7B2 is transiently associated with proPC2 in
      vivo. In the present study, in vitro mutagenesis was used to identify the region
      within the 7B2 sequence responsible for the inhibition of PC2. Mutant proteins
      were produced in a prokaryotic expression system and their effects on PC1/PC3 and
      PC2 activities were studied by two different in vitro enzyme assays. None of the
      7B2 mutant proteins inhibited PC1/PC3 activity. Truncation studies revealed that
      a short segment within the COOH-terminal portion of 7B2 is critical for its
      inhibitory effect on PC2. This segment contains a pair of basic amino acid
      residues which may represent a recognition motif for PC2. Single amino acid
      substitutions within this Lys171-Lys172 site strongly diminished and a double
      mutation abolished the inhibitory potency of 7B2. Our results indicate that,
      although amino acid residues directly surrounding this dibasic pair also
      contribute to PC2 inhibition, the Lys171-Lys172 site is particularly important
      for the ability of 7B2 to inhibit PC2.

PMID- 7782287
TI  - Mutagenesis studies of the phosphorylation sites of recombinant human pyruvate
      dehydrogenase. Site-specific regulation.
AB  - Mammalian pyruvate dehydrogenase (alpha 2 beta 2) (E1) is regulated by
      phosphorylation-dephosphorylation, catalyzed by the E1-kinase and the phospho-E1
      phosphatase. Using site-directed mutagenesis of the three phosphorylation sites
      (sites 1, 2, and 3) on E1 alpha, several human E1 mutants were made with single,
      double, and triple mutations by changing Ser to Ala. Mutation at site 1 but not
      at sites 2 and/or 3 decreased E1 specific activity and also increased Km values
      for thiamin pyrophosphate and pyruvate. Sites 1, 2, and 3 in the E1 mutants were
      phosphorylated either individually or in the presence of the other sites by the
      dihydrolipoamide acetyltransferase-protein X-E1 kinase indicating a site
      independent mechanism of phosphorylation. Phosphorylation of each site resulted
      in complete inactivation of the E1. However, the rates of phosphorylation and
      inactivation were site-specific. Sites 1, 2, and 3 were dephosphorylated either
      individually or in the presence of the other sites by the phospho-E1-phosphatase
      resulting in complete reactivation of the E1. The rates of dephosphorylation and
      reactivation were similar for sites 1, 2, and 3, indicating a random
      dephosphorylation mechanism.

PMID- 7782288
TI  - Multiple transcripts for the human cardiac form of the cGMP-inhibited cAMP
      phosphodiesterase.
AB  - cDNAs for two distinct Type III cGMP-inhibited (cGI) cyclic nucleotide
      phosphodiesterases (PDE), designated cGIP1 and cGIP2, were previously cloned from
      rat adipose and human cardiac cDNA libraries, respectively. In this study,
      another cDNA (approximately 4.0 kilobase (kb)) encoding a cGI-PDE of 74 kDa (658
      amino acids) was isolated from a human placental cDNA library. The nucleotide
      sequence of its open reading frame was virtually identical to a corresponding
      region in the 3' portion of the cardiac cGIP2 cDNA (approximately 7.6 kb) which
      encoded a approximately 125-kDa cGI-PDE (1141 amino acid). Northern blots and
      RNase protection assays revealed a prominent 4.4-kb transcript and a 7.6-kb
      transcript in human placenta. The transcription start site of the 4.4-kb
      transcript was assigned to cardiac cDNA nucleotide 1292, the putative beginning
      of exon 3 of the human cGIP2 gene, with a potential translation initiation site
      183 bases downstream, as determined by RNase protection assay. The 5'-flanking
      region of the 4.4-kb transcript exhibited promoter activity in HeLa cells which
      expressed the 4.4-kb transcript, and contained a TATAA sequence 35 base pairs
      upstream from the tentative transcription start site. Recombinant cGI-PDEs,
      expressed in Sf9 cells from the 7.6- and 4.0-kb cDNA, exhibited differences in
      their subcellular localization and Km for cGMP. Thus, in human tissues,
      alternative transcription may contribute to generating at least two cGIP2
      isoforms, cytosolic and membrane-associated cGI-PDEs with different Km values for
      cGMP.

PMID- 7782289
TI  - The gene structure of tissue inhibitor of metalloproteinases (TIMP)-3 and its
      inhibitory activities define the distinct TIMP gene family.
AB  - Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases
      (TIMPs) play a critical role in extracellular matrix homeostasis. We have
      previously cloned human and mouse TIMP-3 cDNAs and mapped their chromosomal loci
      (Apte, S. S., Mattei, M-G., and Olsen, B. R. (1994) Genomics 19, 86-90; Apte, S.
      S., Hayashi, K., Seldin, M. F., Mattei, M-G., Hayashi, M., and Olsen, B. R.
      (1994) Dev. Dynam. 200, 177-197); the identification of TIMP3 mutations in
      Sorsby's fundus dystrophy has underscored the functional importance of TIMP-3. We
      now report that TIMP-3 is encoded by five exons spanning over 30 kilobase pairs
      of mouse genomic DNA. In the attribution of protein domains to specific exons, as
      well as exon structures, the Timp-3 and Timp-1 genes are similar, confirming the
      common evolutionary origin of the TIMPs and defining a distinct gene family. We
      have expressed human and mouse TIMP-3 in mouse NSO myeloma cells. In each case,
      an N-glycosylated 27-kDa protein was generated, that, like TIMP-1 and TIMP-2,
      inhibited collagenase-1, stromelysin-1, and gelatinases A and B. TIMP-3 and TIMP
      1 inhibition were quantitatively similar, implying that all TIMPs are equally
      efficient in MMP inhibition. Instead, differential regulation of the TIMP genes
      or divergent C-terminal protein sequences may underlie distinct biological
      functions for each TIMP.

PMID- 7782290
TI  - An effector site that stimulates G-protein GTPase in photoreceptors.
AB  - Heterotrimeric G-proteins mediate between receptors and effectors, acting as
      molecular clocks. G-protein interactions with activated receptors catalyze the
      replacement of GDP bound to the alpha-subunit with GTP. alpha-Subunits then
      modulate the activity of downstream effectors until the bound GTP is hydrolyzed.
      In several signal transduction pathways, including the cGMP cascade of
      photoreceptor cells, the relatively slow GTPase activity of heterotrimeric G
      proteins can be significantly accelerated when they are complexed with
      corresponding effectors. In the phototransduction cascade the GTPase activity of
      photoreceptor G-protein, transducin, is substantially accelerated in a complex
      with its effector, cGMP phosphodiesterase. Here we characterize the stimulation
      of transducin GTPase by a set of 23 mutant phosphodiesterase gamma-subunits (PDE
      gamma) containing single alanine substitutions within a stretch of the 25 C
      terminal amino acid residues known to be primarily responsible for the GTPase
      regulation. The substitution of tryptophan at position 70 completely abolished
      the acceleration of GTP hydrolysis by transducin in a complex with this mutant.
      This mutation also resulted in a reduction of PDE gamma affinity for transducin,
      but did not affect PDE gamma interactions with the phosphodiesterase catalytic
      subunits. Single substitutions of 7 other hydrophobic amino acids resulted in a
      50-70% reduction in the ability of PDE gamma to stimulate transducin GTPase,
      while substitutions of charged and polar amino acids had little or no effect.
      These observations suggest that the role of PDE gamma in activation of the
      transducin GTPase rate may be based on multiple hydrophobic interactions between
      these molecules.

PMID- 7782291
TI  - Regulation of the tertiary structure and function of coagulation factor IX by
      magnesium (II) ions.
AB  - The indispensable role of Ca2+ ions in the maintenance of the functional tertiary
      structures of vitamin K-dependent coagulation factors has been definitively
      established but the participation of Mg2+ ions, another alkaline-earth metal that
      is present abundantly in blood plasma, in such a process is not yet understood.
      We show here that the Ca(2+)-stabilized conformation of coagulation factor IX
      undergoes a further conformational change upon binding of Mg2+ ions using three
      independent structural probes. The probes we used were (i) IX/X-bp, a snake venom
      anticoagulant that recognizes the Gla domains in coagulation factors IX and X,
      (ii) conformation-specific polyclonal antibodies against bovine factor IX, and
      (iii) monoclonal antibodies against the Gla domain of human factor IX. The
      binding of all these probes had an absolute requirement for Ca2+ ions, and Mg2+
      ions alone were ineffective. However, when added together with Ca2+ ions, Mg2+
      ions at physiological concentrations greatly augmented the binding of these
      probes to factor IX; the required concentration of Ca2+ ions was much reduced,
      and the affinity of each probe for factor IX was increased even in the presence
      of an excess of Ca2+ ions. These results suggest the presence of a Mg(2+)
      specific binding site that does not interact with Ca2+ ions in factor IX.
      Furthermore, Mg2+ ions potentiated the susceptibility of factor IX to activation
      by factor XIa, concomitant with their effect on the conformation. Similarly, the
      required Ca2+ concentration was reduced by Mg2+ ions, and the rate of conversion
      to factor IXa was increased by Mg2+ ions in the presence of an excess of Ca2+
      ions. At a saturating concentration of Ca2+ ions (5 mM), addition of 1 mM Mg2+
      reduced the apparent Km value for factor IX from 0.31 to 0.18 microM, and in the
      presence of a physiological concentration of Ca2+ ions (1 mM), the reduction in
      Km by Mg2+ ions was far more striking (from 0.91 to 0.24 microM). The apparent
      Vmax values were hardly affected by Mg2+ ions. Our present data reveal a hitherto
      novel physiological role of the Mg2+ ions in plasma. Not only Ca2+ ions but also
      Mg2+ ions are important regulators of the stabilization of the native
      conformation of factor IX as well as of its efficient activation.

PMID- 7782292
TI  - A cytoplasmic region of the Na,K-ATPase alpha-subunit is necessary for specific
      alpha/alpha association.
AB  - While most structural studies of the Na,K-ATPase support a subunit stoichiometry
      of one alpha-subunit to one beta-subunit, the exact quaternary structure of the
      Na,K-ATPase and its relevance to enzyme function is the subject of much debate.
      Formation of a higher order enzyme complex is supported by our previous study
      demonstrating specific alpha/alpha interactions among the rat Na,K-ATPase
      isoforms (alpha 1, alpha 2, alpha 3), expressed in virally infected Sf-9 insect
      cells and among native alpha isoforms in rat brain (1). This detergent-resistant
      association was not observed in insect cells coexpressing the homologous gastric
      H,K-ATPase alpha-subunit, nor was it dependent on the coexpression of the beta
      subunit. To delineate domains necessary for alpha/alpha assembly, a series of H,K
      ATPase-Na, K-ATPase chimerase were constructed by combining the N-terminal,
      cytoplasmic midregion and C-terminal segments derived from the Na,K-ATPase (N)
      and the H,K-ATPase (H) alpha-polypeptides (HNN, HNH, NHH, NHN, and HHN). The
      alpha-subunit chimeras were coexpressed with the Na,K-ATPase alpha 1-subunit in
      Sf-9 cells using the baculovirus expression system. Specific and detergent-stable
      association is observed between the Na,K-ATPase alpha-subunit and the HNN and HNH
      chimeras, but not with the NHH, NHN, or HHN chimeras. Consistent with the Na,K
      ATPase cytoplasmic domain as being necessary for alpha/alpha interactions, the
      full-length alpha-subunit stably associates with an alpha N-terminal deletion
      mutant (delta Gly2-Leu273), but not with an alpha cytoplasmic deletion mutant
      (delta Arg350-Pro785). In addition, the naturally occurring C-terminal truncated
      alpha 1 isoform, alpha 1T (delta Gly554 to C terminus), does not associated with
      the alpha 1-subunit in Sf-9 cells coexpressing both polypeptides. thus, a
      cytoplasmic region in the alpha-subunit (Gly554-Pro785) is necessary for specific
      alpha/alpha association. The same cytoplasmic region contains a strongly
      hydrophobic segment that, by analogy with oligomerization of water-soluble
      proteins, may form the interface of the extramembranous alpha/alpha contact site.

PMID- 7782293
TI  - Voltage-sensitive adenylyl cyclase activity in cultured neurons. A calcium
      independent phenomenon.
AB  - Catalytic subunits of mammalian adenylyl cyclases have been proposed to contain
      12 transmembrane domains, a property shared with some voltage-sensitive ion
      channels. Here we report that adenylyl cyclase activity in cerebellar neurons is
      synergistically stimulated by depolarizing agents and beta-adrenergic receptor
      activation. This phenomenon is Ca(2+)-independent and not attributable to Ca(2+)
      stimulated adenylyl cyclase activity. Cholera toxin and forskolin also
      synergistically stimulate adenylyl cyclase activity in combination with
      depolarizing agents. We hypothesize that conformational changes in the catalytic
      subunit of the enzymes caused by changes in the membrane potential may enhance
      stimulation of adenylyl cyclases by the guanylyl nucleotide stimulatory protein.
      This novel mechanism for regulation of adenylyl cyclases generates robust cAMP
      signals that may contribute to various neuromodulatory events including some
      forms of neuroplasticity.

PMID- 7782294
TI  - Tyrosine phosphorylation and translocation of the c-cbl protein after activation
      of tyrosine kinase signaling pathways.
AB  - The c-cbl protooncogene product (c-Cbl) is a 120-kDa protein that has been shown
      to bind to the Src homology 3 domains of various proteins, suggesting its
      involvement in signal transduction pathways. We identified one of the most
      prominent tyrosine-phosphorylated proteins in Fc gamma receptor (Fc gamma R)
      stimulated macrophages to be c-Cbl. Tyrosine phosphorylation of c-Cbl occurred
      within 20 s after stimulation and reached maximum levels within 3-5 min. c-Cbl
      was also tyrosine-phosphorylated in epidermal growth factor (EGF) receptor
      overexpressing cells upon EGF stimulation, in macrophages in response to CSF-1
      treatment, and in v-src transformed cells. Furthermore, we found that c-Cbl
      associated with these kinases in vivo. In vitro, c-Cbl bound to the Src homology
      3 domains of Src, Fyn, and Lyn in both unstimulated and Fc gamma R-stimulated
      macrophages. Examination of cells by immunofluorescence revealed that c-Cbl is
      diffusely distributed in the cytoplasm in both unstimulated macrophages and EGF
      receptor-overexpressing cells and translocated to a more specific compartment of
      the cell, consistent with the trans-Golgi region, following Fc gamma R clustering
      and EGF stimulation, respectively. These results suggest that c-Cbl is involved
      in the signaling pathways utilized by different types of tyrosine kinases.

PMID- 7782295
TI  - Developmentally expressed Ca(2+)-sensitive adenylyl cyclase activity is disrupted
      in the brains of type I adenylyl cyclase mutant mice.
AB  - The type I Ca(2+)-sensitive adenylyl cyclase has been implicated in several forms
      of synaptic plasticity in vertebrates. Mutant mice in which this enzyme was
      inactivated by targeted mutagenesis show deficient spatial memory and altered
      long term potentiation (Wu, Z. L., Thomas, S. A., Villacres, E. C., Xia, Z.,
      Simmons, M. L., Chavkin, C., Palmiter, R. D., and Storm, D. R. (1995) Proc. Natl
      Acad Sci. U. S. A. 92, 220-224). Long term potentiation in the CA1 region of the
      rat hippocampus develops during the first 2 weeks after birth and reaches maximal
      expression at postnatal day 15 with a gradual decline at later stages of
      development. Here we report that Ca(2+)-stimulated adenylyl cyclase activity in
      rat hippocampus, cerebellum, and cortex increases significantly between postnatal
      days 1-16. This increase appears to be due to enhanced expression of type I
      adenylyl cyclase rather than type VIII adenylyl cyclase, the other adenylyl
      cyclase that is directly stimulated by Ca2+ and calmodulin. Type I adenylyl
      cyclase mRNA in the hippocampus increased 7-fold during this developmental
      period. The developmental expression of Ca(2+)-stimulated adenylyl cyclase
      activity in mouse brain was attenuated in mutant mice lacking type I adenylyl
      cyclase. Changes in expression of the type I adenylyl cyclase during the period
      of long term potentiation development are consistent with the hypothesis that
      this enzyme is important for neuroplasticity and spatial memory in vertebrates.

PMID- 7782296
TI  - Energetics of leukocyte integrin activation.
AB  - Cell adhesion mediated by leukocyte integrin CR3 (CD11b/CD18, alpha m beta 2) may
      be rapidly modulated without changes in receptor number, and transient changes in
      adhesivity are thought to be driven by reversible alteration of the affinity of
      CR3 for ligand. Here we measure the binding affinity of CR3 using purified active
      and inactive receptor and the ligand, C3bi, coupled to alkaline phosphatase.
      Immobilized, active CR3 bound saturably and with high affinity (12.5 +/- 4.7 nM).
      In contrast, inactive CR3 exhibited no measurable binding. High affinity binding
      could be restored by the addition of the activating anti-CR3 monoclonal antibody
      KIM-127 to inactive CR3. Since the affinity of KIM-127 for active and inactive
      receptor was identical, it cannot contribute the energy to convert a low affinity
      receptor into a high affinity receptor. Rather, KIM-127 appears to facilitate
      binding of C3bi by lowering the activation energy for the shift from an inactive
      to an active state. These results suggest that CR3-mediated binding and
      detachment of cells is not driven by a reversible change in affinity but by two
      mechanistically distinct processes, an energetically neutral activation step for
      binding and an energy-dependent step that reverses binding of ligand.

PMID- 7782297
TI  - Acetylcholine differentially affects intracellular calcium via nicotinic and
      muscarinic receptors on the same population of neurons.
AB  - Multiple receptor subtypes activated by the same ligand but coupled to different
      second messengers can produce divergent signaling in a cell, while receptors
      activated by different ligands but sharing the same second messenger can produce
      convergent signaling. We show here that chick ciliary ganglion neurons have three
      classes of receptors activated by the same neurotransmitter, acetylcholine, and
      that all three regulate the same second messenger, intracellular free calcium.
      Activation of muscarinic receptors on the neurons stimulates phosphatidylinositol
      turnover and induces calcium oscillations that are initiated and maintained by
      calcium release from caffeine/ryanodine-insensitive intracellular stores.
      Extracellular calcium is required to sustain the oscillations, while cadmium
      abolishes them. Activation of either of two classes of nicotinic receptors,
      distinguished both by location on the neurons and by subunit composition, induces
      a single, rapid elevation in intracellular calcium without inducing
      phosphatidylinositol turnover. The nicotinic responses are entirely dependent on
      extracellular calcium, show no dependence on release from internal stores, and do
      not display oscillations. Low concentrations of the native agonist,
      acetylcholine, induce repetitive calcium spikes in the neurons characteristic of
      muscarinic receptors, while higher concentrations induce nonoscillating increases
      in intracellular calcium that include contributions from nicotinic receptors. The
      three classes of receptors also differ in the acetylcholine concentration
      required to elicit a response. These differences, together with differences in
      receptor location and sources of calcium mobilized, may enable the receptor
      subtypes to target different sets of calcium-dependent processes for regulation.

PMID- 7782298
TI  - Regulation of vascular smooth muscle cell insulin-like growth factor I receptors
      by phosphorothioate oligonucleotides. Effects on cell growth and evidence that
      sense targeting at the ATG site increases receptor expression.
AB  - We have recently shown that insulin-like growth factor I (IGF I) is a mediator of
      angiotensin II-induced mitogenesis in vascular smooth muscle cells (Delafontaine,
      P., and Lou H. (1993) J. Biol. Chem. 268, 16866-16870). To study the role of the
      IGF I receptor in vascular smooth muscle cell growth, phosphorothioate
      oligonucleotides were used to modulate IGF I receptors. An antisense
      oligonucleotide targeting the ATG site inhibited basal and serum-induced DNA
      synthesis in vascular smooth muscle cells. Mismatch oligonucleotide had no
      effect, while surprisingly sense oligonucleotide increased IGF I receptor number
      and basal and serum-induced DNA synthesis. A 51% reduction in IGF I receptor
      number following exposure to 5 microM antisense oligonucleotide markedly
      inhibited angiotensin II-induced mitogenesis. A 70% increase in IGF I receptor
      number following exposure to 5 microM sense oligonucleotide resulted in a 4-fold
      increase in basal [3H]thymidine incorporation, and angiotensin II (1-1000 nM) had
      no additive stimulatory effect. An antisense oligonucleotide targeting a sequence
      starting at +109 base pairs (relative to ATG) also reduced IGF I receptor number,
      however, the corresponding sense oligonucleotide was without effect. These
      findings demonstrate that alterations in vascular smooth muscle cell IGF I
      receptor density play a critical role in the proliferative response of vascular
      smooth muscle cells to serum and to angiotensin II. In addition, the surprising
      observation that an ATG-directed sense oligonucleotide up-regulates IGF I
      receptors identifies a novel effect of oligonucleotides on gene expression.

PMID- 7782299
TI  - Phage T4 DNA [N6-adenine]methyltransferase. Overexpression, purification, and
      characterization.
AB  - The bacteriophage T4 dam gene, encoding the Dam DNA [N6-adenine]methyltransferase
      (MTase), has been subcloned into the plasmid expression vector, pJW2. In this
      construct, designated pINT4dam, transcription is from the regulatable phage
      lambda pR and pL promoters, arranged in tandem. A two-step purification scheme
      using DEAE-cellulose and phosphocellulose columns in series, followed by
      hydroxyapatite chromatography, was developed to purify the enzyme to near
      homogeneity. The yield of purified protein was 2 mg/g of cell paste. The MTase
      has an s20,w of 3.0 S and a Stokes radius of 23 A and exists in solution as a
      monomer. The Km for the methyl donor, S-adenosylmethionine, is 0.1 x 10(-6) M,
      and the Km for substrate nonglucosylated, unmethylated T4 gt- dam DNA is 1.1 x
      10(-12) M. The products of DNA methylation, S-adenosyl-L-homocysteine and
      methylated DNA, are competitive inhibitors of the reaction; Ki values of 2.4 x
      10(-6) M and 4.6 x 10(-12) M, respectively, were observed. T4 Dam methylates the
      palindromic tetranucleotide, GATC, designated the canonical sequence. However, at
      high MTase:DNA ratios, T4 Dam can methylate some noncanonical sequences belonging
      to GAY (where Y represents cytosine or thymine).

PMID- 7782301
TI  - Endothelial caveolae have the molecular transport machinery for vesicle budding,
      docking, and fusion including VAMP, NSF, SNAP, annexins, and GTPases.
AB  - Transport by discrete vesicular carriers is well established at least in part
      because of recent discoveries identifying key protein mediators of vesicle
      formation, docking, and fusion. A general mechanism sensitive to N-ethylmaleimide
      (NEM) is required for the transport of a divergent group of vesicular carriers in
      all eukaryotes. Many endothelia have an abundant population of non-coated
      plasmalemmal vesicles or caveolae, which have been reported with considerable
      controversy to function in transport. We recently have shown that like other
      vesicular transport systems, caveolae-mediated endocytosis and transcytosis are
      inhibited by NEM (Schnitzer, J. E., Allard, J., and Oh, P. (1995) Am. J. Physiol.
      268, H48-H55). Here, we continue this work by utilizing our recently developed
      method for purifying endothelial caveolae from rat lung tissue (Schnitzer, J. E.,
      Oh, P., Jacobson, B. S., and Dvorak, A. M. (1995) Proc. Natl. Acad. Sci. U. S. A.
      92, 1759-1763) to show that these caveolae contain key proteins known to mediate
      different aspects of vesicle formation, docking, and/or fusion including the
      vSNARE VAMP-2, monomeric and trimeric GTPases, annexins II and VI, and the NEM
      sensitive fusion factor NSF along with its attachment protein SNAP. Like neuronal
      VAMPs, this endothelial VAMP is sensitive to cleavage by botulinum B and tetanus
      neurotoxins. Caveolae in endothelium are indeed like other carrier vesicles and
      contain similar NEM-sensitive molecular machinery for transport.

PMID- 7782302
TI  - The C terminus of the nuclear RAN/TC4 GTPase stabilizes the GDP-bound state and
      mediates interactions with RCC1, RAN-GAP, and HTF9A/RANBP1.
AB  - Ran/TC4 is a member of the Ras superfamily of GTPases. It is unusual in being
      predominantly nuclear and because it possesses an acidic -DEDDDL sequence instead
      of a consensus prenylation domain at the C terminus. Ran is required for nuclear
      protein import and cell cycle progression, and has been implicated in mRNA
      processing and export and DNA replication. The inhibition of cell cycle
      progression by a dominant gain-of-function mutant of Ran has been shown to be
      abrogated by removal of the -DEDDDL sequence, suggesting that this domain is
      essential for Ran function. We demonstrate here that the -DEDDDL sequence
      stabilizes GDP binding to Ran, and that the domain is required for high affinity
      interaction with a Ran-binding protein, HTF9A/RanBP1. HTF9A functions as a co
      stimulator of Ran-GAP (GTPase activating protein) activity on wild-type Ran, but
      in the absence of the acidic C terminus of Ran, HTF9A behaves as a Ran-GAP
      inhibitor. An antibody directed against the C-terminal region preferentially
      recognizes the GTP-bound form of Ran, suggesting that this domain undergoes a
      nucleotide-dependent conformational change. The results suggest that the acidic C
      terminal domain is important in modulating the interaction of Ran with regulatory
      factors, and implicate Ran-binding proteins in mediating the effects of Ran on
      cell cycle progression.

PMID- 7782300
TI  - Critical contributions of amino-terminal extracellular domains in agonist binding
      and activation of secretin and vasoactive intestinal polypeptide receptors.
      Studies of chimeric receptors.
AB  - Secretin and vasoactive intestinal polypeptide (VIP) receptors are closely
      related G protein-coupled receptors in a recently described family possessing a
      large amino-terminal ectodomain. We postulated that this domain might be critical
      for agonist recognition and therefore constructed a series of six chimeric
      receptors, exchanging the amino terminus, the first extracellular loop, or both
      in secretin and VIP receptors. Constructs were expressed in COS cells and
      characterized by cAMP generation and binding of both secretin and VIP radio
      ligands. Wild type receptors demonstrated high affinity binding of respective
      ligands (IC50 values (in nM): at the secretin receptor: 2.2 for secretin, > 1000
      for VIP; at the VIP receptor: 2.2 for VIP, > 1000 for secretin) and appropriately
      sensitive and selective biological responses (EC50 values (in nM): at the
      secretin receptor: 1.5 for secretin, 127 for VIP; at the VIP receptor: 1.0 for
      VIP, 273 for secretin). Replacement of the secretin receptor amino terminus with
      that of the VIP receptor resulted in biological responsiveness typical of the VIP
      receptor (EC50 = 120 nM for secretin, 1.7 nM for VIP). The converse was not true,
      with this domain of the secretin receptor not able to provide the same response
      when incorporated into the VIP receptor (EC50 = 50 nM for VIP, 30 nM for
      secretin). The addition of both the first loop and the amino terminus of the
      secretin receptor was effective in yielding a secretin receptor-like response
      (EC50 = 2.0 nM for secretin, 47 nM for VIP). All chimeric constructs expressing
      selectivity for secretin-stimulated activity bound this hormone with high
      affinity (IC50 = 0.2-2.2 nM); however, there was divergence between VIP binding
      and biological activity. Thus, the amino terminus of secretin and VIP receptors
      plays a key role in agonist recognition and responsiveness, with the first loop
      playing a critical complementary role for the secretin receptor.

PMID- 7782303
TI  - Structural organization of procaryotic and eucaryotic Hsp90. Influence of
      divalent cations on structure and function.
AB  - Hsp90 is a very abundant molecular chaperone that apparently helps to protect
      cellular proteins from denaturation upon temperature upshift. The unusual ability
      of Hsp90 to function under conditions where other proteins unfold prompted us to
      investigate the stability and structural organization of Hsp90 itself. Both
      procaryotic and eucaryotic members of the Hsp90 family were found to have very
      similar physicochemical properties: (i) they are stable against thermal unfolding
      up to at least 50 degrees C, (ii) they show biphasic, reversible unfolding
      transitions in guanidinium chloride, and (iii) their oligomerization state is
      strongly and rapidly affected by millimolar concentrations of divalent cations.
      In the presence of MnCl2 and MgCl2 defined changes in the quaternary structure of
      Hsp90 could be observed which resulted in a decrease in thermostability and an
      increased tendency to form larger aggregates. The addition of divalent cations
      also almost completely abolished the chaperone function of Hsp90 and induced
      release of folding intermediates of citrate synthase bound to Hsp90. These
      modulating effects of divalent cations on structure and function of Hsp90 in
      vitro represent a potential mechanism for regulation of Hsp90 chaperone action in
      vivo.

PMID- 7782304
TI  - Molecular cloning of the isoquinoline 1-oxidoreductase genes from Pseudomonas
      diminuta 7, structural analysis of iorA and iorB, and sequence comparisons with
      other molybdenum-containing hydroxylases.
AB  - The iorA and iorB genes from the isoquinoline-degrading bacterium Pseudomonas
      diminuta 7, encoding the heterodimeric molybdo-iron-sulfur-protein isoquinoline 1
      oxidoreductase, were cloned and sequenced. The deduced amino acid sequences IorA
      and IorB showed homologies (i) to the small (gamma) and large (alpha) subunits of
      complex molybdenum-containing hydroxylases (alpha beta gamma/alpha 2 beta 2 gamma
      2) possessing a pterin molybdenum cofactor with a monooxo-monosulfido-type
      molybdenum center, (ii) to the N- and C-terminal regions of aldehyde
      oxidoreductase from Desulfovibrio gigas, and (iii) to the N- and C-terminal
      domains of eucaryotic xanthine dehydrogenases, respectively. The closest
      similarity to IorB was shown by aldehyde dehydrogenase (Adh) from the acetic acid
      bacterium Acetobacter polyoxogenes. Five conserved domains of IorB were
      identified by multiple sequence alignments. Whereas IorB and Adh showed an
      identical sequential arrangement of these conserved domains, in all other
      molybdenum-containing hydroxylases the relative position of "domain A" differed.
      IorA contained eight conserved cysteine residues. The amino acid pattern
      harboring the four cysteine residues proposed to ligate the Fe/S I cluster was
      homologous to the consensus binding site of bacterial and chloroplast-type [2Fe
      2S] ferredoxins, whereas the pattern including the four cysteines assumed to
      ligate the Fe/S II center showed no similarities to any described [2Fe-2S]
      binding motif. The N-terminal region of IorB comprised a putative signal peptide
      similar to typical leader peptides, indicating that isoquinoline 1-oxidoreductase
      is associated with the cell membrane.

PMID- 7782305
TI  - A role for 3AB protein in poliovirus genome replication.
AB  - The poliovirus polypeptide 3AB, the precursor of the genome-bound VPg protein,
      stimulates in vitro the synthesis of poly(U) directed by the viral polymerase
      3Dpol (Lama, J., Paul, A., Harris, K., and Wimmer, E. (1994) J. Biol. Chem. 269,
      66-70), suggesting that 3AB could be modulating the activity of the viral
      polymerase in poliovirus-infected cells. To address the exact function of 3AB in
      the viral replication cycle, a biochemical and molecular genetic analysis of 3AB
      has been carried out. 3AB protein bound RNA probes in two different assays, and
      amino acid positions implicated in the RNA binding activity of 3AB were
      determined. Mutant proteins with reduced RNA binding activity were unable to
      stimulate 3Dpol polymerase activity. Purified protein 3A showed no RNA binding or
      3Dpol stimulatory activity, but 3A and VPg mutations conferred a synergistic
      effect on the 3AB functions. Polioviruses encoding for these mutant 3ABs were
      constructed. These mutant viruses translated their RNA genomes in vitro and
      processed their polyproteins as wild type virus did. Cells infected with 3AB
      mutant viruses showed over 90% inhibition in the accumulation of plus and minus
      viral RNA strands and more than 100-fold reduction of virus yield at 4 h
      postinfection. Our results suggest that 3AB protein functions in vivo as a co
      factor of the viral polymerase and that the activity of 3AB may be regulated by
      proteolytic processing.

PMID- 7782306
TI  - Comparison of the enzymatic properties of the two Escherichia coli lysyl-tRNA
      synthetase species.
AB  - In Escherichia coli, lysyl-tRNA synthetase activity is encoded by either a
      constitutive lysS gene or an inducible one, lysU. The two corresponding enzymes
      could be purified at homogeneity from a delta lysU and a delta lysS strain,
      respectively. Comparison of the pure enzymes, LysS and LysU, indicates that, in
      the presence of saturating substrates, LysS is about twice more active than LysU
      in the ATP-PPi exchange as well as in the tRNALys aminoacylation reaction.
      Moreover, the dissociation constant of the LysU-lysine complex is 8-fold smaller
      than that of the LysS-lysine complex. In agreement with this difference, the
      activity of LysU is less sensitive than that of LysS to the addition of
      cadaverine, a decarboxylation product of lysine and a competitive inhibitor of
      lysine binding to its synthetase. This observation points to a possible useful
      role of LysU, under physiological conditions causing cadaverine accumulation in
      the bacterium. Remarkably, these conditions also induce lysU expression.
      Homogeneous LysU and LysS were also compared in Ap4A synthesis. LysU is only 2
      fold more active than LysS in the production of this dinucleotide. This makes
      unlikely that the heat-inducible LysU species could be preferentially involved in
      the accumulation of Ap4A inside stressed Escherichia coli cells. This conclusion
      could be strengthened by determining the concentrations of Ap4N (N = A, C, G, or
      U) in a delta lysU as well as in a lysU+ strain, before and after a 1-h
      temperature shift at 48 degrees C. The measured concentration values were the
      same in both strains.

PMID- 7782307
TI  - Gluconeogenesis and intrahepatic triose phosphate flux in response to fasting or
      substrate loads. Application of the mass isotopomer distribution analysis
      technique with testing of assumptions and potential problems.
AB  - We measured gluconeogenesis (GNG) in rats by mass isotopomer distribution
      analysis, which allows enrichment of the true biosynthetic precursor pool
      (hepatic cytosolic triose phosphates) to be determined. Fractional GNG from
      infused [3-13C]lactate, [1-13C]lactate, and [2-13C]glycerol was 88 +/- 2, 89 +/-
      3, and 87 +/- 2%, respectively, after 48 h of fasting. [2-13C]Glycerol was the
      most efficient label and allowed measurement of rate of appearance of
      intrahepatic triose phosphate (Ra triose-P), by dilution. IV fructose (10-15
      mg/kg/min) increased absolute GNG by 81-147%. Ra triose-P increased
      proportionately, but endogenous Ra triose-P was almost completely suppressed,
      suggesting feedback control. Interestingly, 15-17% of fructose was directly
      converted to glucose without entering hepatic triose-P. IV glucose reduced GNG
      and Ra triose-P. 24-h fasting reduced hepatic glucose production by half, but
      absolute GNG was unchanged due to increased fractional GNG (51-87%). Reduced
      hepatic glucose production was entirely due to decreased glycogen input, from 7.3
      +/- 1.8 to 1.1 +/- 0.2 mg/kg/min. Ra triose-P fell during fasting, but efficiency
      of triose-P disposal into GNG increased, maintaining GNG constant. Secreted
      glucuronyl conjugates and plasma glucose results correlated closely. In summary,
      GNG and intrahepatic triose-P flux can be measured by mass isotopomer
      distribution analysis with [2-13C]glycerol.

PMID- 7782308
TI  - Phosphatidylinositol 4-phosphate increases the rate of dephosphorylation of the
      phosphorylated Ca(2+)-ATPase.
AB  - Incubation of the Ca(2+)-ATPase of skeletal muscle sarcoplasmic reticulum with
      ATP in the absence of Ca2+ leads to phosphorylation of phosphatidylinositol
      (PtdIns) to phosphatidylinositol 4-phosphate (PtdIns-4P) and to a doubling of
      ATPase activity. Similarly, reconstitution of the ATPase with mixtures of
      dioleoylphosphatidylcholine and PtdIns-4P also led to a doubling of activity;
      ATPase activity increased with increasing PtdIns-4P content, up to 10% beyond
      which no further increase was observed. Reconstitution with PtdIns had a much
      smaller effect on activity. Changes in the Ca2+ affinity of the ATPase following
      incubation with ATP or reconstitution with PtdIns-4P were small. The rates of
      phosphorylation of the ATPase by ATP and of the Ca2+ transport step were
      unaffected, but the rate of dephosphorylation of the phosphorylated ATPase
      increased by a factor of 2 either following incubation with ATP or following
      reconstitution with PtdIns-4P. Activation of the ATPase led to a decrease in the
      level of phosphorylation of the ATPase by Pi corresponding to a 10-fold decrease
      in the equilibrium constant E2PMg/E2PiMg.

PMID- 7782309
TI  - Purification and characterization of TAFI, a thrombin-activable fibrinolysis
      inhibitor.
AB  - Previous studies demonstrated that tissue plasminogen activator-induced
      fibrinolysis in vitro is retarded in the presence of prothrombin (II) activation
      and that the anticoagulant-activated protein C appears profibrinolytic by
      preventing the formation of thrombin (IIa)-like activity during fibrinolysis. To
      disclose the molecular connection between the generation of IIa and the
      inhibition of fibrinolysis, a lysis assay that is sensitive to the
      antifibrinolytic effect of II activation was developed and was used to purify a
      60-kDa single-chain protein from human plasma. Because the lysis of a clot,
      produced from purified components, is retarded when this protein is present and
      when II activation occurs in situ, the protein was named TAFI (thrombin
      activatable fibrinolysis inhibitor). TAFI is cleaved by IIa yielding 35-, 25-,
      and 14-kDa products. Amino-terminal sequence analyses identified TAFI as a
      precursor of a plasma carboxypeptidase B (CPB). Formation of the 35-kDa product
      correlates with both prolongation of lysis time and CPB-like activity.
      Prolongation of lysis time saturates at about 125 nM TAFI. Activated TAFI
      inhibits the activation of Glu-plasminogen but does not prolong the lysis of
      clots formed in the presence of Lys-plasminogen. 2-Guanidinoethylmercaptosuccinic
      acid, a competitive inhibitor of CPB, completely inhibits prolongation of lysis
      by activated TAFI in a purified system and the prolongation induced by II
      activation in barium-adsorbed plasma. This suggests that TAFI accounts for the
      antifibrinolytic effect that accompanies prothrombin activation and that
      activated protein C appears profibrinolytic by attenuating TAFI activation.

PMID- 7782311
TI  - A novel type of limulus lectin-L6. Purification, primary structure, and
      antibacterial activity.
AB  - Lipopolysaccharide (LPS)-binding protein(s) was first screened in the detergent
      extract of horseshoe crab (limulus) hemocytes using LPS-immobilized agarose. A
      protein, designated L6 (M(r) = 27,000), was found to bind to LPS-agarose and was
      eluted with EDTA or o-phenanthroline. The L6 protein, however, did not inhibit
      the LPS-mediated activation of a limulus serine protease zymogen factor C. L6 had
      an affinity to the matrix of Sepharose CL-6B itself, and it could be eluted with
      high concentrations of monosaccharides (0.5-1.0 M), such as glucose, mannose, and
      galactose, suggesting a lectin-like nature. The entire amino acid sequence of L6
      was determined by sequencing peptides derived from CNBr and enzymatic cleavages.
      L6 contained 7 half-cystines, and 1 cysteine residue at position 201 had a free
      SH-group. In addition, positions of the remaining three intrachain disulfide
      bonds were assigned by amino acid and sequence analyses of three cystinyl
      peptides produced by lysyl endopeptidase digestion. These results indicated that
      the entire sequence of L6 consisted of 221 residues with no N-linked sugar and
      was composed of six tandem repeats, each consisting of 33-38 amino acid residues.
      Inductively coupled plasma spectrometry of L6 indicated the presence of 0.75 mol
      zinc/mol of protein. No significant sequence homology was observed between L6 and
      other proteins, including various animal lectins and LPS-binding proteins.
      However, L6 showed agglutinating activity on LPS-coated sheep erythrocytes and
      Gram-negative and Gram-positive bacteria, it inhibited the growth of Gram
      negative bacteria, and thus it presumably recognizes carbohydrate components in
      the cell wall of bacteria.

PMID- 7782310
TI  - Pleckstrin inhibits phosphoinositide hydrolysis initiated by G-protein-coupled
      and growth factor receptors. A role for pleckstrin's PH domains.
AB  - Pleckstrin is a 40-kDa protein present in platelets and leukocytes that contains
      two PH domains separated by a 150-residue intervening sequence. Pleckstrin is a
      major substrate for protein kinase C, but its function is unknown. The present
      studies examine the effects of pleckstrin on second messenger generation. When
      expressed in cos-1 or HEK-293 cells, pleckstrin inhibited 1) the G alpha-mediated
      activation of phospholipase C beta initiated by thrombin, M1-muscarinic
      acetylcholine, and angiotensin II receptors, 2) the stimulation of phospholipase
      C beta by constitutively active Gq alpha, 3) the G beta gamma-mediated activation
      of phospholipase C beta caused by alpha 2A-adrenergic receptors, and 4) the
      tyrosine phosphorylation-mediated activation of phospholipase C gamma caused by
      Trk A. However, pleckstrin had no effect on either the stimulation or inhibition
      of adenylyl cyclase. The inhibition of phosphoinositide hydrolysis caused by
      pleckstrin was similar in magnitude to that caused by activating protein kinase C
      with phorbol 12-myristate 13-acetate (PMA). When combined, pleckstrin and PMA had
      an additive effect, inhibiting phosphoinositide hydrolysis by as much as 90%.
      Structure-function analysis highlighted the role of pleckstrin's N-terminal PH
      domain in these events. Although deleting the C-terminal PH domain had no effect,
      deleting the N-terminal PH domain abolished activity (but not expression) and
      mutating a highly conserved tryptophan residue within the N-terminal PH domain
      decreased activity by one-third. Notably, however, a pleckstrin variant in which
      the N-terminal PH domain was replaced with a second copy of the C-terminal PH
      domain was nearly as active as native pleckstrin. These results show that: 1)
      pleckstrin can inhibit pathways leading to both phospholipase C beta- and
      phospholipase C gamma-mediated phosphoinositide hydrolysis, 2) this inhibition
      affects activation of phospholipase C beta mediated by either G alpha or G beta
      gamma, but does not affect the regulation of adenylyl cyclase activity by G alpha
      or G beta gamma, 3) although pleckstrin is a substrate for protein kinase C, the
      effects of pleckstrin and PMA are at least partially independent, 4) the
      inhibition caused by pleckstrin appears to be mediated by the PH domain at the N
      terminus, rather than the C terminus of the molecule, and 5) location of the two
      PH domains within the molecule clearly contributes to their individual
      activity.2+1

PMID- 7782313
TI  - Sequence and structural determinants of the interaction between the 5'-noncoding
      region of picornavirus RNA and rhinovirus protease 3C.
AB  - It has previously been established that human rhinovirus 14 protease 3C binds
      specifically to the 5'-noncoding region of the viral RNA. A series of mutants of
      protease 3C and deletion or point mutants of the 5'-noncoding region of the viral
      RNA were analyzed to elucidate the sites of interaction between the protease and
      the RNA. Amino acids in protease 3C essential for RNA binding were found to be
      discontinuous in the amino acid sequence, and mutations which destroyed RNA
      binding did not affect the catalytic (proteolytic) activity of protease 3C. Based
      on the three-dimensional structure of rhinovirus 14 protease 3C, the RNA binding
      region is located in an extended area distinct from the catalytic triad. A single
      stem-loop structure of 27 nucleotides (stem-loop d) in the 5'-noncoding region
      was necessary and sufficient to bind protease 3C. Mutagenesis of either the base
      paired stem or unpaired loop or bulge regions of stem-loop d suggested that the
      base-paired stem, but not the loop or bulge, carries important determinants of
      protease 3C binding. This conclusion is strengthened by the observation that
      rhinovirus 14 protease 3C bound specifically to the 5'-noncoding region of
      poliovirus RNA, and only the base-paired stem of stem-loop d is conserved between
      poliovirus and rhinovirus RNAs.

PMID- 7782312
TI  - Erythropoietin-dependent inhibition of apoptosis is supported by carboxyl
      truncated receptor forms and blocked by dominant-negative forms of Jak2.
AB  - Apoptosis, or programmed cell death (PCD), recently has emerged as an important
      homeostatic mechanism within several hematopoietic lineages. This process is
      subject to both positive and negative modulation by cytokines and within the
      erythroid lineage is inhibited by interleukin-3, stem cell factor, and
      erythropoietin (Epo). Through the expression of carboxyl-truncated Epo receptor
      mutants in FDC-P1 cells, a receptor form possessing 80 membrane-proximal
      cytoplasmic residues is shown to efficiently mediate Epo-dependent inhibition of
      PCD. This is in contrast to previous studies that attributed this activity to a
      distal carboxyl-terminal receptor subdomain (and/or heterodimerization of wild
      type Epo receptors with a truncated non-functional receptor form). Epo-dependent
      inhibition of PCD also is shown to be blocked by ectopic expression of kinase
      deficient dominant-negative forms of Jak2 (Jak2 delta VIII and Jak2-829), further
      underlining a role of this membrane-proximal subdomain of the Epo receptor in the
      inhibition of PCD. To our knowledge, this comprises the first direct evidence for
      an essential role for a Jak tyrosine kinase (Jak2) in this apoptotic response
      pathway.

PMID- 7782315
TI  - Sensory and motor neuron-derived factor. A novel heregulin variant highly
      expressed in sensory and motor neurons.
AB  - The heregulin family of polypeptides arise as splice variants from a single gene
      and share a conserved epidermal growth factor (EGF)-like domain thought to be the
      major determinant of their biological activities. We report here the cloning of a
      novel member of this family, termed sensory and motor neuron-derived factor or
      SMDF, which is highly expressed in sensory and motor neurons in human and rodent
      species. It contains a C-terminal beta-type EGF-like domain and an unique N
      terminal sequence which lacks an Ig-like domain and is distinct from all known
      heregulin variants. Mammalian cell-expressed SMDF activates tyrosine
      phosphorylation of a 185-kDa protein in cell lines expressing p185erbB2,
      indicating that it is biologically active. Analyses of expression patterns
      suggest that, unlike other heregulin variants, SMDF is expressed mainly in the
      nervous system. In situ hybridization signals with the unique SMDF sequence probe
      and with a probe to the conserved EGF-like domain are comparable, suggesting that
      SMDF is the predominant isoform expressed in sensory and motor neurons.
      Expression of SMDF is maintained in both adult motor neurons and dorsal root
      ganglion neurons. These findings suggest that SMDF may mediate biological
      responses such as Schwann cell proliferation and acetylcholine receptor induction
      in the peripheral nervous system.

PMID- 7782314
TI  - Gamma chain-associated cytokine receptors signal through distinct transducing
      factors.
AB  - The IL-2, IL-4, and IL-7 signaling pathways have been shown to utilize shared
      components. The receptors for these cytokines are composed of ligand-specific
      binding chains that associate with a shared signaling subunit, the common gamma
      (gamma c) chain. In addition, IL-2, IL-4, and IL-7 induce activation of a common
      set of nonreceptor tyrosine kinases, Jak-1 and Jak-3. We have further
      investigated the signaling events induced by these cytokines and find that the
      gamma c-associated receptors activate distinct signal transducing factors (STFs).
      In addition, we show that a 94-kDa STAT-related protein (p94) is activated in
      response to IL-2 and IL-7, but not IL-4. These data indicate that IL-2, IL-4, and
      IL-7 activate distinct signaling molecules which might be differentially
      recruited to the receptor complex by the ligand-specific units of the IL-2, IL-4,
      and IL-7 receptors.

PMID- 7782316
TI  - Neuronal cell expression of inserted isoforms of vertebrate nonmuscle myosin
      heavy chain II-B.
AB  - Previous work has demonstrated that unique isoforms of nonmuscle myosin heavy
      chain II-B (MHC-B) are expressed in chicken and human neuronal cells (Takahashi,
      M., Kawamoto, S., and Adelstein, R. S. (1992) J. Biol. Chem. 267, 17864-17871).
      These isoforms, which appear to be generated by alternative splicing of pre-mRNA,
      differ from the MHC-B isoform present in a large number of nonmuscle cells in
      that they contain inserted cassettes of amino acids near the ATP binding region
      and/or near the actin binding region. The insert near the ATP binding region
      begins after amino acid 211 and consists of either 10 or 16 amino acids. The
      insert near the actin binding region begins after amino acid 621 and consists of
      21 amino acids. Using a variety of techniques, we have studied the distribution
      and expression of the inserted MHC-B isoforms. In the developing chicken brain,
      mRNA encoding the 10-amino acid insert gradually increases after embryonic day 4,
      peaks in the 10-14-day embryo, and then declines. In contrast, the mRNA encoding
      the 21-amino acid insert appears just before birth and is abundantly expressed in
      the adult chicken cerebellum. There is a marked species difference between the
      distribution of the inserted isoforms in adult tissues. The mRNA encoding MHC-B
      containing the 10-amino acid insert near the ATP binding region is expressed at
      low levels in the adult chicken brain, but makes up most of the MHC-B mRNA
      expressed in the human cerebrum and approximately 90% of MHC-B in the human
      retina. It is also expressed in neuronal cell lines. The mRNA encoding MHC-B
      containing the 21-amino acid insert is abundantly expressed in the chicken
      cerebellum and human cerebrum, but is absent from the retina and cell lines.
      Employing human retinoblastoma (Y-79) and neuroblastoma (SK-N-SH) cell lines, an
      increase in expression of mRNA encoding the 10-amino acid inserted isoform was
      seen following treatment by a number of agonists or by serum deprivation. In each
      case, expression of the inserted MHC-B isoform correlated with cell
      differentiation (neuronal phenotype) and inhibition of cell division. Using a rat
      pheochromocytoma cell line (PC12), we found that prior to treatment with nerve
      growth factor (NGF), there was no evidence for either inserted isoform, although
      noninserted MHC-B was present. NGF treatment resulted in the appearance of mRNA
      encoding MHC-B containing the 10-amino acid insert, concomitant with neurite
      outgrowth.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782318
TI  - Identification of lysines within alpha 1-antichymotrypsin important for DNA
      binding. An unusual combination of DNA-binding elements.
AB  - The human serum serine protease inhibitor (serpin) alpha 1-antichymotrypsin (ACT)
      appears to be unique among serpins in its ability to bind to double-stranded DNA.
      Using site-directed mutagenesis and chemical modification, a tri-lysine sequence
      (residues 210-212) falling within a solvent exposed loop and the C-terminal
      peptide containing two lysines (residues 391 and 396) were shown to be important
      for DNA binding. Mutation of residues 210-212 from lysines to either glutamates
      or threonines abolished DNA binding. The Lys210-Thr211-212 and Thr210-Th4(211)
      Lys212 variants displayed reduced affinity for DNA, especially at higher ionic
      strength. Limited acetylation of rACT with acetic anhydride led to loss of DNA
      binding and, conversely, DNA protected rACT from acetylation. A combination of
      CNBr digestion, peptide separation, and peptide sequencing identified Lys396, two
      residues from the C terminus, as the most reactive lysine in rACT. Acetylation of
      Lys396 is strongly decreased in the presence of DNA. The double mutant
      K391T/K396T-rACT had very little affinity for DNA. The epsilon-amines of lysines
      210-212 are 8-15 A across a cleft from the epsilon-amines in Lys391 and Lys396,
      and together these two elements may form an unusual DNA binding domain. Attempts
      to isolate a DNA sequence to which ACT binds specifically have been unsuccessful
      to date, raising the possibility that nonspecific binding of ACT to DNA suffices
      to account for the ACT found in certain cell nuclei. ACT variants not binding to
      double-stranded DNA retain ACT protease inhibitory activity, a potentially
      important result for the use of ACT variants as therapeutic agents.

PMID- 7782317
TI  - Phosphorylation of elongation factor Tu prevents ternary complex formation.
AB  - The elongation factor Tu (EF-Tu) is a member of the GTP/GDP-binding proteins and
      interacts with various partners during the elongation cycle of protein
      biosynthesis thereby mediating the correct binding of amino-acylated transfer RNA
      (aa-tRNA) to the acceptor site (A-site) of the ribosome. After GTP hydrolysis EF
      Tu is released in its GDP-bound state. In vivo, EF-Tu is post-translationally
      modified by phosphorylation. Here we report that the phosphorylation of EF-Tu by
      a ribosome associated kinase activity is drastically enhanced by EF-Ts. The
      antibiotic kirromycin, known to block EF-Tu function, inhibits the modification.
      This effect is specific, since kirromycin-resistant mutants do become
      phosphorylated in the presence of the antibiotic. On the other hand,
      phosphorylated wild-type EF-Tu does not bind kirromycin. Most interestingly, the
      phosphorylation of EF-Tu abolishes its ability to bind aa-tRNA. In the GTP
      conformation the site of modification is located at the interface between domains
      1 and 3 and is involved in a strong interdomain hydrogen bond. Introduction of a
      charged phosphate group at this position will change the interaction between the
      domains, leading to an opening of the molecule reminiscent of the GDP
      conformation. A model for the function of EF-Tu phosphorylation in protein
      biosynthesis is presented.

PMID- 7782319
TI  - Subsite affinities and disposition of catalytic amino acids in the substrate
      binding region of barley 1,3-beta-glucanases. Implications in plant-pathogen
      interactions.
AB  - Oligo-1,3-beta-glucosides with degrees of polymerization of 2-9 were labeled at
      their reducing terminal residues by catalytic tritiation. These substrates were
      used in detailed kinetic and thermodynamic analyses to examine substrate binding
      in 1,3-beta-D-glucan glucanohydrolase (EC 3.2.1.39) isoenzymes GI, GII, and GIII
      from young seedlings of barley (Hordeum vulgare). Bond-cleavage frequencies,
      together with the kinetic parameter kcat/Km, have been calculated as a function
      of substrate chain length to define the number of subsites that accommodate
      individual beta-glucosyl residues and to estimate binding energies at each
      subsite. Each isoenzyme has eight beta-glucosyl-binding subsites. The catalytic
      amino acids are located between the third and fourth subsite from the nonreducing
      terminus of the substrate. Negative binding energies in subsites adjacent to the
      hydrolyzed glycosidic linkage suggest that some substrate distortion may occur in
      this region during binding and that the resultant strain induced in the substrate
      might facilitate hydrolytic cleavage. If the 1,3-beta-glucanases exert their
      function as pathogenesis-related proteins by hydrolyzing the branched or
      substituted 1,3;1,6-beta-glucans of fungal walls, it is clear that relatively
      extended regions of the cell wall polysaccharide must fit into the substrate
      binding cleft of the enzyme.

PMID- 7782320
TI  - Human macrophage metalloelastase. Genomic organization, chromosomal location,
      gene linkage, and tissue-specific expression.
AB  - Human macrophage metalloelastase (HME) is a recent addition to the matrix
      metalloproteinase (MMP) family that was initially found to be expressed in
      alveolar macrophages of cigarette smokers. To understand more about HME
      expression, analysis of the structure and location of the gene was performed. The
      gene for HME is composed of 10 exons and 9 introns, similar to the stromelysins
      and collagenases, and HME shares the highly conserved exon size and intron-exon
      borders with other MMPs. The 13-kilobase (kb) HME gene has been localized by
      fluorescence in situ hybridization to chromosome 11q22.2-22.3, the same location
      of the interstitial collagenase and stromelysin genes. We determined that HME and
      stromelysin 1 genes are physically linked within 62 kb utilizing pulse-field gel
      electrophoresis. The promoter region of the HME gene contains several features
      common to other MMP genes including a TATA box 29 bp upstream to the
      transcription initiation site, an AP-1 motif, and a PEA3 element. HME mRNA is not
      detectable in normal adult tissues but is induced in rapidly remodeling tissues
      such as the term placenta. In situ hybridization and immunohistochemistry of
      placental tissue demonstrated HME mRNA and protein expression in macrophages and
      stromal cells. Cell-specific expression and response to inflammatory stimuli such
      as endotoxin is conferred within 2.8 kb of the HME 5'-flanking sequence as
      demonstrated by HME promoter-CAT expression constructs. Knowledge of the genomic
      organization and chromosomal location of HME may allow us to further define
      mechanisms responsible for cell- and tissue-specific expression of HME.

PMID- 7782321
TI  - Purification of mu-calpain by a novel affinity chromatography approach. New
      insights into the mechanism of the interaction of the protease with targets.
AB  - A calmodulin-binding motif is a common structural feature of a number of calpain
      substrates (1). Since a calmodulin-like domain has been identified in both
      subunits of the calpain molecule, the proposal was made that the domain(s) would
      recognize the calmodulin-binding motifs of the substrates prior to the enzymatic
      modification by calpain. In keeping with the proposal, a successful attempt to
      purify mu-calpain from human erythrocytes was made by using an affinity
      chromatography approach in which the synthetic peptide C49, containing the
      calmodulin-binding domain of the plasma membrane Ca(2+)-ATPase, was coupled to a
      Sepharose matrix. The calmodulin-like domain of the catalytic subunit of human mu
      calpain expressed in Escherichia coli was also retained by the C49-Sepharose
      column. Both mu-calpain and the calmodulin-like domain interacted with C49 in a
      Ca(2+)-dependent way and were eluted from the column by Ca(2+)-chelating agents.
      The finding confirmed the interaction between the calmodulin-binding domain of
      the plasma membrane Ca(2+)-ATPase and the calmodulin-like domain of mu-calpain.
      Experiments were performed to establish whether irreversibly inactivated mu
      calpain or its expressed C-terminal portion containing the calmodulin-like domain
      could activate the hydrolysis of ATP by the plasma membrane Ca2+ pump, in keeping
      with evident ATPase stimulation of the same pump by calmodulin. A stimulation was
      observed, but it was much weaker than that induced by calmodulin.

PMID- 7782323
TI  - Phosphorylation of eukaryotic protein synthesis initiation factor 4E at Ser-209.
AB  - Initiation factor 4E (eIF-4E) binds to the m7GTP-containing cap of eukaryotic
      mRNA and facilitates the entry of mRNA into the initiation cycle of protein
      synthesis. eIF-4E is a phosphoprotein, and the phosphorylated form binds to mRNA
      caps 3-4-fold more tightly than the nonphosphorylated form. A previous study
      indicated that the major phosphorylation site was Ser-53 (Rychlik, W., Russ, M.
      A., and Rhoads, R. E. (1987) J. Biol. Chem. 262, 10434-10437). In the present
      study, we synthesized the phosphopeptide expected to result from tryptic
      digestion of eIF-4E, O-phosphoseryllysine. Surprisingly, the tryptic and
      synthetic phosphopeptides did not comigrate electrophoretically. Accordingly, we
      redetermined the phosphorylation site by isolating a chymotryptic phosphopeptide
      on reverse phase high performance liquid chromatography. The peptide was
      sequenced by Edman degradation and corresponded to 198QSHADTATKSGSTTKNRF215. The
      site of phosphorylation was determined to be Ser-209 by four methods: the
      increase in the ratio of dehydroalanine to serine derivatives during Edman
      degradation, the release of 32P, the further digestion of the chymotryptic
      phosphopeptide with trypsin, Glu-C, and Asp-N, and site-directed mutagenesis of
      eIF-4E cDNA. The S209A variant was not phosphorylated in a rabbit reticulocyte
      lysate system, whereas the wild-type, S53A, and S207A variants were. This site
      falls within the consensus sequence for phosphorylation by protein kinase C.

PMID- 7782324
TI  - Regulation of RCK1 currents with a cAMP analog via enhanced protein synthesis and
      direct channel phosphorylation.
AB  - We have recently shown that the rat brain Kv1.1 (RCK1) voltage-gated K+ channel
      is partially phosphorylated in its basal state in Xenopus oocytes and can be
      further phosphorylated upon treatment for a short time with a cAMP analog
      (Ivanina, T., Perts, T., Thornhill, W. B., Levin, G., Dascal, N., and Lotan, I.
      (1994) Biochemistry 33, 8786-8792). In this study, we show, by two-electrode
      voltage clamp analysis, that whereas treatments for a short time with various
      cAMP analogs do not affect the channel function, prolonged treatment with 8
      bromoadenosine 3',5'-cyclic monophosphorothioate ((Sp)-8-Br-cAMPS), a membrane
      permeant cAMP analog, enhances the current amplitude. It also enhances the
      current amplitude through a mutant channel that cannot be phosphorylated by
      protein kinase A activation. The enhancement is inhibited in the presence of (Rp)
      8-Br-cAMPS, a membrane-permeant protein kinase A inhibitor. Concomitant SDS
      polyacrylamide gel electrophoresis analysis reveals that this treatment not only
      brings about phosphorylation of the wild-type channel, but also increases the
      amounts of both wild-type and mutant channel proteins; the latter effect can be
      inhibited by cycloheximide, a protein synthesis inhibitor. In the presence of
      cycloheximide, the (Sp)-8-Br-cAMPS treatment enhances only the wild-type current
      amplitudes and induces accumulation of wild-type channels in the plasma membrane
      of the oocyte. In summary, prolonged treatment with (Sp)-8-Br-cAMPS regulates
      RCK1 function via two pathways, a pathway leading to enhanced channel synthesis
      and a pathway involving channel phosphorylation that directs channels to the
      plasma membrane.

PMID- 7782322
TI  - A novel mitogen-activated protein kinase phosphatase. Structure, expression, and
      regulation.
AB  - Mitogen-activated protein (MAP) kinase lies at the convergence of various
      extracellular ligand-mediated signaling pathways. It is activated by the dual
      specificity kinase, MAP kinase kinase or MEK. MAP kinase inactivation is mediated
      by dephosphorylation via specific MAP kinase phosphatases (MKPs). One MKP (MKP-1
      (also known as 3CH134, Erp, or CL100)) has been reported to be expressed in a
      wide range of tissues and cells. We report the identification of a second widely
      expressed MKP, termed MKP-2, isolated from PC12 cells. MKP-2 showed significant
      homology with MKP-1 (58.8% at the amino acid level) and, like MKP-1, displayed
      vanadate-sensitive phosphatase activity against MAP kinase in vitro.
      Overexpression of MKP-2 in vivo inhibited MAP kinase-dependent gene transcription
      in PC12 cells. MKP-2 differed from MKP-1 in its tissue distribution and in its
      extent of induction by growth factors and agents that induce cellular stress,
      suggesting that these MKPs may have distinct physiological functions.

PMID- 7782326
TI  - Molecular cloning of Sia alpha 2,3Gal beta 1,4GlcNAc alpha 2,8-sialyltransferase
      from mouse brain.
AB  - A cDNA encoding a new alpha 2,8-sialyltransferase (ST8Sia III), which exhibits
      activity toward the Sia alpha 2,3Gal beta 1, 4GlcNAc sequences of N-linked
      oligosaccharides, was cloned from mouse brain by means of the polymerase chain
      reaction-based approach. The predicted amino acid sequence of ST8Sia III showed
      27.6 and 34.4% identity with those of so far cloned mouse alpha 2,8
      sialyltransferases, i.e. GD3 synthase (ST8Sia I) and STX (ST8Sia II),
      respectively. Transfection of the protein A-fused ST8Sia III gene into COS-7
      cells led to alpha 2,8-sialyltransferase activity toward sialylated glycoproteins
      and alpha 2,3-sialylated glycosphingolipids, such as alpha 2,3
      sialylparagloboside and GM3. However, the kinetic properties of ST8Sia III
      revealed that it is much more specific to N-linked oligosaccharides of
      glycoproteins than glycosphingolipids. The expression pattern of the ST8Sia III
      gene was clearly different from those of other alpha 2,8-sialyltransferase genes.
      The expression of the ST8Sia III gene was tissue and stage specific. The ST8Sia
      III gene was expressed only in brain and testis, and it appeared first in 20
      postcoitum embryonal brain and then decreased. Therefore, the new alpha 2,8
      sialyltransferase is closely involved in brain development.

PMID- 7782325
TI  - Identification of three proteins in the eye of Aplysia, whose synthesis is
      altered by serotonin (5-HT). Possible involvement of these proteins in the ocular
      circadian system.
AB  - Previous results using translation inhibitors in the ocular circadian system of
      Aplysia suggest that protein synthesis may be involved in the light and serotonin
      (5-HT) entrainment pathways or perhaps in the circadian oscillator. Proteins have
      been previously identified whose synthesis was altered by treatments of light
      capable of perturbing the phase of the circadian rhythm in the eye of Aplysia. We
      extended these studies by investigating the effects of other treatments that
      perturb the ocular circadian rhythm on protein synthesis. 5-HT altered the
      synthesis of nine proteins. Interestingly, five of the proteins affected by
      treatments with 5-HT were previously shown to be affected by treatments with
      light. Four of the proteins affected by treatments with 5-HT were also affected
      by treatments with analogs of cAMP, a treatment which mimics the effects of 5-HT
      on the ocular circadian rhythm. To identify the cellular function of some of
      these proteins, we obtained their partial amino acid sequences. Based on these
      sequences and additional characterizations, a 78-kDa, pI 5.6 Aplysia protein
      appears to be glucose-regulated protein 78/binding protein, and a 36-kDa, pI 5.7
      Aplysia protein appears to be porin/voltage-dependent anion channel. Heat shock
      experiments on Aplysia eyes revealed that yet another one of the Aplysia proteins
      (70 kDa) affected by 5-HT appears to be a heat-inducible member (heat shock
      protein 70) of the family of heat shock proteins. These findings suggest that
      these three identified proteins, together or individually, may be involved in
      some way in the regulation of the timing of the circadian oscillator in the eye
      of Aplysia.

PMID- 7782327
TI  - Isolation and characterization of a stable Chinese hamster ovary cell line
      overexpressing the plasma membrane Ca(2+)-ATPase.
AB  - Stable Chinese hamster ovary (CHO) cell lines overexpressing the human plasma
      membrane Ca(2+)-ATPase (PMCA) were generated, and three independent cell clones
      were characterized in details. They overexpressed high amounts of active PMCA
      pump (15-20 times over the amount of endogenous PMCA) as indicated by experiments
      in which the formation of the phosphoenzyme intermediate and the uptake of Ca2+
      by microsomes were measured. Immunocytochemistry experiments coupled to the
      biotinylation of the pump in the intact cells indicated the correct deliver of
      the expressed pump to the plasma membrane. The expressed pump was purified by
      affinity chromatography on calmodulin sepharose. The PMCA of transfected CHO
      cells promoted an increase of Ca2+ into the medium, after induction of Ca2+
      release from the internal stores by activation of a purinergic receptor. An
      evident decrease of the activity of the endogenous sarcoplasmic reticulum Ca(2+)
      ATPase pump was observed, probably related to the down-regulation of its
      expression. The cells overexpressing the PMCA pump had delayed recovery after
      trypsinization and plating. Their doubling time was, however, the same as CHO
      cells.

PMID- 7782328
TI  - Intracellular localization of 8-oxo-dGTPase in human cells, with special
      reference to the role of the enzyme in mitochondria.
AB  - We examined the intracellular distribution of 8-oxo-dGTPase (8-oxo-7,8
      dihydrodeoxyguanosine triphosphatase) encoded by the MTH1 gene, a human mutator
      homologue. The activity of 8-oxo-dGTPase mainly located in cytosolic and
      mitochondrial soluble fractions of Jurkat cells, a human T-cell leukemia line.
      Electron microscopic immunocytochemistry, using a specific antibody against MTH1
      protein, showed localization of MTH1 protein in the mitochondrial matrix.
      Activity in the mitochondria accounted for about 4% of the total activity. The
      specific activity in the mitochondrial soluble fraction (8093 units/mg protein)
      was as high as that in the cytosolic fraction (8111 unit/mg protein). The 8-oxo
      dGTPase activities in cytosolic and mitochondrial soluble fractions co-eluted
      with MTH1 protein by anion-exchange chromatography, and the molecular mass of the
      mitochondrial MTH1 protein was much the same as that of the cytosolic MTH1
      protein (about 18 kDa). HeLa cells expressing MTH1 cDNA showed an increased
      cytoplasmic signal together with a weak signal in the nucleus in in situ
      immunostaining of MTH1 protein, and the overexpressed MTH1 protein was recovered
      from both cytosolic and mitochondrial fractions. Thus, the 8-oxo-dGTPase encoded
      by MTH1 gene is localized in mitochondrial and cytosol.

PMID- 7782329
TI  - elt-2, a second GATA factor from the nematode Caenorhabditis elegans.
AB  - We have previously shown that a tandem pair of (A/T)GATA(A/G) sequences in the
      promoter region of the Caenorhabditis elegans gut esterase gene (ges-1) controls
      the tissue specificity of ges-1 expression in vivo. The ges-1 GATA region was
      used as a probe to screen a C. elegans cDNA expression library, and a gene for a
      new C. elegans GATA-factor (named elt-2) was isolated. The longest open reading
      frame in the elt-2 cDNA codes for a protein of M(r) 47,000 with a single zinc
      finger domain, similar (approximately 75% amino acid identity) to the C-terminal
      fingers of all other two-fingered GATA factors isolated to date. A similar degree
      of relatedness is found with the single-finger DNA binding domains of GATA
      factors identified in invertebrates. An upstream region in the ELT-2 protein with
      the sequence C-X2-C-X16-C-X2-C has some of the characteristics of a zinc finger
      domain but is highly diverged from the zinc finger domains of other GATA factors.
      The elt-2 gene is expressed as an SL1 trans-spliced message, which can be
      detected at all stages of development except oocytes; however, elt-2 message
      levels are 5-10-fold higher in embryos than in other stages. The genomic clone
      for elt-2 has been characterized and mapped near the center of the C. elegans X
      chromosome, ELT-2 protein, produced by in vitro transcription-translation, binds
      to ges-1 GATA-containing oligonucleotides similar to a factor previously
      identified in C. elegans embryo extracts, both as assayed by electrophoretic
      migration and by competition with wild type and mutant oligonucleotides. However,
      there is as yet no direct evidence that elt-2 does or does not control ges-1.

PMID- 7782330
TI  - Coupling of human D-1 dopamine receptors to different guanine nucleotide binding
      proteins. Evidence that D-1 dopamine receptors can couple to both Gs and G(o).
AB  - Coupling between D-1 dopamine receptors and G proteins in cell lines expressing
      human D-1 receptors and different G proteins was examined. Pertussis toxin (PTX)
      treatment of rat pituitary GH4C1 cells significantly reduced, but did not
      abolish, agonist high affinity binding sites of the D-1 dopamine receptor; in SK
      N-MC neuroblastoma cells, PTX failed to have any effect on D-1 high affinity
      sites. Cholera toxin (CTX) treatment of GH4C1 cells reduced but did not abolish
      the high affinity sites of D-1 receptors, while in SK-N-MC cells, treatment with
      CTX abolished all the high affinity sites. Western blot analyses with specific
      antisera indicated that Gs alpha, Gi1 alpha, Gi3 alpha, and Gq alpha were
      expressed in both cell lines, while Gi2 alpha and G(o) alpha were expressed in
      GH4C1 but not SK-N-MC cells. Antisera NEI-805 (anti-Gs alpha) and 9072 (anti-G(o)
      alpha) immunoprecipitated 24 +/- 4.3 and 34.4 +/- 6.9%, respectively, of G
      protein-associated D-1 dopamine receptors. Antisera 3646 (anti-Gi1 alpha), 1521
      (anti-Gi2 alpha), 1518 (anti-Gi3 alpha), and 0941 (anti-Gq alpha) failed to
      coimmunoprecipitate appreciable levels of soluble receptors. These data indicate
      that D-1 dopamine receptors are coupled to both Gs alpha and G(o) alpha but not
      to Gq alpha.

PMID- 7782332
TI  - Growth hormone, interferon-gamma, and leukemia inhibitory factor promoted tyrosyl
      phosphorylation of insulin receptor substrate-1.
AB  - The identification of JAK2 as a growth hormone (GH) receptor-associated, GH
      activated tyrosine kinase has established tyrosyl phosphorylation as a signaling
      mechanism for GH. In the present study, GH is shown to stimulate tyrosyl
      phosphorylation of insulin receptor substrate 1 (IRS-1), the principle substrate
      of the insulin receptor. Tyrosyl phosphorylation of IRS-1 is a critical step in
      insulin signaling and provides binding sites for proteins with the appropriate
      Src homology 2 domains, including the 85-kDa regulatory subunit of
      phosphatidylinositol (PI) 3'-kinase. In 3T3-F442A fibroblasts, GH-dependent
      tyrosyl phosphorylation of IRS-1 was detected by 1 min and at GH concentrations
      as low as 5 ng/ml (0.23 nM). Tyrosyl phosphorylation of IRS-1 was transient, with
      maximal stimulation detected at 30 min and diminished signal detected at 60 min.
      The ability of GH receptor (GHR) to transduce the signal for IRS-1 tyrosyl
      phosphorylation is mediated by the intracellular region of GHR between amino
      acids 295 and 380 by a mechanism not involving the two tyrosines in this region.
      This region of GHR is required for GH-dependent JAK2 association and activation
      (VanderKuur, J. A., Wang, X., Zhang, L., Campbell, G. S., Allevato, G.,
      Billestrup, N., Norstedt, G., and Carter-Su, C. (1994) J. Biol. Chem. 269, 21709
      21717). When other cytokines that activate JAK2 were tested for the ability to
      stimulate the tyrosyl phosphorylation of IRS-1, stimulation was detected with
      interferon-gamma and leukemia inhibitory factor. The correlation between JAK2
      tyrosyl phosphorylation and IRS-1 tyrosyl phosphorylation in response to GH,
      interferon-gamma, and leukemia inhibitory factor and in cells expressing
      different GHR mutants, provides evidence that IRS-1 may interact with JAK2 or an
      auxiliary molecule that binds to JAK2. GH is also shown to stimulate binding of
      IRS-1 to the 85-kDa regulatory subunit of PI 3'-kinase. The ability of GH to
      stimulate tyrosyl phosphorylation of IRS-1 and its association with PI 3'-kinase
      provides a biochemical basis for responses shared by insulin and GH including the
      well characterized insulin-like metabolic effects of GH observed in a variety of
      cell types.

PMID- 7782331
TI  - Low affinity binding of phorbol esters to protein kinase C and its recombinant
      cysteine-rich region in the absence of phospholipids.
AB  - Binding of phorbol esters to protein kinase C (PKC) has been regarded as
      dependent on phospholipids, with phosphatidylserine being the most effective for
      reconstituting binding. By using a purified single cysteine-rich region from PKC
      delta expressed in Escherichia coli we were able to demonstrate that specific
      binding of [3H]phorbol 12,13-dibutyrate to the receptor still takes place in the
      absence of the phospholipid cofactor. However, [3H]phorbol 12,13-dibutyrate bound
      to the cysteine-rich region with 80-fold lower affinity in the absence than in
      the presence of 100 micrograms/ml phosphatidylserine. Similar results were
      observed with the intact recombinant PKC delta isolated from insect cells. When
      different phorbol derivatives were examined, distinct structure-activity
      relations for the cysteine-rich region were found in the presence and absence of
      phospholipid. Our results have potential implications for PKC translocation, for
      inhibitor design, and for PKC structural determination.

PMID- 7782333
TI  - Interaction of platelet glycoprotein V with glycoprotein Ib-IX regulates
      expression of the glycoproteins and binding of von Willebrand factor to
      glycoprotein Ib-IX in transfected cells.
AB  - The goal of the present study was to determine whether platelet glycoprotein (GP)
      V interacts directly with the von Willebrand factor receptor GP Ib-IX and, if so,
      whether it affects the expression and function of this receptor. A melanoma cell
      line that does not contain actin-binding protein was transfected with the cDNAs
      coding for GP V and for each of the three subunits of GP Ib-IX. GP V co
      immunoprecipitated and co-localized with GP Ib-IX. Although GP V could be
      expressed in the absence of GP Ib-IX, the amount incorporated in the membrane was
      markedly increased when GP Ib-IX was present. Similarly, there was an enhanced
      expression of GP Ib-IX on the cell surface in the presence of GP V. The binding
      affinity of botrocetin-induced von Willebrand factor to GP Ib-IX was unaffected
      by the presence or absence of GP V. However, the binding capacity was increased
      by the presence of GP V. We conclude that GP V interacts directly with GP Ib-IX,
      that GP V must associate with GP Ib-IX to be efficiently expressed in the
      membrane, and that GP V increases the binding capacity of the cells for von
      Willebrand factor by enhancing the surface expression of the GP Ib-IX complex.

PMID- 7782334
TI  - Heterotetrameric complex formation of inositol 1,4,5-trisphosphate receptor
      subunits.
AB  - The inositol 1,4,5-trisphosphate receptor (IP3R) exists as a tetrameric complex
      to form a functional inositol 1,4,5-trisphosphate-gated Ca2+ channel. Molecular
      cloning studies have shown that there are at least three types of IP3R subunits,
      designated type 1, type 2, and type 3. The levels of expression of IP3R subunits
      in various cell lines were investigated by Western blot analysis using type
      specific antibodies against 15 C-terminal amino acids of each IP3R subunit. We
      found that all the three types of IP3R subunits were expressed in each cell line
      examined, but their levels of expression varied. To determine whether IP3Rs form
      heterotetramers, we employed immunoprecipitation experiments using Chinese
      hamster ovary cells (CHO-K1 cells), in which all three types are abundantly
      expressed. Each type-specific antibody immunoprecipitated not only the respective
      cognate type but also the other two types. This result suggests that distinct
      types of IP3R subunits assemble to form heterotetramers in CHO-K1 cells. We also
      detected heterotetramers in rat liver, in which IP3R type 1 and type 2 are
      expressed abundantly. Previous studies have shown some functional differences
      among IP3R types, suggesting the possibility that various compositions of
      subunits show distinct channel properties. The diversity of IP3R channels may be
      further increased by the co-assembly of different IP3R subunits to form homo- or
      heterotetramers.

PMID- 7782335
TI  - Accelerated hybridization of oligonucleotides to duplex DNA.
AB  - We report two strategies for accelerating the hybridization of oligonucleotides
      to DNA. We demonstrate that oligodeoxyribonucleotides and peptide nucleic acid
      oligomers hybridize to inverted repeats within duplex DNA by D-loop formation.
      Oligonucleotides and duplex template form an active complex, which can be
      recognized by T7 DNA polymerase to prime polymerization. Quantitation of
      polymerization products allowed the rate of hybridization to be estimated, and
      peptide nucleic acid oligomers and oligonucleotide-protein adducts anneal with
      association constants 500- and 12,000-fold greater, respectively, than the
      analogous unmodified oligonucleotides. Together, these results indicate that
      sequences within duplex DNA can be targeted by Watson-Crick base pairing and that
      chemical modifications can dramatically enhance the rate of strand association.
      These findings should facilitate targeting of oligomers for priming DNA
      polymerization, the detection of diagnostic sequences, and the disruption of gene
      expression. The observed acceleration of hybridization may offer a new
      perspective on the ability of RecA or other proteins to accelerate strand
      invasion.

PMID- 7782337
TI  - Altered carbohydrate recognition specificity engineered into surfactant protein D
      reveals different binding mechanisms for phosphatidylinositol and
      glucosylceramide.
AB  - Pulmonary surfactant protein D (SP-D) is a member of the collection subgroup of
      the C-type lectin superfamily that binds glycosylated lipids such as
      phosphatidylinositol (PI) and glucosylceramide (GlcCer). We have previously
      reported that the carbohydrate recognition domain of SP-D plays an essential role
      in lipid binding. However, it is unclear how the carbohydrate binding property of
      SP-D contributes to the lipid binding. To clarify the relationship between the
      lectin property and the lipid binding activity of rat SP-D, we expressed wild
      type recombinant rat SP-D (rSP-D) and a mutant form of the protein with
      substitutions Glu-321-->Gln and Asn-323-->Asp (SP-DE321Q,N323D) in CHO-K1 cells.
      The indicated mutations have previously been shown to change the carbohydrate
      binding specificity of surfactant protein A and mannose-binding protein from
      mannose > galactose to the converse. rSP-D expressed in mammalian cells was
      essentially identical to native rat SP-D in its lipid and carbohydrate binding
      properties. In contrast, SP-DE321Q,N323D was unable to bind GlcCer, but retained
      binding activity toward PI liposomes and solid-phase PI. The efficiency of SP
      DE321Q,N323D binding to PI liposome was approximately 50% of that of rSP-D in the
      presence of 5 mM Ca2+, but equivalent at 20 mM Ca2+. Carbohydrates competed for
      SP-D binding to PI such that maltose > galactose for rSP-D, and the order was
      reversed for SP-DE321Q,N323D. Furthermore, SP-DE321Q,N323D could bind to
      digalactosyldiacylglycerol more effectively than rSP-D. These results suggest the
      following. 1) The carbohydrate binding specificity of SP-DE321Q,N323D was changed
      from a mannose-glucose type to a galactose type; 2) the GlcCer binding property
      of SP-D is closely related to its sugar binding activity; and 3) the PI binding
      activity is not completely dependent on its carbohydrate binding specificity.

PMID- 7782336
TI  - The Ras GTPase-activating protein (GAP) is an SH3 domain-binding protein and
      substrate for the Src-related tyrosine kinase, Hck.
AB  - The Ras GTPase-activating protein (GAP) is a target for protein tyrosine kinases
      of both the receptor and cytoplasmic classes and may serve to integrate tyrosine
      kinase and Ras signaling pathways. In this report, we provide evidence that GAP
      is an SH3 domain-binding protein and substrate for the Src-related tyrosine
      kinase Hck, which has been implicated in the regulation of myeloid cell growth,
      differentiation, and function. Wild-type (WT) or kinase-inactive (K269E) mutant
      Hck proteins were co-expressed with bovine GAP using the baculovirus/Sf-9 cell
      system. GAP was readily phosphorylated on tyrosine by WT but not K269E Hck. GAP
      was present in WT Hck immunoprecipitates from the co-infected cells, indicative
      of Hck.GAP complex formation. Unexpectedly, GAP also associated with the kinase
      inactive mutant of Hck, suggesting that tyrosine autophosphorylation of Hck is
      not required for complex formation. The WT and K269E forms of Hck also associated
      with GAP mutants lacking either the C-terminal catalytic domain (delta CAT) or
      the Src homology region (delta SH), indicating that these GAP domains are
      dispensable for complex formation. Recombinant GST fusion proteins containing the
      Hck, Src, Fyn, or Lck SH3 domains associated with full-length GAP, delta CAT, and
      delta SH, all of which share an N-terminal proline-rich region resembling an SH3
      binding motif (PPLPPPPPQLP). Deletion of the highly conserved YXY sequence from
      the Hck SH3 domain abolished binding. GAP-SH3 interaction was also inhibited by
      the proline-rich peptide GFPPLPPPPPQLPTLG, which corresponds to N-terminal amino
      acids 129-144 of bovine GAP. An N-terminal deletion mutant of GAP lacking this
      proline-rich region did not bind to the Hck SH3 domain. These data implicate the
      Hck SH3 domain in GAP interaction, and suggest a general function for the SH3
      domains of Src family kinases in recognition of GAP via its proline-rich N
      terminal domain.

PMID- 7782338
TI  - Characterization of the mammalian YAP (Yes-associated protein) gene and its role
      in defining a novel protein module, the WW domain.
AB  - We report cDNA cloning and characterization of the human and mouse orthologs of
      the chicken YAP (Yes-associated protein) gene which encodes a novel protein that
      binds to the SH3 (Src homology 3) domain of the Yes proto-oncogene product.
      Sequence comparison between mouse, human, and chicken YAP proteins showed an
      inserted sequence in the mouse YAP that represented an imperfect repeat of an
      upstream sequence. Further analysis of this sequence revealed a putative protein
      module that is found in various structural, regulatory, and signaling molecules
      in yeast, nematode, and mammals including human dystrophin. Because one of the
      prominent features of this sequence motif is two tryptophans (W), we named it the
      WW domain (Bork, P., and Sudol, M. (1994) Trends Biochem. Sci. 19, 531-533).
      Since its delineation, more proteins have been shown to contain this domain, and
      we report here on the widespread distribution of the WW module and present a
      discussion of its possible function. We have also shown that the human YAP gene
      is well conserved among higher eukaryotes, but it may not be conserved in yeast.
      Its expression at the RNA level in adult human tissues is nearly ubiquitous,
      being relatively high in placenta, prostate, ovary, and testis, but is not
      detectable in peripheral blood leukocytes. Using fluorescence in situ
      hybridization on human metaphase chromosomes and by analyzing rodent-human
      hybrids by Southern blot hybridization and polymerase chain reaction
      amplification, we mapped the human YAP gene to chromosome band 11q13, a region to
      which the multiple endocrine neoplasia type 1 gene has been mapped.

PMID- 7782339
TI  - Carbonic anhydrase III. Oxidative modification in vivo and loss of phosphatase
      activity during aging.
AB  - Oxidative modification of DNA, lipids, and proteins occurs as a consequence of
      reaction with free radicals and activated oxygen. Oxidative modification of total
      cellular proteins has been described under many pathologic and experimental
      conditions, but no specific proteins have been identified as in vivo targets for
      oxidative modification. Utilizing an immunochemical method for detection of
      oxidatively modified proteins, we identified a protein in rat liver that was
      highly oxidized. It was purified to homogeneity and identified as carbonic
      anhydrase, isozyme III. Its characteristics match those previously described for
      a protein that was lost during aging of the rat, senescence marker protein-1.
      Carbonic anhydrase III was purified from rats aged 2, 10, and 18 months, and the
      proteins were characterized. All three preparations were highly oxidatively
      modified as assessed by their carbonyl content. The enzyme has three known
      catalytic activities, and the specific activities for carbon dioxide hydration
      and for ester hydrolysis decreased during aging by approximately 30%. However,
      the third activity, that of a phosphatase, was virtually lost during aging. While
      the physiologic role of carbonic anhydrase III is unknown, we suggest that it
      functions in an oxidizing environment, which leads to its own oxidative
      modification.

PMID- 7782341
TI  - The hydroxy amino acid in an Asn-X-Ser/Thr sequon can influence N-linked core
      glycosylation efficiency and the level of expression of a cell surface
      glycoprotein.
AB  - N-Linked glycosylation usually occurs at the sequon, Asn-X-Ser/Thr. In this
      sequon, the side chain of the hydroxy amino acid (Ser or Thr) may play a direct
      catalytic role in the enzymatic transfer of core oligosaccharides to the Asn
      residue. Using recombinant variants of rabies virus glycoprotein (RGP), we
      examined the influence of the hydroxy amino acid on core glycosylation
      efficiency. A variant of RGP containing a single Asn-X-Ser sequon at Asn37 was
      modified by site-directed mutagenesis to change the sequon to either Asn-X-Cys or
      Asn-X-Thr. The impact of these changes on core glycosylation efficiency was
      assessed by expressing the variants in a cell-free
      transcription/translation/glycosylation system and in transfected tissue culture
      cells. Substitution of Cys at position 39 blocks glycosylation, whereas
      substitution of Thr dramatically increases core glycosylation efficiency of Asn37
      in both membrane-anchored and secreted forms of RGP. The substitution of Thr for
      Ser also dramatically enhances the level of expression and cell surface delivery
      of RGP when the sequon at Asn37 is the only sequon in the protein. Novel forms of
      membrane-anchored and secreted RGP which are fully glycosylated at all three
      sequons were also generated by substitution of Thr at position 39.

PMID- 7782340
TI  - Isolation and characterization of gastric trypsin from the microsomal fraction of
      porcine gastric antral mucosa.
AB  - A gastric serine protease(s) was found in porcine gastric antral mucosa and was
      shown to be distributed in the endoplasmic reticulum (ER)-microsome fraction and
      also in the vesicle fraction. Two forms of the protease were purified over 6,000
      fold from the ER-microsome fraction. Analyses of various molecular and enzymatic
      characteristics including the N-terminal and partial internal amino acid
      sequences of both forms revealed that they share the same properties and are
      indistinguishable from porcine pancreatic trypsin. This is the first time that
      trypsin or a protease almost identical with trypsin has been found to be present
      intracellularly in normal tissues. The gastric trypsin activities from the ER
      microsome and the vesicle fractions were located in distinct density regions upon
      density gradient centrifugation, which indicates association of the protease with
      different organelle membranes. Taken together, these results suggest that there
      may be a novel function of trypsin in the gastric mucosa; it might function as a
      specific degrading or processing enzyme as an intracellular protease.

PMID- 7782342
TI  - apobec-1, the catalytic subunit of the mammalian apolipoprotein B mRNA editing
      enzyme, is a novel RNA-binding protein.
AB  - Apolipoprotein B (apoB) mRNA editing is mediated by an enzyme complex which
      includes the catalytic subunit, apobec-1. Recombinant GST/APOBEC-1 binds with
      high specificity to a rat apoB RNA template as demonstrated by UV cross-linking
      and electrophoretic mobility shift assay (EMSA). ApoB RNA binding was competed by
      poly(U), poly(A,U), and tRNA, but not by poly(A) or other homopolymeric
      ribonucleotides. UV cross-linking of GST/APOBEC-1 to an apoB RNA template was
      uninfluenced by the binding of proteins of approximately 60 and approximately 44
      kDa, present in S100 extracts prepared from different sources. The binding of
      these proteins was similarly uninfluenced by the simultaneous binding of GST/APO
      BEC-1. Moreover, the inclusion of heterologous S100 extracts in the RNA binding
      reactions completely abrogated the competitive displacement of GST/APOBEC-1 by
      tRNA. EMSA revealed the onset of RNA binding within 1-2 min, and its specificity
      was confirmed by a supershift with anti-GST/APOBEC-1 antisera. The structural
      specificity for apoB RNA binding, as inferred from EMSA, appears to be distinct
      from apoB RNA editing since wild-type chicken apoB RNA, which is not editable,
      and several mutant chicken apoB RNAs containing clustered mutations within the
      minimal apoB RNA editing cassette, bound with efficiency similar to the rat apoB
      RNA template. In conclusion, while the data suggest that apobec-1 binds AU-rich
      templates, the importance of this observation in the context of mammalian apoB
      mRNA editing remains unknown.

PMID- 7782343
TI  - Mutagenesis of apobec-1, the catalytic subunit of the mammalian apolipoprotein B
      mRNA editing enzyme, reveals distinct domains that mediate cytosine nucleoside
      deaminase, RNA binding, and RNA editing activity.
AB  - Apolipoprotein (apo) B48 is synthesized by mammalian small intestine as a result
      of post-transcriptional RNA editing. This process is mediated by an enzyme
      complex containing a catalytic subunit, apobec-1, which is homologous to other
      cytidine deaminases, particularly in a domain (H/C)-(A/V)-E-(X)24-30-P-C-(X)2-C
      which coordinates zinc, apobec-1, expressed as a glutathione S-transferase fusion
      protein, demonstrates both apoB RNA editing and cytidine deaminase activity.
      His61, Cys93, and Cys96, the putative zinc-coordinating residues, were mutated to
      Arg, Ser, and Ser, respectively, with loss of RNA editing activity and either
      great reduction or abolition of cytidine deaminase activity. Mutation of the
      catalytically active Glu63 residue to Gln and Pro92 to Leu abolished both
      cytidine deaminase and RNA editing activity. The conservative His61-->Cys
      mutation, which should coordinate zinc, retained both editing and cytidine
      deaminase activity. Thus, zinc binding is required for both apoB RNA editing and
      cytidine deaminase activity. Mutation of the first four leucines within the
      heptad repeat of the leucine-rich region (LRR) of apobec-1 resulted in reduced
      RNA editing but preservation of wild-type cytidine deaminase activity. GST/APOBEC
      1 was also demonstrated to cross-link to apoB RNA. Mutation of His61-->Arg
      abolished RNA binding, while the Glu63-->Gln and Cys96-->Ser mutant proteins
      showed wild-type levels of RNA binding. The remaining mutants had reduced levels
      of activity. Overexpression of wild-type apobec-1 in McA 7777 cells resulted in a
      5-6-fold increase in editing of endogenous apoB. Transfection of the His61-->Cys,
      LRR, and Cys93-->Ser mutants increased endogenous editing 2-3-fold, while Glu63-
      >Gln and His61-->Arg mutants acted as dominant negatives, reducing endogenous
      editing. These data suggest that apobec-1 has distinct functional domains which
      modulate activity in the context of the apoB mRNA editing enzyme.

PMID- 7782344
TI  - Intracellular A beta 1-42 aggregates stimulate the accumulation of stable,
      insoluble amyloidogenic fragments of the amyloid precursor protein in transfected
      cells.
AB  - We have analyzed the effect of internalized amyloid beta-protein (A beta) 1-42
      aggregates on the metabolism of the amyloid precursor protein (APP) in stably
      transfected 293 cells. The amount of potentially amyloidogenic fragments of APP
      immunoprecipitated by anti-carboxyl-terminal APP and anti-A beta antibodies is
      dramatically enhanced by the treatment of the cells with A beta 1-42, which is
      resistant to degradation, but not A beta 1-28, which does not accumulate in
      cells. This accumulation of amyloidogenic carboxyl-terminal fragments is
      specific, since there is relatively little effect of A beta 1-42 on the amount of
      the nonamyloidogenic alpha-secretase carboxyl-terminal fragment. The
      amyloidogenic fragments accumulate in the same nonionic detergent-insoluble
      fraction of the cell that contains the internalized A beta 1-42. Western analysis
      indicates that a subset of the amyloidogenic fragments react with antibodies that
      recognize a conformation of A beta that is specifically associated with
      aggregated forms of A beta, suggesting that the adoption of this aggregation
      related conformation may be an early event which precedes the final processing
      that produces A beta. Pulse-chase analysis of the [35S]Met-labeled 16-kDa
      amyloidogenic fragment indicates that it is relatively stable in A beta 1-42
      treated cells, with a half-life of approximately 50 h. This fragment is degraded
      with a half-life of 30 min in control cells treated with A beta 1-28. In
      contrast, the turnover of the nonamyloidogenic alpha-secretase product is not
      significantly altered by the presence of A beta 1-42. The continuous uptake of A
      beta 1-42 from the medium is not required for the stimulation of amyloidogenic
      fragment accumulation, suggesting that the presence of intracellular A beta 1-42
      aggregates establishes a new pathway for APP catabolism in cells which leads to
      the long term stability of the fragments. If these amyloidogenic fragments of APP
      ultimately give rise to A beta, then the production of A beta may be an
      autocatalytic, "runaway" process in cells containing A beta 1-42 nuclei. It is
      conceivable that the accumulation of insoluble APP and amyloidogenic fragments of
      APP in response to A beta 1-42 aggregates may mimic the pathophysiology of
      dystrophic neurites, where the accumulation of intracellular APP and APP
      fragments has been documented by immunohistochemistry.

PMID- 7782345
TI  - The N-terminal domain of a glycolipid-anchored prion protein is essential for its
      endocytosis via clathrin-coated pits.
AB  - The cellular prion protein (PrPC) is a glycolipid-anchored protein that is
      involved in the pathogenesis of fatal spongiform encephalopathies. We have shown
      previously that, in contrast to several other glycolipid-anchored proteins,
      chPrP, the chicken homologue of mammalian PrPC, is endocytosed via clathrin
      coated pits in cultured neuroblastoma cells, as well as in embryonic neurons and
      glia (Shyng, S.-L., Heuser, J. E., and Harris, D. A. (1994) J. Cell Biol. 125,
      1239-1250). In this study, we have determined that the N-terminal half of the
      chPrP polypeptide chain is essential for its endocytosis. Deletions within this
      region reduce the amount of chPrP internalized, as measured by surface iodination
      or biotinylation, and decrease its concentration in clathrin-coated pits, as
      determined by quantitative electron microscopic immunogold labeling. Mouse PrP,
      as well as two mouse PrP/chPrP chimeras, are internalized as efficiently as
      chPrP, suggesting that conserved features of secondary and tertiary structure are
      involved in interaction with the endocytic machinery. Our results indicate that
      the ectodomain of a protein can contain endocytic targeting information, and they
      strongly support a model in which the polypeptide chain of PrPC binds to the
      extracellular domain of a transmembrane protein that contains a coated pit
      localization signal in its cytoplasmic tail.

PMID- 7782347
TI  - The myristoylated amino terminus of ADP-ribosylation factor 1 is a phospholipid-
      and GTP-sensitive switch.
AB  - ADP-ribosylation factor 1 (Arf1) is an essential N-myristoylated 21-kDa GTP
      binding protein with activities that include the regulation of membrane traffic
      and phospholipase D activity. Both the N terminus of the protein and the N
      myristate bound to glycine 2 have previously been shown to be essential to the
      function of Arf in cells. We show that the bound nucleotide affects the
      conformation of either the N terminus or residues of Arf1 that are in direct
      contact with the N terminus. This was demonstrated by examining the effects of
      mutations in this N-terminal domain on guanosine 5'-O-(3-thio)triphosphate (GTP
      gamma S) and GDP binding and dissociation kinetics. Arf1 mutants, lacking 13 or
      17 residues from the N terminus or mutated at residues 3-7, had a greater
      affinity for GTP gamma S and a lower affinity for GDP than did the wild-type
      protein. As the N terminus is required for interactions with target proteins, we
      conclude that the N terminus of Arf1 is a GTP-sensitive effector domain. When
      Arf1 was acylated, the GTP-dependent conformational changes were codependent on
      added phospholipids. In the absence of phospholipids, myristoylated Arf1 has a
      lower affinity for GTP gamma S than for GDP, and in the presence of
      phospholipids, the myristoylated protein has a greater affinity for GTP gamma S
      than for GDP. Thus, N-myristoylation is a critical component in the construction
      of this phospholipid- and GTP-dependent switch.

PMID- 7782346
TI  - Two-hybrid system screen with the small GTP-binding protein Rab6. Identification
      of a novel mouse GDP dissociation inhibitor isoform and two other potential
      partners of Rab6.
AB  - Rab6 is a small GTP-binding protein that belongs to the Ras superfamily and is
      involved in intra-Golgi transport. Using a two-hybrid system screen of a mouse
      brain cDNA library, we have isolated several clones encoding proteins that
      interact with Rab6. Approximately 60% of the clones identified encoded a new
      mouse Rab GDP dissociation inhibitor (GDI) isoform. This GDI isoform is distinct
      from mouse mGDI-1 and mGDI-2, which have been characterized previously, and most
      likely represents the mouse counterpart of the rat Rab GDI beta isoform. In the
      two-hybrid system, GDI beta interacts with wild-type Rab6 and Rab5, but not with
      a GTP-bound Rab6 mutant, or a Rab6 mutant that cannot be post-translationally
      processed. We further examined whether mouse GDI beta is functional; we show that
      recombinant mouse GDI beta is able to remove several Rab proteins, including
      Rab1, Rab2, Rab4, and Rab6, from membranes. The identification of a third GDI
      isoform in mouse raised the question whether GDI genes belong to a larger
      multigenic family. We have shown, by Southern blot analysis of genomic DNA, that
      at least five GDI gene copies exist in both the mouse and rat genomes. In our two
      hybrid screen, we have also characterized another clone that specifically
      interacts with Rab6. This clone was partially sequenced but shows no homology to
      known sequences. Finally, a third clone, interacting with both Rab5 and Rab6,
      also appears to encode a novel protein.

PMID- 7782348
TI  - Differential activation of cytosolic phospholipase A2 (cPLA2) by thrombin and
      thrombin receptor agonist peptide in human platelets. Evidence for activation of
      cPLA2 independent of the mitogen-activated protein kinases ERK1/2.
AB  - The thrombin receptor agonist peptide SFLLRN was less effective than thrombin in
      eliciting the liberation of arachidonic acid and the generation of thromboxane A2
      by human platelets. We found that while SFLLRN evokes an initial transient
      increase in cystolic free calcium concentration ([Ca2+]i) of similar magnitude as
      that caused by thrombin, the SFLLRN-induced elevation of [Ca2+]i declines more
      rapidly to near resting levels than that evoked by thrombin, suggesting that
      disparate levels of [Ca2+]i may contribute to the attenuated arachidonic acid
      release. Furthermore, we observed that SFLLRN is less effective than thrombin in
      mediating the "activating" phosphorylation of cytolic phospholipase A2 (cPLA2).
      Both thrombin and SFLLRN rapidly and transiently activated kinases that
      phosphorylate the 21-residue synthetic peptide Thr669 derived from the epidermal
      growth factor receptor, but the maximal activation of proline-directed kinases by
      SFLLRN was less pronounced than that by thrombin. MonoQ chromatography and
      immunoblot analysis of extracts from stimulated platelets revealed that while
      thrombin induced a prominent activation of the mitogen-activated protein kinases
      ERK1 and ERK2, SFLLRN completely failed to do so. On the other hand, SFLLRN, like
      thrombin, stimulated the activity of a proline-directed kinase distinct from
      ERK1/2, but the activation of this kinase was less pronounced following
      stimulation of platelets with SFLLRN compared with thrombin. We conclude 1) that
      the partial activation of cPLA2 and the subsequent attenuated mobilization of
      arachidonic acid in response to SFLLRN may be the consequence of a less prolonged
      elevation of [Ca2+]i and insufficient activation of proline-directed kinase(s) by
      SFLLRN and 2) that the ability of SFLLRN to mediate the activating
      phosphorylation of cPLA2 in the absence of ERK1/2 stimulation suggest that, at
      least in human platelets, proline-directed kinases other than ERK1/2 may
      phosphorylate and activate cPLA2.

PMID- 7782349
TI  - Phosphorylation of eukaryotic protein synthesis initiation factor 4E by insulin
      stimulated protamine kinase.
AB  - Insulin-stimulated protamine kinase (cPK) and protein kinase C (PKC)
      phosphorylated eukaryotic protein synthesis initiation factor 4E (eIF-4E) on
      serine and threonine residues located on an identical tryptic fragment as judged
      by two-dimensional phosphopeptide mapping. With cPK and PKC, the apparent Km for
      eIF-4E was about 1.2 and 50 microM, respectively. Relative to recombinant human
      eIF-4E, cPK exhibited about 100% and < or = 5% activity with eIF-4ES209A and eIF
      4ET210A, respectively, and eIF-4ES209A was phosphorylated exclusively on
      threonines. Bovine kidney eIF-4E enhanced up to 1.8-fold globin synthesis in
      m7GTP-Sepharose-treated reticulocyte lysates. In contrast, following incubation
      with cPK, these eIF-4E preparations stimulated globin synthesis up to 6-fold.
      Compared to the dephosphorylation of the cPK-modified serine on eIF-4E,
      reticulocyte lysates and highly purified protein phosphatase 2A exhibited marked
      preference for the cPK-modified threonine. The results indicate that cPK
      phosphorylates eIF-4E on Ser209 and Thr210, that the hydroxyl group or
      phosphorylation of Thr210 is necessary for cPK to act on Ser209, and that Ser209
      phosphorylation activates reticulocyte globin synthesis. The results suggest that
      cPK could contribute to the insulin-stimulated phosphorylation of eIF-4E, but
      that protein phosphatase 2A may confer the site specificity of this response.

PMID- 7782350
TI  - Hemolysin transport in Escherichia coli. Point mutants in HlyB compensate for a
      deletion in the predicted amphiphilic helix region of the HlyA signal.
AB  - The alpha-hemolysin transporter of Escherichia coli, a member of the ATP-binding
      cassette transporter super-family, is responsible for secretion of the 107-kDa
      protein toxin HlyA across both membranes of the Gram-negative envelope in a
      single step. Secretion of HlyA is dependent on a signal sequence, which occupies
      the C-terminal 50-60 amino acids of HlyA. Previously, it was shown that point
      mutants in the transmembrane domain of the transporter HlyB could partially
      correct the transport defect caused by a deletion of the C-terminal 29 amino
      acids of HlyA. These suppressor mutations demonstrated a direct interaction
      between HlyA and HlyB. They also displayed suppressor effects on a broad spectrum
      of HlyA signal mutants. In the present study, we selected HlyB alleles that
      complemented an internal deletion of 29 amino acids in HlyA containing a
      predicted amphiphilic helix region immediately upstream from the previous
      deletion. This set of HlyB mutants identifies further sites in HlyB that modulate
      substrate specificity but display allele-specific effects on a range of HlyA
      signal mutants. The inability to isolate mutations with effects restricted to
      either half of the signal sequence suggests that the signal is not recognized in
      a modular fashion by the transporter but rather functions as an integrated whole.
      We also report the isolation of the first substrate specificity mutation, which
      lies within the ATP-binding domain of HlyB. This could support a model in which
      the region of the ATP-binding cassette between the two Walker consensus motifs
      involved in ATP binding interacts with either the substrate or the transmembrane
      domains.

PMID- 7782351
TI  - Regions outside of the CAAX motif influence the specificity of prenylation of G
      protein gamma subunits.
AB  - A family of GTP-binding regulatory proteins (G proteins) transduces signals
      across the plasma membrane from a large number of receptors to a smaller number
      of effectors. Recent studies indicate that a series of post-translational
      modifications are required for their association with the plasma membrane and for
      their function. In the case of the G protein gamma subunits, the post
      translational modifications include the prenylation of a cysteine residue within
      a carboxyl-terminal CAAX motif. Although prenylation has been shown to involve
      the addition of either a C15 farnesyl or a C20 geranylgeranyl group to proteins,
      the structural requirements and functional consequences of adding different types
      of prenyl groups to various members of the gamma subunit family have not been
      examined. In the present study, we have employed the baculovirus expression
      system to study the structural requirements for attaching different types of
      prenyl groups to various members of the gamma subunit family. We show that the
      gamma 2 subunit is modified by a C20 geranylgeranyl group, consistent with the
      presence of a geranylgeranylation target sequence in this protein. However, we
      found that the gamma 1 and mutant gamma 2(Ser-71) subunits are modified by both
      C15 farnesyl and C20 geranylgeranyl groups, despite the presence of an accepted
      farnesylation target sequence in both of these proteins. Using chimeras of the
      gamma 1 and gamma 2 subunits, we provide evidence indicating that structural
      elements upstream of the carboxyl-terminal CAAX motif play a role in the
      recognition of members of the gamma subunit family by the appropriate insect and
      mammalian prenyltransferases.

PMID- 7782352
TI  - Induction of GADD153, a CCAAT/enhancer-binding protein (C/EBP)-related gene,
      during the acute phase response in rats. Evidence for the involvement of C/EBPs
      in regulating its expression.

PMID- 7782354
TI  - Prediction of progression of the curve in girls who have adolescent idiopathic
      scoliosis of moderate severity. Logistic regression analysis based on data from
      The Brace Study of the Scoliosis Research Society.
AB  - In a study conducted by the Scoliosis Research Society, 159 girls with a mean age
      of thirteen years (range, ten to fifteen years) who had adolescent idiopathic
      scoliosis were followed prospectively until skeletal maturity or until the curve
      had increased 6 degrees or more. All patients had had an initial curve of 25 to
      35 degrees and an apical level between the eighth thoracic and first lumbar
      vertebrae, inclusive. Of the 159 patients, 120 were observed without treatment
      and thirty-nine were managed with lateral electrical surface stimulation. The
      curve progressed at least 6 degrees in eighty patients. There was no apparent
      difference in the outcome between the patients who were managed with observation
      only and those who were given electrical stimulation. Logistic regression
      analysis was performed to determine which of eleven factors were predictive of
      progression of the scoliotic curve. A Risser sign of 0 or 1, an apical level
      cephalad to the twelfth thoracic vertebra, and an imbalance of ten millimeters or
      less were found to be independently prognostic of progression of more than 6
      degrees. A prognostic model that included these three factors and chronological
      age allowed correct classification of the curve as either progressive or non
      progressive in 81 per cent of these patients who had a thoracic or thoracolumbar
      adolescent idiopathic scoliosis. The positive predictive value was 82 per cent,
      the negative predictive value was 80 per cent, and the sensitivity and
      specificity were each 81 per cent.

PMID- 7782353
TI  - Effectiveness of treatment with a brace in girls who have adolescent idiopathic
      scoliosis. A prospective, controlled study based on data from the Brace Study of
      the Scoliosis Research Society.
AB  - In a prospective study by the Scoliosis Research Society, 286 girls who had
      adolescent idiopathic scoliosis, a thoracic or thoracolumbar curve of 25 to 35
      degrees, and a mean age of twelve years and seven months (range, ten to fifteen
      years) were followed to determine the effect of treatment with observation only
      (129 patients), an underarm plastic brace (111 patients), and nighttime surface
      electrical stimulation (forty-six patients). Thirty-nine patients were lost to
      follow-up, leaving 247 (86 per cent) who were followed until maturity or who were
      dropped from the study because of failure of the assigned treatment. The end
      point of failure of treatment was defined as an increase in the curve of at least
      6 degrees, from the time of the first roentgenogram, on two consecutive
      roentgenograms. As determined with use of this end point, treatment with a brace
      failed in seventeen of the 111 patients; observation only, in fifty-eight of the
      129 patients; and electrical stimulation, in twenty-two of the forty-six
      patients. According to survivorship analysis, treatment with a brace was
      associated with a success rate of 74 per cent (95 per cent confidence interval,
      52 to 84) at four years; observation only, with a success rate of 34 per cent (95
      per cent confidence interval, 16 to 49); and electrical stimulation, with a
      success rate of 33 per cent (95 per cent confidence interval, 12 to 60).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7782355
TI  - Hip arthroplasty in hemophilic arthropathy.
AB  - As hemophilic arthropathy infrequently affects the hip joint, we performed a
      multicenter retrospective study to determine the results of hip arthroplasty in
      hemophilic patients. Thirty-four hip arthroplasties were performed in twenty
      seven male patients at four major hemophilia centers from October 1972 through
      September 1990. Twenty-six patients had classic hemophilia and one had factor-IX
      deficiency. The mean age of the patients at the time of the operation was thirty
      eight years (range, fifteen to seventy-three years). The mean duration of follow
      up was eight years, with a minimum of two years for all patients who were still
      alive at the time of this review. Four patients were seropositive for the human
      immunodeficiency virus at the time of the operation, and sixteen patients were
      seropositive at the time of the most recent follow-up examination. Nine patients
      (33 per cent) died before the time of this review; seven had been seropositive
      for the human immunodeficiency virus. There were twenty-six total hip
      arthroplasties performed with cement, six total hip arthroplasties performed
      without cement, one total hip arthroplasty in which the femoral component was
      inserted with cement and the acetabular component was inserted without it (so
      called hybrid arthroplasty), and one bipolar arthroplasty performed with cement.
      There were no early infections after these thirty-four primary arthroplasties.
      There were three late infections around prostheses inserted with cement, and all
      led to a resection arthroplasty. Six (21 per cent) of the twenty-eight cemented
      femoral components and six (23 per cent) of the twenty-six cemented acetabular
      components were revised because of aseptic loosening.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7782356
TI  - Use of the Ilizarov technique for treatment of non-union of the tibia associated
      with infection.
AB  - Non-union of the tibia associated with infection was treated with radical
      resection of the necrotic bone and distraction osteogenesis in twenty-eight
      patients who were eighteen to seventy-four years old. Non-union, infection,
      shortening, deformity, and osteoporosis were all addressed simultaneously. All
      patients had either one-segment or two-segment lengthening of bone with a
      technique of bone transport in which a bone fragment is moved toward the site of
      non-union, leaving a defect that is bridged by distraction osteogenesis. The size
      of the bone defect that was bridged averaged six centimeters (range, two to
      thirteen centimeters). The infection was eradicated in all patients before the
      fixator was removed. The mean duration of treatment was ten months. The mean time
      to union, calculated from the day that the intercalary segment came into contact
      with the target segment, was six months. The mean duration of follow-up was
      thirty-nine months. The deformity and the inequality of the lengths of the legs
      were corrected successfully--to less than 7 degrees and to less than 2.5
      centimeters, respectively--in fourteen of the twenty-eight patients. In these
      fourteen patients, the bone result--determined according to the criteria of
      union, healing of the infection, status of the deformity, and amount of residual
      shortening--was considered excellent. Of the fourteen remaining patients, eight
      had a good bone result; one, a fair result; and five, a poor result. The
      functional result was excellent in seven patients, good in eleven, fair in four,
      and poor in five. One patient had an amputation. Three patients (11 per cent) had
      a problem with union that was treated with augmentation with a bone graft. One
      patient, who had sustained a refracture, had an amputation. Twenty-five patients
      (89 per cent) had a total of seventy-one minor or major complications, a rate of
      2.5 complications per patient.

PMID- 7782357
TI  - The tibiofibular syndesmosis. Evaluation of the ligamentous structures, methods
      of fixation, and radiographic assessment.
AB  - Twenty-five fresh-frozen cadaveric specimens were used to evaluate the role of
      the syndesmotic ligaments when the ankle is loaded with external rotation torque.
      An apparatus was constructed that allowed pure external-rotation torque to be
      applied through the ankle with the foot in neutral flexion. The apparatus
      provided solid fixation of the tibia while allowing free movement of the fibula
      in all planes. The syndesmotic ligaments were incrementally sectioned, and direct
      measurements of anatomical diastasis were made. Mortise and lateral radiographs
      were made at each increment under both loaded (5.0 newton-meters) and unloaded
      conditions. After all structures of the syndesmosis had been divided, the
      syndesmosis was reduced and was repaired with one or two screws. The strength of
      the repair was measured with incremental increases in torque of 1.0 newton-meter.
      The radiographs were measured by three independent observers in a blind fashion.
      In order to evaluate intraobserver error, each observer was randomly given forty
      radiographs to reinterpret. Diastasis and rotation were found to be related to
      the amount of injury of the ligament (p < 0.0001). After the entire syndesmosis
      had been divided, application of a 5.0-newton-meter torque resulted in a mean
      diastasis of 7.3 millimeters. The subsequent repair of the anterior tibiofibular
      ligament with suture failed at a mean of 2.0 newton-meters (range, 1.0 to 6.0
      newton-meters) of torque. Repair with two screws was found to be stronger than
      repair with one, with the first construct failing at a mean of 11.0 newton-meters
      (range, 5.0 to 15.0 newton-meters) and the second, at a mean of 6.2 newton-meters
      (range, 2.0 to 10.0 newton-meters) (p = 0.0005). Failure of the screw fixation
      was not associated with the maximum previous diastasis (p = 0.13). Measurements
      of anatomical diastasis were compared with measurements made on the mortise and
      lateral radiographs. Measurements on the stress mortise radiographs had a weak
      correlation with diastasis (r = 0.41, p < 0.0001). However, measurements on the
      stress lateral radiographs had a higher correlation (r = 0.81, p < 0.0001).
      Additionally, interobserver correlation was significantly higher for the
      measurements on the lateral radiographs (r = 0.87, p < 0.0001) than for those on
      the mortise radiographs (r = 0.56, p < 0.0001). Intraobserver correlation for the
      three observers was poor with regard to the measurements on the mortise
      radiographs (r = 0.12, 0.42, and 0.25). The respective correlations for the
      measurements on the lateral radiographs were r = 0.81, 0.90, and 0.89.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 7782358
TI  - Debridement of degenerative, irreparable lesions of the rotator cuff.
AB  - A modified Neer acromioplasty, subacromial decompression, and debridement of
      massive, irreparable lesions of the supraspinatus and infraspinatus tendons was
      performed in fifty-seven patients. Fifty patients (fifty-three shoulders) were
      followed for an average of six and one-half years. The average age of the
      patients was sixty years (range, thirty-eight to seventy-four years). The
      results, as rated on the basis of pain, function, range of motion, strength, and
      satisfaction of the patient, were satisfactory in forty-four shoulders (83 per
      cent) and unsatisfactory in nine (17 per cent). A favorable outcome was observed
      in shoulders in which both the anterior portion of the deltoid muscle and the
      long head of the biceps tendon were intact and in which a previous
      acromioplasties or operations on the rotator cuff had been performed. An
      unsatisfactory outcome was observed in shoulders in which the anterior part of
      the deltoid muscle was weak or absent or in which a previous acromioplasty and
      attempted repair of the rotator cuff had been performed. The active forward
      flexion of the shoulder improved from an average of 105 degrees preoperatively to
      an average of 140 degrees postoperatively. The results of the present study
      suggest that, with proper rehabilitation, adequate decompression of the
      subacromial space, anterior acromioplasty, and debridement of massive tears of
      the rotator cuff can lead to the relief of pain and the restoration of shoulder
      function.

PMID- 7782359
TI  - The thoracolumbar spine in Marfan syndrome.
AB  - We analyzed the prevalence, inheritance, progression, and functional implications
      of spinal deformity in Marfan syndrome using four different groups of patients.
      We studied 113 patients who had Marfan syndrome, eighty-two of whom were
      skeletally immature, in order to characterize the alignment and function of the
      spine. The patients were selected from a clinic that provides total care with no
      bias toward the presence of orthopaedic conditions. Scoliosis was identified in
      fifty-two of the eighty-two patients, and the prevalences for the sexes were
      equal. The thoracic portion of the curve was convex to the right in all but two
      patients. The mean kyphosis was greater than that in the general population. Five
      distinct sagittal profiles were identified on the basis of whether the thoracic
      kyphosis was within, greater than, or less than normal limits and whether the
      transition between the kyphosis and lordosis occurred at or caudad to the normal
      level or whether the curves were reversed. Spondylolisthesis was present in five
      patients (6 per cent), with a mean slip of 30 per cent. Fourteen pedigrees were
      studied in depth. There was no familial pattern of the scoliosis. A separate
      group of fifty-six patients with scoliosis, for whom serial follow-up radiographs
      were available, was studied for progression. Patients who had a curve of more
      than 30 degrees had mild progression, and those who had a curve of more than 50
      degrees had marked progression (mean, 3 +/- 4 degrees per year). Pain and
      function of the back were studied in thirty patients who were thirty-five to
      forty-five years old; these patients were found to be more impaired than matched
      controls. The presence of scoliosis was associated with pain in the region of the
      curve in these patients.

PMID- 7782360
TI  - Rate of degeneration of human acetabular cartilage after hemiarthroplasty.
AB  - Biopsy specimens of cartilage and subchondral bone were obtained from the weight
      bearing dome of the acetabulum in twelve elderly patients who were having a
      revision of a hemiarthroplasty of the hip because of pain. Biopsy specimens of
      acetabular cartilage and subchondral bone were also obtained from eight patients
      of comparable age who were having a primary hemiarthroplasty for a displaced
      fracture of the femoral neck; these served as the control specimens. The
      specimens were stained with hematoxylin and eosin for the initial histological
      assessment of cartilage structure and cellularity as well as the integrity of the
      tidemark. Safranin-O and toluidine-blue stains were used to assess proteoglycan
      content. A histological grading scale was employed for comparative analysis of
      samples. The joint space of the hip was measured on the radiographs that were
      made before the revision and was correlated with the histological grade. Review
      of the histological specimens demonstrated considerable degeneration of
      acetabular cartilage in the patients who were having a revision of a
      hemiarthroplasty as compared with that in the age-matched control patients who
      were having a primary hemiarthroplasty. The progression in the severity of the
      degeneration correlated directly with the duration of articulation of the implant
      with the acetabulum. All six of the patients in whom the implant had been in situ
      for more than five years, and in whom the femoral stem was determined to be
      stable at the operation, had nearly complete loss of cartilage as seen on
      histological examination.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782361
TI  - Non-union of the scaphoid. Revascularization of the proximal pole with
      implantation of a vascular bundle and bone-grafting.
AB  - Eleven patients who had an ununited fracture of the scaphoid associated with loss
      of the blood supply to the proximal fragment were managed operatively with a
      combination of an inlay corticocancellous bone graft from the iliac crest and
      implantation of the second dorsal intermetacarpal artery, its accompanying venae
      comitantes, and a thin cuff of perivascular tissue. The absence of the blood
      supply to the proximal pole was evidenced both by radiographic changes--which
      included increased bone density, absence of normal trabeculae, and cystic changes
      -and by failure to observe bleeding bone during the operation. There were ten men
      and one woman. The average duration of non-union was fourteen months (range, six
      to thirty-three months). Six patients had had previous unsuccessful operative
      attempts to obtain union. Eight non-unions were in the proximal one-third and
      three, at the waist of the scaphoid. Union was achieved in ten patients at an
      average of ten weeks postoperatively. According to the wrist-scoring system of
      the Mayo Clinic, at an average of five years (range, 2.5 to eleven years), three
      patients had a grade of excellent; three, good; three, fair; and two, poor. Four
      patients had subsequent reconstructive procedures; radial styloidectomy,
      styloidectomy and resection of osteophytes, radioscapholunate arthrodesis, and
      total wrist arthrodesis were performed in one patient each.

PMID- 7782362
TI  - Operative treatment of malunited fractures of the forearm.
AB  - We conducted a retrospective review of the results of twenty-seven consecutive
      osteotomies for malunited fractures of the forearm performed at the Mayo Clinic
      from 1976 to 1991. There were seventeen male patients and ten female patients who
      were an average of nineteen years old (range, nine to forty-one years old) at the
      time of the osteotomy. The corrective osteotomy was performed an average of
      seventy-three months (range, two to 324 months) after the fracture. The
      indication for the procedure was functional loss of motion (average arc of
      pronation-supination, 74 degrees; range, 20 to 120 degrees) in twenty patients,
      an unstable and painful distal radioulnar joint in six, and an unacceptable
      appearance of the forearm in one. Twenty patients had a corrective osteotomy of
      the radius; two, of the ulna; and five, of both bones. Of the twenty patients who
      had a corrective osteotomy for loss of motion of the forearm, nine were managed
      within twelve months after the initial injury and eleven were managed more than
      twelve months afterward. The patients who were managed early gained an average of
      79 degrees (range, 20 to 160 degrees) of rotation after the osteotomy. Those who
      were managed late gained an average of only 30 degrees (range, -25 to 95
      degrees). A pain-free, stable wrist was achieved in three of the six patients who
      were managed for an unstable and painful distal radio-ulnar joint. However, these
      six patients lost an average of 7 degrees (range, -25 to 25 degrees) of rotation
      of the forearm.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782364
TI  - Mechanical consequences of bone ingrowth in a hip prosthesis inserted without
      cement.
AB  - Long-term biomechanical problems associated with the use of sintered porous
      coating on prosthetic femoral stems inserted without cement include proximal loss
      of bone and a risk of fatigue fracture of the prosthesis. We sought to identify
      groups of patients in whom these problems are accentuated and in whom the use of
      porous coating may thus jeopardize the success of the arthroplasty. We attempted
      to develop clinical guidelines for the use of sintered porous coating by
      investigating the long-term biomechanical effects of bone growth into partially
      (two-thirds) porous-coated anatomic medullary locking hip prostheses that fit
      well. More specifically, we used a detailed finite element analysis and a
      composite beam theory to determine the dependence of proximal loading of the bone
      and maximum stresses on the stem on the development of clinically observed
      patterns of bone ingrowth and the dependence of the risk of fatigue fracture of
      the stem on the diameter of the stem, the diameter of the periosteal bone, and
      the material from which the prosthesis was made. We found that bone ingrowth per
      se substantially reduced proximal loading of the bone. With typical bone
      ingrowth, axial and torsional loads acting on the proximal end of the bone were
      reduced aa much as twofold compared with when there was no ingrowth; bending
      loads on the proximal end of the bone were also reduced. The risk of fatigue
      fracture of the stem was insensitive to the development of bone ingrowth.
      However, the risk of fatigue fracture of the stem increased with decreased
      diameters of the stem and the periosteal bone and with increased modulus of the
      stem. The maximum risk of fracture was found in active patients in whom a cobalt
      chromium-alloy stem with a small diameter had been implanted in a bone with a
      small diameter.

PMID- 7782366
TI  - Prostaglandin-induced cortical hyperostosis. Case report and review of the
      literature.

PMID- 7782365
TI  - Treatment of supracondylar fractures of the femur proximal to a total knee
      arthroplasty. A report of four cases.

PMID- 7782363
TI  - Evaluation of bone ingrowth in proximally and extensively porous-coated anatomic
      medullary locking prostheses retrieved at autopsy.
AB  - Three proximally (40 per cent) and five extensively (80 per cent) porous-coated
      anatomic medullary locking femoral components were retrieved from seven cadavera
      at autopsy. Each component (with the surrounding, intact femur), was sectioned
      transversely at one-centimeter intervals. Backscattered scanning electron
      microscopy was used to evaluate circumferentially the interface between the bone
      and the porous surface of each section. Bone ingrowth was considered to be
      present within a field when bone was in contact with the outermost layer of the
      sintered beads, it was detected within the porous space, and it had penetrated
      the porous space to a depth of at least one bead diameter. All eight components
      had some bone growth into the porous space. A mean of 35 per cent of the surface
      of the implants had bone ingrowth. In the areas where bone was present, 67 per
      cent of the available porous space on the extensively coated stems and 74 per
      cent on the proximally coated stems contained bone. With both types of implants,
      the greatest amount of compact bone ingrowth was found at the level where the
      porous coating ended. Transverse sections obtained at this level frequently
      demonstrated that bone ingrowth had occurred circumferentially and that the
      ingrowth was continuous with and an integral part of the femoral cortex. These
      direct connections to the cortex could be predicted from the appearance of the
      radiographs. In the most proximal transverse sections of both types of implants,
      bone was most frequently connected to the medial side and corners of the
      implant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782367
TI  - Methemoglobinemia: a complication after fiberoptic orotracheal intubation with
      benzocaine spray. A case report.

PMID- 7782369
TI  - The importance of the posterior oblique ligament in repairs of acute tears of the
      medial ligaments in knees with and without an associated rupture of the anterior
      cruciate ligament. Results of long-term follow-up.

PMID- 7782368
TI  - Enhancement of fracture-healing.

PMID- 7782370
TI  - The importance of the posterior oblique ligament in repairs of acute tears of the
      medial ligaments in knees with and without an associated rupture of the anterior
      cruciate ligament. Results of long-term follow-up.

PMID- 7782371
TI  - Issues related to clinical pathways: managed care, implementation, and liability.

PMID- 7782372
TI  - Critical pathways: what they are and what they are not.

PMID- 7782373
TI  - Steps to pathway development.

PMID- 7782376
TI  - Utilizing critical pathways to facilitate continued quality improvement.

PMID- 7782375
TI  - Development of burn outcomes and quality indicators. A project of the ABA
      Committee on Organization and Delivery of Burn Care.

PMID- 7782374
TI  - Designing tools for pathway implementation and evaluation.

PMID- 7782377
TI  - Utilization of critical pathways to facilitate clinical care.

PMID- 7782378
TI  - Utilization of critical pathways in education.

PMID- 7782379
TI  - Critical pathways in research.

PMID- 7782380
TI  - [Laparoscopic surgery: injuries caused by trocars. (French Survey 1994) in
      reference to 103,852 interventions].
AB  - In a French retrospective survey including 103,852 laparoscopic procedure, and
      390,000 port-insertion, trocar injuries rate have been evaluated. Mortality is
      0.07 per thousand, quite exclusively in relation with vascular injuries
      (especially from aorta and iliac vessels) with a rate of 0.4 per thousand. All
      intra-abdominal viscera and vessels must be injured by the first blind trocar
      insertion. Open laparoscopy is systematically proposed to prevent these
      accidents.

PMID- 7782381
TI  - [Left single-lobe Caroli disease discovered during intraoperative
      cholecystography ... or how a routine cholecystectomy can lead to left
      hepatectomy].
AB  - The authors report a case of single-lobe Caroli's disease discovered at the
      radiologic exploration during a laparoscopic cholecystectomy leading to a left
      hepatic lobectomy 2.5 months later. Localized dilatation of the intrahepatic bile
      ducts are infrequent. They may be associated with others pathological conditions
      such as cystic dilatation of the extrahepatic bile-ducts, congenital hepatic
      fibrosis of the liver or renal pathology. Hepatic resection is the logical
      treatment of such localized lesions, but it may have an excessive risk in case of
      association with a congenital hepatic fibrosis of the liver. The authors insist
      about the necessity of radiographic exploration during every biliary surgical
      approach, even with laparoscopic technic.

PMID- 7782382
TI  - [Retro-duodenal papillary perforation after endoscopic sphincterotomy. Role of
      surgical treatment by exclusion of the duodenum. Apropos of 3 cases].
AB  - Among the complications of endoscopic sphincterotomy whose rate is about 10% of
      cases, the retroduodenal papillary perforation represents about 1% of cases. The
      diagnosis lies on radiological examination which may show during the
      sphincterotomy the extravasation of the contrast fluid used for the retrograde
      cholangiography; it can be suggested by the presence of clinical signs of
      retroperitoneal sepsis or peritonitis. The treatment depends on the severity or
      peritonitis. The treatment depends on the severity of the clinical
      symptomatology; it is generally a medical treatment associating nasogastric
      aspiration and antibiotherapy, and more rarely a surgical one. There is no
      consensus concerning surgical modalities. We report 3 cases of retroduodenal
      papillary perforation treated surgical by a duodenal exclusion aiming to
      transform a complex fistula in a bilio-pancreatic fistula which can be more
      easily managed by somatostatine-like drugs.

PMID- 7782383
TI  - [Hospital procedures and surgical management of patients with stab wounds to the
      heart].
AB  - Stab wounds of the heart are frequent: one case every two and a half months in
      our service. In our series of 9 cases, only three were alive at arrival to the
      emergency ward, but in all of these three, treatment was simple requiring only
      simple wound suture without extra-corporeal circulation. Based on our experience
      and the data in the literature, we propose cooperation between three teams for
      managing these patients: anaesthesists, echocardiographists and cardiothoracic
      surgeons. The patients are admitted directly to the cardiothoracic operating
      theatre where the echocardiographist and the surgery team take charge. The
      surgical procedure depends on the general situation and especially on whether or
      not the echocardiologist can confirm haemopericardium immediately. Every patient
      with possible wound to the heart or major vessels should be managed directly by
      the cardiothoracic surgery team before of formal diagnosis has been established.

PMID- 7782384
TI  - [Ureteral trauma during surgery for aneurysm of the subrenal abdominal aorta.
      Apropos of 2 complete sections discovered postoperatively].
AB  - The lombo-iliac ureter is particularly exposed in surgery of the aorta,
      particularly for bypass surgery and cure of aneurysms. Two recent cases of
      complete section of the ureter were discovered post-operatively. Endo-urologic
      techniques offer a promising means of protecting the upper urinary tract in these
      procedures. Percutaneous nephrostomy and ureteral catheterism have also been
      discussed as have been ureteral endoprosthesis and double J ureteroscopy.

PMID- 7782385
TI  - [Cancer of the breast in men. Apropos of 50 cases].
AB  - Breast cancer, rarely encountered in men, accounts for 0.2 to 1.5% of the cancer
      morbidity in men and 1 to 5.7% of all breast cancers. The aim of this work is to
      analyse the different epidemiological, therapeutic and outcome features of this
      disease in men using a retrospective multicentric approach to 50 cases reported
      in Casablanca from 1980 to 1992. The mean age of the patients was 60.6 years. No
      significant risk factor was found. The mean delay to consultation was 22.5
      months. Diagnosis was made at an advanced stage as, the tumour was located behind
      the nipple in 98% of the cases and ulcerated in 52%. Laterality was almost
      identical. Invasive galactophoric adenocarcinoma was found in 86% of the cases.
      Treatment was usually Patey mastectomy with positive nodes in 84%. Complementary
      treatment included radiotherapy in 60%, chemotherapy in 36% and hormonotherapy in
      1 case. Recurrence was observed in 71% of the patients who has achieved complete
      remission. Surviceal in evaluable cases was 59 and 25% at 2 and 5 years
      respectively. The results in this series was less satisfactory that it is
      generally reported in the literature which suggests the need for better
      codification and management.

PMID- 7782386
TI  - [Stenosis of the rectum secondary to an invasive adenocarcinoma of the prostate.
      Apropos of 3 cases].
AB  - There exist rare cases in which a prostatic carcinoma invades the perirectal
      space producing an extrinsic rectal stenosis. Three cases are discussed.
      Differential diagnosis with a rectal tumor is difficult clinically, but
      endorectal ultrasound and deep rectal biopsies must provide the correct diagnosis
      in most cases. Hormonotherapy is recommended, but prognosis is reserved.

PMID- 7782387
TI  - [Evaluation and treatment of closed traumas of the kidney].
AB  - On the basis of a series of fifty-one blunt renal injuries and a review of
      literature, the characteristics of this affection are reviewed. This trauma
      typically occurs in young adults. Minor injuries are the most frequent (75.5
      percent) and associated lesions are not rare. Computed tomography is the imaging
      technique of choice for renal trauma assessment. It can, sometimes, be replaced
      by urography-ultrasonography couple. Indications of these imaging modalities are
      reviewed. A classification in four types, adapted to new imaging methods, is
      proposed to harmonize or to compare therapeutic indications. The different
      therapeutic methods, their indications and their particularities are studied and
      a simple decisional strategy is proposed.

PMID- 7782388
TI  - [Rare association of a non-functional retroperitoneal paraganglioma and nephrotic
      syndrome].
AB  - Non functional retroperitoneal paragangliomas are rare: less than 50 cases in
      literature. They are usually asymptomatic and can attain reasonable dimensions.
      The association with nephrotic syndrome is exceptional. The authors report a
      clinical observation of non-functional paraganglioma in a 45 year old woman, with
      repeated surgical abstention. Literature was reviewed and therapeutic indications
      discussed.

PMID- 7782389
TI  - [Degenerative colorectal polyps].
AB  - In 23 patients with malignant colorectal polyps we reviewed the frequency of
      recurrence. In the group without subsequent local resection, 8 of 11 patients
      were without recurrent tumour after 2.7 (0.8-4.1) years, in the group with
      subsequent local or conventional colon resection, 10 of 12 patients after 5.3
      (0.8-9.0) years. None of the patients showed any evidence of residual tumour or
      lymph node metastasis. All recurrent tumours (2 x carcinoma, 3 x benign polyps)
      could be resected curatively. There was no difference in recurrence in both
      groups. For safe histopathological examination of malignant colorectal polypi in
      respect of depth of invasion, free resection margins and lymphatic vessel
      invasion, intraoperative fixation and marking must be performed, since local
      recurrence was seen after more than 5 years, long-term follow up is necessary.

PMID- 7782390
TI  - [Evolution of the legal concept of surgical responsibility].

PMID- 7782391
TI  - Chest pain and ST-segment elevation.

PMID- 7782392
TI  - Aggressive volume expansion and pseudo-ARDS.

PMID- 7782393
TI  - Case in point. Systemic amyloidosis.

PMID- 7782394
TI  - Managing the difficult patient.

PMID- 7782395
TI  - Smoking cessation: lights out.

PMID- 7782396
TI  - Jaundice and massive abdominal lymphadenopathy.

PMID- 7782397
TI  - Angioplasty in acute myocardial infarction.
AB  - The results of early trials indicate that angioplasty during the first hours
      after MI onset has a lower incidence of reinfarction, intracranial hemorrhage,
      and death than does thrombolysis. In fact, results have been so good that the
      procedure has been approved for use in hospitals that do not have coronary bypass
      backup programs. Is angioplasty about to become the intervention of choice in
      acute MI?

PMID- 7782398
TI  - Islet cell transplantation for insulin-dependent diabetes.
AB  - About 20 years after investigators began work on the isolation of animal islets,
      we are now poised to use such cells to control blood sugar levels in humans.
      Studies in various laboratories have led to development of transplantation
      techniques that obviate the need for chronic immunosuppression; equally
      important, the techniques also appear to avoid the problem of graft rejection.

PMID- 7782399
TI  - Abdominal pain in a diabetic woman.

PMID- 7782400
TI  - Recognition and management of occult alcohol withdrawal.
AB  - Many patients experience withdrawal because an acute illness has interrupted
      their usual alcohol intake. Medical and psychiatric complications of alcoholism
      may also coexist with withdrawal. Several findings predict the likelihood of
      seizures of delirium tremens and thus are useful in making initial treatment
      decisions.

PMID- 7782402
TI  - Annotation: long-term outcomes of developmental reading problems.

PMID- 7782401
TI  - Managing medication in the elderly.
AB  - The elderly receive 30% of all prescriptions and buy 40% of all OTC drugs. In
      addition to the potential pitfalls inherent to age-related changes in
      bioavailability and clearance, there are less well-known hazards in prescribing
      for the aged. Many drugs, for example, have powerful anticholinergic properties,
      and a generic agent may differ markedly from both the brand drug and another
      generic version.

PMID- 7782403
TI  - Practitioner review: verbal working memory development and its disorders.
AB  - Working memory refers to the systems responsible for the temporary storage and
      manipulation of information during the performance of cognitive tasks. There is a
      good deal of evidence that verbal short-term memory functions as a working memory
      system. We review advances in our understanding of the nature and limitations of
      verbal short-term memory and the reasons for its development with age, and go on
      to consider the common association between impairments of verbal short-term
      memory and other impairments of cognitive development. We conclude by considering
      the relationship between short-term memory development and cognitive development.

PMID- 7782404
TI  - A comparison of phonological skills in children with reading comprehension
      difficulties and children with decoding difficulties.
AB  - This paper examines phonological skills in children with two distinct forms of
      reading difficulty: comprehension problems and decoding problems. In the first
      study a group of children with normal decoding skills but poor reading
      comprehension skills was studied. These children were found to have age
      appropriate phonological skills. It is argued that normal phonological skills
      have enabled them to develop proficient decoding skills. A second study assessed
      the phonological skills of a group of children with decoding difficulties. These
      children showed marked deficits on tests of phonological skills. It appears that
      weak phonological skills underlie these children's decoding difficulties.

PMID- 7782405
TI  - The impact of child IQ, parent IQ and sibling IQ on child behavioural deviance
      scores.
AB  - In an epidemiological sample of 411 13-year-old twins of normal intelligence,
      both parents and teachers reported more behavioural problems among children with
      lower IQs. This was not attributable to the effects of parental IQ or social
      class and was not entirely mediated by lower scholastic attainments. Different
      causal models are discussed: "rater bias" and "IQ is a consequence" explanations
      seem less plausible than "IQ is a cause" and "IQ is a marker" explanations.
      Higher parental IQ was associated with more emotional symptoms in the child, both
      by parental and school report. There was no evidence that being brighter or less
      bright than a (twin) sibling influenced behavioural deviance, casting doubt on
      the importance of contrast effects.

PMID- 7782406
TI  - The significance of self-reported anxious symptoms in first grade children:
      prediction to anxious symptoms and adaptive functioning in fifth grade.
AB  - In an earlier study of an epidemiologically defined sample of first grade
      children, primarily between the ages of 5 and 6, self-reported anxious symptoms
      proved relatively stable and were significantly related to adaptive functioning.
      In the present study we follow that cohort of first graders longitudinally and
      assess the prognostic value of self-reports of anxious symptoms in first grade
      with respect to anxious symptoms and adaptive functioning in the late elementary
      school years or at about age 10. First grade anxious symptoms were found to have
      significant prognostic value in terms of levels of anxious symptoms and adaptive
      functioning in fifth grade.

PMID- 7782407
TI  - Are anxiety symptoms in childhood heritable?
AB  - Although childhood anxiety appears to aggregate in families, transmission could
      be explained by both genetic and shared environmental factors. Twin studies can
      be used to disentangle genetic and environmental effects. In this study, a
      systematically ascertained sample of twins was used to investigate whether
      anxiety symptoms are heritable. Parent-rated anxiety symptoms could best be
      explained by an additive genetic model with heritability estimated at 59%.
      However, when self ratings were analysed (in the adolescent subsample), familial
      transmission could be accounted for by shared environmental factors only.

PMID- 7782408
TI  - A twin-singleton comparison of problem behaviour in 2-3-year-olds.
AB  - Twin-singleton differences in problem behaviours in 2-3-year-olds were studied.
      Maternal ratings of children's problem behaviours were obtained with the CBCL/2
      3. The twin sample consisted of 1363 twin pairs (456 MZ, 907 DZ), the sample of
      singletons consisted of 420 children from the general population. Results
      indicated that the general level of problem behaviours in twins was broadly
      comparable to that in singletons. Four of the seven syndromes showed lower scores
      for twins. These differences, however, were small and mainly caused by lower
      scores for DZ twins in comparison to MZ twins and singletons. Part of the
      difference could be attributed to the higher maternal age in the twin groups.
      Higher means for boys were found for the total problem score, and the Aggressive
      and Overactive syndromes.

PMID- 7782409
TI  - Deafness, conversation and theory of mind.
AB  - The child's developing theory of the mind as an interconnected network of
      beliefs, desires and feelings that govern behaviour provides a cornerstone for
      social and intellectual life. Recent research has suggested that autistic
      children have difficulty acquiring such a theory. Although it is speculated that
      a specific neurological deficit may be responsible for autistic children's
      difficulties on false belief tasks devised to test a theory of mind, these may
      also be due to a lack of exposure to conversation about mental states. In this
      study we explored the development of a theory of mind in a group of 26 signing,
      prelingually-deaf Australian children of normal intelligence, aged 8-13 years.
      Results revealed that 65% of these deaf children failed a simple test of false
      belief which normal preschoolers, mentally retarded children, and other
      handicapped groups--apart from children with autism--routinely pass at a mental
      age of 4-5 years. No significant difference emerged between deaf children's
      performance and that of autistic children tested on the same task in previous
      research. We discuss the results in terms of a conversational account of the
      development of a theory of mind in deaf children, and the extent to which this
      account is applicable to children with autism.

PMID- 7782410
TI  - Emotional role-taking abilities of children with a pervasive developmental
      disorder not otherwise specified.
AB  - Seven to 12-year-old children with a Pervasive Developmental Disorder Not
      Otherwise Specified (PDDNOS) were compared with normal, healthy children of the
      same age and sex on three different emotional role-taking tasks. In these tasks,
      children had to use person-specific information to make an inference about
      another child's emotional reaction and behaviour, Significant differences were
      found between the PDDNOS group and control group: PDDNOS children performed worse
      on all three role-taking tasks. However, the differences on one of these tasks
      could be completely explained by intelligence differences between the two groups.
      On the other tasks, differences could not or be partially explained by
      intelligence differences. The results of this study led to the formulation of a
      more specific hypothesis, namely that PDDNOS children might have problems
      interpreting social information when affectively charged background information
      has to be used.

PMID- 7782411
TI  - Contributing factors in the manifestation of aggression in preschoolers with
      hyperactivity.
AB  - This study examined family characteristics of preschoolers with hyperactivity. We
      assessed child-rearing practices, maternal depression, marital conflict, and
      social support. Sixty-three preschool boys were placed in a hyperactivity
      aggressive, hyperactive, aggressive or comparison group based on behavioral
      ratings. Parents were given questionnaires, mothers were interviewed, and
      children were administered the Woodcock-Johnson Psycho-Educational Battery and
      were observed playing. Compared to preschoolers with hyperactivity, preschoolers
      with hyperactivity plus aggression had families with (a) more restrictive
      fathers, (b) siblings who retaliated aggressively, and (c) mothers who reported
      more physical aggression directed to their partners and more verbal aggression
      received. Follow-forward aggression ratings were predicted by initial child
      manageability and maternal depression, perceived support, and low income.

PMID- 7782412
TI  - The sex ratios of families with a neurodevelopmentally disordered child.
AB  - It has been conjectured that mothers who give birth to neurodevelopmentally
      disordered (ND) children may have hormonal or immunological characteristics that
      bias them toward giving birth to male children. We examined this hypothesis in an
      epidemiological sample of 2,080 ND children drawn for the National Collaborative
      Perinatal Project (NCPP) who had one of nine kinds of NDs. No assumptions were
      made regarding the sex ratio of non-ND children since this could be computed from
      NCPP data for 11,213 families. The sex ratio of families with ND children was not
      significantly biased toward boys as compared to the sex ratio of families with
      non-ND children, provided that the index ND child was excluded from the analysis.

PMID- 7782413
TI  - ICSI and severe male-factor infertility: breaking the sperm tail prior to
      injection.

PMID- 7782414
TI  - Intracytoplasmic injection of testicular and epididymal spermatozoa for treatment
      of obstructive azoospermia.

PMID- 7782415
TI  - The R.A.P.R.U.I. Center experience: from SUZI, through lasers to ICSI using
      spermatozoa with broken tails.

PMID- 7782416
TI  - ICSI of unfertilized oocytes after IVF insemination: are the traditional markers
      of fertilization adequate?

PMID- 7782418
TI  - Systematic examination of immobilizing spermatozoa before intracytoplasmic sperm
      injection in the human.

PMID- 7782417
TI  - Intracytoplasmic sperm injection versus high insemination concentration in-vitro
      fertilization in cases of very severe teratozoospermia.

PMID- 7782419
TI  - Autoreproduction by hermaphrodites.

PMID- 7782420
TI  - Fertilization of an oocyte microinseminated with a spermatid in an in-vitro
      fertilization programme.

PMID- 7782421
TI  - What forms of male infertility are there left to cure?

PMID- 7782422
TI  - Human tubal fluid: formation and composition during vascular perfusion of the
      fallopian tube.
AB  - A vascularly perfused preparation of the Fallopian tube has been developed as a
      model to study the formation and composition of human tubal fluid. An artery
      serving the tube was cannulated and perfused at a rate of 0.7 ml/min for 1 h with
      Medium 199 supplemented with bovine serum albumin, heparin and antibiotics. A
      cannula was also inserted into the lumen. Light and scanning electron micrographs
      of control and perfused tubes showed that the epithelial lining was intact after
      perfusion. Tubal fluid was collected in 13 out of 19 experiments. Fluid could
      always be collected from patients who were in the follicular phase of their
      ovarian cycle. The mean rate of appearance was 48 microliters/h. The glucose,
      lactate and pyruvate concentrations in the tubal fluid, as assessed by
      fluorescence microanalysis, were 0.53, 8.58 and 0.17 mM respectively. There were
      no correlations between metabolite concentration and the length of perfusion,
      cannulation time, patient's age or condition. This technique provides a
      controlled method with which to access and examine human tubal fluid and will
      allow the physiology of both healthy and diseased tubes to be studied.

PMID- 7782423
TI  - The effect of pre-treatment with a gonadotrophin-releasing hormone agonist on
      reproductive functions in mature cycling rats.
AB  - In order to investigate the performance of follicles in a rat model in which
      gonadotrophin-releasing hormone agonist (GnRHa) was used for hypothalamic
      pituitary-ovarian axis suppression, three groups of mature cycling rats were
      studied. One group was treated with buserelin followed by pregnant mare's serum
      gonadotrophin (PMSG), and the second group was treated with PMSG alone. Both
      these hormonally treated groups received human chorionic gonadotropin for
      induction of ovulation. The third group received no hormonal treatment. The
      average number of ovulated oocytes recovered from rat oviducts pre-treated with
      GnRHa was significantly higher than that in rats treated with the gonadotrophin
      alone, in spite of the larger number of pre-ovulatory follicles present in the
      gonadotrophin-treated group. The morphology of both the pre-ovulatory and the
      post-ovulatory cumulus-oocyte complexes in the three groups appeared similar. No
      difference in the capacity of follicles of the three groups to synthesize
      progesterone in vitro in response to luteinizing hormone could be observed. We
      conclude that ovarian morphology and function are not impaired by pre-treatment
      with buserelin.

PMID- 7782424
TI  - Ultrasonographic appearance of polycystic ovaries is associated with exaggerated
      ovarian androgen and oestradiol responses to gonadotrophin-releasing hormone
      agonist in women undergoing assisted reproduction treatment.
AB  - While no single biochemical test is diagnostic of polycystic ovary syndrome
      (PCOS), most patients show a characteristic ovarian ultrasonographic appearance.
      It has been proposed that a dysfunction of cytochrome P-450c17 alpha in PCOS
      leads to an increased 17-hydroxyprogesterone (17-OHP) response to a gonadotrophin
      releasing hormone (GnRH) agonist-induced gonadotrophin rise. We postulated that
      this abnormality of steroid metabolism might influence the ovarian response
      during assisted reproduction treatment. We investigated 106 patients undergoing a
      short 'boost' stimulation regimen for assisted reproduction treatment, including
      in-vitro fertilization and gamete intra-Fallopian transfers. The ovarian
      ultrasound pattern was correlated with serum testosterone, 17-OHP,
      androstenedione and oestradiol responses, and with the clinical outcome.
      Polycystic ovaries, defined ultrasonographically as the presence of > or = 10
      follicles between 2 and 10 mm diameter in either ovary, were found in 48% of the
      whole study population. Dexamethasone was given to suppress adrenal androgen
      secretion. Functional ovarian hyperandrogenism (FOH) was defined as serum
      testosterone > 0.5 nmol/l after dexamethasone. There was a significantly (P <
      0.001) higher prevalence of FOH in patients with polycystic ovaries (23%)
      compared with normal ovaries (7%). Patients with polycystic ovaries had
      approximately double the 17-OHP, androstenedione and oestradiol responses to a
      GnRH agonist as patients with non-polycystic ovaries. Exaggerated 17-OHP and
      oestradiol responses to GnRH agonist were found in 89% of patients with
      clinically diagnosed PCOS. The number of oocytes retrieved was positively
      correlated (r = 0.51, P < 0.001) with the oestradiol responses in all
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782426
TI  - Isolated polycystic morphology in ovum donors predicts response to ovarian
      stimulation.
AB  - The isolated finding of polycystic-appearing ovaries on ultrasound examination of
      normal women is not uncommon. The purpose of this study was to determine the
      clinical significance of polycystic ovaries in a population of healthy, non
      hirsute, fertile women preparing to undergo ovarian stimulation. We evaluated
      whether the finding of polycystic ovaries in oocyte donors predicts a different
      response to ovarian stimulation when compared to donors with normal-appearing
      ovaries. Furthermore, we examined whether oocytes from polycystic ovaries had the
      same capacity for fertilization and development as those retrieved from normal
      ovaries. In all, 11 donors with polycystic-appearing ovaries were compared
      prospectively to 13 donors with normal-appearing ovaries who were undergoing
      ovarian stimulation during the same time interval. The two groups were similar in
      age and baseline androgen concentrations. Significantly more oocytes were
      produced by the polycystic group for the amount of human menopausal gonadotrophin
      (HMG) administered (P < 0.05). In addition, all previous cycles completed by
      these 24 donors were compared (polycystic group: total of 31 cycles; normal
      group: total of 37 cycles). The donors with polycystic ovaries required less HMG
      to obtain optimal stimulation (P < 0.05), attained a greater peak oestradiol
      concentration (P < 0.05), produced a greater number of follicles (P < 0.05) and
      oocytes (P < 0.01) and a higher percentage of mature oocytes (P < 0.05).
      Furthermore, they achieved a higher peak oestradiol/HMG (P < 0.01) and
      oocytes/HMG ratio (P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782427
TI  - Sequential gonadotrophin-releasing hormone agonist/low-dose oral contraceptive
      treatment for leiomyomata uteri.
AB  - On the basis that gonadotrophin-releasing hormone agonists (GnRHa) induce a
      significant but transient shrinkage of leiomyomas and that oral contraceptive use
      may be associated with a decreased risk of fibroids, we tested the hypothesis
      that sequential GnRHa/low-dose oral contraceptive treatment could be a
      therapeutic alternative in perimenopausal women with uterine fibroids. Six
      premenopausal women with leiomyomata uteri were treated with D-tryptophan-6
      luteinizing hormone-releasing hormone (D-Trp-6-LHRH) depot (Decapeptyl 3.75) for
      6 months and demonstrated a significant reduction in mean uterine volume. A low
      dose oral contraceptive containing 30 micrograms of ethinyl oestradiol plus 150
      micrograms of desogestrel was given during the ensuing 12 months. When GnRHa
      therapy was discontinued, there was a rapid regrowth of the uterine fibroids and
      the uterine volume had reached, or even exceeded, pretreatment values by the
      eighth to 12th month of contraceptive therapy. Sequential GnRHa/low-dose oral
      contraceptive treatment is not a useful tool for leiomyomata uteri.

PMID- 7782425
TI  - Two cases of ovarian tumours in women who had undergone multiple ovarian
      stimulation attempts.
AB  - Concerns have been raised recently about the possible association between
      superovulation and ovarian cancer. In order to contribute to the limited
      literature on this important issue, two cases of ovarian tumours in women who had
      undergone multiple ovulation inductions are presented. In the first case, the
      patient had secondary anovulatory infertility. She was treated with human
      menopausal gonadotrophin (HMG) alone and in combination with clomiphene citrate
      or buserelin for six cycles. She then underwent ovarian stimulation with
      buserelin/HMG in the long protocol for in-vitro fertilization (IVF) and embryo
      transfer. In preparation for a new IVF/embryo transfer attempt, 8 months later,
      the screening ultrasound revealed a cystic formation of the left ovary and an
      enlargement of the right. During laparotomy, both ovaries were found to bear
      large tumours (approximately 6 x 5 x 4 cm) which were removed. Histological
      examination showed that they were epithelial tumours (serous-papillary
      cystadenomas) of borderline malignancy. The patient conceived spontaneously 1.5
      years after the operation. In the second case, the patient presented with
      secondary anovulatory infertility. She underwent ovulation induction with
      clomiphene/HMG and with buserelin/HMG in the long protocol, and intra-uterine
      insemination with husband's spermatozoa and conceived (singleton pregnancy). She
      was delivered by Caesarean section, during which a cystic tumour of the left
      ovary was removed. Histological examination revealed a benign mucous cystadenoma
      of the ovary.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782428
TI  - The influence of human chorionic gonadotrophin administration upon the next
      ovarian cycle.
AB  - We examined the influence of human chorionic gonadotrophin (HCG), used as an
      ovulation inducer and/or for supporting the luteal phase, on the next ovarian
      cycle. Four women received 10,000 IU of HCG at mid-cycle and another four
      received the same dose plus 1500 IU on the 17th, 19th and 21st days of the cycle.
      In the menstrual cycle prior to our experiments, venous blood samples were
      collected and vaginal ultrasound of the ovaries was performed every other day
      from day 21-28; the same data were also collected on days 1-10 of the experiment
      cycle. In such a way, control values were obtained. After the administration of
      HCG, venous blood samples were collected and ultrasound was performed in the same
      way and on the same days as in the controls. Follicle stimulating hormone (FSH)
      and luteinizing hormone were determined by radioimmunoassay in all blood samples,
      and HCG only in samples collected after the experiment. The results showed that
      only FSH was lower in the late luteal phase after the administration of 10,000 IU
      of HCG. Follicular diameters were higher during the follicular phase than during
      the previous cycle only in women who received the low dose of HCG. In addition,
      one woman presented with detectable HCG in the following ovarian cycle. The use
      of HCG in the preceding cycle may reduce FSH and develop persistent follicles in
      the subsequent cycle. We suggest that an ultrasound of the ovaries should be
      performed before starting a new ovulation induction cycle in a woman who has
      received HCG in the previous cycle.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782430
TI  - Identification of human sperm surface glycoproteins by sperm membrane-specific
      autoantibodies.
AB  - In order to identify the surface antigens of human spermatozoa recognized by the
      sera of immune infertile men, sperm membrane-specific antibodies were obtained
      from three serum samples exhibiting high titres of antibodies with different
      sperm-binding patterns. Serum antibodies were adsorbed onto normal motile
      spermatozoa and subsequently eluted from the sperm membrane. Using the
      immunoblotting technique under renaturating conditions, the sperm-eluted
      antibodies were tested against an electrophoretically fractionated sperm membrane
      preparation. A total of 15 protein bands ranging from 110 to 16 kDa were defined,
      but the immunoblot profiles differed quantitatively and qualitatively from one
      serum to another. Only two polypeptides were recognized by the three sperm
      membrane-specific antibody preparations; one of 90 kDa and another of 110 kDa.
      Blots were also used for the affinodetection of specific oligosaccharide side
      chains. Three lectins were tested (concanavalin A, Pisum sativum, and wheat germ
      agglutinin). Of the 15 protein zones recognized by the antibodies, 11 bound at
      least one lectin and should contain glycopeptides with oligosaccharides of four
      different types: N-linked biantennary complex type, N-linked fucosylated complex
      type, N-linked lactosaminyl complex type with terminal sialic acid and polysialyl
      type oligosaccharides. Further analysis of these glycoproteins will be pursued
      with sperm-associated antibodies eluted from the ejaculates of infertile men in
      order to define those with a potential role in the fertilization process.

PMID- 7782429
TI  - Ovarian response in consecutive cycles of ovarian stimulation in normally
      ovulating women.
AB  - Ovarian stimulation combined with intra-uterine insemination (IUI) is an
      effective treatment of non-tubal infertility but most women undergo several
      cycles of treatment to achieve a pregnancy. This prospective study was designed
      to assess the consistency (or variation) of ovarian responses and the effect of
      various ovarian stimulation protocols on this consistency in consecutive cycles
      of ovarian stimulation and IUI in women with non-ovulatory infertility. A total
      of 86 regularly menstruating ovulating patients each completed three to six
      cycles of ovarian stimulation and IUI (n = 347 cycles). Ovarian stimulation was
      achieved by sequential clomiphene citrate/human menopausal gonadotrophin (HMG),
      HMG-only or combined gonadotrophin-releasing hormone analogue--HMG protocols in
      33, 29 and 24 patients respectively, and each patient used the same protocol
      consistently throughout the study. Standard methods were used to monitor ovarian
      response and to perform IUI. Using each patient as her own control, repeated
      measurements analysis of variance revealed consistency of ovarian response in
      consecutive ovarian stimulation cycles, as shown by the number and mean diameter
      of maturing pre-ovulatory follicles, peak plasma oestradiol, duration of
      stimulation and mean HMG requirements. This consistency existed using any of the
      ovarian stimulation protocols. We conclude that regularly menstruating and
      ovulating women are likely to have similar ovarian responses in consecutive
      cycles of ovarian stimulation and IUI if the same ovarian stimulation protocol is
      used consistently.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782431
TI  - Anti-endometrial lymphocytotoxicity and natural killer cell activity in baboons
      (Papio anubis and Papio cynocephalus) with endometriosis.
AB  - This study was performed to test the hypothesis that anti-endometrial, lymphocyte
      mediated cytotoxicity and natural killer (NK) activity are reduced in baboons
      with endometriosis when compared to animals with a normal pelvis. Lymphocyte
      mediated cytotoxicity was determined in 28 baboons (15 with endometriosis, 13
      with normal pelvis) and NK cell activity was evaluated in 42 baboons (31 with
      endometriosis, 11 with normal pelvis). Anti-endometrial lymphocyte-mediated
      cytotoxicity was determined by a 20 h assay with effector-target ratios of 50:1
      and 25:1. The NK activity (K562 cell line as target) was simultaneously measured
      in all animals during a 4 h assay with effector:target ratios of 200:1, 100:1,
      50:1, 25:1, 12:1, 6:1 and 3:1. Statistical analysis was performed using analysis
      of variance, paired rank, Mann-Whitney, Kruskal-Wallis and Fisher exact tests
      where appropriate. Lymphocyte-mediated cytotoxicity was significantly lower (P <
      0.025) in baboons with endometriosis (mean 5.9 +/- 8.7%, median 0%, range 0-26%)
      than in animals with a normal pelvis (mean 22.9 +/- 23.0%, median 7%, range 0
      78%). This difference could be explained by the absence of cytotoxicity in
      baboons with moderate to severe endometriosis, probably due to high spontaneous
      release of 51Cr from labelled target cells. When stricter criteria were used and
      only animals with a labelling index (maximal/spontaneous release) of > or = 1.7
      were analysed (n = 11), the anti-endometrial cytotoxicity was comparable between
      baboons with and without endometriosis. NK cell activity was also comparable in
      primates with and without endometriosis. In conclusion, no difference in
      lymphocyte-mediated cytotoxicity and NK cell activity was observed between
      baboons with and without endometriosis.

PMID- 7782432
TI  - Results of decentralized in-vitro fertilization treatment with transport and
      satellite clinics.
AB  - The results of in-vitro fertilization (IVF) treatments carried out in a
      university IVF centre are compared with those obtained following 15-40 min
      transportation of oocytes from a transport IVF clinic to the central IVF
      laboratory of the university centre. Moreover, treatment results following
      monitoring of ovarian stimulation in satellite clinics, combined with ovum
      retrieval at the transport clinic and transport of oocytes to the central IVF
      laboratory, are described. In a total of 5540 IVF treatment cycles, 24-26% of
      viable pregnancies per embryo transfer were found in the three groups. Comparison
      of results, obtained with the three different treatment modalities, showed no
      negative influences of transporting oocytes from transport clinic to IVF
      laboratory and of monitoring ovarian stimulation in satellite clinics. It is
      concluded that decentralization of the clinical phase of IVF treatment is
      possible. This leads to a more optimal use of existing laboratory facilities in
      large urban areas. It is stressed that good communication between satellite
      clinic, transport clinic and IVF laboratory is necessary for a decentralized IVF
      programme. To obtain good quality assurance, both the satellite clinic and the
      transport clinic must adhere to the same protocol.

PMID- 7782433
TI  - Semi-programmed ovarian stimulation as the first choice in in-vitro fertilization
      programmes.
AB  - The objective of this work was to evaluate the results obtained with a protocol
      of semi-programmed ovarian stimulation (low-dose contraceptive pill+clomiphene
      citrate+human menopausal gonadotrophin+dexamethasone) used as the first-choice
      method for in-vitro fertilization (IVF). A total of 207 punctures was performed
      for oocyte collection from 168 patients (mean age 31.0 +/- 4.0 years); mean
      infertility duration was 5.81 +/- 3.30 years. The infertility factors indicating
      IVF for this population were as follows: tubo-peritoneal factor, 68%; pure or
      associated male factor, 9.2%; endometriosis, 11.1%; ovulatory factor, 4.3%;
      idiopathic factor, 11.6%; others, 2.4%. No oocyte was found on aspiration in five
      procedures (2.4%), with the mean number of oocytes collected per cycle being 5.87
      +/- 3.3 (range 0-18). The cancellation rate per puncture was 5%. The mean embryo
      cleavage rate was 60.2 +/- 36.8%, with transfer of at least one embryo occurring
      in 82.6% of all punctures. The mean number of transferred embryos was 2.52 +/-
      1.60 (range 1-5). The clinical pregnancy rates per started cycle and per puncture
      were 22.4 (218 ovarian stimulation cycles) and 23.6% (a total of 49 clinical
      pregnancies, 36 single, nine twins and four triplets) respectively. The clinical
      pregnancy rate per embryo transfer was 28.6%. The embryo implantation rate was
      12.6%. The abortion rate was 16.3%. The index of deliveries per puncture was
      19.8%. There were no cases of moderate or severe ovarian hyperstimulation
      syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782434
TI  - In-vitro fertilization in completely natural cycles.
AB  - Our objective was to assess the efficacy of in-vitro fertilization (IVF) in
      natural ovarian cycles in couples with tubal and unexplained infertility. A
      prospective study design was used. A total of 39 fully investigated couples, who
      were patients at the Reproductive Medicine Unit, St Michael's Hospital, Bristol,
      UK, took part; they were diagnosed with either tubal disease (n = 26) or
      unexplained infertility (n = 13). Procedures involved daily capillary blood
      sampling, daily vaginal ultrasonography and vaginal oocyte recovery under
      sedation at mid-cycle. The main outcome measures were fertilization, implantation
      and pregnancy rates. Although more of the women with tubal disease were parous,
      there were no other significant differences between the two groups. The 39
      couples with infertility of tubal or unexplained aetiology had 79 cycles of IVF
      in otherwise completely natural cycles. The overall fertilization rate was 80%
      and the implantation rate was 14.0%. A trend was observed for higher success
      rates in women with tubal disease. We conclude that natural cycle IVF and embryo
      transfer offers an acceptable chance of pregnancy and an opportunity for the in
      depth investigation of follicular and ovarian function in couples with defined
      causes of infertility. The possibly lower success rate in women with unexplained
      infertility warrants further study of follicular function and endocrinology.

PMID- 7782435
TI  - Hydrosalpinges in in-vitro fertilization: an unfavourable prognostic feature.
AB  - The aim of this study was to determine whether the presence of a hydrosalpinx
      influences in-vitro fertilization (IVF) prognosis. Comparisons were made between
      69 IVF cycles in 37 patients carrying hydrosalpinges (hydrosalpinx group) and 67
      IVF cycles in 41 patients without tubes or surgically sterilized (control group).
      Twenty-two patients carrying hydrosalpinges underwent salpingectomy or
      salpingoplasty (operated group); they then underwent 42 IVF trials which were
      compared with the two former groups. In the hydrosalpinx group, pregnancy rates
      by oocyte retrieval were 10.1% for clinical and ongoing pregnancies. In the
      control group, the corresponding pregnancy rates were 23.0 and 21.3%
      respectively. The implantation rate per embryo was 4.2% for clinical and ongoing
      pregnancies in the hydrosalpinx group and 11.0 and 10.4% respectively in the
      control group. The operated group had pregnancy rates of 38.1% for clinical
      pregnancies and 31.0% for ongoing pregnancies, with implantation rates of 17.4
      (clinical) and 14.8% (ongoing) respectively. Pregnancy and implantation rates
      were statistically lower in the hydrosalpinx group as compared with controls and
      with the operated group. The differences between control and operated groups were
      not significant. In conclusion, the presence of a hydrosalpinx is thus associated
      with poor prognosis in IVF treatment. Surgical correction of such lesions appears
      to restore high success rates.

PMID- 7782436
TI  - The predictive value of computer-assisted semen analysis in the context of a
      donor insemination programme.
AB  - In this paper we examine the value of both conventional and computer-assisted
      semen analysis (CASA) using the Hamilton-Thorn HTM-S 2030 in predicting the in
      vivo fertility of cryopreserved donor semen. Semen samples were examined
      prospectively and data on the conventional criteria of semen quality, sperm
      morphometry and movement were collected. Of 61 ejaculates identified, 33 achieved
      pregnancies ('successful') and 28 failed to do so ('unsuccessful'), despite
      insemination into at least four different normal female recipients. When the post
      thaw semen profiles were compared, no differences were observed between the two
      groups in respect of the conventional criteria of semen quality determined by
      conventional laboratory techniques; however, there were differences in respect of
      both morphometry and movement characteristics determined by the HTM-S. When
      multiple logistic regression was used to examine the ability of the variables
      measured to predict the achievement of pregnancy, the conventional criteria of
      semen quality were of no value (chi 2 = 6.67, P = 0.353). However, the CASA
      assessment successfully predicted outcome in 86.9% of cases (chi 2 = 44.3, P =
      0.0021). It was concluded that CASA assessment is of significant value in
      predicting the ability of an ejaculate to achieve pregnancy.

PMID- 7782437
TI  - Clinical value of sperm morphology for in-vivo fertility: comparison between
      World Health Organization criteria of 1987 and 1992.
AB  - The World Health Organization (WHO, 1992) has suggested new criteria for scoring
      sperm morphology. This study compares the clinical value of the new criteria,
      i.e. classification of a man as fertile or infertile, to those previously
      established by the WHO (1987). Papanicolaou-stained semen smears from 166 men
      attending our infertility clinic, whose fertility status was known, were scored
      using both methods. Using logistic discriminant analysis for compositional data,
      no difference between these two sets of criteria with respect to predicting
      pregnancy outcome was observed. The categorization of the abnormalities (head,
      midpiece, tail) provides no extra clarification. The WHO (1992) cut-off point of
      30% for normal forms is not appropriate, as approximately half of the men in the
      fertile group had a normal sperm morphology below this limit. In conclusion, the
      present WHO (1992) classification of sperm morphology is of no additional
      clinical value. Studies on sperm morphology should concentrate on obtaining
      biological data on, and measurements of, spermatozoa which are functionally
      active. Only then can the definition of normal be achieved and clinically useful
      criteria be adopted.

PMID- 7782438
TI  - Nuclear decondensation of sperm head and failure at in-vitro fertilization: an
      ultrastructural study.
AB  - The problem of unexplained male infertility was investigated by electron
      microscopic study of spermatozoa from 51 males. The subjects were subdivided as
      follows: group A (n = 25) normal fertile males (controls), group B (n = 13)
      successful in-vitro fertilization (IVF) cases (fertilization rate > 50%), group C
      (n = 13) failed IVF cases. All subjects included in groups B and C had a 6-12
      year history of childlessness and IVF was employed when other methods of assisted
      reproduction failed. The study of spermatozoa in fertile males (controls) was
      carried out to establish baseline ultrastructural abnormalities. In all 51 cases,
      an average of 330 (280-800) sperm heads and 660 (330-1190) sperm tails were
      studied. Decondensation of nuclear chromatin was observed in 70 +/- 15% (mean +/-
      SD) of spermatozoa in failed IVF cases, 16 +/- 5% in successful IVF cases and 7
      +/- 3% in controls. These results were found to be statistically significant (P >
      0.001). The mean value for motility of spermatozoa in all three groups was within
      accepted limits of normality. It is concluded that decondensation of nuclear
      chromatin seen by electron microscopy is one of the most important causes of male
      infertility. It is advocated that electron microscopic examination of semen
      should be carried out in all cases of long-standing, unexplained male infertility
      before embarking upon IVF programmes.

PMID- 7782439
TI  - Pregnancy following discontinuation of a calcium channel blocker in the male
      partner.
AB  - The fertility potential of human sperm populations can be assessed by the
      presence of head-directed mannose ligand receptors (mannose-specific lectin) and
      the occurrence of spontaneous acrosome reactions after incubation under
      capacitating conditions in vitro. We have reported previously on the interaction
      between anti-hypertensive medications and their effects on these parameters of
      male fertility potential. In this report we document the effects of cessation of
      calcium ion channel blocker medication on male fertility. Motile spermatozoa from
      a 30 year old infertile patient on a calcium ion channel blocker as anti
      hypertensive treatment had subnormal expression of mannose-specific lectin and
      did not exhibit spontaneous acrosome reactions. Three months following
      discontinuation of the medications, complete recovery of both the expression of
      head-directed mannose ligand receptors and the acrosome reaction was documented,
      though sperm motility and morphology remained unchanged. The couple had 2 years
      of infertility and previously failed to conceive through seven cycles of
      Pergonal/intra-uterine insemination. Conception occurred on the second
      Pergonal/intra-uterine insemination cycle after the husband discontinued calcium
      ion channel blocker medication. Calcium ion channel blockers may adversely affect
      sperm fertilizing potential. Discontinuation of such medications enhances the
      changes for conception.

PMID- 7782440
TI  - Density adjustment of software settings minimizes bias in automated sperm
      motility estimation.
AB  - To minimize overestimation of motility, it is recommended that fresh semen be
      diluted with seminal plasma prior to automated analysis. However, for
      glycerolated or cryopreserved semen this is impractical, and alternative methods
      are needed to minimize automated motility bias. In the present study, the
      proportion of motile spermatozoa was determined in fresh, diluted and
      cryopreserved semen (n = 25 ejaculates) using visual and automated methods. The
      effect of software settings on motility was investigated by assessing samples at
      a range of modified settings. At standard settings, automated motility was biased
      in fresh semen (+7.2%) after dilution with cryopreservative (-2.9%) and after
      cryopreservation (-7.8%) (P < 0.0001 versus visual). Automated motility was
      inversely related to the minimum number of frames for motility sampling (P <
      0.0001), with mean estimates of 41.0, 46.1, 52.0 and 58.2% generated at settings
      of 8, 4, 2 and 1 frame(s) respectively (n = 15 fresh, diluted and cryopreserved
      samples). Based on an arbitrary ordinal scale, a method was developed whereby
      motility sampling was adjusted prior to analysis according to sperm density.
      Analysis of an independent set of semen samples with density-adjusted software
      settings reduced bias in automated estimates (n = 30) before and after freezing
      (P < 0.0001). In addition, bias was no longer related to sperm density. In
      conclusion, modification of software settings is an effective alternative to
      dilution to minimize bias in automated motility estimates in fresh, diluted and
      cryopreserved human semen.

PMID- 7782441
TI  - Clinical and biological characteristics of infertile men with a history of
      cryptorchidism.
AB  - Out of 85 fertile and 1014 infertile men, two (2.4%) and 95 (9.4%) respectively
      had a history of cryptorchidism. Thus cryptorchidism appears to be a risk factor
      for fertility since this difference was significant. Further comparisons showed
      that the volume of a former cryptorchid testis was smaller than the contralateral
      normally descended one and that sperm output/concentration was more impaired in
      bilateral than in unilateral cryptorchidism. A retractile testis, defined as a
      testis reported by the patient to be spontaneously and regularly, i.e. at least
      once a week, ascending up into a supra-scrotal position, was more frequent in
      infertile men with a history of cryptorchidism than in fertile men. Retractility
      was more frequent on the cryptorchid side, and was found more frequently after
      hormonal than after surgical treatment. Independently of all epidemiological and
      clinical parameters studied, retractility was associated with a lower sperm
      output. Among the infertile men with a history of cryptorchidism, 45% had an
      abnormally high scrotal temperature. This abnormal temperature represented a
      pejorative risk factor for fertility in this group, since it was associated with
      a more severely impaired spermatogenesis and a higher incidence of primary
      infertility than in infertile men with a history of cryptorchidism but normal
      scrotal temperatures.

PMID- 7782442
TI  - External quality assessment for semen analysis and sperm antibody detection:
      results of a pilot scheme.
AB  - The need for quality assurance in the seminology laboratory is clear, as the
      techniques of semen analysis and sperm antibody detection are just as susceptible
      to variation as any other routine pathology test. Semen samples were distributed
      to 20 laboratories on six occasions, four samples per distribution, for sperm
      concentration and morphology assessment under routine conditions, together with
      an equal number of serum samples for sperm antibody detection. The semen analysis
      results showed a wide range of values for any given sample, which did not seem to
      be related to the methodology used. However, this variation appears to be related
      to the presence of persistent errors, as most laboratories showed reasonable
      between-assay and within-assay variation. Detection of sperm antibodies by the
      tray agglutination, gelatin agglutination or indirect immunobead test showed a
      consistent discrimination between the intended positive and intended negative
      samples. However, the use of fluorescent microscopy was unable to do this. This
      study has shown the feasibility of operating external quality assessment schemes
      for semen analysis and sperm antibody detection. These schemes provide the
      opportunity for individual laboratories to fully evaluate their own methods
      against those of others and to determine the stages at which any errors occur. An
      increased number of participants will ultimately enable a systematic comparison
      of different methods.

PMID- 7782443
TI  - Successful fertilization and establishment of pregnancies after intracytoplasmic
      sperm injection in patients with globozoospermia.
AB  - Globozoospermia or round-headed spermatozoa is a rare type of teratozoospermia
      where the acrosome is absent resulting in male infertility with no known therapy.
      A few studies have shown that round-headed spermatozoa cannot bind to or
      penetrate the zona pellucida, and no normal fertilization has been observed in in
      vitro fertilization (IVF) after insemination of human oocytes with round-headed
      spermatozoa. In this study, the fertilization capacity of round-headed
      spermatozoa after intracytoplasmic sperm injection (ICSI) into human oocytes has
      been examined. In pre-clinical experiments, 45 oocytes were injected; 41 oocytes
      were intact after injection, 15 oocytes were fertilized normally, and 13 of these
      15 oocytes developed further in vitro. ICSI was carried out in 11 treatment
      cycles of seven infertile couples with globozoospermia. Normal fertilization and
      embryo transfer occurred in four cycles (three patients). Positive serum human
      chorionic gonadotrophin was observed in three cycles (two patients); one patient
      had a pre-clinical abortion and the other patient became pregnant twice; the
      first pregnancy was ectopic and the second pregnancy is a twin pregnancy which is
      currently at 16 weeks of gestation.

PMID- 7782444
TI  - Rectovaginal septum, endometriosis or adenomyosis: laparoscopic management in a
      series of 231 patients.
AB  - A series of 231 cases of deep-infiltrating endometriosis of the rectovaginal
      septum is presented. Laparoscopic procedures with excision of deep fibrotic
      endometriotic nodules were performed in all cases. In three cases, the bowel
      lumen was entered. No other peri-operative complications were observed. Three
      cases of urinary retention were reported. The nodule resection resulted in
      considerable pain relief. Histologically, the rectovaginal nodule was similar to
      an adenomyoma. Indeed it was a circumscribed nodular aggregate of smooth muscle
      and endometrial glands. This form of disease must be considered as a specific
      disease which originates from the Mullerian rests present in the rectovaginal
      septum and we suggest that it be called 'rectovaginal adenomyosis'.

PMID- 7782445
TI  - Can Matrigel substitute for Vero cells in promoting the in-vitro development of
      mouse embryos?
AB  - The influences of Vero cells and the basement membrane substratum for these cells
      (Matrigel) on the rate of hatched blastocyst formation from mouse zygotes in
      vitro were compared. Zygotes obtained from C57BL/6 x BALB/c F1 females pretreated
      with pregnant mare's serum gonadotrophin/human chorionic gonadotrophin mated with
      BDF1 males were cultured (120 h) in human tubal fluid medium supplemented 0.5%
      with bovine serum albumin. The rates of early hatching and hatched blastocyst
      formation at 96 and 120 h of culture were expressed as the percentage of 2-cell
      embryos visualized after the initial 24 h. The rate of total blastocyst formation
      did not differ between treatment groups. However, < 10% of embryos cultured for
      96 h in medium alone advanced to the hatching stage compared with 35-40% of
      blastocysts cultured with Vero cells or with Matrigel alone. Similarly, by 120 h
      of culture, only 20% of embryos cultured in medium alone developed to hatching or
      hatched blastocysts compared with > 70% for those embryos co-cultured with Vero
      cells or with Matrigel. In conclusion, Vero cells improved the rate of
      development of mouse embryos to hatched blastocysts during serum-free culture.
      Similar improvements were seen in the presence of Matrigel alone; Matrigel is the
      basement membrane substratum used for the Vero cells. Further studies on the
      means whereby Matrigel promotes early embryonic development (e.g. appropriate
      combination of basement membrane-associated growth factors) may lead to a safe,
      defined medium preparation for the stimulation of in-vitro development of human
      embryos.

PMID- 7782446
TI  - Timing of pronuclear development and first cleavages in human embryos after
      subzonal insemination: influence of sperm phenotype.
AB  - The sequential transformations of human sperm nuclei in human eggs after subzonal
      insemination (SUZI; n = 104) and the influence of sperm defects on this timing
      were studied. This chronology was compared to that of two control series of
      zygotes obtained after SUZI with normal spermatozoa (n = 35) and after in-vitro
      fertilization (IVF) with normal donor spermatozoa (D-IVF; n = 220). Pronuclear
      formation took place between 4.5 and 10.5 h post-SUZI for 92.8% of the zygotes.
      They remained visible for 13 h and began to disappear 18.5 h post-SUZI. The
      timespan 3 h. Zygotes obtained after D-IVF had a similar rate of pronuclear
      disappearance but approximately 4 h later. The second cell cycle was more rapid
      for zygotes obtained by D-IVF than by SUZI, but the developmental rate of zygotes
      obtained by SUZI varied according to sperm phenotypes. For patients with previous
      unexplained IVF failures (control group with normal spermatozoa), the
      developmental rate was lower, suggesting the influence of oocyte quality. In
      conclusion, the end of the first cell cycle of zygotes obtained by insemination
      under the zona pellucida appears 4 h earlier compared to zygotes obtained after
      insemination outside the zona pellucida.

PMID- 7782447
TI  - Synthetic and biological macromolecules: protection of mouse embryos during
      cryopreservation by vitrification.
AB  - The ability of macromolecules to protect 8-cell mouse embryos during a
      vitrification protocol was assessed by the comparison of a synthetic
      macromolecule, polyvinylpyrrolidone (in the form of Percoll), and a biological
      macromolecule, human serum albumin (HSA). Vitrification solutions, which included
      glycerol (50% v/v), sucrose (0.75 mol/l) and either macromolecule Percoll (50%
      v/v) or HSA (1.125% w/v), were found to provide similar rates of survival. Both
      compounds resulted in a significant reduction in the incidence of disruption to
      the zonae pellucidae of cryopreserved embryos, to 4.8 +/- 1.3% and 10.3 +/- 1.2%
      respectively, when compared to the outcome when neither was present in the
      vitrification solution (20.4 +/- 2.5%; P < 0.01). Polyvinylpyrrolidone in the
      form of Percoll offers advantages over HSA in this work: it provides a lower rate
      of zona disruption and avoids the need for screening for pathogenic contaminants
      such as human immunodeficiency virus and hepatitis B and C.

PMID- 7782448
TI  - Parthenogenetic activation of human oocytes following cryopreservation using 1,2
      propanediol.
AB  - Fresh and aged human oocytes were cryopreserved using 1,2-propanediol (PROH).
      After thawing, the oocytes were cultured for 20 h and examined for
      parthenogenetic activation using light microscopy and an ultraviolet DNA stain.
      Control fresh or aged oocytes and oocytes exposed to PROH without
      cryoperservation were also examined for activation. No control oocytes were
      observed to activate spontaneously (n = 43) and parthenogenetic activation was
      not induced by exposure to PROH alone (n = 26). In both fresh and aged
      cryopreserved oocytes, 27 and 29% of the oocytes respectively were activated, and
      these proportions were significantly elevated compared with the controls (P <
      0.01). Although a similar rate of activation was observed for the cryopreserved
      fresh and aged oocytes, the form of parthenogenetic activation varied between
      these two types of oocyte. A single pronucleus was observed in 18% of the fresh
      and 5% of the aged cryopreserved oocytes. In contrast, the presence of two or
      more pronuclei was observed in 0% of the fresh and 19% of the aged cryopreserved
      oocytes.

PMID- 7782449
TI  - A comparison of the effects of different biopsy strategies on the post-thaw
      survival of 8-cell-stage mouse embryos: implications for preimplantation
      diagnosis.
AB  - The aim of this study was to investigate the effects of two different biopsy
      strategies, zona slitting and zona piercing, on the post-thaw survival and
      subsequent in-vitro development of 8-cell mouse embryos. From control experiments
      it was determined that neither biopsy by zona slitting nor zona piercing
      adversely affected embryo development in vitro, as similar rates of blastocyst
      formation and hatching were found between biopsied and zona-intact embryos; there
      was, however, a trend towards a lower rate of blastocyst hatching in embryos
      biopsied by zona piercing (78.3% compared with 91.9% of zona-intact embryos).
      When biopsy was followed by cryopreservation a different picture was seen:
      similar rates of freeze-thaw survival were found for zona-slit, zona-pierced and
      zona-intact embryos (84.2, 88.5 and 87.2% respectively), but this was superseded
      by a significant (P < 0.05) reduction in the blastocyst formation rates (61.4%
      zona-slit and 63.9% zona-pierced versus 78.7% zona-intact) and hatching rates
      (51% zona-slit and 52.5% zona-pierced versus 72.3% zona-intact) of the biopsied
      embryos. When the effects of zona slitting and piercing were considered in
      isolation, i.e. without performing biopsy, it was found that the larger holes
      produced by zona slitting rendered embryos more susceptible to freeze-thaw
      damage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782450
TI  - First trimester embryo reduction: a medical solution to an iatrogenic problem.
AB  - The incidence of multiple pregnancies is increasing, mainly as a consequence of
      the widespread use of various infertility protocols. Since such gestations
      present a high risk of feto-maternal morbidity and mortality, selective first
      trimester fetocide remains one of the few reasonable options. We reviewed the
      literature dealing with the outcome of 804 multiple pregnancies following the use
      of transcervical, transvaginal or transabdominal approaches. Questions relating
      to dealing with technical failure, method of fetocide and procedural improvements
      are examined. In a comparison of the variables: miscarriage, preterm delivery,
      perinatal and neonatal loss rates, the transvaginal approach fares better, but
      statistical significance (P < 0.001) is achieved only for preterm delivery. We
      speculated that this might be attributable to the very early gestational age at
      which the procedure is usually performed. However, the transabdominal approach
      offers better results when post-manipulation maternal morbidity is considered,
      i.e. infection and vaginal bleeding. Since each option offers different
      advantages and disadvantages, additional experience and larger population samples
      are required to further clarify this important issue.

PMID- 7782451
TI  - A challenge to the concept of tubal reflux to explain the rise and fall of CA125
      in serum during the first trimester.
AB  - Although amniotic fluid concentrations of cancer antigen (CA) 125 rise during the
      first two trimesters of pregnancy, the serum concentrations of CA125 peak during
      the first trimester and drop to non-pregnant values in the second and third
      trimester. A previous hypothesis to explain this phenomenon was that in the early
      first trimester decidual CA125 gains access to the maternal compartment via
      'tubal reflux' and subsequent absorption by peritoneal lymphatics. However, as
      pregnancy advances, the decidua capsularis fuses with the decidua parietalis,
      thus obliterating the endometrial cavity at 10-12 weeks; the Fallopian tubes thus
      become functionally obstructed. To test this hypothesis, we evaluated early first
      trimester CA125 concentrations in women conceiving by in-vitro fertilization
      (IVF) and embryo transfer with patent tubes (group 1) and in those conceiving by
      IVF and embryo transfer with bilateral tubal occlusion (group 2). We also
      compared those conceiving with human menopausal gonadotrophin therapy for
      ovulation induction without assisted reproduction (group 3) and those conceiving
      without fertility drugs in assisted reproduction (group 4). Mean CA125
      concentrations were similar in groups 1-3; the mean CA125 concentration in group
      4 was lower but this difference was not statistically significant, probably due
      to the small sample size. These data do not support the concept that tubal reflux
      explains the rise and fall of serum concentrations of CA125, since these were
      equal in IVF conceptions with or without tubal patency.

PMID- 7782452
TI  - Testosterone and androstenedione in premature ovarian failure pregnancies:
      evidence for an ovarian source of androgens in early pregnancy.
AB  - Numerous anecdotal reports but few scientific approaches have suggested an
      increase in androgens in early pregnancy. In this study we have compared the
      concentration of serum androgens, testosterone and androstenedione in early
      pregnancy, starting within the cycle of conception. We have taken the opportunity
      to study women with premature ovarian failure where pregnancy develops in the
      virtual absence of ovarian functions. This study demonstrates that the
      concentration of testosterone (0.29 +/- 0.04 ng/ml) and androstenedione (1.770 +/
      0.136 ng/ml) in these subjects is as low as, if not lower than, non-pregnant
      women (0.39 +/- 0.02 and 2.170 +/- 0.025 ng/ml), significantly increased in
      normal pregnancies (1.190 +/- 0.118 and 3.920 +/- 0.297 ng/ml; P < 0.05) and even
      further increased in human menopausal gonadotrophin-treated cycles (1.990 +/-
      0.230 and 8.19 +/- 0.72 ng/ml; P < 0.05). These studies demonstrate that the
      ovary is a contributor to the circulating concentrations of testosterone and
      androstenedione starting within the cycle of conception.

PMID- 7782453
TI  - Heterotopic abdominal pregnancy following in-vitro fertilization/embryo transfer
      presenting as massive lower gastrointestinal bleeding.
AB  - We present a case that, as far as we know, is the first report of lower
      gastrointestinal haemorrhage as a complication of heterotopic pregnancy induced
      by artificial reproductive technology. The heterotopic abdominal pregnancy caused
      erosion of the intestinal wall and massive rectal bleeding, 8 weeks after in
      vitro fertilization/embryo transfer. The source of the bleeding could not be
      identified despite comprehensive investigation including gastroscopy,
      ultrasonography, sigmoidoscopy, 99Tc (technetium) scanning and angiography.
      Tagged-erythrocyte isotope scanning revealed an abnormal concentration in the
      left lower quadrant, compatible with active bleeding in the area of the terminal
      ileum. Laparotomy disclosed a heterotopic abdominal pregnancy, causing erosion of
      the intestinal wall at this site. As assisted reproductive technologies become
      more and more common this rare complication of intestinal erosion should be kept
      in mind in case of lower gastrointestinal bleeding.

PMID- 7782454
TI  - Clearance curves of serum human chorionic gonadotrophin for the diagnosis of
      persistent trophoblast.
AB  - A well recognized hazard of conservative surgical treatment of tubal pregnancy is
      incomplete removal of trophoblastic tissue. Persistent trophoblast can be
      detected by postoperative serum human chorionic gonadotrophin (HCG) monitoring.
      The impact of various surgical techniques on the post-operative clearance of
      serum HCG was investigated in a retrospective study. The medical records of 97
      patients treated surgically for tubal pregnancy in the Academic Medical Center of
      the University of Amsterdam, The Netherlands, between 1 January 1992 and 1 August
      1994 were reviewed; 28 patients were treated by salpingostomy by laparoscopy, 16
      by salpingostomy by open surgery and 53 by salpingectomy by either method. There
      was no difference in the post-operative clearance of serum HCG after successful
      conservative surgery compared to radical surgery. However, persistent trophoblast
      occurred in eight patients (29%) after laparoscopic salpingostomy and in only one
      patient (6.3%) who had a salpingostomy by open surgery (relative risk 4.57).
      Serum HCG clearance curves allow early identification of patients with persistent
      trophoblast after conservative surgical treatment. Moreover, monitoring of post
      operative serum HCG until it becomes undetectable is mandatory in order to reveal
      late-onset types of persistent trophoblast.

PMID- 7782455
TI  - Blood flow changes in uterine and ovarian vasculature, and predictive value of
      transvaginal pulsed colour Doppler ultrasonography in an in-vitro fertilization
      programme.
AB  - The role of transvaginal pulsed colour Doppler ultrasound in the prediction of
      the outcome of in-vitro fertilization (IVF) therapy was assessed longitudinally
      in 30 patients during stimulated cycles. The pulsatility index (PI) of the
      uterine arteries did not change significantly until the mid-luteal phase. Within
      6 days after the beginning of stimulation the maximum peak systolic velocity of
      the uterine blood flow had increased significantly from 27.6 +/- 8.9 to 36 +/-
      12.8 cm/s. No difference was found in uterine PI between pregnant and non
      pregnant women. The PI of intra-ovarian flow was also similar in both groups.
      However, there was an insignificant increase in uterine receptivity when the PI
      of the uterine artery was between 2.0 and 2.99 on the day of embryo transfer.
      Nevertheless, the appraisal of the prognostic outcome of the treatment could not
      be made with Doppler.

PMID- 7782457
TI  - Progesterone receptors on lymphocytes.

PMID- 7782456
TI  - Investigation of recurrent miscarriage.

PMID- 7782458
TI  - Endometrial oestrogen and progesterone receptors and their relationship to
      sonographic endometrial appearance.
AB  - The present study was undertaken to evaluate a possible relationship between the
      endometrial concentrations of oestrogen receptor (ER) or progesterone receptor
      (PR), and the sonographic appearance of human endometrium. Sonographic
      assessments and aspirations of the endometrium at the time of or prior to
      ovulation were made in 48 cycles of 45 infertile women. Endometrial patterns were
      classified as A, triple line pattern, or B, not triple line, on the basis of
      echogenicity. We did not find a correlation between ER or PR and serum oestradiol
      or endometrial thickness. Furthermore, serum oestradiol concentrations were not
      correlated with endometrial pattern or thickness. The only significant
      correlations were found between the concentrations of ER and PR in the pattern A
      endometrium (r = 0.80, P < 0.01) and in the pattern B endometrium (r = 0.49, P <
      0.05). There were no differences in the mean concentrations of ER and PR despite
      differences in endometrial pattern and thickness. However, PR was measured at >
      800 fmol/mg protein in 12 out of 38 pattern A endometria, while PR was < 800
      fmol/mg protein in all pattern B endometria. These data suggest that high PR
      expression in the pre-ovulatory period is related to an adequate endometrial
      growth and thereby increases the responsiveness of the endometrium to
      progesterone stimulation after ovulation.

PMID- 7782459
TI  - Roles of growth factors during peri-implantation development.
AB  - Several growth factor ligand and receptor gene products have been shown to play
      roles during preimplantation mammalian development. Genes for insulin-like growth
      factors (IGFs), transforming growth factors (TGFs), fibroblast growth factor
      (FGF), platelet-derived growth factor (PDGF) and receptors for insulin, IGF,
      PDGF, TGF alpha and epidermal growth factor (EGF) are expressed by early embryos
      of several species including mouse, rat, cow and sheep. Roles of growth factors
      during early development have been demonstrated by addition of purified growth
      factors to culture medium or by molecular genetic techniques that interfere with
      gene expression. In this way, it has been shown that successful development of
      the blastocyst is dependent on the action of epidermal growth factor (EGF) and
      leukaemia inhibitory factor (LIF). Recent experiments show that both LIF and EGF
      stimulate secretion of urokinase-type plasminogen activator (uPA) and gelatinase
      B/matrix metalloproteinase-9 (MMP-9) in day 7 mouse blastocyst outgrowths. At the
      same time, tissue inhibitors of MMPs (TIMPs) are also expressed by embryonic,
      decidual and uterine tissues during the implantation process. It appears that LIF
      may act directly or indirectly, by inducing the expression of other cytokines, to
      regulate the temporal and spatial production and activity of proteases and
      protease inhibitors to create a favourable environment for implantation.

PMID- 7782460
TI  - Gelatinase and oncofetal fibronectin secretion is dependent on integrin
      expression on human cytotrophoblasts.
AB  - Collagenolytic activity of cytotrophoblasts is stimulated by glycoproteins of the
      extracellular matrix and since this stimulation can possibly occur through
      integrins, we measured the gelatinolytic activity of villous and extravillous
      cytotrophoblasts according to the type of integrins expressed on these cells.
      Cytotrophoblasts were isolated from legal abortions, immunopurified with anti
      CD45, separated according to their expression of histocompatibility-linked
      antigen (HLA)-G, alpha 6 or alpha 5 integrin subunits and cultured for 5 days on
      plastic or agarose. Fetal fibronectin, human chorionic gonadotrophin (HCG) and
      the gelatinolytic activity were measured in the culture supernatants. Following
      immunopurification with anti-CD45, the gelatinolytic activity of cytotrophoblasts
      was significantly higher than before, indicating that contaminating lymphomyeloid
      cells secreted gelatinolytic inhibitors. HLA-G positive cells secreted
      significantly more gelatinases than HLA-G negative cells but their HCG secretion
      was similar. Compared to alpha 5 positive cells, alpha 6 positive
      cytotrophoblasts secreted significantly more gelatinases, significantly less
      fibronectin but similar amounts of HCG. We conclude that during trophoblast
      invasion, extravillous cytotrophoblasts (HLA-G positive) expressing the alpha 6
      integrin subunit represent the invasive population of cells (high gelatinase and
      low fibronectin secretion). When expression of the alpha 5 integrin subunit is
      turned on, their invasive behaviour ceases and they secrete low amounts of
      gelatinases and high concentrations of fibronectin.

PMID- 7782461
TI  - Multiplex polymerase chain reaction for sex determination of single mouse
      blastomeres.
AB  - Using a multiplex nested polymerase chain reaction (PCR) method with single copy
      genes and a dinucleotide repeat locus for the mouse Y and X chromosomes
      respectively, it was possible to discriminate between single cells derived from
      male and female embryos. Using single cells, amplification of Sry and Zfy
      sequences was not evident in all cases. It could be calculated that, with the PCR
      method used, 0.04% [95% (confidence interval 0.00-2.03)] of the male embryos
      would erroneously be diagnosed as female if analysis is performed on two cells.
      The calculated chance for total amplification failure, if two cells are used for
      analysis, would be 1.4% [95% (confidence interval 0.04-8.04)]. The mouse embryo
      model proved to be a helpful tool to develop skills in the application of PCR for
      preimplantation genetic diagnosis at the single cell level.

PMID- 7782462
TI  - Non-syncytial sources of fetal DNA in transcervically recovered cell populations.
AB  - We have previously shown that fetal DNA can be detected in swabs and flushings
      obtained from the lower uterine pole prior to the termination of pregnancy. The
      presence of syncytiotrophoblast vesicles in transcervically retrieved samples
      suggested that this distinctive placental tissue was an abundant source of fetal
      DNA and a valuable resource in prenatal diagnosis strategies. In a more extensive
      study involving 150 terminations of pregnancy between 7 and 17 weeks gestational
      age, 29% of transcervically retrieved samples contained visible syncytial
      vesicles. Flushing of the uterine pole more frequently contained syncytia than
      direct aspiration (39% compared with 26% of samples) but this difference was not
      statistically significant. No samples > 14 weeks gestational age contained
      syncytia. Polymerase chain reaction analysis using Y-sequence specific-nested
      primers indicated the presence of fetal DNA in the absence of intact syncytial
      vesicles. We therefore examined samples by in-situ hybridization using Y-specific
      DNA probes. Positive labelling was observed in syncytial vesicles where present
      and in clumps of unidentified fetal cells. In addition, high numbers of naked
      nuclei were labelled in samples devoid of syncytia. These isolated nuclei are
      possibly derived from disrupted syncytia, and may be an important and hitherto
      overlooked contributory factor in fetal material which collects at the lower
      uterine pole.

PMID- 7782463
TI  - The effect of administration method: a comparison of the Rapaport and Exner
      Rorschach systems.
AB  - This study compared two Rorschach administration methods across a number of test
      variables. With a within-subjects, counter-balanced design, 20 female subjects
      randomly received either an initial Rapaport (Rapaport, Gill, & Schafer, 1968) or
      an Exner (Exner, 1974, 1986) Rorschach administration. Results showed that the
      Exner administration produced significantly more Color (C), Shading (Shd), and
      Blend (B) responses than did the Rapaport administration. Intersystem differences
      were most prominent on the first presentation of the two administrations. The
      first Exner administration produced significantly more C, Shd, and Blend
      responses than did the first Rapaport administration. Findings are discussed in
      light of their clinical implications, limitations in the experimental design, and
      suggestions for improving future research.

PMID- 7782464
TI  - Koppitz scoring system as a measure of Bender-Gestalt performance in behaviorally
      and emotionally disturbed adolescents.
AB  - Data are presented to assess the use of the Koppitz scoring system for the Bender
      Gestalt Test in a sample (N = 87) of behaviorally and emotionally disturbed
      adolescents. Results suggested that age was modestly related to Koppitz
      Developmental scores, an indication that visual-motor skills continue to develop
      beyond age 11. Scores were related to spatial perception skills as measured on
      the WISC-R. Gender, primary psychiatric diagnosis, educational tests, and MMPI
      scores were not related to Bender performance. Findings are discussed in terms of
      a need for additional research into the utility of the Bender as a measure of
      visual-motor skills in adolescents.

PMID- 7782465
TI  - Temperament and IQ mediate the effects of family history of substance abuse and
      family dysfunction on academic achievement.
AB  - In this study of sons of substance-abusing (n = 57) and normal (n = 71) fathers,
      it was hypothesized that sons' positive affective temperament (PAT) and
      intellectual ability (FSIQ) would mediate the effects of paternal substance abuse
      and family dysfunction on sons' reading achievement scores. Hierarchical, linear,
      and path analytic regression analyses were computed to test the hypotheses. It
      was found that (1) sons' FSIQ and PAT each partially mediated the effects of
      paternal substance abuse on sons' reading achievement scores and (2) that sons'
      PAT mediated the relationship between family dysfunction and their reading
      achievement scores. Because reading achievement is pivotal to academic success
      and school failure is associated with early age substance use, the importance of
      identifying processes that promote academic success is discussed.

PMID- 7782466
TI  - Comparability of correlates of original and revised Wechsler Adult Intelligence
      Scales in an alcohol-abusing population.
AB  - The correlates of the original and revised Wechsler scales were investigated
      among a sample of alcohol abusers referred for assessment of possible
      intellectual impairment. Fifty of the subjects were assessed with the original
      scale, while 44 were examined with the revised scale. The correlates of the two
      scales with other intellectual, demographic, and drinking variables suggested
      that the established correlates of the original scale may be cautiously assumed
      to hold for the revised version.

PMID- 7782467
TI  - Optimistic explanatory style and the perception of health problems.
AB  - Eighty-six adults completed questionnaires that measure explanatory style and
      perception of health problems. Subjects on the average saw themselves as below
      average in risk for a variety of health problems. Those subjects with an
      optimistic explanatory style, who explained bad events with external, unstable,
      and specific causes, in particular saw themselves as less at risk (r = .30, p <
      .01). They also believed that they were more able to prevent these health
      problems. Partialling out perceived preventability reduced to nonsignificance the
      correlation between explanatory style and perceived risk, which suggests that
      perceived preventability may mediate this link.

PMID- 7782468
TI  - Psychometric characteristics of the trait version of the Depression Adjective
      Check Lists (DACL) in adult psychiatric outpatients.
AB  - Psychometric characteristics of the trait version of Set 2 (E, F, G) of the
      Depression Adjective Check Lists (DACL) were studied in a sample of 177
      consecutive admissions to a university medical center clinic of adult psychiatric
      outpatients (60 males, 117 females). The SCL-90-R and the Psychiatric Diagnostic
      Interview also were administered. The trait DACL was shown to have high internal
      consistency (.90 to .92) and alternate form reliability (.86 to .92) and good
      concurrent (.76) and discriminant validity. The DACL (E, F, G) was able to
      differentiate between those with or without the presence of a Major Depression.
      There was a significant correlation between DACL E and levels of distress and
      psychopathology. In addition, the magnitude of DACL score significantly
      differentiated psychiatric diagnostic groups.

PMID- 7782469
TI  - Comparison of depression in the community-dwelling and assisted-living elderly.
AB  - Depressive affect in assisted living (n = 351) and community dwelling (n = 102)
      elderly was compared by means of the state and trait forms of Set 1 of the
      Depression Adjective Check Lists (DACL). Four separate analyses of covariance
      (age as covariate) showed the main effects of living arrangement and form to be
      significant on each of the four lists. Assisted living and the state form were
      significantly higher. Sex was not significant on any of the lists, and none of
      the two-way and three-way interactions reached significance. Implications of the
      findings for program planning for the elderly in assisted living arrangements are
      discussed.

PMID- 7782470
TI  - Reliability of observer ratings in the assessment of personality disorders: a
      preliminary study.
AB  - A 200-item, self-report personality disorder inventory (Coolidge Axis II
      Inventory; CATI) was administered to 52 married target subjects. Their spouses
      and a close friend completed a significant-other form about the targets. The mean
      correlation across all personality disorder scales was .51 for the targets
      spouses, .36 for the targets-friends, and .41 for the spouses-friends. Twenty
      eight target-spouse correlations were significant and ranged from .99 to -.40.
      The mean correlation for the individual 13 personality disorder scales was .46
      for target-spouses and ranged from .63 for the histrionic scale to .27 for the
      paranoid scale. The results were interpreted as establishing a basis for
      significant other assessment of personality disorders.

PMID- 7782471
TI  - Multidimensional Pain Inventory profile classifications and psychopathology.
AB  - The Multidimensional Pain Inventory (MPI) and the MMPI have been used widely to
      assess chronic pain patients. This study examined the relationship between
      patient profile classifications generated by the MPI and psychopathology as
      measured by the MMPI. MPI Dysfunctional and Interpersonally Distressed means were
      significantly different than the MPI Adaptive Coper means on scales 4, 6, 7, and
      8 of the MMPI. The Dysfunctional and Adapative Coper means were also
      significantly different on MMPI scale 2. MMPI profiles for 79% classified as
      Dysfunctional and 62% classified as Interpersonally Distressed displayed
      psychopathology as defined by significant two-point scale elevations. Only 23% of
      those classified as Adaptive Copers had significant two-point MMPI scale
      elevations.

PMID- 7782472
TI  - The Social Support Appraisals Scale: construct validation for psychiatric
      inpatients.
AB  - The concept of social support and its relationship to physical health and
      psychological well-being has been well documented. However, little empirical
      research has been conducted with clinical populations, and no measure of
      perceived social support reportedly has been validated on psychiatric inpatients.
      A psychometric investigation of the Social Support Appraisals Scale, a subjective
      measure of social support, was undertaken with psychiatric inpatients. Good
      reliability and appropriate subscale intercorrelation were indicated by the data.
      Evidence of construct validity included significant associations with another
      social support appraisal measure, measures of other social support dimensions,
      and family-reported data. Strong psychometric properties of the instrument were
      demonstrated for hospitalized psychiatric patients. Clinical implications for
      prevention and treatment are discussed.

PMID- 7782473
TI  - The effect of PTSD and combat level on Vietnam veterans' perceptions of child
      behavior and marital adjustment.
AB  - This study empirically investigated the effects of post-traumatic stress disorder
      (PTSD) and combat level on Vietnam veterans' perceptions of their children's
      behavior, as well as its effects on their marital adjustment. Results indicated
      that the predictor variables of PTSD and combat level together explained 33.6% of
      the variance in perceived child behavior problems (p < .001) and 51.8% of the
      variance in marital adjustment (p < .001). In addition, PTSD and combat level,
      when observed together, reliably predicted internalizing and externalizing
      behavior problems in addition to four specific areas of marital adjustment. When
      observed individually, however, it was shown that child behavior problems and
      marital adjustment were predicted primarily by PTSD, rather than combat level.

PMID- 7782474
TI  - Interrelationship of MMPI-2 validity scales in personal injury claims.
AB  - A sample of MMPI-2s of worker's compensation and personal injury cases (N = 289)
      was gathered to examine the relationship of various indicators of exaggeration.
      Intercorrelations of the F, F-K, the MMPI Dissimulation Scale-revised (Ds-r),
      total of obvious minus subtle scales (O-S), Fake Bad Scale (FBS), VRIN, and TRIN
      were computed and the relative sensitivity of each score calculated using various
      cut-offs. Factor analysis suggests that malingering may take the form of
      inconsistent responding as well as symptom exaggeration. Patients evaluated at
      the request of plaintiff attorneys showed a seemingly greater degree of symptom
      exaggeration and inconsistent responding than did those referred by defense
      counsel.

PMID- 7782475
TI  - Discrimination of cortical from subcortical dementias on the basis of memory and
      problem-solving tests.
AB  - This study compared the discriminative utility of problem-solving and memory
      tasks in patients with Alzheimer's and Huntington's disease and in age-,
      education-, and gender-matched normal control subjects. Problem-solving was
      assessed with a modified version of the Wisconsin Card Sorting Test. Memory was
      measured with a 10-item, 6-trial version of the Buschke Selective Reminding Test.
      Receiver Operating Characteristic curves were plotted to determine which measure
      provided the highest sensitivity (i.e., hit rate) and specificity (i.e., correct
      rejection rate). Both tests provided excellent detection of dementia (88 to 98%
      classification accuracy), but were less robust in differentiating between
      dementia groups. Findings underscore the suitability of both measures to detect
      mild dementia, but emphasize the importance of specific memory measures to
      differentiate between cortical and subcortical dementia.

PMID- 7782476
TI  - The impact of constructional impairment on the WMS-R Visual Reproduction
      subtests.
AB  - The present study investigated the impact of constructional impairment on
      performance on the WMS-R Visual Reproduction subtests that measure memory for
      visual material. Thirteen subjects with constructional impairment had lower
      scores on the immediate and half-hour delayed Visual Reproduction subtests,
      relative to a cognitively comparable group of subjects without constructional
      impairment. However, the two groups did not differ with respect to their
      performance on the WMS-R Logical Memory subtests, which measure verbal memory.
      The implications of these modality specific findings among subjects with
      constructional impairment are discussed, and recommendations for clinicians who
      utilize the WMS-R are provided.

PMID- 7782477
TI  - Validation of an item-reduction short form of the Stanford-Binet Intelligence
      Scale: Fourth Edition with college students.
AB  - This study investigated the comparability of item-reduction and subtest-reduction
      short forms of the Stanford-Binet Intelligence Scale: Fourth Edition (SB:IV) with
      the complete battery in a sample of college students. All item-reduction SASs
      were not significantly different from the full battery SASs. Correlations for
      corresponding SASs and subtests between the complete and short form were highly
      significant, and analyses of the short-form profile supported the interpretation
      of individual subtests. The subtest-reduction short-form SASs were significantly
      lower than both the item-reduction short form and the full battery. Thus, an item
      reduction short form proved to be a more comparable estimate of the full battery
      composite than the subtest-reduction short form.

PMID- 7782478
TI  - Base rates of the WAIS-R intersubtest scatter and VIQ-PIQ discrepancy in normal
      elderly.
AB  - This study provides base rates for WAIS-R VIQ-PIQ discrepancy and for 3 indices
      of intersubtest scatter in a sample of high functioning normal elderly. High
      correlations between indices of scatter, such as (1) range of scatter; (2)
      Profile Variability Index; and (3) number of subtest scores that significantly
      deviated from the individual's own mean, indicate that easy-to-compute range can
      be used as an adequate measure of scatter in many clinical settings. The results
      suggest that bright elderly individuals display a large degree of scatter. The
      clinician should base judgment regarding abnormality of the WAIS-R indices on the
      rarity of the value demonstrated by the individual with respect to the sample of
      comparable age and intelligence level.

PMID- 7782479
TI  - The relationship between psychometric intelligence and the five-factor model of
      personality in a rehabilitation sample.
AB  - WAIS-R and NEO Personality Inventory (NEO-PI) scores obtained from 85
      rehabilitation clients of the Evaluation and Development Center of Southern
      Illinois University's Rehabilitation Institute were utilized to examine the
      relationship between psychometric intelligence and personality. Correlational
      analyses revealed that the NEO-PI Openness domain and its six facets
      significantly correlated with WAIS-R FSIQ, VIQ, PIQ, and 9 of the 11 subtests.
      Multiple regression analyses showed that the five NEO-PI domains accounted for
      significant proportions of WAIS-R, FSIQ, VIQ, and PIQ score variance. The NEO-PI
      Openness domain was found to be the best predictor of WAIS-R FSIQ, VIQ, and PIQ
      scores. The study concludes with a discussion of the meaning and implications of
      the findings and suggestions for future research.

PMID- 7782481
TI  - Personality assessment of children with attention deficit hyperactivity disorder.
AB  - The present research was designed to assess several potentially important factors
      in the personality structure of a sample of children with attention deficit
      hyperactive disorder (ADHD) as compared to normal control children. Three
      questionnaires were administered to a group of 28 ADHD boys and to a control
      group of 83 boys: (1) The Locus of Control Scale for Children; (2) The Revised
      Children's Manifest Anxiety Scale; and (3) The Persistence Scale for Children.
      Results showed that the ADHD children had significantly higher external locus of
      control, were significantly less persistent, and reported an elevated level of
      "concentration/social worry" (an anxiety subscale). Such findings can help to
      clarify both the personality structure and the coping styles of the ADHD child.

PMID- 7782480
TI  - A comparison of the performance of cognitively disabled children on the WISC-R
      and WISC-III.
AB  - This study compared differences in performance on the WISC-III and on the WISC-R.
      Sixty-one students with learning impairments, due for reevaluation of their
      special education placement, were administered the WISC-III as part of a
      psychological assessment battery. Results indicate a mean difference between WISC
      R and WISC-III FSIQ of 7.95 points, which is similar to WISC/WISC-R comparisons.
      Substantial differences that averaged 9.21 points were found between WISC-R and
      WISC-III PIQ means. These findings suggest that for a special education sample an
      average decrease of at least 8 points can be expected on the WISC-III Full Scale
      IQ. Caution should be exercised when one is considering changes in educational
      classification or interpreting qualitative differences in performance on WISC-III
      scores compared with WISC-R scores.

PMID- 7782482
TI  - The safety of concomitant use of sumatriptan and antidepressant treatments.
AB  - It is presently contraindicated to use the antimigraine drug sumatriptan with
      selective serotonin reuptake inhibitors, monoamine oxidase inhibitors, or
      lithium. Consequently, many patients undergoing these pharmacotherapies for
      psychiatric disorders may not benefit from the therapeutic effect of sumatriptan
      in acute migraine attacks. Because sumatriptan does not appear to cross the blood
      brain barrier and has a short half-life, it was deemed relatively safe to
      prescribe sumatriptan with antidepressant treatments. Fourteen patients receiving
      fluoxetine, fluvoxamine, sertraline, moclobemide, lithium, or buspirone did not
      experience significant side effects when they took oral sumatriptan for the
      relief of migraine on a total of 103 episodes. It is concluded that the combined
      use of sumatriptan with the above-mentioned antidepressant treatments may be
      safe.

PMID- 7782483
TI  - The efficacy and safety of divalproex sodium in the treatment of acute mania in
      adolescents and young adults: an open clinical trial.
AB  - This open clinical trial investigated the potential short-term efficacy and
      safety of divalproex sodium in the treatment of adolescents and young adults with
      bipolar affective disorder in an acute manic phase. Fifteen subjects were treated
      for 7 weeks with divalproex sodium (mean drug level in blood +/- the standard
      deviation at trial completion, 642.85 +/- 183.08 mumol/liter) and were assessed
      weekly with the Modified Mania Rating Scale (MMRS), the Brief Psychiatric Rating
      Scale (BPRS), the Global Assessment Scale (GAS), and the Clinical Global
      Impressions Scale (CGI). Of the 15 subjects who entered the study, 8 showed
      marked improvement on the MMRS (pre-post decrease of > or = 75%), 4 showed
      moderate improvement (pre-post decrease of 50 to 74%), 1 showed some improvement
      (pre-post decrease of 25 to 49%), 1 showed no improvement and was withdrawn
      before the seventh study week because of lack of response, and 1 withdrew because
      of side effects. The mean MMRS score was significantly changed by 7 weeks of
      treatment in the 13 subjects who completed the 7-week trial (69.54 +/- 24.21 to
      18.08 +/- 8.70; t = 7.72; p < 0.0001), as were the BPRS (36.31 +/- 12.22 to 12.00
      +/- 4.22; t = 7.53; p < 0.0001), the GAS (30.23 +/- 9.05 to 54.69 +/- 9.40; t =
      7.50; p < 0.0001), and the CGI (5.38 +/- 0.96 to 2.38 +/- 0.87; t = 10.01; p <
      0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782484
TI  - Comparative abuse liability of sertraline, alprazolam, and dextroamphetamine in
      humans.
AB  - Sertraline is an effective antidepressant acting as a selective serotonin
      reuptake inhibitor. The subjective and behavioral effects of sertraline were
      studied and compared with the effects of alprazolam and dextroamphetamine in a
      within-subject, randomized, double-blind study in 20 volunteers aged 18 to 46
      years. These subjects were experienced but nondependent users of central nervous
      system depressants who had the ability to reliably distinguish secobarbital, 150
      mg, from placebo and to report positive subjective effects of secobarbital in an
      experimental setting. The following drug conditions were tested: sertraline, 100
      and 200 mg; alprazolam, 1 mg; dextroamphetamine, 10 mg; and placebo. Drug effects
      were assessed with an objective test of psychomotor performance, subject-rated
      questionnaires, and observer-rated scales. Both alprazolam and dextroamphetamine
      were distinguishable from placebo on most measures, but sertraline produced
      effects discernable from placebo on only a few measures. At 1 hour postdrug
      administration, dextroamphetamine and alprazolam produced positive effects on
      several measures of elation, euphoria, and drug liking greater than placebo and
      both doses of sertraline. In contrast, sertraline produced higher scores on
      measures of dysphoria and physical unpleasantness than did the other drug
      conditions. Observer ratings of satisfaction with the drug and other
      pharmacologic effects were consistent with these findings. Results from this
      study indicate that sertraline, at the doses tested, does not possess the
      behavioral effects profile considered to be indicative of abuse potential when
      compared with alprazolam and dextroamphetamine.

PMID- 7782485
TI  - Inhibition of alprazolam and desipramine hydroxylation in vitro by paroxetine and
      fluvoxamine: comparison with other selective serotonin reuptake inhibitor
      antidepressants.
AB  - In vitro preparations of human liver microsomes were used to study the inhibiting
      effects of two selective serotonin reuptake inhibitor (SSRI) antidepressants,
      paroxetine and fluvoxamine, on metabolism via hydroxylation of alprazolam and of
      desipramine. These reactions are mediated by Cytochromes P450-3A4 and P450-2D6,
      respectively. Paroxetine was a highly potent inhibitor of desipramine
      hydroxylation; the inhibition constant (Ki) value of 2.0 microM indicated greater
      inhibiting potency than fluoxetine or norfluoxetine. The in vitro data predicted
      in vivo impairment of desipramine clearance by coadministration of paroxetine
      which was in the same range as observed in a clinical study. Fluvoxamine, by
      contrast, was a much weaker inhibitor of desipramine hydroxylation, having a Ki
      value (16.6 microM) similar to those of sertraline and desmethylsertraline. For
      hydroxylation of alprazolam, paroxetine was a relatively weak inhibitor,
      approximately comparable to fluoxetine, whereas fluvoxamine showed inhibiting
      capacity similar to that of norfluoxetine. The in vitro data predicted the degree
      of impairment of alprazolam clearance observed in vitro model can therefore
      provide clinically relevant data on prediction of potential drug interactions
      with SSRIs.

PMID- 7782486
TI  - Antagonizing the effects of experimentally induced sleep disturbance in healthy
      volunteers by lormetazepam and zolpidem.
AB  - The effects on sleep of two well known hypnotics, lormetazepam and zolpidem,
      during experimentally induced environmental noise were compared with placebo. In
      a double-blind, crossover study, 12 normal volunteers were subjected to
      prerecorded traffic noise with a mean noise level of 52 dB(A) and peaks to 77
      dB(A) continuously for 8 hours in bed. Both hypnotics increased total sleep time,
      predominantly stage 2 sleep. A significant decrease in the number of sleep stage
      transitions, arousals, and awakenings longer than 3 minutes was found only with
      lormetazepam. No significant effects on rapid eye movement (REM) and slow wave
      sleep were observed. Latencies to persistent sleep and REM sleep onset were not
      different for either active treatment compared with placebo. Only after
      lormetazepam was performance on the morning reaction time test significantly
      affected. However, no differences were found in the subjective sleep quality and
      alertness ratings. Changes in the distribution of sleep stages throughout the
      night were related to the elimination half-life characteristics of the hypnotics,
      but few trends were detected. Both the protective properties against
      environmental noise of the hypnotics studied and the validity of the model of
      induced sleep disturbance in evaluating hypnotic agents are discussed.

PMID- 7782488
TI  - A clinically significant interaction between clozapine and valproate.

PMID- 7782487
TI  - Hypothesized interaction between valproic acid and warfarin.

PMID- 7782489
TI  - Improved efficacy and fewer side effects under clozapine treatment after addition
      of fluvoxamine.

PMID- 7782490
TI  - Thrombocytopenia and delirium associated with tranylcypromine overdose.

PMID- 7782491
TI  - Response to "Sertraline and isocarboxazid cause a serotonin syndrome".

PMID- 7782493
TI  - Canny cases. Case 4: A precipitate poisoning.

PMID- 7782492
TI  - Bromocriptine for prolactinoma-related dissociative disorder and depression.

PMID- 7782494
TI  - The Helsinki Declaration: timeless guide or irrelevant anachronism?

PMID- 7782495
TI  - Desipramine treatment of major depression in patients over 75 years of age.
AB  - The authors investigated the relationship of desipramine concentrations in plasma
      to response, side effects, and dose in depressed patients over 75 years of age to
      determine if these "very old" patients were unusually sensitive to treatment.
      Thirty-four elderly patients consecutively hospitalized for nonpsychotic,
      unipolar major depression were treated with a fixed dose desipramine regimen for
      4 weeks. Twelve nonresponding patients received a second trial at an increased
      dose. Comparisons were made with data from younger patients previously published
      by the authors. At comparable doses, steady-state desipramine concentrations in
      plasma in the elderly patients did not differ from those observed in younger
      patients. Response at levels in blood < 115 ng/ml was low, only 6 (21%) of 28
      patient trials resulted in response. At levels > or = 115 ng/ml, 6 (46%) of 13
      patient trials were effective. These rates were not significantly different.
      Inspection of the data revealed that a concentration in plasma of 105 ng/ml
      significantly separated responders and nonresponders (chi 2 = 3.93, df = 1, p <
      0.05), but even at levels > or = 105 ng/ml, the response rate was still low
      relative to rates in prior studies of younger patients treated for a similar
      duration. The serious adverse reaction rate, 7 of 34, was similar to that
      previously observed in younger patients. This sample of "very old" elderly was
      not unusually "sensitive" to antidepressant drug treatment. In fact, the low rate
      of response observed at usually adequate levels in blood suggested "resistance"
      to treatment. The findings underscore the need for more effective drug treatments
      in the depressed elderly.

PMID- 7782496
TI  - Metabolic mapping of visual areas in the behaving cat: a [14C]2-deoxyglucose
      study.
AB  - Visually responsive cortical areas and subcortical nuclei were studied in the
      awake cat using the 2-deoxyglucose technique. Visual input was confined to one
      hemisphere by unilaterally sectioning the optic tract, the corpus callosum and
      the commissura anterior. Within the intact hemisphere, numerous cortical regions
      were distinguishable in the autoradiographs due to differential labelling.
      Comparison of the intact with the visually deafferented hemisphere confirmed the
      visual character of eighteen cortical areas (areas 17, 18, 19, 20a, 20b, 21a,
      21b, the posteromedial lateral, posterolateral lateral, anteromedial lateral,
      anterolateral lateral, dorsal lateral, ventral lateral, and posterior
      suprasylvian areas, the splenial and anterior ectosylvian sylvian areas, insular
      visual area and posterior area 7) and revealed the visual nature of an area in
      the posterior cingulate gyrus which had not been described previously. We refer
      to this area as cingulate visual area (CVA). This area exhibits a gradient in
      interhemispheric differences along a caudorostral axis similar to that observed
      in posterior area 7 which is in keeping with the strong and topographic
      connections between CVA and posterior area 7. These results support the validity
      of metabolic mapping for the characterisation of cortical areas.

PMID- 7782497
TI  - Abnormal ipsilateral visual field representation in areas 17 and 18 of
      hypopigmented cats.
AB  - We compared the central projections of retinal ganglion cells in temporal retina
      and the cortical representation of visual fields in areas 17 and 18 in cats with
      various hypopigmentation phenotypes (albino, heterozygous albino, Siamese, and
      heterozygous Siamese). In all cats studied, we found that the extent of abnormal
      ipsilateral visual field representation varied widely, and more of the
      ipsilateral visual field was represented in area 18 than in area 17. The greatest
      degree of ipsilateral visual field representation was found in albino cats,
      followed by Siamese, heterozygous albino and heterozygote Siamese cats,
      respectively. Additionally, in the different groups there was wide variation in
      the numbers of contralaterally projecting alpha and beta ganglion cells in
      temporal retina. In all cases, however, contralaterally projecting alpha cells
      were found to extend further into temporal retina than beta cells. We found that
      in each cat studied, the maximum extent of the abnormal ipsilateral visual field
      representation in areas 18 and 17 corresponded to the location of the 50%
      decussation line (i.e., the point where 50% of the ganglion cells in temporal
      retina project to the contralateral hemisphere) for alpha and beta cells,
      respectively, for that cat. Our results suggest that the extent of the abnormal
      visual field representations in visual cortex of hypopigmented cats reflects the
      extent of contralaterally projecting retinal ganglion cells in temporal retina.

PMID- 7782498
TI  - Synapses on axons of sympathetic preganglionic neurons in rat and rabbit thoracic
      spinal cord.
AB  - Axosomatic and axodendritic synapses occur on sympathetic preganglionic neurons,
      but it is not yet known whether their axons receive synaptic input, which could
      be particularly effective at regulating sympathetic outflow. Here, we examined
      retrogradely labelled sympathetic preganglionic axons to see if they received
      synapses. Cholera toxin B subunit (CTB) or CTB conjugated to horseradish
      peroxidase (CTB-HRP) was used to label neurons projecting to the rat or rabbit
      superior cervical ganglion, the rat adrenal medulla, or the rabbit stellate
      ganglion. At the light microscopic level, small groups of CTB-immunoreactive
      axons travelled through the ventral horn near its lateral boundary, with
      occasional axons taking a more medial course. The axons passed through the
      ventrolateral funiculus to exit at the ventral roots. In parasagittal section, a
      few axons branched within the ventral horn, sending processes rostrally and
      caudally for short distances before they turned ventrally to exit the spinal
      cord. At the ultrastructural level, CTB-immunoreactive rat and rabbit sympathetic
      preganglionic axons were almost exclusively unmyelinated. In contrast, labelling
      with CTB-HRP revealed both myelinated and unmyelinated axons in the ventral horn,
      the ventrolateral white matter, and the ventral roots. CTB-HRP also allowed the
      detection of the initial segment of a sympathetic preganglionic axon. Synapses,
      with vesicles clustered presynaptically and membrane specializations
      postsynaptically, were found on some unmyelinated CTB-immunoreactive axons.
      Occasional axons received several synapses. Synapses were most common on CTB
      containing axons just ventral to the intermediolateral cell column. One synapse
      was found on an axon within 2 microns of its origin from a proximal dendrite.
      Rare synapses were found several hundred micrometers ventral to the
      intermediolateral cell column. One branching axon had synapses just below the
      branch point on both the main axon and the axonal branch. These findings indicate
      an extensive synaptic input to the axons of at least some sympathetic
      preganglionic neurons. These axoaxonic synapses could have a profound effect on
      sympathetic activity.

PMID- 7782500
TI  - Regenerative axonal sprouting in the cat trochlear nerve.
AB  - Following peripheral trochlear nerve axotomy in the cat, the normal number of
      myelinated axons is restored despite significant motor neuron death, suggesting
      regulation of the number of myelinated axons in the regenerated nerve. In this
      study we used light and electron microscopy to examine the production and
      maintenance of axonal sprouts at different locations in the nerve and at
      different postoperative intervals. Despite proliferative sprouting and an
      overproduction of nonmyelinated axons in the regenerating trochlear nerve, the
      number of myelinated axons was strictly regulated. Only approximately 1,000
      regenerated axons were eventually remyelinated, but many nonmyelinated axons were
      still present 6-8 months postaxotomy. Regenerated axons were remyelinated in a
      proximal-to-distal direction between 3 and 4 weeks postaxotomy. We also examined
      the maturation of regenerated myelinated axons by measuring axon diameter and
      myelin index (an expression of myelin thickness). Mean myelinated axon diameter
      remained significantly below normal in long-term regenerated nerves. Mean myelin
      index was not different from normal at 4 weeks postaxotomy but was significantly
      decreased at long postoperative intervals, reflecting a slightly thicker myelin
      sheath relative to the axon diameter. This relative increase in mean myelin
      thickness could serve to restore normal conduction velocity despite the decrease
      in mean axon diameter. We suggest that the regulation of the number of myelinated
      axons at the normal number despite cell death and the increase in mean myelin
      thickness may both be compensatory mechanisms that function to restore
      preoperative conditions and maximize functional recovery.

PMID- 7782499
TI  - Origin of microglia in the quail retina: central-to-peripheral and vitreal-to
      scleral migration of microglial precursors during development.
AB  - The origin, migration, and differentiation of microglial precursors in the
      avascular quail retina during embryonic and posthatching development were
      examined in this study. Microglial precursors and developing microglia were
      immunocytochemically labeled with QH1 antibody in retinal whole mounts and
      sections. The retina was free of QH1+ macrophages at embryonic day 5 (E5).
      Ameboid QH1+ macrophages from the pecten entered the retina from E7 on. These
      macrophages spread from central to peripheral areas in the retina by migrating on
      the endfeet of the Muller cells and reached the periphery of the retina at E12.
      While earlier macrophages were migrating along the inner limiting membrane, other
      macrophages continued to enter the retina from the pecten until hatching (E16).
      From E9 on, macrophages were seen to colonize progressively more scleral retinal
      layers as development advanced. Macrophages first appeared in the ganglion cell
      layer at E9, in the inner plexiform layer at E12, and in the outer plexiform
      layer at E14. Therefore, it seems that macrophages first migrated tangentially
      along the inner retinal surface and then migrated from vitreal to scleral levels
      to gain access to the plexiform layers, where they differentiated into ramified
      microglia. Macrophages appeared to differentiate shortly after arrival in the
      plexiform layers, as poorly ramified QH1+ cells were seen as early as E12 in the
      inner plexiform layer and at E14 in the outer plexiform layer. Radial migration
      of macrophages toward the outer plexiform layer continued until posthatching day
      3, after which retinal microglia showed an adult distribution pattern. We also
      observed numerous vitreal macrophages intimately adhered to the surface of the
      pecten during embryonic development, when macrophages migrated into the retina.
      These vitreal macrophages were not seen from hatching onwards, when no further
      macrophages entered the retina.

PMID- 7782501
TI  - Differential expression of mGluR5 metabotropic glutamate receptor mRNA by rat
      striatal neurons.
AB  - Metabotropic glutamate receptors (mGluRs) mediate the effects of glutamate
      neurotransmission on intracellular second messenger systems. Among the seven
      distinct mGluR receptor isoforms currently identified, the mGluR5 isoform is
      expressed particularly prominently in the striatum, where it may contribute to
      neuronal plasticity, motor behaviors, and excitotoxic injury. mGluR5 mRNA
      expression in striatal enkephalinergic, somatostatinergic, and cholinergic
      neurons was examined using double label in situ hybridization techniques. mGluR5
      expression is abundant in a large number of medium-sized striatal cells but is
      absent in a significant minority of neurons. Double label in situ hybridization
      with 35S-dATP- and digoxygenin-dUTP-tailed oligonucleotide probes demonstrated
      that mGluR5 message is highly expressed by enkephalinergic striatal neurons but
      is not detectable in cholinergic or somatostatin interneurons. In addition, some
      nonenkephalin, presumably substance P, neurons were also strongly labeled for
      mGluR5. The differential expression of mGluR5 in striatal projection neurons vs.
      interneurons may contribute to the selective vulnerability of these neurons to
      disease processes.

PMID- 7782502
TI  - Neuropeptide receptors in developing and adult rat spinal cord: an in vitro
      quantitative autoradiography study of calcitonin gene-related peptide,
      neurokinins, mu-opioid, galanin, somatostatin, neurotensin and vasoactive
      intestinal polypeptide receptors.
AB  - A number of neuroactive peptides including calcitonin gene-related peptide
      (CGRP), substance P, neurokinin B, opioids, somatostatin (SRIF), galanin,
      neurotensin and vasoactive intestinal polypeptide (VIP) have been localized in
      adult rat spinal cord and are considered to participate either directly and/or
      indirectly in the processing of sensory, motor and autonomic functions. Most of
      these peptides appear early during development, leading to the suggestion that
      peptides, in addition to their neurotransmitter/neuromodulator roles, may
      possibly be involved in the normal growth and maturation of the spinal cord. To
      provide an anatomical substrate for a better understanding of the possible roles
      of peptides in the ontogenic development of the cord, we investigated the
      topographical profile as well as variation in densities of [125I]hCGRP alpha,
      [125I]substance P/neurokinin-1 (NK-1), [125I]eledoisin/neurokinin-3 (NK-3),
      [125I]FK 33-824 ([D-Ala2, Me-Phe4, Met(O)ol5]enkephalin)/mu-opioid,
      [125I]galanin, [125I]T0D8-SRIF14 (an analog of somatostatin); [125I]neurotensin
      and [125I]VIP binding sites in postnatal and adult rat spinal cord using in vitro
      quantitative receptor autoradiography. Receptor binding sites recognized by each
      radioligand are found to be distributed widely during early stages of postnatal
      development and then to undergo selective modification to attain their adult
      profile of distribution during the third week of postnatal development. The
      apparent density of various receptor sites, however, are differently regulated
      depending on the lamina and the stage of development studied. For example, the
      density of mu-opioid binding sites, following a peak at postnatal day 4 (P4),
      declines gradually in almost all regions of the spinal cord with the increasing
      age of the animal. [125I]substance P/NK-1 binding sites, on the other hand, show
      very little variation until P14 and then subsequently decrease as the development
      proceeds. In the adult rat, most of these peptide receptor binding sites are
      localized in relatively high amounts in the superficial laminae of the dorsal
      horn. To varying extents, moderate to low density of various peptide receptor
      binding sites are also found to be present in the ventral horn, intermediolateral
      cell column and around the central canal. Taken together, these results suggest
      that each receptor-ligand system is regulated differently during development and
      may each uniquely be involved in cellular growth, differentiation and in
      maturation of the normal neural circuits of the spinal cord. Furthermore, the
      selective localization of various receptor binding sites in adult rat spinal cord
      over a wide variety of functionally distinct regions reinforces the
      neurotransmitter/modulator roles of these peptides in sensory, motor and
      autonomic functions associated with the spinal cord.

PMID- 7782504
TI  - The fate of potentially pathogenic bacteria in Swiss hard and semihard cheeses
      made from raw milk.
AB  - This study examined the ability of potentially pathogenic bacteria to grow and to
      survive during the manufacture and ripening of Swiss hard and semihard cheese
      varieties made from raw milk. The results show that hard cheeses are hygienically
      safe; 1 wk after fabrication, the inoculated pathogens (Aeromonas hydrophila.
      Campylobacter jejuni, Escherichia coli, Listeria monocytogenes, Pseudomonas
      aeruginosa, Salmonella spp., Staphylococcus aureus, and Yersinia enterocolitica)
      could no longer be detected. At the age of commercial ripeness, the semihard
      cheeses were free from the inoculated pathogens and their toxic metabolites,
      except for L. monocytogenes, which survived the manufacturing and ripening
      process.

PMID- 7782503
TI  - Distribution and effects of tachykinin-like peptides in the stomatogastric
      nervous system of the crab, Cancer borealis.
AB  - The rhythmically active pyloric and gastric mill motor patterns in the
      stomatogastric ganglion of the crab, Cancer borealis, are influenced by
      modulatory projection neurons whose somata are located primarily in the other
      ganglia of the stomatogastric nervous system. One of these projection neurons
      exhibits substance P-like immunolabeling. However, bath application of substance
      P does not influence these motor patterns. To determine whether a different
      peptide is responsible for the substance P-like immunolabeling, we studied the
      presence and physiological effects of the locustatachykinins and the leucokinins,
      two families of tachykinin-like peptides originally identified in insect nervous
      systems. Locustatachykinin-like immunolabeling has the same distribution in the
      stomatogastric nervous system as substance P-like immunolabeling and colocalizes
      with it in the majority of immunopositive structures. Preincubation of
      locustatachykinin antibody with substance P, and preincubation of substance P
      antibody with locustatachykinin, blocks subsequent immunolabeling in the
      stomatogastric nervous system. In contrast, we found no leucokinin-like
      immunolabeling in this system. Bath application to the stomatogastric ganglion of
      individual locustatachykinins or leucokinins excited the pyloric rhythm in a
      state-dependent manner. Each peptide family had distinct effects on the pyloric
      rhythm. Thus, both of these tachykinin-like peptide families are likely related
      to native neuropeptides that influence the pyloric rhythm. Furthermore, a member
      of the locustatachykinin family is likely to be the source of the previously
      identified substance P-like immunoreactivity in the stomatogastric nervous
      system.

PMID- 7782505
TI  - Effect of individual caseins on plasminogen activation by bovine urokinase-type
      and tissue-type plasminogen activators.
AB  - The effect was examined of individual caseins on the rate of plasminogen
      activation by bovine urokinase-type and tissue-type plasminogen activators. All
      individual caseins (alpha-CN, beta-CN, and kappa-CN) enhanced the activity of
      both types of plasminogen activators. Optimal concentrations for alpha-CN and
      beta-CN were 5 and 25 micrograms/ml, respectively. The enhancement of enzymatic
      activity declined when concentrations of alpha-CN and beta-CN were higher. In
      contrast, increasing concentrations of kappa-CN from 0 to 200 micrograms/ml
      resulted in corresponding increases in activity of both types of plasminogen
      activators. On a weight basis, alpha-CN was the most effective enhancer of
      plasminogen activator activity. Indirect evidence obtained with experiments
      utilizing alpha-CN immobilized on agarose suggested that the effect is related to
      extensive binding of plasminogen and both types of plasminogen activators to
      casein.

PMID- 7782506
TI  - Immunomodulation of human blood cells following the ingestion of lactic acid
      bacteria.
AB  - Because of the lack of data that convincingly show immunomodulatory properties of
      lactic acid bacteria in humans, a study was performed in which healthy volunteers
      were divided into two groups and given a fermented milk product supplemented with
      Lactobacillus acidophilus strain La1 or Bifidobacterium bifidum strain Bb 12 for
      3 wk. Blood was sampled throughout the study to assess changes in lymphocyte
      subsets or leukocyte phagocytic activity following consumption of the fermented
      products. No modifications of lymphocyte subpopulations were detected. In
      contrast, phagocytosis of Escherichia coli sp. in vitro was enhanced after the
      administration of both fermented products. The increment in phagocytosis was
      coincident with fecal colonization by the lactic acid bacteria and persisted for
      6 wk after ingestion of the fermented products. By this time, the fecal
      lactobacilli and bifidobacteria had returned to concentrations prior to
      consumption. Nonspecific, anti-infective mechanisms of defense can be enhanced by
      the ingestion of specific lactic acid bacteria strains. These strains can be used
      as nutritional supplements to improve the immune function of particular age
      groups, i.e., the neonate or the elderly, for which these functions are
      diminished.

PMID- 7782507
TI  - Vitamin A distribution among fat globule core, fat globule membrane, and serum
      fraction in milk.
AB  - In cream suspensions and partly skimmed milks obtained by successive
      centrifugation from whole milk, the concentration of vitamin A per gram of fat
      was inversely related to the mean size of fat globules. This result indicated
      that not all the vitamin A of milk was located in the fat globule core, which was
      further supported by studies of buttermilk and butter oil fractions obtained by
      churning of cream. These studies indicated that a portion of the vitamin A was
      associated with the fat globule membrane. The vitamin A content per gram of fat
      of purified fat globules was similar to vitamin A content per gram of fat of the
      whole milk from which they were isolated. This result indicated that the amount
      of vitamin A in the serum fraction was negligible and that vitamin A was
      localized in the fat globule and fat globule membrane.

PMID- 7782508
TI  - Preparation of casein using carbon dioxide.
AB  - The effects of pressure, temperature, residence time, and mass of skim milk on
      some characteristics of casein, prepared by precipitation with high pressure CO2,
      were examined in a batch reactor. For a 500-g milk sample, precipitation occurred
      at pressures > 2760 kPa and temperatures > 32 degrees C. Residence time was not
      significant and was held at 5 min. Yields were maximum at 2750 to 5520 kPa and at
      38 to 49 degrees C for a 500-g milk sample. The resulting whey had a pH of 6.0.
      The casein product had an acceptable appearance and had greater solids, ash, and
      Ca contents than commercial acid caseins. Particle size distribution studies
      showed that the mean particle size was sensitive to precipitation pressure and
      temperature and was similar to that of acid caseins produced under laboratory
      conditions. The HPLC studies of the casein and whey fractions showed that
      precipitation by CO2 did not result in fractionation of casein or whey proteins
      to their component proteins.

PMID- 7782510
TI  - Characterization of clinical mastitis in primiparous heifers.
AB  - Using data from health records for cows in Finland from between 1983 and 1991, we
      investigated the general trend for frequency of mastitis in heifers, seasonal
      variation, breed differences, and etiology of the disease. The performance of the
      heifers was monitored during first lactation. Treatment of heifer mastitis,
      defined as mastitis treatment 1 wk before and 1 wk after calving, increased from
      1.8 to 4.4% between 1983 and 1991. The increase can be partly attributed to
      increased milk production, subsequent reduced resistance to mastitis, and the
      general trend toward more efficient treatment of mastitis. Heifer mastitis was a
      characteristic disease of well-managed, productive herds with low SCC and a high
      frequency of mastitis treatments administered by a veterinarian. Of the feeding
      factors studied, only use of homemade concentrates was associated with higher
      mastitis frequency. Mastitic heifers had higher genetic potential for milk
      production than control heifers, but actual milk production was 70 to 80 kg lower
      than expected. Most mastitic heifers recovered well and were not more susceptible
      than control heifers to further incidence of mastitis or other diseases. However,
      heifer mastitis caused more heifers than usual to be culled.

PMID- 7782509
TI  - Enhanced antigen-specific responses in bovine mammary glands following
      administration of interleukin-2.
AB  - This study examined the feasibility of using interleukin-2 as a vaccine adjuvant
      to enhance specific immunity in the bovine mammary gland. In trial 1, cows were
      immunized by intramammary infusion of keyhole limpet hemocyanin with either
      saline (n = 3) or interleukin-2 (n = 3) as adjuvants. In trial 2, cows were
      immunized by intramuscular injection near the supramammary lymph node with
      keyhole limpet hemocyanin in conjunction with saline (n = 4). Freund's incomplete
      adjuvant (n = 4), or interleukin-2 (n = 4). Local immunization with interleukin-2
      as an adjuvant significantly increased antibody titers in milk over
      preimmunization levels and levels in saline-treated cows. The use of Freund's
      incomplete adjuvant and interleukin-2 as adjuvants in cows that were immunized
      systemically enhanced both sera and lacteal antibodies to keyhole limpet
      hemocyanin. However, cows that were administered interleukin-2 responded more
      quickly than those given Freund's incomplete adjuvant. Only those cows that
      received interleukin-2 as an adjuvant demonstrated significant increases in blood
      lymphocyte proliferation to keyhole limpet hemocyanin, pokeweed mitogen, and
      interleukin-2. The results of these two trials suggest that immunization with
      interleukin-2 as an adjuvant may be more effective than Freund's incomplete
      adjuvant in enhancing specific immunity in the bovine mammary gland and may
      possibly be an effective adjuvant in mastitis immunization protocols.

PMID- 7782511
TI  - Estimates of variability for somatic cell count measurements in the Iowa dairy
      industry.
AB  - The SCC collected from 15 instruments in 12 laboratories were used to quantify
      accuracy, repeatability, and reproducibility in the Iowa dairy industry. For each
      of three trials, milk was sampled at the morning milking from 30 different
      Holsteins in the Iowa State University herd. Identified samples and unidentified
      duplicates were provided for each participating instrument. Mean SCC was 418,000
      cells/ml, and mean SCC for duplicates ranged from 9000 to 3,966,000. Accuracy for
      a set of 30 duplicates was lowest for trial 1 (CV = 16.4%) and highest for trial
      2 (CV = 7.6%). Intraclass correlations estimated repeatability and were .99 for
      all but one instrument. Coefficients of variation for repeatability (weighted
      mean = 11.4%) were similar to estimates for accuracy (weighted mean = 11.0%), but
      reproducibility was considerably lower (30.0%). Samples were classified by SCC as
      very low, < 125,000; low, 125,000 to 249,000; medium, 250,000 to 500,000; and
      high, > 500,000. Repeatability for high samples was higher than repeatability for
      very low SCC samples; coefficient of variation for high SCC samples was 6.8% but
      was > 25.0% for samples with < 500,000 cells. Repeatability was within standards
      set by the industry, but current procedures for quality control may not
      adequately address reproducibility.

PMID- 7782512
TI  - Body condition scores of Holstein cows on Prince Edward Island, Canada:
      relationships with yield, reproductive performance, and disease.
AB  - An observational study of 429 Holstein cows in 13 herds (mean 305-FCM yield of
      7225 kg) was conducted to determine the relationship between body condition score
      and its changes with milk yield, reproductive performance, and disease incidence.
      Cows were scored once for body condition during the dry period, near calving, and
      then every 14 d until termination of lactation. Condition score at calving had no
      effect on either peak of 305-d milk yields. Condition loss averaged .73 and .83
      points for primiparous and multiparous cows, respectively. The duration and
      magnitude of condition loss depended primarily on score at calving and was
      greater for cows that calved with higher condition scores. After reaching minimum
      score, cows gained an average of .53 condition points in the remainder of
      lactation. Total amount of gain was not affected by body condition score at
      calving or by milk yield. No significant differences were found for days to first
      observed estrus, days to first breeding, days to conception, or number of times
      bred for cows grouped by body condition score at calving or by condition loss
      between calving and first breeding. Body condition score at calving was not
      significantly different for diseased cows. Cows that were diagnosed with a
      disease lost more condition than undiseased cows, but the difference generally
      was < .25 points.

PMID- 7782514
TI  - Ruminally protected lysine and methionine for lactating dairy cows fed a diet
      designed to meet requirements for microbial and postruminal protein.
AB  - Dairy cows, 20 at each of two sites, were used to determine responses to
      ruminally protected Lys and Met in a full lactation study. Cows were fed corn
      silage twice daily for ad libitum intake and a concentrate four times daily in
      proportion to milk production. At Truro, cows were fed 2.7 kg/d of alfalfa and
      timothy hay DM at 0600 and at 1500 h. At Fredericton, cows were fed 2.7 kg of
      timothy silage DM at 0600 h and 2.7 kg of alfalfa hay DM at 1500 h. Diets were
      designed to meet, but not to exceed, recommendations for ruminally degradable CP
      and intestinally digestible protein. Ten cows at each site were fed ruminally
      protected L-Lys.HCl (19 g/d) and DL-Met (6.5 g/d). Cows fed AA at each site
      produced more milk, lactose, protein, and fat; milk protein and fat percentages
      were also higher. No time x treatment interactions occurred for any production
      parameter. In spite of similar production responses between sites, cows fed AA
      consumed more DM at Truro, but those at Fredericton did not. Thus, gross
      efficiency of utilization of dietary N for milk N was increased with AA at
      Fredericton but not at Truro. However, considering the increased intake of CP by
      cows fed AA at Truro, an event that would have been expected to depress
      efficiency of utilization of dietary N, the lack of difference at Truro between
      treatments can be interpreted as an improvement, relative to expectations,
      because of AA feeding. High producing dairy cows fed a diet that was adequate in
      CP responded to ruminally protected Lys and Met primarily with increased
      production of milk protein and fat throughout the full lactation.

PMID- 7782513
TI  - Effects of varying forage types on milk production responses to whole cottonseed,
      tallow, and yeast.
AB  - Four forage treatments (45% corn silage, 33.75% corn silage plus 11.25% alfalfa
      hay, 11.25% bermudagrass hay, or 11.25% cottonseed hulls on a DM basis) were
      arranged factorially with no added fat, 12.5% whole cottonseed, or 2.5% tallow.
      Different diets were fed during three 28-d periods to 20 control Holstein cows
      and to 20 cows receiving yeast continuously in a split-plot design. Milk yield of
      cows fed cottonseed hulls with corn silage was 2.4 kg/d higher than with corn
      silage plus bermudagrass hay and .7 kg/d higher than with corn silage only or
      corn silage plus alfalfa hay. Whole cottonseed depressed milk yield by 1 kg/d.
      Cows fed yeast had increased DMI, and yeast interacted with forage so that more
      milk was produced by cows fed alfalfa diets. Yeast depressed milk protein
      percentage. Holstein cows in a commercial Florida dairy were fed no yeast or 10
      g/d continuously for 60 d; milk fat percentage was greater (3.51 vs. 3.37%) with
      yeast. In summary, effects on milk and SCM were positive when cottonseed hulls
      were utilized with corn silage, negative with whole cottonseed, and neutral with
      supplemental tallow. Yeast effects on SCM, although not significant for either
      experiment, tended to be positive for both (mean +1.2 kg/d per cow).

PMID- 7782515
TI  - Increased milk production of cows in early lactation fed chemically treated
      soybean meal.
AB  - Holstein cows in early lactation and producing about 35 kg/d of milk were fed TMR
      for ad libitum intake and 1 kg/d of long alfalfa hay. Soybean meal and soybean
      meal treated by a novel technique were compared in diets of 15 and 17% CP in a 2
      x 2 factorial design. Digestibilities of DM, CP, and ADF were significantly lower
      for treated soybean meal diets. Mean DMI was about 21 kg/d and was unaffected by
      treatment. Milk production was significantly increased during wk 7 to 16 of
      lactation for cows fed treated soybean meal diets. The production of SCM and milk
      components was greater for cows fed treated soybean meal than for cows fed
      soybean meal, but the differences were not significant. By wk 16, compared with
      wk 3 of lactation, the persistency of production of milk and lactose was markedly
      increased by treated soybean meal. The persistency of milk protein production was
      100.5% for cows fed the diet containing treated soybean meal at 17% CP and about
      97% for the other diets. The hypothesis that Met supply was limiting secretion of
      milk protein in cows fed treated soybean meal is discussed.

PMID- 7782517
TI  - Performance of high producing dairy cows offered drinking water of high and low
      salinity in the Arava desert.
AB  - The effect of supplying high producing Israeli Holstein cows with desalinated or
      salty water on milk composition and production was examined in the Arava desert
      of southern Israel. Daily water consumption of cows offered desalinated water was
      higher by 10.6 L than that of the group offered salty drinking water; DMI was
      similar for the two groups. Daily production of milk and 3.5% FCM was higher for
      the cows receiving desalinated water than for the cows receiving salty water;
      35.2 versus 33.1 kg and 31.6 versus 29.8 kg, respectively. The percentage of
      protein in milk and the daily protein production were higher for the cows
      receiving desalinated water than for the cows receiving salty water: 2.89% and
      1.01 kg versus 2.84% and .93 kg, respectively. The percentage of milk fat and the
      daily fat production were higher for the cows receiving desalinated water. These
      results indicate that water salinity negatively affects milk production.
      Improvement of water quality by desalination increased production of milk and
      milk constituents.

PMID- 7782518
TI  - Effect of selenium supplementation of cows on maternal transfer of selenium to
      fetal and newborn calves.
AB  - A trial was conducted to determine the effect of maternal supplementation of Se
      on transfer of Se to the fetus during late gestation. Holstein cows were randomly
      assigned at dry-off to receive no Se or 3 mg/d of supplemental Se as selenite
      delivered via an intraruminal bolus. Supplementation significantly increased
      concentrations of Se in blood of dams at parturition. Similarly, calves of cows
      that were supplemented with Se had higher Se in blood and liver. Colostral
      concentrations of Se were increased by maternal Se supplementation; Se increased
      in the casein fraction. The Se concentrations in blood, plasma, and liver of
      calves were positively correlated with the Se concentrations in plasma of the dam
      at parturition. Concentrations of Se in colostrum and in calf liver also were
      closely correlated. Concentrations of Se in calf liver at d 42 were closely
      correlated with concentrations of Se in liver at birth. Maternal supplementation
      of Se increased Se reserves in the liver of the newborn and in colostrum.
      Carryover effects of Se supplementation of dams were evident in calves at 42 d of
      age.

PMID- 7782516
TI  - Acid-base status, renal function, water, and macromineral metabolism of dry cows
      fed diets differing in cation-anion difference.
AB  - Dietary cation-anion difference was defined as the summation of the
      milliequivalents of Na and K minus the sum of the milliequivalents of Cl and S
      per kilogram of DM. Twelve Holstein cows were used in a crossover experiment to
      compare the effects of changing the cation-anion difference of a diet based on
      haylage. Two cation-anion differences, 481.8 and 327.2 meq/kg, were compared.
      Increased dietary cation-anion difference had no significant effects on BW or
      intake and digestibility of DM, ADF, NDF, and N. The diet with a cation-anion
      difference of 481 meq/kg of DM increased apparent absorption of water and urine
      volume. Fecal excretion of Na and absorption and urinary excretion of S were
      increased by a cation-anion difference of 327 meq/kg of DM. Although blood
      concentrations were unaffected, lower dietary cation-anion difference reduced
      concentrations of H+ and HCO3- in urine and total urinary excretion of HCO3-.
      Plasma volume, packed cell volume, glomerular filtration rate, and effective
      renal plasma flow were unaffected by diet. Small changes in dietary cation-anion
      differences, even within the positive range, affected acid-base status and water
      metabolism of dry pregnant cows without affecting renal function or blood volume.

PMID- 7782519
TI  - Productive life evaluations: calculation, accuracy, and economic value.
AB  - A preliminary national evaluation of productive life was computed from records of
      11 million Holsteins. Data were a mixture of projected and completed months in
      milk by 7 yr of age. Data were analyzed with the animal model programs currently
      used for yield traits. Genetic trend for productive life was positive as a
      correlated response to past selection for yield and type traits. Phenotypic trend
      was slightly negative. Active AI bulls had PTA that ranged from -1.7 to +4.3 mo
      and mean reliability of 56%; 3-yr-old cows had mean reliability of 29%. Yield and
      type PTA were almost uncorrelated with productive life PTA for active AI bulls
      but had positive correlations (.25 to .36) for all bulls born since 1980. An
      index that combines yield and productive life PTA with relative weights 2.5:1 can
      increase economic progress by up to 4%. Nearly identical progress can result from
      an index that combines yield and productive life adjusted for yield. Multitrait
      evaluations might produce higher reliabilities for productive life by inclusion
      of correlated traits measured earlier in life such as yield, type, and somatic
      cell score.

PMID- 7782520
TI  - Multiple-trait prediction of transmitting abilities for herd life and estimation
      of economic weights using relative net income adjusted for opportunity cost.
AB  - Genetic and phenotypic (co)variances among linear type traits, final score, first
      lactation milk and fat yield, and 84-mo totals for longevity, relative net
      income, and relative net income adjusted for opportunity cost of postponed
      replacement were estimated with a multiple-trait sire model. Data were from
      433,116 cows in herds participating in the classification program for
      conformation traits of the Holstein Association of America. Yield information
      from all cows in classified herds indicated that classified cows are not a random
      sample. Heritability of net income adjusted for opportunity cost was higher, .17,
      than unadjusted net income, .12, but the genetic correlation between the
      estimates of net income was high, .97. Adjusted net income also had high genetic
      correlations with first lactation milk yield, .80; fat yield, .60; and dairy
      form, .48. Heritability of longevity (months in milk to 84 mo) was .06.
      Adjustment of net income for opportunity cost lowered the genetic correlation
      with longevity from .84 to .70. Evaluation of lifetime merit using traits
      measured during first lactation with economic weights developed using adjusted
      net income was more accurate than indirect prediction of longevity; the
      approximate reliability of a first-crop AI sire for lifetime merit was .65
      compared with .42 for longevity.

PMID- 7782522
TI  - A simulation study of selection methods to improve mastitis resistance of dairy
      cows.
AB  - Mastitis problems were assumed to decrease profitability of dairy cows through
      milk price, treatment cost, and involuntary culling cost. Milk price decreased
      through a stepwise function of SCC (actual French conditions). A continuous
      latent variate was supposed to trigger other costs through appropriate
      thresholds. The relative weights for one genetic standard deviation in the
      selection objective were 1, -.07, and -.14 for yield, SCC, and mastitis
      liability, respectively. Annual genetic gains were predicted for a conventional
      breeding scheme using statistical parameters from the literature. Selection on
      yield and log SCC, with or without mastitis culling rate, increased genetic gains
      for the overall profitability of .7 or .9%, respectively, compared with selection
      on yield only. Increases of log SCC and mastitis problems because of selection
      were substantially reduced (40 to 60%). Consequences from constraint of the
      genetic trend for mastitis liability to zero depended on the method used to
      assess mastitis problems. Use of log SCC had a significant and variable negative
      impact (-8.9 to -36% according to parameters) on overall efficiency compared with
      the relevant unconstrained selection. Simultaneous use of log SCC and culling
      rate had a moderate effect (-4.9 to -7.4%) on overall efficiency compared with
      that from unconstrained selection.

PMID- 7782521
TI  - Comparison of lipid composition of milk from half-Danish Jersey cows and United
      States Jersey cows.
AB  - We studied differences in lipid composition of milk from Jersey cows with US
      sires and from Jersey cows with Danish sires. Milk samples were obtained on DHIA
      test day from 32 cows with Danish sires and 32 herdmates with US sires in two
      herds. The Jerseys with US sires were paired with those with Danish sires by
      parity and stage of lactation. Mean percentage of milk fat was 5.7%, for Jerseys
      with Danish sires and 4.8% for Jerseys with US sires. Total fat per day was the
      same (.91 kg) for both groups. Detailed analysis of milk lipids indicated that
      lipid composition of milk was similar for cows with US sires and those with
      Danish sires. However, milk from Jerseys with Danish sires contained more free
      cholesterol than milk from Jerseys with US sires, 17.5 versus 14.3 +/- .6 mg/dl.
      The proportion of polyunsaturated fatty acids was greater for milk from Jerseys
      with US sires than for milk from Jerseys with Danish sires (2.3 vs. 2.1%).
      Although lipid composition of milk from both groups was generally similar, the
      milk of Jersey cows with Danish sires had higher concentrations of free
      cholesterol and lower proportions of polyunsaturated fatty acids, both of which
      are possible negative factors for health of consumers.

PMID- 7782523
TI  - Effects of interrelationships of production and reproduction on net returns in
      Florida.
AB  - Economic aspects of reductions in reproductive efficiency associated with
      increased production of milk and fat were evaluated for Holsteins and Jerseys in
      Florida during warm and cool seasons. Net returns from sire selection for
      increased production were examined with and without incorporation of such
      negative effects. The economic framework is the application of risk analysis in
      portfolio selection to selection of dairy sires. Estimates of effects of
      production on reproduction were from an earlier study of 4293 Holstein and 2143
      Jersey cows in first lactation on 14 Florida dairy farms in warm and cool
      seasons. The scenario represented the typically low reproductive efficiency of
      cows, especially Holsteins, during summer in Florida, although some statistics
      used represented US values. Least squares estimates of net returns after
      adjustment for reproductive losses showed major reductions in net returns for
      both breeds for both seasons, for example, $28 to $30/yr per lactation,
      representing 47 to 53% of predicted net returns for Holsteins and 27 to 31% for
      Jerseys. The results also suggested that increased use of young sires, which
      results generally in higher conception rates and lower semen costs, might be
      justified in tropical and subtropical areas, particularly during hot seasons.

PMID- 7782524
TI  - Initial stages in the development of valid criteria for the replacement of
      amalgam restorations.
AB  - OBJECTIVES: Replacement amalgam restorations account for the largest single cost
      in the General Dental Services in Scotland. There is little practical advice
      available to practitioners on the maintenance and replacement of amalgam
      restorations. A distance learning package is being prepared for distribution to
      general dental practitioners in Scotland and this paper describes the initial
      stages in the development of the policy statements for the proposed package.
      METHODS: In the first stage proposals are being developed by a panel of dental
      academics using a modified Delphi technique. This technique is designed to
      produce a consensus view. Seventeen statements have been set out by the expert
      group. RESULTS AND CONCLUSIONS: While agreement was rapidly reached that
      'ditching' of amalgam restoration margins did not justify their replacement and
      that repair was preferable to total replacement, some difficulty was experienced
      in arriving at a consensus view on the correct management of 'white spot' lesions
      at restoration margins and dentinal staining adjacent to amalgam restorations.
      The next stage in the development will be to present these statements to a
      selected panel of general dental practitioners and to develop their consensus
      view of the proposals, again using the Delphi technique.

PMID- 7782526
TI  - Elderly people's adaptability to complete denture therapy: usability of a
      geriatric behaviour-rating scale as a predictor.
AB  - Accurately predicting prognosis of complete denture therapy requires a reasonable
      estimation of the ability of a patient to adapt. The aim of the current study was
      to test the usability of a geriatric behaviour-rating scale (BOP) as a predictor
      of elderly people's ability to adapt after complete denture therapy. Ninety-five
      complete denture-wearing residents of four nursing homes for somatically
      handicapped patients were randomly divided into two groups, 48 test subjects for
      whom replacement dentures were prepared and 47 test subjects whose current
      dentures were improved on. The results of these treatments were evaluated by
      comparing the scores on the so-called 'scale of appreciation' (complaints of and
      (dis)satisfaction with complete dentures) prior to and at 2 and 6 months post
      treatment. Univariate correlations were computed between the scores on the 'scale
      of appreciation' or the differences in scores at the three evaluation-moments and
      the foremost BOP-subscale (BOP1, infirmity) and some factors that were considered
      to be of influence on the process of adaptation. The BOP1 was the only factor
      showing a significant correlation with the 'scale of appreciation' at 2 months
      posttreatment; this suggests that little infirmity was connected with a low value
      of complaints of and dissatisfaction with complete dentures or a positive
      alteration of this value. It is concluded that the BOP1 can be a useful predictor
      of complete denture therapy in this group of elderly people. A relationship
      between elderly people's adaptability to complete denture therapy and the BOP or
      any other geriatric behaviour-rating scale could be possible.

PMID- 7782525
TI  - A clinical study of pulsed Nd: YAG laser-induced pulpal analgesia.
AB  - The pulsed Nd: YAG laser is advocated as an alternative means of providing
      analgesia during routine dental procedures. Since the evidence to support this
      claim is mainly anecdotal, a clinical trial was carried out using an electric
      pulp tester (EPT) to measure the extent and duration of any analgesic effect
      induced by pulsed Nd: YAG laser treatment. A double-blind crossover experiment
      involving laser and sham treatments was used on 21 subjects. A small (3.6
      arbitrary units) but statistically significant increase was observed in the mean
      responses measured 5 min after laser treatment with 113 mJ pulses at 15 pulses s
      1 (pps) for 3 min. The pain thresholds returned to baseline values after 60 min.
      No statistically significant changes in threshold were found with the sham
      treatment. The order in which laser and sham treatment was received made no
      difference to the results.

PMID- 7782527
TI  - Assessment of tooth wear in an ageing population.
AB  - A random sample of 2222 adults aged 45 years and over was taken from the age/sex
      registers of two general medical practices in Newcastle upon Tyne, and asked to
      take part in a dental health survey. A total of 1002 individuals agreed to take
      part and were visited in their homes. Five hundred and eighty-six subjects were
      dentate and able to undergo an assessment of tooth wear using the Tooth Wear
      Index (TWI). Increasing wear with increasing age was observed for all cervical
      and occlusal/incisal tooth surfaces. Occlusal/incisal surfaces displayed some of
      the highest mean wear scores, especially in the older age cohorts. With the
      exception of lingual surfaces of maxillary anterior teeth, no significant
      variation in tooth wear with age was noted for buccal or lingual surfaces.
      Greater mean wear scores were observed among males than females, but there was
      little variation between subjects of different social class backgrounds. The
      threshold levels of wear suggested for use with the TWI may require modification
      for use among elderly populations.

PMID- 7782529
TI  - Bacterial adhesion to dental amalgam and three resin composites.
AB  - OBJECTIVES: The ability of three oral bacteria to adhere to hydrophobic amalgam
      (water contact angle 60 degrees) and hydrophobic resin composites (Prisma-AP.H 56
      degrees. Herculite XRV 82 degrees and Z100 89 degrees) was compared using an in
      vitro assay. METHODS AND RESULTS: Following preincubation of the materials with
      human saliva, X-ray photoelectron spectroscopy showed the surfaces to adsorb
      carbon and nitrogen-containing compounds in a conditioning film that appeared to
      block the detection of Na and others in 2100 resin. Hg and Ag in amalgam, Si and
      Zn in Prisma AP.H resin and Ag and Na in Herculite resin. The precoating of the
      substrata by a proteinaceous conditioning film led to decreased binding of viable
      cells of Streptococcus sanguis CH3, Streptococcus salivarius HB and Actinomyces
      viscosus WG as compared with the adhesion to bare composites. With and without
      salivary coating, there was a correlation between increased bacterial
      hydrophobicity and increased retention on the substrata. However, there was no
      statistical difference in binding to the amalgam compared with the resin
      composites. In vitro studies showed that the bacteria autoaggregated in the
      presence of saliva. CONCLUSION: The results indicate the potential ability of
      normal oral flora to colonize resin composite.

PMID- 7782528
TI  - An in vitro assessment of tooth preparation for porcelain veneer restorations.
AB  - OBJECTIVES: This in vitro study aimed to examine the depth of preparation and
      incidence of dentine exposure resulting from the use of a 'freehand' technique to
      prepare maxillary central incisors for porcelain veneers. METHODS: Twenty-two
      maxillary central incisors were selected. Prior to preparation an index of the
      labial surface of each tooth was recorded and the tooth secured in a jig to
      permit accurate relocation. Two operators each prepared 11 teeth aiming to reduce
      the labial thickness evenly by 0.5 mm. Low viscosity silicone impression material
      was then placed on the index and the teeth relocated into the jig. Upon removal,
      this material was sectioned in the cervical, middle and incisal thirds of the
      tooth and its thickness measured using a toolmaker's microscope. The teeth were
      acid etched and also stained with a dentine dye to identify any area of dentine
      exposed during preparation. RESULTS: Significant differences (P < 0.001) in the
      depth of preparation at different sites, with least reduction in the mid-incisal
      region, were found. Greater reduction was found at the cervical and proximal
      margins with areas of dentine exposed at those sites in the majority of teeth.
      CONCLUSIONS: In view of the incidence and position of dentine exposure found in
      this study, the use of a dentine bonding system during the placement of porcelain
      veneers would appear essential when employing a 'freehand' preparation technique.

PMID- 7782530
TI  - Antibacterial activity of MDPB polymer incorporated in dental resin.
AB  - OBJECTIVES: Previously, we have reported that dental composite incorporating the
      new monomer methacryloyloxydodecylpyridinium bromide (MDB) showed no release of
      antibacterial components after being cured but still exhibited antibacterial
      activity against Streptococcus mutants on its surface. In this study, in order to
      elucidate the mechanism of the antibacterial effect of immobilized MDPB, the
      bactericidal activity of MDPB polymer in water-soluble and -insoluble form was
      investigated, and the effect of MDPB polymer on bacterial attachment was
      estimated. METHODS: Solutions of homo-polymer of MDPB and co-polymer of MDPB with
      acrylamide were prepared and the viability of seven major oral streptococci was
      determined after incubation with each polymer solution. For the estimation of
      bactericidal activity of insolubilized MDPB polymer, bacteria were kept in
      contact with cured unfilled Bis-GMA-based resin discs with or without MDPB, and
      the recovery of viable cells was measured. Attachment of streptococci to cured
      resin discs with or without MDPB was also compared using radiolabelled bacteria.
      RESULTS: Water-soluble homo-polymer of MDPB and co-polymer with acrylamide showed
      bactericidal activity against oral streptococci. However, cured resin
      incorporating MDPB, which is in water-insoluble form, had little bactericidal
      activity. Attachment of streptococci, including species which are early
      colonizers in dental plaque formation, to the cured resin containing MDPB was
      significantly less than to the control without MDPB. CONCLUSIONS: These results
      indicate that the bactericidal activity of MDPB polymer is reduced after
      immobilization, but MDPB on the surface of a resin-based material still shows a
      bacteriostatic effect and antiadhesion property against oral streptococci.

PMID- 7782532
TI  - Recruitment issues: errors of omission in dental research.

PMID- 7782531
TI  - Influence of light intensity on two restorative systems.
AB  - OBJECTIVES: High intensity curing lights are recommended almost universally on
      the basis of immediate curing depth measurements. Although this single factor is
      well documented, the influence of light intensity on other parameters has not
      been investigated extensively. METHODS: Two restorative systems were examined
      with two light intensities in regard to four properties; polymerization shrinkage
      (density method), flexural modulus and strength (ISO 4049), hardness profiles
      after post-cure (Vickers), and marginal adaptation in dentine cavities
      (quantitative margin analysis). RESULTS: The variation in light intensity did not
      significantly affect curing contraction or post-cure hardness profiles to a depth
      of 4.5 mm for either resin composite. Significant differences were found in
      flexural modulus with both restoratives; only one material demonstrated a light
      intensity-related influence on flexural strength. Marginal gap formation
      increased in each bonding agent/resin composite pair with increased light
      intensity. CONCLUSION: In clinically relevant layer thicknesses, curing a resin
      composite with a higher intensity light may demonstrate significant disadvantages
      due to increased shrinkage stress.

PMID- 7782533
TI  - Multiple-outcomes meta-analysis of treatments for periodontal disease.
AB  - The results of periodontal therapy vary by disease severity, outcome measure, and
      method of data analysis. Several clinical trials and a subsequent meta-analysis
      have demonstrated that, for teeth with severe disease, surgery decreases probing
      depth (PD) and increases attachment level (AL) more than non-surgical treatment.
      For other disease levels, the choice of therapy depends on the outcome measure.
      When clinical trials use two or more outcome measures (such as PD and AL),
      investigators ordinarily analyze each outcome separately. When the correlations
      are incorporated among the outcomes, a meta-analysis can use generalized-least
      squares (GLS) regression to analyze multiple outcomes jointly. We applied the GLS
      multiple-outcomes model in a meta-analysis of 5 trials comparing surgical and non
      surgical periodontal treatments, each assessing the outcomes PD and AL one year
      after treatment. The clinical conclusions are similar to those reported earlier,
      but our estimates of the relative benefits of surgical and non-surgical treatment
      should be more accurate, because the GLS method takes into account correlation
      between AL and PD. When correlations between the two outcomes rise, as they do
      with increasing severity of disease, the GLS estimates depart from those derived
      from separate analyses of PD and AL.

PMID- 7782534
TI  - Monoclonal antibodies against a high-molecular-weight agglutinin block adherence
      to experimental pellicles on hydroxyapatite and aggregation of Streptococcus
      mutans.
AB  - High-molecular-weight (HMW) glycoproteins, agglutinins, in parotid saliva induce
      the aggregation of S. mutans and mediate binding of the bacteria to saliva-coated
      hydroxyapatite (SHA). Two types of monoclonal antibodies (mAb) directed against,
      respectively, protein and carbohydrate epitopes on the agglutinin have been
      reported to inhibit the aggregation of S. mutans. In this study, the mAbs were
      tested for their ability to block aggregation and adherence to SHA of S. mutans
      serotype c mediated by parotid, submaxillary, and whole saliva from three
      subjects. Both types of antibody inhibited the adherence and aggregation in a
      dose-dependent manner. However, individual variations were noted for the effects
      of the antibodies. Sodium dodecylsulfate polyacrylamide gel electrophoresis (SDS
      PAGE) and subsequent immunoblotting with the antibodies revealed a > 300 kDa
      agglutinin component in all types of saliva and in the proteins desorbed from
      SHA. The degree of staining of this component in immunoblots of the salivas and
      the desorbates seemed to be paralleled by the rates of aggregation and adherence,
      respectively. Thus, our results indicate that the adherence to SHA as well as the
      aggregation of S. mutans serotype c is primarily mediated by structurally
      related, HMW glycoproteins in parotid, submaxillary, and whole saliva.

PMID- 7782535
TI  - Salivary PAF levels correlate with the severity of periodontal inflammation.
AB  - Platelet-activating factor (PAF), a potent phospholipid mediator of inflammation,
      has been previously identified in inflamed gingival tissues and gingival
      crevicular fluid. However, the role of PAF in oral pathobiology remains unknown.
      The purpose of the present study was to evaluate the relationship between
      salivary PAF levels and the severity of periodontal inflammation. PAF activity in
      lipid extracts of whole (mixed) saliva collected from 69 untreated subjects
      immediately prior to routine oral evaluation was determined by platelet bioassay.
      Significant positive correlations were observed between the level of PAF in
      saliva and measures of periodontal inflammation, i.e., the percentage of
      periodontal probing depths greater than 4 mm, the number of periodontal bleeding
      sites, and the number of histologically identified polymorphonuclear neutrophilic
      leukocytes (PMN) in saliva. Moreover, when subjects were subdivided into groups
      on the basis of periodontal probing depths, a significant correlation was
      observed between salivary PAF levels and the extent of periodontal disease, i.e.,
      PAF levels in saliva progressively increased from the healthiest group to the
      most severely affected group. Thus, salivary PAF levels correlate with the
      severity of periodontal inflammation. These results support the hypothesis that
      this pro-inflammatory phospholipid autacoid may participate in the pathogenesis
      of periodontal tissue injury and disease.

PMID- 7782536
TI  - Differential expression of IL-1 beta, TNF-alpha, IL-6, and IL-8 in human
      monocytes in response to lipopolysaccharides from different microbes.
AB  - Macrophages respond to bacterial lipopolysaccharides (LPS) and activate several
      host defense functions through production of mediators. However, it is not clear
      whether the degree of macrophage responsiveness to different sources of LPS is
      equivalent to or varies with the source of LPS. Therefore, in this report, we
      examined the extent of the human monocyte response to LPS derived from two oral
      pathogens, Actinobacillus actinomycetemcomitans (Aa) and Porphyromonas gingivalis
      (Pg). Additionally, due to its well-established ability to activate monocytes, we
      used LPS from Escherichia coli (Ec). Human monocytes, when activated with a
      specific source of LPS, exhibited rapid expression of mRNA for IL-1 beta, TNF
      alpha, and IL-8, which was followed by IL-6, as measured by RNA-PCR. Moreover,
      the expression of mRNA for these cytokines was followed by cytokine synthesis.
      Monocytes from the same subject, when activated with LPS from Pg, Aa, or Ec
      expressed quantitatively different levels of mRNA and proteins for all four
      cytokines. A given LPS induced either high or low expression of the battery of
      cytokines tested, indicating that the expression of these pro-inflammatory
      cytokines may be regulated by a single or a cluster of gene(s). However, no
      apparent differences in the time course of mRNA expression for these cytokines
      were observed in response to any of the LPS tested. Furthermore, the relative
      ability of the different sources of LPS to induce mRNA for cytokines varied
      throughout a wide range of LPS concentrations. This suggests that differences
      exist in the sensitivity of monocytes to a specific LPS, rather than in the
      kinetics of the secretory process itself.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782537
TI  - Enhanced cytokine production and collagen synthesis of gingival fibroblasts from
      patients with denture fibromatosis.
AB  - The mechanisms of denture-induced gingival hypertrophy remain to be explored.
      Since fibroblast proliferation and bone resorption characterize this disorder,
      the possible involvement of cytokines was investigated. Gingival fibroblasts were
      obtained from six patients with denture fibromatosis (Den-Fb) and six healthy
      persons (Nor-Fb). Cells were compared for proliferation, collagen synthesis, and
      cytokine production. Incorporation of [3H]thymidine (TdR) was increased in 3 Den
      Fb and 3 Nor-Fb lines in the presence of interleukin-1-beta (IL-1 beta) (10 U/mL)
      and tumor necrosis factor-alpha (TNF-alpha) (from 10 to 100 U/mL). Proline
      incorporation in Den-Fb was higher than that in Nor-Fb, and the mean collagen
      synthesis level in Den-Fb was significantly higher than that in Nor-Fb. Although
      there was no difference between the up-regulation of protein synthesis in Den-Fb
      and Nor-Fb induced by IL-1 beta or TNF-alpha, the receptors for these cytokines
      were expressed at higher levels in cell lines which exhibited higher protein
      synthesis. Between Nor-Fb and Den-Fb, there was no difference in the generation
      of granulocyte-macrophage colony-stimulating factor (GM-CSF) or interleukin-6 (IL
      6). However, most Den-Fb produced more GM-CSF and IL-6 in the presence of TNF
      alpha. Enhancement of IL-6 generation by GM-CSF was also more prominent in Den
      Fb. GM-CSF and IL-6 were synergistically generated after co-culture of the
      fibroblasts with gingival keratinocytes. GM-CSF and IL-6 generation of Den-Fb was
      markedly enhanced by co-culture of Den-Fb with peripheral blood mononuclear cells
      (PBMC), especially PBMC from patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782538
TI  - Effects of fluoride on the calcium phosphate precipitation method for dentinal
      tubule occlusion.
AB  - Use of the calcium phosphate precipitation (CPP) method makes possible the
      occlusion of dentinal tubules to approximately 10 to 15 microns from the dentinal
      surface, and thus shows good potential for the treatment of dentin
      hypersensitivity. The precipitate formed in the dentinal tubules by the CPP
      method is, however, not apatite [HAP; Ca10(PO4)6(OH)2], a component of tooth and
      bone, but dicalcium phosphate dihydrate (DCPD; CaHPO4.2H2O). Since fluoride
      enhances the conversion of DCPD to HAP, we evaluated the effects of fluoride on
      the texture of the precipitate formed by the CPP method and on its capacity to
      occlude dentinal tubules in this in vitro study. CPP solution (1.0 mol/L
      CaHPO4.2H2O dissolved in 2.0 mol/L H3PO4) was applied to a dentin disk and was
      subsequently neutralized with a post-treatment solution (1 mol/L NaOH, from 0 to
      0.1 mol/L NaF). Scanning electron microscopy revealed that the precipitate
      occluded dentinal tubules to a depth of approximately 10 to 15 microns from the
      dentinal surface, regardless of the NaF concentration (from 0 to 0.1 mol/L) in
      the post-treatment solution. Also, dentin permeability was reduced to 15% by the
      CPP treatment regardless of the NaF concentration. The Ca/P molar ratio of the
      precipitate, measured by x-ray micro-analysis, was higher (1.25 +/- 0.04) in the
      presence of NaF than in its absence (1.03 +/- 0.01). For further identification
      of the precipitate formed in the dentinal tubules, the same procedure was used in
      glass tubes (diameter, 1 mm), so that a larger amount of precipitate would be
      obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782539
TI  - Light deposition in dental hard tissue and simulated thermal response.
AB  - Near-IR (approximately 1 micron) lasers are presently used for a variety of intra
      oral applications including dental hard tissue ablation, although the light
      intensity distribution and subsequent heating of the hard tissue are still poorly
      understood. This paper presents a detailed numerical study of the scattered light
      intensity distribution along with the corresponding predicted thermal response.
      The calculations are based on recently published scattering and absorption data
      for dental hard tissue around 1 micron. Our simulations indicate strongly
      enhanced energy deposition and concomitant heating near the dentino-enamel
      junction (DEJ), mainly due to the higher absorption in dentin. We predict from 10
      to 20 times higher internal temperatures near the DEJ compared with the surface.
      For example, for 50-ms pulses of 5-J energy on a 3-mm-diameter spot
      (approximately 1 kW/cm2 or approximately 50 J/cm2), one can expect internal
      temperatures near the DEJ in excess of 100 degrees C. Elevated temperatures are
      predicted to extend far into the dentin, endangering the vitality of the pulp
      several millimeters below the surface. Our results are compared with published
      experimental data taken under similar conditions and are found to be in good
      general agreement. The results of this study do not contradict recently reported
      ablation of dentin with Nd:YAG laser radiation by contact fiber probes. In this
      case, the irradiation intensities are 3 to 4 orders of magnitude higher, so
      plasma formation and plasma shielding of the interior of the tooth are likely.

PMID- 7782541
TI  - Combined estimation of mercury species released from amalgam.
AB  - Amalgam fillings constitute, after food, the main source of exposure to mercury
      for the general population. Banning amalgam would incur huge costs for additional
      dental treatment. An evaluation of potential health risks must be based on the
      mercury dose released from fillings. In this study, dose is estimated by a new
      procedure of mercury speciation which elutes the released elemental and inorganic
      mercury with solvents of differing polarity. We tested the procedure by
      incubating spherical amalgam pellets in a mixture of light paraffin oil and
      saline (0.9% NaCl). Release of mercury into paraffin and saline was linear in
      relation to both amalgam surface area and exposure time. Measurements with this
      method were then extended to a group of 21 amalgam-bearing volunteers. The
      absorbed dose averaged 4.8 micrograms/day compared with 3.7 measured
      conventionally in intra-oral air from the same persons. With both methods, the
      dose was significantly correlated to the number of amalgam-covered tooth
      surfaces. This dose, combined with the nearly equal mercury uptake from food, is
      far below the acceptable daily intake limit.

PMID- 7782540
TI  - Tensile properties of resin-infiltrated demineralized human dentin.
AB  - The ability of adhesive resins to restore the physical properties of
      demineralized dentin has not been well-documented. The unfilled resins that are
      used for adhesion have relatively low moduli of elasticity and limited ability to
      increase dentin stiffness, although they may increase the ultimate tensile
      strength of dentin. This study tested the hypothesis that resin infiltration of
      demineralized dentin can restore its tensile properties to those of mineralized
      dentin. Small (ca. 0.5 mm thick x 0.5 mm wide) specimens of demineralized human
      dentin were infiltrated with one of five different dentin bonding resins over
      many hours, to determine how these resins altered the tensile properties of
      dentin. Tensile stress and strain were measured in these and control (mineralized
      and demineralized) specimens until their ultimate failure. The results indicate
      that some adhesive resins, after infiltrating demineralized dentin, can restore
      and even exceed the ultimate tensile strength of mineralized dentin. These resins
      increased the modulus of elasticity of resin-infiltrated dentin to values equal
      to or greater than those of the resins but far below those of mineralized dentin.
      Although the conditions in this experiment were far removed from the
      manufacturer's recommendations or clinical practice, the results support the
      potential of resin infiltration for reinforcing dentin.

PMID- 7782542
TI  - Preparation and characterization of cyclopolymerizable resin formulations.
AB  - An amine-catalyzed reaction between acrylates and formaldehyde has been used to
      convert mono-acrylates to difunctional monomers and di-acrylates to
      multifunctional oligomers by linking the acrylic double bonds together in 1,6
      diene pairs. The resulting monomers and oligomers undergo efficient
      cyclopolymerization to high conversion with significantly less shrinkage than
      normally found for acrylates. In this study, a convenient single-step process was
      used with mixtures of mono- and di-acrylate starting materials to produce a
      series of resins with potential for effective cyclopolymerization. Incremental
      changes in the ethyl acrylate (EA) to ethoxylated bisphenol A diacrylate (EBPAD)
      ratio directly supplied cyclopolymerizable resins with a broad range of
      viscosities and product distributions. Those resins produced from reaction
      mixtures rich in EA have low viscosities because of high diluent monomer contents
      and limited oligomerization of EBPAD due to end-cap formation. Resin viscosity
      and average molecular weight of the oligomeric component of the resin were
      inversely related to the amount of EA used in the reaction. Through the choice of
      reactants and their ratio, this simple technique has the potential to provide
      cyclopolymerizable resins for use in a variety of dental polymer applications.

PMID- 7782543
TI  - Critical Issues in Dental Clinical Research. Proceeding of a symposium. Seattle,
      Washington, March 10, 1994.

PMID- 7782546
TI  - The Institute of Medicine's report on dental education.

PMID- 7782544
TI  - Critical issues in periodontal research.
AB  - The purpose of this paper is to highlight briefly the major achievements and the
      remaining critical issues in the areas of epidemiology, microbiology,
      pathogenesis, diagnosis, and therapy. Periodontitis affects a relatively small
      proportion of study populations in the United States and other countries.
      Prevalence may be decreasing, but that remains to be seen. The identity and
      characteristics of susceptible individuals and groups are not known, and risk
      indicators for severe disease are only beginning to be identified. A very large
      number of different microbial species has been implicated in the etiology. It
      seems unlikely that all of these are essential participants. Essential
      participants need to be identified and better characterized. Whether putative
      pathogens are members of the commensal flora or exogenous species that must be
      transmitted is unclear. The relationship between the presence of a pathogenic
      flora and disease status is obscure. Pathogenic bacterial species are essential,
      but insufficient to cause disease. A susceptible host and local environmental
      factors--for example, elevated iron concentration--may be necessary for disease
      to occur. Many clonal types may not be virulent, and numbers greater than certain
      threshold levels appear to be necessary. The pathways by which bone and
      connective tissues of the periodontium are destroyed are sufficiently understood
      to permit development of therapies aimed at their modification. Examples are the
      use of vaccines, topical application of anti-inflammatory drugs, and use of
      chemically modified tetracyclines.

PMID- 7782545
TI  - Validity of diagnostic and monitoring tests used for temporomandibular disorders.
AB  - Currently, diagnosis of temporomandibular disorders (TMD) depends on a
      comprehensive history and physical examination, supplemented, when indicated, by
      images of hard and soft tissues. However, there are electronic diagnostic devices
      being marketed to acquire other measures described as relevant to TMD and to use
      these for diagnosis of TMD and for monitoring the effects of treatment. This
      paper reviews the capacity of several devices to measure these variables
      accurately and reliably and to assess the theoretical basis of each of these
      tests. Diagnostic ability was established, when possible, according to the
      commonly accepted measures of sensitivity, specificity, and positive predictive
      values. It was found that many tests lack theoretical validity, that measurement
      validity tends to be poor, and that diagnostic ability can be even worse than
      chance, because of a high percentage of false-positive diagnoses. Based on these
      findings, the use of these instruments in clinical practice is inappropriate at
      this time and may lead to the treatment of large numbers of subjects who have no
      disorder.

PMID- 7782547
TI  - Dental education institutions must respond to the Institute of Medicine report.

PMID- 7782548
TI  - Educating dentists for the twenty-first century.

PMID- 7782550
TI  - Managed care in dental schools.

PMID- 7782549
TI  - Market forces driving health care reform.

PMID- 7782551
TI  - Designing preclinical instruction of psychomotor skills (IV)--Instructional
      engineering: evaluation phase.

PMID- 7782552
TI  - Mandatory consent to treatment by students in dental education: legal and policy
      considerations.

PMID- 7782553
TI  - Survey of clinic fees and clinic revenue--summary report, 1993-94.
AB  - Figure 4 shows the mean unadjusted revenue-per-student by program type. Advanced
      Education General Dentistry programs had the highest revenue-per-student this
      year and in two of the three previous years. Oral and Maxillofacial Surgery
      programs generated the second highest mean amount of clinic revenue-per-student,
      followed by General Practice Residencies, Orthodontic programs, and Prosthodontic
      programs. Pediatric Dentistry, Endodontics, and Periodontics programs also had
      similar mean revenues-per-student. The smallest revenues-per-student were
      generated by D.D.S./D.M.D. and dental hygiene programs. These data should be
      interpreted with care. A review of the information for each program shows that
      there are significant variations in these data from school to school. These
      variations could be caused by different accounting procedures as well as
      differences in program size and location. Consequently, these data are best
      viewed in general terms.

PMID- 7782555
TI  - Dose-response relationship between total cadmium intake and prevalence of renal
      dysfunction using general linear models.
AB  - To determine the maximum allowable intake limits for chronic dietary exposure to
      cadmium (Cd), the dose-response relationship between total Cd intake and
      prevalence of renal dysfunction was examined using general linear models
      considering the effect of age as a confounder. The target population comprised
      1850 Cd-exposed and 294 non-exposed inhabitants of Ishikawa, Japan. They were
      divided into 96 subgroups by sex, age (four categories) cadmium concentrations in
      rice (three categories) and length of residence (four categories). As indicators
      of the cadmium-induced renal dysfunction, glucose, total protein, amino nitrogen,
      beta 2-microglobulin and metallothionein in urine were employed. General linear
      models were fitted statistically to the relationship among prevalence of renal
      dysfunction, sex, age and total Cd intake. Prevalence of abnormal urinary
      findings other than glucosuria had significant associations with total Cd intake.
      When total Cd intake corresponding to the mean prevalence of each abnormal
      urinary finding in the non-exposed subjects was calculated using general linear
      models, total Cd intakes corresponding to glucosuria, proteinuria, aminoaciduria
      (men only) and proteinuria with glucosuria were determined to be ca. 2.2-3.8 g
      and those corresponding to prevalence of metallothioneinuria were calculated as
      ca. 1.5-2.6 g. The low-molecular-weight protein in urine was confirmed to be a
      more sensitive indicator of renal dysfunction, and these total Cd intake values
      were close to those calculated previously by simple regression analysis,
      suggesting them to be reasonable values as the maximum allowable intake of Cd.

PMID- 7782554
TI  - Evaluation of the toxicity of several heavy metals by a fluorescent bacterial
      bioassay.
AB  - This new bioassay determined the toxicity of chemical compounds dissolved in
      water by measuring the degree of inhibition of the ultraviolet light-stimulated
      fluorescence of Escherichia coli in a culture medium in which 4
      methylumbelliferyl beta-D-glucuronide was the only carbon source. Inhibition
      produced by one of five heavy-metal salts (Cd2+, Cr6+, Hg2+, Pb2+ or Zn2+) was
      the end-point and comparison standard to determine the EC50 and minimum effective
      concentration (MEC) that produced a decrease of E. coli growth rate, increased
      doubling time and percentage inhibition and reduced numbers of generations; all
      these values were derived from the fluorescence signals. Only Cr6+ and Hg2+ at
      two concentrations (0.25 and 0.5 mg l-1) almost completely inhibited this E. coli
      strain. All toxicant concentrations tested produced at least partial inhibitions
      of growth; Cr6+, Hg2+ and Cd2+, in that order, were most toxic, and Pb2+ the
      least. Zn2+ gave higher EC50 values at 3 h of incubation than at 4 h. The method
      was simple, rapid and inexpensive and would permit a large number of samples to
      be tested quickly.

PMID- 7782557
TI  - High fat diet and liver damage induced by biliary obstruction in the rat.
AB  - There is a great body of evidence linking a high fat diet with the formation of
      gallstones. However, the effect of fat per se on obstructive liver damage (not
      involving gallstone formation) has not been assessed. The aim of this work was to
      study the effect of a high fat diet on liver damage induced by bile duct ligation
      in rats. Male 21-day-old Wistar rats were divided into two groups: group 1
      received standard Purina chow diet 5001 containing 4.5% fat, group 2 received
      Purina chow diet 5001 enriched with 33% pork fat. Animals were allowed food and
      water ad libitum for 5 weeks. Obstructive jaundice was induced by double ligation
      and division of the common bile duct. The animals were sacrificed 1 week after
      biliary obstruction. Control animals were sham operated. Serum bilirubins and
      alkaline phosphatase, gamma-glutamyl transpeptidase and glutamic pyruvic
      transminase enzyme activities increased by biliary obstruction. Glycogen content
      decreased in the bile duct-ligated rats. These effects were more important in the
      group fed a 33% fat diet. Our results show that a high animal fat diet increases
      liver damage in experimental biliary obstruction in rats. Owing to our
      experimental design (bile duct ligation), the effect of a high fat diet cannot be
      attributed to an increase in the formation of gallstones but a direct effect must
      be considered. The mechanism by which fat augmented liver damage can be
      associated with an increase of total bile content and its toxicity.

PMID- 7782556
TI  - Two-generation reproduction toxicity study with isopropanol in rats.
AB  - A two-generation reproduction toxicity study was conducted in rats with
      isopropanol. Thirty rats of each sex per group (P1) were dosed once daily by oral
      gavage with 0, 100, 500 or 1000 mg isopropanol kg-1 for at least 10 weeks prior
      to mating. Parental animals were mated within groups for up to 3 weeks. Parental
      females were dosed during mating, gestation and lactation; parental males were
      dosed during mating through delivery of their last litter sired. The P2 adults
      were selected from the F1 litters and were dosed for 10-13 weeks before mating to
      produce a single litter. Findings in the parental animals included increased
      lactation body weight gain in the mid- and high-dose females, increased liver and
      kidney weights in the mid- and high-dose groups of both sexes and centrilobular
      hepatocyte hypertrophy in some P2 males. There was also accumulation of hyaline
      droplets and other microscopic findings in the kidneys from the mid- and high
      dose P1 males and from all treated groups of the P2 males. Increased mortality
      was observed in the high-dose F1 offspring during the early postnatal period,
      although no other clinical signs of toxicity were observed in the offspring of
      either generation. In addition, offspring body weight was reduced during the
      early postnatal period in the high-dose F1 males and in the high-dose F2 pups of
      both sexes. Eighteen out of 70 F1 weanlings in the 1000 mg kg-1 group died or
      were euthanized prior to P2 selection. No treatment-related post-mortem findings
      were observed in the offspring from either generation.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7782558
TI  - Decrease in hepatotoxicity by lead exposure is not explained by its mitogenic
      response.
AB  - The present research was conducted to evaluate the effect of mitogen pre-exposure
      on CCl4-induced hepatotoxicity. Male Wistar rats were administered a single i.p.
      injection of CCl4 (0.3 ml kg-1 in corn oil) 48 h following either a single dose
      of lead nitrate (0.33 mg kg-1) or distilled water via i.v. injection.
      Hepatotoxicity, as measured by serum alanine aminotransferase (ALT) and aspartate
      aminotransferase (AST) levels, was monitored 6, 24, 48, 72 and 120 h after CCl4
      exposure. The lead nitrate-pretreated rats displayed markedly lower serum ALT and
      AST levels at 24, 48 and 72 h than rats pretreated with distilled water. However,
      treatment with the antimitotic agent colchicine did not alter the lead-induced
      protection. These findings suggest that the lead-induced protection is not
      associated with the major mitogenic response of lead, despite its strong temporal
      association. A critical review of the available toxicological data also argues
      against the lead protection being a function of its capacity to inhibit
      cytochrome P-450.

PMID- 7782559
TI  - Reduction of erythema in hairless guinea pigs after cutaneous sulfur mustard
      vapor exposure by pretreatment with niacinamide, promethazine and indomethacin.
AB  - Erythema is the initial symptom that occurs after sulfur mustard (HD) cutaneous
      exposure. The time course of HD-induced erythema is similar to that observed
      after UV irradiation, which can be reduced by indomethacin. Sulfur mustard
      lethality is decreased by using promethazine, which is an antihistamine.
      Niacinamide can reduce microvesication after HD vapor exposure in hairless guinea
      pig (HGP) skin. The present study examines the effect of the combined
      administration of niacinamide, indomethacin and promethazine used alone or in all
      possible combinations on the degree of erythema and histopathologic skin damage
      after HD exposure in HGP. Niacinamide (750 mg kg-1, i.p.), promethazine (12.5 mg
      kg-1, i.m.) or indomethacin (4 mg kg-1, p.o.) used singly or in combination was
      given as a 30-min pretreatment before an 8-min HD vapor cup skin exposure. Using
      a combination pretreatment of niacinamide, promethazine and indomethacin,
      erythema was reduced at 4 (91%) and 6 (55%) h, but not 24 h after HD. The
      incidence of histopathological skin changes (microvesicles, follicular
      involvement, epidermal necrosis, intracellular edema and pustular epidermatitis)
      24 h after HD was not reduced. This study indicates that HD-induced erythema may
      result from several different mechanisms, including inflammation, histamine
      release and DNA damage. It is suggested that two phases of inflammation may
      occur: an early phase sensitive to antihistamines and non-steroidal
      antiinflammatory drugs and a late phase of extensive cell damage that was not
      sensitive to these drug pretreatments.

PMID- 7782560
TI  - Acute renal and hepatic effects induced by 3-haloanilines in the Fischer 344 rat.
AB  - Haloanilines are commonly used as chemical intermediates in the manufacture of a
      wide range of products. The purpose of this study was to examine the in vivo
      nephrotoxic and hepatotoxic potentials of the 3-haloanilines. The in vitro
      effects of the 3-haloanilines on renal function were also examined. In the in
      vivo experiments, male Fischer 344 rats (four rats/group) were administered a
      single intraperitoneal (i.p.) injection of an aniline hydrochloride (1.0 or 1.25
      mmol kg-1) or vehicle. Renal and hepatic function were monitored at 24 and/or 48
      h post-treatment. None of the 3-haloanilines were potent nephrotoxicants at
      either dose level. The greatest effects on renal function were observed following
      administration of 3-chloroaniline at a dose of 1.25 mmol kg-1 (oliguria,
      glucosuria, hematuria, decreased p-aminohippurate accumulation by renal cortical
      slices and increased blood urea nitrogen concentration). 3-Chloroaniline also was
      the only aniline compound to increase plasma ALT/GPT activity at 48 h. In the in
      vitro experiments, the ability of an aniline (10(-5) - 10(-3) M) to decrease
      organic ion accumulation in renal cortical slices from untreated rats was
      examined. The decreasing order of in vitro nephrotoxic potential was 3
      iodoaniline > 3-bromoaniline > 3-chloroaniline > aniline > 3-fluoroaniline. These
      results indicate that the 3-haloanilines are not potent nephrotoxicants or
      hepatotoxicants at sublethal doses. In addition, the reasons why the 3
      haloanilines have different orders of nephrotoxic potential in vivo and in vitro
      are not clear at this time.

PMID- 7782561
TI  - An in vitro method for determination of tissue partition coefficients of non
      volatile chemicals such as 2,3,7,8-tetrachlorodibenzo-p-dioxin and estradiol.
AB  - The development of an in vitro vial equilibration technique for determining
      tissue and liquid partition coefficients for non-volatile chemicals is described.
      Radiolabeled chemical dissolved in propylene carbonate is equilibrated with
      tissues or liquid at 37 degrees C in a vial system. The solvent must be
      essentially immiscible with the test material. The amount of chemical movement to
      the tissue or liquid is compared to an appropriate reference vial, and tissue or
      liquid:solvent partition coefficients are calculated. Tissue:solvent values
      divided by blood:solvent values provide tissue:blood partition coefficients
      required for developing physiologically based pharmacokinetic models for
      chemicals. These models are useful for estimating internal tissue doses to assess
      human risk from exposure to chemicals. Partition coefficients for various rat
      tissues, 0.9% saline solution and olive oil were determined in this study for
      radiolabeled 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and for the less fat
      soluble compound, estradiol. The TCDD tissue:propylene carbonate partition
      coefficients were found to be: blood, 0.091; fat, 17.02; liver, 0.419; brain,
      0.632; kidney, 0.305; muscle, 0.408. For estradiol, the tissue:propylene
      carbonate partition coefficients were: blood, 0.286; fat, 0.169; liver, 1.032;
      brain, 0.554. The TCDD results compared well with values reported and estimated
      from a more protracted in vivo approach. Thus, this current technique offers a
      simpler and time-saving alternative to in vivo approaches for determining the
      partition coefficients of non-volatile compounds.

PMID- 7782562
TI  - Isopropanol: acute vapor inhalation neurotoxicity study in rats.
AB  - Five groups of 25 Fischer 344 rats of each sex were exposed for 6 h to
      isopropanol vapor at 0, 500, 1500, 5000 or 10,000 ppm. Behavioral observations
      for 10 rats of each sex were made prior to and 1, 6, and 24 h after exposure.
      Motor activity was evaluated for 15 rats of each sex prior to and immediately
      following exposure. Exposure to isopropanol caused a spectrum of transient
      effects indicative of narcosis at 10,000 ppm and sedation at 5000 ppm.
      Prostration or severe ataxia, decreased arousal, slowed or labored respiration,
      decreased neuromuscular function, hypothermia and loss of reflex function were
      observed 1 and 6 h after exposure to 10,000 ppm isopropanol vapor. Similar, but
      less severe, alterations were observed in animals in the 5000 ppm exposure group
      1 h after exposure. Exposure concentration-related decreases in motor activity
      were observed in males and females in the 5000 and 10,000 ppm groups and slight
      decreases in motor activity were observed in males in the 1500 ppm group. Animals
      in the 1500 and 5000 ppm exposure groups recovered from these motor activity
      effects within 5 h. Based on this study, exposure of male and female rats to
      isopropanol vapor produces transient, concentration-related narcosis and/or
      sedation at concentrations of 5000 and 10,000 ppm and minor decreases in motor
      activity in males at a concentration of 1500 ppm. The no-observed-effect level
      (NOEL) for this was 500 ppm isopropanol.

PMID- 7782563
TI  - Epidermal carcinogenesis studies of EDS liquids.
AB  - A series of liquids representing different potential design options or operating
      configurations for the EDS direct coal liquefaction process* were evaluated for
      skin cancer potential. All of the samples that contained substantial amounts of
      material boiling above 370 degrees C were active dermal carcinogens; tumor yields
      were near 100% and median times to tumor development generally ranged from 30 to
      40 weeks. Two liquids that boiled below ca. 200 degrees C were tested and each
      produced one squamous cell tumor. These data suggested that high-boiling-point,
      coal-derived liquids are likely to be relatively potent dermal carcinogens;
      whereas low-boiling-point liquids do not possess significant carcinogenic
      potential. Based on a comparison of the carcinogenic potency data, liquids
      produced by the EDS process apparently do not present a significantly greater
      dermal carcinogenic hazard than other coal-derived materials of similar boiling
      range.

PMID- 7782564
TI  - Mechanism of citrinin-induced dysfunction of mitochondria. III. Effects on renal
      cortical and liver mitochondrial swelling.
AB  - The effects of the mycotoxin citrinin on renal cortical and liver mitochondrial
      swelling were studied. Citrinin decreases the rate of swelling induced by the
      valinomycin-K+ complex, suggesting that the mycotoxin interferes with the
      mitochondrial membrane fluidity. Citrinin promotes reduction of the amplitude of
      swelling in the presence of Na+ ions. This alteration reflects interference with
      complex I of the respiratory chain and ATP synthase complex activity without
      disarranging the inner mitochondrial membrane, in view of the fact that the
      shrinkage was not affected. The effect increases with citrinin concentration.
      Renal tissue is more susceptible than hepatic tissue.

PMID- 7782565
TI  - Pharmacokinetics of benzophenone-3 after oral exposure in male rats.
AB  - Benzophenone-3 (BZ-3) is one of the UV-absorbing agents that has been used in
      industry and medicine for more than 30 years. Millions of consumers are exposed
      to benzophenones on a daily basis owing to the widespread use of these compounds
      in many of the products on the market, such as lipsticks, hair sprays, hair dyes,
      shampoo and detergent bars and sunscreen lotions. This study was performed to
      investigate the pharmacokinetics of BZ-3 after oral administration at 100 mg kg-1
      body weight in male Sprague-Dawley rats. Absorption from the gastrointestinal
      tract was rapid because BZ-3 was detected in blood 5 min after administration.
      The peak plasma concentration (Cmax) was 25.6 +/- 4.6 micrograms ml-1 and the
      time of occurrence (tmax) was 3.0 +/- 0.4 h. The half-life of absorption of BZ-3
      was 0.71 h. The elimination pattern was biphasic with alpha and beta half-lives
      of elimination of 0.88 and 15.90 h, respectively. The results of this study
      indicate the presence of strong binding between the plasma protein and BZ-3.
      Tissue distribution studies at 6 h indicate that the liver contained the highest
      concentration of free (58.9 +/- 23.8 micrograms) and total (free+bound or
      conjugated) BZ-3 (2087 +/- 60.1 micrograms), followed by kidney and testes,
      respectively. Urine and feces analysis indicate that urine was the major route of
      excretion, followed by feces. Further analysis of urine samples also indicates
      that conjugation of BZ-3 with glucuronic acid was the major systemic elimination
      route for the compound.

PMID- 7782566
TI  - Micturitional disturbance in myotonic dystrophy.
AB  - Micturitional disturbance has attracted little attention in myotonic dystrophy,
      but detailed micturitional histories revealed that two out of six patients (33%)
      had micturitional symptoms. One had difficulty urinating and the other had
      urinary frequency, urgency and stress incontinence. Urodynamic studies were
      performed in all patients and the results were as follows: Two had low maximum
      urethral closure pressure, two had large and three had small bladder capacities,
      one had detrusor hyperreflexia and one had atonic cystometrogram. Urethral
      sphincter electromyography revealed a decreased bulbocavernosus reflex in one,
      and an absent anal reflex in two. Motor unit analysis of external sphincter was
      performed with one patient and showed polyphasic potentials. Dystrophic changes
      of the lower urinary tract muscles, as well as supranuclear type of pelvic nerve
      dysfunction, could cause micturitional disturbance in patients with myotonic
      dystrophy.

PMID- 7782567
TI  - Time-course and frequency dependence of sympathetic stimulation-evoked inhibition
      of vagal effects at the sinus node.
AB  - Vagally-induced chronotropic responses have been shown to be inhibited after the
      termination of sympathetic stimulation. We sought to characterize the onset and
      time-course of the sympathetically evoked inhibition of vagal effects by
      measuring vagally induced chronotropic responses during concomitant sympathetic
      stimulation. In anesthetized dogs we recorded lead II of the electrocardiogram,
      arterial pressure and cardiac cycle length. In 7 dogs, the vagi were stimulated
      for 15 s every minute before, during and after 10-min trains of sympathetic
      stimulation. The sympathetic stimulation was applied at frequencies of 0.5, 1, 2,
      5 and 10 Hz. During the 1, 2 and 5-Hz trains of sympathetic stimulation, the
      vagally induced changes in cycle length diminished progressively and thus, were
      less (P < 0.001) at 3, 5 and 10 min compared with 1 min into the sympathetic
      stimulation. The magnitude of the attenuation of vagal effects on cycle length
      depended (P < 0.001) on the frequency of sympathetic stimulation. To determine
      the role of alpha- and beta-adrenergic receptors, we measured vagally-induced
      changes in cycle length during 5-min trains of sympathetic stimulation (1, 2, 5,
      10 Hz) in the presence and absence of phentolamine and propranolol (n = 6). Both
      before and after combined alpha- and beta-adrenergic receptor blockade, the
      vagally-induced changes in cycle length decreased (P < 0.03) progressively during
      the 1, 2, 5 and 10-Hz trains of sympathetic stimulation and the magnitude of the
      inhibition depended (P < 0.002) on the frequency of sympathetic stimulation.
      These data show that the effects of short trains of vagal stimulation on cardiac
      cycle length are inhibited progressively during continuous trains of sympathetic
      stimulation before and after combined alpha- and beta-adrenergic receptor
      blockade. Thus, substances other than norepinephrine may contribute to the
      inhibition of cardiac vagal effects that occurs during a continuous train of
      sympathetic stimulation.

PMID- 7782568
TI  - Arrangement of dendrites and morphological characteristics of sympathetic
      preganglionic neurones projecting to the superior cervical ganglion and adrenal
      medulla in adult cat.
AB  - Sympathetic preganglionic neurones (SPN) projecting to the superior cervical
      ganglion (SCG) and adrenal medulla (AM) in the adult cat were retrogradely
      labelled with cholera B horseradish peroxidase (CBHRP). Labelled neurones were
      found in 4 sub-nuclei: the nucleus intermediolateralis thoracolumbalis pars
      principalis (ILp), the nucleus intermediolateralis pars funicularis (ILf), the
      nucleus intercalatus spinalis (IC) and the nucleus pars paraependymatis (ICpe).
      The majority of SPN were found in the ILp (75%). Each group of target specified
      SPN had a different segmental distribution. SCG-SPN between cervical 8 (C8) and
      thoracic 6 (T6) and AM-SPN between thoracic 3 (T3) and lumbar 2 (L2). Fusiform
      and round bodied neurones were the most common shapes found, a third longitudinal
      type was occasionally found. SCG and AM-SPN exhibited a dense rostrocaudal
      dendritic projection extending along the length of the ILp. There was also a
      lateral projection into the ILf and a medial one projecting towards the central
      canal. This dendritic arrangement gave the ILp the appearance of being an 'open
      nucleus'. The dendrites branched at their distal ends and all along their lengths
      swellings could be seen. It was concluded that contrary to previous descriptions
      the arrangement of SPN in the adult cat is not too dissimilar to that in the
      adult rat.

PMID- 7782569
TI  - A study of sympathetic preganglionic neuronal activity in a neonatal rat
      brainstem-spinal cord preparation.
AB  - Extracellular recordings were made from 46 sympathetic preganglionic neurones
      (SPNs) in a neonatal rat brainstem-spinal cord preparation. Neurones were
      identified as SPNs as they were: (i) activated at constant latencies (2-10 ms)
      following stimulation of the ventral root, which indicated antidromic activation
      and (ii) recorded at sites located either in the intermediolateral cell column or
      the intercalated nucleus of the thoracic spinal cord. Over one-third of the
      neurones (n = 17) recorded displayed ongoing activity with firing frequencies of
      0.3-5 Hz. Of the neurones analyzed only one showed a very obvious phasic firing
      pattern. Dorsal root stimulation evoked firing in 16 of 26 SPNs recorded from the
      same spinal segment (6 of 10 with ongoing activity). The types of responses
      observed varied between neurones. The excitation of all neurones was
      characterised by a response occurring at a latency of 6-50 ms. In addition, SPNs
      in 'spinalised' preparations (n = 2) responded with latencies of 10-40 ms,
      similar to those observed in the intact preparation. The latencies of responses
      in SPNs were longer and more variable than those observed in ventral horn motor
      neurones. This indicates that a spinal polysynaptic pathway was involved in
      mediating these responses. In 7 SPNs dorsal root stimulation also elicited longer
      latency responses which were observed up to 1000 ms after stimulation. These
      responses may involve activation of bulbospinal and/or propriospinal pathways.
      These results show that the neonatal rat brainstem-spinal cord preparation is
      viable for studying SPNs and that dorsal root-SPN reflexes are intact.

PMID- 7782570
TI  - Effects of the autonomic ganglion blocking agent hexamethonium on vasodilator
      responses mediated by the parasympathetic ganglion on the chorda tympani pathway
      of the cat.
AB  - We investigated the pharmacological properties of a parasympathetic ganglion (a
      chorda tympani ganglion) that mediates vasodilator responses in the lower lip
      induced by electrical stimulation of the distal cut end of the chorda tympani or
      facial nerve root of the cat. These responses were suppressed by prior treatment
      with the autonomic ganglion blocking agent hexamethonium. We compared the effects
      of three doses of hexamethonium (1, 3 and 10 mg/kg, i.v.) on the chorda tympani
      ganglion with their effects on three large ganglia; the otic, submandibular and
      pterygopalatine ganglia that mediate vasodilator responses. Experiments were
      conducted on 20 cats weighing 1-3 kg which had been anesthetized with a mixture
      of urethane (100 mg/kg, i.v.) and chloralose (50 mg/kg, i.v.) then artificially
      ventilated (pancuronium bromide 0.2 mg/kg per h, i.v.). The chorda tympani
      ganglion's sensitivity to hexamethonium was similar to that of the otic ganglion
      but differed from the sensitivities of submandibular and pterygopalatine ganglia.
      We speculate that transmission through the chorda tympani ganglion is
      pharmacologically similar to the otic ganglion, although its precise location has
      yet to be determined.

PMID- 7782571
TI  - Quantitative assessment of the autonomic nervous system activities during
      atropine-induced bradycardia by heart rate spectral analysis.
AB  - Using power spectral analysis of heart rate fluctuation, autonomic nervous system
      activities in bradycardia appearing in the initial phase of atropine
      administration were evaluated quantitatively in 16 healthy females. Atropine
      sulfate (10 micrograms/kg), diluted in 100 ml of 0.9% NaCl solution, was
      intravenously infused at a rate of 0.5 micrograms/kg per min. Electrocardiograms
      were sampled for 4 min for later analysis before and 0, 5, 10, 15 and 20 min
      after initiation of atropine infusion. Powers of low (LFC, 0.05-0.15 Hz) and high
      frequency (HFC, 0.15-0.4 Hz) components in the power spectrum of R-R interval
      variations, and the LFC/HFC ratio were determined at each sampling point. HFC
      power at 0-4 min increased from 1.11 +/- 0.18 ms2 (mean) of baseline value to
      1.37 +/- 0.19 ms2 (P < 0.05). The next 5-9-min value of 1.48 +/- 0.14 ms2 was the
      maximum, and the amount of atropine infused by 9 min was 4.5 micrograms/kg. The
      HFC powers following this point decreased. The 20-24-min value after 10
      micrograms/kg atropine decreased to 0.21 +/- 0.03 ms2 (P < 0.01), which was lower
      than the previous 15-19-min value of 0.36 +/- 0.04 ms2 (P < 0.01). The LFC/HFC
      ratios showed no significant change for the initial 9 min of the atropine
      infusion. However, these ratios at 15-19 min and 20-24 min were increased from
      0.50 +/- 0.04 (mean) of baseline value to 0.75 +/- 0.09 and 0.81 +/- 0.09,
      respectively (P < 0.01). A transient vagotonic state after atropine
      administration, followed by the well-known vagolytic state, was quantitatively
      detected by non-invasive spectral analysis of heart-rate fluctuation.

PMID- 7782572
TI  - Secondary amyloidosis with severe autonomic dysfunctions.
AB  - A 46-year-old male underwent hemodialysis because of progressed glomerulo
      nephritis. Since he suffered from severe diarrhea during the course of the
      illness, both gastric and colon biopsies were performed. Significant amyloid
      deposition was recognized in the submucosal layer of these specimen. This amyloid
      was positive for anti-AA-protein antibody staining and soluble in KMnO4 solution,
      indicating secondary induced amyloid. Despite of absence of orthostatic
      hypotension, examinations revealed extreme reduction in tears and salivary
      secretion, anhidrosis, a decrease in the coefficiency of variation of the
      cardiographic R-R interval, and a decrease in the accumulation of [123I]meta
      iodobenzylguanidine (MIBG) in the heart, suggesting that severe glandular and
      visceral autonomic dysfunctions had occurred in the patient.

PMID- 7782573
TI  - Gait training and falls in the elderly.
AB  - 1. Patients with gait and balance disorder, as measured by the Tinetti Mobility
      Scale, can benefit from physical therapist-assisted gait training. 2. Score in
      the Tinetti Mobility Scale negatively correlates with the number of recurrences
      of falls. 3. The nurse's role includes identification of those who are at risk
      for falls, assessment of their response to training in preventing recurrence of
      falls, and the effect of training in their mobility and independence.

PMID- 7782574
TI  - Hospitalized elders: the difficulties families encounter.
AB  - 1. Family members encountered difficulties when an elder was hospitalized for an
      acute episode of a chronic illness. 2. It is important for nurses to recognize
      the kinds of difficulties that family members experience and develop strategies
      to alleviate them. 3. Failure to include family members in discharge planning can
      place elders at risk for readmission to the hospital.

PMID- 7782575
TI  - Non-equilibrium systems theory: some applications for gerontological nursing
      practice.
AB  - 1. In terms of NEST, aging can be understood as a process of formative change
      toward increasing disorder and order in form, pattern, or structure. The person
      moves toward greater complexity through self-organization processes. 2. Over
      time, self-organization processes result in increasingly unique perceptions and
      behavior. As an older person becomes more unique, he or she becomes more
      different from other older persons. 3. Self-organization processes are an
      appropriate focus of concern for nursing when NEST is used as a practice
      framework. The nurse tries to understand older persons' behaviors as outcomes of
      self-organization processes (attempts to bring order out of disorder).

PMID- 7782577
TI  - Using validation techniques to improve communication with cognitively impaired
      older adults.
AB  - 1. Nurses working with confused older adults in clinical settings need improved
      communication techniques. 2. Reality orientation is commonly used in nursing
      homes with disoriented persons; experienced nurses, however, often find it meets
      with withdrawal, vegetation or increasing hostility. 3. Validation strategies are
      communication techniques which are specifically matched to a particular stage of
      confusion. 4. When validation techniques are appropriately matched to confusional
      stage the effectiveness of the intervention can be significantly improved.

PMID- 7782576
TI  - Perceptions of acute care nurses in the use of restraints.
AB  - 1. Staff nurses continue to use physical restraints in well-intended efforts to
      protect patients from potential harm despite the overwhelming evidence of
      negative consequences from this practice. The use of physical restraints remains
      an unresolved clinical practice issue. 2. This stratified, random sample
      demonstrated that LPNs consistently attached greater importance to the use of
      restraints than either RNs or Managers, suggesting that the educational level of
      nurses may have an impact on the continued use of physical restraints. 3. The
      survey further demonstrates that nurses are aware of many alternatives to
      restraint use. The authors suggest that alternatives may not be widely used
      because the measures are often not considered practical.

PMID- 7782578
TI  - A worthy project.

PMID- 7782579
TI  - Gerontological nursing issues and demands beyond the year 2005.

PMID- 7782580
TI  - [Psychological effects of embryonal reduction. From the decision making to 4
      months after delivery].
AB  - The psychological effect of reducing the number of embryons was studied
      prospectively in two Paris hospitals. All women who had multifetal pregnancy
      reduction (n = 18) were contacted for interviews just after the operation, during
      pregnancy, and four months after delivery. The decision to reduce the number of
      embryons was painful and led to a guilty feeling. After operation, nearly one
      half of the women suffered psychologically. To justify their decision, and
      contain their emotions, the women spoke of the problems related to having
      triplets and, most importantly, the medical arguements explained by the
      physician. Medical counselling is thus essential to help this couples at the time
      of the operation. The pregnancy period is almost always a period of calm for
      these women. Nevertheless, four months after delivery, 5 women expressed a
      psychological malaise related to the reduction, and 2 women refused to continue
      the study because they did not want to revive their suffering. This study shows
      that psychological problems are of major importance after multifetal pregnancy
      reduction and can occur several months after delivery. These negative conclusions
      should however be examined in light of the consequences if reduction had not been
      performed.

PMID- 7782582
TI  - [Post-coital vesicovaginal fistula after treatment for cervical cancer. Cure by
      prolonged bladder drainage after epiploplasty failure. Two cases].
AB  - Post-coitus vagina-bladder fistulas are rarely encountered although they may be
      favoured by radiosurgical treatment for cervical cancer. Treatment is
      particularly difficult. When initial epiploplasty is a failure, most authors
      recommend an ileocytoplasty with ad integrum reconstruction of the vaginal and of
      bladder function.

PMID- 7782581
TI  - [Consequences of laser CO2 treatment of cervical intraepithelial neoplasias on
      the anatomic and functional integrity of the cervix].
AB  - OBJECTIVES: Retrospective study to analyse objectively the effectiveness and
      anatomic and functional consequences for the cervix of conservative CO2 laser
      treatment for cervical intraepithelial neoplasia. PATIENTS AND METHODS: Analysis
      of therapeutic effectiveness and anatomic consequences of 1,114 treated patients
      followed at our colpolaparotomy surgery clinic for cervical dysplasia since 1987.
      Evaluation of function consequences by comparison with a group of patients who
      delivered after laser CO2 therapy for dysplasia (n = 56) and a group of control
      patients (n = 95) with a similar type of dysplasia after delivery and no
      treatment. The clinical course of the pregnancy and delivery were compared
      between the groups in search for risk of prematurity. RESULTS: Good preservation
      of cervical anatomy was achieved after a rigorous treatment protocol only
      applicable with CO2 laser. The preservation of the junctional zone facilitated
      diagnosis of recurrence. The risk of prematurity was low. Therapy was successful
      in 93.4% of the cases. CONCLUSION: The choice of conservative therapy is
      essential, not only when the patient desires a pregnancy but also in others since
      preserved anatomy facilitates diagnosis of recurrence. This findings implicate
      the need for an unagressive energy source and also accepting the early diagnosis
      and treatment.

PMID- 7782583
TI  - [Borderline ovarian tumors. A review and 11 cases].
AB  - OBJECTIVE: To clarify and classify the still debated diagnostic and prognostic
      elements of borderline tumours of the ovary and analyze the data obtained in our
      series. AIM: Develop an adapted management scheme, integrating relatively good
      prognosis and known or suspected factors of poor prognosis. SIEGE: Department of
      Gynaecology-Obstetrics, Hotel-Dieu (CHU) Rennes, France. SUBJECTS: Eleven
      patients with borderline tumour of the ovary diagnosed and managed over the last
      5 years. RESULTS: Current morphology and macroscopy examinations of the tumour do
      not provide data capable of predicting malignancy. The borderline nature of the
      tumour is not a histological diagnosis. The problems encountered lead to a search
      for new techniques such as digitalized nuclear morphology. Some progress has been
      made in classifying prognosis factors. Other than stage, important factors appear
      to be age, histological type, mitotic index, atypical cells and invasive
      peritoneal implants. Management decisions depend on prognosis factors but should
      especially take into account parity. Methods include cystectomy and total
      hysterectomy with annexectomy. Evaluation of chemotherapy and radiotherapy is
      still to preliminary. CONCLUSION: The slow clinical course, allowing good mid
      term prognosis, is still the best reason for a moderated therapeutic approach
      relying on conservative or more aggressive surgery alone.

PMID- 7782584
TI  - [Ovarian hydatic cyst. 7 cases].
AB  - Seven cases with echinococcal infection of the ovary, including 3 on both sides,
      were collected at the Salah Azaiz Institute of Tunis during a period of 23 years.
      This localisation is rare, even in an endemic country. The aetiology and
      pathogenesis of this affection may give rise to many different clinical signs,
      problems with pre-operative diagnosis. It is important to follow up these cases
      after operation in order to sport recurrences. The objective of surgical
      treatment is to achieve cure of both the hydatic cyst of the ovary and the
      primitive cyst simultaneously. Following this treatment, two difficulties may
      arise: the first one is preoperative rupture of the cyst; the second concerns
      fertility in these young women after two-sided salpingo-oophorectomy. Finally,
      when a pelvic cyst is observed systematic hydatic serology must be performed.

PMID- 7782586
TI  - [Complete non-obstetrical uterine inversion].
AB  - A rare case of a gynaecologic uterine inversion is reported emphasizing on the
      exceptional character of the gynecologic uterine inversion and the pathogenic
      problems which are tackled. Gynaecologic inversion results from a tumor implanted
      on fundus of the uterus or from the essential atrophy of suspension ligaments of
      the uterus. Treatment depends on the anatomic type and the stage.

PMID- 7782585
TI  - [Uterine hemangiopericytomas. Two case reports].
AB  - The diagnosis of uterine haemangiopericytoma is still a matter of debate. The
      existence of haemangiopericytoma must be proven on the basis of classical
      histology, ultrastructure histology and immunohistochemical analyses. The
      diagnosis, even when apparently sure, must nevertheless be proven. We described
      two cases emphasizing the clinical and laboratory features of uterine
      haemangiopericytoma. Progress in nuclear magnetic resonance imaging,
      ultrastructural analysis and immunohistochemistry should help in confirming the
      diagnosis of haemangiopericytoma. Highly vascular leiomyoma or low malignity
      grade leiomyosarcoma have been mistakenly identified as haemangiopericytoma.

PMID- 7782587
TI  - [Breast adenomyoepithelioma. A case report and review of the literature].
AB  - Adenomyoepithelioma of the breast is a rare tumor which exceptionally
      degenerates, requiring treatment and large exeresis. We report a new case and
      review the literature.

PMID- 7782589
TI  - [Parvovirus B19 infection and pregnancy].
AB  - Parvovirus B19 was identified in 1975. It causes infections megalerythemia in
      adults associated with skin eruptions and joint pain (about 50% of the adult
      population is immunized). The risk of contamination in case of an epidemia is
      high in school teachers and school personnel. In 1984, the parvovirus B19 was
      implicated as the cause of fetal anasarca. The risk of transplacental
      contamination is estimated at 33% in case of maternal infection. Pregnant women
      with parvovirus B19 infection and confirmed serology should have an echography
      every 15 days. Fetal anasarca can be complicated by in utero fetal death related
      to erythroid stem-cell anaemia. The diagnosis of fetal infection is based on PCR
      techniques on fetal blood. Symptomatic antenatal treatment with in utero
      transfusion was proposed as early as 1988. This method does not however appear to
      be necessary in all cases as the outcome in several reports of untreated fetuses
      was delivery of a normal child. There is the possibility of myocardial damage
      caused by parvovirus B19 which would make in utero transfusion difficult and
      limit its beneficial effect. Finally associated thrombopenia is often severe and
      increased fetal risk.

PMID- 7782588
TI  - [Prenatal diagnosis of nuchal edemas and cystic hygromas of the neck. 49 cases].
AB  - OBJECTIVES: Determine the pathogenesis of fetal nuchal oedema and cystic hygromas
      of the neck and establish prenatal prognosis factors. METHODS: Retrospective
      study of 49 cases including 35 early diagnoses (10 to 14 weeks gestation) and 14
      late diagnosis (after 15 weeks). Chorial villosity biopsy was performed for fetal
      karyotype. RESULTS: The global rate of genetic or chromosomic abnormalities in
      the fetuses was 47%. The fetuses with nuchal associated with other echographic
      anomalies had a high risk of chromosomic aberrations (80%). Fetuses with nuchal
      oedema alone during the first trimester had a higher risk of trisomy 21
      proportionally with the age of the mother and paradoxically no trisomy 21 was
      found in women under 30 years of age. When early nuchal oedema regressed
      spontaneously in an euploid fetus, echographic surveillance can be proposed to
      detect possible polymalformation syndromes discovered late. Cystic hygromas of
      the neck were diagnosed from 15 weeks gestation and were always pathologic.
      CONCLUSION: Interpreting nuchal images in the fetus must take into account the
      echographic term at discovery and its isolated or associated nature. Further
      studies are needed to determine indications for chorial villosity biopsy in
      mothers under 30 with a fetus with isolated nuchal oedema which regresses
      spontaneously during the first trimester.

PMID- 7782590
TI  - [Steinert's disease and pregnancy. A case report and recent literature].
AB  - Steinert's disease or myotonic dystrophy is a heredo-degenerative neuroendocrinal
      dystrophy. It is an autosomal dominant disorder. The arising of a congenital
      myotonic dystrophy of one of the new-born children of the maternity hospital
      enabled to diagnose the Steinert's disease of his mother. A review of the
      international literature enabled us to recall its interactions with pregnancy.
      There is an aggravation of myotonia and multiple obstetric complications such as
      miscarriage, premature onset of labor, polyhydramnios, stillbirth, difficulties
      during the evacuation, atonic postpartum hemorrhage, anesthetic-accidents. The
      congenital variant of myotonic dystrophy (6 to 30% of the cases) is a severe
      disease with a high mortality. It is only seen in the offspring of mothers who
      themselves have myotonic dystrophy. The myotonic dystrophy gene has been isolated
      and the mutation-causing myotonic dystrophy was found to result from a series of
      trinucleotide (CTG) repeats located in the 3' untranslated region of the gene.
      The direct diagnosis is henceforth possible both on the fetus and parents.
      Steinert's disease and its association with pregnancy are rare, especially when
      the affected parent has hypogonadism. The diagnosis of the congenital form is
      difficult because of the mother is unaware of the disorder. Family and personal
      history may give hints: hydramnios, appearance delay and reduced fetal movements,
      and the association at birth of generalized hypotonia with neonatal respiratory
      distress.

PMID- 7782591
TI  - [Manual rotation of vertex presentations in posterior occipital-iliac or
      transverse position. Technique and value].
AB  - OBJECTIVE: Evaluate of the usefulness of manual rotation of occipito-posterior or
      transverse presentation. DESIGN: One year retrospective study (1991). SETTING:
      Maternity hospital, Clinique Universitaire Baudelocque. SUBJECTS: All patients
      during labour having a spontaneous (n = 160) or a manual rotation (n = 368) of an
      occipito-posterior or occipitotransverse presentation. The manual rotation could
      be indicated for a fetal distress, a protracted first stage of labour or
      prophylactically. INTERVENTION: Manual rotation as described by Tarnier, was
      performed at least at 7 cm cervical dilatation. MAIN OUTCOME MEASURES: Success
      rate of manual rotation, cesarean section rate, maternal, fetal and neonatal
      complications.

PMID- 7782592
TI  - [Placenta membranacea. Review of the literature, a case report].
AB  - Placenta membranacea or placenta diffusa is a rare abnormality in which all or
      most of fetal membranes remain covered by chorionic villi, because the chorion
      has failed to differenciate into chorion laeve and chorion frondosum. This
      condition is associated with recurrent antepartum bleeding, abortion in the
      second trimester of the pregnancy, preterm delivery, fetal death, intra-uterine
      growth retardation, post partum haemorrhage and placental retention. In this
      paper, we report our first case of placenta membranacea. A 30-year-old black
      woman, gravida 3, para 1, was admitted at 23 weeks of gestation for vaginal
      bleeding. She was placed on complete bed rest. Ultrasonographic examination
      showed a placenta covering the anterior and posterior uterine walls and the
      internal cervical os. At 28 weeks and 34 weeks of gestation, ultrasound
      examination showed the same findings: total placenta previa covering the entire
      uterine wall and presenting many lacuna. At 38 weeks, she underwent a cesarean
      section. The placenta adhered firmly to the myometrium. Because the attempts to
      remove the placenta was unsuccessful, it was performed a total hysterectomy. The
      total blood loss was 7000 ml. Anatomo-pathologic examination of the placenta led
      do the diagnosis of placenta membranea, total previa and increta. In the
      literature, 35 cases of placenta membranacea have been reported; of these, there
      are ten cases associated with total hysterectomy.

PMID- 7782593
TI  - [Indications and prognosis of cesarean sections at the Dakar University Hospital
      Center].
AB  - From 1st January 1992 to 30 June 1994, 8489 delivered at the Dakar University
      Hospital. Among them, there were 953 cesarean sections, i.e. 11.2%.
      Epidemiological analysis revealed that mean parity was 2 for a mean age of 26
      years. 22% of the women had a clinically perceptible pelvic problem. The
      indications for cesarean section were divided into 3 groups: mandatory operations
      (feto-pelvic disproportion, haemorrhagic placenta praevia, dystocia): 41.4%;
      prudent operations (long-awaited infant, fetal suffering, breech presentation,
      cicatricial uterus): 50%; and necessary operations (maternal disease, especially
      hypertension): 8.6%. There was a high postoperative mortality (1.4%) and major
      morbidity, especially infection (10%). Neonatal prognosis was also poor with a
      14% early neonatal mortality. These findings reflect the major problems facing
      obstetricians in Senegal and Subsaharian Africa. Improved prognosis necessarily
      will involve better organization of our health systems allowing easier access to
      life-saving cesarean section for our rural populations.

PMID- 7782594
TI  - [Validation trial of a neonatal prophylactic antibiotic protocol in the delivery
      room].
AB  - Maternofetal infection occurs in 1 to 10 of every 1,000 newborns. Prognosis is
      poor and an extremely rapid the clinical course is sometimes observed. The
      situation suggests that widespread use of antibiotics and more than 90% of the
      newborns receiving antibiotics are not infected. A prospective study based on
      simple, recognized criteria predictive of maternal-fetal infection was conducted
      in 3,392 deliveries to evaluate the effect of an antibiotic prophylaxy protocol.
      Specificity, sensitivity, positive and negative predictive value were evaluated
      for each of the eleven criteria retained with the goal of increasing sensitivity
      and decrease the use of unnecessary antibiotics. Among the 3,392 infants
      delivered from January 1989 to December 1990, 286 (8.4%) newborns entered the
      study and were given mezlocillin (150 mg/kg/12 h). This treatment was stopped at
      48 hours of life if the infant was not infected. RESULTS. Infection was confirmed
      in 48 of 3,392 infants (1.4%). All were in the risk group: 48/286 (16.7%). The
      germs the most often found were group B Streptococcus (n = 16), Escherichia coli
      (n = 8) and Listeria monocytogenes (n = 3). Nine criteria were well correlated
      with maternal-fetal infection. The two most important criteria were maternal
      pyrexia above 39 degrees C and Apgar score below 7 to 5 min (poor neonatal
      adaptation), with a 99% and 90% and a positive predictive value of 80% and 37%
      respectively. Inversely, Two criteria were poorly correlated with maternal-fetal
      infection: labour duration above 12 hours and instrumental extraction (positive
      predictive value from 10% to 17%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782595
TI  - [Programmed autologous transfusion in obstetrics. Blood samples in 100 patients
      in the last month of pregnancy].
AB  - OBJECTIVES: Evaluation (usefulness and safety) of programmed autologous
      transfusion in obstetrics. SITE. Blood Transfusion Centre, Hopital Louis-Mourier,
      F 92700 Colombes. PATIENTS: Prospective study of 150 patients for whom blood
      withdrawal was planned during the last month of pregnancy. Entry criteria were
      either a risk of haemorrhage or persistent patient request. PROTOCOL: Two
      withdrawals were planned during the last month of pregnancy at the out-patient
      clinic at a one-week interval. The autologous units were transfused per-partum in
      case of haemorrhage and/or post-partum in case of anaemia. RESULTS: One hundred
      pregnant women entered the protocol (43 had a risk of haemorrhage). Both
      preplanned withdrawals were made in 60 of these patients. Per-partum transfusions
      were necessary in only 7 patients including 4/43 with a risk factor (9%) and 3/57
      with no risk factor (5%). Post-partum transfusions were made in 22 other
      patients. Consequently, 117 of the 160 units collected were not used (73%).
      CONCLUSION: Despite good tolerance (5% incidence) due to the known problems in
      evaluating the risk of haemorrhage and the small percentage of patients without
      risk factors who were transfused per-partum, we have decided to reserve this
      protocol for patients with an authentically identified risk of haemorrhage
      (placenta praevia, cesarean section, uterine scar tissue).

PMID- 7782596
TI  - [Practical use of sulprostone in the treatment of hemorrhages during delivery].
AB  - OBJECTIVE: To assess intravenous use of sulprostone (Nalador), a prostaglandin E2
      analogue, is case of post-partum haemorrhage due to uterine atonia. MATERIALS AND
      METHODS: A retrospective study on 315 cases of post-partum haemorrhage (PPH) from
      1st January 1990 to 31st December 1992 in Baudelocque maternity. In 91 cases of
      PPH due to uterine atonia, usual oxytocin drugs were not sufficient and
      intravenous sulprostone was used. Characteristics of the patients, mode of
      sulprostone administration, side effects and treatment failures are reported.
      RESULTS: One or two dose of 500 micrograms were sufficient in 71% cases. Mean
      perfusion rate was 8.3 micrograms/mn. Success of treatment was 89% with few side
      effects (5.5%). No serious complication due to sulprostone was observed. Risk of
      treatment failure was 8.3 times greater when the delay between diagnosis of
      uterine atonia and sulprostone administration was more than 30 mn. CONCLUSION:
      Prostaglandins treatment, and particularly sulprostone, could be used more
      frequently and earlier in case of PPH due to uterine atonia. Further controlled
      studies are necessary to know if they should be used as a first line treatment
      instead of oxytocin in this indication.

PMID- 7782597
TI  - [Streptococcal meningitis: a possible complication of prolonged use of an
      intrauterine device].

PMID- 7782598
TI  - Does iron deficiency raise the seizure threshold?
AB  - To determine the effect of iron status on the seizure threshold, measures of iron
      sufficiency were prospectively evaluated in 51 children presenting to a pediatric
      emergency department with a febrile illness with (26) or without (25) an
      associated febrile seizure. A higher proportion of children from the febrile
      seizure group had a family history of mental retardation (5/26 versus 0/25, P =
      .02) or of previous febrile seizures (10/26 versus 2/23, P = .01). The two groups
      were otherwise comparable for age, sex, race, family history of afebrile
      seizures, temperature at presentation, white blood cell count, differential, and
      vitamin and antibiotic use. Patients with febrile seizures were less frequently
      iron deficient as defined by a free erythrocyte protoporphyrin level above 0.80
      ng/L (2/23 versus 10/25, P < .01), hemoglobin concentration less than 110 g/L
      (1/26 versus 6/25, P < .03), hematocrit less than 0.30 L/L (0/22 versus 4/25, P <
      .02), mean corpuscular hemoglobin less than 20 pg (0/25 versus 3/24, P < .04),
      mean corpuscular volume less than 65 fL (0/26 versus 4/24, P < .02), and platelet
      count higher than 550 x 10(9)/L (0/26 versus 3/25, P < .04). This association was
      even stronger when adjusted for differences in family history. None of the
      patients in the febrile seizure group was being treated for iron deficiency at
      presentation, whereas three of 25 controls used an iron supplement (P < .04).
      Iron deficiency may protect against the development of febrile seizures.

PMID- 7782599
TI  - Fryns syndrome: neurologic findings in a survivor.
AB  - Fryns syndrome, a multiple congenital anomaly syndrome associated with
      diaphragmatic defects, craniofacial dysmorphism, distal digital hypoplasia, and
      neurologic abnormalities, was first described in 1979. This autosomal recessive
      disorder is usually associated with stillbirth or death immediately after birth.
      Detailed neurologic findings in the third survivor beyond the neonatal period are
      reported, and neurologic abnormalities in other cases are reviewed. Initially,
      hypotonia, areflexia, and weakness were seen. Myoclonus developed immediately
      after birth and was well controlled with high-dose valproate.
      Electroencephalography revealed slowing and irregular paroxysmal discharges with
      spikes and sharp waves that disappeared with time and treatment. Magnetic
      resonance imaging demonstrated partial agenesis of the corpus callosum, a Dandy
      Walker malformation, and progressive cerebral and brainstem atrophy. This
      syndrome should be considered in patients with unusual facial features and
      digital abnormalities associated with frequent early myoclonus.

PMID- 7782600
TI  - Replacing carbamazepine slow-release tablets with carbamazepine suppositories: a
      pharmacokinetic and clinical study in children with epilepsy.
AB  - A suppository for rectal administration of carbamazepine has been developed for
      situations in which it is unsuitable to use the oral route of administration. In
      an open, controlled, within-patient study, the pharmacokinetics, clinical
      efficacy, and tolerability of carbamazepine slow-release tablets were compared
      with those of carbamazepine suppositories in children with epilepsy. The
      pharmacokinetic part of the study comprised 22 children, and an additional nine
      children were included in the clinical part of the study. Treatment with slow
      release tablets was replaced for 7 days with carbamazepine suppositories in
      bioequivalent dosage. Clinical factors such as the rate of seizures and the local
      tolerability were studied, and an overall assessment of efficacy was made. In the
      pharmacokinetic part, 24-hour plasma concentration curves for carbamazepine and
      carbamazepine-10,11-epoxide were recorded. The plasma concentration profiles
      (minimum, maximum, and mean concentrations, fluctuation index, and area under the
      curve) for carbamazepine and the other metabolites did not show any significant
      differences between oral and rectal administration when the suppository dose was
      increased by 25% compared to the tablets. No increase in seizure frequency was
      detected, and the overall assessment was very good to good in 25 of the 29
      epileptic children. Increased flatulence during treatment with suppositories was
      noted in two children, one had anal irritation, and one had nausea/vomiting.
      Treatment with carbamazepine slow-release tablets in children with epilepsy can
      be replaced by carbamazepine suppositories in 25% higher dosage, with good
      clinical effect and appropriate pharmacokinetic values, when it is unsuitable to
      use the common oral route of administration.

PMID- 7782602
TI  - Brain weight and sudden infant death syndrome.
AB  - Increased brain weights have been reported in the literature to occur among
      infants who have died from sudden infant death syndrome, suggesting that cerebral
      edema might play a role in the cause of death among these children. We have
      compared brain weights from children between the ages of 1 week and 1 year,
      autopsied between 1980 and 1992. One group consisted of 125 victims of sudden
      infant death syndrome and the other of 38 children who had died with a diagnosis
      other than the sudden infant death syndrome. Brain weights from both groups
      exceeded the 50th percentile in previously published reference material. We were
      unable to show any significant differences between the groups in either the ratio
      between observed and expected brain weights or the ratio between brain weight and
      body weight. We conclude that there is no evidence for the notion that victims of
      sudden infant death syndrome have an increased brain weight. Other authors (in
      previous studies) may have overlooked the low overall weight at gestational age
      of prematurely born children while collecting data for reference levels. A
      revision of the figures seems to be necessary.

PMID- 7782601
TI  - Ataxia-oculomotor apraxia syndrome.
AB  - Ataxia-oculomotor apraxia is a distinct entity first comprehensively described in
      1988. The features include early childhood onset of ataxia and oculomotor
      apraxia, mimicking ataxia telangiectasia but without the extraneurologic findings
      of ataxia telangiectasia. We add to the clinical description of the ataxia
      oculomotor apraxia syndrome by reporting eight patients, ages 2 to 15 years, from
      four families, suggesting autosomal recessive inheritance, with the longest
      follow-up over 6 years. After initial gait deterioration, all had a
      nonprogressive course. We have postulated that ataxia-oculomotor apraxia should
      be established as a separate disease from ataxia telangiectasia or its variants
      not only by clinical history, examination findings, and course, but primarily by
      the biologic markers of normal chromosome breakage and radiation sensitivity
      studies. We found no increased chromosome breakage in the four patients studied
      and intermediate sensitivity to chronic ionizing radiation of cultured skin
      fibroblasts on the three patients studied. Family studies revealed an
      intermediate radiosensitivity from two patients, their asymptomatic parents, and
      a sister. The lack of chromosome breakage strongly separates ataxia-oculomotor
      apraxia from ataxia telangiectasia. The radiation sensitivity studies are
      compatible with two possibilities: (1) symptomatic ataxia telangiectasia
      heterozygotes, but this would be highly unusual because the degree of clinical
      involvement in the ataxia-oculomotor apraxia patients is not mild, as would be
      expected if they were heterozygotes and (2) a separable disease entity, which is
      the interpretation we favor.

PMID- 7782603
TI  - Landau-Kleffner syndrome with continuous spikes and waves during slow-wave sleep.
AB  - The Landau-Kleffner syndrome is sometimes associated with continuous spike-waves
      during slow-wave sleep. The clinical significance of this association is unclear.
      In order to investigate differences in glucose metabolic patterns between awake
      and sleep states in two children with Landau-Kleffner syndrome and continuous
      spike-waves during slow-wave sleep, fluorodeoxyglucose positron-emission
      tomographic (PET) studies were performed in each state. In the first patient, the
      awake interictal PET study revealed moderate hypometabolism in the thalamus and
      frontal and temporal cortex and mild hypometabolism in the parietal and anterior
      cingulate cortex bilaterally. Occipital cortex was severely hypometabolic
      bilaterally. In a repeat PET study performed during sleep in which continuous
      spike-waves during slow-wave sleep were present, the only difference noted
      compared to the awake study was a marked bilateral increase in temporal cortex
      metabolism. The awake interictal PET in the second child was normal, except for
      mildly increased relative glucose metabolism in the left inferior temporal
      cortex. The sleep PET study with continuous spike-waves during slow-wave sleep in
      this child showed hypermetabolism in both temporal lobes; however, this was more
      pronounced, with a wider distribution in the left temporal cortex. In normal
      subjects, PET studies performed during awake and sleep states have not revealed
      such differences. Whether the temporal lobes are involved in the generation of
      continuous spike-waves during slow-wave sleep remains to be confirmed in a larger
      group of patients. The first child was treated surgically with multiple subpial
      transection, following which continuous spike-waves during slow-wave sleep
      disappeared and language function improved.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782604
TI  - The use of felbamate to treat infantile spasms.
AB  - Based on the initial successful use of felbamate for infantile spasms in an
      infant with tuberous sclerosis, three additional infants with infantile spasms of
      different etiologies who had failed conventional therapies were treated with
      felbamate. Three of the four patients have shown complete resolution of infantile
      spasms. All responding patients did so within 1 week of starting felbamate. The
      one treatment failure had an initial reduction of seizure frequency and severity
      but has not maintained that response long term. Controlled studies are needed to
      firmly establish that felbamate is both safe and effective for the treatment of
      infantile spasms. As these cases document, felbamate is currently available for
      use in infantile spasms, and the frequent conversion of infantile spasms to
      Lennox-Gastaut syndrome, for which felbamate is approved, makes its use in
      infantile spasms logical.

PMID- 7782605
TI  - D-2-hydroxyglutaric aciduria.
AB  - Hydroxyglutaric aciduria is detected by gas chromatographic-mass spectrometric
      analysis, and the D and L forms are quantified by chemical ionization with
      deuterated internal standards. Patients have recently been described who
      accumulate the D form, and they appear to be quite different from those with the
      more common L form. Experience is reported with three patients and an animal
      model with D-2-hydroxyglutaric aciduria. The phenotype appears to include mental
      retardation, macrocephaly, hypotonia, seizures, and involuntary movements,
      although neurologic and systemic manifestations of the disorder varied
      considerably between individual patients, even within the same family.

PMID- 7782606
TI  - Medical treatment of West syndrome in Japan.
AB  - Although corticotropin (ACTH) is still the most effective drug for the treatment
      of West syndrome, a variety of other treatment modalities have been tried because
      of corticotropin's frequent and sometimes serious side effects. A recent survey
      on the treatment of this devastating disorder by Japanese child neurologists
      disclosed different therapeutic approaches from those taken by American or
      European child neurologists. Most Japanese child neurologists use vitamin B6 as
      the first agent and corticotropin as the third or second drug. Moreover, the
      dosage of corticotropin used by them is considerably smaller. Therefore, the
      current status of medical treatment of West syndrome is reviewed, especially
      comparing Japan with other countries.

PMID- 7782607
TI  - The glamour of scientific research.

PMID- 7782608
TI  - The childhood muscular dystrophies: diseases sharing a common pathogenesis of
      membrane instability.
AB  - New observations demonstrate that several childhood forms of muscular dystrophy
      share a common pathogenesis. In muscle, dystrophin occurs as part of a membrane
      complex (dystrophin-glycoprotein) linking the cytoskeleton to the basal lamina.
      In Duchenne muscular dystrophy, dystrophin deficiency disrupts the linkage of the
      integral glycoproteins of the sarcolemma and leads to muscle fiber necrosis. In
      severe childhood autosomal recessive muscular dystrophy, a selective deficiency
      of adhalin (50-kd glycoprotein) also causes dysfunction of the dystrophin
      glycoprotein complex. Most recently, a form of congenital muscular dystrophy
      demonstrates deficiency of laminin M (merosin) further demonstrating that
      sarcolemmal instability results from defects in structural proteins of the basal
      lamina. Animal models have been identified also demonstrating defects in specific
      proteins linking the subsarcolemmal cytoskeleton to the extracellular matrix. The
      mdx mouse has a defect in the gene encoding dystrophin. The cardiomyopathic
      hamster shows a specific deficiency of adhalin in skeletal muscle. The dy/dy
      mouse has been found deficient in merosin. These animal models will help
      researchers to understand their human counterparts and provide a system for
      testing therapeutic strategies.

PMID- 7782609
TI  - A clinical approach to the congenital myasthenic syndromes.

PMID- 7782610
TI  - Containing partisan medical experts.

PMID- 7782611
TI  - Magnetic resonance imaging for spinal muscular atrophy.

PMID- 7782612
TI  - Sickle cell disease and stroke.

PMID- 7782614
TI  - Accuracy of neurologic examination and history in detecting evidence of MRI
      diagnosed cerebral infarctions in children with sickle cell hemoglobinopathy.
AB  - We determined the accuracy of neurologic examination and the history of a
      previous neurologic event in detecting clinical evidence of a magnetic resonance
      imaging (MRI)-diagnosed cerebral infarction in 30 children with sickle cell
      hemoglobinopathy. Each patient had an MRI of the brain, neurologic examination,
      chart review, and psychometric evaluation. Seventeen children (57%) had MRI
      evidence of cerebral infarction based on demonstration of parenchymal
      abnormalities in a vascular distribution. Among the 17 children with MRI evidence
      of cerebral infarction, only 12 (71%) had an abnormal neurologic examination, and
      11 (65%) had a history of a prior neurologic event. In contrast, among the 13
      children with normal MRIs, 12 (92%) had normal neurologic examinations, and no
      child had a previous history of a neurologic event. Multiple, bilateral,
      heterogeneous cerebral infarctions frequently occur without overt neurologic
      signs or symptoms in children with sickle cell hemoglobinopathy. Previous studies
      that relied on a focal neurologic examination or a history of a neurologic event
      to identify cerebral infarctions in patients with sickle cell hemoglobinopathy
      most likely underrepresented the true frequency of cerebral infarctions in this
      population. Future prospective studies of cerebral infarctions in children with
      sickle cell hemoglobinopathy should include MRIs for identification and
      classification, rather than neurologic examination or clinical history alone.

PMID- 7782613
TI  - Parasitic infections of the central nervous system in children. Part II:
      Disseminated infections.
AB  - In the second segment of this three-part review of parasitic infections of the
      central nervous system in children, we consider parasitic infections which
      typically involve various tissues and organs in addition to the brain and spinal
      cord. Parasites capable of dissemination in immunocompetent hosts are discussed
      first, and, as in Part I, organisms are grouped according to their predominant
      geographic location. This is followed by a discussion of the unique aspects of
      toxoplasmosis, strongyloidiasis and infection with microsporidia in
      immunocompromised patients, with an emphasis on the central nervous system.

PMID- 7782615
TI  - A persistent biochemical marker for partially treated meningitis/ventriculitis.
AB  - Regulation of circulating iron is important in bacterial, yeast, and fungal
      infections. In the present study, cerebrospinal fluid levels of ferritin, an iron
      binding protein, were determined in controls and in patients with central nervous
      system pyogenic and viral infections. Among 441 controls, cerebrospinal fluid
      ferritin level was higher than 18 ng/mL in two relapsed patients with central
      nervous system leukemia, 12 with bacteremia or pneumonia, and one with
      hemorrhagic herpes simplex encephalitis. Cerebrospinal fluid ferritin levels were
      more than 18 ng/mL in 13 of 63 patients diagnosed with nonhemorrhagic aseptic
      meningitis/ventriculitis, when defined solely by negative cerebrospinal fluid
      culture. Conversely, cerebrospinal fluid ferritin exceeded 18 ng/mL in culture
      proven meningitis (46 of 47 cases) and ventriculitis (five of five cases). Cases
      of indolent cryptococcus and tuberculous meningitis showed modest increases
      despite traditional cerebrospinal fluid markers, at times, being normal.
      Cerebrospinal fluid ferritin levels did not correlate with cerebrospinal fluid
      neutrophil count, cerebrospinal fluid protein concentration, serum ferritin
      level, or patient age. In 16 of 19 cases monitored sequentially during ongoing
      antibiotic treatment, levels remained over 18 ng/mL (average, 15.0 days; range, 1
      to 54 days). This observation suggests that obtaining cerebrospinal fluid
      ferritin levels is helpful whenever traditional laboratory benchmarks normalize,
      as during acute or chronic antibiotic therapy, or create confusion with positive
      cultures stemming from sample contamination.

PMID- 7782616
TI  - Misdiagnosis of appendicitis in nonpregnant women of childbearing age.
AB  - A retrospective case series was conducted at a teaching hospital with an
      emergency department (ED) census of 100,000 patients per year to identify the
      incidence of, and factors associated with, the misdiagnosis of appendicitis in
      nonpregnant women aged 15 to 45 years. There were 174 nonpregnant women
      identified with a pathologic diagnosis of appendicitis. Clinical features were
      then compared between patients misdiagnosed (seen in prior 10 days and given an
      incorrect diagnosis) and those who were initially diagnosed correctly. The
      results showed that 33% of the women with appendicitis were initially
      misdiagnosed. The most common misdiagnoses included pelvic inflammatory disease,
      gastroenteritis, and urinary infections. Misdiagnosed women more frequently
      exhibited diffuse and bilateral lower abdominal pain and tenderness, cervical
      motion, and right adnexal tenderness. Misdiagnosed women also had a lower
      incidence of right lower quadrant pain and tenderness, and peritoneal signs. In
      addition, misdiagnosis was associated with an increased incidence of perforation,
      abscess formation, and an increase in the total length of hospitalization. In
      conclusion, the incidence of misdiagnosis of appendicitis in women of
      childbearing age is high. Women who are misdiagnosed have less typical symptoms
      and physical findings and more frequent abnormal pelvic findings than those who
      are diagnosed correctly. Emergency physicians should be aware that atypical signs
      and symptoms are associated with misdiagnosed appendicitis in nonpregnant women
      of childbearing age.

PMID- 7782617
TI  - Resolution of caffeine-induced complex dysrhythmia with procainamide therapy.
AB  - A case report of a 38-year-old male who ingested 20 gm of caffeine is presented.
      The patient exhibited clinical and laboratory evidence of caffeine toxicity.
      Cardiac monitoring revealed a chaotic rhythm with variable supraventricular and
      ventricular dysrhythmias without hemodynamic compromise. Procainamide was used
      effectively to convert this complex dysrhythmia. The mechanisms, manifestations,
      and therapy of caffeine toxicity are reviewed.

PMID- 7782618
TI  - A new approach to emergency department therapy of migraine headache with
      intravenous haloperidol: a case series.
AB  - Six case reports are presented that describe the use of intravenous haloperidol
      for patients with migraine headache. Haloperidol was used in a dose of 5 mg
      following a 500- to 1000-cc bolus of normal saline. Headache was completely or
      substantially relieved in all six patients 25 to 65 min after administration of
      haloperidol; the median time until discharge was 51 min. Side effects were
      minimal or nonexistent. None of the patients returned to the Emergency Department
      (ED) for any reason over the next 48 h. It is concluded that haloperidol may play
      a role in treatment of migraine headache in the ED, and that further study is
      warranted.

PMID- 7782619
TI  - The incidence and effects of motion sickness among medical attendants during
      transport.
AB  - Motion sickness is a common and often debilitating problem. The purpose of this
      study was to determine the incidence and effects of the motion sickness
      syndromes, the Nausea and Sopite Syndromes, among medical transport personnel.
      Members of the Transport Teams of the University of North Carolina Hospitals
      completed a questionnaire to identify a history of susceptibility to motion
      sickness. An additional questionnaire evaluated each individual for symptoms of
      motion sickness during transport. The Digit Span Test portion of the Mini-Mental
      Status Examination (DST-MMSE) was used to evaluate cognitive function after
      transport. Control data on each subject were obtained by testing during
      nontransport shifts. The Nausea Syndrome was observed during transport in 46% of
      subjects; 65% experienced symptoms consistent with the Sopite Syndrome.
      Pretransport surveys were predictive of the Nausea Syndrome, but not of the
      Sopite Syndrome. The Nausea Syndrome was related to subjective assessments of the
      severity of motion experienced; the Sopite Syndrome did not correlate with the
      severity of motion. The DST-MMSE scores after transport were significantly lower
      than scores during nontransport periods in 85% of personnel. We conclude that
      transport personnel are susceptible to motion sickness manifested by both the
      Nausea Syndrome and the Sopite Syndrome. The presence of motion sickness is
      associated with a significant decline in performance on tests of attention and
      concentration.

PMID- 7782620
TI  - Police perception of intoxication among injured pedestrians.
AB  - To assess police officers' accuracy in perceiving alcohol or drug intoxication of
      injured pedestrians, blood test results from pedestrians struck by vehicles and
      admitted to a Level I trauma center for a 3-year period were linked to police
      reports of the crashes. Police officers were 64.5% sensitive and 99.3% specific
      in identifying alcohol use in injured pedestrians when blood tests were positive
      for alcohol, and 2.2% sensitive and 100% specific in identifying other drug use
      when blood tests were positive for drugs other than alcohol. Those with higher
      blood ethanol levels were more often correctly assessed to be under the
      influence. Injury Severity Score and the presence of head injuries had no
      apparent effect on police assessments. In conclusion, police assessment of
      substance abuse is extremely specific, but not particularly sensitive. Efforts
      are needed to improve police evaluations. The effect of increased legal actions
      on recurrent alcohol and drug-related injuries remains to be seen.

PMID- 7782621
TI  - Hydropneumothorax due to tuberculosis.
AB  - Pulmonary tuberculosis, a disease largely limited to third-world populations only
      15 years ago, is increasingly becoming a public health problem again in the U.S.
      We review an emergent presenting feature of tuberculosis--spontaneous
      pneumothorax--that may now be seen more commonly in emergency departments (EDs).
      Pneumothorax must be quickly and effectively managed in the ED. In addition, the
      emergency physician should readily consider tuberculosis as an etiology in any
      patient with a spontaneous pneumothorax and a significant prodromal illness or a
      history of exposure to tuberculosis so that contagion precautions may be
      instituted promptly.

PMID- 7782622
TI  - Psychogenic status epilepticus.
AB  - A patient was brought to the Emergency Department in presumed status epilepticus.
      However, the seizure had many of the clinical characteristics that, in
      combination, were suggestive of a psychogenic event including asynchronous
      extremity movements, forward pelvic thrusting, and geotrophic eye movements. An
      arterial blood gas and serum electrolytes were normal despite one-half hour of
      tonic-clonic activity, and supported the diagnosis of a nonneurogenic event. The
      patient became conversant toward the end of the event, which confirmed that the
      seizure was nonepileptogenic.

PMID- 7782623
TI  - Bilateral inferior glenohumeral dislocation: luxatio erecta, an unusual
      presentation of a rare disorder.
AB  - Luxatio erecta, or inferior shoulder dislocation, is a rare form of shoulder
      dislocation. The case of a patient presenting with bilateral luxatio erecta,
      which was initially felt by EMS personnel to be an hysterical reaction, is
      discussed. An awareness of this rare entity, the potential-associated
      musculoskeletal and neurovascular injuries, and the proper treatment are
      essential for emergency physicians.

PMID- 7782624
TI  - Reversible acquired tracheobronchomalacia of a combined crescent type and saber
      sheath type.
AB  - A case of tracheobronchomalacia (TBM) in a 71-year-old woman, who had suffered a
      cough syncope, is reported. It was a combination of both the crescent type (the
      posterior membranous portion of trachea or bronchus protrudes into the lumen) and
      the saber-sheath type (the lateral cartilaginous wall of trachea or bronchus
      protrudes into the lumen). In this patient, acute bronchitis had developed
      superimposed upon a chronic bronchitis in addition to age-related regressive
      changes of the trachea and bronchus. A TBM due to acute inflammation can be
      reversible, but aggressive airway management as well as medical treatment of the
      underlying inflammation are critical to a successful outcome.

PMID- 7782625
TI  - Neonatal Trichomonas vaginalis infection.
AB  - Clinical infection with Trichomonas vaginalis (T. vaginalis) in the neonate is an
      unusual occurrence. We present a case of T. vaginalis in a 2-week-old girl with
      vaginal discharge. Our patient had complete resolution of symptoms after
      treatment with metronidazole. We found few references in the medical literature
      on the treatment of this condition. This report discusses the pathogenesis and
      treatment of T. vaginalis in the neonate.

PMID- 7782626
TI  - Steam vaporizer burn injuries.
AB  - Steam vaporizers increase indoor relative humidity by releasing steam into the
      air. The temperature of the steam is sufficiently high to cause severe burns. We
      report two cases of children who received partial thickness burns from steam
      vaporizers. Because of the high risk of burn injury, the manufacturers should be
      required to label the surface of the boiling chamber of the vaporizer with a
      warning statement.

PMID- 7782627
TI  - The effect of cocaine and amphetamines on vital signs in trauma patients.
AB  - The object of this study was to determine if the presence of sympathomimetics
      (cocaine, benzoylecgonine, or amphetamine), detected by routine urine toxicology
      screen, affect the initial presenting pulse, blood pressure, respiratory rate, or
      level of consciousness in trauma patients. A retrospective chart review was
      performed on 1,679 patients enrolled in an urban level 1 trauma registry between
      October 1987, and July 1992, for whom complete toxicology data were available.
      There were no clinically significant differences in the vital signs of patients
      with positive toxicology screens and those with negative screens. There was a
      statistically significant increase in prehospital respiratory rate among patients
      with benzoylecgonine or amphetamines on admission toxicology screens when
      potential confounding factors were controlled. However, these effects disappeared
      upon arrival at the hospital. The detection of sympathomimetics by toxicology
      screening had no effect on pulse and systolic blood pressure when age, sex,
      mechanism, type, and severity of injury, prehospital IV fluid volume, and alcohol
      intoxication were controlled.

PMID- 7782628
TI  - Acute ischemia of the hand following intra-arterial oxymetazoline injection.
AB  - Acute ischemia of the hand following intra-arterial injection of a drug is an
      infrequent problem, but it requires urgent medical attention. In this report, a
      patient injected a nasal decongestant, oxymetazoline hydrochloride (Afrin), into
      his radial artery. This resulted in severe burning pain, and cyanotic, cold, and
      pulseless hand, suggestive of acute ischemia. Intra-arterial papaverine,
      nifedipine, anticoagulation with heparin, prednisone, and stellate ganglion block
      did not improve the hand circulation. Development of gangrene necessitated a
      disarticulation at the wrist joint. Diagnosis, complications, and therapeutic
      measures of acute hand ischemia secondary to intra-arterial drug injection are
      discussed.

PMID- 7782629
TI  - Congestive heart failure and pulmonary edema for the emergency physician.
AB  - Congestive heart failure (CHF) and pulmonary edema are major health problems in
      the United States as well as across the rest of the developing world. The
      prevalence of CHF and pulmonary edema in the general population results in a
      significant number of these patients presenting to Emergency Departments (EDs).
      Mortality from these disorders is substantial, with a 5-year mortality rate for
      patients requiring hospitalization of approximately 50%. Understanding of the
      clinical syndromes of CHF and pulmonary edema requires review of the basic
      determinants of cardiovascular performance. Preload, afterload, contractility,
      and heart rate may all be modified by pharmacological or mechanical techniques.
      Diuretics, vasodilators, cardiac glycosides, and other inotropes all may play a
      role in the ED management of CHF. In rare instances, mechanical devices for
      support of the heart and circulation may be indicated.

PMID- 7782630
TI  - Bidirectional tachycardia associated with digoxin toxicity.

PMID- 7782631
TI  - Management of hymenoptera sting anaphylaxis: a preventive medicine survey.
AB  - The evaluation of aftercare instructions given to patients suffering from
      hymenoptera sting anaphylaxis was the objective of the study. Part of this
      evaluation included asking the physicians questions to examine the knowledge on
      which they based their aftercare instructions. Survey questionnaires were
      completed by 124 of 174 (71%) physicians who worked in an emergency department or
      urgent care center. Fifty-eight percent of the physicians never provided written
      avoidance instructions, 24% provided or prescribed anaphylaxis ID bracelets, 44%
      referred all of their patients to an allergist for further evaluation, and 73%
      reported prescribing an Epi-pen or Ana-kit to all hymenoptera sting anaphylaxis
      victims. Twenty-four percent of physicians did not know where to obtain
      anaphylaxis identification bracelets. This survey demonstrates that a substantial
      number of physicians practicing emergency medicine are not providing appropriate
      aftercare instructions to patients, and substantiates the need for educational
      efforts to increase the awareness of physicians concerning the implications of
      hymenoptera allergy and the value of proper preventive measures.

PMID- 7782632
TI  - Appendicitis: a continuing diagnostic challenge.

PMID- 7782633
TI  - Objectives to direct the training of emergency medicine residents on off-service
      rotations: traumatology, Part 1.
AB  - This is the 30th article in a continuing series of objectives to direct emergency
      medicine resident experiences on off-service rotations. Because injuries account
      for tremendous morbidity and mortality, management of trauma is an essential part
      of training in emergency medicine. Instruction in traumatology during off-service
      rotations may be conducted at the bedside in difficult and demanding clinical
      settings. Therefore, it is essential for residents to have specific goals and
      objectives to guide their acquisition of knowledge required to make rapid,
      accurate decisions for patients with major trauma.

PMID- 7782634
TI  - Comparison of magnetic resonance tomography with computerized axiography in
      diagnosis of temporomandibular joint disorders.
AB  - This study compared the accuracy of two noninvasive methods, computerized
      axiography and magnetic resonance tomography (MRT), in diagnosing
      temporomandibular joint (TMJ) disorders. Forty-seven subjects underwent
      axiography and subsequent assessment of the TMJ by MRT. The statistical analysis
      referred to the correlations of the most relevant clinical diagnoses, i.e., no
      appreciable disease, disk displacement with reposition, disk displacement without
      reposition, morphologic alterations, and hypermobility of the condyle. In 70% of
      the disk-displacement-with-reposition and disk-displacement-without-reposition
      patient groups, axiography and MRT gave the same information. In other patient
      groups, the axiography findings agreed with the MRT findings in 45% of the cases.
      It was concluded that although a large percentage of morphologic alterations
      could be detected by MRT, axiography determined the dysfunctional dynamics more
      clearly.

PMID- 7782635
TI  - Perspectives on craniofacial asymmetry. I. The biology of asymmetry.
AB  - Part I introduces the survey and presents a topic outline of the six parts that
      make up this series of articles on craniofacial asymmetry. The discussion in Part
      I considers normal variation, normal and abnormal laterality, types of anomalies
      that may be asymmetric, and finally, some well-known causes of craniofacial
      asymmetry.

PMID- 7782636
TI  - Combined use of bone grafts and implants in the severely resorbed maxilla.
      Postoperative evaluation by computed tomography.
AB  - Combined horseshoe-shaped iliac bone grafts and Branemark fixtures were used to
      rehabilitate patients with severely resorbed maxillae. Twenty patients were
      followed-up by computed tomography (CT) examination with axial slices to assess
      the fixture sites and to study the changes in height and width of the bone graft
      3 weeks and 3, 6, 12, and 24 months postoperatively. The mean height of the bone
      graft at the 3-week postoperative examination was 8.2 mm; after 2 years the mean
      value had decreased to 6.2 mm. The height reduction occurred mainly between the 3
      month and 1-year examinations. The mean width of the bone graft at the 3-week
      postoperative examination was 12.2 mm, and it decreased to 8.6 mm after 2 years.
      Most of the width reduction took place during postoperative months 1-3. From 1
      year after the grafting procedure, the rate of reduction of both height and width
      was very low.

PMID- 7782637
TI  - Cervical spine injuries in patients with facial fractures: a 1-year prospective
      study.
AB  - A total of 582 consecutive patients with facial fractures were investigated
      prospectively for evidence of a concomitant cervical spine injury. Of them, 1.04%
      (6) were found to have a cervical spine injury, all having occurred in road
      traffic accidents. Only two of the injuries were diagnosable on standard, three
      view, plain cervical spine radiographs. Four were diagnosable from computerized
      tomography scan, while the remaining two required stress views under radiographic
      screening for definitive diagnosis.

PMID- 7782638
TI  - Correlation of histopathologic findings with clinical and radiologic assessments
      of cervical lymph-node metastases in oral cancer.
AB  - The accuracy of preoperative diagnosis of cervical lymph-node metastasis in oral
      cancer was assessed by comparing the histopathologic findings in 136 sides of
      neck dissection with physical examination under anaesthesia (EUA) and
      computerized tomography (CT) assessments of the metastatic status. The overall
      accuracy of EUA and CT assessments was 72% and 73%, respectively, and a
      combination of both methods resulted in sensitivity and specificity rates of 55%
      and 78%, respectively. Twenty-three of the 51 histologically positive necks had
      been assessed as negative on both EUA and CT. Six of these contained only micro
      metastases, and in another 10, the largest positive node was 1.5 cm or less.
      Extracapsular spread of metastatic carcinoma was found in 12 of the 23 EUA and CT
      false-negative dissections. Most of the 21 histologically positive necks which
      had been correctly assessed as positive on both EUA and CT contained enlarged
      metastatic nodes, fused nodal masses, extensive extracapsular spread, or more
      than one of these features. Three of the 85 histologically negative necks had
      been assessed as positive on both EUA and CT; eight had been positive on EUA
      alone, and another eight on CT alone. Reactive nodal hyperplasia or sialadenitis
      was seen in most false-positive dissections. We conclude that the accuracy of
      preoperative diagnosis of metastasis by routine methods remains poor, and that
      EUA and CT are reliable only in patients with bulky metastatic deposits.

PMID- 7782639
TI  - The osteoseptocutaneous or purely septocutaneous peroneal flap with a
      supramalleolar skin paddle.
AB  - There are many indications for using the peroneal flap in maxillofacial
      reconstructive surgery, either as a cutaneous flap or combined with a fibula
      segment. According to the results of our anatomic study and clinical experience
      with 14 patients, the supramalleolar segment is especially suitable as donor
      region because the highest density of septocutaneous perforating vessels exists
      here; hence, the preparation of a long vascular pedicle is possible. The donor
      site leaves an acceptable defect with appropriate patient selection.

PMID- 7782640
TI  - Flow cytometric analysis of nuclear DNA content in oral leukoplakia: relation to
      clinicopathologic findings.
AB  - DNA ploidy of 50 biopsy specimens of oral leukoplakia was investigated by flow
      cytometry, and the results were compared with the clinicopathologic appearances.
      The aneuploidy rate of the leukoplakias was 17/50 (34%), and the mean DNA index
      (DI) of the aneuploid lesions was 1.22, with a range from 0.70 to 1.84. The
      incidence of the aneuploidy was significantly (P < 0.01) higher in nonhomogeneous
      leukoplakias (11/18) than in homogeneous lesions (6/32). The aneuploidy rate of
      the severely dysplastic leukoplakias (11/17) was significantly higher than those
      of the mildly dysplastic (4/22; P < 0.01) and the nondysplastic (2/11; P < 0.02)
      lesions. A significant (P < 0.01) difference in the aneuploidy rate was also
      observed between tongue (12/23) and gingival (2/18) leukoplakias.

PMID- 7782641
TI  - Imaging of mandibular cysts with a dental computed tomography software program.
AB  - Twelve mandibular cysts were examined radiographically by conventional panoramic
      radiography (orthopantomography (OPG)), mandibular tomography (MT), and axial
      computed tomography (CT). The axial CT scans were reformatted with both a
      conventional program and a dental CT software program that displays exactly
      proportional cross-sectional views. The radiographic images obtained with these
      four examination modalities were compared for visualization of mandibular
      anatomy, delineation of the mandibular canal, detection of cortical bone
      involvement, and cystic volume. CT and especially the dental CT program rated
      significantly (P < 0.001) higher in all points examined than two-dimensional
      methods (OPG, MT). The dental CT program was found to be superior for detecting
      cortical bone involvement (P < 0.02) and delineation of the mandibular canal (P <
      0.02) to the conventional CT program.

PMID- 7782642
TI  - Comparison of epithelial dysplasia--the 4NQO rat palate model and human oral
      mucosa.
AB  - Epithelial dysplasia in the rat palatal mucosa was induced by application three
      times a week of the carcinogen 4-nitroquinoline 1-oxide (4NQO). With the
      Epithelial Atypia Index (EAI), the successive stages of 4NQO-induced epithelial
      dysplasia were compared with specimens of human oral epithelial dysplasia. It
      appeared that there was a close similarity between the histologic features of
      4NQO-induced dysplasia in the rat palatal mucosa and human oral epithelial
      dysplasia. Thus, the 4NQO rat palate model seems to be appropriate to study and
      assess new treatment modalities of premalignant epithelial lesions of the oral
      mucosa in man.

PMID- 7782643
TI  - Perspectives on craniofacial asymmetry. II. Asymmetric embryopathies.
AB  - Asymmetric embryopathies--severe malformations and disruptions--that affect the
      craniofacial region are discussed, including anomalies of the eye, nose, mouth,
      and ear. Asymmetric Tessier clefts are also discussed.

PMID- 7782644
TI  - Prefabricated prostheses for the reconstruction of skull defects.
AB  - Cranioplasties using intraoperatively modeled prostheses may fail to create
      harmonic contours with long-term stability. In contrast, preoperative modeling
      would allow more sophisticated planning of the contour and better preparation of
      the implant material, if a sufficiently precise model of the defect-site was
      available. In this respect, computer aided design and manufacturing (CAD/CAM)
      techniques based on helical computed tomography (CT) data are successfully used
      for the prefabrication of prostheses: An individual computer-based 3-dimensional
      model of the bony defect is generated after acquisition, transfer and evaluation
      of the CT data; from this freeform surfaces geometry an individual and
      "idealized" prosthesis-geometry is derived and fabricated by a numerically
      controlled milling machine using modern industrial CAD/CAM-systems and design
      software. The margins of this prosthesis-geometry are generated by the borders of
      the defect and the surface by considering the non-affected neighbouring contours.
      Cranioplasties in cases of large postsurgical skull defects are presented as the
      first clinical applications of this new method, which also allows the use of
      titanium and fabrication of integrated fixation-devices.

PMID- 7782645
TI  - Intraoperative navigation in oral and maxillofacial surgery.
AB  - Surgical procedures in the oral and maxillofacial region may be difficult in
      areas of complex anatomy. Up to now, surgical planning has been based almost
      exclusively on the surgeon's experience and on the interpretation of 2
      dimensional (2D) radiologic information. Our experiences with a commercially
      available 3D navigation system (Viewing Wand, ISG, Mississauga, Ontario, Canada)
      is reported upon. The system consists of a mechanical operating arm with 6 joints
      and 6 degrees of freedom working as a 3D digitizer and is interfaced to a
      computer graphics workstation. After registration of the position of the
      patient's head in relation to the tip of the instrument on the navigation arm,
      the surgeon can observe the 3D position and direction of the instrument in use on
      the monitor, i.e. on the computed tomography and/or magnetic resonance tomography
      images of the patient taken before. In 40 interventions performed so far, the
      accuracy was 2 mm and better. 3 cases are presented in this paper. The system
      facilitates surgery especially in anatomically complicated situations without the
      risk of damaging neighbouring structures. Planning of surgical interventions is
      much easier. By using computer assisted simulation and navigation systems, we
      expect an improvement in quality and a reduction in surgical risks. Thus,
      "looking ahead" surgery has become possible. More extensive and more radical
      interventions are likely to be performed in the near future. Responsibility for
      the surgical intervention, however, remains exclusively with the surgeon.

PMID- 7782646
TI  - Advances in interactive craniofacial surgery planning by 3D simulation and
      visualization.
AB  - In craniofacial surgery careful preoperative planning is essential. Traditional
      preoperative work-up consists of cast model surgery, cephalometric prediction
      tracing and analysis of photographs. Recently, we introduced 3-dimensional (3D)
      computed tomography (CT) model surgery in our preoperative work-up and
      presurgical prediction of the postoperative result. However, only limited
      information can be extracted concerning soft tissue changes which are most
      important for the patients' postoperative appearance. We propose a new system
      which will allow a precise preoperative visualization of not only bony structures
      but also the soft tissue surfaces. 3D CT data of the skull are integrated with 3D
      surface data acquired by laser scanning. Based on the 3D CT data the bony
      structures are segmented automatically and processed interactively to simulate
      the planned surgical procedure. Afterwards, the 3D soft tissue changes resulting
      from the shifting of bony segments are computed. The postoperative appearance of
      the patient is visualized using computer animation techniques.

PMID- 7782647
TI  - CT data acquisition as a basis for modern diagnosis and therapy in maxillofacial
      surgery.
AB  - More than 20 years after its introduction computed tomography has become a
      routine method in the diagnostic work-up of traumatic and neoplastic disorders in
      maxillofacial surgery. Short acquisition times of 1 sec per image reduce motion
      artifacts and permit increased numbers of patient examinations. Different
      reconstruction algorithms allow specific evaluation of either osseous or soft
      tissue structures. By adjusting window center and window width the 2048
      attenuation values can be transformed into the visible gray scale. Single
      sequential slices--as employed in routine diagnosis of tumor patients--still
      yield the highest image quality. Fast volume data acquisition associated with
      spiral scanning proves to be of special benefit in trauma patients. The resulting
      data set can be used for reconstruction of single slices, 2-dimensional (2D)
      reformated images in all planes and 3D surface rendering.

PMID- 7782648
TI  - 2D and 3D CT reconstructions of the facial skeleton: an unnecessary option or a
      diagnostic pearl?
AB  - The introduction of spiral computed tomography (CT) has been a major advance in
      CT scanning, particularly considering the reduction in acquisition time and
      improvements in 2-dimensional (2D) and 3D reconstructions. 314 out of 1262 CT
      examinations of the midface and jaws executed from September 1993 to September
      1994 were performed in the spiral mode. Our experience is critically reviewed and
      a guideline for the use of spiral CT scanning of the midface and jaws for various
      diagnostic purposes is established: Complex midface fractures require axial
      spiral CT scanning with secondary coronal reconstructions Because of the long
      processing time 3D reconstructions are reserved for planning surgical repair of
      craniofacial malformations. Dental CT scans with calculation of panoramic images
      provide important information prior to dental implant surgery and repair of
      alveolar clefts.

PMID- 7782649
TI  - 3D sonography.
AB  - A method of 3-dimensional (3D) sonography (US) is described in this paper.
      Special emphasis is laid upon the basic problem of generating well-orientated 3D
      visualizations on the basis of different evaluation techniques. Furthermore, some
      problems of data acquisition and data processing using US are presented.
      Alternative solutions thereto are briefly discussed.

PMID- 7782650
TI  - CAD by processing of computed tomography data and CAM of individually designed
      prostheses.
AB  - In the past an economic fabrication of individual prostheses used in
      reconstructive cranio-maxillo-facial surgery was not possible due to technical
      deficiencies. Now, through the consistent use of the most modern computer-based
      techniques developed in the field of industrial engineering, these costs can be
      reduced to an economic level. Mathematical freeform surfaces models are first
      created from helical computed tomography data. These serve as the basis for an
      efficient and idealized construction of prostheses geometries, and provide
      control-data for a computerized numerical control-fabrication. In 4 clinical
      cases this new processing technique has successfully been utilized in the
      fabrication of individually designed prostheses for the reconstruction of skull
      defects. The range of opportunities offered is reflected not only in the great
      variety of possible geometric details, but also in the fact that the prostheses
      may be manufactured--partly using indirect impression-taking techniques--from 3
      different biocompatible materials so far and other applications are likely to
      turn up.

PMID- 7782651
TI  - Stereolithography in oral and maxillofacial operation planning.
AB  - Stereolithography (STL) is a method of organ-model-production based on computed
      tomography scans which enables the representation of complex 3-dimensional
      anatomical structures. Surfaces and internal structures of organs can be produced
      by polymerization of UV-sensitive liquid resin using a laserbeam. In oral and
      maxillofacial surgery this technique is advantageous for reconstruction of severe
      skull defects because a more accurate preoperative planning is possible. Using
      recently developed software we are able to reconstruct unilateral bony defects by
      virtual mirror imaging of the contralateral side and production of a STL mirror
      model as well as the reconstruction of non-mirrorable defects by superposition.
      Advantages of STL are the representation of complex anatomical structures, high
      precision and accuracy, and the option to sterilize the models for intraoperative
      use. More accurate planning using this method improves postoperative results,
      decreases risks and shortens treatment time.

PMID- 7782652
TI  - [F-waves in brachial plexus palsy correlated to the prognosis of intrinsic
      paralysis].
AB  - F-waves were examined in 80 nerves of 40 brachial plexus palsies in 37 cases. The
      electrical responses were evoked by 30 consecutive supramaximal electric stimuli
      to the median and ulnar nerves at the wrist and elbow, and recorded from the
      abductor pollicis brevis and abductor digiti minimi muscles. Three parameters in
      the F-waves were analyzed--conduction velocity, the difference between the
      maximal and minimal latencies, and the amplitude. In all cases, examinations were
      done repeatedly to detect changes in these parameters, and the results were
      compared with the clinical course of the intrinsic muscle function. Twenty-seven
      cases were investigated before and after explorative surgery. The findings were
      divided into four groups. The 1st group consisted of 12 nerves in which F-waves
      were not recorded. The intrinsic muscle power in this group was zero, and did not
      show any restoration. The 2nd group consisted of 10 nerves in which the
      conduction velocity was delayed. The muscle power in this group was fair, poor or
      trace, and there was no change in conduction velocity and muscle function. The
      3rd group consisted of 18 nerves in which parameters other than the conduction
      velocity were abnormal, and the intrinsic muscle power in this group was fair,
      good or normal. In 7 of these nerves, the large latency difference decreased to
      normal at the 2nd, 3rd or 4th test with functional recovery in the intrinsic
      muscle. The high amplitude also changed to normal at the 2nd test with functional
      recovery. The 4th group consisted of 40 nerves in which all the parameters were
      normal and had full intrinsic muscle power. In conclusion, an examination of the
      F-waves was valuable to indicate the prognosis of the intrinsic muscle in the
      hand in brachial plexus palsy.

PMID- 7782653
TI  - [Results after cemented total knee arthroplasty: a follow-up study over 5-to-14
      years].
AB  - Eighty-five cemented total knee arthroplasties were followed for five to fourteen
      years (mean 7.8 years). The clinical evaluation was excellent or good in 85% of
      this series. However, a complication developed in 15 knees (17.6%), and two
      thirds of these complications were found in the patello-femoral joint. One
      further case developed an infection (1.2%), and four others (4.7%) developed an
      aseptic loosening. Over all, 8 cases (9.4%) required revision surgery.
      Asymptomatic wear was seen to progress in some implants involving thin
      polyethylene, although their clinical results were rated as excellent. The
      outcome of the cemented knee arthroplasties was considered as acceptable at
      present, but improved surgical techniques and measures against polyethylene wear
      are required for future improvement in this surgery.

PMID- 7782654
TI  - [Femoral neck and iliac bone histomorphometry in femoral neck fracture].
AB  - Involutional osteoporosis is a risk factor for femoral neck fracture in elderly
      people. This study was designed to evaluate the bone mass and quality of the
      femoral neck specimen obtained directly from the femoral neck at the time of hip
      surgery. An iliac bone biopsy was also performed in some cases. A
      histomorphometric analysis of the femoral neck was performed in 31 women with a
      femoral neck fracture, aged 64-104 (mean age 76.2), and in 19 women with
      osteoarthritis of the hip, aged 50-77 (mean age 64.3) as a control. The cortical
      thickness of the lateral, anterior and posterior aspects of the femoral neck was
      significantly less in the fracture group than in the osteoarthritis group.
      However, there was no significant difference in the medial cortical thickness
      between the two groups. The fracture group exhibited an increased resorption
      cavity area and intracortical porosity in the cortical area as well as increases
      in the eroded surface and osteoclast number in the endocortical envelope. The
      bone volume in the cancellous envelope of the medial femoral neck was
      significantly lower in the fracture group. Most parameters of the iliac bone were
      not correlated with those of the femoral neck in either group. Our findings
      suggested that a femoral neck fracture was associated with a decreased cortical
      thickness in the femoral neck. Increased intracortical porosity and a low
      cancellous bone volume were also critical factors in femoral neck fragility, and
      an iliac bone biopsy did not necessarily reflect the femoral neck bone status.

PMID- 7782655
TI  - [Triangular fibrocartilage complex: functional anatomy and histology].
AB  - The functional anatomy and histology of triangular fibrocartilage complex (TFCC)
      were investigated using 20 wrists from fresh cadavers, and a functional model of
      TFCC was proposed. The dynamic changes in the TFCC during pronation and
      supination were examined from both the proximal and distal sides. The distal side
      of the TFCC consisted of the disc proper (DP), the meniscus homologue (MH), the
      ulnolunate ligament (UL), and the ulnotriquetral ligament (UT). The prestyloid
      recess was observed between the DP and MH. The ulnar collateral ligament (UCL)
      existed at the ulnar side of the TFCC and consisted of the sheath floor of the
      extensor carpi ulnaris (ECU) with relatively loose ligamentous tissue recognized
      as 6U-portal in arthroscopy. The fan-shaped triangular ligament spreading from
      the fovea of the ulna was observed on the proximal side of the TFCC. It was
      considered to be the real radioulnar ligament connecting the radius and ulna.
      During pronation and supination, little deformity in the DP was observed, while
      the ulnar insertion of the triangular ligament was twisted. The UCL was distorted
      dorsally in pronation and volary in supination. In the coronal section of the
      TFCC, the area surrounded by the DP, MH and UCL was relatively soft and loose,
      and was considered to have served as a cushion during pronation and supination.
      From these findings, the TFCC was separated into three components; the distal
      component which acted like a hammock to suspend the carpus, the triangular
      ligament as the proximal component which stabilized the radius to the ulna, and
      the UCL as the ulnar component which stabilized the carpus to the ulna. We have
      proposed a suspension theory to account for the stability and mobility of the
      TFCC during pronation and supination when these three components suspend each
      other. The function of the TFCC can be fully accounted for by our theory.

PMID- 7782656
TI  - [Correlation between the concentration of 1,25 alpha dihydroxyvitamin D3
      receptors and growth inhibition, and differentiation of human osteosarcoma cells
      induced by vitamin D3].
AB  - It has been previously reported that several human cancer cell lines possess
      specific receptors for 1,25-dihydroxyvitamin D3. In the present study, the
      concentration of the 1 alpha,25 dihydroxyvitamin D3 receptors has been determined
      in four human osteosarcoma cell lines--MG63, OST, MNNG-HOS, and KHOS-NP, and we
      report the effect of 1 alpha, 25 dihydroxyvitamin D3 on these cells. The
      concentration of 1 alpha, 25 dihydroxyvitamin D3 receptors in MG63, OST, MNNG-HOS
      and KHOS-NP was 31.1, 12.1, 5.9 and 3.0 fmol/mg of cytosol protein, respectively.
      These cell lines were classified into two groups according to the concentration
      of the receptors. The two receptor-rich cell lines were MG63 and OST, and the
      receptor-poor cell lines were MNNG-HOS and KHOS-NP. In a colony-forming assay, 1
      alpha, 25 dihydroxyvitamin D3 (10(-8)M, 10(-9)M) was found to significantly
      suppress the growth of the receptor-rich cell lines (p < 0.01), but did not
      suppress that of the receptor-poor cell lines. In an antitumor assay, athymic
      mice received a transplantation of tumor cells and were treated with 2.5 nmol/kg
      of 1 alpha hydroxyvitamin D3. Then the relative mean weight of the tumor was
      measured (MG63 was, however, not transplantable into athymic mice.) As a result,
      1 alpha hydroxyvitamin D3 was found to have significantly suppressed the relative
      mean tumor weight of OST and MNNG-HOS compared with a control group (p < 0.05),
      but did not suppress that of KHOS-NP. Histologically, 1 alpha hydroxyvitamin D3
      induced marked chondrogenetic differentiation in OST alone.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7782657
TI  - [An experimental study on the prevention of postlaminectomy scar formation:
      efficacy of interpositional collagen-sponge].
AB  - The efficacy of collagen-sponge to reduce postoperative scar formation was
      investigated in 65 Japanese white rabbits that received laminectomy in the 7th
      and 8th thoracic vertebra. The defect after laminectomy was filled by collagen
      sponge in 25 rabbits, by free fat in 20 rabbits, and by nothing in 20 rabbits as
      controls. The animals were sacrificed 2, 4, 8 and 12 weeks and additional 5
      rabbits of which defects were filled with collagen-sponge were sacrificed after
      24 weeks. All the defects were examined histologically. At 4 weeks after
      laminectomy, the defects filled by collagen-sponge showed that fibrous tissue had
      invaded into the sponge, but there was no remarkable adhesion to the dura mater.
      At 8 weeks, the defect with collagen sponge showed foaming cells, and no
      thickening of the dura mater was observed. At 12 weeks, the grouping of foaming
      cells was partially replaced by fat cells. At 24 weeks, most of the foaming cells
      were replaced by fat cells, and the defect was then similar to that filled by
      free fat at 12 weeks. In contrast, the defect with no interposed membrane was
      already filled with fibrous tissue at 4 weeks, and adhesion to the dura mater was
      observed. Although the free-fat graft at 12 weeks postoperatively showed no
      remarkable adhesion around the dura mater, infiltration of fat tissue into the
      spinal canal was observed in 2 of 5 rabbits. These results indicated that
      collagen-sponge can be utilized as a new biomaterial to effectively prevent scar
      formation after laminectomy.

PMID- 7782658
TI  - [The effect of 2 beta-(3-hydroxypropoxy)-1 alpha, 25-dihydroxyvitamin D3 (ED-71)
      on callotasis in rabbit].
AB  - To evaluate the effects of 2 beta-(3-hydroxypropoxy)-1 alpha, 25-dihydroxyvitamin
      D3 (ED-71) on callotasis, we measured the bone mineral content (BMC) using dual
      energy X-ray absorptiometry (DXA) and compared the results with radiographical
      and histological findings, in an experimental model. Leg lengthening by
      callotasis was performed on 37 10-week-old Japanese white rabbits. The rabbits
      were divided into two groups; those in Group A (n = 19) received no medication
      and those in Group B (n = 18) received ED-71 (0.05 micrograms/kg body weight)
      twice a week following osteotomy. In both groups, from 10 days after the
      osteotomy, the bone was lengthened a total of 10 mm at a rate of 0.5 mm every 12
      hours (1.0 mm/day) for a further 10 days. After completion of distraction, the
      bone mineral content (BMC) of the newly formed bone at the site of lengthening
      was then measured by DXA each week for 15 weeks, and the DXA findings were
      compared with those from radiographical and histological studies. The BMC of the
      newly formed bone at the site of the lengthening in both groups increased and
      reached a peak at two weeks after completion of the distraction. Then, the BMC
      gradually decreased and reached a plateau after a further 8 weeks. The BMC in
      Group B was significantly higher than that in Group A, and this correlated with
      the radiographical and histological findings. We concluded that the change in BMC
      at the site of the lengthening corresponded with the radiographical and
      histological findings, and that ED-71 administration may increase the callus
      formation at the site of leg lengthening.

PMID- 7782660
TI  - Noninvasive continuous blood pressure measurement during anaesthesia: a clinical
      evaluation of a method commonly used in measuring devices.
AB  - The objective of the study was assess the utility during anaesthesia of
      noninvasive continuous blood pressure measurement techniques which use
      intermittent oscillometric blood pressure measurement for their calibration. The
      assessment was performed by comparing noninvasive blood pressure with intra
      arterial blood pressure. The noninvasive blood pressure measurement device used
      for evaluation was the NCAT N-500 which uses tonometry for its continuous
      measurements. Fifteen patients were studied. In 10 patients the intra-arterial
      blood pressure curve (IBP) was recorded from the radial artery (radial artery
      group), and in 5 patients it was recorded from the brachial artery (brachial
      artery group). In all patients the oscillometrically calibrated tonometric blood
      pressure (OTBP) was recorded from the other arm. To discriminate between
      calibration dependent measurement error and tonometric measurement error, the
      OTBP signal was recalibrated against the IBP signal to get the intra-arterial
      calibrated tonometric pressure curve (ITBP). OTBP-IBP reflected the overall
      measurement error, ITBP-IBP the error of the tonometric measurement, and OTBP
      ITBP the calibration dependent measurement error. According to criteria
      formulated in the discussion the accuracy and agreement of the ITBP-IBP
      measurements were clinical acceptable. Accuracy and agreement of OTBP-IBP and of
      OTBP-ITBP were not clinical acceptable. Correlation of dynamic behavior was lower
      for OTBP than for ITBP. A significant effect of site difference between
      calibration measurements and continuous measurements was not found. It is
      concluded that the approach of continuous noninvasive blood pressure measurement
      based on the combination of two different measurement methods, in which the
      continuous method is calibrated by the oscillometric method, lead to clinical
      unacceptable accuracy and agreement in the patient group studied.

PMID- 7782659
TI  - [Osteoconduction in porous hydroxyapatite ceramics grafted into the defect of the
      lamina in experimental expansive open-door laminoplasty in the spinal canal].
AB  - We have investigated the osteoconduction in porous hydroxyapatite ceramics
      grafted into the defect of the lamina of dogs in expansive open-door
      laminoplasty. Porous Hydroxyapatite block (HAB) was sintered at 900 degrees C
      with size of 4 x 7 x 19 mm, a mean pore diameter of 90 microns and a void volume
      of 70%. The operation was performed in 29 dogs. The animals were sacrificed at
      three or at six months after the operation (the three-month group and the six
      month group). After the grafted HABs with adjacent vertebrae were removed, the
      stability of the grafted HABs was manually evaluated. The HAB was firmly fixed to
      the laminae in 14 of 20 cases. It seemed that the stability of the HAB was poor
      in those cases in which the HAB had not been tightly sutured. To investigate
      osteoconduction, serial sections of the laminar bones including the HAB were
      prepared without decalcification and were examined histologically. New bone
      formation in the pores of the HAB was found in all cases. However, the
      osteoconduction rate was higher in the six-month group than in the three-month
      group (p < 0.01). And the osteoconduction rate was higher in those cases in which
      the HAB was firmly fixed to the laminae than in those with a loosely fixed HAB.
      Bone ingrowth in the HAB was frequently observed in the zone adjacent to the
      bone, more so than in other zones. Osteoconduction appeared to occur at the
      contact surface and to extend towards the center of the HAB.

PMID- 7782661
TI  - Introduction of knowledge bases in patient's data management system: role of the
      user interface.
AB  - As the number of signals and data to be handled grows in intensive care unit, it
      is necessary to design more powerful computing systems that integrate and
      summarize all this information. The manual input of data as e.g. clinical signs
      and drug prescription and the synthetic representation of these data requires an
      ever more sophisticated user interface. The introduction of knowledge bases in
      the data management allows to conceive contextual interfaces. The objective of
      this paper is to show the importance of the design of the user interface, in the
      daily use of clinical information system. Then we describe a methodology that
      uses the man-machine interaction to capture the clinician knowledge during the
      clinical practice. The different steps are the audit of the user's actions, the
      elaboration of statistic models allowing the definition of new knowledge, and the
      validation that is performed before complete integration. A part of this
      knowledge can be used to improve the user interface. Finally, we describe the
      implementation of these concepts on a UNIX platform using OSF/MOTIF graphical
      interface.

PMID- 7782662
TI  - Automated anaesthesia record systems, observations on future trends of
      development.
AB  - The introduction of electronic anaesthesia documentation systems was attempted as
      early as in 1979, although their efficient application has become reality only in
      the past few years. Today, documentation technology is offered by most of the
      monitor manufacturers and new systems are being developed by various working
      groups. The advantages of the electronic protocol are apparent: Continuous high
      quality documentation, comparability of data due to the availability of a
      anaesthesia data bank, reduction of the workload of the anaesthesia staff and
      availability of new additional information. Disadvantages of the electronic
      protocol have also been discussed. Typically, by going through the process of
      entering data on the course of the anaesthetic procedure on the protocol sheet,
      the information is mentally absorbed and evaluated by the anaesthetist. This
      mental processing of information may, however, be missing when the data are
      recorded fully automatically--without active involvement on the part of the
      anaesthetist. It seems that electronic anaesthesia protocols will be required in
      the near future. The advantages of accurate documentation and quality control in
      the presence of careful planning will outweight cost considerations. However, at
      this time, almost none of the commercially available systems have matured to a
      point where their purchase can be recommended without reservation. There is still
      a lack of standards for the subsequent exchange of data and a solution to a
      number of ergonomic problems still remains to be found.

PMID- 7782663
TI  - Clinical evaluation of the 'head-up' display of anesthesia data. Preliminary
      communication.
AB  - To solve the problem of monitoring the patient during administration of
      anesthesia, a commercially available head-up display (HUD) was evaluated during
      one day of surgery at the Ohio State University Hospitals. This monitor is
      mounted on a headband worn by the anesthesiologist. It projects a monochrome
      image of monitor data directly into one eye. Eleven anesthesiologists tested the
      device. Most users were able to adjust to the monitor in about fifteen minutes.
      Nine of the testers expressed a desire to evaluate the monitor further. Their
      major complaints were that the connecting cable between the HUD and its computer
      was too short, the resolution of the monitor was inadequate, and the data on the
      screen were not organized in a familiar way. If these problems could be
      corrected, most users believed that this HUD could be a valuable tool to aid the
      anesthesiologist in the operating room.

PMID- 7782664
TI  - The calculation of linear dimension and image area using a digitising tablet and
      personal computer.
AB  - An inexpensive image-area and perimeter-length measurement system consisting of a
      personal computer and digital graphics tablet is described. A study to assess the
      efficacy of the system has shown that accuracy and reproducibility of area
      measurement increase with increasing size of cross-sectional area. The system
      generally underestimated all derived areas by less than 2%. Reproducibility of
      measurement, as defined by the coefficient of variation, was typically less than
      2%; the greatest inaccuracies and variability occurring with shapes of smaller
      cross-sectional area. The system seems to be the least accurate when it measures
      shapes with rectangular symmetry. Neither direction of digitisation nor operator
      skill seemed to influence the measurement accuracy of the system.

PMID- 7782665
TI  - Implication of anaesthesiologists' varying location during surgery.
AB  - Anecdote indicates anaesthesiologists in the operating room are not invariably at
      the head of the operating table beside their equipment. The validity of this was
      investigated by a nationally distributed questionnaire. The results support the
      anecdotal evidence. The behaviour can be justified so supports a recommendation
      for appropriate visibility of information displays. Whether such action would
      improve patient safety is debatable.

PMID- 7782667
TI  - A short tutorial: The Internet as a global information source.

PMID- 7782666
TI  - Data processing in prehospital emergency medicine.
AB  - Information about the use of data processing systems in prehospital emergency
      medicine were collected, using a questionnaire sent to all German rescue
      helicopter bases. Twenty-seven of the 42 German rescue helicopter bases returned
      the questionnaire. At present, only 15 of them take advantage of electronic data
      processing. All of them enter their data manually by keyboard, automatic data
      transfer by means of a bar code reader is available at one base only. The stored
      data are used for statistical analysis (n = 15), quality assessment (n = 10),
      administration (n = 10), research (n = 9) and education (n = 7). Based on the
      data of this survey, one fifth of those who replied use their computer only for
      administrative purposes, the other also manage patient and mission data with
      their computer systems. Today, documentation of a rescue mission consists of
      patient data, vital data, mission data and information about the procedures
      carried out. The use of a computer system, however, requires more time and work
      than a handwritten record, when most of the data have to be entered manually
      using a keyboard. Future developments may include automated data transfer and
      digitization of handwritten documents to decrease the workload of the staff. For
      the automation of data transfer, configuration and synchronisation a standardized
      interface in all medical devices is required. There is a clear need for the use
      of data processing systems in emergency medicine.

PMID- 7782668
TI  - ECG of the month. The untamed heart. Atrial flutter.

PMID- 7782669
TI  - Deep neck space infections.
AB  - The incidence of deep neck space infections has dramatically decreased since the
      advent of antibiotics, but with delayed treatment they carry the potential for
      significant morbidity and mortality. Odontogenic infections with involvement of
      the submandibular space are the most common source of deep neck space infections
      in adults, whereas in the pediatric population the most common cause is acute
      tonsillitis with involvement of the peritonsillar space. The newest group of
      patients at risk for deep neck space infections are intravenous drug abusers who
      inject the major vessels of the neck. Knowledge of neck spaces and fascial
      relationships is important in understanding the presentation, treatment, and
      complications of deep neck space infections. The spaces, which are created by
      various fasciae of the head and neck, are only potential spaces in that under
      normal conditions they cannot be examined clinically or radiographically. As the
      spaces are invaded by bacteria, a cellulitis or abscess occurs, and this
      infection may travel through paths of least resistance from one space to another.

PMID- 7782670
TI  - The journal 100 years ago. May 1845 and 1895.

PMID- 7782671
TI  - Management of chronic ischemic heart disease.

PMID- 7782672
TI  - Positron emission tomography in the diagnosis and management of coronary artery
      disease.
AB  - Positron emission tomography has grown rapidly from a little-understood research
      tool into an exciting noninvasive method for the clinician to evaluate myocardial
      perfusion, metabolism, and cell-membrane function. There are three radionuclides
      that are currently being used widely in cardiac positron emission tomography.
      These are nitrogen-13 ammonia, rubidium-82, and fluorine-18 fluordeoxyglucose.
      Nitrogen-13 ammonia and rubidium-82 are used to assess the severity and location
      of coronary artery disease, while fluorine-18 fluordeoxyglucose can identify
      impaired but viable myocardium, thus aiding in the subsequent management of these
      patients.

PMID- 7782673
TI  - The exercise treadmill test for diagnosis and prognosis of coronary artery
      disease.
AB  - After more than 50 years of refinement, the exercise test remains a useful device
      for diagnosis and prognosis of coronary artery disease. In addition, it is within
      the range of skills of primary care physicians. Understanding that the exercise
      test is not a noninvasive angiogram, and that angiography primarily defines
      anatomy, emphasizes the complementary nature of the tests. The addition of
      thallium scintigraphy to the exercise test brings enhanced sensitivity and
      specificity in certain clinical settings. The use of exercise testing with or
      without thallium scintigraphy is not currently recommended for evaluation of
      dysrhythmias, pre-operative clearance, or screening of asymptomatic individuals.

PMID- 7782674
TI  - Ischemic heart failure.
AB  - Heart failure is a major and increasing public health problem. Coronary artery
      disease has become the major etiology of heart failure. The differentiation of
      viable from nonviable myocardium in patients with coronary disease and impaired
      left ventricular systolic function is an issue of extreme importance to the
      clinician. Several diagnostic modalities including thallium imaging, dobutamine
      stress echocardiography, and positron emission tomography have gained
      considerable acceptance as useful tools in detecting myocardial viability. The
      management of heart failure with preserved left ventricular systolic function
      includes the use of beta blockers, calcium channel blockers, and nitrates. In
      patients with heart failure and impaired left ventricular systolic function,
      angiotensin converting enzyme inhibitors have become an integral part of the
      medical management. In patients whose angina is unresponsive to the addition of
      nitrates, a trial of bet blockers should be attempted and first generation
      calcium blockers should be avoided. Revascularization should always be sought,
      particularly when myocardial viability has been established.

PMID- 7782676
TI  - Current trends and considerations in the surgical treatment of coronary artery
      disease.
AB  - Management of coronary artery disease has changed greatly in the past three
      decades. Surgical treatment has improved, especially with the introduction of
      bypass conduits, like the internal mammary artery, which possess a patency rate
      far superior to that of the saphenous vein. Use of this arterial graft has so
      encouraged surgeons that other autologous arterial grafts are being tried. Grafts
      from nonautologous sources are being investigated, but none have yet been found
      to approach the excellent performance of the internal mammary artery. While the
      surgical treatment for myocardial ischemia has greatly improved, characteristics
      of the patient population have not. Patients presently sent for surgery are
      older, in worse general health, and have poorer cardiac function and coronary
      disease than their counterparts of several decades ago. Nevertheless, expansion
      of surgical options, including cardiac transplantation has allowed even the
      highest risk patients to be considered for surgical intervention.

PMID- 7782677
TI  - Percutaneous interventions for ischemic heart disease.
AB  - In the United States, when necessary due to symptoms or prognosis, percutaneous
      coronary interventions are performed on patients with ischemic heart disease more
      frequently than is coronary artery bypass surgery. A wide array of options are
      available to the interventional cardiologist. Improvements over the 17 years that
      coronary balloon angioplasty has been performed have kept it the primary therapy.
      It is currently used safely and effectively in the majority of patients. The
      problems of abrupt closure, restenosis, and inadequate results in some complex
      lesions have spurred the development of intracoronary stents, coronary
      atherectomy and ablation devices, and coronary excimer lasers. Metallic stents
      perform well in large vessels to treat abrupt closures and to reduce restenosis,
      but confer a risk of hemorrhage. Specific complexities of lesion characteristics
      determine the effective use of atherectomy/ablation devices and lasers. Future
      technologic improvements anticipate even better treatments for patients with
      coronary artery disease.

PMID- 7782675
TI  - Pharmacologic therapy of angina pectoris.
AB  - The primary drugs utilized in the treatment of angina pectoris include organic
      nitrates, beta-adrenoceptor antagonists, Ca2+ antagonists, and the antithrombotic
      agents aspirin and heparin. Not all of these drugs are useful in every form of
      angina, and treatment is symptomatic rather than curative. In stable effort
      angina, beta-blockers, Ca2+ antagonists, and organic nitrates provide relief from
      angina pain and improve exercise tolerance primarily through their ability to
      decrease oxygen demand. The antiplatelet action of aspirin may decrease the
      incidence of myocardial infarction in these patients. Ca2+ channel blockers and
      organic nitrates are the drugs of choice for variant angina. These vasodilators
      restore blood flow by relieving the coronary vasospasm that triggers the ischemic
      episode. In unstable angina, aspirin and heparin reduce the risk of myocardial
      infarction, and aspirin increases survival. Heparin and nitrates alleviate angina
      pain, and under some circumstances beta-blockers and Ca2+ antagonists have a role
      in the relief of pain.

PMID- 7782678
TI  - The Birmingham mummy: the first torticollis in history.
AB  - The Birmingham Mummy is of a warrior, 25-35 years of age, from the Graeco-Roman
      period. He was struck from the front by an arrow, which penetrated the soft
      tissues of the neck to some depth and lodged in the right infratemporal fossa. It
      is suggested that the wound became infected and that muscle spasm induced the
      torticollis which was not fully corrected on mummification.

PMID- 7782679
TI  - A long-term review of the Shah Permavent tube.
AB  - A retrospective study of 74 Shah Permavent tube insertions is presented. These
      were inserted into 74 ears of 55 patients during the period between 1985 and
      1988. At the time of review, 35 tubes had extruded spontaneously, 11 tubes had
      been removed for recurrent infections, 10 tubes had been removed electively and
      10 tubes were still in situ. On examination of the ears approximately 12 months
      after the tubes had extruded, the overall rate of tympanic membrane perforation
      was 18.2 per cent. In ears in which the Permavent tube extruded spontaneously the
      perforation rate was 22.2 per cent. In ears which the tube was removed because of
      infection the perforation rate was 20.0 per cent. However in ears in which the
      tube was removed electively the perforation rate was zero. This finding has
      implications in the use and management of long-term ventilation tubes.

PMID- 7782681
TI  - Epithelial migration in open mastoidectomy cavities.
AB  - Twenty patients who had undergone open cavity mastoidectomy for chronic middle
      ear disease were selected for study. Following initial microscopic aural toilet,
      each cavity was painted in its medial aspect with a marker solution of Bonney's
      Blue dye. Each patient was assessed at weekly intervals for a minimum of three
      months following application of dye, and a photographic record made of the
      cavity. Information was also sought regarding the clinical behaviour of the
      mastoid cavities, with particular regard to degree of otorrhoea, and accumulation
      of debris. Migration of epithelium inferred by visible movement of dye occurred
      in 17 of the 20 mastoid cavities. In all these cases migration occurred in a
      medial to lateral direction, towards the exterior. In two cases there was no
      visible migration throughout the period of observation, and inspection after six
      months revealed the dye to be still present in the original position. Both these
      cases were of dry trouble-free cavities in which accumulation of debris did not
      appear to be a problem. This finding calls into question the assumption that
      clean trouble-free cavities are maintained by a satisfactorily functioning
      epithelial migration. In the four cavities which suffered from intermittent
      otorrhoea, epithelial migration occurred at a similar rate to that in dry
      cavities.

PMID- 7782680
TI  - Prevalence of eardrum pathology in a cohort born in 1955.
AB  - The aim of this study was to compare the prevalence of the different types of
      eardrum pathology in a cohort of adults not previously treated by grommet
      insertion with corresponding findings obtained in a cohort previously treated
      with grommet insertion. A cohort born in 1955 were invited to a screening
      examination including otomicroscopy. In the untreated cohort, retraction of
      Shrapnell's membrane was found in four per cent of the ears compared to 20 per
      cent in the cohort treated with grommets. Tensa pathology, including atrophy and
      myringosclerosis, was found in six per cent of the ears in the untreated cohort
      and in 17 per cent in the treated cohort. Normal eardrums were found in 91 per
      cent of the ears. Despite the increased awareness of secretory otitis, as well as
      the increased rate of surgical treatment, the prevalence of eardrum pathology
      seems to be increasing. The reasons for this are discussed.

PMID- 7782682
TI  - Hearing loss associated with weapons noise exposure: when to investigate an
      asymmetrical loss.
AB  - The air conduction thresholds in the right and left ears, and the interaural
      asymmetry of thresholds at 0.5, 1, 2, 3, 4 and 6 kHz were measured in a group of
      225 soldiers exposed to a variety of weapon noise who were referred for
      assessment because of a deterioration in hearing on routine testing. At 0.5 and 1
      kHz the threshold levels rarely exceeded 25 dB and the interaural asymmetry was
      10 dB or less in 90 per cent of cases. The degree of hearing loss and interaural
      asymmetry increased as the frequency increased, with the average loss being
      significantly greater in the left ear at 2, 3, 4 and 6 kHz. Recommendations are
      made for the selection of cases of asymmetrical hearing loss exposed to weapon
      noise which require further investigation to exclude a retrocochlear cause or to
      define spurious hearing threshold levels.

PMID- 7782683
TI  - Nasal laser mucotomy (L-mucotomy) of the interior turbinates.
AB  - Eighty-seven patients who were treated by laser mucotomy (L-mucotomy) of the
      inferior turbinates were followed-up for one year. Patients presented for laser
      surgery because of one of the three following symptoms: sneezing, rhinorrhoea, or
      nasal obstruction. All of them had had prior conservative or surgical treatments
      for their symptoms without improvement in their complaints and/or quality of
      life. L-mucotomy is a simple procedure performed under local anaesthesia on an
      ambulatory basis. A controlled amount of tissue from the inferior turbinates is
      ablated with improvement in the symptoms, as reported by the patients one year
      after laser surgery. The procedure is easy to perform, there is no bleeding, it
      is painless and without complications, but it requires rather expensive surgical
      equipment.

PMID- 7782684
TI  - The management of sinogenic orbital complications.
AB  - The place of conservative treatment in sinogenic orbital complications has not
      been fully explained in the literature. The question that remains unresolved is-
      at which stage of the disease is surgery indicated? A study was undertaken in 240
      patients with sinogenic orbital complications, to determine this. The patients
      were divided into three groups according to the stage of the disease as
      determined clinically: Group 1 (52 patients) with early stage disease, as
      detected by cellulitis only; Group 2 (76 patients) with intermediate stage, as
      detected by periorbital cellulitis and proptosis, but with full range of eye
      movement and unaltered vision; Group 3 (122 patients) with late stage disease, as
      detected by periorbital cellulitis and gross proptosis, with limitation of eye
      movement and altered vision. Group 1 and Group 2 patients were treated
      conservatively, with intravenous antibiotics and antral lavage. Group 3 patients
      were treated with intravenous antibiotics and surgery. External
      frontoethmoidectomy was performed in 31 (bilateral in two), ethmoidectomy in 91
      (bilateral in five), sphenoidectomy in 15 and bilateral antral washout in all
      (122 patients). There was 100 per cent success with conservative treatment in
      Group 1 patients, whilst in Group 2 there was 98.6 per cent failure. The 75
      patients in whom conservative treatment failed were successfully treated with
      surgery: frontoethmoidectomy was performed in 66 and ethmoidectomy in nine. In
      Group 3 patients, 100 per cent success was achieved with intravenous antibiotics
      and surgery. Sinogenic orbital complications can be treated conservatively and
      surgically, depending on the stage of the disease on presentation. Conservative
      treatment is only suitable for early complications, i.e. patients with
      periorbital cellulitis only.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782685
TI  - Lymph node and distant metastases in patients with sinonasal carcinoma.
AB  - A retrospective analysis of 34 cases of sino-nasal squamous cell or
      undifferentiated carcinoma in patients admitted between 1984 and 1992 was
      undertaken. Multimodality therapy incorporated radiation, surgery and
      chemotherapy. The five-year survival rate was 53 per cent. The local control rate
      was 82 per cent. Patients died of local failure (six), distant metastases (six),
      lymph node metastases (one) and other causes (three). Twenty-eight patients with
      local control were separated into groups: G1-2 (well and moderately
      differentiated) and G3-4 (poorly differentiated and undifferentiated) and
      evaluated to find the association between differentiation and metastasis. Lymph
      node metastasis was not related to the degree of differentiation. Distant
      metastasis was significantly related to the degree of differentiation (Fisher's
      exact test: p = 0.007). The result of the combination therapy is poor for
      patients with poorly differentiated or undifferentiated carcinoma because of
      distant metastases. Adjuvant chemotherapy may be necessary for them to prevent
      distant metastasis.

PMID- 7782686
TI  - Comparison between short-term and long-term post-operative evaluation of sleep
      apnoea after uvulopalatopharyngoplasty.
AB  - For a long time uvulopalatopharyngoplasty (UPPP) has been used to treat the
      obstructive sleep apnoea syndrome (OSAS). The diverse surgical effects, the
      inadequate understanding of operation effect consistency, the possibility of
      disease progression, and the few reported papers for long-term evaluation after
      UPPP aroused our interest in designing this study. Fifteen OSAS patients who had
      undergone UPPP with pre-operative, initial post-operative and long-term post
      operative polysomnographic studies were included in this study. Long-term post
      operative polysomnography was undertaken more than five years after surgery. The
      polysomnographic evaluations included respiratory disturbance index (RDI),
      duration of saturation SaO2 < 85 per cent (DOS), and the lowest O2 saturation
      (LOS). Amongst them, 10 patients with initial post-operative RDI reduction > 50
      per cent were considered responders. In these responders, the long-term follow-up
      results of all three parameters showed improvement compared to the pre-operative
      data. In a comparison between the initial and long-term post-operative sleep
      study results, LOS and DOS showed no significant difference. However, the long
      term post-operative RDI result became significantly worse. More than 80 per cent
      of all cases had subjective symptomatic improvement in the long-term post
      operative evaluation. The subjective improvement after operation is not
      adequately correlated to the polysomnographic result. We suggest that long-term
      follow-up for patients after UPPP is necessary.

PMID- 7782687
TI  - Post intubation laryngeal sequelae in an intensive care unit.
AB  - The incidence, severity and pattern of post-intubation laryngotracheal sequelae
      in a 12 bed multidisciplinary intensive care unit (ICU) were assessed in this
      prospective study. One-hundred and fifty consecutive patients requiring
      intubation for more than 24 hours for various indications were studied.
      Evaluation of the larynx and trachea was done using a fibreoptic bronchoscope
      introduced through the endotracheal tube prior to elective extubation. Rigid
      bronchoscopy and direct laryngoscopy were performed in very small children and
      adults requiring tracheostomy. One-hundred and thirty-one (87.6 per cent)
      patients had visible laryngeal pathology in the immediate post-extubation period.
      Thirteen (8.6 per cent) had long term sequelae. A high incidence of long term
      sequelae was noted in patients with seizures (25 per cent) followed by patients
      with head injury (19 per cent). Steroid therapy failed to offer any significant
      protection but resulted in doubling of pulmonary sepsis. A grading system was
      adopted to classify acute laryngotracheal injury and a significant correlation
      was found between the presence of slough in the immediate post-extubation period
      and subsequent development of long term sequelae. There was also a significant
      correlation between a deeper insertion of the endotracheal tube and development
      subsequently of long term sequelae. The significance of these findings is
      discussed.

PMID- 7782688
TI  - A confidential comparative audit of stapedectomies: results of the Royal College
      of Surgeons of England Comparative Audit of ENT surgery 1994.
AB  - This paper presents the results of a national confidential comparative audit of
      stapedectomy: 185 operations by 28 consultants over a two-year period were
      retrospectively analysed. This included 10 revision procedures. Small fenestra
      stapedectomies accounted for 63 per cent of the total. Thirty-nine per cent of
      consultants operated on the second ear. Of the 168 stapedectomies in which the
      hearing change was known at six months, 87 per cent achieved improved hearing,
      eight per cent had no change and five per cent were worse. The overall
      complication rate was 30 per cent with a 'dead ear' rate of two per cent.

PMID- 7782689
TI  - Nasal septal surgery: is routine follow-up necessary?
AB  - An audit project was undertaken to appraise the outcome of 95 cases of septal
      surgery over a 12-month period, taking into account the subjective alteration of
      symptoms, appearances at anterior rhinoscopy and complications. Seventy-three
      patients (76.8 per cent) attended the follow-up clinic three to six months
      (median four months) after surgery. There was an improvement in short-term nasal
      breathing and in the clinical appearance of the septum in 84.9 and 96.9 per cent
      respectively; a complication rate of 10.9 per cent and an overall satisfaction
      rate of 81.3 per cent were also noted. These results support those of other
      reported series and suggest that routine follow-up of uncomplicated cases of
      septal surgery is unnecessary.

PMID- 7782690
TI  - The need for excessive dietary sodium chloride following tympanoplasty.
AB  - Loss of a single nerve function in the peripheral network responsible for taste
      perception is traditionally considered clinically insignificant. However, we
      report the case of a 27-year-old woman who experienced significant selective
      taste loss for salt after manipulation of the chorda tympani during
      tympanoplasty. This effect may be explained by disorder of the functional
      neuroanatomy of salty taste perception together with strong lateralization of
      mastication to the affected side in this patient. Recently described inhibition
      of cranial nerve IX by cranial nerve VII is hypothesized as contributing to the
      contradiction between this case and the commonly accepted role of the chorda
      tympani in taste perception.

PMID- 7782691
TI  - Nasal tuberculosis--an increasing problem?
AB  - Nasal tuberculosis represents a rare manifestation of infection by Mycobacterium
      tuberculosis: a case is presented together with a review of the literature. The
      correct management is documented, especially the need to treat the patients as if
      there was a generalized condition, and the problems concerning drug resistance
      are also considered. The incidence of this disease is rising and its importance
      must once again be highlighted.

PMID- 7782692
TI  - Treatment of Robin sequence with nasal CPAP.
AB  - A 12-year-old schoolgirl presented with severe obstructive sleep apnoea due to
      the Robin sequence. The sleep apnoea, together with the associated findings of
      daytime sleepiness, nocturia, right heart strain and growth retardation, were
      successfully reversed by nasal CPAP therapy. This therapy allows postponement of
      a decision concerning corrective surgery until after full growth has occurred.

PMID- 7782693
TI  - Airway obstruction with stridor due to nasal secretions.
AB  - Two cases of non-fatal airway obstruction by nasal secretions are described. The
      diagnosis was made after laryngoscopy and the features which suggested this
      previously undescribed aetiology were: depression of conscious level; poor oral
      hygiene; and irregular friable mass with mucoid areas obstructing the airway. The
      diagnosis was confirmed by histological examination of the obstructing material
      which was composed of laminated fragments of squamous epithelium, keratin debris
      and mucus. It is suggested that these masses form in the post-nasal space and
      then become dislodged descending into the larynx, where they cause partial
      laryngeal obstruction and stridor. In patients whose conscious level is depressed
      and who have poor oral hygiene, nasal secretions should be considered as a cause
      of sudden unexplained airway obstruction and stridor.

PMID- 7782694
TI  - An unusual presentation of an unusual complication of infectious mononucleosis:
      haematemesis and melaena.
AB  - Tonsillar haemorrhage is a rare complication of infectious mononucleosis. We
      present a case of life-threatening tonsillar haemorrhage secondary to infectious
      mononucleosis in a young man whose predominant symptoms at presentation were
      haematemesis and melaena. The origin of the haemorrhage was not obvious until the
      patient was examined under anaesthesia. The bleeding was controlled by emergency
      tonsillectomy.

PMID- 7782696
TI  - Supraglottic transection: results of repair and functional outcome.
AB  - We present two cases of supraglottic transection, with concomitant neurotemesis
      of the superior laryngeal nerve. Both cases were repaired primarily and a
      temporary tracheostomy was used to protect the airway. In both cases subsequent
      decannulation was achieved within four weeks, following the initial injury. No
      long-term swallowing or voice disturbance was noted in either case. We recommend
      that in such cases it is unnecessary to repair the nerves directly, but that
      careful repair of the wound itself will achieve a functional result.

PMID- 7782695
TI  - Candida epiglottitis in an adult with acquired immunodeficiency syndrome treated
      with oral fluconazole.
AB  - Candida epiglottitis has been reported in immunocompromised patients, but in only
      one paediatric patient with human immunodeficiency virus. We present possibly the
      first reported case of Candida infection of the epiglottis in an adult with human
      immunodeficiency virus treated with oral fluconazole. We review the symptoms,
      diagnosis, and management of the published cases of Candida epiglottitis in
      patients without the human immunodeficiency virus. Laryngoscopy and culture are
      diagnostic.

PMID- 7782697
TI  - Palatal pleomorphic adenoma in a child.
AB  - Benign salivary gland tumours in childhood are rare. We present a case of a
      pleomorphic adenoma arising in a minor salivary gland within the hard palate,
      review the literature and discuss the diagnostic and therapeutic features of the
      condition.

PMID- 7782698
TI  - Radiation-induced tumours of the head and neck.
AB  - In order to study the induction of malignancy in normal tissues due to ionizing
      radiation, we reviewed the files of 2500 patients with a tumour of the head and
      neck treated at the Netherlands Cancer Institute (Antoni van Leeuwenhoek
      Ziekenhuis), Amsterdam, from 1977 to 1993. We then checked whether or not these
      patients had been previously irradiated. Patients with a thyroid carcinoma or
      skin cancer were excluded from the study, since it is generally known that
      previous irradiation is a risk factor in these tumours. Eighteen patients were
      found to have a malignancy within a previously irradiated area (0.70 per cent).
      The mean interval between radiation and diagnosis of the head and neck tumour was
      36.5 years. There were five soft tissue sarcomas, nine squamous cell carcinomas
      and four salivary gland tumours. Fourteen patients were operated upon whereas
      four received palliative treatment only. The median survival of the total group
      was 3.5 years. Particularly, in young patients because of the better cancer
      therapy and prolonged survival one must be aware of the increased risk of
      radiation-induced tumours.

PMID- 7782699
TI  - Case report: greatly enlarged jugular fossa with progressive sensorineural
      hearing loss.
AB  - A case of a five-year-old child with a greatly enlarged jugular fossa and high
      jugular bulb with associated progressive sensorineural hearing loss is presented.
      While various forms of this anatomical variant have been described by many
      authors, this is an extreme example, and progressive symptoms are most unusual.

PMID- 7782701
TI  - What a year!

PMID- 7782700
TI  - Lipomas of the larynx and hypopharynx: a review of the literature with the
      addition of three new cases.
AB  - Lipomas of the larynx and hypopharynx are uncommon mesenchymal neoplasms. This
      report discusses the clinical and pathological features of three cases of
      laryngeal and hypopharyngeal lipomas. Two of the cases occurred in females and
      one in a male. The ages of the patients were 28, 51 and 51 years respectively.
      Two of the cases involved the supraglottic larynx (left arytenoid and left
      vestibular fold); the third involved the pyriform sinus. Symptoms included airway
      obstruction, dysphagia, throat discomfort, a sensation of excessive secretions in
      the throat and an increase in snoring. The complaints occurred over periods
      ranging from several months to one year in duration. Clinically, a polypoid
      lesion described as yellow in appearance was seen. Histologically, the tumours
      were composed of mature adipocytes without evidence of pleomorphism, lipoblasts
      or infiltrative growth. Surgery was the treatment of choice and included simple
      but complete excision in two of the cases. In these two cases, surgery proved
      curative with follow-up periods of 11 and seven years, respectively. In one case,
      the initial tumour was removed in pieces. This lesion recurred 15 years after the
      initial resection and was totally excised at that time. This patient has been
      free of tumour for more than five years.

PMID- 7782702
TI  - Chiropractic politics.

PMID- 7782703
TI  - Medical care in Ukraine (Jan. 1995)

PMID- 7782704
TI  - MSAs: power to the patients.

PMID- 7782705
TI  - On epidemic diseases and public health.

PMID- 7782706
TI  - The "new tuberculosis" and its changing epidemiology. Nosocomial transmission and
      hospital discharge standards.

PMID- 7782708
TI  - Fear not science drives toxicologic risk assessment.

PMID- 7782707
TI  - Laboratory diagnosis of tuberculosis: past, present, and future.
AB  - Resurgence of tuberculosis justifies extraordinary efforts to expedite TB
      diagnosis and susceptibility testing. This demands that laboratory support expand
      to a "second generation" of methods and procedures, including rapid availability
      of fluorochrome smears of concentrated specimens, faster techniques for detection
      (e.g., the BACTEC radiometric broth system and microcolony detection), quicker
      identification (e.g., high-pressure liquid chromatography, nonisotopic genetic
      probes), more rapid susceptibility testing methods (e.g., BACTEC), and reporting
      of these results as critical values. Guidelines have been established for
      turnaround time for results of smears, TB organism identification, and
      susceptibility testing to usual first-line drugs. A "third generation" of
      laboratory techniques soon will make testing not only more effective but also
      more efficient. These methods include direct testing of respiratory specimens
      through nonisotopic genetic probes as well as nucleic acid amplification
      techniques utilizing polymerase chain reaction (PCR) and other molecular
      procedures. These new procedures and protocols place heavy demands on laboratory
      test volume, technologist time and costs. For the healthcare system or clinical
      laboratory without the resources to deal with these new demands, referral of TB
      specimens represents a reasonable alternative, as long as transport is adequate
      to meet current CDC and other guidelines for turnaround time.

PMID- 7782709
TI  - Environmental policy through a systems approach.

PMID- 7782710
TI  - Vertical integration: the next antitrust regulatory frontier.

PMID- 7782711
TI  - The resurgence of tuberculosis: a formidable foe.

PMID- 7782712
TI  - Health care reform: individual freedom or collectivism?

PMID- 7782713
TI  - The truth about Medicaid.

PMID- 7782714
TI  - Provider-assisted suicide: is it ethical?

PMID- 7782715
TI  - The final word: a new public health?

PMID- 7782716
TI  - Ingestive sensory inputs excite serotonin effector neurones and promote serotonin
      depletion from the leech central nervous system and periphery.
AB  - Thermal and chemical stimuli known to promote ingestive behaviours in the
      medicinal leech Hirudo medicinalis were tested for their physiological effects on
      Retzius neurones and for their biochemical effects on serotonin levels in the
      central nervous system, pharynx and body wall. Retzius neurones throughout the
      leech nerve cord receive excitatory synaptic input during thermal or chemical
      stimulation of the prostomial lip. These neurones respond to the rate of change
      of temperature as well as to absolute temperature at the lip. Exposure of the lip
      to sodium chloride excites Retzius neurones, whereas exposure to arginine has
      little effect. Thermal stimulation of the lip elicits a more rapid but less
      prolonged excitation of Retzius neurones than does chemical stimulation.
      Stimulation of the prostomial lip is associated with afferent activities in the
      cephalic nerves D1, D2 and V1-2. Thermal stimulation of the prostomial lip
      results in depletion of serotonin from midbody ganglia, whereas chemical
      stimulation has no effect. Conversely, chemical stimulation of the lip results in
      depletion of serotonin from the body wall, whereas thermal stimulation does not.
      Pharyngeal serotonin content is decreased with either modality. These data
      distinguish two important feeding-related sensory input pathways to central
      serotonergic effector neurones in Hirudo medicinalis.

PMID- 7782717
TI  - Hindleg muscle energy and substrate balances in cold-exposed rats.
AB  - Rats chronically cannulated in the carotid artery and the muscular branch of the
      femoral vein were subjected to a cold (4 degrees C) environment for up to 2 h.
      The changes in blood flow (measured with 46Sc microspheres) and arterio-venous
      differences in the concentrations of glucose, lactate, triacylglycerols and amino
      acids allowed the estimation of substrate (and energy) balances across the
      hindleg. Mean glucose uptake was 0.28 mumol min-1, mean lactate release was 0.33
      mumol min-1 and the free fatty acid basal release of 0.31 mumol min-1 was
      practically zero upon exposure to the cold; the initial uptake of
      triacylglycerols gave place to a massive release following exposure. The
      measurement of PO2, PCO2 and pH also allowed the estimation of oxygen, CO2 and
      bicarbonate balances and respiratory quotient changes across the hindleg. The
      contribution of amino acids to the energy balance of the hindleg was assumed to
      be low. These data were used to determine the sources of energy used to maintain
      muscle shivering with time. Three distinct phases were observed in hindleg
      substrate utilization. (1) The onset of shivering, with the use of
      glucose/glycogen and an increase in lactate efflux. Lipid oxidation was
      practically zero (respiratory quotient near 1), but the uptake of
      triacylglycerols from the blood remained unchanged. (2) A substrate-energy shift,
      with drastically decreased use of glucose/glycogen, and of lactate efflux;
      utilization of triacylglycerol as practically the sole source of energy
      (respiratory quotient approximately 0.7); decreasing uptake of triacylglycerol
      and increased tissue lipid mobilization.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782718
TI  - Adipokinetic hormone stimulates neurones in the insect central nervous system.
AB  - A simple preparation designed to screen and compare the central action of
      putative neuroactive agents in the moth Manduca sexta is described. This approach
      combines microinjections into the central nervous system with myograms recorded
      from a pair of spontaneously active mesothoracic muscles. Pressure injection of
      either octopamine or Manduca adipokinetic hormone (M-AKH) into the mesothoracic
      neuropile increases the monitored motor activity. Under the conditions used, the
      excitatory effects of M-AKH exceed those of the potent neuromodulator octopamine.
      This suggests that M-AKH plays a role in the central nervous system in addition
      to its known metabolic functions and supports recent evidence that neuropeptides
      in insects can be multifunctional.

PMID- 7782719
TI  - Adaptive responses to feeding in Burmese pythons: pay before pumping.
AB  - Burmese pythons normally consume large meals after long intervals. We measured
      gut contents, O2 consumption rates, small intestinal brush-border uptake rates of
      amino acids and glucose, organ masses and blood chemistry in pythons during the
      30 days following ingestion of meals equivalent to 25% of their body mass. Within
      1-3 days after ingestion, O2 consumption rates, intestinal nutrient uptake rates
      and uptake capacities peaked at 17, 6-26 and 11-24 times fasting levels,
      respectively. Small intestinal mass doubled, and other organs also increased in
      mass. Changes in blood chemistry included a 78% decline in PO2 and a large
      'alkaline tide' associated with gastric acid section (i.e. a rise in blood pH and
      HCO3- concentrations and a fall in Cl- concentration). All of these values
      returned to fasting levels by the time of defecation at 8-14 days. The response
      of O2 consumption (referred to as specific dynamic action, SDA) is the largest,
      and the upregulation of intestinal nutrient transporters the second largest,
      response reported for any vertebrate upon feeding. The SDA is a large as the
      factorial rise in O2 consumption measured in mammalian sprinters and is sustained
      for much longer. The extra energy expended for digestion is equivalent to 32% of
      the meal's energy yield, with much of it being measured before the prey energy
      was absorbed.

PMID- 7782720
TI  - An endogenous peptide modulates the activity of a sensory neurone in the leech
      Hirudo medicinalis.
AB  - Sensory and neurosecretory innervation of each leech excretory complex, a
      nephridium and its bladder, is accomplished by a single neurone, the nephridial
      nerve cell (NNC). The NNC monitors the extracellular Cl- concentration, which
      ranges between 20 and 100 mmol l-1 depending on the physiological state. The NNC
      contains FMRFamide in its soma and sensory terminals in the nephridium. Bath or
      focal application of FMRFamide leads to hyperpolarization and decreases the rate
      of firing of the NNC, suggesting autoregulation of peptide release. Experiments
      under single-electrode current-clamp and voltage-clamp show that FMRFamide turns
      off the receptor-specific Cl- current of the NNC, indicating that FMRFamide also
      modulates the receptor gain.

PMID- 7782722
TI  - Haematocrit and cardiovascular risk.

PMID- 7782721
TI  - Ventilatory responses to carboxyhaemoglobinaemia and hypoxic hypoxia in Bufo
      paracnemis.
AB  - The modality of the O2 drive to breathe was evaluated in unanaesthetized Bufo
      paracnemis. Carbon monoxide (CO) hypoxia was applied to reduce CaO2 (arterial O2
      content). Arterial PO2 (PaO2) was reduced through inspiration of hypoxic gas
      mixtures (hypoxic hypoxia). Measurements included pulmonary ventilation, CaO2,
      PaO2, pHa, blood pressure and heart rate. Application of fractional
      concentrations of CO equivalent to 0.001 reduced CaO2 from 11.6 +/- 1.2 to 8.6 +/
      0.7 vol% (mean +/- S.E.M., N = 6) without any effect on heart rate, blood
      pressure or ventilation. Inspiration of fractional concentrations of CO
      equivalent to 0.01 reduced CaO2 to 5.1 +/- 0.7 vol%, which was accompanied by
      increased ventilation. This response, however, correlated with a decreased
      arterial pH. The effect of a fractional concentration of CO of 0.01 on
      ventilation was abolished by compensation of pH through bicarbonate infusion.
      Consequently, carboxyhaemoglobinaemia per se failed to increase ventilation. By
      contrast, reductions of PaO2 clearly stimulated ventilation, which indicates that
      O2 partial pressure provides the principal O2 stimulus to breathe in Bufo
      paracnemis.

PMID- 7782723
TI  - Apoptosis: molecular mechanisms and implications for human disease.
AB  - Apoptosis is a highly regulated process of cell death with characteristic
      morphological changes that are distinct from necrosis. The biochemical machinery
      responsible for apoptotic cell death appears to be constitutively expressed in
      most, if not all, cells and can be triggered by a variety of signals, including
      sustained increases in the intracellular Ca2+ level. Apoptosis is the main
      mechanism of cell deletion during development, normal cell turnover, hormone
      induced tissue atrophy, and pathological processes such as T-cell depletion in
      HIV/AIDS and neurodegenerative disease. The aim of this review is to briefly
      summarize current knowledge of the molecular mechanisms of apoptosis and its role
      in human disease.

PMID- 7782724
TI  - Fasting blood glucose in determining the prevalence of diabetes in a large,
      homogeneous population of Caucasian middle-aged women.
AB  - OBJECTIVES: To determine the usefulness of a single, fasting blood glucose (FBG)
      value in measuring the prevalence of diabetes mellitus in a large, homogeneous
      population. DESIGN: Fasting blood glucose and 2-h oral glucose tolerance test
      (OGTT) values were determined. Based on the results of the OGTT, the sensitivity
      and specificity of different cut-off levels of FBG for the diagnosis of diabetes
      were assessed. ROC (receiver operating characteristic) analysis was performed on
      the data. SETTING: A health screening unit at the University Hospital in Malmo,
      Sweden. SUBJECTS: A total of 1843 Caucasian women without known diabetes aged 55
      57 years. RESULTS: The prevalence of previously undiagnosed diabetes was 3.9% and
      the prevalence of impaired glucose tolerance (IGT) was 27.9% using the WHO cut
      off values for 2-h blood glucose values after an OGTT. With an FBG cut-off value
      of 6.7 mmol L-1, the sensitivity of a single FBG value was 36.6%. Reducing the
      cut-off value to 6.0 mmol L-1 increased the sensitivity to 53.4%. At a cut-off
      level of 4.8 mmol L-1, the sensitivity reached the high value of 85.9%, but the
      specificity was only 45% and the predictive value of a positive test as low as
      5.9%. ROC analysis showed that the optimal cut-off value for FBG in this
      population was 5.3 mmol L-1, giving a sensitivity and specificity of 77% but a
      positive predictive value of only 11.9%. CONCLUSIONS: This study has shown that
      in a large and homogeneous Caucasian population of women aged 55-57 years with a
      high prevalence of IGT, a single FBG value is not useful as a screening tool for
      diabetes mellitus.

PMID- 7782725
TI  - Diterpene composition of oils from Arabica and Robusta coffee beans and their
      effects on serum lipids in man.
AB  - OBJECTIVES: The cholesterol-raising effect of boiled coffee is caused by
      diterpenes from coffee oil. In order to identify the diterpene responsible, we
      analysed the diterpene composition of oils from Arabica (Coffea arabica) and
      Robusta (Coffea canephora robusta) beans and their effects on serum lipids and
      thyroid function. DESIGN, SUBJECTS, AND INTERVENTION: During the first 3-week
      period of a randomized, cross-over trial, 11 healthy, normolipaemic volunteers
      received per day either 2 g of coffee oil (n = 5) or placebo oil (n = 6). After a
      2-week wash-out, the reverse treatments were applied for another 3 weeks. Six
      subjects received Arabica oil, supplying 72 mg day-1 cafestol and 53 mg day-1
      kahweol, and five received Robusta oil, which provided 40 mg of cafestol, 19 mg
      of 16-O-methyl-cafestol, and 2 mg of kahweol per day. Background diets were
      constant. RESULTS: The average serum cholesterol levels rose by 0.65 mmol L-1
      (13%) on Arabica oil (P < 0.025; 95% CI, 0.21-1.09 mmol L-1) and by 0.53 mmol L-1
      (13%) on Robusta oil (NS; 95% CI -0.36-1.42 mmol L-1). The triglycerides levels
      rose by 0.54 mmol L-1 (71%) on Arabica (P < 0.005; 95% CI, 0.22-0.76 mmol L-1)
      and 0.49 mmol L-1 (61%) on Robusta oil (P < 0.005; 95% CI, 0.30-0.68 mmol L-1).
      None of the effects on serum lipids or lipoprotein cholesterol levels was
      significantly different between Arabica and Robusta oil. Concentrations of serum
      total and free thyroxine (T4), triiodothyronine (T3), and thyroid-stimulating
      hormone (TSH) were largely unaffected. CONCLUSIONS: Both Arabica and Robusta oil
      elevated serum lipid levels; therefore, cafestol must be involved and kahweol
      cannot be the sole cholesterol-raising diterpene. The mode of action of coffee
      diterpenes does not involve induction of hypothyroidism.

PMID- 7782726
TI  - Diminished vitamin B12 levels in patients with severe sickle cell disease.
AB  - OBJECTIVE: The aim of this study was to estimate the levels of vitamin B12 in
      patients with severe sickle cell disease compared to normal controls. Complete
      blood count, iron studies and vitamin B12 levels were obtained in 85 consecutive
      patients with severe sickle cell disease (56 males, 29 females, aged 14-49 years)
      and 100 healthy blood donors (67 males, 33 females, aged 17-60 years) as a normal
      control group. RESULTS: Thirty-seven of the 85 patients (43.5%) had serum vitamin
      B12 levels below normal values (mean 84.3 +/- 28.7, range 7-145 pmol L-1) without
      macrocytosis or hypersegmented neutrophils. The mean level of vitamin B12 in the
      remaining 48 patients (56.5%) was normal (mean 233.3 +/- 73.9, range 152-435 pmol
      L-1) which is below the mean of normal control levels (mean 327.7 +/- 168.7,
      range 178-897 pmol L-1). Patients with low B12 achieved a significant symptomatic
      improvement when treated with vitamin B12, 1 mg intramuscularly weekly for 12
      weeks when compared with patients with normal B12 levels. CONCLUSION: We conclude
      that many patients with severe sickle cell disease may suffer from unrecognized
      vitamin B12 deficiency.

PMID- 7782727
TI  - von Willebrand factor, a possible indicator of endothelial cell damage, decreases
      during long-term compliance with a lipid-lowering diet.
AB  - OBJECTIVES: To test whether serum von Willebrand factor (vWf) would be lower in
      men with atherosclerosis who had been consuming a lipid-lowering diet for 3 years
      than in a control group of men with atherosclerosis who had been following their
      normal diet. DESIGN: A randomized, population-based case-control study. SETTING:
      A tertiary health care referral centre at a University Hospital. SUBJECTS: Men
      age less than 66 years with angiographically proven coronary atherosclerosis and
      a cholesterol level > 6 mmol L-1. Sixty started the study and 50 completed it.
      INTERVENTIONS: Subjects were randomized to a lipid-lowering diet or to taking
      their normal diet for approximately 3 years. MAIN OUTCOME MEASURES: The
      components of the subjects' diets were assessed and blood was obtained for total,
      low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol,
      triglycerides and for vWf. RESULTS: Men on the lipid-lowering diet consumed less
      total, saturated and monounsaturated fats (all P < 0.001), cholesterol and
      retinol (both P < 0.002) but increased polyunsaturated fats (P < 0.001), fibre,
      vitamin E (both P < 0.005) and carbohydrate (P < 0.05). Those on the lipid
      lowering diet also had lower serum levels of total and LDL cholesterol (P < 0.002
      and P < 0.05, respectively), triglycerides (P < 0.02) and vWf (P < 0.05) than the
      men on their normal diet. There was no difference in HDL cholesterol. Levels of
      vWf correlated with both total cholesterol (P < 0.005) and inversely with dietary
      polyunsaturated fats (P < 0.02). CONCLUSION: von Willebrand factor, a possible
      indicator of endothelial cell damage, decreases during long-term compliance with
      a lipid-lowering diet.

PMID- 7782728
TI  - Left ventricular thrombosis after anterior myocardial infarction with and without
      thrombolytic treatment.
AB  - OBJECTIVES: To examine the incidence of left ventricular thrombus in patients
      with anterior myocardial infarction, with and without streptokinase treatment. To
      identify predictors of thrombus development. DESIGN: Consecutive patients
      prospectively studied during the hospitalized period. Echocardiography was
      performed within 3 days of admission and before discharge. SETTING: Umea
      University Hospital, a teaching hospital in Northern Sweden. SUBJECTS: Ninety
      nine patients with anterior myocardial infarction of whom 74 were treated with
      streptokinase. MAIN OUTCOME MEASURES: Left ventricular thrombus and left
      ventricular segmental myocardial function. RESULTS: During the hospital stay, a
      thrombus developed in 46% (95% confidence interval [CI], 35-57%) of the patients
      in the thrombolysis group and in 40% (95% CI, 21-59%) of the patients in the non
      thrombolysis group. No difference in left ventricular segmental myocardial
      function was found between the thrombolysis and non-thrombolysis groups at
      hospital discharge. No embolic events were observed. The occurrence of a left
      ventricular thrombus at hospital discharge was significantly associated with
      previous myocardial infarction, peak enzyme levels, left ventricular global and
      segmental dysfunction and an increased dose of peroral diuretics or use of
      parenteral diuretics. In a multiple logistic regression model, left ventricular
      segmental dysfunction was the most important predictor of left ventricular
      thrombus. CONCLUSION: Thrombolytic treatment with streptokinase does not prevent
      the development of a left ventricular thrombus but the risk of embolic
      complications is low. The left ventricular segmental myocardial score can be used
      to assess the risk of thrombus development, also, after thrombolysis.

PMID- 7782729
TI  - Impaired melatonin secretion in patients with Wernicke-Korsakoff syndrome.
AB  - OBJECTIVES: Melatonin (MT) undergoes circadian changes in response to external
      light conditions and has been implicated in the control of other circadian
      hormone variations. Alcohol inhibits MT secretion in healthy subjects. The
      purpose of the present investigation was to elucidate whether patients with
      Wernicke-Korsakoff syndrome (WKS) also have impaired MT secretion after a period
      of prolonged alcohol abstention. If so, it would be of interest to find out
      whether this affects cortisol rhythmicity. DESIGN: Seven patients with WKS and 8
      healthy controls were included in the study. Venous blood was sampled every 2nd h
      between 18.00 and 08.00 hours, and urine collected between 22.00 and 07.00 hours.
      SETTING: Department of Internal Medicine, Endocrinology Section, Sodersjukhuset,
      Stockholm. MAIN OUTCOME MEASURES: Peak serum MT values during the night, total
      nocturnal MT secretion (estimated by MT incremental areas), and urinary excretion
      of MT were determined in each participant. Serum cortisol levels were determined
      in the patients at 18.00, 02.00 and 08.00 hours. RESULTS: Patients with WKS had a
      markedly reduced nocturnal secretion of MT compared to healthy volunteers (MT
      incremental areas 0.33 +/- 0.21 vs. 1.60 +/- 0.29 nmol L-1 h-1, mean +/- SEM; P <
      0.005). Amongst the patients, the serum cortisol level was higher in the morning
      than in the afternoon (331 +/- 46 vs. 240 +/- 52 nmol L-1; P < 0.01), and showed
      a nadir during the night (138 +/- 45 nmol L-1) as in normal individuals.
      CONCLUSION: Patients with WKS have markedly reduced nocturnal secretion of MT.
      The exact mechanism behind this finding has to be further elucidated. However, it
      is of interest to note that despite the lack of clearcut circadian MT changes.
      WKS patients retain normal cortisol secretion, thus suggesting that MT rhythm may
      not be obligatory for the proper control of circadian cortisol rhythmicity.

PMID- 7782730
TI  - Habitual diet, platelet function, fibrinogen and factor VII coagulant activity in
      young Finns.
AB  - OBJECTIVES: The objective of the study was to determine whether an association
      between diet and platelet function, plasma fibrinogen level and factor VII
      coagulant activity (VII:C) could be established in young subjects. DESIGN: Data
      on the habitual diet of the subjects were collected either by a questionnaire on
      food habits (n = 204) or by a 48-h dietary recall interview (n = 53). SUBJECTS:
      The subjects were participants in the project 'Cardiovascular Risk in Young
      Finns' (age range 15-30 years). A total of 204 subjects having a questionnaire on
      food habits participated in the platelet function tests and 53 also participated
      in a 48-h dietary recall interview. Plasma fibrinogen concentration and factor
      VII: C were measured from 79 subjects. MAIN OUTCOME MEASURES: Platelet function
      was tested by turbidometric measurement of platelet aggregation using ADP and
      collagen as aggregation agents. RESULTS: Platelet aggregation with ADP (at up to
      4.0 mumol L-1) and collagen (at up to 5.0 micrograms mL-1 platelet-rich plasma
      PRP) showed that the diet characterized as 'saturated', i.e. containing high-fat
      milk and saturated fat, was associated with platelets less sensitive to
      aggregating agents in vitro when compared to the unsaturated type of diet.
      Collagen- but not ADP-induced aggregation decreased with age of the subjects (P =
      0.026-0.057, regression coefficient). An inverse regression coefficient between
      plasma factor VII:C (101%; range 64-145%) and serum triglycerides (P = 0.006) and
      the intake of rye (g 1000 kcal-1; P = 0.03) were found. CONCLUSIONS: In this
      study we showed that platelet reactivity and factor VII:C already differ
      considerably between subjects at a young age, and diet may explain some of this
      variation.

PMID- 7782732
TI  - Liberalized diet in patients with type 1 diabetes.
AB  - OBJECTIVE: To document that strict dietary regimen are not necessary in the
      context of intensified insulin therapy. DESIGN: German multicentre, prospective
      cohort study; 6 years follow-up. SETTING: Ambulatory examination using a mobile
      ambulance. SUBJECTS: A total of 636 type 1 diabetic patients (age 33 +/- 7 years,
      diabetes duration 15 +/- 7 years; mean +/- SD), who had participated in a
      structured, 5-day, in-patient, group treatment and teaching programme for
      intensification of insulin therapy and liberalization of the diabetes diet 6
      years prior to follow-up. MAIN OUTCOME MEASURES: Relations between the extent to
      which patients practise a liberalized diet, the degree of metabolic control
      (HbA1c, severe hypoglycaemia, body mass index, cholesterol), and the patients'
      perceived burden through dietary treatment. RESULTS: In the total patient group,
      HbA1c was 7.9 +/- 1.6%, and the incidence of severe hypoglycaemia was 0.17 cases
      per patient during the preceding year; 31% patients injected insulin < or = 3
      times per day, 58% 4-7 times per day, and 11% used insulin pump therapy. Only 11%
      patients reported following a meal plan, whereas 89% continually changed timing
      and amount of carbohydrate intake; only 5% had the same number of meals every
      day, whereas as many as 20% varied the number of meals per day by four or more;
      53% skipped main meals; 85% habitually consumed sugar or sugar containing foods.
      Patients with a higher degree of diet liberalization injected insulin or used an
      insulin pump therapy more frequently, and perceived their dietary treatment to be
      less burdensome. No clinically significant associations were found between the
      extent of diet liberalization and metabolic control. CONCLUSIONS: Under the
      conditions where type 1 diabetic patients have the opportunity to participate in
      an intensified insulin treatment and teaching programme, liberalization of the
      diabetes diet is not associated with adverse effects on glycaemic control, but is
      associated with less perceived burden through dietary treatment.

PMID- 7782731
TI  - Incidentally detected adrenal tumours (incidentalomas): histological
      heterogeneity and differentiated therapeutic approach.
AB  - OBJECTIVES: To find a differentiated therapeutical approach to incidentalomas.
      DESIGN: Prospective study of incidentalomas: their histology, hormonal activity,
      and growth if primarily non-operated. SETTING: Admissions to an academic tertiary
      care centre because of incidentaloma. PATIENTS: Thirty-eight female, 25 male, 27
      85 years old. INTERVENTIONS: Ultrasound, computed tomography and adrenal
      scintigraphy when appropriate; investigations to exclude malignancy giving
      metastasis into the adrenal gland; ACTH, cortisol, aldosterone, renin activity,
      androgene, catecholamine measurements; surgery or follow-up. MAIN OUTCOME
      MEASURES: Rate of malignancy; linkage of tumour size to probability of
      malignancy; prevalence of tumours with subtle hormone excess. RESULTS: Cortical
      adenomas occurred in 13/31, metastases in 7/31 of the histologically confirmed
      cases. In 10/31 cases, the computed tomography indicated a size that was smaller
      than the pathological size (mean = 20 mm). 20.6% of all incidentalomas and 61.5%
      of the 13 operated corticol adenomas showed subtle hormonal activity. Twenty
      seven incidentalomas < 30 mm were followed-up (3-41 months; mean 18 months) and
      showed growth in only one case. Sensitivity, specificity, and predictive value
      (PV) of a tumour > or = 30 mm to indicate malignancy were: 1.0, 0.56 and 0.27,
      respectively. The PV of a < 30 mm tumour to exclude malignancy was 1.0.
      CONCLUSIONS: Oncological screening tests are necessary in all incidentalomas.
      Tumours > or = 30 mm should be operated but smaller ones can be followed-up,
      because they are usually benign and rarely show progressive growth. Cortical
      adenomas with subtle hormonal overproduction and hypertension, diabetes or
      osteoporosis should be operated, irrespective of their size, but in the absence
      of relevant clinical symptoms they can be followed-up.

PMID- 7782733
TI  - Membranous glomerulonephritis associated with testicular seminoma.
AB  - Proteinuria, often nephrotic in range, is a recognized paraneoplastic syndrome of
      solid tumours, with membranous glomerulonephritis (MGN) the most common
      histopathological lesion seen on renal biopsy. A 56-year-old male was found to
      have proteinuria on routine medical examination. History, physical and
      serological evaluation failed to reveal an aetiology and subsequent renal biopsy
      showed MGN, presumed to be idiopathic. Prednisone therapy was begun but this
      proteinuria did not resolve (> 1 g 24 h-1). Eleven months later the patient
      discovered a testicular mass which was found to be a stage I seminoma upon
      excision and metastatic evaluation. His proteinuria rapidly normalized after
      orchectomy and regional lymph node radiotherapy. This is the first known case of
      MGN associated with testicular seminoma.

PMID- 7782734
TI  - Danazol in the treatment of endometriosis and hereditary angio-oedema.

PMID- 7782735
TI  - The special role of rimes in the description, use, and acquisition of English
      orthography.
AB  - The links between spellings and sounds in a large set of English words with
      consonant-vowel-consonant phonological structure were examined. orthographic
      rimes, or units consisting of a vowel grapheme and a final consonant grapheme,
      had more stable pronunciations than either individual vowels or initial consonant
      plus-vowel units. In 2 large-scale studies of word pronunciation, the consistency
      of pronunciation of the orthographic rime accounted for variance in latencies and
      errors beyond that contributed by the consistency of pronunciation of the
      individual graphemes and by other factors. In 3 experiments, as well, children
      and adults made more errors on words with less consistently pronounced
      orthographic rimes than on words with more consistently pronounced orthographic
      rimes. Relations between spellings and sounds in the simple monomorphemic words
      of English are more predictable when the level of onsets and rimes is taken into
      account than when only graphemes and phonemes are considered.

PMID- 7782736
TI  - Toward unbiased measurement of conscious and unconscious memory processes within
      the process dissociation framework.
AB  - L.L. Jacoby's (1991) process dissociation framework has been welcomed as a tool
      for differentiating controlled and automatic cognitive processes. Several
      variants of the original process dissociation measurement model are integrated in
      this article, and it is shown that the model ignores guessing and, hence,
      response bias. An extension of the original model is suggested that includes
      guessing parameters. The original model and the extended model are evaluated
      empirically. In 3 experiments using a yes-no recognition task, response bias was
      manipulated in various ways. The original model falsely attributes effects of
      response biases to either controlled or uncontrolled processes or to both. The
      extended model, in contrast, results in estimates of the contributions of
      controlled and uncontrolled memory processes that are relatively unaffected by
      response biases. The extended model is recommended as a measurement tool.

PMID- 7782737
TI  - The role of forensic anthropology in the recovery and analysis of Branch Davidian
      Compound victims: recovery procedures and characteristics of the victims.
AB  - Anthropological contributions to the investigation of the events at the Branch
      Davidian Compound near Waco, Texas in early 1993, were of two major types: the
      recovery of human remains from the site and the analysis of most of those
      individuals at the Medical Examiner's Office in Fort Worth, Texas. This paper
      describes the role of forensic anthropology in the recovery and analysis of
      Branch Davidian Compound victims and the recovery procedures and characteristics
      of the victims.

PMID- 7782738
TI  - The role of forensic anthropology in the recovery and analysis of Branch Davidian
      Compound victims: techniques of analysis.
AB  - The recovery and analysis of human remains from the Branch Davidian Compound,
      Mount Carmel, Texas, was a multidisciplinary team effort. This presentation deals
      with one aspect of the forensic anthropological contribution to this
      collaborative endeavor--the examination and inventory of human skeletal remains
      and the interpretation of these osteological data. Briefly described first are
      the content and format of the skeletal inventory and the examination procedures
      used for data collection. Two subsequent sections illustrate the use of these
      data to determine (a) age, sex, ancestry, stature, and other distinguishing
      characteristics, and (b) the presence and nature of any premortem, perimortem,
      and postmortem trauma. The next section shows how these findings assist in
      establishing positive identification through, for example, comparison with
      medical, dental, and other background records, especially comparison of premortem
      and postmortem radiographs of bones or dentition. In this context, we consider
      also the sorting of commingled remains, which includes preliminary assessment of
      rapidly decomposing remains prior to autopsy to preserve information crucial to
      identification.

PMID- 7782739
TI  - Forensic DNA testing on skeletal remains from mass graves: a pilot project in
      Guatemala.
AB  - A reliable method for extracting DNA from teeth was developed and successfully
      applied to a set of 12 skeletons recovered from two 10-year-old Guatemalan mass
      graves. Attempts to identify the remains by mitochondrial DNA (mtDNA) testing
      were hampered by low sequence diversity. Our findings demonstrate the feasibility
      of using DNA typing to identify victims from mass graves.

PMID- 7782740
TI  - Decomposition of buried human bodies and associated death scene materials on
      coral atolls in the tropical Pacific.
AB  - The decomposition of bodies and the decay of associated cultural materials,
      including clothing, personal ornaments, caskets, and grave goods, was
      investigated based on a series of exhumations on a small sand island on Kwajalein
      Atoll, Marshall Islands. Decay data were documented for an interment period
      between 40 and 80 months.

PMID- 7782741
TI  - Carbon monoxide-related deaths from 1984 to 1993 in Vienna, Austria.
AB  - Carbon monoxide poisoning occurs frequently in industrialized countries. Between
      1970 and 1978 in Vienna, the capital of Austria, carbon-monoxide-rich coal gas
      was replaced with natural gas. Despite this fact, people still die of
      unintentional carbon monoxide poisoning. The main purpose of this study was to
      determine the reasons for unintentional carbon monoxide-related deaths, and
      further to describe the epidemiology of these fetal poisonings in Vienna between
      1984 and 1993. A secondary purpose was to investigate whether intentional carbon
      monoxide poisoning still plays a role among suicides as was the case up to the
      1970s. For this purpose we analyzed carbon monoxide-related deaths in Vienna from
      1984 to 1993, based on actual autopsy reports of postmortems performed at the
      Viennese Institute of Forensic Medicine. Deaths due to fire were excluded. The
      main reason for unintentional carbon monoxide-related deaths in Vienna between
      1984 and 1993 was flueless gas-fueled water heating appliances, overused
      especially by old people during the cold period of the year. The frequency of
      unintentional carbon monoxide-related deaths in 1993 was almost as high as in
      1984. A total of 53% of deceased persons were over age 60. Most fatal carbon
      monoxide poisoning occurred during the cold period of the year. Suicides
      decreased significantly during the investigation period. In 76% of these deaths
      car exhaust fumes were inhaled, especially by men. In conclusion, we recommend
      programs to prevent unintentional carbon monoxide-related deaths. These programs
      should especially target the elderly. Flueless gas boilers should not be
      overused. Furthermore, apartments should be aired sufficiently, even during the
      cold period of the year.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782742
TI  - Forensic implications of biochemical differences among geographic populations of
      the black blow fly, Phormia regina (Meigen).
AB  - Cuticular hydrocarbons were extracted from individual adult blow flies from three
      geographic populations of Phormia regina from areas near Tucannon River and Lyle
      Grove, Washington, and from Rensselaer, Indiana. The individual extracts were
      subjected to gas chromatography/mass spectrometry (GC/MS), and 22 hydrocarbons
      were identified. Discriminant analysis of the cuticular hydrocarbon profiles
      separated the flies according both to location and gender. These results have
      potential forensic applications in the determination of corpse relocation and in
      the study of the population ecology of species and populations.

PMID- 7782743
TI  - Does drug abuse lead to criminal behavior? An analysis based on criminal
      registers of 117 drug-related deaths, examined in 1992 at the Institute of
      Forensic Medicine in Vienna, Austria.
AB  - That there is a link between drug abuse and criminal behavior has been
      established. However, explaining the nature of this relationship has proven
      difficult. The purpose of this study was to investigate whether the traditional
      view that drug abuse leads to future criminal behavior holds true in case of the
      drug-related deaths examined in 1992 at the Institute of Forensic Medicine in
      Vienna, Austria. For this purpose postmortem reports and criminal registers of
      117 drug-related deaths were analyzed. A total of 43% of the examined sample had
      no criminal register. Regarding age at time of death there was no difference
      between those with or without a criminal register. A total of 57% had at least
      one conviction. A minority committed about one third of offenses. Property
      offenses were the most frequent type. Those who started their criminal history
      with a property offense were younger at time of first conviction and committed
      more offenses during their life. In summary, the traditional view that drug abuse
      leads to future criminal behavior does not seem to hold true in case of the drug
      related deaths examined in 1992 at the Institute of Forensic Medicine in Vienna,
      Austria. The results of this retrospective study speak in favor of a view that
      drug abuse may be a part of contemporary delinquent behavior, rather than the
      cause of criminality.

PMID- 7782744
TI  - Postmortem drug metabolism by bacteria.
AB  - Studies were undertaken to determine the possible role of enteric bacteria in the
      postmortem bioconversion of the nitrobenzodiazepines flunitrazepam, clonazepam,
      and nitrazepam. Flunitrazepam, clonazepam, and nitrazepam were completely
      metabolized in blood in the presence of eight species of enteric bacteria to
      their respective 7-amino-metabolites. The rates of metabolism, at 37 degrees C,
      ranged from 0.1 ng/mL/min for Streptococcus faecalis to 8.8 ng/mL/min for
      Clostridium perfringens. The rate of conversion was reduced to 87% by a
      combination of 0.7% (w/v) sodium fluoride and potassium oxalate, and almost
      completely inhibited (96%) by 1% (w/v) sodium fluoride. pH had variable effects
      on the rate of metabolic bioconversion of nitrobenzodiazepines, while increasing
      temperatures were found to generally increase the rate of nitrobenzodiazepine
      bioconversion. These data support the proposal that bacteria may mediate
      postmortem bioconversion of the nitrobenzodiazepines.

PMID- 7782745
TI  - Cocaine, opiates, and ethanol in homicides in New York City: 1990 and 1991.
AB  - Studies using medical examiner cases are useful in monitoring drug use in special
      populations. This study assesses the presence of cocaine and its metabolite,
      benzoylecgonine (BE), opiates and ethanol in all homicide victims who were
      injured and who survived two hours or less after injury in 1990 and 1991 in New
      York City. There were 2824 homicides in the study period and cocaine and/or BE
      were found in 884 (31.3%) of cases. In over half of the cases positive for
      cocaine/BE, ethanol or opiates were found. African-Americans and Latinos were
      much more likely than whites or Asians to be positive for cocaine/BE. There were
      no differences between men and women in regard to being positive for cocaine/BE.
      Cocaine/BE was most frequently identified among victims 25 to 44 years of age.
      Males were more likely to be positive for ethanol. There were no differences
      among age groups or ethnic groups in regard to ethanol except for a very low
      ethanol incidence among Asians. Victims positive for cocaine/BE were more likely
      to be killed with firearms in open places. The percentage of victims positive for
      cocaine/BE remains approximately that found by other studies in the late 1980s,
      however, the percentage of opiate-positive homicides seems to be increasing.
      Opiates usually were found with cocaine/BE. Two-thirds of the cocaine and/or BE
      positive cases had cocaine present, thus they were under the influence of the
      drug at the time they were injured. The authors discuss how the use of cocaine,
      ethanol and opiates may be related to one's becoming a homicide victim.

PMID- 7782746
TI  - Validation of the AmpliFLP D1S80 PCR Amplification Kit for forensic casework
      analysis according to TWGDAM guidelines.
AB  - The validation of the AmpliFLP D1S80 PCR Amplification Kit for use in forensic
      casework was accomplished by performing all the relevant experiments outlined in
      the TWGDAM guidelines. Standard specimen and reproducibility studies were
      performed using organic and rapid DNA extraction techniques on both stain and
      liquid samples (blood, semen and saliva). Over 300 samples from three different
      populations (US Caucasians, African Americans and US Hispanics) were analyzed to
      determine allele and genotype frequencies. Purified DNA was mixed in defined
      ratios (ranging from unmixed DNA samples to 1:9 mixtures of 2 different DNA
      samples) prior to amplification to demonstrate that samples containing DNA from
      more than one individual can be detected and, in many cases, that the genotypes
      contributing to the mixture can be identified. Since casework samples frequently
      are exposed to environmental insults that can result in DNA degradation, purified
      DNA was degraded in the laboratory to analyze the effect of DNA fragment length
      on D1S80 amplification. It is crucial in the validation process to examine actual
      casework evidentiary material. This D1S80 kit can be used successfully by
      forensic scientists to amplify and type nonprobative evidentiary material,
      including bloodstains collected from crime scenes and rape kit materials
      collected for sexual assault cases. The D1S80 kit is specific to human DNA, and
      the D1S80 alleles are inherited according to the laws of Mendel. The sensitivity
      of the novel gel electrophoresis gel matrix allowed the PCR cycle number to be
      reduced to 29 cycles and the D1S80 kit sensitivity to be increased to 2.5 ng from
      the previous D1S80 Reagent Set specifications of 30 cycles and 5 ng,
      respectively.

PMID- 7782747
TI  - Adolescent psychopathy in relation to delinquent behaviors, conduct disorder, and
      personality disorders.
AB  - The purpose of this study was to explore the relationship between psychopathy as
      measured by The Revised Psychopathy Checklist (PCL-R) and delinquent behaviors,
      conduct disorder, and personality disorders in psychiatrically hospitalized
      adolescents. Thirty adolescent inpatients were assessed for psychopathy,
      delinquent behaviors, DSM-III-R Axis I disorders, and personality disorders using
      the Revised Psychopathy Checklist (PCL-R), the Diagnostic Interview for Children
      and Adolescents (DICA-R), and the Structured Interview for DSM-III-R Personality
      Disorders (SIDP-R). Significant relationships were noted between elevated PCL-R
      psychopathy scores and delinquent behaviors, conduct disorder, and narcissistic
      personality disorder. The validity of the PCL-R as a measure of psychopathy in
      adolescence was supported. Longitudinal studies are needed to clarify the
      clinical application of the PCL-R to adolescent populations.

PMID- 7782748
TI  - Homicide in psychiatric in-patient facilities: a review, a six-year study, and a
      case report.
AB  - Many research studies have attempted to explore the apparent relationship between
      mental illness and violence. These studies have generally examined the rates of
      violence during one of three phases: before, after, or during psychiatric
      hospitalization. Violence that takes place during psychiatric hospitalization has
      unique implications for both patients, treatment facilities, and for research on
      violence. This area therefore deserves special study. This article focusses on
      the most extreme violence that can take place on the wards of a psychiatric
      facility, assaults resulting in death. This article reviews the literature in
      this area, reports on a study of the incidence of such occurrences in New York
      State, and reports in some detail on an additional case which occurred prior to
      the period under study. The study presented here found that amongst all
      psychiatric facilities in New York State in six year period there were three
      cases of in-patient homicide. An average of approximately 90,000 people were
      served within these facilities during each of the years under study. Suggestions
      are made for further research in this area.

PMID- 7782750
TI  - Offender and offense characteristics of sexual sadists: a comparative study.
AB  - This paper compares the offender and offense characteristics of 30 sexually
      sadistic criminals studied by Dietz et al. with those of 29 sexually sadistic
      criminals and 28 nonsadistic sexual offenders from the Royal Ottawa Hospital. We
      examined whether the characteristics noted by Dietz et al. would be found among a
      less violent group of sadistic offenders and also to what extent these
      characteristics were specific to sexual sadism. Results suggest some offender and
      offense characteristic are specific to sexual sadism and that others appear to be
      common to sexually aggressive offenders more generally. In addition, there were a
      number of characteristics found exclusively among the most violent offenders
      described by Dietz et al. An explanation of these results in terms of a
      biopsychosocial understanding of sexual sadistic offenders is provided.

PMID- 7782749
TI  - A psychiatric-legal analysis of psychotic criminal defendants charged with
      murder.
AB  - A sample of 25 criminal defendants charged with murder and suffering from
      psychosis from a large urban multi-ethnic, multi-cultural community pool was
      studied. Subject characteristics and information about the homicide and decedents
      are described. Suggestions for further study are briefly discussed.

PMID- 7782751
TI  - HLA-DQA1 and amelogenin coamplification: a handy tool for identification.
AB  - A protocol for HLA-DQA1 and gender identification by single amplification is
      described. The use of the commercial HLA-DQA1 amplification kit (Perkin Elmer)
      permits a positive response for sex determination by adding primers for a short
      sequence on the first intron of Amelogenin gene. The suggested amplification
      protocol results in PCR products easily and clearly detectable on ethidium
      bromide stained agarose gel or silver stained polyacrylamide gel. In both gels
      the HLA-DQA1 observations at 242-239 bp are accomplished with a single band at
      106 bp in females and a doublet 112-106 bp in males. HLA-DQA1 reverse dot-blot
      hybridization is unaffected by the presence of X and Y amplified fragments.

PMID- 7782753
TI  - Viscosity comparisons of polydimethylsiloxane lubricants in latex condom brands
      via Fourier self-deconvolution of their FT-IR spectra.
AB  - Many brands of latex condoms use a polydimethylsiloxane lubricant. The lubricant
      viscosity in ten different brands was compared by determining the average chain
      length through the ratio of the dimethyl to trimethyl peak area obtained after
      applying the resolution enhancement technique of Fourier self-deconvolution to
      their diffuse reflectance FT-IR spectra in the area around 800 cm-1.

PMID- 7782752
TI  - Restriction fragment length polymorphism (RFLP) typing of DNA extracted from
      nasal secretions.
AB  - The restriction fragment length polymorphism (RFLP) analysis of blood, semen, and
      other body fluids, has become increasingly important in violent criminal cases.
      The identification of additional tissues suitable for comparison with suspected
      donors has obvious potential benefit. One type of tissue, that found in nasal
      secretions, has previously received little attention with regards to genetic
      analysis. We collected blood and nasal secretion samples from eight individuals,
      subjected them to traditional RFLP typing methods, and analyzed the results using
      probes for loci D2S44, D1S7, D10S28, D4S139, and D17S79. All nasal samples
      provided high DNA yields and hybridization results that matched the corresponding
      blood standards. Thus, nasal secretions are shown to have potentially significant
      evidentiary value.

PMID- 7782754
TI  - A fatality and the American mountain lion: bite mark analysis and profile of the
      offending lion.
AB  - Attacks on humans by mountain lions have been infrequent in the history of the
      United States. Of the 64 authenticated attacks since 1890 in North America, there
      have been 13 fatalities. This paper reports a case of an adult mountain lion
      which attacked and killed a female jogger during the spring of 1994 in
      California. The lion left an imprint of its teeth on the victim's chin. The
      authors used this bite mark to aid authorities in profiling the approximate age
      and gender of the attacking animal. The authors subsequently utilized bite mark
      analysis to establish that the lion actually responsible for the attack had been
      removed from the area.

PMID- 7782755
TI  - Sexual asphyxiation: an unusual case involving four male adolescents.
AB  - A case of sexual asphyxiation is described involving children, adolescent males,
      homosexuality and two bizarre strangulations. Two adolescent males (ages 13 & 10)
      initially engaged in homosexual activity in conjunction with sexual asphyxiation.
      This unusual activity was by chance observed by one of the boy's younger brother
      and his friend. The younger children (aged 7 & 8) expressed a desire to join in
      the activity, which they did by letting ligatures be tied around their necks and
      engaging in anal intercourse to the point of fatal asphyxiation. The case is of
      interest in the reported way the younger boys discovered the practice (a sexually
      explicit magazine) and is unusual because of the young ages of the boys involved.

PMID- 7782756
TI  - Fatal injuries in a minor traffic collision.
AB  - An elderly woman was the driver and sole occupant of a midsize car involved in a
      minor collision with a standard sized automobile. She was restrained with a lap
      and shoulder belt and the air bag was deployed. Yet she suffered fatal chest
      injuries. No injuries were sustained by the unrestrained driver and passenger of
      the larger vehicle. Despite maximum restraint in a fully functioning new model
      car, even a minor collision can be fatal.

PMID- 7782757
TI  - Hamartomatous malformation of the left ventricle associated with sudden death.
AB  - We describe unusual left ventricular cardiac lesions in a 17 year old boy who
      died suddenly during exertion. These consisted of two grossly evident regions of
      deficient myocardium, containing cavernous spaces which represented exaggerated
      intertrabecular regions of the left ventricular cavity. Dense fibro-elastotic
      tissue was deposited around these spaces along with a variable admixture of
      mature adipose tissue, fibrous tissue and blood vessels. The etiology of these
      presumably congenital developmental abnormalities is obscure. The lesions most
      probably represent a hamartomatous malformation, which is a poorly documented
      pathological entity.

PMID- 7782758
TI  - Fatality due to gamma-hydroxybutyric acid (GHB) and heroin intoxication.
AB  - The first case of fatal intoxication due to ingestion of gamma-hydroxybutyric
      acid (GHB) and intravenous use of heroin is reported. A 42-year-old man, known to
      have been a heroin addict and to have taken other psychoactive substances, who
      had been in treatment with GHB for several months, was found dead.
      Anatomohistopathologic examination showed generalized visceral congestion, edema
      and pulmonary anthracosis, chronic bronchitis and chronic active hepatitis.
      Toxicological findings included fluid and tissue distributions of GHB, morphine
      and 6-monoacetylmorphine. GHB and morphine concentrations were respectively 11.5
      and 0.77 micrograms/mL (blood), 84.3 and 0.3 micrograms/mL (vitreous humor),
      258.3 and 1.35 micrograms/mL (urine), 57.0 and 14.3 micrograms/mL (bile), 40.0
      and 0.43 micrograms/g (brain), 43.0 and 0.60 micrograms/g (liver), 47.0 and 0.68
      micrograms/g (kidney). Blood and urine levels of 6-monoacetylmorphine were 28.5
      and 12.1 ng/mL respectively. The presumed mechanism of action and
      pharmacokinetics of GHB are briefly reviewed, with reference to its therapeutic
      use and to reports of non-fatal GHB intoxication.

PMID- 7782759
TI  - Detection of drugs-of-abuse in meconium of a stillborn baby and in stool of a
      deceased 41-day-old infant.
AB  - When blood or urine is unavailable, postmortem meconium or stool from infants or
      stillbirths can be used to detect drugs-of-abuse, thus providing datum in
      assessing drug-abuse exposure. Two case reports illustrate how drugs-of-abuse
      findings in post-mortem specimens were used to substantiate exposure prior to
      death or a history of maternal drug abuse. The first, a congenital hydrocephalus,
      born to a non-drug abusing mother, expired at the age of 41 days, had opiates in
      the stool by screening method, enzyme multiplied immunoassay technique, confirmed
      by gas chromatographic/mass spectrometric (GC/MS) analysis. Investigation
      revealed that morphine had been administered for three days prior to death. The
      second was a stillbirth infant born to a drug abuser. Almost equal amounts of
      benzoylecgonine were found in different bowel segments, a finding consistent with
      admitted cocaine use throughout pregnancy.

PMID- 7782760
TI  - Differentiation of perimortem and postmortem trauma using taphonomic indicators.
AB  - Skeletal remains discovered at a construction site in Georgia display classic
      "butterfly" fractures on several long bones. Although this fracture pattern is
      usually associated with perimortem trauma, in this case taphonomic indicators
      demonstrate that they can also occur on dry defleshed bone. Variations in bone
      color at the fracture sites indicate recent postmortem trauma. Analysis of the
      directions of force and points of impact indicates that the bones were most
      likely disarticulated when the trauma occurred.

PMID- 7782761
TI  - Repeated exposure of rhesus macaques to low doses of simian immunodeficiency
      virus (SIV) did not protect them against the consequences of a high-dose SIV
      challenge.
AB  - As part of an in vivo titration study of the macaque simian immunodeficiency
      virus (SIVmac) strain 251/spl, macaques were inoculated intravenously with
      various dilutions of this infectious SIVmac. Seven animals received dilutions
      from 10(-3) to 10(-6) of SIVmac251/spl. Two monkeys infected with the 10(-3)
      dilution of SIVmac exhibited a productive infection as indicated by
      seroconversion, detection of genomic RNA and proviral DNA and positive virus
      isolation. These animals showed a cytotoxic T cell (CTL) response against
      different SIVmac proteins without any measurable T cell proliferation. The five
      macaques receiving higher virus dilutions did not seroconvert and were negative
      for both viral RNA and for infectious virus, although proviral DNA was detected
      in their peripheral blood mononuclear cells. In contrast to the animals receiving
      the 10(-3) virus dilution, these five silently infected monkeys developed an SIV
      specific proliferative T cell response but SIV-specific CTL could not be
      observed. The SIV-specific T cell proliferation of the silently infected animals
      could be boosted by a second low-dose exposure with a 10(-4) or 10(-5) dilution
      of SIVmac251/spl. The virological status of the animals was not changed following
      this second virus inoculation. Four months later these macaques were challenged
      intravenously with 2 ml of a 10(-4) dilution of SIVmac251/32H containing 10
      monkey ID50. After this challenge all SIV-pre-exposed animals and three naive
      controls became productively infected. In addition, all infected animals
      developed typical signs of an immunodeficiency within 6 months after infection.
      These observations indicate that macaques infected silently by a low-dose
      exposure to infectious virus generated a virus-specific cellular immune response.
      However, SIV-specific T cell proliferation alone could not protect the monkeys
      against an intravenous challenge with SIVmac and the subsequent development of
      AIDS-like symptoms.

PMID- 7782762
TI  - Replication pattern of human immunodeficiency virus type 1 in mature Langerhans
      cells.
AB  - Langerhans cells (LC), the dendritic antigen presenting cells of the skin, mature
      into potent immunostimulatory cells during migration to regional lymph nodes,
      where they are identified as interdigitating cells (IDC). Since mature Langerhans
      cells (mLC) resemble IDC in phenotype and immunostimulatory capacity, we examined
      whether these cells were susceptible to infection with macrophagetropic and
      lymphotropic strains of human immunodeficiency virus type 1 (HIV-1). Highly
      purified cell preparations of mLC migrating from human epidermis expressed high
      amounts of major histocompatibility complex (MHC) class I and II antigens and of
      the accessory molecules CD40, CD80 and CD86, indicative of the phenotype of
      potent immunostimulatory cells. CD4 expression was upregulated on mLC during
      cultivation, independent of the presence of tumour necrosis factor alpha (TNF
      alpha) and granulocyte-macrophage colony-stimulating factor (GM-CSF) in the
      culture medium. The macrophagetropic HIV-1 strain SF162 replicated to higher
      titres in mLC than the lymphotropic strain IIIB. Both strains induced syncytia,
      with SF162 showing a more rapid cytopathic effect. Addition of TNF-alpha enhanced
      virus production, due to better cell viability under TNF-alpha treatment, whereas
      GM-CSF did not significantly influence viability of cells and replication pattern
      of the virus. These findings suggest that in the infected individual IDC in lymph
      nodes may function as target cells for HIV-1.

PMID- 7782763
TI  - Human immunodeficiency virus type 1 infection of human CD4-transgenic rabbits.
AB  - Investigations of human immunodeficiency virus (HIV) infection of man have
      benefited from the study of relevant animal models of the infection and disease.
      However, the ultimate models use primate species which are either endangered, not
      generally available, or expensive to maintain. A transgenic rabbit specifically
      and stably expressing human CD4 protein on T lymphocytes was assessed as a new
      laboratory animal model for HIV-1 infection. In vitro studies demonstrate that
      lymphocytes derived from the transgenic rabbits are more susceptible to HIV-1IIIB
      infection than those from normal rabbits. In vivo infection of huCD4-transgenic
      rabbits using HIV-1IIIB-infected autologous lymphocytes was demonstrated by virus
      isolation, detection of HIV-1-specific DNA in peripheral blood lymphocytes and
      seroconversion to various HIV-1 proteins. Viral DNA was detected in the tissues
      of one rabbit sacrificed 7 weeks post-infection and virus was isolated from lymph
      node. Although these transgenic rabbits are less sensitive to HIV-1 infection
      than man, such a small and inexpensive animal model may be a useful tool.

PMID- 7782764
TI  - Isolation of the causal virus of infectious salmon anaemia (ISA) in a long-term
      cell line from Atlantic salmon head kidney.
AB  - A long-term cell line (SHK-1) supporting replication of the causal virus of
      infectious salmon anaemia (ISA) has been established. The cell line was developed
      from a culture of Atlantic salmon (Salmo salar L.) head kidney cells. CPE was
      observed in SHK-1 cells 12-14 days after inoculation with ISA-infective tissue
      material. The time for CPE to develop decreased after repeated passages of medium
      from infected cell cultures to new cultures. Transmission trials demonstrated
      that Atlantic salmon parr developed ISA after intraperitoneal injection of
      preparations made from infected cells and growth medium. The ISA infectivity of
      the cell preparations increased with incubation time of inoculated cells. Cell
      cultures in a second passage were found to have a higher infectivity than the
      primary inoculated cultures. Virus particles with a diameter of approximately 100
      120 nm, and which contained an external envelope and granules were seen in
      electron micrographs of thin sections of infected cells. Most of the virus
      particles were located extracellularly close to the cell surface, and in some
      cases, a connection between virus and plasma membrane could be observed. This
      indicates that virus particles were released by budding. Enveloped virus
      particles of 45-140 nm in diameter were seen in abundance in electron micrographs
      of a negatively stained purified virus preparation. Large, highly pleomorphic
      particles up to 700 nm in the longest dimension were occasionally observed in
      unpurified preparations. The evidence is therefore strong that the virus isolated
      in SHK-1 cells is the aetiological agent of ISA.

PMID- 7782765
TI  - Production, characterization and reactivity of monoclonal antibodies to porcine
      reproductive and respiratory syndrome virus.
AB  - This report describes the preparation of six monoclonal antibodies (MAbs) raised
      against a British isolate of porcine reproductive and respiratory syndrome virus
      (PRRSV), their characterization in terms of protein specificity and their
      reactivity with different PRRS viruses from Europe and the USA.
      Radioimmunoprecipitation and Western blotting studies of MAb reactivity with
      proteins from cell lysates of infected cells and purified virus revealed that
      four of the six MAbs (WBE1 and WBE4-6) precipitated a 15 kDa viral protein.
      Further studies using in vitro translated products of the Lelystad virus genome
      showed that this protein was the product of ORF7, the putative nucleocapsid
      protein. The specificity of another MAb, WBE2, was found to be for a 45 kDa
      protein, determined to be the product of ORF3 and demonstrated to be present in
      purified virion preparations. The protein specificity of the sixth MAb, WBE3
      could not be determined. Thirty-three PRRSV isolates from Europe and the USA were
      grown in alveolar macrophages and examined by immunoperoxidase staining, using
      the panel of six MAbs. All European isolates were recognized by the four MAbs
      specific for the putative nucleocapsid, but the viruses showed different patterns
      of reactivity with WBE2 and WBE3. Furthermore, these two MAbs stained only a
      small proportion of the cells infected with certain isolates, suggesting that a
      single isolate may be antigenically heterogeneous. No MAbs bound to US isolates,
      indicating a consistent antigenic difference between the putative nucleocapsid of
      US and European isolates. Detergent extraction of cell lysate antigen abrogated
      the binding of WBE1-3, suggesting that the epitopes are conformation dependent.

PMID- 7782766
TI  - Cholera toxin B stimulates systemic neutralizing antibodies after intranasal co
      immunization with measles virus.
AB  - An efficient mucosal vaccination has a number of obvious advantages over invasive
      routes of immunization. The immune response to measles virus (MV) was
      investigated after intranasal and intragastric co-immunization of mice with
      cholera toxin B (CTB) as an adjuvant. High titres of virus-specific IgG
      antibodies and a transient IgA response were detected in the sera after
      intranasal but not after intragastric immunization when CTB was used. In the
      presence of CTB, higher titres were reached with less antigen and fewer
      intranasal boosts. Neutralizing antibodies were found in all animals only after
      co-immunization with MV and CTB. In the nasal wash and the saliva, IgG and IgA
      titres were significant only in the MV plus CTB groups; IgG levels were
      comparable to those found after intraperitoneal (i.p.) immunization with complete
      Freund's adjuvant. Specific IgA was detected in the mucosal fluids only after
      intranasal immunization with MV plus CTB but not after i.p. or intragastric
      immunization. The antibody response consisted of 99% IgG1 after MV immunization.
      In the CTB groups 10% IgG2b and 1% IgG2a were detected in addition to the
      predominant IgG1 antibodies.

PMID- 7782767
TI  - The Epstein-Barr virus open reading frame BDLF3 codes for a 100-150 kDa
      glycoprotein.
AB  - The Epstein-Barr virus (EBV) open reading frame BDLF3 is predicted to code for a
      glycoprotein on the basis that it contains sequences with signal peptide and
      transdomain characteristics and nine potential N-linked glycosylation sites. No
      sequential or positional homologues of BDLF3 have been located in other
      herpesviruses. A bacterial glutathione S-transferase (GST)-BDLF3 fusion protein
      was used to demonstrate that over one-third of EBV-immune human sera tested
      recognized the fusion protein but not GST alone on Western blots. The fusion
      protein was used to raise polyclonal sera in rabbits. A BDLF3 recombinant
      baculovirus was constructed using the full-length BDLF3 sequence (AcBDLF3).
      Rabbit anti-fusion protein sera and some human EBV-immune sera recognized
      products of approximately 30 and 55 kDa from AcBDLF3-infected insect cells by
      Western blotting. A peptide representing the carboxy-terminal amino acids 215-234
      of the BDLF3 sequence was used to raise anti-peptide sera in rabbits. Anti
      peptide serum detected a product by indirect immunofluorescence in acetone-fixed
      EBV-infected B cells from all cell lines tested. A diffuse band with a molecular
      mass of 100-150 kDa was detected by Western blot in B95-8 cell lysates, partially
      purified B95-8 virus and B95-8-infected cell membranes after probing with anti
      BDLF3 peptide serum. This product was shown to be glycosylated after enzymatic
      deglycosylation of a B95-8 virus preparation using neuraminidase, O-glycosidase
      or N-glycosidase F. The BDLF3 protein products have no known function.

PMID- 7782769
TI  - Sodium valproate, an anticonvulsant drug, stimulates human cytomegalovirus
      replication.
AB  - Valproic acid (VPA), a simple branched-chain fatty acid having anticonvulsant
      activity and used in the treatment of many forms of epilepsy, markedly stimulated
      human cytomegalovirus (HCMV) replication in human fibroblasts (MRC-5 cells). The
      maximum level of stimulation was reached when cells were treated for 24 h before
      infection. The enhancement of virus replication correlated with an increase in
      the number of immediate early (IE) and early (E) antigen-positive cells. VPA also
      induced expression of IE antigens after transfection of fibroblasts with a
      plasmid containing the entire IE1-2 region. Moreover, VPA stimulated the HCMV IE1
      2 promoter/enhancer-mediated expression of beta-galactosidase in a stably
      transfected Jurkat T cell line. Recently, VPA was shown to inhibit glutathione
      reductase in human red blood cells, but an action through the glutathione
      metabolic pathway can be eliminated in this case, since VPA decreased the
      intracellular level of glutathione in Jurkat T cells but not in MRC-5 cells. The
      ability of VPA to stimulate HCMV replication provides an attractive model for
      studying the molecular mechanism of the regulation of HCMV IE1-2 gene expression.

PMID- 7782768
TI  - Qualitative analysis of the expression of Epstein-Barr virus lytic genes in
      nasopharyngeal carcinoma biopsies.
AB  - We recently showed that BZLF1, the gene encoding the Epstein-Barr virus (EBV)
      ZEBRA protein, was expressed in all eight nasopharyngeal carcinoma (NPC)
      specimens studied. We present here studies on the expression of EBV lytic cycle
      genes in the same eight NPC biopsies to determine if production of the ZEBRA
      transactivator could lead to a complete productive cycle. The tumour lesions
      exhibit a number of different patterns of limited lytic gene expression. In three
      out of eight tumours neither BRLF1 nor BMLF1 expression could be detected.
      Otherwise BMLF1 mRNA was expressed in all the other specimens. Three specimens
      also expressed BRLF1. Two specimens not only exhibited BZLF1, BMLF1 and BRLF1
      transcripts, but also expressed the late gene BLLF1 which encodes the membrane
      protein gp220. The early gene product BBLF2 could not be detected in any of the
      eight NPC. However, expression of the late gene encoding the lytic truncated form
      of LMP1 (D1LMP) was found in seven of the eight NPC biopsies. Thus, it could be
      suggested that the EBV abortive lytic cycle occurred in most of the NPC studied.

PMID- 7782770
TI  - Quiescent viral genomes in human fibroblasts after infection with herpes simplex
      virus type 1 Vmw65 mutants.
AB  - The development and utilization of a tissue culture system for the analysis of
      quiescent, nonreplicating herpes simplex virus type 1 (HSV-1) genomes is
      described. It was demonstrated previously that the HSV-1 Vmw65 mutant in1814,
      which is impaired for immediate early (IE) transcription, was retained for many
      days in human fetal lung (HFL) fibroblasts in a quiescent 'latent' state.
      Molecular analysis of the viral genome was not possible, however, due to residual
      expression of IE proteins and consequent cytotoxicity at high m.o.i. In the study
      reported here, IE transcription was reduced further by pretreatment of cells with
      interferon-alpha (IFN-alpha) and by the use of mutant in1820, a derivative of
      in1814 in which the Vmw110 promoter was replaced by the Moloney murine leukaemia
      virus (Momulv) enhancer. The Momulv enhancer was not expressed under IE
      conditions; thus in1820 was more impaired for replication than in1814 and behaved
      as if deficient for both Vmw65 and Vmw110. In cells pretreated with IFN-alpha and
      subsequently infected with in1820 cytotoxicity was overcome, enabling a tissue
      culture system to be developed in which all cells stably retained at least one
      quiescent viral genome. To assist the analysis of gene expression, in1820 was
      further modified by insertion of the Escherichia coli lacZ gene controlled by the
      human cytomegalovirus enhancer (mutant in1883) or the HSV-1 immediate early
      Vmw110 promoter (in1884). Expression of beta-galactosidase was not detected after
      infection of IFN-alpha-pretreated cells with in1883 or in1884 but could be
      induced in almost all cells containing a viral genome, by superinfection of
      cultures. In1820-derived viruses were retained for at least 9 days and were not
      reactivated by subculture of cells. A regular arrangement of nucleosomes, as
      found in cellular chromatin, was not detected on the viral genome at the
      thymidine kinase locus. The non-linear genome was a template for reactivation
      with no requirement for prior conversion to a linear form. A small number of
      remaining linear genomes resulted from incomplete uncoating of input virus.

PMID- 7782771
TI  - Role of viral proteins and concanavalin A in in vitro replication of pseudorabies
      virus in porcine peripheral blood mononuclear cells.
AB  - We examined the capability of pseudorabies virus (PRV) to replicate in vitro in
      porcine peripheral blood mononuclear cells (PBMC) and characterized the phenotype
      of infected cells. In addition, we investigated whether inactivation of various
      PRV proteins or the expression of a foreign gene affected this replication.
      Finally, we studied the replication of PRV strains in concanavalin A (Con A)
      stimulated lymphocytes. The replication of PRV mutants with inactivated
      glycoproteins gE or gG, thymidine kinase (TK), ribonucleotide reductase (RR) or
      US3-encoded protein kinase (PK), and the replication of PRV vector strains
      expressing the envelope glycoprotein E1 of hog cholera virus (HCV) were studied.
      By adherence of PBMC to plastic, monocytes and lymphocytes were largely
      separated. Infected monocytes were analysed with an immunostaining monolayer
      assay and infected lymphocytes were analysed with immunofluorescence staining and
      flow cytometry. We found that the wild-type NIA-3 virus replicated in both
      lymphocyte and monocyte cultures. NIA-3 infected relatively more monocytes (>
      90%) than non-adherent B cells (46-65%) and T cells (17-28%); approximately equal
      numbers of CD4+ and CD8+ T cells were infected. Although E1 is probably involved
      in adsorption of HCV to host cells, the expression of E1 by PRV vector strains
      did not change the level of replication. Inactivation of TK and RR, but not
      inactivation of gE, gG or PK, severely affected the replication in both monocytes
      and lymphocytes. Con A stimulation of lymphocytes restored the reduced
      replication of the TK mutant, but not of the RR mutant. Moreover, Con A
      stimulation of lymphocytes reduced the replication of the wild-type NIA-3 virus.
      We concluded that both viral TK and RR activity are important for efficient
      replication of PRV in resting lymphocytes. Furthermore, Con A-stimulated
      lymphocytes can restore the viral TK defect and PRV replication can also be
      influenced by cellular metabolism.

PMID- 7782772
TI  - Nucleotide sequence and transcriptional analysis of the gp41 gene of Spodoptera
      frugiperda nuclear polyhedrosis virus.
AB  - The Spodoptera frugiperda multiple nucleocapsid nuclear polyhedrosis virus
      (SfMNPV) gp41 structural protein gene was located in the 1.9 kbp EcoRI-S fragment
      and sequenced. An open reading frame (ORF) of 999 nucleotides was detected that
      encoded a protein of 332 amino acids. The gp41 gene transcript was detected after
      12 h post-infection (p.i.) and remained detectable at 48 h p.i. Two major mRNAs,
      about 1.6 and 2.8 kb in length, were determined by Northern blot analysis. Primer
      extension analysis demonstrated that the gp41 gene promoter region contains three
      transcription start sites. Two of the gp41 gene transcription start sites were
      located at -42 and -41 nucleotides from the ATG translation start codon within a
      consensus late transcription start site (TAAG) and another transcription start
      site was located at -140 nucleotides from the ATG translation start codon for
      which no consensus motif has been determined. Comparison of SfMNPV gp41
      nucleotide and amino acid sequences with the gp41 genes from Autographa
      californica, Bombyx mori, and Helicoverpa zea NPVs showed 60% homology of
      nucleotide sequences and 70% similarity of amino acid sequences.

PMID- 7782773
TI  - Mutations in the Autographa californica multinucleocapsid nuclear polyhedrosis
      virus 25 kDa protein gene result in reduced virion occlusion, altered
      intranuclear envelopment and enhanced virus production.
AB  - Serial passage of nuclear polyhedrosis viruses (NPVs) through cultured cell lines
      results in the appearance of mutants with a complex phenotype referred to as the
      'few polyhedra' (FP) phenotype. The altered plaque morphology and reduced
      occlusion production associated with the FP phenotype have been observed in
      Autographa californica multinucleocapsid nuclear polyhedrosis virus (AcMNPV)
      bearing mutations in the gene encoding the 25 kDa protein (25K gene). In this
      study, we sequenced the 25K genes of four spontaneously occurring AcMNPV FP
      mutants. These mutants, together with an artificially generated FP mutant (AcFP
      beta gal, in which the gene for beta-galactosidase is fused in frame with the 25K
      ORF), were examined at the ultrastructural level to see if they exhibited the
      reduced virion occlusion and intranuclear envelopment which is associated with
      the FP phenotype. Observations on Spodoptera frugiperda Sf9 cells infected with
      the FP mutants revealed that all five mutants were impaired in virion occlusion
      and intranuclear nucleocapsid envelopment. The 25K mutants were also found to
      release two- to fivefold more infectious virus (p.f.u.) into the media of
      infected Sf9 cells. Marker rescue of AcFP beta gal restored wild-type virion
      occlusion, intranuclear envelopment and levels of infectious virus production.

PMID- 7782774
TI  - Genome organization of a partitivirus from the filamentous ascomycete
      Atkinsonella hypoxylon.
AB  - We have identified viruses in several isolates of the filamentous ascomycete
      Atkinsonella hypoxylon. The virus from one isolate of the fungus, 2H, was
      selected for genomic characterization. Purified virus particles contained three
      dsRNAs with sizes estimated by gel electrophoresis to be 2.2, 2.1 and 1.8 kb. A
      library of cDNA clones representing the three dsRNA segments of isolate 2H was
      synthesized, mapped and sequenced. The three segments had no significant
      similarity to each other, as determined by Northern blot analysis, and had sizes
      of 2180, 2135 and 1790 nt as determined by nucleotide sequence analysis. Long
      open reading frames were deduced from the sequences of dsRNAs 1 (molecular mass
      78 kDa) and 2 (74 kDa), but not from dsRNA 3. Both terminal regions of dsRNA 1
      and dsRNA had similar nucleotide sequences, as determined from 5' RACE clones.
      Comparisons of the amino acid sequence deduced from dsRNA 1 revealed similarities
      with viral RNA-dependent RNA polymerases. Translation in vitro of full-length
      cDNA clones representing dsRNAs 1 and 2 each yielded single major products of >
      70 kDa by analysis on polyacrylamide gels. Based on properties of its dsRNA
      segments, the virus of A. hypoxylon strain 2H fits into the Partitiviridae
      family, and represents the first member of this family from a fungal host
      completely characterized at the level of primary nucleotide sequence.

PMID- 7782775
TI  - The genome organization of banana bunchy top virus: analysis of six ssDNA
      components.
AB  - We have cloned, sequenced and analysed an additional five circular ssDNA
      components of banana bunchy top virus (BBTV) which we have called components 2,
      3, 4, 5 and 6. These components were present in all BBTV infections tested. Four
      of these components (components 3, 4, 5 and 6) had one large open reading frame
      (ORF) in the virion sense located 3' of a stem-loop structure. Each ORF had a
      potential TATA box and one or two potential polyadenylation signals associated
      with it and each polyadenylation signal had an associated GC-rich region
      containing the trinucleotide sequence TTG. A number of ORFs were identified in
      component 2 but none of these had appropriately located potential TATA boxes and
      polyadenylation signals associated with them. None of the ORF amino acid
      sequences nor the full DNA sequences of any of the components had significant
      sequence identity with any known protein or nucleic acid sequences. However, the
      ORF of component 4 encoded a 30 residue hydrophobic domain which may indicate
      that this ORF encoded a transmembrane protein. Further, the ORFs of components 3
      and 5 potentially encoded proteins of about 20 kDa, the size of the BBTV coat
      protein. There were two regions of sequence identity between the five components
      described here and the previously described component 1. Each component contained
      a conserved stem-loop structure and a nonanucleotide potential TATA box which was
      5' of the large virion-sense ORF in five of the components. The stem-loop
      structures were incorporated in a common region (CR-SL) of 69 nucleotides which
      was 62% identical between components. All six BBTV components also contained a
      major common region (CR-M) which was located 5' of the CR-SL in each component,
      in the non-coding region and was 76% identical over 92 nucleotides. Each CR-M
      contained a near-complete 16 nucleotide direct repeat and a GC-box which was
      similar to the rightward promoter element found in wheat dwarf geminivirus. From
      these results, BBTV appears to belong to an undescribed plant virus group which
      could also include subterranean clover stunt virus, coconut foliar decay virus,
      faba bean necrotic yellows virus and milk vetch dwarf virus.

PMID- 7782776
TI  - Isolation and characterization of an RNA-dependent RNA polymerase from Nicotiana
      clevelandii plants infected with red clover necrotic mosaic dianthovirus.
AB  - A template-bound RNA polymerase was isolated from Nicotiana clevelandii plants
      infected with red clover necrotic mosaic dianthovirus (RCNMV) by differential
      centrifugation, solubilization with dodecyl beta-D-maltopyranoside, and
      chromatography on columns of Sephacryl S-400 and Q-Sepharose. Analysis of the
      purified polymerase by SDS-polyacrylamide gel electrophoresis, followed by silver
      staining or immunoblotting, showed that it contained virus-encoded proteins of
      molecular masses 27 kDa and 88 kDa together with several minor proteins possibly
      of host origin. After removal of endogenous RNA with micrococcal nuclease, the
      polymerase became template-dependent. It was also template-specific, being able
      to utilize as templates RNA of two strains of RCNMV, but not RNAs of three
      viruses in different taxonomic groups, namely cucumber mosaic cucumovirus, tomato
      bushy stunt tombusvirus and tomato mosaic tobamovirus. The products of RNA
      polymerase reactions were double-stranded RNAs corresponding to RCNMV RNAs 1 and
      2. The ability of the template-dependent RNA polymerase to synthesize RNA was
      completely inhibited by antibodies to a peptide containing the GDD motif, whereas
      the activity of the template-bound enzyme was unaffected by these antibodies.

PMID- 7782778
TI  - Antigenic analysis of nematode-transmissible and non-transmissible isolates of
      tobacco rattle tobravirus using monoclonal antibodies.
AB  - Murine monoclonal antibodies (MAbs) were produced against a nematode non
      transmissible isolate of tobacco rattle tobravirus (TRV-PLB). Two of the MAbs
      (SCR 80 and 81) did not react with the serologically closely related isolate TRV
      PPK20 (both isolates belong to the PRN serotype), which is readily transmissible
      by nematodes. When further isolates of the PRN serotype were tested, all the non
      transmissible ones reacted with these two MAbs, but so also did some of those
      that are readily transmissible. SCR 80 and 81 were able to trap TRV-PLB particles
      onto electron microscope grids and reacted with metatopes located near the C
      terminus of the particle protein. The epitope recognized by SCR 81 was
      discontinuous. The MAbs that reacted with both TRV-PLB and TRV-PPK20 recognized
      either continuous cryptotopes (SCR 78) or discontinuous neotopes (SCR 79 and 82).

PMID- 7782779
TI  - Expression, subcellular location and modification of the 50 kDa protein encoded
      by ORF2 of the apple chlorotic leaf spot trichovirus genome.
AB  - A putative movement protein of molecular mass 50 kDa encoded by the ORF2 of the
      apple chlorotic leaf spot virus (ACLSV) genome was expressed in Escherichia coli
      using an expression vector and was then used to produce an antiserum. Immunoblot
      analysis using an antiserum raised against this protein showed that the ORF2
      protein of ACLSV was detected in both cell wall and cell membrane fractions
      prepared from infected Chenopodium quinoa tissues. The ORF2 protein from infected
      tissues had a molecular mass of 52 kDa, larger than that of the full-length ORF2
      protein (50 kDa protein) expressed in E. coli. Incubation of the 52 kDa protein
      with alkaline phosphatase resulted in a decrease in its apparent molecular mass
      from 52 kDa to 50 kDa, strongly suggesting that the ORF2 protein of ACLSV is
      phosphorylated in infected plant tissues.

PMID- 7782777
TI  - The tobacco necrosis virus p7a protein is a nucleic acid-binding protein.
AB  - The two centrally located open reading frames (ORFs) of necroviruses may, by
      analogy with the similarly located and related ORFs of carmoviruses, be expected
      to have a function in virus movement in plants. In the case of tobacco necrosis
      virus (TNV) strain D these proteins both have a molecular mass of approximately 7
      kDa and are thus known as p7a and p7b. We overexpressed p7a in Escherichia coli,
      separated it from bacterial proteins and renatured it on gels, and showed that
      p7a was able to bind single-stranded RNA and single-stranded DNA, but was unable
      to bind double-stranded DNA. These protein-nucleic acid complexes were stable at
      moderately high salt concentrations. Protein p7b could not be expressed in a
      number of bacterial systems. We speculate that in TNV, unlike some other viruses
      which encode a single movement protein with separate functional domains for RNA
      binding and plasmodesmatal targeting, p7a and p7b may respectively provide these
      functions on separate proteins.

PMID- 7782780
TI  - The glycosylation of human immunodeficiency virus type 1 transmembrane
      glycoprotein (gp41) is important for the efficient intracellular transport of the
      envelope precursor gp160.
AB  - The role of the glycans of the human immunodeficiency virus type 1 transmembrane
      glycoprotein (gp41) in the intracellular events of Env precursor (gp160)
      biosynthesis has been examined by the use of a mutant gp160 in which the cluster
      of conserved glycosylation sites within the gp41 domain (Asn-621, -630 and -642)
      has been mutated. Expression of the wild-type and mutant forms of gp160 in BHK-21
      cells using recombinant vaccinia viruses has shown that the kinetics of the
      events occurring in the endoplasmic reticulum (ER) were normal: both Env proteins
      had similar kinetics of disulphide bond formation, as determined by the
      acquisition of CD4-binding capability, and both had similar kinetics of oligomer
      formation. However, in contrast to the parental molecule, mutated gp160 displayed
      relatively slow transport from the cis to the medial Golgi where it was retained
      in the oligomeric state. Transport to the trans Golgi was impaired, as determined
      by the sensitivity of gp160 to glycosidases. Cleavage of mutated gp160 at the
      gp120/gp41 junction was substantially reduced but this was apparently not due to
      the involvement of the gp41 glycosylation in the cleavage reaction by furin
      inasmuch as, in the baculovirus system, mutated gp160 could be cleaved when
      recombinant furin was co-expressed. The reduced cleavage in mammalian cells may
      thus reflect the impaired routing of mutated Env to the compartment where
      cleavage occurs. The glycan component of gp41 is, therefore, important for the
      efficient intracellular transport and processing of gp160. gp160 lacking gp41
      carbohydrates is an additional example, among few others, of a protein lacking
      glycans that is arrested in the Golgi rather than the ER following its
      biosynthesis.

PMID- 7782782
TI  - Genetic stability of cold-adapted A/Leningrad/134/47/57 (H2N2) influenza virus:
      sequence analysis of live cold-adapted reassortant vaccine strains before and
      after replication in children.
AB  - We previously reported that the A/Leningrad/134/47/57 (H2N2) cold-adapted virus
      (A/Len/47) used in preparing reassortant live attenuated vaccines for children
      acquired 14 (11 coding) mutations in genes coding for proteins other than
      haemagglutinin and neuraminidase during cold-adaptation. Preservation of these
      mutations in genomes of viruses isolated from children on the second, fifth, or
      eighth day after vaccination was examined by sequence analysis. The sequence data
      demonstrated that all nine coding mutations selected for examination were
      conserved in the genomes of all 11 strains investigated, indicating that the
      mutations accompanying cold-adaptation and attenuation of the A/Len/47 master
      vaccine are highly stable.

PMID- 7782783
TI  - Expression of beta-galactosidase in neurons of dorsal root ganglia which are
      latently infected with herpes simplex virus type 1.
AB  - Explanation into culture of dorsal root ganglia (DRG) latently infected with
      herpes simplex virus type 1 (HSV-1) causes reactivation of the virus. Previous
      studies have suggested that either latency-associated transcripts (LATs) were
      removed as an early consequence of reactivation or, alternatively, there was a
      population of latently infected cells which did not contain LATs. We have now
      attempted to detect this population of neurons by inserting a reporter gene
      (Escherichia coli lacZ gene), under the control of promoters other than LAT, into
      the HSV-1 strain 17 mutant in 1814, which was used in the earlier studies. One of
      these promoters, the human cytomegalovirus enhancer, resulted in weak expression
      of beta-galactosidase in DRG neurons for at least 5 months. The pattern of
      staining was predominantly homogeneous in neurons at 3 or 5 days post-infection
      or at 3 days post-explanation, and was predominantly speckled in latently
      infected neurons (1 to 5 months post-infection). About 30% of the beta
      galactosidase-positive neurons did not contain LATs by in situ hybridization.
      However, the detergents used to enable penetration of the substrate for beta
      galactosidase had also reduced the levels of the LATs; in neurons which
      originally had only small numbers of LATs this may have reduced levels to below
      those detectable by the methods used. There was, therefore, no unequivocal
      evidence for a population of latently HSV-1-infected cells which did not express
      LATs.

PMID- 7782781
TI  - Cloning, sequencing and expression of the S1 gene of avian reovirus.
AB  - The S1 genome segment of avian reovirus strain S1133 was cloned and completely
      sequenced. The sequence comprised 1636 bp with three distinct open reading frames
      (ORFs), suggesting the gene was polycistronic in nature. The three ORFs from 5'
      to 3' were predicted to encode polypeptides of 9.8, 3.8 and 34.9 kDa,
      respectively. Of the three ORFs, only the third possessed the AUG initiation
      codon in an optimum context for translation. The third ORF-encoded protein, 326
      amino acids in length, was expressed in Escherichia coli and used as antigen in
      immunoblots. The protein was concluded to be sigma 3 on the basis of its
      recognition by a chicken anti-reovirus antiserum and due to the fact that a mouse
      antiserum raised against it recognized specifically the viral sigma 3
      polypeptide. Sequence comparison of the avian reovirus S1 gene with its mammalian
      counterpart did not show any significant similarity between the two. However,
      amino acid sequence analysis and the predicted existence of a heptapeptide repeat
      pattern, as well as the relatively high frequency of alpha-helix structures in
      the amino terminal portion of sigma 3 suggests that this protein is structurally,
      and probably functionally, related to mammalian reovirus sigma 1 protein.

PMID- 7782784
TI  - Genomic heterogeneity in the pol region of ovine lentiviruses obtained from
      bronchoalveolar cells of infected sheep from France.
AB  - In order to determine the genomic heterogeneity of ovine lentiviruses, we
      analysed eight isolates from naturally infected sheep from one geographical
      region of France. A 475 nt fragment in the region of the pol gene coding for
      reverse transcriptase was amplified by RT-PCR from RNA directly extracted from
      uncultured bronchoalveolar lavage cells. The resulting PCR fragments were
      analysed by restriction enzyme digestion, cloned in a TA vector and sequenced.
      Restriction enzyme analysis showed distinct patterns from the eight isolates, and
      sequencing showed them to be closely related in both nucleotide (2.3-8.1%
      variation) and deduced amino acid (0-6.2% variation) sequences. Their amino acid
      sequences differed from that of visna-maedi virus complete viral genome sequence
      K1514 by 12.5-15.3%, but from that of caprine arthritis encephalitis virus (CAEV)
      viral genome sequence Co by only 4.2-6.9%. Phylogenetic analysis showed that the
      French isolates form a group related to CAEV Co and distant from previously
      reported ovine lentivirus sequences from different origins.

PMID- 7782785
TI  - Sequences of VP6 genes of human rotavirus strain RV3 and its vaccine derivative.

PMID- 7782786
TI  - 2,6-diacetylpyridine bis(thiosemicarbazones) zinc complexes: synthesis,
      structure, and biological activity.
AB  - The reaction of zinc chloride, acetate, or perchlorate with two
      bis(thiosemicarbazones) of 2,6-diacetylpyridine [H2daptsc = 2,6-diacetylpyridine
      bis(thiosemicarbazone) and H2dapipt = 2,6-diacetylpyridine
      bis(hydrazinopyruvoylthiosemicarbazone)] leads to the formation of four novel
      complexes that have been characterized by spectroscopic studies (NMR, IR) and
      biological properties. The crystal structures of the two compounds-
      [Zn(daptsc)]2.2DMF (1) and [Zn(H2dapipt)(OH2)2](CIO4)2.3H2O (2)--also have been
      determined by x-ray methods from diffractometer data. Compound (1) is dimeric and
      the two zinc atoms have a distorted octahedral coordination. The ligand is
      deprotonated. In compound (2), the coordination geometry about zinc is pentagonal
      -bipyramidal and the ligand is in the neutral form. The molecular structure of
      (2) consists of cations [Zn(H2dapipt)(OH2)]2+, CIO4- disordered anions, and three
      water molecules of solvation. Biological studies have shown that the ligands and
      the complexes Zn(daptsc).1/2EtOH and Zn(H2daptsc)Cl2 have an effect in vitro on
      cell proliferation and differentiation (inhibition); both are concentration
      dependent. [Zn(daptsc)]2.2DMF (1) shows the effects at lower concentration values
      with respect to other compounds.

PMID- 7782788
TI  - Novel kinetics in a biomimetic redox reaction involving NADH and tetrazolium
      salts in aqueous micellar solutions.
AB  - Aqueous micelles of Triton X-100 are shown to catalyze the redox reaction between
      NADH and 2-p-iodophenyl-3-p-nitrophenyl-5-phenyltetrazolum chloride (INT) at
      neutral pH. The reaction exhibits a first-order dependence on NADH when INT is
      saturating; conversely, when NADH is saturating, the dependence is strictly
      second-order with respect to INT. The second-order dependence of the reaction on
      INT is also evident in situations where micelles of a cationic detergent are used
      in place of Triton X-100. The available kinetic evidence indicates the transient
      formation of a central complex involving the addition of two molecules of INT and
      one molecule of NADH to a "site" on the micelle where they are held together
      until completion of the redox process. However, the reaction does not seem to
      proceed by successive 1-e- steps, suggesting that the second-order dependence on
      INT has no bearing on the mechanism of redox process. The transfer of reducing
      equivalents between NADH and INT is shown to be direct and quantitative, with the
      redox steps confined to a microenvironment, as in the case of enzymatic NAD(P)H
      dependent reactions. A mechanism consistent with the hydridic nature of the
      migrating hydrogen from the C(4) position of the dihydropyridine nucleus of NADH
      is proposed, assuming that only one molecule of INT in the central complex
      participates in the actual redox process and that the other molecule of INT acts
      as a cocatalyst by way of providing the necessary "basicity" at the reaction
      site.

PMID- 7782787
TI  - Effects of thiourea and ammonium bicarbonate on the formation and stability of
      bifunctional cisplatin-DNA adducts: consequences for the accurate quantification
      of adducts in (cellular) DNA.
AB  - Cisplatin reacts with DNA by forming mainly bifunctional adducts via reactive
      monofunctional intermediates. When freshly platinated DNA was postincubated with
      thiourea (10 mM, at 23 or 37 degrees C) for periods of up to 24 h, followed by
      determination of mono- and diadducts, a rapid initial decrease was seen in the
      fraction of diadducts, followed by a much slower decrease. About 40% diadducts
      were found after 10-min postincubation at 23 degrees C, which dropped to some 14%
      after 24 h at 37 degrees C; total platination was hardly affected. Postincubation
      of "aged" platinated DNA (no reactive monoadducts) only showed the slower
      decrease. The rapid process is likely to represent monoadduct inactivation,
      preventing the formation of diadducts, whereas the slow reaction must be
      interpreted as diadduct-to-monoadduct conversion. Similar reactions, but less
      efficient than with thiourea, occurred during dialysis against NH4HCO3 (0.1-1 M).
      Pt-containing (di)nucleotides in digested DNA were hardly affected by thiourea.
      Rapid reduction of the measured level of bifunctional adducts also occurred when
      cisplatin-treated Chinese hamster ovary cells were postincubated with thiourea,
      with concomitant increase in survival. It is concluded that quantification of the
      real levels of mono- and diadducts in freshly platinated DNA requires a
      posttreatment with thiourea of 30-60 min at 37 degrees C.

PMID- 7782789
TI  - An X-ray absorption spectroscopy study of the interactions of Ni2+ with yeast
      enolase.
AB  - An x-ray absorption spectroscopy (XAS) study was carried out at pH 7.6 on
      solutions of Ni2+ and yeast enolase depleted of its physiological cofactor (Mg2+)
      in the presence or absence of substrate/product, the very strongly bound
      competitive inhibitor 2-phosphonoacetohydroxamate and Mg2+. Both "conformational"
      and "catalytic" Ni2+ are distorted octahedral in coordination, in agreement with
      several spectroscopic studies but in contrast to the coordination in the crystal
      at pH 6.0. The data are consistent with direct coordination of what must be the
      catalytic Ni2+ to the phosphate of the substrate, in agreement with some previous
      data but in disagreement with recent interpretations by other workers. The
      ligands around the metal ions obtained from the x-ray structure give simulated
      XAS spectra in good agreement with the observed spectra.

PMID- 7782790
TI  - Antioxidant effect of inorganic ions on UVC and UVB induced lipid peroxidation.
AB  - Phosphate buffer suspensions of unilamellar liposomes of phosphatidylcholine were
      irradiated with UVC (254 nm) and UVB (300 nm) light. The irradiation provoked
      lipid peroxidation and liposome lysis with release of entrapped glucose-6
      phosphate. At the same intensity of absorbed light, the photochemical effect at
      254 nm is higher than at 300 nm. The addition of copper(II) and manganese(II)
      reduced both the peroxidation and the lysis. The copper showed an inhibitory
      effect only on the process provoked by the 254 nm irradiation, whereas the
      manganese was efficient both at 254 and 300 nm. The results are interpreted with
      a mechanism of peroxidation and quenching, involving photoformation of peroxyl
      radicals that are scavenged by manganese(II) and copper(I), with consequent
      breaking of the radical chain and reduction of the peroxidation rate. The
      copper(I), which is the active species, can be formed only at 254 nm by electron
      capture. The experimental data fit the kinetic equations obtained by the proposed
      mechanism by means of computer software.

PMID- 7782791
TI  - Metal ion binding to apo, holo, and reconstituted horse spleen ferritin.
AB  - The binding of Cd2+, Zn2+, Cu2+, Ni2+, Co2+, Mn2+, and Mg2+ to apo, holo,
      reconstituted horse spleen ferritin (HoSF), and native holo HoSF with phosphate
      removed was measured by gel-exclusion chromatography. Three classes of strong
      binding interactions (Kd < 10(-7) M) with apo HoSF at pH 7.5 were found for the
      various M2+ studied: high stoichiometric binding (30-54 M2+/HoSF) for Cd2+, Zn2+,
      Cu2+, with two protons released per metal bound; intermediate binding (16
      M2+/HoSF) for Ni2+ and Co2+, with one proton released per metal bound; and low
      levels of binding (2-12 M2+/HoSF) for Mn2+, Mg2+, and Fe2+, with < 0.5 protons
      released per metal bound. M2+ binding to apo HoSF was nearly abolished at pH 5.5,
      except for Fe2+ and Cu2+, which remained unaffected by pH alteration. Holo HoSF
      bound much higher levels of M2+, a result directly attributable to the presence
      of phosphate binding sites. This conclusion was confirmed by decreased binding of
      M2+ to HoSF reconstituted in the absence of phosphate and by native holo HoSF
      with phosphate chemically removed. The binding of Cd2+ to apo HoSF was 54 per
      HoSF, but in the presence of developing core, the amount bound decreased to about
      30 Cd2+/HoSF. This result indicated that Cd2+ and developing core were competing
      for the same sites on the HoSF interior, suggesting that 24 of the Cd2+ were
      bound to the inside surface. No other M2+ studied bound to the interior of HoSF
      by this criterion. Several of the M2+ appeared to bind strongly to the phosphate
      free mineral core surface in reconstituted HoSF.

PMID- 7782792
TI  - Tb3+ binding to human erythrocyte spectrin resulting in conformation change and
      aggregation.
AB  - The Tb3+ binding to spectrin tetramer (SPT) was studied by Tb3+ fluorescence
      titration and CD spectra. The results indicated that the total high-affinity Tb3+
      binding sites are n1 = 330, with average Kd = 3.6 x 10(-6) M. Among them, ca. 90
      sites are of higher affinity and are probably more specific to Tb3+ than the
      remaining sites. There are 520 low affinity Tb3+ binding sites with average Kd =
      1.5 x 10(-5) M. Fluorescence and CD spectra revealed that the alpha-helix content
      of SPT decreased with Tb3+ binding to specific sites and further binding did not
      result in conformation change. Tb3+ binding to SPT and the subsequent reactions
      were studied by employing stopped-flow fluorescence and light scattering methods.
      The studies demonstrate that this is a multistep reaction assembly: high-affinity
      terbium binding-conformation change-aggregation-low-affinity terbium binding--the
      second conformation change. The critical Tb3+ concentration-induced spectrin
      dimer (SPD) aggregation was determined with a light scattering method.

PMID- 7782793
TI  - A semiquantitative food frequency questionnaire for use in epidemiologic research
      among the elderly: validation by comparison with dietary history.
AB  - A self-administered semiquantitative food frequency questionnaire including 75
      food items and providing information on the habitual intake of 31 nutritional
      parameters, based on the intake of protein, fat, carbohydrate, fiber and 11
      vitamins and minerals, was developed for use in epidemiologic research on chronic
      disease among the elderly, such as diabetes and cardiovascular disease. By means
      of detailed frequency and quantity questions, specifications of types of food,
      preparation methods and seasonal variation, the questionnaire was expected to be
      an improvement on existing instruments. The relative validity of the
      questionnaire was examined in 74 men and women, aged 50-75, by comparison with a
      modified dietary history. Systematic differences were absent or negligible for
      all nutrients, except vitamin C. Bias depending on the level of intake could be
      ruled out for all but seven nutrients. Pearson correlation coefficients for
      estimates from the questionnaire and dietary history were on average 0.71 (range:
      0.65-0.78) and 0.66 (range: 0.36-0.81) for macronutrients, and vitamins and
      minerals, respectively. Classifying individual intake estimates into tertiles of
      the distribution for both methods, on average 62.4 and 54.7% of the intakes were
      categorized into the same tertile and 3.9 and 5.9% into the opposite tertile for
      macronutrients, vitamins and minerals, respectively. These results demonstrate an
      acceptable relative validity for this newly developed questionnaire, as compared
      to the dietary history method.

PMID- 7782794
TI  - Efforts to improve interobserver agreement in histopathological grading.
AB  - The present study aimed to assess the interobserver variation in
      histopathological grading of 88 slides by four experienced pathologists who,
      before the start of the study, reached consensus about the method of grading
      through a joint session behind a discussion microscope. The results were compared
      with two previous studies, the first assessing the observer variation under
      normal conditions, the second doing the same after theoretical agreement about
      which morphological characteristics were relevant for grading. In the present
      study the pathologists first made a provisional diagnosis on low power view,
      followed by a final diagnosis on high power view, scoring various morphological
      characteristics as in the second study. The unweighted and weighted group kappa
      values for the final diagnosis were 0.41 and 0.71 respectively in the present
      study (after the consensus meeting), compared to 0.33 and 0.70 respectively in
      the second study (after only theoretical consensus), and 0.28 and 0.55 in the
      first study (without consensus). We conclude that a consensus meeting appears to
      be useful to improve the interobserver agreement.

PMID- 7782795
TI  - Medicine, practice and guidelines: the uneasy juncture of science and art.
AB  - While physicians are often portrayed as scientists, the defining character of
      medical practice is its being both science and art. Indeed, despite drawing on
      the ever-expanding knowledge base and range of therapies, medical practice
      remains fundamentally an interpersonal experience, drawing on the dynamic and
      rich interaction between practitioner and patient. With the goal of situating
      clinical practice guidelines in a broader context, we briefly explore models of
      medicine and the nature of clinical practice. The implications of these for
      guideline development and implementation are then examined as we present
      guidelines as an opportunity for enhancing medical practice and increasing both
      patient and practitioner satisfaction.

PMID- 7782796
TI  - Fractures and low axial bone density in perimenopausal women.
AB  - The relationship between past fractures and current bone density (BMD) was
      analyzed in a population sample of 3222 women aged 48-58. BMD was determined with
      dual X-ray absorptiometry (DXA) at the spine and femoral neck. 702 women reported
      fractures. Wrist and ankle were the most common fracture sites. Fracture history
      increased the risk [OR (95% CI)] of low spinal BMD (of more than 1 SD below the
      study population mean) by 1.75 (1.41; 2.18). The sensitivity and specificity of
      fracture history to detect a low spinal BMD were 31 and 80%, respectively. One SD
      decreases of spinal and femoral BMD equalled to respective overall fracture risks
      (adjusted ORs) of 1.36 (1.24; 1.50) and 1.38 (1.25; 1.51). Both BMDs related more
      strongly to wrist fracture [1.73 (1.47; 2.05)/1.69 (1.43; 1.99)] than to all
      nonwrist fractures combined [1.24 (1.11; 1.37)/1.27 (1.14; 1.42)]. Ankle and rib
      fractures related only to spinal [1.21 (1.00; 1.46)/1.45 (1.12; 1.87)] but tibia
      and foot bone fractures only to femoral [2.04 (1.37; 3.04)/2.20 (1.42; 3.41)]
      BMD. Spinal BMD related more strongly to fractures due to falls on same level
      than to fractures due to all other trauma combined. Fracture history poorly
      screens out low perimenopausal BMD. The results suggest that pre- and
      perimenopausal fractures relate to low axial bone density and that the magnitude
      of this relation depends on the sites of fracture and densitometry as well as on
      the type of trauma.

PMID- 7782797
TI  - Stability of red blood cell membrane fatty acid composition after acute
      myocardial infarction.
AB  - Questionnaire-based assessment of dietary intake may be invalidated in case
      control studies by biases of recall, reporting or interviewing. Biomarkers, free
      of such biases, can be useful adjunct measures if they themselves are not
      affected by the event under investigation. Consequently, we studied the stability
      of the fatty acid composition of the red blood cell (RBC) membrane during a 1
      week period, in 20 patients aged 40-74 years after an acute myocardial infarction
      (MI). Statistical analysis that accounted for a repeated measures design with
      missing data was undertaken for five fatty acids: C16:0, C18:1, C18:2, C20:5 and
      C22:6. All fatty acids showed change over the 7 day period. Individuals tended to
      maintain their relative ranking over time as reflected by correlations between
      time points of between 0.85 to 0.90, with the exception of C16:0 in which
      correlations were lower and inconsistent. Over the first 24 hr from admission all
      fatty acids except C20:5 showed evidence of a statistically significant change.
      However over the first 7 hr C18:1, C18:2, C20:5 and C22:6 exhibited stability
      whereas C16:0 altered. We conclude that the fatty acid composition of the RBC
      membrane appears to change soon after an acute MI. Consequently, case-control
      studies may be biased towards positive associations for C16:0 and inverse
      associations for C18:2 and C20:5, i.e. consistent with conventional predictions.
      However, if blood samples are drawn within 6 hr of admission, bias in estimation
      of C18:1, C18:2, C20:5 and C22:6 may be unimportant.

PMID- 7782798
TI  - Use of certainty of opinion data to enhance clinical decision making.
AB  - Clinical decision making and diagnostic testing procedures are frequently
      evaluated using indices such as sensitivity and specificity. These indices
      require an assumption that the underlying disease state or the diagnostic test
      result is binary, which may be an unreasonable assumption in many clinical
      situations. They also fail to recognise the potential for different degrees of
      diagnostic confidence. In this paper, we report some data from a clinical study
      of postpartum mothers in which, in addition to the diagnostic result, an
      expression of certainty or strength of belief was ascertained. We illustrate how
      the certainty of opinion data can be combined with the diagnostic opinion in
      order to enhance the interpretation of the study, and the implications for
      improving the accuracy of clinical decision making in general.

PMID- 7782799
TI  - The U-shaped association between body mass index and mortality: relationship with
      weight gain in a Native American population.
AB  - In order to determine whether weight loss explains high mortality rates in those
      with a low body mass index (BMI), the relationships between BMI, rate of weight
      gain and mortality were examined in Pima Indians. Subjects were 814 diabetic and
      1814 nondiabetic participants in a longitudinal survey who had at least two
      examinations after age 20. Median duration of follow-up was 8.1 (range 0.03-25.1)
      years. BMI showed a U-shaped relationship with mortality rates in men with the
      lowest rates in the 30-35 kg/m2 category; an inverse relationship was seen in
      women. Subjects who were losing weight had higher mortality rates than those who
      were gaining. However, excess mortality among the lightest subjects was present
      among those who were gaining weight. Among nondiabetic subjects, the mortality
      ratio (MR) for BMI < 25 kg/m2 compared with 30-35 kg/m2 was 1.5 [95% confidence
      interval (CI) 1.0-2.2] unadjusted for weight gain, while the adjusted MR was 1.3
      [95% CI 0.9-1.9]. Weight loss, which may reflect underlying illness, is
      associated with high mortality rates in Pima Indians but does not fully account
      for the high mortality in the lightest individuals.

PMID- 7782800
TI  - Selecting a patient characteristics index for the prediction of medical outcomes
      using administrative claims data.
AB  - Recently, there has been a great deal of discussion regarding the use of
      administrative databases to study outcomes of medical care. A major issue in this
      discussion is how to classify patients in terms of characteristics such as
      disease-severity, comorbidities, resource needs, stability, etc. Different
      indices have been developed in an attempt to provide a common classification
      scheme in terms of these characteristics. In this paper, we examine the utility
      of four indices in the prediction of length of stay and 30-day mortality for
      patients undergoing total knee replacement surgery between 1985 and 1989. The
      indices that we compare are the Deyo-adapted Charlson Index, the Relative
      Intensity Score derived from Patient Management Categories (PMCs), the Patient
      Severity Level derived from PMCs, and the number of diagnoses (up to five) listed
      in the Medicare claims data. The first three of these indices represent measures
      of comorbidity, resource use, and severity of illness, respectively. The number
      of diagnoses is likely to capture aspects of each of these characteristics. We
      find that all of the indices improve (in terms of model fit) over the baseline
      (no index) models of length of stay and mortality, and the Relative Intensity
      Score and Patient and Severity Level result in the greatest improvement in
      measures of model fit. We found, however, that these two indices have a non
      monotonic relationship with length of stay and mortality. The Deyo-adapted
      Charlson Index performed least well of the four indices in terms of explanatory
      ability. The number of diagnoses performed well, and does not suffer from
      problems associated with miscoding on claims data.

PMID- 7782801
TI  - Associations of serum and dietary magnesium with cardiovascular disease,
      hypertension, diabetes, insulin, and carotid arterial wall thickness: the ARIC
      study. Atherosclerosis Risk in Communities Study.
AB  - The objective of this study was to examine the relationships of serum and dietary
      magnesium (Mg) with prevalent cardiovascular disease (CVD), hypertension,
      diabetes mellitus, fasting insulin, and average carotid intimal-medial wall
      thickness measured by B-mode ultrasound. A cross-sectional design was used. The
      setting was the Atherosclerosis Risk in Communities (ARIC) Study in four US
      communities. A total of 15,248 participants took part, male and female, black and
      white, aged 45-64 years. Fasting serum Mg, lipids, fasting glucose and insulin
      were measured; as was usual dietary intake by food frequency questionnaire and
      carotid intima-media thickness by standardized B-mode ultrasound methods. The
      results showed that serum Mg levels and dietary Mg intake were both lower in
      blacks than whites. Mean serum Mg levels were significantly lower in participants
      with prevalent CVD, hypertension, and diabetes than in those free of these
      diseases. In participants without CVD, serum Mg levels were also inversely
      associated with fasting serum insulin, glucose, systolic blood pressure and
      smoking. Dietary Mg intake was inversely associated with fasting serum insulin,
      plasma high density lipoprotein-cholesterol, systolic and diastolic blood
      pressure. Adjusted for age, race, body mass index, smoking, hypertension, Low
      density lipoprotein-cholesterol, and field center, mean carotid wall thickness
      increased in women by 0.0118 mm (p = 0.006) in diuretic users and 0.0048 mm (p =
      0.017) in nonusers for each 0.1 mmol/l decrease in serum Mg level; the
      multivariate association in men was not significant. In conclusion, low serum and
      dietary Mg may be related to the etiologies of CVD, hypertension, diabetes, and
      atherosclerosis.

PMID- 7782802
TI  - The relation of reported symptoms to social, individual, and behavioral
      indicators of ill-health: is the number of reported symptoms a unique general
      dimension of ill-health?
AB  - Counts of functional symptoms are an accepted measure of ill-health in general
      populations. However, their relation to other indicators of ill-health are still
      poorly understood. The aim of this study was to investigate such relations in
      order to reach a better understanding of the 'meaning' of the number of symptoms.
      The data analyzed was drawn from a telephone health survey conducted among a
      representative sample of 2111 Swiss adults as part of the Intercantonal Health
      Indicators Project in 1989. In a logistic regression analysis the Number of
      symptoms (a summery score of eleven severe function symptoms) was found to be
      strongly associated with eight social, behavioral, and psychological indicators
      of ill-health ('Unable to work', 'Frequently consulting a physician', 'Use of
      analgesics', 'Use of sedatives', 'Poor coping with ill-health', 'Social
      impairment', 'Poor health', and 'Poor psychological well-being'). To control for
      effects due to individual symptoms, they were included in the models by stepwise
      procedure. Although individual symptoms became predictive for all indicators
      (except for Poor coping with illness), the association between the Number of
      symptoms and the indicators (except for Social impairment) remained statistically
      significant. Despite methodological provisos our results seem to support an
      interpretation of the Number of symptoms as a distinct and general dimension of
      ill-health.

PMID- 7782803
TI  - Re-scaling the Spanish version of the Sickness Impact Profile: an opportunity for
      the assessment of cross-cultural equivalence.
AB  - The Sickness Impact Profile (SIP), a behaviour-based measure of health status
      developed in the US, was adapted into Spanish. The aim of this study was to
      obtain the item weights of the Spanish version, to compare these weights with
      those of the original instrument, and to assess cross-cultural differences that
      may affect scale equivalence. Following the original work, weights for the
      Spanish items were obtained using the equal appearing intervals methodology in
      two groups of judges: 25 health professionals and 120 consumers. Correlation
      between professionals' and consumers' item weights was 0.93, thus data were
      combined for further analysis. Correlations between Spanish and American item
      weights was 0.89 (p < 0.001). Among each SIP category, correlations ranged from
      0.61 to 0.99. Cultural differences were found among social items belonging to the
      social interaction category. While specific cultural differences exist when
      specific item weights were compared, overall cultural differences were not
      relevant. For practical purposes, the American and Spanish versions of the SIP
      should be considered cross-culturally equivalent.

PMID- 7782804
TI  - Serum prolactin levels and their relationship to survival in women with operable
      breast cancer.
AB  - The prognostic value of serum prolactin levels was assessed in a sequential
      series of 739 patients who were initially treated at Guy's Hospital, London,
      between 1975 and 1980. Prolactin was measured in 472 patients 1 day before (Hpr1)
      and in 457 patients 10 days after (Hpr2) mastectomy. Follow-up of the patients
      was up to August 1992 giving 6139 women-years with a median follow-up time of
      11.5 years (13.7 for patients still living and 5.1 for those dead). The
      association between the three prolactin variables and reproductive and clinical
      factors was examined before assessing the prognostic value of prolactin levels in
      terms of overall, disease-specific and disease-free survival. Multivariate
      survival models were used in order to adjust for the effect of other prognostic
      variables. These were found to be: tumour size, degree of nodal involvement,
      tumour grade and age at diagnosis. The results showed that high Hpr2 or high
      postoperative increase in prolactin (i.e. Hpr2-Hpr1) were significantly related
      to shorter disease-specific survival (p = 0.04 and 0.01, respectively) in
      postmenopausal women. In addition there was some indication, which did not attain
      formal significance, for this association to occur for disease-free survival.
      Thus the rise in blood prolactin levels after surgery may be a weak indicator of
      poor prognosis of breast cancer in postmenopausal women.

PMID- 7782806
TI  - The development of disability scales for childhood and adolescent injuries.
AB  - Scales for the study of injury-induced disabilities among 0-17 year olds were
      developed. Telephone interviews were conducted among parents of injured children
      (n = 432) 6 months after hospitalization in the three main hospitals of
      Jerusalem, about disabilities immediately following and 6 months after the
      injury. The scale for 4-17 year olds included 25 items derived from the
      International Classification of Disabilities, Impairments and Handicaps. Factor
      analysis revealed three dimensions of disability: personal care and daily
      activities; motor activities; and communication and sensory activities. The scale
      and the derived subscales on personal care and daily activities, and on motor
      activities showed high Cronbach's alpha, especially for disabilities immediately
      after the injury. The scale or subscales are easy to use, related to everyday
      activities performed by children in all cultures, are not related to the
      characteristics of the respondents, and have high consistency-reliability and
      construct validity. They may be used to assess the prevalence of disabilities in
      population studies.

PMID- 7782805
TI  - Wolfe's mammographic patterns in women with gross cystic disease of the breast.
AB  - The epidemiologic determinants of the mammographic pattern were studied in 710
      patients with aspirated gross (> 1 ml) cysts of the breast. The prevalence of the
      mammograms classified as P2-DY, that are considered to be associated with an
      increased breast cancer risk, was 636/710 or 89.6%. No relationship between
      mammographic patterns and characteristics of breast cyst fluid such as K+/Na+
      ratio, apocrine changes and dehydroepiandrosterone sulfate concentration was
      observed. A significant decrease in the proportion of these patterns with
      increasing age (p = 0.006), Quetelet Index (p < 0.001), parity (p = 0.001), and
      in postmenopausal women (p = 0.026) was found. Conversely, P2-DY patterns were
      significantly associated with a later age at menarche (p = 0.023) and alcohol
      consumption (p = 0.001). In multivariate analysis, an independent association
      with age was not observed whereas the associations with age at menarche, parity,
      and relative weight were confirmed. In conclusion, the epidemiologic determinants
      of mammographic patterns are the same in Gross Cystic Disease patients as in
      unaffected women, and the lack of correlation between mammographic pattern and
      cyst type suggests that the latter may represent an independent predictor of
      breast cancer risk.

PMID- 7782807
TI  - The demise of the randomized controlled trial.

PMID- 7782808
TI  - Pitfalls in assessing the effect of time-varying covariates in cross-sectional
      studies.

PMID- 7782809
TI  - Ethics in clinical practice. Introduction.

PMID- 7782810
TI  - Care: the basis for a nursing ethic?
AB  - This article takes issue with the position in the recent general and
      cardiovascular nursing literature that care is the foundation for nursing's
      professional ethic. This literature is critically examined to support the
      determination that care is necessary but insufficient. Care without cure is
      incomplete in any health care discipline, including nursing. Any nursing ethic
      will be inadequate if it does not integrate the care/relationship and
      cure/justice/individual foundations.

PMID- 7782811
TI  - The potential for noncaring when dealing with difficult patients: strategies for
      moral decision making.
AB  - The potential for noncaring when dealing with difficult patients is a very real
      concern in nursing. Noncaring, manifested by distancing and withdrawal or
      punitive behaviors, exacts a high toll on the nurse-patient relationship.
      Noncaring may result in missed diagnoses and interventions, social isolation, and
      minimal or negative contact with the nurse. The purpose of this article is to
      share strategies for moral decision making that support the patient, family, and
      nurse in all care settings. Decisions to care must be based on professional,
      ethical, and moral principles rather than personal preferences. Scrutinizing
      one's personal biases and actions with application of ethical principles provides
      the framework for these strategies.

PMID- 7782812
TI  - Case study: when the nurse and physician don't agree.
AB  - Nurses and physicians by virtue of their roles as health care professionals must
      work together to provide care for their patients. Decisions regarding life
      support and death and dying are made almost daily in most intensive care units.
      Conflicts frequently arise among health care providers when decisions of this
      nature are made. Nurses and physicians, despite having similar value systems,
      operate under a different frame of reference. Understanding the differences and
      how they play themselves out in the clinical setting can alleviate much of the
      stress and frustration common when these issues are encountered. This article
      examines the value systems and perspectives of nurses and physicians using a case
      study format.

PMID- 7782814
TI  - Going through the motions: the ethics of process.
AB  - This article takes the position that the current ethic of nursing is inadequate.
      It is limited to an ethic of process. This ethic limits the discipline of nursing
      to process-oriented activities, including research and the clinical nursing
      process. These processes are not, however, unique to nursing but are shared by
      all professional disciplines. Nursing will continue to be insufficient without
      the development of structure or expert clinical knowledge accompanied by an ethic
      of accountability.

PMID- 7782813
TI  - Are we promoting true informed consent in cardiovascular clinical trials?
AB  - The purpose of this study was to determine variables contributing to patient
      participation in randomized clinical trials while assessing the potential
      relationship of these variables to a valid consent process. Two hundred forty
      seven patients were administered a questionnaire after they made their decision
      about participation. Numerous variables were explored for their relationship to
      patient participation. Of particular significance were the variables of
      education, perception of having enough time to decide, and the person approaching
      the patient. Results of this study reveal the need for further evaluation of
      informed consent as a process, focusing on the areas of patient autonomy and
      comprehension.

PMID- 7782816
TI  - Resources for ethical decision making.
AB  - Nurses often encounter ethical dilemmas during the course of their practice and
      play a key role in the ethical decision-making process. This article identifies
      resources available to assist the nurse in making sound ethical decisions.
      Institution-based resources, such as institutional review boards and pastoral
      care, and unit-based resources, including nursing ethics rounds and peer support,
      are discussed.

PMID- 7782815
TI  - The nurse's role in end-of-life treatment discussions: preliminary report from
      the SUPPORT Project.
AB  - The methods of the Study to Understand Prognosis and Preferences of Outcomes and
      Risks of Treatment (SUPPORT), a five year, five-center study of decision making
      and communication in patients near the end of life, are described. Aspects of the
      study propose to describe the role of the staff nurse and the specially trained
      nurse facilitator in decision making in patients near the end of life. The nurse
      is in a unique position to initiate discussions about patient preferences for end
      of-life treatment and quality of life; however, a review of related research
      describes discordance between clinicians' understanding and patients' preferences
      for treatment. Ethical issues, practice barriers, and practice innovations in end
      of-life treatment are discussed.

PMID- 7782817
TI  - Persistence of 99mTc-labelled microorganisms on surfaces of impression materials.
AB  - Impression materials or prostheses can be contaminated with oral microflora and
      provide a significant source for cross-contamination. A study of such
      contamination was carried out using an approach different from that of infection
      control, which has often been investigated in previous studies. The study focused
      on microorganisms known to cause local and systemic diseases and which are
      normally found in the oral flora. The persistence of Streptococcus mutans (S.
      mutans), Escherichia coli (E. coli), Staphylococcus aureus and Candida albicans
      (C. albicans) on zinc-oxide eugenol, silicone rubber, irreversible hydrocolloid
      and polyether-rubber was investigated using 99mTc-labelled microorganisms. Ten
      specimens from each of the four impression materials were prepared as discs of 3
      mm in height and 10 mm in diameter. After the specimens had been placed into a
      suspension of 99mTc-labelled microorganisms, remaining radioactivity was counted
      in a gamma counter. According to own findings, S. mutans was the most, and E.
      coli the least persistent on the specimen surfaces. The number of microorganisms
      removed after washing was less than the amount remaining on the surfaces. C.
      albicans was removed most easily from all impression surfaces that bore
      persistent microorganisms after washing. Other microorganisms showed various
      degrees of persistence according to the impression material.

PMID- 7782818
TI  - Surgical advancement of the mandible through sagittal ramus osteotomy.
AB  - The sagittal split-ramus osteotomy (SSRO) technique has gained widespread
      acceptance, for it can be easily adapted to correct a wide variety of mandibular
      abnormalities. However, in spite of its many advantages, numerous investigators
      have reported postoperative relapse following mandibular advancement surgery.
      SSRO was performed on four patients with deficiency of mandibular growth which
      had led to characteristic protrusion of the maxilla. In three of the four cases,
      postoperative skeletal relapse occurred, which was corrected by postoperative
      orthodontic treatment.

PMID- 7782819
TI  - Passive mandibular border positions and their relationships with signs and
      symptoms of craniomandibular disorder. A study of linear and angular
      measurements.
AB  - Linear measurements of passive mandibular border positions and angular
      measurements of passive opening were recorded in a group of patients with
      craniomandibular disorders. The relationships between signs and symptoms of
      craniomandibular disorders and abnormal capacity of movement were studied. There
      was significant association of some signs and symptoms related to the
      temporomandibular joint and abnormal vertical and horizontal excursions. On the
      other hand, there was only one relationship between occlusal factors and abnormal
      passive mandibular border positions.

PMID- 7782820
TI  - A study of cysts in the oral region. Cysts of the jaw.
AB  - Clinical cases of cysts of the jaw treated in the Department of Oral Surgery of
      our university during the 10 y between 1980 and 1989 were studied clinically.
      Patients with radicular cyst, dentigerous cyst, odontogenic keratocyst and
      postoperative maxillary cyst, which were found at relatively high frequencies,
      were further analyzed with regard to age, sex and anatomical distribution. A
      diagnosis of cyst was established in 1,444 patients during the above period, and
      1,234 (85.5%) of them had cysts of the jaw. According to a pathological
      classification by Ishikawa's method, these patients included 509 (41.2%) with
      radicular cyst, 259 (27.0%) with dentigerous cyst, 95 (7.7%) with odontogenic
      keratocyst and 267 (21.6%) with postoperative maxillary cyst. The pattern of age
      distribution in cases of radicular cyst, odontogenic keratocyst and postoperative
      maxillary cyst was similar to that found in previous studies. Among patients with
      dentigerous cyst, those aged under 20 y accounted for about 60%. Radicular cyst
      occurred most frequently in the maxillary lateral incisors, dentigerous cyst in
      the mandibular wisdom teeth, and odontogenic keratocyst in the region between the
      mandibular molar and the ramus of the mandible.

PMID- 7782821
TI  - Effects of salivary immune response to Streptococcus mutans on caries occurrence
      and caries development in mice with autoimmune disease.
AB  - MRL/l strain mice, which possess a lymphoproliferative gene inducing swelling of
      systemic lymph nodes, develop a SLE (systemic lupus erythematosus)-like syndrome
      at around 8 w of age. MRL/n mice, which carry 99.6% of the genes of MRL/l mice,
      lack the gene for lymphoproliferation and exhibit only a slight degree of lymph
      node swelling late in life. This study investigated whether the salivary immune
      response caused by Streptococcus mutans(S. mutans) infection prevented dental
      caries in MRL/l and MRL/n mice after 8 w of age. A total of 10 MRL/l mice and 10
      MRL/n mice were fed a commercial pellet diet without sucrose until 74 d of age,
      and then fed Diet 2000 containing 56% sucrose ad libitum from 75 to 130 d of age.
      On d 75, both strains of mice were inoculated with S. mutans JC-2 for 7 d. At 130
      d of age, saliva samples were collected and caries scores were assessed. The
      results obtained suggested that the salivary immune response was one of the most
      important factors regulating caries occurrence.

PMID- 7782822
TI  - A study of temporomandibular joint sounds. Part 2. Acoustic characteristics of
      joint sounds.
AB  - In an attempt to gain a better understanding of temporomandibular joint (TMJ)
      sounds, we recorded joint sounds from 14 non-orthodontically treated dental
      students, analyzed the acoustic characteristics of the TMJ sounds, and correlated
      the sound characteristics with axiographic features, morphologic observations of
      X-ray images and clinical history. The group with a low peak frequency (< 500 Hz)
      of the opening click had a shorter history of subjective joint sound, a longer
      distance between the opening and closing curves, and a low rate of TMJ
      transformation. For the closing click, the history of subjective joint sounds
      tended to be longer when the duration of the wave was short. Acoustic analysis of
      TMJ sounds could be an aid to the differential diagnosis of temporomandibular
      disorders, although it is difficult to deduce the clinical history and internal
      deformities of the TMJ based solely on acoustic characteristics.

PMID- 7782823
TI  - Metrical differential diagnosis based on location. Differential diagnosis among
      various cysts.
AB  - An attempt was made to quantify the location of oral lesions. Panoramic
      radiographs of non-odontogenic cysts (13 globulomaxillary cysts, 8 median
      maxillary cysts, 8 nasopalatine cysts, 5 nasoalveolar cysts and 11 simple bone
      cysts) and odontogenic cysts (37 radicular cysts, 13 radicular granulomas, 68
      dentigerous cysts and 40 odontogenic keratocysts) were examined. Metrical data
      (integers) were obtained from a conversion table and the abscissa values (to the
      first decimal place) were obtained from the centroid of the cysts. Differential
      diagnosis among these lesions revealed the following: 1. In the maxilla, it was
      possible to differentiate median maxillary cysts and nasopalatine cysts from
      globulomaxillary cysts, nasoalveolar cysts, radicular cysts, radicular
      granulomas, dentigerous cysts and odontogenic keratocysts. 2. In the mandible, it
      was difficult to differentiate simple bone cysts, radicular cysts, radicular
      granulomas, dentigerous cysts and odontogenic keratocysts from one another. The
      present findings revealed that data on lesion location can be changed into
      metrical data for differential diagnosis of cysts.

PMID- 7782824
TI  - Surgical management of spinal epidural hematoma: relationship between surgical
      timing and neurological outcome.
AB  - Thirty patients were treated surgically for spinal epidural hematoma (SEH).
      Twelve of these cases resulted from spinal surgery, seven from epidural
      catheters, four from vascular lesions, three from anticoagulation medications,
      two from trauma, and two from spontaneous causes. Pain was the predominant
      initial symptom, and all patients developed neurological deficits. Eight patients
      had complete motor and sensory loss (Frankel Grade A); six had complete motor
      loss but some sensation preserved (Frankel Grade B); and 16 had incomplete loss
      of motor function (10 patients Frankel Grade C and six patients Frankel Grade D).
      The average interval from onset of initial symptom to maximum neurological
      deficit was 13 hours, and the average interval from onset of symptom to surgery
      was 23 hours. Surgical evacuation of the hematoma was performed in all patients;
      26 of these improved; four remained unchanged, and no patients worsened (mean
      follow up 11 months). Complete recovery (Frankel Grade E) was observed in 43% of
      the patients and functional recovery (Frankel Grades D or E) was observed in 87%.
      One postoperative death occurred from a pulmonary embolus (surgical mortality
      3%). Preoperative neurological status correlated with outcome; 83% of Frankel
      Grade D patients recovered completely compared to 25% of Frankel Grade A
      patients. The rapidity of surgical intervention also correlated with outcome;
      greater neurological recovery occurred as the interval from symptom onset to
      surgery decreased. Patients taken to surgery within 12 hours had better
      neurological outcomes than patients with identical preoperative Frankel grades
      whose surgery was delayed beyond 12 hours. This large series of SEH demonstrates
      that rapid diagnosis and emergency surgical treatment maximize neurological
      recovery. However, patients with complete neurological lesions or long-standing
      compression can improve substantially with surgery.

PMID- 7782825
TI  - Pathological effects of angioplasty on vasospastic carotid arteries in a rabbit
      model.
AB  - To define the pathological effects of angioplasty on vasospastic arteries, 36
      rabbits underwent angiography and induction of vasospasm by placement of blood
      filled (vasospasm groups) or empty (control group) silastic sheaths around the
      cervical carotid arteries. Two (Day 2) or 7 days (Day 7) later, angiography was
      repeated and one carotid artery in each animal was dilated by balloon
      angioplasty. The rabbits were sacrificed 1 day, 7 days, or 3 to 4 weeks after
      angioplasty. Significant vasospasm developed after placement of silastic sheaths
      with blood (mean reductions in diameter 39% +/- 6% at Day 2 and 48% +/- 5% at Day
      7). Arterial narrowing was less apparent in the control groups at Day 2 (24% +/-
      7%). Angioplasty performed on Day 2 significantly increased arterial diameters of
      vasospastic arteries (50% +/- 7%; p < 0.05) but not those of control arteries
      (10% +/- 6%, p > 0.05). Angioplasty performed on Day 7 increased the arterial
      diameters by a similar degree (47% +/- 13%, not significant). Arteries remained
      dilated after angioplasty, although there was significant vasospasm 7 days after
      angioplasty when angioplasty was performed on Day 2. Blinded, semiquantitative
      histopathological study of the arteries showed that 3 to 4 weeks after
      angioplasty, there was significant endothelial proliferation and a trend for
      thinning of the tunica media. There were no significant changes in control
      arteries subjected to angioplasty. Angioplasty was not associated with
      significant arterial fibrosis as measured by hydroxyproline content (analysis of
      variance). The increase in endothelial proliferation and decrease in the
      thickness of the tunica media suggest that, in the rabbit model, angioplasty
      damages endothelial and smooth-muscle cells. This may be the basis for the
      observation that vasospastic arteries do not reconstrict after angioplasty.

PMID- 7782826
TI  - Effect of intracarotid nitric oxide on primate cerebral vasospasm after
      subarachnoid hemorrhage.
AB  - The continuous release of nitric oxide (NO) is required to maintain basal
      cerebrovascular tone. Oxyhemoglobin, a putative spasmogen, rapidly binds NO,
      implicating loss of NO in the pathogenesis of cerebral vasospasm after
      subarachnoid hemorrhage (SAH). If vasospasm is mediated by depletion of NO in the
      vessel wall, it should be reversible by replacement with NO. To investigate this
      hypothesis, the authors placed blood clots around the right middle cerebral
      artery (RMCA) of four cynomolgus monkeys; four unoperated animals served as
      controls. Arteriography was performed before and 7 days after surgery to assess
      the presence and degree of vasospasm, which was quantified in the anteroposterior
      (AP) projection by computerized image analysis. On Day 7, cortical cerebral blood
      flow (CBF) in the distribution of the right MCA was measured during four to six
      runs in the right internal carotid artery (ICA) of brief infusions of saline
      followed by NO solution. Arteriography was performed immediately after completing
      the final NO infusion in three of the four animals with vasospasm. Right MCA
      blood flow velocities were obtained using transcranial Doppler before, during,
      and after NO infusion in two vasospastic animals. After ICA NO infusion,
      arteriographic vasospasm resolved (mean percent of preoperative AP area, 55.9%);
      that is, the AP areas of the proximal portion of the right MCA returned to their
      preoperative values (mean 91.4%; range 88%-96%). Compared to ICA saline, during
      ICA NO infusion CBF increased 7% in control animals and 19% in vasospastic
      animals (p < 0.002) without significant changes in other physiological
      parameters. During NO infusion, peak systolic right MCA CBF velocity decreased
      (130 to 109 cm/sec and 116 to 76 cm/sec) in two vasospastic animals. The effects
      of ICA NO on CBF and CBF velocity disappeared shortly after terminating NO
      infusion. Intracarotid infusion of NO in a primate model of vasospasm 1)
      increases CBF, 2) decreases cerebral vascular resistance, 3) reverses
      arteriographic vasospasm, and 4) decreases CBF velocity in the vasospastic artery
      without producing systemic hypotension. These findings indicate the potential for
      the development of targeted therapy to reverse cerebral vasospasm after SAH.

PMID- 7782827
TI  - Effects of potassium channel activators on isolated cerebral arteries of large
      and small diameter in the cat.
AB  - The smooth-muscle relaxant action of adenosine 5'-triphosphate (ATP)-sensitive
      potassium (KATP) channels in cerebral arteries of large diameter has been
      confirmed in a number of in vitro studies, but there is still debate about the
      presence of KATP channels in small cerebral arteries. In the present study, the
      authors compare the effects of cromakalim and bimakalim, two putative KATP
      channel activators, in different parts of the feline isolated middle cerebral
      artery (MCA) designated proximal, intermediate, and distal. The latter
      corresponds to those small pial arteries that are usually studied in vivo. In
      ring segments precontracted with 10(-5) M of uridine-5-triphosphate (UTP), both
      cromakalim and bimakalim induced concentration-related relaxation, with bimakalim
      being more potent than cromakalim, and no significant differences noted among
      segments obtained from the different regions of the MCA. In vessels precontracted
      by adding 30 mM KCl the potency of cromakalim and bimakalim was reduced compared
      with that obtained after UTP precontraction. In the presence of 10(-6) M
      glibenclamide, an antagonist of KATP channel activators, the concentration-effect
      curve to bimakalim was shifted to the right in the proximal and distal MCA,
      indicating a similar route of action for bimakalim and cromakalim in these
      arteries. The present study therefore indicates the presence of KATP channels in
      isolated small cerebral arteries according to results obtained in vivo.
      Activators of KATP channesl may prove helpful in the treatment of vasospasm,
      which may occur in large and small cerebral arteries after subarachnoid
      hemorrhage.

PMID- 7782828
TI  - Histological findings in giant aneurysms treated with Guglielmi detachable coils.
      Report of two cases with autopsy correlation.
AB  - The authors report the pathological and histological findings in two patients
      with giant partially thrombosed aneurysms who were treated by means of Guglielmi
      detachable coils with subtotal occlusion of the aneurysms. Autopsies of these
      patients were performed 2 and 6 months after endovascular treatment. The
      histological findings revealed coils embedded in largely unorganized thrombus in
      the aneurysms; there was no clear reduction in size of the aneurysms over the
      period. There was no evidence of endothelialization of the aneurysm neck
      demonstrated in either case. The significance of these findings is discussed.

PMID- 7782829
TI  - Ossification of the anterior longitudinal ligament and Forestier's disease: an
      analysis of seven cases.
AB  - A retrospective review was conducted on the records and radiographs of six
      symptomatic patients and one asymptomatic patient with Forestier's disease. No
      other series of patients with this disease is found in the neurosurgical
      literature. Forestier's disease, also known as diffuse idiopathic skeletal
      hyperostosis (DISH), is an idiopathic rheumatological abnormality in which
      exuberant ossification occurs along ligaments throughout the body, but most
      notably the anterior longitudinal ligament of the spine. It affects older men
      predominantly; all of our patients were men older than 60 years of age. The
      disease is usually asymptomatic; however, dyspnea, dysphagia, spinal cord
      compression, and peripheral nerve entrapment have all been documented in
      association with the disorder. Five of the six symptomatic patients presented
      with dysphagia due to esophageal compression by calcified anterior longitudinal
      ligaments, and one patient developed recurrent spinal stenosis when scar tissue
      from a previous decompressive laminectomy became calcified. All patients
      responded well to surgery. Two of the four patients who underwent removal of
      cervical osteophytes required several months following surgery for the dysphagia
      to resolve. This would support the hypothesis that not all cases of dysphagia in
      Forestier's disease are due to mechanical compression. Dysphagia may result from
      inflammatory changes that accompany fibrosis in the wall of the esophagus or from
      esophageal denervation. Evaluation of dysphagia even in the presence of
      Forestier's disease must rule out occult malignancy. The authors' experience
      suggests that dysphagia in the setting of Forestier's disease is an
      underrecognized entity amenable to surgical intervention.

PMID- 7782831
TI  - Aneurysm of a persistent primitive olfactory artery. Case report.
AB  - A ruptured anterior cerebral artery (ACA) aneurysm is reported in a patient in
      whom an anomalous ACA arose from the internal carotid artery at the bifurcation.
      The aberrant artery coursed anteriorly along the ipsilateral olfactory tract and
      made a hairpin turn posterior to the olfactory bulb, supplying the circulation of
      the ACA. Persistence of the primitive olfactory artery is suggested as an
      embryological origin of this vascular anomaly.

PMID- 7782830
TI  - Imaging studies of cerebral hyperperfusion after carotid endarterectomy. Case
      report.
AB  - A case is reported of severe unilateral hemispheric edema and localized
      hemorrhage associated with seizures following endarterectomy of an ipsilateral
      high-grade carotid stenosis. Imaging studies including angiography, computerized
      tomography (CT), magnetic resonance imaging/angiography, and xenon-CT, suggested
      postoperative ipsilateral cerebral hyperperfusion. Cerebral hyperperfusion
      syndromes caused by a probable failure of vascular autoregulation are rare but
      potentially serious complications after endarterectomy. The literature on this
      type of complication is briefly reviewed, and the role of various imaging
      modalities in identification of the syndrome and in guiding management decisions
      is emphasized.

PMID- 7782832
TI  - Association of venous and true arteriovenous malformation: a rare entity among
      mixed vascular malformations of the brain. Case report.
AB  - In this article the authors report the case of a mixed cerebrovascular
      malformation in which a true arteriovenous malformation (AVM), harboring a nidus,
      is associated with a venous malformation that serves as the draining vein for the
      nidus. Despite the authors' preoperative rationale for exclusive extirpation of
      the AVM, an inadvertent injury and the obliteration of the venous malformation
      generated delayed postoperative neurological deterioration, which could clearly
      be attributed to venous hemorrhagic infarction. Because this is only the second
      instance of this type of mixed vascular malformation of the brain reported, which
      also underscores the concept of nonsurgical treatment of venous malformations,
      the authors discuss the diverse literature regarding mixed vascular malformations
      and the treatment of venous malformations.

PMID- 7782833
TI  - Melanotic neuroectodermal tumor of infancy: a molecular approach to diagnosis.
      Case report.
AB  - A case of melanotic neuroectodermal tumor of infancy arising from the transverse
      sinus is presented. The tumor was located on the outer surface of the dura and
      extended extracranially through the occipitomastoid suture. Two cell populations
      were observed: pigmented melanocyte-like cells and small neuroblast-like cells.
      Ultrastructural analysis revealed epithelial tumor cells and melanosomes at
      various stages. Expression of melanotransferrin messenger RNA transcripts within
      the tumor tissue was observed using a reverse transcriptase-polymerase chain
      reaction method in addition to immunohistological studies. The positive
      expression of melanotransferrin confirmed that this melanotic neuroectodermal
      tumor was derived from neural crest cells.

PMID- 7782834
TI  - Metachronous ovarian dysgerminoma after a suprasellar germ-cell tumor treated by
      radiation therapy. Case report.
AB  - A case of suprasellar germ-cell tumor in a 9-year-old girl who later developed
      ovarian dysgerminoma is reported. The clinical course of the case is described
      and a double-primary tumor, rather than metastasis from either tumor to the
      other, is suggested by the authors to explain the oncogenesis in this patient.
      The authors strongly encourage that patients with intracranial germinoma be
      examined for associated extraneural lesions before, as well as after, the
      completion of the initial therapy.

PMID- 7782835
TI  - Radiation-induced gliosarcoma. Case report and review of the literature.
AB  - A 13-year-old boy presented with a cerebral gliosarcoma 12 years after having
      acute lymphoblastic leukemia treated by chemotherapy and central nervous system
      prophylaxis treated by radiation therapy (24 Gy) and intrathecal methotrexate. A
      review of the literature disclosed 129 possible radiation-induced gliomatous
      and/or sarcomatous brain tumors: namely, 89 gliomas, 36 sarcomas, and four
      gliosarcomas, including the present case. An analysis of these cases revealed
      several characteristics that differentiate them from similar spontaneous brain
      tumors, thus providing arguments for the carcinogenic effect of radiation therapy
      on intracranial tumors.

PMID- 7782836
TI  - Functional thalamic depression in a case of reversible central pain due to a
      spinal intramedullary cyst. Case report.
AB  - In this report the authors discuss a case of central pain of spinal cord origin
      due to a spinal thoracic intramedullary cyst. Single-photon emission computerized
      tomography with technetium-99m hexamethylpropyleneamineoxime showed thalamic
      hypoperfusion contralateral to the affected leg. Surgical evacuation resulted in
      total relief of the pain and normalization of the thalamic alteration. The reader
      can infer from these findings that functional alterations in thalamic processing
      may be important in the genesis of central pain.

PMID- 7782837
TI  - Symptomatic cerebellar metastasis and late local recurrence of a cauda equina
      paraganglioma. Case report.
AB  - This case report contains a description of a 61-year-old patient who presented
      with a progressive truncal ataxia 22 years after complete removal of a small
      paraganglioma of the cauda equina. Magnetic resonance imaging of the neuraxis
      revealed a large cystic lesion in the cerebellar midline, three small cortical-to
      subcortical nodular tumors in the posterior fossa, and local recurrences of the
      paraganglioma of the cauda equina. Pathological examination showed the cerebellar
      midline lesion to be a paraganglioma, most likely a metastasis from the cauda
      equina localization.

PMID- 7782839
TI  - Crossroads at Salerno: Eldridge Campbell and the writings of Theodorico
      Borgognoni on wound healing.
AB  - During Eldridge Campbell's tour of duty as the neurosurgical consultant to the
      Mediterranean theater of World War II operations, he was introduced to a then
      revolutionary method of wound treatment. Ironically, Campbell's diligent research
      efforts later revealed that this method of wound treatment had first been
      advocated seven centuries earlier--in the same geographical location--by the
      Italian surgeon Theodoric. Although controversial, this method of wound care was
      subsequently applied and supported by Theodoric's outspoken pupil, Henri de
      Mondeville, despite intense opposition from the prevailing medical authorities
      who supported the doctrine of "laudable pus" for wound management. With
      Mondeville's death, Theodoric's technique lapsed into obscurity, relegated to a
      historical footnote until modern biology and the discoveries of Lister and
      Pasteur would again bring to light the benefits of nonsuppurative wound
      treatment. In this article the author discusses the work of Theodoric,
      Mondeville, and Campbell in light of the medical climate of their times and
      explores the contemporary parallels noted by Campbell in terms of the neglect of
      other, more recent medical discoveries. These examples encourage us to accept or
      reject medical treatments based on a thorough examination of their efficacy and
      not on the stature of their advocates within the medical community.

PMID- 7782841
TI  - Right-angle clip applier.

PMID- 7782838
TI  - Histologically verified cerebral aneurysm formation secondary to embolism from
      cardiac myxoma. Case report.
AB  - Multiple aneurysm formation secondary to an embolism from the cardiac myxoma is a
      well-known phenomenon. The cerebral arterial aneurysm formation process involved
      remains to be elucidated, although occupation of the arterial wall by tumor cells
      has been proven histologically. The authors present the case of a patient in whom
      tumor cells in the aneurysm wall were demonstrated and penetration of viable
      myxoma cells into the wall was also observed 19 months after surgical removal of
      the cardiac tumor. Such findings have never before been verified histologically.
      In light of the histological findings, the authors discuss the therapeutic
      problems associated with cerebral aneurysms resulting from cardiac myxoma.

PMID- 7782840
TI  - Relationship of intraoperative electrophysiological criteria to outcome after
      selective functional posterior rhizotomy.
AB  - At British Columbia's Children's Hospital, the criteria used in selective
      functional posterior rhizotomy (SFPR) evolved in three distinct phases. In Phase
      1 the electrophysiological criteria for abnormality included a low threshold to a
      single stimulation, a sustained response to 50-Hz stimulation, and spread outside
      the segmental level being stimulated. In Phase 2 the electrophysiological
      criteria were unchanged, but fewer L3-4 nerve roots were cut. In Phase 3, fewer
      L3-4 nerve roots were cut, as in Phase 2, but based on the results of posterior
      nerve root stimulation in nonspastic controls, the only electrophysiological
      criterion used was contralateral and suprasegmental spread. The present study
      examined the relationship between the criteria used in each phase and patient
      outcome. The records of 77 consecutive children who underwent SFPR and had a
      minimum follow-up period of 1 year were reviewed, comprising 25, 19, and 33
      patients in Phases 1, 2, and 3, respectively. Outcome parameters included
      quantitative assessments of lower-limb spasticity and range of motion, and
      qualitative assessments of lower-limb function. In Phase 3, 52% of the nerve
      roots were cut, compared to 66% in Phases 1 and 2. In all three phases there was
      a significant decrease in lower-limb spasticity and an increase in range of
      movement, with the smallest decrease in spasticity in Phase 3. Over 90% of
      children in each phase improved with respect to lower-limb function, and
      excluding independent walkers and quadriplegics confined to a wheelchair,
      improvement in the level of ambulation occurred in 87.5%, 71.4%, and 73.7% of
      patients, in Phases 1, 2, and 3, respectively.

PMID- 7782842
TI  - Microvascular decompression for trigeminal neuralgia.

PMID- 7782843
TI  - Compliments to NIH.

PMID- 7782844
TI  - Terminal syringomyelia and anorectal anomalies.

PMID- 7782845
TI  - Measurement of exercise tolerance on the treadmill in patients with symptomatic
      lumbar spinal stenosis: a useful indicator of functional status and surgical
      outcome.
AB  - A prospective study of patients with neurogenic claudication and lumbar spinal
      stenosis was undertaken to determine whether measurement of exercise tolerance on
      the treadmill would be useful in defining baseline functional status and response
      to surgical treatment. Twenty patients with an average age of 73 years, all of
      whom had intractable neurogenic claudication and radiographically confirmed
      severe lumbar spinal stenosis, were studied. Lumbar decompressive laminectomy was
      performed in all patients. Preoperatively and 2 months postoperatively,
      quantitative assessment of ambulation was conducted on a treadmill at 0 degree
      ramp incline at two different speeds: 1.2 mph and the patient's preferred walking
      speed. The following information was recorded: time to first symptoms, time to
      severe symptoms, and nature of symptoms (leg pain, back pain, or generalized
      fatigue). The examination was stopped after 15 minutes or at the onset of severe
      symptoms. In the preoperative 1.2-mph trial, the mean time to first symptoms was
      2.68 minutes (median 1.31) and the mean time to severe symptoms was 5.47 minutes
      (median 3.42). In the postoperative trial at the same speed, 13 patients (65%)
      were able to walk symptom free for 15 minutes. The mean time to first symptoms
      was 11.12 minutes (median 15) and the mean time to severe symptoms was 11.81
      minutes (median 15). Similar findings were recorded in the preferred walking
      speed trials. There were no complications from the treadmill testing procedure.
      These findings indicate that exercise stress testing on a treadmill is a safe,
      easily administered, and quantifiable means of assessing baseline functional
      status and outcome following laminectomy in patients with symptomatic lumbar
      spinal stenosis.

PMID- 7782846
TI  - Long-term follow up of 57 patients undergoing automated percutaneous discectomy.
AB  - Automated percutaneous discectomy has been performed in 57 patients at the
      author's institution since 1989, representing 4% of all lumbar spine surgeries.
      All 57 patients had unilateral sciatica. There were 33 women and 24 men ranging
      from 24 to 49 years of age, with a mean age of 45 years. All patients underwent
      computerized tomography (CT) in the prone position and CT and magnetic resonance
      imaging in the supine position. Diffuse versus eccentric disc bulging was
      determined for each patient. Four patients underwent surgery at the L3-4 level,
      four at L5-S1, and 49 at L4-5. One L5-S1 case could not be cannulated and surgery
      was aborted. There have been no complications related to surgery. Fifty patients
      (88%) stated they had reduced sciatica in the first 2 postoperative weeks. Forty
      (70%) had reduced sciatica 2 months postoperatively. The mean follow-up period
      was 27 months (range 6 to 45 months), with no patient lost to follow up. At their
      last follow-up examination, 33 patients (58%) showed improvement in their
      sciatica but only three (5%) were completely pain free. Of the 17 recurrences of
      sciatica, 11 patients have undergone microdiscectomy, with eight showing
      improvement. Chi-square analysis demonstrated a significantly better chance of
      improvement in patients with discs bulging eccentrically to the side of sciatica
      (p < 0.05) compared to patients with diffusely bulging discs. Automated
      percutaneous discectomy is safe and in selected patients can reduce sciatica, but
      only completely eliminated sciatica in 5% of patients with a follow-up period of
      2.5 years.

PMID- 7782847
TI  - Early treatment of subarachnoid hemorrhage after preventing rerupture of an
      aneurysm.
AB  - Twelve patients with Hunt and Hess neurological Grades III to V underwent
      thrombosis of aneurysms using cellulose acetate polymer within 23 hours of
      aneurysm rupture. On computerized tomography (CT), nine of these patients had
      difuse or localized thick subarachnoid blood clots, two had diffuse thin clots
      and one had intraventricular clots. Immediately after thrombosis, all patients
      were administered tissue plasminogen activator (TPA) through spinal or
      ventricular catheters. The pressure of the lumbar cerebrospinal fluid was
      maintained at 100 to 150 mm H2O. The TPA was given as multiple injections of 2 mg
      on Day 0 and 1 to 2 mg on the following 1 to 2 days. In two patients the second
      injection of TPA was not given because of severe brain damage resulting from the
      initial subarachnoid hemorrhage. Ten patients showed complete clearance of the
      cisternal clot on CT within 72 hours after thrombosis. Seven partially thrombosed
      aneurysms and five multiple aneurysms were clipped during delayed surgery. Only
      one patient experienced mild vasospasm as shown on the follow-up angiogram. Eight
      patients improved clinically and had a good recovery, two had severe disability,
      and two died. Urgent thrombosis of a ruptured aneurysm followed by immediate
      postthrombotic administration of TPA may be a safe and reasonable means of
      preventing vasospasm and improving patient outcome.

PMID- 7782848
TI  - Current implications for the efficacy of noninvasive screening for occult
      intracranial aneurysms in patients with a family history of aneurysms.
AB  - Although the technology exists for accurate noninvasive screening for
      intracranial aneurysms, the efficacy of screening depends on several key
      parameters of the natural history of aneurysms. Recent studies suggest that the
      prevalence of intracranial aneurysms may reach 20% in the subpopulation of
      patients with a family history of these lesions; other key parameters are less
      certain. The authors investigated factors that impact the efficacy of screening
      to establish interim guidelines. Three plausible models for the natural history
      of aneurysms were constructed. For each model the monetary cost of screening and
      the average gain in life expectancy were computed for a range of screening ages
      and prevalence rates. It is shown that the efficacy of screening depends on the
      pattern of aneurysm rupture. If aneurysms develop and rupture rapidly, then
      screening has no benefit. On the other hand, if aneurysms remain at risk for some
      time after formation, then screening may improve average life expectancy
      depending on when it occurs. The authors recommend that patients with a positive
      family history of aneurysms who are 30 years of age or younger be screened. This
      recommendation is based on the belief that the gains attributable to screening,
      assuming a constant rupture rate, outweigh the losses attributable to screening
      using a decreasing rupture rate model.

PMID- 7782849
TI  - A clinical and neuroradiological study of X-linked hydrocephalus in Japan.
AB  - To clarify the clinicopathological features of X-linked hydrocephalus, the
      authors studied 30 affected males from 15 families. In utero ultrasonography,
      performed at 21 to 40 weeks of gestation, revealed 18 fetuses with hydrocephalus.
      Computerized tomography (CT) revealed bilateral enlargement of the lateral
      ventricle with preponderant dilation of the posterior horn. In five patients with
      complete magnetic resonance (MR) imaging data, the most specific finding was
      localized atrophy of the anterior vermian lobe. Other MR imaging findings
      included a large massa intermedia, flat corpora quadrigemina, a small brainstem,
      and diffuse hypoplasia of the cerebral white matter. In all cases, the corpus
      callosum was hypoplastic or aplastic. The aqueduct was patent in four of five
      cases. Asymmetrical reduction of the ventricular size and a rippled ventricular
      wall were characteristic postshunt CT findings. Progressive macrocephaly and
      symptoms due to increased intracranial pressure were ameliorated by the shunt;
      however, the neurological outcome was not improved by shunting. Of 14 patients
      who lived to be between 2 and 18 years of age, all are retarded. These results
      indicate that X-linked hydrocephalus is not a disease of simple ventriculomegaly
      due to aqueduct stenosis alone but involves other complicated central nervous
      system anomalies.

PMID- 7782851
TI  - The anatomy of epileptic auras: focal pathology and surgical outcome.
AB  - An aura is generally understood to be the beginning of a seizure. Yet, following
      successful surgery for intractable epilepsy, patients may have persistent auras
      even though they are otherwise seizure free. Ninety patients with intractable
      seizures and auras underwent resective surgery. Forty-three patients had
      hippocampal sclerosis and 47 had temporal or extratemporal lesions such as glial
      tumors or vascular malformations. The semiology of the auras was found to have
      value in localization but not lateralization of the pathology. Epigastric auras
      as well as gustatory and olfactory auras were significantly more frequent in
      patients with hippocampal sclerosis than in those with temporal or extratemporal
      lesions. Auras of vertigo or dizziness were most frequent in patients with
      extratemporal pathology. There was a significant difference between the pathology
      groups in the efficacy of resection in eliminating the auras. Of the patients
      with hippocampal sclerosis who were rendered seizure free, 18.9% had persistent
      auras, whereas only one (2.6%) of the patients with temporal or extratemporal
      lesions who were rendered seizure free had persistent auras. These findings
      suggest that for patients with hippocampal sclerosis an anatomical dissociation
      between seizure and aura may occur, whereas this dissociation is not present in
      patients with lesions. Patients suspected of having hippocampal sclerosis should
      be counseled preoperatively as to the significant likelihood of persistent auras
      even if seizures are successfully abolished.

PMID- 7782850
TI  - Natural history of intracranial cavernous malformations.
AB  - The authors have reviewed the clinical records of 110 patients with intracranial
      cavernous malformations diagnosed by histological examination and/or magnetic
      resonance imaging over a mean follow-up period of 4.71 years. These cases were
      divided, based on their presentation, into a hemorrhage group, a seizure group,
      and an incidentally diagnosed group. The rate of subsequent symptomatic bleeding
      was investigated in relation to age at onset, sex, and location of the initial
      lesion. A high rate of subsequent symptomatic bleeding episodes was found in the
      hemorrhage group, especially among younger females. The nonhemorrhagic-onset
      cases had a very low incidence of bleeding. The outcome was generally good,
      except in patients with lesions in the basal ganglia and brainstem. These
      findings will be helpful in planning a rational therapeutic strategy for
      intracranial cavernous malformations.

PMID- 7782853
TI  - Electrical stimulation of the trigeminal nerve root for the treatment of chronic
      facial pain.
AB  - Between March 1990 and December 1992, 23 patients with chronic intractable facial
      pain due to various forms of injury to the trigeminal nerve or nerve root
      underwent implantation of an electrical stimulating system to treat their pain.
      All patients had failed previous extensive pain treatment efforts. A monopolar
      platinum-iridium electrode was implanted on the trigeminal nerve root via
      percutaneous puncture of the foramen ovale. All patients experienced at least 50%
      reduction in pain intensity during a period of trial stimulation and underwent
      internalization of the electrode and connection to a completely implanted pulse
      generator. Independent assessment of the effect of stimulation was obtained by a
      specially trained nurse practitioner. Over a mean follow-up period of 24 months,
      six patients reported nearly complete relief of pain and six others reported at
      least a 50% reduction in pain intensity using a visual analog scale. Thus, 12
      (52%) of the 23 patients achieved 50% or greater reduction in pain intensity.
      Although changes in the patterns of analgesic medication usage were few, six
      patients (26%) now experience a normal life style. Only one complication was
      seen, namely a dislocated electrode, which was easily replaced. Chronic
      electrical stimulation of the trigeminal nerve root appears to be an easy and
      safe technique for providing relief of chronic facial pain related to injury to
      the trigeminal nerve in a significant number of patients.

PMID- 7782852
TI  - Low-grade astrocytoma with neuraxis dissemination at diagnosis.
AB  - Little is known about low-grade astrocytoma with neuraxis dissemination at
      diagnosis. A review of medical records identified this phenomenon in eight of 150
      pediatric patients evaluated between 1985 and 1994 for histologically confirmed
      low-grade astrocytoma. These patients (five male and three female) ranged in age
      from 5 months to 20 years (median 8 years). Symptoms of neuraxis disease were
      minimal or absent. Primary tumor sites were the hypothalamus in four cases,
      brainstem/spinal cord in three, and temporal lobe in one. Patterns of
      dissemination (evaluated by computerized tomography and/or magnetic resonance
      imaging techniques) appeared to be related to the primary site: hypothalamic
      tumors metastasized along the ventricular cerebrospinal fluid pathways, and
      tumors in other locations disseminated along subarachnoid pathways. Following
      initial treatment with chemotherapy (in three), partial resection (in one),
      radiation therapy (in three), and chemotherapy plus irradiation (in one), four
      patients required salvage therapy for progressive or recurrent disease. Seven of
      the eight patients are alive with stable or progressive disease 6 to 105 months
      postdiagnosis (median 15 months). Low-grade astrocytoma with initial neuraxis
      dissemination is responsive to chemotherapy and radiation, a proportion showing
      periods of stable disease. The optimum therapy or combination of therapies
      remains unclear.

PMID- 7782854
TI  - Performance of sulfhydryl boron hydride in patients with grade III and IV
      astrocytoma: a basis for boron neutron capture therapy.
AB  - This study investigated the rationale of boron neutron capture therapy (BNCT) for
      the treatment of Grade III and IV astrocytoma. The European Community joint
      research program on BNCT plans to use sulfhydryl boron hydride (BSH) in clinical
      trials. The work presented here, examines the performance of BSH in eight
      patients with Grade III and IV astrocytoma using a measurement technique which
      precisely correlates the boron uptake with the histology of the tumor and the
      peritumoral brain. Astrocytomas are exceptionally heterogeneous and spread
      migrating tumor cells into the surrounding brain. The patients were infused with
      50 mg BSH per kilogram of body weight at 12, 18, 24 or 48 hours before surgery.
      At the time of operation, specimens were obtained of the tumor, skin, muscle,
      dura, blood, urine, and, when surgically possible, the brain adjacent to tumor.
      In three patients the intracellular boron distribution was investigated by
      subcellular fractionation. The blood clearance was biphasic with half-lives of
      0.6 and 8.2 hours. After 3 days, approximately 70% of the dose injected was
      excreted in the urine. The maximum boron concentration in the tumor was 20 ppm,
      12 hours after the infusion. The tumor-to-blood ratios ranged between 0.2 and
      1.4, with the highest values after 18 to 24 hours. In the brain specimens the
      boron concentration never exceeded 1 ppm. This work confirms a selective uptake
      of boron in the tumor compared to the surrounding brain and that boron, to some
      extent, is incorporated in the tumor cells.

PMID- 7782855
TI  - Evidence for segregated pain and temperature conduction within the spinothalamic
      tract.
AB  - The lateral spinothalamic tract, located in the anterolateral quadrant of the
      white matter of the spinal cord, is one of the most important structures in
      transmitting pain within the central nervous system. It has been known for almost
      a century that destruction of fibers in this tract results in analgesia
      contralateral to the lesion. The effectiveness and clinical importance of
      interruption of the lateral spinothalamic tract has been proven in many studies.
      Today cordotomies are still a useful neurosurgical treatment modality, especially
      when pain can no longer be sufficiently controlled by analgesic drugs. Although
      analgesia on the contralateral side is the desired effect, one must also expect
      to cause disturbance in temperature sensation when performing a cordotomy. The
      authors' observations showed that after a cordotomy the dermatome level of
      analgesia can be variable within certain limits, which is in accordance with the
      literature. Surprisingly, however, the loss of temperature sensation may differ
      significantly from the loss of pain sensation. It was also found to be possible
      to perform a successful cordotomy without altering the sensation of temperature
      at all. This indicates that pain and temperature sensations may be conducted via
      separate pathways. Possible mechanisms underlying this phenomenon are discussed.

PMID- 7782859
TI  - Non invasive recording of CO2 cerebrovascular reactivity in normal subjects and
      patients with unilateral internal carotid artery stenosis.
AB  - CO2 cerebrovascular reactivity has been recorded in 12 healthy volunteers and 10
      patients with unilateral > 70% extracranial internal carotid artery (ICA)
      stenosis, using non invasive techniques. The relative changes of middle cerebral
      artery blood flow velocity (VMCA) and velocity waveform pulsatility (PIMCA) after
      that hypocapnia was induced by spontaneous hyperventilation were recorded. 35.5%
      average VMCA reduction and 63% PIMCA increment of basal values was produced in
      healthy subjects after hyperventilation. The percentage variation of CO2
      Reactivity Index (RI), expressed in terms of VMCA (V-RI) and PIMCA (PI-RI), per
      mmHg change in pCO2, presents a good right-left side correlation (r = 0.82 and r
      = 0.83 respectively) in healthy subjects, while a dissociation between V-RI and
      PI-RI was found in our patients. A significant reduction of PI-RI was also
      recorded in the group of patients on the side of ICA stenosis. From our data CO2
      reactivity index recorded in terms of PI seems to allow a better separation
      between pathology and normality, without the need to assume a close relationship
      between velocity and blood flow under the condition considered. Furthermore, PI
      RI seems to be a valid index in the evaluation of some attribute pertaining to
      the distal vascular bed.

PMID- 7782856
TI  - A comparative study on the pharmacokinetics and biodistribution of boronated
      porphyrin (BOPP) and sulfhydryl boron hydride (BSH) in the RG2 rat glioma model.
AB  - Boron neutron capture therapy is a treatment modality for cancer that depends on
      the specific uptake of boron by the tumor cells. The infiltrative growth of
      malignant gliomas requires that boron reach and accumulate in migrating cells
      outside the margin of the tumor; thus, it is important that the biodistribution
      of new boron compounds is also studied in the surrounding healthy brain tissue.
      This study is undertaken in the present work, in which the biodistribution and
      pharmacokinetics of sulfhydryl boron hydride (BSH) and boronated porphyrin (BOPP)
      in the RG2 rat glioma model are investigated. This model mimics the
      characteristics of human glioma with cells migrating into the surrounding brain.
      The animals were infused intravenously with either BSH (25 micrograms or 175
      micrograms of boron per gram of body weight) or BOPP (12 micrograms of boron per
      gram body weight). For the low dose of BSH, the maximum tumor-boron content was 8
      ppm at approximately 9 hours after the infusion with a tumor-to-blood ratio of
      0.6. At the higher dose, the corresponding figures were 15 ppm after 12 hours
      with a tumor-to-blood ratio of 0.5. For BOPP, a tumor-boron concentration of 81
      ppm was achieved 24 hours after the infusion and sustained in that range for at
      least 72 hours. The tumor-to-blood ratio at 24 hours was slightly above 6, but
      continued to increase as the blood was cleared. These results indicate that both
      compounds are spread into the normal brain tissue following the same pathways as
      the migrating tumor cells and in this way can be taken up even in distant tumor
      cell foci.

PMID- 7782860
TI  - Primary optic nerve sheath meningiomas. Report of seven cases (clinical
      neuroradiological, pathological and surgical considerations in seven cases).
AB  - Between 1985 and 1993, we treated seven cases of optic nerve sheath meningiomas.
      The median age at onset of their symptoms was 42.14 years. All of the patients
      were aged between 27 and 60 females with a slowly progressive lesion. Computed
      tomography and/or magnetic resonance imaging were used as diagnostic procedure in
      our cases. We operated on using microsurgical techniques in all of these cases.
      Vision was preserved in the three of our cases. The definitive treatment for
      these lesions is surgical resection, although no single best plan for optimal
      management has been determined. The data indicate that only small anterior tumors
      may be removed with preservation of useful vision. With posterior circumferential
      tumors, there have been no cases of tumor removal with preservation of vision. A
      management strategy directed toward preservation of vision is discussed.

PMID- 7782858
TI  - Attenuation of postischemic brain hypoperfusion and reperfusion injury by the
      cyclooxygenase-lipoxygenase inhibitor BW755C.
AB  - Arachidonic acid metabolites are believed to be important mediators of tissue
      injury during reperfusion after cerebral ischemia. To determine whether
      inhibiting the oxygen-dependent metabolism of arachidonic acid would reduce
      reperfusion injury, we administered the mixed cyclooxygenase-lipoxygenase
      inhibitor BW755C (3-amino-1-[m(trifluoromethyl)phenyl]-2-pyrazoline) near the
      time of reperfusion in a rat model of temporary focal ischemia. The duration of
      ischemia + reperfusion was 2 hours + 22 hours, 3 hours + 3 hours, or 3 hours + 21
      hours. The effects of drug or saline treatment on infarct volume, blood-brain
      barrier permeability, and blood flow were determined. Cortical blood flow was
      monitored with laser Doppler flowmetry and blood-brain barrier permeability was
      evaluated by the Evans blue dye method. Infarct volume was determined in all
      groups by computerized image analysis of Nissl-stained sections. We found that
      BW755C treatment significantly attenuated delayed postischemic hypoperfusion in
      the 3 + 3 group (p < 0.05) and reduced the volume of Evans blue dye staining in
      the cortex (p < 0.01) and basal ganglia (p < 0.05). Hemispheric swelling was
      reduced in all treatment groups (p < 0.01), as was total infarct volume in the
      ischemic hemisphere (p < 0.05). These results support the hypothesis that
      arachidonic acid metabolites contribute to acute postischemic reperfusion injury
      and suggest that using a mixed cyclooxygenase-lipoxygenase inhibitor as an
      adjunct to thrombolytic or revascularization therapy could lengthen the ischemia
      time after which reperfusion is beneficial.

PMID- 7782857
TI  - Use of mild intraischemic hypothermia versus mannitol to reduce infarct size
      after temporary middle cerebral artery occlusion in rats.
AB  - To determine which of two treatments for reducing ischemic injury after temporal
      focal ischemia is more effective, the effects of mild (33 degrees C)
      intraischemic hypothermia were compared with those of mannitol, the most commonly
      used neuroprotective agent. Four groups of Sprague-Dawley rats underwent 1 hour
      of endovascular middle cerebral artery occlusion followed by 23 hours of
      normothermic reperfusion. The four experimental groups were as follows: Group A,
      saline control; Group B, mannitol (25%, 1 g/kg); Group C, hypothermia; and Group
      D, hypothermia plus man-nitol. Laser-Doppler estimates of cortical blood flow
      showed that hypothermia did not affect blood flow during ischemia or reperfusion.
      Mannitol increased cortical blood flow during ischemia and reperfusion under both
      normothermic and hypothermic conditions (p < 0.05). Neurological deficit was
      significantly less severe in treated rats (Group B, p < 0.05; Group C or D, p <
      0.01) than in controls (Group A). Infarct volume, measured on semiserial Nissl
      stained sections, was significantly smaller in treated rats (p < 0.01) than in
      controls. Infarct volume was also significantly smaller in rats treated with
      hypothermia than in those treated with mannitol (Group C vs. Group B, p < 0.05);
      there was no difference between rats treated with mannitol and those treated with
      mannitol and hypothermia. All three treatments reduced infarct area in the
      ischemic penumbra; hypothermia with or without mannitol also reduced infarct area
      in the ischemic core. These results demonstrate that both mild intraischemic
      hypothermia and mannitol reduce infarct size and neurological deficit:
      hypothermia reduces infarct size more effectively than mannitol, and mannitol
      adds no significant protection to hypothermia, whereas hypothermia adds
      significant protection beyond that afforded by mannitol after brief focal
      ischemia followed by reperfusion in rats. The results suggest that mild
      intraischemic hypothermia alone, or in combination with mannitol, may be useful
      in avoiding ischemic injury from temporary vessel occlusion during
      cerebrovascular surgery.

PMID- 7782861
TI  - Cerebrospinal fluid shunt infections.
AB  - Cerebrospinal fluid (CSF) shunt infection is one of the most frequent and
      disabling complications. We reviewed the records of 306 patients who underwent
      CSF shunt surgery from 1983 through 1992. Six hundred and twelve procedures were
      performed in these 306 patients. Infection occurred following 46 of the
      procedures for an infection rate of 7.5% per procedure. The 46 infections
      involved 39 patients. There were 8 recurrent infections. The infection rate per
      child was 12.7%. Staphylococcal species were isolated in 50% of all infections.
      Patients younger than 1 year old and children with multiple revisions have a
      greater risk of infection than those of older. Myelomeningocele and meningitis
      had higher infection rate among other etiologies. Patients with multiple
      revisions had higher infection rate than those with single revision or none. The
      incidence of infection was higher in cyst-peritoneal shunts than both ventriculo
      atrial and ventriculo-peritoneal shunts. Mortality was high in Gram negative
      infections.

PMID- 7782862
TI  - Intraventricular pneumocephalus after posterior fossa and CSF shunting surgery.
      Case report.
AB  - The authors report a case of tension intraventricular pneumocephalus developed
      six months after the removal of an acoustic neuroma and a CSF
      ventriculoperitoneal shunt procedure due to a concomitant hydrocephalus. A review
      of the literature show only 19 cases of CSF shunt complicating pneumocephalus.
      The authors discuss both about the etiology of pneumocephalus and its therapeutic
      options. In our case we were unable to preoperatively localize the cranial base
      communication allowing intracranial air antry. The literature show however that
      eroded or thinned bone areas may be multiple and even diffuse their development
      depending upon several factors. We suggest in these cases a direct surgical
      repair through a craniotomy, as reported by others, is not mandatory. According
      to the etiology of pneumocephalus a temporary extraventricular drainage and the
      revision of the shunting pressure regimen may represent an effective treatment of
      this complication.

PMID- 7782863
TI  - Spinal epidermoid cysts without congenital anomalies associated. Report of two
      cases.
AB  - MR findings in two patients with intradural spinal epidermoid tumors without
      spinal anomalies are reported. In one case this tumor was congenital, the other
      one was considered iatrogenic. Origin and MR characteristics of this lesion are
      discussed.

PMID- 7782864
TI  - Bilateral traumatic abducens nerve palsy. Case report.
AB  - Bilateral traumatic abducens nerve palsy after head injury is a rare event. We
      present a case associated with skull fractures and intracranial hematoma, with
      complete recovery of abducens nerve palsy after six months. The mechanism of the
      lesion, the clinical conditions and the radiological findings are presented.

PMID- 7782865
TI  - Neurinoma of the cauda equina misdiagnosed as prolapsed lumbar disk. Report of
      three cases.
AB  - The authors report three cases of neurinoma of the cauda equina initially
      misdiagnosed as prolapsed lumbar disk. Computed Tomography failed to reveal the
      tumour, while showing evidence of disk-degenerative patology and being thus
      misleading. Similar cases are reported in literature. After a thorough analysis
      of the causes of such an apparently gross error, it is concluded that the main
      source of pitfalls arises from neglecting those typical clinical features
      differentiating prolapsed disk from oncogenetic sciatica. When oncogenetic
      sciatica is suspected Computed Tomography is inappropriate and even misleading,
      while the elective investigation is Magnetic Resonance.

PMID- 7782866
TI  - Intramedullary spinal neurinoma: case report and review of 46 cases.
AB  - A case of intramedullary neurinoma of the cervical spinal cord in a patient with
      no sign of von Recklinghausen's disease is reported. This case was diagnosed by
      computed tomography and magnetic resonance imaging and treated surgically. The
      literature covering 46 other cases is reviewed. The discussion, examines the
      possible etiology, the role of diagnostic procedures and the difficulties of the
      surgical treatment of these tumors.

PMID- 7782867
TI  - Intramedullary spinal cord metastasis. Case report.
AB  - The authors report a case of intramedullary spinal cord tumor in a 52-years old
      woman operated, 5 years before the beginning of medullary syndrome, for mammary
      carcinoma. Intramedullary metastasis was associated to another secondary
      localization in the pituitary stalk. The importance of magnetic resonance image
      and aggressive treatment is stressed.

PMID- 7782868
TI  - Spontaneous spinal subdural hematoma.
AB  - A case of spontaneous spinal subdural hematoma is reported. Clinical signs at
      onset, laboratory investigations and bloody CSF at lumbar punction were
      suggesting of subarachnoid hemorrhage. MRI was fully diagnostic. Surgery was
      ruled out and spinal compression cleared spontaneously over one week. Etiological
      factors, possible diagnostic pittfalls and the indication surgical decompression
      are discussed.

PMID- 7782869
TI  - Helping our international colleagues.

PMID- 7782870
TI  - Motivational orientations of urban- and rural-based RNs: implications for staff
      development educators.
AB  - Part of professional development is influencing RNs to return for an
      undergraduate degree, a challenge for the staff development educator. Expanding
      on earlier research using Boshier's Educational Participation Scale to reveal
      motivational orientations, the authors queried 5 groups of RNs who were enrolled
      in BSN education between 1990 and 1992 (N = 235) and living in rural and urban
      areas of Texas. There were no significant differences of overall motivational
      orientations, yet RN students living in rural areas scored higher in professional
      knowledge (P = 0.03) whereas urban-based RN students scored higher in compliance
      with authority (P = 0.02). Specific marketing and educational strategies are
      discussed.

PMID- 7782871
TI  - A collaborative model for research development and utilization: process,
      structure, and outcomes.
AB  - Nursing research development has long been viewed by practicing nurses as an
      activity for those in academia with the "thinking time" and resources to support
      scientific investigation. This view is being challenged by nurses in one hospital
      and its affiliated university. They are setting the pace for research activities
      by establishing a consortium to enhance collaborative research development and
      utilization. The author describes the model and how its goals have been
      operationalized through establishing an innovative collaborative structure.
      Suggestions for implementing such programs are described. Programmatic outcomes
      achieved in the first 3 years are also described.

PMID- 7782872
TI  - The impact of teacher characteristics on teaching.
AB  - A great deal has been written about the impact of positive characteristics on
      success in teaching. But what of negative characteristics? How might these have
      an impact on teaching? This question is explored in this article. The answer to
      this question can help staff development and inservice educators increase
      awareness of the hidden influences on teaching.

PMID- 7782874
TI  - Implementing the Performance Based Development System (PBDS) at Naval Medical
      Center San Diego.
AB  - Competency-based performance development is an educational tool that assesses the
      knowledge and skill base of an RN to enable staff development personnel to
      formulate orientation and training specific to that individual's learning needs.
      Theoretically, competency-based performance development is a time-efficient
      method for orientation. Recent healthcare reform, budgetary constraints, and
      downsizing have also affected the military. The stimulus, rationale, and
      obstacles experienced in implementation of this program in the military are
      common to all staff development educators.

PMID- 7782873
TI  - Professional autonomy: a pilot study to determine the effects of a professional
      development program on nurses' attitudes.
AB  - In this article, the authors describe a pilot study conducted to evaluate a
      component of a professional development program designed for Clinical Nurses in a
      general teaching hospital. Permission was obtained to use an established
      instrument for measuring attitude toward professional autonomy. A non equivalent
      pre-test/post-test, control group design was used. Results indicate that the
      program was influential in changing nurses' attitudes toward autonomy.
      Implications of using an instrument designed for an American cohort of nurses and
      modified to depict an Australian nursing culture are discussed.

PMID- 7782875
TI  - The preceptor experience: a qualitative study of perceptions of nurse preceptors
      regarding the preceptor role.
AB  - This qualitative, exploratory, and descriptive survey was undertaken to identify
      benefits and disadvantages of the preceptor role as perceived by nurse
      preceptors. Information regarding rewards preceptors perceived as desirable also
      was obtained. Findings from this study can be used to develop preceptor programs
      that increase job satisfaction for preceptors and improve the learning
      environment for orientees.

PMID- 7782876
TI  - How to develop a staff development indicator.
AB  - In this article, the author describes a step-by-step approach to generating staff
      development indicators, as well as examples of the evolving indicator during the
      development process. Quality improvement indicators are necessary, not only for
      patient care activities, but also for service activities related to patient care.
      Staff development is one such service.

PMID- 7782878
TI  - The impact of computer anxiety and computer resistance on the use of computer
      technology by nurses.

PMID- 7782879
TI  - Who teaches the teachers?

PMID- 7782880
TI  - Rapid, high-stakes decisions amid frantic innovation.

PMID- 7782877
TI  - The role of staff development in creating a research-based practice environment.

PMID- 7782882
TI  - Senior nursing students' self-reported college experiences and gains toward
      liberal education goals.
AB  - The purpose of this descriptive study is to assess baccalaureate nursing
      students' self-reported achievements toward liberal education goals in college
      and university settings and compare them to norms for the general college
      population by measuring their perceived involvement in campus life and
      activities. At the end of the spring semester, senior nursing students from 11
      nursing programs in the Midwest filled out the College Student Experience
      Questionnaire, developed by Pace (1984), which measures the effort students put
      into liberal education goals. Nursing students reported high involvement in
      academic activities, but little involvement in other types of experiences in the
      college; they reported significant progress toward academic goals like
      intellectual skills, but less progress toward liberal education goals like art,
      literature, and music. Nursing students were very similar to other college
      students (except for students in selective liberal arts colleges) in reported
      involvement in activities and made similar progress toward liberal education
      goals.

PMID- 7782881
TI  - Knowledge-driven problem-solving models in nursing education.
AB  - This paper compares the hypothetico-deductive model of clinical problem solving
      commonly used in current nurse education and practice with the knowledge-driven
      problem-solving model (Bordage, Grant, & Marsden, 1990). It is argued that the
      knowledge-driven model provides a more complete account of the processes involved
      in clinical problem solving. The knowledge-driven model emphasizes the
      organization and availability of relevant content knowledge stored in memory as
      the prime determinant of clinical problem solving. This contention is discussed
      in relation to the development of a clinical problem-solving task for nursing
      students and its implications for nursing curricula.

PMID- 7782883
TI  - International nurses' experiences seeking graduate education in the United
      States.
AB  - Nurses from many countries in the world continue to seek further education in the
      U.S. every year. This study examined their experiences (N = 83) and those of the
      host institutions (N = 35) in the U.S. regarding the difficulties each
      experienced in coping with unfamiliar curricula and cultural mores, as well as
      financial constraints.

PMID- 7782884
TI  - Reflective practice: a focus for caring.
AB  - Nurse education has long been plagued by a perceived disjuncture between theory
      and practice. This paper explores the use of reflection as a mechanism to enable
      students of nursing to overcome this problem. A grounded theory approach is used
      to study a group of first-year students undertaking a 3-year undergraduate
      nursing course. Results of the study indicate that the use of the reflective
      processes of clinical debriefing and journaling does impact on the environment,
      the process, and the focus of learning. Anxiety associated with the learning
      environment was reduced through peer support and cooperation. In addition,
      students moved from a passive to a more active mode of learning. The most
      significant finding was that, over time, reflective processes resulted in the
      emergence of the client as the central focus of care.

PMID- 7782885
TI  - Scholarly productivity levels of nursing faculty in a geriatrics education
      program.

PMID- 7782887
TI  - Professional role development in baccalaureate nursing education.

PMID- 7782886
TI  - Effect of an HIV/AIDS elective on nursing students' knowledge and comfort levels
      in providing care to PWAs.

PMID- 7782889
TI  - Development of an essential health pattern assessment tool for associate degree
      nursing students.

PMID- 7782888
TI  - Professional Nursing Student Retention Program.

PMID- 7782890
TI  - Teaching cultural sensitivity.

PMID- 7782891
TI  - Study groups among nursing students.

PMID- 7782892
TI  - Dietary modulation of the human colonic microbiota: introducing the concept of
      prebiotics.
AB  - Because the human gut microbiota can play a major role in host health, there is
      currently some interest in the manipulation of the composition of the gut flora
      towards a potentially more remedial community. Attempts have been made to
      increase bacterial groups such as Bifidobacterium and Lactobacillus that are
      perceived as exerting health-promoting properties. Probiotics, defined as
      microbial food supplements that beneficially affect the host by improving its
      intestinal microbial balance, have been used to change the composition of colonic
      microbiota. However, such changes may be transient, and the implantation of
      exogenous bacteria therefore becomes limited. In contrast, prebiotics are
      nondigestible food ingredients that beneficially affect the host by selectively
      stimulating the growth and/or activity of one or a limited number of bacterial
      species already resident in the colon, and thus attempt to improve host health.
      Intake of prebiotics can significantly modulate the colonic microbiota by
      increasing the number of specific bacteria and thus changing the composition of
      the microbiota. Nondigestible oligosaccharides in general, and
      fructooligosaccharides in particular, are prebiotics. They have been shown to
      stimulate the growth of endogenous bifidobacteria, which, after a short feeding
      period, become predominant in human feces. Moreover, these prebiotics modulate
      lipid metabolism, most likely via fermentation products. By combining the
      rationale of pro- and prebiotics, the concept of synbiotics is proposed to
      characterize some colonic foods with interesting nutritional properties that make
      these compounds candidates for classification as health-enhancing functional food
      ingredients.

PMID- 7782893
TI  - Dietary nucleotides accelerate intestinal recovery after food deprivation in old
      rats.
AB  - Previous studies in very young rats have shown that dietary nucleotides improve
      small intestine repair after injury or malnutrition. To investigate the potential
      effect of nucleotides in old rats, which have a diminished capability for
      intestinal repair, 17-mo-old rats were deprived of food for 5 d and then fed a
      nucleotide-free diet or a nucleotide-supplemented diet for 3 or 6 d. Intestinal
      jejunal and ileal mucosal weight, protein and DNA were evaluated as intestinal
      growth markers, and brush-border maltase, sucrase, lactase and aminopeptidase
      activities were evaluated as intestinal differentiation markers. The adenine
      nucleotide pool and the adenylate energy charge were also evaluated as indices of
      nucleotide availability. Food deprivation significantly decreased mucosal growth
      markers as well as differentiation markers in both jejunum and ileum. The ATP
      pool was also significantly depressed, but the adenylate energy charge was not
      significantly altered. To a certain extent, refeeding restored the losses, but in
      the rats that were fed the nucleotide-free diet, the restoration of the jejunum
      was significantly slower and the restoration of the ileum differentiation markers
      was incomplete compared with the rats fed the nucleotide-supplemented diet. The
      results suggest that dietary nucleotide intake in the elderly may accelerate the
      normal physiological intestinal response to refeeding after food deprivation.

PMID- 7782894
TI  - Deficiency of vitamin E and selenium enhances calcium-independent phospholipase
      A2 activity in rat lung and liver.
AB  - Conditions promoting oxidative stress, which is implicated in many diseases,
      activate phospholipases A2, a family of enzymes central to phospholipid
      metabolism and signal transduction. Little is known about isozyme specificity
      with respect to this activation process. Accordingly, a dietary deficiency model
      known to induce oxidative stress was used to investigate phospholipase A2 isozyme
      activity in rat tissues. Long-Evans hooded rats were fed purified diets for 6 wk
      with or without the addition of vitamin E and selenium in a 2 x 2 factorial
      design. Phospholipase A2 activity was assessed in lung, liver, kidney and heart
      cytosol and microsomes in the presence (5 mmol/L CaCl2) or absence (5 mmol/L
      EGTA) of calcium with dipalmitoylphosphatidylcholine at pH 6.5. Lung
      phospholipase A2 activity was also assessed with 1-stearoyl-2
      arachidonoylphosphatidylcholine as substrate at pH 8.5. Organ samples from rats
      deficient in both nutrients showed two- to tenfold higher calcium-independent
      phospholipase A2 activity in lung cytosol and microsomes, and in liver cytosol
      compared with samples from control and single nutrient-deficient rats. In
      contrast, the calcium-dependent activity was affected only slightly. The
      malondialdehyde concentration of the organs was measured and the pattern obtained
      mirrored that of enhanced phospholipase A2 activity for lung but not for liver.
      The enhanced phospholipase A2 activity in the lung cytosol and microsomes from
      rats deficient in both nutrients was partially blocked by p-bromophenacylbromide,
      further enhanced by dithiothreitol and unaffected by treatment with
      diisopropylfluorophosphate. These results suggest that deficiency of both vitamin
      E and selenium activates and/or induces unique calcium-independent forms of
      phospholipase A2 markedly in rat lung, and to a lesser extent in liver.

PMID- 7782895
TI  - Amylopectin starch promotes the development of insulin resistance in rats.
AB  - Starches that are high in amylopectin are digested and absorbed more quickly than
      starches with a high amylose content and produce larger postprandial glucose and
      insulin responses. The aim of this study was to test the hypothesis that feeding
      rats a diet containing quickly digested starch could promote insulin resistance.
      Sprague-Dawley rats were fed either a high amylopectin or high amylose diet (two
      10-g meals per day), and insulin sensitivity was assessed after 9 wk by
      intravenous glucose tolerance test (IVGTT). In the rats fed the high amylopectin
      diet, glucose tolerance was significantly lower (P < 0.05) and the insulin
      response to IVGTT was twice as high as in rats fed the high amylose diet (P <
      0.05). A second study using Wistar rats investigated the time course of these
      changes. Differences in the insulin response to the IVGTT were not evident at 4
      wk but began to emerge at 8 wk, and by 12 wk the insulin response was 100%
      greater in rats fed the high amylopectin diet (P < 0.05) than in those fed the
      high amylose diet. In addition, basal plasma insulin concentration was higher in
      rats fed the high amylopectin diet (P < 0.05). There were no differences,
      however, in glucose tolerance at any time point. The results suggests that
      quickly digested starch promotes the development of insulin resistance in rats.
      The relatively slow time course resembles the normal development of insulin
      resistance in humans.

PMID- 7782896
TI  - Glutathione peroxidase and phospholipid hydroperoxide glutathione peroxidase are
      differentially regulated in rats by dietary selenium.
AB  - Phospholipid hydroperoxide glutathione peroxidase (PHGPX) and classical
      glutathione peroxidase (GPX1) are encoded by separate genes with only about 40%
      amino acid and nucleic acid sequence identity. To determine the response of
      tissue PHGPX expression to dietary Se level and to compare these responses with
      those for GPX1, weanling male rats were fed amino acid diets containing from 2 (
      Se) to 130 (+Se) microgram Se/kg diet or a torula diet containing 5 and 190
      micrograms Se/kg diet as Na2SeO3 for 28 d. Tissues were analyzed for PHGPX and
      GPX1 activity and mRNA. There was no effect of Se on growth. In -Se rats, GPX1
      activity was reduced to 1% in liver and 4-9% in heart, kidney and lung compared
      with +Se rats; PHGPX activity was reduced only to 25-50% in these four tissues.
      The Se response curves indicated that the dietary Se requirement to reach plateau
      liver PHGPX activity was half that required for plateau GPX activity. In -Se
      rats, liver and heart GPX1 mRNA levels were reduced to 6 and 12%, respectively,
      whereas PHGPX mRNA was not significantly affected by Se deficiency. Notably, 65
      micrograms Se/kg diet resulted in plateau liver GPX1 mRNA levels but not plateau
      GPX activity. Testis had the lowest GPX activity and GPX1 mRNA of all tissues
      examined, but had 15-fold higher PHGPX activity and 45-fold higher PHGPX mRNA
      levels when compared with liver. There was no significant effect of dietary Se on
      testis GPX1 and PHGPX mRNA levels. This study demonstrates that these two
      selenoperoxidases are differentially regulated by dietary Se.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7782897
TI  - Copper deficiency alters rat peptidylglycine alpha-amidating monooxygenase
      activity.
AB  - Perinatal copper deficiency was studied in 1-mo-old female and male Sprague
      Dawley rat offspring to investigate changes in cuproenzymes. Offspring of dams
      given the low Cu treatment beginning at d 7 of gestation exhibited signs
      characteristic of Cu deficiency, including a 90% reduction in liver Cu levels
      compared with Cu-adequate controls. Compared with Cu-adequate rats, Cu-deficient
      rats had lower activities of the cuproenzymes peptidylglycine alpha-amidating
      monooxygenase (PAM), cytochrome c oxidase (CCO), and Cu,Zn-superoxide dismutase
      (SOD) in heart and midbrain samples. Activity of dopamine-beta-monooxygenase
      (DBM) was higher in midbrain and lower in heart samples from Cu-deficient
      compared with Cu-adequate rats. Following 1 mo of Cu repletion, PAM and CCO
      activity were still lower in heart of Cu-replete rats. Midbrain DBM activity was
      still elevated in the former Cu-deficient males. A second study was conducted
      using weanling male Holtzman rats. After 5.5 wk of treatment, Cu-deficient rats
      had signs characteristic of Cu deficiency and lower PAM, CCO and DBM activities
      in heart but not midbrain as compared with Cu-adequate rats. The PAM activity was
      lower following Cu deficiency. Perhaps neuropeptide maturation is compromised by
      Cu deficiency.

PMID- 7782898
TI  - Large supplements of nicotinic acid and nicotinamide increase tissue NAD+ and
      poly(ADP-ribose) levels but do not affect diethylnitrosamine-induced altered
      hepatic foci in Fischer-344 rats.
AB  - Poly(ADP-ribose) is a homopolymer of ADP-ribose units synthesized from NAD+ on
      nuclear acceptor proteins and is known to be involved in DNA repair. It is not
      known whether large oral doses of the clinically utilized NAD precursors
      nicotinic acid or nicotinamide affect poly(ADP-ribose) metabolism or the cellular
      response to DNA damage. In our first study, using Fischer-344 rats, 2 wk of
      dietary nicotinic acid supplementation (500 and 1000 mg/kg diet) caused elevated
      levels of NAD+ in the blood, liver, heart and kidney, while nicotinamide caused
      elevated levels only in the blood and liver, compared with controls fed a diet
      containing 30 mg/kg nicotinic acid. Both nicotinic acid and nicotinamide, at 1000
      mg/kg diet, caused elevations in liver NAD+, by 44 and 43%, respectively. Only
      nicotinamide, however, elevated liver poly(ADP-ribose) (63% higher than control
      group). Following treatment with the hepatocarcinogen diethylnitrosamine, higher
      levels of hepatic NAD+ were observed in rats fed both nicotinic acid and
      nicotinamide at 1000 mg/kg diet, but only nicotinic acid supplementation caused a
      greater accumulation of hepatic poly(ADP-ribose) (61% higher than control group).
      Neither of the dietary treatments significantly affected the proportion of the
      liver occupied by placental glutathione-S-transferase positive foci. These
      results show that poly(ADP-ribose) synthesis is not directly responsive to
      hepatic NAD+ levels during niacin supplementation, and that the mechanisms of
      action of nicotinic acid and nicotinamide are different. The observed changes in
      poly(ADP-ribose) metabolism do not appear to cause any change in susceptibility
      to chemically induced carcinogenesis in this organ.

PMID- 7782899
TI  - Protein-deficient pigs cannot maintain reduced glutathione homeostasis when
      subjected to the stress of inflammation.
AB  - The mechanisms responsible for depletion of systemic glutathione levels in
      nutritional deprivation and/or in infective and inflammatory conditions have not
      been fully established. We quantified the effects of protein undernutrition and
      experimental inflammation on the concentration and synthesis of reduced
      glutathione in the erythrocytes, liver and jejunal mucosa of young pigs. Two
      groups of five piglets consumed diets containing either 23 or 3% protein and,
      after 4 wk, were infused intravenously with [13C2]glycine before and 48 h after
      subcutaneous injections of turpentine. Erythrocyte, hepatic and intestinal
      mucosal reduced glutathione was quantified as the monobromobimane derivative by
      HPLC. Reduced glutathione synthesis was determined by measurements of the
      tracer/tracee ratio of reduced glutathione-bound glycine. In well-nourished
      piglets, turpentine injection had no effect on erythrocyte reduced glutathione
      concentrations or rate of synthesis. Protein undernutrition was associated with
      lower erythrocyte reduced glutathione concentrations (1.05 +/- 0.04 vs. 1.32 +/-
      0.06 mmol/L, P < 0.01) and synthesis (42 +/- 5 vs. 60 +/- 5%/d), and turpentine
      inflammation caused a further fall in erythrocyte reduced glutathione
      concentration to 0.96 +/- 0.05 mmol/L, despite a significant (P < 0.05) increase
      in reduced glutathione synthesis. The combination of protein undernutrition and
      inflammation had a marked effect on mucosal reduced glutathione concentration (37
      +/- 3% of control) and synthesis (65 +/- 5% of control). Hepatic reduced
      glutathione concentration and synthesis did not differ in the two groups. We
      conclude that the biosynthetic supply of reduced glutathione is sufficient to
      withstand an inflammatory challenge in well-nourished piglets but not in protein
      deficient animals.

PMID- 7782900
TI  - A brief, telephone-administered food frequency questionnaire can be useful for
      surveillance of dietary fat intakes.
AB  - A 13-item questionnaire designed for quick telephone administration was evaluated
      for use in surveillance of fat intake in the United States. Study populations
      included 560 middle-aged and older adults from Beaver Dam, WI, 252 middle-aged
      and older women from Wisconsin, 73 young, low income Hispanic women from Chicago,
      IL, 52 older adults from Arizona and 135 younger adults from Augusta, GA.
      Correlations between fat scores and fat intakes measured by multiple food records
      or recalls or by more extensive food frequency questionnaires ranged from 0.33 to
      0.60, similar to results from other published questionnaire validation studies.
      Correlations with percentage of energy from fat were lower (0.26 to 0.42), except
      for the Chicago population, for which there was no correlation (-0.02). There was
      no systematic variation in correlations among other subgroups defined by
      demographic and health-related characteristics, including race (black vs. white).
      Most, but not all, of the substantial differences in fat intakes among subgroups
      were identified by the questionnaire. The questionnaire will not capture small
      differences in intakes among groups and is inappropriate when the sample size is
      limited or for populations with diets substantially different from the typical
      U.S. diets, such as the Chicago population. However, with attention to its
      limitations, the questionnaire is useful for surveillance.

PMID- 7782901
TI  - Administration of phosphatidylcholine increases brain acetylcholine concentration
      and improves memory in mice with dementia.
AB  - Studies on the effect of phosphatidylcholine administration on memory are
      limited. We administered egg phosphatidylcholine to mice with dementia and to
      normal mice and compared the differences in memory and serum choline
      concentration, and choline and acetylcholine concentrations and choline
      acetyltransferase activities of three forebrain regions (cortex, hippocampus and
      the remaining forebrain). Mice with dementia were produced by mating sibling mice
      who had impaired memory for > 20 generations. These mice had poor memory and low
      brain acetylcholine concentration. We administered 100 mg of egg
      phosphatidylcholine (phosphatidylcholine group) or water (control group) by
      gavage to each mouse daily for about 45 d. Control mice with dementia had poorer
      memory in passive avoidance performance and lower brain choline (cortex and
      hippocampus) and acetylcholine (hippocampus and forebrain excluding cortex and
      hippocampus) concentrations and lower cortex choline acetyltransferase activity
      than the control normal mice (P < 0.05). The administration of
      phosphatidylcholine to mice with dementia improved memory and generally increased
      brain choline and acetylcholine concentrations to or above the levels of the
      control normal mice. In normal mice, phosphatidylcholine treatment did not affect
      memory or acetylcholine concentrations in spite of the great increase in choline
      concentrations in the three brain regions. Serum choline concentration in mice
      treated with phosphatidylcholine increased to a similar level in both strains of
      mice, indicating that the absorption of phosphatidylcholine was not impaired in
      mice with dementia. The results suggest that administration of egg
      phosphatidylcholine to mice with dementia increases brain acetylcholine
      concentration and improves memory.

PMID- 7782902
TI  - Primary chylomicronemia in patients with severe familial hypertriglyceridemia
      responds to long-term treatment with (n-3) fatty acids.
AB  - Because it disturbs microcirculation, chylomicronemia can cause severe clinical
      complications such as acute pancreatitis. Dietary measures are very important in
      the prevention and treatment of this condition. Dietary supplementation with (n
      3) fatty acids has been shown to be of benefit in short-term treatment of
      chylomicronemia. To evaluate the long-term efficacy of (n-3) fatty acids we added
      2.16 or 4.32 g/d (for 3 mo) and 3.24 g/d (for a further 8 mo after 1 mo of no
      treatment) (n-3) fatty acids to the diet of eight patients with primary
      chylomicronemia. Serum triglycerides decreased significantly from 15.0 +/- 2.5 to
      9.9 +/- 2.8 mmol/L (P < 0.01) after 11 mo of treatment, and VLDL triglycerides
      decreased from 12.3 +/- 2.8 to 9.0 +/- 2.4 mmol/L (P < 0.01), resulting in a
      significant decrease of plasma viscosity from 1.56 +/- 0.17 mPa-s to 1.47 +/-
      0.12 mPa.s (P < 0.01). Total cholesterol, HDL and LDL cholesterol as well as
      lipoprotein (a) and fibrinogen concentrations were not affected by fish oil
      treatment. The presence of chylomicrons and chylomicron remnants (apolipoprotein
      B 48 concentration in the lipoprotein fraction with a density lower than 1.006
      kg/L) was significantly reduced from 4.82 +/- 1.08 to 1.06 +/- 0.38 mg/L (P <
      0.01). Body weight increased significantly from 71.0 +/- 4.6 kg to 75.2 +/- 5.3
      kg after 11 mo of treatment with (n-3) fatty acids.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7782903
TI  - In vivo methylation capacity is not impaired in healthy men during short-term
      dietary folate and methyl group restriction.
AB  - Ten healthy adult men were fed a diet low in folate and exogenous methyl groups
      to study the effects on in vivo methylation capability. The men were housed in a
      metabolic unit for the entire 108 d of the study. After a 9-d baseline period
      (Period 1), the men were fed a soy-product-amino acid defined diet for 45 d,
      which provided 25 micrograms/d of folate for 30 d (Period 2) and, with a folate
      supplement, 99 micrograms/d for 15 d (Period 3). During Period 2 and Period 3,
      the low methionine and choline diet was supplemented with methionine for half the
      subjects to vary the dietary methyl group intake. The periods were then repeated
      over the next 54 d (Periods 4-6), with a crossover of methionine intakes in
      Period 5 and Period 6. A 1-g oral dose of nicotinamide was given at the end of
      each period and methylated urine metabolites determined. Other measures related
      to in vivo methylation capability included urine creatinine, and plasma and urine
      carnitine. Even with moderate folate depletion, none of these measures was
      decreased by low methionine and choline intakes. Plasma methionine concentrations
      were unchanged throughout. Limiting exogenous methyl group intake by restricting
      dietary methionine and choline did not impair in vivo methylation capabilities
      for the variables tested, even at low folate intake.

PMID- 7782904
TI  - Sourdough fermentation or addition of organic acids or corresponding salts to
      bread improves nutritional properties of starch in healthy humans.
AB  - Postprandial blood glucose and insulin responses to barley bread containing
      organic acids or corresponding salts were evaluated in healthy human subjects.
      The satiety score and the rate and extent of in vitro starch digestion were also
      studied. Lactic acid was generated by use of a homofermentative starter culture
      or added to the dough. In addition, products were baked with Ca-lactate, or with
      Na-propionate at two different concentrations. Consumption of the product baked
      with a high concentration of Na-propionate significantly lowered the postprandial
      blood glucose and insulin responses, and significantly prolonged the duration of
      satiety compared with all other breads. When subjects consumed the breads baked
      with sourdough, lactic acid and Na-propionate, their glucose and insulin
      responses were reduced compared with the wholemeal bread alone. The rate of in
      vitro amylolysis was reduced only by ingestion of the breads containing lactic
      acid, suggesting that the beneficial impact of Na-propionate on metabolic
      responses and satiety was related to effects other than a reduced rate of starch
      hydrolysis. All bread products had a similar concentration of in vitro resistant
      starch of 1.3-2.1 g/100 g (starch basis). It is concluded that sourdough baking
      and other fermentation processes may improve the nutritional features of starch.
      The results also demonstrate that certain salts of organic acids may have
      metabolic effects.

PMID- 7782905
TI  - Estimation of rat body composition by means of electromagnetic scanning is
      altered by duration of anesthesia.
AB  - We determined the effect of anesthesia on estimation of fat-free mass and body
      fat in rats using electromagnetic scanning (EMS). Male Wistar Furth rats (n = 7,
      approximately 226 g) were injected with 66 mg/kg ketamine hydrochloride and 6.6
      mg/kg xylazine intramuscular anesthesia. EMS measures were repeated every 4 min,
      up to 80 min post-anesthesia injection. From 4 to 44 min post-injection, the EMS
      signal and consequently the estimation of fat-free mass decreased from 198 +/- 5
      to 180 +/- 5 g (mean +/- SD, P < 0.05). Conversely, the estimation of body fat
      increased by 63% during this period of anesthesia (12.9 +/- 2.9 vs. 21.1 +/- 2.6
      g/100 g body wt, P < 0.05). In cohort animals (n = 6), body temperature and
      respiration rate declined following anesthesia (P < 0.05), and may have
      correspondingly suppressed EMS signal via reduced ion flux and/or muscular
      activity. In another study the effects of food deprivation, tail position, and
      anesthesia duration were demonstrated to alter estimation of fat-free mass (P =
      0.0001), but these effects were not interactive (P > 0.05). Proximate analysis of
      body composition in cohort rats indicated that EMS predicted fat-free mass with a
      3.5% error when estimated at 4 min post-anesthesia injection. Taken together,
      these data suggest that standardized EMS protocols should be adopted to account
      for effects of anesthesia, animal position and food deprivation. When
      manufacturer's equations are used, body composition should be measured
      immediately after induction of anesthesia. However, laboratories that choose to
      internally generate EMS regression equations with proximate analysis should
      determine and utilize the period of minimal variability in EMS measures.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7782906
TI  - Dietary fibers differ in their effects on large bowel epithelial proliferation
      and fecal fermentation-dependent events in rats.
AB  - The effects of different fiber types and processing on putative protective
      mechanisms for colorectal cancer were evaluated. Rats were fed diets of similar
      nutrient balance containing either no added fiber or 10% fiber from various
      sources. The rate of distal colonic epithelial proliferation, measured by the
      metaphase arrest method, was dependent on fiber type; ranking of fibers from
      highest to lowest yielded the following order: methylcellulose > coarse wheat
      bran > fine wheat bran approximately parboiled and extruded rice brans > no fiber
      (P = 0.012). Effect on stool output ranked identically. Ranking of effect on
      fecal pH, from most to least acidic was as follows: coarse wheat bran
      approximately the rice brans > fine wheat bran > no fiber approximately
      methylcellulose (P = 0.00001). Coarse wheat bran gave significantly higher fecal
      butyrate concentrations than did the rice brans, which in turn gave higher levels
      than fine wheat bran, methylcellulose and the no-fiber diet. Proximal colon
      epithelial proliferation was unaffected by diet although cecal short-chain fatty
      acid concentrations and pH were affected. Different fibers have different effects
      on events in the fecal environment and distal colonic epithelium. Putative
      protective events (increased output, low fecal pH, high butyrate, low
      proliferation) are not equally affected and are unlikely in themselves to allow
      prediction of the protective effect of a fiber.

PMID- 7782907
TI  - Brain iron, transferrin and ferritin concentrations are altered in developing
      iron-deficient rats.
AB  - To study the iron, transferrin, and ferritin distribution at subcellular levels
      in response to acute dietary iron deficiency, we tested the hypothesis that early
      post-weaning iron deficiency can change iron and iron regulatory protein
      concentrations in rat brain. Male Sprague-Dawley rats were fed diets containing
      either 2 or 35 micrograms iron/g for 2, 3 or 4 wk starting at 21 d of age. Brain
      iron, transferrin and ferritin concentrations in cytosolic and microsomal
      fractions of either whole brain or pons and cerebellum were then determined.
      After 14 d of dietary iron restriction, brain iron concentrations were 50% lower
      in the microsomal fraction and 30% lower in cytosol compared with controls. Brain
      cytosolic transferrin concentration almost doubled in the same animals. Brain
      ferritin concentration in fractions from rats fed the iron-deficient diet for 14
      d was lower than in controls, but then remained fairly constant. Absolute brain
      weight and total brain protein contents were unaffected by iron restriction. This
      study extends previous research by demonstrating that the brain responds to
      changes in body iron status with a change in transferrin concentration. If the
      dietary restriction is quite severe, this adaptation is insufficient. This study
      also notes that brain ferritin decreases with decreasing body iron status, though
      it was less responsive than nonheme iron in liver. The concept that iron enters
      the brain through a highly regulated endocytotic process at the blood brain
      barrier, that undoubtedly involves the regulation of transferrin receptors in
      capillary endothelial cell, is supported by our observation of elevated
      transferrin concentrations in brain of iron-deficient rats.

PMID- 7782908
TI  - Corn oil, palm oil and butterfat fractions affect postprandial lipemia and
      lipoprotein lipase in meal-fed rats.
AB  - Our objective was to investigate the time course of postprandial lipemia and
      lipolytic activity in male Sprague-Dawley rats trained to eat meals containing
      butterfat fractions, palm oil or corn oil. Baseline and postprandial blood
      samples were obtained via a carotid cannula in rats fed the experimental diets
      for 4 wk. Rats fed saturated fats compared with corn oil showed a significantly
      greater peak increase in postprandial triacylglycerol concentrations. Corn oil
      ingestion resulted in significantly lower concentrations of cholesterol and
      triacylglycerol in plasma and significantly less triacylglycerol accumulation
      (millimoles per liter per 24 h) compared with ingestion of saturated fats.
      Postheparin plasma lipoprotein lipase activity and plasma insulin concentration
      were generally greater with ingestion of corn oil compared with palm oil or
      butterfat. Palm oil ingestion resulted in a biphasic plasma triacylglycerol
      response curve and greater postheparin plasma lipoprotein lipase activity
      compared with butterfat ingestion, suggesting differential effects of saturated
      fats on postprandial lipemia. Our results indicate that greater postprandial
      lipemia with ingestion of saturated fats compared with corn oil may be due in
      part to slower plasma triacylglycerol clearance.

PMID- 7782909
TI  - Muscle respiration in rats is influenced by the type and level of dietary fat.
AB  - Experiments were conducted to elucidate the role of muscle in the enhanced
      thermogenic response found in rats fed diets enriched with polyunsaturated fatty
      acids. Isolated soleus muscle respiration and plasma cholesterol and triglyceride
      concentrations were determined in rats (approximately 128 g wt, 5 wk age) fed
      diets (minimum 3 wk) containing coconut oil, beef tallow or safflower oil at 20,
      40 or 60% of the total dietary energy in a 3 x 3 factorial design (5-6 rats per
      treatment). Diet type did not affect plasma cholesterol concentrations but plasma
      triglycerides were lower (P < 0.01) in rats fed safflower oil-based diets.
      Greater levels of fat in the diet resulted in higher (P < 0.01) plasma
      cholesterol concentrations and lower (P < 0.01) plasma triglyceride
      concentrations. Rats fed coconut oil had lower (P < 0.05) rats of soleus muscle
      respiration compared with rats fed the other two diets. This lower respiration
      rate was not related to changes in protein synthesis (cycloheximide-sensitive
      respiration). However, this change may partially be related to enhanced Na+,K+
      transport (ouabain-sensitive respiration). The results indicate that muscle is
      partially responsible for the enhanced thermogenic response found in rats fed
      diets enriched with polyunsaturated fatty acids and that enhanced ion transport
      contributes to this response in muscle.

PMID- 7782910
TI  - Inhibition of starch digestion by alpha-amylase inhibitor reduces the efficiency
      of utilization of dietary proteins and lipids and retards the growth of rats.
AB  - Digestion/absorption and nutritional utilization of starch, protein and lipids
      were studied in rats fed diets containing purified kidney bean alpha-amylase
      inhibitor at levels of 0, 1.6, 3.3 and 6.6 g/kg diet. At the two higher levels,
      the growth rate of rats and the apparent digestibilities and utilization of
      dietary starch and protein were significantly less than in control rats, and
      losses of nitrogen, lipids and carbohydrate resulted in a significant reduction
      in dry body weight. Some organs of the body were also affected: the relative dry
      weights of the intestines and the pancreas were higher, whereas liver and thymus
      weights were lower than in control rats. As starch digestion in the small
      intestine was negligible at higher inhibitor concentrations, the cecum was
      practically blocked by solidified digesta. This effect and the ensuing bacterial
      fermentation stimulated the growth of this tissue by hyperplasia and hypertrophy.
      However, as the distension was not always sufficient, the organ was occasionally
      ruptured and the rats had to be killed. Inhibitor doses in this work were
      comparable to those in clinical studies, implying that the use of the inhibitor
      is not without health risks. Moreover, diets rich in alpha-amylase inhibitor such
      as those containing transgenic plants with high levels of inhibitor gene
      expression cannot be recommended in intensive animal production.

PMID- 7782911
TI  - Petroselinic acid from dietary triacylglycerols reduces the concentration of
      arachidonic acid in tissue lipids of rats.
AB  - Studies in vitro have revealed that triacylglycerols containing petroselinoyl
      [18:1(n-12)] moieties are hydrolyzed by pancreatic lipase at much lower rates
      than other triacylglycerols. To assess the lipolysis and absorption in vivo of
      such unusual triacylglycerols, diets containing 120 g seed oil triacylglycerols
      of coriander (Coriandrum sativum) per kg diet at a level of 72 g 18:1(n-12)
      moieties/100 g oil were fed to a group of weaned male Wistar rats without
      restriction for a period of 10 wk. For comparison, groups of rats were fed
      similar isocaloric diets containing plant oil triacylglycerols with various
      levels of oleoyl [18:1(n-9)] moieties, e.g., high oleic sunflower seed oil [75 g
      18:1(n-9)/100 g oil], olive oil [(66 g 18:1(n-9)/100 g oil], medium oleic
      rapeseed oil [54 g 18:1(n-9)/100 g oil] and conventional high linoleic sunflower
      seed oil [25 g 18:1(n-9)/100 g oil]. All diets were supplemented with 20 g corn
      oil/kg diet. Consumption of coriander oil, compared with the other oils, led to
      significantly greater liver weights. No significant differences were observed
      among the groups fed various levels of oleic acid in body weight, the weights of
      heart, liver, kidneys, spleen or testes, lipid content of heart, or total
      cholesterol, HDL cholesterol and triacylglycerol concentrations of blood plasma.
      Ingestion of coriander oil led to incorporation of 18:1(n-12) into heart, liver
      and blood lipids and to a significant reduction in the concentration of
      arachidonic acid in the lipids of heart, liver and blood with a concomitant
      increase in the concentration of linoleic acid compared with results for the
      other groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782912
TI  - Comparative absorption and transport of five common carotenoids in preruminant
      calves.
AB  - Preruminant calves, maintained in a monogastric state by feeding an all-liquid
      diet, were used to compare the serum appearance and lipoprotein transport of five
      different carotenoids over 144 h. Thirty newborn calves were fed milk replacer
      for 1 wk and then randomly assigned to six groups (n = 5), with each group
      receiving a single 20-mg oral dose of beta-carotene in water-soluble beadlets,
      canthaxanthin in water-soluble beadlets, lutein in oil, lycopene in oil,
      crystalline alpha-carotene in oil or crystalline beta-carotene in oil as part of
      a morning meal. Serial blood samples were taken by jugular puncture for up to 1
      wk post-dosing. Lipoprotein separation and analysis were completed with selected
      animals. All carotenoids were absorbed, but in variable amounts. At peak serum
      carotenoids levels, HDL contained 70-90% of the carotenoids. Canthaxanthin and
      lutein peaked earlier in serum (8 and 12 h) than did the less polar lycopene,
      alpha-carotene, and beta-carotene (16, 24 and 24 h). Canthaxanthin and lutein
      were also cleared more quickly from the serum. Serum concentrations of alpha
      carotene and lycopene displayed slower disappearance rates than did beta
      carotene. The peak serum level (nmol/L +/- SEM) of canthaxanthin (392 +/- 136)
      was lower than that of beta-carotene (1245 +/- 425), and carotenoids levels of
      calves receiving these commercial beadlet sources were higher than the serum
      levels of calves receiving beta-carotene (45 +/- 17.5), alpha-carotene (42 +/-
      18.0), lutein (51 +/- 9.5) and lycopene (18 +/- 4.6), which were fed in
      oil.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782913
TI  - Aging and food restriction alter some indices of bone metabolism in male rhesus
      monkeys (Macaca mulatta).
AB  - Food restriction increases life span, reduces aging rate and affects a wide
      variety of biological functions. In rats, food restriction delays bone growth and
      reduces bone density and mineral content. We report the effects of aging and long
      term (> 6.0 y) food restriction on several indices of bone growth and metabolism
      in rhesus monkeys (Macaca mulatta). Food allotments for controls approximated
      free access consumption, whereas food-restricted monkeys received 30% less food
      on a body weight basis. Cross-sectional and longitudinal age effects on serum
      alkaline phosphatase paralleled those reported for humans. Food restriction
      induced a significant delay in the developmental decline (to adult levels) in
      total alkaline phosphatase and significantly suppressed serum interleukin 6
      concentrations, particularly in younger monkeys. Also, food restriction slowed
      skeletal growth, as reflected by shorter crown-rump length, and significantly
      reduced total body bone mineral content, but not bone mineral density, measured
      by dual energy X-ray absorptiometry. Analyses of serum parathyroid hormone,
      calcium, phosphate and osteocalcin concentrations suggested that the effects on
      skeletal growth were not related to alterations in calcium and phosphate
      homeostasis or a primary defect in bone formation. These findings suggest that
      long-term food restriction delays skeletal development in male rhesus monkeys
      while allowing the development of a reduced but otherwise normal skeleton.

PMID- 7782915
TI  - Maternal dietary carbohydrate restriction and mild-to-moderate exercise during
      pregnancy modify aspects of fetal development in rats.
AB  - To determine whether acute bouts of exercise during pregnancy would predispose
      the fetus to increased risk if maternal dietary carbohydrate were restricted,
      untrained pregnant rats were randomly assigned to a 0% (low), 12% (moderate) or
      60% (high) glucose diet, and either rested or exercised daily for 20 min from d
      16 to term on a rodent treadmill at a mild (15.5 m/min) or moderate (24.3 m/min)
      intensity. A 3 x 3 nested factorial model with and without food intake as a
      covariate was employed. Both greater exercise intensity and the lower levels of
      dietary carbohydrate independently decreased term maternal liver and plantaris
      glycogen concentrations and increased plasma lactate concentrations. However,
      significant differences due to exercise disappeared (except for plasma lactate)
      with food intake controlled for in the model, indicating that energy deficits
      modulated these exercise effects. In contrast, for the offspring, when food
      intake was controlled for, a restricted level of maternal dietary carbohydrate
      significantly lowered fetal weight, plasma glucose and insulin concentrations and
      liver glycogen concentrations measured at term. Exercise alone did not reduce
      mean fetal weight if nested weights within a litter were used in the statistical
      analysis. Mild to moderate maternal exercise lowered only fetal plasma glucose
      concentrations and only if maternal food intake was not controlled for. These
      results indicate that acute exercise during pregnancy can have detrimental
      effects on fetal development only if dietary glucose is severely restricted.
      Otherwise, adequate glucose and energy in the maternal diet in untrained pregnant
      rats during repeated bouts of acute exercise seem to protect the fetus.

PMID- 7782914
TI  - The validity of extrinsic stable isotopic labeling for mineral absorption studies
      in rats.
AB  - The use of extrinsic stable and radioisotopic labels (Fe, Zn, Cu and Se) was
      compared with the use of intrinsic labels by measuring label retention in rats.
      Saccharomyces cerevisiae (Hansen strain CBS 1171) was prepared intrinsically
      enriched with a stable isotope of iron, zinc, copper or selenium, and unenriched
      freeze-dried yeast was extrinsically labeled with the appropriate stable and/or
      radioisotope. Male Wistar rats, weighing 80-100 g and fed a purified diet, were
      given a test meal of one of the above labeled yeasts. Isotopic retention was
      determined by fecal monitoring. Retention of the stable isotopes was determined
      by thermal ionization quadruple mass spectrometry (TIQMS) and retention of the
      radioisotopes by counting feces in a whole-body counter. The results indicated
      that the behavior of the labels differed among the minerals, with copper as the
      only one in which the intrinsic and extrinsic stable isotopes were comparably
      retained. With zinc, retention of the extrinsic radiolabel and intrinsic label
      was similar, but retention of the extrinsic stable isotope label was higher. With
      iron, the intrinsic label had a significantly lower retention than the two
      extrinsic labels; with selenium, retention of all three labels was different, but
      these differences were not of a sufficient magnitude to conclude that extrinsic
      stable isotopic labelling is not valid. These results demonstrate that an
      extrinsic stable isotope label can be used for copper, selenium and inorganic
      iron, but that such a label is not valid for studies on zinc.

PMID- 7782916
TI  - Role of Nutrition in Lung Development and Function. Proceedings of a symposium.
      Anaheim, California, April 25, 1994.

PMID- 7782917
TI  - Role of vitamin A in lung development.
AB  - There is good rationale for presuming a role for vitamin A in lung development.
      In situ studies have demonstrated that certain retinoic acid (RA) receptor
      proteins are localized in a specific fashion during fetal lung branching and
      airway growth. Vitamin A stores are high in fetal lung and decrease toward term,
      possibly being utilized for changes in lung morphogenic remodeling. The binding
      activity, levels and expression of the cytosolic and nuclear receptor proteins
      for vitamin A undergo changes before and after birth in rat lung. RA slows fetal
      Type II cell proliferation in culture but stimulates choline incorporation into
      phosphatidylcholine. RA can regulate several other factors involved in lung
      development such as homeobox genes, matrix molecules and certain growth factors.
      Further study is needed on this potential functional role of RA in lung. Retinol
      deficiency results in lung histopathology that is similar to bronchopulmonary
      dysplasia, which occurs frequently in human premature neonates. Clinical trials
      are attempting to define the role of supplementation of vitamin A in the
      prevention and treatment of that condition.

PMID- 7782918
TI  - The developing rat lung fibroblast and alveolar type II cell actively recruit
      surfactant phospholipid substrate.
AB  - Timely, adequate production of pulmonary surfactant is critical for survival at
      birth. This process is dependent on both maternal nutrition and glucocorticoids.
      Fetal rat lung lipofibroblast triglyceride accumulation is saturable, temperature
      dependent and stimulated by glucocorticoids and cyclic AMP in primary cell
      culture. Spontaneous triglyceride uptake by fibroblasts increases ninefold
      between 17 and 21 days (= term) gestation and is stimulated 30-80% by exogenous
      glucocorticoid treatment. Coculture of Type II cells with fibroblasts preloaded
      with 3H-trioleate and increasing amounts of triglyceride results in a concomitant
      increase in saturated phosphatidylcholine (SPC) synthesized by Type II cells.
      Dexamethasone stimulates mobilization of fibroblast triglyceride incorporation
      into Type II cell-SPC by 36-40%. The hormonally regulated uptake and mobilization
      of triglyceride suggest active recruitment of surfactant phospholipid substrate
      by both alveolar connective tissue and epithelial cells.

PMID- 7782919
TI  - Role of fatty acids in lung development.
AB  - The role of maternal dietary fat in the regulation of fetal and newborn lung
      surfactant lipid synthesis has not been completely elucidated. Dietary fat can
      modulate cell membrane phospholipid fatty acid composition, resulting in altered
      membrane fluidity and affecting cellular functions, including binding to hormone
      receptors and the binding and activity of membrane-associated enzymes. Two
      examples are discussed that support the hypothesis that exogenous fatty acids
      modulate phospholipid synthesis in the lung. In the first example, long-chain
      unsaturated fatty acids were found to inhibit glucocorticoid receptor binding in
      L2 cells, suggesting that fatty acids may affect steroid responsiveness during
      different developmental stages of the lung. In the second example, a relationship
      was established between changes in membrane lipid composition during lung
      development and the activity of cholinephosphate cytidylyltransferase, the rate
      limiting enzyme in phosphatidylcholine synthesis. The effects demonstrated in
      these in vitro studies will need to be confirmed by dietary studies of pregnant
      animals.

PMID- 7782920
TI  - Do polyunsaturated fatty acids protect against oxidant-induced lung damage?
AB  - Little disagreement exists concerning the importance of early provision of lipid
      nutrition to very low birth weight (VLBW) infants in terms of growth and
      development. However, considerable controversy surrounds the relationship of
      lipid and protection against oxidant-induced lung damage in experimental
      situations and in the vulnerable premature infant. This article reviews the
      results of experimental and clinical studies on the protective effects of lipids
      against oxidant injury and chronic lung disease.

PMID- 7782921
TI  - Effect of diet on lung structure, connective tissue metabolism and gene
      expression.
AB  - Nutritional impairment can adversely affect the respiratory system. The structure
      of the lung is altered by severe calorie-protein restriction in rodents producing
      an emphysema-like lesion after several weeks of severe caloric restriction.
      Biochemical and morphological evidence suggests destruction of collagen and
      elastin in nutritional emphysema. Impaired lung growth may explain the
      biochemical changes in growing animals. Although the molecular basis of
      nutritional emphysema is not known, altered gene expression by nutrients affects
      several metabolic pathways, and examples of the effects of nutrients on gene
      expression are given. Nutritional emphysema in animals may be relevant to humans
      because malnutrition may accelerate the progression of the disease in patients
      with advanced emphysema.

PMID- 7782922
TI  - Oxidatively fragmented phospholipids as inflammatory mediators: the dark side of
      polyunsaturated lipids.
AB  - Phospholipids containing a polyunsaturated fatty acyl residue at the sn-2
      position are common constituents of cellular membranes and lipoprotein particles.
      Just as free polyunsaturated fatty acids can be oxidized, derivatized, and
      fragmented, phospholipid acyl residues are also subject to similar oxidative
      attack. Oxidative modification and/or fragmentation of phosphatidylcholines
      generate potent inflammatory mediators that mimic the biologic action of platelet
      activating factor (PAF). The oxidatively fragmented phospholipids with PAF-like
      activity act via the receptor for PAF and mimic most of its biologic actions.
      Thus, oxidation either through inappropriate inflammatory processes, endogenous
      oxygen metabolism or uptake of peroxidized lipids from the diet can all lead to
      inappropriate and unregulated generation of potent inflammatory mediators.

PMID- 7782923
TI  - Suppression of mevalonate pathway activities by dietary isoprenoids: protective
      roles in cancer and cardiovascular disease.
AB  - Diet-cancer and diet-cardiovascular disease interrelationships may be explained
      by the mevalonate-suppressive action of isoprenoid end products of plant
      secondary metabolism. Assorted monoterpenes, sesquiterpenes, carotenoids and
      tocotrienols posttranscriptionally down regulate 3-hydroxy-3-methylglutaryl
      coenzyme A reductase activity, a key activity in the sterologenic pathway. The
      modest decrease in cholesterol synthesis is associated with a concomitant
      lowering of low-density lipoprotein cholesterol. The reductase activity in tumor
      tissues differs from that of liver in being resistant to sterol feedback
      regulation. Tumor reductase activity retains sensitivity to posttranscriptional
      regulation. As a consequence, the isoprenoid-mediated suppression of mevalonate
      synthesis depletes tumor tissues of two intermediate products, farnesyl
      pyrophosphate and geranylgeranyl pyrophosphate, which are incorporated
      posttranslationally into growth control-associated proteins. At 10-fold higher
      concentrations, monoterpenes inhibit the protein isoprenyl transferases that
      catalyze this incorporation. At levels of intake likely provided by a diet based
      on Food Pyramid guidelines, assorted isoprenoids decrease cardiovascular disease
      risk and suppress the growth of initiated cells. At pharmacological levels of
      intake, isoprenoids block the initiation phase of chemical carcinogenesis.
      Isoprenoids targeted to the inhibition of the isoprenylation of oncogenic forms
      of ras proteins may offer a novel approach to chemotherapy. Adjunctive
      isoprenoids might decrease the level of competitive inhibitors of 3-hydroxy-3
      methylglutaryl coenzyme A reductase required to manage hypercholesterolemia.

PMID- 7782924
TI  - Dietary modulation of epidermal protein kinase C: mediation by diacylglycerol.
AB  - Studies on the mechanism of dietary fat and energy modulation of skin
      carcinogenesis suggest that these diets may act through the cellular binding site
      of the phorbol ester tumor promoters, protein kinase C (PKC). High-fat diets
      increase the activity of PKC but have no impact on the steady-state protein
      levels. Energy restriction reduces the activity of PKC, presumably through
      reduction in the steady-state levels of particular isoenzymes (PKC alpha and PKC
      zeta). Phorbol-binding studies with epidermal cells from mice fed energy
      restricted diets indicated a reduction of phorbol-binding sites in these cells.
      Investigations into lipid metabolism showed that both dietary fat and energy
      restriction increased epidermal cell diacylglycerol (DAG). The increase in DAG in
      cells from energy-restricted mice may be due to increased turnover of
      phosphatidylinositol, as was evident in the reduced phosphatidylinositol-4
      phosphate and phosphatidylinositol-4,5-biphosphate and elevated inositol
      biphosphate and inositol triphosphate in these cells.

PMID- 7782925
TI  - Role of dietary sphingolipids and inhibitors of sphingolipid metabolism in cancer
      and other diseases.
AB  - Sphingolipids are found in all eukaryotic and some prokaryotic organisms and
      participate in the regulation of cell growth, differentiation, and diverse cell
      functions including cell-cell communication, cell-substratum interactions and
      intracellular signal transduction. Nonetheless, the field of nutrition has given
      scant attention to these compounds so that little is known about the following
      fundamental questions: What is the fate of sphingolipids that are consumed in
      food? Does consumption of dietary sphingolipids affect the behavior of cells in
      the gastrointestinal tract or other organs? How do other factors in the diet
      affect sphingolipid metabolism? Several recent findings underscore the importance
      of these questions, for examples: 1) Sphingolipids are digested throughout the GI
      tract to ceramide and sphingosine, which are highly bioactive compounds that
      affect cellular regulatory pathways; 2) addition of sphingomyelin to a standard
      AIN diet (which is essentially devoid of sphingolipids) reduces the appearance of
      aberrant colonic crypts, and perhaps the number of tumors, in mice treated with a
      colon carcinogen; and 3) an enzyme of sphingolipid metabolism has been discovered
      to be the target of a class of toxic and carcinogenic mycotoxins called
      fumonisins. Given these recent findings, it is possible that some of the
      confusion that has arisen regarding the relationships between dietary fat and
      disease might be due to the lack of consideration of the sphingolipids that are
      also present.

PMID- 7782926
TI  - Modulation of signal transduction in macrophages by dietary fatty acids.
AB  - Tumor growth can be altered by the amount and type of fat in the diet. Although
      there are several possible mechanisms for this, recent work suggests that
      alterations in the immune system by dietary fat may affect tumorigenesis. The
      focus of recent studies has been on dietary fat modulation of macrophage function
      because that cell plays a pivotal role in many immune responses, including anti
      tumor activity. One possible mechanism of dietary fat effects on macrophages is
      altered signal transduction, which, in turn, could alter gene regulation and
      macrophage function. Initial studies tested the effects of dietary fat on kinase
      activity after stimulation with interferon-gamma. Macrophages from mice fed
      menhaden fish oil (MFO) had slightly decreased protein kinase C activity compared
      with macrophages from mice fed safflower oil (SAF). No differences among the
      diets were observed when the activity of protein kinase A and G were tested. When
      calcium mobilization was tested, we found that macrophages from mice fed MFO had
      an increased response compared with macrophages from mice fed SAF. Dietary fat
      also modified the response of macrophages to platelet-activating factor with
      respect to the induction of Ia expression. In studies to identify genes involved
      in dietary fat effects on macrophage function, we screened a cDNA library of
      macrophages treated with prostaglandin E2 (PGE2), a lipid-based mediator that can
      modulate macrophage function and be altered by dietary fat. The cloned gene,
      BTG1, was enhanced in macrophages treated with PGE2, but the relationship with
      dietary fat remains to be determined.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782927
TI  - Pleiotropic Actions of 1 alpha, 25-dihydroxyvitamin D3: an overview.

PMID- 7782928
TI  - Genomic actions of 1,25-dihydroxyvitamin D3.
AB  - Recent studies have identified a heterodimer of the vitamin D receptor (VDR) and
      the retinoid X receptor (RXR) as the active complex for mediating positive
      transcriptional effects of 1,25-dihydroxyvitamin D3 [1,25(OH)2D3], the active
      hormonal form of vitamin D. The VDR-RXR heterodimer has been shown to bind to
      direct repeat vitamin D-responsive elements (VDREs) upstream of positively
      controlled genes in the target tissues for vitamin D, including bone
      (osteocalcin, osteopontin, and beta 3 integrin), kidney (24-hydroxylase) and
      intestine (calbindin). Residues that participate in heterodimer formation have
      been identified in the C-terminal hormone-binding domain by analysis of VDR
      mutants. The role of the 1,25(OH)2D3 ligand in transcriptional activation by the
      VDR-RXR heterodimer is not entirely clear, but studies of two natural VDR mutants
      suggest that the binding of both hormone and RXR are required to induce a
      receptor conformation that is competent to activate transcription. A final level
      of complexity is added by recent observations that VDR is modified by
      phosphorylation. Thus, the VDR-mediated action of 1,25(OH)2D3 is now known to
      involve multiple factors that may provide a conceptual basis for future
      understanding of the tissue-specific genomic effects of 1,25(OH)2D3.

PMID- 7782929
TI  - Nongenomic effects of 1,25-dihydroxyvitamin D3: potential relation of a
      plasmalemmal receptor to the acute enhancement of intestinal calcium transport in
      chick.
AB  - A number of model systems now exist for studying the nonnuclear actions of the
      seco-steroid hormone 1,25(OH)2D3. The perfused duodenal loop of vitamin D-replete
      chicks has provided the best correlation between nonnuclear actions and a
      physiological end point, namely enhanced calcium transport. Recent progress has
      been made in identifying and purifying an integral protein of the basal lateral
      membrane that may be a receptor for 1,25(OH)2D3. Studies with analogues
      (particularly 1,25(OH)2-7-dehydrocholesterol and 1,25(OH)2-lumisterol3) have
      provided definite correlations between binding to the solubilized membrane
      receptor and the ability to initiate transcaltachia (the rapid hormonal
      stimulation of calcium transport).

PMID- 7782930
TI  - Vitamin D metabolites modulate osteoblast activity by Ca+2 influx-independent
      genomic and Ca+2 influx-dependent nongenomic pathways.
AB  - Previous studies have shown that 1,25(OH)2D3 activates multiple signaling
      pathways in osteoblasts, including rapid nongenomic and long-term genomic
      pathways. Genomic pathways are mediated by the vitamin D receptor (VDR), a member
      of the steroid receptor superfamily, and involve transcriptional regulation of
      target genes. Nongenomic pathways involve lipid turnover, activation of Ca+2
      channels and elevation of intracellular Ca+2, all of which occur within seconds
      after addition of seco-steroid. The interaction of other physiological
      metabolites of vitamin D, such as 24,25(OH)2D3, with target cells such as
      osteoblasts is much less clear. We have used a combination of
      electrophysiological, biochemical, molecular and ion tracer studies to dissect
      the physiological responses of osteoblast-like osteosarcoma cells (ROS 17/2.8) to
      1,25(OH)2D3 and related metabolites. We conclude the following: 1) the structural
      requirements for activation of genomic vs. nongenomic pathways by seco-steroid
      are distinct and likely to involve separate receptors; 2) activation of rapid
      nongenomic pathways is independent of the long-term regulation of target genes;
      and 3) 1,25(OH)2D3 and 24,25(OH)2D3 interact at the level of the plasma membrane
      to regulate Ca+2 permeability. Present studies are aimed toward the understanding
      of the role of both genomic and nongenomic pathways in osteoblast physiology.

PMID- 7782931
TI  - Immunosuppressive actions of 1,25-dihydroxyvitamin D3: preferential inhibition of
      Th1 functions.
AB  - 1,25-Dihydroxyvitamin D3 [1,25-(OH)2-D3] is known to be an immunosuppressive
      hormone. This review primarily deals with in vitro and in vivo effects of 1,25
      (OH)2-D3 and analogue, 1,25-dihydroxy-16ene-vitamin D3 [1,25-(OH)2-16ene-D3], on
      T helper subsets type 1 (Th1) or type 2 (Th2) that have distinctive functional
      characteristics in humans. Th1 secrete interferon (IFN-gamma), interleukin (IL-2)
      and induce B cells to produce immunoglobulin IgG2a while Th2 secrete IL-4, IL-10
      and induce the production of IgG1 and IgE by B cells. The sterol inhibits the
      secretion of IL-12, a cytokine produced by monocytes and B cells, which leads to
      the activation and differentiation of Th1. In addition, 1,25-(OH)2-D3 directly
      inhibits IFN-gamma secretion by Th1 clones while it has little effect on IL-4
      secretion by Th2 clones. The analogue, 1,25-(OH)2-16ene-D3, is 100-fold more
      potent than 1,25-(OH)2-D3 in inhibiting IFN-gamma secretion but also has little
      effect on IL-4 secretion. In mice, when given in vivo, the sterol prevents the
      induction of spontaneous and induced autoimmune diseases and inhibits Th1 induce
      IgG2a responses. These actions of the vitamin D3 compounds suggest that it may
      have potential therapeutic applications in Th1-mediated clinical situations such
      as autoimmunity and transplantation.

PMID- 7782932
TI  - 1,25(OH)2D3-regulated human keratinocyte proliferation and differentiation: basic
      studies and their clinical application.
AB  - Keratinocytes produce vitamin D, metabolize it to its most biologically active
      form, 1,25(OH)2D, and respond to the 1,25(OH)2D they produce with a decrease in
      proliferation and an increase in differentiation. 1,25(OH)2D production by
      keratinocytes is tightly controlled and changes as the cells differentiate,
      increasing during the early stages of differentiation and then decreasing again
      as terminal differentiation ensues. The 1,25(OH)2D produced endogenously or
      supplied exogenously acts in concert with calcium and products of
      phosphoinositide metabolism to stimulate the transition from a proliferating
      basal cell to a terminally differentiated corneocyte. The mechanisms involved
      include changes in gene transcription and messenger RNA stability. These
      antiproliferative, prodifferentiating actions of 1,25(OH)2D3 have led to its
      successful use in psoriasis, a hyperproliferative skin disease, and may lead to
      its use as a chemopreventive agent in malignancy.

PMID- 7782933
TI  - Insulin resistance, obesity and hypertension: an overview.

PMID- 7782934
TI  - Insulin resistance, obesity and hypertension.
AB  - Although controversy exists as to the role that insulin resistance and
      hyperinsulinemia play in the pathogenesis of hypertension, data are presented
      that strongly suggest that selective insulin resistance and hypertension are
      directly related. This paper summarizes how insulin resistance may be linked to
      obesity hypertension and describes some of the other cardiovascular implications
      that insulin resistance may have in the hypertensive obese individual.

PMID- 7782935
TI  - Obesity and hypertension: roles of hyperinsulinemia, sympathetic nervous system
      and intrarenal mechanisms.
AB  - Hypertension is a well-recognized complication of obesity. However, the
      mechanisms for the development of obesity hypertension are not known. One
      mechanism proposed is that the hyperinsulinemia present in obese hypertensive
      patients causes hypertension via sodium retaining and/or sympathetic nervous
      system stimulatory effects. However, numerous studies in dogs have revealed no
      evidence for such chronic pressor actions of hyperinsulinemia. This is in close
      agreement with studies in human insulinoma patients that show marked
      hyperinsulinemia and normal blood pressure. The appropriateness of the dog as an
      experimental model is strengthened by reports from our laboratory and others that
      inducing obesity in dogs reproduces many of the characteristics of obesity in
      humans, including insulin resistance, hyperinsulinemia, sodium retention,
      hypertriglyceridemia and hypertension. Recent studies in obese dogs have
      indicated that significant increases in renal medullary cellularity and
      intercellular matrix deposition could contribute to the sodium retention and
      hypertension. Additional evidence suggests that sympathetic nervous system
      stimulation also may contribute to the elevated blood pressure. However, the
      mechanisms through which obesity induces these changes and the temporal
      relationship between these factors and the development of the hypertension
      remains to be determined.

PMID- 7782936
TI  - Insulin inhibits dog vascular smooth muscle contraction and lowers Ca2+i by
      inhibiting Ca2+ influx.
AB  - Essential hypertension, obesity and non-insulin-dependent diabetes are associated
      with resistance to insulin-induced glucose disposal. Because physiological
      concentrations of insulin inhibit vascular smooth muscle (VSM) contraction in
      vivo, it has been proposed that resistance to insulin-induced inhibition of VSM
      contraction might be partly responsible for the elevated vascular resistance
      found in these clinical conditions. Nevertheless, it is not known how insulin
      inhibits contraction of normal VSM. Several workers have demonstrated that
      insulin attenuates the agonist-induced intracellular Ca2+ (Ca2+i) transient in
      VSM, although the identity of the sarcolemmal and/or sarcoplasmic reticular Ca2+
      transport systems that are affected by insulin is controversial. Our laboratory
      has examined the effects of a physiological concentration of insulin on
      contraction and Ca2+ transport in cultured VSM cells from canine femoral artery.
      We have found that insulin inhibits agonist-induced contraction and attenuates
      the agonist-induced Ca2+i transient by inhibiting Ca2+ influx, but not by
      increasing Ca2+ efflux or inhibiting Ca2+ release from internal stores. Insulin
      also stimulates ouabain-sensitive 86Rb+ uptake (Na(+)-K+ pump activity) and does
      not inhibit VSM contraction in the presence of ouabain. Our data support the
      hypothesis that insulin stimulates Na(+)-K+ pump activity, resulting in
      hyperpolarization of the cell and decreased Ca2+ influx via voltage-operated
      channels.

PMID- 7782937
TI  - Insulin resistance vs. hyperinsulinemia in hypertension: insulin regulation of
      Ca2+ transport and Ca(2+)-regulation of insulin sensitivity.
AB  - Hypertension in obesity and insulin resistance has been attributed to insulin
      stimulation of sympathetic neural output and renal sodium retention. However,
      recent data demonstrates a significant vasodilatory effect of insulin and
      suggests that vascular smooth muscle resistance to this action may instead be the
      cause of hypertension in insulin resistance. This concept is supported by the
      observation that pharmacological amplification of peripheral insulin sensitivity
      results in reduced arterial pressure. Insulin attenuates vasoconstrictor
      responses to pressor agonists and accelerates vascular smooth muscle relaxation,
      while these effects are blunted in obesity and insulin resistance. Insulin
      regulation of vasoconstriction and vascular relaxation appears to be secondary to
      regulation of intracellular Ca2+ ([Ca2+]i), as insulin attenuates both voltage-
      and receptor-mediated Ca2+ influx and stimulates both the transcription and
      activity of Ca(2+)-ATPase in vascular smooth muscle cells. Further, these effects
      are also blunted in insulin resistance. Although [Ca2+]i plays a poorly
      understood role in insulin signalling, increases beyond an optimal range results
      in impaired insulin sensitivity, possibly by Ca(2+)-inhibition of insulin-induced
      dephosphorylation of insulin-sensitive substrates. Consistent with this concept,
      ectopic overexpression of the agouti gene in the viable yellow (Avy) mouse
      results in increased skeletal myocyte [Ca2+]i. Accordingly, increased [Ca2+]i in
      primary insulin target tissues appears to result in peripheral insulin resistance
      which then results in aberrant regulation of vascular smooth muscle [Ca2+]i and
      increases in arterial pressure.

PMID- 7782938
TI  - Alpha-keto acid dehydrogenase complexes: nutrient control, gene regulation and
      genetic defects. Overview.

PMID- 7782939
TI  - The pyruvate dehydrogenase complex: nutrient control and the pathogenesis of
      insulin resistance.
AB  - This review examines the molecular mechanisms underlying substrate competition
      between glucose and lipid in starvation and in insulin-resistant states. We
      demonstrate that lipid-derived substrates are oxidized in preference to glucose
      by skeletal muscle in vivo during prolonged starvation. An accelerated and
      exaggerated lipolytic and ketogenic response to starvation in late pregnancy is
      associated with more rapid suppression of glucose oxidation by the maternal
      skeletal-muscle mass. These benign adaptations to changes in lipid availability
      (which occur secondarily to changes in carbohydrate supply and demand) contrast
      with the well-documented detrimental effects to health of an inappropriately high
      supply of dietary lipid. We present results that indicate that the prolonged
      consumption of a diet high in saturated fat is associated with a stable
      enhancement of pyruvate dehydrogenase (PDH) kinase activity at least in two
      oxidative tissues--liver and heart. This long-term enhancement of PDH kinase
      activity is concomitant with the development of whole-body insulin resistance and
      adds a new dimension to the potential role of dietary composition in the
      pathogenesis of insulin resistance.

PMID- 7782940
TI  - Gene regulation and genetic defects in the pyruvate dehydrogenase complex.
AB  - The mammalian pyruvate dehydrogenase complex (PDC) is subject to both short-term
      (product inhibition and covalent modification) and long-term (increases in total
      activity and protein mass) regulation mediated by dietary and hormonal
      treatments. Recent advances in the isolation and characterization of the
      complementary DNAs as well as genes encoding several components of mammalian PDC
      have facilitated studies concerning long-term regulation of PDC. Analyses of the
      promoter-regulatory regions of the two human PDC genes show characteristics of
      both facultative and housekeeping gene promoters, indicating complex
      transcriptional regulation. Deficiency of PDC activity causes a wide range of
      neurological disabilities. A spectrum of genetic defects in PDC components has
      been reported; however, the most frequent defects are associated with the
      pyruvate dehydrogenase component. Heterogeneity in pyruvate dehydrogenase
      deficiency has been shown to occur at both protein and messenger RNA levels, and
      several mutations in pyruvate dehydrogenase have been identified. Dietary
      treatments such as ketogenic diets and vitamin supplements as well as
      dichloroacetate treatment have been utilized to treat PDC deficiency, but their
      efficacy requires further evaluation.

PMID- 7782941
TI  - Nutritional regulation of the protein kinases responsible for the phosphorylation
      of the alpha-ketoacid dehydrogenase complexes.
AB  - The branched-chain alpha-ketoacid dehydrogenase (BCKDH) and pyruvate
      dehydrogenase (PDH) complexes are regulated by phosphorylation cycles catalyzed
      by complex-specific protein kinases and phosphoprotein phosphatases. Molecular
      cloning of these mitochondrial protein kinases has established a new family of
      protein kinases in eukaryotes that appears related by primary sequence to the
      histidine protein kinase family of prokaryotes. Changes in the activities of both
      kinases that are stable, i.e., not caused directly by allosteric effectors,
      correlate inversely with the changes in the activity states of the complexes that
      occur in different nutritional states. For example, BCKDH kinase activity is
      increased and the BCKDH complex activity state is decreased in rats fed diets
      deficient in protein. The increase in BCKDH kinase activity is due to an increase
      in the amount of BCKDH kinase protein bound to the BCKDH complex. The message
      level for BCKDH kinase also increases in the liver of rats starved for protein,
      suggesting a pretranslational mechanism exists for the long-term regulation of
      BCKDH kinase. Starvation and high-fat feeding cause a stable increase in PDH
      kinase activity and a corresponding decrease in activity state of the PDH
      complex. The mechanism responsible has not been defined.

PMID- 7782942
TI  - Branched-chain alpha-keto acid dehydrogenase complex in rat skeletal muscle:
      regulation of the activity and gene expression by nutrition and physical
      exercise.
AB  - Branched-chain alpha-keto acid dehydrogenase complex is the rate-limiting enzyme
      in the catabolism of branched-chain amino acids in skeletal muscle. It is
      suggested that activation of this enzyme in the muscle during exercise plays an
      important role in the increased oxidation of branched-chain amino acids in the
      muscle. Evidence suggests that branched-chain alpha-keto acids, the substrates
      for the enzyme, regulate the activity state of the enzyme in the muscle during
      exercise through phosphorylation/dephosphorylation cycle of the enzyme protein.
      We propose a model for the mechanism of enzyme activation by exercise. In
      addition to this acute effect of exercise, we present evidence suggesting that
      exercise training modulates the enzyme activity and gene expression for the
      enzyme. Increases in the total activity as well as enzyme proteins by exercise
      training are suggested to be associated with mitochondrial biogenesis in the
      muscle.

PMID- 7782944
TI  - Thyroid hormones, their activation, degradation and effects on metabolism.
AB  - The control of both metabolism and developmental events by thyroid hormones
      involves a variety of metabolic modifier effects. These actions of thyroid
      hormones are mediated by nuclear thyroid hormone receptors that have their
      highest affinity for triiodothyronine (T3). Thyroid hormone deiodinations can
      have activating or inactivating effects, with the production of T3 (the most
      active form) and its degradation being of key importance. At the organismic
      level, the development of thermogenic metabolic responses necessary for
      homeothermy in birds is correlated with the pattern of thyroid development and
      the extrathyroidal deiodinations of thyroid hormones. At the cellular level,
      deiodination effects on cellular T3 availability can protect T3 supply for
      critical developmental processes (e.g., in brain) or potentially play a role in
      the differentiation and maturation of various hormone-responsive tissues. Thyroid
      hormones, both alone and through interactions with other hormones and growth
      factors, also can influence intermediary metabolic responses that, in turn, play
      roles in growth and development.

PMID- 7782943
TI  - Molecular basis of maple syrup urine disease and stable correction by retroviral
      gene transfer.
AB  - Maple syrup urine disease (MSUD) or branched-chain ketoaciduria is caused by a
      deficiency of the branched-chain alpha-keto acid dehydrogenase (BCKAD) complex.
      This results in the accumulation of the branched-chain amino acids (BCAA) and
      branched-chain alpha-keto acids (BCKA), which often produce severe neurological
      damage and mental retardation. The present studies focus on mutations in the E1
      alpha gene of the BCKAD complex and their effects on the assembly of the E1
      decarboxylase component of the enzyme complex. We have developed an efficient
      histidine-tagged bacterial expression system that allows the folding and assembly
      of E1 alpha and E1 beta subunits into the E1 heterotetramer (alpha 2 beta 2) in
      the presence of overexpressed chaperonins GroEL and GroES. The results of pulse
      chase experiments with this bacterial expression system showed that a majority of
      the 15 known E1 alpha mutations, including the prevalent Y393N of Mennonite MSUD
      patients, decrease the rate of association of normal E1 beta with mutant E1
      alpha. This results in limited or no assembly of mutant E1. It is concluded that
      the carboxy-terminal region of the E1 alpha subunit encoded by exons 7-9 is
      important for subunit interaction. To stably correct MSUD, we have developed a
      retroviral vector that contains a normal E1 alpha precursor complementary DNA.
      Transduction of cultured lymphoblasts from a Mennonite MSUD patient with this
      recombinant retroviral vector completely restored the rate of decarboxylation of
      BCKA. The normal decarboxylation activity in transduced MSUD cells remained
      stable without antibiotic selection during the 14-week study.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7782945
TI  - Species variation in mechanisms for modulation of growth by beta-adrenergic
      receptors.
AB  - Beta-adrenergic agonists have been fed to avian and mammalian species to modulate
      growth. Such treatment produces increased rate of gain, decreased feed
      consumption, increased skeletal muscle and decreased fat accretion. There is good
      evidence for the inhibition of adipose tissue lipogenesis and stimulation of
      lipolysis as well as stimulation of skeletal muscle protein synthesis and
      inhibition of degradation. Other effects include increased blood flow and
      modulation of plasma concentration of various hormones. The degree to which each
      of these effects is observed varies considerably between experiments. Some of the
      diversity may be explained by species and/or tissue differences in distribution
      of beta-adrenergic receptor subtypes, in structure and, consequently, in response
      of receptors and in the pharmacodynamics of the agonist. In addition, several
      different agonists have been used, adding further complexity. Oversimplification
      by extrapolation of research observations across species and agonists may confuse
      attempts to derive mechanisms for the growth modulation effects of beta
      adrenergic agonists in vivo.

PMID- 7782946
TI  - Proposed mechanisms for the regulation of growth hormone action in poultry:
      metabolic effects.
AB  - Growth hormone (GH) administration to nonruminant red meat animals markedly
      alters carcass composition so that dramatic reductions in adipose tissue
      accretion and enhancement of lean tissue growth occur. These repartitioning
      effects of GH in the pig are reported to reflect antagonism of the lipogenic
      effect of insulin on adipose tissue, the primary site of fatty acid synthesis in
      this species, so that glucose disposal and utilization by adipose tissue are
      markedly reduced, and substrate availability to muscle is increased. In poultry,
      a significant positive response to GH administration is not consistently
      achieved, and factors such as posthatch period of development and the pattern of
      tissue exposure to GH are important determinants of the response to GH
      enhancement. This may relate to the status of target tissue GH receptors that
      appear subject to down regulation in the adult chicken. Sensitivity of the bird
      to the appetite-suppressive effects of GH and interaction between this effect and
      energy intake have recently been demonstrated and need to be further explored.
      Growth hormone clearly influences hepatic lipogenesis and net lipid deposition in
      the broiler chicken. However, future research emphasis on the regulation of GH
      receptor binding activity and gene expression and their relationship to GH
      action, as well as on newer components of the GH axis such as GH-binding
      proteins, will help to clarify controlling mechanisms in poultry.

PMID- 7782947
TI  - Beyond deficiency: new views of vitamins in ruminant nutrition and health: an
      overview.

PMID- 7782948
TI  - Supranutritional administration of vitamins E and C improves oxidative stability
      of beef.
AB  - Vitamins E and C are important antioxidants in animals. Their antemortem activity
      continues to function in postmortem muscle (meat), where they have a critical
      role in maintaining quality in the food product. Dietary supplementation of
      vitamin E, and intravenous infusion of vitamin C immediately before harvest, are
      efficacious techniques for increasing the concentration of these vitamins in beef
      skeletal muscle. Meat with elevated levels of either and probably both of these
      antioxidant vitamins possesses greater stability of oxymyoglobin and lipid, which
      results in less discoloration and rancidity, respectively. A model is proposed
      for the redox relationships between myoglobin and phospholipid in beef with
      emphasis on vitamins E and C. Antemortem nutritional intervention appears to be a
      promising approach for improving the quality of fresh meat products subsequently
      obtained from livestock.

PMID- 7782949
TI  - Bioavailability and interaction of vitamin A and vitamin E in ruminants.
AB  - Recent interest in antioxidant vitamins and animal nutrition has resulted in the
      investigation of feeding levels of vitamin E which are considerably higher than
      NRC requirements. Relatively high levels of vitamin E are required to improve
      animal product quality such as extending beef color stability and minimizing off
      flavors in milk due to lipid oxidation. Concerns regarding a negative effect of
      vitamin A on vitamin E utilization and the suitability of currently used standard
      activity values for vitamin E supplements for ruminants have been raised. High
      dietary levels of vitamin A have depressed vitamin E utilization in most animals
      studied. In the dairy cow, 675,000 IU of vitamin A acetate per head per day is
      required to significantly depress vitamin E utilization. This is approximately 10
      fold greater than the highest levels currently fed to dairy or beef cattle and
      therefore should not cause a practical problem. Synthetic and naturally derived
      alpha-tocopherol, and their ester forms, are commonly used as vitamin E
      supplements. These various forms give rise to isomer differences, ester
      differences and formulation differences that can affect their absorption and
      subsequent utilization. The current research indicates that the commonly used
      standard activity values based on a value of 1.00 IU per mg of all-rac-alpha
      tocopheryl acetate are probably too low for the ruminant. The roles of isomeric
      forms and gastrointestinal tract absorption have not been completely resolved
      regarding their effects on the bioavailability of vitamin E supplements.

PMID- 7782950
TI  - Antioxidant vitamins affect food animal immunity and health.
AB  - Carotenoids (beta-carotene and lycopene), vitamin E (alpha-tocopherol) and
      vitamin C (ascorbate) are naturally-occurring antioxidant nutrients that play
      important roles in animal health by inactivating harmful free radicals produced
      through normal cellular activity and from various stressors. Both in vitro and in
      vivo studies showed that these antioxidant vitamins generally enhance different
      aspects of cellular and noncellular immunity. The antioxidant function of these
      micronutrients could, at least in part, enhance immunity by maintaining the
      functional and structural integrity of important immune cells. A compromised
      immune system will result in reduced animal production efficiency through
      increased susceptibility to diseases, thereby leading to increased animal
      morbidity and mortality.

PMID- 7782951
TI  - Women's health: nurses pave the way.

PMID- 7782952
TI  - When a baby dies: rights of the baby and parents.
AB  - The Rights of Parents When a Baby Dies and Rights of the Baby were developed by
      the Perinatal Bereavement Team at Women's College in Toronto, Canada. With
      permission, the National Office of SHARE: Pregnancy and Infant Loss Support, Inc.
      has revised and expanded these documents for distribution within the United
      States. The Rights are intended to help caregivers and institutions provide
      parents with information about their options regarding the death of their baby
      and allow them time and support for decision making.

PMID- 7782953
TI  - Pneumothorax in the neonate.
AB  - Neonatal critical-care nurses frequently care for neonates experiencing
      pneumothoraces. The treatment of a pneumothorax varies with the cause. Knowledge
      of the condition will help the nurse in caring for the neonate at high risk. In
      this article, types of pneumothoraces will be reviewed, and information will be
      provided regarding the pathophysiology, diagnosis, treatment, and nursing
      responsibilities in caring for an infant experiencing a pneumothorax.

PMID- 7782954
TI  - Physiologic measures of kangaroo versus incubator care in a tertiary-level
      nursery.
AB  - OBJECTIVE: To determine the safety and feasibility of kangaroo care in a tertiary
      level nursery as defined by apnea, bradycardia, and oxygen desaturation. DESIGN:
      Prospective, long-term, repeated measures with a convenience sample. SETTING: A
      20-bed, tertiary-level nursery with approximately 400 admissions a year.
      PARTICIPANTS: Eight mother-infant pairs. INTERVENTIONS: Researchers compared
      incubator care with kangaroo care for 4 hours a day, 6 days a week, for 3 weeks.
      Physiologic variables were monitored daily and recorded continuously on a
      polygraph for 8 hours each week. MAIN OUTCOME MEASURES: Amount of apnea,
      bradycardia, and oxygen desaturation. SECONDARY OUTCOME MEASURES: Heart rate,
      respiratory rate, percent sleep time, and skin temperature. RESULTS: Apnea,
      bradycardia, oxygen saturation, heart rate, and respiratory rate were similar
      during both kangaroo (K) and incubator (I) care. The infants experienced a lower
      percent (mean +/- standard deviation, K versus I) of total sleep (47 +/- 15
      versus 64 +/- 19, p < .003) during kangaroo care. The infants' mean +/- standard
      deviation temperature during the kangaroo care (36.5 degrees C +/- 0.64 degrees
      C) was lower (p < .03) than that of the control periods before (36.8 degrees C +/
      0.27 degrees C) or after (36.7 degrees C +/- 0.26 degrees C). Percent sleep time
      and skin temperature were slightly lower during kangaroo care, but the
      differences were not clinically significant. CONCLUSION: Kangaroo care is safe
      and feasible for selected mothers and infants in a tertiary-level nursery.

PMID- 7782955
TI  - Sleep disturbances and fatigue in women with fibromyalgia and chronic fatigue
      syndrome.
AB  - OBJECTIVE: To determine the relationship between sleep disturbances and fatigue
      in women with fibromyalgia (FM) and those with chronic fatigue syndrome (CFS) and
      to assess whether any differences existed between the two groups. DESIGN:
      Descriptive comparative. SETTING: Community program on chronic fatigue syndrome
      and related disorders. PARTICIPANTS: Sixty-three women who attended the program;
      13 had CFS, and 50 had FM. MAIN OUTCOME MEASURES: A moderately strong
      relationship between fatigue and sleepiness was found (r = .63, p < .01). Trouble
      staying asleep was the highest rated sleep disturbance, and fatigue was the most
      common subjective feeling reported. Women with CFS reported significantly more
      trouble staying asleep than women with FM, t(61) = 1.81, p < .03. CONCLUSIONS:
      Data from this study support that women with FM and CFS encounter problems
      sleeping. Clinicians are encouraged to assess women with FM and CFS for their
      quality of sleep rather than amount of sleep. Researchers are encouraged to
      continue study of sleep disturbances in women with FM and CFS to improve
      understanding of the disturbances and to test the effectiveness of sleep
      interventions.

PMID- 7782956
TI  - Maternal learning needs during labor and delivery.
AB  - OBJECTIVE: To determine if the learning needs of mothers are met by nurses during
      labor. DESIGN: Descriptive survey with a longitudinal time frame. SETTING: Two
      hospitals in a midsized Canadian city. PARTICIPANTS: Fifty-seven women in their
      last month of pregnancy, selected at random from 276 eligible women referred by
      physicians. Final sample for analysis was 40. MAIN OUTCOME MEASURES: Data
      described patients, their expected learning needs before delivery, the teaching
      they received, and factors related to the experience. RESULTS: The majority of
      subjects wanted teaching in labor and reported that teaching was helpful, but
      that conflicts in teaching and differing expectations of staff were upsetting.
      Mothers' expectations and the teaching they received were congruent for some
      topics and incongruent for others. CONCLUSION: Results suggest a need for
      assessment of learning needs of women in labor, consistency among caregivers, and
      further study with a larger sample.

PMID- 7782957
TI  - Cultural concepts of women's health and health-promoting behaviors.
AB  - Cultural diversity is the reality of the 1990s, and the United States is becoming
      the most ethnically diverse society in the world. The needs and responses of many
      different racial and ethnic groups are competing for recognition, and nurses must
      learn how to meet the health care needs of this multicultural society. This
      article explores cultural concepts relating to women's health and health
      promoting behaviors in the context of this social change. It explores demographic
      change, concepts of heritage consistency, traditional health beliefs, and
      traditional health-promoting behaviors.

PMID- 7782958
TI  - Intercultural communication: finding common ground.
AB  - Diversity has become a leading topic of discussion in virtually all sectors of
      our society. This is certainly true in health care; the nursing profession has
      long been dealing with issues of cultural appropriateness. This article looks at
      the relationship of culture to communication. The current approach to
      intercultural communication discussed in much of the nursing literature is judged
      to be short-sighted. An alternative approach based on the development of a
      functional cultural communication perspective is offered.

PMID- 7782959
TI  - Culture, spirituality, and women's health.
AB  - A review of the literature on culture, health/women's health, and
      spirituality/religion reveals that the purported relationships among these
      variables may be tenuous. Nevertheless, there is a need for health care
      professionals to be aware of existing cultural/religious beliefs that may affect
      women's health behavior if provision of holistic health care is a goal.
      Implications for practice and research can be drawn from the existing evidence in
      the literature.

PMID- 7782960
TI  - Migrant and seasonal farm worker women.
AB  - Migrant and seasonal farm worker women are part of a population whose health care
      needs are underserved. This article provides some definition of this population
      and reviews some of the health needs specific to them. The significant need for
      outreach to and assessment of this population is addressed. The significance of
      the nurse's role is addressed. The need for health care services being delivered
      in a culturally sensitive manner is discussed. Resources to assist health care
      providers in providing more effective interventions and referrals for care of
      migrant and seasonal farm worker women are identified.

PMID- 7782962
TI  - Right diaphragmatic paralysis following orthotopic liver transplantation.
AB  - Although most postoperative complications of liver transplantation are well known
      and their pathophysiology is reasonably understood, right diaphragmatic
      dysfunction occurring after liver transplantation remains an unappreciated
      complication. To evaluate the incidence and mechanisms responsible for such
      injury, a group of 48 liver transplant patients were studied prospectively.
      Partial right diaphragmatic paralysis was found in 11 (23%), complete paralysis
      was found in 10 (21%) and the remaining 27 patients had normal diaphragmatic
      motion (56%). The operative records of these 48 patients were reviewed. Right
      diaphragmatic injury was found to be a common postoperative complication of liver
      transplantation. Moreover, it was found to have a clinically significant effect
      upon the postoperative course of these patients, often necessitating a prolonged
      ICU stay and prolonged ventilatory support. Although the exact mechanism
      responsible for its occurrence remains speculative, careful attention to
      operative technique particularly in the dissection of the upper cava and careful
      closure of the bare area of the diaphragm, may reduce the frequency of this
      untoward complication.

PMID- 7782961
TI  - How much is too much? A study of pregnant women in service industry jobs.
AB  - This qualitative study explored the broad aspects of stress and coping in the
      work and home experiences of pregnant women who worked in the service industry.
      The participants described home roles of mother, spouse/partner, and homemaker
      that were particularly valued and significant. Work provided income and a
      cultural setting for socialization, personal growth, and social support. The
      participants coped with the additional demands of pregnancy by adopting health
      promotion measures and scheduling routines at work and home in different ways.
      However, pregnant working women often are pulled in many directions at once, and
      their health eventually may be affected.

PMID- 7782963
TI  - The Oklahoma-Pittsburgh experience with interferon alpha in the treatment of HCV
      disease.
AB  - Interferon alpha (IFN) is the only Food and Drug Administration (FDA)-approved
      therapy available for the treatment of chronic hepatitis C. The ideal dose and
      frequency of IFN administration that produces the greatest number of patient
      responders with the least number of relapses following drug withdrawal remains
      unclear. METHODS. One hundred seventeen patients recruited over a five-year
      period with chronic hepatitis C were divided into four groups and treated with
      progressively larger doses. The rate of clinical responses defined as a loss of
      detectable hepatitis C virus-ribonucleic acid (HCV-RNA) in serum by polymerase
      chain reaction (PCR) and normalization of the serum ALT (abnormal alanine
      aminotransferase) for each group was calculated. RESULTS. As the dose of IFN
      administration increased, the response rate defined by the absence of HCV-RNA in
      the patient's serum after six months of follow-up increased from 7.7% to 26.6%.
      If the end point utilized was HCV-RNA negativity after six months of treatment,
      the response rate varied from 19.2% to 30%. Using the less difficult end point of
      a normal ALT level, the response rates varied from 32.1% to 63.3% after six
      months of therapy and from 10.7% to 26.7% after six months of follow-up.
      CONCLUSIONS. This experience demonstrates that both the response rate at the end
      of therapy and after six months of follow-up improves with an increase in dose of
      IFN administered over a six-month period.

PMID- 7782964
TI  - A note in support of reversal treatment for coronary artery disease.
AB  - Coronary heart disease is the leading cause of mortality and morbidity in the
      United States at an estimated cost of $56 billion per year. Current approaches to
      treatment of coronary artery disease are not likely to reduce mortality and
      morbidity despite pressure to reduce costs in the changing health care
      environment. Evidence is now available that comprehensive noninvasive medical
      management, which includes aggressive lipid-lowering therapy, can produce results
      equivalent to current approaches at a lower cost. The author supports this
      approach, which can prevent progression and possibly produce regression of
      coronary artery disease. A new approach to management is proposed that integrates
      comprehensive noninvasive management as initial therapy for coronary heart
      disease.

PMID- 7782965
TI  - [Management of hypopharyngeal and cervical esophageal cancer (HCEC): a
      comparative study of primary-surgical and primary-radiotherapeutic regimens].
AB  - The results of two treatment regimens for HCEC were compared. Surgery played a
      main role in the first regimen (Group A), in which patients underwent total
      pharyngo-laryngo-esophagectomy (with bilateral neck dissection and primary
      reconstruction by pectoralis major myocutaneous flap or gastric tube) after
      receiving 20 Gy of irradiation therapy. Chemotherapy was combined in some
      patients. In the second regimen (Group B), radiation was employed as the main
      treatment in order to conserve the larynx. Chemotherapy (UFT 300 to 600 mg/day;
      in some patients one or two courses of intra-venous cisplatinum therapy) was
      combined with radiation therapy (60 Gy) to improve the effectiveness of this
      regimen. In case of radiation failure, a salvage operation was performed. We
      investigated 60 HCEC patients who visited the Kitasato University Hospital during
      the period from 1983 to 1992. The tumor was located in the PC, PS, PW, and Ce
      areas in 3, 48, 5, and 4 patients, respectively. There were 25 cases in group A
      and 35 in group B. Five-year cumulative survival rates were 52% and 55%,
      respectively. In group B, tumor remained or recurred after the initial treatment
      in 13 patients. Three patients refused to receive salvage operation. Four of the
      10 patients who received salvage operation became tumor free. The larynx
      preservation rate was 71% in group B. From the standpoint of improving QOL, the
      group B regimen is recommended.

PMID- 7782967
TI  - [Study of standing exactitude determined by the scatter of the center of pressure
      -study of standing exactitude by center of pressure].
AB  - In so far as stance is maintained during various activities, the center of
      pressure must be maintained with a certain area. This area is the range of the
      center of pressure. It is influenced by standing conditions and vision. In this
      study we used a force platform to measure the range of the center of pressure in
      10 normal adults during maximal voluntary shifting from right to left, back and
      forth under 6 conditions (standing conditions: both legs apart, both legs
      together and standing on one leg; vision: eyes open and eyes closed). We also
      recorded the center of pressure while standing still for 30 seconds under the
      above 6 conditions. The scatter of the center of pressure and the range of the
      center of pressure were compared. Under easy standing conditions, the range of
      the center of pressure was very large and the center of pressure was concentrated
      in a small area. The more difficult the standing condition, the smaller the range
      of the center of pressure, and the wider the scatter of the center of pressure.
      Under very difficult standing conditions, the range of the center of pressure was
      almost as large as the area in which the center of pressure was scattered. Since
      the range of the center of pressure is closely connected with the scatter of the
      center of pressure, it may be possible to determine the accuracy of stance
      regulation by analyzing the range of the center of pressure and the scatter of
      the center of pressure.

PMID- 7782966
TI  - [Study on vomiting and the vestibulo-autonomic reflex].
AB  - When vestibular organs are abnormally stimulated, autonomic reactions such as
      nausea, vomiting, palpitation, etc., occur, indicating the existence of fiber
      connections from the vestibular organs to the autonomic centers. The relationship
      between the "vomiting center" in the medulla oblongata as described by Borison
      and Wang and the vestibular nucleus remains obscure. To investigate the central
      mechanism of vomiting caused by vestibular stimulation, the intragastric
      pressure, gastric peristalsis and respiration during electric stimulation of the
      medullary vomiting center and the semicircular canal nerve were recorded in 12
      adult cats. Evoked potential was also recorded while electrically stimulating the
      semicircular canal nerve. When the peripheral labyrinth was stimulated, a
      conflicting result was founded, namely, that the pressure in the stomach
      increased or decreased. Retching or vomiting-like behavior was observed in
      several sites when the dorsolateral portion of the reticular formation of the
      medulla was stimulated. It was found that neural structures in the dorsolateral
      portion of the reticular formation of the medulla were associated with the
      semicircular canal nerve, but retching or vomiting-like behavior was not always
      observed during stimulation there.

PMID- 7782968
TI  - [Tympanosclerosis--clinical and pathological investigation].
AB  - Fifty-nine cases of tympanosclerosis were investigated clinically and
      pathologically, and the following results were obtained: 1) The male to female
      ratio was about 1:1.8 2) Calcification in the tympanic membrane was most common
      in the upper quadrants of the pars tensa, and never seen in the pars flaccida. 3)
      Calcification in the middle ear cavity was most common around the malleus. 4)
      Chronic otitis media was the most common complication of tympanosclerosis. 5)
      Preoperative audiometry revealed a stiffness curve with elevated bone conduction
      thresholds. 6) 54% of the patient had chronic otitis media in the contralateral
      ear. 7) Microscopic examination revealed calcification in the submucosa of the
      middle ear. 8) Postoperative hearing was improved in 49 ears (79.7%). Because
      there was no difference in the average postoperative hearing gain after type I
      and type III tympanoplasty, type III tympanoplasty is recommended to remove
      sclerotic masses completely.

PMID- 7782969
TI  - [Clinical use of EVAR and OVAR by the dumped rotation test--comparison of normal
      volunteers and patients with unilateral vestibular nerve section].
AB  - Horizontal eye movements in response to either earth vertical axis rotation
      (EVAR) or off vertical axis rotation (OVAR) by a 10 degree tilted axis were
      recorded in six normal subjects and three patients with unilateral vestibular
      nerve section. Both trials consisted of acceleration at approximately 400
      deg/sec2 until an angular velocity of 180 deg/sec was reached followed by
      deceleration at -4 deg/sec2 until rotation ceased. This is the so-called dumped
      rotation procedure. Total numbers of nystagmic beats and the duration of
      perrotatory nystagmus in these two different trials were compared. The results
      were as follows: 1) Total numbers of nystagmic beats in OVAR were significantly
      larger than in EVAR. 2) The duration of perrotatory nystagmus in OVAR was
      significantly longer than in EVAR. Only the horizontal semicircular canals were
      stimulated by angular acceleration in EVAR, whereas both otolith organs and
      semicircular canals were stimulated on changing the position of the head around
      the direction of the gravity in OVAR.

PMID- 7782970
TI  - [Combined macro-micro-endoscopic technique (COMMET) in endonasal sinus surgery:
      II. Objective assessment and results].
AB  - To optimize success in sinus surgery, we use a combined macro-micro-endoscopic
      technique (COMMET). This technique effectively combines use of the headlamp,
      microscope, and endoscope according to the demands of each anatomical region.
      Between April 1991 and March 1994, we successfully performed this technique on
      461 patients (798 sides). According to CT scans, about 40% of the patients had
      pansinusitis, and about 30% of the patients had anterior and posterior
      ethmoiditis combined with inflammation of other sinuses. Hence, severe cases
      requiring total ethmoidectomy accounted for about 70% of all sides. All patients
      were operated on under general anesthesia. The objective of this operation was
      restoration of drainage and ventilation, and then to allow recovery of the
      reversible mucosal lesions. The goal of surgery was to normalize all paranasal
      sinuses. In many patients, there is little correlation between postoperative
      objective findings in the paranasal sinuses and subjective improvement.
      Therefore, postoperative subjective improvement cannot be used as the criterion
      for evaluating the improvement of sinus disease. Hence, we established an
      objective grading system based on CT and endoscopic findings and evaluated
      improvements in each sinus after drainage and ventilation had been restored. The
      rates of normalization over 1 year following surgery (mean follow-up time was 19
      20 months) were 64% in the frontal sinus, 72% in the anterior ethmoid sinus, 68%
      in the maxillary sinus, 90% in the posterior ethmoid sinus and 80% in the
      sphenoid sinus. The results differed from sinus to sinus, suggesting that there
      are different factors impairing recovery in each sinus.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7782971
TI  - [A morphological study of the human ventricular fold: age-related changes and sex
      differences].
AB  - A morphological study of the human ventricular fold was conducted with special
      reference to age-related changes and sex differences. The laryngeal specimens
      examined were obtained from 54 autopsy cases consisting of 27 males and 27
      females ranging in age from 20 to 79 years. Each specimen was frontal-sectioned
      between the anterior and posterior ends of the ventricular fold to yield 8 equal
      portions. The surface of the entire ventricular fold was reconstructed based on
      examination of all of the sections, and extent of squamous metaplasia was 3
      dimensionally evaluated and expressed in the form of a histological map. In the
      cases in which smoking history was ascertained, extent of squamous metaplasia was
      evaluated by the same method. In all of the cases the distribution of the
      different types of tissues such as glandular, adipose and connective, was
      examined in the midportion of the specimen (section No. 5). The following
      conclusions were drawn as a result. 1. The development of squamous metaplasia
      reached a peak in the middle-age group, particularly in males. The 3-dimensional
      extension of metaplasia was classified into 4 patterns, however, there were no
      age-specific differences in pattern, and the posterior-dominant-type and
      widespread-type were the most common in all age groups. The extension of
      metaplasia varied with smoking history, suggesting that smoking promotes the
      extension of squamous metaplasia. 2. Glandular tissue decreased with age, more
      markedly in females. The distribution of the glandular tissue was classified into
      4 patterns. Atrophy of glandular tissue with age occurred in the central area of
      the ventricular fold, extending to the marginal portion. 3. Collagen fibers
      decreased slightly with age. Elastic fibers appeared frequently in the lateral
      portion near the laryngeal ventricle in the aged group.

PMID- 7782972
TI  - [Improvement of olfactory disturbance by endoscopic endonasal surgery for chronic
      sinusitis].
AB  - Olfactory disturbance is the one of the most important symptoms of chronic
      sinusitis. In the present study, we followed up the postoperative clinical course
      of olfactory disturbance in patients who underwent surgery for chronic sinusitis.
      Ninety patients with severe olfactory disturbance or anosmia who underwent
      endoscopic endonasal surgery for chronic sinusitis with severe olfactory
      disturbance or anosmia in the preceding three-year period were enrolled in this
      study. We obtained a high postoperative improvement rate of 78.8%. We compared
      and examined our cases' postoperative clinical course concerning their olfactory
      disturbance and various factors in other patients before and after surgery, and
      obtained the following results: a) Young patients, 30 years old or under at the
      time of surgery, showed significantly higher rates of improvement than patients
      who were 50 years old or more at the time of surgery. b) Even though revision
      surgery was performed, the improvement rates were almost the same as after the
      initial surgery. c) Although the Alinamin intravenous olfaction test is regarded
      as an olfaction threshold test, we have seen quite a few cases in which
      improvement was achieved despite the absence of a preoperative response to the
      Alinamin intravenous olfaction test. d) There was no clear correlation between
      the presence of preoperative lesions of the ethmoid sinus and the olfactory cleft
      and the improvement rates. e) The cases with unsatisfactory results concerning
      the paranasal sinuses and nasal cavity--those accompanied by postoperative
      adhesions of the olfactory cleft, recurrence of polyps, etc.,--showed
      significantly lower improvement rates than cases with satisfactory postoperative
      results. During surgery in patients with severe olfactory disturbance, we
      conclude that it is particularly important to adequately clean the lesions of the
      olfactory cleft and the anterior and posterior ethmoid sinus endoscopically. This
      ensures leaving clear the olfactory cleft.

PMID- 7782973
TI  - [Vascular reconstruction of the carotid artery--studies of a one stage
      ipsilateral reconstructive procedure].
AB  - Recent advance in vascular surgery have made vascular reconstruction of the
      carotid artery possible. Since 1990, the authors have performed en bloc resection
      of the carotid artery and vascular reconstruction of the carotid artery, using a
      temporary shunt tube, in 10 cases. Among these 10 cases of tumors involving the
      carotid artery, two cases had carotid body tumors and the other eight cases had
      metastatic lymph nodes from head and neck cancers. Transient motor paralysis
      occurred in three cases and disorientation in one after the operation. None has
      developed severe neurological complications such as death, coma or permanent
      hemiplegia. Despite preoperative irradiation, local infection was noted in only
      one case after the operation. Rupture of the vein graft was prevented by using a
      DP flap to cover dead space at the anastomotic site. The two patients with a
      carotid body tumor are alive without evidence of recurrence. Among eight patients
      with cancer, three are still alive and disease free (respectively 44, 30 and 16
      months). Two patients died of local recurrence, two of distant metastasis and the
      other of acute heart failure. Local tumor control was possible in six out of
      eight patients. We were able to safely perform en bloc resection of the carotid
      artery and vascular reconstruction of the carotid artery using a temporary shunt
      tube. In conclusion, we anticipate increasing curability of advanced tumors
      involving the carotid artery using this procedure.

PMID- 7782974
TI  - [The effect of cefaclor and cefixime on nasopharyngeal pathogens in children].
AB  - Changes in nasopharyngeal flora were investigated in children with acute otitis
      media and with acute exacerbations of chronic sinusitis in whom antibiotic
      therapy of relatively long duration was required until substantial improvement in
      clinical findings was achieved. 1. The antibiotics used were two cephalosporins,
      i.e., cefaclor (CCL) and cefixime (CFIX), administered to 18 patients each for 1
      week and to 26 and 20 patients, respectively, for 2 weeks. Bacteriologic
      examination of the nasopharyngeal mucosa was performed at the first visit and at
      1 week in those who underwent antibiotic therapy for 1 week, and at the first
      visit and at 1 and 2 weeks in those treated with antibiotics for 2 weeks. 2. The
      elimination rates for the infecting microorganisms in the patients in the CCL
      treated group were 30% for Haemophilus influenzae, 83% for Staphylococcus aureus,
      100% for Streptococcus pyogenes and 100% for Streptococcus pneumoniae at 1 week,
      and 18% for H. influenzae, 100% for S. aureus and 100% for S. pyogenes at 2 weeks
      of antibiotic therapy. Replacement of S. aureus and S. pyogenes by H. influenzae
      was observed. 3. The elimination rates for infecting bacteria in the patients in
      the CFIX-treated groups were 61% for H. influenzae, 50% for S. aureus, 75% for S.
      pyogenes, 80% for S. pneumoniae and 100% for Moraxella catarrhalis at 1 week, and
      72% for H. influenzae, 0% for S. aureus, 100% for S. pyogenes, and 0% for S.
      pneumoniae at 2 weeks of antibiotic therapy. The elimination rate for H.
      influenzae at 2 weeks was significantly higher than the corresponding value for
      the CCL-treated group. Replacement of H. influenzae by S. aureus and S.
      pneumoniae and of S. pyogenes by S. aureus was detected. 4. There was one patient
      with acute otitis media in the CFIX-treated group in whom a clinical relapse
      occurred due to H. influenzae persisters in the nasopharynx. Thus the diagnosis
      in this patient was so-called "recurrent otitis media". 5. H. influenzae tended
      to persist after exposure to therapeutically adequate concentrations of CCL, as
      did S. aureus and S. pneumoniae following treatment with CFIX. Thus, it would
      seem that ample heed must be given to persistence, particularly of H. influenzae
      and S. pneumoniae, the most common causative agents of acute otitis media in
      childhood. 6. A significant rise in the MICs of the cephalosporins was observed
      in 4 of 43 patients in whom the same type of organism was isolated from the
      nasopharynx at weekly intervals during antibiotic therapy.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 7782975
TI  - [Studies on the measurement of the mechanical properties of the round window
      membrane].
AB  - With a microtesting system which can measure the mechanical properties of small
      tissue membranes, we have measured the mechanical properties of the round window
      membrane on the guinea pigs and the human. We also found that, as a result of
      formalin-fixation, round window membranes become weaker and that this effect of
      formalin-fixation is greater on human round window membranes than on those of
      guinea pigs. Since the protein in collagen fibers, which are the main constituent
      of round window membranes, is coagulated and fixed with formalin, we consider
      that the strength of the membranes decreases and that this is more evident in
      human membranes, which contain more collagen fiber. Having compared the
      mechanical properties of the fresh round window membranes of guinea pigs with
      those of humans, we found that the human membranes are approximately five times
      stronger than those of guinea pigs. This difference is considered to stem from
      the species differences. Also, having compared the mechanical properties of the
      tympanic membranes with those of the round window membranes each species, we
      found that the round window membranes of guinea pigs are almost the same as their
      tympanic membranes in terms of strength, whereas human tympanic membranes are
      stronger and harder than the round window membranes. In view of the minimum
      pressure causing destruction of human round window membranes, as deduced from the
      experiment on guinea pigs, it is possible that human round window membranes may
      be ruptured in the perilymphatic fistula.

PMID- 7782976
TI  - [Quantitative analysis of smooth pursuit eye movement].
AB  - Abnormalities of smooth pursuit eye movement (SPEM) have been estimated, mainly
      using the wave form on an electro-oculogram, in a qualitative way. Many methods
      for quantitative analysis of SPEM have been designed, though most are still
      uncommon in present clinical use. Using a personal computer, we developed a
      method of automatic quantitative analysis of ocular tracking eye movement
      recorded by electro-oculography (EOG). The design concept of this method is based
      on the observation that eye movement during ocular tracking consists of two
      different kinds of eye movements, one is SPEM and the other is saccade. The
      combination of SPEM and saccade (composite eye movement: CEM) commonly appears
      during ocular tracking. These two kinds of eye movement are essentially different
      not only in behavior but also about involved neural pathway in the central
      nervous system. From this point of view, we believe that the two kinds of eye
      movements involved in ocular tracking should be evaluated separately. The
      analysis method is outlined as follows. A horizontal sinusoidally moving visual
      target was employed to elicit ocular tracking eye movements. The test frequencies
      were set at 0.1, 0.2, 0.4 and 0.8Hz, and the amplitude of target motion was 15
      deg at each frequency. The 20 seconds of eye movement data measured by EOG were
      fed into the computer through a digital-analog converter for further analysis.
      Using our original saccade detection algorithm, based on the physiological
      behavior of saccades, the saccadic components were detected and removed from the
      eye movement wave. The remaining parts, fragments of SPEM, were connected by
      means of interpolating defective parts. The reconstructed wave was a slow
      cumulative eye position curve (SCEP). Sinusoidal target motion, CEM and SCEP were
      processed by the FFT (Fast Fourier Transformation) method. Bode plots were
      applied to summarize the gain and phase of responses to SCEP and the target
      motion wave. These processes enable us to estimate abnormalities of SPEM such as
      low gain, abnormal phase shift and large trends in tested duration. We conclude
      that the method described here is useful for quantitative estimation of SPEM in
      clinical neuro-otological examinations.

PMID- 7782977
TI  - Caries lesions and dental restorations as predisposing factors in the progression
      of periodontal diseases in adolescents. A 3-year longitudinal study.
AB  - The present study used a novel approach to assess the relationship between
      untreated caries lesions and defective and non-defective dental restorations and
      the incidence of gingival inflammation and the progression of chronic
      inflammatory periodontal diseases at the approximal surfaces of posterior teeth
      and at the adjacent surface of the neighboring tooth in adolescents over a period
      of 3 years. Two hundred-twenty-seven (227) 13-year-old schoolchildren were
      examined clinically and radiographically at baseline and annually at three
      subsequent occasions. At each site the alveolar bone height and presence of
      gingival bleeding were assessed. Incipient caries lesions, manifest caries, and
      defective and non-defective restorations were identified at the same site and
      also at the adjacent approximal tooth surface at all examinations, both
      clinically and radiographically. The data were analyzed by the multi-level
      logistic regression and variance components analyses. On average, 32, 8.5, 7, and
      10% of the sites, respectively, were diagnosed as having incipient caries,
      manifest caries, and defective and non-defective restorations. There was a
      significant association between the presence of untreated manifest caries
      lesions, non-defective and defective dental restorations, and the progression of
      periodontal support loss. Also there was an association between presence of
      defective restorations and manifest caries and the incidence of gingival
      inflammation. Consistently, factors detected at the involved site and at the
      adjacent site had significant effects. The present study indicates that untreated
      cavities and dental restorations are predisposing factors with a significant
      negative effect on periodontal health in adolescents.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7782978
TI  - Lack of effect of oral hygiene training on periodontal disease progression over 3
      years in adolescents.
AB  - A comprehensive new oral hygiene training program has lately been described and
      found effective in controlling dental plaque formation and in significantly
      reducing the incidence of approximal dental caries and gingivitis in adolescents.
      This study investigated the long-term effect of plaque control on the progression
      of periodontal diseases in adolescents. A group of 227 Brazilian schoolchildren
      were followed up over a period of 3 years. The children were divided randomly
      into 3 groups. The first group was given a needs-related intensive program which
      combined detailed information to parents and children pertaining to the etiology
      and prevention of dental diseases, instructions in self-diagnosis of plaque and
      gingivitis, and a detailed oral hygiene training based on individual needs,
      together with continued feedback and motivation during the entire 3 years. The
      second group was given a similar program, but through shorter sessions and with
      no motivation and feedback and no training in self-diagnosis. A control group
      received no motivation sessions or oral hygiene training. The 3 groups were
      examined radiographically at baseline and annually at 3 subsequent occasions. The
      data were analyzed with a multi-level variance analysis. The frequency of
      subjects showing sites with alveolar bone loss increased steadily during the
      entire period in all groups. Neither of the training programs had a significant
      effect on the alveolar bone level during 3 years compared to the control group.
      Generally, girls demonstrated higher proportions of approximal tooth surfaces
      showing radiographic bone loss, though not statistically significant. In this
      population the supragingival plaque control lacked any significant effect on
      periodontal disease progression.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782979
TI  - The modified papilla preservation technique. A new surgical approach for
      interproximal regenerative procedures.
AB  - A modification of the papilla preservation technique has been applied to achieve
      primary closure of the interproximal tissue over barrier membranes placed coronal
      to the alveolar crest. Fifteen patients with deep intrabony interproximal defects
      were treated. Defects had a probing attachment level loss of 9.9 +/- 3.2 mm and a
      recession of the gingival margin of 1.7 +/- 1.6 mm. The depth of the intrabony
      component was 5.5 +/- 2.9 mm; while the suprabony component was 5.9 +/- 2.0 mm.
      Titanium-reinforced teflon membranes were placed 1.3 +/- 0.7 mm from the cemento
      enamel junction, 4.5 +/- 1.6 mm coronal to the interproximal alveolar bone crest.
      Primary closure over the interproximal portion of the membrane was obtained in
      93% of cases. In 73% of the cases complete coverage of the membrane was
      maintained until its removal at 6 weeks. These data indicate that the modified
      papilla preservation technique can be successfully applied to obtain primary
      closure of the interdental space in regenerative procedures with barrier
      membranes.

PMID- 7782980
TI  - Collagen formation at the tooth-cell interface: comparative ultrastructural study
      on the effect of partial demineralization of cementum with dentin.
AB  - In order to compare the effect of partial demineralization with root planing and
      partial demineralization of cementum with that of dentin on healing, the
      ultrastructural morphology of the interface between the layer of human
      periodontal ligament-derived, fibroblast-like cells (HPF) and the treated root
      surface was studied in an in vitro culture system. Sixty (60) pairs made from
      transversally-cut root slices, 500 microns thick, were obtained from extracted
      human periodontally diseased teeth. Thirty (30) pairs of the root slices were
      preliminarily root planed (RP). The remaining half were root planed and then
      partially demineralized in a solution of citric acid (RP+CA). The opposite
      surface of paired slices was made uniform by using either cementum or dentin.
      Consequently, all root slices were classified into four experimental groups: RP
      cementum and RP-cementum pairs (group 1), RP-dentin and RP-dentin pairs (group
      2), RP+CA-cementum and RP+CA-cementum pairs (group 3), and RP+CA-dentin and RP+CA
      dentin pairs (group 4). Each pair of root slices was placed on the floor of a 35
      mm culture dish. HPF were seeded at a concentration of 4 x 10(5) cells/dish. Co
      cultures of HPF and the root slices were examined using phase contrast and
      electron microscope after 4, 6, and 10 weeks. Electron-dense material covered non
      demineralized root surfaces and the lining cells in accumulating cell layers were
      oriented parallel to the root surface and attached to the material in groups 1
      and 2.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7782981
TI  - Polyamines found in gingival fluid inhibit chemotaxis by human polymorphonuclear
      leukocytes in vitro.
AB  - Putrescine and spermidine occur at concentrations approaching 1 mM in gingival
      fluid at diseased periodontal sites. Previous work demonstrates that these
      polyamines potentiate Ca2+ signaling in polymorphonuclear leukocytes (PMNs),
      resulting in enhanced degranulation and superoxide generation. The present study
      extends this work by characterizing the effects of polyamines on PMN chemotaxis
      and phagocytosis, in which Ca2+ signaling plays a less defined regulatory role.
      Putrescine (1 mM) and spermidine (0.1 to 0.5 mM) significantly inhibited
      chemotaxis to fMet-Leu-Phe and C5a (P < 0.05). This inhibition was not strongly
      related to any effect polyamines have on PMN adhesion, actin polymerization, or
      formyl peptide receptor expression. Neither putrescine nor spermidine had a
      significant impact on phagocytosis of opsonized bacteria by PMNs. Thus, at
      concentrations similar to those found in gingival fluid, polyamines could
      potentially inhibit recruitment of PMNs to diseased pockets without impairing
      their ability to engulf invading bacteria.

PMID- 7782982
TI  - Modulation by progesterone of interleukin-6 production by gingival fibroblasts.
AB  - The gingivitis associated with pregnancy has been attributed to increased
      concentrations of circulating estrogen and/or progesterone. However, the
      mechanism by which these steroids increase gingival inflammation is not known.
      Interleukin-6 (IL-6), a pleiotropic cytokine produced by many cell types
      including human gingival fibroblasts (hGF), is secreted in response to
      inflammatory challenges such as bacterial lipopolysaccharide and interleukin-1
      (IL-1). This study tested the hypothesis that progesterone could modulate the
      local production of IL-6 by hGF. The effects of progesterone on IL-6 production
      were measured in vitro in serum-free, phenol red-free medium to eliminate
      possible effects of such medium additives. The concentration of IL-6 secreted
      into supernatant medium after a 24 hour challenge with IL-1 beta was estimated by
      radioimmunoassay. Total RNA from steroid-treated hGF was probed for IL-6 mRNA. In
      serum-free medium, progesterone dose-dependently and significantly (P < 0.05)
      inhibited IL-6 production by hGF, as did the glucocorticoids hydrocortisone (HC)
      and dexamethasone. At progesterone concentrations common in late pregnancy, IL-6
      production was reduced to levels 40 to 50% of control. In addition, mRNA was
      significantly down-regulated by progesterone and HC, at both basal levels and
      after IL-1 beta challenge. These results suggest that high levels of progesterone
      during pregnancy affect the development of localized inflammation by down
      regulation of IL-6 production, rendering the gingiva less efficient at resisting
      the inflammatory challenges produced by bacteria.

PMID- 7782983
TI  - Attachment of Fusobacterium nucleatum to fibronectin immobilized on gingival
      epithelial cells or glass coverslips.
AB  - To learn more about colonization of the oral epithelium by Fusobacterium
      nucleatum and the role of fibronectin in mediating adhesion of this
      microorganism, we studied attachment of this bacterium to cultured gingival
      epithelial cells that were coated with exogenous, purified plasma fibronectin.
      The three strains of F. nucleatum studied adhered in large numbers to epithelial
      cells that had been coated with fibronectin, compared with buffer-coated control
      cells. Bacterial adherence was also enhanced when epithelial cells were coated
      with whole human saliva. However, cells coated with saliva depleted of
      fibronectin did not facilitate adhesion of bacteria. Bacterial adhesion was
      restored when purified fibronectin was added back. We also tested adherence of
      bacteria to coverslips coated with fibronectin, saliva, and saliva depleted of
      fibronectin. The bacteria adhered to coverslips coated with fibronectin or whole
      human saliva, but did not adhere to coverslips coated with fibronectin-depleted
      saliva. Bacterial adhesion to coverslips was restored upon addition of purified
      fibronectin to the fibronectin-depleted saliva. Bacterial attachment to
      fibronectin-coated coverslips was found to be temperature-dependent, with maximal
      adhesion observed at 37 degrees C. Pre-treatment of F. nucleatum with soluble
      fibronectin inhibited attachment of the bacteria by 92%, whereas pre-treatment
      with bovine serum albumin had no effect. Pre-treatment of bacteria with laminin
      or type IV collagen caused moderate inhibition of attachment by 60% and 50%,
      respectively. Treatment of fibronectin-coated coverslips with Fab fragments of
      anti-fibronectin IgG blocked the attachment of F. nucleatum by 93%. Fab fragments
      of the other antisera tested had no inhibitory effect.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7782984
TI  - Mandibular cementifying fibroma in relation to a large periodontal bone defect.
      Report of a case.
AB  - A cementifying fibroma associated with a large intraosseous periodontal defect is
      reported. This tumor was located in the lingual aspect of the first lower left
      molar. Therapy consisted on flap surgery, tumor excision, and placement of a bone
      autograft in order to fill the residual bone defect. Six months after the
      treatment, clinical and radiographic signs of periodontal regeneration were
      evidenced.

PMID- 7782985
TI  - Guided tissue regeneration in severe periodontal defects in anterior teeth. Case
      reports.
AB  - Four consecutive chronic, severe periodontal bone defects in anterior teeth were
      treated by guided tissue regeneration, using a polytetrafluoroethylene
      periodontal membrane. The root surface was not specifically conditioned, and
      osseous grafts were not used. However the membrane was manipulated so that space
      under it was maintained. This was accomplished by painting the outer surface of
      the membrane with butyl-cyanoacrylate, so that it became rigid. The membranes
      were removed after 4 weeks and a bone-like tissue was found in all cases. The
      clinical results suggest that there was a relationship between the amount and
      quality of the new tissue and the volumetric characteristics of the available
      space.

PMID- 7782986
TI  - Post-rhizotomy periodontal atrophy.
AB  - This report details the experience of two people who suffered a unique type of
      periodontal atrophy following trigeminal sensory rhizotomy. The cause is unknown
      but it may be the result of unintentional self-mutilation.

PMID- 7782987
TI  - Successful bone fill in late peri-implant defects using guided tissue
      regeneration. A short communication.
AB  - Severe loss of peri-implant supporting bone traditionally leads to the removal of
      the affected implant, but this may not be necessary in all cases. This paper
      presents a novel treatment approach aimed at the successful regeneration of bone
      lost to peri-implantitis using guided tissue regeneration (GTR). Four years after
      implant placement two patients presented with severe peri-implant tissue
      breakdown. Clinical signs of disease included bleeding on probing, suppuration,
      increased probeable pocket depth (4 to 9 mm) and a decreased level of clinical
      attachment (2 to 10 mm). Radiographic analysis revealed 2.6 to 7.1 mm loss of
      supporting bone. Treatment of these lesions included raising flaps, wound
      debridement, and rinsing with sterile saline and 0.2% chlorhexidine digluconate.
      Subsequently, ePTFE membranes were adapted around the necks of the implants and
      the flaps sutured around the necks of the implants, allowing for transmucosal
      healing. Both patients were placed on a 10-day antibiotic regimen and instructed
      to rinse twice daily with a 0.12% chlorhexidine solution. They were reevaluated
      every 3 weeks at which time professional plaque control was performed. After 4
      1/2 and 6 1/2 months, respectively, the membranes required removal due to
      infection. The radiographic analysis 1 year after membrane removal revealed 1.5
      to 3.6 mm of bone gain. As a result of regenerative therapy the implants in both
      these patients were successfully maintained. It can be concluded that implants
      with severe loss of bone resulting from peri-implantitis need not always be
      extracted. A potential approach for the treatment of peri-implant bone
      destruction is GTR therapy using strict attention to good antimicrobial therapy.

PMID- 7782988
TI  - Re: Periodontal disease in non-insulin dependent diabetes (NIDDM). The effect of
      age and time since diagnosis (J Periodontal; 1994; 65: 991-995)

PMID- 7782989
TI  - Re: Gingival recession: intra-oral distribution and associated factors (J
      Periodontal 1994; 65: 864-871)

PMID- 7782990
TI  - Developmental truths in memories of childhood and adolescence.
AB  - This study of age-related changes in memories of personally important encounters
      showed "developmental truths," that is, patterns that converged with prior
      developmental theories and research. Participants were 47 males and 48 females in
      their early 20s. An average of 16 memories were collected from each person during
      an intensive personal interview. Memories were coded for age at the time of the
      episode, the identity of the other person with whom the study participant was
      interacting, what the participant wanted from the other person, and the outcome.
      As expected, memories of encounters with parents and about wanting help prevailed
      for childhood, whereas memories of encounters with close friends and about
      wanting intimacy prevailed by mid-adolescence. Memories about wanting to help
      others were sparse for this young-adult sample, but, like needs for intimacy,
      increased with age. Although patterns for males tended to be more dramatic than
      patterns for females, this trend appeared more attributable to actual
      developmental differences in social dynamics than to differences in the degree to
      which current concerns intruded into the memory process. The advantages of
      personally salient, event-specific retrospective reports for understanding
      personality development and change are discussed.

PMID- 7782991
TI  - Life after trauma: personality and daily life experiences of traumatized people.
AB  - In this study, we explored differences in personality and daily life experiences
      of traumatized (n = 26) versus nontraumatized (n = 30) college students. Study
      participants completed a variety of personality measures as well as a 28-day
      experience sampling study assessing daily activities, emotions, and physical
      health. Although not differing on general demographics, traumatized individuals
      reported more trait anxiety and lower self-esteem than nontraumatized
      individuals. They scored higher on Neuroticism, were more introverted, and were
      less emotionally stable than nontraumatized participants. Traumatized individuals
      also reported more cognitive disturbances, emotional blunting, and interpersonal
      withdrawal. They did not report being more depressed, but did endorse cognitive
      styles associated with heightened risk for depression. Earlier age of trauma was
      associated with more pathological outcomes: lower self-esteem and psychological
      well-being, more anxiety, more pessimism, and emotional constriction of positive
      mood. We compare this symptom profile to that of posttraumatic stress disorder.

PMID- 7782992
TI  - Extraversion: a "hidden" personality factor in coping?
AB  - Recent evidence suggests a larger role for personality determinants of the coping
      response than has been traditionally held. In the two studies presented here, we
      examined the influence of personality on the use of social support and other
      coping strategies in samples of undergraduate students. The first study surveyed
      a range of coping responses to naturally occurring stressors and found that
      Extraversion was related to social support seeking, optimism (identified as
      germane to coping in prior research) was related to problem solving, and both
      dispositions were negatively related to avoidance. The second study used an
      experimental approach and multiple personality measures to correct for possible
      methodological problems in the first. Extraversion again proved to be associated
      with help seeking; moreover, this relationship accounted for that of another
      disposition, self-esteem--a construct considered crucial in the literature. The
      utility of personality variables, particularly Extraversion, in predicting and
      explaining the choice of a coping strategy is discussed.

PMID- 7782993
TI  - Personality change in Parkinson's disease patients: chronic disease and aging.
AB  - Parkinson's disease patients (N = 41, mean age = 65 years) were described by
      themselves and their spouses as they were presently and before their illness
      using the Adjective Check List. Equivalent self- and spouse descriptions were
      obtained from the members of a matched community sample (N = 96). Descriptions of
      patients and their spouses converged, both reporting sharp, pervasive (e.g., on
      all of the Big Five dimensions), and uniformly negative change in personality.
      Similar, but much less marked change was found in the community sample. The data
      as a set suggest that the reported changes in the patients were veridical and
      that their magnitude was primarily the result of the disease rather than aging.
      Evidence of continuities in personality (for example, differential stability) was
      also noted. We argued that the illness accelerated and intensified changes
      normally expected in later life.

PMID- 7782994
TI  - The conflicted individual: personality-based and domain-specific antecedents of
      ambivalent social attitudes.
AB  - Historically, attitude theory and research has assumed that attitudes are largely
      unconflicted and unidimensional summary statements of feelings and beliefs. More
      recent work has reexamined this assumption (Thompson, Zanna, & Griffin, in
      press). The present article details two studies that continue to investigate this
      notion, examining antecedent variables assumed important in the genesis of
      attitudinal ambivalence. The first study focuses upon personality-based factors
      such as individuals' Need for Cognition (NFC) and Personal Fear of Invalidity
      (PFI) (a heightened concern with error). The pattern of results was consistent
      with our predictions: High NFC was associated with less ambivalence and high PFI
      was associated with greater ambivalence. The second study investigated a domain
      specific antecedent. It was predicted that higher involvement would reduce the
      level of ambivalence experienced. Further, involvement was expected to moderate
      the effect of the personality-based antecedents. Again, results confirmed our
      hypotheses. High NFC was associated with less ambivalence, especially under
      conditions of high involvement with the issues. Conversely, high PFI individuals
      who were highly involved with these issues experienced more ambivalence. These
      results are discussed in terms of their implications for attitude theory.

PMID- 7782995
TI  - On the nature of embarrassability: shyness, social evaluation, and social skill.
AB  - In this study, the correlates of embarrassability, or chronic susceptibility to
      embarrassment, were examined. Competing theoretical models suggest either that
      embarrassable people should be especially concerned about others' evaluations of
      them or that they should lack social skills. Further, shyness and embarrassment
      are typically considered to be closely related states. To test these
      propositions, 310 participants provided extensive self-reports of social skill,
      fear of negative evaluation, self-esteem, self-consciousness, and negative
      affectivity. Regression and factor analyses indicated that, compared to those of
      low embarrassability, highly embarrassable people are particularly concerned with
      the normative appropriateness of behavior and are more motivated to avoid
      rejection from others. In contrast, shyness was best predicted by low social self
      confidence and low social skill. The data best support a social-evaluation model
      of embarrassment and argue that embarrassability is linked to the appropriateness
      of social behavior, and shyness to its effectiveness.

PMID- 7782996
TI  - Synthetic polymers as materials for artificial vitreous body: review and recent
      advances.
AB  - In spite of a century of recorded attempts to replace the vitreous body of the
      eye with a foreign material, there is no permanent substitute currently
      available, and the success of some materials as temporary substitutes is still
      very limited. Among the large number of materials proposed or tested as vitreous
      substitutes, synthetic polymers have been episodically considered during the past
      four decades. This article will review these attempts, their outcomes, and recent
      progress in this field. There were only seven synthetic polymers and a few
      semisynthetic polymers (modified biopolymers) so far proposed or tested as
      vitreous substitutes. It appears that probably a synthetic hydrogel with very
      high water content would eventually be the material of choice for a permanent
      vitreous substitute, but the ideal material has not yet been found.

PMID- 7782997
TI  - Studies on the standardization of cytotoxicity tests and new standard reference
      materials useful for evaluating the safety of biomaterials.
AB  - Standard reference materials (SRM) made of polyurethane films containing various
      amounts of cytotoxic compounds such as zinc diethyldithiocarbamate (ZDEC) and
      zinc dibutyldithiocarbamate (ZDBC) are proposed. The cytotoxicity indices of five
      dithiocarbamates and the SRM films obtained by colony assay were compared with
      those by published standards, i.e., neutral red assay (NF S 90-702), agar
      diffusion assay (USP XXII), and millipore filter diffusion assay (DIN-V 13 930).
      Among them, colony assay using 3 cell lines of Balb 3T3, L929 and V79 was found
      to be most sensitive. The extraction method and direct contact method were
      proposed as two test methods of colony assay. In the former, culture media after
      incubation with test materials were used as test solution, and in the latter,
      cells were directly cultured on test materials. The extraction method gave a
      linear relationship between the cytotoxic potentials of the SRM and its
      concentration of ZDEC or ZDBC. The cytotoxic potentials of the SRM correlated
      well with the thickness of inflammatory layer in rabbit muscle implantation tests
      of the SRM. The direct contact method was found to be useful to detect weak
      cytotoxicity because of its high sensitivity. Based on these data, we propose the
      colony assay and the two kinds of new SRMs as Japanese standard test method for
      evaluating the cytotoxicity of biomaterials.

PMID- 7782998
TI  - Pulsatile blood flow from impeller pump: a dream has come true.
AB  - For decades many investigations have been made on producing a pulsatile blood
      flow with an impeller pump. It has been foiled because of excessive hemolysis.
      Other investigators foretold that a pulsatile centrifugal pump is impossible in
      the near future, without increasing the complexity of the system remarkably. The
      author has presevered in this study and made progress steadily. An axial
      pulsatile impeller pump with constant-rotating speed was developed, in which the
      impeller reciprocates along its axis while rotates. Meanwhile, a pulsatile
      implantable impeller centrifugal pump is now in animal surviving experimental
      stage. The pulsatility of the blood flow is achieved by changing the rotating
      speed of the impeller periodically, via introducing a square wave form voltage
      into the motor coil. The hemodynamic and physiological superiorities to both
      nonpulsatile impeller pump and diaphragm pump were demonstrated. The
      hematological and biochemical data indicated low hemolysis and thrombogenesis,
      low renal and heptic dysfunction. Furthermore, a pulsatile implantable impeller
      total heart has completed its acute biventricular assist animal experiments. This
      is an almost unique total heart at the present, it is driven by a single motor,
      the left and right pumps eject the blood simultaneously, and the volume
      equilibrium of both pumps is achieved naturally. The dream of producing a
      pulsatile blood flow with an impeller pump has come true. Doubtlessly, an
      impeller heart with simplicity, pulsatility, implantability, compatibility and
      reliability, will be a viable alternative to diaphragm heart, really.

PMID- 7782999
TI  - Highly publicized medical device failures have made headlines in the lay press.

PMID- 7783000
TI  - Simultaneous raw starch hydrolysis and ethanol fermentation by glucoamylase from
      Rhizoctonia solani and Saccharomyces cerevisiae.
AB  - Crude glucoamylase preparation from Rhizoctonia solani was used to saccharify raw
      and cooked starch. Various concentrations of potato starch and wheat flour from
      10-40%, w/v were used for mashing but 30% was found to be the optimal and
      economical. The saccharified mash yielded 5.89%, v/v ethanol in a simultaneous
      saccharification and fermentation process using a yeast strain Saccharomyces
      cerevisiae (SC-39) at 35 degrees C for 4 days. Removal of inhibitory substances
      from the fermenting broth through dialysis caused considerable increase in
      ethanol production.

PMID- 7783001
TI  - Microbiological survey of a South African poultry processing plant.
AB  - Bacterial populations associated with poultry processing were determined on neck
      skin samples, equipment surfaces and environmental samples by replicate surveys.
      Aerobic plate counts, Enterobacteriaceae counts, Enterobacteriaceae counts and
      Pseudomonas counts were performed by standard procedures and the prevalence of
      Listeria, presumptive Salmonella and Staphylococcus aureus determined.
      Statistically significant (P < 0.05) increases in counts of all types of bacteria
      were obtained on product samples as a result of processing. Although bacterial
      counts on neck skin samples decreased by 0.3 to 0.4 log CFU g-1 after spray
      washing of carcasses, subsequent spinchilling and packaging of whole carcasses
      resulted in 0.7 to 1.2 log CFU g-1 increases. Bacterial numbers on equipment
      surfaces, however, decreased significantly from the "dirty" to the "clean" areas
      of the abattoir. Transport cages, "rubber fingers", defeathering curtains,
      shackles and conveyor belts repeatedly showed aerobic plate counts in excess of
      5.0 log CFU 25 cm-2. Aerobic plate counts of scald tank and spinchiller water
      were 2 log CFU ml-1 higher than those of potable water samples. Bacterial numbers
      of the air in the "dirty" area were higher than those of the "clean" area.
      Listeria, presumptive Salmonella and Staphylococcus aureus were isolated from
      27.6, 51.7 and 24.1% of all product samples, respectively, and Listeria and
      Staphylococcus aureus were also isolated from selected equipment surfaces.

PMID- 7783002
TI  - Phenol and cresol metabolism in Bacillus pumilus isolated from contaminated
      groundwater.
AB  - From an aquifier contaminated with phenolic compounds seven bacterial strains
      able to grow on phenol and several mono- and disubstituted alkylphenols as sole
      source of carbon and energy were isolated. Five isolates belong to the genus
      Pseudomonas, two to the genus Bacillus. The isolate most active in utilization of
      the applied xenobiotics was identified as Bacillus pumilus and used for the
      investigation of the degradation pathways in liquid cultures. Cells of this
      strain precultured on phenol were able to utilize para-cresol as sole carbon
      source via the oxidation of the methylsubstituent and intradiol ring cleavage of
      the resulting protocatechuic acid, whereas an intradiol ring fission of the
      intermediate 4-methylcatechol led to 4-methylmuconolactone as dead end-product.
      Cells precultured on meta- and ortho-cresol were able to utilize the respective
      compounds as sole carbon sources via 3-methylcatechol, which induced the
      following extradiol ring fission pathway. Cells precultured on phenol were able
      to cooxidize meta- as well as ortho-cresol to 3-methylcatechol, which was cleaved
      via an intradiol ring fission, finally leading to the dead end-product 2
      methylmuconolactone.

PMID- 7783003
TI  - Etiology of oral submucous fibrosis with special reference to the role of areca
      nut chewing.
AB  - Oral submucous fibrosis (OSF) is a high risk precancerous condition,
      predominantly affecting Indians. Consumption of chilli was hypothesized as an
      etiologic factor on the basis of ecological observations and a solitary animal
      experimental study. Subsequent epidemiologic studies that included case-series
      reports, large cross-sectional surveys, case-control studies, cohort and
      intervention studies have identified areca nut as the major etiologic agent.
      Tissue-culture studies involving human fibroblasts, areca nut extracts and areca
      nut alkaloids supported this etiologic hypothesis by showing fibroblastic
      proliferation and increased collagen formation. Currently, the role of genetic
      susceptibility and that of autoimmunity are receiving attention. The influence of
      nutritional factors, if any, remains unclear.

PMID- 7783004
TI  - Enamel microhardness and histological features of composite enamel pearls of
      different size.
AB  - The aim of this study was to investigate the enamel microhardness and the
      histological features of eight enamel pearls of various size. The microhardness
      of the pearl enamel ranged from 272.4 to 407.2 Vickers microhardness values (VMV)
      and resembled that of the enamel of the carrier teeth (277.1-424.3). A
      histological resemblance between the tissues of the enamel pearls and those of
      the carrier teeth was also found. The resemblance was more pronounced in larger
      pearls, which showed a variability of the enamel microhardness and structure in
      the occlusal-cervical direction typical of the tooth crown. Large pearls also
      exhibited a root and a pulp. Some histological features of the enamel pearls were
      probably caused by pressures exerted on the developing pearl by its surroundings.
      It is suggested that the histogenesis of small and large pearls is based on the
      ability of the developing root of the carrier tooth to behave in part as a new
      tooth germ.

PMID- 7783005
TI  - Epithelial cell kinetics in oral leukoplakia.
AB  - Cell proliferation in oral leukoplakia has been studied by estimating the number
      of cells in the S phase using in vitro 3H thymidine labelling. The labelling
      index was found to be increased 1.77 fold in leukoplakias compared to the
      clinically normal control sites (P < 0.005). This rise in labelling index was
      found to be related to an increase in the proportion of the cells in the basal
      cell layer engaged in cell production. Both leukoplakia and the control specimens
      showed epithelial atypia, although in the latter samples this was mild yet
      suggestive of a possible field change in the oral epithelium of a small group of
      tobacco users. A significant positive correlation was found between the
      epithelial atypia score and the labelling index. This raises the possibility of
      using the labelling index as an objective prognostic marker in assessing
      potential malignancy in oral leukoplakia lesions.

PMID- 7783006
TI  - Immunohistochemical characterisation of odontogenic cysts with mesenchymal and
      myofilament markers.
AB  - The aim of the present investigation was to analyse the fibroblast phenotype in
      the main groups of odontogenic cysts. We have examined the muscle differentiation
      markers alpha-smooth muscle actin (ASMA) and desmin and the presence of vimentin
      using immunocytochemistry. Fibroblasts of other cyst types, hyperplastic fibrous
      lesions, and from several normal sites were used as controls. All fibroblasts
      stained for vimentin, but a variable proportion of cyst wall fibroblasts were
      also positive for the antibody to ASMA. Their distribution was not random and two
      positive zones could be distinguished, an inner subepithelial layer and an outer
      region adjacent to the bone-facing surface. This staining pattern was observed
      for all the types of odontogenic cysts studied, although the subepithelial
      staining was more frequent in the presence of an inflammatory infiltrate. The
      contractile nature of these cells was supported by their ultrastructural
      appearance. Some non-odontogenic cysts showed subepithelial fibroblasts strongly
      labelled with ASMA; in the control tissues ASMA was negative except for pericytes
      and some groups of cells in supracrestal gingiva. These results demonstrate a
      distinct cell population with a myofibroblast phenotype in the odontogenic cyst
      wall and with a distribution which may enable them to contribute to wall
      elasticity constraining cyst expansion. Their presence in all types of
      odontogenic cyst studied would suggest that myofibroblast formation is
      independent of the pattern of cyst growth.

PMID- 7783008
TI  - Feline inductive odontogenic tumor (inductive fibroameloblastoma)--a tumor unique
      to cats.
AB  - The inductive fibroameloblastoma is a rare odontogenic tumor that occurs in young
      cats of either sex, predominantly in the anterior maxilla. This article
      critically reviews the previously published examples with emphasis on microscopic
      features, relationship to ameloblastic fibroma, and biologic behavior; an
      additional example is described. This tumor differs microscopically from human
      ameloblastic fibromas in that it is not well-circumscribed but rather originates
      multifocally within the supporting connective tissue as characteristic, spherical
      condensations of fibroblastic connective tissue (ectomesenchyme) associated with
      islands of odontogenic epithelium. Its biologic behavior requires further study
      but the tumor apparently is unique to cats and is distinct from human
      ameloblastic fibroma. Consequently, feline inductive odontogenic tumor is
      suggested as being a more appropriate designation than inductive
      fibroameloblastoma.

PMID- 7783007
TI  - Liposarcomas of the oral tissues: a clinicopathologic study of four tumors.
AB  - Liposarcomas of the oral tissues are rare. There have been 28 previously reported
      in the literature. A clinicopathologic study of 4 patients with liposarcoma
      involving the oral tissues is presented--one in the tongue, one in the palate,
      and two in the submandibular space. Two of the tumors were myxoid, one was of
      well-differentiated type and one was of pleomorphic type. Three of the lesions
      were diagnosed clinically as benign. The most important lesson to be learned from
      the histopathology is the positive identification of atypical lipoblasts. Follow
      up data indicate that prognosis generally corresponds to the tumor type. The
      patients with myxoid and well-differentiated liposarcoma remain alive and with no
      evidence of disease. The patient who died of tumor had a pleomorphic liposarcoma.
      Treatment of these lesions should consist of wide surgical excision and
      consideration of adjunctive or palliative radiotherapy.

PMID- 7783009
TI  - Pterygoid muscle function in excursive jaw movements: a clinical report.

PMID- 7783011
TI  - A postfabrication technique for identification of prosthetic devices.

PMID- 7783010
TI  - Ability of various impression materials to produce duplicate dies from successive
      impressions.
AB  - This in vitro study evaluated the ability of five different impression techniques
      to make duplicate dies of two different types of tooth preparation. One
      mandibular second premolar Ivorine tooth was prepared for a complete crown and
      one for an onlay. A master impression was made of each tooth preparation with the
      use of five impression techniques for a total of 10 master impressions, and a
      master die was made from each of these impressions. Castings were made on these
      master dies, and the fit of each casting was verified on the respective Ivorine
      tooth. Marginal openings of the castings on the master dies were recorded under
      magnification at four predetermined points. Five successive impressions, with the
      use of each impression material, were then made of each tooth preparation for a
      total of 50 test impressions, and 50 test dies were made from these impressions.
      The fit of the respective casting was evaluated under magnification for each test
      die at the four predetermined points, and marginal openings were recorded.
      Differences between the marginal discrepancies of the casting on the master die
      and on the test die were tabulated and the results were statistically analyzed.
      Results indicated that none of the impression materials was capable of producing
      exact replicas. Polysulfide rubber performed significantly better than two
      materials for the production of duplicate dies with the complete crown
      preparation; and polyvinyl siloxane used with a putty-light body, single-stage
      technique produced mean marginal discrepancies that were significantly greater
      than the other four techniques when used for the onlay preparation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7783012
TI  - Retention and stability of the maxillary denture during function.
AB  - The objectives of this study were to provide a quantitative account of the extent
      to which the maxillary complete denture moves during function (chewing,
      swallowing, and speech production) and to determine whether differences in
      movement occur as a function of denture fit. A total of 24 patients were studied,
      12 with poorly fitting dentures and 12 with well-fitting dentures. Denture
      movements were measured with a Myotronics kinesiograph that tracked the movements
      of a small magnet attached to the inferior surface of the denture. Results
      indicated that denture movement was greatest for the two chewing activities;
      varied extensively from individual to individual; and that there were no
      statistically significant overall movement effects as a function of fit. It was
      concluded that all maxillary dentures are subject to movements in all directions,
      but that the degree of movement is related more to the individual denture wearer
      than it is to the fit of the denture.

PMID- 7783013
TI  - Accuracy of freely adapted resin record bases.
AB  - Forty autopolymerizing resin record bases were made; 10 bases were adapted by
      finger pressure on tray resin material dough, 10 bases by sprinkling orthodontic
      resin, and 10 of repair material by either of the two previous techniques. Stone
      casts and acrylic resin bases were sectioned at canine, premolar, and molar
      coronal planes. Width of the gap between base and cast and the thickness of the
      base were measured at the buccal sulcus, ridge crest, lateral palatal slope, and
      palatal midpoint. Measurements were made through the eyepiece of a microhardness
      tester. Statistical analysis of 760 pairs of measurements revealed that (1)
      sprinkled bases fit better than finger-adapted dough bases; (2) specifically
      formulated materials fit better than repair material with either technique; (3)
      gap widths differed at different areas of the same base; and (4) gap width was
      not related to base thickness at any point.

PMID- 7783014
TI  - Prospective clinical evaluation of mandibular implant overdentures: Part I-
      Retention, stability, and tissue response.
AB  - Seventeen subjects with preexisting conventional complete dentures were evaluated
      in this prospective clinical study. Two implants were placed bilaterally in the
      anterior mandible. In a crossover experimental design, the conventional dentures
      were modified, and the retention, stability, and tissue response for conventional
      dentures were compared with implant overdentures that had O-ring and magnet
      overdenture attachments for all subjects. The study indicated statistical
      superiority of the implant overdenture to the conventional denture. The O-ring
      attachment proved significantly better than the magnet attachment for retention
      and stability. The soft tissue response showed a slight but significant
      improvement with implant overdenture therapy.

PMID- 7783015
TI  - Prospective clinical evaluation of mandibular implant overdentures: Part II-
      Patient satisfaction and preference.
AB  - In a crossover experimental design, a prospective clinical study was performed
      with 17 subjects with existing complete dentures. After data collection, two
      implants were placed bilaterally in the anterior mandible. Conventional dentures
      were modified into implant overdentures by use of O-ring and magnet attachments.
      Each attachment was maintained with each subject for 6 months. Subjects responded
      to patient satisfaction and preference questionnaires about the conventional
      denture and each attachment. Subjects were satisfied with both attachment
      overdentures but showed a strong preference for the O-ring. Both attachments
      resulted in a significant increase in patient satisfaction when compared with the
      conventional denture.

PMID- 7783016
TI  - A two-stage impression technique for custom facial prostheses.
AB  - A two-stage impression technique that uses polyvinyl siloxane and irreversible
      hydrocolloid in a custom impression tray is described. The technique records the
      tissues to be contacted by the facial prosthesis with minimal distortion with the
      patient in an upright position and facial musculature at rest. The procedure is
      simple, accurate, and it eliminates some of the shortcomings of other techniques.

PMID- 7783017
TI  - The ultrasonic value of local muscle hypertrophy in patients with
      temporomandibular joint disorders.
AB  - Muscle pain and tenderness on palpation are two common symptoms in patients with
      temporomandibular joint disorders. Examination of the masticatory muscles is
      largely restricted to the use of electromyography. The technique of
      ultrasonography in the diagnosis of muscle hypertrophy in patients with
      temporomandibular joint disorders was investigated. The results of the study
      indicate that ultrasonography may be beneficial to locate affected muscles that
      do not exhibit symptoms of tenderness on palpation and thereby give hints for
      treatment planning.

PMID- 7783018
TI  - Tensile fatigue of 4-META cement bonding three base metal alloys to enamel and
      comparison to other resin cements.
AB  - The tensile median fatigue limits and fracture mode of 4-META cement were
      evaluated after bonding Ni-Cr, Ni-Cr-Be, and Co-Cr alloys to enamel. Alloy
      surfaces, 6 mm in diameter, were grit blasted with 50 microns Al2O3 and cemented
      to etched bovine enamel under a 2 kg load. Samples were cycled in tension to
      failure or 10(6) cycles at 5 Hz in Ringer's solution at 37 degrees C. Two-point
      strategy was used to determine median fatigue limits (S50). Fracture modes were
      evaluated by SEM on samples failing before 10(6) cycles. Results indicated
      differences between all sample groups where S50 (Ni-Cr-Be) > S50 (Co-Cr) > S50
      (Ni-Cr). Failure analysis revealed mixed cohesive fractures near both interfaces
      with small areas of delamination within the cement. Comparison to reported median
      fatigue limits of two commercially available cements were discussed.

PMID- 7783021
TI  - Protection of glass ionomer cements during the setting reaction.

PMID- 7783020
TI  - Effect of dimension of luting space and luting composite on marginal adaptation
      of a class II ceramic inlay.
AB  - This study evaluated the in vitro marginal quality at the interproximal cervical
      margin of class II Cerec restorations. Marginal quality was evaluated separately
      by (1) SEM analysis before and after simultaneous thermocycling and mechanical
      loading for the integrity of the restoration surface and (2) dye penetration
      after thermocycling and mechanical loading to evaluate the strength of the bond
      within the depth of the cavity. The results reveal that marginal integrity is
      influenced by the width of the luting space and the luting composite. With a
      luting space of 100 microns, marginal quality with as little as 3% to 14% loss of
      adhesion can be obtained. Luting spaces greater than 100 microns can partially be
      compensated by the luting composite. For Cerec inlays, highly filled luting
      composites with a high viscosity are recommended.

PMID- 7783019
TI  - Effect of unfilled resins and a silane primer on bonding between layers of a
      light-activated composite resin veneering material.
AB  - This investigation evaluated the effect of unfilled resins and a silane primer on
      bonding between layers of a urethane-based composite resin veneering material.
      Shear bond strengths between the layers were determined with a two-liquid silane
      primer and three unfilled resin bonding agents. The silane primers and unfilled
      resins enhanced the bond between layers of the veneering material. Durability of
      the bond, however, was influenced by the composition of the bonding agent. Among
      the systems investigated, combined use of the silane primer with
      triethyleneglycol dimethacrylate-based unfilled resin exhibited durable and
      consistent bond strength.

PMID- 7783022
TI  - Development of an outpatient perioperative care record.
AB  - Since the 1970s outpatient surgery has become increasingly popular as a mechanism
      for reducing hospitalizations and allowing patients to recuperate in their own
      homes. Advanced nursing care, improved surgical procedures, and modern
      pharmaceuticals and anesthetic techniques increase the rate and quality of
      patient recovery and allow the patient to enter the hospital, undergo surgery,
      and be discharged in the same day. It is now estimated that more than 40% of all
      surgeries are being performed in the outpatient setting. The rapid turn-around
      time for outpatient surgeries creates new challenges for nurses as well as
      patients and their families. Documentation of surgical procedures and nursing
      care is essential for communicating with other providers and for establishing a
      legal document that can be used to evaluate the quality of services delivered.
      Yet the time available for record keeping is greatly reduced. New charting
      procedures are needed to decrease redundancy and enhance the structural
      efficiency of perioperative records. This article describes a method of
      streamlining perioperative outpatient surgery records. The use of nursing
      diagnoses is incorporated into a documentation system that uses checklists,
      flowsheets, and charting by exception.

PMID- 7783023
TI  - Mastering the weaning process in the postanesthesia care unit.
AB  - Most PACUs are accustomed to rapidly weaning patients who arrive on mechanical
      ventilators. However, as the acuity of patients in the PACU continues to
      increase, the ability to quickly wean patients to extubation is becoming less
      possible. The difficult-to-wean patient population is requiring the PACU nurse to
      become more astute in assessing and planning the weaning process. A collaborative
      approach can facilitate the successful weaning of a patient from the ventilator.

PMID- 7783024
TI  - Rewarming hypothermic postanesthesia patients: a comparison between a water coil
      warming blanket and a forced-air warming blanket.
AB  - The warming effects of a Blanketrol water coil-heated hypothermia blanket and a
      Bair Hugger forced-warm air warming blanket were compared. Thirty-two patients
      admitted to the PACU with temperatures 34.4 degrees C (94 degrees F) or lower
      were assigned to treatment with the Blanketrol (Cincinnati Sub-Zero Products,
      Cincinnati, OH) or the Bair Hugger (Augustine Medical, Eden Prairie, MN) in
      alternating fashion, and treatment continued until the patients' temperatures
      reached 36.1 degrees C (97 degrees F). Every half hour each patient's temperature
      was measured using a tympanic temperature device and recorded on the data
      collection sheet. Analysis of the findings showed that the forced-air warming
      blanket warmed patients to 36.1 degrees C (97 degrees F) or higher significantly
      faster than the water coil-heated blanket (P < .001).

PMID- 7783025
TI  - Identification of potential problems for elderly outpatients after preoperative
      medication: a case study.
AB  - Meperidine and promethazine are preoperative medications ordered frequently for
      outpatient and inpatient surgical procedures in this facility. Although all
      medications have the potential to cause adverse reactions, the case studies
      presented in this article suggest a relationship between the use of one or both
      of these drugs and the cancellation of surgery, ie, two surgical procedures were
      cancelled because of the patients' behavior after administration of preoperative
      medication. Nurses are advised of the potential for reactions, especially in the
      elderly patient. Further examination of this topic is essential to prevent other
      episodes of adverse drug reaction or cancellation of surgical procedure and to
      add to the current knowledge base of effective preoperative medications.

PMID- 7783026
TI  - Taking control: an approach to problem solving.

PMID- 7783027
TI  - Reading research critically: results--Part 1.
AB  - Nurses in PACUS as well as other areas of nursing are increasingly being asked to
      incorporate research into their clinical practices. Unfortunately, many nurses
      have limited formal education in research and are not adequately prepared to
      critically analyze the quality of the research they are reading. This is
      especially true when it comes to the statistical analysis section of the
      published research report. This article lays the foundation for understanding the
      statistical analysis most commonly seen in results sections of research
      publications in nursing journals.

PMID- 7783028
TI  - Tomorrow's workplace: no jobs ... just work to be done.
AB  - The workplace of the future will be less structured, and roles will be less
      specific. As teams and teamwork become the way to get the work done, those who
      have relied on a job description to direct what they do will face a real
      challenge. As this shift in thinking moves into the health care setting, there is
      fear and confusion on the part of both managers and staff. By working together,
      managers and staff can build trust and a new sense of security even in an
      uncertain future.

PMID- 7783029
TI  - Is your personal breathing zone healthy or hazardous?
AB  - Numerous studies over several decades have indicated that exposure to ambient
      anesthetic gases place health care providers and their families at risk of
      serious health problems. As a result, scavenging systems are used in virtually
      every Operating Room. But the risk for thousands of caregivers has not been given
      adequate attention. This article discusses the results of several studies and
      their implications for providers of postanesthesia care.

PMID- 7783030
TI  - The habit of synergy.

PMID- 7783032
TI  - Caregiver burden: grandmothers raising their high risk grandchildren.
AB  - 1. The term caregiver burden currently describes the physical, psychological,
      emotional, social, and financial problems that can be experienced by family
      members who are caregivers. 2. The health, emotional and psychosocial well being
      of the grandchild (care recipient) directly affects the grandmother caregiver's
      health, emotional, and psychosocial well being. 3. The nursing profession is in
      an ideal position to identify effective interventions to reduce the stress
      grandmothers feel.

PMID- 7783033
TI  - Protecting our children: where have we gone and where should we go from here?
AB  - 1. There are 3 million cases of child abuse reported each year. Three million
      grandparents in this country rear their grandchildren because the parents are not
      fit enough or competent enough to do so. 2. Each year, 500,000 American children
      give birth. 3. One way to stop child abuse and neglect is to provide children
      with constitutional rights.

PMID- 7783031
TI  - Biology of memory and childhood trauma.
AB  - Examples have been presented of children's behaviors that demonstrate the trauma
      learning pattern of re-enactment, repetition, and displacement. They become
      persistent parts of the symptom complex of PTSD. The encapsulation phase occurs
      when the trauma event occurs and symptoms present themselves, but the events as
      yet are undisclosed. The trauma-specific behavior patterns, the general hyper
      arousal symptoms, and the avoidant, numbing symptoms persist; the emerging
      disruptive behaviors are not linked to the traumatic event and reactions to the
      trauma. The response of the child's social and interpersonal context to the
      internalizing or externalizing behaviors post-trauma, continue shaping the
      internal cognitive schema of the child. When the child is unable to link ongoing,
      self-defeating, disruptive behavior to trauma experience, the underlying fear
      persists. This interferes with the child's ability to modulate emotions either
      through altering the persistence of refractory, self-limiting cognitive schema or
      the inability to use new experience to develop and grow. The flexibility of
      children to discriminate new information may be lost; the children are either
      numb to new information or hyperalert and perceive danger. Issues for treatment
      include children's distress over memories of the trauma and the lack of capacity
      to learn and develop from new interpersonal experiences. It has been our
      experience that nurses first must help the child relearn flexibility through self
      observation, the element of self-soothing and calming behaviors, processing of
      new information, and strengthening of social relationships. With new and
      strengthened personal resources, the child then is able to begin to process the
      traumatic memories.

PMID- 7783034
TI  - Incorporating psychiatric rehabilitation principles into mental health nursing.
      An opportunity to develop a full partnership among nurses, consumers, and
      families.
AB  - 1. Once people with mental illness are perceived as people with disabilities, the
      field of physical rehabilitation can be used as a metaphor for psychiatric (or
      psychosocial) rehabilitation. 2. A rehabilitation approach emphasizes the
      development of skills and sources of support necessary for successful living,
      learning, and working in the community. 3. The essential components of
      psychiatric rehabilitation technology clearly are defined practitioner skills and
      the underlying knowledge about how to use the skills most effectively.

PMID- 7783036
TI  - Logical responses to youth who run away from home: implications for psychiatric
      mental health nursing.
AB  - 1. Runaway youths do not fit into a typical profile; they are adolescents of
      every race, ethnic group, and religious orientation; they are representative of
      every socioeconomic status and geographic location in America. 2. Psychosocial
      events including physical and sexual abuse are common antecedents to runaway
      behaviors. 3. Implications for psychiatric mental health nursing practice include
      working with community programs focused on reducing runaway episodes;
      implementing preventive measures focused on strengthening parenting and problem
      solving skills for reducing conflict with families with adolescent children; and
      promoting responsible sexuality through adequate and responsible sex education
      and counseling.

PMID- 7783035
TI  - Constant observation: implications for nursing practice.
AB  - 1. Constant observation is an increased level of observation and supervision in
      which continuous one-to-one monitoring techniques are utilized to assure the
      safety and well-being of an individual patient or others in the patient care
      environment. 2. Individuals who provide constant observation vary widely among
      health care facilities; but ultimately are the responsibility of the registered
      nurse. There are many areas that must be addressed by institutions when
      considering the use or implementation of constant observation. These include:
      measuring the associated costs, risk management, role development, orientation of
      employees, and performance evaluation. 3. The changing health care environment
      and public concern over the quality of health care and risk management require
      nursing administrators to consider risk-benefit and cost-benefit analyses related
      to constant observation. There is continued need for protocol and policy
      development, as well as for guidelines and orientation of staff regarding
      constant observation.

PMID- 7783037
TI  - [MRI of the rotator cuff: evaluation of a new symptomatologic classification].
AB  - The different classifications use for the rotator cuff pathology seem to be
      incomplete. We propose a new classification with many advantages: 1)
      Differentiate the tendinopathy between less serious (grade 2A) and serious (grade
      2B). 2) Recognize the intra-tendinous cleavage of the infra-spinatus associated
      with complete tear of the supra-spinatus. 3) Differentiate partial and complete
      tears of the supra-spinatus. We established this classification after a
      retrospective study of 42 patients operated on for a rotator cuff pathology.
      Every case had had a preoperative MRI. This classification is simple, reliable,
      especially for the associated intra tendinous cleavage.

PMID- 7783038
TI  - [Diagnosis of non-palpable breast lesions: contribution of cytological punctures
      after stereotaxic localization].
AB  - The authors reviewed the accuracy of stereotaxic fine-needle aspiration cytology.
      Two hundred-twenty-eight lesions were studied: 103 benign lesions, 125 cancers.
      Inadequate sample was obtained in 26% of cases. None of the cytology reports were
      false-positive, whereas 77% of the suspect cytologic reports were malignant on
      histology. In strongly suspicious lesions at mammography, the decision to perform
      surgical biopsy should not be postponed as false negative cytologic findings (7
      cases) are possible. In patients with a low suspicious lesion, cytology found six
      cancers. The benign-to-malignant ratio of excisional biopsies of non palpables
      lesions should be reduced by stereotaxic fine-needle aspiration cytology.

PMID- 7783039
TI  - [Solid breast nodules: reliability of ultrasonographic and cytological studies].
AB  - The authors evaluated the usefulness of US study and US guided fine-needle
      aspiration cytology (FNAC) in 144 solid breast lesions. US studies was performed
      with a 10-MHz transducer. Homogenous hypoechogenicity, elongation along the
      general orientation of the breast tissue plane, regular margins, and
      intensification of posterior echoes were considered as benign signs. US guided
      FNAC was performed when lesions were depicted at US. The smears were performed
      immediately by the cytologist who was present during the procedure. US signs and
      FNAC diagnoses were compared with surgical/core biopsy diagnoses or negative
      imaging follow-up. The sensitivity of US was 93%, specificity 75%, accuracy 81%.
      Among 41 malignant lesions the cytologic findings were malignant (n = 26) or
      suspicious (n = 7) with 1 false positive and 2 false negative. Inadequate
      samplings were less frequent last year study (13.5%). The sensitivity of
      cytologic diagnosis was 94%, specificity 85%, and accuracy 88%. US study and FNAC
      could be helpful in evaluating solid breast lesions. A better accuracy may be
      obtained if FNAC is associated with core biopsy.

PMID- 7783040
TI  - [Imaging of severe forms of hematoma in the rectus abdominis under
      anticoagulants].
AB  - AIM: To describe the US, CT and MRI pattern of the severe rectus sheath hematoma
      (RSH) complicating anticoagulant therapy. MATERIALS AND METHODS: CT scans were
      performed in thirteen patients (12 women, 1 man) aged from 53 to 90 (mean age,
      74) with severe RSH. Five patients also underwent ultrasound examination and
      three MR examination. Nine patients (69%) were receiving subcutaneous injection
      of heparin, three (23%) oral anticoagulant therapy and one continuous IV infusion
      of heparin. Clinical diagnosis was reached in 6 cases. Excessive activity of
      anticoagulant therapy was noted in 4 cases. The location of the RSH, their
      densities and their signal were analysed. RESULTS: All the RSH were mostly
      developed in the lower third of the abdominal wall, had a large spreading into
      the Retzius space and compressed the bladder and/or the bowels. RSH were all
      hyperdense and in 8 cases (61%) a fluid-fluid level due to the hematocrit effect
      was noted. In one case, a retroperitoneal hematoma was discovered. The extension
      of the RSH was well delineated with MRI. The RSH showed itself with heterogeneous
      signal intensities with areas of high-signal-intensity on T1-weighted images.
      Fluid-fluid levels and a concentric ring sign were also noted. CONCLUSION: Older
      women with subcutaneous injection of heparin are especially prone to RSH even
      though there is no overall excessive activity of anticoagulant therapy. Clinical
      and biological diagnosis may be difficult. CT scan is the exam of choice to reach
      a precise and acute diagnosis of RSH.

PMID- 7783041
TI  - [Imaging of hepatic tuberculoma].
AB  - We describe a case of localized macronodular tuberculosis of the liver, the so
      called hepatic tuberculoma. Liver US scan demonstrated an hypoechoic well
      delineated lesion of the left liver lobe. Liver CT scan demonstrated a hypodense
      lesion before and after contrast enhancement. Liver MR scan demonstrated a lesion
      hypointense to liver on T1-weighted images and isointense to liver on T2-weighted
      images.

PMID- 7783042
TI  - [Multilocular cyst of the kidney in a child. Value of MRI?].
AB  - We report one case of multilocular cyst of the kidney in one year and three
      months female infant who underwent echography, computed tomography and MRI before
      surgery. MR image accurately reflect the morphology of the tumor: the capsule is
      hypointense on T1-weighted images, the septa show moderate enhancement with
      intravenous contrast. Varied intensities from fluid in the visualised locules
      presumably represent different concentration of proteins. MR imaging features are
      highly suggestive but non pathognomonic of the disease. Positive diagnosis always
      require histology.

PMID- 7783043
TI  - [Tuberculous tenosynovitis of the wrist: ultrasonographic diagnosis and
      contribution of MRI].
AB  - Chronic tenosynovitis of the hand due to Mycobacterium tuberculosis has become
      rare. In the two cases presented here, the final diagnosis was obtained by
      isolation of the organism in the intercarpal fluid (1 case), or by a synovial
      biopsy (1 case). Ultrasonography showed a hypoechoic thickening of one or several
      tendon sheaths. MR enabled better differentiation between the thickening of the
      synovium itself and a fluid effusion. The criteria permitting to differentiate
      tuberculous from non-infectious tenosynovitis are: young age, male sex, specific
      epidemiological factors, elevated erythrocyte sedimentation rate, marked local
      swelling, association with other foci of tuberculosis, unusual exudation and
      synovial thickening, and association with osteitis.

PMID- 7783045
TI  - [MRI demonstration of soft tissue involvement in algodystrophy of the hip].

PMID- 7783044
TI  - [False aneurysm of the abdominal aorta of hydatid origin].
AB  - The rupture of hydatid cysts into the abdominal aorta is an exceptional and
      serious complication of the hydatid disease. We report a case of hydatid false
      aneurysm of the abdominal aorta, explored by US Doppler, C.T. and arteriography.

PMID- 7783046
TI  - [Immobilization and filtration for arteriography of the lower limbs].

PMID- 7783047
TI  - [MRI aspect of Wernicke encephalopathy].

PMID- 7783048
TI  - [Cleidocranial dysostosis].

PMID- 7783049
TI  - [Radiology education in Quebec: an example to be followed?].

PMID- 7783050
TI  - Soluble tumor necrosis factor receptors in arthritis.

PMID- 7783051
TI  - Activated gelatinase-B (MMP-9) and urokinase-type plasminogen activator in
      synovial fluids of patients with arthritis. Correlation with clinical and
      experimental variables of inflammation.
AB  - OBJECTIVE: To evaluate the occurrence of gelatinase-B (matrix metalloproteinase
      9, MMP-9) in synovial fluids (SF) of patients with arthritis to investigate the
      possible role of this neutral MMP in joint destruction. METHODS: In paired
      (series I) and unpaired SF (series II) we examined the occurrence of gelatinase
      B, prostromelysin-1, and urokinase-type plasminogen activator (u-PA). RESULTS: In
      the paired SF a parallelism between the presence of activated gelatinase-B and
      the local arthritis activity scores of the knees was observed. Activated
      gelatinase-B correlated well with the presence of stromelysin-1 and u-PA, 2
      enzymes probably involved in the activation process of gelatinase-B. In the 2nd
      series, activated gelatinase-B was found in 56 SF samples, whereas 82 samples did
      not exhibit activated gelatinase-B. The SF samples with the activated form of
      gelatinase-B showed a significantly higher ability to induce permeability changes
      in cultured monolayers of human endothelial cells, had more myeloperoxidase
      activity--secreted by infiltrated leukocytes--and had higher u-PA antigen
      concentrations, compared to SF samples without the activated form of gelatinase
      B. CONCLUSION: Our data suggest that the presence of gelatinase-B is a reflection
      of the inflammatory condition of the joints of patients with arthritis, and that
      the activation of gelatinase-B in the joints, which may occur in a u-PA/plasmin
      dependent and/or a stromelysin dependent way, contributes to the progression of
      arthritis.

PMID- 7783052
TI  - T cell receptor distribution in rheumatoid synovial follicles.
AB  - OBJECTIVE: In rheumatoid arthritis (RA) joint erosion is accompanied by T cell
      infiltration of the synovial tissue. The resulting T cell receptor (TCR)
      repertoire is a combination of antigen driven shaping, nonspecific selection by
      endothelial cell-T cell interactions, and cytokine mediated chemoattraction.
      Considering the conflicting results of molecular biology studies of the TCR
      repertoire in RA, we attempted to obtain new data to clarify the situation
      through microscopic distribution analysis of TCR beta chain diversity in synovium
      follicular CD4/CD8 subsets. METHODS: We used dual color fluorescence confocal
      microscopy with CD4/CD8 monoclonal antibodies (Mab) and a panel of new anti-V
      beta Mab. The analysis focussed on lymphocyte rich, follicle-like areas of
      synovial tissue from 4 patients with RA. RESULTS: The expression of individual
      TCR beta families varied between areas within the T cell follicles, and between
      patients. Normal absolute levels of some beta chains can be completely skewed
      towards one subset, indicating that overall TCR evaluation is insufficient.
      CONCLUSION: Confocal microscopy analysis of localized TCR diversity in RA
      synovium offers novel insight into overall V beta gene usage, which appears to be
      the accumulation of several localized microexpansions.

PMID- 7783053
TI  - Synthesis and degradation of hyaluronate by synovia from patients with rheumatoid
      arthritis.
AB  - OBJECTIVE: Hyaluronate degradation was analyzed in cultures of healthy tissue and
      tissue obtained from patients with rheumatoid arthritis. METHODS: Arthritic and
      healthy synovial tissues were incubated in culture with [3H]glucosamine. Labelled
      hyaluronate was extracted and its size determined by gel filtration. The
      production of low molecular weight hyaluronate was analyzed by pulse-chase
      experiments. Radical production was measured by a cytochrome C reduction assay.
      RESULTS: Healthy tissues and some arthritic tissues that did not contain
      significant amounts of granulocytes produced high molecular weight hyaluronate.
      In contrast, arthritic tissue infiltrated with granulocytes released low
      molecular weight hyaluronate. Pulse-chase experiments suggested that hyaluronate
      was degraded in these arthritic tissues. Exogenous hyaluronate was degraded only
      by intact tissue, but not by cells in culture obtained from synovial membranes of
      synovial fluids. Hyaluronate degradation was accompanied by massive oxygen
      radical production. Radical scavengers protected hyaluronate from degradation in
      synovial tissue. Some protection was achieved by superoxide and catalase or by
      methionine and complete protection by the iron chelators
      diethyltriaminepentacetic acid or deferoxamine mesylate. CONCLUSION: Degradation
      of hyaluronate in arthritic synovial tissue may be inhibited in tissue culture by
      radical scavengers.

PMID- 7783054
TI  - Soluble receptors for tumor necrosis factor and interleukin-2 in serum and
      synovial fluid of patients with rheumatoid arthritis, reactive arthritis and
      osteoarthritis.
AB  - OBJECTIVE: To compare levels of soluble tumor necrosis factor receptor (TNF-R)
      and soluble interleukin 2 receptor (sIL-2R) in sera and synovial fluids (SF) of
      patients with rheumatoid arthritis (RA), reactive arthritis (ReA), and
      osteoarthritis (OA) in order to investigate the usefulness of soluble cytokine
      receptors for differentiation diagnosis and their involvement in the
      pathophysiology of rheumatic diseases. METHODS: Soluble TNF-R (55 kDa), sIL-2R,
      and TNF-alpha were measured by ELISA in sera and SF of patients with RA, ReA, and
      OA and correlated with serological and clinical disease activity variables.
      RESULTS: Serum TNF-R was significantly (p < 0.0001) elevated in RA (4.6 +/- 2.1
      ng/ml, mean +/- SD) compared to ReA (2.5 +/- 0.6 ng/ml), OA (2.2 +/- 0.7 ng/ml),
      and healthy controls (2.0 +/- 0.4 ng/ml). In SF mean TNF-R levels were 21 +/- 9.3
      ng/ml in RA, 12.5 +/- 5.1 ng/ml in ReA, and 8.7 +/- 3.7 ng/ml in OA (p < 0.0001
      for RA vs ReA or OA; p < 0.02 for ReA vs OA). SF levels were significantly higher
      in rheumatoid factor (RF) positive than in RF negative patients with RA. In
      patients with RA, correlations were found between TNF-R and TNF-alpha in SF (r =
      0.32, p < 0.01), and between TNF-R and early morning stiffness (r = 0.4, p <
      0.003 in serum; r = 0.29, p < 0.05 in SF). However, there was no correlation with
      disease activity variables such as Ritchie index, erythrocyte sedimentation rate
      (ESR) or C-reactive protein. Serum levels of IL-2R were elevated in RA and ReA,
      but a significant difference was found only for RA versus OA and controls (p <
      0.0005), whereas in SF significant differences existed between all 3 patient
      groups (RA/ReA: p < 0.004; RA/OA: p < 0.0001; ReA/OA: p < 0.0003); both in serum
      and SF, levels of RF positive patients with RA were higher than those of RF
      negative patients. In patients with RA, IL-2R correlated weakly with ESR (r =
      0.24, p < 0.05), iron concentration (r = -0.35, p < 0.005), and CRP (r = 0.24, p
      < 0.05). CONCLUSION: In RA, in contrast to ReA and OA, TNF-R and IL-2R were not
      only elevated in the joint fluid but also in serum. This indicates general
      activation of the immune system in RA, but not in ReA and OA. Therefore the
      soluble receptors, especially TNF-R, might become useful diagnostic variables to
      distinguish RA from ReA and OA.

PMID- 7783055
TI  - Characterization and regulation of CD69 expression on rheumatoid arthritis
      synovial fluid T cells.
AB  - OBJECTIVE: To study CD69+ synovial fluid (SF) T cells and the mechanisms
      regulating CD69 expression in rheumatoid arthritis (RA). METHODS: One or 2 color
      flow cytometry was used to determine CD69 and other surface markers. Cultures of
      SF T cells alone or mixed with autologous SF non-T cells were used for CD69
      maintenance assays. RESULTS: SF T cells were enriched in CD69+. These cells were
      mainly CD3+, CD8+ and CD25-. CD69 was maintained on SF T cells cultured with SF
      non-T cells but not when the former were cultured alone or in the presence of
      different supernatants from RA SF T and non-T cells cultures with sustained CD69
      expression. Pretreatment of T and non-T cells with anti-CD18 monoclonal antibody
      inhibited CD69 expression, while paraformaldehyde-"fixed" non-T cells effectively
      maintained it. CONCLUSION: SF T cells exhibit a phenotype with evidence of past
      and recent activation. Our studies demonstrate that most of the recently
      activated SF T cells are CD8+. We also found that continuous cell-to-cell
      interaction between T and non-T cells are responsible for the maintenance of this
      particular state of activation of SF T cells.

PMID- 7783056
TI  - Isolated microscopic hematuria in patients with rheumatoid arthritis compared
      with age and sex matched controls. A population based study.
AB  - OBJECTIVE: To evaluate the prevalence and causes of isolated microscopic
      hematuria in patients with rheumatoid arthritis (RA). METHODS: An unselected
      population of 1018 patients with RA (810 women, 208 men) were studied
      prospectively (n = 604) or retrospectively (n = 414), and the results were
      compared with an age and sex matched control population (n = 457; 352 women, 105
      men). Hematuria was defined as a positive dipstick result in 2 urine samples, and
      was regarded as isolated when no concomitant proteinuria was found (urine protein
      excretion < or = 0.15 g/24 h). To investigate the urological causes of isolated
      hematuria, urine cytology, renal ultrasound, and urethrocystoscopy were
      undertaken. Renal biopsy was performed when no urological lesions were found.
      RESULTS: There was no difference in the prevalence of isolated hematuria between
      patients with RA and controls (women 10 and 9%, men 5 and 6%, respectively; total
      9% for both). Mild mesangial glomerulopathy was the most common renal biopsy
      finding in patients with RA with isolated hematuria, found in 13 of 15 adequate
      renal biopsy specimens. The cause of hematuria remained uncertain or unknown in
      52% of the patients with RA and in 61% of controls. CONCLUSION: The prevalence of
      isolated microscopic hematuria was not significantly more frequent in patients
      with RA than in age and sex matched controls. This result was independent of the
      definition or grade of hematuria. Mesangial glomerulopathy was the most common
      renal biopsy finding in patients with RA with isolated hematuria.

PMID- 7783057
TI  - The correlates of health perceptions in rheumatoid arthritis.
AB  - OBJECTIVE: Although measures of health perceptions have been routinely
      incorporated into assessments of individuals with rheumatoid arthritis (RA), the
      relationships of other characteristics of these individuals to their health
      perceptions is not fully understood. We describe the cross sectional associations
      of sociodemographic, disease, and functional status characteristics with
      perceived health in individuals with RA. METHODS: This description was generated
      through a 2-phase secondary data analysis using 2 statistical approaches:
      recursive partitioning of the sample and standard multivariate logistic
      regression techniques. RESULTS: Both methodological approaches identified
      education, race, depression, and physical activity as important correlates of
      self-assessed health in RA. Each approach, in its own way, also identified an
      interactive effect between physical activity and education and between depression
      and race in these models. CONCLUSION: An individual's sociodemographic, disease,
      and functional status characteristics form a complex model of the correlates of
      health perceptions of individuals with RA.

PMID- 7783058
TI  - Osteoporosis in rheumatoid arthritis: findings in the metacarpal, spine, and hip
      and a study of the determinants of both localized and generalized osteopenia.
AB  - OBJECTIVE: To determine the relationship between axial and peripheral bone
      density in patients with rheumatoid arthritis (RA) compared to controls. To study
      risk factors for axial and peripheral bone loss in RA. METHODS: Twenty women with
      RA and 20 age matched controls underwent dual energy x-ray absorptiometry (DXA)
      of the spine and hip and microradioscopy of the hands in order to quantify the
      combined cortical thickness (CCT) of the 2nd metacarpal. Sharp's method was used
      to assess the degree of joint space narrowing and erosions. RESULTS: Compared to
      controls, the RA group had significantly decreased bone density at the hip (0.761
      g/cm2 vs 0.852 g/cm2, p < 0.05) and at the 2nd metacarpal (3.77 vs 4.39 mm, p <
      0.05), but not at the spine (0.960 vs 0.947 g/cm2, NS). In patients with RA,
      measurement of the CCT did not predict bone density at the spine or hip (r =
      0.07, NS, and r = 0.095, NS, respectively), whereas in controls, the CCT was
      significantly correlated with bone density at both these axial sites (r = 0.47, p
      < 0.05, and r = 0.64, p < 0.01, respectively). Grip strength in RA was correlated
      with the CCT (r = 0.62, p < 0.01), implying a relationship between hand function
      and local bone density. Sharp's method did not correlate with axial bone density,
      but it was strongly correlated with the CCT (r = -0.64, p < 0.01). CONCLUSION: In
      RA, the CCT is not a useful screen for osteoporosis at the spine or hip. This
      suggests that localized and generalized osteopenia in RA are best viewed as
      independent processes.

PMID- 7783059
TI  - Effects of tenidap on leukocyte-endothelial cell adhesion in mesenteric venules.
AB  - OBJECTIVE: To compare the proinflammatory effects of tenidap to those of
      indomethacin, and to assess the influence of lipoxygenase inhibition with either
      a leukotriene synthesis inhibitor (L663,536) or tenidap on platelet activating
      factor (PAF) induced leukocyte adhesion. METHODS: Adherent leukocytes, emigrated
      leukocytes, number of rolling leukocytes/100 microns venule, flux of rolling
      leukocytes, and leukocyte rolling velocity were quantitated in mesenteric venules
      (25-35 microns diameter and > 150 microns length) of Sprague-Dawley rats using
      intravital microscopy. In some experiments, the mesentery was superfused with
      indomethacin (25 micrograms/ml), tenidap (30 micrograms/ml), or both drugs
      simultaneously. In other experiments the mesentery was superfused with PAF 100 nM
      and the effects of treatment with L663,536 (10 mg/kg given orally) or superfusion
      with tenidap were determined. RESULTS: Indomethacin significantly increased
      leukocyte rolling and adhesion. Tenidap did not promote leukocyte-endothelial
      cell adhesion and blocked the increased leukocyte rolling and adhesion promoted
      by indomethacin. Both L663,536 and tenidap significantly attenuated PAF induced
      leukocyte-endothelial cell adhesion. CONCLUSION: Tenidap does not exhibit the
      proinflammatory properties of indomethacin. The reduction of indomethacin or PAF
      induced leukocyte-endothelial cell adhesion by tenidap appeared to result from
      its lipoxygenase inhibitory activity. Modulation of leukocyte-endothelial cell
      adhesion may be a novel mechanism of the antiinflammatory activity of tenidap and
      may reduce the relative risk of gastric ulceration with tenidap.

PMID- 7783060
TI  - Dietary treatment of hyperlipidemia in patients with systemic lupus
      erythematosus.
AB  - OBJECTIVE: To evaluate dietary therapy in the treatment of hyperlipidemia in
      patients with systemic lupus erythematosus (SLE). METHODS: Using the National
      Cholesterol Education Program (NCEP) guidelines, we screened 89 patients with SLE
      for hyperlipidemia. Step 1 dietary therapy was instituted in 28 patients as
      recommended by the NCEP. Twenty-six patients failed Step 1 intervention and
      received Step 2 dietary therapy for an additional 3 months. Twenty-nine control
      patients with SLE were tested for hyperlipidemia. RESULTS: The 89 patients with
      SLE (94% women, 77% black) had a mean age of 37.2 years. Fasting values were
      total cholesterol (TC) 6.22 +/- 0.16 mmol/l (240.9 +/- 6.0 mg/dl), low density
      lipoprotein cholesterol (LDL-C) 4.08 +/- 0.14 mmol/l, (157.6 +/- 5.3 mg/dl), high
      density lipoprotein (HDL-C) 1.37 +/- 0.08 mmol/l (53.0 +/- 3.1 mg/dl), and
      triglyceride (TG) 1.71 +/- 0.12 mmol/l, (151.9 +/- 10.6 mg/dl). The mean dose of
      prednisone was 14.2 +/- 1.6 mg/day. Prednisone dose correlated with levels of TC
      (p < 0.01) by linear regression. The 28 patients receiving Step 1 dietary
      intervention had TC 6.11 +/- 0.19 mmol/l (236.4 +/- 7.3 mg/dl), LDL-C 4.05 +/-
      0.19 mmol/l (156.6 +/- 7.5 mg/dl), HDL-C 1.31 +/- 0.08 mmol/l (50.7 +/- 3.0
      mg/dl), and TG 1.64 +/- 0.12 mmol/l (145.4 +/- 10.3 mg/dl). The 26 patients
      receiving Step 2 dietary intervention had TC 5.84 +/- 0.17 mmol/l (226.0 +/- 6.6
      mg/dl), LDL-C 3.83 +/- 0.19 mmol/l (148.0 +/- 7.2 mg/dl), HDL-C 1.25 +/- 0.08
      mmol/l (48.5 +/- 3.2 mg/dl), and TG 1.66 +/- 0.15 mmol/l (147.1 +/- 13.4 mg/dl).
      The mean prednisone dose was 14.8 +/- 3.0 mg/day for both study groups. There was
      no significance between prednisone doses in all groups studied (p = 0.08). After
      6 months of dietary therapy, there was a significant decrease in only the TC (p =
      0.158). CONCLUSION: TC correlated directly with the prednisone dose. Six months
      of dietary intervention was required to significantly decrease the TC. Further
      management of hyperlipidemia will probably require drug intervention.

PMID- 7783061
TI  - Dyspnea in ambulatory patients with SLE: prevalence, severity, and correlation
      with incremental exercise testing.
AB  - OBJECTIVE: We sought to determine the prevalence and severity of dyspnea, and to
      correlate dyspnea with clinical features and exercise limitation in ambulatory
      patients with systemic lupus erythematosus (SLE). METHODS: Twenty-five
      consecutive patients were evaluated with a validated pulmonary questionnaire,
      chest radiograph, 2-dimensional echocardiography, resting pulmonary function
      tests, and incremental exercise testing. RESULTS: Dyspnea was reported by 60%
      (95% CI 39-79) of patients; 20% (95% CI 7-40) had severe dyspnea (inability to
      dress without dyspnea) and 12% (95% CI 3-31) had moderate dyspnea (dyspnea after
      walking 100 yards). Compared to patients without dyspnea, patients with dyspnea
      were more likely to have had a history of clinical lupus involving the lung (80
      vs 40%, p = 0.05), a lower total lung capacity (77.5 vs 94.8%, p = 0.002), and a
      reduced maximum oxygen consumption (VO2max of 53.4 vs 67.7%, p = 0.01). Patients
      with severe dyspnea and patients without dyspnea did not differ in duration of
      prednisone use, activity of disease, weight, or in frequency of Raynaud's
      phenomenon (p > 0.05). Only 4% of all patients had abnormal left ventricular
      motion on 2-dimensional echo; patients with moderate or severe dyspnea had normal
      left ventricular motion. Of the 5 patients with severe dyspnea, 4 (80%) had
      restrictive lung disease and 1 (20%) had an isolated diffusion defect. All
      patients with dyspnea had an abnormal exercise test, but so did 9/10 without
      dyspnea (p > 0.05). Severity of dyspnea correlated highly with maximum exercise
      tolerance measured by VO2max (R2 = 0.51, p = 0.0001). CONCLUSION: In ambulatory
      patients with SLE, dyspnea is common, frequently disabling, associated with a
      history of lupus involvement of the lung, and correlates highly with objective
      measures of exercise limitation.

PMID- 7783062
TI  - A pilot study of zileuton, a novel selective 5-lipoxygenase inhibitor, in
      patients with systemic lupus erythematosus.
AB  - OBJECTIVE: This is a pilot study of zileuton, a selective 5-lipoxygenase
      inhibitor in systemic lupus erythematosus (SLE). METHODS: Forty patients with SLE
      received zileuton 600 mg qid or placebo in an 8 week, randomized prospective,
      double blind trial. Disease activity was manifested largely by constitutional,
      articular, and skin manifestations with no evidence of active renal, cardiac, or
      neurologic involvement. Concomitant administration of nonsteroidal
      antiinflammatories, corticosteroids, or antimalarials was not permitted. Disease
      activity was determined at baseline and at Days 15 and 57 by assessment of
      arthritis severity, the Systemic Lupus Activity Measure (SLAM), investigator and
      patient global ratings, hematologic indices, and serologic measures including
      autoantibody titers, complement levels, and interleukin 2 receptors (IL-2R).
      Total body sulfidopeptide leukotriene synthesis was measured by urinary
      leukotriene E4 (LTE4) concentrations. RESULTS: Overall SLAM (the primary measure
      of efficacy in this study) was significantly improved with zileuton compared with
      placebo (-2.1 +/- 1.3, compared with an increase of 2.3 +/- 1.3 with placebo by
      Day 57, p = 0.048). Changes in individual SLAM subscores, arthritis severity,
      global ratings, and IL-2R levels compared with baseline did not achieve
      statistical significance, but were generally decreased from baseline with
      zileuton (indicating trends towards improvement) and increased from baseline with
      placebo (indicating trends towards clinical worsening). Urine LTE4 levels at Day
      57 had increased from baseline in the placebo group (indicating worsening) and
      decreased in the zileuton group (indicating improvement). CONCLUSION: Selective 5
      lipoxygenase inhibition may be beneficial in mild SLE.

PMID- 7783063
TI  - Limited scleroderma is associated with increased prevalence of macrovascular
      disease.
AB  - Microvascular involvement in scleroderma is well recognized. Macrovascular
      disease is not. OBJECTIVE. To test the hypothesis that the prevalence of
      macrovascular disease is increased in patients with limited scleroderma (systemic
      sclerosis, lSSc). METHODS. A retrospective cohort study design was employed in
      which the prevalence of macrovascular disease in all female patients from
      specified hospitals (1974-90) with lSSc of at least 5 years' duration was
      compared and contrasted with that in a comparable group of controls. Each control
      was matched to one lSSc case by sex; age (+/- 5 yrs); number of inpatient
      admissions (+/- 2); year of last hospital admission (+/- 2 yrs), history of
      hypertension, cigarette smoking and diabetes mellitus, and medical record number
      most closely approximating the case. The distribution of vascular disease was
      assessed in the peripheral, coronary, and cerebral arterial territories. RESULTS.
      Peripheral macrovascular disease (PVD) occurred in 18 (58%) of the lSSC patients
      and only 3 (9.6%) of the controls (RR = 6.0; 95% CI 2.0-18). Of the 18 lSSc
      cases, 8 had PVD documented angiographically, 4 by arterial Doppler ultrasound,
      and 6 had absent peripheral pulses. Five of these required subsequent partial
      limb amputation. Two of the 3 controls with PVD had absent peripheral pulses, and
      1 had an angiographically documented abdominal aortic aneurysm. No control
      required limb amputation. There was no significant difference in the prevalence
      of coronary artery or cerebrovascular disease between the groups. CONCLUSION. The
      prevalence of peripheral large vessel occlusive disease is increased in lSSC and
      associated with severe morbidity.

PMID- 7783064
TI  - Muscle strength assessment in polymyositis and dermatomyositis evaluation of the
      reliability and clinical use of a new, quantitative, easily applicable method.
AB  - OBJECTIVE: To evaluate the feasibility and the reliability of a quantitative
      method of maximal isometric strength measurement for the assessment of patients
      with myositis in clinical practice and research. METHODS: Three observers
      independently examined the strength of 13 muscle groups of 7 patients with stable
      polymyositis and dermatomyositis (PM/DM) using a handheld pull-gauge. Reliability
      was assessed following a balanced random 3-way cross classification with
      interactions and using the analysis of variance method. Serial followup strength
      data for 2 patients were compared to change in creatinine kinase (CK) levels.
      RESULTS: All measurements could be performed without causing pain to the
      patients. One single test including 13 muscle groups was done in 7 min or less.
      Both intra and interobserver correlations were strong and significant for all
      muscle groups. The intraobserver reliability ranged from 0.88 for elbow extensors
      to 0.98 for knee extensors and cervical spine flexors. The interobserver
      reliability ranged from 0.81 for elbow flexors to 0.98 for knee extensors and
      cervical spine flexors. The followup of 2 cases yielded moderate to strong
      correlations of serial strength measurements with CK levels. CONCLUSION: Serial
      measurement of isometric muscle strength with a handheld pull-gauge is a
      feasible, inexpensive, time efficient and reliable method and may provide
      additional quantitative information in the clinical assessment of patients with
      myositis.

PMID- 7783065
TI  - Lack of sensitivity of indium-111 mixed leukocyte scans for active disease in
      Takayasu's arteritis.
AB  - OBJECTIVE: Currently, a reliable, noninvasive means of detecting the active
      vasculitic lesions of Takayasu's arteritis does not exist. Based on the cellular
      infiltrates seen in active lesions, we postulated that indium-111 labelled mixed
      leukocytes could be used to scintigraphically detect sites of active vasculitis.
      METHODS: Fifteen In-111 mixed leukocyte scans were performed in 10 patients with
      Takayasu's arteritis and correlated with clinical, laboratory, and radiographic
      findings. Patients had either active, stable/smoldering, or inactive disease at
      the time when 8, 4, and 3 scans were performed, respectively. RESULTS: Two of the
      8 scans performed in patients with active disease were positive for increased
      vessel uptake (sensitivity = 25%). All other scans were interpreted as negative
      for active arteritis. CONCLUSION: We conclude that In-111 mixed leukocyte scans
      have a low sensitivity for detection of active Takayasu's arteritis.

PMID- 7783066
TI  - Variability in the attainment of functional milestones during the acute care
      admission after total joint replacement.
AB  - OBJECTIVE: To quantify patients' functional improvement in the immediate
      postoperative period after total hip arthroplasty (THA) or total knee
      arthroplasty (TKA). METHODS: A prospective observational study design was used to
      examine the number of physical therapy treatment sessions and postoperative days
      required to attain independence in 4 critical functional milestones, with
      independence defined as the ability to perform the activity without the
      assistance of another person. The 4 functional milestones selected were the
      ability to perform supine to sit transfers; sit to stand transfers; ambulation to
      100'; and the ability to climb stairs. Consecutive patients undergoing elective
      THA or TKA for the first time at a community teaching hospital were entered into
      the study. RESULTS: The study group consisted of 81 patients undergoing elective
      THA or TKA (33 THA and 48 TKA). There was wide variability in the number of
      physical therapy sessions and postoperative days required to attain each of the 4
      milestones and all 4 milestones. Climbing stairs was the most difficult task,
      followed by walking 100', performing sit to stand transfers, and performing
      supine to sit transfers. The achievement of the latter 2 milestones was similar.
      CONCLUSION: Our examination of patients' progress in attaining specific
      functional milestones is a unique approach to outcome assessment that emphasizes
      the physical therapy aspect of postsurgical rehabilitation. A wide variability in
      patients' functional progress during the acute care admission after elective THA
      or TKA was demonstrated. The reasons for this variability need to be explored
      since they may have important implications for planning rehabilitation related to
      THA, TKA or other orthopedic reconstructive procedures.

PMID- 7783067
TI  - The association of body weight, body fatness and body fat distribution with
      osteoarthritis of the knee: data from the Baltimore Longitudinal Study of Aging.
AB  - OBJECTIVE: To examine the association of body weight, body fatness, and body fat
      distribution with osteoarthritis (OA) of the knee. METHODS: Bilateral standing
      knee radiographs, taken between 1985 and 1991, of 465 Caucasian men and 275
      Caucasian women subjects aged 40 and above in the Baltimore Longitudinal Study of
      Aging were read by one investigator for grade of OA using Kellgren-Lawrence
      scales. Measures of obesity, assessed at same visit as the last radiograph during
      this interval, included body mass index, percent body fat, and body fat
      distribution. RESULTS: Both men and women with definite knee OA had higher age
      adjusted mean levels of body mass index, while women only had higher age adjusted
      mean levels of percent body fat. Both women and men in the highest tertile of
      body mass index had significantly increased odds of both definite and bilateral
      knee OA; women in the middle and highest tertile of percent body fat had
      significantly increased odds of both definite and bilateral knee OA, and men in
      the highest tertile of waist-hip ratio had significantly increased odds of
      bilateral knee OA. After adjusting for body mass index, however, the association
      of percent body fat and waist-hip ratio with knee OA in women and men,
      respectively, was no longer significant. CONCLUSION: These data further extend
      observations that body weight is associated with both definite and bilateral knee
      OA in both sexes, and support a stronger contribution of mechanical as opposed to
      systemic factors to explain this association.

PMID- 7783069
TI  - Visceral larva migrans mimicking rheumatic diseases.
AB  - OBJECTIVE: To report rheumatologic or rheumatologic-like manifestations of the
      visceral larva migrans (VLM) syndrome. METHODS: We carried out a prospective
      study of patients with VLM seen in a private practice setting in Mexico City
      between 1990 and 1993. RESULTS: From a population of 600 patients we identified 6
      patients (5 women) with VLM. Three patients complained of arthralgia; in 4 a
      history of migratory cutaneous lesions was elicited, and in one monoarthritis of
      the right knee was found. One patient had deep edema that suggested
      thrombophlebitis of the right arm; the man in our series had right testicular
      swelling during followup. In 2 cases, panniculitis was documented by biopsy and
      in one, small vessel vasculitis. Four patients had frequent contact with dogs and
      one with cats; 4 patients frequently ate raw fish. The diagnosis of VLM was
      confirmed either by the clinical picture, biopsy, or ELISA: CONCLUSION: The
      spectrum of rheumatological manifestations in VLM may be wider than previously
      thought.

PMID- 7783068
TI  - Does renal impairment protect from gout?
AB  - OBJECTIVE: To test whether renal impairment protects from the development of
      gout. METHODS: We conducted a retrospective cohort study in which 40
      hyperuricemic patients (serum uric acid > 0.54 mM/l) with renal impairment (serum
      creatinine > 200 microM/l) and 40 equally hyperuricemic patients with normal
      renal function (serum creatinine < 120 microM/l) were given a telephone
      questionnaire eliciting a history of gout, its pattern and severity, and other
      features of medical and family history. RESULTS: There was no significant
      difference among the prevalence of gout (relative risk 1.1, confidence interval
      0.73-1.67), the pattern and severity of gout, and the presence of tophi between
      the 2 groups. A positive family history of gout was significantly increased in
      the patients with gouty arthritis (p < 0.05). CONCLUSION: Renal impairment does
      not protect from gout. There may be a familial factor in the development of gout
      that is independent from the familial tendency for hyperuricemia.

PMID- 7783070
TI  - High prevalence of undetected carpal tunnel syndrome in patients with
      fibromyalgia syndrome.
AB  - OBJECTIVE: To assess the prevalence of carpal tunnel syndrome (CTS) in patients
      with fibromyalgia syndrome (FM). METHODS: A series of 206 consecutive patients
      with FM was evaluated for CTS in an unblinded, uncontrolled study. Sixty patients
      with dermatomal paresthesia in the fingers enervated by the median nerve were
      evaluated with electromyogram and nerve conduction velocity studies (EMG/NCV).
      RESULTS: Thirty-three patients showed EMG/NCV findings diagnostic for CTS (16% of
      the 206 cases, 55% of the 60 EMG studies). Only 2 of the 33 patients with CTS had
      been diagnosed before rheumatologic evaluation. We compared our results with
      those reported for women in the general population. The overall prevalence of CTS
      in women was higher (16 vs 10.2%), but not statistically different. However, in
      our series, there was a clear difference in the higher rate of undetected CTS in
      women with FM compared to that of the general population (14.1 vs 6.7%) (p <
      0.01). CONCLUSION: (1) CTS is at least as common in patients with FM as in the
      general population, contrary to that reported in retrospective studies; (2) the
      rate of underdiagnosed CTS in women with FM is much higher than the rate reported
      in the general population; (3) NCV studies may be necessary to evaluate
      underdiagnosed CTS in patients with FM and dermatomal paresthesia in their hands.

PMID- 7783071
TI  - Musculoskeletal disability, employment, and rehabilitation.
AB  - OBJECTIVE: To determine which, if any, baseline social and disease
      characteristics can be used to identify persons with musculoskeletal disabilities
      accepted for state-federal vocational rehabilitation services who are most likely
      to return to work. METHODS: A database of case closures from the Alabama
      Vocational Rehabilitation Service was analyzed using segmentation modelling. This
      included all persons (n = 4093) with musculoskeletal disability who were accepted
      by the Alabama Vocational Rehabilitation Agency in 1987-91. Demographics, income,
      type of disability, severity of disability, medical insurance, similar benefits,
      benefit status, and referral source were independent variables. Outcome
      (dependent) variable was work status at end of agency services. RESULTS: Overall,
      71% of persons with arthritis and musculoskeletal disorders who were accepted for
      vocational rehabilitation services in 1987-91 returned to work at the end of
      agency services. Segmentation modelling created a tree in which certain baseline
      characteristics formed subgroups with differing rates of successful
      rehabilitation. Social Security Disability Insurance (SSDI) status was the single
      best predictor of rehabilitation. Seventy-three percent of nonbeneficiaries were
      rehabilitated compared to 55% of beneficiaries (p < 0.00001). For non-SSDI
      beneficiaries, education level > or = grade 12 was associated with better
      rehabilitation outcome (p < 0.00001). SSDI beneficiaries with nonback disorders
      fared better than those with back disorders (p < 0.05). Disease severity,
      assessed by Federal Special Programs criteria, was not associated with
      rehabilitation outcome at any level of the tree. CONCLUSION: Simple baseline
      social and disease characteristics can be used to identify groups of persons
      accepted for vocational rehabilitation services with musculoskeletal disability
      with differing rates of vocational rehabilitation. Disability benefit status and
      education level are important predictors of return to work after agency services.
      These findings can lead to the development of strategies to improve the efficacy
      of vocational rehabilitation services.

PMID- 7783072
TI  - The relationship between self-reported pain and sociodemographic variables,
      anxiety, and depressive symptoms in rheumatoid arthritis.
AB  - OBJECTIVE: Self-reported pain is one of the core endpoint measures in RA. The
      objective of this cross sectional study of 238 patients with rheumatoid arthritis
      (RA) was to examine the relationship between self-reported pain intensity,
      sociodemographic variables, anxiety, and depressive symptoms. METHODS: A weighted
      sum score of pain intensity was constructed by combining a visual analog pain
      scale with items from the Arthritis Impact Measurement Scales (AIMS) and the
      Nottingham Health Profile. Symptoms of anxiety and depression were measured by
      subscales of AIMS:  RESULTS: Multiple regression analyses showed no significant
      effects of age, sex, income, or level of education on self-reported pain
      intensity, whereas there was a significant association between the pain index and
      anxiety and depressive symptoms. The correlation between the pain index and
      anxiety, and the pain index and depression, was 0.46 for both. Controlling for
      sociodemographic variables, the Ritchie index, erythrocyte sedimentation rate,
      and C-reactive protein, the standardized regression coefficients were 0.33 and
      0.31 of the pain index on the AIMS anxiety and depression subscale, respectively.
      Furthermore, the results indicate that the effect of inflammation on mental
      distress is mediated by pain. CONCLUSION: Self-reported pain in RA is not
      significantly influenced by sex, age, level of education, or income. Even when
      controlling for disease activity, there was a considerable correlation between
      self-reported pain and mental distress. Furthermore, our study lends support to
      the hypothesis that mental distress is mainly secondary to pain rather than vice
      versa.

PMID- 7783073
TI  - Autoantibodies to the nucleolar organizer antigen NOR-90 in children with
      systemic rheumatic diseases.
AB  - OBJECTIVE: To determine the frequency of autoantibodies directed against the
      nucleolar organizer antigen NOR-90 [human upstream binding factor (hUBF)] in
      pediatric patients with systemic rheumatic diseases. Two children with antibodies
      to NOR-90 are reported. METHODS: Two hundred thirty-eight sera from children with
      systemic rheumatic diseases were screened for autoantibodies directed against
      hUBF by indirect immunofluorescence and immunoblotting using MOLT-4 cell
      extracts. Reactivity with hUBF was confirmed by immunoprecipitation of the
      recombinant hUBF protein. RESULTS: Two sera out of 238 (< 1.0%) with reactivity
      against hUBF were identified. One patient had recurrent abdominal pain, headache,
      and Raynaud's phenomenon. There has been no evidence of an active systemic
      rheumatic disease in more than 8 years of followup. The 2nd patient had Raynaud's
      phenomenon and systemic lupus erythematosus. CONCLUSION: Antibodies to hUBF are
      rare in children with systemic rheumatic diseases. Raynaud's phenomenon was a
      clinical feature common to both patients.

PMID- 7783074
TI  - Fibromyalgia syndrome in children--an outcome study.
AB  - OBJECTIVE: To assess the outcome of fibromyalgia syndrome (FM) in a 30-month
      followup study of children with FM. METHODS: In the original study to assess the
      prevalence of FM in healthy schoolchildren, we found 21 children with FM and an
      additional 7 fulfilling the point count criterion only (11 of 18). Fifteen of the
      21 and all 7 were recruited for a 2nd assessment in our present study. In all
      children, a count of 18 tender points (TP) was conducted by thumb palpation.
      Tenderness of 9 of the TP sites as well as 4 control point sites was further
      assessed using a Chatillon dolorimeter. All children were questioned concerning
      the presence of widespread pain or aching. Children were considered to have FM if
      they met the American College of Rheumatology criteria for diagnosis. RESULTS:
      After 30 months, 11 of the 15 children with FM (73%) were no longer fibromyalgic.
      The mean point count of the 15 children significantly decreased from 12.5 to 4.6
      (p < 0.001). The mean tenderness threshold of the 9 tender sites increased from
      2.4 to 3.4 kg (p < 0.01), and the mean tenderness threshold of the 4 control
      sites increased from 4.1 to 5.6 kg (p < 0.05). Of the 7 children initially
      fulfilling the point count criterion only, none had developed FM. Their mean
      point count decreased from 11.4 to 3.4 (p = 0.001), and their mean tenderness
      thresholds increased from 2.7 kg to 3.9 kg (p = 0.001) at tender sites and from
      4.3 kg to 6.8 kg (p < 0.001) at control sites. CONCLUSION: We suggest that the
      outcome of FM in children is more favorable than in adults. More followup studies
      are needed to clarify the longterm outcomes of FM in children and adults.

PMID- 7783075
TI  - Poststreptococcal reactive arthritis in children: a potential predecessor of
      rheumatic heart disease.
AB  - OBJECTIVE: To report several cases of arthritis seen in children after infection
      with Group A beta-hemolytic Streptococcus (GABHS) which were not associated with
      carditis or other major manifestations of the Jones Criteria for acute rheumatic
      fever (ARF); and to analyze the literature to determine these patients' potential
      risks for the subsequent development of rheumatic heart disease. METHODS: A
      retrospective chart review was performed of all patients seen in a pediatric
      rheumatology clinic from January, 1990 to December, 1992. RESULTS: Four patients
      were identified with poststreptococcal reactive arthritis (PSReA) and no
      carditis. Their arthritis had an acute onset, tended to have a longer duration
      than the arthritis typically seen in ARF, and in most instances did not respond
      promptly to therapy with aspirin or nonsteroidal antiinflammatory agents. In some
      patients, there was no history of sore throat or fever. Diagnosis of PSReA was
      made by serologic testing. Cardiac evaluation in all 4 patients was negative.
      CONCLUSION: PSReA should be considered in the differential diagnosis for any
      pediatric patient with the acute onset of arthritis, whether the arthritis is the
      classic migratory polyarthritis typically seen in ARF or not. Throat culture and
      serologic testing for streptococcal infection should be performed on these
      patients. If recent GABHS infection is confirmed, cardiac evaluation, including
      echocardiogram, is warranted. Both ARF and PSReA occur after GABHS infection, but
      the precise relationship between these 2 entities is unclear. Longterm follow up
      of pediatric patients with PSReA in previous reports have shown that a certain
      percentage of them upon subsequent GABHS infection develop carditis. Until the
      specific risk factors (either host or bacterial characteristics) for developing
      subsequent carditis are better delineated, antibiotic prophylaxis similar to that
      used in ARF should be considered in patients with PSReA.

PMID- 7783077
TI  - Isolated congenital complete heart block: longterm outcome of children and
      immunogenetic study.
AB  - OBJECTIVE: To assess the longterm cardiologic and immunologic outcome of children
      with isolated congenital complete heart block (CCHB) and their HLA antigens.
      METHODS: Sixteen children with isolated CCHB were investigated. HLA typing was
      done using a microcytotoxicity test. RESULTS: Three patients died (18.7%), one in
      utero (35 weeks), one 2 days after birth, and one at 6 years of age. The mean age
      of the 13 living children is now 18.3 years (range 2-34). Eight (50%) have been
      permanently paced for symptoms. No patient developed clinical symptoms or
      serological abnormalities suggesting immune disease. The A31 antigen was more
      prevalent, but one pair of HLA identical twins was observed, and only one had
      CCHB. CONCLUSION: Patients with isolated CCHB have significant cardiac mortality,
      and after a long followup many of them are paced to control symptoms, but in our
      small sample those who survive the perinatal period mostly lead a normal life.
      The longterm immunological outcome of these children seems good. CCHB is not
      related to a specific HLA pattern in affected children.

PMID- 7783076
TI  - Isolated congenital complete heart block: longterm outcome of mothers, maternal
      antibody specificity and immunogenetic background.
AB  - OBJECTIVE: To assess the longterm outcome of mothers of children with isolated
      congenital complete heart block (CCHB), and the maternal specific immunoblot
      pattern and HLA antigens. METHODS: Fifteen mothers of 16 children with isolated
      CCHB were investigated; their followup extended up to 15.8 years on average after
      the index delivery. Anti-Ro and La antibodies were detected by
      counterimmunoelectrophoresis and ELISA; anti-Ro antibodies were studied by
      immunoblot. HLA typing was done using a microcytotoxicity test. RESULTS: One
      mother has systemic lupus erythematosus (SLE) before the index delivery. The
      other mothers developed only minor symptoms (arthralgia, dry eyes and
      photosensitivity) resembling primary Sjogren's syndrome more than classic lupus.
      All 15 mothers were anti-Ro and 9 were also anti-La positive, a mean of 12.5
      years after the index delivery. Eight mothers reacted with the 52 kDa SSA(Ro)
      component, and 2 also with the 60 kDa SSA(Ro) component. The prevalence of the
      DR3 antigen and of the B44/DR5, DR3/DQ2 and A1/Cw7/B8/DR3/DQ2 haplotypes was
      significantly increased. CONCLUSION: The longterm outcome for the mothers of
      children with CCHB is more reassuring than generally assumed. All the mothers
      were anti-Ro positive by sensitive ELISA: Reactivity to the denaturated 52 kDa
      SSA(Ro) component seems characteristic of these mothers, who presented a
      particular immunogenetic background.

PMID- 7783078
TI  - Anorexia nervosa presenting as a peripheral vasculopathy in an adolescent male.

PMID- 7783080
TI  - Subsynovial vascular abnormality causing recurrent hemarthrosis in an 84-year-old
      man.
AB  - We describe a patient with recurrent hemarthrosis of one knee. Investigation
      demonstrated a vascular abnormality of the synovium as the likely cause.
      Structural abnormalities of the synovial vasculature should be considered, in the
      absence of a systemic cause, as a potential source of bleeding in older patients
      with recurrent hemarthrosis.

PMID- 7783079
TI  - Atlantoaxial subluxation in children with seronegative enthesopathy and
      arthropathy syndrome: 2 case reports and a review of the literature.
AB  - We describe 2 HLA-B27 positive children with seronegative enthesopathy and
      arthropathy (SEA) syndrome who developed spontaneous (nontraumatic) atlantoaxial
      subluxation early in their disease course. Neither child had evidence of spinal
      cord compression but both had progressive atlantoaxial subluxation in spite of
      conservative treatment. Both underwent elective posterior cervical (C1-C2)
      fusion.

PMID- 7783081
TI  - Pulmonary capillaritis and alveolar hemorrhage associated with the
      antiphospholipid antibody syndrome.
AB  - Pulmonary hemorrhage due to small vessel vasculitis is a well recognized
      complication of many autoimmune and collagen vascular disorders. The
      antiphospholipid antibody syndrome (APS) is a disorder associated with
      hypercoagulability, thrombocytopenia, and thromboembolic phenomena. Pulmonary
      manifestations include pulmonary embolism, pulmonary hypertension, and
      respiratory failure associated with diffuse pulmonary infiltrates. We describe a
      patient with the APS syndrome, without systemic lupus erythematosus, who
      developed pulmonary hemorrhage due to pulmonary capillaritis with evidence of
      perivascular immune complex deposition.

PMID- 7783082
TI  - Systemic sclerosis sine scleroderma: an unusual presentation in scleroderma renal
      crisis.
AB  - Renal involvement in systemic sclerosis (SSc) has a negative influence on
      prognosis. Cases of SSc sine scleroderma have been reported in which organ
      failure occurred but was not accompanied by cutaneous damage, which in some
      instances did develop later. We describe a patient who, after 6 months of
      symmetric polyarthritis, developed rapid progressive renal failure without skin
      changes. A diagnosis of scleroderma renal crisis, confirmed histologically, was
      made. Anti-RNAP III antibodies were positive. The patient developed typical
      scleroderma skin changes after renal failure. Despite treatment, SSc advanced to
      fatal endstage renal disease.

PMID- 7783083
TI  - Milwaukee shoulder associated with primary hyperparathyroidism.
AB  - We describe a 69-year-old woman with a Milwaukee shoulder syndrome in the
      presence of primary hyperparathyroidism. After removal of a parathyroid adenoma,
      effusion of the shoulder did not recur. We believe that primary
      hyperparathyroidism and Milwaukee shoulder can be causally related.

PMID- 7783084
TI  - Serum aldolase level is a useful indicator of disease activity in eosinophilic
      fasciitis.
AB  - The serum levels of muscle enzymes have been considered normal in patients with
      eosinophilic fasciitis (EF). We observed elevated serum aldolase levels in 3
      patients with EF. Serum creatinine kinase levels were within the normal range. We
      measured the aldolase levels longitudinally. In all patients, the levels
      decreased to the normal range after oral corticosteroid treatment, and skin
      sclerosis improved. Afterwards, serum aldolase levels increased again, with the
      recurrence of skin sclerosis. These observations suggest that serum aldolase
      level may be a useful indicator of disease activity.

PMID- 7783085
TI  - Giant cell arteritis limited to the prostate.
AB  - We describe a 66-year-old man with giant cell arteritis (GCA) limited to the
      prostate. His symptoms, which resembled prostatic neoplasia, resolved with
      systemic steroid therapy. Pathology studies revealed no clinical or histologic
      data indicating temporal artery involvement. To our knowledge this is the first
      described case of GCA involving the prostate.

PMID- 7783086
TI  - Treatment of amyloidosis secondary to rheumatoid arthritis.

PMID- 7783087
TI  - Prognostic value of rheumatoid factors in rheumatoid arthritis.

PMID- 7783088
TI  - Automated diagnosis and characterization of Lyme disease using neural network
      analysis.

PMID- 7783089
TI  - Gold induced colitis.

PMID- 7783090
TI  - Hemorrhagic rupture of the shoulder.

PMID- 7783091
TI  - Polyglandular autoimmune endocrinopathy following procainamide induced lupus.

PMID- 7783092
TI  - Nontyphoidal salmonella ovarian abscess in systemic lupus erythematosus.

PMID- 7783094
TI  - Moraxella septic arthritis in an adult.

PMID- 7783093
TI  - Inclusion body myositis responding to longterm chlorambucil treatment.

PMID- 7783095
TI  - Poisoning with anti-hypertensive drugs: calcium antagonists.
AB  - Calcium antagonists are used increasingly to treat hypertension and other
      conditions, so the possibility of accidental or deliberate self-poisoning is
      substantially increased. These drugs account for a high proportion of deaths in
      cases of poisoning associated with cardiovascular drugs. Most of our present
      knowledge is with the older calcium antagonists, namely verapamil, nifedipine and
      diltiazem; newer sustained-release preparations of these drugs may produce
      serious toxicity in patients who initially appear well. This review discusses the
      cases reported in the literature, the presenting symptoms and the management of
      patients with calcium antagonist poisoning.

PMID- 7783096
TI  - Favourable interaction of calcium antagonist plus ACE inhibitor on cardiac
      haemodynamics in treating hypertension: rest and effort evaluation.
AB  - The aim of the study was to evaluate the effects of verapamil sustained release
      (SR) 240 mg, enalapril and their combination on blood pressure (BP) and cardiac
      haemodynamics at rest and during exercise in 20 patients with moderate essential
      hypertension (seven men and 13 women, mean age +/- s.d. 53.7 +/- 15.8 years).
      After a 4 week placebo run-in period, patients were randomly allocated to
      received verapamil SR 240 mg once daily or enalapril 20 mg once daily for 4 weeks
      in a double-blind fashion. Patients whose diastolic blood pressure (DBP) was
      still > or = 95 mm Hg at the end of this period received verapamil SR plus
      enalapril for an additional 4 weeks. At the end of the placebo, single and
      combined treatment periods, resting and exercise (bicycle ergometry)
      haemodynamics were evaluated by radionuclide ventricular angiography (technetium
      99m) and the following parameters were assessed: BP, heart rate, double product,
      systemic vascular resistances (SVR), cardiac output (CO), stroke volume (SV),
      ejection fraction (EF) mean ejection rate (mER) and peak filling rate (PFR). Both
      verapamil SR and enalapril monotherapies significantly reduced resting and
      exercise BP (P < 0.01), with a BP normalisation (DBP < or = 95 mm Hg) of five of
      10 and 4 of 10 patients respectively. A greater BP fall and a normalisation of 11
      of 11 patients was obtained in non-responders to monotherapy, when treated with
      verapamil SR and enalapril (P < 0.01). Verapamil SR also reduced heart rate at
      rest and during exercise (-11.8% and -18.4%, respectively, P < 0.05).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7783098
TI  - Isolated systolic hypertension as a major risk factor for stroke and myocardial
      infarction and an unexploited source of cardiovascular prevention: a prospective
      population-based study.
AB  - The purpose of this study was to determine the prevalence of isolated systolic
      hypertension (ISH) and associated risk of major cardiovascular events. The
      Copenhagen City Heart Study is a prospective population survey with
      cardiovascular examinations at 5-year intervals. Blood pressure measurement was
      carried out as office blood pressure. ISH was defined as SBP > or = 160 mmHg and
      DBP < 90 mm Hg. The risk of stroke and myocardial infarction (MI) in association
      with ISH was assessed using a multivariate Cox regression model. Follow-up was
      carried out by means of the National Patients Register and Death Register. The
      19,698 subjects were randomly selected after age stratification from an area of
      central Copenhagen. Subjects (n = 6621) were included if > or = 50 years, not on
      anti-hypertensive or cardiac medicine, and had no history of a previous stroke or
      MI. Initial cases of verified stroke or MI were recorded from 1976 to 1988. The
      prevalence of ISH showed an age-related increase from 3% in the 55-year olds to
      13% in the 72-year olds. No sex difference was found. Relative risk of stroke
      corrected for other risk factors was 3.0 (95% CI 1.6-5.3) for women and 2.7 (1.8
      4.3) for men. This was the highest relative risk among all hypertensive groups.
      Relative risk of MI corrected for other risk factors was 0.8 (0.3-2.0) for women
      and 1.6 (1.0-2.5) for men. Population attributable risk for stroke associated
      with ISH is up to 30%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783097
TI  - Accuracy of an oscillometric automatic blood pressure device: the Omron HEM403C.
AB  - The purpose of this study was to assess the accuracy of the Omron HEM403C blood
      pressure (BP) device and to study whether this accuracy was affected by subject
      related factors such as BP level and age. A comparison was made with a Hawksley
      random zero sphygmomanometer. BP was measured with both meters connected to one
      arm-cuff by means of a T-connector. To assess the level of agreement of the Omron
      HEM403C with the random zero meter, BP was measured in 212 subjects. Systolic and
      diastolic readings with the Omron HEM403C were on average 1 mmHg (s.d. 9, 95% CI
      0.4-2.2) and 4 mm Hg (s.d. 8, 95% CI 3.6-5.1) respectively, higher than those
      with the random zero meter. The Omron HEM403C underestimated SBP compared with
      the random zero at higher SBP levels and overestimated SBP at lower SBP levels.
      The Omron meter overestimated the diastolic pressure at all DBP levels and the
      diastolic difference was not related to the DBP level. A multiple linear
      regression analysis demonstrated that the SBP level and not age was the factor
      that independently influenced the systolic difference between the meters.
      According to the criteria of the British Hypertension Society the Omron HEM403C
      is accurate enough to be recommended for those clinical and research purposes
      that are in need of automatic measurements.

PMID- 7783099
TI  - Assessment of effects of two anti-hypertensive regimens on overall cardiovascular
      risk.
AB  - Anti-hypertensive drugs differ in their effects on other cardiovascular risk
      factors. To date there have been few attempts to quantitate the impact of such
      differences. Twenty five unmedicated patients with primary hypertension were
      randomised to initial therapy with either the calcium antagonist, felodipine, or
      a diuretic and doses titrated to achieve similar levels of blood pressure (BP).
      Second drugs were added if needed (metoprolol and prazosin, respectively). The
      aim was to determine over 1 year whether similar anti-hypertensive effects were
      associated with differences in a multivariate index of overall cardiovascular
      risk. The target supine diastolic blood pressure (DBP) (85 mm Hg) required the
      second agent in four of 13 evaluable patients in the felodipine group and six of
      10 in the diuretic group. There was a significant rise in serum cholesterol and a
      fall in serum potassium in the diuretic group, but not in the felodipine group.
      Cardiovascular risk scores were ranked in percentiles in relation to the age
      matched general population. This score fell to a greater degree in felodipine
      patients particularly over the first 6 months, but remaining lower at 12 months.
      Left ventricular hypertrophy assessed by echocardiography, another measure of
      cardiovascular risk, was generally unchanged by either regimen. At equivalent
      blood pressure levels, the calcium antagonist-based regimen had a greater benefit
      on cardiovascular risk, particularly in the first 6 months of therapy. This
      method may be widely applicable in the assessment of anti-hypertensive therapy.

PMID- 7783100
TI  - Intrarenal production of dopamine and natriuresis following DOPA and saline
      infusions in healthy human volunteers.
AB  - The interactions of intrarenal dopamine (DA) synthesis and natriuresis were
      studied in 11 healthy volunteers by giving a low and high sodium diet (LoSo, 50
      mmol Na+; HiSo, 250 mmol Na+). On 2 days in both dietary phases an acute saline
      load was given, without or with an infusion of the DA precursor 3, 4
      dihydroxyphenylalanine (DOPA) 0.15 microgram kg-1 min-1. Urinary excretion rates
      of sodium (UNa V), DOPA (UDOPA V), DA (UDA V) and noradrenaline (NA; UNA V),
      hormonal parameters, blood pressure (BP), glomerular filtration rate (GFR) and
      effective renal plasma flow (ERPF) were measured. On HiSo UDOPA V increased by
      35% (P < 0.05) while UDA V remained unchanged. Only weak correlations were found
      between 24h UNa V and UDA V (r = 0.23) or UDOPA V (r = 0.39). On both diets and
      without the DOPA infusions, the saline infusions enhanced UNa V but did not
      increase UDA V. The DOPA infusions caused no significant change of UNa V, in
      spite of five- to eight-fold increases in UDA V. During LoSo the DOPA infusion
      only caused a slightly larger increase of UNa V after the saline infusion, when
      expressed as percentage change to the pre-saline UNa V (119 +/- 25% without DOPA
      infusion, 244 +/- 56%, P < 0.05 with DOPA infusion). On HiSo the DOPA infusion
      did not affect UNA V. The dietary sodium intake and the DOPA infusions did not
      influenced BP, GFR, or ERPF. In conclusion, dietary sodium intake or acute sodium
      loads did not clearly modulate UDA V.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783101
TI  - Investigation of ambulatory blood pressure monitoring data editing criteria.
AB  - Ambulatory blood pressure monitoring (ABPM) allows multiple measurements of BP
      over a 24h period but often produces a proportion of measurements which are
      distant from the mean and unlikely to be genuine. The software which accompanies
      the SpaceLabs 90207 monitor requires criteria to be set which excludes outliers
      (autoediting) but there is no published data evaluating at what levels these
      autoediting criteria should be set. This study set out to ascertain whether
      outlying BP measurements represent true blood pressures or machine error, the
      determinants of machine error and appropriate autoedit criteria. Twenty subjects,
      both normotensive and hypertensive, were studied by ABPM with a blinded observer
      recording BP using a standard mercury sphygmomanometer (SMS) connected via a T
      tube during three activity phases: sitting with cuffed arm still, walking but
      keeping arm still during measurement and sitting but gently moving the arm during
      measurement. The results show that a high ABPM/SMS discrepancy is associated with
      arm movement. After studying different autoediting criteria which aimed to
      eliminate the maximum number of conflicting readings while excluding the minimum
      number of unconflicting readings, an autoediting threshold of between 1.75 and 2
      s.d.s from the mean based separately on sleep and awake measurements is
      suggested.

PMID- 7783102
TI  - Low fasting and insulin-mediated intracellular magnesium accumulation in
      hypertensive patients with left ventricular hypertrophy: role of insulin
      resistance.
AB  - Twenty-five hypertensive patients (13 males/12 females) with left ventricular
      hypertrophy (LVH) and 12 hypertensive patients (6 males/6 females) without LVH
      were studied. Both groups were matched for age, sex, body mass index, percentage
      body fat, arterial BP and known duration of hypertension. After a seven day wash
      out period from antihypertensive treatment each subject underwent: (1) an oral
      glucose tolerance test, (2) an euglycemic hyperinsulinaemic glucose clamp
      (insulin infusion rate 7.1 pM/kg per min), (3) an echocardiographic determination
      of left ventricular mass index, and (4) 24h ECG Holter monitoring. All tests were
      performed in random order and on different days. All investigators were unaware
      of the patient groups. Hypertensive patients with LVH had lower fasting
      intracellular (erythrocyte) magnesium concentrations (1.85 +/- 0.06 vs. 2.07 +/-
      0.04 mM; P < 0.001) but higher fasting plasma insulin concentrations (86 +/- 4
      vs. 59 +/- 5 pM; P < 0.001) Glucose clamp study demonstrated a lower insulin
      mediated glucose disposal (24.8 +/- 0.4 vs. 30.1 +/- 0.3 microM/kg of lean body
      mass per min; P < 0.05) and a net change in intracellular magnesium accumulation
      (17.9 +/- 1.3 vs. 27.3 +/- 1.8%, P < 0.01) in response to insulin infusion in
      hypertensive patients with LVH than in those without LVH. After adjustment for
      fasting plasma insulin levels and insulin-mediated glucose uptake, fasting and
      insulin-mediated erythrocyte magnesium accumulation were no longer different
      between the two groups. In conclusion, hypertensive patients with LVH compared
      with those without LVH have a lower intracellular magnesium content due a higher
      degree of insulin resistance.

PMID- 7783103
TI  - Evaluation of the accuracy and reproducibility of the Takeda TM-2420 in the
      elderly.

PMID- 7783104
TI  - Hypertension and left ventricular hypertrophy in black people.

PMID- 7783105
TI  - Gastrointestinal bleeding induced by amlodipine.

PMID- 7783106
TI  - Mean platelet volume in human essential hypertension.

PMID- 7783107
TI  - Calcium channel blockade: is lowering office blood pressure enough? Introduction.

PMID- 7783108
TI  - Renal effects of amlodipine.
AB  - The effects of a new dihydropyridine calcium channel blocker, amlodipine, on
      blood pressure (BP) and renal function were studied in spontaneously hypertensive
      rats (SHR). These effects were compared with those of an angiotensin-converting
      enzyme (ACE) inhibitor, enalapril. In addition, the effects of amlodipine on BP
      and renal function were studied in hypertensive patients with renal impairment.
      In five of six nephrectomised salt-loaded SHR, increases in BP, urinary excretion
      of protein and serum creatinine were attenuated by the administration of 2
      mg/kg/day of amlodipine. The progression of renal histological damage was also
      markedly decreased. The protective effects of amlodipine against renal damage
      were similar to those of enalapril. However, the mechanisms of action of these
      two agents seem to differ as, unlike enalapril, amlodipine did not significantly
      dilate the efferent arteriole in hydronephrotic perfused rat kidney. In a
      clinical study, 2.5-5 mg/day of amlodipine was administered once a day for 8-10
      weeks to 39 hypertensive patients with renal impairment (serum creatinine > or =
      1.5 mg/dl to < 5 mg/dl) or renal parenchymal disease (serum creatinine < 5
      mg/dl). A significant reduction in BP (reduction of mean BP > or = 13 mm Hg) was
      observed in 28 patients (80%). Headache was experienced as a side-effect in one
      of 35 patients (2.9%). With respect to the influence of amlodipine on renal
      function, mean values of blood urea nitrogen and serum creatinine were unchanged
      for the total group whereas a slight elevation of serum creatinine was observed
      in four of 35 patients (11.4%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783110
TI  - Comparative effects of amlodipine and felodipine ER on office and ambulatory
      blood pressure in patients with mild to moderate hypertension. Danish Multicentre
      Group.
AB  - The anti-hypertensive efficacy and safety of extended-release (ER) felodipine (5,
      10 or 20 mg) and amlodipine (5 or 10 mg) once daily were compared in patients
      with mild to moderate essential hypertension in a double-blind, double-dummy,
      randomised, comparative study. One hundred and eighteen patients were randomised
      to receive either felodipine ER (n = 57) or amlodipine (n = 61) for 12 weeks.
      Efficacy was assessed by measuring office blood pressure (BP) at baseline and
      after 4, 6, 8 and 12 weeks, together with 24h ambulatory blood pressure
      monitoring (ABPM) at baseline, on day 1 of treatment and at the end of the study.
      The mean office BP changes from baseline to week 12 were -13.4/-11.8 mmHg for
      felodipine ER (mean daily dose 11.2 mg) and -15.3/-12.9 mm Hg for amlodipine
      (mean daily dose 7.4 mg). Changes in office BP between treatment groups were not
      significant. The mean 24h ambulatory BP changes from baseline to end of the study
      were -11.6/-10.0 mm Hg for felodipine ER and -16.3/-9.6 mm Hg for amlodipine,
      both significant (P < 0.01). The fall in systolic ambulatory BP was significantly
      greater (P < 0.001) in the amlodipine-compared with felodipine ER-treated
      patients but there was no difference between the groups with respect to diastolic
      ambulatory BP. Both drugs were well tolerated with only seven patients
      withdrawing because of side-effects, equally distributed between treatment
      groups. Headache and flushing were significantly (P < 0.05) more frequent in the
      felodipine ER group. Amlodipine appears to be more potent on a milligram to
      milligram basis and induces fewer side-effects than does felodipine ER.

PMID- 7783109
TI  - Evaluation and quality-of-life assessment of amlodipine and enalapril in patients
      with hypertension.
AB  - In this multicentre, double-blind trial in 461 patients with essential
      hypertension, amlodipine (5-10 mg once daily) and enalapril (10-40 mg once daily)
      were compared in terms of quality of life, efficacy and tolerability after 1 year
      of treatment (part 1). In part 2, 177 patients successfully treated with
      amlodipine in part 1 continued in an open evaluation of efficacy and safety of
      antihypertensive treatment with amlodipine for a further 2 years. In part 1, both
      drugs were similarly effective in lowering blood pressure (BP) (although
      significantly more enalapril patients required a diuretic) while maintaining
      quality of life. Apart from class-typical effects, such as oedema for calcium
      antagonists and cough for angiotensin-converting enzyme inhibitors, both drugs
      were equally well tolerated, with few adverse effects of clinical significance.
      Only a few patients (eight amlodipine (4%), nine enalapril (4%)) were withdrawn
      from the trial because of drug-related adverse events, demonstrating that the
      tolerability was good. Neutral to slightly beneficial effects were found in blood
      lipid concentrations after treatment with amlodipine. The BP reduction seen in
      the amlodipine patients after part 1 was maintained during part 2. Also, blood
      lipids and safety variables remained virtually constant. It is concluded that, at
      similar BP reduction, quality of life is equally well maintained on amlodipine
      and enalapril therapy. Thus, amlodipine compares favourably with enalapril as an
      effective and well-tolerated anti-hypertensive agent over the first year.
      Additionally, amlodipine patients evaluated over a 2-year extension maintained
      good BP control and the drug was well tolerated.

PMID- 7783112
TI  - Limits of lipid-lowering therapy: the benefits of amlodipine as an anti
      atherosclerotic agent.
AB  - Treatment of atherosclerosis has mainly focused on decreasing low-density
      lipoprotein cholesterol (LDL-C). However, recent coronary angiographic trials
      revealed that aggressive lowering of LDL-C below 100 mg/dl arrests
      atherosclerosis progression in only 50-60% of patients. Furthermore, quantitative
      coronary angiography in these trials showed significant regression only in
      advanced fibrous-fatty plaques (> or = 50% stenosis) and not in the younger, more
      cell-proliferative lesions (< 50% stenosis). It is clear that lipid-lowering
      therapy has limited efficacy and there is therefore a need for other drugs,
      especially anti-proliferative agents, for secondary and primary prevention. To
      test this hypothesis, a new calcium antagonist, amlodipine, was studied for its
      anti-atherogenicity in non-human primates because of its known in vitro anti-cell
      proliferant, cell membrane stabilising and anti-oxidant properties. Amlodipine
      was found to normalise elevated plasma levels of oxidised LDL without reducing
      elevated total LDL-C levels in monkeys fed an atherogenic diet which, however,
      significantly suppressed atherosclerosis progression. These data suggest that
      amlodipine may be an excellent candidate, in combination with lipid-lowering
      drugs, for dual therapy of atherosclerotic vascular disease and may also be
      effective as monotherapy even when LDL-C is not lowered satisfactorily.

PMID- 7783111
TI  - Vascular reactivity: a measurement of calcium channel blockade.
AB  - Clinical studies have shown that calcium antagonist drugs interfere with the
      reactivity of vascular smooth muscle and thereby attenuate the pressor responses
      to adrenergic and non-adrenergic vasoconstrictor agents. It is, therefore,
      possible to explore the extent and duration of calcium channel blockade by
      studying the magnitude and time course of the attenuation of pressor responses.
      The effects of three long-acting calcium antagonists, amlodipine, lacidipine and
      nifedipine GITS (gastrointestinal therapeutic system), on vascular reactivity
      were assessed over 24h and 48h dosage intervals. It was shown that all three
      agents attenuate the vasoconstrictor responses to both adrenergic and non
      adrenergic stimuli. However, amlodipine and nifedipine GITS were found to
      suppress vascular reactivity more consistently than lacidipine over 24h.
      Extending the analysis to 48h after dosing showed that amlodipine had the most
      consistent effect.

PMID- 7783113
TI  - Calcium channel blockade: is lowering office blood pressure enough?

PMID- 7783114
TI  - Design and syntheses of potent and selective dipeptide inhibitors of Candida
      albicans myristoyl-CoA:protein N-myristoyltransferase.

PMID- 7783115
TI  - A-ring ortho-disubstituted aporphine derivatives as potential agonists or
      antagonists at serotonergic 5-HT1A receptors.
AB  - (R)- And (S)-11-hydroxy-10-methylaporphine 1 and 2 are, respectively, a potent,
      highly specific serotonergic (5-HT1A) agonist and antagonist. In an ongoing
      structure-activity study, racemates of the positional isomers 8-hydroxy-9-methyl-
      and 8-methyl-9-hydroxyaporphine were prepared by modifications of literature
      methods and were resolved. The methyl ethers of the target compounds were also
      evaluated pharmacologically. All of the free phenolic derivatives [(+)- and (-)-8
      and 10] were inert in an assay for 5-HT1A receptor activity. All of the methyl
      ethers [(+)- and (-)-9 and 11] demonstrated quantitatively similar low potency
      stimulant effect at 5-HT1A receptors. The agonist or antagonist activity
      exhibited by 1 and 2 reflects the high degree of structural specificity required
      of aporphine derivatives for action at 5-HT1A receptors.

PMID- 7783116
TI  - The cholesterol derivative of a triantennary galactoside with high affinity for
      hepatic asialoglycoprotein receptor: a potent cholesterol lowering agent.
AB  - Cholesterol-derivatized galactosides have been devised in order to induce liver
      uptake of lipoproteins via the galactose-recognizing asialoglycoprotein receptor
      in the liver. In this study we describe the derivatization of a newly developed
      triantennary cluster galactoside having high affinity for the asialoglycoprotein
      receptor, N-[[tris-O-(3,6,9-trioxaundecanyl-beta-D-galactopyranosyl)metho xym
      ethyl] -N alpha-[1-(6-methyladipyl)]glycinamide (TG(20A)) with cholesterol.
      Hereto, TG(20A) was coupled to glycine-(5-cholesten-3 beta-yl ester) in the
      presence of (benzotriazol-1-yloxy)tris(dimethylamino)phosphonium
      hexafluorophosphate, affording N-[[tris-O-(3,6,9-trioxaundecanyl-beta-D-
      galactopyranosyl)methoxymethyl]methyl]-N alpha-[1-(6-(5-cholesten-3 beta
      yloxy)glycyl)adipyl]glycinamide (TG(20A)C) in 46% yield. This compound is an
      amphiphilic, water-soluble compound. In aqueous solution it readily formed small
      micelles (4.9 +/- 1.2 nm) consisting of approximately 20 molecules. Upon
      incubation with human serum, TG(20A)C spontaneously incorporated into the most
      prominent serum lipoproteins, i.e., low-density lipoprotein (LDL) and high
      density lipoprotein (HDL), thereby inducing an increase in buoyant density of
      these lipoproteins. The integrity of HDL and LDL, as judged from particle size
      analysis of both lipoproteins, was not altered by incubation with up to 0.33% of
      TG(20A)C (w/v). Following intravenous bolus injection into rats, TG(20A)C induced
      a dose-dependent decrease in the serum cholesterol content of maximally 44%, at a
      dose of 1.9 mg kg-1. This makes TG(20A)C at least 30-fold more effective than the
      previously developed N-[[tris-O-(beta-D-galactopyranosyl)methyl]methyl]-N alpha
      [4-(5- cholesten-3 beta-yloxy)succinyl]glycinamide (TG(4A)C), provided with a
      cluster galactoside that displayed a 2000-fold lower affinity for the
      asialoglycoprotein receptor than TG(20A). In conclusion, the hypocholesterolemic
      activity of a cholesterylated galactoside can be strongly enhanced by using a
      cluster galactoside with higher affinity for the asialoglycoprotein receptor.

PMID- 7783117
TI  - Preparation and in vitro activities of ethers of [D-serine]8-cyclosporin.
AB  - Reactions of the [D-serine]8-cyclosporin (2) with a series of alkylating agents
      under phase transfer conditions gave the alkylated products 3-6. Alkylations of 2
      with hindered esters of bromoacetate gave the crystalline esters 7 and 8.
      Hydrolysis under basic conditions gave the acid 10. Reduction of ester 8 led to a
      novel cyclosporin 11. This was transformed in two additional steps to 15. In a
      similar two-step sequence 17 was prepared from 15. From 2 and methyl 2
      (bromomethyl)acrylate product 20 was obtained. Alkylation of 2 with 49 followed
      by deprotection yielded 24. The linear isomer 27 was prepared. The 3
      hydroxypropyl ether 30 was prepared in two steps from 28. The 4-hydroxybutyl
      ether 31 was accessible from 2 and 1,4-dibromobutane. The hydroxy group of 11 was
      converted to the tosylate 32. Base treatment of 32 led to the bicyclic [3(R)
      morpholinecarboxylic acid]8-cyclosporin (39). The [2-ethoxy-5
      morpholinecarboxylic acid]8-cyclosporin 40 was prepared via 36. Base treatment of
      the bromoacetate 37 gave the morpholinone derivative 41. [4(R)
      Oxazolidinecarboxylic acid]8-cyclosporin (42) was obtained from 2 and methylene
      bromide. From 24 the tosylate 38 was prepared and cyclized to the
      hexahydrooxazepine derivative 43. [2(R)- Piperidinecarboxylic acid]8-cyclosporin
      (49) was prepared from 42 and 2(R)-piperidinecarboxylic acid 45 via 46-48. The
      bicyclic cyclosporin 39 was found to be about 3-4 times more active than
      cyclosporin A in our in vitro tests.

PMID- 7783118
TI  - Prodrugs of nitroxyl as potential aldehyde dehydrogenase inhibitors vis-a-vis
      vascular smooth muscle relaxants.
AB  - The synthesis and the chemical/biological properties of N-hydroxysaccharin (1) (2
      hydroxy-1,2-benzisothiazol-3(2H)-one 1,1-dioxide), a nitroxyl prodrug, are
      described. When treated with 0.1 M aqueous NaOH, 1 liberated nitroxyl (HN=O), a
      known inhibitor of aldehyde dehydrogenase (AlDH), in a time-dependent manner.
      Nitroxyl was measured gas chromatographically as its dimerization/dehydration
      product N2O. Under these conditions, Piloty's acid (benzenesulfohydroxamic acid)
      also gave rise to HNO. However, whereas Piloty's acid liberated finite quantities
      of nitroxyl when incubated in physiological phosphate buffer, pH 7.4, formation
      of nitroxyl from 1 was minimal. This was reflected in the differential inhibition
      of yeast AlDH (IC50 = 48 and > 1000 microM) and the differential relaxation of
      preconstricted rabbit aortic rings in vitro (EC50 = 1.03 and 14.0 microM) by
      Piloty's acid and 1, respectively. The O-acetyl derivative of 1, viz., N
      acetoxysaccharin (13a), was much less active in both assays. It is concluded that
      N-hydroxysaccharin (1) is relatively stable at physiological pH and liberates
      nitroxyl appreciably only at elevated pH's. As a consequence, neither 1 nor its O
      methyl (8a) and O-benzyl (8b) derivatives were effective AlDH inhibitors in vivo
      when administered to rats at 1.0 mmol/kg.

PMID- 7783119
TI  - Carbethoxylating agents as inhibitors of aldehyde dehydrogenase.
AB  - N,O-Dicarbethoxy-4-chlorobenzenesulfohydroxamate (1c) and O-carbethoxy-N
      hydroxysaccharin (6), both potential carbethoxylating agents, inhibited yeast
      aldehyde dehydrogenase (AlDH) with IC50's of 24 and 56 microM, respectively. The
      esterase activity of the enzyme was commensurably inhibited. AlDH activity was
      only partially restored on incubation with mercaptoethanol (20 mM) for 1 h. On
      incubation with rat plasma, 1c liberated nitroxyl, a potent inhibitor of AlDH.
      Under the same conditions, nitroxyl generation from 6 was minimal, a result
      compatible with a previous observation that nitroxyl generation from N
      hydroxysaccharin (7), the product of the hydrolysis of the carbethoxy group of 6,
      was minimal at physiological pH. Since chemical carbethoxylating agents
      represented by the O-carbethoxylated N-hydroxyphthalimide, 1
      hydroxybenzotriazole, and N-hydroxysuccinimide (8, 9, and 10, respectively)
      likewise inhibited yeast AlDH, albeit with IC50's 1 order of magnitude higher, we
      postulate that 1c and 6 act as irreversible inhibitors of AlDH by
      carbethoxylating the active site of the enzyme.

PMID- 7783120
TI  - Use of medium-sized cycloalkyl rings to enhance secondary binding: discovery of a
      new class of human immunodeficiency virus (HIV) protease inhibitors.
AB  - A unique strategy for the enhancement of secondary binding of an inhibitor to an
      enzyme has been demonstrated in the design of new human immunodeficiency virus
      (HIV) protease inhibitors. When the planar benzene ring of a 4-hydroxycoumarin
      lead compound (1a, Ki = 0.800 microM) was replaced with medium-sized (i.e., 7-9),
      conformationally-flexible, alkyl rings, the enzyme inhibitory activity of the
      resulting compounds was dramatically improved, and inhibitors with more than 50
      fold better binding (e.g., 5d, Ki = 0.015 microM) were obtained. X-ray crystal
      structures of these inhibitors complexed with HIV protease indicated the
      cycloalkyl rings were able to fold into the S1' pocket of the enzyme and fill it
      much more effectively than the rigid benzene ring of the 4-hydroxycoumarin
      compound. This work has resulted in the identification of a promising lead
      structure for the design of potent, deliverable HIV protease inhibitors. Compound
      5d, a small (MW = 324), nonpeptidic structure, has already shown several
      advantages over peptidic inhibitors, including high oral bioavailability (91
      99%), a relatively long half-life (4.9 h), and ease of synthesis (three steps).

PMID- 7783122
TI  - Studies on the monoamine oxidase (MAO)-catalyzed oxidation of phenyl-substituted
      1-methyl-4-phenoxy-1,2,3,6-tetrahydropyridine derivatives: factors contributing
      to MAO-A and MAO-B selectivity.
AB  - The structural parameters responsible for the substrate and inhibitor
      selectivities of the monoamine oxidases (MAO) A and B remain poorly understood.
      This situation has improved somewhat with structure-activity studies that have
      been performed on nuclear-substituted pargyline derivatives and 4-substituted 1
      methyl-1,2,3,6-tetrahydropyridine derivatives. The results of these studies
      suggest that the active site of MAO-A is sterically more accommodating than the
      active site of MAO-B. In the present work we have undertaken a more systematic
      structure-substrate activity analysis with the aid of a series of 4
      phenoxytetrahydropyridine analogs substituted at the para, meta, and ortho
      positions of the phenyl ring with chloro, methoxy, methyl, nitro, and phenyl
      groups. All of the compounds proved to be good substrates for both MAO-A and MAO
      B, and all were better MAO-A substrates than MAO-B substrates. The best defined
      structural parameter relating to selectivity again was the relatively better MAO
      A substrate properties of tetrahydropyridine derivatives bearing bulky C-4
      substituents. Attempts to identify stereoelectronic effects related to substrate
      properties and selectivity with this series of compounds were not successful.
      Although some structural correlates with substrate activity can be made, overall
      the present state of knowledge is inadequate to provide good descriptors of
      structural features that characterize MAO-A and MAO-B substrates.

PMID- 7783121
TI  - Synthesis and biological evaluation of novel 2,6-diaminobenz[cd]indole inhibitors
      of thymidylate synthase using the protein structure as a guide.
AB  - The design, synthesis, and biochemical and biological evaluations of a novel
      series of 2,6-diaminobenz[cd]indole-containing inhibitors of human thymidylate
      synthase (TS) are described. The compounds are characterized by having either a
      pyridine or pyridazine ring in place of the (phenylsulfonyl)morpholinyl group of
      the known inhibitor N6-[4-(morpholinosulfonyl)benzyl]-N6-methyl-2,6-diaminobenz[
      cd]indole glucuronate (i). Active compounds from this series showed human TS
      inhibition constants below the 10 nM level and were potent, selective
      submicromolar antitumor agents in cell culture. The compounds were synthesized by
      reductive alkylation of a substituted 6-aminobenz[cd]indole or reductive
      cyclization of a substituted 1-cyano-8-nitronaphthalene.

PMID- 7783123
TI  - Synthesis, characterization, and antimalarial activity of the glucuronides of the
      hydroxylated metabolites of arteether.
AB  - The hydroxylated metabolites (log P 2.6-2.7) of beta-arteether (1) in rat liver
      microsomes that retain their endoperoxide moiety showed comparable in vitro
      antimalarial activity to that of the parent drug arteether (log P = 3.89). The
      search for analogs of artemisinin (7) more suitable for intravenous use led to
      the synthesis of the glucuronide conjugates of the phase I hydroxylated
      metabolites of arteether which were found to have good water solubility, yet
      retained moderate lipophilicity (log P = 0.6-1.8). While a strong correlation was
      observed between the log P value of the glucuronides, the phase I metabolites,
      and the parent compound, it was found that 9 beta-hydroxyarteetherglucuronide
      (26) was the most active and the most polar (log P = 0.61) of the glucuronides.
      While the in vitro antimalarial activity of 26 (IC50 = 89.3 ng/mL) was found to
      be much less than that for the parent compound, the activity of 26 was within a
      range that would have potential therapeutic use.

PMID- 7783124
TI  - Antimalarial activity of novel ring-contracted artemisinin derivatives.
AB  - Bromoacetal 2 undergoes a novel ring-contracted reaction to give the aldehyde 3
      in the presence of DBU or triethylamine. The aldehyde 3 is reduced to the alcohol
      4 and oxidized to the carboxylic acid 5. The alcohol 4 reacts with
      dihydroartemisinin to give the two diastereoisomers 38 and 39. All the compounds
      were tested for antimalarial activity in mice infected with chloroquine sensitive
      Plasmodium berghei. If the activity of a compound was comparable to that of the
      standard compound, such as arteether, it was tested against chloroquine resistant
      NS strain infection in mice. Initially the compounds were administered
      subcutaneously, and if found to be active, they were tested by oral route. The
      antimalarial activity of compounds 19, 38, and 39 was found to be comparable to
      that of arteether when tested in K-173-infected mice. They were also active
      against chloroquine resistant NS strain infection in mice.

PMID- 7783125
TI  - Hypoxia-selective antitumor agents. 10. bis(nitroimidazoles) and related
      Bis(nitroheterocycles): development of derivatives with higher rates of metabolic
      activation under hypoxia and improved aqueous solubility.
AB  - A series of analogues of the previously described compound N-[2-(2-methyl-5
      nitroimidazol-1H-yl)ethyl]-4-(2-nitroimidazol- 1H-yl)butanamide (4), a novel
      hypoxic cell cytotoxin and radiosensitizer, have been prepared and evaluated for
      hypoxia-selective cytotoxicity and hypoxic cell radiosensitization in vitro. The
      new derivatives were designed to overcome the low aqueous solubility of 4 and its
      slow kinetics of killing under hypoxia. The nitroheterocycle unit had a
      significant effect on solubility, with 3-nitrotriazoles being about 6-fold more
      soluble than the corresponding 2-nitroimidazoles. Analogues with a range of
      neutral linker chains (polyhydroxy, alkanesulfonamide, and bisamide) showed only
      slightly improved solubility and were unable to be fully evaluated. However, a
      series of analogues with cationic amine linkers had adequate aqueous solubility
      (up to 280 mM). The amine analogues could not be prepared by direct reduction of
      precursor amides such as 4 and were most conveniently synthesized by aza-Wittig
      condensation of the appropriate azide and aldehyde components. The amine-linked
      compounds were more cytotoxic than 4, with the symmetrical bis(2-nitroimidazole)
      derivatives (13 and 14) up to 9-fold more potent. They showed hypoxic
      selectivities comparable to that of 4 (ca. 200-fold) but had much more rapid
      kinetics of killing under hypoxia, resulting in high hypoxic selectivity at early
      times in culture. The nature of the mechanism of cytotoxicity of these compounds
      remains unclear but appears not to be DNA cross-linking, with the compounds
      showing a lack of hypersensitivity toward repair-deficient UV4 cells. The
      enhanced solubility and hypoxia-selective cytotoxicity (at early times) of 13
      compared with 4 represent significant potential advantages.

PMID- 7783126
TI  - N4-unsubstituted N1-arylpiperazines as high-affinity 5-HT1A receptor ligands.
AB  - In order to explore the structural requirements for high 5-HT1A affinity, a
      series of aryl-substituted N1-phenylpiperazines were synthesized and evaluated
      for their ability to displace [3H]-8-OH-DPAT from its specific binding sites in
      rat frontal cortex homogenates. We found 2-methoxy substitution to be favorable,
      while 4-methoxy substitution was detrimental for 5-HT1A affinity. Substitution
      with annelated rings at the 2,3-positions was highly favorable for all
      investigated compounds, with the exception of a pyrrole ring. All other
      substitutions, except fluoro, in this class of heterobicyclic phenylpiperazines
      decreased affinity in the order: ortho > para > meta. The loss of affinity in the
      ortho and para positions is probably due to steric factors: the substituents
      either cause steric hindrance with the receptor or prevent the compound from
      adopting the appropriate conformation for binding to the 5-HT1A receptor.
      Conformational analysis combined with structure-affinity relationships (SAR)
      indicates that our arylpiperazines may bind at the 5-HT1A receptor in a nearly
      coplanar conformation. Observed interactions of the compounds in our 5-HT1A
      receptor model appeared to be in agreement with SAR data. The aromatic part of
      the arylpiperazine moiety has pi-pi interactions with the aromatic residues
      Trp161 and Phe362 in helices IV and VI, respectively. The positively charged
      protonated basic nitrogen forms a hydrogen bond with the negatively charged
      Asp116 in helix III. The ammonium-aspartate complex is surrounded by aromatic
      residues Trp358 and Phe361 in helix VI. A lipophilic pocket is formed by Phe362,
      Leu366 (both helix VI), and the methyl group of Thr200 (helix V). In agreement
      with the model, addition of a methyl substituent to the structure of the
      benzodioxine analogue 12 in this region, yielding 13, is favorable for 5-HT1A
      receptor affinity. Unfavorable positions for substitution with bulky groups, like
      the 3- and 4-positions in the benzofuran compound 14, are explained by steric
      hindrance with the backbone atoms of helix V. Thus, we were able to rationalize
      the 5-HT1A SAR of existing N1-phenylpiperazines, as well as a series of newly
      synthesized bicyclic heteroarylpiperazines, in terms of receptor-ligand
      interactions. Several of these N4-unsubstituted compounds had affinities in the
      low-nanomolar range.

PMID- 7783127
TI  - Potent, orally active, competitive N-methyl-D-aspartate (NMDA) receptor
      antagonists are substrates for a neutral amino acid uptake system in Chinese
      hamster ovary cells.
AB  - A series of enantiomerically pure (phosphonomethyl)-substituted phenylalanine
      derivatives related to SDZ EAB 515 (1) were prepared as competitive N-methyl-D
      aspartate (NMDA) receptor antagonists. Unlike most known competitive NMDA
      antagonists, analogs in this series with the S-configuration are potent NMDA
      antagonists whereas analogs with the unnatural R-configuration are weak NMDA
      antagonists, as determined by receptor binding experiments and their
      anticonvulsant action in mice. Examination in a previously reported competitive
      NMDA pharmacophore model revealed that receptor affinity can be explained
      partially by a cavity that accommodates the biphenyl ring of 1, while the
      biphenyl ring of the R-enantiomer 2 extends into a disallowed steric region. We
      proposed that analogs with the natural S-configuration and a large hydrophobic
      moiety would have an advantage in vivo over analogs with an R-configuration by
      being able to use a neutral amino acid uptake system to enhance both peripheral
      adsorption and transport into the brain. Examination in a system L neutral amino
      acid transport carrier assay shows that 1 competes with L-Phe for transport in an
      apparent competitive and stereospecific manner (estimated Ki = 50 microM). The 1-
      and 2-naphthyl derivatives 3a,3b were found to be among the most potent,
      competitive NMDA antagonists yet discovered, being ca. 15-fold more potent than 1
      in vitro and in vivo, with a long duration of action. The title compound 3a had
      potent oral activity in MES (ED50 = 5.0 mg/kg). 3a also retains its ability to
      compete, albeit more weakly than 1 (estimated Ki = 200 microM), for L-Phe uptake
      to CHO cells. In this series, analogs with the R-configuration are not substrates
      for the system L neutral amino acid transport carrier. These results provide
      evidence that central nervous system active agents can be designed as substrates
      of a neutral amino acid transporter as a means to enhance penetration of the
      blood-brain barrier.

PMID- 7783128
TI  - Cardioselective antiischemic ATP-sensitive potassium channel openers. 2.
      Structure-activity studies on benzopyranylcyanoguanidines: modification of the
      benzopyran ring.
AB  - The ATP-sensitive potassium channel (KATP) openers are of considerable interest
      as myocardial protecting agents. However, there exists a narrow window of safety
      for the use of first-generation compounds as antiischemic agents due to their
      powerful peripheral vasodilating effects, which can result in underperfusion of
      the area already at risk. We have recently disclosed the discovery of
      benzopyranylcyanoguanidine type KATP openers (BMS-180448) which are more
      selective for the ischemic myocardium compared to the first-generation compounds.
      This publication deals with structure-activity relationships for the antiischemic
      activity of the lead compound 8. The presence of an electron-withdrawing group at
      C6, an sp3 center at C4, and a gem-dimethyl group at C2 appears to be essential
      for antiischemic activity. Cyanoguanidine can be replaced with a urea moiety. The
      results reported here support the hypothesis that distinct structure-activity
      relationships exist for antiischemic and vasorelaxant activities of compounds
      related to 8 and cromakalim. The trifluoromethyl analog 10 is 550-fold more
      selective in vitro for the ischemic myocardium compared to the first-generation
      agent cromakalim. The reasons for the selectivity of these compounds for the
      ischemic myocardium are not clear at the present time. They may be related to the
      existence of receptor subtypes in smooth muscle and the myocardium.

PMID- 7783129
TI  - Three-dimensional quantitative structure-activity relationships of somatostatin
      analogues. 1. Comparative molecular field analysis of growth hormone release
      inhibiting potencies.
AB  - Somatostatin is a hypothalamic hormone that inhibits the release of growth
      hormone (GH). It has also been shown to inhibit the release of a broad range of
      hormones including insulin, glucagon, and gastrin. Presently, five different
      receptor subtypes of somatostatin have been characterized and cloned. Our
      previous work on the structure-activity relationship of somatostatin and that of
      many others has generated a large database of analogues with different biological
      activities and receptor affinities. This present work is an investigation of the
      growth hormone release-inhibiting potencies of somatostatin analogues by the
      three-dimensional quantitative structure-activity paradigm, comparative molecular
      field analysis (CoMFA). A total of 64 analogues were modeled in SYBYL using
      structural information from two NMR studies. The molecules were aligned by a root
      mean-square fit of atoms and field-fit of the steric and electrostatic molecular
      fields and the resulting databases analyzed by partial least squares analysis
      with cross-validation to extract the optimum number of components. The analysis
      was then repeated without cross-validation to give the final QSAR models.
      Preliminary investigations with the CoMFA models led to the synthesis of a new
      somatostatin analogue. This compound together with five other newly synthesized
      compounds not included in the original training sets were used to test the
      predictive ability of the CoMFA models. Two models with good predictive powers
      are presented.

PMID- 7783131
TI  - Sigma ligands with subnanomolar affinity and preference for the sigma 2 binding
      site. 1. 3-(omega-aminoalkyl)-1H-indoles.
AB  - A series of 4-(1H-indol-3-yl)-1-butyl-substituted 4-phenylpiperidines, 4-phenyl
      1,2,3,6-tetrahydropyridines, and 4-phenylpiperazines was synthesized. The phenyl
      group was optionally substituted with 4-fluoro or 2-methoxy substituents. High
      affinity for both sigma 1 and sigma 2 binding sites was achieved with these
      compounds. Additionally, these compounds had relatively high affinity for
      serotonin 5-HT1A and 5-HT2A, dopamine D2, and adrenergic alpha 1 receptors.
      Introduction of a 4-fluorophenyl substituent at the indole nitrogen atom rendered
      very selective sigma 2 ligands with subnanomolar affinity for the sigma 2 binding
      site. The prototype of such a compound was 1-(4-fluorophenyl)-3-[4-[4-(4
      fluorophenyl)-1-piperidinyl]-1-butyl]-1H- indole, 11a (code no. Lu 29-253). This
      compound had the following binding affinities: IC50 (sigma 1) = 16 nM, IC50
      (sigma 2) = 0.27 nM, IC50 (5-HT1A) = 22,000 nM, IC50 (5-HT2A) = 270 nM, IC50 (D2)
      = 4200 nM, IC50 (alpha 1) = 220 nM. Spiro-joining of the phenyl and the
      piperidine rings into a spiro[isobenzofuran-1(3H),4'-piperdine] ring system
      resulted in even more selective compounds. Variations of the 1-substituent at the
      indole and of the chain length of the alkylene spacer group were studied. The
      optimal compound was the spiro analogue of compound 11a. This compound is 1'-[4
      [1-(4-fluorophenyl)-1H-indol-3-yl]-1-butyl]spiro[isobenzofuran- 1(3H),4'
      piperidine], 14f (code no. Lu 28-179), with the binding affinities: IC50 (sigma
      1) = 17 nM, IC50 (sigma 2) = 0.12 nM, IC50 (5-HT1A) = 21,000 nM, IC50 (5-HT2A) =
      2000 nM, IC50 (D2) = 800 nM, IC50 (alpha 1) = 330 nM. However, the most selective
      sigma 2 versus sigma 1 ligand was the tropane derivative 1-(4-fluorophenyl)-3-[4
      [3-(4-fluorophenyl)-8-azabicyclo[3.2.1]oct-2- en-8-yl]-1-butyl]-1H-indole, 15a.
      This compound had the following binding affinities: IC50 (sigma 1) = 1200 nM,
      IC50 (sigma 2) = 2.5 nM. Potent anxiolytic activity in the black/white box
      exploration test in rats was found with the two most prominent sigma 2 ligands Lu
      29-253 and Lu 28-179. Good penetration into the CNS was documented both after
      subcutaneous and peroral administration of Lu 28-179 by ex vivo binding studies.
      Long duration of action was demonstrated both in ex vivo binding (T1/2
      approximately 20 h) and in the black/white box exploration test.

PMID- 7783130
TI  - Structure-activity relationships of milrinone analogues determined in vitro in a
      rabbit heart membrane Ca(2+)-ATPase model.
AB  - The cardiac activity of a series of analogues of the positive inotropic
      bipyridines amrinone (5-amino-[3,4'-bipyridin]-6(1H)-one) and milrinone (2-methyl
      5-cyano-[3,4'-bipyridin]-6(1H)-one) was evaluated in vitro in a rabbit myocardial
      membrane Mg(2+)-dependent, Ca(2+)-stimulable adenosine triphosphatase (Ca(2+)
      ATPase) model and structure-activity relationships were compared for nine closely
      related derivatives. In the present studies, a 5-bromo analogue of milrinone
      stimulated myocardial membrane Ca(2+)-ATPase significantly (10(-7) M; P < 0.001
      vs control, with 67% of the activity of milrinone), whereas a 2'-methyl-2H
      milrinone derivative was inactive. Although amrinone was inactive in this assay,
      its 2-methyl analogue was stimulatory. However, analogues lacking a 2-substituent
      (with or without a 5-cyano group) or with the 3-N position blocked by a methyl
      group did not stimulate myocardial membrane Ca(2+)-ATPase activity. Structural
      data for these bipyridines show that those with either a 2- or 2'-methyl
      substituent have a twist conformation, whereas those without are nearly planar.
      Activity data reveal that those bipyridines with a nonplanar conformation are
      more active in the Ca(2+)-ATPase assay. Further study of milrinone analogues with
      a 2'-methyl substituent shows that even though the effect on the twist angle is
      equivalent to that of 2-methyl substitution, these analogues are less potent.
      Data for this series reveal that the prerequisites for Ca(2+)-ATPase stimulation
      include not only a 2-methyl to maintain a twist conformation but also a free 3-N
      position and a 5-substituent. This model for optimal activity in the myocardial
      membrane Ca(2+)-ATPase system differs from those proposed for phosphodiesterase
      enzyme receptor recognition only in the requirement for a nonplanar molecule. We
      have previously shown that milrinone, but not amrinone, shares structural
      homology with thyroxine and was able to stimulate myocardial membrane Ca(2+)
      ATPase activity in a manner similar to the thyroid hormone. Additionally,
      milrinone, but not amrinone, was an effective competitor for thyroxine binding to
      the serum transport protein transthyretin. Analysis of the milrinone
      transthyretin crystal complex confirms the structural homology between milrinone
      and thyroid hormone which is not shared by amrinone. Modeling studies of the
      binding interactions of milrinone analogues indicate that the 2
      desmethylmilrinone analogue, the most inhibitory analogue, lacks the hydrophobic
      contacts present in milrinone in its transthyretin-bound complex.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 7783133
TI  - Ocular delivery of the beta-adrenergic antagonist alprenolol by sequential
      bioactivation of its methoxime analogue.
AB  - Ocular delivery of alprenolol, a beta-adrenergic antagonist, by site-specific
      bioactivation of its methoxime analogue results in significant and prolonged
      decrease of the intraocular pressure in rabbits after topical administration.
      Alprenolone methoxime is stable in isotonic phosphate vehicle but undergoes
      enzymatic hydrolysis to the corresponding ketone in the eye. The ketone is then
      converted to alprenolol by a carbonyl reductase present in the iris-ciliary body.
      The benefit of this chemical delivery system approach includes the facile release
      of a potential antiglaucoma agent only at the site of the action; thus, unwanted
      systemic effects of the drug can be avoided.

PMID- 7783132
TI  - Sigma ligands with subnanomolar affinity and preference for the sigma 2 binding
      site. 2. Spiro-joined benzofuran, isobenzofuran, and benzopyran piperidines.
AB  - Spiro[isobenzofuran-1(3H),4'-piperidines] and the corresponding benzofuran and
      benzopyran derivatives have been synthesized and evaluated as sigma ligands. The
      compounds are related to Lu 28-179 (1'-[4-[1-(4-fluorophenyl)-1H-indol-3-yl]-1-
      butyl]spiro[isobenzofuran-1(3H),4'-piperidine]) that has been demonstrated to be
      a selective sigma 2 ligand with affinity in the subnanomolar range. The object of
      the study was to determine the structural factors governing sigma 1/sigma 2
      affinity and selectivity within this class of compounds. The N-substituent in
      spiro[isobenzofuran-1(3H),4'-piperidines] is highly important, both for affinity
      and selectivity. Spiropiperidines with no or small N-substituents (H, Me, Et)
      exert very low affinity for both sigma 1 and sigma 2 binding sites (IC50(sigma 1,
      sigma 2) > 100 nM), whereas medium-sized substituents (e.g., Pr, Bu, Ph(CH2)2)
      result in potent, but unselective compounds (IC50(sigma 1, sigma 2) = 2-5 nM).
      Increasing the chain length and the lipophilicity of the N-substituent result in
      compounds in which high affinity for sigma 2 binding sites is retained and with
      selectivity for sigma 2 vs sigma 1 binding sites (e.g., 4-cyclohexyl-1-butyl:
      IC50-(sigma 1) = 1.5 nM, IC50(sigma 2) = 0.07 nM). Introduction of substituents
      in the benzene ring of the spiro[isobenzofuran-1(3H),4'-piperidine] ring system
      of Lu 28-179 mainly affects affinity for sigma 1 binding sites. Compounds with
      substituents (F, CF3) in the 4- or 7-position of the isobenzofuran display high
      affinity for sigma 2 binding sites (IC50(sigma 2) = 0.5-2 nM) and very low
      affinity for sigma 1 binding sites (IC50(sigma 1) > 100 nM). Compounds with
      substituents (F, CF3, Me) in the 5- or 6-position of the isobenzofuran exert
      increased affinity for sigma 1 binding sites (IC50(sigma 1) = 5-30 nM, IC50(sigma
      2) = 0.3-7 nM), thus rendering unselective compounds. Exchanging the
      isobenzofuran moiety of Lu 28-179 with thioisobenzofuran, benzofuran, or
      benzopyran also has a pronounced effect on both affinity and selectivity for
      sigma binding sites. The position of the oxygen atom and the position of the
      spiroconnection with the 4-position of the piperidine ring were varied, and only
      compounds in which both the benzene ring and the heteroatom are attached directly
      to the piperidine ring retain high affinity and selectivity for sigma 2 binding
      sites (e.g., 3,4-dihydro-1'-[4-[1-(4-fluorophenyl)-1H-indol-3-yl]-1-
      butyl]spiro[1H-2-benzopyran-1,4'-piperidine]: IC50(sigma 1) = 53 nM, IC50(sigma
      2) = 0.9 nM).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7783134
TI  - Ribozymes as human therapeutic agents.

PMID- 7783135
TI  - Synthesis, antitubulin and antimitotic activity, and cytotoxicity of analogs of 2
      methoxyestradiol, an endogenous mammalian metabolite of estradiol that inhibits
      tubulin polymerization by binding to the colchicine binding site.
AB  - In order to define the structural parameters associated with the antitubulin
      activity and cytotoxicity of 2-methoxyestradiol, a mammalian metabolite of
      estradiol, an array of analogs was synthesized and evaluated. The potencies of
      the new congeners as inhibitors of tubulin polymerization and colchicine binding
      were determined using tubulin purified from bovine brain, and the cytotoxicities
      of the new compounds were studied in a variety of cancer cell cultures. Maximum
      antitubulin activity was observed in estradiols having unbranched chain
      substituents at the 2-position with three non-hydrogen atoms. 2-Ethoxyestradiol
      and 2-((E)-1-propenyl)-estradiol were substantially more potent than 2
      methoxyestradiol itself. The tubulin polymerization inhibitors in this series
      displayed significantly higher cytotoxicities in the MDA-MB-435 breast cancer
      cell line than in the other cell lines studied. The potencies of the analogs as
      cytotoxic and antimitotic agents in cancer cell cultures correlated with their
      potencies as inhibitors of tubulin polymerization, supporting the hypothesis that
      inhibition of tubulin polymerization is the mechanism of the cytotoxic action of
      2-methoxyestradiol and its congeners. Several of the more potent analogs were
      tested in an estrogen receptor binding assay, and their affinities relative to
      estradiol were found to be very low.

PMID- 7783136
TI  - Design and synthesis of new naphthalenic derivatives as ligands for 2
      [125I]iodomelatonin binding sites.
AB  - New melatonin-like agents were designed from the frameworks of 2,5
      dimethoxyphenethylamine, an important structural moiety for the 5-HT receptor,
      and (2-methoxynaphthyl)-ethylamine. The compounds were synthesized by classical
      methods and evaluated in binding assays with chicken brain membranes using 2
      [125I]iodomelatonin as the radioligand. Preliminary studies on the series of N
      acyl-disubstituted phenethylamines showed the favorable role of the methoxy group
      in the ortho position of the side chain on the affinity for the receptor (Ki = 8
      +/- 0.2 nM) for N-[2-(2-methoxy-5-bromophenyl)ethyl]propionamide (3o). This
      effect was confirmed in a series of the naphthalene derivatives, a bioisosteric
      moiety of the indole ring, and several potent ligands for melatonin binding sites
      were prepared such as N-[2-(2-methoxynaphthyl)ethyl]propionamide (4b) (Ki = 0.67
      +/- 0.05 nM) and N-[2-(2,7-dimethoxynaphthyl)ethyl]cyclopropylformamide (Ki =
      0.05 +/- 0.004 nM) (4k). Structure-activity relationships are discussed with
      regard to melatonin and bioisosteric naphthalenic compound 2. The Ki value for 4b
      was affected to a similar extent to that of melatonin by GTP-gamma-S or Mn2+ in
      competition experiments, suggesting an agonist profile for this compound.

PMID- 7783137
TI  - Application of the free energy perturbation method to human carbonic anhydrase II
      inhibitors.
AB  - An analysis of the free energy perturbation (FEP) method is presented that
      attempts to evaluate the efficacy of the FEP method in the drug discovery
      process. To accomplish this we have evaluated whether the FEP technique can
      accurately predict energetic and structural quantities relating to the inhibition
      of human carbonic anhydrase II (HCAII) by sulfonamides. Three well-characterized
      (both structurally and energetically) sulfonamide inhibitors of HCAII were
      examined in this study, 1a, 1b, and 1c. Results from FEP simulations on these
      compounds indicate that the FEP method can predict energetic trends reasonably
      well; however, the FEP method was less successful in reproducing detailed
      structural data. In particular, an expected movement of His-64 when inhibitor 1c
      was bound did not occur. We conclude that the FEP method can be used to determine
      relative free energies of binding but cannot be relied upon to reproduce subtle
      geometric changes.

PMID- 7783138
TI  - Investigation of the configurational and conformational influences on the
      hormonal activity of 1,2-bis(2,6-dichloro-4-hydroxyphenyl)ethylenediamines and of
      their platinum(II) complexes. 1. Synthesis, estradiol receptor affinity, and
      estrogenic activity of diastereomeric [N-alkyl- and N,N'-dialkyl-1,2- bis(2,6
      dichloro-4-hydroxyphenyl)ethylenediamine]dichloroplatinum(II) complexes.
AB  - N-Monoalkylated (Et) and N,N'-dialkylated (Me and Et) 1,2-bis(2,6-dichloro-4
      hydroxyphenyl)-ethylenediamines and their dichloroplatinum(II) complexes were
      synthesized, and their configuration and conformational behavior were 1H-NMR
      spectroscopically clarified. The latter was brought in relation to their relative
      binding affinity (RBA) to the estrogen receptor as well as to their estrogenic
      potency. In contrast to the RR/SS-configurated diamines, the R/S-configurated
      ones showed marked estrogenic properties which correlate with the RBA's. In the
      related R/S-configurated complexes the estrogenic activity is determined by the
      same structural requirements as in the diamine series. However, a correlation
      between RBA's and estrogenic potencies is missing. The connection between spatial
      structure and activity is discussed by use of a drug-receptor model recently
      proposed by Holtje and Dall.

PMID- 7783139
TI  - Receptor surface models. 1. Definition and construction.
AB  - A receptor site model is a hypothetical model that characterizes the putative
      active site of a receptor. This paper describes a type of receptor site model
      called a receptor surface model, which is based on the construction of surfaces
      to represent spatial and electrostatic properties of the receptor active site. A
      receptor surface model is visually intuitive and is modifiable as the hypothesis
      is refined. It allows computations comparable to those that can be performed with
      traditional atomistic models. Structures can be energy minimized within the
      receptor surface model to arrive at conformations that are consistent with the
      model, and interaction energies can be estimated. Such calculations facilitate
      the evaluation of new candidate structures and provide a means to assess the
      predictive ability of a model.

PMID- 7783140
TI  - Receptor surface models. 2. Application to quantitative structure-activity
      relationships studies.
AB  - A new technique for using receptor surface models in quantitative structure
      activity relationship (QSAR) analysis is described. Receptor surface models
      provide compact, quantitative descriptors which capture three-dimensional
      information about putative receptor/ligand interactions. Receptor surface models
      can be constructed quickly, which allows the construction of multiple plausible
      models; a variable selection technique such as genetic function approximation
      (GFA) can then be used to suggest which receptor surface models provide the most
      valuable descriptors for QSAR. Advantages of this approach are shown by applying
      it against two previously-published and well-studied QSAR data sets. Our results
      indicate that the approach can model data as effectively as established 3D-QSAR
      techniques.

PMID- 7783141
TI  - Pyridyl-substituted tetrahydrocyclopropa[a]naphthalenes: highly active and
      selective inhibitors of P450 arom.
AB  - The synthesis and biological evaluation of substituted exo-1-(4-pyridyl)
      1a,2,3,7b-tetrahydro-1H-cyclopropa[a]naphthalene s as inhibitors of estrogen
      biosynthesis is described [H (1); 4-OCH3 (2); 5-OCH3 (3); 6-OCH3 (4); 1-CH3, 6
      OCH3 (5); 4-OCH3, 7-Br (6); 6-OCH3, 5-Br (7); 4-OH (8); 5-OH (9); 6-OH (10)]. The
      synthetic key step--the formation of the cyclopropyl ring--was accomplished using
      the conditions of a modified Wolff-Kishner reduction (N2H5OH/KOH; delta T) and
      yielded exclusively the exo-configurated diastereomers. The racemic compounds 1
      10 showed an inhibition of human placental aromatase (P450 arom) exhibiting
      relative potencies (rp) from 3.7 to 303 (compounds 8 and 4, respectively; rp of
      aminoglutethimide (AG) identical to 1, fadrozole = 359). The enantiomers of 4 and
      7 were separated by LPLC on tribenzoyl cellulose and by crystallization of the
      diastereomeric tartrates (4). (1aS,2S,7bS)-(+)-4 (absolute configuration
      determined by X-ray crystallographic analysis) is the active P450 arom inhibiting
      enantiomer of 4 and shows a rp value of 617. Compound 4 is a reversible inhibitor
      showing a competitive type of inhibition and a type II difference spectrum. In
      vitro 4 influenced other steroidogenic P450 enzymes either not at all (bovine
      adrenal P450 scc) or only marginally (rat testicular P450 17, bovine adrenal P450
      18). In ACTH-stimulated rat adrenal tissue, 4 was less active, inhibiting
      corticosterone and aldosterone formation compared to AG and fadrozole,
      respectively. In vivo 4 was not superior to AG as far as the inhibition of the
      uterotrophic activity of androstenedione (juvenile SD rats) and the reduction of
      the plasma estradiol concentration (pregnant mares' serum gonadotropin-primed SD
      rats) are concerned. Compound 4 shows marked antitumor activity in the
      dimethylbenzanthracene-induced mammary carcinoma of the SD rat: in the
      postmenopausal model it is at least as active as AG; in the premenopausal
      experiment it is clearly superior to AG. No induction of hepatic P450 enzymes was
      observed in the latter experiment. The rp value of 4 toward rat ovarian P450
      arom, i.e., 23 (rp of AG identical to 1), is markedly decreased compared to the
      human enzyme (rp value of 303). From this fact it must be concluded that 4 should
      be more active in the human than in the rat.

PMID- 7783142
TI  - Synthesis and cytotoxicity of novel lignans.
AB  - In this study the syntheses of 11 novel lignans are described. Their
      cytotoxicities are studied in GLC4, a human small cell lung carcinoma cell line,
      using the microculture tetrazolium (MTT) assay. Ten of these compounds were
      substituted with a menthyloxy group on the 5-position of the lactone. These
      compounds can easily be prepared in (novel) 'one-pot', three- or four-step
      syntheses. In addition, methods for controlling the stereogenic centers are
      described. Furthermore, five naturally occurring podophyllotoxin-related
      compounds were tested. The cytotoxicities of all lignan compounds, and of three
      non-lignan intermediates originating from the syntheses, were compared with the
      clinically applied anticancer agents etoposide, teniposide, and cisplatin. Most
      compounds showed moderate to high activities against GLC4, and two of the
      compounds containing a menthyloxy group showed activities comparable to the
      reference cytotoxic agents.

PMID- 7783143
TI  - Hydroxamic acids as potent inhibitors of endothelin-converting enzyme from human
      bronchiolar smooth muscle.
AB  - Hydroxamic acids 6a-h, derived from malonyl amino acids, and 25a-d, derived from
      succinyl amino acids, were synthesized as inhibitors of human bronchiolar smooth
      muscle endothelin-converting enzyme (HBSM ECE). Several unexpected side reactions
      were discovered, particularly in the synthesis of hydroxamates derived from
      succinates. In vitro evaluation against human bronchiolar ECE revealed that in
      all cases hydroxamates derived from malonate were more potent than hydroxamates
      derived from succinate. Isopropyl and isobutyl P1' side chains were suitable;
      omission of the P1' side chain seriously diminished potency. In the P2' position,
      several amino acids gave potent malonate-derived hydroxamate inhibitors (6b, d-h,
      IC50 = 0.2-6.8 nM), and beta-Ala provided an extremely potent inhibitor (6c, IC50
      = 0.01 nM). C-terminus carboxylates are much more potent ECE inhibitors than the
      corresponding amides. Most of the hydroxamates were also potent inhibitors of
      thermolysin and neutral endopeptidase (NEP); however, the P2' beta-Ala derivative
      6c uniquely inhibited HBSM ECE much more potently than NEP.

PMID- 7783144
TI  - Development of a novel series of trialkoxyaryl derivatives as specific and
      competitive antagonists of platelet activating factor.
AB  - The synthesis and structure-activity relationship (SAR) analysis of a novel
      series of trialkoxyaryl derivatives, as specific and competitive inhibitors of
      platelet activating factor (PAF), are described. Molecular modeling comparisons
      of PAF with the known antagonists Ginkgolide B and L-652731 led to the selection
      of N-[2-[(3,4,5-trimethoxybenzoyl)oxy]ethyl]-N,N,N-trimethylammonium iodide (1)
      from the Wellcome registry of compounds and to the synthesis of the lead compound
      N-[2-[[4-(hexyloxy)-3,5-dimethoxybenzoyl]oxy]ethyl]-N,N,N- trimethylammonium
      iodide (3, pKb 5.43). Further SAR considerations directed the design to 2
      (hexyloxy)-1,3-dimethoxy-5-[4-(4-methylthiazol-5-yl)butyl] benzene (38) (pKb
      7.14), a novel, specific, and competitive inhibitor of the PAF receptor in rabbit
      washed platelets.

PMID- 7783145
TI  - Immunospecific reduction of antioligonucleotide antibody-forming cells with a
      tetrakis-oligonucleotide conjugate (LJP 394), a therapeutic candidate for the
      treatment of lupus nephritis.
AB  - A discrete tetravalent conjugate, 7a (LJP 394), consisting of four
      oligonucleotides attached to a common carrier or platform was prepared. Single
      stranded oligonucleotide 20-mers consisting of alternating deoxycytidine
      deoxyadenosine nucleotides, (CA)10, were attached to a tetrabromoacetylated
      platform by displacement with sulfhydryl-terminated linkers. The
      tetrabromoacetylated platform 3a was synthesized in three steps using triethylene
      glycol bis-(chloroformate). The single-stranded conjugate was characterized by
      polyacrylamide gel electrophoresis, DNA sequencing, phosphate analysis, carbon
      and nitrogen combustion analysis, and correlation of stoichiometry to conversion
      in the conjugation process. HPLC and capillary electrophoretic methods were
      developed to evaluate purity. The tetrakis, single-stranded conjugate was
      annealed with a stoichiometric amount of a complementary single-stranded
      oligonucleotide 20-mer consisting of alternating thymidine-deoxyguanosine
      nucleotides, (TG)10. The double-stranded conjugate LJP 394 was characterized by
      melt temperature and hyperchromicity, phosphate analysis, and carbon and nitrogen
      combustion analysis. LJP 394 inhibits binding of DNA to anti-double-stranded
      oligonucleotide antibodies and reduces anti-oligonucleotide-specific plaque
      (antibody)-forming cells in an immunized mouse model by a proposed mechanism
      involving cross-linking B cell surface immunoglobins.

PMID- 7783146
TI  - Synthesis and biological evaluation of a series of new parenteral optically
      active 3-[[(N-alkylpyridinium-4'-yl)thio]methyl]-2-oxaisocephems.
AB  - The preparation and biological evaluation of a series of 7-[2-(2-aminothiazol-4
      yl)-2-(Z)-[(cyclopentyloxy)imino]acetamido] optically active 2-oxaisocephems,
      substituted at the 3-position with [(N-alkylpyridinium-4'-yl)thio]methyl groups,
      are described. The resulting family of parenteral compounds displays a broad
      spectrum of in vitro antibacterial activity. These compounds exhibit increased
      activity against Gram-positive organisms including methicillin-resistant
      Staphylococcus aureus and Enterococcus faecalis which are resistant to most
      cephalosporins with a similar level of Gram-negative activity to that of the
      third-generation antibiotics. In vivo efficacy of new antibacterial agents in
      this investigation is excellent against both Gram-positive and Gram-negative
      bacteria as compared with reference compounds. The in vitro and in vivo
      antimicrobial activity and the structure-activity relationships are presented.

PMID- 7783147
TI  - Novel 2,4-diamino-5-substituted-pyrrolo[2,3-d]pyrimidines as classical and
      nonclassical antifolate inhibitors of dihydrofolate reductases.
AB  - Eight novel, nonclassical, antifolate 2,4-diamino-5-(anilinomethyl)pyrrolo[2,3
      d]pyrimidines, 1-8, with 3',4',5'-trimethoxyphenyl, 3',4'-dimethoxyphenyl, 2',5'
      dimethoxyphenyl, 4'-methoxyphenyl, 2',5'-diethoxyphenyl, 3',4'-dichlorophenyl,
      1'naphthyl, and phenyl substituents were synthesized as potential inhibitors of
      dihydrofolate reductases (DHFRs). The classical analogue N-[4-[N-[(2,4
      diaminopyrrolo[2,3-d]pyrimidin- 5-yl)methyl]amino]benzoyl]-L-glutamic acid (9)
      was also synthesized as an inhibitor of DHFR and an antitumor agent. The
      classical and nonclassical analogues were obtained via reductive condensations of
      the key intermediate 2,4-diamino-5-cyanopyrrolo[2,3-d]pyrimidine (12) with the
      appropriate substituted aniline or (p-aminobenzoyl)-L-glutamate followed by
      reduction of the intermediate Schiff bases with NaCNBH3. Compounds 1-9 were
      evaluated in vitro as inhibitors of rat liver (rl), Pneumocystis carinii (pc),
      and Toxoplasma gondii (tg) DHFRs. The nonclassical analogues were significantly
      selective against tgDHFR (vs rat liver DHFR), ranging from 7- to 92-fold. The
      inhibitory activity was lower in pcDHFR and rlDHFR (IC50s > 10(-5) M) than in
      tgDHFR (IC50s = 10(-6) M). The classical analogue had inhibitory activity similar
      to that of methotrexate (MTX) against the growth of human leukemia CCRF-CEM,
      A253, and FaDu squamous cell carcinoma (SCC) of the head and neck cell lines.
      Further evaluation of 9 against CCRF-CEM and its sublines having defined
      mechanisms of MTX resistance demonstrated that the analogue utilizes the reduced
      folate/MTX-transport system and primarily inhibits DHFR and poly-gamma
      glutamylation plays a role in its mechanism of action. Compound 9 was found to be
      3-fold more efficient than aminopterin as a substrate for human
      folylpolyglutamate synthetase.

PMID- 7783148
TI  - Comparison of the protonation of isophosphoramide mustard and phosphoramide
      mustard.
AB  - The alkylating agent isophosphoramide mustard (IPM) spontaneously forms a
      relatively stable aziridine derivative which can be directly observed using NMR
      spectroscopy. The protonations of IMP and its aziridine were probed using 1H,
      31P, 15N, and 17O NMR spectroscopy. The positions of the 31P, 15N, and 17O
      resonances of IPM between pH 2 and 10 each exhibit a single monobasic titration
      curve with the same pKa of 4.31 +/- 0.02. On the basis of a comparison with other
      compounds and our earlier work with phosphoramide mustard, the NMR results for
      IPM indicate that protonation occurs at nitrogen and not oxygen. Over this same
      pH range, each of the 1H, 31P, and 15N resonances of IPM-aziridine also show a
      single monobasic titration with a pKa of 5.30 +/- 0.09. The magnitude of the
      change in chemical shifts suggests that the protonation of the IPM-aziridine
      occurs at the ring nitrogen. Theoretical gas-phase calculations of PM, IPM, and
      IPM-aziridine suggest O-protonation to be more likely; however, aqueous phase
      calculations predict the N-protonated forms to be most stable. Furthermore, for
      PM and IPM-aziridine, which contain nonequivalent nitrogens, the theoretical
      calculations and experimental data both agree as to which nitrogen undergoes
      protonation. These results suggest that the IMP-aziridine remains unprotonated
      under physiological conditions and may, in part, explain the lower alkylating
      activity of IPM as compared to PM.

PMID- 7783149
TI  - Structure-activity relationship of alpha-galactosylceramides against B16-bearing
      mice.
AB  - Agelasphin-9b, (2S,3S,4R)-1-O-(alpha-D-galactopyranosyl)-16-methyl-2- [N-((R)-2-
      hydroxytetracosanoyl)-amino]- 1,3,4-heptadecanetriol, is a potent antitumor agent
      isolated from the marine sponge Agelas mauritianus. Various analogues of
      agelasphin-9b (a lead compound) were synthesized, and the relationship between
      their structures and biological activities was examined using several assay
      systems. From the results, KRN7000, (2S,3S,4R)-1-O-(alpha-D- galactopyranosyl)-2
      (N-hexacosanoylamino)-1,3,4-octadecanetriol , was selected as a candidate for
      clinical application.

PMID- 7783150
TI  - Annulated heterocyclic bioisosteres of norarecoline. Synthesis and molecular
      pharmacology at five recombinant human muscarinic acetylcholine receptors.
AB  - A series of O-alkylated analogs of 5,6,7,8-tetrahydro-4H-isoxazolo[4,5-c]azepin-3
      ol (THAO) were synthesized and characterized as ligands for muscarinic
      acetylcholine receptors (mAChRs). O-Methyl-THAO (4a), O-ethyl-THAO (4b), O
      isopropyl-THAO (4c), and O-propargyl-THAO (4d) were shown to be potent inhibitors
      of the binding of tritiated quinuclidinyl benzilate (QNB), pirenzepine (PZ), and
      oxotremorine-M (Oxo-M) to tissue membrane preparations. In the [3H]-Oxo-M binding
      assay, receptor affinities in the low nanomolar range were measured for 4a (IC50
      = 0.010 microM), 4b (IC50 = 0.003 microM), 4c (IC50 = 0.011 microM), and 4d (IC50
      = 0.0008 microM). Pharmacological effects (EC50 or Ki values) and intrinsic
      activities (per cent of maximal carbachol responses) were determined using five
      recombinant human mAChRs (m1-m5) and the functional assay, receptor selection and
      amplification technology (R-SAT). Compound 4c antagonized carbachol-induced
      responses at m1, m3, and m5. With the exception of 4b, which was an antagonist at
      m5, 4a,b,d showed partial agonism at m1-m5 with very similar subtype selectivity
      (m2 > m4 > m1 > or = m3 > m5). Agonist index values for 4a-d, which were
      calculated from [3H]QNB (brain) and [3H]Oxo-M (brain) binding data, were shown to
      be predictive of pharmacologically determined intrinsic activities at m1-m5, the
      same rank order of intrinsic activity being observed at all five mAChRs (4a > 4d
      > 4b > 4c). It is concluded that within this class of high-affinity mAChR (m1-m5)
      ligands, containing secondary amino groups, minor changes of the bioisosteric
      ester alkyl groups have marked effects on potency and, in particular, intrinsic
      activity.

PMID- 7783151
TI  - Synthesis of some 2-aryl-1,2,4-triazolo[1,5-c][1,3]benzoxazin-5-ones as tools to
      define the essential pharmacophoric descriptors of a benzodiazepine receptor
      ligand.
AB  - The synthesis and benzodiazepine receptor (BZR) affinity of some 1,2,4
      triazolo[1,5-c][1,3]benzoxazin-5-ones, 2-22, are reported. Compounds 2-22 are
      devoid of the proton donor group, which according to a BZR schematic model was
      one of the pharmacophoric descriptors for receptor-ligand interaction. The
      binding data show that 2-(2-fluorophenyl)-9-chloro-1,2,4-triazolo[1,5
      c][1,3]benzoxazin-5 -one (12) and some other compounds display nanomolar BZR
      affinity, indicating that the hydrogen donor group is not essential for the
      anchoring of 6,6,5-tricyclic systems to the BZR but only affects the potency of a
      ligand.

PMID- 7783152
TI  - Structure-activity relationships in the 8-amino-6,7,8,9-tetrahydro-3H
      benz[e]indole ring system. 1. Effects of substituents in the aromatic system on
      serotonin and dopamine receptor subtypes.
AB  - A series of 1-, 3-, and 4-substituted analogs to the potent 5-HT1A against 8
      (dipropylamino)-6,7,8,9-tetrahydro-3H-benz[e]indole-1-carbaldehyde (5) were
      prepared and tested in vitro at 5-HT1A, 5-HT1D alpha, 5-HT1D beta, D2, and D3
      receptors and in vivo for agonist activity in the 5-HTP and DOPA accumulation
      assays in reserpine-pretreated rats. Some of the compounds were resolved. The
      substituents used in the 1-position were chosen from a principal component
      analysis (PCA) plot constructed from both tabulated variables and variables
      calculated by semiempirical methods (PM3) and molecular mechanics software (MMX).
      Among the analogs prepared, some, e.g., compound 21, were equipotent to compound
      5 with respect to 5-HT1A effects. All compounds were more or less selective for
      the 5-HT1A receptor, but many of the compounds displayed higher affinities for 5
      HT1D alpha than for 5-HT1D beta receptors.

PMID- 7783154
TI  - Irreversible inhibitors of nicotinic acetylcholine receptors: isolation and
      structural characterization of the biologically active solvolysis products of
      bipinnatin-A and bipinnatin-C.
AB  - The lophotoxins irreversibly inhibit nicotinic acetylcholine receptors by
      covalent modification of Tyr190 in the alpha-subunits of the receptor. Previous
      studies have shown that the naturally occurring lophotoxin analogs bipinnatin-A, 
      B, and -C are actually inactive protoxins and that their ability to irreversibly
      inhibit nicotinic receptors is enhanced by preincubation in buffer. However, the
      ability of lophotoxin to irreversibly inhibit nicotinic receptors does not appear
      to be enhanced by preincubation in buffer. These observations led to the current
      effort to isolate and determine the structures of biologically active
      bipinnatins. Disappearance of the lophotoxins from solution followed a simple
      first-order exponential decay function. Lophotoxin, however, was approximately 40
      fold more stable then bipinnatin-A, -B, or -C. Solvolysis of the bipinnatins, but
      not of lophotoxin, resulted in production of an equimolar amount of acetic acid
      at a rate similar to the rate of solvolysis, suggesting that the initial event in
      solvolysis of these toxins involves hydrolysis of an acetate ester. Proton NMR
      and fast-atom bombardment mass spectroscopy were used to confirm the structures
      of the active solvolysis products of bipinnatin-A and -C. Their structures and
      the relative pH insensitivity of the solvolysis reaction suggest that biological
      activation of the bipinnatins may proceed through an SN1 type of substitution
      reaction involving elimination of acetate followed by reaction of a carbocation
      intermediate with solvent.

PMID- 7783153
TI  - Structure-activity relationships in the 8-amino-6,7,8,9-tetrahydro-3H
      benz[e]indole ring system. 2. Effects of 8-amino nitrogen substitution on
      serotonin receptor binding and pharmacology.
AB  - A series of analogs of the potent and selective 5-HT1A agonist 8-(di-n
      propylamino)-6,7,8,9-tetrahydro-3H-benz[e]indole-1-carbaldehyde (2b) (OSU191) was
      prepared in which the dipropylamino group was modified to bear a variety of
      substituents. These compounds were evaluated for both in vitro and in vivo
      effects, including the establishment of a receptor binding profile for these
      analogs at the 5-HT1A, dopamine D-2, dopamine D-3, 5-HT1D alpha, and 5-HT1D beta
      sites. Several of the analogs were evaluated for their biochemical effects in
      reserpinized rats, specifically with regard to in vivo changes in brain levels of
      5-HTP and DOPA. Nearly all of the compounds prepared for this study were
      exceedingly potent at the 5-HT1A receptor, although most also displayed
      significant affinity for the dopamine D-2 receptor. A strong preference for the 5
      HT1D alpha over the 5-HT1D beta receptor was also apparent. An analog bearing a
      butylglutarimide side chain, S-7k, was extremely selective for the 5-HT1A
      receptor. Although this compound possessed a Ki of 0.6 nM, it elicited only
      modest changes in 5-HTP brain levels. However, this compound did not appear as an
      antagonist when tested in a cyclic-AMP-based intrinsic activity assay.

PMID- 7783155
TI  - Identification of 3,5-dihydro-2-aryl-1H-pyrazolo[3,4-c]quinoline-1,4(2H)-diones
      as novel high-affinity glycine site N-methyl-D-aspartate antagonists.
AB  - Almost all of the existing known antagonists at the glycine site of the N-methyl
      D-aspartate (NMDA) receptor have a low propensity for crossing the blood-brain
      barrier. It has been suggested that in many cases this may be due to the presence
      of a carboxylic acid which is a common feature of most of the potent full
      antagonists at this receptor. In this study, 2-aryl-1H-pyrazolo[3,4-c]quinoline
      1,4(2H)-diones were found to have high-affinity binding at the glycine receptor.
      In particular, structure-activity studies identified 7-chloro-3,5-dihydro-2-(4
      methoxyphenyl)-1H-pyrazolo[3,4-c]quinoline- 1,4(2H)-dione as the most potent of a
      series of analogues with an IC50 of 3.3 nM. The measured pKa values in this class
      of compounds (typically 4.0) indicate they are of equivalent acidity to
      carboxylic acids. Functional antagonism was demonstrated by inhibition of NMDA
      evoked responses in rat cortical slices. Anticonvulsant activity in DBA/2 mice
      was achieved after dosing by direct injection into the cerebral ventricles, but
      no activity was seen after systemic administration, suggesting low brain
      penetration with this class of antagonists.

PMID- 7783156
TI  - New analogs of burimamide as potent and selective histamine H3 receptor
      antagonists: the effect of chain length variation of the alkyl spacer and
      modifications of the N-thiourea substituent.
AB  - Burimamide was one of the first compounds reported to antagonize the activation
      of the histamine H3 receptor by histamine. We have prepared a large series of
      burimamide analogs by variation of the alkyl spacer length of burimamide from two
      methylene groups to six methylene groups and also by replacement of the N-methyl
      group with other alkyl and aryl groups. All analogs are reversible, competitive
      H3 antagonists as determined on the guinea pig intestine. Elongation of the alkyl
      chain from an ethylene chain to a hexylene chain results in an increase of the H3
      antagonistic activity. The H3 selective pentylene and hexylene analogs of
      burimamide are about 10 times more potent than burimamide. The N-thiourea
      substituents, however, have no beneficial influence on the affinity.

PMID- 7783157
TI  - 2-Phenyl-4-(aminomethyl)imidazoles as potential antipsychotic agents. Synthesis
      and dopamine D2 receptor binding.
AB  - A series of 2-phenyl-4-(aminomethyl)imidazoles were designed as conformationally
      restricted analogs of the dopamine D2 selective benzamide antipsychotics. The
      title compounds were synthesized and tested for blockade of [3H]YM-09151 binding
      in cloned African green monkey dopamine D2 receptor preparations. The binding
      affinity data thus obtained were compared against that of the benzamides and a
      previously described series of 2-phenyl-5-(aminomethyl)-pyrroles.

PMID- 7783158
TI  - Application of 15N nuclear magnetic resonance spectroscopy to the determination
      of the stability of aryl nitrogen mustards.
AB  - An excellent correlation has been shown to exist between the 15N NMR chemical
      shifts of a series of aryl nitrogen mustards and the Hammett constant, sigma,
      which is much improved by the use of sigma-. These chemical shifts also correlate
      well with the hydrolysis rates of the compounds in 50% aqueous acetone at 66
      degrees C and their alkylation of 4-(4'-nitrobenzyl)pyridine under similar
      conditions. Thus 15N NMR is a straightforward and material-conserving method for
      estimating the relative stabilities of aryl nitrogen mustards.

PMID- 7783159
TI  - Effects of tubercidin and its 5'-O-methyl ether on adenosine receptors and
      mediator release functions in mast cells.
AB  - Tubercidin (7-deazaadenosine, Tu) is a highly cytotoxic nucleoside xenobiotic
      that, as the nucleoside or nucleotide derivatives, closely mimics the actions of
      adenosine (or its corresponding nucleotides) in a wide variety of
      biochemical/biological systems. In light of its acceptance in these test systems
      as an adenosine (Ado) surrogate, it was postulated that the compound might
      interact with adenosine receptors. To test this hypothesis, a nonphosphorylatable
      derivative (5'-O-methyl tubercidin, MeTu) was prepared and evaluated in
      comparison with tubercidin and Ado in a variety of biological systems. In a cell
      culture assay using Chinese hamster ovary cells, MeTu is approximately one-third
      as cytotoxic as is Ado and 10(5)-fold less cytotoxic than Tu. Both Tu and MeTu
      inhibited the antigen-stimulated release of beta-hexosaminidase from mouse bone
      marrow derived mast cells in vitro, but only Tu was active in the in vivo PCA
      test. The inhibitory effect of MeTu on mast cell mediator release does not appear
      to involve interaction with adenosine receptors or to be the result of conversion
      to Tu per se.

PMID- 7783160
TI  - Synthesis and biological evaluation of novel C-4 aziridine-bearing paclitaxel
      (taxol) analogs.
AB  - Three novel C-4 aziridine-bearing paclitaxel analogs, 3-5, have been synthesized
      during the course of our continuing effort at C-4 modification. The key step in
      the synthesis is the aziridine ring formation at the C-4 position via an
      intramolecular Mitsunobu reaction. The syntheses and the biological evaluation of
      these C-4 aziridine-containing derivatives are herein discussed.

PMID- 7783161
TI  - Genetic testing for cancer predisposition: need and demand.

PMID- 7783162
TI  - FRAXE and mental retardation.
AB  - Mental impairment and instability of the CCG repeat at FRAXE is described in six
      kindreds. Cosegregation of FRAXA and FRAXE was found within one of these
      kindreds. Cytogenetic expression of FRAXE was shown to skip a generation when
      associated with a reduction in size of the CCG expansion when transmitted through
      a male; however, in general, transmission occurred through females and a copy
      number increased from one generation to the next. In these respects the behaviour
      of FRAXE paralleled that of FRAXA. A relationship between FRAXE and non-specific
      mental impairment is strongly suggested by the occurrence in these families of
      more mentally impaired male and female carriers, after removal of index cases,
      than could reasonably be expected by chance.

PMID- 7783163
TI  - A rapid, non-radioactive screening test for fragile X mutations at the FRAXA and
      FRAXE loci.
AB  - Screening of referrals for the mutations associated with the fragile X syndrome
      constitutes a significant workload in many genetics laboratories. Since the great
      majority of these referrals will be negative, there is a need for a rapid and
      inexpensive screening test. We have developed an assay which allows simultaneous
      amplification of the triplet repeat sequences at the FRAXA and FRAXE loci by
      polymerase chain reaction, and detection of the products on non-denaturing gels
      stained with ethidium bromide. Alleles of normal size are detected, leaving a
      small minority of samples to be tested by Southern blotting. A PCR based assay
      for detection of methylation at the CpG island upstream of the FMR-1 gene has
      also been devised.

PMID- 7783164
TI  - Saethre-Chotzen syndrome associated with balanced translocations involving 7p21:
      three further families.
AB  - We describe three families segregating different reciprocal chromosome
      translocations, t(7;18)(p21.2;q23), t(2;7)(q21.1;p21.2), and t(5;7)(p15.3;p21.2).
      A total of seven apparently balanced carriers have been identified and all
      manifest features of the Saethre-Chotzen syndrome, although only two have overt
      craniosynostosis. In one family the carriers are immediately recognisable by
      their unusual ears, and clefts of the hard or soft palate are present in all
      three families. These observations extend previous linkage and cytogenetic
      evidence that a locus for Saethre-Chotzen syndrome resides in band 7p21.2.

PMID- 7783165
TI  - A clinical, cytogenetic, and molecular study of 40 adults with the Prader-Willi
      syndrome.
AB  - A clinical, cytogenetic, and molecular study has been carried out on 40 adults
      with a firm diagnosis of Prader-Willi syndrome. A cytogenetically detectable
      deletion was observed in 58% while further subjects had a deletion which was
      detectable by molecular methods only, giving a total of 76%. Four cases of
      maternal uniparental disomy (UPD) were all female. Three of them were
      heterodisomic while the fourth was isodisomic. Two male probands were
      heterozygous at all loci tested yet did not have UPD. Although methylation
      studies showed that one of them had a single band using probe PW71, the other one
      had two bands. Psychiatric studies suggest that females with maternal UPD are
      indistinguishable psychologically from those with a paternal deletion in
      15q11q13.

PMID- 7783166
TI  - Heterogeneity in Li-Fraumeni families: p53 mutation analysis and
      immunohistochemical staining.
AB  - We have screened two families for constitutional TP53 mutations, one family with
      Li-Fraumeni syndrome and the other with features of this syndrome. We report a
      germline mutation in exon 7 of the TP53 gene in the family with "Li-Fraumeni
      like" syndrome. The mutation occurred at codon 245 and causes a Gly-Ser amino
      acid change. It was inherited by both affected and unaffected subjects. Malignant
      tumours from all members of this family showed strong positive nuclear
      immunohistochemical staining with antibodies CM-1 and DO1, directed against TP53.
      In contrast, no constitutional TP53 mutations were found in a "classic" Li
      Fraumeni family. In this family positive staining was seen in both malignant and
      normal tissues. These results support previous findings that variants of the Li
      Fraumeni syndrome exist since not all LFS families carry TP53 germline mutations.
      Secondly, immunohistochemical positivity is not synonymous with an underlying
      mutation and is therefore inadequate as an exclusive diagnostic marker.

PMID- 7783167
TI  - Male neonatal death and progressive weakness and immune deficiency in females: an
      unknown X linked condition.
AB  - We report a family with an undiagnosed X linked condition. The grandmother, two
      of her three daughters, and one of her grand-daughters have a slowly progressive
      proximal weakness, brisk reflexes, poor bladder function, static reduced night
      vision, and IgG2 deficiency. The diagnosis of the three living symptomatic
      females was "hereditary spastic paraplegia plus". They have lost five male
      children who died in the neonatal period of severe hypotonia and were of low
      birth weight. Investigations have not led to a unifying diagnosis: myotonic
      dystrophy, NARP, and X linked hyper IgM were specifically eliminated. Using the
      hypothesis that the condition is X linked dominant, haplotype analysis of the
      family suggests that the disease locus is within Xq26-qter. This entity should be
      considered in the differential diagnosis of families presenting with severe
      neonatal hypotonia in males and females with symptoms suggestive of complex
      hereditary spastic paraplegia.

PMID- 7783168
TI  - A gene for familial venous malformations maps to chromosome 9p in a second large
      kindred.
AB  - Venous malformations are a common form of vascular anomaly that cause pain and
      disfigurement and can be life threatening if they involve critical organs. They
      occur sporadically or in a familial form, where multiple lesions are usually
      present. We have identified a large kindred showing autosomal dominant
      inheritance of venous malformations. Using this family we confirm linkage of a
      familial form of venous malformations to chromosome 9p. We suggest that blue
      rubber bleb naevus syndrome can be considered a particular manifestation of this
      form of familial venous malformations. The candidate region for this gene
      encompasses the interferon gene cluster and the MTS1 (p16) tumour suppressor
      gene.

PMID- 7783170
TI  - Further evidence for an intermittent pattern of neural tube closure in humans.
AB  - Evidence is presented to support the recent suggestion that human neural tube
      closure is similar to that observed in mice, and comprises several regionally
      distinct closure sites rather than being a simple zipping up process. Seven
      subjects, each with more than one neural tube defect (NTD), are described.
      Comparative studies of the location of the lesions in relation to the closed
      parts of the neural tube imply that such NTD could only have come about if there
      were intermittent closure of the neural tube.

PMID- 7783169
TI  - Absence of linkage between familial neural tube defects and PAX3 gene.
AB  - Neural tube defects (NTD) are among the most common and disabling birth defects.
      The aetiology of NTD is unknown and their genetics are complex. The majority of
      NTD cases are sporadic, isolated, nonsyndromic, and generally considered to be
      multifactorial in origin. Recently, PAX3 (formerly HuP2, the human homologue of
      mouse Pax-3), on chromosome 2q35-37, was suggested as a candidate gene for NTD
      because mutations of Pax-3 cause the mouse mutant Splotch (Sp), an animal model
      for human NTD. Mutations in PAX3 were also identified in patients with
      Waardenburg syndrome type 1 (WS1). At least eight patients with both WS1 and NTD
      have been described suggesting pleiotropy or a contiguous gene syndrome.
      Seventeen US families and 14 Dutch families with more than one affected person
      with NTD were collected and 194 people (50 affected) from both data sets were
      genotyped using the PAX3 polymorphic marker. The data were analysed using
      affecteds only linkage analysis. The lod scores were -7.30 (US), -3.74 (Dutch),
      and -11.04 (combined) at theta = 0.0, under the assumption of the autosomal
      dominant model. For the recessive model, the lod scores were -3.30 (US), -1.46
      (Dutch), and -4.76 (combined) at theta = 0.0. Linkage between PAX3 and familial
      NTD was excluded to 9.9 cM on either side of the gene for the dominant model and
      to 3.63 cM on either side of the gene for the recessive model in the families
      studied. No evidence of heterogeneity was detected using the HOMOG program. Our
      data indicate that PAX3 is not a major gene for NTD.

PMID- 7783172
TI  - Menkes disease.

PMID- 7783171
TI  - Haplotype analysis in autosomal dominant polycystic kidney disease.
AB  - Haplotype analysis was performed in 35 autosomal dominant polycystic kidney
      disease (ADPKD) families typed with 13 markers close to the PKD1 locus. The
      identification of recombinants close to the PKD1 gene on chromosome 16p indicates
      that PKD1 lies between CMM65 distally and 26-6 proximally. In addition, three
      unlinked (PKD2) families and two families with potential new mutation were
      identified.

PMID- 7783173
TI  - Neonatal spinal muscular atrophy with diaphragmatic paralysis is unlinked to
      5q11.2-q13.
AB  - Two sibs affected by the severe neonatal form of spinal muscular atrophy (SMA)
      with diaphragmatic paralysis are described. The two sibs were discordant for the
      haplotypes determined by DNA markers flanking the SMA locus. This supports non
      linkage of SMA to chromosome 5 in this family and indicates that the uncommon SMA
      type I variant associated with early onset respiratory failure maps outside the
      5q11.2-q13.3 region.

PMID- 7783174
TI  - A mutation causing DHPR deficiency results in a frameshift and a secondary
      splicing defect.
AB  - In our analysis of mutations causing DHPR deficiency we identified a patient in
      whom there was an aberrant transcription pattern detected by PCR of DHPR cDNA.
      However, unlike the pattern observed as a result of most splicing mutations,
      there is some full length transcript. The mutation was located and is a single
      nucleotide deletion at position 570/571 of the DHPR cDNA sequence and results in
      a frameshift and premature termination after the addition of six amino acids. The
      mutation is present in a homozygous state in the patient and in a heterozygous
      state in both parents. The exon which is deleted at high frequency in the patient
      is the putative exon 4, which is remote from the mutation, and confirms our
      observation that exon 4 skipping is a relatively common event.

PMID- 7783175
TI  - Genetic refinement of the chromosome 5q lattice corneal dystrophy type I locus to
      within a 2 cM interval.
AB  - Lattice corneal dystrophy type I (LCDI) is a relatively common corneal dystrophy
      which can cause severe visual impairment. Recent studies have suggested a genetic
      localisation for the disease to chromosome 5q. Independent genetic linkage
      analysis in a six generation LCDI pedigree confirmed linkage to the 5q region
      bounded by marker loci IL9 and D5S436 suggesting genetic homogeneity. A maximum
      two point lod score of 7.51 (theta = 0.03) was obtained with marker D5S393.
      Multipoint and haplotype data positioned the disease between loci D5S393 and
      D5S396 corresponding to a genetic distance of 2cM, thus refining linkage
      sufficiently to allow for physical mapping of this disorder.

PMID- 7783176
TI  - Kabuki syndrome-like features in monozygotic twin boys with a pseudodicentric
      chromosome 13.
AB  - We present monozygotic twin boys with features of Kabuki syndrome. The twins were
      discordant for cleft palate and coarctation of the aorta. The occurrence of
      Kabuki syndrome in monozygotic twins has not been previously reported and
      reinforces the belief that this condition has a genetic basis. Chromosomal
      analysis on the boys showed a pseudodicentric chromosome 13 with an inactive
      centromere and satellite stalks at 13q12.11: 46,XY,psu dic(13)(13pter-
      >13q12.11::13p12-->13q11.00:: 13q12.11-->13qter). Their phenotypically normal
      mother appears to carry the same pseudodicentric chromosome 13.

PMID- 7783177
TI  - Assignment of microsatellite sequences to the region duplicated in CMT1A (17p12):
      a useful tool for diagnosis.
AB  - Charcot-Marie-Tooth disease type 1A (CMT1A), the most prevalent form of the
      peripheral hereditary neuropathies, has been associated with a duplication of a
      genomic segment of 1.5 Mb, located in 17p11.2. Recently, the same segment has
      been found to be deleted in patients with another peripheral neuropathy,
      hereditary neuropathy with liability to pressure palsies (HNPP). Highly
      polymorphic markers are rare in this area, rendering the diagnosis highly
      dependent either on invasive examinations (like nerve biopsy) or not totally
      reliable (like gene dosage). Thus, we used a contig of YACs, including the whole
      region duplicated in CMT1A, to map highly polymorphic microsatellite loci,
      designed in Genethon. We showed that four of these loci are located in the
      duplicated region, allowing us to propose them as diagnostic markers for CMT1A
      and HNPP.

PMID- 7783178
TI  - Renal tubular leakage complicating microcephalic osteodysplastic primordial
      dwarfism.
AB  - We describe a male infant with phenotypic and radiological features of
      microcephalic osteodysplastic primordial dwarfism type I/III. He showed severe
      osteoporosis and biochemical derangement owing to renal tubular leakage, which
      has not previously been reported in this condition. He died aged 5 months.

PMID- 7783180
TI  - Linkage refinement localises Sorsby fundus dystrophy between markers D22S275 and
      D22S278.
AB  - Sorsby fundus dystrophy is an autosomal dominant disorder which both clinically
      and histopathologically bears striking similarities to age related macular
      degeneration, one of the leading causes of blindness in the developed world.
      Recent studies have suggested a genetic localisation of the disease to chromosome
      22q in a large genetic interval of approximately 25 cM. Independent genetic
      linkage analysis in a six generation British pedigree confirms linkage to the
      chromosome 22q region. A maximum two point lod score of 7.09 with no
      recombination was obtained with marker D22S280. Haplotype data positioned the
      disease between loci D22S275 and D22S278, thus significantly reducing the region
      on chromosome 22q where the gene is located.

PMID- 7783179
TI  - Unusual (CGG)n expansion and recombination in a family with fragile X and
      DiGeorge syndrome.
AB  - In a fragile X family referred for prenatal diagnosis, the female fetus did not
      inherit the full fragile X mutation from her mother, but an unexpected expansion
      within the normal range of CGG repeats from 29 to 39 was observed in the paternal
      X chromosome. Also, a rare recombination between DXS548 and FRAXAC1 was recorded
      in the maternal meiosis. Follow up of the neonate confirmed the same DNA genotype
      as in the CVS, but the child died of DiGeorge syndrome after four days and was
      subsequently found to carry a microdeletion of chromosome 22 using probe cEO. It
      is suggested that in this family the deletion of chromosome 22 is likely to be a
      chance event but the rare recombinant and the fragile X mutation might be
      causally related.

PMID- 7783181
TI  - Familial schizencephaly: further delineation of a rare disorder.
AB  - We report on two Somalian sibs with severe developmental retardation and spastic
      cerebral paresis. Both children have bilateral cerebral clefts in the Sylvian
      region with dilatation of the ventricles, absence of the septum pellucidum, and
      heterotopia. The diagnosis of familial schizencephaly was made. The occurrence of
      schizencephaly in two affected sibs supports a genetic basis for schizencephaly.

PMID- 7783182
TI  - Thalassaemia in Azerbaijan.

PMID- 7783183
TI  - Blepharophimosis-mental retardation syndrome and terminal deletion of chromosome
      3p.

PMID- 7783184
TI  - Mechanism of image formation for thick biological specimens: exit wavefront
      reconstruction and electron energy-loss spectroscopic imaging.
AB  - With increasing frequency, cellular organelles and nuclear structures are being
      investigated at high resolution using electron microscopic tomography of thick
      sections (0.3-1.0 microns). In order to reconstruct the structures in three
      dimensions accurately from the observed image intensities, it is essential to
      understand the relationship between the image intensity and the specimen mass
      density. The imaging of thick specimens is complicated by the large fraction of
      multiple scattering which gives rise to incoherent and partially coherent image
      components. Here we investigate the mechanism of image formation for thick
      biological specimens at 200 and 300 keV in order to resolve the coherent
      scattering component from the incoherent (multiple scattering) components. Two
      techniques were used: electron energy-loss spectroscopic imaging (ESI) and exit
      wavefront reconstruction using a through-focus series. Although it is commonly
      assumed that image formation of thick specimens is dominated by amplitude
      (absorption) contrast, we have found that for conventionally stained biological
      specimens phase contrast contributes significantly, and that at resolutions
      better than approximately 10 nm, superposed phase contrast dominates. It is shown
      that the decrease in coherent scattering with specimen thickness is directly
      related to the increase in multiple scattering. It is further shown that exit
      wavefront reconstruction can exclude the microscope aberrations as well as the
      multiple scattering component from the image formation. Since most of the
      inelastic scattering with these thick specimens is actually multiple inelastic
      scattering, it is demonstrated that exit wavefront reconstruction can act as a
      partial energy filter. By virtue of excluding the multiple scattering, the
      'restored' images display enhanced contrast and resolution. These findings have
      direct implications for the three-dimensional reconstruction of thick biological
      specimens, where a simple direct relationship between image intensity and mass
      density was assumed, and the aberrations were left uncorrected.

PMID- 7783186
TI  - Medical malpractice and doctor-patient communication.

PMID- 7783185
TI  - Electrophoretic transfer of protein-pigment complexes from non-denaturing gels to
      electron microscopy grids.
AB  - Different fractions of a mixture of protein-pigment complexes have been separated
      from one another by non-denaturing gel electrophoresis. These complexes were
      prepared for observation by inserting electron microscope grids directly into the
      focused bands of the pigment-protein complexes and resuming electrophoresis for a
      brief time, so that the complexes were deposited onto the grids. It was found
      that complexes deposited from each band exhibited distinctly different
      appearances. It was also found that the exact conditions of electrophoretic
      deposition onto the grids affected the appearance of the complexes. The protein
      pigment complexes were characterized additionally by spectroscopy and denaturing
      gel electrophoresis.

PMID- 7783187
TI  - Swimming in a pool of paper.

PMID- 7783188
TI  - Laryngeal carcinoma--a relationship to tobacco and alcohol use.

PMID- 7783189
TI  - Calcium chanel blockers safe, says UMC hypertension expert.

PMID- 7783190
TI  - Force-induced conformational change of bacteriorhodopsin.
AB  - The cytoplasmic surface topography of purple membranes imaged by the atomic force
      microscope depends mainly on the force applied to the stylus. Imaged at forces of
      300 pN, individual bacteriorhodopsin molecules reveal two domains. The resulting
      donut-shaped trimers reversibly transform into structures exhibiting three
      prominent protrusions when scanned at 100 pN. In parallel, the height of the
      protein moiety above the lipid layer increases from 4 A to 6 A. From the known
      structure of bacteriorhodopsin it appears that this change may be related to a
      bending of the most prominent cytoplasmic loop.

PMID- 7783191
TI  - Conserved structural features on protein surfaces: small exterior hydrophobic
      clusters.
AB  - The extent to which side-chains at the surface of globular proteins adopt well
      defined conformations is a matter of some controversy and, in turn, the idea that
      specific interactions amongst them might make a significant contribution to
      defining tertiary structures would be generally seen as questionable. In at least
      some cases, however, there is evidence for organisation of the surface to form
      discrete, tightly packed clusters. In this paper we examine the role of such
      clusters in accommodating large, hydrophobic residues on the exterior of protein
      structures. Taking poplar plastocyanin as a detailed example, we find a variety
      of ways in which solvent accessibility of such non-polar groups can be limited
      and we highlight, in particular, a rather simple type of cluster in which a
      single hydrophobic residue is substantially excluded from solvent by a cage of
      surrounding, chiefly hydrophilic, side-chains. Comparison with the structures of
      a number of other proteins which share with plastocyanin the Greek key beta
      sandwich topology, but are otherwise unrelated, produces the remarkable finding
      that analogous clusters are commonly found in the topologically equivalent
      position. This suggests that these features, which we call small exterior
      hydrophobic clusters (SEHCs), may have an important structural role and we able
      that their recurrent position in these proteins is such that they may help to fix
      the register of non-sequential beta-strands and, perhaps, to specify their
      association during folding. Similar SEHCs can also be identified in other classes
      of protein structure and we give a four-helix bundle protein, the rop dimer, as
      an example. It seems likely that accommodation of large non-polar residues
      provides a mechanism for introducing a degree of local order in to the surface
      layers of proteins in solution and it is possible that this behavior could play a
      role in locking tertiary structures. Thus, while the packing of the hydrophobic
      core of a globular protein is surely the dominant driving force for folding, it
      may be that, in some cases at least, interactions among surface residues also
      play an important role in determining the fine details of the structure.

PMID- 7783193
TI  - Mechanism of post-segregational killing by hok-homologue pnd of plasmid R483: two
      translational control elements in the pnd mRNA.
AB  - The pnd system of plasmid R483 mediates plasmid stabilization by killing of
      plasmid-free cells. The pnd mRNA is very stable and can be translated into PndA
      protein, a cell toxin which kills the cells from within by damaging the cell
      membrane. Translation of the pnd mRNA is inhibited by the PndB antisense, a small
      labile RNA of 63 nt. The rapid decay of the PndB antidote leads to onset of PndA
      synthesis in plasmid-free segregants or after addition of rifampicin.
      Surprisingly however, the full-length pnd mRNA was found to be translationally
      inactive whereas a 3'-end truncated version of it was found to be active. We have
      therefore suggested previously, that the 3'-end of the full-length pnd mRNA
      encodes a fold-back inhibitory sequence (fbi), which prevents its translation.
      Here we present an analysis of the metabolism of the pnd mRNAs. A mutational
      analysis shows that single point mutations in the fbi motif results in more rapid
      truncation. The fbi mutations could not be complemented by second-site mutations
      in either of the pndA or pndC Shine-Dalgarno (SD) elements. Surprisingly,
      mutations in the pndC SD element also lead to a more rapid truncation. The effect
      of these latter mutations was, however, complemented by mutations in a proposed
      anti-SD element upstream of the pndC SD. Mutations in the anti-SD element were
      lethal. These results show, that the pnd mRNA contains two negative control
      elements, one located in its very 3'-end (fbi), and one located just upstream of
      the pndC SD region (the anti-SD element). These observations add to the
      complexity of the induction scheme previously proposed to explain activation of
      pndA expression in plasmid-free cells: In addition to its negative effect of
      translation, the fbi structure also maintains a reduced processing rate in the 3'
      end of the mRNA. This permits the accumulation of a reservoir of pnd mRNA, which
      can be activated by 3'-end processing in plasmid-free cells. The anti-SD may
      prevent translation of the pnd mRNA during transcription, thus preventing
      detrimental synthesis of toxin.

PMID- 7783192
TI  - A transcriptional role for conserved footprinting sequences within the larval
      promoter of a Drosophila alcohol dehydrogenase gene.
AB  - All Drosophila alcohol dehydrogenase (Adh) genes that are expressed in larvae
      display strong transcription in the larval fat body. To identify and characterize
      elements needed for Adh promoter function, footprinting analysis of the
      Drosophila affinidisjuncta Adh gene was performed with stage-specific nuclear
      proteins from embryos and larvae. Multiple sites upstream of the larval promoter
      were protected from deoxyribonuclease digestion by both embryonic and larval
      extracts. Comparison with foot-printing results for Adh genes from other
      Drosophila species revealed only one nuclease-protected region that is conserved
      in both sequence and position. Clustered point mutations in this sequence were
      analyzed by footprinting analysis, transient transformation and in vitro
      transcription. Two separate sequences in this footprinting region exerted
      positive effects on transcription from the Adh proximal promoter in the larval
      fat body. The effects of these sequences on gene expression were synergistic. One
      of these sequences, TGATAA, bound in vitro to Drosophila melanogaster box A
      binding factor protein, as shown by gel mobility shift assays. This is the first
      direct demonstration of specific protein-DNA interactions influencing
      transcription of a Drosophila Adh gene in the larval fat body.

PMID- 7783194
TI  - A complete plasmid-based complementation system for RNA coliphage Q beta: three
      proteins of bacteriophages Q beta (group III) and SP (group IV) can be
      interchanged.
AB  - Our laboratory has established a bacteriophage Q beta cDNA-containing plasmid
      system in which virtually all coding defects present within the 4217 nucleotide Q
      beta genome can be complemented in trans. In this system, Q beta minus strand
      RNAs are constitutively transcribed from plasmid cDNA by Escherichia coli RNA
      polymerase. Replication of these minus strands results in the synthesis of Q beta
      plus RNA, thereby triggering an infectious cycle in which Q beta phase particles
      are generated. Genetically engineered Q beta genome mutations that result in
      defective viral proteins can be complemented in trans by the products of one or
      more Q beta helper plasmids that express either: (1) Q beta maturation protein,
      which can complement defects in the Q beta maturation cistron (nucleotides 61 to
      1320); (2) Q beta readthrough protein, which can complement defects in the
      readthrough cistron (nucleotides 1344 to 2330); or (3) Q beta replicase, which
      can complement defects in the replicase cistron (nucleotides 2352 to 4118). Each
      plasmid component of this system contains a unique origin of replication and
      carries a different antibiotic gene, thereby enabling all combinations of these
      plasmids to coexist in the same host. We have further developed a second series
      of helper plasmids that generate the corresponding viral proteins of the related
      group IV RNA phage SP. Each of these SP helper proteins can complement respective
      defects within the Q beta genome with efficiencies similar to those observed for
      the Q beta helper proteins. It is now possible to supply functional Q beta or SP
      proteins in trans to examine Q beta genomes that contain protein coding defects
      for their ability to synthesize Q beta proteins, replicate Q beta RNA, assemble
      virions, and/or lyse the host cell.

PMID- 7783195
TI  - Multiple interacting elements delineate an ecdysone-dependent regulatory region
      with secondary responsive character.
AB  - Within the 2.2 kb region between hsp23 and gene 1 of the small heat shock gene
      locus 67B1 of Drosophila melanogaster, an approximately 1 kb perturbation of the
      chromatin architecture has previously been observed to occur in response to the
      steroid hormone ecdysone. Transient expression assays in hormonally-responsive
      Drosophila tissue culture cells utilizing hsp70-lacZ chimeric reporter constructs
      revealed the presence of ecdysone-dependent regulatory sequences in this hsp23
      gene 1 intergenic region. The analysis delimited five functional segments: three
      core regions which were completely encompassed within the region of chromatin
      perturbation, and two gene-proximal regions which appear to be functionally
      equivalent under some circumstances. None of the delineated regions was capable
      of stimulating expression independently, while sub-maximal expression was
      obtained when combinations of two or three regions were monitored. This
      requirement for multiple DNA segments to drive maximal transcription suggested
      that cooperative interactions between the regions were essential for full
      hormonal responsiveness. Unexpectedly, no binding of the ecdysone receptor was
      detectable within any of the delineated regions, implying the involvement of
      multiple non-receptor factors in the observed hormonal responsiveness. The
      ecdysone-dependent activation of reporter constructs driven by these sequences
      showed a significant time lag and was coupled with a marked sensitivity to low
      concentrations of cycloheximide. The data obtained strongly suggest that the cis
      acting elements delimited within the hsp23-gene 1 intergenic region respond to
      ecdysone in a secondary manner, presumably by requiring interaction with the
      product(s) of primary ecdysone-responsive genes.

PMID- 7783196
TI  - Stabilization of a ribosomal RNA tertiary structure by ribosomal protein L11.
AB  - Interactions between ribosomal protein L11 and a domain of large subunit rRNA
      have been highly conserved and are essential for efficient protein synthesis. To
      study the effects of L11 on rRNA folding, a homolog of the Escherichia coli L11
      gene has been amplified from Bacillus stearothermophilus DNA and cloned into a
      phage T7 polymerase-based expression system. The expressed protein is 93%
      homologous to the L11 homolog from Bacillus subtilis, denatures at temperatures
      above 72 degrees C, and has nearly identical rRNA binding properties as the
      Escherichia coli L11 in terms of RNA affinity constants and their dependences on
      temperature, Mg2+ concentration, monovalent cation, and RNA mutations. Mg2+ and
      NH4+ are specifically bound by the RNA-protein complex, with apparent ion-RNA
      affinities of 1.6 mM-1 and 19 M-1, respectively, at 0 degree C. The effect of the
      thermostable L11 on the unfolding of a 60 nucleotide rRNA fragment containing its
      binding domain has been examined in melting experiments. The lowest temperature
      RNA transition, which is attributed to tertiary structure unfolding, is
      stabilized by approximately 25 degrees C, and the interaction has an intrinsic
      enthalpy of approximately 13 kcal/mol. The thermal stability of the protein-RNA
      complex is enhanced by increasing Mg2+ concentration and by NH4+ relative to Na+.
      Thus L11, NH4+, and Mg2+ all bind and stabilize the same rRNA tertiary
      interactions, which are conserved and presumably important for ribosome function.

PMID- 7783197
TI  - Mutual stabilisation of bacteriophage Mu repressor and histone-like proteins in a
      nucleoprotein structure.
AB  - Integration host factor (IHF) binds in a sequence-specific manner to the
      bacteriophage Mu early operator. It participates with bound Mu repressor, c, in
      building stable, large molecular mass nucleoprotein complexes in vitro and
      enhances repression of early transcription in vivo. We demonstrate that, when the
      specific IHF binding site with the operator is mutated, the appearance of large
      molecular mass complexes still depends on IHF and c, but the efficiency of their
      formation is reduced. Moreover, the IHF-like HU protein, which binds DNA in a non
      sequence-specific way, can substitute for IHF and participate in complex
      formation. Since the complexes require both c and a host factor (IHF or HU), the
      results imply that these proteins stabilise each other within the nucleoprotein
      structures. These results suggest that IHF and HU are directed to the repressor
      operator complexes, even in the absence of detectable sequence-specific binding.
      This could be a consequence of their preferential recognition of DNA containing a
      distortion such as that introduced by repressor binding to the operator. The
      histone-like proteins could then stabilise the nucleoprotein complexes simply by
      their capacity to maintain a bend in DNA rather than by specific protein-protein
      interactions with c. This model is supported by the observation that the
      unrelated eukaryotic HMG-1 protein, which exhibits a similar marked preference
      for structurally deformed DNA, is also able to participate in the formation of
      higher-order complexes with c and the operator DNA.

PMID- 7783198
TI  - Identification and analysis of multigene families by comparison of exon
      fingerprints.
AB  - Gene families are often recognised by sequence homology using similarity
      searching to find relationships, however, genomic sequence data provides gene
      architectural information not used by conventional search methods. In particular,
      intron positions and phases are expected to be relatively conserved features,
      because mis-splicing and reading frame shifts should be selected against. A fast
      search technique capable of detecting possible weak sequence homologies apparent
      at the intron/exon level of gene organization is presented for comparing
      spliceosomal genes and gene fragments. FINEX compares strings of exons delimited
      by intron/exon boundary positions and intron phases (exon fingerprint) using a
      global dynamic programming algorithm with a combined intron phase identity and
      exon size dissimilarity score. Exon fingerprints are typically two orders of
      magnitude smaller than their nucleic acid sequence counterparts giving rise to
      fast search times: a ranked search against a library of 6755 fingerprints for a
      typical three exon fingerprint completes in under 30 seconds on an ordinary
      workstation, while a worst case largest fingerprint of 52 exons completes in just
      over one minute. The short "sequence" length of exon fingerprints in comparisons
      is compensated for by the large exon alphabet compounded of intron phase types
      and a wide range of exon sizes, the latter contributing the most information to
      alignments. FINEX performs better in some searches than conventional methods,
      finding matches with similar exon organization, but low sequence homology. A
      search using a human serum albumin finds all members of the multigene family in
      the FINEX database at the top of the search ranking, despite very low amino acid
      percentage identities between family members. The method should complement
      conventional sequence searching and alignment techniques, offering a means of
      identifying otherwise hard to detect homologies where genomic data are available.

PMID- 7783199
TI  - Crystal structure of a pyrimidine dimer-specific excision repair enzyme from
      bacteriophage T4: refinement at 1.45 A and X-ray analysis of the three active
      site mutants.
AB  - Crystallographic study of bacteriophage T4 endonuclease V, which is involved in
      the initial step of the pyrimidine dimer-specific excision repair pathway, has
      been carried out with respect to the wild-type and three different mutant
      enzymes. This enzyme catalyzes the cleavage of the N-glycosyl bond at the 5'-side
      of the pyrimidine dimer, and subsequently incises the phosphodiester bond at the
      apyrimidinic site through a beta-elimination reaction. The structure of the wild
      type enzyme refined at 1.45 A resolution reveals the detailed molecular
      architecture. The enzyme is composed of a single compact domain classified as an
      all-alpha structure. The molecule is stabilized mainly by three hydrophobic
      cores, two of which include many aromatic side-chain interactions. The structure
      has a unique folding motif, where the amino-terminal segment penetrates between
      two major alpha-helices and prevents their direct contact, and it is incompatible
      with the close-packing category of helices for protein folding. The concave
      surface, covered with many positive charges, implies an interface for DNA
      binding. The glycosylase catalytic center, which comprises Glu23 and the
      surrounding basic residues Arg3, Arg22 and Arg26, lie in this basic surface. The
      crystal structures of the three active-site mutants, in which Glu23 was replaced
      by Gln(E23Q) and Asp (E23D), respectively, and Arg3 by Gln (R3Q), have been
      determined at atomic resolution. The backbone structures of the E23Q and R3Q
      mutants were almost identical with that of the wild-type, while the E23D mutation
      induces a small, but significant, change in the backbone structure, such as an
      increase of the central kink of the H1 helix at Pro25. In the catalytic center of
      the glycosylase, however, these three mutations do not generate notable movements
      of protein atoms, except for significant shifts of some bound water molecules.
      Thus, the structural differences between the wild-type and each mutant are
      confined to the remarkably small region around their replaced chemical groups.
      Combined with the biochemical studies and the difference circular dichroism
      measurements, these results allow us to conclude that the negatively charged
      carboxyl group of Glu23 is essential for the cleavage of the N-glycosyl bond, and
      that the positively charged guanidino group of Arg3 is crucial to bind the
      substrate, a DNA duplex containing a pyrimidine dimer. The amino terminal alpha
      amino group is located at a position approximately 4.4 A away from the carboxyl
      group of Glu23. These structural features are generally consistent with the
      reaction scheme proposed by Dodson and co-workers.

PMID- 7783200
TI  - A molecular model for the redox potential difference between thioredoxin and
      DsbA, based on electrostatics calculations.
AB  - The disulphide active sites of thioredoxin and DsbA are known to possess a high
      degree of structural homology. However, DsbA is a much stronger oxidant than
      thioredoxin. The redox potential difference between DsbA and thioredoxin has been
      measured to be 160 mV, equivalent to a shift of 15.4 kJ/mol in the
      reduced/oxidised equilibrium. Electrostatics calculations have been used to study
      the relative stabilities of the reduced forms of the two proteins. Model
      calculations suggest that much of the redox potential difference between DsbA and
      thioredoxin arises form altered stabilisation of the exposed and ionised
      thiolates of the reduced forms, supporting suggestions previously made on the
      basis of experimental studies. The calculations have been used to construct a
      molecular model for the difference in thiolate stabilisation. Although specific
      interactions, such as thiolate-NH 35 (thioredoxin)/33 (DsbA), provide substantial
      stabilisation in each reduced protein, the difference between thioredoxin and
      DsbA is predicted to reside in several side-chain and main-chain groups acting in
      concert. Residues H32 and Q97 in DsbA are predicted to contribute, along with
      substantial regions of the polypeptide backbone in the protein domain which is
      common to DsbA and thioredoxin. Increased thiolate stabilisation by the peptide
      dipoles is suggested to arise from altered main-chain disposition, and the effect
      of the additional protein domain of DsbA on the electric field. Peptide dipoles
      in a region of about 20 residues close to the active site disulphide are
      predicted to contribute significantly to the redox potential difference.

PMID- 7783201
TI  - Crystallisation of RNA-protein complexes. II. The application of protein
      engineering for crystallisation of the U1A protein-RNA complex.
AB  - The hairpin is one of the most commonly found structural motifs of RNA and is
      often a binding site for proteins. Crystallisation of U1A spliceosomal protein
      bound to a RNA hairpin, its natural binding site on U1snRNA, is described. RNA
      oligonucleotides were synthesised either chemically or by in vitro transcription
      using T7 RNA polymerase and purified to homogeneity by gel electrophoresis.
      Crystallisation trials with the wild-type protein sequence and RNA hairpins
      containing various stem sequences and overhanging nucleotides only resulted in a
      cubic crystal form which diffracted to 7-8 A resolution. A new crystal form was
      grown by using a protein variant containing mutations of two surface residues.
      The N-terminal sequence of the protein was also varied to reduce heterogeneity
      which was detected by protein mass spectrometry. A further crystallisation search
      using the double mutant protein and varying the RNA hairpins resulted in crystals
      diffracting to beyond 1.7 A. The methods and strategy described in this paper may
      be applicable to crystallisation of other RNA-protein complexes.

PMID- 7783202
TI  - Isolation, crystallization, crystal structure analysis and refinement of
      allophycocyanin from the cyanobacterium Spirulina platensis at 2.3 A resolution.
AB  - The phycobiliprotein allophycocyanin from the cyanobacterium Spirulina platensis
      has been isolated and crystallized. The crystals belong to space group P6(3)22
      with cell constants a = b = 101.9 A, c = 130.6 A, alpha = beta = 90 degrees,
      gamma = 120 degrees, with one (alpha beta) monomer in the asymmetric unit. The
      three-dimensional structure of the (alpha beta) monomer was solved by multiple
      isomorphous replacement. The crystal structure has been refined in a cyclic
      manner by energy-restrained crystallographic refinement and model building. The
      conventional crystallographic R-factor of the final model is 19.6% with data from
      8.0 to 2.3 A. The molecular structure of the subunits resembles other solved
      phycobiliprotein structures. In comparison to C-phycocyanin and b-phycoerythrin
      the major differences arise from deletions and insertions of segments involved in
      the protein-chromophore interactions. The stereochemistry of the alpha 84 and
      beta 84 chiral atoms are C(2)-R, C(3)-R and C(31)-R. The configuration (C(4)-Z,
      C(10)-Z and C(15)-Z) and the conformation (C(5)-anti, C(9)-syn and C(14)-anti)
      are equal for both chromophores.

PMID- 7783203
TI  - Determination of the solution structure of Apo calbindin D9k by NMR spectroscopy.
AB  - The three-dimensional structure of apo calbindin D9k has been determined using
      constraints generated from nuclear magnetic resonance spectroscopy. The family of
      solution structures was calculated using a combination of distance geometry,
      restrained molecular dynamics, and hybrid relaxation matrix analysis of the
      nuclear Overhauser effect (NOE) cross-peak intensities. Errors and
      inconsistencies in the input constraints were identified using complete
      relaxation matrix analyses based on the results of preliminary structure
      calculations. The final input data consisted of 994 NOE distance constraints and
      122 dihedral constraints, aided by the stereospecific assignment of the
      resonances from 21 beta-methylene groups and seven isopropyl groups of leucine
      and valine residues. The resulting family of 33 structures contain no violation
      of the distance constraints greater than 0.17 A or of the dihedral angle
      constraints greater than 10 degrees. The structures consist of a well-defined,
      antiparallel four-helix bundle, with a short anti-parallel beta-interaction
      between the two unoccupied calcium-binding loops. The root-mean-square deviation
      from the mean structure of the backbone heavy-atoms for the well-defined helical
      residues is 0.55 A. The remainder of the ion-binding loops, the linker loop
      connecting the two sub-domains of the protein, and the N and C termini exhibit
      considerable disorder between different structures in the ensemble. A comparison
      with the structure of the (Ca2+)2 state indicates that the largest changes
      associated with ion-binding occur in the middle of helix IV and in the packing of
      helix III onto the remainder of the protein. The change in conformation of these
      helices is associated with a subtle reorganization of many residues in the
      hydrophobic core, including some side-chains that are up to 15 A from the ion
      binding site.

PMID- 7783204
TI  - Slow ligand-induced transitions in the allosteric phosphofructokinase from
      Escherichia coli.
AB  - The fluorescence of the unique tryptophan residue of the allosteric
      phosphofructokinase from Escherichia coli varies upon binding of any ligand,
      whether substrate or effector, suggesting that the protein undergoes a
      conformational change. This fluorescent probe has been exploited to determine the
      rates of the structural transitions that occur upon ligand binding and that are
      responsible for the remarkable allosteric behavior of this enzyme. The kinetics
      of fluorescence changes measured after rapidly mixing phosphofructokinase with
      one of its ligands show the presence of several allosteric transitions with
      widely different rates, ranging from a few hundred s-1 to less than 0.1 s-1. The
      rate of each conformational change increases with the concentration of the ligand
      used to trigger it, suggesting that ligands induce a conformational change and do
      not displace a pre-existing equilibrium. The hypothesis that each ligand
      stabilizes a different conformational state of the protein is confirmed by the
      kinetics of displacement of one ligand by another: for instance, the binary
      complexes between phosphofructokinase and either its substrate, fructose-6
      phosphate, or its allosteric activator, ADP, have the same low fluorescence and
      should be in the same active state, but they show different rates of
      conformational transition upon binding the inhibitor phosphoenolpyruvate. It
      appears that phosphofructokinase can exist in more than two states. Some
      conformational changes between these multiple states are slow enough to play an
      important role in the kinetics of the reaction catalyzed by phosphofructokinase,
      and could even explain part of its allosteric behavior. These results show that
      steady-state measurements are not sufficient to analyze the regulatory properties
      of E. coli phosphofructokinase.

PMID- 7783205
TI  - The complexity and accuracy of discrete state models of protein structure.
AB  - The prediction of protein structure depends on the quality of the models used. In
      this paper, we examine the relationship between the complexity and accuracy of
      representation of various models of protein alpha-carbon backbone structure.
      First, we develop an efficient algorithm for the near optimal fitting of
      arbitrary lattice and off-lattice models of polypeptide chains to their true X
      ray structures. Using this, we show that the relationship between the complexity
      of a model, taken as the number of possible conformational states per residue,
      and the simplest measure of accuracy, the root-mean-square deviation from the X
      ray structure, is approximately (Accuracy) varies; is directly proportional to
      (Complexity)-1/2. This relationship is insensitive to the particularities of
      individual models, i.e. lattice and off-lattice models of the same complexity
      tend to have similar average root-mean-square deviations, and this also implies
      that improvements in model accuracy with increasing complexity are very small.
      However, other measures of model accuracy, such as the preservation of X-ray
      residue-residue contacts and the alpha-helix, do distinguish among models. In
      addition, we show that low complexity models, which take into account the uneven
      distribution of residue conformations in real proteins, can represent X-ray
      structures as accurately as more complex models, which do not: a selected 6-state
      model can represent protein structures almost as accurately (1.7 A root-mean
      square) as a 17-state lattice model (1.6 A root-mean-square). Finally, we use a
      novel optimization procedure to generate eight 4-state models, which fit native
      proteins to an average of 2.4 A, and preserve 85% of native residue-residue
      contacts. We discuss the implications of these findings for protein folding and
      the prediction of protein conformation.

PMID- 7783206
TI  - A supprescin from a phytopathogenic fungus deactivates transcription of a plant
      defense gene encoding phenylalanine ammonia-lyase.
AB  - Both elicitor and supprescin (suppressor) are present in the pycnospore
      germination fluid of a pea pathogen Mycospharella pinodes. A nuclear run-on assay
      revealed that supprescin rapidly deactivated elicitor-triggered transcription of
      the gene encoding phenylalnine ammonia-lyase in pea epicotyl tissues. The
      mechanism underlying the deactivation of the plant defense gene by signal
      molecules secreted from the fungal pathogen was investigated. Cis-acting
      sequences and trans-acting factors responsive to supprescin in a TATA-proximal
      region of a member of the phenylalanine ammonia-lyase gene family in pea were
      examined in vitro. Gel mobility-shift assays and DNase I footprinting analysis
      revealed that the promoter region of PSPAL2 was modified by the binding of
      nuclear factors at multiple sites that were possibly involved in supprescin
      mediated deactivation. The prominent changes by supprescin were observed at boxes
      2 and 4 and near exonic sequences.

PMID- 7783207
TI  - The DNA sequence of equine herpesvirus 2.
AB  - The complete DNA sequence of equine herpesvirus 2 (EHV-2) strain 86/67 was
      determined. The genome is 184,427 bp in size and has a base composition of 57.5%
      G + C. Unusually for a herpesvirus, about a third of the sequence distributed in
      several large blocks appears not to encode proteins. The 79 open reading frames
      that were identified as probably polypeptide-coding are predicted to encode 77
      distinct proteins. Amino acid sequence comparisons confirmed that EHV-2 is a
      gamma-herpesvirus that is genetically collinear with herpesvirus saimiri (HVS; a
      gamma 2-herpesvirus) and Epstein-Barr virus (EBV; a gamma 1-herpesvirus), with a
      closer relationship to the former. Moreover, EHV-2 specifies eight proteins that
      have counterparts in HVS but not in EBV and only a single protein that has a
      homologue in EBV but not in HVS (EBV BCRF1, which encodes an interleukin 10-like
      protein). EHV-2 also encodes three potential G protein-coupled receptors, one
      with a counterpart in HVS that is specific for alpha chemokines, another with a
      counterpart in human cytomegalovirus (a beta-herpesvirus), which is specific for
      beta chemokines, and a third that is assigned more tentatively and lacks
      detectable counterparts in other herpesviruses.

PMID- 7783208
TI  - Cold denaturation of CheY.
AB  - The thermal stability of the bacterial chemotaxis protein CheY from Salmonella
      typhimurium has been examined by thermal denaturation at pH 7.0 in the presence
      of guanidine-HCl and urea. For both denaturants, thermal denaturation monitored
      by circular dichroism spectropolarimetry consists of transitions both above and
      below 25 degrees C, which is strong evidence for a heat capacity change that is >
      or = 1500 cal/(mol K) upon unfolding. While many data for chemical and thermal
      denaturation are consistent with data for CheY from Escherichia coli, the
      observation of cold denaturation for S. typhimurium CheY is inconsistent with the
      small heat capacity change, 600 to 850 cal/(mol K), reported for denaturation of
      the E. coli protein.

PMID- 7783209
TI  - The KIN28 gene is required both for RNA polymerase II mediated transcription and
      phosphorylation of the Rpb1p CTD.
AB  - Kin28p, associated with cyclin Ccl1p, is a putative cyclin-dependent kinase (CDK)
      of the p34cdc2 family in Saccharomyces cerevisiae. Search for mutations co-lethal
      (syn mutations) with a kin28 thermosensitive mutation (kin28-ts3) has uncovered
      genetic interactions between gene KIN28 and genes RAD3, SIN4, STI1 and CDC37. The
      genetic interaction between KIN28 and the CDC37 cell division cycle gene suggests
      that a connection exists between the activity of CDK-Kin28p and cell-cycle
      progression. Both RAD3 and SIN4 gene products are implicated in the RNA
      polymerase II transcription process. Here we show that RNA polymerase II
      transcription is drastically reduced in a kin28-ts mutant, at restrictive
      temperature. This impairment correlates with a markedly decreased phosphorylation
      of the C-terminal domain (CTD) of the largest subunit of RNA polymerase II
      (Rpb1p). Thus, the Kin28 gene product is required in vivo for RNA polymerase II
      phosphorylation and transcriptional activity as recently suggested by experiments
      using an in vitro reconstituted system.

PMID- 7783210
TI  - RNA binding, packaging and polymerase activities of the different incomplete
      polymerase complex particles of dsRNA bacteriophage phi 6.
AB  - phi 6 is an enveloped dsRNA bacterial virus. Its segmented genome resides inside
      the virion associated polymerase complex which is formed by four proteins (P1,
      P2, P4 and P7) encoded by the viral L segment. Complete and incomplete polymerase
      complex particles can be produced using cDNA copies of this largest genome
      segment. We have analysed the capacity of the different purified particles to (1)
      package phi 6 (+) sense genomic precursors and unspecific RNA, (2) synthesize (-)
      and (+) strands and (3) bind phi 6 specific and unspecific RNAs. Both (-) and (+)
      strand synthesis polymerase activities were found to be associated with protein
      P2. In addition to complete particles, particles lacking protein P2 were found to
      package and protect genomic precursor ssRNAs. Protein P7 was needed for efficient
      packaging. Regulation and specificity of the packaging were found to be
      independent of P2. Particles composed of proteins P1 and P4 did not package or
      protect RNA but did bind phi 6 genomic (+) strand RNAs. The three phi 6 (+)
      strands bound in equal amounts to the particles when tested alone in a filter
      binding assay. In competition experiments they competed each other for binding,
      indicating that individual binding sites for the three genomic (+) strands do not
      exist. Differences in RNA binding competition among the four particles were
      observed, suggesting that packaging specificity is achieved by complex
      interactions of proteins and genomic (+) strand RNAs during the advancement of
      the packaging process after the initial binding events.

PMID- 7783211
TI  - A reporter gene to analyse the hypermutation of immunoglobulin genes.
AB  - The affinity maturation of antibodies is driven by somatic hypermutation which is
      localized to specific segments of the coding genes. The information available on
      this process derives from studies in vivo. With the intention of developing new
      approaches, we have constructed a fusion gene between a kappa chain and a
      selectable neomycin resistance gene, neor. The neor gene, which includes the SV40
      small t intron and polyadenylation site, but not the upstream elements nor its
      first 12 amino acids, is an in-frame substitution of the FR2-CDR3 fragment of a
      rearranged V kappa OX1-J kappa 5 gene. Expression of neor activity is therefore
      dependent on the upstream immunoglobulin sequence. A stop codon was placed in the
      CDR1 region so that only mutants survive treatment with geneticin sulphate
      (G418). The effectiveness of the system was tested by transfecting the NS0
      myeloma cell line and isolating spontaneous mutants. Neomycin-resistant clones
      arose at an estimated rate of 1 x 10(-8)/cell division, and over 90% were
      authentic structural mutants. Unlike the somatic hypermutations, the majority
      arose by in-frame deletions including the stop codon, although up to 30% involved
      a point mutation. The reporter gene was then modified by substituting all the
      sequences downstream of the J kappa 5 with others known to be required for full
      hypermutation in vivo. Different cell lines were transfected and G418-resistant
      clones analyzed. No significant increase in the rate of reversion or in the
      generation of point mutations versus deletions was detected, even using
      conditioned culture medium. In the presence of azacytidine however, a mutant
      involving multiple events (single base addition and deletion plus two point
      mutations) was detected. The reporter gene system therefore seems suitable to
      test culture conditions and modifications of the host cells aimed at the
      derivation of an in vitro assay of somatic hypermutation.

PMID- 7783212
TI  - E-box variants direct formation of distinct complexes with the basic helix-loop
      helix protein ALF1.
AB  - The murine transcription factor ALF1 belongs to the class of basic helix-loop
      helix proteins specific for the NCAGNTGN-version of the E-box. Binding of
      homodimeric ALF1 to variants of this motif was studied by a combination of
      binding site selection technology and DNA modification interference analysis. The
      results showed that substitutions at the non-conserved positions in the E-box
      sequence could cause profound alterations in the patterns of specific contacts at
      the protein-DNA interface. Thus, both the overall extent of the binding region
      and the backbone phosphate contact pattern differed markedly between closely
      related E-boxes with similar affinities for ALF1. The identity of the base at the
      inner N was an important determinant of contact pattern specification. The E-box
      variants differed in their ability to mediate ALF1 dependent transcriptional
      activation in vivo. We discuss the possibility that adaptability in basic helix
      loop-helix protein-DNA interactions can result in complexes with different
      functional properties.

PMID- 7783213
TI  - Structures of fd gene 5 protein.nucleic acid complexes: a combined solution
      scattering and electron microscopy study.
AB  - Small-angle scattering and electron microscopy studies of fd gene 5 protein (g5p)
      and reconstituted g5p.nucleic acid complexes have been used to test models for
      the complexes and evaluate their uniqueness. In addition, we have obtained new
      information on the dependence of nucleotide type and protein/nucleotide (P/N)
      ratio on the structure of the complexes. Reconstituted complexes were made with
      single-stranded fd viral DNA (fd ssDNA), poly[d(A)] and poly[r(A)]. All complexes
      form similar left-handed, flexible superhelices having approximately the same
      diameter, but the pitch differs among these complexes. The g5p protein is a dimer
      in solution and the dimers associate to form a superhelical framework to which
      the polynucleotide is attached. The combined X-ray and neutron scattering data
      confirm the nucleic acid is inside the protein superhelix. A Monte Carlo
      integration modeling procedure applied to the scattering data was used to
      systematically test large numbers of possible models for each complex, and
      previously proposed models based on parameters obtained from electron microscopy
      were found to be essentially correct and unique. The data on the complexes with
      different P/N ratios showed that mass per unit length values decreased while the
      rise per dimer and pitch of the superhelix increased for g5p.fd-ssDNA complexes
      with decreasing P/N ratios.

PMID- 7783214
TI  - NMR cross-relaxation investigated by molecular dynamics simulation: a case study
      of ubiquitin in solution.
AB  - A one nanosecond molecular dynamics simulation of ubiquitin in solution has been
      used for the calculation of the total dipolar, the radial and the reorientational
      correlation functions of 174 interproton NOEs and the 76 peptide chain NH
      vectors. The NOEs have been classified according to the structural elements they
      are associated with. Using multiexponential fits of the raw data spectral
      densities and cross-relaxation rate constants have been determined. Statistical
      distributions of correlation function parameters are given. On the basis of these
      data the assumptions underlying the standard method for distance measurement
      using NOE enhancements have been scrutinized. The separability of elongation and
      reorientation is verified for the vast majority of NOEs, but the rigid-body
      assumption is not supported by the simulation results. Relying on a spectral
      density expression that neither makes use of the product approximation nor
      neglects spatially restricted motion, a "bias-free" (with regard to molecular
      motion) distance measurement method is suggested and compared with the standard
      method. Errors in distances up to 24% and 50% occur due to the neglect of the
      dispersion of order parameters and correlation times, respectively. The
      preconditions for a class-specific calibration method have been investigated.
      Within the framework of the product approximation a method for decomposing the
      total cross-relaxation rate constant into contributions from radial and angular
      motion has been developed and applied. In several cases distance fluctuation
      contributes significantly to cross-relaxation with both amplitude and time
      behaviour.

PMID- 7783215
TI  - A thermodynamic study of mutant forms of Streptomyces subtilisin inhibitor. I.
      Hydrophobic replacements at the position of Met103.
AB  - The thermodynamic effects of replacing the Met residue at amino acid position 103
      of Streptomyces subtilisin inhibitor with other non-polar aliphatic residues were
      studied by means of differential scanning calorimetry. All but the Leu mutant,
      which is as stable as the wild-type but has different cooperative units in the
      course of unfolding, showed destabilization in terms of free energy. Similar
      losses in free energy, however, were caused by different reasons, i.e. by
      increased entropy for the Ala mutant and by decreased enthalpy for the Ile
      mutant, with a tendency that increases in entropy are accompanied by increases in
      enthalpy. The gain in entropy that caused the largest loss in free energy for the
      Gly mutant was unexpectedly smaller than that for the Ala mutant. The changes in
      enthalpy and entropy induced by the mutations exhibited some correlations with
      hydrophobicity, while no clear correlation was found between the changes in free
      energy and hydrophobicity.

PMID- 7783216
TI  - A thermodynamic study of mutant forms of Streptomyces subtilisin inhibitor. II.
      Replacements at the interface of dimer formation, Val13.
AB  - Amino acid replacements in a homodimeric protein, Streptomyces subtilisin
      inhibitor, at the position of Val13, which is located at the center of the beta
      sheet interface of the domain-domain interaction, changed both the overall
      stability and the denaturational scheme. All the mutant forms lost stability,
      losses in free energy at 82.21 degrees C at pH 7.0 obtained by calorimetric
      measurements ranging from 10.3 kcal (mol dimer)-1 for the Gly mutant, which
      involved a loss in enthalpy without a compensating loss in entropy, to 0.84 kcal
      (mol dimer)-1 for the Ile mutant, which involved comparable losses in enthalpy
      and entropy. A gain in enthalpy for the Ala mutant was overcome by a gain in
      entropy, resulting in a loss in free energy by 6.78 kcal (mol dimer)-1. It was
      found that decreases in enthalpy and entropy showed good correlation with
      increasing side-chain hydrophobicity, while no such correlation was present for
      free energy. Replacements with Gly, Ala, Met and Phe altered the thermal
      denaturational scheme from N2 reversible 2D, which was the case for the Leu and
      Ile mutants as well as for the wild-type, to N2 reversible 2N* reversible 2D,
      where the first step can be regarded as a dissociation of the native dimer
      followed by a major unfolding in the second step. The free energy acquired by
      forming the dimer was estimated to be 2.03 kcal mol-1 for the Ala mutant at 66.95
      degrees C at pH 9.5 and lower for the other three mutants.

PMID- 7783217
TI  - A thermodynamic study of mutant forms of Streptomyces subtilisin inhibitor. III.
      Replacements of a hyper-exposed residue, Met73.
AB  - Amino acid replacements of Met73, which is hyper-exposed in the native structure,
      with Asp, Glu, Lys, Gly, Ala, Val, Leu or Ile changed the stability of
      Streptomyces subtilism inhibitor by +1.60 to -0.94 kcal/mol-1 in free energy at
      82.21 degrees C at pH 7.0, with higher hydrophobicity of the replacing amino acid
      side-chain showing a correlation with lower stability. Thermodynamic parameters
      obtained from detailed calorimetric analyses gave a nearly proportional relation
      between the entropy change and the enthalpy change of denaturation, i.e. T delta
      delta S degrees = -0.03 (+/- 0.11) + 1.14 (+/- 0.03) delta delta H, with the
      linear correlation coefficient 0.996 for 18 data points. This proportionality
      observed uniquely for the substitutions at position 73 was caused primarily by
      the water/side-chain interaction, or hydration effect, which can account for the
      majority of the changes in enthalpy and entropy induced by the mutations.

PMID- 7783218
TI  - Investigating the structural determinants of the p21-like triphosphate and Mg2+
      binding site.
AB  - Amongst the superfamily of nucleotide binding proteins, the classical
      mononucleotide binding fold (CMBF), is the one that has been best characterized
      structurally. The common denominator of all the members is the triphosphate/Mg2+
      binding site, whose signature has been recognized as two structurally conserved
      stretches of residues: the Kinase 1 and 2 motifs that participate in triphosphate
      and Mg2+ binding, respectively. The Kinase 1 motif is borne by a loop (the P
      loop), whose structure is conserved throughout the whole CMBF family. The low
      sequence similarity between the different members raises questions about which
      interactions are responsible for the active structure of the P-loop. What are the
      minimal requirements for the active structure of the P-loop? Why is the P-loop
      structure conserved despite the diverse environments in which it is found? To
      address this question, we have engineered the Kinase 1 and 2 motifs into a
      protein that has the CMBF and no nucleotide binding activity, the chemotactic
      protein from Escherichia coli, CheY. The mutant does not exhibit any
      triphosphate/Mg2+ binding activity. The crystal structure of the mutant reveals
      that the engineered P-loop is in a different conformation than that found in the
      CMBF. This demonstrates that the native structure of the P-loop requires external
      interactions with the rest of the protein. On the basis of an analysis of the
      conserved tertiary contacts of the P-loop in the mononucleotide binding
      superfamily, we propose a set of residues that could play an important role in
      the acquisition of the active structure of the P-loop.

PMID- 7783219
TI  - The 1.9 A crystal structure of a nucleoside diphosphate kinase complex with
      adenosine 3',5'-cyclic monophosphate: evidence for competitive inhibition.
AB  - The X-ray structure of Myxococcus xanthus nucleoside diphosphate (NDP) kinase
      complexed with adenosine 3',5'-cyclic monophosphate (cAMP) has been determined.
      The structure was solved by difference Fourier analysis. The refined structure
      has a crystallographic R-factor of 0.17 at 1.9 A resolution. The phosphoryl group
      and ribose moiety make extensive polar interactions with the protein, whereas the
      base interacts only with two hydrophobic residues. The comparison with the
      structure of the enzyme complex with the substrate adenosine diphosphate (ADP)
      reported earlier shows that cAMP and ADP interact similarly with the enzyme. The
      base of the cAMP is present in two conformations, syn and anti, with respect to
      the sugar. The syn conformer is dominant. Based on the effect of cAMP on
      phosphorylation of the human NDP kinase NM23, it had been proposed that cAMP
      might interact with NDP kinase in a manner distinct from other nucleotides.
      However, the structure of the M. xanthus NDP kinase/cAMP complex indicates that
      the nucleotide is a competitive inhibitor of the enzyme and occupies the usual
      nucleotide site. Kinetic assays of the NDP kinase activity in the presence of
      cAMP were done. Their results are consistent with a competitive character of the
      cAMP inhibition.

PMID- 7783220
TI  - Atomic environment energies in proteins defined from statistics of accessible and
      contact surface areas.
AB  - Atomic contact potentials are derived by statistical analysis of atomic surface
      contact areas versus atom type in a database of non-homologous protein
      structures. The atomic environment is characterized by the surface area
      accessible to solvent and the surface of contacts with polar and non-polar atoms.
      Four types of atoms are considered, namely neutral polar atoms from protein
      backbones and from protein side-chains, non-polar atoms and charged atoms.
      Potential energies delta Ej(E) are defined from the preference for an atom of
      type j to be in a given environment E compared to the expected value if
      everything was random; Boltzmann's law is then used to transform these
      preferences into energies. These new potentials very clearly discriminate
      misfolded from correct structural models. The performance of these potentials are
      critically assessed by monitoring the recognition of the native fold among a
      large number of alternative structural folding types (the hide-and-seek
      procedure), as well as by testing if the native sequence can be recovered from a
      large number of randomly shuffled sequences for a given 3D fold (a procedure
      similar to the inverse folding problem). We suggest that these potentials reflect
      the atomic short range non-local interactions in proteins. To characterise atomic
      solvation alone, similar potentials were derived as a function of the percentage
      of solvent-accessible area alone. These energies were found to agree reasonably
      well with the solvation formalism of Eisenberg and McLachlan.

PMID- 7783221
TI  - The Aminoacyl-tRNA Synthetases and the Evolution of the Genetic Code. Proceedings
      of a workshop. Berkeley, California, July 17-20, 1994.

PMID- 7783222
TI  - Divergence of glutamate and glutamine aminoacylation pathways: providing the
      evolutionary rationale for mischarging.
AB  - Aminoacyl-tRNA for protein synthesis is produced through the action of a family
      of enzymes called aminoacyl-tRNA synthetases. A general rule is that there is one
      aminoacyl-tRNA synthetase for each of the standard 20 amino acids found in all
      cells. This is not universal, however, as a majority of prokaryotic organisms and
      eukaryotic organelles lack the enzyme glutaminyl-tRNA synthetase, which is
      responsible for forming Gln-tRNAGln in eukaryotes and in Gram-negative
      eubacteria. Instead, in organisms lacking glutaminyl-tRNA synthetase, Gln-tRNAGln
      is provided by misacylation of tRNAGln with glutamate by glutamyl-tRNA
      synthetase, followed by the conversion of tRNA-bound glutamate to glutamine by
      the enzyme Glu-tRNAGln amidotransferase. The fact that two different pathways
      exist for charging glutamine tRNA indicates that ancestral prokaryotic and
      eukaryotic organisms evolved different cellular mechanisms for incorporating
      glutamine into proteins. Here, we explore the basis for diverging pathways for
      aminoacylation of glutamine tRNA. We propose that stable retention of glutaminyl
      tRNA synthetase in prokaryotic organisms following a horizontal gene transfer
      event from eukaryotic organisms (Lamour et al. 1994) was dependent on the
      evolving pool of glutamate and glutamine tRNAs in the organisms that acquired
      glutaminyl-tRNA synthetase by this mechanism. This model also addresses several
      unusual aspects of aminoacylation by glutamyl- and glutaminyl-tRNA synthetases
      that have been observed.

PMID- 7783223
TI  - Searching tRNA sequences for relatedness to aminoacyl-tRNA synthetase families.
AB  - tRNA sequences were analyzed for sequence features correlated with known classes
      of aminoacyl-tRNA synthetase enzymes. The tRNAs were searched for distinguishing
      nucleotides anywhere in their sequences. The analyses did not find nucleotides
      predictive of synthetase class membership. We conclude that such nucleotides
      never existed in tRNA sequences or that they existed and were lost from many of
      the tRNA sequences during evolution.

PMID- 7783224
TI  - Phylogenetic analysis of the aminoacyl-tRNA synthetases.
AB  - Numerous aminoacyl-tRNA synthetase sequences have been aligned by computer and
      phylogenetic trees constructed from them for the two classes of these enzymes.
      Branching orders based on a consensus of these trees have been proposed for the
      two groups. Although the order of appearance can be rationalized to fit many
      different scenarios having to do with the genetic code, the invention of a system
      for translating nucleic acid sequences into polypeptide chains must have predated
      the existence of these proteins. In the past, a variety of schemes has been
      proposed for matching amino acids and tRNAs. Most of these have invoked direct
      recognition of one by the other, whether or not the anticodon was involved. Often
      ignored is the possibility of a nonprotein (presumably RNA) matchmaker for
      bringing the two into conjunction. If such had been the case, then the
      contemporary aminoacyl-tRNA synthetases could have entered the system gradually,
      each specific type replacing its matchmaking RNA counterpart in turn. A simple
      displacement scheme of this sort accommodates the existence of two different
      families of these enzymes, the second being introduced well before the first had
      undergone sufficient genetic duplications to specify the full gamut of amino
      acids. Such a scheme is also consistent with similar amino acids often, but not
      always, being the substrates of enzymes with the most similar amino acid
      sequences.

PMID- 7783225
TI  - The class II aminoacyl-tRNA synthetases and their active site: evolutionary
      conservation of an ATP binding site.
AB  - Previous sequence analyses have suggested the existence of two distinct classes
      of aminoacyl-tRNA synthetase. The partition was established on the basis of
      exclusive sets of sequence motifs (Eriani et al. [1990] Nature 347:203-306). X
      ray studies have now well defined the structural basis of the two classes: the
      class I enzymes share with dehydrogenases and kinases the classic nucleotide
      binding fold called the Rossmann fold, whereas the class II enzymes possess a
      different fold, not found elsewhere, built around a six-stranded antiparallel
      beta-sheet. The two classes of synthetases catalyze the same global reaction that
      is the attachment of an amino acid to the tRNA, but differ as to where on the
      terminal adenosine of the tRNA the amino acid is placed: class I enzymes act on
      the 2' hydroxyl whereas the class II enzymes prefer the 3' hydroxyl group. The
      three-dimensional structure of aspartyl-tRNA synthetase from yeast, a typical
      class II enzyme, is described here, in relation to its function. The crucial role
      of the sequence motifs in substrate binding and enzyme structure is high-lighted.
      Overall these results underline the existence of an intimate evolutionary link
      between the aminoacyl-tRNA synthetases, despite their actual structural
      diversity.

PMID- 7783226
TI  - An operational RNA code for amino acids and variations in critical nucleotide
      sequences in evolution.
AB  - An operational RNA code relates specific amino acids to sequences/structures in
      RNA hairpin helices which reconstruct the seven-base-pair acceptor stems of
      transfer RNAs. These RNA oligonucleotides are aminoacylated by aminoacyl tRNA
      synthetases. The specificity and efficiency of aminoacylation are generally
      determined by three or four nucleotides which are near the site of amino acid
      attachment. These specificity-determining nucleotides include the so-called
      "discriminator base" and one or two base pairs within the first four base pairs
      of the helix. With three examples considered here, nucleotide sequence variations
      between the eubacterial E. coli tRNA acceptor stems and their human cytoplasmic
      and mitochondrial counterparts are shown to include changes of some of the
      nucleotides known to be essential for aminoacylation by the cognate E. coli
      enzymes. If the general locations of the specificity-determining nucleotides are
      the same in E. coli and human RNAs, these RNA sequence variations imply a similar
      covariation in sequences/structures of the E. coli and human tRNA synthetases.
      These covariations would reflect the integral relationship between the
      operational RNA code and the design and evolution of tRNA synthetases.

PMID- 7783227
TI  - A comparison of mitochondrial tRNAs in five vertebrates.
AB  - Sequences of several vertebrate mitochondrial tRNAs were aligned and compared.
      The comparisons were made in pairs of the tRNAs for an identical amino acid.
      There are 22 genes for different tRNAs in each vertebrate mitochondrial DNA. The
      closet similarities were between rat and mouse, the next were between mammals,
      and the widest difference was between human or rat and Xenopus laevis. However,
      there were very wide variations between different amino acids in each set of
      comparisons. The time lapse for each percent of difference greatly increased with
      evolutionary separation. Most of the nucleotide substitutions appeared to be
      neutral in character.

PMID- 7783228
TI  - Speculations on the origin of the genetic code.
AB  - The most primitive code is assumed to be a GC code: GG coding for glycine, CC
      coding for proline, GC coding for alanine, CG coding for "arginine." The genetic
      code is assumed to have originated with the coupling of glycine to its anticodon
      CC mediated by a copper-montmorillonite. The polymerization of polyproline
      followed when it was coupled to its anticodon GG. In this case the aminoacyl-tRNA
      synthetase was a copper-montmorillonite. The first membrane is considered to be a
      beta sheet formed from polyglycine. As the code grew more complicated, the
      alternative hydrophobic-hydrophilic polypeptide (alanine-"arginine") was coded
      for by the alternating CG copolymer. This alternating polypeptide (ala-"arg")
      began to function as both a primitive membrane and as an aminoacyl-tRNA
      synthetase. The evolution of protein structure is tightly coupled to the
      evolution of the membrane. The alpha helix was evolved as lipids became part of
      the structure of biological membranes. The membrane finally became the fluid
      mosaic structure that is now universal.

PMID- 7783229
TI  - Evolution of the aminoacyl-tRNA synthetases and the origin of the genetic code.
AB  - The aminoacyl-tRNA synthetases exist as two enzyme families which were apparently
      generated by divergent evolution from two primordial synthetases. The two classes
      of enzymes exhibit intriguing familial relationships, in that they are
      distributed nonrandomly within the codon-amino acid matrix of the genetic code.
      For example, all XCX codons code for amino acids handled by class II synthetases,
      and all but one of the XUX codons code for amino acids handled by class I
      synthetases. One interpretation of these patterns is that the synthetases
      coevolved with the genetic code. The more likely explanation, however, is that
      the synthetases evolved in the context of an already-established genetic code--a
      code which developed earlier in an RNA world. The rules which governed the
      development of the genetic code, and led to certain patterns in the coding
      catalog between codons and amino acids, would also have governed the subsequent
      evolution of the synthetases in the context of a fixed code, leading to patterns
      in synthetase distribution such as those observed. These rules are (1)
      conservative evolution of amino acid and adapter binding sites and (2)
      minimization of the disruptive effects on protein structure caused by codon
      meaning changes.

PMID- 7783230
TI  - A sensitive and reliable locomotor rating scale for open field testing in rats.
AB  - Behavioral assessment after spinal cord contusion has long focused on open field
      locomotion using modifications of a rating scale developed by Tarlov and Klinger
      (1954). However, on-going modifications by several groups have made
      interlaboratory comparison of locomotor outcome measures difficult. The purpose
      of the present study was to develop an efficient, expanded, and unambiguous
      locomotor rating scale to standardize locomotor outcome measures across
      laboratories. Adult rats (n = 85) were contused at T7-9 cord level with an
      electromagnetic or weight drop device. Locomotor behavior was evaluated before
      injury, on the first or second postoperative day, and then for up to 10 weeks.
      Scoring categories and attributes were identified, operationally defined, and
      ranked based on the observed sequence of locomotor recovery patterns. These
      categories formed the Basso, Beattie, Bresnahan (BBB) Locomotor Rating Scale. The
      data indicate that the BBB scale is a valid and predictive measure of locomotor
      recovery able to distinguish behavioral outcomes due to different injuries and to
      predict anatomical alterations at the lesion center. Interrater reliability tests
      indicate that examiners with widely varying behavioral testing experience can
      apply the scale consistently and obtain similar scores. The BBB Locomotor Rating
      Scale offers investigators a more discriminating measure of behavioral outcome to
      evaluate treatments after spinal cord injury.

PMID- 7783231
TI  - Plasma and cerebrospinal fluid concentrations of 4-aminopyridine following
      intravenous injection and metered intrathecal delivery in canines.
AB  - Potassium channel blockade by 4-aminopyridine (4-AP) has been shown to initiate
      modest levels of functional recovery in spinal-injured dogs and people following
      intravenous administration; however, the relevant central nervous system (CNS)
      concentration mediating these effects is not known. We have determined the
      concentrations of 4-aminopyridine in plasma and cerebrospinal fluid following
      intravenous administration (0.5 mg/kg) in large (> 22 kg) dogs, using liquid
      column chromatography. Plasma levels are initially high (> 1 microgram/mL) and
      fall rapidly to levels less than 100 ng/mL by about 2 h postinjection. A
      characteristic secondary peak in plasma 4-AP is observed at about 1 h
      postinjection. Corresponding concentrations of 4-AP in CSF were relatively stable
      for nearly 2 h, never exceeding (as a mean) 50 ng/mL within the first 2 h
      postinjection. We suggest behavioral recovery in clinical cases of spinal cord
      injury in both dogs and humans is mediated by such low (< 50 ng/mL)
      concentrations of 4-AP bathing the lesion. Since the adverse side effects that
      accompany IV administration of the drug limit its potential clinical usefulness,
      we have evaluated the feasibility of an alternate route of administration,
      continuous metered delivery of 4-AP into the spinal cord's subarachnoid space.
      This is accomplished by using a surgically implantable pump and delivery
      catheter. The pump itself can be interrogated, and is fully programmable, by
      noninvasive telemetry. Intrathecal delivery rates of between 1 and 60 micrograms
      of 4-AP per hour never produced detectable levels of the drug in plasma or
      cervically sampled CSF in dogs independent of the amount or duration of infusion
      (hours to days). The levels of 4-AP in lumbar samples of CSF near the lumbar
      delivery site suggest a very steep gradient of the drug, with local
      concentrations easily reaching 1 microgram/mL or higher (10- to 20-fold higher
      than can be safely produced by IV administration). The most frequent adverse
      reaction to intrathecal 4-AP delivery was a mild hindlimb tremor, fully
      reversible following reduction in the rate of drug delivery or termination of
      delivery. This route of drug administration relative to clinical spinal cord
      injury is discussed.

PMID- 7783233
TI  - Blood-brain barrier breakdown and edema formation following frontal cortical
      contusion: does hormonal status play a role?
AB  - The present experiment was designed to evaluate and correlate the time course of
      blood-brain barrier (BBB) integrity and cerebral edema in adult male rats given
      medial frontal cortex contusions. The effect of sex hormones on BBB integrity in
      the same injury model was also examined, because previous work has shown that
      progesterone can reduce cerebral edema (Roof et al., 1993). BBB breakdown was
      assessed by Evans blue extravasation and albumin immunostaining while edema
      formation was measured by the wet weight dry weight technique. These processes
      were examined beginning 2 h and continuing up to 10 days after injury. Our
      findings show that medial frontal contusion in rats produces changes in cerebral
      water content and opening of the BBB that endures at least 7 days postinjury.
      Although pseudopregnancy has been shown to reduce cerebral edema at day 1
      postinjury, we did not find any evidence that this hormonal state is associated
      with BBB repair.

PMID- 7783232
TI  - Altered immunoexpression of microglia and macrophages after mild head injury.
AB  - In this study we examined the temporal response of microglia and macrophages to
      mild head injury in the rat. Microglia and macrophages were identified by their
      distinct morphology and by immunophenotype. With regard to the latter, antibodies
      to OX42 and ED1 were used to define microglia and macrophages, respectively.
      Although there was no change in the morphology of brain macrophages after mild
      head injury, the morphology of microglia was dramatically altered. Microglial
      cell bodies appeared larger with a more elaborate arborization of cellular
      processes. After head injury certain populations of macrophages and microglia
      were more intensely immunostained. By 3 days postinjury these intensely stained
      cells exhibited a characteristic distribution in the brain. Prominently stained
      microglia were detected in the thalamus, hippocampus, lateral and medial
      geniculate body, and the substantia nigra. Intensely stained macrophages were
      located primarily in the cortex and subarachnoid space adjacent to the site of
      impact. By 7 days postinjury intensely immunostained macrophages and microglia
      were widespread throughout the injured cortex. These results demonstrate that
      microglia and macrophages are sensitive to mild head injury. Early changes in the
      macrophage population are more directly correlated with the most damaged tissue
      and may reflect migration of these cells from either the subarachnoid space or
      across the damaged blood-brain barrier. The early widespread microglial response
      in regions exhibiting no overt neuronal cell damage suggests that these cells are
      responding to more subtle factor(s) that are expressed in the mildly traumatized
      brain.

PMID- 7783234
TI  - Effect of hypoxia or hyperbaric oxygen on cerebral edema following moderate fluid
      percussion or cortical impact injury in rats.
AB  - This study was designed to evaluate the production of cerebral edema [as measured
      by tissue specific gravity (SpG)] following moderate fluid percussion (FP) and
      cortical impact (CI) injury in rodents. To determine the effects of a secondary
      systemic insult, hypoxia (13% oxygen for 30 min) was added to some experimental
      groups immediately after head injury. To determine the effects of hyperbaric
      oxygen (HBO) on injured cortical tissue, additional animal groups were exposed to
      HBO (1.5 atm, for 60 min), beginning 4 h after head trauma. Both injury models
      produced equal amounts of tissue edema at the site of injury (mean SpG +/- SEM =
      1.035 +/- 0.001), when measured 6 h posttrauma. There was no significant edema at
      the tissue sites immediately adjacent to the trauma sites. The addition of
      hypoxia to either injury system did not increase edema formation beyond that
      produced by injury alone. HBO reduced the water content of the trauma site in
      animals that had received FP, but not in animals receiving CI. We conclude that
      with the injury parameters used in this protocol, both FP and CI appear to
      produce focal cerebral edema at the site of trauma. Hypoxia does not worsen
      edema. HBO appears to reduce edema produced by FP, but not by CI.

PMID- 7783235
TI  - The effect of acute cocaine or lidocaine on behavioral function following fluid
      percussion brain injury in rats.
AB  - One of the goals of our laboratory is to examine how the presence of drugs of
      abuse will influence traumatic brain injury. Previous studies in our laboratory
      have shown that cocaine or lidocaine treatment before experimental fluid
      percussion brain injury in rats reduces the cortical hypoperfusion normally found
      in the early posttraumatic period. The purpose of the current study was to
      determine if pretreatment with cocaine or lidocaine is also associated with
      changes in trauma-induced suppression of reflexes and motor and cognitive
      dysfunction that occurs following traumatic brain injury (TBI). Twenty-four hours
      after surgical preparation, rats were randomly assigned to a saline or drug
      pretreatment group, cocaine (0.5, 2, or 5 mg/kg) or lidocaine (2 mg/kg), which
      was injected via the tail vein. None of the drug pretreatments worsened injury.
      Lidocaine and cocaine decreased the duration of suppression of some neurological
      reflexes and reduced posttraumatic body weight losses. Lidocaine and cocaine both
      decreased postinjury motor deficits. Lidocaine and cocaine did not affect
      cognitive function on days 11-15 postinjury. The mechanism by which lidocaine
      improves acute neurological and motor function following brain injury is unknown,
      but may involve improved posttraumatic cortical blood flow, as seen in our
      previous study. Our results, along with other studies showing lidocaine to be
      neuroprotective in animal models of ischemia, suggest that studies of the effect
      of posttraumatic administration of lidocaine are warranted.

PMID- 7783236
TI  - Wrist strength measured by myometry as an indicator of functional independence.
AB  - The purpose of this study was to show that independence of self care activities
      of motor complete quadriplegic patients related better to the force of
      contraction of the wrist extensor (WE) muscles measured by a hand held myometer
      than to the manual muscle test (MMT) for grades 3 to 5. The patients (n = 24),
      identified by having unilaterally or bilaterally functional WE muscle (MMT > or =
      3/5) with bilateral elbow extensor (EE) muscles < 3/5, were evaluated at 2 to 6
      months after injury for four feeding activities utilizing the Quadriplegia Index
      of Function (QIF). We found 54% were independent drinking from a cup, 58% using a
      spoon or fork, 13% cutting food, and 23% pouring liquids. Comparisons were made
      between right, left, and bilateral mean myometry scores and median MMT scores for
      each of the QIF activities. The independent group of patients had myometry scores
      54 to 140% greater (p < 0.05) than those patients dependent in the self care
      activity except when the right or left WE myometric score was analyzed for
      cutting food (p = 0.1). MMT comparisons showed no significant median score
      differences in any activity performed. There were no patients with only one WE
      muscle > or = 3/5 (n = 9) who were able to cut food or pour liquids
      independently. In conclusion, myometry appeared to be a better indicator than the
      MMT for some self care activities evaluated utilizing the Quadriplegia Index of
      Function.

PMID- 7783237
TI  - Acute low back problems in adults. Guideline overview. Agency for Health Care
      Policy and Research Rockville, Maryland.

PMID- 7783238
TI  - Health-care reform: a view from the National Medical Association.

PMID- 7783239
TI  - A new Provident Hospital.

PMID- 7783240
TI  - Outcomes in African-American women with suspected acute myocardial infarction:
      the Myocardial Infarction Triage and Intervention Project.
AB  - Increasing attention has been given to the investigation of cardiovascular
      disease in women, although African-American women have received little attention.
      This study compares characteristics and outcomes in women admitted to coronary
      care units for suspected acute myocardial infarction (MI). Between January 1988
      and December 1991, a total of 554 (5%) African-American and 9738 (95%) white
      women with suspected acute MI were admitted to coronary care units in
      metropolitan Seattle, Washington. Relevant demographic socioeconomic, clinical,
      and outcome data were abstracted from the medical record and entered in the
      Myocardial Infarction Triage and Intervention registry. African-American women
      were younger, more often single and unemployed, and were less likely to have
      health insurance than their white counterparts. In addition, a higher proportion
      of African-American women reported a history of hypertension and diabetes
      mellitus. After adjustment for age, African-American women were equally as likely
      to develop acute MI and were more likely to die in the hospital. In addition, a
      higher proportion of African-American women were readmitted to coronary care
      units for suspected MI. Compared with their white counterparts, African-American
      women with suspected acute MI were considerably worse off from both socioeconomic
      and clinical standpoints, and their relative disadvantage was apparent in poor
      outcomes.

PMID- 7783242
TI  - Consumer product-related ocular trauma.
AB  - Leading causes of consumer product-related ocular trauma have not been well
      described. To delineate these causes in a nationally representative sample, data
      collected by the US Consumer Product Safety Commission (USCPSC) were reviewed.
      Data were obtained from the National Electronic Injury Surveillance System
      (NEISS), a national probability sample survey conducted by USCPSC that
      continuously monitors consumer product-related injuries treated in hospital
      emergency rooms across the United States. These data formulated the product
      summary report for the calendar year 1991. The sampling frame for the NEISS
      consisted of hospitals listed on the Center for Health Statistics Master
      Inventory File stratified geographically by size of hospital and number of
      emergency-room visits. During the calendar year 1991, there were a nationally
      estimated 298,852 consumer product-related eye injuries treated in hospital
      emergency rooms. Appoximately 500 different products were implicated in these
      injuries, with the leading cause being contact lenses (hard and soft), accounting
      for an estimated 26,490 emergency-room visits. This is followed by welding
      equipment (12,771 visits), hair curlers/curling irons (5946 visits), and workshop
      power grinders (5476 visits). Consumer products account for a sizable number of
      ocular injuries requiring treatment in hospital emergency rooms. Research on
      outcomes and prevention strategies of the injuries is warranted.

PMID- 7783241
TI  - Group A beta-hemolytic streptococcal bacteremia in a patient with sickle cell
      anemia on penicillin prophylaxis.
AB  - Serious invasive bacterial infections, particularly those due to Streptococcus
      pneumoniae and Hemophilus influenzae, are a well-known complication in patients
      with sickle cell disease. Early penicillin prophylaxis has been shown to prevent
      these infections and also to improve survival. This article describes a child
      with sickle cell anemia who, while on penicillin prophylaxis, developed a group A
      streptococcal bacteremia, a pathogen not commonly associated with bacteremia in
      sickle cell disease.

PMID- 7783243
TI  - Attitudes and behaviors of African-American and Mexican-American women delivering
      newborns in inner-city Los Angeles.
AB  - To study some of the factors relating to the care of mothers and newborns in an
      inner-city hospital, three sources of information were reviewed: an obstetric
      database including information on prenatal care and perinatal mortality, a
      database of all admissions to the hospital neonatal intensive care unit over the
      past 5 years, and a detailed questionnaire concerning attitudes and behaviors of
      recently delivered women. While analyses from these hospital-based data are not
      conclusive, the results add evidence for the following propositions: 1) Optimal
      prenatal care is infrequently obtained by mothers delivering at inner-city
      hospitals. Lack of prenatal care is clearly associated with increased perinatal
      mortality. While the need for prenatal care is appreciated by 98% of the mothers
      in this sample, the most frequent reasons why prenatal care is not obtained
      earlier or more frequently involve knowledge about and access to prenatal care.
      2) Inner-city mothers, in general, manifest attitudes and behaviors that promote
      the welfare of their pregnancies and newborns. These attitudes and behaviors are
      in stark contrast to those that are frequently attributed to inner-city women by
      the media. 3) Acute perinatal medical and nursing care are perceived by many
      postpartum women as suboptimal, particularly in terms of the lack of respect
      shown to patients by nurses and doctors. 4) Improved acute obstetric and neonatal
      care improves perinatal morbidity and mortality of infants delivered at inner
      city hospitals.

PMID- 7783244
TI  - Beyond controlling blood pressure in the black patient: metabolic considerations.
AB  - Hypertension is highly prevalent among African Americans, who are also more
      likely than whites to develop end-organ complications of hypertension.
      Traditional diuretic-based stepcare therapy has successfully reduced such
      complications of hypertension as stroke, congestive heart failure, and premature
      death in all populations tested. Prevention of coronary deaths has been less
      successful. Potentially adverse metabolic effects of thiazide diuretics and some
      beta-blockers may partially explain the less successful cardiac outcomes. Use of
      antihypertensive agents lacking adverse metabolic effects but still achieving
      effective blood pressure control could improve cardiac outcomes while maintaining
      the benefits achieved with older forms of therapy. Achievement of improved
      cardiac outcomes is now one of the principal goals of hypertension research and
      treatment.

PMID- 7783245
TI  - The natural history of homozygous S sickle cell anemia in two sisters.
AB  - This article describes the natural history of homozygous S sickle anemia in two
      sisters who have completely different morbidity patterns. Medical records
      beginning in May 1976 from the Urban League Sickle Cell program and my office,
      hospital records, and personal interviews were used. The sisters were older than
      20 years when the diagnosis was made. Both had two essentially uneventful
      pregnancies, and neither was treated with prophylactic transfusions during the
      pregnancies. One sister has a hemoglobin F level of 23%, has been hospitalized
      only 15 times to date, and has no gallstones. The other sister has a hemoglobin F
      level below 3%, has been hospitalized more than 148 times to date, and had a
      cholecystectomy in 1979. Clinical symptoms in sickle cell patients with high
      levels of hemoglobin F is reportedly mild, and this has been supported by this
      study. Likewise, the conclusion by some investigators that prophylactic blood
      transfusions during pregnancy are unnecessary also has been supported. While many
      exciting investigative approaches relative to management and prevention of sickle
      cell anemia continue, it is equally important to maintain emphasis on the
      variables that encourage and facilitate positive psychosocial adaptations by
      these patients.

PMID- 7783246
TI  - Carpal tunnel syndrome: issues and answers.
AB  - Carpal tunnel syndrome has received a lot of attention recently in both the
      medical literature and the lay press. This is due, in large part, to increased
      recognition and treatment of this condition and its acceptance in the 1980s as
      being a work-related injury. The latter has been a source of confusion for
      patients and for many physicians, and signifies a real need for a clearer
      understanding of the entity known as carpal tunnel syndrome. This article
      addresses some of the current major issues regarding carpal tunnel syndrome and
      provides answers to those important issues.

PMID- 7783248
TI  - The Veteran's Hospital controversy.

PMID- 7783247
TI  - Profuse bleeding in epiphrenic diverticula: an unusual finding.
AB  - Profuse bleeding is an unusual and previously unreported finding in epiphrenic
      diverticula. The present case describes a man with a history of significant
      alcohol and tobacco abuse who presented to an emergency room expectorating blood
      and was then admitted. Further evaluation revealed a large bleeding ulcer crater
      in the distal esophagus. Findings consistent with candida esophagitis were noted
      on biopsy. Radiographic examination revealed two large, wide-mouthed diverticula.
      While hypertensive lower esophageal pressure was noted on manometric evaluation,
      surgery was not performed on the patient, and he subsequently curtailed his
      alcohol and tobacco intake. A follow-up examination at 90 days' postdischarge
      revealed no further bleeding episodes with continued decreased alcohol and
      tobacco intake.

PMID- 7783249
TI  - Role of alterations in Ca(2+)-associated signaling pathways in the immunotoxicity
      of polycyclic aromatic hydrocarbons.
AB  - Polycyclic aromatic hydrocarbons (PAHs) are an important class of environmental
      pollutants that are known to be carcinogenic and immunotoxic. The effects of PAHs
      on the immune system of various animals and models have been studied for at least
      30 yr. Despite these efforts, the mechanism or mechanisms by which PAHs exert
      their effects on the immune system are still largely unknown. During recent
      years, the molecular events associated with lymphocyte activation and receptor
      mediated signaling have become increasingly clear. Substantial progress has been
      made in understanding the molecular and cellular bases for toxicant-induced
      immune cell injury. Understanding mechanisms of drug or chemical effects on the
      immune system is an important area of research in the field of immunotoxicology,
      and indeed in all fields of toxicology. Mechanistic toxicology plays an important
      role in risk assessment and extrapolation of potential human health effects. In
      this review, we have summarized recent evidence that has examined the effects of
      PAHs on the immune system of animals and humans. In particular, we have focused
      on the effects of PAHs on cell signaling in lymphoid cells and have examined the
      hypothesis that PAHs alter lymphocyte activation via calcium-dependent
      mechanisms. Previously published reports are discussed, and new data obtained
      with murine B cells and cell lines are presented demonstrating the relationship
      between alterations in intracellular calcium and immune dysregulation. These data
      demonstrate a strong association between PAH-induced alterations in B- and T
      lymphocyte activation and changes in calcium homeostasis.

PMID- 7783250
TI  - A multidisciplinary approach to toxicological screening: I. Systemic toxicity.
AB  - The toxicity of 10 chemicals, including pesticides (carbaryl, chlordane,
      heptachlor, and triadimefon), solvents (carbon tetrachloride, dichloromethane,
      tetrachloroethylene, and trichloroethylene), and industrial chemicals
      [diethylhexylphthalate (DEHP) and phenol] was examined in the liver, kidneys,
      spleen, thymus, and adrenals of female F344 rats after 1 or 14 d of oral dosing.
      For each chemical, 4 doses were based on fractions of the acute LD50, which was
      estimated using an abbreviated (up-and-down) method. A multivariate analysis
      (MANOVA) was conducted for each organ using selected measures of toxicity. A post
      hoc contrast analysis was also conducted for significant MANOVA results in order
      to determine effective and ineffective doses. A single dose of heptachlor
      resulted in necrotic lymphocytes in the spleen and thymus at doses > or = 23
      mg/kg. Triadimefon altered liver and spleen weights; this effect has not been
      described previously. Dichloromethane (> or = 337 mg/kg/d for 14 d) increased the
      incidence of necrosis of individual centrilobular hepatocytes. Trichloroethylene
      induced hepatotoxicity was obtained at doses an order of magnitude lower than
      those reported in the literature. Acute DEHP (150 mg/kg) increased mitotic
      figures in hepatocytes, which were replaced by hepatocellular cytomegaly after 14
      d of dosing at the same level. Following phenol exposure, there was an increased
      incidence in hepatocellular necrosis at 1 d, and an increased incidence of kidney
      lesions at 1 and 14 d; these findings were considered to be the result of
      vascular stasis. Overall, the algorithm used to select doses was effective for
      both 1- or 14-d dosing regimens. For all chemicals except carbon tetrachloride,
      the lowest effective dose for systemic toxicity was within the range of 3-56% of
      the LD50 for acute dosing, and 1-30% of the LD50 for repeated administration.

PMID- 7783251
TI  - A multidisciplinary approach to toxicological screening: II. Developmental
      toxicity.
AB  - As part of the validation of an integrated bioassay for systemic toxicity,
      neurotoxicity, and developmental toxicity, we evaluated the effects of four
      pesticides, four chlorinated solvents, and two other industrial chemicals in
      Fischer 344 rats. The pesticides included carbaryl, triadimefon, chlordane, and
      heptachlor; the solvents included dichloromethane (DCM), carbon tetrachloride,
      trichloroethylene (TCE), and tetrachloroethylene (perchloroethylene, PER); and
      the industrial chemicals were di(2-ethylhexyl)phthalate (DEHP) and phenol. In the
      developmental toxicity studies, timed-pregnant rats were treated by gavage with
      vehicle or 1 of 2 dose levels of each compound on gestation d 6-19. The dams were
      allowed to deliver and their litters were examined on postnatal d 1, 3, and 6.
      Litter weights were determined on postnatal d 1 and 6. Implants were also counted
      to determine prenatal loss. Maternal toxicity was evidenced by dose-related
      alterations in weight gain for all 10 compounds. Clinical signs of maternal
      toxicity were present for all chemicals except chlordane and heptachlor. DEHP
      exposure resulted in the most pronounced developmental toxicity (high levels of
      pre- and postnatal mortality), whereas chlordane induced extensive postnatal
      loss. Of the solvents, only DCM did not cause a high incidence of full-litter
      resorption. Phenol, heptachlor, triadimefon, and carbaryl showed only slight
      potential for developmental toxicity. Malformations suggestive of teratogenicity
      included kinked tail (phenol), microphthalmia (TCE, PER, DEHP), and cleft palate
      with renal agenesis (DEHP). Although several findings (eye defects caused by TCE
      and PER, full-litter resorption and delayed parturition caused by PER, and
      delayed parturition/dystocia associated with triadimefon) have not been
      previously reported, the results are generally consistent with previous reports
      and highlight the importance and relative ease of incorporation of developmental
      evaluations into a multidisciplinary screening battery.

PMID- 7783252
TI  - A multidisciplinary approach to toxicological screening: III. Neurobehavioral
      toxicity.
AB  - The neurobehavioral effects of 10 known toxicants were examined as part of a
      multidisciplinary screening battery. The toxicants included carbaryl (CAR),
      triadimefon (TDM), heptachlor (HEP), chlordane (CDN), diethylhexyl phthalate
      (DEHP), carbon tetrachloride (CCl4), phenol, trichloroethylene (TCE),
      tetrachloroethylene (PER or perchlorethylene), and dichloromethane (DCM or
      methylene chloride). A functional observational battery and motor activity
      measurements were conducted before exposure, at specified times after an acute
      exposure, and during and after 14-d exposure. Severity scoring analysis was used
      to generate profiles of effect. The pesticides, CAR, TDM, HEP, and CDN, displayed
      the most acute neurotoxicity and were active at lower proportions of their
      respective acute LD50 values than were the solvents or the industrial chemicals.
      Although CAR and TDM showed little or no neurobehavioral effects with repeated
      dosing, cumulative neurotoxicity and lethality were evident with HEP and CDN.
      Phenol produced acute convulsive effects, and the most prominent finding with
      repeated exposure was lethality. DEHP displayed no neurobehavioral toxicity. The
      organic solvents, TCE, PER, CCl4, and DCM, produced various degrees of general
      nervous system depression following acute administration of high dose levels.
      Repeated dosing produced little or no effect with TCE or PER, marked
      physiological changes with CCl4, and cumulative toxicity and lethality with DCM.
      Some results of these studies were unexpected and should provide impetus for
      further research. Overall, these findings illustrate the utility of these
      screening methods.

PMID- 7783253
TI  - A multidisciplinary approach to toxicological screening: IV. Comparison of
      results.
AB  - Toxicity data collected under standardized test conditions may be of the utmost
      importance in health risk assessment, in which human exposure limits are often
      derived from laboratory experiments. A standardized approach to data collection
      is also important for evaluating the sensitivity and specificity of test methods
      used to determine toxic potential. Several experiments were undertaken to
      determine the effects of chemical exposures using a multidisciplinary screening
      battery, which included tests for systemic, neurological and developmental
      toxicity. The effects of 1- and 14-d exposures to 10 chemicals on systemic and
      neurological indices of toxicity were determined in female F344 rats using
      standardized test batteries. Parallel experiments determined chemical effects on
      prenatal and postnatal development following exposure of the dams for 14 d. The
      chemicals included four pesticides (carbaryl, triadimefon, chlordane, and
      heptachlor), four solvents (trichloroethylene, tetrachloroethylene, carbon
      tetrachloride, and dichloromethane), and two industrial compounds (phenol and
      diethylhexyl phthalate). The results showed that the chemicals produced markedly
      different qualitative patterns of effect on systemic, neurological, and
      developmental indices of toxicity. Differences in the pattern of systemic and
      neurological effects were also obtained that depended on dosing duration.
      Quantitative analyses indicated that the highest ineffective dose as well as the
      lowest effective dose could vary by as much as two orders of magnitude across the
      different indices of toxicity. These results clearly show that a test battery
      focused on a single endpoint of toxicity cannot be used to accurately predict
      either qualitatively or quantitatively a chemical's systemic, neurological, and
      developmental toxicity profile.

PMID- 7783254
TI  - Neurobehavioral and physiologic effects of trifluoromethane in humans.
AB  - Nuclear magnetic resonance (NMR) imaging shows promise in the measurement of
      human cerebral blood flow (CBF) in that nonradioactive indicators may be used.
      Our earlier investigations with trifluoromethane (FC-23) gas have shown that this
      compound can be used to safely and effectively measure CBF in anesthetized animal
      models. In this Phase I dose-escalation study we set out to determine the maximal
      tolerated concentration (MTC) of FC-23 in normal healthy male volunteers and to
      assess its feasibility as an NMR indicator. Five subjects were exposed in a
      blinded fashion to escalating concentrations of FC-23 between 10% and 60%,
      randomly interleaved with exposures to both room air and 40% nitrous oxide. On
      each study day, the subjects breathed the test gas for eight pulses of 3 min each
      with 2-min clearance periods between the pulses. The subjects underwent intensive
      physiologic and neurobehavioral monitoring throughout the study period. The first
      subject experienced an anesthetic response to 60% FC-23, and the second subject
      experienced "discomfort" and requested discontinuation at the initiation of 40%
      FC-23. The MTC was subsequently determined to be 30% FC-23 (all subjects
      tolerated the gas), although a small (37.6 vs. 40.5) but statistically
      significant retention of carbon dioxide was found (p = .003). When one subject
      received 30% FC-23 during an NMR imaging study, a pronounced anesthetic effect
      with intolerable hyperacusis was demonstrated. Human studies of FC-23 have been
      discontinued in our laboratory.

PMID- 7783255
TI  - Effect of radiofrequency catheter ablation on calcium channel of ventricular
      myocytes.
AB  - Using whole-cell patch-clamp technique, the effect of radiofrequency catheter
      ablation (RFCA) on calcium current (Ica) of guinea pig ventricular myocytes was
      examined. The radiofrequency energy delivered was 20 W x 10 s. RF-CA decreased
      Ica apparently with the affected area reaching up to 1.2 cm from the ablation
      focus. In the meanwhile, the pathological lesion size resulted from RFCA was
      merely 0.41 +/- 0.11 cm. These findings indicate that RFCA, apart from causing
      tissue necrosis by heat, can affect myocyte membrane currents in a large area.
      This may explain why RFCA has a very high success rate with a small pathological
      lesion.

PMID- 7783256
TI  - Study on three dimensional reconstruction of transesophageal echocardiographic
      images.
AB  - Using biplane transesophageal echocardiography and the concept of three
      dimensional transthoracic echocardiography, we performed three dimensional
      reconstruction of transesophageal images of various clinicopathologic cases,
      including atrial septal defect, mitral stenosis, mitral valve prolapse and
      pulmonary stenosis. The hardware equipment and image processing flow chart of
      three dimensional reconstruction of transesophageal echocardiographic images are
      described. Our present study indicates that three dimensional reconstruction of
      transesophageal echocardiographic images could display multi-regional three
      dimensional structures of heart and great vessels, including superior vena cava,
      ascending aorta, right ventricular outflow tract, pulmonary artery and left
      heart, with clear, visual and stereoscopic imaging. The regional structures could
      be displayed at different levels of stereo-anatomic-sections and in different
      orientations of rotating stereo-images, which could provide accurate three
      dimensional anatomical information for cardiac stereo-morphological study and
      definition of spatial location and size of cardiac abnormalities.

PMID- 7783257
TI  - Role of the pericytes of intra-acinar pulmonary artery in the structural
      remodeling of pulmonary vessels.
AB  - Whether or not the pericytes exist in the intra-acinar pulmonary arteries and
      their normal structure and morphological changes during development of the
      structural remodeling of pulmonary vessels were observed using a pulmonary
      hypertension model in rats induced by monocrotaline injection. The results showed
      that the pericytes in the peripheral pulmonary vessels proliferated and
      transformed into smooth muscle cells during development of pulmonary
      hypertension, and at the same time, the pericytes could synthesize and secrete
      extracellular matrix including collagen, suggesting that the pericytes play an
      important role in the development of pulmonary hypertension and structural
      remodeling of the pulmonary vessels.

PMID- 7783258
TI  - [Neuron-specific enolase: a serum marker of clinical progression for metastatic
      malignant melanoma].

PMID- 7783260
TI  - Observations on therapeutic effects of huangdan decoction and Tripterygium
      Wilfordii compound tablet on membranous glomerulonephritis in rats.
AB  - The model of membranous glomerulonephritis (MGN) in rats was successfully
      established using self-made cationic bovine serum albumin (C-BSA) and treated
      with Huangdan Decoction (HDD) and Tripterygium Wilfordii Co. tablet (TW). Results
      indicated that the levels of urinary protein, blood urea nitrogen (BUN) and serum
      creatinine (Scr) in treated groups (groups A, B and C) were significantly
      decreased as compared with the control group (group D) (P < 0.01). By light and
      electron microscope and immunofluorescent technique, the damage to kidney in
      groups A, B and C was found much milder than that in group D with lesion in group
      A being slightest. These findings suggest that HDD and TW may alleviate the
      pathological lesions of MGN, prevent or retard its progression, and have
      remarkable therapeutic effects on MGN.

PMID- 7783259
TI  - Effects of 3,4-dihydroxyacetophenone (3,4-DHAP) on hypoxic pulmonary and systemic
      vascular response in dogs.
AB  - The effects of 3,4-DHAP on hypoxic pulmonary and systemic vascular responses were
      studied in anaesthetized dogs. The percentage change in pulmonary vascular
      resistance (delta PVR %) and that in systemic vascular resistance (delta SVR %)
      induced by 5 min hypoxia decreased significantly. 3,4-DHAP in doses of 1 mg/kg, 3
      mg/kg, and 10 mg/kg i.v. caused a decrease in delta PVR% from the control value
      of 47.27 +/- 22.27% to 24.62 +/- 21.76%, 18.15 +/- 18.73%, and 24.10 +/- 19.76%
      respectively, and a decrease in delta SVR % from the control value of 12.91 +/-
      7.39 % to -0.34 +/- 12.70%, -2.11 +/- 12.76%, and -2.37 +/- 15.52 % respectively.
      The results showed that 3,4-DHAP could decrease the hypoxic responses of
      pulmonary and systemic blood vessels. But it did not change delta PVR % or delta
      SVR % in dose of 30 mg/kg, neither did it influence the heart rate, cardiac
      output or cerebral blood flow during hypoxia in all the doses used.

PMID- 7783261
TI  - Effect of huoxuequyu recipe on erythrocyte membrane Ca(2+)-ATPase activity in
      pregnant rats with asymmetrical intrauterine growth retardation induced by
      passive smoking.
AB  - The effect of Huoxuequyu recipe on erythrocyte membrane Ca(2+)-ATPase activity in
      pregnant rats with passive smoking induced asymmetrical intrauterine growth
      retardation (IUGR) was observed. The rats were divided into three groups: control
      group, model group and treated group. The fetal mean birth weight and erythrocyte
      membrane Ca(2+)-ATPase activity were found to be decreased in the model group as
      compared with the control and treated groups. There was a significant difference
      between the model group and the control group (P < 0.01), while no significant
      difference existed between the treated group and the control group (P > 0.05).
      Furthermore, the findings indicated that the erythrocyte membrane Ca(2+)-ATPase
      activity seem to be positively correlated with the birth weight (P < 0.05). On
      the basis of our observation, it is believed that the Huoxuequyu decoction could
      increase erythrocyte membrane Ca(2+)-ATPase activity and promote blood
      circulation, thereby exerting a beneficial effect on fetal development.

PMID- 7783262
TI  - Experimental study of corneal innervation in diabetic mellitus.
AB  - The morphology of corneal innervation was studied in rabbits with alloxan-induced
      diabetes. The experimental rabbits were killed after 6, 8, 10, 12 weeks. Corneal
      innervation was studied by histochemical techniques and transmission electron
      microscopy. The results revealed that in diabetic rabbits, from 6 weeks, the
      density of nerve-nets was markedly sparser, the fibers were thinner and the
      activity of nerves was lower than those of the control group. Ultrastructural
      changes showed swelling of axons, irregular distribution of fibril and
      degeneration of mitochondria of varying degree. With the progress of disease the
      above changes were becoming more marked gradually. It may be assumed that these
      changes are related to hyperglycemia.

PMID- 7783263
TI  - Microcomputer system for automatic identification of the Cryptococcus neoformans
      and its clinical application.
AB  - In this study, microcomputer image processing and pattern recognition technology,
      and the knowledge of morphology and optical characteristics of Cryptococcus
      neoformans were used for identification of Cryptococcus neoformans. Four groups
      of mice were lethally infected with standard strain, Wuhan strain, American B
      2643 strain and Var. Shanghainesis of the Cryptococcus neoformans. The samples
      collected included mice brain, lung, kidney, liver, small intestine tissue and
      were observed under a light microscope. More than 600 images of the fungus were
      input into a microcomputer. A system of computer for automatic identification of
      the Cryptococcus neoformans was developed. The technique involved image
      preprocessing, image segmenting, coding of line-length on the edge, curve
      fitting, extracting of image feature, building of image library and feature data
      bank etc.. And then, 768 images of the clinical samples and other fungus samples
      whose morphological features tend to be confused with Cryptococcus neoformans
      were input into microcomputer and subjected to automatic identification. The
      Cryptococcus neoformans was accurately identified within 15 min, and the
      consistency rate with results of routine culture was 98%.

PMID- 7783264
TI  - [Experimental studies of embolization of different hepatotropic blood vessels
      using Bletilla striata in dogs].
AB  - Bletilla striata and gelfoam were used as embolizing agents for the embolization
      of various hepatotropic vessels in dogs. The results proved that Bletilla striata
      was superior to gelfoam. The mechanisms of embolization by Bletilla striata are
      attributable to following factors: non--absobent property, mechanical
      obstruction; effects on coagulative and anticoagulative systems and secondary
      obstruction resulted from the injury to wall of blood vessels.

PMID- 7783265
TI  - A new model of experimental cerebral infarction in New Zealand white rabbits.
AB  - To develop an easy, reproducible experimental model of cerebral infarction (CI)
      without craniotomy in New Zealand white rabbits, a silicone rubber cylinder
      embedded in a nylon suture was delivered to the middle cerebral arteries through
      the internal carotid artery in anesthetized animals. Rabbits were sacrificed 0.5
      5 h after embolization. CI size and location were ascertained by the triphenyl-2H
      tetrazolium chloride (TTC) staining method; cerebral blood flow (CBF) was
      measured prior to and after embolization. PCO2, temperature and blood pressure
      were monitored and kept constant. CI occurred in all rabbits after 4 h of
      ischemia, in 50% after 3 h and only in 33% after 2.5 h. CI did not occur within
      less than 2.5 h of ischemia. No correlation was found between size and location
      of CI and occlusion time. CBF was maximally reduced in the right MCA territory
      but was also reduced in both anterior cerebral arteries and left MCA territories.
      This model is technically easy and the retrievable embolus allows the study of
      reperfusion by pulling on the nylon suture. It is suitable for studying chemical
      and molecular changes of the ischemic cells and/or for studying neuroimage
      changes after ischemic stroke.

PMID- 7783266
TI  - Studies on the role of sodium/hydrogen exchange system in myocardial ischemia
      reperfusion injury.
AB  - This study aimed at the exploration of the relationship between Na(+)-H+ exchange
      system and myocardial ischemia-reperfusion injury (MRI) in an attempt to provide
      a theoretic basis for the prevention and treatment of MRI. We used the isolated
      working guinea pig hearts as the experimental model to mimick cardiopulmonary
      bypass, which included 120 min hypothermic ischemic cardioplegic arrest followed
      by 60 min normothermic reperfusion. The hearts were divided into 2 groups: the
      control group receiving St. Thomas' Hospital Solution (STS) and the treated group
      receiving STS + amiloride, a Na(+)-H+ exchange blocker. The results showed that
      during reperfusion, [Na+]i and [Ca2+]i overloads, poor recovery of cardiac
      function, increases in CPK release and OFR generation, reduction of ATP content
      and serious damage of ultrastructure were seen in group 1; whereas there were no
      [Na+]i and [Ca2+]i overloads and better recovery of cardiac function accompanied
      by improved results of biochemical assay and less damage of ultrastructure was
      found in group 2. Our study indicates that amiloride can inhibit Na(+)-H+
      exchange system in cardiac cells during early reperfusion period, which prevents
      [Na+]i overload produced by Na(+)-H+ exchange, and stops Na(+)-Ca2+ exchange
      activated by high level of [Na+]i, thus attenuating [Ca2+]i overload caused by
      Na(+)-Ca2+ exchange and myocardial injury. Therefore, we conclude that Na(+)-H+
      exchange blocker, amiloride, can exert significant protective effects on MRI and
      its use may prove to be a new clinical approach to prevention and cure of MRI.

PMID- 7783267
TI  - Portal vein embolization with lipiodol for treatment of HCC--an experimental
      study.
AB  - A suspension of iodized oil and anticancer agent was injected into the portal
      veins of 20 rats with hepatic carcinoma. Oil drops were seen in tumor cell lines,
      small blood vessels inside the cancer nest, the sinusoid, and the central veins.
      After injection of oil suspension through the portal vein the distal small
      vessels were embolized and necrotic changes of tumor cells and their subordinate
      normal liver cells were observed. The results obtained in this experiment
      provided a good anatomical and pathological basis for treating liver cancers with
      the portal vein embolization with chemotherapeutic agents.

PMID- 7783268
TI  - [An epidemiological study on the relationship between musculoskeletal disorders
      and work load].
AB  - 965 workers engaged in working tasks of work intensity grade 2, 3, 4 (based on
      Chinese National Standard) were investigated on the musculoskeletal disorders
      with a questionnaire. The lumbar vertebra of 136 randomly chosen workers were
      also radiologically examined. The result revealed that the prevalence of low-back
      disorders was 51.2% on average and it was obviously correlated with such factors
      as age, standing, previous back injury, education level, sport activity, work
      intensity, working posture, satisfaction with the tools as well as work condition
      and house work. Heavy work load and unneutral working posture were proved to be
      the main factors as revealed by the multifactor analysis and further supported by
      the findings of X-ray examination.

PMID- 7783269
TI  - A common-source outbreak of shigellosis involving a piped public water supply in
      northern Thai communities.
AB  - We report an epidemiological investigation of an explosive common-source water
      borne shigellosis outbreak traced to a piped public water system in northern Thai
      communities. In August 1991, 242 cases of acute diarrhoeal illness occurred in
      Sam Ngao Subdistrict, Tak Province. About 30% of the cases were culture-positive
      for multiresistant Shigella flexneri 2a. The outbreak affected all age groups,
      with the highest attack rate (9.4%) in children < 5 years old. The first ten
      cases occurred during 1 and 5 August 1991 and a subsequent 158 cases (65.3%)
      clustered between 6 and 10 August 1991. Most cases (93.0%) occurred in the
      villages sharing the common piped water system A. The inhabitants who were served
      by system A had a significantly (P < 0.01) higher attack rate of infection (7.0%)
      than those who used the other piped public water system B (0.1%) or well water
      (0.3%). A case-control study revealed a significant association between disease
      and drinking unboiled piped water (P < 0.05, odds ratio 2.8). The implication of
      piped water was supported by the presence of faecal contamination in the piped
      water system, the result of interrupted chlorination. Rapid identification of the
      possible transmission source and prompt implementation of control measures
      curtailed the spread of this outbreak.

PMID- 7783270
TI  - Application of dot-immunogold-silver staining in the diagnosis of clonorchiasis.
AB  - All 35 confirmed clonorchiasis cases showed a positive reaction in dot-immunogold
      silver staining (Dot-IGSS) with a mean serum titre of 1:1656, while none of the
      sera from 35 normal individuals reacted. A seroepidemiological survey of middle
      school students revealed a positive rate of 17.0% (142/836), and 76.1% (105/138)
      of the serologically positive students were egg positive in stool examination.
      The egg positive rates in those with antibody at levels of 1+ to 4+ were 57.1%
      (28/49), 75.7% (28/37), 94.7% (36/38) and 92.9% (13/14) respectively. It is
      believed that Dot-IGSS can be used for the clinical diagnosis and epidemiological
      survey of clonorchiasis.

PMID- 7783271
TI  - A study of neonatal deaths at the Ogun State University Teaching Hospital,
      Sagamu, Nigeria.
AB  - A two-year prospective study of neonatal deaths at a Nigerian University Teaching
      Hospital is presented. There were 55 deaths among 1081 inborn live deliveries
      (50.88/1000). Low birthweight babies accounted for 60% of deaths. There were 49
      (45.33/1000) perinatal deaths, 61% of which occurred within 24 hours. The
      mortality rate of term small-for-gestational age neonates was higher than that of
      their appropriate-for-gestational age counterparts (chi 2 = 4.55, P < 0.05). The
      mortality rate for 315 referred admissions was 400/1000. Referred very low
      birthweight babies had a better outcome than inborn ones. Severe infections,
      severe birth asphyxia, respiratory distress syndrome and recurrent apnoea were
      among the leading causes of death in this study. There is a need for improved
      intensive care facilities for the high-risk newborn. Greater effort is required
      to improve early utilization of available maternity services.

PMID- 7783272
TI  - Prevalence and presentation of hepatitis C related chronic liver disease in
      southern India.
AB  - To determine the importance of hepatitis C virus (HCV) infection in the aetiology
      of chronic liver disease in southern India, the prevalence of HCV antibodies and
      HBV markers was estimated in 100 patients with chronic liver disease and in 56
      patients with a variety of other gastrointestinal and liver diseases who served
      as controls. HCV antibody was measured by a second-generation ELISA. HBsAg, anti
      HBc, anti-HBs and anti-D were also estimated. HCV antibodies were detected in
      26/100 patients with chronic liver disease compared to 0/56 controls. HBV markers
      were present in 72 of 100 patients with chronic liver disease compared to 21/56
      (37.5%) controls. Anti-D was noted in 4/100 patients with chronic liver disease
      and in none of the controls. Many patients had serological evidence of both B and
      C infection; 73% of those with anti-HCV also tested positive for HBV markers. HCV
      related disease presented at a median age of 60 years compared to HBV related
      disease which presented at a median age of 40. There was no significant
      difference between HCV and HBV positive patients in symptomatology, but
      encephalopathy was uncommon and cirrhosis the usual finding at histology in HCV
      positive individuals, while chronic active hepatitis was found in 30% of biopsied
      HBV related disease. HCV is a significant cause of chronic liver disease in this
      geographic region, although HBV infection continues to account for the largest
      proportion of cases.

PMID- 7783273
TI  - Platelet function studies in Indian kala-azar.
AB  - Platelet function studies were conducted on 25 parasitologically positive cases
      of Indian kala-azar and 25 age and sex matched healthy controls. Ninety-two per
      cent of patients had thrombocytopenia of variable degree; in 44% of patients,
      platelets were less than 60,000 mm-3. The platelet adhesive index was less than
      30% in 70% of patients with kala-azar (normal 31-60%). Platelet aggregation time
      with ADP and adrenaline was abnormally prolonged compared to the controls.
      Platelet factor III availability was poor in 40% of cases. There was a fair
      degree of correlation between platelet adhesiveness and platelet factor III
      availability in these patients: 50% of patients with poor platelet adhesiveness
      showed reduced platelet factor III availability.

PMID- 7783274
TI  - Use of fundal height as a proxy for length of gestation in rural Africa.
AB  - Lack of information on the date of the last menstrual period is a common problem
      in antenatal care in developing countries. The aim of this study was to see
      whether the fundal height can be used as a proxy for the length of gestation. A
      graph representing the expected remaining time to delivery was constructed from
      fundal height measurements in 7790 pregnant women delivered in a rural African
      hospital from 1970 to 1988. The graph was used to predict the probable week of
      delivery in 604 pregnant women giving birth to a singleton child in 1989. The
      mean deviation of the actual week of delivery from the predicted week was -0.6
      (s.d. 3.4) weeks. In 270/604 cases (45%) delivery occurred within 2 weeks of the
      predicted week. Birthweight and perinatal mortality were strongly related to the
      deviation from the predicted week of delivery. The majority of perinatal deaths
      (34/50, 68%) occurred in children delivered early. The fundal height, as measured
      by paramedicals in routine antenatal care in rural Africa, may be used as a proxy
      for the length of gestation when the date of the last menstrual period is not
      known.

PMID- 7783275
TI  - Coxiella burnetii antibody prevalences among human populations in north-east
      Africa determined by enzyme immunoassay.
AB  - Retrospective serosurveys were conducted to determine the prevalence of antibody
      to phase-I Coxiella burnetii among humans in various locations of north-east
      Africa. Sera were tested by the enzyme immunoassay (EIA). Initially the EIA was
      compared with the standard indirect fluorescent antibody (IFA) method for the
      detection of antibody to C. burnetii. Results indicated that the EIA was slightly
      less sensitive (88%), but highly specific (94%) and less subjective than the IFA
      technique. EIA was subsequently adopted for estimating prevalences in the studied
      human populations. Data obtained by EIA indicated that the prevalence of C.
      burnetii antibody among adult Egyptian blood donors was 20% (n = 358) in the Suez
      Canal area, 16% (n = 501) in the Nile Valley and 10% (n = 427) in the Nile Delta.
      Among adult patients with acute, undifferentiated fever in Egypt, the prevalence
      was 28% (n = 50) of acute sera, with seroconversion in 12% of convalescent sera.
      Antibody to C. burnetii was detected by EIA in the sera of 25% (n = 71) of cattle
      workers in Egypt, 10% (n = 100) of housewives in Sudan, and 37% (n = 104) of
      adults in north-west Somalia. Following a fever outbreak affecting all ages in
      northern Sudan, IgG antibody to C. burnetii was present in 54% of the febrile
      persons (n = 185) and in 53% of afebrile persons (n = 186). IgM antibody to C.
      burnetii was demonstrated in 29% of the febrile persons and 15% of the afebrile
      persons. These results implicate C. burnetii as a possibly important and under
      reported cause of human disease and undiagnosed fevers in north-east Africa.

PMID- 7783276
TI  - Tetanus: a recurring intensive care problem.
AB  - A fifteen-year retrospective study of 108 cases of tetanus admitted to the
      Intensive Care Unit (ICU) at the University Hospital of the West Indies is
      presented. Males predominated (70%), with peak incidence occurring amongst the
      young and the elderly. In 57% the disease was severe enough to require
      neuromuscular blockade and controlled ventilation. Respiratory complications
      occurred most commonly (80%), predominantly as a result of infection.
      Dysautonomia, exhibited by 55% of patients, presented the greatest difficulty in
      management. Mortality was high (20%), with sudden cardiac arrest being the most
      common cause of death. The average duration of stay in the ICU was long (27
      days). As Jamaica is a Third World country with limited resources, the continued
      occurrence of this preventable disease represents a drain on existing intensive
      care funds. This must be brought to the attention of institutions responsible for
      planning health care programmes for developing countries.

PMID- 7783277
TI  - Epidemiology of human brucellosis in southern Saudi Arabia.
AB  - There have been indications that human brucellosis is widely distributed in Saudi
      Arabia. In order to assess the situation in the south, and as a part of a
      nationwide prevalence survey, a sample of 4900 subjects was randomly selected for
      a house-to-house survey. Investigations included an interview, clinical
      examination and blood sampling for antibody titre determinations. Blood samples
      were first screened for Brucella antibodies by a microplate agglutination test to
      measure the exposed rate. Reactive sera were further analysed by the standard
      tube agglutination and 2-mercaptoethanol tests. A total of 4794 completed the
      study. Results of laboratory tests indicated that a significant proportion of the
      population in the southern region (19.2%) had serological evidence of exposure to
      Brucella antigen, and 2.3% had active disease. Direct contact with domestic
      animals and consumption of raw products of animal origin were identified as the
      main risk factors.

PMID- 7783278
TI  - A chronic cavitary pulmonary histoplasmosis case from Turkey.
AB  - Histoplasmosis, a disease endemic to North America, is caused by Histoplasma
      capsulatum. To the best of our knowledge, the chronic cavitary pulmonary
      histoplasmosis patient described here presents the first case in which the fungus
      was isolated from sputum culture in Turkey.

PMID- 7783279
TI  - Malaria and filariasis transmission in a village/forest setting in Baram
      District, Sarawak, Malaysia.
AB  - Entomological investigations on malaria and bancroftian filariasis transmission
      were carried out in the endemic area of Baram District, Sarawak. The Anopheles
      composition, survival and infection rates of malaria and filariasis were compared
      in the village and 0.5 km from the village ecotype, in forested areas. Anopheles
      leucosphyrus, An. barbirostris and An. donaldi are the vectors for malaria and
      bancroftian filariasis in both ecotypes. Biting and infection rates vary, but An.
      leucosphyrus differed with a peak around midnight in the forested area and soon
      after dusk in the village setting. The parous rate of An. leucosphyrus was
      significantly higher in the forest ecotype (P < 0.0001); however, the proportion
      of 3-parous and older was not overall higher in the forest ecotype (P = 0.68).
      The entomological inoculation of malaria parasites by An. leucosphyrus was
      comparatively higher in the forested areas (P > 0.5). The implications of malaria
      and filariasis transmission in the forested areas in Baram District are
      discussed.

PMID- 7783280
TI  - Urban schistosomiasis in Lusaka, Zambia: a preliminary study.
AB  - A preliminary survey was conducted in Lusaka, Zambia to determine the extent of
      schistosomiasis transmission in the city. Stool and urine samples were collected
      from 240 children from seven schools selected to give a cross-sectional
      representation of the various socio-economic neighbourhoods of the city. In
      addition to the parasitological examination, students were questioned with
      respect to their knowledge of the disease and other epidemiological factors. In
      addition, water bodies near the schools were examined for the presence of snail
      hosts. Results of the survey suggest that schistosomiasis is actively transmitted
      within Greater Lusaka. An overall prevalence of 20.9% for S. haematobium was
      observed, but only one case of S. mansoni was detected. Prevalence rates for S.
      haematobium in individual schools ranged from 7.5 to 37.5%.

PMID- 7783281
TI  - Early childhood survivorship in Vietnam.
AB  - The effects on early childhood mortality of birth order, age of the mother at the
      time of the child's birth, mother's education, as well as infant mortality risk
      in the province, urban/rural residence, the presence of schools and other
      facilities and health care services, were examined using data from the 1988
      Vietnam Demographic and Health Survey and the 1990 Study of Accessibility of
      Contraceptives in Vietnam. A total of 4137 urban and rural children born between
      1983 and 1988 to the 4172 women interviewed in the Demographic and Health Survey
      were included in the hazard model analysis of maternal and child characteristics.
      However, since the Accessibility of Contraceptives Study included only rural
      respondents, the hazard model analysis of community development characteristics
      and health services effects on early childhood mortality was based on a subsample
      of 3314 rural children. Rural children in birth orders five and higher had the
      greatest risk of early childhood death, birth order one an intermediate risk and
      orders 2-4 the lowest risk of early childhood death. Rural children residing in
      communes with fewer than 10,000 inhabitants were at significantly greater risk of
      early childhood death than children from larger communes. Neither age nor
      education of the mother nor gender of the child, had a significant impact on
      early childhood survivorship independent of other variables. Risk of infant
      mortality in the child's province was of borderline significance.

PMID- 7783282
TI  - Alexandre Yersin and the plague bacillus.
AB  - To most doctors, the name Yersin is known only for its eponymous connection with
      the plague bacillus, Yersinia pestis. In Vietnam, where he lived for over 50
      years, Alexandre Yersin is a legendary figure. On the 100th anniversary of the
      identification of the plague bacillus, a review of this extraordinary man and his
      controversial discovery is timely.

PMID- 7783283
TI  - Pathologists request autopsy revival.

PMID- 7783284
TI  - Silver anniversary celebrated for Penn State heart.

PMID- 7783285
TI  - Acellular pertussis vaccine scores high in trial.

PMID- 7783286
TI  - Tougher on tattoos.

PMID- 7783287
TI  - From the Health Care Financing Administration.

PMID- 7783288
TI  - From the Food and Drug Administration.

PMID- 7783289
TI  - From the Centers for Disease Control and Prevention. Reptile-associated
      salmonellosis--selected states, 1994-1995.

PMID- 7783290
TI  - Binge drinking in college.

PMID- 7783291
TI  - Binge drinking in college.

PMID- 7783292
TI  - Heart failure practice guidelines: guidance, not proscription.

PMID- 7783293
TI  - False-positive benzodiazepine urine test due to oxaprozin.

PMID- 7783294
TI  - Medical devices: significant vs non-significant risk.

PMID- 7783295
TI  - Medical devices: significant vs nonsignificant risk.

PMID- 7783296
TI  - Public attitudes toward autopsy, organ donation, and dissection.

PMID- 7783297
TI  - A food-borne outbreak of expensive antibiotic use in a community teaching
      hospital.

PMID- 7783298
TI  - Allele-specific chromosome 3p deletions occur at an early stage in the
      pathogenesis of lung carcinoma.

PMID- 7783299
TI  - Reform of child immunization service delivery in Israel.

PMID- 7783300
TI  - Adolescents' perceptions of factors affecting their decisions to seek health
      care.
AB  - OBJECTIVE: To have adolescents, rather than adults, identify characteristics of
      health care providers and sites that affect their decision to seek care. DESIGN:
      Five stages conducted over a 10-month period: (1) focus groups to frame the study
      questions; (2) nominal group technique to generate student responses; (3) three
      surveys to assess response importance; (4) one survey to link the most important
      responses with the decision to seek care; and (5) focus groups to explain the
      variables associated with the decision to seek care. SETTING: The Philadelphia
      (Pa) School District. PARTICIPANTS: The study population consisted of all ninth
      graders from 39 of Philadelphia's 42 public high schools. The 6821 students who
      returned the final survey comprised the study sample (69% of in-school youth).
      RESULTS: In the final survey, students used a Likert scale (1 to 5) to describe
      the impact of 31 ideas on their decision to seek care. The most important
      characteristics were provider hand washing, clean instruments, honesty, respect
      toward teens, cleanliness, know-how, carefulness, experience, seronegativity for
      the human immunodeficiency virus, equal treatment of all patients, and
      confidentiality. There was little variation in the order of the items by sex,
      race, or socioeconomic status. Factor analysis showed that the most important of
      four identified latent factors related to infection control and provider
      competency. CONCLUSION: Four of the top 10 characteristics that affect an
      adolescent's decision to seek care involve cleanliness and infection control.
      These findings offer providers and planners straightforward, modifiable factors
      that teens believe influence their decision to seek care.

PMID- 7783301
TI  - The role of coronary angiography and coronary revascularization before noncardiac
      vascular surgery.
AB  - OBJECTIVE: To determine whether preoperative coronary angiography and
      revascularization improve short-term outcomes in patients undergoing noncardiac
      vascular surgery. DESIGN: Decision analysis. PATIENTS: Patients undergoing
      elective vascular surgery who had either no angina or mild angina and a positive
      dipyridamole-thallium scan result. INTERVENTIONS: Three strategies were compared.
      The first strategy was to proceed directly to vascular surgery. The second was to
      perform coronary angiography, followed by selective coronary revascularization,
      before proceeding to vascular surgery and to cancel vascular surgery in patients
      with severe inoperable coronary artery disease (CAD). The third was to perform
      coronary angiography, followed by selective coronary revascularization, before
      proceeding to vascular surgery and to perform vascular surgery in patients with
      inoperable CAD. MAIN OUTCOME MEASURES: Mortality, nonfatal myocardial infarction,
      stroke, uncorrected vascular disease, and cost. All outcomes were assessed within
      3 months. RESULTS: Proceeding directly to vascular surgery led to lower morbidity
      and cost in the base case analysis. The coronary angiography strategy led to
      higher mortality if vascular surgery would proceed in patients with inoperable
      CAD, but led to slightly lower mortality if vascular surgery were canceled in
      patients with inoperable CAD. The coronary angiography strategy also led to lower
      mortality when vascular surgery was particularly risky. CONCLUSIONS: Decision
      analysis indicates vascular surgery without preoperative coronary angiography
      generally leads to better outcomes. Preoperative coronary angiography should be
      reserved for patients whose estimated mortality from vascular surgery is
      substantially higher than average.

PMID- 7783302
TI  - Serum total cholesterol and mortality. Confounding factors and risk modification
      in Japanese-American men.
AB  - OBJECTIVE: To further investigate the relationship between serum total
      cholesterol (TC) level and mortality due to major causes. In particular, is the
      elevated mortality among persons with low TC levels due to confounding conditions
      that both lower TC level and increase the risk of mortality, and is the
      association between low or high TC level and mortality homogeneous in the
      population or, alternatively, restricted to persons with other risk factors?
      STUDY DESIGN: Prospective cohort study. SETTING: Free-living population in Oahu,
      Hawaii. PARTICIPANTS: A total of 7049 middle-aged men of Japanese ancestry. MAIN
      OUTCOME MEASURES: Age- and risk factor-adjusted mortality due to coronary heart
      disease, hemorrhagic stroke, cancer, chronic obstructive pulmonary disease,
      nonmalignant liver disease, trauma, miscellaneous and unknown, and all causes.
      RESULTS: During 23 years of follow-up, a total of 1954 deaths were documented
      (38% cancer, 25% cardiovascular, and 37% other). Men with low serum TC levels (<
      4.66 mmol/L [< 180 mg/dL]) were found to have several adverse health
      characteristics, including a higher prevalence of current smoking, heavy
      drinking, and certain gastrointestinal conditions. In an age-adjusted model, and
      in relation to the reference group (4.66 to 6.19 mmol/L [180 to 239 mg/dL]),
      those in the lowest TC group (< 4.66 mmol/L [< 180 mg/dL]) were at significantly
      higher risk of mortality due to hemorrhagic stroke (relative risk [RR], 2.41; 95%
      confidence interval [Cl], 1.45 to 4.00), cancer (RR, 1.41; 95% Cl, 1.17 to 1.69),
      and all causes (RR, 1.23; 95% Cl, 1.09 to 1.38). Adjustment for confounders in
      multivariate analysis (and exclusion of cases with prevalent disease at baseline
      and deaths through year 5) did not explain the risk of fatal hemorrhagic stroke
      but reduced the excess risk of cancer mortality by 51% (to 1.20 from 1.41) and
      reduced the excess risk of all-cause mortality by 56% (to 1.10 from 1.32) in the
      low TC group. In addition, there were clear differences in the patterns of risk
      when comparing men with and without selected risk factors (ie, smoking, alcohol
      consumption, and untreated hypertension). CONCLUSIONS: We conclude that the
      excess mortality at low TC levels can be partially explained by confounding with
      other determinants of death and by preexisting disease at baseline, and TC
      mortality associations are not homogeneous in the population. In our study, TC
      level was not associated with increased cancer or all-cause mortality in the
      absence of smoking, high alcohol consumption, and hypertension.

PMID- 7783303
TI  - T-helper 1-type immunity to trophoblast in women with recurrent spontaneous
      abortion.
AB  - OBJECTIVE: To test the hypothesis that peripheral blood mononuclear cells in
      women with unexplained recurrent abortion (URA) produce T-helper 1 (TH1)-type
      cytokines in response to trophoblast antigens. DESIGN: Cohort study. SETTING:
      Medical center. PARTICIPANTS: A total of 244 women with URA, 13 reproductively
      normal parous control women, and 10 men. MAIN OUTCOME MEASURES: Supernatants from
      trophoblast-activated peripheral blood mononuclear cells from all participants
      were tested for toxic effects on mouse embryos and by enzyme-linked immunosorbent
      assay (ELISA) for interferon gamma (IFN-gamma). Supernatants from 20 URA patients
      with embryotoxic activity and IFN-gamma, 13 reproductively normal parous women,
      and 10 men were further tested by ELISA for other TH1-type cytokines (interleukin
      2 [IL-2], tumor necrosis factor-beta [TNF-beta]), TH2-type cytokines (IL-4, IL
      10), and TNF-alpha. RESULTS: Embryotoxic activity was detected in supernatants
      from 160 of 244 URA patients and in none of the controls. Interferon gamma was
      detected in supernatants from 125 of 244 URA patients and was significantly
      associated with embryotoxicity (121 of 160 supernatants with embryotoxicity vs
      four of 84 supernatants without embryotoxicity [P < .001]). Of 20 supernatants
      from patients chosen for further study, all were positive for TNF-alpha, 17 for
      TNF-beta, two for IL-10, and one for IL-4. No cytokines were detected in
      supernatants from unstimulated or red blood cell membrane-activated cells of
      women with URA. In contrast, trophoblast-activated lymphocyte supernatants from
      reproductively normal women and men neither were embryotoxic nor contained TH1
      type cytokines, but most contained the TH2-type cytokine IL-10. Three
      supernatants from reproductively normal women also contained IL-4. CONCLUSION:
      Whereas TH1-type immunity to trophoblast is associated with URA and may play a
      role in reproductive failure, TH2-type immunity may be a natural response to
      trophoblast contributing to successful pregnancy.

PMID- 7783304
TI  - The independent practice association in theory and practice. Lessons from
      experience.
AB  - This article examines an advanced managed care area, the San Francisco East Bay
      Area in California, for basic organizational issues posed by managed care for the
      medical profession. Of the three basic structures found, the independent practice
      association (IPA) model is theoretically most promising. Unlike the integrated
      health plan, the IPA seeks to retain traditional practice autonomy. Unlike the
      isolating direct gatekeeper model, the IPA assembles physicians in self-directed
      groups to invent and implement solutions and to exert political influence upward.
      In practice, however, it has proved difficult to balance practice autonomy with
      IPA authority. Both large, successful East Bay Area IPAs show signs (perhaps
      inevitably) of favoring authority over autonomy, as shown by their policies on
      governance, membership, and administration. Several policies are suggested to
      help redress this balance. Medical leaders must act now, before all the evidence
      is in, or the institutions of the past--hospitals and insurance companies--will
      control our future.

PMID- 7783305
TI  - Automated telephone screening survey for depression.
AB  - OBJECTIVE: To test the application of fully automated telephone screening using
      computerized digital voice recordings and touch-tone responses to assess symptoms
      of depression. DESIGN: A cross-sectional study of a 2-week-long telephone survey.
      SETTING: Toll-free telephone calls placed from home, work, or school to a central
      telephone/computer system at a telecommunications company in the Boston, Mass,
      area. PARTICIPANTS: A total of 1812 participants called the system. Of these, 278
      were students and faculty at a large midwestern state university, 725 were
      employees of a large northeastern high-technology firm, and 809 did not identify
      which site they were calling from. MAIN OUTCOME MEASURES: The 20-question
      multiple-choice Zung Depression Scale was used to screen for depressive symptoms,
      and additional questions gathered demographic and caller satisfaction
      information. RESULTS: No technical problems were encountered during the trial. Of
      1812 callers, 1597 (88.1%) completed all questions. Of these, 412 callers (25.8%)
      met criteria for "moderate or marked" depression and another 194 (12.1%) met
      criteria for "severe or extreme" depression. The majority of callers scoring
      positive for depression had received no previous treatment for depression. Of
      callers who completed the screening questionnaire, 74.6% reported the call to
      have been at least "moderately" helpful. CONCLUSION: Readily available low-cost
      technology provides a fully automated, widely accessible, and confidential method
      of screening for a common mental illness.

PMID- 7783307
TI  - NIH consensus conference: Total hip replacement. NIH Consensus Development Panel
      on Total Hip Replacement.
AB  - OBJECTIVE: To provide physicians with a current consensus on total hip
      replacement. PARTICIPANTS: A nonfederal, nonadvocate, 13-member consensus panel
      representing the fields of orthopedic surgery, rehabilitation and physical
      medicine, biomechanics and biomaterials, internal medicine, public health,
      geriatrics, biostatistics, and a public representative. In addition, 27 experts
      in orthopedic surgery, rehabilitation and physical medicine, biomechanics and
      biomaterials, rheumatology, geriatrics, and epidemiology presented data to the
      consensus panel and a conference audience of 425. EVIDENCE: The literature was
      searched through MEDLINE and an extensive bibliography of references was provided
      to the panel and the conference audience. Experts prepared abstracts with
      relevant citations from the literature. Scientific evidence was given precedence
      over clinical anecdotal experience. CONSENSUS: The panel, answering predefined
      consensus questions, developed their conclusions based on the scientific evidence
      presented in open forum and the scientific literature. CONSENSUS STATEMENT: The
      panel composed a draft statement that was read in its entirety and circulated to
      the experts and the audience for comment. Thereafter, the panel resolved
      conflicting recommendations and released a revised statement at the end of the
      conference. The panel finalized the revisions within a few weeks after the
      conference. CONCLUSIONS: Total hip replacement is an option for nearly all
      patients with diseases of the hip that cause chronic discomfort and significant
      functional impairment. Most patients have an excellent prognosis for long-term
      improvement in symptoms and physical function. At this time, a cemented femoral
      component using modern cementing techniques, paired with a porous-coated
      acetabular component, can give excellent long-term results. Revision of a total
      hip replacement is indicated when mechanical failure occurs. Continued periodic
      follow-up is necessary to identify early evidence of impending failure so as to
      permit remedial action before a catastrophic event.

PMID- 7783306
TI  - Myocardial injury in critically ill patients. A frequently unrecognized
      complication.
AB  - OBJECTIVE: To determine the incidence and effect of unrecognized cardiac injury
      in critically ill patients. DESIGN: Prospective, blinded, single-center study.
      SETTING: The medical and respiratory intensive care unit of an academic health
      center. PATIENTS: Two hundred nine patients (224 admissions). MAIN OUTCOME
      MEASURES: Daily measurement of levels of cardiac troponin I, a sensitive, highly
      specific, and long-lived marker of myocardial injury. Concurrently, signs and
      symptoms potentially related to myocardial ischemia were tabulated by blinded
      investigators. All clinical evaluation and management decisions were made by the
      physicians responsible for the care of the patient. RESULTS: Thirty-two (15%) of
      the 209 patients had evidence of myocardial damage based on elevated levels of
      cardiac troponin I. Only 12 (37%) of these 32 patients were diagnosed as having
      acute myocardial infarction by the intensive care unit staff. Cardiac damage was
      unrecognized in the other 20 (63%). Unrecognized cardiac injury was more common
      in young patients and in blacks. Mortality in patients with myocardial injury
      that was recognized (42%) or unrecognized (40%) was higher than in those without
      myocardial injury (15%) (P < .001). Patients with cardiac injury were more
      frequently hypotensive (75% vs 50%; P = .007) and in need of mechanical
      ventilation (66% vs 27%; P < .001) and had longer intensive care unit stays (5.3
      vs 3.1 days; P < .007) than patients without cardiac injury. CONCLUSION: The
      incidence of myocardial injury defined by elevated levels of cardiac troponin I
      was unexpectedly high and associated with increased morbidity and mortality.
      Clinically, it was often unrecognized.

PMID- 7783308
TI  - The adolescent viewpoint. Implications for access and prevention.

PMID- 7783309
TI  - Recurrent pregnancy loss and cytokines. Not as simple as it seems.

PMID- 7783310
TI  - Exercise and hypertension.

PMID- 7783311
TI  - A piece of my mind. Teen sex blues.

PMID- 7783312
TI  - [Tosufloxacin].

PMID- 7783313
TI  - [A comparative study of tazobactam/piperacillin and piperacillin in bacterial
      pneumonia].
AB  - The efficacy, safety and usefulness of tazobactam/piperacillin (TAZ/PIPC), in
      bacterial pneumonia and lung abscess were determined with PIPC as the control in
      a multi-institutional comparative study a penicillin antibiotic for injection
      prepared by combining a newly developed beta-lactamase inhibitor, tazobactam
      (TAZ), with a broad spectrum penicillin antibiotic, piperacillin (PIPC), at a
      ratio of 1:4. TAZ/PIPC was intravenously injected at a dose of 2.5 g (titer)
      twice a day, and PIPC at a dose of 2.0 g (titer) twice a day as a rule for 14
      days. The following results were obtained: 1. The efficacy rates for bacterial
      pneumonia and lung abscess were 94% (80/85) in TAZ/PIPC group and 89% (70/79) in
      PIPC group, showing no significant difference between the two groups. 2. In a
      comparison of degrees of improvement in clinical symptoms, signs and laboratory
      findings, there were no significant differences between the two groups except for
      results on thoracic rales after three days of administration. 3. As for
      bacteriological effects, the elimination rates of causative organisms were 98%
      (40/41) in the TAZ/PIPC group and 80% (28/35) in the PIPC group. Thus, the
      TAZ/PIPC group was significantly superior to the PIPC group. The TAZ/PIPC group
      showed significantly better eradication of bacteria as well. Bacteria considered
      to be pyogenic were detected in 80 patients (43 administered TAZ/PIPC and 37
      administered PIPC), but beta-lactamase production was confirmed in only 11
      patients of each group. There were no significant differences in bacteriological
      effects among these patients. Minimum inhibitory concentrations of TAZ/PIPC
      against beta-lactamase producing organisms were distinctly superior to those of
      PIPC. 4. Side effects occurred in 10% (10/96) of the TAZ/PIPC group and 7% (7/95)
      of the PIPC group. Abnormal clinical laboratory test values were observed in 22%
      (20/92) of the TAZ/PIPC group and 18% (17/93) of the PIPC group. Thus, there were
      no significant differences between the two administration groups. 5. The
      usefulness rate in the TAZ/PIPC group was 87% (75/86) and it was 85% (67/79) in
      the PIPC group, showing no significant difference between them. The results
      suggest that TAZ/PIPC administered at a dose of 2.5 g (titer) twice a day is more
      useful than PIPC administered at a dose of 2.0 g (titer) twice a day in the
      treatment of bacterial pneumonia.

PMID- 7783314
TI  - [A comparative study of tazobactam/piperacillin and piperacillin in chronic
      respiratory tract infections].
AB  - The efficacy, safety and usefulness were evaluated for a combined antibiotic
      tazobactam/piperacillin (TAZ/PIPC) consisting of a new beta-lactamase inhibitor,
      tazobactam (TAZ), and a broad spectrum penicillin antibiotic, piperacillin
      (PIPC), in chronic respiratory tract infections with PIPC as the control in a
      multi-institutional comparative study. The drugs used were a preparation
      containing 0.5 g of TAZ and 2.0 g of PIPC per vial (TAZ/PIPC group) and a
      preparation containing 2.0 g of (PIPC group). The drugs were intravenously
      injected one vial at a time twice a day for 14 days as a rule. The following
      results were obtained: 1. Clinical effect There was no significant difference
      between TAZ/PIPC (86% or 76/88) and PIPC (81% or 69/85). 2. Bacteriological
      effect There was no significant difference between TAZ/PIPC (93% or 42/45) and
      PIPC (88% or 36/41) in terms of bacterial eradication rates. In 34 patients with
      beta-lactamase-producing pyogenic bacteria, there was no significant difference
      between TAZ/PIPC (77% or 10/13) and PIPC (88% or 15/17). 3. Degrees of
      improvement in clinical symptoms, signs and laboratory findings The TAZ/PIPC
      group was likely to show reductions in fever and the amount of sputum soon after
      administration. 4. Side effects Incidences of side effects were 7% (7/96) in the
      TAZ/PIPC group and 3% (3/89) in the PIPC group, showing no significant difference
      between the two groups. The main symptoms were allergic reaction and
      gastrointestinal symptoms. 5. Abnormal clinical laboratory test values The
      incidence was 17% (15/89) in the TAZ/PIPC group and 21% (18/87) in the PIPC
      group. The main symptoms were eosinophilia and hepatic dysfunction, and most of
      these symptoms were mild. 6. Usefulness The usefulness rates in the TAZ/PIPC
      group were 80% (71/89) and 78% (66/85) in the PIPC group, showing no significant
      difference. Thus, TAZ/PIPC exhibited excellent clinical effects and presented no
      troubles with safety. When comprehensively evaluated, TAZ/PIPC appears to be a
      very useful drug for the treatment of chronic respiratory tract infections.

PMID- 7783315
TI  - [Clinical evaluation of cefpodoxime proxetil, a new oral cephem, in the treatment
      of respiratory tract infections with the special reference to community-acquired
      Streptococcus Pneumoniae infections].
AB  - The clinical usefulness of cefpodoxime proxetil (CPDX-PR) was investigated in the
      treatment of pneumonia and chronic airway infections occurring in patients first
      visiting our outpatient clinic or those being treated at the outpatient clinic.
      CPDX-PR was orally administered twice a day after meals at a dose of 100-200 mg
      for acute respiratory tract infections and at a dose of 200 mg for chronic
      respiratory tract infections. Excellent, good, fair, and poor responses were
      observed in 20, 33, 10, and 3 of 66 patients (4 with acute bronchitis, 27 with
      pneumonia, and 35 with acute exacerbation of chronic airway infection),
      respectively, demonstrating an 80.3% efficacy rate (53/66). Causative organisms,
      including Streptococcus pneumoniae, were all eradicated from the patients whose
      causative organisms were examined over time, although 2 of the patients were
      superinfected with Pseudomonas aeruginosa. There were no serious adverse
      reactions or abnormal changes in laboratory test results. It was concluded that
      CPDX-PR could be used as a first-choice drug for the treatment of respiratory
      tract infections at an outpatient clinic, and that this drug should acquire
      greater importance in particular consideration of recent increases in infections
      with S. pneumoniae.

PMID- 7783316
TI  - [Antimicrobial activities of sulbactam/ampicillin against clinically isolated
      microbial strains].
AB  - Antimicrobial activities were examined for sulbactam/ampicillin (SBT/ABPC)
      against clinically isolated microbial strains in 1987, 1990, 1994. Besides, the
      beta-lactamase productivity and MICs of these strains were measured, and the
      following conclusions were obtained. 1. The ratio of beta-lactamase producing
      strains were 90% of methicillin (DMPPC)-susceptible Staphylococcus aureus subsp.
      aureus (MSSA), about 80% of DMPPC-resistant S. aureus (MRSA), 100% of Escherichia
      coli, Klebsiella pneumoniae subsp. pneumoniae and Proteus mirabilis, 95% of
      Moraxella subgenus Branhamella catarrhalis and 15-20% of Haemophilus influenzae.
      Several kinds of beta-lactamase productivity were observed. 2. Antimicrobial
      activities of SBT/ABPC against beta-lactamase producing strains of MSSA, M. (B.)
      catarrhalis, H. influenzae, and almost all of Enterobacteriaceae were stronger
      than those of ampicillin (ABPC) and piperacillin (PIPC), but antimicrobial
      activities of SBT/ABPC were weak against MRSA and cephems (CEPs)-resistant
      strains detected in some of Enterobacteriaceae. 3. It appeared that
      benzylpenicillin (PCG)-insensitive Streptococcus pneumoniae (PISP) or PCG
      resistant S. pneumoniae (PRSP) and CEPs-resistant Escherichia coli increased year
      by year. 4. Antimicrobial activities of SBT/ABPC were strong against
      Streptococcus pyogenes, S. pneumoniae, M. (B.) catarrhalis and H. influenzae
      including beta-lactamase producing strains. Additionally, beta-lactamase
      inhibiting effect of SBT was observed against beta-lactamase produced by S.
      aureus and K. pneumoniae which demonstrate indirect pathogenicity. Thus, SBT/ABPC
      is an injectable antibiotic that is expected to demonstrate clinical usefulness,
      especially as the first line drug for the respiratory tract infections that are
      community-acquired.

PMID- 7783318
TI  - Synergistic enhancement of in vitro antimicrobial activity of cefmetazole and
      cefazolin, cefotiam, cefamandole or cefoperazone in combination against
      methicillin-sensitive and -resistant Staphylococcus aureus. I. Effect of NaCl.
AB  - The in vitro antimicrobial activity of cephamycin, e.g. cefmetazole and
      cephalosporin, such as cefazolin, cefotiam, cefamandole and cefoperazone, alone
      and in combination, was studied employing 9 strains of methicillin-sensitive
      Staphylococcus aureus (MSSA) and 30 strains of methicillin-resistant
      Staphylococcus aureus (MRSA). Using the checkerboard agar dilution method, strong
      synergism was demonstrable in a majority of MSSA and MRSA strains for cefmetazole
      combined with these cephalosporins, with the minimum fractional inhibitory
      concentration index < or = 0.5. In the presence of a concentration < or = 6.25
      micrograms/ml of these cephalosporins in Mueller-Hinton agar medium, the activity
      of cefmetazole against MRSA was most prominently potentiated by cefotiam,
      followed by cefamandole, cefazolin and cefoperazone. At a concentration of 12.5
      micrograms/ml, cefotiam and cefamandole showed a similar effect in potentiation
      of cefmetazole activity. In hypertonic agar medium containing 4% NaCl, these
      synergistic combination effects were reduced. However, the activity of
      cefmetazole and cefamandole in combination under these conditions was influenced
      to a lesser extent and more potent than that of other combinations.

PMID- 7783317
TI  - [Postantibiotic effects (PAE's) of macrolide antibiotics evaluated using
      Bioscreen C method].
AB  - Postantibiotic effects (PAE's) of macrolide antibiotics were determined for
      Staphylococcus aureus and Enterococcus faecalis using viable counting and
      Bioscreen C method and the two methods were compared. No major differences
      between the two methods were observed. The Bioscreen C method was less laborious
      than the viable counting. The durations of PAE for S. aureus following exposures
      to erythromycin (EM), josamycin (JM) and rokitamycin (RKM) for 2 hours at twice
      the MICs were in ranges of 0.85 to 1.45, 2.36 to 3.48 and 1.93 to 5.45 hours,
      respectively. A definite PAE of 1.0 to 5.8 hours was also observed in E. faecalis
      strains exposed for 2 hours to EM, JM and RKM at twice the MICs.

PMID- 7783320
TI  - [Antimicrobial activities of piperacillin against fresh clinically isolated
      strains].
AB  - In order to evaluate the antimicrobial activity of piperacillin (PIPC), along
      with control agents, minimum inhibitory concentrations (MIC's) were determined
      against fresh clinically isolated strains from January to June, 1994. 1. The
      MIC70's of PIPC against major strains were approximately equal to those reported
      in the mid 1980s. 2. Strains for the study were supplied in approximately equal
      numbers from community-acquired hospitals and general hospitals. The ratios of
      bacteria resistant to beta-lactams including PIPC were low in the former group
      and high in the latter. 3. "New types of beta-lactam-resistant strains" which did
      not exist in mid 1980s but found at this time included benzylpenicillin (PCG)
      insensitive Streptococcus pneumoniae, PCG-resistant S. pneumoniae, cephems
      resistant Escherichia coli and beta-lactamase producing Prevotella spp. These
      bacteria were also found among strains obtained from community-acquired
      hospitals.

PMID- 7783319
TI  - Synergistic enhancement of in vitro antimicrobial activity of cefmetazole and
      cefotiam, cefamandole or cefoperazone in combination against methicillin
      sensitive and -resistant Staphylococcus aureus. II. Effect of inoculum size.
AB  - The inoculum effect was studied on the activity of cefmetazole and cefotiam,
      cefamandole or cefoperazone alone and in combination against 9 strains of
      methicillin-sensitive Staphylococcus aureus (MSSA) and 20 strains of methicillin
      resistant Staphylococcus aureus (MRSA) by means of the checkerboard titration
      method with Mueller-Hinton agar plate using 10(6) and 10(8) CFU/ml. The
      antimicrobial activity against MSSA and MRSA was potentiated synergistically in
      combination of cefmetazole and these cephalosporins either with inoculum size
      10(6) or 10(8) CFU/ml. At a concentration of cephalosporins < or = 6.25
      micrograms/ml, the combination effect of cefmetazole and cefotiam or cefamandole
      against MRSA was more potent than that of cefmetazole and cefoperazone. With a
      higher inoculum size the effect was reduced. Under these conditions with a low
      dose level of drugs, the enhancement of the activity of cefmetazole by cefotiam
      was least influenced by inoculum size among cephalosporins studied.

PMID- 7783321
TI  - [Clinical study of ciclosporin in patients with aplastic anemia and pure red-cell
      aplasia].
AB  - We administered cyclosporine to patients with aplastic anemia and pure red-cell
      aplasia as a multicenter clinical trial. The cyclosporine was given by a dose of
      6 mg/kg orally daily for 16 weeks. The efficacy of cyclosporin for aplastic
      anemia was 13.8% after 8 weeks, and 28.0% after 16 weeks. The severity of the
      disease was improved, and the amount of blood transfusion was reduced. The
      efficacy of cyclosporine for patients with pure red-cell aplasia was 60.0% at 16
      weeks treatment. Adverse effects of cyclosporine were observed in some patients
      and the hirsutism was seen most commonly. In laboratory data, an increase of
      serum creatinine was seen but was transient. Our results showed that cyclosporine
      is an effective drug for treatment of aplastic anemia and pure red-cell aplasia.

PMID- 7783322
TI  - [A case of Kasabach-Merrit syndrome complicated with DIC treated effectively by
      long term oral administration of warfarin].
AB  - A 20 year-old female patient with Kasabach-Merrit syndrome, suffered from chronic
      consumption coagulopathy due to localized intravascular coagulation in the
      tumors. She had been diagnosed as Kasabach-Merrit syndrome immediately after
      birth and below knee amputation of her right lower leg was performed at the age
      of 2 years because of her giant hemangioma on the right foot and lower leg. After
      the operation, she had often complained of severe pain and enlargement of the
      residual tumors due to continuous thrombus formation within the tumors. She was
      admitted to the third Department of Tohoku University Hospital in order to
      initiate oral anticoagulant therapy with Warfarin at the age of 12 years. After
      the administration of 2.5 mg/day Warfarin, she has maintained good clinical
      condition until now, despite the occasional occurrence of coagulation
      abnormalities. We believe that the results of this case indicate the efficacy of
      oral anticoagulant therapy in the treatment of chronic consumption coagulopathies
      complicated with other diseases.

PMID- 7783323
TI  - [Aspergillus lumbar discitis in a patient with acute lymphoblastic leukemia
      following induction therapy].
AB  - A 47-year-old female was admitted in October 1988 because of anemia and
      lymphoblastic cells in peripheral blood. A bone marrow aspirate was hypercellular
      with 93.9% lymphoblasts negative for peroxidase staining. The case was diagnosed
      as ALL (L2), and treated with JALSG ALL-87 regimen. She developed spiky fever and
      endotoxin shock due to bacteremia caused by pseudomonas aeruginosa, then was
      treated with several antibiotics. With the recovery of leukocytes, the chest X
      ray showed an infiltrative shadow and a cavity forming lung abscess resembling
      aspergilloma in her left lung. The cavity improved of transbronchial infusion
      following amphotericin B (AMPH-B). Although she achieved complete remission, she
      felt severe lumbago accompanied by a marked erosion of the vertebral body with
      disc space narrowing on her X-ray. Then she underwent surgery to remove a disc
      abscess, and 1 colony of the aspergillus species was cultured from the specimen.
      She was treated with intravenous AMPH-B, and post remission therapies were
      performed under the injection of anti-fungal agents. No remarkable symptoms of
      complications were recognized during the chemotherapy. AMPH-B is useful and safe
      for the management of aspergillus discitis.

PMID- 7783324
TI  - [Persistent discrepancy between FDP and D-dimer in a patient with acute
      leukemia].
AB  - In a patient with acute myeloblastic leukemia, serum fibrinogen/fibrin
      degradation products (FDP) were markedly elevated to 54.91 micrograms/ml, but
      plasma D-dimer was only slightly elevated (1.44 micrograms/ml). FDP in plasma
      measured by a method using monoclonal antibody specific to FDP was less than 5
      micrograms/ml. Gradual reduction of blastic cells was obtained with the therapy
      of low-dose cytarabine, G-CSF and etoposide. The serum FDP increased up to 71.74
      micrograms/ml accompanied with a transient elevation of D-dimer, and subsequently
      declined without any anticoagulant therapy. However, a discrepancy between serum
      FDP and plasma D-dimer lasted for a long time. In this case persistent
      acceleration of coagulation and fibrinolysis which may result in the elevation of
      serum FDP was not observed, suggesting that the greater part of increased FDP
      didn't reflect the true FDP formed by plasmin. There were possibilities that
      elevated serum FDP values were also caused by the presence of soluble fibrin,
      unclottable fibrinogen and the degradation products by nonplasmic proteinases.
      Simultaneous measurements of FDP and D-dimer are useful for a more accurate
      evaluation of hyperfibrinolytic states and to avoid possible misinterpretations
      due to falsely positive FDP.

PMID- 7783325
TI  - [Chronic active EB virus infection accompanied by monoclonal proliferation of
      granular lymphocytes].
AB  - An 18-year-old man was admitted to our hospital because of 39 degrees C fever for
      over one month, marked hepatosplenomegaly, and pancytopenia. Malignant
      histiocytosis, malignant lymphoma, or hemophagocytic syndrome were ruled out by
      bone marrow aspiration and liver biopsy. A diagnosis of chronic EB virus
      infection was made according to his characteristic clinical features, abnormally
      high titiers of anti-EBV antibodies (VCA-IgG x 2560, EA-IgG x 1280), and the
      detection of EBV genome in the peripheral blood mononuclear cells by polymerase
      chain reaction. He also manifested granular lymphocyte proliferative disorder
      (GLPD). The phenotype of the proliferating granular lymphocytes was CD2 (+), CD3
      (-), CD56 (+), and IL-2R beta (+), showing the NK lineage of these cells.
      Chromosomal abnormality of the cells cultured for a short time with IL-2 and a
      monoclonal junctional DNA structure of EB virus terminal repeat analyzed by the
      Southern blotting provided definitive evidence for the monoclonal expansion of
      the granular lymphocytes. These findings indicate a causative role of EV virus in
      NK-GLPD or NK-leukemia.

PMID- 7783326
TI  - [Neoplastic angioendotheliosis diagnosed by open lung biopsy].
AB  - Neoplastic angioendotheliosis (NAE) is a rare neoplastic disease, and its pre
      mortem diagnosis is extremely difficult. A 49-year-old male developed vertigo,
      hearing and visual disturbance, transverse myelopathy below Th 5 and
      hypercalcemia. These symptoms were markedly improved by VEPA chemotherapy. Thirty
      four months after onset, diffuse reticular shadows were noted on chest X-ray. The
      biopsy specimen of the lung revealed intravascular lymphoid cells differentially
      stained with L26 and LCA. Southern blot analysis of the DNA from the tissue
      showed rearranged bands for the immunoglobulin gene (JH). A diagnosis of NAE of B
      cell nature was established.

PMID- 7783327
TI  - [Plasma tissue factor assay: its significance and application].

PMID- 7783328
TI  - [Reticulated platelets--automated measurement and clinical utility].
AB  - Development of the method to determine reticulated platelets is briefly reviewed.
      A new rapid method to automatically count reticulated platelets is very recently
      established by our research group. The principle of the measurement of
      reticulated platelets is based on flow cytometry. The platelets are quickly
      stained with a RNA fluorescent dye, auramine O and fluorescent intensity (RNA
      content) and forward scatter (cell size) are measured in only 80 seconds with a
      reticulocyte counter, equipped with special software for analysis of reticulated
      platelets. Both of the reproducibility and the linearity were shown to be good.
      Normal percentage value for reticulated platelets was 0.98% +/- 0.41% and its
      absolute count was 2.12 +/- 0.69 x 10(9)/l. The absolute count was decreased in
      patients with reduced thrombopoiesis such as acute myeloblastic leukemia,
      aplastic anemia and was elevated in patients with essential thrombocythemia and
      in chronic myelocytic leukemia. The patients with chronic idiopathic
      thrombocytopenic purpura had a high percentage of reticulated platelets. An
      apparent rise was noticed in the percentage of reticulated platelets which
      preceded by several days a progressive increase in the platelet count at the
      recovery phase of thrombocytopenia in a couple of leukemic patients. These
      suggest that an automated measurement of reticulated platelets can be clinically
      useful to estimate thrombopoiesis in bone marrow.

PMID- 7783329
TI  - [Clonal study of hematopoietic cells].
AB  - Clonal analyses using X-chromosome inactivation patterns of the phosphoglycerate
      kinase (PGK) and DXS255 (M27 beta) genes were performed in women with various
      hematological diseases or normal hematopoiesis. Four (17%) of 24 hematologically
      normal females had a skewed Lyonization pattern. It, however, appeared that in
      the majority of cases clonality determination of myeloid cells would be possible
      in comparison with lymphocytes. Blasts of acute myeloid leukemia (AML) (21) and
      granulocytes and bone marrow cells of chronic myeloproliferative disorders (6)
      were all shown to be clonal, suggesting that this method was useful for the
      concept formation of a clonal disorder. Twelve of 14 patients with the
      myelodysplastic syndromes had a clonal pattern and 8 of 10 patients with aplastic
      anemia had a polyclonal pattern. Three of 34 patients with AML during remission
      were diagnosed as a clonal hematopoiesis and associated with features of
      myelodysplasia during remission, when clonal patterns are different in patients
      with the same disease, it seems important to elucidate their clinical
      implications.

PMID- 7783330
TI  - [Cytofluorometric analysis of tumor cell size and follicle formation of B-cell
      lymphomas].
AB  - In order to investigate the size variation of neoplastic B cells (NBC) from lymph
      nodes of patients with B-cell lymphomas (BCL), we carried out two-dimensional
      analysis by flow cytometry (FCM) using the forward light scatter (FLS) and the
      fluorescence intensity (FI) of surface immunoglobulin light chain (sIgL). NBC
      were identified as having the homogeneous characteristics of both FLS and tumor
      restricted sIgL (kappa or lambda). The FLS variation of NBC was then analyzed
      using CD3+ T-cells as a scale control. The results closely coincided with the
      cell types determined by the pathologic diagnosis. Secondly, we used FCM to
      investigate how strongly NBC express VLA-4 alpha and LFA-1 alpha, which seemed to
      play important roles in neoplastic follicle formation. The expression intensities
      of these molecules were classified into three grades (-, + & ++). The results
      were presented in the order of VLA-4 alpha and LFA-1 alpha; follicular 8/15
      (++/++), 6/15 (++/+), 1/15 (+/++), partially follicular 3/5 (+/++), 2/5 (+/+),
      diffuse 2/16 (++/-), 6/16 (+/++), 8/16 (+/+), B-CLL 8/8 (-/+ or -). These
      findings suggest that follicular lymphomas are phenotypically distinguishable
      from diffuse lymphomas.

PMID- 7783331
TI  - [Soluble lymphocyte antigens in hematological diseases].
AB  - Plasma levels of soluble CD8 (sCD8) and soluble CD4 (sCD4) in patients with
      infectious mononucleosis (IM) and hematological disorders were studied. In IM
      patients, a marked increase in sCD8 (22, 366 +/- 2,702U/ml, control: 219 +/-
      10U/ml, p < 0.0001) and significant increase in sCD4 (19.3 +/- 0.9, control: 8.1
      +/- 0.2, p < 0.0001) strongly suggest activation of both CD8+ and CD4+
      lymphocytes, which is important in restraining Epstein-Barr virus-infected B
      lymphocytes. We showed that the elevation of plasma sCD8 is due to expansion of
      CD8+ subset as well as increased sCD8 release from each CD8+ cell. Increased sCD4
      release from CD4+ lymphocytes was also seen. During convalescence sCD8 and sCD4
      levels showed progressive decrease; however, even at 60-120 days after onset the
      levels of sCD8 and sCD4 remained higher than normal, suggesting prolonged
      lymphocyte activation. In hematological malignancies, elevated serum levels of
      sCD4 and sCD8 were found in non-Hodgkin lymphoma (NHL), acute lymphocytic
      leukemia, multiple myeloma, acute non-lymphocytic leukemia and chronic
      myelogenous leukemia. Levels of sCD4 and sCD8 in patients with NHL reflect
      disease status and are useful in monitoring disease activity.

PMID- 7783332
TI  - [Detection of minimal residual disease by means of FISH and PCR methods and its
      clinical evaluation].
AB  - The monitoring of MRD by FISH and PCR is now clinically evaluated for a
      prediction of the relapse of leukemia. However, these methods include several
      technical limitations. In FISH, an appropriate cut off value should be settled
      for each probe or procedure in estimating chromosomal gain, loss, or
      translocation and the sensitivity depends on the cut off values but it may reach
      to 10(-3). In PCR, the sensitivity is higher than that of FISH especially using
      genomic DNA as a template. However, the detection of chromosomal translocation
      specific DNA or RNA constructs is currently applicable to limited cases and the
      amplification of Ig or TCR gene rearrangement has a major pitfall caused by the
      clonal evolution. Clinically, MRD can be an indicator for a prediction of the
      relapse. For example, a greater MRD on entering CR tends to be related with an
      early relapse, a return to MRD-positive after disappearance of MRD will be a sign
      of impending relapse, and MRD negativity at the termination of therapy may be
      correlated with a long-term disease free status. More precise evaluation of MRD
      is necessary with regard to therapeutic strategy.

PMID- 7783333
TI  - [Molecular biological analysis of hereditary thrombophilia--genetic
      characterization of protein S deficiency].
AB  - Protein S is a plasma glycoprotein, which functions as a cofactor for activated
      protein C in the protein C pathway and also directly inhibits factors Va and Xa,
      independently of protein C. In plasma, protein S circulates as a free molecule
      (40%) or in a complex with C4b-binding protein (60%). Only a free protein S acts
      as an anticoagulant and its activity is lost by binding to C4b-binding protein.
      The physiological importance of protein S has been established by observations in
      patients with hereditary protein S deficiency who have an increased risk of
      developing thrombosis. Several previous studies reported that hereditary protein
      S deficiency was as common as protein C deficiency and that approximately 5% of
      hereditary thrombophilia was caused by protein S deficiency. But molecular
      biological analysis of protein S deficiency is not as advanced as protein C
      deficiency because the genetic characterization of protein S deficiency is
      limited by the presence of the inactive pseudogene that is highly homologous to
      the active true gene. Only a few previous studies have examined the genetic
      features of hereditary protein S deficiency. Further investigation is needed to
      characterize the pathophysiology and molecular basis of hereditary protein S
      deficiency.

PMID- 7783334
TI  - [Study of signal transduction through thrombin receptor and anti-thrombotic
      strategy using its controls].
AB  - Thrombin, a key enzyme in the hemostatic pathway, also has various effects on the
      function of human platelet, endothelial cells (HUVEC) and vascular smooth muscle
      cells (VSMC). A thrombin receptor (TR) has been cloned and is thought to mediate
      a variety of thrombin-induced responses. The post-receptor signals are mediated
      by several protein kinases responsible for NF-kappa B activation, and most
      thrombin-inducible genes have the kappa B sequence in the regulatory elements. TR
      stimulation resulted in a biphasic activation of NF-kappa B and the late phase of
      which required new NF-kappa B synthesis. We showed that the antisense
      oligodeoxynucleotides (ODNs) of NF-kappa B have a marked inhibitory effect on
      thrombin-induced cellular responses. Furthermore, E5510, a compound with anti
      platelet activity preferentially inhibited the thrombin-inducible NF-kappa B
      activation. Therapeutic potential of inhibition of TR-NF-kappa B activation
      signaling for treatment with thrombotic disease is also indicated.

PMID- 7783335
TI  - [Monitoring for oral anticoagulant therapy].
AB  - Warfarin has been widely used for an oral anticoagulant therapy against
      thrombotic diseases. For the monitoring of its anticoagulant intensities,
      prothrombin time (PT) ratio and percentage of thrombotest (TT) are commonly used
      in Japan. Recently, International Normalized Ratio (INR) was recommended by
      ICSH/ICTH. Practicality and usefulness of INR and its combined use of thrombin
      antithrombin III complex (TAT) for the monitoring of oral anticoagulation therapy
      were evaluated among patients of ischemic heart disease with or without
      interventions, and of cardiomyopathies and valvular diseases. Difference in
      thromboplastin sensitivities have been shown to cause errors in PT elongation and
      in the evaluation of anticoagulant activity, so that the monitoring only by PT
      ratio is considered to be irrelevant, and that INR is recommended to be used. INR
      was comparable to the levels of TT. Majority of the patients, whose TAT levels
      were kept normal, were controlled below the proposed therapeutic ranges of INR.
      With the combination of INR and TAT monitoring, anticoagulant effect of warfarin
      could be achieved safer in lower dose than the levels that might cause bleeding
      accidents.

PMID- 7783336
TI  - [Classification and treatment of DIC].
AB  - Disseminated intravascular coagulation (DIC) is characterized by extreme
      activation of intravascular coagulation, and clinical manifestations such as
      bleeding and/or multiple organ failure is sometimes observed in advanced cases of
      DIC. The balance of coagulation and fibrinolysis activation varies according to
      the underlying diseases of DIC. DIC cases are classified as the type with
      predominant coagulation activation and the type with predominant fibrinolysis
      activation in former type plasma levels of thrombin-antithrombin III complex
      (TAT) are greatly increased, and those of plasmin-alpha 2 plasmin inhibitor
      complex (PIC) are slightly increased. In addition plasma levels of plasminogen
      activator inhibitor 1 (PA1) are greatly increased, multiple organ failure is a
      major clinical manifestation in advanced cases and sepsis is a representative
      underlying disease. In the second type both plasma levels of TAT and PIC are
      greatly increased, plasma levels of PA1 are almost within normal limits. Bleeding
      is a major clinical manifestation in advanced cases and acute promyelocytic
      leukemia (APL) is a representative underlying disease. The classification of DIC
      should be considered when choosing treatment with DIC. Diagnosis of pre-DIC
      status is based on gradually decreasing platelets counts in sepsis and on mild
      elevation of FDP and D dimer in APL, leukemia and cancer.

PMID- 7783337
TI  - [Thrombosis in patients with SLE and antiphospholipid syndrome].
AB  - Clinical and serological features in SLE patients with arterial or venous
      thrombosis were studied. The subjects consisted of 140 patients with SLE who met
      the revised criteria for the classification of SLE by the American Rheumatism
      Association. Forty patients (29%) had arterial or venous thrombosis. Arterial
      thrombosis such as stroke was found in 30 patients, and venous thrombosis such as
      deep vein thrombosis was seen in 24 patients. Average age at the disease onset
      was 34.5 +/- 12.5 years old. Renal disorder was found as a clinical feature, and
      IgG anticardiolipin antibodies (aCL), IgG phospholipid-dependent anti-beta 2
      glycoprotein I (beta 2-GPI) antibodies and IgG anti-Annexin V antibodies were
      identified as serological features in SLE patients with thrombosis. These
      patients were diagnosed as having antiphospholipid syndrome. It was necessary to
      perform primary prevention therapy as well as secondary prevention therapy.
      Multiple thrombotic events in the past history and sustained positive reactions
      of IgG aCL were suggested as predictors of recurrent thrombosis. These data
      indicated the clinical and serological characteristics in SLE patients with
      arterial or venous thrombosis.

PMID- 7783338
TI  - [Treatment results of acute nonlymphocytic leukemia in childhood--Kyushu
      Yamaguchi Children's Cancer Study Group].
AB  - Seventy-three children with acute nonlymphocytic leukemia (ANLL) have been
      treated with ANLL-85 and ANLL-88 protocol at Kyushu-Yamaguchi Children's Cancer
      Study Group between June, 1985 and February, 1993. Ten boys and 10 girls (0y4m
      16ylm) were treated with the ANLL-85 protocol. The complete remission (CR) rate
      was 75% and the 5-year event free survival (EFS) was 20 +/- 9%. It was terminated
      because of frequent early relapse (within 6 months after CR). Thirty-four boys
      and 19 girls (0y3m-17ylm) were treated with the ANLL-88 protocol. The CR rate was
      85% and the 5-year EFS was 32 +/- 7%. Early relapse rate with ANLL-88 was lower
      than that of ANLL-85, however 9 cases relapsed after terminating therapy.
      Although bone marrow transplantation (BMT) from related donors during the first
      CR was effective in ANLL-88, EFS was not improved. Recognition of risk factors
      and appropriate chemotherapy regimens with or without the support of stem cell
      transplantation may be necessary to cure children with ANLL.

PMID- 7783340
TI  - [Transformation into chronic myelomonocytic leukemia in a patient with primary
      myelofibrosis associated with severe hypoplasia: report of an autopsy case].
AB  - A 70-year-old male was admitted because of anemia in September 1989, and primary
      myelofibrosis was diagnosed based on the presence of leukoerythroblastosis, a
      normal chromosomal analysis and pathological findings of fibrosis in bone marrow.
      Although he was anemic, he did not require any treatment for two years. Then his
      hematological status deteriorated to severe pancytopenia, and the marrow biopsy
      revealed marked hypoplasia with fatty replacement and scattered fibrosis. He was
      treated with metenolon without success and frequent transfusion of packed red
      cell was required. This hypoplastic status continued for seven months. In May
      1992 his WBC count increased gradually with monocytosis. The marrow was filled
      with various stages of monocytes, with almost no fibrosis remaining. The
      chromosomal analysis was repeated but disclosed no abnormalities, consistent with
      the negative result of BCR-ABL rearrangement investigated by the RT-PCR method.
      One month later, when the patient died of multiple cerebral bleeding and
      infection, the leukocyte count exceed 90,000/microliters. It is known that major
      causes of death for patients with primary myelofibrosis are infection, bleeding,
      cardiac trouble and transformation to leukemia. We describe a case of
      myelofibrosis who developed to chronic myelomonocytic leukemia following severe
      aplastic phase.

PMID- 7783339
TI  - [Autoimmune hemolytic anemia reactivated by alpha-interferon therapy in a case of
      chronic active C-type hepatitis].
AB  - A case with autoimmune hemolytic anemia (AIHA) induced by interferon-alpha (IFN
      alpha) is presented. A 40-year-old male who had a previous history of autoimmune
      hemolytic anemia, agranulocytosis and thrombocytopenia was admitted to our
      hospital because of chronic C type hepatitis. Liver biopsy was performed, which
      diagnosed chronic active hepatitis and IFN-alpha was administrated at a dose of 3
      Meg unit per day. 11 days after the initiation of the therapy he developed
      hemolytic anemia, but Coombs tests were negative. Although IFN was withdrawn 15
      days later, anemia became progressively more serious. 20 days later, both direct
      and indirect Coombs tests became positive. He was diagnosed as AIHA and treated
      with methylprednisolone pulse therapy, then he recovered soon afterward. Further
      analysis of Coombs tests revealed that he had both cold type and warm type (IgG)
      autoantibodies which was the same type of antibodies for AIHA he suffered 10
      years ago. In conclusion, latent AIHA may be reactivated by the treatment with
      IFN-alpha.

PMID- 7783342
TI  - [Isolation and characterization of the hematopoietic stem cell].
AB  - When one hundred of c-Kit+Sca-1+Lin- cells obtained from B6. Ly 5.1 mouse were
      injected into lethally irradiated B6. Ly 5.2, 100% of the mice injected survived.
      Sequential analyses of recipient's peripheral blood leukocytes revealed presence
      of Ly 5.1+ myeloid and lymphoid cells even 12 months after the injection. We also
      examined the fate of these cells in the recipient mouse after transplantation.
      Time course analyses of the mouse injected with 500 FACS-purified c-Kit+Sca-1+L-
      cells revealed that spleen is the primary site for expansion of the injected c
      Kit+Sca-1+Lin- cells. By day 28 s/p transplantation, more than 50,000 donor type
      c-Kit+Sca-1+Lin- cells were found in the spleen and over 15,000 cells in the bone
      marrow. By day 60, number of c-Kit+Sca-1+Lin- cells decreased in the spleen and
      returned to normal level in the bone marrow. Stem cell activity of the donor
      derived c-Kit+Sca-1+Lin- cells in the primary recipient was confirmed by in vitro
      and in vivo colony formation as well as transplantation to the secondary
      recipient. These results provide evidence that c-Kit+Sca-1+Lin- cells in the bone
      marrow have capability of self-renew as well as multilineage differentiation
      potential and that spleen is the primary site of stem cell expansion after bone
      marrow transplantation in mouse.

PMID- 7783341
TI  - [Recent progress in the treatment of adult acute leukemia].
AB  - Due to the advance of chemotherapy and bone marrow transplantation, adult acute
      leukemia has become a curable disease. In acute myeloid leukemia, the JALSG AML89
      study resulted in 77% complete remission (CR) rate in 326 adults and 38% 4.5-year
      disease-free survival (DFS) in CR cases. However, the result of acute
      lymphoblastic leukemia in the JALSG ALL87 study is not satisfactory; 84% CR in
      116 adults and only 24% 6-year DFS. For acute promyelocytic leukemia (APL), all
      trans retinoic acid works remarkably, and the JALSG AML92 study for newly
      diagnosed APL resulted in 89% CR in 109 adults and 81% 2.5-year DFS.

PMID- 7783343
TI  - [Macrophage cell cycle control by M-CSF/CSF-1].
AB  - Temporally orderly activation of the cyclin-dependent kinases (cdks) governs the
      progression and the transitions of the cell cycle in mammalian cells. Macrophages
      require a specific growth factor, M-CSF/CSF-1, for their proliferation throughout
      the G1 phase of the cell cycle. Once cells enter S phase, macrophages complete
      mitosis in the absence of M-CSF/CSF-1. During the G1 phase, cyclin D1 is induced
      by M-CSF/CSF-1 stimulation and forms enzymatically active complex with cdk 4. The
      enzymatic activity of the cyclin D1 and cdk 4 complex could be negatively
      regulated by recently reported inhibitory proteins to determine the timing for
      entry into S phase in macrophages.

PMID- 7783344
TI  - [Prospects for antisense therapy].
AB  - Inability to distinguish between normal and diseased cells by chemotherapeutic
      agents causes systemic toxic effects. This problem may be solved by the direct
      genetic approach using antisense oligodeoxynucleotide (AS ODN) based on the
      specificity of Watson-Crick base pair formation, if an appropriate disease
      specific target can be identified. Since the pioneering works by Zamecnik and
      Stephenson to inhibit gene expression using AS ODN, recent progress in cloning of
      pathogenic genes and technical advance in the synthesis of ODN analogues have
      spurred a research effort dedicated to the development of AS therapy for cancer
      and viral disease. Chemically-modified ODNs such as phosphorothioate analogues,
      which are nuclease resistant and considered to be suitable for clinical use, can
      effectively inhibit the expression of activated oncogenes or the viral
      replication and lead to the growth suppression of cancer cells and viral genomes
      in vitro and in experiments using animal models as well. Phase I clinical trials,
      designed to evaluate the toxicity of these compounds in leukemia or AIDS
      patients, have already commenced. In these trials, which are now in its infancy,
      a considerable number of problems will be encountered. However, these hurdles may
      not be insurmountable.

PMID- 7783345
TI  - [Current status and the future of HIV infection].

PMID- 7783346
TI  - [HIV infection: pathophysiology and its clinical features--clinical course and
      surrogate marker].
AB  - Clinical courses and several hematological and serological markers were evaluated
      in 34 patients with HIV infection (32 with hemophilia and 2 with homosexuality)
      who had been followed up at Shizuoka Prefecture Children's Hospital for 3 to 13
      years, with the reference to the results observed in 1,082 patients with HIV
      infection registered with the Ministry of Health and Welfare Study Group, Natural
      History Committee. The results indicated as significant follow-up markers as (1)
      CD4- and CD8-positive lymphocyte count, (2) IgA, IgG and beta-2 microglobulin,
      (3) HIV p24 antigen and HIV culture isolation, and (4) serum HIV-RNA. Of these
      markers, the quantification of serum HIV-RNA seemed particularly useful for
      prognosis estimation, determination of therapy onset, and efficacy assessment of
      a given anti-HIV agent. In addition, we encountered 2 HIV-infected patients who
      seemed to meet the definition of long-term survivors. Factor analysis in these
      patients will be an important subject of investigation from a clinical point of
      view as well.

PMID- 7783348
TI  - [AIDS-associated lymphomas].

PMID- 7783347
TI  - [Induction of protective immune responses by a chimeric soluble protein from a
      recombinant BCG vector candidate vaccine to HIV-1].
AB  - We have been isolated HIV strains from blood specimens of HIV infected
      individuals in Japan for these 6 years. The number of specimens tested reached
      approximately 1,700 that ninety percent of them were from hemophiliacs repeatedly
      injected blood products from the United States. More than 300 of field HIV were
      successfully isolated from the samples. The isolation rates has decreased to 30
      percent in 1993 from 40 percent in 1992, suggesting that treatment with anti-HIV
      drugs such as AZT and/or ddI may be effective to HIV-infected individuals.
      Further, both of the viral and genomic sequences of HIV were classified to be
      clade B virus. The clinical isolates that expressed IHIGPGRAFY sequence at the
      center of the HIV-V3 domain were found to be neutralized by an anti-clade B-V3
      monoclonal antibody, mu 5.5. By individual levels, when asymptomatic
      seropositives have progressed to disease-states, neutralization core motif of
      GPGR in approximately 6% of the viruses has changed to GPGG and hydrophilic amino
      acid changed to hydrophobic amino acid, correlating the loss of binding activity
      to PND-peptide of Japanese Consensus virus. Further, rapid progressors to HIV
      induced diseases showed decreased activity of the binding antibody. By using the
      Japanese consensus sequence of HIV-1, we successfully constructed chimeric
      protein secretion vectors by selecting an appropriate insertion site of a carrier
      protein, and established the PND-peptide secretion system in BCG. The recombinant
      BCG inoculated guinea pigs were initially screened by delayed-type
      hypersensitivity (DTH) skin reactions to the PND peptide followed by passive
      transfer of the DTH by the systemic route.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783349
TI  - [Chemotherapy and vaccine against HIV infection].
AB  - Anti-HIV treatment is the major strategy against HIV infection and AIDS.
      Nucleoside reverse transcriptase inhibitors have been studied extensively, and
      some of them have been approved for clinical use. Efficacy of non-nucleoside
      reverse transcriptase inhibitors and HIV-protease inhibitors are also being
      confirmed. It became clear, however, that all of these agent, allow emergence of
      drug-resistant HIV mutants when used as monotherapy. Therefore, combination
      therapy or alternating therapy using these and other new agents may become the
      main mode of treatment in the future. Clinical trials for HIV vaccines are now
      being conducted in U.S.A. and other countries. In many of them, immunological
      responses were confirmed, although clinical benefit was not known yet. Vaccines
      which induce cellular immunity against broad spectrum of epitopes are desired to
      overcome viral mutations. Gene therapy is very attractive, and extensive studies
      are being conducted in many laboratories including ours. Methodology for early
      and correct diagnosis of opportunistic infections are now developing especially
      by using molecular technology. Steady improvement in the clinical management of
      opportunistic infections is achieved.

PMID- 7783350
TI  - [Present situation of health care setting for patients living with human
      immunodeficiency virus type-1 in medical institutions of Japan].
AB  - We investigated the present health care situation in medical institutes of
      medical doctors who are the members of human immunodeficiency virus type-1 (HIV) 
      research group headed by Prof. Yamada through mailing-questionnaire. It was
      revealed that there are many HIV-treatment-related problems in medical
      institutes, included a refusal to accept a newly-diagnosed HIV-infected patients
      or to conduct surgical treatment on them. Furthermore, it was also clarified that
      there are quite a many HIV-infected patients who were not informed their HIV
      status yet, thus causing secondary-HIV-infection to their sexual partners. From
      these results, urgent drastic measures to solve these problems are needed for the
      caring patients living with HIV.

PMID- 7783351
TI  - [Hypocellular acute leukemia].
AB  - To establish diagnostic criteria for hypocellular acute leukemia (HL) 32 cases
      (mean age 67) with 40% or less bone marrow cellularity were analysed and compared
      with 40 cases of MDS, 27 cases of AML in the elderly (60 > or = ) and 39 cases of
      AML in the young (60 <). The mean bone marrow cellularity was 30% in HL, 85% in
      MDS, 87% in elderly AML and 95% in young AML, respectively. Thus hypocellularity
      was evident in HL. Blast % in bone marrow of HL patients was 17-70% in all
      nucleated cells including lymphocytes (ANC), 36-93% in non-lymphocytic cells
      (NLC) and 50% or more in all cases in non-erythroid/non-lymphocytic cells
      (NENLC). Thus maturation arrest of blast cells was evident in HL, which
      corresponds to that of overt AML. Out of 20 cases treated with low-dose ara-C 13
      cases (65%) achieved complete remission, but most of them relapsed early by
      manifesting hypocellular bone marrow again. In conclusion HL is a distinct
      clinical subtype of AML in the elderly, which can be clearly defined by 40% or
      less cellularity and 30% or more blasts in bone marrow.

PMID- 7783352
TI  - [Hematological neoplasm--how to treat low-grade lymphomas].
AB  - Low-grade lymphomas are rare in Japan, comprising about 10% of non-Hodgkin's
      lymphomas. They are indolent in natural history with median survival of 7-10
      years. Despite a good initial response to radiotherapy or chemotherapy, most
      patients (Pts), being incurable, ultimately die of their disease. Pts with
      clinical stage (CS) I/II disease are generally treated with locoreginal
      radiotherapy. Long-term survival of 60% to 70% and disease-free survival (DFS) of
      50% to 55% have been reported. The more precise the staging procedures, the
      better the results. Chemotherapy used as a primary therapy or as an adjuvant to
      radiotherapy may improve DFS of pts with CS II with many sites of lymph node
      involvement or bulky disease. For CS III/IV disease there is no accepted standard
      therapy. There is no survival advantage for any of the different first-line
      treatment methods ranging from initial deferral of treatment albeit in highly
      selected pts, an alkylating agent +/- steroid hormone, to combination
      chemotherapy (C-MOPP, CHOP, ProMace-MOPP etc) +/- irradiation. The international
      index for prognostication of aggressive lymphoma has also been shown to be
      applicable to stratification of low-grade lymphomas. In future studies
      effectiveness of treatment strategies should be investigated with long-term DFS
      and improved quality of life being set as primary endpoints.

PMID- 7783353
TI  - [Multiple myeloma--diagnosis, prognostic factors and treatment].
AB  - The problem of diagnosis, prognostic factors and the efficacy of therapies were
      investigated in 330 patients with multiple myeloma (MM) and 51 patients with
      benign monoclonal gammopathy (BMG)/monoclonal gammopathy of undetermined
      significance (MGUS). Seven out of 51 patients with BMG/MGUS were transformed into
      MM. The mean time to the transformation was 61.6 months. M protein level in these
      patients had been gradually and constantly increasing until the transformation in
      contrast with stable level in non-transformed patients. In MM there was one year
      difference between median survival from the time of diagnosis and start of
      chemotherapies. It depended on the deferral of treatment in patients with stage I
      myeloma. No difference of survival time was found between initial and differed
      therapy for stage I myeloma. Earlier therapy is not advantageous in this stage.
      Stages and immunoglobulin classes of MM were prognostic factors. Stage I or IgG
      myeloma had the longest survival and stage III or BJP myeloma had the shortest
      one. The new protocol, DMVM plus natural interferon alpha therapy induced high
      complete remission rate of 37.1% in initial treatment patients. The survival rate
      at three years from the treatment was 70%.

PMID- 7783354
TI  - [Diagnosis and treatment of essential thrombocythemia].
AB  - Essential thrombocythemia (ET) is one of the chronic myeloproliferative disorders
      (MPD), clonal disorders of hematopoietic stem cell. The differential diagnosis
      from the other MPD and reactive thrombocytosis was described. The treatment of
      this disease was then stated with emphasis on the importance of control of
      platelet count. For the control, drugs to suppress the megakaryocytic
      proliferation are used, including busulfan, hydroxyurea, interferon-alpha and
      Anagrelide. The therapy for asymptomatic patients and pregnant women as well as
      patients with acute hemorrhage and thrombosis was also discussed.

PMID- 7783355
TI  - [Peripheral T-cell lymphoma with abundant ATL-like cells in the blood].
AB  - A 69-year-old woman was admitted to our hospital because of leucocytosis and
      systemic lymphadenopathy. On admission, white blood cell count was
      163,000/microliters, most of which consisted of flower-like cells with convoluted
      nuclei in the peripheral blood. In the abnormal lymphocyte cells surface-marker
      test by flow cytometry showed that they expressed CD2, CD3, CD4, CD29, CD45RA,
      and CD38, but not CD8, CD16, and CD25. Serum anti-Human T-lymphotropic virus type
      I (HTLV-I) antibody was negative in particle agglutination, enzyme-linked
      immunosorbent assay (ELISA) and western-blotting assay. HTLV-I proviral DNA in
      the abnormal lymphocyte cells was not detected by southern blotting hybridization
      technique. Moreover, HTLV-I provirus was not detected using a polymerase-chain
      reaction (PCR). A monoclonal rearrangement of the TCR-beta chain gene was evident
      by using DNA probe in southern blot hybridization. Because of the rapid progress
      of the disease, chemotherapy was started immediately after admission. Though,
      this patient became refractory, and she died about 1 year after admission.

PMID- 7783356
TI  - [Non-Hodgkin's lymphoma presenting as a soft tissue tumor in the connective
      tissue at the thigh].
AB  - A 62-year-old man visited our hospital in July 1993, because of a right thigh
      mass which had grown gradually since two years previously. Physical examination
      revealed that the mass at the right thigh region, was elastic soft and about 15 x
      10 cm in diameter, without regional lymph node swelling. An ultrasound study
      showed a hypoechogenic and mesh patterned mass. MRI revealed that the tumor was
      well defined from subcutaneous adipose tissue and skeletal muscle, indicating
      that it arose in connective tissue. Angiography demonstrated diffuse
      hypervascularization of the tumor, and Gallium scintigraphy showed remarkable
      accumulation at the tumor. Serum IgM was increased, which was proven to be an
      monoclonal hypergammopathy (IgM, lambda). Histological examination of a biopsied
      specimen obtained from the thigh mass revealed B cell lymphoma, lymphoplasmacytic
      cell type. The patient achieved a complete remission after surgical treatment
      following radiation and combination chemotherapy.

PMID- 7783357
TI  - [Epstein-Barr virus associated natural killer cell leukemia: report of an autopsy
      case].
AB  - A 20-year-old female was admitted because of high fever, hepatosplenomegaly,
      severe hepatic dysfunction and coagulopathy. Peripheral blood showed pancytopenia
      and granular lymphocytes bearing the natural killer cell phenotype (CD2+CD3
      CD16+CD56+CD57-TCR alpha beta-TCR gamma delta-) constituted 97% of leucocytes.
      Southern blot analysis of DNA obtained from peripheral blood mononuclear cells
      showed germ-line configuration of TCR beta, gamma and delta chain genes. EBV-DNA
      was detected in a single episomal form by using EBV-terminal repeat probe. Bone
      marrow findings were consistent with hemophagocytic syndrome and administration
      of VP-16 was effective transiently. After ten months she died from massive
      gastrointestinal bleeding. An in situ hybridization study identified EBV-RNA
      (EBER-1) in atypical lymphocytes infiltrating bone marrow, spleen and lymph
      nodes. Sections of liver showed steatosis and infiltration of T cells (CD3+ and
      EBER-1-negative) in the portal areas and few atypical lymphocytes in sinusoids.
      The patients developed an EBV-associated clonal proliferation of natural killer
      (NK) cells, but the clinical features were suggestive of chronic active EBV
      infection or virus-associated hemophagocytic syndrome (VAHS) rather than
      leukemia. Bone marrow transplantation for NK cell leukemia is an issue to be
      discussed.

PMID- 7783358
TI  - [Quantitative bleeding time].
AB  - Bleeding time, which reflects the interaction of the platelets with the damaged
      vessel wall and the subsequent formation of the primary hemostatic plug, has been
      widely used in the diagnosis of bleeding disorders, especially platelet
      abnormalities. We have developed a computerized method to measure the bleeding
      pattern and the amount of blood loss from the bleeding time incision
      (quantitative bleeding time). In 87 normal subjects (51 males and 36 females),
      the bleeding time was 389 +/- 137 sec and the amount of blood loss was 15.7 +/-
      7.2 microliters (mean +/- S.D.). The bleeding pattern was classified into four
      types (I-IV). Type II showed the prolongation of the bleeding time, continuous
      constant bleeding, and considerably large amount of blood loss from the incision.
      This type which includes severe von Willebrand disease and serious
      thrombocytopenia is related to the severe bleeding tendency. Type III exhibited
      the prolongation of the bleeding time keeping a trace of blood loss from the
      incision. In type III patients, the bleeding tendency was generally mild despite
      the prolonged bleeding time as in patients with moderate thrombocytopenia or
      aspirin ingestion. Measurement of bleeding pattern and blood loss will provide a
      useful information to evaluate the defect of primary hemostasis.

PMID- 7783359
TI  - [Detection of platelet aggregates using light scattering].
AB  - Platelets play an important role in hemostasis and thrombosis. Evaluation of
      platelet function provides useful information on the diagnosis and cure of
      diseases associated with hemostasis and thrombosis. Among various platelet
      functions, platelet aggregometry is most widely used in clinical application.
      Platelet aggregation has been assessed by measuring the changes in the optical
      density of the platelet suspensions. However, this method has several
      shortcomings such as failure to detect the formation of small aggregates and lack
      of correlation between aggregate formation and changes in optical density. Thus,
      we have developed a new method of platelet aggregometry based on light
      scattering. This device emits laser beams against platelet aggregates and
      efficiently detects light scattering produced by these aggregates. The intensity
      and frequency of light scattering provides information as to the size and number
      of aggregates present in a limited area. By this method, we were able to
      determine several different modes of inhibitory effects on platelet aggregation.
      The high sensitivity of this method also allowed us to detect slight platelet
      activation, which had not been possible by the conventional method using changes
      in optical density. Clinical application of this method revealed frequent
      occurrence of spontaneous aggregation in diabetic patients and a close
      relationship between this phenomenon and diabetic complications.

PMID- 7783360
TI  - [Recent progress in evaluation of glycemic control by glycated protein and 1,5
      AG].
AB  - The aim of treatment of diabetes is to prevent the progress of diabetic
      complications. A recent report by the DCCT (Diabetes Control and Complications
      Trial) clearly shows the importance of strict glycemic control for prevention of
      diabetic complications. For this purpose, some markers for long-term glycemic
      control other than glucose concentration will be helpful, because glucose levels
      fluctuate too severely to assess whether they are precise. HbA1c is the longest
      established marker for glycemic control but still large interlaboratory variation
      is present. The standardized procedure for measurement of HbA1c was just proposed
      by the Japan Diabetes Society. Fructosamine is measured by a simpler procedure
      but many deoxidizing materials in serum especially superoxide may interfere with
      the reaction. Glycated albumin should be more reliable than fructosamine but a
      standard method of measurement has not been established yet. Future measurement
      of advanced glycation end product (AGE) should prove to be good marker for not
      only glycemic control but also diabetic complications or diagnosis of diabetes.
      The decrease in serum 1,5-anhydro-D-glucitol(1,5-AG) is very sensitive to urinary
      glucose excretion and may be useful as a marker of glycemic control and diagnosis
      of diabetes.

PMID- 7783361
TI  - [Plasma fatty acids, lipids, lipoprotein and macroangiopathy].
AB  - Epidemiological studies have elucidated that diabetes mellitus (DM) is one of the
      risk factors of coronary heart disease and that DM often accompanies
      dyslipidemia. Dyslipidemia in DM can be classified as either quantitative or
      qualitative. Although dyslipdemia in DM is affected by the type of DM and
      glycemic conditions, the characteristics of dyslipidemia in DM, especially in
      NIDDM are the increase in triglycerides accompanied by the decrease in HDL
      cholesterol level. Recently, new commercial kits for measurement of atherogenic
      lipoproteins which increase in DM are clinically available. The usefulness of
      these kits in DM was reviewed. Polyacrylamide electrophoresis can detect IDL and
      Lp(a) qualitatively. It has also become possible to estimate Lp(a) quantitatively
      by ELISA, TIA and LIA methods. Remnant lipoprotein can be measured in the
      fraction unbound to anti-apo A1 and anti-apo B100 antibodies by immunoaffinity
      gel analysis. Apoproteins, apoprotein E phenotype, post-heparin lipoprotein
      lipase, and Lp AI (HDL with apo AI and without apo AII) can be measured by the
      commercially available kits. Modified LDLs (glycated, oxidative) increase in DM,
      but their measurements remain complicated at the moment. Analysis of plasma fatty
      acids by gaschromatography is useful for dietary assessment. The measurement of
      these new markers seems to be useful to assess the extent of atherogenic risk in
      DM.

PMID- 7783362
TI  - [Determinations of microproteinuria in early diabetic nephropathy].
AB  - Microalbuminuria, transferrin and IgG were determined in the urine of diabetic
      patients with normal renal function. Microalbuminuria was assayed by the
      immunoturbidity method, transferrin by the latex agglutination method and IgG by
      the ELISA method using biotin labelled IgG.HRP labelled protein G. The
      correlation between microalbuminuria and urinary transferrin concentrations was
      high (r = 0.902). However, a low titer of transferrinuria was observed, (25.5%)
      among the patients with microalbuminuria; a wider distribution of transferrinuria
      was noted than microalbuminuria. Determination of transferrinuria did not appear
      to be superior to the determination of microalbuminuria in early diabetic
      nephropathy. The urinary IgG levels assayed by ELISA using biotin labelled
      IgG.HRP labelled protein G method were distributed from zero to 5 mg/g Cr in the
      patients with normoalbuminuria. The reference intervals of the urinary IgG
      concentration should be settled below 5 mg/g Cr. In the patients with
      microalbuminuria, the concentration of urinary IgG showed a wide variation and no
      correlation between concentrations of microalbuminuria and urinary IgG was noted
      (r = 0.02). Determination of urinary IgG is not useful as an early diagnostic
      procedure for diabetic nephropathy.

PMID- 7783363
TI  - [Islet cell antibodies].
AB  - Islet cell antibodies (ICA) are a marker of insulin-dependent diabetes mellitus
      (IDDM). ICA are detected in 60-80% of the patients with IDDM at the onset of the
      disease. The presence of ICA in patients with non-insulin-dependent diabetes
      mellitus (NIDDM) indicates that the patients are likely to develop IDDM. However,
      as ICA are measured by the indirect immunofluorescent method, the reliability of
      the ICA assay is not high in some institutes. Use of the pancreas tissue having
      high antigenicity is recommended as one solution for a reliable assay.
      Standardization of the ICA assay is under way with the use of an ICA positive
      standard sera as 80 JDF units. Anti-glutamate decarboxylase (GAD) antibody assays
      using a radioimmunoassay (RIA) or enzyme-linked immunosorbent assay (ELISA) have
      recently been developed. The significance of anti-GAD antibodies is comparable to
      that of ICA. Since the anti-GAD assay is reproducible and easy to perform, it
      should be used widely in parallel with the ICA assay.

PMID- 7783364
TI  - [Genetic diagnosis of diabetes mellitus].
AB  - NIDDM is likely to have a major genetic component in view of the different
      prevalence between ethnic groups, the familial clustering, and the high
      concordance in monozygotic twins. Linkage analysis of extended pedigrees of
      patients with maturity-onset diabetes of the young (MODY) identified the
      glucokinase gene mutations. Specific phenotypes have also led to the discovery of
      the insulin gene mutations in patients with high insulin or proinsulin levels, to
      the insulin receptor mutations in patients with marked insulin resistance, and to
      the mutations in mitochondrial DNA associated with deafness and maternal
      inheritance. These four types of diabetogenic gene mutations account for only a
      minor proportion of NIDDM. Direct screening for mutations in candidate genes with
      single-strand conformation polymorphism or heteroduplex screening or with direct
      sequencing in the diabetic patients with the appropriate pathophysiological
      abnormality can be a successful strategy. Genetic diagnosis provides clear
      definite diagnosis and specific therapies, such as IGF-1 for the insulin receptor
      mutations and coenzyme Q10 for the mitochondrial gene mutations.

PMID- 7783365
TI  - [The glutamic acid decarboxylase (GAD) antibodies and their clinical
      significance].
AB  - Since it was reported that the 64kD antigen that had been found to be the target
      of autoantibodies in the sera from IDDM patients was the same as GAD, GAD
      antibodies have been one of the focuses of many investigations. In this study, we
      developed a sensitive radioimmunoassay (RIA) system for GAD antibodies in human
      sera using native GAD purified from the pig brain. To confirm the relevance of
      pig GAD as the target antigen, we compared the sequences and antigenic activities
      among pig, rat and recombinant human GAD65. Based on the data from our and other
      laboratories, the homology of amino acid sequences between pig and human GAD65
      was 96.4%. The coefficient of correlation between the results of human and pig
      GAD RIA was 0.948. The GAD antibody study group confirmed the clinical usefulness
      of GAD antibodies not only for the diagnosis of IDDM but also slowly progressive
      IDDM.

PMID- 7783366
TI  - [An interlaboratory standardization of HbA1c determination in Japan].
AB  - A survey of the actual state of interlaboratory differences in HbA1c values
      revealed a great variation of the values among 107 laboratories throughout Japan;
      the coefficient of variation (CV) for measurements of fresh blood samples was as
      high as 10.5%. On the basis of this results, it became apparent that this large
      interlaboratory variation was mainly due to differences in evaluation of a labile
      HbA1c component and in values measured with an instrument of one manufacture with
      another. To verify this assumption, we asked the laboratories to measure only a
      stable component using common calibrations. These procedures resulted in a marked
      reduction of the interlaboratory difference in HbA1c values; the CV decreased to
      2.82%. The reference intervals of HbA1c calculated from the HbA1c results of 725
      healthy subjects measured using the standardized procedure was from 4.3% to 5.8%.

PMID- 7783367
TI  - [Telepathology].
AB  - Telepathology, introduced in 1986 by Weinstein, was not adopted in Japan because
      its image could not be transmitted by the National Television Standard Committee
      (NTSC) transmission. In 1990 a new system of Hi-Vision (HDTV) with 1125 lines,
      was implemented in Yamagata University and was highly evaluated. This success was
      followed by new developments both in NTSC and HDTV telepathology systems. Real
      time HDTV images are transmitted via optical fiber cables for in-house hospital
      operations. Static HDTV and NTSC images are transferred via integrated services
      digital network (64 Kbit/s and 1.5 Mbit/s). Today telepathology networks are
      extending all over the country.

PMID- 7783369
TI  - [Detection of heterogeneous MRSA by using the PCR method and population
      analysis].
AB  - To assess the clinical usefulness of the PCR method for the detection of
      methicillin-resistant Staphylococcus aureus (MRSA) by targetting the mecA gene,
      we surveyed 150 clinical isolates of Staphylococcus aureus and compared the
      results of the PCR method with those of the standard broth microdilution method.
      Fifty-four isolates (36%) were positive for the mecA gene and two of them,
      presenting coagulase type IV, were recognized as susceptible strains by
      microdilution method, while all the other mecA positive strains were drug
      resistant. Population analysis revealed that these two strains were heterogeneous
      in terms of drug-resistance and composed of two populations of cells; i.e.,
      relatively susceptible cells and highly resistant cells. The discrepancy between
      the phenotypic expression (drug-resistance) and the genotype (mecA gene) seems to
      be due to the small percentage of highly resistant cells. Drug-resistant colonies
      could be induced in these strains by the contact with methicillin, indicating the
      selective increase of the population of resistant cells by a passage in the drug.
      These observations suggest that it is clinically important to detect the
      resistance-inducible strains (prototype MRSA) by using the PCR method and
      population analysis.

PMID- 7783368
TI  - [Immunohistochemical study of proliferation index of astrocytomas classified by
      new histopathological grading].
AB  - A new grading method of astrocytoma, proposed by Daumas-Duport et al, was based
      on four criteria:nuclear atypia, mitosis, necrosis and endothelial proliferation
      (0 criteria = Grade 1, 1 criteria = Grade 2, 2 criteria = Grade 3, 3 or 4
      criteria = Grade 4). To elucidate the correlation of the classification based on
      four criteria, cellularity and proliferative activities, we studied proliferating
      index of 67 astrocytomas, using immunohistochemical staining for Ki-67 antibodies
      (MIB-1). A new grading method was related to proliferating index in this study,
      however, cellularity of tumor cells was not related to proliferating index. In
      this study, endothelial proliferation was invariably seen in high grade(Grade 3
      and 4) astrocytomas. These tumor vessels were associated with dysfunction of
      blood-brain barrier and some growth factors accelerated to tumor cell
      proliferation. Relation between histopathological grade of astrocytoma and
      proliferation index was supposed, and new grading system was thought to be useful
      for routine pathological examination.

PMID- 7783370
TI  - [Detection of nuclear antigen within the leukemic cells using immunocytochemical
      technique].
AB  - Immunocytochemical methods were examined for their sensitivity in the detection
      of nuclear antigens (proliferating cell nuclear antigen, Ki-67 associated
      proliferative antigen and p53 protein) in the leukemic cells. A comparative study
      of the biotin streptavidin enhanced peroxidase technique, the biotin streptavidin
      enhanced alkaline phosphatase technique and the indirect immunoperoxidase
      technique showed that the indirect immunoperoxidase technique was more sensitive
      than the other techniques for detecting p53 protein. The results of several
      fixation methods demonstrated that formalin and methanol, formalin and ethanol
      (1:9) and buffered formalin acetone gave good results for detecting p53 protein.
      In the eosinophils and neutrophils the endogenous peroxidase reaction disappeared
      after microwave heating for over three minutes. Thus enzyme pre-blocking of blood
      smears could be omitted. Four solutions for microwave treatment were tested.
      Excellent antigen retrieval was obtained with pH6.4, pH7.4 phosphate buffer
      saline and pH6.0 citric acid. However, the nuclear antigens could not be
      retrieved and the positive reaction could not be obtained after the treatment
      with distilled water. The optimal microwave heating time was five to ten minutes.
      The indirect immunoperoxidase technique performed using microwave treatment under
      these optimal conditions may be potentially applicable for detecting low levels
      of nuclear antigens in the leukemic cells within conventional blood smears.

PMID- 7783371
TI  - [Phenotypical diagnosis of Japanese chronic lymphocytic leukemia--an
      international cooperative study based on the French-American-British
      classification of mature B-cell leukemias].
AB  - To better understand the accuracy in the diagnosis of chronic lymphocytic
      leukemia (CLL) and characterize the clinical features of CLL in Japan, where the
      disease is extremely rare, an international cooperative study was conducted by
      hematologists between Japan and UK. Blood and bone marrow films from 36 patients
      with a possible-diagnosis of CLL were referred to two laboratories of Nagasaki
      University Hospital (Nagasaki) and Royal Marsden Hospital (London). According to
      the FAB criteria, typical CLL 16 and CLL/PL 2, a subtype of atypical CLL, were
      completely accordant in diagnosis. However, phenotypical diagnosis of CLL mixed,
      the other of atypical CLL, and intermediate lymphocytic leukemia (ILL) in
      leukemic phase often gave inconsistent results. Especially, 8 cases of atypical
      CLL designated as likely CLL were equivocal between CLL and ILL, suggesting
      clinical feature more close to typical CLL than ILL. This indicates the presence
      of a relatively high incidence of atypical CLL in Japan which dose not exactly
      fit with the FAB Criteria. Finally, we would like to emphasize that an
      international cooperative study allows improvement of accuracy in diagnosis and
      better understanding of the disease entity of lymphoid malignancies, having on
      ethnically different morbidity.

PMID- 7783372
TI  - [The ABO blood groups-dependent reference intervals for serum alkaline
      phosphatase isozymes and total activity in individuals 20-39 years of age].
AB  - Reference intervals of the activity of serum alkaline phosphatase isozymes (AP
      IZ: high molecular-, liver-, bone- and intestinal-types) were determined
      according to the ABO (blood type) system in 200 healthy subjects aged 20-39
      years. AP activity was determined according to the JSCC method. AP-IZ was stained
      by the formazan method after isolation by TITANIII-Lipo plate electrophoresis.
      For the electrophoresis, treated serum with neuraminidase and untreated one were
      concomitantly used for detecting liver AP and bone AP respectively. As a result
      of comparison of mean AP-IZ activity among the groups divided according to the
      ABO system, total AP, intestinal AP and liver AP activities in the type B and O
      persons were significantly higher than in the type A and AB persons. It is well
      known that the activities of total AP and intestinal AP in type B and O persons
      are higher than in type A and AB persons, but there have been no reports showing
      that the activity of liver AP in type B and O persons is higher than in type A
      and AB persons. Furthermore, in the type B and O persons there was a low
      correlation (r = 0.195, p < 0.05) between the activities of liver AP and
      intestinal AP. The present assessment included subjects in the age group (20-39
      years) considered not to show fluctuations in the activity of bone AP, which is
      influenced by age. The above findings should be investigated in regard to other
      age groups.

PMID- 7783373
TI  - [Clinical significance of serum troponin T following coronary artery bypass
      surgery].
AB  - We evaluated the clinical significance of serum cardiac troponin T(TnT) following
      coronary artery bypass surgery (CABG) as an indicator of cardiac damage during
      the operation. We studied 21 patients who underwent CABG and 8 patients who
      underwent open thoracotomy for lung disease. In the CABG patients, serum TnT
      levels showed roughly biphasic release kinetics, with a peak less than 10h
      postoperatively and a second peak on or about the fourth day. The serum TnT
      levels at 0 and 10h postoperatively were 8.58 +/- 1.07 (mean +/- SE) and 9.19 +/-
      1.35ng/ml, respectively, levels were 30-40 times higher than the cut-off value of
      0.25ng/ml. On the fourth day after CABG, serum TnT in the 3 graft groups (7.21 +/
      2.56ng/ml) was significantly higher than in the 1 or 2 graft groups (2.57 +/-
      0.05 and 2.53 +/- 0.46ng/ml, respectively). The peak serum TnT level of the
      patients with perioperative myocardial infarction was 34.6 +/- 5.29ng/ml, which
      was significantly higher than in the patients without specific evidence of
      perioperative infarction. On the other hand, in the patients undergoing thoracic
      surgery for lung disease, serum TnT showed no postoperative increase. In
      conclusion, serum TnT appears to be a specific marker of cardiac damage after
      CABG, and may be useful for the diagnosis of perioperative myocardial infarction.

PMID- 7783374
TI  - [Recent clinical research of familial adenomatous polyposis].

PMID- 7783375
TI  - [Epidemiological evaluation of the protective effect for dying of stomach cancer
      by screening programme for stomach cancer with applying a method of case-control
      study--a study of a efficient screening programme for stomach cancer].
AB  - An epidemiological evaluation of the protective effect for dying of stomach
      cancer by screening programme for stomach cancer was conducted with applying a
      method of case-control study. And also in order to carry out an efficient
      screening programme, the age groups who should be intensively recommended to
      receive screening and an optimal screening time interval since the last test were
      analyzed. 527 cases of men and 273 of women, dying of stomach cancer in the years
      1981-1989 in the Awa region of Chiba prefecture, were identified from Chiba
      Cancer Registry. For each case, 3 controls were drawn at random from Awa living
      residents (about 162000 inhabitants at 1989 national census), with being matched
      strictly according to the district of residence, sex and born within 3 years of
      birth-year. For both cases and controls, the information about the screening
      history until the date of diagnosis of the case in each matched set was collected
      respectively from comparison with the screening certification. The results showed
      a relative risk of 0.417 (99% CI 0.284-0.612) in ever screened men compared with
      never screened and 0.480 (99% CI 0.280-0.823) in women. The significant reduction
      in risk was intensively observed on age groups 40-74 years among men and 50-69
      years among women and the protective effect continued at most in the following
      three years since last screening. For an efficiency of screening programme, these
      age groups should be intensively recommended to receive screening and it is
      allowable that an optimal screening time interval since last negative test is at
      most 3 years for general attendance.

PMID- 7783376
TI  - [Macroscopic characteristics of depressed type early gastric cancer special
      reference to their mucosal localizations].
AB  - Macroscopic characteristics of 143 lesions from 138 cases of depressed type early
      gastric cancer less than 2.0cm in the major axis (74 lesions of undifferentiated
      cancer, 69 lesions of differentiated cancer) were studied with respect to the
      localization in the gastric mucosa divided into 3 areas (area F: fundic gland
      region, 36 lesions, area I :intermediate gland regions, 29 lesions, area P
      :pyloric gland region, 79 lesions). (1) All 36 lesions in the area F were of the
      undifferentiated type. Narrowing and/or interruption of the folds were found in
      83%. The abnormal folds were found in 97% of the lesions found in the area where
      the mucosal folds were present. (2) 72% lesions in the area I were determined to
      be undifferentiated cancers. Uneven depressed surface was observed in 95% of the
      undifferentiated cancer. Steep depressed margine was found in their 86%.
      Narrowing and/or interruption of the folds were detected in their 81%. In cases
      of differentiated cancer, the findings of folds both on the depressed surface and
      margin were scarcely observed. (3) The undifferentiated cancer was diagnosed in
      22% of the lesion in the area P. In 18% and 76% of them, uneven depressed surface
      and steep depressed margin were observed respectively. Narrowing and/or
      interruption of the folds were recognized in only 6%. Although these abnormal
      macroscopic findings were less in this area, the marginal elevation was found in
      59%. In differentiated cancer of this area, the presence of marginal elevation
      was the highest up to 72% compared with cancers in the other areas.

PMID- 7783377
TI  - [Effects of centrally administered NPY on stress induced gastric ulcers in the
      rat].
AB  - We investigated the central effects of neuropeptide Y (NPY) on stress-induced
      gastric ulcers in water immersion rats. Intracisternally administered NPY dose
      dependently aggravated, but intravenously administered NPY did not affect stress
      ulcers in rats. Intraperitoneal pre-treatment of atropine completely blocked the
      central effect of NPY, but neither pyrilamine nor cimetidine affected.
      Intracisternal administration of NPY aggravated stress ulcers not through
      histamine mediated mechanism but by parasympathetic pathway. It is suggested that
      centrally administered NPY acted by the inhibition on gastric motility and by the
      suppression on gastric mucosal blood flow rather than by the stimulation on
      gastric secretion in rats.

PMID- 7783378
TI  - [Residual gastritis after gastrectomy and Helicobacter pylori--its clinical
      significance].
AB  - Residual gastritis after gastrectomy brings the various symptoms such as
      abdominal pain, nausea, emesis and loss of appetite, and often hazards quality of
      life of the patient. Bile reflux to the stomach is believed as one of the
      important pathogenesis of residual gastritis, however the prevention for bile
      reflux cannot always heal the gastritis. Helicobacter pylori (H. pylori) is
      considered as one of the most important pathogenesis of gastroduodenal ulcer and
      gastritis, and H. pylori may possibly cause residual gastritis after gastrectomy.
      However, the association between infection with H. pylori and the residual
      gastritis has not revealed yet. In the present study, the association with H.
      pylori and the residual gastritis after gastrectomy was investigated in 56
      patients who had undergone gastrectomy before. Twenty-four patients (42.9%) had
      H. pylori infection at their stomachs and the incidence of the infection in the
      patients with gastrectomy was significantly higher with subtotal gastrectomy. As
      for the histological gastritis score of Rauws (Rauws' score), Rauws' score of H.
      pylori positive group was significantly higher than H. pylori negative group.
      Furthermore, the eradication of H. pylori for the patients with serious symptoms
      of gastritis improved the symptoms and decreased significantly Rauws' score.
      These results suggest that H. pylori was associated with the pathogenesis of
      residual gastritis after gastrectomy.

PMID- 7783379
TI  - [A successful treatment of jejunal leiomyosarcoma accompanied with liver
      metastases].

PMID- 7783380
TI  - [A case of primary signet-ring cell carcinoma in the 3rd part of the duodenum].

PMID- 7783381
TI  - [A case of digestive fract T-cell malignant lymphoma with clinical course of
      twenty years].

PMID- 7783382
TI  - [A case of pyogenic granuloma in the sigmoid colon].

PMID- 7783383
TI  - [A case report of colon cancer in ulcerative colitis followed up for 9 years
      after the detection of high-grade dysplasia on biopsy].

PMID- 7783384
TI  - [A case of actinomycosis of the greater omentum].

PMID- 7783385
TI  - [A case of chronic active hepatitis C presenting heart failure during interferon
      alpha 2 alpha therapy].

PMID- 7783386
TI  - [An autopsy case of multiple myeloma with veno-occlusive disease of the liver
      induced by ionized radiation].

PMID- 7783388
TI  - [A new trial of intraluminal ultrasonography in the diagnosis of gallbladder
      diseases by endoscopic transpapillary catheterization in the gallbladder
      technique (ETCG technique)].

PMID- 7783387
TI  - [A case of HCV-RNA positive liver cirrhosis with hyper-gamma-globulinemia and
      high titers of ANA, accompanied by hypothyroidism].

PMID- 7783389
TI  - Correlation of alpha-1-antitrypsin (PI) polymorphism between blood and semen.
AB  - The correlation between isoprotein types of alpha-1-antitrypsin (PI) in blood and
      semen samples from the same individual was determined in 48 Japanese men by the
      combined technique of isoelectric focusing with immobilized pH gradients and
      immunoblotting. Five common PI types (M1, M1M2, M1M3, M2 and M2M3) were detected
      in the blood plasma samples. However, PI-specific bands in semen migrated more
      cathodally than those in plasma into a pI region of approximately 5.05, and about
      17% of the semen samples could not be phenotyped: the rest were easily phenotyped
      and their PI types were found to correlate with the type found in the
      corresponding blood samples. PI typing could therefore provide an additional
      discriminant characteristic for the forensic examination of individualization
      from semen samples.

PMID- 7783390
TI  - [Analysis of sex chromosomal DNA markers by a molecular biological method and
      it's application to forensic medicine].
AB  - We attempted sex and individual identifications of several forensic specimens by
      detecting various sex chromosome-specific sequences by the polymerase chain
      reaction (PCR) method. The specimens were 30 blood stains that were attached to
      gauze and stored for 11 months -15 years (15 males, 14 females and 1 of unknown
      gender) and 10 bleached white bones (8- about 10000 years after death). Of the
      known 29 blood stains, the sex determination rate was the highest by DYZ-1
      (amplified DNA fragment = 149bp, about 3000 copies on Y chromosome) recombinated
      with DXZ-1 (28 of the 29 samples) although 27 samples could be determined by DYZ
      1 (amplified DNA fragment = 1000bp, about 3000 copies on Y chromosome)
      recombinated with DXZ-1. The sex determination rate was relatively low by DYZ-3
      (amplified DNA fragment = 170bp, about 100 copies on Y chromosome) recombinated
      with DXZ-1 (23 of the 29 samples). The sex determination rate by two single locus
      markers, PAB or Amelogenin was markedly low (7 and 9 of 29 samples,
      respectively). The sex determination rate by the 27H39 locus was 27 of the 29
      samples; 14 of the 15 male were determined (A = 186bp, 1; B = 190bp, 7; C =
      194bp, 5; D = 198bp, 1; E = 202bp, 0). One unknown gender could be identified as
      male by multiple locus markers, but could not be identified by any single locus
      markers except for the 27H39 locus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783392
TI  - [Arterial oxygen saturation monitoring of sleeping infants by pulse-oximeter-
      effect of sleeping position on arterial oxygen saturation in infants].
AB  - Monitoring of the arterial oxygen saturation (SaO2) in two sleeping infants was
      reported. They were a couple of female twins and had grown up normally after
      admission to NICU (Neonatal Intensive Care Unit) for a month. We investigated
      their SaO2 with the puls-oximeter at the terms between the 2nd and the 10th
      month. There was no significant difference between SaO2 in prone positions (n =
      29) and that in supine positions (n = 30). In the infant with the sniffing
      conditions, however, SaO2 in prone positions seemed to be slightly lower than
      that in the healthy conditions. The slightly low SaO2 would give no effects on
      the healthy infants, but it may cause ALTE (Apparent Life Threatening Event) or
      death from SIDS (Sudden Infant Death Syndrome) to some infants who are not in
      good health and/or who are prone to get into ALTEA or SIDS. Especially, in the
      sniffing condition with hyperthermia, as the oxygen dissociation curve sifts to
      right and SaO2 degradation appears easily, sudden infant death may be possible to
      happen in prone position.

PMID- 7783391
TI  - [Simple determination methods for blood grouping from biological stains. 1.
      Immunologic gold colloid aspiration test and dot ELISA test by membrane
      aspiration method for determining ABO blood groups from saliva specimens].
AB  - Two immunologic tests using nitrocellulose membrane and an aspiration device were
      applied to determine the ABO blood groups and secretor status from saliva
      specimens. First, immunologic gold colloid membrane aspiration test (IMAT) was
      performed with orange-red colloidal gold particles (GP) sensitized with anti-A or
      anti-B antibody or anti-H lectin (A chicken antiserum to O secretor saliva was
      also used as an anti-H reagent in some experiments). The boiled saliva specimens
      were serially diluted and dotted to the nitrocellulose membrane, which was
      equipped to a disposable aspiration kit, and the antibody- or lectin-coated GP
      was aspirated through the membrane. The stained saliva changed red by the
      immunologic binding of the GP. Test results could be obtained within some
      minutes. Detection limits of IMAT shown by saliva dilution were 1:100 to 1:10,000
      for secretor salivas, whereas those for non-secretor salivas were 1:10 or lower.
      Second, a revised dot ELISA was performed by using the membrane aspiration
      device. The requisite time for this test (Dot ELISA-A) was 40 to 45 minutes,
      whereas that for conventional dot ELISA was 3 to 4 hours. The detection limits of
      the dot ELISA-A shown by the saliva dilutions were 1:1,000 to 1:100,000 for
      secretor salivas, whereas those for non-secretor salivas were 1:1,000 or below.

PMID- 7783393
TI  - Pharmacokinetics of ethanol drinking--absorption kinetics and first-pass effect.
AB  - The pharmacokinetics of alcohol drinking was studied in male rabbits. Various
      doses (D) of ethanol (0.25, 0.5, 1, 2 and 3 g/kg BW) were administered perorally
      to the animals and blood alcohol (ethanol) concentration (BAC) was measured.
      Simultaneous multiline fitting was attempted using the BAC-time curves of 5
      peroral doses and of 5 intravenous doses. The two-compartment open model with
      parallel first-order and Michaelis-Menten elimination and first-order absorption
      kinetics was concluded to be the best model. To estimate the value of the
      absorption rate constant (ka) and the bioavailability (F) at each dose, curve
      fitting was also attempted by using a single BAC-time curve. The F value
      decreased with a low dose (0.25 g/kg), but complete systemic bioavailability was
      noted in higher doses. A first-pass effect was suggested to occur with the low
      dose. With low doses, the peak BAC might be too low to saturate the ethanol
      metabolism. The conventional method using area under the BAC-time curve (AUC)
      underestimated the F value. The other conventional method using theoretical BAC
      at time zero (C0) [F = C0oral x D(i.v.)/C0i.v. x Doral)] was compared to the AUC
      method. The estimated F value by this C0 equation method was closer to it by
      curve fitting than that by the AUC method. The effects of various ka, F and D
      values were also studied using a computer simulation. Consequently, the
      conventional AUC method was concluded to overestimate the first-pass metabolism
      of ethanol. The C0 equation method is thought to be more useful.

PMID- 7783394
TI  - [Immunology of tuberculosis and cytokines].
AB  - One of the unique features characterizing human tuberculosis (TB) is its
      pathogenesis. The pathogenesis of TB involves cell-mediated immune responses
      against Mycobacterium tuberculosis. Concisely, macrophages activated by various
      soluble mediators or cytokines released through the cellular interactions after
      infection with M. tuberculosis play a pivotal role in the pathogenesis of human
      TB. In fact, very complex cellular interactions are going on within the host
      after infection with or endogenous reactivation of M. tuberculosis. Cells
      communicate by cell-cell contact and by the release of mediators which may
      originate locally, called cytokines. In TB infection, macrophages can be
      activated by two ways; directly with mycobacterial organisms or lipid fractions
      of their cell walls at the earlier phase of infection, and indirectly with
      cytokines produced by CD4+ T cells specifically activated by mycobacterial
      peptide antigens at the later phase of infection. The various clinical features
      of TB are the summarized outcome of cell to cell interactions mediated by diverse
      cytokines produced by various immune cells which are initially triggered by M.
      tuberculosis infection. CD4+ T cells can be classified into two subsets according
      to the patterns of cytokines they produce; Th1 cells give rise to cell-mediated
      immunity and are characterized by the production of IL-2 and IFN-gamma, whereas
      Th2 cells are more efficient in mediating antibody production and secrete IL-4,
      IL-5, IL-6 and IL-10. Th2 cells can control Th1 cells and vice versa. Th2 cells
      therefore inhibit the production of cytokines by Th1 cells by releasing IL-4 and
      IL-10. Infection with mycobacteria stimulates macrophage IL-12 production which
      appears to act directly on naive CD4+ T cells to induce Th1 development and
      initiation of cell-mediated immunity. IL-12 is a critical component in the
      development of cell-mediated immunity. In addition, IL-12 also activates NK cells
      and gamma/delta T cells, both of which secrete various macrophage-activating
      factors to kill M. tuberculosis. One of the structural characteristics of M.
      tuberculosis is the cell wall rich in lipid components. Of importance among
      various biological activities of the cell wall lipids is the stimulation of
      mononuclear phagocytes to produce a certain number of cytokines or monokines
      including IL-12 and IL-10, both of which play important roles in regulation of
      immune responses in mycobacterial infection and in pathogenesis of TB.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 7783395
TI  - [An outbreak of tuberculosis involving foreign workers from South America].
AB  - A twenty-four year old male Peruvian of Japanese origin, who came to Japan in
      September 1990 and had been working in a minor factory in a rural area, was
      admitted to a hospital in March '91 with severe cough. Smear examination of his
      sputum smear was positive for acid-fast bacilli and his chest X-ray showed
      multiple cavities (Index case). Subsequent contact examination identified further
      four patients with pulmonary tuberculosis among his colleagues in the factory,
      all of whom lived in the same house with the index case. During following three
      years, further six patients with mycobacteriosis, two Peruvians and four
      Japanese, were found among the employee of that factory. M. tuberculosis was
      cultured from the sputa obtained from seven of these eleven patients. Another
      patient was diagnosed as non-tuberculous mycobacteriosis. Restriction fragment
      length polymorphism (RFLP) analysis carried out with five strains of M.
      tuberculosis isolated from these patients revealed the identical RFLP pattern
      which is uncommon in Japan. Still more, an isolate from another patient was
      subjected to RFLP analysis by chance, and was found to show the same RFLP
      pattern. Later epidemiological study revealed that the last patient, a 53 year
      old saleswoman of boxlunch, might have some contact with the index case at her
      booth. Though RFLP analysis was not done for the isolate from the index case,
      from the identity of RFLP patterns of other isolates, clinical course and
      epidemiological study, it is considered that six patients were certainly, and two
      others were probably infected from the index case.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7783396
TI  - [A case of eosinophilic pneumonia associated with Mycobacterium avium infection].
AB  - A 54 year-old woman was admitted with cough and high fever. Computed tomographic
      scan of the chest showed bilateral patchy infiltrates, predominantly in the upper
      lobes. Eosinophils in the bronchoalveolar lavage fluid (BALF) accounted for 19%
      of BALF cells. Furthermore, Mycobacterium avium was isolated from a bronchial
      washing from the upper area of the right lung (S3) and a sample of sputum which
      had been submitted for microbial examination about 1 month before admission by
      another clinic. Based on these finding's the diagnosis of eosinophilic pneumonia
      associated with Mycobacterium avium infection was established. The infiltrates of
      the lung rapidly decreased after administration of antituberculous agents. The
      simultaneous presentation of eosinophilic pneumonia and Mycobacterium avium
      infection has not been previously reported. Because of the efficacy of
      antituberculous agents in this case, we concluded that Mycobacterium avium was a
      cause of eosinophilic pneumonia.

PMID- 7783397
TI  - [The 69th annual meeting special lecture. Present situation of leprosy].
AB  - Many leprosy patients have deformity or disability owing to the characteristics
      of Mycobacterium leprae i.e. M. leprae affects skin and peripheral nerve. Optimum
      growth temperature of M. leprae was estimated by clinical manifestations and
      animal experiments, and it was concluded that the optimum temperature is 33
      degrees C, and this characteristic of M. leprae may be one of the reason why M.
      leprae affects skin tissue. There was no reliable treatment of leprosy before
      1943, but effectiveness of promin against leprosy was proven in 1943, and
      chemotherapy of leprosy was gradually improved especially since 1960 after the
      discovery of mouse footpad inoculation of M. leprae. In vitro cultivation
      technique of M. leprae is still unestablished, but susceptibility of ninebanded
      armadillo to M. leprae was discovered in 1970. Supply of M. leprae collected and
      purified from M. leprae infected armadillo tissue became available, then
      biochemistry, immunology and molecular biology of M. leprae was improved
      significantly. Ridley-Joppling's classification of leprosy i.e. two types
      (tuberculoid and lepromatous) and two groups (indeterminate and borderline)
      classification is being adopted at present. Rifampicin, DDS (dapsone) and
      clofazimine (lamprene) are widely used for chemotherapy of leprosy. WHO is
      recommending Multidrug Therapy (MDT) of leprosy i.e. administration of rifampicin
      and DDS for paucibacillary group, administration of rifampicin, DDS and
      clofazimine for multibacillary group. About 2.4 million leprosy patients are
      registered and under chemotherapy in the world at present, and about five hundred
      thousand new patients are being registered every year. Target of leprosy
      elimination by WHO is prevalence rate of leprosy should be less than one per ten
      thousand in every country.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783398
TI  - Heparin lowers blood pressure: biological and clinical perspectives.

PMID- 7783399
TI  - Evaluation of the lithium clearance method: direct analysis of tubular lithium
      handling by micropuncture.

PMID- 7783400
TI  - Albumin interaction with the glomerular capillary wall in vitro.
AB  - The binding of albumin to the glomerular capillary wall was studied using albumin
      gold in perfused kidneys, the interaction of [3H]albumin with isolated glomeruli
      at 37 degrees C and 4 degrees C and the interaction at [3H]albumin with purified
      basement membrane. The albumin-gold was found to bind predominantly to the
      basement membrane and this interaction could be dissociated with high
      concentrations of albumin. There was binding of albumin to isolated rat glomeruli
      which exhibited temperature dependence. Glomeruli exhibited a binding site at
      both 37 degrees C and 4 degrees C with an association constant in the range of 1
      to 3 x 10(4) M-1 that bound 7 x 10(13) molecules/glomerulus. At 37 degrees C,
      however, there was anomalous Scatchard binding behaviour at relatively higher
      concentrations of albumin (30 to 50 mg/ml) which could be due to either
      glomerular cell uptake or the appearance of multiple binding sites or both. The
      binding of albumin to isolated glomeruli and the glomerular albumin levels in
      isolated kidney perfusion could largely be accounted for by the binding of
      albumin to the glomerular basement membrane. The albumin binding to glomeruli at
      37 degrees C was enhanced by Pronase digestion and heparinase digestion, but
      remained unchanged following trypsin treatment or neuraminidase treatment.
      Similarly, albumin was shown to bind to purified basement membrane preparations.
      This binding was also enhanced (approximately 80 times) by heparinase digestion
      but remained unchanged after digestion with chondroitinase ABC or
      hyaluronidase.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783401
TI  - Modulation of sodium-coupled uptake and membrane fluidity by cisplatin in renal
      proximal tubular cells in primary culture and brush-border membrane vesicles.
AB  - The proximal tubule appears to be the main target for the adverse effects of cis
      diamminedichloroplatinum (II) (cDDP). We evaluated the early effects of cDDP at
      concentrations (3 to 67 microM) lower that those which alter cell viability, on
      three apical transport systems and on the physical state of the brush border
      membrane (BBM) in rabbit proximal tubule (RPT) cells in primary culture. The
      maximal effect, corresponding to a 30% decrease in Na(+)-coupled uptake of
      phosphate (Pi) and alpha-methylglucopyranoside (MGP) and a twofold increase in
      Na(+)-coupled alanine uptake, was obtained at 17 microM (5 micrograms/ml) cDDP
      and occurred through a modification of their affinity. At this concentration,
      cDDP increased BBM fluidity and decreased the BBM cholesterol content by 28%,
      without increasing the permeability of tight junctions. To clarify the role of
      cDDP-induced increase in BBM fluidity on alterations of Na(+)-coupled uptake,
      these parameters were also investigated in BBM vesicles isolated from rabbit
      renal cortex directly exposed to cDDP. cDDP induced a concentration-dependent
      inhibition of Na(+)-coupled uptake of MGP, Pi and alanine in BBM vesicles from
      the renal cortex, associated with a decrease in protein sulfhydryl content,
      without modifying BBM fluidity. Our findings strongly suggest that the cDDP
      induced increase in BBM fluidity in RPT cells results from an indirect mechanism,
      possibly an alteration of cholesterol metabolism, and did not play a major role
      in the cDDP-induced inhibition of Na+/Pi and Na+/glucose cotransport systems that
      may be mainly mediated through a direct chemical interaction with essential
      sulfhydryl groups of the transporters.

PMID- 7783402
TI  - High glucose concentrations and protein kinase C isoforms in vascular smooth
      muscle cells.
AB  - High extracellular glucose activates protein kinase C (PKC), a family of kinases
      vital to intracellular signaling. However, which PKC isoforms are involved and
      where in the cell they operate is unclear. We tested the hypothesis that only
      those PKC isoforms binding to diacylglycerol (DAG) are activated by high glucose.
      We also reasoned that the isoforms would translocate to different parts of the
      cell, where they presumably serve different functions. The PKC isoforms alpha,
      beta, delta, epsilon, and zeta were studied. Twenty mM glucose caused an increase
      in total PKC activity at six hours, which was maintained at 24 hours. High
      glucose decreased the angiotensin II-induced calcium signal. This effect was
      reversed by preincubating the cells with the PKC inhibitor staurosporine. Glucose
      induced a translocation of all PKC isoforms except PKC zeta by Western blot.
      Confocal microscopy showed that PKC alpha, beta, and epsilon were translocated
      into the nucleus. PKC delta showed strong association with cytoskeletal
      structures. The effects were sustained at 24 hours for PKC isoform beta and to a
      lesser extent for PKC delta and epsilon, but not for PKC alpha. Thus, PKC
      isoforms differ in their propensity to be activated by high glucose. Those
      isoforms binding to DAG are activated. Both cytoskeletal and nuclear signaling
      may be involved.

PMID- 7783403
TI  - Non-iron mediated alteration in hepatic transferrin gene expression in the
      nephrotic rat.
AB  - Both transferrin and the iron it carries are lost in the urine in the nephrotic
      syndrome. Patients may develop hypochromic microcytic anemia and synthesis of
      transferrin, a protein regulated in large part by iron availability, is
      increased. Transferrin synthesis has also been reported to be increased in liver
      slices from rats with hereditary analbuminemia, and their plasma transferrin
      levels are increased, suggesting that transferrin synthesis may be stimulated by
      processes other than iron depletion in this hypoalbuminemic condition.
      Transferrin metabolism was studied in rats with Heymann nephritis (HN), in a
      strain of Sprague-Dawley (SD) rats with hereditary analbuminemia [Nagase
      analbuminemic rats (NAR)], and in normal SD rats. Plasma transferrin
      concentration and mass was decreased significantly in HN, but increased in NAR.
      Transferrin synthesis was increased both in NAR (measured either as the
      disappearance of [125I] labeled transferrin or as the incorporation of [3H]
      phenylalanine) and in HN (incorporation of [3H] phenylalanine). The fractional
      rate of transferrin catabolism was unchanged in NAR. Thus transferrin mass was
      increased in NAR entirely as a consequence of increased synthesis. Transferrin
      and albumin synthesis correlated with one another in both HN and SD (P < 0.001).
      Transferrin mRNA was increased in both HN and NAR and was unaffected by
      administration of iron to HN. Hepatic transferrin and albumin mRNA levels were
      also correlated positively in HN and SD, suggesting that increased hepatic
      synthesis of both proteins might be responding to the same stimuli. Transferrin
      gene transcription was increased in both HN and NAR and was unaffected by
      administration of iron to HN. Transferrin mRNA was not increased in the testis in
      either HN or NAR, suggesting that augmentation in transferrin gene expression is
      driven by a non-iron dependent process and is confined to the liver.

PMID- 7783404
TI  - Direct podocyte damage in the single nephron leads to albuminuria in vivo.
AB  - The hypothesis that detachment of podocytes leads to albuminuria was tested by
      studying the single nephron albuminuria in vivo after injecting a saponin
      solution (0.6 mg/ml) in Bowman's space of superficial glomeruli, which produces
      selective damage of the podocytes, in female Munich-Wistar-Fromter rats. Animals
      were subsequently installed under a fluorescence microscope, a purified
      fluoresceinated rat albumin solution was intravenously injected and the passage
      of the fluorescent albumin was followed through the microscope. Of the 47
      glomeruli injected with the saponin solution (in 6 animals) 46 became fluorescent
      within seconds with the fluorescence progressing from Bowman's space into the
      proximal tubule and then in the rest of the tubule. In superficial non-injected
      and control-injected glomeruli weak fluorescence could be detected only in the
      glomerular tuft and the peritubular capillaries. Tubuli injected with the saponin
      solution remained indistinguishable from non-injected tubuli. Electron
      microscopic study of the saponin-injected glomeruli confirmed the selective
      removal of podocytes. Immunogold electron microscopy confirmed that the intact
      albumin molecule effectively passed the glomerular capillary wall at the site
      where podocyte detachment had occurred. It is concluded that selective removal of
      podocytes at the single nephron level leads to albuminuria in vivo, and therefore
      podocytes play a crucial role in regulating the permeability of the glomerular
      capillary wall.

PMID- 7783405
TI  - Plasmalogen phospholipid hydrolysis during hypoxic injury of rabbit proximal
      tubules.
AB  - We have identified and quantified the major species of arachidonate-containing
      phospholipids in proximal tubules by high performance liquid chromatographic and
      gas chromatographic analyses. Arachidonate was found to comprise 53% of the total
      mass of fatty acids esterified at the sn-2 position of ethanolamine
      phospholipids, and 51% of that amount resides in three plasmenylethanolamine
      species containing the vinyl ethers of palmitaldehyde, oleylaldehyde or
      stearylaldehyde at the sn-1 position. Choline phospholipids contained 21%
      arachidonylated species and 33% of that amount resides in a single
      plasmenylcholine species containing the vinyl ether of palmitaldehyde at the sn-1
      position. Ten minutes of hypoxia did not cause a significant change in the total
      phospholipid mass of ethanolamine or choline phospholipids; however, phosphate
      analysis of the individual phospholipid molecular species containing esterified
      arachidonic acid in isolated proximal tubules demonstrated a 24% reduction in the
      mass of the plasmenylethanolamine molecular species with the vinyl ether of
      oleylaldehyde at the sn-1 position and a 35% reduction in the mass of
      plasmenylcholine species with palmitaldehyde at the sn-1 position. These studies
      underscore the pathophysiological importance of plasmalogen phospholipid
      hydrolysis and suggest that activation of PLA2s, which utilize endogenous
      proximal tubule plasmalogen substrates, may play an important role in the early
      generation of arachidonic acid and accompanying phospholipid catabolism during
      hypoxic cell injury.

PMID- 7783406
TI  - Ontogeny of angiotensin II type 2 (AT2) receptor mRNA in the rat.
AB  - To study the distribution of the recently cloned angiotensin II type 2 (AT2)
      receptor in the rat fetus, a double stranded cDNA was generated by a new and
      recently described methodology requiring no cloning procedure. The cDNA obtained
      after reverse transcription (RT) and polymerase chain reaction (PCR)
      amplification corresponded to 500 base pairs of the gene coding sequence, and
      included the SP6 and T7 promoters at the 5' and 3' end, respectively. 35S-labeled
      cRNA sense and antisense probes were synthesized by in vitro transcription and
      used for in situ hybridization. From 13 to 19 days of gestation the AT2 receptor
      mRNA expression evolved and extended from a series of paired spots located para
      axially, which were not identifiable at this level of observation, to a
      distribution in various mesenchymes (perichondrium, subepidermal layers), muscle
      cells (tongue, diaphragm, stomach), and classical target organs for Ang II
      (adrenal gland, kidney, aorta). During the first days after birth, the AT2
      receptor mRNA decreased and remained detectable only in the adrenal gland and
      kidney. The distribution of the AT2 receptor mRNA appeared strikingly different
      from that of the AT1A receptor, which was studied in parallel for comparison.

PMID- 7783407
TI  - Renal amino acid transport in adults with oxidative phosphorylation diseases.
AB  - The clinical manifestations of mitochondrial DNA (mtDNA) mutations depend on a
      variety of factors including ratios of normal to abnormal mtDNA and tissue
      specific differences in ATP production by oxidative phosphorylation (OXPHOS). In
      order to investigate the effects of OXPHOS defects on renal tubule function, we
      characterized sodium-coupled transport processes in six individuals with OXPHOS
      diseases. Pathogenic mtDNA mutations were identified in five of these
      individuals. Sodium coupled transport processes were evaluated by determining
      fractional excretions of amino acids, glucose, lactate, urate, and phosphate in
      patients and controls. Four of the six individuals had high fractional excretions
      of neutral amino acids, indicating abnormal renal tubule reabsorbtion of these
      amino acids. Abnormalities in fractional excretions of lactate, glucose, urate,
      and phosphate were less pronounced. These results demonstrate that sodium-coupled
      transport processes in the kidney are sensitive to OXPHOS impairment. When
      abnormalities in these processes are encountered, an OXPHOS disease should be
      included in the differential diagnosis.

PMID- 7783408
TI  - Glomerular morphometry in childhood reflux nephropathy, emphasizing the capillary
      changes.
AB  - As a consequence of nephron loss, reflux nephropathy (RN) causes considerable
      glomerular hypertrophy. To examine the relative contributions of capillary
      dilatation and growth in producing hypertrophy, glomeruli contained in unscarred
      areas of renal biopsies from 19 children with RN were compared with those in 16
      children with minimal change nephrotic syndrome and 16 with recurrent hematuria,
      who were used as controls representing normal childhood growth. Using
      computerized digitometry we measured the mean glomerular tuft area (GTA) in all
      complete, undistorted, nonsclerotic glomeruli in periodic acid-Schiff (PAS)
      stains. Measurements were repeated in four glomeruli of uniform size in periodic
      acid-silver methenamine stains, the results (GTA4) correlating significantly with
      GTA. In the same four glomeruli we measured the mean individual capillary luminal
      area (CLA) and counted the mean number of lumens per glomerulus (N). Mean
      mesangial area (MA) was calculated as GTA4 - (CLA x N). Cells per distal
      mesangial region were counted in PAS stains. GTA, GTA4, N, MA and mesangial cell
      counts were significantly greater in RN than controls, but CLA and fractional MA
      (MA/GTA%) did not differ. N correlated highly significantly with GTA4 in both RN
      and controls, but CLA did not do so. These findings are consistent with capillary
      growth by subdivision being the main mechanism of glomerular hypertrophy when
      nephron loss occurs during childhood, and the identity of the regressions of N
      versus GTA4 in RN and controls suggests that compensatory hypertrophy resembles
      the normal glomerular growth pattern in this age group.

PMID- 7783410
TI  - A controlled trial of cyclosporine in patients with progressive membranous
      nephropathy. Canadian Glomerulonephritis Study Group.
AB  - A controlled trial of cyclosporine in patients diagnosed with progressive
      membranous nephropathy (MGN) was carried out to determine whether cyclosporine
      (D) would be more effective than placebo (P) in reducing the rate of
      deterioration in renal function. Patients (N = 64) with MGN were placed on a
      restricted protein diet (< or = 0.9 g/kg) and followed closely for 12 months
      (Part 1). Patients at high risk of progression based on an absolute loss in
      creatinine clearance (CCr) of > or = 8 ml/min and persistent nephrotic range
      proteinuria (Pr) were selected and randomly assigned to either (D) (N = 9) or (P)
      (N = 8) for 12 months (Part 2). No differences in the two groups were noted at
      entry. After 12 months, the improvement in CCr slope in ml/min/month was
      significantly greater in the D patients (D + 2.1 vs. P + 0.5, mean difference
      1.6; 95% CI 0.3 to 3.0, P < 0.02). This improvement was maintained in six of
      eight D (75%) over a mean follow-up period of 21 months. Daily Pr also improved
      with D (by month 3, D - 4.5 g/day vs. P + 0.7 g/day, P = 0.02) and was sustained
      in six of eight (75%) D patients. When Pr was expressed as a function of their
      concurrent CCr, the D versus P patients' time to halving was faster (P = 0.02)
      and absolute number higher (4/9 D vs 0/8 P). In the D group a trend towards worse
      hypertension and an increase in the number of transient rises in serum creatinine
      were noted.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783409
TI  - Renal ischemia/reperfusion injury contributes to renal damage in experimental
      anti-myeloperoxidase-associated proliferative glomerulonephritis.
AB  - The occurrence of focal fibrinoid necrosis of capillary loops in the very early
      stages of ANCA-associated necrotizing crescentic glomerulonephritis (NCGN) and
      the increased prevalence of this disease at older age suggest that renal ischemia
      may play an additional role in its pathophysiology. In the present study we
      investigated the contribution of renal ischemia to the induction of anti
      myeloperoxidase (MPO) associated NCGN in a previously described rat model of this
      disease. The development of renal lesions is dependent on the presence of an anti
      MPO immune response and the localization of a lysosomal extract containing lytic
      enzymes and MPO in combination with hydrogen peroxide (H2O2) along the glomerular
      basement membrane (GBM). The hypothesis tested whether perfusion of hydrogen
      peroxide (H2O2) could be replaced by ischemia/reperfusion (I/R) injury, as I/R
      injury activates endothelial cells to produce oxygen metabolites. I/R was induced
      by clamping the renal artery for 20 minutes in kidneys in which the circulation
      had been restored several minutes after perfusion with the lysosomal extract in
      MPO immunized rats. Rats developed lesions characterized by intra- and
      extracapillary cell proliferation, periglomerular infiltration, ruptures in
      Bowman's capsule, ischemic tubuli, and interstitial mononuclear infiltrate.
      Immune deposits, however, persisted for a longer time along the GBM after
      perfusion of lytic enzymes followed by I/R injury compared to previous studies in
      which H2O2 in conjunction with lytic enzymes were perfused in MPO-immunized
      rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783411
TI  - Racial differences in renal allograft survival: the role of systemic
      hypertension.
AB  - The rate of decline in the number of functioning renal allografts beyond the
      first year after transplantation has changed little in the last 25 years, and
      during long-term follow-up most allografts are lost due to chronic transplant
      rejection or patient death. The recipient race correlates with allograft
      survival, and African American recipients have a lower allograft survival than
      Caucasians. The goal of the present study was to identify clinical variables
      present during the first six months after transplantation that predict the loss
      of renal allografts beyond six months after transplantation, and in particular to
      determine the role of systemic hypertension on renal allograft survival in black
      and white recipients. This study includes 547 recipients of first cadaveric renal
      allografts performed at The Ohio State University. All patients were treated with
      a uniform immunosuppressive protocol and had a follow-up of at least three years.
      By multivariate analysis the following variables correlate with poor allograft
      survival: an elevated serum creatinine concentration measured six months after
      transplantation (SCr6mo) (P < 0.0001); black race (P < 0.0001); increasing
      numbers of acute rejection episodes (ATR) (P = 0.002); and young recipients (P =
      0.026). Allograft survival is significantly worse in black (mean allograft half
      life of 7.7 +/- 1.3 years) than in white recipients (24 +/- 3 years) (P <
      0.0001). Black recipients also have a significantly higher six month average mean
      arterial blood pressure (MAP) (105 +/- 8 mm Hg) than white recipients (102 +/- 7
      mm Hg) (P = 0.002). However, the prevalence of hypertension is not significantly
      different in black (33%) than in white recipients (26%).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7783412
TI  - Autosomal recessive Alport syndrome: immunohistochemical study of type IV
      collagen chain distribution.
AB  - Alport syndrome (AS) is an hereditary disease of basement membrane collagen. It
      is mainly transmitted as a dominant X-linked trait and caused by mutations in the
      COL4A5 gene encoding the alpha 5 chain of type IV collagen. However, autosomal
      recessive AS due to mutations in the COL4A3 or COL4A4 genes could represent up to
      15% of AS. Using the immunofluorescence technique, we analyzed the distribution
      of the different chains of type IV collagen in renal (12 specimens) and skin (4
      specimens) basement membranes of 12 AS patients belonging to 11 unrelated
      kindreds in which autosomal recessive inheritance had been demonstrated (3
      kindreds) or was suggested by clinical and genealogic data (8 kindreds). The
      renal and skin distribution was normal in one patient with COL4A4 mutations. A
      peculiar pattern of distribution of the alpha 3-alpha 5(IV) chains was observed
      in the other patients. It was characterized the co-absence of the alpha 3(IV),
      alpha 4(IV) and alpha 5(IV) chains in the glomerular basement membrane, and the
      presence of the alpha 5(IV) chain in a series of extraglomerular basement
      membranes including capsular, collecting ducts and epidermal basement membranes,
      a combination never observed in X-linked AS. This immunohistochemical pattern is
      correlated with the specific distribution of the alpha 3-alpha 5 chains of type
      IV collagen chains within extraglomerular basement membranes. It could be a
      useful marker for the identification of autosomal recessive AS.

PMID- 7783413
TI  - Treatment of malnourished CAPD patients with an amino acid based dialysate.
AB  - Nineteen malnourished chronic peritoneal dialysis patients who were ingesting a
      low protein intake underwent metabolic balance studies to test whether a
      dialysate that contained amino acids would improve their protein nutrition.
      Patients lived in the hospital for 35 days while they ate a constant diet and
      underwent their usual regimen of continuous ambulatory peritoneal dialysis
      (CAPD). The first 15 days served as a Baseline Phase. For the last 20 days, the
      usual dialysate was substituted with a dialysate of essentially the same
      composition except that it contained 1.1% essential and nonessential amino acids
      and no glucose. Patients received one or two dialysate exchanges with amino acids
      each day depending on the amount necessary to bring the individual's dietary
      protein plus dialysate amino acid intake to 1.1 to 1.3 g/kg body weight/day.
      During Baseline, patients were in neutral nitrogen balance; net protein anabolism
      was positive, as determined from 15N-glycine studies. After commencing
      intraperitoneal amino acid therapy, nitrogen balance became significantly
      positive, there was a significant increase in net protein anabolism, the fasting
      morning plasma amino acid pattern became more normal, and serum total protein and
      transferrin concentrations rose. Patients generally tolerated the treatment well,
      although some patients developed mild metabolic acidemia. These findings indicate
      that a dialysate containing amino acids may improve protein malnutrition in CAPD
      patients ingesting low protein intakes.

PMID- 7783414
TI  - Impaired endotoxin-induced interleukin-1 beta secretion, not total production, of
      mononuclear cells from ESRD patients.
AB  - Lipopolysaccharide (LPS)-induced interleukin-1 beta (IL-1 beta) and tumor
      necrosis factor alpha (TNF alpha) production and secretion from peripheral blood
      mononuclear cells (PBMC) were determined in a longitudinal study with repeated
      measurements in PBMC from patients with chronic uremia not on hemodialysis (N =
      8), end-stage renal disease (ESRD) patients (N = 8), and healthy controls (N =
      7). ESRD patients were studied while using low-flux Cuprophan dialyzers and again
      using high-flux AN 69 dialyzers. Total (cell-associated plus secreted) LPS
      induced IL-1 beta production was enhanced in uremic patients, but similar to
      controls in ESRD patients on Cuprophan. In contrast, LPS-induced IL-1 beta
      secretion (secreted amounts in % of total production) was similar to controls in
      uremic patients, but significantly reduced in ESRD patients on Cuprophan (P <
      0.01). During AN 69 hemodialysis, LPS-induced total IL-1 beta production remained
      unchanged but IL-1 beta secretion increased significantly (P < 0.05) compared to
      Cuprophan dialysis. Increased IL-1 beta secretion coincided with a suppression in
      PGE2 synthesis (P < 0.02). Similarly, blockade of endogenous PGE2 by indomethacin
      increased LPS-induced IL-1 beta secretion (P < 0.01) but did not enhance total IL
      1 beta production in PBMC from controls and patients on Cuprophan hemodialysis.
      Neither total production nor secretion of TNF alpha was different comparing the
      three study groups. We conclude that LPS-induced IL-1 beta secretion, but not
      total production, is impaired in PBMC from ESRD patients on long-term Cuprophan
      hemodialysis. This functional change in the PBMC response is specific for IL-1
      beta, not due to uremia per se but hemodialysis-dependent and reversible.
      Hemodialysis with AN 69 suppresses endogenous PGE2 synthesis in PBMC which is
      associated with increased LPS-induced IL-1 beta secretion in the presence of
      unchanged total IL-1 beta production. We speculate that PGE2 could inactivate the
      IL-1 beta converting enzyme which is essential for processing and secretion of
      mature IL-1 beta.

PMID- 7783415
TI  - Long-term thromboxane-synthase inhibition prolongs survival in murine lupus
      nephritis.
AB  - Systemic lupus erythematosus (SLE) is an autoimmune disease, characterized by
      nephritis, in which mortality is largely influenced by the severity of renal
      involvement. As there are evidences that thromboxane (TX)A2 plays an important
      role in the pathogenesis of lupus nephritis, we decided to assess the effects of
      long-term suppression of TXA2 synthesis on the progression of the disease, by
      designing a study of TXA2-synthase inhibition having adequate size to detect an
      effect on mortality as the primary end-point. Thus, we randomized 362 NZBxNZW
      mice (11-week-old at entry) to one of the following treatments: a TXA2 synthase
      inhibitor, FCE 22178 (300 mg/kg daily), saline or cyclophosphamide (5 mg/mouse
      weekly x 4 weeks) used as reference treatment. The TXA2 synthase inhibitor
      suppressed TXA2 biosynthesis, as reflected by urinary TXB2 and 2,3-dinor-TXB2
      excretion (by 78% and 90%, respectively) and significantly reduced mortality
      (death rate: 34% vs. 61% in controls, at 37 weeks, P < 0.01). A significant
      reduction in proteinuria (9 +/- 1.6 vs. 17.3 +/- 2.4 mg/24 hr in FCE 22178 vs.
      saline, P < 0.01) and glomerular lesions was observed up to 30 weeks but not at
      37 weeks. In contrast, cyclophosphamide prevented the development of proteinuria
      and histologic lesions, and reduced mortality to 8% at 37 weeks. Renal plasma
      flow and glomerular filtration rate were lower (by 29% and 52%, respectively) in
      37-week-old as compared to young NZBxNZW mice. These parameters were further
      depressed by cyclophosphamide (by 48% and 45% vs. age-matched controls,
      respectively, P < 0.01) but were not altered significantly by FCE 22178.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7783416
TI  - Association of ACE gene polymorphism and diabetic nephropathy? The Diabetic
      Nephropathy Study Group.
AB  - In patients with type 1 diabetes an association has been found between an
      insertion/deletion (I/D) polymorphism in the gene for angiotensin I converting
      enzyme and the presence of diabetic nephropathy. Our objective was (i) to assess
      this association in a large cohort of patients with type 1 diabetes and (ii) to
      examine whether this finding also applies to type 2 diabetes. We examined 247
      patients with type 1 diabetes of more than 10 years duration (135 patients > or =
      20 years): Nephropathy was present in 114 and absent in 133 patients. Furthermore
      we separately analyzed 455 patients with type 2 diabetes of more than 10 years
      duration (158 patients > or = 20 years). Nephropathy was present in 247 and
      absent in 208 patients. Nephropathy was defined by confirmed presence of
      albuminuria > 30 mg/day (or > 20 micrograms/min). The I/D polymorphism was
      analyzed with PCR technique and alleles were visualized on 2% agarose gels after
      ethidium staining. Allele frequencies in the overall diabetic population did not
      differ significantly from the normal population. Distribution of genotypes was
      not significantly different between type 1 patients with and without nephropathy
      (P = 0.377). Also, no significant difference in genotype distribution was found
      between type 2 diabetic patients with and without nephropathy (P = 0.948). We
      conclude that no significant association between I/D polymorphism and nephropathy
      was demonstrable in either type 1 or type 2 diabetes, despite considerable
      statistical power of the patient sample and adequate duration of diabetes for
      nephropathy to become manifest.

PMID- 7783417
TI  - Down-regulation of PTH-PTHrP receptor of heart in CRF: role of [Ca2+]i.
AB  - The mRNA of PTH-PTHrP receptor in the kidney and liver of CRF rats is down
      regulated. It is not known whether this is a generalized phenomenon and the
      signals that mediate such down-regulation are not evident. Excess PTH in CRF
      induces a rise in basal levels of cytosolic calcium ([Ca2+]i), and the high
      [Ca2+]i is implicated in the genesis of cell dysfunction in CRF. Therefore, it is
      reasonable to propose that the PTH-induced rise in [Ca2+]i provides a negative
      feedback control system for the down-regulation of the mRNA of the PTH-PTHrP in
      order to protect the cells from the harmful effects of progressive rise in blood
      levels of PTH in CRF. The heart contains the mRNA for this receptor and it is a
      target organ for PTH action. We examined whether the message of the PTH-PTHrP
      receptor is down-regulated in the heart of CRF animals and evaluated the role of
      [Ca2+]i in this process. The expression of the mRNA of the PTH-PTHrP was
      significantly reduced in the heart of CRF rats as compared to normal animals.
      Also, the CRF rats had elevated blood levels of PTH and high [Ca2+]i of cardiac
      myocytes. The parathyroidectomy of CRF rats prevented the rise in blood PTH
      levels and normalized [Ca2+]i of cardiac myocytes and returned the mRNA of their
      PTH-PTHrP receptor towards normal levels. The treatment of CRF rats with
      verapamil normalized [Ca2+]i of cardiac myocytes and returned the mRNA of their
      PTH-PTHrP receptor towards normal levels, despite marked elevation of blood
      levels of PTH.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783418
TI  - Assessing the peritoneal dialysis capacities of individual patients.
AB  - A method for measuring the peritoneal dialysis capacity (PDC) of the individual
      patient has been developed as an aid to treatment of patients with renal failure
      and peritoneal dialysis. The patient collects the data him or herself during an
      almost normal CAPD day using a carefully designed protocol whereby the nursing
      time is kept to a minimum. The three-pore model is used to describe the PDC with
      three physiological parameters: (1.) the 'Area' parameter (A0/delta X), which
      determines the diffusion of small solutes and the hydraulic conductance of the
      membrane (LpS); (2.) the final reabsorption rate of fluid from the abdominal
      cavity to blood (JVAR) when the glucose gradient has dissipated; and (3.) the
      large pore fluid flux (of plasma, JVL), which determines the loss of protein to
      the PD fluid. In the adult PD population (age 60, N = 97) the normal 'Area'
      parameter was 23,600 cm/1.73 m2, with an SEM of 650. The JVAR was 1.49
      ml/min/1.73 m2 and JVL was 0.078 ml/min/1.73 m2. The PDC parameters were
      reproducible and could adequately predict the concentrations of the test solutes
      as well as that of beta 2-microglobulin. The results in terms of clearance, 'UF
      volume' and nutritional consequences were presented on easily understandable
      graphs, whereby patient compliance was improved. These physiological parameters
      are highly dynamic, as evidenced by the marked increases observed during
      peritonitis. It seems safe to conclude that PDC is a useful tool to achieve
      adequate dialysis and to enhance the understanding of PD exchange.

PMID- 7783419
TI  - A COL4A3 gene mutation and post-transplant anti-alpha 3(IV) collagen
      alloantibodies in Alport syndrome.
AB  - The X-linked Alport syndrome is associated with mutations and deletions in COL4A5
      gene, one of six genes which constitute the alpha-chains of type IV collagen in
      basement membranes. The autosomal recessive form of Alport syndrome is
      characterized by mutations and deletions in the COL4A3 and COL4A4 genes. A
      fraction of Alport patients who undergo renal transplantation develop anti
      glomerular basement membrane (GBM) nephritis, which results in loss of the renal
      allograft function. Recently, the target for alloantibodies from an X-linked
      Alport patient with complete COL4A5 gene deletion was determined to be the alpha
      3 chain of type IV collagen. The present study characterized the post-transplant
      alloantibodies from an autosomal recessive Alport patient with anti-GBM
      glomerulonephritis and a COL4A3 gene mutation which predicted a loss of 85% of
      the alpha 3(IV) NC1 domain. The specificity of these new antibodies were studied
      using glomerular basement membrane constituents and recombinant type IV collagen
      domains. The results establish the target for the alloantibodies from an
      autosomal recessive Alport patient with COL4A3 deletion as principally the alpha
      3(IV) collagen chain, similar to the post-transplant alloantibodies from X-linked
      Alport patients with COL4A5 gene deletions. The absence of alpha 3(IV) chain in
      the GBM of patients with both these forms of Alport syndrome, due either to a
      failure of synthesis or a failure of assembly, presumably leads to a loss of
      immunologic tolerance for the alpha 3(IV) NC1 domain in transplanted allografts.

PMID- 7783420
TI  - Trade-offs in the adaptation to acidosis.

PMID- 7783421
TI  - Interleukin-12. Biologic activity, therapeutic utility, and role in disease.
AB  - IL-12 is a heterodimeric cytokine that promotes cell-mediated immunity through
      its regulatory effects on T and NK cells. In some murine infectious disease
      models, IL-12 was shown to be produced endogenously in response to infection, and
      the exogenous administration of IL-12 to mice with either infectious diseases or
      tumors has resulted in significant therapeutic effects. IL-12 was protective
      early in the disease process, as well as against established disease. However,
      the biologic activities of IL-12 that are beneficial in the host response to
      these infectious diseases and malignancies can also be deleterious in certain
      disease states. Thus, IL-12 has considerable potential for the treatment of a
      variety of human disorders if used under the appropriate conditions. Likewise,
      antagonists of IL-12 may have a role in controlling diseases with pathologies
      that are mediated through immune mechanisms.

PMID- 7783422
TI  - Down-regulation of the IGF-1 system parallels the attenuation in the
      proliferative capacity of rat ventricular myocytes during postnatal development.
AB  - BACKGROUND: Insulin-like growth factor-1 receptor (IGF-1R) and its ligand (IGF-1)
      have been implicated in the growth of several cell types, including ventricular
      myocytes. However, the growth-promoting effect of this pathway on myocyte
      hypertrophy and hyperplasia has not been determined. During early postnatal
      development, myocyte cell volume increases nearly 25-fold, and myocyte
      proliferation is markedly attenuated, so a progressive decrease in this signaling
      mechanism will indicate that the IGF-1-IGF-1R system is mostly involved in cell
      proliferation. Conversely, a continuous increase in the expression of IGF-1 and
      IGF-1R in myocytes with maturation will suggest its involvement in cellular
      hypertrophy. DESIGN: Myocytes were isolated from fetal rats and from rats at 1,
      5, 11, 21, 35, and 60 days of age. Total RNA was extracted from these cells, and
      the expression of IGF-1, IGF-2, IGF-1R, and DNA polymerase alpha was measured by
      reverse transcriptase-PCR. IGF-1R mRNA levels were also determined by RNase
      protection assay, and the changes in IGF-1R protein were determined by the cross
      linking technique. Finally, the expression of late growth-related genes was
      determined and compared with the fraction of muscle cells synthesizing DNA. These
      analyses were restricted to the left ventricular free wall and septum combined.
      RESULTS: Myocardial development was characterized by a progressive decrease in
      the expression of late growth-related genes in myocytes, which was particularly
      evident at 21 days after birth and persisted up to 2 months of age. The
      expression of IGF-2 in these cells decreased at birth, whereas the attenuation in
      IGF-1 mRNA became apparent a few days later during postnatal development. The
      induction of IGF-1R at the message and protein levels decreased by 11 days, and
      this phenomenon was more evident at the subsequent age intervals. Moreover, DNA
      synthesis in myocytes was sharply reduced at 21 days after birth. CONCLUSIONS: In
      conclusion, the decline in myocyte proliferation with cardiac development appears
      to be coupled with attenuation of the IGF-1-IGF-1R system, which may condition
      the changes in late growth-regulated genes, DNA replication, and cellular mitotic
      division in the myocardium.

PMID- 7783423
TI  - Use of differential display to identify differentially expressed mRNAs induced by
      rat carotid artery balloon angioplasty.
AB  - BACKGROUND: We have used differential display technology in an animal model of
      arterial restenosis to study the molecular mechanisms of neointima formation.
      EXPERIMENTAL DESIGN: Balloon angioplasty of the rat common carotid artery was
      performed, and tissues were examined from naive animals (control) and from
      animals that had undergone angioplasty 6 hours, 3 days, and 14 days earlier.
      Total RNA was isolated, and differential display was performed to identify mRNA
      transcripts whose expression is modulated in a temporal fashion as a consequence
      of balloon angioplasty. RESULTS: Using total RNA isolated from vessels excised
      from naive rats and those from rats that underwent angioplasty up to 14 days
      earlier, we describe two differentially regulated transcripts by differential
      display and verify the expression pattern of these same transcripts by Northern
      analysis. DNA sequence analysis has identified one of these angioplasty-induced
      transcripts as a novel sequence and the other as the tryptophan hydroxylase and
      protein kinase C regulatory protein 14-3-3 gamma. CONCLUSIONS: In this study, we
      describe the in vivo application of the differential display technique in a rat
      carotid artery angioplasty model to identify mRNA transcripts whose expression is
      modulated selectively in vessels undergoing neointima formation. Use of this
      technique in animal models of disease should facilitate our understanding of gene
      expression patterns in pathogenesis and may serve as a reliable technique to
      "fingerprint" disease processes.

PMID- 7783425
TI  - Transforming growth factor-beta 1 and collagen gene expression during postnatal
      skin development and fibrosis in the tight-skin mouse.
AB  - BACKGROUND: The tight-skin (Tsk) mutation in the mouse leads to widespread
      connective tissue abnormalities characterized by excessive collagen deposition
      that is similar to that observed in human scleroderma. Heterozygous mice develop
      skin fibrosis shortly after birth, providing a valuable model to investigate the
      sequence of events leading to fibrosis. EXPERIMENTAL DESIGN: We have studied by
      in situ RNA hybridization the expression of procollagen alpha 1(I), alpha 1(III),
      alpha 2(VI) and transforming growth factor-beta 1 (TGF-beta 1) genes in the skin
      of Tsk mutant and normal newborn to aged mice. Tsk and normal skin sections at
      each age were mounted on the same slide to ensure identical experimental
      conditions, allowing for comparative analyses. RESULTS: All genes are under
      temporospatial regulation and exhibit characteristic patterns of expression
      during postnatal skin growth and development. TGF-beta 1 mRNA is detected in
      fibroblasts only during the rapid postnatal growth of the skin in parallel with
      high collagen I, III, and VI gene expression. Collagen I and III gene-expressing
      fibroblasts are observed in excess in the Tsk fibrotic lesions. An abnormal
      pattern of collagen VI expression is only observed at later stages in the
      fibrotic process. Collagen VI shows a different expression pattern in both normal
      skin development and fibrosis, suggesting noncoordinate regulation with collagen
      I and III genes. CONCLUSIONS: The fibrotic process in Tsk mice results from the
      persistence of high collagen I and III expression by a subpopulation of
      fibroblasts. Collagen VI overexpression participates later in the fibrotic
      process. In contrast with human scleroderma and other skin fibrotic diseases, TGF
      beta 1 mRNA is not detected in the areas of abnormal collagen expression and
      fibrosis of Tsk. Alternative pathways should be explored to understand the
      abnormal extracellular matrix deposition of Tsk fibroblasts.

PMID- 7783424
TI  - Differential expression of the versican and decorin genes in photoaged and sun
      protected skin. Comparison by immunohistochemical and northern analyses.
AB  - BACKGROUND: Chronic sun exposure induces numerous changes in exposed skin; the
      most striking histopathologic change is the massive accumulation of material with
      the staining characteristics of elastin, termed solar elastosis, in the
      superficial dermis. Previous studies have identified elastic fibers within areas
      of solar elastosis, as well as a decrease in collagen content. Recently, the
      large chondroitin sulfate (CS) proteoglycan, versican, has been identified in the
      dermis in association with elastic fibers, and the smaller CS proteoglycan,
      decorin, has been shown to codistribute with collagen fibers. Thus, changes in
      expression of these CS proteoglycans might be expected in photoaging and may help
      to explain the clinical alterations of chronically sun-exposed skin. EXPERIMENTAL
      DESIGN: Immunohistochemical staining and confocal laser scanning microscopy for
      versican and decorin was performed on paired tissue samples from photoaged and
      non-sun-exposed skin taken from the same individuals. To investigate versican and
      decorin mRNA expression, Northern analysis was performed on paired fibroblast
      cultures derived from tissue explants of photoaged and non-sun-exposed skin.
      RESULTS: Immunohistochemical staining and confocal laser scanning microscopy
      revealed a massive accumulation of versican localized to the abnormally large
      fibers comprising solar elastosis in the superficial and mid-dermis of photoaged
      specimens. Decorin staining was greatly decreased within the area of solar
      elastosis. Similarly, changes in mRNA were measured from fibroblast cultures,
      with a significant increase in versican mRNA in cultures derived from photoaged
      skin, whereas decorin mRNA levels were significantly decreased in photoaged skin.
      CONCLUSIONS: This study provides further evidence for the close association of
      versican with elastic fibers and decorin with collagen fibers, even in the
      situation of abnormal fiber deposition occurring in photodamaged skin. In
      addition, changes in versican and decorin immunostaining are accompanied by
      similar alterations in gene expression.

PMID- 7783426
TI  - Immunophenotypic and immunoelectron microscopic characterization of major
      constituent cells in malignant fibrous histiocytoma using human cell lines and
      their transplanted tumors in immunodeficient mice.
AB  - BACKGROUND: Malignant fibrous histiocytoma (MFH) is the most common soft tissue
      sarcoma of adult life. Its histogenesis, however, is still a matter of debate
      because of its various cellular components. EXPERIMENTAL DESIGN: To elucidate the
      nature of tumor cells of MFH, six human MFH cell lines were compared
      immunohistochemically and immunoelectron microscopically with fibrosarcoma and
      fibroblast cell lines. In vitro differentiation of tumor cells was evaluated
      after the treatment with 12-O-tetradecanoylphorbol 13-acetate (TPA), IL-3,
      macrophage CSF, and granulocyte-macrophage CSF. Heterotransplantation of MFH
      tumor cells into nude mice and severe combined immunodeficient mice was performed
      to examine whether the tumor cells differentiate toward histiocytes or not. Gene
      expression of monocyte chemoattractant protein-1 in cultured tumor cells and
      transplanted tumors was also evaluated. RESULTS: All MFH cell lines examined were
      positive for collagen type I and prolyl hydroxylase. They failed to react with
      most anti-myeloid mAb such as CD11c, CD14, CD15, CD33, CD35, CD45, anti-HLA-DR,
      and PM-2K. Several Ab, including CD13, CD32, CD68, CD71, and HAM56, were reactive
      with MFH cells. However, all of these Ab were also reactive with fibrosarcoma
      and/or fibroblastic cell lines. These data indicate that MFH cell lines possess
      immunophenotypic characteristics very similar to those of fibrosarcoma and
      fibroblastic cell lines. In vitro treatment of tumor cells with TPA, IL-3,
      macrophage CSF, granulocyte-macrophage CSF, or their combination did not change
      their immunophenotypic characteristics and did not induce differentiation toward
      histiocytes (macrophages). Transplantation of tumor cells into nude mice and
      severe combined immunodeficient mice produced tumors similar in histology to
      human MFH. Tumor cells in the transplanted tumors revealed the same
      immunophenotypic characterization that they did in vitro. No in vivo
      differentiation of tumor cells toward histiocytes was observed.
      Immunohistochemical staining with anti-mouse macrophage mAb revealed marked
      infiltration of macrophages of mouse origin. Quantitative immunoelectron
      microscopy disclosed that these cells coincided with histiocyte-like cells. Gene
      expression of monocyte chemoattractant protein-1 was detected in all MFH cell
      lines as well as in transplanted tumors. CONCLUSIONS: The histiocyte-like cells
      in malignant fibrous histiocytoma are not a neoplastic component but rather
      infiltrated macrophages attracted by tumor-derived monocyte chemoattractant(s),
      and the tumor cells belong to a fibroblastic lineage differentiated from
      mesenchymal cells.

PMID- 7783427
TI  - Bovine melanoma growth stimulatory activity: a new monocyte-macrophage-derived
      cytokine of the IL-8 family. Partial structure, function, and expression in acute
      pulmonary inflammation.
AB  - BACKGROUND: Neutrophil-chemotactic peptides are a family of small basic peptides
      70 to 80 amino acids in length. They contain four conserved cysteine residues,
      the first two spaced by one amino acid (C-X-C). The best characterized species is
      human IL-8. Other prominent members are melanoma growth stimulatory activity (GRO
      alpha), neutrophil-activating peptide-2, and epithelial-cell derived neutrophil
      activating protein 78. EXPERIMENTAL DESIGN: Bovine monocytes and alveolar
      macrophages were induced by lipopolysaccaride, and a major neutrophil chemotactic
      activity in the supernatant was purified by cation-exchange chromatography and
      reversed-phase HPLC. The chemotaxin was then analyzed for biologic activity on
      bovine neutrophils by in vitro chemotaxis, shape change, and transient rise of
      intracellular-free calcium concentration. The in vivo role of bovine GRO (boGRO)
      was tested immunohistologically in confirmed cases of pneumonic pasteurellosis.
      RESULTS: We have purified and partially sequenced a bovine homologue of human GRO
      alpha. The partial amino acid sequence of boGRO was:
      APVVNELRCQCLQTLQGIHLKNIQSVKVTTPGP. BoGRO was biologically active and induced a
      dose-dependent neutrophil migration in the range of 10(-7) to 10(-9) M. BoGRO
      also induced a dose-dependent shape change in bovine neutrophils similar to human
      IL-8. This effect was detectable down to 10(-10) M. Similar effects were observed
      on the transient rise of intracellular-free calcium concentration. In bovine
      pneumonic pasteurellosis and, to a lesser extent, in normal lungs,
      immunoreactivity to human GRO was highly positive in hypertrophic type-II
      epithelial cells and in mesothelial cells, whereas pleural fibroblasts and
      bronchial epithelial cells were negative. CONCLUSIONS: BoGRO is a prominent
      neutrophil chemoattractant secreted by monocytes and alveolar macrophages. It is
      active at similar concentrations as human IL-8. The strong immunoreactivity in
      type-II epithelial and mesothelial cells of bovine pneumonia strongly suggest a
      role for boGRO in the genesis of pulmonary inflammation.

PMID- 7783428
TI  - The role of macrophage colony-stimulating factor in the differentiation and
      proliferation of Kupffer cells in the liver of protein-deprived mice.
AB  - BACKGROUND: Protein calorie malnutrition is known to induce various macrophage
      dysfunctions, such as the impairment of their phagocytic function, proliferative
      capacity, and bactericidal activity. However, little is known about the behavior
      of Kupffer cells under protein calorie malnutrition in vivo. EXPERIMENTAL DESIGN:
      To investigate the behavior of Kupffer cells under protein calorie malnutrition,
      we fed mice on a low protein (protein-derived) diet for 4 weeks and examined the
      number, cytologic changes, and proliferative capacity of their Kupffer cells. To
      detect macrophage precursor cells, colony-forming assays were performed in the
      bone marrow, spleen, and liver of the mice. To investigate the relationship of
      Kupffer cells to CSF, the serum levels of IL-6 and granulocyte-macrophage colony
      stimulating factor were measured by ELISA, and the expression of macrophage
      colony-stimulating factor (M-CSF) mRNA in the liver was determined by Northern
      blot analysis. The recovery processes of Kupffer cells in the protein-deprived
      mice after normal protein feeding or daily recombinant human macrophage colony
      stimulating factor administration were also investigated. RESULTS: In the protein
      deprived mice, Kupffer cells decreased in number to two-thirds that of the
      normally fed (nondeprived) mice, showed the cytologic and ultrastructural
      features of maturation failure, and had reduced proliferative capacity. After
      normal protein feeding or recombinant human macrophage colony-stimulating factor
      administration, the number, morphology, and proliferative capacity of the Kupffer
      cells in the liver returned to normal, and they matured as in the nondeprived
      mice. In the protein-deprived mice, the serum levels of IL-6 and granulocyte
      macrophage colony-stimulating factor increased, and the expression of M-CSF mRNA
      in the liver was reduced. In the bone marrow, the granulocyte-macrophage colony
      forming cells and macrophage colony-forming cells were increased, and the influx
      of monocytes into the liver was temporarily enhanced; however, the number of
      monocytes in the peripheral blood was decreased. CONCLUSIONS: These results
      suggest that the reduced production of M-CSF in the liver of protein-deprived
      mice results in numerical reduction, maturation failure, and decreased
      proliferative capacity of Kupffer cells.

PMID- 7783429
TI  - Laminin abnormality in severe childhood autosomal recessive muscular dystrophy.
AB  - BACKGROUND: In skeletal muscle, dystrophin exists in a large oligomeric complex
      tightly associated with several novel sarcolemmal proteins, including the 50-kDa
      transmembrane glycoprotein called adhalin. The dystrophin-glycoprotein complex
      links the subsarcolemmal actin cytoskeleton to the basal lamina component
      laminin, thus providing stability to the sarcolemma. Disturbance of this linkage
      due to the absence of dystrophin plays a crucial role in the molecular
      pathogenesis of muscle fiber necrosis in Duchenne muscular dystrophy. Severe
      childhood autosomal recessive muscular dystrophy (SCARMD) is similar to Duchenne
      muscular dystrophy in phenotype but is characterized by the deficiency of
      adhalin. At present, the status of the link between the dystrophin-glycoprotein
      complex and laminin is unclear in SCARMD. EXPERIMENTAL DESIGN: We investigated,
      by immunohistochemistry using confocal laser scanning microscopy, the status of
      the expression of laminin subunits, A, M, B1, B2, and S chains, in skeletal
      muscle biopsy specimens of eight SCARMD patients from various human populations.
      In addition, we correlated the severity of laminin abnormality with the severity
      of both clinical symptoms and histopathologic changes in these patients. RESULTS:
      The reduction of laminin B1 chain and the overexpression of the S chain, a
      homologue of B1, in the extrajunctional basal lamina were observed in the five
      patients who had advanced clinical symptoms and histopathologic changes.
      Abnormalities in the expression of laminin were not observed in the three less
      affected patients. CONCLUSIONS: The expression of laminin is greatly disturbed in
      severely diseased SCARMD muscle deficient in adhalin. Disturbance of sarcolemma
      basal lamina interaction may play an important role in the molecular pathogenesis
      of muscle fiber necrosis in SCARMD.

PMID- 7783430
TI  - Liver and kidney necrosis in selenium-deficient rats depleted of glutathione.
AB  - BACKGROUND: Selenium and glutathione have interrelated oxidant defense roles in
      vivo. Experiments were carried out to determine the effect of glutathione
      depletion in selenium-deficient rats. EXPERIMENTAL DESIGN: Selenium-deficient and
      control rats were injected with phorone to deplete glutathione. Histologic
      assessment of liver and kidney injury was performed at 24 hours. In another
      experiment, glutathione depletion, lipid peroxidation, and liver injury were
      measured for 12 hours after phorone administration to determine their
      relationships with one another. In a final experiment, selenoproteins were
      correlated with protection against lipid peroxidation and liver necrosis.
      Selenium-deficient rats were injected with vehicle alone and with 5, 10, or 25
      micrograms of selenium/kg. Twelve hours later, selenoproteins were measured in
      some of the rats, and phorone was injected into others. Liver injury and lipid
      peroxidation were assessed 6 hours after the phorone injection. RESULTS: Twenty
      four hours after phorone administration (125 mg/kg), centrilobular hepatic
      necrosis and renal tubular necrosis were evident in selenium-deficient rats but
      not in controls. The time-course experiment revealed that phorone (250 mg/kg)
      caused sharp decreases in liver and kidney glutathione levels in both groups
      within 2 to 4 hours. Lipid peroxidation, as assessed by F2 isoprostane
      concentrations, in selenium-deficient animals. Liver necrosis, indicated by a
      rise in plasma ALT, took place in selenium-deficient rats but not in controls.
      Selenium injections into selenium-deficient rats increased selenoprotein P
      concentrations from 4% of control to as high as 39% but had little effect on
      glutathione peroxidase activities. Six hours after phorone administration, rats
      that had received selenium had no rise in ALT, and the rises in F2 isoprostanes
      were abolished or attenuated. CONCLUSIONS: We conclude that depletion of
      glutathione in selenium-deficient liver and kidney leads to necrosis in those
      organs associated with evidence of lipid peroxidation. Protection against this
      injury by selenium correlates with selenoprotein P concentration in plasma but
      not with glutathione peroxidase activity in tissues or in plasma. These findings
      raise the possibility that selenoprotein P protects cell membranes against
      oxidant injury and that glutathione is involved in that protection.

PMID- 7783431
TI  - Heterogeneous hepatocellular expression of glutamine synthetase in developing
      mouse liver and in testicular transplants of fetal liver.
AB  - BACKGROUND: Glutamine synthetase is exclusively expressed in pericentral
      hepatocytes in mammalian liver, but its regulation mechanism is still largely
      unknown. EXPERIMENTAL DESIGN: Heterogeneous expression of glutamine synthetase
      was examined in detail during mouse liver development by immunohistochemistry and
      by in situ hybridization. Heterogeneous expression of this enzyme was also
      analyzed in immature liver fragments transplanted to an ectopic site where no
      portal blood flow exists. RESULTS: At 18.5 days of gestation, a random, spotty
      distribution of low levels of glutamine synthetase mRNA was observed all over the
      liver parenchyma, but the enzyme protein was not detectable immunohistochemically
      in the liver at any fetal stage. Glutamine synthetase and its mRNA began to be
      heterogeneously expressed in pericentral hepatocytes 2 to 3 days after birth,
      when glycogen accumulation in the liver parenchyma was rather homogeneous. In the
      early postnatal development, a mosaic distribution of positive and negative
      hepatocytes with respect to glutamine synthetase protein and mRNA was noted
      around the central veins. Subsequently, mRNA distribution gradually became
      continuous, although some hepatocytes still lacked protein, indicating partial
      regulation at the translational level. When fetal liver fragments that had not
      yet heterogeneously expressed glutamine synthetase were cultured under the testis
      capsule of male mice, only pericentral hepatocytes expressed this enzyme after 2
      months. However, the distribution of glutamine synthetase protein- and mRNA
      positive hepatocytes around the central veins was patchy rather than continuous,
      as in perinatal livers. CONCLUSIONS: These results support the importance of
      local interactions of hepatocytes with intrahepatic cell populations and/or
      structural elements. Furthermore, they demonstrate that the capacity for the
      positional expression of glutamine synthetase is already established at a fetal
      age before expression of glutamine synthetase can be detected.

PMID- 7783432
TI  - Vascular endothelium-derived cells containing smooth muscle actin are present in
      restenosis.

PMID- 7783433
TI  - Percutaneous biopsy of abdominal organs under ultrasound guidance.
AB  - Percutaneous sampling of one or more abdominal organs was performed under
      ultrasound guidance in 89 dogs and 16 cats. Tissue core samples were considered
      to be of diagnostic quality in 92 per cent of hepatic and 100 per cent of renal
      biopsies. Core biopsies were collected from the prostate in only three cases but
      each was adjudged of diagnostic quality. The technique allowed a definitive
      diagnosis or normal tissue to be confirmed in 65 per cent of animals undergoing
      hepatic biopsy, 83 per cent undergoing renal biopsy and 82 per cent undergoing
      prostatic biopsy or aspiration. Few complications occurred which could be
      ascribed with certainty to the procedure. One dog with extensive hepatic necrosis
      died one week after the biopsy, but necropsy examination was denied. One severely
      debilitated cat did not recover from general anaesthesia. One dog underwent
      aspiration of a sterile intraprostatic cyst, and developed prostatic abscessation
      one week later; prostatic carcinoma was subsequently found. Careful selection and
      preparation of patients for biopsy are essential. With this caveat, ultrasound
      guided sampling of abdominal organs is a useful technique allowing a definitive
      diagnosis in a high proportion of cases. The technique is minimally invasive and
      the complication rate low.

PMID- 7783434
TI  - [What is your diagnosis? Paraprostatic cyst in a dog].

PMID- 7783436
TI  - Canine eosinophilic folliculitis and furunculosis in three cases.
AB  - The historical, clinical and histopathological features of three dogs with
      eosinophilic folliculitis and furunculosis are described. The disease was
      characterised by the rapid development of pruritic, papular, pustular and
      ulcerative lesions on the dorsum of the muzzle. Skin lesions were confined to the
      face in two cases. The third dog had more generalised pustular lesions. Skin
      biopsy specimens showed marked eosinophil infiltration particularly centred on
      pilosebaceous units. Dermal collagen necrosis was evident in two cases. Similar
      facial lesions have previously been described as 'nasal pyoderma'. The three dogs
      failed to respond to initial antibacterial therapy but showed a rapid clinical
      response when prednisolone was given orally at doses ranging from 1 to 2.2 mg/kg,
      in addition to the antibacterial therapy, suggesting that glucocorticoids are
      indicated for the treatment of eosinophilic folliculitis and furunculosis. The
      aetiology of the disease was not determined.

PMID- 7783435
TI  - Vitamin K-dependent coagulopathy in a British Devon rex cat.
AB  - Deficiencies of the vitamin K-dependent coagulation factors were identified in a
      Devon rex cat which had bled after castration. Haemorrhage was controlled by
      plasma transfusion. Clotting times were normalised by oral administration of
      vitamin K. This report confirms the existence of this bleeding disorder in a
      Devon rex cat in the United Kingdom.

PMID- 7783437
TI  - Fracture associated sarcoma in the cat.
AB  - A nine-year-old neutered male cat developed an osteosarcoma 15 months after the
      surgical repair of the proximal femur using an intramedullary pin at the fracture
      site. The repair had been effective with good healing of the fracture and
      restoration of normal activity.

PMID- 7783438
TI  - Neutrophil phagocyte dysfunction in a weimaraner with recurrent infections.
AB  - A five-and-a-half-month-old male weimaraner with severe recurrent bacterial
      infections was assessed for immunocompetence. Results revealed a low serum
      immunoglobulin G concentration and defective neutrophil phagocytosis.

PMID- 7783440
TI  - Old age is not a disease.

PMID- 7783439
TI  - Megaoesophagus and glucocorticoid-deficient hypoadrenocorticism in a dog.
AB  - A seven-year-old German shepherd dog was referred for acute onset regurgitation.
      Muscle weakness and severe dermatological disease were present. Thoracic
      radiographs revealed generalised megaoesophagus. Diagnostic testing revealed
      glucocorticoid deficiency, and rapid resolution of the megaoesophagus followed
      appropriate supplementation. The dog made a full recovery. Unique features of
      this case include a transiently positive antinuclear antibody titre and clinical
      features of myasthenia gravis.

PMID- 7783441
TI  - Inheritance of histiocytosis in Bernese mountain dogs.
AB  - One hundred and twenty-seven cases of histiocytosis in Bernese mountain dogs
      (BMD) were evaluated to determine if the tumour is inherited. Family data ruled
      out autosomal recessive, autosomal dominant and sex-linked modes of inheritance.
      The trait was determined to be inherited with a polygenic mode of inheritance.
      The salient points permitting this conclusion are: pedigrees developed from
      independently selected propositi link up allowing the tracing of all cases
      through several generations; multiple cases occur in the same litter; multiple
      cases have been produced by given dams and sires; there is a higher frequency of
      the disease among offspring of affected parents when compared to offspring of
      normal parents that produced histiocytosis and all offspring in the general
      population of BMDs; the fact that histiocytosis is common in BMDs and rare in
      eight other breeds and accounts for 25.4 per cent of the 500 tumours studied in
      this breed. The heritability of this trait was calculated to be 0.298.

PMID- 7783442
TI  - Comparison of two shampoos for treatment of Malassezia pachydermatis-associated
      seborrhoeic dermatitis in basset hounds.
AB  - A randomised-double-blind parallel study compared the clinical and antimicrobial
      efficacies of a miconazole-chlorhexidine shampoo with a selenium sulphide shampoo
      for the treatment of seborrhoeic dermatitis associated with Malassezia
      pachydermatis in 33 basset hounds. All 16 miconazole-chlorhexidine treated hounds
      and 11 of 17 selenium sulphide treated hounds improved when shampooed at three
      day intervals for three weeks. The miconazole-chlorhexidine treated hounds showed
      significantly greater reductions in pruritus (P < 0.01), erythema (P < 0.001),
      exudation (P < 0.01) and overall severity (P < 0.001), and in counts of M
      pachydermatis (P < 0.001), total bacteria (P < 0.001) and coagulase-positive
      staphylococci (P < 0.001), when compared to the selenium sulphide treated group.
      Improvements in scaling and coat condition did not vary significantly between the
      two groups. These results indicate that seborrhoeic dermatitis in basset hounds
      is often associated with elevated cutaneous populations of M pachydermatis and
      bacteria, and that the miconazole-chlorhexidine shampoo is more effective than
      the selenium sulphide product for the treatment for this disease.

PMID- 7783444
TI  - Complementary coding conforms to the primeval comma-less code.
AB  - The hypothesis that the universal genetic code is adapted to double-strand coding
      is supported by its remarkable compatibility with the RNY comma-less hypothesis.
      Coding by a triplet code on a polynucleotide double-strand allows for enciphering
      of five additional messages with reference to a chosen primary reading frame.
      Assuming the acceptance of coupled mutations on both strands, the best codon
      register for two overlapping messages can be inferred. The idea of evolutionarily
      compatible coding of two proteins by one nucleotide double-strand is extended to
      complementary coding for one protein in folded, single-stranded RNA.

PMID- 7783443
TI  - Lymphocyte memory and affinity selection.
AB  - The persistence of antigen-specific immune memory appears to require the presence
      of antigen--suggesting that memory may be due to restimulation of "memory"
      lymphocytes by persisting antigen. Persistence of antigen, in a form capable of
      stimulating B cell proliferation, on long-lived, follicular dendritic cells of
      lymphoid tissue is well documented. Existence of an analogous mechanism for T
      cell memory maintenance is controversial but can not be ruled out. Here we
      examine the consequences of immune memory maintenance by antigen-specific
      lymphocyte restimulation, and estimate the duration of memory as a function of
      model parameters. We show that the competition for restimulation among memory
      cell populations results in the selection of the clone having the highest overall
      affinity for the retained antigen. Thus affinity selection, an important
      attribute of immunity, is a constitutive property of memory maintenance by
      antigen-specific restimulation. In the case of B cells, affinity selection is
      predicted to continue to increase antibody affinity even after somatic mutation
      stops, and thus may be an important component of affinity maturation. Finally, we
      discuss several other hypotheses proposed to explain immune memory, including T
      cell stimulation by cross-reactive antigens.

PMID- 7783445
TI  - Selection, mutations and codon usage in a bacterial model.
AB  - We present a statistical model of bacterial evolution based on the coupling
      between codon usage and tRNA abundance. Such a model interprets this aspect of
      the evolutionary process as a balance between the codon homogenization effect due
      to mutation process and the improvement of the translation phase due to natural
      selection. We develop a thermodynamical description of the asymptotic state of
      the model. The analysis of naturally occurring sequences shows that the effect of
      natural selection on codon bias affects genes whose products are largely required
      at maximal growth rate conditions or undergo rapid transient increases.

PMID- 7783446
TI  - Periodic selection and hitchhiking in a bacterial population.
AB  - The accumulation of a neutral marker in a bacterial population under balanced
      growth in a chemostat follows a jagged curve as adaptive variants continuously
      appear and sweep the population. Such periodic selection curves are simulated in
      the present work using deterministic equations that, in contrast to previous
      models, take full account of the stochastic character of the process. The
      uncertainties due to the appearance time, the survival probability, and the
      extent of early growth at small numbers are included as stochastic initial
      conditions for every new variant--adaptive or neutral--that appears. The model is
      used to calculate the substitution rate via hitchhiking where a neutral or weakly
      selected mutation is carried along when a new adaptive one takes over the
      population. The expected ratio for the probabilities of the presence or absence
      of a weakly selected or counterselected mutation in the population is also
      calculated. This can be related to the standard result without hitchhiking if the
      average time between adaptive shifts is interpreted as an effective population
      size.

PMID- 7783447
TI  - Quantification of the three point receptor hypothesis of Cheng and Zee-Cheng.
AB  - The placement of three heteroatoms at the corners of an acute angle triangle was
      found to correlate roughly with the antineoplastic activity of a wide range of
      compounds by Cheng & Zee-Cheng (1972, J. Pharm. Sci. 61, 485). Since then the
      synthetic routes to compounds having a large number of degrees of freedom, as in
      the 1,4-dihydroxy-5,8-bis([2-(2-hydroethyl)amino]ethyl) amino-9,10
      anthracenedione (DHAQ, mitoxantrone) have been discovered. The subsequent high
      activity of DHAQ vs. numerous cancers has partially verified the worth of the
      original hypothesis. Quantitative verification of pharmacophoric hypotheses as
      theories necessitates the use of Popper's risky experiments. These experiences
      give rise to verification because, unenlightened by the theory undergoing
      testing, they would predict a result that would refute the theory. Computational
      chemistry allows such a confirmation through molecular modeling. The molecular
      force field, MMX, gives confirmation of the theory by showing the riskiness of
      the synthetic production of DHAQ for the gas phase. The MM+ forcefield in an
      aqueous medium computation (132 water molecules) shows that the confirmations of
      DHAQ does not change appreciably from the gas phase. This computation adds a
      considerable risk. Aquation could significantly change the favorable
      conformations of the very conformationally free DHAQ molecule. The fact that it
      does not confirm that the Zee-Cheng and Cheng hypothesis is a strong one.
      Additionally, a quantitative relationship arises from the new model for the N-O-O
      atomic placement. This new quantitative relationship further predicts
      quantitative risky experiments for further verification (falsification).

PMID- 7783448
TI  - Linear invariants under Jukes' and Cantor's one-parameter model.
AB  - Linear invariants are random variables with zero expectations under certain
      assumptions. In this paper, linear invariants under Jukes' and Cantor's one
      parameter model, both with and without the assumption that nucleotide frequencies
      are at equilibrium, are studied using the method developed in a previous paper.
      Phylogenetic linear invariants (random variables that are linear invariants of
      some but not all trees of the same number of species) for trees with up to seven
      species are derived and bases of phylogenetic linear invariant spaces for
      unrooted trees with four, five and six species are presented. All these bases
      consist of invariants of simple form. The constraints that specify non
      phylogenetic linear invariants (invariants shared by all trees of the same number
      of species) are determined. Under the assumption that nucleotide frequencies are
      at equilibrium, it is found that (i) each five-species tree has 17 independent
      phylogenetic linear invariants, and for two different trees with five species,
      there are at least three phylogenetic linear invariants of one tree that are not
      invariants of the other tree; (ii) each six-species tree has 98 independent
      phylogenetic linear invariants, and for two different trees of six species there
      are at least nine independent phylogenetic linear invariants that are not
      invariants of the other tree; and (iii) each seven-species tree has 482
      independent phylogenetic linear invariants. It is also found that the number of
      independent phylogenetic linear invariants is much larger without the assumption
      of equilibrium than with it, but the reverse is true for the number of non
      phylogenetic linear invariants. A class of random variables that are phylogenetic
      linear invariants with or without the equilibrium assumption is also identified.

PMID- 7783449
TI  - Deducing protein structures using logic programming: exploiting minimum data of
      diverse types.
AB  - The extent to which a protein can be modeled from constraint data depends on the
      amount and quality of the data. This report quantifies a relationship between the
      amount of data and the achievable model resolution. In an information-theoretic
      framework the number of bits of information per residue needed to constrain a
      solution was calculated. The number of bits provided by different kinds of
      constraints was estimated from a tetrahedral lattice where all unique molecules
      of 6, 9, ..., 21 atoms were enumerated. Subsets of these molecules consistent
      with different constraint sets were then chosen, counted, and the root-mean
      square distance between them calculated. This provided the desired relations. In
      a discrete system the number of possible models can be severely limited with
      relatively few constraints. An expert system that can model a protein from data
      of different types was built to illustrate the principle and was tested using
      known proteins as examples. C-alpha resolutions of 5 A are obtainable from 5 bits
      of information per amino acid and, in principle, from data that could be rapidly
      collected using standard biophysical techniques.

PMID- 7783450
TI  - Evolutionary predictions from invariant physical measures of dynamic processes.
AB  - The invariant physical measure of a dynamic process comprises the information
      necessary to compute statistical quantities of the system. It allows us to
      replace time averages over the system's trajectory by integrals over state-space.
      In particular, it allows us to compute the long-term growth rate of a fluctuating
      population and hence to make evolutionary predictions. This is explained here
      using a one-dimensional difference equation. The invariant physical measure
      reflects three types of selection in this model: K-selection when the resident
      has a stable equilibrium; r-selection when the resident exhibits complex
      dynamics; and c-selection, i.e. selection for lower complexity when the resident
      undergoes large fluctuations. For all three evolutionary scenarios the
      interaction of the physical measure with the higher moments of the distribution
      of offspring numbers is crucial. It is also shown how stochastic noise can affect
      the invariant physical measure and the evolutionary predictions made from it.

PMID- 7783451
TI  - Variation of multifunctional surface binding proteins--a virulence strategy for
      group A streptococci?
AB  - Variation in surface antigens has been well recognized as a mechanism by which
      pathogenic organisms can avoid elimination and remain as potential pathogens in
      immunocompetent individuals. A variety of viral and parasitic organisms elude the
      immune system by varying their surface antigenic structures. Other persistent
      human pathogens, for example group A streptococci, are associated with cyclic
      variation in the severity of infections without any major change in their surface
      antigenic structures. Recent analysis of group A streptococcal proteins, in
      particular surface M and M-like proteins, has documented the existence of an
      array of multifunctional surface proteins which have the ability to bind to a
      variety of normal human plasma proteins, extracellular matrix components and
      human cells. The ability to change the functional activities of these surface
      molecules by genetic recombination among members of a closely related M protein
      supergene family has now been reported. In this paper, the potential importance
      of generating functional heterogeneity in surface binding proteins of group A
      streptococcus is discussed. The role of these proteins in enabling an organism to
      sense its environment and express the appropriate virulence factors is proposed
      as an explanation for the periodic changes in the frequency and severity of
      invasive group A streptococcal infections that can occur in the absence of a
      toxic-shock-like syndrome.

PMID- 7783452
TI  - Search strategies for applied molecular evolution.
AB  - A new approach to drug discovery is based on the generation of high diversity
      libraries of DNA, RNA, peptides or small molecules. Search of such libraries for
      useful molecules is an optimization problem on high-dimensional molecular fitness
      landscapes. We utilize a spin-glass-like model, the NK model, to analyze search
      strategies based on pooling, mutation, recombination and selective hill-climbing.
      Our results suggest that pooling followed by recombination and/or hill-climbing
      finds better candidate molecules than pooling alone on most molecular landscapes.
      Our results point to new experiments to assess the structure of molecular fitness
      landscapes and improve current models.

PMID- 7783453
TI  - Therapeutic effects of the blood-activating and stasis-reducing method in 80
      cases of coronary heart disease.
AB  - The pathogenesis and treatment of coronary heart disease (CHD) may vary, whereas
      the author believes that the disease is due to blood stasis on a fundamental
      basis of deficiency, and the principle of treatment is activation of blood. Since
      stasis may lead to deficiency and vice versa, CHD cannot be cured without removal
      of stasis, and stasis cannot be completely removed without proper correction of
      deficiency. The basic method for the treatment of CHD is therefore activation of
      blood for reduction of stasis. At the same time, according to the conditions of
      individual patients, the methods of replenishing Qi, warming Yang, nourishing
      Yin, reducing phlegm and subduing Yang should be applied simultaneously to
      resolve the problem of deficiency. The author treated 80 cases of CHD by the
      above rationale and found the results satisfactory, i.e., 28 cases (35%) showed
      marked symptomatic relief, 46 (57.5%) showed symptomatic improvement, while 6
      cases (7.5%) failed. The total effective rate was 92.5%. ECG examination
      indicated 9 cases markedly effective, 27 improved, while 44 cases failed, for a
      total effective rate of 45%. Blood pressure and blood lipids also showed
      significant drops (P < 0.001).

PMID- 7783454
TI  - Clinical observation on 80 children with peptic ulcer treated primarily by
      traditional Chinese medicine.
AB  - Using the empirical recipe of Wang Pengfei (a very experienced TCM doctor) as the
      main treatment, the authors treated 80 children with peptic ulcer by means of
      promoting blood circulation, removing blood stasis as well as regulating the flow
      of qi, alleviating pain, tonifying the stomach and reinforcing the spleen.
      Measures for hemostasis, correction of anemia and other general treatment were
      also taken. After 8 weeks of treatment, a total effective rate of 92.5% was
      obtained.

PMID- 7783455
TI  - Treatment of senile hypertension based on differential diagnosis of syndromes.

PMID- 7783456
TI  - Effects of the clearing-heat and nourishing-stomach method in the treatment of
      chronic gastritis with positive Campylobacter pylori.

PMID- 7783457
TI  - Prospect for study on treatment of AIDS with traditional Chinese medicine.
AB  - In this paper, studies on single Chinese medicinal herbs, composite
      prescriptions, and their active principles, which have been used against HIV both
      in China and abroad, are highlighted; and the results from clinical treatment of
      158 HIV infected patients performed by a China-Tanzania Coordinating Group are
      also reported. Six of the patients displayed seronegative conversion and remained
      so in the follow-up for 10 to 15 months. The author assumes that the
      prescriptions and drugs strengthening the patients' resistance could enhance the
      efficacy of AIDS treatment.

PMID- 7783458
TI  - Treatment of primary trigeminal neuralgia with acupuncture at the sphenopalatine
      ganglion.

PMID- 7783459
TI  - Composite acupuncture treatment of mental retardation in children.
AB  - 128 children of mental retardation were diagnosed in accordance with the
      diagnostic standards proposed by WHO in 1985. The patients were treated
      compositely with acupuncture, auriculo-acupoint pellet pressure and herbal
      plasters on acupoints, bringing about improved mental developments in
      intelligence quotient (IQ) and social adaptation behaviour (SAB), as evidenced by
      recognized intelligence tests for children.

PMID- 7783461
TI  - Dr. Yang Jiasan's experience in applying the back-shu points.

PMID- 7783460
TI  - Treatment of chronic prostatitis with laser acupuncture.

PMID- 7783462
TI  - 78 cases of periomarthritis treated with acupuncture.

PMID- 7783463
TI  - Effects of chai ling tang on proteinuria in rat models.
AB  - Effects of Chai Ling Tang (a decoction of medicinal herbs) on passive Heymann
      nephritis (PHN) in rats, a model similar to human membranous nephropathy, were
      examined. Four hundred mg/kg (body weight) of Chai Ling Tang, or 240 mg/kg B.W.
      of Xiao Chai Hu Tang, or 130 mg/kg B.W. of Chai Hu (Radix Bupleuri), Ban Xia
      (Rhizoma Pinelliae) and Sheng Jiang (Rhizoma Zingiberis Recens) were
      intraperitoneally injected respectively into three groups of female Wistar rats
      once a day starting from 5 days before intravenous injection of anti-FxlA
      antibody to the end of the experiment. Another group of rats intraperitoneally
      injected with phosphate buffered saline (PBS) was used as the control. It was
      found that the excretion of urinary protein was significantly suppressed in the
      Chai Ling Tang treated group (52.2 +/- 46.9 mg/day) as compared to that in the
      PBS control group (276.5 +/- 127.0 mg/day) 15 days after anti-FxlA antibody
      injection (P < 0.01). The decrease of serum albumin and total protein, and the
      increase of serum total cholesterol were significantly inhibited in the Chai Ling
      Tang treated group as compared to that in the control group (P < 0.05, P < 0.05
      and P < 0.01 respectively). It is therefore concluded that proteinuria in PHN can
      be significantly suppressed by Chai Ling Tang.

PMID- 7783464
TI  - Effect of massotherapy on the in vivo free radical metabolism in patients with
      prolapse of lumbar intervertebral disc and cervical spondylopathy.
AB  - The endogenous free radical scavenger superoxide dismutase (SOD) and blood
      catalase (CAT) in 2 groups of patients with prolapse of lumbar intervertebral
      disc and cervical spondylopathy were lower than that of the healthy control
      group, while the -SH reflecting the metabolic disturbance of free radical was
      higher. After massotherapy, blood SOD and CAT were increased, while lipid
      peroxide (LPO), -SH in urine were decreased, demonstrating that there are
      distinct parallel relationships existing in the changes of these enzymes in blood
      and urine.

PMID- 7783465
TI  - The effects of massage on the left heart functions in patients of coronary heart
      disease.

PMID- 7783466
TI  - Review on acupuncture treatment of peripheral facial paralysis during the past
      decade.

PMID- 7783467
TI  - Progress of modern research on tumor blood stasis syndrome and its treatment with
      the method of promoting blood circulation by removing blood stasis.

PMID- 7783468
TI  - [Insulin treatment in diabetes mellitus type II: the usefulness of the breakfast
      test].
AB  - BACKGROUND: Insulin treatment in patients with type-II diabetes mellitus (DMII)
      is normally undertaken by clinical criteria. The aim of the present was to study
      the efficacy of a standard mixed meal (breakfast test) to predict the need for
      insulin therapy to thereby evaluate whether it is possible to obtain more
      objective criteria for the indication of insulin treatment. METHODS: Fifty-six
      patients with DMII were studied to evaluate the need for insulin therapy over a
      one-year period. Serum glucose and basal C peptide and their maximum values were
      determined in all the patients following stimulation with the breakfast test.
      Insulin treatment was initiated according to exclusively clinical criteria during
      admission. The patients were followed as out patients for a minimum of 3 months.
      Treatment at the end of follow up (insulin or no insulin) was evaluated and the
      results of the test were retrospectively analyzed. RESULTS: The basal C peptide
      (BCP) values were significantly lower in the individuals requiring insulin in
      comparison to those who did not require insulin (mean +/- SD 0.64 +/- 0.28 versus
      1.18 +/- 0.41 nmol/l, p < 0.0001) similar to what was found with the stimulated
      maximum C peptide values (MCP) (1.48 +/- 0.77 versus 2.49 +/- 0.63 nmol/l, p <
      0.0001). On considering a BCP of less than 0.9 nmol/l for the patients with
      insulin treatment the sensitivity of BCP was 83.6% and the specificity 78.9%. For
      a BCP value of less than 1.9 nmol/l sensitivity was 77.7% and specificity 78.9%.
      Using the values together, sensitivity was 66.6% and specificity 84.4%.
      CONCLUSIONS: The breakfast test is useful to indicate the need for insulin
      therapy in patients with type II diabetes mellitus but is not more useful than a
      determination of isolated basal C peptide.

PMID- 7783469
TI  - [Changes in the natural history of AIDS in patients from Mallorca and Ibiza: 1986
      1992].
AB  - BACKGROUND: Longitudinal follow-up studies in patients with human
      immunodeficiency virus (HIV) infection and AIDS, which are fundamental for the
      knowledge of variations the natural history of this disease, have generally been
      carried out by Public Health Departments and in populations in which homosexual
      males predominate. The aim of the present study was to analyze the changes in the
      natural history of the patients diagnosed with AIDS in the islands of Mallorca
      and Ibiza. METHODS: A prospective study of the adult patients diagnosed with AIDS
      in Mallorca and Ibiza, from 1986 to 1992 was performed. RESULTS: The annual
      incidence of the cases of AIDS increased throughout the study. The mean age of
      the patients did not vary, and neither did that in relation to sexes. A
      progressive decrease was observed in CD4 lymphocytes at the time of diagnosis
      (from 0.168 x 10(9)/l in 1986 to 0.079 x 10(9)/l in 1992). There was an increase
      in heterosexual transmission patients with no known risk factors also increased
      over the period studied. The incidence of extrapulmonary tuberculosis decreased
      both as the form of presentation and in its global frequency. Pneumonia by
      Pneumocystis carinii increased mainly as a initial feature. The median survival
      was 547 days and did not vary significantly throughout the study. CONCLUSIONS:
      The epidemiologic and clinical study of AIDS in Mallorca and Ibiza, Spain is
      similar to that observed in other Mediterranean regions. The incidence of
      extrapulmonary tuberculosis has decreased.

PMID- 7783471
TI  - [Adolescence: a fertile terrain for drug abuse and addiction].

PMID- 7783470
TI  - [The Spanish version of the SF-36 Health Survey (the SF-36 health questionnaire):
      an instrument for measuring clinical results].
AB  - BACKGROUND: The present study, performed within the International Quality of Life
      Assessment project (including researchers from 15 countries) presents preliminary
      results of the process of adaptation of the SF-36 to be used in Spain. METHODS:
      The adaptation was based on the translation/back-translation methodology.
      Meetings of translators, researchers and patients were organized in order to
      produce successive versions. A study involving 47 individuals was carried out to
      assess the relative value (through a visual analogue scale) of each response
      choice of the questionnaire items. Finally, internal consistency and
      reproducibility of the Spanish version of the SF-36 was assessed by administering
      the questionnaire to 46 patients with stable coronary heart disease in two
      different occasions 2 weeks apart. RESULTS: The average ratings of equivalence of
      the translated version with the original were high regardless of the difficulty
      of translation. The rank ordering of mean scores for each responses choice agreed
      with the ranking assigned in the questionnaire in all cases. Cronbach's Alpha was
      higher than 0.7 for all dimensions (range: 0.71-0.94) except for Social
      Functioning scale (alpha = 0.45). Intraclass correlation coefficients between
      both administrations of the questionnaire ranged from 0.58 to 0.99. CONCLUSIONS:
      The adaptation process of the SF-36 has concluded with an instrument apparently
      equivalent to the original and with an acceptable level of reliability.
      Nevertheless, other basic characteristics of the adapted questionnaire (i.e.
      validity and sensitivity to changes) should be also assessed.

PMID- 7783472
TI  - [The genetic markers of arterial hypertension: a long road already begun].

PMID- 7783473
TI  - [Adolescents faced with addictive substances: tobacco, alcohol and
      noninstitutionalized drugs].
AB  - BACKGROUND: A large share of premature mortality is Spain in related with the
      abuse of addictive substances: tobacco, alcohol and non-institutionalized drugs.
      Adolescence is a key period for the adoption of their use. An accurate knowledge
      of the attitudes, beliefs, environmental perceptions and behaviours of teen-agers
      is necessary for the design and evaluation of preventive interventions. METHODS:
      Data were obtained from a survey conducted in 1992 on smoking, alcohol and non
      institutionalized drugs in 8th grade students (13-14 years old) of a
      representative sample of the schools of the city of Barcelona (Catalonia, Spain).
      RESULTS: Up to 44.1% have ever smoked, 10.9% are regular smokers and 15.5% have
      bought tobacco at some point. There are no differences in smoking patterns by sex
      at this age. Even if 35.5% never drink alcohol, 1.7% drink it daily, 15.5% drink
      on week-ends and 62.9% at family celebrations, while 13.5% have bought alcohol at
      some point and 22.4% report having got drunk at least once. There are no
      differences by sex in alcohol use at this age. Concerning non-institutionalized
      drugs, 35.4% of the students think that many adults use them, and 22.4% say that
      some friends have tried them. CONCLUSIONS: The results show the increasing
      penetration of tobacco and alcohol in the personal environment of the students,
      and the process of initiation. Compared with previous studies in this population,
      we can estimate a modest and non-significant reduction of regular smoking, and a
      reduction in daily and regular alcohol use.

PMID- 7783474
TI  - [Asthenia, anorexia, weight loss, somnolence, abdominal pain and vomiting in a 74
      year-old woman].

PMID- 7783475
TI  - [Mycoplasma hominis bacteremia in a multiple-trauma patient].

PMID- 7783476
TI  - [Emergency admissions to a hospital: the role of primary care].

PMID- 7783477
TI  - [Giant-cell aortic arteritis (Takayasu's arteritis) whose presentation simulates
      infectious aortic endocarditis].

PMID- 7783478
TI  - [False melanuria in a female patient treated with 5-ASA for ulcerative colitis].

PMID- 7783479
TI  - [Spontaneous bacterial peritonitis due to Salmonella enteritidis].

PMID- 7783480
TI  - ["AIDS-ic": belonging or relative to AIDS].

PMID- 7783481
TI  - [Monocytoid B-cell lymphoma with peripheral blood expression at the time of its
      diagnosis].

PMID- 7783482
TI  - [Ineffective measures against malpractice by physicians].

PMID- 7783483
TI  - [Foot surgery--not all the methods are good].

PMID- 7783484
TI  - [Occupational injury and assessment of etiologic factors].

PMID- 7783485
TI  - [Patient committees needed also in malpractice cases].

PMID- 7783486
TI  - [Dialysis patients are often undernourished].

PMID- 7783487
TI  - [Bedside. The portable pencil computer for complete medical history taking in
      hospitals].

PMID- 7783488
TI  - [Cytostatic agents administrated via a subcutaneous intravenous port: the course
      was a nightmare].

PMID- 7783490
TI  - [Nutritional tubes displaced. No dramatic symptoms but the food went down into
      the bronchi].

PMID- 7783489
TI  - [Radical or conservative surgery in craniopharyngioma? Importance of
      individualized treatment!].
AB  - In a retrospective study of 36 children aged 3-16 years, undergoing 'radical'
      surgery for craniopharyngioma, postoperative radiography showed tumour excision
      to have been complete in 25 cases and partial in 11 cases. The recurrence rate
      was 40% among those treated with surgery alone (N = 27), whereas there were no
      recurrences among those given adjunctive radiotherapy (RT) (N = 9). Although
      surgery in the hypothalamic region carries a high risk of severe lasting
      sequelae, long-term follow-up (mean duration 15 years) showed no difference in
      this respect between the RT and non-RT subgroups. Until large, preferably
      international, prospective studies may resolve the lack of consensus regarding
      the optimal treatment of craniopharyngioma, the authors advocate a more
      individualised approach, the choice between different treatment modalities and
      combinations being based on tumour size, location and structure.

PMID- 7783491
TI  - [Arthrosis of the hip and knee. Heredity, sports and overweight are usually more
      hazardous than work].

PMID- 7783492
TI  - [Hand perspiration was his death. The cause was sympathetic imbalance].

PMID- 7783493
TI  - [Eye injuries caused by air bags. The importance of information about alkalic
      aerosol].

PMID- 7783494
TI  - [Dialysis treatment is satisfactory. A survey of all patients with chronic renal
      failure in Stockholm].

PMID- 7783495
TI  - [The apparent increase in cancer survival].

PMID- 7783496
TI  - [Surgery of colorectal cancer outside the regional hospitals. Good results, but
      internal specialization is desirable].

PMID- 7783497
TI  - [A consensus statement. Heart attack--acute or threatening myocardial
      infarction].

PMID- 7783499
TI  - [Are agreements between private practitioners and county councils welcomed?].

PMID- 7783498
TI  - [Children of hiding refugees shall have the right to medical care!].

PMID- 7783500
TI  - [Information systems and confidentiality are worth to be discussed].

PMID- 7783501
TI  - [A comparative study needed].

PMID- 7783502
TI  - [Tuberculosis is coming back. A forgotten knowledge of the infection should be
      revived].

PMID- 7783503
TI  - [Lung x-rays for people seeking asylum! Watch for fever, fatigue, weight loss and
      prolonged cough to control tuberculosis].

PMID- 7783504
TI  - [Hyperthyroxinemia after parathyroidectomy. Not an unusual transient symptomatic
      condition].

PMID- 7783505
TI  - [Sterile water papules against labor pain. A simple, safe, effective method].

PMID- 7783506
TI  - [Platelet-derived growth factor. A growth factor of great physiopathological
      importance].
AB  - Platelet-derived growth factor (PDGF) is a 30 kilodalton dimeric peptide
      comprising A and B chains. The two types of PDGF receptors (alpha and beta) that
      have been identified belong to the protein-tyrosine kinase family of growth
      factor receptors. PDGF is a potent mitogen for a variety of cell types, and in
      gene knock-out experiments has been shown to be required for the development of
      inter alia mesangial cells of renal glomeruli and smooth muscle cells of lung
      alveolar septa. PDGF is believed to fulfil important autocrine and paracrine
      growth-related functions, and its overproduction has been recognised in various
      malignant tumours and in non-neoplastic hyperproliferative disorders.

PMID- 7783507
TI  - [Permanent brain damage and fatal outcome. Postoperative hyponatremia--a female
      Achilles heel?].

PMID- 7783508
TI  - [Leonardo da Vinci. A pioneer in the study of blood circulation dynamics].

PMID- 7783509
TI  - [Ischemic heart disease: is it really time to change therapeutic routines?].

PMID- 7783510
TI  - [Positive stress! Esa-Pekka Salonen about the good stress in the unique
      leadership role of the conductor... Interview by Birgit Wilhelmson].

PMID- 7783511
TI  - [Why do conductors live longer than composers? About working conditions, creation
      and re-creation].

PMID- 7783513
TI  - [Health care at the crossroads--manage or lead? Support responsibility ot the
      individual persons].

PMID- 7783512
TI  - [Life changes after prolonged sick leave].

PMID- 7783514
TI  - [Unethical private practice--a privare reaction].

PMID- 7783515
TI  - [An unacceptable attempt to silence the critics of the medical society].

PMID- 7783516
TI  - [Primary treatment of breast cancer. Axillary dissection is necessary for
      staging].

PMID- 7783517
TI  - [Improve the benefit of axillary excision. At least 10 examined glands should be
      a standard].

PMID- 7783518
TI  - [New therapeutic principles in shoulder instability. Preparatory work is as
      important as surgery].

PMID- 7783519
TI  - [Peripheral nerve tumors. Excirpation may presently be done without disabling
      neurological loss].

PMID- 7783520
TI  - [SVIR, the national intensive care registry. An important evaluation of expensive
      care].

PMID- 7783521
TI  - [Depressive conditions in the elderly and patients with dementia. Underdiagnosed,
      but curable].

PMID- 7783522
TI  - [Working conditions of district medical officers at the turn of the century].

PMID- 7783523
TI  - [Recently acquired knowledge of flat adenomas in the large intestine. Hidden
      precancerous changes demonstrable by endoscopy].

PMID- 7783524
TI  - [A case report. Enlarged lymph nodes should give rise to HIV testing].

PMID- 7783525
TI  - [From being a student to becoming a good physician. A model project improves the
      student-teacher relation].

PMID- 7783526
TI  - [Chronic non-compliance in connection with prescriptions. Drugs that have been
      left over - confusing. A prescription instaed of empathy?].

PMID- 7783527
TI  - [Olof Joh:Broman--an 18th century dean and self-thought physician: "the clue for
      good health: everything in moderation is best"].

PMID- 7783528
TI  - [Management control in health care. Of what importance is it and towards what is
      it aimed?].

PMID- 7783529
TI  - [Withdraw metformin prior to contrast radiography. A warning in the Fass was
      forgotten, two patients died].

PMID- 7783530
TI  - Shall we nim a horse?

PMID- 7783531
TI  - Beyond all reasonable DNA.

PMID- 7783532
TI  - Alcohol and hypertension.

PMID- 7783533
TI  - To conquer poliomyelitis forever.

PMID- 7783534
TI  - Diagnosing Prader-Willi syndrome.

PMID- 7783535
TI  - Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type
      after cure of Helicobacter pylori infection. MALT Lymphoma Study Group.
AB  - Lymphoma of gastric-mucosa-associated lymphatic tissue (MALT) type has been
      linked to infection with Helicobacter pylori. We investigated the effect on MALT
      lymphoma of eradicating H pylori infection. 33 patients with primary gastric low
      grade MALT lymphoma associated with H pylori gastritis were treated with
      omeprazole (120 mg daily) and amoxycillin (2.25 g daily) for 14 days to eradicate
      H pylori. In addition to histology, PCR was used to examine proliferation of
      monoclonal B cells before treatment and during follow-up. All patients had at
      least two post-treatment examinations, and all became negative for H pylori, 2
      after a second treatment course. On histology, 23 (70%) patients showed complete
      regression and 4 (12%) partial regression of lymphoma. 6 (18%) patients had no
      change after cure of H pylori infection. 1 was treated with chemotherapy. Of 5
      treated surgically, 4 were found to have high-grade B-cell lymphoma on histology
      of the resected stomach and 1 a high-grade T-cell lymphoma. PCR showed complete
      disappearance of monoclonal B cells after cure of H pylori infection in 13 of 16
      patients investigated. During median follow-up of 1 year no relapse of MALT
      lymphoma occurred. Low-grade primary gastric MALT lymphoma can completely regress
      after eradication of H pylori infection. However, longer follow-up is needed to
      clarify whether the remission is lasting.

PMID- 7783536
TI  - Prevention of relapses in systemic lupus erythematosus.
AB  - Many relapses of systemic lupus erythematosus (SLE) are preceded by a rise in
      antibodies against double-stranded DNA (anti-dsDNA). We investigated whether
      these relapses can be prevented by giving prednisone when a rise in anti-dsDNA
      occurs. 156 patients with SLE were studied. Anti-dsDNA was measured by Farr assay
      monthly. When a rise in anti-dsDNA was found, patients were randomly assigned
      either conventional treatment or 30 mg prednisone added to the current daily dose
      and tapering off to baseline over 18 weeks. A rise in anti-dsDNA was detected in
      46 patients (24 assigned conventional treatment and 22 prednisolone). The relapse
      rate was higher in the conventional group than in the prednisolone group (20 vs
      2, p < 0.001). Although rises in anti-dsDNA in the prednisone group were treated
      with additional prednisone, the cumulative oral doses of prednisone in the two
      groups did not differ significantly (p = 0.025). 7 major relapses requiring
      additional cytotoxic immunosuppressive treatment occurred in the conventional
      group versus 2 in the prednisone group. Treatment with prednisone as soon as a
      significant rise in anti-dsDNA occurs prevents relapse in most cases, without
      increasing the cumulative dose of prednisdone given.

PMID- 7783537
TI  - Association of angiotensinogen gene T235 variant with increased risk of coronary
      heart disease.
AB  - Several genes, including some encoding components of the renin angiotensin
      system, are associated with the risk of cardiovascular diseases. There have been
      reports linking a homozygous deletion allele of the angiotensin converting enzyme
      (ACE) gene (DD) with an increased risk of myocardial infarction, and some
      variants of the angiotensinogen gene with an increased risk of hypertension. In a
      case-control study of a caucasian population from New Zealand, we examined the
      associations with coronary heart disease (CHD) of ACE DD and of a mis-sense
      mutation with methionine to threonine aminoacid substitution at codon 235 in the
      angiotensinogen gene (T235). We studied 422 patients (mean age 62 years, 81%
      male) with documented CHD (50% with myocardial infarction) and 406 controls
      without known CHD (frequency-matched to cases by age and sex). Risk factors for
      CHD were assessed by standard questionnaire, physical examination, and blood
      tests. Genomic DNA from leucocytes was analysed for various ACE and
      angiotensinogen alleles. Angiotensinogen T235 homozygotes were at significantly
      increased risk of CHD generally (odds ratio 1.7, 2 p = 0.008) and of myocardial
      infarction specifically (1.8, 2 p = 0.009). Adjustment for several risk factors
      increased the estimate of CHD risk associated with this allele to 2.6 (2 p <
      0.001) and the estimate for myocardial infarction risk to 3.4 (2 p < 0.001). By
      contrast, there was no evidence of a significant increase in the risk of CHD or
      myocardial infarction among individuals with ACE DD. We conclude that the T235
      polymorphism of the angiotensinogen gene is an independent risk factor, which
      carries an approximately two-fold increased risk of CHD. In this study, however,
      ACE DD was not associated with any detectable increase in CHD risk.

PMID- 7783538
TI  - Viridans streptococcal bacteraemia in patients with neutropenia.
AB  - Viridans streptococcal bacteraemia is frequent in neutropenic patients. 25
      neutropenic patients with viridans streptococcal bacteraemia were compared with
      64 control patients. Exposure to repeated chemotherapy or cytarabine were
      independent risk-factors for streptococcal bacteraemia. The use of
      carboxyureidopenicillins and a stay in laminar-airflow rooms were protective. In
      a further cohort study of 49 patients, oral streptococci with the same ribotype
      as blood isolates were recovered from all 7 bacteraemic patients. The oral cavity
      is a portal of entry for viridans streptococci bacteraemia in neutropenic
      patients, especially after oral mucosal damage induced by repeated chemotherapy.

PMID- 7783539
TI  - Cerebrospinal fluid concentration of neuron-specific enolase in diagnosis of
      Creutzfeldt-Jakob disease.
AB  - Neuron-specific enolase (NSE) is among the biochemical markers in cerebrospinal
      fluid reported to be useful in the differential diagnosis of Creutzfeldt-Jakob
      disease from other dementing illnesses. In a group of 58 patients with definite
      and probable Creutzfeldt-Jakob disease, NSE concentrations (median 94.0,
      interquartile range 256 ng/mL) were significantly higher (p < 0.001) than in 26
      control patients (9.5, 15.5 ng/mL). At a cut-off of 35 ng/mL an optimum
      sensitivity of 80% with a specificity of 92% for the diagnosis of Creutzfeldt
      Jakob disease by NSE in cerebrospinal fluid was obtained.

PMID- 7783540
TI  - Preventive health care.

PMID- 7783541
TI  - Can overall results of clinical trials be applied to all patients?
AB  - It is generally assumed that the overall results of a clinical trial are
      generalisable to all patients in the trial and all similar future patients; in
      other words, that the relative treatment effect in individual patients is similar
      to the overall trial result. Although this assumption underpins the application
      of trial results to clinical practice, it has rarely been tested. By
      independently derived prognostic models, the results of the European Carotid
      Surgery Trial and the UK-TIA Aspirin Trial were reanalysed to find out whether
      relative treatment effect varied with absolute baseline risk of stroke. There was
      significant heterogeneity of relative treatment effect in both trials, resulting
      in substantial variation in absolute treatment effect with predicted baseline
      risk. Although, on average, the application of overall trial results to all
      patients will do more good than harm, a knowledge of the association between
      relative treatment effect and absolute baseline risk will increase the cost
      effectiveness of healthcare interventions by identifying those patients in whom
      treatment is ineffective and those patients who are most likely to benefit.

PMID- 7783542
TI  - HIV research: a need to focus on the right target.

PMID- 7783544
TI  - Diabetes update.

PMID- 7783543
TI  - A continuing community-care crisis.

PMID- 7783545
TI  - Screening tests: are they worth doing?

PMID- 7783546
TI  - Neuropsychological effects of exposure to sheep dip.

PMID- 7783547
TI  - Neuropsychological effects of exposure to sheep dip.

PMID- 7783548
TI  - Ionomeric cement and aluminium encephalopathy.

PMID- 7783549
TI  - Time to HIV seroconversion after needlestick injury.

PMID- 7783550
TI  - Carcinogenic consequences of coal-tar shampoo?

PMID- 7783551
TI  - Hyperthermia in cancer treatment.

PMID- 7783552
TI  - Hyperthermia in cancer treatment.

PMID- 7783553
TI  - Vibrio cholerae O139 in Denmark.

PMID- 7783555
TI  - Octreotide for protein-losing enteropathy with intestinal lymphangiectasia.

PMID- 7783554
TI  - Activated-carbon-oriented laparoscopic colectomy.

PMID- 7783556
TI  - Problems encountered by hearing-impaired people in hospitals.

PMID- 7783557
TI  - Mortality and social deprivation.

PMID- 7783558
TI  - Notifying former patients of an infected health-care worker.

PMID- 7783559
TI  - Pregnancy after intracytoplasmic injection of spermatid.

PMID- 7783560
TI  - Classification of azoospermic samples.

PMID- 7783561
TI  - Sudden fall in breast cancer death rates in England and Wales.

PMID- 7783562
TI  - Colon cancer in a 16-year-old girl.

PMID- 7783563
TI  - High-dose folic acid treatment for red-cell aplasia.

PMID- 7783564
TI  - Helicobacter pylori eradication and reinfection.

PMID- 7783565
TI  - Helicobacter pylori eradication and reinfection.

PMID- 7783566
TI  - Helicobacter pylori eradication and reinfection.

PMID- 7783567
TI  - Swabaholics?

PMID- 7783569
TI  - Patients' health-care decision making: a framework for descriptive and
      experimental investigations.

PMID- 7783568
TI  - P-glycoprotein-mediated multidrug resistance in tumor cells: biochemistry,
      clinical relevance and modulation.

PMID- 7783570
TI  - The effects of computer-assisted electrocardiographic interpretation on
      physicians' diagnostic decisions.
AB  - OBJECTIVE: To evaluate the effect of computer-assisted interpretation of
      electrocardiograms (ECGs) on diagnostic decision making by primary care
      physicians. DESIGN: Randomized controlled trial. SETTING: Primary care
      physicians' outpatient clinics in or near the Minneapolis/St. Paul metropolitan
      area. PARTICIPANTS: Forty family physicians and general internists who were
      members of either of two large consortia of clinics. INTERVENTION: Subjects
      evaluated ten clinical vignettes accompanied by ECGs and reported their
      diagnostic impressions. The vignettes were based on actual patient visits. Half
      of the subjects received ECGs with computer-generated reports, the other half
      received the same ECGs without reports. MAIN OUTCOME MEASURES: ECG reading time;
      agreement with the clinical diagnosis; agreement with the computer report;
      diagnostic confidence. RESULTS: The subjects receiving the reports were more
      likely to agree with the clinical diagnoses of the original cases, particularly
      for two vignettes in which the diagnoses were uncommon and were mentioned in the
      reports. The subjects receiving the reports were also more likely to make
      diagnoses that were consistent with the reports, even when the reports were
      erroneous. Those receiving the reports spent, on average, 15 seconds less time
      looking at each ECG, a 25% decrease. CONCLUSIONS: In simulated cases, primary
      care physicians appear to use computer interpretations of ECGs when available, as
      shown by enhanced diagnostic accuracy and modestly reduced time spent reading the
      tracings. However, erroneous reports may mislead physicians. Since the effects of
      computerized ECG interpretation do not appear to have been uniformly favorable in
      this mock-clinical setting, it will be important to evaluate the effects of this
      technology in actual practice.

PMID- 7783571
TI  - Information seeking in primary care: how physicians choose which clinical
      questions to pursue and which to leave unanswered.
AB  - Primary care physicians have many questions about optimal care while they are
      seeing patients, but they pursue only about 30% of their questions. The authors
      designed a study to determine the factors that motivate physicians to pursue
      answers to some of their questions, while leaving the majority of their questions
      unanswered. They interviewed 49 non-academic primary care physicians during
      office hours to record clinical questions as they arose in the course of patient
      care. The physicians then recorded their perceptions of each question with
      respect to 12 factors expected to motivate information seeking. Two to five days
      after the interview, each physician was telephoned to determine which questions
      had been pursued. In a multiple logistic-regression model only two factors were
      significant predictors of pursuit of new information: the physician's belief that
      a definitive answer existed, and the urgency of the patient's problem. Other
      factors, including the difficulty of finding the answer, potential malpractice
      liability, potential help or harm to the patient, and self-perceived knowledge of
      the problem, were not significant in the model. Primary care physicians are
      significantly more likely to pursue answers to their clinical questions when they
      believe that definitive answers to those questions exist, and when they perceive
      the patient's problem to be urgent. Medical information systems must be shown to
      have direct and immediate benefits to solving the problems of patient care if
      they are to be more widely used by practitioners.

PMID- 7783572
TI  - The covariance decomposition of the probability score and its use in evaluating
      prognostic estimates. SUPPORT Investigators.
AB  - The probability score (PS) or Brier score has been used in a large number of
      studies in which physician judgment performance was assessed. However, the
      covariance decomposition of the PS has not previously been used to evaluate
      medical judgment. The authors introduce the technique and demonstrate it by
      analyzing prognostic estimates of three groups: physicians, their patients, and
      the patients' decision-making surrogates. The major components of the covariance
      decomposition--bias, slope, and scatter--are displayed in covariance graphs for
      each of the three groups. The decomposition reveals that whereas the physicians
      have the best overall estimation performance, their bias and their scatter are
      not always superior to those of the other two groups. This is primarily due to
      two factors. First, the physicians' prognostic estimates are pessimistic. Second,
      the patients place the large majority of their estimates in the most optimistic
      category, thereby achieving low scatter. The authors suggest that the
      calculational simplicity of this decomposition, its informativeness, and the
      intuitive nature of its components make it a useful tool with which to analyze
      medical judgment.

PMID- 7783573
TI  - Comparison of time-tradeoff utilities and rating scale values of cancer patients
      and their relatives: evidence for a possible plateau relationship.
AB  - Because they are easy to administer, rating scales are often used as proxies for
      utility measures. The authors investigated the relationship between time-tradeoff
      utilities and rating scale values in two populations: 124 cancer patients asked
      to evaluate their current states of health and 102 relatives and close friends of
      cancer patients asked to evaluate health-state scenarios. None of the models
      tested effectively described the relationship between individual patients' rating
      scale values and time-tradeoff utilities for their current states of health. In
      contrast, both a plateau and a power-function model explained the variability in
      the responses of the relatives reasonably well (R2 = 0.56 and R2 = 0.58,
      respectively). Given that many respondents who were unwilling to trade off any
      time assigned rating scale values of well below 100, a plateau model may
      represent the best approach to adjusting rating scale values for health-state
      scenarios when it is not feasible to elicit time-tradeoff utilities.

PMID- 7783574
TI  - Optimal interval for triple-lumen catheter changes: a decision analysis.
AB  - A survey of 53 university and community hospitals revealed that 73% of the
      institutions had no standard policy for the replacement of triple-lumen catheters
      (TLCs). Since the maintenance of a TLC in place for a prolonged period may lead
      to infectious complications, it appeared warranted that standards of management
      be developed. A decision-tree model was constructed for evaluating the optimal
      time for changing a TLC that would minimize infection. Cost estimates and health
      effects at three-, five-, and ten-day change intervals were considered for
      catheter insertion and complications resulting from such insertion. The results
      suggested that prophylactic catheter changes should occur no later than every
      five days, provided that there are no signs of infection. However, sensitivity
      analysis of several variables suggested that individual institutions should
      establish policy timing changes based upon careful interpretation of their own
      data. A model was developed to assist in determining the optimal time to change a
      TLC based upon such data.

PMID- 7783575
TI  - Decision analysis for lower-third-molar surgery.
AB  - The objective of the study was to identify those factors that should affect
      treatment planning for patients who have lower third molars, using decision
      analytic techniques. Utility values based on data from 104 patients indicated
      that the respondents considered that postoperative complications (except mild
      pain and temporary paresthesia) reduced health to a greater degree than did
      complications following non-intervention. A decision analysis indicated that the
      maximum expected utility of prophylactic third-molar surgery (60.25) was lower
      than that for non-intervention (76.96). The decision was sensitive to changes in
      the probabilities of occurrence of recurrent pericoronitis (threshold = 0.52),
      resorption of an adjacent tooth (threshold = 0.29), loss of an adjacent tooth
      (threshold = 0.32), and cystic change (threshold = 0.34). These thresholds are
      much higher than the incidence of problems affecting the lower third molar shown
      by a concurrent clinical audit and literature review. This study therefore
      suggests that lower third molars should not be removed prophylactically.

PMID- 7783577
TI  - Life expectancy biases in clinical decision modeling.
AB  - Clinical decision models often rely upon survival models predicated on disease
      specific hazard functions combined with baseline hazard functions obtained from
      standard life tables. Two biases may arise in such a modeling process. First,
      life expectancy estimates may be biased even if estimates of survival
      probabilities are unbiased (misestimation bias). In simulation studies, the
      authors discovered that the magnitude of misestimation bias is larger as life
      expectancy increases, sample size decreases, and censoring percentage increases.
      In the context of a simple decision analysis, they found that imbalances in the
      sample sizes for the data used to estimate the parameters among different
      strategies resulted in non-optimal decisions in the long run. The second bias
      stems from misspecification of the survival model itself (misspecification bias).
      Using a simple cost-effectiveness model, the authors found that life expectancies
      and incremental cost-effectiveness ratios differed depending on whether an excess
      mortality or a proportional-hazards model was specified. In addition, a
      predictable pattern was observed for these two survival models when extrapolated
      to other age and gender groups.

PMID- 7783576
TI  - Communicating the benefits of chronic preventive therapy: does the format of
      efficacy data determine patients' acceptance of treatment?
AB  - Patients' informed acceptance of chronic medical therapy hinges on communicating
      the potential benefits of drugs in quantitative terms. In a hypothetical scenario
      of treatment initiation, the authors assessed how three different formats of the
      same data affected the willingness of 100 outpatients to take what were implied
      to be three different lipid-lowering drugs. Side-effects were declared negligible
      and costs insured. Subjects make a "yes-no" decision about taking such a
      medication, and graded the decision on a certainty scale. Advised of a relative
      risk reduction--"34% reduction in heart attacks"--88% of the patients assented to
      therapy. All other formats elicited significantly more refusals (p < 0.0001): for
      absolute risk difference--"1.4% fewer patients had heart attacks"--42% assented;
      for inverted absolute risk--"treat 71 persons for 5 years to prevent one heart
      attack"--only 31% accepted treatment. When the data were extrapolated to disease
      free survival--"average gain of 15 weeks"--40% consented. Similar responses were
      obtained for descriptions of an antihypertensive drug: 89% assented to therapy
      when given relative risk reduction but only 46% when given absolute risk
      reduction. The subjects were confident in both acceptance and refusal: 93% of the
      decisions were rated "somewhat certain" to "completely certain." The authors
      conclude that patients' views of medical therapy are shaped by the formats in
      which potential benefits are presented. Multiple complementary formats may be
      most appropriate. The results imply that many patients may decline treatment if
      briefed on the likelihood or extent of benefit.

PMID- 7783578
TI  - A new model for category-scaling data with an application to the development of
      health-status measures.
AB  - Category rating is used to assess patient, family-member, provider, and societal
      preferences for health outcomes. Often, it is of interest to compare ratings
      obtained from different groups. Standard methods for making comparisons, such as
      regressions, correlations, and multiple t-tests, do not account for the
      dependency among ratings. The authors propose a new model for category ratings
      that does consider their relative dependency. This model provides a profile of
      ratings for a single group and facilitates comparisons across groups. It was
      applied to category ratings for four levels of Bending and Lifting function as
      defined by the recently developed Functional Capacity Index (FCI). Differences in
      ratings were observed across groups with different personal experiences of
      functional limitations and across groups with different degrees of clinical
      knowledge. These differences were not observed when standard methods were used.
      Thus, ignoring the relative nature of category ratings can lead to different
      conclusions about group preferences for health outcomes. When the ratings are
      being used to scale a health-status measure, this discrepancy has implications
      for the application of the measure in resource allocation.

PMID- 7783579
TI  - Explaining distortions in utility elicitation through the rank-dependent model
      for risky choices.
AB  - The standard-gamble (SG) method has been accepted as the "gold standard" for the
      elicitation of utility when risk or uncertainty is involved in decisions, and
      thus for the measurement of utility in medical decisions. It is based on the
      assumptions of expected-utility theory. Unfortunately, there is now abundant
      evidence that expected utility is not empirically valid, and that the SG method
      overestimates risk aversion and the utilities of impaired health states. This
      paper shows how rank-dependent utility theory, a newly developed theory in
      decision science, can explain the main violations of expected utility. Thus it
      provides a means for correcting the SG method and for improving the assessments
      of quality-adjusted life years for medical decisions in which there is
      uncertainty about outcomes.

PMID- 7783580
TI  - When decision support doesn't support.

PMID- 7783581
TI  - Improving information search and retrieval for practitioners.

PMID- 7783582
TI  - [Equipment for computerized radiodiagnosis without film].
AB  - The paper deals with the problems which have currently arisen in X-ray diagnosis,
      such as shortage of film because of its high price, modernization of X-ray
      equipment, reduction in ray loading. A set of computering filmless X-ray
      diagnostic tools has been proposed to solve these problems. The implementation of
      this technology is concerned with the developed MCP-92M system operating in
      combination with a RUM-20M apparatus. The paper provides the technical
      characteristics of the system and the principle of operation. Brief data on the
      use of the system in Novomoskovsk Hospital No. 1 are also given.

PMID- 7783583
TI  - [Problems of radiation protection in radiodiagnosis].
AB  - The paper outlines the ways of technological progress in controlling and
      recording the dosage loading on the patients undergone X-ray studies. Differences
      have been established in the concepts "an effective dose" which are proposed by
      the International Radiation Protection Committee and given in the documents
      issued by the National State Committee for Standardization. The paper also
      describes the accepted methods for regulating the patients' dosage loads, which
      determine the ways of improving X-ray equipment and means of patients' individual
      protection.

PMID- 7783584
TI  - [Medical and technical evaluation of drying cabinet for radiologic film ShS-160].
AB  - The paper describes the design of a drying cabinet to be equipped in the X-ray
      laboratories and its testing results.

PMID- 7783585
TI  - [Educational programs on ventilation-perfusion ratio].
AB  - The paper describes a learning programme for calculating the characteristics of
      arterial blood from the ventilation-perfusion ratios in the lungs by using a
      three-variable mathematical model of the lung. The lungs are presented as a set
      of three components which differ in ventilation and perfusion: 1) a fraction of
      ventilated and O2-perfused alveoles; 2) a fraction of non-perfused and ventilated
      alveoles; 3) a fraction of unventilated and non-perfused alveoles. Results of
      calculations are provided.

PMID- 7783586
TI  - [Non-invasive mapping of cardiac electric potential of a specific quasi
      epicardium].
AB  - A procedure was proposed for non-invasive mapping of the cardiac electrical
      potential or a spherical quasiepicardium from its synchronous multichannel
      measurement on the surface of the chest, i.e. routine electrocardiodraphic
      mapping. Mathematical simulation was used to demonstrate that the quasiepicardial
      potential can be calculated with the accuracy sufficient for clinical diagnosis
      by applying the multipole electric field resolution method with allowance made
      for three lowest resolution terms. Due to the fact that the spherical
      quasiepicardium is more approximate to the heart and more concentric as to its
      center than the chest surface, the maps of the quasiepicardial potential permit
      recognition of some features of the pattern of a cardiac electric process, which
      do not manifest themselves in the distribution of the potential on the body's
      surface. The examples showing that the assessment of a cardiac abnormality can be
      made more accurate by using this method are given in the paper.

PMID- 7783587
TI  - [Basic characteristics of magnetic resonance tomographs "Obraz"].
AB  - This paper described block diagrams of national magnetic tomographs having a 0.12
      T resistive magnet and gives their comparative characteristics , indicated the
      optimal modes of their operation.

PMID- 7783588
TI  - [Computerized devices for biological testing].
AB  - The paper provides evidence for perspectives of the toxicological equipment for
      protozoa chemotaxis bioassay, which allows one to solve the problems in preparing
      a culture, a sample, testing solutions and measurement of protozoan reactions. A
      Poisson process device was proposed to use for construction of a mathematical
      model of a protozoan concentration transducer. The experimental findings
      supported the dependence theoretically forwarded. With the new approach, a
      BIOTESTER-2 device was designed, which has found its use in controlling the
      quality of water, antibiotics, in mapping the contamination of areas. The device
      may be used in the evaluation of the toxicity of biological fluids.

PMID- 7783589
TI  - [Automated processing of electrophysiologic signals].
AB  - The paper outlines a diagram of a multichannel analyzer of electrophysiological
      signals while are significantly non-stationary (such as those of
      electroencephalograms, myograms, etc.), by using a method based on the ranging
      procedure by the change-over points which may be the points of infection,
      impaired locality, minima, maxima, discontinuity, etc.

PMID- 7783590
TI  - [Methodologic aspects of combined physiotherapeutic effect].
AB  - The paper describes a conceptually logic and mathematical model of the body's
      responses to the combined exposure to several physiotherapeutical factors. The
      model has been developed by transforming the basic differential equation of
      Volterra's survival theory and realizing as a computer program. The model enables
      one to find the optimal combinations of the parameters of the influencing factors
      which produce the maximum therapeutical effect without exhausting the
      compensatory abilities of the body's physiological systems.

PMID- 7783591
TI  - [Design and serial manufacturing of medical equipment in the Siberia and the Far
      East].

PMID- 7783592
TI  - [Guidelines of European Federation of Societies of Medical Physics (EFSMP)].

PMID- 7783593
TI  - [Automatization of the workplace of radiologist].
AB  - The authors propose and implement a roentgenologist's IBM PC/AT-compatible
      computer-aided automatic working place designed for the digital processing and
      analysis of medical introscopic images. The two-levelled architecture of APM-BP
      software allows one to optimize the speed of computations and to apply as
      computer technologies the know-how and experience gained in solving specific
      problems in the analysis of informative features of medical images. A procedure
      for the digital processing of linear pulmonary tomograms by using the designed
      working place in order to solve the problems of preclinical diagnosis of
      peripheral lung cancer is described.

PMID- 7783594
TI  - Identification of differentially expressed genes in scrapie-infected mouse
      neuroblastoma cells.
AB  - In vitro cDNA libraries from scrapie-infected and non-infected murine
      neuroblastoma cell lines were screened with cDNA probes derived by subtractive
      hybridization from scrapie-infected and uninfected cells to identify genes with
      altered expression associated with scrapie infection. Eleven independent
      recombinant clones, whose expression was either increased or decreased in scrapie
      infected cells, were identified. Expression of these genes was also analyzed in a
      panel of scrapie-infected and non-infected cell lines. Five genes had altered
      mRNA expression in most scrapie-infected neuroblastoma cell clones compared to
      non-infected clones. These genes were chromogranin B, intracisternal-A particle
      envelope, ornithine decarboxylase antizyme, heat shock protein 70 and one
      unidentified gene. None of these alterations in gene expression was uniquely
      scrapie-specific; however, the skewed association of increased expression with
      scrapie infection suggested that a causal relationship might exist between
      scrapie infection and altered expression of these genes in mouse neuroblastoma
      cells in vitro.

PMID- 7783595
TI  - Protection of SJL/J mice from demyelinating disease mediated by Theiler's murine
      encephalomyelitis virus.
AB  - Intracerebral infection with the DA strain of Theiler's murine encephalomyelitis
      virus induces a chronic demyelinating disease in SJL/J mice. Intraperitoneal
      inoculation with either the wild-type DA virus or an attenuated variant virus of
      DA, H7A6-2, results in protection from development of chronic demyelinating
      disease. Protective anti-viral immune responses result in reduced viral titers
      and decreased inflammation in the central nervous system within the first week
      following intracerebral challenge with virus. Development of protective immunity
      requires the presence of B cells and CD4+ T cells but does not require CD8+ T
      cells. High titers of serum anti-viral IgG and neutralizing antibodies are
      induced following the intraperitoneal inoculation with the DA virus or H7A6-2
      virus prior to challenge. While protection could not be transferred with immune
      serum from DA virus-infected mice or neutralizing monoclonal antibodies,
      protection was correlated with increased numbers of DA virus-specific plasma
      cells in the central nervous system within the first week following intracerebral
      challenge. Protected mice also had enhanced levels of anti-DA virus IgG and
      neutralizing antibodies in the cerebral spinal fluid by 1 week following
      intracerebral challenge with DA virus. Thus, we conclude that vaccination with
      live virus results in protection from chronic demyelinating disease by inducing
      immune responses which are manifested in the central nervous system and rapidly
      clear infection after intracerebral challenge with DA virus.

PMID- 7783597
TI  - Serum bactericidal activity and phagocytosis in host defence against Haemophilus
      ducreyi.
AB  - Serum bactericidal activity and phagocytic killing are two important mechanisms
      involved in the host defence against bacteria. Using some in vitro methods, serum
      bactericidal assay, phagocytic killing by polymorphonuclear leukocytes (PMN) and
      chemiluminescence, we have evaluated the significance of these mechanisms in the
      killing of Haemophilus ducreyi bacteria. Furthermore, induction of C3 conversion
      and deposition of immunoglobulins, C1q and C3, on the surface of bacteria was
      studied by crossed immunoelectrophoresis and ELISA, respectively. Transmission
      electron microscopy was employed to study internalization of bacteria by PMN. H.
      ducreyi and lipooligosaccharide preparations from these bacteria were able to
      induce conversion of complement factor C3 in normal human serum (NHS). Exposure
      of bacteria to NHS resulted in deposition of IgG, IgM and complement factors C1q
      and C3 on the surface of bacteria. H. ducreyi bacteria lost their viability when
      incubated with fresh but not inactivated normal serum at high concentrations,
      indicating that the bacteria are sensitive to the complement-dependent
      bactericidal activity of serum. There were some variations between different
      strains regarding their susceptibility to the bactericidal activity of NHS, but
      for eight strains tested, all of the bacteria exposed were not killed in medium
      containing up to 70% of fresh serum. Complement-mediated opsonophagocytic killing
      of H. ducreyi by PMN was more effective than complement-dependent bactericidal
      activity of fresh normal sera. Bacteria treated with heat inactivated immune
      sera, on the other hand, were as sensitive to the bactericidal effect of PMN as
      those treated with non-inactivated immune sera, indicating the role of antibodies
      in opsonophagocytosis. H. ducreyi bacteria were also killed by PMN in the absence
      of serum antibodies and complement. Using the chemiluminescence assay, H. ducreyi
      was shown to activate PMN in the absence of serum as well as after opsonization
      with complement and antibodies. Our results therefore indicate that both opsonic-
      and non-opsonic mechanisms are involved in the phagocytosis and the subsequent
      killing of H. ducreyi bacteria. Although both complement and antibodies enhance
      the ability of phagocytes to kill H. ducreyi, neither component is sufficient for
      effective killing of H. ducreyi.

PMID- 7783596
TI  - Molecular cloning of an Actinobacillus pleuropneumoniae outer membrane
      lipoprotein (OmlA) from serotype 5a.
AB  - The gene encoding an outer membrane lipoprotein (OmIA) was cloned from
      Actinobacillus pleuropneumoniae strain NG-8 (serotype 5a). The deduced amino acid
      sequence of OmIA from strain NG-8 showed 61% identity to the OmIA from serotype 1
      strain, which confers protective immunity to pigs. Southern blot analysis showed
      the presence of a sequence highly homologous to the omIA gene of strain NG-8 in
      strains of serotype 5a, 5b and 10. A specific serum against OmIA of NG-8 also
      detected a homologous protein in the strains of these serotypes. These data shows
      the presence of antigenic variability among A. pleuropneumoniae OmIA proteins.

PMID- 7783598
TI  - Streptokinase activity among group A streptococci in relation to streptokinase
      genotype, plasminogen binding, and disease manifestations.
AB  - Certain genotypic variants of streptokinase (ska) of beta-hemolytic streptococci
      group A have been associated with acute post-streptococcal glomerulonephritis
      (APSGN). In our earlier studies on strains isolated from Ethiopian children with
      various streptococcal disease manifestation, we reported an even distribution of
      streptokinase genotypes with no association to disease patterns. Considering the
      possibility that strains could differ in their ability to secrete the protein,
      levels of streptokinase activity in culture supernatants of these strains were
      determined by a plasminogen activation assay using a synthetic tripeptide, H-D
      valyl-leucyl-lysin-p-nitroaniline, as a substrate. Of the 53 streptococcal group
      A strains, ten (19%), which belonged to genotype ska4 and ska8, did not activate
      human plasminogen. These strains did not activate bovine, sheep, horse, rabbit or
      porcine plasminogens either. They represented at least five M protein and non
      typeable serotypes, and were characterized by high human plasminogen binding
      activity. Six of the 53 strains (11%) harbouring genotype ska3 and ska7 showed
      low levels of human plasminogen activation. Strains of ska1 and ska2, 37/53,
      activated human plasminogen at a higher level (p < 0.005). Levels of plasminogen
      activation were not significantly different among the ska1 and ska2 strains
      associated with various streptococcal disease manifestations. Antibody levels
      against streptokinase were higher (p < 0.05) in convalescent sera from acute
      rheumatic fever and APSGN patients in comparison with sera from other patient
      categories and healthy controls. Streptokinase genotype and in vitro
      streptokinase production do not correlate directly to streptococcal disease
      manifestation, indicating a probable significance of additional streptococcal
      and/or host factors in the initiation of APSGN.

PMID- 7783599
TI  - Confirmation that DNA encoding the major fimbrial subunit of Av24 fimbriae is
      homologous to DNA encoding the major fimbrial subunit of F107 fimbriae.
AB  - Plasmid DNA from porcine enterotoxigenic Escherichia coli strain Av24
      (O141:K85ab) was cloned into recipient E. coli strain JM105 using the plasmid
      vector pUC18. Clones were obtained that produced fimbriae which reacted with
      antisera specific to the fimbriae produced by strain Av24. Restriction mapping of
      cloned DNA, PCR with fedA primers and DNA sequencing showed a portion of the
      cloned DNA to be homologous to that encoding the major fimbrial subunit of F107
      fimbriae. This confirms that the fimbriae possessed by strains of E. coli causing
      both edema disease and post-weaning diarrhoea in piglets are variants of the same
      fimbriae.

PMID- 7783600
TI  - Improved techniques for kidney transplantation in mice.
AB  - Improved microsurgical techniques for kidney transplantation in the mouse are
      described. Left renal transplantation is performed with end-to-side anastomoses
      of the donor renal vein to the inferior vena cava and the donor aortic cuff to
      the aorta. Urinary tract reconstruction is accomplished by suturing the donor
      ureter with a bladder patch to the recipient bladder. With these modifications,
      it is possible to achieve success rates as high as 90%. This stable and
      reproducible model provides a useful tool to study the immunological mechanisms
      of kidney allograft rejection at the molecular level.

PMID- 7783601
TI  - Development of a mouse aortic transplant model of chronic rejection.
AB  - Chronic rejection is the most common cause of late graft failure after solid
      organ transplantation. A model of chronic rejection, the rat aortic allograft,
      has histologic features that parallel those in the vessels of human transplanted
      organs. However, the molecular tools required to dissect the immunology of
      chronic rejection are unavailable in the rat. We developed aortic transplantation
      in the mouse as a new model of chronic rejection. This will allow the use of the
      diversity of recombinant cytokines and monoclonal antibodies available for the
      mouse and its well-defined genetics to investigate chronic rejection in greater
      detail. We describe the perioperative care and surgical technique for the model
      in which a 1 cm segment of donor thoracic aorta was used to replace a section of
      recipient abdominal aorta below the renal arteries and above the aortic
      bifurcation. Mortality rates were initially high (70%) due to thrombosis and
      shock. Changes in technique and operator facility resulted in a high rate of
      success (75%). After 192 operations, the current success rate is > 80%. Mice free
      from complications at 12 hrs postop had indefinite survival, and after 2 months
      the typical vascular lesion of chronic rejection was present. This new model of
      chronic rejection will be a valuable tool to study the molecular immunology and
      genetics of chronic rejection.

PMID- 7783602
TI  - Hemodynamic study of different angled end-to-side anastomoses.
AB  - This study assessed the postoperative microvascular hemodynamics in end-to-side
      arterial anastomoses of varied angles in order to determine whether the angle of
      the anastomosis affects arterial flow. Thirty male rats were divided into three
      groups of ten. Carotid to carotid end-to-side anastomoses were performed with
      anastomotic angles of 45, 90, and 135 degrees. Postoperative flow was assessed
      using high frequency pulsed Doppler ultrasound (HFPDU) at 30 and 120 min
      postoperatively. Measurements at 30 min demonstrated significant differences in
      flow, with the 45 degrees grafted vessels utilizing 56.5% of total carotid flow,
      and the 90 degrees and 135 degrees anastomoses appropriating 46.5% and 43.2% of
      flow, respectively (comparing 45 degrees to both 90 degrees, P < 0.05, and 135
      degrees, P < 0.002). The change from baseline in 45 degrees and 90 degrees groups
      dissipated over a 2 hr postoperative period, but flow in the grafted vessels in
      the 135 degrees group continued well below 50% at 39.9% (comparing to both 45
      degrees and 90 degrees, P < 0.001), thereby displaying a significant difference
      in the postoperative arterial flow of varied angled microanastomoses.

PMID- 7783603
TI  - New burst test method for comparing strengths of blood vessel repairs.
AB  - An in vivo system was developed which allows researchers to determine the
      intraluminal pressures necessary to burst anastomosed blood vessels. Rat femoral
      arteries underwent standard microsurgical anastomoses and sham surgeries. After 6
      min of leak-free blood flow, the vessels were ligated and cannulated with PE 50
      tubing. The catheter was tied into position with 6-0 suture, constructing a water
      tight balloon of tissue inclusive of the repair site around the tubing, then
      attached via a "Y" adapter to a pressure transducer with a digital readout and to
      a saline filled syringe in an infusion pump. The digital readout from the
      transducer accurately expressed the pressure on the anastomosis. The highest
      pressure recorded when the anastomosis ruptured was taken to be the anastomotic
      burst pressure. Mean burst pressure for 9 suture anastomoses was 326 mm mercury.
      All vessel burst pressures exceeded rat mean systolic pressure; 90% exceeded rat
      maximum systolic pressure. All sham surgeries failed to burst, even at pressures
      exceeding 1,500 mm Hg. The burst pressure test clearly provides researchers with
      a valid quantitative measure for in vivo comparison of the efficacies of various
      anastomotic techniques.

PMID- 7783604
TI  - Rat tail: a useful model for microvascular training.
AB  - The rat femoral vessel model is widely used as the basic model for microvascular
      training; however, it offers only a limited number of anastomoses and vessel
      sizes. Rat tail vessels provide long length, almost as long as the tail; adequate
      diameters, from about 1 mm to 0.2 mm; as well as the economy and a convenient
      location for practicing microvascular anastomoses. It is also the best choice for
      anastomosing vessels smaller than 0.5 mm diameter. Using stored, frozen tails
      harvested from sacrificed rats of other projects makes it even more frugal and
      convenient. Hence, it is an ideal model for microvascular training. The related
      anatomy and dissecting method are described and discussed.

PMID- 7783605
TI  - The first elective free flap in a cardiac transplant patient.
AB  - A case of free fibula transfer for mandibular reconstruction in a cardiac
      transplant patient is described. The reconstructive microsurgeon should be aware
      of the special requirements of these immunosuppressed patients and flap transfer
      should be performed in specialized centers with the interaction of different
      specialties to make the procedure safe and successful.

PMID- 7783606
TI  - Vascularized fibular graft for bone reconstruction of the extremities after tumor
      resection in limb-saving procedures.
AB  - We treated 18 patients (8 males and 10 females) with bone or soft tissue tumors
      in the extremities by vascularized fibular grafts (VFGs). The average age was 29
      years. Two had malignant soft tissue tumors in the forearm (angiosarcoma and
      synovial sarcoma) and the other 16 had bone tumors [osteosarcoma (8),
      chondrosarcoma (3), angiosarcoma (1), adamantinoma (1), and giant cell tumor
      (3)]. Affected sites of the bone tumor cases were tibia (5), femur (5), humerus
      (3), radius (2), and ulna (1). According to the surgical staging system of
      Enneking et al. 1 patient was in stage III, 12 in IIB, 2 in IB, and 3 in IA. The
      surgical margin was curative in 5 patients, wide in 9, marginal in 2, and
      intralesional in 2. One patient died due to lung metastasis although bone union
      was obtained by the VFGs. Functional results of the bone reconstruction in the
      remaining 17 patients were evaluated according to the modified scale of Enneking
      et al. The VFGs resulted in substantial bone unions in all patients except 1.
      Bone unions in all 17 patients occurred in less than 10 months. Overall clinical
      results were satisfactory. Based on a 30-point scale overall clinical results
      ranged from 10 to 30 points with an average of 21 points. Functional evaluation
      in the upper extremity were, generally, superior to those in the lower extremity.
      Postoperative complications were 5 metastases (4 in the lung and 1 in the
      mediastinum) in 4 patients, 1 recurrence, and 2 fractures after obtaining bone
      union. One patient died from metastasis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783607
TI  - Inside-out vein graft repair compared with nerve grafting for nerve regeneration
      in rats.
AB  - The inside-out vein graft is a vein conduit pulled through itself to invert the
      normal orientation and place the adventitial layer within the lumen of the
      conduit. Our study compares regeneration of peripheral nerves in the rat through
      two conduits: inside-out graft of the jugular vein and autogenous nerve graft. In
      10 rats, the right jugular vein was harvested, turned inside out, and used to
      bridge a 10 mm defect created in the right sciatic nerve. The 10 mm nerve segment
      from the right was then used as a standard nerve graft to bridge a 10 mm gap
      created in the left sciatic nerve. Rats were sacrificed at 8 and 12 weeks.
      Regeneration on the inside-out vein graft side showed superior functional results
      (faster conduction velocities) and improved histological results (greater axon
      counts) compared with the nerve grafted side. We feel the adventitial surface of
      the wall of the vein promotes nerve regeneration by providing an environment rich
      with collagen, laminin, and Schwann cells and promotes increased vascularization
      of the new nerve.

PMID- 7783608
TI  - Experimental model for local administration of nerve growth factor in
      microsurgical nerve reconnections.
AB  - An experimental model for local administration of neuronotrophic substances at
      the site of peripheral nerve lesion is presented. The model consists of a
      subcutaneously located silicone reservoir and a connecting tube with its distal
      end fixed in the proximity of the severed and repaired nerve. The results of the
      preliminary tests of the model are presented. Sixty Sprague-Dawley rats were
      divided into two groups: control (saline-treated) (n = 30) and NGF-treated (n =
      30). After axotomy of the sciatic nerve, an epineurial repair is performed. NGF
      or saline is injected daily into the subcutaneous reservoir during the first 3
      weeks after axotomy and a single dose in the fourth week. The regenerated nerve
      observed in the NGF-treated group after four weeks of treatment presents a
      greater percentage of myelinated axons, thicker myeline sheaths, and more mature
      endoneurial layers. This experimental model provides a reliable and quantitative
      way to deliver neuronotrophic substances in site and at different administration
      rates.

PMID- 7783609
TI  - The rat brachial plexus and its terminal branches: an experimental model for the
      study of peripheral nerve regeneration.
AB  - Despite the introduction of microsurgical techniques into clinical practice, the
      results of surgical procedures involving the brachial plexus and peripheral
      nerves are still far from spectacular. We therefore studied the rat brachial
      plexus and its terminal branches in 203 rats. Detailed anatomic and morphologic
      analyses of the biceps brachii and musculocutaneous nerve, finger flexors, flexor
      carpi radialis, and the median nerve were performed. Various sources of
      conventional and vascularized nerve grafts were explored. After musculocutaneous
      nerve section or median nerve section, there were no articular contractures or
      automutilations, which constitutes an advantage for these experimental models
      over the sciatic nerve model. The brachial plexus and its terminal branches
      provide a good experimental model which can be used to assess the development and
      normal control of muscle function, examine the mechanisms underlying functional
      recovery, and test the effects of treatments to enhance recovery.

PMID- 7783610
TI  - Improved reflow and viability in reperfused ischemic rat island groin flaps using
      dexamethasone.
AB  - Reperfusion injury and the no-reflow phenomenon are manifestations of a complex
      series of events that culminate in an acute inflammatory reaction within
      reperfused tissue. Antiinflammatory therapy attenuates ischemia-reperfusion
      injury. The purpose of this study is to evaluate the effects of dexamethasone on
      blood flow and viability of ischemic rat island groin flaps. Thirty-three mature
      male Sprague-Dawley rats were divided into 3 groups. The flaps were subjected to
      8 hr of ischemia in the control and treatment groups. Fluorescein studies were
      performed, and flap viability was assessed. Twenty-four hour fluorescence (after
      reperfusion) correlated very closely with the percentage of eventual flap
      viability. The blood flow and viability of the treatment group flaps were
      significantly better than those in the ischemic control group. Dexamethasone
      significantly improved ischemic flap survival in the rat 8 hr ischemic island
      groin flap model in our study.

PMID- 7783611
TI  - Intravascular heparin protects muscle flaps from ischemia/reperfusion injury.
AB  - Heparin has been found to decrease ischemia/reperfusion injury in skeletal muscle
      and other tissue/organ systems. The timing of heparin administration to the
      muscle vasculature has not been explored. We investigated the use of heparinized
      blood as a washout solution during ischemia to reduce ischemia/reperfusion
      injury. A rat cutaneous maximus muscle free flap was subjected to a 10-hr period
      of room temperature ischemia, then was heterotopically transplanted to the groin
      via microsurgical revascularization to the femoral vessels. In three experimental
      groups, flaps were subjected to brief ex vivo perfusion with autologous
      heparinized blood, at 2, 5, or 8 hr into the 10-hr ischemic interval. In the two
      other groups, the flaps were not perfused, and the animals were systemically
      heparinized either before ischemia or before transplantation, respectively. A
      control group underwent no flap perfusion or systemic heparinization. After
      transplantation, flaps were given a 48-hr period of in vivo reperfusion, then
      were harvested for evaluation. Flaps undergoing ex vivo perfusion or preischemic
      heparinization had no significant differences in weight gain (edema) compared
      with flaps receiving posttransplant heparinization or no heparinization
      (controls). The dehydrogenase staining of muscle biopsies was significantly
      faster (indicative of viable tissue) for perfused flaps and the flaps for which
      the animals received preischemic heparinization, when compared with flaps for
      which the animals received posttransplant heparinization or no heparinization.
      From these results, we conclude that heparin offers protection from
      ischemia/reperfusion injury when it can be introduced into the vascular network
      either prior to or during the ischemia period. These findings suggest the
      possibility of using heparinized washout solutions to enhance survival in
      amputated extremities.

PMID- 7783612
TI  - Experimental microvenous thrombosis following anastomosis with a knotted suture.
AB  - An experimental model for producing venous thrombosis was developed in end-to-end
      anastomoses of femoral veins in rats. The anastomoses were performed using a
      suture (9-0 suture-70 microns needle) with a knot 1 cm from the needle. The knot
      was formed by making either six or eight half-hitches in one throw of the suture.
      Vessel patency was assessed through the direct "milking test" at 20 min and 24
      hrs. The incidence of thrombosis when using one knot with six half-hitches ranged
      from 20% to 40% and with eight half-hitches, from 50% to 70%. The incidence of
      femoral vein thrombosis varied directly with the presence and size of the knot.
      In this model, thrombosis was induced by exaggerating vessel injuries that may
      occur when performing routine microvascular anastomoses. This study demonstrates
      a reproducible thrombogenic model which mimics clinical practice and may be used
      to study the effects of local and systemic antithrombogenic agents.

PMID- 7783613
TI  - Alkaliphiles: 'basic' molecular problems of pH tolerance and bioenergetics.
AB  - Alkaliphilic Bacillus species provide experimental opportunities for examination
      of physiological processes under conditions in which the stress of the extreme
      environment brings issues of general biological importance into special focus.
      The alkaliphile, like many other cells, uses Na+/H+ antiporters in pH regulation,
      but its array of these porters, and other ion-flux pathways that energize and
      support their activity, result in an extraordinary capacity for pH homeostasis;
      this process nonetheless becomes the factor that limits growth at the upper edge
      of the pH range. Above pH 9.5, aerobic alkaliphiles maintain a cytoplasmic pH
      that is two or more units below the external pH. This chemiosmotically adverse
      delta pH is bypassed by use of an electrochemical gradient of Na+ rather than of
      protons to energize solute uptake and motility. By contrast, ATP synthesis occurs
      via completely proton-coupled oxidative phosphorylation that proceeds just as
      well, or better, at pH 10 and above as it does in the same bacteria growing at
      lower pH, without the adverse pH gradient. Various mechanisms that might explain
      this conundrum are described, and the current state of the evidence supporting
      them is summarized.

PMID- 7783614
TI  - Identification of a novel cellulose-binding domain within the multidomain 120 kDa
      xylanase XynA of the hyperthermophilic bacterium Thermotoga maritima.
AB  - A segment of Thermotoga maritima strain MSB8 chromosomal DNA was isolated which
      encodes an endo-1,4-beta-D-xylanase, and the nucleotide sequence of the xylanase
      gene, designated xynA, was determined. With a half-life of about 40 min at 90
      degrees C at the optimal pH of 6.2, purified recombinant XynA is one of the most
      thermostable xylanases known. XynA is a 1059-amino-acid (approximately 120 kDa)
      modular enzyme composed of an N-terminal signal peptide and five domains, in the
      order A1-A2-B-C1-C2. By comparison with other xylanases of family 10 of glycosyl
      hydrolases, the central approximately 340-amino-acid part (domain B) of XynA
      represents the catalytic domain. The N-terminal approximately 150-amino-acid
      repeated domains (A1-A2) have no significant similarity to the C-terminal
      approximately 170-amino-acid repeated domains (C1-C2). Cellulose-binding studies
      with truncated XynA derivatives and hybrid proteins indicated that the C-terminal
      repeated domains mediate the binding of XynA to microcrystalline cellulose and
      that C2 alone can also promote cellulose binding. C1 and C2 did not share amino
      acid sequence similarity with any other known cellulose-binding domain (CBD) and
      thus are CBDs of a novel type. Structurally related protein segments which are
      probably also CBDs were found in other multidomain xylanolytic enzymes. Deletion
      of the N-terminal repeated domains or of all the non-catalytic domains resulted
      in substantially reduced thermostability while a truncated xylanase derivative
      lacking the C-terminal tandem repeat was as thermostable as the full-length
      enzyme.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783615
TI  - Induction of phospholipase- and flagellar synthesis in Serratia liquefaciens is
      controlled by expression of the flagellar master operon flhD.
AB  - When a liquid culture of Serratia spp. reaches the last part of the logarithmic
      phase of growth it induces the synthesis of several extracellular hydrolytic
      enzymes. In this communication we show that synthesis and secretion of the
      extracellular phospholipase is coupled to expression of flagella. Expression of
      flagella is demonstrated to follow a growth-phase-dependent pattern. Cloning,
      complementation studies and DNA-sequencing analysis has identified a genetic
      region in Serratia liquefaciens which exhibits extensive homology to the
      Escherichia coli flhD flagellar master operon. Interruption of the chromosomal
      flhD operon in S. liquefaciens results in non-flagellated and phospholipase
      negative cells, but the synthesis of other exoenzymes is not affected. By placing
      the flhD operon under the control of a foreign inducible promoter we have shown
      that increased transcription through the flhD operon leads to induction of
      flagellar synthesis and phospholipase expression.

PMID- 7783616
TI  - comK encodes the competence transcription factor, the key regulatory protein for
      competence development in Bacillus subtilis.
AB  - comK is a positive autoregulatory gene occupying a central position in the
      competence-signal-transduction network. All regulatory routes identified in this
      network converge at the level of comK expression. The ComK protein is required
      for the transcriptional induction of comK and the late competence genes, which
      specify morphogenetic and structural proteins necessary for construction of the
      DNA-binding and uptake apparatus. In this report we demonstrate that ComK
      specifically binds to DNA fragments containing promoter and upstream sequences of
      the genes it affects (comC, comE, comF, comG and comK). Using portions of the
      region upstream of comC we show that the ComK-binding sequences are essential for
      the expression of competence. Moreover, we demonstrate that the presence of ComK
      stimulates the expression of comF-lacZ and comG-lacZ translational fusions in
      vivo in Escherichia coli. These results indicate that the gene product of comK is
      identical to the previously inferred competence transcription factor (CTF).

PMID- 7783617
TI  - Plasmodium falciparum protein associated with the invasion junction contains a
      conserved oxidoreductase domain.
AB  - The merozoite cap protein-1 (MCP-1) of Plasmodium falciparum follows the
      distribution of the moving junction during invasion of erythrocytes. We have
      cloned the gene encoding this protein from a cDNA library using a monoclonal
      antibody. The protein lacks a signal sequence and has no predicted transmembrane
      domains; none of the antisera reacts with the surfaces of intact merozoites,
      indicating that the cap distribution is submembranous. MCP-1 is divided into
      three domains. The N-terminal domain includes a 52-amino-acid region that is
      highly conserved in a large family of bacterial and eukaryotic proteins. Based on
      the known functions of two proteins of this family and the pattern of amino acid
      conservation, it is predicted that this domain may possess oxido-reductase
      activity, since the active cysteine residue of this domain is invariant in all
      proteins of the family. The other two domains of MCP-1 are not found in any other
      members of this protein family and may reflect the specific function of MCP-1 in
      invasion. The middle domain is negatively charged and enriched in glutamate; the
      C-terminal domain is positively charged and enriched in lysine. By virtue of its
      positive charge, the C-terminal domain resembles domains in some cytoskeleton
      associated proteins and may mediate the interaction of MCP-1 with cytoskeleton in
      Plasmodium.

PMID- 7783618
TI  - Regulation of succinate dehydrogenase (sdhCDAB) operon expression in Escherichia
      coli in response to carbon supply and anaerobiosis: role of ArcA and Fnr.
AB  - Succinate dehydrogenase (SDH) of Escherichia coli, the sole membrane-bound enzyme
      of the tricarboxylic acid cycle, participates in the aerobic electron-transport
      pathway to generate energy via oxidative phosphorylation reactions. Previous
      studies have established that succinate dehydrogenase (SDH) synthesis is elevated
      by aerobiosis and suppressed during growth with glucose. To examine how the
      sdhCDAB genes that encode SDH are regulated by changes in the environment, sdh
      lacZ fusions were constructed and analysed in vivo following cell growth under a
      variety of alternative culture conditions. Expression of sdh-lacZ was highest
      under aerobic conditions and was decreased 10-fold in the absence of oxygen. The
      fnr and arcA gene products are required for this oxygen control and each acts to
      repress sdhC-lacZ expression. Expression of sdh-lacZ also varied 10- to 14-fold
      depending on the type of carbon substrate used or the medium richness. This
      control was shown to be independent of the crp and fruR gene products, and
      indicates that some other regulatory element exists in the cell to adjust SDH
      enzyme levels accordingly. Iron and haem availability affected sdhC-lacZ
      expression by two- to three-fold. Lastly, sdhC-lacZ expression was shown to vary
      with the cell growth rate during aerobic and anaerobic conditions.

PMID- 7783619
TI  - Genetic suppression and phenotypic masking of a Myxococcus xanthus frzF- defect.
AB  - An insertion of transposon Tn5-lac, omega 4519, generates a lacZ fusion with a
      Myxococcus xanthus promoter expressed during both vegetative growth and
      development. Sequence analysis of the junction of omega 4519 with M. xanthus DNA
      shows that the insertion is in frzF, a homologue of cheR from Salmonella
      typhimurium. When frzF- (or frzCD-) cells are starved for nutrients at modest
      densities, they aggregate to form a radial pattern and produce fewer than 1% of
      the wild-type complement of spores. At higher densities, frzF::omega 4519 cells
      form 'frizzy' aggregates and produce 80-90% of the wild-type complement of
      spores. In contrast, when cells with both a frzF- (or frzCD-) and an sglA1
      mutation are allowed to develop at either low or high cell densities, they
      produce frizzy aggregates containing a near wild-type complement of heat
      resistant spores. In addition to suppressing the density dependence of fruiting
      body morphogenesis, the sglA1 mutation also suppresses the sporulation defect
      caused by two different frzF- mutations and a frzCD- mutation. In contrast, a
      mutation in a different S motility gene, sglG1, does not suppress the frz-
      mutations. Thus, the suppression of frz- mutations by sgl- mutations is allele
      specific, and depends on the sgl allele, but not the frz allele. Because the
      phenotypes of frz- mutations have been determined in a (suppressing) sglA1
      genetic background, the frz genes may play more central roles in development than
      initially recognized.

PMID- 7783620
TI  - Comparative characterization of the iga gene encoding IgA1 protease in Neisseria
      meningitidis, Neisseria gonorrhoeae and Haemophilus influenzae.
AB  - Cloning and sequencing of the IgA1 protease gene (iga) from Neisseria
      meningitidis strain HF13 showed an overall structure equivalent to iga genes from
      Neisseria gonorrhoeae and Haemophilus influenzae, although no region
      corresponding to the gonococcal alpha-peptide was evident. An additional 18 N.
      meningitidis and 3 H. influenzae iga genes were amplified by the polymerase chain
      reaction technique and sequenced corresponding approximately to the N-terminal
      half of the mature enzyme. Comparative analyses of a total of 29 iga genes showed
      that pathogenic Neisseria have iga genes with a significantly lower degree of
      heterogeneity than H. influenzae iga genes. Recombinational events indicated by
      mosaic-like structures corresponding to those found among N. gonorrhoeae protease
      genes were detected among N. meningitidis iga genes. One region showed
      characteristic differences in sequence and length which correlated with each of
      the different cleavage specificities. Meningococci were extremely conserved in
      this region with no evidence of recombination between isolates of different
      cleavage specificities. Sequences further downstream showed no obvious
      relationship with enzyme cleavage type. This region consisted of conserved areas
      interspersed with highly variable areas. Amino acid sequence homologies in the
      variable regions of meningococci reflected the antigenic types defined by using
      polyclonal neutralizing antibodies.

PMID- 7783621
TI  - Overexpression of the Shigella flexneri genes coding for DNA topoisomerase IV
      compensates for loss of DNA topoisomerase I: effect on virulence gene expression.
AB  - Introducing the Escherichia coli topA20::Tn10 allele to Shigella flexneri results
      in osmotic sensitivity, a reduced growth rate, an increase in reporter plasmid
      supercoiling (all common to the E. coli mutants), an inability to grow on
      MacConkey agar and a loss of virulence gene expression. E. coli mutants
      harbouring this topA allele often compensate for the loss of DNA topoisomerase I
      by amplifying the genes coding for topoisomerase IV. Unlike the E. coli topA
      mutants, derivatives of S. flexneri harbouring this topA allele did not appear to
      acquire any compensatory mutations. We investigated the possibility that this was
      due in part to an inability of the S. flexneri topoisomerase IV genes to
      compensate for loss of DNA topoisomerase I when overexpressed. The S. flexneri
      genes encoding the alpha- and beta subunits of topoisomerase IV were detected and
      cloned in separate multicopy plasmids. These plasmids complemented well
      characterized Salmonella typhimurium temperature-sensitive topoisomerase IV
      mutations, showing that the S. flexneri and S. typhimurium proteins are capable
      of combining to form active complexes. When the S. flexneri topoisomerase IV
      genes were cloned in the same multicopy plasmid and introduced into a S. flexneri
      topA mutant, the plasmid restored osmotic tolerance, improved the growth rate,
      allowed growth on MacConkey indicator plates and resulted in a relaxation of
      reporter plasmid supercoiling. The same plasmid also partially restored S.
      flexneri virulence gene transcription. These data show that overexpression of the
      S. flexneri topoisomerase IV genes can compensate for the loss of topoisomerase I
      in terms of general viability of the cell, DNA supercoiling, and (partially)
      virulence gene expression. The fact that S. flexneri does not exploit
      topoisomerase IV gene amplification as E. coli does points to a significant
      difference in the abilities of these species to adapt to the loss of
      topoisomerase I.

PMID- 7783622
TI  - Purification, characterization and mode of action of PdhR, the transcriptional
      repressor of the pdhR-aceEF-lpd operon of Escherichia coli.
AB  - The repressor of the pdhR-aceEF-lpd operon of Escherichia coli, PdhR, was
      amplified to 23% of total cell protein and purified to homogeneity by heparin
      agarose and cation-exchange chromatography. The purified protein is a monomer
      (M(r) 29,300) which binds specifically to DNA fragments containing the pdh
      promoter (Ppdh) in the absence of pyruvate. The pdh operator was identified by
      DNase I footprinting as a region of hyphenated dyad symmetry,
      +11AATTGGTaagACCAATT+27, situated just downstream of the transcript start site.
      In vitro transcription from Ppdh was repressed > 1000-fold by PdhR and this
      repression was antagonized in a concentration-dependent manner by its co
      effector, pyruvate. Studies on RNA polymerase binding at Ppdh showed that RNA
      polymerase protects the -44 to +21 region in the absence of PdhR, but no RNA
      polymerase binding or protection upstream of +9 could be detected in the presence
      of PdhR. It is concluded that PdhR represses transcription by binding to an
      operator site centred at +19 such that effective binding of RNA polymerase is
      prevented.

PMID- 7783623
TI  - The Neisseria meningitidis haemoglobin receptor: its role in iron utilization and
      virulence.
AB  - The Neisseria meningitidis haemoglobin receptor gene, hmbR, was cloned by
      complementation in a porphyrin-requiring Escherichia coli mutant. hmbR encodes an
      89.5 kDa outer membrane protein which shares amino acid homology with the TonB
      dependent receptors of Gram-negative bacteria. HmbR had the highest similarity to
      Neisseria transferrin and lactoferrin receptors. The utilization of haemoglobin
      as an iron source required internalization of the haemin moiety by the cell. The
      mechanism of haemin internalization via the haemoglobin receptor was TonB
      dependent in E. coli. A N. meningitidis hmbR mutant was unable to use haemoglobin
      but could still use haemin as a sole iron source. The existence of a second N.
      meningitidis receptor gene, specific for haemin, was shown by the isolation of
      cosmids which did not hybridize with the hmbR probe, but which were able to
      complement an E. coli hemA aroB mutant on haemin-supplemented plates. The N.
      meningitidis hmbR mutant was attenuated in an infant rat model for meningococcal
      infection, indicating that haemoglobin utilization is important for N.
      meningitidis virulence.

PMID- 7783624
TI  - ComC is required for the processing and translocation of comGC, a pilin-like
      competence protein of Bacillus subtilis.
AB  - ComGC is a cell surface-localized protein required for DNA binding during
      transformation in Bacillus subtilis. It resembles type IV prepilins in its N
      terminal domain, particularly in the amino acid sequence surrounding the
      processing cleavage sites of these proteins. ComC is another protein required for
      DNA binding, which resembles the processing proteases that cleave type IV
      prepilins. We show here that ComGC is processed in competent cells and that this
      processing requires ComC. We also demonstrate that the PilD protein of Neisseria
      gonorrhoeae, a ComC homologue, can process ComGC in Escherichia coli, and that
      the ComC protein itself is the only B. subtilis protein needed to accomplish
      cleavage of ComGC in the latter organism. Based on NaOH-solubility studies, we
      have shown that in the absence of ComC, but in the presence of all other
      competence proteins, B. subtilis is incapable of correctly translocating ComGC to
      the outer face of the cell membrane. Finally, we show that ComGC can be cross
      linked to yield a form with higher molecular mass, possibly a dimer, and present
      evidence suggesting that formation of the higher mass complex takes place in the
      membrane, prior to translocation. Formation of this complex does not require ComC
      or any of the comG products, other than ComGC itself.

PMID- 7783626
TI  - Identification of cellular proteins involved in nikkomycin production in
      Streptomyces tendae Tu901.
AB  - Expression of genes involved in nikkomycin production in Streptomyces tendae was
      investigated by two-dimensional gel electrophoresis of cellular proteins. Ten
      gene products (P1-P10) were identified that were synthesized when nikkomycin was
      produced; these proteins were not detected in non-producing mutants. N-terminal
      sequences of six of the 10 proteins were obtained by microsequencing of protein
      spots excised from preparative two-dimensional gels. Protein P8 was identified as
      L-histidine amino-transferase (HisAT), which has been previously correlated with
      nikkomycin production. By using oligonucleotide probes deduced from the N
      terminal sequences of protein P2 and P6, we isolated an 8 kb BamHI fragment and a
      6.5 kb PvuII fragment, respectively, from the genome of Streptomyces tendae
      Tu901. Restriction analyses revealed that both fragments overlapped within a
      region of 1.5 kb. Mapping of the oligonucleotide probe hybridizing sites
      indicated that the genes encoding protein P2 and P6 are closely spaced on the 8
      kb BamHI fragment, and the latter is located on the overlapping region. DNA
      sequence analysis revealed that proteins P1 and P2 are encoded by a single gene,
      orfP1, that is translated at two initiation codons. The orfP1 gene was
      interrupted by homologous recombination using the integrating vector pWHM3. The
      gene-disrupted transformants did not produce nikkomycin, indicating that proteins
      P1 and P2 are essential for nikkomycin production. The data presented show that
      reverse genetics was successfully used to isolate genes involved in nikkomycin
      production.

PMID- 7783625
TI  - AmpD, essential for both beta-lactamase regulation and cell wall recycling, is a
      novel cytosolic N-acetylmuramyl-L-alanine amidase.
AB  - In enterobacteria, the ampD gene encodes a cytosolic protein which acts as a
      negative regulator of beta-lactamase expression. It is shown here that the AmpD
      protein is a novel N-acetylmuramyl-L-alanine amidase (E.C.3.5.1.28) participating
      in the intracellular recycling of peptidoglycan fragments. Surprisingly, AmpD
      exhibits an exclusive specificity for substrates containing anhydro muramic acid.
      This anhydro bond is mainly found in the peptidoglycan degradation products
      formed by the periplasmic lytic transglycosylases and thus might behave as a
      'recycling tag' allowing the enzyme to distinguish these fragments from the newly
      synthesized peptidoglycan precursors. The AmpD substrate (or substrates) which
      accumulates in the absence of the corresponding enzymatic activity acts as an
      intracellular positive effector for beta-lactamase expression and might represent
      an element of a communication network between the chromosome and the cell wall
      peptidoglycan.

PMID- 7783627
TI  - Identification of phosphoproteins in Escherichia coli.
AB  - The substrates of ion- and lipid-stimulated protein kinase activity in extracts
      of Escherichia coli were purified by chromatography. Subsequent N-terminal
      sequencing suggests that these substrates include the following: a novel 80 kDa
      protein co-purifying with RNA polymerase but partially homologous to elongation
      factor G; a protein with an apparent molecular weight of 65 kDa identified as the
      ribosomal protein S1; and a 32 kDa protein identified as succinyl CoA synthetase,
      a key enzyme in the tricarboxylic acid cycle. The phosphorylation of these three
      proteins was markedly stimulated by the addition of manganese, and occurred on
      threonine, serine or tyrosine residues as indicated by the stability of the
      phosphoresidues during acid treatment. In addition, a calcium-stimulated protein
      of 70 kDa was identified as the heat-shock protein DnaK, and a 17 kDa lipid
      stimulated phosphoprotein as nucleotide diphosphate kinase.

PMID- 7783628
TI  - Group B streptococci adhere to a variant of fibronectin attached to a solid
      phase.
AB  - Group B streptococci (GBS) are the leading cause of neonatal pneumonia and
      meningitis. Adherence of GBS to host tissues may play an important role in the
      pathogenesis of infection. The host molecules which mediate GBS adherence to host
      tissues are unknown. Many bacterial pathogens adhere to fibronectin, an important
      component of the extracellular matrix (ECM). Some pathogens adhere to both
      immobilized and soluble fibronectin, while others adhere to immobilized
      fibronectin, but not to soluble fibronectin. Previous data indicated that GBS do
      not adhere to soluble fibronectin. We studied the ability of GBS to adhere to
      immobilized fibronectin. Forty-five per cent of the input inoculum of COH1, a
      virulent GBS isolate, adhered to fibronectin immobilized on polystyrene. COH1 did
      not adhere to the other ECM proteins tested (laminin, type I collagen,
      vitronectin, and tenascin). Nine out of nine GBS strains from human sources
      tested adhered specifically to fibronectin at levels varying from 4-60%. We
      considered the possibility that GBS were adherent to a contaminant in the
      fibronectin preparation. Properties of fibronectin, including the presence of an
      immunologic epitope of fibronectin and binding to collagen, were verified to be
      properties of the molecule to which GBS adhere. COH1 adhered to fibronectin
      captured by a monoclonal antibody to fibronectin (FN-15), confirming that the
      molecule to which GBS adhere bears immunologic determinants of fibronectin.
      Adherence of COH1 to fibronectin was inhibited by collagen, confirming that the
      molecule to which GBS adhere binds to collagen. These data strongly suggest that
      GBS adhere to fibronectin, and not to a contaminant.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7783629
TI  - Homologies between salmolysin and some bacterial regulatory proteins.

PMID- 7783630
TI  - Na(+)-driven flagellar motors as a likely Na+ re-entry pathway in alkaliphilic
      bacteria.

PMID- 7783631
TI  - Mobile gene cassettes and integrons: capture and spread of genes by site-specific
      recombination.
AB  - An integron is a genetic unit that includes the determinants of the components of
      a site-specific recombination system capable of capturing and mobilizing genes
      that are contained in mobile elements called gene cassettes. An integron also
      provides a promoter for expression of the cassette genes, and integrons thus act
      both as natural cloning systems and as expression vectors. The essential
      components of an integron are an int gene encoding a site-specific recombinase
      belonging to the integrase family, an adjacent site, attI, that is recognized by
      the integrase and is the receptor site for the cassettes, and a promoter suitably
      oriented for expression of the cassette-encoded genes. The cassettes are mobile
      elements that include a gene (most commonly an antibiotic-resistance gene) and an
      integrase-specific recombination site that is a member of a family of sites known
      as 59-base elements. Cassettes can exist either free in a circularized form or
      integrated at the attI site, and only when integrated is a cassette formally part
      of an integron. A single site-specific recombination event involving the integron
      associated attI site and a cassette-associated 59-base element leads to insertion
      of a free circular cassette into a recipient integron. Multiple cassette
      insertions can occur, and integrons containing several cassettes have been found
      in the wild. The integrase also catalyses excisive recombination events that can
      lead to loss of cassettes from an itegron and generate free circular cassettes.
      Due to their ability to acquire new genes, integrons have a clear role in the
      evolution of the genomes of the plasmids and transposons that contain them.

PMID- 7783632
TI  - The twisted 'life' of DNA in the cell: bacterial topoisomerases.
AB  - DNA topoisomerases are essential to the cell for the regulation of DNA
      supercoiling levels and for chromosome decatenation. The proposed mechanisms for
      these reactions are essentially the same, except that a change in supercoiling is
      due to an intramolecular event, while decatenation requires an intermolecular
      event. The characterized bacterial topoisomerases appear capable of both types of
      reaction in vitro. Four DNA topoisomerases have been identified in Escherichia
      coli. Topoisomerase I, gyrase, and topoisomerase IV normally appear to have
      distinct essential functions within the cell. Gyrase and topoisomerase I are
      responsible for the regulation of DNA supercoiling. Both gyrase and topoisomerase
      IV are necessary for chromosomal decatenation. Multiple topoisomerases with
      distinct functions may give the cell more precise control over DNA topology by
      allowing tighter regulation of the principal enzymatic activities of these
      different proteins.

PMID- 7783633
TI  - Chlamydial envelope components and pathogen-host cell interactions.
AB  - Few bacterial pathogens are as widespread in nature or as capable of eliciting
      such a diversity of disease syndromes as are the chlamydiae. As obligate
      intracellular organisms, they pose a special research challenge in defining the
      molecular components and mechanisms for productive growth within host cells and
      the overall progress of infection throughout host tissue. Although a
      comprehensive view of chlamydial envelope composition and respective functions in
      pathogenesis is far from complete, ongoing investigations continue to expose new
      and intriguing avenues for exploration.

PMID- 7783634
TI  - Cloning and characterization of a Chlamydia psittaci gene coding for a protein
      localized in the inclusion membrane of infected cells.
AB  - Chlamydiae are obligate intracellular bacteria which occupy a non-acidified
      vacuole (the inclusion) throughout their developmental cycle. Little is known
      about events leading to the establishment and maintenance of the chlamydial
      inclusion membrane. To identify chlamydial proteins which are unique to the
      intracellular phase of the life cycle, an expression library of Chlamydia
      psittaci DNA was screened with convalescent antisera from infected animals and
      hyperimmune antisera generated against formalin-killed purified chlamydiae.
      Overlapping genomic clones were identified which expressed a 39 kDa protein only
      recognized by the convalescent sera. Sequence analysis of the clones identified
      two open reading frames (ORFs), one of which (ORF1) coded for a predicted 39 kDa
      gene product. The ORF1 sequence was amplified and fused to the malE gene of
      Escherichia coli and antisera were raised against the resulting fusion protein.
      Immunoblotting with these antisera demonstrated that the 39 kDa protein was
      present in lysates of infected cells and in reticulate bodies (RBs), but was at
      the limit of detection in lysates of purified C. psittaci elementary bodies.
      Fluorescence microscopy experiments demonstrated that this protein was localized
      in the inclusion membrane of infected HeLa cells, but was not detected on the
      developmental forms within the inclusion. Because the protein produced by ORF1 is
      deposited on the inclusion membrane of infected cells, this gene has been
      designated incA, (inclusion membrane protein A) and its gene product, IncA. In
      addition to the inclusion membrane, these antisera labelled structures that
      extended from the inclusion over the nucleus or into the cytoplasm of infected
      cells. Immunoblotting also demonstrated that IncA, in lysates of infected cells,
      had a migration pattern that seemed indicative of post-translational
      modification. This pattern was not observed in immunoblots of RBs or in the E.
      coli expressing IncA. Collectively, these data identify a chlamydial gene which
      codes for a protein that is released from RB and is localized in the inclusion
      membrane of infected cells.

PMID- 7783635
TI  - Structural identification of the lipo-chitin oligosaccharide nodulation signals
      of Rhizobium loti.
AB  - Rhizobium loti is a fast-growing Rhizobium species that has been described as a
      microsymbiont of plants of the genus Lotus. Nodulation studies show that Lotus
      plants are nodulated by R. loti, but not by most other Rhizobium strains,
      indicating that R. loti produces specific lipo-chitin oligosaccharides (LCOs)
      which are necessary for the nodulation of Lotus plants. The LCOs produced by five
      different Rhizobium loti strains have been purified and were shown to be N
      acetylglucosamine pentasaccharides of which the non-reducing residue is N
      methylated and N-acylated with cis-vaccenic acid (C18:1) or stearic acid (C18:O)
      and carries a carbamoyl group. In one R. loti strain, NZP2037, an additional
      carbamoyl group is present on the non-reducing terminal residue. The major class
      of LCO molecules is substituted on the reducing terminal residue with 4-O
      acetylfucose. Addition of LCOs to the roots of Lotus plants results in abundant
      distortion, swelling and branching of the root hairs, whereas spot inoculation
      leads to the formation of nodule primordia.

PMID- 7783636
TI  - The enterotoxin gene (cpe) of Clostridium perfringens can be chromosomal or
      plasmid-borne.
AB  - The location of the cpe gene, encoding the enterotoxin responsible for food
      poisoning in humans, has been studied in a series of enterotoxigenic Clostridium
      perfringens strains by means of pulsed field gel electrophoresis of genomic DNA.
      The cpe gene was found at the same chromosomal locus in strains associated with
      food poisoning in humans and was shown to be linked to a repetitive sequence, the
      HindIII repeat, and an open reading frame, ORF3, that may be part of an insertion
      sequence. In contrast, when the strains originated from domesticated livestock
      cpe was located on a large episome where it was often close to a copy of the
      transposable element IS1151. In these cases, the HindIII repeat was not linked to
      the cpe gene although this was generally preceded by ORF3.

PMID- 7783637
TI  - The bacteriophage T4 middle promoter PuvsX: analysis of regions important for
      binding of the T4 transcriptional activator MotA and for activation of
      transcription.
AB  - Bacteriophage T4 middle promoters, which are transcribed using phage-modified
      host RNA polymerase and the T4 transcriptional activator, MotA, match the host
      sigma 70 consensus sequence at -10, but they have a different consensus
      ((t/a)(t/a)TGCTT(t/c)A) (a MotA box) at -30. While the T4 middle promoter PuvsX
      has these -10 and -30 motifs, it also has matches to the MotA box at -35, -51, 
      70, and -87. We show that MotA binds to PuvsX DNA, footprinting a region that
      includes the MotA boxes at -30, -35, and -51. Very high levels of MotA are
      required for footprinting and gel-shift experiments, and protein-DNA complexes
      formed in the presence of both phage-modified polymerase and MotA are more
      resistant to HindIII cleavage than those formed with either protein alone. These
      results suggest that MotA-DNA interactions may be stabilized by phage-modified
      polymerase. Sequences between -18 and -38 are absolutely required for MotA
      activation of transcription, but sequences upstream of -38 are stimulatory,
      particularly when chloride instead of glutamate is the major anion. Our results
      dissect PuvsX into a core promoter, downstream of -38, which is required for MotA
      activation, and an upstream region that enhances transcription especially under
      conditions less favourable for protein-DNA interactions.

PMID- 7783639
TI  - Phosphorylation and functional analysis of PilA, a protein involved in the
      transcriptional regulation of the pilin gene in Neisseria gonorrhoeae.
AB  - The transcriptional regulation of the pilE gene, coding for the pilin in
      Neisseria gonorrhoeae, by PilA/PilB proteins is quite complex. Sequence analysis
      of PilA suggested that it has multiple domains. PilA appears to have in its N
      terminal half a DNA-binding site followed by a region showing sequence similarity
      with other bacterial transcriptional regulators. In its C-terminal half, PilA has
      extensive homology with the 54 kDa protein of the eukaryotic signal-recognition
      particle which is involved in protein secretion. A transcriptional fusion between
      the promoter of pilE and the lacZ gene was constructed and integrated into the
      gonococcal chromosome. We show that transcription of the pilE-lacZ fusion is
      affected in pilA mutants in the absence of any possible interference with pilin
      secretion. Moreover, pilE transcription depends on a -24/-12-type promoter which
      could be a member of a family of promoters recognized by the alternative sigma
      subunit, RpoN, of the RNA polymerase. We also show that PilA binds specifically
      to the promoter region of pilE and that it is phosphorylated in a manner
      dependent on acidic residues Glu-59, Asp-149 and Asp-186. The functional
      organization of PilA suggests that it may be an unusual transcriptional regulator
      different from other RpoN-dependent activators.

PMID- 7783638
TI  - Protective antigen-binding domain of anthrax lethal factor mediates translocation
      of a heterologous protein fused to its amino- or carboxy-terminus.
AB  - The edema factor (EF) and lethal factor (LF) components of anthrax toxin require
      anthrax protective antigen (PA) for binding and entry into mammalian cells. After
      internalization by receptor-mediated endocytosis, PA facilitates the
      translocation of EF and LF across the membrane of an acidic intracellular
      compartment. To characterize the translocation process, we generated chimeric
      proteins composed of the PA recognition domain of LF (LFN; residues 1-255) fused
      to either the amino-terminus or the carboxy-terminus of the catalytic chain of
      diphtheria toxin (DTA). The purified fusion proteins retained ADP
      ribosyltransferase activity and reacted with antisera against LF and diphtheria
      toxin. Both fusion proteins strongly inhibited protein synthesis in CHO-K1 cells
      in the presence of PA, but not in its absence, and they showed similar levels of
      activity. This activity could be inhibited by adding LF or the LFN fragment
      (which blocked the interaction of the fusion proteins with PA), by adding
      inhibitors of endosome acidification known to block entry of EF and LF into
      cells, or by introducing mutations that attenuated the ADP-ribosylation activity
      of the DTA moiety. The results demonstrate that LFN fused to either the amino
      terminus or the carboxy-terminus of a heterologous protein retains its ability to
      complement PA in mediating translocation of the protein to the cytoplasm. Besides
      its importance in understanding translocation, this finding provides the basis
      for constructing a translocation vector that mediates entry of a variety of
      heterologous proteins, which may require a free amino- or carboxy-terminus for
      biological activity, into the cytoplasm of mammalian cells.

PMID- 7783640
TI  - Localization of the start sites of lagging-strand replication of rolling-circle
      plasmids from gram-positive bacteria.
AB  - A number of small, multicopy plasmids from Gram-positive bacteria replicate by an
      asymmetric rolling-circle mechanism. Previous studies with several of these
      plasmids have identified a palindromic sequence, SSOA, that acts as the single
      strand origin (SSO) for the replication of the lagging-strand DNA. Although not
      all the SSOA sequences share DNA sequence homology, they are structurally very
      similar. We have used an in vitro system to study the lagging-strand replication
      of several plasmids from Gram-positive bacteria using the SSOA sequences of
      pT181, pE194 and pSN2 as representative of three different groups of
      Staphylococcus aureus plasmids. In addition, we have investigated the lagging
      strand replication of the pUB110 plasmid that contains an alternative single
      strand origin, SSOU. Our results confirm that RNA polymerase is involved in
      lagging-strand synthesis from both SSOA and SSOU-type lagging-strand origins.
      Interestingly, while initiation of lagging-strand DNA synthesis of pUB110
      occurred predominantly at a single position within SSOU, replication of pT181,
      pSN2 and pE194 plasmids initiated at multiple positions from SSOA.

PMID- 7783641
TI  - A gene required for nutritional repression of the Bacillus subtilis dipeptide
      permease operon.
AB  - An insertion mutation was isolated that resulted in derepressed expression of the
      Bacillus subtillis dipeptide transport operon (dpp) during the exponential growth
      phase in rich medium. DNA flanking the site of insertion was found to encode an
      operon (codVWXY) of four potential open reading frames (ORFs). The deduced
      product of the codV ORF is similar to members of the lambda Int family; CodW and
      CodX are homologous to HsIV and HsIU, two putative heat-shock proteins from
      Escherichia coli, and to LapC and LapA, two gene products of unknown function
      from Pasteurella haemolytica. CodX also shares homology with a family of ATPases,
      including ClpX, a regulatory subunit of the E. coli ClpP protease. CodY does not
      have any homologues in the data-bases. The insertion mutation and all previously
      isolated spontaneous cod mutations were found to map in codY. In-frame deletion
      mutations in each of the other cod genes revealed that only codY is required for
      repression of dpp in nutrient-rich medium. The codY mutations partially relieved
      amino acid repression of the histidine utilization (hut) operon but had no effect
      on regulation of certain other early stationary phase-induced genes, such as
      spoVG and gsiA.

PMID- 7783642
TI  - The Pseudomonas aeruginosa pilK gene encodes a chemotactic methyltransferase
      (CheR) homologue that is translationally regulated.
AB  - A new locus, designated pilK, located immediately adjacent to the previously
      described Pseudomonas aeruginosa pilG-J gene cluster, has been identified.
      Sequence analysis of a 1.3 kb region revealed the presence of a single open
      reading frame of 291 amino acid residues (M(r) 33,338) that contained significant
      homology to the chemotactic methyltransferase proteins of Escherichia coli,
      Bacillus subtilis and the gliding bacterium Myxococcus xanthus. The 60 bp pilJ
      pilK intergenic region was devoid of promoter consensus sequences, suggesting
      that pilJ and pilK are contained within the same transcriptional unit. The
      intergenic region did contain, however, a large, highly GC-rich, inverted repeat
      that prevented PilK production in expression studies. To investigate the
      regulatory role of these sequences, pilK-lacZ gene fusions, as well as
      derivatives containing sequence alterations in the potential stem-loop region,
      were constructed and analysed in E. coli and P. aeruginosa. Modification of the
      inverted repeat region in pilK-lacZ protein fusion constructs resulted in as much
      as a 24-fold increase in beta-galactosidase activity, whereas similar
      modifications in pilK-lacZ transcriptional fusions had only a marginal effect on
      beta-galactosidase levels. These results indicated that PilK production may be
      largely regulated at the level of translation. In stark contrast to pilG-J
      mutants, which are dramatically impaired in pilus production and/or function, a
      PAO1 pilK deletion mutant was indistinguishable from the wild type. In addition,
      complementation studies suggested that the PilK and E. coli CheR proteins are not
      functionally interchangeable.

PMID- 7783643
TI  - Analysis of Vibrio cholerae ToxR function by construction of novel fusion
      proteins.
AB  - The ToxR protein is a transmembrane protein that regulates the expression of
      several virulence factors of Vibrio cholerae. Previous analysis of fusion
      proteins between ToxR and alkaline phosphatase (ToxR-PhoA) suggested that ToxR
      was active as a dimer. In order to determine whether dimerization of the ToxR
      periplasmic domain was essential for activity, this domain was replaced by
      monomeric and dimeric protein domains. Surprisingly, PhoA (dimeric), beta
      lactamase (monomeric, ToxR-Bla), or the leucine zipper of GCN4 (dimeric, ToxR
      GCN4-M) could substitute functionally for the ToxR periplasmic domain. ToxR-GCN4
      fusion proteins, in which the ToxR transmembrane domain was eliminated (ToxR-GCN4
      C), were inactive, but an additional fusion protein that contained a heterologous
      membrane-spanning domain retained activity. Strains containing each of these ToxR
      fusion proteins were analysed for in vivo colonization properties and response to
      in vitro growth conditions that are known to affect expression of the ToxR
      regulon. Strains containing ToxR-GCN4-M and ToxR-Bla responded like wild-type
      strains to in vitro growth conditions. In the infant-mouse colonization model,
      strains containing ToxR fusion proteins were all deficient in colonization
      relative to strains containing wild-type ToxR, and strains containing monomeric
      ToxR-Bla were most severely outcompeted. These results suggest that, under in
      vitro conditions, ToxR does not require a dimerized periplasmic domain, but that,
      under in vivo conditions, the correct conformation of the ToxR periplasmic domain
      may be more important for function.

PMID- 7783645
TI  - A 40 kb chromosomal fragment encoding Salmonella typhimurium invasion genes is
      absent from the corresponding region of the Escherichia coli K-12 chromosome.
AB  - Many Salmonella typhimurium genes are required for bacterial entry into host
      cells. P22 transduction analysis has localized several invasion loci near minute
      59 on the S. typhimurium chromosome. To further characterize the 59-60 min
      chromosomal region, we determined the physical and genetic map of 85 kb of S.
      typhimurium DNA between srl and cysC. It was previously shown that some of the
      invasion genes from this region are not present in Escherichia coli K-12. We
      examined whether other S. typhimurium genes on the 85 kb of DNA were similarly
      absent from E. coli. We found that a contiguous 40 kb fragment of the S.
      typhimurium chromosome which encodes invasion genes is absent from the
      corresponding region of the E. coli K-12 chromosome and may represent a
      'pathogenicity island'. We speculate that acquisition of the 40 kb region must
      have significantly advanced the evolution of Salmonella as a pathogen.

PMID- 7783644
TI  - NolR controls expression of the Rhizobium meliloti nodulation genes involved in
      the core Nod factor synthesis.
AB  - The synthesis of Rhizobium meliloti Nod signal molecules, encoded by the nod gene
      products, is finely regulated. A negative control of plasmid-borne nod gene
      expression is provided by the NolR repressor encoded by the chromosomal nolR
      gene. NolR was previously shown to downregulate the expression of the activator
      nodD1 gene and the common nodABC operon by binding to an overlapping region of
      the two promoters adjacent to the n1 nod-box (Kondorosi et al., 1989). We
      demonstrate here that NolR also controls the expression of two additional genes,
      nodD2 and nodM, but does not directly regulate the expression of the host
      specific nod genes located downstream of the n2, n3 and n5 nod-boxes. Thus, the
      nod genes are differentially regulated by NolR and only those providing common
      nodulation functions, by determining the synthesis of the core Nod factor
      structure, are subjected to this negative regulation. Furthermore, NolR has a
      strong negative effect on the production of Nod metabolites, the level of which
      may serve as a fine-tuning mechanism for optimal nodulation, specific to host
      plant genotypes. In addition, it elicits preferential synthesis of Nod factors
      carrying unsaturated C16 fatty acids. Expression of nolR was high both in the
      free-living bacterium and in the bacteroid and it was downregulated by its own
      product and by the nod gene inducer luteolin.

PMID- 7783646
TI  - Requirement for FlhA in flagella assembly and swarm-cell differentiation by
      Proteus mirabilis.
AB  - Swarming by Proteus mirabilis is characterized by cycles of rapid population
      migration across surfaces, following differentiation of typical rods into long,
      aseptate swarm cells that overexpress flagella and virulence factors,
      particularly haemolysin. A non-swarming Tn5phoA mutant was unable to synthesize
      flagella, to fully elongate or to induce high levels of the toxin. The mutation
      lay within a 2091 bp gene encoding a homologue of the Escherichia coli FlhA
      belonging to a family of proteins that are required for assembly of flagella or
      virulence proteins and that are suggested to act either directly in membrane
      translocation and/or in regulating synthesis of the export apparatus. In trans
      expression of multicopy flhA restored cell elongation and migration and generated
      differentiation-specific hyperexpression of flagellin and toxin genes to levels
      above those seen in the wild-type strain. Transcription of flhA was strongly
      induced during differentiation, from its own putative sigma 28 promoter. The
      results suggest a mechanistic coupling of flagella assembly and swarm-cell
      differentiation.

PMID- 7783648
TI  - Hypotheses and the regulation of the bacterial cell cycle.

PMID- 7783647
TI  - Topological analyses of the L-fucose-H+ symport protein, FucP, from Escherichia
      coli.
AB  - The transport of L-fucose into Escherichia coli is mediated by the L-fucose-H+
      symport protein (FucP). The fucP gene has been sequenced and encodes a
      hydrophobic protein that contains 438 amino acid residues, with a predicted M(r)
      of 47,773. The hydropathic profile of FucP indicates 10 to 12 hydrophobic regions
      that could span the membrane as alpha-helices. A 12-helix model with the N- and C
      termini located in the cytoplasm was derived from the hydropathic profile and
      from application of the 'positive inside' rule. This model was tested using beta
      lactamase fusion technology. Analyses of 62 different FucP-beta-lactamase fusions
      suggested that the FucP protein crosses the cytoplasmic membrane of E. coli 12
      times, with the N- and C-termini in the cytoplasm. From measurements of [14C]-L
      fucose uptake, it was deduced that the last putative transmembrane region must be
      complete for transport activity to be retained and that the four C-terminal
      residues were unnecessary for transport activity. Fourier transform analyses show
      that all the predicted helices contain a periodicity that enables
      hydrophobic/hydrophilic faces to be identified; these were particularly evident
      in putative helices 1, 3, 4, 5, 6, 10 and 11.

PMID- 7783649
TI  - A tumor necrosis factor-beta polymorphism associated with hypertriglyceridemia in
      non-insulin-dependent diabetes mellitus.
AB  - Non-insulin-dependent (type II) diabetes mellitus is associated with significant
      abnormalities of lipoprotein metabolism. Control of glycemia rarely completely
      corrects the alterations in lipid metabolism, suggesting a participation of
      environmental and genetic factors. The observation that tumor necrosis factor
      (TNF) can modulate triglyceride metabolism offers a new genetic candidate to be
      analyzed. Samples of DNA from 91 control subjects and 61 diet-treated type II
      diabetic patients were analyzed to determine the lipid profile and a possible
      association with TNF genetic polymorphisms. For TNF restriction fragment length
      polymorphisms, we used the Nco I restriction enzyme and a TNF-alpha probe
      obtaining two allelic bands at 10.5 and 5.5 kb. We found a significant
      association (P < .01) of the 10.5-kb homozygous genotype in type II diabetic
      subjects with high triglyceride levels. Furthermore, these patients showed
      significant differences in triglycerides as compared with matched control
      subjects with the same genotype (P < .001). This study provides support for
      considering the TNF locus as a susceptibility genetic region in the
      hypertriglyceridemia of type II diabetes.

PMID- 7783650
TI  - Impaired nitric oxide release by glomeruli from diabetic rats.
AB  - Basal nitric oxide (NO) production and NO responses to carbamylcholine (CCh) and
      the Ca2+ ionophore A23187 were measured with a NO electrode in glomeruli isolated
      from 2 to 3-month-diabetic versus age-matched control rats. In the presence of
      CCh or A23187, NO production was markedly reduced in glomeruli from diabetic
      versus control rats. Spontaneous generation of NO by s-nitrosopenicillamine
      (SNAP) was also reduced in the presence of glomeruli from diabetic rats as
      compared with values either in control glomeruli or in buffer alone. The results
      demonstrate an impairment of NO generation and/or stability in glomeruli from 2
      to 3-month-diabetic rats, which correlates with the previously observed
      suppression of NO-dependent glomerular cyclic guanosine 3',5'-monophosphate
      (cGMP) induced by diabetes.

PMID- 7783651
TI  - Human hepatic macrovesicular steatosis: a noninvasive study of mitochondrial
      ketoisocaproic acid decarboxylation.
AB  - Differentiating between alcoholic and nonalcoholic hepatic steatosis is often a
      difficult clinical task. However, decreased fatty acid mitochondrial oxidation
      appears as the main factor for alcoholic steatosis, whereas nonalcoholic
      steatosis may be due to other causes. We studied mitochondrial function, based on
      a 13C-ketoisocaproic acid (13C-KIC) breath test, in nine alcoholic and 12
      nonalcoholic steatosis patients and 10 healthy volunteers. Our results showed a
      42% 13C-KIC decarboxylation decrease in alcoholic steatosis patients, but not in
      nonalcoholic steatosis patients. This noninvasive breath test appears helpful for
      the diagnostic work-up of hepatic steatosis.

PMID- 7783652
TI  - Effect of kinesiologic recreation on plasma lipoproteins and apolipoproteins in
      fertile women.
AB  - The effect of physical exercise on lipid and apoprotein levels was studied in 31
      healthy fertile women (mean age, 39.7 +/- 2.3 years) working as civil servants
      and leading a mostly sedentary way of life (group 1). A control group consisted
      of 31 age-matched women (mean age, 39.2 +/- 2.4 years) with a comparable life
      style (group 2). Group 1 performed physical exercise for at least 30 minutes
      three times per week. They also climbed a 500-m hill at least once per week. The
      study lasted 6 months, ie, from May to November 1990. Changes in maximum oxygen
      consumption (Vo2max), body weight, body mass index (BMI), waist to hip ratio
      (WHR), and levels of lipids and apolipoproteins (apos) A-1 and B were compared
      between the two groups of subjects. During the May-November period, the control
      group showed an increase in body weight (P < .02), total cholesterol, high
      density lipoprotein (HDL) cholesterol, HDL3, and low-density lipoprotein (LDL)
      cholesterol (P < .01) and a decrease in HDL2 (P < .05). In contrast, group 1 did
      not show any increase in total cholesterol, and their body weight decreased (P <
      .01). Very-low-density lipoprotein (VLDL) cholesterol and triglyceride levels
      decreased (P < .02), as did LDL cholesterol and HDL2 levels (P < .05), whereas
      HDL cholesterol and HDL3 levels increased (P < .01). There were no statistically
      significant changes in WHR and apo A-1 level. The findings indicated possible
      seasonal variations in lipoprotein levels in group 2.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7783653
TI  - Amylin-mediated reduction in insulin sensitivity corresponds to reduced insulin
      receptor kinase activity in the rat in vivo.
AB  - Studies were undertaken to elucidate further the mechanism whereby the pancreatic
      peptide amylin induces insulin resistance. Sixteen male Sprague-Dawley rats
      underwent hyperinsulinemic (14 pmol/kg/min, 0 to 120 minutes) euglycemic clamps
      in the presence or absence of amylin (500 pmol/kg/min, 60 to 120 minutes). Amylin
      induced insulin resistance at both the hepatic level (mean +/- SE: hepatic
      glucose output [HGO] with amylin 1.4 +/- 0.2 v without amylin -1.9 +/- 0.3
      mmol/kg/h, P < .001) and peripheral level (glucose disposal [Rd] with amylin 5.0
      +/- 0.2 v without amylin 8.5 +/- 0.6 mmol/kg/h, P < .001). Serum insulin levels
      were similar in the presence or absence of amylin alone (661 +/- 89 v 636 +/- 50
      pmol/L, respectively, P = NS), but were significantly less when somatostatin
      (SRIF) was simultaneously infused (408 +/- 15 pmol/L, P < .02 v the other two
      groups). This suggests that endogenous insulin production was not suppressed by
      amylin under these study conditions. Similar findings were obtained in 18 animals
      in the absence of exogenous insulin infusion. In vitro kinase activity toward
      histone of skeletal muscle insulin receptors (IRs) activated by insulin in vivo
      was reduced in the presence of amylin to 6.0 +/- 0.8 versus 9.1 +/- 1.2 fmol
      phosphate into histone (insulin-infused) and 3.9 +/- 0.7 versus 6.9 +/- 1.4 (non
      insulin-infused; P < .03 by ANOVA). Serum calcium was significantly decreased in
      amylin-treated animals (1.93 +/- 0.04 v 2.30 +/- 0.05 mmol/L, P < .001).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7783654
TI  - Factors affecting lipoprotein lipase in hypertensive patients.
AB  - Arterial hypertension is frequently associated with serum lipid abnormalities.
      Lipid metabolism can also be affected by antihypertensive treatment, possibly via
      an interference with lipoprotein lipase (LPL) activity. The aims of this study
      were to investigate the metabolic and hemodynamic factors that can interfere with
      plasma postheparin LPL activity in a sample of 13 patients with mild,
      uncomplicated arterial hypertension. The effects of vasodilator administration
      (prazosin and hydralazine) alone or in combination with a beta-blocker
      (propranolol) were also studied. A direct correlation between serum insulin
      levels and LPL activity was found during placebo treatment. This was confirmed by
      multiple regression analysis, which also showed a positive correlation of LPL
      activity with aortic flow velocity and plasma adrenaline (F significance =
      0.0007, R2 = .905). Serum insulin was also directly correlated with cholesterol
      in high-density lipoproteins (HDLs) and in the HDL2 subfraction. A significant
      decrease in LPL activity was observed during the addition of propranolol to
      vasodilators as compared with vasodilators alone. A positive correlation was
      found between LPL and adrenaline changes induced by the combined treatment. These
      data suggest that LPL may play a role in the pathophysiologic connections between
      insulin action, the adrenergic nervous system (ANS), and lipid metabolism.

PMID- 7783655
TI  - Role of membrane transport in interorgan amino acid flow between muscle and small
      intestine.
AB  - In the fasting state, amino acids are released from the periphery to be used in
      splanchnic tissues. To understand the mechanism of such interorgan substrate
      exchange at the tissue level, we have determined the relationships between inward
      and outward amino acid transport and intracellular amino acid kinetics in the
      small intestine and skeletal muscle of postabsorptive anesthetized dogs. In the
      gut, amino acids appearing intracellularly (from inward transport, protein
      degradation, and absorption from the lumen) were used for protein synthesis more
      efficiently (P < .05) than in muscle (phenylalanine, 55% +/- 5% v 13% +/- 3%;
      lysine, 70% +/- 7% v 28% +/- 3%). In contrast, in muscle, amino acids appearing
      intracellularly (from inward transport and protein degradation) were
      preferentially (P < .05) released into the bloodstream, as opposed to being
      incorporated into protein (phenylalanine, 87% +/- 4%; lysine, 72% +/- 3%). Inward
      transport accounted for a greater (P < .05) proportion of total intracellular
      amino acid appearance in the gut than in muscle (leucine, 63% +/- 3% v 37 +/- 3%;
      valine, 75% +/- 5% v 53% +/- 3%; phenylalanine, 66% +/- 1% v 50% +/- 4%; lysine,
      52% +/- 2% v 31% +/- 2%). We conclude that differences in transmembrane amino
      acid transport kinetics in both the inward and outward directions contribute to
      the net flow of amino acids from the muscle to the gut in the fasting state.

PMID- 7783656
TI  - Effect of short-term treatment with recombinant human growth hormone on lipids
      and lipoproteins in women and men without growth hormone disturbances.
AB  - The effect of recombinant human growth hormone (rHGH) on cholesterol, high- and
      low-density lipoprotein (HDL and LDL) cholesterol, triglycerides (TG),
      apolipoprotein (apo) B, apo A-I, and lipoprotein(a) [Lp(a)] was studied in 40
      postmenopausal women treated with 0.05, 0.1, or 0.2 IU/kg/d rHGH or placebo for 7
      days. Cholesterol, LDL cholesterol, and HDL cholesterol decreased in a dose
      dependent manner (P = .001, P = .001, and P = .003, respectively), whereas apo B
      decreased insignificantly (P = .15). Apo A-I decreased significantly only among
      women treated with rHGH at a dose of 0.1 IU/kg/d (P = .03). When all rHGH-treated
      women were grouped together, Lp(a) increased (P = .001). We also studied 20 young
      men treated with either 0.2 IU/kg/d rHGH or placebo. As in women, cholesterol and
      apo B decreased P = .005 and P = .02, respectively), whereas Lp(a) increased (P =
      .05). There was no detectable effect of rHGH on TG concentrations in men. As in
      women, there was no significant effect of 0.2 IU/kg/d rHGH on apo A-I
      concentrations. All lipid and lipoprotein measures reached pretreatment levels
      during the first week after treatment was stopped, except Lp(a), which remained
      elevated 2 weeks after rHGH cessation.

PMID- 7783657
TI  - Glucocorticoids upregulate high-affinity, high-density lipoprotein binding sites
      in rat hepatocytes.
AB  - Glucocorticoid hormones (GL) regulate high-density lipoprotein (HDL) plasma
      concentrations by increasing synthesis and secretion of HDL by the liver.
      However, little is known about the effect of GL on the uptake and processing of
      HDL by hepatocytes (HEP). To investigate this question, we studied the effects of
      dexamethasone (DEX) on the expression of high-affinity HDL-binding sites via the
      specific binding and internalization of iodine-labeled apolipoprotein E (apo E)
      free HDL3 in a culture of rat HEP. Specific binding and internalization of HDL3
      decreased by 60% in cells cultured in the absence of DEX for 48 hours. At
      concentrations of 10(-7) and 10(-5) mol/L, DEX prevented the decrease,
      maintaining specific binding and internalization versus the control level (at 24
      hours). HDL-binding sites with a Kd of 20 micrograms/mL were revealed on the
      surface of cultured HEP. HEP demonstrated a greater binding capacity in the
      presence of DEX at concentrations of 10(-7) and 10(-5) mol/L (125 v 45 ng/mg cell
      protein). The effect of the hormone has demonstrated to be dose-dependent at
      concentrations between 10(-9) and 10(-7) mol/L, leveling off at 10(-7). Higher
      concentrations did not induce a further increase in specific binding and
      internalization. Withdrawal of the hormone from culture medium was associated
      with a decrease in specific binding of the ligand by 60% in the following 24
      hours. To investigate the effect of glucocorticoid deficiency on liver uptake of
      HDL in vivo, specific binding and internalization were studied in a culture of
      HEP isolated from adrenalectomized rats (AER) at 2 hours after seeding.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7783658
TI  - Effect of combined administration of growth hormone (GH)-releasing hormone, GH
      releasing peptide-6, and pyridostigmine in normal and obese subjects.
AB  - Growth hormone (GH) secretion in response to all provocative stimuli is decreased
      in patients with obesity. Recently, we found that the combined administration of
      GH-releasing hormone (GHRH) and the hexapeptide GH-releasing peptide-6 (GHRP-6)
      induced a large increase in plasma GH levels. To gain further insight into the
      disrupted mechanism of GH regulation in obesity, we investigated whether the
      inhibition of somatostatinergic tone with pyridostigmine could further increase
      the GH response to combined administration of GHRH and GHRP-6. In normal
      subjects, administration of GHRH plus GHRP-6 induced a marked increase in plasma
      GH with a peak at 30 minutes (mean +/- SEM, 76.7 +/- 9.7 micrograms/L), which was
      similar to that obtained after pretreatment with pyridostigmine (74.7 +/- 9.4
      micrograms/L). In obese patients, combined administration of GHRH plus GHRP-6
      induced a clear increase in GH secretion with a peak at 15 minutes of 42.2 +/-
      10.0 micrograms/L, which was also unaffected after pretreatment with
      pyridostigmine (38.4 +/- 5.8 micrograms/L). The GH response was lower in obese
      patients than in controls as assessed by the area under the curve after
      administration of both GHRH plus GHRP-6 (1,846 +/- 396 v 4,773 +/- 653, P < .01)
      and pyridostigmine plus GHRH plus GHRP-6 (1,989 +/- 372 v 5,098 +/- 679, P <
      .005). In conclusion, these data suggest that GHRP-6 can behave as a functional
      somatostatin antagonist, and that somatotrope responsiveness to the combined
      administration of GHRH plus GHRP-6 is largely independent of somatostatinergic
      tone.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783659
TI  - Changes in plasma lipoprotein concentrations and composition in response to a low
      fat, high-fiber diet are associated with changes in serum estrogen concentrations
      in premenopausal women.
AB  - We have investigated the effects of a low-fat, high-fiber diet on plasma lipid
      and lipoprotein levels and serum sex hormone concentrations in 22 normal
      premenopausal women (mean age, 25.8 +/- 3.8 years). Participants consumed a
      baseline diet for 4 weeks (40% of calories as fat, 16% as saturated fatty acids,
      8% as polyunsaturated fatty acids, 400 mg/d cholesterol, and 12 g/d dietary
      fiber) and then a low-fat, high-fiber diet for 8 to 10 weeks (16% to 18% of
      calories as fat, 4% as saturated fatty acids, 4% as polyunsaturated fatty acids,
      150 mg/d cholesterol, and 40 g/d fiber). Blood samples for determination of
      plasma lipids and serum hormones were obtained during the follicular and luteal
      phases of the menstrual cycle during both diets. Compared with the baseline diet,
      the low-fat, high-fiber diet resulted in significant decreases in total
      cholesterol (TC), low-density lipoprotein (LDL) cholesterol, and high-density
      lipoprotein (HDL) cholesterol concentrations during both the follicular and
      luteal phases (TC, -14% and -16%; LDL cholesterol, -14% and -17%; and HDL
      cholesterol, -15% and -18%, respectively). During the follicular phase but not
      the luteal phase on the low-fat, high-fiber diet, women exhibited significant
      increases in plasma triglyceride ([TG] 22%) and very-low-density lipoprotein
      (VLDL)-TG (36%) concentrations. During the follicular phase, serum estrone
      sulfate concentrations decreased by 25% (P < .0001) when subjects were fed the
      low-fat, high-fiber diet.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783660
TI  - In vivo beta-cell function at the transition to early non-insulin-dependent
      diabetes mellitus.
AB  - Impaired insulin secretion occurs at some stage in the development of non-insulin
      dependent diabetes mellitus (NIDDM), possibly during impaired glucose tolerance
      (IGT) or early NIDDM. To assess insulin secretion at these critical stages, we
      measured the first-phase insulin response (to glucose and arginine), maximal
      secretory capacity, and glucose potentiation slope for insulin secretion in Pima
      Indians with normal glucose tolerance (n = 20), IGT (n = 9), and mild (fasting
      glucose < 7.8 mmol/L) NIDDM (n = 7). We also measured oral glucose tolerance and
      insulin action. Subjects with IGT were more insulin-resistant (P < .05) than
      normals. A wide range of insulin secretion was noted, although as a group, no
      significant impairment was detected. Subjects with mild NIDDM were similarly
      insulin-resistant, but they also had impaired insulin secretion. The first-phase
      response to glucose was markedly reduced in absolute terms (P < .001), but all
      secretion indices were impaired relative to the degree of insulin resistance (P =
      .05 to P < .0001). These results suggest that in Pima Indians, impairment of
      insulin secretion, especially the first-phase response to glucose, is associated
      with mild NIDDM. Insulin secretion in IGT is variable and, overall, seems intact,
      although a subtle defect in the first-phase insulin response to glucose could not
      be ruled out in this study. Glucose sensing for first-phase secretion may be one
      of the early secretory defects in the progression of glucose intolerance and
      seems to be critical at the transition from IGT to early NIDDM.

PMID- 7783661
TI  - Short-term changes in energy metabolism after 1 month of a regular oral diet in
      severely malnourished cirrhotic patients.
AB  - Malnutrition in patients with liver cirrhosis is currently associated with
      abnormal fuel metabolism. The aim of this study was to evaluate changes in energy
      production and substrate oxidation rates in a group of 26 nonanorectic severely
      malnourished cirrhotic patients in stable clinical condition after 1 month of an
      oral diet. Child-Pugh score, nutritional status, energy expenditure, rates of
      nutrient oxidation, and plasma levels of intermediary metabolites in the
      postabsorptive phase were assessed before and after 1 month of oral nutrition.
      Upon entry onto the study, caloric and protein intakes were 40.1 +/- 2.0 kcal/kg
      and 1.44 +/- 0.8 g/kg, respectively. The Child-Pugh score did not change during
      the study, whereas nutritional status improved as shown by increased muscular
      midarm circumference, ([MMAC] P < .02), height-creatinine index (P < .05),
      triceps skinfold thickness ([TST] P < .01), and fat mass (P < .001). Inflammatory
      state improved during the study, as shown by the decrease of C-reactive protein
      ([CRP] P < .01) and orosomucoid (P < .001). The ratio of caloric intake to
      resting energy expenditure (REE) increased (1.53 +/- 0.06 v 1.66 +/- 0.07, P <
      .05), as well as the rate of glucose oxidation ([Gox] 73.6 +/- 9.9 v 128.1 +/-
      10.3 mg/min, P < .001) and urine nitrogen excretion (6.69 +/- 0.47 v 7.96 +/-
      0.48 g/d, P < .02). On the other hand, the rate of lipid oxidation (Lox)
      decreased (67.3 +/- 3.9 v 47.3 +/- 4.9 mg/min, P < .001) and was correlated with
      the decrease of free fatty acid (FFA) levels (P < .05).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7783662
TI  - Tissue-specific alterations in G protein expression in genetic versus diet
      induced models of non-insulin-dependent diabetes mellitus in the mouse.
AB  - Various tissues were obtained from the well-characterized genetic model (C57BL/6J
      ob/ob) of non-insulin-dependent diabetes mellitus (NIDDM) and from a diet-induced
      model of NIDDM produced in the same genetic background (C57BL/6J). The objectives
      were to determine whether the previously observed changes in guanine nucleotide
      binding regulatory protein (G protein) expression in adipose tissue from ob/ob
      mice were mirrored by concomitant changes in other tissues, and whether NIDDM of
      a different etiology would share similar alterations in G protein expression.
      Plasma membranes from adipocytes, brain, heart, liver, and testes were probed
      with alpha-subunit-specific antisera, and the level of G protein expression in
      each model was compared with that in its lean littermate control. Adipose, heart,
      and liver cell membranes from ob/ob mice contained significantly less alpha
      subunit of stimulatory G protein (Gs alpha) than those from their lean
      littermates. As compared with the lean littermates, heart alpha-subunit-2 of
      inhibitory G protein (Gi alpha-2), liver Gi alpha-3, and adipocyte G1 alpha-1 and
      Gi alpha-3 were also reduced in ob/ob mice. In contrast, Gi alpha-2 and Go alpha
      were increased over lean-control levels in brain tissue from ob/ob mice, whereas
      Gs alpha was unchanged. G protein expression in the testes did not differ between
      lean and ob/ob mice. In the diet-induced model of NIDDM, Gs alpha expression in
      the liver was twofold greater in obese/diabetic mice as compared with lean
      controls. However, G protein expression in all other tissues examined did not
      differ between obese/diabetic animals and lean littermates.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7783664
TI  - Change in skeletal muscle lipoprotein lipase activity in response to
      insulin/glucose in non-insulin-dependent diabetes mellitus.
AB  - Skeletal muscle lipoprotein lipase (SMLPL) provides fatty acids to myocytes for
      lipoprotein triglyceride oxidation. In human obesity, an insulin-resistant state,
      SMLPL levels measured in the fasted state are either decreased or unchanged as
      compared with levels in normal-weight controls. However, insulin/glucose infusion
      increases SMLPL activity in obese individuals, whereas in normal-weight subjects
      the activity is decreased. One of the goals of this study was to determine the
      impact of obesity with concomitant non-insulin-dependent diabetes mellitus
      (NIDDM) on fasting SMLPL and on the change in SMLPL activity (delta MLPL) in
      response to an insulin/glucose infusion. Because NIDDM is often a more insulin
      resistant state, it was hypothesized that SMLPL activity would be further
      increased by insulin/glucose in subjects who were obese and had NIDDM.
      Measurements of SMLPL were made from biopsies of vastus lateralis skeletal muscle
      taken before and after a 6-hour insulin/glucose infusion in the setting of a
      euglycemic clamp. Thirteen nondiabetic obese women (OBC) and six nondiabetic
      normal-weight women (NWC) were used as control subjects. SMLPL levels measured in
      the fasted state were significantly lower in obese NIDDM subjects as compared
      with either control group. Relative insulin action was determined by calculation
      of the mean glucose infusion rate (GIR) required to sustain euglycemia over the
      last 60 minutes of the infusion. For all three groups combined, representing a
      continuum of insulin sensitivity, there was a positive correlation between GIR
      and fasting SMLPL. As described earlier, in the NWC group SMLPL activity
      decreased significantly after 6 hours of insulin/glucose, and in the OBC group
      SMLPL increased after insulin/glucose.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783663
TI  - Ethanol as a xanthine dehydrogenase inhibitor.
AB  - In the present study, we investigated whether ethanol inhibits the activity of
      xanthine dehydrogenase. Ethanol and/or inosine were administered to normal
      subjects, and plasma concentration and urinary excretion of purine bases were
      measured together with blood concentrations of lactic acid and pyruvic acid. In
      addition, ethanol and pyrazinamide were administered to these subjects, and
      plasma concentration and urinary excretion of pyrazinamide and its major
      metabolites were measured. Increases in plasma concentration and urinary
      excretion of xanthine induced by a combination of ethanol and inosine were
      greater than the sums of increases induced separately by ethanol and inosine,
      although increases in plasma concentration and urinary excretion of uric acid
      induced by the combination of ethanol and inosine were not different from the
      sums of increases induced separately by ethanol and inosine. Ethanol increased
      the ratio of blood lactic acid to blood pyruvic acid and decreased plasma
      concentration and urinary excretion of 5-hydroxypyrazinamide and 5
      hydroxypyrazinoic acid. These results suggest that ethanol inhibits xanthine
      dehydrogenase presumably by an ethanol-induced increase in the cytosolic
      concentration of NADH in the liver.

PMID- 7783665
TI  - Na+/H+ exchanger isoform-1 abundance in skin fibroblasts of type I diabetic
      patients with nephropathy.
AB  - In diabetic nephropathy and essential hypertension, the cellular Na+/H+ exchanger
      (NHE) exhibits increased activity. Whether this reflects increased numbers of NHE
      isoform-1 (NHE-1) transporters or increased turnover per molecule has not been
      established. We have used a specific polyclonal antibody directed toward the C
      terminal of NHE-1 to measure NHE-1 content in cultured skin fibroblasts from
      diabetic patients with (DN) and without (DCON) nephropathy and normal controls
      (CON). NHE-1 content in fibroblasts from DN subjects was significantly less than
      that in the other two groups. This suggests that increased NHE activity in
      diabetic nephropathy is attributed to increased NHE-1 turnover per site rather
      than increased NHE-1 expression.

PMID- 7783666
TI  - Sorbitol malabsorption and nonspecific abdominal symptoms in type II diabetes.
AB  - Some data suggest that sorbitol intake may be responsible for diarrhea in
      diabetic patients. One hundred thirteen hydrogen breath tests were performed in
      type II diabetics (72) and normal controls (41) after oral loads of sorbitol
      ranging from 2.5 to 20 g in iso-osmolar solutions to assess the role of
      malabsorption of this compound in the genesis of abdominal symptoms. The
      prevalence of sorbitol malabsorption and abdominal symptoms, peak (Cmax H2) and
      total (Ctot H2) hydrogen production, and mouth to cecum transit time (MCTT) did
      not differ in type II diabetics and controls. Malabsorption was observed more
      frequently with the highest doses of sorbitol (10% of patients at a dose of 2.5 g
      and approximately 75% at 20 g). Symptoms, usually consisting of mild discomfort
      and abdominal distension, were observed only after sorbitol loads of 10 and 20 g
      in 27.2% of the diabetics and in 36.3% of the controls. Diarrhea was present in
      three subjects (two diabetics and one control) only at a dose of 20 g. These data
      indicate that it is highly unlikely for sorbitol to play a role in inducing
      diabetes diarrhea. A moderate (up to 10 g) sorbitol intake is not contraindicated
      in type II diabetics.

PMID- 7783667
TI  - Fish oil enhances macrophage tumor necrosis factor-alpha mRNA expression at the
      transcriptional level.
AB  - Dietary supplementation with fish oil has previously been shown to enhance in
      vivo and in vitro (macrophage) synthesis of tumor necrosis factor-alpha (TNF
      alpha) in response to bacterial lipopolysaccharide (LPS) stimulation. The studies
      reported here were conducted to gain insight into the molecular mechanisms of
      this nutrient-immune interaction by comparing the concentration, rate of
      synthesis, and rate of decay of TNF-alpha mRNA upon LPS stimulation of
      macrophages obtained from mice fed high-fat diets, rich in either fish oil, corn
      oil, or coconut oil, or a low-fat diet for a period of 4 weeks. The results
      indicate that compared with the other diet groups, LPS stimulation of macrophages
      from mice fed fish oil resulted in (1) enhanced levels of mRNA and protein for
      TNF-alpha, and (2) increased transcription of TNF-alpha mRNA as assessed by
      nuclear run-on assays. Posttranscriptional studies showed that the rate of decay
      of TNF-alpha mRNA did not vary significantly for macrophages from mice fed with
      fish oil as compared with corn oil. Further studies using actinomycin D and
      cycloheximide suggested that RNA synthesis, but not protein synthesis, was
      necessary for TNF-alpha mRNA accumulation. Taken together, the present studies
      suggest that fish oil enhances macrophage TNF-alpha mRNA expression at the
      transcriptional level. Although such TNF-alpha upregulation may provide a
      mechanism for the beneficial effects of fish oil in certain inflammatory and
      immune disorders, it can also underlie its potential deleterious effects if the
      degree of upregulation leads to exaggerated TNF-alpha production that exceeds the
      limits of benefit to reach toxic levels.

PMID- 7783668
TI  - Abnormal arachidonate distribution in low-density lipoprotein and thoracic aorta
      in hyperinsulinemia.
AB  - The mechanism by which hyperinsulinemia promotes atherogenesis is unknown. The
      effects of hyperinsulinemia on risk factors for atherosclerosis were investigated
      by subcutaneously injecting rats daily with an insulin-zinc suspension (20 U/kg)
      for 12 weeks. After this period, body mass and food consumption did not differ
      significantly between control and insulin-treated animals. Daily insulin
      injection significantly increased urinary excretion of epinephrine and decreased
      urinary excretion of norepinephrine and dopamine, but had no significant effect
      on blood pressure or heart rate. Although insulin decreased plasma triglyceride
      concentration by 44% (P < .01), the triglyceride to protein ratio in plasma low
      density lipoprotein (LDL) was increased by 34% (P < .05) in insulin-treated rats;
      the cholesterol to protein and triglyceride to protein ratios remained
      unaffected, indicating a change in the quality of the LDL particle. Insulin also
      increased the percentage of arachidonic acid (20:4) in LDL triglycerides by 37%
      (P < .05). In contrast, cholesteryl esters and triglycerides in the thoracic
      aorta were significantly increased (49% and 91%, respectively) by insulin
      treatment. Insulin increased the percentage of monounsaturated fatty acids and
      decreased the percentage of n-6 fatty acids, including arachidonate, in aortic
      triglycerides. Insulin also increased the percentage of palmitoleic acid (16:1)
      and decreased the percentages of saturated fatty acids and n-6 fatty acids in
      aortic cholesteryl esters. These results indicate that insulin induced deposition
      of cholesteryl esters and triglycerides, especially those containing
      monounsaturated fatty acids, and abnormal arachidonate distribution in LDL and
      tissues. The data further suggest that the development of atherosclerosis in
      response to hyperinsulinemia may be associated with arachidonate-rich
      triglycerides in LDL.

PMID- 7783669
TI  - Adaptations in glucose homeostasis during chronic nutritional deprivation in
      rats: hepatic resistance to both insulin and glucagon.
AB  - The role of glucagon in glucose homeostasis during chronic malnutrition was
      studied in weanling-littermate rats either fed ad libitum or restricted to 60% of
      ad libitum intake for 8 weeks. Fasting glucose and insulin levels were lower in
      malnourished rats, and their response to glucagon (0.02 mg/kg intravenous [IV])
      after a 16-hour fast was significantly less than in control littermates for both
      glucose (P = .039) and insulin (P = .008). During euglycemic glucose clamp
      studies at identical plasma glucose (PG) levels, insulin suppression of hepatic
      glucose production (HGP) was impaired in malnourished rats, indicating insulin
      resistance (mean +/- SE HGP: 48 +/- 5 v 32 +/- 10 mumol.kg-1.min-1 for controls,
      P = .028). Glucose disposal was not significantly different in the two groups.
      However, after IV glucagon, the increase in HGP was markedly impaired in
      malnourished rats (P = .0004), with the total amount of glucose produced by the
      liver over 15 minutes being 1,397 +/- 114 mumol/kg as compared with 2,031 +/- 118
      in controls (P = .0047). The impaired response was not due to defective
      glycogenolysis, because the release of glucose from prelabeled glycogen in
      response to glucagon injection contributed only 6% to 8% of the overall increase
      in glucose output from the liver, and was not different in the two groups.
      Furthermore, liver glycogen stores were virtually exhausted after the 16-hour
      fast, without glucagon injection. Glucagon receptor affinity and number were not
      affected by malnutrition. It is concluded that (1) chronic malnutrition is
      associated with hepatic resistance to both insulin and glucagon, (2) the glucagon
      resistance is not due to impaired glycogenolysis, and (3) it is mediated by a
      postreceptor defect.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783671
TI  - The Michigan physician today. Results of the MSMS survey on practice
      characteristics. Executive summary.

PMID- 7783670
TI  - AMA, state medical societies launch "litigation center".

PMID- 7783672
TI  - Virus activation by host proteinases. A pivotal role in the spread of infection,
      tissue tropism and pathogenicity.

PMID- 7783673
TI  - Isolation and characterization of bile acid 7-dehydroxylating bacteria from human
      feces.
AB  - Methods for isolation of fecal 7 alpha-dehydroxylating bacteria are presented. A
      total of 219 strains were isolated from feces of healthy humans, and their
      ability to 7-dehydroxylate cholic, chenodeoxycholic, and ursodeoxycholic acids
      were examined. Of all the isolates, 14 strains were found to be capable of
      eliminating the hydroxy group at C-7 alpha and/or C-7 beta. All the isolates were
      strictly anaerobic, Gram-positive rods. Thirteen isolates were non-sporeforming
      bacteria showing certain saccharolytic properties with the production of acid and
      gas from dextrose, and were catalase-positive but indole-, lecithinase-, urease-
      and oxidase-negative. Based on the data available at present, it was concluded
      that they could be regarded as members of the genus Eubacterium. One strain,
      however was identified as Clostridium sordellii. The isolated strains capable of
      7 alpha-dehydroxylating cholic acid and chenodeoxycholic acid were also able to
      oxidize the hydroxy group at C-7 alpha. Nine strains (10, 12, 36S, M-2, M-17, M
      18, Y-98, Y-1112, and Y-1113) of the 7 alpha-dehydroxylating bacteria were
      confirmed to have 7 beta-dehydroxylation ability, but five strains (O-51, O-52, O
      71, O-72, and Y-67) could not transform ursodeoxycholic acid to lithocholic acid.

PMID- 7783674
TI  - Molecular cloning of the leuB gene from Bacteroides fragilis by functional
      complementation in Escherichia coli.
AB  - Clones containing the Bacteroides fragilis leuB-complementing gene were isolated
      by screening of a B. fragilis genomic library constructed in Escherichia coli.
      One recombinant clone, designated pOT865, with the smallest DNA insert (4.5 kb)
      could complement three independent leuB mutations in E. coli and the leuB
      complementing determinant in pOT865 was localized to a region of 1.5-kb DNA. The
      results of Southern blot analysis suggested that a single copy of the cloned gene
      was present in the B. fragilis genome. The cloned fragment appeared to contain a
      sequence that could function as promoter in E. coli and direct the synthesis of a
      42-kDa protein. These results suggest that the cloned segment contains the
      structural gene for beta-isopropylmalate dehydrogenase (leuB).

PMID- 7783675
TI  - Purification and characterization of metallo-beta-lactamase from Serratia
      marcescens.
AB  - Carbapenem-hydrolyzing beta-lactamase from Serratia marcescens FHSM4055 was
      purified 926-fold by means of carboxylmethyl Sephadex C-50, Sephacryl S-200, and
      Mono S column chromatography. The molecular weight was 30,000 by SDS-PAGE and the
      isoelectric point was 8.7. The enzyme activity was inhibited by EDTA, and
      restored by adding zinc (II) or manganese (II). It was inhibited by p
      chloromercuribenzoate and iodine as well as the heavy metals, Hg (II), Fe (II),
      Fe (III), and Cu (II). These results indicate that the enzyme is a metallo-beta
      lactamase and that the SH-group of only one cysteine residue probably binds to
      the metal ion, thus contributing to the stability of the enzyme active center.
      The specific constant (kcat/Km) showed that the enzyme hydrolyzed various beta
      lactam antibiotics such as carbapenems, cephalosporins, moxalactam, cephamycins,
      and penicillins other than monobactams. Ampicillin and piperacillin with
      respective amino- and imino-groups, ceftazidime with a carboxypropyloxyimino
      group, and cefclidin with a carbamoylquinuclidine-group were poor substrates
      among the beta-lactam antibiotics other than the monobactams tested. The plots of
      the turnover number (kcat) against pH for the hydrolysis of cephaloridine gave an
      asymmetrical curve with the 'tail' on the acid side (pK1, 5.9; pK2, 9.0; pK3,
      10.8), whereas those of kcat/Km gave a bell-shaped curve (pK1, 5.8; pK2, 9.8).
      Both results suggest that two ionic forms of an intermediate yield the same
      product at different rates and that the enzyme is stable under alkaline
      conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783676
TI  - Characterization of the mode of Hantaan virus infection in adult mice using a
      nested reverse transcriptase polymerase chain reaction: transient virus
      replication in adult mice.
AB  - A polymerase chain reaction (PCR) for the detection of hantavirus genome was
      established and applied to analyze the mode of infection of Hantaan virus in
      adult ICR mice. The cDNA for the S genome segment of Hantaan virus was reverse
      transcribed from the total RNA of organs of the infected mice. The sequence in
      the S genome segment of Hantaan virus was successfully amplified by reverse
      transcriptase (RT)-PCR followed by nested PCR. In 5-week-old ICR mice inoculated
      intraperitoneally with Hantaan virus, strain 76-118 (1.3 x 10(5) FFU/mouse), the
      virus was detected in clots and lungs from 3 to 10 days post-inoculation (p.i.)
      by nested PCR and virus-isolation techniques. No virus was detected in any
      specimens collected on 1 day and after 28 days p.i., and in spleens and brains
      through the observation period by both methods. The antibody which was measured
      by indirect immunofluorescence antibody assay (IFA) appeared at 7 days p.i. and
      the geometric mean titer was elevated to its maximum level of 1:203 at 10 days
      p.i., maintaining the same level until 35 days p.i. These results suggest that
      adult mice are transiently infected with Hantaan virus.

PMID- 7783677
TI  - Analysis of cellular response and gamma interferon synthesis in bronchoalveolar
      lavage fluid and lung homogenate of mice infected with Pneumocystis carinii.
AB  - The cellular and cytokine responses in the lungs of mice infected with
      Pneumocystis carinii were examined on both lung homogenates and bronchoalveolar
      lavage (BAL) fluids. In the lungs of infected mice, the number of P. carinii
      cysts rapidly decreased by day 7, then started to increase with a peak on day 14,
      and thereafter decreased gradually. When the presence of P. carinii was examined
      at the DNA level by dot blot hybridization, a similar clearance curve was
      obtained, and the organisms were shown to be completely eliminated on day 28. In
      the late phase of infection, leukocytes, mainly lymphocytes, increased in number
      when analyzed on lung homogenates, while no significant increase of inflammatory
      cells was observed in BAL fluids. An accumulation of both CD4+ and CD8+ T cells
      and an increase of activated T cells expressing IL-2R alpha were observed in lung
      homogenates of the infected mice. In addition, a considerable amount of IFN-gamma
      was detected in lung homogenates, but not in BAL fluids. These data indicate that
      lung homogenates are more suitable than BAL fluids for the analysis of cellular
      and cytokine responses in the lungs of mice infected with P. carinii. To define
      the involvement of IFN-gamma in host defense against P. carinii, the effect of
      this cytokine on the killing activity of macrophages against P. carinii was
      examined in vitro. IFN-gamma was found to augment this activity by increasing
      nitric oxide synthesis of the macrophages. Thus, it is suggested that IFN-gamma
      plays an important role in the protection of mice from P. carinii infection.

PMID- 7783678
TI  - Comparison of a reversed passive latex agglutination and a polymerase chain
      reaction for identification of cholera toxin producing Vibrio cholerae O1.
AB  - Production of cholera toxin (CT) in AKI medium and conservation of CT gene (ctx)
      of 49 strains of Vibrio cholerae O1 were compared by reversed passive latex
      agglutination (RPLA) and polymerase chain reaction (PCR). The production of CT
      agreed with conservation of the ctx in 48 out of the 49 strains. Ten strains were
      positive, and 38 strains were negative by both methods. Only one strain was
      negative in RPLA and positive in PCR. This suggested that the combination of AKI
      SW and RPLA is comparable to PCR to identify CT-producing V. cholerae O1.

PMID- 7783679
TI  - Serological studies of the antigenic similarity between typhus group rickettsiae
      and Weil-Felix test antigens.
AB  - The sera from two patients with murine typhus reacted with whole cells of
      Rickettsia prowazekii, R. typhi, and Proteus vulgaris OX19, and with
      lipopolysaccharides (LPS) from the spotted fever group rickettsia strain TT-118
      and P. vulgaris OX19 in the enzyme-linked immunosorbent assay. Sera from these
      patients reacted with ladder-like bands of LPS from R. prowazekii and R. typhi in
      the immunoblot, whereas the reactivity of these sera with LPS from P. vulgaris
      OX19 differed from each other. These results indicate that LPS from the typhus
      group rickettsiae and P. vulgaris OX19 contain similar epitopes.

PMID- 7783680
TI  - Production of antigenically related exocellular elastolytic proteases mediating
      hemagglutination by vibrios.
AB  - Exocellular proteases produced by Vibrio fluvialis, V. furnissii, V.
      metschnikovii and V. campbellii were characterized and compared to those of V.
      mimicus protease (VMP) and V. vulnificus protease (VVP). These proteases
      possessed both elastolytic and hemagglutinating abilities and were identified,
      except that of V. metschnikovii, as metalloprotease. Conversely, V. metschnikovii
      protease failed to exhibit some of the salient features for metalloproteases
      suggesting the existence of protease(s) other than metalloprotease. However,
      antibodies against VVP cross-reacted to these proteases and to VMP indicating
      antigenic relatedness amongst vibrio proteases. This study, thus, demonstrated
      the prevalent distributions of antigenically related proteases both in pathogenic
      and non-pathogenic vibrios, bringing their status as a virulence determinant into
      question.

PMID- 7783681
TI  - Experimental dental caries on gnotobiotic inbred mice.
AB  - The purpose of this study in mono-infected gnotobiotic BALB/cA and C3H/HeN mice
      was to evaluate the cariogenicity of Enterococcus faecalis. The caries incidence
      and mean caries score in the BALB/cA mice were significantly higher than those in
      the C3H/HeN. In both of the mouse strains, the mean number of E. faecalis
      isolated from the cecum content was almost the same, however, the mean number of
      E. faecalis from the maxilla of BALB/cA was significantly higher than that of
      C3H/HeN. These results indicate that C3H/HeN has some factors that prevent E.
      faecalis from attaching to the tooth surfaces.

PMID- 7783682
TI  - A gene encoding a cytochrome c oxidase-like protein is located closely to the
      cytochrome c-553 gene in the anaerobic bacterium, Desulfovibrio vulgaris
      (Miyazaki F).
AB  - The gene encoding cytochrome c-553 from Desulfovibrio vulgaris (Miyazaki F) was
      cloned using a synthetic oligodeoxyribonucleotide probe. The nucleotide sequence
      indicated that cytochrome c-553 was synthesized as a precursor protein with an
      NH2-terminal signal sequence of 23 residues. In the cloned DNA fragment, there
      are three other open reading frames whose products have 191, 157, 541 amino acid
      residues, respectively. The putative ORF-4 product is highly homologous with the
      cytochrome c oxidase subunit I from various organisms.

PMID- 7783683
TI  - Carbohydrate-dependent biological activities of glycosylated human interferon
      beta on human hepatoblastoma cells in vitro.
AB  - To evaluate the relationship between the sugar chain structure and biological
      activity, fibroblast-derived glycosylated human interferon-beta, Chinese hamster
      ovary cell-derived glycosylated recombinant human interferon-beta and Escherichia
      coli-derived unglycosylated recombinant human interferon-beta were evaluated
      using human hepatoblastoma cells in vitro. Native fibroblast interferon-beta
      expressed more cell-growth inhibitory action, 2'5'-oligoadenylate synthetase
      induction, and the inhibition of hepatitis B virus DNA replication than its
      asialoform and two recombinant interferon-betas. These results showed that the
      sugar chain structure of human interferon-beta affects its biological activity on
      human hepatoblastoma cells.

PMID- 7783684
TI  - Influence of exogenous interleukin-2 concentration on the isolation of human
      immunodeficiency virus.
AB  - A significant increase (P = 0.015) in the HIV isolation rate from plasma samples
      was achieved by use of 10 U/ml exogenous interleukin-2 compared to 20 U/ml. The
      sensitivity rose from 0% to 29% in patients negative for p24 core antigen (P =
      0.031) and from 71% to 86% in patients positive for p24 core antigen in plasma (P
      > 0.05). Titration of infectious HIV revealed that 10 U/ml interleukin-2 is the
      optimal concentration to isolate low numbers of infectious particles of HIV.

PMID- 7783686
TI  - T cell-dependent activation of macrophages and enhancement of their phagocytic
      activity in the lungs of mice inoculated with heat-killed Cryptococcus
      neoformans: involvement of IFN-gamma and its protective effect against
      cryptococcal infection.
AB  - Previous investigations have demonstrated that macrophages play a critical role
      in the first-line cellular defense mechanism against infection with Cryptococcus
      neoformans. In the present study, to elucidate the way in which anticryptococcal
      activity of macrophages is regulated at the site of infection, pulmonary
      intraparenchymal macrophages were directly analyzed for expression of their
      surface molecules and their phagocytic activities against the organism, and the
      effects of depletion of T cells and endogenous IFN-gamma in vivo on these
      parameters were examined. In the lungs of mice intratracheally inoculated with
      heat-killed C. neoformans, macrophages were activated, as indicated by augmented
      expression of MHC class II, intercellular adhesion molecule-1 (ICAM-1) and Fc
      receptor (FcR), and about two-thirds of macrophages were found to have ingested
      an average of 3.77 +/- 0.12 yeast cells per macrophage. In mice depleted of both
      CD4+ and CD8+ T cells by injecting the specific monoclonal antibodies (mAbs) or
      anti-IFN-gamma mAb, not only augmentation of the expression of macrophage
      activation markers but also phagocytosis of C. neoformans was significantly
      reduced. These results suggest that anticryptococcal activity of macrophages is
      regulated by IFN-gamma endogenously produced by T cells. Additionally, treatment
      with IFN-gamma were shown to significantly prolong the survival time of mice
      infected with viable C. neoformans. Additionally, preimmunization with heat
      killed C. neoformans significantly prolonged the survival time of mice which
      received the following infection.

PMID- 7783685
TI  - CD3+/TCR-alpha beta- cells are important in protecting spinal cord tissues
      against Theiler's virus strain GD VII infection.
AB  - Intravenous infection with Theiler's virus strain GD VII causes acute
      encephalomyelitis in mice. Endogenous IFN-gamma produced in the spinal cord is
      important to protect the tissue in mice infected with this virus. Neither CD4+
      cells nor CD8+ cells infiltrated the spinal cords of infected mice until Day 9
      postinfection. However, the number of CD3+/TCR-gamma delta+ cells increased in
      the spinal cords of mice infected with the virus. These cells resided in the
      spinal cords of normal mice, and produced IFN-gamma as a result of stimulation by
      immobilized anti-CD3 mAb. Elimination of CD3+ cells by the administration of a
      specific mAb augmented viral replication and suppressed production of endogenous
      IFN-gamma. Depletion of TCR-alpha beta+ cells and ASGM1+ cells did not affect the
      viral replication, and did not alter the production of IFN-gamma. Therefore,
      CD3+/TCR-alpha beta- cells producing IFN-gamma play an important role in the
      protection of the spinal cord against Theiler's virus infection. These results
      suggest that CD3+/TCR-alpha beta- cells might be identical to TCR-gamma delta+
      cells.

PMID- 7783687
TI  - C3d and Epstein-Barr virus (CR2/CD21 ligands) stimulate cells of an HTLV-I line,
      MT-2.
AB  - We studied the physiological role of complement receptor type II (CR2, C3d/EBV
      receptor) expressed on T cells using MT-2 cells. First, we confirmed CR2
      expression on MT-2 cells by flow cytometry and found that the MW of CR2 molecules
      on these cells and Raji B cells were the same by SDS-PAGE analysis. When MT-2
      lysates were incubated with anti-CR2 mAb HB5 and thereafter with 32P-labeled ATP,
      52- and 74-kDa proteins were phosphorylated, suggesting the activation of MT-2
      cells through the complex of CR2 with these proteins. In this respect, we
      measured lymphotoxin production by MT-2 cells when incubated with C3d or EBV. The
      cytotoxicity of the MT-2 supernatant against L929 cells was elevated in a dose-
      and time-dependent manner. Next, we confirmed EBNA expression on EBV-infected MT
      2 cells and attempted to establish an EBV-positive MT-2 clone by in vitro EBV
      infection. However, these clones disappeared during cloning. To clarify this
      mechanism, we examined the EBV genome in MT-2 cells. By Southern blot analysis,
      BamHI digestion of DNA extracts from MT-2 cells 3 days after EBV treatment gave a
      3.0-kb signal which comigrated with the EBV BamHI-W probe. The 3.0-kb signal of
      genomic EBV-DNA was detected at 1, 2, 3, 5, and 7 days after EBV treatment, but
      could not be detected at 14 days. Thus, natural ligands of CR2 stimulate CR2
      positive MT-2 cells through their functionally active CR2 molecules and in vitro
      EBV infection of MT-2 cells might be transient.

PMID- 7783688
TI  - Conspicuous growth of intravenously inoculated Staphylococcus aureus in
      subcutaneously established Ehrlich ascites tumor tissue of mice.
AB  - Intratumoral growth of Staphylococcus aureus was compared with the intrarenal
      growth, to examine the usefulness of the method as a marker of its pathogenicity.
      When 5 x 10(7) CFU/mouse of three derivatives from S. aureus Cowan I with
      different intrarenal growth were intravenously injected into Ehrlich tumor
      bearing mice, they lodged in the tumor tissue at approximately 10(3) CFU/0.1 g by
      30 min after infection, and grew in the range of 10(6) CFU/0.1 g to 10(8) CFU/0.1
      g by day 4, regardless of their intrarenal growth capacity. In contrast, S.
      saprophyticus lodged in both tissues to the same degree as S. aureus, but did not
      grow at all. The time course of the staphylococcal growth was different between
      tumor tissue and kidney, suggesting differences in the local responses against S.
      aureus.

PMID- 7783689
TI  - Evaluation of two assay kits for thermostable direct hemolysin (TDH) as an
      indicator of TDH-related hemolysin (TRH) produced by Vibrio parahaemolyticus.
AB  - Reversed passive latex agglutination (RPLA) or enzyme-linked immunosorbent assay
      kits with beads (Bead-ELISA) are commercially available in Japan to detect the
      thermostable direct hemolysin (TDH) produced by Vibrio parahaemolyticus isolates.
      We evaluated whether these kits can be used to assay the pathogenic toxin, TDH
      related hemolysin (TRH), produced by some so-called Kanagawa phenomenon-negative
      V. parahaemolyticus strains isolated from patients with diarrhea. Our results
      showed that the two kits, RPLA and Bead-ELISA, can detect TRH, although they were
      originally developed for detection of TDH. This may be due to the use of
      polyclonal anti-TDH antisera that cross react with TRH. Although the sensitivity
      for TDH detection by RPLA and Bead-ELISA differed tenfold, that for TRH detection
      was essentially equal. The minimum concentration of TRH required for detection by
      the two assay kits was about 10 ng/ml.

PMID- 7783690
TI  - Characterization of an enterotoxin produced by Vibrio cholerae O139.
AB  - A cholera-like enterotoxin was purified from Vibrio cholerae O139 strain AI-1841
      isolated from a diarrheal patient in Bangladesh. Its characteristics were
      compared with that of cholera toxins (CTs) of classical strain 569B and El Tor
      strain KT25. Al-1841 produced as much toxin as O1 strains. The toxins were
      indistinguishable in terms of their migration profiles in conventional
      polyacrylamide gel disc electrophoresis, sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis and isoelectrofocusing as well as their affinity for
      hydroxyapatite. The skin permeability factor activity and the fluid accumulation
      induced in rabbit ileal loops of the toxin of AI-1841 were identical to those of
      the CTs. Three toxins equally reacted against anti-569B CT antiserum in Western
      blotting, and their B subunits formed a precipitin line against any anti-B
      subunit antiserum by double gel immunodiffusion. Anti-569B CTB antibody
      neutralized the three toxins in their PF activities and enterotoxicities. The
      amino acid sequence of 1841 toxin B subunit was identical with that of KT25 CTB,
      corresponding to the DNA sequence of ctxB from El Tor strains of the seventh
      pandemic. We concluded 1841 toxin was identical to CT of the seventh pandemic El
      Tor vibrios.

PMID- 7783691
TI  - Different sensitivity of complement to Salmonella typhimurium accounts for the
      difference in natural resistance to murine typhoid between A/J and C57BL/6 mice.
AB  - The difference in natural resistance to Salmonella typhimurium between S.
      typhimurium-resistant A/J mice and S. typhimurium-susceptible C57BL/6 mice was
      analyzed. In both strains, the growth of S. typhimurium was controlled in the
      spleen until 48 hr of infection, while serum C3b levels were increased in A/J
      mice immediately after infection but not in C57BL/6 mice. Incubation of A/J mouse
      serum with S. typhimurium or its lipopolysaccharide (LPS) generated sufficient
      amounts of C3b, but that of C57BL/6 mouse serum with them did not. A/J
      macrophages had higher intracellular killing activity in vitro than did C57BL/6
      cells against S. typhimurium pre-opsonized with each corresponding fresh serum.
      However, the cells from both mice exhibited a similar level of killing activity
      against S. typhimurium pre-opsonized with fresh A/J serum or rabbit complement.
      The resistance of C57BL/6 mice was significantly increased by opsonizing S.
      typhimurium with fresh A/J serum or rabbit complement before inoculation. The
      serum level of interferon-gamma (IFN-gamma) in A/J mice was 2.7 times as high as
      in C57BL/6 mice at 48 hr post-infection. Recombinant murine IFN-gamma enhanced
      the intracellular killing activity of macrophages from both mice when S.
      typhimurium was pre-opsonized with fresh A/J serum but not with fresh C57BL/6
      serum. These findings suggest that A/J macrophages exhibit maximal killing
      activity against A/J serum-opsonized S. typhimurium in vivo when the cells are
      activated with IFN-gamma. Therefore, the rapid and sufficient activation of
      complement by Salmonella LPS may render A/J mice more resistant against murine
      typhoid.

PMID- 7783692
TI  - Varicella vaccine.

PMID- 7783693
TI  - Losartan for hypertension.

PMID- 7783694
TI  - Investigation of single and recurrent stone formers.
AB  - A routine programme for investigation of patients with renal stone disease is
      presented. The different steps in this process are determined by the stone
      composition and the patient's previous history of stone formation. Assessment of
      the supersaturation and the crystallization properties are carried out in urine
      collected during a 24-hour period in one 16-hour and one 8-hour sample. The
      programme described in this paper has been formulated with a therapeutic goal in
      mind, whereby expensive and unnecessary procedures are avoided.

PMID- 7783696
TI  - Primary hyperoxaluria.
AB  - Primary hyperoxaluria (PH) is a rare inborn error of amino acid metabolism, now
      genetically defined, that results in excessive production and urinary excretion
      of oxalate. It serves as a model of severe nephrolithiasis that requires
      management of urinary supersaturation to prevent the common outcome of renal
      failure, which can be the presenting finding: the continued oxalate excess than
      causes progressive systemic oxalosis (deposition). Routine kidney transplantation
      almost invariably fails, but a (live donor) protocol that reduces danger of the
      accumulated load of oxalate can reduce the risk of recurrence. The attractive
      (and curative) option of combined kidney/liver transplant has considerably
      greater risk of mortality (in the US), although the European experience is
      considerably better, often employed earlier in the course. Key to appropriate
      decisions are early recognition, certain diagnosis, testing for vitamin B6
      response, and immediate planning for definitive therapy when renal function is
      failing. PH provides one example of the absolute need for workup of the metabolic
      causes of stone disease.

PMID- 7783695
TI  - Pathogenesis and management of hypercalciuric nephrolithiasis.
AB  - Hypercalciuria has long been recognized as an important metabolic derangement
      associated with the formation of calcareous renal stones. Hypercalciuria
      increases the saturation of the urine with respect to stone-forming salts and
      reduces inhibitor activity. There is now ample evidence that 'idiopathic
      hypercalciuria' is a heterogeneous disorder, comprising several entities
      including absorptive, renal and resorptive forms of hypercalciuria. Absorptive
      hypercalciuria is the most common variety, and recent studies suggest that in a
      large subset of these patients, increased intestinal calcium absorption is caused
      by increased production of calcitriol or greater sensitivity to calcitriol (e.g.
      upregulation of vitamin D receptors). Reduced spinal bone density found in these
      patients may relate to increased action of calcitriol on bone or to other
      factors. Since patients with vitamin D-dependent absorptive hypercalciuria may
      develop negative calcium balance when placed on diets restricted in calcium,
      therapy is shifting from severe dietary calcium restriction and sodium cellulose
      phosphate (calcium-binding resin) to thiazides and orthophosphates, which promote
      calcium retention. For each form of hypercalciuria, selective therapy should
      provide the best results.

PMID- 7783697
TI  - Enteric and mild hyperoxaluria.
AB  - Enteric hyperoxaluria complicates extensive disease or resection of the small
      intestine in the presence of an intact colon, and is associated with calcium
      oxalate nephrolithiasis. In addition to hyperoxaluria these patients have a low
      urine volume, low urinary ionic strength and hypocitraturia. Many forms of
      treatment have been recommended, but none has been subjected to a prospective
      clinical trial. Mild idiopathic hyperoxaluria is reported in 8-50% of idiopathic
      calcium oxalate stoneformers. Several pathophysiological mechanisms have been
      proposed, including low dietary calcium and possible oxalate transport defects in
      the gut and/or the kidney. Mild hyperoxaluria, or a high oxalate:calcium ratio in
      the urine, may be particularly important risk factors for calcium oxalate stone
      formation; an approach to the correction of these abnormalities is proposed.

PMID- 7783698
TI  - Urate and calcium oxalate stones: from repute to rhetoric to reality.
AB  - A critical appraisal of the evidence commonly cited to support a link between
      high urate excretion and calcium oxalate (CaOx) urinary calculi is presented. Two
      theories have been invoked to provide a scientific explanation for urate's
      apparent promotory effect. The first proposes that urinary urate crystals promote
      CaOx precipitation by the phenomenon of epitaxy; the second hypothesis is that
      colloidal particles of urate reduce the inhibitory activity of urinary
      glycosaminoglycans (GAGs) which normally prevent the crystallization of CaOx.
      However, to the present, neither has been verified experimentally. More recent
      research from our group has revealed that at normal physiological pH values
      dissolved urate directly promotes CaOx precipitation by the classic 'salting-out'
      effect by enhancing nucleation, growth and aggregation of CaOx crystals. It is
      therefore suggested that the beneficial effect of allopurinol in reducing CaOx
      stone recurrences may be attributed to its lowering the urinary output of urate
      and thereby reducing the probability that CaOx will be salted out of urine,
      rather than to epitaxy or inactivation of urinary GAGs.

PMID- 7783699
TI  - Citrate and renal calculi: an update.
AB  - Citrate is an inhibitor of the crystallization of stone-forming calcium salts.
      Hypocitraturia, frequently encountered in patients with nephrolithiasis, is
      therefore an important risk factor for stone formation. Potassium citrate
      provides physiological and physicochemical correction and inhibits new stone
      formation, not only in hypocitraturic calcium nephrolithiasis but also in uric
      acid nephrolithiasis. Inhibition of stone recurrence has now been validated by a
      randomized trial. Ongoing research has disclosed additional causes of
      hypocitraturia (sodium excess, low intestinal alkali absorption, but not primary
      citrate malabsorption). Moreover, new insights on potassium citrate action have
      been shown, notably that some of absorbed citrate escapes oxidation and
      contributes to the citraturic response, that ingestion with a meal does not
      sacrifice physiological or physicochemical action, that orange juice mimics but
      does not completely duplicate its actions, that potassium citrate may have a
      beneficial bone-sparing effect, that it may reduce stone fragments following
      ESWL, and that danger of aluminum toxicity is not great in subjects with
      functioning kidneys. Finally, the research on potassium citrate has led to two
      promising products, calcium citrate as an optimum calcium supplement and
      potassium-magnesium citrate which may be superior to potassium citrate in the
      management of stone disease.

PMID- 7783700
TI  - Role of nephrocalcin in inhibition of calcium oxalate crystallization and
      nephrolithiasis.
AB  - Kidney cells produce at least three proteins that slow the rate of calcium
      oxalate crystallization. Nephrocalcin (NC), one of the three, is an acidic
      glycoprotein that contains gamma-carboxyglutamic acid (GLA), and inhibits
      nucleation, aggregation and growth of calcium oxalate crystals. Nephrocalcin is
      abnormal in urine of stone-forming patients, in lacking GLA. It acts by absorbing
      to crystal surfaces. NC is produced by cultured renal proximal tubule cells, and
      by some lines of renal carcinoma cells, but its regulation is not yet
      characterized. Its sequence is not known, nor do we known the molecular basis for
      the abnormal character of NC is stone-forming patients. Compared to Tamm
      Horsefall protein and uropontin, the two other inhibitors, NC is very potent, and
      is probably of major importance in protecting kidneys against supersaturations
      caused by normal water conservation.

PMID- 7783701
TI  - Uropontin in urinary calcium stone formation.
AB  - Normal urine is frequently supersaturated with respect to calcium oxalate. Thus,
      urinary inhibitors of crystallization appear to have an important role in
      preventing urinary stone formation. Uropontin was isolated by monoclonal antibody
      immunoaffinity chromatography and has the same N-terminal sequence as osteopontin
      derived from bone. This urinary form of osteopontin is a potent inhibitor of
      calcium oxalate monohydrate crystal growth at concentrations (approximately 0.1
      microM) that normally prevail in human urine. Interaction with calcium oxalate
      monohydrate in vivo was shown by analysis of EDTA extracts of calcium stones.
      Uropontin is an abundant component of calcium oxalate monohydrate stones and
      present in only trace quantities in calcium oxalate dihydrate and hydroxyapatite
      stones. However, the precise role of uropontin in the pathogenesis of urinary
      stone formation is not known and is the subject of ongoing investigations.

PMID- 7783702
TI  - Tamm-Horsfall glycoprotein and calcium nephrolithiasis.
AB  - Available data on the effects of Tamm-Horsfall glycoprotein (THP) on calcium
      oxalate crystallization processes are apparently conflicting. With the main
      emphasis on calcium oxalate crystal aggregation, this review demonstrates that
      THP has a dual role as a modifier of crystal aggregation: in solutions with high
      pH, low ionic strength (IS) and low concentrations of calcium and THP itself, the
      glycoprotein acts as a powerful inhibitor of calcium oxalate crystal aggregation.
      Conversely, low pH, high IS and high concentrations of calcium and THP all favor
      self-aggregation of THP molecules which lowers their inhibitory activity against
      calcium oxalate crystal aggregation. Some patients with severely recurrent Ca
      stone disease excrete abnormal THPs which self-aggregate at levels of pH, IS and
      concentrations of Ca and THP at which normal THPs remain in monomeric form. With
      high Ca concentrations, such abnormal THPs become strong promoters of crystal
      aggregation, since conformational changes in crystal-bound THP molecules induce
      strong viscous binding forces which overcome repulsive electrostatic surface
      charges. By chelating free Ca ions, citrate reduces self-aggregation of THP
      molecules and turns promoting THPs into inhibitors of calcium oxalate crystal
      aggregation.

PMID- 7783704
TI  - Prevention of recurrent calcium stones: diet versus drugs.
AB  - Excessive intakes of meat protein, oxalate and potentially sodium, as well as
      insufficient intakes of vegetables fibers, calcium and fluid all lead to
      increased urinary crystallization. Renal stone disease, however, does not have to
      ensue. The underlying condition in a given patient is of paramount importance to
      allow 'bad eating habits' to lead to nephrolithiasis. Several of these underlying
      abnormalities have been detected so far from which we recently derived the powder
      keg and tinderbox theory. Most of the time, the dietary approach to
      nephrolithiasis allows recurrence of renal stone formation to be prevented. The
      pharmacological approach should be reserved for refractory cases.

PMID- 7783703
TI  - Crystal matrix protein--getting blood out of a stone.
AB  - The short history of crystal matrix protein began in 1991, when it was shown to
      be the predominant protein present in the organic extract of calcium oxalate
      crystals precipitated from fresh human urine. Here, we review what has
      subsequently come to be known about the protein, from its highly specific
      immunohistochemical distribution in the human nephron, to its finding in kidney
      stones, to the discovery of its relationship with the human blood coagulation
      zymogen prothrombin, and, finally, its identification as a urinary form of
      prothrombin activation fragment 1. A vitamin K-dependent glycopeptide, fragment 1
      possesses the so-called GLA domain of its parent molecule; its known properties
      suggest that it may fulfil a determinant role in calcium oxalate urolithiasis as
      a potent urinary inhibitor of crystal growth and aggregation.

PMID- 7783705
TI  - Cystinuria: pathogenesis and treatment.
AB  - Cystinuria is an inherited disorder of cystine and dibasic amino acids involving
      renal and intestinal transport mechanisms. Cystine stones are caused by the
      excessive renal excretion of cystine due to its low solubility in urine. The
      prevalence of homozygous cystinuria appears to vary in different parts of the
      world. Cystine stones frequently occur in the second or third decade of life,
      with an occasional occurrence in infancy and in old age. Urinary cystine
      excretion exceeding 250 mg/g creatinine is usually diagnostic of homozygous
      cystinuria. The goal of treatment is to reduce the urinary cystine concentration
      below its solubility limit (250 mg/l).

PMID- 7783706
TI  - Uric acid nephrolithiasis.
AB  - Uric acid is the end-product of purine nucleotide metabolism in man. The renal
      handling of urate is a complicated process, resulting in a fractional clearance
      of 8.2-10.3%. The anhydrous form is thermodynamically the most stable uric acid
      crystal. Uric acid is a weak acid that ionizes with a Pka at pH 5.75. At the
      normal acidic region, uric acid solubility is strongly increased by urinary pH.
      The prevalence of uric acid stones varies between countries, reflecting climatic,
      dietary, and ethnical differences, ranging from 2.1% (in Texas) to 37.7% (in
      Iran). The risk for uric acid stone formation correlates with the degree of uric
      acid supersaturation in the urine, depending on uric acid concentration and
      urinary pH. Hyperuricosuria is the major risk factor, the most common cause being
      increased purine intake in the diet. Acquired and hereditary diseases accompanied
      by hyperuricosuria and stone disease include: gout, in strong correlation with
      the amount of uric acid excreted, myelo- and lymphoproliferative disorders,
      multiple myeloma, secondary polycythemia, pernicious anemia and hemolytic
      disorders, hemoglobinopathies and thalassemia, the complete or partial deficiency
      of HGPRT, superactivity of PRPP synthetase, and hereditary renal hypouricemia. A
      common denominator in patients with idiopathic and gouty stone formers is a low
      urinary pH. Uric acid nephrolithiasis is indicated in the presence of a
      radiolucent stone, a persistent undue urine acidity and uric acid crystals in
      fresh urine samples. A radiolucent stone in combination with normal or acidic pH
      should raise the possibility of urate stones.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783707
TI  - [The X-ray fluorescence (XRF) spectrometry of biomaterials used in dentistry. 2].
AB  - In this work we analyze the following biomaterial: biomaterials used in this
      study are: reabsorbable Dac Blu, non reabsorbable Dac Blu, non reabsorbable
      atomized Dac Blu, non reabsorbable thin Dac Blu, reabsorbable Biocoral 450,
      Calcitite 2040-12, Orthogel, Apagen, BTF 65, Calcitite 4060-2, Osprogel, Bio-Oss,
      Biostite, Osprovit, Merck Hydroxiapatite. The quantitative XRF analysis was
      performed by a Philips PW 1480 with Rh tube. This research, besides underlining
      the possibility of applying the XRF method to the analysis of biomaterials. This
      study, shows the facility and the rapidity in the preparation of samples and
      standards in the form of tablets to undergo the analysis: furthermore the study
      shows the possibility of verify the analysis on the same sample in the future,
      because the tablet if well conserved, does not deteriorate. We can also verify a
      good analytic accuracy both for the principal elements (Ca, P) and for trace
      elements. The analyses show a moderate variability in the Ca/P ratio in the
      hydroxylapatites, and a greater variability in the secondary and trace elements.

PMID- 7783708
TI  - [X-ray powder diffraction (XRD) in the study of biomaterials used in dentistry.
      3].
AB  - This study considers X-ray power diffraction (XRD) applied to the study of
      mineral-based biomaterials used in odontostomatology. By means of this method the
      following materials were analysed: reabsorbable Dac Blu, non reabsorbable Dac
      Blu, non reabsorbable atomized Dac Blu, non reabsorbable fine Dac Blu,
      reabsorbable Biocoral 450, Calcitite 2040-12, Orthogel, Apagen, BTF 65, Calcitite
      4060-2, Osprogel, Bio-oss, Biostite, Osprovit, Merck Hydroxyapatite. These
      analysis allow the identification of the crystalline phases, the study of the
      crystallinity and the crystal chemistry of the samples prepared as powder
      mixtures. This method permits the determination of the physical chemical and
      crystalline characteristics of these mineral based biomaterials formed by powders
      or transformable in powders. All of this information is indispensable for the
      evaluation of the functional biocompatibility of a biomaterial when its reaction
      in a biological environment is already known. This method has a great number of
      advantages against the traditional methods, marking with solid phases, it does
      not destroy the sample, it does not modify the physical or chemical
      characteristics and gives more information.

PMID- 7783709
TI  - [The characteristics and properties of calcium phosphates in biomaterial
      formulations used in dentistry. 1].
AB  - In this work we present the features and the properties of natural and synthetic
      apatites, which we use in an experimental study of various commercial products
      composed by calcium phosphate. After having considered the general concepts of
      biomaterials and biocompatibility, we describe non biological tests used for the
      characterization of these products. Biomaterials used in this study are:
      reabsorbable Dac Blu, non reabsorbable Dac Blu, non reabsorbable atomized Dac
      Blu, non reabsorbable thin Dac Blu, reabsorbable Biocoral 450, Calcitite 2040-12,
      Orthogel, Apagen, BTF 65, Calcitite 4060-2 Osprogel, Bio-oss, Biostite, Osprovit,
      Merck Hydroxiapatite. Tests used are: X-ray fluorescence (XRF), X-ray diffraction
      (XRD), Fourier transform infrared spectroscopy (FT-IR), thermogravimetric and
      thermodifferential analysis (TG, DTG, DTA), scanner-ing electron microscopy (SEM)
      morphological analysis. Last but not least, we underline the particular features
      of these tests whose interpretation allows a more precise definition of the
      bioactivity of a biocompatible material.

PMID- 7783710
TI  - [The characterization by Fourier-transform infrared vibration spectroscopy of
      mineral-based biomaterials commonly used in dentistry. 4].
AB  - In this study the following biomaterials were analysed by means of Fourier
      transform infrared vibrational spectroscopy (FTIR); they are: reabsorbable Dac
      Blu, non reabsorbable Dac Blu, non reabsorbable atomized Dac Blu, non
      reabsorbable fine Dac Blu, reabsorbable Biocoral 450, Calcitite 2040-12,
      Orthogel, Apagen, BTF 65, Calcitite 4060-2 Osprogel, Bio-Oss, Biostite, Osprovit,
      Merck Hydroxyapatite. The analysis was performed with a Jasco 5300-FTIR. At 64
      readings for spectrum with a 2 cm-1 resolution. By means of this method it has
      been possible to perform a structural study at a molecular level of the
      commercial products mentioned before. The analysis showed which of the samples
      examined had lost the apatite OH- group during production. It also allowed the
      identification of some of the hydroxyapatites examined as carbonate apatites.
      Finally, it allowed the identification and quantification of the organic
      substances in the examined products.

PMID- 7783711
TI  - [The thermal analysis of mineral-based biomaterials used in dentistry. 5].
AB  - In this study the following commercial products were thermo-analysed (TG, DTG,
      DTA): reabsorbable Dac Blu, non reabsorbable Dac Blu, non reabsorbable atomized
      Dac Blu, non reabsorbable thin Dac Blu, reabsorbable Biocoral 450, non
      reabsorbable thin Dac Blu, reabsorbable Biocoral 450, Calcitite 2040-12,
      Orthogel, Apagen, BTF 65, Calcitite 4060-2, Osprogel, Bio-Oss, Biostite,
      Osprovit, Merck Hydroxiapatite. The apparatus utilized was a Setaram TAG 24, in a
      symmetrical set up, which gave the TG, DTG and DTA analysis simultaneously. The
      analysis of all the materials were performed in correct operative conditions. The
      thermo analyses gave useful information about the thermal stability of the
      samples. The TG analysis gave the data relative to the percentage of weight loss
      due to the volatile substances in the samples (H2Oass C, OH-, CO2). The DTG graph
      made it possible to establish the presence of carbonate apatite and/or
      hydroxyapatite or the absence of both the substances. Finally, DTA and DTG
      analyses allowed show the presence of various organic substances. These data were
      very useful to characterize the examined materials and confirmed the extreme
      importance and sensibility of this method.

PMID- 7783712
TI  - [Scanning electron microscopy (SEM) and microanalysis (EDS) applied to the study
      of biomaterials for dental use. 6].
AB  - The study considers the use of scanning electron microscopy (SEM) and EDS
      microanalysis applied to the study of numerous mineral-based biomaterials of
      common use in odontostomatology. The products studied are the following:
      reabsorbable Dac Blu, non reabsorbable Dac Blu, non reabsorbable atomized Dac
      Blu, non rabsorbable fine Dac Blu, reabsorbable Biocoral 450, Calcitite 2040-12,
      Orthogel, Apagen, BTF 65, Calcitite 4060-2, Osprogel, Bio-Oss, Biostite, Ospro
      vit, Merck Hydroxyapatite. By means of SEM it was possible to study the
      morphology and the microchemistry of the various biomaterials so as to have
      information about their physical and chemical characteristics, such as the
      crystalline form, the crystalline aggregations, the space dimensional
      distribution of the pores and check the possibilities of composition variability.
      All of these factors are fundamental to evaluate the functional biocompatibility
      of a biomaterial, once that its performance in a biological environment is known.

PMID- 7783713
TI  - [The specific characteristics determined by nonbiological tests of mineral-based
      biomaterials used in dentistry. 7].
AB  - In this work we relate about the results coming from crystallographic, physical
      and mineral tests taken on following biomaterials used in odontostomatology:
      reabsorbable Dac Blu, non reabsorbable Dac Blu, not reabsorbable atomized Dac
      Blu, not reabsorbable thin Dac Blu, reabsorbable Biocoral 450, Calcitite 2040-12,
      Orthogel, Apagen, BTF 65, Calcitite 4060-2, Osprogel, Bio-Oss, Biostite,
      Osprovit, Merck Hydroxiapatite. The data were obtained using the following tests:
      XRF, XRD, FTIR, TG, DTG, DTA, SEM. The results, although taken on few samples,
      showed that these biomaterials present a variability in some features, which can
      define the structural functionality.

PMID- 7783714
TI  - Laser surgery for retinopathy of prematurity.
AB  - Retinopathy of prematurity (ROP) is a common eye disorder occurring in preterm
      infants. Formally known as retrolental fibroplasia, ROP is defined as a
      vasoproliferative disorder that occurs in the developing retina of premature
      infants' eyes. Until recently, cryotherapy was the recommended treatment for
      infants diagnosed with advancing ROP. Now laser surgery is being used as an
      alternative treatment. This article reviews the pathophysiology, etiology, and
      classification of ROP, considers the pros and cons of laser surgery versus
      cryotherapy, and outlines the experience with laser surgery in our NICU.

PMID- 7783715
TI  - Adhesive tape vs pectin-based barrier use in preterm infants.
AB  - This controlled trial studied 20 premature infants, 28-33 weeks of gestational
      age, over 21 days. It compared the gross skin condition on the side of the face
      where tape was applied directly to the skin to anchor a nasogastric tube to the
      other side, where the tape was applied over a pectin-based barrier. Ninety-four
      percent of the infants had no gross signs of skin breakdown on the side under the
      barrier for as long as 21 days. In contrast, 80 percent of the same infants had
      gross signs of skin breakdown within five days on the side of the face where the
      tape was applied directly to the skin. The results indicate that a pectin-based
      barrier should be applied when tape must be used to anchor equipment in premature
      infants.

PMID- 7783716
TI  - Differential diagnosis: a case study.
AB  - Health care professionals who care for neonates must be able to recognize early
      signs/symptoms that suggest acute illness. Such early recognition and appropriate
      management may improve outcome. This article presents a case study and permits
      the reader to evaluate data and make decisions about diagnoses and treatment.
      Current research-based approaches to management are also discussed.

PMID- 7783717
TI  - Predictors of postnatal head molding in very low birth weight infants.
AB  - This study examined potential predictors of postnatal head molding in very low
      birth weight (VLBW) infants. Occipital-frontal circumference (OFC) and anterior
      posterior (AP) and biparietal (BP) diameter measurements were obtained on 144
      premature infants with birth weights of less than 1,500 gm. Measurements were
      obtained at four days of age (baseline) and weekly until discharge. Increasing
      gestational age, higher birth weight, and delivery by cesarean section predicted
      larger OFC at three weeks of life. Only baseline AP:BP measurements significantly
      predicted AP:BP measurements at week 3 and 5. Within-group t-tests indicated that
      the severity of head molding (as indicated by AP:BP ratio) increased throughout
      the first six weeks of life. Results indicate that postnatal head molding can be
      reliably predicted and that neonates with higher AP:BP ratios at birth are at
      greater risk for continued narrow, elongated head shape.

PMID- 7783718
TI  - Integrating research into clinical practice.

PMID- 7783719
TI  - Vancomycin levels: to monitor or not to monitor.

PMID- 7783720
TI  - The effect of feeding method on the oxygen saturation of the premature infant.

PMID- 7783721
TI  - Get the most out of a literature search using a computerized system.

PMID- 7783723
TI  - Educating secondary caregivers.

PMID- 7783722
TI  - Clinical practice and research.

PMID- 7783724
TI  - A laying off of hands.

PMID- 7783725
TI  - Research utilization: pharmacologic management of neonatal pain.
AB  - Opioids, particularly morphine sulfate and fentanyl, continue to be the most
      commonly used agents for analgesia. Morphine provides greater sedation, and there
      is less of a problem with rigidity of the chest wall than with fentanyl. Morphine
      also has a higher level of tolerance than does fentanyl. Table 2 provides
      considerations for administration of morphine and fentanyl. Sedation for the
      relief of pain without analgesia is not acceptable. Sedation and analgesia
      together may be in the baby's best interest. Before any plan of care is
      implemented, the baby should be evaluated for need based on the amount of current
      respiratory support versus spontaneous respiration. There is evidence in the
      research literature that narcotic administration can be safely carried out in the
      preterm when using intravenous caffeine simultaneously to offset the risk of
      apnea. Others state that there really is no safe therapeutic window for narcotic
      administration in the preterm infant, yet the benefits outweigh the respiratory
      depressant effect. The complication of respiratory depression can be readily
      dealt with through the administration of neonatal Narcan via the intramuscular,
      intratracheal, or intravenous routes.

PMID- 7783726
TI  - Methadone maintenance and breast feeding continued....

PMID- 7783727
TI  - Reflections for Jason.

PMID- 7783728
TI  - Renal physiology Part 1: Structure and function.
AB  - To assess, plan, and implement care of the critically ill neonate, the nurse must
      have a thorough understanding of renal embryology and physiology. This articles
      focuses on the developmental and anatomical structure of the kidney and the
      general physiological activities of the renal components. Renal embryological
      development begins during the 1st week of gestation and continues until around
      the 36th week of gestation. Functional capacity, although not mature, begins
      around the 6th week of gestation. Infants born premature have underdeveloped
      structures and decreased renal function. Comprehending renal anatomy and
      physiology requires a complete understanding of a single nephron, the functional
      unit of the kidney. Each nephron consists of a glomerulus, Bowman's capsule, and
      tubules, which work together to maintain ion balance for cellular function and
      elimination of unwanted substances from the plasma. Renal blood flow, controlled
      by either autoregulation or hormonal control, must remain both rapid and constant
      for glomerular filtration to occur. Alterations in any of these components of
      renal anatomy and physiology will alter the condition of the neonate. Renal
      evaluations are done based on output, urine chemistries, and serum chemistries.
      These evaluations lead to a diagnosis on which the nurse can base her plan of
      care.

PMID- 7783729
TI  - Heat--related illnesses and deaths-United States, 1994-1995.
AB  - Although heat-related illness and death are readily preventable, exposure to
      extreme temperatures causes at least 240 deaths during years with no heat wave. A
      heat wave is defined by the National Weather Service as > or = 3 consecutive days
      of temperatures > or = 90.0 F (> or = 32.2 C). In 1980, 1983, and 1988 (recent
      years with prolonged heat waves), 1700, 556, and 454 deaths, respectively, were
      attributed to heat. This report describes four instances of heat-related illness
      and death that occurred in the United States during 1994 and 1995 and summarizes
      risk factors for heat-related illness and death.

PMID- 7783730
TI  - Update: outbreak of Ebola viral hemorrhagic fever--Zaire, 1995.
AB  - As of June 25, public health authorities have identified 296 persons with viral
      hemorrhagic fever (VHF) attributable to documented or suspected Ebola virus
      infection in an outbreak in the city of Kikwit and the surrounding Bandundu
      region of Zaire (1,2); 79% of the cases have been fatal, and 90 (32%) of 283
      cases in persons for whom occupation was known occurred in health-care workers.
      This report summarizes characteristics of persons with VHF from an initial
      description of cases and preliminary findings of an assessment of risk factors
      for transmission.

PMID- 7783731
TI  - Update: management of patients with suspected viral hemorrhagic fever--United
      States.
AB  - In 1988, CDC published guidelines for managing patients with suspected viral
      hemorrhagic fever (VHF) (1). Pending a comprehensive review of the 1988
      guidelines, this notice provides interim recommendations that update the 1988
      guidelines for healthcare settings in the United States. This update applies to
      four viruses that cause syndromes of VHF: Lassa, Marburg, Ebola, and Congo
      Crimean hemorrhagic fever viruses; although the risk and/or mode of nosocomial
      transmission differs for each of these viruses, the limited data do not permit
      clear distinctions.

PMID- 7783733
TI  - [CG-methylation and mutagenesis of human mitochondrial DNA].
AB  - It is demonstrated that human mitochondrial DNA (mtDNA) exhibits the chain
      asymmetry of TG and CA dinucleotide frequencies presumably due to replicative and
      postreplicative methylation of CG sites of mtDNA and specific mitochondrial
      genome replication. The analysis of population data on human mtDNA variability
      has revealed two mutation flows: one intense G-->A and C-->T and less intense A-
      >G, T-->C and C-->G flows; the letter results in formation of G,C-enriched mtDNA
      palindromic structures and CG dinucleotides. The interaction of these two
      mutation flows through the system of DNA methylation/deamination enables to
      consider the above mentioned processes as a mechanism of DNA evolution
      maintaining certain level of mtDNA diversity in human populations.

PMID- 7783732
TI  - [Results of work on the project "Instruments, reagents, probes" of the state
      scientific-technical program "Human genome" (1989-1994)].
AB  - This report reviews the activities of the "Reagents, Devices, Probes" branch of
      the Russian State "Human Genome" Project for six-year period (1989-1994). Data on
      pilot and commercial production of reagents and equipment for human genome
      studies along with information on the project costs and awarded grants are
      presented.

PMID- 7783734
TI  - [Determination and analysis of the primary structure of a genomic sequence
      adjacent to the 3'-end of the human tissue plasminogen activator gene].
AB  - Primary structure was determined for the recently cloned f1/BglII-fragment [19]
      containing 2102 b.p. of the human tissue plasminogen activator (tPA) gene 3' end
      and adjacent DNA region. Computer analysis has revealed an Alu-repeat 820 b.p.
      downstream the tPA gene; the sequence proved to have a considerable homology (86
      88%) with the Alus from the 3'-untranslated regions (3'UTRs) of cytochrome P-450,
      lysozyme and p53 protein human mRNAs. The same homology was estimated for this
      Alu in reversed orientation and Alus from the 3'UTRs of some other human mRNAs.
      In contrast, the homology between this 3' end tPA gene flanking Alu-repeat and
      other Alus dispersed throughout the gene introns either direct or reversed, was
      less than 70%. The polyadenylation signal AATAAA downstream the Alu and two
      nearby signals CACAG and GTGTT resembling consensus sequences CACAG and YGTGTTYY,
      respectively, were also detected. The two latter motifs located close to the 3'
      ends in most mammalian genes are likely to regulate mature mRNA formation. The
      comparison of the sequenced spaser flank adjacent to the tPA gene with short
      homologous sequence from the same genomic region primary structure reported
      previously has revealed discrepancies (substitutions, deletions or insertions) in
      21 nucleotide positions. The nucleotide sequence of E. coli uvrB gene fragment
      (980 b.p.) is also reported. This E. coli gene fragment was cloned accidentally
      within the f1/BglII-fragment being an artifact of the host-vector system used.

PMID- 7783735
TI  - [The critical significance of a conserved single-stranded interdomain linker in
      the 5'-untranslated region of poliovirus RNA].
AB  - Translation of polioviral RNA is initiated by interaction of a small ribosomal
      subunit with internal segments of the 5'-untranslated region (5'UTR). Several
      mutations were constructed within 5'UTR segment 425-449. All of them (including a
      single C444-->U replacement) inhibited in vitro translation, which decreased
      about 10-fold. Two mutant constructs, pPV12-05 (C444-->U) and pPV12K (containing
      also an AAUU insert between positions 441 and 442) produced plaques on monolayers
      of susceptible cells. All the viruses isolated from these plaques exhibited a
      reversion at position 444; the template activities of the revertant RNAs were
      restored completely or significantly. The results show the importance of the
      relevant 5'UTR segment for the initiation of polioviral RNA translation.

PMID- 7783736
TI  - [The mutagenic activity of N4-(4-aminobutoxy)-2'-deoxycytidine-5'-triphosphate].
AB  - We have shown that deoxycytidine-5'-triphosphate modified by O-(4
      aminobutyl)hydroxylamine in the pyrimidine ring, is effectively incorporated into
      DNA synthesizing in vitro, replacing deoxythymidine-5'-triphosphate or
      deoxycytidine-5'-triphosphate and inducing A-->G and G-->A transitions,
      respectively. UV spectroscopy and NMR spectroscopy have shown that the modified
      cytidine-5'-triphosphate is identical to N4-(4-aminobutoxy)-2'-deoxycytidine-5'
      triphosphate. When the modified deoxycytidine-5'-triphosphate was inserted into
      DNA in vitro by DNA polymerase I of E. coli Klenow fragment, retardation sites
      correlating with poly-A sites (when the modified triphosphate replaced
      deoxythymidine-5'-triphosphate) or with poly-G sites (when it replaced
      deoxycytidine-5'-triphosphate) were revealed. Our data show high mutagenic effect
      of the modified deoxycytidine-5'-triphosphate inserted into DNA, allowing us to
      recommend this compound for localized static mutagenesis.

PMID- 7783737
TI  - [Cloning and analysis of the nucleotide sequence of the segment in the Mycoplasma
      gallisepticum genome containing the gene for the ATP-binding subunit of DNA
      topoisomerase type II (topIIB)].
AB  - M. gallisepticum genome fragment carrying complete coding sequence for ATP
      binding subunit of topoisomerase II (topIIB), partial coding sequence for N
      terminal part of A-subunit of topoisomerase II and region upstream of topIIB gene
      (open reading frame encoding 99 amino acids) was sequenced. The nucleotide
      sequence of topIIB has significant homology with previously reported gyrase genes
      and parE gene of E. coli. No protein sequence significantly similar to the open
      reading frame upstream from the gene topIIB was found in GeneBank data.

PMID- 7783739
TI  - [Study of the interaction of a DNA molecule with coordination compounds of
      divalent platinum. I. Effect of cis-diaminodichloroplatinum on molecular
      parameters of DNA in solution].
AB  - DNA interaction with cis-diaminodichloroplatinum (cis-DDP in solutions of
      different ionic strength was studied by flow birefringence, viscometry, circular
      dichroism. Though cis-DDP is not an electrolyte, electrostatic interactions are
      important for binding of cis-DDP with DNA probably for transporting cis-DDP to a
      macromolecule. The charges aqua-complex is formed by cis-DDP. The complexation
      being dependent on the platinum/DNA ratio in solution. Along with the increase of
      platinum concentration, it forms first the complexes with phosphate groups, then
      with bases without destruction of the DNA secondary structure. The next type of
      complex formation is accompanied by the local destruction of the hydrogen bonds
      and stacking interactions. And when the Pt/DNA ratio grows high enough, DNA is
      denatured. It is suggested that the stability of the complex is provided by
      nitrogen groups of the bases incorporated in the platinum first coordination
      sphere. The phosphate DNA groups play the role of counterions in the external
      coordination sphere.

PMID- 7783740
TI  - [A synthetic zinc chelating peptide competes for DNA binding sites with
      antibiotics, adsorbed in a minor DNA groove].
AB  - Effects of sibiromicyn, distamicyn A and its analogs on binding to DNA and to
      poly(dA).poly(dT) are reported for a 23-amino acid synthetic zinc-binding
      peptide, a part of the DNA-binding domain of the transcriptional activator GAL-4.
      Circular dichroism and fluorometry have shown that the synthetic peptide and two
      distamicyn A analogs compete for binding sites on DNA and on poly(dA).poly(dT).
      Antibiotic sibiromycin which forms a covalent bond with a guanine 2-amino group
      in the minor DNA groove can displace the peptide from a 19 bp self-complementary
      oligonucleotide serving as a specific target site for Gal-4 protein. The peptide
      is shown to bind to a glucosylated phage T2 DNA, but its affinity to T2 DNA is
      weaker than to calf thymus DNA under the same conditions. A method to estimate
      binding constant and size of the binding site for the synthetic peptide and
      poly(dA).poly(dT) is proposed based on the binding isotherms of distamycin
      analogs in the absence and in the presence of the peptide. Using isotherms of
      binding to poly(dA).poly(dT) for two distamycin analogs with binding constants
      differing 60-fold, the binding constant of the peptide in the presence of 0.1 M
      NaCl is estimated as 1.4.10(7)-1.8.10(7) M-1.

PMID- 7783741
TI  - [The possible role of rare tautomers of DNA bases in mutagenesis: study of the
      effect of hydration on tautomeric equilibrium by the Monte-Carlo method].
AB  - Monte Carlo simulation of hydration of keto and enol tautomers of 9-methylguanine
      (G) and 1-methyluracil (U) has been performed in relation to a possible role of
      tautomer transitions of DNA bases in mutagenesis. The comparison of the
      simulation results with published experimental data and results of quantum
      mechanical computations leads us to conclusion about difference in the origins of
      keto-form prevalence in water solutions of G and U. Such a reason for uracil
      (thymine) is a greater intrinsic stability of keto tautomer while the more
      preferable hydration of keto form of G is the reason of its predominance. As a
      consequence, during biosynthesis less hydrophylic environment (as compared to
      water solution) can be a reason for guanine transition into enol form and can
      result in mispair formation. Such a mutation mechanism is of a minor probability
      through thymine (uracil) tautomerization.

PMID- 7783738
TI  - [Study of conformation transitions in proteins by tryptophan fluorescence and
      phosphorescence at low temperatures].
AB  - The well-known conformational changes in proteins containing a single tryptophan
      residue, such as pH-induced N-->F transition in human serum albumin, pH-induced
      acidic transition in cod parvalbumin, and KCl-induced tetramerization of bee
      venom melittin were monitored by changes in low temperature phosphorescence and
      fluorescence spectra suggesting two independent series of normal components.
      Parameters of low temperature tryptophan luminescence were sensitive to
      chromophore environment. A correlation of changes of some spectral parameters
      with accessibility of tryptophan to water was revealed, however, spectral changes
      mainly depend on specific interactions of the chromophore with its environment.

PMID- 7783742
TI  - [The mechanism of tautomeric transitions of nucleic acid bases with limited
      access to water molecules].
AB  - Pathways of tautomeric transformations of nucleic acid bases have been considered
      in the conditions when only few separate water molecules can interact with the
      bases. Field ionization mass-spectrometric study has demonstrated that
      substitution of one of the labile hydrogen atoms for deuterium takes place when
      thymine (or 1-methylthymine) interacts with heavy water in vacuo. This
      observation was explained by a supposition that a transient water-thymine complex
      is formed and then tautomeric transition of the base occurs via double proton
      transfer along hydrogen bonds. Calculations of the interaction energy between
      base and water molecules allowed us to suggest the structure of such a complex in
      which water molecule lays in the plane of the base. Formation of such complexes
      during biosynthesis of nucleic acids can give rise to point errors, probability
      of their appearance being dependent on the structure and properties of a
      macromolecular DNA-enzyme-nucleotide complex.

PMID- 7783743
TI  - [Production of biologically active recombinant ricin B-chain].
AB  - Escherichia coli cells transformed with plasmids containing ricin B-chain coding
      sequences are shown to express this heterologous protein in inclusion bodies.
      After denaturation and renaturation of the product in the presence of glutathione
      and lactose, the recombinant ricin B-chain is soluble, biologically active and
      stable. Cytotoxicity of heterodimer containing this protein and ricin A-chain is
      found to be only ten times lower, than that of native ricin. Recombinant B-chain
      alone was nontoxic to cells (ID50 > 10(-6) M). Our data suggest that ricin B
      chain oligosaccharides are essential for stability preserving protein from
      proteolytic degradation in cells.

PMID- 7783745
TI  - [Analysis of stationary kinetics of translation elongation within the framework
      stereospecific stabilization hypothesis of codon- anticodon complexes in a
      ribosome. I. Kinetic schemes of factorless elongation].
AB  - Dependences of steady-state rates of polypeptide elongation on concentrations of
      substrate (aminoacyl-tRNA) and product (deacylated tRNA) in the absence of
      elongation factors and GTP are theoretically analyzed in context of
      stereospecific stabilization of the codon-anticodon complexes at a ribosome.
      General kinetic scheme and different ribosome isomerization stages are examined.
      The effect of isomerization stage allows to identify reaction stage
      experimentally. Regulation of the direct reaction by product and regulation of
      the reverse reaction by substrate are possible. Under certain conditions
      elongation system may show kinetic cooperativity.

PMID- 7783744
TI  - [Reactions of 5'-H-phosphonates, 5'-F-phosphates, and 5'-phosphates of modified
      thymidines in human blood plasma].
AB  - Mechanisms and rates of hydrolytic dephosphorylation of 5'-hydrogen phosphonates,
      5'-fluorophosphates, and 5'-phosphates of 3'-azido-3'-deoxythymidine, 3'-fluoro
      3'-deoxythymidine, and thymidine in human blood serum were investigated. 5'
      Hydrogen phosphonates of 3'-substituted thymidines are dephosphorylated 50-100
      times slower than the corresponding 5'-phosphates. 5'-fluorophosphates of 3'
      substituted thymidines are dephosphorylated 2 times slower than corresponding 5'
      phosphates; first, substituted thymidine 5'-phosphates are formed, which are
      later dephosphorylated into substituted thymidines. These data illustrate
      probable molecular mechanisms of anti-HIV action of such nucleotides. 5'-hydrogen
      phosphonates of thymidines can serve as depot forms of corresponding thymidines,
      but other metabolic pathways are not excluded. Thymidine 5'-fluorophosphates can
      serve as depot-forms of both thymidines and their phosphates. Their fate in cells
      depends probably on their diffusion and on the activities of dephosphorylating
      and phosphorylating enzymes.

PMID- 7783746
TI  - [Analysis of stationary kinetics of translation elongation within the framework
      of the stereospecific stabilization hypothesis of codon- anticodon complexes in a
      ribosome. II. Kinetic schemes in the presence of protein elongation factors and
      GTP].
AB  - Kinetics of the factor-dependent polypeptide elongation is theoretically studied
      in context of stereospecific stabilization of the codon-anticodon complexes at a
      ribosome. Kinetic schemes for the different ribosome isomerization stages are
      examined. The dependence of steady-state elongation rate on elongation factor
      concentration for each of the schemes is unique, allowing to identify
      isomerization stages experimentally.

PMID- 7783747
TI  - [Formation of 8-hydroxyguanine upon damage of guanine nucleotides by gamma
      radiation].
AB  - Formation of 8-hydroxyguanine derivatives caused by the exposure of aqueous
      solutions of guanine nucleosides and nucleotides (Guo, dGuo, GMP, dGMP, GDP, and
      GTP) to gamma-radiation was studied by differential UV-spectroscopy. 8
      hydroxyguanine had linear dose-yield relationship with G-value (radiation
      chemical yield) of 0.2-0.4 molecules per 100 eV. Data on irradiation of D2O
      solutions of nucleotides show that the mechanism of gamma-radiation-induced
      formation of 8-hydroxyguanine is probably different from that of heat-induced
      one. Levels of intracellular guanine nucleotide pool damage caused by natural
      background radiation and induced by heat were compared for different
      temperatures. Level of DNA precursor pool damage by natural background radiation
      at 37 degrees C is insignificant and comprises approximately 0.2% of the heat
      induced damage but rises sharply as the temperature decreases. The possible
      biological consequences of gamma-radiation-induced damage of guanine and
      deoxyguanine nucleotide cell pools are discussed.

PMID- 7783748
TI  - [Group-selective immunoanalysis].
AB  - The new solid-phase immunoassay technique has been applied for antidigoxin
      monoclonal antibodies (Mabs) detection. At the first assay step, antidigoxin Mabs
      (IgG1, Kaff = 9.2 x 10(9) M-1) bound with specially prepared immunosorbent:
      microtiter plates with adsorbed digoxin-human serum albumin conjugate, in which
      free amino groups were blocked by glutaraldehyde (the microtiter plates with
      immobilized conjugate were treated for 3h by 2.5% glutaraldehyde at 45 degrees C,
      this had no significant effect on the immunological properties of
      immunosorbents). After antigen-antibody reaction and solid phase separation, free
      amino groups were located only at the antidigoxin Mabs bound to GSI
      immunosorbent. At the second assay step, N-hydroxysuccinimide-biotin ester
      solution was added to bind with the free amino groups. After separation at the
      third assay step, biotin labels were detected by the streptavidin-peroxidase
      conjugate. The method does not require second labeled antibodies and may be used
      for anti-hapten screening.

PMID- 7783749
TI  - Single peptide and anti-idiotype based immunizations can broaden the antibody
      response against the variable V3 domain of HIV-1 in mice.
AB  - The third variable (V3) domain of the human immunodeficiency virus type 1 (HIV-1)
      external envelope glycoprotein gp120 is a major target of neutralizing antibodies
      in infected persons and in experimental immunized animals. Given the high degree
      of sequence variability of V3, the humoral response toward this region is very
      type-specific. In the present study, we evaluated the potential of a single
      peptide and an anti-idiotypic antibody to broaden the anti-V3 antibody
      specificity in BALB/c mice. We show that a synthetic peptide derived from the V3
      determinant of HIV-1 MN isolate (V3MN), when used as an immunogen, was able to
      induce an antibody response to multiple (up to six) HIV-1 strains. The extent of
      this cross-reactivity, which tended to enlarge as the injections increased,
      appeared to be inversely correlated with the binding affinity to V3MN peptide.
      These data thus present evidence that, despite its great sequence heterogeneity,
      the V3 loop encompasses conserved amino-acid positions and/or stretches which may
      be less immunogenic than their variable counterparts. We additionally demonstrate
      that a rabbit anti-idiotype (Ab2), recognizing a binding site related idiotype on
      a V3-specific mouse monoclonal antibody (Ab1), could mount a broadened humoral
      response (Ab3) in mice. Unlike nominal antibody Ab1 which strictly reacted with
      the European HIV-1 LAI isolate, elicited Ab3 recognized the two divergent HIV-1
      strains SF2 and 1286, originating respectively from North America and Central
      Africa, in addition to LAI. The reasons accounting for this Ab2-induced
      enlargement of the V3 antibody response are discussed. Our findings suggest that
      single peptide and anti-idiotype based immunizations may provide viable
      approaches to overcome, at least in part, HIV epitope variability.

PMID- 7783750
TI  - Evidence that the hinge region plays a role in maintaining serum levels of the
      murine IgG1 molecule.
AB  - The site of the murine IgG1 molecule that regulates catabolism has recently been
      shown to encompass amino acids that are located at the CH2-CH3 domain interface.
      The CH2 and CH3 domains are connected to each other by a relatively flexible
      "mini-hinge" region, and flexibility in this region could clearly affect the
      orientation of the domains with respect to each other. The internal movement of
      the CH2 domain depends on the absence/presence of the hinge disulphide. The
      increased mobility of the CH2 domain relative to the CH3 domain in a hinge less
      IgG or Fc fragment may result in a conformational change at the CH2-CH3 domain
      interface and alter the accessibility of the residues that are involved in
      catabolism control. To investigate this possibility, four Fc fragments which
      differ in the presence/absence of hinge disulphides and hinge sequences have been
      analysed in both in vivo pharmacokinetic studies and in vitro by limited
      proteolysis with pepsin. The data show that the presence of hinge disulphide(s)
      in the Fc fragment results in a longer intravascular half life but a higher
      susceptibility to pepsin attack. This, taken together with the knowledge that
      pepsin cleaves close to the CH2-CH3 domain interface, suggests that the longer
      half life of disulphide linked Fc fragments relative to unlinked fragments may be
      due to conformational differences in this region of the IgG molecule, and these
      conformational changes may affect the accessibility of the catabolic site for
      binding to putative protective Fc receptors.

PMID- 7783751
TI  - Immunoglobulin isotype switching in xid mice.
AB  - Mice with the x-linked immunodeficiency mutation (xid) are unresponsive to
      polysaccharide antigens, lack a subset of B cells, and have low serum IgM (2-20%
      of normal) and IgG3 (3% of normal). Because of the disproportionate reduction of
      IgG3, the ability of B cells from xid mice to switch to gamma 3 was examined.
      Switching was indirectly measured by comparing IgG3 production and C gamma 3 mRNA
      steady state levels of purified B cells activated to switch to IgG3 by LPS in
      bulk culture. Direct measurement of switching was achieved by enumerating on a
      percentage basis switched cells in a filter disk culture assay and by FACS
      analysis. In both bulk culture and the filter disk assay, switching to gamma 3
      was equivalent between xid and non-xid B cells.

PMID- 7783752
TI  - Quantitative polymerase chain reaction analysis reveals marked overexpression of
      interleukin-1 beta, interleukin-1 and interferon-gamma mRNA in the lymph nodes of
      lupus-prone mice.
AB  - The nature of the stimuli driving autoantibody production in systemic lupus
      erythematosus (SLE) is unclear, but cytokines are believed to play an important
      role. Since cytokines primarily appear to act locally at the tissue level, we
      analysed mRNA expression of several cytokines (IL-1 alpha, IL-1 beta, IL-2, IL-4,
      IL-5, IL-6, IL-10, IFN gamma, TNF alpha, TNF beta and TGF beta 1) in the lymph
      nodes of lupus-prone mice, in models of early onset disease. We constructed a
      multispecific competitor fragment that allowed quantification of these cytokine
      transcripts by competitive PCR assay. The results reveal considerable
      overexpression of IL-1 beta, IL-10 and IFN gamma transcripts in SLE-prone MRL
      lpr/lpr (MRL/l) and BXSB male (BXSBm) mice, but with some strain differences. IFN
      gamma was most markedly augmented in MRL/l mice (in some cases over 100-fold
      greater than control mice), IL-1 beta was most severely overexpressed in BXSBm
      mice while IL-10 was equally increased in both strains. In addition, TGF beta 1
      expression was moderately elevated in the lymph nodes of BXSBm (but not MRL/l)
      mice. We found no abnormality in the expression of the other cytokines. Cytokine
      transcript levels were only slightly altered at 4 weeks of age, but were elevated
      from 10 to 22 weeks of age. The latter phase corresponds to a period where lupus
      like disease escalates, resulting in frequent mortality. Interestingly, our
      results do not reveal a clear Th1 or Th2 cytokine expression pattern in these
      lupus-prone mice. IL-1 beta, IFN gamma and IL-10 are pleiotropic cytokines with
      pro-inflammatory and B-cell stimulatory effects. These results point to certain
      cytokines as potential targets for immunotherapy in lupus.

PMID- 7783753
TI  - Recombinant allergen Lol p II: expression, purification and characterization.
AB  - Pollen from perennial rye grass (Lolium perenne) is a major cause of type I
      allergies worldwide. It contains complex mixtures of proteins, among which Lol p
      II is a major allergen. Previously, we have reported the cloning and sequencing
      of Lol p II and its expression in fusion with the heavy chain of human ferritin
      as carrier polypeptide (Sidoli et al., 1993, J. biol. Chem. 268, 21819-21825).
      Here, we describe the expression, purification and characterization of a
      recombinant Lol p II overproduced as a non-fusion protein in the periplasm of E.
      coli. The recombinant allergen was expressed in high yields and was easily
      purified in milligram amounts. It competed with the natural Lol p II for binding
      to specific IgE, and it induced allergic responses in skin prick tests,
      indicating to be immunologically analogous to the natural protein. Biochemical
      analyses indicate that recombinant Lol p II is a highly stable and soluble
      monomeric molecule which behaves like a small globular protein.

PMID- 7783754
TI  - Effect of VH and VL consensus sequence-specific primers on the binding and
      neutralizing potential of a single-chain FV directed towards HuIFN-gamma.
AB  - We have previously reported on the cloning and bacterial expression of a
      biologically active scFv antibody fragment (scFv-D9D10) derived from the mouse
      anti-human interferon-gamma (HuIFN-gamma) antibody, D9D10. Since the variable (V)
      regions were isolated by means of VH and VL consensus sequence-specific PCR
      primers and cloned in an expression vector relying on primer-incorporated
      restriction sites, some amino acids (aa) at the N- and C-terminal ends of the
      cloned V domains were expected to differ from the corresponding ones in the
      natural D9D10 antibody. Therefore, the naturally occurring sequences of both V
      domains were isolated by means of traditional cDNA synthesis procedures. In
      comparison with scFv-D9D10, the "natural" V sequences differed in three aa in VH
      and three in VL. The V domains of scFv-D9D10 were adapted to their natural
      sequence by means of PCR-directed mutagenesis to yield scFv-D9D10N. Comparison of
      the binding and neutralizing potentials of both antibody fragments did not reveal
      differences in either of both activities. In addition, their affinities for HuIFN
      gamma were found to be equal. These results show that murine VH and VL consensus
      specific primers can yield antibody fragments having functional properties
      equivalent to those of the natural scFv. Information on the impact of the use of
      V-specific primers on kinetics of interaction between the recombinant antibody
      and the corresponding antigen is important for the development of most engineered
      antibodies or their fragments.

PMID- 7783755
TI  - Isolation and characterization of a new basic antigen from short ragweed pollen
      (Ambrosia artemisiifolia).
AB  - A new basic antigen with a molecular weight of 36.5 kDa and a pI of 8.65 was
      purified from short ragweed pollen using ammonium sulfate precipitation, Q
      sepharose chromatography and S-sepharose chromatography. The purified protein,
      herein referred to as Ambrosia artemisiifolia basic antigen (AaBA), migrated as a
      single band in SDS-polyacrylamide gel electrophoresis and isoelectric focusing,
      and as a single peak on reverse phase HPLC. AaBA reacted with sera from humans
      allergic to ragweed pollen including pooled NIH serum. AaBA and two major acidic
      allergens, Amb a I (antigen E) and Amb a II (antigen K), displayed immunological
      cross-reactivity inasmuch as they competed significantly with each other in a
      competition ELISA. This suggests that at least some major epitopes in all three
      antigens are similar; however, other possibilities like adjacent location of
      different epitopes cannot be ruled out at this time. Molecular weight, amino acid
      composition and sequence data suggest that AaBA is very similar to Amb a II
      whereas it is significantly different from other basic antigens purified from
      ragweed pollen.

PMID- 7783756
TI  - Characterization of class I MHC folding intermediates and their disparate
      interactions with peptide and beta 2-microglobulin.
AB  - Newly synthesized class I heavy chains achieve domain structure using disulfide
      bonds, assemble with beta-2 microglobulin (beta 2m), and bind peptide ligand to
      complete the trimeric complex. Although each of these initial events is thought
      to be critical for class I folding, their sequential order and effect on class I
      structure are unknown. Using mAb specific for distinct conformations of H-2Ld and
      Lq, we have defined folding intermediates of class I molecules. We show here that
      non-peptide-associated forms of Ld or Lq, detected by mAb 64-3-7 and designated L
      alt, lack numerous conformational epitopes surrounding their ligand binding
      sites. These results support the notion that L alt molecules have an open
      conformation. Interestingly, a significant proportion of L alt molecules were
      detected in association with beta 2m and these L alt/beta 2m heterodimers were
      preferentially folded by peptide in cell lysates. These findings indicate that
      class I heavy chain/beta 2m association can precede ligand binding and that
      peptide is probably the limiting factor for completion of the Ld/beta 2m/peptide
      trimeric complex in vivo. The characteristics of L alt molecules were
      investigated further by ascertaining the disulfide bond status of these molecules
      and their association with beta 2m and peptide. Treatment of cells with
      dithiothreitol (DTT), a membrane-permeable reducing agent, demonstrated that L
      alt molecules constitute a heterogeneous population including reduced, partially
      reduced and native class I molecules. Furthermore, partially reduced Ld alt
      molecules, in a cell line expressing a mutant Ld molecule lacking the alpha 2
      domain disulfide bond, accumulated intracellularly, were not beta 2m-associated
      and displayed marginal peptide-induced folding in vitro. In accordance with this
      latter finding, peptide was found to preferentially convert fully disulfide
      bonded forms of Ld alt to conformed Ld. Thus, we propose that intrachain
      disulfide bond formation precedes the association of class I heavy chain with
      beta 2m and peptide, and that disulfide bond formation is required for efficient
      assembly, ligand binding and folding of the class I heavy chain.

PMID- 7783757
TI  - Dynamical analysis of neuromuscular transmission jitter.
AB  - Utilizing prolonged axonal stimulation single fiber EMG, neuromuscular
      transmission becomes a time-series of interpotential intervals (IPIs). In this
      form, the underlying processes of neuromuscular transmission can be studied using
      standard numerical techniques to determine whether these processes can be
      described by a simple mathematical model. In particular, neuromuscular
      transmission jitter can be examined in this way. In this article, we attempt to
      determine whether healthy jitter is noise or deterministic chaos. The presence of
      deterministic chaos was assessed by analysis of the IPI time-series using visual
      inspection of both phase-space plots and their principal component dimensions,
      and using the Grassberger-Procaccia algorithm to determine the correlation
      dimension of the time-series dynamics. These graphical and mathematical
      techniques provided little evidence for the existence of deterministic chaos.
      Linear autoregression time-series prediction also failed to account for the
      variability of the data and IPI histograms exhibited simple gaussian
      distributions. These results suggest normal neuromuscular transmission jitter is
      the result of intrinsic noise.

PMID- 7783758
TI  - Neurological multisystem manifestation in multiple symmetric lipomatosis: a
      clinical and electrophysiological study.
AB  - Multiple symmetric lipomatosis (MSL) is characterized by a typical neck and
      shoulder distribution of subcutaneous lipomata and is often associated with
      polyneuropathy. Occasionally, the central nervous system (CNS) can be involved.
      Twelve of 14 patients in this retrospective study had clinical or
      electrophysiological evidence of a predominantly axonal polyneuropathy. Among
      those were 10 with alcohol abuse, but 2 patients without alcohol abuse also
      showed clinical or electrophysiological polyneuropathy. Clinical CNS involvement
      was present in 4 patients. CNS dysfunction was documented by evoked potentials in
      8 subjects [prolonged latency or low amplitude of the motor response following
      cortical magnetic stimulation (4 patients), abnormal visually evoked potentials
      (4 patients) or somatosensory evoked potentials (SEP) (4 patients)]. These
      findings were compared to 10 chronic alcoholics without clinical signs of MSL.
      Five of these showed mild sensory neuropathy. Additionally, 2 also had delayed
      SEP latencies. Motor evoked potentials were normal in all controls. We propose
      that the multisystem involvement in MSL demonstrated here cannot be attributed to
      alcohol abuse alone. Biochemical studies have suggested mitochondrial dysfunction
      as the basis of the widespread neurological pathology in MSL.

PMID- 7783759
TI  - Dynamic electromyography and muscle biopsy changes in a 4-year follow-up: study
      of patients with a history of polio.
AB  - Eighteen patients who had had polio 29-56 years prior to the first investigation
      were studied on two occasions, 4 years apart. Isokinetic and isometric strength
      measurements and Macro EMG were performed in 28 legs. Muscle biopsy specimens
      were obtained on both occasions from 11 legs. On average the muscle strength was
      56% of control values at the first examination, and decreased by another 8%
      during the observation period. The muscle fiber area was increased compared to
      that of controls and did not change significantly. Macro EMG, comprising muscle
      fiber area and number of muscle fibers, and/or single fiber EMG showed clear
      signs of reinnervation in all legs. The motor units at the first examination were
      increased 11-fold, on average, compared with age-matched control values. During
      the observation period, reinnervation continued and the size of motor units
      increased by another 56% as a result of ongoing denervation, that is, loss of
      neurons. This compensation was particularly pronounced in patients with stable
      conditions. The parameters studied did not reveal any definite pattern predicting
      future development of new muscle weakness in individual subjects.

PMID- 7783760
TI  - CT muscle imaging and the clinical assessment of neuromuscular disease.
AB  - Twenty patients with neurogenic disorders, polymyositis, or muscular dystrophies
      were assessed clinically and by CT imaging of limb, limb girdle, and trunk
      muscles, using a standard protocol. On each side of these patients 26 movements
      were graded by the MRC scale, and 20 muscles were assessed by CT imaging. The
      clinical and CT findings could be compared, in a blind evaluation, in 10 muscles
      on each side. A quantitative assessment of the CT muscle images were also made.
      The CT images showed striking abnormalities, even in many muscles of normal
      strength by clinical testing. Asymmetrical involvement of muscles was found in
      all the disorders studied, even when not suspected on clinical examination.
      Muscles in patients with muscular dystrophy were more abnormal than those in
      patients with neurogenic disorders. In polymyositis the attenuation values were
      intermediate to the other two groups. A "washed-out" appearance with very low
      attenuation values was very suggestive of muscular dystrophy. Involvement of
      paraspinal and rectus abdominis muscles was uncommon in neurogenic disorders. The
      gracilis muscle was relatively resistant to degeneration. CT imaging can enhance
      the clinical assessment of patients with neuromuscular disease, often revealing
      unexpected abnormalities.

PMID- 7783761
TI  - Lambert-Eaton myasthenic syndrome (LEMS) in association with lymphoproliferative
      disorders.
AB  - LEMS is a presynaptic neuromuscular junction disorder typically associated with
      small cell lung carcinoma. The characteristic electrophysiological abnormality is
      a low amplitude compound muscle action potential that shows a marked increment
      after short maximal contraction or brief tetanic nerve stimulation. Here we
      describe 3 patients who had LEMS in association with lymphoproliferative
      disorder. The first patient had Castleman's syndrome with typical clinical and
      electrophysiological features of LEMS, which responded partially to treatment
      with 3-4-diaminopyridine. The second patient was a 7-year-old boy who had an
      unusual acute onset of LEMS associated with relapse of his Burkitt's leukemia.
      The third patient was a 60-year-old woman with non-Hodgkin's lymphoma. These 3
      patients (together with 6 additional patients identified in the literature) lead
      us to suggest that lymphoproliferative diseases are another, hitherto
      unrecognized, type of malignancy associated with LEMS. Thus, any patient with
      these malignancies and unexplained muscle weakness should have
      electrophysiological evaluation for LEMS.

PMID- 7783763
TI  - Myophosphorylase deficiency associated with rhabdomyolysis and exercise
      intolerance in 6 related Charolais cattle.
AB  - A Charolais calf presented to the Veterinary Medical Teaching Hospital with a
      history of recumbency following forced exercise. The calf was unable to stand,
      and had severe rhabdomyolysis, dehydration, and electrolyte imbalance. Blood
      selenium concentrations were within normal limits. A complete absence of
      histochemical staining for phosphorylase was apparent in muscle biopsies. Five
      other animals in the herd also had exercise intolerance and had a complete
      absence of phosphorylase staining in muscle biopsies. Biochemical analyses
      confirmed a deficiency of myophosphorylase (range 0-0.3 mumol/g per minute:
      normals 15-27) with normal to slightly elevated muscle glycogen concentrations.
      Pedigrees from all affected animals showed a common ancestor on the sire's and
      dam's side of each phosphorylase-deficient animal, suggesting an autosomal
      recessive transmission. Although myophosphorylase deficiency was described in
      humans (McArdle's disease) over 40 years ago, these cattle represent the first
      animal model for this disease.

PMID- 7783764
TI  - Amyotrophic lateral sclerosis is a multifactorial disease.
AB  - Amyotrophic lateral sclerosis (ALS) is probably biphasic. An initial trigger(s)
      is followed by a terminal cascade coinciding with the onset of neurological
      deficits. The terminal cascade involves interactive multifactorial pathogenic
      mechanisms. Aging must play a crucial role leading to multiple defective or
      degraded gene products accumulating with progressing years. This in turn leads to
      failure of receptor integrity and resulting excitotoxicity, free radical
      accumulation, failure of neurotrophism, and possibly immunological disturbances.
      These events are predated by months or years by a trigger which is also likely to
      be multifactorial and cumulative. Evidence suggests that environmental factors
      may be important triggers. Failure of specific glutamate transporters and calcium
      binding proteins may account for selective vulnerability of the
      corticomotoneuronal system. It is postulated that in ALS the primary target cell
      is the corticomotoneuron or the local circuit interneurons which modulate its
      activity. Glia cells may play an important role in the demise of the
      corticomotoneuronal cell. The disordered corticomotoneuron induces excessive
      excitatory transmitter (glutamate?) release at the corticomotoneuronal-spinal
      motoneuronal synapse resulting in the subsequent demise of this neuron.

PMID- 7783762
TI  - Five-year experience in the treatment of focal movement disorders with low-dose
      Dysport botulinum toxin.
AB  - We report the results of botulinum toxin type A (Dysport, Porton Products, UK)
      treatment over 5 years in 107 patients with blepharospasm, Meige's syndrome,
      oromandibular dystonia, hemifacial spasm, cervical dystonia, and writer's cramp.
      Electromyography was used to localize dystonic muscles and guide Dysport
      injections in Meige's syndrome, oromandibular dystonia, cervical dystonia, and
      writer's cramp. All but 2 Meige's syndrome and 2 writer's cramp patients
      responded to treatment. Improvement was dramatic in blepharospasm (79%) and
      hemifacial spasm (90%); pronounced in cervical dystonia (74%); and moderate in
      Meige's syndrome (53%), oromandibular dystonia (57%), and writer's cramp (34%).
      Although Dysport doses were 50-75% lower than usually reported, response and
      improvement rates as well as relapse intervals were similar to those of others.
      To treat cervical dystonia relapses, only 50% of the initial dose was required
      for continued optimal relief of symptoms. Low-dose Dysport was associated with a
      very low incidence of dysphagia in cervical dystonia.

PMID- 7783765
TI  - Mitochondrial encephalomyopathy with autosomal dominant inheritance: a clinical
      and genetic entity of mitochondrial diseases.
AB  - We report a Japanese family with chronic progressive external ophthalmoplegia
      (CPEO) with autosomal dominant inheritance, and review 54 reported CPEO patients
      in seven families (including the present family) with autosomal dominant
      inheritance and mtDNA deletions in the skeletal muscle. Mean age at onset in the
      CPEO was 26 years, which is older than that in published solitary cases. In
      addition to blepharoptosis and external opthalmoplegia, proximal muscle atrophy
      and weakness were found in 62%, hearing loss in 25%, and ataxia in 17% of the
      patients. Retinal degeneration was not found, and cardiac involvement was very
      rare. mtDNA deletions in the muscle were multiple and large scale, and all such
      deletions were located in the non-D-loop region. Autosomal dominant CPEO has
      unique clinical features which differ from those of solitary CPEO, and is
      associated with multiple large-scale mtDNA deletions. Thus, autosomal dominant
      CPEO can be considered a clinical and genetic entity of mitochondrial diseases.

PMID- 7783766
TI  - Limited longitudinal sliding of the median nerve in patients with carpal tunnel
      syndrome.
AB  - During normal movements or changes in position of the limbs, nerve structures
      must accommodate the resulting changes in length of the nerve path. In patients
      with carpal tunnel syndrome, we monitored electrophysiologically the longitudinal
      adjustment of the median nerve to positions of extreme flexion and extreme
      extension of the wrist and elbow, by measuring the differences induced in the
      latency of the sensory nerve action potential (SNAP) recorded in the forearm and
      upper arm. In patients, the latency difference was significantly shorter than in
      normal subjects (0.196 +/- 0.084 ms vs. 0.088 +/- 0.059 ms in the forearm, and
      0.485 +/- 0.122 ms vs. 0.129 +/- 0.086 ms in the upper arm). These results
      indicate that the displacement of the source of the median nerve SNAP with
      movements of flexion and extension is limited in patients with carpal tunnel
      syndrome. Such an abnormality may partly underlie the pathophysiology of
      entrapment syndromes.

PMID- 7783767
TI  - Paradoxical heat sensation in uremic polyneuropathy.
AB  - Sensory aspects of uremic neuropathy were studied in 36 patients using clinical
      assessment and quantitative sensory tests (QST). The outstanding abnormality in
      sensory quality was perception of heat in response to low temperature stimuli.
      This paradoxical heat sensation was found in the foot in 42% (15) of patients,
      far beyond the normal prevalence of 10%. Paradoxical sensation was positively
      related to cold hypoesthesia (P = 0.0004) suggesting disinhibition as a possible
      mechanism. Paradoxical heat sensation also positively related to creatinine level
      (P = 0.0012). Pruritus was present in 20 patients (56%), intensity not related to
      any biochemical or clinical parameter. Signs of sensory polyneuropathy (PNP),
      based on at least two abnormal parameters in the clinical assessment or QST, were
      found in 39% of patients (14), of whom 11 had paradoxical heat sensation. Thus,
      in 4 patients (11%), this sensory aberration preceded other signs for PNP.
      Paradoxical heat sensation seems to be a common and often early expression of the
      sensory neuropathy in uremia.

PMID- 7783769
TI  - Proximal myotonic myopathy syndrome in the absence of trinucleotide repeat
      expansions.

PMID- 7783768
TI  - Cerebrospinal fluid and serum from patients with inflammatory
      polyradiculoneuropathy have opposite effects on sodium channels.
AB  - The effects of cerebrospinal fluid (CSF) and serum from patients having Guillain
      Barre syndrome (GBS) or chronic inflammatory demyelinating polyradiculoneuropathy
      (CIDP) on voltage-dependent Na+ channels were compared. Bathing human myoballs in
      CSF substantially reduced their Na+ currents (by > 40% with 8 of 10 patients)
      elicited at 1 Hz under whole-cell recording conditions. This was because, at the
      resting potential, more Na+ channels were inactivated (left-shift of the h
      infinity curve). CSF from patients with other neurological diseases (OND)
      produces a similar, but smaller, effect. In contrast, serum samples from the same
      GBS and OND patients caused an increase of the Na+ currents by reducing the
      number of Na+ channels inactivated at the resting potential. This right-shift of
      the h infinity curve is in part explained by the effect of serum albumin. We
      confirm that the CSF of most GBS and CIDP patients contains factors inhibiting
      voltage-dependent Na+ currents. There is no indication that such factors are
      effective in the serum of these patients.

PMID- 7783770
TI  - Evidence for low production of lactate and pyruvate in alcoholic rhabdomyolysis.

PMID- 7783771
TI  - F-wave quantitation in neuropathy (a reply)

PMID- 7783773
TI  - Electrophysiological assessment of functional corpus callosum integrity in
      internal hydrocephalus.

PMID- 7783774
TI  - Electrodiagnosis in the management of focal neuropathies: the "wog" syndrome.

PMID- 7783775
TI  - Assessment of variability in the shape of the motor unit action potential, "the
      jiggle," at consecutive discharges.

PMID- 7783772
TI  - On the myofascial origin of muscle cramps.

PMID- 7783776
TI  - Sciatic nerve impingement from piriformis hematoma due to prolonged labor.

PMID- 7783777
TI  - Tarsal tunnel revisited.

PMID- 7783778
TI  - Effect of processing on the composition of dietary fibre and starch in some
      legumes.
AB  - The effect of processing on the total dietary fibre (TDF) insoluble (IDF) and
      water-soluble (SDF) fractions as well as total (TS), available (AS) and resistant
      (RS) starch were studied in three legumes, viz. bengalgram (Cicer arietinum L.),
      Cowpea (Vigna unguiculata) and greengram (Vigna radiata). The processes studied
      were fermentation, germination, pressure-cooking and roasting. The dietary fibre
      (DF) content and its components were determined using the enzymatic-gravimetric
      method. The TS content was determined by the enzymatic method after
      solubilization with KOH. The DF content ranged from 23.2 to 25.6 g/100 g in the
      raw and 16.0 to 31.5 g/100 g in the processed legumes. All the processing
      treatments significantly decreased the SDF content and increased the IDF content
      of all the three legumes. The mean TS, AS and RS content of the raw legumes were
      similar, 46.9, 36.7 and 10.2 g/100 g respectively. AS content of all the legumes
      was reduced by the processing treatments, except pressure cooking.
      Correspondingly, higher amounts of RS were observed in the processed legumes,
      except pressure cooked, resulting in an increase in the TDF content.

PMID- 7783779
TI  - [The quantitative determination of the protein content of milk by means of violet
      spectral photometry. 7. The milk analyzer MAG 100 (Carl Zeiss Jena GmbH)--a
      possibility for simultaneous measurement of protein and fat content in raw milk
      at the dairy farm].
AB  - A new analysing apparatus is introduced, which allows to measure protein and fat
      contents of milk in the dairy farm. The instrument works on the basis of
      ultraviolet spectral photometry. Before measuring the milk sample must be diluted
      with a hydrous detergent solution in the ratio 1:100 and then homogenized.
      Accuracy and precision of the analytic results are influenced by detergent type,
      the water quality of detergent solution, the detergent foam, the air content and
      the pH of detergent solution, the reliability of homogenizer and thermostating
      system, the stability of photometer and by the error of dosage. Also a milk
      standard was developed, which is required for daily calibration of the apparatus.

PMID- 7783780
TI  - Evaluation of functional properties of offal proteins.
AB  - Evaluation of functional properties of beef heart and lip tissue proteins was
      based on the data obtained in the following determinations: protein
      extractability, fat emulsifying capacity, emulsion stability, gel forming
      ability, and water holding capacity after heat treatment. Beef skeletal muscles
      were used as the control. It was found that extractability of proteins of the raw
      materials was low as well as their ability to stabilize emulsions was on a low
      level. Proteins soluble at high ionic strength (fraction HIS) of beef heart and
      lip tissue emulsified 80.7 ml and 68.9 ml of oil/100mg of protein, respectively,
      as compared to 106.6 ml in the control group. Analogically, protein soluble at
      low ionic strength (fraction LIS) emulsified 77.9 ml, 61.2 ml and 100.4 ml of
      oil, respectively. Emulsion stability of offal proteins appeared to be dependent
      on ionic strength. Generally at higher concentrations of salt their ability to
      stabilize emulsions was better as well as their water holding capacity increased.
      Their gelation properties as compared to control were also low. In each case, the
      functionality of cardiac proteins proved to be better than that of beef lip
      tissue.

PMID- 7783782
TI  - Content of some metals in mean tissue of salt-water and fresh-water fish and in
      their products.
AB  - The main goal of this work was to determine the concentration of some metals in
      meat tissue of salt-water and fresh-water fish and in their products. These
      studies refer to 13 species of fish most often eaten in Poland, caught in 1992.
      Fish (samples) for testing and examination were taken from each species once
      every month during the term of 6 months. The lead content in tested fish and
      their products did not exceed the set limits (0.6 mg Pb/kg), which were exceeded
      only in preserve from oyster. The average content of cadmium in flounder, Alaska
      pollack, Baltic herring, pickled herring pieces and in preserves with shrimp,
      crab and oyster exceeded the set limits (0.05 mg Cd/kg). The copper and zinc
      content in tested fish and their products is also within the set domestic limits
      (10.0 mg Cu/kg and 50.0 mg Zn/kg). The iron (3.6-24.2 mg/kg), magnesium (170-380
      mg/kg) and manganese (0.12-0.31 mg/kg) contents in muscle tissue of the tested
      fish and their products seem to be typical. The presence of absolutely toxic
      metals (lead and cadmium) in some species of fish and their products points to
      extreme contamination of water environment by those metals.

PMID- 7783781
TI  - Influence of harvesting and drying techniques on microflora and mycotoxin
      contamination of figs.
AB  - Mould growth and mycotoxin (aflatoxins and ochratoxin A) formation were examined
      in the 1993 dried figs crop. The relationships between mould/mycotoxin
      contamination and orchard conditions, different harvesting techniques, harvesting
      time and intactness of fruits were investigated. The fruits were examined during
      drying and effects of different pretreatments, sun drying and solar drying on the
      mould and mycotoxin contamination in figs were also studied. Aflatoxins (B1, B2,
      G1 and G2) were not present in the firm or shrivelled ripe figs. Among the
      samples examined during drying, only one of the 32 samples was found to be
      aflatoxin positive. Ochratoxin A was not detected in any of the samples analysed.
      The moisture content, aw and pH values of full ripe and shrivelled fruits were
      suitable for mould growth and mycotoxin formation while these parameters in
      pretreated and dried fruits were found to be too low to allow such outcome. It
      was observed that harvesting the fruit by hand-treating with different solutions
      and application of solar drying were effective in reducing contamination level.

PMID- 7783783
TI  - [The psychophysics of sweet taste. 6. Context effects by use of multiple stimuli
      sequences].
AB  - For the determination of differentiation probabilities in a multiple experimental
      design the range of stimuli is a significant source of disturbance. In order to
      determine their efficiency, sequences with 5 equidistant gradated concentrations
      of sucrose were used, which were compared with a basic concentration. The
      probability for each gradation was carried out with help of 2-AFC-technique (60
      pairs each). 5 gradations at 3 basic concentrations with fixed, average balance
      were examined in a factorized experimental design. The frequency of the correct
      judgments is linearily dependent on the sequence of stimuli. In the experimental
      space the slope of this relationships decreases with increasing gradation
      hyperbolically (range-effects). The level of the basic stimuli is in this view
      without any greater importance. When determining the difference thresholds these
      context effects are to be considered.

PMID- 7783784
TI  - On carrots and sticks, and honey and vinegar.

PMID- 7783785
TI  - An interview with Sandra C. Matherly and Shannon Hodges. Interview by Connie C.
      Curran.
AB  - Sandra C. Matherly, MA, RNC, FNP, is senior vice president, business development,
      and Shannon Hodges, MBA, is vice president, clinical development, Nurse On Call,
      Inc., Norcross, GA. Founded in 1993, Nurse on Call is a software and services
      company offering nursing, medical, and business expertise in setting up and
      operating a patient management unit using telecommunications and information
      systems. In this interview, Ms. Matherly and Ms. Hodges discuss the history and
      development of Nurse on Call, and offer advice for starting a successful nurse
      entrepreneur enterprise.

PMID- 7783786
TI  - A cost-effectiveness analysis of acute care case management outcomes.
AB  - Case management was more cost effective in a moderately uncertain practice
      environment than in either a low or a high uncertainty environment. The
      environmental state, case manager role differentiation, and information
      coordination contributed most strongly to these outcomes.

PMID- 7783787
TI  - Economic pressures building in the hospital employed RN labor market.
AB  - Over the past several years, a number of powerful forces have rapidly changed
      hospitals' operating environment. Other forces, stemming from changes in the
      nation's economy and the debate over health care reform, have directly influenced
      RNs' employment activity. The hospital RN labor market has responded quickly and
      hospitals no longer face RN shortages.

PMID- 7783788
TI  - A decentralized model for case management.
AB  - Case management has been implemented in a variety of health care settings. The
      implementation of case management at one hospital, including rationale for
      selection and outcomes, is described here. A decentralized model emphasizing
      staff nurse control is recommended for hospitals with TQM and shared governance
      programs already in place.

PMID- 7783789
TI  - Dimensions of the staff nurse role in ambulatory care: Part II--Comparison of
      role dimensions in four ambulatory settings.
AB  - Ambulatory care nursing is one of the fastest growing and least studied areas of
      nursing practice. Information from a national survey of ambulatory nurses has
      been used to delineate the core dimensions of the current staff nurse role.
      Comparison of practice patterns of ambulatory staff nurses employed in university
      hospitals, community hospitals, physician group practices, and health maintenance
      organizations can provide insights for nurse managers interested in improving
      ambulatory nursing care delivery. Part III of this series, which will be
      published in the July/August 1995 issue, will examine how to use research data to
      design new models of nursing care delivery.

PMID- 7783790
TI  - Stage managing change: supporting new patient care models.
AB  - The scope and accelerated pace of change is providing high drama in health care
      organizations today. The Central DuPage Hospital experience of transitioning to
      patient-focused care was driven by aggressive targets and tight timelines.
      Providing practical, adaptable change management strategies to key players
      ensured a well-staged transition to the new models of patient care.

PMID- 7783791
TI  - Reducing specialty bed use.
AB  - Saint Joseph Hospital is a tertiary care teaching facility with 602 licensed
      beds. In 1992 it was noted that there was a significant rise in the use of
      specialty beds within the hospital. Guidelines for selection, initiation, and
      termination were nonexistent. In an effort to reduce high costs associated with
      specialty bed use a study was conducted to determine appropriate selection
      criteria and monitor patient outcomes.

PMID- 7783793
TI  - Re-engineered out of your job: what next?

PMID- 7783792
TI  - Managing your career as a contingent worker: the nurse manager's challenge.

PMID- 7783794
TI  - A bad month?

PMID- 7783796
TI  - Medicare at risk: to whose benefit?

PMID- 7783797
TI  - [Current treatment of Hirschsprung disease: the end of the stoma period].

PMID- 7783798
TI  - [Oral contraception increases the chance of venous thrombosis in factor V Leiden
      mutation].

PMID- 7783795
TI  - Managed care 'marriage' benefits perioperative nursing.

PMID- 7783799
TI  - [Display screens, eye symptoms, eyeglasses].

PMID- 7783800
TI  - [Diagnosis of lymph node metastasis of head-neck carcinomas].

PMID- 7783801
TI  - [Shortage of lung donors: 3-year experience in the Groningen Academic Hospital].
AB  - OBJECTIVE: To analyse the background of the shortage of donor lungs; to present
      the procedure of allocation of donor lungs in the Eurotransplant region and the
      selection of donor lungs in the lung transplantation programme Groningen. DESIGN:
      Descriptive. SETTING: Groningen University Hospital. METHODS: From March 23, 1991
      to December 31, 1993, the lungs of 279 multi-organ donors were offered to the
      lung transplantation programme of Groningen University Hospital. The assessment
      and selection criteria are presented. RESULTS: Only 35 out of all donor lungs
      offered could be used for transplantation: 24 double and 11 single lung
      transplants. Medical contraindications (notably pulmonary injury and hypoxaemia)
      were present in 155 out of the 244 (64%) lung donors. Forty-five out of 244 (18%)
      lung donors were rejected for logistic reasons, predominantly too little time
      between offer and imposed start of the explantation or long travel time.
      CONCLUSION: Lung donor shortage is the main factor limiting the expansion of lung
      transplantation programmes. Increase of the number of suitable donors can be
      achieved by improving donor recognition and donor management, and by improving
      preservation techniques allowing increased acceptable cold ischaemia periods.

PMID- 7783803
TI  - [Vaginal infection caused by Saccharomyces cerevisiae].
AB  - In a woman of 26, who suffered from a vulvovaginal infection and had previously
      been treated for Candida vaginitis, Saccharomyces cerevisiae was cultured and
      identified. At her work she sold baking yeast. Topical treatment with
      amphotericin B 100 mg suppositories was successful. Microscopic examination (1000
      x) of the discharge in saline showed haloed yeast cells. For treatment, oral
      ketoconazole or topical administration of amphotericin B or clotrimazole, in
      relatively high doses, may be applied. This yeast might be the cause of 'chronic
      candidiasis' more often than suspected, notably in women working in a bakery or a
      brewery.

PMID- 7783802
TI  - [Drug use by mentally handicapped persons in institutions and family-replacing
      residential facilities].
AB  - OBJECTIVE: Description of use of medication by people with mental handicaps in
      relation to age, level of mental handicap and living facility. DESIGN: Cross
      sectional study. SETTING: Institutions and group homes for people with mental
      handicaps in North Brabant and Limburg, the Netherlands. METHODS: Of a patient
      sample (n = 1265), stratified according to age and living facility (i.e.
      institution or group home) data were collected by means of questionnaires to be
      completed by the general practitioners. For 101 persons data about level of
      mental handicap were lacking. RESULTS: 57% of the patients used one or more
      drugs. The numbers of drugs used were significantly related to (increased) age
      and level of mental handicap. Older patients more often used antipsychotics,
      laxatives and cardiovascular medication, younger ones more often used
      anticonvulsants. More severely handicapped persons used antipsychotics,
      anticonvulsants, laxatives, antacids, psychoactive medication and
      gastrointestinal medication more often. There was no relationship between amount
      of medication and living facility. CONCLUSION: Many mentally handicapped use
      medication. Since epilepsy, psychiatric and behavioural diseases and
      gastrointestinal problems are frequent, and because the patients offer little
      spontaneous information, alertness with respect to drug interaction and side
      effects is indicated.

PMID- 7783804
TI  - [From the library of the Nederlands Tijdschrift voor Geneeskunde: Conservandae
      sanitatis praecepta saluberrima: hygiene according to the Salerno School].

PMID- 7783805
TI  - [Gastroesophageal reflux in infants; recommendations for diagnosis and
      treatment].

PMID- 7783807
TI  - [Are supplemental studies always a supplement in suspected paradoxical
      embolism?].

PMID- 7783806
TI  - [Marginal notes on esophageal pH measurement in the diagnosis of gastroesophageal
      reflux in children].

PMID- 7783808
TI  - [Are supplemental studies always a supplement in suspected paradoxical
      embolism?].

PMID- 7783809
TI  - [Retrobulbar hemorrhage].

PMID- 7783811
TI  - [The status of transcranial color-coded real time ultrasound in diagnosis of
      cerebral lesions].
AB  - Transcranial color-coded real-time sonography (TCCS) combines transcranial
      Doppler sonography and color-coded B-mode scanning of the brain parenchyma and
      cerebral vessels. This technique is not invasive and a broad spectrum of
      intracerebral lesions such as vascular lesions (ischemic stroke and intracerebral
      hemorrhage, aneurysms, arteriovenous malformations, arteriosclerotic vascular
      degeneration) and parenchymal lesions (brain tumors, degenerative and
      neuropsychiatric disorders) can be disclosed. Compared with MRI and CT, the
      ultrasound system is movable. Thus, it can be used easily in emergency rooms and
      intensive care units. In addition, TCCS can disclose new insights into the
      pathophysiology of disorders of the CNS, as in neuropsychiatric diseases.
      Ultrasound contrast agents improve the depiction of intracranial vessels. The
      pathology of the venous system can be identified.

PMID- 7783812
TI  - [Photographic pupil diagnosis in Horner syndrome].
AB  - In cases of miosis without other clinical signs and not contributory medical
      history it is often hard to differentiate Horner's syndrome. In these cases the
      pharmacological testing with cocaine eye drops is a well established and
      validated method. The physiological testing, i.e. the detection and measurement
      of a dilatation lag in Horner's syndrome, is not so common. For this reason we
      measured the dilatation of pupils in 22 Horner's syndromes and 16 physiological
      anisocorias to find limit ("cut off") values. We used flash photography and a
      commercial available camcorder and took photos in bright light (400 cd/m2) as
      well as 4 and 15 seconds after cessation of light stimulus in darkness. An
      anisocoria after 4 seconds of darkness greater than 0.6 mm distinguishes both
      groups with a sensitivity of 82% and a specifity of 69%. A dilatation speed of
      the smaller pupil during the first 4 seconds of darkness lower than 1.1 mm/4 sec
      is also a good threshold value. Because of the additional good correlation of
      these parameters to the anisocoria after cocaine the photographic methods are at
      least a supplement to pharmacological testing with cocaine, which is sometimes
      equivocal and always delays the localizing hydroxyamphetamine test. The advantage
      of using a camcorder is the immediate evaluation on a TV screen. Because of the
      similar price it is more useful to buy an infrared camera to perform real
      pupillography. Because of the missing possibility of magnification we prefer the
      evaluation of slides instead of Polaroid flash photographs.

PMID- 7783810
TI  - [Electroconvulsive therapy in neurologic diseases].
AB  - Numerous developments have improved the safety and efficacy of electroconvulsive
      therapy (ECT) in recent years, so that ECT is now one of the safest forms of
      treatment under anesthesia. The indications for psychiatric patients are clearly
      defined. ECT is also under discussion with respect to certain neurological
      disorders. This discussion has, however, been largely ignored by the German
      medical profession. Critical evaluation of previous experience, especially in the
      United States and in Scandinavia, reveals some clinical situations (e.g.,
      akinetic crisis in Parkinson's disease) in which a primary neurological
      indication for ECT might be present. ECT is frequently indicated in other brain
      diseases if pronounced psychopathological disturbances (especially of a
      depressive type) occur and fail to respond to conventional treatment with
      psychotropic drugs. ECT may then be indicated on a case-by-case basis. ECT should
      not be withheld from such patients; on the other hand, there is the risk of
      uncontrolled expansion of these indications for ECT.

PMID- 7783813
TI  - [Infarcts in the brain areas supplied by the posterior cerebral artery. Clinical
      aspects, pathogenesis and prognosis].
AB  - The clinical and neuroradiological features of 127 patients with ischemia of the
      posterior cerebral artery (PCA) and a positive CT scan (n = 122) or pathological
      angiography findings (n = 63) were analyzed. Unilateral headache was the most
      common presenting symptom (50%), making complicated migraine an important
      differential diagnosis. Clinical findings were visual field deficits (93%),
      sensory (29%), motor (28%), and neuropsychological deficits (25%). Infarcts,
      including the thalamus (n = 27), were mostly associated with sensory and slight
      motor deficits. Our findings suggest that motor deficits in PCA ischemia,
      particularly if minor and reversible, are likely to be due to ischemia-induced
      edema in the internal capsule adjacent to an associated thalamic infarct. Based
      on angiography, stroke etiology was considered embolic in 83/127 (65%),
      atherothrombotic in 20/126 (16%), and probably migrainous in 4 (3%) patients. In
      the remaining 20 patients (16%), the etiology was uncertain. Prognosis of PCA
      infarcts is usually good.

PMID- 7783814
TI  - [Local thrombolytic treatment of spontaneous intracerebral hemorrhage with
      plasminogen activator (rt-PA). Indications and limits].
AB  - Twenty patients underwent a regimen of stereotactic puncture and consecutive
      local lysis with recombinant tissue plasminogen activator (rt-PA) for their
      spontaneous intracerebral hemorrhage (ICH). Rt-PA was administered via a
      stereotactically placed silicone catheter according to a hematoma-size-related
      formula. There was no extensive intraoperative hematoma aspiration so that the
      capacity of rt-PA for blood-clot lysis could be investigated. Fifteen patients
      were somnolent/stuporous on admission and 5 comatose, the hematoma-size ranging
      from 3 x 3 x 4 cm up to 7 x 4 x 4 cm (mean: 5.1 x 3.9 x 3.5 cm). Control computed
      tomography (CT) was performed on a daily basis, and in 19 patients the hematoma
      showed complete or almost complete resolution on CT within 4 days. The rt-PA
      dosage necessary ranged from 5 to 14 (mean: 8.5) mg. Rt-PA application was
      performed once in 1 patients, twice in 7, three times in 11 and four times in 1
      patient. On follow-up after a mean of 7.2 months 3 patients had died (Glasgow
      Outcome Score--GOS I). Another was GOS II, 10 GOS III, 5 GOS IV and 1 had made an
      excellent recovery (GOS V). Patients who were somnolent or stuporous on admission
      or who exhibited secondary deterioration of their level of consciousness
      benefitted from the treatment protocol. Early postoperative mobilization and
      thereby reduction of secondary complications during the patient's stay in the
      intensive care unit appear to be possible. Comatose patients did not benefit from
      this treatment and those should be treated conservatively.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7783816
TI  - [Adenomatous hypophyseal apoplexy. Clinical, diagnostic and therapeutic aspects
      of a frequently misdiagnosed emergency state].
AB  - Pituitary adenoma apoplexy was considered an acute life-threatening condition
      until more benign and even asymptomatic courses were found by advanced
      neuroimaging procedures. Necrosis and hemorrhage in the pituitary adenoma can
      cause acute enlargement of the tumor. sometimes with rupture of the tumor capsule
      and bleeding into the subarachnoid space and surrounding parts of the brain.
      Clinical symptoms include acute or subacute headache in combination with signs of
      meningeal irritation and neuroophthalmological and cerebral dysfunction. Severe
      panhypopituitarism may be an additional complication. Acute blindness due to
      compression of the optic chiasm and symptomatic compression of basal cerebral
      arteries require immediate transsphenoid tumor resection. If panhypopituitarism
      is suspected, immediate hormone substitution is necessary.

PMID- 7783817
TI  - [Differential therapeutic aspects in treatment of obstructive sleep apnea
      syndrome].
AB  - We report the case of a 43-year-old man who suffered from obstructive sleep apnea
      with excessive daytime sleepiness and nocturnal sweating. His initial apnea index
      of 60/h improved under treatment with an Esmarch device. Apneas were totally
      suppressed by nCPAP application with a pressure of only 4 mb, but the patient
      rejected nCPAP therapy. After two years with the Esmarch device he reported
      increasing temporomandibular joint pain and Esmarch therapy had to be stopped. A
      cephalometric evaluation showed good prognosis for maxillomandibular advancement
      osteotomy, which was performed and which suppressed the apneas completely over a
      period of more than one year. Indication, surgical technique, and risks are
      discussed.

PMID- 7783818
TI  - [Cladribine in chronic progressive multiple sclerosis].

PMID- 7783819
TI  - [Current therapy of multiple sclerosis: are there indications for intravenous
      immunoglobulins?].

PMID- 7783815
TI  - [The idiopathic QT syndrome as the cause of epileptic and nonepileptic seizures].
AB  - The long QT syndrome (LQTS) is characterized by a pathological lengthening of the
      corrected QT interval on the surface ECG and the occurrence of syncopal attacks,
      sometimes presenting as a seizure disorder. They are caused by ventricular
      tachycardia of the torsade de pointes type, an arrhythmia that is also
      responsible for the high incidence of sudden death among these patients. Besides
      the acquired forms of LQTS which are transient (e.g. therapy with QT-prolonging
      drugs), congenital variants (Romano-Ward syndrome, Jervell/Lange-Nielsen
      syndrome, sporadic form) can occur as well. The latter mostly become manifest
      during childhood or adolescence. Because the syndrome is rare, it is often not
      included in the primary differential diagnosis of syncope. Thus,
      misinterpretation as epilepsy may occur. Especially if siblings are affected, a
      genetic epilepsy may be diagnosed. However, the correct diagnosis can be made by
      standard ECG methods. Early recognition of the syndrome is very importance
      because of prognostic and therapeutic consequences. In this article, two cases of
      idiopathic LQTS are presented. Problems regarding differential diagnosis and
      therapy are discussed.

PMID- 7783820
TI  - [Phobic vertigo. A panic disorder--or?].

PMID- 7783821
TI  - The position of theophylline in the treatment of asthma and chronic obstructive
      pulmonary disease.

PMID- 7783822
TI  - Acute pernicious or fulminating beriberi heart disease. A report of 6 patients.
AB  - OBJECTIVE: To investigate the incidence and presentation of acute pernicious or
      fulminating beriberi in a general district hospital. METHODS: All patients with a
      diagnosis of acute pernicious or fulminating beriberi heart disease made between
      1978 and 1994 were identified, and their medical records were retrospectively
      examined. RESULTS: Six cases of acute pernicious or fulminating beriberi heart
      disease were recognized. The disease was characterized by circulatory shock and
      peripheral cyanosis. All patients had severe lactic acidosis, in 5 of them
      without hypoxaemia. Four patients were alcoholics. The most important diagnostic
      criterion was the impressive improvement after thiamine administration.
      CONCLUSIONS: Acute pernicious or fulminating beriberi heart disease can be
      recognized occasionally. Thiamine should be administered as soon as possible in
      suspected cases.

PMID- 7783823
TI  - CAPD patients exhibit a nocturnal fall in blood pressure: a single-centre study.
AB  - BACKGROUND: In 29 CAPD (continuous ambulatory peritoneal dialysis) patients the
      height and diurnal variation of the blood pressure (BP) and heart-rate (HR) were
      analyzed by means of 24-hour ambulatory blood pressure monitoring (ABPM).
      METHODS: Normal diurnal variation was defined as a fall of 10% or more during
      nighttime (NT) compared with daytime (DT) BP or HR (DT = 10.00 a.m.-9.00 p.m., NT
      = midnight-06.00 a.m.). To evaluate high BP in the course of time we used the
      concept of "whole-day BP load", defined as the percentage of BP readings above
      140/90 mmHg during a 24-h period. A "hypertensive BP load" was defined as a
      systolic BP (SBP) load of more than 50% and/or a diastolic BP (DBP) load in
      excess of 40%. In addition to analysis of the circadian rhythm of BP and HR and
      the prevalence of a hypertensive BP load in CAPD patients, the influence of
      various factors such as gender, creatinine clearance, recombinant human
      erythropoietin, antihypertensive medication, haematocrit, whole-day BP load, and
      the nightly dialysis glucose concentration on the diurnal variation of BP and HR
      were studied. RESULTS: Based on the 95% confidence intervals for the proportional
      nocturnal decrease, normal diurnal variation of BP and HR was present in most
      CAPD patients. No correlation could be demonstrated between a blunted circadian
      rhythm and the variables mentioned above. However, when other time-period
      definitions (DT = 6.00 a.m.-11.00 p.m., NT = 11.00-6.00 and DT = 8.00 a.m.-8.00
      p.m., NT = 8.00 p.m.-8.00 a.m.) were applied to the data, considerably fewer
      patients displayed normal diurnal variation. Whereas all patients showed normal
      home BP readings, ABPM of 21 out of 29 patients displayed a hypertensive BP load.
      CONCLUSION: The majority of our CAPD patients exhibited normal diurnal variation
      of SBP and DBP depending, however, on the definitions of DT and NT used. The
      absence of a normal circadian rhythm could not be explained by any of the
      variables analyzed. Surprisingly, uncontrolled hypertension, as defined by a
      hypertensive BP load, was found in 72% of the patients.

PMID- 7783824
TI  - The choriocarcinoma syndrome: an emergency.
AB  - A 36-year-old male patient is described who presented with gynaecomastia,
      pulmonary nodules and a retroperitoneal mass in combination with a markedly
      elevated HCG level. A diagnosis of "choriocarcinoma syndrome" was made. Despite a
      clear response from the tumour to chemotherapy the patient died, at least
      partially due to delay in treatment. Prompt treatment even without cytological or
      histological proof is therefore stressed.

PMID- 7783825
TI  - Urethral stricture as unusual complications of Wegener's granulomatosis.
AB  - A patient with Wegener's granulomatosis is reported. The diagnosis was confirmed
      by parotid gland biopsy. The patient responded to treatment with cyclophosphamide
      and prednisone. After many years, urethral stricture and subglottic stenosis
      developed and responded satisfactorily to surgery.

PMID- 7783826
TI  - Interference of MIBG uptake by medication: a case report.
AB  - Phaeochromocytoma is one of the causes of hypertension. Topographic diagnosis is
      made by CT-scans or scanning with 123I- or 131I-metaiodobenzylguanidine (123I- or
      131I-MIBG). We describe a patient with recurrent episodes of severe hypertension
      and increased serum catecholamines. With the suspicion of a phaeochromocytoma
      labetalol was given. Subsequently the 123I-MIBG scan showed an abnormal
      distribution of MIBG. After discontinuation of labetalol therapy the
      biodistribution of 123I-MIBG returned to normal. A list of drugs known and one
      drug which may be expected to interfere with MIBG scintigraphy are appended. It
      seems advisable to discontinue labetalol and other medication that may interfere
      with MIBG for at least several days before administering MIBG.

PMID- 7783828
TI  - Computer assistance in the practice of internal medicine.
AB  - An overview is given of the possibilities of electronic support in the practice
      of internal medicine and of the preferred electronic environment in the hospital.
      For efficient exchange of information, mutual cooperation between all departments
      and medical specialists in the hospital is of great importance. The development
      of a sufficient hospital information system has to start with the composition of
      an information design, based on the concept of an open hospital database with
      connections to subsystems of the different departments and medical specialisms.
      Within this design basic, organizational, management and (medical) knowledge
      providing programs can be applied. General, medical, scientific and
      organizational aspects of electronic support in internal medicine are discussed
      with some practical examples. A brief comment is made on the necessity of using
      code numbers for diagnoses.

PMID- 7783827
TI  - Hyperhomocysteinaemia: a role in the accelerated atherogenesis of chronic renal
      failure?
AB  - Moderate hyperhomocysteinaemia has recently been established as an independent
      risk factor for atherothrombotic disease. It might be caused by heterozygosity
      for cystathionine beta-synthase deficiency, an enzyme involved in the conversion
      of methionine to cysteine through the transsulphuration pathway or by inherited
      thermolability of the enzyme which remethylates homocysteine into methionine. In
      chronic renal failure (CRF) homocysteine levels are significantly elevated at a
      relatively early stage. The normal kidney possibly plays an important role in
      homocysteine catabolism, which cannot be performed in CRF. Alternatively,
      decreased extrarenal catabolism can contribute to the hyperhomocysteinaemia in
      this disease state. Treatment with folic acid, 5 mg daily, significantly lowers
      homocysteine levels in chronic renal patients.

PMID- 7783829
TI  - [Viral hepatitis C and membranoproliferative glomerulonephritis in a renal
      transplant patient].
AB  - We report the case of a 36 year-old-patient, hemodialyzed for idiopathic
      membranous glomerulonephritis, who suffers from type I membranoproliferative
      glomerulonephritis five years after a successful kidney transplantation.
      Etiologic evaluation evidenced chronic viral hepatitis C complicated by type III
      cryoglobulinemia. If hepatitis C induced membranoproliferative glomerulonephritis
      has yet been described among non transplanted patients, it is at our knowledge,
      the first observation in a renal transplant recipient.

PMID- 7783830
TI  - [Nasal carriage of Staphylococcus aureus: prevalence in a hemodialysis center and
      effect on bacteremia].
AB  - We evaluated nasal carriage of Staphylococcus aureus (S. aureus) in 114
      hemodialysis patients by performing two nasal swab cultures at a one month
      interval. The incidence of bacteremia was then followed for one year. Other
      factors associated with infections in hemodialysis patients, such as diabetes,
      central venous catheter, and high serum ferritin levels were also evaluated.
      Nasal carriage of S. aureus was present in 29.8% of patients (34/114). Six S.
      aureus bacteremia occurred in 6 patients. This represents an annual incidence of
      0.058 bacteremia/patient-year. The incidence of bacteremia was higher in patients
      with S. aureus nasal carriage (0.0945) than in patients without (0.0417), but the
      difference was not significant. The relative risk (RR) was 2.35. On the contrary,
      bacteremia were significantly more frequent in patients with diabetes (RR =
      11.41; p = 0.004) or in patients with central venous catheter (RR = 14.29; p =
      0.002). In conclusion, in our population, diabetes and central venous catheter
      are more significant risk factors of bacteriemia than S. aureus nasal carriage.

PMID- 7783831
TI  - [Anticancer chemotherapy. Prescription in the presence of renal insufficiency].

PMID- 7783833
TI  - [Production of IFN gamma, IL6 and IL10 by infiltrating cells of renal allografts
      and irreversible rejection: modulation by IL2 and IL4].
AB  - The frequency of isolated low density graft-infiltrating cells (GIC) secreting
      IFN gamma, IL6 and IL10 was studied in 8 cases of irreversible rejection of human
      renal allografts, using ELISPOT assays. The GIC were mostly CD8+ T cells although
      CD4+ T cells, B cells and macrophages could also be detected. In average, in
      10(6) cells, 189 secreted IFN gamma, 747 IL10, and 17,114 IL6. Culture of GIC in
      the presence of IL2 resulted in an increase on the frequency of IFN gamma
      producing cells (IFN gamma-PC), in a dose dependent manner, with an optimal 6.5
      fold increase at 50 U/ml. In contrast, 25 U/ml IL4 decreased the frequency of
      spontaneous and IL2 induced IFN gamma-PC. Furthermore, IL4 reduced the frequency
      of IL6-PC.

PMID- 7783832
TI  - [Lymphocyte adhesion of human peripheral blood to aortic endothelial cells of a
      porcine xenograft: preferential adhesion to NK CD3-CD16+ cells].
AB  - Xenotransplantation, the transplantation of tissues or organs between species
      find renewal interest because of human organ shortage. As the xenogeneic
      transplantation leads immediately to an humoral mediated rejection with graft
      necrosis, the study of the cellular response is not possible in vivo. So we
      developed an in vitro model to study the adhesion of human peripheral blood
      lymphocytes (PBL) to porcine aortic endothelial cells (PAEC). We showed that PBL
      were able to bind to PAEC, and that this adhesion was increased when PAEC were
      stimulated with human recombinant TNF-alpha. The action of TNF-alpha is maximal
      when PAEC were stimulated during 6 hours with 100 U/ml TNF-alpha. This adhesion
      involved preferentially CD3-CD16+ NK cells compared with CD3+CD16- T lymphocytes.
      Finally monoclonal antibodies directed against PBL adhesion molecules decreased
      PBL adhesion to PAEC. PBL adhesion to PAEC would be a first step in a cellular
      mediated rejection in xenotransplantation.

PMID- 7783834
TI  - [Bourneville's tuberous sclerosis (BTS) and nephrocalcinosis].

PMID- 7783835
TI  - Baclofen is cytoprotective to cerebral ischemia in gerbils.
AB  - The release of the neurotransmitter, glutamate, and the activation of receptor
      operated calcium channels, may increase the degree of damage in ischemic brain
      tissue. Inhibition of excitatory neurotransmitters should therefore result in
      cytoprotection of ischemic brain tissue. In this study we evaluated the effect of
      baclofen, an inhibitor of presynaptic glutamate release, on ischemic gerbil
      cortex, hippocampus (CA 1 and CA4), striatum and thalamus. Histological
      evaluation was done in a blind manner in 4 groups (total 36 animals): a control
      group (9 animals) and three groups (27 animals) with varying doses of baclofen.
      For cerebral ischemia, we used single episode of five minutes of arterial
      occlusion of the carotid arteries. Baclofen in doses of 0, 25, 50, and 100 mg/kg
      were given to different groups five minutes prior to ischemic insult. This was
      followed by intraperitoneal injections given 24 and 48 hours after the initial
      insult. Statistically significant histological cytoprotection was demonstrated.
      Doses of 25 mg/kg appeared to demonstrate significant protection of the cortex (p
      = 0.0002), the CA1 and CA4 regions of the hippocampus (p = 0.0004 and 0.0001)
      respectively. At a dose of 50 mg/kg, significant cytoprotection was demonstrated
      at the hippocampus (CA1 and CA4 regions), in particular at the CA4 region (p =
      0.0029). The 100 mg/kg dose appeared to have most significant protection at the
      CA1 and CA4 regions of the hippocampus (both p = 0.0001), striatum (p = 0.0011),
      and the thalamus (p = 0.0008). All statistical comparisons were done using non
      parametric tests (Mann-Whitney U test). Our study demonstrates that baclofen is
      cytoprotective to ischemic neuronal cells, especially in the
      hippocampus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783836
TI  - Quantitative autoradiography demonstrates selective modulation of rat brain
      regional dopamine (D1 and D2) receptor subtypes after chronic manipulation of
      dietary salt.
AB  - The effects of chronic dietary sodium chloride (NaCl) consumption on renal
      function and brain dopamine receptors were studied in adult, male normotensive
      rats. Compared to rats maintained on the normal NaCl (0.33%) diet, animals
      maintained on the low NaCl (0%) diet for 4 weeks exhibited significant increases
      in plasma aldosterone, chloride and changes in urinary electrolyte excretion. In
      contrast, rats maintained on the high NaCl (8%) diet for 4 weeks demonstrated
      significant increases in urine volume and urinary sodium, chloride and dopamine
      excretions and water intake. Rats fed the high NaCl diet displayed a 42-59%
      decrease (p < 0.001-0.05) in D1 binding in the nucleus accumbens (NA), olfactory
      tubercle (OT) and the striatum (STM), without any effects on D2 binding in these
      brain regions. Rats maintained on the low NaCl diet also demonstrated decreased
      D1 binding in the ventral (24%, p < 0.02) and lateral (29%, p < 0.01) STM, but
      not in the OT, NA, entopeduncular nucleus and substantia nigra. Rats fed low or
      high NaCl diets exhibited a 35-180% increase (p < 0.01-0.05) in D2 binding in
      several mid-brain areas (e.g. hypothalamus, thalamus and hippocampus) and
      hindbrain regions (e.g. superior colliculus and nucleus tractus solitarius)
      without affecting the D1 binding. These data indicate that chronic modification
      of dietary salt intake profoundly affects the renal handling of sodium/water
      excretion and leads to selective up- and/or down-regulation of DA receptor
      subtypes in different areas of the brain.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783837
TI  - Current Triton X-100 treatments do not allow a complete plasminogen activator
      extraction from developing nervous tissue.
AB  - Determinations of plasminogen activator (PA) activity are usually performed in
      Triton X-100-treated tissue homogenates or crude membrane fractions. Such
      preparations usually involve a single Triton X-100 treatment. In the present
      paper we describe the pattern of variability of PA activity measured in different
      fractions obtained from the developing chick CNS by a repetitive procedure of
      Triton X-100 treatment and ultracentrifugation. To further characterize this PA
      activity we have also performed zymographic analyses during the embryonic
      development and the early postnatal life. Our results show that: a) a single
      Triton X-100 treatment does not completely extract the enzyme and this lead to an
      underestimation of the total PA activity; b) the PA activity is associated with
      the particulate component of the total tissue homogenate requiring its complete
      solubilization more drastic Triton X-100 treatments; c) better estimations of
      total and specific activities are obtained by using soluble fractions derived by
      ultracentrifugation from Triton X-100-treated membrane fractions; d) the
      developing chick optic lobe expresses only one kind of PA molecule along the
      entire development; e) the level of PA activity vary characteristically during
      the ontogeny and the early postnatal life indicating the existence of a
      developmentally regulated mechanism of PA expression.

PMID- 7783838
TI  - Modifications by chronic intermittent hypoxia and drug treatment on skeletal
      muscle metabolism.
AB  - The energy metabolism was evaluated in gastrocnemius muscle from 3-month-old rats
      subjected to either mild or severe 4-week intermittent normobaric hypoxia.
      Furthermore, 4-week treatment with CNS-acting drugs, namely, alpha-adrenergic
      (delta-yohimbine), vasodilator (papaverine, pinacidil), or oxygen-increasing
      (almitrine) agents was performed. The muscular concentration of the following
      metabolites was evaluated: glycogen, glucose, glucose 6-phosphate, pyruvate,
      lactate, lactate-to-pyruvate ratio; citrate, alpha-ketoglutarate, succinate,
      malate; aspartate, glutamate, alanine; ammonia; ATP, ADP, AMP, creatine
      phosphate. Furthermore the Vmax of the following muscular enzymes was evaluated:
      hexokinase, phosphofructokinase, pyruvate kinase, lactate dehydrogenase; citrate
      synthase, malate dehydrogenase; total NADH cytochrome c reductase; cytochrome
      oxidase. The adaptation to chronic intermittent normobaric mild or severe hypoxia
      induced alterations of the components in the anaerobic glycolytic pathway [as
      supported by the increased activity of lactate dehydrogenase and/or hexokinase,
      resulting in the decreased glycolytic substrate concentration consistent with the
      increased lactate production and lactate-to-pyruvate ratio] and in the
      mitochondrial mechanism [as supported by the decreased activity of malate
      dehydrogenase and/or citrate synthase resulting in the decreased concentration of
      some key components in the tricarboxylic acid cycle]. The effect of the
      concomitant pharmacological treatment suggests that the action of CNS-acting
      drugs could be also related to their direct influence on the muscular biochemical
      mechanisms linked to energy transduction.

PMID- 7783839
TI  - Involvement of both a Zn2+ site and an anionic binding site in the selective
      inhibition of a Zn(2+)-glycerophosphocholine cholinephosphodiesterase by thiols
      and tellurites.
AB  - Inhibition of a Zn(2+)-glycerophosphocholine cholinephosphodiesterase by thiols
      or tellurites were examined mechanistically. Inactivation of the
      phosphodiesterase by thio-carboxylates, which was due to the removal of Zn2+ in
      the catalytic site, was enhanced by introduction of an amino group in the
      structure of thiols, suggesting the presence of an anionic site adjacent to a
      Zn2+ site. In support of the suggestion, it was found that thiols, associable
      with both a Zn2+ site and an anionic site, were more potent reversible
      inhibitors; dimethylaminoethanethiol (Ki, 17 microM), diethylaminoethanethiol
      (Ki, 1.2 microM) and thiocholine (Ki, 2.6 microM). Meanwhile, the inhibition of
      the phosphodiesterase by tellurites is ascribed to the binding of tellurite
      anions to a Zn2+ site, based on the protective action of tellurite anions against
      the inactivation of the enzyme by EDTA. Moreover, the inhibition of the
      phosphodiesterase by tellurites was prevented by phosphate ions, which expressed
      the protective effect against EDTA inactivation. In further support, it was
      observed that tellurite and thiocholine appeared to interact with active site in
      an additive manner, in contrast to a synergistic action between tellurites and
      quaternary ammonium compounds such as acetylcholine or choline.

PMID- 7783841
TI  - Inhibition of plasma membrane and mitochondrial transmembrane potentials by
      ethanol.
AB  - The actions of ethanol and its primary oxidative metabolite, acetaldehyde, on
      plasma membrane and mitochondrial transmembrane potentials were examined in rat
      brain using fluorescence techniques. Subchronic treatment of adult rats with
      ethanol resulted in a significant depolarization of both the plasma and
      mitochondrial membranes when the mean blood ethanol level of the rats was 59 +/-
      11 mM (mean +/- SEM, n = 6). Acute dosing of animals (4.5 g/kg, i.p.) failed to
      show any significant alterations. Various concentrations of ethanol, added in
      vitro to a crude synaptosomal preparation isolated from the rat cerebrocortex
      (P2) from untreated animals, depolarized both the plasma and mitochondrial
      transmembrane potentials in a dose-related manner. Addition of acetaldehyde in
      vitro did not reveal any significant effects on plasma or mitochondrial
      transmembrane potential.

PMID- 7783840
TI  - Changes in extracellular levels of glutamate and aspartate in rat substantia
      nigra induced by dopamine receptor ligands: in vivo microdialysis studies.
AB  - The microdialysis technique was utilized to study the local effects of D1 and D2
      family type dopamine (DA) receptor (R) ligands on the in vivo release of
      endogenous glutamate (GLU) and aspartate (ASP) from rat substantia nigra (SN).
      Addition to the dialysis perfusion solution of either D1-R and D2-R agonists,
      such as SKF-38393 (50 and 100 microM) and Quinpirole (5 and 10 microM), resulted
      in dose-dependent increases in extracellular concentrations of GLU and ASP,
      respectively. The SKF-38393 and Quinpirole-induced effects were reduced by SCH
      23390 (0.5 microM), a D1-R antagonist, and by Spiperone (1.0 microM), a D2-R
      antagonist, respectively. However, SCH-23390 and Spiperone did increase GLU and
      ASP extracellular concentrations. Local infusion with Tetrodotoxin (TTX) (1.0
      microM), a blocker of voltage-dependent Na+ channels, increased basal
      extracellular levels of GLU. In addition, co-infusion of TTX and SKF-38393 evoked
      increases in extracellular GLU levels higher than those observed after SKF-38393
      alone. Finally, chemical lesions of nigral DA cells with 6-OH-DA increased the
      basal extracellular levels of GLU. It is proposed that the release of GLU and ASP
      from SN may be regulated by D1- and D2-receptors present in this basal ganglia
      structure. In addition, part of the D1 receptors present in SN might be located
      presynaptically on GLU-containing nerve endings.

PMID- 7783842
TI  - Characterization of the carrier-mediated [3H]GABA release from isolated synaptic
      plasma membrane vesicles.
AB  - Synaptic plasma membrane (SPM) vesicles were isolated under conditions which
      preserve most of their biochemical properties. Therefore, they appeared
      particularly useful to study the cytoplasmic GABA release mechanism through its
      neuronal transporter without interference of the exocytotic mechanism. In this
      work, we utilized SPM vesicles isolated from sheep brain cortex to investigate
      the process of [3H]GABA release induced by ouabain, veratridine and Na+
      substitution by other monovalent cations (K+, Rb+, Li+, and choline). We observed
      that ouabain is unable to release [3H]GABA previously accumulated in the vesicles
      and, in our experimental conditions, it does not act as a depolarizing agent. In
      contrast, synaptic plasma membrane vesicles release [3H]GABA when veratridine is
      present in the external medium, and this process is sensitive to extravesicular
      Na+ and it is inhibited by extravesicular Ca2+ (1mM) under conditions which
      appear to permit its entry. However, veratridine-induced [3H]GABA release does
      not require membrane depolarization, since this drug does not induce any
      significant alteration in the membrane potential, which is determined by the
      magnitude of the ionic gradients artificially imposed to the vesicles. The
      substitution of Na+ by other monovalent cations promotes [3H]GABA release by
      altering the Na+ concentration gradient and the membrane potential of SPM
      vesicles. In the case of choline and Li+, we observed that the fraction of
      [3H]GABA released relatively to the total amount of neurotransmitter released by
      K+ or Rb+ is about 28% and 68%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783843
TI  - Synaptosomal glutamate uptake in a model of experimental cerebral ischemia.
AB  - In the present investigation we studied the synaptosomal uptake of glutamate in
      brain omogenate of Mongolian gerbils submitted to bilateral common carotid
      occlusion, with and without subsequent return of blood flow. The results show
      that glutamate uptake after ischemia is reduced by about 35%. The damage appears
      to be persistent, since return of blood flow restores uptake only slightly. The
      membrane alterations occurring in ischemia could explain the persistence of
      glutamate transporter impairment. Besides the blockade of NMDA receptors, the
      stimulation and/or the protection of the uptake systems for glutamate could be of
      help in preventing neuronal ischemic damage.

PMID- 7783844
TI  - Effect of dibutyryl cyclic AMP and dexamethasone on glutamine synthetase gene
      expression in rat astrocytes in culture.
AB  - Astrocytes are the primary site of glutamate conversion to glutamine in the
      brain. We examined the effects of treatment with either dibutyryl cyclic AMP
      and/or the synthetic glucocorticoid dexamethasone on glutamine synthetase enzyme
      activity and steady-state mRNA levels in cultured neonatal rat astrocytes.
      Treatment of cultures with dibutyryl cyclic AMP alone (0.25 mM-1.0 mM) increased
      glutamine synthetase activity and steady state mRNA levels in a dose-dependent
      manner. Similarly, treatment with dexamethasone alone (10(-7)-10(-5) M) increased
      glutamine synthetase mRNA levels and enzyme activity. When astrocytes were
      treated with both effectors, additive increases in glutamine synthetase activity
      and mRNA were obtained. However, the additive effects were observed only when the
      effect of dibutyryl cyclic AMP alone was not maximal. These findings suggest that
      the actions of these effectors are mediated at the level of mRNA accumulation.
      The induction of glutamine synthetase mRNA by dibutyryl cyclic AMP was dependent
      on protein synthesis while the dexamethasone effect was not. Glucocorticoids and
      cyclic AMP are known to exert their effects on gene expression by different
      molecular mechanisms. Possible crosstalk between these effector pathways may
      occur in regulation of astrocyte glutamine synthetase expression.

PMID- 7783845
TI  - Glutamate efflux from rat brain slices and cultures: a comparison of the
      depolarizing agents potassium, 4-aminopyridine, and veratrine.
AB  - The major excitatory amino acid neurotransmitter in the mammalian brain is
      glutamate (GLU). GLU release from nerve terminals is both calcium-dependent and 
      independent, yet these mechanisms of release are not fully understood. Potassium,
      4-aminopyridine (4-AP) and veratrine are commonly used depolarizing agents that
      were studied for their ability to stimulate GLU efflux from brain slices. These
      agents produced significant regional variations in GLU efflux from rat brain
      slices. Potassium was the most potent of the three secretogogues tested. 4-AP
      produced a significant GLU efflux only in the cerebellum. Veratrine produced
      consistent stimulation of GLU efflux from all brain regions tested. Potassium was
      the only depolarizing agent tested that stimulated GLU release from primary
      astroglial cultures of rat cerebral cortex. All three agents also demonstrated an
      ability to inhibit GLU reuptake in brain slice preparations. This data suggest
      that both GLU release and uptake are modulated in a regionally selective manner,
      and that commonly used depolarizing agents affect not only calcium-dependent
      neuronal release, but also uptake and glial responses.

PMID- 7783846
TI  - Acute effects of sigma ligands on the extracellular DOPAC level in rat frontal
      cortex and striatum.
AB  - Acute administration of (+)-N-allylnormetazocine ((+)-SKF-10,047) and (+/-)
      pentazocine, was found to increase the extracellular level of 3,4
      dihydroxyphenylacetic acid (DOPAC), a major dopamine (DA) metabolite, in the rat
      frontal cortex. By contrast, these benzomorphan sigma ligands did not change the
      extracellular DOPAC level in the rat striatum. On the other hand, 1,3-di(2
      tolyl)guanidine (DTG) increased the extracellular DOPAC level in the frontal
      cortex, while it decreased that level in the striatum. Another non-benzomorphan
      sigma ligand, (+)-3-(3-hydroxyphenyl)-N-(1-propyl)piperidine ((+)-3-PPP)
      decreased the extracellular DOPAC level in both frontal cortex and striatum.
      Moreover, the increase of the extracellular DOPAC level elicited by (+)-SKF
      10,047 was significantly inhibited by rimcazole, a putative sigma antagonist,
      while the DTG-induced increment was not reversed by rimcazole. These findings
      indicated that the effects of sigma ligands on the mesocortical DA neurons
      differed from those on the nigrostriatal DA neurons. In addition, the effects of
      benzomorphan sigma ligands on the central DA neurons were different from those of
      non-benzomorphan sigma ligands.

PMID- 7783848
TI  - Neuropeptide Y: distribution of immunoreactivity and quantitative analysis in
      diencephalic structures and cerebral cortex of dwarf hamsters under different
      photoperiods.
AB  - The distribution of neuropeptide Y-like immunoreactivity (NPY-LI) was
      investigated by immunohistochemistry and radioimmunoassay (RIA) in the brain of
      the Djungarian hamster (Phodopus sungorus) held under either long or short
      photoperiods. In the diencephalic and telencephalic structures studied, distinct
      patterns of NPY-LI were basically consistent in male and female animals of both
      groups. NPY levels detected by RIA from tissue samples taken at six time points
      throughout the 24-hour cycle were in the range of 15-60 pmol/mg protein in the
      diencephalon or below 5 pmol/mg protein in cerebral cortex. In the diencephalon,
      immunoreactive structures were seen in the preoptic, peri- and paraventricular,
      supraoptic, anterior, lateral, dorso- and ventromedial hypothalamic nuclei and in
      the median eminence. The suprachiasmatic nuclei exhibited a dense innervation by
      NPY-LI terminals mainly in its ventrolateral subdivision. NPY levels in the
      suprachiasmatic nucleus were nocturnally augmented under long-day, but not under
      short-day conditions. The quantification of NPY in the paraventricular nucleus
      revealed a decrease at night in long-day animals and a small nocturnal
      augmentation in short-day hamsters. In the pineal gland and habenular nuclei,
      varicose fibers were observed which appeared mainly perivascular in location
      (pineal) or formed a dense plexus (habenular nuclei). Pineal NPY contents fell
      during the night in long-day animals and were relatively constant in short-day
      hamsters. NPY-LI structures were also observed in the metathalamic
      intergeniculate leaflet and in a variety of telencephalic structures including
      the cerebral cortex, caudate nucleus putamen, lateral septal nucleus, bed nucleus
      of the stria terminalis and amygdala.

PMID- 7783849
TI  - Pro-melanin concentrating hormone messenger ribonucleic acid and peptides
      expression in peripheral tissues of the rat.
AB  - Melanin-concentrating hormone (MCH) is a cyclic peptide which is predominantly
      synthetized in the hypothalamus of fish and mammalian brains. In the present
      paper we examined the expression of MCH mRNA and pro-MCH-derived peptides, i.e.
      MCH and neuropeptide-(N)-glutamic acid (E) isoleucine (I) amide (NEI), in
      peripheral tissues of adult rodents. By means of polymerase chain reaction (PCR)
      of reverse-transcribed RNA, low levels of MCH gene transcripts were detected
      reliably in testis, stomach, and intestine of Sprague-Dawley and Wistar rats,
      whereas strong expression was found in hypothalamus. Subsequent sequence analysis
      of the PCR products verified the authenticity of MCH mRNA found in hypothalamus
      and stomach. The length of MCH RNA species was measured by Northern blot and
      multiple MCH RNA species were detected in both rat species. Shortest
      polyadenylated tails were found in MCH RNAs isolated from the peripheral organs
      by comparison with hypothalamus MCH RNAs of Wistar rats. In order to localize MCH
      expression in gastrointestinal and genital tracts of Wistar rats we performed in
      situ hybridization with specific 33P-labeled oligoprobes joined to
      immunocytochemical studies with rat MCH or NEI antisera. In testis, the MCH
      transcripts and pro-MCH-derived peptide immunoreactivities were found at the
      periphery of the seminiferous tubules, suggesting expression in Sertoli cells.
      Studies with MCH oligoprobes and antisera directed towards MCH, NEI and alpha A
      inhibin revealed similar pattern of expression in isolated Sertoli cells from
      Swiss mice, indicating that MCH RNA species were actually synthesized and
      translated in these cells. In the gastrointestinal (GI) tract, the cells
      expressing MCH RNA species and pro-MCH-derived peptides were predominantly
      expressed in the antral portion of the stomach and duodenum. Strikingly, distinct
      oligoprobes, recognizing antisense MCH transcript, revealed a pattern of
      hybridization in the GI tract similar to this observed with oligoprobes revealing
      the mature MCH mRNA. Furthermore, total RNA from the pyloric junction, duodenum,
      jejunum, ileum and hypothalamus as well appeared to contain RNA complementary to
      MCH mRNA suggesting therefore that antisense MCH RNA species may play a general
      role in regulation of MCH synthesis. Taken together, our present and previous
      data indicate that authentic MCH RNA species and translational products are
      expressed in various rodent tissues at the periphery. The cellular location
      suggests that MCH and associated peptides may play a role in spermatogenesis and
      in digestive processes.

PMID- 7783847
TI  - Expression of synapsin I gene in primary cultures of differentiating rat cortical
      neurons.
AB  - Synapsin I is a neuron-specific protein which is present in two isoforms, Ia and
      Ib. In the last few years this protein has been demonstrated to play a central
      role in the regulation of neurotransmitter release and synaptic plasticity. In
      this paper the developmental expression of this protein has been investigated in
      primary neuronal cultures from fetal rat brain cortices. The presence of thyroid
      hormone in the culture medium stimulates an early expression of the protein
      without exerting any effect at the level of mRNA transcription and accumulation.
      These observations implicate a T3-dependent regulation of this neuron-specific
      gene at the level of mRNA translation.

PMID- 7783850
TI  - Bombesin-like immunoreactivity in the forebrain and pituitary and regulation of
      anterior pituitary hormone release by bombesin in goldfish.
AB  - The presence and distribution of bombesin (BBS)/gastrin-releasing peptide (GRP)
      like immunoreactivity (IR) was examined in the goldfish pituitary and forebrain.
      BBS/GRP-like IR nerve fibres were consistently observed throughout the pituitary
      neurointermediate lobe (NIL); occasionally, BBS/GRP-like material was localized
      in cells and few fibres within the pars distalis. Within the goldfish forebrain,
      sparse, fine-beaded BBS/GRP-like IR fibres and few perikarya were detected in the
      preoptic hypothalamus. BBS/GRP-like IR material was also present in the ventro
      posterior hypothalamus and the hypothalamic inferior lobes, and, in particular,
      within the nucleus lateral tuberis pars anterioris (NLTa) and nucleus lateral
      tuberis pars posterioris (NLTp), nucleus anterior tuberis (NAT), nucleus recessus
      lateralis (NRL), nucleus recessus posterioris (NRP), and the nucleus diffusus
      lobi inferioris (NDLI). Several BBS/GRP-like IR perikarya were observed in
      periventricular regions of the NLT, NRL, and NRP. Finally, BBS/GRP-like IR
      material was detected in the nucleus habenularis, the nucleus rotundus, several
      thalamic nuclei, and the optic tectum of the dorso-posterior diencephalon. The
      presence of BBS/GRP-like IR material within the preoptic hypothalamus,
      hypophysial stalk, and in the pituitary suggests that BBS-like peptides may
      regulate pituitary hormone release in fish. Perifusion of goldfish pituitary
      fragments with initial pulses of 0.1, 10, 100 or 1,000 nM BBS stimulated both
      growth hormone (GH) and gonadotropin (GtH-II) release. Repeated pulses of the
      same dose of BBS generally stimulated GH and GtH-II release to a similar
      magnitude. These studies provide initial evidence that BBS/GRP-like peptides are
      present within the central nervous system of teleost fish. The anatomical
      distribution of BBS/GRP-like IR in goldfish hypothalamic feeding center supports
      our previous report indicating a role for BBS in the central regulation of food
      intake in fish. Additionally, the presence of BBS/GRP-like IR material in the
      pituitary and brain areas associated with the regulation of anterior pituitary
      hormone secretion, as well as evidence demonstrating a direct action of BBS at
      the level of the goldfish pituitary to modify GH and GtH-II secretion, indicates
      that BBS/GRP-like peptides likely act to regulate pituitary hormone release in
      teleosts.

PMID- 7783851
TI  - Pituitary adenylate cyclase-activating polypeptide activates different signal
      transducing mechanisms in cultured cerebellar granule cells.
AB  - Pituitary adenylate cyclase-activating polypeptide (PACAP) is a novel 38-residue
      neuropeptide which stimulates adenylate cyclase activity in rat pituitary cells
      as well as in other neuronal and non-neuronal tissues. In this study we have
      investigated whether PACAP27 and PACAP38 may stimulate either cyclic AMP
      accumulation or phosphoinositide formation in cultured cerebellar granule cells.
      In cultures at 8 days of maturation in vitro (DIV), a 15-min exposure to PACAP27
      or PACAP38 equally promoted a concentration-dependent increase in intracellular
      cAMP content: the effect was significant at 1-5 nM and maximal between 10 and 100
      nM, while VIP was 1,000-fold less potent in elevating cAMP levels. In the
      presence of 3-isobutyl-1-methylxanthine (200 microM), stimulation by PACAP was
      present already at 0.1 nM and was maximal (6-fold increase) at 1 nM. A rapid
      elevation in intracellular cAMP (about 80%) was observed within a 30-second
      exposure to 10 microM PACAP38 or PACAP27; the maximal activity of PACAP was
      present between 15 and 30 min and progressively declined at 60 min without
      reaching basal values. PACAP27 and PACAP38, but not VIP, were also able to
      stimulate inositol phospholipid hydrolysis: PACAP38 (EC50: 0.16 nM) was 10-fold
      more potent than PACAP27 (EC50: 2.1 nM) in stimulating [3H]inositol phosphate
      formation. The effect of PACAP was rapid: fractionation of [3H]inositol
      phosphates revealed that inositol trisphosphate and inositol bisphosphate
      increased earlier (within 20 s) than inositol monophosphate (within 60
      s).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783852
TI  - Nicotinic agonists administered into the fourth ventricle stimulate
      norepinephrine secretion in the hypothalamic paraventricular nucleus: an in vivo
      microdialysis study.
AB  - Nicotinic cholinergic agonists stimulate ACTH secretion by a central mechanism
      involving brainstem catecholamines. In vivo microdialysis studies were conducted
      to measure the release of norepinephrine (NE) in the hypothalamic paraventricular
      nucleus (PVN) in response to the administration of nicotine (Nic) or another
      nicotinic cholinergic (NAch) agonist, cytisine (Cyt), directly into the IVth
      ventricle. Alert, freely mobile rats, equipped 24 h previously with a chronic
      guide cannula in the IVth ventricle and microdialysis probe in the PVN, were
      injected with artificial cerebrospinal fluid (CSF, 500 nl/60 s), Nic (1-5
      micrograms), or Cyt (1-25 micrograms) after three 20-min baseline samples had
      been taken. Analysis of the dialysates by HPLC with electrochemical detection
      demonstrated the dose-dependent secretion of PVN NE to Nic or Cyt with ED50s of
      approximately 1 or 6 micrograms, respectively; these were completely blocked by
      prior IVth ventricular injection of the NAch antagonist, mecamylamine (4
      micrograms). In contrast, alpha-bungarotoxin, which antagonizes the action of
      NAch agonists by acting through the alpha 7 bungarotoxin-type NAchR, failed to
      reduce the NE response to Nic. Partial, but significant desensitization of NE
      secretion in response to a second injection of Nic (2.5 or 5 micrograms) 100 min
      after the first was seen, whereas NE responses to the second injection of Cyt (5
      or 25 micrograms) were completely desensitized. However, cross-desensitization of
      each agonist to the other did not occur. This may reflect heterogeneity of the
      NAch receptor subtypes involved. The results of this study establish a
      correlation between the action of nicotine on brainstem norepinephrinergic
      regions and the resultant release of NE in the PVN, which would lead to the
      release of ACTH secretagogues.

PMID- 7783853
TI  - Effect of testosterone and its metabolites upon the level of vasopressin
      messenger ribonucleic acid in the hypothalamus of the hyperosmotically stimulated
      male rat.
AB  - We previously reported that gonadal steroids modify the expression of arginine
      vasopressin (AVP) in the hypothalamus of rats administered 2% sodium chloride
      solution for 5 days. Gonadectomy prevented, and testosterone (T) replacement
      restored, enhanced AVP mRNA levels in the supraoptic nucleus (SON) of male rats
      receiving this hyperosmotic challenge. The present study investigated the effects
      of the androgenic and estrogenic metabolites of T on hypothalamic AVP mRNA levels
      in response to chronic hyperosmolality. Gonadectomized male rats receiving 2%
      NaCl for 5 days and treated with T, dihydrotestosterone (DHT), or DHT+estradiol
      (E2), but not E2 alone or empty implants, had increased AVP mRNA levels compared
      to gonadectomized animals receiving tap water. Our results support a role for T
      and DHT-mediated effects upon the enhanced accumulation of AVP mRNA in the SON of
      male rats receiving a chronic hyperosmotic challenge.

PMID- 7783854
TI  - Effect of chronic hyponatremia on central and peripheral oxytocin and vasopressin
      secretion in rats.
AB  - Previous studies have shown that many treatments that stimulate the peripheral
      secretion of oxytocin (OT) and vasopressin (AVP) from the pituitary
      simultaneously increase the levels of these peptides in the cerebrospinal fluid
      (CSF). Since osmotically and nonosmotically stimulated pituitary secretion of OT
      and AVP is markedly blunted in hyponatremic rats, the present studies evaluated
      whether central OT and AVP secretion into the CSF is similarly inhibited during
      sustained hyponatremia. Adult male rats with indwelling cisterna magna cannulae
      were rendered hyponatremic (plasma [Na+] < 110 mmol/l) by s.c. infusion of
      desmopressin (dDAVP; 10 ng/h) in combination with ingestion of a liquid diet for
      3 days, then subjected to osmotic (i.v. or i.p. injection of 2 M NaCl; HS) or
      nonosmotic (6 mmol/kg of 0.15 M LiCl i.p.) stimulation. In normonatremic rats
      both i.v. and i.p. HS caused marked increases in plasma OT and AVP levels 30 min
      after treatment. Significant elevations of OT, but not AVP, were also present in
      CSF. Despite similar increases in plasma Na+ concentrations, plasma OT responses
      in the hyponatremic rats were absent after HS i.v. and were significantly blunted
      after HS i.p., but neither group had increased plasma AVP. In parallel with the
      plasma results, CSF OT responses were absent in hyponatremic rats given HS i.v.
      and significantly blunted in hyponatremic rats given HS i.p., but neither group
      had increased CSF AVP. Nonosmotic stimulation with isotonic LiCl increased OT
      levels both in plasma and CSF in normonatremic rats 20 min after
      treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783855
TI  - Regulation of thyrotropin-releasing hormone in the posterior pituitary.
AB  - Although the presence of thyrotropin-releasing hormone (TRH) in the posterior
      pituitary (PP) was reported more than one decade ago, knowledge on its origin,
      regulation and functional significance is lacking. In the present study we
      investigated the regulation of TRH in the rat PP. Analysis by specific RIA, anion
      and cation exchange chromatography and reverse-phase HPLC showed that all TRH
      immunoreactivity in the PP is accounted for by authentic TRH. Induction of
      hyperthyroidism with thyroxine increased levels of TRH in the PP by 20%, whereas
      in methimazole-treated, hypothyroid rats the content decreased by 25% versus
      untreated, euthyroid controls. Food deprivation for 3 days increased levels by
      35% and refeeding completely normalized TRH content again. Also 14-17 days after
      castration, TRH in the PP was increased by 25% while testosterone substitution
      prevented this increase. Castration did not affect proTRH mRNA levels in the
      hypothalamus. One week after adrenalectomy or daily subcutaneous dexamethasone
      injections, TRH content in the PP was not affected. Treatment with disulfiram, an
      inhibitor of the peptidylglycine alpha-amidating monooxygenase (PAM), reduced
      levels of TRH in the PP by 20%. ProTRH and PAM mRNA levels were not affected in
      the hypothalamus by this treatment. Since TRH in the PP has been suggested to
      play a role in prolactin (PRL) release, we determined the content of TRH in the
      PP during a 6-hour suckling stimulus that increased PRL levels in peripheral
      blood 30-fold. Whereas TRH in the median eminence increased by 35%, 6 h after the
      initiation of suckling, TRH levels in the PP remained constant.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7783856
TI  - Adrenergic control of alpha-melanocyte-stimulating hormone release in frog
      pituitary is mediated by both beta- and a nonconventional alpha 2-subtype of
      adrenoreceptors.
AB  - Previous studies have shown that melanotrope cells of the pars intermedia of Rana
      ridibunda are inhibited by dopaminergic D2 agonists and stimulated by beta
      adrenergic agonists. In the present study, we have examined the possible
      involvement of alpha-adrenoreceptors in the regulation of frog melanotrope cells.
      Reversed-phase HPLC analysis combined with electrochemical detection revealed the
      presence of both dopamine and noradrenaline in pars intermedia extracts (74.1 and
      3.2 ng/mg protein, respectively), while adrenaline was undetectable.
      Administration of graded doses of noradrenaline and adrenaline (from 0.1 to 10
      microM) to perifused frog neurointermediate lobes induced a dose-dependent
      inhibition of alpha-MSH release. The inhibitory effect of adrenaline was
      partially blocked by the D2-dopaminergic antagonist sulpiride and totally
      suppressed by concomitant administration of sulpiride and yohimbine (an alpha 2
      adrenergic antagonist). Conversely, in the presence of sulpiride, noradrenaline
      provoked a strong stimulation of alpha-MSH secretion which was totally blocked by
      the beta-adrenergic antagonist propranolol. Taken together, our results indicate
      that endogenous catecholamines may exert a complex regulatory action on frog
      melanotrope cells through activation of dopaminergic D2, alpha 2- and beta
      adrenergic receptors.

PMID- 7783857
TI  - Direct regulation of hypothalamic corticotropin-releasing-hormone neurons by
      angiotensin II.
AB  - The possible role of angiotensin II (AII) in the control of the hypothalamic
      pituitary-adrenal (HPA) axis was studied in the rat by examining the regulation
      and cellular localization of AII receptors in the paraventricular nucleus (PVN)
      of the hypothalamus and the effect of AII on corticotropin-releasing hormone
      (CRH) and vasopressin (VP) mRNA levels. In situ hybridization studies using cRNA
      35S-labelled probes showed that while type 1 AII receptor (AT1) mRNA levels were
      high in the periventricular and parvicellular pars of the PVN, only very low
      levels were present in the magnocellular pars. A similar distribution of AT1
      receptor binding in the periventricular, parvicellular and magnocellular
      divisions of the PVN was observed in autoradiographic studies in hypothalamic
      sections labelled with 125I[Sar1,Ile8]AII. In addition, AII receptor binding was
      clearly evident in nerve fibers adjacent to the PVN. Double-labelling
      hybridization using digoxigenin-labelled CRH, VP and oxytocin probes and 35S
      labelled AT1 receptor cRNA probes showed AT1 receptor mRNA in cells stained for
      CRH mRNA, but not in VP or oxytocin cells. Four hours after a single
      intracerebroventricular (i.c.v.) injection of 50 ng AII in conscious rats, CRH
      mRNA levels in the PVN were increased by 43%, similar to the increases observed
      following acute stress by intraperitoneal (i.p.) injection of 1.5 M NaCl (76%).
      On the other hand, while i.p. hypertonic saline injection increased VP mRNA
      levels by 29% in the PVN and by 32% in the supraoptic nucleus, i.c.v. AII
      injection had no significant effect.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783858
TI  - Intracerebroventricular administration of corticotropin-releasing factor
      antagonist attenuates c-fos mRNA expression in the paraventricular nucleus after
      stress.
AB  - Corticotropin-releasing factor (CRF) plays a role in coordinating endocrine,
      physiological and behavioral responses to stressful stimuli. We have previously
      reported that centrally administered CRF rapidly induces c-fos mRNA expression in
      most areas that express c-fos following stress: the limbic structures including
      the hippocampus, amygdala, septal nucleus and hypothalamic nuclei such as the
      paraventricular nucleus (PVN), and brainstem nuclei such as Barrington's nucleus
      and locus ceruleus (LC). These results suggest several candidate structures
      through which CRF could exert its effects on the central nervous system. The aim
      of the present study was to explore the role of endogenous CRF in activating
      these brain regions after stress using a specific CRF receptor antagonist, alpha
      helical CRF(9-41). One hundred micrograms of alpha-helical CRF or vehicle alone
      was injected into the right lateral ventricle of rats. Thirty minutes later, they
      were exposed to restraint stress for 30 min, and the rat brain was then perfused
      transcardially with 4% paraformaldehyde. Another control group of rats was
      sacrificed 60 min after intracerebroventricular (ICV) injection of vehicle
      without restraint. In situ hybridization was performed by hybridizing sections
      with 35S-labeled c-fos cRNA probes. ICV injection of vehicle alone induced a weak
      c-fos mRNA expression in the lateral septal nucleus (LSV) and PVN in the rats
      without restraint, probably due to the mild stress of ICV injection. Restraint
      stress produced strong c-fos mRNA induction in the PVN, LSV, LC and Barrington's
      nucleus. However, ICV injection of 100 micrograms alpha-helical CRF significantly
      decreased c-fos mRNA expression in the PVN without affecting c-fos mRNA induction
      in the LSV, LC, or Barrington's nucleus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783860
TI  - Neuroendocrine correlates of the aging brain in humans.
AB  - Physiological brain aging is characterized by important biochemical and
      structural changes and by the unbalance among the different neurotransmitters and
      neuromodulators. The study of the circadian organization of neuroendocrine
      functions may be considered a clinically reliable tool to investigate the changes
      of the CNS and particularly of the limbic-hypothalamic system occurring in aged
      people. The circadian rhythms of plasma melatonin, ACTH and cortisol and of oral
      temperature were studied in 16 clinically healthy women aged 66-90 years and in
      14 young controls aged 20-30. In addition, the effect of dexamethasone on the
      plasma cortisol circadian rhythm and the cortisol response to Synacthen pulse
      intravenous injection were evaluated. All subjects were studied as inpatients,
      with the same synchronization to the hospital life schedule. When compared with
      young controls, elderly subjects exhibited a reduction of the mean level and of
      the amplitude of the circadian rhythm of oral temperature, an increase of the
      mean level of ACTH and cortisol rhythms and a selective impairment of melatonin
      nocturnal secretion. Furthermore, elderly subjects showed a reduced sensitivity
      to the dexamethasone suppression test, by comparison to young controls. These
      changes were age-related and they may depend either on CNS modification or on
      alterations of the hormonal metabolic clearance.

PMID- 7783859
TI  - Ventromedial hypothalamic lesions inhibit corticosteroid feedback regulation of
      basal ACTH during the trough of the circadian rhythm.
AB  - We have determined the effects of bilateral electrolytic lesions of the
      ventromedial hypothalamus (VMH) on activity in the hypothalamo-pituitary-adrenal
      (HPA) system. Acutely, during the first 5 days, lesions of the anterior-medial
      VMH caused loss of the diurnal rhythms in food intake and plasma corticosterone
      (B) levels. Plasma B concentrations were elevated during the time of the normal
      trough of the basal diurnal rhythm in HPA axis activity and the diurnal rhythm in
      food intake was abolished, in agreement with the results of others. Consistent
      with hyperactivity in the HPA axis, lesioned rats had increased adrenal weight,
      decreased thymus and body weights and decreased plasma transcortin
      concentrations. To determine how lesions of the VMH provoke these increases in
      activity of the HPA system, the sensitivity of ACTH in adrenalectomized, lesioned
      rats to replacement with exogenous B was determined under basal conditions during
      the trough (morning-AM) and peak (evening-PM) of the diurnal rhythm in HPA axis
      activity. ACTH in lesioned rats in the AM was insensitive to feedback over the
      very low range of plasma B of 1-4 micrograms/dl, whereas sham-lesioned controls
      exhibited the normal, high sensitivity of ACTH to B at this time of day. There
      was no difference between the sensitivity of ACTH to this low range of B in the
      PM in VMH- and sham-lesioned rats. Two to 5 weeks after VMH lesions, as found by
      others, mean daily plasma B levels did not differ from sham-lesioned controls;
      however, plasma B during the AM was still mildly elevated in these rats.
      Inhibition of plasma B in the PM by dexamethasone was less effective in lesioned
      rats. Although HPA system responses to hypoglycemia, corticotropin-releasing
      factor and ACTH were normal, the lesioned rats exhibited obesity,
      hyperinsulinemia, hyperglycemia, hypertension and tachycardia, all signs
      consistent with mild hyperactivity of the PHA axis. Occupancy of type I, high
      affinity corticosteroid receptors is known to control basal activity of the HPA
      system during the trough of the diurnal rhythm and to interact with
      glucocorticoid receptors to affect basal activity during the peak of the diurnal
      rhythm and during AM stress. We conclude that VMH lesions disrupt transmission of
      inhibitory signals, mediated by occupancy of type I corticosteroid receptors,
      that are initiated by a B feed-back site.

PMID- 7783861
TI  - The use of sumatriptan in patients on monoamine oxidase inhibitors.

PMID- 7783862
TI  - Cigarette smoking and protection from Parkinson's disease: false association or
      etiologic clue?
AB  - We reviewed 46 published reports associating cigarette smoking and Parkinson's
      disease. Although the majority indicated an approximate halving of smoking
      frequency in persons with Parkinson's disease, many observers have suggested that
      the effect could be a spurious result. That the association may be real is
      suggested by at least six observations: (1) the consistency of findings between
      independent studies of different design, conducted by different investigators, in
      different nations, over 35 years; (2) the association's predominance and strength
      in prospective studies; (3) the apparent detection of a dose-response relation;
      (4) the inability to explain the association by confounding variables; (5) the
      flaws in certain arguments against the association's validity; and (6) the
      identification of a similar association, of similar magnitude, between smoking
      and reduced occurrence of Alzheimer's disease. A protective association of
      cigarette smoking for Parkinson's disease may constitute an important etiologic
      clue.

PMID- 7783863
TI  - A primary care plan for neurology.

PMID- 7783864
TI  - Familial progressive subcortical gliosis: presence of prions and linkage to
      chromosome 17.
AB  - Progressive subcortical gliosis (PSG) is a sporadic and familial dementing
      disease characterized pathologically by astrogliosis at the cortex-white matter
      junction, a feature present in some prion diseases. With immunocytochemical and
      Western blot analyses, we investigated the presence of deposits of the prion
      protein (PrP) and of the protease-resistant PrP isoform, the hallmarks of prion
      diseases, in six affected members of two large kindreds with PSG. The coding
      region of the PrP gene was sequenced and chromosomal linkage determined. We
      demonstrated "diffuse" PrP plaques in the cerebral cortex of two subjects from
      one kindred and protease-resistant PrP fragments in four of the five subjects
      examined. We found no mutation in the coding region of the PrP gene. Moreover,
      the disease was linked to chromosome 17 and not to chromosome 20, where the PrP
      gene resides. The familial form of PSG is the first human genetic disease
      characterized by the presence of protease-resistant PrP that lacks a mutation in
      the coding region of the PrP gene. The linkage to chromosome 17 suggests that
      other genes are involved in the PrP metabolism. Whether the protease-resistant
      PrP plays a primary or secondary role in the pathogenesis of this form of PSG
      remains to be determined.

PMID- 7783866
TI  - Relationship of headache to phase of the menstrual cycle among young women: a
      daily diary study.
AB  - We investigated the relationship between headache occurrence and phase of the
      menstrual cycle in a 4-month daily diary study of 74 women, 22 to 29 years old,
      residing in Washington County, Maryland. We selected subjects from women
      reporting a history of migraine symptoms and at least two migraine headache
      attacks per month in a 1986 to 1987 population-based survey. Data collection was
      from March 1987 through April 1988. By using detailed headache symptom
      information collected daily, we classified headaches into four categories:
      migraine with aura, migraine without aura, tension-type, and all other headaches.
      Odds ratios were separately estimated for the individual headache types and all
      types combined during each of three phases of the menstrual cycle. Risk of
      migraine without aura was significantly elevated during the first 3 days of
      menstruation (odds ratio, 1.66; 95% confidence interval, 1.21 to 2.26), but
      headache risk was not significantly increased during the 2 days immediately
      preceding onset of menstruation or on the estimated day of ovulation (day 14
      before the onset of menstruation). Participants reported headaches on 28% of the
      study days overall, suggesting that onset of menstruation is an independent but
      not exclusive precipitating factor for headache attacks among young adult women
      with migraine. Our data show that onset of menstruation only accounts for a small
      proportion of migraine attacks among young women with frequent episodes of
      migraine.

PMID- 7783865
TI  - Clinical and genetic studies of fatal familial insomnia.
AB  - We report a 42-year-old man who, for 8 months, had intermittent motor
      abnormalities and mild difficulty falling asleep. A diagnosis of fatal familial
      insomnia (FFI) became evident over the next 6 months when he developed
      progressive insomnia, myoclonus, sympathetic hyperactivity, and dementia. The
      amyloid or prion protein (PrP) genotype showed features typically seen in FFI,
      with a 178Asn mutation and a 129Met polymorphism. There was also a deletion of
      one octapeptide repeat, suggesting that the association of 178Asn mutation with
      the 129Met polymorphism is not due to "founder effect." Western immunoblot showed
      a trace of protease-resistant PrP in the thalamus--which had the most significant
      neuronal loss and gliosis--a moderate amount of PrP in the fronto-temporal area,
      and no detectable protein elsewhere in the brain. Endocrine studies showed that a
      circadian modulation of hormonal levels could be maintained despite a near-total
      absence of sleep. Administration of gamma-hydroxybutyrate induced a remarkable
      increase in slow-wave sleep.

PMID- 7783867
TI  - Mitral valve prolapse and the risk of stroke after initial cerebral ischemia.
AB  - Referral-based studies suggest that patients with cerebral ischemia and mitral
      valve prolapse are prone to recurrent cerebral ischemic events. Our purpose was
      to determine the risk of subsequent stroke in a population-based group of
      patients with ischemic stroke or TIA and mitral valve prolapse. From 1975 through
      1990, 49 residents of Olmsted County, MN, had an initial ischemic stroke or TIA
      and echocardiographically diagnosed mitral valve prolapse. Risk of subsequent
      stroke in this cohort was compared with the age- and sex-adjusted rates of
      recurrent stroke after initial cerebral ischemia in the Rochester, MN,
      population. Mean age of the patients was 72 years. Thirty-one (63%) were women.
      Nine had subsequent stroke (5.5 per 100 person-years). For Rochester patients who
      had initial ischemic stroke in the period 1975 through 1984, 10.72 recurrent
      strokes were expected (relative risk, 0.84; 95% confidence limits, 0.38 to 1.59).
      For Rochester patients with initial ischemic stroke or TIA in the period 1975
      through 1979, 12.31 recurrent strokes were expected (relative risk, 0.73; 95%
      confidence limits, 0.33 to 1.39). There is no evidence of increased subsequent
      stroke risk among patients with initial episodes of cerebral ischemia and mitral
      valve prolapse relative to the age- and sex-adjusted recurrent stroke rates in
      the community.

PMID- 7783868
TI  - Autosomal dominant migraine with MRI white-matter abnormalities mapping to the
      CADASIL locus.
AB  - Cerebral autosomal dominant arteriopathy with subcortical infarcts and
      leukoencephalopathy (CADASIL) is an autosomal dominant cerebral arteriopathy
      mapped to chromosome 19 and characterized mainly by recurrent subcortical
      ischemic strokes and extensive white-matter signal abnormalities (WMAs) on
      magnetic resonance imaging. Other clinical features include migraine attacks and
      progressive subcortical dementia. Herein, we describe several members of the same
      family who suffered migraine attacks, mostly with aura, associated with WMAs,
      segregating with an autosomal dominant pattern of inheritance. One individual had
      a progressive subcortical dementia with similar WMAs. Although ischemic stroke,
      one of the hallmarks of CADASIL, was not present in this family, we hypothesized
      that the present disorder resulted from an alteration of the CADASIL gene.
      Genetic linkage analysis, using four chromosome 19 markers spanning the CADASIL
      locus, supports this hypothesis.

PMID- 7783869
TI  - Interactions of apolipoprotein E genotype, total cholesterol level, age, and sex
      in prediction of Alzheimer's disease: a case-control study.
AB  - OBJECTIVE: The joint effects of total cholesterol (TC) levels and the APOE
      genotype in Alzheimer's disease (AD) were evaluated because of previous reports
      that the APOE locus epsilon 4 allele was associated with both late-onset AD and
      elevated TC. DESIGN: Logistic regression was used to determine the effects of the
      APOE genotype, TC, age, and sex on prediction of AD in a community-based study of
      206 cases and 276 controls. RESULTS: The relationship of the APOE genotype and AD
      was dependent on TC, age, and sex. However, current TC level does not fully
      explain the epsilon 4-Alzheimer's disease association. Affected men with higher
      TC and age under 80 years had the highest epsilon 4 allele frequencies. The
      epsilon 4 frequency declined significantly with age. SIGNIFICANCE: A pathologic
      role of higher TC or cholesterol-based differential survival of epsilon 4
      carrying individuals may be involved in the relationship of the epsilon 4 allele
      with AD. The observed association of the APOE genotype and AD is expected to
      depend on the age, sex, and TC distributions of a given sample.

PMID- 7783870
TI  - Trigeminal neuralgia in multiple sclerosis relieved by a prostaglandin E
      analogue.
AB  - Trigeminal neuralgia is an uncommon but troublesome symptom of multiple sclerosis
      that can be refractory to conventional treatments. Misoprostol, a long-acting
      prostaglandin E1 analogue, relieved pain in six of seven patients who had failed
      to respond to conventional pharmacologic therapy.

PMID- 7783871
TI  - X-linked adrenoleukodystrophy presenting as neurologically pure familial spastic
      paraparesis.
AB  - The familial spastic paraplegias (FSPs) are heterogeneous neurologic disorders
      that are known to occur clinically as "pure" or "complicated" forms. Although
      some of the complicated FSPs have been linked to specific metabolic defects, the
      pure forms of this disorder remain idiopathic and are considered to be primary
      system degenerations. We report the case of a 28-year-old man who has evidenced a
      neurologically pure spastic paraparesis since age twenty-five. Consistent with
      this diagnosis were the findings of magnetic resonance imaging, which revealed
      atrophy of the thoracic spinal cord without evidence for white matter disease in
      the cerebrum, cerebellum, or brainstem. His 32-year-old brother has also
      evidenced progressive spastic paraparesis since age 30, but his case is
      confounded by a severe head injury at age 24 that caused a skull fracture and a
      focal demyelinating lesion of the right frontal lobe. Both patients have had
      hypogonadism, requiring treatment with testosterone, since age 20. Measurement of
      plasma levels of very long-chain fatty acids (VLCFA) revealed that both brothers
      had concentrations diagnostic of adrenoleukodystrophy; their mother had plasma
      VLCFA levels in the heterozygous range. We conclude that neurologically pure FSP
      can be an early manifestation of adrenoleukodystrophy and that levels of plasma
      VLCFA should be determined for all cases of FSP in which X-linked inheritance
      appears tenable. These considerations may have bearing on the ongoing linkage
      studies for these disorders.

PMID- 7783872
TI  - Extensive macrogyri or no visible gyri: distinct clinical,
      electroencephalographic, and genetic features according to different imaging
      patterns.
AB  - We studied 43 children with extensive brain gyral anomalies diagnosed
      radiologically and defined by (a) the absence or paucity of sulci over cortical
      areas affecting at least two lobes in each hemisphere, and (b) the absence or
      reduction of interdigitation between gray and white matter. We correlated the
      clinical, EEG, and genetic findings with the imaging features. A seemingly
      homogeneous group of patients (group A, n = 30) presented a common imaging
      pattern characterized by four features: (1) a thickened neocortex, (2) widened
      lateral ventricles, (3) apparent verticalization and widening of sylvian
      fissures, and (4) bilateral and symmetric distribution of the abnormalities.
      Another group of patients (group B, n = 13) exhibited heterogeneous imaging
      anomalies, termed "nonlissencephalic brain malformation," differing in at least
      one of the following four ways from the radiologic criteria defining group A:
      absence of verticalization of sylvian fissures (n = 12), thin neocortex (n = 2),
      normal-size lateral ventricles (n = 2), and asymmetric brain defects (n = 3). In
      group A, some clinical features had a significantly lower frequency (p < or =
      0.01) than in group B: microcephaly, a complete lack of postural development, and
      intractable epilepsy. There was a significant relationship, but only in group A,
      between the degree of gyral anomalies and the extent of neurodevelopmental delay.
      Some EEG patterns (rapid rhythms and delta-theta rhythms) were highly specific
      for the group A patients. There was lower risk of familial recurrence in group A
      (recurrence of convolutional anomalies was 3.5% of sibship in group A versus 44%
      of sibship in group B, p = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783873
TI  - Lacrimation induced by thermal stress in patients with a facial nerve lesion.
AB  - I measured facial sweating, flushing, and lacrimation during body heating in 10
      patients with a facial nerve lesion compromising parasympathetic outflow. During
      heating, moisture accumulated in the symptomatic eye of patients with facial
      nerve palsy, particularly in patients with a long-standing lesion. Sweating and
      flushing in the forehead were symmetrical. These findings suggest that
      sympathetic neural discharge during heat stress influences lacrimation in the
      symptomatic eye of patients with a long-standing facial nerve lesion. Cross
      innervation of lacrimal neurons by sympathetic fibers passing through the
      sphenopalatine ganglion or occupation of degenerated parasympathetic pathways by
      sympathetic fibers in the periphery could mediate this response.

PMID- 7783874
TI  - Variables influencing neuropathic endpoints: the Rochester Diabetic Neuropathy
      Study of Healthy Subjects.
AB  - We determined the normal limits for various neuropathic tests in healthy
      subjects. The study, the Rochester Diabetic Neuropathy Study (RDNS), is
      noteworthy because of its size (more than 400 subjects), random selection of
      subjects, and selection of at least 15 men and 15 women without neuropathy,
      neurologic disease, or diseases predisposing to neuropathy from each hemidecade
      between 18 and 74 years of age from the population of a defined region
      (Rochester, MN). Subjects were classified into those with (nonhealthy subjects,
      RDNS-NS) and without (healthy subjects, RDNS-HS) neuropathy, neurologic or
      psychiatric disease, or diseases known to predispose to neuropathy. The study
      provides normal limits for tests used in the RDNS but it has broader uses as
      well. We found that (1) less than 10% of subjects in the third decade,
      approximately 20% in the fourth decade, and approximately 30% in the fifth or
      older decades were placed into the RDNS-NS category; (2) healthy subjects (RDNS
      HS) retain their ability to walk on toes and heels regardless of age, excessive
      weight, or lack of physical fitness, but not their ability to arise from a
      kneeled position--lost in more than 5% of persons 60 years and older; (3) the
      frequency of decreased or absent ankle reflexes exceeds 5% in healthy subjects
      older than 50 years--limiting their value as a sign of diabetic polyneuropathy
      and necessitating a grading change with age in the neuropathy impairment
      score.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783875
TI  - Blood-brain barrier disruption on contrast-enhanced MRI in patients with mild
      relapsing-remitting multiple sclerosis: relationship to course, gender, and age.
AB  - MRI has provided insight into the pathophysiology and course of MS, particularly
      through the use of a paramagnetic contrast agent that allows visualization of
      blood-brain barrier (BBB) breakdown. Neither the overall frequency of BBB
      breakdown in MS patients nor the characteristics associated with BBB breakdown in
      MS are known. We studied 68 relapsing-remitting MS (RRMS) patients with three
      monthly MRIs to examine these questions. Seventy-eight percent of the RRMS
      patients studied had evidence of BBB breakdown on at least one MRI. While there
      was a great deal of variability among patients in terms of mean enhancing lesion
      frequency, BBB breakdown was associated with younger age at onset of disease,
      measured by age at first symptom or age at diagnosis, and more severe disease as
      measured by Expanded Disability Status Scale scores equal to or greater than 4.0.
      We found no relationship between BBB breakdown and duration of disease or gender.
      We conclude that BBB breakdown is a relatively common phenomenon in RRMS patients
      and may be most commonly found in patients with more aggressive disease and
      younger onset. These findings have implications for clinical trials that use MRI
      as an outcome measure.

PMID- 7783876
TI  - Gerstmann-Straussler-Scheinker disease with mutation at codon 102 and methionine
      at codon 129 of PRNP in previously unreported patients.
AB  - We present two patients with Gerstmann-Straussler-Scheinker disease (GSS), one
      from a previously undescribed kindred and one from the Canadian branch of a
      previously reported British kindred. In both patients, GSS is caused by a
      substitution of thymine for cytosine at codon 102 of the prion protein gene
      (PRNP). In each patient, we confirmed the clinical diagnosis by neuropathologic
      examination. The mutation, causing a substitution of leucine for proline at
      residue 102 (P102L) of the prion protein, has been previously reported in at
      least 30 other families. In the patients described here, the mutation was in
      coupling with methionine at PRNP codon 129.

PMID- 7783878
TI  - Increased iron-related MRI contrast in the substantia nigra in Parkinson's
      disease.
AB  - Elevated iron levels in the substantia nigra (SN) of the brain in Parkinson's
      disease (PD) may mediate lipid peroxidative reactions, promoting SN neuronal
      death. To assess SN iron accumulation in living PD patients and its relation to
      motor performance, we measured, in 13 nondemented PD patients and 10 normal
      control subjects, simple reaction time (SRT) and simple movement time (SMT),
      followed by head MRI in a 3-tesla system. We measured T2 and T2* in the right and
      left SN of all subjects and calculated R2', the relaxation rate due to local
      magnetic field in-homogeneities, from these values. Asymmetries of 1/T2 (R2),
      1/T2* (R2*), or R2' versus asymmetries of SRT and SMT were assessed in eight PD
      subjects who had not taken anti-PD medication(s) for 12 hours. The average of
      right and left SN values for R2 was lower, and R2* and R2' were higher, in PD
      patients than in controls (R2, p = 0.046; R2*, p = 0.001; R2', p < 0.001). R2'
      best predicted group differences. The asymmetry of SRT performance was highly
      correlated with asymmetries of SN R2* (0.91; p = 0.001) and R2' (0.72; p = 0.03).
      These results strongly suggest that the increases in iron levels seen postmortem
      in the SN in PD are reflected in increased iron-related MRI contrast at 3 tesla
      in living PD patients. Correlations with motor performance in PD suggest that the
      clinical severity of PD may be related to SN iron accumulation.

PMID- 7783877
TI  - Serum neuron-specific enolase in human status epilepticus.
AB  - Neuron-specific enolase (NSE) is a sensitive marker of brain injury after stroke,
      global ischemia, and coma. We report changes in serum NSE (s-NSE) in 19 patients
      who sustained status epilepticus. s-NSE peaked within 24 to 48 hours after status
      epilepticus. The mean peak s-NSE level for the entire group was elevated compared
      with the levels for normal controls (24.87 ng/ml versus 5.36 ng/ml, p = 0.0001)
      and for epileptic controls (24.87 ng/ml versus 4.61 ng/ml, p = 0.0001). The mean
      peak s-NSE level for the 11 subjects without an acute neurologic insult (15.44
      ng/ml) was also significantly increased compared with levels for normal and
      epileptic controls. Further, s-NSE was significantly correlated with outcome and
      duration. We conclude that s-NSE is a promising in vivo marker of brain injury in
      status epilepticus and warrants further study in larger populations.

PMID- 7783879
TI  - Visual alterations in de novo Parkinson's disease: pattern electroretinogram
      latencies are more delayed and more reversible by levodopa than are visual evoked
      potentials.
AB  - There are increased latencies of pattern-reversal visual evoked potentials (VEPs)
      and electroretinograms (PERGs) in Parkinson's disease (PD) patients who have not
      received therapy. This study aimed to evaluate whether these delays are present
      in the early stage of PD and whether they are dopamine-sensitive. The results
      show that both PERG P50 and VEP P100 latencies are increased (p < 0.0001) in a
      group of patients with de novo PD (13 subjects; 13.3 +/- 5.6 months' mean disease
      duration) before therapy in comparison with an age-matched control group (eight
      subjects). A larger latency increase (9.9% at the 47% contrast level and 7.8% at
      the 96% contrast level) was present in PERG recordings than in VEPs (6.2% at the
      47% contrast level and 3.9% at the 96% contrast level). Levodopa therapy produced
      recovery of both PERG and VEP latency increases at both contrast levels, but only
      the PERG recovery at 47% of contrast was statistically significant. Before
      therapy, five eyes from PD patients showed no reproducible PERG at the 47%
      contrast level although the simultaneously recorded VEP was present. Both
      potentials were recordable in the same eyes at the 96% contrast level. During
      therapy, four of those five eyes showed a clear PERG even at the 47% contrast
      level. We conclude that, using an adequate midspatial frequency, both VEPs and
      PERGs are delayed even in the early stage of PD, and that PERGs are more
      sensitive if low contrast (47%) is used. The larger alterations, as well as the
      larger recovery during levodopa therapy, seem to correlate the PERG response more
      than the VEP response to dopaminergic transmission.

PMID- 7783880
TI  - GM1 ganglioside treatment of Parkinson's disease: an open pilot study of safety
      and efficacy.
AB  - We performed an open-label study testing the effects of GM1 ganglioside on 10
      Parkinson's disease (PD) patients. Patients received 1,000 mg of GM1 by IV
      infusion after the last of three baseline functional assessments. Patients then
      self-administered GM1 at a dose of 200 mg/d, by subcutaneous injection, for 18
      weeks. Under these conditions, GM1 ganglioside proved to be safe and well
      tolerated. There were no serious adverse events and none of the patients
      developed elevated anti-GM1 antibody titers. Improvements on at least some
      functional measures were present in most patients, beginning after 4 to 8 weeks
      of GM1 treatment. When functional improvements occurred, they lasted for the
      duration of the study. These results suggest that GM1 ganglioside is well
      tolerated and may be a useful adjunct to the treatment of PD, and that a double
      blind, placebo-controlled study is now warranted.

PMID- 7783882
TI  - Ictus emeticus: further evidence of nondominant temporal involvement.
AB  - We report two cases of ictal vomiting in patients who had left temporal lobe
      epilepsy. In one patient, vomiting developed when the discharge spread to the
      right temporal lobe as seen during depth electrode recording. In the second
      patient, ictal vomiting occurred with a restricted left temporal discharge, but
      the patient was left-handed and had right-hemisphere language dominance. These
      cases provide additional evidence of the involvement of the nondominant temporal
      lobe in ictus emeticus.

PMID- 7783881
TI  - Effects of long-term treatment with antiepileptic drugs on serum lipid levels in
      children with epilepsy.
AB  - We determined serum levels of total cholesterol (TC), high-density lipoprotein
      cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low
      density lipoprotein cholesterol (VLDL-C), and triglycerides (TGs) in 125 healthy
      children and in 119 children with epilepsy who had been receiving carbamazepine
      (58 children), phenobarbital (22 children), or valproic acid (39 children) for 7
      months to 10.5 years (mean, 5.8 years). None of the variables considered was
      significantly correlated with time elapsed since start of treatment or with drug
      concentration in serum. In the groups receiving carbamazepine or phenobarbital,
      mean TC, HDL-C, and LDL-C levels were higher than in the control group, the
      differences being statistically significant for all except LDL-C in the
      phenobarbital group. In neither group did mean TC/HDL-C ratio or mean LDL-C/HDL-C
      ratio differ significantly from the corresponding control-group mean. In the
      group receiving valproic acid, mean TC level, mean LDL-C level, mean TC/HDL-C
      ratio, and mean LDL-C/HDL-C ratio were significantly lower than in the control
      group. In none of the treated groups did mean VLDL-C or TG level differ
      significantly from the corresponding control-group mean. Our results suggest, in
      contrast to previous reports, that the effects on the serum lipid profile of long
      term treatment with hepatic-enzyme-inducing antiepileptic drugs (such as
      carbamazepine and phenobarbital) are probably not beneficial as regards risk of
      atherosclerosis-related disease. Our results additionally suggest a need for
      careful monitoring of serum cholesterol levels in children with epilepsy
      receiving carbamazepine or phenobarbital.

PMID- 7783883
TI  - Incidence and risk factors of vascular dementia and Alzheimer's disease in a
      defined elderly Japanese population: the Hisayama Study.
AB  - We followed 828 nondemented residents of Hisayama Town, Kyushu, Japan, aged 65
      years or older (88.3% of the elderly population) for 7 years starting in 1985 in
      order to determine the type-specific incidence of dementia and its risk factors
      in the general Japanese population. Only two subjects were lost to the follow-up,
      during which period 103 subjects developed dementia. Morphologic examination of
      the brains of 89 subjects (86.4%) was made by autopsy or CT. We made the initial
      diagnosis of dementia based on the DSM-III-R criteria, with the diagnoses of
      vascular dementia (VD) being based on the NINDS-AIREN criteria and Alzheimer's
      disease (AD) on the NINCDS-ADRDA criteria. The incidence of VD and AD increased
      with age for both sexes. The age-adjusted total incidence (per 1,000 person
      years) of dementia was 19.3 for men and 20.9 for women. The corresponding rates
      for VD were 12.2 for men and 9.0 for women, and for AD, 5.1 for men and 10.9 for
      women. Among the VD subjects whose brain morphology we examined, the most
      frequent type of stroke was multiple lacunar infarcts (42%), but half these
      subjects lacked a stroke episode in their histories. Multivariate analysis showed
      that age, prior stroke episodes, systolic blood pressure, and alcohol consumption
      were significant independent risk factors for the occurrence of VD. In contrast,
      age and a low score on Hasegawa's dementia scale were significant risk factors
      for AD, and physical activity was a significant preventive factor for
      AD.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783884
TI  - Using motion perimetry to detect visual field defects in patients with idiopathic
      intracranial hypertension: a comparison with conventional automated perimetry.
AB  - Motion perimetry, a method of visual field testing that uses computer graphics to
      measure motion perception, quantitates a subject's ability to detect a coherent
      shift in position of dots in a defined circular area against a background of
      fixed dots. Motion size threshold is defined as the smallest detectable circular
      target in which dot motion is detected. Subjects respond by touching a computer
      monitor screen with a light pen, first when they see a target (reaction time) and
      a second time where motion targets are detected (localization). Reaction time
      (msec) to the stimulus and localization error (number of pixels from target
      center) are then calculated and stored. We tested on eye in each of 20 idiopathic
      intracranial hypertension (IIH) patients and 40 age-matched normal subjects by
      conventional automated perimetry (Humphrey visual field analyzer, program 24-2)
      and motion perimetry. Pointwise probability plots of individual abnormal test
      points for size threshold responses were generated for the IIH patients based on
      the 95% confidence limits of the normal subject responses. An analysis of the
      subjects' visual field pairs (motion versus conventional automated perimetry) was
      performed based on these probability plots. The IIH patients had an elevated mean
      motion threshold (p < 0.001) and reaction time (p < 0.001) compared with the
      normal subjects. There were no significant differences for the localization
      errors. Based on the probability plot analysis, there was good correlation of the
      visual field defects between the two perimetry tests. In addition, motion
      perimetry identified nerve fiber bundle-shaped defects in nine patients in whom
      they were not detected with conventional automated perimetry.

PMID- 7783885
TI  - Cerebral morphometric abnormalities in Tourette's syndrome: a quantitative MRI
      study of monozygotic twins.
AB  - Although the pathologic substrate of Tourette's syndrome (TS) is unknown, studies
      have implicated subtle changes in the basal ganglia. To further investigate
      structural basal ganglia pathology in TS, we performed morphometric analyses of
      MRIs of 10 monozygotic twin pairs discordant for severity of TS but concordant
      for the presence of tic disorders (mean age, 16.3 years; range, 9 to 31 years).
      Right caudate volume was slightly but significantly reduced in the relatively
      more severely affected twins as a group compared with the less affected twins
      (mean difference = 6%, p < 0.01). Most of this difference was attributable to
      volume reduction in the anterior right caudate (p < 0.02), which was smaller in
      the more severely affected twin in nine of 10 twin sets. The mean volume of the
      left lateral ventricle was 16% smaller in the more severely affected twins than
      in the less severely affected twins (p < 0.01). The normal asymmetry of the
      lateral ventricles (left greater than right) was not present in the more severely
      affected twins, who had a trend toward a larger right lateral ventricle.
      Moreover, the difference within a pair in the degree of loss of the normal
      ventricular asymmetry correlated with the difference within a pair in the
      severity of the tic disorder (r = 0.75, p < 0.02). There were no other basal
      ganglia, ventricular volumetric, or asymmetry abnormalities. These findings
      partially replicate other MRI studies and suggest that subtle structural
      abnormalities in the CNS, particularly in the caudate, may play a role in the
      pathophysiology of TS.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7783886
TI  - Fluctuations in autonomic nervous activity during sleep displayed by power
      spectrum analysis of heart rate variability.
AB  - OBJECTIVE: The use of an efficient noninvasive method to investigate the
      autonomic nervous system and cardiovascular control during sleep. BACKGROUND:
      Beat-to-beat heart rate variability displays two main components: a low-frequency
      (LF) one representing sympathetic and parasympathetic influence and a high
      frequency (HF) component of parasympathetic origin. Sympathovagal balance can be
      defined as LF/HF ratio. METHODS/DESIGN: We reviewed normal, standardly staged all
      night polysomnograms from 10 healthy children aged 6 to 17 years. Recorded 256
      second traces of heart rate and respiration were sampled. Power spectra of
      instantaneous heart rate and respiration were computed using a fast Fourier
      transform method. RESULTS: The study revealed a decrease in LF during sleep, with
      minimal values during non-REM slow-wave sleep and elevated levels similar to
      those of wakefulness during REM. HF increased with sleep onset, reaching maximal
      values during slow-wave sleep, and behaved as a mirror image of LF. LF/HF ratio
      displayed changes similar to those in LF. CONCLUSION: The sympathetic
      predominance that characterizes wakefulness decreases during non-REM sleep, is
      minimal in slow-wave sleep, and surges toward mean awake levels during REM sleep.
      The autonomic balance is shifted toward parasympathetic predominance during slow
      wave sleep. This noninvasive method used to outline autonomic activity achieves
      results that are in complete agreement with those obtained with direct invasive
      tools.

PMID- 7783887
TI  - Demyelinating polyneuropathy in a patient with the tRNA(Leu)(UUR) mutation at
      base pair 3243 of the mitochondrial DNA.
AB  - A novel feature of demyelinating polyneuropathy was observed in a patient with
      the tRNA(Leu(UUR)) mutation at base pair 3243 of the mitochondrial DNA. Based on
      electrodiagnostic examination, the polyneuropathy was defined as being of the
      demyelinating, mixed (motor more than sensory) type. In a 1-year follow-up we
      observed approximately 7% reduction in both the motor and sensory conduction
      velocities. The other clinical features of the proband included a mild to
      moderate cognitive impairment and a combined hearing loss with a moderate
      sensorineural component. The proportion of the mutant genome found in the muscle
      of the proband was 29%, but the mutation was not found in his blood. A wide
      variability of the clinical phenotype was observed in the family of the proband.
      Heteroplasmic mutation was detected in the blood of most family members. The
      proportion of abnormal mitochondrial DNA was highest in the proband's brother,
      who had clinically definite mitochondrial myopathy, encephalopathy, lactic
      acidosis, and stroke-like episodes (MELAS) syndrome, while the mutant genome was
      less frequent or absent in the subjects with less severe phenotypes and in
      healthy individuals. The findings on this pedigree emphasize the need for studies
      of complete families in the search for new clinical phenotypes of mutations in
      mitochondrial DNA.

PMID- 7783888
TI  - Short-term dichloroacetate treatment improves indices of cerebral metabolism in
      patients with mitochondrial disorders.
AB  - We performed a short-term, double-blind, placebo-controlled, crossover trial of
      sodium dichloroacetate (DCA) therapy in 11 patients affected by various primary
      mitochondrial disorders. Independent measures of oxidative metabolism (venous
      blood metabolites, exercise testing, phosphorus magnetic resonance [MR]
      spectroscopy of muscle, and proton MR spectroscopy of brain) were used in order
      to monitor metabolic responses to the drug. One week of DCA treatment produced
      significant decreases (p < 0.05) in blood lactate, pyruvate, and alanine at rest
      and after bicycle exercise. Proton MR spectra collected from a supraventricular
      volume of interest in brain of seven of 11 patients also showed significant
      changes. Brain lactate/creatine ratio decreased by 42% during DCA treatment (p <
      0.05). Brain choline/creatine ratio (which is low in patients with
      myelinopathies) increased by 18% (p < 0.01) after therapy. N
      Acetylaspartate/creatine ratio (an index of neuronal damage or loss) increased by
      8% after treatment (p < 0.05). Proton MR spectra collected in two of 11 patients
      from a volume of interest including the basal ganglia showed similar results
      (decrease of 36.6% in lactate/creatine; increases of 16% in choline/creatine and
      4.5% in N-acetylaspartate/creatine). Phosphorus MR spectroscopy of muscle and
      self-assessed clinical disability were unchanged. Our study indicates that short
      term DCA treatment not only lowers blood lactate but also improves indices of
      both brain oxidative metabolism and neuronal and glial density or function.

PMID- 7783889
TI  - MRI and PET studies of manganese-intoxicated monkeys.
AB  - Using MRI and PET, we investigated the consequences of manganese intoxication in
      a primate model of parkinsonism and dystonia. Three rhesus monkeys were injected
      intravenously with doses of 10 to 14 mg/kg of MnCl2 on seven occasions, each a
      week apart. Two animals became hypoactive with abnormal extended posturing in the
      hind limbs. These motor disturbances did not improve with administration of
      levodopa. In all three monkeys, T1-weighted MRI demonstrated high signal
      intensities in the regions of the striatum, globus pallidus, and substantia
      nigra. No significant changes were found on [18F]6-fluoro-L-dopa,
      [11C]raclopride, or [18F]fluorodeoxyglucose PET. These results are consistent
      with the pathologic findings, which were primarily confined to the globus
      pallidus, and indicate that manganese intoxication is associated with
      preservation of the nigrostriatal dopaminergic pathway, despite clinical evidence
      of parkinsonian deficits. Chronic manganese intoxication may cause parkinsonism
      by damaging output pathways downstream to the nigrostriatal dopaminergic pathway.
      This is consistent with the demonstrated lack of therapeutic response to
      levodopa.

PMID- 7783890
TI  - Frontal lobe neglect in monkeys.
AB  - Using a crossed-response task, monkeys with neglect induced by frontal lesions
      appear to have motor rather than sensory neglect. However, the crossed-response
      task may not reveal sensory neglect (inattention) if no perceptual discrimination
      is required. We therefore trained two monkeys in a perceptually complex crossed
      response task. Following unilateral frontal (arcuate gyrus) ablation, we found no
      contralateral perceptual disorders or sensory neglect in either monkey but did
      find a failure to respond with the contralateral arm (motor neglect) in both
      monkeys. We also found that the monkeys made more incorrect responses with the
      arm ipsilateral to the lesion than they did with the contralateral arm. The
      errors made by the ipsilateral arm could be a compensatory strategy or a
      disinhibition phenomenon. Because these incorrect responses were not rewarded and
      became more frequent as motor neglect improved, the incorrect responses of the
      ipsilateral arm are not a compensatory strategy, but rather a defect we term
      "disinhibition hyperkinesia" or "allokinesia."

PMID- 7783891
TI  - Cardiac arrest following use of sumatriptan.
AB  - I report a 35-year-old woman with occult coronary artery disease who experienced
      cardiac arrest within minutes after receiving a first-time dose of subcutaneous
      sumatriptan for migraine. The patient was resuscitated, and subsequent serial
      cardiac enzymes indicated myocardial infarction. Because sumatriptan can cause
      coronary artery vasospasm, patients with significant risk factors for coronary
      artery disease should be carefully evaluated for cardiovascular disease prior to
      the use of sumatriptan.

PMID- 7783892
TI  - Neurologic complications following chiropractic manipulation: a survey of
      California neurologists.
AB  - To obtain an estimate of how often practicing neurologists in California
      encounter unexpected strokes, myelopathies, or radiculopathies following
      chiropractic manipulation, we surveyed each member of the American Academy of
      Neurology in California and inquired about the number of patients evaluated over
      the preceding 2 years who suffered a neurologic complication within 24 hours of
      chiropractic manipulation. Four hundred eighty-six neurologists were surveyed,
      177 responded; 55 strokes, 16 myelopathies, and 30 radiculopathies were reported.
      Patients were between the ages of 21 and 60, and the majority experienced
      complications following cervical manipulation. Most of the patients continued to
      have persistent neurologic deficits 3 months after the onset, and about one-half
      had marked or severe deficits. Nearly all of the strokes involved the posterior
      circulation and almost one-half were angiographically proven. Patients,
      physicians, and chiropractors should be aware of the risk of neurologic
      complications associated with chiropractic manipulation.

PMID- 7783893
TI  - Gabapentin treatment of seizures in acute intermittent porphyria.
AB  - Most antiepileptic drugs (AEDs) available have demonstrated porphyrogenicity in
      hepatic porphyrias. Gabapentin is a new AED not appreciably metabolized by the
      liver in humans. We report two patients with acute intermittent porphyria
      successfully treated with gabapentin without its inducing porphyric crisis.

PMID- 7783895
TI  - Unique presentation of a prolapsed thoracic disk: Lhermitte's symptom in a golf
      player.
AB  - We describe a man with a thoracic disk prolapse whose major manifestation for 10
      years was Lhermitte's symptom precipitated by a rotatory movement of the thoracic
      spine during during the golf swing.

PMID- 7783894
TI  - Impaired perception of facial identity and facial affect in Huntington's disease.
AB  - We tested five patients with Huntington's disease on tasks of facial
      discrimination and facial affect discrimination and matching. Four patients were
      impaired on a task or tasks of face discrimination, and all patients were
      impaired on at least one task of facial affect discrimination. We suggest that
      these findings reflect the role of the basal ganglia or its connections in visual
      processing.

PMID- 7783896
TI  - Monozygotic twins discordant for familial hemiplegic migraine.

PMID- 7783897
TI  - C-5 radiculopathy as a manifestation of giant cell arteritis.

PMID- 7783898
TI  - Combined system disease after nitrous oxide anesthesia: a case report.

PMID- 7783899
TI  - Microangiopathy of the brain and retina (Susac's syndrome): two patients with
      atypical features.

PMID- 7783900
TI  - Paraneoplastic cerebellar degeneration with anti-Yo antibody in a man.

PMID- 7783901
TI  - Early American neurologic textbooks.
AB  - Although European treatises were translated and available to American doctors
      interested in neurology during the 19th century, the early American neurologic
      textbooks were distinctive in their comprehensive integration of basic and
      clinical science. William A. Hammond, in 1871, published the first comprehensive
      American textbook of neurology, preceding the manuals by Gowers (1886) and
      Oppenheim (1894) by more than a decade. Four other American adult neurologic
      textbooks expanded on Hammond's model and incorporated other important topics,
      including neurologic anatomy, the formal examination, neurochemistry, and
      complete bibliographies. Bernard Sachs' 1895 textbook was the first pediatric
      neurologic textbook published in America and made significant contributions to
      the organization of childhood neurologic disorders. These works functioned as
      centralized resources for neurologic information, were influential educational
      tools, and helped foster a growing appreciation of the American neurologic school
      both nationally and internationally.

PMID- 7783902
TI  - CNS lymphoma.

PMID- 7783903
TI  - Beethoven's illness.

PMID- 7783904
TI  - Reflex sympathetic dystrophy.

PMID- 7783905
TI  - Meningeal metastases.

PMID- 7783906
TI  - Rasmussen's syndrome.

PMID- 7783907
TI  - Cytokine networks in multiple sclerosis. Proceedings of the 3rd Multiple
      Sclerosis Forum Workshop. Amsterdam, October 22, 1994.

PMID- 7783908
TI  - Circulating adhesion molecules and inflammatory mediators in demyelination: a
      review.
AB  - Accumulating evidence shows that adhesion molecules are critically involved in
      inflammatory demyelination in the focusing of systemic immune responses into the
      target tissue, the nervous system. Adhesion molecules are upregulated through the
      action of cytokines. Tumor necrosis factor alpha appears to be of prime
      importance. Circulating adhesion molecules probably reflect acute inflammatory
      episodes in the central and peripheral nervous system, but may also function to
      modulate ongoing inflammatory responses. Cytokines released by TH1 cells render
      resident and immigrant macrophages, as well as microglia, activated to synthesize
      and release increased amounts of inflammatory mediators, such as oxygen radicals,
      nitric oxide metabolites, and components of the complement system. A more
      detailed understanding of the sequence of immunopathologic events that culminate
      in myelin damage in the central and peripheral nervous systems has revealed
      several sites to which more specific and effective immunointervention can be
      targeted.

PMID- 7783909
TI  - The role of autoimmune T lymphocytes in the pathogenesis of multiple sclerosis.
AB  - Autoimmune T cells play a key role as regulators and effectors of autoimmune
      disease. In multiple sclerosis (MS), activated T cells specific for myelin
      components or other locally expressed autoantigens enter the CNS and recognize
      their antigen(s) on local antigen-presenting cells. After local stimulation, the
      T cells produce a plethora of cytokines and inflammatory mediators that have
      profound effects on the local cellular environment, induce and recruit additional
      inflammatory cells, and contribute to myelin damage. An increasingly detailed
      knowledge of these processes will greatly facilitate the development of new
      immunotherapies. This article focuses on the role of T cells in MS. We provide a
      brief overview of the principles of T-cell immunology, discuss the experimental
      techniques available for studying T cells, address the role of T cells in the
      pathogenesis of MS, and highlight modern concepts for immunotherapy.

PMID- 7783911
TI  - Differential aspects of cytokines in the immunopathology of multiple sclerosis.

PMID- 7783910
TI  - Inhibitory cytokines and cytokine inhibitors.
AB  - Cytokines such as interleukin-1 and tumor necrosis factor are involved in the
      triggering of the immune response, induction of acute inflammatory events, and
      transition to, or persistence of, chronic inflammation. The action of
      proinflammatory cytokines is regulated by their receptor expression,
      downregulation and shedding, by specific inhibitors, and by inhibitory cytokines
      mainly produced by lymphocytes. This review aims to pinpoint recent findings in
      the assessment of the biologic activities of cytokine inhibitors and inhibitory
      cytokines. The suitability of these agents as therapeutic tools is discussed.

PMID- 7783913
TI  - Interferons in multiple sclerosis: warnings from experiences.
AB  - Administering or neutralizing a single cytokine is currently considered to
      represent a promising approach to therapeutic intervention in the immune network
      in autoimmune diseases. In this article, evidence from animal model experiments
      is reviewed: intervention in such models can have results opposite to those in
      the clinical disease; and intended neutralization of a cytokine by the
      administration of anticytokine antibodies can enhance as well as block in vivo
      cytokine activity. In experimental autoimmune encephalitis in mice, a model
      system for multiple sclerosis, administration of interferon gamma (IFN-gamma) was
      found to reduce disease severity and, concordantly, administration of anti-IFN
      gamma antibodies was found to aggravate disease. These experimental data are,
      however, in sharp contrast to the reports on clinical trials, in which IFN-gamma
      administration was followed by disease relapses. Administration of a neutralizing
      anti-interleukin-6 (IL-6) antibody to mice to block in vivo activity of IL-6
      resulted in increased rather than decreased serum titers, an effect that was
      found to be due to formation of immune complexes whose elimination from the body
      is retarded.

PMID- 7783912
TI  - Experimental autoimmune encephalomyelitis: immunotherapy with anti-tumor necrosis
      factor antibodies and soluble tumor necrosis factor receptors.
AB  - Multiple sclerosis (MS) is a demyelinating disease in which an inflammatory cell
      infiltrate represents a characteristic pathologic feature of active lesions
      within the CNS. The possibility has been raised that cell-mediated immune
      mechanisms orchestrate the pathogenesis of MS. Cytokines play a particularly
      important role in cellular immune mechanisms. These soluble glycoproteins,
      nonimmunoglobulin in nature, act nonenzymatically to regulate immune cell
      function. A unique family of cytokines, the tumor necrosis factors (TNFs),
      demonstrate immunoregulatory activity but are also involved in the effector arm
      of cellular immune responses. Recently, studies both in vitro and in vivo have
      suggested a role for TNFs in the pathology of MS. This report summarizes data
      implicating TNFs in the mechanisms of MS and attempts to apply the anti-TNF
      approach in the future therapeutic strategy for this disease.

PMID- 7783914
TI  - The role of cytokines in multiple sclerosis.

PMID- 7783915
TI  - Cytokine production in the central nervous system.
AB  - Cytokines participate in normal physiologic events within the CNS. At times of
      infection and inflammation, their role is emphasized by the upregulation of
      cytokines and their receptors within the CNS, with concomitant effects on brain
      function. Cytokines produced by glial cells, T cells, and macrophages interact
      within the CNS to determine the outcome of the inflammatory reaction. Cytokines
      have been implicated in the pathogenesis of many CNS diseases, including multiple
      sclerosis (MS), and their role continues to be intensely investigated. The
      possibility of novel cytokine therapies, such as anticytokine antibodies or
      receptor antagonists acting on the cytokine network, provides an optimistic
      future for treatment of MS and other CNS diseases in which cytokines have been
      implicated.

PMID- 7783916
TI  - Suicides in the military: 1980-1992.
AB  - Data abstracted from the Report of Casualty (DD 1300) is used to describe
      suicides of active duty personnel for the period 1980 through 1992. The Marine
      Corps had the fewest suicides (345), but the highest rate (13.65 per 100,000)
      compared to the other services: Army (1,205/12.38), Air Force (828/11.31), and
      the Navy (800/11.01). Personnel 17 to 24 years of age accounted for 48% of the
      suicides and had the highest age group-specific rate, 12.34. White males
      accounted for 79% of all suicides and had the highest rates across all age
      groups. Males had significantly higher rates than females in the Air Force, Army,
      and Navy. The risk of suicide among all active duty males was over two times that
      of all active duty females and about half that of males in the general
      population. Active duty females had a risk slightly lower than females in the
      total population. Enlisted personnel had rates two times higher than officers.
      Firearms were used in 61% of the male and 55% of the female suicides.

PMID- 7783917
TI  - Homicide victims in the military: 1980-1992.
AB  - Data abstracted from the Report of Casualty (DD 1300) is used to describe active
      duty homicide victims for the period 1980 through 1992. The Marine Corps
      experienced the fewest homicides (186) but the highest rate (7.36 per 100,000)
      compared to the other services: Army (619/6.36), Navy (381/5.24), and Air Force
      (194/2.65). Those younger than 25 accounted for 57% of the homicides and had a
      higher rate than the older age groups. Blacks had a rate 2.1 times higher than
      whites, and the overall female-to-male rate ratio was 1.2. Firearms were used
      against 63% of male and 35% of female homicide victims. Twenty-eight percent of
      female victims were beaten or strangled and females were over 10 times more
      likely than males to be strangled. The risk for homicide among active duty males
      was less than for males in the general population. Conversely, active duty
      females were at an increased risk for homicide in comparison to both males in the
      military and females in the general population.

PMID- 7783918
TI  - Female dentists in the U.S. Army: the origins.
AB  - Female dentists were not accepted into the U.S. Army Dental Corps until the
      exigencies of the Korean War in 1951 called for the "maximum utilization" of the
      country's professional resources. As early as 1898, during the Spanish-American
      War, and in 1917, during World War I, women dentists had volunteered their
      services to Uncle Sam. It is appropriate that the story of these early pioneers
      be told.

PMID- 7783919
TI  - Organization and work of the War Hospital in Sturba near the town of Livno,
      Bosnia and Herzegovina.
AB  - The work of the Croatian Defense Council (armed forces of the Croatian citizens
      of Bosnia and Herzegovina) War Hospital at Sturba, outskirts of the town of
      Livno, is described. The hospital was established in the beginning of April and
      worked until September 1992. It provided services for the battlefield of
      approximately 100 km of a very difficult mountainous terrain. The hospital was
      situated in a concrete dugout taken from the Yugoslav Federal Army. It was well
      equipped and supplied exclusively by numerous donations. Medical personnel were
      recruited partly from local medical professionals and partly from volunteers from
      Croatia. During the 5-month period, 597 patients (571 soldiers and 26 civilians)
      were admitted. A total of 314 operations, 141 in general and 173 in regional
      anesthesia, were performed. None of the patients died in the hospital. There was
      not a single epidemic either among soldiers or civilians in the area.

PMID- 7783920
TI  - Reconstructive surgery during Operations Just Cause and Desert Storm.
AB  - Operations Just Cause and Desert Storm were of relatively brief duration;
      however, severe wounds were produced that required complex reconstructive
      procedures. This paper describes the type of wounds managed in theater and
      subsequently at three U.S. military medical centers. Specific reconstructive
      techniques included local and free muscle, fasciocutaneous, and composite flaps.
      Emphasis is placed on the application of microsurgical techniques to battle
      related injuries.

PMID- 7783921
TI  - Health behaviors of military retirees: incidence of smoking and alcohol use.
AB  - Previous investigations of the health behaviors of active duty military members
      and their dependent spouses generally have found a higher rate of smoking and
      greater alcohol use in this group compared to their civilian counterparts.
      However, it is not known whether military retirees and their dependents also
      report higher smoking and alcohol use compared to the general senior population.
      Therefore, this study examined cigarette and alcohol use in a group of military
      retirees (n = 1,359) and dependents (n = 983). Contrary to studies surveying
      active duty members and their spouses, the present study found that smoking rates
      and alcohol use among military retirees and dependents were similar to those
      reported in surveys of the general senior population. In addition, the fact that
      the majority of retirees (68%) classified themselves as ex-smokers suggests that
      these individuals may adopt more healthy lifestyles over time. Factors associated
      with smoking and alcohol use are also presented, along with suggestions for
      future research.

PMID- 7783922
TI  - Medical staff resources model and methodology: ambulatory/outpatient services.
AB  - This paper describes a methodology that has practical applicability in the
      planning, implementation, and evaluation of ambulatory/outpatient services at
      site specific health care organizations. Fiscal year 1990 cost and reimbursement
      data are used for baseline values, however the methodology remains constant, for
      use in future years, by updating fiscal year by fiscal year as increases occur.
      This conceptual model can be used by military, other public sector, and civilian
      community health center ambulatory/outpatient services organizations that require
      24 hour medical staff coverage, and economically feasible cost reimbursement
      accountability.

PMID- 7783923
TI  - Amputee soldiers and their return to active duty.
AB  - This study was undertaken to determine the percentage of soldiers who remain on
      active duty after undergoing a Physical Evaluation Board (PEB) for an amputation.
      The computerized records of all amputee soldiers who were presented to one of
      four Army PEBs during an 8-year period (October 1980 to September 1988) were
      reviewed. Only 11 of 469 soldiers (2.3%, 95% CI 1.2-4.2%) remained on active duty
      after amputation. Of those who returned to duty, most (6 of 11) sustained partial
      hand amputations, three had partial foot amputations, and two were below-knee
      amputees. Among those returning to duty, there were no female soldiers. We
      conclude that continuation on active duty is a rare event after amputation.
      Further studies on active duty is a rare event after amputation. Further studies
      are necessary to define the characteristics associated with active duty service
      as an amputee and the impact of an amputation on performance of military duties.

PMID- 7783924
TI  - On being informed you are HIV positive: experiences of Navy service members.
AB  - This study addressed the experience of being told that one has become infected
      with the human immunodeficiency virus (HIV) while serving in the United States
      Navy. Responses to a questionnaire, administered to 150 HIV-positive service
      members, indicated that feelings of fear, shock, disbelief, and embarrassment
      were experienced by study participants upon learning of their HIV-positive
      status. The manner in which their HIV diagnosis was disclosed was generally
      viewed in favorable terms and more so in recent years relative to the earliest
      days of the Navy's HIV program. Having a medical officer as a disclosing official
      was associated with more negative experiences than was the case for other
      categories of disclosing officials. Lastly, post-disclosure events were often
      excessively stressful, and no improvement in this regard over 6 years of the
      Navy's HIV program was evident.

PMID- 7783925
TI  - Epidemiology of ametropia of U.S. Army recruits.
AB  - All people attempting to enlist in the U.S. Army must undergo a physical
      examination that requires a rudimentary vision screening. Those who pass the
      physical, upon reporting to basic training, are again evaluated and any treatment
      necessary to allow the recruits to function during their initial indoctrination
      is provided. Those who fail to see 20/20 O.D. and O.S. with their current
      spectacles fail the screening and are evaluated by an optometrist. If their
      condition is not disqualifying, appropriate correction is prescribed. We reviewed
      the records of all the recruits in a 1-month period who either required
      spectacles to see 20/20 or failed the screening at the 43rd AG BN (reception).
      Epidemiological evaluation revealed most to be either simple myopes or myopic
      astigmats. Hyperopia and hyperopic astigmatism accounted for the next most common
      diagnosis. Other conditions included anisometropia, antimetropia, amblyopia,
      keratoconus, and nystagmus. Examinations of these recruits were very limited,
      with dilated fundus evaluations being performed only when there was a high
      probability of a disqualifying condition. Therefore, it is unknown what retinal
      disease or degeneration may be present other than what would be visible with
      direct ophthalmoscopy.

PMID- 7783926
TI  - Posttraumatic meningioma: explanation of an epidemiologic dichotomy.
AB  - A 23-year-old soldier sustained a penetrating gunshot wound to the right
      frontoparietal region of the head in 1971 while serving in Vietnam. In 1984, he
      developed headaches and seizures, and a meningioma was found at the cranioplasty
      site. Recurrent meningiomas, requiring resection, developed at this site in 1988
      and 1990. In 1994, he developed right proptosis. An extensive mass involving the
      right intraorbital region and the anterior and middle cranial fossa was found.
      Pathological examination of this tumor demonstrated malignant meningioma.
      Although antecedent head trauma has been implicated as a risk factor for
      meningioma, epidemiological studies of this association have yielded divergent
      conclusions. An explanation for this epidemiologic dichotomy is suggested.

PMID- 7783927
TI  - Spastic quadriparesis, dysarthria, and dysphagia following cervical
      hyperextension: a traumatic pontomedullary syndrome.
AB  - A 44-year-old man developed a clinical syndrome characterized by nonprogressive
      spastic quadriparesis, dysarthria, and dysphagia following a severe cervical
      hyperextension injury. These clinical features, coupled with normal neuroimaging
      studies, are consistent with a stretch injury of the corticospinal and
      corticobulbar tracts at the pontomedullary junction.

PMID- 7783928
TI  - Military surgery: certification is long overdue.
AB  - Military surgery is a complex discipline that has progressed far beyond triage
      and the debridement of battle wounds. The evolution of modern warfare now demands
      that the combat surgeon be knowledgeable in military tactics, logistics,
      transport of personnel, trauma surgery, tropical medicine, public health,
      industrial medicine, and special weapons, as well as have a familiarity with the
      organizational structure and culture of the military services. This complexity
      qualifies military surgery as a subspecialty of surgery according to the criteria
      of the Accreditation Council for Graduate Medical Education (ACGME).
      Accreditation of military surgery as a defined specialty should be sought because
      that recognition will produce better care for our troops, improve education of
      military medical personnel, and stimulate research.

PMID- 7783929
TI  - The effect of father absence on the psychiatric hospitalization of Navy children.
AB  - Some Navy families are subject to unusual stress in that the active duty parent
      may be deployed for several months at a time. This study examined children and
      adolescents from Navy and civilian families who were admitted to a private
      psychiatric hospital. Deployment of the father placed Navy children and
      adolescents at risk for psychiatric hospitalization, but mainly in non-intact
      families where step-parents or single parents were present. Deployment may strain
      an already vulnerable family structure in selected Navy families.

PMID- 7783930
TI  - Current management of carotid atherosclerosis.
AB  - Carotid atherosclerosis affects thousands of individuals each year. A history of
      transient ischemic attacks should alert the clinician to the possibility of
      carotid artery disease. Carotid endarterectomy is of proven benefit in both
      symptomatic and asymptomatic individuals, with angiographically confirmed carotid
      stenosis of from 70 to 99%, respectively. Guidelines for the diagnostic and
      preoperative screening procedures as well as the surgical technique used by the
      Department of Neurosurgery at the National Naval Medical Center are reviewed.

PMID- 7783931
TI  - Seasonal symptoms in the sub-Arctic.
AB  - To obtain information regarding the frequency and severity of seasonal symptoms
      in the sub-Arctic, 361 Seasonal Pattern Assessment Questionnaires (SPAQ) were
      collected from four separate populations, all either assigned to Fort Wainwright,
      in Interior Alaska, or receiving treatment there. The study included both
      civilian and military personnel, of both genders, over 16 years of age. The mean
      score on the SPAQ was in the low end of the range of sub-syndromal seasonal
      affective disorder. Females scored significantly higher than males, the mean
      score approaching that found in seasonal affective disorder. Active duty females
      scored higher than civilians, and were found to have symptoms severe enough to
      qualify as true seasonal affective disorder in 10.9% of cases. The highest scores
      and highest rates of true seasonal affective disorder were found in a group of 25
      Medical Activity (MEDDAC) female non-commissioned officers who were not in
      patient status.

PMID- 7783932
TI  - Radiation safety training program at the National Institutes of Health.
AB  - At the U.S. Public Health Service's National Institutes of Health (NIH), one of
      the world's largest biomedical and clinical research institutions, 70 to 80% of
      all research is performed using radiation or radioactive materials. To maintain a
      safe environment and minimize risks to the health and safety of the employees,
      patients, visitors, and the surrounding community, a radiation protection program
      is required. Under U.S. Nuclear Regulatory Commission licenses and NIH policies,
      the Radiation Safety Branch (RSB), Division of Safety, administers a
      comprehensive radiation safety program covering over 3,500 NIH laboratories and
      some 7,000 laboratory and ancillary staff workers. The NIH radiation protection
      program provides for the effective supervision, control, and monitoring of all
      radioactive materials and radiation sources at NIH. This includes activities such
      as radiation exposure monitoring, laboratory inspections, waste management,
      consulting, environmental monitoring, and training. Training is considered an
      integral part of the radiation safety program. RSB offers an extensive training
      program with over 20 different training courses each year. For example, in 1993
      some 6,700 employees attended 243 classes.

PMID- 7783933
TI  - Maxillofacial war injuries in civilians and servicemen during the aggression
      against Croatia.
AB  - Although civilian populations have been heavily involved in most of the recent
      wars and conflicts throughout the world, most reports analyzed casualty data of
      military personnel, often leaving civilian casualties excluded or underestimated.
      A comparison of epidemiologic and medical data for maxillofacial injuries between
      civilians and servicemen (policemen, soldiers, and United Nations Protection
      Forces) during the aggression against Croatia is attempted. Of the 220 casualties
      admitted to the Department of Maxillofacial Surgery in Zagreb between August 1991
      and December 1992, almost one-fourth were civilians. A significant difference
      between civilians and servicemen was noted in age and sex distribution. The
      incidence and severity of maxillofacial and associated injuries is almost equal,
      and the pattern of injuries is of the same type for civilian and military
      personnel.

PMID- 7783934
TI  - War wounds in the Sibenik area during the 1991-1992 war against Croatia.
AB  - This report presents the analysis of war casualties treated at the Department of
      Surgery of Sibenik Medical Center during a 5.5-month period, i.e., from the
      beginning of the aggression in August 1991 to the international recognition of
      the Republic of Croatia on January 15, 1992. A total of 321 war casualties were
      treated, 157 of whom were out-patients and 164 in-patients with severe multiple
      injuries, 39.25% of the wounded were civilians, 10 of whom were children.
      Fragment wounds from mortar shells, anti-personnel mines, and infantry weapons
      were the most frequent type of injuries. The most common were injuries of the
      limbs. Gunshot injuries to the brain had the worst prognosis. Early management of
      the wounds was of special importance. Stabilization of the fracture using
      external fixators was indicated in patients with severe, complicated fractures
      associated with extreme defects of the tissue. Comatose patients with possible
      intra-abdominal injury presented a specific diagnostic problem, which was best
      treated by exploratory laparotomy. The overall mortality rate was 2.49%.

PMID- 7783935
TI  - Orthopedic casualties in an activated National Guard Mechanized Infantry Brigade
      during Operation Desert Shield.
AB  - From November 1990 to April 1991, the 48th Infantry Brigade (Mechanized), an Army
      National Guard unit, was activated under Operation Desert Shield and deployed to
      the National Training Center, Fort Irwin, California, for training in desert
      warfare. All casualties requiring care beyond the battalion aid stations were
      evacuated to the medical company organic to the 48th Brigade. Each of 727
      orthopedic patient visits were grouped into one of eight etiologies: trauma,
      degenerative, overuse, infectious, neoplastic, congenital/pediatric,
      miscellaneous, and psychiatric. Each case was also classified according to
      anatomic region, severity, and disposition as well as need for a minor procedure,
      operation, or referral. Orthopedic casualties in a reserve mechanized infantry
      brigade undergoing intensive field training primarily arose from four common
      etiologic/regional presentations: wrist/hand trauma, knee/leg trauma,
      spine/pelvis degenerative, and ankle/foot overuse. Many of these injuries are
      predictable consequences of a particular soldier's military occupational
      specialty and unit mission.

PMID- 7783936
TI  - Physical health symptomatology of Gulf War-era service personnel from the states
      of Pennsylvania and Hawaii.
AB  - We present data on physical health and possible "Gulf War syndrome" from a
      Congressionally mandated study of over 4,000 active duty and reserve service
      members from the states of Hawaii and Pennsylvania who served during Operation
      Desert Storm. We found that deployed veterans report significantly more physical
      health symptoms than non-deployed veterans that cannot be explained by reasons
      other than deployment alone. We also identified a subgroup of 178 deployed
      veterans at risk for possible Gulf War syndrome. We recommend that services
      collect baseline information from units likely to deploy in the future and update
      that information regularly.

PMID- 7783937
TI  - Do Vietnam-era veterans who suffer from posttraumatic stress disorder avoid VA
      mental health services?
AB  - It has been suggested that Vietnam veterans who suffer from posttraumatic stress
      disorder (PTSD) avoid Department of Veterans Affairs (VA) health services because
      their experiences in the military engendered a profound distrust of the Federal
      Government and its institutions. Data from a national survey of 1,676 veterans
      who served during the Vietnam era show that veterans with PTSD were 9.6 times
      more likely than other veterans to have used VA mental health services; but only
      3.3 times more likely to have used non-VA services. After controlling for other
      factors, veterans suffering from PTSD were 1.8 times more likely than other
      veterans to have used VA services, but were no more likely to have used non-VA
      services. Contrary to conventional belief, veterans with PTSD show a preference
      for VA compared to non-VA mental health services.

PMID- 7783938
TI  - Evaluation of glucose monitoring devices in the hyperbaric chamber.
AB  - Diabetic patients may experience fluctuations in whole blood glucose (WBG) levels
      while receiving hyperbaric oxygen therapy (HBO) resulting in seizure-like
      activity. Therefore, hyperbaric medical attendants must accurately monitor the
      WBG levels of these patients during HBO. In addressing this concern, this study
      evaluated the accuracy and reliability of commercially available glucometers
      (Glucometer M+, Companion 2, HemoCue, One Touch II, and ExacTech Pen) in the
      hyperbaric environment. WBG samples were prepared, ranging from 25 to 250 mg/dl,
      for testing glucometers at ground level and at 2.36 atmospheres absolute (ATA).
      It was noted that at 2.36 ATA, glucose values increased using the Glucometer M+,
      but decreased with the Companion 2 and HemoCue. The One Touch II values decreased
      in the hyperglycemic ranges (> 150 mg/dl), whereas the ExacTech Pen monitor
      readings increased in the hypoglycemic ranges (< 100 mg/dl). The accuracy of WBG
      monitors is significantly affected by changes in atmospheric pressure.

PMID- 7783939
TI  - New studies disputing allegations of bacteriological warfare during the Korean
      War.
AB  - In the television series Korea the Unknown War produced jointly by Thames
      Television (London) and WGBH (Boston) in 1990, General Matthew Ridgway, Commander
      in Chief of United Nations forces during the Korean War, called the accusations
      that the United States waged bacteriological warfare "black propaganda." The
      charges discredited the United States and, despite denials and many international
      discussions, have not been completely refuted until new. Following studies in
      archives previously not available for research and after uncovering new sources,
      many specific examples of black propaganda were discovered that contained false
      information and lies discrediting the United States. The mechanism of lies, which
      convinced the Korean population that bacteriological warfare was going on and
      that the only way not to become victims of the United States' inhuman cruelty was
      to fight, are shown in this paper.

PMID- 7783940
TI  - Reversible inactivation of dorsal hippocampus by tetrodotoxin impairs blocking of
      taste aversion selectively during the acquisition but not the retrieval in rats.
AB  - The role of the dorsal hippocampus in the different stages of blocking was
      examined in a taste aversion learning task. Blocking is a learning effect in
      which one previously conditioned element of a compound makes the conditioning of
      the added element difficult. An effective blocking procedure with one trial in
      each stage was tested in unoperated rats. In the first stage, rats drank
      saccharin and later received lithium chloride by i.p. injection. In the second
      stage, they were presented with a serial compound saccharin-cider vinegar before
      lithium injection. In a one-bottle, test a reduced aversion to cider vinegar was
      observed in this group compared to control groups with no previous saccharin
      aversion. Bilateral tetrodotoxin (TTX) injection (10 ng/microliters) in the
      dorsal hippocampus attenuated blocking if this was applied before drinking the
      compound stimulus during the second stage, but it produced no effect applied
      either before drinking saccharin in the first stage or before testing. Non
      specific retrieval deficit produced by TTX injection applied before testing was
      ruled out in a control group subjected to a conventional cider vinegar aversion
      learning which showed complete retrieval of the aversion under TTX. It is
      concluded that the hippocampal function relevant for blocking takes place during
      the compound phase.

PMID- 7783941
TI  - S100 immunoreactivity in a subpopulation of oligodendrocytes and Ranvier's nodes
      of adult rat brain.
AB  - The Ca(2+)- and Zn(2+)-binding S-100 proteins (S100) are predominantly localized
      in astrocytes of adult mammalian brain. In addition, light and electron
      microscopic immunocytochemistry revealed S100 in a small subpopulation of
      oligodendrocytes. By nuclear morphology and abundance of rough ER and Golgi
      fields, these cells resembled actively myelinating oligodendrocytes. S100
      immunoreactivity was also found in paranodal loops and outer mesaxons of isolated
      of myelin sheaths. Data suggests that oligodendroglial content of S100 relates to
      cell turnover and/or myelin repair in the adult rat brain, and that S100 is
      present during myelin compaction.

PMID- 7783942
TI  - Deficits in cerebral glucose metabolism demonstrated by positron emission
      tomography in individuals at risk of familial Alzheimer's disease.
AB  - In order to establish whether positron emission tomography (PET) can identify
      metabolic changes in Alzheimer's disease at a presymptomatic stage, we have
      examined 24 asymptomatic at risk individuals from families with Alzheimer's
      disease. A significant reduction in global cerebral metabolic rate for glucose
      was found when compared with 16 age-matched controls. There was also a focal,
      parieto-temporal deficit similar to, although less extensive than, that found in
      18 symptomatic individuals from familial Alzheimer's disease (FAD) pedigrees.
      Follow up of this cohort will establish whether these metabolic changes relate to
      a presymptomatic stage of the disease.

PMID- 7783943
TI  - Cerebroside formation in the peripheral nervous system of normal and Trembler
      mice.
AB  - The formation of cerebrosides by the galactosylation of ceramides was
      investigated in a microsomal fraction prepared from sciatic nerves of normal and
      Trembler mice. In the control, cerebroside synthesis is observed in the presence
      of uridine-diphosphate-galactose both from endogenously synthesized [1
      14C]stearoyl-sphingosine (C18-ceramide), and from [1-14C]lignoceroyl-sphingosine
      (C24-ceramide). Cerebroside formation is also demonstrated by studying the
      galactosylation of exogenous ceramides with UDP[1-14C]-galactose. In the mutant,
      only trace amounts of labeled cerebrosides are formed from labeled stearoyl
      sphingosine, whereas with lignoceroyl-sphingosine, no cerebroside synthesis is
      detected under conditions allowing their formation in the control. However, a
      higher rate of synthesis of short acyl chain-glucosyl ceramides is observed in
      the Trembler samples.

PMID- 7783944
TI  - Inhibitory action of nicotinic antagonists on transmitter release at the
      neuromuscular junction of the rat.
AB  - The effects of two nicotinic antagonists, d-tubocurarine (TC) and hexamethonium
      (HEX) were tested on the rat diaphragm neuromuscular junction during train-of-six
      stimuli to determine if a second action of these antagonists on evoked release
      could be demonstrated, in addition to its known impact of blocking the
      autoreceptor pathway. To minimize the autoreceptor pathway, the preparations were
      examined under low transmitter release conditions. It was observed that both
      compounds significantly depressed the end-plate potential amplitudes more than
      the miniature end-plate potential amplitudes, while also significantly depressing
      quantal release output. This inhibitory action is contrary to what is observed
      when transmitter release is high, where feedback regulation via the autoreceptors
      serves a prominent role. It is concluded that this depressive action on
      transmitter output contributes to onset of tetanic fade and that when higher
      concentrations of these antagonists are used this inhibitory action of TC and HEX
      may override autoreceptor feedback regulation.

PMID- 7783945
TI  - Nitric oxide is involved in the non-adrenergic, non-cholinergic inhibitory
      neurotransmission of the pig intravesical ureter.
AB  - NADPH-diaphorase histochemical staining and electrical field stimulation (EFS)
      were performed in vitro to investigate whether nitric oxide (NO) is involved in
      non-adrenergic non-cholinergic (NANC) inhibitory neurotransmission of pig
      intravesical ureter. NADPH-diaphorase activity was expressed in nerve trunks and
      thin nerve fibres around arteries and muscular bundles in the intravesical
      ureter. Relaxations to EFS were tetrodotoxin (10(-6) M)-sensitive which indicates
      their neurogenic origin. Addition of the NO-synthase inhibitor, L-NG
      nitroarginine (L-NOARG, 3 x 10(-5) M), abolished the electrically induced
      relaxations, which were significantly reversed by L-arginine (3 x 10(-3) M).
      Addition of acidified sodium nitrite (NaNO2, 10(-5)-10(-3) M) evoked
      concentration-dependent relaxations of ureteral strips which were unaffected by L
      NOARG. It is concluded that NO synthase is present in nerve fibres and NO seems
      to mediate the inhibitory neurotransmission of the porcine intravesical ureter.

PMID- 7783946
TI  - Increased sympathetic nerve discharge without alteration in the sympathetic
      baroreflex response by serotonin3 receptor stimulation in the nucleus tractus
      solitarius of the rat.
AB  - Previous studies have shown that serotonin3 receptor activation in the nucleus
      tractus solitarius (NTS) increased mean arterial pressure (MAP) and inhibited the
      cardiac component of the baroreceptor reflex [9]. We have examined the effects of
      such stimulation upon spontaneous and evoked sympathetic nerve activity.
      Microinjection of serotonin (10 nmol) into the NTS of halothane-anaesthetized,
      paralyzed and artificially ventilated rats produced an increase in MAP and lumbar
      sympathetic nerve discharge which could be completely prevented by prior local
      microinjection of zacopride, a potent serotonin3 antagonist (200 pmol). In
      addition, 1-(m-chlorophenyl)-biguanide, a selective serotonin3 receptor agonist,
      mimicked the sympathoexcitatory effect of serotonin. Since the gain of the
      sympathetic component of the baroreflex was unaltered after intra-NTS
      microinjection of serotonin, it could be concluded that serotonin3 receptors
      activation in the NTS induces a sympathetic activation which is not mediated
      through an inhibition of the sympathetic baroreceptor reflex arc.

PMID- 7783947
TI  - Modulatory effects of magnolol on potassium-stimulated 5-hydroxytryptamine
      release from rat cortical and hippocampal slices.
AB  - Magnolol, a phenolic constituent of magnolia bark, is a known central nervous
      system depressant. To examine the possibility that magnolol may elicit its
      depressant effect by modulating central serotonergic activity, its effect on 35
      mM K(+)-stimulated 5-[3H]HT release from rat hippocampal and frontal cortical
      slices were examined. Inclusion of magnolol (1-100 microM) had no effect on 5-HT
      release in hippocampal slices but elicited a dose-related inhibition on 5-HT
      release from cortical slices. The inhibitory effect of magnolol on K(+)
      stimulated 5-HT release from the cortex was not affected by either antagonists
      (metergoline, propranolol, and cyproheptadine) (0.01-10 microM) of various 5-HT
      receptor subtypes or the voltage-dependent sodium channel blocker tetrodotoxin (1
      microM). It is concluded that the suppression of brain 5-HT release by magnolol
      is site-specific, and the suppression of cortical 5-HT release by magnolol is not
      via the 5-HT autoreceptors at the 5-HT terminals.

PMID- 7783949
TI  - Growth factors and gangliosides stimulate laminin production by human glioma
      cells in vitro.
AB  - Neoplastic cells from intrinsic, neuroectodermal tumours may migrate up to
      several millimeters away from the original tumour mass into normal nervous
      tissue. The biological mechanisms underlying this local invasive behaviour of
      gliomas are poorly understood. We have demonstrated recently that growth factors
      and cell surface gangliosides are positively involved in human glioma cell
      adhesion, migration and invasion in vitro. In order to study the mechanism of
      action of gangliosides and growth factors in this process, their role in the
      production of laminin, the major component of glioma vascular basal lamina, was
      investigated. Both growth factors and gangliosides stimulated laminin production
      in vitro suggesting that these factors increase laminin production in order to
      enable glioma cells to adhere and then migrate and invade in vivo.

PMID- 7783948
TI  - Platelet activating factor induces nerve growth factor production by rat
      astrocytes.
AB  - During the course of brain injury and inflammation there is an enhanced secretion
      of neurotrophic substances. We have examined the effect of platelet activating
      factor (PAF), which has been associated with various pathological conditions in
      the central nervous system, on the secretion of nerve growth factor (NGF) by
      astrocytes. Enriched cultures of rat cortical astrocytes were treated with
      various concentrations of PAF for different periods of time. PAF induced a dose
      dependent increase in NGF secretion, the maximal increase of 120% obtained with
      50 nM PAF after 48 h of treatment. This effect was blocked by the specific
      antagonist WEB 2086 and was not related to a proliferative response of the cells
      to PAF. Concomitant treatment of the cells with PAF and tumor necrosis factor
      alpha resulted in a synergistic increase in NGF secretion. These results indicate
      that PAF may provide a neurotrophic signal to injured neurons and may cooperate
      with TNF-alpha in this effect.

PMID- 7783951
TI  - Cerebral endothelial cells are a major source for soluble intercellular adhesion
      molecule-1 in the human central nervous system.
AB  - Immunohistological analysis of tissue sections from human brain revealed that
      intercellular adhesion molecule-1 (ICAM-1) is mainly expressed on endothelial
      cells of small vessels, including the subependymal vessels of the choroid plexus.
      In addition, it is expressed on cerebrospinal fluid (CSF) cells in patients with
      inflammatory diseases of the central nervous system. Stimulation of confluent
      monolayers of adult human cerebral endothelial cells with lipopolysaccharide
      (LPS) or recombinant human tumor necrosis factor-alpha (TNF-alpha) could induce
      expression and secretion of soluble ICAM-1 in a dose dependent manner. In
      addition, sICAM-1 was also present in the supernatant from U251 glioma cells. No
      sICAM was detected in the culture supernatant from activated blood or CSF
      lymphocytes. Cerebral endothelial cells are therefore a likely source for sICAM-1
      in the CSF.

PMID- 7783950
TI  - Preservation of acetylcholine muscarinic M2 receptor G-protein interactions in
      the neocortex of patients with Alzheimer's disease.
AB  - The efficacy of acetylcholine muscarinic M2 receptor-G protein coupling was
      investigated in Alzheimer's disease and control neocortical membranes by
      measuring the effects of MgCl2 and 5'-guanylylimidodiphosphate (Gpp[NH]p) on high
      affinity [3H]oxotremorine-M ([3H]OXO-M) binding. MgCl2 gave similar enhancements
      of [3H]OXO-M binding in Alzheimer's disease and control occipital cortex. In
      contrast, MgCl2 enhanced [3H]OXO-M binding was significantly higher in
      Alzheimer's disease superior temporal cortex, compared to controls. MgCl2
      enhanced [3H]OXO-M binding in both the occipital and temporal cortices of the
      Alzheimer's disease cases was reversed to control levels by Gpp[NH]p. It is
      concluded that the number of high-affinity muscarinic M2 sites is increased in
      Alzheimer's disease superior temporal, but not occipital, cortex and that M2
      sites in both regions maintain an efficient G-protein coupling.

PMID- 7783953
TI  - Role of vagal afferents in the ventilatory response to naloxone during loaded
      breathing in the rabbit.
AB  - It was previously shown that inspiratory resistive loading (IRL) increases the
      cerebrospinal fluid (CSF) level of beta endorphin in awake goats, and also that
      the slower ventilation induced by injection of this substance into the CSF of
      anesthetized dogs is suppressed after vagotomy. In the present study, performed
      on anesthetized rabbits, we evaluated the part played by vagal afferents in the
      ventilatory response to IRL after opioid receptor blockade by naloxone. During
      unloaded breathing, naloxone injection did not modify baseline ventilation.
      Conversely, naloxone partially reversed IRL-induced hypoventilation through an
      increase in respiratory rate. This effect was abolished after either vagotomy or
      cold blockade of large vagal fibers, but it persisted after procaine blockade of
      thin vagal fibers. These results suggest that pulmonary stretch receptors, which
      are connected to some large vagal afferent fibers, would play a major role in the
      ventilatory response to IRL under opioid receptor inhibition.

PMID- 7783952
TI  - Ageing affects cytosolic Ca2+ binding proteins and synaptic markers in the retina
      but not in cerebral cortex neurons of the rat.
AB  - Two cerebral cortex areas (frontal and occipital) and the retina of rats varying
      in age from 0.4 to 30 months were investigated for the expression levels and
      distribution of two cytosolic high affinity Ca2+ binding proteins, calbindin-28
      and calretinin, and of two presynaptic protein markers. Of these latter proteins,
      one is integral (synaptophysin) the other peripheral (synapsin I) to the synaptic
      vesicle membranes. In the cortex areas, no significant changes of the markers
      were observed, except for a drop of calretinin from 0.4 to 2 months, probably
      related to a stage of neuronal development. In the retina, calbindin-28 decreased
      progressively during ageing (-40% at 30 months) while calretinin remained
      unchanged. Concomitantly, the two synaptic vesicle proteins dropped,
      synaptophysin > 50% and synapsin I > 85%. The role of these changes in sustaining
      the functional alterations previously described in the retina of aged animals
      remains to be investigated.

PMID- 7783954
TI  - Low-affinity nerve growth factor receptor immunoreactivity in the human urinary
      bladder.
AB  - The localization of low-affinity nerve growth factor receptor (LNGFR) in the
      human urinary bladder was examined immunohistochemically using the mouse
      monoclonal antibody (ME20-4) against human LNGFR. LNGFR immunoreactivity was
      present in the human urinary bladder. The distribution of LNGFR-positive fibers
      was more abundant in the mucosa than in the muscle layer. Results also showed
      that some LNGFR-positive fiber bundles contained tyrosine hydroxylase
      immunoreactivity. Electron microscopic examination revealed that LNGFR
      immunoreactivity was located on the surface of Schwann cells, and frequently on
      the interface of axons and Schwann cells.

PMID- 7783955
TI  - Intracerebroventricular administration of a nitric oxide-releasing compound, NOC
      18, produces thermal hyperalgesia in rats.
AB  - This study was undertaken to define the role of nitric oxide (NO) in central
      nociceptive mechanisms by intracerebroventricular injection of an NO-releasing
      compound, NOC-18, in rats. The nociceptive threshold was evaluated by the radiant
      heat tail-flick test. Sixty-nine rats were divided into the seven groups, and the
      following drugs were injected intracerebroventricularly in 5 microliters of
      saline: no drug (control) (n = 13), 15 micrograms of NOC-18 (n = 15); 150
      micrograms of NOC-18 (n = 9); 100 micrograms of N-nitro-L-arginine methyl ester
      (L-NAME) (n = 8); 15 micrograms of NOC-18 + 100 micrograms of L-NAME (n = 8); 10
      micrograms of methylene blue (MB) (n = 8); 15 micrograms of NOC-18 + 10
      micrograms of MB (n = 8). NOC-18 caused a dose-dependent curtailment (7% and 23%
      decreases for 15 micrograms and 150 micrograms of NOC-18, respectively) of the
      tail-flick latency during the period from 15 to 120 min. L-NAME caused
      prolongation (15% maximum) of the tail-flick latency during the period from 15 to
      150 min. However, NOC-18-induced hyperalgesia was not influenced by L-NAME. MB
      also caused prolongation (9% maximum) of the tail-flick latency during the period
      from 15 to 150 min, and completely blocked the hyperalgesia induced by 15
      micrograms of NOC-18. These findings indicate that the NO-cGMP pathway is
      directly involved in thermal hyperalgesia in the brain.

PMID- 7783956
TI  - Regional differences in the interaction of the excitotoxins domoate and L-beta
      oxalyl-amino-alanine with [3H]kainate binding sites in human hippocampus.
AB  - The excitotoxic amino acid domoate causes anterograde amnesia and memory deficits
      while the excitotoxin L-beta-oxalyl-amino-alanine (L-BOAA) is considered the
      causative agent of the motoneurone disorder, neurolathyrism. Employing
      quantitative autoradiography we investigated the potency of domoate and L-BOAA to
      inhibit [3H]kainate binding in human hippocampus. Domoate inhibited binding of
      [3H]kainate with inhibition constants between 5.8 +/- 2.8 nM (deep layers of
      gyrus parahippocampalis) and 200.9 +/- 247.8 nM (CA1 region of hippocampus). It
      was about a thousandfold more potent than L-BOAA with inhibition constants
      between 2.1 +/- 0.5 microM (superficial layers of gyrus parahippocampalis) and
      51.0 +/- 41.9 microM (CA2/3 region of hippocampus). Interestingly, L-BOAA showed
      lowest affinity to [3H]kainate binding sites in those regions in which domoate
      showed highest affinity (e.g. CA2/3) and vice versa (e.g. CA1). These data
      further support the notion that the neurological symptoms observed after domoate
      intoxication are due to an excitotoxic action at kainate receptors and provide
      evidence for heterogeneity of kainate receptors in human hippocampus.

PMID- 7783957
TI  - Binding of Lambert-Eaton myasthenic syndrome IgG to synaptosomal proteins does
      not correlate with an inhibition of calcium uptake.
AB  - The immunochemical and functional properties of IgG fractions from patients with
      Lambert-Eaton myasthenic syndrome (LEMS) were examined in chick and rat
      synaptosomes. LEMS IgG immunoprecipitated 125I-omega conotoxin GVIA (125I-omega
      CgTx) labeled N-type calcium channels solubilized from both tissues, and reacted
      with a 65 kDa protein band in immunoblots of rat synaptosomes. Depolarization
      induced 45Ca2+ influx into chick synaptosomes was partially inhibited by omega
      CgTx, whereas influx into rat synaptosomes was insensitive to omega CgTx. No
      effect of LEMS sera or IgG on 45Ca2+ uptake was apparent in either preparation.

PMID- 7783958
TI  - Allelic variations in apolipoprotein E and prion protein genotype related to
      plaque formation and age of onset in sporadic Creutzfeldt-Jakob disease.
AB  - Prion gene sequence is thought to affect the phenotypic expression of prion
      disease and the E2 variant of apolipoprotein E (Apo E) can be neuroprotective in
      dementia. We determined codon 129 of the prion gene and the Apo E variants in
      Creutzfeldt-Jakob disease (CJD) using PCR and restriction digest. We found a
      significant correlation between valine at codon 129 of the prion protein gene and
      the presence of plaque in CJD and a later age of onset in CJD cases possessing
      the Apo E2 allele. This study provides further evidence that sequence variations
      in the prion gene can modify disease pathology and the neuroprotection afforded
      by Apo E2 is not confined to Alzheimer's disease.

PMID- 7783960
TI  - Extracellular phosphorylation of membrane protein modifies theta burst-induced
      long-term potentiation in CA1 neurons of guinea-pig hippocampal slices.
AB  - The involvement of ecto-protein kinase activity in activity-dependent long-term
      potentiation (LTP) was studied in CA1 neurons of guinea-pig hippocampal slices.
      Application of 5 microM K-252b, an ecto-protein kinase inhibitor, blocked LTP
      induced by a theta-burst stimulation (3 bursts composed of 5 pulses at 100 Hz
      with inter-burst intervals of 200 ms). On the other hand, under 10 microM RK682,
      an ecto-phosphatase inhibitor, a robust LTP was induced by a weak theta-burst
      stimulation (3 bursts composed of 3 pulses) which was just at the threshold for
      the induction of LTP in the control perfusate. These findings suggest that ATP
      released from presynaptic terminals during the burst stimulation plays an
      important role in the induction of LTP through phosphorylation of extracellular
      domains of synaptic membrane proteins, as the substrate for ecto-protein kinase.

PMID- 7783959
TI  - The mechanism of ATP-induced long-term potentiation involves extracellular
      phosphorylation of membrane proteins in guinea-pig hippocampal CA1 neurons.
AB  - The mechanism of ATP-induced long-term potentiation was studied pharmacologically
      using guinea-pig hippocampal slices. Application of 1-10 microM ATP for 10 min
      transiently depressed and then slowly augmented the synaptic transmission in CA1
      neurons leading to long-term potentiation (LTP). This ATP-induced LTP was blocked
      by the addition of K-252b, an ecto-protein kinase inhibitor, but was enhanced by
      the addition of RK682, an ecto-phosphatase inhibitor, both of which do not
      permeate the cell membrane. These results suggest that ATP applied to the
      perfusate provides enough substrate for ecto-protein kinase to induce LTP through
      phosphorylation of extracellular domains of membrane proteins in CA1 neurons.

PMID- 7783961
TI  - Inhibition of spinal nociceptive neurons by microinjections of somatostatin into
      the nucleus raphe magnus and the midbrain periaqueductal gray of the anesthetized
      cat.
AB  - The effects of somatostatin (SOM) after intravenous application and intracerebral
      microinjection into the medullary nucleus raphe magnus (NRM) or into the
      periaqueductal gray (PAG) on the spinal nociceptive transmission was
      quantitatively studied in the anesthetized cat. Noxious heat-evoked responses of
      multireceptive lumbar spinal dorsal horn neurons were reversibly depressed to
      56.6 +/- 9.7% of the control after systemically applied SOM (7 micrograms/kg
      i.v.; 7 micrograms/kg per h infusion rate). At 11 of 14 brainstem microinjection
      sites in the NRM and PAG, SOM (2.5 micrograms/microliter) attenuated the heat
      evoked responses to 58.9 +/- 6.2% (n = 5) (NRM) and 64.4 +/- 6.3% (n = 6) (PAG)
      of the control. After microinjection, maximal inhibition was reached within 8-14
      min (NRM) or 23-29 min (PAG), respectively. Inhibition was reversible within 60
      min after the injection. Thus, SOM has an antinociceptive potency by activating
      descending inhibition of nociceptive dorsal horn neurons from the NRM and PAG.

PMID- 7783962
TI  - Increased density of cortical apolipoprotein E immunoreactive neurons in rabbit
      brain after dietary administration of cholesterol.
AB  - Rabbits were fed 2% cholesterol diet for 4, 6 and 8 weeks or control diet for 6
      weeks. Frontal cortex and hippocampal formation were stained with apolipoprotein
      E (Apo-E) antibody using standard immunocytochemical methods. The number of
      neurons expressing the Apo-E epitope and the intensity of Apo-E immunoreactivity
      increased with increasing time on the cholesterol diet. Because Apo-E chaperones
      cholesterol in the brain, the data may suggest that elevated circulating levels
      of cholesterol eventually cause increased cerebral levels.

PMID- 7783963
TI  - A severe loss of choline acetyltransferase in the frontal cortex of Alzheimer
      patients carrying apolipoprotein epsilon 4 allele.
AB  - We measured the activities of choline acetyltransferase (ChAT) in the post mortem
      frontal cortex in 32 Alzheimer's disease (AD) patients with different
      apolipoprotein E (apoE) genotypes. The ChAT values were significantly lower for
      the AD patients with 2 epsilon 4 alleles than for those with 0 epsilon 4 (ANOVA,
      P < 0.05). The ChAT activities of AD patients carrying 2 or 1 epsilon 4 alleles
      and those without the epsilon 4 allele also differed significantly: 16.3 +/- 15.2
      versus 30.5 +/- 20.6 pmol/mg protein per min, ANOVA, P < 0.05. However, the AD
      patients carrying the epsilon 4 allele were significantly younger than those with
      0 epsilon 4 allele. The study indicates that AD patients carrying the epsilon 4
      allele have a more severe cholinergic deficit than the AD patients without the
      epsilon 4 allele.

PMID- 7783964
TI  - The circadian thyrotropin rhythm is delayed in regular night workers.
AB  - In order to determine whether the circadian thyrotropin (TSH) rhythm is adapted
      to a night-active schedule, plasma TSH and body temperature were measured for 28
      h every 10-min in 8 regular night workers and in 8 day-active subjects. In night
      workers, the shift of 8-h in the sleep period induced a mean shift of 6 h 30 min
      of the TSH acrophase which remained located, as in day-active subjects, at about
      the time of sleep onset. The nadir of the body temperature rhythm was shifted by
      an equivalent amount and occurred systematically during the sleep period, so that
      both parameters maintained a fixed phase relationship. TSH and temperature
      rhythms had similar amplitudes in the two groups. However, mean TSH values in
      night workers returned more rapidly to basal values. These results demonstrate
      that, together with body temperature, TSH acrophase is adapted to regular night
      work, suggesting that TSH may be a good index for evaluating the orientation of
      the endogenous clock.

PMID- 7783965
TI  - GABAergic neuronal circuits in the cerebellum of the dogfish Scyliorhinus
      canicula (Elasmobranchs): an immunocytochemical study.
AB  - The presence of GABAergic cells and fibres in the corpus cerebelli and auricles
      of a dogfish, Scyliorhinus canicula, was studied with immunocytochemistry. In
      both locations, two types of GABA-immunoreactive (GABA-ir) neurons were observed:
      stellate cells in the molecular layer and Golgi cells in the granular layer.
      Stellate cell axons gave rise to numerous GABA-ir boutons distributed throughout
      the molecular layer and a smaller number of boutons which contacted Purkinje cell
      perikarya. No GABA-ir baskets around Purkinje cells were observed. Golgi cells of
      the granular layer gave rise to numerous GABA-ir boutons which were located
      around cerebellar glomeruli. Purkinje cell perikarya and their axon terminals in
      the cerebellar nucleus were not GABA-immunoreactive. These findings are discussed
      in terms of the phylogeny of cerebellar circuits.

PMID- 7783966
TI  - Protein kinase A-dependent increase in frequency of miniature GABAergic currents
      in rat CA3 hippocampal neurons.
AB  - The whole-cell configuration of the patch clamp technique was used to study the
      effect of an intracellular increase in cAMP on the frequency of GABA-mediated
      miniature post synaptic currents (MPSCs) in neonatal rats from (P6 to P12) CA3
      hippocampal neurons in slices. In the presence of tetrodotoxin (1 microM), and
      kynurenic acid (1 mM) to block ionotropic glutamatergic currents, forskolin, an
      activator of adenylate cyclase, markedly increased the frequency of MPSCs without
      affecting their amplitude or kinetics. The inactive forskolin analog, 1,9
      dideoxyforskolin (30 microM), had no effect on the frequency of MPSCs. The effect
      of forskolin was prevented by the specific protein kinase A (PKA) antagonist Rp
      cAMP (30 microM). It is concluded that stimulation of PKA potentiates spontaneous
      GABA release in immature hippocampal neurons.

PMID- 7783967
TI  - Organization of preparatory postural responses for the initiation of lateral body
      motion during goal directed leg movements.
AB  - Postural responses preceding single leg flexion movements were examined in human
      subjects with respect to a hypothesized primary role of the hip joint abductor
      adductor musculature in initiating lateral body motion during alterations in
      stance. The results indicated a speed sensitive interlimb response organization
      compatible with predictions based on a mechanical model. In conjunction with
      other recent studies, the findings may be indicative of a common organizational
      substrate for the initiation of laterally directed motion of the body.

PMID- 7783968
TI  - The bipotential glial progenitor cell line can develop into both oligodendrocytes
      and astrocytes in the mouse forebrain.
AB  - Oligodendrocyte-type 2 astrocyte (O2A) progenitor cells in vivo might
      differentiate into oligodendrocytes. To examine the influence of the brain micro
      environment on the differentiation, a bipotential glial cell line from the mouse
      cerebrum, designated OS3 cells, was implanted into the telencephalon of infant
      and adult mice. About a half of the OS3 cells injected into 1-week postnatal
      brain expressed galactocerebroside (GalC), and even myelin basic protein, which
      were not observed to be expressed in vitro. By contrast, in the brain over 6
      months postnatally, many OS3 cells expressed glial fibrillary acidic protein, and
      did not express much GalC. These findings suggest that the differentiation of
      glial cells is controlled by stage specific factors in the brain.

PMID- 7783970
TI  - Expression of messenger RNA for somatostatin receptor subtype 4 in adult rat
      brain.
AB  - The distribution and cellular localisation of somatostatin receptor subtype 4
      (SSTR4) was investigated in the adult rat brain using the technique of in situ
      hybridisation with subtype specific oligonucleotide probes. Somatostatin receptor
      subtype 4 was found mainly in the hippocampus CA1 > CA2 > CA3 pyramidal cells and
      in the pyramidal cells in layers (IV-VI) of the cerebral cortex. Reverse
      transcription-PCR with SSTR4 specific primers confirmed the tissue distribution
      revealed by in situ hybridisation.

PMID- 7783969
TI  - Intracranial microdialysis of salicylic acid to detect hydroxyl radical
      generation by monoamine oxidase inhibitor in the rat.
AB  - The effect of pargyline, a monoamine oxidase inhibitor, on the generation of
      hydroxyl free radicals (OH) was investigated using striatal microdialysis.
      Salicylic acid in Ringer's solution (0.5 nmol microliter-1 min-1) was infused
      through a microdialysis probe to detect the generation of hydroxyl radicals (OH)
      as reflected by the formation of dihydroxybenzoic acid (DHBA) in the striatum.
      When pargyline (100 nmol microliter-1 min-1) was infused in rat brain, the level
      of 3,4-dihydroxyphenylacetic acid (DOPAC) gradually decreased in a time-dependent
      manner. In addition, a marked elevation of DHBA was observed. The present results
      indicate that accumulation of dopamine (DA) in the extracellular fluid elicited
      by pargyline can be auto-oxidized, which in turn leads (possibly by an indirect
      mechanism) to the formation of cytotoxic OH free radicals.

PMID- 7783971
TI  - Postnatal changes in glutamate binding in the lower medulla of the rat.
AB  - Changes in [3H]glutamate (Glu) binding occurring in the lower medulla of the rat
      between birth (P0) and adulthood (P72) were investigated on cryostat sections
      using in vitro receptor autoradiography. Densitometric measurements were
      performed in both autonomic (nucleus tractus solitarii, dorsal motor nucleus of
      the vagus nerve, ventrolateral medulla) and non-autonomic (inferior olive, spinal
      trigeminal nucleus) medullary regions. In all these areas, binding densities
      peaked at P9 and then gradually declined. Values close to those measured in adult
      animals were reached by P23-P30. These data indicate that glutamatergic
      neurotransmission within the lower medulla undergoes developmental changes during
      the early postnatal period. They thereby suggest that the neural circuits
      essential in organizing autonomic functions are still immature at birth.

PMID- 7783972
TI  - Phrenic responses to contralateral spinal stimulation in rats: effects of old age
      or chronic spinal hemisection.
AB  - Serotonin reveals ineffective spinal pathways from the C2-lateral funiculus to
      contralateral phrenic motoneurons in young adult rats with acute spinal
      hemisection. We tested the hypothesis that old age (1.5-2 years) or chronic
      hemisection (3-5 days) strengthens these pre-existing crossed spinal pathways.
      There were no consistent differences between young adult rats with acute
      hemisection versus young adult rats with chronic hemisection or old rat with
      acute hemisection except that one long-latency phrenic excitation could not be
      elicited in old rats. The results indicate that neither old age nor chronic
      hemisection strengthens crossed-spinal pathways, but that old age may selectively
      diminish spinal pathways involved in the neural control of breathing.

PMID- 7783973
TI  - Opening of brain potassium-channels inhibits the ACTH-induced behavioral syndrome
      in the male rat.
AB  - In adult male rats, the intracerebroventricular (i.c.v.) injection of pinacidil,
      a potassium channel opener, at the doses of 100, 200 or 300 micrograms/rat, dose
      dependently reduced the display of the most typical behavioral symptoms
      (excessive grooming, stretching, yawning, penile erections) induced by the i.c.v.
      administration of ACTH-(1-24) (4 micrograms/rat). These data indicate that the
      complex mechanism of the melanocortin-induced behavioral syndrome involves
      closure of potassium channels in target neurons, and provide further experimental
      support to the idea that melanocortins are functional antagonists of opioids.

PMID- 7783975
TI  - The effect of paroxetine on 5-HT efflux in the rat dorsal raphe nucleus is
      potentiated by both 5-HT1A and 5-HT1B/D receptor antagonists.
AB  - Serotonin (5-HT) efflux in slices of rat dorsal raphe nucleus (DRN) was evoked by
      pseudo one pulse electrical stimulation (20 pulses at 100 Hz, 190 ms train
      duration) and measured, along with 5-HT uptake, by fast cyclic voltammetry (FCV).
      The selective serotonin re-uptake inhibitor (SSRI) paroxetine (10(-7) M)
      increased 5-HT efflux to 147 +/- 6% of pre-drug values at maximum (mean +/- SEM,
      n = 5) and the half-life of uptake to 443 +/- 38%. The non-selective 5-HT1
      antagonist methiothepin (2 x 10(-7) M) increased 5-HT efflux to 147 +/- 9% at
      maximum but had no effect on uptake half-life. In contrast, (+)-WAY 100135 (10(
      6) M) and GR 127935 (5 x 10(-8) M), selective antagonists at 5-HT1A and 5-HT1B/D
      receptors, respectively, affected neither 5-HT efflux nor uptake. When given in
      combination with paroxetine, the antagonists significantly increased the effect
      of paroxetine on efflux: methiothepin to 228 +/- 24% (P < 0.001), (+)-WAY 100135
      to 212 +/- 31% (P < 0.05) and GR 127935 to 203 +/- 23% (P < 0.01). These data
      suggest that, under these experimental conditions, DRN 5-HT autoreceptors are
      tonically activated in the presence of the uptake blocker and that the
      antagonists act by blocking this counteracting autoinhibitory tone. The data also
      strongly indicate that 5-HT efflux in the rat DRN is under the control not only
      of 5-HT1A but also of 5-HT1B/D receptors.

PMID- 7783974
TI  - Protein L-isoaspartyl methyltransferase: developmentally regulated gene
      expression and protein localization in the central nervous system of aged rat.
AB  - We have cloned a cDNA encoding protein L-isoaspartyl methyltransferase (PIMT) and
      characterized gene expression in the development, maturation, and the aging
      process of the central nervous system by RNA blot analysis, western blot
      analysis, and immunohistochemistry. PIMT transcript was detected in rat embryonic
      brain and showed a linear up-regulation during the maturation of the brain and
      maintained its level in aged rat brain. Immunoblot analysis also supported a
      linear increase in the amount of PIMT in the maturation process of rat brains. An
      immunohistochemical study showed that PIMT is strongly expressed in neurons and
      weakly but definitively in glial cells and oligodendrocytes. These
      immunoreactivities significantly increased in some neurons of the hippocampus,
      cerebral cortex, and the brain stem of aged rat brain. The present results
      suggest that the expression of PIMT is associated with the amount of
      racemized/isomerized proteins accumulated during the developmental and aging
      process of the central nervous system.

PMID- 7783977
TI  - Temporal analysis of neuropeptide Y expression in the rat trigeminal ganglion
      following peripheral axotomy of the inferior alveolar nerve.
AB  - Temporal changes in the appearance and the cell-size spectrum of neuropeptide Y
      (NPY)-like immunoreactive (IR) cells in the rat trigeminal ganglion (TG)
      following peripheral axotomy of the inferior alveolar nerve (IAN) were studied by
      retrograde neuronal tracing with True Blue (TB) and immunohistochemistry for NPY.
      The number of labeled cells following application of TB to the cut-end of the IAN
      increased rapidly up to 3 days, and was maintained at a constant level
      thereafter. The size distribution of cross-sectional areas of TB-labeled cells
      was similar at 3 days and afterwards. NPY-IR cells, which were not detected in
      the normal TG, appeared on the first day following axotomy, and increased
      gradually in number reaching a maximum at 14 days. The frequency histogram of the
      cross-sectional areas of NPY-IR cells was similar at 3 days and afterwards. The
      present results indicate that the effect of nerve injury on the levels of NPY
      expression in the sensory neurons began soon after nerve injury, reaching a
      maximum around 14 days, and that induction of NPY in the sensory neurons occurred
      in the same cell size-specific manner for a long period.

PMID- 7783976
TI  - Day-night differences in the contents of vasoactive intestinal peptide, gastrin
      releasing peptide and Arg-vasopressin in the suprachiasmatic nucleus of rat pups
      during postnatal development.
AB  - To investigate the developmental features of peptide levels in the
      suprachiasmatic nucleus (SCN), the contents of vasoactive intestinal polypeptide
      (VIP), gastrin-releasing peptide (GRP) and Arg-vasopressin (AVP) were measured in
      punched-out SCN tissue from rat pups on postnatal days (PD) 4, 15 and 20 using a
      specific enzyme immunoassay. The VIP content was high at night, and the day-night
      difference was largest at PD4 throughout the developmental stage. GRP and AVP
      contents increased following the maturation. GRP levels were higher during the
      dark than the light period from PD4 to PD20. Subjective day-night differences
      were also observed in blinded pups. Our results indicate that VIP, GRP and AVP in
      the SCN already show a diurnal rhythm in the SCN during the nursing period.

PMID- 7783978
TI  - Influence of acute arterial hypertension on blood-brain barrier permeability in
      streptozocin-induced diabetic rats.
AB  - The effect of acute arterial hypertension on blood-brain barrier (BBB)
      permeability was studied in streptozocin-induced diabetic rats using Evans blue
      as a barrier tracer. Four groups of rats were studied: Group 1, normotensive
      normoglycemia; Group II, normotensive+diabetes mellitus; Group III, arterial
      hypertension+diabetes mellitus; Group IV, arterial-hypertension+normoglycemia.
      During adrenaline-induced acute arterial hypertension the mean arterial blood
      pressure increased in both non-diabetic and diabetic animals. Changes in BBB
      permeability were observed in 52% of the non-diabetic rats, and in 72% of the
      diabetic rats after adrenaline-induced acute arterial hypertension. Mean levels
      of Evans blue in the whole brain were found to be 0.63 +/- 0.1 mg% in non
      diabetic and 0.90 +/- 0.2 mg% in diabetic rats. The difference between the non
      diabetic and the diabetic rats was found to be statistically significant (P <
      0.01). From these results it was suggested that the extravasation of Evans blue
      albumin is more pronounced in the brains of diabetic rats in comparison with non
      diabetic rats after adrenaline-induced acute hypertension, which is indicative of
      changes in BBB permeability due to diabetes mellitus.

PMID- 7783979
TI  - Nitric oxide mediates neuropathic pain behavior in peripherally denervated rats.
AB  - The involvement of spinal cord nitric oxide (NO) in the development of autotomy,
      a proposed behavioral model of denervation pain, was studied in sciatic and
      saphenous nerves transected rats injected intrathecally, 10-15 min prior to
      neurectomies, with NG-nitro-L-arginine methyl ester (L-NAME, 20-500 nmol), NG
      nitro-D-arginine methyl ester (D-NAME, 500 nmol), L- or D-arginine (5 mumol), and
      8-bromoguanosine 3':5'-cyclic monophosphate sodium salt (8-Br-cGMP, 100 and 200
      nmol). Self-inflicted lesions were scored daily for 8 weeks. The main effects on
      autotomy were: (1) a significant suppression in rats injected with L-NAME (500
      nmol), but not with D-NAME; (2) a significant potentiation after L-arginine, but
      not D-arginine; and (3) a significant potentiation with 8-Br-cGMP, which was
      blocked by co-administration of L-NAME. These findings indicate that autotomy in
      rats can be modulated by blocking or enhancing nitroxidergic transmission at
      lumbosacral level, and suggest new therapeutic approaches for the prevention of
      certain pain syndromes, such as phantom limb pain.

PMID- 7783980
TI  - Glutamate-induced calcium responses in rat primary cortical cultures are
      potentiated by co-administration of glutamate transport inhibitors.
AB  - The effects of glutamate uptake inhibitors on the L-glutamate-induced increase in
      intracellular calcium concentrations were assessed in rat primary cortical
      cultures. The glutamate (10 microM)-induced rise in intracellular calcium
      concentrations was strongly and dose dependently increased and prolonged by
      simultaneous administration of micromolar concentrations of the reference
      glutamate transport inhibitors, L-trans-pyrrolidine-2,4-dicarboxylate (PDC) and D
      or L-threo-beta-hydroxyaspartate. PDC in concentrations up to 10 microM showed
      no effect on intracellular calcium when administered alone. The anticancer drug
      tamoxifen, which was found to be effective as a glutamate transport inhibitor,
      did not increase but prolonged the cellular calcium response to glutamate,
      indicating that it had a different mechanism of action compared to that of
      standard glutamate transport inhibitors. The findings suggest that compounds
      which inhibit the glutamate transporter may potentiate the excitatory
      glutamatergic signal of cultured neurons when administered together with
      glutamate.

PMID- 7783981
TI  - Cerebral vascular amyloid deposition in rabbits with induced thyroglobulin
      immunity.
AB  - Cerebral amyloid angiopathy (CAA) occurs in humans along with the neuritic
      amyloid plaques in Alzheimer's disease, in several familial (inherited)
      syndromes, and in a sporadic form that increases in prevalence with age to attain
      a rate of about 60% after age 90. In the non-Alzheimer conditions, it is often
      accompanied by cerebral hemorrhage and sometimes also by dementia. We report here
      the experimental induction of cerebrovascular amyloid (CVA) in thyroglobulin (Tg)
      immunized rabbits. The vascular deposits in these rabbits are comparable to that
      seen in humans in that they primarily involve arterioles, venules, and
      capillaries and exhibit microscopic and ultrastructural characteristics similar
      to the human lesion. Prominent congophilic vascular lesions in the brain were
      seen in three out of six Tg-immunized rabbits, whereas less striking basement
      membrane thickening was evident in three other experimental animals, probably
      reflecting individual variations in vascular responses to actively induced Tg
      immunity. Occasional primitive amyloid plaques were also encountered adjacent to
      vascular lesions. These observations are of particular interest since in other
      experimental models, cerebral vascular amyloid deposits have not been observed,
      thus suggesting that immunopathogenic events induced by active Tg immunization
      may be unique in their effects on the cerebral vasculature.

PMID- 7783982
TI  - Reciprocal control of inflammatory cytokines, IL-1 and IL-6, and beta-amyloid
      production in cultures.
AB  - To investigate the role of IL-6 in the pathogenesis of Alzheimer's disease (AD)
      its effect on amyloid precursor protein (APP) mRNA expression was evaluated. The
      levels of APP mRNA were determined by Northern blot analysis in primary cultured
      rat cortical neurons and glial cells exposed to IL-6 (50-200 ng/ml). The cytokine
      increased neuronal APP mRNA expression about 100% at the highest dose after 6 h
      of exposure. APP mRNA expression was unaffected in astroglial cells exposed to IL
      6. Since IL-1 beta also increased neuronal APP mRNA, the combination of IL-1 beta
      and IL-6 was tested. The effects were partially additive. The ability of beta
      amyloid fragment 25-35 to induce IL-1 or IL-6 mRNA was also investigated in
      astroglial cells. IL-1 beta mRNA was strongly induced by beta 25-35 (25-100
      microM) while the expression of IL-6 mRNA remaining unchanged. The results
      suggest roles for both IL-1 and IL-6 in the neuronal mechanisms related to beta
      amyloid protein deposition in AD.

PMID- 7783983
TI  - Presynaptic A2-adrenoceptors and neuropeptide Y Y2 receptors inhibit
      [3H]noradrenaline release from rat hypothalamic synaptosomes via different
      mechanisms.
AB  - Presynaptic receptors may reduce transmitter release with different mechanisms.
      Both the alpha 2-agonist, clonidine and the Y2-agonist, neuropeptide Y fragment
      13-36 (NPY 13-36), induce a concentration-dependent inhibition of the 4
      aminopyridine (4-AP)-evoked [3H]noradrenaline ([3H]NA) release from hypothalamic
      synaptosomes. Changes in alpha 2- and Y2-modulation of noradrenaline (NA) release
      were observed by lowering the calcium influx with the use of omega-conotoxin
      (omega-CgTx), a calcium-channel blocking agent. In these experimental conditions,
      clonidine was less active, whereas NPY 13-36 preserved its efficacy. It therefore
      seems possible that presynaptic alpha 2-adrenoceptors can primarily inhibit NA
      release by reducing calcium influx via voltage-sensitive calcium channels (VSCC),
      while Y2-receptors may inhibit the intracellular release process with a mechanism
      independent of the calcium entry.

PMID- 7783984
TI  - Antiretroviral treatment of HIV infection.

PMID- 7783985
TI  - Anaesthetists, errors in drug administration and the law.
AB  - AIM: To document the problem of drug administration error in anaesthesia in New
      Zealand, with regard to: prevalence (in context of the total number of drugs that
      might be administered during an anaesthetist's career); preventative strategies;
      and anaesthetists' perceptions concerning the medicolegal environment prevailing
      in New Zealand. METHODS: A questionnaire was posted to a random sample of 75 New
      Zealand anaesthetists. Drug administrations per anaesthetic were counted on a
      random sample of anaesthetic records at Green Lane Hospital. Ten anaesthetists
      were asked the number of anaesthetics administered per year. RESULTS: Eighty-nine
      percent of 66 respondents reported at least one error of drug administration, and
      12.5% had actually harmed patients. There was no relationship between any
      preventative strategy and frequency of error. All respondents were concerned
      about the possibility of manslaughter charges arising from a drug error; 57%
      thought the medicolegal environment in New Zealand impacted adversely on their
      practice; 83% thought it might impede the reporting of errors. There seems to be
      no definitive strategy for the elimination of drug error. CONCLUSION: Error is
      inherent in drug administration in anaesthesia, as it is in any complex human
      endeavour; therefore it is illogical to treat it as necessarily criminal.
      Instead, effort and resources should be aimed at rational initiatives to reduce
      this worrying problem.

PMID- 7783986
TI  - Prevalence of childhood asthma symptoms in an industrial suburb of Christchurch.
AB  - AIM: In response to community concern about the possible respiratory effects of
      emissions from a fertiliser plant, a study was carried out to determine whether
      the prevalence of asthma symptoms in 5-8 yr old children in an industrial suburb
      of Christchurch (Hornby) was the same as in the rest of Christchurch. METHODS: A
      sample of 646 children aged 5-8 years in Hornby was compared with 1183 6-7 year
      old children randomly selected from schools throughout the Christchurch
      metropolitan area. The Christchurch sample was part of the International Study of
      Asthma and Allergies in Childhood (ISAAC) carried out during 1993. ISAAC
      questionnaires on respiratory symptoms with some additional questions about
      smoking and pets were answered by the caregivers of the children sampled.
      RESULTS: Response rates were 97% in Hornby and 94% in Christchurch. Of the
      sample, 29% (Hornby) and 27% (Christchurch) had 'wheeze in the last 12 months'
      while 45% of Hornby and 44% of Christchurch children had 'ever wheezed', 28% had
      'ever had asthma'. Significantly more children in Hornby (44%) were exposed to
      passive smoking compared to Christchurch (29%). Indoor pets were present in 73%
      and 67% of homes, respectively. CONCLUSION: There was no evidence of an increase
      in asthma symptoms reported in children in the industrial area of Hornby.

PMID- 7783987
TI  - Pregnancy in renal transplant recipients: the Christchurch experience.
AB  - AIM: Assess the pregnancies of our female renal transplant recipients and to
      document long term maternal and fetal outcome. METHODS: Between 7 June 1972 and
      31 December 1992 112 females had at least one renal transplant. Sixty-four of
      these 112 women were in the reproductive age and had a functioning graft.
      RESULTS: Nine women had 16 pregnancies which resulted in 11 live births and three
      first trimester abortions. Two unplanned pregnancies were terminated. Mean age at
      transplantation was 17.2 yr [range 16-22.5 yr] and mean interval from transplant
      to pregnancy was 6.8 yr [range 1.8-9.0 yr]. Prednisone and azathioprine were used
      in all patients and cyclosporin in five. For seven of the successful pregnancies
      plasma creatinine remained < or = 0.10 mmol/L. One of these women developed
      allograft nephropathy 5 years after delivery and returned to dialysis 9 years
      later. For the other four successful pregnancies the preconception plasma
      creatinine was 0.12-0.14 mmol/L. The woman with two successful pregnancies had a
      halving of glomerular filtration rate during the second pregnancy, but it has
      remained stable for 15 years; one was poorly compliant with her immunosuppressive
      regimen and reached endstage renal failure two years after delivery; one
      developed cyclosporin nephrotoxicity, but 18 months later renal function was
      stable after a dosage reduction. Ten infants were delivered by caesarean section,
      four of them urgently. Three babies were preterm and five growth retarded. One
      died of sudden infant death syndrome at four months. All other infants developed
      normally. CONCLUSION: There is no contraindication to pregnancy in female
      transplant recipients who have stable graft function and controlled blood
      pressure. Management of such pregnancies should be by shared
      obstetrical/nephrological/paediatric care.

PMID- 7783988
TI  - Triclonal gammopathy in a woman with nonHodgkin's lymphoma.

PMID- 7783989
TI  - Funding long term care for elderly people.
AB  - Asset testing of elderly people in long term care discriminates unfairly on
      grounds of age in two ways: only elderly people are charged for public hospital
      inpatient care and only for elderly people are public health system charges
      determined by assets not income. In this paper it is argued that the essential
      requirement for a public health system is that it is universally and promptly
      available to every person, irrespective of a person's ability to pay. This does
      not preclude direct charges. The costs for long term care should be met by
      charges for living and accommodation expenses and any charge for medical and
      nursing costs should be determined by income and not asset testing. There is no
      justification for charging for medical and nursing inpatient costs in long term
      care and not in other areas of public hospital care. If direct charges have to be
      made for inpatient care, then in the interests of equity, and to achieve adequate
      funding for the public health system, direct charges for such care should be for
      acute as well as long term care and for the young and middle aged as well as for
      the elderly, providing these charges do not preclude any person receiving
      necessary care.

PMID- 7783990
TI  - The Paediatric Society of New Zealand: passive exposure of children to
      environmental tobacco smoke.

PMID- 7783991
TI  - The management of hypertension.

PMID- 7783993
TI  - Nocturnal leg cramps in the elderly.

PMID- 7783992
TI  - Treatment of basal cell carcinoma with intralesional interferon alpha-2a.

PMID- 7783994
TI  - No measles parties.

PMID- 7783995
TI  - Skin reactions and terfenadine.

PMID- 7783997
TI  - Who should treat the infertile couple?

PMID- 7783996
TI  - The potential adverse effects of soybean phytoestrogens in infant feeding.

PMID- 7783998
TI  - Osteitis pubis: a review.
AB  - Osteitis pubis is a painful, noninfectious inflammatory condition that involves
      the pubic bone, symphysis, and surrounding structures. Initially associated with
      urologic procedures, osteitis pubis has been described as a complication of
      various obstetrical and gynecological procedures including vaginal deliveries. An
      incidence of approximately 2 to 3 percent has been observed after the Marshall
      Marchetti-Krantz urethropexy. Although the pathogenesis of osteitis pubis is not
      clear, periosteal trauma seems to be an important initiating event. Pain is the
      primary symptom associated typically with difficulty in ambulation and the
      characteristic "waddling gait." A low grade fever, elevated sedimentation rate,
      and mild leukocytosis may be observed. Radiographic findings which include
      reactive sclerosis, rarefaction, and osteolytic changes lag behind the symptoms
      by about 4 weeks. The major differential diagnosis is osteomyelitis; however, the
      self-limiting nature and its response to nonantibiotic therapy indicates that
      osteitis pubis is a separate clinical entity. Treatment is directed at the
      associated inflammation with most minor cases responding to antiinflammatory
      agents and bedrest. Other more recalcitrant cases require more involved therapy
      including systemic steroids and rarely surgical resection. The diagnosis of
      osteitis pubis should be considered when pelvic pain is present in association
      with potential trauma to the symphysis pubis. Also, with more women participating
      in sporting activities patients may present to the physician with osteitis pubis
      related to athletic injury.

PMID- 7783999
TI  - Pheochromocytoma in pregnancy: case report and review of the literature.
AB  - Pheochromocytoma is a rare disease that may occur during pregnancy. Only a few
      hundred cases have been published in the literature. Manifestations include
      hypertension with various clinical presentations, possibly resembling those of
      pregnancy-induced hypertension, or pre-eclamptic toxemia. Differentiation of
      these conditions is not always feasible, thus creating a serious risk, because
      fetal and maternal morbidity and mortality are far higher with pheochromocytoma.
      Biochemical measurements of catecholamines and their metabolites are apparently a
      convenient way to establish diagnosis during pregnancy, inasmuch as
      interpretation of radiological evaluation is complicated by the gravid uterus,
      and might even be potentially dangerous due to the use of ionizing radiation.
      More sophisticated methods for evaluation are not always practical during
      pregnancy. Medical treatment aims at controlling symptoms, mandating the use of
      alpha- and beta-receptors blockade medication. Surgical intervention is the only
      possible curative method available, but the critical issue is probably to
      identify the exact timing during the course of pregnancy for such intervention,
      or the ability to control symptoms until delivery. Although malignant
      transformation of pheochromocytoma have been reported, it is extremely uncommon.
      The overall prognosis is mainly affected by early diagnosis, and
      multidisciplinarian management.

PMID- 7784000
TI  - Combined antenatal vitamin K and phenobarbital therapy for preventing
      intracranial hemorrhage in newborns less than 34 weeks' gestation.
AB  - ok--q----_xD-xD whether maternal antenatal therapy with vitamin K and
      phenobarbital prevents intracranial hemorrhage in premature newborns. METHODS:
      Women at high risk for spontaneous or indicated premature delivery before 34
      weeks' gestation were randomly assigned to receive either placebo or vitamin K
      and phenobarbital. All patients received betamethasone and antibiotics and were
      managed uniformly by a single perinatal group in one hospital. All newborns were
      managed uniformly in the same nursery by one neonatal group. Two independent
      interpretations of neonatal head ultrasound examinations were obtained. RESULTS:
      The duration of gestation at study entry and at delivery were similar in the
      placebo (181 mothers) and treatment (191) groups. With the hospital radiology
      group (the primary interpreter), the incidence rates of severe intracranial
      hemorrhage (8 versus 7%) and mild intracranial hemorrhage (38 versus 32%) were
      similar for both groups. With the secondary interpreter (a single pediatric
      radiologist), the incidence rates of severe intracranial hemorrhage (9 versus 7%)
      and mild intracranial hemorrhage (27 versus 26%) were also similar. Neonatal
      mortality was equivalent in both the placebo and treatment groups (8 versus 10%).
      CONCLUSION: Combined antenatal therapy with vitamin K and phenobarbital does not
      reduce the frequency or severity of intracranial hemorrhage in premature
      newborns.

PMID- 7784002
TI  - A computer model of uterine contractions based on discrete contractile elements.
AB  - OBJECTIVE: To predict uterine contraction waveforms using a microcomputer-based
      model of uterine activity based on discrete contractile elements, varying the
      shape of the model, total number of cells, and pacemaker locations. METHODS: The
      model is a hollow ovoid composed of discrete contractile elements (cells) that
      propagate electrical impulses, generate tension, and have defined contracting and
      refractory periods. Each cell contacts eight surrounding cells and propagates
      impulses iteratively from cell to cell. Contraction pressure is the sum of the
      tension contributions by contracting cells. Sample contraction waveforms were
      generated based on various numbers of cells organized in ovoids with long:short
      axis ratios of 1:1, 3:2, and 2:1, with one or two pacemakers at varying
      positions. RESULTS: Contraction waveforms are altered by altering the shape of
      the matrix, but not by increasing the number of contractile elements. The
      vertical placement of the pacemaker has a dramatic effect on the shape and
      symmetry of contractions, including the development of patterns characteristic of
      "dysfunctional" uterine contractions. CONCLUSION: Abnormal uterine contraction
      patterns may result from pacemaker activity in unusual locations, such as mid
      uterus. Further refinement of this computer model of uterine activity may
      contribute to a better understanding of the genesis of normal and abnormal
      intrauterine pressure waveforms and their relationship to the progress of labor.

PMID- 7784001
TI  - The effect of maternal obesity on the accuracy of fetal weight estimation.
AB  - OBJECTIVE: To determine if maternal obesity affects the accuracy of either
      clinical or sonographic fetal weight estimations. METHODS: In a year-long study,
      998 singleton pregnancies of 26-43 weeks' gestation underwent both clinical
      (Leopold) and sonographic (Shepard and Hadlock) fetal weight estimation within 5
      days of delivery (mean 1.1, 95% confidence interval 1.0-1.3). Patients were
      stratified into four different groups based on increasing maternal body mass
      index (BMI): underweight (less than 19.8), normal weight (19.8-26.0), overweight
      (26.1-29.0), and obese (more than 29.0). The various estimations of fetal weight
      were compared with actual birth weight, and the mean absolute percent error was
      calculated for each specific method and analyzed among the four BMI groups.
      RESULTS: For each method of weight estimation, there was no difference
      (specifically, no increase) in the magnitude of the absolute percent error with
      increasing maternal obesity. Regardless of maternal size, almost half of the
      weight predictions were within 5% of the actual birth weight. CONCLUSION:
      Increasing maternal obesity does not alter or decrease the accuracy of either
      clinical or sonographic fetal weight estimations. Therefore, fetal weight
      predictions provide equally accurate and valid guidelines for determining
      management decisions in women, regardless of body size.

PMID- 7784003
TI  - Gender influences on earnings of obstetrician-gynecologists.
AB  - OBJECTIVE: To test the hypothesis that the observed difference in earnings
      between male and female obstetrician-gynecologists could be explained by
      variations in productivity and human capital. METHODS: Data from a 1991 national
      survey of ACOG Fellows were used to provide a descriptive analysis of male and
      female obstetrician-gynecologists' demographic characteristics, net income,
      experience, practice characteristics, workload, and practice activities.
      Variables found to have a significant impact on net income or to vary
      significantly by sex were included in a multiple regression analysis. RESULTS:
      Twenty-one percent of the 1286 survey respondents were female obstetrician
      gynecologists. Women were almost twice as likely as men to be in salaried
      positions (P < .001) and more than twice as likely to have less than 10 years of
      experience (P < .001). Women reported fewer annual patient-contact hours (P <
      .05) and performed fewer than half as many hysterectomies (P < .001). Average
      annual earnings for women were 71% of men's annual net income (P < .001). The
      multivariate regression analysis found that male-female differences in the
      factors included in the analysis (ie, workload, experience, practice type)
      resulted in an 18.7% male-female income gap. The analysis also revealed an income
      gap of 14.2% that was not accounted for by differences in the objective factors
      included in the model. CONCLUSION: More than half of the overall male-female
      income gap was explained by differences in personal and practice characteristics.
      However, female obstetrician-gynecologists earned 14.2% less than men, after
      controlling for variations in productivity and human capital.

PMID- 7784004
TI  - Screening and treatment of asymptomatic bacteriuria of pregnancy to prevent
      pyelonephritis: a cost-effectiveness and cost-benefit analysis.
AB  - OBJECTIVE: To compare the effectiveness, benefits, and costs of two asymptomatic
      bacteriuria screening and treatment strategies to prevent pyelonephritis in
      pregnancy. METHODS: A decision analytic model was created to compare strategies
      based on either 1) a leukocyte esterase-nitrite dipstick, or 2) on urine culture,
      with a policy of no screening or treatment. A literature search was conducted to
      generate probability estimates. Cost estimates were based on a local pharmacy and
      laboratory survey and supplemented by recent literature estimates. Sensitivity
      analyses were performed over wide ranges of probability and cost estimates.
      RESULTS: Under baseline assumptions, no screening resulted in 23.2 cases of
      pyelonephritis per 1000 pregnancies, versus 16.2 cases with the dipstick strategy
      and 11.2 with the culture strategy. The cost of screening and treatment of
      asymptomatic bacteriuria per 1000 pregnancies was $1968 with dipstick and $19,264
      with culture. The cost of treating pyelonephritis with no screening was $57,562,
      versus $40,257 with dipstick and $27,832 with culture. Therefore, both the
      dipstick strategy and the culture strategy were cost-beneficial (based on a
      pyelonephritis cost of $2485) when compared with no screening. However, because
      it cost $3492 to prevent each additional case of pyelonephritis with culture that
      was not prevented by dipstick, the culture strategy was not cost-beneficial
      compared with the dipstick strategy. These results were sensitive to varying
      estimates for the prevalence of asymptomatic bacteriuria, the rate of progression
      of asymptomatic bacteriuria to pyelonephritis, the sensitivity of the dipstick,
      culture costs, and the cost of a case of pyelonephritis. CONCLUSION: When
      compared with a policy of no screening, screening for and treatment of
      asymptomatic bacteriuria to prevent pyelonephritis in pregnancy is cost
      beneficial whether based on the leukocyte esterase-nitrite dipstick or on urine
      culture. However, the culture strategy is not cost-beneficial when compared with
      the dipstick strategy.

PMID- 7784005
TI  - Routine statistical screening revisited.

PMID- 7784006
TI  - Detection of human parvovirus B19 DNA by nested polymerase chain reaction.
AB  - We describe the development of a nested polymerase chain reaction (PCR) technique
      used to detect human parvovirus B19 DNA. It was performed in a two-step reaction,
      first with a pair of outer primers, then with a pair of inner (ie, nested)
      primers. Primer sequences were selected in the VP1 gene, corresponding to the
      capsid protein, of human parvovirus B19. To establish the nested PCR assay, the
      plasmid pGEM-1 containing almost the entire coding sequence of a human parvovirus
      B19 isolate was used. The nested PCR could detect up to 1.8 x 10(-3) ag of B19
      DNA, equivalent to 10(-4) genomes, by electrophoresis. No amplification product
      was detected by gel electrophoresis when the reaction mixture contained human
      placental DNA, cytomegalovirus DNA, and sterile distilled water as templates. We
      used this assay to evaluate four cases of maternal B19 infection that were
      diagnosed by determination of the presence of anti-B19 immunoglobulin-M in
      maternal serum. The advantages of our nested PCR for detecting B19 DNA are
      plating simplicity, safety, sensitivity, and specificity. Our results suggest
      that this method may have general applicability in the evaluation of nonimmune
      hydrops fetalis and in the documentation of the natural history of fetal
      infection with B19 when applied to specimens of amniotic fluid or fetal blood.

PMID- 7784007
TI  - Modifying training attitudes and practice during health care reform.
AB  - Health care reform has focused on the high cost of care today. To comply with
      proposed changes, new attitudes, training, and practice patterns are needed.
      Constant concern about the cost of diagnosis must exist, and only proven
      therapies can be justified.

PMID- 7784008
TI  - Ideal residency curriculum in reproductive endocrinology and infertility.
AB  - OBJECTIVE: Knowledge in reproductive endocrinology and infertility is fundamental
      to the delivery of quality women's health care. In 1991, the American Fertility
      Society formed a resident education committee to gather data on the current
      status of reproductive endocrinology and infertility training and develop an
      ideal curriculum. METHODS: Program directors and reproductive endocrinology and
      infertility faculty from 288 residencies in obstetrics and gynecology were
      surveyed about training in reproductive endocrinology and infertility; 257 (89%)
      of the program directors (survey I) and 203 (82%) of the reproductive
      endocrinology and infertility faculty (survey II) responded. An ideal curriculum
      has been developed from consensus discussions, review of survey data, and polling
      of experienced educators. The curriculum was reviewed and approved by the board
      of directors of both the Society for Reproductive Endocrinologists and the
      American Fertility Society. RESULTS: The curriculum is divided into subject
      matter and therapeutics, which are prioritized into three levels of knowledge:
      critical core curriculum, less critical material, and material with which
      residents should have familiarity and general knowledge. In addition, other
      recommendations and suggestions are made regarding the number of rotations,
      duration of rotations, and teaching methods. CONCLUSION: The ideal curriculum may
      serve as a guide to assist program directors in the formulation of the most
      effective residency training in reproductive endocrinology and infertility. The
      curriculum can help prioritize what should be taught and where an emphasis can be
      placed. There is not enough time or resources to teach residents all aspects of
      reproductive endocrinology and infertility.

PMID- 7784009
TI  - The effects of a course in cadaver dissection on resident knowledge of pelvic
      anatomy: an experimental study.
AB  - OBJECTIVE: To determine whether a course in cadaver dissection can significantly
      increase resident knowledge of pelvic anatomy beyond that of current educational
      practices. METHODS: Thirteen first- and second-year residents were randomly
      assigned to a cadaver dissection course (seven) or a control group (six). The
      dissection group performed dissections with instruction, using a dissection guide
      designed specifically for the course. The control group received study references
      on pelvic anatomy and protected study time. Each participant took a practical and
      written examination at the beginning and end of the study. RESULTS: The two
      groups did not differ statistically in their scores on the pre-test. Both groups
      improved on the post-test, but the dissection group scored nearly 50% higher on
      the test than did the controls. The two groups differed significantly on the post
      test, adjusted for pre-test performance (P < .01). In their evaluation of the
      course, participants from the dissection group emphasized its educational value
      and urged that it be offered to residents as a regular part of their training.
      CONCLUSION: Dissection of a human cadaver provides a valuable experience,
      allowing participants to gain a greater understanding of surgical anatomy and
      surgical procedures in a no-risk, unhurried setting. Residents who participated
      in a cadaver dissection course designed specifically for their needs showed a
      statistically significant increase in knowledge compared with those without this
      experience. Both objectively and subjectively, a cadaver dissection course is an
      excellent tool for instructing gynecology residents.

PMID- 7784010
TI  - Perinatal implications of shoulder dystocia.
AB  - OBJECTIVE: To assess the antecedents of shoulder dystocia, the risk of
      recurrence, and the perinatal morbidity associated with the different maneuvers
      used for its management. METHODS: We conducted a 10-year (1980-1989)
      retrospective case record review of all instances of shoulder dystocia in a
      teaching maternity hospital. RESULTS: There were 254 cases of shoulder dystocia
      in 40,518 vaginal cephalic deliveries (0.6%), with 33 cases (13.0%) of brachial
      plexus palsy and 13 fractures (5.1%). There were no perinatal deaths attributable
      to shoulder dystocia. The risk of shoulder dystocia was increased with prolonged
      pregnancy (threefold), prolonged second stage of labor (threefold), mid-forceps
      deliveries (tenfold), and increasing birth weight. Of the maneuvers used to deal
      with shoulder dystocia, strong downward traction on the head was significantly
      correlated with brachial plexus palsy compared with other individual methods of
      delivering the shoulders. There was only one case of recurrent shoulder dystocia
      in 80 women having 93 cephalic vaginal deliveries after their original delivery
      coded with shoulder dystocia. CONCLUSION: Shoulder dystocia is not a reliably
      predictable event in labor. Although the risk of shoulder dystocia is increased
      with prolonged pregnancy, prolonged second stage of labor, increasing birth
      weight, and mid-forcepts delivery, the majority of cases occur without these risk
      factors. Strong downward traction on the head is associated with the greatest
      degree of neonatal trauma, whereas McRoberts maneuver has the least. The risk of
      recurrent shoulder dystocia is low.

PMID- 7784011
TI  - Development of a guidebook for senior students applying for residency training in
      obstetrics and gynecology.
AB  - This article describes a detailed residency guidebook that I developed over the
      course of 4 years based on interaction with 42 student advisees. Questions most
      frequently asked by the students were recorded, and comprehensive written
      responses were prepared that addressed their specific concerns. The completed
      guidebook contains several major sections. The introductory portion provides a
      general description of the discipline of obstetrics and gynecology, outlines the
      format of residency training programs, and assesses the competitiveness of
      residencies in obstetrics and gynecology compared with other disciplines. The
      second section lists deadlines for completing various tasks, such as selecting an
      adviser, planning the senior curriculum, requesting and submitting applications,
      preparing the curriculum vitae and personal statement, and soliciting letters of
      recommendation. The next section of the guidebook provides suggestions for the
      senior curriculum and specifically addresses the issue of "audition electives" in
      obstetrics and gynecology. The next two sections present formats for the
      student's personal statement and curriculum vitae. Next, guidelines for
      requesting letters of recommendation are presented. Thereafter, information is
      provided to help students determine the number of applications they should
      submit, and training programs targeted by the student are classified by size,
      type, and competitiveness. Finally, the guidebook addresses questions related to
      scheduling and preparing for interviews.

PMID- 7784012
TI  - Good practice with endometrial ablation.
AB  - OBJECTIVE: To provide clear guidelines for the safe and effective performance of
      endometrial ablation. DATA SOURCES: Representatives of American, Australian,
      British, and Canadian hysteroscopists were brought together to produce a
      consensus document of good practice in endometrial ablation. METHODS OF STUDY
      SELECTION: The guidelines were produced after researching the literature,
      combining the extensive experience of the group, and debating the relevant
      issues. CONCLUSIONS: Endometrial ablation is a new procedure. Correct patient
      selection is essential in producing good results. Patients must be counseled
      carefully about the advantages, disadvantages, and potential complications of
      this approach to the management of menstrual disorders. The main indication for
      endometrial ablation is heavy menstrual loss in the absence of organic disease.
      Excessive uterine size, the presence of active pelvic infection, and evidence of
      malignant and premalignant endometrium are absolute contraindications. Ablation
      can be produced by electrosurgical resection, rollerball or rollerbarrel ablation
      and Nd-YAG laser ablation. Severe complications can occur, and techniques should
      be adopted to avoid uterine perforation, hemorrhage, and excessive fluid
      absorption. In skilled hands, endometrial ablation can be a safe and effective
      treatment for menorrhagia.

PMID- 7784013
TI  - Cesarean delivery: a reconsideration of terminology.
AB  - The terminology we employ influences our perceptions. Thus, we believe in
      reviewing terminology regularly. The term "cesarean section" should be abandoned.
      A medical procedure is rarely named after a historic figure, and almost never
      after an ancient Roman law. Cesarean section has recently been amended to
      cesarean birth; however, the term is still inadequate. The word "hysterotomy"
      more appropriately describes the procedure we regularly perform. The adjectives
      used to describe cesarean birth should also be reevaluated. If we are to keep the
      term "classical" for the original fundal vertical uterine incision, then the
      other designations of hysterotomy should retain the same architectural context.
      Contemporary hysterotomy should be used in reference to a low transverse
      cesarean. Neoclassical hysterotomy might be used to describe the low vertical
      procedure. Transitional hysterotomy may be an appropriate term for the "hockey
      stick" or "J" incision. Cesarean delivery best describes a postmortem cesarean.
      Vaginal birth after cesarean (VBAC) is inappropriate because a vaginal birth
      after a cesarean section would not occur if cesarean section refers to a
      perimortem procedure. Vaginal birth after hysterotomy should be substituted for
      VBAC. Such revision of our terminology will keep obstetrics at the forefront of
      medical science and bring us most efficiently into the 21st century.

PMID- 7784014
TI  - Serious adverse events in Norplant users related to the Food and Drug
      Administration's MedWatch Spontaneous Reporting System.

PMID- 7784015
TI  - The clinical significance of a single umbilical artery as an isolated finding on
      prenatal ultrasound.

PMID- 7784016
TI  - New suturing device for laparoscopic hysterectomy.

PMID- 7784017
TI  - Preterm prelabor amniorrhexis: outcome of live births.
AB  - OBJECTIVE: To investigate the risk of postnatal death in pregnancies with preterm
      prelabor amniorrhexis in relation to gestational age at both amniorrhexis and
      delivery. METHODS: In 172 singleton pregnancies with preterm prelabor
      amniorrhexis resulting in live births, postnatal survival and cause of death were
      examined in relation to gestational age at both amniorrhexis and delivery. In 108
      of the patients, the amniotic fluid index (AFI) and fetal breathing movements
      were determined, and in 98, the internal thoracic circumference and
      cardiothoracic ratio were also measured. The value of these indices in the
      prediction of pulmonary hypoplasia was examined. RESULTS: There were 30 (17%)
      deaths, 18 of which were due to pulmonary hypoplasia and 12 to prematurity
      related complications. Survival was related to both gestational age at
      amniorrhexis (50% for amniorrhexis before 20 weeks' gestation and 98% when
      amniorrhexis occurred after 25 weeks) and gestational age at delivery (57% for
      those born at 24-28 weeks' gestation and 96% for those born after 32 weeks).
      Pulmonary hypoplasia was also related to both gestational age at amniorrhexis
      (causing 92% of deaths in the group with amniorrhexis at less than 20 weeks'
      gestation but none of those with amniorrhexis after 23 weeks) and gestational age
      at delivery (causing 50% of deaths in the group delivered at 24-28 weeks'
      gestation and 87% of deaths in infants delivered after 28 weeks). Fetal breathing
      movements were present in 33 and 63% of cases with and without pulmonary
      hypoplasia, respectively. The corresponding values for internal thoracic
      circumference below the 2.5 percentile were 33 and 9%, respectively. There were
      no significant differences in the AFI or cardiothoracic ratio between the cases
      with and without pulmonary hypoplasia. Multivariate analysis demonstrated that
      the only characteristic that contributed significantly in distinguishing between
      cases with and without pulmonary hypoplasia was gestational age at amniorrhexis.
      CONCLUSION: In pregnancies with preterm prelabor amniorrhexis, postnatal survival
      is related to both gestational age at amniorrhexis and gestational age at
      delivery. Prediction of pulmonary hypoplasia is primarily dependent on
      gestational age at amniorrhexis.

PMID- 7784018
TI  - Bone mineral loss during lactation and recovery after weaning.
AB  - OBJECTIVE: To test the hypothesis that bone mineral content (BMC) and density
      (BMD) are lost during lactation and regained within 6 months after weaning.
      METHODS: Two cohorts of women, defined by time postpartum, were enrolled into the
      study; each cohort was followed for 6 months. Women in the lactation cohort (65
      lactating women and 48 nonlactating postpartum controls) were enrolled at 2 weeks
      postpartum. Women in the weaning cohort (40 lactating and 43 nonlactating
      postpartum controls) were enrolled at 4-6 months postpartum. Lactating women
      enrolled in the weaning cohort had been fully breast-feeding at enrollment and
      weaned within 2 months of enrollment. Bone mineral content of the total body and
      BMD of the lumbar spine and distal radius were measured by dual-energy x-ray
      absorptiometry. RESULTS: Lactating women lost significantly more bone in the
      total body (-2.8 versus -1.7%) and lumbar spine (-3.9 versus 1.5%) than did
      nonlactating women during the first 6 months postpartum. There was no effect of
      lactation on bone changes at the distal radius. After weaning, lactating women
      gained significantly more bone in the lumbar spine than did nonlactating women
      (5.5 versus 1.8%). Earlier resumption of menses was associated with a smaller
      loss of bone during lactation and a greater increase of bone after weaning.
      CONCLUSION: Women lose bone during lactation but gain bone after weaning. Thus,
      lactation may not result in net bone loss.

PMID- 7784019
TI  - Mutational analysis of the estrogen-receptor gene in endometrial carcinoma.
AB  - OBJECTIVE: To determine whether mutation in the DNA of the estrogen-receptor gene
      occurs in endometrial cancer. METHODS: Polymerase chain reaction amplification
      and single-stranded conformation polymorphism analysis of the entire coding
      region (exons 1-8) of the human estrogen-receptor gene, as well as an
      untranslated region (exon I*) in the gene, were performed on genomic DNA
      extracted from 56 snap-frozen endometrial cancers. All cancers demonstrating
      mobility shifts on single-stranded conformation polymorphism suggestive of DNA
      sequence alteration were subjected to definitive DNA sequencing of the relevant
      portion of the estrogen-receptor gene. RESULTS: In addition to detecting a
      frequent, previously described polymorphism in exon 1, single-stranded
      conformation polymorphism analysis of the 56 endometrial cancers identified seven
      cancers with mobility shifts. Three cancers shifted in exon 3, one cancer each
      shifted in exons 4 and 7, and two shifted in exon 8. Deoxyribonucleic acid
      sequencing revealed sequence alterations in all seven cases demonstrating
      mobility shifts. In six of these seven cases, these alterations were consistent
      with infrequent silent polymorphisms; in the seventh cancer, the sequence
      alteration proved to be a somatic missense mutation at codon 537 in the region of
      the estrogen-receptor gene encoding the hormone-binding domain of the receptor
      protein. CONCLUSION: The infrequent DNA mutation in the estrogen-receptor gene is
      unlikely to account for the variation in estrogen-receptor expression observed in
      endometrial cancer.

PMID- 7784020
TI  - Comparison of D&C and office endometrial biopsy in predicting final
      histopathologic grade in endometrial cancer.
AB  - OBJECTIVE: To compare the accuracy of D&C and office Z-sampler endometrial biopsy
      in predicting hysterectomy tumor grade in women with endometrial cancer. METHODS:
      Between September 1987 and July 1994, 183 women with endometrial cancer had D&C
      or office Z-sampler endometrial biopsy before hysterectomy. RESULTS: One hundred
      thirty-one patients (72%) had Z-sampler biopsies and 52 (28%) had D&C. The Z
      sampler correctly identified the hysterectomy tumor grade in 76 of 131 patients
      (58%), compared with 40 of 52 (77%) with D&C, a significant difference (P =
      .024). The major difference observed was an increased fraction of lesions
      undergraded (ie, a lower grade tumor found in the biopsy than in the hysterectomy
      specimen) by the Z-sampler (34 of 131, 26%) versus D&C (five of 52, 10%).
      CONCLUSION: Dilation and curettage was more accurate in identifying hysterectomy
      tumor grade and less likely to miss a higher-grade tumor than was Z-sampler
      biopsy. However, the inaccuracy of D&C alone necessitates further preoperative
      and intraoperative assessment for other risk factors to determine the
      aggressiveness with which an individual patient should be staged surgically.

PMID- 7784021
TI  - Cervical carcinoma: computed tomography and magnetic resonance imaging for
      preoperative staging.
AB  - OBJECTIVE: To assess the accuracy of computed tomography (CT) and magnetic
      resonance imaging (MRI) in the evaluation of invasive cervical cancer. METHODS:
      Seventy-nine women with untreated cervical cancer underwent pre-treatment MRI (n
      = 71) and/or CT (n = 37) within 4 weeks of surgical evaluation. Twenty-nine women
      had both MRI and CT. Images were evaluated for tumor detection, size, stromal
      invasion, local extension, and nodal metastases. RESULTS: Tumor size was
      evaluated accurately by MRI, with a correlation coefficient of 0.93. Magnetic
      resonance estimates of tumor size were within 0.5 cm of the surgical sample in 64
      of 69 women (93%). Magnetic resonance was 88% accurate evaluating the presence of
      stromal invasion and 78% accurate for depth of stromal invasion. Computed
      tomography could not evaluate tumor size or stromal invasion because it could not
      distinguish cancer from the surrounding normal cervical tissue. In evaluating
      stage of disease, MRI had an accuracy of 90%, compared with 65% for CT (P <
      .005). Magnetic resonance imaging was more accurate than CT (94 versus 76%, P <
      .005) in assessing parametrial invasion. Both modalities were comparable in
      evaluating lymph node metastases (86% each). In determining operative candidates
      (stage I and minimal IIA), MRI was 94% accurate, compared with 76% for CT (P <
      .005). CONCLUSION: Compared with CT, MRI offered significantly improved
      evaluation of tumor size, stromal invasion, and local and regional extent of
      disease in pre-treatment imaging for cervical cancer.

PMID- 7784023
TI  - Blood flow in benign ovarian tumors and normal ovaries during the follicular
      phase.
AB  - OBJECTIVE: To identify the Doppler flow characteristics of benign ovarian tumors,
      and to compare the variables involved with those of normal ovaries during the
      follicular phase. METHODS: Ninety-one women comprised the study group: 43 were
      recruited from patients undergoing surgical exploration because of adnexal
      masses, and the remaining 48 were asymptomatic volunteers with normal ovaries.
      The ovarian volume and morphology, location of the intratumoral and intraovarian
      arteries, pulsatility index (PI), resistance index (RI), peak systolic velocity,
      and minimum diastolic velocity were assessed with transvaginal color Doppler
      ultrasonography. We examined patients with adnexal tumors before surgery and
      asymptomatic volunteers during the follicular phase of their menstrual cycles.
      RESULTS: Arterial blood flow was detected in 49 (89%) of the 55 benign tumors and
      in 89 (94%) of the 95 normal ovaries. The PI was less than 1.0 in 80% of the
      benign tumors and 94% of the normal ovaries. The RI was less than 0.4 in 43% of
      the benign tumors and 25% of the normal ovaries. Blood flow exhibited a lower
      mean PI but a higher mean peak systolic velocity and minimum diastolic velocity
      value in benign tumors compared with normal ovaries. There were no differences in
      the Doppler characteristics of the benign tumors between the follicular and
      luteal phases. CONCLUSION: The blood flow in benign tumors and normal ovaries may
      have low PIs and RIs, even during the follicular phase. Therefore, low PIs and
      RIs alone should not be interpreted as pathognomonic signs of malignancy.

PMID- 7784022
TI  - Carcinoma of the vulva in young women.
AB  - OBJECTIVE: To determine if young women with carcinoma of the vulva have a
      different risk factor history and outcome compared with older women. METHODS: We
      conducted a retrospective review of the medical records of 78 women treated at
      the Medical College of Georgia for squamous carcinoma of the vulva during 1979
      1993. Women younger than 45 years were compared with those 45 and over for
      historic risk factors, treatment modality, and outcome. RESULTS: Over the study
      interval, the average presenting age of these patients decreased from 69 to 55
      years. Women under 45 were found to have a stronger history of condyloma (P <
      .001, 95% confidence interval [CI] 3.69-87.96). There was no significant
      difference by age in the duration of symptoms before presentation, smoking
      history, or tumor size. Women 45 and over were more likely to have advanced-stage
      disease (International Federation of Gynecology and Obstetrics [FIGO] stage III
      or IV) (P = .03, 95% CI 0.43-0.91). Treatment did not differ significantly with
      age. In a univariate analysis, advanced FIGO stage, presence of metastases, and
      tumor size were associated with shorter survival. There was no detected
      difference in survival for women in either age group. CONCLUSION: There appears
      to be a trend in our patient population toward younger women presenting with
      squamous carcinoma of the vulva. Human papillomavirus infection appears to be
      more common in younger women with vulvar carcinoma. There may be a difference in
      the etiologies producing squamous carcinomas of the vulva. Education encouraging
      the early detection and prevention of sexually transmitted diseases might alter
      the rising incidence of this disease in younger women.

PMID- 7784024
TI  - Vaginal hysterectomy by uterine morcellation: an efficient, non-morbid procedure.
AB  - OBJECTIVE: To evaluate the relationship between uterine size and a possible
      increase in operative morbidity and procedure failure rates in women undergoing
      total vaginal hysterectomy. METHODS: A retrospective chart analysis of all
      hysterectomies performed for histologically confirmed leiomyomata was completed.
      A total of 128 cases qualified. Patients were stratified into three groups: group
      I, patients undergoing vaginal hysterectomy with a uterine weight of 300 g or
      greater but less than 1000 g; group II, patients undergoing vaginal hysterectomy
      with a uterine weight of 100-299 g; and group III, patients undergoing abdominal
      hysterectomy with a uterine weight of 100-1000 g. The variables evaluated
      included the following: length of hospital stay, operative time, estimated blood
      loss, and operative complications. Data regarding failed vaginal hysterectomy
      requiring an abdominal approach were also obtained. RESULTS: Both vaginal
      hysterectomy groups had a significantly reduced length of stay compared with the
      total abdominal hysterectomy group. There was no significant difference in mean
      estimated blood loss between groups I and III. Similarly, there were no
      significant differences in complication rates among the three groups. Group I had
      an 84% (31 of 37) success rate versus 95% (40 of 42) for group II (not
      statistically significant). There were no significant differences in the mean
      uterine weight, estimated blood loss, and complication rate in unsuccessful
      versus successful vaginal hysterectomies. The estimated blood loss was
      significantly higher for unsuccessful vaginal hysterectomy. CONCLUSION: Uterine
      size alone is not an absolute contra-indication to vaginal hysterectomy. Large
      uterine size (greater than 300 g) was not related to a significant increase in
      failed vaginal hysterectomy. Conversely, failed vaginal hysterectomy was not size
      dependent. Furthermore, there is no additional operative morbidity when vaginal
      hysterectomy is converted to a total abdominal hysterectomy because of a
      technical inability to complete the surgery vaginally.

PMID- 7784025
TI  - GnRH agonist and iron versus placebo and iron in the anemic patient before
      surgery for leiomyomas: a randomized controlled trial. Leuprolide Acetate Study
      Group.
AB  - OBJECTIVE: To determine the effectiveness of leuprolide acetate depot plus iron
      compared with iron alone in the preoperative treatment of anemia due to prolonged
      or excessive bleeding associated with uterine leiomyomas. METHODS: This was a
      phase III, stratified, randomized, double-blind, placebo-controlled, parallel
      group, 12-week multicenter study. Enrolled patients had hemoglobin levels of 10.2
      g/dL or less and/or hematocrit values of 30% or less. Patients were entered into
      one of two strata based on their pre-study hematocrit level: stratum A,
      hematocrit less than or equal to 28%, and stratum B, hematocrit greater than 28%.
      Patients within each stratum were randomized to one of three treatment arms:
      leuprolide acetate depot 7.5 mg, leuprolide acetate depot 3.75 mg, or placebo.
      All patients received iron orally. Response was defined as a hemoglobin level of
      12 g/dL or more and a hematocrit value of 36% or greater. RESULTS: Three hundred
      nine patients were entered into the study, of whom 265 were evaluated. Using our
      response criteria, a significantly greater number of patients in both leuprolide
      acetate groups (combined strata) responded to therapy than did those in the
      placebo group: 74% in each leuprolide acetate group versus 46% in the placebo
      group (P < .001). Gonadotropin-releasing hormone agonist-treated patients had a
      significant reduction in uterine and myoma volume when compared with the placebo
      group (P < .01). Hot flashes and vaginitis were reported significantly more often
      (P < .001) in the leuprolide acetate-treated groups than in the placebo group.
      CONCLUSION: Both dosages of GnRH agonist plus iron were more effective than iron
      alone in treating the anemia of patients with uterine leiomyomas, in reducing
      uterine-myoma volume, and in alleviating bleeding and other leiomyoma-related
      symptoms.

PMID- 7784026
TI  - Bone loss after hysterectomy with ovarian conservation.
AB  - OBJECTIVE: To examine the long-term effects of hysterectomy with conservation of
      the ovaries on bone density of the lumbar spine and proximal femur. METHODS: A
      cross-sectional study of the bone density of 40 postmenopausal women who had
      undergone hysterectomy with ovarian conservation before menopause compared with a
      matched group of 40 women who had not had hysterectomy. The 40 women who had
      undergone hysterectomy were also compared with a control population, using
      multiple linear regression analysis. Bone density of the femoral neck and lumbar
      spine was measured by quantitative digital radiography. RESULTS: Bone density in
      the hysterectomy group was significantly reduced at the spine (P < .05) and at
      the femoral neck (P < .05) compared with the matched group. Comparisons of the
      hysterectomy group with the reference group demonstrated that in addition to
      significant reductions in bone density at the spine (P < .05) and hip (P < .05),
      bone density at the femoral neck (P < .05), trochanter (P < .05), Ward's triangle
      (P < .05), and the second (P < .05) and fourth (P < .05) lumbar vertebrae was
      also significantly less in the hysterectomy group. CONCLUSION: Premenopausal
      women who have hysterectomy will have significantly lower bone density than
      controls, despite conservation of both ovaries at the time of surgery.

PMID- 7784027
TI  - Dirithromycin increases ethinyl estradiol clearance without allowing ovulation.
AB  - OBJECTIVE: To use a novel, sensitive study design to detect a potential oral
      contraceptive (OC) and dirithromycin drug interaction by assessing the
      pharmacokinetics of the ethinyl estradiol (E2) component of a common OC and the
      potential failure of OC effectiveness. METHODS: In this nonblinded study, 20
      healthy women using Ortho Novum 7/7/7-28 were selected for a three-OC-cycle
      study. Baseline measures included E2 and progesterone serum levels on days 21,
      23, 25, and 27 of cycle one and days 1, 3, 5, and 7 of cycle two. During cycle
      two, 24-hour blood sampling and radioimmunoassay analysis for ethinyl E2
      pharmacokinetics were performed on day 8 and pelvic ultrasound on day 13. Oral
      dirithromycin 500 mg/day for 14 days began on day 21 of cycle 2. After starting
      dirithromycin, cycle two and three serum E2, progesterone, and serial ethinyl E2
      levels and pelvic ultrasound replicated the baseline schedule. Ovulation was
      assumed if E2 concentration was greater than 50 pg/mL, progesterone concentration
      was greater than 3 ng/mL, or if an ovarian cyst greater than 10 mm was present on
      ultrasound. RESULTS: Pharmacokinetic analysis demonstrated a small (7.6%) but
      statistically significant decrease (P = .03) in the mean ethinyl E2 24-hour area
      under the curve and an increase in apparent oral clearance. No woman ovulated,
      based on E2 levels and progesterone concentrations or ultrasound. CONCLUSION:
      Dirithromycin increased the apparent oral clearance of ethinyl E2. The clinical
      importance of the interaction may be negligible because no woman ovulated or had
      compromised OC effectiveness in this small series.

PMID- 7784028
TI  - Evaluation of current urodynamic testing methods in the diagnosis of genuine
      stress incontinence.
AB  - OBJECTIVE: To determine the sensitivity and specificity of several urodynamic
      testing methods in the diagnosis of genuine stress urinary incontinence (GSI).
      METHODS: One hundred eight consecutive patients were evaluated prospectively by
      history and physical examination, cough stress test, and single and multichannel
      urodynamics. Sensitivities and specificities in detecting genuine stress
      incontinence were calculated for: a positive cough stress test with a negative
      cystometrogram, equalization throughout a cough urethral pressure profile, a
      positive stress leak-point pressure determination, observed urine loss with cough
      during multichannel urodynamics, and a pressure transmission ratio of less than
      90% for each third of the urethra. RESULTS: Sixty-five patients (60%) were found
      to have GSI. Observed urine loss with cough during multichannel studies was 91%
      sensitive and 100% specific. A positive stress leak-point pressure determination
      had a 78% sensitivity and was 100% specific. A positive cough stress test with a
      negative cystometrogram was 77% sensitive and 100% specific. Pressure
      equalization throughout the length of the urethra during a cough urethral
      pressure profile was 49% sensitive and 98% specific. A pressure transmission
      ratio of less than 90% in the distal, middle, and proximal urethra had
      sensitivities and specificities of 54 and 79%, 51 and 65%, and 45 and 58%,
      respectively. A pressure transmission ratio of less than 90% along the entire
      length of the urethra was 22% sensitive and 93% specific. CONCLUSION: Observed
      urine loss with cough during multichannel urodynamics was the best examination
      for diagnosing GSI in our population.

PMID- 7784029
TI  - A randomized study to assess the efficacy of the amniotic fluid index as a fetal
      admission test.
AB  - OBJECTIVE: To determine whether there is a difference in the incidence of
      abdominal delivery for presumed fetal distress in women who have an intrapartum
      fluid index assessment and those who do not. METHODS: Over a 7-month period,
      parturients at 26-42 weeks' gestation and in early labor were randomized to the
      study (measured amniotic fluid index [AFI] on admission) or a control group (no
      sonographic assessment of amniotic fluid [AF] volume). The labor and delivery
      staff were aware of the AFI results of the study subjects. All patients had
      continuous electronic fetal monitoring, and none had an abnormal tracing on
      admission. Student t test or chi 2 was used for statistical analysis. P < .05 was
      considered significant. RESULTS: The study (N = 447) and control groups (N = 436)
      had similar maternal demographics as well as medical and obstetric complications.
      In the study group, the incidence of abdominal delivery for fetal distress (29 of
      447) was significantly higher than among controls (14 of 436) (P = .02; relative
      risk 1.3, 95% confidence interval 1.1-1.7). Among parturients who had abdominal
      delivery for fetal distress, the decision-to-incision times (mean +/- standard
      deviation) were similar for parturients who had undergone assessment of AFI and
      those who had not (38.5 +/- 14.7 versus 32.5 +/- 14.7 minutes, respectively; P =
      .47). Mean birth weight, incidence of low birth weight, macrosomia, Apgar scores
      less than 7, and the number of admissions to the neonatal intensive care unit
      were not significantly different in the two groups. CONCLUSIONS: Patients having
      an intrapartum assessment of AFI as a fetal admission test are significantly more
      likely to have abdominal delivery for presumed fetal distress. However, the
      decision-to-incision time is not decreased and the perinatal outcome is not
      improved if the status of AF volume is known for patients in early labor.

PMID- 7784030
TI  - Long-term clinical and urodynamic evaluation of the polytetrafluoroethylene
      suburethral sling for treatment of genuine stress incontinence.
AB  - OBJECTIVE: To assess long-term clinical and urodynamic outcomes of suburethral
      sling procedures using polytetrafluoroethylene grafts. METHODS: Between January
      1986 and May 1991, 108 women underwent suburethral sling placement to treat
      genuine stress incontinence. At least 1 year after surgery, 62 women participated
      in a telephone interview about surgical outcome and completed a follow-up
      urodynamic evaluation. RESULTS: Seventy-three percent of patients reported stress
      incontinence cure and 61% were objectively cured. Neither low urethral closure
      pressure nor a history of multiple prior anti-incontinence procedures, singly or
      in combination, adversely affected outcome. Postoperative maximum urethral
      closure pressure and functional urethral length were significantly greater in
      patients who were cured of their incontinence than in those whose surgery failed.
      Patients who were cured had higher amplitude detrusor contractions during
      micturition and greater post-void residual urine than those who were not cured.
      Thirty-three percent of patients with urodynamically stable bladders
      preoperatively developed detrusor instability after surgery. Detrusor instability
      remitted after surgery in half of the patients who had this condition
      preoperatively. Postoperative wound complications developed in 40% of patients
      who underwent sling placement, and 22% of the grafts were eventually removed.
      CONCLUSION: Polytetrafluoroethylene suburethral sling placement is an effective
      treatment for stress incontinence and low urethral pressure. Urodynamic data
      suggest that urethral obstruction is responsible for surgical cure. Patients
      should be warned of the high complication rate for this suburethral sling
      procedure and that graft removal may be necessary.

PMID- 7784031
TI  - Gestational diabetes mellitus: antenatal variables as predictors of postpartum
      glucose intolerance.
AB  - OBJECTIVE: To determine whether antepartum variables can predict postpartum
      glucose intolerance. METHODS: Glucose tolerance was assessed 6 weeks postpartum
      in 94 of 238 women with gestational diabetes using a 2-hour, 75-g oral glucose
      tolerance test (GTT). Selected antepartum variables were analyzed for predictive
      ability for postpartum glucose intolerance. RESULTS: Of 238 patients, 94 (39%)
      returned for a GTT. Those returning and those not returning were similar in all
      variables. Postpartum glucose intolerance occurred in 34%: impaired glucose
      tolerance in 18%, overt diabetes in 16%. No single maternal, intrapartum, or
      neonatal variable was predictive of postpartum glucose intolerance in all cases.
      Predictive variables included: requirement for insulin (insulin versus diet: 25
      versus 3% impaired glucose tolerance, 26 versus 0% diabetes; P = .001), poor
      glycemic control (any 2-hour postprandial blood sugar level of 150 mg/dL or
      higher: 34 versus 5% diabetes; P = .005), and the 50-g GTT value (200 mg/dL or
      higher: 32 versus 6% diabetes; P = .01). For insulin requirement, the relative
      risk (RR) was 17.28 (95% confidence interval [CI] 2.46-121.45), and for the above
      three variables combined, the RR was 19.68 (95% CI 2.88-134.2). When the insulin
      dose was at least 100 U/day, all patients had abnormal glucose tolerance
      postpartum (RR = 34.00, 95% CI 4.93-234.39). CONCLUSIONS: Postpartum glucose
      screening is not warranted for women at low risk who do not require insulin
      during pregnancy. The incidence of postpartum glucose intolerance in this group
      is very low. Women with risk factors should receive postpartum screening.
      Patients receiving at least 100 U/day of insulin have a 100% incidence of
      postpartum glucose intolerance.

PMID- 7784032
TI  - Management of anesthetic complications and emergencies in the obstetric patient.
AB  - The importance of cooperation and understanding between the obstetrician and
      anesthesiologist in the management of obstetric emergencies cannot be
      overemphasized. Indications for cesarean section and choice of anesthetic are
      significant considerations. Algorithms for the management of special treatment
      problems such as malignant hyperthermia, postdural headache, and epidural abscess
      and hematoma are presented. Posting of protocols for the management of particular
      crises in both delivery and postanesthesia care units is strongly recommended.

PMID- 7784033
TI  - Acute hypotension related to hemorrhage in the obstetric patient.
AB  - Acute hypotension in the setting of hemorrhage most often signifies abrupt and
      dangerous blood loss. The physiologic changes of pregnancy are designed to
      protect the mother from blood loss at parturition. When this protective reserve
      is exceeded, hypovolemic shock occurs. Ideally, blood loss of this magnitude
      should not be allowed to occur. Notwithstanding, obstetric hemorrhage continues
      to be an important cause of maternal mortality. Most deaths due to hemorrhage are
      preventable. Successful treatment requires that the clinician must react with the
      immediate institution of effective resuscitative measures. The importance of an
      organized, team approach with input from relevant specialties in the scheme of
      management cannot be overemphasized.

PMID- 7784034
TI  - The antepartum patient. Sudden changes in central nervous system status and
      sensorium.
AB  - An approach to the pregnant patient with altered consciousness is presented. The
      unconscious pregnant patient often represents a straightforward simple problem if
      the event is a minor syncope secondary to physiologic changes of pregnancy. Most
      loss of consciousness is postictal in nature after either an epileptic or
      eclamptic seizure. If these are ruled out, other more serious causes must be
      considered, and the patient must be fully evaluated by appropriate neurologic
      consultants.

PMID- 7784035
TI  - Management of drug dependency, overdose, and withdrawal in the obstetric patient.
AB  - This article discusses the approach to pregnant patients with substance use
      problems, a growing problem in obstetric practice. Two alternatives used to
      detect patients with problematic substance use are discussed: (1) historic
      screening, which depends on the patient to self-report about her substance use;
      and (2) toxological assays for substances or their metabolites in the patients'
      body fluids. Management of women using cocaine and alcohol is also discussed.

PMID- 7784036
TI  - Management of diabetic ketoacidosis in the obstetric patient.
AB  - Because of the normal metabolic changes found in pregnancy, diabetics are at
      increased risk to develop ketoacidosis. Even though the incidence of DKA during
      pregnancy has declined in recent years, prompt recognition of the presenting
      signs and symptoms followed by appropriate treatment of the associated metabolic
      disturbances can be lifesaving to the mother and her unborn child. Therapy is
      directed toward aggressive fluid resuscitation, avoidance of hypokalemia, and
      reversal of the hyperglycemia and ketoacidosis. When the clinician is confronted
      with DKA in the obstetric patient, aggressive therapeutic measures should
      maximize maternal and fetal outcome.

PMID- 7784037
TI  - New-onset hypertension in the pregnant patient.
AB  - The new onset of hypertension in pregnancy most often reflects preeclampsia,
      underlying chronic hypertension, chronic hypertension with superimposed
      preeclampsia, or gestational hypertension, and less commonly is due to substance
      abuse or any of several rare conditions. The term "pregnancy-induced
      hypertension" applies to all of these categories, but because it does not
      adequately and specifically define the patient's condition, its use therefore is
      discouraged. Attention to accurate identification of the specific type of
      "pregnancy-induced hypertension" is important since treatment varies depending on
      the diagnosis and the stage of pregnancy from observation with gestational
      hypertension to active intervention in the patient with chronic hypertension and
      superimposed preeclampsia. Both perinatal and maternal outcomes are dependent
      also on the categorization of the hypertensive disorders of pregnancy. Efforts to
      selectively identify, correctly diagnose, and optimally treat each hypertensive
      mother should help to achieve the best possible outcome with the least maternal
      risk.

PMID- 7784038
TI  - Sudden joint and extremity pain in pregnancy.
AB  - To diagnosis sudden joint and extremity pain in pregnancy, the obstetrician must
      call upon information from several disciplines, including obstetrics, internal
      medicine, neurology, and orthopedics. The initial evaluation of the patient
      should begin with a generalized assessment, and more distant causes of the pain
      should be ruled out as possible causes are considered, evaluated, and rejected.
      This article discusses the importance of medical history, physical examination,
      laboratory studies, synovial fluid analysis, and immunologic studies to aid in
      the diagnosis of pain, as well as common presentations of musculoskeletal pain in
      pregnancy.

PMID- 7784039
TI  - Sudden chest pain and cardiac emergencies in the obstetric patient.
AB  - The differential diagnosis and work-up of a patient with chest pain during
      pregnancy is presented in this article. This is followed by discussions of
      cardiac emergencies including hypertensive crisis, pulmonary edema, arrhythmias,
      cardiopulmonary resuscitation, myocardial infarction, and aortic dissection.

PMID- 7784040
TI  - Acute pulmonary dysfunction and distress.
AB  - Acute pulmonary dysfunction and distress is not uncommon in the obstetric
      patient. In these situations, however, a quick assessment and intervention is
      necessary in many cases. This article familiarizes the practicing obstetrician
      with the physiology and therapy to evaluate and effectively treat these patients.

PMID- 7784041
TI  - Acute abdominal pain in pregnancy.
AB  - The anatomic and physiologic changes of pregnancy make the diagnosis and
      management of abdominal pain difficult. Abdominal conditions both related and
      unrelated to the pregnancy may be life threatening for mother or fetus;
      therefore, accurate diagnosis and proper management are essential. This article
      reviews the most common conditions presenting as acute abdominal pain during
      pregnancy.

PMID- 7784042
TI  - Management of moderate to severe trauma in pregnancy.
AB  - Severe trauma to an obstetric patient is truly an injury of double magnitude.
      While being cognizant of the fetus and its well-being, all expediency must be
      employed to accomplish a thorough evaluation of the injured patient and allow for
      the prompt employment of appropriate therapeutic measures. The best key to fetal
      survival is successful maternal therapy.

PMID- 7784043
TI  - Acute hypotension related to sepsis in the obstetric patient.
AB  - While infections are a common complication of pregnancy, bacteremia and septic
      shock are relatively rare. Efforts to prevent serious bacterial infections are
      the most effective means of minimizing maternal and fetal morbidity. Screening
      for first trimester asymptomatic bacteriuria, prompt and thorough evaluation of
      suspected bacterial infections, and conscientious intrapartum assessment can have
      a significant impact in decreasing localized bacterial infections. The prompt
      recognition and institution of antimicrobial therapy in women suspected of having
      systemic infections is of paramount importance in reducing the incidence of
      serious maternal morbidity and mortality. Initial efforts in the treatment of
      sepsis should be directed at intravascular volume expansion in an effort to
      improve myocardial performance and tissue oxygenation. Inotropic agents
      occasionally may be necessary; however, they should be used with caution and only
      after adequate volume expansion has been provided. Adequate antimicrobial therapy
      requires treatment with multiagent therapy, providing coverage for the wide
      variety of genital tract pathogens.

PMID- 7784044
TI  - [Surgical management of acute and chronic arterial occlusion].
AB  - Arterial occlusion may develop acutely and chronically, can affect any artery in
      the body. Surgical treatment of the disease is reasonable when definite symptoms
      occur. The forms of surgical treatment are: in acute arterial occlusion
      embolectomy or thrombectomy with Fogarty balloon catheter, under special
      circumstances in this group of patients we are compelled to use the typical
      surgical technique for chronic occlusion; the bypass and thrombendarteriectomy.
      Reconstructive operations are made most often on the lower extremities:
      thrombendarteriectomy or artificial prosthetic grafting on the aortoiliac
      section, autogenous saphenous vein bypass on the femoropopliteal section, and
      this is also the recommended procedure in the cases when the occlusive disease
      affects the crural arteries. Other operations in connection with occlusive
      arterial disease are lumbal and thoracal sympathectomy, fasciotomy and amputation
      at different levels. The recognition of occlusive disease on the extracranial
      carotid arteries are getting more and more common nowadays. The recommended
      operation in carotid occlusive disease is eversio endarteriectomy. Compared with
      the above the reconstructive operations of the mesenterial and renal arteries are
      rare. In the cases we do operate the operations are seldomly
      thrombendarteriectomies and more often bypasses with autogenous saphenous vein or
      artificial prosthetic grafts.

PMID- 7784045
TI  - [Growth hormone therapy in adults].
AB  - GH deficiency in adults is associated with decreased lean body mass and increased
      adiposity. Since body composition changes in the elderly are similar to those of
      GH deficiency and can be partially reversed by hGH replacement, it has been
      postulated that the diminished GH secretion in the later years of life may
      contribute to the geriatric changes in body composition. GH treatment of GH
      deficient adults or old men increases nitrogen retention, lean body mass,
      decreases percent of body fat. Clinical trials have shown beneficial effects of
      hGH in several disorders associated with protein catabolism. The short-term
      adverse effects of GH therapy have been minimized by using low-dose regimens. GH
      treatment is justified to certain elderly patients, such as those suffering
      mainly from catabolic illnesses, malnourishment, burns, cachexia, and can be
      considered in GH-deficient adults.

PMID- 7784046
TI  - [Early stage gastric cancer in Vas County].
AB  - Between 1983 and 1992, 44 patients with early gastric cancer underwent operative
      treatment. This group comprised 13.3 percent of all patients with gastric cancer
      operated on during this period. Every patient underwent oesophago-gastro
      duodenoscopy before operation. The indication for surgery was histologically
      confirmed carcinoma in 37 patients, gastric haemorrhage in 2 patients and gastric
      ulcer unresponsive to medical treatment in 5 patients. The gastric carcinoma was
      limited to the mucosa in 28 cases and involved the submucosa in 16. Five
      patients, one with mucosal and four with submucosal early gastric cancer had
      regional metastatic lymph node involvement. Life-table calculated patient
      survival rate at 5 years, excluding the perioperative mortality, was 79.4
      percent. CONCLUSIONS: 1. The prevalence of early gastric cancer proved to be
      similar to previously published in West-Europe and United States. 2. If early
      gastric cancer is limited only to the mucosa, regional metastatic lymph node is
      relatively rare. 3. Gastrointestinal bleeding can be the first clinical sign of
      early gastric cancer. 4. Therapy resistant gastric ulcer requires surgery
      irrespective of the histological examination of the biopsy specimen.

PMID- 7784047
TI  - [Use of a stoma-pouch after temporary pharyngostoma and neck fistula following
      surgery in the head and neck region].
AB  - The authors report on a new way of stoma care that to their best knowledge has
      not been used yet in head and neck surgery patients. Their cases demonstrate the
      usefulness of this method for the rehabilitation of patients with pharyngeal
      stoma of any origin.

PMID- 7784048
TI  - [Simultaneous occurrence of ulcerative colitis and psoriasis in childhood].
AB  - Authors report of a 10 years old girl who at age 2 showed signs of psoriasis and
      after 8 years typical symptoms of ulcerative colitis manifested. In connection
      with this case the association of two diseases is emphasized which may be
      explained by the similarity of genetic and immunological factors in both
      disorder. It is accentuated that at the observation of enteral symptoms in
      patients with psoriasis the possibility of non specific inflammatory bowel
      disease has also to be considered.

PMID- 7784049
TI  - [Possibilities of conservative treatment of childhood vesicoureteral reflux].

PMID- 7784050
TI  - [Possibilities of conservative therapy of childhood vesicoureteral reflux
      (discussion)].

PMID- 7784052
TI  - The pRb-related protein p130 is a possible effector of transforming growth factor
      beta 1 induced cell cycle arrest in keratinocytes.
AB  - Transforming growth factor beta 1 (TGF-beta 1) is known to inhibit epithelial
      cell growth by inducing a G1 cell cycle arrest. We have studied the effect of TGF
      beta 1 on protein binding to a transcription factor E2F consensus element in
      extracts from early passage human keratinocytes (HFKs) and a permanent human
      keratinocyte cell line (HaCaT). Treatment of these cells with TGF-beta 1 resulted
      in the formation of a DNA binding complex between the pRb-related protein p130
      and E2F. Formation of the E2F-p130 complex correlated with inhibition of cell
      cycle progression in G1 and suppression of the E2F-regulated cdc2 gene. While
      p130 mRNA and protein levels were not influenced by TGF-beta 1, the activity of
      cyclin-dependent kinase 2 (Cdk2) towards p130 in vitro was inhibited. The results
      identify p130 as a downstream target of TGF-beta 1 and a possible mediator of the
      G1 cell cycle arrest.

PMID- 7784051
TI  - A complex between E2F and the pRb-related protein p130 is specifically targeted
      by the simian virus 40 large T antigen during cell transformation.
AB  - The p130 protein is a recently cloned member of the retinoblastoma protein
      family. We show here that transformation of NIH3T3-L1 fibroblasts (L1 cells) by
      the simian virus 40 large T antigen (LTAg) depends on the disruption of DNA
      binding complexes between transcription factor E2F and p130. LTAg binds to the
      pocket region of p130 in vivo and disrupts the E2F-p130 complexes. E2F-p130
      complexes are present only in quiescent L1 cells and disappear at the G1/S phase
      boundary concomitantly to induction of DNA synthesis and expression of the E2F
      regulated cdc2 gene. p130 is a substrate of cyclin-dependent kinase 2 (Cdk2) in
      vitro and associates with a Cdk in vivo which is activated upon serum stimulation
      in late G1. Overexpression of p130 inhibits cdc2 promoter activity and entry of
      quiescent L1 cells into S phase. The results demonstrate that p130 is negative
      regulator of cell cycle progression which is specifically targeted by LTAg during
      cell transformation.

PMID- 7784053
TI  - Cloning and characterization of human DP2, a novel dimerization partner of E2F.
AB  - The transcription factor E2F consists of a family of proteins that bind to the
      sequence TTTCGCGC and regulate the expression of various cellular and viral
      promoters. E2F binds to DNA as homodimers or as heterodimers in association with
      a protein, DP1 (for dimerization partner 1). E2F-DP1 heterodimers bind more
      efficiently than homodimers to DNA, retinoblastoma gene product as well as the
      adenovirus E4 protein and DP1 can stimulate transcription from E2F sites in a
      synergistic fashion. Here we describe the cloning and characterization of a novel
      human DP gene, DP2, whose product dimerizes efficiently with E2F. Unlike DP1,
      there appear to be multiple transcripts for DP2 and their distribution appears to
      vary in different tissues and cell lines. DP2 binds to E2F as detected by in
      vitro reconstitution assays and an E2F-DP2 heterodimer can bind to DNA in gel
      retardation assays. We believe that DP2 also plays a major role in modulating the
      function of E2F in cell cycle regulation and oncogenesis.

PMID- 7784054
TI  - Raf phosphorylates p53 in vitro and potentiates p53-dependent transcriptional
      transactivation in vivo.
AB  - Using recombinant baculovirus expressed p53 and Raf proteins, we show that
      activated Raf-1 kinase can phosphorylate mouse p53 in vitro. We also show that co
      expression of vRaf and p53 in NIH3T3 fibroblasts, potentiates the ability of p53
      to transactivate a minimal promoter with a p53 cognate DNA binding site. A
      dominant negative mutant of Raf inhibits the transactivation function of p53 in
      NIH3T3 fibroblasts. Incubation of Raf-1 kinase with a series of p53 derived
      synthetic peptides maps the Raf-1 phosphorylation sites to the 27 amino terminal
      residue region of p53 which coincides with the transactivation domain.
      Phosphorylation occurs on serines which are phosphorylated in vivo. Our results
      suggest that the transactivation function of p53 can be regulated by a signaling
      cascade involving Raf.

PMID- 7784055
TI  - Effects of p53 mutants on wild-type p53-mediated transactivation are cell type
      dependent.
AB  - The spectrum of p53 mutations differs among human cancer types. We have
      hypothesized that the p53 mutational spectrum observed in particular tumor types
      reflects the functional ability of different p53 mutants to modulate wild-type
      (WT) p53-dependent gene transcription. Missense p53 mutants representing several
      mutational hotspot codons were cotransfected with WT p53 and analysed for their
      effects on p53-dependent transactivation of a reporter construct containing a
      specific p53 binding sequence (PG13-CAT) in human tumor cell lines lacking
      endogenous p53. Our results show that the ability of p53 mutants to inhibit WT
      p53-mediated transactivation is cell type dependent. In cell lines derived from a
      lung adenocarcinoma and a mesothelioma, the transactivation function of WT p53
      was strongly inhibited by all p53 mutants examined. However, in cell lines
      derived from a prostate carcinoma and an osteosarcoma, the mutants examined
      generally had only minimal dominant negative effects. In cell lines derived from
      a hepatocellular carcinoma and an ovarian carcinoma, two mutants (248trp and
      273his) enhanced WT p53-mediated transactivation of the reporter construct.
      Additional mutants retained the ability to inhibit WT p53-mediated
      transactivation in these cell lines. In addition, in a series of four breast
      tumor cell lines, the p53 mutants examined had similar effects on WT p53
      transactivation ability including enhanced transactivation activity in the 273his
      cotransfectants. The p53 mutants were incapable of transactivating the PG13-CAT
      reporter in the absence of WT p53 expression. Therefore, the dominant negative
      effects of p53 mutants on WT p53 function may vary depending on the particular
      cell type. In addition, mutants with stronger inhibitory capabilities may confer
      a selective advantage during the tumorigenic process.

PMID- 7784056
TI  - Signalling pathways involved in the mitogenic action of lysophosphatidylinositol.
AB  - Lysophosphatidylinositol has been previously shown to stimulate cell
      proliferation in differentiated and in K-ras transformed thyroid cells. Increased
      levels of lysophosphatidylinositol, but not lysophosphatidylcholine or
      lysophosphatidylethanolamine, are present in thyroid as well as in other ras
      transformed cell lines. We have now investigated the mechanism of action of this
      lysolipid by analysing its effects in a differentiated thyroid cell line.
      Lysophosphatidylinositol did not increase the levels of cAMP, the main stimulator
      of cell proliferation in the thyroid, whereas it stimulated phosphoinositide
      breakdown, mobilization of cytosolic Ca2+ and arachidonic acid release,
      suggesting that it activates both phospholipases C and A2. None of the effects of
      lysophosphatidylinositol were prevented by pretreatment of cells with pertussis
      toxin. Instead, the tyrosine kinase inhibitors, tyrphostins AG18 and AG561,
      completely blocked its mitogenic action. The effects of lysophosphatidylinositol
      were distinguishable from those of the well known mitogen lysophosphatidic acid,
      which affected differently the signalling pathways analysed and was not mitogenic
      in ras-transformed cells. These results suggest that the mitogenic activity of
      lysophosphatidylinositol is associated with the activation of phospholipase C and
      phospholipase A2 and is relatively specific for ras-transformed cells.

PMID- 7784057
TI  - Cyclin D2 is a moderately oscillating nucleoprotein required for G1 phase
      progression in specific cell types.
AB  - To explore regulation and function of cyclin D2, a candidate cell cycle
      regulatory proto-oncogene, we examined subcellular localisation, cell type- and
      cell cycle-dependent expression, and requirement of cyclin D2 protein for G1
      progression, in a panel of 40 human normal and cancer cell types. Except for
      lymphoid cells and sarcoma cell lines, expression of cyclin D2 was considerably
      more restricted than that of cyclin D1, whereas both D-type cyclin proteins were
      low or undetectable in cells lacking functional retinoblastoma gene product. In
      G1 cells, the cyclin D2 protein was more resistant to extraction and localised
      predominantly to nuclei, whereas it became more soluble and distributed in both
      nuclei and cytoplasm from G1/S transition onwards. Centrifugal elutriation and
      multiparameter flow cytometry analyses of several cell types showed moderate cell
      cycle oscillation with maximum levels of the cyclin D2 protein reached in late
      G1. Microinjection and/or electroporation of antibodies to cyclin D2 during G1
      arrested the cyclin D2-expressing lymphocytes, breast myoepithelium, and U-2-OS
      sarcoma cells in G1 phase, whereas cyclin D2-negative cell types were unaffected
      by such treatment. Consistent with the putative proto-oncogenic role of cyclin D2
      in specific cell types, our data show that this G1 cyclin has properties closely
      resembling those of cyclin D1, including the essential positive role in
      regulation of G1.

PMID- 7784059
TI  - Wild-type p53 down-regulates transcription from oncogenic human papillomavirus
      promoters through the epithelial specific enhancer.
AB  - High-risk Human Papillomavirus (HPV) E6 and E7 immortalizing oncoproteins are
      expressed from a promoter tightly regulated by an epithelial specific enhancer.
      To determine if the p53 tumour suppressor protein can modulate the transcription
      of these genes, we performed co-transfection experiments with plasmids containing
      the HPV type 16 or 18 long control regions linked to the chloramphenicol acetyl
      transferase gene, along with p53 expression vectors. Wild-type, but not mutant,
      murine or human p53 expression vectors reduced the activity of reporter
      constructs when co-transfected into HeLa or C33 cell lines. Mutations within the
      HPV TATA boxes did not significantly alter the levels of p53 repression,
      suggesting a TATA-independent mechanism. Deletion analyses mapped the p53
      responsive domain to the constitutive 230 base pair epithelial specific enhancer.
      In addition, the enhancer could confer p53-mediated repression when placed
      upstream of a heterologous promoter.

PMID- 7784058
TI  - Combined oral carcinogenicity of HPV-16 and benzo(a)pyrene: an in vitro multistep
      carcinogenesis model.
AB  - We previously immortalized normal human oral keratinocytes by transfection with
      recombinant HPV-16 DNA and subsequently exposed the cells to benzo(a)pyrene for 7
      days. The exposure to benzo(a)pyrene modified the immortalized cells: the
      modified cells (HOK-16B-BaP) proliferated in an ordinary culture medium
      containing physiological calcium level (1.5 mM), but demonstrated only enhanced
      proliferation capacity without tumor formation in nude mice and failed to show in
      vitro anchorage-independency. In this study, we further modified the HOK-16B-BaP
      cells by subculturing the cells in a medium containing benzo(a)pyrene for 6
      months. The cells were further modified with a chronic benzo(a)pyrene exposure
      and were termed HOK-16B-BaP-T cells (1) demonstrated a malignant phenotype in
      organotypic 'raft' culture, (2) showed in vitro anchorage-independency, (3)
      developed tumors in nude mice when injected subcutaneously, (4) contained a
      significantly higher copy number of intact and integrated HPV-16 DNA; (5)
      contained higher level of HPV-16 E6/E7 messages and E7 protein, (6) were more
      resistant to transforming growth factor-beta 1 and (7) secreted higher level of
      vascular endothelial growth factor with molecular weight of 56 kd than parental
      HOK-16B-BaP cells. However, the levels of p53 and ras proteins and the levels of
      p53, c-myc and c-fos transcripts in the HOK-16B-BaP-T cells were not different
      from those in the HOK-16B-BaP cells. The highly conserved coding regions of the
      p53, c-Ha-ras1, and c-Ki-ras2 genes of the tumor cells were not mutated. These
      data indicate that the HPV-immortalized human oral keratinocytes can convert to
      tumorigenic cells by chronic exposure to benzo(a)pyrene. The tumorigenic
      conversion seems to be associated with (1) the overexpression of viral oncogenes
      such as E6 and E7 genes, (2) the higher resistance of cells to transforming
      growth factor-beta 1 and (3) the high secretion of 56 kd vascular endothelial
      growth factor from the cells.

PMID- 7784060
TI  - Expression of antisense osteopontin RNA inhibits tumor promoter-induced
      neoplastic transformation of mouse JB6 epidermal cells.
AB  - Elevated expression of osteopontin (OPN), a secreted adhesive
      phosphoglycoprotein, is frequently associated with many transformed cell lines of
      epithelial and stromal origin. Moreover, several clonal lines of preneoplastic
      JB6 cells derived from Balb/c mouse epidermal cultures (Colburn et al., 1978,
      1979), upon treatment with 12-O-tetradecanoyl phorbol-13-acetate (TPA), become
      irreversibly oncogenic and concomitantly synthesize OPN at elevated levels (Smith
      and Denhardt, 1989). In the present study we sought to determine whether OPN
      expression facilitates transformation of such preneoplastic (initiated) cells. We
      transfected TPA-promotable JB6 c141.5a cells with an expression vector containing
      mouse OPN cDNA in antisense orientation under transcriptional control of
      dexamethasone-inducible MMTV-LTR promoter. Four stably transfected clones, which
      expressed drastically reduced levels of OPN in the presence of both dexamethasone
      and TPA, were characterized. We found that (a) more than 20 copies of OPN
      antisense cDNA were stably incorporated into the genome of cells from two of
      these clones that were examined by Southern blot analysis; (b) dexamethasone
      induced expression of antisense OPN RNA prevented augmented OPN expression at
      both mRNA and protein levels following TPA treatment; and (c) cells from all four
      clones failed to form colonies in soft agar medium containing both dexamethasone
      and TPA. Taken together, these data demonstrate that inhibition of elevated OPN
      expression blocks TPA-induced anchorage-independent growth of JB6 c141.5a cells,
      suggesting the possibility that OPN overproduction is causally related to
      transformation of preneoplastic cells.

PMID- 7784061
TI  - TTF, a gene encoding a novel small G protein, fuses to the lymphoma-associated
      LAZ3 gene by t(3;4) chromosomal translocation.
AB  - We have previously shown that the LAZ3/BCL6 gene encoding a potential
      transcription factor, is disrupted in B-diffuse large cell non-Hodgkin's
      lymphomas (NHL) with 3q27 chromosomal abnormalities involving the immunoglobulin
      (IG) genes. However, LAZ3 rearrangement also occurs in NHL bearing 3q27
      translocations without involvement of the IG genes: for example the VAl cell line
      exhibits t(3;4)(q27;p11). In the present work we have used a RT-PCR method to
      detect and to sequence the LAZ3 mRNA products from the VAL cell line. We report
      that the consequence of the t(3;4) is the expression of a chimeric transcript of
      LAZ3 with a new gene encoding a small G-like protein, termed TTF (Translocation
      Three Four). Nucleotide sequence analysis of a 1.4 kb cDNA predicts that the TTF
      gene encodes a protein of 191 amino-acids similar to members of the RAS
      superfamily including HRAS (27% identical), RAB1A (30% identical) and RHO
      proteins: the human RAC1, RHOB and CDC42Hs proteins (respectively 43, 44 and 45%
      identical) and the yeast RHO2 protein (44% identical). Unlike most other small G
      proteins which are expressed ubiquitously, TTF was transcribed only in
      hemopoietic cells as a 2.2 kb transcript. TTF may define a new subgroup of RHO
      like proteins.

PMID- 7784063
TI  - Identification of the promoter of the human von Hippel-Lindau disease tumor
      suppressor gene.
AB  - The von Hippel-Lindau (VHL) disease gene is a novel multiple tumor suppressor
      gene which plays a causal role in the origin of some common cancers including
      clear cell renal carcinomas and hemangioblastomas of the central nervous system.
      Here we report the identification of transcription start sites and the promoter
      of the human VHL gene. The promoter sequence does not contain TATA and CCAAT
      boxes. Transcription is initiated around a putative SP1 binding site about 60 bp
      upstream from the first AUG codon in the VHL mRNA. Several putative transcription
      factor binding sites, notably for nuclear respiratory factor 1 and PAX, were
      found upstream of the transcription start sites. Promoter-luciferase expression
      constructs demonstrate, that the promoter is functional when transfected into 293
      cells (transformed primary human embryonal kidney cells) and UMRC 6 renal
      carcinoma cells. Activity is dependent on correct orientation of the promoter. A
      minimal promoter region of 106 bp was delineated. A set of VHL minigenes,
      containing the 5' flanking VHL genomic region, was constructed and transfected
      into UMRC 6 cells. In these cells the level of transcription from the minigenes
      driven by VHL promoter was comparable with endogenous VHL expression.

PMID- 7784062
TI  - Elevated expression of Unph, a proto-oncogene at 3p21.3, in human lung tumors.
AB  - The murine Unp proto-oncogene encodes a nuclear ubiquitin protease whose
      overexpression leads to oncogenic transformation of NIH3T3 cells. We have cloned
      cDNAs originating from the human homolog of this gene, designated herein as Unph
      (Unp, human), and have used these cDNAs to map the gene to 3p21.3, a region
      frequently rearranged in human tumor cells. Unph mRNA levels are consistently
      elevated in small cell tumors and adenocarcinomas of the lung, suggesting a
      possible causative role for the gene in the neoplastic process.

PMID- 7784064
TI  - Specific c-myc and max regulation in epithelial cells.
AB  - We have investigated c-myc, max and c-fos mRNA and protein expression in
      proliferating, quiescent and stimulated immortalized, SV40 T antigen (LT)
      transformed and tumor-derived epithelial cells as well in human primary
      keratinocytes and have compared them to their expression in fibroblasts. In
      proliferating immortalized and tumor-derived epithelial cells, the levels of c
      myc, max and c-fos expression were comparable and much higher than in transformed
      fibroblasts. c-myc and c-fos mRNA and protein levels remained high even during
      quiescence, when cells stopped dividing. In contrast, whereas max mRNA was
      constitutively expressed, max protein levels decreased in both fibroblasts and
      epithelial cells at high cell density. Changing the medium to serum-free medium
      of confluent epithelial cells induced a complete proliferative response which
      started with a transient increase in c-fos and c-myc mRNA, followed by the
      expression of max. Addition of serum to the medium did not induce additional
      effects. In fibroblasts, similar treatment induced the arrest of c-myc expression
      and growth, but max expression was also induced in these cells by serum. Our
      results therefore show that max expression is growth regulated in both
      immortalized and transformed epithelial as well as fibroblast cells. In contrast,
      in epithelial cells, c-myc displayed two contrasting behaviors.

PMID- 7784066
TI  - Overexpression of PKC zeta in NIH3T3 cells does not induce cell transformation
      nor tumorigenicity and does not alter NF kappa B activity.
AB  - Signal transduction is the major mechanism by which cells communicate among
      themselves through extracellular stimuli. Among the different structural
      components involved in signal transduction, protein kinases are one of the key
      elements in the process. Protein kinase C is a multimember family of kinases
      which has been involved in the regulation of diverse cellular functions.
      Regulation of cell growth in fibroblasts has been reported to be one of such
      functions. In particular the PKC zeta isoenzyme has been postulated to be
      transforming to NIH3T3 cells (Berra et al., 1993) and to serve as an effector for
      Ras proteins through the regulation of the NF kappa B transcription factor
      (Dominguez et al., 1993) and direct interaction (Diaz-Meco et al., 1994). We have
      investigated the effects of overexpressing the mouse wild-type PKC zeta in NIH3T3
      cells. When compared to the parental NIH3T3 cells, we have found (1) no
      significant effect on cell morphology; (2) no difference in growth properties in
      the absence of serum or in the presence of individual growth factors such as
      insulin, phorbol esters or PDGF; (3) no growth in soft agar nor tumorigenic
      activity in nude mice. In addition cells stably overexpressing the PKC zeta
      kinase did not interfere or amplify the induction of NF kappa B activity by tumor
      necrosis factor alfa (TNF-alpha) nor altered NF kappa B activity in transient
      expression of cells treated with TNF-alpha. Thus, mammalian PKC zeta is most
      likely not directly involved in the regulation of cell proliferation in
      fibroblasts nor affects directly or indirectly the activation of NF kappa B.

PMID- 7784065
TI  - Regulation of Bcl-2 expression by oncogenic Ras protein in hematopoietic cells.
AB  - Interleukin 3 (IL-3) and granulocyte-macrophage colony stimulating factor (GM
      CSF) induce DNA synthesis and suppress apoptosis of hematopoietic cells. IL-3/GM
      CSF exert pleiotropic functions by activating multiple signaling cascades through
      distinct domains of the common receptor subunit. As we previously reported, the
      Ras signaling pathway plays a pivotal role in suppressing apoptotic death rather
      than stimulating DNA synthesis in IL-3 dependent hematopoietic cells. In order to
      clarify the molecular basis of Ras-induced cell survival, we investigated the
      effect of Ras activation on the expression of Bcl-2 and its related molecules.
      Activation of the Ras pathway by using an inducible oncogenic Ras resulted in the
      rapid up-regulation of bcl-2 and bcl-xL, and the level of expression was nearly
      equivalent to that observed in growing cells. On the other hand, expression of
      bax, an antagonistic bcl-2 homologue, was not affected by oncogenic Ras or IL-3
      deprivation. Thus, the Ras pathway regulates the expression of Bcl-2 and its
      related survival protein, and this appears to underlie the mechanism by which IL
      3/GM-CSF inhibit apoptosis through activation of the Ras pathway.

PMID- 7784067
TI  - High affinity DNA binding of native full length c-Myb and differential
      proteolytic sensitivity of its N- and C-terminal domains.
AB  - c-Myb is the prototype of a family of transcription factors characterised by a
      unique DNA binding domain. Previous analyses have concentrated on truncated
      versions of c-Myb as it has been very difficult to produce full length c-Myb. To
      overcome these difficulties we expressed full length c-Myb in HeLa cells using a
      recombinant vaccinia virus. Partially purified native full length c-Myb bound
      efficiently and specifically to DNA with a dissociation constant similar to that
      obtained with bacterially expressed DNA binding domains. No evidence was found
      for a negative effect of the leucine zipper on DNA binding. Furthermore the DNA
      binding domain was protease resistant in contrast to the transactivation and
      negative regulatory domains. Phosphorylation had no apparent effect on this
      differential protease sensitivity. The increased sensitivity of the C-terminal
      domain suggests a more open conformation, which may be relevant in the
      integration of signals and/or in protein-protein interactions.

PMID- 7784068
TI  - A transactivator of c-myc is coordinately regulated with the proto-oncogene
      during cellular growth.
AB  - A recently cloned nuclear protein, which binds a far upstream element (FUSE) of
      the human c-myc proto-oncogene, stimulates promoter driven expression in
      undifferentiated cells. In concert with a loss of c-myc expression, both FUSE
      binding protein (FBP) mRNA and protein levels disappeared in HL60 cells after PMA
      induced differentiation, due to a drop in the rate of transcription that was
      measured by nuclear runoff. During the differentiation of these cells, the brief
      half-lives of FBP mRNA (3 h) and protein (1.5 h) did not change, allowing for the
      rapid down-regulation of nuclear protein levels, as detected by
      immunohistochemical staining. Like c-myc, FBP is expressed in proliferating cells
      from a variety of lineages, but not in quiescent cells. When T cells and
      fibroblasts were stimulated to transit from G0 into the cell cycle, there was a
      dramatic rise of both FBP mRNA and DNA sequence specific nuclear FBP binding
      activity, which correlated with the appearance of c-myc mRNA. In contrast to the
      transient expression of many other immediate early growth response genes, both
      FBP and c-myc expression were sustained for more than 24 h. In fibroblasts, the
      coordinate expression of FBP and c-myc throughout all phases of the cell cycle is
      consistent with FBP's role as a growth-dependent regulator of c-myc expression.

PMID- 7784069
TI  - Identification of alternative exons, including a novel exon, in the tyrosine
      kinase receptor gene Etk2/tyro3 that explain differences in 5' cDNA sequences.
AB  - Protein tyrosine kinase transmembrane receptors trigger signal transduction
      cascades upon ligand binding, resulting in cellular proliferation,
      differentiation, differentiation inhibition or apoptosis depending upon the cell
      target. The ETK2/TYRO3 receptor is a tyrosine kinase expressed in embryonic stem
      cells, brain and testis that has recently been cloned by several groups. Analysis
      of cDNA clones isolated from several tissues shows 2 isoforms of the Etk2/tyro3
      gene product that result from usage of alternative exons near the 5' end of the
      gene. In addition, our data suggest that a third alternative exon is positioned
      between these two alternative exons. This novel exon encodes yet another isoform
      that predicts a unique amino-terminal protein sequence. The alternative exons
      (exons 2A, 2B and 2C), predict three isoforms with different initiation codons,
      signal sequences and lengths. The existence of these multiple isoforms may be
      important for protein processing, translocation, or function.

PMID- 7784070
TI  - Chromosome 10 deletion mapping in human gliomas: a common deletion region in
      10q25.
AB  - The high incidence of loss of chromosome 10 alleles in glioblastoma multiforme
      suggests the presence on this chromosome of a tumor suppressor gene that is
      important in glioma tumorigenesis and progression. Our initial deletion mapping
      studies using restriction fragment length polymorphism markers indicated a common
      deletion region in 10q24-qter. In an attempt to localize the deleted region
      further, we screened a panel of 117 gliomas for loss of heterozygosity for
      chromosome 10 loci using 10 microsatellite markers. Seventeen tumors showed
      partial loss of a copy of chromosome 10 and were further analysed using 28
      additional microsatellite markers. Of these, 10 had terminal deletion in the q
      arm, three had deletions in both p and q arms, two contained interstitial
      deletion in 10q and two carried deletions in 10p. In the 15 tumors with deletions
      in 10q, the minimal overlapping deletion region was in distal 10q between markers
      D10S587 and D10S216. Loci D10S587 and D10S216 are approximately mapped to a 5 cM
      region in 10q25.1.

PMID- 7784071
TI  - v-Src-induced degradation of focal adhesion kinase during morphological
      transformation of chicken embryo fibroblasts.
AB  - Morphological transformation of cells by the v-Src tyrosine kinase is
      incompletely understood. However, it is independent of nuclear functions and
      probably involves phosphorylation of targets associated with the cytoskeleton and
      focal adhesions, structures which tether the cytoskeleton to the points of cell
      attachment. v-Src activity both stimulates tyrosine phosphorylation of a tyrosine
      kinase present in focal adhesions (focal adhesion kinase or pp125FAK) and
      disrupts focal adhesions, leading to cell rounding and detachment. However,
      pp125FAK is also phosphorylated on tyrosine as a result of integrin stimulation
      which induces quite different biological consequences including the organisation
      of focal adhesions when cells spread on fibronectin (reviewed in Schaller and
      Parsons, 1993). To address this paradox, we examined changes in pp125FAK during
      activation and shut-off of temperature sensitive mutant v-Src proteins that
      induce varying degrees of transformation in chick embryo fibroblasts. An
      efficiently transforming v-Src mutant initially stimulated pp125FAK tyrosine
      phosphorylation, but induced subsequent pp125FAK degradation prior to the onset
      of cell rounding and detachment. v-Src mutants which are impaired in their
      ability to induce morphological transformation were much less efficient at
      inducing degradation of pp125FAK. Moreover, cell spreading during restitution of
      normal morphology did not require detectable tyrosine phosphorylation of
      pp125FAK, or its potential substrate paxillin, suggesting that pp125FAK may
      function more in the turnover of focal adhesions than in their assembly.

PMID- 7784072
TI  - Co-regulated expression of dbl and poly(ADP-ribose) polymerase in Ewing's sarcoma
      cells and dbl-transformed NIH3T3 fibroblasts.
AB  - Poly(ADP-ribose) polymerase (PADPRP) is a ubiquitous enzyme constitutively
      expressed at low levels in the majority of eukaryotic cells, including most
      mammalian tumors and tumor-derived cell lines. Overexpression of PADPRP following
      the introduction of cDNA recombinant constructs into various cell types results
      in cell death. An exception to this effect are Ewing's sarcoma (ES) cells, which
      have been shown to contain elevated steady-state levels of PADPRP mRNA and high
      constitutive levels of protein and polymerase activity. In fact, this excess of
      PADPRP has been suggested to participate in the intrinsic radiosensitivity of
      Ewing's sarcomas, a highly malignant childhood bone tumor frequently curable with
      radiotherapy. It appears that ES cells might possess a hitherto unknown
      mechanism(s) by which PADPRP overexpression is controlled and made compatible
      with cell survival and proliferation. In order to investigate the contribution of
      other genetic alterations to PADPRP regulation in ES cells, we analysed the
      expression levels of PADPRP and of other genes, such as oncogenes and tumor
      suppressor genes, which may enhance the proliferative potential of ES cells. We
      have detected a positive correlation between the expression levels of the DNA
      repair enzyme poly(ADP-ribose) polymerase and the dbl proto-oncogene in Ewing's
      sarcoma cells. The co-regulated expression of these genes has been established in
      NIH3T3 cells transformed by the human dbl oncogene or by overexpression of the
      dbl proto-oncogene. In both instances, the increase in dbl expression resulted in
      elevated levels of PADPRP mRNA and polymerase activity. The dbl oncogene was more
      efficient than the proto-oncogene in upregulating PADPRP expression. The
      inability of other oncogenes to upregulate PADPRP upon transformation of NIH3T3
      cells demonstrated the specificity of the dbl in the process. Transfection of dbl
      transformed NIH3T3 cells with retroviral PADPRP vectors resulted in the
      establishment of clones with PADPRP levels higher than those detectable in
      untransformed NIH3T3 cells transfected with the same retroviral constructs. These
      results suggest that dbl plays a role in the mechanism by which mammalian cells
      autoregulate their endogenous levels of PADPRP. Post-translational modification
      of the dbl or proto-dbl proteins by cytoplasmic PADPRP does not participate in
      the mechanism(s) underlying the observed PADPRP/dbl co-regulation.

PMID- 7784073
TI  - The 8 kD product of the putative oncogene MTCP-1 is a mitochondrial protein.
AB  - An unusually small (8 kD) protein (p8MTCP-1) is coded by the putative oncogene
      MTCP-1 (also called c6.1B), involved in the translocation t(X;14)(q28;q11)
      associated with some mature T-cell proliferations. Here, we show by subcellular
      fractionation and by confocal microscopy that this protein is located in the
      mitochondria. This localization orientates toward a role of p8MTCP-1 in the
      mitochondrial metabolism which may be relevant for the oncogenic process.

PMID- 7784074
TI  - p53 involvement in control of G2 exit of the cell cycle: role in DNA damage
      induced apoptosis.
AB  - DNA damage in proliferating mammalian cells induces a complex cellular response
      comprising perturbation of the cell cycle and programmed cell death. The
      relationship between p53-dependent and p53-independent apoptotic cell death, as
      well as the cell cycle checkpoints induced by DNA damaging agents were explored
      in hematopoietic cells, using M1 myeloblastic leukemia cells, which are null for
      p53 expression, genetically engineered M1 variants, expressing p53ts and bcl-2
      transgenes, as well as myeloblast enriched bone-marrow cells obtained from wild
      type p53 (wt p53) and p53-deficient mice. It is shown that gamma-irradiation of
      M1p53ts cells activated a function of the temperature sensitive mutant transgene
      p53 (p53ts), promoting increased apoptosis relative to parental, null p53 M1
      cells. It is also shown that the kinetics of apoptotic cell death induced by
      gamma-irradiation correlated with the rapidity of exit from gamma-ray-induced G2
      arrest for all the different hematopoietic cell types indicated above. Finally,
      data has been obtained to demonstrate that, in addition to a role in apoptosis
      and G1 arrest, wild-type p53 positively modulated the exit from the gamma-ray
      induced G2 checkpoint. Taken together, these findings indicate that this new
      function for p53 is a component of the physiological pathway by which p53 exerts
      its role in apoptosis.

PMID- 7784075
TI  - p53-mediated transcriptional activity increases in differentiating epidermal
      keratinocytes in association with decreased p53 protein.
AB  - The regulation of p53 protein synthesis and p53-mediated gene transactivation
      were evaluated in cultured mouse keratinocytes maintained as basal cells or
      induced to differentiate by Ca2+ > 0.1 mM. p53 protein half-life, p53 protein
      synthesis and the level of p53 mRNA decreased during terminal differentiation, as
      detected by immunoprecipitation with a panel of p53-specific antibodies and
      Northern blotting. Thus differentiating keratinocytes have lower levels of p53
      protein. This decline is not observed following growth arrest alone, or in
      papilloma cell lines which do not terminally differentiate in response to Ca2+.
      In contrast, the ability of endogenous p53 to transactivate transcription from
      the PG13 CAT plasmid increased during differentiation in vitro. This change in
      activity cannot be explained by changes in p53 conformation or nuclear
      localization. Consistent with these findings, mRNA for the p53-mediated genes
      WAF1 and mdm-2 increased with Ca(2+)-induced differentiation in a time dependent
      manner, suggesting activation of p53 contributes to the differentiated phenotype.
      However, p53-null mice exhibit histologically normal skin and epidermal
      keratinocytes from these mice express the appropriate markers of differentiation
      and suppression of DNA synthesis in vitro when the [Ca2+] is > 0.1 mM. The
      observation that proliferating cells have higher levels of p53 protein which is
      less active for its function than differentiated cell types could have a
      consequence for the selection of p53 gene mutations during carcinogenesis,
      depending upon the stage of differentiation of the tumor cell type.

PMID- 7784076
TI  - Identification of binding domains on the p21Cip1 cyclin-dependent kinase
      inhibitor.
AB  - Members of the recently discovered family of cyclin-dependent kinases inhibitors
      (CKIs) appear to play an essential regulatory role in the control of cell
      proliferation. To investigate the molecular basis of the interaction between
      these proteins and the cyclin-dependent kinases (CDKs), we performed a systematic
      mutagenesis of the CKI family member p21Cip1 using the alanine-scanning strategy.
      We have examined the interaction between in vitro translated human cdk2, cyclins
      A and D1, purified proliferating cell nuclear antigen (PCNA) and a set of human
      p21Cip1 mutants fused to glutathione S-transferase. Independent domains that are
      required for the interaction with cdk2 and with PCNA have been identified. The
      cdk2 binding domain is located in the N-terminal part of the protein, between
      residues 45 and 60, a region that is fully conserved in the p27Kip1 inhibitor. A
      PCNA binding region was localised to the C-terminus of the protein, between
      residues 142 and 163. These findings define protein motifs that are highly
      conserved between members of the CKI family and that are likely to play an
      essential function in the regulation of the G1/S transition.

PMID- 7784077
TI  - Critical role of Rho in cell transformation by oncogenic Ras.
AB  - We demonstrate that Rho, a regulator of cytoskeletal actin, is necessary for Ras
      transformation. A dominant inhibitory Rho gene (RhoBN19) specifically suppressed
      Rat1 cell focus formation induced by oncogenic Ras but not by Raf. An activated
      Rho gene (RhoBV14) lacked focus formation activity but augmented the focus
      formation activity of both oncogenes. NIH3T3 cell lines expressing RhoBV14 grew
      to higher saturation density and displayed reduced serum and anchorage
      requirements for growth. We concluded that Rho played a role in cell growth
      regulation and was required for transformation by oncogenic Ras but not Raf. A
      model for Ras signal transduction proposing separate Rho-dependent and Raf
      dependent pathways is discussed.

PMID- 7784079
TI  - Ligand-independent activation of tyrosine kinase in fibroblast growth factor
      receptor 1 by fusion with beta-galactosidase.
AB  - To examine the biological role of fibroblast growth factor receptor 1 (FGFR1)
      oligomerization for its signal transduction, we construct an expression vector
      encoding a FGFR1-beta-galactosidase fusion protein. This vector is designed to
      fuse the 3'-portion of FGFR1 to beta-galactosidase. Transfection of this vector
      into FGFR-negative rat L6 myoblast cells results in ligand-independent inhibition
      of differentiation into myocytes, suggesting that FGFR1 within this fusion
      protein is constitutively activated. This can be confirmed by demonstrating that
      this fusion protein exhibits the tyrosine kinase activity and phospholipase C
      gamma 1 is tyrosine-phosphorylated even in the absence of ligand stimuli. Since
      the transfected cells also exhibit the enzyme activity of beta-galactosidase
      which is known to be active only in a tetramer form, this constitutive activation
      can be elicited by tetramerization of FGFR1. Furthermore, deletion of a region
      corresponding to C terminal 10 amino acids important for tetramerization of beta
      galactosidase from this expression vector abolishes the constitutively active
      nature of FGFR1 with simultaneous loss of beta-galactosidase activity.
      Transfection of non-deleted expression vector into NIH3T3 cells results in
      acquisition of focus-forming activity while a deleted form of expression vector
      fails to show this activity even in the presence of basic FGF. These results
      would suggest that tetramerization of FGFR1 can produce a constitutively active
      form responsible for transformation of NIH3T3 cells.

PMID- 7784078
TI  - Growth suppression of acute promyelocytic leukemia cells having increased
      expression of the non-rearranged alleles: RAR alpha or PML.
AB  - The balanced t(15;17) rearrangement found in acute promyelocytic leukemia (APL)
      cells fuses PML on chromosome 15 to the retinoic acid receptor alpha (RAR alpha)
      on chromosome 17. PML/RAR alpha is expressed in APL cells with the non-rearranged
      alleles, PML and RAR alpha. Clinical remissions induced by all-trans-retinoic
      acid (RA) treatment of APL patients are linked to expression of PML/RAR apha, a
      transcription factor with reported dominant negative functions. The roles of PML
      and RAR alpha in the RA response of APL have not yet been fully explored. This
      study examines these roles by individually transfecting RAR alpha and PML into
      NB4 APL cells. NB4 is the sole APL cell line containing the t(15;17). RA
      treatment represses NB4 cell growth and induces a myeloid phentoype. Full length
      cDNAs for RAR alpha and PML were individually cloned into a CMV-driven expression
      vector containing the neomycin resistance gene. Surprisingly, none of the
      obtained stable transfectants expressed exogenous RAR alpha or PML mRNAs even
      when reverse transcription polymerase chain reaction (RT-PCR) detection assays
      were used. All clones expressed the neomycin resistance gene and were similar to
      parental NB4 cells in their growth and differentiation properties. An explanation
      explored for this lack of gene expression was that increased levels of RAR alpha
      or PML might suppress APL cell growth. To examine this possibility, transfection
      experiments were repeated using an episomal vector-based expression system
      containing an SV40 driven RAR alpha or PML cDNA and the hygromycin B resistance
      gene. A new selection strategy augmented expression of the desired cDNAs. A
      control episomal vector lacked a cDNA insert. Following electroporation and
      selection, exogenous RAR alpha expression was obtained. Compared to controls, the
      growth of these transfectants was markedly inhibited before and after RA
      treatment and these cells more prominently induced myeloid maturation markers. In
      contrast, exogenous PML expression was transient since these transfectants did
      not appear to propagate in culture. These findings indicate: (1) a growth
      disadvantage for NB4 cells having increased expression of RAR alpha or PML and
      (2) increased RAR alpha expression augmented RA-mediated maturation of NB4 cells.
      This implicates a role for RAR alpha or PML in regulating the growth or
      differentiation of APL cells. It is hypothesized this occurs through antagonism
      of PML/RAR alpha actions in these leukemic cells.

PMID- 7784080
TI  - Expression of beta-galactosidase under the control of the human c-myc promoter in
      transgenic mice is inhibited by mithramycin.
AB  - In order to assess the functional contribution of the human c-myc promoter region
      in the expression of the c-myc gene, transgenic mouse lines containing a
      bacterial lac Z gene encoding beta-galactosidase under the control of the human c
      myc protooncogene promoter were generated. Transgenic mouse embryos heterozygous
      for the human c-myc Z transgene demonstrate high amounts of beta-galactosidase
      activity as early as day 11 of embryogenesis by histochemical staining of whole
      embryos using 5-bromo-4-chloro-3-indolyl-beta-D-galactopyranoside (X-Gal) as
      substrate, localizing specifically to early spinal cord tissue. beta
      galactosidase activity can be demonstrated by histochemical staining in brain
      tissue of day 14 embryos, localizing mainly to the prefrontal cortex region,
      while relative amounts of beta-galactosidase in spinal cord tissue are reduced.
      Determination of specific activity of beta-galactosidase using resorufin-beta
      galactopyranoside as substrate in homogenates of whole embryos heterozygous for
      the human c-myc/lac Z transgene demonstrates significantly elevated beta
      galactosidase activity over control embryos in day 11 and day 14 embryos.
      Surprisingly, cell homogenates of brain tissue from adult G1 generation mice
      heterozygous for the human c-myc/lac Z transgene demonstrate greater than 10-fold
      higher specific activity of beta-galactosidase over normal control brain tissue.
      Specific inhibition of the c-myc/lac Z transgene was also demonstrated in
      developing embryos using mithramycin given at a dose of 150 micrograms kg-1 d-1
      intraperitoneal to pregnant females on days 7-13 of gestation. Both histochemical
      staining of beta-galactosidase and specific activity assays of day 14 embryos
      demonstrated significantly lower levels of beta-galactosidase than untreated
      controls. These results are unique since we are able to detect expression of beta
      galactosidase in developing embryonic central nervous system tissue along with
      adult brain tissue of animals carrying the human c-myc Z transgene and we are
      able to specifically inhibit expression of the transgene using mithramycin
      administered in utero.

PMID- 7784081
TI  - The proto-oncogene FGF-3 is constitutively expressed in tumorigenic, but not in
      non-tumorigenic, clones of a human colon carcinoma cell line.
AB  - The human colon carcinoma cell line, SW613-S, is composed of cells with a high
      level amplification of the MYC proto-oncogene that are tumorigenic in nude mice
      and of cells with a low-level amplification of MYC that are not tumorigenic.
      Transcripts from FGF-3, a member of the fibroblast growth factor gene family,
      accumulate in cells from tumorigenic clones, but are undetectable in those from
      non-tumorigenic clones. Nuclear run-on analyses indicate that this differential
      FGF-3 expression is regulated at the level of transcription initiation.
      Determination of the structure of the FGF-3 transcripts indicates that they are
      generated by splicing of the three exons and termination at the single
      polyadenylation site predicted from the genomic sequence. Their size
      heterogeneity is due to multiple initiation sites spanning a 700 base-pair long
      promoter region. FGF-3 is activated in tumors induced in nude mice by MYC
      transfected cells from non-tumorigenic clones. However, in most of the cell lines
      established from these tumors, FGF-3 expression tends to be lost upon in vitro
      propagation. Thus, in these transfectant cell lines, the presence of exogenous
      MYC gene copies is not sufficient to activate FGF-3 expression and in vivo growth
      is also required.

PMID- 7784082
TI  - PuF/NM23-H2/NDPK-B transactivates a human c-myc promoter-CAT gene via a
      functional nuclease hypersensitive element.
AB  - We have isolated the transacting factor PuF that, through its interaction with a
      nuclease hypersensitive element (NHE) located upstream of the c-myc gene,
      transactivates the human c-myc gene in vitro (Postel et al., 1989). PuF was
      recently identified as being encoded by the nonmetastatic 23-H2 (nm23
      H2)/nucleoside diphosphate kinase-B (NDPK-B) gene (Postel et al., 1993). In
      addition to its ability to transactivate the c-myc gene in vitro, PuF/NDPK-B
      catalyzes the shuttling of gamma-phosphates between nucleoside triphosphates and
      diphosphates (Gilles et al., 1991; Postel and Ferrone, 1994) and has been
      postulated to suppress tumor metastasis (Stahl et al., 1991). Here we have
      extended our studies of PuF and c-myc transcription by testing whether PuF
      affects c-myc transcription using a transient transfection assay. A plasmid
      containing the human c-myc promoter-NHE region was cloned upstream of the
      bacterial chloramphenicol acetyltransferase (CAT) gene. When cotransfected with a
      PuF expression vector, CAT activity was elevated 3-4 fold relative to
      transfections containing the myc-CAT plasmid. In contrast, a myc-CAT reporter
      plasmid in which the NHE element was deleted showed no increase in CAT activity
      when cotransfected with the PuF expression vector. From these results we conclude
      that PuF transactivates the c-myc gene via the nuclease hypersensitive element.

PMID- 7784083
TI  - Cloning and developmental expression analysis of the murine c-mer tyrosine
      kinase.
AB  - We have cloned the putative mouse homologue of the human c-mer receptor tyrosine
      kinase proto-oncogene. Comparison of the mouse and human c-mer amino acid
      sequences reveals an overall identity of 88%. Similar to the human, the
      extracellular region of the murine c-mer protein possesses two amino terminal
      immunoglobulin-like domains and two membrane proximal fibronectin type III
      domains, which places it in the Axl family of tyrosine kinases. Our analysis of
      the Axl family identifies eight different regions of amino acid consensus that
      have residues characteristic of this and no other tyrosine kinase family; six of
      the eight are within tyrosine kinase subdomains. The homology within the Axl
      family is highest between c-mer and c-eyk, the chicken proto-oncogene of the
      tumor virus gene product v-eyk. Northern analysis of adult tissues suggests that
      the mouse c-mer, although expressed in many tissues, has an expression pattern
      unique among Axl family members. In normal adult hematopoietic cells c-mer seems
      to be expressed predominantly if not exclusively in the monocytic lineage. Mouse
      c-mer is expressed during most, if not all, stages of embryological development
      beginning in the morula and blastocyst and progressing through the yolk sac and
      fetal liver stages. This early and consistent expression of c-mer was confirmed
      during in vitro differentiation of embryonic stem cells. The embryonic expression
      profile of c-mer suggests that this tyrosine kinase may play an important
      function in the developing mouse.

PMID- 7784084
TI  - Identification of p53 target genes through immune selection of genomic DNA: the
      cyclin G gene contains two distinct p53 binding sites.
AB  - An immune-selection procedure was employed in order to isolate p53-binding sites
      from rat genomic DNA. One such site was found to reside within the first intron
      of the cyclin G gene. Cyclin G mRNA levels are strongly elevated upon induction
      of wild type p53 activity in cells carrying a temperature sensitive p53 mutant.
      The cyclin G gene also carries a second p53-binding motif upstream to its
      transcriptional start site. The presence of two high affinity p53-binding sites
      may confer upon the cyclin G gene the potential to be activated very efficiently
      by p53. These data raise the possibility that cyclin G may be a downstream
      mediator of at least some of the biological effects of p53.

PMID- 7784085
TI  - Cloning and characterization of cbl-b: a SH3 binding protein with homology to the
      c-cbl proto-oncogene.
AB  - We have cloned a new gene, cbl-b, with homology to the c-cbl proto-oncogene. A
      large protein is predicted (approx. MW 108,000) that has a proline rich domain, a
      nuclear localization signal, a C3HC4 zinc finger and a putative leucine zipper.
      There is striking nucleotide and amino acid homology to the c-cbl proto-oncogene
      most notably in the structural motifs described above. Cbl-b is expressed in
      normal and malignant mammary epithelial cells, in a variety of normal tissues,
      and in hematopoietic tissue and cell lines. Cbl-b expressions is up-regulated
      with macrophage/monocyte differentiation of the HL60 and U937 cell lines. There
      is direct association of the cbl-b protein with the Src Homology 3 domains of
      several proteins including signaling, cytoskeletal and adaptor proteins. Our data
      suggest that cbl-b encodes a protein which can interact with signal transduction
      proteins to regulate their function or to be regulated by them. Together, cbl-b
      and c-cbl are members of a novel family of proto-oncogenes involved in signal
      transduction.

PMID- 7784086
TI  - Role of the autophosphorylation site on the biological function of pp56lck.
AB  - Src-family tyrosine kinases act as signaling molecules in a wide array of
      cellular activation processes. The existence of the various src-family members
      reflects the requirement for different cell-surface receptors to transmit cell
      type specific intracellular signals. The structural basis for the functional
      specificity of src-kinases is being actively investigated. In the present report
      we have analysed the contribution of the area surrounding the autophosphorylation
      site (located at subdomain VII of the catalytic domain) in determining src
      kinases activity and functional specificity. To this end we analysed the kinase
      activities of the lymphoid src-kinase pp56lck and a mutant of pp56lck in which
      this region has been exchanged for the corresponding area of the serine/threonine
      kinase c-Raf. Our studies indicate that the change at subdomain VII affected the
      ability of pp56lck to phosphorylate physiological substrates. Furthermore, when
      analysed in T cells, the mutant at subdomain VII failed to induce interleukin-2
      production, a specific biological function of pp56lck. Thus, the area surrounding
      the autophosphorylation site of pp56lck plays a critical role in mediating its
      specific biological function.

PMID- 7784087
TI  - Two critical hydrophobic amino acids in the N-terminal domain of the p53 protein
      are required for the gain of function phenotypes of human p53 mutants.
AB  - Some mutant forms of the p53 protein have been shown to gain new functions that
      are not shared by the wild-type p53 protein; (1) mutant p53 proteins can
      transcriptionally transactivate the multi-drug resistance gene-1 (MDR-1) and (2)
      when expressed in non-tumorigenic cells with no endogenous p53 protein, mutant
      p53 proteins can enhance the tumorigenic potential of these cells (Dittmer et
      al., 1993). It has recently been shown (Lin et al., 1994b) that the
      transcriptional activator domain of the p53 protein contains two amino acids, leu
      22 and trp-23, which are required by the wild-type p53 protein for
      transcriptional activity. To determine whether these same amino acid residues are
      utilized by mutant p53 proteins for their gain of function phenotype, the triple
      mutant p53 protein (at residues 22 and 23 in the transactivation domain and
      residue 281 in the DNA binding domain--a gain of function mutant) was made. While
      the p53-281 mutant transcriptionally activates the MDR-1 gene and enhances the
      tumorigenic potential of cells it is expressed in, the 22, 23, 281 triple mutant
      failed to carry out either of these functions.

PMID- 7784088
TI  - Gamma-radiation-induced apoptosis in human colorectal adenoma and carcinoma cell
      lines can occur in the absence of wild type p53.
AB  - The tumour suppressor gene p53 codes for a transcription factor which is thought
      to play a critical role in the induction of G1 cell cycle arrest and programmed
      cell death (apoptosis) following DNA damage by ionizing radiation. The aim of
      this investigation was to determine whether a p53 independent radiation-induced
      apoptosis pathway exists in human colon epithelial cell lines. This report
      describes the induction, by gamma-radiation, of apoptosis in the colorectal
      adenoma cell line S/RG/C2, and in the colorectal carcinoma cell line PC/JW, both
      of which lack wild type p53. In addition, flow cytometry revealed that both cell
      lines failed to arrest in G1 after radiation. Thus, although loss of wild type
      p53 may abrogate G1 arrest, radiation-induced apoptosis can still occur in human
      colonic tumour cell lines through a p53 independent mechanism.

PMID- 7784090
TI  - Abrogation of p53 function by transfection of HPV16 E6 gene enhances the
      resistance of human diploid fibroblasts to ionizing radiation.
AB  - In order to examine the role of p53 expression on the sensitivity of cells to
      radiation-induced reproductive failure, we examined the radiosensitivity of a
      human diploid fibroblast cell strain (AG1521) before and after transfection with
      the E6 or E6/E7 genes of human papillomavirus 16 (HPV16)3. HPV E6 binds to p53,
      promoting its degradation and abrogating wild-type p53 function. AG1521 cells
      transfected with either E6 or E6/E7 showed no radiation induction of either p53
      or WAF1/Cip1. The radioresistance of these cells were significantly increased;
      the D0 of the survival curves rose from 130 +/- 4 cGy for wild type (neo
      transfected) cells to 178-192 cGy for three subclones transfected with E6 alone,
      and 151-218 cGy for eight subclones transfected with E6/E7. The change in
      radiosensitivity took place before the process of cellular immortalization and
      transformation produced by transfection with these genes. Thus, the effect on
      radiosensitivity appears to be an early effect of the loss of p53 function in non
      transformed cells, perhaps related to the loss of the G1 checkpoint and of the
      capacity for programmed death amongst radiation damaged cells.

PMID- 7784089
TI  - Loss of Fas/Apo-1 receptor accelerates lymphomagenesis in E mu L-MYC transgenic
      mice but not in animals infected with MoMuLV.
AB  - The Fas/Apo-1 receptor is an integral membrane protein that transduces apoptotic
      signals upon binding to its natural ligand or to specific antibodies. Loss of
      Fas/Apo-1 receptor leads in (lpr,lpr) mice to a nonmalignant accumulation of
      abnormal T-cells very probably due to the lack of induction of apoptosis in
      peripheral T-cells. It has been reported that soluble forms of Fas/Apo-1 receptor
      that may interfere with apoptotic signaling occur in patients suffering from
      various forms of lymphoid neoplasms. Therefore, we wished to investigate whether
      the loss of proper homeostatic regulation through Fas/Apo-1 receptor mediated
      apoptosis could influence the process of lymphomagenesis. To this end, we
      performed two experiments (i) we infected (lpr,lpr) animals with Moloney Murine
      Leukemia Virus (MoMuLV) that causes T-cell lymphoma in mice and (ii) we crossed
      (lpr,lpr) animals with E mu L-myc transgenic mice that are prone to develop T-
      and B-cell lymphoma due to deregulated expression of the L-myc transgene by the
      immunoglobulin enhancer E mu. We find that infection with MoMuLV did not
      accelerate the formation of lymphoid neoplasms in (lpr,lpr) mice when compared to
      infected normal animals. However, E mu L-myc/(lpr,lpr) animals that
      constitutively express the L-myc transgene in the lymphoid lineage clearly show
      accelerated formation of T- and B-cell lymphoma when compared to normal E mu L
      myc transgenics. These data demonstrate that in cooperation with particular
      oncogenes impairment of Fas/Apo-1 receptor function can indeed affect and
      modulate the process of tumor formation.

PMID- 7784092
TI  - RET mutations in exons 13 and 14 of FMTC patients.
AB  - RET is a receptor tyrosine kinase gene which is responsible for three different
      inherited cancer syndromes namely multiple endocrine neoplasia type 2A (MEN 2A),
      type 2B (MEN 2B) and familial medullary thyroid carcinoma (FMTC) as well as for
      Hirschsprung disease (HSCR), a congenital disorder affecting the intestinal
      motility. Germ-line mutations in the RET exons 10 and 11 were demonstrated in the
      majority of the MEN 2A and FMTC patients. On the other hand, one codon of RET
      exon 16 is preferentially changed in MEN 2B patients. Recently, a germ-line
      mutation in the exon 13 was described in one FMTC family as well as in four
      sporadic MTCs. In the present study, we observed the same exon 13 mutation in two
      FMTC families. In addition, we identified a previously unreported substitution of
      RET exon 14 in two unrelated FMTC families. Both mutations segregate with the
      disease in these four FMTC families and involve the tyrosine kinase domain of
      RET. Haplotype analysis using polymorphic markers tightly linked to the RET gene
      indicates that in each pedigree the mutation arose as an independent event.

PMID- 7784091
TI  - Tyrosine phosphorylation of Shc proteins and formation of Shc/Grb2 complex
      correlate to the transformation of NIH3T3 cells mediated by the point-mutation
      activated neu.
AB  - PLC-gamma, ras-GAP and Shc have been proposed to be in vivo substrates for the
      neu-encoded p185neu receptor tyrosine kinases. We compared the tyrosine
      phosphorylation levels of PLC-gamma, ras-GAP and Shc in two NIH3T3 derived cell
      lines, transformed B104-1-1 and non-transformed DHFR/G8 cells in which point
      mutation activated and normal rat neu genes were transfected and expressed,
      respectively. We found that tyrosine phosphorylation of Shc and formation of
      Shc/Grb2 complex were more significant in B104-1-1 cells than in DHFR/G8 cells,
      while no obvious difference could be detected for the tyrosine phosphorylation
      levels of ras-GAP and PLC-gamma between these two cell lines. Furthermore, we
      observed that association with Shc was severely impaired by deletion of most of
      the major autophosphorylation sites of the point-mutated neu. The truncated neu
      product, however, fully retained its ability to transform NIH3T3 cells, induce
      Shc tyrosine phosphorylation and Shc/Grb2 complex formation. Our results suggest
      that tyrosine phosphorylation of Shc which allows formation of Shc/Grb2 complex
      may play an important role for cell transformation induced by the point mutation
      activated neu, and that stable binding to mutant p185neu may not be necessary for
      Shc to mediate this signaling pathway.

PMID- 7784093
TI  - The role of p53 in coordinated regulation of cyclin D1 and p21 gene expression by
      the adenovirus E1A and E1B oncogenes.
AB  - Expression of the cyclin D1 gene is induced when quiescent fibroblasts are
      stimulated to reenter the cell cycle by addition of growth factors. Moderate
      ectopic expression of cyclin D1 in early G1 facilitates progression through G1.
      When transiently overexpressed at the G1/S boundary, cyclin D1 prevents S phase
      entry, suggesting a dual role for this protein in cellular growth control. It was
      shown that the retinoblastoma protein (pRB) can activate cyclin D1 gene
      expression; furthermore, there is evidence that expression of the cyclin D1 gene
      is down-regulated by the SV40 large T and adenovirus E1A genes, both of which
      were shown to target pRB. We now report that in diploid human fibroblasts
      functional inactivation of pRB by adenovirus E1A is not sufficient for efficient
      repression of cyclin D1 gene expression, since the E1B gene product, in addition
      to E1A, is required for repression of the cyclin D1 gene. Since E1B was shown to
      target p53, we investigated the role of p53 for expression of the cyclin D1 gene.
      In a cell line with temperature-sensitive p53, cyclin D1 is moderately expressed
      at the restrictive temperature. Induction of p53 function by temperature shift
      leads to an increase of cyclin D1 mRNA and protein, parallel to the activation of
      p21WAF-1/CIP1 gene expression in this system. When the capability of adenovirus
      gene products to affect expression of either gene was analysed, we found that
      infection of Ad5 drastically reduced cyclin D1 and p21WAF-1/CIP1 gene expression
      in cells where p53 function is limiting. Under these conditions E1A and E1B
      cooperate to reduce the cyclin D1 level, while p21WAF-1/CIP1 expression was found
      insensitive to E1A expression. In cells containing elevated p53 function,
      modulation of gene expression by E1B was severely compromised; under these
      conditions, expression of E1A reduced expression of cyclin D1 without affecting
      p21WAF-1/CIP1. The data suggest that E1A and E1B cooperate to inhibit expression
      of cyclin D1 and identify the cyclin D1 gene as a new downstream target for p53.

PMID- 7784094
TI  - Characterisation of the interaction between PCNA and Gadd45.
AB  - We have examined the interaction between the DNA replication and repair protein
      PCNA, and the growth arrest and DNA damage induced protein Gadd45. An anti-Gadd45
      polyclonal antibody co-immunoprecipitates PCNA but in reciprocal experiments, an
      anti-C terminal anti-PCNA antibody failed to co-immunoprecipitate Gadd45. We used
      a yeast two hybrid assay to demonstrate that human Gadd45 interacts with both
      human and S. pombe PCNA. We have determined that the N-terminal 94 amino acids of
      Gadd45 bind to PCNA, and using a series of N-terminal and C-terminal deletions of
      human PCNA we have mapped two potential Gadd45 binding sites. Deletion of the
      last 6 amino acids of PCNA ablated interaction, suggesting a role in Gadd45
      binding. This explains the inability of an anti-C terminal PCNA antibody to co
      immunoprecipitate Gadd45. Using a peptide ELISA approach, we showed that Gadd45
      protein binds strongly to three regions of PCNA (residues 1-20, 61-80, and 196
      215) and weakly to residues 121-170. The crystal structure of PCNA provides
      insight into our genetic and immunochemical data. Our results confirm an
      interaction between PCNA and Gadd45, define regions of both molecules involved in
      this interaction, and are consistent with a potential stoichiometry of 2 Gadd45
      molecules to each PCNA monomer. These data provide support for the notion that
      PCNA-Gadd45 interactions co-ordinate cell cycle and DNA repair.

PMID- 7784096
TI  - Genomic stability and wild-type p53 function of lymphoblastoid cells with germ
      line p53 mutation.
AB  - Increased cancer risk associated with germ-line p53 mutation was linked to a
      deficit in the ability to maintain genomic stability. Accordingly, normal
      fibroblasts from cancer-prone individuals accumulate genomic aberrations with
      concomitant loss of wild-type p53 allele during in vitro culture. We tested
      whether such changes also occur in EBV-immortalized lymphoblastoid cells. Both
      normal and p53 germ-line mutant lymphoblastoid cells maintained functional p53
      and genomic stability during long term in vitro culture. These unexpected
      differences between fibroblastic and lymphoblastic cells suggest that phenotypic
      expression of p53 deficiency is cell type specific. This could contribute to
      selective tissular localization of tumours observed in patients with Li-Fraumeni
      syndrome despite the presence of a mutant p53 allele in all cells.

PMID- 7784095
TI  - HER-2 tyrosine kinase pathway targets estrogen receptor and promotes hormone
      independent growth in human breast cancer cells.
AB  - Growth of human breast cells is closely regulated by steroid hormone as well as
      peptide hormone receptors. Members of both receptor classes are important
      prognostic factors in human breast cancer. Clinical data indicate that
      overexpression of the HER-2 gene is associated with an estrogen receptor-negative
      phenotype. In this study, we demonstrate that introduction of a HER-2 cDNA,
      converting non-overexpressing breast cancer cells to those which overexpress this
      receptor, results in development of estrogen-independent growth which is
      insensitive to both estrogen and the antiestrogen, tamoxifen. Moreover,
      activation of the HER-2 receptor in breast cancer cells by the peptide growth
      factor, heregulin, leads to direct and rapid phosphorylation of ER on tyrosine
      residues. This is followed by interaction between ER and the estrogen-response
      elements in the nucleus and production of an estrogen-induced protein,
      progesterone receptor. In addition, overexpression of HER-2 receptor in estrogen
      dependent tumor cells promotes ligand-independent down-regulation of ER and a
      delayed autoregulatory suppression of ER transcripts. These data demonstrate a
      direct link between these two receptor pathways and suggest one mechanism for
      development of endocrine resistance in human breast cancers.

PMID- 7784097
TI  - One or two genetic loci mediate high opiate analgesia in selectively bred mice.
AB  - The analgesic responses of humans and laboratory animals are characterized by
      substantial individual differences. The genetic basis of this variability can be
      studied experimentally in rodents using a program of selective breeding. One such
      program selected for high (HA) and low (LA) swim stress-induced analgesia (SSIA)
      on the hot-plate (56 degrees C) test in Swiss-Webster mice. These lines, which
      have been selectively bred for more than 25 generations, display markedly
      divergent opioid-mediated SSIA (3-min swims in 38 degrees C water), morphine
      analgesia (10 mg/kg, i.p.), and analgesia to the kappa-receptor agonist, U
      50,488H (30 mg/kg, i.p.). The present study investigated the mode of inheritance
      of these opioid analgesias in HA and LA mice, using Mendelian genetic analyses.
      We report that the differential sensitivity of HA and LA mice to each of these
      analgesic manipulations appears to be determined oligogenically, by one or at the
      most two major genetic loci. The loci associated with each type of analgesia do
      not co-segregate, however, indicating that three distinct oligogenic effects have
      been identified. These findings suggest that the genetic determination of
      analgesic mechanisms may have simple components and as such may be amenable to
      further analysis using molecular genetic techniques.

PMID- 7784099
TI  - Effects of inflammatory irritant application to the rat temporomandibular joint
      on jaw and neck muscle activity.
AB  - An electromyographic (EMG) study was carried out in 40 anaesthetized rats to
      determine if the activity of jaw and neck muscles could be influenced by
      injection of the small-fibre excitant and inflammatory irritant mustard oil into
      the region of the temporomandibular joint (TMJ). Injection of a vehicle (mineral
      oil, 20 microliters) did not produce any significant change in EMG activity. In
      contrast, injection of mustard oil (20 microliters, 20%) evoked increases in EMG
      activity in the jaw muscles but not in the neck muscles. The increased EMG
      activity evoked by mustard oil was reflected in 1 or 2 phases of increased
      activity. The early EMG increase occurred soon after the mustard oil injection
      (mean latency +/- SD: 3.5 +/- 2.3 sec), peaked within 1 min, and then subsided
      (mean duration: 7.5 +/- 5.2 min). The later EMG increase occurred at 14.6 +/-
      10.0 min after the mustard oil injection and lasted 14.3 +/- 12.3 min. These
      excitatory effects of mustard oil on the EMG activity of jaw muscles appear to
      have a reflex basis since they could be abolished by pre-administration of local
      anaesthetic into the TMJ region. These results document that TMJ injection of
      mustard oil results in a sustained and reversible activation of jaw muscles that
      may be related to the reported clinical occurrence of increased muscle activity
      associated with trauma to the TMJ.

PMID- 7784098
TI  - The consumption of fentanyl is increased in rats with nociceptive but not with
      neuropathic pain.
AB  - The question whether opioids relieve neuropathic pain remains a controversial
      issue. Experimental as well as clinical studies report contradictory results.
      This study investigated the consumption of fentanyl, a short-acting opioid, in
      rats with neuropathic pain, induced by partial sciatic nerve injury. The
      experiment consisted of a drug choice procedure in which the animals could choose
      between a solution containing 0.008 mg/ml of fentanyl and a highly palatable
      sweet solution. It was reasoned that if opioids have an analgesic effect in
      neuropathic pain, this will reinforce the intake of fentanyl more so in rats with
      neuropathic pain than in pain-free controls. This protocol was previously already
      used by Colpaert et al. (1982) in a rat model of chronic pain of nociceptive
      origin, namely polyarthritis. No significant differences were found in the
      relative oral intake of the fentanyl solution in mononeuropathic and pain-free
      control rats. In contrast, rats with nociceptive pain, adjuvant monoarthritis,
      drank significantly more of the fentanyl solution than did control rats. These
      data give experimental support for the clinical findings that opioids have a poor
      analgesic effect in neuropathic pain.

PMID- 7784100
TI  - Effects of an acute muscle nerve section on the excitability of dorsal horn
      neurones in the rat.
AB  - A previous study of this laboratory showed that an acute myositis (which is
      associated with increased activity in slowly conducting muscle afferent fibres)
      is followed by marked excitability changes in the dorsal horn within a few hours.
      The present work addresses the question as to how the responsiveness of dorsal
      horn neurones changes when the same muscle nerve is transected. In anaesthetized
      rats, an axotomy of the gastrocnemius-soleus (GS) muscle nerves was performed and
      the electrical and mechanical excitability of single dorsal horn neurones in the
      lumbar spinal cord determined 2-8 h after the lesion. Axotomy led to a decrease
      in the proportion of neurones responding to A-fibre input from the cut nerve and
      to an increase in the efficacy of sural and peroneal nerve stimulation. The
      change in GS input became significant only 5-8 h after the lesion and could
      reflect the beginning of neuroplastic changes. The change in sural and peroneal
      input was most marked 2-5 h after axotomy and is probably due to fast neuronal
      processes. The efficacy of C-fibre input from the sural and peroneal nerves
      increased significantly in the lateral dorsal horn only. In comparison with the
      effects of an acute myositis, the axotomy had opposite effects with regard to the
      GS input, but similar effects with regard to the C-fibre drive from the other
      nerves. It is concluded that transection of a muscle nerve is similarly effective
      in inducing acute changes in dorsal horn excitability as is an increase in muscle
      nerve activity.

PMID- 7784101
TI  - The effect of abdominal surgery on thresholds to thermal and mechanical
      stimulation in sheep.
AB  - Thresholds to noxious mechanical and thermal stimulation were measured in 6
      groups of sheep prior to induction of anaesthesia and subsequently for a period
      of 2 h in the post-anaesthetic period. Groups 1-4 were anaesthetised using
      thiopentone and underwent ventral midline laparotomy. Four animals (group 5)
      underwent anaesthesia but not surgery, and a further 6 sheep (group 6) undergoing
      surgery were anaesthetised using ketamine. Groups 1-3 were intravenously
      administered the following drugs intra-operatively: flunixin meglumine, carprofen
      and buprenorphine, respectively. Groups 4-6 received no additional treatment.
      Thresholds to the mechanical test were not changed in the post-anaesthetic period
      for any group. There was a significant reduction in the responses to thermal
      stimulation after surgery for sheep in group 4 (45 and 60 min), while sheep in
      group 2 had thresholds to thermal stimulation greater than those recorded in the
      remaining groups at all time points post-operatively. Responses to thermal
      stimulation in sheep undergoing anaesthesia but not surgery (group 5) were
      unaltered during the 2 h recording period after anaesthesia ended. These data
      indicate that abdominal surgery induces thermal but not mechanical hyperalgesia
      in sheep, which appears to be centrally mediated. Moreover, the absence of
      mechanical hyperalgesia raises the possibility that central changes in noxious
      information processing may not be detected using mechanical stimuli in the same
      time course as thermal stimuli.

PMID- 7784102
TI  - Subanesthetic concentrations of lidocaine selectively inhibit a nociceptive
      response in the isolated rat spinal cord.
AB  - Systemically administered local anesthetics are known to provide analgesia in a
      variety of pain states; however, the site of action and the mechanism by which
      these effects are produced remain in question. In the present study, the effects
      of low (subblocking for nerve conduction) concentrations of lidocaine on a spinal
      cord nociceptive potential were studied. Spinal cords were removed from neonatal
      rats and maintained in vitro. Lumbar dorsal and ipsilateral ventral roots were
      attached to suction electrodes for stimulation and recording, respectively.
      Following a stabilization period (60-120 min) with control measurements, each
      preparation was exposed to a single concentration of lidocaine (30-60 min) then
      returned to control perfusate for recovery (60-120 min). Data were digitized and
      integrals computed for both monosynaptic and slow ventral root potentials (VRP).
      Low concentrations of lidocaine produced a selective reduction in the magnitude
      of the slow-VRP. At lidocaine concentrations of 1-10 micrograms/ml (3.6-36
      microM), the slow-VRP was reduced from 79% to 36% of control. Recovery to pre
      exposure control levels was slow and sometimes not complete after 60-120 min in
      drug-free perfusate. The monosynaptic component of the VRP was unaffected by
      lidocaine at any concentration, suggesting that the depression of the slow-VRP
      cannot be attributed to simple conduction block. The addition of naloxone 0.1
      microM to the perfusate had minimal effect on lidocaine-induced depression.
      Although resembling the selective effects of morphine, the antinociceptive
      effects of lidocaine do not appear to be primarily mediated through opiate
      receptors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784103
TI  - Prostanoid synthesis in the spinal cord enhances excitability of dorsal horn
      convergent neurones during reperfusion of ischaemic receptive fields on the rat's
      tail.
AB  - In 40 rats anaesthetized with enflurane, we identified convergent dorsal horn
      neurones responding to both noxious (pinch) and innocuous (brush) mechanical
      stimulation of their receptive fields on the tail. We recorded extracellular
      activity before and during ischaemia of the receptive fields, as well as during
      subsequent reperfusion. Two NSAIDs, indomethacin and diclofenac sodium, or saline
      were applied locally to the spinal cord before the induction of ischaemia. During
      ischaemia, spontaneous activity of the neurones increased significantly, and the
      responses to both pinch and brush were reduced significantly; indomethacin and
      diclofenac sodium had no effect on either spontaneous activity or sensitivity to
      mechanical stimuli. The neurones became hypersensitive to both pinch and brush
      during reperfusion of their receptive field, and receptive field size increased.
      Application of indomethacin and diclofenac sodium to the spinal cord abolished
      both the hypersensitivity and the increase in receptive field size. Our results
      indicate that spinal cord prostanoid synthesis facilitates the enhanced
      excitability of dorsal horn convergent neurones to both noxious and innocuous
      mechanical stimuli during reperfusion of their receptive fields, but does not
      affect the neurones' responses to receptive field ischaemia, nor their responses
      to mechanical stimuli in the absence of a conditioning stimulus.

PMID- 7784104
TI  - The effect of past-injury on pain threshold and tolerance.
AB  - Forty male veterans who had been injured during their military service in the
      Israeli Defense Forces were assessed for pain threshold and tolerance in a
      thermal pain procedure. Based on their medical records, subjects were classified
      by three independent judges as having been either severely or lightly injured.
      Veterans who had been severely injured had much higher threshold and tolerance
      for thermal pain as compared to lightly injured veterans. These results are
      interpreted as supporting adaptation-level theory, which implies that painful
      experiences can change the internal anchor points for the subjective evaluation
      of pain.

PMID- 7784105
TI  - Confirmatory factor analysis of a 4-factor model of chronic pain evaluation.
AB  - Extending the earlier work of Mikail et al. (1993), a confirmatory factor
      analysis (CFA; LISREL VII) of a 4-factor model of pain assessment was tested.
      This model, comprised of the Beck Depression Inventory (BDI) and 13 subscales of
      the McGill Pain Questionnaire (MPQ) and the West Haven-Yale Multidimensional Pain
      Inventory (WHYMPI), adequately accounted for the pain experience with minimal
      overlap. Subjects were 306 outpatient chronic pain patients seen at a
      multidisciplinary chronic pain clinic. Subscale scores were subjected to CFA
      procedures that yielded a well-fitting final model that explained 91% of the
      covariance in the observed data. This final model was derived through an
      exploratory post-hoc procedure that allowed for correlated errors among subscales
      of the same instrument. The 4 factors were identified as Affective Distress,
      Support, Pain Description, and Functional Capacity. Results supported the
      hypothesis that the MPQ, WHYMPI and BDI are representative of the
      multidimensionality of the pain experience with minimal overlap among measures.
      Theoretical and clinical implications of reducing the overlap among existing
      measures in the assessment of pain patients are discussed.

PMID- 7784106
TI  - The Chronic Pain Coping Inventory: development and preliminary validation.
AB  - This paper describes the development and validation of a measure of strategies
      used by patients to cope with chronic pain, the Chronic Pain Coping Inventory
      (CPCI). A 104-item measure of pain coping responses and 3 measures of functioning
      were completed by 176 chronic pain patients. Two-week retest data were provided
      by 111 of these patients. Item and scale analyses resulted in a 65-item measure
      that assessed 11 pain coping dimensions. This inventory was then cross-validated
      in a second sample of chronic pain patients (n = 78), who also completed a
      measure of pain-related distress. The significant others (typically, spouses) of
      patients in the second sample rated patients on a significant-other version of
      the CPCI and on other measures of patient functioning. The results support the
      reliability of the CPCI scales. Four scales (Guarding, Resting, Asking for
      Assistance, and Task Persistence) predicted patient- and significant other
      reported patient adjustment. Eight scales (Guarding, Opioid Medication Use, NSAID
      Use, Sedative-Hypnotic Medication Use, Resting, Asking for Assistance, and
      Exercise/Stretch) demonstrated moderate-to-strong relationships between patient
      and significant-other versions, further supporting their validity.

PMID- 7784107
TI  - Beneficial effects of ketamine in a chronic pain state with allodynia, possibly
      due to central sensitization.
AB  - Allodynia is a well-known component of neuropathic pain resulting from injury to
      the nervous system. Clinical pain states with allodynia in connection with
      longstanding superficial wounds have, however, not been reported in the
      literature. In this case a chronic pain state developed in a previously healthy
      17-year-old girl in and around a persistently suppurating appendectomy wound.
      There was no spontaneous pain but pronounced allodynia in the wound and in the
      surrounding skin. Quantitative thermal tests showed abnormal thresholds for
      several sensory modalities confirming abnormal processing of sensory input from
      the involved area. The pattern of sensory abnormalities evaluated with thermal
      testing changed transiently and the allodynia diminished during a phentolamine
      block. Since the pain responded poorly to opioids and ketamine has been reported
      to reduce allodynia, it was administered in a sub-dissociative bolus dose during
      wound dressing. The wound was essentially unchanged after treatment for 3 months
      but the allodynia and sensory aberrations had decreased significantly. We
      interpret these results as a de-sensitizing effect in the long term of repeated
      NMDA-receptor blockade by ketamine in a chronic pain state, with indications of
      central sensitization, partially maintained by sympathetic activity.

PMID- 7784108
TI  - Phantom limb pain: are cutaneous nociceptors and spinothalamic neurons involved
      in the signaling and maintenance of spontaneous and touch-evoked pain? A case
      report.
AB  - A patient suffered multiple fractures of the right leg and a left brain-stem
      infarction involving the anterolateral fasciculus of the central nociceptive
      system following multiple trauma. Later, the right leg was amputated, resulting
      in spontaneous and touch-evoked phantom pain and mechanical stump allodynia.
      However, quantitative sensory testing revealed considerable impairment of
      sensations normally mediated by cutaneous nociceptors and central spinothalamic
      systems on the right body side, including the stump but nearly intact touch and
      vibration senses. Quantitative assessment of peripheral nociceptive C-fiber
      function (axon reflex vasodilatation and flare) showed no abnormalities on both
      sides. Sympathetic blocks did not change spontaneous and evoked pain. Epidural
      and spinal anesthesia abolished evoked pain but had no effect on spontaneous
      phantom pain. Extirpation of a neuroma of the sciatic nerve did not alter
      spontaneous and evoked pain. TENS resulted in an increase in pain. We concluded
      the following. (i) Painful somatosensory memories that are responsible for
      phantom limb pain are located in the brain, most probably in the thalamus or
      cortex. (ii) Touch-evoked phantom pain and stump allodynia are not mediated by
      cutaneous nociceptive C and A delta fibers and spinal nociceptive pathways
      (spinothalamic tract). Activity in the lemniscal system (low-threshold
      mechanoreceptive A beta afferents, dorsal columns and medial lemnicus system) may
      be transferred to central pain signaling neurons in the thalamus or cortex
      resulting in touch-evoked pain sensations. (iii) Ongoing activity in cutaneous
      nociceptive C fibers and spinal nociceptive systems is not necessary to maintain
      central processes that account for spontaneous and touch-evoked pain sensations.
      Activity in nociceptors of deep somatic tissues might be more important.

PMID- 7784109
TI  - The riddle of trigeminal neuralgia.

PMID- 7784110
TI  - Anti-inflammatory efficacy of treatments with aspirin and acetaminophen.

PMID- 7784111
TI  - Comments on DeConno (Pain, 55 (1993) 383-385) and Brown (Pain, 56 (1994) 139-143)

PMID- 7784112
TI  - A comparison of the chest radiograph and computerised tomography in assessing
      lung changes in acute spinal injuries--an assessment of their prevalence and the
      accuracy of the chest X-ray compared with CT in their assessment.
AB  - Lung function in patients following an acute spinal injury is frequently much
      more compromised than may be expected from the level of injury and the chest
      radiograph appearance. Experimental evidence in anaesthetised patients and
      subsequently our own experience with patients with acute spinal injuries
      suggested that in paralysed patients lung changes were frequent and that in many
      spinal patients large pleural effusions and lung consolidation could be present
      without the usual associated chest radiograph changes being recognised. This
      study was performed to assess the prevalence of chest pathology and the
      sensitivity of the chest radiograph in portraying it. Sixty patients (50 males,
      10 females, 31 cervical, 29 thoracic or thoracolumbar; 15 incomplete, 45
      complete; ages 17-66, mode 22 years) with spinal injuries from a variety of
      causes were assessed with a supine chest radiograph and three computerised
      tomography axial cuts at standardised locations through the thorax. The chest
      radiograph agreed with the computerised tomography in only 12 patients (six
      normal, six abnormal). The chest radiograph suggested that there were 19 normals
      but computerised tomography only showed 12. In a total of 35 patients, the chest
      radiograph significantly underestimated the degree of change and in 13 the chest
      radiograph suggested greater pathology than was shown on computerised tomography.
      Thirteen of the 20 patients with cervical lesions but no chest trauma had lung
      changes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784113
TI  - Restoration of gait by functional electrical stimulation in paraplegic patients:
      a modified programme of treatment.
AB  - Restoration of standing and of gait by functional electrical stimulation in
      clinically complete paraplegic patients was modified in the course of treatment
      and in the stimulation parameters. By substituting an initial cyclic muscle
      strengthening with an active stimulated standing, four patients with T3-11
      lesions started walking with electrical stimulation in 10-17 days. They walked
      without ankle-foot orthoses. With a satisfactory stride length of 0.75-0.97 m,
      their gait velocity ranged from very slow to that of a leisurely healthy gait.
      Already established stimulation of the quadriceps muscles for standing and of the
      peroneal nerves for lower limb flexion during the swing phase of gait was
      applied. Diminished limb flexion after several weeks was restored by an increase
      of the stimulation frequency of the peroneal nerve from 20 to 60 Hz. EMG and
      kinesiological measurements displayed an improved direct response of the ankle as
      well as of the reflex mediated hip, knee and ankle flexion response. At the same
      time stimulation frequency was reduced to 16 Hz for the quadriceps muscles in
      order to reduce fatigue.

PMID- 7784114
TI  - The management of upper urinary tract calculi by piezoelectric extracorporeal
      shock wave lithotripsy in spinal cord injury patients.
AB  - From May 1988 to September 1994, 15 spinal cord injury patients were treated by
      piezoelectric extracorporeal shock wave lithotripsy. Aged from 23 to 71 years
      (mean = 39), they presented with a total of 23 stones, of which 18 were located
      in the calyces, three in the renal pelvis and two in the proximal ureter. The
      maximum dimensions of calculi varied from 5 to 35 mm (mean = 11). Patients were
      placed in a dorsal decubitus position during the sessions, three being sedated
      with diazepam, while the other 12 remained unsedated. All were treated routinely
      with systemic antibiotics. Auxiliary procedures consisted of two pyelocalyceal
      flushings, three double J ureteral stenting and three ureteroscopies with
      fragment removal with a Dormia basket. No episode of autonomic dysreflexia was
      observed. Short term side effects were limited to a few cases of gross haematuria
      which regressed spontaneously. Overall, eight successes (53%), and seven failures
      (47%), were registered. Of the failures, one was the result of a partial
      fragmentation, while six were related to intrarenal retention of residual
      fragments resulting in four cases in rapid recurrences. Extracorporeal shock wave
      lithotripsy can be easily applied to spinal cord injury patients. Its usefulness
      and limitations need to be well understood and a global consideration must be
      applied to the prevention and early detection of the upper urinary calculi in
      this exposed population of patients.

PMID- 7784116
TI  - Early progressive changes in tissue viability in the seated spinal cord injured
      subject.
AB  - The patient with spinal cord injury is at high risk of tissue breakdown at all
      times due to a number of adverse factors, such as reduced mobility and
      anaesthesia. It is therefore essential that each patient is prescribed
      appropriate support media during initial rehabilitation. In this study, the
      effectiveness of prescribed wheelchair cushions has been assessed in terms of
      tissue response at the ischial tuberosities. A total of 42 subjects who had
      sustained traumatic spinal cord injury within 1 year were monitored on at least
      two occasions during initial rehabilitation. Changes in transcutaneous gas
      response (TcPO2 and TcPCO2) were monitored concurrently with regional interface
      pressures. A series of six transcutaneous gas variables were established, as
      markers of tissue viability. Non-parametric statistical analyses revealed some
      significant correlations between these variables. The results of this study also
      indicate that (1) spinal cord injury subjects with lesions below T6 show a
      progressive decrease in ability to maintain blood flow in sitting on prescribed
      support cushions and (2) SCI subjects with lesions above T6 show a progressive
      improvement in tissue viability status at the seating support interface.
      Therefore results imply that paraplegics are at a potentially higher risk of
      tissue breakdown than tetraplegics and thus require effective support cushions
      with strict adherence to a pressure relief regime.

PMID- 7784117
TI  - Efficacy of rowing, backward wheeling and isolated scapular retractor exercise as
      remedial strength activities for wheelchair users: application of
      electromyography.
AB  - Shoulder dysfunction due to regular wheelchair use is a common problem among
      people with spinal cord injuries. As a remedial measure, strengthening of the
      scapular retractor muscles has been suggested. Electromyographical analysis was
      utilized to examine scapular retraction muscle use during rowing, backward
      wheeling and a standardized scapular retraction exercise in seven people with
      spinal cord injuries and seven able bodied subjects. In addition, a pilot study
      using indwelling electrodes was completed to validate the use and placement of
      surface electrodes. Both rowing and the standardized scapular retraction exercise
      recruited higher levels of retractor involvement than backward wheeling. We
      suggest that rowing, because of its value as a cardiovascular exercise and high
      level of retractor recruitment, is an appropriate and effective means of
      remediating scapular retractor weakness.

PMID- 7784118
TI  - Radiological percutaneous gastrostomy placement for enteral feeding.
AB  - Many patients who are unable to swallow have normal intestinal absorption and
      therefore do not need expensive and potentially problematic parenteral nutrition.
      Long term nasogastric tubes are unpleasant and interfere with communications,
      thus a gastrostomy is often felt to be appropriate. Traditionally this has been
      inserted at laparotomy but recently, other less invasive techniques of insertion
      such as endoscopy have been used for placement. We describe three patients where
      a percutaneous gastrostomy was placed by a radiological technique that we feel
      deserves wider recognition. It is quicker, cheaper and more versatile than the
      endoscopic method and avoids the unpleasant necessity for intubation by other
      than a fine-bore nasogastric tube.

PMID- 7784115
TI  - Degeneration of axons in the corticospinal tract secondary to spinal cord
      ischemia in rats.
AB  - Occlusion of the thoracic aorta and both subclavian arteries (XC) in the rat
      model produces spastic paraplegia. In order to characterize the lesion of white
      matter, 14 male Sprague-Dawley rats underwent XC for 10.5 to 12 min, were
      observed for 32 days and assessed with a lesion score. A sham group of eight
      underwent surgical manipulations without XC. The spinal cords were studied by
      optical microscopy and electron microscopy. An additional group of normal animals
      (n = 8) underwent spinal cord blood flow measurement with the autoradiographic
      technique. Optical microscopy showed normal histology in sham operated rats and
      rats with aortic cross-clamp and lesion score = 2-4 (n = 5), rare changes in the
      white matter of rats with lesion score = 8 (n = 2), and demyelination of the
      anterior and lateral tracts of the white matter and motor neuron loss in the gray
      matter of rats with lesion score = 13-15 (n = 7) and spastic paraplegia. In this
      last group, electron microscopy disclosed severe axonal degeneration of
      corticospinal tracts. In the same region spinal cord blood flow was higher than
      the remaining white matter. This study confirms that spastic paraplegia observed
      in the rat model after XC is due to degeneration of the pyramidal tracts, perhaps
      more susceptible to injury due to the high spinal cord blood flow.

PMID- 7784119
TI  - Trimethoprim-sulfamethoxazole prophylaxis against urinary tract infection in the
      chronic spinal cord injury patient.
AB  - Suppressive therapy with antibiotics has long been thought to decrease the number
      of complications from the neuropathic bladder in spinal cord injury patients, but
      it may also induce resistance to antibiotics which subsequently causes
      difficulties in treating symptomatic urinary tract infections. Forty-three
      chronic spinal cord injury patients were randomized to continue to receive daily
      trimethoprim-sulfamethoxazole (TMP-SMX) urinary tract prophylaxis versus
      discontinuing antibiotic prophylaxis. Patients were all at least 6 months after
      spinal cord injury. Patients were followed for a minimum of 3 months, with weekly
      catheter urine cultures. The difference in the colonization rate at onset and
      after 3 months (percent of cultures with asymptomatic bacteriuria) between the
      control and prophylaxis group was not statistically significant (P > 0.1). There
      was a significant decrease in the percentage of TMP-SMX resistant asymptomatic
      bacteriuria in the control group, 78.8%, compared to 94.1% in the suppressive
      group (P < 0.05). There was no significant difference in the number of
      symptomatic urinary tract infections following the withdrawal of suppressive
      therapy between the control group, 0.035/week, and the prophylaxis group,
      0.043/week (P > 0.5). There was a larger percentage of TMP-SMX resistant
      symptomatic urinary tract infections in the treated group, 42.5% versus 37.5% in
      the control group, but the difference was not significant (P > 0.5). Irrespective
      of the method of bladder management, suppressive therapy with TMP-SMX did not
      reduce the incidence of symptomatic bacteriuria and did increase the percentage
      of cultures resistant to TMP-SMX in asymptomatic patients.

PMID- 7784120
TI  - Compliance and complications of clean intermittent catheterization in the spinal
      cord injured patient.
AB  - The optimal management of the neuropathic bladder secondary to spinal cord injury
      remains unsettled. Some have advocated the use of chronic indwelling catheters in
      tetraplegic patients supposedly due to comparable complication rates with non
      indwelling catheter management. We assessed the urological complication and
      compliance rates in a group of spinal cord injured patients followed over a mean
      of 5.9 years. Complication rates from clean intermittent catheterization were
      comparable if not better than the rates previously reported for clean
      intermittent catheterization and significantly better than chronically
      catheterized patients. The compliance rate in our series was 71% as determined by
      the number of patients remaining on clean intermittent catheterization at their
      last urological follow-up. We conclude that the use of clean intermittent
      catheterization can provide optimal management of the lower urinary tract in
      spinal cord injured patients.

PMID- 7784121
TI  - Heterotopic ossification and rhabdomyolysis.
AB  - Heterotopic ossification and rhabdomyolysis are well described entities but, as
      far as we know, their association has never been described in the literature. We
      recently treated a patient who presented with this association. After a suicide
      attempt, this patient developed rhabdomyolysis of the left upper and lower limbs
      with peripheral neurological impairment. Two months later radiographs showed
      ectopic ossification around the left hip. Rhabdomyolysis is underdiagnosed, and
      is due to local disturbance of the calcium-phosphorus metabolism resulting in
      soft tissue calcifications. Underlying rhabdomyolysis may be a possible aetiology
      of heterotopic ossification. Recognition of this may help us to understand the
      pathophysiology and to improve the management of heterotopic ossification.

PMID- 7784122
TI  - Brucellar spondylitis mimicking lumbar disc herniation. Case report.
AB  - In this paper, a patient with brucellar spondylitis who was initially diagnosed
      as having a lumbar disc herniation is presented. As the disc tissue enlarges in
      the early stages of discitis because of the inflammatory reaction, it may
      compress the related root(s) mimicking a disc herniation. For this reason
      infectious discitis, as in our case, should be kept in mind in the differential
      diagnosis of the radicular symptoms caused by a disc herniation. The crucial role
      of magnetic resonance imaging in making the differential diagnosis of the case is
      especially emphasized.

PMID- 7784123
TI  - Prolonged fever and heterotopic ossification in a C4 tetraplegic patient. Case
      report.
AB  - Prolonged fever is an uncommon diagnostic problem in a spinal cord injury
      patient. The underlying causes include recurrent infections, thromboembolic
      phenomena and central fever. We report a case of heterotopic ossification in a
      traumatic C4 tetraplegic patient presenting as prolonged fever of 3 months'
      duration. Treatment with oral indomethacin led to prompt resolution of the fever
      and acute manifestations of heterotopic ossification. The efficacy of
      indomethacin in the treatment of heterotopic ossification in spinal cord injury
      needs to be further confirmed in larger studies.

PMID- 7784124
TI  - A commercial vaccine for ovine toxoplasmosis.
AB  - This paper describes the development of the first commercial vaccine for
      toxoplasmosis. The vaccine comprises live tachyzoites of the S48 'incomplete'
      strain of Toxoplasma gondii and is deployed to control toxoplasma abortion in
      sheep. A discussion of protective immune mechanisms and recent studies on host
      responses to the vaccine is also included.

PMID- 7784126
TI  - Field trials of an asexual blood stage malaria vaccine: studies of the synthetic
      peptide polymer SPf66 in Thailand and the analytic plan for a phase IIb efficacy
      study.
AB  - Several years ago the Walter Reed Army Institute of Research (WRAIR) initiated an
      independent analysis of the candidate malaria blood stage vaccine SPf66. WRAIR
      contracted for the synthesis and formulation of SPf66 in United States Food and
      Drug Administration (FDA) inspected laboratories within the U.S., and in 1992,
      filed an Investigational New Drug (IND) application with the FDA. Preclinical
      studies indicated that the vaccine could be synthesized to meet its release
      specifications, and when adjuvanted with alum, was essentially equivalent to
      Colombian produced SPf66 in regards to immunogenicity in preclinical studies of
      rodents and primates, and in human volunteers in Phase I studies. The goal of
      these efforts was ultimately to conduct a Phase IIb field trial to determine the
      safety and efficacy of SPf66 produced under current Good Manufacturing Practices
      (cGMP). Such a trial is currently underway in a malaria endemic refugee camp
      along the Thai-Burmese border. Here we briefly describe the study and present the
      formal analytic plan that was submitted to regulatory authorities in the United
      States for analysis of the study results. We believe such independent
      confirmatory studies are an essential part of the vaccine development process and
      are required to provide important data regarding the safety and efficacy of
      candidate vaccines in diverse geographical regions, and as a means to assess
      their role in the context of broader malaria control programmes.

PMID- 7784125
TI  - The development of oral vaccines against parasitic diseases utilizing live
      attenuated Salmonella.
AB  - Genetically defined, live attenuated Salmonella vaccines are proving useful both
      as oral vaccines against salmonellosis and for the development of multivalent
      vaccines based on the expression of heterologous antigens in such strains.
      Several candidate attenuated S. typhi strains are at present being evaluated as
      new single dose oral typhoid vaccines in human volunteers. The emergence of such
      a vaccine will facilitate the development of multivalent vaccines for humans.
      Many antigens from different infectious organisms have been expressed in
      attenuated Salmonella. A focus of this work has been on developing vaccines
      against parasitic diseases. This review will summarize the efforts that have been
      made in this area.

PMID- 7784127
TI  - Field trials of a recombinant rabies vaccine.
AB  - To improve both safety and stability of the vaccines used in the field to
      vaccinate foxes against rabies by the oral route, a recombinant vaccinia virus,
      expressing the glycoprotein of rabies virus (VVTGgRAB) has been developed.
      VVTGgRAB innocuity was verified in target species and in domestic animals as well
      as in numerous wild animal species that could compete with the red fox in
      consuming vaccine baits in Europe. Oral immunization of foxes, by distributing
      VVTGgRAB vaccine-baits, was undertaken for the whole infected area in Belgium
      (10,000 km2). Five campaigns of fox vaccination, were carried out from autumn
      1989 until 1991. Each time, 150,000 vaccine-baits were dropped by air at a mean
      density of 15 per km2. These campaigns induced a drastic decrease in the
      incidence of rabies and the elimination of the disease from 80% of the initially
      infected area. Regarding the geographical evolution of rabies in Belgium and in
      adjacent regions in neighbouring countries, new spatial strategies for bait
      dispersal were planned for 1992, 1993 and 1994: successive confined campaigns
      were carried out along political borders only. These campaigns induced a new
      decrease of incidence; no rabid fox could be detected in 1993 in spite of an
      improved epidemiological surveillance. In 1994, rabies was again confirmed in 13
      foxes collected in an area close to the French border. These cases demonstrated
      the persistence of a border rabies focus and justify further restricted
      vaccination campaigns.

PMID- 7784128
TI  - Commercialisation of a recombinant vaccine against Boophilus microplus.
AB  - Increasingly, there is need for methods to control cattle tick (Boophilus
      microplus) infestations by the use of non-chemical technology. This need is
      brought about by a mixture of market forces and the failure or inadequacy of
      existing technology. A recombinant vaccine has now been developed against the
      tick. This vaccine relies on the uptake with the blood meal of antibody directed
      against a critical protein in the tick gut. The isolation of the vaccine antigen,
      Bm86, and its production as a recombinant protein is briefly described. The
      vaccine has been tested in the field, has been taken through the full
      registration process and is now in commercial use in Australia. A related
      development has occurred in Cuba. The potential for improvement of the current
      vaccine and for the development of similar vaccines against other haematophagous
      parasites is discussed.

PMID- 7784129
TI  - Taenia ovis recombinant vaccine--'quo vadit'.
AB  - Several years have elapsed since the publication by Johnson et al. (1989) of the
      cloning of a recombinant antigen from the cestode parasite Taenia ovis which
      stimulated high levels of protective immunity in sheep. A great deal of
      subsequent research and development was necessary to bring the fledgling vaccine
      to the point of being a registered commercial product. The results of these
      subsequent studies are dealt with briefly in this paper, including the results of
      field trials. The T. ovis vaccine was registered by the New Zealand Animal
      Remedies Board in February 1994. Where then is the commercial product? This paper
      gives a background to market problems which have emerged through the politics
      (and realities) of the NZ T. ovis control campaign. It serves as notice that the
      best science dedicated to producing vaccines or products for parasitic, or other,
      diseases often faces significant hurdles in the real world of commerce and
      politics.

PMID- 7784130
TI  - The practicality and sustainability of vaccination as an approach to parasite
      control.
AB  - The development of a successful vaccine depends not only on the production of the
      vaccine itself, but also on the design pf the vaccination programme. This
      involves a better understanding of the epidemiology of the disease to be
      controlled, the delivery system to be used and the costs involved. This review
      focuses on current understanding of parasite population dynamics and
      epidemiology, and on the logistic experience gained from immunization programmes
      using existing viral and bacterial vaccines. The feasibility and sustainability
      of any new vaccine would greatly benefit from research into epidemiology and
      health systems which are conducted in parallel, rather than sequential to,
      vaccine development.

PMID- 7784131
TI  - Reduction of cytochrome aa3 measured by near-infrared spectroscopy predicts
      cerebral energy loss in hypoxic piglets.
AB  - Near-infrared spectroscopy is a noninvasive monitoring technique that allows
      quantitative measurement of changes in cerebral oxygenated Hb (HbO2),
      deoxygenated Hb (Hb), total Hb, and oxidized cytochrome aa3 (CytO2). Changes in
      cerebral Hb oxygenation and CytO2 have been measured in human neonates and
      infants under a variety of conditions. However, the association of these
      measurements with cerebral high-energy phosphate loss is not known. We studied
      simultaneous changes in cerebral HbO2, Hb, total Hb, and CytO2 by near-infrared
      spectroscopy and changes in nucleoside triphosphate (NTP, mostly ATP) and
      phosphocreatine (PC) concentrations and intracellular pH by in vivo 31P-labeled
      magnetic resonance spectroscopy. Four-wk-old piglets (n = 8) underwent sequential
      hypoxic episodes of increasing severity (inspired O2 concentration, 12, 8, 6, 4,
      and 0%). Animals were anesthetized and mechanically ventilated. At all levels of
      hypoxia, cerebral HbO2 decreased, and Hb increased. Loss of PC or NTP was not
      observed until inspired O2 concentration was decreased to less than 12%. With
      such severe hypoxia, hypotension, intracellular acidosis, and increasingly severe
      PC and NTP depletions occurred. Decreases in PC and NTP correlated closely with
      decreased CytO2 and arterial blood pressure (p < 0.0001) but not with changes in
      HbO2 and Hb. In conclusion, cerebral hypoxemia is readily detected by near
      infrared spectroscopy as a decrease in HbO2 and an increase in Hb. However,
      relative changes in cerebral HbO2 and Hb have low predictive value for cerebral
      energy failure. Reduction of CytO2 is highly correlated with decreased brain
      energy state and may indicate impending cellular injury.

PMID- 7784132
TI  - Glial fibrillary acidic protein in the cerebrospinal fluid: a possible indicator
      of prognosis in full-term asphyxiated newborn infants?
AB  - Glial fibrillary acidic protein (GFAP) is the structural protein of intermediate
      filaments in astroglia. GFAP has extensively been used as a marker of gliosis in
      neuropathology. It also appears in excessive amounts in the cerebrospinal fluid
      in various acute brain disorders. Hypoxic-ischemic encephalopathy after perinatal
      asphyxia is a condition in which levels of GFAP could be expected to be elevated
      if brain cell damage occurs. We examined levels of GFAP by a sensitive ELISA in
      the cerebrospinal fluid of full-term infants between 12 and 48 h after birth.
      Cerebrospinal fluid-GFAP increased 5-fold in infants after perinatal asphyxia
      compared with a reference group (675 versus 137 ng/L, p < 0.001). The levels of
      GFAP also increased gradually in accordance with the severity of the neurologic
      symptoms ranked as degree of hypoxic-ischemic encephalopathy. We conclude that
      the cerebrospinal fluid levels of GFAP might be an important adjunct in the
      neonatal assessment of infants subject to perinatal asphyxia, and together with
      other neuronal or glial proteins, it might also help in defining temporal
      relationships in asphyxia.

PMID- 7784133
TI  - Surfactant treatment at birth reduces lung vascular injury and edema in preterm
      lambs.
AB  - To study the effect of surfactant administration on fluid balance in the
      premature lung, we measured pulmonary vascular pressures, lung lymph and pleural
      liquid flow, and concentrations of protein in lymph, pleural liquid, and plasma
      before and after birth in 12 chronically catheterized preterm lambs (127-128 d
      gestation) treated with either placebo or surfactant just before surgical
      delivery. Eight lambs received intrapulmonary saline (placebo), and four lambs
      received surfactant; all lambs were mechanically ventilated with O2 for 8 h after
      birth. In control lambs, lung lymph and pleural liquid flow increased from 2.7 +/
      0.4 mL/h during the 2-4 h before birth to 9.2 +/- 2.1 mL/h by 6-8 h after birth;
      lymph and pleural space protein drainage increased from 58 +/- 7 mg/h during the
      2-4 h before birth to 134 +/- 25 mg/h by 6-8 h after birth. In lambs treated with
      surfactant, there was no significant increase in lymph and pleural liquid flow
      after birth (before birth, 2.3 +/- 0.3 mL/h; 6-8 h after birth, 3.4 +/- 0.9
      mL/h); likewise, lymph and pleural space protein drainage did not change after
      birth (before birth, 54 +/- 6 mg/h; 6-8 h after birth, 50 +/- 8 mg/h). Postmortem
      extravascular lung water was significantly less in lambs treated with surfactant
      compared with control lambs (control, 6.5 +/- 0.3 g/g dry lung; surfactant
      treated, 5.0 +/- 0.2 g/g dry lung).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784134
TI  - Surfactant protein-B supplementation improves in vivo function of a modified
      natural surfactant.
AB  - The effect of the addition of surfactant protein (SP)-B or SP-B plus SP-C (SP-BC)
      to a surfactant made from bovine lung (Survanta) was evaluated in 27-d-gestation
      preterm rabbits. The animals were treated with Survanta, Survanta + 2% SP-B,
      Survanta + 3% SP-BC, or sheep surfactant. They were then ventilated with 3 cm H2O
      positive end-expiratory pressure and tidal volumes of 8 mL/kg. Survanta + 2% SP-B
      was prepared by adding SP-B in water to Survanta or by adding SP-B in chloroform
      [SP-B(Chl)] to lipid-extracted Survanta. Dynamic compliances of the Survanta + 2%
      SP-B(Chl)- and Survanta + 3% SP-BC-treated rabbits were greater (p < 0.05) than
      those treated with Survanta or Survanta + 2% SP-B in water and were comparable to
      sheep surfactant. Postventilation pressure-volume curves for the groups treated
      with Survanta supplemented with SP-B had significantly larger retained volumes on
      deflation compared with those treated only with Survanta (p < 0.01). The effects
      of ventilation style on the responses were assessed by ventilating other groups
      of rabbits treated with Survanta, Survanta + 0.5% SP-B(Chl), Survanta + 2% SP
      B(Chl), or sheep surfactant with tidal volumes of 10 mL/kg and 0 cm H2O positive
      end-expiratory pressure. SP-B (2%) augmented the in vivo function of Survanta
      without positive end-expiratory pressure, and 0.5% SP-B had no effect. Infasurf,
      a surfactant with more SP-B, was more effective than Survanta when tested in the
      preterm rabbits. SP-B is a critical factor for optimum immediate surfactant
      function.

PMID- 7784135
TI  - Effects of triiodothyronine on retention of beta-adrenergic responsiveness of
      voltage-gated transmembrane calcium current during culture of ventricular
      myocytes from neonatal rabbits.
AB  - To study the effects of triiodothyronine (T3) on responsiveness of L-type calcium
      currents to beta-adrenergic stimulation in neonatal hearts, ventricular myocytes
      were isolated from neonatal rabbits and cultured in medium containing 10% fetal
      bovine serum to which T3 had been added to achieve either hypothyroid, euthyroid,
      or hyperthyroid conditions, as assessed by measurement of free T3 concentrations.
      During a 24-h culture period, the striated rod-shaped myocardial cells
      progressively assumed a stellate shape with reduced surface area; however, the
      rate constants for diffusion of Na+ from a microelectrode pipette into the cells
      remained unchanged. Voltage-dependent characteristics of L-type calcium currents
      as assessed by whole-cell voltage clamp studies were also unchanged after culture
      with various concentrations of free T3. By contrast, the stimulation of voltage
      gated transmembrane calcium current from baseline by isoproterenol was reduced (p
      < 0.05) in hypothyroid cells (15 +/- 8%; n = 14) compared with either euthyroid
      (86 +/- 15%; n = 18), hyperthyroid (54 +/- 16%; n = 12) or freshly isolated (50
      +/- 12%; n = 10) myocytes. The differences in beta-adrenergic responsiveness of
      voltage-gated transmembrane calcium current to isoproterenol between euthyroid,
      hyperthyroid, and freshly isolated cells were not significant (p > 0.05). These
      results indicate that retention of beta-adrenergic responsiveness of voltage
      gated transmembrane calcium current in neonatal cardiac myocytes depends on
      physiologic amounts of active thyroid hormone. Our culture method for neonatal
      cardiac myocytes will be useful for studying physiologic modulation of beta
      adrenergic responsiveness.

PMID- 7784136
TI  - Organization and fine structure of a pacemaker derived from fetal rat myocardium.
AB  - At an unknown point in mammalian development, cardiac precursor cells become
      committed to the cardiocyte phenotype. Certain of these are believed to
      specialize further into pacemaker cardiocytes. By culturing explanted embryonic
      ventricles into in vivo organ culture (Tucker DC, Snider C, Woods WT Jr: Pediatr
      Res 23:637-642, 1988), we observed pacemaker cells arising apparently from
      cardiocytes. We hypothesized that this event can be triggered by intercellular
      attachments, innervation, vascularization, or other factors. The present study
      was designed to test the hypothesis that primitive ventricular cells in the
      tubular heart can organize into an anatomically and electrophysiologically
      distinct pacemaker structure in the absence of innervation or vascularization
      from extrinsic sources. Developing ventricles of tubular hearts from 10-d-old rat
      embryos (n = 22) were excised and incubated in culture dishes. Within each
      explant, a group of cells organized into a uniform cluster (diameter, 150 +/- 50
      microns) after 8 +/- 2 d in culture. These cells resembled immature conduction
      system cells and had electrophysiologic features similar to those of mature
      pacemaker cells. Single-cell action potentials and impulse conduction patterns
      proved that the pacemaker cluster was the dominant pacemaker for the entire
      explant. These results confirm that, in the absence of extrinsic nerves and blood
      vessels, culture of the tubular ventricle elicits formation of an organized
      pacemaker, resembling the mature cardiac pacemaker and suggesting that contact
      with the culture dish surface or some other factor triggers conversion of
      cardiocytes to the pacemaker phenotype.

PMID- 7784138
TI  - Development and maturation of the autonomic nervous system in premature and full
      term infants using spectral analysis of heart rate fluctuations.
AB  - The changes in the power spectra of heart rate (HR) fluctuations, in particular
      the total power (within 0.02-2.0 Hz) and the power in the low- (0.02-0.2 Hz) and
      high- (0.2-2.0 Hz) frequency ranges, were computed from the ECG and respiratory
      signals of 59 premature and full-term infants. The objective of the study was to
      investigate the development and maturation of the autonomic nervous system from
      the first day of extrauterine life to several weeks of postnatal age. The study
      population was divided into four age groups. Group A: seven 1-d-old premature
      infants with gestational age of 34-35 wk. Group B: 28 premature infants 7-49 d
      old with a conceptional age of 34-35 wk. Group C: seven 1-d-old full-term infants
      of 39-41 wk gestation. Group D: six premature infants 35-97 d old with a
      conceptional age of 39-40 wk. Mean HR (+/- SEM) of groups C and D combined, i.e.
      135 +/- 2 bpm, was significantly lower compared with groups A and B, i.e. 152 +/-
      2 (p < 0.01). The mean (+/- SEM) of the low- to high-frequency power ratio
      obtained from the HR power spectrum decreased progressively from 71 +/- 31 in
      group A to 34 +/- 8 in group B, 16 +/- 3 in group C, and 17 +/- 2 in group D. The
      mean low to high ratio for the combined groups C and D, 17 +/- 1, was
      significantly lower compared with the combined group A and B, i.e. 44 +/- 9 (p <
      0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784137
TI  - Heart rate-dependent characteristics of diastolic ventricular filling in the
      developing chick embryo.
AB  - The contributions of the early (passive) and late (active) components of
      ventricular filling have been reported to decrease and increase, respectively,
      during chick embryo cardiac development. We hypothesized that the observed
      changes in ventricular filling during early cardiac development results from a
      decrease in cycle length. We studied the effect of development and cycle length
      on atrioventricular inflow in 28 chick embryos, Hamilton-Hamburger stages 17, 24,
      and 26. Cycle length was perturbed (range 240-1040 ms) in ovo by transiently
      heating or cooling the sinus venosus. Atrioventricular inflow and dorsal aortic
      velocities were obtained by 20-MHz pulsed Doppler flow-meter and digitally
      recorded at 500 samples per second. Stroke volume was calculated from dorsal
      aortic velocity and cross-sectional area. The atrioventricular inflow wave form
      was integrated and partitioned by area and percentage of total into early
      (passive) and late (active) components using three methods. Regardless of method,
      the proportion of filling volume due to the early and late components was cycle
      length and stage dependent (p < 0.05). The early and late filling volumes were
      large in the older embryos, and during cycle length decrease (heart rate
      increase) the early filling volume decrease was greater than the late filling
      volume decrease. When compared with the percentage of intrinsic heart rate, the
      percentage of stroke volume due to early filling decreased as heart rate
      increased and was greater in younger embryos at all heart rates. That due to late
      filling increased as the percentage of intrinsic heart rate increased.
      Ventricular filling characteristics are both developmentally determined and cycle
      length dependent.

PMID- 7784139
TI  - A potential role for adenosine in the inhibition of nonshivering thermogenesis in
      the fetal sheep.
AB  - Adenosine is released by the placenta into the fetal circulation and has potent
      antilipolytic properties in vitro. Nonshivering thermogenesis cannot be
      demonstrated by cooling fetal sheep in utero but can be induced by supplemental
      oxygenation and umbilical cord occlusion; this suggests the presence of
      inhibitor(s) of placental origin. To test whether circulating adenosine could be
      such an inhibitor, a series of experiments was carried out in nine fetal sheep at
      136-145 d gestation. Birth was simulated in utero by sequentially cooling the
      fetus 2.49 +/- 0.23 degrees C with no change in the low levels of plasma FFA or
      glycerol; ventilating with O2 via an exteriorized tracheostomy tube and umbilical
      cord occlusion. Thermogenic indices rose markedly, and plasma FFA and glycerol
      concentrations peaked at 725 +/- 88 microEq/L (p < 0.01) and 771 +/- 154 mumol/L,
      (p < 0.001), respectively, O2 consumption rose to 20 +/- 2 mL/min/kg, and
      temperature increased 1.99 +/- 0.35 degrees C. The long-acting adenosine analog
      N6-(L-2-phenylisopropyl)-adenosine (PIA) was then infused (90 micrograms/kg
      bolus, then 300 micrograms/kg/h for 30 min); plasma FFA and glycerol decreased to
      265 +/- 56 microEq/L (p < 0.003) and 477 +/- 102 mumol/L (p < 0.04),
      respectively; O2 consumption fell rapidly to 4.5 +/- 0.3 mL/min/kg (p < 0.01);
      temperature decreased 1.89 +/- 0.39 degrees C (p < 0.001); and fetal arterial BP
      decreased to 38 +/- 5 mm Hg (p < 0.004) in 30 min. A stepped dose-response study
      was performed in three fetal sheep.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784140
TI  - Dietary sodium modulates neonatal but not adult cardiac atrial natriuretic
      peptide in rats.
AB  - After an initial postnatal diuresis, neonates are in positive sodium balance.
      Because atrial natriuretic peptide (ANP) contributes to sodium homeostasis, this
      study was designed to evaluate the maturational effects of increased dietary
      sodium intake on cardiac ANP production. Preweaned Sprague-Dawley rat pups were
      artificially reared by feeding them either a normal-sodium or high-sodium diet
      for 7 d and were compared with maternally reared rat pups. Adult rats were
      divided into three groups: the first group was given ad libitum rat food and 1%
      sodium chloride to drink, the second group was pair-fed with this group but given
      tap water to drink, and the third group was fed ad libitum rat food and water for
      10 d. Atrial and ventricular pro-ANP and ANP contents and plasma ANP
      concentrations were measured by RIA. Steady state atrial and ventricular ANP mRNA
      expression was determined by Northern and dot-blot analysis. There was a 2-fold
      increase in atrial pro-ANP and ANP content and a 50% decrease in plasma ANP
      concentration in preweaned rat pups fed a high-salt diet. In contrast, atrial pro
      ANP and ANP content and plasma ANP concentration were not affected by increased
      sodium intake in adult rats. Atrial and ventricular ANP mRNA levels and
      ventricular pro-ANP and ANP contents were not altered by dietary sodium at either
      age. We conclude that chronic increase in sodium intake in the preweaning period
      results in increased storage of atrial pro-ANP. The decrease in plasma ANP
      concentration in these preweaned rats may be due to reduced basal secretion or
      enhanced degradation of the peptide.

PMID- 7784141
TI  - Effect of chronic infusion of cortisol on renin gene expression and renin
      response to hemorrhage in fetal lambs.
AB  - In the ovine fetus, plasma renin levels increase close to term, and renin
      responses to various stimuli are enhanced when compared with responses earlier in
      gestation. These changes are accompanied by increases in renal renin gene
      expression and renin content, and they occur in conjunction with elevations in
      fetal plasma cortisol. Thus, the purpose of this study was to test the hypothesis
      that a chronic, physiologic elevation in fetal plasma cortisol in early gestation
      would increase activity in the renin-angiotensin system prematurely. We studied
      fetuses (control, n = 8; cortisol infused, n = 11) at 94 +/- 2 d of gestation.
      Fetal vessels were catheterized, and cortisol or saline solution was infused for
      6 d. At the end of infusion, fetuses were hemorrhaged approximately 30% of
      estimated blood volume. Blood samples were collected to measure plasma renin
      concentration. Then the animals were killed, and kidneys were removed to measure
      renin mRNA and renin content. Plasma cortisol concentrations in the control and
      cortisol-treated animals were 7.2 +/- 0.8 and 57.7 +/- 8.6 nmol/L (p < 0.01),
      respectively. Basal plasma renin concentrations were similar in the two groups
      3.2 +/- 0.4 versus 4.4 +/- 1.8 ng of angiotensin I/mL/h, and there was a
      significant increase after hemorrhage in the cortisol-treated group only. Renal
      renin content and mRNA levels were similar in the two groups. These data indicate
      that chronic increases in cortisol in fetal lambs at 0.65 gestation significantly
      enhance the renin response to hemorrhage but do not alter renal renin gene
      expression.

PMID- 7784142
TI  - Role of metallothionein and cysteine-rich intestinal protein in the regulation of
      zinc absorption by diabetic rats.
AB  - Hyperzincuria and low Zn absorption in diabetic animals and humans have prompted
      speculation that diabetics are more susceptible to Zn deficiency. There is little
      information, however, describing the effects of diabetes on the biochemical
      mechanisms of intestinal Zn transport. We evaluated Zn absorption in
      streptozotocin-induced diabetic rats based on a model of Zn transport in which
      cysteine-rich intestinal protein serves as an intracellular carrier that is
      inhibited by metallothionein (MT). Apparent absorption and retention of Zn and Cu
      in rats fed a purified diet were measured in a balance study 15-17 d after
      induction of diabetes. The rate of 65Zn absorption from isolated intestinal
      segments, molecular distribution of 65Zn in mucosal cytosol, and tissue MT levels
      were measured on d 20-22. Food consumption, and thus Zn and Cu intake, by
      diabetic rats was twice that of controls. Although fractional absorption
      (percent) of Zn and Cu was lower in the diabetic rats, net absorption
      (micrograms/100 g body weight/d) was higher. The higher net absorption in the
      diabetic group was offset, however, by higher urinary excretion, so that Zn and
      Cu retention was similar in both groups of animals. Low fractional absorption is
      attributable to the down-regulation of intestinal Zn transport, as indicated by
      the lower rate of 65Zn absorption from isolated intestinal segments in the
      diabetic rats. Down-regulation of intestinal transport is in turn attributable to
      higher concentrations of intestinal MT, which resulted in more 65Zn in the
      mucosal cytosol bound to MT, an inhibitor of Zn transport, and less to cysteine
      rich intestinal protein.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784143
TI  - Dietary nucleotides enhance plasma lecithin cholesterol acyl transferase activity
      and apolipoprotein A-IV concentration in preterm newborn infants.
AB  - The activity of lecithin cholesterol acyl transferase (LCAT), a key enzyme in
      lipoprotein metabolism, is low in newborn preterm infants. It has been suggested
      that a normal gastrointestinal function might be necessary to induce a postnatal
      increase of LCAT activity because apoproteins A-I and A-IV (apoA-I and apoA-IV)
      synthesized in considerable amounts in the intestine are known activators of
      LCAT. Dietary nucleotides have been reported to enhance intestinal growth and
      maturation; therefore, we hypothesized that nucleotide supplementation to
      formulas for preterm infants may influence LCAT activity. To investigate this
      hypothesis, two groups of preterm infants were fed either a nucleotide-free
      formula or a nucleotide-supplemented formula during the first month of life. The
      plasma LCAT activity, plasma levels of apoA-I and apoA-IV, plasma cholesteryl
      esters, and plasma fatty acid composition of cholesteryl esters and phospholipids
      were then determined. Infants receiving nucleotides had higher LCAT activities
      and apoA-IV levels than those receiving the nucleotide-free formula for a few
      weeks. The changes in apoA-IV levels were highly correlated with those of the
      LCAT activities. However, there were no significant correlations between changes
      in LCAT activity and plasma cholesteryl esters or phospholipids. These findings
      indicate that nucleotide supplementation to formulas for preterm infants may
      improve dietary lipid tolerance by enhancing plasma LCAT activity, probably as a
      result of an increase in apoA-IV plasma concentrations; they also suggest that
      nucleotides may enhance apoA-IV synthesis in the intestine during the neonatal
      period.

PMID- 7784144
TI  - Correlations between maternal metabolism and deranged development in the
      offspring of normal and diabetic rats.
AB  - In an attempt to define the pathogenesis of congenital malformations in diabetic
      pregnancy, a number of serum factors were determined in normal and diabetic
      pregnant rats and correlated to the outcome of gestation with the aid of
      multivariate linear regression analysis. The animals were from two different
      lines of Sprague-Dawley rats with documented differences in rates of fetal
      dysmorphogenesis in diabetic pregnancy. The diabetic rats increased less in body
      weight than the normal rats, yet displayed increased liver and kidney weights.
      The serum concentrations of glucose, beta-hydroxybutyrate, triglycerides, the
      branched-chain amino acids, and asparagine, proline, alanine, citrulline,
      tyrosine, and ornithine were increased by diabetes. In contrast, IGF-I, glutamic
      acid, glutamine, cystine, and lysine were decreased in the serum of the diabetic
      pregnant rats. The maternal metabolic imbalance exerted profound effects on
      embryonic development. Thus, the embryos of the diabetic rats were smaller, had
      fewer somites, and contained less DNA and protein than the control embryos. In
      addition, the resorption and malformation rates were increased in the embryos of
      the diabetic rats. The regression analysis of the data revealed significant
      interrelationships between adverse embryonic outcome (rates of malformations and
      resorptions) and the maternal serum concentrations of glucose, triglycerides,
      beta-hydroxybutyrate, branched-chain amino acids, and creatinine. This suggests
      that the maternal metabolism of the three major classes of nutrients covariates
      with the embryonic development in diabetic rat pregnancy. The monitoring of only
      one of these maternal parameters, e.g. the serum glucose concentration, may
      therefore not adequately predict the developmental status of the offspring. Our
      results suggest that the pathogenesis of fetal malformations in diabetic
      pregnancy is multifactorial. Thus, maintaining metabolites from all nutrient
      classes at a normal level may be important in preventing adverse fetal outcome.

PMID- 7784145
TI  - Fatty acid oxidation in peripheral blood cells: characterization and use for the
      diagnosis of defects of fatty acid oxidation.
AB  - Disorders of mitochondrial fatty acid oxidation are increasingly recognized as an
      important group of inborn errors of metabolism that are associated with a
      significant, but easily preventable, morbidity and mortality in children.
      However, diagnosis is often delayed because there is no easily applied method
      that detects all defects. Therefore, we have characterized the acylcarnitine
      intermediates of fatty acid oxidation in peripheral blood cells from healthy
      control volunteers and patients with four different defects. After selective
      permeabilization with histone II AS, a novel permeabilizing agent, the cells were
      incubated with [U-14C]hexadecanoate and beta-oxidation flux and the acylcarnitine
      esters formed were measured. Blood cells from the control population produced
      large amounts of 3-hydroxyacylcarnitines and 2-enoylcarnitine esters, in addition
      to saturated acylcarnitine esters. This result is different from that found in
      other tissues (fibroblasts and muscle), where only saturated acylcarnitine esters
      could be detected. In blood cells from patients with defects of enzymes involved
      in long-chain fatty acid oxidation, flux was significantly reduced at 15 to 20%
      of control values (7.1 +/- 2.3 nmol C2 units formed per minute per International
      Unit of citrate synthase activity). There was a characteristic accumulation of
      acylcarnitines that was pathognomonic for the site of the defect. Thus, analysis
      of beta-oxidation intermediates from blood cells allows unequivocal
      identification of the four most common beta-oxidation defects.

PMID- 7784147
TI  - [Magnetic resonance imaging of sacral insufficiency fractures: characteristic
      features and differentiation from sacral metastasis].
AB  - Seven patients with sacral insufficiency fractures and seven patients with sacral
      metastasis were studied with MR imaging. The diagnoses were confirmed with other
      imaging modalities and clinical follow-up. The insufficiency fractures appeared
      as bands of abnormal signal: low signal intensity on T1-weighted images and
      slightly low to iso signal intensity on T2-weighted images. The lesions were
      delineated better on T1-weighted images than on T2-weighted images. The sacral
      alae were involved in all patients; five patients had bilateral lesions. The
      lesions that run across the sacral body were seen in three cases. Inclined
      coronal images were useful in demonstrating the pattern of distribution of the
      sacral insufficiency fractures. In three patients with follow-up MR studies, the
      lesions were markedly reduced or disappeared. The sacral metastatic tumors were
      of low signal in density on T1-weighted images and iso to high signal in density
      on T2-weighted images. The extent and distribution patterns of the lesions were
      various. It is possible to differentiate sacral insufficiency fractures from
      sacral metastases based on their distribution patterns on MRI. However, if the
      diagnosis is uncertain or if the symptoms persist or become worse, follow-up MR
      studies may be necessary.

PMID- 7784146
TI  - Identification of a unique form of protein C in the ovine fetus: developmentally
      linked transition to the adult form.
AB  - To investigate fetal development of protein C, a pregnant ovine model was used.
      Protein C was isolated from ovine plasma, and a polyclonal antibody was raised.
      Citrated plasma was obtained from undisturbed chronically catheterized fetal
      lambs. On Western blot, nonreduced adult ovine protein C had a molecular mass of
      70 kD. Fetal ovine protein C was determined to have a molecular mass of 4 to 6 kD
      larger than the adult molecule. Crossed immunoelectrophoresis demonstrated
      slightly increased anodal migration of the fetal form. Isoelectric focusing
      demonstrated a decreased pI of the fetal molecule (4.45 versus 4.6). The ovine
      protein C molecules were deglycosylated with N-glycanase. Deglycosylated fetal
      protein C migrated more similarly to the adult form, although a portion of the
      fetal form persisted. These experiments demonstrate the first example of a unique
      fetal form of a vitamin K-dependent protein and are compatible with increased
      glycosylation of fetal ovine protein C. It is speculated that altered
      posttranslational processing may exist as a general process by which certain
      coagulation proteins are modified during fetal development. mRNA was isolated
      from maternal and fetal hepatic tissue and analyzed by Northern hybridization.
      Fetal plasma concentration and hepatic mRNA for protein C were both 40% of normal
      maternal values from midgestation onward. At term, protein C mRNA increased to
      adult range (p < 0.025), although plasma protein C concentration decreased
      slightly (p < 0.001). A transition from fetal to adult protein C form was found
      beginning 6 d before term birth, with a doubling time of 24 h. These data are
      compatible with a gestationally determined maturation of ovine protein
      C.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784149
TI  - [Detectability of hypervascular small hepatocellular carcinoma by dynamic spiral
      CT].
AB  - Thirty-one cases of small hepatocellular carcinoma (HCC) under 3 cm in diameter
      underwent Spiral CT with bolus injection of contrast medium (Dynamic Spiral CT).
      Dynamic Spiral CT was compared with CT after intra-arterial injection of iodized
      oil (Lipiodol-CT). The detectability of 79 nodules of small HCC on early phase
      images of Dynamic Spiral CT was 49.4% (32.6% for those under 1 cm in diameter,
      58.3% for 1-2 cm, 91.7% for 2-3 cm). The detectability of small HCCs above the
      hilum of the liver was better than that below the hilum. Five lesions were
      detected only on delayed CT images, but not on early phase CT images. Dynamic
      Spiral CT is useful for detecting hypervascular small HCCs, and both early phase
      and delayed CT images must be obtained.

PMID- 7784148
TI  - [Evaluation of anastomosis between intrahepatic or extrahepatic vessels by intra
      arterial digital subtraction angiography using carbon dioxide].
AB  - Carbon dioxide (CO2) intraarterial subtraction angiography (IADSA) was performed
      in 31 patients with various hepatobiliary diseases. The injection sites of CO2
      were proper hepatic artery (10/31; group A), segmental hepatic artery (18/31;
      group B), and peripheral inferior phrenic artery (3/31; group C), respectively.
      In group A, only the third order branches of the portal venous system were
      visualized anterogradely in 8 of 10 patients. In group B, the microcatheter was
      placed coaxially through a 5 French guiding catheter at the main arterial supply
      of the tumor in 7 patients and at the peripheral segmental branch of the hepatic
      artery in 11 patients. The portal venous system was visualized retrogradely in
      all of the patients regardless of the injection site. The injected CO2 may flow
      back into the portal vein through the anastomosis known as the peribiliary or
      periportal plexus. In group C, not only the portal vein but also the pulmonary
      artery or pericardial vein were visualized by this method. CO2-IADSA was useful
      to image the minute communications between the various vessels, which have been
      not hitherto visualized by iodinated contrast medium.

PMID- 7784150
TI  - [Alginate gel beads for chemoembolization: initial report].
AB  - Alginate gel beads (AGB) were studied as a new material for chemoembolization
      therapy. AGB were quickly produced by dripping a sodium alginate solution through
      a cannula into a calcium chloride solution, with bead size controlled by cannular
      size. AGB containing adriamycin or contrast medium were produced from the
      corresponding mixture. Sixty percent of adriamycin was eluted from AGB within one
      hour and 90% within 24 hours, while 95% of iopamidol was eluted in 30 minutes.
      AGB released these contents slower than gelatin sponge particles. Four dogs
      underwent transcatheter hepatic arterial embolization with AGB. Normal daily
      activity was recorded until sacrifice on the fourteenth day. There was no hepatic
      infarction in those embolized with AGB of 0.5 to 1.0 mm in diameter. Partial
      liver infarction was found in one with compelled embolization and in two with
      fragile beads. These observations suggested that AGB constitute an instantly
      preparable embolic material with slow-release activity and flexible solidity.

PMID- 7784152
TI  - [Application of digital tomosynthesis to radiographic diagnosis of the temporal
      bone: studies on visualization in normal subjects].
AB  - To examine the usefulness of digital tomosynthesis for conducting radiographic
      diagnosis of the temporal bone, visualization of various aural structures such as
      the semicircular canals, cochlea, vestibular apparatus, ossicles of the ear and
      facial nerve canal was examined in 18 volunteers. The visualization of temporal
      bone specimens by digital tomosynthesis and CT images (slice thickness: 1.5 mm)
      was compared. The results showed that this system (Digital Tomosynthesis)
      produced clear images of bony labyrinthine structures such as the semicircular
      canals, cochlea, and vestibular apparatus. Visualization of the ossicles was also
      clear, and their continuity could be comprehended better than on CT images. This
      system also provided good visualization of the labyrinthine and tympanic parts of
      the facial nerve canal, although CT images had greater sharpness. Visualization
      of the lower half of the mastoid part was poor with this system.

PMID- 7784151
TI  - [MR imaging of intramuscular hemangiomas].
AB  - Magnetic resonance images of eight surgically confirmed intramuscular hemangiomas
      were correlated with the pathologic findings. T1- and T2-weighted images were
      obtained in all cases; STIR images were also obtained in six cases, and fat
      suppressed enhanced images in seven cases. All eight hemangiomas showed markedly
      high signal intensity on T2-weighted images. Linear and round low-signal
      intensity components within hemangiomas corresponded to fibrous tissues, high
      flow vessels and phleboliths. Fat-suppressed enhanced images were superior to
      images without fat suppression in defining the extent of lesions. STIR images
      were useful in defining the extent of hemangiomas with infiltration into
      surrounding tissues. MRI is useful for distinguishing intramuscular hemangiomas
      from other soft tissue tumors and also supplies valuable information about the
      extent of the lesions.

PMID- 7784153
TI  - [Dose-volume histogram analysis of patients with hepatocellular carcinoma
      regarding changes in liver function after proton therapy].
AB  - Seventy-five patients with hepatocellular carcinoma were treated with proton
      beams from 1983-1993 at the Proton Medical Research Center, University of
      Tsukuba. For the purpose of confirming the feasibility of proton therapy for
      hepatocellular carcinoma, we investigated the influence of proton therapy on
      liver function and also tried to evaluate the possibility of optimization using
      dose-volume histogram (DVH) analysis. The results indicated that proton therapy
      did not cause clinically symptomatic damage in liver function and the only
      notable change after proton therapy was the transient increase of transminase.
      DVH analysis showed that this transient increase of transaminase was well
      correlated to the normal tissue complication probability (NTCP). These results
      indicate that localized high dose radiation using proton beams is feasible for
      the treatment of liver cancers and optimization of this treatment may be possible
      using DVH analysis.

PMID- 7784155
TI  - [Assessment by three-dimensional CT of pleural indentation or invasion by
      peripheral lung cancer].
AB  - We evaluated the effectiveness of three-dimensional (3D) CT for pleural
      indentation or invasion by peripheral lung cancer adjacent to pleura. Pleural
      indentation was shown in three of nine cases on conventional CT, and six cases
      were demonstrated three-dimensionally. 3D-CT was superior to conventional CT in
      demonstrating pleural indentation. Pleural invasion could not be assessed on 3D
      CT because the pleura adjacent to the tumor was not visualized.

PMID- 7784154
TI  - [Trial of a small image network system in a radiology department of an university
      hospital].
AB  - This paper describes the construction of an image network system in Shinshu
      University Hospital, and some of its current issues and advantages. Our
      discussion is based on our experience with a PACS system. SAIPACS, which was
      installed in 1990 for use in clinical conferencing and pre- and post-graduate
      education, and with a new CT and MRI network, which was subsequently introduced
      in 1993. The SAIPACS interconnects eight digital imaging modalities, including
      CT, MRI, XTV-DR (including digital tomosynthesis), FCR, nuclear medicine (RI),
      DSA, US, and a film digitizer (FD), with a workstation. Transmission time from
      the magnetic disk of each imaging modality to the SAIPACS image disk is not rapid
      enough. Therefore, we need to select images for transfer that are pertinent to
      our specific purpose, to complete image transmission within a practically
      acceptable period of time. The new CT/MRI network is composed of two CT units,
      two MRI systems, an image processing unit and a Universal Gateway. It provides
      faster image transmission than the SAIPACS system, because there is no need to
      reform image data to send them in a reversible compressed form. A versatile
      network system connected to the SAIPACS and CT/MRI network enables digital image
      data to be processed and edited and images to be transferred back to SAIPACS for
      clinical or educational use.

PMID- 7784156
TI  - [Evaluation of photon-counting X-ray radiography for the detection of pulmonary
      nodule: a preliminary report on experimental and clinical studies].
AB  - To evaluate the utility of photon counting X-ray radiography (quantum
      radiography: QR) for the detection of pulmonary nodules, experimental and
      clinical studies were performed in comparison with conventional X-ray (CXR). In
      the experimental study, spatial resolution was analyzed by using the micro-chart
      method. The simulated nodule detection study was performed by using a chest
      phantom. The results were evaluated by means of ROC analysis. In the clinical
      study, both images of CXR and QR were evaluated in a case of metastatic lung
      tumor. In the experimental study, the spatial resolution of QR was 200 microns.
      QR was superior to CXR in detecting simulated nodules in all areas. In clinical
      cases, QR was superior to CXR in depicting not only normal structures but also
      retrocardiac and retrodiaphragmatic pulmonary nodules.

PMID- 7784157
TI  - [19F-MR imaging of transplanted tumor: perfluorochemicals as a fluorine tumor
      imaging agent].
AB  - PURPOSE: The purpose of our study was to detect tumor selectively using 19F
      magnetic resonance imaging (MRI) and to assess Fluosol-DA, a perfluorochemical
      emulsion, as a tumor imaging agent for 19F-MRI. MATERIALS AND METHODS: SCC VII
      cells were transplanted in the right leg of mice. After 6 days, Fluosol-DA was
      administrated intravenously (40 ml/kg). 19F-MR imaging was performed on a Bruker
      CSI Omega 2 at 4.7 Tesla using a homemade volume coil. RESULTS: In vitro, the
      concentration and 19F signal intensity of FDA showed a very high correlation (r =
      0.9997). Detection on MRI was possible at a concentration of 2%. In vivo, images
      of 19F in SCC VII tumors were achieved in animals 2 days after the administration
      of FDA. CONCLUSION: Our study confirms the feasibility of 19F-MR in vivo imaging
      of tumors using the fluorine compound FDA.

PMID- 7784158
TI  - [3D-MR cholangio-angiography].
AB  - This report introduces a new 3D-MR cholangioangiography technique using 3D Fast
      SE MR cholangiography and 3D phase contrast MR angiography for obstructive
      jaundice. In all eight cases, dilated biliary tracts as well as portal veins were
      clearly visualized on the same image. This new technique helped to determine the
      operability and surgical strategy for cases with obstructive jaundice. It also
      provided anatomical guidance for surgical procedures. This study suggests that
      this technique may replace the currently used modalities for obstructive
      jaundice.

PMID- 7784159
TI  - [Patient insurance in Scandinavia].

PMID- 7784160
TI  - [Positive experiences in Scandinavian patient insurance].
AB  - Voluntary insurance for the compensation of patients for damage sustained in
      health care was introduced in Sweden 20 years ago and similar systems exist in
      Finland, Denmark and Norway. This type of insurance is, or is in the process of
      becoming, statutory. The basic principle is that the apportioning of blame to any
      individual(s) is not a prerequisite for compensation to be paid out for injury
      sustained by a patient. Owing to hospital proprietors and care givers having
      taken out patient insurance policies with approved insurance companies, it has
      been possible for damages to be compensated in accordance with current insurance
      norms and the frequency of lawsuits arising from injury sustained in health care
      has been minimised. This type of insurance is universally accepted, and has often
      enabled unfortunate confrontations between doctors and patients to be avoided.

PMID- 7784161
TI  - [Patient insurance in preventive activities. Wealth of injury material
      demonstrates risks of complications].
AB  - The patient insurance system in Sweden has manifest advantages where the mapping
      out of complications to medical treatment is concerned. The insurance data base
      contains a wealth of information which can be used for preventive purposes--not
      only overall statistics, but also patients' records and expert opinions in damage
      cases. During the 20 years since patient insurance was introduced, cases of
      special fundamental interest have been published, injury statistics have reported
      to clinics and departments, and certain issues have undergone special scrutiny-
      e.g. neural damage during surgery, infections arising from cataract surgery, bile
      duct injuries, injuries at delivery and damage resulting from physiotherapy.

PMID- 7784162
TI  - [Multiple sclerosis--the great imitator!].
AB  - Multiple sclerosis (MS) is traditionally a clinical diagnosis based on relapsing
      and remitting multifocal CNS symptoms. In recent years new diagnostic tools such
      as cerebrospinal fluid analysis, magnetic resonance imaging and evoked potential
      testing have been developed. This article reviews diagnostic difficulties and
      discusses other medical conditions that can be mistaken for MS due to similar
      clinical, laboratory or radiological findings.

PMID- 7784163
TI  - [Astute in vivo observations discover anti-asthma medication].
AB  - Will the new reductive biology write the book of revelation of all progress as
      concerns the pathophysiology and pharmacology of asthma? The early and recent
      medical history of anti-asthma drugs supports the possibility that exploratory in
      vivo research involving patients and disease-like test systems may "unexpectedly"
      provide leap discoveries in pathophysiology and pharmacology. New treatments
      based on defined molecular disease mechanisms will no doubt emerge. However, the
      future may also hold novel important anti-asthma drugs where the exact mode of
      action remains a challenge. Indeed, many aspects of the efficacies of the already
      long established anti-asthma drug principles have yet to be explained at the end
      organ, cellular and molecular levels.

PMID- 7784164
TI  - [Health and environment strategy in WHO].

PMID- 7784165
TI  - [Preventive activities for the elderly--what happens after screening?].
AB  - Preventive geriatric health care has become a regular part of geriatric health
      service in some of Norway's municipalities. There are many reports concerning the
      findings from screenings, but there is little material about the target group's
      experience with the subsequent intervention. This article describes the results
      from interviews with the elderly in three municipalities, concerning the
      perceived value of participating in geriatric screening. A random sample
      comprising 60 persons with a registered need of intervention was interviewed. Of
      the registered needs, intervention was implemented in 69 percent of the cases. In
      65 percent of the cases the elderly person was satisfied with the intervention,
      five percent were dissatisfied and for 30 percent, the registration of a need for
      intervention had no practical significance. In 26 percent of the cases of
      registered need, the elderly person planned to seek assistance from the
      health/assistance services on his/her own. The most important reasons why
      intervention was not implemented were: the lack of a service to intervene in
      cases of loneliness and/or social isolation, and the lack of motivation on the
      part of the elderly to seek dental treatment.

PMID- 7784166
TI  - [Problem-based learning during surgery courses--good experiences with combination
      curriculum].
AB  - Problem solving and critical thinking are important components of problem based
      learning (PBL). The driving forces are the students' interest, involvement and
      sense of responsibility. A curriculum comprising a combination of PBL and
      conventional instruction was introduced during the surgery course at Huddinge
      Hospital in the autumn term 1993. The results showed the level of knowledge
      attained by the students to be comparable with that attained under conventional
      instruction. The authors of the article conclude that good results can be
      obtained by introducing PBL in isolated sections of medical education within the
      framework of an otherwise traditional curriculum.

PMID- 7784167
TI  - [Society for homosexual physicians in Scandinavia].

PMID- 7784168
TI  - Distamycin A and tallimustine inhibit TBP binding and basal in vitro
      transcription.
AB  - The antibiotic distamycin A is a DNA minor groove binding drug (MGB) that
      recognizes a stretch of at least four ATs. The alkylating benzoyl mustard
      derivative tallimustine (FCE 24517) has powerful anti-tumor activity. Using the
      electrophoretic mobility shift assay (EMSA) we determined that both compounds can
      prevent binding of TBP and, with 10-fold higher concentration, TBP-TFIIA (DA) and
      TBP-TFIIA-TFIIB (DAB) to a TATA box. Once formed, the DA and DAB complexes are
      more resistant to MGB challenge. Both drugs can inhibit basal in vitro
      transcription of a minimal TATA-containing promoter and similar concentrations
      are necessary for binding and transcriptional inhibition. Tallimustine shows
      strong selectivity by decreasing only correctly initiated transcripts. Even at
      high doses (20 microM), however, they cannot disturb a competent pre-initiation
      complex or Pol II progression. This functional in vitro model will provide a way
      to investigate the activity of sequence-specific DNA binding drugs with potential
      anti-viral and anti-tumour activity and to develop novel more selective
      compounds.

PMID- 7784169
TI  - Novel reagents for chemical cleavage at abasic sites and UV photoproducts in DNA.
AB  - Hot piperidine is often used to cleave abasic and UV-irradiated DNA at the sites
      of damage. It can inflict non-specific damage on DNA, probably because it is a
      strong base and creates significant concentrations of hydroxyl ions which can
      attack purines and pyrimidines. We show that several other amines can cleave
      abasic DNA at or near neutral pH without non-specific damage. One diamine, N,N'
      dimethylethylenediamine, efficiently cleaves abasic DNA at pH 7.4 by either beta-
      or beta,delta-elimination, depending on temperature. Using end-labelled
      oligonucleotides we show that cleavage depends mainly on elimination reactions,
      but that 4',5'-cyclization is also significant. This reagent also cleaves at
      photoproducts induced by UVC and UVB, producing the same overall pattern as
      piperidine, but with no non-specific damage. It should prove valuable in locating
      low levels of photoproducts in DNA, such as those induced by natural sunlight.

PMID- 7784170
TI  - Sequencing of an upstream region of the human HLA-DRA gene containing X' and Y'
      boxes.
AB  - In this paper we report the characterization of a newly sequenced 5' upstream
      region of the human HLA-DRA gene. We performed (i) search for transcription
      factor motifs, (ii) analysis of CpG display and observed/expected frequency
      ratios, (iii) search for regions homologous to the 5' upstream sequences of the
      murine EA gene, (iv) DNase I footprinting experiments and (v) electrophoretic
      mobility shift assays. Our results demonstrate the existence, in the HLA-DRA
      gene, of Y' and X' boxes highly homologous to the Y and X boxes present in MHC
      class II genes, but oriented in the opposite direction. These Y' and X' boxes
      have been conserved during the molecular evolution of both human HLA-DRA and
      murine EA genes. DNase I footprinting and gel retardation experiments suggest
      that the X' and Y' boxes of the HLA-DRA upstream gene region are specifically
      recognized by nuclear proteins that also bind to the X and Y boxes of the HLA-DRA
      proximal promoter, respectively.

PMID- 7784171
TI  - Regulation of the Saccharomyces cerevisiae DNA repair gene RAD16.
AB  - The RAD16 gene product has been shown to be essential for the repair of the
      silenced mating type loci [Bang et al. (1992) Nucleic Acids Res. 20, 3925-3931].
      More recently we demonstrated that the RAD16 and RAD7 proteins are also required
      for repair of non-transcribed strands of active genes in Saccharomyces cerevisiae
      [Waters et al. (1993) Mol. Gen. Genet. 239, 28-32]. We have studied the
      regulation of the RAD16 gene and found that the RAD16 transcript levels increased
      up to 7-fold upon UV irradiation. Heat shock at 42 degrees C also results in
      elevated levels of RAD16 mRNA. In sporulating MAT alpha/MATa diploid cells RAD16
      mRNA is also induced. The basal level of the RAD16 transcript is constant during
      the mitotic cell cycle. G1-arrested cells show normal induction of RAD16 mRNA
      upon UV irradiation demonstrating that the induction is not a secondary
      consequence of G2 cell cycle arrest following UV irradiation. However, in cells
      arrested in G1 the induction of RAD16 mRNA after UV irradiation is not followed
      by a rapid decline as occurs in normal growing cells suggesting that the down
      regulation of RAD16 transcription is dependent on progression into the cell
      cycle.

PMID- 7784172
TI  - A modified oestrogen receptor ligand-binding domain as an improved switch for the
      regulation of heterologous proteins.
AB  - A number of proteins have been rendered functionally oestrogen-dependent by
      fusion with the hormone-binding domain of the oestrogen receptor. There are,
      however, several significant disadvantages with such fusion proteins. First,
      their use in cells in vitro requires phenol red-free medium and laborious
      stripping of steroid hormones from serum in order to avoid constitutive
      activation. Secondly, control of oestrogen receptor fusion proteins in vivo is
      precluded by high endogenous levels of circulating oestrogens. Thirdly, the
      hormone-binding domain of the oestrogen receptor functions as a hormone-dependent
      transcriptional activation domain making interpretation of fusions with
      transcription factors problematical. In order to overcome these drawbacks we have
      used a transcriptionally inactive mutant of the murine oestrogen receptor which
      is unable to bind oestrogen yet retains normal affinity for the synthetic ligand,
      4-hydroxytamoxifen. When the hormone-binding domain of this mutant oestrogen
      receptor is fused to the C-terminus of the c-Myc protein, Myc-induced
      proliferation and apoptosis in fibroblasts becomes dependent on 4
      hydroxytamoxifen, but remains refractory to 17 beta-oestradiol.

PMID- 7784174
TI  - The processing of macronuclear-destined DNA sequences microinjected into the
      macronuclear anlagen of the hypotrichous ciliate Stylonchia lemnae.
AB  - We describe the construction of a vector carrying the micronuclear versions of
      two macronuclear DNA molecules, one of which was modified by the insertion of a
      polylinker sequence. This vector was injected into the polytene chromosomes of
      the developing macronucleus of Stylonychia and its processing during further
      macronuclear development and its fate in the mature macronucleus were analyzed.
      In up to 30% of injected cells the modified macronuclear DNA sequence could be
      detected. While the internal eliminated sequences (IES) present in the
      macronuclear precursor DNA sequence are still retained in the mature
      macronucleus, the modified macronuclear DNA sequence is correctly cut out from
      the vector, telomeres are added de novo and it is stably retained in the
      macronucleus during vegetative growth of the cells. This vector system represents
      an experimental system that allows the identification of DNA sequences involved
      in the processing of macronuclear DNA sequences during macronuclear development.

PMID- 7784175
TI  - A trigonal form of the idarubicin:d(CGATCG) complex; crystal and molecular
      structure at 2.0 A resolution.
AB  - The X-ray crystal structure of the complex between the anthracycline idarubicin
      and d(CGATCG) has been solved by molecular replacement and refined to a
      resolution of 2.0 A. The final R-factor is 0.19 for 3768 reflections with Fo > or
      = 2 sigma (Fo). The complex crystallizes in the trigonal space group P31 with
      unit cell parameters a = b = 52.996(4), c = 33.065(2) A, alpha = beta = 90
      degree, gamma = 120 degree. The asymmetric unit consists of two duplexes, each
      one being complexed with two idarubicin drugs intercalated at the CpG steps, one
      spermine and 160 water molecules. The molecular packing underlines major groove
      major groove interactions between neighbouring helices, and an unusually low
      value of the occupied fraction of the unit cell due to a large solvent channel of
      approximately 30 A diameter. This is the first trigonal crystal form of a DNA
      anthracycline complex. The structure is compared with the previously reported
      structure of the same complex crystallizing in a tetragonal form. The geometry of
      both the double helices and the intercalation site are conserved as are the
      intramolecular interactions despite the different crystal forms.

PMID- 7784173
TI  - A novel initiator regulates expression of the nontissue-specific helix-loop-helix
      gene ME1.
AB  - The mouse ME1 gene (HEB, REB and GE1, homologues in human, rat and chick,
      respectively) is a member of the nontissue-specific helix-loop-helix (HLH) gene
      family that includes E2A, E2-2 and Drosophila daughterless. We have examined the
      factors that control ME1 gene expression. ME1 is a single copy gene that spans >
      or = 150 kb of DNA and contains > 10 exons. Transcription was directed by an
      unusual initiator element that contained a 13 bp poly d(A) tract flanked by
      palindromic and inverted repeat sequences. Both RNase protection and primer
      extension analyses mapped the ME1 transcriptional start site to the center of the
      13 bp poly d(A) tract. The ME1 initiator and its proximal sequences were required
      for promoter activity, supported basal levels of transcription, and contributed
      to cell type-specific gene expression. Other cis-elements utilized by the TATA
      less ME1 promoter included a cluster of Sp1 response elements, E-boxes and a
      strong repressor. Collectively, our results suggest that the ME1 initiator and
      other cis-elements in the proximal promoter play an important role in regulating
      ME1 gene expression.

PMID- 7784176
TI  - A gene-type-specific enhancer regulates the carbamyl phosphate synthetase I
      promoter by cooperating with the proximal GAG activating element.
AB  - The rat carbamyl phosphate synthetase I gene is expressed in two cell types:
      hepatocytes and epithelial cells of the intestinal mucosa. The proximal promoter
      contains a single activating element, GAG, two repressor elements (sites I and
      III) and an anti-repressor element (site II). Although these elements together
      exhibit the potential for complex regulation, they are unable to confer tissue
      specific promoter activity. Here we have identified a cell-type-specific enhancer
      that lies 10 kilobases upstream of the promoter. Unexpectedly, the enhancer also
      functioned in a gene-type-specific manner. The enhancer stimulated promoter
      activity exclusively through the proximal GAG element. Abrogation of GAG, either
      directly by mutation of GAG or indirectly by sites I and III repressors,
      abolished enhancer activation. Conversely, activation of the heterologous
      thymidine kinase promoter by the enhancer required the introduction of GAG. The
      requirement for GAG, therefore, functions to constrain the enhancer to a specific
      target promoter.

PMID- 7784177
TI  - Physical and functional interaction of the Epstein-Barr virus BZLF1
      transactivator with the retinoic acid receptors RAR alpha and RXR alpha.
AB  - Epstein-Barr virus (EBV) reactivation, indicated by induction of EBV early
      antigens from latently infected lymphoid cell lines by phorbol esters, is
      inhibited by retinoic acid (RA). Viral reactivation, which is triggered by the
      immediate-early BZLF-1 (Z) viral gene product, is repressed by retinoic acid
      receptors (RARs) RAR alpha and RXR alpha. These proteins negatively regulate Z
      mediated transactivation of the promoter for an EBV early gene product, early
      antigen-diffuse (EaD). Here we confirm a direct physical interaction between the
      AP1-like protein Z and RXR alpha and map the domains of interaction in the Z
      protein and RXR alpha. The domain required for homodimerization of Z is separate
      from that required for its interaction with RXR alpha. Z also has the effect of
      repressing activation of an RAR-responsive cellular promoter (BRE). Point mutants
      in the dimerization domain of Z unable to interact with RXR alpha do not repress
      RXR alpha-mediated transactivation of BRE, the promoter for RAR beta, which
      suggests that interaction between the two proteins is required for this repressor
      effect. The domain of RXR alpha required for interaction with Z has been mapped,
      and is again separate from that required for homodimerization. These results
      indicate that a 'cross-coupling' or direct interaction between Z and RAR alpha
      and RXR alpha can modulate the reactivation of latent EBV infection and suggest
      that, reciprocally, the viral protein Z may influence cellular regulatory
      pathways.

PMID- 7784178
TI  - Genetic and molecular analysis of the tRNA-tufB operon of the myxobacterium
      Stigmatella aurantiaca.
AB  - The tufB gene, encoding elongation factor Tu (EF-Tu), from the myxobacterium
      Stigmatella aurantiaca was cloned and sequenced. It is preceded by four tRNA
      genes, the first ever described in myxobacteria. The tRNA synthesized from these
      genes and the general organization of the locus seem identical to that of
      Escherichia coli, but differences of potential importance were found in the tRNA
      sequences and in the intergenic regions. The primary structure of EF-Tu was
      deduced from the tufB DNA sequence. The factor is composed of 396 amino acids,
      with a predicted molecular mass of 43.4 kDa, which was confirmed by expression of
      tufB in maxicells. Sequence comparisons between S.aurantiaca EF-Tu and other
      bacterial homologues from E.coli, Salmonella typhimurium and Thermus thermophilus
      displayed extensive homologies (75.9%). Among the variable positions, two Cys
      residues probably involved in the temperature sensitivity of E.coli and
      S.typhimurium EF-Tu are replaced in T.thermophilus and S.aurantiaca EF-Tu. Since
      two or even three tuf genes have been described in other bacterial species, the
      presence of multiple tuf genes was sought for. Southern and Northern analysis are
      consistent with two tuf genes in the genome of S.aurantiaca. Primer extension
      experiments indicate that the four tRNA genes and tufB are organized in a single
      operon.

PMID- 7784180
TI  - Cell stress and translational inhibitors transiently increase the abundance of
      mammalian SINE transcripts.
AB  - The abundance of Alu RNA is transiently increased by heat shock in human cell
      lines. This effect is specific to Alu repeats among Pol III transcribed genes,
      since the abundance of 7SL, 7SK, 5S and U6 RNAs is essentially unaffected by heat
      shock. The rapid induction of Alu expression precedes the heat shock induction of
      mRNAs for the ubiquitin and HSP 70 heat shock genes. Heat shock mimetics also
      transiently induce Alu expression indicating that increased Alu expression is a
      general cell-stress response. Cycloheximide treatment rapidly and transiently
      increases the abundance of Alu RNA. Again, compared with other genes transcribed
      by Pol III, this increase is specific to Alu. However, as distinguished from the
      cell stress response, cycloheximide does not induce expression of HSP 70 and
      ubiquitin mRNAs. Puromycin also increases Alu expression, suggesting that this
      response is generally caused by translational inhibition. The response of
      mammalian SINEs to cell stress and translational inhibition is not limited to
      SINEs which are Alu homologues. Heat shock and cycloheximide each transiently
      induce Pol III directed expression of B1 and B2 RNAs in mouse cells and C-element
      RNA in rabbit cells. Together, these three species exemplify the known SINE
      composition of placental mammals, suggesting that mammalian SINEs are similarly
      regulated and may serve a common function.

PMID- 7784179
TI  - Cleavage of the HIV replication primer tRNALys,3 in human cells expressing
      bacterial anticodon nuclease.
AB  - Anticodon nuclease is a bacterial restriction enzyme directed against tRNA(Lys).
      We report that anticodon nuclease also cleaves mammalian tRNA(Lys) molecules,
      with preference and site specificity shown towards the natural substrate.
      Expression of the anticodon nuclease core polypeptide PrrC in HeLa cells from a
      recombinant vaccinia virus elicited cleavage of intracellular tRNA(Lys),3. The
      data justify an inquiry into the possible application of anticodon nuclease as an
      inhibitor of tRNA(Lys),3-primed HIV replication. They also indicate that the
      anticodon region of tRNA(Lys) is a substrate recognition site and suggest that
      PrrC harbors the enzymatic activity.

PMID- 7784182
TI  - Cloning and functional analysis of the TATA binding protein from Sulfolobus
      shibatae.
AB  - Archaea (formerly archaebacteria) comprise a domain of life that is
      phylogenetically distinct from both Eucarya and Bacteria. Here we report the
      cloning of a gene from the Archaeon Sulfolobus shibatae that encodes a protein
      with strong homology to the TATA binding protein (TBP) of eukaryotes. Sulfolobus
      shibatae TBP is, however, almost as diverged from other archaeal TBPs that have
      been cloned as it is from eukaryotic TBPs. DNA binding studies indicate that
      S.shibatae TBP recognizes TATA-like A-box sequences that are present upstream of
      most archaeal genes. By quantitatively immunodepleting S.shibatae TBP from an in
      vitro transcription system, we demonstrate that Sulfolobus RNA polymerase is
      capable of transcribing the 16S/23S rRNA promoter weakly in the absence of TBP.
      Most significantly, we show that addition of recombinant S.shibatae TBP to this
      immunodepleted system leads to transcriptional stimulation and that this
      stimulation is dependent on the A-box sequence of the promoter. Taken together,
      these findings reveal fundamental similarities between the transcription
      machineries of Archaea and eukaryotes.

PMID- 7784181
TI  - Modular structural elements in the replication origin region of Tetrahymena rDNA.
AB  - Computer analyses of the DNA replication origin region in the amplified rRNA
      genes of Tetrahymena thermophila identified a potential initiation zone in the
      5'NTS [Dobbs, Shaiu and Benbow (1994), Nucleic Acids Res. 22, 2479-2489]. This
      region consists of a putative DNA unwinding element (DUE) aligned with predicted
      bent DNA segments, nuclear matrix or scaffold associated region (MAR/SAR)
      consensus sequences, and other common modular sequence elements previously shown
      to be clustered in eukaryotic chromosomal origin regions. In this study, two mung
      bean nuclease-hypersensitive sites in super-coiled plasmid DNA were localized
      within the major DUE-like element predicted by thermodynamic analyses. Three
      restriction fragments of the 5'NTS region predicted to contain bent DNA segments
      exhibited anomalous migration characteristic of bent DNA during electrophoresis
      on polyacrylamide gels. Restriction fragments containing the 5'NTS region bound
      Tetrahymena nuclear matrices in an in vitro binding assay, consistent with an
      association of the replication origin region with the nuclear matrix in vivo. The
      direct demonstration in a protozoan origin region of elements previously
      identified in Drosophila, chick and mammalian origin regions suggests that
      clusters of modular structural elements may be a conserved feature of eukaryotic
      chromosomal origins of replication.

PMID- 7784183
TI  - Presence of negative torsional tension in the promoter region of the
      transcriptionally poised dihydrofolate reductase gene in vivo.
AB  - DNA topology has been suggested to play an important role in the process of
      transcription. Negative torsional tension has been shown to stimulate both pre
      initiation complex formation and promoter clearance on plasmid DNA in vitro. We
      recently showed that genomic DNA in human cells contains localized torsional
      tension. In the present study we have further characterized and mapped torsional
      tension in the dihydrofolate reductase (DHFR) gene in Chinese hamster ovary (CHO)
      cells and investigated the effects of differential rates of transcription on the
      magnitude and location of this tension. Using psoralen photo-cross-linking in
      conjunction with X-irradiation, we found that relaxable psoralen hypersensitivity
      was specifically localized to the promoter region of the serum-regulated DHFR
      gene in serum-stimulated, but not in serum-starved, cells. Moreover, this
      hypersensitivity did not appear to be caused by transcription elongation, since
      it persisted in cells in which transcription of the DHFR gene had been reduced by
      the transcription inhibitor 5,6-dichloro-1-beta-D-ribofurano-sylbenzimidazole
      (DRB). We suggest that the generation of negative torsional tension in DNA may
      play an important role in gene regulation by poising genes for transcription.

PMID- 7784185
TI  - Ultrasensitive hybridization analysis using fluorescence correlation
      spectroscopy.
AB  - The hybridization of fluorescently tagged 18mer deoxyribonucleotides with
      complementary DNA templates was analysed by fluorescence correlation spectroscopy
      (FCS) in a droplet under an epi-illuminated fluorescence microscope at the level
      of single molecules. The interaction can be monitored by the change in the
      translational diffusion time of the smaller (18mer) primer when binding to the
      bigger (7.5 kb) DNA containing the complementary sequence. The hybridization
      process in the presence of template M13mp18 ssDNA was monitored in a small volume
      (2 x 10(-16)I) at various temperatures. The Arrhenius plot of the association
      rate constant shows that the activation energy was 38.8 kcal/mol, but the
      hybridization process may involve several components. The titration experiment
      suggested that approximately 2 primers can be associated with one template DNA at
      40 degrees C. Results of a simple homology search for the sequences complementary
      to the primer indicate the existence of additional sites of lower specificity.

PMID- 7784184
TI  - Function of the upstream hypersensitive sites of the chicken beta-globin gene
      cluster in mice.
AB  - We have shown previously that the chicken beta A-globin gene, with its 3'
      enhancer, is expressed in a copy number-dependent manner in transgenic mice. The
      expression level was low but increased approximately 6-fold upon inclusion of 11
      kb of upstream DNA containing four DNase I hypersensitive sites. To study the
      effect of the individual upstream hypersensitive sites on transgene expression,
      we produced lines of mice in which the individual upstream sites were linked to
      the beta A gene and enhancer. RNA levels were measured in blood from adult
      animals. With each of these four constructs, the level of transgene RNA per DNA
      copy varied over a > 20-fold range. These data suggest that addition of a
      hypersensitive site to the beta A-globin/enhancer region abrogates its position
      independent expression. The average beta A-globin expression per copy in the
      lines carrying an upstream site was comparable with that in lines without an
      upstream site. Thus, no single upstream hypersensitive site accounts for the
      higher level of beta A-globin expression seen in mice containing the complete
      upstream region. We had shown previously that control of the chicken beta-globin
      cluster is distributed between at least two regions, the beta A/epsilon enhancer
      and the upstream region. Our current results suggest that the control mediated by
      the upstream DNA is itself distributed and is not due to a single hypersensitive
      site.

PMID- 7784187
TI  - Solution structure of a nucleic acid photoproduct of deoxyfluorouridylyl-(3'-5')
      thymidine monophosphate (d-FpT) determined by NMR and restrained molecular
      dynamics: structural comparison of two sequence isomer photoadducts (d-U5p5T and
      d-T5p5U).
AB  - Acetone-sensitized irradiation using UV-B (sun lamp, lambda max = 313 nm) of
      deoxyfluorouridylyl-(3'-5')-thymidine monophosphate (d-FpT, F = fluorouracil),
      produces two major photoproducts, the cis-syn cyclobutane-type photodimer and a
      defluorinated (5-5) photoadduct, d-U5p5T. Product distribution is dependent on
      the pH of the irradiation solution, as was the case of irradiated d-TpF. At high
      pH (8-10) the (5-5) photoadduct is the major photoproduct. Irradiation of d-FpT
      shows a much faster photodegradation rate than the sequence isomer d-TpF.
      Multinuclear NMR experiments establish the formation of (5-5) covalent bonding
      between the C5 (d-U5p-, where the fluorine had been) and the C5 (-p5T) and the C6
      (-p5T) acquires an OH group. NOE interproton distances and dihedral angles
      derived from J coupling analysis are constrained to refine model structures of d
      U5p5T in restrained molecular dynamics calculations. The resultant structures
      obtained show 5S-6S as the most chiralities of the C5 and C6 atoms of the
      thymine, which is the opposite chirality to the corresponding atoms in the
      sequence isomer d-T5p5U. The orientation of the C5 substituents (-p5T fragment),
      the CH3 and the uracil are pseudo-axial and pseudo-equatorial respectively.
      Glycosidic angles are in the anti regions for both the d-U5p- and -p5T residues.
      Averaged backbone conformations of the two photoadducts, d-U5p5T and d-T5p5U, are
      similar, although the overall structure of d-U5p5T appears much more flexible
      than that of d-T5p5U. In particular, the sugar conformations of the 5'-end
      residues show a remarkable difference in flexibility.

PMID- 7784186
TI  - Polyamines alter sequence-specific DNA-protein interactions.
AB  - The polyamines are abundant biogenic cations implicated in many biological
      processes. Despite a plethora of evidence on polyamine-induced DNA conformational
      changes, no thorough study of their effects on the activities of sequence
      specific DNA binding proteins has been performed. We describe the in vitro
      effects of polyamines on the activities of purified, representative DNA-binding
      proteins, and on complex protein mixtures. Polyamines at physiological
      concentrations enhance the binding of several proteins to DNA (e.g. USF, TFE3,
      Ig/EBP, NF-IL6, YY1 and ICP-4, a herpes simplex virus gene regulator), but
      inhibit others (e.g. Oct-1). The degree of enhancement correlates with cationic
      charge; divalent putrescine is ineffective whereas tetravalent spermine is more
      potent than trivalent spermidine. Polyamine effects on USF and ICP-4 result from
      increased rate of complex formation rather than a decreased rate of dissociation.
      DNAse I footprint analysis indicated that polyamines do not alter DNA-protein
      contacts. Polyamines also facilitate formation of complexes involving binding of
      more than one protein on a DNA fragment.

PMID- 7784188
TI  - Dehydrating agents sharply reduce curvature in DNAs containing A tracts.
AB  - The structural basis of DNA curvature remains elusive, because models for
      curvature based on crystallographic structures of molecules containing A tracts
      do not agree with any of the models for sequence-directed curvature based on
      solution studies. Here we demonstrate that the difference is probably due to MPD
      (2-methyl-2,4-pentanediol), the dehydrating agent commonly used in
      crystallography. One characteristic signature of curved DNA molecules is that
      they run anomalously slowly on polyacrylamide gels, appearing to be larger than
      they actually are. The gel anomalies of three curved DNAs from trypanosome
      kinetoplast minicircles drop monotonically with increasing MPD concentration,
      indicating that MPD straightens molecules that are curved in aqueous solution.
      This is not due to some non-specific effect of MPD on poly(dA) or polypurine
      tracts, because control molecules containing dA70 and dG43 run normally over the
      full range of MPD concentrations. Circular dichroism spectra are not affected by
      MPD, ruling out a conformational change to a structure outside the B-DNA family.
      The effect is not due to MPD-induced changes in phasing of the curved sequences,
      because MPD has virtually no effect on the linking numbers of relaxed plasmids
      containing either curved sequences or dA70. At the concentrations of MPD used in
      X-ray crystallography, the curvature of DNAs containing A tracts is substantially
      lower than in solution, which probably explains the ongoing discrepancies between
      the crystallographic results and models based on solution studies.

PMID- 7784190
TI  - Integrative modification of YAC clones in a 96-well microplate format.

PMID- 7784189
TI  - Multiple protein-DNA interactions over the yeast HSC82 heat shock gene promoter.
AB  - We have utilized DNase I and micrococcal nuclease (MNase) to map the chromatin
      structure of the HSC82 heat shock gene of Saccharomyces cerevisiae. The gene is
      expressed at a high basal level which is enhanced 2-3-fold by thermal stress. A
      single, heat-shock invariant DNase I hypersensitive domain is found within the
      HSC82 chromosomal locus; it maps to the gene's 5' end and spans 250 bp of
      promoter sequence. DNase I genomic footprinting reveals that within this
      hypersensitive region are four constitutive protein-DNA interactions. These map
      to the transcription initiation site, the TATA box, the promoter-distal heat
      shock element (HSE1) and a consensus GRF2 (REB1/Factor Y) sequence. However, two
      other potential regulatory sites, the promoter-proximal heat shock element (HSE0)
      and a consensus upstream repressor sequence (URS1), are not detectably occupied
      under either transcriptional state. In contrast to its sensitivity to DNAase I,
      the nucleosome-free promoter region is relatively protected from MNase; the
      enzyme excises a stable nucleoprotein fragment of approximately 210 bp. As
      detected by MNase, there are at least two sequence-positioned nucleosomes arrayed
      5' of the promoter; regularly spaced nucleosomes exhibiting an average repeat
      length of 160-170 bp span several kilobases of both upstream and downstream
      regions. Similarly, the body of the gene, which exhibits heightened sensitivity
      to DNase I, displays a nucleosomal organization under both basal and induced
      states, but these nucleosomes are not detectably positioned with respect to the
      underlying DNA sequence and may be irregularly spaced and/or structurally
      altered. We present a model of the chromatin structure of HSC82 and compare it to
      one previously derived for the closely related, but differentially regulated,
      HSP82 heat shock gene.

PMID- 7784191
TI  - Differential display by PCR: novel findings and applications.

PMID- 7784192
TI  - Combinatorial libraries by cassette mutagenesis.

PMID- 7784193
TI  - arg3+, a new selection marker system for Schizosaccharomyces pombe: application
      of ura4+ as a removable integration marker.

PMID- 7784194
TI  - Selection of a sublibrary enriched for a chromosome from total human bacterial
      artificial chromosome library using DNA from flow sorted chromosomes as
      hybridization probes.

PMID- 7784195
TI  - Site-specific initiation of DNA replication within the non-transcribed spacer of
      Physarum rDNA.
AB  - Physarum polycephalum rRNA genes are found on extrachromosomal 60 kb linear
      palindromic DNA molecules. Previous work using electron microscope visualization
      suggested that these molecules are duplicated from one of four potential
      replication origins located in the 24 kb central non-transcribed spacer [Vogt and
      Braun (1977) Eur. J. Biochem., 80, 557-566]. Considering the controversy on the
      nature of the replication origins in eukaryotic cells, where both site-specific
      or delocalized initiations have been described, we study here Physarum rDNA
      replication by two dimensional agarose gel electrophoresis and compare the
      results to those obtained by electron microscopy. Without the need of cell
      treatment or enrichment in replication intermediates, we detect hybridization
      signals corresponding to replicating rDNA fragments throughout the cell cycle,
      confirming that the synthesis of rDNA molecules is not under the control of S
      phase. The patterns of replication intermediates along rDNA minichromosomes are
      consistent with the existence of four site-specific replication origins, whose
      localization in the central non-transcribed spacer is in agreement with the
      electron microscope mapping. It is also shown that, on a few molecules, at least
      two origins are active simultaneously.

PMID- 7784196
TI  - Protein-DNA interactions in soluble telosomes from Saccharomyces cerevisiae.
AB  - Telomeric DNA in Saccharomyces is organized into a non-nucleosomal chromatin
      structure called the telosome that can be released from chromosome ends in
      soluble form by nuclease digestion (Wright, J. H., Gottschling, D. E. and Zakian,
      V. A. (1992) Genes Dev. 6, 197-210). The protein-DNA interactions of soluble
      telosomes were investigated by monitoring isolated telomeric DNA fragments for
      the retention of bound protein using both gel mobility shift and nitrocellulose
      filter-binding assays. Telosomal proteins remained associated with telomeric DNA
      at concentrations of ethidium bromide that dissociated nucleosomes. The protein
      DNA interactions in the yeast telosome were also disrupted by much lower salt
      concentrations than those known to disrupt either the interactions of ciliate
      terminus-binding proteins with telomeric DNA or the interactions of histones with
      DNA in nucleosomes. Taken together, these data corroborate previously published
      nuclease mapping data indicating that telosomes are distinct in structure from
      conventional nucleosomes. These data also indicate that yeast do not possess
      telomere binding proteins similar to those detected in ciliates that remain
      tightly bound to telomeric DNA even in high salt. In addition, the characteristic
      gel mobility shift of soluble telosomes could be mimicked by complexes formed in
      vitro with yeast telomeric DNA and recombinant Rap1p suggesting that Rap1p, a
      known component of soluble yeast telosomes (Wright, J. H., Gottschling, D. E. and
      Zakian, V. A. (1992) Genes Dev. 6, 197-210; Conrad, M. N., Wright, J. H., Wolf,
      A. J. and Zakian, V. A. (1990) Cell 63, 739-750), is likely to be the major
      structural protein bound directly to yeast telomeric DNA.

PMID- 7784197
TI  - Defining a novel cis element in the 3'-untranslated region of mammalian
      ribonucleotide reductase component R2 mRNA: role in transforming growth factor
      beta 1 induced mRNA stabilization.
AB  - Ribonucleotide reductase R2 gene expression is elevated in BALB/c 3T3 fibroblasts
      treated with transforming growth factor beta 1. We investigated the possibility
      that the 3'-UTR of ribonucleotide reductase R2 mRNA contains regulatory
      information for TGF-beta 1 induced message stability. Using end-labeled RNA
      fragments in gel shift assays and UV cross-linking analyses, we detected in the
      3'-UTR a novel 9 nucleotide (nt) cis element, 5'-GAGUUUGAG-3' site, which
      interacted specifically with a cytosolic protease sensitive factor to form a 75
      kDa complex. The cis element protein binding activity was inducible and markedly
      up-regulated cross-link 4 h after TGF-beta 1 treatment of mouse BALB/c 3T3 cells.
      Other 3'-UTRs [IRE, GM-CSF, c-myc and homopolymer (U)] were poor competitors to
      the cis element with regard to forming the TGF-beta 1 dependent RNA-protein
      complex. However, the cis element effectively competed out the formation of the
      R2 3'-UTR protein complex. Cytosolic extracts from a variety of mammalian cell
      lines (monkey Cos7, several mouse fibrosarcomas and human HeLa S3) demonstrated
      similar TGF-beta 1 dependent RNA-protein band shifts as cell extract from BALB/c
      3T3 mouse fibroblasts. Binding was completely prevented by several different
      mutations within the cis element, and by substitution mutagenesis, we were able
      to predict the consensus sequences, 5'-GAGUUUNNN-3' and 5'-NNNUUUGAG-3' for
      optimal protein binding. These results support a model in which the 9 nt region
      functions in cis to destabilize R2 mRNA in cells; and upon activation, a TGF-beta
      1 responsive protein is induced and interacts with the 9 nt cis element in a
      mechanism that leads to stabilization of the mRNA. This appears to be the first
      example of a mRNA binding site that is involved in TGF-beta 1-mediated effects.

PMID- 7784198
TI  - The lytic replicon of bacteriophage P1 is controlled by an antisense RNA.
AB  - The lytic replicon of phage P1 is used for DNA replication during the lytic
      cycle. It comprises about 2% of the P1 genome and contains the P1 C1 repressor
      controlled operator-promoter element Op53.P53 and the kilA and the repL genes, in
      that order. Transcription of the lytic replicon of P53 and synthesis of the
      product of repL, but not kilA, are required for replicon function. We have
      identified an additional promoter, termed P53as (antisense), at the 5'-end of the
      kilA gene from which a 180 base transcript is constitutively synthesized and in
      the opposite direction to the P53 transcript. By using a promoter probe plasmid
      we show that transcription from P53 is strongly repressed by the C1 repressor,
      whereas that of P53as remains unaffected. Accordingly, the C1 repressor inhibits
      binding of Escherichia coli RNA polymerase to P53, but not to P53as, as shown by
      electron microscopy. Under non-repressed conditions transcription from P53
      appears to be inhibited by P53as activity and vice versa. An inhibitory effect of
      P53as on the P1 lytic replicon was revealed by the construction and
      characterization of a P53as promoter-down mutant. Under non-repressed conditions
      transcription of repL and, as a consequence, replication of the plasmid is
      strongly enhanced when P53as is inactive. The results suggest a regulatory role
      for P53as on the P1 lytic replicon.

PMID- 7784199
TI  - Transcription activation of yeast ribosomal protein genes requires additional
      elements apart from binding sites for Abf1p or Rap1p.
AB  - All ribosomal protein (rp) gene promoters from Saccharomyces cerevisiae studied
      so far contain either (usually two) binding sites for the global gene regulator
      Rap1p or one binding site for another global factor, Abf1p. Previous analysis of
      the rpS33 and rpL45 gene promoters suggested that apart from the Abf1 binding
      site, additional cis-acting elements play a part in transcription activation of
      these genes. We designed a promoter reconstruction system based on the beta
      glucuronidase reporter gene to examine the role of the Abf1 binding site and
      other putative cis-acting elements in promoting transcription. An isolated Abf1
      binding site turned out to be a weak activating element. A T-rich sequence
      derived from the rpS33 proximal promoter was found to be stronger, but full
      transcription activation was only achieved by a combination of these elements.
      Both in the natural rpL45 promoter and in the reconstituted promoter, a Rap1
      binding site could functionally replace the Abf1 binding site. Characteristic rp
      gene nutritional control of transcription, evoked by a carbon source upshift or
      by nitrogen re-feeding to nitrogen starved cells, could only be mediated by the
      combined Abf1 (or Rap1) binding site and T-rich element and not by the individual
      elements. These results demonstrate that Abf1p and Rap1p do not activate rp genes
      in a prototypical fashion, but rather may serve to potentiate transcription
      activation through the T-rich element.

PMID- 7784200
TI  - The CUG codon is decoded in vivo as serine and not leucine in Candida albicans.
AB  - Previous studies have shown that the yeast Candida albicans encodes a unique
      seryl-tRNA(CAG) that should decode the leucine codon CUG as serine. However, in
      vitro translation of several different CUG-containing mRNAs in the presence of
      this unusual seryl-tRNA(CAG) result in an apparent increase in the molecular
      weight of the encoded polypeptides as judged by SDS-PAGE even though the
      molecular weight of serine is lower than that of leucine. A possible explanation
      for this altered electrophoretic mobility is that the CUG codon is decoded as
      modified serine in vitro. To elucidate the nature of CUG decoding in vivo, a
      reporter system based on the C. albicans gene (RBP1) encoding rapamycin-binding
      protein (RBP), coupled to the promoter of the C. albicans TEF3 gene, was
      utilized. Sequencing and mass-spectrometry analysis of the recombinant RBP
      expressed in C. albicans demonstrated that the CUG codon was decoded exclusively
      as serine while the related CUU codon was translated as leucine. A database
      search revealed that 32 out of the 65 C. albicans gene sequences available have
      CUG codons in their open reading frames. The CUG-containing genes do not belong
      to any particular gene family. Thus the amino acid specified by the CUG codon has
      been reassigned within the mRNAs of C. albicans. We argue here that this unique
      genetic code change in cellular mRNAs cannot be explained by the 'Codon
      Reassignment Theory'.

PMID- 7784201
TI  - Prokaryotic ribosomes recode the HIV-1 gag-pol-1 frameshift sequence by an E/P
      site post-translocation simultaneous slippage mechanism.
AB  - The mechanism favoured for -1 frameshifting at typical retroviral sites is a pre
      translocation simultaneous slippage model. An alternative post-translocation
      mechanism would also generate the same protein sequence across the frameshift
      site and therefore in this study the strategic placement of a stop codon has been
      used to distinguish between the two mechanisms. A 26 base pair frameshift
      sequence from the HIV-1 gag-pol overlap has been modified to include a stop codon
      immediately 3' to the heptanucleotide frameshift signal, where it often occurs
      naturally in retroviral recoding sites. Stop codons at the 3'-end of the
      heptanucleotide sequence decreased the frame-shifting efficiency on prokaryote
      ribosomes and the recording event was further depressed when the levels of the
      release factors in vivo were increased. In the presence of elevated levels of a
      defective release factor 2, frameshifting efficiency in vivo was increased in the
      constructs containing the stop codons recognized specifically by that release
      factor. These results are consistent with the last six nucleotides of the
      heptanucleotide slippery sequence occupying the ribosomal E and P sites, rather
      than the P and A sites, with the next codon occupying the A site and therefore
      with a post-translocation rather than a pre-translocation -1 slippage model.

PMID- 7784203
TI  - Modified nucleotides reveal the indirect role of the central base pairs in
      stabilizing the lac repressor-operator complex.
AB  - Guanine residues in the lac operator were replaced by 2-aminopurine or purine
      analogues, pairing the modified nucleotides with C. The observed equilibrium
      dissociation constants for lac repressor binding to substituted operators were
      measured in 10 mM Tris, 150 mM KCl, 0.1 mM EDTA, 0.1 mM DTE, pH 7.6 at 25 degrees
      C. These measurements revealed five positions that destabilized the complex when
      substituted with either analogue. Two positions, which are related by a 2-fold
      symmetry, are in the major groove of the operator thought to directly interact
      with the protein. Three sites were in the central region of the operator. A
      purine analogue at a sixth site perturbed the local DNA structure and
      destabilized the complex. Alkylation interference experiments of the 2
      aminopurine substituted operators demonstrated that, of the five affected, two
      substitutions displayed altered phosphate interference patterns at the phosphate
      adjacent to the substituted base. For these operators, complex formation was
      measured in different concentrations of KCl to assess the contribution of
      counterion release to the bimolecular process. The results indicated that both
      complexes were similar to wild-type, although minor changes were observed. The
      Kobs of the complex was then measured when 2-aminopurine or purine analogues were
      paired with uracil nucleotide, a base pair that serves to stabilize the DNA. The
      introduction of the new base pairs revealed two effects on the bimolecular
      interaction. For those operator sites that are thought to perturb the interaction
      directly, the affinity of the complex was weakened to levels observed for the
      singly-substituted operators. In contrast, the nucleotides of 2-aminopurine
      paired with uracil positioned in the central region of the operator served to
      enhance the stability of the complex. The purine-uracil base pair substitution on
      the other hand had a significant destabilizing effect on the interaction. We
      propose that the central base pairs modulate binding of the complex by altering
      the intrinsic properties of the DNA. Two specific attributes are required to
      achieve the lowest free energy of interaction. The DNA must have two interstrand
      hydrogen bonds to stabilize the duplex and it must have properties associated
      with directional bending or unwinding. This analysis does not rule out
      contributions by direct interactions between the protein and the central region
      of the operator but underscores how indirect effects play a major role in complex
      formation in this system.

PMID- 7784202
TI  - A Sindbis virus mRNA polynucleotide vector achieves prolonged and high level
      heterologous gene expression in vivo.
AB  - The direct intramuscular delivery of naked plasmid DNA has been demonstrated to
      allow expression of encoded heterologous genes in the target myocytes. The method
      has been employed to elicit immunization based upon delivery of antigen encoding
      plasmid DNA. For application in the context of achieving anti-tumor immunization
      against antigenic transforming oncoproteins, delivery of plasmid DNAs encoding
      these molecules would create significant potential safety hazards. As an
      alternative to DNA polynucleotide vectors, we explored the utility of mRNA
      vehicles for inducing foreign gene expression in muscle cells in vivo. Synthetic
      reporter-gene encoding mRNA transcripts were derived for this analysis. The
      Sindbis virus vector was also used to derive luciferase mRNA transcripts which
      possessed self-replication capacity. In these studies, it could be shown that the
      replicative vector was capable of directing significantly elevated levels of
      reporter gene expression in myocytes compared to a non-replicative mRNA species.
      In addition, the replicative species was capable of achieving significantly
      prolonged levels of in vivo gene expression compared to non-replicative mRNA.
      Both of these characteristics will make replicative mRNA vectors of utility for
      polynucleotide-based immunization protocols.

PMID- 7784205
TI  - The Escherichia coli MelR transcription activator: production of a stable
      fragment containing the DNA-binding domain.
AB  - A set of nested deletions has been made in the Escherichia coli melR gene,
      encoding the MelR transcription activator protein. Expression of the resulting
      melR derivatives led to the production of nine MelR proteins with N-terminal
      deletions of different lengths. The properties of the shortened proteins have
      been studied both in vivo and in vitro. None of the truncated proteins activate
      transcription from the E.coli melAB promoter but three; MelR220, MelR183 and
      MelR173, inhibit activation of the melAB promoter by chromosomally-encoded full
      length MelR. In gel retardation assays, both MelR183 and MelR173 clearly retard
      DNA fragments carrying the melAB promoter. MelR173 has been overproduced in a T7
      expression system and shown to be stable in vivo for up to 2 h. DNAase I
      footprinting assays of partially purified protein show that it binds to the melAB
      promoter, protecting the same sites as the full-length protein. This fragment may
      be suitable for further structure/function studies of this class of transcription
      activator.

PMID- 7784204
TI  - Role for the highly conserved region of domain IV of 23S-like rRNA in subunit
      subunit interactions at the peptidyl transferase centre.
AB  - The function of the highly conserved and accessible region of domain IV of 23S
      rRNA (positions 1900-1981 in Escherichia coli 23S rRNA) was investigated by
      subjecting it to a random mutagenesis procedure that produced single-site
      mutations efficiently. Nine single-site mutants were selected that were recessive
      lethal. High levels of mutated 23S rRNA were expressed in E. coli and extracted
      ribosomes were investigated for their content of mutated rRNA. The peptidyl
      transferase activity of the ribosomes was also estimated using a newly developed
      method involving selective inhibition of chromosome-encoded ribosomes by
      clindamycin. Two of the mutants, U1940A and U1955G, yielded 50S subunits that
      were defective in subunit-subunit association but active in peptidyl transferase
      activity and five, U1926C, U1946C, U1979C, U1982A and G1984A, produced 50S
      subunits that were defective in both subunit-subunit interactions and peptidyl
      transferase activity. We infer that the large conserved rRNA region generates a
      complex structure that plays an essential role in maintaining and modulating
      subunit-subunit interactions and argue that its involvement in the peptidyl
      transferase centre is secondary, possibly involving the correct alignment of
      protein L2.

PMID- 7784206
TI  - Direct measurement via phage titre of the dissociation constants in solution of
      fusion phage-substrate complexes.
AB  - Studies of interactions between filamentous fusion phage particles and protein or
      nucleic acid molecules have gained increasing importance with recent successes of
      screening techniques based upon random phage display libraries (biopanning).
      Since a number of different phage are usually obtained by biopanning, it is
      useful to compare quantitatively the binding affinities of individual phage for
      the substrate used for selection. A procedure is described for determination of
      relative dissociation constants (KdRel) between filamentous phage carrying
      peptide fusions to the coat protein gpIII and substrates in solution. This novel
      method is based on the measurement of phage titres. Phage selected from a random
      fusion phage library for binding to a monoclonal antibody or a viral structural
      protein exhibited KdRel values in the nanomolar and micromolar ranges for their
      respective substrates, thus validating the method over a wide range of binding
      affinities.

PMID- 7784207
TI  - Transcriptional activation by the orphan nuclear receptor ARP-1.
AB  - ARP-1 is a ubiquitous orphan nuclear receptor that binds to a site (site A) in
      the apolipoprotein AI (apoAI) liver-specific enhancer and represses its
      transcriptional activity in hepatoblastoma HepG2 cells. Electrophoretic mobility
      shift analysis of HepG2 cell nuclear extracts showed that in addition to ARP-1,
      site A also binds the orphan nuclear receptors Ear-2 and HNF-4. In in vitro
      transcription assays, Hela cell nuclear extracts which contain ARP-1 had no
      effect on transcription from a basal promoter linked to multiple copies of site
      A. However, supplementation of these extracts with excess amounts of recombinant
      ARP-1 resulted in significant stimulation. Supplementation of the extracts with
      purified polypeptides representing fusions between the ARP-1 N- or C-terminal
      domains and the yeast activator GAL4 DNA binding domain also stimulated
      transcription from a basal promoter linked to multiple GAL4 DNA binding sites. Co
      immunoprecipitation assays using ARP-1-selective antibodies revealed specific
      physical interactions between ARP-1 and the basal transcription factor TFIIB. We
      conclude that ARP-1 possesses intrinsic transcription activation potential which
      is modulated, at least in part, by the intracellular balance of other nuclear
      receptors that also bind to its cognate DNA binding site.

PMID- 7784208
TI  - Site-directed mutagenesis of the human DNA repair enzyme HAP1: identification of
      residues important for AP endonuclease and RNase H activity.
AB  - HAP1 protein, the major apurinic/apyrimidinic (AP) endonuclease in human cells,
      is a member of a homologous family of multifunctional DNA repair enzymes
      including the Escherichia coli exonuclease III and Drosophila Rrp1 proteins. The
      most extensively characterised member of this family, exonuclease III, exhibits
      both DNA- and RNA-specific nuclease activities. Here, we show that the RNase H
      activity characteristic of exonuclease III has been conserved in the human
      homologue, although the products resulting from RNA cleavage are dissimilar. To
      identify residues important for enzymatic activity, five mutant HAP1 proteins
      containing single amino acid substitutions were purified and analysed in vitro.
      The substitutions were made at sites of conserved amino acids and targeted either
      acidic or histidine residues because of their known participation in the active
      sites of hydrolytic nucleases. One of the mutant proteins (replacement of Asp-219
      by alanine) showed a markedly reduced enzymatic activity, consistent with a
      greatly diminished capacity to bind DNA and RNA. In contrast, replacement of Asp
      90, Asp-308 or Glu-96 by alanine led to a reduction in enzymatic activity without
      significantly compromising nucleic acid binding. Replacement of His-255 by
      alanine led to only a very small reduction in enzymatic activity. Our data are
      consistent with the presence of a single catalytic active site for the DNA- and
      RNA-specific nuclease activities of the HAP1 protein.

PMID- 7784209
TI  - Interaction of Xenopus TFIIIC with a 5S RNA gene.
AB  - Using fractionated Xenopus transcription factors we have identified and
      characterized a unique protein-DNA complex formed between TFIIIA, TFIIIC and a 5S
      RNA gene. The formation of this complex was blocked by specific competitor DNAs
      and by the inactivation of TFIIIC using two different methods. In addition,
      TFIIIC activity was retained when the complexes were affinity purified using a
      reversibly immobilized DNA template. The TFIII(A+C)-5S RNA gene complex has a
      distinct electrophoretic mobility on band-shift gels and a unique DNase I
      footprint. The characteristic feature of the DNase I footprint is a TFIIIC
      dependent extension of the TFIIIA footprint an additional 25 bp toward the 5' end
      of the gene. This indicates a direct interaction between Xenopus TFIIIC and the
      template DNA.

PMID- 7784210
TI  - Versatile vectors to study recoding: conservation of rules between yeast and
      mammalian cells.
AB  - In many viruses and transposons, expression of some genes requires alternative
      reading of the genetic code, also called recoding. Such events depend on specific
      mRNA sequences and can lead to read through of an in-frame stop codon or to +1 or
      -1 frameshifting. Here, we addressed the issue of conservation of recoding rules
      between the yeast Saccharomyces cerevisiae and mammalian cells by establishing a
      versatile vector that can be used to study recoding in both species. We first
      assessed this vector by analysing the site of +1 frameshift of the Ty1
      transposon. Two sequences from higher organisms were then tested in both yeast
      and mammalian cells: the gag-pol junction of human immunodeficiency virus type 1
      (HIV-1) (a site of -1 frameshift), and the stop codon region of the replicase
      cistron from the tobacco mosaic virus (a site of UAG read through). We show that
      both sequences direct a high level of recoding in yeast. Furthermore, different
      mutations of the target sequences have similar effects on recoding in yeast and
      in mouse cells. Most notably, a strong decrease of frameshifting was observed in
      the absence of the HIV-1 stem-loop stimulatory signal. Taken together, these data
      suggest that mechanisms of some recoding events are conserved between lower and
      higher eukaryotes, thus allowing the use of S. cerevisiae as a model system to
      study recoding on target sequences from higher organisms.

PMID- 7784212
TI  - Increased stability of nucleic acids containing 7-deaza-guanosine and 7-deaza
      adenosine may enable rapid DNA sequencing by matrix-assisted laser desorption
      mass spectrometry.
AB  - The use of matrix-assisted laser desorption mass spectrometry (MALDI-MS) has been
      suggested as an ultrafast readout of Sanger DNA sequencing ladders in a manner
      analogous to that used with sequencing gels. Currently, a serious limitation of
      MALDI-MS for the analysis of DNA results from the tendency for oligonucleotides
      to undergo facile fragmentation in the gas phase. The present study was
      undertaken to gain an understanding of the influence of various chemical
      structural features of purine bases on the stability of oligodeoxynucleotide ions
      produced by MALDI. The study focused on the stability of model compounds of the
      type d(TTTTTTTTTTXTTTTTTTTT TTTT), where T designates deoxythymidine and X a
      purine-containing 2'-deoxynucleotide. A variety of different purine derivatives
      were chosen as the base in the nucleotide X. The mass spectra of the model
      compounds containing 7-deaza analogues of guanine and adenine reveal a
      significantly increased stability compared to the 7-aza analogues under the
      conditions of MALDI-MS. The previously reported incorporation of the 7-deaza-2'
      deoxy-adenosine triphosphate and the 7-deaza-2'-deoxy-guanosine triphosphate into
      DNA by polymerases suggests their use in a Sanger dideoxy sequencing experiment.
      The dideoxy termination products with the 7-deaza-purines instead of the 7-aza
      purines might be sufficiently stable to allow separation and detection of the
      sequencing ladder by MALDI-MS. Thus, an ultrafast (seconds) read-out of DNA
      sequence may become feasible.

PMID- 7784211
TI  - Tandem repeats of the 5' non-transcribed spacer of Tetrahymena rDNA function as
      high copy number autonomous replicons in the macronucleus but do not prevent rRNA
      gene dosage regulation.
AB  - The rRNA genes in the somatic macronucleus of Tetrahymena thermophila are
      normally on 21 kb linear palindromic molecules (rDNA). We examined the effect on
      rRNA gene dosage of transforming T.thermophila macronuclei with plasmid
      constructs containing a pair of tandemly repeated rDNA replication origin regions
      unlinked to the rRNA gene. A significant proportion of the plasmid sequences were
      maintained as high copy circular molecules, eventually consisting solely of
      tandem arrays of origin regions. As reported previously for cells transformed by
      a construct in which the same tandem rDNA origins were linked to the rRNA gene
      [Yu, G.-L. and Blackburn, E. H. (1990) Mol. Cell. Biol., 10, 2070-2080], origin
      sequences recombined to form linear molecules bearing several tandem repeats of
      the origin region, as well as rRNA genes. The total number of rDNA origin
      sequences eventually exceeded rRNA gene copies by approximately 20- to 40-fold
      and the number of circular replicons carrying only rDNA origin sequences exceeded
      rRNA gene copies by 2- to 3-fold. However, the rRNA gene dosage was unchanged.
      Hence, simply monitoring the total number of rDNA origin regions is not
      sufficient to regulate rRNA gene copy number.

PMID- 7784213
TI  - The binding modes of a rationally designed photoactivated DNA nuclease determined
      by NMR.
AB  - The complex between the rationally designed synthetic DNA cleaving agent
      netropsin-diazene and the double-stranded DNA oligomer 5'-CGCAAAGGC-3'.5'
      GCCTTTTGCG-3' was characterized by two-dimensional NMR spectroscopy in solution.
      Photolysis of netropsin-diazene bound to DNA generates a trimethylenemethane
      diradical intermediate that induces single-strand breaks in the DNA. The pi-diyl
      trimethylenemethane based compounds are a new class of DNA nucleases. We tested
      the following design criteria: (i) binding of the diazene and subsequent reactive
      diyl to the DNA, (ii) sequence selectivity in the ligand binding and (iii)
      prevention of diyl dimerization. Sixteen NOE derived ligand-DNA distance
      restraints were used to obtain the energy minimized model of the complex. The
      ligand is bound to the minor groove of the oligomer with the diazene at the 5'
      end of the A-tract in the predominant conformation of the complex. This form of
      the complex exchanges with a minor conformation in which the ligand is in the
      opposite orientation. The DNA maintains a B-form structure. Netropsin-diazene has
      fulfilled all of the design criteria, binding to the DNA duplex studied in the
      minor groove of the central AAAA tract in a 1:1 mode, preventing diyl
      dimerization and other side reactions from occurring.

PMID- 7784214
TI  - Methylation of slipped duplexes, snapbacks and cruciforms by human DNA(cytosine
      5)methyltransferase.
AB  - When human DNA(cytosine-5)methyltransferase was used to methylate a series of
      snapback oligodeoxy-nucleotides of differing stem lengths, each containing a
      centrally located CG dinucleotide recognition site, the enzyme required a minimum
      of 22 base pairs in the stem for maximum activity. Extrahelical cytosines in
      slipped duplexes that were 30 base pairs in length acted as effective methyl
      acceptors and were more rapidly methylated than cytosines that were Watson-Crick
      paired. Duplexes containing hairpins of CCG repeats in cruciform structures in
      which the enzyme recognition sequence was disrupted by a C.C mispair were also
      more rapidly methylated than control Watson-Crick-paired duplexes. Since enzymes
      have higher affinities for their transition states than for their substrates, the
      results with extrahelical and mispaired cytosines suggest that these structures
      can be viewed as analogs of the transition state intermediates produced during
      catalysis by methyltransferases.

PMID- 7784215
TI  - The DNA binding domain of the vaccinia virus early transcription factor small
      subunit is an extended helicase-like motif.
AB  - The vaccinia virus early transcription factor (VETF) is an ATP-dependent
      activator of the early class of viral genes. VETF is a heterodimeric protein that
      binds an initiator-like element surrounding the start site of transcription.
      Previous studies indicated that the small subunit of VETF contacts the promoter
      DNA. We have taken a mutational approach to determine sequences in the VETF small
      subunit that are important for DNA binding. Two types of sequences were targeted
      for mutation: ones resembling motifs that are conserved in the nucleic acid
      helicase family and positively charged residues in predicted alpha-helices.
      Mutations affecting transcription activation were clustered in two regions. One
      mutation that impaired DNA binding is located near the N-terminus within the
      putative ATP-binding pocket that comprises helicase domain I. DNA binding was
      also severely reduced by mutations in a sequence resembling helicase domain VI
      and two putative alpha-helices that flank this domain in the C-terminal third of
      the polypeptide. These results indicate that the DNA binding domain in the small
      subunit of VETF is not isolated within a separable domain as is the case with
      most transcription factors, but rather, spans most of the length of the 637
      residue polypeptide. A model for VETF structure is suggested in which the active
      site for ATP hydrolysis is integrated within an extended DNA-binding domain such
      that the structure and function of each domain influences that of the other.

PMID- 7784216
TI  - Specific inhibition of DNA polymerase beta by its 14 kDa domain: role of single-
      and double-stranded DNA binding and 5'-phosphate recognition.
AB  - DNA polymerase beta (beta-polymerase) has been implicated in short-patch DNA
      synthesis in the DNA repair pathway known as base excision repair. The native 39
      kDa enzyme is organized into four structurally and functionally distinct domains.
      In an effort to examine this enzyme as a potential therapeutic target, we
      analyzed the effect of various beta-polymerase domains on the activity of the
      enzyme in vitro. We show that the 14 kDa N-terminal segment of beta-polymerase,
      which binds to both single- and double-stranded DNA, but lacks DNA polymerase
      activity, inhibits beta-polymerase activity in vitro. Most importantly, the 8, 27
      and 31 kDa domains of beta-polymerase do not inhibit beta-polymerase activity,
      demonstrating that the inhibition by the 14 kDa domain is specific. The
      inhibition of beta-polymerase activity in vitro is abolished by increasing the
      concentrations of both of the substrates (template-primer and deoxynucleoside
      triphosphate). In contrast, an in vitro base excision repair assay is inhibited
      in a domain specific manner by the 14 kDa domain even in the presence of
      saturating substrates. The inhibition of beta-polymerase activity by the 14 kDa
      domain appears specific to beta-polymerase as this domain does not inhibit either
      mammalian DNA polymerase alpha or Escherichia coli polymerase I (Klenow
      fragment). These data suggest that the 14 kDa domain could be used as a potential
      inhibitor of intracellular beta-polymerase and that it may provide a means for
      sensitizing cells to therapeutically relevant DNA damaging agents.

PMID- 7784218
TI  - 8-Methoxypsoralen photoinduced plasmid-chromosome recombination in Saccharomyces
      cerevisiae using a centromeric vector.
AB  - The characterization of a new system to study the induction of plasmid-chromosome
      recombination is described. Single-stranded and double-stranded centromeric
      vectors bearing 8-methoxypsoralen photoinduced lesions were used to transform a
      wild-type yeast strain bearing the leu2-3,112 marker. Using the SSCP methodology
      and DNA sequencing, it was demonstrated that repair of the lesions in plasmid DNA
      was mainly due to conversion of the chromosomal allele to the plasmid DNA.

PMID- 7784217
TI  - The HMG-1 box protein family: classification and functional relationships.
AB  - The abundant and highly-conserved nucleoproteins comprising the high mobility
      group-1/2 (HMG-1/2) family contains two homologous basic domains of about 75
      amino acids. These basic domains, termed HMG-1 boxes, are highly structured and
      facilitate HMG-DNA interactions. Many proteins that regulate various cellular
      functions involving DNA binding and whose target DNA sequences share common
      structural characteristics have been identified as having an HMG-1 box; these
      proteins include the RNA polymerase I transcription factor UBF, the mammalian
      testis-determining factor SRY and the mitochondrial transcription factors ABF2
      and mtTF1, among others. The sequences of 121 HMG-1 boxes have been compiled and
      aligned in accordance with thermodynamic results from homology model building
      (threading) experiments, basing the alignment on structure rather than by using
      traditional sequence homology methods. The classification of a representative
      subset of these proteins was then determined using standard least-squares
      distance methods. The proteins segregate into two groups, the first consisting of
      HMG-1/2 proteins and the second consisting of proteins containing the HMG-1 box
      but which are not canonical HMG proteins. The proteins in the second group
      further segregate based on their function, their ability to bind specific
      sequences of DNA, or their ability to recognize discrete non-B-DNA structures.
      The HMG-1 box provides an excellent example of how a specific protein motif, with
      slight alteration, can be used to recognize DNA in a variety of functional
      contexts.

PMID- 7784219
TI  - Enzymic removal of 5-methylcytosine from poly(dG-5-methyl-dC) by HeLa cell
      nuclear extracts is not by a DNA glycosylase.
AB  - A recent report in this journal [Vairapandi, M. and Duker, N.J. (1993) Nucleic
      Acids Res. 21, 5323-5327) presented evidence of an activity in HeLa cell nuclear
      extracts that released radiolabeled material from a poly(dG.dC) polymer that had
      been methylated and simultaneously labeled on cytosine residues by incubation
      with a CpG-specific DNA methylase and [methyl-3H]S-adenosylmethionine. Based on
      chromatographic evidence that the released products were thymine and 5
      methylcytosine and on f1p4olabeling data suggesting a concomitant increase in
      abasic sites, the authors concluded that the releasing activity was a 5
      methylcytosine-specific glycosylase and that the solubilized 5-methylcytosine was
      converted to thymine by a nuclear deaminase. We have confirmed that HeLa nuclear
      extracts promote release of ethanol-soluble radioactivity from a methyl-labeled
      poly(dG-5-methyl-dC)polymer, but the products released were neither 5
      methylcytosine nor thymine. Furthermore, free 5-methylcytosine was not deaminated
      by incubation with the nuclear extract. The labeled compound released initially
      from the polymer appeared to be 5-methyl-deoxycytidine monophosphate, which was
      converted to 5-methyl-deoxycytidine, thymidine monophosphate, and/or thymidine by
      further incubation with the nuclear extract. The activity responsible for the
      release, therefore, was a nuclease. Release of 32P-labeled nucleotides from a 32P
      labeled poly(dG-dC) polymer suggested, furthermore, that the activity was not
      specific for methylated DNA.

PMID- 7784220
TI  - The G-rich auxiliary downstream element has distinct sequence and position
      requirements and mediates efficient 3' end pre-mRNA processing through a trans
      acting factor.
AB  - A downstream G-rich sequence (GRS), GGGGGAGGUGUGGG, has been previously shown to
      influence the efficiency of 3' end processing of the SV40 late polyadenylation
      signal. We have now defined several important parameters for GRS-mediated
      polyadenylation. The ability of the GRS to influence 3' end processing efficiency
      was sensitive to individual and multiple point mutations within the element, as
      well as the position of the element in the downstream region. Competition
      analysis indicated that the GRS functioned through a titratable trans-acting
      factor. The GRS-specific DSEF-1 protein was found to be bound to the same
      population of RNAs as the 64 kDa protein of the general polyadenylation factor
      CstF, indicating that DSEF-1 is associated with RNA substrates undergoing 3' end
      processing. Furthermore, an association was obtained between the relative
      strength of DSEF-1 protein binding to GRS variants and the relative ability of
      the GRS variants to mediate efficient cleavage in vitro. Finally, mutations in
      the GRS affected the efficiency of cross-linking of the 64 kDa protein of CstF.
      These data define a novel class of auxiliary downstream element and suggest an
      important role for DSEF-1 in 3' end processing.

PMID- 7784222
TI  - Single-step direct PCR amplification from solid tissues.

PMID- 7784223
TI  - Growth of E. coli at low temperature dramatically increases the transformation
      frequency by electroporation.

PMID- 7784224
TI  - Rapid and high efficiency site-directed mutagenesis by improvement of the
      homologous recombination technique.

PMID- 7784221
TI  - Identification of ribosome binding sites in Escherichia coli using neural network
      models.
AB  - This study investigated the use of neural networks in the identification of
      Escherichia coli ribosome binding sites. The recognition of these sites based on
      primary sequence data is difficult due to the multiple determinants that define
      them. Additionally, secondary structure plays a significant role in the
      determination of the site and this information is difficult to include in the
      models. Efforts to solve this problem have so far yielded poor results. A new
      compilation of E. coli ribosome binding sites was generated for this study.
      Feedforward backpropagation networks were applied to their identification.
      Perceptrons were also applied, since they have been the previous best method
      since 1982. Evaluation of performance for all the neural networks and perceptrons
      was determined by ROC analysis. The neural network provided significant
      improvement in the recognition of these sites when compared with the previous
      best method, finding less than half the number of false positives when both
      models were adjusted to find an equal number of actual sites. The best neural
      network used an input window of 101 nucleotides and a single hidden layer of 9
      units. Both the neural network and the perceptron trained on the new compilation
      performed better than the original perceptron published by Stormo et al. in 1982.

PMID- 7784226
TI  - Genetics in cancer prediction, screening, and counseling: Part I, Genetics in
      cancer prediction and screening.
AB  - PURPOSE/OBJECTIVES: To review molecular biology and gene technology as they
      relate to cancer prediction and screening. DATA SOURCES: Published professional
      articles, texts, and proceedings; computerized data bases. DATA SYNTHESIS: Basic
      principles of inheritance and mutations; a discussion of proto-oncogenes,
      oncogenes, and anti-oncogenes; a summary of gene-mapping techniques; and a review
      of genes linked to familial, breast, ovarian, and colorectal cancers.
      CONCLUSIONS: Most human cancers are influenced genetically but are not inherited.
      Discoveries about cancer genes play a major role in identifying individuals and
      families who are likely to develop cancer. IMPLICATIONS FOR NURSING PRACTICE:
      Nurses need to heighten their awareness of this science and its ramifications,
      which ultimately will affect recommendations for early detection and screening.

PMID- 7784227
TI  - Genetics in cancer prediction, screening, and counseling: Part II, The nurse's
      role in genetic counseling.
AB  - PURPOSE/OBJECTIVES: To describe an expanded role for oncology nurses in genetic
      counseling for cancer. DATA SOURCES: Published professional articles,
      computerized data bases, lay publications. DATA SYNTHESIS: A description of the
      availability of genetic counseling, of motivation for undergoing genetic
      counseling, and of the basic components of genetic counseling for cancer.
      CONCLUSIONS: The need for genetic counseling will increase as more families with
      inherited cancer are identified, more cancer genes are isolated, and genetic
      analysis becomes more available. IMPLICATIONS FOR NURSING PRACTICE: Advances in
      genetic technology provide nurses with the opportunity for an expanded role in
      genetic counseling for cancer. Oncology nurses also can act as case finders of
      families with inherited cancers and conduct research in this area.

PMID- 7784228
TI  - Gene therapy: current strategies and future applications.
AB  - PURPOSE/OBJECTIVES: To provide a brief introduction to gene therapy, including
      gene transfer methods and safety issues, as well as the role of nursing in gene
      therapy. To identify current applications of gene therapy in oncology. DATA
      SOURCES: Published articles, book chapters, and the author's experience with the
      care of patients receiving gene therapy. DATA SYNTHESIS: Gene therapy is used to
      add a new function to cells or to label cells for future identification.
      Presently, gene transfer is accomplished primarily through safety-modified
      retroviral vectors. A variety of innovative gene therapy approaches currently are
      being investigated in clinical trials, but no outcomes have been reported.
      CONCLUSIONS: Gene therapy is a new, rapidly-evolving investigational modality
      with promising applications in the treatment of patients with brain, skin,
      kidney, and other cancers and patients who are undergoing bone marrow
      transplantation. NURSING IMPLICATIONS: Gene therapy is an investigational
      modality in phase I clinical trials that requires thorough patient care planning
      and patient monitoring for unexpected side effects. There is an increasing need
      for nurses to understand gene therapy so that they can educate patients and
      families.

PMID- 7784229
TI  - Genetics in cancer care: confronting a Pandora's Box of dilemmas.
AB  - PURPOSE/OBJECTIVES: To provide an overview of sociopolitical, bioethical, and
      psychological issues emerging from the application of genetic technologies in
      cancer care in the United States and to provoke oncology nurses to consider the
      impact that advances in genetics may have on their practice. DATA SOURCES:
      Published professional articles, tests, and proceedings as well as government and
      lay publications. DATA SYNTHESIS: This article reviews underlying sociopolitical
      issues and forecasts bioethical dilemmas and psychological responses likely to
      emerge from expanding genetic screening and treatment options in oncology. The
      sociopolitical issues revolve around individual rights, the role of government,
      and the influence of religious dogma and public perception. The bioethical
      dilemmas fall within a framework of five scenarios, and a range of psychological
      responses are described. CONCLUSIONS: Significant changes will occur in cancer
      care as a result of advances in genetic technology. These changes will be
      accompanied by a new set of dilemmas in clinical practice and by as yet
      undescribed psychological responses. In addition to building a knowledge base
      relevant to these new technologies, oncology nurses must anticipate the new
      dilemmas and be prepared to manage the emotional responses of their patients.
      NURSING IMPLICATIONS: Nurse are in a strategic position to make significant
      contributions to the genetics data base by designing and conducting research to
      describe the ethical dilemmas and patient/family responses engendered as genetic
      science is integrated into cancer care.

PMID- 7784230
TI  - The human genome exposed: a glimpse of promise, predicament, and impact on
      practice.
AB  - PURPOSE/OBJECTIVES: To review basic gene biology, discuss current genetic
      advances, and project the potential impact of these advances on oncology nursing
      practice. DATA SOURCES: Published professional articles, tests, proceedings,
      governmental and lay publications. DATA SYNTHESIS: The Human Genome Project seeks
      to better describe the human complement of genes, which may hold the key to
      further defining the mechanism of carcinogenesis. The identification of genetic
      defects responsible for cancer will facilitate development of both preventive and
      therapeutic antitumor strategies. CONCLUSIONS: The data base emerging from
      genetic research will result in both promise and predicaments. The promise
      relates to the discovery of genetic abnormalities that can be used to predict
      risk for cancer or serve as targets for therapeutic intervention. The
      predicaments involve the psychosocial, ethical, and legal implications of
      revealing an individual's genetic profile without knowing the ultimate
      ramifications of that information. IMPLICATIONS FOR NURSING PRACTICE: Nurses will
      be at the forefront of these advances as they describe the effects of genetic
      advances on the public and on individuals and create innovative strategies to
      manage negative effects. To take advantage of opportunities presented by the
      genetic revolution, nurses must develop a knowledge base about gene biology and
      its relationship to cancer.

PMID- 7784225
TI  - Splinkerettes--improved vectorettes for greater efficiency in PCR walking.

PMID- 7784231
TI  - Australian NHMRC Twin Registry: a resource for pediatric research.

PMID- 7784232
TI  - Effect of technical development on the apparent incidence of congenital heart
      disease.

PMID- 7784233
TI  - Histopathology of the ductus arteriosus after PGE1 treatment.

PMID- 7784234
TI  - Hemolysis associated with umbrella occlusion of the arterial duct.

PMID- 7784237
TI  - Chest pain in children referred to a cardiology clinic.
AB  - One hundred consecutive patients (54 girls, 46 boys) referred to a pediatric
      cardiology department with the primary complaint of chest pain were evaluated.
      The age distribution was 2.5-16.0 years (mean 11.3 years for girls and 9.9 years
      for boys). The history showed 17% of patients with chest pain, 22% with heart
      disease, and 19% with recent death in the family. The time course of the pain was
      longer than 1 week in 92 patients. Localization was on the left precordium in 60
      patients, and there was no radiation from the original site in 66 cases. Ninety
      two percent of cases were idiopathic in origin. Of the 74 patients who had a
      psychiatric interview, 55 (74%) had psychiatric symptoms and 5 required
      psychiatric care. Anxiety, conversion disorder, and depression were the main
      psychiatric symptoms.

PMID- 7784236
TI  - Favorable effects of immunosuppressive therapy in children with dilated
      cardiomyopathy and active myocarditis.
AB  - Among 68 children with severe dilated cardiomyopathy, 43 (aged 10 months to 15
      years) presented with active myocarditis, diagnosed by endomyocardial biopsy.
      They were divided into four treatment groups: I, controls: 9 patients submitted
      to conventional treatment (digitalis, diuretics, and vasodilators) for 8.1 +/-
      0.7 (SD) months; II, prednisone: 12 patients received conventional therapy plus
      prednisone; III, azathioprine: 16 patients submitted to conventional therapy plus
      prednisone and azathioprine; IV, cyclosporine: 13 patients treated with
      conventional therapy plus prednisone and cyclosporine. Immunosuppressive therapy
      was maintained for a mean of 8.4 +/- 1.2 months. They were submitted to
      noninvasive (electrocardiogram, chest radiograph, Doppler echocardiogram, and
      radioisotopic scintigraphy) and invasive (hemodynamic) studies. In the control
      group only 2 of 9 patients showed clinical and hemodynamic improvement and 1 of
      4, histologic regression of the myocarditis. Among patients submitted to
      conventional therapy plus prednisone, 3 of 12 presented clinical and hemodynamic
      improvement; 2 of 5 also showed histologic regression of inflammatory process. By
      contrast, patients treated with azathioprine or cyclosporine associated with
      prednisone had significantly better results: 13 of 16 and 10 of 13 patients,
      respectively, had clinical and hemodynamic improvement; all 6 patients in the
      azathioprine group and all 4 patients in the cyclosporine group had histologic
      regression of the myocarditis. Two patients in the prednisone group, one in the
      azathioprine group, and one in the cyclosporine group died during treatment, in
      cardiogenic shock. In our experience immunosuppressive therapy with azathioprine
      or cyclosporine associated with prednisone improves the prognosis of children
      with active myocarditis and severe ventricular dysfunction.

PMID- 7784238
TI  - Congenital valvar aortic stenosis and abnormal origin of the right coronary
      artery: rare combination with important clinical implications.
AB  - Congenital valvar aortic stenosis in association with an abnormal coronary artery
      origin and distribution has not been previously reported. The right coronary
      artery arose in the left ventricular (LV) outflow tract and supplied much of the
      LV myocardium. Aortic valvotomy with standard antegrade cardioplegia resulted in
      infarction of the left ventricle. Aggressive attempts to ascertain the origin of
      the coronary arteries in right dominant coronary systems must be performed before
      any intervention in this group of patients.

PMID- 7784235
TI  - Relation between age at surgery and regression of right ventricular hypertrophy
      in tetralogy of Fallot.
AB  - Pre- and postoperative echocardiographic right ventricular wall thickness (RVW),
      transverse dimension (RVD), and their ratio (W/D) were measured from subcostal
      views in 29 patients with Tetralogy of Fallot (TOF) in order to assess whether
      primary reparative surgery without prior palliative shunts in early infancy
      results in significantly faster regression of RV hypertrophy than repair later in
      life. Fourteen patients who were repaired before 6 months of age were compared
      with 15 patients who were repaired after 6 months of age. In the group of
      patients who were repaired before 6 months of age both RVW and W/D ratio
      decreased significantly whereas RVD did not change from pre- to postoperative
      status. The group of patients who were repaired after 6 months of age showed no
      significant changes in RVW, RVD, or W/D ratio. These findings suggest that early
      primary reparative surgery of TOF may have a positive effect on faster regression
      of RVH during the first postoperative year which may reduce the detrimental
      effect of longstanding hypertrophy on myocardial function and the potential for
      arrhythmia.

PMID- 7784239
TI  - Reversible cardiomyopathy due to carnitine deficiency from renal tubular wasting.
AB  - The clinical course of a 4-month-old male infant with a dilated cardiomyopathy
      secondary to renal tubular losses of carnitine is outlined. He was admitted to
      the hospital with severe congestive heart failure. An echocardiogram demonstrated
      normal anatomy. The left ventricular shortening fraction measured 10%. A
      comprehensive cardiomyopathy evaluation was initiated. The total plasma carnitine
      level was only 25 mumol/ml, but the urine carnitine measured 434 nm/mg of
      creatinine. He was begun on oral L-carnitine and weaned from mechanical
      ventilation and inotropic support 10 days later. Two years later he remains
      asymptomatic with normal left ventricular function.

PMID- 7784240
TI  - Effective use of magnesium for acquired torsade de pointes in a 4-month-old
      infant.
AB  - We report a 4-month-old infant with torsade de pointes secondary to procainamide
      treatment. The infant presented with atrial flutter and converted to normal sinus
      rhythm with intravenous procainamide. Oral procainamide therapy was initiated as
      the infusion was tapered, and the patient subsequently developed incessant
      torsade de pointes. Once the proarrhythmia was recognized, procainamide was
      withheld, and intravenous magnesium was administered. The torsade de pointes
      resolved after one bolus of magnesium sulfate. An infusion regimen of magnesium
      was given until the procainamide and N-acetylprocainamide concentrations became
      undetectable. Intravenous magnesium should be administered to newborns with
      acquired torsade de pointes; dosing guidelines for its use are suggested.

PMID- 7784242
TI  - Intussusception of the catheter sheath: a nonemergency.
AB  - Percutaneous balloon dilatation angioplasty is a common therapeutic modality in
      patients with congenital heart disease. We report three cases of the catheter
      sheath telescoping into the hub of the sheath after removal of the balloon
      catheter. Although initially it appeared as though the sheath was torn, in
      actuality it was intact. We report this problem so others can avoid needless
      searching and concern for the "missing" catheter tip.

PMID- 7784241
TI  - Ventricular fibrillation in two infants treated with amiodarone hydrochloride.
AB  - Antiarrhythmic agents may induce ventricular arrhythmias. Whereas amiodarone is a
      reported cause of ventricular fibrillation in children, there are no reported
      cases in infants. We observed two patients with atrial flutter and congestive
      heart failure who were treated with amiodarone. Both had anatomic heart defects
      and had failed conventional therapy. Ventricular fibrillation occurred 3 and 12
      days after the initial dose. Q-T interval, electrolytes, digoxin level, and
      amiodarone level (one patient) were normal. Amiodarone may provoke life
      threatening ventricular tachyarrhythmias during the convalescent period.
      Consideration should be given to monitoring in a hospital setting for at least 2
      weeks following initiation of amiodarone therapy.

PMID- 7784243
TI  - Biphasic flow velocity pattern in the descending aorta in double aortic arch.
AB  - We report a case of double aortic arch in which the biphasic flow velocity
      pattern in the descending aorta changed to a monophasic flow velocity pattern
      after corrective surgery. The hypoplasia of left aortic arch might prolong the
      acceleration time of the flow velocity in the left aortic arch.

PMID- 7784244
TI  - Pulmonary atresia and ventricular septal defect with coronary artery to pulmonary
      artery fistula: case report and review of the literature.
AB  - The pulmonary blood supply in patients with pulmonary atresia and ventricular
      septal defect is highly variable. Several cases have been reported in the
      literature in which a coronary artery to pulmonary artery fistula, alone or in
      combination with additional vessels, supplies the pulmonary circulation. We
      report a case of successful repair during early infancy, with unique hemodynamic,
      clinical, and anatomic features. The literature is reviewed.

PMID- 7784245
TI  - Unusual combination of congenital heart defects in an infant with Noonan
      syndrome.
AB  - Congenital heart disease occurs in 35-50% of patients diagnosed with Noonan
      syndrome. We present an infant with an unusual combination of congenital heart
      defects not previously reported, including partial atrioventricular septal
      defect, polyvalvular dysplasia, and progressive hypertrophic cardiomyopathy. We
      discuss the possible interaction between these lesions that may have led to the
      patient's rapid demise.

PMID- 7784246
TI  - Effect of acute and chronic treatment with desglycinamide-[Arg8]vasopressin in
      young male and female volunteers.
AB  - A single dose of DGAVP (2 mg) and a chronic treatment of 2 weeks (1 mg/day) were
      given to male and female volunteers by the intranasal route. Memory, mood,
      vigilance, and attention were tested starting 60 min after treatment. Initial
      storage of abstract words was improved in the males but not in the females after
      chronic treatment with DGAVP. This effect persisted after discontinuation of
      treatment. Initial storage and learning of concrete words were not affected by
      treatment with DGAVP. Chronic, but not acute, treatment with DGAVP reduced the
      reaction time for scanning of digits in a memory comparison task (Sternberg
      paradigm) in both sexes. No treatment effects were found for visual memory,
      vigilance, attention, mood, or blood pressure. The present study indicates a
      sexual dimorphism in the effect of DGAVP on certain memory processes.

PMID- 7784247
TI  - Third trimester POMC disregulation predicts use of anesthesia at vaginal
      delivery.
AB  - In a prospective study, third trimester plasma levels of BE and ACTH were
      determined in 58 women who delivered vaginally. Peptide regulation was compared
      between subjects who used conduction anesthesia at delivery and subjects who did
      not. Third trimester levels of maternal BE and ACTH were significantly related;
      however, the relationship was significant only in subjects who did not receive
      conduction anesthesia (n = 24) at delivery. The normal co-release pattern between
      BE and ACTH in subjects receiving conduction anesthesia (n = 34) during birth was
      uncoupled. The use of conduction analgesia during vaginal delivery was
      significantly related to a disregulation index created to quantify the BE-ACTH
      release pattern. Uncoupled ACTH and BE patterns may result from modified control
      of pro-opiomelanocortin (POMC) expression during pregnancy or unique proteolytic
      processing of POMC, and may alter pain tolerance during delivery.

PMID- 7784248
TI  - Opioid peptide receptor studies. 1. Identification of a novel delta-opioid
      receptor binding site in rat brain membranes.
AB  - Our laboratory was among the first to propose the existence of delta receptor
      subtypes: a delta site thought to be associated with a mu-delta-opioid receptor
      complex termed the delta cx binding site and delta site not associated with the
      mu-delta-opioid receptor complex, termed the delta ncx site. In previous studies,
      we assayed the delta cx site with [3H][D-Ala2,D-Leu5]enkephalin using rat brain
      membranes depleted of delta ncx sites by pretreatment with the site-directed
      acylating agent, (+)-trans-SUPERFIT. In the present study, we investigated, using
      (+)-trans-SUPERFIT-pretreated membranes, the possibility of heterogeneity of the
      delta cx binding site. Two sites were resolved: the delta cx-1 site at which mu
      ligands are potent noncompetitive inhibitors and delta ligands are weak
      competitive inhibitors, and the delta cx-2 site where delta ligands are potent
      and mu ligands are weak, mixed competitive-noncompetitive inhibitors. Although
      the delta cx-2 site has a delta-like ligand-selectivity profile, several
      experiments distinguished it from the delta ncx site. Two lines of evidence
      suggest that the delta ncx site corresponds to the cloned delta receptor. One,
      the delta receptor was cloned from the NG108-15 cell line, and this receptor,
      like the delta ncx binding site, irreversibly binds SUPERFIT and (+)-trans
      SUPERFIT. Secondly, administration of delta-antisense DNA selectively decreases
      delta ncx binding. Viewed collectively, the major finding of this study is the
      discovery of a novel SUPERFIT-insensitive and delta-antisense-insensitive delta
      cx-2 binding site.

PMID- 7784250
TI  - Synthesis and biological activity of N-terminal-truncated derivatives of human
      epidermal growth factor (h-EGF).
AB  - To investigate the contribution of the N-terminal sequence of h-EGF to its
      biological activity and the formation of three intramolecular disulfide bonds by
      oxidative refolding via air oxidation, five derivatives of h-EGF with a single N
      terminal amino acid deletion were synthesized by solid-phase synthesis. The
      homogeneity of the synthetic peptides was confirmed by analytical reversed-phase
      HPLC, amino acid analysis, and FAB-MS. The pairing of the three disulfide bridges
      in synthetic peptides was determined by thermolytic digestion. All N-truncated
      derivatives of h-FGF formed the correct intramolecular three disulfide linkages
      during oxidative refolding and had equipotent activity in both EGF receptor
      binding on A-431 epidermoid carcinoma cells and mitogenesis on NIH-3T3 fibroblast
      cells, compared with authentic h-EGF. The results suggested that the five
      residues from N-terminal sequence of h-EGF have no effect on the formation of the
      correct disulfide linkages in h-EGF and do not exert a significant influence on
      its biological activity.

PMID- 7784249
TI  - Structure-activity relationships of the crustacean myotropic neuropeptide
      orcokinin.
AB  - Orcokinin (OK, NFDEIDRSGFGFN) was recently identified from the crayfish,
      Orconectes limosus, as a potent hindgut-stimulating factor (14). To assess the
      importance of structural features of the peptide involved in effective ligand
      receptor interactions, synthetic analogues of orcokinin were tested in the
      hindgut bioassay. Tests with N- and C-terminal-truncated analogues and the C
      terminal-amidated analogue (OK-NH2) demonstrate that changes at the C-terminus
      interfere less with biological activity than changes at the N-terminus. Removal
      of more than one amino acid at the N-terminus resulted in a complete loss of
      activity, whereas the C-terminal deletion of three amino acids still produced an
      analogue with full intrinsic activity but with a drastic shift in threshold
      concentration of activity from 1 x 10(-10) to 1 x 10(-7) M. Deletion of four
      amino acids at the C-terminus resulted in a completely inactive analogue. The C
      terminal hydroxyl group does not seem to be important because amidation (OK-NH2)
      resulted in almost no loss of activity. Replacing Arg7 with Ala produced an
      analogue almost equipotent to orcokinin. Replacement of Phe2 by Tyr resulted in
      considerable loss of activity. An important role of Phe2 is further suggested by
      the steep drop of activity after removal of this residue in the N-terminal
      deleted analogues.

PMID- 7784251
TI  - Pheromonotropic activity of naturally occurring pyrokinin insect neuropeptides
      (FXPRLamide) in Helicoverpa zea.
AB  - Insect neuropeptides, having the common C-terminal sequence FXPRLamide X = V, T,
      S, or G), were tested for phyeromonotropic activity in the moth, Helicoverpa zea.
      Dose-response studies indicated that locustamyotropin-II or locustapyrokinin-II
      induced production of more pheromone than was stimulated by the pheromone
      biosynthesis activating neuropeptide of this moth. Other peptides showed various
      degrees of pheromonotropic activity. The data indicated that substitution of the
      variable amino acid in the C-terminal pentapeptide sequence resulted in
      significant differences in pheromonotropic activity. However, the overall
      structure of the peptide was also found to be of importance.

PMID- 7784252
TI  - [125I]SNF 8702: a selective radioligand for CCKB receptors.
AB  - The CCK-8 analogue, SNF 8702, was radioiodinated. [125I]SNF 8702 showed high
      affinity specific binding for both guinea pig and mouse brain tissues, whereas no
      specific binding was seen for guinea pig pancreatic tissue. The properties of the
      site labeled by [125I]SNF 8702 were characterized by binding inhibition studies
      for a series of CCKA and CCKB receptor ligands. The binding selectivity profile
      corresponded to that for the CCKB receptor. The labeled compound is stable for
      more than 6 weeks during storage at -20 degrees C.

PMID- 7784253
TI  - Glucagon-like peptide-1 binding to rat skeletal muscle.
AB  - We have found [125I]glucagon-like peptide-1(7-36)-amide-specific binding activity
      in rat skeletal muscle plasma membranes, with an estimated M(r) of 63,000 by
      cross-linking and SDS-PAGE. The specific binding was time and membrane protein
      concentration dependent, and displaceable by unlabeled GLP-1(7-36)-amide with an
      ID50 of 3 x 10(-9) M of the peptide; GLP-1(1-36)-amide also competed, whereas
      glucagon and insulin did not. GLP-1(7-36)-amide did not modify the basal
      adenylate cyclase activity in skeletal muscle plasma membranes. These data,
      together with our previous finding of a potent glycogenic effect of GLP-1(7-36)
      amide in rat soleus muscle, and also in isolated hepatocytes, which was not
      accompanied by a rise in the cell cyclic AMP content, lead use to believe that
      the insulin-like effects of this peptide on glucose metabolism in the muscle
      could be mediated by a type of receptor somehow different to that described for
      GLP-1 in pancreatic B cells, where GLP-1 action is mediated by the cyclic AMP
      adenylate cyclase system.

PMID- 7784254
TI  - Identification of a new chromogranin B fragment (314-365) in endocrine tumors.
AB  - A rabbit antiserum was raised against the fragment (350-365) of human
      chromogranin B corresponding to the C-terminal end of a putative proteolytic
      fragment generated by the cleavage of a dibasic doublet located in position 366
      367 of the precursor. A radioimmunoassay was developed. Chromatographic analysis
      of 10 endocrine tumor extracts (one liver metastasis of a gastrinoma, one liver
      metastasis of a medullary carcinoma of the thyroid, one VIPoma, one insulinoma,
      one nonsecreting pancreatic endocrine tumor, one local recurrence of a gut
      carcinoid, two pituitary gonadotropinoma, and two non-secreting pituitary
      adenomas) revealed the presence of two forms of immunoreactive material. The most
      abundant form had an apparent molecular weight of 4500 and was purified to
      homogeneity by successive reverse-phase HPLC chromatographies and partially
      sequenced. The N-terminal sequence of the peptide, established by automated Edman
      degradation, was A-S-E-E-E-P-E-Y-G-E-E-I-K-G-Y-P-V-Q and corresponded to the 314
      332 sequence of human chromogranin B. Taking into account the specificity of the
      antiserum used for peptide identification, we deduced that the purified peptide
      was chromogranin B(314-365) and represented a new form generated by limited
      proteolysis of chromogranin B.

PMID- 7784255
TI  - Triiodothyronine regulates somatostatin gene expression in cultured fetal rat
      cerebrocortical cells.
AB  - The effect of triiodothyronine (T3) on somatostatin (SS) mRNA levels in cultured
      fetal rat cerebrocortical cells was studied. Two different experimental
      approaches were sought. They differed in the length of time in which cells were
      deprived of thyroid hormones prior to the addition of exogenous T3. When the
      cells were not deprived of thyroid hormones, T3 caused a dose-related decrease in
      SS mRNA content at all doses tested. However, when the cells were deprived of T3
      for 24 h, a biphasic effect was observed. These findings suggest that T3
      regulates SS gene expression in fetal cultured cerebrocortical cells.

PMID- 7784256
TI  - Synthetic peptides demonstrate RGD-independent platelet glycoprotein IIb/IIIa
      recognition site in cell binding domain of human fibronectin.
AB  - Fibronectin binds to platelet membrane glycoprotein (GP) IIb/IIIa in both an Arg
      Gly-Asp (RGD)-dependent and -independent manner. The identification of an RGD
      independent binding domain(s) that interacts with GPIIb/IIIa may be the key to
      understand the mechanism of thrombus formation. A recombinant fibronectin
      fragment containing the residues from Ile1359 to Ser1436 (lacking the RGD
      sequence) had been shown to bind to GPIIb/IIIa in a divalent cation- and
      activation-dependent manner. To identify a minimal peptide ligand that
      participates in the recognition of GPIIb/IIIa, we synthesized peptides extending
      this region, which consist of 12 amino acid residues in length and overlapping by
      six amino acids. We obtained evidence that two 12-residue peptide sequences from
      this region (residues 1371-1382 and 1377-1388) inhibit fibronectin binding to
      GPIIb/IIIa by interacting directly with this receptor, with IC50s of 95 +/- 16
      and 104 +/- 19 microM, respectively. These peptides inhibited the binding of
      fibrinogen to GPIIb/IIIa, as well as ADP-induced platelet aggregation. These
      results indicate that an RGD-independent GPIIb/IIIa binding site in the cell
      binding domain of fibronectin was localized within the residues His1377-Ile1382.

PMID- 7784257
TI  - Effects of testosterone on the behavioral response to arginine vasopressin
      microinjected into the central gray and septum.
AB  - Arginine vasopressin (AVP) plays an important role in the control of a gonadal
      hormone-dependent communicative behavior in the Syrian hamster (Mesocricetus
      auratus) called flank marking. Previous studies have shown that gonadal hormones
      alter the amount of flank marking stimulated by the microinjection of AVP into
      the medial preoptic area-anterior hypothalamus (MPOA-AH). The purpose of the
      present study was to determine if testicular hormones alter the amount of flank
      marking stimulated by the microinjection of AVP into two other sites involved in
      the control of flank marking, the lateral septum-bed nucleus of the stria
      terminalis (LS-BNST) and the central gray. The data of the present study indicate
      that testicular hormones may influence the amount of AVP-stimulated marking in
      the central gray and LS-BNST; however, these effects are subtle and appear to
      occur primarily at high concentrations of AVP. When taken together with previous
      studies, these data indicate that gonadal hormones have greater effects on AVP
      stimulated marking in the MPOA-AH than in the LS-BNST or central gray.

PMID- 7784258
TI  - Bombesin stimulates c-fos and c-jun mRNAs in small cell lung cancer cells.
AB  - The effects of bombesin/gastrin-releasing peptide (BN/GRP) on c-fos and c-jun
      gene expression were investigated using small cell lung cancer (SCLC) cells. BN
      (10 nM) increased c-fos mRNA fivefold using NCI-H345 or NCI-H510 cells. The
      increase was concentration dependent with 1 nM BN half-maximally increasing c-fos
      mRNA. Also, the increase in c-fos mRNA caused by BN was time dependent, being
      maximal after 1 h and returning to basal values after 4 h. GRP and GRP(14-27) but
      not GRP(1-16) increased c-fos mRNA. BW2258U89 (1 microM), a GRP receptor
      antagonist, had no effect on basal c-fos but inhibited the increase in c-fos mRNA
      caused by 10 nM BN. Also, BN transiently increased c-jun mRNA twofold and the
      increase caused by BN was blocked by BW2258U89. These data suggest that GRP
      receptors may regulate nuclear oncogene gene expression in SCLC cells.

PMID- 7784259
TI  - Effects of calcitonin gene-related peptide on intracellular calcium concentration
      in longitudinal muscle of guinea pig ileum.
AB  - The effect of rat calcitonin gene-related peptide (rCGRP) on intracellular free
      calcium concentration ([Ca2+]i) and its relationship with muscle relaxation were
      examined in plexus-free longitudinal muscle (LM) of the guinea pig ileum using a
      [Ca2+]i-tension simultaneous recording technique. Tissue was stimulated with
      either histamine (0.5 microM) or KCl (30 mM). rCGRP at a concentration of 263 nM
      (which displayed maximal relaxation of the LM) caused a small and brief but
      significant decrease in the [Ca2+]i in histamine-treated tissue. On the other
      hand, the same concentration of rCGRP relaxed the muscle without affecting the
      [Ca2+]i in KCl-treated tissue. rCGRP caused a dissociation between the changes in
      [Ca2+]i and tension. The effects of forskolin 0.5 microM) and nifedipine (10 nM)
      on both [Ca2+]i and tension were examined in comparison with rCGRP. Forskolin
      lowered the tension to greater extent than the [Ca2+]i whereas nifedipine (10 nM)
      diminished both the [Ca2+]i and tension in a parallel manner in histamine-treated
      tissues. These results suggest that rCGRP may not reduce [Ca2+]i as its primary
      mechanism of relaxation and it may change the calcium sensitivity of the
      contractile elements of the smooth muscle.

PMID- 7784260
TI  - Validation, role in perioperative assessment, and clinical applications of an
      immunoradiometric assay for human calcitonin.
AB  - We have evaluated a new immunoradiometric assay (IRMA) for calcitonin (CT)
      (Medgenix, Belgium). The detection limit of immunoreactive CT (IR-CT) was 2.8
      pg/ml, and plasma levels of IR-CT of 134 healthy adults (dynamic range, 2.8-1000
      pg/ml) were < 19 pg/ml (median 4.1 pg/ml). Both basal and pentagastrin-stimulated
      IR-CT levels were < 30 pg/ml and were well separated from the levels in patients
      with medullary thyroid carcinoma (MTC) (46-29,000 pg/ml, n = 38). In preoperative
      plasma samples in five patients with C-cell hyperplasia, CT IRMA confirmed the
      diagnosis, although in two patients RIA failed to detect a significant increase
      of IR-CT. By modifying the IRMA, we could identify residual tumor tissues
      perioperatively in patients undergoing thyroidectomy for MTC. RIA of gel
      permeation chromatography showed four IR-CT peaks, but IRMA had only three peaks,
      suggesting that IRMA is more specific. CT-IRMA is more specific, sensitive,
      robust, rapid, and reliable than RIA. In addition, neat plasma can be used
      directly in a single step in CT-IRMA.

PMID- 7784261
TI  - Homologous regulation of vasoactive intestinal peptide (VIP) receptors on rat
      peritoneal macrophages.
AB  - In the present study, we examined the effect of pretreatment with VIP and various
      peptides structurally related to VIP such us PHI, helodermin, and secretin on VIP
      receptor number and affinity, as well as VIP-stimulated cyclic AMP production in
      rat peritoneal macrophages. Short-term (5-30 min) exposures of rat peritoneal
      macrophages to 0.1 microM VIP induced a rapid reduction in specific binding.
      Pretreatment for 15 and 30 min caused 26% (SEM = 6) and 48% (SEM = 4) reduction
      in specific binding, respectively. The maximal effect was observed at 120 min,
      causing a decrease of 67% (SEM = 6) in specific binding. Pretreatment with 0.1
      microM VIP for 15, 30, and 120 min caused 23% (SEM = 9), 52% (SEM = 4), and 76%
      (SEM = 4) reduction in cyclic AMP production, respectively. Only VIP
      concentrations at the nanomolar level and higher were shown to be effective. The
      potency of VIP and related peptides to desensitize was similar to their potency
      to occupy receptors and to activate cyclic AMP production. The internalization of
      radioiodinated VIP was also studied. It was shown that receptor-bound ligand is
      internalized during the downregulation process. However, the diminution in VIP
      binding to macrophages was not completely explained by internalization.

PMID- 7784262
TI  - Pharmacological evidence for the involvement of endogenous alpha-MSH-like
      peptides in peripheral nerve regeneration.
AB  - The possible involvement of alpha-MSH-like peptides in the regenerative response
      of peripheral nerves was investigated with a competitive antagonist of alpha-MSH,
      the synthetic hexapeptide [D-Trp7,Ala8,D-Phe10)alpha-MSH(6-11)-amide.
      Subcutaneous administration of the alpha-MSH antagonist during the first 10 days
      following sciatic nerve crush significantly decreased functional recovery as
      measured by the foot flick withdrawal test and the walking pattern analysis.
      Hypophysectomy delayed both the initial sprouting response and the outgrowth rate
      after major caudal nerve crush. When hypophysectomized rats were treated with the
      alpha-MSH antagonist, a further delay in initial sprouting was observed, whereas
      the outgrowth rate of nerve fibers was not affected. These results suggest that
      1) endogenous alpha-MSH-like peptides stimulate nerve outgrowth following
      peripheral nerve injury and 2) alpha-MSH-like peptides derived from a source
      other than the pituitary may contribute to the physiological stimulus leading to
      sprouting.

PMID- 7784263
TI  - Properties of rat brain dipeptidyl aminopeptidases in the presence of detergents.
AB  - Rat brain dipeptidyl aminopeptidases I to IV were assayed in the soluble and
      membrane-bound fractions of rat brain, and the effects of the detergents Triton X
      100 and sodium deoxycholate on their activities were studied. Dipeptidyl
      aminopeptidases I and II were significantly inhibited in the presence of sodium
      deoxycholate, but were not affected by the presence of Triton X-100. However,
      dipeptidyl aminopeptidase III was not influenced by either detergent, whereas the
      activity of dipeptidyl aminopeptidase IV was stimulated in the presence of Triton
      X-100, but remained unaffected by deoxycholate. These effects were partially or
      totally reversed after detergents were removed from the medium with adsorbent
      polymeric beads. Although detergents may have different effects on each DAP
      activity, the behavior of each enzyme activity in the presence of these
      substances was similar regardless of their subcellular location. These findings
      suggest that, as with other aminopeptidases, each of these proteins corresponds
      to the same molecular species in two different cell compartments.

PMID- 7784264
TI  - Processing of the L5-67 precursor peptide and characterization of LUQIN in the
      LUQ neurons of Aplysia californica.
AB  - Metabolic labeling of the dorsal Left Upper Quadrant (LUQ) cells of the abdominal
      ganglion of Aplysia californica and RP-HPLC separation of their peptide content
      allowed us to identify the L5-67 precursor and its processed peptides. Cleavage
      of the signal peptide occurred between amino acids 23 and 24 of the prepropeptide
      and generated a propeptide of 89 amino acids. Further processing by
      endopeptidases at the twin basic residues Lys12-Arg13 of the precursor generated
      a peptide of 76 amino acids, as well as an amidated decapeptide, LUQIN. The
      sequence of LUQIN was determined by amino acid sequencing and by its comigration
      with the synthetic peptide Ala-Pro-Ser-Trp-Arg-Pro-Gln-Gly-Arg-Phe-amide in three
      different RP-HPLC systems. The amidation of LUQIN was further demonstrated by its
      resistance to carboxypeptidase A digestion.

PMID- 7784265
TI  - Characterization of neurotensin-like immunoreactivity in human basal ganglia:
      increased neurotensin levels in substantia nigra in Parkinson's disease.
AB  - A method that combines high performance liquid chromatography with
      radioimmunoassay (HPLC/RIA) has been used to characterize neurotensin-like
      immunoreactivity (NT-IR) in the basal ganglia from control subjects and
      Parkinson's disease (PD) patients. In samples from the caudate nucleus and
      putamen, NT-IR eluted as two HPLC peaks. One was indistinguishable from the
      synthetic tridecapeptide, while the other peak corresponded to oxidized NT, as
      judged by its chromatographic behaviour and its reaction with the antiserum
      employed. There were marked discrepancies between the IR detected in crude
      extracts and that in HPLC purified samples. NT levels (HPLC/RIA) were unaltered
      in the caudate nucleus, putamen and both segments of the globus pallidus in the
      parkinsonian brain. In contrast, there was a two-fold increase in NT content in
      both zona compacta and zona reticulata of the substantia nigra in PD patients
      compared to controls. Degeneration of the nigrostriatal pathway and/or prolonged
      antiparkinsonian treatment in PD appears to alter neurotensin levels in an
      attempt to activate the dopaminergic nigrostriatal pathway.

PMID- 7784266
TI  - Neuropeptide FF-like immunoreactivity in human plasma.
AB  - In order to examine whether neuropeptide FF (NPFF), an octapeptide with pain
      modulating and blood pressure-raising properties in the rat, is present in
      circulating human blood, a radioimmunoassay (RIA) was established. Using this
      highly specific and sensitive RIA, the mean concentration of NPFF in human plasma
      was 2.9 pg/ml +/- 1.1 (n = 111). The concentration did not correlate with age or
      sex. Reversed-phase high pressure liquid chromatography (HPLC) followed by RIA
      using two different antisera for NPFF showed that plasma NPFF eluted in a
      position identical to that of synthetic NPFF. In view of published Kd values
      (0.06 mM) for NPFF receptor, the concentrations detected of NPFF in human plasma
      may be too low for systemic actions. Thus, plasma NPFF may represent leakage of
      the peptide from nervous tissue.

PMID- 7784267
TI  - Delta-opioid peptide receptors in muscles from obese diabetic and normal mice.
AB  - Autoradiography was used to study the opioid receptors in soleus and extensor
      digitorum longus (EDL) muscles from normal mice and mice with type II diabetes.
      Binding sites for [125I]beta-endorphin were present on the surface membranes in
      muscles from normal mice. The density of receptors was higher in muscles from
      obese diabetic mice. The specific delta-opioid ligands DPDPE and [D
      Ala2]deltorphin-II inhibited the binding of [125I]beta-endorphin whereas mu and
      kappa agonists did not. Therefore, the opioid receptor present in skeletal muscle
      fibers of the mouse is of the delta subtype and the number of these receptors is
      increased in type II diabetes in the mouse.

PMID- 7784268
TI  - Commentary on the Dunning tumor.

PMID- 7784269
TI  - Androgenic and antiandrogenic control on epidermal growth factor, epidermal
      growth factor receptor, and androgen receptor expression in human prostate cancer
      cell line LNCaP.
AB  - Both androgen and antiandrogen treatments enhance the proliferation rate of the
      hormone-dependent prostate cancer cell line LNCaP, expressing a mutated androgen
      receptor (AR). We studied the modification of the expression of epidermal growth
      factor (EGF), of its receptor (EGF-R), and of androgen receptor (AR) in the LNCaP
      cell line, under basal conditions and during androgen (R1881) and antiandrogen
      hydroxy-flutamide (OH-FLU) treatment. After prolonged R1881 administration, a
      marked increase of EGF release was observed, completely blocked by the addition
      of OH-FLU. The Scatchard plot analysis of EGF-R binding revealed two classes of
      binding sites with high and low affinity. The administration of OH-FLU alone or
      combined with R1881 did not modify the affinity constants, while the low-affinity
      component disappeared after androgen administration. Both androgen and
      antiandrogen administration led to a significant increase of the EGF-R high
      affinity component. AR mRNA and protein levels were downregulated by R1881
      treatment. Following OH-FLU administration, AR mRNA was slightly downregulated,
      and there was not a strict parallelism between AR mRNA levels and AR binding
      capacity. When combined with R1881, OH-FLU partially counteracted the androgen
      induced AR downregulation. Our data show that EGF-R binding capacity is the only
      parameter constantly raised in cell proliferation with respect to quiescent
      cells, and highlights the nonunivocal action of OH-FLU on androgen-induced
      effects.

PMID- 7784270
TI  - Inhibition of prostate cancer growth by estramustine and colchicine.
AB  - Hormone-refractory prostate cancer continues to be associated with a very poor
      prognosis. Agents that inhibit microtubule function have been found to be
      cytotoxic to prostate cancer cells in preclinical and clinical settings. It was
      the aim of this study to assess the activity of estramustine and colchicine, two
      microtubule inhibitors, in hormone-refractory prostate cancer. In clinically
      achievable concentrations, the combination of estramustine and colchicine was
      cytotoxic to both the Dunning rat prostate adenocarcinoma cell line MAT-LyLu
      (MLL) and human prostate cancer cells (PC-3). Microtubule function was assessed
      in vitro to evaluate possible mechanisms of action. In motility and cell cycle
      analysis assays, estramustine and colchicine inhibited cellular motility but not
      cell cycle transit. In vivo, these two agents both inhibited the growth of
      implanted Dunning rat prostate adenocarcinoma MLL cells but did not appear to
      have additive effects. The use of oral colchicine in the treatment of hormone
      refractory prostate cancer requires further investigation.

PMID- 7784271
TI  - Survival of patients with localized prostate cancer treated with percutaneous
      transperineal placement of radioactive gold seeds: stages A2, B, and C.
AB  - Between 1984 and 1991, a total of 177 patients with adenocarcinoma of the
      prostate were treated with transcutaneous, transperineal radioactive gold seeds.
      Of these 177 patients, 20 were determined to have pelvic lymph node involvement
      and were excluded from this review. The remaining 157 patients received a median
      radioactivity dose of 164 mCi with a median follow-up of 48 months. Cancer
      specific survival at 5 years was 100% for stage A2 and B1, 90% for stage B2, and
      76% for stage C cancer. Covariates of grade, total radioactivity administered,
      age of the patient, and number of seeds implanted did not influence disease-free
      survival in a statistically significant manner. Significant complications were
      observed in two patients. The survival rates of patients treated with 198Au seed
      implantation for localized cancer are equivalent or better when compared to
      historical data of patients treated with 125I implantation, external beam
      radiotherapy, combination radioactive gold seed implantation and external
      irradiation, and radical prostatectomy. In addition, these comparable survival
      rates using interstitial 198Au seeds may be achieved with less morbidity.

PMID- 7784272
TI  - Components of a geriatric medical service: view from the UK.

PMID- 7784273
TI  - Urinary incontinence.

PMID- 7784274
TI  - Stroke prevention.

PMID- 7784275
TI  - Parkinson's disease.

PMID- 7784276
TI  - Alzheimer's disease.

PMID- 7784277
TI  - The role of ultrasound in the diagnosis of ganglion cysts.
AB  - Ganglion cysts are usually diagnosed clinically. We report three cases in which
      diagnostic doubt existed and in which ultrasound enabled the correct diagnosis to
      be made.

PMID- 7784278
TI  - Spectrum of renal cortical necrosis in acute renal failure in eastern India.
AB  - Renal cortical necrosis is an uncommon cause of acute renal failure. We report 23
      cases of biopsy-proven renal cortical necrosis which constituted 6.3% (23/363) of
      all cases of acute renal failure studied over a period of seven years (1985-92).
      The patients were divided into two groups: obstetric and non-obstetric. Obstetric
      complications were responsible for renal cortical necrosis in 15 (65.2%) patients
      while non-obstetric conditions accounted for the remaining eight (34.8%) cases.
      The overall incidence of cortical necrosis in obstetric acute renal failure was
      15/63 (23.8%) patients, the incidence being nearly equal in early (20.5%) and
      late (29%) pregnancy. Post-abortum renal failure was the sole cause of cortical
      necrosis in early pregnancy in the obstetric group. Haemolytic uraemic syndrome
      (three patients) and septicaemia (two patients) were the main cause of necrosis
      in the non-obstetric group. The cortical necrosis was diffuse and patchy in 17
      and six patients, respectively. The disease had a fatal prognosis in 20 (87%)
      patients; mortality was due to uraemic complications and infections in the
      majority of patients. The high frequency of post-abortum renal cortical necrosis
      in our patients is similar to the experience of other Indian workers.

PMID- 7784279
TI  - Fractional excretion of potassium in normal subjects and in patients with
      hypokalaemia.
AB  - The aim of our study was the determination of fractional excretion of potassium
      (FEK+) in both normal subjects and hypokalaemic patients. Three hundred and
      twelve normal subjects aged 21-69 years and 84 hypokalaemic patients aged 36-72
      years were studied. The mean FEK+ in normal subjects was 8% (range 4-16%). FEK+
      was positively correlated with serum potassium (r = 0.74, p < 0.0001) and
      inversely with serum creatinine (r = -0.51, p < 0.001). The mean FEK+ in patients
      with hypokalaemia of external origin was 2.8% (range 1.5-6.4%). On the contrary,
      the mean FEK+ in hypokalaemic patients in whom renal potassium loss was the main
      aetiologic factor for the pathogenesis of hypokalaemia was 15% (range 9.5-24%).

PMID- 7784281
TI  - High dependency units in the UK: variable size, variable character, few in
      number.
AB  - An exploratory descriptive survey was conducted to determine the size and
      character of high dependency units (HDUs) in the UK. A telephone survey and
      subsequent postal questionnaire was sent to the 39 general HDUs in the UK
      determined by a recent survey from the Royal College of Anaesthetists; replies
      were received from 28. Most HDUs (82%, n = 23) were geographically distinct from
      the intensive care unit and varied in size from three to 13 beds, although only
      64% (n = 18) reported that all beds were currently open. Nurse: patient ratios
      were at least 1:3. Fifty per cent of units had one or more designated consultants
      in charge, although only 11% (n = 3) had specifically designated consultant
      sessions. Junior medical cover was provided mainly by the on-call speciality
      term. Twenty units acted as a step-down facility for discharged intensive care
      unit patients and 21 offered a step-up facility for patients from general wards.
      Provision of facilities and levels of monitoring varied between these units. Few
      HDUs exist in the UK and they are variable in size and in the facilities and
      monitoring procedures which they provide. Future studies are urgently required to
      determine cost-effectiveness and outcome benefit of this intermediate care
      facility.

PMID- 7784280
TI  - Factors associated with high risk of marginal hyperthermia in elderly patients
      living in an institution.
AB  - The elderly, the very young, and the sick are known to be adversely affected by
      high environmental temperatures. In a retrospective open case-note review of 872
      patients in a large institution during a hot summer we identified characteristics
      in the elderly that increase the risk of marginal hyperthermia. Women were more
      likely to be affected than men (25.6% vs 16.9%). We found an age-related increase
      in marginal hyperthermia, 15.7% of those below 60 years developed a hyperthermia
      compared to 18.9% in those between 70-79 years (non-significant), 28.3% in those
      between 80-89 years (p = 0.01) and 50% in those above 90 years (p < 0.01). There
      was also a direct relationship between the incidence of hyperthermia and the
      ambient temperature (29% in the warmer wards, compared to 17.2% in cooler ones; p
      < 0.01) and with the level of dependence (42.3% of the bedridden group, p < 0.01,
      and 20.4% of the semi-dependent, p < 0.01, compared to 11.1% of the mobile
      group). These factors were more significant as predictors of risk than the
      diagnosis. Identifying high risk patients early and taking appropriate measures
      to avoid hyperthermia and dehydration is important to try to decrease mortality
      during heatwaves.

PMID- 7784283
TI  - Severe theophylline poisoning: charcoal haemoperfusion or haemodialysis?
AB  - Theophylline poisoning with a blood level of 183 mg/l in a 38-year-old man was
      treated with activated charcoal by mouth, but despite this the blood level of
      theophylline rose and there was circulatory collapse with rhabdomyolysis, acute
      renal failure and hyperthermia. Treatment with charcoal haemoperfusion and
      simultaneous haemodialysis was given, followed by continuous arteriovenous
      haemodialysis (CAVHD). Mean extraction rates of theophylline were 26% during
      CAVHD, and 86% during combined dialysis and charcoal haemoperfusion. During
      combined treatment, the mean extraction rate of haemodialysis was 62%, compared
      with 48% for charcoal haemoperfusion. In summary, activated charcoal given by
      mouth may be unable to prevent a rise in blood levels and the development of
      complications after substantial theophylline overdose. If theophylline is to be
      removed from the blood, a combination of charcoal haemoperfusion and
      haemodialysis will give the best clearance, but haemodialysis alone may be
      effective.

PMID- 7784282
TI  - Role of TSH measurements in predicting the outcome of treatment for Graves'
      disease following drug therapy.
AB  - Thyroid-stimulating hormone (TSH) levels obtained one month after the cessation
      of anti-thyroid drug treatment were assessed retrospectively for possible use in
      predicting outcome in 50 patients with a clinical diagnosis of Graves' disease.
      Thirty-four patients remained in remission at the end of the follow-up period and
      16 patients relapsed. Although a TSH level of < 1.2 mU/1 did not discriminate
      between the two groups, none of the 24 patients who had TSH levels of > 1.2 mU/1
      relapsed during the follow-up period, making early discharge from the thyroid
      clinic possible for these patients.

PMID- 7784284
TI  - Poisoning due to an over-the-counter hypnotic, Sleep-Qik (hyoscine,
      cyproheptadine, valerian).
AB  - The clinical features and risk of hepatotoxicity of 'Sleep-Qik' (valerian dry
      extract 75 mg, hyoscine hydrobromide 0.25 mg, cyproheptadine hydrochloride 2 mg)
      were determined in 23 patients treated in our hospital between 1988 and 1991. The
      main clinical problems were central nervous system depression and anticholinergic
      poisoning. There was no clinical evidence of acute hepatitis in the 23 patients
      after taking an average of 2.5 g of valerian (range 0.5 to 12 g). There was no
      evidence of subclinical liver damage in 12 patients who had routine liver
      function tests performed approximately 6-12 hours after ingestion. Delayed onset
      of severe liver damage was excluded in 10 patients in whom a telephone follow-up
      was possible. However, subclinical liver dysfunction in the acute stage (onset
      after 12-24 hours) and in the intervening period after discharge from hospital
      could not be excluded. To establish the risk of hepatotoxicity in long-term users
      and in those taking an overdosage of valerian, a much larger study of longer
      duration with serial liver function tests is clearly needed.

PMID- 7784285
TI  - Iatrogenic Cushing's syndrome due to nasal betamethasone: a problem not to be
      sniffed at!

PMID- 7784286
TI  - Antiphospholipid syndrome in a patient with rapidly progressive fibrosing
      alveolitis.
AB  - The antiphospholipid syndrome is a thrombotic disorder which can occur in a
      primary form or more classically in systemic lupus erythematosus. An association
      between cryptogenic fibrosing alveolitis and the antiphospholipid syndrome has
      not previously been reported. We describe a patient with severe cryptogenic
      fibrosing alveolitis who developed pulmonary embolism and myocardial infarction
      in the presence of antiphospholipid antibody. The case also illustrates that
      worsening respiratory function may represent superimposition of one lung
      pathology on another, and may not simply be a deterioration of the pre-existing
      disease.

PMID- 7784287
TI  - Central pontine myelinolysis following orthotopic liver transplant: association
      with cyclosporine toxicity.
AB  - Central pontine myelinolysis can occur after orthotopic liver transplantation
      leading to high mortality and serious morbidity. In our case, central pontine
      myelinolysis was associated with wide fluctuations in cyclosporine levels during
      an episode of hypocholesterolaemia, which may have precipitated central pontine
      myelinolysis.

PMID- 7784289
TI  - Methotrexate-induced pericarditis and pericardial effusion; first reported case.
AB  - We report a case of methotrexate-induced pericarditis and pericardial effusion in
      a 22-year-old pregnant woman. These complications have not previously been
      described as isolated phenomena associated with methotrexate therapy.

PMID- 7784288
TI  - Post-thymectomy collapse: an unusual case of acute adrenal insufficiency.
AB  - A 54-year-old man who had an appearance strongly suggestive of Cushing's
      syndrome, collapsed after the removal of a carcinoid tumour of the thymus. The
      clinical suspicion of acute adrenal insufficiency was supported by invasive
      haemodynamic data and the diagnosis was subsequently confirmed biochemically.
      These post-operative events were subsequently ignored and a further crisis was
      probably prevented by tumour recurrence (and hence resumption of
      adrenocorticotropic hormone (ACTH) production). The ectopic production of ACTH
      from a carcinoid tumour of the thymus is recognised but a report of acute adrenal
      insufficiency from its removal is probably unique.

PMID- 7784290
TI  - The association of hereditary neuropathies and heritable skeletal disorders.
AB  - We describe two patients with associations of hereditary neuropathies and
      heritable skeletal disorders not previously reported. The first patient had
      Marfan's syndrome and hereditary motor and sensory neuropathy Type 1. The second
      patient had Ehlers-Danlos syndrome, Klippel-Feil syndrome and tomaculous
      neuropathy.

PMID- 7784291
TI  - Dysphagia in an HIV-positive man.
AB  - An HIV-positive man whose dysphagia was due to non-Hodgkin's lymphoma. The
      differential diagnosis of this symptom in the context of HIV infection is
      summarised in box 3.

PMID- 7784293
TI  - Wernike-Korjakoff syndrome due to hyperemesis gravidarum precipitated by
      thyrotoxicosis.

PMID- 7784292
TI  - Thiamine in Wernicke's syndrome--how much and how long?

PMID- 7784294
TI  - Peritonitis complicating leptospirosis.

PMID- 7784295
TI  - Lead preparations in Ayurvedic medicines.

PMID- 7784296
TI  - Streptococcus mitis causing epidural abscess.

PMID- 7784298
TI  - Giant chest wall arteriovenous malformation with spinal cord compression.

PMID- 7784297
TI  - Benign spontaneous pneumoperitoneum in an elderly patient treated medically with
      recovery.

PMID- 7784299
TI  - A negative skin biopsy for malignancy does not exclude the possibility of
      subsequent fatal disease.

PMID- 7784300
TI  - Fluctuating dementia and rhinorrhoea.

PMID- 7784301
TI  - Treatment with omega-3 fatty acid ethyl esters in hyperlipoproteinaemias:
      comparative studies on lipid metabolism and thrombotic indexes.

PMID- 7784302
TI  - Gastroprotective effect of aqueous extract of Cistus incanus L. in rats.
AB  - The antiulcer activity of a short-boiled aqueous extract from aerial parts of
      Cistus incanus was studied in rats against gastric lesions induced by necrotizing
      agents (1N HCl and absolute ethanol), indomethacin, serotonin and reserpine. The
      extract, containing bioflavonoids, was orally administered in the range from 0.25
      to 0.50 g kg-1. It was found to have significant dose-related protective effects
      in all these experimental models, and was more effective against reserpine- and
      serotonin-induced mucosal congestion and haemorrhagic ulcers. These data suggest
      that the active constituents of the crude extract could be responsible for its
      protective effect by maintaining an efficient gastric mucosal microvascular
      supply.

PMID- 7784303
TI  - Protective effects of cilazapril against free radical injury in myocardial
      ischaemia-reperfusion.
AB  - Cilazapril is a prodrug which is rapidly hydrolysed to the pharmacologically
      active cilazaprilat following absorption to the bloodstream. In clinical
      pharmacological studies, administration of cilazapril resulted in potent,
      reversible, selective and competitive angiotensin converting enzyme inhibition.
      In this study, we have examined the protective effect of cilazapril on a
      myocardial ischaemia-reperfusion model by using different parameters of lipid
      peroxidation and protein oxidation. We have observed increased levels of diene
      conjugates, carbonyls and malondialdehyde as well as protein carbonyls after
      ischaemia-reperfusion, whereas protein sulphydryl groups were decreased. Our
      results clearly demonstrate that cilazapril, a non-sulphydryl, long-acting
      angiotensin converting enzyme inhibitor, has free-radical-scavenging potential in
      a model comparable to the clinical situation observed in humans.

PMID- 7784304
TI  - A modified liquid diet of chronic ethanol administration: validation by ethanol
      withdrawal syndrome in rats.
AB  - The validity of a modified liquid diet prepared from cow's milk, 7.2% ethanol,
      vitamin A and sucrose mixture has been investigated for chronic ethanol
      administration in rats. The rats fed by the modified liquid diet lost 3.8% of
      their body weight along 20 days. The mean ethanol consumption was in the range of
      12.6 to 17.6 g kg-1 day-1. The blood ethanol level just before the withdrawal of
      ethanol was found to be 301.38 +/- 36.68 mg dl-1. A severe ethanol withdrawal
      syndrome was observed after 20-day exposure to ethanol in the modified liquid
      diet. The results suggest that the modified liquid diet can be used
      satisfactorily for chronic ethanol administration in rats.

PMID- 7784305
TI  - Regional differences in motor responsiveness to antimuscarinic drugs in rabbit
      isolated small and large intestine.
AB  - The pirenzepine-related analogue, nuvenzepine, and the antagonists selective for
      the three muscarinic receptor subtypes 4-DAMP (M1 and M3 receptors), pirenzepine
      (M1 receptors), methoctramine (M2 receptors) have been tested on rabbit isolated
      small and large intestinal regions provided with spontaneous motor activity. The
      employed drugs differently affected intestinal motility patterns. The ileum
      pendular movements as well as the proximal colon and taenia coli tone, spike
      amplitude and frequency were concentration-dependently inhibited by the compounds
      here employed. Their pIC50 values followed the rank order of potency generally
      reported for the involvement of the M3 muscarinic receptors (4-DAMP > or =
      atropine > nuvenzepine > or = pirenzepine > methoctramine). Unlike nuvenzepine
      and the other antimuscarinics assayed, the M1 selective antagonist pirenzepine,
      at nanomolar concentrations, was able to enhance the proximal taenia coli
      motility patterns suggesting that a M1-inhibitory pathway might operate in the
      physiological modulation of taenia coli motility. At variance with longitudinal
      ileum and colon contractile activity, proximal circular colon motility was
      resistant to muscarinic as well as to alpha 1-, H1-, 5-HT-blockade indicating
      that NANC neuronal mechanisms could act at this level. In summary, these data
      provide evidence that, at intestinal level, nuvenzepine is almost completely
      devoid of reliable M1-linked effect thus possessing a different pharmacological
      selectivity at muscarinic receptor subtypes with respect to pirenzepine.
      Furthermore, it emerges that rabbit spontaneous small and large intestinal
      motility is probably driven by different physiological mechanisms regional
      related. The peculiar circular colon refractoriness deserves further studies to
      be extended to the human tissue.

PMID- 7784306
TI  - Impact of drug dosage and brand on bioavailability and efficacy of praziquantel.
AB  - The efficacy of two brands (brand 1 = Biltricide; Bayer AG, Leverkusen, Germany;
      brand 2 = Distocide; EPICO pharmaceuticals, Cairo, Egypt) of praziquantel (PZQ)
      in full and half doses (40 and 20 mg kg-1) monitored as percentage egg reduction
      and cure rate was investigated in S. mansoni infected school-children. A total of
      506 school-children (8-16 years of age) were classified into three groups
      according to their intensity of infection, heavy [> 500 eggs per grams (epg)],
      moderate (100-500 epg) and light (< 100 epg), after examination three stool
      samples (three slides per sample) on three consecutive days. Percentage egg
      reduction and cure rate were monitored 4 and 10 weeks post-treatment for each
      dose regimen in the different test groups. Before testing the efficacy of either
      bran in patients, the pharmacokinetic parameters of the two brands were studied
      in non-infected normal volunteers. Statistical analysis of the pharmacokinetic
      parameters of brand 1 vs brand 2 (in a dose of 20 or 40 mg kg-1) revealed no
      significant difference in elimination (ke), absorption rate constant (ka),
      elimination half life (t1/2e), area under the time-concentration curve (Auc),
      serum maximum concentration (Cpmax) and time to maximum concentration (Tmax). As
      regards the efficacy of test drugs, statistical analysis revealed that up to 10
      weeks post-treatment the two brands of PZQ in full dose were equally effective in
      reducing egg count as their half doses except in heavily infected cases treated
      with brand 2 of PZQ.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784307
TI  - Anti-inflammatory potency and gastrointestinal toxicity of a new compound,
      nitronaproxen.
AB  - Naproxen and its derivative nitronaproxen at the doses of 5 and 10 mg kg-1 were
      compared for their acute anti-inflammatory efficacy in a carrageenan oedema model
      and gastrointestinal toxicity in rats. Moreover, the effects of the two drugs
      were evaluated in the adjuvant arthritis, after chronic doses of 4 and 8 mg kg-1
      administered orally for 18 days. The oedema reduction was maintained much longer
      (until 5 h) with nitronaproxen; the inhibition of arthritis was 50% or more with
      both doses of the examined drugs. From the histological examination of the
      stomachs, an extensive mucosal vasocongestion and haemorrhagic lesions have been
      observed in some rats treated with naproxen. The percentages of animals with
      ulcers were 50, 100 and 10 with naproxen 6 and 18 mg kg-1 and nitronaproxen 54 mg
      kg-1 respectively. A better gastrointestinal tolerability has been observed in
      arthritic and oedemic rats treated with nitronaproxen compared to naproxen: this
      could be due to the presence of nitric oxide that acts in maintaining the tissue
      perfusion and integrity.

PMID- 7784308
TI  - Protective effect of propionyl-L-carnitine against PAF-induced rat paw oedema.
AB  - Recent reports from our laboratory gave evidence showing that propionyl-L
      carnitine (PLC), unlike L-carnitine (LC) and acetyl-L-carnitine (ALC), has anti
      inflammatory activity in some models of vascular inflammation in rodents. The
      present paper shows that PLC (50 to 200 mg kg-1 i.p.) inhibits rat paw oedema
      induced by platelet activating factor (PAF), while LC and ALC, as well as
      indomethacin and phenylbutazone, are ineffective. The extent of the maximal
      inhibition produced by PLC at 200 mg kg-1 was comparable to that of betamethasone
      0.05 mg kg-1 or sodium salicylate 100 mg kg-1. PLC inhibited also the early phase
      (1-2 h) of carrageenin-induced rat paw oedema, which is partly dependent on PAF
      release, but it was ineffective in the eicosanoid-dependent late phase (3-4 h) of
      the carrageenin oedema. We suggest that such anti-inflammatory activity of PLC
      may be due to various mechanisms converging on a stabilizing action upon
      biomembranes.

PMID- 7784309
TI  - Effect of pumpkin-seed oil on the level of free radical scavengers induced during
      adjuvant-arthritis in rats.
AB  - Pumpkin-seed oil (PSO), a natural supplement rich with antioxidant ingredients,
      was given to rats in which arthritis was induced using Freund's complete
      adjuvant. Its effect was compared with that of indomethacin, as a classical anti
      inflammatory agent. Two experimental patterns were studied, an acute phase that
      was applied only with PSO and a chronic phase applied for both PSO and
      indomethacin. Compared to normal untreated rats, it was shown that the induction
      of arthritis caused a decrease in serum sulphhydryl groups, with an increase in
      serum ceruloplasmin in both phases. Blood glutathione was first elevated in the
      acute phase, then its level was reduced in the chronic phase. Serum N-acetyl-beta
      D-glucosaminidase activity was elevated only at the acute phase, while plasma
      total proteins and albumin were reduced at the chronic phase. Liver glucose-6
      phosphate dehydrogenase activity was markedly increased, while no changes were
      observed in the levels of liver lipid peroxides and glutathione. These changes in
      the studied parameters were attributed to the superoxides and free radicals
      during arthritic inflammation. Administration of PSO succeeded in modulating most
      of the altered parameters affected during arthritis, especially at the chronic
      phase. Also, a remarkable inhibition of paw oedema was observed. A similar
      pattern was obtained upon treatment with indomethacin except that indomethacin
      markedly elevated liver lipid peroxides levels. Concurrent administration of PSO
      with indomethacin caused no changes in the parameters studied compared to that
      induced by treatment with indomethacin alone.

PMID- 7784311
TI  - Management of dementia.

PMID- 7784310
TI  - Pharmacology of competitive inhibitors of HMG-CoA reductase.

PMID- 7784312
TI  - Child abuse--true or false?

PMID- 7784313
TI  - Anterior cruciate ligament injury.

PMID- 7784314
TI  - Multiple pathology in the elderly.

PMID- 7784315
TI  - Written papers.

PMID- 7784316
TI  - Dermatology.

PMID- 7784317
TI  - Skin surgery.

PMID- 7784318
TI  - Skin changes in systemic disease.

PMID- 7784319
TI  - Management of superficial fungal infections.

PMID- 7784320
TI  - Acne--general practice management.

PMID- 7784321
TI  - Atopic eczema.

PMID- 7784322
TI  - Hypertension and renal disease.

PMID- 7784323
TI  - Atypical pneumonias.

PMID- 7784324
TI  - A radical review of antenatal care?

PMID- 7784325
TI  - Communication and cooperation.

PMID- 7784326
TI  - Management of peptic ulcer.

PMID- 7784327
TI  - Rheumatology symposium.

PMID- 7784328
TI  - Rheumatology symposium.

PMID- 7784329
TI  - A contraindication to HRT.

PMID- 7784330
TI  - Transfollicular drug delivery.
AB  - The hair follicle, hair shaft, and sebaceous gland collectively form what is
      recognized as the pilosebaceous unit. This complex, three-dimensional structure
      within the skin possesses a unique biochemistry, metabolism and immunology.
      Recent studies have focused on the hair follicle as a potential pathway for both
      localized and systemic drug delivery. Greater understanding of the structure and
      function of the hair follicle may facilitate rational design of drug formulations
      to target follicular delivery. Targeted drug delivery may enhance current
      therapeutic approaches to treating diseases of follicular origin. Presented here
      is a review of follicular drug delivery and a discussion of the feasibility of
      the pilosebaceous unit as a target site.

PMID- 7784332
TI  - Physical entrapment of adriamycin in AB block copolymer micelles.
AB  - The entrapment of Adriamycin (ADR) in micelles composed of AB block copolymers
      (poly(ethylene oxide-co-beta-benzyl L-aspartate) (PEO-PBLA)) was investigated.
      The loading process involved transfer of ADR and PEO-PBLA into an aqueous milieu
      from dimethylformamide (DMF) through a dialysis procedure. Evidence for the
      physical entrapment of ADR in the polymeric micelles was derived from
      fluorescence spectroscopy and gel permeation chromatography (GPC). The total
      fluorescence intensity of ADR was low, suggesting that the drug was self
      associated in the micelles. In addition, quenching experiments, using a water
      soluble quencher (iodide (I-)), showed that the fluorescence of ADR present in
      micellar solutions was largely unaffected by I-, whereas the fluorescence of free
      ADR was readily quenched. From Stern-Volmer plots, quenching constants (KSV) of
      2.2 and 17 M-1 were determined for ADR in micellar solutions and free ADR,
      respectively. As a result of the entrapment of ADR in the micelles, ADR binds
      only slightly serum albumin as evidenced by GPC. In contrast, ADR readily binds
      serum albumin in aqueous solutions. The findings suggest that ADR is stably
      entrapped in PEO-PBLA micelles. ADR entrapment in polymeric micelles is expected
      to affect markedly the pharmacokinetics of ADR.

PMID- 7784331
TI  - Synthesis and pharmacological properties of 2-[S-acetylthiorphan]-1,3-
      diacylaminopropan-2-ol derivatives as chimeric lipid drug carriers containing an
      enkephalinase inhibitor.
AB  - The design of 1,3-dacylaminopropan-2-ols as CNS-directed carrier groups is based
      on their resemblance to endogenous lipids and the properties of
      pseudotriglyceride esters to facilitate the brain penetration of therapeutic
      agents. 2-[S-acetylthiorphan]-1,3-diacylaminopropan-2-ols, differing from the
      nature of 1,3-acyl chains, were synthesized and evaluated in vivo using the hot
      plate jump test. The compounds exhibited naloxone reversible analgesic
      properties. The effects were superior to those of parent compounds thiorphan and
      S-acetylthiorphan. The palmitoyl derivative showed also activity at 0.8 mmol/kg
      after oral administration. Like acetorphan, a thiorphan prodrug, these compounds
      were poor substrates for brain enkephalinase, suggesting the release of the
      pharmacological active inhibitor at the site of action in the brain.

PMID- 7784333
TI  - Construction of an intermittent-motion capsule filling machine simulator.
AB  - A pneumatically operated apparatus is described which simulates the forces
      generated by and the component movements encountered in a Macofar 13/2 dosator
      type capsule filling machine. Force transducers are fitted to the dosing piston
      and dosator tip, and the movement of the dosator piston and the powder bed
      followed by displacement transducers. Calibration of the transducers is
      described. The output from the transducers is collated, stored and manipulated by
      microcomputer. The manufacturing parameters which can be studied using this
      apparatus are discussed.

PMID- 7784334
TI  - Preparation and physicochemical characterization of aqueous dispersions of
      coenzyme Q10 nanoparticles.
AB  - The present study describes a novel pharmaceutical formulation of coenzyme Q10,
      viz. submicron-sized dispersions of the substance prepared by emulsification of
      molten coenzyme Q10 in an aqueous phase. Photon correlation spectroscopy reveals
      mean diameters of 60 to 300 nm depending on process parameters. Coenzyme Q10
      nanoparticles remain stable on storage for more than 30 months. Lipophilic drugs
      can be incorporated into the nanoparticles demonstrating their potential use as a
      drug carrier system. Transmission electron micrographs of freeze-fractured
      replica show spherical particles with an amorphous core. Cryo-electron microscopy
      reveals the coexistence of small unilamellar vesicles in phospholipid stabilized
      dispersions. Thermoanalysis and X-ray studies indicate that the dispersed and
      emulsified coenzyme Q10 does not recrystallize even at 4 degrees C over 30
      months. These agree with 1H NMR data which demonstrate that coenzyme Q10
      molecules have a high mobility when formulated as nanoparticles and that
      colloidally dispersed coenzyme Q10 remains in the state of a supercooled melt.
      Despite the high melting point of the bulk material, coenzyme Q10 dispersions
      represent no suspensions but O/W emulsions according to the IUPAC definition (1).

PMID- 7784335
TI  - Design for cell-specific targeting of proteins utilizing sugar-recognition
      mechanism: effect of molecular weight of proteins on targeting efficiency.
AB  - Hepatic targeting of proteins utilizing the sugar-recognition mechanism was
      investigated in mice after intravenous injection. Five proteins with different
      molecular weights, i.e., bovine gamma-globulins (IgG), bovine serum albumin
      (BSA), recombinant human superoxide dismutase (SOD), soybean trypsin inhibitor
      (STI), and chicken egg white lysozyme (LZM), were modified with 2-imino-2
      methoxyethyl 1-thiogalactoside to obtain galactosylated proteins (Gal-IgG, Gal
      BSA, Gal-SOD, Gal-STI, and Gal-LZM). The numbers of galactose residues were 38,
      20, 11, 6, and 5 for Gal-IgG, Gal-BSA, Gal-SOD, Gal-STI, and Gal-LZM,
      respectively. All galactosylated proteins were dose-dependently taken up by the
      liver and the relative amount accumulated in the liver was decreased with an
      increase of the administered dose. At low doses (0.05 and 0.1 mg/kg), Gal-IgG,
      Gal-BSA, and Gal-SOD could be taken up by the liver up to more than 70-80% of
      dose within 10 min after intravenous injection, but the maximum amounts
      accumulated in the liver were approximately 40 and 30% of the dose for Gal-STI
      and Gal-LZM, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784336
TI  - Stabilization of chimeric BR96-doxorubicin immunoconjugate.
AB  - Chimeric BR96-doxorubicin conjugate (BR96-DOX) is an immunoconjugate designed to
      specifically target and kill certain tumor cells. The linker between the chimeric
      BR96 antibody and DOX is an acid-labile hydrazone group which was designed to
      undergo lysosomal hydrolysis to release DOX in vivo. Stability studies indicated
      that acid-catalyzed hydrazone hydrolysis was the major degradation route in
      vitro. Even under optimal conditions of pH and temperature, the stability of BR96
      DOX in solution was not acceptable for long-term storage. Lyophilization of BR96
      DOX in the presence of added sugars, such as lactose or sucrose, and subsequent
      storage of the lyophile under refrigeration significantly improved the stability.
      Therefore lyophilization appears to be a viable approach for achieving long-term
      stabilization of BR96-DOX.

PMID- 7784337
TI  - Efficacy evaluation of a novel submicron miconazole emulsion in a murine
      cryptococcosis model.
AB  - Submicron emulsions of miconazole were stabilized by using a combination of three
      emulsifiers comprising phospholipids, poloxamer, and deoxycholic acid (DCA). The
      presence of DCA was vital for prolonged emulsion stability owing to its
      contribution to the elevated zeta potential of the emulsion. Further, the results
      by the phospholipid surface labelling colorimetric technique clearly suggested
      that poloxamer molecules interacted with phospholipid polar-head groups of the
      mixed DCA-phospholipid interfacial film, resulting in the stabilization of the
      emulsion by a steric enthalpic entropic mechanism. The plain emulsion vehicle was
      well tolerated up to a dose of 0.6 ml injected i.v. to BALB/c mice. The maximum
      tolerated dose of miconazole was 80 and 250 mg/kg in Daktarin i.v. (a marketed
      product) and emulsion, respectively, showing an improved safety ratio of 1 to 3
      in favor of the emulsion. These results tended to confirm that the adverse
      effects associated with Daktarin i.v. injection should be associated with the
      vehicle rather than with the miconazole itself. In a murine cryptococcosis model,
      only one mouse out of ten remained alive by day 15 in the infected group treated
      with Daktarin i.v., while in the miconazole emulsion treated group, mice began to
      die from day 16 up to day 25 post inoculation. Thus, the multiple-dose treatment
      with the miconazole emulsions improved the protection offered to the infected
      mice. However, the therapeutic levels of miconazole that were reached in the
      target organ (brain) were lower than those required for complete eradication of
      Cryptococcus neoformans, which is known to multiply preferentially in the brain.

PMID- 7784338
TI  - Comparison of gamma scintigraphy and a pharmacokinetic technique for assessing
      pulmonary deposition of terbutaline sulphate delivered by pressurized metered
      dose inhaler.
AB  - A comparison has been made of pulmonary deposition of terbutaline sulphate from a
      pressurized metered dose inhaler (pMDI), measured in 8 healthy male subjects by
      gamma scintigraphy and by a pharmacokinetic (charcoal-block) method, involving
      drug recovery in urine. Measurements were carried out with a pMDI at slow (27
      l/min) and fast (151 l/min) inhaled flows and with Nebuhaler large volume spacer
      device (average inhaled flow 17 l/min). Overall, the two methods did not differ
      significantly in their estimates of whole lung deposition, although values
      obtained by gamma scintigraphy exceeded those from the charcoal-block method for
      the pMDI with fast inhalation. The regional distribution of drug within the lungs
      and deposition in the oropharynx could be assessed by gamma scintigraphy, but not
      by the charcoal-block method. It is concluded that either method may be used to
      assess whole lung deposition of terbutaline sulphate from pMDIs, both with and
      without a spacer, although each method has its own inherent advantages and
      disadvantages.

PMID- 7784339
TI  - Estimation of agitation intensity in the GI tract in humans and dogs based on in
      vitro/in vivo correlation.
AB  - In this study, we assessed the hydrodynamic flow around a dosage form in the GI
      tract in humans by comparing the characteristics of in vitro and in vivo release
      of two different types of controlled release acetaminophen (paracetamol) tablets,
      A and B. The former tablet showed an agitation speed-dependent release at a high
      speed range (50-100 rpm), whereas the latter showed this characteristic at a low
      speed range (10-50 rpm). The mean release amount-time profiles of tablets A and B
      in humans showed biphasic characteristics, and the first phase of the absorption
      profiles of A and B was close to their in vitro profiles at a paddle speed of 10
      rpm. The in vivo profiles were also superimposable on in vitro dissolution curves
      obtained by the flow-through cell method at a flow rate of 1 mL/min (velocity
      0.89 cm/min) or less. These results indicate that the hydrodynamic flow around
      the dosage forms in the human GI tract could be extremely low. The in vivo
      release rate of these tablets in dogs was greater than in humans, and was
      estimated to be equivalent to the release rate determined by the paddle method at
      100 rpm. This indicates that a higher agitation intensity in the GI tract in dogs
      than in humans may be one cause of the discrepancies between humans and dogs in
      drug absorption studies.

PMID- 7784340
TI  - In vivo evaluation of a colon-specific drug delivery system: an absorption study
      of theophylline from capsules coated with azo polymers in rats.
AB  - Azo polymers based upon 2-hydroxyethyl methacrylate, methyl methacrylate, and
      methacrylic acid, and containing N,N'-bis
      [(methacryloyloxyethyl)oxy(carbonylamino)]azobenzene as azo aromatic agent were
      evaluated in vivo as coating for colon-specific drug delivery. The
      gastrointestinal absorption of theophylline from capsules coated with the azo
      polymers was examined in the proximal part of the small intestine and the cecum
      of male Wistar rats. The capsules were surgically inserted in the region of
      interest. The plasma concentration of the drug was higher when the capsules were
      inserted in the cecum as compared to the small intestine. The appearance of
      theophylline in the plasma when capsules were administered in the small intestine
      can be attributed to simple diffusion of the drug through the swollen polymer
      coating. Release and absorption from the cecum is the combined results of
      diffusion and degradation of the azo polymer coatings by bacterial azo reductase.

PMID- 7784341
TI  - Drug transport across nylon 610 films: influence of synthesis variables.
AB  - Nylon 610 is a hydrophilic polymer with considerable potential as a membrane for
      drug microencapsulation. To better understand drug transport through such
      membrane, the influence of the solvents and monomers used in the synthesis of
      nylon films were examined using a full factorial study. Nylon 610 films were
      synthesized by an interfacial polycondensation reaction using
      hexamethylenediamine (HD) in the water phase and sebacoyl chloride (SC) in the
      organic phase, which was a solvent blend of chloroform and
      trichlorotrifluoroethane at ratios of 1:1, 1:4, and 4:1. Monomer concentrations
      studied were 0.2, 0.4, and 0.6 M with respect to their appropriate phase, while
      the monomer ratios were 1:1, 3:1, and 1:3. The molecular weight, porosity,
      thickness, and crystallinity of the films were characterized. The transport of
      potassium chloride, hydrocortisone, and m-cresol was studied at 25 degrees C as a
      function of the synthesis variables. Potassium chloride was selected to measure
      the porosity of the membrane. Hydrocortisone and m-cresol, a known solvent for
      nylon 610, were used to study pore and solution-diffusion transport,
      respectively. The molecular weight of the films was proportional to the
      chloroform concentration. As the molecular weight increased, film thickness,
      porosity, and hydrocortisone permeability increased. As the molecular weight
      decreased, film thickness and porosity decreased, while m-cresol permeability
      increased. These results can be explained on the basis of HD ability to readily
      partition into a good solvent such as chloroform permitting high molecular weight
      polymer to form before precipitation.

PMID- 7784342
TI  - Effect of norfloxacin on theophylline disposition: a comparison with other
      fluoroquinolones.
AB  - The effects of norfloxacin (NOR), at steady-state plasma concentrations of 0-32
      mg.l-1, on the plasma clearance of a 6 mg.kg-1 i.v. bolus dose of theophylline
      (THEO) in the male Sprague-Dawley rat have been studied. The effects were
      characterised by a Ki value (Ki = 12 microM), which was comparable with Ki values
      obtained previously under identical conditions for ciprofloxacin, but higher than
      that obtained for enoxacin. The distributional characteristics, volume of
      distribution and liver to plasma concentration ratio, were very similar for the
      three compounds. The only marked pharmacokinetic differences were in hepatic
      clearance, where there was a rank order NOR > ciprofloxacin > enoxacin, a reverse
      of the order in the reduction of THEO clearance seen in clinical studies. The
      advantages of using the steady-state experimental design described here are that
      equivalent concentrations are utilised to compare related drugs and differences
      in pharmacokinetics are accounted for, to allow a direct comparison of potency.
      This information, together with additional pharmacokinetic considerations,
      suggests that the different effects on THEO clearance seen in the clinic for NOR,
      ciprofloxacin and enoxacin are not solely due to differences in inhibitory
      potency, but also involve differences in hepatic clearance and hence systemic
      availability of the fluoroquinolones.

PMID- 7784343
TI  - Incorporation of first-order uptake rate constants from simple mammillary models
      into blood-flow limited physiological pharmacokinetic models via extraction
      efficiencies.
AB  - Incorporation of First-Order Uptake Rate Constants from Simple Mammillary Models
      into Blood-Flow Limited Physiological Pharmacokinetic Models via Extraction
      Efficiencies. W. L. Roth, L. W. D. Weber, and K. Rozman (1995). Pharm. Res. 263
      269. First-order rate constants obtained from classical pharmacokinetic models
      correspond to mammillary systems in which all of the blood (or plasma) is assumed
      to be located in a central compartment. In such models the rate at which
      chemicals are transported out of this pool and into another compartment is the
      product of the mass of chemical in the central compartment multiplied by a rate
      constant, which is not limited in magnitude by the blood flow, or the rate at
      which chemicals from the blood are delivered to the peripheral compartment. Most
      of the physiologically-based models published to date dispense with some of the
      information available from mammillary models by assuming that all of the chemical
      delivered by the flow of blood rapidly equilibrates and can be taken up by the
      tissue under the control of a "partition coefficient" (Rij = Cj/Ci). We show that
      the partition coefficient alone does not retain the uptake rate (kji) information
      available from a classical mammillary model, but that the uptake rate information
      can be incorporated via unitless extraction efficiency parameters, epsilon j.

PMID- 7784344
TI  - Pharmacokinetic study of zeolite A, sodium aluminosilicate, magnesium silicate,
      and aluminum hydroxide in dogs.
AB  - Zeolite A is a synthetic zeolite which may have therapeutic utility in
      osteoporotic individuals because of its ability to stimulate bone formation. A
      study of Zeolite A (30 mg/kg), sodium aluminosilicate (16 mg/kg), magnesium
      trisilicate (20 mg/kg), and aluminum hydroxide (675 mg) was designed in beagle
      dogs. The purpose of this study was to compare the oral bioavailability of
      silicon and aluminum from Zeolite A, sodium aluminosilicate, magnesium
      trisilicate, and aluminum hydroxide in dogs. Twelve female dogs received each
      compound as a single dose separated by one week in a randomized, 4-way, crossover
      design. Plasma samples were drawn at time 0 and for 24 hours after dosing. The
      concentrations of silicon and aluminum were determined by graphite furnace atomic
      absorption. The mean plasma silicon AUC values (+/- S.D.) were 9.5 +/- 4.5, 7.7
      +/- 1.6, 8.8 +/- 3.0, 6.1 +/- 1.9 mg.hr/L and the mean plasma silicon Cmax values
      (+/- S.D.) were 1.07 +/- 1.06, 0.67 +/- 0.27, 0.75 +/- 0.31, 0.44 +/- 0.17 mg/L
      for Zeolite A, sodium aluminosilicate, magnesium trisilicate, and aluminum
      hydroxide respectively. Although mean silicon AUC and Cmax values were elevated
      when compared to baseline after administration of the silicon containing
      compounds, only the AUC from Zeolite A reached statistical significance (p =
      0.041). The mean plasma silicon Tmax values (+/- S.D.) were 7.9 +/- 6.4, 5.8 +/-
      4.6, 6.9 +/- 6.3 and 8.5 +/- 3.4 hrs for Zeolite A, sodium aluminosilicate,
      magnesium trisilicate and aluminum Hydroxide respectively.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7784345
TI  - Comparative tissue distribution and elimination of amphotericin B colloidal
      dispersion (Amphocil) and Fungizone after repeated dosing in rats.
AB  - The pharmacokinetic profiles of amphotericin B (AmB) after administration of
      Amphocil, an AmB/cholesteryl sulfate colloidal dispersion (ABCD) and the micellar
      AmB/deoxycholate (Fungizone) were compared after repeated dosing in rats. After
      administration of ABCD and Fungizone at an equal AmB dose (1 mg/kg), AmB
      concentrations in plasma and most tissues were lower for the ABCD dose,
      especially in the kidneys where reduced drug concentration correlated with
      reduced nephrotoxicity. In contrast, AmB concentrations in the liver were
      substantially higher when ABCD was administered; however, without an accompanying
      increase in hepatotoxicity. Daily administration of ABCD for 14 days did not lead
      to AmB accumulation in plasma; while a slight accumulation was observed after
      multiple administration of Fungizone. AmB was eliminated more slowly from the
      plasma and various tissues and urinary and fecal recoveries of AmB were reduced
      after ABCD administration. These results suggest that ABCD may be stored in
      tissues in a form that is less toxic and is eliminated from the systemic
      circulation by a different mechanism than the free and protein-bound AmB in
      plasma. AmB accumulation in the spleen was observed when higher, doses of ABCD (5
      mg/kg) were administered, which could be due to saturation of hepatic uptake of
      AmB. Comparison of spleen concentrations of AmB between ABCD and Fungizone at 5
      mg/kg AmB doses was not possible because of Fungizone's toxicity in rats. In all
      other organs, AmB concentrations reached or approached a steady state within two
      weeks of dosing with ABCD. Urinary and fecal clearences of AmB were not different
      between ABCD and Fungizone administration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784346
TI  - Age-dependent intestinal absorption of valproic acid in the rat.
AB  - The absorption of valproic acid (VPA) across isolated perfused segments of
      jejunum, ileum and colon was examined in situ in 14-day- to 24-month-old Fischer
      344 rats. Within each age group, the intrinsic absorptive clearance (Cla) of VPA
      at a perfusate concentration of 1 mg/ml was highest in the jejunum, lowest in the
      colon, and intermediate in the ileum. When intestinal Cla was normalized for the
      dry weight of the segment, within-group variability decreased. In all segments,
      VPA Cla normalized by dry weight decreased during development (< or = 20 to 90
      days) and remained relatively constant during aging (90 days to 24 months). The
      mechanism of valproate absorption (active vs. passive) was examined across age in
      everted intestinal sacs prepared from each of the three segments. Data were
      consistent with active transport of VPA in the jejunum and ileum of rats of all
      ages, and in the colon of pre-weanling animals. Colonic absorption of VPA
      appeared to occur by passive diffusion in adult rats. In contrast, colonic
      absorption of d-glucose occurred, only by passive diffusion in all age groups.
      These data indicate that, during development, significant alterations in the rate
      of VPA absorption occur throughout the rat intestine. Furthermore, while active
      transport of VPA by the small intestine was present throughout the age range
      investigated, active transport by the colon became negligible by the time of
      weaning.

PMID- 7784348
TI  - Estimation of impurity profiles of drugs and related materials. 12. Isolation and
      identification of an isomeric impurity in danazol.
AB  - We report on a new isomeric impurity of danazol. This impurity designated as
      isodanazol was detected by reversed-phase high-performance liquid chromatography
      (HPLC) and thin-layer chromatography (TLC). Its structure was determined after
      separation by preparative HPLC. Mass spectrometry revealed the isomeric nature of
      the impurity while the UV spectrum indicated profound difference in the isoxazole
      moieties. The structure of the isomeric isoxazole ring in isodanazol was
      determined by NMR spectroscopy using COSY, HETCOR and NOE measurements. The
      difference between the UV spectra of danazol and isodanazol is explained on the
      basis of the difference between the aromaticities of their isoxazole rings
      supported by quantum chemical calculations. The quantitative determination of the
      impurity down to the 0.05% level can be performed by HPLC, gas chromatography and
      TLC densitometry.

PMID- 7784347
TI  - Microdialysis sampling to determine the pharmacokinetics of unbound SDZ ICM 567
      in blood and brain in awake, freely-moving rats.
AB  - The free concentrations of the serotoninergic 5-HT3 antagonist SDZ ICM 567 in
      blood and in the central nervous system were examined in awake, freely-moving
      rats using blood and brain microdialysis coupled to liquid chromatography.
      Microdialysis probes were implanted in the jugular vein and in the frontal cortex
      and dialysis samples were simultaneously collected from both sites.
      Pharmacokinetic parameters were calculated after a 10 mg/kg intravenous dose of
      [14C]SDZ ICM 567. The elimination half lives measured in whole blood, brain and
      blood microdialysates were similar (congruent to 1.7 h). The AUC0-5h
      corresponding to the unbound drug was 462 +/- 142 ng.ml-1.h in blood dialysate,
      not significantly different from the AUC corresponding to the free concentration
      in whole blood, i.e. 586 +/- 63 ng.ml-1.h. The free fraction in blood obtained in
      vitro by equilibrium dialysis (21%) or by microdialysis (19%) was not
      statistically different from that obtained in vivo (17%) in microdialysis
      experiments. The unbound concentrations (AUC0-5h) of SDZ ICM 567 in the brain
      cortex were 86 +/- 24 ng.ml-1.h, lower than those expected from unbound blood
      concentrations, suggesting an active transport out of the central nervous system.
      Finally, microdialysis sampling allowed the determination of pharmacokinetic
      parameters of SDZ ICM 567 in blood and brain as well as the estimation of the
      free fraction of drug in blood.

PMID- 7784349
TI  - Changes in solid-state structure of cyclophosphamide monohydrate induced by
      mechanical treatment and storage.
AB  - The effects of mechanical treatment and various storage conditions on the
      structure of cyclophosphamide monohydrate were evaluated by thermal and X-ray
      analyses and molecular modeling. The monohydrate form of cyclophosphamide was
      found to convert to the anhydrous form through a metastable phase. Metastable
      forms were produced by mechanical treatment and by desiccation. These forms could
      be detected in differential scanning calometric thermograms as endothermic peaks,
      at approximately 39 degrees C, and X-ray powder diffractometric analysis, e.g.;
      by a characteristic reflection at 15.3 degrees (2 theta). Molecular modeling was
      used to study molecular interactions and putative metastable structures. The
      dehydration enthalpies of the cyclophosphamide monohydrate obtained from quantum
      chemical calculations and DSC analysis were 51.6 and 36.1 J/g, respectively. In a
      unit cell of the stable monohydrate, a water molecule is held by O(7) of the
      cyclophosphamide molecule and N(6)H of a neighboring cyclophosphamide molecule,
      with hydrogen bonds enabling existence of a water tunnel. The metastable form of
      cyclophosphamide is detected when a sterically formed block in the possible
      tunnel is removed, and the water molecules are allowed to leave the system one by
      one.

PMID- 7784350
TI  - Chemical pathways of degradation of the bradykinin analog, RMP-7.

PMID- 7784351
TI  - Differential expression of the phenol family of UDP-glucuronosyltransferases in
      hepatoma cell lines.

PMID- 7784352
TI  - Pharmacokinetics of caffeine and its demethylated metabolites in lactation:
      predictions of milk to serum concentration ratios.

PMID- 7784353
TI  - Structural requirements for interaction with the oligopeptide transporter in Caco
      2 cells.

PMID- 7784354
TI  - [Patient admission to a child and adolescent psychiatric polyclinic. Referral,
      patient information, preparation, concepts, expectations and fears of children,
      adolescents and their parents].
AB  - This study investigates 77 families i.e. their children, aged 7-17, and their
      parents, who attended the out-patient clinic of the child psychiatric department
      for the first time. It was intended to examine and outline the subjective
      situation on entering the clinic. A structured verbal interview was conducted
      with the children before the start of the actual examination procedure, while a
      written questionnaire was submitted to the parents. Among the questioned items
      were modes of referral, references, sources of information, knowledge and
      preparedness, ideas, expectations and apprehensions about the institution and its
      treatments. The answer that were obtained reflected a lack of self-determination
      on the part of the children and the strength of influence exerted by the parents
      along with other relevant authorities. The children were often taken to the
      clinic without any active consent on their part. When asked about hopes of
      improvement they did not often confirm. Similarly fears about the impending
      examination were at first denied by most children but subsequently conceded, when
      concrete suggestions were made. Strikingly the better informed and prepared,
      children were able to admit to their fears more often. The results of the
      parental questionnaire illustrate an extensive lack of information about the
      institution that the families were actually attending. It may be concluded that
      the parents had also been little assertive when preparing their children for the
      examination. When asked about their expectations the parents primarily quoted
      "help" and "advice". Scepticism about the examination came only at the bottom of
      the list.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784355
TI  - [Is there an end to adolescence?--Observations from the ethnopsychoanalytic
      viewpoint].
AB  - Being an adult today does not mean anymore to have secure knowledge and routine
      at one's disposal, but rather being able to endure anxiety and uncertainty in
      culture. In the course of the process of civilization youth has more and more
      become the model and embodiment of a dynamic, ever-changing culture. As a
      consequence of abolishing initiation rituals, which originally determined the
      transition to adulthood, adolescents today must develop their own strategies in
      order to relate chaos and order to each other. The antagonism between family and
      culture plays a central role here: The individual must be able to personify two
      aggregate states as it were, that is being firm in the family and being fluid in
      culture. Today adolescence only ends inside the family when the individual takes
      on a parent role, but in the cultural area we should remain adolescents all of
      our lives, in order to muster the creativity necessary for a changing culture.

PMID- 7784356
TI  - [The inpatient routine as a therapeutic community: multiprofessional treatment
      concept within the scope of a child psychiatric day care clinic].
AB  - The article will describe a multiprofessional (nurses, social workers, teachers,
      psychologists, physicians) treatment in a child psychiatric daycare-clinic. In
      that context the importance of relationship as an equivalence to the "primary
      motherliness" for early-disturbed children will be stressed. Further the article
      will focus on the relevance of continuous "post-education" and the broadening of
      the children's cognitive range by way of this object relation. Also, the article
      will inform about the uncovering psychotherapy with the children and their
      parents and about the importance of informations both from the therapists to the
      team as the other way round. Based on case studies it will be demonstrated how
      the multiprofessional team functioning as a "whole object" becomes instrumental
      for patients to work through affective relationships and mechanisms of defence.

PMID- 7784357
TI  - [Diagnosis of performance anxiety in educational spelling tests: new results of
      the psychometric properties and validity of a relevant brief scale].
AB  - In the present study the psychometric properties and the criterion-related
      validity of a short scale for measuring students' spelling-specific test anxiety
      were analyzed. This scale consists of 13 self-rating items which reflect
      students' worry and emotionality reactions in face of spelling requirements at
      school. Along with some concurrent criterion variables (such as general self
      esteem, academic and spelling-related self-concept, and spelling-related
      attributions, spelling and mathematics achievement, regressive classroom
      behavior), data were gathered at the beginning (N = 274) and, nearly 11 months
      later, at the end (N = 257) of the school year. At both measurement times,
      principal component analyses correspondingly revealed one common test anxiety
      factor and led to an overall scale format. This final scale solutions appeared to
      be sufficiently reliable and stable. Furthermore, their relationships to the
      various criterion variables largely turned out as theoretically expected.
      Especially, the spelling-specific test anxiety scores could be best predicted by
      spelling-specific self-concept and by spelling achievement, respectively. Thus,
      the findings of the present study could replicate the results of a previous pilot
      study and provided further support for the construct validity of interpretations
      based upon the spelling-specific test anxiety scale.

PMID- 7784358
TI  - [Aspects of pediatric psychotherapy with children and adolescents with
      uncontrolled aggressive behavior].
AB  - Starting from theoretical psychodynamic preliminary thoughts concerning the
      symptomatics of aggressive-uncontrolled behavior of children and adolescents,
      aspects of practical childpsychotherapeutic treatment processes are described.
      The latter is described as being dependent from the individual level of
      development of each child. Since it is usually the case that children and
      adolescent with these symptoms are psycho-socially immature based on ego
      structural deficits at the beginning of treatment, the therapist primarily has
      the function of a transition object in accordance with Winnicott in the
      therapeutic beginning phase. Since the communication possibilities of these
      children are situated mostly on a deep nonverbal level of affectively loaded
      patterns of interaction in the beginning, the affective 'answer' of the therapist
      is of primary importance at this stage. In later stages of increased ego maturity
      symbolic communication possibilities increasingly open, whereby the child's
      conflicts can be worked through, shifted to play and shaping objects.

PMID- 7784359
TI  - [Prolegomena on transcultural pediatric psychotherapy].
AB  - In a first step the concept of "transcultural child psychotherapy" is explained.
      Based on an analysis on the demand for a transcultural child psychotherapy in
      Germany the necessity for its development is pointed out. Names of institutions
      and persons suitable for transcultural child psychotherapy are given. A
      systematic attempt follows to integrate the transcultural point of view into
      general strategies and intervention techniques of child psychotherapy, stressing
      the psychoanalytical, client-centered and behaviour therapeutic approach.
      Specific problems as non-verbal, verbal and diagnostic aspects in transcultural
      child psychotherapy as well as toys are briefly mentioned. Problem groups of a
      special interest of a transcultural child psychotherapy (e.g. asylum seeking,
      migrant, persecuted, sold, and adopted children) are mentioned and pointed out to
      as specific risk groups. The essay ends with questions regarding the
      effectiveness of transcultural child psychotherapy and with an outlook into
      further research activities.

PMID- 7784360
TI  - [Sexual abuse by staff of inpatient facilities for children and adolescents].
AB  - Examples of sexual abuse by professionals in residential agencies for children
      are presented as well as aspects of sexual attraction between staff members and
      children which is put under taboo among professionals. The author focuses on
      incestuous and sexual abuse supporting institutional structures: a) rigid and
      authoritarian structures, which contribute to the emotional isolation of staff
      members and b) unstructured and diffuse leadership. Indications are given for
      staff members who suspect colleagues of sexual abuse of children.

PMID- 7784361
TI  - An audit of trisomy 16 in man.
AB  - Sufficient information is now available from the literature to produce an audit
      of trisomy 16, in a theoretical cohort of 100,000 recognized pregnancies, from
      gametogenesis to term and onwards. Recent reports of premature separation of
      chromosome 16 bivalents during maternal meiosis I provide a novel mechanism for
      generation of this aneuploidy. Most, if not all, errors resulting in recognized
      mosaic and non-mosaic trisomy 16 pregnancies investigated using polymorphic DNA
      markers appear to originate at that stage. The incidence of this maternally
      derived trisomy 16 in the late first trimester is equivalent to 1500 cases in
      100,000 recognized pregnancies, a figure which now corresponds very closely to
      the reinterpreted oogenesis data. Most trisomy 16 pregnancies are lost around 12
      weeks' gestation, but of the order of 10 per cent (120-150 in this audit) undergo
      reduction to disomy, with 30 of these excluding aneuploidy from the fetal cell
      lineage (trisomic zygote rescue) and continuing into the second trimester.
      Maternal uniparental disomy (UPD) in one-third of this latter group is associated
      with loss later in pregnancy or severe intrauterine growth retardation, but can
      be compatible with a viable pregnancy. Adverse pregnancy outcomes are not
      restricted to those with UPD. Analysis of reports of confined placental mosaicism
      for chromosome 16 without associated UPD indicates that the presence of high
      levels of trisomic cells in the placenta alone consistently produces a more
      variable inhibition of fetal growth, which may also, in cases, be associated with
      late pregnancy loss.

PMID- 7784362
TI  - An accessory marker derived from chromosome 20 and its co-existence with a mosaic
      trisomy 20 cell line.
AB  - We report a 16-month-old boy with delayed psychomotor development, dysmorphic
      features, and failure to thrive. He had a mosaic karyotype detected prenatally:
      mos 46,XY/47,XY, +r(20)/47,XY, +20. After birth, the abnormal cell lines were
      confirmed in a number of tissues. The small ring chromosome was identified using
      fluorescence in situ hybridization as derived from chromosome 20. We compared our
      patient with previously reported cases of mosaic trisomy 20 detected prenatally
      and associated with an abnormal phenotype. In an attempt to characterize an r(20)
      syndrome, we also compared our case with two similar reports in the literature.

PMID- 7784363
TI  - Prenatal diagnosis of neurofibromatosis type 1: from flanking RFLPs to intragenic
      microsatellite markers.
AB  - Even though the neurofibromatosis type 1 (NF1) gene was cloned more than 3 years
      ago, the process of identifying mutations has not been fruitful, and genetic
      counselling is mainly based on the use of linked markers. Since 1990, we have
      analysed 130 NF1 families and have performed six prenatal diagnoses. In each
      case, genetic counselling has relied on linked markers and informativity was
      achieved in all of them. The use of intragenic microsatellite polymorphisms
      (IVS27AAAT2.1, IVS27AC28.4, IVS27AC33.1, and IVS38GT53.0) has increased the
      informativeness in our series of NF1 families to an average of 90 per cent,
      providing accurate diagnosis and confirmation of the disease status.

PMID- 7784364
TI  - Early prenatal diagnosis of cartilage-hair hypoplasia (CHH) with polymorphic DNA
      markers.
AB  - Cartilage-hair hypoplasia (CHH) is an autosomal recessive disorder resulting in
      short stature and hypoplasia of hair. Associated features include impaired T-cell
      mediated immunity, deficient erythropoiesis, gastrointestinal dysfunction, and an
      increased risk of malignancies. As the condition may, in some cases, be severe or
      even fatal during childhood, families with a previous history of CHH may wish to
      have prenatal diagnosis. We have previously assigned the gene for CHH to the
      proximal 9p by linkage analysis using several polymorphic DNA markers. Here we
      report the prenatal testing for CHH in three Finnish and one Australian family
      using three DNA markers closely linked to the CHH gene. In three cases a fetus
      unaffected with CHH was predicted at the probability level of more than 94 per
      cent. In one case, an affected fetus was predicted. The results were in
      concordance with ultrasonography performed for all fetuses. The three children
      born to date were unaffected as predicted. The DNA marker-based analysis thus
      provides a useful method for early prenatal testing for CHH.

PMID- 7784365
TI  - Rapid fetal karyotype from cystic hygroma and pleural effusions.
AB  - Fluid from pleural effusion (n = 2) and cystic hygroma (n = 7) was obtained from
      eight fetuses, between 13 and 32 weeks of pregnancy at the time when a
      conventional prenatal diagnosis procedure was carried out. As these fluids
      contain lymphocytes, they were processed like peripheral blood. A karyotype was
      obtained in 4 days in both cases of pleural effusion and in four out of seven
      samples of cystic hygroma. An abnormal karyotype was detected in three of the
      four samples of cystic hygroma: two trisomies 21 and a monosomy X. Different
      parameters were evaluated in order to predict the feasibility of obtaining a
      cytogenetic diagnosis. Our data showed that if the amount of fluid obtained was >
      or = 4 ml and the initial lymphocyte count (ILC) was > 0.2 x 10(6) cells/ml, a
      cytogenetic diagnosis was possible from an initial concentration of cultured
      lymphocytes (ICCL) of > 0.06 x 10(6) cells/ml.

PMID- 7784366
TI  - Fetal erythroblasts from maternal blood identified with 2,3-bisphosphoglycerate
      (BPG) and in situ hybridization (ISH) using Y-specific probes.
AB  - Different types of fetal nucleated cells can be found in maternal blood,
      providing the possibility of non-invasive prenatal diagnosis. For this purpose,
      we have studied fetal erythroblasts. We discovered that haemoglobin-containing
      cells treated with 2,3-bisphosphoglycerate (BPG) can be visualized by a
      peroxidase reaction, which at the same time visualizes an in situ hybridization
      (ISH) signal, specific for the X, Y or 21 chromosome. In order to prove that the
      BPG-positive cells were erythroid, an anti-glycophorin A (GPA) antiserum combined
      with a staphylococcal rosette technique was used. To enrich for erythroblasts,
      leukocytes were depleted from maternal blood by treatment with anti-CD45
      monoclonal antibody and passage over an anti-mouse IgG-coated glass bead column.
      To evaluate the potential of the method for clinical use, we studied maternal
      blood samples from 18 women referred to us for prenatal diagnosis between 6 and
      19 weeks of gestation. Erythroblasts were found in 13 out of 14 normal
      pregnancies. Erythroblasts with a Y-signal were found as early as 9 weeks of
      gestation, but at 6 weeks the Y-signal was seen in BPG-negative cells only. These
      cells showed an epithelioid morphology indicating that they were
      cytotrophoblasts. The BPG-ISH method provides a simple technique for identifying
      erythroblasts and simultaneously visualizing a desired probe.

PMID- 7784368
TI  - Oligohydramnios with amnio-chorionic separation at 15-16 weeks' gestation.
AB  - Nine patients with oligohydramnios and amnio-chorionic separation were identified
      out of 7000 women who underwent a vaginal ultrasound examination at 15-16 weeks'
      gestation. Oligohydramnios was defined as a reduced amount of amniotic fluid, a
      distance of more than 1 cm between the chorion and amnion, and a good turgor of
      the amnion without floating membranes of intrauterine sheets. Fetal malformations
      were observed in all nine cases. In four of six fetuses where chromosomal
      analysis was available, an abnormal karyotype was found. It is concluded that
      oligohydramnios in the early second trimester is associated with fetal
      abnormality.

PMID- 7784367
TI  - The development of the fetal eye: in utero ultrasonographic measurements of the
      vitreous and lens.
AB  - Our objective was to establish nomograms for fetal eye measurements from 12
      weeks' gestation by using transvaginal and transabdominal high-resolution
      ultrasound techniques. A prospective cross-sectional study was performed on 450
      normal singleton pregnancies between 12 and 37 weeks' gestation. Vitreous and
      lens circumferences were measured by transvaginal ultrasonography until 17 weeks,
      and by abdominal ultrasound between 18 and 37 weeks' gestation. Regression
      analyses were used to create nomograms, and several transformations were done to
      obtain linearity. Eye measurements of 12 fetuses at risk for ocular disturbances
      were plotted on the constructed nomograms. Linear relationships were fitted
      between vitreous (r2 = 0.79) and lens (r2 = 0.88) circumferences and gestational
      age. In addition, there was a significant correlation between these measurements
      and the biparietal diameter. Data of the fetuses at risk showed that disturbances
      in ocular growth were associated mainly with abnormal cerebral development. These
      normative data may be helpful in the prenatal diagnosis of suspected congenital
      syndromes that include, among their manifestations, ocular growth disturbances
      such as microphthalmos and anophthalmos.

PMID- 7784369
TI  - Collagen biosynthesis in cell culture from chorionic villi.
AB  - After chorionic villus biopsy of human placenta, cell cultures were propagated
      with Ham's F10 medium or Eagle's minimum essential medium (MEM). It was possible
      to study the morphology of the cells by transmission electron microscopy (TEM)
      after a special culture of the cells in a collagen gel. The cells embedded in a
      collagen gel were able to contract the gel and to organize collagen fibres, as
      fibroblast cultures do. TEM showed vacuolization and well-developed cisternae of
      the endoplasmic reticulum, especially in the case of MEM culture. The aim was to
      determine whether cells cultivated from early placenta were able to synthesize
      enough collagen for a metabolic study. A high level of collagen biosynthesis
      could be quantified. Types I and III collagen can be determined which is useful
      for studying the abnormalities of collagen synthesis in suspected cases of
      osteogenesis imperfecta or Ehlers-Danlos type IV syndrome. The hydroxylation of
      lysine can also be studied with respect to Ehlers-Danlos type VI syndrome.
      Moreover, these cells, in contrast to fibroblast cultures, made it possible to
      study the biosynthesis of type IV collagen.

PMID- 7784370
TI  - Early second-trimester diagnosis of sirenomelia.
AB  - Two cases of sirenomelia are described, detected in the 14th and 16th weeks of
      gestation by transvaginal ultrasonography. A hypothesis for the aetiology of
      sirenomelia and its associated anomalies is discussed.

PMID- 7784371
TI  - Prenatal diagnosis of Freeman-Sheldon syndrome (whistling face).
AB  - The diagnosis of Freeman-Sheldon syndrome was made by ultrasonographic evaluation
      of a 20-week fetus with a positive family history. The ultrasonographic features
      were abnormalities of the extremities and mouth.

PMID- 7784372
TI  - Echocardiographic diagnosis of fetal Marfan syndrome at 34 weeks' gestation.
AB  - Fetal echocardiography was performed during the third trimester in a normal
      primigravida. The fetal heart was severely affected with the typical cardiac
      manifestations of Marfan syndrome. The medical history of the father was
      investigated and a mild form of the syndrome was diagnosed. The neonate died at 2
      months of age of congestive heart failure.

PMID- 7784373
TI  - Early prenatal diagnosis of an infratentorial arachnoid cyst: association with an
      unbalanced translocation.
AB  - Arachnoid cysts are an uncommon central nervous system malformation, representing
      only 1 per cent of all intracranial masses. We report the second-trimester
      prenatal diagnosis of a posterior fossa arachnoid cyst, associated with an
      unbalanced X;9 translocation.

PMID- 7784374
TI  - Digeorge syndrome with total monosomy 22 diagnosed prenatally.
AB  - A case of monosomy 22 diagnosed prenatally is reported. During pregnancy,
      ultrasonic observations already revealed several cardiac malformations of the
      fetus in the 25th week. Following counselling, the pregnancy was terminated.
      Fetal autopsy revealed several abnormalities associated with DiGeorge syndrome.

PMID- 7784375
TI  - Fetal cholecystomegaly: a prenatal marker of aneuploidy.
AB  - The fetal gall bladder can now be easily identified during the second and third
      trimesters using high-resolution ultrasonography. In this report we present eight
      fetuses with an enlarged gall bladder detected on prenatal ultrasonography at a
      mean gestational age of 24.6 weeks (range 19-31 weeks). Additional
      ultrasonographic findings were present in four cases: fetal anomalies and
      intrauterine growth retardation in three and polyhydramnios in one. Of those
      cases associated with fetal anomalies, one women underwent amniocentesis at 21
      weeks revealing trisomy 18. The other two declined prenatal karyotyping; neonatal
      karyotyping revealed trisomy 13 in one and trisomy 18 in the other. Although an
      enlarged fetal gall bladder can be a normal variant in the second and third
      trimesters, the prenatal detection of cholecystomegaly should prompt a search for
      associated anomalies and other markers of aneuploidy. If found, prenatal
      karyotyping should be considered.

PMID- 7784376
TI  - Possibility of screening for fetal hyperinsulinism at genetic amniocentesis in
      women of advanced maternal age.

PMID- 7784377
TI  - An increased incidence of haemangiomas in infants born following chorionic villus
      sampling (CVS).
AB  - The incidence of haemangiomas was ascertained by questionnaire in infants born to
      578 consecutive CVS patients and 445 consecutive mid-trimester amniocentesis
      patients seen at a single institution between 1 January 1989 and 31 May 1991. The
      incidence of 7.4 per cent reported in the amniocentesis group was comparable to
      previous estimates of the incidence of haemangiomas in the general population. In
      contrast, a 21.1 per cent incidence, three-fold higher than that observed in the
      amniocentesis group, was observed among CVS-exposed infants (P < 0.001). This
      increased incidence was largely confined to patients undergoing a transcervical
      procedure. No correlation was observed between the incidence of haemangiomas and
      gestational age at sampling, sample size, number of sampling attempts, or a
      history of bleeding following the procedure.

PMID- 7784379
TI  - Genetic amniocentesis following multifetal pregnancy reduction to twins:
      assessing the risk.
AB  - Fifty-three patients who elected to reduce their pregnancies to a twin gestation
      in our centre are known to have subsequently undergone genetic amniocentesis.
      Five of these patients lost entire pregnancy following the genetic amniocentesis
      procedure. This is equivalent to a 9.4 per cent pregnancy loss rate for reduced
      twin gestations in comparison with an expected loss rate of 2 per cent for non
      reduced twin gestations.

PMID- 7784378
TI  - Prenatal sonographic signs of possible fetal genital anomalies.
AB  - The sonographic markers of female and male external genitalia have been
      documented in early and late gestation. The aim of the present study was to
      report our experience of possible sonographic markers of fetal genital anomalies.
      Sonography was performed with a vaginal probe in early gestation and an abdominal
      sector scanner in advanced gestation. The following genital anomalies were
      observed: hypospadias, epispadias, ambiguous genitalia, and testicular
      feminization or Smith-Lemli-Opitz syndrome. It is therefore concluded that
      prenatal diagnosis of some genital anomalies is now possible.

PMID- 7784381
TI  - Prenatal sonographic diagnosis of intracranial haemorrhage: report of a case with
      a sinusoidal fetal heart rate tracing, and review of the literature.
AB  - The sinusoidal fetal heart rate pattern has been described in association with
      severe fetal anaemia, with fetal hypoxaemia, and with the administration of
      parenteral narcotics. Here, we report a case of decreased fetal movement in which
      a sinusoidal tracing was recorded. The sonographic diagnosis of a massive fetal
      intracranial haemorrhage was made. A non-interventive approach was taken and the
      fetus died soon after in utero. We review 28 previous cases in which the prenatal
      sonographic diagnosis of fetal intracranial haemorrhage was made, including the
      underlying maternal and fetal factors and neonatal outcomes. We propose that the
      sinusoidal tracing in this case was due to the intracranial bleed and suggest
      that fetal intracranial haemorrhage be considered in the sonographic evaluation
      of the fetus with a sinusoidal pattern.

PMID- 7784380
TI  - Serum lipid, apolipoprotein and lipoparticle levels in the human fetus.
AB  - Blood collected from 62 fetuses aged 20-38 weeks of gestation was studied. The
      values of ten lipid parameters were determined: cholesterol (TC), triglycerides
      (TGs), apolipoprotein A1 (apo A1), apolipoprotein B (apo B), apolipoprotein E
      (apo E), total apolipoprotein CIII (apo CIII), apolipoprotein CIII present in
      particles containing apo B (apo CIII LpB) or not (apo CIII Lp non-B),
      lipoparticles A1 (LpA1), and lipoprotein a (Lp(a)). The results show that, except
      for apo E, all the studied parameters were present in lower concentrations than
      in adults and newborns, and that Lp(a) is not detectable at that stage in life.

PMID- 7784382
TI  - Prenatal diagnosis of trisomy 21 using interphase fluorescence in situ
      hybridization of post-replicated cells with site-specific cosmid and cosmid
      contig probes.
AB  - Interphase fluorescence in situ hybridization (FISH) with chromosome 21-specific
      cosmid clones was used to identify trisomy 21 in cultured and uncultured amniotic
      cells. Two novel site-specific cosmid clones (regions 21q22 and 21qtel) were
      compared with a cosmid contig (Zheng et al., 1992). Correct identification of
      chromosome 21 copy number was made in 65-75 per cent of trisomic cells and in 70
      75 per cent of normal disomic cells by using all the tested probes. However, the
      chromosome 21-specific telomeric probe (cos 17F8) showed the best results due to
      more intense and clearly visible hybridization. Utilization of a directly
      fluorophorated telomeric probe using Cy3-dCTP and FluorX-dCTP allows accurate
      detection of chromosome 21 in a fast 'one-step' FISH procedure on uncultured
      interphase nuclei. In addition, we compared the efficacy of FISH analysis for the
      total population of interphase cells and cells in the post-replication (late S,
      G2) periods of the cell cycle. Selective scoring of cells in the post-replicative
      period (showing a pair of hybridization signals on each chromatid of the
      replicated interphase chromosome) increased the number of informative nuclei by
      up to 95-97 per cent. This approach allows cells with overlapping chromosomes,
      artificial double hybridization signals on separate chromatids in interphase
      chromosomes, background hybridization, and polyploid cells to be analysed.
      Application of directly labelled telomeric cosmid probes and integral analysis of
      hybridized nuclei in the pre- and post-replication periods of the cell cycle may
      help to further improve the prenatal detection of trisomy 21.

PMID- 7784383
TI  - Parental reaction and adaptability to the prenatal diagnosis of fetal defect or
      genetic disease leading to pregnancy interruption.
AB  - The objective of the study was to evaluate the psychological reaction of two
      groups of parents to a pregnancy termination after they had undergone a prenatal
      diagnostic procedure. The analysis involved interviews with a study group of 76
      patients who were at risk of giving birth to a child with a genetic disease or
      defect and a comparison group of 124 who had a pregnancy termination after a
      major anomaly had been detected by routine ultrasound and who were not at known
      risk for a genetic disease. Only patients in the study group had received
      counselling before the prenatal diagnosis and were aware that the fetus could be
      affected. The overall reaction of the comparison group was one of shock, denial
      of fetal abnormality, and guilt over 'abandoning the fetus'. A feeling of guilt
      was expressed by patients in the comparison group (73 per cent versus 29 per
      cent) in the period immediately following the interruption. One-third of patients
      in both groups felt obliged to undergo a therapeutic abortion. More patients in
      the study group than in the comparison group expressed the need to see a
      psychiatrist at the time of the study (19 per cent versus 7 per cent) and viewed
      future pregnancies as a replacement for the lost pregnancy (63 per cent versus 19
      per cent). The recommendations of the study focus on information sessions to
      personnel, nursing support, analgesia during the expulsion period, an atmosphere
      of respect that should be present at the time that the fetus is viewed, the
      anticipation of mourning, and the long-term follow-up of the couple to ensure
      that counselling for future pregnancies and psychological support are provided
      when needed.

PMID- 7784384
TI  - Detection of fetal HLA-DQa sequences in maternal blood: a gender-independent
      technique of fetal cell identification.
AB  - The objective of this study was to detect fetal HLA-DQa gene sequences in
      maternal blood. HLA-DQa genotypes of 70 pregnant women and their partners were
      determined for type A1. We specifically sought couples where the father, but not
      the mother, had genotype A1. In 12 women, maternal blood samples were flow
      sorted. Candidate fetal cells were isolated and amplified by using PCR primers
      specific for a paternal HLA-DQa A1 allele. Fetal HLA-DQa A1 genotype was
      predicted from sorted cells; amniocytes or cheek swabs were used for
      confirmation. Six of twelve sorted samples had amplification products indicating
      the presence of the HLA-DQa A1 allele; 6/12 did not. Prediction of the fetal
      genotype was 100 per cent correct, as determined by subsequent amplification of
      amniocytes or cheek swabs. We conclude that paternally inherited uniquely fetal
      HLA-DQa gene sequences can be identified in maternal blood. This system permits
      the identification of fetal cells independent of fetal gender, and has the
      potential for non-invasive prenatal diagnosis of paternally inherited conditions.

PMID- 7784385
TI  - Prenatal diagnosis of familial ring 21 chromosome.
AB  - Ring chromosome 21 is a rare chromosome anomaly often associated with mental
      retardation and dysmorphic features. Less commonly, the ring chromosome can be
      familial and associated with a normal phenotype. Phenotypically normal female
      carriers, however, are at increased risk of having children with Down syndrome,
      mosaic monosomy 21, and variable duplication or deletion of chromosome 21.
      Because of the relative mitotic and meiotic instability of ring chromosomes,
      abnormal cytogenetic findings encountered during prenatal diagnosis may not
      reflect the true genetic status of the fetus. This is a report of a
      phenotypically normal female carrier of a familial ring 21 chromosome. Prenatal
      diagnosis on her twin pregnancy revealed a mosaic 46,XX,r(21)(p13;q22) (77 per
      cent)/45,XX,-21 in one fetus and a normal male karyotype in the second. The
      pregnancy was carried to term. Both infants are completely normal, with a non
      mosaic ring 21 karyotype from the lymphocytes of one twin. The diagnostic
      uncertainty and problematic genetic counselling related to fetal cytogenetic
      abnormalities are the subjects of this report.

PMID- 7784386
TI  - Prenatal diagnosis of mosaic 4p- in a fetus with trisomy 21.
AB  - Mosaicism for the Wolf-Hirschhorn syndrome, del(4)(p16), is extremely rare and
      has not been reported in association with a numerical chromosome abnormality. We
      report the prenatal diagnosis of mosaic del(4)(p16) and non-mosaic trisomy 21 in
      a 16-week female fetus. The pregnancy ended in spontaneous abortion at 34 weeks
      secondary to fetal demise. The fetus had features of both 4p- and trisomy 21.

PMID- 7784387
TI  - Fetal translocation between chromosomes 2, 18, and 21 resolved by fish.
AB  - An apparently balanced t(2q;21q) translocation was discovered in fetal blood and
      amniocytes of a 22-week fetus, monitored because of ultrasonographic evidence of
      a heart disease. FISH (fluorescence in situ hybridization) analysis disclosed a
      complex translocation between chromosomes 2q, 18q, and 21q, which was inherited
      from the healthy mother. This observation corroborates the usefulness of
      molecular cytogenetic techniques in raising the quality of prenatal diagnosis and
      detecting subtle rearrangements not resolved by standard cytogenetics.

PMID- 7784388
TI  - Blood transferrin receptor expression in chromosomally abnormal fetuses.
AB  - In a cross-sectional study of 13 chromosomally abnormal fetuses, umbilical venous
      blood was obtained by cordocentesis at 17-32 weeks' gestation. Fetal blood
      transferrin receptor (CD71) expression (mean = 79.8 per cent, range = 60-98 per
      cent) and nucleated red cell count (mean = 10.4 x 10(9) per 1, range = 1.0-25.0 x
      10(9) per 1) were significantly higher than the appropriate normal mean for
      gestation (z = 3.92, P < 0.0001 and z = 3.69, P < 0.001, respectively). These
      haematological changes in chromosomally abnormal fetuses would facilitate their
      prenatal diagnosis by analysis of fetal nucleated red blood cells isolated from
      the maternal circulation on the basis of CD71 expression.

PMID- 7784389
TI  - 46,XY,dup(10q) in direct CVS preparation and mosaic 48,XXXY,dup(10q) in CVS long
      term culture and fetal tissue.
AB  - Chorionic villus sampling (CVS) was performed on a 40-year-old woman at 9 1/2
      menstrual weeks because of advanced maternal age. The direct preparation showed
      46,XY,dup(10)(q11.2q23.2). CVS long-term culture and fetal tissue revealed a rare
      additional abnormality: 48,XXXY,dup(10)(q11.2q23.2). This abnormality represented
      the major cell line (> 85 per cent in 691 cells) in an (XY)/XXY/XXXY/(XXXXY)
      mosaic (all cell lines presumably bearing the dup(10q); the presence of XY and
      XXXXY cell lines is uncertain). To our knowledge, this is the first report of
      trisomy 10q11-q23 and of prenatally detected 48,XXXY in chorionic villi. The
      mosaic could have resulted from early post-zygotic non-disjunctions in a
      46,XY,dup(10q) or 47,XXY,dup(10q) zygote. The results from DNA studies of four
      polymorphisms, mapped to Xp and Xq, support this theory. The literature on
      prenatally detected cases with sex chromosome tetrasomy and pentasomy and those
      with additional autosomal abnormalities is reviewed. The reported case underlines
      the problem of false-negative findings when only direct CVS preparations are
      karyotyped.

PMID- 7784390
TI  - Chromosome abnormality in an isolated choroid plexus cyst.

PMID- 7784391
TI  - Current awareness in prenatal diagnosis.

PMID- 7784392
TI  - Acceptability and viscosity of low cost home processed supplementary foods
      developed for preschool children.
AB  - Four supplement mixtures using whole wheat, pearl millet, bengal gram, green
      gram, groundnuts and amaranth leaves were developed employing roasting and
      malting techniques. Malting used in the formation of the supplements reduced
      significantly hot paste viscosity of all the four supplements and increased their
      nutrient density per unit volume. The organoleptic trials conducted on rural
      mothers revealed that taste, texture, colour, aroma, appearance and overall
      acceptability of all the four supplements were found to be excellent with mean
      overall acceptability. Children did not develop any GIT disorders after consuming
      the products. Trained panelists found all the four supplements acceptable as
      indicated by a nine point hedonic scale.

PMID- 7784393
TI  - Formulation and characterization of dry mixes based on dehydrated fresh high
      lysine corn.
AB  - Fresh sweet corn pulp from high-lysine corn was dehydrated in a drum-dryer and
      utilized in the formulation of creamy instant soups. Studied formulas contained
      27.5 to 67% dehydrated high-lysine corn pulp. The sensory profiles of the
      formulas improved with increasing proportion of dehydrated fresh corn pulp.
      Formula with 27.5% fresh corn pulp was rated lowest by the tasters on the basis
      of poor appearance, low characteristic fresh corn flavor and low overall
      impression. Formulas with 60 and 67% corn pulp rated highest in sensory quality
      and were nutritionally adequate. The PER for these formulas did not differ from
      casein control diet but nitrogen absorption and nitrogen retention was inferior
      for the formulas protein as compared to casein.

PMID- 7784394
TI  - Nutrient content of young cassava leaves and assessment of their acceptance as a
      green vegetable in Nigeria.
AB  - Cassava (Manihot esculenta Crantz) leaves contained a high level of crude protein
      (29.3-32.4% dry weight) compared to a conventional vegetable, Amaranthus (19.6%).
      Ash was 4.6-6.4% in cassava leaf samples but 13.1% dry weight in Amaranthus.
      Dietary fibre was very high in all samples (26.9-39% dry weight) while HCN
      potential was low (5.1-12.6 mg/100 g dry weight). Tannin was the highest in IITA
      red cassava leaves (29.7 mg/g) and the lowest in Amaranthus vegetable. In vitro
      digestibility was very low in oven dried samples (15.6-22.7%). Blanching
      increased protein content (except Amaranthus) and in vitro protein digestibility
      but decreased ash, minerals, dietary fibre and tannin, while HCN-potential was
      unchanged. Grinding reduced both HCN-potential and tannin by 84 and 71%
      respectively while oven drying only reduced the HCN content marginally.
      Preference studies showed that the highest percentage of respondents (25.3%)
      preferred Amaranthus vegetable, followed by Celosia (17.5%), Talinum (12.4%),
      garden egg (11.5%), with cassava leaves as the least (0.5%). Organoleptic
      evaluation rated cassava leaf soup inferior to Amaranthus in terms of appearance,
      colour and texture but equal in terms of taste and flavour and overall
      acceptability.

PMID- 7784395
TI  - Seed characteristics and nutrient composition of selected beans (Phaseolus
      vulgaris L.) with different ozone tolerance.
AB  - Ozone sensitivity, nutritional quality, seed characteristics, and growth habit of
      beans (Phaseolus vulgaris L.) were evaluated in two separate experiments. In the
      first experiment the data showed a significant variation among 34 bean accessions
      for ozone sensitivity following acute exposure of 18-day-old plants to 0.6
      microliters/l O3 for 2 hours under environmentally controlled greenhouse
      conditions. PI-163579, PI-169735, PI-171790, PI-176684, PI-201374, PI-310711, PI
      345576, PI-370569, PI-379435, and PI-414831 were identified as tolerant to acute
      ozone exposures. Protein, oil, starch, sugar, and ash contents in the seed of
      selected germplasm were determined and no correlation was found between these
      components and ozone sensitivity. Seed size and growth habit varied considerably
      among the 34 accessions but were not correlated to ozone sensitivity. In a second
      experiment, ten accessions, selected from the tolerant ones identified in the
      first experiment, were subjected to chronic ozone exposure in open-top chambers
      at 0.04 and 0.08 microliters/l concentrations for 7 hours/day 44 days after
      transplanting. Based on foliar injury and yield reductions, only PI-370569 and PI
      414831 were tolerant to prolonged ozone exposure (0.08 microliters/l). A
      significant positive correlation (r = 0.83) existed between foliar injury rating
      from chronic treatments involving 0.04 and 0.08 microliters O3/l and acute
      exposure (0.6 microliter O3/l/2 hours). The data indicated that acute ozone
      exposure can be used to initially screen a large number of bean accessions,
      however, this is an imperfect indicator of ozone sensitivity with chronic
      exposure.

PMID- 7784396
TI  - Anti-hypertensive substances in fermented soybean, natto.
AB  - Natto is a traditional Japanese fermented food made by fermenting boiled soy
      beans with Bacillus natto. Its contents of inhibitors against the angiotensin
      converting enzyme (ACE, EC3.4.15.1) were investigated. Relatively strong
      inhibitory activity (IC50: 0.4 mg/ml, 11.8 inhibition units/g natto) was detected
      in natto extracts and the inhibitory activity observed in the viscous fraction
      was more potent than in the bean extract. Two groups of inhibitors in the viscous
      material, high and low molecular weight inhibitors, were resolved by dialysis
      test. The inhibitor of high molecular weight was a protein with low IC50 value
      (0.12 mg/ml). The two types of low molecular weight inhibitors were detected in
      ethanol extracts (IC50: 0.53 mg/ml and 0.95 mg/ml) and they were found to be
      stable over a wide range of pH and temperature up to 100 degrees C. They were
      different in the mode of ACE inhibition. One is competitive, and the other
      noncompetitive against the hydrolysis of Bz-Gly-His-Leu by ACE.

PMID- 7784397
TI  - Amaranth seed proteins: effect of defatting on extraction yield and on
      electrophoretic patterns.
AB  - Acetone and hexane were used to know the effect of defatting amaranth flour on
      the extraction yield of protein fractions and on the electrophoretic patterns. It
      was found that albumins (33%) and globulins (20%) did not present yield changes
      when using these two solvents, but it was noted that with hexane compared to
      acetone, prolamins extraction was reduced by half (3.0 to 1.6%) whereas glutelins
      increased from 26.5 to 30%. Sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis (SDS-PAGE) patterns of prolamins extracted with acetone and
      hexane showed one band of low molecular weight (22 KDa) and five bands between 52
      to 22 KDa, respectively. No electrophoretic changes were observed in the
      remaining fractions.

PMID- 7784398
TI  - The Indian laburnum (Cassia fistula L.) fruit: an analysis of its chemical
      constituents.
AB  - The edible fruit tissue of Indian laburnum fruit (Cassia fistula L.), a member of
      the leguminosae family, was analyzed for certain organic compounds and mineral
      nutrients. Of the nine macro- and micronutrients studied, K was the most highly
      concentrated such that 100% of the US Recommended Dietary Allowances (RDA) for
      adults could be met by the consumption of about 100 g of the fresh fruit. Na
      contents in pulp and seeds are relatively low. Ca content at 827 mg per 100 g of
      dry matter is one of the highest of any fruits, and could contribute towards the
      RDA requirement of 800 mg of Ca for adults per day. The fruit is a good source of
      Fe and Mn, and their concentrations are considerably higher than those found in
      apple, apricot, peach, pear, and orange. Aspartic acid, glutamic acid, and lysine
      constituted 15.3, 13.0, and 7.8% of the total amino acids respectively in the
      pulp. In the seeds the same amino acids constituted, 16.6, 19.5, and 6.6%. The
      relatively high energy content of the fruit at 18 kJ/g could enhance the daily
      energy requirement of people in need of adequate caloric intake. The results of
      the present study demonstrate that the Indian laburnum fruit could be a source of
      some important nutrients and energy for humans.

PMID- 7784399
TI  - Biosynthesis of ascorbic acid in germinating rapeseed cultivars.
AB  - Biosynthesis of ascorbic acid in irradiated and unirradiated germinating rapeseed
      cultivars was studied at ambient room temperature (20-35 degrees C). Appreciable
      quantities of ascorbic acid (19.8-24.1 mg/100 g) were detected in the seeds and
      synthesis of this vitamin increased significantly (three fold) with increasing
      germination time depending upon rapeseed cultivars (p < 0.05). Soaking of seeds
      in tap water (1:2) for 24 hours resulted in the decrease of the vitamin in each
      case. Among the radiation treatments (0.05-0.20 kGy), maximum amounts of ascorbic
      acid were found in 0.10 kGy (342.1 mg/100 g dry weight) and 0.15 kGy (113.8
      mg/100 g wet weight) samples after 96 hours of germination. An overall
      significant linear relation (r = 0.96) was observed between vitamin biosynthesis
      and germination time upto 96 hours in rapeseed.

PMID- 7784400
TI  - Use of peanut and cowpea in wheat-based products containing composite flours.
AB  - Cowpeas and peanuts are legumes of major dietary and economic importance. They
      are favored worldwide because of their palatability, contribution to nutritional
      status, and low cost as a protein source compared to animal protein. Flours
      processed from cowpeas and peanuts have unique physico-chemical and sensory
      properties when used in composite flour mixtures. Appropriate blends of cowpea
      and peanut flours to replace wheat flour in Chinese-type noodles, muffins, and
      tortillas were determined using modelling and optimization procedures. For
      noodles, 15% peanut flour and 8% cowpea flour supplementation produced an
      acceptable product with high protein content (21%). For wheat flour replacement
      in muffins, up to 43% cowpea and up to 44% peanut flours may be used. However,
      when wheat flour replacement is 50% or greater, cassava flour should comprise 56
      to 72% of the blend with a few exceptions. In tortillas, 24% cowpea and 46%
      peanut flours produced products similar in quality characteristics to those made
      from 100% wheat flour. The systematic approach used in these studies is more
      efficient than the traditional substitution method to optimize sensory qualities
      of wheat-based products containing composite flours.

PMID- 7784401
TI  - [Antral gastritis in chronic alcoholism. Role of cirrhosis and Helicobacter
      pylori].
AB  - OBJECTIVES: Antral gastritis is frequent in alcoholics. The role of H. pylori in
      the pathogenesis of gastritis in these patients is not well known. The aim of our
      study was to study the role of H. pylori and cirrhosis in the pathogenesis of
      antral gastritis in alcoholic patients. METHODS: Seventy-nine patients were
      included in the study. All underwent upper gastrointestinal tract endoscopy with
      antral biopsies, independently of the presence of abdominal pain, and had
      serological examination for H. pylori antibodies. RESULTS: Cirrhosis and
      gastritis were present in 50 and 40 patients respectively, H. pylori serological
      assay and histological identification of the bacterium were positive in 35 (44%)
      and 19 (24%) patients respectively. Discrepancy between the 2 tests were observed
      more frequently in cirrhotic patients. A positive serology with a negative
      histologic examination for H. pylori was present for 18 cirrhotic and 4
      noncirrhotic patients (p < 0.05). A gastritis without evidence of H. pylori was
      more frequent in cirrhotic than in noncirrhotic patients. H. pylori was
      histologically present in 11 of 29 cirrhotic patients and in 8 of the 11
      noncirrhotic patients with a gastritis (p < 0.05). CONCLUSIONS: Discrepancies
      between histological examination and H. pylori serology in patients with
      cirrhosis might be due to the inhospitable environment for H. pylori in case of
      portal hypertension; the positive serology could be in relation with a past
      infection.

PMID- 7784402
TI  - [Evolution of levels of free thyroxine and thyrotropin in treated Cushing
      disease].
AB  - OBJECTIVE: Determine the frequency and changes in thyroid hormones in Cushing's
      disease. METHODS: Free thyroxin and thyrotropin levels were measured in 11
      patients (age range 17 to 60 years) with Cushing's disease both before and after
      resection of the pituitary adenoma. RESULTS: Free thyroxin levels were low (8.3
      to 11.7 pmol/l) in 7 patients. These patients had no clinical manifestations of
      hypothyroidism. In 4 patients, cure of the pituitary adenoma led to normalization
      of the thyroid hormones 10 days after operation (13 to 55 pmol/l); in the other
      cases surgical cure was unsuccessful and thyroxin levels remained low. Cortisol
      levels were finally normalized in these patients after irradiation of the
      pituitary, a second pituitary operation, or bilateral resection of the adrenal
      glands in 2 patients. Normal thyroxin levels were thus achieved. There was no
      correlation between serum cortisol and free thyroxin. CONCLUSION: Thyroid
      hormones should be assayed regularly in patients with Cushing's disease as a
      supplementary control of treatment effectiveness.

PMID- 7784403
TI  - [Pneumopathies caused by Streptococcus pneumoniae in 27 HIV infected patients].
AB  - OBJECTIVES: Determine the clinical features and outcome of acute pneumonia due to
      Streptococcus pneumoniae in HIV infected patients compared with non-HIV infected
      patients. METHODS: From January 1986 to February 1992, we observed 33 episodes of
      pneumococcal pneumonia in 27 HIV-infected patients. Most of the patients were
      drug addicts (16/27), and/or originated from Central Africa or Haiti (10/27). In
      9/27 (33%) patients, HIV infection was previously unknown. Eleven of the 27
      patients were at the CDC stages II-III and CD4 cell count was greater than
      200/mm3 and CD8 cell count was greater than 1000/mm3 in 12/23 patients and 10/20
      patients respectively. RESULTS: In 10/33 episodes, respiratory symptoms were
      severe: bilateral pneumonia (n = 2) and/or hypoxaemia (n = 9). In 22/33 episodes,
      hospitalization occurred less than 24 h after the onset of symptoms and in 9/33
      episodes, the initial chest X-ray was normal. Streptococcus pneumoniae was
      isolated in 16/33 episodes, from blood (n = 10), bronchoalveolar lavage (n = 3)
      or sputum (n = 3). Penicillin G or amoxicillin was used and allowed a favorable
      and quick response in all episodes. Recurrence occurred in 5/18 (27%) followed
      patients. These recurrences were not favoured by a low CD4 cell count since it
      was more than 200/mm3 in these five patients. However, the mean count of CD8
      cells was higher in patients with recurrence than in patients without recurrence,
      1990/mm3 versus 995/mm3 (p = 0.03). CONCLUSION: CD8 hyperlymphocytosis could
      increase the risk of recurrence and would help identify a subgroup with higher
      risk of pneumococcal pneumonia among HIV infected persons.

PMID- 7784404
TI  - [Idiopathic massive osteolysis of the femur. Syndrome called Gorham-Stout
      syndrome].
AB  - A case of massive osteolysis (disappearing bone disease, phantom bone, Gorham's
      massive osteolysis) was observed in a young african man with two lesions of the
      femur. This is a very rare syndrome characterized by an acute spontaneous
      resorption of bone, without any sign of malignant or infectious disorder. The
      lesion may develop in any part of the skeleton, with extensive bone loss, but is
      benign. Bone is replaced by haemangiomatous tissue. The diagnosis lead on the
      association of clinical, radiological and histological signs. The pathogenesis is
      still unknown and the treatment remains controversial. Osteolysis stops after a
      few years, but this is unpredictable; in our case, we have proposed prosthetic
      replacement, associated with bone grafting and irradiation.

PMID- 7784405
TI  - [Relationship between type III intestinal metaplasia, age and gastric cancer. 560
      biopsies].
AB  - OBJECTIVE: A significant association between type III intestinal metaplasia and
      gastric adenocarcinoma has been demonstrated in gastrectomy and biopsy series. We
      investigated the effect of age in a large series of gastric biopsies in order to
      determine whether this association is age dependent or independent. METHODS:
      Histochemistry examinations were performed in 560 gastric biopsies showing
      intestinal metaplasia. The percentage of type III versus type I/II metaplasia in
      patients with malignant (n = 41) or benign disease (n = 519) was compared between
      patients aged 50 to 69 years and patients aged 70 to 89 years. RESULTS: The
      prevalence of type III metaplasia increased with age both in malignant (30 vs 61%
      in the 50-69 and 70-89 year age groups respectively) and benign disease (9 vs 17%
      respectively). In patients with cancer, type III metaplasia was found more often
      than type I/II metaplasia (n = 22 vs 19). In the 70-89 year age group, there was
      a significant difference (p < 0.001) in the percentage of type III metaplasia in
      patients with cancer (61%) and those with benign disease (17%). CONCLUSION: These
      findings demonstrate that there is a specific age-independent relationship
      between intestinal metaplasia and gastric cancer.

PMID- 7784407
TI  - [Methods for the measurement of insulin resistance. Hyperinsulinemic euglycemic
      clamp].
AB  - Insulin resistance is defined as the decrease of the biological action of
      insulin, and it mainly presents as an hyperinsulinaemia. The clinical
      investigation of the states of insulin resistance requires expertise in
      sophisticated in vivo and in vitro methods. The hyperinsulinaemic euglycemic
      clamp is the reference method for quantifying insulin resistance. The clamp
      technique consists in infusing insulin at constant rate and, to prevent any
      decrease in the plasma glucose level, by infusing dextrose. The rate of dextrose
      infused to maintain euglycaemia is an estimate of the amount of glucose which is
      taken up by the tissues under the effect of a defined plasma insulin
      concentration. Using several rates of insulin infusion allows to establish the
      relationship between the whole body glucose disposal and plasma insulin levels,
      and to discriminate between the states of decreased insulin sensitivity and/or
      altered maximal capacity to dispose of glucose. The measurement of glucose
      fluxes, using the constant infusion of stable isotope labelled glucose, allows to
      differentiate the hepatic and the peripheral components of insulin resistance.
      Insulin sensitivity may be estimated using other methods, such as the minimal
      model which consists in a mathematical analysis of the intravenous glucose
      tolerance test. In vitro studies include the search for anti-insulin antibodies
      and anti-insulin-receptor antibodies, the study of insulin receptors (insulin
      binding, tyrosine-kinase activity and gene structure) and of the post-receptor
      glucose metabolism. Genetic syndromes of extreme insulin resistance, the
      pathophysiology of which is poorly known, are the main applications of these
      investigations. However, insulin resistance plays an important role in non
      insulin-dependent diabetes mellitus, and also in insulin-dependent diabetes and
      various pathological or physiological endocrine disorders.

PMID- 7784406
TI  - [Farnesyl transferase inhibitors (anti-Ras). A new class of anticancer agents].
AB  - Ras genes are frequently activated in human tumours. The role of their product,
      the P21 proteins, in the transduction of the mitogenic signal makes them
      attractive targets for an anti-neoplastic therapy. The p21 ras proteins are
      linked to the plasma membrane and transformed into an active form for signal
      transmission. Their effect is to mediate the effects of growth factors. Two drug
      families, the Benzodiazepine peptidomimetics and the CAAX tetrapeptides which
      inhibit the farnesylation of P21-Ras proteins abolish the transforming properties
      of mutated P21. These promising drugs could rapidly have clinical applications.
      They have been shown to be highly active at precise concentrations on ras
      transformed cells but at the same concentrations are not toxic for untransformed
      cells. They do not effect other similar enzyme systems within the cell,
      underlining their selective capacity. Theoretically anti-ras therapy could only
      suspend cell transformation although it might be possible that if given long
      enough, a lethal threshold could be reached.

PMID- 7784408
TI  - [Amyotrophic neuralgia, a multiple atypical form. Possible role of herpes simplex
      virus].

PMID- 7784409
TI  - [Tumor of Oddi's sphincter associated with pemphigus].

PMID- 7784410
TI  - [Acute appendicitis in newborn infants. Value of repeated clinical examinations
      and directed ultrasonography].

PMID- 7784411
TI  - [Acute hyponatremia after resection of a pituitary micro-adenoma by
      transphenoidal approach].

PMID- 7784412
TI  - [Critical serum concentration of antibiotics. A therapeutic tool and means of
      comparative evaluation].
AB  - It is difficult to predict the clinical activity of antibiotics solely on the
      basis of in vitro data. Experimental models measuring the relationship between
      serum concentration and in vivo activity are essential for comparing the activity
      of different compounds currently available. The critical serum concentration can
      be used to compare the intrinsic activity of antibiotics on a given bacterial
      strain. When compared with the minimal inhibiting concentration measured in
      vitro, "activity loss" can be determined for each antibiotic placed in contact
      with bacteria in an infected tissue. The relevance of this therapeutic tool in
      comparison with other methods is discussed.

PMID- 7784413
TI  - [Hyperprolactinemic amenorrhea:treatment with cabergoline versus bromocriptine.
      Results of a national multicenter randomized double-blind study].
AB  - OBJECTIVES: Cabergoline is a new, long-acting D2 agonist, highly effective in
      suppressing prolactin and restoring gonadal function in hyperprolactinaemic
      amenorrhoea. This study compares its efficacity and safety with that of the
      reference compound, bromocriptine. METHODS: A prospective study involved 21
      French Centres and 120 women, with hyperprolactinaemic amenorrhoea, randomized to
      either cabergoline (CAB 0.5-1 mg twice weekly) or bromocriptine (BRC 2.5-5 mg
      twice daily). Treatment is given under double-blind conditions for the first 8
      weeks, and subsequently in open conditions in further 16 weeks with dose
      adjustments according to response. Patients were assessed for biochemical and
      clinical efficacy and drug safety (adverse symptoms and biology). RESULTS:
      Normoprolactinaemia was achieved in 56/60 (93.3%) taking CAB and 27/58 (48.2%)
      taking BRC (p < 0.0001). Ovulatory cycles or pregnancy were recorded in 71.6% and
      48.2% of patients (p = 0.001). Prolactin suppression to below 50% of the baseline
      value was observed in 1.6% and 15.5% (p = 0.007). Adverse symptoms were recorded
      in 31/60 (51.6%) and 40/58 (69.2%) patients respectively in the double-blind
      period, and 53.3% versus 65.5% for the full course of the study. There were
      significantly fewer gastro-intestinal symptoms in the CAB group, 36.6% versus
      84.5% (p < 0.0001). CONCLUSION: Cabergoline is a new prolactin-lowering drug,
      more effective and better tolerated with fewer gastrointestinal symptoms than the
      reference compound, bromocriptine.

PMID- 7784414
TI  - [Directional velocity of the arterial flow, systemic vascular resistance and
      urinary excretion of sodium in cirrhotic patients].
AB  - OBJECTIVES: We have studied the vascular resistance at the posterior tibial
      artery utilizing the Doppler reverse/forward flow ratio, and its relationship to
      systemic vascular resistance and renal function in 32 nonazotemic cirrhotic
      patients. METHODS: Patients were divided into three groups. Group A comprised 10
      patients without ascites or oedema; group B comprised 9 patients with ascites and
      a relatively high sodium excretion (40 +/- 34 mmol/day); and group C comprised 13
      patients with ascites and very low sodium excretion (4.9 +/- 2 mmol/day).
      RESULTS: No significant differences were found in urine flow, creatinine or
      creatinine clearance between the three groups. Renin and aldosterone levels were
      found increased in group C. Systemic vascular resistance differed significantly
      in the three groups, being lower in group C. Significant higher values in the
      Doppler reverse/forward ratio were observed in patients with markedly increased
      sodium retention and less systemic vascular resistance (group C). The Doppler
      reverse/forward ratio showed significant correlations with systemic vascular
      resistance (r = 0.65; n = 32; p < 0.001), urinary sodium excretion (r = 0.53; n =
      32; p < 0.01), renin (r = 0.474; n = 32; p < 0.01) and aldosterone levels (r =
      0.589; n = 32; p < 0.001). CONCLUSIONS: These preliminary results suggest in
      patients with hepatic cirrhosis vascular resistance, assessed non-invasively, at
      the posterior tibial artery, increases with the severity of sodium retention and
      the impairment in systemic hemodynamics. Thus, this measurement may be useful for
      the evaluation and follow-up of patients with cirrhosis of the liver.

PMID- 7784415
TI  - [Cardiovascular effects of a calcium channel blocker in hypoxia caused by
      altitude].
AB  - OBJECTIVE: High altitude pulmonary oedema can be successfully treated and
      prevented by calcium channel blockers. Moreover, calcium entering in the cells
      could explain the congestive phenomena of acute mountain sickness (AMS). These
      findings led us to study the action of a calcium channel blocker, isradipine, in
      the prevention of non-complicated AMS. METHODS: In a double blind randomized
      study, 20 healthy volunteers received 5 mg of isradipine (n = 6) or placebo (n =
      6) for 8 days. After 5 days of treatment in normoxia, the subjects were rapidly
      transported to an altitude of 4350 m. The efficiency of the treatment was then
      estimated by the AMS symptom score, haemodynamic parameters and renal function.
      RESULTS: The administration of isradipine did not significantly modify AMS
      symptom score nor most of other parameters measured in high altitude hypoxia.
      Heart rate was an average of 15 b/min lower in the isradipine group, probably
      because of a direct action of isradipine on the sinus node. Otherwise, the
      effects of hypoxia were similar in both groups and were in accordance with the
      literature. There was no clear explanation for the increase in cardiac output and
      stroke volume when the subjects moved from supine to standing position. Renal
      blood flow, measured by Doppler or para-aminohippuric acid clearance was not
      modified by hypoxia. Cerebral blood flow was elevated, due to the direct
      vasodilator effect of hypoxia. However this increase did not seem to be the main
      mechanism responsible for the congestive phenomena. On the other hand, the
      increase in capillary permeability (demonstrated by the increased transcapillary
      escape rate of albumin, and albuminuria) appeared to play a major role in the
      pathogenesis of AMS and high altitude cerebral oedema. Isradipine had no
      protective effect on these phenomena and its use should be restricted to the
      treatment of high altitude pulmonary oedema.

PMID- 7784416
TI  - [Detection of the Arg 3500-->Gln mutation of B apolipoprotein. Value in clinical
      practice].
AB  - OBJECTIVE: Familial defective apolipoprotein B-100, caused by a mutation in
      position 3500 of apolipoprotein B, induces hypercholesterolaemia, a major risk
      factor of coronary artery disease. The objective is to evaluate the interest of
      the detecting subjects bearing the Arg3500-->Gln mutation and to observe the
      response of these subjects to different physiological and therapeutic situations,
      in clinical practice. METHODS: We performed a systematic screening among
      hypercholesterolaemic outpatients attending a lipid clinic. The heterozygote
      subjects were followed up during more than one year and, in some of them, we
      compared the efficiency of cholesterol-lowering drugs belonging to the different
      classes: fibrate and statine. RESULTS: Two probands and 3 related subjects were
      detected. Three patients were treated. For two patients, reduction of LDL
      cholesterol plasma levels was observed with both drugs but was significantly
      higher with statine than with fibrate. For the third one, carrying the E2E4
      phenotype, the statine did not seemed to have a major effect. CONCLUSION: The
      number of probands is in agreement with the frequency reported in literature. A
      possible interaction of the effect of statine with the apo E2 isoform is
      discussed.

PMID- 7784417
TI  - [Microfibroendoscopy of the eustachian tube].
AB  - The development of extremely minute high performance optical fibers have made
      possible fibroscopic examination of the Eustachian tube. We have developed a
      microfibroendoscopic technique since 1987 to explore the Eustachian tube and the
      tympanic cavity without opening the tympanic membrane. This technique has been
      used in 125 patients with chronic otitis. The exploration is performed in the
      operating theatre during a tympanoplasty procedure. Patients are placed in supine
      position under general anaesthesia. Endoscopic exploration of the Eustachian tube
      has demonstrated that tube obstruction is very rare, encountered in only 2% of
      our cases. The major advantage of the technique is the direct antero-posterior
      visualization of the middle ear. Viewing the middle ear from this anterior view
      point, the surgeon can analyze regions unattainable with other techniques. The
      future challenge for this technique is to achieve the goal of non-invasive
      surgery of the middle ear.

PMID- 7784418
TI  - [RU 486: current and potential indications. Great expectations and strong
      resistance].
AB  - RU 486 is the code name for mifepristone, a 19-norsteroid first synthesized in
      1980. Its chemical structure is similar to progesterone and progesterone
      derivatives. The difference lies in an 11 beta ring substitution which results in
      high affinity for progesterone and cortisol receptors. Once linked to the
      receptor, RU 486 temporarily blocks the action of the corresponding hormone. In
      vitro and in vivo, RU 486 has a powerful anti-progesterone and anti
      glucocorticoid effect and a less powerful but nevertheless important anti
      androgen effect. The essential clinical application for RU 486 involves its anti
      progesterone effect, currently used in several indications including voluntary
      pregnancy termination and preparation for the prostaglandin action used to induce
      labour in interrupted pregnancies. Potential indications have been suggested for
      preparing the cervix for endo-uterine manoeuvres, induction of labour in term
      pregnancy and contraception. Other potential indications in gynaecology include
      breast cancer, endometriosis and uterine fibroma. Meningioma and Cushing's
      syndrome would be further indications. How far will we go with RU 486? All will
      depend on the social and economic resistance to the drug and to an even greater
      extent on ethical considerations. The strength of the anti-RU 486 lobby may well
      dampen the development of non-contraception indications for this effective anti
      progesterone agent.

PMID- 7784419
TI  - [Medical treatment of atrial fibrillation in the healthy heart].
AB  - Whatever the cause and clinical features, establishing the strategy for the
      medical treatment of atrial fibrillation, requires three basic steps. First sinus
      rhythm must be restored, followed by the prescription of antiarrhythmic drugs to
      prevent recurrence and finally the use of anticoagulants. Obviously the
      underlying heart disease has a major effect on the patient's tolerance of atrial
      fibrillation, the risks of peripheral embolism and overall mortality. In patients
      with "solitary atrial fibrillation" and an apparently normal heart, each step of
      the treatment must be examined in light of the individual patients clinical
      situation and the risks of haemorrhage with anticoagulants as well as the risk of
      lethal ventricular arrhythmia due to the arrhythmogenic effect of class la or 1c
      antiarrhythmic drugs.

PMID- 7784420
TI  - [Uveitis and rifabutin: two new cases].

PMID- 7784421
TI  - [Apropos of the resistance to activated protein-C in venous thromboembolic
      accidents].

PMID- 7784422
TI  - [Diaphragmatic paralysis during hereditary myasthenia].

PMID- 7784423
TI  - Funnels, pathways, and the energy landscape of protein folding: a synthesis.
AB  - The understanding, and even the description of protein folding is impeded by the
      complexity of the process. Much of this complexity can be described and
      understood by taking a statistical approach to the energetics of protein
      conformation, that is, to the energy landscape. The statistical energy landscape
      approach explains when and why unique behaviors, such as specific folding
      pathways, occur in some proteins and more generally explains the distinction
      between folding processes common to all sequences and those peculiar to
      individual sequences. This approach also gives new, quantitative insights into
      the interpretation of experiments and simulations of protein folding
      thermodynamics and kinetics. Specifically, the picture provides simple
      explanations for folding as a two-state first-order phase transition, for the
      origin of metastable collapsed unfolded states and for the curved Arrhenius plots
      observed in both laboratory experiments and discrete lattice simulations. The
      relation of these quantitative ideas to folding pathways, to uniexponential vs.
      multiexponential behavior in protein folding experiments and to the effect of
      mutations on folding is also discussed. The success of energy landscape ideas in
      protein structure prediction is also described. The use of the energy landscape
      approach for analyzing data is illustrated with a quantitative analysis of some
      recent simulations, and a qualitative analysis of experiments on the folding of
      three proteins. The work unifies several previously proposed ideas concerning the
      mechanism protein folding and delimits the regions of validity of these ideas
      under different thermodynamic conditions.

PMID- 7784424
TI  - Computational approaches to study protein unfolding: hen egg white lysozyme as a
      case study.
AB  - Four methods are compared to drive the unfolding of a protein: (1) high
      temperature (T-run), (2) high pressure (P-run), (3) by imposing a gradual
      increase in the mean radius of the protein using a penalty function added to the
      physical interaction function (F-run, radial force driven unfolding), and (4) by
      weak coupling of the difference between the temperature of the radially outward
      moving atoms and the radially inward moving atoms to an external temperature bath
      (K-run, kinetic energy driven unfolding). The characteristic features of the four
      unfolding pathways are analyzed in order to detect distortions due to the size or
      the type of the applied perturbation, as well as the features that are common to
      all of them. Hen egg white lysozyme is used as a test system. The simulations are
      analyzed and compared to experimental data like 1H-NMR amide proton exchange
      folding competition, heat capacity, and compressibility measurements.

PMID- 7784425
TI  - Modeling the quinone-B binding site of the photosystem-II reaction center using
      notions of complementarity and contact-surface between atoms.
AB  - Functional identity and significant similarities in cofactors and sequence exist
      between the L and M reaction center proteins of the photosynthetic bacteria and
      the D1 and D2 photosystem-II reaction center proteins of cyanobacteria, algae,
      and plants. A model of the quinone (QB) binding site of the D1 protein is
      presented based upon the resolved structure of the QB binding pocket of the L
      subunit, and introducing novel quantitative notions of complementarity and
      contact surface between atoms. This model, built without using traditional
      methods of molecular mechanics and restricted to residues in direct contact with
      QB, accounts for the experimentally derived functional state of mutants of the D1
      protein in the region of QB. It predicts the binding of both the classical and
      phenol-type PSII herbicides and rationalizes the relative levels of tolerance of
      mutant phenotypes.

PMID- 7784427
TI  - Dramatic differences in the motions of the mouth of open and closed cytochrome
      P450BM-3 by molecular dynamics simulations.
AB  - Molecular dynamics trajectories were calculated separately for each of the two
      molecules in the asymmetric unit of the crystal structure of the hemoprotein
      domain of cytochrome P450BM-3. Each simulation was 200 ps in length and included
      a 10 A layer of explicit solvent. The simulated time-average structure of each
      P450BM-3 molecule is closer to its crystal structure than the two molecular
      dynamics time-averaged structures are to each other. In the crystal structure,
      molecule 2 has a more accessible substrate binding pocket than molecule 1, and
      this difference is maintained throughout the simulations presented here. In
      particular, the substrate docking regions of molecule 1 and molecule 2 diverge in
      the solution state simulations. The mouth of the substrate binding pocket is
      significantly more mobile in the simulation of molecule 2 than in the simulation
      of molecule 1. For molecule 1, the width of the mouth is only slightly larger
      than its X-ray value of 8.7 A and undergoes fluctuations of about 1 A. However,
      in molecule 2, the mouth of the substrate binding pocket is dramatically more
      open in the time-average molecular dynamics structure (14.7 A) than in the X-ray
      structure (10.9 A). Furthermore, this region of the protein undergoes large
      amplitude motions during the trajectory that are not seen in the trajectory of
      molecule 1, repeatedly opening and closing up to 7 A. Presumably, the binding of
      different substrates will induce the mouth region to adopt different
      conformations from within the wide range of structures that are accessible.

PMID- 7784426
TI  - A model for the LexA repressor DNA complex.
AB  - A structural model for the interaction of the LexA repressor DNA binding domain
      (DBD) with operator DNA is derived by means of Monte Carlo docking. Protein-DNA
      complexes were generated by docking the LexA repressor DBD NMR solution structure
      onto both rigid and bent B-DNA structures while giving energy bonuses for
      contacts in agreement with experimental data. In the resulting complexes, helix
      III of the LexA repressor DBD is located in the major groove of the DNA and
      residues Asn-41, Glu-44, and Glu-45 form specific hydrogen bonds with bases of
      the CTGT DNA sequence. Ser-39, Ala-42, and Asn-41 are involved in a hydrophobic
      interaction with the methyl group of the first thymine base. Residues in the loop
      region connecting the two beta-sheet strands are involved in nonspecific contacts
      near the dyad axis of the operator. The contacts observed in the docked complexes
      cover the entire consensus CTGT half-site DNA operator, thus explaining the
      specificity of the LexA repressor for such sequences. In addition, a large number
      of nonspecific interactions between protein and DNA is observed. The agreement
      between the derived model for the LexA repressor DBD/DNA complex and experimental
      biochemical results is discussed.

PMID- 7784429
TI  - Packing constraints of hydrophobic side chains in (alpha/beta)8 barrels.
AB  - An analysis of possible tight packing of hydrophobic groups simultaneously at the
      both surfaces of beta-hyperboloid-8 was conducted. This analysis shows that the
      disposition of amino acid side chains at the real beta-structure's surface is
      unique. If we sign the mean distance between adjacent beta-strands as "a," and
      the mean distance along beta-strand between C alpha atoms, whose side chains are
      directed to one side of the beta-sheet, as "b," the ratio b/a = square root of 2
      very precisely. This ratio ensures the most efficient packing of side hydrophobic
      groups at the outer surface of beta-hyperboloid-8, forming, at the same time, the
      second by efficiency packing at its inner surface.

PMID- 7784428
TI  - The first solvation shell of magnesium ion in a model protein environment with
      formate, water, and X-NH3, H2S, imidazole, formaldehyde, and chloride as ligands:
      an Ab initio study.
AB  - The first coordination shell of an Mg(II) ion in a model protein environment is
      studied. Complexes containing a model carboxylate, an Mg(II) ion, various ligands
      (NH3, H2S, imidazole, and formaldehyde) and water of hydration about the divalent
      metal ion were geometry optimized. We find that for complexes with the same
      coordination number, the unidentate carboxylate-Mg(II) ion is greater than 10
      kcal mol-1 more stable than the bidentate orientation. Imidazole was found to be
      the most stable ligand, followed in order by NH3, formaldehyde, H2O, and H2S.

PMID- 7784430
TI  - Preliminary X-ray diffraction analysis of crystals of tomato aspermy virus (TAV).
AB  - Tomato aspermy virus (TAV) is a member of the T = 3 cucumovirus group, and the
      chrysanthemum strain (C-TAV) has been crystallized in a form suitable for X-ray
      structural analysis. The crystals, which grow in 14-17% ethanol at pH 8.5, are of
      orthorhombic space group I222 with unit cell dimensions of a = 295.1 A, b = 320.5
      A, and c = 383.6 A. There are two T = 3 virus particles in the unit cell, which
      means that they must be centered at 0,0,0 and 1/2, 1/2, 1/2 with icosahedral 222
      symmetry elements coincident with crystallographic symmetry operators. The
      asymmetric unit of the crystals, therefore, contains one quarter of a virus
      particle, or 45 capsid subunits. Native diffraction data to 4 A resolution have
      been collected using synchrotron radiation, though data appear to be present
      beyond that resolution.

PMID- 7784431
TI  - Purification, crystallization, and preliminary X-ray diffraction analysis of even
      skipped homeodomain complexed to DNA.
AB  - Embryonic development in metazoa, to a significant extent, is directed by genes
      which contain a conserved sequence motif named the homeobox. This sequence
      encodes a polypeptide called the homeodomain which has sequence specific DNA
      binding activity. We report the purification, crystallization, and preliminary
      diffraction analysis of the Drosophila Even-skipped homeodomain (Eve HD) bound to
      two different oligonucleotides. Crystals of Eve HD complexed with an AT-rich
      sequence belong to space group P2(1), a = 34.06, b = 61.61, c = 39.99 Angstrom,
      beta = 90.0 degrees. These crystals diffract to at least 2.0 Angstrom and both
      native and derivative data sets have been collected. Crystals of Eve HD complexed
      with a GC-rich sequence belong to space group P6(3), a = b = 124.52, c = 66.78
      Angstrom and diffract to 3.5 Angstrom resolution. A native data set has been
      collected.

PMID- 7784432
TI  - Inward rectification of neuronal nicotinic acetylcholine receptors investigated
      by using the homomeric alpha 7 receptor.
AB  - The strong inward rectification observed in neuronal nicotinic ACh receptors was
      examined by using alpha-bungarotoxin sensitive, homomeric alpha 7 neuronal
      nicotinic ACh receptors derived from chick brain. Receptors were expressed in
      Xenopus laevis oocytes and functionally assessed by the two electrode voltage
      clamp technique. Site directed mutagenesis of residues thought to line the
      putative ion pore revealed that negatively charged glutamate residues located at
      the inner mouth of the channel are essential for rectification. This finding was
      confirmed both for the active open state and for receptors mutated to conduct in
      one of the desensitized states. No outward tail relaxations were observed with
      voltage jumps to depolarizing potentials, suggesting that rectification was not
      due to intrinsic gating. For the wild type receptor, intracellular injection of
      CDTA, a chelating agent having a high affinity for Mg2+, reduced rectification in
      a dose dependent manner, suggesting that rectification originates, in part, from
      open channel block by internal free Mg2+. These findings support the hypothesis
      that charged residues at the inner mouth of the pore influence the Mg2+ affinity
      of the blocking site.

PMID- 7784433
TI  - Conformational study of the Thr-Gly repeat in the Drosophila clock protein,
      PERIOD.
AB  - Recent results with the Drosophila melanogaster period gene suggest that the
      apparently conserved repetitive motif (Thr-Gly)n encoded by this gene may play an
      important role in the temperature compensation of the circadian clock. We have
      therefore initiated both a theoretical and experimental conformational analysis
      of (Thr-Gly)n peptides. By using a build-up method, it is clear that the
      hexapeptide (Thr-Gly)3 represents a 'conformational monomer' and generates a
      stable type II or type III beta-turn. Circular dichroism and nuclear magnetic
      resonance spectra of synthetic (Thr-Gly)3 and poly(Thr-Gly) peptides revealed
      that these peptides exhibit flexible conformations, especially in more polar
      environments and at higher temperatures. We speculate that this flexibility may
      illuminate our understanding of both the molecular mechanism of temperature
      compensation and the systematic geographical distribution within Europe of the
      Thr-Gly length polymorphism in D. melanogaster.

PMID- 7784434
TI  - Phenomenal motion seen through artificial intra-ocular lenses.

PMID- 7784435
TI  - Brain-created visual motion: an illusion?

PMID- 7784436
TI  - Colour identification and colour constancy are impaired in a patient with
      incomplete achromatopsia associated with prestriate cortical lesions.
AB  - We have examined visual functions, including colour vision, in a patient with
      bilateral cortical lesions involving mainly the fusiform and lingual gyri, areas
      known to be involved in the central processing of chromatic stimuli. The patient
      has near normal (6/9) acuity, and his responses to tests of binocular function
      and spatial vision are normal, as are his discrimination of changes in target
      speed and surface lightness. He does, however, exhibit minor losses in the upper
      visual field, mild prosopagnosia and topographical agnosia, all conditions
      commonly associated with cerebral achromatopsia. Colour matches and spectral
      response data establish that his cone photoreceptors have normal spectral
      characteristics and his spectral sensitivity measured against a white background
      reveals normal postreceptoral chromatic function. The patient's colour
      discrimination for differences in wavelength, hue or saturation is, however,
      impaired and his colour naming is significantly disturbed, particularly for blues
      and greens. We have determined the areas of the chromaticity chart that
      correspond to his naming categories for surface colours, and show that changes in
      illuminant cause him to alter the names of surface colours in a manner consistent
      with the changes in their chromaticities. Other subjects with normal or
      congenital red-green deficient colour vision make many fewer name changes under
      changes in illuminant. We conclude that the patient's colour constancy is
      impaired as a consequence of abnormal central processing of colour vision.

PMID- 7784437
TI  - Molecular support for vicariance as a source of diversity in rainforest.
AB  - The origin of high diversity in tropical rainforests is attributed to divergence
      amongst relatively mesic, late Pleistocene refuges. To test this hypothesis we
      analysed sequence variation within the mitochondrial DNA of populations of six
      rainforest-dwelling vertebrate species (one lizard and five birds) in the Wet
      Tropical rainforests of northeastern Australia. Vicariance among historical
      refuges was indicated by geographically congruent variation across a historical
      climatic barrier previously predicted by modelling. Sequence divergence across
      the barrier varied widely, being highest in species with lowest vagility and
      greatest restriction to rainforest. A high altitude, rainforest-restricted
      species was exceptional in lacking mtDNA variation. These data support the
      suggested role of vicariance in promoting evolutionary diversity in rainforests
      but also indicate variation in the timing of vicariance events, with most
      speciation or divergence events occurring well before the late Pleistocene. The
      relation between the amount of molecular divergence and current ecology suggests
      a sequence of isolation events, perhaps of increasing severity, occurring between
      the late Tertiary and the late Pleistocene.

PMID- 7784438
TI  - The inner ear of the echidna Tachyglossus aculeatus: the vestibular sensory
      organs.
AB  - The monotremes, comprising the echidnas and platypus, have more sensory organs in
      the inner ear than do other mammals. In addition to the organs usually seen in
      the mammalian inner ear, they have a lagenar macula, a sense organ found in all
      non-mammalian vertebrates. In the echidna Tachyglossus aculeatus, this macula
      consists of a narrow sensory strip at the end of the cochlea. All vestibular
      sensory organs are populated by two types of sensory cells, cylindrical bouton
      innervated hair cells and more or less regular bottle-shaped calyceal-innervated
      hair cells. The two types are mixed in all vestibular organs, as in placental
      mammals, and their arrangement in the maculae in particular is very unlike that
      in reptiles. The sensory epithelia are very large relative to the size of the
      animals. The utricular macula contains more sensory cells than found in any other
      amniote so far examined.

PMID- 7784439
TI  - Kinematics of eye movement control.
AB  - In this paper a kinematic description of the restrictions imposed on the eye
      movements is presented. The restrictions arise from a pattern of nonlinear
      interactions between desired changes in viewing direction and current eye
      position. It is shown that various reported relations between eye torsion and
      viewing direction can be derived by changing only the relative weights of the
      interactions terms. This descriptive scheme may help to elucidate the control of
      eye torsion in the brainstem.

PMID- 7784440
TI  - Control of re-entrant activity in a model of mammalian atrial tissue.
AB  - We evaluate the feasibility of using resonant drift under feedback driven
      stimulation to control re-entrant excitation in atrial muscle. We simulate a two
      dimensional sheet of atrial tissue, where the local kinetics are described by the
      Earm-Hilgemann-Noble equations for a rabbit atrial cell, and the effects of small
      amplitude spatially uniform forcing of the whole sheet are computed. Repetitive
      forcing can induce a drift of a spiral wave in the two-dimensional model, with a
      drift velocity of up to 10 cm s-1. For a 4 cm x 4 cm atrial surface this resonant
      drift can move the re-entrant spiral to the inexcitable boundaries, eliminating
      re-entry in less than 10 s when the amplitude of the repetitive stimulation is
      10% that of the single shock defibrillation threshold.

PMID- 7784442
TI  - Monthly prostaglandin bibliography prepared by Sheffield University Biomedical
      Information Service.

PMID- 7784441
TI  - Concordant evolutionary patterns among Indo-West Pacific butterflyfishes.
AB  - Genetic differences within a 495 base pair section of the mitochondrial
      cytochrome b gene reveal a striking concordance among species in two monophyletic
      groups of Indo-west Pacific butterflyfishes. In both species groups, an
      approximately 2.0% genetic break clearly partitions individuals between the
      Indian Ocean and Pacific Ocean. However, levels of intra-Pacific mtDNA variation
      are low, on average less than 1.0%, and fail to cluster by species boundaries
      defined by colour pattern. Individuals from different species, separated by
      thousands of kilometers, often possess identical cytochrome b sequences, whereas
      conspecifics from the same reefs can show up to 1.5% difference. The discrepancy
      between the mtDNA gene tree and species boundaries may reflect retained ancestral
      variation or may be the result of hybridization. The strong temporal and
      phylogenetic concordance between these two independent species groups suggests
      that genetic differentiation was influenced by common environmental factors. Low
      levels of within- and between-species genetic differences imply a recent
      divergence time and suggest a link between speciation within each group and
      Pleistocene climatic fluctuations. These results paint a turbulent picture of the
      recent evolutionary history of the Indo-West Pacific.

PMID- 7784443
TI  - Fate of exogenous arachidonic acid in THP-1 cells: incorporation in cell lipids
      and conversion to outer N-6 fatty acids.

PMID- 7784444
TI  - Effects of fatty acids on hepatic gene expression.
AB  - Polyunsaturated fatty acids (PUFA) have dramatic effects on hepatic lipid
      metabolism by regulating the transcription of specific genes encoding enzymes
      involved in glycolysis and lipogenesis. The S14 gene, a putative lipogenic
      protein, has been used as a model to define the molecular basis of PUFA action on
      hepatic gene expression. We have shown that PUFA-regulated hepatic transcription
      factors target cis-regulatory elements located between -220 and -80 bp upstream
      from the 5' end of the S14 gene. Peroxisomal proliferators (PP) also have
      dramatic effects on hepatic lipid metabolism through effects on gene expression.
      The mechanism of PP action is mediated, at least in part, through nuclear
      receptors, i.e. PP activated receptor (PPAR). We found that the potent PP, i.e.
      WY14,643, suppressed mRNAS14 and the activity of an S14CAT fusion gene in
      cultured primary hepatocytes. Preliminary mapping studies showed that WY14,643
      cis-regulatory elements were located either within the S14 proximal promoter (
      290 and +19), the S14 TRE (-2900 to -2500) or both regions. Gel shift analysis
      showed that PPAR did not bind S14 promoter elements. These studies suggest that
      PUFA- and PP-regulated factors may share common cis-acting elements within the
      S14 promoter. However, if PUFA control of S14 gene transcription is mediated by
      PPAR, this mechanism does not involve direct interaction of PPAR with the S14
      proximal promoter.

PMID- 7784445
TI  - Fatty acids and adipose cell differentiation.
AB  - Fatty acids are important metabolic substrates for adipose tissue. In preadipose
      cells, fatty acids are also potent inducers of various genes encoding proteins
      directly involved in fatty acid metabolism. On a longer-term basis, fatty acids
      induce the terminal differentiation of preadipose to adipose cells. Fatty acids
      act primarily at a transcriptional level. A member of the steroid/thyroid hormone
      receptor superfamily has been identified by cDNA cloning from a mouse Ob1771
      preadipose cell library. This receptor is likely the fatty acid-activated
      receptor implicated in the transcriptional effects of fatty acids in adipose
      cells. Thus fatty acids appear to play a new role as signal transducing molecules
      which are involved in adipose cell differentiation.

PMID- 7784446
TI  - Cellular differentiation and dietary regulation of gene expression.
AB  - The differentiation of 3T3-L1 preadipocytes into adipocytes is one of the few
      well characterized model systems available to study cellular differentiation in
      culture. We cloned and determined the genetic organization of two murine stearoyl
      CoA desaturase genes (SCD1 and SCD2), both of which are transcriptionally
      activated during preadipocyte differentiation, but are regulated differentially
      by diet in liver and other tissues. These genes are now being used as a model to
      study mechanisms of cellular differentiation, tissue-specific gene expression,
      and dietary regulation of gene expression. It is the objective of this article to
      provide a brief overview of some of the studies on the regulation of the SCD1 and
      SCD2 genes during 3T3-L1 preadipocyte differentiation, and also on their
      differential responses to dietary manipulations in liver tissue.

PMID- 7784447
TI  - Fatty acids in cell signalling: modulation by lipid binding proteins.
AB  - Long-chain fatty acids and several of their metabolites have now been shown to be
      involved as primary or secondary messengers in specific cell signalling pathways.
      In view of their extremely low aqueous solubility, the extracellular as well as
      intracellular transport of these compounds is assumed to be facilitated by
      specific lipid binding proteins, such as cytoplasmic fatty acid-binding protein
      (FABP). In this paper a survey is given on the biological significance and
      possible modulatory action of intracellular lipid binding proteins for fatty acid
      mediated signal transduction pathways.

PMID- 7784448
TI  - Protein kinase C: cellular target of the second messenger arachidonic acid?

PMID- 7784449
TI  - Fatty acids: ancestral ligands and modern co-regulators of the steroid hormone
      receptor cell signalling pathway.
AB  - Long chain fatty acids derived from endogenous metabolism and/or nutrition are
      regulators of cell signalling pathways. They can be lipid second messengers of
      signal transduction systems or modulators and regulators of intracellular
      signalling pathways such as those involved in the mechanism of action of steroid
      hormones. Fatty acids have been shown to activate gene transcription under the
      control of some evolutionarily primitive members of the steroid/thyroid
      superfamily of receptors. They may represent ancestral ligands of this
      superfamily of receptors. Fatty acids are also known to regulate the activity of
      protein kinases, particularly protein kinase C, and thereby phosphorylation of
      intracellular proteins involved in regulation of gene transcription. Fatty acids
      may be co-regulators in the cross-talk between membrane-triggered signal
      transduction and the intracellular steroid hormone signalling pathway. Fatty
      acids are known to affect either negatively and/or positively the binding of
      steroid hormones to their specific plasma transport proteins and their specific
      intracellular receptors and, very recently, fatty acids have also been shown to
      co-regulate glucocorticoid-dependent gene expression. The mechanism of action of
      steroid hormones will be used as an illustration of how fatty acids can intervene
      at different levels of cellular organization to regulate biological activity,
      with a focus on the glucocorticoid receptor.

PMID- 7784450
TI  - Specificity and mechanism of fatty acid inhibition of aldosterone secretion.
AB  - We have shown that unesterified, unsaturated long-chain fatty acids inhibit
      angiotensin II (AII) binding to receptors in adrenal glomerulosa cells. In this
      report, we show that oleic and arachidonic acids are specific inhibitors of the
      AT1 subtype of angiotensin receptor, and exert no effect on receptors of the AT2
      subtype. By contrast, decanoic acid is a weak inhibitor of the AT2 subtype only.
      Our previous work on a post-receptor locus of inhibition by fatty acids of
      aldosterone biosynthesis showed that the 18-oxidase step is uniquely sensitive.
      In brief, the first and last steps involved in angiotensin-stimulated aldosterone
      secretion are particularly sensitive to inhibition by fatty acids. These results
      suggest a specific role for unesterified fatty acids in regulation of salt and
      water metabolism.

PMID- 7784452
TI  - Blood cell redox status and fatty acids.
AB  - Glutathione-dependent peroxidase (GSH-Px) degrades the deleterious
      hydroperoxides, including those issued from arachidonic acid (AA) by the action
      of lipoxygenases, into their alcohol counterpart. We report that the
      hyperactivity of platelets from elderly people and of polymorphonuclear
      neutrophils from allergic patients, at least partly due to higher formation of
      thromboxane A2 and leukotriene B4, respectively, is associated with a depressed
      GSH-Px activity. As we report that n-3 fatty acids may enhance the cell GSH-Px
      activity, we conclude that the reduction of cell hyperactivity described in
      response to those fatty acids might be linked to their effect on GSH-Px.

PMID- 7784451
TI  - Role of GTP-binding proteins in the polyunsaturated fatty acid stimulated
      proliferation of mouse mammary epithelial cells.
AB  - Polyunsaturated fatty acids enhance the proliferation of mouse mammary epithelial
      cells stimulated by epidermal growth factor (EGF) by modulating the post-receptor
      signaling pathways. The growth stimulatory effect of these fatty acids is
      completely inhibited by pertussis toxin, whereas the inhibition of EGF and
      insulin stimulated growth is only partial. The treatment of cell cultures with 12
      O-tetradecanoyl-phorbol-13 acetate (TPA) reverses the growth inhibitory effect of
      pertussis toxin and fully restores the growth as was in the control cultures
      untreated with the toxin suggesting a role for PKC in this reversal. It appears
      that the functions of Gi-proteins are required in the mediation of fatty acid
      effect on growth. The predominant types of Gi alpha in mammary epithelial cells
      are Gi alpha 1, Gi alpha 2, and Gi alpha 3. Among these, the levels of Gi alpha 1
      and 2 appears to be regulated by steroid hormones. Linoleic acid raises the level
      of GTP-bound Ras in the cells above the levels induced by EGF. Pertussis toxin
      reduces the level of Ras-GTP and inhibits phosphorylation of MAP kinase by EGF.
      It has been speculated that Gi-proteins interact with the receptor bound
      nucleotide exchange factor and the membrane anchored Raf kinase and constitute
      two sites for pertussis toxin action. The phosphorylation by PKC may uncouple Gi
      protein interaction with these effectors and enable the agonist-induced signals
      to bypass the inhibitory action of PT on growth.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784454
TI  - Structure-activity relationship of the effect of cis-unsaturated fatty acids on
      heart sarcolemmal phospholipase D activity.
AB  - This study examined the role of fatty acids on the phosphatidylcholine-specific
      phospholipase D (PLD) function of purified sarcolemmal (SL) membranes isolated
      from rat hearts. The enzyme's hydrolytic activity was determined by measuring
      [14C] phosphatidic acid formation from exogenous [14C] phosphatidylcholine
      (PtdCho) in the absence or presence of the sodium salts of various saturated or
      unsaturated long-chain fatty acids (FA). In certain experiments the enzyme was
      also assayed in the transphosphatidylation mode. Cis-unsaturation and free
      carboxyl groups were structural prerequisites for the stimulatory effect exerted
      by FA on SL PLD. The most effective compounds were arachidonate and oleate, which
      maximally activated PLD at 4 and 5 mM concentration, respectively. To verify if a
      detergent-like mechanism was involved in PLD activation, anionic, zwitterionic
      and non-ionic detergents were used. Only anionic taurodeoxycholate had a slight
      effect, which was about 7% of that achieved by arachidonate or oleate. These
      results suggest that cis-unsaturated FA activate cardiac sarcolemmal PLD by a
      mechanism(s) which seems to be unrelated to non-specific perturbation of the
      membrane.

PMID- 7784453
TI  - Fatty acyl CoA esters as regulators of cell metabolism.
AB  - Long chain fatty acyl CoA esters have the ability to interact with certain
      proteins and thereby serve as effectors in cell metabolism. In particular, they
      can displace nucleotides from specific nucleotide dependent or binding proteins
      and interfere with their action. The ADP/ATP carrier and uncoupling protein are
      two examples where the interplay of nucleotide and acyl CoA binding to the
      proteins regulate their function. Other proteins such as glucokinase can be
      considered in this group. In certain tissues like liver they are affected during
      fasting and insulin deficiency, and when serum fatty acids and liver acyl CoA
      levels are elevated. More recently, an acyl CoA binding protein in E. coli has
      been found to be a transcription factor for gene regulation of fatty acid
      metabolism enzymes. There appears to be some consensus in the amino acid sequence
      for acyl CoA binding sites on these proteins which serve a variety of important
      roles in cellular metabolism.

PMID- 7784455
TI  - Direct effects of fatty acids and other charged lipids on ion channel activity in
      smooth muscle cells.
AB  - A variety of fatty acids increase the activity of certain types of K+ channels.
      This effect is not dependent on the three enzymatic pathways that convert
      arachidonic acid to various bioactive oxygenated metabolites. One type of K+
      channel in toad stomach smooth muscle cell membranes in activated by fatty acids
      and other single chain lipids which possess both a negatively charged head group
      and a sufficiently hydrophobic acyl chain. Neutral lipids have no effect on K+
      channel activity, while positively charged lipids with a sufficiently hydrophobic
      acyl chain suppress channel activity. Acyl Coenzyme A's, which do not flip across
      the bilayer, act only from the cytosolic surface of the membrane, suggesting that
      the binding site for channel activation is also located there. This fatty acid
      activated channel is also activated by membrane stretch. Moreover, this
      mechanical response is either mediated or modulated by fatty acids. Thus, fatty
      acids and other charged single chain lipids may comprise another class of first
      or second messenger molecules that target ion channels.

PMID- 7784456
TI  - Regulation of pituitary-adrenocortical activity by free fatty acids in vivo and
      in vitro.
AB  - Virtually every metabolic disorder characterized by elevated plasma free fatty
      acid (FFA) levels is also associated with hypercorticoidism. For example, the
      glucocorticoid response to insulin-hypoglycemia is shown in this report to be
      greatly potentiated in Type I diabetic rats. Since glucocorticoids
      (corticosterone, in rats) potentiate lipolysis and promote gluconeogenesis, they
      exacerbate diabetes. We found that elevation of circulating FFA levels in normal
      rats (via Intralipid/heparin infusion) increased plasma levels of
      adrenocorticotropic hormone (ACTH) and corticosterone, and resulted in
      hyperglycemia. In vitro, however, cultured pituitary cells were relatively
      unaffected by FFA except at very high concentrations. Neither basal ACTH
      secretion nor the ACTH response to corticotropin-releasing hormone (CRH) was
      affected by pathophysiological molar ratios of FFA:BSA. Thus, the ACTH secretory
      response to FFA in vivo likely is mediated via neuroendocrine activation.
      Cultured adrenocortical cells, however, were stimulated by oleic acid and, to a
      lesser extent, by linoleic acid; saturated fatty acids were without effect. The
      latencies of oleic acid-induced steroidogenesis in vitro and Intralipid-induced
      corticosterone secretion in vivo were both about 60 min. We conclude that
      pathophysiological levels of circulating FFA (typical of diabetes, obesity,
      starvation, and consumption of high-fat diets) initiate a positive feedback loop
      between the adipocyte and the HPA axis, which ultimately exacerbates the symptoms
      of these disorders.

PMID- 7784457
TI  - Omega-3 fatty acids and prevention of ventricular fibrillation.
AB  - Interest in the potential cardiovascular benefits of omega-3 long chain
      polyunsaturated fatty acids has been largely focused on possible
      antiatherothrombotic effects. In addition, however, definitive antiarrhythmic
      effects of these dietary omega-3 fatty acids have been reported by Charnock &
      McLennan. Our studies commenced with the observation that two of these fatty
      acids, eicosapentaenoic (C20:5n-3, EPA) and docosahexaenoic acid (C22:6n-3, DHA)
      prevented contracture and fibrillation of isolated neonatal cardiac myocytes when
      exposed to toxic levels of ouabain (0.1 mM). This protection was associated with
      prevention of excessively high intracellular calcium concentrations in the
      myocyte. Further, it was shown that these fatty acids modulate calcium currents
      through L-type calcium channels and that the effect occurs within a few minutes
      of adding EPA or DHA to the medium perfusing the cultured cardiac myocytes.
      Infusing an emulsion of the omega-3 fatty acids intravenously just prior to
      compression of a coronary artery in a conscious, prepared dog will prevent the
      expected subsequent ischemia-induced ventricular fibrillation.

PMID- 7784458
TI  - Altered lipid metabolism in the failing heart of cardiomyopathic hamsters (UM
      X7.1).
AB  - The lipid composition of different anatomic regions of 150 day-old UM-X7.1
      cardiomyopathic hamster and age-matched controls (Syrian golden hamsters) was
      examined. Cardiomyopathic hamsters exhibit a phospholipid to protein ratio higher
      than healthy animals in atria, whereas the contrary is true in the other anatomic
      regions examined. In all tissues the cholesterol to phospholipid ratio is higher
      in cardiomyopathic hamster than in controls. Healthy and UM-X7.1 hamsters differ
      substantially as far as the percent distribution of fatty acids in total lipids
      is concerned, the lipids from cardiomyopathic animals accumulating fatty acids of
      the omega-6 series and being relatively poor in monoenoic fatty acids. The
      different fatty acid composition of heart lipids appears to be a consequence of a
      generalized disturbance of the lipid metabolism in cardiomyopathic hamsters
      during congestive heart failure.

PMID- 7784460
TI  - Central obesity and free fatty acid metabolism.

PMID- 7784459
TI  - Coupling the cholesterol- and tumor-suppressive actions of palm oil to the impact
      of its minor constituents on 3-hydroxy-3-methylglutaryl coenzyme A reductase
      activity.
AB  - The impact of palm oil on cardiovascular disease and cancer may be explained by
      the mevalonate-suppressive action of constituent isoprenoid end products of plant
      secondary metabolism. Assorted monoterpenes, sesquiterpenes, carotenoids and
      tocotrienols down regulate, post-transcriptionally, 3-hydroxy-3-methylglutaryl
      coenzyme A reductase activity thereby modestly decreasing cholesterol synthesis
      and concomitantly decreasing LDL cholesterol. The reductase activity in tumor
      tissues differs from that of liver in being resistant to sterol feedback
      regulation. Tumor reductase activity retains sensitivity to the post
      transcriptional regulation. As a consequence, the isoprenoid-mediated suppression
      of mevalonate synthesis depletes tumor tissues of two intermediate products,
      farnesyl pyrophosphate and geranylgeranyl pyrophosphate, which are incorporated
      post-translationally into growth control-associated proteins.

PMID- 7784461
TI  - Proceedings of the 2nd International Round Table on Fatty Acids in Cell
      Signaling. Madison, Wisconsin, 12-13 June 1994.

PMID- 7784462
TI  - The binding of novel phenolic derivatives of anandamide to brain cannabinoid
      receptors.
AB  - Arachidonylethanolamide (N-2-hydroxyethyl-arachidonamide) or 'anandamide' is a
      naturally occurring derivative of arachidonic acid that has been shown to bind
      and activate cannabinoid receptors in the brain. Since other potent ligands for
      the cannabinoid receptor have an aromatic hydroxyl group, we investigated the
      hypothesis that replacement of the ethanolamine hydroxyl with an aromatic
      hydroxyl will increase the binding affinity for the cannabinoid receptor. Two
      novel congeners of anandamide containing aromatic hydroxyl groups were
      synthesized: N-2-(4-hydroxyphenyl)ethyl arachidonamide (HEA) and N-2
      hydroxyphenyl arachidonamide (HPA). The affinity of these congeners for the brain
      cannabinoid receptor was determined by competition with [3H]CP55940. HEA competed
      for [3H]CP55940 binding with a Ki of 600 nM; HPA had a Ki of 2200 nM. These
      results indicate that increased size in the amide portion of anandamide decreases
      affinity for the receptor. Phenylmethylsulfonyl fluoride (PMSF), an inhibitor of
      anandamide catabolism by brain membranes, had no effect on the binding of either
      HEA or HPA. We conclude that these congeners are not substrates for the amidase
      that catabolizes anandamide.

PMID- 7784463
TI  - Fatty acid ethyl esters: non-oxidative metabolites of ethanol.
AB  - Fatty acid ethyl esters are esterification products of fatty acids and ethanol.
      These compounds have been detected in the serum and cells of individuals
      following ethanol ingestion. Fatty acid ethyl esters can be quantitated by gas
      chromatography-mass spectroscopy (GC-MS) in the serum following ethanol ingestion
      and have been found in concentrations up to 42 microM. Fatty acid ethyl esters
      have also been isolated from adipose tissue of subjects ingesting fatty acid
      ethyl ester capsules as well as from subjects ingesting ethanol. HepG2 cells, a
      human hepatoblastoma cell line, have also been shown to generate fatty acid ethyl
      esters when incubated with 1.25 microM fatty acid and 0.17 M ethanol. Fatty acid
      ethyl esters were found to be toxic to HepG2 cells when presented to the cells in
      the core of low density lipoprotein particles.

PMID- 7784464
TI  - Cellular regulation of arachidonate mobilization and metabolism.
AB  - Synthesis of eicosanoids is initiated by signal transduction cascades which
      result in the hydrolysis of free arachidonic acid from membrane phospholipids.
      Both a cytosolic 85 kDa and a nonpancreatic 14 kDa PLA2 may contribute to
      cellular arachidonate mobilization. In many cells, agonist-stimulated fatty acid
      release is dependent upon increases in intracellular free calcium and is enhanced
      by pretreatment with agents such as phorbol esters and soluble diglycerides. The
      response is specific for arachidonate and structurally similar polyunsaturated
      fatty acids containing a cis 5, 6 double bond. DMSO-differentiation of U937 cells
      markedly enhances the A23187-stimulated release of [3H]arachidonate, which
      appears to be coupled to differentiation-induced enhancement of capacitance
      calcium entry. Although both phorbol esters and soluble diglycerides enhance
      subsequent fMLP or A23187-stimulated arachidonate release in human neutrophils,
      several lines of evidence indicate that the effects of oleoylacetylglycerol and
      1,2-dioctanoylglycerol are protein kinase C-independent. Soluble diglycerides,
      but not phorbol esters, enhance the coupling of arachidonate mobilization to
      subsequent leukotriene B4 synthesis. Further studies will be required to
      elucidate the mechanisms which regulate activation of cellular phospholipases and
      subsequent synthesis.

PMID- 7784466
TI  - Monthly prostaglandin bibliography prepared by the University of Sheffield
      Biomedical Information Service.

PMID- 7784465
TI  - Differences in the regulation of biosynthesis of 20- versus 22-carbon
      polyunsaturated fatty acids.

PMID- 7784467
TI  - Regulation of prostaglandin endoperoxide synthase (cyclooxygenase) isozyme
      expression.

PMID- 7784468
TI  - Curcumin, a major component of food spice turmeric (Curcuma longa) inhibits
      aggregation and alters eicosanoid metabolism in human blood platelets.
AB  - In traditional medicine, Ayurveda, several spices and herbs are held to possess
      medicinal properties. Earlier we have reported that extracts from several spices,
      including turmeric, inhibit platelet aggregation and modulate eicosanoid
      biosynthesis. Due to their eicosanoid-modulating property, it was suggested that
      the spices may serve to provide clues to drugs directed to arachidonic acid (AA)
      pathway enzymes as pharmacological targets. Curcumin, a major component of
      turmeric, inhibited platelet aggregation induced by arachidonate, adrenaline and
      collagen. This compound inhibited thromboxane B2 (TXB2) production from exogenous
      [14C] arachidonate in washed platelets with a concomitant increase in the
      formation of 12-lipoxygenase products. Moreover, curcumin inhibited the
      incorporation of [14C]AA into platelet phospholipids and inhibited the
      deacylation of AA-labelled phospholipids (liberation of free AA) on stimulation
      with calcium ionophore A23187. Curcumin's anti-inflammatory property may, in
      part, be explained by its effects on eicosanoid biosynthesis.

PMID- 7784469
TI  - The regulation of arachidonate lipoxygenase metabolite formation in cells derived
      from intrauterine tissues.
AB  - Products of arachidonic acid (AA) metabolism via the lipoxygenase pathways may
      have key roles in the maintenance of pregnancy and the onset of labor. We have
      determined whether calcium ionophores can modulate the rate of biosynthesis
      within the uterus of five important arachidonate lipoxygenase metabolites, i.e.
      leukotriene B4 (LTB4), LTC4, 5-hydroxyeicosatetraenoic acid (5-HETE), 12-HETE,
      and 15-HETE. Amnion, chorion, and decidual cells were isolated, grown to
      confluence and incubated with ionomycin. The production of LTB4, LTC4, 5-HETE, 12
      HETE, and 15-HETE was determined using specific radioimmunoassays. Cell-specific,
      concentration-related stimulatory actions of ionomycin on 5-HETE, 12-HETE, 15
      HETE, and LTC4 but not LTB4 production were found. A23187 had effects similar to
      ionomycin. Hence elevation of intracellular calcium levels can result in enhanced
      intrauterine production of arachidonate lipoxygenase metabolites that may affect
      pregnancy outcome.

PMID- 7784470
TI  - Prostaglandin metabolism during growth and differentiation of the regenerating
      vertebrate appendage.
AB  - House lizards are able to regenerate their tails. This is an ideal model to study
      the growth and differentiation of an organ. Prostaglandins (PGs) are local
      hormones having diverse and potent biological activities. In an effort to
      understand PG metabolism during the growth and differentiation of the
      regenerating lizard tail, we analysed the fatty acid (FA) composition of
      phospholipids are free FAs by GC, the activity of two rate-limiting enzymes
      (phospholipases A and C), the activity of the enzyme responsible for the
      oxygenation of polyunsaturated fatty acids to PGs (cyclooxygenase) and
      characterized the endogenous PGs by HPLC. It was observed that on the 20th day,
      i.e. the tissue differentiation period, there was an increase in phospholipase A
      activity, together with a sudden fall in the free arachidonic acid (AA) level, an
      increase in cyclooxygenase activity and the appearance of endogenous PGE2. PGE2
      can stimulate cyclic adenosine monophosphate (cAMP) production and it may
      stimulate a cascade of events associated with tissue differentiation.

PMID- 7784471
TI  - Angiotensin II stimulates peptide leukotriene production by guinea pig airway via
      the AT1 receptor pathway.
AB  - Angiotensin II (Ang II) regulates a variety of physiological functions, including
      contraction of smooth muscle. Peptide leukotrienes (LTs) have recently been
      reported to be potent bronchoconstrictors and may play a role in the pathogenesis
      of airway inflammation. However, the possibility that Ang II and peptide LTs
      interact in the control of airway function has not been studied. In this study,
      we showed that Ang II receptors are present on guinea pig airway, and that they
      are of the AT1 subtype. We showed the possibility that Ang II induced the release
      of peptide LTs from guinea pig airway by activation of the AT1 receptor pathway.
      Our findings thus suggest that interaction between Ang II and peptide LTs might
      increase airway inflammation in the guinea pig.

PMID- 7784472
TI  - Studies on the mechanism of PAF-induced vasopermeability in rat lungs.
AB  - The present study evaluated the effect of platelet activating factor (PAF)
      instilled into rat airways on vascular permeability assessed in isolated lung
      tissues by Evans blue (EB)-labelled plasma protein extravasation. It was found
      that intratracheal instillation of PAF induces a dose-dependent increase of EB
      extravasation in the bronchi (upper and inner) but not in the lung parenchyma.
      The contribution of eicosanoids to PAF-induced increase of vascular permeability
      was investigated by treating the animals with selected inhibitors prior to PAF
      administration. Mepacrine (5 mg/kg), L-663,536 (10 mg/kg), indomethacin (4 mg/kg)
      and dazoxiben (10 mg/kg) significantly reduced EB extravasation in the bronchi.
      The PAF antagonists BN-52021 (5 mg/kg), WEB-2086 (1 mg/kg), WEB-2170 (5 mg/kg)
      and PCA-4248 (3 mg/kg) were all effective in reducing the extravasation. These
      results suggest that PAF-induced increase of vascular permeability in rat bronchi
      is mediated by cyclooxygenase and lipoxygenase products of arachidonic acid
      metabolism.

PMID- 7784473
TI  - Hypoglycemia stimulates thrombin-induced PGI2 production by cultured human
      umbilical vein endothelial cells.
AB  - The effect of a low concentration of glucose on prostacyclin (PGI2) production by
      human umbilical vein endothelial cells in culture (HUVEC) was examined. When
      HUVEC were cultured for 24 h in a medium containing various concentrations of
      glucose (0.26, 0.63, or 1.29 mg/ml), thrombin-induced PGI2 production was
      increased in the cells exposed to low concentrations of glucose; the increase was
      inversely proportional to the glucose concentration and was seen at all
      concentrations of thrombin tested. Thus, hypoglycemia may increase the production
      of PGI2 by endothelial cells in vivo, leading to a compensatory vasodilation with
      an increase in blood flow to increase the delivery of glucose.

PMID- 7784474
TI  - Effects of fatty acyl coenzyme A esters on lipoxygenase and cyclooxygenase
      metabolism of arachidonic acid in rabbit platelets.
AB  - The effects of fatty acyl coenzyme A (CoA) esters (palmitoyl-, stearoyl-, oleoyl
      , linoleoyl- and arachidonoyl--CoA) on the activities of lipoxygenase and
      cyclooxygenase in rabbit platelets were examined. Palmitoyl-, stearoyl-, oleoyl-
      and linoleoyl- CoA were potent inhibitors of platelet lipoxygenase activity. In
      addition to the lipoxygenase, the four fatty acyl-CoA esters elicited inhibitory
      activity on platelet cyclooxygenase, although the inhibition was a little weaker.
      The CoA derivative of the icosanoid precursor arachidonic acid (AA) showed little
      inhibition on lipoxygenase and cyclooxygenase. Palmitic, stearic and oleic acids
      had little or no effect on lipoxygenase and cyclooxygenase, in contrast with
      their CoA derivatives. Linoleic acid was more potent than linoleoyl-CoA as an
      inhibitor of the cyclooxygenase, but it was a weak inhibitor of the lipoxygenase.
      These results suggest that the CoA derivatives of palmitic, stearic, oleic and
      linoleic acids have the potential to modulate both platelet lipoxygenase and
      cyclooxygenase activities and may have functional effects within platelets.

PMID- 7784475
TI  - Eicosapentaenoic acid modulates arachidonic acid metabolism in rat alveolar
      macrophages.
AB  - Eicosapentaenoic acid (EPA) is an unsaturated fatty acid contained in fish oils.
      In order to clarify the mechanism of its anti-inflammatory effects on the lung,
      we studied arachidonic acid (AA) metabolism by in vitro exposure of rat alveolar
      macrophages to EPA. EPA was found to inhibit the endogenous production of
      leukotriene B4 (LTB4) from AA. At a low concentration of EPA, generation of LTB5
      was increased, while at a high concentration it was decreased. These results
      suggest that at a lower concentration EPA may be competitive with AA as a
      substrate, and that at a higher concentration it may directly inhibit AA
      metabolism via inhibition of 5-lipoxygenase or phospholipase A2.

PMID- 7784476
TI  - Enhancement of prostacyclin production in cultured bovine aortic endothelial
      cells by oxidized glycated low-density lipoprotein.
AB  - Oxidized low-density lipoprotein (oLDL) is implicated in the pathogenesis of
      atherosclerosis. The serum concentration of glycated LDL (gLDL) is increased in
      diabetics, and it is possible that oxidative modification of gLDL contributes to
      the increased incidence of atherosclerosis associated with diabetes. The
      mechanism and effect on prostacyclin (PGI2) production by cultured bovine aortic
      endothelial cells of oxidized glycated LDL (ogLDL) prepared in vitro have now
      been examined. Glycation of LDL was performed by incubating LDL with 20 mM
      glucose for 3 days. ogLDL was then prepared by incubation of gLDL with 1 microM
      CuSO4 for 12 h. Both the electrophoretic mobility and the thiobarbituric acid
      reactive substance content of ogLDL were greater than those of native LDL (nLDL)
      or gLDL. Binding, cell-association, and degradation of ogLDL in endothelial cells
      were significantly greater than those of nLDL and gLDL. The stimulatory effect of
      ogLDL on PGI2 production was significantly greater than that of nLDL or gLDL;
      this effect was dose dependent. Both cell-association and the stimulatory effect
      on PGI2 production of oLDL were dependent on the extent of oxidation in a
      biphasic manner. Endothelial cells thus appear to protect against atherosclerosis
      by removing atherogenic lipoproteins and by producing PGI2.

PMID- 7784477
TI  - Diabetes mellitus-induced alterations of hepatobiliary function.

PMID- 7784478
TI  - Induction of immediate-early genes and the control of neurotransmitter-regulated
      gene expression within the nervous system.

PMID- 7784479
TI  - Contribution of kinins to the cardiovascular actions of angiotensin-converting
      enzyme inhibitors.
AB  - From pharmacological investigations and clinical studies, it is known that ACE
      inhibitors exhibit additional local actions that are not related to hemodynamic
      changes and that cannot be explained only by interference with the renin
      angiotensin system by means of an inhibition of ANG II formation. Because ACE is
      identical to kininase II, which inactivates the nonapeptide BK and related
      kinins, potentiation of kinins might be responsible for these additional effects
      of ACE inhibitors. ACE inhibition, concentration, and time dependently increased
      the formation of NO and PGI2 in cultured endothelial cells of different origin
      and from different species, including humans. The specific B2 kinin receptor
      antagonist, icatibant, suppressed the ACE inhibitor-induced increase in
      endothelial cyclic GMP accumulation index for NO-formation and, in parallel,
      attenuated the increase in PGI2 release. In renovascular models of hypertension
      associated with a stimulated renin-angiotensin system (two-kidney, one-clip),
      blood pressure reduction by ACE inhibitors was attenuated by icatibant, whereas
      in rats with genetic hypertension with normal to low plasma renin, blood pressure
      reduction through ACE inhibitors was not affected. In experimental
      atherosclerosis in rabbits, ACE inhibitors were able to preserve endothelial
      function and vascular reactivity and to reduce surface involvement. In the
      balloon denudation model of carotid arteries in rats, it was found that ACE
      inhibition markedly reduced neointima formation. However, when the ACE inhibitor
      was given together with icatibant, its effect was significantly blunted.
      Perfusion with ACE inhibitors induced a reduction of the incidence, as well as of
      the duration, of ventricular fibrillation and improved cardiodynamics and
      myocardial metabolism. BK perfusion induced comparable cardioprotective effects.
      In addition, perfusion with ACE inhibitors markedly increased the outflow of BK
      and related kinins from isolated rat hearts. The antiischemic effect of ACE
      inhibitors and BK were abolished by the addition of L-NNA (1 x 10(-6) mol/l) or
      icatibant (1 x 10(-9) mol/l). Similar results were found in dogs and rabbits with
      myocardial infarction. BK and related kinins also seem to be involved in
      preconditioning and remodeling. The effect of ACE inhibition in LVH was
      investigated in rats made hypertensive by aortic banding. ACE inhibition with
      ramipril, in the antihypertensive dose of 1 mg/kg/day for 6 weeks, prevented the
      increase in blood pressure and the development of LVH. A lower,
      nonantihypertensive dose of the ACE inhibitor (10 micrograms/kg/day for 6 weeks)
      had no effect on the increase in blood pressure or on plasma ACE activity, but
      also prevented LVH after aortic banding.4+ off

PMID- 7784480
TI  - Transforming growth factor alpha: expression, regulation, and biological
      activities.

PMID- 7784481
TI  - Regulation of pulmonary vascular tone.

PMID- 7784482
TI  - Dr. William James: physician-philosopher (1842-1910).

PMID- 7784483
TI  - Will there be a job for you? The physician work force under health care reform.

PMID- 7784484
TI  - From stethoscope to spreadsheet: the physician with an M.B.A.

PMID- 7784485
TI  - Traditional African medicine.

PMID- 7784486
TI  - A night at the clinic.

PMID- 7784487
TI  - Basic lessons in resource allocation: sharing, setting limits, and being fair.

PMID- 7784489
TI  - Physician education in a diverse society: listening to and learning from new
      voices.

PMID- 7784491
TI  - Questions and reflections. Death, where is thy sting?

PMID- 7784488
TI  - Anthrax: from Mesopotamia to molecular biology.

PMID- 7784490
TI  - Western and traditional medicine in Africa: a century of encounter.

PMID- 7784492
TI  - Polish medicine.

PMID- 7784493
TI  - Tuberculosis in New York City's homeless.

PMID- 7784494
TI  - In defense of defensive medicine.

PMID- 7784495
TI  - Encounters with Soma Weiss.

PMID- 7784496
TI  - Pulmonary circulation and Ibn Nafis.

PMID- 7784498
TI  - Sixty-eight president of APS.

PMID- 7784497
TI  - Health care workers, patients, and HIV: an analysis of the policy and ethical
      debate.

PMID- 7784499
TI  - The future of academic health centers.

PMID- 7784500
TI  - O'Doherty receives APS-Genentech Fellowship.

PMID- 7784501
TI  - Purification, characterization, and cDNA cloning of profilin from Phaseolus
      vulgaris.
AB  - Profilin from common bean (Phaseolus vulgaris L.) was purified to homogeneity by
      poly-L-Pro affinity chromatography and gel filtration. The hypocotyl and
      symbiotic root nodule protein was detected as a single isoform with a 14.4-kD
      molecular mass and an isoelectric point of 5.3. Partial amino acid and DNA
      sequencing of a full-length cDNA clone confirmed its identity as profilin. An
      antibody generated against the purified protein binds to a protein with the same
      molecular mass in leaves and nodules. Immunolocalization of the protein showed a
      diffuse distribution in the cytoplasm of hypocotyls and nodules but enhanced
      staining at the vascular bundles. The strong identity of the sequence among the
      profilins of birch, maize, and bean suggests that it may play an important role
      in the signal transduction mechanism of plant cells and plant-bacterial
      symbioses.

PMID- 7784502
TI  - Three glycosylated polypeptides secreted by several embryogenic cell cultures of
      pine show highly specific serological affinity to antibodies directed against the
      wheat germin apoprotein monomer.
AB  - Embryogenic tissues of Pinus caribaea Morelet var hondurensis produce
      extracellular proteins; among them germins have been identified. Two-dimensional
      electrophoresis followed by electroblotting onto a polyvinylidene difluoride
      membrane allowed isolation and N-terminal amino acid sequencing of extracellular
      GP111, which is present within the five embryogenic cell lines studied. The amino
      acid sequence showed strong homologies with the sequences of germins deduced from
      cDNA sequencing, starting at the same amino acid position but one, compared with
      other sequences of mature germins deduced from protein sequencing. Immunoblots of
      embryogenic and nonembryogenic extracellular proteins indicated that the
      polypeptide GP111 plus two others with similar relative molecular mass values are
      present in embryogenic cell lines but not in nonembryogenic ones. They were
      recognized by an antiserum raised against the nonglycosylated monomer of wheat
      germin. The cross-reaction between pine and wheat apoproteins was highly
      specific. An antiserum against the glycosylated pentameric germin-like protein
      (an oxalate oxidase) of barley cross-reacted with all three, as well as with
      several other glycosylated polypeptides.

PMID- 7784503
TI  - Pathogenesis-related PR-1 proteins are antifungal. Isolation and characterization
      of three 14-kilodalton proteins of tomato and of a basic PR-1 of tobacco with
      inhibitory activity against Phytophthora infestans.
AB  - Three distinct basic 14-kD proteins, P14a, P14b, and P14c, were isolated from
      tomato (Lycopersicon esculentum Mill. cv Baby) leaves infected with Phytophthora
      infestans. They exhibited antifungal activity against P. infestans both in vitro
      (inhibition of zoospore germination) and in vivo with a tomato leaf disc assay
      (decrease in infected leaf surface). Serological cross-reactions and amino acid
      sequence comparisons showed that the three proteins are members of the PR-1 group
      of pathogenesis-related (PR) proteins. P14a and P14b showed high similarity to a
      previously characterized P14, whereas P14c was found to be very similar to a
      putative basic-type PR-1 from tobacco predicted from isolated DNA clones. This
      protein, named PR-1 g, was purified from virus-infected tobacco (Nicotiana
      tabacum Samsun NN) leaves and characterized by amino acid microsequencing, along
      with the well-known acidic tobacco PR-1a, PR-1b, and PR-1c. The various tomato
      and tobacco PR-1 proteins were compared for their biological activity and found
      to display differential fungicidal activity against P. infestans in both the in
      vitro and in vivo assays, the most efficient being the newly characterized tomato
      P14c and tobacco PR-1g.

PMID- 7784504
TI  - The choice of reducing substrate is altered by replacement of an alanine by a
      proline in the FAD domain of a bispecific NAD(P)H-nitrate reductase from birch.
AB  - Differences in the amino acid sequence between the bispecific NAD(P)H-nitrate
      reductase of birch (Betula pendula Roth) and the monospecific NADH-nitrate
      reductases of a variety of other higher plants have been found at the
      dinucleotide-binding site in the FAD domain. To pinpoint amino acid residues that
      determine the choice of reducing substrate, we introduced mutations into the cDNA
      coding for birch nitrate reductase. These mutations were aimed at replacing
      certain amino acids of the NAD(P)H-binding site by conserved amino acids located
      at identical positions in NADH-monospecific enzymes. The mutated cDNAs were
      integrated into the genome of tobacco by Agrobacterium-mediated transformation.
      Transgenic tobacco (Nicotiana tabacum) plants were grown on a medium containing
      ammonium as the sole nitrogen source to keep endogenous tobacco nitrate reductase
      activity low. Whereas some of the mutated enzymes showed a slight preference for
      NADPH, as does the nonmutated birch enzyme, the activity of some others greatly
      depended on the availability of NADH and was low with NADPH alone. Comparison of
      the mutations reveals that replacement of a single amino acid in the birch
      sequence (alanine871 by proline) is critical for the use of reducing substrate.

PMID- 7784505
TI  - Correct processing of the kiwifruit protease actinidin in transgenic tobacco
      requires the presence of the C-terminal propeptide.
AB  - A 355 cauliflower mosaic virus promoter and a tapetum-specific promoter were used
      to direct the synthesis in tobacco of preproactinidin and a derivative that
      lacked a C-terminal extension. Preproactinidin was processed into a form that
      migrated identically on protein gels with mature actinidin extracted from
      kiwifruit. This protein was proteolytically active in vitro, and high-level
      accumulation of this protein appeared to be detrimental to plant growth. Plants
      expressing an actinidin cDNA construct that lacked the sequence encoding the C
      terminal propeptide were phenotypically normal but accumulated N-proactinidin,
      which was proteolytically active in vitro but did not self-cleave to mature
      actinidin. In transgenic tobacco, the C-terminal extension of actinidin is
      therefore required for correct processing.

PMID- 7784506
TI  - Induction of apoplastic invertase of Chenopodium rubrum by D-glucose and a
      glucose analog and tissue-specific expression suggest a role in sink-source
      regulation.
AB  - Photoautotrophic suspension-culture cells of Chenopodium rubrum that were shifted
      to mixotrophic growth by adding glucose were used as model system to investigate
      the influence of the source-sink transition in higher plants on the expression
      and enzyme activities of intracellular and extracellular invertases. The complete
      cDNA coding for an extracellular invertase was cloned and sequenced from C.
      rubrum, and its identity has been proven by heterologous expression in
      Saccharomyces cerevisiae. The higher activity of extracellular invertase after
      preincubation in the presence of glucose was paralleled by an increased
      expression of the corresponding gene. The induction by glucose could be mimicked
      by the nonmetabolizable glucose analog 6-deoxyglucose. Both enzyme activity and
      mRNA level of extracellular invertase showed a sink-tissue-specific distribution
      in plants. The activity of neutral and acidic intracellular invertases were not
      affected by preincubation of autotrophic tissue cultures with sugars, nor did
      they show a tissue-specific distribution in plants. The data suggest that
      apoplastic invertase not only has an important function in phloem unloading and
      carbohydrate partitioning between source and sink tissues but may also have a
      role in establishing metabolic sinks.

PMID- 7784507
TI  - Purification, characterization, and intracellular localization of glycosylated
      protein disulfide isomerase from wheat grains.
AB  - Wheat (Triticum aestivum) storage proteins fold and assemble into complexes that
      are linked by intra- and intermolecular disulfide bonds, but it is not yet clear
      whether these processes are spontaneous or require the assistance of endoplasmic
      reticulum (ER)-resident enzymes and molecular chaperones. Aiming to unravel these
      processes, we have purified and characterized the enzyme protein disulfide
      isomerase (PDI) from wheat endosperm, as well as studied its developmental
      expression and intracellular localization. This ER-resident enzyme was previously
      shown to be involved in the formation of disulfide bonds in secretory proteins.
      Wheat PDI appears as a 60-kD glycoprotein and is among the most abundant proteins
      within the ER of developing grains. PDI is notably upregulated in developing
      endosperm in comparison to embryos, leaves, and roots. In addition, the increase
      in PDI expression in grains appears at relatively early stages of development,
      preceding the onset of storage protein accumulation by several days. Subcellular
      localization analysis and immunogold labeling of electron micrographs showed that
      PDI is not only present in the lumen of the ER but is also co-localized with the
      storage proteins in the dense protein bodies. These observations are consistent
      with the hypothesis that PDI is involved in the assembly of wheat storage
      proteins within the ER.

PMID- 7784508
TI  - Purification and characterization of a DNA strand transferase from broccoli.
AB  - A protein with DNA binding, renaturation, and strand-transfer activities has been
      purified to homogeneity from broccoli (Brassica oleracea var italica). The
      enzyme, broccoli DNA strand transferase, has a native molecular mass of at least
      200 kD and an apparent subunit molecular mass of 95 kD and is isolated as a set
      of isoforms differing only in charge. All three activities are saturated at very
      low stoichiometry, one monomer per approximately 1000 nucleotides of single
      stranded DNA. Strand transfer is not effected by nuclease activity and
      reannealing, is only slightly dependent on ATP, and is independent of added Mg2+.
      Transfer requires homologous single- and double-stranded DNA and at higher enzyme
      concentrations results in very high molecular mass complexes. As with Escherichia
      coli RecA, transfer by broccoli DNA strand transferase depends strongly on the
      presence of 3' homologous ends.

PMID- 7784510
TI  - Alteration of seed fatty acid composition by an ethyl methanesulfonate-induced
      mutation in Arabidopsis thaliana affecting diacylglycerol acyltransferase
      activity.
AB  - In characterizing the enzymes involved in the formation of very long-chain fatty
      acids (VLCFAs) in the Brassicaceae, we have generated a series of mutants of
      Arabidopsis thaliana that have reduced VLCFA content. Here we report the
      characterization of a seed lipid mutant, AS11, which, in comparison to wild type
      (WT), has reduced levels of 20:1 and 18:1 and accumulates 18:3 as the major fatty
      acid in triacylglycerols. Proportions of 18:2 remain similar to WT. Genetic
      analyses indicate that the fatty acid phenotype is caused by a semidominant
      mutation in a single nuclear gene, designated TAG1, located on chromosome 2.
      Biochemical analyses have shown that the AS11 phenotype is not due to a
      deficiency in the capacity to elongate 18:1 or to an increase in the relative
      delta 15 or delta 12 desaturase activities. Indeed, the ratio of
      desaturase/elongase activities measured in vitro is virtually identical in
      developing WT and AS11 seed homogenates. Rather, the fatty acid phenotype of AS11
      is the result of reduced diacylglycerol acyltransferase activity throughout
      development, such that triacylglycerol biosynthesis is reduced. This leads to a
      reduction in 20:1 biosynthesis during seed development, leaving more 18:1
      available for desaturation. Thus, we have demonstrated that changes to
      triacylglycerol biosynthesis can result in dramatic changes in fatty acid
      composition and, in particular, in the accumulation of VLCFAs in seed storage
      lipids.

PMID- 7784509
TI  - Plasma membrane intrinsic proteins of Beta vulgaris L.
AB  - The plasma membrane (PM) of higher plants contains numerous proteins; however,
      due to their low abundance, only a few have been identified and characterized by
      direct biochemical approaches. The major intrinsic protein (MIP) family is a
      class of highly hydrophobic integral membrane proteins thought to function as
      channels that facilitate the passage of water, small solutes, and possibly other
      moieties through the membrane. A family of PM intrinsic proteins was purified and
      characterized from PM vesicles derived from storage tissue of Beta vulgaris L.
      using the detergent 3-[(3-cholamidopropyl)dimethylammonio]-1-propane sulfonate.
      This PM intrinsic protein-enriched fraction also contains high levels of UDP
      glucose:(1,3)-beta-glucan (callose) synthase activity. Dithiothreitol is required
      to visualize the monomeric species of these highly hydrophobic integral membrane
      proteins. Sequence analysis of tryptic fragments derived from polypeptides of 31
      and 27 kD revealed significant homologies to plant MIPs identified from cloned
      sequences. These MIPs include clone 7a from pea and RD28 from Arabidopsis, both
      of which are water-stress proteins, a tomato ripening-associated membrane
      protein, and PIP 2b, a PM-bound water channel protein from Arabidopsis. MIPs,
      therefore, represent abundantly occurring components of PMs derived from beet
      storage tissue.

PMID- 7784511
TI  - Ascorbate free radical reductase mRNA levels are induced by wounding.
AB  - A cDNA clone encoding ascorbate free radical (AFR) reductase (EC 1.6.5.4) was
      isolated from tomato (Lycopersicon esculentum Mill.) and its mRNA levels were
      analyzed. The cDNA encoded a deduced protein of 433 amino acids and possessed
      amino acid domains characteristic of flavin adenine dinucleotide- and NAD(P)H
      binding proteins but did not possess typical eukaryotic targeting sequences,
      suggesting that it encodes a cytosolic form of AFR reductase. Low-stringency
      genomic DNA gel blot analysis indicated that a single nuclear gene encoded this
      enzyme. Total ascorbate contents were greatest in leaves, with decreasing amounts
      in stems and roots and relatively constant levels in all stages of fruit. AFR
      reductase activity was inversely correlated with total ascorbate content, whereas
      the relative abundance of AFR reductase mRNA was directly correlated with enzyme
      activity in tissues examined. AFR reductase mRNA abundance increased dramatically
      in response to wounding, a treatment that is known to also induce ascorbate
      dependent prolyl hydroxylation required for the accumulation of hydroxyproline
      rich glycoproteins. In addition, AFR reductase may contribute to maintaining
      levels of ascorbic acid for protection against wound-induced free radical
      mediated damage. Collectively, the results suggest that AFR reductase activity is
      regulated at the level of mRNA abundance by low ascorbate contents or by factors
      that promote ascorbate utilization.

PMID- 7784512
TI  - Cloning of a harvest-induced beta-galactosidase from tips of harvested asparagus
      spears.

PMID- 7784513
TI  - Nucleotide sequence of the Rhodobacter capsulatus hemB gene.

PMID- 7784514
TI  - Nucleotide sequence of the Rhodobacter capsulatus hemE gene.

PMID- 7784515
TI  - Identification of a cell cycle-related gene, cyclin, in Nicotiana tabacum (L.).

PMID- 7784516
TI  - Cloning and nucleotide sequence of the S7-RNase from Nicotiana alata Link and
      Otto.

PMID- 7784517
TI  - Nucleotide sequence of a cDNA clone encoding caffeoyl-coenzyme A 3-O
      methyltransferase of Stellaria longipes (Caryophyllaceae).

PMID- 7784518
TI  - A cDNA encoding ribosomal protein S4e from cotton (Gossypium hirsutum L.).

PMID- 7784520
TI  - Sequencing and analysis of a calmodulin cDNA from pea (Pisum sativum L. var
      Alaska).

PMID- 7784519
TI  - Sequence of a cDNA encoding carbonic anhydrase from barley.

PMID- 7784522
TI  - Complete cDNA and genomic sequence encoding a flooding-responsive gene from maize
      (Zea mays L.) homologous to xyloglucan endotransglycosylase.

PMID- 7784521
TI  - Isolation, sequencing, and analysis of a calmodulin-like cDNA from pea (Pisum
      sativum L. var Alaska).

PMID- 7784523
TI  - The cDNA sequence of a cauliflower apetala-1/squamosa homolog.

PMID- 7784524
TI  - cDNA clones encoding beta-ketoacyl-acyl carrier protein synthase III from Cuphea
      wrightii.

PMID- 7784525
TI  - Characterization of membrane-bound small GTP-binding proteins from Nicotiana
      tabacum.
AB  - We have cloned nine cDNAs encoding small GTP-binding proteins from leaf cDNA
      libraries of tobacco (Nicotiana tabacum). These cDNAs encode distinct proteins
      (22-25 kD) that display different levels of identity with members of the
      mammalian Rab family: Nt-Rab6 with Rab6 (83%), Nt-Rab7a-c with Rab7 (63-70%), and
      Nt-Rab11a-e with Rab11 (53-69%). Functionally important regions of these
      proteins, including the "effector binding" domain, the C-terminal Cys residues
      for membrane attachment, and the four regions involved in GTP-binding and
      hydrolysis, are highly conserved. Northern and western blot analyses show that
      these genes are expressed, although at slightly different levels, in all plant
      tissues examined. We demonstrate that the plant Rab5, Rab6, and Rab11 proteins,
      similar to their mammalian and yeast counterparts, are tightly bound to membranes
      and that they exhibit different solubilization characteristics. Furthermore, we
      show that the yeast GTPase-activating protein Gyp6, shown to be specifically
      required to control the GTP hydrolysis of the yeast Ypt6 protein, could interact
      with tobacco GTP-binding proteins. It increases in vitro the GTP hydrolysis rate
      of the wild-type Nt-Rab7 protein. In addition, it also increases, at different
      levels, the GTP hydrolysis rates of a Nt-Rab7m protein with a Rab6 effector
      domain and of two other chimaeric Nt-Rab6/Nt-Rab7 proteins. However, it does not
      interact with the wild-type Nt-Rab6 protein, which is most similar to the yeast
      Ypt6 protein.

PMID- 7784527
TI  - 4-coumarate:coenzyme a ligase from loblolly pine xylem. Isolation,
      characterization, and complementary DNA cloning.
AB  - 4-Coumarate:CoA ligase (4CL, EC 6.2.1.12) was purified from differentiating xylem
      of loblolly pine (Pinus taeda L.). The pine enzyme had an apparent molecular mass
      of 64 kD and was similar in size and kinetic properties to 4CL isolated from
      Norway spruce. The pine enzyme used 4-coumaric acid, caffeic acid, ferulic acid,
      and cinnamic acid as substrates but had no detectable activity using sinapic
      acid. 4CL was inhibited by naringenin and coniferin, products of phenylpropanoid
      metabolism. Although the lignin composition in compression wood is higher in p
      hydroxyphenyl units than lignin from normal wood, there was no evidence for a
      different form of 4CL enzyme in differentiating xylem that was forming
      compression wood. cDNA clones for 4CL were obtained from a xylem expression
      library. The cDNA sequences matched pine xylem 4CL protein sequences and showed
      60 to 66% DNA sequence identity with 4CL sequences from herbaceous angiosperms.
      There were two classes of cDNA obtained from pine xylem, and the genetic analysis
      showed that they were products of a single gene.

PMID- 7784528
TI  - Cardiac function and behavioral reactivity during infancy.
AB  - Longitudinal cardiac data from the end of the fetal period to 21 months of age
      were examined for change and stability over age and relations to the
      temperamental characteristics of high and low reactivity at 4 months of age and
      fear to the unfamiliar in the second year. Heart period and power in the cardiac
      spectra changed dramatically over the first 2 years, and individual differences
      were not preserved until 9-14 months of age. Sleep heart period at 2 weeks of age
      and low frequency power at 2 months of age were better predictors of the
      temperamental categories than later measures of the same variables, suggesting
      that cardiac function early in life may be an especially sensitive index of
      temperamental qualities.

PMID- 7784529
TI  - Fear conditioning, preparedness, and the contingent negative variation.
AB  - Psychophysiological research on preparedness has previously focused on autonomic
      nervous system parameters. The present study used electrocortical indices of fear
      conditioning. Subjects (n = 10) were tested under fear-relevant and fear
      irrelevant conditions (1 week apart, order of conditions counterbalanced). Each
      condition comprised acquisition and extinction sessions. The contingent negative
      variation (CNV) was elicited in anticipation of forewarned slides (fear relevant:
      small animals; fear irrelevant: landscapes). In acquisition, reinforced
      conditioned stimulus (CS+) (but not nonreinforced conditioned stimulus [CS-])
      slides were followed by white noise as an unconditioned stimulus (UCS). In
      extinction, the UCS was omitted. In the fear-relevant condition, CNV amplitude
      was significantly larger for CS+ than CS- in both acquisition and extinction. In
      the fear-relevant condition, CNV amplitude was significantly larger for CS+ than
      CS- in both acquisition and extinction. In the fear-irrelevant condition, CNV
      differentiation between CS+ and CS- was weak in both sessions. CNV was
      significantly larger in the fear-relevant than in the fear-irrelevant condition,
      for CS+ but not CS-. The findings are consistent with a preparedness
      interpretation and suggest that CNV under such circumstances may represent an
      automatic affective response to fear-relevant stimuli. Electrocortical measures
      could be particularly useful in examining information processing mechanisms in
      phobia and cognition-affect relationships generally.

PMID- 7784526
TI  - Biochemical, physiological, and molecular characterization of sucrose synthase
      from Daucus carota.
AB  - Sucrose synthase (EC 2.4.1.13) from carrot (Daucus carota) is a tetramer with a
      molecular mass of 320 kD and subunits of 80 kD. The enzyme has a pH optimum of
      7.0 (cleavage direction). Maximal activities were measured at 55 degrees C. The
      Km for Suc was estimated as 87 mM and for UDP as 0.39 mM. Fructose acts as a
      noncompetitive inhibitor with an inhibition constant of 17.2 mM. In contrast,
      glucose inhibits carrot sucrose synthase uncompetitively with an inhibition
      constant of 4.3 mM. cDNA clones encoding a single class of sucrose synthase
      polypeptide were isolated and sequenced. DNA gel blot analysis also indicated the
      occurrence of only one to two genes. The deduced amino acid sequence of the
      carrot enzyme is highly homologous to the sucrose synthase sequences of tomato,
      potato, and bean. A comparison of the cDNA-derived amino acid sequence with the
      SS1- and SS2-type sucrose synthase sequences of the monocot plants maize, rice,
      and barley showed that the carrot enzyme is neither of the SS1 nor of the SS2
      type. High enzyme activity was found in roots and petioles of developing carrot
      plants, with maximal activity in roots at the transition of primary roots to tap
      roots. Enzyme activity was highly correlated with both polypeptide and transcript
      levels, indicating that gene expression is regulated mainly at the mRNA level in
      the different tissues and organs of developing carrot plants.

PMID- 7784530
TI  - Language, memory, and aging: an electrophysiological exploration of the N400
      during reading of memory-demanding sentences.
AB  - Twenty-four young and 24 middle-aged academics carried out a language recognition
      task in which sentences were presented that made either a high or a low demand on
      working memory (WM). The sentences ended either normally (i.e., congruent) or
      with an incongruous word. Middle-aged subjects had smaller WM scores, a
      marginally slowed down recognition performance, and a smaller and delayed N400
      component. The event-related potential (ERP) difference between congruent and
      incongruent endings was smaller in the high-load condition for younger subjects
      and totally disappeared for the middle-aged subjects. ERPs for all subjects
      showed a WM-related positivity in the middle of the sentence and a WM-related
      negativity at the sentence ending. These shifts could be associated with either
      storage and retrieval processes or with clause wrap-up processes. Most ERP
      effects were dependent on WM capacity. Age differences in sentence processing are
      not simply explained by age itself but depend to a large extent on individual
      memory capacity.

PMID- 7784531
TI  - Response complexity and precue interval effects on the lateralized readiness
      potential.
AB  - Fundamental properties of an important new tool in cognitive electrophysiology,
      the lateralized readiness potential (LRP), were examined in two experiments.
      Experiment 1 resolved an apparent inconsistency in the literature by
      demonstrating that this response-specific lateralization is larger preceding
      complex then preceding simple finger movements. In Experiment 2, the foveally
      presented precue, which indicated hand of response, preceded the go/no-go
      stimulus by 0, 100, 300, or 1,400 ms. Analyses of LRP latency indicated that hand
      specific preparation began earlier with longer foreperiods but was temporally
      linked to the reaction stimulus as well as the precue. Although the degree of
      lateralization did not predict reaction speed in either study, a nonlateralized,
      response-locked negativity was larger prior to faster reactions.

PMID- 7784532
TI  - Mental effort during active and passive coping: a dual-task analysis.
AB  - This study was designed to examine the invested mental effort during active and
      passive coping by means of performance data. Dual-task performance was measured
      while subjects coped with a situation, either actively or passively. Thirty-six
      male students worked on a primary mental arithmetic task (MAT) and a secondary
      choice reaction time task simultaneously. Half of the sample could avoid an
      aversive tone by performing well on the MAT. For the remaining half, their
      performance had no influence on the tone. The aversive tone stimulation of these
      subjects was yoked to a "partner," in the first group. Subjects with control
      showed elevated cardiovascular responses and inferior secondary task performance
      than subjects without control. No differences were found in the performance on
      the MAT. These results were in line with the assumption that subjects with
      control spent more effort on the primary task. Subjects under the active coping
      condition probably payed more attention to the tone, which consumed more
      cognitive resources.

PMID- 7784533
TI  - Sources of P300 attenuation after head injury: single-trial amplitude, latency
      jitter, and EEG power.
AB  - Single trial amplitude, latency jitter, and electroencephalographic (EEG) power
      were examined as sources of the group difference in averaged P300 amplitude among
      15 traumatically brain injured and 20 control individuals in an auditory oddball
      paradigm. Mean amplitude of the individual trials was highly correlated with the
      amplitude of the averaged P300, with little additional unique variance
      attributable to latency jitter or EEG power. The group difference in P300
      amplitude was also explained by the mean amplitude of the single trials. These
      results support the robustness of the evtent-related potential averaging
      technique within the paradigm used.

PMID- 7784534
TI  - P300 topography in Alzheimer's disease.
AB  - This study assessed whether P300 scalp topography distinguished subjects with
      Alzheimer's disease (AD) from controls. Specifically, it was predicted that the
      AD group would show maximum P300 amplitude over frontal areas and the largest
      P300 reduction over parietal and left hemisphere areas. These hypotheses were
      tested using a standard auditory oddball paradigm to compare 26 AD subjects and
      26 controls matched on age, sex, handedness, and education. P300 was measured at
      frontal, central, parietal, and occipital sites over left and right hemispheres
      and along the midline. Results revealed that the distribution of P300 was
      different for the two groups such that the controls manifested a maximum over
      parietal areas, whereas the AD subjects showed a maximum at frontal sites with
      the largest reductions in P300 over parietal areas. No hemispheric differences in
      P300 were found. These results are consistent with the hypothesis that P300
      represents the activity of multiple neural generators that are differentially
      disrupted by the disease process.

PMID- 7784535
TI  - Attentional modulation of startle in psychosis-prone college students.
AB  - Attentional modulation of startle eyeblink was studied in college students
      putatively at risk for psychosis and in normal controls. At-risk subjects had
      extreme scores on scales for either anhedonia or perceptual aberration-magical
      thinking (per-mags). Subjects were presented with to-be-attended and to-be
      ignored tones; white noise startle probes were presented at lead intervals of 60,
      120, 240, or 2,000 ms following the onset of attended and ignored tones and
      during intertone intervals. Controls showed greater inhibition of startle blink
      at 120 ms and greater facilitation at 2,000 ms during to-be-attended than to-be
      ignored tone, demonstrating attentional modulation of prepulse inhibition and
      facilitation. Both at-risk groups showed normal overall levels of early
      inhibition and late facilitation. However, per-mags failed to show attentional
      modulation of either inhibition at 120 ms or facilitation at 2,000 ms; anhedonics
      showed no modulation of inhibition and modulation of facilitation was delayed in
      development. The results for the per-mags are strikingly similar to those
      observed in schizophrenic patients and suggest that these deficits index a trait
      linked vulnerability to disorders in the schizophrenic spectrum.

PMID- 7784536
TI  - The N400 as a function of the level of processing.
AB  - In a semantic priming paradigm, the effects of different levels of processing on
      the N400 were assessed by changing the task demands. In the lexical decision
      task, subjects had to discriminate between words and nonwords, and in the
      physical task, subjects had to discriminate between uppercase and lowercase
      letters. The proportion of related versus unrelated word pairs differed between
      conditions. A lexicality test on reaction times demonstrated that the physical
      task was performed nonlexically. Moreover, a semantic priming reaction time
      effect was obtained only in the lexical decision task. The level of processing
      clearly affected the event-related potentials. An N400 priming effect was only
      observed in the lexical decision task. In contrast, in the physical task a P300
      effect was observed for either related or unrelated targets, depending on their
      frequency of occurrence. Taken together, the results indicate that an N400
      priming effect is only evoked when the task performance induces the semantic
      aspects of words to become part of an episodic trace of the stimulus event.

PMID- 7784537
TI  - Circadian distribution of motor activity and immobility in narcolepsy: assessment
      with continuous motor activity monitoring.
AB  - The circadian distribution of motor activity and immobility of 14 unmedicated
      narcoleptics and matched controls was evaluated by monitoring continuous wrist
      motor activity 5 successive days and nights at home. Sleep was also assessed by
      sleep logs. The amplitude of the circadian rhythm of motor activity and
      immobility was significantly lower in narcoleptics than in controls. The
      variables that best distinguish narcoleptics from controls were the diurnal and
      nocturnal mean duration of uninterrupted immobility, which can be explained by
      excessive daytime sleepiness and frequent nocturnal awakenings, respectively.
      Thus, measures of diurnal and nocturnal motor activity and immobility appear
      useful for the objective assessment of some of the sleep-wakefulness
      manifestations of narcolepsy.

PMID- 7784538
TI  - Removing the heart from the brain: compensation for the pulse artifact in the
      photon migration signal.
AB  - Various factors, including variations in the concentration of hemoglobin,
      determine changes in the transparency of living tissue to near-infrared light.
      Hence, optical measures have been proposed as a noninvasive method for
      investigating regional changes in brain activity. However, the amount of near
      infrared light traversing a region of the head is also influenced by the periodic
      changes in blood pressure that occur during the cardiac cycle (pulse). These
      large changes may obscure smaller, localized events associated with brain
      activity. We developed a least-squares regression algorithm for compensating for
      the artifact introduced by the pulse. This procedure takes into account beat-to
      beat variability in heart rate and differences in the shape of the pulse among
      subjects and among recording conditions.

PMID- 7784539
TI  - Professor Dorothy Hodgkin.

PMID- 7784541
TI  - Earning a living.

PMID- 7784540
TI  - Fundamentals of drug design from a biophysical viewpoint.

PMID- 7784542
TI  - Patients vs. paperwork.

PMID- 7784544
TI  - Using virtual reality to teach radiographic positioning.
AB  - Using virtual reality to teach radiographic positioning overcomes many of the
      limitations of traditional teaching methods and offers several unique advantages.
      This article describes a virtual reality prototype that could be used to teach
      radiographic positioning of the elbow joint. By using virtual reality, students
      are able to see the movement of bones as the arm is manipulated. The article also
      describes the development and challenges of using virtual reality in medical
      education.

PMID- 7784543
TI  - Radiography education in the United Kingdom.
AB  - The U.S. system of educating radiologic technologists is changing to meet the
      demands of an evolving health care work force. As a result, the educational
      standards and role of tomorrow's radiologic technologist will be very different
      from those of today. Many of the changes being considered by radiologic science
      professionals in the United States already have occurred in the United Kingdom.
      Beginning this year, for example, all entry-level radiographers in the United
      Kingdom must be graduates of a baccalaureate degree program. This article
      describes how radiography programs in the United Kingdom made the transition to a
      baccalaureate degree standard. It also examines how the role and scope of
      practice of U.K. technologists changed following the increase in educational
      standards.

PMID- 7784545
TI  - Recording the radiographic image.

PMID- 7784546
TI  - Computer-based instruction.

PMID- 7784547
TI  - Split screen contiguous ultrasound imaging.

PMID- 7784548
TI  - Hedis 2.0 and its impact on radiology.

PMID- 7784549
TI  - Thrombolysis in interventional radiology.

PMID- 7784550
TI  - Health care reform and human resources.

PMID- 7784551
TI  - Neuroradiology: a historical perspective.

PMID- 7784552
TI  - Superior hypogastric plexus block for chronic pelvic pain in the presence of
      endometriosis: CT techniques and results.
AB  - PURPOSE: To evaluate the use of superior hypogastric plexus block with computed
      tomographic (CT) guidance in patients with endometriosis and chronic pelvic pain.
      MATERIALS AND METHODS: Seven blocks were performed on an outpatient basis in five
      women with endometriosis and pelvic pain. In the first four patients, one or two
      20-gauge, 15-cm needles were placed anterior to the spine at the common iliac
      bifurcation from a posterior approach. In the fifth patient, the block was
      performed from an anterior approach with a single needle. RESULTS: One procedure
      resulted in mild pain relief, three in considerable pain relief, one in complete
      midline pain relief with no change in the lateral pain, and one in complete pain
      relief. One procedure was terminated because anesthetic was injected into the
      peritoneal cavity. There were no other complications. CONCLUSION: CT-guided
      superior hypogastric plexus block is easily performed and can be used to assess
      whether chronic pelvic pain can be attenuated by blocking the superior
      hypogastric plexus.

PMID- 7784553
TI  - Mechanism of colloidal particle uptake into the lymphatic system: basic study
      with percutaneous lymphography.
AB  - PURPOSE: To examine the extracellular (dispersed particles) and intracellular
      (phagocytosed particles) colloidal particle transport from subcutaneous tissue
      into the lymphatic system. MATERIALS AND METHODS: Perfluorocarbon emulsions
      LA11063 (mean particle diameter, 0.34 micron) and ZY12149 (mean particle
      diameter, 0.06 micron) were individually injected into the dorsal skin of the
      hind foot of rabbits. Lymph flow rates and particle concentrations were
      determined in prenodal lymph fluid after injection, with and without massage of
      the skin over the injection site. RESULTS: In the first 24 hours after injection,
      extracellular colloid flux was substantially larger than intracellular flux.
      Lymph flow rates and colloid concentrations increased substantially with massage.
      Extracellular LA11063 flux was smaller than ZY12149 flux, whereas intracellular
      LA11063 flux exceeded ZY12149 flux. CONCLUSION: Transport of colloids into
      lymphatic vessels is dependent on particle size. Both extracellular and
      intracellular pathways are utilized. External tissue movement contributes
      substantially to the rate of particle uptake via both pathways.

PMID- 7784554
TI  - Staging of suspected breast cancer: effect of MR imaging and MR-guided biopsy.
AB  - PURPOSE: To investigate the effect of contrast material-enhanced magnetic
      resonance (MR) imaging on staging of breast cancer in patients with
      mammographically or clinically suspected tumor. MATERIALS AND METHODS: One
      hundred seventy-six patients underwent breast MR imaging at 1.5 T before
      excisional biopsy of a suspicious mammographic or palpable abnormality.
      Diagnostic imaging studies in patients with biopsy-proved or presumed breast
      carcinoma were reviewed. RESULTS: Sixty-four patients met the study criteria. MR
      imaging enabled detection of all 57 invasive breast cancers and nine of 15 in
      situ cancers. In 22 patients (34%), MR imaging depicted one or more cancers not
      visible at mammography, 13 (20%) of which were unsuspected multifocal or diffuse
      disease. As a result of the increased sensitivity of MR imaging compared with
      that of mammography, clinical staging and subsequent treatment were altered in
      seven patients (11%). CONCLUSION: MR imaging allows detection of mammographically
      and clinically occult foci of carcinoma in patients with suspected breast cancer.

PMID- 7784555
TI  - Solid breast nodules: use of sonography to distinguish between benign and
      malignant lesions.
AB  - PURPOSE: To determine whether sonography could help accurately distinguish benign
      solid breast nodules from indeterminate or malignant nodules and whether this
      distinction could be definite enough to obviate biopsy. MATERIALS AND METHODS:
      Seven hundred fifty sonographically solid breast nodules were prospectively
      classified as benign, indeterminate, or malignant. Benign nodules had no
      malignant characteristics and had either intense homogeneous hyperechogenicity or
      a thin echogenic pseudocapsule with an ellipsoid shape or fewer than four gentle
      lobulations. Sonographic classifications were compared with biopsy results. The
      sensitivity, specificity, and negative and positive predictive values of the
      classifications were calculated. RESULTS: Benign histologic features were found
      in 625 (83%) lesions; malignant histologic features, in 125 (17%). Of benign
      lesions, 424 had been prospectively classified as benign. Two lesions classified
      as benign were found to be malignant at biopsy. Thus, the classification scheme
      had a negative predictive value of 99.5%. Of 125 malignant lesions, 123 were
      correctly classified as indeterminate or malignant (98.4% sensitivity).
      CONCLUSION: Sonography can be used to accurately classify some solid lesions as
      benign, allowing imaging follow-up rather than biopsy.

PMID- 7784556
TI  - Dynamic three-dimensional imaging with partial k-space sampling: initial
      application for gadolinium-enhanced rate characterization of breast lesions.
AB  - PURPOSE: To evaluate a method to monitor gadolinium enhancement patterns at
      magnetic resonance (MR) imaging with high temporal resolution and full coverage
      through both breasts. MATERIALS AND METHODS: In 12 patients with 13 masses,
      including nine carcinoma, nonenhanced three-dimensional MR imaging was performed
      with full-matrix resolution. At dynamic imaging, 32 serial passes were made
      during bolus administration of contrast material, and temporal resolution was
      reduced to 12 seconds by collecting the central (low spatial frequency) 32 x 16
      or 16 x 16 phase-encode views. Full-matrix dynamic images were reconstructed by
      complementing central phase-encode data with precontrast data from peripheral
      high-spatial-frequency views. RESULTS: Results at time-course analysis with a
      mono-exponential saturation model indicated malignant lesions tend to show rapid
      (< 60 seconds) contrast change relative to benign masses and normal tissues. One
      cancer displayed an exceptionally slow contrast change (260 seconds). CONCLUSION:
      The technical objectives of full tissue coverage, rapid temporal sampling, and
      quantification of enhancement curves are met with this method for certain lesions
      (> 5 mm in largest diameter).

PMID- 7784557
TI  - Management of solid breast nodules: what is the role of sonography?

PMID- 7784558
TI  - Breast MR imaging with commercially available techniques: radiologic-pathologic
      correlation.
AB  - PURPOSE: To evaluate the clinical utility of dynamic gadolinium-enhanced magnetic
      resonance (MR) imaging of the breast with commercially available techniques in
      patients scheduled for excisional biopsy. MATERIALS AND METHODS: A total of 91
      breast abnormalities, 70 benign and 21 malignant, were evaluated. Thin-section
      three-dimensional gradient-echo images were obtained before and 2, 4, and 7
      minutes after injection of contrast material. Three radiologists prospectively
      evaluated the mammograms and MR images. RESULTS: The areas under the receiver
      operating characteristic curves were 0.820 for mammography and 0.893 for MR
      imaging (P = .67). Sensitivity of MR imaging was 82.5%, compared with 74.6% for
      mammography. Specificity of MR imaging was 82.5%, compared with 79.1% for
      mammography. Enhancement profiles showed early intense enhancement in
      malignancies but considerable overlap with enhancement of benign disease.
      CONCLUSION: Breast MR imaging is a slightly more sensitive modality than
      mammography but not a highly specific technique for evaluating breast lesions. It
      has utility in several clinical situations but should not be used as a substitute
      for biopsy or general screening.

PMID- 7784559
TI  - Breast dose during electron-beam CT: measurement with film dosimetry.
AB  - PURPOSE: To measure the breast dose and dose distribution from examinations
      performed with electron-beam computed tomography (CT). MATERIALS AND METHODS:
      Radiographic film was placed bilaterally at three depths in the breasts of an
      anthropomorphic phantom and exposed with clinically relevant protocols. The
      average breast dose and the dose distribution were obtained from the digitized
      and calibrated film and compared with those obtained with conventional CT.
      RESULTS: Breast doses from electron-beam CT chest, coronary artery calcium, and
      cardiac function examinations were 21.9, 2.87, and 1.55 mGy, respectively. Within
      the breast, the dose decreased linearly by a factor of three from the axilla to
      the sternum. The breast dose from a conventional CT chest examination ranged from
      18 to 33 mGy and did not vary substantially across the breast. CONCLUSION: For
      chest examinations, the average breast dose from an electron-beam CT scanner was
      comparable to that from conventional CT scanners, despite the differences in dose
      distribution.

PMID- 7784560
TI  - Electron-beam CT: use of a calibration phantom to reduce variability in calcium
      quantitation.
AB  - PURPOSE: To measure scanner and patient variation in computed tomographic (CT)
      numbers for electron-beam CT and to determine the ability of calibration phantoms
      to reduce variability in calcium quantitation. MATERIALS AND METHODS: Two
      calibration phantoms were imaged to ensure longitudinal homogeneity and to
      determine the short-term intrascanner variation in CT numbers. Each phantom set
      was imaged twice a day for 14 weeks to determine intra- and interscanner
      variation. Data from examinations of 167 patients that included the phantom were
      analyzed to determine the intra- and interpatient variation in CT numbers of
      objects with known calcium concentrations. RESULTS: The calibration reduced
      scanner variations by approximately 25%. The calcium concentration associated
      with a CT number of 130 HU varied from 77.1 to 136.4 mg/cm3 and was dependent on
      patient girth, sex, smoking history, and image level. CONCLUSION: Scanner and
      patient variations in CT numbers in electron-beam CT can be reduced with a
      calibration phantom. In vitro and in vivo estimates of calcium concentration had
      a precision of 2% and 7%, respectively.

PMID- 7784561
TI  - Breast cancer staging with contrast material-enhanced MR imaging: should it
      change patient treatment?

PMID- 7784562
TI  - Lung cancer: reproducibility of quantitative measurements for evaluating 2-[F-18]
      fluoro-2-deoxy-D-glucose uptake at PET.
AB  - PURPOSE: To study the precision of repeated 2-[fluorine-18]-fluoro-2-deoxy-D
      glucose (FDG) uptake measurements at positron emission tomography (PET) in
      patients with primary lung cancer. MATERIALS AND METHODS: Ten patients with
      untreated lung cancer underwent two dynamic FDG PET examinations after a 4-hour
      fast within 1 week. Kinetic modeling of tumor FDG uptake was performed on the
      basis of a three-compartment model. The tumor concentration of F-18 (standardized
      uptake value calculated on the basis of predicted lean body mass [SUV-lean]) was
      also measured 50-60 minutes after injection of a tracer. Blood glucose, insulin,
      and free fatty acid levels were monitored. RESULTS: SUV-lean and the FDG influx
      constant Ki were measured with a mean +/- standard deviation difference of 10% +/
      7 and 10% +/- 8, respectively, over repeated PET scans. The mean difference was
      reduced to 6% +/- 6 and 6% +/- 5 by multiplying SUV-lean and Ki by plasma glucose
      concentration. CONCLUSION: SUV-lean and graphical Ki can be measured
      reproducibly, supporting their use in quantitative FDG PET algorithms.

PMID- 7784563
TI  - Peripheral bronchopleural fistula: CT evaluation in 20 patients with pneumonia,
      empyema, or postoperative air leak.
AB  - PURPOSE: To assess the usefulness of standard and thin-section computed
      tomography (CT) in the examination of patients with possible bronchopleural
      fistulas (BPFs). MATERIALS AND METHODS: Twenty patients with known or suspected
      BPFs underwent CT. Twelve had pleural air and fluid collections; eight had air
      leaks. Fourteen patients also underwent thin-section CT. RESULTS: The BPF or its
      probable cause was visualized in all patients with air and fluid collections and
      in two of the patients with air leaks. BPFs due to bronchiectasis, necrotizing
      pneumonia, or alveolar cell carcinoma were identified in 10 patients. In four
      others, bronchiectasis was seen but the actual communication was not. In seven
      patients with postoperative air leaks, standard or thin-section CT demonstrated
      the air-leak source in only one. Thin-section CT was superior to standard CT in
      six of eight patients in whom the BPF or its probable cause was visible.
      CONCLUSION: Standard and thin-section CT are useful in the diagnosis and
      management of peripheral BPFs.

PMID- 7784564
TI  - Needle aspiration lung biopsy: reevaluation of the blood patch technique in an
      equine model.
AB  - PURPOSE: To reexamine the blood patch technique in a laboratory model of lung
      biopsy free of confounding clinical variables. MATERIALS AND METHODS: An equine
      model of lung biopsy was developed with an excised lobe connected to an
      insufflation bulb and pressure monitor. Patched and control unpatched punctures
      were made in the lung surface, and the pressure within the lung was raised to the
      maximum achievable. Whether air leakage from the puncture sites could be induced
      was determined and, if so, at what pressure it occurred. RESULTS: At statistical
      analysis with the Kaplan-Meier test and the Cox proportional hazards regression
      model, the difference between failure of the patched and unpatched punctures was
      statistically significant (P < .0001). CONCLUSION: The blood patch technique is
      effective in the laboratory setting and deserves reevaluation in a clinical
      series with updated biopsy techniques.

PMID- 7784565
TI  - Intracranial arteriovenous malformations: quantitative analysis of magnitude
      contrast MR angiography versus gradient-echo MR imaging versus conventional
      angiography.
AB  - PURPOSE: To quantitatively analyze magnitude contrast (MC) magnetic resonance
      (MR) angiography and gradient-echo (GRE) MR imaging for evaluation of persistent
      transnidal blood flow in intracranial arteriovenous malformations (AVMs) of
      various sizes before or after stereotaxic radiosurgery. MATERIALS AND METHODS:
      Thirty-three patients with AVMs underwent 42 MC MR angiographic (maximum
      intensity projection [MIP] and source imaging), GRE imaging with and without flow
      compensation, and conventional angiographic studies within 90 days of each other.
      RESULTS: For MIP, source, and GRE images, the sensitivities for detection of
      large AVMs (> 1 cm) were 95%, 100%, and 100%, respectively, and for small AVMs (<
      or = 1 cm) were 27%, 50%, and 67%, respectively. MC MR angiography and GRE
      imaging depicted all eight nidi that were completely thrombosed on conventional
      angiograms. CONCLUSION: GRE imaging and MC MR angiography reliably depict AVMs
      larger than 1 cm. GRE is more sensitive for detection of small residual nidi (< 1
      cm). Source images must be evaluated to accurately assess low-flow lesions.
      Neither GRE nor MR angiography is reliable for detection of mean nidus diameters
      less than 0.36 cm.

PMID- 7784566
TI  - Intracolonic pressure and enemas in children: form follows function.

PMID- 7784567
TI  - Cerebrospinal fluid flow waveforms: analysis in patients with Chiari I
      malformation by means of gated phase-contrast MR imaging velocity measurements.
AB  - PURPOSE: To determine the features of the cardiac cycle-related cerebrospinal
      fluid (CSF) flow pulsations in with Chiari I malformation before and after
      decompressive surgery. MATERIALS AND METHODS: Fifteen patients and 23 healthy
      subjects underwent cine phase-contrast magnetic resonance imaging. Ten patients
      were also examined after decompressive surgery. Four regions of interest were
      selected in the upper cervical subarachnoid space and premedullary cistern.
      Velocity and fraction of the cardiac cycle waveforms were plotted, and amplitude,
      temporal, and CSF displacement parameters were assessed. RESULTS: In the Chiari I
      patients, impaired systolic and unaltered diastolic CSF flow pulsations
      immediately below the foramen magnum were identified. After surgery, the systolic
      flow pulsations immediately below the foramen magnum improved. Good correlation
      with post-surgical improvement was observed. CONCLUSION: CSF flow waveform
      analysis helps demonstrate abnormalities in CSF flow at the foramen magnum and
      the benefits of decompressive surgery in patients with the Chiari I malformation.

PMID- 7784568
TI  - Metabolic changes in acute and subacute cerebral infarctions: findings at proton
      MR spectroscopic imaging.
AB  - PURPOSE: To analyze the advantages of proton magnetic resonance (MR)
      spectroscopic imaging in the evaluation of acute and subacute cerebral infarcts.
      MATERIALS AND METHODS: Metabolite maps of choline-containing compounds, total
      creatine consisting of creatine and phosphocreatine, N-acetyl aspartate (NAA),
      and lactate were obtained in 23 patients with acute and subacute cerebral
      infarctions 1-35 days after onset of symptoms. Maps were obtained with a 1.5-T MR
      system with 32 x 32 phase-encoding steps. RESULTS: Distinct abnormal metabolite
      distributions could be detected in all lesions larger than 1 cm in diameter. In
      the center of infarcts with a diameter larger than the section thickness of 2 cm,
      NAA values decreased to 20% +/- 8 compared with contralateral brain as early as 1
      day after onset of symptoms (P < .0001). Choline was reduced to 67% +/- 30 (not
      significant) and creatine to 51% +/- 22 (P = .0025). Large amounts of lactate
      were detected in all acute infarcts. Choline, creatine, and lactate values
      declined during the first 5 weeks after stroke. CONCLUSION: MR spectroscopic
      imaging allows visualization of metabolic changes in stroke with a reasonable
      spatial resolution.

PMID- 7784569
TI  - Moyamoya disease: comparison of assessment with MR angiography and MR imaging
      versus conventional angiography.
AB  - PURPOSE: To evaluate magnetic resonance (MR) angiography and MR imaging in
      assessment of moyamoya disease. MATERIALS AND METHODS: The cases of 26 patients
      with moyamoya disease were evaluated prospectively. After three-dimensional time
      of-flight 1.5-T MR angiography and MR imaging, images were evaluated in blinded
      separate interpretation. RESULTS: MR angiography and MR imaging accurately
      depicted 217 (82%) and 184 (70%) of 264 arteries, respectively, but the degree of
      stenosis was overestimated in the other arteries. Basal cerebral moyamoya vessels
      were depicted in all 52 hemispheres with conventional angiography and in 42 (81%)
      and 48 (92%) hemispheres with MR angiography and MR imaging, respectively. The
      respective sensitivity and specificity for diagnosis of moyamoya disease were 73%
      and 100% for MR angiography, 92% and 100% for MR imaging, and 92% and 100% for MR
      angiography plus MR imaging. CONCLUSION: Assessment of moyamoya disease is most
      thorough with MR angiography and MR imaging.

PMID- 7784570
TI  - MR imaging: quality assessment method and ratings at 33 centers.
AB  - PURPOSE: To outline a quality assessment method with peer review for magnetic
      resonance (MR) imaging. MATERIALS AND METHODS: Thirty-three providers in the
      Philadelphia area were rated on a random sample of 132 brain, 124 cervical spine,
      and 113 lower extremity MR imaging examinations performed during 1990. Blinded
      peer review was performed by panels of three subspecialty-trained academic
      radiologists. Technical performance, completeness, and report appropriateness of
      each MR imaging examination were evaluated. Aggregated scores were calculated to
      rate provider performance for each of the three parameters of quality. RESULTS:
      Two or three panelists assessed technical performance as inadequate in 15 cases,
      completeness as incomplete in 58 cases, and the interpretative report as
      inappropriate and affecting treatment in 72 cases. Eleven providers received an
      unsatisfactory rating on one or more parameters of quality. The association
      between unsatisfactory ratings and the use of low-field-strength (< or = 0.6-T)
      imagers was statistically significant (P < .008). CONCLUSION: Substantial
      deficiencies were identified in the performance of examinations and
      interpretation of MR images in the Philadelphia area in 1990. These findings
      indicate the need for a program to monitor quality of MR imaging.

PMID- 7784571
TI  - Triangular fibrocartilage in asymptomatic subjects: investigation of abnormal MR
      signal intensity.

PMID- 7784572
TI  - Evaluation of a non-breath-hold MR cholangiography technique.
AB  - PURPOSE: To evaluate prospectively a non-breath-hold magnetic resonance (MR)
      cholangiographic technique. MATERIALS AND METHODS: Twenty-nine non-breath-hold,
      heavily T2-weighted, turbo spin-echo MR cholangiograms were obtained in 28
      patients and compared with 28 direct cholangiographic studies in 24 patients.
      RESULTS: MR cholangiography showed the intrahepatic ducts (IHDs) within the
      peripheral third of the liver and within the four hepatic segments in 100% of
      cases with dilated ducts. IHDs were seen in the peripheral third in 82% of cases
      with nondilated ducts and within the four hepatic segments in 91%. The
      extrahepatic duct (EHD), dilated and nondilated, was visualized in 90% of cases.
      Filling defects were identified in the EHD in 71% of cases and in the gallbladder
      in 100%. All obstructions were identified and their site and character accurately
      shown in most cases. The presence of IHD dilatation was accurately shown, and
      estimates of EHD and main pancreatic duct caliber correlated closely with those
      of direct cholangiography. CONCLUSION: Non-breath-hold MR cholangiography is a
      reliable method for depiction of the biliary system.

PMID- 7784573
TI  - Carcinoma of the head of the pancreas: evaluation of the pancreaticoduodenal
      veins with dynamic CT--potential for improved accuracy in staging.
AB  - PURPOSE: To determine if detection of abnormal dilatation of pancreaticoduodenal
      veins can improve the accuracy of computed tomographic (CT) staging of pancreatic
      adenocarcinoma. MATERIALS AND METHODS: CT scans obtained during bolus
      administration of contrast material in 86 patients (aged 34-85 years) with
      pancreatic head carcinoma were reviewed. The diameter of the small veins that
      surround the head of the pancreas was measured (normal diameter of gastrocolic
      trunk, < or = 7 mm; of anterior superior pancreaticoduodenal vein, < or = 4 mm;
      of posterior superior pancreaticoduodenal vein, < or = 4 mm). RESULTS: Twenty
      nine abnormally dilated peripancreatic veins were identified in 22 patients.
      Twenty-two of these dilated veins were in 16 patients with other CT criteria of
      tumor unresectability; seven dilated veins were in six patients with tumors
      deemed resectable at CT. All tumors in these latter six patients were
      unresectable at surgery. CONCLUSION: Although dilatation of these small
      peripancreatic veins without other CT criteria of tumor unresectability is an
      unusual finding, it may be a reliable sign of unresectable pancreatic carcinoma.

PMID- 7784574
TI  - Experimental gastrointestinal hemorrhage: detection with contrast-enhanced MR
      imaging and scintigraphy.
AB  - PURPOSE: To examine the use of O-methoxy poly(ethylene)glycol-O'-succinyl-N
      epsilon-poly(L-lysyl) gadolinium diethylenetriaminepentaacetic acid (MPEG-PL-Gd
      DTPA) as a potential magnetic resonance (MR) angiographic contrast agent for the
      detection of gastrointestinal (GI) bleeding. MATERIALS AND METHODS: MPEG-PL-Gd
      DTPA was used for blood pool enhancement, and MPEG-PL-technetium-99m DTPA was
      used for planar nuclear imaging studies. GI bleeding was tested in rats by
      controlled injection of contrast material-doped blood through a jejunostomy
      catheter. MR imaging was performed at 1.5 T. RESULTS: Ideal flip angle, used with
      a spoiled gradient-echo pulse sequence, was 40 degrees. The smallest amount of
      hemorrhage detected at MR imaging was 0.05 mL; at nuclear imaging it was 0.02 mL.
      With the superior spatial resolution of MR imaging, individual loops of contrast
      material-filled bowel were identified and bleeding points were pinpointed.
      CONCLUSION: GI hemorrhage can be easily detected at MR imaging if a long
      circulating macromolecular contrast agent is used to decrease the T1 of
      extravasated blood.

PMID- 7784575
TI  - The dangers of roentgenoscopy and methods of protection against them: state of
      the art, 1930s.

PMID- 7784576
TI  - Hepatic pseudolesion in the left lobe around the falciform ligament at helical
      CT.
AB  - PURPOSE: To determine the prevalence and possible cause of pseudolesions in the
      left hepatic lobe around the falciform ligament at hepatic helical computed
      tomography (CT). MATERIALS AND METHODS: Portal venous-dominant CT scans of 472
      consecutive patients were reviewed. CT of the left hepatic lobe was performed
      after injection of contrast material into the portal vein in 73 patients, the
      hepatic artery in 32, and the internal thoracic artery in four. The scans were
      compared with those obtained at helical CT, and the findings were analyzed.
      RESULTS: Pseudolesions were seen on 64 (14%) of 472 helical CT scans and
      correlated well (accuracy, 96%) with portal perfusion defects. They were not more
      enhanced than the surrounding liver parenchyma at CT arteriography with hepatic
      artery injection but were enhanced in two patients at CT arteriography with
      internal thoracic artery injection. CONCLUSION: Pseudolesions are caused by
      portal perfusion defects and may receive an aberrant blood supply.

PMID- 7784577
TI  - Pancreaticogastrostomy and the Whipple procedure: radiographic appearance and
      complications.
AB  - PURPOSE: To evaluate the radiographic appearance of a pancreaticogastrostomy (PG)
      and its complications. MATERIALS AND METHODS: Seventy-two patients underwent
      pancreaticoduodenectomy and PG or pancreaticojejunostomy. Those who underwent PG
      and were evaluated postoperatively with T-tube cholangiography and upper
      gastrointestinal (UGI) series constitute the study group (n = 22; 10 men, 12
      women; age range, 33-88 years). RESULTS: Twenty-one of the patients had a gastric
      filling defect radiographically detected. Four patients had clinically apparent
      delayed gastric emptying and one patient had a clinically apparent pancreatic
      fistula not detected radiographically. Two patients outside the study group had
      complications: One had a pancreatic fistula seen only with sinography, and one
      had a PG leak seen only with repeat UGI series and computed tomography (CT).
      CONCLUSION: PG caused a gastric filling defect in most patients. Suspected
      pancreatic fistulas are best confirmed with sinography, and suspected PG leaks
      may require repeat evaluation and CT. Clinical findings of delayed gastric
      emptying do not correlate with findings of UGI.

PMID- 7784578
TI  - Evaluation of 2-(3-aminobenzamido)-2-deoxy-D-glucose as a radiosensitizer.
AB  - PURPOSE: 3-Aminobenzamide (3-AB), an inhibitor of poly(adenosine diphosphate
      [ADP]-ribose) synthetase, functions as a radiosensitizer in several human tumor
      cell lines. 2-(3-AB)-2-deoxy-D-glucose (3-AB-G) was designed to increase
      preferentially the intracellular concentration of the drug in tumor cells. Both
      the toxicity and effectiveness of 3-AB-G as a radiosensitizer were determined.
      MATERIALS AND METHODS: The toxicity of 3-AB-G was measured in HeLa and Chinese
      hamster ovary cells. The radiosensitizing effect of 3-AB-G was determined for
      both cell lines. RESULTS: 3-AB-G was not toxic to cells at concentrations of 10
      mmol/L or less. 3-AB-G did not alter cell survival after irradiation. CONCLUSION:
      3-AB-G was not an effective radiosensitizer for the cells tested. Coupling 2
      deoxyglucose to 3-AB may block the uptake of the inhibitor into the cell by
      altering the ability of the receptor to recognize the molecule or may interfere
      with the specificity of the inhibitor for poly(ADP-ribose) synthetase.

PMID- 7784579
TI  - Glenohumeral ligaments and shoulder capsular mechanism: evaluation with MR
      arthrography.
AB  - PURPOSE: To evaluate the efficacy of magnetic resonance (MR) arthrography in
      identification of the glenohumeral ligaments (GHLs) and to determine the location
      of abnormalities of the GHL, joint capsule, and labrum. MATERIALS AND METHODS: MR
      arthrograms were evaluated retrospectively in 46 patients with a history of
      shoulder instability, impingement syndrome, or pain of unknown cause. Imaging
      findings were correlated with surgical observations. RESULTS: The superior,
      middle, and inferior GHLs were identified on MR arthrograms in 39 (85%), 39
      (85%), and 42 (91%) of the 46 patients, respectively. In diagnosis of tears of
      the superior, middle, and inferior GHLs, MR arthrography had a sensitivity of
      100%, 89%, and 88% and a specificity of 94%, 88%, and 100%, respectively.
      CONCLUSION: Findings at MR arthrography can help accurate identification and
      demonstration of the integrity of the GHL and labrum and can help in staging of
      abnormalities. The large number of abnormalities depicted in the middle and
      inferior GHLs suggests that both might be important in the maintenance of
      glenohumeral joint congruity.

PMID- 7784580
TI  - Superficial esophageal cancer: multicenter analysis of results of definitive
      radiation therapy in Japan.
AB  - PURPOSE: To assess the effectiveness of definitive radiation therapy in patients
      with superficial esophageal cancer. MATERIALS AND METHODS: Method of irradiation,
      local control rate, survival rate, and complications were assessed in 105
      patients (89 men, 16 women; age range, 50-88 years) with superficial esophageal
      cancer treated with definitive radiation therapy at 15 hospitals in 1981-1990.
      RESULTS: All lesions were confirmed to be squamous cell carcinoma. The overall 5
      year survival rate was 38.7%; the 5-year disease-specific survival rate was
      71.0%. The 2-year local control rate was 83.0%. Late complications occurred in 16
      patients. The prevalence of complications was relatively high in the group
      treated with intraluminal radiation therapy. CONCLUSION: Local control and
      survival rates in patients treated with radiation therapy were excellent,
      especially in the group treated with external and intraluminal radiation therapy;
      however, the optimal dose and optimal combination of external and intraluminal
      radiation therapy should be further assessed.

PMID- 7784581
TI  - Definitive radiation therapy for extrahepatic bile duct carcinoma.
AB  - PURPOSE: To evaluate retrospectively the role of radiation therapy for
      extrahepatic bile duct (EHBD) carcinoma. MATERIALS AND METHODS: Twenty-seven
      patients with local-regional EHBD carcinomas were treated with definitive
      radiation therapy. Radiation therapy was delivered by means of external beam
      radiation therapy (EBRT) alone or combined with transcatheter iridium-192
      brachytherapy. The median total dose was 54 Gy (range, 30-144 Gy). Survival rates
      were calculated and compared by using the log-rank test. Possible prognostic
      factors affecting survival were evaluated by means of univariate analysis.
      RESULTS: The median survival of all patients was 13 months, with 1- and 2-year
      actuarial survival rates of 52% and 10%, respectively. Univariate analysis
      revealed that men, patients with tumors limited to the bile duct, and patients
      receiving EBRT doses of at least 45 Gy had significantly better outcomes. Local
      regional recurrence was the main cause of treatment failure (82%). Two patients
      developed gastric outlet obstruction. CONCLUSION: Patients with locally advanced
      EHBD carcinomas have a low survival rate. Certain factors, however, appear to
      have prognostic significance.

PMID- 7784582
TI  - Renal perfusion in humans: MR imaging with spin tagging of arterial water.
AB  - The authors tested a noninvasive technique for magnetic resonance imaging of
      perfusion in human kidneys. Magnetic labeling (spin tagging) of aortic arterial
      water was performed to generate an endogenous tracer. Breath-hold renal perfusion
      images obtained in seven volunteers yielded average perfusion rates in cortex and
      medulla of 278 mL.100 g-1.min-1 +/- 55 (standard error) and 55 mL.100 g-1.min-1
      +/- 25, respectively.

PMID- 7784583
TI  - Diseases of the bronchioles: CT and histopathologic findings.

PMID- 7784585
TI  - Lateral epicondylitis: correlation of MR imaging, surgical, and histopathologic
      findings.
AB  - PURPOSE: To determine the value of magnetic resonance (MR) imaging in the
      clinical management of chronic refractory lateral epicondylitis. MATERIALS AND
      METHODS: Coronal three-dimensional Fourier transform, multiplanar gradient
      recalled-echo, and fat-suppressed sagittal images were obtained in 33 patients.
      Twenty of these patients underwent surgical debridement and/or primary tendon
      repair and were included in the correlative study. Surgical and pathologic
      reports were reviewed to determine the location and gross characteristics of the
      tissue. RESULTS: Findings at MR imaging correlated with the surgical findings of
      primary degeneration of the extensor carpi radialis brevis (n = 20).
      Histopathologic examination demonstrated neovascularization, disruption of
      collagen, and mucoid degeneration without inflammation. CONCLUSION: The use of MR
      imaging in patients with recalcitrant lateral epicondylitis assists in surgical
      planning. The definition of tendon degeneration and degree of tear, as depicted
      on MR images, correlate well with surgical and histologic findings.

PMID- 7784584
TI  - Glenoid labrum: MR imaging with histologic correlation.
AB  - PURPOSE: To document the histopathologic basis of altered intralabral and
      sublabral signal intensity on magnetic resonance (MR) images. MATERIALS AND
      METHODS: Ten fresh cadaveric shoulder specimens underwent transaxial MR imaging
      with T1-weighted, proton-density-weighted, and T2-weighted spin-echo; multiplanar
      gradient-recalled echo (MPGR); three-dimensional Fourier transform gradient
      recalled echo (GRE); spoiled gradient-recalled echo (SPGR); and T1-weighted, fat
      suppressed sequences before and after intraarticular injection of gadolinium.
      Shoulders were then frozen and transversely sectioned, and histologic analysis of
      the labrum was performed. RESULTS: Altered intralabral signal intensity
      correlated with fibrovascular tissue, mucoid or eosinophilic degeneration,
      calcification, ossification, synovial tissue, or combinations of these findings.
      A sublabral transitional band of intermediate signal intensity correlated with a
      transitional zone of fibrocartilage. CONCLUSION: There are several causes of
      altered intralabral signal intensity. A transitional fibrocartilaginous zone
      correlates with sublabral increased signal intensity. Intraarticular
      administration of gadolinium improves evaluation of the glenoid labrum.

PMID- 7784586
TI  - Meniscal ossicle: radiographic and MR imaging findings.
AB  - PURPOSE: To determine the magnetic resonance (MR) imaging appearance of meniscal
      ossicles and correlate that with the radiographic and clinical features.
      MATERIALS AND METHODS: Radiographs and MR images were studied retrospectively in
      six patients with meniscal ossicles; all patients had intermittent discomfort in
      the knee, and five patients had experienced knee trauma. Imaging findings were
      correlated with the clinical history. Four patients underwent arthroscopy.
      RESULTS: All patients had a visible ossicle on conventional radiographs initially
      interpreted as a loose joint body. MR imaging features included a corticated
      marrow-containing structure within the substance of the medial meniscus near the
      tibial attachment that appeared as a rounded focus of increased signal intensity
      on T1-weighted images that decreased in signal intensity on T2-weighted images.
      CONCLUSION: Meniscal ossicles have a characteristic MR appearance that may help
      distinguish them from loose bodies. They should be considered diagnostically when
      a circumscribed ossification is identified near the posterior horn of the medial
      meniscus on radiographs.

PMID- 7784587
TI  - Another RSNA Malaysian journey.
AB  - The RSNA International Visiting Professor program gave us an opportunity to live
      in a different and exciting country for 6 months. We had adequate travel
      opportunities to visit in Southeast Asia. Most of all, the feeling of
      appreciation and accomplishment we received from the master students as
      exemplified by their concern for us made our adventure extremely rewarding. For
      example, on the day of departure about half the class came to the airport to bid
      us farewell. This gesture, as well as several farewell parties in our honor, was
      certainly very gratifying. I enthusiastically recommend the opportunity afforded
      by the RSNA Visiting Professor program, and, specifically, I am enthusiastic
      about the program at Universiti Malaya.

PMID- 7784588
TI  - Participation by radiologists and other specialists in percutaneous vascular and
      nonvascular interventions: findings from a seven-state database.
AB  - PURPOSE: To determine the relative degree of participation by radiologists and
      other specialists in percutaneous interventional procedures. MATERIALS AND
      METHODS: By using 1992 Medicare Part B claims data that covered seven states, the
      specialty of the physician provider was determined for all services performed
      within various percutaneous vascular and nonvascular interventional procedure
      codes. RESULTS: Radiologists' performance of interventional procedures in
      descending percentage of participation was as follows: renal cyst aspiration
      (92.7%), biliary decompression (90.5%), abdominal or retroperitoneal mass biopsy
      (87.7%), lung or mediastinal biopsy (84.2%), noncardiac angioplasty (76.8%),
      pancreatic biopsy (75.2%), upper urinary tract decompression (73.7%), liver
      biopsy (43.7%), renal biopsy (38.4%), certain types of abscess drainages (38.2%),
      and thoracentesis with tube insertion (29.4%). They had only small roles in
      thoracentesis for aspiration (4.7%) and tube thoracostomy (1.7%). CONCLUSION:
      Despite controversy between radiologists and other specialists over who should
      perform percutaneous interventions, radiologists have maintained strong
      predominance in many types of these procedures. In others, they have a shared,
      but still major, role.

PMID- 7784590
TI  - Posttraumatic arterial priapism in children: management with embolization.
AB  - PURPOSE: To evaluate selective embolization for management of posttraumatic
      priapism in preadolescent boys and color Doppler sonography for diagnosis of the
      causative lesion and for planning embolization. MATERIALS AND METHODS: Five
      preadolescent boys with posttraumatic priapism underwent selective angiography
      and embolization. Color Doppler sonography was performed in the last three
      patients. RESULTS: Selective angiography showed an intracavernosal arteriovenous
      fistula in two patients, pseudoaneurysm of the cavernosal artery in two patients,
      and asymmetric cavernosal arterial flow in the other patient. After successful
      embolization, detumescence was achieved in all patients. Color Doppler sonography
      enabled localization and characterization of the lesion causing the priapism in
      the three patients. CONCLUSION: Angiography with selective embolization is a safe
      and effective method to correct posttraumatic priapism in children. Color Doppler
      sonography is a valuable preangiographic study, as it allows for characterization
      and localization of the causative lesion and obviates diagnostic cavernosal
      aspiration.

PMID- 7784589
TI  - Intracolonic pressure measurements during hydrostatic and air contrast barium
      enema studies in children.
AB  - PURPOSE: To prospectively evaluate intraluminal pressure changes in the colon of
      children undergoing conventional hydrostatic (barium and water-soluble contrast
      material) and air contrast barium enema studies. MATERIALS AND METHODS: Dynamic
      intracolonic pressure was measured in 26 children undergoing hydrostatic barium
      (23% wt/vol) enema studies, air contrast barium enema studies, or water-soluble
      contrast material enema examinations. Measurements were obtained with a measuring
      device capable of recording rapid changes in pressure. Pressure measurements were
      obtained with the contrast reservoir system open (contrast material was free to
      run through the tubing into the patient's colon) and closed (tube was clamped).
      RESULTS: The colonic pressures during the filling phase with liquid contrast
      material were equal to those elsewhere at the same level with the hydrostatic
      system. Mean pressure ranged from 30 to 50 mm Hg with peaks of more than 100 mm
      Hg during Valsalva maneuvers. During air contrast barium enema studies, sharp
      pressure increases and rapid swings in the intracolonic pressure occurred during
      and after manual insufflation of air. CONCLUSION: During conventional hydrostatic
      barium enema studies, intracolonic pressures remain low. During air insufflation,
      there were intermittent high, sharp pressure peaks.

PMID- 7784591
TI  - AIDS-related lymphoma: radiologic features in pediatric patients.
AB  - PURPOSE: To determine the clinical, pathologic, and radiologic features in
      pediatric patients with acquired immunodeficiency syndrome (AIDS)-related
      lymphoma and to compare these features with those in adult patients with AIDS
      related lymphoma. MATERIALS AND METHODS: Clinical and radiologic findings were
      retrospectively reviewed in nine children (aged 1-15 years) with AIDS-related
      lymphoma. All patients had neoplastic changes that were not consistent with
      hyperplastic lymphoid tissue. The children underwent ultrasonography, computed
      tomography, magnetic resonance imaging, and plain radiography. RESULTS: Sites of
      involvement by malignant non-Hodgkin lymphoma at diagnosis were the liver (n =
      7), spleen (n = 5), kidney (n = 4), central nervous system (n = 2), and testis
      and bone (n = 1). Symptoms included seizures, respiratory distress, testicular
      swelling, and increased abdominal girth. CONCLUSION: Children with AIDS-related
      lymphoma have symptoms distinct from those found in adults, but clinical,
      radiologic, and pathologic findings show that almost any anatomic site in these
      children can be involved.

PMID- 7784592
TI  - Long iliac stenosis: initial clinical experience with the Cragg endoluminal
      graft.
AB  - PURPOSE: To determine the feasibility of use of a self-expanding nitinol stent
      covered with polyester fabric in long iliac stenoses. MATERIALS AND METHODS: In
      10 patients with 12 iliac artery stenoses (6-10 cm long [mean, 7.5 cm]), a Cragg
      endoluminal graft was placed percutaneously after failure of percutaneous
      transluminal angioplasty. RESULTS: At angiography after implantation of 15 Cragg
      endoluminal grafts, patency was restored and the dissection flap was eliminated
      without any residual stenosis in all cases. At 1-13-month follow-up (mean, 7
      months), eight patients were asymptomatic, with a mean ankle-brachial index of
      0.90 +/- 0.15 (standard deviation). Arterial rupture occurred in one patient,
      with thrombosis of the artery with the stent within 1 day. In one patient, tight
      restenosis was seen at the proximal part of the stent. In another patient,
      moderate restenosis was seen at the distal junction of the prosthesis with the
      native artery, but restenosis did not occur within the stent. The 6-month primary
      patency rate of the stent graft was 80%. CONCLUSION: In long iliac artery
      stenoses, the deployment of the Cragg endoluminal graft is feasible and no short
      term complications were seen.

PMID- 7784593
TI  - Thrombosed hemodialysis grafts: percutaneous mechanical balloon declotting versus
      thrombolysis.
AB  - PURPOSE: To compare a technique of mechanical balloon declotting of thrombosed
      hemodialysis grafts with conventional pulsed-spray thrombolysis. MATERIALS AND
      METHODS: Forty patients had 53 episodes of graft thrombosis over a 19-month
      period. Twenty-nine grafts were randomly treated with thrombolysis with urokinase
      and 24 grafts with mechanical declotting by placement of crossed balloon
      catheters within the graft. Patency was determined by retrospective review of
      hemodialysis records. RESULTS: Successful hemodialysis for 1 week after the
      procedure was achieved in 21 (88%) of the 24 grafts treated mechanically and 26
      (90%) of 29 grafts treated with thrombolysis. Continuous pulse oximetry showed no
      change in oxygen saturation in either group, and no clinical signs or symptoms of
      pulmonary embolism were noted. Average total procedure times were 2.2 hours for
      mechanical declotting and 3.5 hours for thrombolysis (P < .05). Probability of
      patency (mechanical vs thrombolysis) was 42% vs 45% at 3 months, 36% vs 25% at 6
      months, and 8% vs 4% at 12 months. One major complication of ulnar artery
      embolization occurred in the thrombolysis group. CONCLUSION: Mechanical
      declotting of hemodialysis grafts is faster and as effective as thrombolysis.

PMID- 7784594
TI  - Coronary artery stenosis: detection with contrast-enhanced MR imaging in dogs.
AB  - PURPOSE: To monitor with fast gradient-echo magnetic resonance (MR) imaging the
      dynamics of gadolinium benzyloxypropionictetraacetate (gadobenate) dimeglumine on
      myocardial signal intensity in dogs with critical left circumflex coronary artery
      stenosis. MATERIALS AND METHODS: Fast gradient-echo MR images were acquired in a
      short axis of the left ventricle. Two bolus injections of 0.05 mmol/kg gadobenate
      dimeglumine were administered in the basal state after stenosis and after
      infusion of 0.5 mg/kg dipyridamole. RESULTS: In the basal state, there was an
      equivalent increase in signal intensity of normal and hypoperfused myocardium
      during the first pass. Dipyridamole increased left anterior descending flow (287%
      +/- 36; P < .05) and decreased left circumflex flow (65% +/- 14; P < .05). The
      magnitude of signal intensity increase during the second bolus in the
      hypoperfused region was less than that of normal myocardium (P < .05). Contrast
      enhanced images showed the hypoperfused region as smaller than the postmortem
      measurement (43.8% +/- 3.3; P < .05). CONCLUSION: Contrast-enhanced fast MR
      imaging in the vasodilated state allows detection of hypoperfused myocardium in
      the presence of critical coronary stenosis.

PMID- 7784595
TI  - Left pulmonic recess of the pericardium: findings at CT and MR imaging.
AB  - PURPOSE: To assess the prevalence and appearance of fluid in the left pulmonic
      pericardial recess (LPR) on computed tomographic (CT) scans and magnetic
      resonance (MR) images of patients without pericardial effusion. MATERIALS AND
      METHODS: Eighty consecutive contrast material-enhanced CT scans and 50
      consecutive MR images of the thorax were evaluated for the presence of fluid in
      the LPR, transverse sinus, and superior pericardial recess. RESULTS: Fluid was
      identified in the LPR in approximately 25% of patients without pericardial
      effusion (14 of 62 CT scans, eight of 30 MR images). At MR imaging, the LPR and
      other recesses appeared as a signal void on spin-echo images but demonstrated
      high signal intensity on gradient-echo flow-sensitive images. CONCLUSION:
      Recognition that fluid in the LPR can be a normal finding in patients without
      pericardial effusion should help avert misdiagnoses of lymphadenopathy.

PMID- 7784596
TI  - Takayasu arteritis: evaluation of mural changes in the aorta and pulmonary artery
      with CT angiography.
AB  - PURPOSE: To evaluate mural changes in the aorta and pulmonary artery in Takayasu
      arteritis by using computed tomographic (CT) angiography. MATERIALS AND METHODS:
      CT angiography was prospectively performed in 12 women with Takayasu arteritis
      and in 10 healthy adults. Scanning included three distinct phases: precontrast
      (before administration of contrast material), arterial, and delayed. RESULTS:
      Precontrast transverse images revealed a high-attenuation aortic wall (10
      patients) and mural calcifications in the aorta (nine patients). Arterial-phase
      images revealed circumferential wall thickening of 1-4 mm in all patients and
      enhancement in five patients with active disease. Delayed-phase CT revealed
      circumferential enhancement in eight patients. A concentric, low-attenuation ring
      was also identified inside the aorta on the arterial-phase (two patients) and
      delayed-phase (three patients) images. In the pulmonary artery, wall thickening
      was revealed with early and delayed enhancement in two patients. CONCLUSION: CT
      angiography may demonstrate changes in the vascular wall in patients with
      Takayasu arteritis.

PMID- 7784597
TI  - Hepatic artery resistance changes in portal vein thrombosis.
AB  - PURPOSE: To determine if portal vein thrombosis (PVT) is associated with changes
      in the hepatic artery resistive index (RI) at Doppler ultrasonography (US).
      MATERIALS AND METHODS: In 35 patients with findings suspicious for PVT,
      prospective hepatic artery RIs were obtained before angiographic proof of portal
      vein status. RIs were also obtained from 27 age-matched patients with liver
      disease (without PVT) and from eight patients with PVT (without occlusion).
      RESULTS: Twenty-seven of the 35 patients had proved PVT and a significantly lower
      (P < .01) mean hepatic artery RI than did patients in any other group studied.
      Twelve of these 27 patients had RI values of .50 or less, while none of the
      patients in any other group studied had an RI value this low (specificity, 100%).
      CONCLUSION: A reduction in hepatic artery RI accompanies PVT and may be a helpful
      secondary sign to determine this venous abnormality.

PMID- 7784598
TI  - Acoustic shadowing from uterine leiomyomas: sonographic-pathologic correlation.
AB  - PURPOSE: To investigate the origin of discrete shadowing from uterine leiomyomas
      at ultrasound (US) that does not progress from an echogenic origin. MATERIALS AND
      METHODS: Seven hysterectomy specimens with leiomyomas were scanned in a water
      bath. With US guidance, 13 self-retaining needles were placed at the origin of
      shadows that did not (12 cases) or did (one case) arise from an echogenic focus.
      The localized tissues were inspected for gross pathologic features and
      microanatomic detail. RESULTS: In the 12 cases, the shadow originated from
      transitional zones: the margins of the fibroid with adjacent myometrium (three
      needles), the edges of nodular whorls of smooth muscle (four needles), and the
      margin between smooth muscle bundles and hyalinized connective tissue (five
      needles). There was no evidence of calcification, hemorrhage, or necrosis. In the
      other case, microcalcifications were found. CONCLUSION: Discrete shadowing not
      arising from echogenic foci resulted from the structural features of the
      leiomyomas and occurred at transitional boundaries between juxtaposed tissue
      types or at the curved margins of organized anatomic structures.

PMID- 7784599
TI  - [Why (some) psychoanalytic therapies (must) have a long duration. Thoughts on
      appropriate catamnestic methods].
AB  - First the author discusses some of the reasons why psychoanalytic therapy takes
      time, showing in the process how the psychoanalytic understanding of time is at
      odds with the everyday concept of it. He then makes out a case against the
      unthinking adoption of the psychometric procedures and evaluation techniques used
      hitherto in determining the success of psychotherapy. In this way certain
      erroneous developments in traditional psychology can be avoided in psychoanalytic
      catamnesis. In the concluding section the author outlines an alternative
      methodology of catamnesis geared to the specific epistemological requirements
      inherent in the process of psychoanalysis.

PMID- 7784600
TI  - [The individual case study as a psychoanalytic research instrument].
AB  - The attacks mounted by Grawe, Donati and Bernauer on the individual case study as
      an instrument of research in psychoanalytic studies has had major political
      repercussions, not least with regard to professional corporate identity. The
      author takes the opportunity of inquiring into the quality and the advantages of
      scientific inquiry into the individual case. She proceeds in this from a
      discussion of the familiar quandary posed by the fact that the necessarily
      idiosyncratic nature of the individual case will by definition resist
      generalization. The very definition of inquiry that qualifies for the term
      "scientific" is, however, precisely that it should be able to make statements
      with a claim to general validity. The line taken by Leuzinger-Bohleber is that
      the internal (narrative) coherence of psychoanalytic interpretations should be
      supplemented by an external form of coherence in such a way as to ensure that
      genuinely psychoanalytic interpretations and concepts do not stand at odds with
      accepted knowledge in other scientific disciplines. With special reference to
      Moser's arguments, she demonstrates that a trial-and-error research approach with
      an inbuilt suspicion of and resistance to orthodox tenets, professions of faith
      and ultimate truths is quite definitely in a position to proceed from individual
      cases to subsequent generalizations, from data to metaphors, concepts and finally
      theories susceptible of validation by further new data. By referring theoretical
      models back to new practical situations (the therapeutic situation, the
      experimental situation, computer simulation) the author feels that it is entirely
      possible to at least sustain, if not resolve, the tension between individual case
      study and scientific claims of general validity. This is entirely in line with
      the view of psychoanalysis as a "science between the sciences", an approach
      reconciling "understanding" and "explanation", hermeneutics and hardcore science.

PMID- 7784602
TI  - [The Bern psychotherapeutic universal spirit: Klaus Graw et al].

PMID- 7784601
TI  - [Klaus Grawe's confession and the psychoanalytic profession].
AB  - 1994 saw the publication of the volume Psychotherapie im Wandel. Von der
      Konfession zur Profession ("Psychotherapy in Transition. From Confession to
      Profession") by K. Grawe et al. This book did much to fuel the professional
      policy debate on the purpose and efficiency of long-term and high-frequency
      analytic psychotherapies. The author examines Grawe's book, comparing its
      methodological approach with other (largely US-American) studies on
      psychotherapeutic research, and concludes that the studies analysed by Grawe do
      not do justice to the realities of psychoanalytic therapy. He advocates more
      naturalist designs reflecting the change from controlled therapies in
      institutions to clinical treatment in private practices. Finally he criticises
      psychoanalysts for having failed to provide evaluation of long-term and high
      frequency analysis.

PMID- 7784603
TI  - [Classical form of congenital adrenal hyperplasia due to 21-hydroxylase
      deficiency. Genetic considerations in light of personal studies].
AB  - Long-term immunogenetic studies on HLA and GLOI systems in the families of
      probands with classic 21-hydroxylase related adrenal hyperplasia served as a
      basis for a complex analysis. The analyzed factors included the phenotype and
      haplotype incidence, HLA-ABC homozygosity, and -in informational families-the
      strength of genetic linkage for recombinant fractions (lod score). The results
      suggest the usefulness of routine determinations of class I HLA antigens in
      families of patients with 21-hydroxylase deficiency.

PMID- 7784604
TI  - [Personal experience in clinical use of low power laser therapy].
AB  - The results of our own clinical trials regarding therapeutical effects of low
      power lasers in the treatment of some diseases of motional system, skin and
      lesions of peripheral circulation were presented in the paper. The laser therapy
      was used in over 320 patients in period of last 3 years. The infra-red laser
      (wave-length 904 nm, mean power 4 mW) was used. The procedures were performed
      daily, for 5 days a week in 2 stages: the scan of sore region (3-min.) and the
      irradiation of trigger points (2-3 min. each). As a result of 10-25 procedures a
      significant clinical improvement in 65-90% patients was obtained. On the base of
      obtained results one can conclude that low-power laser therapy could make a
      useful supplementary method of treatment of overloading syndrome of motional
      system, postthrombotic syndrome, lymphatic edema and trophic lesions of skin.

PMID- 7784605
TI  - [Significance of myoinositol in renal physiology and pathology].

PMID- 7784606
TI  - [The role of hydrochloric acid and pepsin in the etiology of peptic ulcer].

PMID- 7784607
TI  - [Metformin -- biguanid of choice].

PMID- 7784608
TI  - [Retinal autoimmunity].

PMID- 7784609
TI  - [Intensive insulin therapy-- benefits and risks].

PMID- 7784610
TI  - [All-trans-retinoic acid in the differential therapy of proliferative hemocytic
      diseases. I. Properties of biological retinoids].

PMID- 7784611
TI  - [Inspection of work on Polish territory in the XIX century-historical features].

PMID- 7784612
TI  - [Cytogenetic studies in clinical diagnosis --analysis of 1611 examination
      results].
AB  - An analysis of the frequency and type of chromosome aberrations found in 1611
      cytogenetic studies has been done in relation to the clinical indications. The
      most frequent reason for referral was: MCM/MR syndrome (15.4% cases), suspicion
      of sex chromosome abnormality (13.1%), Down syndrome (11.2%) and reproductive
      wastage (10.6%). The incidence of abnormal karyotypes in these groups of patients
      was 10.1%, 24.2%, 87.9% and 9.3% per couple, respectively. The lowest percentage
      of chromosome aberrations was found among patients with nonspecific mental
      retardation (2.2%) and in the families who lost a baby with MCM Syndrome (3.3%
      per couple). On the whole, abnormal karyotype was found in 364 patients (22.6%).
      Among 62 families identified by the affected child with, structural chromosome
      aberration in 24 families (38.7%) the abnormality was familial in the origin.

PMID- 7784613
TI  - [Respiratory infections in the surgical intensive care unit].
AB  - The purpose of the study was to assess microbiological structure and the
      influence of the predisposing factors on frequency of lower respiratory tract
      infections. The study group consisted of 72 patients admitted to the Intensive
      Care Unit between January and October 1994. We found that 27 pts. (39%) developed
      respiratory infections. The risk of an infection was much higher in the group
      with long (over 5 days) stay on ICU, which required artificial ventilation as
      well as in the group of patients treated due to acute pancreatitis. More than 75%
      of isolated strains were Gram negative bacteria. Using susceptibility tests we
      conclude that Pseudomonas aeruginosa, Serratia, and Acinetobacter baumanii are
      highly resistant to antibiotics. The results suggests that 3rd generation
      cephalosporins and imipenem are most efficient in vitro.

PMID- 7784614
TI  - [Prognostic significance of some clinical and laboratory parameters in patients
      with chronic myelogenous leukemia].
AB  - The correlations between select clinical and laboratory data recorded at the time
      of diagnosis in 125 chronic myelogenous leukemia patients (60 men and 65 women)
      and survival time these patient was analysed. All patients were treated with
      similar methods. Characteristics for which there was evidence of associations
      with shorter survival outcome were older age, anemia, high percentage of
      peripheral and marrow blasts and thrombocytopenia or thrombocytosis. There was no
      evidence of statistically significant prognostic value such parameters as: sex,
      presence of symptoms, hepatosplenomegaly, high leukocytosis (WBC), high
      proportion of circulating promyelocytes, neutrophils and eosinophils and serum
      LDH or leukocyte alkaline phosphatase activity. Peripheral basophilia appeared to
      have advantage prognostic relevance to survival time. The median survival time
      observed patients was 38-65 months.

PMID- 7784615
TI  - [Hepatitis B (HBV) and C (HCV) virus infections as an eventual cause of chronic
      hepatic damage in patients undergoing maintenance hemodialysis ].
AB  - In 67 hemodialysis patients with high prevalence of HBV infection (64/67-95.5%)
      the occurrence of anti-HCV antibodies in second generation enzyme immunoassay was
      61.2% (41/67). Among 40/67 (59.7%) patients with actually or previously detected
      biochemical signs of chronic hepatic injury the H Bs antigen or/and/anti-HCV
      antibodies were positive in 38 (95.0%) cases. High prevalence of HBV and HCV
      infections in studied population and their connection with biochemical signs of
      chronic hepatic injury shows the necessity of introduction the intensive
      prophylaxis of those infections in polish hemodialysis centers.

PMID- 7784616
TI  - [The value of serum CA 125 for monitoring treatment of patients with ovarian
      cancer].
AB  - To evaluate the value of serum CA 125 antigen in monitoring of treatment of
      ovarian carcinoma, serum levels of this marker were monthly assayed during
      treatment and follow-up period in a group of 112 patients. CA 125 levels
      decreased in all 67 patients with remission. In a group of 41 patients with
      progressive disease, in 38 (93%) CA 125 levels increased, and in 3 (7%) -
      remained elevated. CA 125 became negative in all patients with clinical complete
      remission, although in 14 (38%) patients in this group second-look laparotomy
      revealed microscopic disease. In 12 of 15 patients with complete pathologic
      remission the increase of CA 125 preceded (2 to 58 weeks, median - 12 weeks) the
      recurrence of the disease. Time to progression depended on the increase rate of
      the antigen level.

PMID- 7784618
TI  - [Use of alprazolam in treatment of mental disorders].

PMID- 7784617
TI  - [Postoperative complications after intestinal bypass operations for extreme
      obesity].

PMID- 7784619
TI  - [The role of selenium in the metabolism of thyroid hormones].

PMID- 7784620
TI  - [Non-typical tumor of the left kidney].
AB  - The paper presents the diagnosis and treatment of 62-years old male, admitted to
      the hospital with supposition of splenomegaly. X-ray of abdomen and urography
      showed in the location of left kidney irregularly calcified tumor with features
      of a huge mould concretion in the collecting system of the left kidney. After
      subsequent diagnostic procedures as: ultrasonography of abdomen,
      aortonephrography, CT, patient was qualified for surgical intervention. A large
      tumor (10 cm in diameter) with calcified walls, in part infiltrating mesenterium
      of large intestine suggesting neoplastic infiltration, was removed from
      extraperitoneal area. Histopathological examination identified the tumor as a
      defunct kidney filled with caseous masses, separated from the remains of kidney
      with calcified wall. No active tuberculosis was found in examined sections. The
      paper presents the problems in differential diagnosis of tumors localised in left
      hypochondrium.

PMID- 7784621
TI  - [Electrolyte disturbance and hyperglycemia in villous adenoma of the sigmoid
      colon-case report].

PMID- 7784622
TI  - [Inspiration for initiation of collections in the Medical Department Museum of
      the Jagellonian University].

PMID- 7784623
TI  - A novel application of a competitive binding model in dioxin risk assessment.
AB  - The EPA-recommended toxicity equivalence factor (TEF) approach to estimating the
      lifetime incremental cancer risks for dioxins does not address (a) differences in
      the severity of toxicity according to the composition of chemical mixture and (b)
      potentials for modification of tissue-level doses of congeners in mixtures and
      consequently the cancer risk estimates. Our earlier efforts to model the binding
      of congeners to the Ah receptor in the low-dose range and to develop quantitative
      estimates for the formation of fractions of Ah receptor-congener complexes
      resulted in the definition of a unique parameter, defined as competitive binding
      ratio (CBR), to adjust tissue-level doses for mixture exposure. We made an effort
      to incorporate CBR values in the dose-response analysis and risk characterization
      of congeners in two distinct exposure scenarios. The modified approach to
      estimating tissue-level doses of congeners in mixtures by the use of a
      competitive binding model indicated that (a) the Ah receptor affinity is an
      important criterion in the determination of tissue-level dose of congeners, (b)
      the TEF doses calculated by using the model algorithms modified the tissue-level
      doses for congeners in mixture exposures, and (c) the combined lifetime
      incremental cancer risks for all congeners were generally lower when model
      algorithms were used in the dose-response analysis. However, the percentage
      contribution of toxic congeners was significantly higher when model algorithms
      were used. The percentage contribution of higher congeners with low toxicity was
      considerably reduced when model algorithms were used.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7784624
TI  - Evaluation of ambient asbestos concentrations in buildings following the Loma
      Prieta earthquake.
AB  - On October 17, 1989, an earthquake struck central, coastal California including
      San Francisco and the Bay Area, damaging many buildings. Because of concern over
      the possible exposure to asbestos in the damaged buildings, building
      owners/managers hired several Bay Area industrial hygiene firms to collect air
      samples in suspect buildings. RJ Lee Group analyzed a total of 419 air samples
      from 55 buildings (25 school, 3 university, 20 commercial, 5 public, and 2
      residential buildings) using transmission electron microscopy and has compiled
      the results. The data from each building were averaged and grouped accordingly
      into three classifications: indoor buildings, buildings with asbestos abatement
      in progress at the time of the earthquake, and buildings where sampling was
      performed to monitor clean-up of debris. Several buildings were sampled on more
      than 1 day. The results indicate that asbestos levels differed little from
      outdoor levels, even immediately after the earthquake. Exceptions to this were
      samples collected in the vicinity of debris clean-up and in buildings undergoing
      abatement which were higher than the indoor or outdoor samples. However, these
      samples generally had concentrations below the AHERA clearance levels and all
      were well below the OSHA action limit.

PMID- 7784625
TI  - Lung particle overload: implications for occupational exposures to particles.
AB  - Chronic pulmonary inflammation, pulmonary fibrosis, and even lung tumors
      developed in a number of chronic inhalation studies in rats with highly insoluble
      nonfibrous particles of low cytotoxicity. Concerns were expressed that these
      responses are due to excessive particulate lung burdens, and the term "particle
      overload" was coined to characterize these conditions. The hallmark of the
      particle-overloaded lung is an impairment of alveolar macrophage (AM)-mediated
      lung clearance which has been demonstrated in all species tested so far and which
      eventually leads to accumulation of excessive lung burdens. Experimental evidence
      suggests that the volume of the particles phagocytized by AM is most critical for
      causing their impaired clearance function, and that the condition of lung
      overload is reached once the retained lung particle burden reaches a level
      equivalent to a volume of approximately 1 microliter/g of lung. Cytotoxic
      particles also cause impaired AM clearance function, yet at a much lower lung
      burden which does not qualify as particle overload. Significant species
      differences exist with respect to the induction of adverse chronic effects in
      response to lung overload; i.e., mice and hamsters are less prone to developing
      chronic inflammation and pulmonary fibrosis, and lung tumors have been observed
      only in rat studies. Lung tumors or fibrosis in the rats were seen only at lung
      burdens having caused impaired particle clearance, and a threshold dose for the
      adverse chronic effects can be postulated which is defined by a lung particle
      burden not causing impairment of clearance. Thus, the lung tumors observed in
      chronic rat studies at very high particulate exposure concentrations may not be
      relevant for human extrapolation to low-exposure concentrations. Evidence in
      humans suggests that particle-overloaded lungs, e.g., in coal workers, respond
      with fibrosis, but no increased incidence of lung tumors has been found in this
      group. However, it cannot be excluded that other types of chronically inhaled
      particles may have a carcinogenic potential in the human lung if accumulating to
      very high lung burdens. More research is needed for a detailed understanding of
      the basic mechanism leading to nonfibrous particle-induced tumorigenesis in the
      lungs of different species. Altered particle accumulation and retention kinetics
      and chronic inflammation in the overloaded lung indicate that the maximum
      tolerated dose (MTD) has been exceeded. No specific guidelines for inhalation
      studies defining the MTD have been established; general guidelines are not
      necessarily applicable for chronic inhalation studies.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 7784626
TI  - Human exposure to polychlorinated biphenyls (PCBs): a critical assessment of the
      evidence for adverse health effects.
AB  - Results from epidemiologic studies involving human exposures to polychlorinated
      biphenyls (PCBs) are often used to estimate the potential risk or hazard posed by
      the presence of these chemicals in the workplace or the environment. The use of
      results and conclusions from individual studies requires an assessment of the
      scientific quality of the information contained in published reports. The results
      of a critical review of the scientific literature reported here should be an aid
      to those who are interested in risk evaluations surrounding exposures to PCBs.
      There are diverse approaches that one could take to an evaluation of scientific
      reports of the health hazards of various chemicals. We present one approach to
      assessing the strengths and weaknesses of studies conducted to understand the
      potential association between PCB exposure and human health effects. A
      comprehensive review of the scientific literature involving human exposures to
      PCBs was performed and each study was evaluated on the basis of a defined set of
      criteria that were considered standards in epidemiologic research. Two of the 39
      occupational studies reviewed provided positive evidence and 3 suggestive
      evidence for an exposure-related effect, whereas none of the 33 studies where
      exposure had occurred in the natural environment provided positive or suggestive
      evidence of an association with adverse effects.

PMID- 7784628
TI  - Copper guideline values for drinking water: reviews in need of review?

PMID- 7784627
TI  - Analysis of studies related to tumorigenicity induced by hydroquinone.
AB  - Hydroquinone (HQ) produced renal adenomas in male F344 rats, and these tumors
      appeared to arise from areas of spontaneous progressive nephropathy; the
      nephropathy itself has been found to be enhanced by HQ. Other neoplasms were not
      confirmed to be causally related to HQ among the reported bioassays. In the male
      F344 rat, HQ administered alone was not DNA reactive. HQ produced enhanced
      proliferation of renal tubular epithelium, presumably through toxicity involving
      glutathione conjugate formation. In the kidney, bone marrow, and other tissues,
      HQ may induce toxicity by redox cycling and lipid peroxidation. In bone marrow,
      HQ may produce microtubulin dysfunction, which is a plausible explanation for
      positive cytogenetic tests, the only consistently positive genotoxicity effect
      reported for HQ. Although HQ is a metabolic product of benzene, several lines of
      evidence suggest that the effects of HQ exposure are significantly different from
      those of benzene. Based upon the plausible mechanisms by which HQ may produce
      kidney tumors in male rats, we have concluded that occupational exposure levels
      of HQ are not predicted to be a cancer risk for humans.

PMID- 7784629
TI  - Ischemic heart disease and spousal smoking in the National Mortality Followback
      Survey.
AB  - Data on never-smoking decedents from the 1986 National Mortality Followback
      Survey were used to perform a case-control analysis of ischemic heart disease in
      relation to spousal cigarette smoking. The case groups consisted of 475 men and
      914 women who died from heart disease. Controls consisted of 998 men and 1930
      women who died from other causes. In this study there was no association between
      spousal smoking and ischemic heart disease in either sex (males, odds ratio =
      0.97; females, odds ratio = 0.99). The results of this study are in striking
      disagreement with risk elevations reported in several previous studies of spousal
      smoking and heart disease.

PMID- 7784631
TI  - Short communication: selecting input distributions for use in Monte Carlo
      simulations.
AB  - Monte Carlo analysis is increasingly employed as a means of quantifying
      uncertainties in risk assessment. However, the output of any Monte Carlo analysis
      is extremely sensitive to the input distributions used. In this paper we present
      a simple set of guidelines for the selection of input distributions. The
      guidelines involve allocating variables with unknown distributions to appropriate
      distributional "classes," based on the range of possible values that could be
      obtained for the data and known characteristics about the behavior of the
      variable. If the class of distribution is not identifiable, then variables can be
      related to a specific distribution using goodness-of-fit techniques. If these
      identification schemes fail, bootstrapping techniques may be used to generate a
      sampled distribution from the available data. Finally, "default" distributions
      may be employed using analogous data if site-specific data are unavailable.

PMID- 7784630
TI  - Publication bias in the environmental tobacco smoke/coronary heart disease
      epidemiologic literature.
AB  - Two approaches are used to assess publication bias in the environmental tobacco
      smoke/coronary heart disease (ETS/CHD) literature: (1) Statistical tests applied
      to all sex-specific relative risk (rr) estimates from 14 previously published
      studies indicate that publication bias is likely. A funnel graph of the studies'
      log relative risks plotted against their standard errors is asymmetrical, and
      weighted regression of the studies' log relative risks on their standard errors
      is significant (P < 0.01). (2) Previously unpublished ETS/CHD relative risks from
      the American Cancer Society's Cancer Prevention Studies (CPS-I and CPS-II) and
      the National Mortality Followback Survey (NMFS) do not show an increased CHD risk
      associated with ETS exposure. CPS-I: men, rr = 0.97 (0.90-1.05); CPS-I: women, rr
      = 1.03 (0.98-1.08); CPS-II: men, rr = 0.97 (0.87-1.08); CPS-II: women, rr = 1.00,
      (0.88-1.14); NMFS: men, rr = 0.97 (0.73-1.28); women, rr = 0.99 (0.84-1.16).
      Comparison of pooled relative risk estimates from 14 previously published studies
      (rr = 1.29; 1.18-1.41) and unpublished results from three studies (rr = 1.00;
      0.97-1.04) also indicates that published data overestimate the association of
      spousal smoking and CHD (chi 2 = 25.1; P < 0.0001).

PMID- 7784632
TI  - A reexamination of recent publications suggesting o-toluidine may be a human
      bladder carcinogen.

PMID- 7784633
TI  - Integrated approach for environmental assessment of new and existing substances.
AB  - To ensure the environmental safety of new and existing substances, the
      environmental fate and potential effects resulting from their release into the
      environment must be assessed. This requires the development of reasonable,
      consistent, and effective methods to conduct environmental risk assessments and
      to prioritize testing for these substances. This assessment must integrate fate
      and effects at the point-of-entry; it should also extend to an assessment of the
      potential to persist, and the consequences of increases in exposure
      concentrations, and to bioaccumulate. The conventional environmental risk
      assessment approach is used to assess the fate and effects of a substance at its
      point-of-entry into the environment. In this paper, an approach is presented for
      conducting quantitative environmental risk assessments of new and existing
      substances that builds on this conventional approach by including quantitative
      assessment of the potential for, and consequences of, persistence and
      bioaccumulation. The approach is described for aquatic, sediment, and terrestrial
      environments. For each environmental compartment, the approach includes (i)
      classification of the substance, based on environmental partitioning processes,
      to ensure that the appropriate data are collected and models used; (ii) a fate
      assessment to understand the ultimate fate of the substance after entry into the
      environment or "an environmental compartment" and to predict the exposure
      concentration of the substance at point-of-entry; (iii) a persistence assessment
      which determines the potential for increase in the exposure concentration as a
      result of repeated additions of the substance; (iv) effects assessment; (v)
      environmental risk assessment to examine the potential for adverse impact on
      ecosystems; and (vi) a bioaccumulation assessment to evaluate the potential for
      direct and indirect effects on the species of interest due to bioaccumulation.
      The assessment approach is illustrated using data for a hypothetical consumer
      product substance that is disposed down-the-drain.

PMID- 7784634
TI  - Historical review of the rodent bioassay and future directions.

PMID- 7784635
TI  - Bioassay design and MTD setting: old methods and new approaches.
AB  - The proper design of carcinogenicity bioassays is critical to the interpretation
      and use of the data that emerge upon its completion. This paper explores some of
      the scientific underpinnings that need to be considered when designing bioassays.
      It also discusses new approaches that can be used to improve dose setting and
      interpretation of bioassay results. Critical information that determines the
      shape of the dose-response curve include the molecular dose of the agent that
      binds to DNA, cell proliferation, and cell death. Such data can be used to
      replace default assumptions and improve the extrapolation of risk from animal
      studies to humans.

PMID- 7784636
TI  - Data analysis: statistical analysis and use of historical control data.
AB  - Survival-adjusted methods for the statistical analysis of tumor data from long
      term rodent carcinogenicity studies are described. Although most of these methods
      require knowledge of whether individual tumors are "fatal" or "incidental," such
      determinations may be difficult. Several methods for dealing with this and with
      other data analysis issues are discussed. Historical control tumor data may be
      useful in the interpretation of rodent carcinogenicity studies, particularly for
      rare tumors and for borderline effects. Although statistical methods are
      available for using historical control data in a formal testing framework, the
      primary difficulty is establishing a database that is truly comparable to the
      study under evaluation with respect to those factors known to influence tumor
      occurrence. Major sources of variability in tumor incidence include the animal
      room environment, dietary factors/body weight, gross necropsy and slide
      preparation procedures, and histopathology diagnosis. The National Toxicology
      Program's use of historical control data is briefly described and illustrated.

PMID- 7784637
TI  - Modulators of carcinogenesis.
AB  - For decades, it has been known that a number of different factors (e.g., species,
      metabolism, age, animal husbandry, diet) may exhibit a significant modulating
      effect on the process of carcinogenesis. Often, however, these modulators have
      been largely uncontrolled and thus have made uncertain the results of many
      carcinogenicity bioassays. Fortunately, current research into molecular
      carcinogenesis is beginning to provide methods, not only to understand the
      molecular basis of known modulators of carcinogenesis, previously described only
      in empirical terms, but also to allow genetic modulation of carcinogenesis in
      experimental systems. An expanding body of knowledge regarding the role of
      oncogenes and tumor suppressor genes in neoplastic events is leading to a better
      understanding of carcinogenic mechanisms and points to the use of transgenic
      animal species in carcinogenicity bioassays. The transgenic animal provides
      methods to examine the molecular basis of carcinogenesis in experimental systems
      in addition to enhancing the sensitivity of carcinogen identification and the
      biological specificity of chemical risk extrapolation.

PMID- 7784638
TI  - Regulatory aspects of carcinogenicity studies and the Delaney clause.

PMID- 7784639
TI  - Human relevance of animal carcinogenicity studies.
AB  - Extrapolation of results from rodent bioassays involving high-dose exposures to
      possible carcinogenic risk in humans exposed to low doses is based on the
      assumptions of species relevance and high- to low-dose extrapolation. For
      genotoxic chemicals, such as 2-acetylaminofluorene and N-[4-(5-nitro-2-furyl)-2
      thiazolyl]formamide, these assumptions appear to be appropriate, although the
      dose response can be greatly modified by cell proliferation effects of these
      chemicals at high doses. In contrast, nongenotoxic chemicals, such as chemicals
      causing urinary calculi or sodium saccharin and related sodium and potassium
      salts, frequently are carcinogenic only at high doses and/or only in specific
      species. Consequently, for extrapolation of results for nongenotoxic chemicals
      these assumptions may not be appropriate.

PMID- 7784640
TI  - Benzoyl peroxide: an integrated human safety assessment for carcinogenicity.
AB  - Topical benzoyl peroxide has been used in the treatment of acne for over 30
      years, with no reports of adverse effects that could be related to skin
      carcinogenesis. Two case-control epidemiological studies have found a lack of
      association between the specific use of benzoyl peroxide and skin cancer. In
      addition to these findings in humans, 23 carcinogenicity studies in rodents with
      benzoyl peroxide, including 16 employing topical application, have yielded
      negative results. An increase in skin carcinomas was reported in 1 study in which
      benzoyl peroxide in acetone was applied to the skin of SENCAR mice for a 1-year
      period; however, this study did not employ adequate control groups to fully
      understand the unusual findings, and the results were inconsistent with those of
      6 other similar studies. While benzoyl peroxide is not a complete carcinogen in
      animals and has weak or no mutagenic potential, it has been found to be a tumor
      promoter in mouse skin using experimental two-stage models of carcinogenesis.
      Consistently positive results have been obtained in tumor promotion studies in
      which SENCAR mice were exposed to initiating doses of potent experimental
      carcinogens followed by promotion with benzoyl peroxide in acetone. Negative
      results have been obtained in similar studies with commercial formulations.
      However, the results of promotion studies with benzoyl peroxide do not carry
      significant weight for human safety assessment as evidenced by (i) the absence of
      demonstrated carcinogenicity in humans of a number of rodent tumor promoters
      despite long-term human exposure; (ii) the observation that tumor promotion in
      mouse skin occurs only under specific experimental conditions and predominantly
      in highly sensitive strains; (iii) clinical use scenarios markedly different from
      the conditions resulting in tumor promotion in mouse skin; and (iv) the
      significant physiological differences between mouse and human skin. Thus, to
      date, available scientific evidence does not allow the results of these rodent
      promotion studies to be meaningfully applied to human safety assessment. As such,
      significant scientific progress must be made before human safety estimations can
      be derived from rodent promotion data.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7784641
TI  - [Dynamic anterior jerk of the shoulder. A new clinical test for shoulder
      instability. Preliminary study].
AB  - PURPOSE OF STUDY: A new clinical test named "The shoulder anterior jerk test" is
      proposed to confirm the diagnosis of chronic shoulder anterior instability.
      MATERIAL: The test combines of a compression force and a translation force,
      applied along the arm between the humeral head and the glenoid cavity. In so
      doing, a subluxation of the humeral head is provoked and it is accompanied with a
      jerk recognised by the patient as his instability. METHODS: Three different
      populations of patients had been studied: Population A: 28 patients operated on
      for chronic anterior dislocation, uni or bilateral (32 shoulders), had been
      tested before the operation, without and under anesthesia. Population B: 100
      patients without any problem at the shoulder, had been tested before and under
      anesthesia done for knee or hip surgery. Population C: 100 young sportive
      athletes with normal shoulder tested without anesthesia. RESULTS: Population A:
      The 28 patients suffering from shoulder instability had all a positive shoulder
      jerk test under anesthesia. Without anesthesia the test had been positive only in
      10 cases (30 per cent). The jerk is potentially present for all the patients, but
      it is disturbed by apprehension. Population B: Among the 200 shoulders tested, 26
      shoulders (17 patients) had a positive test under anesthesia (13 per cent). 5 had
      positive jerk test without anesthesia. Population C: 5 among the 200 shoulders
      tested had a positive jerk test (2.5 per cent) Under anesthesia the test has a
      sensitivity of 100 per cent, a specificity of 87 per cent, a positive predictive
      value of 55 per cent and a negative value of 100 per cent. Without anesthesia,
      the test has a sensitivity of 31 per cent, a specificity of 97.5 per cent, a
      positive predictive value of 66 per cent and a negative predictive value of 90
      per cent. DISCUSSION: The instability which is shown by the jerk test is in
      relation with the anterior subluxation of the humeral head in front of the
      anterior edge of the glenoid cavity. It reproducts, with a minimal amplitude, the
      clinical instability which is recognized by the patient. The test is always
      positive under anesthesia in case of chronic anterior instability, it may confirm
      pre-operative diagnosis just before the begining of the procedure and may
      orientate the choice of it. Apprehension is a major obstacle to the research of
      the jerk, but it is the same with the other classical clinical tests of the
      shoulder anterior instability. CONCLUSION: The anterior jerk test of the shoulder
      is thus a test which is able to prove the diagnosis of an anterior instability.
      The future will permit to confirm its efficiency and will confirm if the test may
      differenciate anterior and inferior instability with variation of the abduction,
      as it has been shown in this preliminary study.

PMID- 7784642
TI  - [Long-term result of lumbar disk chemonucleolysis (a 8-12 years follow-up)].
AB  - INTRODUCTION: This study is an attempt to assess the effects of chemonucleolysis
      over an extended period of time (8 to 12 years follow-up). MATERIAL AND METHODS:
      From 1981 to 1985, chemonucleolysis using Chymopapain was performed on 134
      patients for the relief of radicular pain from herniated lumbar discs. The long
      term results were evaluated in 110 patients. This represented a total follow-up
      rate of 82 per cent. 24 patients were lost to follow-up. RESULTS: Of the 110
      patients who had been reviewed at 8 to 12 years follow-up: 76 patients did not
      need other treatment than the initial chemonucleolysis. The results were
      excellent or good in 69 patients (63 per cent) and fair in 7 patients (6 per
      cent). 34 required surgery (31 per cent). This rate does not reflect the real
      failure rate of chemonucleolysis: 7 patients underwent early surgery and
      corresponded with the beginning of our experience with chemonucleolysis. 7
      patients needed surgical treatment after a successful initial result for two to
      nine years. The real failure rate concerned 19 patients (17 per cent). These
      patients did not have any pain relief following chemonucleolysis. Surgical
      treatment was undertaken on the average 18 months after chemonucleolysis. One
      patient had suffered from radicular pain 6 years following the first
      chemonucleolysis. In this case, iterative chemonucleolysis had been done on the
      same lumbar level. It was effective on the radicular pain but not on the back
      pain. Chemonucleolysis had been effective in 70 per cent of the patients.
      DISCUSSION: Our study showed that the long term results following
      chemonucleolysis were effective and the mortality rate was low. (No severe
      complication in this study). This study is compared with the literature, studying
      the results of chemonucleolysis patients, or comparing patients treated by
      chymopapain or surgical discectomy. CONCLUSION: We conclude that chemonucleolysis
      is an effective and safe method for treating sciatica by herniated lumbar discs.

PMID- 7784643
TI  - [Letournel's ilio-femoral way in acetabular fractures of the two columns. A
      prospective study].
AB  - PURPOSE OF THE STUDY: The authors present the anatomical and functional results
      of the systematic use of Letournel's extensive lateral approach for internal
      fixation of the fractures of the acetabulum involving the two columns. MATERIAL:
      This prospective study concerns 25 patients. Mean age was 38 years. Mean follow
      up was 4 years and 6 months (with extremes of 1 year and 9 years 9 months). 13
      cases had a minimum of 4 years of follow-up. There were 1 transversal fracture, 9
      transversal fractures associated with a posterior wall fracture, 2 anterior
      column fractures associated with a hemitransversal posterior fracture, 6 "T"
      shaped fractures, 7 fractures of the two columns. During the procedure, a
      trochanterotomy was carried out. Not any of the patients was irradiated
      postoperatively and they did not take any indomethacin. The patients were
      operated on 10 days after the accident, on average (with the extremes of 2 and 60
      days). The average time of the procedure was 4 H 20 and 1080 cc of globular
      sediment were used during the intervention on average. The same surgeons
      participated in each operation. METHODS: The anatomical results were analysed
      according to Matta's criteria and the congruence study head-roof and head
      acetabulum of the SOFCOT symposium in 1981. The functional results were analysed
      using the quotation of Merle d'Aubigne. Complications were searched
      systematically. The appearance of heterotopic ossifications was analysed
      according to Brooker. RESULTS: 23 patients had a satisfactory anatomical
      reduction and 11 patients out of 13 did not present any arthrosis after a minimum
      of 4 years follow-up. 12 patients had very good or good functional results. 3
      patients had no heterotopic ossifications, 7 were grade I, 5 grade II, 8 grade
      III, and 2 grade IV. The gluteus medius was quoted 4 in 18 patients and 5 in 5
      patients. There were 2 cases of deep suppuration, one of them was a patient who
      died 6 months later of a pancreas cancer unrecognized at the time of the
      accident. There were 5 aseptic osteonecroses and 3 cases of regressive paralysis
      of the sciatic nerve. 4 total hip prosthesis were inserted secondarily.
      DISCUSSION: The Letournel extensive lateral approach was efficient to obtain an
      anatomical reduction but, functionally, it was only efficient in one case out of
      two. For the moment, the authors associate systematically a postoperative
      irradiation to reduce the ossifications (10 to 12 gray in 5 sessions). On the
      other hand, they try to obtain a more efficient reinsertion of the glutei
      muscles, thank to a bone fragment of the iliac crest. CONCLUSION: The authors
      limit their indications of the Letournel's extensive lateral approach to the
      fractures of the two columns, not older than 10 days or to the comminuted ones.

PMID- 7784645
TI  - [Prosthetic replacement for pathological fractures of the proximal end of the
      femur: total prosthesis or bipolar arthroplasty?].
AB  - INTRODUCTION: The purpose of this prospective study was to present our experience
      with bipolar or total hip arthroplasty in 28 consecutive cases of metastasis of
      the intertrochanteric and subtrochanteric area. MATERIALS AND METHODS: Twenty
      eight patients with metastatic involvement of the proximal femur underwent either
      bipolar or total hip arthroplasty. Proximal femoral resection and prosthetic
      replacement with a massive component was routinely performed. RESULTS: The
      postoperative morbidity rates for dislocation and pressure sores were
      significantly lower (p < 0.05) in the bipolar arthroplasty group. Postoperative
      pain relief according to Habermann was excellent in 81.5 per cent and good in
      14.8 per cent of the patients. The functional results according to the hip rating
      scale of Merle d'Aubigne were rated as excellent in 19 per cent, very good in 22
      per cent and good in 22 per cent of the hips. The prognosis for survival was
      superior in patients with a preoperative Karnofsky performance status index of
      more than 60 points (p < 0.01) and in patients without postoperative pulmonary
      complications (p < 0.01). New bone formation around the femoral prosthetic
      component occurred in 11 (61 per cent) of the 18 patients surviving three months
      or longer. This bone formation did not affect the clinical results. In the
      current series pain relief as well as postoperative walking ability were
      comparable in both groups but the dislocation rate was significantly lower (p <
      0.05) with bipolar arthroplasty. CONCLUSION: We recommend bipolar arthroplasty
      rather than total hip arthroplasty in patients with a preoperative Karnofsky
      performance status index of more than 60 points if bone disease of the acetabulum
      is not evident on standard radiographs and if during operation the acetabular
      cartilage appears normal.

PMID- 7784644
TI  - [Femoral osteotomy for severe hip osteoarthritis: an actuarial analysis of
      results].
AB  - INTRODUCTION: In cases of severe hip osteoarthritis in young patients, the
      intertrochanteric osteotomy can delay total hip arthroplasty. The main advantage
      of the osteotomy is to preserve the bone stock. The main disadvantages are the
      lasting postoperative invalidity and the varying longterm success rate. Our aim
      was to quantify these disadvantages using survivorship analysis. MATERIAL AND
      METHODS: The study included 64 patients (65 osteotomies) ranging from 16 to 68
      years. The osteotomies were performed between 1975 and 1987. The osteoarthritis
      was stage III or IV, with a joint space less than 50 per cent. Osteoarthritis was
      primitive in 25 cases and secondary in the others. The osteotomy always included
      a medial displacement of the shaft according to the principle of Mac Murray's
      procedure, but also 22 cases (33.8 per cent) had a varus angulation and 19 (29.2
      per cent) a valgus angulation. The preoperative pain score according to the Merle
      d'Aubigne (MDA) grading was 2.6 (1 to 4) and the global functional score was 11.1
      (5 to 15). The patients were reviewed in 1991 and examined clinically and
      radiographically. RESULTS: The results of the 65 cases were distributed into 3
      groups: -29 cases having reached the follow-up without difficulty, -7 patients
      were lost for follow-up examination, 6 of these latter than 9 years, -29 patients
      taking osteotomy failure as a pain lesser than the 3 MDA score. The postoperative
      delay to obtain the best functional result was 6 to 24 months (mean: 13.65). This
      result ranged from 5 to 17 MDA score (mean: 15) with pain ranging from 2 to 6
      (mean: 5). The survivorship analysis curve showed 67.5 +/- 19.5 per cent survival
      for all osteotomies to the interval of 9-10 years. There were 3 types of results:
      -3 early failures (4.6 per cent) one because of a deep infection, -in 7 cases,
      after a short initial functional improvement, there was a progressive degradation
      leading to failure in 3.7 years (2 to 6 years), -55 cases with a lasting period
      of functional improvement, 26 osteotomies leading to failure in 3.5 to 15
      postoperative years and, 29 cases having reached the follow-up (7 to 16 years
      mean 10 years). There was radiographic improvement of the osteoarthritis
      increasing the joint space in 59 cases (90.7 per cent). There was no radiographic
      improvement in the 6 other cases, including the 2 functional failures. The
      functional degradation appeared parallel to the radiographic degradation leading
      to a decrease of joint space to 90 per cent. We tested differences between
      various groups using Log Rank test. We found no difference in survival between
      the 3 different types of osteotomy. DISCUSSION: The results of this study can
      help to choose between intertrochanteric osteotomy and THA in the case of severe
      osteoarthritis. The best functional result of the osteotomy is in one
      postoperative year, with a mean MDA score of 15 and a mean pain score of 5. It
      appears that we do not predict the duration of functional improvement, the
      patient has 2/3 chances that this improvement reaches 10 years.

PMID- 7784646
TI  - [Femoral neck fractures: position of the implant, unrecognized articular
      penetration and its consequences].
AB  - INTRODUCTION: Only two dimensions of a three dimensional object are visible on
      plain roentgenograms. Therefore, on gross inspection of antero-posterior and
      lateral roentgenograms, a screw may project as being safely within the head of
      the femur even though penetration has occurred. This region may be referred to as
      a "blind zone". MATERIAL AND METHODS: Unrecognized screw penetration into the hip
      joint during internal fixation of femoral neck fractures was researched on intra
      operative roentgenograms of 30 patients. Unrecognized pin penetration through the
      posterior part of the neck was also analyzed on the same X Rays. RESULTS:
      Unrecognized screw penetration into the hip joint was observed in 20 per cent and
      penetration at the posterior part of the neck was observed in 10 per cent of
      cases. DISCUSSION: Several methods of determining screw position are described
      and discussed in this study.

PMID- 7784647
TI  - [Hollow femoral trochlea and femoro-patellar osteoarthritis].
AB  - INTRODUCTION: The high frequency of femoro-patellar syndrome encountered in
      Libreville (Gabon) and its association with shallow trochlea and important
      cartilaginous lesions in our surgical cases urged us to investigate the role of
      this dysplasia as a cause of femoro-patellar osteoarthritis. MATERIAL AND
      METHODS: Our study consisted of two series: a retrospective study: 50 patients
      operated for complications of femoro-patellar syndrome. a prospective study: we
      analysed the trochlea morphology of 100 healthy Gabonese. RESULTS: In our
      operated cases, we noted a high frequency of shallow trochlea (61 per cent) with
      important cartilaginous lesions (64 per cent of femoro-patellar osteoarthritis).
      In the prospective study, we noted 89 per cent of shallow trochlea. The average
      trochlea angle was 126 degrees. DISCUSSION: The review of the operated patients
      showed important cartilaginous lesions associated with a "closed angle trochlea",
      confirming the observations of Buard and coll., and showing that this dysplasia
      can be a cause of femoro-patellar osteoarthritis. The prospective study found 89
      per cent of shallow trochlea, which is higher to that seen in Europe (19 per cent
      for Buard and Coll.) and may pose the problem of an anatomic predisposition of
      osteoarthritis in the Central African patients. CONCLUSION: The shallow trochlea
      is a dysplasia often encountered in Central Africa. It is associated with
      important cartilaginous lesions. The shallow trochlea seems to be a favourable
      factor to femoro-patellar osteoarthritis.

PMID- 7784648
TI  - [Posterior luxation of the tibia on total knee prosthesis: apropos of 6 cases].
AB  - PURPOSE OF THE STUDY: Posterior dislocation of Total knee arthroplasty is an
      infrequent but serious complication. Six cases of this complication were treated
      from 1979 to december 1993, all occurring on primary arthroplasties. MATERIAL AND
      METHODS: Knee arthroplasty was performed once for rheumatoid arthritis, five
      times for osteoarthritis. All cases occurred with a semi constrained prosthesis
      sacrifying posterior cruciate ligament: 2 Total condylar without posterior
      stabilisation, and 4 posterior stabilised prosthesis. In one case the dislocation
      occurred on a very severe rheumatoid arthritis: the patient, confined in a wheel
      chair, was not reoperated. In two patients, the dislocation was due to rotatory
      malposition of the tibial component. In the last three cases, we did not found
      any cause to the dislocation, except ligament laxity: 2 of these patients had,
      pre operatively, a valgus deformity. In 6 cases, we found only 2 problems on
      extensor system (one patellar dislocation and one patellectomy). RESULTS: 5
      patients required a surgical treatment In 2 cases, we used a more constrained
      prosthesis, with poor results, but the knee was stable. Once, by changing the
      position of the tibial component, and using a thicker plate. In 2 patients we
      only put a thicker tibial polyethylene component. These 3 patients had a good
      stability: 2 have an excellent result with H.S.S. rating system, the third one
      has a poor result explained by patellar pseudoarthrosis occurring after traumatic
      patellar fracture. DISCUSSION: With our patients and cases published in North
      American works, we have studied the different mechanisms of such a posterior
      dislocation: rotatory disorder on tibial component, ligament laxity in flexion,
      extensor system deficiency, valgus deformity with important postero lateral
      release. CONCLUSION: The causes of posterior dislocation on Total knee
      arthroplasties must be known: we have to try to prevent such a complication. If
      it occurs, a precise analysis will permit a logical curative treatment, which
      must avoid constrained prosthesis.

PMID- 7784649
TI  - [Upper metaphyseal lengthening of the tibia. Report of 57 cases in children and
      adolescents].
AB  - INTRODUCTION: The authors reviewed 57 upper metaphyseal lengthenings of the
      tibia. They especially studied complications in order to evaluate this method.
      MATERIAL AND METHODS: Fifty seven tibial lengthenings in 47 children and
      adolescents were reviewed. All lengthenings were performed according to the
      callotasis technique, using Judet's lengthener in the first 15 cases, the, OF
      Garches Orthofix in 42 cases. All the callotasis principles were applied: delayed
      elongation, 1 mm per day distraction, one month neutralization after elongation
      period, then dynamization before removing the apparatus. Particularities were: a)
      metaphyseal osteotomy of the upper tibia, b) screw fixation and osteotomy of the
      fibula, c) classical dynamization according to De Bastiani and Aldegheri in 29
      cases, dynamization by a silastic collar (OF-Dyna-Ring) in 28 cases. METHODS:
      Severity of complications was classified according to Caton: none, benign,
      serious (needed reoperation or reanesthesia) and severe (sequel). Complications
      and rate of lengthenings without complication or with benign complications were
      studied relative to etiology, age, amount of lengthening and the stage of program
      in which they occurred. A table summarizes data of all the lengthenings. RESULTS:
      Lengthening was 52.3 mm in average. Healing time (number of days to lengthen and
      to fuse the bone divided by the number of lengthened centimeter) was 40 in
      average (range: 20-105): it was 45.6 days per cm when using classical
      dynamization and only 34.3 with silastic collar dynamization (p = 0.002). Total
      of complications was 59 out of 57 lengthenings. 21 complications were benign, 37
      serious and 1 severe (partial motor palsy of the foot). Thirty two (56 per cent)
      lengthenings were performed without unforeseen procedure or anesthesia. There
      were 4 intra-operative complications: 1 vascular lesion, 1 incomplete osteotomy
      and 2 malpositioned half screws. Complications of elongation period were the most
      numerous, 4 transient palsies, 6 knee contractures (2 led to a supracondylar
      fracture), 6 equinism (4 needed an Achilles tendon lengthening), 12 valgus
      deviations in which 9 were realigned using OF-Garches fixator without
      reoperation, 1 serious depression occurred in a bilateral lengthening.
      Consolidation was achieved without complication in 52 cases. Complications were:
      1 refracture (fourth lengthening of the same tibia), 1 delayed union, 1 non
      union, 2 late deviations. DISCUSSION: Rate of nervous and joint complications is
      close to that of other series. However, a high osteotomy decreases the
      consequences on the foot without increasing knee contracture in flexion. The
      ability to realign during the elongation period appears to be a prevention of
      valgus deformity compared to Wagner's technique. The authors's distractor is
      better tolerated than Ilizarov's. Problems with consolidation are rare, less than
      9 per cent of the cases. CONCLUSION: A modular distractor improves the results of
      tibial lengthening; realignment is possible before, during or after the
      elongation. OF-Orthofix is easy to apply and well-tolerated by the patient,
      especially in bilateral lengthenings. Performing a high osteotomy, the callus is
      thick and the consolidation is quickly achieved and safe. A well-thought
      dynamization using Orthofix Dyna-Ring decreases the treatment time which is 35
      days per centimeter in average.

PMID- 7784650
TI  - [Neuro-aggressive dorsal vertebral hemangioma and vertebrectomy. Apropos of 2
      cases. Review of the literature].
AB  - PURPOSE OF STUDY: Vertebral hemangioma is a benign and relatively frequent
      lesion. It is rarely associated with medullary compression. Two cases of
      vertebral hemangioma with progressive neurologic deficit are presented. METHODS
      AND RESULTS: Successful treatment was accomplished using pre-operative
      embolization and vertebrectomy. The tumor was resected by an antero-lateral
      transthoracic and posterior approach. DISCUSSION: The technique of operative
      management and complications are discussed. Based on these two patients and a
      review of the literature, the authors recommend that management of patients with
      progressive neurological deficit should include pre-operative angiography and
      embolization, decompressive surgery with the approach determined by the degree of
      vertebral involvement and site of spinal compression.

PMID- 7784651
TI  - [Necrotizing fasciitis of the foot. An unknown surgical emergency. Apropos of a
      case].
AB  - INTRODUCTION: The purpose of this study was to review the literature concerning
      Necrotizing Fasciitis (N.F.) and to discuss a typical case where late diagnosis
      led to severe consequences. MATERIAL AND METHODS: A young male patient with no
      pertinent medical history, progressively developed a large swelling of his foot
      and severe pain 3-4 days following a simple contusion. The absence of an entry
      site lead to local incision without microbiological study. The patient developed
      blistering on the leg, then septic shock necessitating amputation. DISCUSSION:
      N.F. is an infectious necrosis of the sub-cutaneous tissue appearing frequently
      in surgical or post traumatic contexts. Streptococcal origin is classical but
      multibacterial anaerobic infection is more and more frequently observed. An entry
      site is not always found while the affected site becomes red, hot and painful.
      Evolution is extremely rapid with the appearance of blisters and cutaneous
      necrotic sites and a severe alteration in the general condition of the patient.
      The extent of sub-cutaneous necrosis is larger than the affected area of skin.
      N.F. is a surgical emergency. Treatment consists of complete debridement,
      sometimes very extensive and mutilating. High dose intra-venous antibiotic
      therapy is necessary while the benefits of hyperbaric therapy are discussed.
      Because of the lack of specific clinical signs, diagnosis is difficult and is
      often made too late. The rapidity of the evolution shows that vital and
      functional prognosis is better with early diagnosis and treatment even for
      patients without associated pathology. The rate of mortality is approximately 50
      per cent. CONCLUSION: Better information of practitioners allowing a rapid
      clinical diagnosis could improve the prognosis which is still life-threatening in
      1994.

PMID- 7784652
TI  - [The present and future of transplants in Spain].

PMID- 7784653
TI  - [The liver transplant program of the Hospital General Universitario Gregorio
      Maranon: an analysis of the first 100 patients].
AB  - During a 3-year period between 1990 and 1993, 100 patients received orthotopic
      liver transplantation at the "Gregorio Maranon" University General Hospital. The
      mean age of the patients was relatively high (46.9 +/- 10 years), with an
      important number of cirrhotic patients (91%). The rate of primary liver failure
      was relatively low (4.5% of transplantations) although 12 cases with more than 55
      years were included in the present series. Eleven retransplantations were
      performed, 8 for early failure of the graft and 3 for chronic failure.
      Postoperative complications of the graft were vascular in 9 cases, biliary in 17
      cases, and acute rejection (cellular) in 70 patients, although only 50 of these
      patients required treatment with steroid boluses. Infections were diagnosed in 60
      cases with 80% of major infections, 6 of them caused by Aspergillus fumigatus
      that were lethal in all the cases. Postoperative survival was 82%, 72%, 69% and
      69% at 1 month, 6 months, 1 year and 2 years respectively.

PMID- 7784654
TI  - [A decrease in the basal levels of serum pepsinogen I after H. pylori
      eradication].
AB  - Hyperpepsinogenaemia has long been considered an important factor in the
      pathophysiology of duodenal ulcer. Moreover, H. pylori infection has been
      reported in virtually all duodenal ulcers. OBJECTIVE. To demonstrate the
      influence of H. pylori eradication on basal pepsinogen I levels in patients with
      duodenal ulcer. METHODS. 86 patients with endoscopically proven duodenal ulcer
      were prospectively studied. Different therapeutic regimens were used:
      Amoxycillin/clavulanate plus omeprazole or ranitidine, triple therapy, omeprazole
      and ranitidine. At diagnostic endoscopy and after therapy, three biopsy samples
      were taken from different levels and analyzed by microbiological and histological
      methods; also, basal pepsinogen I levels were measured. RESULTS. H pylori
      eradication was associated with a significant histological improvement (p <
      0.001), both in gastric antrum and corpus. In patients where H. pylori was
      eradicated pepsinogen I levels decreased from 107.6 +/- 31 ng/ml to 79.7 +/- 32
      ng/ml after therapy (p < 0.001); however, when eradication was not achieved
      differences were not significant. CONCLUSION. H pylori eradication in patients
      with duodenal ulcer was associated with a significant decrease in basal
      pepsinogen I levels. The verification of such a decrease could represent a useful
      non-invasive method to monitor the efficiency of therapy, both in H. pylori
      eradication and in the resolution of the associated gastritis. This procedure is
      also associated with early results and a low cost.

PMID- 7784655
TI  - [H. pylori infection at the duodenal bulb in different endoscopic diagnoses].
AB  - Biopsy samples obtained by endoscopy to diagnose infection by H. pylori usually
      come from the antral region. Nevertheless, there are few reports documenting the
      prevalence of infection at duodenal level. OBJECTIVE. To investigate the
      prevalence of H. pylori infection in duodenal bulb in different endoscopic
      diagnosis. METHODS. 331 patients with the following endoscopic diagnosis were
      studied: normal appearance (n = 55), gastritis (87), gastric ulcer (49), duodenal
      ulcer (120), and duodenitis (20). At endoscopy, different samples from duodenal
      bulb were obtained (apart from gastric fundus, body and antrum), which were
      processed for microbiology (Gram stain and culture) and histology (hematoxilin
      eosin). RESULTS. Patients with duodenal ulcer or duodenitis had the highest H.
      pylori infection rate at duodenal bulb (47.7% and 65%, respectively). Differences
      were significant when compared with normal appearance (14.5%; p < 0.001) and
      gastritis (25%; p < 0.05). In all patients with H. pylori at duodenal bulb this
      organism was also detected at antral region. CONCLUSIONS. 1) The highest
      prevalence rates for H. pylori infection in duodenal bulb were found in patients
      with duodenal ulcer or duodenitis. 2) Diagnosis of H. pylori infection should not
      be based on the duodenal bulb samples alone, as this sample yields high false
      negative results.

PMID- 7784657
TI  - [The SAPHO syndrome or psoriatic arthritis: a complicated differential diagnosis.
      Apropos 3 cases].
AB  - SAPHO syndrome is characterized by osteoarticular involvement of ventral chest
      wall in the form of sternocostoclavicular osteoarthritis and hyperostosis and
      skin changes such as palmoplantar pustulosis and acne. Occasionally, psoriatic
      lesions and sacroiliitis are observed. However, despite the higher frequency of
      psoriasis in this syndrome, its inclusion in psoriatic arthropathy spectrum is
      not clearly established. The authors report three cases of SAPHO syndrome in
      psoriatic patients commenting on the difficulty in differentiating this entity
      from psoriatic arthritis as well as its relationship with seronegative
      spondyloarthropathies. This disease has been described mainly in Japan and only a
      few cases of this disease have been reported in the European or American
      literature.

PMID- 7784656
TI  - [Guidelines for the dietetic treatment of patients with anorexia nervosa based on
      an assessment of their nutritional status].
AB  - The evaluation of the nutritional status of patients with anorexia nervosa is of
      great utility when establishing guidelines for specific and appropriate dietary
      programs to face nutritional deficiencies and thus favoring their recovery. The
      nutritional status of patients was evaluated by means of anthropometric,
      biochemical, and dietetic parameters in a group of 78 anorexics who followed a
      psychiatric and nutritional therapy, 57 in an ambulatory basis and 21 as in
      patients. Anthropometric parameters (weight and body mass index) showed a severe
      depletion of the nutritional status, particularly in in-patients. Only 25% of
      patients had a body mass index higher than 18 and 5% had values within normal
      ranges. While biochemical indexes (hemoglobin, hematocrit, red blood cells, mean
      corpuscular volume, total proteins and vitamins: thiamine, riboflavin, B6,
      ascorbic acid, alpha-tocopherol, retinol and beta-carotene) were within normal
      ranges in most cases, there were variable percentages of patients with marginal
      values and clearly deficient for group B vitamins: thiamine (79 +/- 11 U/l; P25 =
      70 U/l), riboflavin (884 +/- 160 U/l; P5 = 640 U/l) and B6 (309 +/- 131 U/l; P25
      = 227 U/l). The study of the diet showed a marked lack of energy supply (only 25%
      of patients had their needs satisfied (P75 = 101%) and minerals (iron, magnesium,
      and zinc). Intake of proteins and vitamins was, in general, satisfactory.
      Critical points to be considered in refeeding are energy and mineral
      deficiencies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784658
TI  - [Cervical spondylosis: a review of up-dated concepts].

PMID- 7784659
TI  - [The physiopathology of duodenal ulcer: an attempt at a link between "classical"
      knowledge and Helicobacter pylori infection].

PMID- 7784660
TI  - [Practical toxicologic mycology for physicians. Independent synonyms].

PMID- 7784661
TI  - [Painful neuropathy].

PMID- 7784662
TI  - [A young woman with asthenia and electrocardiographic changes].

PMID- 7784663
TI  - [Syncope and a heart murmur in a 37-year-old woman].

PMID- 7784664
TI  - [A 51-year-old woman with hypothyroidism, hypogonadism and an acute picture of
      abdominal pain, diarrhea, vomiting, fever and hypotension].

PMID- 7784665
TI  - [Cardiorespiratory arrest as the first manifestation of hypothyroidism].

PMID- 7784666
TI  - [Bacteremic pneumonia due to Moraxella catarrhalis in an immunosuppressed
      patient].

PMID- 7784667
TI  - [Laryngeal tuberculosis. A report of 3 cases].

PMID- 7784669
TI  - [Epidemiological research on handicaps in children].

PMID- 7784668
TI  - [Monoclonal gammopathy and anti-HCV: a mixed cryoglobulinemia?].

PMID- 7784670
TI  - [Comparative analysis of the costs of cytogenetic techniques and molecular
      biology techniques in the diagnosis of fragile X disease].
AB  - Mental retardation is sometimes due to chromosomal abnormalities. Most frequent
      illnesses are Down syndrome and Fragile X syndrome. Using a cost analysis, we try
      to see what diagnosis method is the most relevant to find chromosomic causes for
      mental retardation in an institutionalized male population. Two techniques are
      compared: cytogenetic technique and molecular biology technique. Four diagnostic
      strategies are identified. They all have the same effectiveness, but, costs vary.
      Results depend on prevalence rates in the epidemiologic literature on Fragile X
      syndrome and other chromosomic abnormalities. The least-cost diagnostic strategy
      is molecular biology then constitutional karyotype in case of a negative result.
      This strategy costs about 600 FF1991 less compared with Fragile X karyotype and
      about 120 FF1991 less than when molecular biology is done in second, for fixed
      prevalence rates (i.e. Fragile X prevalence rate between 4.5 and 10% and other
      abnormalities between 2.2 and 25%). Fragile X karyotype strategy has the highest
      cost whatever the prevalence rates. Those results are discussed when introducing
      female population and delay to test results for prenatal diagnosis.

PMID- 7784671
TI  - [Risk factors in prematurity and intrauterine growth retardation in Burkina
      Faso].
AB  - A case-control study to investigate determinants of preterm delivery and
      intrauterine growth retardation (IUGR) in Bobo-Dioulasso, Burkina Faso, was
      conducted between December 1991 and November 1992. A total of 581 cases were
      recruited, 281 preterm infants with birthweight < 2500 g and 300 term infants
      with birthweight < 2500 g. 578 infants born at term with birthweights of 2500 g
      or more were recruited as controls. Logistic regression analyses identified three
      factors linked independently to both preterm delivery and IUGR: maternal illness
      during the pregnancy, nulliparity and failure to attend three antenatal
      consultations. In addition, primiparity and a maternal weight < 50 kg were
      associated with an increased risk of preterm delivery. Other factors associated
      with increased risk of IUGR were maternal height less than or equal to 155 cm,
      mid-upper arm circumference < 24 cm, and female sex of the infant. Improvements
      in the pre-pregnancy weight of women and in antenatal care focused on nulli- and
      primiparous women might in this population, reduce substantially the incidence of
      preterm delivery and IUGR.

PMID- 7784672
TI  - Prevalence of non-insulin dependent diabetes as perceived by general
      practitioners in France.
AB  - A representative, random sample of French general practitioners, reported the
      number of diabetic patients they treated in their practices. The resulting NIDDM
      prevalence rate for France was 1.71% (SE +/- 0.03), compatible with the rates
      found in other studies. Prevalence rates for NIDDM were also calculated by region
      and a multivariate covariance model was used to correlate the prevalence with
      known risk factors. The three significant factors were: the quantity of wine
      consumed, the female/male sex ratio of people over 45 years of age, both
      positively correlated, and the consumption of animal fats, which was negatively
      correlated with NIDDM prevalence.

PMID- 7784674
TI  - [Comparison of 3 quality of life instruments in the longitudinal study of
      rheumatoid arthritis].
AB  - Quality of life measures take into account the patient's perception of health.
      Many generic or specific instruments are available. The psychometric properties
      of such measures should allow for adequately testing the hypothesis of an
      investigation. We studied the properties of three quality of life measures: the
      Health Assessment Questionnaire (HAQ) specific for rheumatic diseases, the
      Nottingham Health Profile (NHP)--a generic measure--and the General Health
      Questionnaire (GHQ) which measures psychological dimensions. They were applied in
      a one year cohort study of 111 French rheumatoid arthritis patients set up for
      determining prognosis factors of quality of life. Criterion validity was
      established on high correlation between Ritchie index and physical dimensions (r
      = 0.29 to 0.58, p < 0.01). Internal consistency was good with Cronbach's alpha
      coefficients over 0.8 for all dimensions. Reproducibility was studied for
      physical dimensions with Intra-class Correlation Coefficient (ICC) for patients
      clinically unchanged. It was excellent for the HAQ (ICC = 0.89), good for the NHP
      (ICC = 0.57 to 0.73) but weak for the GHQ (ICC = 0.13 for somatic dimension).
      After one year follow-up, a significant change in quality of life could only be
      evidenced by the HAQ (Standardized Response Mean = 0.4, p < 0.05) in patients
      with clinical significant change. So among the three instruments, the HAQ should
      be preferred for longitudinal studies, possibly supplemented with a generic
      instrument that investigates more dimensions of quality of life.

PMID- 7784673
TI  - Misuse of pressurized metered dose inhalers by asthmatic patients treated in
      French private practice.
AB  - Although metered dose inhalers (MDIs) are widely used to treat asthma, clinical
      studies suggest that misuse is frequent. We studied the frequency of, and factors
      related to, misuse of MDIs in asthmatic patients of French private practice. 264
      chest specialists or general practitioners completed questionnaires including
      characteristics of patients and asthma, technique in using inhalers and previous
      instruction, for three consecutive asthmatics aged > 6 years and currently using
      MDIs: 668 adults (mean age 47.8 years +/- 18.5, 51.8% males) and 100 children
      (mean age 11.5 years +/- 2.1, 72.0% males) were included. Adequate technique
      (deep inspiration synchronized with inhaler activation, followed by holding
      breath for 5 seconds) was used by 33.2% of adults and 26.0% of children; optimal
      technique (same, plus shaking the inhaler before use and activating it only once)
      was used by 22.1% of adults and 20.0% of children. The main factor related to
      misuse of MDIs was absence of previous instruction. However only 26.5% of
      instructed adults and 22.1% of instructed children used the optimal technique.
      Misuse of MDIs is a public health problem and instruction is unlikely to solve
      it. The use of different types of devices, like dry powder breath-actuated
      inhalers should be encouraged.

PMID- 7784675
TI  - [Relationship between perceived health status and career choice in a sample of
      wage-earners].
AB  - Many factors were related with subjective health status (SHS), but few studies
      have focused on identifying some intrinsic personal factors like the choice of
      job and perceived working situations. The present paper examines the
      relationships among such factors in a large French sample. Data were collected
      from 21,378 subjects who were randomly selected from the lists of male and female
      wage earners who were followed up by 380 occupational physicians and who were
      born in 1938, 1943, 1948 or 1953. SHS was evaluated using the French version of
      the Nottingham Health Profile (NHP). Socio-demographic and job characteristics
      were assessed by means of closed questions during the annual medical examination.
      Results showed that low subjective health status was related to sex, age and
      perceived working situation: for each of the six areas of the NHP (pain, physical
      mobility, energy, sleep, social isolation, emotional reactions) there was a lower
      SHS for women and a decrease with age for both sexes. The poorer the perceived
      working situations the worse was the SHS. Using general linear models it appeared
      that independently of these factors and the socio-economical category
      dichotomized in upper classes versus lower classes, those who had claimed to have
      not chosen their job had a lower SHS, whatever the area of SHS. Awaiting the
      second survey in 1995, it is difficult to explain these results from this cross
      sectional analysis: is the choice of job a possible risk factor or an artefact
      due to some unmeasured confounding factors like motivation or job satisfaction.

PMID- 7784676
TI  - [Levels of low birth-weight in Europe: registration problems and effects of
      medical interventions].
AB  - The rate of low birthweight births, percentage of live births weighing less than
      2500 grams is one of the perinatal health indicators recommended by the World
      Health Organisation. A review of the literature has revealed numerous problems
      related to this indicator. Some countries, including France and the Netherlands
      do not collect birthweight data. Elsewhere, there are more than 10% "unknown
      birthweight". The poorest registration is for birthweights below 1000 grams.
      Exclusion of babies who were registered as stillborn, when in fact they died
      shortly after birth can cause underregistration of low birthweights. Conversely,
      inclusion of true stillbirths will bring on an overestimation of low birthweight
      rate. Some countries have too few births to deliver accurate rates. Rates of
      medical interventions, such as infertility treatment and elective induction
      should be taken into account when analyzing differences between countries.
      Improvement in quality of registration and caution in the use of this indicator
      are warranted.

PMID- 7784677
TI  - Daily smoking among adolescents in the European Community.

PMID- 7784679
TI  - [Evaluation of a self-assessment questionnaire with optical reader in a cohort
      study].

PMID- 7784678
TI  - [Surveillance of HIV infection in children in Europe].

PMID- 7784680
TI  - [HIV-1 infection: how are long-term asymptomatic subjects characterized?].

PMID- 7784681
TI  - [Breast cancer between 2 screenings: is a 3-year interval too long?].

PMID- 7784682
TI  - [Obstetric analgesia. Still controversial?].

PMID- 7784683
TI  - [Comparative study of single-dose intradural anesthesia and continuous intradural
      anesthesia with or without fentanyl].
AB  - OBJECTIVE: To compare the hemodynamic effects, level of anesthetic blockade and
      advantages of single-dose versus continuous intrathecal anesthesia with
      hyperbaric bupivacaine with and without fentanyl. PATIENTS AND METHOD:
      Prospective study in 45 patients under 65 who were scheduled for elective surgery
      of the lower abdomen, randomly divided into 3 groups. Group 1 and 2 received
      continuous intrathecal anesthesia with 10 mg hyperbaric bupivacaine; group 2 also
      received 25 mcg fentanyl. Patients in group 3 were given a single intrathecal
      dose of 15 mg hyperbaric bupivacaine. Mean arterial pressure and heart rate were
      recorded at baseline and 10, 20 and 30 minutes after the start of anesthesia. The
      level of block achieved was recorded after 10, 30 and 60 minutes. Hemodynamic
      changes, differences in blockade and side effects were analyzed. RESULTS:
      Hemodynamic changes were greater in group 2 (fentanyl) than in groups 1 and 3 (p
      < 0.05), with group 3 showing the greatest degree of hemodynamic stability. Level
      of blockade was always higher in group 2, with significant differences at 30 min
      (p < 0.05). Seven and 5 reinjections by catheter were necessary in groups 1 and
      2, respectively. Two patients in group 3 required general anesthesia when
      blockade was inadequate. Apart from pruritus in group 2 (40%), no side effects
      due to anesthesia were observed. CONCLUSIONS: A single dose intrathecal
      anesthesia, produces less hemodynamic changes than a continuous intrathecal
      block. Nevertheless, continuous intrathecal block, allows the maintenance of the
      block as long as required. The association of fentanyl enhances the hemodynamic
      changes with no other beneficial effects.

PMID- 7784685
TI  - [Analgesia of postoperative pain in ambulatory surgery].
AB  - Although the role of outpatient surgery has become increasingly important in the
      campaign to reduce waiting lists and health care costs, careful control and
      treatment of postoperative pain too often receives slight attention. Pain control
      after surgery must produce high quality analgesia without lengthening the
      hospital stay or increasing the risk of complications. The risk of side effects
      must be low, the safety margin wide and administration simple. Anesthesiologists
      must therefore take preventive measures as well as apply techniques during and
      after surgery that diminish the intensity of pain and the incidence of nausea or
      vomiting. Drugs that act in the short term and have few side effects, regional
      anesthesia (depending on type of operation), non-opioid analgesics and balanced
      analgesia seem to give good quality control of pain after outpatient surgery.

PMID- 7784684
TI  - [Published books on pain and its treatment in Spain. Analysis with the ISBN
      database].
AB  - INTRODUCTION: Although analyses have been done on the publishing of scientific
      articles on pain in Spanish, book publications in the field have not been
      studied. This article fills that gap. MATERIAL AND METHODS: A bibliography of
      books with pain approached from a medical standpoint was compiled from ISBN CD
      ROM database (updated for 1993). Books going into more than one edition were
      considered single titles. Multi-volume collections were considered single books.
      We analyzed type of book, subject, ISBN classification, year, language (of
      publication and original), publisher and place of publication. RESULTS: Two
      hundred books were studied. Over 60% had been published within the previous 10
      years. The year that showed the most books published was 1990 (19) followed by
      1989 (16) and 1988 (16). Output has been rising steadily. One hundred ninety
      eight books were published in Spanish and 2 in Catalan. The original language was
      Spanish in 114 cases, English in 51 cases, French in 21 and German in 7. By ISBN
      classification, most (146) covered pathology, disease and medical/therapeutic
      clinical practice. By topic, 51 books were general, 41 treated lumbalgia,
      sciatica or back pain and 35 covered headaches in general or migraine. Most of
      the books were issued by trade publishers. The cities most often involved were
      Barcelona and Madrid. CONCLUSIONS: An increased number of books about pain are
      being published in Spain, coinciding with a rise in the publication of scientific
      articles on the subject.

PMID- 7784686
TI  - [Obstetric anesthesia-analgesia in Spain. A review of its historic evolution
      during the second half of the past century].
AB  - To examine the historical development of obstetric anesthesia in Spain during the
      second half of the nineteenth century. Research was based on in-depth analysis of
      accounts of anesthesia during the period covered, mainly from original sources,
      using established methods for studying the history of medicine. We collected a
      great deal of documentary evidence, much of it unpublished and of clear
      historical value for tracing the history of obstetric anesthesia in Spain and
      identifying the main factors that have influenced it. We emphasize that
      controversy limited to a large extent the use of anesthesia in obstetrics. The
      controversy seems to have been fed by physicians' uneasiness with anesthesia as
      well as by certain prejudices of a religious or moral nature that are deeply
      rooted in Spanish society.

PMID- 7784687
TI  - [Anesthetic management of labor in a pregnant woman with myocardial infarction].
AB  - Given the rarity of acute myocardial infarction (AMI) in parturients, we report
      the case of a 29-years-old woman who suffered 2 AMIs related to her 2
      pregnancies. In our patient, the anesthetic technique chosen for the second
      birth, which was vaginal, was epidural analgesia with invasive hemodynamic
      monitoring. No complications occurred during the birth or the perinatal period.

PMID- 7784688
TI  - [Placenta praevia accreta and obstetric hysterectomy].
AB  - We present the case of a 38-years-old tertipara at full term with a diagnosis by
      ultrasound of placenta previa who underwent elective cesarean under spinal
      anesthesia. After a difficult birth, anomalous adhesion of the placenta prevented
      its removal and caused massive hemorrhage of the placental bed and hypovolemic
      shock. Blood volume was restored and emergency hysterectomy under general
      anesthesia was effected, as bleeding and hemodynamic state were brought under
      control. Abnormal heart rhythm appearing after the operation responded to
      treatment; postoperative recovery was unremarkable. Placenta accreta is a rare
      complication of placenta previa. Given that massive obstetric hemorrhage is
      associated with significant mortality and morbidity, both maternal and fetal, the
      anesthesiologist must be aware of potential problems that might arise in cases of
      placental accreta so that readiness can keep risk to a minimum.

PMID- 7784689
TI  - [HELLP syndrome and its complications during preeclampsia-eclampsia].
AB  - HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) is a rare
      complication that can appear during and/or after pregnancy in patients with
      preeclampsia or eclampsia. As the syndrome can have serious complications, early
      diagnosis is important for management. We describe a patient with HELLP syndrome
      who developed one of its unusual but severe complications: ruptured liver
      capsule.

PMID- 7784690
TI  - [Anuria in the third trimester of pregnancy in a patient with renal transplant].
AB  - We present a pregnant patient with a transplanted kidney experiencing chronic
      rejection, with chronic kidney failure and arterial hypertension. During the
      third trimester the patient's kidney function deteriorated somewhat and
      hypertension worsened. In the thirty-second week of pregnancy uterine activity
      increased, fetal movement decreased and oliguria progressed rapidly to anuria,
      leading to an emergency cesarean section. Surgery was performed under epidural
      anesthesia; after removal of the fetus diuresis immediately began and was
      maintained. Both mother and infant recovered, but after three months the patient
      entered a hemodialysis program due to terminal kidney failure. The risk of acute
      kidney failure is greater in the parturient who has been the recipient of a
      transplanted kidney because of the functional overload that pregnancy involves,
      the possible exacerbation of acute or chronic rejection, and the higher incidence
      of pyelonephritis and preeclampsia. The extraperitoneal location of the
      transplanted organ in the iliac fossa may cause obstructive anuria. Our patient's
      recovery of diuresis immediately after removal of the fetus suggests that the
      excretory channel coming from the kidney was compressed by the uterus.

PMID- 7784691
TI  - [Anesthetic management of abdominal pregnancy and postoperative complications].

PMID- 7784692
TI  - [Intraoperative rupture of subclavian aneurysm caused by self intra-arterial
      injections in a drug addict].

PMID- 7784693
TI  - [Diagnostic value of microalbuminuria and the calcium/creatinine ratio in the
      early detection of preeclampsia].
AB  - We have evaluated the biochemical and clinical parameters for early detection of
      their alterations in pregnant women with late preeclampsia. Eighty nine patients
      between 24 and 32 gestation weeks were studied. Fifteen of them (18%) developed
      arterial hypertension (mean 141.5 +/- 3mmHg). The perinatal results, gestational
      age at delivery, birth weight and Apgar score of the newborns were not
      significantly different among the groups that were evaluated. The
      microalbuminuria was analyzed through radioimmunoanalysis and reactive strips for
      the immunochemical semiquantitative determination. The calciura was analyzed
      using the compleximetric method and the urinary creatine using the colorimetric
      method of Jaffe. No significative differences were found among the results of
      each evaluated method. The RIA showed greater sensibility, greater specificity
      and greater positive or negative predictive value with respect to other methods,
      but the differences were not wide enough to consider it the method of choice. In
      the group of patients (n = 15) who developed arterial hypertension, all the
      biochemical methods showed a normality higher than 80%. We conclude that none of
      these methods used alone is useful for the early prediction of the appearance of
      preeclampsia.

PMID- 7784694
TI  - [Angiolymphoid hyperplasia: clinico-pathological considerations].
AB  - Two cases of angiolymphoid hyperplasia with eosinophilia or Kimura's disease are
      presented. A nodular and papuoid pattern of presentation was observed. The first
      one is the histologic expression of the vascular and cellular components which
      were found in the subcutaneous fat whereas the latter was in the dermis. Clinical
      and pathological considerations were made to differentiate both illnesses.
      However, due to the overlapping of certain criteria it is considered that we are
      dealing with the same disease at different phases.

PMID- 7784695
TI  - [PAS-positive T-lymphocytes in chagasic cardiomyoneuropathy. I. Immunopathologic
      mechanisms in Chagas].

PMID- 7784696
TI  - [An experience with teaching training at the School of Medical Sciences of the
      National University of Cordoba].

PMID- 7784697
TI  - [Quantitative study of encephalic components in 3 tinamid species, with an
      ecoethological approach (birds: Tinamidae)].
AB  - The encephalon of three tinamids: Eudromia elegans, Nothura maculosa, and
      Rhynchotus rufescens are quantitatively analyzed. Both relative volumes and
      cerebral indexes are calculated for eleven encephalic components. Results are
      discussed from an eco-etiological approach. The relative size of encephalic
      components in Eudromia, Rhynchotus, and Nothura indicate a close relationship
      among brain components and some behavioral patterns and the environment. Marked
      differences in the cerebral organization of these tinamid genera are not evident.
      A greater development of the wulst and low values of olfactory bulbs suggest that
      Eudromia and Rhynchotus are progressive species. Nothura is considered primitive.

PMID- 7784698
TI  - [Treatment of non tuberculous mycobacteriosis with quinolones].
AB  - Two cases of Non-tuberculous Mycobacterium from the MAI group and another by
      Mycobacterium Fortuitum are presented. None of them with extrapulmonary
      manifestations. They were treated with a scheme of four drugs among which the
      Quinolone was included. The patients were adults with pulmonary processes
      clinically and radiologically similar to pulmonary Tuberculosis (TBC); non
      tuberculous mycobacteria were isolated from the sputum. It has been shown "in
      vitro" that the nontuberculous mycobacteria are sensitive to the
      Fluoroquinolones. Thus, Ciprofloxacine or Ofloxacine were used, taking into
      consideration the initial polirresistence to the habitual tuberculostatics.
      Consequently, these patients were treated with schemes which included these new
      Quinolones, getting good clinical responsiveness and negativization of the sputum
      in all the cases.

PMID- 7784699
TI  - Effect of prior portosystemic shunt on early hepatic hemodynamics and sinusoids
      following 84% hepatectomy in dogs.
AB  - The effects of a prior portosystemic shunt (PSS) on the hepatic hemodynamics and
      sinusoids shortly after an 84% hepatectomy (Hx) were investigated in dogs.
      Fifteen mongrel dogs were divided into three groups, a 70% Hx group (n = 5), an
      84% Hx group (n = 5) and an 84% Hx+PSS group (n = 5). In the last group, a shunt
      was inserted between the splenic and femoral veins prior to the hepatectomy. The
      systemic and hepatic hemodynamics were measured, before and 180 min after the
      hepatectomy, and the remaining liver tissue was then examined
      immunohistochemically by light microscopy using the thrombomodulin (TM) staining
      method. The postoperative portal vein pressure and the vascular resistance were
      significantly lower in the PSS group than in the 84% non-PSS group. The total
      postoperative hepatic blood flow was higher in the 84% non-PSS group than in the
      other two groups. Immunohistochemical observation after TM staining indicated
      that the sinusoidal endothelial cells in the 84% non-PSS group were markedly
      damaged 3 h after surgery. We conclude that a prior PSS improves the hepatic
      hemodynamics and is beneficial to the sinusoids within the first few hours of an
      84% hepatectomy in dogs.

PMID- 7784700
TI  - Semi-quantitative analysis of cytokine gene expression in blood and cerebrospinal
      fluid cells by reverse transcriptase polymerase chain reaction.
AB  - An easy, reproducible and semi-quantitative, non-radioactive method for the
      analysis of mRNA expression for various cytokines, (i.e., Interleukin (IL)-1
      beta, IL-4, IL-6, tumor necrosis factor (TNF)-alpha, lymphotoxin (LT),
      transforming growth factor (TGF)-beta, interferon (IFN)-gamma and endothelin-1
      (ET-1)) in cells from cerebrospinal fluid (CSF) and peripheral blood mononuclear
      cells (PBMC) has been established. By means of polymerase chain reaction primers
      that cover a splice junction, amplification of contaminating DNA was omitted.
      Densitometric scanning of ethidium bromide-stained agarose gels proved to be very
      sensitive for semiquantitative analysis of PCR products. Serial tenfold dilutions
      of cDNA revealed a log-linear regression from 10(6) to 10(2) cells under optimal
      cycle conditions. The intra- and inter-assay variability of the method was below
      10%. With this assay, the cytokine expression pattern of as few as 10(4)
      mononuclear cells from blood or CSF was determined. This method made it possible
      to detect differences in the cytokine gene expression pattern of mononuclear
      cells from patients with different neurological diseases. CSF cells from 43
      patients with various neurological diseases were analyzed. TNF-alpha, LT, and IL
      1 mRNA were prominent in the CSF cells of most patients with bacterial
      meningitis. TNF-alpha, LT, IFN-gamma and IL-6 mRNAs were detected in patients
      with active multiple sclerosis, whereas TNF-alpha, IL-6, and endothelin-1 mRNA
      expression was found frequently in patients with HIV encephalitis. Pro
      inflammatory cytokines were rarely detected in CSF cells from patients with non
      inflammatory diseases of the central nervous system. In blood mononuclear cells
      from patients with multiple sclerosis, TNF-alpha mRNA expression was associated
      with disease activity. The sensitivity, specificity, velocity and reliability of
      this assay considerably facilitates the analysis of cytokine production in
      mononuclear cells even in conditions where only a limited number of cells is
      available for analysis.

PMID- 7784701
TI  - Experimental evaluation of peritoneum and pericardium as dural substitutes.
AB  - Although many substances have been tested in the search for an ideal dural
      substitute, an entirely satisfactory material has still not been found. The
      authors report an experimental study involving the closure of dural defects in
      rabbits with biomaterials developed from pig peritoneum and pericardium.
      Macroscopic and histologic examination, performed over a period between 15 and 45
      days after implantation showed slight or no adhesion between the graft material
      and the cortex. No infection, CSF leakage, fistula or toxicity was noticed. The
      results demonstrated that these biomaterials could be used as satisfactory dural
      substitutes.

PMID- 7784702
TI  - Differing kinase activity of the c-yes and c-src gene proteins in TPA-induced
      megakaryocytic differentiation of T-33 and K562 cell lines.
AB  - We examined the protein kinase (PK) activity of the c-yes and c-src gene proteins
      (c-YES, c-SRC) at an early phase of 12-O-tetradecanoyl phorbol-13-acetate (TPA)
      induced megakaryocytic differentiation of T-33 and K562 cells with use of
      immunoprecipitation and in vitro kinase assay. We found that c-SRC PK activity of
      TPA-treated T-33 and K562 cell lines had been enhanced compared with the
      untreated ones, but in contrast, no enhancement of c-YES PK activity by the TPA
      treatment was observed in these cell lines. We also examined PK activity in TPA
      induced monocytic differentiation of U937 monoblastic cells that exhibited no
      megakaryocytic markers and found that both the c-YES and c-SRC PK activity was
      enhanced by the TPA treatment. Our data suggest that c-YES and c-SRC play
      different and unique roles in TPA-induced megakaryocytic differentiation in T-33
      and K562 cells.

PMID- 7784703
TI  - Delayed gastric emptying in conscious male rats following chronic estrogen and
      progesterone treatment.
AB  - Several clinical observations and animal experiments have led to speculation
      concerning the possible effects of pregnancy and pregnancy-associated sex
      steroids on gastrointestinal function. It was reported that estrogen increases
      intestinal contractile activity, while progesterone or the combination of
      estrogen and progesterone decreases it. In order to measure gastric emptying, a
      methylcellulose test meal was given orally into the stomach of conscious rats. In
      progesterone-treated rats, at the dose of 0.2 mg/kg, gastric emptying was not
      significantly different from that of the control, but it was found to be
      significantly delayed at the dose of 10 mg/kg (P < 0.05). Estrogen treatment at
      doses of 20 micrograms/kg and 600 micrograms/kg significantly delayed gastric
      emptying, when compared with controls (P < 0.001). Combined therapy of estrogen
      and progesterone induced a significant delay in gastric emptying rate compared
      with the control group (P < 0.001). In the animals with pseudopregnancy treatment
      (100 micrograms/kg estrogen+ 15 mg/kg progesterone; 7-12 days) the gastric
      emptying rate was significantly different from that of the control (P < 0.05). We
      conclude that both estrogen and progesterone exert inhibitory effects on gastric
      emptying, and this may account for the disturbances in gastrointestinal function
      that pregnant women frequently experience.

PMID- 7784704
TI  - Influence of chronic liver damage on regeneration of the organ in rats.
AB  - To investigate the influence of chronic hepatic damage on liver regeneration, a
      70% hepatectomy was carried out in male BDE rats in which chronic hepatic damage
      had been induced by i.m. injection of 0.1 ml CCl4/100 g b. w. twice a week for 4
      weeks. After resection, we examined adenine nucleotide concentration in the
      remaining liver tissues, also body weight and wet and dry weight of the liver.
      The total adenine nucleotide concentration fell 6 h after resection from 2.89 +/-
      0.22 mumol/g to 2.03 +/- 0.15 mumol/g and then recovered on the 3rd postoperative
      day. However, control animals showed lowest values 3 h after resection, and had
      already begun to recover at 6 h. Energy charges fell 3 h after liver both groups
      to the lowest values, but recovery was slower in the animals with chronic liver
      damage. These observations suggest that in animals with hepatic damage
      regeneration is delayed in the initial post-resection period. However, 5 days
      after resection the wet and dry weights of the liver were completely normalized
      and there was no difference between the two groups, i.e., 5 days after 70% liver
      resection we could not find any delayed regeneration tendency in animals with
      chronic liver damage.

PMID- 7784705
TI  - Pulmonary damage due to paraquat poisoning through skin absorption.
AB  - A case of recovery from acute respiratory insufficiency due to paraquat is
      described. A 57-year-old farmer developed breathlessness, high fever and
      interstitial infiltrates in the upper and middle lung fields few days after
      percutaneous paraquat poisoning with rapid evolution to pulmonary fibrosis. Anti
      inflammatory drugs and antioxidants, were administered to the patient, though
      with a delay, with some improvement; the patient survived despite residual lung
      fibrosis. Paraquat lung, as confirmed by this paper, is not invariably fatal.

PMID- 7784706
TI  - Fatal intrathoracic hemorrhage in a patient with von Recklinghausen's disease.
AB  - Neurofibromatosis can involve the mediastinum. A 44-year-old woman with a
      dumbbell-shaped mediastinal mass developed a large pleural effusion, respiratory
      failure and fatal hemoptysis. Autopsy revealed systemic neurofibromatosis
      involving the mediastinum and pleura. Mediastinal and pleural hemorrhage probably
      occurred as a result of an eroded thoracic artery. Massive hemorrhage in
      mediastinal neurofibromatosis occurs uncommonly but with potentially fatal
      results.

PMID- 7784707
TI  - Pneumonia caused by Listeria monocytogenes.
AB  - Pneumonia due to Listeria monocytogenes is extremely uncommon. We report the case
      of an 87-year-old woman with no underlying immunosuppressive disease who
      presented with listerial pneumonia. Cutaneous anergy and a decrease in total
      lymphocyte count in this elderly woman could predispose her to listerial
      infection.

PMID- 7784708
TI  - Lymphoepithelial cysts in the mediastinum with an opening to the trachea.
AB  - A case of lymphoepithelial cysts (LECs) in the mediastinum, manifested
      radiographically by paratracheal air collection, is reported. Percutaneous
      injection of radiopaque material and indocyanine green into a cyst showed an
      opening to the trachea. During surgical resection, three well-circumscribed cysts
      were isolated. Pathologically the cysts were lined by a ciliated columnar
      epithelium and surrounded by lymphoid tissue with germinal centers. Judging from
      the level of the duct opening onto the airway, these LECs might have derived from
      a remnant of the fourth branchial pouch. To the authors' knowledge, this is the
      first case described.

PMID- 7784709
TI  - Necrotizing bronchitis, angiitis, and amyloidosis associated with chronic Q
      fever.
AB  - The authors report the clinical, radiological and histological findings in a 63
      year-old male patient who developed severe necrotizing bronchitis, necrotizing
      angiitis, and secondary amyloidosis of the right upper love and intermediate
      bronchus. The patient expired due to respiratory insufficiency. At the age of 27
      years, the patient had had radiotherapy of the mediastinum because of suspected
      Hodgkin's disease. Acute pneumonia suggestive of Q-fever infection was diagnosed
      at the age of 48. Progressive restrictive lung disease developed during the last
      decade. Serological evaluation revealed IgM and IgA high titers against Coxiella
      burnetii. IgA, complement and amyloid deposits were detected in the walls of
      small arteries. Bronchial lavage and pleural effusions displayed numerous
      activated T lymphocytes. Analysis of endogenous lectins revealed alterations of
      the pulmonary defense system. The clinical history, histological and
      immunological findings suggest that chronic Q fever may induce remarkable changes
      in the immune system, comparable to autoimmune-reactive diseases.

PMID- 7784710
TI  - Pleural cholesterol in differentiating transudates and exudates. A prospective
      study of 232 cases.
AB  - Two hundred and four patients with pleural effusion were studied to investigate
      the utility of Light's criteria and pleural fluid cholesterol level (pCHOL) in
      the identification of exudative pleural effusion (EPE) and transudative pleural
      effusion (TPE). There were 48 TPE, 56 tumor, 47 tuberculous, 30 metapneumonic and
      23 miscellaneous patients. A value > or = 54 mg/dl for pCHOL and > or = 0.32 for
      the pleura/serum cholesterol ratio (p/sCHOL) showed sensitivity (S) and
      specificity (Sp) of 95.5% and 91.6% for pCHOL, and 97.4% and 91.6% for p/sCHOL,
      respectively. Combined pCHOL and/or p/sCHOL showed a S of 98.7% and Sp of 89.5%.
      Light's criteria achieved a S of 100% and Sp of 64.5%. Combined pCHOL and p/sCHOL
      revealed a similar accuracy to Light's criteria in EPE diagnosis but was found to
      be more exact in TPE diagnosis.

PMID- 7784712
TI  - Hypercapnic ventilation response in patients with lung disease: improved accuracy
      by correcting for ventilation ability.
AB  - The hypercapnic ventilation response (HCVR) is positively correlated with forced
      expired volume in 1 s (FEV1). Therefore, subjects of small stature or patients
      with lung disease have low values for HCVR. However, indexing the HCVR for the
      subject's predicted maximal voluntary ventilation (MVV) results in a corrected
      HCVR (CHCVR) which is not dependent on FEV1 in normal subjects [Respiration
      1993;60:197-202]. We hypothesized that the CHCVR would also be useful in
      assessing chemosensitivity in patients with poor lung function. To obtain the
      predicted MVV, we used the linear regression for FEV1 vs. measured MVV obtained
      from 411 patients with a wide range of FEV1 values (MVV = 31.2 x FEV1 + 11.8, r =
      0.90, p < 0.001). We compared HCVR and CHCVR to the occlusion pressure response
      to hypercapnia (OPRH) in 34 patients with chronic obstructive pulmonary disease
      (COPD) and in 19 patients with low FEV1 due to small stature. All patients had
      been referred for assessment of possible sleep apnea. The results for the two
      groups of patients were similar. For the COPD patients, the HCVR had high values
      for sensitivity (86%) and negative predictive value (94%), but specificity,
      positive predictive value and accuracy were low (59, 35 and 65%, respectively).
      In contrast, CHCVR had high values for all the foregoing (86, 96, 100, 100 and
      97%, respectively). Our results suggest that the CHCVR is useful in assessing
      chemosensitivity in patients who are ventilation-limited.

PMID- 7784711
TI  - Aberrant appearance of lung surfactant protein A in sera of patients with
      idiopathic pulmonary fibrosis and its clinical significance.
AB  - Pulmonary surfactant protein A (SP-A) is known to be a major phospholipid
      associated glycoprotein in pulmonary surfactant, which is specific to the lung.
      In this study, the SP-A concentrations in sera of patients with various lung
      diseases were determined using an enzyme-linked immunosorbent assay. Patients
      with idiopathic pulmonary fibrosis (IPF) and pulmonary alveolar proteinosis (PAP)
      exhibited prominently high concentrations of serum SP-A compared to those of
      other lung diseases and healthy volunteers, although there were significant
      increases in serum SP-A concentrations in patients with pulmonary tuberculosis,
      chronic pulmonary emphysema, diffuse panbronchiolitis and bacterial pneumonia
      compared to those of healthy volunteers. Successive measurement in 2 patients
      with IPF showed that serum SP-A levels reflect the disease activity of IPF. In
      patients with IPF, serum SP-A concentrations were significantly correlated with
      those of serum lactate dehydrogenase, whereas there were no significant
      correlations of serum SP-A concentrations with erythrocyte sedimentation rate,
      arterial oxygen saturation, vital capacity and carbon monoxide diffusing
      capacity. Determination of serum SP-A will contribute to diagnosing IPF and PAP,
      and may reflect the disease activity of IPF.

PMID- 7784714
TI  - Pulmonary infections in bone marrow transplantation: the Hong Kong experience.
AB  - The pattern of pulmonary infections in 59 consecutive bone marrow
      transplantations in Hong Kong was reviewed. Compared with published data from
      other marrow transplant units, we had a lower incidence of cytomegalovirus
      pneumonitis (1.7%) and a higher incidence of mycobacterial infections (5%). The
      latter is probably related to the high background prevalence of tuberculosis in
      the local population. Treatment with antituberculous drugs was effective.

PMID- 7784713
TI  - Preliminary evidence that augmentation therapy diminishes degradation of cross
      linked elastin in alpha-1-antitrypsin-deficient humans.
AB  - It is hypothesized that emphysema develops in some severely alpha 1-antitrypsin
      (AAT)-deficient persons because endogenous elastases are not adequately
      controlled by AAT, and accelerated elastin degradation occurs. It is not known
      whether augmentation therapy with AAT diminishes degradation of lung elastin in
      severely deficient persons with lung disease. Two severely deficient, PiZ
      patients were studied, a 63-year-old never-smoking woman with bronchiectasis and
      a 41-year-old smoking man with emphysema. Urinary desmosine (DES) was determined
      before and after augmentation therapy with AAT, 260 mg/kg/month. Mean +/- SEM
      pretreatment urinary DES was elevated in both patients, 19.7 +/- 0.9 (n = 2) and
      10.8 +/- 0.2 (n = 2) micrograms/g creatinine, respectively, compared to normal
      values of 7.5 +/- 0.3 (n = 22) micrograms/g creatinine. Following augmentation
      therapy, urinary DES values decreased 40 and 36%, respectively, to 11.9 +/- 0.3
      (n = 8) and 6.9 +/- 0.4 (n = 7) microgram/g creatinine (p < 0.05). We conclude
      that monthly AAT augmentation therapy decreased DES excretion in the urine of
      these PiZ patients. We speculate that since there was lung disease in both
      patients, a decrease in degradation of lung elastin is the most likely
      explanation for this observation.

PMID- 7784715
TI  - Circulating gamma delta-T-cell-receptor-positive lymphocytes in sarcoidosis.
AB  - We investigated phenotypic surface markers of peripheral blood lymphocytes
      including expression of gamma delta T cell receptor (TCR gamma delta) in 185
      patients with sarcoidosis and 42 normal subjects. The proportion of TCR gamma
      delta+ lymphocytes in peripheral blood of patients with sarcoidosis (5.5 +/-
      5.4%) was significantly higher than in normal subjects (3.6 +/- 2.2%; p < 0.05).
      A number of patients with sarcoidosis had prominently increased levels of
      circulating TCR gamma delta+ lymphocytes. Successive measurements of circulating
      TCR gamma delta+ lymphocytes demonstrated the persistence of increased levels of
      circulating TCR gamma delta+ lymphocytes. We divided the patients with
      sarcoidosis into two groups, one with high, the other with low TCR gamma delta+
      expression. Compared with the low-value group, the high-value group had
      significantly decreased levels of circulating CD4+ lymphocytes, decreased
      incidence of a positive tuberculin reaction, and higher levels of serum
      angiotensin-converting enzyme and lysozyme, suggesting that these two groups may
      differ in their immunological response and disease activity of sarcoidosis.
      Measurement of TCR gamma delta+ expression in the circulation seems to be useful
      for estimating the disease activity of sarcoidosis.

PMID- 7784716
TI  - Stimulatory effect of 1 alpha,25-dihydroxyvitamin D3 on mouse alveolar macrophage
      tumor necrosis factor-alpha production in vitro: involvement of protein kinase C
      and Ca2+/calmodulin-dependent kinase.
AB  - 1 alpha,25-Dihydroxyvitamin D3 [1 alpha,25(OH)2D3, calcitriol] has been shown to
      modulate the immune function of peripheral monocytes and peritoneal macrophages.
      However, its effect on alveolar macrophage (AM) cytokine secretion has not been
      reported. We therefore investigated the influence of calcitriol on tumor necrosis
      factor (TNF-alpha) production by murine AMs and attempted to elucidate changes in
      the signal transduction system involved in such effects. Calcitriol significantly
      enhanced TNF-alpha secretion by AM stimulated with either lipopolysaccharide
      (LPS; 10 micrograms/ml; p < 0.005) or phorbol 12-myristate 13-acetate (PMA; 100
      ng/ml; p < 0.05) at low doses (between 10(-11) and 10(-9) M). However the protein
      kinase C (PKC) inhibitor, H7 (10 microM), and the Ca2+/calmodulin inhibitor, W7
      (25 microM), reversed such calcitriol effects. Calcitriol increased the total PKC
      activity of AMs. These findings indicate that calcitriol enhances both LPS- and
      PMA-stimulated TNF-alpha secretion through PKC- or Ca2+/calmodulin-dependent
      pathways.

PMID- 7784717
TI  - Effect of three different doses of a slow-release theophylline formulation on
      bronchial response to inhaled methacholine in asthmatic patients.
AB  - This study investigated whether or not a sustained release formulation of
      theophylline (SRT) at different dosages had any effect on bronchial
      hyperresponsiveness as measured by the methacholine challenge. On four separate
      occasions, 16 patients with mild asthma took either placebo or 300, 400, 500 mg
      of SRT twice a day. SRT had a slight bronchodilating effect that was not dose
      related, but produced a dose-related decrease in the bronchial response to
      inhaled methacholine (r = 0.39, p = 0.007). This effect was present after all
      three treatment periods with the active drug when mean +/- SE theophylline serum
      concentrations of 10.3 +/- 0.7, 12.6 +/- 0.9 and 17.1 +/- 1.1 mg/l respectively
      were reached. A highly significant relationship between theophylline serum
      concentration and the degree of protection against methacholine bronchospasm was
      also found (r = 0.45, p = 0.001). It is concluded that oral theophylline does
      reduce bronchial hyperresponsiveness in a dose dependent fashion, this effect
      being present at all the serum concentrations within the normal range.

PMID- 7784718
TI  - Hospital mortality after out-of-hospital cardiac arrest among patients found in
      ventricular fibrillation.
AB  - The aim of this study was to describe factors associated with in-hospital
      mortality among patients being hospitalised after out-of-hospital cardiac arrest
      and who were found in ventricular fibrillation. The study was set in the
      community of Goteborg, Sweden. The subjects consisted of all patients who were
      hospitalised alive after out-of-hospital cardiac arrest, being reached by our
      mobile coronary care unit and who were found in ventricular fibrillation, between
      1981 and 1992. In all, 488 patients fulfilled the inclusion criteria of which 262
      (54%) died during initial hospitalization. In a multivariate analysis including
      age, sex, history of cardiovascular disease, chronic medication prior to arrest
      and circumstances at the time of arrest, the following appeared as independent
      predictors of hospital mortality: (1) interval between collapse and first
      defibrillation (P < 0.001); (2) on chronic medication with diuretics (P < 0.01);
      (3) age (P < 0.01); (4) bystander initiated CPR (P < 0.05); and (5) a history of
      diabetes (P < 0.05). In a multivariate analysis considering various aspects of
      status on admission to hospital, the following were independently associated with
      death: (1) degree of consciousness (P < 0.001) and (2) systolic blood pressure (P
      < 0.05). In conclusion, among patients with out of hospital cardiac arrest found
      in ventricular fibrillation and being hospitalised alive, 54% died in hospital.
      The in-hospital mortality was related to patient characteristics before the
      cardiac arrest as well as to factors at the resuscitation itself.

PMID- 7784719
TI  - Comparison of exertion required to perform standard and active compression
      decompression cardiopulmonary resuscitation.
AB  - OBJECTIVE: Active compression-decompression (ACD) cardiopulmonary resuscitation
      (CPR) utilizes a hand-held suction device with a pressure gauge that enables the
      operator to compress as well as actively decompress the chest. This new CPR
      method improves hemodynamic and ventilatory parameters when compared with
      standard CPR. ACD-CPR is easy to perform but may be more labor intensive. The
      purpose of this study was to quantify and compare the work required to perform
      ACD and standard CPR. METHODS: Cardiopulmonary testing was performed on six basic
      cardiac life support- and ACD-trained St. Paul, MN fire-fighter personnel during
      performance of 10 min each of ACD and standard CPR on a mannequin equipped with a
      compression gauge. The order of CPR techniques was determined randomly with > 1 h
      between each study. Each CPR method was performed at 80 compressions/min (timed
      with a metronome), to a depth of 1.5-2 inches, and with a 50% duty cycle.
      RESULTS: Baseline cardiopulmonary measurements were similar at rest prior to
      performance of both CPR methods. During standard and ACD-CPR, respectively, rate
      pressure product was 18.2 +/- 3.0 vs. 23.8 +/- 1.7 (x 1000, P < 0.01); mean
      oxygen consumption 15.98 +/- 2.29 vs. 20.07 +/- 2.10 ml/kg/min or 4.6 +/- 0.7 vs.
      5.7 +/- 0.6 METS (P < 0.01); carbon dioxide production 1115.7 +/- 110 vs. 1459.1
      +/- 176 ml/min; respiratory exchange ratio 0.88 +/- 0.04 vs. 0.92 +/- 0.04 (P =
      NS); and minute ventilation 35.5 +/- 5.1 vs. 45.6 +/- 9.2 l/min (P < 0.01).
      CONCLUSIONS: Approximately 25% more work is required to perform ACD-CPR compared
      with standard CPR. Both methods require subanaerobic energy expenditure and can
      therefore be sustained for a sufficient length of time by most individuals to
      optimize resuscitation efforts. Due to the slightly higher work requirement, ACD
      CPR may be more difficult to perform compared with standard CPR for long periods
      of time, particularly by individuals unaccustomed to the workload requirement of
      CPR, in general.

PMID- 7784720
TI  - Standard doses versus repeated high doses of epinephrine in cardiac arrest
      outside the hospital.
AB  - Among all of the cathecolamines used for cardiac arrest treatment, epinephrine
      injection during cardio-pulmonary resuscitation is currently the most powerful
      means of enhancing effectiveness; however, deliberations about the optimal dosage
      have recently become intense. In the SAMU of Lyon (F), we conducted a double
      blind prospective randomized study over an 18-month period, comparing repeated
      standard-dose epinephrine (1 mg) and repeated high-dose epinephrine (5 mg) in the
      management of cardiac arrest outside the hospital. Five-hundred thirty-six
      patients were enrolled with 265 in the standard-dose group and 271 in the high
      dose group; both groups are globally similar. One-hundred eighty-one (33.8%)
      patients returned to spontaneous circulation (R.O.S.C.); 85 in the standard-dose
      group (32%) and 96 in the high-dose group (35.5%). One-hundred nineteen patients
      (22.2%) were admitted; 54 in the standard-dose group (20.4%) and 65 in the high
      dose group (24%). At 6 months nine patients (7.6%) were alive; three patients
      from the standard-dose group (5.5%) and six from the high-dose group (9.2%). We
      never noticed cardiac or neurologic adverse effects with the high doses. The
      results of this study are not statistically significant, but we observed a
      marginal trend towards repeated 5 mg epinephrine doses. A large French
      multicentre study is now necessary.

PMID- 7784721
TI  - Evaluation of outcome following cardiac arrest in patients presenting to two
      Scottish emergency departments.
AB  - OBJECTIVES: To compare and contrast outcomes following cardiac arrest managed in
      two Accident and Emergency departments, and to identify factors which might
      account for such differences. DESIGN: Prospective 1-year evaluation of patients
      sustaining an out-of-hospital cardiac arrest. SETTING: The Accident and Emergency
      departments of the Edinburgh (ERI) and Glasgow (GRI) Royal Infirmaries which
      serve two large urban municipalities. PATIENTS: All patients sustaining a
      prehospital cardiac arrest and brought to ERI or GRI were included. Children (<
      13 years), those declared dead on arrival at the scene, and events related to
      poisoning, near drowning, trauma and pregnancy were excluded. MEASUREMENTS AND
      MAIN RESULTS: There were 297 prehospital arrests from ERI, and 158 from GRI.
      Eighty-two (27.6%) were admitted as 'in-patients' to ERI and 23 (14.6%) to GRI (P
      < 0.01). Thirty-nine (13.1%) survived to hospital discharge from ERI; 13 (8.2%)
      survived to discharge from GRI (NS). The proportion of VF/VT:Asystole observed
      was significantly different between the two centres--162:98 from ERI, 54:73 from
      GRI (P < 0.001). Significantly more prehospital arrests were witnessed and
      received bystander CPR in those brought to ERI (P < 0.02). For the combined
      VF/VT/Asystole groups the ERI ambulance response times were significantly shorter
      (P < 0.01). However, there was no significant difference in the collapse to EMS
      arrival at the scene times between ERI and GRI. Two survivors from ERI had
      asystole as their initial observed rhythm. From GRI, one survivor had asystole,
      one had electromechanical dissociation and in another the initial rhythm was
      unknown. No survivor to discharge had severe neurological disability.
      CONCLUSIONS: Patients suffering out-of-hospital cardiac arrests in Edinburgh have
      a significantly better chance of being admitted to a ward. There is a trend
      favouring better survival to discharge in Edinburgh, but with the numbers
      investigated this does not achieve statistical significance. Amongst those
      factors which contribute to survival there are fewer witnessed arrests, less
      bystander CPR and slower ambulance response times in those brought to GRI. There
      is a need to investigate the environment in which patients collapse, to train the
      public in CPR, and to review the efficiency and resourcing of the ambulance
      service.

PMID- 7784722
TI  - Failure of ambulance crew to initiate cardiopulmonary resuscitation.
AB  - The Utstein style of reporting out-of-hospital cardiac arrests requires that all
      confirmed cardiac arrests considered for resuscitation are analysed and that a
      record is made of the number of cases where no resuscitation is attempted. We
      report a series of 942 confirmed cardiac arrests considered for resuscitation by
      South Glamorgan Emergency Medical Service (EMS). There were 370 (39.3%) cases
      where no resuscitation was attempted by the EMS. The ages, male/female ratio and
      EMS response times were similar in both the group that received ambulance
      resuscitation and those that did not. Those not receiving resuscitation were less
      likely to have had an arrest of cardiac aetiology (51.3% vs. 75%, P < 0.00001).
      Rigor mortis or decomposition of the body was present in 50.8% of cases and in
      20% a doctor had already confirmed the patient dead. In the remainder the
      ambulance crew failed to start resuscitation for a variety of reasons.

PMID- 7784723
TI  - Pre-hospital cardiac arrest: room for improvement.
AB  - OBJECTIVE: To audit the outcome from pre-hospital cardiac arrest managed by
      ambulance personnel, and to assess their proficiency by analysing the time to
      initiate basic and advanced cardiac life support, the compliance with national
      guidelines, and the overall success of resuscitation. DESIGN: A retrospective
      analysis of ambulance service report forms of pre-hospital cardiac arrests, where
      active resuscitation was attempted by ambulance personnel between October 1992
      and May 1993. SETTING: The City of Salford. SUBJECTS: 100 consecutive patients
      who suffered cardiac arrest out-of-hospital and who were brought to the accident
      and emergency department of Hope Hospital alive, or with resuscitation still in
      progress. RESULTS: Only 4 of 100 patients were successfully resuscitated out of
      hospital, of whom 2 survived to leave hospital. Detailed analysis of pre-hospital
      performance was performed on 89 patients only, as 11 report forms were missing
      (no successful pre-hospital resuscitations in this 11). Ventricular fibrillation
      was the first recorded rhythm in 51.7%, but 85.7% were in asystole or
      electromechanical dissociation on arrival at hospital. No patient who was still
      in cardiac arrest on arrival at hospital was successfully resuscitated. 11
      patients received 'bystander CPR'. The median time to basic life support was 6
      min; the median call-to-response interval was 8 min; the median call-to-advanced
      cardiac life support interval was 21 min; the median on-scene time was 31 min
      (paramedics), or 15 min (technicians). The dose of drugs given by the intravenous
      route did not comply with the contemporary recommendations in 43.2%, and those
      doses given by the endotracheal route were inadequate in 37.9% of the cases.
      Endotracheal intubation was attempted in all paramedic resuscitations (91.4%
      success); intravenous access was attempted in 60.3% (91.7% success). CONCLUSIONS:
      The survival from pre-hospital cardiac arrest in this community is worse than the
      national average. There is no single explanation for this. Better community CPR
      training, greater efficiency at the scene through additional personnel, and
      stricter compliance with national ACLS guidelines, facilitated by extended
      refresher training, are all required if outcome is to be improved.

PMID- 7784724
TI  - The technique of endobronchial lidocaine administration does not influence plasma
      concentration profiles and pharmacokinetic parameters in humans.
AB  - This study investigated plasma concentration profiles, pharmacokinetic
      characteristics and side-effects of lidocaine following 3 different
      administration techniques. Sixty ASA I/II patients undergoing elective ENT
      operations were randomised into 4 groups. Lidocaine 1% (1 mg/kg) was administered
      50 min before the end of the operation, via a regular endotracheal tube (group
      1), a suction-catheter deep endobronchially (group 2), or an EDGAR-(Endobronchial
      Drug and Gas Application during Resuscitation)-tube characterized by a separate
      injection channel ending at the orifice of the tube (group 3). For the control
      group, a regular endotracheal tube was inserted without lidocaine administration
      (group 4). Anesthesia was induced with propofol (2 mg/kg), sufentanil (0.5
      micrograms/kg), and vecuronium (0.08 mg/kg) and continued as total intravenous
      anesthesia with propofol (8 mg/kg/h) and oxygen in air (FiO2 = 0.33). A control
      and 13 blood samples were taken up to 180 min after lidocaine administration.
      Lidocaine plasma concentrations were determined using a fluorescence polarization
      immunoassay (TDxFLx). Heart rate, blood pressure, endtidal PcO2, and oxygen
      saturation were similar in all groups investigated. Ventilation was interrupted
      for 3.6 +/- 0.5 s in group 1 and 10.2 +/- 0.8 s in group 2, to administer
      lidocaine. Patients from group 3 were ventilated continuously because of a
      separate injection channel integrated in the EDGAR-tube. Sore throat was
      significantly increased in group 2 as compared with groups 1, 3 and 4. Asorption
      of lidocaine in groups 1-3 resulted in maximal mean plasma concentrations ranging
      from 0.78 to 0.85 micrograms/ml after 16.9 to 22.4 min.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7784727
TI  - [Classification of Klebsiella strains with lectins].
AB  - Fourteen different plant seeds were used to obtain lectins which in turn were
      used to agglutinate 72 different serological strains of Klebsiella. The results
      were used to design a scheme which distinguishes 62 serotypes (91.6%) with a
      unique agglutination pattern with lectins. Two pairs of strains as well as two
      sets of three strains gave the same patterns. This procedure is useful as an
      alternative in the identification of strains for epidemiological purposes.

PMID- 7784725
TI  - Contribution of brain injury to hypertension following intravenously-administered
      pancuronium in rats.
AB  - Abnormal hypertension sometimes occurs following intravenous administration
      (i.v.) of pancuronium in patients with brain injury. The present experiment was
      designed to determine whether brain injury contributes to the hypertensive
      response of i.v. pancuronium. Forty-six Wister strain rats were studied, of which
      39 had induced brain injury at (a) upper pons (b) midbrain (c) thalamus region
      (excluding hypothalamus) and (d) cerebellum or a combination of these sites. The
      injury was made by single insertion of a 22 Gauge needle through the skull
      surface. The quantity of pancuronium solution administered i.v. in each case was
      1.0 ml containing either 0.8 mg/kg or 8 mg/kg of pancuronium. Group A (n = 7) had
      no brain injury and the mean arterial pressure (MAP) did not change following
      i.v. administration of pancuronium. In Group B (n = 9) (a+b+c, 8.0 mg/kg) MAP
      rose from 90.9 +/- 15.4 to 102 +/- 22.0 mmHg and in Group C (n = 7) (a+b+c, 0.8
      mg/kg) MAP rose from 148.4 +/- 13.3 to 160 +/- 14.4 mmHg. In Group D (n = 5)
      (b+c, 8.0 mg/kg) MAP remained unchanged. In Group E (n = 5) (a, 8.0 mg/kg) MAP
      rose from 130.3 +/- 18.7 to 146 +/- 27.6 mmHg and in Group F (n = 6) (a, 0.8
      mg/kg) MAP rose from 129.7 +/- 15.6 to 135.8 +/- 13.8 mmHg. In Group G (n = 7)
      (d, 8.0 mg/kg) MAP remained unchanged. Since the MAP was elevated in only those
      groups that received injury in the upper pons, we concluded that injury in the
      upper pons can lead to hypertension following i.v. administration of pancuronium.

PMID- 7784726
TI  - [Pseudomonas fluorescens: production of pyoverdine in human blood at 4 degrees C
      and cytotoxic effect of the pigment].
AB  - Pseudomonas fluorescens PAB strain produced pyoverdine in a synthetic medium,
      this pigment was purified by solvent extraction and ion exchange, then sterilized
      by filtration. Where cytotoxic effect on human leukocytes was assayed, death and
      lysis was observed. Sublytic doses decreased leukocytes phagocytosis and
      chemotaxis. Bacteria grew and produced pigment in blood stored a 4 degrees C,
      with a pyoverdine production of 0.13 mg/ml of serum after 5 days of incubation.

PMID- 7784728
TI  - [Gardnerella vaginalis biotypes: modification of a proposed system].
AB  - A modified scheme is proposed for biotyping Gardnerella vaginalis based on
      detection of hippurate hydrolysis, beta-galactosidase (ONPG) and lipase, and
      fermentation of arabinose, galactose and xylose. Thirty three biotypes were found
      among 140 strains from women with and without bacterial vaginosis (non-specific
      vaginitis). The distribution of biotypes were found to be significantly
      different, being more predominant the biotypes 1A; 5G; 7A; 7D and 7G in women
      with vaginosis and the biotypes 5G and 6H in women without vaginosis. These data
      suggest that some biotypes of Gardnerella vaginalis are associated with bacterial
      vaginosis.

PMID- 7784729
TI  - A discrete factor A is detected on Vibrio cholerae Non-O1, O:139 by laser flow
      cytometry.
AB  - A new serogroup of Vibrio cholerae non-O1, O:139, has been implicated in recent
      epidemics. It was scanned with a factor A-specific fluoresceine-conjugated
      monoclonal antibody, searching for antigen determinants by laser flow cytometry.
      First, a group of gram-negative 4-amine-4, 6 dideoxy-D-mannose antigen-related
      microorganisms were tested to assess monoclonal antibody cross reactions. Later,
      a clear recognition of antigen determinants was found with this monoclonal
      antibody, on V. cholerae non-O1, O:136, Bengal, and MO45 strains, showing no
      cross reactions with the antigenically related non O1, O:22, and Inaba and Ogawa
      O1 strains. On the other hand, factor A of V. cholerae O1 strains was recognized
      by the specific monoclonal antibody and a discrete factor A on V. cholerae non
      O1, O:139, Bengal and MO45 strains was detected.

PMID- 7784732
TI  - Tn1, a Tn3-like transposon present in plasmid RP1, transposes more frequently to
      another plasmid than to the chromosome.

PMID- 7784730
TI  - Biological and protective activities of outer membrane proteins from Bordetella.
AB  - In this work the biological properties and the capability of the outer membrane
      proteins (OMPs) from different strains of Bordetella to induce protection against
      challenge with B. pertussis 18323 were examined. The OMPs from each strain were
      isolated using Schnaitmann's method. Two OMPs (30 and 32 kDa) were found to be
      specific for the vaccine strains of B. pertussis and were absent in the OMPs
      preparation from both B. parapertussis and B. bronchiseptica. When the OMPs from
      the vaccine strains of B. pertussis were assayed in the mouse intracerebral
      protection test, they were found to be highly protective (75%-88%) against a
      challenge with 250 50% lethal doses (LD50) of B. pertussis 18323. However, no
      correlation was observed between the protective activity and the lymphocytosis
      promoting factor (LPF) content of different preparations. Moreover, neither LPF
      activity or histamine-sensitizing activity (HSA) were found in any of the OMPs
      assayed. Our results show that OMPs from B. pertussis vaccine strains play a key
      role in the induction of protective immunity against B. pertussis 18323 in mice,
      making them excellent candidates to be used in further studies for the
      development of a pertussis vaccine for humans.

PMID- 7784731
TI  - [Biological flow tracers: growth and survival of Bacillus subtilis 65-8 under
      environmental stress].
AB  - Microbial flow tracers are presently limited to a strain of Bacillus globigii and
      a few highly specific bacteriophages. Bacillus subtilis 65-8 produces a black
      pigment as part of the primary metabolism under minimal nutritional conditions,
      with glucose as the sole carbon and energy source. This work shows that Bacillus
      subtilis 65-8 spores are thermostable (55 degrees C during 150 dias),
      halotolerant (they germinate and grow in an enriched medium with up to 12% NaCl),
      persistent in a system of sand-soil and sewage, even in the presence of added
      commercial oil derivatives (kerosene, leaded gasoline and unleaded diesel), they
      are capable to move through porous systems even as the liquids, viscous as they
      may be, move through. Moreover, spores were resistant to the presence of
      autochtonous microorganisms in sewage, where we did not detect any other organism
      with differential characteristics like our strain (black pigment production in
      minimal medium) which could interfere with the identification of our biological
      flow tracer. The characteristics of Bacillus subtilis 65-8 make it a suitable
      biological flow tracer.

PMID- 7784733
TI  - [Sporulation of the entomopathogenic fungi Hirsutella thompsonii Fisher and H.
      nodulosa petch in mixed culture].
AB  - A large-scale method for producing fungal pathogens for mites, Hirsutella
      thompsonii and H. nodulosa in two phase culture (liquid and solid), was developed
      to induce conidiogenesis. The vegetative growth that was obtained in the liquid
      media of soy meal with shaking, from an inoculum 0.5 g wet weight equivalent to
      0.1 g of dry weight, was inoculated on eight solid supports. Generally for most
      of the strains, the three supports yielding greater conidiogenesis were rice,
      barley and bran, excluding the strains whose greater sporulation is achieved in
      rice, oats and sorghum, sorghum and oats as compared to barley and bran,
      respectively. Maximum production of conidia was obtained with HtM2, HtM4481 and
      HtC59 strains of H. thompsonii, which reached on solid support 334.75, 269.68 and
      137.12 x 10(7) conidia/g, respectively.

PMID- 7784734
TI  - Comparison of neuroinvasive abilities of HSV-1 and HSV-2 in mice.
AB  - We compared neuroinvasive properties of HSV-1 MacIntyre strain and HSV-2 G
      strain, after inoculation of mice by intraperitoneal, intranasal and intracaudal
      route, by scoring for encephalitis and death. HSV-2 was more neuroinvasive than
      HSV-1 by any route, since mice inoculated intranasally or intracaudally with HSV
      2 required 100 fold lower dose than HSV-1 to induce encephalitis and death, which
      occurred earlier than in HSV-1 infected mice. HSV-2 was found in brain tissues at
      a lower concentration (10(1.8) to 10(2.7) PFU per 0.1 g of brain) than HSV-1.
      Mice inoculated with HSV-2 developed a more aggressive behavior than those
      inoculated with HSV-1, although they showed a lower virus concentration per gram
      of brain. These results showed that HSV-2 G strain was more neuroinvasive than
      HSV-1 MacIntyre strain and its ability to produce damage of CNS was not directly
      related to the amount of virus in it, and suggests that neuroinvasiveness is a
      complex phenomenon, which could involve viral genomic expression and evasion of
      the immune system.

PMID- 7784735
TI  - Detection of Borrelia burgdorferi DNA in human skin biopsies and dog synovial
      fluid by the polymerase chain reaction.
AB  - The polymerase chain reaction was used to amplify DNA sequences of the etiologic
      agent of Lyme disease, Borrelia burgdorferi, and was applied to the detection of
      the spirochete in humans and dogs. Oligonucleotide primers used in the reaction
      flank a 244-base-pair representing part of the variable region V4 of the B.
      burgdorferi 16S rRNA from biopsies of patients with acrodermatitis, and in
      synovial fluid from a dog with arthritis. These data suggest the presence of the
      disease in our state.

PMID- 7784737
TI  - [Current progress in chemotherapy for bronchial cancer].
AB  - Recent progress has, as practical consequence, placed chemotherapy as the first
      line therapy for any type of lung cancer, except for stages I and II non-small
      cell lung cancers where surgery alone remains the best approach so far. Indeed,
      the introduction of cisplatin-based chemotherapy in front-line ("neo-adjuvant")
      has significantly improved in non small lung cancer the results of surgery and
      radiotherapy in stage III and of supportive care in stage IV, mainly in term of
      survival. The development of new cytostatic agents and growth factors and the
      evolution of therapeutic concepts have lead to multiple clinical investigations
      that are reviewed in both small cell and non small cell lung cancers.

PMID- 7784736
TI  - [Trypanosoma cruzi: influence of human plasma on the morphogenesis of blood
      trypomastigotes in a cell-free culture media].
AB  - Morphogenesis of blood stream trypomastigotes in the cell free culture medium F69
      at 37 degrees C for 10 days showed qualitative differences either with or without
      human plasma. Without human plasma, blood stream trypomastigotes performed only
      one cycle before disappearing and the culture kept growing as amastigotes and
      epimastigotes until the end of the experiment. In contrast, human plasma induced
      multiple cycles of transformation. The sequence was blood stream trypomastigotes,
      regressive parasites, amastigotes, progressive parasite and again
      trypomastigotes. Human plasma preserved the trypomastigote stage, produced a
      blockade of the epimastigote stage and inhibited the division of amastigotes. In
      this experimental model, human plasma modified the biological cycle of T. cruzi
      by inducing or inhibiting different stages.

PMID- 7784738
TI  - [Cardiovascular toxicity of anticancer chemotherapy: 5 cases treated in intensive
      care].
AB  - During a five-months period, 5 cases of cardiovascular toxicity related to
      chemotherapy were observed. Various hypotheses are discussed to explain the
      pathogenicity of this type of toxicity. Cardiovascular risk factors may favor
      this toxicity. In the presence of known cardiovascular risk factors, the choice
      of a less toxic regimen is desirable and, if this is not possible, the patient
      should be treated with continuous monitoring of the vital parameters.

PMID- 7784739
TI  - [Exploratory laparotomy under local anesthesia].
AB  - Diagnostic laparoscopy under local anaesthesia for acute pain in the right iliac
      fossa in an old man is reported. Exploring the abdominal cavity under local
      anaesthesia is an excellent method for establishing a diagnosis in doubtful
      abdominal pain presentation. This technically easy procedure may avoid up to 45%
      of unnecessary laparotomies and related complications.

PMID- 7784740
TI  - [Crises of public health, medicine, society?].
AB  - Public health is in crisis. Apart from temporary factors, this crisis could have
      also its origin in theoretical and conceptual insufficiencies relative to the
      definition of this scientific domain. Organisational and institutional conditions
      needed for the strengthening of public health are discussed in relation with the
      localization of its production sites, taking into account the needed synthesis or
      consensus to reach and in view of the larger and valuable intellectual traditions
      to which it belongs. The crisis of public health is only part of a crisis of
      medicine and of our modern societies.

PMID- 7784741
TI  - [Complications of intrauterine devices].
AB  - Abdominal migration of intrauterine devices is very rare. However, during the
      puerperium when the uterus is small and the uterine wall thin, the risk of
      perforation increases. A device removed by coelioscopy is described.

PMID- 7784742
TI  - [Syndrome X and general medicine].
AB  - The general practitioner man be confronted with the X syndrome, which includes
      central obesity, impaired glucose tolerance or type II diabetes mellitus,
      dyslipidemia and eventually hypertension. Insulinoresistance and
      hyperinsulinaemia contribute to the pathogenesis of these disorders. The syndrome
      X, which leads to important cardiovascular morbidity, needs appropriate
      treatment, which has to take into account the actions of drugs on glucose and
      lipid profiles. Syndrome X is rarely treated as a whole, but to treat separately
      each of its manifestations would be a mistake. The necessity of a global
      approach, a complete understanding of the familial environment and also the
      duration of the development of syndrome X justify the prominent part of the
      family doctor in the follow-up.

PMID- 7784743
TI  - [Food deficiencies in children--multicenter survey in the school environment.
      Analysis of the daily diet of adolescents].
AB  - The aim of this work is to study the food habits in a group of 131 children of
      school ages (11-14 years); they had to take notice of their food, with control by
      interview; results shown a shortage in calories (80% of normal supply for age),
      but also a severe imbalance: too many lipids, too few complex sugars,
      deficiencies in calcium, phosphorus, iron, iodine, vitamins A and C, fibers (30%
      of normal supply); alcohol has been used by 35 children. A nutritional education
      is recommended for this age group.

PMID- 7784744
TI  - [How I treat... a patient with severe or aggravated cardiac insufficiency].

PMID- 7784745
TI  - [Hashimoto-Pritzker self-healing histiocytosis: a skin tumor in infants].

PMID- 7784746
TI  - [Role of converting enzyme inhibitors in myocardial infarction].

PMID- 7784748
TI  - [Value of the study of induced expectoration in pulmonary pathology].

PMID- 7784747
TI  - [Current pharmacological approach to the treatment of locomotion disorders due to
      spinal lesions].

PMID- 7784749
TI  - [Asialia: diagnosis--treatment].

PMID- 7784750
TI  - [Endoscopy in plastic surgery].

PMID- 7784751
TI  - [Sports activities and susceptibility to infection].

PMID- 7784752
TI  - [Recombinant alpha 2b interferon in the treatment of chronic viral hepatitis C:
      comparison of 2 schemes, classical and high-dosage].

PMID- 7784753
TI  - [How I manage... a type 2 diabetic patient].

PMID- 7784754
TI  - [Drug of the month. Citalopram (Cipramil)].

PMID- 7784755
TI  - Can running injuries be effectively prevented?

PMID- 7784756
TI  - The use of doubly labelled water in quantifying energy expenditure during
      prolonged activity. Personal observations.

PMID- 7784757
TI  - The relationship of hypercapnic ventilatory responses to age, gender and
      athleticism.
AB  - When a gas mixture containing carbon dioxide (CO2) is inhaled by an individual,
      alveolar ventilation is increased. This ventilatory response to CO2 highlights
      the relationship between the increase in exercise ventilation and the increase in
      alveolar CO2 pressure (paCO2). This response is mediated centrally by brainstem
      chemoreceptors in the medulla and, to a lesser extent, peripherally by the
      carotid and aortic bodies. However, the response of increased breathing to rising
      paCO2 varies markedly among individuals. The responses to CO2 rebreathing have
      been investigated by a variety of research groups for different reasons. The
      range of responses by children and adults including: gender differences;
      responses by athletes; the relationship between age and body size; and whether it
      is an acquired or inherited response have been studied. The following is a
      summary of these different aspects of CO2 rebreathing has been complied to assist
      researchers studying any single or multiple facets of the area.

PMID- 7784758
TI  - Applied physiology of ice hockey.
AB  - Today's elite hockey players are physically bigger and have improved levels of
      physiological fitness when compared with their predecessors. Correspondingly,
      previous ice hockey studies that have become widely referenced may have little
      relevance to current players and the way the game is presently played. A great
      need exists to apply exercise science to the game of ice hockey. Although much
      has been written about the physiology of ice hockey, there is little information
      based on well controlled studies. Particularly, there is a paucity of knowledge
      concerning optimal training schedules, training specificity, recovery profiles
      and seasonal detraining. Moreover, the reports that do exist have attempted to
      make comparisons across all levels of skill and talent. Thus, fundamental
      questions remain as to actual physiological exercise response and specialised
      training programmes for ice hockey players, particularly at the elite level.
      There is a demand for new properly designed experiments to find answers
      pertaining to the appropriate training methods for today's ice hockey players.
      Future research directions should consider the relationships between performance
      and such variables as neuromuscular skills, strength, power, peripheral
      adaptations, travel, hydration, detraining and sport-specific training
      programmes. Incidence and severity of injury among ice hockey players in relation
      to fatigue and fitness must also be investigated. Much of the information
      currently used in ice hockey will remain speculative and anecdotal until these
      studies are conducted.

PMID- 7784761
TI  - [What is your diagnosis? Scar of the lower and anterior wall in coronary heart
      disease].

PMID- 7784759
TI  - Isokinetic eccentric exercise.
AB  - The development of active isokinetic dynamometers has allowed the assessment of
      muscular moment under eccentric activations that have different characteristics
      to concentric actions. It is well documented that at a given angular velocity the
      eccentric moment is greater than the corresponding concentric moment. The moment
      velocity relationship under eccentric conditions has been investigated, with
      conflicting results. Particularly, eccentric moment was reported to remain
      similar to, or to increase or decrease with, increasing angular velocity. As with
      concentric actions, the reliability of isokinetic eccentric measurements is
      influenced by a number of factors such as gravity, preload force and testing
      position. The velocity-specific effects of eccentric training have not been
      extensively investigated. Based on current knowledge, eccentric exercise does not
      appear to be velocity-specific. Although the mode specificity of both concentric
      and eccentric exercises have been investigated, the resultant observations are
      conflicting. Eccentric training has been found to improve both concentric and
      eccentric strength: yet, it has also been reported to improve only concentric or
      eccentric strength. The reciprocal muscle group ratios under eccentric actions
      were found not to be influenced by angular velocity, but the significant role of
      the eccentric/concentric moment ratio of each muscle has not been examined
      thoroughly. It is well documented that eccentric activations are associated with
      delayed muscle soreness and muscle damage. A limited number of studies have
      reported that isokinetic eccentric efforts may result in a lower amount of muscle
      soreness compared with other exercise modalities. Isokinetic dynamometers provide
      some unique characteristics for rehabilitation applications. Examination of the
      clinical application of eccentric exercise is limited. Consequently, the use of
      this exercise modality in prevention and assessment of musculoskeletal injuries
      should be investigated further.

PMID- 7784760
TI  - Syncope in athletes.
AB  - Syncope is a brief sudden loss of consciousness and muscle tone secondary to
      cerebral ischaemia, inadequate oxygen or glucose delivery to the brain. The
      causes of syncope may be benign and require very little in the way of evaluation
      or treatment. However, syncope may be the harbinger of sudden death, and
      extensive evaluation, monitoring and detailed recommendations regarding
      advisability of participating in sports should be reviewed with the patient. The
      history is the most important clue when attempting to identify which patient with
      syncope is at risk for sudden death. A careful cardiac and neurological
      examination should be performed in any patient presenting with syncope. Selective
      use of laboratory testing and cardiac monitoring may assist the practitioner in
      making the diagnosis. Most often patients with syncope will have a benign cause
      such as vaso-vagal events, hyperventilation or orthostatic hypotension. Patients
      with a cardiac condition causing their syncope are at increased risk for sudden
      death. The ominous, cardiac-related causes of syncope in the younger population
      include hypertrophic cardiomyopathy, aberrant coronary arteries and aortic
      dissection secondary to Marfan's syndrome. In the older athletic population,
      coronary atherosclerosis may present with syncope. Dysrhythmias may be the cause
      of syncope in both populations.

PMID- 7784762
TI  - [The most dangerous drug in patients over 70 years old].

PMID- 7784763
TI  - [Adult patients with congenital heart diseases: Berne statistics].
AB  - Data of the 272 adult patients with congenital heart disease followed up in our
      department are analyzed. We emphasize the lack of reliable statistical surveys of
      this group of patients at the present time. The need for better intra- and
      interdisciplinary cooperation, specially between referring physicians and
      tertiary centers, is stressed.

PMID- 7784764
TI  - [Hypertrophic osteoarthropathy as indicator for bronchial carcinoma].
AB  - Clubbing of the fingers and periosteal bone formation are the typical signs of
      hypertrophic osteoarthropathy, which mostly is a secondary manifestation of an
      underlying disease. Reporting a case of hypertrophic osteoarthropathy in
      association with bronchial carcinoma, we stress the importance of an extensive
      diagnostic evaluation with chest X-ray as a first step.

PMID- 7784765
TI  - [Possibilities in psychiatric-psychotherapeutic and family practice treatment of
      borderline patients].
AB  - In this article it is shown that, in spite of the diagnostic heterogeneity and in
      spite of differing concepts for treatment, basic principles for treatment may be
      assessed that have proven effective in daily therapeutic routine. It is decisive
      to consider typical difficulties in which therapists of borderline patients may
      get involved. Treatment is primarily based on psychotherapy. After a short review
      of different therapeutic concepts for borderline derangements, fundamental
      psychotherapeutic principles are illustrated. According to target symptoms,
      psychotropic drugs may be indicated as an adjunct. The use of various drugs is
      discussed. Ambulatory and clinical options for treatment and their indications
      are summarized, and treatment of borderline patients by their family doctor is
      stressed in particular.

PMID- 7784766
TI  - [Circumscribed skin necrosis following intramuscular injection (embolia cutis
      medicamentosa)].
AB  - Among the local complications following the intramuscular injection of
      therapeutic drugs, the syndrome of 'embolia cutis medicamentosa' deserves special
      attention. Shortly after the intramuscular injection, the patients notice severe
      pain and an erythematous discoloration of the skin at the injection site,
      followed by central demarcation and a sharply circumscribed skin necrosis with or
      without damage to peripheral nerves. We report about three patients, two of which
      had to be hospitalized. The drugs injected were combinations of analgesics of the
      phenylbutazone-type, corticosteroids, local anesthetics and cyanocobalamin. The
      observation that this severe complication may be associated with technically
      proper ventrogluteal injection of a wide array of therapeutic drugs shows that
      intramuscular injections require valid indications.

PMID- 7784767
TI  - [A case from practice (325). 1. Strongyloidiasis--reactive arthritis. 2. Anemia
      in multiple helminth infestation. 3. Essential hypotension].

PMID- 7784768
TI  - [Psoriasis: diagnosis and therapy].
AB  - The pathogenesis of psoriasis is not fully understood, but two mechanisms seem
      important, i.e. epidermal proliferation and an inflammatory process. Among these,
      the cytokines production and the expression of adhesion molecules, are the most
      important. To make an exact diagnosis of psoriasis it is essential to have the
      case history and the clinical findings. In difficult cases it might be necessary
      to make a biopsy. If the patient has not been treated, the histopathology is very
      characteristic. There are two main possibilities for treatment: either local
      therapy or internal therapy. Local treatment usually starts with the treatment of
      keratotic plaques, mostly by baths (salt or sulphur), followed by ointments or
      oils containing salicylic acid 5% or 10%. After a couple of days a specific local
      treatment is started. In the clinic or in a day care center one might use the
      classical therapeutic modalities such as dyes (Castellani) or tar or dithranol
      preparations. The inconveniences of these modalities are that they either color
      the body or the textiles or that they smell. These preparations, especially in
      combination with UV light, are very effective and useful. On an outpatient basis
      corticosteroid preparations are mostly used, but in certain skin areas they might
      provoke skin atrophy. With the development of the vitamin-D derivative
      calcipotriol, further progress has been achieved. This preparation is not
      colored, does not smell and is not followed by atrophy. The efficacy of
      calcipotriol is similar to potent corticosteroids. Calcipotriol can very well be
      combined with UV therapy. UV therapy modalities consist in solar light therapy
      (sea shore or mountains), UVB phototherapy, SUP therapy, or PUVA
      therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784769
TI  - [Surgical diseases in the inguinal area in children].
AB  - This outline describes the diagnostic and prognostic factors as well as the
      operative procedures based on the experiences made at the University Clinic for
      Pediatric Surgery, Zurich. Focused on practical work, the most frequent
      congenital, acute and chronic affections are described with respect to
      differential diagnostic characteristics.

PMID- 7784770
TI  - [Practice-oriented treatment of depression today].
AB  - The modern treatment methods which are relevant for everyday practice are
      summarized, and their application is discussed based on an integrative depression
      model. The biological and psychosocial therapeutic methods can be complementary,
      if the actual stage of illness is taken into consideration. An antidepressive
      medication is needed, especially in severe depressive episodes. The application
      of some simple rules can assist in the choice of antidepressive medication. But
      also the employment of sound principles for the psychosocial treatment of
      depressive patients is recommended.

PMID- 7784772
TI  - [What is your diagnosis? Hypertrophic cardiomyopathy].

PMID- 7784771
TI  - [Current treatment concepts in patients in the acute stage of subarachnoid
      hemorrhage due to rupture of an intracranial aneurysm].
AB  - Subarachnoid hemorrhage (SAH) due to rupture of intracranial aneurysm constitutes
      almost 10% of all strokes and is a neurosurgical emergency along with head injury
      and intracerebral hemorrhage. Accurate diagnosis and surgical intervention
      without time loss are the key factors for successful treatment. Almost 40% of the
      patients with SAH already die or are in a moribund status at the first bleeding
      before hospitalization, the rest of the patients (60%) can be transferred to
      hospitals for further treatment. The factors determining prognosis of SAH involve
      a direct initial injury to the brain at the time of the rupture, a high
      rebleeding rate in the acute stage, development of cerebral vasospasms, and
      hydrocephalus due to stasis of the cerebrospinal fluid. Surgical intervention is
      intended to eliminate these factors as much as possible. Perioperative intensive
      medical care in combination with the surgical intervention is essential to
      achieve best outcome from the surgical treatment. The aim of this article is to
      make a short review over SAH and to give a current concept of therapy in the
      acute stage of SAH. The results of treatment of SAH in our institute are also
      presented and discussed.

PMID- 7784773
TI  - [Diabetic nephropathy: course, therapy and prevention of a serious complication].

PMID- 7784774
TI  - [The borderline patient. Diagnosis, psychodynamics and physician-patient
      relation].
AB  - 'Borderline' is a popular psychiatric diagnosis. The uses of the term are
      variable and often unclear. It is the goal of this presentation to elaborate a
      borderline concept for use in daily clinical practise. First, development of the
      term over the preanalytical, analytical and empirical areas is summarized. Next,
      the term of borderline for clinical practise is developed on the basis of
      characteristics and the global picture. Characteristics are: intensive, instable
      behaviour in relations, reduced control of impulse, disturbed affection and mood,
      psychotic manifestations, instable social adaptation. Diagnosis is founded on
      exploration of characteristics and on seizing of the global picture. The
      combination with other psychiatric disorders and separation from other
      personality disorders have to be considered with respect to differential
      diagnosis. The descriptive diagnosis has to be complemented from a psychodynamic
      point of view. The borderline patient has in his psychologic development failed
      to segregate sufficiently from his primary reference person. This results in a
      structural deficit and a weak ego. This latter is characterized by deficient
      integration and deficient separation, by disturbed perception of reality and by a
      non-specific general weakness of the ego. Finally, difficulties arising in the
      relations between physician and borderline patient are outlined.

PMID- 7784775
TI  - [The Sentinella reporting system in Switzerland exemplified by pertussis
      monitoring from 1991 to 1993. Sentinel Work Group].
AB  - Since 1986, 150 to 180 general practitioners, internists and pediatricians in
      private practises have reported morbidity data to the Swiss Federal Office of
      Public Health within the Sentinella network. Data on a certain number of
      infectious diseases, some noninfectious diseases and other reasons for
      consultation are collected through this reporting system. The number of
      participating physicians corresponded to 2.3 to 3.1% of all family practitioners
      for each of the three specialties. They also covered approximately 2.7% of the
      total annual number of consultations in Switzerland. In 1992/93, all cantons and
      all half-cantons except Nidwalden and the two half-cantons of Appenzell were
      represented by at least one physician who reported during 75% or more of the
      total reporting period. When compared to other countries, the network density of
      the Swiss Sentinel network is high. Since 1986, several infectious diseases have
      been continuously monitored by the Sentinella system (measles, mumps, rubella,
      influenza). Surveillance of pertussis, which was started in 1991, will be
      continued for several years. According to these data, an annual pertussis
      incidence rate of 60 out of 100,000 population and 100 out of 100,000 population
      was estimated in 1991/92 and 1992/93, resp. More than 55% of cases were children
      aged between one and eight years. Of these children, 70.4% were reported to be
      vaccinated, and 62.6% had a well-documented vaccination status (based on a
      vaccination certificate). In 95.6% of these cases, at least three vaccine doses
      were given.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784776
TI  - [Disulfiram in the treatment of alcoholic patients].
AB  - In a retrospective investigation we report our experience with alcohol-dependent
      patients who were hospitalized between 1987 and 1990. There were 58 patients, 29%
      of them were hospitalized several times. In the middle of 1991 and 1992 we
      interviewed the family doctors and the social workers who cared for the patients.
      In 48% of the patients there was improvement, in 24% there was a stabilization,
      and in 28% we noted a deterioration. There was no difference in patients treated
      by the family doctor alone or in patients treated by the social workers.
      Comparing patients taking Disulfiram with patients taking no drug, there was no
      difference in improvement (48% versus 50%). But the good results in patients not
      taking disulfiram were nearly exclusively noted for those who had been
      hospitalized in a special clinic for alcohol-dependent persons. Patients who were
      hospitalized several times for alcohol withdrawal had a worse chance to improve
      their situation (-20%). The therapy with disulfiram in alcohol-dependent patients
      is helpful to cure chronic alcoholics. Programs in a specialized clinic improve
      also the chance to be cured of the addiction.

PMID- 7784778
TI  - [A case from practice (326). Dysentery (inflammatory diarrhea, cause
      Campylobacter jejuni].

PMID- 7784779
TI  - [HIV seropositive pregnant women from black Africa seen at the Guy de Lorier
      maternity unit of Tenon hospital. Report of 33 cases].
AB  - There were 5503 deliveries between 1989 and 1991 in the Guy de Lorier Maternity
      Unit (Pr Salat-Baroux) of Tenon Hospital, Paris. These included 81 women testing
      HIV+ in the department with 33 asymptomatic black African women among 781
      deliveries. Africans account for 14% of women delivered in the department but for
      40% of seropositives in the unit, with a predilection for women from Zaire
      (central Africa), accounting for 17 seropositives. They only represent 50% of all
      cases of African HIV+ and 20% of the unit, while they account for only 6% of the
      black African community and 0.8% of the maternity unit. Women from west Africa
      accounted for 45.5% of African seropositive cases, with Ivory Coast in first
      place with 24.3% while only 9% of women from Mali, accounting for 40% of African
      patients and 5% the units, tested positive (3 cases out of 309 patients). The
      mean age of seropositive patients was 23 +/- 4, pregnancies proceeded normally
      and there were 4 therapeutic abortions. There were 9 births by cesarean section,
      with no evidence of neonatal contamination, the same applying in the other 20
      vaginal deliveries. Routine testing (informed consent) for HIV in these high-risk
      (endemic zone, drug addiction) or unrecognised seropositive patients is important
      whenever the opportunity presents itself (prenuptial examinations, prenatal
      visits, family planning, preoperative assessment) in order to attempt to lower
      infection rates and ensure the best possible care for mother and child when there
      is a wish to continue the pregnancy, but also to protect hospital staff from the
      risks to which they may be exposed.

PMID- 7784780
TI  - [Basedow's disease and pregnancy in a black African population. Epidemiology and
      interrelations in 51 pregnancies].
AB  - Forty one patients with 51 pregnancies form the basis of this study of
      etiological factors and reciprocal effects of pregnancy and thyrotoxicosis.
      Pregnancy influences the course of thyrotoxicosis and may modify its diagnostic
      aspects, clinical course, variations in laboratory parameters and treatment. The
      effect of thyrotoxicosis on pregnancy may lead to abortions, premature labour
      and/or toxemia. It may sometimes influence the products of conception. The
      essential point appears to be to seek the minimal dose of antithyroid drug
      capable of controlling thyroid disease without impairing fetal thyroid function.

PMID- 7784777
TI  - [Chest pain, dyspnea, syncope].
AB  - We report about the history of a 53-year-old female who suffered from dyspnea as
      well as leg and chest pain for six months; in addition she experienced two
      syncopal events. Recurrent pulmonary embolism was suspected, which was
      subsequently confirmed by positive scintigraphical findings. Acute cor pulmonale
      may have caused the syncopes. Therapy with heparin and oral warfarin was started.
      Within few days the patients condition improved markedly. Signs of pulmonary
      hypertension disappeared within five months.

PMID- 7784781
TI  - [Anemia and pregnancy. Epidemiologic, clinical and prognostic study at the
      university clinic of the Ignace Deen Hospital, Conakry (Guinee)].
AB  - Our intentions were to determine the incidence of the association of anemia and
      pregnancy, to evaluate maternal and fetal prognosis and to offer some
      recommendations regarding national health care policies. This prospective study
      lasting 30 months included all cases of anemia and pregnancy detected by clinical
      and laboratory examinations. Thus 13,191 women were enrolled in the study but
      only 1408 cases of anemia and pregnancy (10.67%). Primipara and grand multipara
      were particularly at risk. Severe forms of anemia and pregnancy were encountered
      often (51.71%). Maternal and fetal prognoses were very poor. Maternal mortality
      was 852/100,000, accounting for 65% of the maternal mortality of the department.
      The stillborn rate was 50 per thousand. This is a serious health problem which
      needs to be dealt with by a national health education programme.

PMID- 7784782
TI  - [Role of iron deficiency in anemia in pregnant women in Mali].
AB  - The epidemiological characteristics of iron deficiency anemia after
      radioimmunoassay of serum and erythrocyte ferritin were evaluated in 209 Malian
      women at the time of delivery in a maternity unit in Bamako, Mali. The incidence
      of iron deficiency anemia was high (36.8%). This incidence did not reflect socio
      economic status, nor even any particular obstetric history, but was significantly
      higher in younger mothers (aged under 26). The severity of anemia was such that
      2.4% of women would require a blood transfusion post-partum. It looks therefore
      desirable, in Mali, to screen routinely and to ensure the prevention of iron
      deficiency in adolescent girls and to include, in the prevention of anemia of
      pregnant women, routine iron supplements from the beginning of pregnancy.

PMID- 7784783
TI  - [Determinant factors in the choice of site of delivery and the role of peripheral
      maternity units in a semi-urban environment in Tunisia].
AB  - The authors analyse, in the context of a developing country, a number of factors
      which can determine the choice of site of delivery in a population with access to
      several possibilities. The role of peripheral (or local) maternity units is
      considered in particular, in view of the utilisation problems which they raise.
      This leads to the conclusion of a degree of irrationality in the choice of health
      care services and the characteristics of women interacting with those of
      professionals when explaining the choice of site of delivery. Better management
      of available services is desirable in order to render peripheral maternity units
      more useful, and improve the medical performance at the time of delivery.
      Sensitization of the public and above all of health professionals nevertheless
      remains essential.

PMID- 7784784
TI  - [Fetal risk factors in twin pregnancies. Critical analysis of 265 cases].
AB  - The authors report their critical analysis of perinatal mortality concerning 265
      twin pregnancies collected between 1982 and 1993 in the Maternity Unit of the
      Yaounde (Cameroon) Teaching Hospital Group. There were a total of 14,277
      deliveries during this period. The twin pregnancy rate was 1.8 per cent. Delivery
      was spontaneous in 89.6 per cent of cases and by cesarean section in 10 per cent
      of cases. In 3 cases the second twin was delivered by section after spontaneous
      delivery of the first twin. Perinatal mortality evaluated at 6.9 per cent (37
      cases) was analysed according to fetal risk factors such as gestational age, type
      of delivery, fetal presentation, birth weight, birth rank and the time interval
      between birth of the first and second twin. Perinatal mortality of premature
      twins with 25 fetal deaths accounted for approximately 2/3 of the fetal deaths in
      this series. Twenty-two cases of fetal deaths seen in the group of second twins
      accounted for more than half of all fetal mortality. The time interval between
      the two births was an important factor in the fetal prognosis of the second twin.
      There were 14 cases of death of the second twin for a time interval longer than
      20 minutes as compared with 8 fetal deaths for an interval of 20 minutes or less.
      Breech presentation was associated with abnormally high fetal mortality (16
      cases). Our conclusion is that improved perinatal mortality in twin pregnancies
      must be sought by preventing prematurity. Breech presentation is a factor of poor
      prognosis, in which it is important to widen indications for prophylactic
      cesarean section aimed at improving fetal prognosis.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7784785
TI  - [Coexistence of a partial hydatiform mole and a viable twin pregnancy. A case
      seen at the Sokode regional hospital (Togo)].
AB  - A case was seen of partial hydatidiform mole coexisting with a viable twin
      pregnancy. Apart from prematurity which created early problems in caring for
      these girls twins, born with a good Apgar score and birth weights of 1400 g and
      1350 g, the outcome was satisfactory for both the mother and daughters, who
      thrived marvelously. The incidence of this clinical form of trophoblastic disease
      which is 1/10,000 deliveries in our series confirms it rarity as reported by many
      authors.

PMID- 7784786
TI  - [Uterine rupture during labor. Report of 106 cases at the Maternity Center of
      Tunis (Tunisia)].
AB  - This study involves 106 cases of the uterus seen at the Rabta Maternity and
      Neonatology Center (Tunis) over a period of 6 years. The incidence was 1.51% of
      labors and 75.4% of cases involved rupture of a scarred uterus. Rupture of a
      healthy uterus accounted for 24.6% of cases. The clinical picture was
      asymptomatic in 66.25% of cases involving a scarred uterus. Treatment of rupture
      of the uterus was essentially conservative by suture of the tear (73.6%).
      Maternal mortality was 2.8%. Perinatal mortality was high at 37.7%.

PMID- 7784787
TI  - [Endoscopic gynecologic surgery in Africa. Luxury of necessity?].
AB  - Per- and postoperative mortality remain high in black Africa, with rates of the
      order of 30 to 40% according to teams. Three essential causes are generally
      reported: infection, hemorrhage and anesthetic complications. There can be no
      doubt as to the advantages of celiosurgery over open surgery: low postoperative
      morbidity, less than 1% serious complications, real savings in treatment costs by
      shortening of average hospital stay and time off work. Celio-surgery is
      technology-dependent and operator-dependent. The cost of equipment remains
      prohibitive and its maintenance delicate and expensive, potentially hampering the
      implantation and spread of this new technique in Africa, which also lacks
      specifically trained staff as well as an appropriate technical infrastructure.
      Nevertheless, the experience of teams in Cameroon and Gabon are encouraging with
      110 and 220 patients respectively treated by celio-surgery without complications.
      A veritable journeyman-apprentice approach is necessary for the learning of these
      new techniques by teams in developing countries, in several possible ways
      (locally or abroad), in order that the population as a whole can enjoy the
      benefits of the reproducible therapeutic and diagnostic advances of new
      techniques (celio-surgery, MAP, antenatal diagnosis, medical imaging).

PMID- 7784788
TI  - Prevalence of septal deviations in school-aged children.
AB  - A total of 687 school children, aged 6-15 years, were examined for nasal septal
      deviations with anterior rhinoscopy and maxillary sinus radiography. Septum
      deviations were divided into four different categories and the final evaluation
      included the clinically significant deviation, based on purely morphological
      findings. Columella deviation was an exceptional condition in 0.7% of children,
      septum spurs were found in 3.8%, bending of the quadrilateral cartilage was
      present in 13.4%, and premaxillary luxation in 28.7%. A clinical diagnosis of
      septum deviation was made in 9.5% of children. The occipitomental projection of
      the maxillary sinus X-ray was a good diagnostic tool in evaluating the clinical
      significance of septum deviation.

PMID- 7784789
TI  - A comparison of budesonide nasal dry powder with fluticasone propionate aqueous
      nasal spray in patients with perennial allergic rhinitis.
AB  - There is circumstantial evidence that the incidence of allergic rhinitis is
      becoming increasingly common. There may also be a need for more potent drugs with
      minimal local and systemic side effects. This study has compared the efficacy and
      safety of budesonide delivered as nasal dry powder with fluticasone propionate
      aqueous nasal spray in the treatment of perennial allergic rhinitis. Ninety-eight
      patients participated in a randomized, parallel group and partly blinded study.
      Treatment consisted of budesonide dry powder (Rhinocort Turbuhaler) at once daily
      doses of 200 micrograms (n = 24) or 400 micrograms (n = 22), fluticasone
      propionate (200 micrograms) once daily (n = 25), and placebo for budesonide dry
      powder (n = 27). A six-week treatment period was preceded by a two-week baseline
      period without treatment. Efficacy was assessed by daily subjective scoring of
      nasal symptoms. Safety was assessed by rhinoscopy, analysis of urine cortisol,
      and questioning of adverse events. All active treatments were significantly
      superior to placebo in controlling nasal symptoms. No significant differences in
      efficacy were found between the two budesonide regimens and fluticasone
      propionate. Adverse events were few and minor, and non-significantly distributed
      between treatments. In conclusion, this study shows that budesonide dry powder
      administered from Turbuhaler (200 or 400 micrograms) and fluticasone propionate
      aqueous spray (200 micrograms) administered in once daily doses, are effective
      and safe treatments of perennial allergic rhinitis. These novel treatments may
      enhance the current available alternatives in clinical practice.

PMID- 7784790
TI  - Effects of inflammatory mediators on ciliary function in vitro.
AB  - Prostaglandins and histamine released during inflammatory and allergic reactions
      can affect the mucociliary system in different ways. By studying the effect of
      these mediators on ciliary beat frequency (CBF) with a photo-electrical technique
      in airway explants from different species, i.e. guinea-pig trachea, rabbit
      maxillary sinus, and human adenoid, the mechanisms underlying the effects of
      prostaglandin and histamine were further elucidated. Prostaglandin E1 (PGE1)
      produced a modest increase in CBF in preparations from guinea-pig trachea. The
      maximum response was 12.9 +/- 3.4% for the dose of 0.1 micrograms/ml,
      corresponding with 0.28 microM. Prostaglandin E1 produced a dose-dependent
      increase in explants from rabbit maxillary sinus, the maximum effect was 35.9 +/-
      14.1% at a dose of 1.0 micrograms/ml. PGE1 produced a lesser increase in CBF in
      explants from human adenoids. A maximum increase of 4.1 +/- 1.6% was observed at
      a dose of 0.1 mg/ml. Histamine produced a moderate increase in CBF in explants
      from human adenoid at concentrations of 0.01-0.1 mM, corresponding with 1.84-18.4
      micrograms/ml. In contrast, histamine did not significantly alter CBF in explants
      from the rabbit maxillary sinus or guinea-pig trachea. These results indicate
      that there are interspecies differences in the responsiveness to prostaglandins,
      and that PGE1 seems to have more powerful effects on CBF in the upper than in the
      lower airways.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784791
TI  - New aerodynamic aspects of nasal patency.
AB  - In considering possible aerodynamic indicators of subjective nasal stuffiness, we
      measured nasal resistance, acceleration change of nasal airflow, and alteration
      of differential pressure and compared those with the degree of severity of
      sensation of nasal obstruction in 75 patients. The acceleration change of airflow
      and alteration of differential pressure are presented as an equation: y = ax2 +
      bx + c, in which "a" represents the approximate shape of the curve. Nasal
      resistance, on either inspiration or expiration, and coefficient "a" of
      acceleration change the rapid phase from inspiration to expiration correlated
      well with subjective nasal patency, while coefficient "a" of acceleration change
      the rapid phase from expiration to inspiration and alteration of differential
      pressure either the rapid phase from inspiration to expiration or from expiration
      to inspiration did not correlate well with perception of nasal blockage. It seems
      that measurement of respiratory acceleration of airflow of quiet nasal breathing
      is a useful indicator of subjective nasal patency.

PMID- 7784792
TI  - Suture tip plasty.
AB  - The three main characteristics of the nasal tip are projection, rotation, and
      contour. During rhinoplasty the surgeon will strive to preserve or change these
      characteristics in a predictable fashion, avoiding undesirable sequelae, even
      after long-term follow-up. Conservation, relocation and augmentation rather than
      reduction are key principles in modern rhinoplasty, i.e. for obtaining gratifying
      tip surgery. Interdomal suture, transdomal suture, and lateral crural steal
      follow these modern principles, while having their clear indications for
      different nasal tip pathology. All three types of techniques involve (semi
      )permanent sutures to change the shape of alar cartilages and can be considered
      complementary. Based on the same surgical philosophy these three techniques can
      be captured with the term "suture tip plasty". The objective of this paper is to
      describe, in a retrospective fashion, a series of 112 patients in whom suture tip
      plasty has been used as part of the rhinoplasty procedure. The technique proved
      versatile with predictable results and few manageable complications.

PMID- 7784793
TI  - Modified midfacial degloving. A practical approach to extensive bilateral benign
      tumours of the nasal cavity and paranasal sinuses.
AB  - Midfacial degloving is a well-known technique for entering the nasal and
      paranasal cavities, the rhinopharynx and the base of the skull. We report our
      experience with a modification of midfacial degloving, applied to two patients
      with extensive bilateral benign tumours in the nasal cavities and the paranasal
      sinuses. No rhinoplastic procedure is necessary in this modification, and the
      access to the upper part of the nasal cavity is improved.

PMID- 7784794
TI  - Chronic nasal obstruction in children. A fiberscopic study.
AB  - In this prospective study, fiberscopies were gently performed in 375 paediatric
      patients. The purpose of the study was to evaluate the nasal and nasopharyngeal
      anatomy and aetiologies of chronic nasal obstruction using fiberoptic examination
      in children. The essential advantage of this examination is that it allows a more
      thorough inspection of these cavities. The authors demonstrated that there exists
      a significant relationship between the relative size of the adenoid tissue and
      nasal obstruction complaints in children (p < 0.001). When the presence of
      adenoid hypertrophy was confirmed endoscopically, surgery proved to be highly
      efficacious in relieving chronic nasal obstruction.

PMID- 7784795
TI  - Sphenochoanal polyp in children. Diagnosis and treatment.
AB  - Two cases of sphenochoanal polyp (SCP) in children are reported. SCPs originate
      in the sphenoid sinus cavity, and extend into the choanal via the ostium.
      Symptoms associated with the syndrome include nasal blockage and headaches.
      Endoscopical examination reveals the presence of a choanal polyp, and the
      sphenoid origin of the polyp can be determined by CT scan. In cases where the
      middle meatus is obstructed, an opacity of the maxillary sinus is often observed.
      SCPs cannot be distinguished from antrochoanal polyp (ACP) by histological means.
      The treatment of the SCPs involves surgical removal and enlargement of the
      sphenoid sinus ostium. Ignorance surrounding the existence and the treatment of
      this syndrome may result in insufficient treatment and the consequent recurrence
      of the disorder.

PMID- 7784797
TI  - Giant sphenoid sinus. A case report.
AB  - A rare case of giant sphenoid sinus with excessive pneumatization is presented.
      The relevant literature is discussed.

PMID- 7784796
TI  - Aspergillosis of the paranasal sinuses.
AB  - Aspergillosis of the paranasal sinuses is a well-established clinical entity
      which has recently been classified into non-invasive and invasive forms with
      distinct sub-divisions of both types. Two cases are described, both highlighting
      potential serious complications of the disease as well as the importance of
      adequate medical and surgical treatment in effecting a favourable outcome. The
      disease is reviewed and the question as to whether cases necessarily fall into
      previously-defined clinical and pathological categories is also discussed.

PMID- 7784798
TI  - Noninvasive polygraphic cardiac changes in daunorubicin-induced cardiomyopathy in
      rabbits.
AB  - The use of anthracycline antitumour agents (e.g., adriamycin and daunorubicin) is
      limited by their dose-related cardiotoxicity. The effects of the repeated i.v.
      administration of daunorubicin (50 mg/m2, once weekly, max. 11 weeks)) were
      investigated in rabbits in vivo from the point of view of the occurrence of
      cardiotoxicity and compared with a control group of animals. Noninvasive
      polygraphic records (in ketamine anaesthesia, 50 mg/kg i.m.) were used for the
      measurement of systolic time intervals (especially the PEP:LVET ratio) to
      evaluate the function of the heart. The administration of daunorubicin induced a
      significant, progressive increase in the PEP:LVET ratio (0.3775-0.9473) and in
      the PEP:LVETcorr. ratio, as well as a lengthening of the preejection period PEP
      and a shortening of the left ventricular ejection time LVET without significant
      changes in the electromechanical systole Q-2. The values in the daunorubicin
      group were mostly significantly different from the control group of animals. The
      results of polygraphic records reflect thus a presence of cardiac dysfunction on
      the basis of daunorubicin-induced cardiomyopathy. It is thus possible to conclude
      that the results obtained in the study confirm the adequacy of the rabbit model
      of daunorubicin-induced cardiomyopathy and the methods used in the study.

PMID- 7784799
TI  - Treatment of intoxication with GV compound in laboratory rats.
AB  - Changes of some physiological functions in rats were studied following
      intoxication with new type of highly toxic organophosphate GV [2
      dimethylaminoethyl-(dimethylamido)-fluorophosphate] in doses of 2x and 4x LD50
      i.m. The intoxication has begun with increasing motoric activity followed by
      increased salivation, rumination and bristling. Tachypnoe and fasciculations
      followed by convulsions and death were observed later. Therapy of intoxication
      with GV compound (in dose of 2x LD50) in rats demonstrated the best antidotal
      effect of combination of benactyzine, atropine and HI-6. In GV intoxication in
      higher doses (4x LD50), therapeutic efficacy (survival of experimental animals)
      was limited for 24 hours. HI-6 can be therefore considered as potentially
      universal reactivator for the treatment of nerve agents intoxication.

PMID- 7784800
TI  - Teaching programs for medical biophysics: the frequency analysis.
AB  - Teaching programs and possibilities of creating them are discussed. A teaching
      program the Frequency Analysis written in the C++ language is described.
      Principle of harmonic analysis and FFT is explained.

PMID- 7784801
TI  - The immunofluorescence evaluation of some subepidermal bullous diseases by use of
      NaCl-split skin.
AB  - Authors described the results of immunohistological investigation in 13 patients-
      12 with clinical diagnosis of bullous pemphigoid and 1 patient with clinical
      diagnosis of epidermolysis bullosa acquisita. 1 M NaCl solution was used to split
      normal human skin, used as substrates for immunohistological testing of the
      antilamina lucida and anti-sublamina densa antibodies.

PMID- 7784802
TI  - Examination of sensory nerve fibers by needle recording in the carpal tunnel
      syndrome; use of the orthodromic method with special attention to the paresthetic
      forms.
AB  - The authors examined clinically, by EMG and by electrostimulation the motor and
      sensory fibers of the median nerve in 15 control hands (group A), 35 hands with
      the paresthetic form of CTS (group B), and 33 hands with CTS and pathologic DML
      (group C). The examination of the sensory fibers was performed on the first
      (thumb) to 4th digits separately by the orthodromic technique with monitoring the
      NAP by needle electrodes from the wrist. Two hundred fifty six responses were
      averaged out and always 4 stimulatory values were followed on the sensory fibers.
      The highest percentage of pathologic values by DSL in group B was on the first
      digit (thumb: 37%), in group C on the 3rd digit (93%). By DSCV the highest number
      of pathologic values in groups B and C was on the thumb (43 and 90 per cent
      respectively), for NAP duration in groups B and C on the third digit (26 and 60
      per cent respectively). In the controls the mean amplitude of NAP fluctuated
      between 19-50 uV. The best parameters are considered: the DSL, DSCV, somewhat
      less the duration of NAP. In the paresthetic form of CTS pathologic values of
      sensory parameters fluctuated between 8.6-42.8 per cent, in the group with
      pathologic DML in the range of 24.2-93.3 per cent. If one considered pathologic
      an examination that had at least one pathologic sensory parameter at least on one
      digit, group B yielded 77 per cent, and group C 100 per cent of pathological
      results.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784803
TI  - Long-term results of scleroplasty operations in children.
AB  - The authors refer results of 773 scleroplasty operations performed in 411
      children, mean age was 11.3, S.D. 3.6 years. Irradiated human sclera proved to be
      the best material for scleral reinforcement. Mean myopia progression was 0.26
      D/year in myopia progressiva and 0.23 D/year in myopia gravis. Mean visual acuity
      was better in all intervals after surgery (p = 0.0000 one and four years after,
      0.0002 six years after in myopia progressiva, in the same intervals in myopia
      gravis it was 0.0009, 0.0027, 0.0002). Scleral reinforcement can positively
      influence myopia progression.

PMID- 7784804
TI  - Conservative surgery for renal cell carcinoma--indications, technique and
      results.
AB  - At the Department of urology in Hradec Kralove between 1989-1993 287 patients
      with a tumor of the kidney were operated on, in 45 of them (15.6%)
      conservatively. In this set there are 29 men and 16 women with the mean age 56.5
      years. In 29 patients the contralateral kidney was normal (64%), 5 patients
      underwent nephrectomy for renal cell carcinoma, in 9 patients the opposite kidney
      was hypofunctionalised (hydronephrosis, cysts). In two patients the conservative
      approach was used for reasons of another type of malignancy (haematological). In
      33 (73.3%) patients enucleation, in 12 patients resection of the lower or upper
      pole were done. The tumor was classified as T 1 stage in 6 patients, but in 4
      patients already as T 3a (in patients with imperative indication). In 35 patients
      the tumor was moderately differentiated, in two ones with histologically
      confirmed renal cell carcinomas the tumors were poorly differentiated, in 8
      patients there were histologically adenomas, in one angiomyolipoma and in another
      case scar after PCN (percutaneous nephrolithotomy). Preoperative examination
      included immunological examination, this was not done in two patients. Good
      results were obtained in 21 patients (60%), 12 patients were in high risk and 6
      of them received immunotherapy. As an early complication one patient had urinary
      fistula, which resolved after introduction of stent. Relapse of malignancy in the
      screening period was not noticed.

PMID- 7784805
TI  - Low prevalence of anti-HCV antibodies among Italian Air Force recruits.
AB  - In 1990, the prevalence of antibodies to hepatitis C virus (anti-HCV) was
      assessed among 4,978 Air Force recruits aged 18-26 years coming from all regions
      of Italy. Positivity to anti-HCV was found by both IIIrd generation EIA and RIBA
      in 24 (0.48%) study participants. The prevalence was twice as high in Southern
      Italy and the islands as in Northern and Central Italy (0.76% vs. 0.35%), a
      difference which was not statistically significant. The results of multiple
      logistic regression showed that no sociodemographic variable (region of birth,
      father's years of education, number of siblings) was associated with anti-HCV
      positivity. No anti-HCV-positive individual was positive for HBsAg. Anti-HCV
      positivity was found in 0.8% (2/236) of the participants who were positive for
      anti-HBc and in 0.5% (22/4742) of those who were anti-HBc negative, also a
      difference which was not statistically significant. Thus no association was found
      between HCV and HBV infections. These findings indicate that in Italy, HCV
      infection is an uncommon event among young adult males.

PMID- 7784806
TI  - Prevalence of antibodies against tick-borne encephalitis among residents of north
      eastern Poland.
AB  - In 37 out of 613 (6%) residents of north eastern Poland, IgG antibodies to tick
      borne encephalitis virus (TBEV) were detected at levels exceeding the diagnostic
      value of 60 VIEU/ml. The prevalence of the antibodies was not related to sex or
      place or residence. However, significantly higher antibody levels were found in
      the group of forest workers than in individuals not professionally connected with
      forestry.

PMID- 7784807
TI  - Arcanobacterium haemolyticum and streptococcal pharyngitis in army conscripts.
AB  - Arcanobacterium haemolyticum was found in 1.4% and beta-haemolytic streptococci
      in 23% of throat cultures from army conscripts with sore throat (n = 498). 38% of
      the beta-haemolytic streptococci were of group A. Patients culture-positive for
      A. haemolyticum or beta-haemolytic streptococci had pharyngeal exudate, cervical
      lymphadenopathy and ear ache significantly more often--but cough less often--than
      culture-negative patients. The pharyngeal colonization rate of healthy conscripts
      (n = 232) by A. haemolyticum was 0.4% and by beta-haemolytic streptococci, 6.5%.

PMID- 7784809
TI  - Human nocardiosis in northern Italy from 1982 to 1992. Northern Italy
      Collaborative Group on Nocardiosis.
AB  - We conducted a retrospective survey of nocardiosis in 9 city hospitals in
      northern Italy from 1982 to 1992. The medical records of 30 patients with
      documented nocardiosis were reviewed. Microbiological data included morphology,
      biochemical characteristics, serology and in vitro susceptibility testing. The 29
      isolates (1 case was diagnosed on the basis of serological results) were Nocardia
      asteroides (n = 25) and Nocardia farcinica (n = 4). Predisposing factors
      including immunosuppression for organ transplant rejection prophylaxis, lung
      disease (silicotuberculosis and pulmonary fibrosis), solid tumours and
      hematological malignancies, and AIDS. Three patients had no identified risk
      factors. 20 cases of pulmonary nocardiosis were observed. Sites of infection in
      patients without previous pulmonary involvement were: brain abscesses, soft
      tissues, pericardium, blood, and cerebrospinal fluid. Most strains tested were
      susceptible to amikacin and imipenem. Resistance to several antimicrobial agents
      was found, particularly erythromycin, fosfomycin, pefloxacin, sulphonamides and
      trimethoprim. Antimicrobial chemotherapy included sulphonamides, amikacin,
      ceftriaxone, imipenem and minocycline. 21 patients survived, although 2 relapsed
      transiently. Nocardiosis appears to be more common than generally realised by
      physicians in northern Italy. The local species distribution and disease spectrum
      are similar to those described elsewhere. Nocardiosis should be part of the
      differential diagnosis in patients with pulmonary infiltrates or brain abscess,
      particularly those with predisposing factors.

PMID- 7784808
TI  - Mortality rate and magnitude of Staphylococcus aureus bacteremia as assessed by a
      semiquantitative blood culture system.
AB  - A 4-year retrospective study ascertained the relation between the magnitude of
      Staphylococcus aureus bacteremia and mortality. 253 episodes of S. aureus
      bacteremia diagnosed in a Danish regional Department of Clinical Microbiology
      were included. Blood cultures were routinely done by inoculation of aseptically
      drawn blood into multiple tubes of bacteriological media. The rate of positive
      tubes was assumed to distinguish high- from low-grade bacteremia without
      providing an absolute count of colony forming units. The median number of tubes
      inoculated was 18 (range 6-48) with approximately 0.5-1 ml of blood per tube. The
      rate of positive tubes was related neither to the source of infection, i.e.
      whether the S. aureus infection was nosocomially or community-acquired, nor to
      the portal of entry. However, mortality increased with increasing rate: it was
      18% for rates < 0.30, 23% for 0.30-0.69, 30% for 0.70-0.99, and 37% for a rate of
      1.0. Thus, for S. aureus infections the magnitude of bacteremia seems to be a
      prognostic factor with possible bearings on clinical and therapeutic decisions.

PMID- 7784810
TI  - Treatment of louse-borne relapsing fever with low dose penicillin or
      tetracycline: a clinical trial.
AB  - A clinical trial was conducted in order to evaluate the efficacy of procaine
      penicillin and tetracycline, respectively, in the treatment of louse-borne
      relapsing fever. 184 patients (160 men, 24 women) admitted to the Gondar hospital
      during the rainy season 1992 were assigned to 1 of 4 treatment groups: procaine
      penicillin 100,000 (PP100), 200,000 (PP200) or 400,000 (PP400) international
      units (IU) intramuscularly (i.m.), or tetracycline 250 mg per os (TTC, p.o.). All
      drugs were given as single doses. The overall case fatality rate was 3.3%.
      Frequency of relapses, Jarisch-Herxheimer-like reactions (JHR) and deaths were
      significantly different between patients treated with TTC and those treated with
      PP100. Relapses occurred most often in the group receiving the lowest dose of
      penicillin (46%), and decreased with increasing dosage of penicillin; none of the
      patients treated with TTC had a relapse. Occurrence of JHR showed the opposite
      pattern: whilst 2 (5%) patients treated with PP100 developed a JHR, 16 (29%) in
      the PP200 group, 10 (31%) in the PP400 group, and 27 (47%) in the TTC group
      developed a JHR. As mortality is linked to severe JHR, and most relapses are
      clinically mild and easily treated, these results speak in favour of using low
      dose penicillin to initiate the treatment of relapsing fever.

PMID- 7784811
TI  - Prevention of hepatitis B by immunization of the newborn infant--a long-term
      follow-up study in Stockholm, Sweden.
AB  - In order to assess the present hepatitis B immunization program in Stockholm,
      Sweden, 212 children of HBsAg carrier mothers were followed up 2-9 years after
      birth. In babies of HBeAg-positive mothers a combined passive and active
      immunization schedule with hepatitis B immunoglobulin (HBIG) and hepatitis B
      vaccine was used. Among 25 children to such mothers, 1 HBsAg carrier and 5
      children with asymptomatic seroconversion were found. To newborns of HBeAg
      negative/anti-HBe-negative mothers, only vaccine was given. Among 15 such
      children, no HBsAg carrier (but 1 child with an asymptomatic seroconversion) was
      found. In babies of HBeAg-negative/anti-HBe-positive mothers, immunization was
      withheld between 1983 and 1987. Among 90 such children, 1 HBsAg carrier and 8
      asymptomatic seroconversions were detected. After 1987, newborns in this group
      were vaccinated whereafter 3 asymptomatic seroconversions were found among 82
      children. We conclude that in low prevalence areas a screening program for HBsAg
      should be offered to pregnant women originating from hepatitis B endemic regions,
      since immunoprophylaxis gave long-term protection to most children at risk.
      Children born to HBeAg-positive mothers should receive vaccine in combination
      with HBIg, whereas for children of mothers lacking HBeAg, vaccination only seems
      sufficient, at least if a rapid vaccination schedule is used.

PMID- 7784812
TI  - Endotoxin, interleukin-6 and phospholipase-A2 as markers of sepsis in patients
      with hematological malignancies.
AB  - The concentrations of endotoxin, interleukin-6 (IL-6) and group II phospholipase
      A2 (PLA2-II) were measured in serum or plasma during cytotoxic chemotherapy,
      fever of unknown origin and sepsis in 56 patients with hematological malignancies
      and during sepsis and viral infections in 22 non-hematological patients. High
      concentrations of IL-6, PLA2-II and endotoxin were detected in sepsis, the levels
      being similarly elevated in hematological and non-hematological patients. The
      levels of IL-6 and PLA2-II correlated closely with that of C-reactive protein
      (CRP). The levels of PLA2-II and IL-6 declined earlier than the level of CRP
      during the course of antimicrobial treatment. The levels of IL-6 also rose
      earlier than the level of CRP. The ability of IL-6 and PLA2-II and endotoxin to
      discriminate between sepsis and other causes of fever was comparable to that of
      CRP. IL-6 and PLA2-II are, together with CRP, valuable tools for the detection of
      sepsis in patients with hematological malignancies who undergo cytotoxic
      medication. Endotoxin is not suitable for routine laboratory diagnosis of sepsis.

PMID- 7784813
TI  - Disk diffusion susceptibility tests: need for laboratory-specific breakpoints.
AB  - Significant changes were observed in the measured resistance levels of
      Escherichia coli and Staphylococcus aureus when the Biodisk disk susceptibility
      test method used in 1992 was replaced with another commercial method, Oxoid. For
      example, when non-species-specific breakpoints were used, the frequency of
      cephalotin-resistant E. coli was 12% of all isolates in 1992 but only 4% in 1993;
      the corresponding figures for the intermediately resistant isolates were 84% and
      8%. The population distribution histograms were however, practically unchanged.
      Thus, the resistance percentages apparently did not reflect the real development
      of resistance. Similar findings were also made for several other antimicrobials.
      Susceptibility test breakpoints should therefore be examined separately for all
      bacterial species in each laboratory, and the application of adjusted laboratory
      specific breakpoints should be considered. For this purpose, the WHONET computer
      program provides excellent assistance.

PMID- 7784814
TI  - Detecting erythromycin resistance in Streptococcus pyogenes: reliability of the
      disk diffusion method and the breakpoint susceptibility testing method. Finnish
      Study Group for Antimicrobial Resistance (FIRE).
AB  - Erythromycin susceptibility of clinical Streptococcus pyogenes isolates was
      determined at 19 Finnish clinical microbiology laboratories by their routine disk
      diffusion method and by a screening method adapted from the breakpoint
      susceptibility testing method. Results obtained at 12 laboratories using 4 major
      variants of the disk method were further evaluated. From these laboratories, 286
      consecutive resistant and 349 consecutive susceptible isolates were sent to the
      Antimicrobial Research Laboratory, Turku where the MIC of erythromycin was
      determined. 96% and 97% of the disk results were correct, as compared with MIC
      results, when general and laboratory-specific breakpoints, respectively, were
      used. The results of the screening method were comparable to those of the disk
      method.

PMID- 7784815
TI  - Antimicrobial resistance in Haemophilus influenzae isolated from blood,
      cerebrospinal fluid, middle ear fluid and throat samples of children. A
      nationwide study in Finland in 1988-1990.
AB  - A nation-wide survey of the prevalence of antimicrobial resistance in Haemophilus
      influenzae was conducted on isolates collected in 1988-90 from middle ear fluid
      (MEF), blood, or cerebrospinal fluid (CSF) in infected children or throat samples
      of healthy children. Altogether 885 strains were examined regarding capsular type
      b, beta-lactamase production and the minimal inhibitory concentration (MIC) of
      ampicillin, cefaclor, erythromycin, tetracycline, chloramphenicol, trimethoprim
      and trimethoprim-sulfamethoxazole for these strains was determined by the agar
      dilution method. 99% (578/585) of MEF isolates, 93% (112/121) of throat isolates,
      but only 6% (10/179) of blood/CSF isolates were not of type b (Hib). The rate of
      beta-lactamase production was 11.4% among Hib strains, 8.0% among non-type b MEF
      isolates, and 4.5% among non-type b throat isolates. No increase in the
      prevalence of beta-lactamase production in H. influenzae has taken place in
      Finland since the early 1980s. Resistance to ampicillin among strains that lacked
      beta-lactamase activity was rare (0.2%). Of the non-type b MEF and throat
      isolates, 5.9% and 2.7%, respectively, were resistant to trimethoprim and 3.6%
      and 2.7%, respectively, to trimethoprim-sulfamethoxazole. Resistance to other
      drugs was rare (< 2%) in all isolate groups.

PMID- 7784816
TI  - Invasive Haemophilus influenzae disease: epidemiology and clinical spectrum
      before large-scale H. influenzae type b vaccination.
AB  - In a prospective study between January 1987 and December 1992, 103 patients with
      invasive Haemophilus influenzae (Hi) infection were identified in a well-defined
      population before large-scale Haemophilus influenzae type b (Hib) vaccination was
      introduced. The incidence (case/100,000/year) of invasive Hi infection was 5.9
      for the whole population, 55 for children 0-4 years old and as high as 2.8 for
      adults. Hib was the predominant cause of the infection (83 cases) in children
      but, in adults, 13/39 (30%) cases were caused by non-typable Hi and 6/39 (19%) by
      Hi serotype f. Three patients (3%) died and 6 (5.8%) suffered a permanent sequel
      from the infection. All patients with such a sequel had invasive Hib infection.
      No significant difference between patients 0-6 years old and matched controls
      regarding the frequency of subnormal serum levels of immunoglobulins was found.

PMID- 7784817
TI  - Prevalence of Cryptosporidium sp. in patients with neoplasia and diarrhea.
AB  - The prevalence of Cryptosporidium sp. was investigated in fecal specimens from
      106 patients with neoplasia and diarrhea (74 females, 32 males) by using Ziehl
      Neelsen and Giemsa stains. Oocystic forms of Cryptosporidium sp. were found in 18
      (17%) of these patients. No oocystic form of Cryptosporidium sp. was detected in
      the control group of 60 patients with neoplasia (37 females, 23 males) but
      without diarrhea. The frequent findings of Cryptosporidium sp. in patients with
      neoplasia and diarrhea who are undergoing chemotherapy indicates that a search
      for this organism is justified.

PMID- 7784819
TI  - Cranial nerve palsies and cerebral infarction in a young infant with
      meningococcal meningitis.
AB  - A previously healthy 30-day-old male infant became ill with fever, poor activity,
      and refusal to feed for 2 days. A cerebrospinal fluid examination revealed 7.15 x
      10(8) leukocytes/l with 72% neutrophils, protein 4.6g/l, and glucose 7 mg/dl.
      Neisseria meningitidis was isolated from the blood and cerebrospinal fluid. On
      the fourth day of hospitalization, the baby was found to have left oculomotor and
      facial palsies, which resolved gradually. He was treated with intravenous
      penicillin for 2 weeks. A repeat CSF examination revealed a high persisting
      protein level of 2.9 g/l and a computerized tomographic brain scan revealed a
      cerebral infarction in the bilateral frontal lobes. The treatment was extended to
      4 weeks. No relapse of the infection was noted. This is the first case report of
      an infant with meningococcal meningitis complicated by cranial nerve palsies and
      cerebral infarction. This and previous reports, show that meningococcal
      meningitis at an extremely young age is associated with a greater risk of
      developing neurological complications.

PMID- 7784818
TI  - Disseminated toxoplasmosis in AIDS patients--report of 16 cases.
AB  - Between June 1986 and October 1992, disseminated toxoplasmosis was diagnosed in
      16 AIDS patients. 13 cases were diagnosed at autopsy where multiple organ
      involvement was documented in all 13. Three patients were diagnosed intra vitam.
      All 3 survived with appropriate treatment. Clinical features indicative of
      disseminated toxoplasmosis were: fever of unknown origin between 39 degrees and
      40 degrees C in 16 cases, clinical signs suggestive of sepsis or septic shock in
      15, with progression to multiorgan failure in 10, disseminated intravascular
      coagulopathy in 6, confusion, disorientation or apathy in 13 and lack of a
      systemic pneumocystis carinii prophylaxis in all 16. Typical laboratory markers
      were: CD4 cell counts below 100 x 10(6)/l in 16 cases, elevation of serum lactic
      dehydrogenase in 16 and creatine phosphokinase (in 4/6), normal or only slightly
      elevated C-reactive protein (in 9/11), positive Toxoplasma gondii IgG antibodies
      in 15/16 and negative IgM antibodies in all 16. Lesions indicative of cerebral
      toxoplasmosis were visualized on cranial computerized tomography in only 3/10
      evaluated patients. In patients with advanced HIV infection presenting with a
      systemic illness, including the clinical and laboratory features described above,
      systemic Toxoplasma gondii infection must be included in the differential
      diagnosis. In these patients, specific and if warranted, invasive diagnostic
      procedures followed by early vigorous therapeutic intervention should be
      considered.

PMID- 7784820
TI  - Acute epiglottitis in the adult caused by Neisseria meningitidis.
AB  - Acute epiglottitis is being increasingly encountered in the adult population.
      While it has many similarities to its pediatric counterpart, the presentation and
      associated pathogens are distinct. In addition, although the recent literature
      has suggested that acute epiglottitis in the adult follows a benign course this
      is not always the case. Here we describe a case of acute, fulminant epiglottitis
      in an immunocompetent host, caused by Neisseria meningitidis.

PMID- 7784821
TI  - Bacteraemia caused by Rahnella aquatilis: report of two cases and review.
AB  - Rahnella aquatilis, a rare Gram-negative rod, usually found in fresh water, was
      isolated from blood of a diabetic patient and a patient with laryngeal carcinoma.
      Both recovered from the infection after treatment with parenteral antibiotics
      including gentamicin.

PMID- 7784822
TI  - First documented case of bacteremia with Vibrio vulnificus in Sweden.
AB  - A few days after a mild trauma to a toe, a 90-year-old woman presented with
      fever, malaise and cellulitis. On suspicion of erysipelas the patient was
      initially treated with benzylpenicillin and cefuroxime. Her general condition
      improved rapidly, but there was local progression with numerous necrotic areas
      with surrounding bullae. Vibrio vulnificus was isolated from the blood. After
      susceptibility testing, the patient was finally treated with ciprofloxacin and
      pivampicillin, and recovered slowly. To our knowledge, this is the first reported
      case of bacteremia with V. vulnificus in Sweden.

PMID- 7784823
TI  - Fusobacterium nucleatum, a new invasive pathogen in neutropenic patients?
AB  - Three chemotherapy-induced neutropenic hematologic patients with severe systemic
      infection caused by Fusobacterium nucleatum, a Gram-negative anaerobic rod, are
      described. Anaerobic infections are not very common in this patient category, but
      in a short period of time, several such patients were seen. The infection was
      considered to be caused by a combination of chemotherapy-induced mucositis, which
      served as a portal of entry for the systemic infection, and the antibiotic regime
      used in these patients. This is a serious infection with a high mortality. In
      hematological neutropenic patients suffering from severe mucositis and fever,
      antibiotic therapy should cover anaerobic bacteria.

PMID- 7784824
TI  - Catheter-related infections by Hansenula anomala in children.
AB  - During August and September, 1992, we experienced 4 cases of Hansenula anomala
      (H. anomala, synonym Pichia anomala) fungemia in immunocompromised patients. Two
      patients had been suffering from a malignant disease, 3 of them had received
      broad-spectrum antibiotics and a central venous catheter (CVC) had been inserted
      in all of them. H. anomala was isolated as the sole pathogen from all 4 patients.
      Three of them responded favorably to fluconazole after withdrawal of the
      catheter, but one failed. H. anomala should be considered as a possible cause of
      catheter-related infections.

PMID- 7784825
TI  - Histoplasma capsulatum infection in three AIDS patients living in Africa.
AB  - Three AIDS patients are reported, 2 European and 1 African. All 3 developed
      Histoplasma capsulatum infection while living in Africa. Two developed a
      pulmonary infiltrate, and 2 had skin lesions. One patient was successfully
      treated with itraconazole, 400 mg daily; in a second patient, itraconazole was
      partially successful; the third patient was lost to follow-up before adequate
      treatment could be started. Histoplasma infection is probably an often
      undiagnosed complication in African AIDS patients.

PMID- 7784826
TI  - Etiology of acute sporadic hepatitis in adults in Senegal and Tunisia.
AB  - Markers for acute hepatitis A, B, C and E virus infections were examined in the
      sera of 72 patients suffering from acute hepatitis in Senegal and Tunisia.
      Hepatitis B was responsible for 36% and hepatitis C for 21% of the cases. Acute
      hepatitis A was not diagnosed. HEV infection was not observed in Senegal and
      represents only 4% of the acute hepatitis cases in Tunisia.

PMID- 7784828
TI  - Moraxella catarrhalis bacteraemia in an immunocompetent adult.

PMID- 7784827
TI  - Hypersensitivity hepatitis due to pyrazinamide.
AB  - Pyrazinamide hepatotoxicity is considered secondary to a direct and dose-related
      toxic effect. At currently used doses, pyrazinamide provides effective short-term
      treatment and is free from serious side effects. We report a case of pyrazinamide
      induced hepatitis for which the rechallenge data strongly suggest a
      hypersensitivity mechanism.

PMID- 7784829
TI  - Dapsone as prophylaxis for disseminated Mycobacterium avium complex infection.

PMID- 7784830
TI  - Back to work: neck-and-shoulder problems; etiology, prevention, consequences and
      rehabilitation. Proceedings of an international conference. Stockholm, April 21
      23, 1992.

PMID- 7784831
TI  - Health economy: evaluating the costs and benefits of occupational health
      programs.

PMID- 7784832
TI  - Neck-and-shoulder pain, an increasing problem. Strategies for using insurance
      material to follow trends.

PMID- 7784834
TI  - Ethical issues in prevention and rehabilitation.

PMID- 7784833
TI  - The Swedish social insurance system: overview of organization and costs.

PMID- 7784835
TI  - Conclusions and consensus statements presented by the chairmen responsible for
      the workshops.

PMID- 7784836
TI  - Pain physiology and principles of treatment.

PMID- 7784837
TI  - Clinical aspects of neck-and-shoulder pain.

PMID- 7784838
TI  - Impairments, disabilities, and handicaps of patients with neck-and-shoulder pain;
      how are these consequences of disease classified?
AB  - This article describes various ways of classifying clinical problems related to
      pain in the neck-and-shoulder regions: the classification of impairments,
      disabilities, and handicaps, the classification of diseases and injuries, and the
      classification of chronic pain. It has been argued that diagnosis and
      classification is bad for patients: "it only labels the patient", it has been
      said. Of course, the individual patient must be taken care of with a
      comprehensive view, yet the best way to improve our possibilities to help
      patients is to strive for better understanding of the mechanisms underlying the
      problem they present, and this cannot be done without tools of categories. Hence
      the classifications of clinical problems are absolutely necessary.
      Classifications do not harm the patients, but lack of knowledge can do so!

PMID- 7784839
TI  - Principles for medical rehabilitation of patients with chronic neck-and-shoulder
      pain.

PMID- 7784840
TI  - An overview of psychosocial and behavioral factors in neck-and-shoulder pain.
AB  - Psychological factors are suspected to be pertinent in the etiology, maintenance,
      treatment and prevention of neck and shoulder pain problems. I present a broad
      overview of current knowledge and trends concerning cognitive-behavioral factors
      for these pain problems. Although there is a dire lack of research concerning
      cognitive-behavioral approaches and no psychological theory specific to neck and
      shoulder problems is currently available, a good deal is nevertheless known about
      musculoskeletal pain in general. Consequently, there is reason to believe that
      these factors may be involved in the etiology of neck-and-shoulder disorders. In
      particular, psychological factors appear to be important in the development and
      maintenance of subacute and chronic problems. Treatment techniques, adherence,
      and prevention are examined from a psychological perspective. The application of
      cognitive-behavioral factors to the treatment and prevention of neck and shoulder
      pain should provide new avenues which enhance results. It is concluded that while
      a lack of research precludes definite conclusions, there is ample reason to
      believe that research into psychological factors may well result in a better
      understanding of neck and shoulder pain and enhanced treatment and prevention
      outcomes.

PMID- 7784841
TI  - Should physical therapists treat pain or dysfunction? What is the primary
      treatment goal?

PMID- 7784842
TI  - The new role of Swedish Occupational Health Care in relation to rehabilitation.

PMID- 7784843
TI  - A new role of the Swedish social insurance office in rehabilitation: current
      research and development at the Stockholm Office.

PMID- 7784845
TI  - Predicting injury and identifying the cause. Can we always do so?

PMID- 7784846
TI  - Scandinavian journal of social medicine: continuation and change.

PMID- 7784844
TI  - Principles of prevention of neck-and-shoulder pain.

PMID- 7784847
TI  - Social network, social support and the prevalence of neck and low back pain after
      retirement. A population study of men born in 1914 in Malmo, Sweden.
AB  - In this study we investigated the importance of social network and social support
      systems outside the workplace and workload and psychological job strain in former
      work for the prevalence of daily neck and low back pain. The study population (n
      = 621) comprised a random half of all male residents in Malmo, Sweden, born in
      1914, of whom 500 (80.5%) participated. Two of the social network and social
      support indices (social anchorage and availability of material and informational
      support) were independent of life-style factors (leisure time physical activity,
      smoking and alcohol consumption) related to daily neck and back pain after
      retirement (OR = 2.0, 95% CI 1.2-3.4 and OR = 1.7, 95% CI 1.0-2.7, respectively),
      while the psycho-social and physical factors in former work were not. As no
      conclusion about the direction of the association can be drawn, prospective
      studies are needed to further explore these findings.

PMID- 7784848
TI  - Social inequality in height. A comparison between 10-year-old Helsinki and
      Stockholm children.
AB  - The height of children may be used to indicate social inequality. The aim of this
      study was to analyze the difference in height of the socially more and less
      privileged 10-year-old Helsinki children in 1963 and 1991 and to compare the
      social gap to the corresponding gap in 1943, 1963 and 1991 in previous studies of
      Stockholm children. The difference in mean height of the Helsinki boys in 1963
      was 4.5 cm (p < 0.001) and for girls 4.4 cm (p < 0.001). In Stockholm the
      corresponding differences in 1963 were negligible. Twenty years earlier (in 1943)
      it was 3.2 cm (p < 0.001) in Stockholm. In 1991 the difference was 1.4 cm (p <
      0.05) for boys and 0.6 cm (n.s.) for girls in Helsinki, equivalent to the
      findings of the Stockholm children at the same time. The well-off Helsinki
      children already in 1963 were as tall as the Stockholm children. Thus, the
      decrease of the social gap in height from 1963 to 1991 in Helsinki seems to be
      mainly due to an increase in height of the socially less privileged children,
      exactly what was previously found for the Stockholm children between 1943 and
      1963. Would the time for the equalization of height mirror the time for the
      development of the welfare states in Finland and Sweden respectively?

PMID- 7784849
TI  - Height and social mobility. A study of the height of 10 year olds in relation to
      socio-economic background and type of formal schooling.
AB  - Based on a representative sample of Stockholm school-children born in 1943, the
      association between the height at 10 years of age and the selection to higher and
      lower education at the same age was examined for upper and lower social groups
      defined by the father's occupational status. The hypothesis that there is a link
      between height and change of social position even among children was examined.
      Upwardly mobile boys (lower class boys selected for higher education) were taller
      than those staying in their social position. Downwardly mobile boys (higher class
      boys selected only for elementary education) were smaller than those remaining in
      their social position. The same tendency was found for girls--although not
      statistically significant.

PMID- 7784850
TI  - Social class and cardiovascular disease--an update.
AB  - Cardiovascular disease is associated with a low social class position in numerous
      epidemiological studies. The mechanisms behind this finding are not fully known,
      although several factors may be of importance (e.g. lifestyle, neuroendocrine
      regulation, foetal deprivation). A better understanding of the biological basis
      for class-related disease may facilitate efforts in preventive medicine related
      to cardiovascular health.

PMID- 7784851
TI  - Smoking or quitting during pregnancy: associations with background and future
      social factors.
AB  - Current and future social factors associated with smoking habits during pregnancy
      were assessed. Data on maternal smoking, social background and the family's
      development during the 21 years after delivery were gathered for a prospective
      longitudinal cohort study of 12,068 pregnant women and their children in Northern
      Finland in 1966 and for a second birth cohort of 9,362 mothers in 1985-86. The
      prevalence of smoking before pregnancy was 22% in the 1966 cohort (29% in 1985
      86). 12% (18%) of the women continued smoking throughout their pregnancy. The
      following background factors were mainly associated with the mother's smoking
      and/or continuing during pregnancy in both cohorts when mother's age, parity,
      place of residence and social class were standardized: mother's age under 23,
      parity two or more, low social class, urban dwelling, unmarried, gainful
      employment and heavy smoking. The follow-up responses after 14 and 21 years,
      respectively, were mostly more favourable among the non-smoking mothers and those
      who quit smoking during pregnancy-e.g. stable family structure, child's smoking
      and drinking habits and application for intermediate education. Smoking
      throughout pregnancy or quitting of smoking late in pregnancy were associated
      with undesirable future development of the child and family in most of these
      aspects.

PMID- 7784852
TI  - Health promotion in schools: policies and practices in Stockholm county, 1990.
AB  - A survey was undertaken of the policies and practices concerning organisation and
      implementation of health education and health promotion in schools in 151 of the
      total 213 Local Educational Areas (LEAs) in Stockholm county in 1990. Health
      education was included in the workplan of 49% of the responding LEAs, while 39%
      of respondents had a local action programme or guidelines for health education.
      Topic areas taught to all pupils and considered most important included alcohol,
      drug abuse, smoking, sex education, bullying, nutrition and physical exercise.
      Most senior level schools (55-83%) had written policies concerning pupils using
      alcohol, drugs or smoking in school, and 68% of LEAs had restrictions on staff
      smoking in school. Continuing health education was desired by 87% of the
      respondents. A written programme/plan regarding health education was identified
      as an important indicator of interest and commitment in health education and
      health policy issues by the local school.

PMID- 7784853
TI  - Physicians' experience with Norplant implantable contraceptives in Finland.
AB  - Norplant contraceptives are manufactured in Finland, but the majority of Norplant
      users live in the Third World. The objective of this study was to study Finnish
      family planning physicians experience with and attitudes towards Norplant
      contraceptives. Three data sources were used: (1) review of articles published in
      non-commercial Finnish medical journals between 1980 and 1990, (2) a sample of
      eleven physicians known to have experience with Norplant and chosen by a snow
      ball method, and (3) a random sample of 22 physicians in charge of public family
      planning services stratified by municipality and degree of urbanization. The
      articles reflected a positive attitude towards Norplant, but the authors did not
      believe that Norplant should replace any previous method of contraception. In the
      random sample the amount of experience with Norplant was low. In both groups the
      general attitude towards Norplant was reserved. It was not used as a method of
      first choice, but was considered a good method for carefully selected women.
      Norplant was considered troublesome for the physician, requiring surgical
      procedures, producing side-effects and demanding time for counselling. Adequate
      use of Norplant calls for a good health care infrastructure, hygienic facilities
      and trained personnel. These are often lacking in Third World settings.

PMID- 7784855
TI  - Asthma and allergic rhinitis among Finnish adolescents in 1977-1991.
AB  - OBJECTIVES: To study whether asthma and allergic rhinitis had increased from 1977
      to 1991 and if so, in which subpopulations; to study if structural changes of the
      society or change in the genetic susceptibility of the population could explain
      the increase. DESIGN: Cross-sectional surveys with mailed questionnaires in 1977,
      1979 and 1991, data from 1977 and 1979 combined; national mortality statistics.
      SETTING: Finland. SUBJECTS: A nationwide sample of 12-, 14-, 16- and 18- year
      olds. Sample sizes were 4335 and 3059, response rates 88% and 77%. Mortality
      statistics from 1958 to 1990. MAIN OUTCOME MEASURES: Point prevalence rate (%) of
      self-reported, physician-diagnosed asthma and allergic rhinitis, susceptibility
      of the population measured by probability of respiratory death. RESULTS:
      Prevalence of asthma was 1.0% in 1977-1979 and 2.8% in 1991, that of allergic
      rhinitis 5.0% and 14.9%. Logistic regression analysis showed that the increase
      did not differ in socio-demographic subgroups or parents' smoking groups and that
      changes in the distribution of socio-demographic variables did not explain the
      difference either. Respiratory deaths in ages 0-4 were fewer in the birth cohorts
      measured in 1991. CONCLUSIONS: Physician-diagnosed asthma and allergic rhinitis
      increased three-fold among Finnish adolescents in 1977-1991. Factors which
      explain the increase affected all subgroups similarly. Such factors could be
      changes in diagnostic practices and indoor air quality. Increased susceptibility
      could explain only a small part. It is likely that a major part of this
      considerable increase is real.

PMID- 7784854
TI  - Nonresponse bias due to consent procedures in school-based, health-related
      research.
AB  - Written, parental consent was solicited from parents of 517 seventh grade
      students in four junior high schools in Bergen, Norway for their children's
      participation in a longitudinal nutrition education study. After having received
      several reminders, 97.3% of the parents gave their written consent. Students
      whose parents gave an immediate written consent reported more positive eating
      habits and were more likely to plan for college than were students whose parents
      responded after receiving one or more reminders. The observed differences did not
      severely bias our baseline estimates of these variables, and the magnitude of the
      observed intervention impact did not change as a result of excluding students
      whose parents were slow to respond. Excluding these students did, however, affect
      our ability to identify important factors associated with healthy eating behavior
      including socio-economic status. Subject selection bias may represent a threat to
      the validity of studies using a written parental consent procedure.

PMID- 7784857
TI  - Data quality after restructuring a national medical registry.
AB  - The validity of the 1991 Finnish Medical Birth Registry data was assessed, with
      special emphasis on the effects of changes made to the data collection form in
      1990. Data abstracted from medical records for all births occurring in 49
      hospitals during a five-day sample period (n = 865) were compared to the register
      information. Good or satisfactory validity was found for 32 of 33 variables, when
      minor error was tolerated in variables with continuous scales. For diagnoses and
      procedures, recorded in check-box format, satisfactory validity was found for 10
      of 45 variables. Validity could not be assessed for 18 variables because of
      insufficient number of cases (13 items) or definition problems (5 items). When
      the results were compared to a 1987 data quality study, many of the variables
      that had been changed to the check-box format showed improvement in validity. In
      addition, in some cases a small change in question alternatives or instructions
      caused a noticeable change in validity.

PMID- 7784856
TI  - Validity assessment of a social support index.
AB  - The purpose of this study was to reevaluate the psychometric properties of the
      social support sumindex used earlier in a Swedish longitudinal study. The results
      based on the data of a cross-sectional survey in 1992. A randomly selected cohort
      consisted of 212 men, aged 50 to 60 years. The population sample (n = 4853) was
      resident in Kuopio Province, Eastern Finland. The 34-item-index was stable. Item
      total and item-item coefficients showed low internal consistency of the overall
      index and of most of the subindices. The index had good content validity. Limited
      evidence of construct validity was noticed. Index assessed well person's social
      network and support level, and association between the blood pressure and some of
      the subindices was noticed. The eight underlying subindices did not emerge in
      factor analysis. Before further using this index we propose its shortening with
      six items and re-grouping items into subindices.

PMID- 7784858
TI  - Major differences in cardiovascular risk indicators by educational status.
      Results from a population based screening program.
AB  - All people aged 30-59 years living in one primary health care center's catchment
      area were invited to participate in a population based screening program. A total
      of 2642 people (68%) participated. An overall risk index for having a heart
      attack within 5 years (Ps) was calculated based on diastolic BP, smoking status,
      total cholesterol, and age. Other risk indicators registered were Body Mass
      Index, and physical activity. A highly significant association between education
      level and age-adjusted overall risk index for both men (p = 0.001) and women (p <
      0.001) was found. Also Body Mass Index, total cholesterol, smoking status, and,
      for women, diastolic blood pressure showed similar significant variation with
      education level with higher education associated to lower risk. These findings
      imply the possibility of a great variation in the "risk" of receiving
      pharmacological treatment for one's CVD risk factors.

PMID- 7784859
TI  - Reducing random measurement error in assessing postural load on the back in
      epidemiologic surveys.
AB  - OBJECTIVES: The goal of this study was to design strategies to assess postural
      load on the back in occupational epidemiology by taking into account the
      reliability of measurement methods and the variability of exposure among the
      workers under study. METHODS: Intermethod reliability studies were evaluated to
      estimate the systematic bias (accuracy) and random measurement error (precision)
      of various methods to assess postural load on the back. Intramethod reliability
      studies were reviewed to estimate random variability of back load over time.
      RESULTS: Intermethod surveys have shown that questionnaires have a moderate
      reliability for gross activities such as sitting, whereas duration of trunk
      flexion and rotation should be assessed by observation methods or inclinometers.
      Intramethod surveys indicate that exposure variability can markedly affect the
      reliability of estimates of back load if the estimates are based upon a single
      measurement over a certain time period. Equations have been presented to evaluate
      various study designs according to the reliability of the measurement method, the
      optimum allocation of the number of repeated measurements per subject, and the
      number of subjects in the study. CONCLUSION: Prior to a large epidemiologic
      study, an exposure-oriented survey should be conducted to evaluate the
      performance of measurement instruments and to estimate sources of variability for
      back load. The strategy for assessing back load can be optimized by balancing the
      number of workers under study and the number of repeated measurements per worker.

PMID- 7784860
TI  - Mortality among Icelandic nurses.
AB  - OBJECTIVE: The goal of the study was to investigate the mortality pattern of
      female nurses in a retrospective cohort study with special focus on suicide.
      METHODS: The mortality of nurses was compared with that of the general female
      population. The main outcome measure was the standardized mortality ratio (SMR).
      The participants were 2159 female nurses (ie, all registered nurses in Iceland
      between 1920-1979). RESULTS: A long-lasting healthy worker effect was found in
      the cohort. A moderate excess of suicide was observed. A deficit was found for
      stomach cancer, ischemic heart disease, and respiratory disease. When the cohort
      was divided according to employment time, there was an excess of brain cancer
      among those with an employment time of less than 20 years, and all the suicides
      occurred in that group. The deficit of ischemic heart disease and respiratory
      disease was more pronounced in the group employed more than 20 years.
      CONCLUSIONS: It was concluded that nurses, primarily those with a long employment
      time, enjoy the benefits of their initial good health, but the moderate excess of
      suicide could be associated with stress and frustration, which the nurses relate
      to their work situation.

PMID- 7784861
TI  - Occupational back pain--an unhelpful polemic.
AB  - In most industrialized countries, disability and work absence due to occupational
      back pain have risen steadily in recent decades. Conventional views of the causes
      of this slow epidemic tend to fall into one of the following three areas: (i) the
      clinical pathology view, which attributes the level of pain and disability to
      either the severity of the initial injury or to psychosomatic conditions; (ii)
      the biomechanical exposures view, which attributes the problem to hazardous and
      preventable conditions of work; and (iii) the perverse incentives view, which
      suggests that reporting and disability are influenced by a combination of work
      dissatisfaction and accessible disability benefits. This paper reviews, from an
      epidemiologic perspective, the specific methodological hurdles faced during
      investigations of the etiology of occupational back pain. It is argued that
      methodological issues have contributed to the perpetuation of the three distinct
      but incomplete views of the problem. New research directions are suggested and a
      broader interdisciplinary perspective is proposed to help resolve the existing
      polemic.

PMID- 7784862
TI  - Dermatoses determined in a population of farmers in a questionnaire-based
      clinical study including methodology validation.
AB  - OBJECTIVES: The study analyzed skin diseases in a population sample of Finnish
      farmers descriptively and in the process validated the question "Do you have a
      skin disease now?" METHODS: All farmers from one Finnish municipality were
      surveyed for dermatoses, first with a questionnaire and then with a clinical
      examination of those who reported dermatoses. Another population of farmers
      answered a set of questions immediately before a clinical examination, and the
      self-report of current dermatosis was validated. RESULTS: Eczema was diagnosed
      for 66% of the women and 53% of the men who had reported dermatosis in the
      questionnaire study 6 to 12 months earlier. Toe-web maceration, psoriasis,
      folliculitis, and acne were, after eczema, the most frequent diagnoses (in that
      order). In more than 50% of the cases, the location of clinically determined
      dermatoses corresponded with the skin disease areas reported 6 to 12 months
      earlier. In the validation study, everyone who reported a skin disease
      immediately before the clinical examination were found to have a skin disease. In
      addition 22% of those not reporting dermatosis were found to have a skin disease.
      Toe-web maceration was the most common dermatosis not reported by the farmers.
      CONCLUSIONS: Finnish farmers suffered from the same type of dermatoses as other
      populations. The prevalence of eczema and hand eczema was similar to that of
      other risk populations. A self-report of current dermatosis is probably a good
      indicator of the point prevalence of explicit skin diseases in populations.

PMID- 7784863
TI  - Single-strand breaks in deoxyribonucleic acid in fire fighters accidentally
      exposed to o-nitroanisole and other chemicals.
AB  - OBJECTIVES: The aim of the study was to detect single-strand breaks in
      deoxyribonucleic acid (DNA) in mononuclear blood cells of fire fighters exposed
      to o-nitroanisole and other substances released into the environment during an
      accident in a chemical plant. METHODS: The level of DNA single-strand breaks in
      mononuclear blood cells was detected by alkaline elution. The results were
      compared for 16 fire fighters who worked in a contaminated area for about 8 h and
      two reference groups (one of fire fighters who had not worked in the contaminated
      area, group I, and one of persons without any apparent occupational exposure to
      genotoxic substances, group II). RESULTS: The mean normalized elution rate (nER)
      19 d after the accident was slightly but statistically significantly (P < 0.05)
      higher for the exposed fire fighters [mean 1.48 +/- 95% confidence interval (95%
      CI) 0.21] than for reference group I (mean 1.21 +/- 95% CI 0.21) or reference
      group II (mean 1.17 +/- 95% CI 0.18). No statistically significant difference was
      found between reference groups I and II. Another analysis was performed three
      months after the first. The level of DNA single-strand breaks (mean nER 1.12 +/-
      95% CI 0.11) was no longer increased in comparison with the levels of the
      reference groups. CONCLUSIONS: DNA single-strand breaks were increased in fire
      fighters exposed to o-nitroanisole and other substances. In comparison with the
      extent of DNA strand breaks found in other occupational groups the increase was
      only moderate. The observed decrease in DNA single-strand breaks to the reference
      level in exposed fire fighters three months later suggests a DNA repair mechanism
      for DNA single-strand breaks caused by o-nitroanisole.

PMID- 7784864
TI  - Assessment and grouping of occupational magnetic field exposure in five electric
      utility companies.
AB  - OBJECTIVES: Occupational exposure to 60-Hz magnetic fields was surveyed among
      randomly selected workers in five electric power companies. METHODS: The study
      facilitated the examination of exposure variability and provided the base for a
      job-exposure matrix linking health outcomes and occupational magnetic field
      exposures. RESULTS: Average exposures ranged from 0.11 to 1.50 microT. The
      differences among the five companies were small, the more urban companies showing
      somewhat higher averages. The day-to-day component of variance exceeded the
      within- and between-group components of variance. The final job-exposure matrix
      consisted of five groups with average exposure levels of 0.12, 0.21, 0.39, 0.62,
      and 1.27 microT. Given the variance in exposure, even this optimal grouping
      considerably overlapped. CONCLUSIONS: The job-exposure matrix used in this study
      efficiently incorporated the differences in exposure within occupational
      categories between companies and provided an objective and statistically based
      method for estimating cumulative magnetic field exposure.

PMID- 7784865
TI  - Health symptoms and the work environment in four nonproblem United States office
      buildings.
AB  - OBJECTIVES: The objective of this study was to quantify health symptom reports in
      four "nonproblem" buildings and to assess the relationship between symptoms and
      air quality measures, workstation characteristics, and psychosocial aspects of
      the workplace. METHODS: Environmental sampling was conducted in four office
      buildings occupied by employees working for the state of Washington in March of
      1992. A questionnaire was concurrently administered to building occupants.
      RESULTS: While measured contaminant levels were low, symptoms were frequent.
      Fifty-five percent of the 646 respondents reported recent symptoms which affected
      the eyes, nose, or throat and improved when away from work. Symptoms were not
      associated with measured contaminant levels, but, rather, with perceptions about
      air movement, dryness, odors, and noise. Psychosocial factors were less strongly
      associated with symptoms. CONCLUSIONS: Even in nonproblem buildings, symptom
      reports can be frequent and may represent overall satisfaction with the work
      environment. In response to symptoms ascribed to air quality problems, it may be
      appropriate to address employee perceptions regarding the work environment in
      addition to evaluating environmental characteristics relating to chemicals,
      biological contamination, air movement, temperature, and humidity.

PMID- 7784866
TI  - Musculoskeletal disorders among operators of visual display terminals.
AB  - Using a visual display terminal (VDT) is today a common occupational task with
      both benefits and hazards. One of the hazards is the occurrence of
      musculoskeletal disorders. This paper examines the possible causes of such
      disorders and suggests some preventive strategies. The debate on the relationship
      between musculoskeletal disorders and VDT usage usually centers around
      occupational factors (eg, constrained posture, poor ergonomic design of the
      workplace, equipment design), work-related psychological factors (eg, perceived
      high job demands, mundane, boring and repetitive job activity, little control,
      poor support from colleagues and superiors), and psychosocial factors (eg,
      biodemographic characteristics such as age, previous musculoskeletal injuries,
      emotional stress, family burden, environmental factors). Improving the ergonomic
      design of VDT workstations, changing occupational legislation, and improving
      occupational health services have been suggested as means to decrease the
      incidence of musculoskeletal disorders among VDT workers. Much research with a
      multidisciplinary approach is still needed.

PMID- 7784867
TI  - Does welding stainless steel cause cancer?

PMID- 7784868
TI  - Sex ratio of offspring of female physiotherapists exposed to low-level high
      frequency electromagnetic radiation.

PMID- 7784869
TI  - [Thrombendarterectomy in aorto-iliac occlusive disease].
AB  - An overview is given of the history and operative techniques of open and
      semiclosed thrombendarterectomy (TEA) for aortoiliac obstructive disease. The
      second part of the paper reviews the long-term results of 514 aortoiliac TEA's
      performed in 415 patients between 1959 and 1972. The data were prospectively
      acquired and the analysis was done on a retrospective basis. Median follow-up was
      over 15 years. Open and semiclosed TEA were performed on 167 and 347 limbs
      respectively. Hospital mortality was 1.2% and operative morbidity 11.1%. The
      overall life-table patency rate at 5, 10, 15, and 20 years was 93.4%, 90.4%,
      84.2% and 69.5% respectively. Patency rate depended on significant factors: open
      versus semiclosed method (p < 0.04), anatomic localization: common iliac artery
      versus external iliac artery (p < 0.0004), preexisting stage of occlusive
      disease: stage II versus stage IV (p < 0.008), and gender: female versus male (p
      < 0.007). Patient's age was not a predictive factor on patency. The limb salvage
      rate was greater than 90% even in long-term follow-up. We conclude that in
      aortoiliac obstructive disease both open and semiclosed TEA give highly
      satisfactory long-term results with low mortality and morbidity rates.

PMID- 7784870
TI  - [Comparative study of preliminary and definitive anatomo-pathological diagnoses
      in 375 autopsies in adults].
AB  - For the past 5 years the institute of pathology of the University of Lausanne has
      been delivering both provisional and final autopsy reports. The provisional
      reports are based mainly upon macroscopic findings, whereas the final reports
      include the information provided by supplementary investigations such as
      microscopy, histochemistry, more rarely electron microscopy, immunohistochemistry
      and/or microbiology. The reliability and usefulness of the provisional reports
      were analyzed by systematic comparison between the provisional and final reports
      of 375 adult post-mortems as well as through an inquiry among requesting
      physicians. No significant difference was found between the two reports in 77.1%
      of the cases. In 22.1% the supplementary investigations provided information
      which had a bearing on the final diagnosis and made it possible to complete or
      correct the macroscopic diagnosis. In 0.8% the significant difference was due to
      the omission, in the provisional report, of an obvious macroscopic diagnosis.
      Finally, 95% of the consulted physicians found the provisional reports useful
      because of the precise written and particularly rapid information they provided.
      These results not only demonstrated that the establishment of such provisional
      reports is fully justified, but further emphasize the fundamental and
      complementary role played by the final autopsy reports.

PMID- 7784871
TI  - [Torsion of the large omentum in Prader-Willi syndrome].
AB  - Although excess fat deposition in the omentum and obesity have been suggested as
      possible predisposing factors for omental torsion, no previous descriptions of an
      association between the Prader-Willi syndrome and omental torsion have been found
      in the literature. We therefore report the case of a 6-year-old boy with Prader
      Willi syndrome and primary torsion of the greater omentum.

PMID- 7784872
TI  - [Lung transplantation].
AB  - Human lung transplantation was successfully performed in the early eighties and
      is now an option for patients with endstage lung disease, which is associated
      with poor survival. Most frequent indications for lung transplantation are
      emphysema, cystic fibrosis, fibrosing alveolitis, primary pulmonary hypertension
      and Eisenmenger's syndrome. Single lung transplantation (SLT) is most often
      performed in emphysema, fibrosing alveolitis and other diseases which are not
      associated with chronic infection of the lung. Double lung transplantation was
      recently replaced by the technique of sequential single lung or bilateral lung
      transplantation (BLT). Cardiopulmonary bypass can often be avoided and problems
      of the airway anastomosis are less frequent using BLT. Main indications for this
      procedure are cystic fibrosis, bronchiectasis and primary pulmonary hypertension
      (PPH). In PPH often only SLT is performed. Cor pulmonale is reversible following
      SLT or BLT even if the heart is not replaced. Combined heart-lung transplantation
      (HLT) is reserved for some cases of Eisenmenger's syndrome and few centers still
      prefer HLT in patients with cystic fibrosis. Patients are usually accepted for
      transplantation when they are considered to have life expectancy of 12 to 24
      months. Quality of life and physical working capacity are severely decreased and
      patients suffer dyspnea NYHA grade III or IV. Most of the patients are hypoxic
      and need continuous oxygen therapy. Hypercapnia is also a negative predictive
      factor for survival without transplantation. In PPH cardiac index of less than 2
      litres/m2 is associated with poor outcome. Not only absolute values for FEV1 and
      pO2 have to be considered in finding the best moment for assessment for
      transplantation but the clinical course of the disease during previous months and
      years also has to be taken into account. Contraindications to transplantation
      include acute infection, concomitant diseases of other organs, bronchial
      carcinoma and psychiatric disorders if noncompliance is likely. To achieve good
      results after lung transplantation, proper donor and recipient selection,
      experienced surgery and careful postoperative management are essential.
      Complications must be diagnosed early to provide effective treatment. Most
      complications occur within the first months after surgery. Early complications
      include primary organ failure, pleural bleeding, problems at the site of the
      airway anastomosis, infection and acute rejection. Acute rejection is common but
      can be treated successfully if diagnosed early.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7784874
TI  - [And if we speak of continuing education!].

PMID- 7784873
TI  - [Scientific raisins from 125 years SMW (Swiss Medical Weekly). On systematic
      goiter therapy and prevention. 1922].

PMID- 7784875
TI  - [The chemical solubility and stability of low-melting dental porcelains].
AB  - The aim of this investigation was to study the chemical solubility of 3 new low
      fusing ceramics (Duceram-LFC, Duceragold and Vita Omega 800) in comparison with a
      conventional PFM-ceramic (Vita Omega) together with different surface treatments.
      Additionally, the three-point flexure strengths were measured. Although the test
      conditions were very stringent in comparison to the standard solubility test, all
      ceramics comply with ISO/DIS 6872 specifications, and are thus deemed to be well
      tolerated in the oral environment. Vita Omega demonstrated the lowest chemical
      solubility. Mechanical polishing of the surfaces of LFC and Duceragold ceramics
      produced lower solubility results as compared to glazing. Vita Omega and Omega
      800 behaved contrarily. After repeated hydrolysis testings Ducera-LFC
      demonstrated the highest disintegration resistance. The three-point flexure
      strengths of low-fusing ceramics were generally higher than that of the
      conventional PFM-ceramic. As opposed to the other ceramic materials tested, the
      flexure strength of Duceram-LFC increased significantly after hydrolysis testing.

PMID- 7784876
TI  - [A mathematical model for the treatment of root surfaces with rigid and flexible
      instruments].
AB  - The objective of this study was to assess the accessibility of root surfaces
      using stiff instruments in order to evaluate the advantages of a new flexible
      instrument-set for the treatment of periodontally diseased roots. 100 extracted
      human teeth were sectioned and histologically prepared. They were divided into
      two groups each containing 50 sections. Group I showing the interproximal, group
      II the buccal/lingual morphology. Slides were taken of each section under a
      constant magnification (3.2x) and a selected number of distances and angles were
      measured on each section. Using trigonometric functions the following parameters
      were calculated and set in relation with hypothetical probing depths ranging from
      0-15 mm: 1.) instrument length; 2.) change of the instrument angulation; 3.)
      theoretical deflection of the gums. Statistical analysis was performed using
      Student's t-test. For a given probing depth the instrument length was independent
      of the sites and the deflection of the gums. When a deflection of the gums was
      assumed, the instrument angulation was constant; an exponential decrease of the
      angulation with increasing probing depth was found with gum deflection. The
      deflection was increasing with increasing probing depth, showing statistically
      significant differences between interproximal and buccal/lingual sites (p < or =
      0.05). In conclusion the instrument length seems not to be an impeding factor for
      the accessibility of root surfaces in contrast to the instrument angulation and
      the fact that teeth are encircled by the gum. Due to morphological reasons stiff
      instruments seem to be inferior to flexible instruments when a non-surgical root
      treatment is performed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784877
TI  - [Personnel and instrumental differences in the treatment of root surfaces. A
      comparison on a phantom model].
AB  - The treatment of root surfaces in periodontal lesions with mechanical instruments
      is becoming more and more popular as an alternative to the conventional treatment
      with curets. In this in-vitro study a phantom head with a simulated periodontitis
      was used. The aim of this investigation was to determine the percentage of the
      subgingival non-treated root surfaces after treatment with different instruments
      and by different persons. Newly developed mechanical file instruments (Rootshape)
      were tested. Hand curets served as control group. The treatment of the teeth was
      carried out by three groups, each including 4 people. Group one were dental
      hygienists (DH), group two dentists with (Spez) and group three dentist without
      (Zaz) experience in the therapy of periodontal diseases. They were asked to
      perform a scaling and root planing on six teeth (16, 21, 24, 36, 41, 44) both
      with curets and Rootshape files. The size of the non-treated areas was
      subsequently determined planimetrically and expressed as percentage of the entire
      subgingival root surface. Independent of the group the percentage after file
      treatment was significantly lower (mean 9.85 +/- 7.78%) than that after curet
      treatment (mean 14.74 +/- 10.20%). Significant differences were found when the
      three groups were compared after treatment either with files or curets (DH 9.61
      +/- 8.02%, Spez 12.11 +/- 8.01%, Zaz 15.18 +/- 11.01%; p < 0.001). Zaz working
      with files achieved as good results as DH or Spez with curets (p < or = 0.05).
      The results indicate that the files represent an alternative to hand instruments
      concerning the accessibility of root surfaces.

PMID- 7784878
TI  - [The intraoral bacterial colonization of temporary denture plastics].
AB  - Plastic materials used for temporary crowns and bridges in prosthetic dentistry
      are investigated with regard to the possibility of their microbial colonization.
      For this purpose four different kinds of materials, i.e. Resincap, Trim, Snap
      (Polyalcylmethacrylate) and Protemp (Bisphenol-A-Glycidyl-Methacrylate) were
      chose. With the help of 10 test persons in vivo experiments were carried out.
      After a period of two weeks it could be verified, that the bacteria have a
      stronger affinity to Protemp than to Polyalcylmethacrylate. The hypothesis, that
      the different intensity of colonization is due to the roughness of certain
      surfaces could be confirmed by additional experiments.

PMID- 7784879
TI  - [The TIME technic. Local osteoplasty with micro-titanium mesh (TIME) for alveolar
      ridge augmentation].

PMID- 7784880
TI  - [Deciduous tooth reconstruction with composite polymers. The ITN care of
      amelogenesis imperfecta (first dentition) with composite polymeric materials as
      well as steel crowns--a case report].

PMID- 7784881
TI  - ["Every movement, even out on the periphery, immediately affects the chief, who
      is in the middle, and indeed abruptly". Interview by Kurt Venner].

PMID- 7784882
TI  - [Modern prosthodontics--with and without implants. A report on the 4th Winter
      Symposium, Going/Tirol (A), 15-21 January 1995].

PMID- 7784883
TI  - [Esthetic dentistry. Interview by Kurt Venner].

PMID- 7784884
TI  - [The Swiss Union for Preventive and Restorative Dentistry founded. Interview by
      Kurt Venner].

PMID- 7784885
TI  - [The first case in Switzerland: profession-related HIV infection].

PMID- 7784887
TI  - [Transfer without the particulars of concrete questioning is not ideal. Interview
      by Kurt Venner and Catherine Strahm].

PMID- 7784886
TI  - [A response to the letter of Dr. J. Stassen in SMfZ 2/1995].

PMID- 7784888
TI  - ["Do not do the maximum but what is truly necessary". The meeting of consulting
      dentists and specialists in insurance of 26 January 1995 at Bern].

PMID- 7784889
TI  - [The founding of the Swiss Association of Working Groups for the Treatment of
      Cheilognathopalatoschisis and Craniofacial Anomalies].

PMID- 7784890
TI  - [Caries prevention in Peru].

PMID- 7784891
TI  - [Amino acid neurotransmitter receptors of carp brain expressed in amphibian
      oocytes].
AB  - GABA receptor and inotropic glutamate receptors were expressed in amphibian
      oocytes and studied with the voltage-clamp technique and pharmacological method
      after injection of mRNA from carp (Carassius carassius) brains. It was found that
      about 90% of the response to GABA was mediated by GABAA receptor, but there was
      also about 10% of the response which was insensitive to bicuculline, a selective
      antagonist to GABAA receptor, baclofen, a selective agonist to GABAB receptor,
      had no effect on the injected oocytes. These observations suggest the existence
      of GABAC receptor. Subtypes of glutamate receptors, including NMDA subtype,
      KA/AMPA subtype and metabotropic glutamate receptors were also expressed and the
      dose-response relations were studied. Furthermore, we found that NMDA
      competitively suppressed the current response to KA, suggesting that NMDA
      probably was a weak antagonist of the KA/AMPA receptor.

PMID- 7784892
TI  - [Aging changes of the electro-physiological characteristics of hypothalamic
      neurons in culture].
AB  - The aging changes of the electrophysiological characteristics of the hypothalamic
      neurons cultured for 0-140 days were studied in neonatal SD rats by the
      intracellular microelectrode recording technique. The growth velocity of the
      neurites was used as an index to divide the living process of the neurons into
      three periods, i.e. recovering period, growth period and aging period. It was
      found that the time constant and the membrane capacitance reached a top value in
      the growth period and then decreased significantly in the aging period (P < 0.05,
      P < 0.01). In the recovering period, the membrane resistance reached the highest;
      and then decreased significantly in growth period but did not change
      significantly in the aging period. The amplitude of the membrane resting
      potential was about -30 - -60 mv and increased with the days in vitro (P < 0.05).
      The neurons could produce single or burst discharges. It appears that certain
      electrophysiological characteristics of the hypothalamic neurons in culture could
      characterize certain aging changes.

PMID- 7784893
TI  - [Preventive effect of quinacrine on the development of heat injury by stabilizing
      membrane phospholipids metabolism and beta-adrenoceptor].
AB  - Previous studies have demonstrated that the activation of phospholipase A2 (PLA2)
      during heat stress would caused disorder of membrane phospholipids metabolism,
      accompanied by a decrease in phosphatidylcholine and phosphatidyl-serine and an
      increase in arachidonic acid. In heat stressed rats, a down-regulation of beta
      adrenergic receptor in lung tissue was observed due to activation of PLA2. In the
      present work, it was demonstrated that pretreatment of rats with PLA2 inhibitor,
      quinacrine (20 mg/kg, I.P.), 1 h before heat stress could block these membrane
      lipid alterations, and the tolerance of rats to heat exposure was enhanced. The
      effect of quinacrine on the thermotolerance of marching soldiers with 15 kg of
      load under hot environment was also investigated. The results indicated that in
      the soldiers taken orally 200 mg quinacrine 1 h before marching, their heart
      rate, body temperature, accumulation of blood lactic acid and the changes of
      index of heart function were significantly improved as compared to the control
      group at the end of 3 h marching. According to these data, it can be concluded
      that quinacrine is a useful drug to prevent derangement of beta-adrenoceptor and
      membrane phospholipids metabolism in the development of heat stress. So as to
      prevent heat injury, and to improve tolerance to heat stress.

PMID- 7784895
TI  - [Reversible elimination of K+ and Na+ currents at motor nerve terminals by SM486,
      a derivative of artemisinin].
AB  - Some derivatives of Artemisinin have been used as malariacides. Artemisinin
      derivative SM486 is water-soluble and has been shown also to have local
      anesthesia action. Here we report the effect of SM486 on Na+ and K+ channels at
      motor nerve terminals. Experiments were performed on mouse triangularis sterni
      nerve-muscle preparations. Presynaptic currents were picked up with a
      microelectrode inserted into the subendothelial space of the superficial nerve
      bundle under visual control using a x400 magnification water immersion objective.
      The results showed: (1) Both IK and INa were depressed in a dose-dependent
      manner, although the minimal effective concentration of SM486 for IK was lower
      than that for INa; (2) The depression was reversible as shown by the fact that
      the nearly completely blocked INa and IK currents could be restored to the
      control by simply washing away the perfusate SM486. (3) The decrease of IK was
      progressive, while the change of INa always began after IK proceeded to decrease
      rapidly. The effects of procaine on INa and IK are similar to SM486 but the
      effective concentration was higher.

PMID- 7784894
TI  - [Effect of hypothalamic paraventricular beta-endorphin on burn shock in rats].
AB  - Dynamic changes of immunoreactive beta-endorphin (ir-beta-EP) in perfusates
      collected from hypothalamic paraventricular nuclei at different times after burn,
      and the effects of intrahypothalamic paraventricular microinjection of beta
      endorphin or its antiserum on various cardiac indices (MAP, dP/dtmax, Lvsp and
      HR) and survival time, were observed in anesthetized SD rats after third degree
      burn of 20% total body surface area. The results showed a significant increase of
      ir-beta-endorphin contents in the perfusate with the appearance of two peaks.
      According to the cardiac indices and mean survival time, the condition of the
      burned animals were improved by injection of anti-beta-endorphin serum, while
      injection of beta-endorphin did the reverse. The above results suggest that
      massive accumulation of beta-endorphin in the paraventricular nucleus appears to
      be one of the important factors detrimental to burn shock.

PMID- 7784897
TI  - [Elevated expression of B-50 (GAP-43) -mRNA in a subpopulation of olfactory bulb
      mitral cells following axotomy].
AB  - Using in-situ hybridization method. We studied B-50 (GAP-43) mRNA expression
      following lesion of olfactory bulb mitral cells in rats. Expression of B-50 mRNA
      in approximately 40% of the mitral cells was upregulated in response to
      transection of their axons in the lateral olfactory tract (LOT). Enhanced
      expressin persisted for 10 days postlesion but than declined to control levels by
      4 weeks after the lesion. A large proportion of the mitral cells gradually
      degenerated subsequent to LOT transection. Thus, a subpopulation of mitral cells
      maintain their ability to upregulate B-50, a protein characteristic of growing
      axons, but enhanced B-50 expression is not accompanied by regeneration of the
      severed LOT.

PMID- 7784896
TI  - [Fate of human fetal dopamine neurons transplanted into rhesus monkey model of
      Parkinson's disease: a tyrosine hydroxylase immunocytochemical study].
AB  - To predicate the value of human fetal substantia nigra transplantation in
      clinical treatment of Parkinson's disease (PD), dissociated cells of substantia
      nigra from 8-12 week old abortive human fetus were grafted into the neostriatum
      of 5 adult rhesus monkeys with hemiparkinsonism induced by unilateral injection
      of MPTP. At 2, 5 and 12 months after transplanting the monkeys were sacrificed
      for tyrosine hydroxylase (TH) immunocytochemistry to examine the survival and
      possible synaptic contact of transplanted dopamine (DA) neurons. Transplanted TH
      immunoreactive cells took a pattern of patches scattered in the neostriatum. Each
      of the cell patches consisted of 3-10 cells. The TH immunoreactive fiber network
      was seen in the neostriatum. Electron microscopic survey revealed that TH+
      buttons arising from grafted DA neurons formed symmetric or asymmetric synapses
      with TH- dendritic shafts/spines, and TH+ dendrites were seen to form synapses
      with TH- axons of the host. Additionally, there were a few synapses formed by TH+
      axonal terminals with negative buttons. The results suggest that DA neurons from
      8-12 week old abortive human fetus are able to survive grafting into the
      neostriatum of monkey, a species phylogenetically very close to human, and to
      establish reciprocal synaptic connectivity with the host even at 2 months post
      transplanting. It is, therefore, inferable that embryonic human DA neurons
      transplanted into human neostriatum may have the same fate as in monkeys.

PMID- 7784898
TI  - [Dual mode control of head movements during eye-head coordination].
AB  - Eye-head coordination during the shift of gaze is investigated. Dynamic
      trajectories of eye movements and head movements were measured for exploring the
      control mechanism of the head movement in eye-head coordination. The experimental
      results revealed the dual mode control of the head movement in eye-head
      coordination: a linear control for small amplitude movement (less than 30
      degree), and a Bang-Bang control for larger amplitude.

PMID- 7784899
TI  - [Study of H(+)-Ca2+ exchange in cultured heart cells after hypoxia and
      reoxygenation].
AB  - Reoxygenation is more serious for hypoxic myocardial cells because of the
      subsequent calcium overload. The calcium overload is known due to augmentation of
      H(+)-Na+, Na(+)-Ca2+, exchange during pH paradox. But the present experiment
      showed that, when H(+)-Na+, Na(+)-Ca2+ exchange was inhibited, calcium could
      still enter myocardial cells after hypoxia or reoxygenation. Similar result was
      observed after using Na(+)-Free solution, suggesting that calcium entrance into
      the cell was unrelated to Na+ channel. It was further shown that calcium
      accumulation was related to pH gradient across the myocardial cell membrane,
      i.e., being increased with increase of H+ concentration in the cell. Therefore,
      it appears that, besides H(+)-Na+, Na(+)-Ca2+ exchange, H(+)-Ca2+ exchange is one
      of the reasons of calcium overload during intracellular pH paradox.

PMID- 7784900
TI  - [Angiotensin II induces c-fos and c-myc proto-oncogene expression in the left
      ventricle].
AB  - In the present study, the effects of angiotension II on the expression of
      protooncogene c-fos and c-myc in the left ventricle were investigated on
      Langedorff heart preparations. It was observed that angiotensin induced both c
      fos and c-myc expression in a dose-dependent manner and the c-fos expression
      showed an earlier appearance than c-myc. All these induced expressions were
      blocked by a Angiotensin II receptor antagonist saralasin. The Angiotensin II
      induced expression of c-fos was also blocked by TTX, but the c-myc gene
      expression was unaffected.

PMID- 7784901
TI  - [Morphine-3-glucuronide (M3G) potentiates noxious stimulus-evoked Fos protein
      like immunoreactivity in the rat spinal cord].
AB  - The effect of morphine-3-glucuronide (M3G) on noxious stimulus-evoked Fos protein
      like immunoreactivity in the rat spinal cord were assessed by ABC method. It was
      found that a dose-dependent increase of Fos-like immunoreactive neurons could be
      induced by M3G intrathecal injection followed by formaline injection into
      hindpaw. With high dosage M3G (1.1 x 10(-7) mole), dense Fos-like labelling was
      found in the superficial and the deep dorsal horn bilaterally, While with low
      dosage M3G (5.4 x 10(-8) and 1.1 x 10(-8) mole), most of the positively labelled
      neurons were only found in laminae I and II of the ipsilateral dorsal horn to the
      injured paw. The above results revealed that M3G exerts a potentiating effect on
      the noxious stimulus-evoked Fos protein-like immunoreactivity in the rat spinal
      cord.

PMID- 7784902
TI  - [Effects of recurrent laryngeal nerve on thyroid hormone secretion in rats].
AB  - The effects of recurrent laryngeal never (RLN) on serum thyroid hormones and
      thyroidal radioiodide uptake were examined in rats. The results are (1) Serum
      thyroxine (T4) level increased significantly after section of unilateral RLN.
      When the sectioned peripheral end was stimulated immediately after section, the
      serum T4 level went even significantly lower than the control within 30 minutes.
      (2) Radioiodide uptake by homolateral thyroid increased significantly after
      section of unilateral RLN. These results indicate that RLN normally exerts an
      inhibitory effect on thyroxine secretion possibly mediated by muscarinic
      receptors.

PMID- 7784903
TI  - [Depression of TTX-blocking effect on Na+ current by 8A5, an anti-TTX monoclonal
      antibody].
AB  - Anti-TTX effect of 8A5 on Na+ current was observed by whole-cell voltage-clamp
      technique in NG108-15 cells. The results show that 8A5 inhibits TTX action
      efficiently: (1) When 1 mumol/L TTX is added to the normal perfusion solution INa
      disappears immediately, and can be restored to the control level with futher
      addition of 8A5. (2) When the cell is pre-incubated with 1 mumol/L 8A5, 1 mumol/L
      TTX can only cause a partial inhibition of INa.

PMID- 7784904
TI  - [Effects of stimulating rabbit's cerebral cortex on respiratory frequency and
      amplitude].
AB  - The effects on respiration upon stimulation of different areas of cerebral cortex
      were studied in 38 urethance anesthetized rabbits after both vagotomy and section
      of the maxillary division of trigeminal nerves. The results showed that: (1)
      Light continuous stimulations of the limb motor area (L) enforced inspiration by
      increasing respiratory frequency (RF) and tidal volume (TV). Stimulation of the
      facial motor area (F) increased RF notably, but depth of expiration and
      inspiration were notably decreased. Upon stimulation of the masticatory motor
      area (M), expiration or inspiration was accentuated, RF and TV were obviously
      increased. Upon stimulation of the posterior orbital area RF and TV were
      decreased markably. No obvious effects on respiration were observed on
      stimulation of the other areas of the cortex. (2) With shortened total period of
      stimulation, a stimulating L, F or M area would cause a longer period of apnoea
      after expiration and resumption of inspiration insured an increased TV.

PMID- 7784906
TI  - Medical genetics in primary health care.

PMID- 7784907
TI  - Congenital anomalies in black South African liveborn neonates at an urban
      academic hospital.
AB  - STUDY OBJECTIVE: The aim was to study the spectrum of clinical problems and
      outcomes in infants born at an urban academic hospital. In consequence, as part
      of the overall study, the incidence of congenital anomalies and the outcomes of
      affected infants were recorded. DESIGN: This was a prospective, hospital-based
      study, undertaken on liveborn infants born over a 3-year period, 1 May 1986 to 30
      April 1989. SETTING: Kalafong Hospital, Pretoria. MAIN RESULTS: A total of 17,351
      liveborn infants was examined and the total congenital anomalies incidence was
      11.87 per 1,000 livebirths. The central nervous system was the system most
      frequently involved (2.30 per 1,000 livebirths), followed by the musculoskeletal
      system (2.13 per 1,000 livebirths). The commonest individual congenital anomaly
      was Down syndrome (1.33 per 1,000 livebirths), followed by neural tube defects
      (0.99 per 1,000 livebirths) and ventricular septal defects (0.69 per 1,000
      livebirths). In 11% (2.25 per 1,000 livebirths) of neonatal deaths, infant loss
      was attributable to congenital anomalies. CONCLUSIONS: The incidence of
      congenital anomalies in black South African neonates, born in an urban setting,
      is as high as in other First- and Third-World countries, and the incidence of
      some individual congenital anomalies is higher. This study indicates the need for
      further research and the establishment of prenatal, genetics and paediatric
      facilities to manage these problems.

PMID- 7784905
TI  - [Effect of prolactin on gonadotropin-induced ovarian estrogen and progesterone
      production in mouse].
AB  - Immature mice (21-23 days old) were injected with 8 IU PMSG to stimulate follicle
      growth and followed 24 h later by either injection of 8 IU hCG alone or hCG plus
      100 micrograms of prolactin (PRL). The animals were killed at 3, 12 and 24 h
      after hCG treatment. The ovaries and blood samples were collected. Granulosa
      cells were prepared for incubation. Progesterone and estrogen concentrations in
      both the serum and the culture medium were determined. The results showed that
      PRL significantly enhanced hCG-induced mouse serum progesterone content, while
      serum estrogen concentrations were considerably decreased by the co-injection of
      PRL. Prolactin was also capable of stimulating gonadotropin-induced progesterone
      secretion in the cultured GC. However, the aromatase activity induced by FSH and
      hCG was remarkably inhibited by the presence of PRL. These data suggest that PRL
      inhibition of hCG-induced ovulation may be due to its interference with the
      gonadotropin-induced estrogen production by the follicular granulosa cells.

PMID- 7784908
TI  - Congenital anomalies in rural black South African neonates--a silent epidemic?
AB  - STUDY OBJECTIVE: To ascertain the incidence and spectrum of congenital anomalies
      in neonates born in a rural hospital. DESIGN: This was a prospective, hospital
      based study, undertaken on liveborn neonates over the period 12 June 1989 - 31
      December 1992. SETTING: Mankweng Hospital, Sovenga, Northern Transvaal. MAIN
      RESULTS: Of a total of 10,380 neonates born during this period, 7,617 (73.4%)
      were examined within the first 24 hours of life. On the basis of published
      observations, only 26.2% of severe congenital anomalies diagnosable by age 5
      years are diagnosable at birth. In this South African study the finding at birth
      of severe, externally visible congenital anomalies in 14.97 per 1,000 livebirths
      could mean that by age 5 years the minimum cumulative incidence of severe
      congenital anomalies may involve 57.14 per 1,000 children. Extrapolating from
      other Third-World studies, the cumulative incidence of severe congenital
      anomalies in such communities may affect up to 84.85 per 1,000 children by the
      age of 5 years. High incidences of neural tube defects (3.55 per 1,000
      livebirths) and Down syndrome (2.10 per 1,000 livebirths), both conditions which
      can be prevented by prenatal screening, were recorded. CONCLUSIONS: These figures
      indicate the necessity for inclusion of appropriate prenatal, genetic, family
      planning and paediatric facilities into the primary health care delivery system
      of rural areas, to manage such problems and to initiate programmes to reduce the
      incidence of selected congenital anomalies such as Down syndrome and neural tube
      defects.

PMID- 7784909
TI  - The costs and benefits of a vaccination programme for Haemophilus influenzae type
      B disease.
AB  - Haemophilus influenzae type b (Hib) infection is a major cause of severe
      bacterial infection in young children in South Africa and world-wide. These
      diseases can be prevented by immunisation with conjugate Hib vaccines. In South
      Africa, unlike some developed countries, Hib vaccines are not part of the routine
      immunisation schedule. The objective of this study was to measure the expected
      net benefits from a hypothetical programme of vaccination of the 1992 Cape Town
      birth cohort (N = 46,537). Costs were calculated by summing the estimated direct
      medical care costs together with the indirect costs of Hib disease. The latter
      were calculated by valuing human life using alternative, and conservative human
      capital and willingness-to-pay measures. The difference between Hib disease costs
      (i.e. the benefits which would be gained from a successful vaccination programme)
      and the costs of the vaccination programme itself (HibTITER, Praxis Biologicals)
      defined the expected net benefits. In the absence of an immunisation programme,
      the estimated economic costs of Hib disease in the 1992 Cape Town cohort ranged
      from R10.7 million to R11.8 million. The costs of introducing the vaccine would
      have amounted to R8.3 million. Had the vaccine been administered to the 1992
      birth cohort, benefits would have exceeded costs by between R2.4 million and R3.5
      million.

PMID- 7784910
TI  - Prevalence and incidence of blindness due to age-related cataract in the rural
      areas of South Africa.
AB  - OBJECTIVES: The Bureau for the Prevention of Blindness is responsible for the
      provision of cataract surgery to the rural indigent population of South Africa.
      It is important for the Bureau to know both the prevalence and the incidence of
      cataract blindness in the population. DESIGN, SETTING AND SUBJECTS: Blindness
      prevalence surveys were conducted in KwaZulu in 1990 and 1993. OUTCOME MEASURES
      AND RESULTS: The prevalence of cataract blindness was 0.59% (95% confidence
      interval 0.21) in 1990 and 1993. The prevalence of aphakia was 0.1% in 1990 and
      0.2% in 1993, demonstrating a probable increase in the delivery of cataract
      surgical services, although this had not produced a demonstrable fall in the
      prevalence of cataract blindness. The calculated annual incidence of cataract
      blindness was 0.14%. CONCLUSION: Among a rural population of approximately 19
      million South Africans, there is a backlog of 113,000 unoperated cataract-blind
      people and an incidence of 27,000 new cataract blind per year. The implications
      of this backlog for cataract blindness in our rural areas are discussed.

PMID- 7784911
TI  - Impact of a sight-saver clinic on the prevalence of blindness in northern
      KwaZulu.
AB  - The prevalence of blindness in the Ingwavuma district of northern KwaZulu was 1%
      (95% confidence interval 0.75 - 1.25) in 1990, and the prevalence of blindness
      due solely to age-related cataract was 0.39% (95% CI 0.24 - 0.54). Eight sight
      saver clinics were held between 1990 and 1993. Nine hundred and thirteen patients
      were seen and 113 cataract extractions performed at a cost of R62,000. The
      prevalence of blindness due solely to age-related cataract was reduced by 25% to
      0.29% (95% CI 0.17 - 0.41). The overall prevalence of blindness was reduced by 4%
      to 0.96% (95% CI 0.72 - 1.20). The provision of aphakic spectacles to aphakic
      patients whose spectacles have either been lost or broken would effect a further
      11% reduction to 0.85% (95% CI 0.63 - 1.07). The establishment of a permanent
      sight-saver clinic staffed by an ophthalmic medical assistant who is working full
      time in this capacity would facilitate an improvement in the delivery of eye care
      in the area.

PMID- 7784912
TI  - Inpatient care and mental handicap.

PMID- 7784913
TI  - Lletz look before we leep.

PMID- 7784914
TI  - Towards a rational cervical cytology screening strategy. Case study of a peri
      urban settlement.
AB  - OBJECTIVES: To assess cervical cytology screening activity in a peri-urban
      settlement near Cape Town, with a view to informing rational policy development.
      METHOD: Total and age-specific prevalence rates of women who had been screened,
      relative prevalence by age group of women who had not been screened, and yield of
      screening were estimated from cytopathology laboratory records and available
      demographic data. Age-specific prevalence rates among women who had been screened
      were compared with age at presentation with cervical cancer at the referral
      hospital. Attendance for colposcopy follow-up was assessed from colposcopy clinic
      records. RESULTS: The number of smears taken and the prevalence of women who had
      been screened peaked in the 20 - 24-year age group, and declined to low levels in
      those over the age of 40 years. The relative prevalence of those who had not had
      a smear exceeded 9 in all age groups over 39 years, compared with women of 20 -
      24 years. Smears which showed signs of CIN III, malignancy or possible malignancy
      comprised 0.13%. Thirty-six per cent of women booked for colposcopy did not
      attend. CONCLUSIONS: Efficiency of screening could be improved by emphasising
      coverage of higher-risk age groups, e.g. women over the age of 30 years, and
      better follow-up.

PMID- 7784915
TI  - Phenylketonuria in South Africa. A report on the status quo.
AB  - During the 1980s a pilot newborn screening programme for the early detection (and
      treatment) of amino acidopathies, especially phenylketonuria (PKU), was conducted
      by the Department of National Health and Population Development. The motivation
      for this pilot programme was the high priority accorded PKU screening in Europe
      and North America and the presumed similarly high incidence of this condition
      among South Africans of European origin. From a cohort of 59,600 newborns
      screened in the Pretoria area over a period of 8 consecutive years (1979-1986),
      only 1 case of PKU (and 1 of tyrosinaemia) was found. Statistically this result
      is compatible (Poisson distribution, 95% confidence interval) with a 'true'
      incidence of not more than 3/59,600 (or about 1/20,000) newborns. It is concluded
      from this result and other relevant information that newborn screening for PKU
      and other amino acidopathies is not cost-effective and justifiable, especially
      against the background of prevailing demographic conditions and more pressing
      health priorities in South Africa. This particular screening programme was
      discontinued in 1986. The results and conclusions are presented here for the
      record.

PMID- 7784916
TI  - Micromanipulation at an infertility centre.
AB  - AIM: Human in vitro fertilisation (IVF) and gamete intrafallopian transfer have
      been used in the management of various forms of infertility. In cases of severe
      male-factor infertility, fertilisation can be a factor. In this study
      micromanipulation was used to increase fertilisation in such cases. METHODS: Two
      micromanipulation techniques, subzonal sperm injection (SUZI) and partial zona
      dissection (PZD), were used to assist fertilisation in patients with abnormal
      semen parameters. Ten couples with severe oligo-, terato- and asthenozoospermia
      participated in the SUZI programme. Seventy-three oocytes were obtained from
      these 10 patients. PZD was used on day 1 oocytes in cases of male infertility as
      well as a rescue attempt on day 2 oocytes when fertilisation had failed after
      routine insemination. RESULTS: The SUZI technique had a fertilisation rate of
      37.7%. In this group, a biochemical pregnancy was achieved. Differences between
      the fertilisation rate of conventional IVF (33.3%) and PZD (56.3%) in cases of
      male infertility, were not statistically significant although a clinical
      difference could be detected. PZD was statistically effective in facilitating
      fertilisation (37.5% v. 8.3%) in couples where this procedure was introduced to
      reinseminate 24-hour-old unfertilised oocytes. Four patients received PZD
      reinseminated embryos. An average of 1.45 PZD embryos were replaced and 1
      implantation pregnancy was confirmed. CONCLUSION: The micromanipulation results
      are encouraging and seemed to increase the efficiency of IVF in humans.
      Furthermore, our data support the conclusion that micromanipulation procedures
      can bring about pregnancies.

PMID- 7784917
TI  - Impoverished Africa--time to restress the value of breast-feeding.

PMID- 7784918
TI  - Myringoplasty--effects on hearing and contributing factors.
AB  - Indications for myringoplasty are chronic otorrhoea and hearing impairment. Some
      authors have described poor postoperative hearing results and sensorineural
      hearing loss associated with the surgery, and question the indication for
      myringoplasty on an ear with normal hearing (< 25 dB). This study of 211
      consecutive myringoplasties performed over 1 year details the 'take rate,'
      hearing gains and losses, and factors found to influence the above. The take rate
      of 78% is comparable with figures in the literature. The most significant factors
      influencing this are the grade of the surgeon and the size of the perforation.
      The average pre-operative air-bone gap was closed from 23.7 dB to 13.9 dB with a
      4.5% incidence of postoperative sensorineural hearing loss. Postoperatively 77.9%
      of patients had an air-bone gap of less than 20 dB. We conclude that
      myringoplasty is a beneficial procedure, closing the tympanic membrane and
      improving the hearing.

PMID- 7784919
TI  - Macrosomia--maternal and fetal risk factors.
AB  - Risk factors associated with fetal macrosomia were studied in 348 pregnancies
      resulting in the delivery of an infant weighing 4,000 g or more in a black
      population. Identifiable maternal risk factors included a mother in her 3rd
      decade of life, multiparity, maternal weight of 70 kg or more at the end of
      pregnancy, prolonged or post-term pregnancy, abnormal glucose tolerance and
      previous history of a macrosomic infant. Male infants had a higher risk of being
      macrosomic. Macrosomic infants accounted for 3.4% of all singleton deliveries,
      with their caesarean section rate of 33.9% being almost three times that of
      control infants. The importance of antenatal prediction of fetal weight is
      emphasised and suggestions for reduction of the high perinatal mortality and
      morbidity rates, as well as maternal morbidity, are discussed.

PMID- 7784920
TI  - A wolf in wolf's clothing--the abdominal compartment syndrome.
AB  - Four patients are described in whom massive abdominal distension after laparotomy
      led to increased airway and central venous pressure and severely reduced urine
      output. All cases were associated with massive fluid resuscitation and operative
      findings were a grossly oedematous bowel with free fluid under pressure in the
      abdomen. These findings are consistent with the diagnosis of intra-abdominal
      compartment syndrome. In 1 case trauma was remote from the abdomen indicating
      that abdominal surgery or trauma may not be a prerequisite for the development of
      the condition. Recognition of the features of the condition is essential as it
      can only be treated by decompression of the abdominal contents.

PMID- 7784921
TI  - An update on AIDS.

PMID- 7784922
TI  - Inadequate seals on enflurane bottles.

PMID- 7784923
TI  - 'A cervical smear, please!'.

PMID- 7784924
TI  - WHO cervical cytology screening guidelines--how relevant to us?

PMID- 7784925
TI  - Pioneering in modern ophthalmology in South Africa.

PMID- 7784926
TI  - Laparoscopically assisted vaginal hysterectomy--gimmick or gain?

PMID- 7784927
TI  - Laparoscopic versus open cholecystectomy.

PMID- 7784928
TI  - Last virologically confirmed cases of wild-type poliomyelitis in South Africa.

PMID- 7784929
TI  - Schizophrenia and prenatal influenza exposure.

PMID- 7784930
TI  - HIV testing and informed consent.

PMID- 7784931
TI  - HIV testing and informed consent.

PMID- 7784932
TI  - Active STDs at rural community clinics in KwaZulu.

PMID- 7784934
TI  - Food allergy and chronic disease--a link to keep in mind.

PMID- 7784935
TI  - Genetics, primary health care and the Third World.

PMID- 7784933
TI  - The syndromic management of genital ulcer--a note of caution.

PMID- 7784936
TI  - Should routine screening of neonates for deafness be introduced in South Africa?

PMID- 7784937
TI  - The epidemiological basis for cervical cancer screening.

PMID- 7784938
TI  - [Evaluation of 3 automatic systems for measurement of the erythrocyte
      sedimentation rate].
AB  - PURPOSE: To evaluate three automated devices for measuring the erythrocyte
      sedimentation rate (ESR) (VES-MATIC 60, Menarini(R); SEDISCAN Becton-Dickinson(R)
      y SEDIMATIC, Ral(R)) by comparison with the Westergren method (WM). MATERIAL AND
      METHODS: A total of 1576 whole blood samples (VM: 694, SC: 316 and SM: 566) from
      patients of the Hospital Clinic i Provincial de Barcelona were included in this
      study. In all the specimens, the ESR was determined following the ICSH
      recommendations (WM). The Student's t test for paired data and linear regression
      analysis were used for inaccuracy study. Reproducibility was assessed after five
      measurements of three different samples and establishing the coefficient of
      variation (CV). RESULTS: Significant correlation was found between the systems
      studied and th WM. Moreover, for ESR > 21 mm/h (groups II, III and IV) the
      results provided by VM system were not significantly different from those of WM.
      Finally, all the systems presented a good reproducibility, although the lower
      values of CV were obtained with the VM method. CONCLUSIONS: The automatic systems
      for measurements of the ESR demonstrate important advantages and, from this
      analysis, we concluded that the VM could be the alternative method to
      conventional Westergren for the ESR determination.

PMID- 7784939
TI  - [Relationship between HLA antigens and the HIV infection in patients from the
      state of Zulia].
AB  - PURPOSE: Some genetic factors associated to the HLA system phenotypes may
      allegedly predispose to the development of infection in patients exposed to the
      human immunodeficiency virus (HIV). So the aim of this study was to assess if
      certain HLA antigens are positive or negative risk factors in the development of
      AIDS in Zulia State. PATIENTS AND METHODS: A total of 62 samples were studied, 31
      from HIV seropositive subjects and 31 form healthy individuals. The patients were
      subclassified into four groups in accordance with Atlanta's CDC guidelines. Tests
      for histocompatibility including HLA-A-B-C, DR and DQ typing were performed with
      Terasaki's technique. VIH positivity was determined by ELISA and confirmed by
      Western Blot. The statistical evalub1p4n was performed with the chi 2 test for
      antigen frequency comparison, the relative risk (RR) was estimated with the Ryder
      and Svelgaard test, and the inferential analysis was made by means of non
      parametric statistics. RESULTS: Most patients were included in CDC's groups II
      and IV, 48.4% and 29.0%, respectively. Increased B35 and DQw2 and decreased B39
      and DR2 antigens were found when comparing the HLA distribution in the sample and
      the antigenic frequency of the population. RR > 1 was observed in the infected
      patients A for A1, A3, A10, A11, B5, B7, B12, B14, B35, B61, CW4, DR4, DRW52 and
      DQW2 HLA antigens. A positive association between symptomatic infected patients
      and antigen B35 was present (X = 7.045). CONCLUSION: The findings reported here
      suggest that antigen B35 is a major risk factor for the development of AIDS.

PMID- 7784940
TI  - [Treatment with fludarabine of chronic refractory lymphoid leukemia].
AB  - PURPOSE: New antimetabolic drugs, purine-analogous, have been introduced in the
      treatment of advanced or refractory cases of chronic lymphocytic leukaemia (CLL),
      fludarabine (FLU) being one of such drugs. The results attained with FLU in 6
      cases of refractory CLL are reported. PATIENTS AND METHODS: The efficacy and
      toxicity of FLU was evaluated in 6 patients (median age 63 years) between March
      1993 and March 1994. Five patients were in stage III-IV and one in stage II of
      the Rai's system, and they were refractory to the usual treatment. The dosis used
      here was 30 mg/sq m/day, for 5 days every 4 weeks, up to a total of 6 therapeutic
      courses. The response was assessed after 3 and 6 courses. Anti-infectious
      prophylaxis was made with co-trimoxazole, monthly benzathine penicillin G and
      isoniazid in Mantoux-positive patients. The response criteria were those given by
      the NIC Working Group for CLL. RESULTS: The patients received 2 to 6 courses.
      None of them attained complete remission: 1 had nodular remission, 2 had partial
      remission, 2 responded partially although not reaching criteria for partial
      remission (1 died of pancytopenia), and 1 had disease progression and died after
      the second course. Fast and important reduction of the lymphocyte count as well
      as the CD4 lymphocytes was present in all cases. Bone-marrow infiltration
      decreased strikingly in 2 cases and the platelet count improved in 3 cases and
      worsened in 2 others. The following toxicity was recorded: 2 patients had nausea,
      5 had neutropenia (below 500 x 10(9)/L in 3 instances) and 4 had thrombocytopenia
      (lower than 40 x 10(9)/L in one case). In 26 therapeutic courses there were 10
      febrile episodes (1 for pneumonia, 1 for gastroenteritis and 8 without any septic
      foci); 1 patient developed pulmonary tuberculosis after completing the treatment
      and one patient died of posttransfusion graft versus host disease after
      splenectomy once she had completes six courses. CONCLUSION: This experience
      confirms the efficacy of FLU in the treatment of refractory B-CLL patients and is
      in agreement with previous reports as no response is initiated after the 3rd
      course. The lymphocyte count decreases quickly and strikingly. Depletion of CD4
      lymphocytes along with neutropenia and hypogammaglobulinaemia make these patients
      highly sensitive to all types of infection, chiefly by opportunistic germs, so
      adequate anti-infectious prophylaxis is of great importance. The two patients
      with pre-treatment haemoglobin and platelet values lower than 10 g/dL and 40 x
      10(9)/L, respectively, were the only ones in need of transfusion. No cumulative
      myelosuppression was appreciated.

PMID- 7784941
TI  - [Evaluation of the hematologic autoanalyzer Coulter Maxm].
AB  - PURPOSE: To evaluate the performance of the Coulter MaxM autoanalyser, based on
      volume, cell conductivity and laser-beam dispersion, and to assess the automated
      leucocyte differential count (LDC). MATERIAL AND METHODS: A total number of 2,016
      blood samples drawn on tri-K EDTA as anticoagulant were studied. The following
      data were analysed: 1-Intra- and inter-assay inaccuracy, the findings being
      expressed as mean and variation coefficient (CV%). 2- Correlation with the
      results attained with other systems (Coulter STKS and Technicon H1); The
      Pearson's correlation coefficient was used for this analysis. 3- Assessment of
      the morphologic suspect warning flags, optic microscope examination being used as
      reference. 4- Stability of the samples along time; the samples were analysed at
      2, 6, 24 and 48 hours after withdrawal, and the Scheffe's test was used for
      comparison of results. 5- Performance speed. RESULTS: 1- The intra-assay
      inaccuracy was found acceptable for all the values except the basophil count (CV:
      30.8%). The lack of reproducibility for basophil count is similar to that
      observed in the Coulter STKS system. 2- Correlation: Optimal LDC was found for
      neutrophils, eosinophils and lymphocytes. Excellent correlation with the Coulter
      STKS was seen except for haemoglobin, haematocrit and basophil count. The
      correlation with the Technicon H1 was better then with the STKS, except for
      basophil and monocyte counts. The correlation with basophil count was low with
      every system. 3- Warning flags appeared in 13.4% of the samples, the worse
      results corresponded to basophils, monocytes, stabs and atypical lymphocytes. 4-
      Samples stored at 4 degrees C for 24 hr had not significant variations in LDC.
      Those ones stored at 20-25 degrees C only showed significant variations after 24
      hr in the monocyte count. 5- The working speed was 60 samples processed and
      printed in one hour. CONCLUSION: The Coulter MaxM autoanalyser is a useful
      machine for laboratories and provides a 5-class LDC plus a sound screen for
      leucocyte morphologic anomalies.

PMID- 7784942
TI  - [Circulating thrombomodulin: current knowledge and future prospects].

PMID- 7784943
TI  - [Significance of blood components in oxidative stress].

PMID- 7784944
TI  - [Production of specific antibodies against isoforms of the beta subunit of human
      Na,K-ATPase].
AB  - The study of the differential and functional tissular distribution of the
      isoforms of Na,K-ATPase, an enzyme located on the plasma membrane of animal
      cells, must be performed with the aid of antibodies capable of specifically
      recognising beta 1 and beta 2 subunits. In order to facilitate the study of the
      functions and distribution of such isoforms, proteins were generated using pET
      series plasmid construction and transformation in E coli bacteria, and their
      production was promoted with IPTG, these being the antigens that induce
      antibodies specific for each isoform. The antisera thus obtained were used in
      Western Blot assays with tissue microsomes from different animal species;
      specifically, beta 1 and beta 2 isoforms of Na,K-ATPase could be recognised. A
      panel of polyclonal antibodies was obtained which proved capable of recognising
      these isoforms in different animal species, as well as their deglycosylated
      isoform. Such antibodies can be used as an efficient tool for functional and
      tissue distribution studies of the two isoforms.

PMID- 7784945
TI  - [Richter syndrome: morphologic transformation with persistence of the same
      phenotype].
AB  - Richter's syndrome is termed as the occurrence of a high-grade lymphoma along
      with a chronic lymphocytic leukaemia. We report a patient diagnosed as having a
      CLL evolving into an immunoblastic lymphoma. In spite of this morphologic change,
      the same identical immunophenotype remained in both types of cells assessed, that
      is, CLL-type lymphocytes and immunoblastic and lymphoplasmocytoid cells. This
      event appears to favour the common clonal origin of these two entities.

PMID- 7784947
TI  - [External evaluation of the quality of visual count if reticulocytes: 4 years'
      experience].

PMID- 7784946
TI  - [Idiopathic myelofibrosis with extramedullary hematopoiesis foci in the skin and
      testicles. Report of a case].
AB  - Idiopathic myelofibrosis (IMF) is a clonal chronic myeloproliferative syndrome
      characterized by the proliferation of the three haemopoietic series and the
      marrow connective tissue and by the development of extramedullary haemopoiesis in
      the liver, spleen and lymph nodes. Cutaneous extramedullary haemopoiesis is an
      uncommon event and we could not find any reported cases of testicular involvement
      in this disease. We report the case of a 28 year-old male with diagnosis of
      idiopathic myelofibrosis in November 1988. During the course of the disease,
      three years later, he developed a tumor on his right testis. Histologic
      examination showed extramedullary haemopoiesis with cells of the myeloid,
      erythroid and megakaryocyte series, in the interstice. Eight months later,
      numerous red-purple papules and nodules developed on the patients's trunk. The
      biopsy of a skin lesion revealed an infiltration of the dermis by myeloid,
      erythroid cells and few megakaryocytes. The patient's clinical condition
      worsened, and he died in February 1993 following progressive deterioration of the
      general condition. We describe a case of IFM with extramedullary hemopoiesis
      involving the skin and the testis pointing out the rarity of these localization.

PMID- 7784948
TI  - [Fever caused by myeloma or brucellosis? Overlapping of 2 entities].

PMID- 7784949
TI  - [Paraparesis caused by epidural granulocytic sarcoma in a non-leukemic patient].

PMID- 7784950
TI  - [Lymphocytotoxic antibodies in blood donors. Relationship with HIV antibodies at
      the blood bank of the state of Zulia-Venezuela].

PMID- 7784951
TI  - [Hematology at local hospitals. An option with a future? Workshop on Hematology
      of the Local Hospitals of Catalonia].

PMID- 7784952
TI  - [Hematology: a specialty in crisis?].

PMID- 7784953
TI  - [Blood fractionation based on the extraction of the buffy-coat layer. Analysis of
      our results].
AB  - PURPOSE: To compare a procedure of blood processing via a quadruple bag for the
      preparation of white-cell-poor blood components with the results obtained with
      triple-bag-system, in order to adopt it as routine in our blood centre. MATERIAL
      AND METHODS: Blood was collected in 289 quadruple-bag-system containing 63 mL of
      CPD as anticoagulant and 100 mL of SAG M solution as additive for the red cells.
      We used 237 standard quadruple-bags supplied by Fenwal (195) and NPBI (42), and
      52 of the top-and-bottom system supplied by Fenwal. Blood separation was made
      automatically by CompomatR (NPBI) and platelet concentrates were prepared from
      the buffy-coat fraction. Standard bags were processing as follows: After the
      first centrifugation of the whole blood (28,800 g), the plasma was transferred
      into the 300-mL bag until the interface of red cells and plasma was detected;
      then approximately 80 mL of plasma and buffy-coat (BC) were collected into the
      100-mL satellite bag. Top-and-bottom bags were centrifuged at 43,500 g., the red
      cells were transferred into the bottom-bag containing SAGM, and plasma was
      transferred into the top-bag. The buffy-coat fraction remains in the original
      bag. In both procedures, platelet concentrates were prepared from buffy-coat
      fraction. After the centrifugation of this fraction (1,400 g and 1,600 g), the
      supernatant (concentrated platelets in plasma) was transferred into a 300-mL bag
      and the bag with the residual buffy-coat was then discarded. 287 triple-bags were
      separated in the traditional way, using platelet-rich plasma (PRP) as a source
      for the preparation of platelet concentrate (PC). Volumes were measured by weigh
      and specificity gravity. Platelet, leukocytes and red-cells were counted in the
      Coulter-Counter (STKR.Izasa). T-Student test and Chi2 test were used for
      statistical analysis and p < 0.05 was taken as a significant difference between
      samples. RESULTS: The three kinds of quadruple-bags showed results very
      homogeneous with little differences. For all brand of bags packed-red-cells
      showed a volume of 300 +/- 2.9 mL, EVF of 51.9 +/- 0.7%. The recovery of red
      cells into the packed red cells and of platelets into the platelet concentrate
      was 90 +/- 0.4 percent and 69 +/- 2 percent respectively, of the original value.
      White cells in the packed red cells were 9.7 +/- 03 x 10(9) with recovery of 30.1
      +/- 1.4 percent of the original value; statistical difference was found in
      comparison with triple bags PRC (p < 0.001). The PC volumes averaged 71 +/- 1 mL
      and the overall mean platelet concentration was 77 +/- 2 x 10(9). Eighty three
      percent of PC contained more than 55 x 10(9). White cells contamination of
      platelet concentrates was 0.283 +/- 0.039 x 10(9), with a recovery of 9.5 +/- 1.5
      percent of the leukocytes present in the whole blood. This value is below the
      threshold that prevents febrile reactions and microaggregate formation. The
      plasma yield in the quadruple-bag system was much greater than that in the triple
      bag system (p < 0.001). With this process we removed about 77 +/- 0.5 percent of
      the plasma present in the original unit in comparison with 56 +/- 1 percent
      removed in that of the triple-bag system. CONCLUSION: With this procedure
      leukocyte-poor blood components are obtained in which more of 90 percent original
      white cells have been removed, with a red-cell recovery of 90 percent. Moreover,
      the plasma yield is also excellent.

PMID- 7784954
TI  - [Age and racial geographic distribution of S hemoglobin in Brazil].
AB  - OBJECTIVES: This paper was meant to analyse distribution of HbS carriers in
      Brazil, comprising its regional prevalence and the relationship with racial
      settlement and age groups. MATERIAL AND METHODS: 67,667 blood samples from 48
      Brazilian towns were analysed from 1976 to 1988. Such samples were classified as
      Caucasoid and Negroid. The diagnosis was defined by means of qualitative
      electrophoresis in alkaline and acid pH, quantification of haemoglobin fractions,
      cytological studies and some cases were confirmed after examination of the
      parents. RESULTS: The study of those 67,667 samples allowed us to detect 1,492
      HbS carriers (2.2%). That frequency is higher among Negroids (5.16%) than among
      Caucasoids (1.22%): Z = 22.1397 (Zcritical; 0.05 = 1.9600). Taking the HbS
      carrier distribution into consideration, we noticed that it is relatively
      homogeneous among Negroids and higher than 5% in 9 out of the 16 areas involved
      in the study. By classifying the age group of the areas in the general sample and
      by comparing the proportions, we found out that there are significant differences
      (chi 2 = 50.88; chi 2 critical; 0.05; 5 gl = 11.070). CONCLUSIONS: Sickle-cell
      anaemia diseases play an important role among the pathologies found in several
      countries, including Brazil. This paper shows that the carriers prevalence varies
      in the several areas under study and is higher among Negroids in almost all of
      them. The decreasing frequency occurring from North to South in the general
      samples and among Caucasoids may be assigned to the contribution of the Negroes
      in the interracial crossing, particularly in the Northeast.

PMID- 7784955
TI  - Forskolin induces preproenkephalin and preprodynorphin mRNA in rat striatum as
      demonstrated by in situ hybridization histochemistry.
AB  - Cyclase response elements (CREs) are located in the promoter regions of several
      neuropeptide and immediate early genes. Activation of the adenylate cylase/cAMP
      second messenger cascade leads to phosphorylation of CRE-binding proteins (P
      CREBs) which bind to CREs in the promoter regions of these genes and alter their
      rate of transcription. We have previously reported an increase in striatal
      immunoreactivity for P-CREB (phosphorylated on Ser-133) and Fos following
      intracerebroventricular (ICV) injection of H2O-soluble forskolin, a direct
      activator of adenylate cyclase. Because CREs are located in the promoter regions
      of the opioid peptide genes, preproenkephalin (PPE) and preprodynorphin (PPD), we
      investigated what effect continuous ICV infusion of H2O-soluble forskolin has on
      striatal PPE and PPD mRNA levels. Quantitative in situ hybridization
      histochemistry demonstrated that continuous activation of the adenylate
      cyclase/cAMP second messenger cascade results in a significant induction of
      striatal PPE and PPD mRNA at 6, 24, and 72 h. The sustained induction of striatal
      PPE and PPD mRNA indicates that pro-opioid gene transcription is not desensitized
      following 72 h of continuous adenylate cyclase activation. Continuous ICV
      infusion of 1, 9-dideoxyforskolin, a forskolin analog which does not activate
      adenylate cyclase, did not induce striatal PPE and PPD mRNA. These data are
      consistent with cAMP-dependent protein kinase-induced phosphorylation and binding
      of CREBs to CREs in the promoter regions of pro-opioid genes during sustained
      activation of adenylate cyclase.

PMID- 7784956
TI  - Neuropeptide Y and dynorphin-immunoreactive large dense-core vesicles are
      strategically localized for presynaptic modulation in the hippocampal formation
      and substantia nigra.
AB  - Neuropeptide Y (NPY) and dynorphin elicit regionally selective presynaptic
      modulation in the hippocampal formation and the pars reticulata of the substantia
      nigra, respectively. We examined potential anatomical substrates for their
      presynaptic modulation by determining the distribution and size of large (80-120
      nm) dense-core vesicles (DCVs), organelles previously shown to be immunoreactive
      for each peptide. Throughout the hippocampal formation, NPY-immunoreactive DCVs
      were located primarily in axon terminals and were more sparingly distributed in
      dendrites. In comparison with other portions of the hippocampal formation, NPY
      labeled DCVs were most abundant in axons and terminals of the CA1 region. The
      DCVs in the CA1 region of the hippocampus also more frequently had larger mean
      cross-sectional diameters when located along portions of the terminal in contact
      with unlabeled axons. In both the CA1 region of the hippocampus and the dentate
      gyrus, NPY-labeled DCVs in contact with portions of the axonal membrane apposed
      to astrocytes also were larger than those located more centrally in the axon
      terminal. Dynorphin-immunoreactive DCVs in axon terminals of the substantia nigra
      were significantly larger when found near portions of the axonal membrane in
      contact not only with other axons and astrocytic processes, but also occasionally
      with postsynaptic dendrites. The parallels between diameters of DCVs and known
      selectivity of NPY for presynaptic modulation in the CA1 region of the
      hippocampus suggest a direct correlation between the size and distribution of
      immunoreactive DCVs and their sites of exocytotic release.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7784957
TI  - Evidence for 5-HT autoreceptor-mediated, nerve impulse-independent, control of 5
      HT synthesis in the rat brain.
AB  - To gain further insight into the operation of 5-HT autoreceptor-mediated feedback
      control of 5-HT biosynthesis in serotonergic nerve terminal areas, the effect of
      the 5-HT1B and the 5-HT1A receptor agonists, TFMPP and 8-OH-DPAT, respectively,
      were investigated in the rat central nervous system (CNS) using in vivo and in
      vitro neurochemical approaches. TFMPP suppressed 5-HT synthesis (5-HTP
      accumulation after decarboxylase inhibition) both in vivo and in vitro. In vivo,
      the 5-HT synthesis-suppressing effect of the drug (3.0 mg/kg, s.c.) proved
      resistant to either acute hemitransection or reserpine (5 mg/kg, i.p.; 90 min
      before) pretreatment. In vitro, in cortical, hippocampal and striatal slice
      preparations, TFMPP (0.1-10 microM) decreased 5-HT synthesis under basal and
      stimulated (30 mM K+) conditions, an effect which was unaltered by prior in vivo
      reserpine-induced 5-HT depletion but was attenuated in the presence of 5-HT1B
      receptor antagonists such as methiothepin, cyanopindolol or propranolol. The 8-OH
      DPAT (0.1 mg/kg, s.c.)-induced decrease of 5-HT synthesis in vivo was abolished
      by hemitransection but resistant to acute reserpine pretreatment; 8-OH-DPAT (10
      microM) did not decrease 5-HT synthesis in vitro. In conclusion, the present
      study confirms the importance of 5-HT autoreceptors in the feedback control of
      nerve terminal 5-HT biosynthesis. Specifically, our data indicate: (1) that the
      reduction of rat brain 5-HT synthesis after TFMPP is mediated by 5-HT1B
      autoreceptors located on the serotonergic axon terminals, and (2) that the effect
      is directly mediated and occurs independently of 5-HT neuronal firing and intact
      monoamine stores.

PMID- 7784959
TI  - Functional diversity of GABAA receptor ligand-gated chloride channels in rat
      synaptoneurosomes.
AB  - Experiments were performed to examine neurochemically the functional diversity of
      GABAA receptors as measured by muscimol-, 5 alpha-pregnane-3 alpha,21-diol-20-one
      (THDOC)-, and pentobarbital-stimulated 36Cl- uptake, and region-specific changes
      in muscimol-, THDOC- and THDOC-induced potentiation of muscimol-stimulated 36Cl-
      uptake in rats treated acutely or subacutely with a subconvulsive dose of
      bicuculline. The data for stimulation of 36Cl- uptake by muscimol showed a single
      binding site interaction in the cerebral cortex, hippocampus and cerebellum. The
      concentration-response curves for muscimol in the cerebral cortex and hippocampus
      were steep and indicated an increase of approximately 130% at the maximum
      concentration. In contrast, the curve for the cerebellum was shallow and
      exhibited a smaller maximal response (approximately 60%). Apparent affinity for
      muscimol also differed among these brain regions. The regional differences in
      36Cl- uptake induced by THDOC and pentobarbital were not as apparent as those
      induced by muscimol; however, the maximal modulatory effect of pentobarbital in
      the hippocampus was significantly higher than that in the cerebellum. In rats
      treated subacutely with a subconvulsive dose of bicuculline, a significant
      increase in muscimol-stimulated 36Cl- uptake was observed in the cerebellum but
      not in the frontal cortex or hippocampus. Analysis of the concentration-response
      curves for muscimol-stimulated 36Cl- uptake in the cerebellum revealed that the
      Vmax for muscimol in the subacutely treated group was significantly higher than
      those for muscimol in the control and acutely treated groups without any
      differences in the KD value.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7784958
TI  - PET imaging studies of dopamine D2 receptors: comparison of [18F]N
      methylspiperone and the benzamide analogues [18F]MABN and [18F]MBP in baboon
      brain.
AB  - A series of positron emission tomography (PET) imaging studies was conducted in a
      baboon with the benzamide derivatives [18F]2,3-dimethoxy-N-[9-(4-fluorobenzyl)-9
      azabicyclo[3.3.1]non an-3 beta-yl]benzamide ([18F]MABN) and [18F]2,3-dimethoxy-N
      [1-(4-fluorobenzyl)piperidin-4-yl]be nza mide ([18F]MBP). Studies were also
      conducted with the butyrophenone [18F]N-methylspiperone (NMSP) for comparison.
      Tissue-time activity curves of [18F]MABN are similar to those of [18F]NMSP since
      both compounds displayed approximately the same uptake in the basal ganglia and
      displayed irreversible binding kinetics in vivo. However, the rapid rate of
      clearance from the cerebellum and high basal ganglia:cerebellum ratio of
      [18F]MABN indicate that this compound has a much lower amount of nonspecific
      binding than [18F]NMSP. [18F]MBP displayed a higher uptake in the basal ganglia
      relative to [18F]NMSP and [18F]MABN and exhibited reversible binding kinetics in
      vivo. This property of [18F]MBP is desirable since the uptake of radioactivity in
      D2-rich ligands is less likely to be influenced by changes in cerebral blood
      flow. The current data suggest that both [18F]MABN and [18F]MBP are promising
      ligands for studying dopamine D2 receptors with PET.

PMID- 7784960
TI  - Long-lasting inhibition of in vivo cocaine binding to dopamine transporters by 3
      beta-(4-iodophenyl)tropane-2-carboxylic acid methyl ester: RTI-55 or beta CIT.
AB  - Cocaine analogs such as 3 beta-(4-iodophenyl)tropane-2 beta-carboxylic acid
      methyl ester (RTI-55 or beta CIT) with a higher affinity for the dopamine
      transporter (DAT) may be potentially useful in interfering with cocaine's actions
      in brain. This study evaluates the time course of the effects of RTI-55 on
      cocaine binding in baboon brain using PET and [11C]cocaine. [11C]Cocaine binding
      was measured prior to, and 90 minutes, 24 hours, 4-5 days and 11-13 days after
      RTI-55 (0.3 mg/kg i.v.). Parallel studies with [3H]cocaine and RTI-55 (0.5 mg/kg
      i.v. or 2 mg/kg i.p.) were performed in the mouse. RTI-55 significantly inhibited
      [11C]cocaine binding at 90 minutes and 24 hours after administration. The half
      life for the clearance of RTI-55 from the DAT was estimated to be 2 to 3 days in
      the baboon brain. In the mouse brain, RTI-55 significantly inhibited [3H]cocaine
      binding at 60 and 180 minutes after administration and recovery was observed at
      12 hours. These results document long-lasting inhibition of cocaine binding by
      RTI-55 and corroborate that binding kinetics of RTI-55 in striatum observed in
      imaging studies with [123I]RTI-55 represents binding to DATs.

PMID- 7784961
TI  - Brain transcription factor gene expression, neurotransmitter levels, and novelty
      response behaviors: alterations during rat amphetamine withdrawal and following
      chronic injection stress.
AB  - Transcription factors are known to act as gene expression regulators, possibly
      linking extracellular stimuli to long-term modifications at the neuronal level.
      Such modifications may potentially underlie chronic psychostimulant- and stress
      induced behavioral alterations. This study illustrates how a 2 week, twice daily
      7.5 mg/kg d-amphetamine or saline regimen alters rat brain regional expression of
      transcription factor genes, including c-fos, fos-B, jun-B, c-jun, and zif 268,
      and seeks potential correlations between those changes and alterations in
      neurotransmitter levels and behavioral novelty responses. Amphetamine withdrawal
      induced decreases in transcription factor mRNA levels, assessed using Northern
      blot analysis, appear most prominent in prefrontal cortex, begin approximately 12
      h after the last injection, and largely recover to control levels by 54 h.
      Prefrontal cortical and striatal dopamine content, assessed using HPLC, decrease
      and recover over a similar time course. Behavioral "stereotypy time" manifest by
      animals exposed to a novel environment, a measure sensitive to psychostimulant
      withdrawal, also decreases beginning 12 h after the last injection, is still
      significantly reduced at 54 h, and recovers at 72 h. Chronic saline injections
      are followed by a consistent decrease in transcription factor gene expression,
      observed 6 h after the last injection, followed by a "rebound" increase at 12 h.
      These changes are accompanied by dramatic, mostly biphasic alterations in
      prefrontal cortical biogenic amines and by a short-lived increase in striatal
      dopamine turnover. At the same time, rats display much longer-lasting decreases
      in locomotor responses when exposed to a novel environment, with recovery
      occurring only 54 h after the last injection. The delayed recovery of behavioral
      responses to novelty is consistent with potential involvement of changes in
      transcription factor-mediated gene expression in neurochemical mechanisms
      underlying psychostimulant withdrawal and chronic injection stress-induced
      behavioral alterations.

PMID- 7784963
TI  - [Therapists and therapeutic service during World War II].

PMID- 7784962
TI  - Biological mechanisms and perinatal exposure to abused drugs.
AB  - Use of illicit and licit drugs during pregnancy is a major public health concern,
      as it can have adverse effects on the developing fetus. Infants born of women
      addicted to narcotics, cocaine, alcohol, or polydrugs often undergo a
      characteristic withdrawal syndrome and may have physical, behavioral, and/or
      neurological abnormalities. As it is not feasible to ascertain whether these
      functional changes in human infants are produced by abused substance(s) per se or
      by a combination of complex socioeconomic factors and polydrug use, researchers
      in recent years have developed and utilized various innovative animal models to
      assess drug-induced alterations and their biological mechanisms during the
      developmental period under a controlled environment. To promote interdisciplinary
      communications as well as to assess the progress and the future needs in this
      area, the National Institute on Drug Abuse (NIDA) held a technical review at
      which biomedical researchers discussed their current findings in various
      physiological systems. This report summarizes the major findings and the
      methodological and experimental issues discussed at the conference. The meeting
      was held in Washington, DC, on May 25 and 26, 1994.

PMID- 7784964
TI  - [In the last year of the war (the notes of a therapist in mobile surgical field
      hospital No. 200)].

PMID- 7784966
TI  - [Medicine of the twentieth century. The evolution of diagnosis].

PMID- 7784965
TI  - [The organizers of therapeutic operations in World War II 1941-1945 (on the 50th
      anniversary of a great victory)].

PMID- 7784967
TI  - [Magnetic resonance tomography in hydronephrotic transformation, cystic lesions
      and tumors of the kidneys in patients with arterial hypertension].
AB  - MR tomography was carried out on MR tomographs Tomicon 1100 (Bruker, 0.23 T) and
      Magnetom SP 63 (Siemens, 1.5 T) in 126 hypertensive subjects (66 had cysts, 20 HT
      and 31 renal tumors) and 27 healthy controls. MR tomography proved highly
      specific and sensitive in diagnosis of renal new growths. In complicated cases
      additional information can be provided by paramagnetic contrast examinations. MR
      tomography as an on demand diagnostic method is recommended for use in a two
      stage check-ups of patients with arterial hypertension.

PMID- 7784968
TI  - [The characteristics of the intracardiac hemodynamics in hypertrophic
      cardiomyopathy: the role of cine-magnetic resonance tomography].
AB  - Cine-magnetic resonance (CMR) tomography was assessed for ability to determine
      cardiac function and structure in patients with hypertrophic cardiomyopathy
      (HTCM). CMR tomography findings were compared to those of two-dimension and
      doppler-echocardiography, cardiac catheterization. The trial entered 16 patients
      with obstructive, 22 patients with nonobstructive HTCM and 14 healthy controls.
      CMR tomography was performed on a superconducting tomograph (1.5 T) in
      synchronism with ECG. CMR tomography helped detect obstruction for the blood
      outflowing from the left ventricle. This was impossible with the use of spin
      echo. It also defined area and volume of low-intensity regions. CMR tomography
      proved sensitive in bringing out mitral regurgitation, the results being close to
      those of doppler-echocardiography. Opportunities of MRT in HTCM gets expanded in
      cine-regimen as it provides additional information on cardiac function and
      intracardiac hemodynamics.

PMID- 7784970
TI  - [The clinico-hemodynamic effects of the antioxidant ceruloplasmin in IHD
      patients].
AB  - Ceruloplasmin- and placebo-treated CHD patients were studied for severity of
      angina pectoris, changes in central hemodynamics, exercise tolerance. It is shown
      that ceruloplasmin promoted an increase in exercise tolerance, higher quality of
      life, arrest of the disease progress. Combined treatment of CHD incorporating
      ceruloplasmin produced a positive effect on central hemodynamics and contractile,
      pump capacities of the myocardium.

PMID- 7784972
TI  - [Ultrasonic methods in evaluating the blood supply of the kidney. The
      characteristics of normal renal blood flow].

PMID- 7784971
TI  - [Predictors of coronary artery restenosis in IHD patients after transluminal
      balloon coronary angioplasty].
AB  - To determine clinical and angiographic predictors of restenosis after successful
      PTCA, we analysed the data on 63 patients (68 stenoses) who had undergone repeat
      coronary angiography during the first eight months after successful PTCA. The
      overall restenosis rate was 42.6%. Four clinical and angiographic factors were
      associated with high risk of restenosis. Residual stenosis > or = 25% was the
      strongest predictor of restenosis (p = 0.002). Among other factors presence of
      unstable angina, complicated lesion morphology and absence of intimal dissection
      had equal value of significance (p = 0.02 in all the cases).

PMID- 7784969
TI  - [The assessment of left ventricular diastolic function in patients with systemic
      scleroderma by radionuclide ventriculography].
AB  - To assess left ventricular (LV) diastolic function in scleroderma systematica
      (SS) with regard to SS course and skin lesion degree, a total of 24 SS patients
      were examined versus control subjects. Though cardiac symptoms manifested
      clinically only in 8 patients, parameters of LV diastolic function underwent
      changes in the majority of the examinees: the time to attaining maximal filling
      velocity increased, contribution of the first diastolic third to LV filling
      diminished, hemodynamic significance of the left atrial systole grew. More
      pronounced dysfunction of the myocardium occurred in patients with diffuse skin
      lesions, acute and subacute disease who also appeared to have reduced LV ejection
      fraction. The conclusion is made on frequent subclinical pattern of myocardial
      involvement in SS patients which runs primarily as LV diastolic dysfunction.
      Systolic disturbance emerge later or in more active forms.

PMID- 7784973
TI  - [The formation and development of therapeutic care during World War II].

PMID- 7784975
TI  - [The first experience in Russia of using DNA diagnosis in Alport's syndrome in a
      family with a unique morphological picture of the kidney lesion].
AB  - Clinicomorphological findings are reported for two children from families with
      hereditary predisposition to hematuria characterized by early occurrence of
      chronic renal insufficiency, neurosensory hypoacusis, congenital ocular
      abnormalities inherited by sex-linked dominant type. Light microscopy of
      nephrobiopsies revealed diffuse mesangial proliferation in both children. Final
      diagnosis of Alport's syndrome was feasible only on molecular-genetic level after
      polymerase chain reactions had identified mutation in collagen type 4 alpha-5
      chain gene on a long arm of X-chromosome in genotypes of both patients and their
      mothers. Genetical, clinical, morphological, evolutional and diagnostic aspects
      of Alport's syndrome are reviewed.

PMID- 7784974
TI  - [The venous occlusion test in assessing the fibrinolytic activity of the vascular
      endothelium in lupus nephritis patients].
AB  - A venous occlusion test was used to evaluate the reserves of the kidneys and that
      of vascular endothelium fibrinolytic activity (VEFA) in patients with lupus
      nephritis (LN). Prior to and following venous occlusion functional activity of
      plasminogen activators in plasma and urine (PAPU), plasma activity of
      antiactivator (PAAA), urokinase urine activity (UUA) were measured by fibrin
      plate lysis test in 24 patients with active LN, 6 SLE patients with intact
      kidneys, 10 healthy subjects. Venous occlusion test revealed normal reserve of
      plasma activator activity in mild LN and depletion of this reserve in LN patients
      with nephrotic syndrome and rapidly progressive LN. In the latter patients PAPU
      and PAAA were suppressed. PAPU reserve existed in all the patients, but those
      with rapidly progressive LN. UUA in LN was close to normal and did not change
      significantly after venous occlusion. The data obtained suggest that patients
      with severe LN had reduced reserves of VEFA, while in those with progressive LN
      there were also diminished reserves of renal fibrinolytic activity reflecting the
      severity of endothelial lesion.

PMID- 7784976
TI  - [Postcoital allergy: the possibilities for a specific diagnosis].

PMID- 7784977
TI  - [Lipid peroxidation markers in the exhaled breath and microsomal oxidation in
      patients with chronic diffuse liver diseases].
AB  - Low-molecular hydrocarbons (butan, pentan) from the exhaled air as lipid
      peroxidation (LPO) markers were quantified in patients with chronic diffuse liver
      diseases. The study was also made of microsomal oxidation enzymic activity by
      antipirin metabolism. The above parameters were followed up in the course of
      antioxidant treatment. As shown by total butan and pentan levels, LPO activity
      varied with the disease, being high in hepatic cirrhosis and primary biliary
      cirrhosis, but low in chronic active hepatitis and fat dystrophy. Increased
      levels of butan and pentan occurred in association with inhibited activity of
      P450-dependent monooxygenases. This was determined by antipirin biotransformation
      and confirmed by a strong inverse correlation between the amount of hydrocarbons
      and antipirin metabolites (4-hydroxy- and norantipirin) clearance. In the course
      of antioxidant therapy the most pronounced inhibiting action on formation of low
      molecular hydrocarbons was distinctive of essenciale, pikamilon and copmplivit.
      Relevant efficacy of carsil was weaker. Similar regularity for these drugs takes
      place in relation to activation of microsomal oxidation.

PMID- 7784978
TI  - [The conservative treatment of thrombophlebitis of the surface veins of the lower
      extremities].
AB  - Clinical presentation of acute thrombophlebitis affecting lower limbs,
      classification of its forms and the response of the patients to essaven-gel are
      reviewed. Indications to such treatment are provided. High efficacy of essaven
      gel is stated.

PMID- 7784979
TI  - [Pneumatic balloon dilatation using a Rigiflex dilator in the treatment of
      patients with achalasia].

PMID- 7784981
TI  - [The genetics of intermediate phenotypes in hypertension].

PMID- 7784980
TI  - [Prognostic criteria for the clinical course of systemic lupus erythematosus].
AB  - To develop some individual prognostic criteria of SLE clinical course the Wald's
      analysis of immunogenetic markers (HLA) was used. The obtained summarized
      diagnostic coefficients allow predicting a subacute or chronic pattern of the
      disease, the rate of generalization and the most frequent location of the process
      in certain organs. The constant character of HLA-typing results and the
      simplicity of the given prognostic tables made the proposed diagnostic method
      convenient for medical practice.

PMID- 7784982
TI  - [Enzyme autoantibodies--the key to the more specific diagnosis of autoimmune
      diseases].

PMID- 7784983
TI  - [Rapidly progressing glomerulonephritis].

PMID- 7784984
TI  - [The early diagnosis of kidney failure in diabetic patients and the new
      developments in its treatment].

PMID- 7784985
TI  - [The basic trends in the research on and treatment of chronic obstructive lung
      diseases. The Working Group of the Canadian Thoracic Society].

PMID- 7784986
TI  - [The drug treatment of gastric and duodenal peptic ulcer].

PMID- 7784987
TI  - [The ultrasonic diagnosis of a mycotic aneurysm of the superior mesenteric artery
      in a patient with infectious endocarditis].

PMID- 7784988
TI  - [Cases of the outpatient diagnosis and treatment of Horton-Magath-Brown disease].

PMID- 7784989
TI  - [A case of relapsing febrile nonsuppurative panniculitis].

PMID- 7784992
TI  - [Cystic kidneys (autosomal dominant polycystic kidney disease)].
AB  - Polycystic kidney disease is a rather common genetic disorder, with an estimated
      amount of 8 to 10% of patients in the dialysis population. Meanwhile the
      defective gene of autosomal dominant polycystic kidney disease [ADPKD], another
      common terminus for this disorder, has been localized on the short arm of
      chromosome 16. The genetic disorder is not strictly localized on the kidney,
      whereas other organ systems like cardiac valves, brain arteries, liver, colon,
      etc. may be involved in the disease process. Hypertension is an early and common
      feature of the disease and its probably an important factor for progression of
      renal failure in ADPKD. Not all carriers of the ADPKD-trait progress to endstage
      renal failure, about 50% at the age of 50 years. Patients with ADPKD have a good
      prognosis in renal replacement therapy programs such as dialysis or renal
      transplantation.

PMID- 7784993
TI  - [Therapy of primary chronic glomerulonephritis].
AB  - Primary chronic glomerulonephritis may emerge clinically as acute nephritis, the
      nephrotic syndrome as well as asymptomatic hematuria and proteinuria. Therapeutic
      consequences still depend on the morphological diagnosis. In cases of minor
      proteinuria [< 3,5 g/24 h] immunosuppressive therapy is not superior to
      symptomatic therapy. In patients with nephrotic syndrome immunosuppressive
      therapy depends on the morphological diagnosis. Glucocorticoids are the therapy
      of choice in minimal changes glomerulopathy and should be tried in focal
      segmental sclerosing glomerulonephritis. Steroids may be tried in pure mesangial
      as well as in IgA and IgM nephropathy. Especially Ponticelli claims significant
      therapeutic success in patients with membranous glomerulonephritis treated with
      Prednisolone and Chlorambucil. Failures and relapses may be treated with
      Cyclophosphamide, Chlorambucil or Cyclosporin A. Anticoagulants may be
      advantageous in the therapy of membranoproliferative glomerulonephritis.

PMID- 7784990
TI  - [Clinical nephrology].

PMID- 7784991
TI  - [Nephritic sedimentation findings].
AB  - The urinary nephritic sediment represents a well defined microscopic pattern,
      which indicates an active renal disease or its relapse. Therefore, once a
      nephritic sediment is found, the physician should immediately proceed to further
      diagnostic steps to define the renal disease and to start treatment.

PMID- 7784995
TI  - [Ischemic nephropathy].
AB  - Ischemic nephropathy encompasses renal insufficiency due to 3 different diseases,
      namely renal artery stenosis, so-called benign nephrosclerosis, and renal
      cholesterol embolism. All 3 disease entities may lead to a progressive loss of
      renal excretory function. If a patient presents with renal failure of unknown
      origin, renal artery stenosis should be looked for by color-coded duplex scanning
      or arteriography. The clinical presentation of benign nephrosclerosis in
      caucasians has no typical clues. Usually, a renal biopsy identifies this renal
      disorder in a patient with long-standing hypertension, moderate proteinuria and
      renal insufficiency. Cholesterol embolism typically affects several arterial
      trees, and is induced by arteriography in patients with arteriosclerosis of the
      aorta. The best treatment for ischemic nephropathy due to renal artery stenosis
      [conservative, angioplasty, surgery] is unknown because appropriately controlled
      trials are lacking. Invasive therapy should be considered in patients with
      bilateral renal artery stenosis or stenosis of a single functioning kidney,
      particularly if the affected kidney is not contracted. Arguments in favor of
      invasive therapy include the progressive nature of renal artery stenosis and the
      poor outcome of dialysis patients with this diagnosis as underlying renal
      disease.

PMID- 7784994
TI  - [Diagnosis and therapy in systemic vasculitis with renal involvement].
AB  - The diagnosis of Wegener's granulomatosis, microscopic polyarteritis and
      idiopathic rapidly progressive glomerulonephritis as the main cause of renal
      involvement in systemic necrotizing vasculitis was revolutionized following the
      introduction of the ANCA test. The different clinical manifestations of these
      diseases are described. By means of the ANCA test it could be demonstrated that
      the pulmonary-renal syndrome was mainly caused by these vasculitides and not by
      Goodpasture's syndrome. Cyclophosphamide and steroids remain the drugs of choice
      in the treatment. They can be administered in different ways depending upon the
      clinical manifestation of the diseases. As therapeutic alternatives cyclosporin,
      trimethoprim/sulfamethoxazole, intravenous immunglobulins and monoclonal
      antibodies are discussed.

PMID- 7784996
TI  - [Acute kidney failure caused by Hantaviruses].
AB  - Hantavirus-induced acute renal failure is a worldwide occurring disease and
      rarely known and diagnosed in Germany and in Western Europe. Its various clinical
      features are embraced by the term Hemorrhagic Fever With Renal Syndrome (HFRS).
      Cardinal symptoms of the mild European form called Nephropathia epidemica (NE)
      leading to diagnosis are: abrupt onset, fever, pain (abdominal, loin-, or
      headache), acute renal failure, proteinuria and/or hematuria, polyuria, and
      thrombocytopenia. Etiologic agent of NE is the vole transmitted Puumula-serotype
      of Hantaviruses. Severe courses of HFRS characterized by hemorrhagic
      complications occur in Asia and Southeast Europe and are caused by the serotypes
      Hantaan (Korean Hemorrhagic Fever), Seoul (rat associated) and Belgrade (both
      Epidemic Hemorrhagic Fever). Serological evidence of IgG and/or IgM-antibodies by
      indirect immunofluorescent antibody assay (IFA), enzyme linked immunosorbent
      assay (ELISA) or mu-capture-ELISA proves the diagnosis and allows distinction of
      the infecting virus type. Transmission occurs primarily through inhalation of
      virus contaminated aerosols or dust. Transmission between humans has never been
      observed. The incubation period ranges between four days to four weeks. All
      persons who have much outdoor activities in forests, open fields, farms, and
      nearby waters are at risk to be infected. Practical exposure prophylaxis seems
      rarely possible. Therapy of NE is only symptomatic, confined to the treatment of
      pain, diuretic therapy in oliguric patients, and volume and electrolyte
      substitution in volume depleted or polyuric patients. Sometimes temporary
      hemodialysis is needed. Renal history reveals commonly the pattern of acute
      interstitial nephritis with typical focal interstitial microhemorrhages.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7784997
TI  - [What should the general practitioner know about diagnosis and treatment of acute
      kidney failure?].
AB  - Acute renal failure (ARF) is defined as a renal insufficiency of sudden onset
      (increase of creatinine and urea in the serum) combined with or without oliguria
      (less than 500 ml of urine per day). Nephrotoxins (drugs, contrast medium) or
      renal ischemia (hypovolemia, hypotension, shock, septicemia, treatment with CEI)
      may affect the renal tubulus through several pathways, all of which may result in
      ARF. Ultrasound allows to distinguish hydronephrosis from ARF which is
      characterized by increased width of the parenchyma and low echodensity of the
      medulla. ARF is usually reversible. If conservative therapy fails, dialysis
      treatment is necessary.

PMID- 7784998
TI  - [Conservative treatment in chronic kidney insufficiency].
AB  - Modern therapeutic concepts of chronic renal insufficiency are based on
      observations showing a retardation of progressive renal failure by therapeutic
      measures. In the context emphasis is now placed on the treatment of arterial
      hypertension and on the patient's adherence to a protein-restricted diet. In
      addition to these conservative measures it is important to avoid nephrotoxins, to
      hydrate the patient sufficiently and to treat advanced hyperlipidemias.
      Deficiencies of active vitamin D should be treated by oral vitamin D substitution
      after correction of hyperphosphatemia. In the treatment of the latter,
      preparations of calcium carbonate are now the preferred mode of treatment. In
      advanced renal insufficiency it is important to maintain a salt-restricted diet
      and to treat any attendant hyperkalemia and hyponatremia.

PMID- 7784999
TI  - [Urinary tract infections in adults: old and current aspects].
AB  - Urinary tract infections are common clinical problems. Intense research in the
      last decade has led to improved knowledge about the pathogenesis, diagnosis and
      management of these infections. Virulence factors of uropathogenic E. coli have
      been well defined. Factors putting the host at increased risk of infections such
      as behaviour in women and men and genetic determinants in women such as blood
      group secretor status have been elucidated. Several diagnostic studies have shown
      that in symptomatic women colony counts of > or = 10(2) CFU/ml [CFU = colony
      forming units] of urine usually indicate infection. Finally, optimal and cost
      effective management of urinary tract infections is now well defined based on
      clinical studies. We review the management of urinary tract infections in adults
      taking into account recent research data and some of the still controversial
      issues.

PMID- 7785000
TI  - rhDNase in cystic fibrosis.

PMID- 7785001
TI  - Pulmonary surfactant: unanswered questions.

PMID- 7785002
TI  - The consequences of chronic allergic inflammation.

PMID- 7785003
TI  - Medium term treatment of stable stage cystic fibrosis with recombinant human
      DNase I.
AB  - BACKGROUND: A phase II multicentre double blind placebo controlled study in 1993
      showed that short term treatment (10 days) with recombinant human DNase I
      (rhDNase) was safe and improved pulmonary function in patients with cystic
      fibrosis with stable stage lung disease. A six month open label treatment study
      was conducted in some of the patients who participated in the short term study to
      assess the medium term effects of rhDNase. METHODS: Patients who completed the
      phase II study and were stable for 14 days prior to treatment were eligible. They
      were treated with rhDNase 2.5 mg twice daily for six months and reviewed at
      regular intervals to assess safety and efficacy. RESULTS: Fifty nine patients
      (31M,28F) of age range 16-55 years were recruited. Mean baseline values for
      forced expiratory volume in one second (FEV1) and forced vital capacity (FVC)
      were 41.5% and 72.4% of predicted, respectively. The mean increase in FEV1 over
      the first month of treatment was 13.1% (range 12-14.1%) and then stabilised at
      6.2% (4.6-7.8%) for the subsequent five months. FVC was similarly improved.
      Administration of rhDNase improved the severity of dyspnoea, cystic fibrosis
      related symptoms, and the modified Taussig/NIH score (not statistically
      significant). Fifty seven of the 59 patients completed the study; two died from
      progression of their pulmonary disease unrelated to treatment with rhDNase. The
      adverse events and intercurrent illnesses were no different from those expected
      in a cystic fibrosis population. Pharyngitis was the only possible drug related
      adverse event which occurred at least once in 14% of patients during the six
      month period. CONCLUSIONS: Administration of rhDNase was safe, well tolerated,
      and improved pulmonary function in patients with cystic fibrosis. When rhDNase
      was stopped at day 169 there was a deterioration in pulmonary function and
      dyspnoea score.

PMID- 7785004
TI  - Bronchial responsiveness and symptoms in 5-6 year old children: a comparison of a
      direct and indirect challenge.
AB  - BACKGROUND: The level of bronchial responsiveness in those with definite asthma
      correlates with disease severity and markers of airway inflammation. However, in
      population studies no clear distinction between normal and abnormal is found.
      Since the outcome of wheeze in early childhood is very variable, a marker of
      underlying airway inflammation would be of practical value. A stimulus acting
      indirectly may be more appropriate than one acting directly on smooth muscle. In
      this study the airway response to a direct (methacholine) and indirect
      (hypertonic saline) challenge have been compared in 5-6 year old children with
      past or present wheeze to see if symptom patterns or severity could be
      distinguished by either test. METHODS: Forty children with a wide spectrum of
      wheeze were monitored for a six month period after which their pattern and
      severity of symptoms were graded. Hypertonic saline and methacholine challenges
      were then performed on separate days. The response was assessed by both
      respiratory resistance (Rrs6) and transcutaneous oxygen (PTCO2). Atopic status
      was determined by IgE and skin prick tests. RESULTS: The results of both
      challenges were similar whether assessed by Rrs6 or PTCO2. There was no
      difference in the response to either methacholine or saline between different
      symptom patterns or severity grades, nor was there any correlation with either
      test to atopic status. CONCLUSIONS: Neither an indirect nor a direct challenge
      distinguished between past or present wheeze or degree of clinical severity in
      this group of children. Either wheezy children of this age do not have airway
      inflammation or bronchial responsiveness is not a marker for it.

PMID- 7785005
TI  - Analysis of tidal expiratory flow pattern in the assessment of histamine-induced
      bronchoconstriction.
AB  - BACKGROUND: There are times in clinical practice when it would be useful to be
      able to assess the severity of airways obstruction from tidal breathing. Three
      indices of airways obstruction derived from analysis of resting tidal expiratory
      flow have previously been described: (1) Tme/TE = time to reach maximum
      expiratory flow/expiratory time; (2) Krs = decay constant of exponential fitted
      to tidal expiratory flow versus time curve; and (3) EV = extrapolated volume-
      that is, area under the curve when the fitted exponential is extrapolated to zero
      flow. In this paper a further index--dtr/TE, time from the beginning of
      expiration till the rapid decay of flow begins/expiratory time--is evaluated. The
      aim of this study was to assess the ability of these indices to detect mild
      airways obstruction. METHODS: A histamine bronchial provocation test was
      performed in 20 adult patients with a diagnosis of asthma or symptoms of cough
      and/or shortness of breath. Baseline forced expiratory volume in one second
      (FEV1), functional residual capacity (FRC), and specific inspiratory conductance
      (sGaw) were measured and the measurements repeated after the final inhalation of
      histamine. Expiratory flow patterns during quiet breathing over five consecutive
      representative breaths were analysed before and after histamine. The test was
      concluded in 12 subjects when FEV1 had decreased by 20% of the post saline value,
      and in the remaining eight after inhalation of 16 or 32 mg/ml histamine. RESULTS:
      FEV1, sGaw, FRC, Krs, EV, and dtr/TE were all different after histamine (paired t
      test). For Tme/TE no difference was shown. Change in EV detected change in end
      tidal volume but underestimated it compared with the change measured by body
      plethysmography. Percentage fall in Krs after histamine correlated with
      percentage fall in FEV1 (r = 0.527, Pearson correlation coefficient). This was of
      a similar order to the correlation between the percentage fall in sGaw and in
      FEV1 (r = 0.543). CONCLUSIONS: Analysis of expiratory tidal flow-time patterns
      predicted a decrease in FEV1 following histamine challenge as did measurement of
      sGaw. This analysis of tidal breathing would be useful in circumstances where
      forced expiratory manoeuvres are unreliable or inapplicable.

PMID- 7785008
TI  - Expiratory muscle training and sensation of respiratory effort during exercise in
      normal subjects.
AB  - BACKGROUND: The sensation of respiratory effort may increase as expiratory
      muscles become fatigued during expiratory loading. A study was performed to
      determine whether expiratory muscle training (EMT) affects the sensation of
      respiratory effort during exercise in healthy subjects. METHODS: Six subjects
      performed EMT for 15 minutes twice daily for four weeks using a pressure
      threshold device; another six subjects served as a control group. The expiratory
      threshold was set at 30% of the individual's maximum expiratory mouth pressure
      (PEmax). The sensation of respiratory effort was evaluated during a progressive
      exercise test using the Borg scale. RESULTS: After EMT PEmax increased by 25% in
      the training group. The Borg score increased as exercise grade increased before
      and after EMT, but scores for each grade were lower after EMT. Minute ventilation
      during exercise decreased after EMT, as did the breathing frequency during
      exercise, while the expiratory time increased. Although there was no difference
      in the relationship between Borg score and minute ventilation before or after
      EMT, the curve shifted to a lower Borg score after EMT. There were no changes in
      PEmax, Borg score, minute ventilation, or breathing pattern after the four week
      study period in the control group. CONCLUSION: These findings suggest that EMT
      increases expiratory muscle strength and reduces the sensation of respiratory
      effort during exercise, presumably by reducing minute ventilation.

PMID- 7785007
TI  - Bronchial inflammation in chronic bronchitis assessed by measurement of cell
      products in bronchial lavage fluid.
AB  - BACKGROUND: Bronchial inflammation in chronic bronchitis has not been
      characterised as well as in asthma. The present study was undertaken to assess
      whether a characteristic pattern of bronchial inflammatory markers could be found
      in patients with chronic bronchitis. METHODS: Bronchoscopy with bronchial lavage
      was performed in 42 patients with chronic bronchitis and in 13 healthy controls.
      Twenty three of the patients had non-obstructive chronic bronchitis and 19 had
      chronic bronchitis and chronic obstructive pulmonary disease (COPD). Eighteen of
      the patients with bronchitis had recurrent infective exacerbations and 24 did
      not. Intrabronchial bacterial cultures were taken with a protected specimen
      brush. RESULTS: Increased activity of neutrophils, fibroblasts, and eosinophils
      was found in the patients with chronic bronchitis as assessed by the levels of
      myeloperoxidase (MPO) and interleukin-8 (IL-8), hyaluronan, and eosinophil
      cationic protein (ECP), respectively. The levels of tryptase did not differ from
      the controls. High correlations were found between the levels of MPO and IL-8, as
      well as ECP and IL-8. No differences were found between the patients with COPD
      and those with non-obstructive chronic bronchitis. CONCLUSIONS: Recruitment and
      activation of both neutrophils and eosinophils seem to be a characteristic of
      chronic bronchitis. This activation is associated with IL-8. The patients with
      intrabronchial cultures of Streptococcus pneumoniae had the highest individual
      levels of MPO, ECP, and IL-8 of all subjects in the study, indicating that
      colonisation with S pneumoniae could promote bronchial inflammation.

PMID- 7785009
TI  - Maximal values of sniff nasal inspiratory pressure in healthy subjects.
AB  - BACKGROUND: Inspiratory muscle strength is often better reflected by oesophageal
      pressure during a maximal sniff (sniff POES) than by maximal inspiratory pressure
      (PImax). Sniff POES can be estimated non-invasively by measuring the sniff nasal
      inspiratory pressure (SNIP). The aim was to establish maximal normal values for
      the SNIP and to compare them with PImax. METHODS: One hundred and sixty healthy
      subjects (80 men) aged 20-80 years were recruited. All subjects had a forced
      vital capacity (FVC) of > 80%, a forced expiratory volume in one second
      (FEV1)/FVC of > 85% predicted value, and a body mass index of 18-31 kg/m2.
      Because PImax is known to be reduced in the supine posture, the SNIP was measured
      in both the sitting and the supine positions. PImax sustained over one second was
      measured from functional residual capacity (FRC) in the sitting position with a
      standard flanged mouthpiece during four manoeuvres. SNIP was measured from FRC in
      the sitting and supine positions using a catheter through a plug occluding one
      nostril during 10 maximal sniffs through the contralateral nostril. For each test
      the largest pressure measured in cm H2O was taken into account. RESULTS: For both
      men and women maximal SNIP was negatively correlated with age, and was similar in
      the sitting and the supine positions. In the sitting position maximal SNIP was
      greater or equal to PImax in 107 of 160 subjects. The mean (SD) ratio SNIP/PImax
      was 1.08 (0.22) in men and 1.17 (0.29) in women. CONCLUSIONS: Normal values of
      maximal SNIP can be predicted from age and sex. Maximal SNIP is similar in the
      sitting and the supine position and is significantly higher than PImax in healthy
      subjects. The low level of agreement between maximal SNIP and PImax indicates
      that the two manoeuvres are not interchangeable but complementary.

PMID- 7785010
TI  - Respiratory muscle activity during rapid eye movement (REM) sleep in patients
      with chronic obstructive pulmonary disease.
AB  - BACKGROUND: In patients with chronic obstructive pulmonary disease (COPD) periods
      of hypopnoea occur during rapid eye movement (REM) sleep, but the mechanisms
      involved are not clear. METHODS: Ten patients with stable COPD were studied
      during nocturnal sleep. Detailed measurements were made of surface
      electromyographic (EMG) activity of several respiratory muscle groups and the
      accompanying chest wall motion using magnetometers. RESULTS: Hypopnoea occurred
      in association with eye movements during phasic rapid eye movement (pREM) sleep.
      During pREM sleep there were reductions in EMG activity of the intercostal,
      diaphragm, and upper airway muscles compared with non-REM sleep. Episodic
      hypopnoea due to partial upper airway occlusion ("obstructive" hypopnoea) was
      seen consistently in four subjects while the others showed the pattern of
      "central" hypopnoea accompanied by an overall reduction in inspiratory muscle
      activity. Although activity of the intercostal muscles was reduced relatively
      more than that of the diaphragm, lateral rib cage paradox (Hoover's sign) was
      less obvious during pREM-related hypopnoea than during wakefulness or non-REM
      sleep. CONCLUSIONS: Hypopnoea during REM sleep in patients with COPD is
      associated with reduced inspiratory muscle activity. The pattern of hypopnoea may
      be either "obstructive" or "central" and is generally consistent within an
      individual. Relatively unopposed action of the diaphragm on the rib cage during
      REM sleep is not accompanied by greater lateral inspiratory paradox.

PMID- 7785006
TI  - Beta 2 adrenergic receptor gene restriction fragment length polymorphism and
      bronchial asthma.
AB  - BACKGROUND: Beta 2 adrenergic dysfunction may be one of the underlying mechanisms
      responsible for atopy and bronchial asthma. The gene encoding the human beta 2
      adrenergic receptor (beta 2ADR) has recently been isolated and sequenced. In
      addition, a two allele polymorphism of this receptor gene has been identified in
      white people. A study was carried out to determine whether this polymorphism is
      functionally important and has any relation to airways responsiveness, atopy, or
      asthma. METHODS: The subjects studied were 58 family members of four patients
      with atopic asthma. Restriction fragment length polymorphism (RFLP) with Ban-I
      digestion of the beta 2ADR gene was detected by a specific DNA probe with
      Southern blot analysis. Airways responses to inhaled methacholine and the beta 2
      agonist salbutamol, the skin prick test, and serum IgE levels were also examined
      and correlated to the beta 2ADR gene RFLP. In addition, measurements of cAMP
      responses to isoproterenol in peripheral mononuclear cells were performed in 22
      healthy subjects whose genotype for beta 2ADR was known. RESULTS: A two allele
      polymorphism (2.3 kb and 2.1 kb) of the beta 2ADR gene was detected in the
      Japanese population. Family members without allele 2.3 kb (homozygote of allele
      2.1 kb) had lower airways responses to inhaled salbutamol than those with allele
      2.3 kb. The incidence of asthma was higher in those without allele 2.3 kb than in
      those with allele 2.3 kb. The beta 2ADR gene RFLP had no relation to airways
      responses to methacholine and atopic status. cAMP responses in peripheral
      mononuclear cells of the subjects without allele 2.3 kb tended to be lower than
      those of the subjects with allele 2.3 kb. CONCLUSIONS: These results suggest that
      Ban-I RFLP of the beta 2ADR gene may have some association with the airways
      responses to beta 2 agonists and the incidence of bronchial asthma.

PMID- 7785012
TI  - Attenuation of ischaemia reperfusion injury by human thioredoxin.
AB  - BACKGROUND: Active oxygen species are thought to play a part in ischaemia
      reperfusion injury. The ability of a novel agent, human thioredoxin (hTRX), to
      attenuate lung damage has been examined in a rat model of ischaemia reperfusion
      injury. METHODS: Twenty eight animals were studied. At thoracotomy the left main
      bronchus and the left main pulmonary artery were clamped for 75 minutes and the
      lung was then reperfused for 20 minutes. Phosphate buffered saline was
      administered intravenously to nine control animals and hTRX (30 micrograms/g body
      weight) was given intravenously to another group of nine animals. Two experiments
      were carried out. The first (Exp 1) was a time matched pair experiment (five
      treated, five controls), and the second (Exp 2) was performed under controlled
      conditions (four treated, four controls; temperature 25 degrees C, humidity 65%).
      In another 10 nonischaemic rats and those in Exp 1 biochemical measurements of
      lipid peroxide, superoxide dismutase, and glutathione peroxide levels were
      performed. RESULTS: In both experiments rats perfused with hTRX survived longer
      than controls. In Exp 1 the arterial oxygen tension (PaO2) on air in the hTRX
      group was higher at 20 minutes than at one minute after reperfusion. In Exp 2
      PaO2 at 20 minutes was higher in the hTRX group than in the controls. Lipid
      peroxide, superoxide dismutase, and glutathione peroxide levels in the control
      group were higher than in the hTRX group and in the non-ischaemic groups.
      Histological examination showed less thickening and oedema of the alveolar walls
      in the hTRX group than in controls. CONCLUSIONS: These results suggest that hTRX
      is effective as a radical scavenger and can limit the extent of ischaemia
      reperfusion injury of the lungs of experimental animals.

PMID- 7785013
TI  - Initial experience of video assisted thoracoscopic pneumonectomy.
AB  - BACKGROUND: Preliminary experience of video assisted thoracoscopic pneumonectomy
      in six patients with bronchogenic carcinoma is described. METHODS: Four left and
      two right pneumonectomies were performed under video thoracoscopic imaging.
      Thoracoscopic instruments were passed through two separate stab incisions on the
      lateral chest wall and a separate 6 cm submammary incision was also created to
      allow further access for instrumentation and removal of the resected lung. In
      this initial experience resection was restricted to patients with bronchogenic
      carcinomas of less than 6 cm in diameter who had no involvement of the
      mediastinum. RESULTS: There were no operative deaths and no complications
      attributable to the technique. One patient developed postoperative atrial
      fibrillation and a small sacral sore and one patient was readmitted with
      abdominal pain and pyrexia which settled following exclusion of post
      pneumonectomy empyema. The remaining four patients made a rapid uncomplicated
      postoperative recovery with less pain and discomfort than that normally
      associated with a standard posterolateral thoracotomy. Postoperatively the mean
      (SD) patient controlled morphine consumption was 1.36 (1.90) mg per hour in the
      first 36 hours compared with the unit mean for open thoracotomy of 1.73 (1.68) mg
      per hour. The mean linear visual analogue pain score was 15.4 (15.6) in the first
      24 hours compared with the unit mean for open thoracotomy of 34.5 (8.5).
      CONCLUSIONS: Video assisted thoracoscopic pneumonectomy can be performed safely
      in patients who have stage I and stage II bronchogenic carcinomas, up to 6 cm in
      diameter, with no mediastinal involvement on mediastinoscopy and thoracic
      computed tomographic assessment. This technique may result in less postoperative
      pain and discomfort and should allow a quicker return to normal activities.

PMID- 7785011
TI  - Critical evaluation of computerised x ray planimetry for the measurement of lung
      volumes.
AB  - BACKGROUND: Computerised x-ray planimetry has been advocated as an alternative to
      body plethysmography and helium dilution for measuring static lung volumes. The
      accuracy and reproducibility of this method has been assessed in comparison with
      these standard methods. METHODS: Plethysmographic and planimetric measurements of
      total lung capacity (TLC) and functional residual capacity (FRC) were made in 10
      normal subjects and in 12 patients with chronic obstructive pulmonary disease
      (COPD), with additional helium dilution measurements in the latter 12 patients.
      RESULTS: Mean lung volumes (TLC and FRC) for groups of subjects measured by
      planimetry and by plethysmography were similar in both groups and larger than the
      helium dilution measurement in patients with COPD. Intraindividual agreement
      between planimetry and plethysmography was poor, however, with a wide confidence
      interval (-2.2 to +2.31). The planimeter did not measure reliably changes in
      volume from TLC to FRC in individuals. CONCLUSIONS: Mean lung volumes measured by
      planimetry in a group of patients probably reflect a regression to the mean of
      the computer algorithm rather than accurate TLC estimation. The technique is not
      yet robust enough to replace the established techniques of helium dilution or
      plethysmography.

PMID- 7785014
TI  - Surgical management of pulmonary hydatid cysts in children.
AB  - BACKGROUND: Hydatid disease is common in Libya with a prevalence of 2%. Surgery
      of pulmonary hydatid disease remains the best treatment and aims to remove the
      cyst or its remnants and obliterate the residual cavity. METHODS: Forty three
      consecutive patients under 15 years of age were investigated by plain chest
      radiography, ultrasonography of the abdomen, and indirect haemagglutination
      tests. At thoracotomy the parasite or its remnants were removed and the bronchial
      fistula sutured. RESULTS: All but four of the patients were discharged within 12
      days. These four had had their large cavities obliterated by purse string sutures
      and developed air fluid levels with cavity reformation at the cyst site. They
      were treated conservatively by physiotherapy and antibiotics and remained in
      hospital for 2-3 weeks. There was only one recurrence after three years of follow
      up. CONCLUSIONS: Pulmonary hydatid cysts in children can be treated successfully
      by evacuation and obliteration. The methods described can also be applied to
      adults.

PMID- 7785015
TI  - Acute lung injury in fulminant hepatic failure following paracetamol poisoning.
AB  - BACKGROUND: There is little information on the incidence of acute lung injury or
      changes in the pulmonary circulation in acute liver failure. The aim of this
      study was to record the incidence of acute lung injury in fulminant hepatic
      failure caused by paracetamol poisoning, to document the associated pulmonary
      circulatory changes, and to assess the impact of lung injury on patient outcome.
      METHODS: The degree of lung injury was retrospectively assessed by a standard
      scoring system (modified from Murray) in all patients with fulminant hepatic
      failure caused by paracetamol poisoning, admitted to the intensive care unit over
      a one year period. The severity of liver failure and illness, other organ system
      failure, and patient outcome were also analysed. RESULTS: Twenty four patients
      with paracetamol-induced liver failure were admitted and nine developed lung
      injury of whom eight (33%) had severe injury (Murray score > 2.5). In two
      patients hypoxaemia contributed to death. Patients with lung injury had higher
      median encephalopathy grades (4 v 2 in the non-injured group) and APACHE II
      scores (29 v 16). Circulatory failure, requiring vasoconstrictor support,
      occurred in all patients with lung injury but in only 40% of those without.
      Cerebral oedema, as detected by abnormal rises in intracranial pressure, also
      occurred in all patients with lung injury but in only 27% of the non-injured
      patients. The incidence of renal failure requiring renal replacement therapy was
      similar in both groups (67% and 47%). Pulmonary artery occlusion pressures were
      normal in the lung injury group. Cardiac output was high (median 11.2 1/min),
      systemic vascular resistance low (median 503 dynes/s/cm-5), and pulmonary
      vascular resistance low (median 70 dynes/s/cm-5), but not significantly different
      from the group without lung injury. Mortality was much higher in the lung injury
      group than in the non-injured group (89% v 13%). CONCLUSIONS: Acute lung injury
      was common in patients with paracetamol-induced fulminant hepatic failure and was
      associated with systemic circulatory failure and cerebral oedema. The development
      of acute lung injury was associated with high mortality.

PMID- 7785016
TI  - Compliance at night with low flow oxygen therapy: a comparison of nasal cannulae
      and Venturi face masks.
AB  - BACKGROUND: The factors that influence nocturnal compliance among patients
      prescribed low flow oxygen therapy were determined and tolerance of nasal
      cannulae and Venturi face masks compared. METHODS: Two studies were performed:
      (1) a prospective study of 99 hospitalised patients prescribed low flow oxygen
      therapy, 49 on nasal cannulae and 50 on Venturi face mask; and (2) a prospective
      study of 20 separate patients with an acute respiratory disorder requiring low
      flow oxygen therapy who were given nasal cannulae and Venturi face mask on
      successive nights in random order. RESULTS: In study 1, 49 patients dislodged
      their device at least once during the night. Those using Venturi face masks and
      those over 75 years of age had the most dislodgements. In study 2 patients also
      dislodged Venturi face masks more frequently (mean (SD) 2.0 (2.4)) than nasal
      cannulae (0.7 (1.4)). Most patients expressed a preference for nasal cannulae.
      CONCLUSIONS: Nocturnal tolerance of nasal cannulae is superior to Venturi face
      masks, and this factor should be considered when choosing the method of oxygen
      delivery.

PMID- 7785017
TI  - AIDS and the lung: update 1995. 3. Intrathoracic Kaposi's sarcoma in patients
      with AIDS.

PMID- 7785019
TI  - Fatal chickenpox pneumonia in an asthmatic patient on oral steroids and
      methotrexate.
AB  - A 49 year old man with a long history of severe chronic asthma, treated with oral
      corticosteroids and weekly doses of methotrexate, contracted chickenpox from his
      son whose chickenpox rash had developed three weeks before presentation. Five
      days before admission the patient developed a vesicular skin rash which became
      extensive, with general malaise, bilateral pneumonia, and acute deterioration of
      his asthma. He died two weeks after admission despite treatment with acyclovir.

PMID- 7785020
TI  - Bronchiectasis and homozygous (P1ZZ) alpha 1-antitrypsin deficiency in a young
      man.
AB  - Pulmonary complications of alpha 1-antitrypsin deficiency are most commonly
      manifested by panlobular emphysema. This report describes histologically proven
      bronchiectasis in a 21 year old man with massive haemoptysis and homozygous
      deficiency of alpha 1-antitrypsin. Neither panlobular emphysema nor cirrhosis of
      the liver were present. Bronchiectasis must be considered part of the spectrum of
      the pulmonary pathology that may be encountered in individuals with alpha 1
      antitrypsin deficiency.

PMID- 7785018
TI  - New strategies for treatment of pulmonary fibrosis.

PMID- 7785021
TI  - Demonstration of supernumerary tracheal bronchus by computed tomographic scanning
      and magnetic resonance imaging.
AB  - A bronchus arising directly from the trachea is an infrequent congenital anomaly
      which usually represents the displaced origin of a normal bronchus. Rarely, a
      true supernumerary tracheal bronchus occurs supplying an associated tracheal
      lobe. The case is described of a patient in whom a supernumerary tracheal
      bronchus and tracheal lobe was demonstrated by computed tomographic scanning and
      magnetic resonance imaging.

PMID- 7785022
TI  - Replacement of one lung by a large bulla in active tuberculosis.

PMID- 7785023
TI  - Co-amoxiclav levels in bronchial mucosa.

PMID- 7785025
TI  - [While we are waiting for the Social Welfare Draft...the constitutional law on
      social insurance may be critically scrutinized].

PMID- 7785024
TI  - Effects of ACE inhibition on sodium excretion in COPD.

PMID- 7785026
TI  - [Under the magnifying glass--treatment of stroke].

PMID- 7785027
TI  - [Testicular cancer--Norway among the countries with the highest frequency.
      Regional multicenter cooperation is effective].

PMID- 7785029
TI  - [Rehabilitation status at a regional social insurance office. Experiences with
      103 clients at the Grunerlokka-Sofienberg office].
AB  - 103 patients, mostly females, on rehabilitation measures mainly because of
      psychiatric conditions and chronic musculo-skeletal pain syndromes, were
      investigated with regard to outcome. In general, the patients had a low level of
      education, only 10% had vocational training, and most were unskilled labourers.
      Prior to the rehabilitation period they had been certified sick on several
      occasions. On average, the patients were followed up for three years. 84% were
      still on medical rehabilitation, i.e. they were under more or less systematic
      medical treatment, and were receiving benefits. 8% had been granted a disability
      pension, and only 4% had managed to become independent of the social insurance
      system. Until the recent years the rehabilitation system has functioned
      inefficiently as regards bringing people back to work. The patients remain
      inactive for long periods, owing to lack of planning and systematic
      implementation of rehabilitation measures, medical as well as vocational. In
      addition the vocational quality requirements of the labour market make it hard
      for people even with mainly minor health problems to obtain employment.

PMID- 7785030
TI  - [Ethical considerations in neonatal medicine].
AB  - Ethical dilemmas are a daily occurrence in neonatal intensive care units. Some of
      these questions relate to life-and-death issues such as whom to treat or not to
      treat, if and when to discontinue life support, and organ donation. However,
      other issues are just as important in daily practice. These include the choice of
      a framework for ethical discussions, the question of who participates in the
      discussions, the parents' right to participation and information, the process and
      timing of decision-making, the ethics of clinical research in subjects unable to
      consent, respect and communication between health professionals, and the limits
      of confidentiality. In most of these dilemmas there is no quick and easy route to
      the one and only true answer. Neonatal health care workers are frequently
      confronted with ethical dilemmas, and are forced to reflect ethically. In this
      process, it is essential to be able to listen attentively to others, health
      workers as well as lay persons, and to integrate their opinions into one's own
      reflections. These two factors together must form the basis for daily clinical
      work and for ethical decisions.

PMID- 7785031
TI  - [Ventilator treatment at a subregional neonatal unit. Experiences form the
      Vestfold central hospital 1989-1994].
AB  - During the six-year period 1989-94, 106 infants were treated with mechanical
      ventilation at the neonatal unit, Vestfold Central Hospital, Tonsberg, Norway
      (0.8% of live born infants). A total of 114 treatments were started. Indications
      were respiratory distress syndrome (RDS) in 63 (55%) of the treatments, asphyxia
      in 21 (18%), septicaemia/pneumonia in 12 (11%), congenital malformations in 8
      (7%) and other indications in 10 (9%). 56 (49%) of the treatments lasted less
      than 24 hours until extubation or transportation to a regional hospital. The mean
      duration of treatment was 42.2 hours (range 0.7-183 hours). Pneumothorax occurred
      in seven infants (7%), in six of these during resuscitation and stabilizing
      treatment before mechanical ventilation. 16 infants (15%) died (cumulated
      mortality). Of the 90 surviving infants, nine (10%) acquired brain damage. The
      local ventilator treatment programme reduced the need of postnatal transports in
      infants with RDS by 65% during the period 1989-94 (1.2 per 1000 live born
      infants) compared with the period 1982-88 (3.4 per 1000) (p < 0.01). Ventilator
      treatment programmes for newborn infants can be undertaken safely at a
      subregional neonatal unit. The incidence of postnatal transports to a regional
      hospital is reduced.

PMID- 7785028
TI  - [Testicular cancer treated at the regional hospital in Tromso 1985-1993].
AB  - The case histories of 98 patients (47 seminomas and 51 non-seminomas) treated at
      the Department of Oncology, University Hospital of Tromso between January 1985
      and March 1993 were retrospectively analysed in August 1994. The analysis was
      undertaken to ascertain whether a small centre can achieve state of the art
      results. Complete remission was achieved in all cases. During a four year median
      follow-up period (range 1-10 years), three seminomas and eight non-seminomas
      relapsed. Only one retroperitoneally located relapse was revealed after
      retroperitoneal lymph node dissection. Two patients (one seminoma, one non
      seminoma) died of progressive disease. A statistically significant correlation
      was found between stage of disease and human chorionic gonadotropin, lactate
      dehydrogenate and alpha-fetoprotein in non-seminoma. Our results are similar to
      those of the major oncological centres. Hence our unit is able to achieve state
      of the art results in the treatment of testicular carcinomas.

PMID- 7785033
TI  - [Stroke. An effective evaluation and specialized treatment].
AB  - Stroke is an acute disorder with a high fatality rate and with severe residual
      impairment among many of the survivors. Advances in neuroimaging and ultrasound
      have increased our understanding of the disease process. New drugs seem to reduce
      the neuronal damage caused by brain infarction if they are administered within
      the first few hours after onset of stroke. Management of stroke patients in a
      specialised stroke unit hastens recovery and is associated with a sustained
      reduction in mortality. Both recovery and survival can be jeopardized by
      cerebral, systemic, and cardiac complications, which may be attenuated by
      rigorous attention to general medical factors. Treatment of acute stroke will
      certainly change dramatically in coming years.

PMID- 7785032
TI  - [Combination of low molecular weight heparin and non-steroidal anti-inflammatory
      agents].
AB  - Non-steroidal anti-inflammatory drugs (NSAIDs) play an important part in
      postoperative relief of pain. Non-steroidal anti-inflammatory drugs and
      paracetamol should act as non-opioid basis analgesics in the postoperative
      period, leading to reduced need of opioid analgesia. This is beneficial, since it
      may reduce possible dosage-dependent side-effects of opioids such as nausea,
      tiredness and respiratory depression. The inhibition of prostaglandin synthesis
      by non-steroidal anti-inflammatory drugs also affects haemostasis, and the
      combination of these drugs with prophylaxis against postoperative thrombosis with
      heparin is controversial. We refer to a case history which illustrates this
      controversy. We also discuss the effect of non-steroidal anti-inflammatory drugs
      on pain and inflammation. Possible side-effects of these drugs and their
      interaction with heparin are reviewed.

PMID- 7785034
TI  - [Peripheral neuropathies].
AB  - Some new aspects of peripheral nerve disease are reviewed. Hereditary motor and
      sensory neuropathy (HSMN) constitutes a genetically heterogeneous group of
      chronic polyneuropathies with loci mapping to chromosome 17 (type Ia), chromosome
      1 (type Ib), and the X chromosome (X-linked HSMN). Although peripheral nerve
      abnormalities occur in approximately 50% of diabetic patients, the frequency of
      severe diabetic neuropathy even in insulin-dependent persons is rather modest
      (6%). Intensified insulin treatment seems more important for preserving
      peripheral nerve function than treatment with aldose reductase inhibitors. Acute
      inflammatory demyelinating polyradiculoneuropathy (Guillain-Barre syndrome) and
      chronic inflammatory demyelinating polyneuropathy may both be beneficially
      influenced by plasma exchange or intravenous immunoglobulin. In acute
      inflammatory demyelinating polyradiculoneuropathy, campylobacter jejuni infection
      is a common preceding event. There is some evidence of cross reactivity between
      this infectious agent and the ganglioside GM1 in peripheral nerve myelin.

PMID- 7785035
TI  - [What do we know about the frequency of stroke? A review of incidence studies].
AB  - In Norway, mortality from stroke has declined during the last 30-40 years. It is
      unknown whether the frequency of stroke has declined. This article presents
      studies on incidence and trends in incidence of stroke in different countries,
      especially Scandinavian countries. Geographical differences in incidence are
      small, when the rates are compared, adjusted for age and sex. Time trend studies
      on incidence give conflicting results. Some studies suggest increasing incidence
      of stroke, others a decrease or even no change of incidence. The age-standardised
      incidence rate (adjusted to the Norwegian population) from six studies in people
      aged 55-84 years is estimated to 6-8 per 1,000 per year. Little is known about
      incidence and time trend in Norway. Factors of importance for primary prevention
      of stroke (e.g. treatment of hypertension), treatment and rehabilitation of the
      stroke patient and knowledge about the incidence.

PMID- 7785036
TI  - [Rehabilitation of stroke patients--does it have an effect?].
AB  - A search of the literature was carried out in order to identify controlled trials
      to study the effect of rehabilitation after a stroke. A limited number of studies
      have been published, and many are of poor quality. Making the organization of
      rehabilitation more efficient, emphasizing early start of rehabilitation, and
      close cooperation between the involved health professionals and an improvement of
      their competence have the best documented effect on mortality and on the
      percentage of patients who return home. There is also evidence that retraining of
      motor function and of language skills is effective. Rehabilitation seems to lead
      to more rapid recovery and a better result overtime. However, the achieved
      functional level may decline when the rehabilitational efforts are scaled down.
      The effect of rehabilitation on sensory and cognitive functioning is poorly
      documented.

PMID- 7785039
TI  - [A catalog of institutions for drug abuse treatment].

PMID- 7785037
TI  - [Assessment by consulting physicians and general practitioners about complex
      disability pension matters].
AB  - In the study we wanted to explore physicians' judgement of applicants for
      disability benefit who have complex medical and psychosocial histories. A postal
      questionnaire was used, containing six patient management problems focusing on
      whether the applicant would fill the criteria for obtaining a disability benefit
      according to Norwegian legislation. The participants were all medical officers
      hired as consultants by the social security officers in Norway (n = 122, response
      rate 75%) and a random sample of Norwegian general practitioners (n = 160,
      response rate 55%). There was a high degree of variation among physicians. The
      tendency to spread was almost parallel in the two groups of doctors, but the
      general practitioners tended to be slightly more liberal (in favour of disability
      benefit) than the social security medical officers. The latter expressed a more
      optimistic view of the rehabilitation potential of the applicants. Some
      physicians in each group seemed to be generally restrictive, others were liberal.
      Younger doctors seemed to be slightly more restrictive than older ones, while the
      attitudes of the physicians did not seem to be influenced by their sex, the form
      of payment or the location of the practice. The variation within each group of
      doctors indicates that both feedback and further discussion are needed to improve
      quality in this field of social security medicine.

PMID- 7785038
TI  - [What happens to patients not granted disability pension?].
AB  - Subsequent to a recent (1991) narrowing of the medical legibility criteria for
      granting disability pensions in Norway, we wanted to follow up rejected
      applicants with regard to main sources of income. As setting were chosen five
      mainly rural municipalities on the North-West coast of Norway and the city of
      Trondheim. The study was carried out as a historic prospective study of a sample
      of rejected applicants for a disability pension, mainly based on follow-up data
      from local social security offices. Among a sample of 146 applicants rejected in
      1990/91 and 1992, 143 (87 women and 56 men) were available for the analysis in
      March 1994. A rather stable 20% of the sample were occupationally active
      throughout three years of follow-up, this percentage being slightly higher among
      women than among men. In spite of the initial rejection, 25% had been granted a
      disability pension after two years. The rest received other kinds of public
      social support, or had left the labour market and had no social security support
      (mostly women).

PMID- 7785040
TI  - [An advertising campaign with adverse effects].

PMID- 7785041
TI  - [Suture material and suturing of the laparotomy wound in horses and cattle].
AB  - Wound healing is discussed in the introduction. Subsequently in a review of the
      suture materials used in large animal laparotomies is presented. In the
      discussion examples are given of the suture materials that are used at the
      Department of General and Large Animal Surgery.

PMID- 7785043
TI  - [Veterinary medicine after 2002, preliminary questions].

PMID- 7785042
TI  - [A pig farm with chronic fertility problems].
AB  - A herd with 320 sows with chronic fertility problems is described. About 20 to
      30% of the inseminated sows returned to oestrus, for unknown reasons. When the
      interval from insemination to return to oestrus was analysed, it appeared that
      20% of the sows returned between 24 and 28 days. A thorough and extensive control
      of the pig-farmer's oestrus detection technique revealed that nearly all sows
      were inseminated between 4 to 6 days post-weaning. However, this was too early
      for a number of sows. These sows showed optimal oestrus symptoms 6-8 days post
      weaning. This was also the explanation for the high number of sows returning to
      oestrus 'irregularly' between 24 and 28 days. Thus when analysing insemination
      intervals, the interval between 24 and 35 days should not be considered as one
      period but should be divided into the periods, 24-28 days and 29-35 days. In this
      way it is possible to distinguish between sows inseminated too early and sows
      returning to oestrus irregularly.

PMID- 7785044
TI  - [Veterinary medicine after 2002: the market].

PMID- 7785045
TI  - [Bald back].

PMID- 7785046
TI  - [Hepatic encephalopathy].

PMID- 7785047
TI  - Chemical-induced vasculature injury. Summary of the symposium presented at the
      32nd annual meeting of the Society of Toxicology, New Orleans, Louisiana, March
      1993.
AB  - The cross-sectional structure of the vasculature is comparatively simple,
      comprising three layers--the intima, adjacent to the lumen, the media, and the
      adventitia. Notwithstanding this simplicity, the vessels are host to a variety of
      reactions to injury. Two cell types, endothelial cells of the intima and smooth
      muscle cells of the media, are principal targets of damage and repair. The
      endothelial cells of the intimal layer of the vessel wall present a
      macromolecular barrier and are important in maintaining vessel integrity. When
      the integrity is compromised by physical or chemical injury, endothelial cells
      play a key role in the repair processes. The use of single-cell wound models
      allows the mechanisms of damage and subsequent repair to be studied in depth.
      Repair processes can be observed using time-lapse photography and differences
      between cytoskeleton changes during repair and reendothelialization of small and
      large wounds can be discriminated. In rats treated with the plant toxin
      monocrotaline, pulmonary vascular injury occurs which manifests as thrombosis and
      remodeling with consequent progressive pulmonary hypertension. In vivo and in
      vitro studies of the mechanism of monocrotaline toxicity suggest that the
      endothelial cells are an important target. In vitro studies show monocrotaline to
      be directly cytotoxic; in cells that survive, there are functional changes to the
      endothelial cells, resulting in a decreased repair capability which may lead to
      the complex, progressive lung lesions that develop. The other target cells of the
      vasculature are the smooth muscle cells of the media. Ingestion of primary amines
      allylamine and beta-aminopropionitrile (beta-APN) results in chronic
      vasculotoxicity to the aorta and medium-sized arteries. For allylamine, subtle
      changes in smooth muscle result in medial hypertrophy and subintimal
      proliferation. The changes are slow to occur, taking weeks or months of repeated
      treatment. For beta-APN, which is the active ingredient of the toxic sweet pea
      Lathyrus odoratous, vascular toxicity is manifested by fatal rupture of aortic
      aneurysms. When these agents are administered concomitantly, a synergistic acute
      smooth muscle necrosis occurs in large elastic arteries and degenerative changes
      are seen in muscular arteries. A change in the target for toxicity of allylamine
      toward the vasculature may be responsible for this synergistic toxic insult.
      Medial smooth muscle necrosis is also noteworthy after administration of certain
      pharmaceutical agents of diverse structure and pharmacological activity. These
      agents induce arteriopathies in dogs and rats, although at different sites. In
      dogs, the coronary arteries are susceptible, whereas in rats the mesenteric
      arteries are the principal sites of injury.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7785049
TI  - Sex differences in hexachlorobutadiene biotransformation and nephrotoxicity.
AB  - Hexachlorobutadiene is nephrotoxic in rats, causing damage to the proximale
      tubules. Renal toxicity is presumed to be due to bioactivation by glutathione S
      conjugate formation. Hexachlorobutadiene is conjugated with glutathione to S
      (1,2,3,4,4-pentachlorobutadienyl)glutathione and further transformed to S
      (1,2,3,4,4-pentachlorobutadienyl)-L-cysteine (PCBC), which is N-acetylated in the
      liver to form N-acetyl-S-(1,2,3,4,4-pentachlorobutadienyl)-L-cysteine (N-ac
      PCBC). N-ac-PCBC is accumulated in the kidney. Renal acylases cleave N-ac-PCBC to
      PCBC, which is a substrate for renal cysteine conjugate beta-lyase and
      transformed to a reactive thioketene. Binding of this intermediate to renal
      macromolecules is most likely responsible for the nephrotoxicity of
      hexachlorobutadiene. In this study, we administered [14C]HCBD (200 mg/kg, per
      gavage) to male and female Wistar rats and compared the distribution and
      biotransformation. No significant differences in the disposition and rates of
      excretion of [14C]hexachlorobutadiene-derived radioactivity were observed between
      male and female rats. A portion of the dose (15.6 +/- 4.2) was excreted in the
      feces and 3.1% ( +/- 0.7) in the urine of male rats, and 11.1% ( +/- 3.8) of the
      dose was excreted in the feces and 4.5% ( +/- 1.5) in the urine of female rats.
      The major metabolite excreted by female rats was N-ac-PCBC, while small amounts
      of PCBC were also detected. In the urine of male rats, in addition to small
      amounts of PCBC and N-ac-PCBC, N-acetyl-S-(1,2,3,4,4-pentachlorobutadienyl)-L
      cysteine sulfoxide and [14C]hexachlorobutadiene were identified. Formation of the
      electrophile N-ac-PCBC sulfoxide must be considered as an alternative, beta-lyase
      independent, bioactivation pathway for hexachlorobutadiene-derived S-conjugates.
      In isolated rat renal tubular cells, N-ac-PCBC sulfoxide induced a significantly
      more marked loss in cell viability than N-ac-PCBC. After identical doses of
      hexachlorobutadiene, the extent of necrosis to the pars recta of the proximal
      tubules was increased in male rats compared to the necrotic changes in female
      rats. While female animals showed a normal liver histology, male rats revealed
      slight toxic centrilobular liver changes in addition to the renal necroses. In
      vitro, only liver microsomes from male rats catalyzed the formation of N-ac-PCBC
      sulfoxide from N-ac-PCBC. Our results describe a new pathway of
      hexachlorobutadiene biotransformation in male rats, the formation of a
      mercapturic acid sulfoxide. The formation of this Michael acceptor may contribute
      to sex differences in hexachlorobutadiene nephrotoxicity.

PMID- 7785048
TI  - MK-801 protects against carbon monoxide-induced hearing loss.
AB  - MK-801, a glutamate receptor blocker, has been reported to protect against
      hypoxic-ischemic neuronal degeneration. The purpose of this study was to
      investigate the protective effects of MK-801 on cochlear impairment induced by
      carbon monoxide (CO) in the guinea pig and whether the protection reflected
      systemic or local effects. Glutamate has been proposed to be the neurotransmitter
      at the inner hair cell/type I spiral ganglion cell synapse. CO (35 ml/kg ip)
      elevated the compound action potential threshold at high frequencies (16-40 kHz)
      30 min after treatment. In the group pretreated with 1 mg/kg MK-801 ip there was
      no significant elevation of compound action potential threshold 30 min after CO
      exposure, suggesting that MK-801 provided some protection at this dosage. In the
      group pretreated with 0.1 mg/kg MK-801 there was protection against cochlear
      dysfunction 15 min after CO injection, but significant elevation of compound
      action potential threshold occurred 30 and 60 min after CO exposure. Data also
      indicated that 1 mM MK-801 applied topically on the round window membrane
      provided protective effects against CO hypoxia from 15 up to 60 min. This
      experiment suggests that cochlear impairment induced by CO hypoxia may result
      from excess extracellular concentrations of glutamate.

PMID- 7785051
TI  - Transforming growth factor beta 1 preferentially induces apoptotic cell death in
      rat hepatocytes cultured under pericentral-equivalent conditions.
AB  - The cytotoxicity of transforming growth factor beta 1 (TGF beta 1) was assessed
      in rat hepatocytes cultured under periportal (PP)-or pericentral (PC)-equivalent
      conditions. TGF beta 1 induced a 5-fold greater DNA fragmentation and LDH release
      in PC cultures than in PP cultures. At low exposure level (1 ng/ml TGF beta 1),
      albumin secretion and mitochondrial activity (rhodamine-123 uptake) were
      selectively reduced in PP cultures, whereas the incidence of apoptotic cells in
      PC cultures was about 10-fold higher than that in PP cultures. The time profiles
      of TGF beta 1-induced apoptotic and necrotic events and the concentration
      response relationship differed in PC and PP cultures. In PC cultures the early
      appearance of cells with apoptotic nuclei was not associated with DNA
      fragmentation nor with an increase in LDH release or impaired mitochondrial
      function. At a high exposure level (5 ng/ml TGF beta 1), again cells with
      apoptotic nuclei were much more strongly induced in PC cultures but DNA
      fragmentation, LDH release, and impairment of mitochondrial activity all
      increased in an exposure-time dependent manner in both PP and PC cultures. At
      this exposure level 48 and 72% of the apoptotic cells detected in PC cultures
      after continuous exposure for 24 hr were induced within an exposure of 1 and 4
      hr, respectively. Aurintricarboxylic acid (50 microM), an inhibitor of
      endonucleases, significantly inhibited the appearance of apoptotic cells and the
      progression in apoptosis. Clearly, TGF beta 1 preferentially induced apoptotic
      cell death in hepatocytes with PC-equivalent metabolism at low exposure levels.
      High exposure levels or prolonged exposure periods produced both apoptosis and
      necrosis.

PMID- 7785050
TI  - The hematotoxic effects of 6-hydroxy-trans,trans-2,4-hexadienal, a reactive
      metabolite of trans,trans-muconaldehyde, in CD-1 mice.
AB  - 6-Hydroxy-trans,trans-2,4-hexadienal (CHO-M-OH) is a metabolite of trans,trans
      muconaldehyde (muconaldehyde or MUC), a microsomal hematotoxic ring-opened
      metabolite of benzene. In the present study, the toxicity of CHO-M-OH was
      examined. In order to assess potential toxic effects of CHO-M-OH on the
      maturation of erythroid cells in the bone marrow, 10-week-old male CD-1 mice were
      administered CHO-M-OH intraperitoneally and 59Fe incorporation into erythrocytes
      was measured. The uptake of 59Fe by erythroid cells was significantly inhibited
      at doses of 20, 25, and 30 mg/kg. There was no inhibition of 59Fe incorporation
      at a dose of 15 mg/kg. In other hematotoxicity studies, bone marrow cellularity,
      peripheral blood cells, and sulfhydryl contents in bone marrow cells were
      examined in mice administered CHO-M-OH intraperitoneally. An increase in the
      white blood cell count was observed in mice treated with 5 mg/kg/day for 16
      consecutive days, while bone marrow cellularity and red blood cell parameters
      were not changed. Administration of 10 mg/kg/day for 16 consecutive days caused a
      significant decrease in sulfhydryls of bone marrow cells but no changes in bone
      marrow cellularity and peripheral blood parameters compared with controls. At a
      dose of 25 mg/kg/day for 4 days, there was a significant decrease in nucleated
      bone marrow cells. The white blood cell count, mainly lymphocytes, also
      significantly decreased. Our results indicate that CHO-M-OH is a hematotoxin in
      mice and conceivably could play a role in benzene toxicity.

PMID- 7785052
TI  - Differential toxicity of cisplatin, carboplatin, and CI-973 correlates with
      cellular platinum levels in rat renal cortical slices.
AB  - The differential toxicity of the platinum-containing compounds, cisplatin,
      carboplatin, CI-973, and transplatin, was investigated in renal cortical slices
      over a 24-hr period. Platinum accumulation was measured to assess whether
      platinum levels correlated with inhibition of specific cell functions
      (accumulation of organic ions, protein synthesis) or potassium loss. The earliest
      indicator of toxicity was decreased accumulation of the organic anion, para
      aminohippuric acid (PAH), which preceded a decrease in the accumulation of the
      organic cation, tetraethyl-ammonium (TEA), and protein synthesis. Cisplatin (1
      mM) and CI-973 (3 mM) treatment reduced PAH accumulation within 2 hr; carboplatin
      (3 mM) decreased PAH at 6 hr. TEA accumulation was absent in slices incubated for
      6 hr or longer in 1 mM cisplatin, or for 24 hr in 3 mM carboplatin or CI-973.
      Protein synthesis was inhibited 80, 75, and 87% in slices treated for 24 hr with
      100 microM cisplatin, 1 mM carboplatin, and 1 mM CI-973, respectively, compared
      to control. Intracellular potassium levels, which decreased between 6 and 24 hr,
      were the least sensitive indicator of cell damage. Transplatin, which lacks
      antitumor activity and is nonnephrotoxic in vivo, effectively decreased protein
      synthesis, intracellular potassium, and organic ion accumulation in rat renal
      cortical slices in vitro. The concentration of slice-associated platinum
      following treatment with cisplatin, carboplatin, CI-973, and transplatin
      increased with time and concentration. Inhibition of protein synthesis and loss
      of intracellular potassium correlated with increased total cellular platinum,
      indicating that platinum compounds negatively affect cell function and viability.
      The relative toxicity of these compounds in rat renal cortical slices was
      cisplatin = transplatin > CI-973 > carboplatin.

PMID- 7785054
TI  - Regeneration of renal proximal tubule cells in primary culture following toxicant
      injury: response to growth factors.
AB  - Growth factors may play an important role in the repair of the renal proximal
      tubule epithelium following toxic injury. This study investigated the
      regeneration of rabbit renal proximal tubule cell (RPTC) monolayers following
      exposure to the nephrotoxicants tert-butylhydroperoxide (TBHP) and 1,2
      dichlorovinyl-L-cysteine (DCVC), and the effect of exogenous growth factors on
      the regeneration process. Confluent monolayers exposed to TBHP or DCVC for 1.5-2
      hr were 23 and 43% confluent, respectively, after 24 hr. Confluency increased to
      63 and 80% 4 days after TBHP or DCVC exposure, but decreased to 29 and 24% after
      8 days. Monolayer DNA content did not increase after TBHP or DCVC exposure;
      however, monolayer protein/DNA ratio increased above control values after DCVC
      exposure. Recovery of confluency was not sensitive to RGD-containing peptides
      that inhibit the binding of integrins to extracellular matrix. Epidermal growth
      factor (EGF) treatment resulted in complete recovery of confluency, and protein
      and DNA contents 4-6 days after injury. Unlike EGF, IGF-1 or insulin treatment
      produced a small increase in confluency following TBHP exposure. These results
      suggest that hypertrophy following DCVC exposure and migration/spreading after
      TBHP and DCVC exposure play a partial and temporary role in the regeneration of
      RPTC monolayers, that in the absence of exogenous growth factors proliferation
      and complete regeneration of the monolayer does not occur, that toxicants may
      alter the production of mitogenic factors, and that EGF is a potent and
      efficacious growth factor in promoting regeneration.

PMID- 7785053
TI  - TCDD reduces rat hepatic epidermal growth factor receptor: comparison of binding,
      immunodetection, and autophosphorylation.
AB  - Administration of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), a potent tumor
      promoter, to rats resulted in a dose-dependent decrease in hepatic plasma
      membrane epidermal growth factor receptor (EGFR). The present study is the first
      to quantify and compare alterations in hepatic EGFR levels in female Sprague
      Dawley rats 7 days after a single oral gavage dose of TCDD (0, 1, 5, 25, and 50
      micrograms/kg) using three different techniques: (1) equilibrium receptor
      binding, (2) EGF induced receptor autophosphorylation, and (3) Western blot
      detection with a rabbit anti-rat EGFR polyclonal antibody. All three methods
      similarly demonstrated that the level of hepatic EGFR is significantly decreased
      at a dose of TCDD as low as 1 micrograms/kg. We showed that the immunoblot
      technique is a sensitive and quantitative alternative to radioligand binding
      assays. It is concluded that TCDD decreased total EGFR protein and maximum
      binding capacity without altering ligand binding affinity (Kd). The results
      demonstrated that ligand-induced autophosphorylation capacity and basal
      phosphotyrosine residues of plasma membrane EGFR were both decreased parallel
      with the decrease in EGFR protein, suggesting no TCDD-related alteration in the
      inherent functional ability of the receptor to undergo activation. Furthermore,
      it was found that the dose-response curve for EGFR protein level determined by
      Western blot analysis was similar for both male and female Sprague-Dawley rats.

PMID- 7785055
TI  - High concentrations of butadiene epoxides in livers and lungs of mice compared to
      rats exposed to 1,3-butadiene.
AB  - 1,3-Butadiene (BD) is carcinogenic in B6C3F1 mice and Sprague-Dawley rats, and
      mice are more sensitive than rats. This study measured the concentrations of the
      putative DNA-reactive BD metabolites, butadiene monoxide (BMO) and butadiene
      diepoxide (BDE), in lung and liver of male Sprague-Dawley rats and B6C3F1 mice
      exposed to BD by inhalation. Samples (n = 3-6) of lung and liver were collected
      at 3 and 6 hr during and at 6 and 12 min following 6-hr nose-only inhalation
      exposure to 0, 62.5, 625, 1250, or 8000 (rats only) ppm BD. BMO and BDE were
      extracted into methylene chloride and quantified by gas chromatography-mass
      spectrometry. Since BD epoxides can be conjugated with glutathione (GSH), the
      nonprotein sulfhydryl content of lung and liver was quantified colorimetrically.
      Analytical limitations precluded quantitation of BD epoxides in tissues of rats
      or mice exposed to 62.5 ppm BD. Exposures greater than or equal to 625 ppm BD
      resulted in higher BMO concentrations in lungs and livers of mice compared to
      rats. In mice exposed to 625 and 1250 ppm BD, the maximum concentrations of BMO
      at 3 or 6 hr of exposure in lungs (2.6 +/- 0.2 and 3.7 +/- 1.2 nmol/g tissue;
      mean +/- SE) were higher than in livers (0.58 +/- 0.12 and 0.93 +/- 0.19 nmol/g).
      Rats exposed to 625 and 1250 ppm BD had lower concentrations of BMO in lungs
      (0.16 +/- 0.03 and 0.31 +/- 0.07 nmol/g) and livers (0.06 +/- 0.01 and 0.16 +/-
      0.06 nmol/g) than mice. In rats exposed to 8000 ppm BD, the maximum
      concentrations of BMO in lungs (1.3 +/- 0.2 nmol/g) and livers (1.2 +/- 0.1
      nmol/g) were nearly identical. BDE was quantified in lungs, but not livers, of
      mice exposed to 625 and 1250 ppm BD. The maximum concentrations of BDE in mouse
      lungs were 0.71 +/- 0.06 and 1.5 +/- 0.1 nmol/g, respectively; BDE was not
      detected in livers or lungs of rats exposed to any of the concentrations of BD
      tested. GSH depletion was dependent on the concentration and duration of BD
      exposure. The lungs of mice sustained the greatest magnitude of depletion (26% of
      control at 6 hr of exposure to 1250 ppm BD).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7785056
TI  - Organic anion transport and action of gamma-glutamyl transpeptidase in kidney
      linked mechanistically to renal tubular uptake of inorganic mercury.
AB  - In the present study, the roles of renal tubular gamma-glutamyl transpeptidase
      and renal organic anion transport on the renal uptake and accumulation and
      intrarenal distribution of injected inorganic mercury were investigated. The
      renal (and general) disposition of injected inorganic mercury (Hg2+) was
      evaluated in control rats, rats pretreated with two 10 mg/kg doses of acivicin,
      rats pretreated with a 10 mmol/kg dose of p-aminohippurate (PAH), and rats
      pretreated with both acivicin and PAH. The dose(s) of acivicin were used to
      inhibit the activity of renal gamma-glutamyl transpeptidase to a near maximal
      level and the dose of PAH (which is a water-soluble organic anion) was used to
      competitively inhibit the renal organic anion transport system to a near maximal
      level. Dispositional data were obtained at both 1 and 24 hr after a nontoxic, 0.5
      mumol/kg iv dose of mercuric chloride had been administered. Radiolabeled
      inorganic mercury (203Hg2+) was added to the injection solution containing the
      mercuric chloride to make it possible to quantitate the accumulation and
      disposition of mercury using standard isotopic methods. The renal concentration
      and content of mercury were significantly lower in the rats pretreated with
      either acivicin or PAH than in the control rats at both times after the injection
      of inorganic mercury. Pretreatment with acivicin mainly affected the content of
      mercury in the renal cortex, while pretreatment with PAH affected the content of
      mercury in both the renal cortex and the outer stripe of the outer medulla.
      Interestingly, the renal concentration and content of mercury in the rats
      pretreated with both acivicin and PAH were significantly lower than in any of the
      other three groups at both times after injection of inorganic mercury. Evaluation
      of the intrarenal distribution of mercury indicated that the renal cortex was the
      main zone in which the uptake of mercury was significantly affected by both
      acivicin and PAH. The findings from this study indicate that the renal tubular
      uptake of administered inorganic mercury is linked both to the transport of
      organic anions and to the action of gamma-glutamyltransferase. Thus, at least two
      mechanisms appear to be involved in the renal tubular uptake of inorganic
      mercury.

PMID- 7785057
TI  - Systemic autoimmunity due to mercury vapor exposure in genetically susceptible
      mice: dose-response studies.
AB  - Six groups of genetically mercury-susceptible female SJL/N (H-2s) mice were
      exposed to mercury vapor at a concentration of 0.3-1.0 mg Hg/m3 air for 0.5-19
      hr/day 5 days a week for 10 weeks. The absorbed doses were calculated to be
      between 75 and 2365 micrograms Hg/week/kg body wt (micrograms Hg/week/kg). The
      correlation between the dose and the concentration of Hg in kidney, spleen, and
      thymus was highly significant (p < 0.0001; Spearman's rank correlation test). The
      lowest observed adverse effect level (LOAEL) for serum IgG antinucleolar
      antibodies (ANoA) was 170 micrograms Hg/week/kg, corresponding to a renal mercury
      concentration of 4.0 +/- 0.76 micrograms Hg/g wet wt. The correlation between the
      absorbed dose and the ANoA titer was highly significant (p < 0.0001; Spearman's
      rank correlation test), and all mice were ANoA-positive at a dose of 480
      micrograms Hg/week/kg. High-titer ANoA targeted the nucleolar 34-kDa protein
      fibrillarin. The LOAEL for B-cell stimulation, measured as an increase in serum
      IgG2a and IgG1 concentrations, was 360 micrograms Hg/week/kg, but the increase
      was fivefold higher and also included IgE at a dose of 690 and 2365 micrograms
      Hg/week/kg. The serum Ig concentrations peaked after 2-4 weeks and then slowly
      declined but, except for IgE, remained significantly increased during the entire
      exposure time. Glomerular, mesangial IgG immune complex (IC) deposits,
      accompanied by systemic vessel wall IC deposits, were first detected at a dose of
      480 micrograms Hg/week/kg. The mesangium also showed increased titers of IgM IC
      deposits and complement factor C3c. The correlation between the absorbed dose,
      and the individual titer of IgG, IgM, and C3c, was highly significant (p <
      0.0001; Spearman's rank correlation test). In conclusion, mercury vapor
      efficiently induced an autoimmune syndrome in genetically susceptible mice, and
      the LOAEL for the adverse effects varied in the order ANoA < B-cell stimulation <
      IC deposits. Comparing the body burden of mercury in mice at the LOAEL for
      autoantibodies with the body burden in populations of occupationally exposed
      humans suggests that the safety margin may be narrow for genetically susceptible
      individuals.

PMID- 7785058
TI  - Validation of an in vitro teratology system using chiral substances:
      stereoselective teratogenicity of 4-yn-valproic acid in cultured mouse embryos.
AB  - In vitro systems are important for toxicity testing as well as for investigating
      the mechanism of action of xenobiotics. The validation of such in vitro systems
      is often incomplete and extrapolation to the in vivo situation is equivocal. In
      the present study, we studied the effects of enantiomers of an analogue of the
      antiepileptic drug valproic acid (VPA): R(+)- and S(-)-4-yn-VPA (R- and S-2-n
      propyl-4-pentynoic acid), which have previously been shown to induce selective
      teratogenicity in mice after in vivo administration, in mouse whole-embryo
      culture (WEC). Aqueous solutions of the sodium salts of the pure R- and S
      enantiomers as well as R,S-4-yn-VPA (racemic mixture) or VPA itself were added to
      the culture medium at 0, 0.075, 0.15, 0.3, 0.6, or 1.2 mmol/liter and embryos
      were evaluated 24 hr later. The S-4-yn-VPA enantiomer induced clear concentration
      dependent dysmorphogenesis that was evident even at the lowest concentration. The
      primary anomalies were neural tube defects, erratic neural seams, blisters, and
      rotational defects. Embryolethality was observed at 1.2 mmol/liter. The R-4-yn
      VPA enantiomer was neither embryotoxic nor dysmorphogenic at any tested
      concentration. The lack of biological activity over 24 hr in WEC with the R
      enantiomer suggests also that, as previously shown in vivo, there was no
      racemization of this isomer to the more active S-enantiomer. The racemic mixture
      of R and S isomers appeared to be slightly more embryolethal and dysmorphogenic
      than VPA. Overall, the potency of the S-enantiomer was approximately four times
      that of VPA. Therefore, the rank order of the four chemicals tested was S(-) >>
      S(-), R(+) > VPA >>> R(+), which is in agreement with the effects observed in in
      vivo exposed mice. These data demonstrate a direct stereoselective effect of
      these compounds on the embryo. This is the first illustration of the
      stereoselectivity of a xenobiotic in the WEC in vitro test system. Pure and
      stable enantiomers, which induce stereoselective toxicity in vivo, are
      demonstrated to be valuable for validation of this in vitro system.

PMID- 7785059
TI  - Peroxisome proliferator-activated receptor response specificities as defined in
      yeast and mammalian cell transcription assays.
AB  - Peroxisome proliferators include a heterogeneous group of xenobiotic agents
      capable of inducing peroxisome proliferation and hepatocellular carcinomas in
      rodent model systems. These chemicals appear to mediate their activity through a
      family of transcription factors known as peroxisome proliferator-activated
      receptors (PPAR). Recently it has been shown that DNA binding of PPAR is
      contingent upon heterodimerization with a member of the retinoic acid X (RXR)
      family of receptors. In this report transcription parameters of a rat PPAR alpha
      were analyzed using mammalian and yeast cotransfection assays. PPAR activity was
      observed to be peroxisome proliferator dependent in the mammalian cotransfection
      assay, and heterodimer dependent but peroxisome proliferator independent in a
      yeast version of the same assay. Moreover, when the naturally occurring ligand
      for RXR, 9-cis-retinoic acid (RA), was tested in the same assays, it was observed
      to generate an RXR-specific response in the yeast cell assay but host cell
      specific response in the mammalian cell assay. Finally, the combination of
      peroxisome proliferator and 9-cis-RA had very little added effect on the yeast
      cell assay but again produced a cell-specific synergistic response in the
      mammalian cell assay. These data demonstrate that PPAR transcriptional activity
      is strongly influenced by the RXR family of receptors, and that peroxisome
      proliferators may be regulating PPAR mammalian cell activity through a secondary
      mechanism.

PMID- 7785060
TI  - Autometallographic determination of inorganic mercury distribution in the cortex
      of the calcarine sulcus of the monkey Macaca fascicularis following long-term
      subclinical exposure to methylmercury and mercuric chloride.
AB  - The distribution of accumulated inorganic mercury deposits in the cortex of the
      calcarine sulcus of adult female Macaca fascicularis following long-term
      subclinical exposure to methyl-mercury (MeHg) and mercuric chloride (inorganic
      mercury-IHg) has been determined by autometallography. Four groups of monkeys
      were exposed to MeHg (50 micrograms Hg/kg body wt/day) by mouth for 6, 12, and 18
      months or 12 months followed by 6 months without exposure (clearance group). A
      fifth group of monkeys was administered inorganic mercury (as HgCl2; 200
      micrograms Hg/kg body wt/day) for 3 months by constant rate intravenous infusion
      via an indwelling catheter. Staining of IHg deposits in the MeHg-exposed groups
      increased for all cell types with increased length of exposure. The astrocytes
      and microglia in the MeHg exposure groups contained the largest deposits of IHg.
      Neurons in the 6-month MeHg exposure group were either not labeled or contained
      very fine deposits of IHg. The frequency of labeled neurons increased somewhat in
      the 12-month and clearance exposure groups. Virtually all neurons in the 18-month
      exposure group contained labeled deposits of IHg; however, these total deposits
      were considerably smaller than those present within the astrocytes and microglia.
      The majority of endothelial cells and pericytes did not contain notable mercury
      deposits, although scattered individual cells were heavily labeled. Labeled
      oligodendrocytes were relatively rare in all MeHg-exposed groups. Gitter cells,
      primarily located in a perivascular position, were common in the 12-month, 18
      month, and clearance groups and many of these were found to be heavily labeled.
      The staining of mercury deposits in the IHg-exposed animals was low compared to
      the MeHg-exposed groups. The astrocytes and microglia were the primary cell types
      labeled. It is concluded that the astrocytes, and possibly microglia, are the
      primary location of the demethylation of MeHg into IHg within the cortex of the
      calcarine sulcus.

PMID- 7785061
TI  - Relative potencies of induction of hepatic drug-metabolizing enzyme genes by
      individual PCB congeners.
AB  - The induction of a variety of drug-metabolizing enzymes by polychlorinated
      biphenyl (PCB) congeners that elicit a 2,3,7,8,-tetrachlorodibenzo-p-dioxin
      (TCDD)-type hepatic pleiotropic response, including 2,3,3',4,4'
      pentachlorobiphenyl (BZ 105), 2,3',4,4',5-pentachlorobiphenyl (BZ 118),
      2,3,3',4,4',5-hexachlorobiphenyl (BZ 156), and 3,3',4,4',5,5'-hexachlorobiphenyl
      (BZ 169) was examined. Following dietary exposure to the individual congeners for
      5 days, livers were removed and catalytic assays for cytochrome P450 (CYP)
      isozymes 1A1 and 1A2 were performed. Additionally, total cellular RNA coding for
      hepatic drug-metabolizing genes (CYP 1A1, CYP 1A2, microsomal epoxide hydrolase,
      glutathione S-transferase [GST] Ya/Yc, and the TCDD-inducible isozyme of aldehyde
      dehydrogenase [ALDH] was quantified. 3-Methylcholanthrene (MC), TCDD, or BZ 156
      (32 ppm) caused nearly maximal induction of the CYP 1A proteins but lower
      induction of the other genes. When the dose-response curves for induction of
      various drug-metabolizing genes (CYP 1A1 and 1A2, microsomal epoxide hydrolase,
      the GST Ya/Yc subfamily and ALDH) were examined, a spectrum of ED50s (half
      maximal inductions) was observed. While CYP 1A2 exhibited an ED50 of 1.7 ppm, the
      induction of ALDH was shifted far to the right (ED50 > 11 ppm). Thus, different
      genes in a single tissue may display different dose-response characteristics. The
      potency (extent of induction of CYP 1A1 activity resulting from a given dietary
      dose) was BZ 169 >> BZ 156 > BZ 118 > BZ 105. In contrast, the potencies of the
      four congeners for CYP 1A1 induction were nearly equivalent when related to
      hepatic PCB burden, apparently due to the preferential accumulation in the liver
      of BZs 169 and 156 following low-level administration in the diet.

PMID- 7785062
TI  - Protective effect of various antagonists of inflammatory mediators against
      paraoxon-induced pulmonary edema in the rabbit.
AB  - The protective effect of some antagonists of various inflammatory mediators
      against paraoxon-induced increases in endothelial permeability has been
      investigated in isolated perfused rabbit lungs. The edema induced by paraoxon has
      been previously related to a chain reaction mediated by acetylcholine. Lungs were
      ventilated and blood-free perfused with a constant flow. Arterial and venous
      pressures and lung weight were continuously recorded. Endothelial permeability
      was evaluated by measuring the capillary filtration coefficient (Kf,c). Paraoxon
      (4 x 10(-4) M) was injected in the perfusion circuit, in lungs with or without
      pretreatment with atropine, ketanserin, clonidine, morphine, indomethacin, and
      terfenadine plus cimetidine. Paraoxon induced a time-dependent increase in the
      Kf,c, a maximal effect being recorded 60 min after the injection. All the
      antagonists used as pretreatment significantly reduced the maximal effect
      recorded after paraoxon. These results show that muscarinic receptor antagonists,
      inhibitors of neuropeptides release, cyclooxygenase inhibitors, and 5
      hydroxytryptamine and histamine receptor antagonists can protect the lung against
      the edema induced by paraoxon. This protective effect is due to inhibition of the
      chain reaction triggered by acetylcholine.

PMID- 7785063
TI  - Diffusion of the culture of contraception: program effects on young women in
      rural Bangladesh.
AB  - This article describes a process of diffusion of family planning information,
      ideas, and technology among an unanticipated audience of young, unmarried women
      in rural Bangladesh. The data are derived from a focus-group study conducted in
      1987-88 in the Maternal Child Health and Family Planning Project in Matlab,
      Bangladesh. A discussion with a staff member revealed her vivid memory of the
      arrival of the community-based family planning worker in her village 10 years
      earlier, before she was married. Based on this research lead, four focus-group
      sessions were held with newly married young women, and a set of questions about
      young women were incorporated into the sessions with other community women. The
      discussions showed that many young, unmarried women learn about family planning
      from an early age from the community-based family planning worker, from female
      relatives, peers, and the media. The findings of this exploratory study suggest
      that greater attention be paid to the contraceptive needs of young women and that
      continued research be conducted with this population of women.

PMID- 7785065
TI  - Beliefs and practices regarding delivery and postpartum maternal morbidity in
      rural Bangladesh.
AB  - Most maternal deaths occur in the puerperium and most maternal morbidities
      probably also arise at that time. Maternal morbidities occur much more frequently
      than maternal deaths, but very little is known about their magnitude or causes.
      This study uses focus-group discussions to explore the experiences of childbirth
      and postpartum illness among rural Bangladeshi women. The women's beliefs about
      disease causation, and their use of traditional health care, are explored. The
      significance of the findings for the training of traditional birth attendants and
      for programs of postpartum care is discussed.

PMID- 7785064
TI  - Comparing women's reports with medical diagnoses of reproductive morbidity
      conditions in rural Egypt.
AB  - This article is based on a survey of a random sample of 509 ever-married
      nonpregnant women residing in two villages in the Giza Governorate of Egypt, each
      of whom responded to a questionnaire on symptoms of gynecological conditions and
      then was accompanied to the village health center for a gynecological exam. A
      response rate of 91 percent was achieved. The article focuses on reproductive
      tract infections and genital prolapse, highly prevalent conditions in the
      community. The women's reports of symptoms are compared with the medical
      diagnoses, using indicators of sensitivity, specificity, positive and negative
      predictive values, and percentage of agreement. The findings show that women's
      reports of vaginal discharge agree moderately well with the physicians'
      observations but are not good predictors of the occurrence of reproductive tract
      infections. Women's reports of the symptoms of prolapse do not agree well with
      medical diagnoses of the condition. The findings are analyzed, taking into
      account the social context of the lives of the women surveyed to arrive at
      conclusions as to how to improve ways of learning from women themselves about
      gynecological problems in the community.

PMID- 7785067
TI  - Sterilization regret in the Dominican Republic: looking for quality-of-care
      issues.
AB  - This report approaches the concept of quality of care by looking at the
      covariates of sterilization regret in the Dominican Republic according to the
      results from the 1991 Demographic and Health Survey. The main variables observed
      are the women's satisfaction with sterilization, their decisionmaking process,
      sterilization experience, use of family planning, and socioeconomic
      characteristics. The more detailed measurement and analysis of the outcomes of
      care point to a need for improvement in the public program effort with regard to
      sterilization. Substantial proportions of women were sterilized who were younger
      than 30, who had three or fewer living children, and who had the operation before
      they had used any other method of contraception. Because a greater proportion of
      sterilization regret is observed among these groups, women must be enabled to
      make a free and informed decision about sterilization by means of programs that
      offer a more balanced choice of methods, as well as better counseling, education,
      and access to high-quality services.

PMID- 7785068
TI  - Philippines 1993: results from the National Demographic Survey.

PMID- 7785066
TI  - Maternal mortality estimation: separating pregnancy-related and non-pregnancy
      related risks.
AB  - The increased availability of survey data and improved estimation techniques have
      furthered our understanding of maternal mortality in developing countries. Both
      the indirect and direct sisterhood methods of estimation depend on time-of-death
      information from surveys. This report proposes a method for calculating two
      rates, one during the pregnancy period and one outside of it. Analysis of both
      rates provides more information about mortality associated with pregnancy than do
      methods that only produce one rate. The pregnancy-related mortality rate can be
      estimated by assuming that non-pregnancy-related risks are constant, irrespective
      of whether women are pregnant or not. An estimated 69 percent of deaths in
      Bolivia during pregnancy may be pregnancy related; this result is significantly
      lower than that obtained using the traditional sisterhood method. In certain
      cases, this result may be viewed as a plausible lower bound. A variety of
      estimates should probably be used for policy purposes.

PMID- 7785069
TI  - New bedfellows in the mammalian sex-determination affair.

PMID- 7785070
TI  - Gene therapy by and for muscle cells.

PMID- 7785071
TI  - Is TFIIH an activator of the p53-mediated G1/S checkpoint?

PMID- 7785073
TI  - PCR on the gram-positive organism Frankia without prior DNA extraction.

PMID- 7785072
TI  - Mitochondria contaminate databases.

PMID- 7785074
TI  - Cloning of PCR fragments with a modified M13mp18 T-vector.

PMID- 7785075
TI  - Artefacts in protein-DNA interactions produced by DNA probes isolated using a
      transilluminator.

PMID- 7785076
TI  - Transcriptional regulation during the mammalian cell cycle.
AB  - Progression of the cell cycle in mammalian cells, as in all other organisms, is
      associated with the phase-specific transcription of defined sets of genes. Such
      periodically expressed genes frequently encode proteins that either directly
      control cell-cycle progression or function in metabolic processes linked to the
      cell cycle, such as nucleotide and DNA biosynthesis. Here, I summarize our
      current knowledge and views of the mechanisms governing the coupling of cell
      cycle control mechanisms to transcriptional regulation, with particular emphasis
      on the transcription factor E2F and its connections with cyclin-dependent kinases
      and the retinoblastoma gene family.

PMID- 7785077
TI  - Platyfish and swordtails: a genetic system for the analysis of molecular
      mechanisms in tumor formation.
AB  - Inspired by recent reports, many geneticists would agree that it is worth looking
      into aquaria or even replacing the Drosophila bottles in their laboratories with
      fish tanks. Indeed, encouraging results from large-scale mutagenesis screens in
      zebrafish have promoted this organism to a prominent position in the research of
      vertebrate developmental biology. Some other small aquarium fish species still
      inhabit side streams or backwaters of science, like the zebrafish did before,
      serving smaller communities of researchers as tools in fields such as
      developmental biology and neurobiology. One such type of fish is Xiphophorus,
      which offers a genetic system for the analysis of molecular mechanisms in
      tumorigenesis.

PMID- 7785078
TI  - Chicken genome mapping: a new era in avian genetics.
AB  - More than 460 loci representing either expressed or anonymous sequences have been
      mapped on to the first comprehensive molecular genetic linkage map of the chicken
      genome. Here, we review the current status of poultry genome mapping and discuss
      some of the new opportunities this provides.

PMID- 7785079
TI  - The elusive fertility genes of Drosophila: the ultimate haven for selfish genetic
      elements.
AB  - The Y chromosomes of Drosophila are necessary for male fertility. They carry
      giant genes that have some unconventional properties besides controlling the
      motility of the spermatozoa. Classical genetic and molecular studies suggest that
      evolution has favoured the close association between these genes and repetitive
      DNA sequences with 'selfish' traits.

PMID- 7785080
TI  - [Respiratory activity, ATP content and Rb+ transport in a cell culture after
      freezing-thawing].
AB  - Energy-dependent processes and cation transfer in calf's kidney finite cell
      culture following freezing-thawing have been studied. It has been established
      that cell culture cryopreservation under the optimum conditions results in the
      reduction of breathing activity level, ATP, reduction of 86Pb+ general transfer
      ratio and increase of passive cation permeability of cytoplasmic membrane that
      indicates considerable changes of bioenergetic processes of recryopreserved
      cells. At the same time in the process of restoration of cell culture after it
      has been frozen and following two consecutive passages with application of
      enriched growth media, parameters of studied energy-dependent processes and
      cation membrane transfer system are completely restored.

PMID- 7785081
TI  - [Use of monoclonal antibodies for determining complement-binding activity of
      human immunoglobulins G in health and in chronic lympholeukemia].
AB  - Mouse monoclonal IgG1-antibodies (MA) against melittin were used for the
      investigation of human IgG-C1q binding. The ELISA method, allowing one to
      determine the dissociation constants of IgG-C1q complex, based on the competition
      of two IgG (investigating human IgG and MA, labelled by peroxidase) for C1q
      binding was developed. The method was used to show that IgG in 50% of cases of
      chronic lymphoid leukemia possessed lesser complement-binding activity than
      normal human IgG. This effect can be the result of screening of effector centres
      of immunoglobulins by ligands which appeared in the process of tissue destruction
      under pathology.

PMID- 7785082
TI  - [Peptide hydrolases of marine organisms].
AB  - The survey is devoted to the description of properties of proteolytic enzymes of
      some sea organisms. Structure peculiarities and properties of proteinases of
      trypsin and chymotrypsin type, carboxypeptidases A and B, aminopeptidase and
      leucine aminopeptidase of molluscs, stars, shrimps, fishes and other sea
      organisms have been considered. Data are presented about trypsins typical of the
      sea organisms which are characterized by high content of asparaginic and
      glutaminic acids and small values of activation energy of the reactions which
      they catalyse. Data are discussed concerning stability of enzymes as to heat
      denaturation, effect of the environment with external values of pH. Based on the
      similarity of the substrate specificity of enzymes, their sensitivity to
      inhibitors, it is concluded that the enzymes of the sea organisms and mammals are
      similar.

PMID- 7785083
TI  - [Correction of radiation injuries caused by low-intensity irradiation using
      antioxidants].
AB  - The appearance of active oxygen form beginning and lipid peroxidation's
      activation (side by side with DNA injury) play the leading role in the mechanism
      of radiation injury. It is expedient to use antioxydants as prophylactic and
      early pathogenetic therapy remedies. The paper includes the survey of data from
      literature about usage of different classes of antioxidants (enzymes, vitamins,
      thiols and other) during prolonged low intensive radiation action.

PMID- 7785084
TI  - [Role of S'2-stimulation of serine proteases in regulation of proteolysis].
AB  - Data about ligand specificity and functionality of the nearest surrounding of
      hydrolytic centre of serine proteases are presented. A regulatory role of S'2
      site predetermining highly-specific activation of proenzymes into the enzymes and
      formation of stable enzyme-serine complexes is discussed.

PMID- 7785085
TI  - Protein phosphatases: function and regulation.
AB  - Thousands of proteins are expressed in a typical mammalian cell, of which a third
      are now thought to contain covalently bound phosphate. About 200 protein kinases
      and 100 protein phosphatases have already been identified. Whereas the
      classification, properties and regulation of protein kinases are largely studied,
      the information about the protein phosphatase is far to be completed. Relatively
      better is studied a group of serine/treonine protein phosphatases. It has been
      discovered that besides the control of the key enzymes of metabolic pathways,
      these phosphatases participate in the regulation of gene transcription and cell
      division in eukariots. In addition, the identification of tyrosine protein
      phosphatases points to a novel intracellular signalling pathways, controlling
      cell-cell communication, cell proliferation and signal transduction of receptors
      for peptide hormones and growth factors. The recent progress in these families of
      protein phosphatases is the topic of present review.

PMID- 7785086
TI  - Some evidence in favour of the partnership between rabbit muscle aldolase and
      glyceraldehyde 3-phosphate dehydrogenase in the consecutive reactions.
AB  - An additional indication in favour of interaction between sequential glycolytic
      enzymes is provided by the mutual enhancement of aldolase and glyceraldehyde 3
      phosphate dehydrogenase activities. The efficiency of aldolase as the activator
      is progressively affected by the presence of its substrate, fructose-1,6
      diphosphate, and its structural analogue, hexitol-1,6-diphosphate. Such
      interrelation of two sequential glycolytic enzymes can originate from their
      conformational interadjustment for the subsequent metabolic channeling between
      them.

PMID- 7785087
TI  - [Thermal sensitivity of Na+,K+-ATPase isoenzymes in the brain and kidney].
AB  - Thermal stabilities of Na+, K(+)-ATP-ase preparations with different isozyme
      content from brain and kidneys of different animal species have been compared.
      The greater thermal lability of the alpha(+)-isoform of a catalytic subunit of
      Na+, K(+)-ATP-ase is established. The method of specific thermal inactivation of
      in brain preparations was used in comparative study of ouabain sensitivity of
      Na+, K(+)-ATP-ase isozymes from rat, cow and rabbit. It is concluded that the
      existing structural and functional model of the receptor site of Na+, K(+)-ATP
      ase catalytic subunit is not sufficient for the complete explanation of the
      species heterogeneity of Na+, K(+)-ATP-ase affinity to heart glycosides.

PMID- 7785088
TI  - [Isolation and some properties of protein inhibitor of trypsin from acorns of the
      oak tree].
AB  - Four protein fractions with trypsin-inhibiting activity have been isolated from
      acorns of oak tree (Quercus robur L.) by chromatography on DEAE-cellulose.
      Further their purification on trypsin-agarose column have demonstrated 12 peaks
      of activity. Every fraction corresponded to these peaks, left the column with
      Sephadex G-50 with the same volume of elution that corresponded to molecular
      weight of 16000 +/- 10% dalton. It was concluded that they have the same protein
      inhibitor. All the fractions proved to be steady to high-temperature
      denaturation, 8 M carbamide and 0.1% SDS, but preserved not more than 20% of
      activity under dithiothreitol effect. All they had specificity to trypsin only
      and were significantly less active to chymotrypsin, peptine and pronase.

PMID- 7785089
TI  - [Ca2+ metabolism in the sarcoplasmic reticulum of skeletal muscle after surgical
      denervation].
AB  - The ability of sarcoplasmic reticulum to regulate Ca(2+)-metabolism was studied
      at different terms after surgical denervation. The increase of Ca(2+)-ATP-ase
      activity, intensification of active Ca(2+)-accumulation under insignificant
      change of passive Ca(2+)-outflow from sarcoplasmic reticulum vesicles were
      observed 3-days after denervation. At more remote terms 14 days and 28 days after
      denervation all these parameters decreased except for Km: Ca(2+)-ATP activity and
      active Ca2+ accumulation decreased below normal level.

PMID- 7785090
TI  - [Interaction of anionic complex of palladium (II) with the bilayer lipid
      membrane].
AB  - The interaction of anionic complex of palladium (II) with the bilayer
      phospholipid membrane (BLM) have been studied. It is shown that electric
      conductivity of membrane increases with the rise of concentration of the complex
      compound. The effect of the lipophilicity and polar properties of a cation on the
      transmembrane that carries this complex across BLM have been discussed. The
      mechanism of biological action of the compound under study is supposed.

PMID- 7785091
TI  - [Aggregation of neutrophils and their generation of active forms of oxygen as
      affected by lectins].
AB  - It was shown that neutrophil aggregation is caused by all lectins with different
      specificity for carbohydrates but generation of active oxygen forms is induced
      only by some lectins. Polyspecific lectins-erythroagglutinin and
      phytohemagglutinins have the greatest activity in relation to both processes.

PMID- 7785093
TI  - [Antioxidant system of rat erythrocytes under conditions of prolonged intake of
      honeybee flower pollen load].
AB  - The state of erythrocyte redox system of rats feeding on apis flower pollen load
      during a month was investigated. It was established that the content of
      glutathione, total SH-groups as well as activities of glutathione peroxidase and
      glutathione reductase in these animals in comparison with the control group were
      increased. Simultaneously a decrease of malondialdehyde and dienic conjugates in
      erythrocytes was shown. The activity of catalase and superoxide dismutase were
      increased, but it was not statistically reliable. A conclusion was made that the
      antioxidative system is nonspecifically activated and oxidative processes are
      blocked in erythrocytes of rats fed on apis flower pollen load.

PMID- 7785092
TI  - [Immunomodulatory effect of honeybee flower pollen load].
AB  - Primary and secondary humoral immune response (the level of specific IgM and IgG)
      as well as the intensity of delayed-type hypersensitivity to sheep erythrocytes
      were investigated in rabbits fed with apis flower pollen load for a month. It is
      shown that apis flower pollen load is an immunomodulator. It stimulated humoral
      immune response and changed the reaction of delayed-type hypersensitivity.

PMID- 7785094
TI  - [Electron donor capacity of various amino acids].
AB  - Constants of equilibria of reactions of 13 amino acids with I2 have been
      determined. It is shown that the values of constants are determined by the nature
      of side radicals. The highest values of donor-acceptor characteristics are noted
      in sulphur-containing amino acids, triptophan, low ones--in hydroxy-amino acids.
      It is shown on the example of flavonoid quertzetin that formation of donor
      acceptor bonds is characteristic of aminoacids parallel to the acid-base
      interaction.

PMID- 7785095
TI  - [Treatment of venous thromboses and pulmonary embolisms].

PMID- 7785096
TI  - [Molecular biology and medical bacteriology].

PMID- 7785097
TI  - [Anticoagulant and thrombolytic therapy in deep venous thrombosis and pulmonary
      embolism].
AB  - During the last 10 years anticoagulant (AC) therapy and thrombolytic treatment of
      venous thromboembolism (VT) have been evaluated in randomized studies. Adjusted
      subcutaneous (s.c.) heparin and low molecular weight heparin (LMWH) are found at
      least as effective as intravenous (i.v.) infusion of heparin in deep venous
      thrombosis (DVT) without an increased bleeding risk. In pulmonary embolism (PE)
      randomized trials assessing the efficacy of s.c. heparin and LMWH are missing.
      Oral AC-treatment can be initiated from the first or second day in VT. The
      recommended duration is three months for medical patients, and 4 weeks seem
      appropriate for surgical patients that are completely mobilized and without
      persisting predisposing factors. Long-term efficacy of thrombolytic treatment of
      DVT has only been assessed in small trials showing a trend towards reduced risk
      of developing chronic venous insufficiency. Short-term thrombolytic treatment of
      DVT is evaluated in ongoing trials. In the treatment of PE short-term
      thrombolysis with either t-PA or urokinase is found to be as effective as long
      term thrombolytic treatment with a reduced bleeding risk. Thrombolytic therapy
      rapidly reduces embolic mass and stabilizes haemodynamics, but mortality and long
      term efficacy of thrombolysis and AC-treatment versus AC-treatment alone in PE
      are being assessed in ongoing studies.

PMID- 7785099
TI  - [Long-term prognosis of pulmonary sarcoidosis. 1. Prognostic value of lung
      function and symptoms].
AB  - A follow-up of 254 patients with intrathoracic sarcoidosis has been carried out
      after a median of 27 years from diagnosis. All patients could be traced. No
      excess mortality was found (80 deaths observed versus 66 expected). The causes of
      death were related to sarcoidosis in 41%. X-ray stage was related to survival
      with a significant excess mortality for stage 3. Early clearing of X-ray changes
      gave a favourable vital prognosis. Survival was related to lung function,
      especially forced expiratory volume in 1 second (FEV1) and total lung capacity
      (TLC). All deaths from sarcoidosis were seen among patients with respiratory
      symptoms at presentation. For sarcoidosis & sarcoidosis-related deaths (N = 33),
      presence of one or more of the respiratory symptoms increased the risk
      significantly. For overall mortality respiratory symptoms were also significant
      predictors; this was the case even after adjusting for age, sex, x-ray stage and
      lung function (FEV1 & TLC) at presentation. In conclusion, no excess mortality
      was observed after a median of 27 years follow-up. Lung function, respiratory
      symptoms and to some extent X-ray stage at time of diagnosis influenced long-term
      mortality in patients with intrathoracic sarcoidosis.

PMID- 7785098
TI  - [Laser-assisted balloon angioplasty of occlusions in the femoropopliteal
      segment].
AB  - During 1990 through 1992, 32 patients with arterial occlusive disease of the
      femoropopliteal segment underwent laser-assisted balloon angioplasty at the
      vascular service of Rigshospitalet, Copenhagen. A pulsed ultraviolet excimer
      laser was employed. Initial angiographic and clinical success was achieved in 20
      of 32 femoropopliteal occlusions (63%). Life-table analysis revealed a cumulated
      patency rate of 40%, 33% and 25% after one month, one and three years,
      respectively. There was no correlation between initial success rate and length of
      occlusion, status of run-off, calcification or number of collateral vessels. In
      this series, laser angioplasty carried a high risk of perforation. The initial
      and long-term results were no better than could be expected of percutaneous
      transluminal angioplasty, suggesting that laser-assisted balloon angioplasty has
      no place in the vascular surgical armamentarium.

PMID- 7785100
TI  - [Long-term prognosis of pulmonary sarcoidosis. 2. Cardiac sarcoidosis and other
      extrapulmonary manifestations].
AB  - Frequency and prognostic importance of extrapulmonary manifestations have been
      examined in 254 patients with intrathoracic sarcoidosis. A follow-up was carried
      out after a median of 27 years from diagnosis. All patients could be traced.
      Extrapulmonary manifestations were found in 119 patients (47%), mostly occurring
      within the first years after diagnosis of intrathoracic sarcoidosis; skin
      manifestations were most frequently seen. ECG-abnormalities were found in 35
      patients (14%); in 17 cases in the form of sinus tachycardia. No excess mortality
      was found (80 deaths observed versus 66 expected). The causes of death were
      related to sarcoidosis in 41%. Only tachycardia was associated with an
      unfavourable prognosis and this association vanished after adjusting for
      decreased lung function. None of the other extrapulmonary manifestations were
      associated with an unfavourable vital prognosis. Erythema nodosum was of no
      prognostic significance concerning survival. In conclusion, extrapulmonary
      manifestations are frequent in patients with intrathoracic sarcoidosis but do not
      influence vital prognosis.

PMID- 7785101
TI  - [Respiratory tract infections in general practice--the effect of a medical audit
      project].
AB  - A medical audit of the management of respiratory tract infections was performed
      among 31 general practitioners in Funen county. The first registration of
      prescriptions in 1992 showed that broadspectrum antibiotics were used to a higher
      extent than seemed necessary. An intervention with courses, visits to the
      department of clinical microbiology and distribution of recommendations
      concerning diagnosis and treatment was performed. The intention was to give the
      necessary and only the necessary amount of antibiotics and when an antibiotic was
      indicated to use penicillin as often as possible. A new registration was made one
      year after the first one. The proportion of antibiotic prescriptions was reduced
      from 0.49 to 0.38 and the proportion of prescriptions of broadspectrum
      antibiotics was reduced from 0.21 to 0.12. Detection of group A streptococci in
      tonsillitis was used more frequently in 1993 than in 1992. Medical audit
      performed after this model seems a good instrument for changing prescription
      habits. Medical audit thus seems to be a useful tool in quality improvement in
      general practice.

PMID- 7785103
TI  - [Unexpected cardiac arrest during combined spinal-epidural analgesia].
AB  - A 58-year old man who had combined spinal-epidural anaesthesia for a total knee
      alloplasty suffered a sudden and unexpected cardiac arrest during an otherwise
      uncomplicated anaesthesia. The patient was promptly resuscitated by ephedrine
      i.v. The reason for the cardiac arrest is thought to be relative hypovolaemia.
      The importance of monitoring the patient, giving proper fluid-treatment and early
      use of ephedrine is emphasized.

PMID- 7785102
TI  - [Sick leave in relation to occupational environment and family conditions. An
      analysis of data from a study on health and morbidity performed 86].
AB  - Data previously collected by the Danish Institute of Clinical Epidemiology (DICE)
      in 1986/87 by a structured interview of a sample of the adult Danish population
      was analysed to evaluate sick leave among 1) persons with preschool children, 2)
      persons with either physically demanding work or with exposure to chemicals, and
      3) persons with mentally demanding employment. Average absence from work in the
      year previous to the interview was increased in unmarried women with preschool
      children (9.8 days). Average absence from work increased in a stepwise fashion
      from 4.7 to 18.7 days with increasing physical work loads, and from 5.6 to 10.1
      days with increasing exposure to chemicals. In the group with mentally demanding
      work, the increased was from 6.3 to 20.0 days up to a load level of five. Risk of
      long lasting (above 10 days) sick leave was increased among the 52.9% of persons
      in the study base who either had physically demanding work or who were exposed to
      chemicals, prevalence rate 1.91 (1.56-2.35, 95% CI), as well as among the 20.9%
      of persons in the study base with mentally demanding work, prevalence rate 1.68
      (1.38-2.05, 95% CI). Logistic regression analysis revealed statistically
      significant odds ratios also when age, tobacco smoking, marital status, chronic
      disease and overlap between the risk groups were taken into consideration.

PMID- 7785104
TI  - [Nitrogen oxide inhalation in acute pulmonary failure].
AB  - Two cases of adult respiratory distress syndrome (ARDS) treated successfully with
      nitric oxide (NO) inhalation are described. One patient had severe sepsis and the
      other had trauma induced ARDS. The slow entry criteria for extracorporeal
      membrane oxygenation (ECMO) was fulfilled in both cases. NO inhalation
      substantially improved oxygenation, reduced pulmonary arterial pressure and peak
      inspiratory pressure. Treatment with NO inhalation was without side effects and
      easy to administer through the ventilator. Both patients survived without
      sequelae. We suggest that inhalation with NO should be tried before ECMO
      treatment is considered in severe ARDS.

PMID- 7785105
TI  - [Improved prognosis in breast cancer].

PMID- 7785106
TI  - [The osteoporosis profile].

PMID- 7785107
TI  - [The U-formed connection between alcohol and mortality].

PMID- 7785109
TI  - [Lansoprazole--a new acid pump inhibitor].

PMID- 7785108
TI  - [Blood alcohol and (air)traffic].

PMID- 7785110
TI  - [The late results of the surgical treatment of vesicorenal reflux in children].
AB  - 1-27-year follow-up results are available for 455 patients who at the age of 3
      months-14 years were operated on vesicoureteral segments with reflux of the II,
      III and IV degree. Overall 648 interventions were made, of them 78 according to
      Gregoir-Lich (54 patients). Good results were obtained in 91.02% of cases (reflux
      degree II and III). Resection of distal ureter with its implantation into the
      bladder by Politano-Leadbetter technique was performed in 401 patients on 570
      vesicoureteral segments. In reflux degree II and III good outcomes were reached
      in 97.37%, degree IV in 90.80% of the cases. Histological findings on the
      resected ureters showed that pathogenetically the reflux was initiated by
      structural changes in distal ureteral wall which occurred as a congenital or
      acquired condition. The removal of the destroyed segment contributed to advanced
      treatment effects. The reflux elimination favoured renal growth and clinical
      improvement of pyelonephritis. X-ray images of 150 kidneys (95 patients) 10-26
      years after the reflux discontinuation reflected a 1.5-5-fold increase in the
      kidney size. Before stabilization parenchymal sclerosis developed the following 1
      2 to 10-15 years.

PMID- 7785111
TI  - [The treatment of neurogenic hyperreflexic bladder dysfunctions in girls with low
      intensity laser radiation].
AB  - 120 girls were investigated for the efficacy of three methods of treatment:
      conventional, infrared laser radiation on the projection of the bladder plus He
      Ne laser radiation on biologically active points (BAP), red He-Ne laser BAP
      radiation. All the patients suffered from neurogenic hyperreflexic dysfunctions
      of the bladder, 99.8% had the diagnosis of vegetovascular dystonia, 94.9% had
      sympathetic-tonic or mixed patterns. The combined laser exposure brought about
      the greatest response rate-90.0%.

PMID- 7785113
TI  - [The concept of the development of a Russian urology].

PMID- 7785112
TI  - [Valves of the posterior urethra in children].
AB  - The paper reports the analysis of 62 cases of posterior urethra valves treated
      from 1988 to 1993 in the Central Children's Hospital of Russia. The patients' age
      ranged from 6 months to 14 years. The patients were examined with the use of
      urethroscopy, urethrography and urodynamic tests providing accurate differential
      diagnosis of the urethral valves and other infravesical obstructions.
      Transurethral electroresection of the valvular cusps proved most effective
      treatment. There exists high probability of self cure of upper urinary tract
      complications after the transurethral resection (65%). The expectant policy
      should be followed in relation to vesicoureteral reflux and megaureter (3-6 and 6
      12 months, respectively). The exceptions comprise the cases of the above reflux
      with marked lateralization, ectopy and exposure of ureteral ostia which are more
      effectively managed by simultaneous valvular transurethral resection and
      endoscopic submucous injections of teflon paste underneath ureteral ostia. The
      study of the prevalence of chronic renal failure suggested a conclusion on its
      equal occurrence in different age groups.

PMID- 7785114
TI  - [Lipid peroxidation in patients with nephrolithiasis and chronic pyelonephritis
      in the remission stage].
AB  - Lipid peroxidation (LPO) was evaluated in 31 patients with nephrolithiasis and
      chronic pyelonephritis in remission. Chronic inflammation of renal parenchyma is
      shown to be associated with LPO activation. Urine diene conjugates excretion,
      plasma and red cell membrane malonic dialdehyde concentrations increase. LPO
      activation may contribute to maintenance of chronic renal inflammation in
      nephrolithiasis.

PMID- 7785115
TI  - [Xanthogranulomatous pyelonephritis].
AB  - Based on the evidence obtained on 28 cases of xanthogranulomatous pyelonephritis
      (XP), the authors suggest to distinguish two XP clinical forms: obstructive and
      nonobstructive. The former may occur in noticeable destruction of renal tissue
      and urine retention secondary, most frequently, to long-standing nephrolithiasis.
      The latter simulates by symptoms and examination results renal carcinoma. In
      suspicion of nonobstructive XP, the surgeon should consider fast-made
      intraoperative biopsy to decide on feasibility of sparing intervention.

PMID- 7785116
TI  - [Varicocele in children and adolescents and infertility].
AB  - 28 adolescents aged 16-18 were examined 2-4 years after correction of varicocele.
      Some ejaculate characteristics were found subnormal as well as the function of
      the prostate gland as indicated by reduced concentrations of citric acid and zinc
      ions. To make definite conclusions on possible effect of varicocele in
      adolescents on their future fertility further studies are necessary.

PMID- 7785119
TI  - [Clinical and diagnostic problems in angiomyolipoma of the kidney].
AB  - 29 cases of angiomyolipoma (AML) reported in the paper illustrate clinical
      pictures and difficulties in this disease diagnosis. It is shown that when AML
      overgrows 5 cm in size it often provokes pain (13 cases), which ranks the first
      among AML symptoms. Ultrasonic differential diagnosis is not easy in large
      bleeding AML, in extrarenal AML location, whereas well and poorly vascularized
      tumors, the absence in them of clear-cut spiral arteries or aneurysm-like
      cavities cause much trouble for AML angiographic diagnosis. For the above causes
      computed tomography is also likely to provide misdiagnosis. A comprehensive
      approach to AML preoperative diagnosis brings about satisfactory results in 80%
      of the cases.

PMID- 7785118
TI  - [Arterial factors in the mechanism of penile erection].
AB  - Hemodynamic study of the penis in diagnosis of erectile impotence is thought
      essential because many investigators have obtained evidence for involvement of
      vascular affections in the mechanisms of somatogenic erectile disturbances in 70
      80% of the cases. The authors have assessed arterial and venous phases of penile
      hemodynamics in healthy males at rest and erection (28 subjects aged 24-56) and
      in 37 patients with functional sex disturbances aged 21-43. It was found that
      erection is maintained not only in participation of deep penile arteries, but
      also dorsal ones. This is also confirmed by synchronous changes in a.a. dorsalis
      et profunda penis circulation in response to sexual stimulation. However, more
      expanded network of arteriovenous anastomoses in the system of dorsal arteries
      makes hemodynamic changes in the course of erection less pronounced than in deep
      penile arteries. No hemodynamic alterations in the system of common iliac
      arteries during erection confirmed autonomic pattern of the processes running in
      penile vascular system.

PMID- 7785120
TI  - [The effect of a Rhodiola rosea extract on the incidence of recurrences of a
      superficial bladder cancer (experimental clinical research)].
AB  - Oral administration of Rhodiola rosea extract to a small group of patents (n =
      12) with superficial bladder carcinoma (T1G1-2) improved the characteristics of
      the urothelial tissue integration, parameters of leukocyte integrins and T-cell
      immunity. The average frequency of relapses for these patients has been found to
      fall twice, though statistical differences were not significant.

PMID- 7785117
TI  - [Azoospermia in patients with kidney diseases taking immunosuppressants long
      term].
AB  - Ten sterile males of reproductive age previously treated with immunodepressants
      were examined andrologically. Azoospermia in them was treated with zinc sulfate
      (30-90 mg/day, 2-12 months), which was replaced by clomifen citrate in 6 of them
      (100 mg/day, 2-6.6 months). The response was recorded only in one male: zinc
      sulfate administration induced subnormal spermatogenesis improved by clomifen
      citrate as a result of which the patient became a father. In the rest cases
      azoospermia did not improve. Testicular biopsy performed in 3 patients detected
      the absence of cells of spermatogenic epithelium (del Castillo syndrome). The
      absence of response to stimulating therapy may indicate bad prognosis in
      azoospermia patients with renal diseases treated with immunodepressants.

PMID- 7785122
TI  - [The possibilities for arresting the progression of diffuse nephropathies].

PMID- 7785121
TI  - [Rupture of the corpora cavernosa (clinical observations)].
AB  - The authors performed emergency operation for rupture of the cavernous bodies in
      2 patients whose urethra remained intact. The defect of the bodies and tunica
      albuginea was repaired by placing interrupted catgut sutures. Postoperative
      policy included antiinflammatory and resolving modalities. 10-year follow-up
      results were satisfactory. Complications did not occur. The patients retained sex
      function.

PMID- 7785123
TI  - [Computed renal angiography in the diagnosis of congenital hydronephrosis in
      children].

PMID- 7785125
TI  - Ultrasonic B-mode image enhancement based on level-dependent spread functions.
AB  - The concept of level-dependent spatial summation is applied to the 2-dimensional
      amplitude distribution comprising an ultrasonic brightness image. The
      distribution is convolved with a level-dependent kernel. The size (i.e., extent)
      of the kernel is inversely proportional to the local signal level. The result is
      a 2-dimensional distribution of Mach bands, accentuating edges and providing
      useful information for the reduction of speckle. In addition, a small but
      powerful extension of the processing scheme is presented that supports global
      edge enhancement and contrast enhancement. The level of improvement has been
      quantified in terms of an increase in the lesion signal-to-noise ratio on the
      order of 60 percent. Only two system-dependent parameters have to be supplied for
      adjustment. The algorithm is rather insensitive to the exact choice of the
      parameters, making it quite robust. Since only a limited number of simple
      operations is required for the processing of a frame, the algorithm is expected
      to be suitable for real time application.

PMID- 7785124
TI  - [The central hemodynamics and hormonal status before, during and after urologic
      operations in children].
AB  - Urological operations in children are made as a rule to correct congenital
      malformations. The prevention of operative injury to the child' body is secured
      only in conditions of adequate anesthesiological defense. This is possible only
      in availability of rapid information on cardiovascular, oxygen metabolic and
      hormonal statuses. Central hemodynamics, oxygen metabolism and hormonal findings
      have been summarized for 89 children. The above parameters were measured before
      and during plastic reconstruction of the upper urinary tract. Initially
      hyperkinetic hemodynamics because of inadequate premedication to control
      psychoemotional lability, changed for stable and hypokinetic circulation to the
      end of the operative intervention as a result of neuroleptanalgesia. Eukinetic
      trends were induced by balanced promedol analgesia throughout the operation.
      Concentrations of hydrocortisone, aldosterone and STH were on the increase, while
      T3 and T4 levels lowered. Hyperkinetic and eukinetic hemodynamics were observed
      postoperatively after neuroleptanalgesia and balanced promedol-including
      analgesia, respectively.

PMID- 7785126
TI  - An efficient real time focusing delay calculation in ultrasonic imaging systems.
AB  - An efficient real time focusing delay calculation algorithm is proposed for
      variable sampling clock generation (SCG) with high accuracy needed in digital
      focusing in ultrasonic imaging systems. The proposed algorithm is an extension of
      the midpoint drawing algorithm that is well known in the computer graphics area.
      It can be implemented with simple hardware amenable to VLSI realization, without
      using a large amount of look-up memory to store the sampling clock information
      otherwise required.

PMID- 7785127
TI  - Postprocessing of velocity distributions in real-time ultrasonic color velocity
      imaging.
AB  - A robust processing scheme is proposed that improves the presentation of 2
      dimensional velocity distributions in real-time ultrasonic color velocity images.
      Essentially, the algorithm is a modification of a first order recursive filter,
      processing each velocity signal in the spatial distribution separately from the
      others. It restores the sudden holes and notches in the velocity profiles that
      occur whenever the observed blood velocity is incidentally close to zero. At the
      same time, unlike conventional persistence filters, it does not influence any of
      the true velocity information that is measured. The result is a consistent
      sequence of color velocity images with smooth transitions between the borders of
      the consecutive velocity profiles and with an improved definition of the regions
      containing blood.

PMID- 7785128
TI  - Ultrasound echo envelope analysis using a homodyned K distribution signal model.
AB  - The statistics of ultrasound echo envelope signals can be used to characterize
      scattering media. The Rayleigh distribution and its generalized forms, the K and
      Rice distributions, have been previously used to model the echo signal. A more
      generalized statistical model, the homodyned K distribution, combines the K and
      Rice distribution features to better account for the statistics of the echo
      signal. We show that this model can give two parameters that are useful for media
      characterization: k, the ratio of coherent to diffuse signals, and, beta, which
      characterizes the clustering of scatters in the medium.

PMID- 7785130
TI  - [Immune response to Epstein-Barr virus in patients with otorhinolaryngologic
      neoplasms of various morphology and invasiveness].
AB  - Both nasopharyngeal and tumors and epithelial cancer of topographically different
      sites of the mouth, laryngopharynx are shown to be associated in many cases with
      high immunity to virus Epstein-Barr (VEB) antigens. VEB-associated antibody
      quantitation in patients with laryngeal, laryngopharyngeal, oral and lingual
      cancer revealed that the malignant process dissemination and the tumor
      differentiation are related to immune response to VEB antigens: the more advanced
      is cancer and the poorer is its differentiation, the more pronounced is the
      immune response.

PMID- 7785129
TI  - [Clinical and morphological characteristics of verrucous carcinoma].
AB  - Verrucose carcinoma is well differentiated squamous carcinoma characterized by
      exophitic growth, slow surface spread, marked lymphoplasmocytic infiltration and
      fibrosis of submucosal lining. Verrucose carcinoma runs relatively benign course,
      is effectively treated surgically, is prognostically favourable. There are cases
      free of both metastases and recurrences for postdiagnosis 15 years.

PMID- 7785131
TI  - [Prognostic significance of tumor necrosis in cancer of laryngeal vestibule].
AB  - The degree of tumor necrosis in 245 patients with squamous cancer of the larynx
      were graded as: pronounced necrosis (group I), moderate necrosis (group II),
      insignificant necrosis (group III), absence of necrosis (group IV). Regional
      metastases were identified in 39%, 32%, 28.5%, 18.5% of the patients from groups
      I, II, III and IV, respectively. Five-year survival was, respectively, 53, 70, 14
      and 78%. Tumor necrosis severity seems to be more prognostically significant than
      differentiation of squamous carcinoma.

PMID- 7785132
TI  - [Repeated adenoidectomy and prevention of the recurrence of adenoid hypertrophy].
AB  - Basing on comprehensive clinical experience and the analysis of long- and short
      term results of adenotomy, the author evaluates the effectiveness of this
      procedure, the causes of residual nasal respiration problems. The main reason of
      postoperative incomplete restoration of nasal respiration is suggested to be
      nonradical removal of the adenoid tissue which may result from specific features
      of the adenoids size, location, anatomical structure of the nasopharynx, the
      surgeon's equipment and experience, etc. The author thinks postadenotomy nasal
      problems should be managed with repeat operation which is recommended in the
      literature and has been practiced by the author for 30 years with the overall
      efficacy of 90%. Clinical symptoms, indications to repeat surgery are provided.
      Repeat adenotomy in a few days after the initial operation permits the author to
      reduce the percent of the vegetations recurrences in many patients.

PMID- 7785133
TI  - [Clinical and biochemical aspects in the treatment of acute maxillary sinusitis
      with antioxidants].
AB  - A trial has been made of traditional versus antioxidant treatment of acute
      maxillary sinusitides. The patients were injected a mixture consisting of 4 ml
      emulsion of 10% dibunol liniment and 2 ml of 5% ascorbic acid made by dilution of
      10 g dibunol in 30 ml sterile 0.5% novocaine solution. The mixture was introduced
      into the sinuses 2 times a day, in one of the study groups it was combined with
      500,000 U of ampicillin in cases of purulent sinusitis. In catarrhal form the
      mixture was injected once a day without the antibiotic. Control groups received 4
      ml dioxidine in a single dose after the sinus lavage in catarrhal sinusitis and
      500,000 U ampicillin plus hydrocortisone emulsion (1 ml in 4 ml solution) 2 times
      a day in case of purulent sinusitis. All the patients received aevit (one capsule
      daily). The mean number of manipulations for the study groups were 4.4 +/- 0.4 in
      catarrhal sinuses and 6.3 +/- 0.5 in purulent sinusitis; in control groups,
      respectively, 5.9 +/- 0.5 and 10.7 +/- 0.7. Mean duration of treatment reached
      5.3 +/- 0.4, 6.2 +/- 0.3 and 7.1 +/- 0.1 in the study groups and 8.5 +/- 0.2,
      10.2 +/- 0.4 days in the control groups. Positive response to the treatment with
      antioxidants was confirmed by positive changes in blood levels of LPO products,
      activity of lysosomal hydrolases and antioxidant defense enzymes. The results
      obtained justify the inclusion of antioxidants in the schemes of acute sinusitis
      treatment.

PMID- 7785134
TI  - [Peripheral nervous system in children with chronic inflammatory
      otorhinolaryngologic diseases].
AB  - A comparative evaluation of central and vegetative nervous as well as
      cardiovascular systems in 20 normal children and 45 patients with ENT problems
      found out vegetative lability in 8 children. Three of them were from the control
      healthy group, 4 had tonsillitis, 1 purulent sinusitis. These children were
      referred to the vegetative dystonia risk group. In 28 patients (9.3 and 16 cases
      of purulent-polypous, purulent and decompensated tonsillitis, respectively)
      parasympathicotonic and sympathicotonic shifts revealed in the baseline
      vegetative tone and vegetative reactivity require adequate therapeutic
      correction.

PMID- 7785135
TI  - [Complications of ENT diseases as a criterion in the evaluation of physician's
      competency].

PMID- 7785136
TI  - [Computed tomography in the diagnosis of postoperative changes of paranasal
      sinuses].
AB  - Basing on the evidence obtained at examinations of 37 patients within 15-year
      follow-up after surgery on the maxillary and ethmoidal sinuses, the authors
      analyse potentialities and techniques of computed tomography in diagnosis of the
      developments in operated on paranasal sinuses. CT demonstrated advantages in
      examination of paranasal sinus walls and soft tissue alterations in them.

PMID- 7785137
TI  - [The syndrome of sphenopalatine ganglion].
AB  - The author considers a rare disease of the sphenopalatine ganglion known in the
      literature as Sluder's syndrome. In view of the ganglion anatomical structure and
      connections with afferent and vegetative formations of the face and skull,
      clinical presentation of the syndrome various greatly. The author analyses the
      causes of the disease, its differential diagnosis, methods of treatment, gives a
      case report of a male patient who has been followed up for 26 years to illustrate
      the complicacy of Sluder's syndrome diagnosis.

PMID- 7785138
TI  - [An unusual foreign body in the larynx].

PMID- 7785139
TI  - [Injury of internal carotid artery and internal jugular vein during emergency
      laryngotomy in an infant].

PMID- 7785140
TI  - [Chronic asymptomatic foreign body in the frontal sinus].

PMID- 7785141
TI  - [Chronic suppurative polypous sinusitis complicated with rhinogenous basal
      meningoencephalitis with impairement of the V,VI,VII,VIII,X,XI cranial nerves].

PMID- 7785142
TI  - [Metastasis of kidney cancer into the maxillary sinus].

PMID- 7785144
TI  - [Diagnostic significance of eye movements in otoneurology].

PMID- 7785143
TI  - [A case of chronic foreign body in the nasal cavity].

PMID- 7785145
TI  - [Statistics and prehospital diagnosis of malignant neoplasms of upper respiratory
      tract in Russia].
AB  - In 1990 in Russia there were 12,264 newly diagnosed cases of upper respiratory
      tract cancer and 7562 relevant lethal cases. The authors provide data on such
      cancer incidence rate by site, groups of population, sex, age, type of tumor.
      Standardized incidence and mortality rates for various regions of Russia are
      indicative of the trend to the rates increase and relevant economic losses. The
      emphasis is on late diagnosis of ENT cancer, as 70-85% of the patients start
      anticancer treatment in advanced stages of the disease. This shows unsatisfactory
      situation in prehospital diagnosis of such tumors, numerous cases of
      misdiagnosis. The authors express their concern about poor oncological
      qualification of the practicing ENT specialists and urge improvements in current
      system of otorhinolaryngological training, performance of updated prophylactic
      and diagnostic measures.

PMID- 7785146
TI  - [Methods in the control of educational level in ENT students].

PMID- 7785147
TI  - [Effect of cryotherapy and laser destruction on experimental model of human
      vascular tumor].
AB  - Macro- and microscopical changes in the biological model of hemangioma, hen's
      comb, were assessed to compare the effectiveness of cryotherapy, CO2-, YAG-Nd-
      and copper vapour (in the green part of the spectrum) laser radiation. The best
      results were obtained upon exposure to laser on copper vapour and SO2-laser of
      minor capacity.

PMID- 7785148
TI  - [Rhinologic and otoneurologic tests in the diagnosis of nasal liquorrhea and
      their significance in the choice of surgical treatment].
AB  - Liquorrhea nasalis (LN) is considered by ENT specialists as vasomotor--allergic
      rhinitis. It is divided into craniosinusonasal and cranionasal. The latter form
      is more dangerous as to intracranial complications. Otorhinolaryngological and
      otoneurological examinations of LN patients are essential in the disease
      diagnosis, evaluation of surgical results (by nasal endoscopy), detection of
      intranasal medullary hernia, liquor cysts and tumors as well as residual
      otoneurological symptoms consequent to meningitis, brain trauma, etc. In choice
      of surgical treatment the attention of the physician should be directed to
      concomitant intranasal hernias and liquor cysts, tumors, purulent sinusitis. Out
      of 70 LN cases residual symptoms of olfactory disorders were recorded in 35%,
      neurosensory hypoacusis in 30% of the cases. The best position of the patient and
      relevant facilities for identification of even minimal LN are described.

PMID- 7785149
TI  - [Use of sinus catheter "Iamik" in children].
AB  - Sinus catheters were inserted in 44 children (mean age 8.5 years) suffering from
      acute and chronic purulent polysinusitis. In 33 outpatients sinus catheterization
      was combined with nasal irrigation providing a persistent therapeutic effect on
      the inflammation focus. In view of good treatment results both methods are
      offered for inpatient and outpatient pediatric practice of treating sinusitis.

PMID- 7785151
TI  - [Time factors in the acoustic reflex of intra-aural muscles and brain stem
      acoustic evoked potentials in workers with occupational hearing loss and normal
      and delayed speech discrimination].
AB  - Time characteristics of brain stem acoustic evoked potentials and acoustic reflex
      of the intra-aural muscles were measured in workers with occupational hypoacusis
      having normal and delayed capacity for speech discrimination. The findings
      provided evidence for inhibition of speech information analysis at the level of
      the brain stem and dissociation of interaction between the brain stem nuclei.

PMID- 7785152
TI  - [Post-traumatic rehabilitative treatment of hollow neck organs].
AB  - The attention of the reader is focused on the errors and shortcomings in
      rendering urgent emergency care for patients who underwent traumas of the neck
      hollow organs. The 30-year experience with 1000 patients managed by the authors
      convinced him of the necessity to consider more carefully the medical history of
      the patient, to use more frequently Killian's and Brunings's examinations,
      microlaryngoscopy, fibroendoscopy, x-rays. Restorative treatment becomes more
      effective under ultrasound and laser separation of the tissues, laryngochioido
      plexy, tracheopexy with establishment of the laryngeal patency and that of
      trachea. The technique is proposed for broadening the lumen of the cervical
      trachea in cicatricial stenosis and in going-on scarring in the thoracic trachea.
      The progress in the surgery of the neck hollow organs depends on adequate
      facilities and treatment policy.

PMID- 7785150
TI  - [Thromboelastography of blood coagulation in patients with complicated nasal
      furunculosis].
AB  - The study of blood coagulation in 50 patients with complicated nasal furuncle
      using thromboelastogram indicated that such patients have hypercoagulation
      correctable by intravascular laser radiation. Thromboelastography proved a
      reliable objective technique in evaluation of blood coagulation this promoting a
      valid choice of therapeutic policy in complicated nasal furunculi.

PMID- 7785153
TI  - [Diagnosis of pharyngeal and laryngeal diphtheria in adults].
AB  - 142 adults with pharyngeal and laryngeal diphtheria were registered in
      Yekaterinburg in 1993. Of them, 136 patients recovered and 6 died. The analysis
      of the clinical features and diagnostic errors showed that subjects with chronic
      visceral diseases and alcoholics are more likely to have poor prognosis of
      diphtheria. Diphtheria manifested primarily with edema followed by infiltration
      of the mucosa, with appearance of thin transparent furs, tenderness of cervical
      regional lymph nodes. The typical greyish-brown thick and firm false membranes
      occurred only in the late stage of the disease. The features of the diphtheric
      croup in the adults complicated the diagnosis. These were, unlike croup in
      children, the vagueness of the stages of this syndrome, rapid involvement of the
      trachea and bronchi, mixed type of dispnea and delirious state in alcoholics. It
      is necessary to set up the duty of ENT specialists in the diagnostic departments
      of the infectious hospitals for repeated endoscopic and bacteriologic
      examinations of the diphtheria suspects.

PMID- 7785154
TI  - [Allergy and acute stenosing laryngotracheitis in children].
AB  - An allergological examination of 144 patients suffering from acute stenosing
      laryngotracheitis revealed food, drug, bacterial allergy of exudative diathesis
      in 62.5% of the cases. Allergic children had laryngostenosis of degree II and
      more advanced two times more frequently, whereas recurrences (12 cases) occurred
      primarily in children in premorbid condition. Allergy of shown to contribute to
      the onset of acute stenosing laryndotracheitis as allergic subjects are more
      susceptible to respiratory bacterial and viral infection. Local factors are
      mostly responsible for this. The author offers recommendations on more advanced
      treatment of acute stenosing laryngotracheitis with consideration of allergic
      aspects.

PMID- 7785155
TI  - [Occupational diseases of upper respiratory tract caused by ecologic factors].
AB  - The author considers evidence for a close relationships between industrial zone
      pollution with irritants, allergens and diseases of the upper respiratory tracts.
      The investigators emphasize that 80% of the subjects exposed to the above
      pollution at their jobs develop chronic dystrophy and allergy affecting nose,
      pharynx and larynx.

PMID- 7785157
TI  - [Use of collagen in otorhinolaryngology].

PMID- 7785156
TI  - [Critical and emergency medical care in ammonia intoxication of upper respiratory
      tract].
AB  - 37 subjects were admitted to hospital after the accident which caused their
      exposure to liquid ammonia which produced respiratory lesions in 29 of them. The
      severity of the respiratory damage depended on oxygen insufficiency (stenosing
      laryngeal or tracheal bronchitis, pneumonia) and intoxication. Multimodality
      treatment resulted in cure of 24 patients, 3 patients improved, 2 patients died.
      The authors think it proper to place such victims into general hospitals where
      multiprofile care can be rendered including that of ENT specialist whose care
      proved necessary for the majority of the above patients. Subjects exposed to
      ammonia can be transported to distant hospitals as the symptoms worsen gradually.

PMID- 7785159
TI  - [Chronic sinusitis complicated with multiple brain abscesses].

PMID- 7785158
TI  - [Physical therapy of otorhinolaryngologic inflammatory diseases].
AB  - The paper reviews clinical, morphological, immunological and biochemical effects
      on acute and chronic inflammation in the upper airways and the ear produced by
      the exposure to cryoeffects, He-Ne or infrared laser radiation, ultraviolet blood
      radiation. The original advanced procedures developed by the author seem superior
      to conventional approaches to diagnosis and treatment of ENT inflammation.

PMID- 7785160
TI  - [A rare case of malignant trichoepithelioma of the external acoustic meatus].

PMID- 7785161
TI  - [Development of scientific research of professor Undrits V.F., member of Academy
      of Medical Sciences of USSR, in the works of Leningrad Scientific Research
      Institute on ear, larynx, nose and speech diseases].

PMID- 7785162
TI  - [Intravascular laser irradiation of the blood in the treatment of suppurative
      septic complications in otorhinolaryngology].
AB  - The paper reviews the results of intravascular laser radiation (ILR) for
      pyoseptic complications in 8 patients with otogenic and 2 patients with
      rhinogenic meningitis, 1 patient with cavernous sinus thrombosis and 5 patients
      with Dupuytren's phlegmon. The adjuvant to conventional treatment use of ILR
      activates immune system, improves rheological blood characteristics, enhances
      tissue regeneration.

PMID- 7785163
TI  - Clinicopathologic evaluation of the liver.
AB  - Clinicopathologic data are important tools in the evaluation of a patient with
      liver dysfunction. It is imperative, however, that the data not be looked at with
      a dogmatic approach. Many of the laboratory tests are sensitive indicators of
      hepatic dysfunction; however, they seldom, if ever, indicate a specific cause of
      hepatic dysfunction. History, physical, radiographic, and ultrasonographic
      examination findings, and laboratory data must be used together to fully evaluate
      a patient with biochemical abnormalities related to hepatic function. The
      prevalence of secondary hepatic disease and the difficulty of differentiating it
      from primary hepatic disease based on laboratory data must always be kept in
      mind.

PMID- 7785164
TI  - Hepatic aspiration and biopsy techniques.
AB  - Hepatic biopsy can be a key part of the diagnostic plan in dogs or cats with
      liver disease. There are a wide variety of techniques for the clinician to choose
      from based on the patient's condition, liver size, equipment available,
      experience of the operator, and financial considerations. Although major
      complications are rare, the clinician should not attempt a biopsy procedure
      without being prepared to diagnose and treat complications appropriately if they
      occur. Many techniques for hepatic biopsy are easy to learn and to perform and
      should be a part of small animal practice at every level.

PMID- 7785165
TI  - Interpretation of liver biopsies.
AB  - Liver biopsies help define the disease process and can assist the clinician in
      forming a prognosis. The small size of liver biopsy specimens and limited
      responses of the liver to a wide spectrum of injuries often do not allow for a
      specific etiologic diagnosis. Determination of the distribution and morphology of
      the lesion often provides useful diagnostic and prognostic information. Maximum
      value can be attained from liver biopsies when the histologic findings are
      correlated with the results of other diagnostic tests and there is good
      communication between the clinician and pathologist.

PMID- 7785166
TI  - Hepatic imaging with radiology and ultrasound.
AB  - Radiographically, the diseased liver may change in size, shape, position, or
      opacity. Contrast studies such as peritoneography, cholecystography, portography,
      and arteriography may be performed to increase the specificity of the
      radiographic diagnosis. Ultrasound can be used to detect the changes in liver
      echogenicity associated with disease, identify focal verses diffuse disease
      processes, detect vascular and biliary abnormalities noninvasively, and direct
      needle aspirates and biopsies for culture, cytology, and histopathology.

PMID- 7785167
TI  - Hepatic encephalopathy: clinical signs, pathogenesis, and treatment.
AB  - Hepatic encephalopathy is a metabolic encephalopathy that is completely
      reversible if treated early and appropriately. It is seen most commonly in dogs
      and cats with portosystemic portal hypertension. Antibiotics, lactulose, and
      dietary manipulation should be initiated as soon as hepatic encephalopathy is
      suspected. The prognosis of hepatic encephalopathy is complex and is not
      completely understood.

PMID- 7785168
TI  - Feline idiopathic hepatic lipidosis.
AB  - Feline IHL is a severe hepatopathy that can be treated by aggressive nutritional
      support. Until the underlying mechanisms of protein and lipid metabolism are
      understood in both healthy and ill cats, dietary therapy remains supportive. It
      is likely that the pathogenesis of IHL in cats is multifactorial, involving both
      increased fatty acid mobilization to the liver and a defect in oxidation of fatty
      acids or removal of VLDL. It is also possible that individual variation may play
      a role in the development of this disease in cats undergoing starvation.
      Continued studies will focus on the unique pathways of hepatic metabolism in the
      cat, and how these pathways are altered, leading to hepatic lipid accumulation
      and clinical disease. Hopefully, these studies can be applied to the prevention
      or treatment of IHL in cats.

PMID- 7785169
TI  - Feline cholangiohepatitis complex.
AB  - Feline cholangiohepatitis complex causes a diffuse intrahepatic cholestasis of
      unknown etiology. Recognized histologic forms include acute suppurative
      cholangitis/cholangiohepatitis, long-term nonsuppurative
      cholangitis/cholangiohepatitis, and biliary cirrhosis. Treatment of
      cholangiohepatitis complex varies based on histologic type. Thus a liver biopsy
      is necessary for definitive diagnosis and treatment. Because cholangiohepatitis
      complex causes diffuse hepatic change, percutaneous needle biopsies are often
      sufficient for obtaining a diagnosis. Antibiotics are used to treat all forms of
      feline cholangiohepatitis complex, but steroids may be of equal or greater
      importance for use in the treatment of long-term nonsuppurative
      cholangiohepatitis. Prognosis is guarded for cats with any form of
      cholangiohepatitis complex due to the variable response to treatment seen in many
      cats. Spontaneous remission occasionally occurs.

PMID- 7785170
TI  - Chronic hepatitis in dogs.
AB  - Chronic hepatitis in dogs is not one disease but a diverse group of diseases,
      resulting in a common clinical and clinical pathologic picture. Viruses,
      leptospires, other infectious agents, drugs, hereditary factors, and autoimmunity
      have all been associated with hepatic disease leading to chronic hepatitis in
      dogs. In most cases of canine hepatitis, the etiology is unknown. Biopsy and
      histopathology are needed to establish a diagnosis, possible etiology, and
      prognosis. Treatment is mostly supportive. In some cases of chronic active
      hepatitis, corticosteroid therapy is appropriate. Sequential liver biopsies are
      the best way to monitor progress.

PMID- 7785171
TI  - Copper-associated hepatopathies in dogs.
AB  - Copper-associated hepatotoxicity in certain breeds has been identified for almost
      20 years, and the list of affected breeds is growing. The importance for copper
      analysis of liver specimens is emphasized by the realization that copper
      accumulation occurs in many hepatic disease states, and it may become pathologic.
      Many treatment possibilities exist. It is important that therapy be tailored to
      the needs of the animal and the severity of accumulation. To determine efficacy
      of treatment and when an endpoint has been reached, follow-up liver biopsies are
      essential.

PMID- 7785172
TI  - Hepatic neoplasia in the dog and cat.
AB  - The histopathologic types of liver tumors in dogs and cats are reviewed with
      particular emphasis on the presenting signs and distribution within the liver.
      Ultrasonographic findings are discussed, as well as laboratory abnormalities.
      Finally, treatment options, prognoses, and survival times are presented,
      including chemotherapy protocols.

PMID- 7785173
TI  - The diagnosis and management of acute liver failure in dogs and cats.
AB  - Management of the small animal patient with a presumptive diagnosis of acute
      liver failure should aim to provide high quality supportive care aimed at the
      functional derangements that occur. A definitive histopathologic diagnosis should
      be pursued to allow evaluation of the reversibility of the underlying condition.
      With the current advances in veterinary critical care, improved medical and
      technical management should reduce both morbidity and mortality in the patient
      with potentially reversible liver failure.

PMID- 7785174
TI  - Management of portal hypertension and its consequences.
AB  - Increased pressure in the protal venous system results from impedance to blood
      flow at any point along it's course from the splanchnic circulation through the
      liver to the right heart. Typical manifestations of sustained increases in portal
      venous pressure commonly may include accumulation of abdominal fluid and
      development of acquired portosystemic shunts. Pathophysiology of altered portal
      vascular dynamics, diagnostic approach for animals suspected of having an intra
      abdominal source of portal hypertension and treatment options are discussed.

PMID- 7785175
TI  - Nutritional management of liver disease.
AB  - The provision of adequate nutrition to the patient with liver disease is a
      challenge. The practitioner must avoid overwhelming the remaining metabolic
      capabilities of the damaged organ. The ability of the liver to regenerate and the
      patient to recover depends on the availability of sufficient nutrients. There is
      no default diet for the patient with liver disease. Each patient must be
      evaluated individually, with consideration given to the type and origin of the
      liver disease, the current extent of hepatic dysfunction, and the patient's
      previous dietary history. Efforts should be directed at the provision of an
      energy intake adequate to maintain body weight and a protein intake as close to
      normal as can be tolerated without precipitating signs of hepatic encephalopathy.

PMID- 7785176
TI  - Bile acids in the diagnosis, pathology, and therapy of hepatobiliary diseases.
AB  - Bile acids are normally confined in the enterohepatic circulation in which they
      play an important role in bile formation, biliary lipid excretion, and intestinal
      lipid absorption. In hepatobiliary diseases, bile acids escape the confinement of
      the enterohepatic circulation, allowing the measurement of the serum total bile
      acid concentration as a diagnostic indicator. Accumulation of certain bile acids
      within the hepatocyte, amplified as a consequence of cholestatic hepatobiliary
      disease, probably enhances cytotoxicity and leads to secondary pathology.
      Ursodeoxycholate, a bile acid with atypical physiological effects, may be useful
      in the treatment of various long-term cholestatic hepatobiliary diseases.
      Presently, most of the information on the toxicity and therapeutic usefulness of
      bile acids are based on studies in humans and experimental animals. Further
      studies, both basic and clinical, are needed to determine the pathologic as well
      as the therapeutic effects of bile acids in domestic animals.

PMID- 7785177
TI  - Treatment of naturally occurring sheep scab (Psoroptes ovis infestation) in the
      United Kingdom with ivermectin.
AB  - An outbreak of naturally occurring sheep scab in a flock of 207 sheep was
      successfully treated with three consecutive weekly subcutaneous injections of
      ivermectin at a dose rate of 200 micrograms/kg. Plunge dipping ewes during early
      pregnancy was not considered appropriate on welfare grounds.

PMID- 7785178
TI  - Ultrasonographic examination of the small intestine of cows.
AB  - The small intestine of 50 cows was examined ultrasonographically with a 3.5 MHz
      linear transducer. The cows were examined on the right side, from the tuber coxae
      to the eighth intercostal space and from the transverse processes of the
      vertebrae to the linea alba. The appearance of loops of small intestine and their
      contents and motility were assessed. In the majority of cases, the intestine
      contained feed and the contents appeared hyperechoic, but in some cows, the
      intestinal lumen contained mucus or fluid which was hypoechoic. The cranial part
      of the duodenum could be viewed longitudinally and in cross-section: its largest
      diameter varied from 1.1 to 5.4 cm and it could be identified with certainty only
      medial to the gall bladder, which served as an acoustic window. The descending
      part of the duodenum was adjacent to the abdominal wall and was enveloped in the
      hyperechoic greater omentum, differentiating it from the jejunum and ileum. The
      largest diameter of the descending part of the duodenum varied from 0.9 to 3.7
      cm. The ascending duodenum could not be identified because of its anatomical
      position. Loops of jejunum and ileum were usually viewed in cross-section and
      sometimes longitudinally; in contrast with the duodenum, they were constantly
      moving. The average diameter of the jejunum and ileum varied from 2.2 to 4.5 cm.

PMID- 7785180
TI  - Sudden death in dairy cattle with putative acute aflatoxin B poisoning.

PMID- 7785179
TI  - Canine Lyme disease in Belgium.
AB  - Lyme borreliosis is a multisystem disease caused by the tick-borne spirochaete
      Borrelia burgdorferi. In addition to causing human illness, borreliosis has been
      recorded in many species of mammals, including domestic animals which come into
      contact with the infected tick vector. This paper describes the first two cases
      to the authors' knowledge of Lyme borreliosis in dogs in Belgium. Both animals
      suffered recurrent lameness and general prostration. In addition, one of the dogs
      had recurrent paralysis of nerves V, VII, IX and X, leading to dysphagia and
      total bilateral paralysis of the mandibular muscles. This complication of Lyme
      borreliosis has been well documented in human pathology, but has not previously
      been recorded in the veterinary literature.

PMID- 7785181
TI  - Serological survey for swine vesicular disease in the UK.

PMID- 7785182
TI  - New rules on medicines.

PMID- 7785183
TI  - New rules on medicines.

PMID- 7785184
TI  - Future of the State Veterinary Service.

PMID- 7785185
TI  - Ethics of farm animal exports.

PMID- 7785186
TI  - Peracute pleuropneumonia in adult cattle.

PMID- 7785187
TI  - Detection of antibodies against Actinobacillus pleuropneumoniae, serotype 2 in
      porcine colostrum using a blocking enzyme-linked immunosorbent assay specific for
      serotype 2.
AB  - A blocking enzyme-linked immunosorbent assay (ELISA) developed for detection of
      antibodies to Actinobacillus pleuropneumoniae serotype 2 in sera from pigs
      (Nielsen et al., 1991) was evaluated for its suitability to detect antibodies in
      colostrum to this serotype. Using colostrum from sows experimentally infected
      with serotype 2 and from herds known to be infected with this serotype, the
      sensitivity of the test was 100%. Antibodies to A. pleuropneumoniae serotype 2
      could be detected in colostrum of experimentally infected sows until at least 5
      days after farrowing. Positive results were not observed with colostrum samples
      from herds known to be free from A. pleuropneumoniae. The high diagnostic
      sensitivity and specificity of the assay indicated that screening of herds for A.
      pleuropneumoniae serotype 2 infection by testing colostrum would be a reliable
      and simple method for herd monitoring.

PMID- 7785188
TI  - Identification of herd-specific bovine viral diarrhoea virus isolates from
      infected cattle and sheep.
AB  - Thirteen pestiviruses isolated from ruminants on four different farms in Sweden
      were compared antigenically and genetically. On two farms, viruses were isolated
      from both cattle and sheep, a third farm contained only sheep and a fourth only
      cattle. Seven viruses were isolated from six different cattle and six viruses
      were isolated from five different sheep. Epitope conservation between the viruses
      was studied with a panel of 32 monoclonal antibodies, revealing that all of the
      isolates were BVDV-like. However, certain epitopes present in isolates from
      cattle were lost following virus transmission to sheep. In vitro amplification of
      the 5'-untranslated region of the 13 isolates by the polymerase chain reaction
      (PCR) and subsequent analyses of amplified products with restriction enzymes also
      indicated that all 13 isolates belong to the BVDV group of pestiviruses. A
      fragment of the E2 (gp53) gene of each virus was amplified by PCR and a
      comparison of the amplified sequence of 188 nucleotides separated the isolates
      into four groups each of which could be identified with a particular farm of
      origin. The 13 isolates were thus herd-specific rather than species-specific
      demonstrating that BVDV is readily transmitted between cattle and sheep.

PMID- 7785189
TI  - Chemiluminescent detection of caprine arthritis encephalitis virus with a PCR
      generated single stranded nonradiolabelled probe.
AB  - A 814-bp digoxigenin-labelled single stranded DNA probe was produced and utilized
      in slot-blot hybridization for detection of caprine arthritis encephalitis virus
      (CAEV) in goat synovial membrane (GSM) cell culture infected with CAEV. The
      sensitivity of a PCR-generated probe was compared with a random primer labelled
      probe. The probe with digoxigenin-dUTP incorporated in the PCR reaction mixture
      was more sensitive for RNA detection than the random primer probe and it was much
      simpler to use. The probe was applied for detection of CAEV by blot blot
      hybridization in peripheral blood mononuclear cells (PBMC) and macrophage
      cultures obtained from naturally infected goats. This technique was not
      sufficiently sensitive to detect the viral nucleic acid directly from PBMC or
      cultured macrophages. When macrophages were cultured in vitro and then cocultured
      with susceptible GSM cells, samples gave a positive signal in the slot-blot
      hybridization technique. The use of slot-blot RNA hybridization permits more
      convenient and rapid confirmation of CAEV isolation in susceptible cells than the
      conventional identification by syncytia formation.

PMID- 7785190
TI  - Rapid method utilizing the polymerase chain reaction for detection of canine
      parvovirus in feces of diarrheic dogs.
AB  - By using primers based on the sequence of the VP2 gene of canine parovirus (CPV),
      we established a rapid and specific assay for identification of the virus from
      fecal specimens based on the polymerase chain reaction (PCR). By use of a pair of
      primers, a specific 226-bp sequence was amplified by the PCR. All strains of CPV
      tested gave a specific amplification product by the PCR, while neither porcine
      parovirus nor host cell did so. The PCR assay can detect fewer particles of CPV
      than the conventional methods, being able to detect CPV from fecal specimens in a
      rapid manner, provided that gel filtration of the samples through a spun column
      was done to remove inhibitory substances from the fecal specimens. These results
      suggest that the PCR assay can detect the presence of CPV in dogs early enough to
      prevent secondary infection by CPV in veterinary hospitals.

PMID- 7785191
TI  - Antibioresistance of Escherichia coli strains isolated in Morocco from chickens
      with colibacillosis.
AB  - Two hundred and fifty eight isolates of Escherichia coli were made from autopsied
      chickens showing lesions of avian colibacillosis. Antibiograms showed high levels
      of resistance (greater than 40%) to sulphonamides (SSS), oxytetracycline (OT),
      trimethoprim + sulphamethoxazole (STX) and chloramphenicol (C). Medium
      frequencies of resistances (from 15 to 40%) were noted for streptomycin (S),
      spectinomycin (SPT), nalidixic acid (NA), oxolinic acid (OA), flumequine (UB) and
      enrofloxacine (ENR). For ampicillin (AM), gentamicin (GM), nitrofurans (FT),
      colistin (CS) and rifampin (RA) the frequencies of resistance were low (less than
      15%). A linked resistance was observed for the 4 quinolones. A significant
      percentage of isolates (82.5%) were resistant to at least 2 antimicrobial agents.
      The most frequent antibiotypes were: C.OT.SSS.STX (4.65%),
      C.OT.SSS.STX.OA.NA.UB.ENR (4.65%), AM.S.C.OT.SSS.STX (4.26%) and OT.SSS.STX
      (3.87%).

PMID- 7785193
TI  - [Comparative evaluation of subtotal irradiation and polychemotherapy in the
      treatment of patients with lymphogranulomatosis].
AB  - Subtotal irradiation after a method developed at the Central Research Roentgeno
      Radiological Institute in St.-Petersburg was used as the first stage of antitumor
      treatment in 15 patients with Hodgkin's disease. In another group of 15 patients
      with the same disease antitumor treatment was started with a cycle of
      polychemotherapy. Comparison of the two types of total-system cytostatic therapy
      demonstrated their similar antitumor efficacy as far as the immediate results
      were concerned, but it also showed a higher hematologic toxicity of subtotal
      irradiation vs. polychemotheapy. Possibility of assessing the total dose of
      cytostatic exposure in multiple-modality treatment (chemoradiotherapy) is
      discussed.

PMID- 7785192
TI  - [Clinical, radiologic and morphologic characteristics of localized forms of
      pulmonary tuberculosis. Tuberculosis and hypoplasia].
AB  - Clinical and x-ray examinations and study of operation material from 555 patients
      with local forms of tuberculosis permitted the authors to distinguish three form
      of the condition: tuberculoma (77% of cases), cavitary (cavernous) tuberculosis
      (16%), and tuberculosis of the bronchi (5%). Morphologic investigations showed
      the local tuberculosis develops at small sites of pulmonary tissue hypoplasia.
      Sites of hypoplasia are usually concentrated in the pulmonary segments which are
      formed in the postnatal period, thus explaining the typical localization of a
      postprimary tuberculous focus. Tissue decomposition with development of
      destruction cavities is not characteristic of local tuberculosis. Cavitary
      (cavernous) form is a morphologic reflection of a tuberculous inflammation in the
      zone of cestous hypoplasia. Morphonesis of local forms of tuberculosis reflects
      its social dependence.

PMID- 7785194
TI  - [Use of magnevist in the clinical practice (clinical trials].

PMID- 7785195
TI  - [Radiologic diagnosis of inflammatory complications of colonic diverticulosis].
AB  - The authors analyze x-ray findings in 194 patients with colonic diverticulosis
      and its inflammatory complications. Clinical, x-ray, and morphologic studies
      helped the authors to specify the x-ray semeiotics of diverticulitis,
      paraintestinal infiltrates, intestinal fistulas. An optimal complex of
      radiological methods to detect each of these complications has been developed.
      The authors claim that irrigoscopy supplemented, if necessary, with simultaneous
      fistulography, or oral enterography is the priority and basic method for the
      diagnosis of inflammatory complications of colonic diverticulosis.

PMID- 7785196
TI  - [Radiologic endoscopy of the biliary system in cholelithiasis].
AB  - Roentgenoendoscopic interventions combining diagnostic and therapeutic procedures
      were carried out in 320 patients with various pancreatobiliary diseases.
      Different combinations of therapeutic roentgenoendovascular interventions on the
      biliferous system are shown, which were used in 102 patients with clolelithiasis.
      These interventions were found a highly effective method for preoperative
      treatment and therapy of patients with cholelithiasis. Roentgenoendovascular
      interventions in cholelithiasis are conductive to optimization of surgical
      treatment.

PMID- 7785197
TI  - [Clinical and radiologic diagnosis of etiology of macrohematuria from urinary
      tract].
AB  - Clinical, laboratory, ultrasonic, X-ray, and endoscopic methods were used to
      specify the cause of macrohematuria from the urinary tract at all levels. Seventy
      two patients with macrohematuria were examined; in 37 the process was localizes
      in the urinary tract (pelvic tumors in 2, calculi in 14, bladder tumors in 9,
      hemorrhagic cystitis in 2, cystic diverticuli in 3, tuberculosis in 1, prostatic
      adenoma in 2, prostatic cancer in 4, cases). An ultrasonic examination, though a
      valuable method, failed to detect papillary tumors of the pelvis when used alone.
      Transabdominal and transrectal ultrasonic examinations are sufficient to diagnose
      calculi, diverticuli, or cancer of the bladder, and the advantages of computer
      aided tomography over ultrasonic examination in the diagnosis of bladder
      carcinoma are doubtful. Examination of the prostate by transabdominal and
      transrectal ultrasonic methods helps to assess its true size and shape, detect
      changes in these parameters both in prostatitis and in tumors, including
      metastases of the tumor into adjacent organs and tissues. The problem of
      recognizing metastases of cancer of the bladder and prostate, when computer-aided
      tomography and magnetic imaging are of no avail for today, is still to be solved.

PMID- 7785198
TI  - [Radiographic evaluation of the clinical course and outcome in acute pneumonias].
AB  - The authors review the data of x-ray functional examinations of 525 patients with
      acute parenchymatoys pneumonia, 393 convalescents after pneumonia 3-6 months
      after the disease and analyze 480 case histories of patients, hospitalized for
      acute pneumonia 10 years ago. Development, x-ray picture, and resolution of the
      process are described. Besides traditional x-ray examination, roentgenography in
      oblique projections and pulmonary sonography are recommended in order to specify
      the anatomic changes in the lungs. Functional peculiarities of the involved and
      intact lungs were studied. Altogether 92.4% of convalescents are discharged from
      hospital with changed pulmonary pattern and, rather often, with infiltration of
      the parenchyma in the subpieural portions of the involved lobes and segments, as
      well as with disordered respiratory function of the lungs. Unfavorable outcomes
      in remote period after disease (pneumosclerosis, pneumocirrhosis, emphysema,
      chronic pneumonia) are observed mainly in subjects discharged from hospital
      before complete clinical cure.

PMID- 7785199
TI  - [Interventional radiology of chronic hemorrhoids].
AB  - Basing on the concept of hemorrhoids from pathologically changed groups of
      cavernous bodies of submucous layer of rectal transitional zone, the author used
      for the first time selective dearterialization of hyperplastic cavernous bodies
      which were at the same time three internal hemorrhoidal nodes. The therapeutic
      method consisted in roentgenoendovascular catheterization of the superior
      hemorrhoidal artery and embolization of its distal branches delivering blood to
      the internal hemorrhoidal nodes. Results of roentgenoendovascular treatment of 34
      patients suffering from chronic hemorrhoids are analyzed. The author emphasizes
      the advantages of roentgenoendovascular occlusion of the superior hemorrhoidal
      artery in comparison with traditional drug therapy and surgery. No recurrences
      were recorded over 24 months after the intervention.

PMID- 7785200
TI  - [Psychophysiological factors in radiodiagnosis].

PMID- 7785201
TI  - [Radiologic equipment with reduced radiation dosage].

PMID- 7785202
TI  - [Magnetic resonance tomography in the diagnosis of intramedullary tumors].
AB  - The data of magnetic resonance imaging in 23 patients is hardly sufficient to
      characterize the histologic types of intramedullary tumors. However, the presence
      of cystous type of structure of intramedullary tumors on magnetic tomograms with
      nonhomogeneous (iso- or hypointensive) signal on T1-suspended tomograms or of
      hyper- or hypointensive signal on T2-suspended ones is to a great measure
      indicative of infiltration and diffuse growth of a tumor. A solid structure of
      intramedullary tumor with homogenous hyperintensive signals on both T1- and T2
      dependent tomograms is more frequently indicative of a slowly growing tumor not
      involving the medulla, e.g. ependioma.

PMID- 7785204
TI  - [Radiologic evaluation of effectiveness of physical training in patients with
      myocardial infarction].
AB  - The findings of two-projection large-image fluorography of the thorax of 134 men
      aged 32 to 60 with a history of myocardial infarction are presented. Physical
      rehabilitation of these patients was either traditional (controls) or enhanced by
      physical training (test group). X-Ray characteristics of the pulmonary vascular
      bed help to detect left ventricular insufficiency even in cases when there are no
      clinical symptoms of it. Time course of X-ray and cardiometrical data helps not
      only to assess the efficacy of training, but permits detection of the progress of
      left ventricular insufficiency as well. Cardiometrical parameters (volume of the
      heart, left ventricular coefficient, hvs index, right-atrial coefficient) may be
      used to predict the course of coronary heart disease in the postinfarction
      period.

PMID- 7785203
TI  - [Transcutaneous transvenous occlusion of patent ductus arteriosus].
AB  - Transvenous closure is described of the patent ductus arteriosus with a conical
      device that consists of polyurethane foam mounted on a stainless steel flame.
      Since 1981, the procedure has been performed in 273 patients in Russia. Permanent
      complete ductus closure was achieved in 258 (95%) patients. In eight cases (3%),
      the occlusion was incomplete. Complications occurred in 10 patients (4%), seven
      of whom required emergency surgery. The new technique combines certain advantages
      of both alternative methods. The conical shape of the occlusion device is well
      suited for the anatomic structure of the ductus. The possibility of selecting the
      size of the device permits reduction in the rate of incomplete closure while
      still taking advantage of transvenous delivery to avoid entryside problems. In
      the initial 10 years of experience, the described technique proved effective,
      safe, and applicable in the vast majority of patients older than 2 years.

PMID- 7785205
TI  - [Radiologic evaluation of the invasiveness of obliterative esophageal tumors].
AB  - An original method of double contrast staining of the esophagus performed at the
      height of Muller's test has been developed and tried in 170 patients with
      obturating cancer of the esophagus. The composition and preparation of the
      mixture used is described, as well as the steps of the technique. The advantages
      of the new method in comparison with routine double contrast staining are
      demonstrated, for the extent of cancerous process in the caudal direction was
      accurately determined in each case. The authors recommend their method for
      surgical clinics and radiological departments to be used for determining the
      scope of surgical intervention and specifying the topometry before radiotherapy.

PMID- 7785206
TI  - [Combination of mandibular fibromyxoma and fibrous dysplasia of cranial bones].

PMID- 7785207
TI  - [Differential diagnosis of benign spinal neoplasms].
AB  - The authors analyze problems arising in differential diagnosis of benign spinal
      tumors not adequately described in available literature. The most characteristic
      x-ray symptoms of rare spinal tumors are presented. Methods of radiologic
      investigation such as polipositional roentgenography, tomography, roentgenography
      with direct image amplification are described in detail. A total of 102
      observations of benign spinal tumors are analyzed: osteoblaclastomas responsible
      for 14.7% of osteoblastoclastomas, angiomas responsible for 66.7% of cases,
      osteochondroma occurring in 6.7% of cases, chordomas and osteoid ostema occurring
      in 10.7 and 1.0% of cases, respectively.

PMID- 7785208
TI  - [Advocating radiotherapy of non-neoplastic diseases].
AB  - The authors a sum of the principal proofs, phenomena and facts that confirm the
      high efficacy of radiotherapy in acute and chronic inflammatory processes,
      degenerative dystrophic and hyperplastic diseases. The authors analyze the causes
      responsible for the unjustified rejection of the method in practical medicine and
      prove its efficacy in therapy of nontumorous diseases.

PMID- 7785209
TI  - [Gd-DTPA in the diagnosis of brain metastasis].
AB  - The potentialities of present-day methods of imaging (computer-aided and magnetic
      resonance tomography) in the diagnosis of metastatic involvement of the brain are
      discussed. Besides routine scanning, the authors assess the efficacy of a
      contrast agent Gd-DTPA (Magnevist, Schering AG, Germany) used in magnetic
      imaging. The potentialities of reinforced-aided tomography, 0.04 and 1.0 Tesla
      magnetic imaging are compared on the basis of 23 cases. The results indicate that
      magnetic imaging at low-intensity magnetic field is approximately as effective as
      computer-aided tomography in the assessment of metastatic involvement of the
      brain; contrast reinforcement with Gd-DTPA appreciably improves the informative
      value of the method in comparison with reinforced computer-aided tomography. As
      for 1.0 Tesla magnetic imaging, it is highly informative and accurate in
      assessment of the type (single or multiple) of the pathologic process. Extra
      contrast staining with Gd-DTPA makes magnetic imaging still more reliable and
      superior to computer-aided tomography and 0.04 T magnetic imaging in the
      diagnosis of metastatic involvement of the brain. In this investigation authors
      performed analysis of 23 observations with metastases (22 cases were hystological
      verified) and estimated possibilities of modern diagnostic methods such as CT
      (+CM), standard MR imaging and MRI with Gd-DTPA (Magnevist, Schering AG,
      Germany). Authors have noticed that MR imaging with contrast enhancement is more
      efficient in diagnosis of brain metastases in comparison with CT. Metastases
      showed the signal intensity increase after Gd-DTPA injection. Small tumors and
      nodi situated nearly skull base and in cerebellum were more distinguished on MR
      imaging with contrast enhancement than before it.

PMID- 7785210
TI  - [Diagnosis of kidney tumors invading the vascular pedicle and inferior vena
      cava].

PMID- 7785211
TI  - [The use of halotherapy for the rehabilitation of patients with acute bronchitis
      and a protracted and recurrent course].
AB  - Halotherapy was used for rehabilitation in 25 patients with acute bronchitis of
      long-standing and recurrent types. The main therapeutic action was ensured by
      aerodispersed medium saturated with dry highly dispersed sodium chloride aerosol,
      the required mass concentration being maintained in the range of 1 to 5 mg/m3.
      Therapy efficacy was controlled through assessment of clinical, functional,
      immunological and microbiological findings. Metabolic activity values were taken
      into consideration as well. Positive dynamics of the function indices in the
      clinical picture resulted from elimination of pathogenic agents, control of
      slowly running inflammatory lesions and stimulation of some immune system
      factors. Favourable changes in metabolic activity were present: normalization of
      serotonin excretion, marked decrease of unbalance in lipid peroxidation
      antioxidant system.

PMID- 7785213
TI  - [Physical factors in the rehabilitative treatment of patients who have undergone
      operations on the fallopian tubes].
AB  - Treatment results assessed in 170 females of the reproductive age who had
      previously undergone reconstructive-plastic operations on uterine tubes provide
      evidence for effectiveness of differentiated use of impulse infrared laser and
      sinusoidal modulated currents in combination with balneotherapy. The above
      physiotherapeutic modalities are considered good aftertreatment for females
      operated on the uterine tubes.

PMID- 7785212
TI  - [The treatment of patients with a disordered menstrual function by the
      transcerebral action of an ultrahigh-frequency electrical field].
AB  - Transcerebral exposure to 27.12 MHz electric field was used in 100 females of
      reproductive age with menstrual dysfunction because of neuroendocrine syndrome.
      The treatment proved highly effective in menstrual disorders of central genesis
      this making it a treatment of choice in combined therapy of the above patients.

PMID- 7785214
TI  - [The use of low-temperature pelotherapy in the treatment of patients with
      rheumatoid arthritis (II)].
AB  - Low-temperature peloids (t = +13, +14, +15 degrees C) application in rheumatoid
      arthritis patients produces local antiinflammatory, analgetic actions, suppresses
      immunocompetent system, improves locomotor functions. The above balneotherapy is
      indicated for patients with articular seropositive or seronegative RA
      irrespective of its activity in the presence of exudative-proliferative
      manifestations in the affected joints. In articular-visceral RA it is better to
      apply peloids in minimal activity of the inflammation.

PMID- 7785215
TI  - [Changes in the lipid peroxidation indices during the sanatorium-health resort
      treatment of patients with joint diseases, victims in the accident at the
      Chernobyl Atomic Electric Power Station].
AB  - Joint degeneration and dystrophy observed in some subjects exposed to low-dose
      radiation after the Chernobyl accident is accompanied with more active production
      of lipid peroxidation products. This overproduction is corrected by combined
      sulfurated hydrogen balneotherapy and magnetophoresis of vitamin E on the
      affected joints.

PMID- 7785216
TI  - [Therapeutic physical exercise for patients after the amputation of the lower
      extremities at the sanatorium stage of rehabilitation].
AB  - The authors propose a set of therapeutic exercises developed to prevent
      degenerative-dystrophic processes and to improve locomotor function in patients
      undergoing sanatorium treatment after lower limb amputation. Swimming and loading
      exercises have improved strength and performance of spinal muscles, amputated and
      supporting limb, reduced osteoporosis of the stump bone fragment. The efficacy of
      the above approach was evaluated by dynamometry on the test-dynamometer Biodex
      and by ultrasound osteometry.

PMID- 7785217
TI  - [The rehabilitation of patients with secondary (radiation) injuries to the
      brachial plexus].
AB  - A close control is needed over large nerve trunks and plexuses in the course of
      their area radiation in cancer patients to prevent radiation damage to peripheral
      nervous system. Rehabilitation of patients with radiation-induced plexitis and
      neuritis urges early diagnosis and treatment as essential conditions for adequate
      recovery of the limb function. Diagnosis of radiation damage to peripheral
      nervous system should rest on clinical electrophysiological findings defining the
      degree of the nerve fiber injury and predict treatment outcomes.

PMID- 7785218
TI  - [Experience in treating patients with lymphedema using radon baths combined with
      local barotherapy at Belokurikha health resort].
AB  - The efficacy of thermal nitrogen-radon water and local pneumocompression was
      studied in 66 patients with lymphedema of the lower limbs stage I-II receiving
      treatment in Belokurikha resort. The response of 10-48-month duration was
      achieved in 63 (95.5%) of those treated. The course of radon baths only was less
      effective.

PMID- 7785220
TI  - [A comparative evaluation of the results of using different means for stone
      expelling therapy in urolithiasis].
AB  - A conventional approach to urolith elimination involving spasmolytics, water
      loading, terpene-containing drugs warrants efficacy in 80% of the cases. Diuretic
      tea promoted the stones evacuation from the ureter in 88.5%. Sinusoidal modulated
      currents with inductothermia and sound stimulation of the upper urinary tracts
      resulted in the stones elimination in 88 and 85.7% of the cases, respectively. A
      new method of urolithiasis treatment is suggested, tried and patented. It implies
      introduction of upper urinary tract sound stimulation with the frequency 2.4-3.3
      kHz at the height of urinative effect of the tea. The resultant elimination of
      uroliths occurred in 129 of 134 patients treated (96.3%). The treatment is
      feasible both in inpatient and outpatient settings.

PMID- 7785219
TI  - [The stress-limiting action of pulsed infrared laser radiation].
AB  - Experiments were carried out on male rats to study molecular background of stress
      limiting effect of impulse infrared laser radiation (0.89 mu). The motor cortex
      was subjected to 4.8 W local impulse laser radiation with an impulse length 10(
      8) sec, 3000 Hz base frequency and 10 Hz modulating frequency during 10 minutes.
      The following data were estimated: DNA synthesis in the cells of the cortex,
      skeletal muscles and thymus recorded by 3H-thymidine inclusion in nuclear DNA, 11
      OCS content in blood plasma. It was revealed that IR radiation stimulated DNA
      synthesis in all the examined tissues of intact animals and animals after
      proactive physical load (swimming). The preliminary laser radiation was an
      effective stress-limiting factor for the cortex and thymocytes of swimming rats,
      but did not prevent decreasing 3H-thymidine inclusion in muscles' nuclear DNA
      initiated by swimming.

PMID- 7785221
TI  - [The health resort as a center for propagandizing social health].

PMID- 7785222
TI  - [The efficacy of the internal use of Slavyanovsk mineral water and a pectin
      extract in the combined health resort treatment of children exposed to radiation
      action].

PMID- 7785224
TI  - [Regional hemodynamic indices as a criterion of the efficacy of massage effects].

PMID- 7785223
TI  - [The effect of the types of balneo- and physiotherapeutic treatment on nickel and
      cobalt elimination from the body].

PMID- 7785226
TI  - [The 80th anniversary of the I. M. Sechenov Crimean Republic Research Institute].

PMID- 7785225
TI  - [The primary prevention of osteopenia].

PMID- 7785227
TI  - [The 75th anniversary of the State Research Institute of Health Resort Science in
      Pyatigorsk].

PMID- 7785228
TI  - [The 150th anniversary of Krainka health resort].

PMID- 7785229
TI  - [The effect of different types of laser therapy on the reactivity of the
      peripheral blood neutrophils in patients with ischemic heart disease].
AB  - The responses to laser therapy (intravenous, continuous skin exposure without a
      magnet, magnetic laser therapy) of 83 patients with coronary heart disease aged
      50-80 demonstrated the advantages of noninvasive laser irradiation of blood.
      Myeloperoxidase activity may serve a criterion for estimating the number of
      irradiation procedures needed.

PMID- 7785230
TI  - [The terrain cure under moderate altitude hypoxia in the combined sanatorium
      health resort treatment of patients with ischemic heart disease after
      aortocoronary bypass].
AB  - Muscular exercise in the form of terrain walking proved to be a useful component
      of combined conditioning of coronary heart disease patients after aortocoronary
      shunt functional class 1 and 2. In conditions of moderate altitude resort such
      training mobilizes cardiovascular reserves of CHD patients. The outcome of the
      above sanatorium rehabilitation depends largely on contractility of left
      ventricular myocardium.

PMID- 7785232
TI  - [Macrosomia and prognosis in cancer patients].

PMID- 7785233
TI  - [Photodynamic therapy for malignant tumors].

PMID- 7785231
TI  - [The effect of cold exposure on the respiratory function in children suffering
      from inflammatory lung diseases].
AB  - Single total (air bath, douche) and local (cooling of the feet with water)
      exposure to mild cold do not arise noticeable disorders of the respiration
      function in children suffering from recurrent and asthmatic bronchitis in
      remission. Local cold procedures improve bronchial patency while the exposure to
      heat results in its worsening.

PMID- 7785234
TI  - [Molecular mechanisms of estradiol-dependent tumor growth].

PMID- 7785235
TI  - [Breast cancer morbidity in Dagestan].

PMID- 7785236
TI  - [Biochemical parameters in the comprehensive diagnosis of lung cancer].
AB  - Biochemical characteristics of blood serum were studied in 310 patients with lung
      cancer (stage I-IV), 188 cases of non-malignant pathology od the lung and 35
      healthy subjects. Mean levels of total sialic acids, lipid-bound sialic acids,
      neuron-specific enolase and lactate depydrogenase in blood serum of cancer
      patients were significantly higher than those in control groups. Mean neuron
      specific enolase concentrations in small cell carcinoma of the lung were
      significantly higher than those in squamous cell and glandular carcinoma and
      carcinoid. Significant differences were observed for blood serum levels in cases
      of lung cancer disseminated to the liver and bones, as compared with those
      without distant metastases. Gamma-glutamyl transferase proced the most sensitive
      and specific when used for diagnosis of hepatic metastases, while alkaline
      phospohase--for bone metastases.

PMID- 7785237
TI  - [Diagnostic value of investigating exhaled air condensate in lung cancer].
AB  - Parameters of lipid peroxidation and the levels of calcium ions in blood plasma
      and exhaled air condensate (EAC) were studied in 47 patients with lung cancer.
      The changes in EAC turned out to be more specific than those of blood plasma. The
      level of lipoperoxidation in condensate in cancer patients was lower than in
      healthy subjects. However, calcium cations concentrations in both blood and EAC
      were relatively higher, the latter difference being significant. The
      investigation pointed to a greater diagnostic value of EAC measurements, as
      compared with blood plasma, in lung cancer patients.

PMID- 7785238
TI  - [Evaluation of radiation and non-radiation factors in the development of lung
      cancer in radiochemical plant employees].
AB  - Five hundred workers of a nuclear facility (162 cases of lung cancer and 338
      healthy subjects) were examined on a case-control basis using the logical
      regression method and 10 radiation and non-radiation factors. Five significant
      factors were identified. The following rick values were obtained for them:
      tobacco smoking-6.6; plutonium-associated pneumosclerosis-4.6; plutonium
      incorporation-3.1; chronic non-specific diseases of the lung-2.1 and gamma ray
      exposure-1.6. Radiation-associated rick was under 25%, while that of non
      radiation factors not less than 70%.

PMID- 7785239
TI  - [Prostaglandins E in malignant stomach neoplasms].
AB  - Prostaglandins E (PGE) levels in gastric neoplasme have been studied
      radioimmunologically in 84 patients (aged 31-77) with tumors of different stages.
      A relationship between PGE level and main clinico-morphological features of tumor
      has been established. PGE concentration was shown to correlate with age, stage,
      histological pattern of tumor, cell differentiation and tumor infiltration. The
      highest PGE concentrations were observed in young patients, low-differentiated
      adenocarcino, a and pronounced tumor infiltration to adjacent tissues. No
      correlation has been found between PGE level and sex and tumor localization and
      size. The PGE level in the intact gastric mucosa was significantly lower in the
      body of the stomach than in its proximal and upper parts. The results of the
      investigation suggest a possible use of PGE antagonists for stomach cancer
      treatment.

PMID- 7785240
TI  - [Lactate dehydrogenase isozyme profile in gastric mucosa as an early marker of
      possible neoplastic pathology in children with chronic gastroduodenal diseases].
AB  - The lactate dehydrogenase (LDH) isoenzyme profile was studied in bioptic samples
      of gastric mucosa taken from 57 infantile patients suffering from chronic
      gastroduodenal pathology and 7 children with gastric functional disorders. The
      investigation showed LDH1 level to decrease and that of LDH5 to increase, the
      LDH5/LDH1 ratio increasing accordingly, in cases of erosive gastro-like
      gastroduodenitis and duodenal ulcers. The degree of said changes was found to
      correlate with the extent of morphological lesions of gastric mucosa and the most
      pronounced changes were recorded in cases of gastric mucosa gland atrophy.
      Similar changes in LDH isoenzyme profile had been identified in patients with
      gastric tumors. Said findings may be used in identification of groups at high
      risk for gastric carcinoma.

PMID- 7785241
TI  - [Evaluation of tumor necrosis factor (TNF) in cancer patients].
AB  - The levels of TNF spontaneously produced in monocyte and macrophage supernatants
      were measured in 65 patients with tumors of different localization and stages.
      The TNF levels in blood monocyte and macrophage supernatants obtained from
      peritoneal washings were found to significantly differ from those in blood serum
      in the same patients. The highest TNF concentrations were registered in monocytes
      supernatants sampled from rectal and breast cancer patients. A relationship
      between cancer cachexia and TNF level is discussed.

PMID- 7785242
TI  - [Distribution of alleles of DRB, DQB and DQA loci of major histocompatibility
      complex in healthy donors of Saint Peterburg].
AB  - The distribution of alleles of DRB, DQB and DQA loci was investigated in 118
      healthy donors from St. Petersburg. Said alleles were identified by the
      restriction fragment length polymorphism method using DRB, DQB and DQA probes
      after TaqI digestion and Southern blotting. The frequencies of said alleles were
      compared with those of a cohort of healthy donors living in Germany. A
      significantly higher frequency of DRB-17-2 was identified in the Russian donors,
      as compared with the German counterparts. Also, the Russian donors revealed a
      decrease in the frequency of DQB-1 (P = 0.01) and an increase in that of DQB-X
      allele (P = 0.05). An analysis of DRB, DQB and DQA locus a alleles adhesion in a
      sample of donors from St. Petersburg showed it to agree, in a large proportion of
      cases, with the literature data. A parallel study of immunological specificity of
      DR antigen was undertaken to compare the results of genetic and serologic typing;
      errors in DR specificity identification were found to have been made in 17.0%.

PMID- 7785243
TI  - [Intrathecal synthesis of immunoglobulins G in patients with nervous system
      neoplasms].
AB  - Brain tumor development and their recurrence are accompanied by an increase in
      IgG levels in liquor as well as in the number of circulating immunocomplexes and
      by the presence of blockage factors in liquor. The data presented in the paper,
      on the whole, illustrate the development of autoimmune reactions, which happen to
      be mechanisms involved in the pathogenesis of brain tumor growth and recurrence.
      Surgical removal of tumor is followed by a reduction in the rates of IgG
      synthesis.

PMID- 7785245
TI  - [Functional status of mast cells in subcutaneous connective tissue of rats with
      lymphosarcoma of Pliss].
AB  - The functional status of a population of mast cells taken from the subcutaneous
      connective tissue of rats with lymphosarcoma of Pliss and those suffering from
      aseptic inflammation was evaluated. The experiment established such
      manifestations of remote influence on the mast cell population, at early stages
      of tumorigenesis, as faster rates of tumor growth and mast cells maturation and
      enhanced degranulation. Initial signs of functional exhaustion of the mast cells
      population was seen as a paraneoplastic syndrome.

PMID- 7785244
TI  - [Leukemia in delta-GAG-MYC transgenic mice].
AB  - Transgenic mice carrying two delta-gag-myc genetic constructions were produced
      and kept under observation during their whole life. Nineteen out of 119
      transgenic mice developed such hemopoietic diseases as lymphoid tissue
      hyperplasia, lymphoma, lymphosarcoma and myeloma. Lymphoid tissue hyperplasia and
      lymphoma generally involved multiple hyperplastic and neoplastic pathologies
      which were regarded, on the whole, as "malignant disease". In all cases,
      lymphosarcoma and myeloma were the only deadly pathologies. Lymphomas and
      myelomas were detected after 3-9 months, lymphosarcomas--18-29 months while
      lymphoid tissue hyperplasia occurred virtually throughout the entire life span--3
      31 months. The study has shown that transgenic mice carrying delta-gag-myc gene
      in their genome can be used in the designing of special models for investigations
      of certain patterns of leukemia.

PMID- 7785247
TI  - [Criteria for evaluation of non-specific anti-tumor resistance].
AB  - Non-specific antitumor resistance levels have been measured by correlation
      regression analysis on the basis of 33 parameters in rats with tumors and under
      the influence of Thio-TEPA treatment, endolymphatic administration included. The
      study established 16 highly-informative criteria and parameter a, an integral
      indicator for non-specific antitumor resistance evaluation, which describes the
      synthetic activity of peripheral blood lymphocytes.

PMID- 7785246
TI  - [Coordination of lymphocytic enzymes of the rat thymus gland in experimental
      chemotherapy].
AB  - The report deals with an investigation of the relationship between thymal
      cortical lymphocytes metabolism and antitumor response in Wistar rats with
      ovarian tumors, injected with Thio-TEPA intramuscularly and endolymphatically.
      Antitumor response and enzymatic indexes coordination appeared to be higher with
      the latter route.

PMID- 7785248
TI  - [Groups at high risk for skin cancer].
AB  - A special program aimed at detecting skin cancer at early stages was worked out
      and launched into use in 1989. It provides for a series of measures for primary
      examination and subsequent follow-up of population. Dermatologists conducted
      examinations of persons at high risk 2-4 times a year depending on the disease.
      They were joined by oncologists, whenever required, and morphological
      examinations were sometimes carried out. The group at high risk for skin cancer
      included patients older than 50, with the following pathologies: (I) Obligate
      precancerous dermatites: Bowen's syndrome, erythroplasia of Queyrat, Paget's
      disease (extramammary localization), intraepidermal epithelioma of Jadassohn,
      late-onset radiation dermatitis, early childhood-Kaposi's disease, Manganotti's
      chilitis and verrucous precancer of the lip; Optional precancerous dermatosis:
      childhood-onset epidermodysplasia veruciformis, actinic keratosis, cutaneous
      horn, keratoacanthoma, carcinoid papillomatosis of Gottron, giant condyloma of
      Buschke-Lowenstein, leukoplakia and limited precancerous hyperkeratosis of the
      lip's red edge; (2) Dermatoses involving pathological regeneration:
      eruthematosis, lupus tuberculosis, psoriasis (more than 15 years old), trophic
      ulcers, extensive scars (particularly, those caused by burns), chronic ulcerative
      pyoderma and pyoderma vegetans; (3) Hemorrhagic diathesis on the surface or
      fundus of neoplasm; (4) Consolidation at neoplasm base; (5) Absence of
      complaints; (6) Resistance to therapy.

PMID- 7785249
TI  - [Diagnosis of cerebral meningioma before hospitalization].
AB  - Clinical neurologic symptoms were evaluated in 300 cases of brain meningioma
      eersus tumor course. An attempt was made to assess difficulties involved and
      errors made in diagnosing tumors before admission to hospital. The study
      identified initial signs of the disease, symptom combinations as well as single
      symptoms considering their frequency and importance for cerebral meningioma
      diagnosis before admission.

PMID- 7785251
TI  - [Morbidity and mortality of malignant tumors in the population of a Moscow
      district].
AB  - An epidemiologic study of malignant tumors was carried out in a cohort of
      population of a district in Moscow. The district is situated on the leeward side
      of a cluster of factories which discharge 270 cu tons of pollutants per year.
      Nine of the eleven apartment houses under study were put up in the 60-70 ies when
      the factories were in operation. The cohort included 1,095 males and females who
      had lived in that district at least 5 years until the start of the investigation.
      The tumor morbidity and mortality in this cohort were evaluated for the period of
      1988-1992. Morbidity of virtually all known tumors and mortality proved to be in
      excess of all expectations. However, significant differences between the actual
      and expected levels were obtained in the total number of tumors, in females, only
      (actual number-24; expected number-13.76), and for breast tumors (7 and 2.82,
      respectively).

PMID- 7785250
TI  - [Use of navoban for nausea and vomiting caused by chemotherapy for malignant
      tumors].
AB  - The antiemetogenic effect of navoban (Sandoz) was studied in 26 patients
      receiving chemotherapy, with application of platidiam in 22 cases included. No
      vomiting was registered. Nausea was observed in 9 cases within the first 24 hrs
      and a slight reduction in appetite--in 13 cases. Navoban proved one of the most
      potent antiemetics devoid of any untoward side-effects.

PMID- 7785252
TI  - [Combined multi-stage treatment of a patient with non-differentiated
      adenocarcinoma of the lungs with solitary brain metastasis].

PMID- 7785253
TI  - [Representation of the dynamics of a neoplastic process].

PMID- 7785254
TI  - Neurologic complications of lightning injuries.
AB  - Over the past ten years, we have cared for 13 patients who suffered serious
      neurologic complications after being struck by lightning. The spectrum of
      neurologic lesions includes the entire neuraxis from the cerebral hemispheres to
      the peripheral nerves. We describe these various neurologic disorders with regard
      to the site of the lesion, severity of the deficit, and the outcome. Damage to
      the nervous system can be a serious problem for patients struck by lightning.
      Fatalities are associated with hypoxic encephalopathy in patients who suffered
      cardiac arrests. Patients with spinal cord lesions are likely to have permanent
      sequelae and paralysis. New technology for detecting lightning with wideband
      magnetic direction finders is useful in establishing lightning-flash densities in
      each state. Florida and the Gulf Coast states have the highest densities.
      Colorado and the Rocky Mountain states have the next highest.

PMID- 7785256
TI  - Costs of minimally invasive laser surgery compared with transurethral
      electrocautery resection of the prostate.
AB  - We reviewed hospital charges for patients undergoing uncomplicated endoscopic
      surgical resection for symptomatic bladder outlet obstruction due to benign
      prostatic hyperplasia over a 1-year period at a single institution. Of 115
      patients, 67 underwent transurethral electrocautery resection of the prostate,
      and 48 underwent endoscopic neodymium:yttrium-aluminum-garnet laser ablation of
      the prostate under direct vision. Analysis showed a cost differential between
      these 2 surgical treatments in excess of $2,000, favoring laser prostatectomy (P
      < .0001) over transurethral electrocautery resection. The single greatest
      difference between the treatments was the ability to manage all patients
      receiving laser treatment as outpatients, whereas the mean and median hospital
      stay after transurethral electrocautery resection was 3.0 days. Taking additional
      cost variables into account and decreasing the cost of laser delivery systems
      would further increase this cost differential in favor of laser therapy. The
      diminished postoperative morbidity associated with laser treatment also promises
      lower total costs over the long term.

PMID- 7785255
TI  - Immunopathologic effects of silicone breast implants.
AB  - Silicone-gel breast implants have been associated with a myriad of autoimmune and
      connective tissue disorders by anecdotal reports and small observational series.
      To date, no prospective epidemiologic studies have been done to substantiate
      these observations, but an increasing body of literature is being developed and
      older studies are being recognized that point to immunotoxic or inflammatory
      effects of these breast implant components. The development of disease due to
      implants would depend on the interaction of genetic host factors so that only a
      few patients would potentially be at risk. Based on the example of other
      chemically mediated disorders, such as scleroderma in association with silica
      exposure, latency periods of more than 30 years before disease develops may be
      possible. Herein we review studies on silicone and immunity.

PMID- 7785257
TI  - Glycemic control and complications of diabetes mellitus.

PMID- 7785259
TI  - Cervical pathology--the Bethesda System and the 'atypical squamous cells of
      undetermined significance' controversy.
AB  - The Council on Scientific Affairs of the California Medical Association presents
      the following epitomes of progress in pathology. Each item, in the judgment of a
      knowledgeable physicians, has recently become reasonably firmly established, both
      as to scientific fact and clinical importance. The items are presented in simple
      epitome, and an authoritative reference, both to the item itself and to the
      subject as a whole, is generally given for those who may be unfamiliar with a
      particular item. The purpose is to assist busy practitioners, students,
      researchers, and scholars to stay abreast of progress in medicine, whether in
      their own field of special interest or another. The epitomes included here were
      selected by the Advisory Panel to the Section on Pathology of the California
      Medical Association, and the summaries were prepared under the direction of
      Yutaka Kikkawa, MD, and the panel.

PMID- 7785260
TI  - Specimen quality and accuracy of fine-needle aspiration biopsies.

PMID- 7785258
TI  - Role of nitric oxide in insulin-dependent diabetes mellitus-related vascular
      complications.
AB  - Patients with insulin-dependent diabetes mellitus are at high risk for vascular
      disorders such as hypertension, nephropathy, and retinopathy. The most common
      cause of morbidity and mortality in patients with insulin-dependent diabetes is
      vascular disease. Despite ongoing research, the pathogenesis of vascular disease
      in diabetes remains unclear. In recent years, numerous investigators have
      examined the role of the endothelium-derived relaxing factor, nitric oxide, in
      the disease state of hypertension and its complications. We review the role of
      nitric oxide in the development of diabetes-related vascular disease and discuss
      findings suggesting that nitric oxide metabolism and vascular responsiveness to
      nitric oxide are altered in diabetes. Patients with diabetes may benefit from
      therapy that addresses this pathogenic deficiency.

PMID- 7785261
TI  - Molecular pathology and cancer genetic screening.

PMID- 7785262
TI  - Predisposition to thrombosis by a factor V mutation causing hereditary resistance
      to activated protein C.

PMID- 7785263
TI  - Microalbuminuria.

PMID- 7785264
TI  - 'Crystal' and pregnancy--methamphetamine-associated maternal deaths.

PMID- 7785265
TI  - Congenital malaria in a nonidentical twin.

PMID- 7785266
TI  - Cardiac rhabdomyoma with cardiac arrest.

PMID- 7785267
TI  - Lesbian health care. What a primary care physician needs to know.
AB  - Many primary care physicians take care of lesbians and women sexually active with
      women without being aware of their patients' sexual orientation. These women have
      unique medical and psychosocial needs that each physician must consider. Lesbian
      identity or being sexually active exclusively with women influences care in areas
      such as sexually transmitted diseases, risk of human immunodeficiency virus
      infection, counseling, cancer risk, screening, parenting, depression, alcohol
      use, and violence. We review an approach to taking a history with all women that
      facilitates open, comfortable communication with lesbians. We also review
      specific medical and psychosocial areas of primary care in which caring for
      lesbians is different from caring for other women. Further research is needed on
      lesbian health issues to provide appropriate guidelines to clinicians.

PMID- 7785268
TI  - Work-site health promotion programs and health care reform.

PMID- 7785269
TI  - Management of diabetes mellitus after the DCCT--what's next?

PMID- 7785270
TI  - Dietl's crisis revisited--the enigma of nephroptosis.

PMID- 7785271
TI  - Can specialists practice primary care?

PMID- 7785272
TI  - Guns and violence--a second opinion.

PMID- 7785273
TI  - Lead poisoning alert--false alarm?

PMID- 7785274
TI  - Gallium citrate Ga 67 scanning in acute renal failure.

PMID- 7785276
TI  - [Multifocal-motor neuropathy and motor neuropathy with multifocal conduction
      block (Lewis-Sumner syndrome)].
AB  - Multifocal motor neuropathy, which mimics lower motor neuron disease, is a rare
      and curious demyelinating neuropathy characterised by slowly progressive,
      asymmetric limb weakness within the distribution of individual peripheral nerves,
      wasting, cramps, fasciculations and rare sensory involvement, but without upper
      motor neuron signs. The cardinal feature and primary pathophysiological basis for
      the weakness is the multifocal motor conduction block which remains stable for
      years at the same site and is confined to motor axons. It is defined as > 50%
      reduction in both the CMAP and the negative peak area on proximal stimulation, as
      compared with the distal stimulus response without any change in the negative
      peak duration. Nerves at the site of the conduction block show demyelination,
      endoneural edema, rudimentary onion bulbs and lymphocytic inflammation. Sensory
      nerves may show mild demyelination, axon loss and lymphocytic inflammation. The
      majority of patients shows elevated titers of anti-glycolipid antibodies, which
      may block the Na+ channels, produce demyelination or interfere with
      remyelination. However, their role in the pathogenesis of multifocal motor
      neuropathy remains uncertain. Multifocal motor neuropathy is regarded as the
      predominantly motor variant of chronic inflammatory demyelinating polyneuropathy
      and can be treated best with immunoglobulins and cyclophosphamide.

PMID- 7785275
TI  - [The interactions of antidepressant drugs].
AB  - An overview is presented of interactions of currently frequently used
      antidepressants with various other drugs. The effects of interactions of
      tricyclic antidepressants, tetracyclics, monoamine oxidase (MAO) inhibitors,
      lithium and carbamazepine are comparatively well documented, their pharmcodynamic
      and pharmacokinetic characteristics extensively researched and well known to the
      practitioner. These interactions concern synergic effects, enzyme inhibition,
      enzyme induction in the liver, competitive inhibition of absorption and
      reciprocal effects on the receptor. With regard to lithium, problems of renal
      clearance and circulation are also important. On the other hand, interactions of
      reversible and selective MAO-A inhibitors (RI-MA) and selective serotonin
      reuptake inhibitors (SSRI) with various other drugs are in the process of
      elucidation. Very threatening interactions are known to be caused by a
      combination of SSRI and MAO inhibitors (serotonergic syndrome). SSRI and
      tricyclic antidepressants dispensed concurrently cause an increase in the plasma
      level of the tricyclic antidepressant. Hence, the practitioner must become aware
      of this high responsibility towards the patient when prescribing even on single
      drug, which must be selected with the utmost care.

PMID- 7785277
TI  - [Peripheral cranial nerve paralysis as a sequela of operations of the carotid
      artery].
AB  - 265 carotid endarterectomies in 210 patients (all vein patch in the carotid
      bifurcation) were investigated postoperatively for the presence and reversibility
      of cranial nerve palsy especially for N. facialis, N. hypoglossus, and N. vagus
      paresis. Additionally, the anatomical relationship between the affected cranial
      nerve and the carotid artery and the influence of surgical case load on the
      incidence of cranial nerve paresis were investigated. Altogether 28 (10.5%)
      cranial nerve injuries were registered. In 6 (2.2%) cases the hypoglossus nerve
      was injured, in 13 (4.9%) the vagal nerve (N. laryngeus recurrens) and in 9
      (3.4%) facial nerve paresis occurred. Cranial nerves VII and X, which are not
      directly connected with the area operated on, show significantly more injuries
      than the hypoglossal nerve (p < 0.01), which is located closer to the carotid
      artery. Significantly lower rates of cranial nerve injuries (p < 0.01) were
      recorded in cases operated on by surgeons with greater experience (> 30 cases)
      than by surgeons with a case load below this threshold. Although different
      reasons for cranial nerve injuries such as direct pressure, retraction or edema
      are known, all pareses show an excellent spontaneous recovery rate within the
      period of one year.

PMID- 7785278
TI  - [Comparative psychiatric diagnosis in dialysis patients and kidney transplant
      recipients].
AB  - 12 male and 8 female patients treated by hemodialysis (mean age: 38.5 years, s =
      11.1) and 10 male and 10 female renal transplant recipients (mean age: 35.4
      years, s = 9.7) were given 8 psychological tests. The results of both groups were
      compared with each other and with the respective standardizations. RESULTS: In
      comparison with the respect standardizations the transplant recipients obtained
      average results in 5 to 6 achievement tests, whereas the dialysis patients showed
      deficiencies in higher perceptive processes, namely attentiveness, power of
      concentration, speed of performance, reductive thinking, and short-time memory.
      Confronted with problems which must be solved by making use of formerly acquired
      knowledge, experiences, and skills (crystallized intelligence), the average
      results of both groups coincided with the average of the respective
      standardizations. As for their way of acting in frustrating situations, the
      persons of both groups tried to avoid any aggressive reaction against fellow-men.
      They tended to self-reproaches, though generally referring to inevitable
      circumstances. If possible they evaded any question of guilt by minimizing the
      problems. All in all, renal transplantation can effect a substantial improvement
      in mental ability, especially of fluid intelligence.

PMID- 7785279
TI  - Chronic relapsing polyradiculoneuropathy in IgG lambda monoclonal gammopathy of
      undetermined significance (MGUS)--complete remission following carmustine
      treatment.
AB  - A previously healthy 43 year-old female developed IgG lambda monoclonal
      gammopathy of undetermined significance (MGUS) and ascending sensorimotor
      polyradiculoneuropathy which relapsed 11 times within 2 years. Marked improvement
      was noted repeatedly after plasmapheresis. However, on each occasion symptoms and
      signs of polyradiculoneuropathy recurred almost exactly 3 weeks after plasma
      pheresis. Following 6 weeks of treatment with carmustine (70 mg/week), nearly
      complete recovery was established, which has persisted up to now (82 months after
      the end of therapy). The close temporal correlation between clinical relapse and
      recurrence of the IgG paraprotein and its permanent absence in stable clinical
      remission after carmustine treatment suggest a causal relationship between the
      paraprotein and the polyradiculoneuropathy. However, further studies are required
      to confirm this observation, as well as the efficacy of carmustine therapy.

PMID- 7785280
TI  - [Microinvasive, CT-controlled periradicular therapy in treatment of chronic
      intervertebral disk-induced functional disorders].
AB  - The disease of the spinal column is number 2 of common diseases world-wide and
      leads to high business- and commerce-related losses as well as to high expenses
      for the health care systems. An effective treatment of this disease is given by
      the microinvasive. CT controlled periradicular therapy (micro PRT). Under
      visibility, the tip of a canula is led directly and high precisely in close
      neighbourhood to the prolaps, then locally NaCl and cristaline cortisone (40 mg
      Volon A) is instillated. The periradicular distribution and the distribution into
      the epidural space is documented via contrast medium. A retrospective study with
      220 patients and a prospective randomized double blind study with 40 patients (10
      mg vs. 40 mg Volon A) were carried out. The average age of the retrospective
      collective was 53.1 +/- 12.4 years, average treatment period 18.4 weeks, and the
      mean follow-up 17 months. The mean value of successful treatment of lumbal spine
      was at 60% (spine 88.5%) with protrusion, with prolaps at 75% (spine 94%), with
      sequester at 94%, and with stenoses at 69% (spine 60%). With 78.8% of the
      patients, the percentual result was constantly good at the time of questionnaire
      as to the end of the treatment. 7.7% still took analgesics, 5.9% were post
      operated. 1.8% of the patients made a pension application. The average age of
      patients within the prospective randomized double-blind-study was 47.2 +/- 11.9
      years. At 27.5% of the patients, the start of pain was about more than 5 years
      ago and goes back to about 23 years (72.5% had pain more than 1 year). The mean
      value of visits was 4 physicians per patient, and 5 months of follow-up. There is
      a high significant improvement in results within the group with 40 mg Volon A (p
      = 0.0351479). The entire improvement, subjectively estimated (visual analogical
      scale) within this group was at 90%. After end of therapy, 83.3% (n = 30) had
      stopped the taking of analgesics and the neurologic deficit decreased
      significantly. Furthermore, significant reduction of prolapses could be observed
      at 60% of the patients in both study groups (n = 156). The CT scopic micro PRT
      with 40 mg Volon A leads to a significant improvement of pain and neurologic
      symptoms caused by chronical disk herniation.

PMID- 7785281
TI  - [Unexpected fatalities of patients in medical treatment].
AB  - Our results are based on 190 autopsy records of unexpectedly deceased patients in
      connection with medical treatment between 1984 and 1993. 161 times autopsy has
      been ordered by the local Public Health Office to establish cause of death. In 5
      of these cases indications of medical maltreatment were found and the cases had
      been brought to trial. Inspite of suspected problems with medical treatment the
      treating doctors certified natural death in 8 of these cases and autopsies were
      carried out by general pathologists. Secundarily these cases were brought to
      court and corpses were reexamined by forensic pathologists. 29 times autopsy has
      been ordered by court from the beginning. 102 patients (53.7%) died during
      medical treatment ("mors in tabula"), while 88 patients (46.3%) died within days
      or weeks after treatment. 135 fatal incidents occurred in surgery, 13 cases
      during diagnostic procedures or puncturing veins, 5 cases after drug
      administration, 5 cases during attempts at resuscitation, and 8 fatal cases
      during other special treatment. 11 times no medical treatment has been started
      (omission). Legal consequences of 42 cases done by court were: no accusation in
      48%, only accusation and cessation in 26%, condemnation in 21% and acquittal in
      5%.

PMID- 7785282
TI  - [A case of patient homicide].
AB  - The phenomenon of patient homicides committed by health service employees has, in
      the previous years, repeatedly aroused much attention. The cases made known in
      Germany, the USA, Holland, Norway, and Austria appear to provide evidence to the
      effect that we are not only dealing with unique incidents. The scientific
      investigation of this especially sensitive taboo-topic is, to date, missing. The
      judicial trials carried out emphatically indicate that culprit motives, colleague
      behavior, but also to a large extent decisions made by superiors remain unclear.
      It remains controversial, what effect working conditions, strain of employees,
      their level of education and personal viewpoints over such criminal acts they
      possess. Finally, the long latency period between the first internal suspicions
      and the responsible parties' appropriate reactions requires duplicatable
      explanation. The following paper presents a German single-case study of patient
      homicide by a female nurse. The focus on causality rests on the presentation of
      developments up to the point where the long-fermenting suspicion could no longer
      be dismissed, and appropriate consequences took place. The account largely avoids
      the "definite" findings required during the judicial process. It concerns rather
      above all an open, uncertain, and possibly without external influence course of
      development which in stages each colleague in the health professions can trace,
      to the point where the uncertain and horrifying suspicion became a certainty.
      With this single-case study in hand it is made understandable in which ways
      personal circumstances and professional conditions at the worksituation can
      intertwine in such a way that the original motivation to help turns into its
      abysmal opposite. It is the author's intention to make preventive learning
      possible through this single case study. Every employee in the health professions
      should proceed on the assumption that such occurrences could also in his own
      field of work come to pass. In this respect, it is of considerable importance to
      differentiate between hasty and untenable incriminations and original increasing
      early-warning signs.

PMID- 7785283
TI  - [Bioprosthesis degeneration and reoperation in the aortic and mitral position].
AB  - In agreement with our experiences from our first study 15 patients (8 men, 7
      women) underwent reoperation because of degeneration of bioprosthetic valves
      implanted in aortic or mitral position during the last 24 months. At reoperation
      4 patients had a more complex cardiac procedure (double valve replacement, double
      valve replacement with bypass grafting, valve replacement with enlargement of the
      valvular area). There was no acute operation and only 1 patient was serious
      symptomatic preoperatively (NYHA IV). We revealed a mean implantation time of
      126.4 months +/- 32.2 (median 130) for all bioprostheses without a significant
      difference in implant time regarding to aortic or mitral position. At reoperation
      bypass time (p = 0.001) and aortic clamp time (p = 0.011) was significantly
      longer compared to the first operation. There was no perioperative death, all
      patients are still alive and in good condition (8 of them NYHA I, 7 NYHA II). The
      early change of tissue degenerated bioprostheses can be carried out under
      elective conditions with improved postoperative outcome: mortality and morbidity
      remains acceptable low. In our group incremental risk factors for early mortality
      are severely affected patients with low functional status (NYHA IV) and acute
      operation. Preoperative coronary angiography remains essential for evaluation of
      concomitant coronary artery disease.

PMID- 7785286
TI  - The gynecological manifestations of Crohn's disease.

PMID- 7785287
TI  - Cap on malpractice awards.

PMID- 7785285
TI  - Caring for the diabetic patient.

PMID- 7785288
TI  - An unusual sonographic appearance of a chronic renal peritransplant lymphocele.
AB  - Lymphoceles are the most common renal peritransplant collections. They typically
      develop and progress within 6 months of transplantation. Clinical presentation is
      varied and includes azotemia, lower extremity edema, fever, weight gain,
      tenderness over the allograft, palpable mass, and thromboembolic complications.
      Herein, we present a chronic peritransplant lymphocele with unusually thick and
      irregular internal septae which could easily be mistaken for other complex
      peritransplant or pelvic masses. In this case, color Doppler flow imaging helped
      to limit the differential diagnosis as well as to guide appropriate intervention.
      Additionally, we describe the pathophysiology of lymphocele formation and
      treatment options.

PMID- 7785289
TI  - The Wisconsin Diabetes Control Program: a health systems and community-based
      approach.
AB  - The Wisconsin Diabetes Control Program will address the health needs of people
      with diabetes by working closely with the Wisconsin Affiliate of the American
      Diabetes Association and other diabetes health professionals in the state. The 5
      year program will use both health systems and community-based approaches to
      coordinate prevention, detection, and control activities required to reduce the
      burden of this chronic condition. This program represents a major shift in focus
      from previous diabetes control programs supported by the CDC, and is designed to
      establish the program as a key component of an evolving health care environment.

PMID- 7785290
TI  - A primary care perspective on "upgrading diabetes therapy" and NIDDM.

PMID- 7785284
TI  - [Expanded diagnostic possibilities for diagnosis and differential diagnosis of
      autoimmune hepatopathies using polymerase chain reaction (PCR)].
AB  - This is a report on a case of autoimmunehepatopathy with misleading virus
      serology: A 34-year old female patient presented with abdominal signs of
      hepatopathy at Graz University School of Medicine. Hepatitis-C virus (HCV)
      serology was strongly positive indicating virus contact. The cellular activation
      was elevated, additionally increased ds-DNA-titer and mitochondrial antibody
      titres including the subfraction M2 were increased. In view of the differential
      diagnosis and therapeutic consequences molecular biology was used for additional
      information and a PCR carried out. The latter excluded infection with HCV
      confirming a false positive virus serology. The patient was treated with
      ursodesoxycholic acid, steroids and enzymes. She improved and showed no viral
      exposure. We conclude, that molecular biology represents an essential tool for
      the diagnosis of some selected critical cases of autoimmune-diseases such as
      autoimmune hepatopathy with false positive virus serology, if the underlying
      etiopathogenesis is not clear.

PMID- 7785291
TI  - Effects of a high protein intake on renal acid excretion in bodybuilders.
AB  - Bodybuilders often prefer a high protein diet to achieve maximum skeletal muscle
      hypertrophy. In this study the effect of a high protein diet on renal acid load
      and renal handling of proton excretion was studied comparing dietary intake and
      urinary ionograms in 37 male bodybuilders and 20 young male adults. Energy intake
      (+ 7%), protein intake (128 vs 88 g/d/1.73 m2), and renal net acid excretion (95
      vs 64 mmol/d/1.73 m2) were higher in the bodybuilders than in the controls,
      however, urine-pH was only slightly lower (5.83 vs 6.12). In the bodybuilders
      renal ammonium excretion was higher at any given value of urine pH than in the
      controls. In a regression analysis protein intake proved to be an independent
      factor modulating the ratio between urine-pH and renal ammonium excretion. The
      concomitant increase of renal net acid excretion and maximum renal acid excretion
      capacity in periods of high protein intake appears to be a highly effective
      response of the kidney to a specific food intake leaving a large renal surplus
      capacity for an additional renal acid load.

PMID- 7785292
TI  - Olive oil- and sunflower oil-fried sardines in the prevention of rat
      hypercholesterolemia.
AB  - The effect of diets containing olive-oil-fried sardines (diet 1) or sunflower-oil
      fried sardines (diet 3) upon the serum cholesterol-raise induced by dietary
      cholesterol was studied after a 4-week experiment in growing Wistar rats. Results
      of diet 1 were compared to those obtained in diets containing casein plus olive
      oil (diet 2), whereas results of diet 3 were compared to those obtained with
      casein plus sunflower oil (diet 4). All diets contained cholesterol and bovine
      bile as a cholesterol-raising agent. The hypercholesterolemic effect of dietary
      cholesterol in fried-sardine groups (a total cholesterol (TC) increase of 0.9
      mmol/L (p < 0.05 and 0.4 mmol/L (not significant) in groups 1 and 3,
      respectively) was markedly lower than in groups 2 and 4 (a TC increase of 13.9
      mmol/L (p < 0.01) and 18.2 mmol/L (p < 0.01), respectively). Serum triglyceride
      levels decreased in fried-sardine diets (p < 0.05) while they increased in casein
      diets (p < 0.05). HDL-cholesterol levels appear lower in diet 1 than in diet 2 (p
      < 0.05), but similar in diets 3 and 4. However, HDL-fraction carries in diets 1,
      2, 3 and 4, 13%, 4%, 53% and 5% of TC, respectively. Results showed that fried
      sardine diets exert a powerful check effect on the cholesterol-raising effect
      induced by dietary cholesterol.

PMID- 7785293
TI  - [Mealtime patterns in a southern German population. Results from the WHO MONICA
      1984/1985 Augsburg nutritional survey project].
AB  - Seven-day food records of the MONICA project Augsburg dietary survey, which were
      collected between October 1984 and May 1985 in 899 men aged 45-64 years (random
      sample), were used to analyze meal patterns. Among other variables, the emphasis
      was placed on meal frequency and rhythm, frequency of meal combinations, place
      and time of meal intake as well as on the contribution of different meals to
      selected nutrient intake. Breakfast delivers 17%, lunch 29%, and dinner 33% of
      the total daily energy intake; all other meals (snacks) deliver 21% of the energy
      intake. The mean contribution of the three major meals, such as breakfast, lunch
      and dinner to daily protein intake is 14%, 36%, and 36%; to fat intake 17%, 33%,
      and 35%, and to carbohydrate intake 23%, 25%, and 29%, respectively. Data on meal
      patterns are useful for the development of preventive strategies.

PMID- 7785295
TI  - Variation of trans fatty acids in milk fats.
AB  - Trans fatty acids are discussed in connection with an increased risk of
      atherosclerosis. Therefore, the development of a rapid and exact measuring method
      for the determination of trans fatty acids in milk fat is of great interest.
      Using gas chromatographic analysis of the trans-octadecenoic fatty acids as well
      as of the triglycerides of 100 different milk fat samples a formula consisting of
      different triglycerides for the quick determination of trans contents was
      developed by means of statistical methods (standard deviation = 0.293%, r =
      0.9977). Subsequently, the seasonal variations of the trans contents in milk fat
      samples from a large milk collection area were determined using rapid
      triglyceride analyses. For the trans fatty acid contents of the 100 milk fat
      samples and the samples from the milk collection area scattering ranges of 1.91
      6.34 wt% resp. 1.97-4.37 wt% were found; the mean contents were 3.83 and 3.18
      wt%, and the median values 3.67 and 3.30 wt%, respectively.

PMID- 7785296
TI  - [Percutaneous mitral valvulotomy with the Inoue balloon in over 65-year-old
      patients--acute results and short-term follow-up in comparison with younger
      patients].
AB  - Percutaneous balloon mitral valvulotomy (PBMV) with the Inoue-balloon is a proven
      therapy in young patients with mitral stenosis. In this study, we investigated
      primary results in PBMV of elderly patients. In 383 patients with mitral stenosis
      PBMV was done with the Inoue-balloon. We compared primary success rates and short
      term follow-up of 287 (74.9%) < 65-year-old patients and 96 (26.1%) > or = 65
      year-old patients. Elderly patients were more likely to have atrial fibrillation
      (58% vs. 45%; p < 0.05), tricuspid regurgitation < or = II degrees (58% vs. 45%;
      p < 0.05), coronary artery disease (16% vs. 6%; p < 0.01), and previous pulmonary
      edema (42% vs. 30%; p < 0.05). PBMV was successful in 73.9% of the elderly and
      84.7% of the younger patients (p < 0.05). Mitral valve gradients could be reduced
      from 12.5 +/- 11.6 mm Hg to 6.2 +/- 6.8 mmHg (p < 0.001) in elderly patients and
      from 15.5 +/- 6.9 mm Hg to 7.0 +/- 3.2 mm Hg (p < 0.001) in younger patients.
      Mitral valve areas increased from 1.0 +/- 0.3 cm2 to 1.6 +/- 0.5 cm2 (p < 0.001)
      in elderly patients and from 1.0 +/- 0.3 cm2 to 1.7 +/- 0.4 cm2 (p < 0.001) in
      younger patients. No patient died during the procedure. Two younger patients had
      emergency surgery because of pericardial tamponade following transseptal
      puncture. After PBMV elderly patients had more often an increase of mitral
      regurgitation (47% vs. 35%; p < 0.05) without need of an emergency mitral valve
      replacement.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785294
TI  - [Improved microbiological assay of heterocyclic aromatic amines in cooked food].
AB  - Heating of protein, especially muscle meat and meat extracts, can result in the
      formation of heterocyclic aromatic amines (HA) which are carcinogenic in animals.
      They are therefore unwelcome in human food. Here, an improved method for the
      microbiological assay of HA is reported; it makes use of the high mutagenic
      potency of HA in the Ames test and of the new Salmonella typhimurium strain
      YG1024 instead of strain TA98. The high sensitivity of the new strain is a
      consequence of its high acetyltransferase activity which results in a more
      efficient formation of genotoxic HA metabolites. The mutagenic activity of three
      selected HA in YG1024 is 10-20 times higher than that in TA98. This method can be
      used for the analysis of the HA content of food. A study of meat patties revealed
      significant differences in the mutagenic activity in the center and crust and of
      home-made and commercial patties; in both, the mutagenic activity was localized
      in the crust.

PMID- 7785298
TI  - [Dynamic obstruction of the left ventricular outflow tract by prosthesis
      dysfunction].
AB  - We report on a case of dynamic left ventricular (LV) outflow tract obstruction
      combined with a prosthetic valve dysfunction 13 years following mitral valve
      replacement with a Hancock bioprosthesis in a 46-year-old patient. Previously,
      repeated echocardiographic controls had been performed at regular intervals and
      the prosthesis had been found to be oversized and seated in abnormal position,
      with projection of the struts into the LV outflow tract. Moreover, a mild chronic
      LV outflow tract obstruction had been diagnosed upon intermittent findings of
      relatively high velocity in the outflow tract. Clinically, however, the patient
      had been stable and the function of the prosthesis had been good. With the onset
      of the mitral regurgitation due to prosthesis failure, a dynamic obstruction to
      LV outflow occurred, with severe narrowing of the LV outflow tract by a strut of
      the bioprosthesis during systole. Subsequently, a low cardiac output syndrome
      developed. The patient was referred for a mitral valve reoperation. The valve was
      replaced with a Sorin Bileaflet Carbon prosthesis. On the setting of a mild
      chronic LV outflow obstruction due to the oversized prosthesis and its abnormal
      position, hypercontractile cardiac function as a result of mitral regurgitation
      may have caused the dynamic and symptomatic LV outflow tract obstruction.

PMID- 7785297
TI  - [Results of valve-sparing correction of aortic valve insufficiency].
AB  - The risk of valve-related complications and the necessity of anticoagulation in
      patients with prosthetic valves, has led to new operative techniques in the
      correction of severe aortic insufficiency. In the last 2 years, 35 patients (mean
      age 41.3 years, range 10-80 years) with aortic insufficiency underwent
      reconstructive valves surgery. Eighteen patients had a commissuroplasty with or
      without triangular resection. In 5 patients with perforation, the valves could be
      reconstructed with a pericardial patch. In 12 patients with insufficiency due to
      aortic aneurysm, the valves were resuspended within the aortic prosthesis. In 2
      patients the aortic valves were replaced intraoperatively because of
      unsatisfactory results. The perioperative mortality was 5.7%. The
      echocardiographic degree of aortic insufficiency decreased from 3.3 +/- 0.5
      preoperatively to 0.45 +/- 0.53 postoperatively. Two patients were reoperated
      within the first week. Five of 23 patients at 1-year follow-up have mild to
      moderate aortic insufficiency. Mean ventricular dimensions and function at
      discharge and after 1-year follow-up are normal. With the new operative
      techniques described recently, valve-sparing corrections of aortic insufficiency
      are possible in an increasing number of patients, and autologous valve tissue can
      be saved. With more refinement of surgical technique, early postoperative results
      will further improve.

PMID- 7785299
TI  - [Experiences with the new cardioverter-defibrillator Ventak PRxII].
AB  - Clinical safety and efficacy of the new third-generation implantable cardioverter
      defibrillator (ICD) Ventak PRxII was studied in 50 patients (pts) with
      ventricular tachycardia (VT) and/or fibrillation (VF). In 23 pts (46%) the ICD
      was implanted with a transvenous lead system as first implant and 27 pts (54%)
      received the Ventak PRxII as generator replacement. Intraoperatively, the mean
      defibrillation threshold (DFT) was 13 +/- 8 joules and 12 +/- 8 joules,
      respectively. One pt died perioperatively. During a follow-up of 5.3 +/- 3.8
      months 3 patients died due to heart failure. During follow-up 1060 arrhythmia
      episodes (AE) occurred and were terminated primarily by countershock in 121 AE
      (11%). Antitachycardia pacing (ATP) was tried in 939 AE (89%) and was successful
      in 878 AE (94%). Acceleration was present in 6 AE (< 1%). We conclude that there
      is a high efficacy rate in AE termination by the Ventak PRxII, using ATP or
      countershock. Therefore, the Ventak PRxII allows a flexible approach to cardiac
      rhythm management.

PMID- 7785300
TI  - [The T-wave shock: a new reliable method for induction of ventricular
      fibrillation in ICD testing].
AB  - During ICD-implantation it is necessary to induce ventricular fibrillation
      several times to determine the defibrillation threshold. In third generation ICDs
      there are several options to induce ventricular fibrillation. We want to present
      a new method, called T-wave-shock, which is first available in the PCD Jewel 7219
      (Medtronic). The T-wave-shock is the delivery of a low-energy-shock into the
      vulnerable period after ventricular stimulation with a basic cycle-length. We
      applied the T-wave-shock in 46 consecutive ICD-recipients intraoperatively and at
      the pre-hospital-discharge test. The method is highly effective when applying the
      shock into the ascending part of the T-wave (98% of the patients were inducible),
      and the duration of cardial and cerebral ischemia during induction is short
      (between 3.1 and 3.8 s). This raises defibrillation efficacy.

PMID- 7785301
TI  - [Modern electrodes with and without steroid: effects on stimulation current of
      cardiac pacemakers].
AB  - The aim of the investigation was to test whether new leads without steroid, a
      meshwire tip leads (Ionyx 4180, CPI; n = 10) and a carbon tip lead (Facet ITP 13,
      Vitatron; n = 10), have electrical characteristics similar to a new steroid
      eluting tip lead (CapSure SP 4023, Medtronic; n = 10) and their impact on the
      pacemaker's pacing current. Pacing thresholds, impedance, and R-wave amplitudes
      measured at implantation were similar for the three leads. One, 4 and 12 weeks
      after implantation both nonsteroid leads had significantly higher pacing
      thresholds at 0.1 and 0.3 ms pulse duration in comparison to the steroid lead
      (after 12 weeks at 0.3 ms steroid: 0.9 +/- 0.2 V, carbon: 2.1 +/- 0.5 V;
      meshwire: 1.5 +/- 0.5 V). This result was restricted to the carbon lead after 52
      weeks. At 0.5 ms pulse duration higher pacing thresholds were obtained for the
      carbon lead (after 12 weeks at 0.5 ms; steroid: 0.8 V, carbon: 1.7 +/- 0.6 V;
      meshwire: 1.1 +/- 0.4 V). Impedance of the steroid lead was 531 +/- 61 ohms, 535
      +/- 54 ohms, and 511 +/- 50 ohms, respectively, after 4, 12, and 52 weeks,
      whereas the carbon lead had significantly higher values with 652 +/- 84 ohms, 669
      +/- 93 ohms, and 657 +/- 107 ohms, respectively. The impedance of the meshwired
      lead (4 weeks: 585 +/- 92 ohms; 12 weeks: 592 +/- 89 ohms; 52 weeks: 550 +/- 130
      ohms) did not differ from the steroid lead.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785302
TI  - [An unusual series of complications in therapy with implantable cardioverter
      defibrillator].
AB  - A 48-year-old man with dilative cardiomyopathy and a history of resuscitation due
      to ventricular fibrillation received an implantable cardioverter-defibrillator
      (ICD) with epicardial sensing and defibrillation electrodes in March 1990. An
      early battery depletion due to increased electrical leakage of a filter capacitor
      necessitated a generator exchange in July 1990. Subsequent inappropriate
      discharges occurred, but no underlying cause could be documented by history,
      clinical examination, Holter monitoring, and beepograms. Only 3 months later was
      it possible to demonstrate oversensing by repeated beepograms, and a new
      generator and transvenous sensing electrode were implanted in October 1991. Four
      months later, inappropriate shocks were suspected again. Once more, history,
      clinical examination, Holter monitoring, and beepograms were without pathological
      result. At follow-up, repeated beepograms during exercise demonstrated an
      oversensing, and an insulation defect of the newly implanted sensing electrode
      close to the edge of the generator could be documented on x-ray. Since
      replacement of generator and sensing electrode in July 1992 the patient is doing
      well. He received two appropriate shocks which were associated with presyncope.
      ICD therapy is very complex and therefore should only be performed in centers
      providing the necessary personal, apparative and logistic conditions.

PMID- 7785303
TI  - [Autoantibodies against cardiac myosin in patients with myocarditis and dilated
      cardiomyopathy].
AB  - Evidence accumulated in recent years indicates that autoimmunologic mechanisms
      may play an important role in the pathogenesis of myocarditis and dilated
      cardiomyopathy. In animal studies with Coxsackie B3-virus-induced murine
      myocarditis circulating autoantibodies against cardiac myosin have been detected.
      The present study investigates whether in patients with myocarditis and dilated
      cardiomyopathy antimyosin-autoantibodies can be detected. Patients with other
      cardiac diseases and healthy blood donors were used as controls. In 30 of 62
      (48.4%) patients with myocarditis antimyosin-antibodies could be detected,
      whereas in patients with dilated cardiomyopathy only 10 of 41 (24.4%) sera
      contained antimyosin-antibodies (p < 0.05). In patients with other cardiac
      diseases, 9 of 43 (21%) sera showed antimyosin-autoantibodies (p < 0.05 vs
      myocarditis, not significant vs DCM). In healthy blood donors, antimyosin
      autoantibodies could only be detected in 1 of 39 (2.5%) sera. In Western-blot
      tests, the antimyosin-antibodies in patients with myocarditis bound to the myosin
      heavy chain. Protein A-Sepharose chromatography showed that the antimyosin
      autoantibodies are of the IgG-type. No organ-specificity of the antibodies for
      cardiac myosin could be detected, and the antimyosin-autoantibodies bind equally
      to myosin prepared from either cardiac or skeletal muscle, respectively.

PMID- 7785304
TI  - [Presentation and quantification of acute myocardial infarct using antibody-bound
      MR contrast medium].
AB  - A magnetically labeled antimyosin (MION-AM) has previously been developed for
      immunospecific MR imaging in vivo. The current study was designed to extend
      previous feasibility studies and to correlate MR infarct size to that determined
      by histopathology. The left anterior coronary artery (LAD) was temporarily
      occluded in rabbits (n = 10) and subsequently reperfused for 1 h prior to the
      administration of 100 mumol Fe/kg of MION-AM (corresponding to 0.5 mg AM). One
      hour after i.v. administration, the infarcted myocardium appeared hypointense by
      MRI as a result of target-specific attachment of the magnetic T2 label to damaged
      but not normal myocardium. There was a close correlation between infarct size
      determined by MR and pathology (SE 2500/30: r = 0.92, p < or = 0.0001; SE
      2500/60: r = 0.85, p < or = 0.0001). Our results are evidence that a)
      immunospecific magnetic probes can be utilized for cardiac MR imaging, and b)
      that these or similar agents may aid in the quantitation of myocardial infarct
      size.

PMID- 7785306
TI  - [Traumatic aortic rupture: diagnosis using biplanar transesophageal
      echocardiography].
AB  - Acute aortic rupture is a typical consequence of severe blunt chest trauma often
      associated with rapid deceleration in car accidents. Initial diagnostic findings
      are often misleading and multiorgan injuries add to the diagnostic complexity;
      therefore, the natural history of acute rupture is usually fatal during the first
      24 h after injury if left untreated. Prompt and simple diagnosis is, hence, of
      paramount importance for successful treatment of acute aortic rupture.
      Transesophageal echocardiography, particularly with a biplane or multiplane
      probe, currently represents the diagnostic tool of choice to meet these criteria;
      because of its high sensitivity and specificity transesophageal echocardiography
      will replace aortography as "gold standard" for diagnosis of acute aortic
      rupture. We report on a 47-year-old woman with severe blunt thoraco-abdominal
      trauma resulting from a car accident; at hospital admission abdominal injuries
      were predominant and diagnosis of an acute rupture of the descending thoracic
      aorta was made only about 18 h after admission using biplane transesophageal
      echocardiography. Emergency surgical revision confirmed the diagnosis of complete
      transsection of the descending thoracic aorta immediately after the origin of the
      left subclavian artery; the site of transsection was surrounded by a large
      hematoma. Despite successful reconstruction of the descending thoracic aorta by
      means of graft interposition, a recurrent local bleeding event lead to complete
      circulatory destabilization and, finally, to the death of the patient.

PMID- 7785305
TI  - [Magnetic resonance tomography findings in adult patients with congenital
      corrected transposition of great arteries].
AB  - In four adult patients with congenitally corrected transposition (C-TGA) of the
      great arteries the typical anatomy and relevant additional lesions such as
      perimembranous ventricular septal defect (n = 3), secundum atrial septal defect
      (n = 2), sub-/valvular pulmonic stenosis (n = 3) and pulmonary artery dilatation
      (n = 4) and/or relevant tricuspid valve insufficiency (n = 3) were depicted by
      magnetic resonance imaging (MRI) using spin-echo and gradient-echo techniques.
      The severity of the additional lesions could be evaluated qualitatively.
      Therefore, in cases of C-TGA magnetic resonance imaging may provide additional
      information or in selected patients may serve as a useful alternative to
      conventional imaging techniques such as echocardiography and angiocardiography.

PMID- 7785307
TI  - [The organized brain (an essay on the structure of functional brain
      organization). II].
AB  - This communication is dedicated to the main postulates of the author's conception
      about systematic-structural organization of the cerebral functions--the
      principles of the space and temporal dispersion of the external and internal
      signals, the division of connections on the mono- and oligoprojections as well as
      hierarchic stage of fashion and modulation of entering information, the
      functional multifactory of the sensory stimuli as well as principles of
      overlapping both afferent and efferent influences and their mutual regulation.
      The principle of the change of dominant participation of one brain system to
      another within the behavioral act's formation is one of the main postulate of our
      conception. These data testify to very complicate dynamic character of the
      function's correlation with the brain structures. This correlation depends on the
      self cerebral organization as well as the role in its acting the diverse afferent
      messages and effector reactions.

PMID- 7785308
TI  - [The morphofunctional bases of forebrain and cerebellum interaction].
AB  - The article reviews data on structural and functional basis of forebrain and
      cerebellum interactions. The results of studies of cortical and thalamic
      structures' neuronal activity under cerebellar influence are considered. Specific
      and nonspecific cerebello-thalamo-cortical projection systems are analysed. Data
      on functioning of corticocerebellar loops as well as synaptic transmission in its
      various links are given. Hypotheses and modern ideas of cerebellocortical
      interaction' mechanisms are discussed.

PMID- 7785309
TI  - [The action of high-molecular linear polymers on the circulatory system].
AB  - An analysis of the hemodynamic consequences of the injections of long linear
      polymers with high molecular weight is introduced. These injections lead to an
      increase of the cardiac output, to a decrease of the blood pressure, and hence
      cause a reduction of the resistance to blood flow. It follows that such kind of
      polymers is able to normalize hemodynamics under some pathophysiological
      conditions, e.g., during experimental atherosclerosis, ischemic state,
      hemorrhagic shock. An addition of drag-reducing polymers into the blood system is
      associated with a modification of the blood flow microstructure itself.

PMID- 7785310
TI  - [The neuroendocrine regulation of gonadotropin and prolactin secretion and the
      role of neuromediators].
AB  - The paper deals with the neuroendocrine relationships between true neuromediators
      of adrenergic and cholinergic nature as well as the neuromediators of peptidic
      character and the neurosecretory neurons controlling the secretion of
      gonadotropines and prolactine. The properties of about 30 neuromediators of
      different character with consideration for the structures of the central nervous
      system, participation in the synthesis and secretion of gonadoliberine,
      gonadotropines and prolactine and hence functioning of the reproductive system as
      a whole are characterized. The significance of the hormonal background of sexual
      steroids in the system of these complex relationships is analyzed. The author's
      and literature findings on the time-course of changing the contents of
      catecholamines in the hypothalamic structures relating to the control of the
      gonadotropic function of pituitary body are studied; the correlation
      relationships between a changed level of sexual steroids and gonadotropines in
      the blood during the cycle and the time-course of changing the catecholamines and
      luliberine in the hypothalamus are discussed. The possible mechanisms of
      coordinating the different neuromediators of adrenergic character and amino
      neuromediators with various mechanisms of action in the regulation of normal
      activity of the reproductive system are investigated.

PMID- 7785312
TI  - [The physiological classification of human thermal states under high
      environmental temperatures].
AB  - The paper deals with the physiological classification of human thermal states in
      a hot environment. A review of the basic systems of classifications of thermal
      states is given, their main drawbacks are discussed. On the basis of human
      functional state research in a broad range of environmental temperatures the
      system of evaluation and classification of human thermal states is proposed. New
      integral one-dimensional multi-parametric criteria for evaluation are used. For
      the development of these criteria methods of factor, cluster and canonical
      correlation analyses are applied. Stochastic nomograms capable of identification
      of human thermal state for different intensity of influence are given. In this
      case evaluation of intensity is estimated according to one-dimensional criteria
      taking into account environmental temperature, physical load and time of man's
      staying in overheating conditions.

PMID- 7785311
TI  - [The mechanisms of the temperature sensitivity of the hypothalamic neurons].
AB  - Studies of the 1960-80-s in intact animals and brain slices showed the existence
      of brain temperature-sensitive neurons in the vertebrate hypothalamus. Increased
      firing rate of these units activates the thermoregulatory processes. Applications
      of synaptic blockade in slices, and of intracellular recordings and clamp
      technique in the last 3-4 years allowed to find that many hypothalamic
      thermosensitive neurons possess an intrinsic mechanism of temperature sensitivity
      central to. This mechanism is a change in ionic permeability of neuronal
      membrane. The review summarizes the results of these studies and considers
      possible causes of thermo-induced changes in ionic conductivity of hypothalamic
      thermosensitive neuron membrane.

PMID- 7785313
TI  - [The role of the substantia nigra in the mechanisms of the cessation of epileptic
      activity].
AB  - In the review of literature and author's own data the participation of pars
      compacta and pars reticulata of the substantia nigra in mechanisms of epileptic
      syndrome development and cessation of epileptic activity was shown. The results
      are given which testified for dependence of substantia nigra-derived effects upon
      form and intensity of epileptic activity as well as upon neuromediator and
      peptidergic systems of the brain involvement. The conclusion was made concerning
      the significance of substantia nigra as a part of antiepileptic system of the
      brain in the processes of restriction and suppression of epileptiform
      manifestations.

PMID- 7785314
TI  - Complete nucleotide sequence of RNA segment 3 of bluetongue virus serotype 2 (Ona
      A). Phylogenetic analyses reveal the probable origin and relationship with other
      orbiviruses.
AB  - The nucleotide sequence of the RNA segment 3 of bluetongue virus (BTV) serotype 2
      (Ona-A) from North America was determined to be 2772 nucleotides containing a
      single large open reading frame of 2703 nucleotides (901 amino acid). The
      predicted VP3 protein exhibited general physiochemical properties (including
      hydropathy profiles) which were very similar to those previously deduced for
      other BTV VP3 proteins. Partial genome segment 3 sequences, obtained by
      polymerase chain reaction (PCR) sequencing, of BTV isolates from the Caribbean
      were compared to those from North America, South Africa, India, Indonesia,
      Malaysia and Australia, as well as other orbiviruses, to determine the
      phylogenetic relationships amongst them. Three major BTV topotypes (Gould, A.R.
      (1987) Virus Res. 7, 169-183) were observed which had nucleotide sequences that
      differed by approximately 20%. At the molecular level, geographic separation had
      resulted in significant divergence in the BTV genome segment 3 sequences,
      consistent with the evolution of distinct viral populations. The close
      phylogenetic relationship between the BTV serotype 2 (Ona-A strain) from Florida
      and the BTV serotypes 1, 6 and 12 from Jamaica and Honduras, indicated that the
      presence of BTV serotype 2 in North America was probably due to an exotic
      incursion from the Caribbean region as previously proposed by Sellers and Maaroof
      ((1989) Can. J. Vet. Res. 53, 100-102) based on trajectory analysis. Conversely,
      nucleotide sequence analysis of Caribbean BTV serotype 17 isolates suggested they
      arose from incursions which originated in the USA, possibly from a BTV population
      distinct from those circulating in Wyoming.

PMID- 7785315
TI  - Expression in Escherichia coli and purification of biologically active L
      proteinase of foot-and-mouth disease virus.
AB  - The foot-and-mouth disease virus (FMDV) Lb gene was cloned into bacterial
      expression vectors under the control of a T7 RNA polymerase promoter. The Lb
      protein was expressed in both an in vitro transcription-translation system and in
      Escherichia coli. In vitro expression of a construct containing the Lb gene fused
      to a portion of the VP4 and 3D genes demonstrated cis cleavage activity that
      could be blocked by the thiol protease inhibitor E-64. Lb expressed in E. coli
      was purified from the soluble fraction by metal chelation chromatography.
      Purified Lb had trans cleavage activity at the L/P1 junction and cleaved the p220
      component of the cap-binding protein complex.

PMID- 7785316
TI  - Molecular characterization of the S proteins of two enterotropic murine
      coronavirus strains.
AB  - Enterotropic strains of murine coronaviruses (MHV-Y and MHV-RI) differ
      extensively in their pathogenesis from the prototypic respiratory strains of
      murine coronaviruses. In an effort to determine which viral proteins might be
      determinants of enterotropism, immunoblots of MHV-Y and MHV-RI virions using anti
      S, -N and -M protein-specific antisera were performed. The uncleaved MHV-Y and
      MHV-RI S proteins migrated slightly faster than the MHV-A59 S protein. The MHV-Y
      S protein was inefficiently cleaved. The MHV-Y, MHV-RI and MHV-A59 N and M
      proteins showed only minor differences in their migration. The S genes of MHV-Y
      and MHV-RI were cloned, sequenced and found to encode 1361 and 1376 amino acid
      long proteins, respectively. The presence of several amino acids changes upstream
      from the predicted cleavage site of the MHV-Y S protein may contribute its
      inefficient cleavage. A high degree of homology was found between the MHV-RI and
      MHV-4 S proteins, whereas the homology between the MHV-Y S protein and the S
      proteins of other MHV strains was much lower. These results indicate that the
      enterotropism of MHV-RI and MHV-Y may be determined by different amino acid
      changes in the S protein and/or by changes in other viral proteins.

PMID- 7785317
TI  - Characterization of a protein kinase gene from two Chlorella viruses.
AB  - An open reading frame (ORF) with strong homology to eukaryotic serine/threonine
      protein kinases was found in the two Chlorella viruses SC-1A and PBCV-1. The
      deduced molecular weights of each putative protein kinase were 35 kDa and the
      predicted amino acid sequences of the two proteins were 95% identical. The ORF
      encoding the SC-1A protein kinase was over-expressed as a fusion protein in
      Escherichia coli. The recombinant fusion protein had autophosphorylation activity
      and could phosphorylate certain exogenous proteins. Antiserum against the
      recombinant fusion protein reacted with a 35 kDa protein plus three larger
      proteins from virus infected cells. The 35 kDa protein was a late protein;
      however, the 35 kDa protein was not packaged in the virion, even though virions
      contain protein kinase activity.

PMID- 7785318
TI  - Analysis of flavivirus envelope proteins reveals variable domains that reflect
      their antigenicity and may determine their pathogenesis.
AB  - Studies on the molecular basis of flavivirus neutralisation, attenuation and
      tropism indicate that amino acid substitutions, in different parts of the
      envelope gene, may be responsible for the altered phenotypes. However, the
      association of particular substitutions with individual characteristics has
      proven difficult. Comparative analysis of all known tick-borne flavivirus
      envelope proteins through sequence alignment and a sliding window, reveals
      clusters of amino acid variation distributed throughout the envelope protein
      coding region. Further comparison with mosquito-borne flaviviruses reveals
      essentially the same profile of variability throughout the envelope protein
      sequence although there is a major difference within the postulated B domain of
      these viruses which may reflect their different evolutionary development. Most
      phenotypically variant properties, such as serotypic differences, variants
      characteristic of vaccine strains, altered tropisms and neutralisation escape
      mutants, map within the variable clusters. Thus, we propose that natural
      mutagenesis and selection may occur at specific sites that do not destroy the
      secondary and tertiary E protein structure and that the variable clusters
      represent the exposed surface amino acids of the envelope protein defining
      antigenicity, tropicity and pathogenesis.

PMID- 7785319
TI  - Receptor proteins on newborn Balb/c mouse brain cells for coxsackievirus B3 are
      immunologically distinct from those on HeLa cells.
AB  - Newborn Balb/c mice are highly susceptible to infection by the six coxsackievirus
      serotypes of group B (CVB) and it is known that receptor for these viruses are in
      highest concentration in the brain as compared to other tissues. Therefore,
      proteins from the brain tissues of these animals were solubilized (Brain-Ext) and
      characterized for the identification of mouse brain receptor (MBR) proteins.
      Virus-blot analyses of Brain-Ext suggested that each of three virus variants of
      CVB3-(N, W and RD) recognized four receptor proteins designated p46, p44, p36 and
      p33 according to their molecular size. Similar analyses of cultured neurons from
      newborn Balb/c mice revealed the presence of the same four receptor proteins,
      while astrocytes appeared to possess only p46 and/or p44. Isoelectric focusing of
      Brain-Ext, focused MBR proteins in the pH range 4.0-8.5, with a peak around pH
      5.7. P46 was found to be neuraminidase sensitive. A polyclonal rat antiserum
      (anti-MBR) protected cultured neurons and astrocytes against infection by CVB3,
      inhibited virus binding to these cells and recognized the same four receptor
      proteins on western-blots as detected on virus-blots by CVB3. However, a rabbit
      polyclonal anti-HeLa cell antiserum, which strongly binds to HeLa cells and
      protects them from CVB3 infection, neither recognized any of the receptor
      proteins in western-blot analyses of Brain-Ext nor inhibited CVB3 infection on
      cultured neurons and astrocytes. Conversely, anti-MBR did not recognize any of
      the receptor proteins by western-blot analysis of HeLa cell extracts nor did it
      inhibit CVB3 infection of HeLa cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785321
TI  - A map of the Kluyveromyces lactis genome.

PMID- 7785320
TI  - Localization of a protein A-tagged Kex2 protein to the vacuole of Saccharomyces
      cerevisiae allows rapid purification of vacuolar membranes.
AB  - We have previously reported an immunoisolation procedure which allows
      purification of Kex2p-containing Golgi membranes from lysed yeast cells. In order
      to evaluate the use of tagging procedures in organelle isolation we set out to
      isolate the same Golgi membrane fraction using a version of the Kex2 protease
      that had been affinity-tagged at its C-terminus. This protein is found to be
      localized in the vacuole, providing the basis of a method for the affinity
      purification of vacuolar membranes.

PMID- 7785322
TI  - Molecular analysis of the SNF8 gene of Saccharomyces cerevisiae.
AB  - Mutations in the SNF8 gene impair derepression of the SUC2 gene, encoding
      invertase, in response to glucose limitation of Saccharomyces cerevisiae. We
      report here the cloning of the SNF8 gene by complementation. Sequence analysis
      predicts a 26,936-dalton product. Disruption of the chromosomal locus caused a
      five-fold decrease in invertase derepression, defective growth on raffinose, and
      a sporulation defect in homozygous diploids. Genetic analysis of the interactions
      of the snf8 null mutation with spt6/ssn20 and ssn6 suppressors distinguished SNF8
      from the groups, SNF1, SNF4 and SNF2, SNF5, SNF6. Notably, the snf8 ssn6 double
      mutants were extremely sick. Mutations of SNF8 and SNF7 showed similar phenotypes
      and genetic interactions, and the double mutant combination caused no additional
      phenotypic impairment. These findings suggest that SNF7 and SNF8 are functionally
      related.

PMID- 7785323
TI  - Effects of phleomycin-induced DNA damage on the fission yeast Schizosaccharomyces
      pombe cell cycle.
AB  - The effect of phleomycin, a bleomycin-like antibiotic, has been investigated in
      the fission yeast, Schizosaccharomyces pombe. We report that in response to
      phleomycin-induced DNA damage, growth was inhibited and S. pombe cells arrested
      in the G2-phase of the cell cycle. DNA repair mutants rad9 and rad17 did not
      arrest and were hypersensitive to phleomycin. Cell cycle mutants that entered
      mitosis without monitoring the completion of DNA replication also displayed an
      increased sensitivity to this DNA-damaging agent. Thus, phleomycin could be used
      as a tool in the fission yeast S. pombe model system for the study of DNA damage
      and cell cycle checkpoints, or as a new selective agent.

PMID- 7785324
TI  - Genetic and carbon source regulation of phosphorylation of Sip1p, a Snf1p
      associated protein involved in carbon response in Saccharomyces cerevisiae.
AB  - The SIP1 gene of Saccharomyces cerevisiae is a carbon-catabolite-specific
      negative regulator of GAL gene transcription and acts as a multicopy suppressor
      of growth defects associated with impaired Snf1p protein kinase activity. The
      Sip1 protein is known to undergo phosphorylation when associated in vitro with
      the Snf1 protein kinase. We have carried out in vivo studies of the genetic and
      carbon control of Sip1p phosphorylation. Metabolic labeling reveals
      phosphorylation of Sip1p under both carbon catabolite-repressing and non
      repressing conditions and in both SNF1 wild-type and snf1-deletion cells. By
      sodium dodecyl sulfate-polyacrylamide gel electrophoresis immunoblot assay, we
      detect apparent changes in Sip1p phosphorylation states in response to changes in
      carbon source. At least one dephosphorylation of Sip1p occurs with a shift from
      non-repressing carbon source to repressing carbon source. The MIG1 gene, acting
      through SNF1-dependent and SNF1-independent pathways, is required for some Sip1p
      phosphorylations. REG1 appears to be required for at least one dephosphorylation
      of Sip1p, whereas SSN6 appears to be required for at least one phosphorylation of
      Sip1p. These results reveal new complexities in carbon response signaling, and
      may reflect the involvement of the Sip1 protein in the same complex as the Mig1
      and Ssn6 proteins.

PMID- 7785326
TI  - The IFH1 gene product interacts with a fork head protein in Saccharomyces
      cerevisiae.
AB  - FHL1 encodes a polypeptide closely related to the fork head protein family of
      transcriptional activators. Deleting this gene leads to a slow-growth phenotype
      with impaired rRNA maturation. IFH1 (located on chromosome IV) was isolated as a
      dosage-dependent suppressor partially correcting the growth defect of the fhl1
      deletion. It codes for a highly hydrophilic protein with a predicted molecular
      weight of 122 kDa and a pI of 4.8, that is very rich in charged residues (mostly
      acidic) but otherwise unrelated to any known protein. Carboxy-terminal deletions
      removing the last third of the protein lead to a leaky growth phenotype with
      impaired rRNA maturation, as in the case of the fhl1 deletion. A full deletion of
      IFH1 is lethal, but growth was restored in a strain deleted for both IFH1 and
      FHL1. Thus, Ifh1p is essential for growth, but only in the presence of a
      functional Fhp1p protein. Conversely, its overexpression by increased gene dosage
      partially compensates for the genetic inactivation of Fhl1p. These data suggest a
      direct interaction between the Fhl1p and Ifh1p proteins, and are consistent with
      a model where Fhl1p is converted from a transcriptional repressor to an activator
      on binding of Ifh1p.

PMID- 7785325
TI  - UASNTR functioning in combination with other UAS elements underlies exceptional
      patterns of nitrogen regulation in Saccharomyces cerevisiae.
AB  - UASNTR, the UAS responsible for nitrogen catabolite repression-sensitive
      transcriptional activation of many nitrogen catabolic genes in Saccharomyces
      cerevisiae, has been previously thought to operate only as a pair of closely
      related dodecanucleotide sites each containing the sequence GATAA at its core.
      Here we show that a single UASNTR the unrelated cis-acting element was TTTGTTTAC
      situated upstream of GLN1, while in another the cis-acting element was the one
      previously shown to bind the PUT3 protein. When a UASNTR site functions in
      combination with an unrelated site, the regulatory responses observed are a
      hybrid consisting of characteristics derived from both the UASNTR site and the
      unrelated site as well. These observations resolve several significant
      inconsistencies that have plagued studies focused on elucidation of the
      mechanisms involved in the global regulation of nitrogen catabolism.

PMID- 7785327
TI  - Vacuolar carboxypeptidase Y of Saccharomyces cerevisiae is glycosylated, sorted
      and matured in the fission yeast Schizosaccharomyces pombe.
AB  - Vacuolar carboxypeptidase Y of Saccharomyces cerevisiae (CPYsc) has been
      expressed in a Schizosaccharomyces pombe strain devoid of the endogenous
      equivalent peptidase, employing a 2 mu derived plasmid. Immunoblot analysis
      revealed that CPYsc produced in the fission yeast has a higher molecular mass
      than mature CPYsc produced by the budding yeast. CPYsc is glycosylated when
      expressed in S. pombe and uses four N-linked glycosylation sites as shown by
      endoglycosidase H digestion. Carbohydrate removal leads to a protein moiety which
      is indistinguishable in size from deglycosylated CPYsc produced by S. cerevisiae.
      CPYsc isolated from S. pombe soluble extracts is enzymatically active and thus is
      presumed to undergo correct proteolytic maturation. Subcellular fractionation
      experiments showed a cofractionation of CPYsc with the S. pombe endoproteinases
      PrA and PrB, suggesting that the protein is correctly sorted to the vacuole and
      that these peptidases might be responsible for zymogen activation.

PMID- 7785329
TI  - Current awareness on yeast.

PMID- 7785328
TI  - Sequence, mapping and disruption of CCC2, a gene that cross-complements the
      Ca(2+)-sensitive phenotype of csg1 mutants and encodes a P-type ATPase belonging
      to the Cu(2+)-ATPase subfamily.
AB  - We have isolated, sequenced, mapped and disrupted a gene, CCC2, from
      Saccharomyces cerevisiae. This gene displays non-allelic complementation of the
      Ca(2+)-sensitive phenotype conferred by the csg1 mutation. Analysis of the CCC2p
      amino acid sequence reveals that it encodes a member of the P-type ATPase family
      and is most similar to a subfamily thought to consist of Cu2+ transporters,
      including the human genes that mutate to cause Wilson disease and Menkes disease.
      The ability of this gene, in two or more copies, to reverse the csg1 defect
      suggests that Ca(2+)-induced death of csg1 mutant cells is related to Cu2+
      metabolism. Cells without CCC2 require increased Cu2+ concentrations for growth.
      Therefore CCC2p may function to provide Cu2+ to a cellular compartment rather
      than in removal of excess Cu2+.

PMID- 7785330
TI  - Cloning and heterologous expression of the Candida albicans gene PMI 1 encoding
      phosphomannose isomerase.
AB  - Using a DNA fragment derived from the Saccharomyces cerevisiae phosphomannose
      isomerase (PMI) structural gene as a probe against a random ordered array library
      of genomic DNA from the pathogenic fungus Candida albicans, we have cloned the C.
      albicans PMI 1 gene. This gene, which is unique in the C. albicans genome, can
      functionally complement PMI-deficient mutants of both S. cerevisiae and
      Escherichia coli. The DNA sequence of the PMI 1 gene predicts a protein with
      64.1% identity to PMI from S. cerevisiae. Sequential gene disruption of PMI 1
      produces a strain with an auxotrophic requirement for D-mannose. The heterologous
      expression of the PMI 1 gene at levels up to 45% of total cell protein in E. coli
      leads to partitioning of the enzyme between the soluble and particulate
      fractions. The protein produced in the soluble fraction is indistinguishable in
      kinetic properties from the material isolated from C. albicans cells.

PMID- 7785331
TI  - Tandem integration of multiple ILV5 copies and elevated transcription in
      polyploid yeast.
AB  - An industrial yeast strain was modified by introducing DNA into brewing yeast
      such that the derived cells contain only yeast DNA. Thus selectable markers and
      bacterial sequences are not present in the final strain, making this procedure
      attractive for the development of generally acceptable brewing yeast. Linear DNA
      containing the cloned ILV5 gene was introduced into lager yeast along with an
      unlinked circular bifunctional plasmid containing a dominant resistance marker.
      Resistant colonies were screened for site-directed integration of the ILV5 DNA.
      Candidates were examined by several methods including Southern transfer and
      polymerase chain reaction. In this way, a strain WM56 was identified containing
      three tandem copies of ILV5. The amplified ILV5 region is stable during repeated
      subculturing in the absence of selective pressure. Correspondingly elevated
      levels of ILV5 transcript in strain WM56 compared to the control (i.e. non
      tandem) parental strain led to increased amounts of encoded acetohydroxyacid
      reductoisomerase as evidenced by significantly lower diacetyl production. WM56
      appears to be identical to the parental strain judged by CHEF, total restriction
      digestion patterns, and probing, but differs in the ILV5 region of the
      chromosome. The method is generally applicable to other yeast strains, and if
      desired, is amenable to iterated cycles of integration to increase the number of
      copies.

PMID- 7785332
TI  - Transient responses of Candida utilis to oxygen limitation: regulation of the
      Kluyver effect for maltose.
AB  - The facultatively fermentative yeast Candida utilis exhibits the Kluyver effect
      for maltose: this disaccharide is respired and assimilated but, in contrast to
      glucose, it cannot be fermented. To study the mechanism of the Kluyver effect,
      metabolic responses of C. utilis to a transition from aerobic, sugar-limited
      growth to oxygen-limited conditions were studied in chemostat cultures.
      Unexpectedly, the initial response of maltose-grown cultures to oxygen limitation
      was very similar to that of glucose-grown cultures. In both cases, alcoholic
      fermentation occurred after a lag phase of 1 h, during which glycerol, pyruvate
      and D-lactate were the main fermentation products. After ca. 10 h the behaviour
      of the maltose- and glucose-grown cultures diverged: ethanol disappeared from the
      maltose-grown cultures, whereas fermentation continued in steady-state, oxygen
      limited cultures grown on glucose. The disappearance of alcoholic fermentation in
      oxygen-limited chemostat cultures growing on maltose was not due to a repression
      of the synthesis of pyruvate decarboxylase and alcohol dehydrogenase. The results
      demonstrate that the Kluyver effect for maltose in C. utilis does not reflect an
      intrinsic inability of this yeast to ferment maltose, but is caused by a
      regulatory phenomenon that affects a key enzyme in maltose metabolism, probably
      the maltose carrier. The observed kinetics indicate that this regulation occurs
      at the level of enzyme synthesis rather than via modification of existing enzyme
      activity.

PMID- 7785333
TI  - Glucose metabolism, enzymic analysis and product formation in chemostat culture
      of Hanseniaspora uvarum.
AB  - The physiology of Hanseniaspora uvarum K5 was studied in glucose-limited
      chemostat cultures and upon glucose pulse. Up to a dilution rate of 0.28 h-1,
      glucose was completely metabolized in biomass and CO2. Above this value, increase
      in the dilution rate was accompanied by sequential production of metabolites
      (glycerol, acetate and ethanol) and decrease in cell yield. Similar results were
      observed upon glucose pulse. From the enzyme activities (pyruvate dehydrogenase,
      pyruvate decarboxylase, NAD and NADP-dependent acetaldehyde dehydrogenases,
      acetyl coenzyme A synthetase and alcohol dehydrogenase) and substrate affinities,
      the following conclusions were drawn with respect to product formation of cells:
      (1) pyruvate was preferentially metabolized via pyruvate dehydrogenase, when
      biomass and CO2 were the only products formed; (2) acetaldehyde formed by
      pyruvate decarboxylase was preferentially oxidized in acetate by NADP-dependent
      aldehyde dehydrogenase; acetate accumulation results from insufficient activity
      of acetyl-CoA synthetase required for the complete oxidation of acetate; (3)
      acetaldehyde was oxidized in ethanol by alcohol dehydrogenase, in addition to
      acetate production.

PMID- 7785334
TI  - Extraordinary sequence conservation of the PRP8 splicing factor.

PMID- 7785335
TI  - Plasmid reorganization during integrative transformation in Hansenula polymorpha.
AB  - During studies of integrative transformation in Hansenula polymorpha, it was
      found that transformants with plasmids possessing the LEU2 gene of H. polymorpha
      were frequently unstable and lost plasmids while growing on non-selective medium.
      These transformants possessed reorganized plasmids capable of replication in H.
      polymorpha. Two such plasmids were isolated and characterized. It was shown that
      they contain additional DNA segments which were not present in the original
      plasmid used for transformation. Southern hybridization analysis carried out with
      labeled DNA probes derived from these segments showed that they consisted of H.
      polymorpha DNA. The hybridization patterns indicated that corresponding sequences
      were homologous to several chromosomal regions. These chromosomal DNA segments
      apparently carried H. polymorpha autonomous replicating sequences (HARS), since
      plasmids bearing them could transform H. polymorpha with high efficiency and were
      maintained in transformants in an autonomous state. Sequence analysis of one such
      captured chromosomal fragment revealed several eight- to ten-base AT-rich blocks
      similar to the presumed HARS sequence defined by Roggenkamp et al. (1986).
      Analogous reorganization was also observed with respect to integrative plasmids
      carrying the TRP3 and HIS3 genes of H. polymorpha and the ADE2 gene of
      Saccharomyces cerevisiae as selectable markers.

PMID- 7785336
TI  - Studies on the transformation of intact yeast cells by the LiAc/SS-DNA/PEG
      procedure.
AB  - An improved lithium acetate (LiAc)/single-stranded DNA (SS-DNA)/polyethylene
      glycol (PEG) protocol which yields > 1 x 10(6) transformants/micrograms plasmid
      DNA and the original protocol described by Schiestl and Gietz (1989) were used to
      investigate aspects of the mechanism of LiAc/SS-DNA/PEG transformation. The
      highest transformation efficiency was observed when 1 x 10(8) cells were
      transformed with 100 ng plasmid DNA in the presence of 50 micrograms SS carrier
      DNA. The yield of transformants increased linearly up to 5 micrograms plasmid per
      transformation. A 20-min heat shock at 42 degrees C was necessary for maximal
      yields. PEG was found to deposit both carrier DNA and plasmid DNA onto cells. SS
      carrier DNA bound more effectively to the cells and caused tighter binding of 32P
      labelled plasmid DNA than did double-stranded (DS) carrier. The LiAc/SS-DNA/PEG
      transformation method did not result in cell fusion. DS carrier DNA competed with
      DS vector DNA in the transformation reaction. SS plasmid DNA transformed cells
      poorly in combination with both SS and DS carrier DNA. The LiAc/SS-DNA/PEG method
      was shown to be more effective than other treatments known to make cells
      transformable. A model for the mechanism of transformation by the LiAc/SS-DNA/PEG
      method is discussed.

PMID- 7785337
TI  - Production of senescent cells of Saccharomyces cerevisiae by centrifugal
      elutriation.
AB  - The centrifugal elutriator has been used as a baby machine by loading the chamber
      with a population of mixed-generation daughter cells and allowing this population
      to grow, divide and age under continuous washing-out of newborn daughter cells.
      Clear peaks in the number of elutriated cells were reproducibly obtained for at
      least ten generations. The parent cells growing in the chamber continued to
      divide at the steady-state generation time of 95-100 min, showing no change in
      cycle time during aging. The washed-out daughter cells increased in volume during
      the first five generations from their steady-state value of 17 micro3 to a
      maximum of 34 micro3. As to be expected, the generation times of these large
      daughters, determined in a synchronous batch culture, were shorter (130 min) than
      that of the steady-state daughters (240 min), even when derived from 15
      generation parents. No indication for a volume increase of daughter cells without
      bud was observed when a population was allowed to grow in the chamber without
      washing-out the smaller daughter cells. The 15-generation parent population,
      recovered from the chamber, had an average volume of 80 micro3 and consisted of:
      (i) 71% cells with more than ten scars, (ii) 13% cells with one to nine scars,
      and (iii) 17% daughter cells. The production of senescent cells by undisturbed
      growth in the elutriator chamber has been prolonged to 29 generations. The method
      is therefore suitable to examine what factors determine the life span of budding
      yeast.

PMID- 7785338
TI  - Sequence analysis of the right end of chromosome XV in Saccharomyces cerevisiae:
      an insight into the structural and functional significance of sub-telomeric
      repeat sequences.
AB  - Approximately 3.9 kb of DNA, centromere proximal to the previously sequenced Y'
      element at the right end of chromosome XV in Saccharomyces cerevisiae strain YP1,
      has been sequenced. A number of the known sub-telomeric repeat sequences were
      identified, including Y', core X and STRs A, B. C and D. Several of these repeat
      elements contain potentially functional sequences. In addition, two other members
      of repeated gene families were identified. The first of these shows 61% and 60%
      DNA sequence identity to Enolases 1 and 2 respectively. The Enolase-like sequence
      appears to be species specific, with three copies being found in all strains of
      S. cerevisiae studied. The location of the three copies is the same for all
      strains. The second repeated sequence has homology with known open reading frames
      on chromosomes III, V and XI. There are five or six copies of this sequence in
      all S. cerevisiae and S. paradoxus strains studied and three in S. bayanus
      strains. The analysis of this region and comparison to sub-telomeric regions on
      other chromosomes gives some indication as to the potential functional and
      structural significance of sub-telomeric repeat sequences. In addition, these
      findings are consistent with the idea that sub-telomeric regions may be targets
      for unusual recombination events.

PMID- 7785339
TI  - Nucleotide sequence and characterization of the Saccharomyces cerevisiae RPL19A
      gene encoding a homolog of the mammalian ribosomal protein L19.
AB  - A gene designated RPL19A has been identified in the region downstream from the 3'
      end of the Saccharomyces cerevisiae MIS1 gene encoding the mitochondrial C1
      tetrahydrofolate synthase. The gene codes for the yeast ribosomal protein YL19
      which exhibits 57.5% identify with the mammalian ribosomal protein L19. RPL19A is
      one of two functional copies of the YL19 gene located on chromosome II. The
      disruption of RPL19A has no effect on the growth of the yeast. The RPL19A gene
      contains an intron located near the 5'-end. The 5'-flanking region contains one
      similar and one complete UASrpg upstream activating sequence. RPL19A was also
      found to be adjacent to the chromosome II AAC3 gene, encoding the mitochondrial
      ADP/ATP carrier protein.

PMID- 7785340
TI  - Acid-catalysed reduction of ferrylmyoglobin: product distribution and kinetics of
      autoreduction and reduction by NADH.
AB  - The pH dependence of iron(II)/iron(III) product distribution, following reduction
      of the hypervalent iron in equine ferrylmyoglobin by the protein moiety of the
      pigment (so-called autoreduction) and by NADH (nicotinamide adenine dinucleotide,
      reduced) and the rate of reduction was found to depend different on pH.
      Autoreduction is specific acid catalysed and has a more modest temperature
      dependence than autoxidation of oxymyoglobin, with the activation parameters
      delta H# = 58.5 +/- 0.4 kJ.mol-1 and delta S# = 2.7 +/- 0.1 J.mol-1.K-1 in 0.16
      mol.l-1 NaCl. The product of autoreduction is the iron(III) pigment metmyoglobin,
      which is slightly modified in the protein moiety. The reaction has a positive
      kinetic salt effect from which it is deduced that the reactive centre of
      ferrylmyoglobin has a charge of +1 in agreement with the structure Fe(IV) = O.
      Reduction by NADH involves parallel reactions of two pigment forms in acid/base
      equilibrium with each other with a pKa equal to 4.9, both forms yielding
      metmyoglobin as well as the iron(II) pigment, oxymyoglobin, as products. The
      protonated form reacts faster than the deprotonated form, and two-electron
      transfer has greater importance for the protonated form with a limiting
      Fe(II)/Fe(III) product ratio of 0.6 in acidic solution compared to 0.12 in
      alkaline solution. A square root dependence of rate on NADH concentration
      suggests involvement of NAD.radicals with a disproportionation as the termination
      reaction.

PMID- 7785341
TI  - Frozen storage of dressed and pre-fried portions of minced sardine muscle.
AB  - The aim of this work was to study the modifications occurring during frozen
      storage (-18 degrees C) of dressed and pre-fried portions of minced muscle of the
      sardine (Sardina pilchardus). Various samples were prepared in order to discover
      the effect on the samples of different preparatory frying times, the influence of
      vacuum-packing and the possible alterations in the state of preservation of the
      portions due to the presence of anti-oxidant agents. The results indicate that
      the presence of tocopherols did not have the expected effect on rancidity; it
      reduced the degree of rancidity reached during storage only slightly, while
      texture with respect to the control sample remained the same. Although the washed
      muscle sample presented minimum rancidity values, the tasting panel awarded it
      the lowest score for acceptability. In contrast, the vacuum-packed sample
      presented less toughness and rancidity and was considered more acceptable, in the
      light of which this latter procedure would appear to be the best suited for
      frozen storage for pre-fried battered sardine portions.

PMID- 7785342
TI  - Chemical and fatty acid composition of meat from Spanish wild rabbits and hares.
AB  - The differences in the chemical and fatty acid compositions between the meats of
      five Spanish wild rabbits (Oryctolagus cuniculus) and five Spanish wild hares
      (Lepus europaeus) for foreleg, loin, hindleg and perirenal fat have been studied.
      Only significant differences (P < 0.05) in the meat chemical composition were
      observed between rabbits and hares for dry matter and fat in loins, and for ash
      in hindlegs. Significant differences (P < 0.05) between saturated fatty acids in
      foreleg and perirenal fat and between unsaturated C-18:1 and C-18:2 fatty acids
      in loins were observed.

PMID- 7785343
TI  - Rapid determination of alpha-tocopherol in muscle and adipose tissues of pork.
AB  - A fast, sensitive and reproducible method for the analysis of alpha-tocopherol in
      pork tissues is presented. It combines saponification of the tissue and alpha
      tocopherol extraction in a single vessel, followed by HPLC separation and
      fluorescence detection. Added alpha-tocopherol was recovered quantitatively. The
      reduction of lipid peroxides with potassium iodide before the saponification step
      did not alter the amounts of alpha-tocopherol detected. Membrane-bound alpha
      tocopherol was not oxidized by lipid peroxides during the procedure. The
      coefficient of variation of alpha-tocopherol analysed using this method was +/-
      4.2% for muscle and +/- 2.5% for adipose tissues.

PMID- 7785344
TI  - A microbiological screening method for the indication of irradiation of frozen
      poultry meat.
AB  - A microbiological screening method for the detection of irradiation of frozen
      poultry meat was developed on the basis of the combined use of total cell count
      by the direct epifluorescent filter technique (DEFT) and viable cell count by the
      aerobic plate count method (APC). Samples of ground, deboned poultry leg were
      irradiated or not with dose levels of 3, 5 and 7 kGy using an electron beam
      accelerator. All samples were frozen before the irradiation treatment. The
      average values of the differences between DEFT and APC counts in control samples
      and those irradiated with doses of 3, 5 and 7 kGy were 1.14 log units for control
      samples, and 3.16, 3.68 and 3.79 log units for the irradiated samples. A
      difference of at least 2 log units can therefore be considered as a limit value
      indicating probable irradiation treatment necessitating further investigations.

PMID- 7785345
TI  - [Bakery goods from irradiated and unirradiated eggs--detection of irradiation in
      a processed food].
AB  - The detection of radiation-specific degradation products in fat has become an
      established method which has successfully been applied to egg products. This
      study is making evident the detectability of irradiated eggs as an ingredient of
      specified processed foods. Tart layers were produced from both irradiated and non
      irradiated liquid whole egg. When the fat components were isolated from the tart
      layers and investigated by GC/MS, the presence of irradiated eggs could clearly
      be shown. While the radiation-induced hydrocarbons and 2-alkylcyclobutanones
      could not be found in unirradiated samples, tart layers from irradiated eggs
      contained these substances. Especially for the hydrocarbons a satisfying
      correlation between radiation dose and concentration could be observed. The
      concentrations of radiation-induced compounds were generally lower in the tart
      layers than in the liquid egg samples they had been produced from.

PMID- 7785346
TI  - [Intake of folic acid in the total daily diet--effect of food preparation on its
      folic acid content].
AB  - The folic acid content of total daily diet was determined by means of high
      performance liquid chromatography (HPLC). The contents of tetrahydrofolic acid
      (THF), 5-methyl-THF and 5-formyl-THF were differentiated. The mean of the folic
      acid content of the total daily diet samples determined analytically was 205 +/-
      60 micrograms and the mean of the individual ingredients of the samples was 401
      +/- 78 micrograms, which implies that about 50% of folic acid is destroyed by
      common household food preparation methods. If the contents of pteroylglutamic
      acid (PteGlu) and 10-formyl-PteGlu (which cannot be determined analytically) are
      added, it can be assumed that the folic acid content with only be reduced by
      about 40%. THF and 5-methyl-THF proved to be less stable than 5-formyl-THF. The
      monoglutamate portion of the total folat content was higher in the total diet
      samples than in the individual foodstuffs as a consequence of the action of the
      enzyme "deconjugase" which is released when the matrix of food-stuffs is
      destroyed.

PMID- 7785347
TI  - Utilisation of nitrates--a decisive criterion in the selection of Lactobacilli
      for bioconservation of vegetables.
AB  - This work presents results of the observations of cabbage and carrot juice
      fermentation after inoculation with pure cultures of lactic acid bacteria. From
      the point of view of nitrates, utilisation, the most suitable microorganisms
      found from those studied were Lactobacillus plantarum 92H, Lb. plantarum 90H and
      Lb. delbrueckii 37H. At the same time, other observed parameters were assessed as
      well for their suitability for vegetable bioconservation.

PMID- 7785348
TI  - Dietary fibre in white asparagus before and after processing.
AB  - The changes that occur, especially in the dietary fibre, during processing of
      white asparagus have been studied. Processing consists of submitting the
      vegetable to a treatment with hot water (96 degrees C), for 4 min (blanching) and
      subsequently immersing it in a sodium chloride solution (brining). Finally, the
      asparagus is sealed and sterilised at 115-116 degrees C. The study was performed
      on the whole asparagus and also, separately, on the apex and stem. As a result of
      processing there was an increase in the moisture and protein contents and a
      decrease in those of uronic acids and free sugars, saccharose disappearing
      entirely. It is concluded that the most important changes taking place in the
      asparagus fibre fraction during thermal treatments are the slight decrease of
      lignin and uronic acids, the slight increase in proteins and an important
      decrease in hemicelluloses.

PMID- 7785349
TI  - [Chemical composition of seeds and testa of Vicia faba L].
AB  - Different chemical components were analysed in the seeds and in testa of Vicia
      faba. The seeds contain a relatively high crude protein (27.5%), a low crude fat
      (3.36%) content; and the lignin concentration is low (2.65%). The testa of the
      seeds has a very high fibre concentration and is a significant Ca-source (1.86
      g/kg). The higher macroelement concentrations in the seeds were measured from K,
      P and Mg. The main microelements (Fe, Mn, Cu, Zn) have significant higher
      concentrations in the seed than in the testa. The amino acid composition of seeds
      is positive (compared to data of white lupine), the rate of essential amino acids
      is good. The concentrations of the examined antinutritive organic constituents,
      especially of alkaloids, are low. On the basis of chemical analysis, the
      production and utilisation of seeds of Vicia faba is recommended.

PMID- 7785350
TI  - Silicon, phosphorus, sulphur, chlorine and ash contents of Spanish commercial
      honeys.
AB  - Silicon, phosphorus, sulphur, chlorine and ash contents were determined in
      samples of 24 Spanish commercial honeys. Mean contents (mg/kg of honey) were 3.2
      for silicon, 78 for phosphorus, 45 for sulphur and 262 for chlorine. The values
      for phosphorus and chlorine are high with respect to honeys from other regions.
      Mean ash content was 0.19%. In all cases there were high coefficients of
      variation, ranging from 0.43 for silicon to 0.58 for phosphorus.

PMID- 7785351
TI  - Fast and sensitive determination of furosine.
AB  - Sensitive determination of furosine in acid hydrolysates of foods was achieved by
      isocratic ion-pair reversed-phase HPLC and direct UV-detection within a run time
      of 5 minutes and levels lower than 1.5 mg per kg of protein. The formation of
      furosine during hydrolysis of food samples with hydrochloric acid of varying
      concentration was studied. Furosine formation increased linearly with acid
      concentration (4 to 8 mol/L).

PMID- 7785352
TI  - [Automated determination of total nitrogen in milk by the Dumas method].
AB  - A nitrogen analyser based on the Dumas method (LECO FP-428) and equipped with a
      liquid injector has been tested. The intensive steam production during injection
      may result in poor nitrogen recoveries for volatile nitrogen compounds such as
      ethylene diamine. However, recoveries could be improved by slow injection and by
      filling the combustion tube with Cer(IV)-oxide. For the analysis of milk the
      instrument was calibrated with NaN3 solutions because their response was found to
      be less sensitive to burning conditions. Dumas-N and Kjeldahl-N of milk showed
      good correlation (r = 0.998). However, with the Dumas method about 6.7% (+ 0.035%
      N) higher nitrogen values were obtained. With a standard deviation of
      repeatability S(r) = 0.002% N (CVr = 0.33) and a between day reproducibility SD =
      0.006% N (CVD = 1.1%) the precision of the Dumas method was similar to that
      reported for the Kjeldahl method. In order to avoid systematic errors the use of
      standard milk samples for calibration is recommended. It is concluded that modern
      instruments using the Dumas method allow precise measurements of nitrogen in milk
      with a high sample throughout.

PMID- 7785353
TI  - Alteration of the electrophoretic pattern of myofibrillar proteins in fish mince
      during frozen storage.
AB  - A study was made of the variations in the electrophoretic profile of myofibrillar
      proteins in the muscles of blue whiting (Micromesistius poutassou R.), horse
      mackerel (Trachurus trachurus L.) and mackerel (Scomber scombrus L.). It was
      shown that all species presented different deterioration patterns during frozen
      storage. The fish were caught at two separate times of the year (winter and
      summer) and were stored frozen at -18 degrees C for 1 year. The results indicate
      that during frozen storage, electrophoretic patterns varied according to species.
      Comparison of myosin heavy chain/actin (MHC/A) ratios indicates that blue whiting
      is the species that undergoes most alteration, and that this is more intense in
      fish caught in the summer than in the winter. Alteration of the MHC/A ratio was
      similar in horse mackerel and mackerel caught in the winter, whereas in the
      summer horse mackerel proved to be the most stable species. In all cases, the
      reduction of the MHC/A ratio was due essentially to alteration of the MHC, an
      effect which was particularly marked in blue whiting. Tropomyosin remained stable
      throughout the storage period in all three species.

PMID- 7785354
TI  - A comparison between conventional and fluorescence detection methods of cooking
      induced damage to tuna fish lipids.
AB  - The damage to tuna fish lipids induced by cooking was investigated in the Thunnus
      obesus and Th. thynnus varieties, using conventional and fluorescence detection
      methods, and the results were compared. As a consequence of thermal processing,
      the peaks at longer wavelengths increased, which correlated with other
      conventional indices of lipid damage (i.e. carbonyl compound formation, browning
      and increases in the free fatty acid content). A special significance was given
      to the fluorescence ratio between the maxima of the excitation emission data at
      393/460 nm and 327/415 nm; increases in this ratio as a result of cooking were
      less dependent on the samples than were other conventional methods of measuring
      lipid damage.

PMID- 7785355
TI  - Comparison between ion chromatography and a spectrophotometric method for
      determination of nitrates in meat products.
AB  - Ion chromatography and colorimetry were used to determine nitrate ion
      concentration in 76 different pork meat products (salami, mortadella, wurstel,
      raw and cooked ham and other whole-muscle cooked products) and the results were
      compared. The comparison revealed that the two techniques yield quantitatively
      similar results, except in cases where the matrix was so complex that it might
      have influenced the analytical data. These results are consistent with those
      obtained by other authors who used UV spectrophotometric detection.

PMID- 7785356
TI  - Biogenic amines and microbial quality of sprouts.
AB  - Changes in the biogenic amine content relative to microbial activities in mung
      bean, lentil and radish sprouts were investigated in prepacked and "home-grown"
      products. Biogenic amines were determined by ion-exchange chromatography. The
      major groups of micro-organisms were enumerated by aerobic plate count
      procedures, using universal and selective media. Putrescine, cadaverine,
      spermidine, agmatine and spermine were detected in different concentrations,
      depending on the type of sprouts. In prepacked retail products the total biogenic
      amine content was higher than in home-grown samples (mung bean 106 micrograms/g
      compared to 87 micrograms/g; lentil 316 micrograms/g compared to 181
      micrograms/g; radish 1486 micrograms/g compared to 252 micrograms/g). It is
      concluded that sprouting time and storage conditions play a major part in the
      hygienic quality of legume sprouts.

PMID- 7785357
TI  - On the origin of benzene, toluene, ethylbenzene and xylene in extra virgin olive
      oil.
AB  - Concentrations of benzene, toluene, C2-benzenes and styrene were determined in
      olives and the oils produced thereof, as well as at various intermediate steps
      during production. Concentrations were compared to those found in samples of air
      taken from the olive grove and the olive mills. In an exposition experiment in
      the laboratory, olives absorbed aromatic compounds, approaching saturation
      corresponding to the partition coefficient between air and oil. However,
      concentrations in olives delivered to the mills were 4-10 times higher than
      expected from the analysis of the air in the olive grove. In the olive mills,
      concentrations were increased further by a factor of up to 2 because of uptake
      from air which contained high concentrations of aromatics. Styrene concentrations
      strongly increased during storage of crushed olives at ambient temperature, which
      confirms the hypothesis that styrene is a product of metabolism.

PMID- 7785358
TI  - Preservation of raw milk with CO2. Sensory evaluation of heat-processed milks.
AB  - The effect of CO2 on the growth of psychrotrophic milk spoilage organisms was
      studied, both in raw fresh milk and in pure cultures of three species of
      Pseudomonas growing in sterilised milk. Changes of sensory properties of CO2
      treated samples after heat treatment were also analysed. Inhibition of
      psychrotrophic growth at 7 degrees C in milk treated with CO2 to a pH 6.2 or 6.0
      was impaired by a gradual reduction of the CO2 content during storage. Growth
      inhibition was considerably improved by pH adjustment at 24-h intervals. Sensory
      analysis showed significant differences between non-acidified and acidified
      samples after heat treatment at 75 degrees C for 20 s or 110 degrees C for 5 min.
      No sensory differences were found between non-acidified and acidified milks
      degassed before heat treatment.

PMID- 7785359
TI  - Extraction of ewe's milk cream with supercritical carbon dioxide.
AB  - The extraction of ewe's milk cream by supercritical carbon dioxide in the
      pressure range 9-30 MPa (90-300 bar) and at temperatures of 40 degrees C and 50
      degrees C was studied. The solubility of total fat increased with pressure at
      both temperatures until a plateau was reached. The extraction of cholesterol also
      increased with pressure until a plateau was reached and it was higher at 50
      degrees C than at 40 degrees C when the pressure was > or = 15 MPa (150 bar). The
      triglyceride composition of each extract, determined by GC, showed that extracts
      obtained at lower pressures were enriched in short-chain triglycerides and their
      concentration decreased as the pressure increased. In the other hand, long-chain
      triglycerides were enriched in the extracts obtained at higher pressures and
      their concentration rose with increasing pressure.

PMID- 7785360
TI  - Daily dietary copper intake in Belgium, using duplicate portion sampling.
AB  - Daily dietary copper intake in Belgium has been evaluated by duplicate portion
      sampling, heating in a microwave oven and atomic absorption spectrometric
      determination of this element. The mean intake value (1.5 +/- 0.4 mg/day) is
      similar to levels found for most other countries, but is situated at the lower
      end of the recommended range for a safe and adequate daily dietary intake.

PMID- 7785361
TI  - [Reversible changes in brain volume in anorexia nervosa].
AB  - Cranial computed tomography (CT) was performed in three different samples of
      young women with anorexia nervosa before and after treatment. The biggest changes
      in cerebrospinal fluid volume were observed in the supratentorial and
      extracerebral-subarachnoid area, with smaller changes in the ventricles. These
      changes, as assessed by different methods of volumetric and planimetric
      measurement, were statistically significant and were correlated with the changes
      in body weight. Two patient groups could be distinguished on the basis of the
      presence or absence of cerebellar pseudoatrophy in the initial CT, and these
      groups also showed differences in preclinical and clinical course.

PMID- 7785362
TI  - [Diagnosis of psychiatric disorders in children and adolescents using structured
      interviews].

PMID- 7785363
TI  - [Behavioral medicine].

PMID- 7785364
TI  - [Responsibilities and problems in quality assurance in psychiatry and
      psychotherapy in childhood and adolescence].
AB  - The goals of quality assurance in child and adolescent psychiatry and
      psychotherapy and related problems are reviewed. Three dimensions of quality
      assurance are differentiated: the substantive aspect (quality of the treatment
      process and results, quality of structural aspects of treatment facility) the
      area (diagnosis, therapy, staff training) and the tasks to be accomplished in the
      process of quality assurance (development of standards, assessment of the current
      situation, comparison of current situation with standards, planning and
      implementation of changes). Several important problems related to quality
      assurance are outlined and the most urgent tasks discussed in detail (development
      of quality standards and assessment of the current situation). It is proposed
      that quality assurance documentation is divided into four parts: documentation of
      structural characteristics of facility, basic documentation about patient,
      documentation of diagnostic and treatment services provided, and documentation of
      evaluation of services provided. An example of a therapy evaluation method
      (Questionnaire for Therapy Evaluation, QTE) is described.

PMID- 7785365
TI  - [Subjective evaluation by parents and objective findings in former perinatal risk
      children].
AB  - Several studies have shown no correlation between individual perinatal risk
      factors and outcome. Rather, the children's development depends more on social
      factors. In our retrospective study we compared the development of 26 at-risk
      newborns with that of a same-sex healthy sibling 10 to 16 years later. Data were
      collected by interview, questionnaires and neuropsychological tests. In the
      parents' view, the children who were at-risk newborns had a special position in
      the family (close mother-child relationship, overprotectiveness, child cause for
      concern). They had more educational and behavioral problems and their social
      network was limited. With one exception (d2 test), the neuropsychological tests
      showed no significant differences between the two groups of children. However,
      overall the at-risk children had more attention deficit disorders with
      hyperactivity (ICD-10, F90.0) and more selected learning disturbances (F81). A
      division of the children into those with minor and major perinatal risk factors
      was not of predictive value for outcome. There was only a low correlation between
      the parent's assessments of the at-risk children and more objective criteria
      (need for professional help or special schooling). The authors discuss the types
      of support that should be provided to parents with at-risk newborns.

PMID- 7785367
TI  - [Psychological versus psychogenic--a necessary clarification of terminology].
AB  - Confusion exists regarding the usage of the two adjectives psychic and
      psychogenic. Therefore a differentiation of the two words is necessary. We will
      try to do this with the help of concrete examples. Regarding the pair of terms
      psychic versus somatic one has to differentiate strictly between (psychic or
      somatic) causes on the one hand and the forms of manifestation in the psychic or
      somatic field of observation on the other hand. The discussion about the
      linguistic ruling of psychic versus psychogenic has important consequences for
      the responsibilities and care of the different professions: psychiatrist,
      psychosomatist/psychotherapist, other specialists, general physician.

PMID- 7785366
TI  - [The intelligence structure of autistic persons].
AB  - In a research project on the genetics of autistic disorders 115 subjects were
      examined. An autistic disorder was diagnosed in 102 of the subjects using the
      standardized Autism Diagnostic Interview (ADI; Le Couteur et al., 1989/ADI-R;
      Lord et al., 1994). The WAIS-R or WISC-R could be administered to 42 of the
      subjects. The mean full-scale IQ was 84.4, slightly below the range of normal
      intelligence. The mean verbal IQ (89.3) was considerably higher than the
      performance IQ (78.9). Analysis of the subtest patterns showed the highest scores
      to be in those subtests measuring knowledge of dates and facts and visuospatial
      abilities. The lowest scores were on subtests requiring an understanding of
      social relations and the ability to understand concrete social actions. This
      subtest pattern confirms results of other studies on the intelligence of
      individuals with autism and was independent of gender and level of intelligence.
      The subtest pattern appears to be specific for autistic disorder; it has been
      interpreted with reference to the theory of "weak central coherence" (Frith,
      1989; Shah & Frith, 1993), which postulates that in autistic individuals stimulus
      perception and processing occurs independently of the general context. The
      results suggest that the differentiation between different types of autistic
      disorders should be abandoned in favor of a continuum of autistic disorders with
      differing degrees of severity.

PMID- 7785368
TI  - [Disordered partner relations in neurotic diseases and treatment with
      psychotherapy].
AB  - Couples with neurotic partner problems are characterized by considerable psychic
      and/or psycho-somatic complaints. Men usually judge the relationships with their
      spouses more satisfactory than women do. Women suffer more from conflicts in
      partner-relationships than men do responding to such conflicts with psychic
      and/or psycho-somatic complaints. Men are more disturbed by a conflict mobilizing
      therapy than women are. The strongest decrease of men's psychic symptoms can be
      found in the year after their therapy. Women's defence against psychic problems
      is less strong than men's. Decrease of women's symptoms can be found during
      therapy already. Character neuroses don't make psychic and/or psycho-somatic
      symptoms in a direct manner. Character neuroses rather give rise to conflicts
      with other people, and stress by those conflicts cause symptoms.

PMID- 7785369
TI  - [Markers of the "fit" between therapist and patient as determinants of treatment
      outcome of inpatient group psychotherapy].
AB  - Within a study concerning process and outcome of inpatient longterm group
      treatments the specific question was tested to what extent characteristics of the
      "fit" between the therapist and the patients were related to treatment outcome.
      The study shows that a concordance in the formulation of the treatment goals
      seems to be favorable for a positive outcome. Similarly, congruences between the
      therapeutic factors of the group treatment, subjectively important for the
      patients, and those factors classified as typical for the treatment concept by
      the therapists, were related to treatment success. The results can be discussed
      within the context of concepts of the therapeutic alliance and might help to
      operationalize those concepts in a more specific manner.

PMID- 7785370
TI  - [Social support and social stress in tumor patients and their partners].
AB  - Social support is widely believed to be an important buffer against stress in
      patients coping with cancer. Support efforts can, however, in turn prove to
      become a source of distress in themselves, both in patients and support
      providers. The present study was designed to explore the connections between
      support and emotional distress. N = 120 lung cancer patients and their relatives
      (n = 57) are interviewed at three intervals. Social support is assessed by
      multiple methods: Content analysis, a questionnaire and a confidant rating
      performed by experts. Cross-sectional and longitudinal analyses are combined.
      Content-analytical and self-report data show a correlation of support efforts and
      emotional distress. In the confidant rating, however, the expected differences
      between supportive and non-supportive spousal relationships emerge. The results
      are discussed from an interactional point of view.

PMID- 7785371
TI  - [Physicians' attitudes of relations with AIDS, cancer and metabolic patients:
      core conflictual relationship theme and affects].
AB  - With this comes the question: Are there typical relationship patterns and
      affects, that appear in physicians experience of their relationships to patients
      with different illnesses? We asked 33 physicians about impressive experiences
      with one AIDS-, one cancer- and one metabolic disorder patient each. The
      narratives we received were evaluated with two contentanalytic methods. The
      relationship patterns were assessed by the Core Conflictual Relationship Theme
      (CCRT), developed by Luborsky. The affects were assessed by the Gottschalk-Gleser
      Content Analysis Scales. We found some significant differences between the
      relationship experience with AIDS- and cancer patients on the one hand, and
      metabolic disorder patients on the other hand. In relationships with critical ill
      AIDS- and cancer patients the physicians verbalize more death anxiety and more
      diffuse or nonspecific anxiety. Furthermore they show more covert hostility
      against the AIDS- and cancer patient, whereas they verbalize more overt hostility
      against the metabolic disorder patients. We found also some fine distinction
      between the relationship experiences with AIDS-patients on the one hand and
      cancer patients on the other hand. The physicians get more involved with the
      relationships to AIDS-patients and the closeness-distance-regulation seems to be
      one central issue in this relationships.

PMID- 7785372
TI  - [The course of immunologic parameters in inpatient psychotherapy exemplified by 2
      single case studies].
AB  - Psycho-neuroimmunology depicts a conceptual frame in which possible interactions
      between psychic and physical processes can be examined. It could be very
      significant in the field of psychosomatics when the courses of psychic and
      somatic processes are examined. However, the research results from this field of
      study are varied and only for a few parameters of immunity is it possible to
      prove correlations with psychic variables. Many of the studies that have been
      conducted up to date were construed as cross-section studies and possibly
      therefore are not very suitable for depicting the probably very complicated forms
      of interactions between psychic and somatic levels in an adequate manner. In the
      framework of stationary psychosomatic psychotherapy two single case studies were
      carried out in order to examine temporal connections between psychic and
      immunological course parameters. Both single case studies are to be viewed as
      explorative attempts of examining questions of examination design and
      organization which are highly resolved regarding time. Furthermore we report
      several interesting individual results which emphasize in general the correlation
      between psychic and somatic parameters also in the course of time. However the
      limits of such studies regarding the significance of the individual immunological
      parameters, using time serial analytical methods as well as constructing models
      in the field of psycho-neuroimmunology are discussed.

PMID- 7785373
TI  - [Physician-surgeons in Serbian medieval medicine--contribution to the history of
      the Serbian medical school].

PMID- 7785374
TI  - [Limited or extensive surgery in gastric carcinoma?].
AB  - Although the incidence of gastric cancer has dropped it is still the most
      frequent carcinoma of dhe digestive tract. Surgical management of gastric
      carcinoma was always dependent on the stage of the disease. Contemporary
      knowledge of gastric lymph drainage and attempts to remove metastatic glands with
      the tumor gave rise to more optimism. In the beginning such and approach did not
      fulfill expectations, but during the past decades, especially in Japan, it became
      evident that more aggressive and extensive surgical procedures could benefit
      certain groups of patients. In order to asses this new approach it is necessary
      to have a unique TNM classification and to perform a rigorous and systematic
      identification of cancer metastasis in the lymph nodal system of the stomach.
      Comparison of partial gastric resection with limited standard lymphadenectomy to
      total gastrectomy with extensive lymphadenectomy is not possible. Nevertheless,
      patients with gastric cancer stages Ib, II and IIIa profit from more extensive
      surgery. The author present the modifications in the extent of surgical
      procedures for the management of gastric cancer. Special emphasis is drawn to the
      surgical technique and results of systemic extensive lymphadenectomy. The author
      has demonstrated the benefits of the new extensive surgical approach in he
      management of gastric cancer in his series. Operative mortality in the group of
      patients after systemic lymphadenectomy was 6.7% and the 5-year survival rate was
      21.0%. In the group of patients where gastric resection with standard
      lymphadenectomy was performed postoperative mortality was 14.0% and the 5-year
      survival was only 5.3%.

PMID- 7785375
TI  - [Causes of dehiscence in the anastomosis between the stomach and small intestine
      in our clinical data 1970-1990].
AB  - Gastrojejunal anastomotic leakage occurred in our clinical material of 4284
      gastric resections Billroth II type with an incidence of 0.93 percent. 62 cases
      with anastomotic dehiscence were analyzed, with 22 from other clinics. The most
      critical part of the anastomosis was the upper angle of Billroth II Hoffmeister
      Finsterer anastomosis. The causes were mostly local; reoperations and resuture
      with necrotic and devitalized tissue, impaired vascularization of the stomach and
      small intestine due to rough manipulation, too narrow anastomosis and too tight
      securing of ligatures, as well as too massive tissue aglomeration in more layers.
      Stomach obstruction is a significant cause, as it is dista obstruction to
      anastomosis, duodenal dehiscence, peritonitis or pancreatitis. Some of the local
      causes are likely to be solved with using of one layer of resorptive suture
      material or using of a stapling device. General conditions are also important,
      but only as factors that stress the local conditions of risk. The mortality rate
      in this serial is high as 70.9%, in spite of the reoperations and complex
      conservative treatment.

PMID- 7785376
TI  - [Comparative analysis of vascular injuries during times of peace and war].
AB  - The authors present results of reconstructive surgical procedures in 127 non-war
      and 59 war vascular injures operated on in the last ten and 2 years,
      respectively. Non-war injures were dominated by blunt trauma, while fire arms and
      explosives caused most of war injuries. Two thirds of the patients were subjected
      to primary, and one third to secondary operations. As much as 85% of secondary
      operations were made in cases of war injuries. The most common reasons for
      inappropriate primary operations were: incomplete diagnostics, inappropriate
      surgical procedure and technical errors. About two thirds of the cases were
      isolated vascular injuries, and one third were combined injuries where in
      addition to blood vessels, bones and peripheral nerves were also affected.
      Topographically, the upper and lower extremities were most commonly affected.
      Most of the operations were complex reconstructive procedures such as graft
      interpositions or by-passes, and less frequently only suture of a blood vessel or
      end-to-end anastomosis were made. Fasciotomy was an auxillary method used in all
      patients with late vascularization syndrome, and exposure in a special "tent" in
      patients with wound infection. Early success was noted on 88% of operated
      patients. In 12% of them amputation was performed. Primary amputation (without
      attempts of reconstruction) was performed in 4% out of the total number of
      patients. After primary operations they performed (127) the authors had to
      undertake amputation because of failure of the primary surgery in 4% of patients,
      while after secondary reconstructions (primary operations performed elsewhere)
      amputations were necessitated in 23% out of 57 patients. A significant difference
      was noted which directly correlated with the number of primary and secondary
      operations after war (28%) and non-war (6%) injuries.

PMID- 7785377
TI  - [Bronchoplasty surgery].
AB  - Bronchoplastic operations are analysed in 114 patients: 76 (66.67%) with
      bronchial carcinoma, 33 (28.94%) bronchial adenoma, 4 (3.51%) bronchial rupture
      or stenosis and bronchial hondroma in one case. Sleeve resection was done in 99
      (86.84%) and other kind of bronchoplastic operations in 15 (13.16%). Preoperative
      diagnostic procedures were focused on: clinical course and symptomatology, exact
      location of bronchial lesion, type of tumor, mediastinal lymph nodes, bronchial
      three distal from the lesion and respiratory lung tests. Intraoperatively
      attention was toward to the evidence of peribronchial growth of tumor,
      mediastinal lymph nodes and lung tissue. Early postoperative course was without
      complications in 85 (75.89%), with complications in 26 (23.21%) but two patients
      died. Incomplete reexpansion or athelectasis of the entire lung or lobe but
      easily treated, were the commonest complications. There was no evidence of
      bronchial fistula or bronchial sutura at the level of submucosal growth of tumor.
      In certain indications bronchoplastic operations are good operative choice for
      surgical treatment of bronchial tumors and traumatic bronchial rupture or its
      sequelas-stenosis. For malignant tumors, late results, are, after this kind of
      operations, equivalent to those achieved after classic resections and they do not
      depend of the kind of surgical procedures but correlate to the nature of the
      tumor. For benign and slowly growing malignant tumors late results after these
      operations are excellent.

PMID- 7785378
TI  - [Surgical treatment of peroperative injuries of the duodenum].
AB  - Operative duodenal lesions are rare, but often fatal complications of certain
      abdominal procedures. This was reported in small series with an incidence of 0.2%
      of all abdominal operations. The management of these injuries requests the
      surgeon to be familiar with a number of specific operative approaches, which are
      to be used according to the operative situation. In the 1985-1992, year period,
      21 cases of the operative injury of duodenum were managed without mortality, and
      with 3 cases of transient postoperative fistula, which healed spontaneously. The
      most important factors in the management of this complication are the early
      operative recognition of duodenal injury, or early reoperation, if, in a case of
      duodenal fistula, distal outflow is considered insufficient. The particularities
      of the duodenal suture and perioperative treatment are to be well understood.
      Roux en Y covering of the duodenal defect by open jejunal loop is the best method
      in management of these injuries.

PMID- 7785380
TI  - [Disorders of respiratory function in rib fractures].
AB  - In the one-year prospective study 71 injured patients were observed (75% male and
      25% female). Traffic traumatism was the dominant case (45%). The wounded are
      divided in the groups with one side fracture of ribs (left/right) and on both
      sides fracture of ribs considering the side of fracture, and there is
      consideration about the kind of fracture--there are single fracture of ribs and
      serial fracture of ribs. The samples of artery blood were followed in PaCO2,
      %SaO2 and level pH in three points of time: when the patients came, after 24 and
      after 48 hours. In the group with the both side fracture of the ribs, the fall of
      worth pH was observed after 48 hours, PaCO2 is increasing to the 6.98 kPa. PaO2
      is falling after 48 hours. In %SaO2 there is no considerable difference at any
      time, but%SaO2 is the highest in the second group. With the serial fracture of
      ribs wounded are considerate the fall of worth pH which is progressively
      increasing and is the highest after 48 hours. PaCO2 is increasing in the both
      groups, but with the serial fracture the worth are considerably higher. PaO2 and
      %SaO2 are much lower after 48 hours. The authors conclude that the wounded on
      both sides and wounded with serial fracture along one or several lines of with
      fracture of all ribs suffer the highest respiratory insufficiency (ARI), so they
      need artificial ventilation as respiratory support.

PMID- 7785379
TI  - [Experience of the surgical service and surgeons at the 1st Surgical Clinical
      Center in Belgrade in the primary care of abdominal war injuries 1991-1992].
AB  - During the recent (1991/92) war on the territory of the former Yugoslavia, 12 of
      our surgeons participated in the treating of war abdominal injuries, on 8
      localities with the various characteristics of combat. Treating all injuries,
      with adequate evidence and documentation, the general experience of all
      participants of our team was that abdominal injuries range from 0-12% depending
      on the the intensity of combat, with the mean percentage of 5.43% while combined
      injuries approximate 50% with the most common injuries of extremities (24%). The
      number of laparotomies was 65. The most common cause of abdominal injuries were
      bullets (75%) except in the localities with heavy combat where the explosive and
      bullet woundings were equally observed. The blast injuries were recorded in 3%.
      The most common injured organs were large (29.5%), small intestine (23.46%)
      liver, stomach and spleen subsequently. The severity of injury and mortality
      depends mostly of the number of injured organs, and multiorgan lesions were
      systematically observed (1.89 of injured organs SD 0.96). The total hospital
      mortality was 6.15% (4 cases: 2 "in tabula" and 2 later) due to multiorgan
      injuries with severe shock and bleeding. To achieve better results, early
      transportation to a place where operation could be made is necessary, with the
      effective first aid and good organisation of the initial management and triage.
      The diagnosis must be fast and effective, decision quick and the operation must
      deal with all the injuries primary, by the most safe surgical procedure, with the
      exposition of external wound.

PMID- 7785381
TI  - [Leiomyosarcoma of the duodenum (case report)].
AB  - Leiomyosarcomas of the duodenum are rare tumors, usually presented with
      gastrointestinal bleeding and/or symptoms of duodenal obstruction, rarely with
      obstructive jaundice. If successfully removed, these tumors have better prognosis
      than carcinomas of duodenum or head of the pancreas. A 62 year old man in whom
      leiomyosarcoma of the duodenum was successfully removed by cephalic
      duodenopancreatectomy (Whipple's procedure) is presented.

PMID- 7785382
TI  - [Percutaneous transluminal angioplasty of the abdominal aorta using the "kissing
      balloon" technic].
AB  - Percutaneous transluminal angioplasty (PTA) of the distal abdominal aorta is
      still rarely performed procedure. Sporadic reports come from selected
      institutions with extensive experience in the field of PTA. Procedure is
      performed using so called "kissing-balloon" technique, and may be an alternative
      to the surgical treatment in well selected cases. We present a 45 years old woman
      with intermittent claudications and infrarenal abdominal aortic stenosis, treated
      successfully using above mentioned technique.

PMID- 7785383
TI  - [Sepsis and septic shock].

PMID- 7785384
TI  - [Does extracorporeal shock wave lithotripsy have a role in the treatment of
      biliary calculosis?].

PMID- 7785385
TI  - (Vladan Dordevic, the first trained surgeon. Contribution to the history of the
      Serbian medical School (2).

PMID- 7785386
TI  - [Surgery of colorectal carcinoma--limitations and possibilities].

PMID- 7785388
TI  - [Results of surgical treatment of primary hyperparathyroidism].
AB  - In the period 1981-1993, 102 patients underwent surgery for primary
      hyperparathyroidism (HP). Parathyroid adenoma was found in 81, carcinoma in 4 and
      hyperplasia in 17 patients. HP was usually diagnosed late with marked skeletal or
      renal damage, psychiatric symptoms and hypertension. Following the first
      operation in our institution hypercalcemia was successfully reduced in 100 of 102
      patients, in two hypercalcemia persisted after the operation and both were
      reoperated. Postoperative hypocalcemic syndrome (transitory hypoparathyroidism)
      due to advanced stage of HP and enormous calcium deficit in bones, occurred in
      47% of patients (most frequently with skeletal and hypercalcemic form of the
      disease).

PMID- 7785387
TI  - [Importance of oximetry parameters in the detection of hypoxia in the early phase
      of septic shock].
AB  - The routinely monitored variables in shock stages include: arterial pressure,
      heart rate, central venous pressure, pulmonary artery wedge pressure and cardiac
      index. With vigorous therapy it is possible to bring these values back into the
      normal range in both survivors and nonsurvivors. The therapeutic goal in septic
      shock stages is to maximize the values of cardiac index, O2 delivery (DO2) and O2
      consumption (CO2). The aim of this study is to determine the relationship between
      O2 delivery and O2 consumption as an early sign of hypoxia. Fifteen patients with
      septic shock were treated in order to maximize the value of CI, DO2 and VO2. We
      compared the levels of these parameters between the survivors and nonsurvivors
      and found no significant differences after 24 hours. High levels of DO2 and VO2
      do not exclude tissue hypoxia in the early stage of septic shock.

PMID- 7785389
TI  - [Surgical treatment of recurrent Crohn's disease].
AB  - According to the literature, the incidence of Crohn's disease is 6.0:100,000, and
      the prevalence is 50.0-60.0:100,000. The prevalence in this countries 3.2:100,000
      and the characteristics of the disease are: a more benign course, better
      prognosis and infrequent involvement of the colon. The incidence of recurrence is
      40.0% during a 5 year period and 65% during a 10 year period. Practically, every
      patient operated for Crohn's disease will be reoperated once during the first
      five postoperative years. The experience of the authors indicates that the
      situation in this country is considerably better. During the period ranging from
      1980-1992, a total of 70 patients were operated for Crohn's disease. In this
      group of operated patients 24 (34.40%) had recurrent symptoms. Seven patients
      (10.0%) in the series, operated at an earlier date at this Institution, were
      reoperated for Crohn's disease. Another 8 patients (11.43%) were also reoperated
      for Crohn's disease in this series, but their initial operation had been done at
      a different Institution (palliative or inadequate prior surgery). Indications for
      reoperation did not differ from indications for the initial operation: existence
      of surgical complications. The most important factors in the surgical management
      of recurrence are: assessment of disease activity and progression and adequate
      preoperative and postoperative nutrition in order to improve the immune response,
      which is often impaired by previous surgery, disease activity and inadequate
      management. Correct operative strategy is crucial. The authors, in both initial
      and reoperations, perform limited resection of the small intestine, generous
      resection of the large intestine and stricturoplasty and divergent stomas on the
      small intestine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785390
TI  - [Modern surgical treatment of pulmonary tuberculosis].
AB  - Correctly performed antituberculous chemotherapy, together with the early
      diagnostics of tuberculosis, significantly lowered the need for surgery. Surgery
      is limited to patients with poor or no response to chemotherapy. In the period
      between 1983-1992 212 tuberculous patients were operated in the Clinic for
      Thoracic surgery, the Institute for the Pulmonary Disease the operated patients
      had the following form of the disease: primary tuberculosis in 4 patients
      (1.87%), 104 patients (49.06%) had the postprimary form of the disease, 67
      patients (31.60%) had tuberculoma (causative lesion) cavernous tuberculosis
      existed in 33 patients (15.57%), while only 4 patients (1.87%) had diffuse
      pulmonary lesion. Diagnosis of post-tuberculous syndrome was made in 68 patients
      (32.08%). Secondary aspergylloma existed in 36 patients while the frequency of
      bronchial stenosis and bronchiectasis was the same -m 31 patients (16.98% and
      14.63% respectively). One patient had broncho-oesophageal fistula. Tuberculous
      empiema, complicating the disease, existed in 36 patients (16.98%). Comparing the
      two 5-years periods, (1983-87 and 1988 to 1992) the authors conclude that the
      number of operations for tuberculosis is decreasing. Treatment was successful in
      all patients except in a patient with a broncho-esophageal fistula, who died
      postoperatively slow lung reexpansion existed in 5 patients, and in two cases
      partial upper thoracoplasty had to be done in order to solve the complication of
      the initial treatment. In all cases postoperative antituberculous chemotherapy
      was performed taking in consideration the problem of possible drug-resistance.
      There were no recurrences.

PMID- 7785392
TI  - [Diagnostic and surgical approaches in the treatment of tracheal diseases].
AB  - The authors present 100 patients operate for diseases of the trachea during a
      period ranging from 1972-1991. Stricture of the trachea was observed in 75% of
      pts. and tumours in the remaining 25%. Stricture resulting from tracheostomy was
      the most frequent. The majority of patients underwent end-to-end anastomosis. A
      Nevill prosthesis was implanted in 5 patients. The results were good in 93.34% of
      pts. The mortality was 6.6%. The most frequent operation for malignant tumours
      was resection of the trachea and end-to-end anastomosis. The length of the
      respected segment ranged from 3-6 cm. There was no mortality. The authors
      conclude that adequate preoperative diagnostic procedures unable good assessment
      of a lesions and a well planed operation with good results and no mortality.

PMID- 7785393
TI  - [Personal experience in the treatment of injured patients with craniocerebral
      injuries associated with thoracic injuries].
AB  - In the Emergency Center of the Neurosurgical Intensive Care Unit Belgrade, in the
      one-year period (from January, 1st 1992 to December, 31st 1992), 54 injured
      patients with severe head injuries associated with chest trauma were treated. In
      all injured patients the following parameters were considered: sex, age,
      mechanism of injury, surgical procedures, and fatal outcome. Thirty-nine patients
      (72.22%) survived.

PMID- 7785391
TI  - [Teratogenic tumors of the mediastinum].
AB  - Primary teratogen tumors of the mediastinum are rarities in clinical and
      pathological practice. Their polymorphic histological picture and their enormous
      size provoke a great diagnostic difficulty. We analyze 85 primary teratogen
      tumors of the mediastinum (except those that were localized in thymus) which have
      been diagnosed in Institute for pulmonary diseases and tuberculosis, Clinical
      center of Serbia, between 1973 and 1991. Material for pathohistological
      evaluation was obtained by surgical resection of the whole tumor in 58 patients
      or by percutaneous needle aspiration biopsy in 47 patients. Malignant (immature
      or teratomas with malignant transformation) were present in 49 (57.65%) patients
      and benign (mature) teratomas in 36 (42.35%). The majority of benign (mature)
      teratomas (83.33%) were composed of a variety of tissue elements derived from all
      three germ layers and 16.67% show only ectodermal and mesodermal derivates.
      Malignant (immature) teratomas contained both epithelial and mesenchymal
      incompletely differentiated elements in 67.35% of cases and in 22.45% of cases
      only epithelial component undergoes malignant transformation. In our series there
      were two cases of primary seminoma of the mediastinum and one case of primary
      embryonal carcinoma, primary yolk sac tumor and primary choriocarcinoma of the
      mediastinum.

PMID- 7785394
TI  - [Treatment of severe craniocerebral injuries].
AB  - During 1992. 19357 patients were examined at the Department for Neurosurgery of
      the Emergency Centre, Clinical Center of Serbia, out of which 15879 had head
      injury. In addition to those necessitating hospitalisation, there was also a
      large number of patients with mild head injury that were not admitted for
      hospital management and were sent home following initial first aid. The average
      incidence of these patients was 45 patients per day during 1992. During 1992. a
      total of 1,978 patients were hospitalised, out of which 1,520 (84%) were injured.
      A total of 633 patients (25%) were hospitalised due to injuries sustained in
      traffic accidents. All patients were examined and evaluated according to the
      standard protocol including GCS as well.

PMID- 7785395
TI  - [Isolated tuberculosis of the liver--case report].
AB  - Tuberculosis of the liver is rare even in areas where tuberculosis is widespread.
      Isolated tuberculosis of the liver is extremely rare. It usually presents as a
      nodular - pseudo-tumorous form. Tuberculosis of the bile ducts is even less
      frequent. A 37 year old woman with nodular - pseudotumorous form of tuberculosis
      of the liver is presented. The diagnosis was established after surgical biopsy
      and histology. It may be caused by the bovine type of the bacillus. The patient
      had an excellent response to tuberculostatic drugs. Tuberculosis of the liver
      must be taken into account in the differential diagnosis of the liver masses.

PMID- 7785396
TI  - [Mesenteric panniculitis--case report].
AB  - Mesenteric panniculitis is a very rare disease usually involving the mesentery of
      the small bowel, less frequently the sigmoid colon or other intraabdominal fat
      tissue. The disease is benign with a favorable prognosis. Diagnosis is, as a
      rule, established at operation or autopsy and histology. A 58 year old male with
      this disease is presented. The paticut hod mild abdominal pain and a palpable
      mass. A tumor of the mesentery was suspected on CT scan. The exact diagnosis was
      established at operation and confirmed at histology.

PMID- 7785397
TI  - [A surgical technic for bilio-enterostomy].

PMID- 7785398
TI  - [Biofeedback and surgery in the treatment of fecal incontinence and lesion of the
      external anal sphincter: long-term follow-up].
AB  - INTRODUCTION: In children, damage in the anal area which affects both the
      external anal sphincter and the internal anal sphincter is serious problem.
      Biofeedback is not effective if the external anal sphincter is severely damaged,
      and surgery by itself cannot effect a cure for incontinence in these cases.
      CLINICAL CASE: a girl aged 6 yrs 8 months who from the age of two suffered from
      massive recurrent tricolephalosis, causing rectal prolapse, anal abscesses and
      fistulas, fistulectomy, and finally severe damage in the anal area with total
      incontinence. The treatment began with recto-anal manometry, and rectal
      sensitivity studies. Biofeedback was used before and after gracilis muscle
      transfer and colostomy. After 12 months, total continence was achieved, and has
      continued through 7 years of follow-up examinations. CONCLUSIONS: To treat fecal
      incontinence combined with severe damage in the external anal sphincter, the
      following procedure should be followed: manometry and sensitivity studies,
      reconstruction of the external anal sphincter with gracilis muscle transfer, and
      biofeedback.

PMID- 7785399
TI  - [Predictive factors in the treatment of esophageal achalasia].
AB  - With aim of determining if there are predictive factors in the treatment of
      achalasia of the esophagus, we analyzed in a group of 119 patients variables such
      as age, gender, X-Rays, Chagas' disease serology and esophageal manometry before
      and after treatment. The only significant factor was the LES pressure post
      treatment but, since the sampling was heterogeneous, and the differences where
      the same between bad and good results, we believe it has no predictive value in
      the treatment of achalasia of the esophagus.

PMID- 7785400
TI  - [Do the physical characteristics of radiopaque markers modify the results of the
      measurement of colonic transit time?].
AB  - This study was performed in 15 healthy control subjects (8 males- age 23-70 and 7
      females age 20-74) as a way to compare the total and segmental colonic transit
      time with two different type of radiopaque markers. One type of markers was 3 mm
      cut sections of a radiopaque polietilene 14 French Levine tube, with a medium
      weight of 64.3 mg and a specific gravity (SG) of 1.28. The other type were 7 mm
      lenticular insoluble barium (lentils) with medium weight of 231 mg and a SG of
      1.87. Each subject ingested 20 markers of each type with the breakfast and front
      and profile plain films of the abdomen were taken 24 and 48 hs after. The total
      colonic transit time for the polietilene markers was 17.7 hs and 27.3 hs for the
      barium type (BM) (p < 0.001). The segmental transit time for right colon was 2.4
      hs (PM) and 9.7 hs (PM) and 9.7 hs (BM) (p < 0.001) in the left colon 9.5 hs (PM)
      and 11.3 hs (BM) and in rectoanun 5.9 hs (BM) with no statistical significance.
      CONCLUSION: the physical characteristics of the radiopaque markers can modify the
      results of the colonic transit times.

PMID- 7785401
TI  - [Viral hepatitis infection and response to the hepatitis B vaccine in
      hemodialyzed patients].
AB  - Data from 219 hemodyalized patients receiving attention in our Hospital and other
      private centers in our city are shown. Mean age was 46.9 (range: 14-85), and 132
      were male; mean time under dialysis was 20 months, and subjects received an
      average of 5 transfusions per patient year. Serological reactivity to HBs Ag,
      Anti HBs and IgG anti HBc by ELISA were investigated in all of them, and anti HCV
      by second generation enzimo-immunoassay (EIA II) in 73 HBe Ag/anti HBe system
      were determined in HBs Ag positive patients and those reactive to anti HCV (EIA
      II) were confirmed by LIA (immunoblotting of synthetic peptides LIA-TEK Organos
      Teknica). Recombinant anti HBV vaccine 40 mcg at 0-1 and six month were received
      by 81 cases without HBV markers in their sera and a protective response was
      considered when anti HBs titration of 10 mU/ml or more were obtained two months
      later. Prevalence for anti HBc and anti HBs were 38.8% respectively and that for
      HBs Ag was 21% with 78% of them reactive for HBs Ag. True reactivity for anti HCV
      (confirmed by LIA) was present in 35.6%, but it was 9.7% in our Hospital and
      54.8% in private units (p < 0.0002). Anti HBs titration was done in 69/81
      patients who received anti HBV vaccine, and a protective response in 49% were
      obtained; the other 12 patients underwent acute hepatitis B during the
      vaccination period.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785402
TI  - [Congenital hepatic fibrosis. Study of 26 cases].
AB  - We studied 26 children with congenital hepatic fibrosis during the period 1971
      1993. About half of the children were about the 6 years old. Only two had
      brothers with same disease. The chief clinical manifestation was hematemesis
      associated or not with liver enlargement, predominantly of left lobe. Only one
      case showed fever and cholangitis. Liver function tests were usually normal.
      Twenty-two children had portal hypertension. Liver biopsy was of definitive for
      diagnosis. Seven children died.

PMID- 7785403
TI  - [Non cardiogenic chest pain, sensorial-motor esophageal dysfunction, and
      provocation tests].

PMID- 7785404
TI  - [Anal incontinence].

PMID- 7785405
TI  - [5-ASA versus sulfasalazine].

PMID- 7785406
TI  - [Lymphatics of the thoracic surface of the diaphragm especially located around
      the inferior surface of the pericardial sac].
AB  - The lymphatics on the thoracic surface of the diaphragm, especially lying around
      the lateral and posterior sides of the base of the cardiac sac, were examined in
      68 adult Japanese cadavers macroscopically (37 males and 24 females, aged 45-92
      years, no clinical evidences of neoplasms). In this observation, a vein which
      drained into the terminal portion of the inferior vena cava was observed. The
      lymph nodes in this region were located along the vein frequently (80.9%). The
      vein passed through the esophageal hiatus, or penetrated the diaphragm and
      finally communicated with veins around the esophagogastric junction. However,
      lymphatic vessels were not observed passing through the phrenico-esophageal
      membrane and/or the diaphragm. The collecting vessels, which originated from the
      lymphatics, drained into the esophageal lymphatics, and it drained into the
      thoracic duct via the esophageal lymphatics. In pleural effusion cases, lymphatic
      nets were clearly observed on the thoracic surface of the diaphragm immediately
      under the parietal pleura. The lymphatic nets did not communicate with the
      diaphragmatic lymphatics around the base of the cardiac sac. Moreover, large
      collecting vessel from the lymphatic nets passed through the muscular crus of the
      diaphragm near the medial arcuate ligament and traveled inferior to merge at the
      original portion of the thoracic duct at the level of the renal vessels. From
      these observations, the lymphatics on the posterior part of the thoracic surface
      of the diaphragm communicated with several regional lymphatics independently.
      This morphological lymphatic traveling suggests that the route differs in cases
      of pleural effusion or cancer metastasis.

PMID- 7785407
TI  - An unusual coursing of the facial vein.
AB  - During the dissections of 50 adult cadavers for educational purposes, we found a
      45-year-old male cadaver with an abnormally coursing facial vein which has joined
      the retromandibular vein at a higher level--in the parotid gland--on the right
      side of the face. This anomaly has also been detected radiologically.

PMID- 7785408
TI  - [A case of mandibular retromolar canal: elements of nerves and arteries in this
      canal].
AB  - The large bilateral mandibular retromolar canals were found in a 47-year-old
      Japanese man. This paper presents the nature and distribution of the elements of
      nerves and arteries in the left retromolar canal which were able to examined. The
      left mandibular retromolar canal arose from the bifurcation of the mandibular
      canal at 18 mm anterior to the mandibular foramen and it opened on the surface of
      the retromolar fossa at 13 mm posterior to the third mandibular molar. The total
      length of the retromolar canal from the bifurcation to the retromolar foramen was
      about 16 mm, and 2.5-2.6 mm in diameter. The radiographic image of this
      retromolar canal was a liner shadow with thin radiopaque anterior and posterior
      borders cast on a lateral radiography of the left half of the head. Within the
      retromolar canal, the artery that was branched from the inferior alveolar artery
      ran through the canal forwards and joined with the branches of the buccal artery
      and the facial artery, and then gave off the superior and inferior labial
      arteries. The nerve (R. retromolaris) in the retromolar canal derived from the
      inferior alveolar nerve trunk and branched off to the following areas: the third
      mandibular molar, the mucosa of retromolar triangle, the buccal mucosa, and the
      buccal gingiva of the mandibular premolar and molar region. The retromolar canals
      and foramina were found in 8 out of 41 Japanese skulls. Clinically, if the
      arteries in the retromolar canal become injured, complications may arise such as
      bleeding, and iatrogenic nerve damage may lead to paralysis.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7785409
TI  - Anomaly of the ulnar artery arising from the brachial artery.
AB  - A high origin of the ulnar artery was encountered in the body of an 87-year-old
      Japanese man in the course of normal anatomic dissection at Nara Medical
      University. The left ulnar artery originated from the brachial artery at the
      height of the left inferior angle of the left scapula and passed medially to the
      brachial artery and the median nerve. In the forearm, the ulnar artery passed
      deep to the flexor carpi ulnaris muscle. Thereafter, the two branches from the
      ulnar artery contributed to form the superficial and deep palmar arterial arches.
      The left brachial artery was divided into two terminal branches of the radial and
      common interosseous arteries.

PMID- 7785410
TI  - CT measurement of the normal brain ventricular system in 100 adults.
AB  - Examination of 100 voluntary cases with no physical or neurological deficit
      revealed that the sizes of the cerebral ventricles increase with age in both
      sexes. According to regression analysis in women, increase in the size of the
      third ventricle by age was statistically significant. Compared to women, the size
      of the third ventricle was larger in men. In the measurements of the lateral
      ventricles, it was observed that bifrontal the cerebroventricular index in men
      and the bicaudal cerebroventricular index in women increase significantly with
      age. The indices showed no significant difference between the two sexes.

PMID- 7785411
TI  - Axonal elongation of grafted, embryonic inferior olivary neurons in the adult rat
      cerebellum and their synaptic formation on host Purkinje cells.
AB  - Although the brain grafting of adult mammals had failed to show reinnervation of
      host targets, embryonic neural tissue grafted to adult brains has been reported
      to establish new neuronal connections. However, the trajectories of growing axons
      of grafted neurons in the host brain are poorly understood. To study the
      morphological aspects of the trajectories of growing axons of grafted neurons in
      detail, ventromedial medulla containing the inferior olivary nucleus of 14-day
      rat embryos were grafted into the hemicerebella of 8-week-old adult rats whose
      inferior olivary neurons and climbing fibers were previously destroyed. The
      cerebellum and the inferior olivary complex of host rats were histologically
      examined 1-6 weeks after surgery. The heterotopically grafted neurons sent their
      axons into the white matter and the molecular layer of the host cerebellum. These
      growing fibers made plexus formation in the molecular layer, ending with axo
      somatic and/or axo-dendritic synapses on host Purkinje cells whose afferent
      climbing fibers had been eliminated. These results show that the growth cones of
      growing axons arising from the grafted neuron can find and reach host targets
      along unusual pathways, and that some of the mature host Purkinje cells retain
      the ability to form synapses with newly developing axons from the grafted
      immature inferior olivary neuron.

PMID- 7785412
TI  - Immunohistochemical studies on supporting cells in the adrenal medulla and pineal
      gland of adult rat, especially on S-100 protein, glial fibrillary acidic protein
      and vimentin.
AB  - In the adrenal medulla and pineal gland, the morphological and chemical nature of
      supporting cells were examined immunohistochemically. In the adrenal medulla,
      supporting cells in noradrenaline (NA)-cell regions showed similar and intense
      immunoreactivities to the three glial marker proteins, S-100 protein, glial
      fibrillary acidic protein (GFAP) and vimentin, forming a network, while those in
      adrenaline (A)-cell regions were less numerous and their immunoreactivity was
      positive to S-100 protein but negative to GFAP and, at least in part, negative to
      vimentin. In the pineal gland, supporting cells in the stalk and the proximal
      region of the body portion formed a network and showed immunoreactivities to the
      three antibodies, while those in the distal region of the body portion were less
      numerous and their immunoreactivity was positive to S-100 protein and vimentin,
      but negative to GFAP. Thus, the distribution pattern and chemical nature of
      supporting cells showed regional differences in both glands. There were several
      similarities in supporting cells between those in NA-cell regions of the adrenal
      medulla and in the stalk and the proximal region of the body portion of the
      pineal gland, and also between in A-cell regions of the adrenal medulla and in
      the distal region of the body portion of the pineal gland, respectively. The
      biological and functional significances of these results are discussed.

PMID- 7785413
TI  - Architecture and function of the extravascular fluid pathway: special reference
      to the macula cribriformis in the diaphragm.
AB  - Silver staining, transmission electron microscopy (TEM) and scanning electron
      microscopy (SEM) have been used to delineate the structure and function of the
      extravascular fluid pathway of the diaphragm of monkeys, rats, mice and rabbits.
      The submesothelial connective tissue was examined by SEM using the NaOH
      maceration method. A sieve-like structure, the macula cribriformis, was found in
      the submesothelial connective tissue on the peritoneal side of both the muscular
      and tendinous portions. The macula cribriformis, which consisted of densely
      packed collagen fibrils, was oval, spindle and polygonal in shape and ranged in
      diameter from 20 to 300 microns with 5-300 foramina (3-15 microns). The macula
      cribriformis was located between peritoneal mesothelial cells with stomata and
      subperitoneal lymphatic capillaries. Intraperitoneally-injected latex particles
      were carried into the diaphragmatic lymphatic capillaries via the peritoneal
      stomata and the foramina of the macula cribriformis. These results support the
      hypothesis proposed by Kihara (Okajimas Fol Anat Jpn 28: 601-621, 1956) that the
      macula cribriformis is a pre-lymphocapillary pathway, one of the extravascular
      fluid pathways.

PMID- 7785414
TI  - Distribution and size of cerebellar and thalamic projection neurons in the
      trigeminal principal sensory nucleus and adjacent nuclei in the rat.
AB  - Using retrograde axonal transport of wheat germ agglutinin conjugated with
      horseradish peroxidase (WGA-HRP), the distribution and size of the cerebellar and
      thalamic projection neurons were demonstrated in the trigeminal principal sensory
      nucleus (Vpr) and four adjacent nuclei: the trigemino-angular nucleus (Ta), the
      supratrigeminal nucleus (SupV), the intertrigeminal nucleus (IntV) and the
      juxtatrigeminal nucleus (JxtV). In the control animal, the size of the
      constituent neurons of these five nuclei was also analyzed. The mean size of the
      somata was significantly (p < 0.05) different among these nuclei: it was largest
      in the Ta, followed by the IntV, SupV and JxtV, and smallest in the Vpr. After
      cerebellar and thalamic injections of WGA-HRP, labeled neurons were found in all
      of these nuclei. The cerebellar projection from the SupV and the thalamic
      projections from the Ta, SupV and IntV were observed for the first time in this
      study. The proportion of neurons projecting to the cerebellum and the thalamus
      varied in these nuclei. In the Ta and IntV, the majority of neurons were labeled
      after cerebellar injections, whereas nearly all neurons in the Vpr were labeled
      after thalamic injections. In the SupV and JxtV, thalamic projection neurons were
      greater in number. Thus, each nucleus examined in this study had distinct
      organizations concerning the soma size and the mode of projection to the
      cerebellum and the thalamus.

PMID- 7785415
TI  - Lateral plate mesoderm and guidance cues for cutaneous nerve growth in the avian
      body wall.
AB  - Transplantation of the somatic layer of the lateral plate mesoderm (somatic
      mesoderm) was performed using the quail-chick chimera system in order to evaluate
      whether the connective tissue acts as guidance cues for the developing cutaneous
      nerve in the body wall. When quail somatic mesoderm at the sacro-coccygeal
      (pudendal) level was transplanted into the chick somatic mesodermal region at the
      thoracic level, the ventral nerve exhibited the pudendal type of branching
      pattern in the thoracic region. However, the cutaneous nerve course remained the
      thoracic type. These results suggest that the connective tissue derived from the
      somatic mesoderm provides cues for the determination of the nerve branching
      pattern. In contrast, the pathway selection might require other guidance cues
      than the somatic mesoderm in the ventral cutaneous nerve growth in the body wall.

PMID- 7785416
TI  - Agenesis of the celiac trunk: an angiographic case.
AB  - In the angiography performed for a clinical diagnosis, a unique case of "agenesis
      of the celiac trunk" was encountered in a 42-year-old Turkish male. There was
      instead an artery which arose from the aorta at the level of the first lumbar
      vertebra, and supplied blood to the territory of both the celiac and superior
      mesenteric arteries by giving rise to the splenic, the jejunal, the ileal, the
      pancreaticoduodenal, the proper hepatic and the left gastric arteries,
      consecutively.

PMID- 7785417
TI  - Fine incremental lines observed on the enamel surfaces with a prismless structure
      in human teeth after phosphoric acid etching.
AB  - In human tooth enamel, the surface prismless layer contains liner laminas
      homologous to the cross-striations of enamel prisms other than the Retzius lines,
      while these lines terminate on the perikymata or run in parallel with the enamel
      surface. In our present scanning electron microscope observations after
      phosphoric acid etching, many fine incremental lines (FIL) running transversely
      were found on the inner occlusal enamel with a prismless structure in a young
      permanent premolar. Almost the same structures were also found on the upper
      coronal enamel with scattered prismless and indistinct prism structures in an
      exfoliated deciduous molar, and the FIL occasionally went across the indistinct
      prisms or caused the lower half of the prisms to disappear. Their intervals
      ranged from about 0.5 to 2 microns; less than the diameter of the prisms. Such
      results suggest that the FIL are not the termination of the laminate striations
      in the surface prismless layer, but that the previously unnoticed patterns
      sometimes formed by the sequential completion of the activity of ameloblasts
      which interact with each other in a transverse row at the final stage of matrix
      formation.

PMID- 7785418
TI  - Morphological studies on the kidney of the spontaneous nephrotic (ICGN) mice in
      the late stage.
AB  - Spontaneous nephrotic (ICGN) mice develop proteinuria, hypoproteinemia and
      hypercholesterolemia. These symptoms steadily progress to chronic renal failure.
      Details of the changes of the kidney, in the late stage (more than 5 months old)
      were investigated by both light and electron microscopy. The kidney exhibited a
      slightly whitish, granular surface and the cortex became thinner and contained
      fibrous lesions, in which clusters of unaffected and occluded renal tubules were
      randomly scattered. In the juxtamedullary and outer medullary zone, there were
      highly dilated renal tubules, which sometimes contained urinary casts. The
      glomerulus exhibited basement membrane thickening in the capillary loops and the
      capillary lumen was narrowed in size and sometimes occluded. No detachment of the
      podocyte from the basement membrane was observed and the podocyte foot-processes
      were extensively fused, causing their characteristic slits to be lost. The
      thickened basement membranes were found both in the glomerulus and around the
      occluded renal tubules, while the basement membrane in the dilated renal tubule
      appeared normal. Therefore, the basement membranes of the glomerulus and renal
      tubules appear to react differently in the pathogenesis of the condition. In
      conclusion, ICGN mice are a good model for not only the nephrotic syndrome but
      also for chronic renal failure.

PMID- 7785419
TI  - Inhibitory motor seizures: correlation with centroparietal structural and
      functional abnormalities.
AB  - Six adults and 2 children with focal inhibitory motor seizures (ictal paralysis)
      were evaluated during a 4-year period. Paresthesias at seizure onset occurred
      during some seizures in all patients, and focal clonic activity followed
      paralysis in 4. EEG-CCTV recordings of the seizures in 2 patients showed that
      ictal paralysis coincided with an ictal discharge starting in one centroparietal
      area. MRI showed centroparietal structural lesions in six patients. One patient
      with a normal MRI scan had right centroparietal hypometabolism on PET. Inhibitory
      motor seizures must be differentiated from transient ischemic attacks and
      migraine. In our patients a centroparietal epileptogenic focus was suggested by
      neuroimaging studies, and in 2 instances by ictal EEG.

PMID- 7785421
TI  - Rasch analysis in the development of a rating scale for assessment of mobility
      after stroke.
AB  - The study describes the development of a rating scale for assessment of mobility
      after stroke. It was based on 74 first-stroke patients, 40 men and 34 women, each
      assessed three times during rehabilitation. Their median age was 69 years, and
      they represented all degrees of severity of paresis. Content, construct,
      criterion and convergent validity were examined, as well as the inter-rater
      reliability. The final rating scale has three special characteristics: 1) it
      reflects the regularity in the recovery of mobility after stroke; 2) the sum of
      item scores comprises the information contained in the 10-item subscores; 3) the
      score sum is independent of age, side of hemiparesis, and gender of the patient.
      Latent trait analysis (Rasch) was found to be an ideal model for statistical
      investigation of these properties.

PMID- 7785420
TI  - Guillain-Barre syndrome in south-west Stockholm, 1973-1991, 1. Quality of
      registered hospital diagnoses and incidence.
AB  - We describe the incidence and explore the quality of registered diagnosis for
      Guillain-Barre syndrome (GBS) in a population-based retrospective study in South
      West Stockholm (SWS), Sweden, during the period 1973-1991. We used data on
      registered hospital discharges and open-care visits, and from medical records.
      Medical records were available for 83 (80.6%) of 103 patients with registered GBS
      diagnosis at discharge from hospitals. For 69 (83.1%) of such patients, the
      information from the hospital record fulfilled the National Institute of
      Neurological and Communicative Disorders and Stroke (NINCDS) clinical criteria
      for GBS. One out-patient presented with suspected GBS. In contrast, none of 40
      patients discharged with diagnosis of unspecific polyneuropathy fulfilled the
      above mentioned criteria. During the period 1973-1991, the mean annual incidence
      of GBS per 100,000 was 1.74, 95% CI 1.41-2.12, from register data and 1.49, 95%
      CI 1.19-1.85, after excluding those not fulfilling criteria for GBS. The age
      adjusted incidence after validation was higher for men, 1.64, 95% CI 1.19-2.21,
      than for women, 1.46, 95% CI 1.05-1.99. An increasing incidence with age was
      found, presenting the age-specific curve a bimodal shape. The results of this
      study confirm that hospital discharge diagnostic data in Sweden can be used for
      purposes of epidemiological research and surveillance for GBS, and show that the
      incidence of GBS in SWS compares to those described in other populations.

PMID- 7785422
TI  - Recurrent hypertensive intracerebral hemorrhage.
AB  - Hypertensive intracerebral hemorrhage has been considered as a one-time event
      with rare recurrence. This observation is quite different from our experience in
      Taiwan. We, therefore, conducted a systematic review of our series of consecutive
      patients with recurrent bleeding. During a 2-year period, we encountered 47
      patients with recurrent hypertensive intracerebral hemorrhage from a total of 892
      consecutive patients with hypertensive hemorrhage (5.3%). There were 25 men and
      22 women with a mean age of 59 +/- 10 (range: 36-78) years at the onset of the
      first hemorrhage and 62 +/- 9 (range: 39-80) years at the second hemorrhage. The
      median interval between 2 hemorrhages was 2 years and 4 months (range: 1 month to
      8.5 years). All except one recurrent hemorrhages occurred at a site different
      from the previous one. Of the 38 patients admitted to our hospital for both
      hemorrhages only 5 were regularly treated with antihypertensive therapy. The
      outcome for the recurrent bleeding was grave: 26% died and 51% became totally
      dependent or vegetative. Recurrent hypertensive hemorrhage is not as rare as
      previously thought; it comprises 5.3% of our patients with hypertensive
      intracerebral hemorrhage. The recurrent hemorrhage, however, rarely occurs at the
      same location as the previous one. Uncontrolled hypertension appears to be an
      important risk factor for the recurrence. Control of blood pressure after the
      first bleeding should be attempted to prevent recurrent hemorrhage.

PMID- 7785423
TI  - A syndrome of olivopontocerebellar atrophy and deafness with onset in infancy.
AB  - Olivopontocerebellar atrophy (OPCA) is rare in childhood and onset in infancy is
      uncommon. We encountered 11 consecutive children with clinical and radiological
      features of OPCA which started in infancy. In addition to cerebellar ataxia,
      these children also had sensorineural deafness and speech impairment. Of the
      present cases, 8 were sporadic and the pedigree patterns in 3 (with a sibling
      also involved) point to an AR inheritance. The CT scan showed varying degrees of
      cerebellar and pontine atrophy. The underlying genetic and neurochemical
      substrates of this syndrome await further study.

PMID- 7785425
TI  - F wave in acute cerebellar damage.
AB  - Studies of occurrence of the F wave can be considered as a method of assessment
      of excitability of the spinal cord motoneurones. So far it has been analyzed in
      relation to the damage to the pyramidal and extrapyramidal systems. In the
      present paper, various parameters of the F response (maximal and mean amplitude
      absolute and in relation to the M response, frequency of occurrence of all and
      identical F waves, minimal latency and chronodyspersion) were given analysis in
      15 patients with hypotonia after acute cerebellar damage, and in 35 healthy
      subjects. In the patients, the F response was found to be decreased in amplitude
      (mean-absolute and ratio to M) and in frequency. Therefore, a conclusion can be
      drawn that it confirms the decrease of segmental motoneurone excitability after
      cerebellar damage.

PMID- 7785424
TI  - Immunocytochemical detection of tumor necrosis factor-alpha in infiltrating tumor
      cells in the cerebrospinal fluid from five patients with leptomeningeal
      carcinomatosis.
AB  - We studied the immunoreactivity for tumor necrosis factor-alpha (TNF-alpha) in
      cerebrospinal fluid (CSF) cell smears from five patients with leptomeningeal
      carcinomatosis (LC). Immunostained TNF-alpha-positive tumor cells had brownish
      deposits in the cytoplasm, but no deposits were observed in the nucleus. The
      intensity of the TNF-alpha staining was greater in these tumor cells than in
      macrophages from patients with inflammatory diseases. Approximately 27-72% of the
      tumor cells were found to be TNF-alpha immunoreactive in all five samples from
      the patient with LC. These results suggest that the large amount of TNF-alpha
      produced by infiltrating tumor cells may play an important role in the
      development of the tumor.

PMID- 7785426
TI  - Microsatellite D21S210 (GT-12) allele frequencies in sporadic Alzheimer's
      disease.
AB  - Four disease-causing mutations have so far been described in the amyloid
      precursor protein gene on chromosome 21 in familial early-onset Alzheimer's
      disease. Linkage analysis with a fourteen-allele microsatellite at D21S210 named
      GT-12 has proven useful in the elucidation of amyloid precursor protein gene
      involvement in Alzheimer's disease families, as it is closely linked to the gene.
      Most cases of Alzheimer's disease are thought to be sporadic and not familial.
      However, evidence from earlier studies suggests an important genetic contribution
      also in sporadic cases, where gene-environment interaction may contribute to the
      disease. We have determined frequencies of the GT-12 alleles in 78 Swedish and 49
      British sporadic Alzheimer's disease cases and 104 healthy elderly control
      subjects, to investigate if the disease associates with a particular genotype in
      GT-12. However, no differences in allele frequencies were observed between any of
      the groups.

PMID- 7785427
TI  - Absence of 4,977-bp deletion of blood cell mitochondrial DNA in patients with
      young-onset Parkinson's disease.
AB  - Decreased mitochondrial Complex I activities and a 4,977-bp deletion in
      mitochondrial DNA (mtDNA) have been reported in patients with Parkinson's
      disease. Based on the assumption of possible links between this 4,977-bp deletion
      and the etiology of Parkinson's disease, we analyzed mtDNA of blood cells from 15
      patients with young-onset Parkinson's disease after the DNA was amplified by
      polymerase chain reaction. We could not detect the 4,977-bp mtDNA deletion in any
      of these patients. This result suggests that Parkinson's disease is not a
      mitochondrial disease due to the 4,977-bp mtDNA deletion. The 4,977-bp deletion
      in mtDNA appears to be an age-related phenomenon.

PMID- 7785428
TI  - Regional cerebral glucose metabolism in autopsy-confirmed Creutzfeldt-Jakob
      disease.
AB  - Regional cerebral glucose metabolism was measured in a 72-year-old man, with
      Creutzfeldt-Jakob disease (CJD), by positron emission tomography using [18F]-2
      fluoro-2-deoxy-D-glucose as the tracer. The diagnosis of CJD, a rare
      neurodegenerative disorder, was confirmed at autopsy 13 months later. Compared
      with five unaffected elderly men, the patient had reduced metabolism
      heterogeneously distributed throughout the brain. The hypometabolism was most
      evident in the right hemisphere, particularly in the posterior frontal, parietal,
      Sylvian, and temporal regions. This left-right asymmetry is more extensive than
      that previously reported in Alzheimer's disease, and may provide a useful
      metabolic marker for early diagnosis of CJD.

PMID- 7785429
TI  - High levodopa use in periodically time-clustered, Icelandic birth cohorts. A
      vestige of parkinsonism etiology? Europarkinson Preparatory Activity Research
      Group.
AB  - We evaluated levodopa use (LDU) by the Icelandic population focusing on: 1)
      annual gross levodopa (LD) sales from wholesalers to pharmacies for the period
      1978-1990, using a reported method; 2) data from a prescription survey conducted
      from October 1st, 1990 to March 31st, 1991; and 3)raw and reported data on
      prevalences of Parkinson's disease (PD) in 1963 in this country. The standard for
      adjustments and reference population for LDU comparisons was the Swedish in 1984.
      Crude gross sales of LD in Iceland in 1990 and in Sweden in 1984 amounted to 1.67
      and 1.35 DDD/1000 person days respectively. After respective adjustments for age,
      and for age and the infant mortality rates, taken as an indicator of health care
      quality, LDU in Iceland in 1990 was found to be 1.82 and 1.63 (95% CI 1.47-1.89)
      times that for Sweden. Prevalences of LD-prescription recipients in 1990-1991 and
      of PD in 1963 increased with age; however, those of drug users were higher than
      those of PD among the elderly. Higher-than-expected prevalences of PD and LD
      prescription users (there being a partial overlap between these two categories)
      were found in periodically-clustered, one-year birth cohorts. These results
      support the notion that Iceland has a high LDU and suggest that this variation is
      due to a high prevalence of LD responsive disorders. Cohorts born after
      registered whooping cough outbreaks in Iceland may account for the magnitude and
      birth-related pattern of PD prevalences and LDU levels.

PMID- 7785430
TI  - Levodopa use in Denmark: high levels in Greenland and the Faroe Islands.
      Europarkinson Preparatory Activity Research Group.
AB  - Levodopa (LD) sales from wholesalers to pharmacies during the periods, 1977-1989
      in Denmark, 1981-1989 in Greenland, and April 1988-May 1989 in Danish counties
      and the Faroe Islands, were evaluated using a reported method and a procedure
      expressly developed for assessment of random variation comparative levodopa use
      (LDU) measurements. The reference population for comparison of LDU was the
      Swedish from 1984. LDU diffusion had stabilized by 1989 in Denmark, but
      considerable annual increments of LD sales were still seen in Greenland in 1989.
      Crude LDU in Denmark and most Danish counties amounted to a level similar to that
      of Sweden. Adjustments for age and infant mortality rates, taken as an indicator
      of socioeconomic development, disclosed statistically significant twofold levels
      of LDU in the Faroe Islands and Greenland, and lowest LDU in urban regions. The
      social or biological factors underlying such differences in drug use remain
      unknown.

PMID- 7785431
TI  - Autonomic dysfunction in pathologically confirmed multiple system atrophy and
      idiopathic Parkinson's disease--a retrospective comparison.
AB  - INTRODUCTION: Autonomic dysfunction (AD) can be a feature of both multiple system
      atrophy (MSA) and idiopathic Parkinson's disease (IPD), conditions that are
      frequently misdiagnosed in life. Most studies on AD in MSA and IPD are based on
      clinical cases without pathological verification. MATERIAL AND METHODS: We
      retrospectively analysed AD in 135 pathologically confirmed cases of IPD and in
      33 of MSA from the UK PD Society Brain Bank. RESULTS: MSA started at a younger
      age than IPD (54.4 +/- 10.7 yrs versus 60.6 +/- 10.8 yrs), and AD began earlier
      in the course of the illness All MSA patients had some degree of AD in life
      whereas AD was absent in 24% of IPD patients. Although each of five autonomic
      domains was affected in variable numbers of IPD patients, AD in MSA generally
      involved more autonomic domains than in IPD, and to a more severe degree, in
      particular with regard to inspiratory stridor. CONCLUSIONS: These results
      indicate that the presence of autonomic disturbance alone does not distinguish
      between MSA and IPD in individual cases. However, the presence of severe AD, of
      AD preceding parkinsonism, or of inspiratory stridor, are all individually
      suggestive of MSA.

PMID- 7785432
TI  - [Antiulcer effect of polycyclicamine compound HH01 on experimental gastric ulcer
      in rats].
AB  - HH01(1-methyl-3,4,5,6,9,10-hexahydro-7H-cyclopenta [j,k]-1,3-dioxolo [4,5-h]
      pyrrolo[2,1-b] [3]-benzazepine) A and B in doses 30 mg.kg-1 and 60 mg.kg-1 were
      shown to protect gastric mucosa of rats from damage induced by absolute ethanol,
      cold-immersion stress and pylorus ligation. No effect was found in indomethacin
      model in mice. HH01 was found to decrease secretion of gastric juice and HCl in
      pylorus ligated rats. The content of DNA in gastric juice of animals treated with
      HH01 was lower than in control. The results suggest that HH01 is effective as an
      anti-ulcer agent, but its mechanism of action is yet unknown.

PMID- 7785433
TI  - [Synthesis of Achyranthes bidentata polysaccharide sulfate and its antivirus
      activity].
AB  - Sulfation of Achyranthes bidentata polysaccharide (Abps) with sulfuric acid or
      sulfur trioxide-pyridine or chlorosulfonic acid-pyridine was studied. A
      homogeneous sulfation method with good yield of 82.11% was obtained, using
      chlorosulfonic acid in an excess of pyridine. Sulfated Achyranthes bidentata
      polysaccharide was obtained as an amorphous sodium salt easily soluble in water.
      The UV and IR spectrum of Abps sulfate showed absorptions at 208, 268, 286 nm and
      1232, 823.6 cm-1 respectively. The sulfur content of the products was found to be
      20-22%. The degree of substitution varied from 2.8 to 3.2. It showed that the
      hydroxy group of Abps was almost completely esterified by chlorosulfonic acid.
      The Abps sulfate was shown to have high activity as anti-HBsAg and HBeAg. It is
      also effective on simple herpes virus type-I.

PMID- 7785434
TI  - [Comparison of multiple dosage bioavailability between phenylpropanolamine
      controlled release suspension and conventional tablet in healthy volunteers].
AB  - Compared studies between the pharmacokinetics of phenylpropanolamine (PPA)
      controlled release suspension (CRS) and that of PPA conventional tablet in 10
      healthy volunteers showed that the maximal plasma concentration (Cmax), the
      minimal plasma concentration (Cmin) and the fluctuation index (FI) values were
      169.06 +/- 7.76 ng.ml-1, 82.80 +/- 4.29 ng/ml-1 and 0.20 +/- 0.04 respectively
      for PPA CRS, 180.5 +/- 8.91 ng.ml-1, 76.18 +/- 5.97 ng.ml-1 and 0.81 +/- 0.07
      respectively for the conventional tablet. The Cmax and FI of PPA CRS were
      significantly lower compared with those of the conventional tablet (P < 0.01)
      during steady state. The Cmin of PPA CRS was higher than that of the conventional
      tablet (P < 0.05).

PMID- 7785435
TI  - [Inhibition of chemically induced microvascular leakage by ONO-1078, a
      leukotriene antagonist, in rat skin].
AB  - This study is to determine whether ONO-1078, a potent leukotriene antagonist,
      influences chemically induced rat skin microvascular leakage which is considered
      to be, at least in part, due to stimulation of sensory nerve ending and release
      of sensory neuropeptides. Evans blue dye was used as a tracer for plasma leakage.
      Intradermal injections of chemical stimuli, histamine (10 micrograms), capsaicin
      (10 micrograms) and formalin (0.5 mg), evoked Evans blue dye extravasation in rat
      skin. Intraperitoneal ONO-1078 dose-dependently inhibited the dye extravasation
      induced by these stimuli, with ID5v values of 1.98 mg.kg-1 for histamine, 1.78
      mg.kg-1 for capsaicin, and 2.23 mg.kg-1 for formalin. In contrast to
      chlorpheniramine, a H1 receptor antagonist, the inhibitory effect of ONO-1078 was
      weaker on histamine, but more potent on capsaicin and formalin. The inhibitory
      effect of dexamethasone was more potent than that of ONO-1078 on these stimuli.
      On the other hand, ONO-1078 inhibited the dye extravasation induced by
      leukotriene D4 (0.05 micrograms), but showed no effect on those induced by
      substance P (0.5 micrograms, a sensory neuropeptide), a larger dose of histamine
      (100 micrograms), and bradykinin (1 microgram). These results suggest that
      inhibition of chemically induced skin microvascular leakage by ONO-1078 may be
      mediated by inhibiting the release of sensory neuropeptides from capsaicin
      sensitive sensory fibers.

PMID- 7785437
TI  - [Tyr-D-Ala-Gly-Phe-D-Leu (DADL) solid-phase synthesis and its effects on immune
      function].
AB  - DADL, a delta-receptor selective enkephalin analogue, was prepared with the
      technique of solid-phase peptide synthesis. It was found to stimulate directly
      the proliferation of mouse splenic lymphocytes dose-dependently. However,
      synergistic effect of DADL at different concentrations with ConA and LPS were not
      found. In addition, TNF-alpha production was increased by ip DADL (1.0 mg.kg-1 x
      6 d) in mice and the production of LPS-induced TNF-alpha in mouse peritoneal
      macrophages was enhanced after DADL was added in vitro. These results suggest
      that DADL, like enkephalins, exerts some immunoregulatory activities.

PMID- 7785436
TI  - [Effects of tetrandrine on cardiac hemodynamics of hypertrophied left ventricle
      from deoxycorticosterone-salt hypertensive rats].
AB  - Effects of tetrandrine (Tet) on cardiac mass and hemodynamic parameters were
      studied in deoxycorticosterone-salt (DOCA-salt) hypertensive rats. Treatment with
      Tet (50 mg.kg-1, qd x 9 wk) markedly lowered systolic blood pressure and left
      ventricular (LV) weight. Study on isolated working heart demonstrated that the
      Tet group compared with the LVH group, AP, LVSP, +/- dp/dtmax, LVDP, coronary
      blood flow and cardiac output were increased while LVEDP and T were decreased.
      Studies on LV pressure-volume relation showed that Tet can markedly improve the
      LV compliance and the LV stiffness constant of LVH rat. These findings suggest
      that the regression of LVH in DOCA-salt hypertensive rats with Tet is associated
      with improvement of the contraction, relaxation and pump function, especially
      relaxation function and hemodynamics.

PMID- 7785438
TI  - [Effects of berberine on platelet aggregation and plasma levels of TXB2 and 6
      keto-PGF1 alpha in rats with reversible middle cerebral artery occlusion].
AB  - Berberine (Ber) 20 mg.kg-1.d-1 for 1, 3, or 5 d inhibited platelet aggregation
      induced by ADP, arachidonic acid (AA) and collagen (Coll) in rats with 24 h
      reversible middle cerebral artery occlusion (MCAO), and the platelet adhesiveness
      was inhibited as well. Using radioimmunoassay method, the thromboxane B2(TXB2)
      and 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) contents in rat plasma were
      measured 24 h after MCAO. The results indicate that the TXB2 levels after drug
      treatment were lower than those in ischemia control rats, but the 6-keto-PGF1
      alpha levels showed no obvious difference between the two groups. The same dose
      of Ber was also shown to inhibit thrombosis formation. This suggests that the
      decline of platelet aggregation and decrease of TXB2 content may be one of the
      important factors involved in the anti-cerebral ischemia effect of Ber.

PMID- 7785439
TI  - Demonstration of the potassium channel opening activity of GYKI-12743 by 86Rb+
      efflux studies.
AB  - It has been demonstrated that the novel antihypertensive compounds GYKI-12743
      showed a potassium channel opening effect as studied in rabbit ear arteries with
      86Rb+ as K+ marker. GYKI-12743 produced a concentration dependent 86Rb+ efflux in
      the same concentration range as the well-known K(+)-channel openers, pinacidil
      and cromakalim.

PMID- 7785440
TI  - The combined cardiovascular effect of alcohol and noise in rats.
AB  - Groups of 20 CFY male rats were made to drink water containing 10% alcohol and 5%
      sugar or 5% sugar. Half of both groups (10-10 animals) were exposed to 95 dBAeq
      mixed industrial noise for 3 weeks, 6 hours daily. Haemodynamic measurements were
      carried out using isotope (57Co) labelled microspheres, which were repeated after
      the i.v. administration of 30 micrograms/kg/3 min noradrenaline, using a second
      isotope (113Sn). It was found, that alcohol decreased the cardiac fraction of the
      cardiac output, the nutritive blood flow of the myocardium and increased the
      vascular resistance of the adrenals. Noise decreased the lung fraction of the
      cardiac output and the hepatic blood flow. Interaction between noise and alcohol,
      inhibiting the effect of alcohol, was demonstrated on the intestinal blood flow,
      adrenal fraction of cardiac output and testicular vascular resistance. The
      haemodynamic effects of noradrenaline observed in the control were in several
      organs more or less modified in the animals treated with alcohol or noise or
      both. It was concluded that the exposures (alcohol, noise or both) modify the
      alpha-adrenergic effect of noradrenaline.

PMID- 7785441
TI  - Pharmacokinetic study on a new antiischaemic agent (BRLP-42).
AB  - In the present study the pharmacokinetics of BRLP-42--a new antiischaemic agent-
      was investigated in dogs and rats. Plasma concentrations were measured by HPLC.
      After intravenous application the curves can be characterized by a two
      compartment open pharmacokinetic model. The central volume of distribution
      (Vcentr.) is large (1.07 +/- 0.14 l/kg in dogs and 2.74 l/kg in rats), the first
      elimination half-life (t1/2 alpha) is 5.47 +/- 1.67 min in dogs and 13.7 min in
      rats. These facts indicate rapid and large tissue distribution. The excretion
      and/or metabolic elimination of BRLP-42 resulted in short second elimination half
      life (t1/2 beta = 41.45 +/- 2.34 min in dogs and 43.8 min in rats). After oral
      application high individual variability can be seen. This fact may be due to the
      different rate and/or extent of absorption process. The plasma level curves can
      be characterized by a one-compartment open pharmacokinetic model. The absorption
      seems to conceal the distribution phase of the kinetic curve. The absorption half
      life was short (t1/2a = 17.36 +/- 5.90 min in dogs and 2.7 min in rats). The
      bioavailability was 40 +/- 8% in dogs and 28% in rats. The elimination half-life
      (t1/2e = 28.77 +/- 0.88 min in dogs and 30.1 min in rats) is connected dominantly
      with metabolic elimination and/or excretion of BRLP-42. In the cases of
      intravenous as well as oral administrations the plasma concentrations decreased
      under the limit of quantitation by 4-6 hours in dogs and 4 hours in rats after
      treatments.

PMID- 7785442
TI  - Adaptive control in drug therapy.
AB  - In medical practice, drugs are administered with the goal of attaining a
      therapeutic effect without exceeding predetermined safety limits on any adverse
      action. This paper is intended to provide an introduction to pharmacokinetic
      model based adaptive control of drug levels that can be of use in achieving such
      therapeutic objectives. The principles are illustrated by the problem of
      providing rapid relief of acute asthmatic symptoms by infusing theophylline.

PMID- 7785443
TI  - Administration of benzpyrene and allylestrenol in fetal or neonatal periods of
      life: does it make difference in the microsomal activity?
AB  - Administration of allylestrenol or benzpyrene in fetal and neonatal periods of
      life make the rats susceptible to phenobarbiturate induction. Changes to controls
      could be observed in three of the enzyme activities tested (p-nitrophenol
      hydroxylase, cytochrome P450 and aniline-hydroxylase), with a dominance of the p
      nitrophenol-hydroxylase among them. There seemed to be no difference in the
      action of allylestrenol and benzpyrene, although treatment protocol in the
      neonatal period proved to be more effective.

PMID- 7785444
TI  - Changes in binding of monoclonal antibodies to TSH receptor following thyrotropin
      (TSH) and gonadotropin (GTH) pretreatments (studies on human thyroid and CHO cell
      lines).
AB  - Monoclonal antibody to TSH-receptor binds to the cells of human thyroid gland and
      to Chinese hamster ovary cell cultures. Pretreatments with TSH can decrease the
      binding of antibody, which effect is more expressed in CHO than in thyroid cells.
      Gonadotropin (FSH + LH) cannot influence the binding of antibody to thyroid, but
      there is an effect on CHO cells. Endotoxin (lipopolysaccharide, LPS) can depress
      the binding of antibodies on both objects and abolishes the difference between
      thyrotropin and gonadotropin receptors in their binding capacity, on both cell
      types. The experiments prove the similarity of thyrotropin and gonadotropin
      receptors which is responsible for the hormonal overlap.

PMID- 7785445
TI  - LB-145 a new radioactive isotope eliminating product with high selectivity.
AB  - LB-145 is a macrocyclic ligand, which forms, 200 times more stable complex with
      Stroncium (Sr) ions, than with calcium ones. The product is not toxic, it has no
      effect on circulation, respiratory system. 85,90Sr and 144Ce were given oral,
      i.p., s.c. or by inhalation, LB-145 either prophylactic or 30 (60) minutes after
      the radiointoxication i.v. or i.p. to the animals. The isotope contents of the
      organism were measured by whole body autoradiography, liquid scintillation, or by
      NK 350 ratemeter. One injection given prophylactic inhibited the incorporation of
      isotopes into the organism, within 24 hours after radiointoxication 75-80% of the
      isotopes were excreted by urine and faeces on the first day, 90-95% excreted on
      the first week. Also the isotope contents of femur and scissors were mobilised.
      The suggested human dose-0.5 g/70 kg bw-can be life-saving antihavaric injection.

PMID- 7785446
TI  - Methodological aspects in the studies on the mechanism of action of synthetic
      direct thrombin antagonists.
AB  - Requirements reported for an ideal anticoagulant [12] and for an ideal
      antithrombotic [18] show the necessity of many-sided methodological approach in
      order to detect the molecular mechanism of action of a novel synthetic antagonist
      of thrombin. The lack of a protocol internationally accepted, on the one hand,
      and with regard to a general proposal accepted [16], on the other hand, authors
      applied a complex methodological system involving also the study on the possible
      interactions at molecular level of some novel thrombin antagonists with the main
      components of their site of action. The surprising contradiction found between in
      vitro and in vivo efficacy of several antagonists could be attributed and
      explained by the significant differences in Ki and IC50 values determined in
      complex clotting assays containing plasma proteins and/or blood cells versus
      those measured in reaction mixtures consisting of a synthetic chromogenic
      substrate, the target enzyme, thrombin, and the antagonist compound in buffer
      solution.

PMID- 7785447
TI  - Three-dimensional (type I) microcrystals of detergent-solubilized membrane-bound
      gastric (H+, K+)-ATPase enzyme from hog and rabbit stomachs.
AB  - Multilamellar 3-dimensional (Type I) microcrystals of detergent-solubilized crude
      microsomes or purified protein preparations of membrane-bound gastric (H+, K+)
      ATPase from rabbit or hog stomachs develop in media consisting of 0.1 M KCl, 20
      mM imidazole, 5 mM MgCl2, 3 mM NaN3, 5 mM DTT, 25 IU/ml Trasylol, 2 micrograms/ml
      DTBpC and 20-40% glycerol, using nonionic detergent of C12E8 or BRIJ 36 for
      solubilization. Crystals developed in a pH-range of 6.0-7.25, during 3-10 days of
      incubation, at 2 degrees C. For C12E8, the most effective detergent:protein ratio
      for crystallization varied between (1.8-2.0):1 for the microsomes and between
      (0.25-0.75):1 for the purified preparations. The results of biochemical and
      structural analysis of the (H+, K+)-ATPase crystals showed close resemblance to
      those of the sarcoplasmic reticulum Ca(2+)-ATPase from skeletal muscle and
      plasmamembrane (Na+, K+)-ATPase from kidney (J. Biol. Chem., 269, 10107-111,
      1994). Based on these identities and the high (62%) overall sequential homology
      to the (Na+, K+)-ATPase, we conclude that the new crystals of the (H+, K+)-ATPase
      could also contain only the alpha-chain of the alpha beta heterodimers found in
      the native membrane. High-resolution electron microscopy of frozen-hydrated
      crystalline (H+, K+)-ATPase samples are in progress to give unit cell dimensions
      and molecular packing of the new crystals.

PMID- 7785448
TI  - Post-implantation fasting does not induce pregnancy failure in newly inseminated
      mice.
AB  - The effect of food deprivation on the rate of pregnancy failure in newly
      inseminated mice was evaluated. The pre-implantation fasting for 48 h beginning
      on day 4 or 5 postcoitum induced a high rate of pregnancy failure in newly
      inseminated females. However, fasting for 48 h on day 6 had a moderate effect in
      inducing pregnancy failure. By contrast, females which were deprived of food on
      day 7 postcoitum exhibited a significant reduction in the rate of pregnancy
      failure. Pre-implantation fasting was highly effective in inducing pregnancy
      failure compared to that of post-implantation fasting. The results suggest that
      fasting (i.e. day 4 or 5 postcoitum)--induced depression in prolactin has
      resulted in failure of pregnancy and fasting at post-implantation period (i.e.
      day 6 or after postcoitum) has not been interfered with progesterone production
      by placenta.

PMID- 7785449
TI  - Bradykinin-induced shifts in microhemodynamics, lymph production and flow in cat
      intestine; the effect of gut denervation.
AB  - In experiments on anaesthetized cats increased doses of bradykinin were
      administered intraarterially into an innervated part of the small intestine
      perfused in situ with constant inflow. It is concluded that the main factor
      accelerating transcapillary fluid efflux and lymph flow in this region with
      bradykinin is the rise in permeability of gut capillaries. This is confirmed by
      elevation in capillary filtration coefficient which takes place on the background
      of an increase in capillary hydrostatic pressure (when the intestine is naturally
      blood supplied), as decrease in the latter (when the preparation is perfused
      under constant inflow). The gut denervation decreasing regional vascular tone
      modifies bradykinin-induced lymph flow and shifts of hemodynamics in the small
      intestine. In denervated small intestine when compared with innervated ones
      bradykinin causes less expressed increase in lymph production and capillary
      hydrostatic pressure, but more marked elevation in capillary filtration
      coefficient.

PMID- 7785450
TI  - O2 transport in hypoxic albino rats of first and second generation.
AB  - The generations of rats raised in normobaric hypoxia (10% O2 in N2) were observed
      for changes in their oxygen-hemoglobin affinity, hemoglobin content (Hb) blood O2
      capacity and pO2-O2 content curves: the first generation (H1) and the second
      generation (H2). H1 rats possessed a lower O2-Hb affinity while H2 rats had a
      higher O2-Hb affinity than normoxic control rats. Hb was greater in both hypoxic
      groups, however, H2 rats showed a Hb lower than that of H1 rats. Both hypoxic
      groups showed a leftward shift of the pO2-O2 content curve. In pO2 range between
      25 and 50 mmHg, H2 rats showed a shift greater than H1 rats. So in hypoxic
      conditions the H1 rat's ability to supply enough O2 to the tissues is smaller
      than that of H2 rats. In the rat's adaptation to hypoxia the Hb increase plays
      only a minor role while O2-Hb affinity increase constitutes a physiologically
      meaningful adaptation.

PMID- 7785451
TI  - Protein level in testes, kidneys and liver after AET or MEA treatment of mice.
AB  - The adult male Swiss mice were treated intraperitoneally with AET (2
      aminoethylisothiouronium Br.HBr) or MEA (cysteamine HCl), in a toxic dose of 400
      mg/kg body weight. The measurements of the protein content in crude homogenates
      of testes, kidneys and liver were done every fourth hour throughout a 24-hour
      period. Treatment of mice with AET and MEA resulted in different patterns of
      temporal changes in the protein content in testes, kidneys and liver expressed in
      mg per 1 g of fresh tissue and per the whole organ weight. The extent and timing
      of the alterations in the protein level appeared to depend on the particular
      organ chosen and the thiol agent applied.

PMID- 7785452
TI  - Changes in the mast cell number and degranulation pattern during periovulatory
      period and after blocking gonadotrophin surge in mice ovarian compartments.
AB  - Mast cell in the ovary of cyclic mice were observed in the ovarian medulla, hilum
      and bursa, but not in the cortex. A significant increase in the degranulation of
      mast cells was observed in the hilum and bursa but not in the medulla following
      the gonadotrophin (Gn) surge as compared with before the surge at proestrus. The
      results of pentobarbital treatment at proestrus imply the significant role played
      by estradiol 17-beta (E2) in inducing mast cells migration and degranulation,
      specially in the medullary, cortical and bursal region of the ovary. The results
      indicate differential regulation of mast cells number and degranulation in
      different ovarian compartments of mice.

PMID- 7785453
TI  - Ultrasound velocity, through bone predicts incident vertebral deformity.
AB  - We followed 130 postmenopausal women without evidence of vertebral deformity by
      lateral spine radiographs on entry into study for 2 years, and repeat spine
      radiographs were taken at the end of that time. Incident deformities occurring
      within this 2 year period were detected by two methods, a level-specific
      radiogrammetric approach and visual inspection by skilled clinicians. Fourteen
      incident deformities were detected by the radiogrammetric method, and 19 by the
      clinicians. Ultrasound transmission velocity was measured at the patella in each
      subject on entry. Values for ultrasound velocity were significantly correlated
      with incident fracture occurrence, with individuals having velocity values more
      than one standard deviation below the mean for the group exhibiting from 3.3 to
      4.6 times the probability of incident fracture as individuals with velocity
      values more than one standard deviation above the mean. Thus, low values for
      ultrasound transmission velocity at the patella detect yet-unexpressed bony
      fragility at the spine and predict future fracture.

PMID- 7785454
TI  - Comparison of speed of sound ultrasound with single photon absorptiometry for
      determining fracture odds ratios.
AB  - The purpose of this study was to compare the ability of ultrasound velocity
      measurement with that of single photon absorptiometry to determine the odds of
      history of fracture since age 40, for a population-based study. To do this we
      computed odds ratios and 95% confidence intervals for 809 women and 502 men, aged
      50 years and older, who are participants in the prospective phase of the Saunders
      County Bone Quality Study. These participants received both the ultrasound and
      single photon absorptiometry bone measurements at the initiation of the study. In
      addition, a history of all fractures that had occurred to participants since age
      40 was obtained. The two bone assessment methods were compared by examining the
      magnitude of the odds ratios, to determine which produces the highest estimate of
      the probability of odds of fracture, and by examining widths of the respective
      confidence intervals to show which estimate of odds ratio is the most precise.
      Ultrasound velocity estimates a higher probability of odds of both low-trauma
      fractures and all fractures than distal radius and ulna bone mineral content, but
      lower than bone mineral density at the same sites for both women and men.
      However, the ultrasound measure is more precise than bone mineral density, but
      less precise than bone mineral content. We conclude that ultrasound velocity is
      as good as single photon absorptiometry in estimating odds of fracture.

PMID- 7785455
TI  - Quantitative ultrasound and vertebral fracture in postmenopausal women. Fracture
      Intervention Trial Research Group.
AB  - Quantitative ultrasound is a promising technique to evaluate fracture risk. To
      test the hypothesis that reduction of one ultrasound measurement, broadband
      ultrasound attenuation (BUA), is associated with an increased risk of vertebral
      fracture in postmenopausal women, we performed a cross-sectional analysis of 442
      women aged 55-80 years enrolling in a clinical trial of alendronate. Prior to
      randomization, we obtained bone mineral density (BMD) measurements of the hip,
      spine, and whole body, radiographs of lateral lumbar and thoracic spine, and
      duplicate measurements of calcaneal BUA with a Walker Sonix UBA575. Vertebral
      fractures were defined by morphometry and semiquantitative reading by a
      radiologist. After adjustment for potential confounders, the relative risk of
      vertebral fracture was 1.8 (95% CI 1.4-2.3) for each standard deviation reduction
      in BUA; for each standard deviation reduction in BMD, the relative risk was 1.7
      (95% CI 1.3-2.1) at the femoral neck, and 2.2 (95% CI 1.7-2.9) at the spine.
      Adjustment for hip, spine, or whole body BMD did not significantly alter the
      relation between BUA and vertebral fracture. For example, after adjusting for
      spine BMD, the relative risk of vertebral fracture was 1.5 (95% CI 1.1-2.0) for
      each standard deviation reduction in BUA. We conclude that low BUA is associated
      with the presence of vertebral fractures in postmenopausal women. The relation
      between BUA and vertebral fracture is similar to that observed for BMD and
      vertebral fractures. Furthermore, the relation between BUA and vertebral fracture
      persists after adjustment for BMD.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785456
TI  - Ethnic differences in bone density in female South African nurses.
AB  - In the United States, the higher prevalence of osteoporosis and the higher
      incidence of fractures in whites than in blacks may be attributed to the finding
      of lower bone density (BD) in both white children and adults. In South Africa,
      osteoporosis and fractures also occur more frequently in whites than in blacks.
      Appendicular BD has been found to be similar in black and white children in South
      Africa, but there is little information available on BD of adults in South
      Africa. This cross-sectional study aimed to assess changes in BD with age in
      adult females in South Africa and to assess possible differences in peak BD and
      in the rate of postmenopausal bone loss between blacks and whites. Data for 180
      black and 184 white female nurses aged 20-64 years were analyzed. The distal
      radius bone density (RBD) was measured by single photon absorptiometry. The
      lumbar spine bone density (SBD) and the femur bone density (FBD) were measured by
      dual-energy X-ray absorptiometry. Blacks were shorter than whites (p = 0.0001),
      and blacks' weight, body mass index, and skinfold thickness increased with age.
      Peak SBD and RBD were similar in blacks and whites, but peak FBD was higher in
      blacks (p = 0.0001). This ethnic difference in peak FBD became apparent in the
      fourth decade. Peak FBD was similar in black and white subjects with normal body
      mass indices (p = 0.09), but in overweight subjects peak FBD was higher in blacks
      than in whites (p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785457
TI  - Sources of interracial variation in bone mineral density.
AB  - Many studies have demonstrated significant differences in bone mineral density
      between various racial groups. Although it has been suggested that differences in
      body weight contribute to such interracial variation, the artifactual effect of
      the skeletal size inherent in projectional absorptiometry methods has been
      largely ignored. We have measured bone mineral density by dual-energy X-ray
      absorptiometry in the lumbar spine and at three femoral sites in 200
      premenopausal women of Chinese, Indian, European, or Polynesian origin (50 of
      similar mean age in each group). In the Chinese and Indian women the measured
      bone mineral density measurements (g/cm2) were similar, but significantly less,
      at all sites, than those of European women (p < or = 0.005). The European women
      were, however, significantly taller than both the Chinese and Indian women (p <
      0.0001), and when the scale artifact of absorptiometry was removed by dividing
      the measured bone mineral density either by the height of the subject, or by the
      square root of the area over which the X-ray beam was projected, then the
      differences in mean bone mineral density between the Chinese, Indian, and
      European women were almost completely eliminated. The Polynesian women were
      significantly more obese (as judged from mean body mass index) than all the other
      groups (p < 0.0001) and had significantly greater bone mineral density at all
      sites than all the other groups both before (p < 0.0001) and after (p < 0.0001)
      correcting for the scale artifact.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785458
TI  - The relations between physical ability and bone mass in women aged over 65 years.
AB  - In this cross-sectional study of 55 women (mean age 73.54 +/- 5.87), the
      magnitude of the relation between different indices of physical ability and
      confounding factors to bone density were determined. Physical fitness was
      assessed by direct measurement of maximal oxygen consumption (VO2 max),
      isokinetic muscle strength, and quadriceps and psoas muscle surfaces and
      densities using computed tomography. Anthropometry, chronological and
      gynecological ages, and dietary calcium intake were also recorded. The bone
      mineral density (BMD) was evaluated at the axial level (lumbar spine and proximal
      femur) and at the peripheral level (radius and tibia, cancellous and cortical
      compartments). Parameters related to physical ability proved to be the best
      predictors of BMD in radial and tibial cancellous compartments, spine, femoral
      neck, and trochanter, accounting for 15-27.5% of the total variance. The VO2 max
      was a major determinant of the femoral mineral density and one of the predictors
      of radial and tibial cancellous compartments. Psoas parameters were strongly
      related to spine mineral density and also constituted a predictor of radius
      (cancellous) and tibia mineral densities. The arm muscle strength could predict,
      though weakly, the BMD of axial skeleton, whereas thigh muscle strength only
      predicted the BMD of inferior limbs. No correlation was observed between current
      dietary calcium intake and BMD. Age-postmenopause and fertile life remained
      predictive of BMD at mostly cancellous sites, whereas anthropometry exerted
      important effects on radial and tibial cortices. The study suggests distinct sets
      of relations between physical ability and the BMD variables. Subjects with
      greater and denser psoas muscles had greater spine BMD, and those with higher VO2
      max had greater proximal femur BMD.

PMID- 7785459
TI  - Bone density in young women is associated with body weight and muscle strength
      but not dietary intakes.
AB  - Potential determinants of bone mineral density (BMD) were studied cross
      sectionally in 115 healthy, sexually mature Caucasian women aged 18 years. Bone
      mineral density (Hologic QDR1000W) of the lumbar spine, proximal femur (five
      sites), and distal tibia and fibula; fasting blood and urine calcium
      biochemistry; serum sex hormone levels (follicular phase); nutrient intakes;
      aerobic fitness; trunk muscle strength; and habitual activity levels were
      measured. The effects of heredity were considered by measuring the BMD of 107 of
      the subjects' mothers. Simple and stepwise regression analysis were used to
      identify significant determinants of BMD at each of the regions studied. The
      analysis indicated that significant bivariate correlations exist between BMD at
      all sites and body weight (r = 0.23-0.47, p < or = 0.01), lean body weight (r =
      0.34-0.46), trunk strength (r = 0.27-0.47), physical activity score (r = 0.20
      0.25), and aerobic fitness (r = 0.29-0.45). Dietary calcium intake correlated
      significantly with BMD at the trochanter site only (r = 0.19), and none of the
      biochemical or hormonal indices measured correlated consistently with BMD at any
      site. Significant correlations between the BMD of mothers and daughters ranged
      from r = 0.43 at lumbar spine to r = 0.34 at the intertrochanteric site. Paired t
      tests showed the daughters had significantly (p < 0.03) lower BMD than their
      mothers at the lumbar spine (98 +/- 12% [mean +/- SD]) and significantly higher
      (p < 0.002) BMD at the femoral neck, trochanter, and total hip sites (110 +/-
      16%, 108 +/- 17%, 103 +/- 14%, respectively). When stepwise regression analysis
      included weight-corrected strength of the trunk flexor muscles (Corr Flex),
      weight-corrected aerobic fitness (Corr VO2max), physical activity score, and body
      weight, body weight was the only significant determinant of BMD at all sites.
      Corr Flex made significant contributions at all sites except the femoral neck,
      while Corr VO2max made additional contribution at the femoral neck, trochanter,
      total hip, and shaft of femur sites. These variables accounted for 13-27% of the
      variance in BMD. The addition of mother's BMD to these independent variables, in
      stepwise regression analysis, improved the prediction to 18-31% of the variance.

PMID- 7785460
TI  - Physicochemical effects of a new slow-release potassium phosphate preparation
      (UroPhos-K) in absorptive hypercalciuria.
AB  - A new slow-release, neutral potassium phosphate salt (UroPhos-K) has been
      formulated in order to minimize gastrointestinal side effects and avoid sodium
      induced calciuria. It was tested in a prospective randomized, double-blind trial
      in a group of 21 kidney stone patients with absorptive hypercalciuria type I
      (AH). Twelve patients allocated to the UroPhos-K group received four tablets
      twice daily with breakfast and an evening snack providing 1240 mg of phosphorus
      and 63.5 mEq of potassium daily. Nine patients assigned to the placebo group
      received placebo tablets of the same appearance containing excipient only.
      Subjects were studied during a 3-day period in the hospital while consuming a
      constant metabolic diet containing 400 mg Ca, 100 mEq Na, and 800 mg P per day
      before and after 3 months of treatment. Treatment with UroPhos-K did not cause
      any significant gastrointestinal side effects; nor did it raise fasting serum K
      or phosphorus, or reduce hemoglobin or creatinine clearance. It was associated
      with a rise in urinary K from 46 +/- 7 to 98 +/- 9 mEq per day and phosphorus
      from 744 +/- 185 to 1535 +/- 112 mg per day (p < 0.001 each). UroPhos-K treatment
      reduced urinary Ca from 288 +/- 63 to 171 +/- 49 mg/day (p < 0.001), without
      altering oxalate excretion. It reduced the urinary saturation of calcium oxalate
      without altering that of brushite. Moreover, by increasing urinary excretion of
      inhibitors (citrate and pyrophosphate), it reduced the propensity for spontaneous
      nucleation of brushite (increased formation product of brushite) and inhibited
      crystal agglomeration of calcium oxalate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785461
TI  - Expression of bone morphogenetic protein-6 messenger RNA in bovine growth plate
      chondrocytes of different size.
AB  - Bone morphogenetic protein-6 (BMP-6) is an osteoinductive factor that may have a
      regulatory role in the terminal differentiation of chondrocytes. We investigated
      the expression of BMP-6 messenger RNA in freshly isolated newborn calf rib
      chondrocytes separated by density gradient centrifugation into five highly
      enriched subpopulations at different stages of maturation as assessed by cell
      size and alkaline phosphatase activity. Expression of BMP-6 mRNA was compared
      with expression of type II collagen mRNA and type X collagen mRNA using Northern
      analysis. Type X collagen mRNA expression increased with increasing cell size
      whereas type II collagen mRNA varied little with cell size. BMP-6 mRNA expression
      was highest in small cells and lowest in the largest cells, which were maximally
      expressing type X collagen mRNA. This suggests that up-regulation of the BMP-6
      gene may precede chondrocyte hypertrophy.

PMID- 7785462
TI  - Autoregulation of inducible prostaglandin G/H synthase in osteoblastic cells by
      prostaglandins.
AB  - Prostaglandins (PGs) have been postulated to amplify their own production by
      stimulating cyclic adenosine monophosphate activity, which in turn stimulates PG
      production. We examined regulation of messenger RNA levels for the inducible and
      constitutive prostaglandin G/H synthases, PGHS-2 and PGHS-1, in murine
      osteoblastic MC3T3-E1 cells, which express both PGHS-1 and PGHS-2, and in rat
      osteoblastic Py1a cells, which express only PGHS-2. Prostaglandins E2, F2 alpha,
      and D2 induced PGHS-2 mRNA in both cell lines under serum-free conditions and
      stimulated small increases in PGHS-1 mRNA levels in MC3T3-E1 cells. PGE2 (1
      microM) increased the transcription rate of PGHS-2 mRNA 9-fold at 2 h in serum
      free cells and also induced PGHS-2 protein. In the presence of arachidonic acid
      or serum, PGs also increased medium PGE2. Both forskolin, a protein kinase A
      activator, and phorbol 12-myristate 13-acetate (PMA), a protein kinase C (PKC)
      activator, have previously been shown to induce PGHS-2 mRNA in MC3T3-E1 cells,
      but in the present study only PMA induced PGHS-2 expression in Py1a cells. The
      induction of PGHS-2 mRNA in Py1a cells by PGs was inhibited by chelerythrine, a
      PKC inhibitor, and blocked by 24 h of pretreatment with PMA. The 2 h serum
      stimulation of PGHS-2 mRNA in MC3T3-E1 cells was inhibited 40-50% by three
      structurally unrelated nonsteroidal anti-inflammatory drugs (NSAIDs), suggesting
      that endogenous PGs also amplify PG production through induction of PGHS
      2.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785464
TI  - Effect of 1,25-dihydroxyvitamin D3 treatment on bone formation by transplanted
      cells from normal and X-linked hypophosphatemic mice.
AB  - Bone cells isolated from the Hyp mouse, the murine homologue for hypophosphatemic
      vitamin D-resistant rickets, produce abnormal bone when transplanted to either
      normal or phosphate-supplemented Hyp mice. To assess whether correction of the
      bone formation by mutant cells transplanted into either normal or Hyp mice could
      be achieved in the presence of supraphysiologic serum concentrations of 1.25
      dihydroxyvitamin D3 (1.25-(OH)2D3), recipient mice of both genotypes were infused
      continuously with 1.25-(OH)2D3 (0.2 micrograms/kg/day). Bone nodules present in
      transplants recovered after 14 days were characterized by measuring the osteoid
      thickness and volume. Administration of 1.25-(OH)2D3 to Hyp mice corrected the
      defective bone formation by normal cells but not by pair-transplanted Hyp cells,
      despite normalization of serum phosphate levels and 3-fold increases in serum
      1.25-(OH)2D3. The osteoid thickness and volume in Hyp transplants into 1.25
      (OH)2D3-treated Hyp mice were, however, markedly reduced down to values observed
      for Hyp transplants into recipient normal mice. Administration of 1.25-(OH)2D3 to
      normal mice improved further bone formation by mutant cells without affecting
      that by pair-transplanted normal cells. Administration of 24.25-(OH)2D3 (1
      microgram/kg/day) combined with 1.25-(OH)2D3 to recipient mice of both genotypes
      prevented the sharp fall in serum 24.25-(OH)2D3 but was not more beneficial than
      1.25-(OH)2D3 alone for improving bone formation by transplanted Hyp cells. These
      observations demonstrate an abnormal response of the mutant cells to the
      extracellular environment and support the concept of an intrinsic osteoblast
      defect in the Hyp mouse.

PMID- 7785463
TI  - Rat tail suspension reduces messenger RNA level for growth factors and
      osteopontin and decreases the osteoblastic differentiation of bone marrow stromal
      cells.
AB  - We previously reported that bone marrow stromal cells produce insulin-like growth
      factors (IGF-I and -II), and that medium conditioned by marrow stromal cells
      stimulates osteoblast proliferation in vitro. The present study employed the rat
      tail-suspension model to unload the hindlimbs. It was designed to test the
      hypothesis that the development of osteopenia or osteoporosis could be due to a
      deficit in the osteogenic function of marrow stromal cells. Although tail
      suspension suppressed body weight during the first 3 days of an 11-day pair-fed
      study, the overall weight gain recorded by these animals was normal.
      Nevertheless, bone growth was inhibited by suspension. Similarly, the total
      adherent marrow stromal cell population harvested from the femurs and tibias was
      decreased by tail suspension, and only half the normal number of fibroblastic
      stromal cell colonies grew when they were cultured. The proliferation of alkaline
      phosphatase-positive cells in the stroma was also inhibited. Northern
      hybridization revealed that the messenger RNA level for transforming growth
      factor-beta 2 and IGF-II in stromal cell was reduced by tail suspension. The
      production of IGF-II by marrow stromal cells was also decreased. The steady-state
      level of five different transcript sizes of IGF-I mRNA was altered differentially
      by tail suspension. Osteopontin mRNA was also reduced in marrow stromal cells
      from tail-suspended rats compared with the normal rats. These data suggest that
      skeletal unloading not only alters the mRNA level for growth factors and peptide
      production, but also affects the proliferation and osteogenic differentiation of
      marrow stromal cells. These changes may be responsible for the reduced bone
      formation in osteopenia and osteoporosis.

PMID- 7785465
TI  - Upper extremity bone mass and osteoarthritis of the knees: data from the
      Baltimore Longitudinal Study of Aging.
AB  - To examine the association of upper extremity bone mass with osteoarthritis (OA)
      of the knee, bilateral standing knee radiographs, taken between 1985 and 1991, in
      430 Caucasian male and 266 Caucasian female subjects aged 40 years and above in
      the Baltimore Longitudinal Study of Aging, were read by one investigator for
      grade of OA using Kellgren-Lawrence scales. Several measures of upper extremity
      bone mass, size, and density, including combined cortical thickness (CCT), total
      width and percentage of cortical area of the second metacarpal, and bone mineral
      content (BMC), width, and density of the distal third of the left radius measured
      with single photon absorptiometry, were assessed at the same visit. In univariate
      analyses, men and women with definite knee OA were significantly older, men had
      significantly greater radial width, and women had significantly lower bone mass
      as measured by both CCT and BMC. After adjustment for age and body weight,
      however, men with knee OA had significantly higher BMC and radial width while
      neither of these measures of upper extremity bone mass and size was significantly
      associated with the presence of definite knee OA in women. Neither measure of
      upper extremity bone density was significantly associated with definite knee OA
      in either sex. These data suggest that, although men (but not women) with
      definite knee OA have significantly higher levels of adjusted radial bone mass
      and size, subjects with knee OA do not have significantly higher levels of
      adjusted bone mineral density at either upper extremity site.

PMID- 7785467
TI  - Zinc is a potent inhibitor of osteoclastic bone resorption in vitro.
AB  - It is well established that zinc, an essential trace element, plays an important
      role in growth and stimulates bone formation. However, the effects of zinc on
      bone resorption have received little attention. We studied its effects on
      isolated rat osteoclasts. Unexpectedly, osteoclasts were exquisitely sensitive to
      zinc, with a significant decrease in bone resorption occurring at concentrations
      as low as 10(-14) M. This effect was specific for zinc and was not observed with
      the other transitional or alkaline metals studied. There was no evidence of
      toxicity at concentrations up to 10(-4) M. Zinc also completely abolished the
      stimulatory effect of parathyroid hormone. Zinc is therefore a highly potent and
      selective inhibitor of osteoclastic bone resorption in vitro. The mode of action
      remains to be established and may represent a novel inhibitory mechanism in the
      osteoclast.

PMID- 7785466
TI  - Regulation of parathyroid hormone messenger RNA levels by protein kinase A and C
      in bovine parathyroid cells.
AB  - Secretion of parathyroid hormone (PTH) is regulated by Ca2+ as well as by protein
      kinases A and C. In this study we report that protein kinases A and C regulate
      PTH messenger RNA levels in vitro in dispersed bovine parathyroid cells.
      Incubation of bovine parathyroid cells with cholera toxin (10(-9) M), which
      activates adenylate cyclase and indirectly stimulates protein kinase A, increased
      PTH mRNA levels about 2-fold after 3 and 7 h incubation, but not at 24 h.
      Incubation with pertussis toxin (5 x 10(-9) M), which blocks the high-calcium
      mediated inhibition of cyclic adenosine monophosphate accumulation in these
      cells, also reversed the inhibition of PTH mRNA levels at high Ca2+ (2.0 mM) with
      a marked increase in PTH mRNA levels. Pertussis toxin also increased PTH mRNA at
      a low extracellular Ca2+ concentration (0.7 mM) (4-fold increase) and a normal
      concentration (1.25 mM) (2-fold increase). Inhibition of protein kinase C both by
      staurosporine (1 x 10(-8) M) and by prolonged incubation with the phorbol ester
      phorbol 12-myristate 13-acetate (PMA) (1 x 10(-7) M), decreased PTH mRNA levels
      at 24 h, reaching approximately 40% and 5% of control, respectively.
      Staurosporine and PMA had no effect on PTH mRNA levels at 3 h. The inactive
      phorbol ester, phorbol 12-13-dibutyrate (PDBu), had no effect on PTH mRNA levels
      at 1 and 24 h. There were no changes in a control gene 18S RNA in these
      studies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785469
TI  - Relations between histologic indices of bone formation: implications for the
      pathogenesis of spinal osteoporosis.
AB  - Wall thickness, a major determinant of trabecular thickness, falls with age and
      falls further in osteoporosis. To estimate the importance of defective osteoblast
      recruitment in the pathogenesis of this defect, we compared various histologic
      indices of bone formation in iliac bone biopsies in three groups of subjects-
      healthy premenopausal women, healthy postmenopausal women, and patients with
      postmenopausal osteoporosis and at least one non-traumatic vertebral compression
      fracture. Indices that reflect the frequency of activation of bone remodeling and
      consequent birth rate of new teams of osteoblasts (osteoid surface, mineralizing
      surface, osteoblast surface, and bone formation rate, all expressed per unit of
      bone surface) were each higher in healthy subjects who were postmenopausal than
      in those who were premenopausal, but lower in osteoporotic than in normal
      postmenopausal women. In each group, the primary surface measurements were
      significantly correlated with each other, but the correlation was less close in
      those with osteoporosis. Indices that reflect the average collective performance
      of individual teams of osteoblasts (mineralizing surface and osteoblast surface
      per unit of osteoid surface, mineral apposition rate, adjusted apposition rate,
      and wall thickness) were all lower in postmenopausal than in premenopausal normal
      subjects, and even lower in those with postmenopausal osteoporosis. The
      parameters of the regression lines relating bone formation rate to osteoblast
      surface were essentially the same in each group, indicating that bone formation
      rate per unit of osteoblast surface was unaffected by age or menopause, and was
      the same in osteoporosis as in healthy subjects of similar age.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7785468
TI  - Discriminative value of biochemical markers of bone turnover in assessing the
      activity of Paget's disease.
AB  - Clinical biochemical markers of bone turnover are usually increased in Paget's
      disease. However, the analysis of "new" markers, such as serum bone alkaline
      phosphatase (BAP), carboxy-terminal propeptide of type I procollagen (PICP),
      tartrate-resistant acid phosphatase (TRAP), telopeptide carboxy-terminal
      propeptide of type I collagen (ICTP), and urinary pyridinoline (PYR) and
      deoxipyridinoline (D-PYR), may improve the diagnostic efficacy and the evaluation
      of Paget's disease compared with conventional markers, such as serum total
      alkaline phosphatase (TAP) and urinary hydroxyproline (HYP). To evaluate the
      diagnostic accuracy and the changes of biochemical markers of bone turnover
      according to Paget's disease activity, we measured the levels of all these
      markers in three groups of pagetic patients classified according to their serum
      TAP activity: G-I, patients with serum TAP lower than 250 U/l (upper limit) (n =
      15); G-II, patients with serum TAP between 251 and 500 U/l (n = 18); and G-III,
      patients with serum TAP greater than 501 U/l (n = 26). Serum TAP and BAP showed
      the highest diagnostic accuracy among the markers of bone formation with a
      sensitivity of 78% and 84%, respectively, when the specificity was 100%. Urinary
      PYR was the most sensitive marker of bone resorption. Also, urinary PYR showed
      the highest proportion of increased values in pagetic patients (73%) compared
      with urinary HYP (64%), urinary D-PYR (60%), serum ICTP (41%), or serum TRAP
      (39%). In pagetic patients with normal serum TAP activity (G-I), serum BAP
      concentration was increased in 60% of patients, and urinary PYR was increased in
      40% of patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785470
TI  - Bone marrow cells are targets for the anabolic actions of prostaglandin E2 on
      bone: induction of a transition from nonadherent to adherent osteoblast
      precursors.
AB  - Although prostaglandin E2 (PGE2) is known to stimulate bone formation in vivo,
      its mechanism of action is not well understood. Circumstantial evidence suggests
      that bone marrow cells (BMC) may well be involved in this, and in order to
      investigate this further we have studied the effect of PGE2 on proliferation and
      matrix synthesis in high-density BMC cultures and on colony-forming unit (CFU-f)
      formation efficiency by BMC in vitro. High-density cultures of BMC formed a
      collagenous, calcified matrix, synthesized osteocalcin and expressed alkaline
      phosphatase activity. The addition of PGE2 caused a concentration-dependent
      increase in total (but not specific) APase activity, cell number, and collagen
      accumulation. It was found that PGE2 need only be present during the first 48
      hours of the culture period and that longer exposure had no additional effect.
      PGE2 also caused a concentration-dependent increase in CFU-f formation, and it
      was found that this was due to the recruitment of new mesenchymal precursor cells
      from the nonadherent fraction of the BMC. Once again, the presence of PGE2 for
      only the first 48 hours of the culture period was enough to precipitate a maximal
      response. We conclude that one mechanism for the anabolic actions of PGE2 may be
      the recruitment of OB precursors from a population of nonadherent mesenchymal
      precursor cells present in the bone marrow.

PMID- 7785471
TI  - Morphologic stages in lamellar bone formation stimulated by a potent mechanical
      stimulus.
AB  - The temporal stages of lamellar bone formation were studied using an animal model
      subject to up to 16 weeks of a controlled, externally applied load. The left
      ulnae of 15 adult male turkeys were functionally isolated via transverse
      metaphyseal osteotomies, while transcutaneous Steinmann pins permitted in vivo
      loading of the preparation via a servo-hydraulic actuator. For 5 days per week,
      the ulnae were exposed to 100 cycles per day of an applied load sufficient to
      cause a peak strain normal to the bone's longitudinal axis of 2000 microstrain
      (mu E). The contralateral limb was left surgically undisturbed and served as a
      baseline control. Following a loading period of 4, 8 or 16 weeks, ulnae were
      harvested and prepared for quantitative bone histomorphometry. Compared with each
      animal's contralateral ulna, the area of the experimental ulnae increased by
      12.5% (+/- 5.6%) at 16 weeks. Periosteal mineral apposition rates in the loaded
      ulnae were significantly increased compared with control values, with a maximum
      rate of 6.0 +/- 3.4 microns/day at 5 weeks, slowing to 2.0 +/- 0.3 microns/day by
      15 weeks. At 16 weeks, new bone was composed of primary and secondary osteons as
      well as circumferential lamellae, with osteocyte density and organization
      indistinguishable from that of the original cortex. Remnants of the initial woven
      bone response seen at 4 weeks remained clearly visible at both 8 and 16 weeks as
      diffusely labeled interstitial elements within the newly formed lamellar
      construct.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785473
TI  - Hip axis length and osteoporotic fractures. Study of Osteoporotic Fractures
      Research Group.

PMID- 7785472
TI  - Human parathyroid hormone-(1-38) restores cancellous bone to the immobilized,
      osteopenic proximal tibial metaphysis in rats.
AB  - The purpose of this study was to determine if human parathyroid hormone-(1-38)
      (hPTH(1-38)) can restore cancellous bone mass to the established osteopenic,
      immobilized proximal tibial metaphyses of female rats. The right hindlimbs of 6
      month-old female Sprague-Dawley rats were immobilized by bandaging the right
      hindlimbs to the abdomen. After 30 days of right hindlimb immobilization, the
      rats were subcutaneously injected with 200 micrograms hPTH(1-38)/kg/day for 15
      days (short-term treatment) or 75 days (longer-term treatment). Static bone
      histomorphometry was performed on the primary spongiosa, and both static and
      dynamic histomorphometry were performed on the secondary spongiosa of the right
      proximal tibial metaphyses. Immobilization for 30 days without treatment
      decreased trabecular bone area, number, and thickness in both primary and
      secondary spongiosa, and induced an increase in eroded perimeter and a decrease
      in tissue referent-bone formation rate in the secondary spongiosa. These changes
      reached a new steady state thereafter. Treatment with 200 micrograms hPTH(1
      38)/kg/day for 15 days, beginning 30 days after immobilization, significantly
      increased trabecular bone area, thickness, and number in both primary and
      secondary spongiosa despite continuous immobilization when compared with
      controls. The short-term PTH treatment (15 days) significantly increased labeling
      perimeter, mineral apposition rate, and tissue referent-bone formation rate in
      the secondary spongiosa and stimulated longitudinal bone growth as compared with
      the controls. Longer PTH treatment (75 days) further increased trabecular bone
      area, thickness, and number as compared with controls and groups given short-term
      PTH treatment (15 days). The bone formation indices in the secondary spongiosa of
      the longer-term treated rats were lower than those of the short-term treated
      group, but they were still higher than those of controls. Our findings indicate
      that PTH treatment stimulates cancellous bone formation, and restores and adds
      extra cancellous bone to the established, disuse-osteopenic proximal tibial
      metaphysis of female rats with continuously immobilized right hindlimbs. These
      results suggest that PTH may be useful in treating disuse-induced osteoporosis in
      humans.

PMID- 7785475
TI  - The relationship between gender, symptoms of bulimia, and tolerance for stress.
AB  - University students completed a questionnaire that included a measure of bulimia
      and a measure of tolerance for stress. Women reported significantly more symptoms
      of bulimia and a lower tolerance for stress than did men. Women in their first
      year on campus reported significantly more symptoms of bulimia than those not in
      their first year. For both women and men, a greater number of bulimic symptoms
      was associated with lower levels of stress tolerance. The present results suggest
      that women in their first year on campus should be targeted in intervention and
      prevention activities for eating disorders and that the relationship between
      disordered eating and stress is the same for both women and men.

PMID- 7785474
TI  - Evaluating multiple outcomes and gender differences in alcoholism treatment.
AB  - This study followed 592 alcoholics (180 women and 412 men) after discharge from
      inpatient treatment. Multiple measures of treatment outcome were used to broaden
      our understanding of the process of recovery from alcohol abuse, and how that
      process differs for men and women. Patients were interviewed by telephone between
      3 and 15 months after discharge to gather information about post-treatment
      experiences including: relationship with family, role performance, psychological
      impairment, and effort toward recovery. Additionally, if any alcohol use took
      place after treatment, information was collected about the pattern of alcohol
      consumption. Results indicated being married is consistently related to less
      drinking for men, while for women, being married contributes to relapse in the
      short term. The determinants of each measure of outcome were different for women
      and men, indicating that the process of recovery is not the same for both
      genders. The study confirms that drinking is related to other adverse outcomes
      for men, but not necessarily for women. It is evidence that women and men have
      different post-treatment functioning, and that different characteristics are
      predictive of these outcomes.

PMID- 7785476
TI  - Pretreatment dropout as a function of treatment delay and client variables.
AB  - Utilizing a retrospective analysis we examined factors correlated with preintake
      dropout in patients phoning to make intake appointments for cocaine treatment.
      Inquiries of 235 individuals calling our outpatient cocaine treatment program
      over a 7-month period were analyzed for relationships between patient age and
      gender; residence in the city where the program is located; marital status;
      referral source; reported problems with alcohol, marijuana, and heroin; reported
      last use of cocaine or other illicit stimulants; assigned counselor gender;
      person who made the appointment; days to the intake appointment; and attending
      the scheduled intake session. Only days to appointment was significantly (Wald =
      12.4587, df = 1, p < .05 and chi 2 = 17.7, df = 8, p < .05) correlated with
      attending the scheduled intake session. Appointments scheduled the same day
      differed significantly (chi 2 = 4.3, n = 235, df = 1, p < .05) from appointments
      scheduled later. This suggests that client and situational variables are not
      significantly related to initial attendance and enhances the significance of
      systemic variables that are under a clinic's control, such as appointment delay.
      The results indicate that the longer the delay between the initial phone contact
      and the scheduled appointment, the less likely a client is to attend an
      appointment. Further, they suggest that the greatest decrease in initial
      attendance occurs in the first 24 hours following the phone inquiry. Taking a
      "microscopic" look at the appointment delay variable is valuable in understanding
      and addressing preintake dropout.

PMID- 7785477
TI  - Participation in a parent training program for methadone clients.
AB  - Programs for drug abusers are plagued by high rates of dropout. Because of the
      strong relationship between longer treatment and positive outcome, researchers
      have begun to study individual and program-specific factors that influence
      premature termination of treatment. For the most part, these studies have focused
      on dichotomous measures of dropout or number of sessions attended. In this
      article, we extend this line of research in two ways. First, we develop and
      measure a number of indicators of treatment participation based on therapist
      ratings. Second, we develop a model of treatment participation that employs both
      individual and program-specific factors. The data show that tremendous variation
      in participation occurred even among those who attended a majority of sessions,
      which highlights the importance of obtaining more elaborate measures of treatment
      participation. The model predicting treatment participation suggests that
      initiation of heroin use later in life, continued use of marijuana, and
      behavioral indicators of motivation are the strongest predictors of program
      participation. Research and practical implications of the findings are discussed.

PMID- 7785478
TI  - Influence of family disharmony and parental alcohol use on adolescent social
      skills, self-efficacy, and alcohol use.
AB  - Deficits in social skills have been found to be related to adolescent substance
      use. Little effort has been devoted to understanding how family factors influence
      the acquisition of these skills. This study examined the manner in which family
      disharmony and parental alcohol use affect adolescent alcohol use through their
      influence on the acquisition of social skills and self-efficacy regarding one's
      ability to utilize these skills. It was hypothesized that family disharmony and
      parental alcohol use directly influenced usage and affected usage indirectly
      through their influence on acquisition of social skills. Social skills were also
      hypothesized to affect usage directly and to affect usage indirectly by
      influencing beliefs regarding one's ability to implement these skills. Results
      indicated that family disharmony was directly related to adolescent alcohol use
      and social skills. Parental alcohol use was related only to adolescent usages,
      not to social skills. Social skills were related to self-efficacy, which was
      related to alcohol use but was not directly related to usage. Results are
      discussed in terms of the importance of family influences on adolescent alcohol
      use, the importance of including families in prevention efforts, and the
      importance of the acquisition of self-efficacy relative to social skills.

PMID- 7785479
TI  - MMPI performance among women with bulimia: a cluster-analytic study.
AB  - Forty-two women, meeting criteria for bulimia, completed the MMPI. Cluster
      analysis of their scores revealed two distinct profile types. The first cluster,
      comprising about 64% of subjects, produced a mean profile in which only the Pd
      scale exceeded a t score of 70. In contrast, about 36% of subjects yielded a
      cluster-derived mean profile that was significantly elevated on many scales,
      including Pd, D, Pt, and Sc. The existence of these two very different subgroups
      of women with bulimia replicates previous work in this area and has potentially
      important implications for the description, treatment, and general understanding
      of those with this condition.

PMID- 7785480
TI  - An empirical classification of drinking patterns among alcoholics: binge,
      episodic, sporadic, and steady.
AB  - Steady (daily, continuous) versus nonsteady (binge, episodic, bout, intermittent)
      drinking pattern have been influential Jellinek's (1960) formulation of delta and
      gamma drinkers, and are used as variables in various typological systems and
      drinker profiles. However, definitions of drinking patterns vary widely across
      studies, and most studies rely on one self-report item to establish a subject's
      pattern. To systematize and empirically test drinking-pattern schemas, we
      developed detailed definitions of binge, episodic, sporadic, and steady drinking
      patterns. A computer algorithm was written in SAS to classify 94 male alcoholics
      participating in outpatient conjoint therapy, using 6-month pretreatment drinking
      data from the Timeline Followback Interview. The final classification was: 3 (3%)
      binge, 33 (35%) episodic, 12 (13%) sporadic, and 40 (43%) steady drinkers. Six
      (6%) were unclassifiable (due to too few drinking days or too many interruptions
      to the pattern) by the computer. Episodic, sporadic, and steady drinkers did not
      differ in demographics, alcohol-related consequences, global psychological
      distress, or marital satisfaction. Steady drinking was associated with later
      onset of drinking problems (> 25), while episodic and sporadic drinking were
      associated with earlier onset. These results are contrary to current use of
      "binge drinking" as a variable associated with Type 1 alcoholism. Predictive
      validity analyses indicated that steady drinkers continued to drink more
      frequently than episodic and sporadic drinkers during treatment and 6 months
      posttreatment. Also, preliminary data indicate that pretreatment drinking pattern
      may be predictive of similar within-treatment urge-to-drink patterns.
      Implications for research and treatment are discussed.

PMID- 7785481
TI  - Vagal tone regulation during sustained attention in boys exposed to opiates in
      utero.
AB  - Attention and learning problems among children exposed to opiates in utero have
      been previously reported but are difficult to interpret due to imprecise
      measurement and inadequate control of postnatal factors. In this study, we used a
      behavior-based measure of attention (continuous-performance tasks) and a
      physiological index of sustained attention (cardiac vagal tone) to measure more
      precisely the process of sustained attention. Boys, aged 7 to 12, exposed to
      opiates in utero, were compared to boys whose mothers began using illicit
      substances after the child's birth (environmental controls), and boys whose
      mothers were non-drug users. This three-group design was intended to isolate in
      utero effects from postnatal environmental influences. Vagal tone, a measure of
      heart-rate variability sensitive to vagal influences on the heart, was measured
      pre- and postbaseline and during the three tasks of the Gordon Diagnostic System
      (Delay, Vigilance, and Distractibility). Vagal tone has been found to be
      sensitive to changes in environmental demand for sustained attention in infants,
      school-age children, and adults. Results indicated that when distractors were
      added to the vigilance task (Distractibility task), opiate-exposed boys failed to
      suppress vagal tone compared to both control groups. However, both the opiate
      exposed boys and the environmental controls made fewer correct responses than non
      drug-exposed controls on this task. These results indicate that normal
      physiological responses to increased attentional demand may be impaired in boys
      exposed in utero to opiates in this age range. However, the poor Distractibility
      scores of both the opiate-exposed and environmental controls suggests an
      important role of environmental influences on attentional performance.

PMID- 7785483
TI  - Eating style and symptoms of eating disorders: further explorations.
AB  - Based on earlier efforts to document relationships between eating styles
      involving hunger, deprivation, and restraint and symptoms of eating disorders,
      three scales--Eating Style, Feeling Deprived, and Dieting Style--were created and
      administered to 259 University females, 118 males, and 50 nonstudent females. Of
      interest were psychometric properties of the scales, their relationships to each
      other and with symptoms, beliefs about weight control, and body weight. One year
      later, findings based on Eating Style were replicated and extended in smaller
      groups of the original University subjects. Appreciable relationships occurred
      almost uniformly between Eating Style (addressing hunger, deprivation, and
      restraint) and proposed correlates. Feeling Deprived (a measure of avowed
      deprivation) correlated consistently with beliefs about weight control and weight
      variables, but not symptoms. Measurement of Dieting Style was hampered by small
      ns.

PMID- 7785482
TI  - Parent-child closeness affects the similarity of drinking levels between parents
      and their college-age children.
AB  - College males reported drinking more frequently and in higher amounts than
      females. Correlations between quantity-frequency (QF) indices of drinking by
      parents and by their college-age children showed the greatest similarity between
      fathers and sons. Log linear analyses compared each parent's drinking level
      against each of three other factors that might affect the QF levels of college
      age children: the relationship between parent and child, the effect of the
      parent's drinking on the parent, and how the parent's drinking affected their
      treatment of the child. The results supported models in which the relationship of
      each parent's drinking to the QF levels of both sons and daughters was affected
      by the closeness of the parent-child relationship. However, there was no support
      for models involving how each parent's drinking affected that parent or how each
      parent's drinking affected their treatment of the child.

PMID- 7785484
TI  - Childhood and adulthood temperament and problem behaviors and adulthood substance
      use.
AB  - A sample of 229 adult men and women were assessed to examine the relationships
      between childhood and adulthood temperament and problem behaviors. The influence
      of these variables on adult substance use was also assessed. Results indicated
      that individuals who had "difficult" temperament characteristics (e.g.,
      hyperactivity) and who experienced problem behaviors (e.g., antisocial behaviors)
      as children were likely to exhibit them as adults. In addition, the continuation
      of temperament characteristics and problem behaviors from childhood into
      adulthood did not demonstrate a high degree of specificity. When the
      relationships between temperament and problem behaviors to substance use were
      examined, conduct disorder during childhood and antisocial behavior during
      adulthood were found to be the best predictors of adult substance abuse.
      Moreover, this relationship became increasingly stronger with more substance
      involvement. These results underscore the importance of examining substance use
      in finer detail by assessing the pattern of substance use, instead of overall
      substance use involvement.

PMID- 7785486
TI  - Alcohol consumption: biochemical and personality correlates in a college student
      population.
AB  - The frequency of alcohol use among a subject population of 28 male and 60 female
      college students was assessed using the Student Alcohol and Drug Use Survey
      (STADUS). Data were also collected on personality traits as measured by the
      Sensation Seeking Scale V (SSSV) and the Eysenck Personality Questionnaire (EPQ).
      Finally, three biochemical variables were assessed: monoamine oxidase (MAO)
      activity, dopamine beta hydroxylase (DBH) activity, and testosterone levels.
      Among males, high SSSV scores, high testosterone levels, and low MAO activity
      contributed to the variance in alcohol use, whereas among females, a significant
      proportion of the variability in alcohol use was accounted for by high SSSV
      scores, high DBH activity, and younger age.

PMID- 7785485
TI  - Exercise enhances the maintenance of smoking cessation in women.
AB  - We examined the effects of physical exercise on smoking relapse. Twenty
      previously sedentary female smokers were randomly assigned to smoking cessation
      plus exercise or smoking cessation with frequency contact control. The smoking
      cessation program included 12 professionally led sessions over 12 weeks. Exercise
      treatment included three supervised exercise sessions per week for 15 weeks.
      Contact control included three women's health/wellness lectures per week for 15
      weeks. Smoking abstinence was validated by carbon monoxide and saliva cotinine.
      Mean exercise attendance for exercise subjects was 88% with an increase in
      estimated VO2 of 25%. The percentage of subjects who quit for 24 hours was 80%
      for the exercise and 90% for the contact group. One subject in the contact group
      remained abstinent at the end of the 12-week treatment and at 1-, 3-, and 12
      month follow-ups, whereas three subjects in the exercise group were abstinent at
      these time points. These results suggest that exercise training improves short
      term quit rates and may prove a useful strategy for long-term maintenance of
      smoking cessation.

PMID- 7785487
TI  - The pathogenesis of rheumatoid arthritis and the development of therapeutic
      strategies for the clinical investigation of biologics.
AB  - This review discusses current concepts of the pathogenesis of rheumatoid
      arthritis. It is proposed that RA is a T cell mediated disease following which a
      large number of subsequent inflammatory events are unleashed. Many of the
      pathogenetic steps are targets for new therapies including biologics. Laboratory,
      clinical and radiological methods of assessing disease activity are sufficiently
      sensitive and reproducible to permit their use in multicentre studies capable of
      detecting a biologic with disease modifying activity. The clinical assessment of
      the efficacy and toxicity of biologics poses unique problems. These have been
      illustrated by the example of 3 monoclonal antibodies directed against ICAM-1,
      CD4 and TNF alpha. The main role of most biologics may be to pinpoint important
      therapeutic targets which can be attacked by more easily administered and less
      costly xenobiotic drugs.

PMID- 7785488
TI  - Inflammation, Mechanisms and Therapeutics. Proceedings of the 7th International
      Conference of the Inflammation Research Association. White Haven, Pennsylvania,
      September 25-29, 1994.

PMID- 7785489
TI  - Regulation of alpha 6 beta 1 integrin-mediated migration in macrophages.
AB  - Several integrin alpha subunits have structural variants that are identical in
      their extracellular and transmembrane domains but that differ in their
      cytoplasmic domains. In the present study, we examined the possibility that the A
      and B variants of the alpha 6 beta 1 integrin laminin receptor differ in
      function. P388D1 macrophages that had been transfected with the alpha A integrin
      subunit were 3-4 fold more migratory than P388D1 macrophages that had been
      transfected with the alpha 6 B integrin subunit. Deletion of the alpha 6
      cytoplasmic domain markedly inhibited the ability of the alpha 6 beta 1 receptor
      to promote migration.

PMID- 7785491
TI  - C. Gordon van Arman Scholarship Competition 7th International Conference of the
      Inflammation Research Association.

PMID- 7785492
TI  - New animal models of inflammatory disease workshop.

PMID- 7785493
TI  - Cell adhesion workshop.

PMID- 7785490
TI  - Site-directed mutagenesis--molecular biology and rational drug design.
AB  - Using site-directed mutagenesis, we have determined the location and composition
      of the binding sites in human IL-1 alpha and IL-1 beta for the Type I IL-1
      receptor (IL-1R). The binding site in each ligand is a discontinuous epitope made
      up of at least seven amino acids whose side chains are exposed on a contiguous
      region of the protein surface. Although human IL-1 alpha and IL-1 beta have
      similar affinities and cross-compete for binding to the human Type I IL-1R, the
      binding site residues are not identical in the two ligands. In addition, the
      residues in the binding site of each ligand contribute differently to binding of
      the human versus the mouse IL-1R. The structure of the IL-1 binding site has
      implications for the rational design of IL-1 antagonists.

PMID- 7785494
TI  - Cartilage degradation and osteoarthritis workshop.

PMID- 7785495
TI  - New drugs in phase I and beyond workshop.

PMID- 7785498
TI  - Inflammatory cytokines workshop.

PMID- 7785497
TI  - Lipid mediators: mechanisms.

PMID- 7785499
TI  - Pulmonary inflammation workshop.

PMID- 7785496
TI  - Lymphocyte activation and immunoregulation workshop.

PMID- 7785500
TI  - Poster discussion lipid mediators--new agents.

PMID- 7785502
TI  - Cytokine networks in rheumatoid arthritis: implications for therapy.

PMID- 7785503
TI  - T cell receptor peptide vaccines as immunotherapy.

PMID- 7785501
TI  - Immunoglobulin gene expression in rheumatoid arthritis.
AB  - Rheumatoid arthritis (RA) is characterized by inflammation of synovium, in which
      immunoglobulin-secreting plasma cells are generally present. The forces driving
      immunoglobulin expression in RA synovium are unknown. Sequences of VH and VK
      transcripts from an RA synovial cDNA library demonstrate patterns of somatic
      mutation typical of an antigen-driven response. Moreover, 5% of the kappa
      repertoire appears to derive from the same B cell progenitor, suggesting an
      oligoclonal response. Immunoglobulin expression in this synovium thus appears to
      result from antigen stimulation. In addition, this patient's synovium is enriched
      for unusually long VK-JK joins (CDR3s), suggesting abnormal selection or
      regulation of the B cell response in RA.

PMID- 7785504
TI  - Antigen specific therapies for the treatment of autoimmune diseases.

PMID- 7785505
TI  - Protein kinase C in cell signaling: strategies for the development of selective
      inhibitors.
AB  - Protein kinase C plays a central role in the cellular signaling pathway for the
      lipophilic second messenger sn-1,2-diacylglycerol, which is involved in many
      biological responses, including tumor promotion and inflammation. A major effort
      has been directed at understanding diversity within this system in order to
      develop strategies for selective inhibition. Two classes of ligands for the
      regulatory domain of protein kinase C have been identified which, although they
      function in vitro as activators of the enzyme, paradoxically behave in vivo as
      partial antagonists. Identification of targets for the phorbol esters distinct
      from protein kinase C argues that antagonists acting on the regulatory and
      catalytic domains of protein kinase C will have different spectra of action.

PMID- 7785508
TI  - [Distribution of free amino acids and related compounds in ocular fluids of rat-
      I. Aging and inherited cataracts].
AB  - The distribution of free amino acids and their related compounds has been
      determined in the aqueous humors of Wistar strain and Ihara cataract f-strain
      (ICR) aging rats. Taurine was the most abundant amino acid in aqueous humors
      except in ICR rats of 16 and 70 weeks. It was supposed that the increase of
      serine and glutamine, and the decrease of aspartate, proline and glycine in
      aqueous humors were related to aging. There were interesting changes in amino
      acids related to opacity of lens, concentration of taurine was lower than that of
      Wistar rats in ICR rats of 4, 16, and 70 weeks, alanine and citrulline increased
      in Wistar rats and decreased in ICR rats, and histidine increased in ICR rats
      with aging. The changes in free amino acids in aqueous humors were the greatest
      in ICR rats, and these data will provide useful clues for the formation of
      cataract and the transportation of amino acids.

PMID- 7785506
TI  - [Recent advances in neuro-ophthalmological research and clinical application].

PMID- 7785507
TI  - [Induction of oral tolerance to experimental allergic conjunctivitis in rats].
AB  - Immunological tolerance can be induced by the oral administration of antigen. We
      induced oral tolerance rats to experimental allergic conjunctivitis by ovalbumin
      and investigated the suppression of inflammation. In groups which had started
      eating antigen both before and after the immunization, the serum anti-ovalbumin
      IgE level measured by passive cutaneous anaphylaxis reaction was significantly
      lower than in a group that had not been fed antigen. The intensity of
      experimental allergic conjunctivitis in the group which had started eating
      antigen before immunization, was significantly suppressed in regard to the
      leakage of Evans Blue from conjunctival vessels 30 minutes after the challenge
      and the neutrophil infiltration 6 hours after. The dye leakage of the group which
      had started feeding after immunization was also significantly suppressed. There
      was a positive correlation between the serum IgE level and the leakage of Evans
      Blue (r = 0.90, p < 0.001). These results suggest that the suppression of antigen
      specific IgE antibody production caused by oral tolerance affected the decrease
      of local inflammation on the conjunctiva.

PMID- 7785510
TI  - [In vitro topically applied fluoroquinolone penetration into the anterior
      chamber].
AB  - The penetration mode of five fluoroquinolone ophthalmic solutions (OFLX, NFLX,
      LVFX, LFLX and CPFX) through the rabbit cornea was examined with an in vitro
      experimental system. The system was an artificial anterior eye segment model made
      of acrylamide covered with a New Zealand albino rabbit cornea with a scleral
      flap. In vivo studies on the penetration of OFLX and NFLX ophthalmic solutions
      into the anterior chamber of albino rabbits were performed separately. Parameters
      gained from in vivo pharmacokinetic analysis and those from the model eye were
      compared. The permeability coefficients (K) (cm/s) through the cornea and
      partition coefficient were 6.95 x 10(-7) cm/s in LVFX, 6.78 x 10(-7) cm/s in
      OFLX, 3.58 x 10(-7) cm/s in LFLX, 2.46 x 10(-7) cm/s in CPFX and 0.06 x 10(-7)
      cm/s in NFLX, and 0.24, 0.23, 0.14, 0.06 and 0.07, respectively. High correlation
      was seen between the corneal permeability coefficients, and the partition
      coefficient Cmax of OFLX obtained from the in vivo study was higher than that of
      NFLX. The applied experimental system would be a useful tool for the estimation
      of the in vivo Cmax of the examined drug.

PMID- 7785509
TI  - [Permeability to horseradish peroxidase of the ciliary muscle vessels of squirrel
      monkeys].
AB  - The morphology and permeability to horseradish peroxidase (HRP) of the ciliary
      muscle capillaries of squirrel monkeys were studied. The endothelial cells of the
      capillaries were of the continuous type and the interendothelial clefts were
      closed by a zonula occludens. Many vesicles were present in the cytoplasm of the
      endothelial cells. In addition to these vesicles, large vacuole-like structures,
      100-500 nm in diameter, were observed in the cytoplasm of capillary endothelium,
      especially in the circular and radial ciliary muscles. When HRP was perfused into
      the anterior chamber, the 3,3'-diaminobenzidine reaction product was observed in
      the lumen of the ciliary muscle vessels after 30 minutes. When HRP was
      administered intravenously, the reaction product was observed among the muscle
      fiber bundles after 15 minutes. In both cases, the reaction products were also
      present in the cytoplasmic vesicles and vacuole-like structures, suggesting that
      these structures are involved in the bidirectional transport of HRP between
      interstitium and blood.

PMID- 7785511
TI  - [MHC and non-MHC gene effects on the development of experimental autoimmune
      uveoretinitis].
AB  - Experimental autoimmune uveoretinitis (EAU) can be induced in rats by
      interphotoreceptor retinoid-binding protein (IRBP), and served as a model for
      human uveitis. Using IRBP-derived peptide R16, we investigated the MHC and non
      MHC genes' effect on the regulation and susceptibility to EAU. EAU-high
      susceptible LEW (RT1l), EAU-low susceptible WKAH (RT1k), and WKAH.1L rats which
      carry RT1l and WKAH background were immunized with 2 nmol of R16. One hundred
      percent of LEW rats developed EAU and 92.9% of WKAH. 1L rats. Only, 18.8% of WKAH
      rats developed EAU. Among these strains tested, the severity of EAU was 2.06 in
      LEW, 1.23 in WKAH.1L, and 0.38 in WKAH. R16 evoked substantial proliferative
      responses in all these strains. The present data suggest that both MHC and non
      MHC genes play distinct roles in development of EAU.

PMID- 7785512
TI  - [Endothelin receptors in bovine retinal vessels--quantitative receptor
      autographic analysis with radioluminography].
AB  - Endothelin (ET) receptors in bovine retinal macrovessels, microvessels, and
      nonvascular tissues were characterized using a quantitative receptor
      autoradiographic method with 125I-endothelin-1 (125I-ET-1), ET-1, ET-, ET-3,
      BQ123 (a selective antagonist for the ETA receptor) and sarafotoxin S6c (an
      agonist for the ETB receptor). A quantitation was made with a computerized
      radioluminographic system and imaging plates. The method we used revealed that
      there were specific binding sites for 125I-ET-1 in the bovine retinal
      macrovessels, microvessels, and nonvascular tissues. There was no difference in
      the dissociation constant (Kd) showing binding characteristics between the
      retinal macrovessels and the microvessels. The bindings to the retinal
      macrovessels and the microvessels were effectively displaced by BQ123, whereas
      the binding to the retinal nonvascular tissues was displaced by sarafotoxin S6c.
      Thus, we obtained evidence that macrovessels and microvessels of the bovine
      retina have ETA receptor, and that the nonvascular tissues have ETB receptors.

PMID- 7785513
TI  - [An electrophysiological study on the effect of antioxidant drugs against retinal
      ischemia-reperfusion damage].
AB  - The effects of antioxidant drugs on retinal ischemia-reperfusion damage were
      studied by electroretinograms (ERGs) from reperfused Dutch rabbit eyes. After
      inducing retinal ischemia by increasing the intraocular pressure (IOP) up to 140
      mmHg for 60 minutes, the reperfusion was started by lowering the IOP to the
      normal level. Mannitol, polyethylene glycol superoxide dismutase (PEG-SOD), or
      ascorbic acid was administered by drip-infusion to the rabbits immediately after
      (early group) or 1 hr after (delayed group) the start of reperfusion. Saline, as
      a control, was administered by the same method as the early group. The a- and b
      waves were recorded before the ischemia and during the reperfusion. In the early
      group treated by each drug, the recovery rates of the b-wave amplitudes at 4 hrs
      after the start of reperfusion were significantly greater than those in the
      controls. In the delayed group, the ERG recovery rate in rabbits treated with PEG
      SOD was significantly better than in the controls. These results indicated that
      all these drugs were effective in protecting from the retina from the ischemia
      reperfusion damage, and that some antioxidant drugs might be effective even when
      they were administered after the start of reperfusion.

PMID- 7785514
TI  - [Matrix metalloproteinase in the cynomolugus monkey optic nerve heads].
AB  - Gelationolytic and caseinolytic activity of matrix metalloproteinase in normal
      cynomolugus monkey optic nerve heads was investigated. Optic nerve heads of three
      eyes were incubated in the media for 20 hours. Each media was applied to the
      gelatin or casein containing gels, and zymography was performed. Major bands of
      94 kDa and 62 kDa gelatinase activities were demonstrated in all three eyes. In
      one eye gelatinolytic activity of the 58 kDa band was also demonstrated.
      Caseinase activity was not detected in any of the three optic nerve heads.

PMID- 7785515
TI  - [Localization and response characteristics of thalamic corneal units in the cat].
AB  - Units in the thalamus responsive to mechanical stimulation of the cornea
      (thalamic corneal units) were studied in urethane-chloralose anesthetized cats.
      Four different classes of corneal units were found in the nucleus ventralis
      posteromedialis (VPM) and intralaminar nuclei. They corresponded to 4 different
      classes of corneal units in the trigeminal subnucleus caudalis and adjacent
      bulbar lateral reticular formation reported by Nishida (1987). Low threshold
      corneal specific (LTCS) units, whose mechanical threshold was well below the pain
      threshold in patients with cataract, were located in the dorsolateral part of the
      VPM proper. High threshold corneal specific (HTCS) units and wide dynamic range
      (WDR) units, whose mechanical threshold was well above the pain threshold of the
      human cornea, were located in the shell region of caudal VPM. Each class of these
      three corneal units was incorporated in the somatotopic organization of low
      threshold mechanoreceptive, nociceptive specific, or WDR units having a cutaneous
      receptive field in the contralateral trigeminal nerve territory. Units having
      receptive fields in the head similar to those of subnucleus reticularis ventralis
      (SRV) units were found in the intralaminar nuclei. Their corneal mechanical
      thresholds were much the same as those of HTCS units and WDR units. These results
      supported the suggestion that both nonpainful sensation and pain can be evoked in
      the cornea.

PMID- 7785516
TI  - [A new method to elicit pathological entoptic phenomenon from the retina-
      stenopeic flicker test].
AB  - Patients with central serous chorioretinopathy noticed that a part of the visual
      field became light for a few seconds when half of the visual field was covered in
      front of the eye. We devised a stenopeic flicker test (s-f test) to elicit this
      phenomenon continuously, and evaluated the clinical usefulness. We examined 17
      eyes with central serous chorioretinopathy using the s-f test and Amsler grid
      test. Retinal abnormality was detected in 17 of 17 eyes with the s-f test and 14
      of 17 eyes with the Amsler grid test. In detecting the extent of the retinal
      detachment on fluorescein angiograms, the s-f test (p < 0.0001, r = 0.842) was
      more precise than the Amsler grid test (p < 0.0003, r = 0.506). These results
      suggest that the s-f test is useful to detect retinal abnormality and to grasp
      the extest of the retinal detachment in central serous chorioretinopathy.

PMID- 7785517
TI  - [An apparatus using laser speckle phenomenon for noncontact two-dimensional
      analysis of microcirculation in optic nerve head or choroid in human eyes].
AB  - The previously reported apparatus using the laser speckle phenomenon for
      noncontact two-dimensional analysis of the fundus peripheral circulation was
      improved so that peripheral circulation in the optic nerve head (ONH) or choroid
      in human eyes can be measured on a real-time basis. The fundus was illuminated by
      a diode laser spot and its image speckle was detected with an area sensor. The NB
      value, a quantitative index of blood velocity, was calculated by the logic board
      every 0.125 sec successively for 7 sec. Using this apparatus, the NB averaged
      over the measurement field located in the temporal site of ONH, free of visible
      surface vessels (NBONH), and that located in the posterior choroid (NBCh) were
      measured in normal human eyes. The coefficients of reproducibility of 5-minute
      interval measurements were 11.7% for the NBONH averaged over 5 pulses (mean
      NBONH) and 8.7% for the NBONH averaged over 5 pulses (mean NBCh), and those of 24
      hour interval measurements were 13.0% for the former and 9.7% for the latter,
      respectively. The average of pulsatile component of NBONH was 38.4% of mean NBONH
      and that of NBCh was 26.6% of mean NBCh.

PMID- 7785518
TI  - [Static characteristics of accommodation on the relationship between
      accommodative resting position and viewing distance].
AB  - The steady-state accommodation of subjects during a 15 min visual task was
      measured in real time by an infrared optometer to investigate the relationship
      between accommodative resting position and the effect of viewing distance. When
      the subjects were loaded at 50 cm (closer than their resting state), the steady
      state accommodation showed an inward shift which was enhanced when computation
      was done. On the contrary, when they worked outside their resting position-2m
      viewing distance-, an outward shift of steady-state accommodation was seen in the
      control group who reacted only to the visual objects displayed. For the mental
      task group this was not evident. It appears that the steady-state accommodation
      is different between the cases of visual stimuli given inside and outside the
      resting position.

PMID- 7785519
TI  - [Functional magnetic resonance imaging of the human primary visual cortex during
      visual stimulation].
AB  - Signal changes in the human primary visual cortex during visual stimulation were
      evaluated using non-invasive functional magnetic resonance imaging (fMRI). The
      experiments were performed on 10 normal human volunteers and 2 patients with
      homonymous hemianopsia, including one who was recovering from the exacerbation of
      multiple sclerosis. The visual stimuli were provided by a pattern generator using
      the checkerboard pattern for determining the visual evoked potential of full
      field and hemifield stimulation. In normal volunteers, a signal increase was
      observed on the bilateral primary visual cortex during the full-field stimulation
      and on the contra-lateral cortex during hemifield stimulation. In the patient
      with homonymous hemianopsia after cerebral infarction, the signal change was
      clearly decreased on the affected side. In the other patient, the one recovering
      from multiple sclerosis with an almost normal visual field, the fMRI was within
      normal limits. These results suggest that it is possible to visualize the
      activation of the visual cortex during visual stimulation, and that there is a
      possibility of using this test as an objective method of visual field
      examination.

PMID- 7785520
TI  - [A case of multifocal choroiditis associated with progressive subretinal
      fibrosis].
AB  - Multifocal choroiditis associated with progressive subretinal fibrosis, which was
      reported by Cantrill and Folk in 1986, is characterized by acute multifocal
      choroiditis resulting in progressive subretinal fibrosis. All cases were young,
      healthy females. Our case was a 17-year-old female who complained of visual
      disturbance in her left eye. Ophalmoscopy showed multiple, small, yellowish-white
      hypopigmented, choroidial lesions in the posterior fundus of her left eye. These
      lesions showed hyperfluorescence in fluorescein angiography and hypofluorescence
      in indocyanine green (ICG) angiography. One month later the yellowish-white
      hypopigmented, choroidal lesions increased in number and subretinal fibrosis
      appeared in the macular area. Two months later subretinal fibrosis was also found
      in the area except for the macula. In her right eye, ophthalmoscopy and
      fluorescein angiography showed no abnormal findings, but ICG angiography revealed
      choroidal hypofluorescence areas. Two years later the subretinal fibrosis was
      increased and the yellowish-white lesions showed pigmentation.

PMID- 7785521
TI  - [Horizontal gaze palsy due to lesion of the abducens nucleus detected with
      magnetic resonance imaging].
AB  - A case of unilateral horizontal gaze palsy is reported. The lesion of the
      abducens nucleus was clearly detected with magnetic resonance imaging. In the
      early stage, the adduction of the right eye and abduction of the left eye were
      completely limited and the vestibulo-ocular reflex was also impaired. However,
      during the recovery stage, the improvement of limitation of abduction was delayed
      compared with that of adduction. We suggest that this phenomenon is useful as a
      differential diagnosis between lesions of the abducens nucleus and of the
      paramedian pontine reticular formation.

PMID- 7785522
TI  - Mapping the densities of malaria vectors within a single village.
AB  - Small scale spatial variation and temporal heterogeneity in mosquito densities
      can have important consequences for disease transmission, but the extreme
      variation which is observed in populations of malaria vectors makes it difficult
      to obtain good predictions of densities for short time periods over limited
      areas. We have applied Bayesian techniques derived for use in cancer epidemiology
      in order to map densities of Anopheles gambiae s.l. and A. funestus in a
      Tanzanian village where there is intense transmission of Plasmodium falciparum
      malaria. Estimates derived in this way should prove useful in vector population
      biology and in improving estimates of exposure-response relationships of the
      human host to malaria. The same methods can be applied in other fields of animal
      ecology.

PMID- 7785523
TI  - Immunodiagnosis of schistosomiasis mansoni in a low endemic area in Surinam by
      determination of the circulating antigens CAA and CCA.
AB  - We evaluated the applicability of circulating antigen detection in serum and
      urine for the diagnosis of Schistosoma infections in a low endemic area. In total
      389 individuals from Saramacca (Surinam) participated in the survey. Stool
      samples were examined using the Kato method, while circulating anodic antigen
      (CAA) and circulating cathodic antigen (CCA) were determined by highly specific
      monoclonal antibody-based ELISA's. Also schistosome specific IgM antibodies were
      measured by the indirect immunofluorescence assay, but the diagnostic performance
      of this test was found to be poor in this population. S. mansoni eggs were found
      in 29% of the examined cases, while CAA and CCA could be demonstrated in 23% and
      17% of the serum samples and in 3% and 28% of the urine samples, respectively.
      Forty three percent of the study population was positive in at least one of these
      diagnostic assays, indicating that each individual test misses a substantial part
      of the subjects with an active infection. In most positive cases, intensities of
      infection were very low. As 204 individuals participated in all screening assays,
      diagnostic performance of each test was evaluated in this sub-population. The
      highest sensitivities were achieved with the urine-CCA assay and the
      parasitological examination, detecting 59 and 58 out of the 107 cases with an
      active infection, respectively. The serum-CAA assay detected 47 positive cases.
      Our results demonstrate that determination of circulating antigens, especially
      CCA in urine and CAA in serum, provides information additional to the
      parasitological examination, for the assessment of prevalence and intensity of
      Schistosoma infection in low endemic areas.

PMID- 7785524
TI  - Characterisation of taeniid cestode species by PCR-RFLP of ITS2 ribosomal DNA.
AB  - Seven species of taeniid cestode (Echinococcus granulosus. E. multilocularis,
      Taenia hydatigena, T. ovis, T. pisiformis, T. multiceps and T. serialis) were
      characterised using a polymerase chain reaction-based restriction fragment length
      polymorphism technique (PCR-RFLP). The second internal transcribed spacer of
      ribosomal DNA (ITS2) was amplified from various geographical isolates of each of
      the seven species, digested separately with four restriction endonucleases and
      the fragments were separated by conventional agarose gel electrophoresis. PCR
      RFLP produced characteristic patterns for each taeniid species examined. No
      variation in RFLP patterns was observed among different isolates of E.
      multilocularis and the species of Taenia, but distinct intraspecific variation
      was detected in E. granulosus. The present study indicates the usefulness of the
      PCR-RFLP of ITS2 for systematic, epidemiological and diagnostic purposes.

PMID- 7785526
TI  - Anaemia and Plasmodium falciparum infections among young children in an
      holoendemic area, Bagamoyo, Tanzania.
AB  - Although the aetiology of anaemia in tropical areas is multifactorial, Plasmodium
      falciparum malaria is commonly associated with anaemia in children living in
      holoendemic malaria areas. Such an association was examined in a population based
      study of 338 children 6 to 40 months of age living in the Bagamoyo area of
      Tanzania. Stepwise regression analysis showed that fever and parasitaemia were
      effective in predicting anaemia and that the anaemic condition was age dependent.
      The majority of the children were iron deficient, followed by normochromic
      macrocytic anaemias. There was strong evidence in this age group that the anaemia
      was associated with malaria and not geohelminth infection. The importance of
      malaria and anaemia as a cause of childhood morbidity in Africa is discussed.
      This condition has taken on new significance with the realization that blood
      transfusions commonly used to treat severe anaemia are a major vehicle for Human
      Immunodeficiency Virus (HIV) transmission.

PMID- 7785525
TI  - Social aspects of malaria in Heping, Hainan.
AB  - This paper presents findings from a study conducted in Heping Town, Qiongzhong
      County, Hainan Province, China. The study, conducted in 1992, used qualitative as
      well as quantitative methods to gather social, cultural and behavioural data
      associated with the acquisition, transmission and prevention of malaria, and the
      diagnosis and treatment of disease. These methods included focus groups, key
      informant and other in-depth interviews, and observations, a household survey and
      tests of school children of knowledge of malaria. The study is among the first to
      our knowledge that has utilized this broad mix of methods for tropical disease
      research in China.

PMID- 7785528
TI  - Establishment of a partly DFMO-sensitive primate model of Trypanosoma rhodesiense
      sleeping sickness.

PMID- 7785527
TI  - Inoculum size and severity of malaria induced with Plasmodium ovale.
AB  - Although it might be expected that the size of the infecting inoculum would
      influence the severity of the consequent malaria, evidence that it does so is
      scarce. Using records from 80 non-immune neurosyphilis patients who received
      malaria therapy with a single strain of Plasmodium ovale by blood inoculation,
      the relationships between the number of trophozoites inoculated, the prepatent
      period, and measures of severity of the resulting malaria were examined. The
      number of trophozoites was not related to any of the outcome measures, but
      patients with shorter prepatent periods had higher and more peaks of fever and
      longer lasting infections.

PMID- 7785529
TI  - Proceedings of the Belgian Society of Urology International Congress. Ghent, May
      12-13, 1995.

PMID- 7785530
TI  - Clinical history and computerized questionnaires in the evaluation of
      incontinence.

PMID- 7785531
TI  - Commercial television bladder dysfunction.
AB  - Bladderdysfunction seems to have an increasing frequency in infancy, and
      especially in children without obvious congenital organic or functional
      bladderdysfunction. The disorder seems is related with changes in our behaviour,
      that are stimulated by familial and social pseudo-reasons. Commercial interests
      and marketing play a major role. This leads to wrong dry-training, an exaggerated
      hygienic education, prudisheness, wrong toilet-posture, lack of time to void,
      post-poning, wrong drink- and void-pattern, wrong food-pattern and increasing
      constipation. Prevention is necessary by an adapted reeducation of parents ans
      society.

PMID- 7785532
TI  - Female incontinence: critical analysis of diagnostic procedures.

PMID- 7785533
TI  - Reducing uncertainty for vesico-urethral sonography in women.
AB  - The author endeavours to detail the technical modalities which can be used to
      avoid uncertainty in urodynamic sonography, and to obtain easily reproducible
      quality imaging. The 5 major techniques (transparietal, transperineal, introital,
      endovaginal and endorectal) are compared. The artifacts generated are described.
      A choice between these different techniques is performed as a function of the
      methodological advantages specific to each of them and the clinical applications
      contemplated by the sonographer. The characteristics of the "ideal" equipment are
      defined to help the sonographer-to-be to choose his or her equipment with full
      awareness of the facts (characteristics of the probe, emission frequency,
      settings by the sonographer, automatic image freeze during coughing). The
      methodology is described in detail and widely illustrated: position of the
      patient, choice of the section plane, choice of the reference system, location of
      the urethra, and definition of the vesical neck, maintenance of the probe
      position during effort or free movement, degree of vesical fullness, choice of
      the parameters. Some difficulties can be linked to the patient's anatomical
      characteristics (vaginal scar, short or narrow vagina, twisted urethra,...); ways
      to avoid them are briefly described.

PMID- 7785534
TI  - Female urinary incontinence: imaging by or for the urologist.
AB  - The author reviews the imaging techniques useful in the evaluation of female
      urinary incontinence: voiding cystourethrography and videoradiourodynamics.
      Voiding cystourethrography allows to disclose two forms of bladder base
      suspension defects: anterior and posterior suspension defects. It will be
      performed before surgery. Videoradiourodynamics will be limited to patients with
      recurrent urinary incontinence following unsuccessful surgery.

PMID- 7785535
TI  - Female incontinence: critical analysis of diagnostic procedures.
AB  - Urodynamic procedures when required as part of the evaluation of female urinary
      incontinence should be tailored to the individual case. A wide range of tests are
      available which are reviewed with hints to which will add most information to
      previously obtained clinical data.

PMID- 7785536
TI  - Minimal prerequisites to operate a stress-incontinent woman.

PMID- 7785537
TI  - Non surgical treatment of female incontinence.

PMID- 7785538
TI  - Indications and operative treatment of stress urinary incontinence.

PMID- 7785539
TI  - The artificial urinary sphincter AMS 800: our experience in women with or without
      uterine prolapse.

PMID- 7785540
TI  - Colpopromontoriopexy.
AB  - This is a review article about the colposacropexy and the colpopromontoriopexy in
      the treatment of vaginal prolapse. We reviewed the literature through the eyes of
      a urologist dealing with genuine stress incontinence. The treatment of genuine
      stress incontinence without sphincterdeficiency consists in the correction of the
      anterior compartment prolapse. Preoperative it is important to examen the middle
      and the posterior compartment of the vagina in order to achieve good
      postoperative results. Most urologists cure genuine stress incontinence with an
      abdominal approach. The combination of a colposuspension and a
      colpopromontoriopexy is an operation that corrects anterior, middle and posterior
      compartment prolapse by the same approach without significant more complications
      or bloodloss.

PMID- 7785541
TI  - Testicular and vascular changes in patients with varicocele.

PMID- 7785542
TI  - Recurrence of varicocele after spermatic vein embolization in young patients:
      radiological aspect.

PMID- 7785543
TI  - [Antegrade scrotal sclerotherapy in the treatment of varicocele].
AB  - The antegrade scrotal sclerotherapy is a minimally invasive surgical technique in
      the treatment of the varicocele. Through a small scrotal incision a straight vein
      merging in the spermatic vein is isolated and cannulated. An antegrade
      phlebography is performed and ethoxysclerol is injected in the vein. We have
      performed this technique in 35 patients with a follow-up of at least 3 months.
      All patients except one (97%) show no more varicocele. This technique has a low
      morbidity, is cheap and as effective as the other treatment modalities. The
      antegrade sclerotherapy is competitive to the retrograde embolisation and has the
      advantage that the treatment can be performed in all cases, even in cases of
      recidive.

PMID- 7785544
TI  - [Laparoscopic treatment of recurrence and embolization failure of varicocele].
AB  - Varicocele is a benign pathology, for which the less invasive treatment is
      percutaneous embolisation. Literature reports results from 70 to 85% (1,2).
      Laparoscopic treatment seems to be a good alternative for patients suffering from
      a recurrence, or patients who can not be embolised. We report our experience
      concerning the first 13 patients treated with laparoscopic technic. In all 13
      cases it was possible to practice the technic, and patients were cured.

PMID- 7785545
TI  - [Examination of the non-palpable cryptorchid testis].
AB  - Cryptorchidism affects approximately 1 in 150 boys. Non-palpable testes represent
      nearly 20% of all cases. If present, they are situated between the inferior renal
      pole and the external inguinal ring. Often at surgical exploration, however, a
      "nubbin" of testicular tissue is found at the end of blind ending spermatic
      vessels without demonstration of a recognizable testis; this finding is referred
      to as an absent testis. In other patients, no vascular or ductular (epididymis
      vas deferens) or even testicular structure can be observed. This situation
      defines true testicular agenesis. Non-palpable testes have an increased risk of
      malignant transformation, infertility, associated inguinal hernia and congenital
      ductular abnormalities. Surgical treatment is often more complex and
      unsuccessful. Many imaging diagnostic methods to investigate patients with non
      palpable testes (pneumoperitoneography, angiography, ultrasonography, CT scan and
      RMN) have been used so far but none of these has been uniformly accepted as the
      ideal investigative technique because they are unreliable and/or they involve a
      fair risk. Since Cortesi and associates first described in 1976 a case of
      abdominal testes identified by laparoscopy, this technique has gained increased
      acceptance by pediatric urologists and surgeons. Today, celioscopy plays a
      central role in the exploration of non-palpable cryptorchid testes. The authors
      try to establish an algorithm methodology for investigating non-palpable testes
      under the light of recently reported anatomical, pathological and surgical data.

PMID- 7785546
TI  - Hormonal treatment of cryptorchidism: lessons from 15 years of worldwide
      experience.

PMID- 7785547
TI  - Cryptorchidism: the disease and its management.

PMID- 7785548
TI  - Laparoscopy: any indication in the work-up and treatment of undescended testis?
AB  - About 10% of undescended testis are non palpable. Surgical exploration of the
      inguinal region was the standard treatment, mainly because reliable "localisation
      tests" were not available. Today, laparoscopy is becoming the first step for
      optimal management of this problem. This technique combines relevant diagnostic
      information with therapeutic facilitations.

PMID- 7785549
TI  - Female incontinence. Clinical examination by the gynecologist.

PMID- 7785551
TI  - Pitfalls in urodynamic investigations in children.
AB  - For the evaluation of bladder (dys)function in young children with neuropathic
      bladder or other congenital malformations urodynamic investigations have become
      widely accepted. Although urodynamic studies can be conducted as early as the
      newborn period, there are some specific studies that can only be performed in
      somewhat older children, such as pressure-flow studies. Unlike adult patients,
      children most often do not understand why such an invasive study needs to be
      performed and are therefore less co-operative. In order to make the study as
      pleasant as possible some special measures have to be taken. This paper describes
      the different modalities available to perform urodynamic investigations in
      children, its drawbacks, pitfalls, indications, clinical implications and
      prerequisites.

PMID- 7785550
TI  - Bladder function and non-neurogenic dysfunction in children: classification and
      terminology.
AB  - Urological function and dysfunction in children are different from function and
      dysfunction in adults. The dynamics of the urinary tract in children are more
      complex as development from simple reflex controlled infant bladder to mature
      bladder function takes place during the first five years of live. The most
      crucial event in this development is the maturation of the inhibition that takes
      place in the growing urinary tract. Apart from gaining neurological control over
      de lower urinary tract there is the physical growth of the bladder-sfincter unit.
      Otherwise in children there exist a large amount of structural organic congenital
      pathology of the lower urinary tract that can trouble the normal development.
      Finally there is the cognitive function that has no anatomical substrate in the
      lower urinary tract but which takes place in the central nervous system and which
      is influenced by training and which can play a major role in development of non
      structural functional dysfunction. In order to train a child adequately the
      anatomical structure needs to have undergone enough maturation. By training a
      child on a too early age one can help to develop non structural functional
      dysfunction. In a time where competition in dry-training is encouraged by
      commercial pressure and where parents have less time, so that they are urged to
      train their children dry, more and more non-structural functional dysfunction in
      children is seen. The most prominent symptom of maldevelopment of the urinary
      tract, be it structural or functional is urinary incontinence. It is the most
      common problem seen in the paediatric urology practice.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7785552
TI  - [Evaluation of surgical treatment for bone metastatic lesion in renal cell
      carcinoma].
AB  - Ten renal cell carcinoma (RCC) patients with bone metastatic lesions were treated
      in the Kyoto Prefectural University of Medicine between January, 1977, and
      December, 1992. Surgical treatment for the metastatic lesion was performed on 4
      patients, while conservative treatment was performed on the other 6 patients.
      Surgical treatment made the patients painless consecutively, resulting in higher
      activities of daily life. However, recurrence of RCC developed in all the cases
      between 2 and 7 years later. Surgical treatment for the metastatic lesion was
      considered to be only a palliative therapy for RCC with bone metastasis and the
      indication should be limited to patients expected to have a good prognosis.

PMID- 7785553
TI  - [Clinical study on antimicrobial prophylaxis following extracorporeal shock wave
      lithotripsy].
AB  - One hundred and sixty one patients with upper urinary stones were examined for
      antimicrobial prophylaxis following extracorporeal shock wave lithotripsy (ESWL).
      They were divided into two groups, the low-risk group (n = 133) and high-risk
      group (n = 28), according to the risk factors of urinary tract infection. The
      patients in the low-risk group were further randomized into two groups which were
      orally given ofloxacin for 7 days after ESWL (Group A, n = 66), no antimicrobial
      (Group B, n = 67). The patients in the high-risk group were randomly subdivided
      into three groups which were given flomoxef intravenously for 2 or 3 days and
      ofloxacin for 4 or 5 days thereafter (Group C, n = 10), flomoxef only for 2 or 3
      days and no drugs later (Group D, n = 10), ofloxacin for 7 days (Group E, n = 8).
      In all of the patients in the low-risk group, during the 7 days after ESWL, fever
      elevation was observed in only 1.5% of patients, and bacteriuria in 10.0% on the
      7th day. There was no difference in frequency of fever elevation and bacteriuria
      following ESWL between Group A and Group B. These findings indicate that
      prophylactic antimicrobial after ESWL treatment is not necessary for low risk
      patients with urinary tract infections. In the high-risk group, the over-all
      rates of fever elevation and bacteriuria were 21.4% and 24.0% respectively. The
      difference of effectiveness among the prophylactic regimens of the three groups
      (Group C, D, E) was not shown.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785554
TI  - [Expression of PCNA/cyclin, p53, C-erbB-2 versus histological grade in
      transitional cell carcinoma of urinary bladder].
AB  - It is important to know the proliferating ability and the malignant potential of
      tumor tissues. We have examined the expression of PCNA/cyclin, p53 and C-erbB-2
      in transitional cell carcinoma of the human urinary bladder by an
      immunohistochemical method, and compared the results with the histological grade,
      stage and survival rate. Immunohistochemical studies, using monoclonal and
      polyclonal antibodies, on these proteins were performed with formaline fixed
      paraffin sections of tumor tissue from 40 patients with bladder cancer.
      Generally, a higher grade and higher stage tumors expressed PCNA/cyclin, p53 and
      C-erbB-2 with a greater frequency than the tumors with a lower grade and lower
      stage and strongly stained cases had a lower survival rate than weakly stained
      cases. These findings suggest that the detection of each antigen is useful for
      estimating the malignant potential of transitional cell carcinoma as the adjuvant
      studies, because of its applicability to paraffin-embedded tissue sections and
      its simple, rapid technique.

PMID- 7785555
TI  - [Morphological changes in major pelvic ganglion neurons and histological
      structure of bladder using rat model of partial urethral ligation].
AB  - Ninety six rats were divided into 4 groups (normal control group (N = 4),
      ligation group (N = 20), ligation-removed group (N = 36), and sham surgery group
      (N = 36)). The neuronal size of the 4-week ligated rats returned to normal 6
      weeks after removal of the ligation. Rats ligated for 7, 11 and 20 weeks also
      exhibited a significant increase in the mean area but they could not make a
      complete recovery after removal of ligation for 6 weeks. Only the rats in the 1-
      and 4-week ligation groups could recover their neuronal size. Area densities of
      smooth muscle: connective tissue (ADsc ratio) was calculated using Elastica van
      Gieson staining sections of bladder strips. When ligation was removed, the ratio
      dropped and became nearly equal to the value of the sham surgery group. Only the
      7-week group showed a lower ADsc ratio than the sham surgery group after the
      ligation was removed. These findings suggest that the reversibility of neuronal
      hypertrophy might become irreversible when the period of partial urethral
      ligation persisted beyond 7 weeks. Irreversible hypertrophy of major pelvic
      ganglion (MPG) neurons might be greatly related with the irreversibly enlarged
      fibrous bladder which could not show the same ADsc ratio as was seen in the sham
      surgery groups.

PMID- 7785556
TI  - [Experimental studies on evaluation of rat testicular function by 31P magnetic
      resonance spectroscopy].
AB  - To evaluate the efficacy of 31P magnetic resonance spectroscopy (31P MRS) as a
      diagnostic method for abnormal testicular function, we examined three conditions
      using rat testes, ischemia, irradiation, and hormone manipulation. 1) Ischemia:
      Immediately after clamping of the feeding vessels, ATP signals began to fall and
      disappeared within 60 minutes. With the release of blood supply after 3 hours of
      ischemia, ATP appeared within 2 hours. However, after more than 4 hours of
      ischemia, ATP did not recover within 2 hours and the testis became necrotic after
      1 week. 2) Irradiation: 31P MRS of the testis 2 weeks after irradiation with 10
      Gy., 9 MeV showed a significant decrease (P < 0.05) in the PME/beta-ATP ratio
      from 1.30 +/- 0.11 (control level) to 1.11 +/- 0.12 and a decrease in PME/PDE
      ratio from 1.43 +/- 0.17 to 1.13 +/- 0.20. However 3 weeks later, the PME/beta
      ATP ratio recovered to a control level. 3) Hormone manipulation: In the testes 5
      weeks after weekly intramuscular injections of estradiol benzoate and
      testosterone enanthate, PDE/beta-ATP ratio significantly increased (P < 0.01)
      from 0.83 +/- 0.09 (control level) to 1.03 +/- 0.19. 31P MRS is a non-invasive
      method for evaluation of various testicular abnormalities, and ATP signals may be
      useful to evaluate an acute ischemic change for example testicular torstion and
      the changes of PME, PDE signals may be useful parameters in the assessment of the
      status of spermatogenesis.

PMID- 7785557
TI  - [Consecutive annual changes in minimum inhibitory concentration in clinically
      isolated Neisseria gonorrhoeae strains].
AB  - Between 1983 and 1991, 465 gonococcal strains isolated in the urological
      department of Japanese Red Cross Medical Center. The minimum inhibitory
      concentration (MIC) of these isolates to 22 kinds of antibiotics including
      penicillins (PC), cephems, tetracyclins (TC) and new quinolons (NQ) were
      determined and the annual difference of MIC was studied. The annual incidence of
      penicillinase producing neisseria gonorrhoeae (PPNG) of these 9 years were
      distributed in 3 to 17% and increasing tendency was not observed. As for
      Penicillin G, the MIC 90 of PPNG was seven fold higher than that of non-PPNG. No
      remarked difference was observed between MIC 90 of Cephems, TC and NQ of PPNG and
      non-PPNG. No annual difference was observed in MIC of PC, Cephems and SPCM.
      However the rising tendency of MIC was observed in NQ.

PMID- 7785558
TI  - Evaluation of effects of chitosan in preventing hemorrhagic cystitis in rats
      induced by cyclophosphamide.
AB  - Hemorrhagic cystitis is a common problem following cyclophosphamide or radiation
      therapy. Chitosan has been shown to be an effective hemostatic agent and promoter
      of wound healing in animal experiments. We evaluated the safety and efficacy of
      intravesical chitosan in an animal model of cyclophosphamide cystitis.
      Hemorrhagic cystitis was induced in female F344 rats by intraperitoneal
      cyclophosphamide, 100 mg/kg. Chitosan solution (0.3 ml) was instilled
      intravesically on day 1 (Group 1), on days 1, 3, and 5 (Group 2), or 1 hour after
      the administration of cyclophosphamide (Group 3). The rats in group 4 were
      treated with chitosan diluent on day 1 after cyclophosphamide, and the rats in
      group 5 received intravesical chitosan without cyclophosphamide. Sequential
      examination revealed decreased mortality and lower incidences of severe bladder
      bleeding, necrosis and inflammation in Group 3. Treatment delayed until after the
      appearance of the cystitis, especially repeated treatments, appeared to make the
      cyclophosphamide-induced changes worse. Used within 1 hour of cyclophosphamide
      administration, before the cystitis develops, chitosan seemed to have the
      possibility to inhibit the appearance of hemorrhagic cystitis. In addition to the
      changes in the bladder, severe changes occurred in the kidneys secondary to
      cyclophosphamide.

PMID- 7785559
TI  - [A case of middle ureteral tumor treated by end-to-end anastomosis following
      resection of 6.7 cm segment].
AB  - A 71-year-old male with a right ureteral tumor in the midportion and contracted
      kidney of the opposite side, due to complete vesicoureteral reflux, underwent end
      to-end anastomosis after partial ureterectomy 6.7 cm in length. Our experience in
      this case led us to conclude that end-to-end anastomosis of the upper or mid
      portion of the ureter was possible for the maximal 7.0 cm length of the ureteral
      loss, when the kidney could be fixed downward as much as possible.

PMID- 7785560
TI  - [Intra-arterial chemotherapy with cisplatin, vincristine, methotrexate and
      adriamycin for recurrent penile cancer: a case report].
AB  - A 60-year-old man visited our hospital with a chief complaint of penile tumor on
      November 13, 1984. Circumcision of true phimosis was performed and biopsy of the
      27 x 27 mm fixed tumor on the glans revealed well differentiated squamous cell
      carcinoma. Seventy Gy of electron irradiation to the penis revealed a complete
      response. On February 1, 1985 bilateral inguinal lymph node dissection was
      performed and revealed metastasis to a left inguinal node. In May 1990, erosive
      changes occurred on the irradiated region, and local recurrence was confirmed.
      Since 2 courses of MBD (methotrexate, bleomycin, cisplatin) chemotherapy was not
      effective, additional wedge dissection was performed. In January 1992, local
      recurrence was found. Four courses of intra-arterial chemotherapy (cisplatin,
      vincristine, methotrexate, adriamycin) was performed with a complete response. No
      evidence of disease has been recognized for more than two years after completion
      of the treatment.

PMID- 7785562
TI  - [A case of granulomatous orchitis].
AB  - A 69-year-old man complained of a painless left scrotal swelling. The scrotal
      mass was enlarged to a hen's egg size with a smooth surface. The scrotal
      ultrasonogram showed diffuse hypoechogenicity. A testicular tumor was suspected
      and left high orchiectomy was performed. Histopathological diagnosis was
      granulomatous orchitis.

PMID- 7785561
TI  - [Two cases of priapism cured by transcatheter embolization of internal pudendal
      arteries].
AB  - We report here two cases of priapism. One of these cases was suspected to be drug
      induced and high and low flow mixed type. The patient had taken the drugs, alpha
      blocker for hypertension and dysuria by BPH for a long time. He was treated by a
      caveno-glandular shunt. After surgery, detumescence was obtained for some time,
      but erection appeared again soon. Transcatheter embolization of the internal
      pudendal arteries was then performed, and detumescence became permanent. The
      other case was an idiopathic and high flow type. Detumescence was achieved soon
      by transcatheter embolization of the internal pudendal arteries only, then he
      experienced morning erection imperfectly on the 9th day after this treatment. The
      management of priapism as reported to date is also reviewed.

PMID- 7785563
TI  - [Clinical statistics at the urological clinic of Sanjukai Hospital--statistics on
      new outpatients during the last five years].
AB  - We report the clinical statistics of new outpatients for five years since 1989 at
      our hospital. The average total number of new outpatients in a year was 8309.8
      (8122-8691) and new outpatients tended to show little change. The male to female
      ratio was 1.57:1, and 24.3% of the outpatients were referred to us by others
      sources. The representative operations on outpatients were circumcision,
      vasectomy, resection of condyloma and resection of caruncle. A statistical study
      was made on new outpatients according to the international classification of
      disease. There were 140.6 (1.97%) malignant urogenital tumors per year. Sexually
      transmitted diseases showed a tendency to increase for the last five years. In
      males the major disease was upper urinary tract stone (21-24%), prostatistis (21
      24%) and benign prostatic hypertrophy (17-20%) and in females they were cystitis
      (58-61%), upper urinary tract stone (15-17%) and pyelonephritis (3-4%). We
      conclude that our hospital plays a major role as a private urological hospital.

PMID- 7785564
TI  - Duplex sonography after transjugular intrahepatic portosystemic shunts (TIPS):
      normal hemodynamic findings and efficacy in predicting shunt patency and
      stenosis.
AB  - OBJECTIVE: Portal hemodynamics are altered by placement of a transjugular
      intrahepatic portosystemic shunt (TIPS). Normal duplex sonographic findings after
      TIPS placement and hemodynamic alterations indicating shunt failure have not yet
      been well described. The purposes of this study were to determine normal
      hemodynamic changes on duplex sonography after TIPS placement and to assess the
      efficacy of duplex sonography in detecting shunt dysfunction. SUBJECTS AND
      METHODS: Forty patients underwent TIPS placement and were entered into a study
      that included routine sonographic evaluation and portal venography at regular
      intervals. Portal venography was also performed if shunt velocities on duplex
      sonography changed from the baseline, which raised the question of shunt stenosis
      or occlusion. The pre-TIPS duplex sonographic study included determination of
      patency, velocity, and flow direction in the main, right, and left portal veins
      and in the hepatic artery. Follow-up sonography included the pre-TIPS examination
      in addition to velocity determinations in three segments of the shunt.
      Correlation was made between 82 concurrent sonographic and portal venographic
      studies. RESULTS: High-velocity blood flow (mean peak velocity, 135-200 cm/sec)
      was consistently seen within patent, well-functioning shunts. Hepatic artery peak
      systolic velocities increased from 79 cm/sec before TIPS placement to 131 cm/sec
      after TIPS placement (p < .001). Main portal vein velocities increased from 21.8
      cm/sec before TIPS placement to 41.5 cm/sec after TIPS placement (p < .001). When
      compared with portal venography, duplex sonography was 98% sensitive and 100%
      specific in predicting the presence of blood flow within the stent. Sonography
      was highly sensitive and specific for detecting stent stenosis. Final sonographic
      criteria for shunt stenosis in angiographically documented cases were low
      velocity shunt flow (< or = 60 cm/sec) in the entire stent, or low-velocity shunt
      flow with an associated focal velocity elevation. CONCLUSION: Consistent changes
      in portal venous and hepatic arterial hemodynamics are normally seen on duplex
      sonography after placement of a TIPS. Duplex sonography accurately predicts shunt
      patency and dysfunction when compared with portal venography. Duplex sonography
      is an effective, noninvasive method of evaluating shunt function and should be
      considered for use as the primary imaging technique in routine follow-up after
      TIPS placement.

PMID- 7785565
TI  - Pheochromocytoma of the bladder in an adolescent: sonographic and MR imaging
      findings.

PMID- 7785566
TI  - Filmless musculoskeletal radiology: why is it taking so long?
AB  - Digital images as an alternative to plain radiographs in musculoskeletal
      radiology have not been readily accepted to date. This article looks at the
      different aspects of filmless imaging and offers an opinion concerning this lack
      of acceptance. Although spatial resolution, image storage, and image transmission
      present potential problems, the greatest problem is image display. Commercially
      available workstations do not compete well with the speed and simplicity of the
      conventional film and view box.

PMID- 7785567
TI  - Predicting neurologic outcome with MR imaging in a patient in spinal shock.

PMID- 7785568
TI  - Increased signal in the normal supraspinatus tendon on MR imaging: diagnostic
      pitfall caused by the magic-angle effect.
AB  - OBJECTIVE: Increased signal intensity within the distal portion of the
      supraspinatus tendon during MR imaging is a frequent observation even in healthy
      subjects. This finding has been variously attributed to the presence of fat,
      muscle, connective tissue, abnormal vascularity, or degenerative changes. More
      recently, the effect of tendon orientation in the static magnetic field (Bo) has
      been implicated. It has been shown that tendons at the magic angle of 55 degrees
      to Bo show markedly increased signal. This study was designed to determine the
      contribution of the magic-angle effect to the MR signal in the distal portion of
      the supraspinatus tendon. SUBJECTS AND METHODS: Five healthy volunteers were
      imaged in a 1.5-T unit using short TR/TE sequences in standard supine position;
      they were then reimaged laterally flexed at the waist to reorient the plane of
      the distal portion of the supraspinatus tendon by approximately 20 degrees
      relative to Bo. In the second part of the study, three cadaveric shoulders were
      similarly imaged, first in standard position and then reoriented approximately 35
      degrees by simple rotation of the specimen. The supraspinatus tendon was
      evaluated in each subject by noting the length of the segment with increased
      signal and the position of this segment relative to the insertion of the tendon
      on the greater tuberosity. Comparisons were made for each live and cadaveric
      subject between neutral and rotated positions. RESULTS: Segments of increased
      signal changed in length and position for each live and cadaveric subject from
      the neutral to the reoriented position. CONCLUSION: Our study suggests that
      tendon orientation contributes significantly to the presence of increased signal
      within the supraspinatus tendon, as caused by the magic-angle effect. Failure to
      recognize this effect may lead to diagnostic inaccuracy when evaluating the
      rotator cuff on short TR/TE sequences.

PMID- 7785569
TI  - Correlation of MR imaging and pathologic findings in athletes undergoing surgery
      for chronic patellar tendinitis.
AB  - OBJECTIVE: Jumper's knee, or chronic patellar tendinitis, can be a source of
      considerable pain in athletes. The changes that occur with shearing of the
      tendinous fibers from repeated microtrauma can progress to significant
      degeneration and increase the risk of tendon rupture. In order to better
      understand this phenomenon, a correlative study relating the MR imaging and
      pathologic findings was performed. SUBJECTS AND METHODS: Nine high-performance
      athletes 18-22 years old (mean age, 20 years) underwent operation of 11 knees for
      long-standing jumper's knee. The average period of symptoms was 3 years (range, 2
      to 6 years). MR knee examinations were performed before surgery in all athletes.
      The symptoms, MR findings, and pathological findings were correlated. RESULTS:
      There was focal thickening in the proximal one third of the patellar tendon
      (range, 9-16 mm; mean, 12 mm) in all 11 knees, involving the medial portion of
      the tendon in 10 and the center in one. On proton-density-weighted MR images, all
      knees demonstrated a focus of abnormal signal intensity in the proximal one third
      of the patellar tendon. On T2-weighted MR images, 10 knees demonstrated abnormal
      signal intensity; eight were isointense to that seen on proton-density-weighted
      images, and two were relatively hyperintense. Ten tendons demonstrated a poorly
      defined posterior margin. Pathologically, the areas of abnormal signal intensity
      corresponded to tissue containing tenocyte hyperplasia, prominent angiogenesis
      with endothelial hyperplasia, loss of longitudinal collagenous architecture, and
      microtears with collagen fiber separation. Hyaline degeneration was present in
      specimens from every patient. CONCLUSION: In athletes with chronic patellar
      tendinitis, areas of abnormal signal intensity on MR imaging corresponded to
      degenerative pathologic changes consistent with angiofibroblastic tendinosis. In
      nearly all patients, the tendon thickening occurred eccentrically.
      Disproportionate medial tendon thickening may be related to unequal tensile
      forces across the knee joint, resulting in greater stress on the medial portion
      of the extensor mechanism of the knee.

PMID- 7785570
TI  - Abnormalities of the foot and ankle: MR imaging findings.
AB  - Although plain film radiography remains the appropriate imaging technique used in
      the initial evaluation of ankle and foot disorders, MR imaging has rapidly become
      important because it provides high soft-tissue contrast and multiplanar
      capability, and because it can detect subtle marrow abnormalities. MR imaging is
      most useful for evaluating pathologic processes that involve soft-tissue
      structures and for evaluating patients whose clinical findings remain unexplained
      despite normal findings with other imaging techniques. This pictorial essay
      illustrates various applications for MR imaging of the foot and ankle.

PMID- 7785571
TI  - Treatment of high-grade bone sarcomas with neoadjuvant chemotherapy: the utility
      of sequential color Doppler sonography in predicting histopathologic response.
AB  - OBJECTIVE: The purpose of this study was to use color Doppler flow imaging to
      predict the response to preoperative chemotherapy in patients with Ewing's
      sarcoma or high-grade osteosarcomas early in treatment. SUBJECTS AND METHODS:
      Color Doppler flow imaging was done in 31 patients before, during, and after
      chemotherapy. In each phase of treatment, semiquantitative changes in
      intratumoral blood flow, changes in maximum intratumoral Doppler shifts, and
      changes in resistive indexes of arteries feeding limbs that contained tumors
      relative to contralateral normal arteries were compared with the histopathologic
      response, as evaluated on the resected specimens. RESULTS: Before chemotherapy,
      pathologic flow was found in the extraosseous component of all but two patients.
      Resistive indexes in arteries that fed tumors were significantly lower (p < .001)
      than the resistive indexes in the contralateral normal arteries. Histopathologic
      response could not be predicted on the basis of the initial measurements of
      Doppler shifts and resistive indexes taken before or after the first cycle of
      chemotherapy. Histopathologic response could be predicted after the second cycle
      of chemotherapy. After the second cycle of chemotherapy, the resistive index in
      the arteries that fed tumors increased in eight of nine good respondents but did
      not change or decreased in eight of nine poor respondents (p = .03). Lower
      intratumoral Doppler shifts were measured in six of 10 good respondents but also
      in five of 13 poor respondents (p = .07). After the full course of chemotherapy,
      persistent lower resistive indexes were measured in the arteries that fed tumors
      in all poor respondents but one. Intratumoral flow and Doppler shifts further
      decreased in all good respondents but one. Changes in Doppler shifts (p = .001)
      and resistive indexes (p < .001) were statistically significant between good and
      poor respondents, irrespective of the tumor type studied. CONCLUSION: Decreased
      or unaltered resistive index in the arteries that feed tumors in addition to
      persistent intratumoral flow and high-frequency Doppler shifts after two cycles
      of chemotherapy suggest poor histologic response to chemotherapy in osteosarcoma
      and Ewing's sarcoma. An increased resistive index after two cycles is indicative
      of good response.

PMID- 7785572
TI  - Primary bone tumors: value of MR angiography for preoperative planning and
      monitoring response to chemotherapy.
AB  - OBJECTIVE: The purposes of our study were to investigate the use of MR
      angiography with two- (2D) and three-dimensional (3D) displays in evaluating
      vascular morphology of musculoskeletal neoplasms for preoperative planning of
      limb-salvage surgery and to assess the use of MR angiography for monitoring
      changes in neovascularity and evaluating response to chemotherapy. SUBJECTS AND
      METHODS: We used MR angiography (2D time-of-flight) to study 13 patients with
      primary bone tumors (nine osteogenic sarcomas, two Ewing's sarcomas, and two
      primary lymphomas of bone) at the time of initial presentation. Eight patients
      (all of whom had osteogenic sarcoma) also underwent MR angiography following
      chemotherapy before limb-salvage surgery. Two-dimensional maximum intensity
      projections were obtained. Three-dimensional reconstructions of vascular
      structures were created from the angiographic source images and were displayed
      simultaneously with 3D reconstructions of tumor and normal bone generated from
      conventional MR images. RESULTS: Two-dimensional maximum intensity projections
      were useful for evaluating small vessel neovascularity; 3D displays demonstrated
      spatial relationships of tumor, feeder vessels, and normal vascular structures.
      Tumor encroachment onto or encasement of normal vascular structures was shown in
      four patients on 2D maximum intensity projections and on 3D displays. The eight
      patients with osteogenic sarcoma who had follow-up imaging showed marked
      neovascularity prior to chemotherapy. Five patients responded to chemotherapy (>
      or = 90% tumor necrosis at histology); MR angiography showed marked reduction in
      tumor neovascularity in these patients. Three patients did not respond to
      chemotherapy; MR angiography showed unchanged neovascularity in one and increased
      neovascularity in two of these patients. CONCLUSION: MR angiography provides good
      visualization of peripheral vascular branches and tumor neovascularity in
      patients with primary bone tumors. MR angiography demonstrates encroachment onto
      and encasement of major vessels by the tumor mass and appears to be useful for
      assessing response to chemotherapy in osteogenic sarcoma and possibly other
      primary bone tumors by detecting treatment-induced changes in tumor
      neovascularity.

PMID- 7785573
TI  - Renal osteodystrophy: imaging findings that mimic those of other diseases.
AB  - Musculoskeletal complications in patients with chronic renal failure are common
      and may be related to the disease itself or to treatment. The altered metabolism
      in patients with chronic renal failure leads to renal osteodystrophy, which
      consists of osteomalacia and secondary hyperparathyroidism [1]. Erosive changes
      attributable to secondary hyperparathyroidism may be easily confused with
      rheumatoid arthritis, seronegative spondyloarthropathies, infection, or even
      malignancy. Brown tumors and amyloid deposition can easily be mistaken for a
      neoplastic process. The purpose of this article is to illustrate radiographic
      findings that are caused by renal failure and that often mimic other diseases by
      use of plain radiographs, CT scans, and MR images. Particular emphasis is placed
      on periarticular findings.

PMID- 7785574
TI  - Estimation of total lung capacity from chest radiography and chest CT in
      children: comparison with body plethysmography.
AB  - OBJECTIVE: The purpose of this study was to evaluate two methods of estimating
      lung volume using chest radiographs and one using chest CT in children. Estimates
      made with these techniques were compared with total lung capacity calculated with
      body plethysmography. MATERIALS AND METHODS: CT scans and posteroanterior and
      lateral radiographs of the chest were obtained in 21 children (14 girls and seven
      boys) for follow-up evaluation after lung transplantation. Lung volume was
      measured by CT using a previously validated technique of tracing the margins of
      the lungs on each axial CT scan. Two methods were used to estimate lung volume on
      chest radiographs: a technique previously described in adults and children that
      requires 21 measurements on posteroanterior and lateral radiographs, and a
      modification of a simplified technique previously reported in adults that uses
      only two measurements on a posteroanterior radiograph alone. Estimated lung
      volumes from CT and from both methods using chest radiographs were compared with
      total lung capacity determined from body plethysmography using regression
      analysis, and 95% prediction intervals were generated. RESULTS: All three methods
      of estimating lung volumes from radiographs correlated well with total lung
      capacity from plethysmography (r = .89-.92). However, we found no statistically
      significant or clinically meaningful difference among the methods of estimating
      lung volume. CONCLUSIONS: Lung volumes in children can be accurately estimated
      from specific measurements made on chest radiographs and on CT scans. Of the two
      methods tested with chest radiographs, the technique that required only two
      measurements from a posteroanterior chest radiograph was as accurate as the more
      complicated technique that required 21 measurements.

PMID- 7785576
TI  - The role of imaging in patients with ascites.
AB  - Imaging plays a significant role in patients with ascites for assessing the size
      and the causes of ascitic fluid, for assisting sampling or draining of ascitic
      fluid, for selecting candidates for TIPS placement, and for surveilling and
      detecting complications after TIPS placement. Sonography and CT are primary
      imaging tools, and MR imaging is used in selected cases such as demonstration of
      peritoneal or ascitic fluid enhancement, particularly in patients with
      compromised renal function. Interventional procedures combined with CT and
      sonography play a major role in the assessment of patients considered for TIPS
      placement because of refractory esophageal bleeding or ascites. Before the TIPS
      procedure, these procedures are used to exclude contraindications such as
      polycystic liver disease, hypervascular hepatic tumors, and portal vein
      thrombosis. After the TIPS procedure, sonography combined with interventional
      procedures is used to detect immediate complications such as hemorrhage or
      intractable shunt-induced encephalopathy due to excessive portosystemic diversion
      and to detect and treat mid- to long-term complications such as shunt stenosis
      and occlusion through a routine surveillance program.

PMID- 7785577
TI  - Sudden death in Marfan syndrome.

PMID- 7785575
TI  - Lateral ventricular effacement as an isolated sonographic finding in premature
      infants: prevalence and significance.
AB  - OBJECTIVE: The sonographic finding of effaced lateral ventricles in premature
      infants, defined as the absence of visible CSF within the lateral ventricles on
      both coronal and sagittal sonograms, may be cause to suspect diffuse cerebral
      edema, especially as published reference standards do not address this
      phenomenon. This investigation was undertaken to determine the prevalence and
      significance of effaced lateral ventricles without associated parenchymal
      abnormality (isolated lateral ventricular effacement, or ILVE) in premature
      infants. MATERIALS AND METHODS: Sonographic records of 398 consecutive newborns
      examined from January 1 to December 31, 1993, were reviewed retrospectively to
      identify those premature infants (< 36 weeks of gestational age) whose initial
      sonograms showed no evidence of intracranial hemorrhage, ventriculomegaly,
      structural abnormality, or abnormal parenchymal echogenicity. We identified 142
      neonates who met these criteria. Patients were separated into two groups on the
      basis of whether they had at least one sonographic study in which CSF was not
      visible within both lateral ventricles on coronal and sagittal images. Medical
      records were reviewed to assess neurologic outcome. RESULTS: Forty patients (28%)
      had at least one sonogram demonstrating ILVE, with neurologic follow-up in 33
      (representing group A). One hundred two patients (72%) never demonstrated ILVE,
      with neurologic follow-up established in 86 (representing group B). A comparison
      of the two groups showed no significant difference in the development of ischemic
      injury (one patient in each group). ILVE was first detected on the initial
      sonogram obtained (mean, 4 days) in 30 of the 33 neonates in group A. ILVE was
      demonstrated beyond the seventh day of life in 30%. Of the 89 patients whose
      initial sonograms showed CSF in the lateral ventricles (86 in group B and three
      in group A), three (3%) subsequently had sonograms that showed ILVE; all three
      were normal at follow-up. CONCLUSION: ILVE in premature infants is common and not
      associated with neurologic deficits indicative of hypoxic-ischemic
      encephalopathy. By itself, ILVE is not a significant finding.

PMID- 7785578
TI  - Portal vein stenosis in children with segmental liver transplants: treatment with
      percutaneous transhepatic venoplasty.
AB  - OBJECTIVE: We reviewed the early results of percutaneous portal venoplasty as a
      method of treating portal vein stenosis in 11 children with reduced-size liver
      transplants. SUBJECTS AND METHODS: Percutaneous transhepatic portal venoplasty
      was attempted in 11 children with portal vein stenoses over a period of 9 months.
      The venoplasty was performed by direct puncture of an intrahepatic portal vein
      followed by balloon angioplasty of the stenotic segment. Patients presented with
      symptoms of portal venous hypertension or were identified by routine surveillance
      with posttransplant Doppler sonography. All stenoses were verified with
      angiography before portal venoplasty was attempted. In patients with suboptimal
      results after portal venoplasty or who developed recurrent stenoses,
      intravascular stents were placed across stenoses. RESULTS: In eight of 11
      patients, initial clinical and technical success was achieved. Intravascular
      stents were placed in two of these patients. In the three unsuccessful
      procedures, complete occlusion of the portal vein precluded vascular access. Two
      procedure-related complications and one nonprocedure-related complication
      developed. In one patient, the portal vein restenosed after 6 months, and a
      metallic intravascular stent was placed to alleviate the stenosis. Portal vein
      patency in all other successful procedures has been maintained for 3-9 months
      (mean, 6.1 months) without further intervention. CONCLUSION: Percutaneous
      transhepatic portal venoplasty of portal vein stenosis in children with living,
      related liver transplant donors has excellent early results. In patients with
      this complication, the procedure has become the initial choice in our hospital,
      eliminating the need for surgical revision, portacaval shunting, or
      retransplantation.

PMID- 7785580
TI  - Sinus pericranii: sonographic findings.

PMID- 7785579
TI  - The value of portal vein pulsatility on duplex sonograms as a sign of portal
      hypertension in children with liver disease.
AB  - OBJECTIVE: The purpose of this study was to determine the significance of portal
      vein pulsatility on duplex Doppler waveforms in children with end-stage hepatic
      failure undergoing liver transplantation. SUBJECTS AND METHODS: Thirty-eight
      children with end-stage hepatic decompensation were examined with color-assisted
      spectral Doppler waveform analysis of the hepatic artery and the portal vein.
      Correlation was made with age, duration of illness, clinical and pathologic
      diagnosis, and presence of portal hypertension. Findings were compared with those
      for six patients with acute viral hepatitis and 12 healthy control subjects.
      RESULTS: Portal vein pulsatility was noted in all 36 patients in whom portal vein
      flow was detected by Doppler imaging. The majority of these (34) had clinical or
      sonographic evidence of portal hypertension. In two patients, no portal vein flow
      was identified in the liver hilum; both had a large portosystemic shunt through
      collaterals or surgical graft. Significantly increased pulsatility of the hepatic
      artery waveform (resistive index [RI] = 0.89 +/- 0.15, p < .0001) was seen in
      patients with end-stage liver disease. In contrast, no portal vein pulsatility
      and normal hepatic artery pulsatility (RI = 0.60 +/- 0.11) was noted in all
      patients with acute hepatitis and control subjects. CONCLUSION: Portal vein
      waveform pulsatility is 94% sensitive and 90% specific for portal hypertension in
      end-stage liver disease.

PMID- 7785581
TI  - Accuracy of a voice-to-text personal dictation system in the generation of
      radiology reports.
AB  - OBJECTIVE: Systems that convert spoken words directly into text have recently
      become available. The purpose of this study was to test the accuracy, on a word
      for-word basis, of one such system for generating radiology reports. MATERIALS
      AND METHODS: The IBM Personal Dictation System (IPDS), with the optional add-on
      radiology vocabulary, was assessed (the system is now known as VoiceType
      Dictation). The system requires one to use discrete speech (i.e., with a
      momentary pause between words). Two hundred current radiology reports, including
      100 consecutive chest radiographs, 50 consecutive thoracic CT scans, and 50
      random sonography and angiography reports, were read to the system. Before
      testing, the IPDS had been used in the dictation of material related to chest
      radiology. All errors were noted on a word-for-word basis and categorized as
      follows: incorrect, partially incorrect (no effect on meaning), not in dictionary
      (word was then added), homophone, or formatting. Medical words (those thought to
      be relevant to the meaning of the report) were considered separately. Specific
      assessments of numbers and dates were made. Words added to the dictionary were
      reread after the 200 reports had been assessed. RESULTS: When all mistakes were
      considered, the accuracy was 0.99 for chest radiology and 0.96 for material not
      concerning chest radiology. When only relevant mistakes on medical words were
      considered, the accuracies were 0.98 and 0.96, respectively. Accuracy for numbers
      was 0.95 and for dates 0.97. Redictation of the 22 words previously not in the
      dictionary was 100% accurate. CONCLUSION: The IPDS is an accurate system for
      direct voice-to-text dictation of radiology reports that improves with continued
      use. The most important future enhancement of such systems will be to allow the
      more natural continuous or conversational speech style.

PMID- 7785582
TI  - American martyrs to radiology. Walter James Dodd (1869-1916). 1936.

PMID- 7785583
TI  - Chest case of the day. Metastatic bronchial carcinoid.

PMID- 7785584
TI  - Chest case of the day. Hypersensitivity pneumonitis.

PMID- 7785585
TI  - Chest case of the day. Fibrosing mediastinitis.

PMID- 7785586
TI  - The mammography audit: a primer for the mammography quality standards act (MQSA).
AB  - The medical audit of a mammography practice is a recognized method for evaluating
      mammography and the accuracy of mammographic interpretation [1-4]. As such,
      portions of the audit will become integral to the quality assurance activities of
      every mammography practice under the Mammography Quality Standards Act (MQSA) of
      1992, administered by the Food and Drug Administration (FDA). The FDA Interim
      Rules, which became effective October 1, 1994, state that "each facility shall
      establish a system for reviewing outcome data from all mammography performed,
      including follow-up on the disposition of positive mammograms and correlation of
      surgical biopsy results with mammogram reports" [5]. It is expected that the
      proposed final rules, due to be released for public comment in 1995, will require
      collection of additional data for medical audits (public meeting of the National
      Mammography Advisory Committee, May 3, 1994). Although most mammography practices
      are now collecting clinical outcomes data on abnormal mammographic examinations,
      very few have established an organized and deliberate system of data collection
      necessary for a more complete mammography audit [6]. A detailed discussion of and
      recommendations for such an audit were recently published as part of the Quality
      Determinants of Mammography Guideline by the Agency for Healthcare Policy and
      Research (AHCPR) [7]. As members and consultants on the multidisciplinary panel
      that produced the guideline, we offer the following review of the various
      elements, definitions, and processes of the mammography audit. This is intended
      as a primer for all radiologists who will be performing some of the same audit
      activities for the MQSA.

PMID- 7785587
TI  - Chest case of the day. Williams-Campbell syndrome.

PMID- 7785588
TI  - Gastrointestinal case of the day. Obturator hernia causing small bowel
      obstruction.

PMID- 7785590
TI  - Gastrointestinal case of the day. Mirizzi syndrome.

PMID- 7785591
TI  - Gastrointestinal case of the day. Cystic fibrosis with colonic intussusception.

PMID- 7785589
TI  - Gastrointestinal case of the day. Systemic mastocytosis.

PMID- 7785592
TI  - Genitourinary case of the day. Renal lymphangiomatosis.

PMID- 7785593
TI  - Genitourinary case of the day. Angiomyolipoma of the kidney with fat thrombus in
      the inferior vena cava.

PMID- 7785594
TI  - Genitourinary case of the day. Renal tuberculosis.

PMID- 7785595
TI  - Genitourinary case of the day. Replacement lipomatosis of the kidney.

PMID- 7785596
TI  - Musculoskeletal case of the day. Giant cell tumor of the sacrum.

PMID- 7785597
TI  - Musculoskeletal case of the day. Sarcomatous degeneration of Paget disease.

PMID- 7785598
TI  - Musculoskeletal case of the day. Periosteal (juxtacortical) chondroma.

PMID- 7785600
TI  - Pediatric radiology case of the day. Peritoneal carcinomatosis.

PMID- 7785601
TI  - Pediatric radiology case of the day. Congenital goiter secondary to inherited
      thyroid dyshormonogenesis.

PMID- 7785599
TI  - Musculoskeletal case of the day. Tuberculous sacroiliitis.

PMID- 7785603
TI  - Pediatric radiology case of the day. Disseminated neonatal hemangiomatosis.

PMID- 7785604
TI  - Neuroradiology case of the day. Von Hippel-Lindau disease.

PMID- 7785602
TI  - Pediatric radiology case of the day. Multifocal infantile fibromatosis.

PMID- 7785606
TI  - Neuroradiology case of the day. Gliomatosis cerebri.

PMID- 7785605
TI  - Neuroradiology case of the day. Enhancing calcified hematoma due to prior
      hypertensive bleed.

PMID- 7785608
TI  - What technique should I try if spontaneous reflux does not occur?

PMID- 7785607
TI  - Neuroradiology case of the day. Multifocal inflammatory leukoencephalopathy due
      to treatment with 5-fluorouracil and levamisole.

PMID- 7785609
TI  - What is the simplest and most easily monitored regimen of sedation for CT and MR
      in children in a setting in which only occasional outpatients are scanned?

PMID- 7785610
TI  - Which is the most sensitive study for testicular torsion in children--Doppler
      sonography or testicular nuclear scan?

PMID- 7785611
TI  - When should you use contrast agents for CT of the head?

PMID- 7785612
TI  - What MR sequences should be used in the evaluation of pulsatile tinnitus?

PMID- 7785613
TI  - Focal anterior mediastinal fibrosis following median sternotomy.

PMID- 7785614
TI  - Liquefaction of thrombus in thoracic aortic aneurysm: MR findings.

PMID- 7785615
TI  - Traumatic pneumatocele as a complication of guidewire manipulation.

PMID- 7785616
TI  - Minimizing repeat mammography.

PMID- 7785617
TI  - Granular cell tumor of the breast in a male.

PMID- 7785619
TI  - Primary hepatic actinomycosis: association with portal vein thrombosis.

PMID- 7785620
TI  - Schwannoma arising from peripancreatic nerve plexus.

PMID- 7785618
TI  - Surgical injury of the common bile duct.

PMID- 7785622
TI  - Scalp lipogranuloma due to dermal lipid injections: CT and MR findings.

PMID- 7785621
TI  - MR appearance of intratesticular varicocele.

PMID- 7785624
TI  - Re: Advances in perinatal neurosonography.

PMID- 7785623
TI  - Carotid artery stenosis: old measurement for new technology?

PMID- 7785625
TI  - Triage of patients to angiography for detection of aortic rupture after blunt
      chest trauma: cost-effectiveness analysis of using CT.
AB  - OBJECTIVE: The purpose of this study was to evaluate the cost-effectiveness of
      dynamic chest CT, compared with plain chest radiography and immediate
      angiography, in deciding when angiography should be performed in hemodynamically
      stable patients with suspected aortic rupture after blunt chest trauma. The use
      of CT was evaluated in relation to the prior probability of aortic rupture.
      MATERIALS AND METHODS: A cost-effectiveness analysis comparing six diagnostic
      strategies combining chest radiography, CT, and angiography in various sequences
      was performed. Effectiveness was expressed as survival to hospital discharge, and
      costs were those incurred to society. Estimates for the variables in the analysis
      were derived from published reports. The model was evaluated for two cohorts of
      patients: those undergoing and those not undergoing CT for the evaluation of
      other injuries. Sensitivity analysis was performed for all variables in the model
      with emphasis on the prior probability of aortic rupture. RESULTS: Selecting
      patients for triage to angiography based on the CT findings yielded higher
      effectiveness at a lower cost-effectiveness ratio than doing so based on the
      chest radiograph, and the incremental cost-effectiveness ratio was less than
      $500,000 per life saved. For the cohort undergoing CT for the evaluation of other
      injuries, triage to angiography based on the CT findings yielded equivalent
      survival chances compared with immediate angiography and cost less ($1468 per
      patient evaluated compared with $2508). For the cohort not undergoing CT for
      other injuries, immediate angiography yielded the highest survival chances but
      was expensive, with an incremental cost-effectiveness ratio of $2 million per
      life saved compared with triage based on CT. In the latter cohort, immediate
      angiography yielded higher survival chances and had a cost-effectiveness ratio of
      less than $500,000 compared with the triage by CT if the prior probability of
      aortic rupture was 5% or more. CONCLUSION: Selecting hemodynamically stable
      patients after blunt chest trauma with suspected aortic rupture for angiography
      on the basis of CT findings is more effective than doing so based on the findings
      on chest radiography and is cost-effective compared with other accepted health
      care programs. Immediate angiography has a high incremental cost-effectiveness
      ratio compared with triage by CT and is warranted only in patients not undergoing
      CT for the evaluation of other injuries who have a prior probability of aortic
      rupture of 5% or more.

PMID- 7785626
TI  - Radiology decision making: the importance of cost-effectiveness analysis.

PMID- 7785627
TI  - Radiology in Lithuania: impressions of a visiting professor.
AB  - In the fall of 1993, I had the privilege of spending 3 months as a Radiological
      Society of North America (RSNA) International Visiting Professor at the Kaunas
      Medical Academy in Lithuania. This visiting professor program was started in 1986
      and is funded by the RSNA Research and Education Fund [1]. It is designed for a
      visiting professor who can spend 3 months or longer at a radiology residency
      training program in an evolving country. Lithuania, with a population of about 4
      million, is located on the eastern shore of the Baltic Sea, just north of Poland.
      The land area is approximately equal to that of Switzerland. An independent
      country until World War II, when it was forcibly occupied and integrated into the
      Soviet Union, it regained independence in 1990. As a result of 50 years of
      communist rule, two generations grew up having little knowledge about Western
      medicine in general and radiology in particular. A communist legacy is still
      evident not only in education but also in the thought process of the people,
      although there is a clear desire to integrate into western Europe. Currently
      Western and Asian consumer goods are readily available, but the country has
      undergone steep inflation and it is the perception of many that the standard of
      living continues to decline.

PMID- 7785628
TI  - Grandpa takes the boards.

PMID- 7785629
TI  - Detection of pneumoperitoneum on chest radiographs: comparison of upright lateral
      and posteroanterior projections.
AB  - OBJECTIVE: This study was done to determine whether upright lateral chest
      radiographs were more sensitive than upright posteroanterior chest radiographs in
      detecting pneumoperitoneum. SUBJECTS AND METHODS: We prospectively evaluated the
      ability of upright posteroanterior and lateral chest radiographs to show
      subdiaphragmatic air in 100 consecutive patients with known pneumoperitoneum from
      a variety of causes. The difference in sensitivity between the two was evaluated
      by means of McNemar's test. RESULTS: The upright lateral chest radiograph showed
      pneumoperitoneum in 98% of the cases; the upright posteroanterior chest
      radiograph showed pneumoperitoneum in only 80%. The upright lateral chest
      radiograph was significantly better at showing pneumoperitoneum than was the
      upright posteroanterior chest radiograph (p < .01). CONCLUSION: The upright
      lateral chest radiograph is more sensitive than the upright posteroanterior chest
      radiograph in detecting small amounts of pneumoperitoneum. When there is a strong
      clinical suspicion of a perforated hollow viscus, it may be of benefit to include
      an erect lateral chest radiograph as part of the acute abdominal series.

PMID- 7785630
TI  - Pulmonary lymphangitic carcinomatosis: chronicity of radiographic findings in
      long-term survivors.
AB  - OBJECTIVE: Long-term survival after development of pulmonary lymphangitic
      carcinomatosis is considered unusual. However, modern chemotherapy can result in
      surprising stability or only gradual progression of lymphangitic carcinomatosis.
      We evaluated the course of radiographic findings in 10 patients with chronic
      lymphangitic carcinomatosis. MATERIALS AND METHODS: Ten patients met our
      criterion of having lymphangitic carcinomatosis for at least 6 months. The
      primary tumor was a carcinoma of the breast in six cases, the ovary in two, the
      pancreas in one, and the skin in one. Serial radiographs (all cases) and CT scans
      (eight cases) were analyzed retrospectively. RESULTS: Survival with lymphangitic
      carcinomatosis ranged from 11 to 30 months (median, 13 months). With
      chemotherapy, the radiographic abnormalities and pulmonary symptoms initially
      regressed in six patients, progressed in two, and remained unchanged in two; the
      radiographic findings of lymphangitic carcinomatosis were progressing at the time
      of death in four patients. All patients had periods of at least 4 months of
      relative stability or slow progression of pulmonary radiographic abnormalities.
      Serial transbronchial biopsies in one case confirmed persistent lymphangitic
      carcinomatosis despite therapy, and autopsy disclosed persistent lymphangitic
      tumor in two others. CONCLUSION: Stability or slow progression of radiographic
      findings can occur in some patients with lymphangitic carcinomatosis. Therefore,
      chronicity of radiographic findings should not be taken as evidence against
      lymphangitic carcinomatosis as the cause of an interstitial abnormality in a
      patient with cancer.

PMID- 7785631
TI  - CT-guided automated needle biopsy of the chest.
AB  - OBJECTIVE: The purpose of this study was to determine the diagnostic accuracy and
      frequency of complications of CT-guided transthoracic needle biopsy done with an
      automated biopsy system. MATERIALS AND METHODS: Thirty-three consecutive biopsies
      were performed on 32 patients between February 1992 and July 1994 (mean age, 55
      +/- 15 years; 18 men and 14 women). An 18-gauge (n = 28) or 20-gauge (n = 5)
      needle was used. Core specimens were submitted for pathologic examination in 10%
      formalin. No cytopathologist or frozen section analysis was available at the time
      of biopsy. All biopsies but one were performed by one chest radiologist. RESULTS:
      Thirty-one lung biopsies and two mediastinal biopsies yielded a mean lesion size
      of 4.0 cm (range, 1.2-13.0 cm). Postbiopsy pneumothorax occurred in three (9%) of
      33 biopsies; none of the pneumothoraces required placement of a chest tube. The
      mean number of needle passes was 1.3 (+/- 0.6). Thirty biopsies (91%) yielded
      sufficient tissue for pathologic evaluation. The diagnoses included carcinoma in
      14 cases, acute or chronic pneumonia in 4 cases, non-Hodgkin's lymphoma in two
      cases, and Kaposi's sarcoma, plasma cell granuloma, hypersensitivity pneumonitis,
      Pneumocystis carinii pneumonia, and fibrosis in one case each. One patient with a
      1.5-cm nodule stable for 1 year on CT had fibrosis and chronic inflammation found
      on needle biopsy, and the nodule was considered benign. Overall, biopsies in 12
      (80%) of 15 patients without carcinoma were diagnostic. In three patients, the
      tissue obtained was not representative of the underlying abnormality. The biopsy
      specimen showed only inflammatory changes in two patients who ultimately had
      proved carcinoma. One patient with multiple pulmonary infarcts due to tumor
      emboli showed evidence of only pulmonary infarct on biopsy. Three patients had
      insufficient tissue for analysis; none of the three had malignant tumor on follow
      up. The sensitivity of CT-guided automated needle biopsy of the chest was 84%.
      CONCLUSION: CT-guided transthoracic needle biopsy of the chest done with an
      automated biopsy system is safe, with a pneumothorax rate comparable to that of
      skinny needle aspiration. An overall accurate tissue diagnosis was made in 26
      (81%) of 32 patients. Biopsies in 12 (80%) of 15 patients without carcinoma were
      diagnostic, which compares favorably with the reported accuracy of skinny needle
      aspiration.

PMID- 7785632
TI  - Thoracic bacillary angiomatosis in a patient with AIDS.

PMID- 7785633
TI  - Mammography immediately after stereotaxic breast biopsy: is it necessary?
AB  - OBJECTIVE: The purpose of this study was to determine whether mammography
      immediately after stereotaxic core breast biopsy should be performed routinely to
      diagnose hematoma, to confirm the sampling site, and to establish a new baseline
      for future mammograms. MATERIALS AND METHODS: Stereotaxic core biopsies of 113
      mammographically indeterminate or suspicious lesions were performed by use of a
      dedicated stereotaxic table with digital imaging, a 14-gauge needle, and an
      automated gun. The indication for biopsy was a mass with or without
      calcifications in 59 cases (52%) and calcifications without a mass in 54 cases
      (48%). The number of core biopsies per case ranged from one to 16 (mean = six).
      Craniocaudal and mediolateral oblique mammograms of the sampled breast were
      obtained immediately after the biopsies and were compared with prebiopsy
      mammograms. In cases with microcalcifications, the mammograms also were compared
      with specimen radiographs. RESULTS: Mammograms obtained immediately after the
      procedure showed changes related to the biopsy in 86 cases (76%). These findings
      included decreased lesion size in 11 (10%), air at the biopsy site in 47 (42%),
      and hematoma, manifested as poorly defined increased density at the biopsy site,
      in 58 (51%). One hematoma was clinically significant, but the remaining 57 were
      clinically occult. When core biopsies were performed for calcifications, the
      postprocedural mammograms showed a decrease in the number of calcifications in 26
      (48%) of 54 cases, but specimen radiographs showed calcium in 50 (93%) of 54
      cases. Four lesions (three masses and one cluster of microcalcifications)
      disappeared after biopsy. In three cases, hematomas obscured residual
      calcifications at the biopsy site. CONCLUSION: Mammography immediately after core
      biopsy is not necessary for the diagnosis of procedure-related hematoma and is
      inferior to specimen radiography for verifying that calcifications have been
      sampled. Postprocedural mammograms also may be suboptimal for the establishment
      of a new baseline because of the frequent finding of hematoma.

PMID- 7785634
TI  - Granular cell tumor of the breast in a male patient.

PMID- 7785635
TI  - Medullary thyroid carcinoma metastatic to the breast: mammographic appearance.

PMID- 7785636
TI  - Cytomegalovirus colitis in AIDS: CT features.
AB  - OBJECTIVE: The purpose of this study was to determine the CT features of
      cytomegalovirus colitis in patients with AIDS. MATERIALS AND METHODS: Abdominal
      CT scans of 24 patients with biopsy-proved cytomegalovirus colitis (colonoscopy,
      n = 14; sigmoidoscopy, n = 8; surgery, n = 2) were jointly reviewed by two
      observers. Patients were men 26-68 years old (mean age, 39 years; SD, 9 years)
      with CD4 counts of 3-129 mm3 (mean, 32 mm3; SD, 34 mm3). The mean interval
      between CT and biopsy was 6 days (range, 0-20 days; SD, 6 days). Scans were
      assessed for colonic wall thickening (> or = 4 mm), ulceration, mural edema,
      pericolonic stranding, ascites, lymphadenopathy, and thickening of the small
      bowel wall. Mural involvement was recorded as asymmetric or circumferential.
      Disease location was recorded as ascending colon, transverse colon, descending
      colon, rectosigmoid colon, or pancolonic. RESULTS: Colonic wall thickening of 8
      to 33 mm (mean, 15 mm; SD, 6 mm) was seen in 22 patients. One patient had
      pancolonic involvement. The ascending colon was involved in 13, the transverse
      colon in five, the descending colon in 10, and the rectosigmoid colon in 16.
      Circumferential colonic thickening was seen in 17 patients. Deep mural ulceration
      was seen in 15 patients, mural edema in 15, pericolonic stranding in 23, ascites
      in 10, lymphadenopathy in four, and small-bowel involvement in 10. Two patients
      had appendicitis. Three patients had perforations (two rectal, one cecal). One
      patient had a giant rectal ulcer. CONCLUSION: Although many of the CT features of
      cytomegalovirus colitis are nonspecific, the diagnosis should be suggested when
      CT shows colonic wall thickening, particularly if the thickening is associated
      with mural ulceration in patients with AIDS and CD4 counts of less than 200 mm3.

PMID- 7785637
TI  - Helical CT of the liver: clinical application of an automated computer technique,
      SmartPrep, for obtaining images with optimal contrast enhancement.
AB  - OBJECTIVES: The purpose of this study was to evaluate an automated computer
      technique (SmartPrep) for achieving a consistently high level of contrast
      enhancement in the liver with helical CT. The technique compensates for
      variability between patients by indicating graphically the time at which scanning
      should be initiated to reach a desired level of hepatic enhancement. MATERIALS
      AND METHODS: One hundred nine consecutive patients undergoing helical CT of the
      abdomen were randomly evaluated, using either a standard 70-sec delay from the
      start of the injection of contrast material to scanning or a newly developed,
      commercially available automated technique, SmartPrep. A series of multiple low
      dose scans was performed until an arbitrary threshold of hepatic enhancement (50
      H) over baseline was achieved. Three regions of interest (ROIs) were imaged on a
      baseline scan and on contrast-enhanced scans at the upper, mid, and lower liver.
      Average hepatic enhancement and the standard deviation over baseline was
      calculated for each group at all anatomic levels. For the SmartPrep group, the
      range of time between scan initiation and onset of scanning was calculated.
      RESULTS: The mean hepatic enhancement for the control group (n = 56) was 59.8 +/-
      20.1 H, which differed significantly (p = .0002) from that for the SmartPrep
      group (n = 53), which was 71.6 +/- 15.2 H. Comparison of the variability between
      the two groups' enhancement levels was also significant (p = .02). The range of
      delay times for the SmartPrep group was 48-86 sec. In two additional cases,
      abnormal graphically displayed enhancement curves were the first indication of an
      improper injection. CONCLUSION: Use of SmartPrep yields a greater and more
      consistent level of hepatic enhancement from patient to patient than does use of
      a conventional fixed delay time. The ability to scan more efficiently to achieve
      greater hepatic enhancement using SmartPrep has significant implications for
      potential contrast cost savings.

PMID- 7785639
TI  - Base hospital.

PMID- 7785638
TI  - High-dose localized radiation therapy for treatment of hepatic malignant tumors:
      CT findings and their relation to radiation hepatitis.
AB  - OBJECTIVE: High-dose radiation therapy of the liver performed using overlapping
      portals defined by a three-dimensional treatment-planning system (conformal
      radiation therapy) is a new method of treating hepatic tumors. This study was
      performed to delineate the differences in the CT appearances of the liver after
      therapy compared with other methods of radiotherapy and to correlate imaging
      findings to clinical findings of radiation hepatitis. MATERIALS AND METHODS:
      Contrast-enhanced CT scans were obtained at 8- to 12-week intervals on 31
      consecutive patients with primary or metastatic hepatic malignant tumors. All had
      undergone high-dose conformal radiation therapy and injection of
      fluorodeoxyuridine into the hepatic artery as part of the treatment for
      unresectable hepatic neoplasms. Tumor size, location, presence of changes within
      the target volume after therapy, presence of atrophy of the treated segments or
      hypertrophy of the untreated segments, ascites, and any changes in adjacent
      organs seen on serial CT scans obtained before and after treatment were recorded.
      Clinical records were reviewed for evidence of radiation hepatitis (nonmalignant
      ascites evident on physical examination and a twofold elevation of alkaline
      phosphatase in the anicteric patient). RESULTS: In 23 (74%) of the 31 patients,
      follow-up CT studies after treatment showed a low-attenuation area adjacent to
      the hepatic tumor in the target volume. In two patients with fatty infiltration
      of the liver, CT showed relative increased density in the treatment portal. A
      sharp, straight interface was rarely seen at the treatment margin. Maximal effect
      was seen 2-3 months after completion of therapy and persisted for up to 3 months.
      Atrophy in the treated segment or lobe was seen in four patients, hypertrophy of
      the untreated liver was seen in four patients, and both effects were seen in
      seven patients. Extrahepatic effects included segmental right renal atrophy in
      three patients and duodenal wall thickening in two patients. Only two patients
      (6%) in this series had clinical evidence of radiation hepatitis. CONCLUSION:
      High-dose localized radiotherapy of the liver results in reversible hypodense
      regions in the liver parenchyma within the target volume that do not have a sharp
      interface delineating the radiation portal. This appearance should not be
      confused with tumor progression or irreversible liver injury. The changes evident
      on CT scans after therapy are not predictive of radiation hepatitis.

PMID- 7785640
TI  - Acute cholecystitis in an animal model: findings on color Doppler sonography.
AB  - OBJECTIVE: The purpose of our study was to evaluate the color Doppler findings of
      acute cholecystitis in a controlled canine model. MATERIALS AND METHODS: Fourteen
      animals had a laparotomy: cystic duct ligation was done in eight, and incision
      with closure was performed in six control subjects. Animals were scanned in a
      blinded fashion preoperatively, immediately postoperatively, and on postoperative
      days 1-5. On postoperative day 5, a hepatobiliary scan was done with 2 mCi (74
      MBq) 99mTc-mebrofenin. Blinded histopathology was performed and correlated with
      imaging. RESULTS: Flow was seen in the wall of each gallbladder at some point
      during the postoperative course, demonstrating vascular patency. Hepatobiliary
      scintigraphy confirmed cystic duct status in 12 cases; two animals died before
      radionuclide imaging was complete. Color Doppler signal decreased in the
      gallbladder wall in ligated dogs from postoperative day 1 to postoperative day 3
      (p = .03 versus controls at postoperative day 2) and increasingly returned by
      postoperative day 5. Hyperemia was seen in only two cases (both with severe
      necrotizing cholecystitis) and only at postoperative day 5. Although not
      statistically significant, a weak trend of increasing flow with more severe
      pathologic grades of cholecystitis was observed (p = .20). CONCLUSIONS: In this
      animal model, loss of vascular signal (not hyperemia) at postoperative day 2 was
      the finding to diagnose early acute cholecystitis, although lack of flow can also
      be seen in some normal subjects. Flow tended to return by postoperative day 5,
      and it increased in some of the more severe cases of cholecystitis. Hyperemia was
      a somewhat useful sign of acute necrotizing cholecystitis.

PMID- 7785641
TI  - Diagnosis and management of ascites in the age of TIPS.
AB  - In the mid 1990s, radiologists are asked to provide advice on managing patients
      with cirrhosis and refractory ascites. Liver disease is the most common cause of
      ascites. However, appropriate management of these patients is based on the
      ability to exclude other causes as well as knowledge of the physiological
      abnormalities that result in ascites. The goal of this review is to summarize
      advances in these areas as well as to discuss therapeutic options.

PMID- 7785642
TI  - Characterization of adrenal masses (< 5 cm) by use of chemical shift MR imaging:
      observer performance versus quantitative measures.
AB  - OBJECTIVE: The purposes of this study were to evaluate the ability of chemical
      shift MR imaging to differentiate 1- to 5-cm adrenal adenomas from metastases and
      to compare subjective interpretation with several different quantitative
      measures. SUBJECTS AND METHODS: Forty-three patients with 46 proved adrenal
      lesions (28 adenomas and 18 metastases) had MR imaging with a gradient-echo
      breath-hold technique and echo time varied to obtain in-phase and out-of-phase
      images. Qualitative analysis of the MR images was done by three experienced
      observers, who reported their confidence in diagnosing the benignity versus the
      malignancy of the adrenal masses on the basis of signal loss on out-of-phase
      images. Quantitative analysis was performed by calculating the difference in
      signal intensity between in-phase and out-of-phase images by use of regions of
      interest (signal intensity index) and by use of adrenal-liver, adrenal-spleen,
      and adrenal-muscle signal intensity ratios. Results between quantitative and
      qualitative measures were compared by use of receiver operating characteristic
      (ROC) analysis. RESULTS: The mean signal intensity was significantly different
      between adenomas and metastases on out-of-phase images (64 versus 98) (p < .0005)
      but not in-phase images (130 versus 122) (p = .47). The adrenal-spleen ratio
      discriminated between adenomas and metastases better than did the adrenal-liver
      ratio, the adrenal-muscle ratio, or the signal intensity index. No significant
      difference in interpretation among the three observers was evident (areas under
      the ROC curves, 0.93, 0.95, and 0.96). The performance of the observers was
      comparable to the results obtained with the adrenal-spleen ratio measurement
      (area under the ROC curve, 0.97). CONCLUSION: Experienced observers were able to
      differentiate adrenal adenomas from metastases just as well as quantitative
      measures. The adrenal-spleen ratio is the best quantitative means of
      distinguishing benign from malignant adrenal masses. Chemical shift MR imaging is
      a good but imperfect discriminator of adrenal adenomas.

PMID- 7785645
TI  - A case of lumbar hernia occurring through surgical defect of iliac crest.
AB  - Hernias occurring in the lumbar area are rare. The lumbar area is a broad
      anatomic area bordered superiorly by the 12th rib, interiorly by iliac crest,
      medially by the erector spinae muscle and laterally by the external oblique
      muscle. Acquired hernias occurring in the lumbar area are often diffuse and
      grotesque appearing and most of them are post operative incisional hernias
      occurring in nephrectomy incisions. Rarely hernias occur through bicortical
      surgical defect of iliac crest. We would like to present such a case and review
      the literature briefly.

PMID- 7785644
TI  - Fatal post-cesarean endometritis: report of two Alabama cases.
AB  - Postpartum endometritis remains a major cause of morbidity in the puerperium with
      a fatal outcome on occasion. We present two cases of fatal, post-cesarean
      endometritis which occurred within a fifteen month period in Alabama. We discuss
      the features of endometritis including pathophysiology, causative organisms, risk
      factors and complications.

PMID- 7785643
TI  - Percutaneous balloon catheter dilatation of benign ureteral strictures: effect of
      multiple dilatation procedures on long-term patency.
AB  - OBJECTIVE: The purpose of this study was to evaluate the long-term efficacy of
      multiple percutaneous balloon dilatations of benign ureteral strictures.
      Percutaneous dilatation of ureteral strictures with a balloon catheter was done
      as an alternative to open surgical repair. MATERIAL AND METHODS: Twenty-eight
      benign ureteral strictures (in 23 patients) were dilated. These included 21
      postoperative strictures, 18 of which were at ureteroenteric anastomosis, three
      postradiation strictures, and four strictures of unknown origin. If the stenosis
      persisted, dilatation was repeated (maximum of four dilatations at 1-month
      intervals). Patients were reevaluated with sonography at 1-month intervals after
      stent removal. RESULTS: The procedure was considered a technical success if there
      was no radiographic evidence of a stricture or if hydronephrosis improved on the
      sonographic examination. Clinical success was determined by stable or improved
      renal function. All dilatations were technically successful. Fifteen (54%) of the
      28 ureters remained patent 1 month after the final dilatation and removal of the
      stent. Of these 15, 12 were patent 2 months after stent removal, and only five
      were free of stenosis at the 9-month follow-up, making overall success 18%. All
      five of these ureters were in the subgroup of patients with ureteroenteric
      strictures. CONCLUSION: Balloon dilatation of ureteral strictures is technically
      successful; however, long-term results are poor. Multiple dilatations are of no
      benefit in maintaining ureteral patency.

PMID- 7785646
TI  - The real contract with America.

PMID- 7785647
TI  - Reactive tumor-like lesions of the peritoneum.

PMID- 7785649
TI  - The role of pathologists in cancer patient staging. Cancer Committee.

PMID- 7785650
TI  - Vernix caseosa peritonitis. An infrequent complication of cesarean section with
      distinctive histopathologic features.
AB  - The authors report two cases of vernix caseosa peritonitis, an infrequent
      complication of cesarean section with distinctive histopathologic findings. Both
      patients underwent exploratory laparotomy for unexplained abdominal pain after
      cesarean section. Histopathologic evaluation of surgically removed tissue
      revealed an organizing peritonitis, which included prominent collections of
      anucleate squamous cells in association with a foreign body-type granulomatous
      response. In both cases, the surgical pathologist suggested that the abdominal
      pain was likely a result of peritoneal reaction to spillage of keratinous
      material (vernix caseosa) derived from amniotic fluid contents during cesarean
      section. Surgical pathologists should be aware of this entity and include it in
      the differential diagnosis of acute abdominal pain.

PMID- 7785651
TI  - Hamartoma of the breast, an underrecognized breast lesion. A clinicopathologic
      and radiographic study of 25 cases.
AB  - This study investigated the clinical, radiographic, and pathologic features of
      breast hamartoma. The patients ranged in age from 18 to 89 years, with a mean age
      of 45 years, and a median age of 43 years. Seventy-five percent of the patients
      were asymptomatic, other than reporting a breast lump. In two patients, the
      lesions recurred at 7 and 18 months after the initial resection. The clinical
      diagnoses were fibroadenoma in 10 cases, carcinoma in 5 cases, hamartoma in 4
      cases, and phyllodes tumor and lipoma in 2 other cases. Mammograms were available
      in 12 cases, the majority of which showed a well-defined mass of homogeneous
      density. Grossly, these lesions were oval to round, well-circumscribed masses,
      ranging in size from 1 to 7 cm in maximum dimension (mean, 3.9 cm). The
      microscopic appearance of these tumors corresponded to their gross appearance.
      Lesions that were grossly firm, rubbery, and white consisted largely of dense
      fibroconnective tissue with variable amounts of glandular elements with little
      adipose tissue. Softer, pale, yellow lesions contained more adipose tissue. A
      consistent and important diagnostic feature was the presence of both lobules and
      ducts, in contrast to fibroadenoma in which lobules are often absent or rare. The
      current trend of mammographic breast screening has made us aware that mammary
      hamartomas are not uncommon. These lesions may go unrecognized by the
      pathologists because they show all the constituents of normal breast tissue and
      may be reported as "no pathological diagnosis" or "normal breast tissue," which
      are inappropriate diagnoses for a lesion that presents as a palpable and a well
      circumscribed mass.

PMID- 7785648
TI  - Clinical laboratory informatics, the promised land. Are we there yet?

PMID- 7785652
TI  - Assessment of histopathologic changes in the colonic biopsy in acute graft-versus
      host disease.
AB  - The authors reviewed 78 colonic biopsies from 63 patients undergoing bone marrow
      transplantation (BMT), 56 allogeneic and 7 autologous, to assess different
      morphologic changes related with intestinal acute graft-versus-host disease (A
      GVHD). Only five biopsies were done before the 20th day after BMT. The authors
      studied the presence of ulcers and atrophy in the mucosa, the nuclear atypia, and
      inflammatory infiltrate in the surface epithelium, and the architectural
      abnormalities, as well as dilation of the glands, and the presence of crypt
      abscesses. The authors explored the glandular epithelium for apoptosis and
      intraepithelial lymphocytes. They examined the lamina propria for inflammatory
      infiltrate, especially for so-called "focal periglandular infiltrate (FPGI),"
      edema fibrosis, increase of capillary vessels and presence of muciphages and
      clusters of enterochromaffin cells. Cases were grouped according to clinical
      symptoms and histologic diagnosis of A-GVHD in skin or liver. Group A had 15
      asymptomatic cases (control). Group B had 20 cases from asymptomatic patients
      with a histologically proven A-GVHD. Group C had 43 cases with gastrointestinal
      symptoms and histologically proven A-GVHD. Then, the relative frequency of every
      histologic feature previously described were compared in the different groups by
      means of an univariate analysis. Apoptosis of the glandular epithelium was found
      in 48 cases, two of them in patients carrying an auto-BMT. Focal periglandular
      infiltrate was found in 11 cases that was associated with apoptosis (P < .03,
      Fisher's exact test). In this series, the presence of FPGI was linked with
      finding apoptosis in a given specimen with a probability of 91%. Glandular
      architectural changes and dilation were also more frequent in group C than in
      groups A and B when compared in the univariate analysis.

PMID- 7785653
TI  - Intraneural perineurioma. A clonal neoplasm associated with abnormalities of
      chromosome 22.
AB  - The nature of perineurioma, variably termed "localized hypertrophic neuropathy,"
      "intraneural neurofibroma," and "hypertrophic interstitial neuritis" has long
      been an issue of contention. Most authors consider it a neoplasm, but some a
      reactive process. Eight clinically and morphologically typical perineuriomas were
      studied by histologic, immunohistochemical and ultrastructural methods. One
      perineurioma was subject to tissue culture and cytogenetic study and another to
      fluorescence in situ hybridization (FISH) analysis. The patients, 3 males and 5
      females, ranged in age from 11 to 38 years. All tumors were intraneural, and
      involved extremities (2 sciatic, 1 median, 1 femoral, 1 peroneal, 1 brachial
      plexus, 1 ulnar, and 1 radial). Neurologic symptoms, motor in all cases and
      sensory in 4, were present from 1 month to 7 years (mean 1.2 years). Fusiform,
      segmental nerve enlargement was clinically apparent in only two patients, but was
      evident on MRI in five of eight patients. Lesion length ranged from 3.5 to 30 cm,
      the largest involving the sciatic nerve from the obturator foramen to the knee.
      One lesion involved two nerve roots, but no association with a phakomatosis was
      noted. Treatment consisted of biopsy in six cases and resection in two cases.
      Histologically, pseudo-onion bulbs composed of epithelial membrane antigen
      reactive, S-100 protein-negative perineurial cells surrounded myelinated or
      nonmyelinated nerve fibers. Many were accompanied by their S-100 protein-positive
      Schwann sheaths. Some whorls lacked a central axon. A single mitosis was noted in
      one case. The MIB-1 antigen labelling index ranged from 4% to 17%. Staining for
      p53 antigen in six cases showed no (2 of 6), rare (2 of 6), or scattered (2 of 6)
      immunoreactive nuclei. Cytogenetic analysis in one case demonstrated a
      chromosomally abnormal clone. Each of 16 metaphases was abnormal; the tumor cells
      appeared to be homozygously deficient for the region 22q11.2qter. In another
      case, 53% of interphase nuclei showed three FISH signals with a chromosome 14/22
      probe, thus suggesting either monosomy for the centromere of chromosome 14 or
      that of chromosome 22.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7785654
TI  - Protoplasmic astrocytoma. A clinicopathologic study of 16 tumors.
AB  - Protoplasmic astrocytomas, composed of process-poor astrocytic cells and a
      microcystic background, are rare variants of low grade astrocytoma. Three hundred
      eight low grade astrocytomas over a 23-year period were reviewed. Sixteen (5.2%)
      were classified as pure protoplasmic astrocytoma. Patients (12 males, 4 females)
      ranged in age from 2.5 to 41 years (mean, 20.7 years). All patients presented
      with seizures and three had headaches. Duration of symptoms ranged from 7 months
      to 28 years (mean, 6.6 years). Nine tumors (56%) were left-sided and seven right
      sided (44%). Seven (44%) occurred in the temporal lobe, six (37%) in the frontal
      lobe, two (13%) in the parietal lobe, and one (6%) in the thalamus. Surgery
      consisted of partial lobectomy with total tumor resection in nine and biopsy
      alone in seven. Five patients received adjuvant therapy with no apparent effect
      on survival. At frozen section, protoplasmic astrocytoma was most confused with
      fibrillary low grade astrocytoma (n = 6). Follow-up revealed 10 patients with no
      evidence of disease 2 to 108 months postoperatively (mean, 41 months), 5 patients
      were alive with disease 10 to 84 months postoperatively (mean, 56 months) and 1
      patient died with disease at 36 months. Of patients with total tumor resection,
      eight had no evidence of disease and one died with disease. IN CONCLUSION: (1)
      protoplasmic astrocytomas in this study were more frequently observed in males at
      a younger mean age than fibrillary low grade astrocytomas as reported in
      literature; (2) temporal and frontal lobes were the most likely site of origin;
      and (3) complete excision may be beneficial, whereas adjuvant therapy appeared to
      have no effect on outcome.

PMID- 7785655
TI  - Identification of patients for pharmacologic review by computer analysis of
      clinical laboratory drug concentration data.
AB  - Clinical pharmacokinetics evaluation and consultation can improve drug therapy
      and decrease the incidence of adverse reactions in selected patients. However,
      identification of patients appropriate for review is difficult. The authors
      developed a microcomputer-based expert system that scans clinical laboratory drug
      concentration data to identify patients for follow-up. Rules were developed from
      a review of data for digoxin, phenytoin, and theophylline. These were implemented
      in software that provides for simple rule creation and modification, on-screen
      graphic review of data, and printing of chart reports. This program is readily
      adapted for use with most laboratory information systems. In a retrospective
      study of 868 patients monitored for digoxin, phenytoin, and theophylline, 29%
      were flagged as having drug level profiles of possible concern. The majority
      (62%) of these patients had multiple specimens flagged, suggesting persistent
      problems. These data suggest that patients can be identified for follow-up by
      scanning serial drug concentrations, allowing consultative resources to be
      focused on patients most likely to benefit from them.

PMID- 7785656
TI  - A strategy to promote rational clinical chemistry test utilization.
AB  - There is abundant evidence that clinical chemistry laboratory tests are over
      ordered in North America, but there does not seem to be an effective corrective
      strategy that has a prolonged effect. The goal of this study was to design one
      that had a prolonged effect. Using a pre- and post-intervention survey study
      design, the authors observed the effect of physician education followed by a ban
      on test-panel ordering of common clinical chemistry tests, reinforced by written
      reminders to physicians not heeding the ban, on ordering patterns (tests per
      specimen), and total numbers of these tests ordered. Panels of > 16 common
      biochemistry tests per specimen were reduced from 15% to 6% of orders for
      inpatients and from 44% to 11% for outpatients 1 year after the implementation of
      the ban on test-panel ordering. However, the ban had little effect on the
      ordering rates for panels of 7 common tests. Educational exercises (newsletters
      and lectures) had no effect. The authors conclude that a ban on test-panel
      (profile) ordering reinforced by continuing reminders to nonconforming physicians
      is an effective means of reducing clinical chemistry test usage over the long
      term. A 38% reduction of common biochemistry tests ordered was achieved. However,
      overall costs savings were modest. Nevertheless, the authors conclude that the
      cost-effective use of the clinical pathology laboratory by careful selection of
      tests in an essential part of a medical trainee's education.

PMID- 7785657
TI  - Is myoglobin useful in the diagnosis of acute myocardial infarction in the
      emergency department setting?
AB  - The authors evaluated the usefulness of a rapid fluorometric enzyme immunoassay
      for myoglobin (Myo) for early diagnosis of acute myocardial infarction (AMI) in
      patients in the emergency department. The rapid fluorometric enzyme immunoassay
      for myoglobin was performed on timed blood samples collected previously for
      serial CK and CKMB determinations from 41 patients who initially presented to the
      ED with chest pain and were subsequently admitted to patient care units. Twenty
      two patients were AMI positive and 19 were AMI negative. In 12 patients who were
      AMI positive, Myo increased rapidly and significantly peaking at 6.53 +/- 5.45
      hours, whereas in the other 10 patients who were AMI positive, only the declining
      slopes of Myo were observed due to late AMI presentation. In the AMI negative
      group, Myo values were within reference range in 8 and persistently elevated in
      11. Using the initial rate of Myo release of 20 ng/mL per hour as criteria of
      discrimination, this assay has a sensitivity of 90.1% and a specificity of 74%.
      Available samples for the two patients who were false negative were past the
      window of Myo release for AMI detection. All five patients who were false
      positive were associated with various degrees of muscular trauma or renal
      disorder. The authors conclude that the initial rate of Myo release demonstrates
      good utility both at early detection and early exclusion of AMI. However, its
      tissue nonspecificity may not permit AMI recognition in the presence of muscular
      injury.

PMID- 7785658
TI  - Acute intermittent porphyria in a native North American family. Biochemical and
      molecular analysis.
AB  - A native North American family with acute intermittent porphyria was investigated
      by molecular methods to locate the causative mutation and identify carriers of
      the mutant allele. All 15 exons of the porphobilinogen deaminase gene were
      screened by single-strand conformation polymorphism analysis, and a unique
      banding pattern was observed in exon 14. Sequencing revealed a one base-pair
      insertion in this exon that shifts the reading frame of the mRNA, and generates a
      premature stop codon. Family members were tested for the mutation by
      amplification of exon 14 followed by digestion with the restriction enzyme
      NlaIII. The activity of erythrocyte porphobilinogen deaminase was measured in 36
      family members. The results agreed with mutational analysis in 32 cases. However,
      four individuals who were not gene carriers had low enzyme activity, and in the
      absence of molecular genetic data would have been incorrectly diagnosed. This is
      the first study to identify the molecular basis of acute intermittent porphyria
      in native North Americans.

PMID- 7785659
TI  - Heparin-induced increase in the international normalized ratio. Responses of 10
      commercial thromboplastin reagents.
AB  - A clinician's concern about an erratic response to oral anticoagulation in a
      patient treated concurrently with heparin and warfarin led the authors to
      investigate the effect of heparin on INR values obtained with various commercial
      thromboplastin reagents. Studies conducted with pooled normal plasma and with
      pooled plasma from patients treated long-term with oral anticoagulants
      demonstrated a wide range of sensitivities to heparin of these reagents as
      characterized by prolongation of INR values. Innovin was unaffected by
      concentrations of heparin as high as 1 U/mL. In contrast, Ortho thromboplastin
      showed the greatest increase in INR values over the range of heparin
      concentrations studied. Three other thromboplastins including Neoplastine CI,
      Dade thromboplastin, and Simplastin A demonstrated only limited sensitivity to
      heparin. Prolongation of the INR by heparin was reversed by protamine in a dose
      related manner and also by preincubation of the plasma with heparinase. Some
      patients treated with warfarin while on the authors' institutional protocol for
      heparin had plasma concentrations greater than 0.8 U/mL. When thromboplastin
      reagents sensitive to heparin were used with such specimens, the INR values
      obtained were falsely elevated. The authors suggest that reagents insensitive to
      heparin be employed to avoid this difficulty.

PMID- 7785660
TI  - Platelet satellitism is Fc gamma RIII (CD16) receptor-mediated.
AB  - Platelet satellitism (PS), the phenomenon of platelet rosetting around
      polymorphonuclear neutrophils (PMN), which is observed in
      ethylenediamineetetraacetic acid (EDTA)-anticoagulated blood at room temperature,
      is caused by the presence of IgG autoantibodies in the serum. Fourteen patients
      with PS were studied, and the presence of both EDTA-dependent antiplatelet and
      EDTA-dependent antineutrophil IgG (auto)antibodies were found in their sera. Anti
      neutrophil activity was completely abolished when the sera were absorbed on
      normal platelets, which suggests that a single antibody is involved. Inhibition
      studies with monoclonal antibodies indicated that this IgG autoantibody is
      directed against the glycoprotein IIb/IIIa complex of the platelet membrane, as
      well as the neutrophil Fc gamma receptor III (Fc gamma RIII). In addition, the
      antibody did not react with platelets from a patient with type I Glanzmann's
      disease, nor with neutrophils from a patient with congenital Fc gamma RIII
      absence (NAnull phenotype), thus confirming both specificities. As in other
      literature cases, a clear correlation between the presence of this IgG and a
      specific clinical situation, disease, or use of drugs could not be shown.
      Therefore, these antibodies, which are present in some normal individuals, might
      occur naturally. Because of the exposure of particular cryptoantigenic structures
      present on EDTA-modified platelet and PMNs, they may manifest themselves by
      triggering the PS phenomenon.

PMID- 7785661
TI  - The effect of a heparin removal filter on platelet aggregation studies in heparin
      induced thrombocytopenia.
AB  - Patients having a heparin-associated platelet antibody who are receiving heparin
      at the time of testing for heparin-induced thrombocytopenia (HIT) by platelet
      aggregometry may exhibit aggregation in the negative control channel. Filtering
      plasma to remove the heparin in may produce a nonaggregating negative control
      channel. The effect of the Pall Hepchek (Pall Biomedical, East Hills, NY) heparin
      removal filter on platelet aggregation studies was evaluated. Samples were
      studied from 10 patients with clinically established HIT. The pre-filtration
      platelet aggregation studies were unequivocally positive for heparin antibody.
      The remainder of each sample was filtered and the aggregation studies were
      repeated. Of the four patients on IV heparin, only one remained positive post
      filtration. Of the six patients receiving subcutaneous heparin or flushes, one
      remained strongly positive, one was borderline, and four became negative. Pall
      Hepchek heparin filtration unpredictably alters the results of platelet
      aggregation studies, and should not be used routinely to remove heparin in the
      presence of aggregation in the negative control.

PMID- 7785663
TI  - Lymphocytosis of gamma/delta T cells in human ehrlichiosis.
AB  - The majority of T cells in peripheral blood express a T-cell receptor (TCR)
      comprised of alpha and beta chains. An alternate form of the TCR is comprised of
      gamma and delta chains. These gamma/delta T cells are associated with certain
      infectious lesions, and modestly elevated in peripheral blood in certain disease
      states. Human ehrlichiosis is characterized by hematologic abnormalities
      including multi-lineage cytopenias. In most cases reported, a lymphocytopenia has
      been present either at diagnosis, or at some time during the illness. Early in
      the course of antibiotic treatment (48-72 hours), the lymphocytopenia corrects
      itself and is rapidly followed by a lymphocytosis of T cells that express CD3,
      but are negative for CD4 and CD8, as well as the major form of the TCR formed by
      the alpha/beta heterodimer. Instead, these CD3+4-8- T cells express the
      gamma/delta heterodimer associated with V gamma 9 and V delta 2 chains, a
      population of cells usually the distinctive minority of peripheral blood T cells,
      but constituting the major phenotype of peripheral gamma/delta T cells.

PMID- 7785662
TI  - Posttransplantation lymphoproliferative disorders in solid organ recipients are
      predominantly aggressive tumors of host origin.
AB  - Patients immunosuppressed after organ transplantation have an increased frequency
      of lymphoproliferative disorders, known as posttransplantation
      lymphoproliferative disorders (PTLDs). In recipients of bone marrow allografts.
      PTLDs are often of donor origin. In only a few cases of lymphoma arising in solid
      organ transplant recipients has the origin from host or donor lymphocytes been
      established. The authors have analyzed 11 cases of PTLD from Massachusetts
      General Hospital, arising in seven male and four female patients, aged 8 to 63,
      five with renal, four with cardiac, and two with hepatic allografts. Using the
      polymerase chain reaction (PCR) to investigate genetic polymorphism at the D4S174
      locus on chromosome 4, the Rb1.20 locus on chromosome 13, and the D19S178 locus
      on chromosome 19, only one tumor (previously reported) was of donor origin,
      whereas 10 were of host origin. Follow-up revealed that six patients died of
      PTLD, one was alive with recurrent PTLD, and four were alive and well or had died
      of other causes, including the patient with donor-origin PTLD. Based on these
      cases and on a review of previously reported cases, the authors conclude that the
      majority of PTLDs in solid organ recipients are of host origin. There appears to
      be a trend toward a greater likelihood of persistent or recurrent PTLD among
      solid organ recipients with host-origin tumors than among those with donor-origin
      tumor.

PMID- 7785664
TI  - Comparing methods of estimating maximum allowable analytical error in
      glycohemoglobin testing.

PMID- 7785665
TI  - S100 protein and HMB-45 negative "rhabdoid" malignant melanoma: a totally
      dedifferentiated malignant melanoma?

PMID- 7785666
TI  - Invited commentary on "Aerial dissemination of pulmonary tuberculosis. A two-year
      study of contagion in a tuberculosis ward".

PMID- 7785667
TI  - Re: "Validity of parental report of a child's medical history in otitis media
      research".

PMID- 7785668
TI  - Re: "Statistical significance testing in the American Journal of Epidemiology,
      1970-1990".

PMID- 7785669
TI  - Associations between ambient particulate sulfate and admissions to Ontario
      hospitals for cardiac and respiratory diseases.
AB  - The association of daily cardiac and respiratory admissions to 168 acute care
      hospitals in Ontario, Canada, with daily levels of particulate sulfates was
      examined over the 6-year period 1983-1988. Sulfate levels were recorded at nine
      monitoring stations in regions of southern and central Ontario spanned by three
      monitoring networks. A 13-micrograms/m3 increase in sulfates recorded on the day
      prior to admission (the 95th percentile) was associated with a 3.7% (p < 0.0001)
      increase in respiratory admissions and a 2.8% (p < 0.0001) increase in cardiac
      admissions. Increases were observed for all age groups examined. Admissions for
      cardiac diseases increased 2.5% for those under 65 years and 3.5% for those 65
      years and older. After adjusting for ambient temperature and ozone, similar
      increases in respiratory admissions were observed in the period from April to
      September (3.2%) and in the period from October to March (2.8%). A 3.2% increase
      was observed for cardiac admissions in the period from April to September, and a
      3.4% increase was observed in the period from October to March after adjusting
      for ambient temperature and ozone.

PMID- 7785670
TI  - Air pollution and hospital admissions for cardiovascular disease in Detroit,
      Michigan.
AB  - In the December 1952 smog disaster in London, a substantial increase in mortality
      was closely associated with the increase in air pollution. Deaths from
      cardiovascular causes were elevated as well as respiratory deaths. The increase
      was greatest in the elderly. Hospital admissions were increased for both
      respiratory and cardiovascular diseases. Since then, many studies have reported
      associations between lower concentrations of air pollution and daily mortality.
      Little attention has been paid to the question of hospital admissions for
      cardiovascular illness, however. This study examined the association between air
      pollution and cardiovascular hospital admissions for persons aged 65 years and
      older in the Detroit, Michigan, metropolitan area during the years 1986-1989.
      After controlling for seasonal and other long-term temporal trends, temperature,
      and dew point temperature, the particulate matter with an aerodiameter of < or =
      10 microns (PM10) was associated with daily admissions for ischemic heart disease
      (relative risk (RR) = 1.018, 95% confidence interval (CI) 1.005-1.032 for an
      interquartile range (32 micrograms/m3) increase in pollution). SO2, CO, and ozone
      made no independent contribution to ischemic heart disease admissions. Both PM10
      (RR = 1.024, 95% CI 1.004-1.044) and CO (RR = 1.022, 95% CI 1.010-1.034 for an
      interquartile range (1.28 ppm) increase in pollution) showed independent
      associations with heart failure admissions. These results were robust to
      alternate methods of estimation and weather control.

PMID- 7785671
TI  - Aerial dissemination of pulmonary tuberculosis. A two-year study of contagion in
      a tuberculosis ward. 1959.

PMID- 7785672
TI  - Clustering of risk habits in young adults. The Cardiovascular Risk in Young Finns
      Study.
AB  - The authors studied the occurrence of common lifestyle risk factors, namely,
      nonprudent diet, smoking, physical inactivity, and frequent inebriation by
      alcohol in a cohort of young adults aged 18, 21, and 24 years (n = 484) as part
      of the Cardiovascular Risk in Young Finns Study in 1986. Risk habits showed
      significant clustering; the number of subjects was greater than expected in
      groups with zero and three of four risk habits and less than expected in the
      group with only one or two risk habits. Stepwise logistic regression analysis was
      used to find independent determinants for this clustering from a set of
      socioeconomic, demographic, and behavioral (type A components) determinants. The
      logistic model suggested several independent risk factors for risk habit
      clustering. These included male sex, aggressiveness, and past unemployment.
      Paying a lot of attention to health habits, higher education (being a student),
      good self-perceived health, and a high sense of responsibility seemed to be
      protective factors against risk habit clustering. The accumulation of risk habits
      was also associated with an atherogenic lipid and blood pressure profile
      (clustering of high density lipoprotein cholesterol/total cholesterol ratio,
      triglycerides, and diastolic blood pressure in their extreme tertiles). These
      findings show that common risk habits cluster among young adults. Knowledge about
      the determinants of this clustering will aid in the planning of future preventive
      strategies against cardiovascular diseases in young people.

PMID- 7785673
TI  - Coronary heart disease mortality and sudden death: trends and patterns in 35- to
      44-year-old white males, 1970-1990.
AB  - Trends in coronary heart disease mortality and sudden death were studied in 35-
      to 44-year-old white male residents of Allegheny County, Pennsylvania. Deaths
      coded as any cardiac or vascular disease, diabetes, unexplained sudden death, and
      other rubrics were eligible for investigation, and the cause of death was
      validated by physicians examining multiple data sources about the deaths. During
      1970-1990, 1,424 white male deaths were investigated, with 903 validated as
      coronary heart disease. In that time span, white male coronary heart disease
      mortality fell from 93.4 to 36.7 per 100,000 population per year, a 60% decline.
      Little proportionate change was seen in characteristics of the deaths, which were
      predominantly sudden and out-of-hospital. Diabetes mellitus history increased
      proportionately over time, largely because diabetics' mortality rates, unlike
      those of all other subgroups, did not fall. These observations support the
      contention that the decline in coronary heart disease mortality relates to risk
      factor modification more than to improvements in the treatment of coronary heart
      disease. Differences in death certification practices must be considered when
      interpreting and comparing vital statistics data.

PMID- 7785674
TI  - Relation of body fat distribution to ischemic heart disease. The National Health
      and Nutrition Examination Survey I (NHANES I) Epidemiologic Follow-up Study.
AB  - Although an excess of adipose tissue in the abdominal and truncal regions is
      associated with various metabolic alterations, relatively few cohort studies have
      examined its importance in the development of ischemic heart disease, and little
      information is available from black populations. The authors examined the
      relation of central obesity, as characterized by a thick subscapular skinfold
      relative to the triceps skinfold, to the incidence of ischemic heart disease
      among 9,822 persons in the Epidemiologic Follow-up Study of the National Health
      and Nutrition Examination Survey I; baseline data were collected in 1971-1975 and
      follow-up was through 1987. We found that, independently of relative weight,
      cigarette smoking, and other covariates, the hazard rate ratios for ischemic
      heart disease incidence contrasting the upper and lower quintiles of central
      obesity were 1.75 (95% confidence interval 1.3-2.3) among women and 1.65 (95%
      confidence interval 1.3-2.2) among men. Although central obesity was related
      similarly to disease among white and black men, the association among women
      differed between whites (rate ratio = 1.94) and blacks (rate ratio = 0.73); p =
      0.002 for race x the central obesity product term. Additional research is needed
      to clarify the relation of various anthropometric measurements to ischemic heart
      disease, particularly among blacks, but the assessment of fat distribution may
      help identify high-risk persons for whom weight loss might be most beneficial.

PMID- 7785675
TI  - Effects of question order on estimates of the prevalence of attempted weight
      loss.
AB  - Although numerous surveys have been conducted to estimate the prevalence of
      attempted weight loss, little information is available on the possible effects of
      question order on the prevalence estimates. The authors examined data collected
      from 231,852 respondents to surveys conducted in the District of Columbia and 20
      states that participated in the Behavioral Risk Factor Surveillance System
      between 1985 and 1992. In surveys conducted from 1985 to 1988, respondents (n =
      117,827) were first asked their body weight and then were asked if they were
      trying to lose weight; 48% of the women and 29% of the men reported that they
      were trying to lose weight. In 1989, 1991, and 1992 (no questions about weight
      control were asked in 1990), the order of the questions was reversed so that
      respondents (n = 114,025) were asked whether they were trying to lose weight
      before they were asked to report their weight; 41% of the women and 26% of the
      men reported that they were trying to lose weight. The authors conclude that
      survey respondents, especially women, may be more likely to report that they are
      trying to lose weight when questions about weight control practices immediately
      follow questions on current weight. This apparent effect of question order points
      to the need for caution in comparing prevalence estimates across surveys in which
      the questions are not asked in a similar order, even when the questions are
      worded identically.

PMID- 7785676
TI  - Incidence of benign gastrointestinal tumors among atomic bomb survivors.
AB  - Using the Hiroshima and Nagasaki tumor and tissue registries, benign tumors of
      the stomach, colon, and rectum were identified among members of the Life Span
      Study cohort of atomic bomb survivors. During the period 1958-1989, a total of
      470 cases with histologically confirmed benign gastrointestinal tumors (163
      stomach, 215 colon, and 92 rectum) were identified among approximately 80,000
      Life Span Study members with known radiation doses, who were alive in 1958.
      Restricting the analysis to adenomatous tumors not detected at autopsy, a dose
      response relation was observed for stomach tumors (excess relative risk at 1
      sievert (ERR1Sv) = 0.53; 95% confidence interval (CI) -0.01 to 1.43). However,
      there was little evidence of a dose response for colon tumors (ERR1Sv = 0.14; 95%
      CI -0.20 to 0.76), and no evidence was present for rectal tumors (ERR1Sv = -0.25;
      95% CI undetermined to 0.80). The excess relative risk (ERR) for benign tumors of
      the stomach is consistent with the excess found for stomach cancer. For cancer of
      the rectum, the dose response was not significant, but the point estimate of the
      excess relative risk was positive. The excess relative risk for benign colon
      tumors is less than that reported for colon cancer (ERR1Sv = 0.72). The authors
      observed a dramatic increase in colon tumors detected after 1985, suggesting that
      the relatively recent introduction of colonoscopy may be influencing these
      results.

PMID- 7785677
TI  - Irritable bowel syndrome in a community: symptom subgroups, risk factors, and
      health care utilization.
AB  - The clinical relevance of subdividing the irritable bowel syndrome (IBS) into
      subgroups based on bowel habit is largely unknown. We therefore obtained an age-
      and sex-stratified random sample of Olmsted County, Minnesota, residents aged 20
      95 years. All subjects were mailed a valid self-report questionnaire during the
      years 1988-1993; the response rate was 74% (n = 3,022). Among subjects with IBS
      (n = 536), four symptom-based subgroups of similar size were identified:
      constipation predominant, diarrhea predominant, alternating constipation and
      diarrhea, and neither. The prevalence of IBS was significantly greater in
      females, primarily because of a higher prevalence of constipation-predominant IBS
      in women. Of persons > or = 60 years of age, 23% reported the initial onset of
      IBS in the previous year compared with 10% in younger subjects; the age at onset
      of IBS was similar among the subgroups. Marital status, education level, smoking,
      and alcohol use were not significantly different among the subgroups. Of those
      with IBS, 25% reported visiting a physician for abdominal pain or disturbed
      defecation in the prior year compared with only 8% of persons without IBS. Female
      sex, an increased number of Manning's symptom criteria, and the individual IBS
      subgroups were not associated with higher rates of physician visits. We conclude
      that the onset of IBS may not be limited to early adulthood and that subgroups of
      IBS based on bowel patterns may not identify clinically distinct entities.

PMID- 7785678
TI  - Fetal growth retardation in sudden infant death syndrome (SIDS) babies and their
      siblings.
AB  - To evaluate the intrauterine growth potential of infants that die from sudden
      infant death syndrome (SIDS), the authors compared SIDS infants with their
      surviving siblings. The SIDS sibships themselves were also compared with sibships
      where all infants survived. Data from the population-based Medical Birth Registry
      of Norway, with 1.3 million births during 1967-1988, were used. From the birth
      cohorts, 1,984 SIDS cases were identified. All births were linked into sibships.
      The mean birth weight and gestational age were calculated across sibships of
      different sizes for first to fourth birth order. In a further analysis, birth
      weights were standardized to adjust for gestational age. Mothers of SIDS infants
      give birth to smaller babies in general. SIDS infants weighed, on average, 85 g
      less at birth than their siblings and 164 g less compared with babies in
      nonaffected sibships. When birth weights were standardized for gestational age,
      most of the weight difference between SIDS infants and siblings was due to a
      shorter gestational age of SIDS infants, while the difference between surviving
      siblings of SIDS infants and births from nonaffected sibships remained. All
      births in sibships with a SIDS infant were intrauterine growth retarded. This may
      reflect factors that contribute to SIDS risk (such as maternal smoking). The
      factors that contribute to shorter gestational age and further slowing of growth
      in the SIDS infants may specifically influence the SIDS infant and not its
      siblings.

PMID- 7785679
TI  - Control sampling strategies for case-crossover studies: an assessment of relative
      efficiency.
AB  - The case-crossover study design is a method to assess the effect of transient
      exposures on the risk of onset of acute events. Control information for each case
      is based on his/her past exposure experience, and a self-matched analysis is
      conducted. Empiric evaluation of five approaches to the analysis of case
      crossover data from a study of heavy physical exertion and acute myocardial
      infarction onset is shown. The data presented are from the Onset Study, a case
      crossover study of the determinants of myocardial infarction onset conducted in
      45 centers from August 1989 to October 1992. In model 1, exactly one control
      period (matched on clock-time) was sampled per case. In models 2-4, up to 25
      control periods were sampled, and the effect of clock-time on the baseline hazard
      of infarction was modeled. In model 5, a census of the person-time experienced by
      each subject over the year preceding the infarction was sampled. The 95%
      confidence interval for model 1 was 2.7 times wider, and the relative efficiency,
      defined as v infinity/vM, where vM represents the asymptotic variance estimate of
      the estimated log relative risk with M control periods sampled per case, was only
      about 14% of model 5. In models 2-4, the efficiency increased with the number of
      control periods, regardless of the modeling assumptions. Even with many control
      periods sampled, models 2-4 achieved only half the efficiency of model 5. The
      control sampling strategy in any given case-crossover study should be selected
      with the trade-offs between precision and potential biases of the estimates in
      mind.

PMID- 7785680
TI  - Re: "Air-conditioning and mortality in hot weather".

PMID- 7785681
TI  - Color Doppler imaging and spectral analysis of the optic nerve vasculature in
      glaucoma.
AB  - PURPOSE: We used color Doppler imaging to study blood flow velocity in the
      central retinal artery and the short posterior ciliary arteries in patients with
      glaucoma. METHOD: Fifty-two patients with chronic open-angle glaucoma, 24
      patients with normal-tension glaucoma, and 28 normal subjects were studied. The
      mean of the peak systolic velocity, the end diastolic velocity, and the resistive
      index were compared in the three groups. RESULTS: Compared with the normal
      subjects, the patients with chronic open-angle glaucoma showed a statistically
      significant (P < .05) decrease in the mean end diastolic velocity and an increase
      in the mean resistive index in all vessels studied. The patients with normal
      tension glaucoma showed similar changes, achieving significance most prominently
      in the central retinal arteries, compared with normal subjects (P < .05). There
      were no statistically significant differences between the patients with chronic
      open-angle glaucoma and those with normal-tension glaucoma. CONCLUSIONS: Open
      angle glaucoma appears to be associated with a decreased mean flow velocity and
      an increased mean resistive index in the ocular vasculature. These changes are in
      keeping with possibly compromised circulation in this region.

PMID- 7785684
TI  - The effect of artificial tears on computer-assisted corneal topography in normal
      eyes and after penetrating keratoplasty.
AB  - PURPOSE: To examine the effect of adding artificial tears for one minute to
      normal eyes and eyes that have undergone keratoplasty by using computer-assisted
      videokeratography. METHODS: We prospectively analyzed 24 normal corneas (24
      patients) chosen by random number table (reproducibility section [10 eyes], tear
      section [14 eyes]) as well as 14 postkeratoplasty corneas. The parametric
      descriptors analyzed statistically included the simulated keratometry value,
      surface asymmetry index, surface regularity index, power at the vertex normal,
      and the pupil offsets from the visual axis. Vectoral analysis was used to
      calculate the difference in power and axis between the simulated keratometry
      values before and after tear instillation. RESULTS: In normal eyes, tear
      instillation increased the surface asymmetry index (0.28 +/- 0.34, P = .01),
      changed the simulated keratometry value (0.23 diopter by 27.8 degrees), and power
      (0.79 +/- 0.82 diopters, P = .004) and location (0.91 +/- 0.76 mm) of the
      steepest point of the cornea changed. In postkeratoplasty eyes, the surface
      regularity index decreased (0.49 +/- 0.80, P = .04), surface asymmetry index
      decreased (0.37 +/- 1.03, P = .21), mean simulated keratometry value changed
      (1.04 diopters by 1.01 degrees), and power (0.70 +/- 2.34 diopters, P = .28) and
      location (1.04 +/- 1.17 mm) of the steepest point of the cornea changed. Changes
      were greater than the variability of the surface regularity index (0.07 +/-
      0.05), surface asymmetry index (0.04 +/- 0.03), simulated keratometry value power
      (0.08 +/- 0.06 diopter), and axis (4.6 +/- 5 degrees). CONCLUSIONS: The addition
      of artificial tears to normal or regular and symmetric eyes that have undergone
      keratoplasty worsened symmetry and changed the power and location of the steepest
      point. However, the addition of artificial tears to irregular eyes that have
      undergone penetrating keratoplasty created a more regular and symmetric surface
      and significantly altered the simulated keratometry values. We recommend that
      corneal topography be performed before the application of artificial tears.

PMID- 7785682
TI  - Color Doppler ultrasound analysis of ocular circulation after topical calcium
      channel blocker.
AB  - PURPOSE: To investigate the effect of topical administration of the calcium
      channel blocker verapamil on intraocular pressure and retrobulbar hemodynamics.
      METHODS: In this randomized, prospective, double-masked study, we examined the
      effects of single-dose topical administration of verapamil in ten normal human
      volunteers by using color Doppler ultrasound imaging to measure hemodynamic
      parameters. Limitations of this study include single-dose application of
      verapamil and relatively small sample size. RESULTS: No systemic effect on heart
      rate or blood pressure was detected after administration of topical verapamil.
      The intraocular pressure significantly decreased compared with baseline two hours
      after topical 0.125% and 0.25% verapamil (P = .015 and .040, respectively).
      Pourcelot's ratio, an index of vascular resistance, measured in the central
      retinal artery was significantly reduced after topical application of 0.125%
      verapamil (P = .008). The change in Pourcelot's ratio primarily resulted from an
      increased end diastolic velocity in the central retinal artery. No significant
      differences compared with baseline values were detected in the color Doppler
      ultrasound measurements of the posterior ciliary arteries and the central retinal
      vein two hours after topically administered verapamil. CONCLUSIONS: Topical
      administration of verapamil decreases intraocular pressure and alters ocular
      hemodynamics, reducing the vascular resistance index in the central retinal
      artery.

PMID- 7785683
TI  - Membranous outgrowth suggesting lens epithelial cell proliferation in
      pseudophakic eyes.
AB  - PURPOSE: We sought to determine the incidence and structure of membranous
      outgrowth, which extends from the anterior capsular opening onto the intraocular
      lens surface in pseudophakic eyes. METHODS: Thirty-four eyes of 31 patients with
      age-related cataract were prospectively studied. No patient had any abnormality
      other than cataract. Each patient underwent continuous circular capsulorhexis,
      phacoemulsification, and implantation within the capsule of a three-piece
      posterior chamber lens. A slit lamp and specular microscope were used to observe
      and photograph the intraocular lens surface and anterior capsular opening every
      day for the first postoperative week, and at days 14, 21, and 28. We counted the
      number of eyes with the membranous outgrowth and graded the outgrowth according
      to its shape and length at each postoperative period. RESULTS: In total, 27 of 34
      (79%) eyes had the membranous outgrowth from the anterior capsular opening onto
      the intraocular lens surface. The membrane was first observed on day 3. Three of
      34 eyes had the dendritic or fan-shaped structure, which extended less than 0.5
      mm from the capsular edge. The membranes were most frequently found on day 7.
      Twenty-five of 34 eyes had the outgrowth in various grades. After four weeks, no
      membranes were observed. CONCLUSIONS: The time course and structure of the
      membranous outgrowth we observed were comparable to those of the outgrowth of
      lens epithelial cells under tissue culture conditions. The membranous outgrowth
      may be the result of a transient but active proliferation of human lens
      epithelial cells onto the intraocular lens surface.

PMID- 7785685
TI  - Assessment of the power and height of radial aspheres reported by a computer
      assisted keratoscope.
AB  - PURPOSE: The two purposes of this study were (a) to assess the accuracy with
      which a keratoscope, the Topographic Modeling System (TMS-1), calculated the
      heights and powers of rotationally symmetric, radially aspheric test surfaces and
      (b) to determine whether the TMS-1 used an axial solution for radius of curvature
      to determine the power of a sphere that would produce the same semichord as would
      the test surface on a keratograph. METHODS: The TMS-1 heights and powers were
      studied for four test surfaces that had radial profiles similar to those of
      normal corneas. The powers of the surfaces were calculated from the local radius
      of curvature derived from the surfaces' manufacturing formulas. The heights and
      powers that would result from an axial solution were calculated in a TMS-1
      simulator. TMS-1 data were compared with data from the surfaces' formulas and
      with data from the simulation. RESULTS: The TMS-1 data were almost identical to
      the heights and powers calculated from the simulated axial solution. The TMS-1
      data were similar to the heights and powers calculated from the mathematical
      formulas from the apex to 2 mm from the apex but differed by up to 85 microns of
      height and 10 diopters of power in the periphery. CONCLUSIONS: The TMS-1 appeared
      to use the axial solution that does not calculate power from local radius of
      curvature. Clinicians should use caution when inferring corneal shape from power
      maps based on an axial solution, especially outside the central 2-mm radius of a
      normal cornea, because such power does not depict corneal curvature.

PMID- 7785686
TI  - Refractive changes at extreme altitude after radial keratotomy.
AB  - PURPOSE: We studied the effects of altitude on four corneas that had undergone
      radial keratotomy and four normal corneas exposed to increasing elevation during
      a high-altitude excursion. METHODS: We measured visual acuity, cycloplegic
      refraction, keratometry, and intraocular pressure at sea level and after 24-hour
      exposure to 12,000 and 17,000 ft. RESULTS: We observed a significant increase in
      spherical equivalence (hyperopic shift) in radial keratotomy eyes exposed to
      altitude as compared to controls (P < .0001). The average change in spherical
      equivalent cycloplegic refraction from sea level to 12,000 ft was 1.03 +/- 0.16
      diopters and from sea level to 17,000 ft was 1.94 +/- 0.26 diopters. We also
      observed a significant decrease in keratometry values at altitude as compared
      with control corneas (P < .0001). The average change in keratometry from sea
      level to 12,000 ft was 0.59 +/- 0.19 diopter and from sea level to 17,000 ft was
      1.75 +/- 0.27 diopters. CONCLUSIONS: Although the specific origin of these
      changes is open to question, we hypothesize that hypoxic corneal expansion in the
      area of the radial keratotomy incisions may lead to central corneal flattening
      and a hyperopic shift in refractive error. The cornea that has undergone radial
      keratotomy appears to adjust constantly to changing environmental oxygen
      concentration, producing a new refractive error over a period of 24 hours or
      more. Additional study is required to identify with certainty the specific origin
      of the hyperopic shift at high altitude.

PMID- 7785687
TI  - The effect of cleaning and disinfection of soft contact lenses on corneal
      infectivity in an animal model.
AB  - PURPOSE: Bacterial contamination of previously worn soft contact lenses,
      especially at sites of lens deposits, might play a role in the pathogenesis of
      lens-associated bacterial keratitis. We studied the effects of three commercial
      contact lens cleaners and disinfectants in a rabbit model to determine whether
      cleaning and disinfection reduced infectivity. METHODS: Duragel 75 soft contact
      lenses, designed to fit the eyes of rabbits, were worn by rabbits under
      tarsorrhaphies, then were removed and cleaned in one of three cleaner and
      disinfectant solutions according to the manufacturers' instructions. The lenses
      were contaminated by overnight incubation in a suspension of 10(8) Pseudomonas
      aeruginosa/ml and were placed under tarsorrhaphies on the eyes of fresh rabbits.
      The rabbits were observed for two weeks for signs of infection. Control rabbits
      wore new, uncleaned but contaminated lenses or worn, uncleaned but contaminated
      lenses. RESULTS: The rates of infection with the three commercial cleaner and
      disinfectant solutions ranged from 18% (two of 11) to 31% (four of 13); these
      incidences were not significantly different from one another or from the 19%
      (three of 16) incidence with new, contaminated but uncleaned lenses. By contrast,
      when worn, uncleaned but contaminated lenses were placed in rabbits' eyes, seven
      of eight were infected, a rate that is significantly higher than that of the
      other four groups (P = .0003). CONCLUSIONS: These data indicate that the three
      commercial lens cleaner and disinfectant solutions were of similar efficacy in
      reducing the infectivity of contaminated contact lenses to a level similar to
      that of new, unworn lenses.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785688
TI  - The prevalence of dissociated vertical deviation in patients with sensory
      heterotropia.
AB  - PURPOSE: We reviewed 281 consecutive patients with sensory esotropia or exotropia
      to determine the prevalence of dissociated vertical deviation in patients with
      sensory strabismus. METHODS: We reviewed the charts of all patients who received
      a diagnosis of sensory heterotropia or dissociated vertical deviation and who
      were examined at the Pediatric Ophthalmology Service at the Texas Children's
      Hospital between 1973 and 1992. Statistical analyses of the prevalence of
      dissociated vertical deviation were determined after evaluating the direction of
      the accompanying horizontal strabismus and examining the temporal relationship of
      the unilateral vision loss. RESULTS: Dissociated vertical deviation was diagnosed
      in 35 patients (12.5%). It occurred more frequently in sensory esotropia (22
      patients, 18.3%) than exotropia (13 patients, 8.1%) (P = .009). The age at which
      unilateral visual loss occurred did not influence the development of dissociated
      vertical deviation. CONCLUSION: Dissociated vertical deviation in patients with
      acquired loss of vision does not support the contention that dissociated vertical
      deviation is a genetically predetermined anomaly of binocular vision.

PMID- 7785690
TI  - Reappraisal of biomicroscopic classification of stages of development of a
      macular hole.
AB  - PURPOSE: To update the biomicroscopic classification and anatomic interpretations
      of the stages of development of age-related macular hole and provide explanations
      for the remarkable recovery of visual acuity that occurs in some patients after
      vitreous surgery. METHODS: Recent biomicroscopic observations of various stages
      of macular holes are used to postulate new anatomic explanations for these
      stages. RESULTS: Biomicroscopic observations include the following: (1) the
      change from a yellow spot (stage 1-A) to a yellow ring (stage 1-B) during the
      early stages of foveal detachment is unique to patients at risk of macular hole;
      (2) the prehole opacity with a small stage 2 hole may be larger than the hole
      diameter; and (3) the opacity resembling an operculum that accompanies macular
      holes is indistinguishable from a pseudo-operculum found in otherwise normal
      fellow eyes. CONCLUSIONS: The change from a yellow spot (stage 1-A) to a yellow
      ring (stage 1-B) is caused primarily by centrifugal displacement of retinal
      receptors after a dehiscence at the umbo. The hole may be hidden by semiopaque
      contracted prefoveolar vitreous cortex bridging the yellow ring (stage 1-B occult
      hole). Stage 1-B occult holes become manifest (stage 2 holes) either after early
      separation of the contracted prefoveolar vitreous cortex from the retina
      surrounding a small hole or as an eccentric can-opener-like tear in the
      contracted prefoveolar vitreous cortex, at the edge of larger stage 2 holes. Most
      prehole opacities probably contain no retinal receptors (pseudo-opercula).
      Surgical reattachment of the retina surrounding the hole and centripetal movement
      of the foveolar retina induced by gliosis may restore foveal anatomy and function
      to near normal.

PMID- 7785689
TI  - Diode laser photocoagulation for threshold retinopathy of prematurity in eyes
      with tunica vasculosa lentis.
AB  - PURPOSE: To determine possible side effects of diode laser photocoagulation for
      threshold retinopathy of prematurity in eyes with tunica vasculosa lentis.
      METHODS: In a prospective clinical study, threshold retinopathy of prematurity
      was treated in 14 eyes of seven consecutive preterm infants with tunica vasculosa
      lentis (birth weight, 480 to 980 g; mean +/- S.D., 777 +/- 175 g; gestational
      age, 24 to 27 weeks; mean +/- S.D., 25.7 +/- 0.9 weeks) by using the diode laser
      indirect ophthalmoscope. Main outcome measure was the incidence of adverse
      treatment effects. Follow-up included anterior segment examination with a hand
      held slit lamp and ranged from seven to 17 months (12.6 +/- 3.5 months). RESULTS:
      The tunica vasculosa lentis did not interfere with photocoagulation in any of the
      14 eyes. Laser power ranged from 200 to 400 mW (260 +/- 52 mW). Duration of a
      single spot was 200 msec. Number of burns ranged from 1,060 to 2,132 (1,556 +/-
      315). Retinopathy of prematurity regressed in all eyes, and the outcome was a
      flat, attached retina. A small amount of postoperative anterior chamber bleeding
      was noticed in one eye (7% of the eyes, 14% of the patients). There were neither
      lenticular opacities nor cataract formation. CONCLUSION: Diode laser
      photocoagulation with the laser indirect ophthalmoscope can be used safely in
      eyes with tunica vasculosa lentis. At the laser energy levels used in our study,
      no transient lens opacities or cataract formation occurred. However, the results
      of this study are limited by a relatively small number of patients and a
      relatively short follow-up.

PMID- 7785691
TI  - Quantitation of retinal ablation in proliferative diabetic retinopathy.
AB  - PURPOSE: We studied 294 eyes of 182 patients, to quantitate the amount of retinal
      ablation required for regression of proliferative diabetic retinopathy. METHODS:
      Eyes included in the study had two or more proliferative diabetic retinopathy
      risk factors, received panretinal photocoagulation, and had a minimum follow-up
      of one year. Laser photocoagulation or cryotherapy was given to eyes that failed
      to regress or had progression of retinopathy. Eyes treated by other physicians,
      treated with xenon arc photocoagulation, or undergoing laser treatment or
      vitrectomy for other retinal conditions were excluded. The total area of retina
      ablated was calculated and used as a quantitative measure of treatment. RESULTS:
      Regression was observed in 275 eyes (93%); 19 eyes (7%) failed to regress and
      eventually required vitrectomy. Panretinal photocoagulation alone successfully
      led to regression in 229 eyes (77%), whereas 46 eyes (15.6%) required both
      photocoagulation and peripheral anterior retinal cryotherapy. An average of 1.7
      treatments per eye led to regression. Eyes were bimodally distributed by
      requirement for treatment, into low and high treatment groups. Low treatment eyes
      received an average of 510 mm2 of retinal ablation (2,600 500-microns burns), and
      high treatment eyes, 1,280 mm2 (6,500 500-microns burns). More extensive
      treatment was required with more retinopathy risk factors (P = .002 for four vs
      three risk factors and P = .0007 for four vs two risk factors); duration of
      diabetes mellitus longer than 15 years (P = .004), and onset of diabetes mellitus
      before 30 years of age (P = .0008). CONCLUSION: Patients with proliferative
      diabetic retinopathy should be treated aggressively with panretinal
      photocoagulation, cryotherapy, or both. The amount of initial treatment required
      for regression may be considerably more than that recommended by the Diabetic
      Retinopathy Study.

PMID- 7785692
TI  - Accidental Nd:YAG laser injuries to the macula.
AB  - PURPOSE: To study the clinical course of accidental, single-focus Nd:YAG laser
      injuries to the macula. METHODS: We reviewed the clinical course of five eyes
      (four patients) that sustained macular injuries from a Nd:YAG laser. All patients
      were examined within 24 hours of injury and were observed without surgical
      intervention for a mean of 20 months (range, 12 to 32 months). RESULTS: A single
      full-thickness foveal or parafoveal retinal hole was apparent in all eyes either
      on initial examination or within two weeks of injury. All macular holes were
      within 650 microns of the foveal center. The mean final visual acuity was 20/60
      (range, 20/25 to 20/400) and was related to the distance between the macular hole
      and the foveal center. None of the eyes developed either subretinal
      neovascularization or clinically significant epiretinal membrane formation during
      the study period. CONCLUSIONS: Despite initial poor visual acuity in patients who
      had a full-thickness foveal or parafoveal retinal hole, visual acuity improved
      without treatment when the site of the laser injury was located outside the
      foveal center.

PMID- 7785693
TI  - Vancomycin levels in the vitreous cavity after intravenous administration.
AB  - PURPOSE: We studied the effects of inflammation, repeated antibiotic doses, and
      the surgical status of the eye on penetration of vancomycin hydrochloride into
      the rabbit vitreous cavity after intravenous administration. METHODS: We studied
      three anatomic states (phakic, aphakic, and aphakic, vitrectomy-treated eyes)
      subdividing each into inflamed and noninflamed groups. Intravenous vancomycin
      hydrochloride (15 mg/kg of body weight) was administered every 12 hours for 48
      hours. Eyes were harvested for the assay of vitreous cavity antibiotic levels at
      various intervals from one to 49 hours. We determined concentrations and
      calculated mean values and S.E.M. RESULTS: Therapeutic levels were not
      established in the vitreous cavity at any time period in the two phakic groups.
      At 25 hours, the inflamed aphakic eyes had concentrations of 5.05 +/- 1.9
      micrograms/ml and the control noninflamed aphakic eyes 4.5 +/- 1.23
      micrograms/ml; slight increases were found by 49 hours. Concentrations tested in
      the aphakic, vitrectomy-treated eyes at two, 13, 25, and 49 hours demonstrated
      progressive increases both in the inflamed eyes (5.4 +/- 2.4 micrograms/ml, 9.64
      +/- 4.25 micrograms/ml, 9.2 +/- 3.96 micrograms/ml, 10.34 +/- 4.49 micrograms/ml)
      and noninflamed eyes (3.52 +/- 2.1 micrograms/ml, 5.4 +/- 1.96 micrograms/ml, 6.8
      +/- 2.53 micrograms/ml, 8.7 +/- 5.44 micrograms/ml). CONCLUSIONS: Vitreous
      vancomycin concentrations in aphakic and aphakic, vitrectomy-treated eyes after
      intravenous administration exceed the minimal inhibitory concentrations for the
      usual gram-positive pathogens that create endophthalmitis, suggesting a role for
      intravenous vancomycin in the treatment of bacterial endophthalmitis.

PMID- 7785694
TI  - Metastatic tumors to the pituitary.
AB  - PURPOSE: To illustrate how the ophthalmologist can distinguish a metastatic tumor
      to the pituitary from a pituitary adenoma through clinical, particularly
      ophthalmic, findings. METHODS: We studied three patients with metastatic disease
      to the pituitary. One patient had a history of breast cancer without known
      metastatic disease, and two patients had no previous diagnosis of malignancy. We
      reviewed the literature with respect to signs and symptoms that may differentiate
      such lesions from histologically benign pituitary adenomas. RESULTS: Including
      our patients and the recent cases in the literature, 42% of patients with
      metastatic tumors had oculomotor palsies, compared with less than 5% of patients
      with pituitary adenomas. Of patients with metastatic tumors, 33% had diabetes
      insipidus, compared with 1% who had pituitary adenomas. Furthermore, with respect
      to differentiating a pituitary adenoma from a metastatic process, radiographic
      examinations were not helpful, and histopathologic examination was occasionally
      incorrect. CONCLUSION: The ophthalmologist can potentially differentiate a
      metastatic tumor to the pituitary from a pituitary adenoma, thereby assisting in
      the proper treatment of patients.

PMID- 7785695
TI  - No demonstrated effect of pre-enucleation irradiation on survival of patients
      with uveal melanoma.
AB  - PURPOSE: To evaluate the hypothetical effect of pre-enucleation irradiation on
      survival of patients with uveal melanoma. METHODS: In a prospective study between
      1978 and 1990, 145 patients with uveal melanoma were treated by irradiation in
      two fractions of 4 Gy before enucleation. A historical control group of 89
      patients with uveal melanoma treated by enucleation alone was operated on between
      1971 and 1990. Patients were followed up until December 1992 or until death. The
      mean follow-up period was 65 months in the irradiated group and 88 months in the
      control group. RESULTS: The preoperatively irradiated group of patients showed no
      significant improvement of the survival rate after 7 1/2 years (75.9%) compared
      with the control group (72.1%). Preoperative irradiation was not associated with
      survival (P = .93), as assessed by Cox proportional hazard analysis, adjusted for
      age, gender, tumor location, tumor size, cell type, and year of enucleation.
      Women in both the irradiated and control groups had a better prognosis than men
      (P = .002). CONCLUSION: Preoperative irradiation in this nonrandomized study had
      no effect on survival of patients with uveal melanoma.

PMID- 7785696
TI  - Diagnostic criteria for Graves' ophthalmopathy.
AB  - PURPOSE: To propose criteria for the diagnosis of Graves' ophthalmopathy.
      METHODS: We reviewed the evolution of nomenclature describing Graves'
      ophthalmopathy. and the diagnostic schema used in key published reports. RESULTS:
      A laboratory test or clinical finding pathognomonic for Graves' ophthalmopathy
      currently is not available or recognized. Extant diagnostic criteria may exclude
      appropriate cases. CONCLUSIONS: Graves' ophthalmopathy is considered to be
      present if eyelid retraction occurs in association with objective evidence of
      thyroid dysfunction or abnormal regulation, exophthalmos, optic nerve
      dysfunction, or extraocular muscle involvement. The ophthalmic signs may be
      unilateral or bilateral, and confounding causes must be excluded. If eyelid
      retraction is absent, then Graves' ophthalmopathy may be diagnosed only if
      exophthalmos, optic nerve involvement, or restrictive extraocular myopathy is
      associated with thyroid dysfunction or abnormal regulation and if no other cause
      for the ophthalmic feature is apparent.

PMID- 7785697
TI  - Possible role of herpes simplex virus in the origin of Posner-Schlossman
      syndrome.
AB  - PURPOSE/METHODS: We conducted this study to determine if the herpesviruses are
      possible etiologic agents in Posner-Schlossman syndrome. We aspirated aqueous
      humor samples from patients during acute attacks of the syndrome. Ten normal
      aqueous humor specimens from patients undergoing cataract surgery were used as
      controls. DNA was extracted and subjected to polymerase chain reaction
      amplification and Southern blot hybridization. RESULTS/CONCLUSION: All three
      specimens were positive for amplified genomic fragments of herpes simplex virus
      and negative for varicella-zoster virus and cytomegalovirus. Ten normal aqueous
      specimens were negative for all three. Herpes simplex virus may play a role in
      the origin of Posner-Schlossman syndrome.

PMID- 7785698
TI  - Infection after radial keratotomy.
AB  - PURPOSE/METHODS: Eight years after eight-incision radial keratotomy, a corneal
      ulcer developed around the inferotemporal incision in an otherwise healthy 39
      year-old man. There was no history of corneal trauma or contact lens wear.
      RESULTS/CONCLUSIONS: Both Fusarium and Acanthamoeba organisms were eventually
      isolated from the ulcer. A therapeutic keratoplasty was performed. Inferotemporal
      incisions may be predisposed to epithelial breakdown and infection many years
      after radial keratotomy.

PMID- 7785700
TI  - Asymmetric canthaxanthin retinopathy.
AB  - PURPOSE/METHODS: We studied a case of crystalline retinopathy occurring after
      prolonged use of oral canthaxanthin. The patient was followed up for 38 months
      during which time she sustained a branch retinal vein occlusion in her left eye.
      RESULTS/CONCLUSIONS: An asymmetric appearance to the crystalline deposition was
      noted with increased sedimentation seen in the left eye. Vascular alterations
      after a branch retinal vein occlusion may lead to local stasis that may
      exacerbate the development of canthaxanthin retinopathy.

PMID- 7785699
TI  - Psoriatic corneal abscess.
AB  - PURPOSE/METHODS: We examined a patient with psoriasis and stromal infiltrate that
      was treated with topical corticosteroids. RESULTS/CONCLUSIONS: The patient
      gradually improved and the stromal infiltrate diminished. The cause of psoriasis
      and its ocular manifestations remains unknown. A corneal abscess without
      epithelial infiltration that responds to topical corticosteroid therapy may
      represent a specific ocular manifestation of psoriasis.

PMID- 7785701
TI  - Scleromalacia after retinal detachment surgery.
AB  - PURPOSE/METHODS: A 34-year-old man developed severe scleral thinning with
      imminent prolapse after conventional retinal detachment repair, including pars
      plana vitrectomy, endolaser photocoagulation, and perfluoropropane injection.
      Cadaveric dura mater was used to repair the scleral defect. RESULTS/CONCLUSION:
      The cause of scleromalacia in this case remains to be determined. Commercially
      prepared cadaveric dura mater can be successfully used as a tectonic graft for
      the treatment of scleral thinning.

PMID- 7785702
TI  - White-centered retinal hemorrhages as an early sign of preeclampsia.
AB  - PURPOSE/METHOD: We examined a pregnant patient who had symptomatic white-centered
      retinal hemorrhages. Severe preeclampsia rapidly developed despite the patient
      not having hypertension, proteinuria, or edema at initial examination.
      RESULTS/CONCLUSIONS: Retinal hemorrhages gradually resolved without treatment and
      visual acuity returned to 20/20 six months after emergency delivery of a healthy
      infant. Retinal or choroidal vascular abnormalities in pregnant patients may be
      caused by early preeclampsia and immediate obstetric referral is indicated.

PMID- 7785704
TI  - Duane's retraction syndrome associated with chromosome 4q27-31 segment deletion.
AB  - PURPOSE/METHOD: A 15-year-old boy with bilateral blepharoptosis, bilateral type 1
      Duane's retraction syndrome, and mild learning difficulties underwent chromosomal
      analysis. RESULTS/CONCLUSIONS: A de novo deletion of a segment of the long arm of
      chromosome 4 (4q27-31) was found. To our knowledge, no other individuals with
      this chromosome deletion have Duane's retraction syndrome. The chromosome defect
      lies close to the epidermal growth factor gene, 4q25, which was recently linked
      to Rieger's syndrome. We suggest that families with Duane's retraction syndrome
      should be assessed for linkage to the area of 4q27-31.

PMID- 7785703
TI  - Branch retinal vein occlusion in a child with ocular sarcoidosis.
AB  - PURPOSE/METHODS: A 13-year-old girl had unilateral iridocyclitis and
      periphlebitis. The periphlebitis exacerbated, and macular edema as well as branch
      retinal vein occlusion developed. The patient was treated with systemic
      corticosteroids. RESULTS/CONCLUSIONS: The lesions responded well to systemic
      corticosteroids. Histologic diagnosis of sarcoidosis was obtained by
      transbronchial lung biopsy. Ocular lesions in this child were similar to those
      seen in adult sarcoidosis. Branch retinal vein occlusion may occur as a rare
      vascular complication of sarcoidosis.

PMID- 7785705
TI  - Tonic pupil and orbital glial-neural hamartoma in infancy.
AB  - PURPOSE/METHODS: Tonic pupils in early childhood are rare. We studied an
      otherwise healthy 31/2-month-old girl who had a right pupil that was poorly
      reactive to light, without other signs of oculomotor nerve palsy.
      RESULTS/CONCLUSIONS: Constriction of the right pupil after instillation of 0.125%
      pilocarpine eyedrops confirmed denervation hypersensitivity, consistent with a
      tonic pupil. There was no strabismus or proptosis. A magnetic resonance imaging
      scan demonstrated a right orbital mass, interposed between the lateral and
      inferior recti muscles. Biopsy was consistent with a benign, glial-neural
      hamartoma. Thus, in this young patient, a tonic pupil was associated with a
      benign orbital mass.

PMID- 7785706
TI  - Horner's syndrome in subadventitial carotid artery dissection and the role of
      magnetic resonance angiography.
AB  - PURPOSE/METHODS: A 47-year-old man with a postganglionic Horner's syndrome and
      severe right facial pain was found to have a normal carotid angiogram. We
      obtained a magnetic resonance angiogram of the neck because of our continued
      clinical suspicion of dissection. RESULT/CONCLUSION: An area of hyperintensity
      was identified along the lumen of the right internal carotid artery, suggesting a
      subadventitial dissection. Magnetic resonance angiography is a noninvasive,
      sensitive technique for identifying some carotid dissections.

PMID- 7785707
TI  - Oval defect in detached posterior hyaloid membrane in idiopathic preretinal
      macular fibrosis.

PMID- 7785708
TI  - Cyclodeviation in skew deviation.

PMID- 7785709
TI  - Silicone intubation without intranasal fixation for treatment of congenital
      nasolacrimal duct obstruction.

PMID- 7785710
TI  - Progression of nuclear sclerosis and long-term visual results of vitrectomy with
      transforming growth factor beta-2 for macular holes.

PMID- 7785711
TI  - Who is the keeper of occupational therapy's practice and knowledge?

PMID- 7785713
TI  - Reasoning and the art of therapy for spinal cord injury.
AB  - In this pilot study, qualitative methodology was used to examine the clinical
      reasoning of four experienced occupational therapists as they presented and
      modified therapeutic activities to treat patients with spinal cord injuries. The
      therapists demonstrated the multi-layered thinking discovered in previous
      research, but hierarchical structuring of knowledge emerged as an unexpectedly
      dominant theme in their reasoning. Examples of hierarchical thinking about
      therapeutic activity included creating mental files of therapy tasks and
      materials sequenced from elementary to advanced and determining the level of
      difficulty at which to present an activity in order to build the patient's skills
      in a stepwise manner. The therapists reported that they learned to make decisions
      about the use of activities in treatment by observing skilled clinicians and by
      treating patients.

PMID- 7785712
TI  - Building inclusive community: a challenge for occupational therapy. 1994 Eleanor
      Clarke Slagle Lecture.
AB  - Occupational therapy was founded on values of choice, relevance, and active
      participation in meaningful occupations. To assure choice in daily living,
      learning, work, and play for persons with disabilities or significant health
      issues, occupational therapy practitioners are challenged to gain increased
      understanding of the unique culture and community of each person and family with
      whom they work; create opportunities for these persons to develop their
      capabilities in community settings of their choice; promote more interactive
      models of practice in which the practitioner affects the arrangements between the
      person and society; work with communities to welcome the gifts of diversity; and
      develop skill in analyzing environments and facilitating environmental
      interaction. The environment category of the spatiotemporal adaptation theory is
      expanded and a communication model for collaboration in building individual
      community is proposed as means for addressing the challenges.

PMID- 7785714
TI  - Spherical grip strength in children 3 to 6 years of age.
AB  - OBJECTIVE: The purpose of this study was to establish normative data on spherical
      grip strength of children 3 to 6 years of age with the Martin Vigorimeter.
      METHOD: Two hundred twenty-five preschoolers in the Kalamazoo, Michigan, area
      were tested with standardized positioning and instructions. The mean of three
      trials for each hand was used as the grip-strength score. A repeated measure
      design was used and the right and left hands were alternated during testing to
      allow a 20-sec rest period between trials. Hand width also was measured in inches
      from the head of the second metacarpal to the head of the fifth metacarpal.
      RESULTS: Hand width and grip strength were significantly correlated for both the
      right (p < .0001) and the left hands (p < .001). Grip strength increased linearly
      across all of the age groups (p < .001). The results of paired t tests did not
      show a significant difference in grip strength between the right and left hands
      or between boys and girls. A table of mean grip-strength scores and hand width
      measurements along with their standard deviations is presented for clinical use.
      CONCLUSION: The vigorimeter could be used to assess the grip strength of children
      with rheumatic disorders without putting excessive pressure on the joints or skin
      of the hand.

PMID- 7785715
TI  - Functional capacity evaluations of persons with chronic fatigue immune
      dysfunction syndrome.
AB  - Chronic Fatigue Immune Dysfunction Syndrome (CFIDS) is estimated to affect 2 to 5
      million people in the United States. Despite its high incidence, persons with
      CFIDS have been neglected by the medical community mainly because there is no
      singular confirming diagnostic test or proven effective treatment. The CFIDS
      population is incorrectly stereotyped as upper-middle-class, white, female
      hypochondriacs; consequently, symptoms often are belittled or ignored. In
      reality, CFIDS is a severe medical condition that affects women, men, and
      children of any race and often causes long-term or total disability. The results
      of a modified functional capacity evaluation developed by the author and
      completed on 86 persons with CFIDS between 1988 and 1990 confirm that this
      population has severe physical and cognitive disabilities that affect their
      professional, familial, and social lives. The results of these evaluations are
      used to present a profile of persons with CFIDS that can serve as a basis for
      understanding this population and for guiding intervention.

PMID- 7785716
TI  - A problem-based learning curriculum for occupational therapy education.
AB  - To prepare practitioners and researchers who are well equipped to deal with the
      inevitable myriad changes in health care and in society coming in the 21st
      century, a new focus is needed in occupational therapy education. In addition to
      proficiency in clinical skills and technical knowledge, occupational therapy
      graduates will need outcome competencies underlying the skills of critical
      reflection. In this article, the author presents (a) the rationale for the need
      for change in occupational therapy education, (b) key concepts of clinical
      reasoning and critical reflection pertaining to the outcome such change in
      occupational therapy education should address, (c) problem-based learning as a
      process and educational method to prepare occupational therapists in these
      competencies, and (d) the experience of the Program in Occupational Therapy at
      Shenandoah University in Winchester, Virginia, in implementing a problem-based
      learning curriculum.

PMID- 7785717
TI  - Using the case method to develop clinical reasoning skills in problem-based
      learning.
AB  - Clinical reasoning is increasingly recognized as a crucial component of the
      occupational therapy process. Different types of clinical reasoning used by
      occupational therapists have been identified, including scientific, procedural,
      interactive, narrative, conditional, and pragmatic reasoning. This article
      describes the use of the case method in the University of New Mexico
      undergraduate occupational therapy curriculum to facilitate development of
      occupational therapy students' problem-solving and reasoning abilities. The case
      method is a component of problem-based learning that emphasizes small group work
      to solve clinical problems that are presented as case studies. Students are
      presented with a variety of case formulas including paper or written cases,
      videotape cases, simulated client cases, and real client cases to promote the
      development of specific types of clinical reasoning. Problem-based learning may
      also hold promise as an educational strategy for fieldwork students and
      clinicians.

PMID- 7785719
TI  - An education program on acquired immunodeficiency syndrome for patients with
      mental illness.

PMID- 7785718
TI  - A group approach to mental health fieldwork.
AB  - Fieldwork opportunities in mental health settings are limited and difficult to
      find. There is increased pressure for occupational therapy supervisors to accept
      more students although they have less time to devote to them. This article
      describes a group approach to training occupational therapy students that was
      used at one fieldwork site. The occupational therapy staff members were each
      responsible for specific teaching assignments that allowed them to work with a
      number of students simultaneously. Program development and evaluation meetings
      created an alternative forum for exploring ideas and practice issues and for
      providing guidance and supervision. This approach reduced the amount of time each
      therapist spent with students, provided students with several role models, and
      encouraged independent thinking in students.

PMID- 7785720
TI  - Vestibular rehabilitation with graded occupations.
AB  - These three case reports are examples of the use of graded, purposeful activities
      in remediating the symptoms of vestibular disorders. Therapists can design
      individualized treatment plans for each patient by incorporating activities of
      interest to the patient. The treatment activities must include the particular
      head movements and positions that elicit vertigo during assessment. Additionally,
      activities must be interesting to the individual patient. Use of interesting
      activities may sustain the patient's interest and motivation for the treatment
      program and enable the patient to relate the learning process to real life
      experience. The principle that graded, repetitive head movement exercise is
      efficacious in reducing vertigo and disequilibrium in patients with vestibular
      disorders is now well accepted among physicians and therapists who treat these
      patients. The principle of adding meaning or purpose to otherwise rote exercise
      is well accepted among occupational therapists and is supported by evidence from
      the empirical literature (Heck, 1988; Kircher, 1984; Yoder, Nelson, & Smith,
      1989). This concept of adding purpose to repetitive exercise may now be extended
      to the treatment of patients with peripheral vestibular disorders.

PMID- 7785721
TI  - Certified occupational therapy assistants need a name change: a response to
      Hirama.

PMID- 7785722
TI  - Ohalo II H2: a 19,000-year-old skeleton from a water-logged site at the Sea of
      Galilee, Israel.
AB  - The discovery of well-preserved human remains at the site of Ohalo II in the
      northern Jordan Valley substantially augments the meager fossil record of the
      Levantine late Upper Pleistocene. The Ohalo II H2 specimen, dated to ca. 19,000
      B.P., is the most complete early Epipaleolithic hominid discovered in Israel and
      promises to contribute to the clarification of a number of problematic issues in
      the local evolution of anatomically modern humans. In addition to a description
      of the burial and its Kebaran context, a detailed anatomical description of the
      skeleton is offered and morphometric comparisons are made to other Upper
      Paleolithic hominids. Ohalo II H2 is shown to demonstrate affinities in the
      craniofacial skeleton to fossils from the early Upper Paleolithic and late Epi
      Paleolithic of the Levant.

PMID- 7785723
TI  - Faunal assemblage seriation of southern African Pliocene and Pleistocene fossil
      deposits.
AB  - Fossil assemblages from the Pliocene and Pleistocene of southern Africa were
      seriated in order to give a better idea of their relative chronology. Time
      sensitive mammals were selected for calculation of the Faunal Resemblance Index
      among 17 site units. On the basis of a logistical seriation and subsequent site
      analysis, the following sequence of sites was deemed most probable: Makapansgat
      Member 3, Makapansgat Member 4, Taung Dart deposits, Sterkfontein Member 4 and
      Taung Hrdlicka deposits, Sterkfontein Member 5 (in part) and Kromdraai B,
      Kromdraai A and Swartkrans Member 1, Swartkrans Member 2, Swartkrans Member 3,
      Plovers Lake, Cornelia, Elandsfontein Main Site, Cave of Hearths Acheulian
      levels, Florisbad and Equus Cave and Klasies River Mouth.

PMID- 7785724
TI  - Sexual dimorphism in the snub-nosed langurs (Colobinae: Rhinopithecus).
AB  - Sexual dimorphism in the dentition and skeleton of the four extant species of
      snub-nosed langurs, Rhinopithecus (R.) bieti, R. (R.) brelichi, R. (R.) roxellana
      and R. (Presbytiscus) avunculus, was studied. The species shared a similar
      general pattern of sexual dimorphism, but were found to differ in respects that
      appear to reflect the influence of disparate socioecological and environmental
      factors. All the species showed marked canine dimorphism but the very high degree
      of canine dimorphism in R. bieti appeared to be due to the intensity of intermale
      competition for mates during a temporally restricted breeding season, and
      possibly also to the intensity of competition between males for other resources
      during other times of the year. Sexual dimorphism in the postcranial skeleton of
      Rhinopithecus species was also most pronounced in R. bieti and may be related to
      the relatively higher frequency of terrestrial locomotion in males of the
      species.

PMID- 7785725
TI  - Nonlinearity in the relationship between bone Sr/Ca and diet: paleodietary
      implications.
AB  - Strontium in archaeological human bones is widely, almost paradigmatically, used
      as a measure of the relative dietary abundances of plants and meat. Quantitative
      modeling reveals, however, that there is not a simple proportional relationship
      between bone strontium and the dietary plant/meat ratio. While knowledge of
      specific foods and their compositions may permit accurate calculation of average
      bone strontium levels, knowledge of bone strontium does not inversely allow
      accurate calculation of specific foods. Although bone strontium quantitatively
      reflects the average dietary Sr/Ca ratio, it is disproportionately sensitive to
      high-calcium foods and can be easily affected by minor dietary constituents and
      culinary practices. Bone strontium, and by analogy, barium, should be seen as a
      reflection of the high-mineral dietary components rather than a quantitative
      index of trophic position.

PMID- 7785726
TI  - Pattern profile analysis of hominid and chimpanzee hand bones.
AB  - In a study designed to complement morphological research on hominid hand bones,
      length and width measurements of the thumb, index, and middle rays were obtained
      from radiographs of modern human hands. These rays are primary in precision
      gripping postures and are therefore the ones most relevant for investigating
      evolutionary changes in fine manipulation. Pattern profile analysis allows
      individuals or samples to be plotted against a reference sample in standard
      deviation units, or Z-scores. It provides an indication of how different
      measurements are from modern human averages, while taking into consideration the
      degree of variation present within modern human samples. A pattern profile for
      chimpanzees is clearly distinct from humans but quite similar to that of a
      bonobo, demonstrating the promise of pattern analysis. Partial pattern profiles
      of several of the more complete early hominid bones from Hadar, Swartkrans, and
      Olduvai (O.H. 7) are presented and compared. Hadar bones are long and wide at
      midshaft relative to articular widths; both body-size effects and functional
      differences are likely. Thumb distal phalanges from Swartkrans and Olduvai both
      have relatively small base widths, but they differ in other proportions. Two
      first metacarpals from Swartkrans show distinct patterns. The profiles of La
      Ferrassie I and Shanidar IV show the characteristically large Neanderthal distal
      phalanges. Profiles of Skhul IV and Predmost III are alike in some regions with
      reference to modern North American white males, though they are less similar
      overall than are those of the two Neanderthals.

PMID- 7785727
TI  - Enamel hypoplasia in the middle pleistocene hominids from Atapuerca (Spain).
AB  - The prevalence and chronology of enamel hypoplasias were studied in a hominid
      dental sample from the Sima de los Huesos (SH) Middle Pleistocene site at the
      Sierra de Atapuerca (Burgos, northern Spain). A total of 89 permanent maxillary
      teeth, 143 permanent mandibular teeth, and one deciduous lower canine, belonging
      to a minimum of 29 individuals, were examined. Excluding the antimeres (16
      maxillary and 37 mandibular cases) from the sample, the prevalence of hypoplasias
      in the permanent dentition is 12.8% (23/179), whereas the deciduous tooth also
      showed an enamel defect. No statistically significant differences were found
      between both arcades and between the anterior and postcanine teeth for the
      prevalence of hypoplasias. In both the maxilla and the mandible the highest
      frequency of enamel hypoplasias was recorded in the canines. Only one tooth (a
      permanent upper canine) showed two different enamel defects, and most of the
      hypoplasias were expressed as faint linear horizontal defects. Taking into
      account the limitations that the incompleteness of virtually all permanent
      dentitions imposes, we have estimated that the frequency by individual in the SH
      hominid sample was not greater than 40%. Most of the hypoplasias occurred between
      birth and 7 years (N = 18, X = 3.5, SD = 1.3). Both the prevalence and severity
      of the hypoplasias of the SH hominid sample are significantly less than those of
      a large Neandertal sample. Furthermore, prehistoric hunter-gatherers and historic
      agricultural and industrial populations exhibit a prevalence of hypoplasias
      generally higher than that of the SH hominids. Implications for the survival
      strategies and life quality of the SH hominids are also discussed.

PMID- 7785728
TI  - Brief communication: estimation of adult stature from the calcaneus and talus.
AB  - Calcanei and tali of 100 skeletons in the Hamann-Todd Collection at the Cleveland
      Museum of Natural History were measured. The skeletons represented 50 males and
      50 females distributed equally by race, i.e., whites and blacks. Linear
      regression equations, with standard errors ranging from 4.09 to 6.11 cm, were
      derived from these measurements for the purpose of estimating stature. Two
      independent control samples, including one comprised of remains of American
      servicemen lost in World War II and the Korea and Vietnam wars, were tested with
      relatively accurate results.

PMID- 7785729
TI  - [The treatment of hirsutism].

PMID- 7785730
TI  - [So-called familial forms of uterine myoma].

PMID- 7785731
TI  - [The transplacental passage and distribution of ceftazidime in the fetal and
      maternal organs in a 2nd-trimester abortion].
AB  - Transplacental passage of ceftazidime was studied in 17 women with second
      trimester pregnancy which had to be discontinued for medical causes. A single
      intramuscular injection of the antibiotic resulted in creation of therapeutically
      active concentrations in fetal blood and organs, amniotic fluid, and placenta.
      Transplacental passage of ceftazidime from the mother to the fetus was 19.12%,
      diffusions to the amniotic fluid 14.46%, diffusion to the placenta 48.46%.
      Ceftazidime may be effective for the prevention and therapy of fetal intrauterine
      infection and chorioamnionitis.

PMID- 7785732
TI  - [A prospective study of antipyrine pharmacokinetics in pregnancy].
AB  - Pharmacokinetics of a single dose of antipyrin (10 mg/kg) subjected to
      biotransformation at the expense of microsomal oxidation of its molecule in the
      liver was studied in 6 healthy nonpregnant women and in 24 women within the
      frames of a prospective follow-up starting from the early terms of gestation; 7
      of these women developed edemas, proteinuria and/or hypertension in the course of
      follow-up. The results permit us consider that a test with a single antipyrin
      dose may be used as a marker to characterize drugs with similar metabolic
      transformations when used in pregnant women. The identity of pharmacokinetic
      regularities of antipyrin in samples of blood plasma and saliva permit the use of
      saliva as biological material for assessment of the metabolic profile of pregnant
      women. The problem of drug therapy in the third trimester is closely connected
      with specific features of pharmacokinetic profile detected by antipyrin test both
      in normal and complicated gestation. Our data evidence that the third trimester
      is characterized by special tension of the metabolic processes. A complicated
      course is associated with unambiguous changes in the metabolic activity of drugs,
      this necessitating special attention of a physician to drug dose.

PMID- 7785733
TI  - [The steroid content of the amniotic fluid in the 1st and 2nd pregnancy
      trimesters in 21-hydroxylase insufficiency and in fetal central nervous system
      defects].
AB  - A total of 103 samples of amniotic fluid obtained by transabdominal amniocentesis
      were examined, 52 of these from women at a high risk of giving birth to children
      with congenital adrenal hyperplasia due to 21-hydroxylase (21-OH) deficiency and
      30 ones with fetuses with different neural tube malformations. 17
      Hydroxyprogesterone was found to be a reliable marker indicating the disease in
      fetuses from the group at risk of hereditary 21-OH deficiency. This marker can be
      effectively used as early as in the 1 gestation trimester. Fetal CNS defects are
      associated with hypofunction of the adrenal cortex in the II gestation trimester,
      observed in 60-63% of cases with hydrocephalus, anencephaly, or microcephaly.
      Since the function of fetal adrenals is of paramount importance for the
      development and maturation of a fetus, it should be examined in case of
      developmental defects of the neural tube, in order to predict the effect of
      prenatal treatment.

PMID- 7785735
TI  - [The main trends of research in obstetrics in the 90s].

PMID- 7785736
TI  - [The clinical importance of the dopplerometric study of the blood flow in the
      normal iliac, uterine and ovarian arteries, in myoma and in endometriosis interna
      of the corpus uteri].
AB  - Dopplerometric investigation of pelvic arteries was carried out in 30 women
      without gynecologic diseases, in 51 patients with internal endometriosis, and 48
      ones with uterine myomas. Internal endometriosis of the uterus was found to be
      characterized by specific qualitative changes in spectral curves of bloodstream
      velocity in the internal iliac and uterine arteries. Moreover, progressive
      changes in spectral curves related to dissemination of endometrioid heterotopias
      were revealed. In patients with uterine myomas combined with internal
      endometriosis disorders of peripheral circulation typical of endometriosis
      predominated.

PMID- 7785734
TI  - [The importance of the vertical transmission of enteroviruses in the epidemiology
      of congenital viral infections].
AB  - A total of 814 newborns were examined using a highly sensitive method of
      indication of viral antigens. A high incidence of congenital viral infection was
      revealed: 450 per 1000 live-born children. Enteroviral infections (mainly
      Coxsackie) ranked first in prevalence. These infections in the newborns are
      mainly caused by the vertical transmission of enteroviruses from mothers with
      persistent forms of infections. Virtually all the other viruses (influenza
      viruses, cytomegalovirus, herpes simplex virus, parainfluenza, measles, and
      rubella viruses) are detected in the newborns included in the group at a high
      risk of vertical transmissions of enteroviral infections. In the majority of
      cases the said viruses were detected in association with enteroviruses.

PMID- 7785738
TI  - [Changes in the phosphoinositide metabolism in the blood and tissues of benign
      and malignant uterine tumors].
AB  - Measurements of phosphoinositide levels in the blood, immunocompetent cells, and
      tumors of 105 patients with uterine myomas, 24 patients with cancer of the corpus
      uteri, and 17 ones with uterine sarcoma showed that the parameters of
      phosphoinositide metabolism in the blood of patients with tumors of the uterus
      reliably differed from those in healthy women. The content of
      phosphatidylinosites and other phosphoinositide fractions in patients with
      uterine myomas reliably differed from those in patients with malignant tumors of
      the uterus, this permitting the use of such measurements in the differential
      diagnosis. Phosphoinositide mechanism of development of tumors of the uterus is
      discussed, which is related to the "new" phosphoinositides and secondary
      messengers directly participating in transfer of cell growth signals.

PMID- 7785737
TI  - [The prevention of the adhesive process after surgical interventions in
      gynecological patients in the reproductive period].
AB  - Dynamic laparoscopy making use of special tubes was carried out in 149 patients
      (30 with acute inflammatory diseases of the uterine tubes, 80 following
      reconstructive surgery on the tubes suffering from tuboperitoneal sterility, 9
      operated on the internal genitals). Repeated laparoscopic examinations were
      carried out in the course of 14 days, every 2-3 days. The course of the
      postoperative period was assessed by the presence of adhesions, hyperemia, edema,
      and exudation. Adhesions were separated, during mixtures were delivered including
      antibiotics, corticosteroids, enzymes, rheopolygluquins; chromohydrotubations was
      carried out. Dynamic laparoscopy in patients with inflammatory diseases of the
      internal genitals helped detect positive results 2-3 days after intensive care
      was started and prevent adhesions. This method appears to be particularly
      valuable if used after inflammatory processes and interventions on the internal
      genitals in young, more so in nulliparous women planning to have children in
      future.

PMID- 7785739
TI  - [Coagulation hemostasis in pregnant women with toxicosis and the effect of
      vitamin antioxidants].

PMID- 7785740
TI  - [The characteristics of uterine hemodynamics during labor pains].

PMID- 7785741
TI  - [Labor during the collision of twins].

PMID- 7785742
TI  - [The ultrasonic characteristics of breast status in gynecologic patients].

PMID- 7785743
TI  - [Memoirs of service on a military ambulance train in World War II].

PMID- 7785744
TI  - [The central and peripheral maternal hemodynamics in an uncomplicated course of
      pregnancy and in EPH gestosis].

PMID- 7785745
TI  - [Endothelins and their role in obstetrical pathology].

PMID- 7785746
TI  - Clinical experience with Tilavist: an overview of efficacy and safety.
AB  - A programme of clinical studies was carried out to determine the basic efficacy
      and safety of 2% nedocromil sodium eye drops (Tilavist) in treating allergic
      conjunctivitis, in 2,905 patients from 3-76 years of age. Results of all the
      double-masked placebo comparative studies completed to date-five in vernal
      keratoconjunctivitis (VKC), five in perennial (PAC) and 16 in seasonal allergic
      conjunctivitis (SAC)-have been assessed in a statistical overview analysis.
      Nedocromil sodium, administered four times daily to 153 patients with VKC, was
      significantly more effective than placebo (155 patients) and in the clinicians'
      opinion gave good control in 76% of cases, compared with 46% for placebo (p <
      0.001). Patients with chronic symptoms of PAC also responded better to nedocromil
      sodium given four times daily (n = 146) rather than twice daily (n = 86), and
      significantly more patients (p < 0.001) were effectively controlled by four times
      daily treatment with nedocromil sodium (72%) than with placebo (47%; n = 156).
      Twice-daily dosage with nedocromil sodium (n = 677) was adequate for SAC,
      however, and the treatment was statistically better than placebo (p < 0.01-p <
      0.001) whether dosed twice or four times daily. Speed of action was assessed in
      seven SAC studies in which 79% of all patients (n = 295) using nedocromil sodium
      had experienced relief of symptoms when questioned, half of them within 15
      minutes and 74% during the first hour after dosing. Test treatments were well
      accepted by both adults and children, and there were no major adverse events.
      Minor irritations reported more frequently with nedocromil sodium than placebo
      were stinging or burning of the eyes on application of the drops and a
      distinctive taste, noted by 5% of the active treatment group (n = 1,552).

PMID- 7785747
TI  - Comparative therapeutic studies with Tilavist.
AB  - Comparative clinical trials which include known therapies as well as placebos are
      essential in constructing a solid basis from which to 'launch' any new drug. This
      applies especially to eye drops for treatment of seasonal allergic
      conjunctivitis, where the symptomatology, already dependent on the vagaries of
      the natural pollen challenge season, is further influenced by a positive washing
      action of the placebo eye drops. Tilavist (2% nedocromil sodium ophthalmic
      solution) has therefore been compared with sodium cromoglycate eye drops and non
      sedating antihistamine tablets, both mainstays in the treatment of seasonal
      allergy, in a series of double-masked, placebo-controlled, mainly multicentre
      studies. Nedocromil sodium, twice or four times daily, proved as effective
      overall as sodium cromoglycate (2% or 4% four times daily) in three seasonal
      trials, and was the more effective treatment in a study of patients with vernal
      keratoconjunctivitis. Its efficacy was most evident during peak periods of pollen
      challenge, when neither placebo nor sodium cromoglycate eye drops controlled
      breakthrough symptoms. Three further seasonal studies showed nedocromil sodium
      eye drops to be as effective as standard oral doses of astemizole and
      terfenadine, whilst a faster onset of action than terfenadine was reported in one
      multicentre study.

PMID- 7785748
TI  - Current practice: diagnosis and treatment in primary healthcare.
AB  - In a primary healthcare facility, there are certain 'rules of thumb' that can be
      recommended for the diagnosis and treatment of conjunctivitis. The type of
      discharge is a crucial factor in the differential diagnosis and can also be a
      clue towards the management in primary care. It is important to identify whether
      the conjunctivitis is an isolated case or part of another disease, and if it is
      acute or chronic, and I would suggest taking a smear or culture sample whenever
      possible. When the aetiology is not clear, I would try antibiotics. If the
      patient is allergic, and an allergic conjunctivitis is suspected, the best
      management today is to use mast cell stabilisers, and combine these with
      conservative measures of frequent washings, and compresses. If the aetiology
      remains doubtful, or if there is no obvious improvement using these treatments,
      the patient should be re-evaluated and/or referred to an ophthalmologist or
      specialist eye centre. The use of corticosteroids for conjunctivitis should
      certainly be avoided in primary healthcare. Conjunctivitis is often self-limited
      and the drug-induced consequences of improper management can be far more
      devastating than the disease itself.

PMID- 7785749
TI  - The pathophysiology of ocular allergy: current thinking.
AB  - Seasonal allergic conjunctivitis is the only ocular disease to involve solely
      Type-1 hypersensitivity, the other main forms of ocular allergy--perennial
      allergic conjunctivitis, vernal and atopic keratoconjunctivitis and giant
      papillary conjunctivitis--each having a more complex immunological basis and a
      chronic inflammatory component. Involvement of secondary inflammatory cells,
      particularly eosinophils, in addition to the mast cells resident in the
      conjunctival substantia propria, can lead to more serious corneal damage with
      vision-threatening potential. Thoughtful management of allergic conjunctivitis is
      needed in order to control the ocular inflammation without incurring steroid
      induced side-effects, and patient education is also an important factor in
      maintaining optimal allergen avoidance, especially in the more severe and chronic
      cases. Laboratory models can be helpful in assessing the potential of new drugs,
      and SWR mice (topically sensitised and challenged with short ragweed) show
      clinical signs of allergic conjunctivitis, together with mast cell and eosinophil
      involvement, remarkably similar to the human pathophysiology. The
      antiinflammatory activity of both steroids and nedocromil sodium observed in this
      animal model supports therapeutic evidence of the usefulness of second-generation
      mast cell stabilising drugs in the treatment of ocular allergy.

PMID- 7785750
TI  - [Cerebral vasospasm following aneurysmal subarachnoid hemorrhage. Therapeutic
      value of treatment with calcium antagonists, hypervolemic hemodilution and
      induced arterial hypertension].
AB  - Only 53%-58% of patients with a subarachnoid haemorrhage (SAB) following the
      rupture of a cerebral aneurysm survive without neurological damage. Morbidity and
      mortality are closely related to the delayed ischaemic neurological deficit due
      to cerebral vasospasm. The following review gives an account of
      pathophysiological mechanisms; the importance of treatment with calcium
      antagonists, hypervolaemic haemodilution, and induced arterial hypertension is
      discussed in light of the current literature. PATHOPHYSIOLOGY. In addition to
      other vasoactive substances in the blood, haemoglobin, which is released from
      lysed erythrocytes on the 2nd to 4th day after the haemorrhage, plays an
      important role in inducing vasospasm. An inflammatory angiopathy ensues, with
      complete resolution after 6-12 weeks. The cerebral blood flow (CBF) is reduced
      depending on the extent of vasospasm. Irreversible infarction may follow the
      decrease of CBF below a critical value. Severe vasospasm causes autoregulatory
      disturbances and reduced responsiveness of cerebral vessels to CO2. CALCIUM
      ANTAGONISTS. The calcium blocker nimodipine causes dilatation of small pial
      vessels with increased CBF. However, systemic vasodilation with the subsequent
      fall in blood pressure may limit the increase in CBF. Furthermore, it is known
      that nimodipine decreases intracellular calcium concentrations resulting in some
      protection against ischaemic cellular injury. Seven placebo-controlled clinical
      studies have shown that nimodipine improves the outcome of patients with severe
      neurological damage due to cerebral vasospasm. HYPERVOLAEMIC HAEMODILUTION.
      Volume expansion and haemodilution to a hematocrit of 30%-33% is suggested to
      improve cerebral perfusion during vasospasm. The central venous and pulmonary
      capillary wedge pressures should be 10-12 mm Hg and 15-18 mm Hg, respectively.
      But there is no evidence of improved outcome with this measure, and pulmonary
      edema is a frequent side effect. However, impairment of cerebral perfusion and
      increased neurological damage can be demonstrated with hypovolaemia and
      haemoconcentration. INDUCED ARTERIAL HYPERTENSION. In the presence of cerebral
      vasospasm and resulting autoregulatory disturbances, cerebral perfusion can be
      increased by raising systemic arterial pressure. This measure, too, fails to
      improve neurological outcome. CONCLUSION. Treatment of cerebral vasospasm
      following a SAB aims to avoid any impairment of cerebral perfusion. Hypovolaemia
      and haemoconcentration have to be corrected. Normoventilation should be
      established to avoid hypocapnic vasoconstriction. Nimodipine should be
      administered continuously after a SAB. In view of the autoregulatory
      disturbances, systemic hypotension with its danger of decreased CBF must be
      prevented. The importance of hypervolaemic haemodilution and/or induced arterial
      hypertension is not clear. Despite therapeutic efforts, the number of patients
      who have survived a SAB without a substantial neurological deficit has not
      increased.

PMID- 7785751
TI  - [The role of autologous blood transfusion in the the Federal Republic of Germany.
      Results of a 1993 questionnaire. 1. The reunited Germany].
AB  - The objective of the study was to evaluate the role of autologous blood
      transfusion in current clinical practice in the Federal Republic of Germany after
      reunification. METHODS: Questionnaires were sent to the anaesthesia departments
      of 684 German hospitals in January 1993. The sample consisted of 400 randomly
      selected hospitals from the former West Germany ("old federal states") and 284
      hospitals from the former German Democratic Republic ("new federal states"). Only
      hospitals with more than 25 surgical beds were included in the study. The
      questionnaire contained 36 questions related to (1) general information on the
      hospital, (2) preoperative autologous blood donation (PABD), (3) preoperative
      plasmapheresis, (4) isovolaemic haemodilution, (5) perioperative blood salvage,
      and (6) general management of blood transfusion. RESULTS: A total of 502
      completed questionnaires (73%) were returned, 305 from hospitals in the "old
      federal states" and 197 from hospitals in the former German Democratic Republic.
      Nine per cent of the responding hospitals were running their own transfusion
      services, and 56% were located in the vicinity of a regional blood bank. The
      overall proportion of surgical procedures requiring perioperative blood
      transfusion ranged from 1% to 90% (median 10%). PABD was performed "not at all"
      in 18%, "rarely" in 20% "occasionally" in 27%, "frequently" in 17%, and "mostly"
      in 16% of the responding hospitals. The principal use of PABD was in orthopaedic
      surgery and cardiac surgery (83% and 70% of the departments in question,
      respectively). In more than 50% of the hospitals reporting, the PABD service was
      run by the anaesthesia department. Patients not meeting the established criteria
      for homologous blood donors were accepted for autologous blood donation
      "frequently" and "mostly" in 20% and 12% of the hospitals, respectively, but at
      most "occasionally" in 63% of the hospitals. Preoperative plasmapheresis was
      performed in 12% of the responding hospitals. Autologous fresh frozen plasma
      predominantly was used for volume replacement, and for prevention of coagulation
      disorders when major blood loss was anticipated. Isovolaemic haemodilution was
      performed "not at all" in 28%, "rarely" in 19%, "occasionally" in 28%,
      "frequently" in 16%, and "mostly" in 8% of the responding hospitals. The reasons
      most frequently invoked for not performing haemodilution were "too time
      consuming" and "too little blood-saving effect". Cell separators for
      perioperative blood salvage were available in 30% of the responding hospitals. Of
      the other hospitals not equipped with cell-washing devices, 11% performed
      perioperative blood salvage of unprocessed blood by means of simple collection
      devices. Some 80% of those hospitals using intraoperative autotransfusion devices
      also performed blood salvage postoperatively. The principal use of perioperative
      blood salvage was in cardiac surgery, orthopaedics, and vascular surgery (90%,
      54%, and 54% of departments, respectively). Some 48% of the responding
      anaesthetists "mostly" considered haemoglobin levels of 8-10 g/dl acceptable in
      patients without cardiopulmonary disease, but only 18% did so in patients with
      cardiopulmonary disease. CONCLUSIONS: Although available in the majority of
      hospitals surveyed, the simple techniques of both PABD and isovolaemic
      haemodilution are unduly neglected in routine clinical practice. The consistent
      use of both of these techniques, and the careful weighing up of the indication
      for every single blood transfusion, would not only effectively reduce homologous
      blood transfusions, but also enable even small hospitals to run successful
      autologous transfusion programmes without expensive cell-washing and
      plasmapheresis devices.

PMID- 7785752
TI  - [Quality control in anesthesiology. Results of a prospective study following the
      recommendations of the German Society of Anesthesiology and Intensive Care].
AB  - The German Social Law has required quality assurance (QA) procedures since 1989.
      The measures must be suitable to allow "comparing investigations". In 1992 the
      German Society of Anaesthesiology and Intensive Care Medicine published
      recommendations for QA in anaesthesia: most problems during an anaesthetic should
      be documented in a standardised manner, and thus, a list of 63 pitfalls, events,
      and complications (PECs) and five degrees of severity were defined. The goal of
      this study was to determine the frequency of PECs in anaesthesia and to correlate
      PECs with procedures and preoperative health status. MATERIALS AND METHODS.
      Demographic data, preoperative findings, type and duration of anaesthesia and
      operation, and kind and severity of PECs were integrated in an automatically
      readable anaesthetic data record (ARADR). During 12 months all anaesthetics in
      our department were documented by the ARADR; the records were read by a reading
      device and the data stored in a modern SQL database (Informix). Degrees of
      severity: I. PEC leads to reaction of anaesthetist, no impact for recovery room
      (RR); II. impact for RR, no impact on transfer to ward; III. significant
      prolongation of RR stay or additional monitoring on ward; IV. PEC leads to
      intensive care unit admission; V. disabling damage or death. RESULTS. In all,
      18350 anaesthetics were recorded (9055 male, 9295 female); the median age was 41
      years (1 day-99 years). In 4251 (23.2%) anaesthetics 5927 PECs occurred, 3412 of
      them involving the cardiovascular and 949 the respiratory system, the latter with
      a tendency to higher degrees of severity. PECs caused by technical equipment
      (126) or lesions caused by anaesthesists (342) had no fatal outcomes and were
      less severe. Patients in ASA class I had 12.3% anaesthetics with PECs, ASA II
      23.3%, ASA III 33.8%, ASA IV 34.9%, and ASA V 58.5%. PECs of degrees IV and V
      showed a higher incidence in the higher ASA classes. There was no fatal PEC in an
      ASA class I patient and only one (of 13615) in an elective procedure. Emergency
      cases had more frequent and more severe PECs: 16 of 19 PECs of degree V were in
      ASA class IV and V patients and 15 in emergency situations, all of them in
      surgical patients. Patients with cardiovascular disease had a more frequent
      incidence of PECs by a factor of 1.39 to 5.93 than those without such disease.
      CONCLUSIONS. Standardised incident reporting by defined PECs seems a good way to
      describe problems in anaesthesia. The types of PECs in our study had a similar
      distribution to those in other investigations, but there was a tendency to less
      frequent fatal PECs in ASA classes I to IV and more frequent ones in ASA class V.
      We expect better comparability when multicenter studies are done using identical
      methods in the next few years. Perhaps different patients collectives with
      special risks will be detected; efforts in quality improvement could focus on
      these patients.

PMID- 7785753
TI  - [Anesthesia for heart transplantation in newborn and suckling infants. Special
      aspects of the hypoplastic left heart syndrome].
AB  - Paediatric cardiac transplantation (pHTX) has gained widespread acceptance as a
      therapy in end-stage myocardial failure and some forms of congenital heart
      disease, particularly hypoplastic left heart syndrome (HLHS). The major problems
      to the anaesthesiologist in these patients are induction of anaesthesia in
      infants with HLHS and treatment of pulmonary hypertension in the early post
      bypass period. PATIENTS AND METHODS. Anaesthesia for pHTX was performed in 15
      children < 1 year of age (4-237 days); 12 suffered from HLHS, 2 from endocardial
      fibroelastosis, and 1 from dilatative cardiomyopathy. Induction of anaesthesia in
      patients with HLHS IS a challenge to the anaesthesiologist, as he has to maintain
      the delicate balance between pulmonary and systemic blood flow. Anaesthesia was
      induced with fentanyl (10-15 micrograms/kg) and pancuronium (0.2-0.4 mg/kg) and
      maintained with fentanyl (total dosage 70-100 micrograms/kg). Modification of
      ventilatory parameters such as FiO2, PaCO2, and airway pressure (PEEP, I:E ratio)
      was used to influence systemic and pulmonary blood distribution in the pre-bypass
      period according to changes in haemodynamics (target: O2 saturation approximately
      75%-80%, PaCO2 45-50 mmHg). Treatment of pulmonary hypertension in the weaning
      and early post-bypass period consisted of respiratory (PaCO2 < 30 mmHg) and
      metabolic alkalinisation (pH 7.45-7.55, BE > +3 mmol/l), the use of prostaglandin
      E1 (3-6-12 micrograms/kg.h), and the phosphodiesterase inhibitor enoximone (10-15
      micrograms/kg.min). Additional positive inotropic support was achieved with
      dobutamine (5-10 micrograms/kg.min), adrenaline (0.1-0.5 micrograms/kg.min),
      and/or orciprenaline (0.1-0.2 micrograms/kg.min) and calcium chloride (25-100
      mg/kg). RESULTS. Two children died intraoperatively and 1 on the 1st
      postoperative day from overwhelming pulmonary vascular resistance and right
      ventricular failure. Three children died between 3 and 4 weeks postoperatively, 1
      from cytomegalovirus infection, 1 from sepsis, and 1 from acute rejection. Nine
      patients survived and are well up to 5.5 years after transplantation. CONCLUSION.
      Pulmonary hypertension in the weaning and early post-bypass period is the main
      anaesthesiological problem of pHTX, particularly in children with HLHS. A
      polypragmatic approach to this problem consisting of alkalinisation, pulmonary
      vasodilatation, and inotropic support is presented and seems to be effective.
      Further improvements in concepts of pHTX are limited by the lack of donor organs.
      Though the experience with pHTX in neonates and infants is growing slowly, it
      might be a routine procedure from the anaesthesiological point of view within a
      few years in some selected centres.

PMID- 7785754
TI  - [Operations with a heart-lung machine in adult members of Jehovah's Witnesses].
AB  - Members of Jehovah's Witnesses refuse blood transfusions and blood products under
      any circumstances. Because of an improvement in blood salvage techniques in our
      centre, they are not excluded from open-heart surgery. In recent years
      recombinant human erythropoietin (rhEPO) has been applied to correct
      perioperative anemia in these patients. METHODS. Seventeen members of Jehovah's
      Witnesses who were more than 18 years of age were operated on using various blood
      salvage technique, e.g., haemoseparation and a high dose of Aprotinin. We present
      the first three patients treated with 4 x 500 U of i.v. rhEPO/kg body wt. given
      within 11 days preoperatively. Thirteen of the patients operated on had elevated
      preoperative risk factors, for instance poor left ventricle, severe aortic valve
      stenosis, metabolic syndrome, age older than 70 years, etc. In other centres that
      perform cardiac operations on members of Jehovah's Witnesses, these risk factors
      represent contraindications for open-heart surgery in these patients. RESULTS.
      Patients with rhEPO treatment showed a preoperative hematocrit increase of 7
      Vol.% within 10 days and no postoperative complications. At the 6th postoperative
      hour the hematocrit returned to the starting values; in patients without rhEPO,
      however, the hematocrit generally had not increased to preoperative values even
      by the 8th day after operation. In 9 patients with preoperative elevated risk
      factors and a postoperative relative decrease in hematocrit below 33% we observed
      an uncomplicated postoperative period. Four patients with these risk factors, a
      pronounced decrease in hematocrit and blood loss postoperatively had various
      severe complications. CONCLUSIONS. Preoperative treatment with a high dose of
      rhEPO to enhance the hematocrit and maturity by precursor red blood cells in
      patients with a hematocrit below 45 Vol.% is a possibility to compensate for the
      blood loss perioperatively and to avoid complications from a decrease in oxygen
      transport capacity. The anaemia and high blood loss postoperatively are the main
      causes for a slightly elevated operation risk in members of Jehovah's Witnesses
      in all heart centres that perform cardiac operations on these patients.
      Nevertheless, Jehovah's Witnesses should be not excluded from cardiac operations,
      since open-heart surgery without use of homologous blood is becoming a routine
      procedure.

PMID- 7785755
TI  - [Postoperative pulmonary function after lung surgery. Total intravenous
      anesthesia with propofol in comparison to balanced anesthesia with isoflurane].
AB  - After lung resection, early extubation and the rapid return of the patients
      ability to cooperate is the predominant goal. Propofol anaesthesia is
      characterised by rapid awakening and recovery of cognitive and psychomotor
      functions and is consequently desirable for such operations. Experience so far in
      lung surgery, however, is limited. Besides the level of consciousness we
      investigated various spirometric parameters after lung resection. Total
      intravenous anaesthesia was performed with propofol, while balanced anaesthesia
      was performed with isoflurane. METHODS. A total of 93 patients evaluated
      electively for wedge excision or lobectomy were enrolled in an open, prospective,
      randomised, interindividual comparative study. Sixty-three patients could be
      evaluated with complete data sets. In the evening and the morning before the
      operation the patients were premedicated orally with clorazepate 0.5-0.7 mg/kg.
      Anaesthesia was induced in group 1 with propofol (1.0-2.5 mg/kg) and maintained
      with propofol (4-12 mg/kg) in 50% O2/air. The patients in group 2 received
      methohexital (1-2 mg/kg) for induction and isoflurane (0.4-2.0 vol%) in 50%
      O2/air for the maintenance of general anaesthesia. In both groups analgesia was
      achieved by using fentanyl (up to 10 micrograms/kg) and muscle relaxation by
      using atracurium. Psychomotor tests (minimal mental state, reaction time) were
      performed the day before the operation (t1), immediately prior to induction of
      anaesthesia (t2) and 5 min, 30 min, 60 min, 90 min, 24 h, and 7 days after
      extubation (t3-t8). Spirometry (forced expiratory volume in 1 s, FEV1; forced
      vital capacity, FVC; peak expiratory flow, PEF) was carried out at times t1, t2
      and t5-t8. RESULTS. The two groups were comparable regarding preoperative status
      (age, sex, preoperative risk score, psychomotor tests, and spirometric values)
      and the operation performed (wedge excision/lobectomy, duration of anaesthesia).
      The extubation time was slightly shorter in the propofol group (18 +/- 8 min)
      than in the isoflurane group (20 +/- 6 min). Also, the results of the psychomotor
      tests were somewhat better in the propofol group than those in the isoflurane
      group. The clearest differences were found in the early postoperative period, but
      not all differences were significant. Statistically highly significant
      differences between the two groups were found for the three spirometric
      parameters. Based on the FEV1 value of the 7th postoperative day, FEV1 taken 60
      min after extubation declined by 27.9% in the propofol group vs. 51.7% in the
      isoflurane group (P = 0.01). At 90 min after extubation the corresponding decline
      in the propofol group was 26.6%, in the isoflurane group 51.1% (P = 0.003). In
      addition, the decline of FVC and PEF measured 60 min and 90 min after extubation
      was significantly smaller in the propofol group than in the isoflurane group.
      CONCLUSION. The postoperative impairment of lung function after lung resection
      under propofol anaesthesia is statistically significantly smaller than under
      isoflurane anaesthesia. Total intravenous anaesthesia with propofol is
      particularly suitable for this kind of operation.

PMID- 7785757
TI  - [Three isoflurane preparations from various manufacturers. A comparison of
      isoflurane concentrations in fresh gas after vaporization with a Drager vaporizer
      type 19.3].
AB  - OBJECTIVES: The purpose of this study was to check the precision of the Drager
      vaporizer model 19.3 when filled with three different preparations of isoflurane.
      METHODS: Six Drager vaporizers model 19.3 calibrated with forene were filled with
      forene (Abbott), isoflurane (Lilly) and isoflurane (Pharmacia); gas output was
      measured by infrared absorption (Irina, Drager) at vaporizer settings of 0.2,
      0.4, 0.6, 0.8, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0 and 5.0 vol%, starting with a
      fresh gas flow of 2 1/min followed by 4, 6 and 12 1/min. Thus each of the three
      isoflurane preparations was checked in six different vaporizers and with four
      different fresh gas flows. RESULTS: Within the concentration range used in
      clinical practice there was no significant difference in the delivery of the
      three isoflurane preparations. Each of the six vaporizers produced a controllable
      and predictable concentration of the three preparations. CONCLUSION: Vaporizers
      of Drager type 19.n calibrated with forene deliver the same predictable
      concentration of the volatile anaesthetic when filled with isoflurane from Lilly
      or isoflurane from Pharmacia instead of forene and may be used without impairment
      in patient safety. In addition, no specific calibration with one of the new
      isoflurane preparations is required.

PMID- 7785756
TI  - [Heat and moisture exchangers for conditioning of inspired air of intubated
      patients in intensive care. The humidification properties of passive air
      exchangers under clinical conditions].
AB  - Heat and moisture exchangers (HME) are used as artificial noses for intubated
      patients to prevent tracheo-bronchial or pulmonary damage resulting from dry and
      cold inspired gases. HME are mounted directly on the tracheal tube, where they
      collect a large fraction of the heat and moisture of the expired air, adding this
      to the subsequent inspired breath. The effective performance depends on the water
      retention capacity of the HME: the amount of water added to the inspired gas
      cannot exceed the stored water uptake of the previous breath. This study
      evaluates the efficiency of four different HME under laboratory and clinical
      conditions using a new moisture-measuring device. METHODS. In a first step, the
      absolute efficiency of four different HME (DAR Hygrobac, Gibeck Humid-Vent 2P,
      Pall BB 22-15 T, and Pall BB 100) was evaluated using a lung model simulating
      physiological heat and humidity conditions of the upper airways. The model was
      ventilated with tidal volumes of 500, 1,000, and 1,500 ml and different flow
      rates. The water content of the ventilated air was determined between tracheal
      tube and HME using a new high-resolution humidity meter and compared with the
      absolute water loss of the exhaled air at the gas outlet of a Siemens Servo C
      ventilator measured with a dew-point hygrometer. Secondly, the moisturizing
      efficiency was evaluated under clinical conditions in an intensive care unit with
      25 intubated patients. Maintaining the ventilatory conditions for each patient,
      the HME were randomly changed. The humidity data were determined as described
      above and compared with the laboratory findings. RESULTS AND DISCUSSION. The
      water content at the respirator outlet is inversely equivalent to the humidity of
      the inspired gases and represents the water loss from the respiratory tract if
      the patient is ventilated with dry gases. Moisture retention and heating capacity
      decreased with higher volumes and higher flow rates. These data are simple to
      obtain without affecting the patient and can easily be interpreted. It was
      demonstrated that, compared to physiological conditions, the DAR Hygrobac and
      Gibeck Humid Vent 2P-HME coated with hygroscopic salts-were able to maintain
      sufficient inspiratory humidity and heat. The Pall-HME, solely a condensation
      humidifier, did not meet the physiological requirements.

PMID- 7785758
TI  - [Intravenous administration of ondansetron vs. metoclopramide for the prophylaxis
      of postoperative nausea and vomiting].
AB  - This randomized, double-blind, multicentre, parallel-group study compared the
      efficacy and safety of an intravenous dose of ondansetron 4 mg for the prevention
      of postoperative nausea and vomiting (PONV) with metoclopramide 10 mg and placebo
      in patients undergoing major gynaecological surgery. A total of 1044 patients
      (465 ondansetron, 462 metoclopramide, 117 placebo) received study medication
      immediately prior to induction of anaesthesia and were included in the analysis
      of data. The proportion of patients experiencing no emesis and no nausea or
      provided with rescue antiemetic medication, the number of emetic episodes, and
      the duration and severity of nausea were recorded during the 24-h period after
      recovery. Significantly more patients who received ondansetron had no emetic
      episodes (44%) than those who received metoclopramide (36%, P = 0.049) or placebo
      (25%, P < 0.001). A higher proportion of patients receiving ondansetron (32%) did
      not experience nausea (metoclopramide 24%, P = 0.009; placebo 16%, P < 0.001).
      Significantly fewer patients in the ondansetron group required rescue medication
      or were withdrawn due to treatment failure (P < 0.05). In the ondansetron group
      the total number of emetic episodes, the median time to the first emetic episode
      or treatment failure, and the duration and severity of nausea were reduced
      significantly compared with metoclopramide or placebo (P < 0.05). The safety
      profile was similar for each treatment group.

PMID- 7785759
TI  - [Controlled hypotension].
AB  - Induced hypotension is defined as a reduction in mean arterial blood pressure to
      50-60 mm Hg in normotensive subjects. The aim of induced hypotension is to
      decrease intraoperative blood loss, decrease the need for blood transfusions and
      improve operating conditions. Most studies indicate that induced hypotension can
      decrease intraoperative blood loss by 50% in many surgical procedures; however,
      some studies report that blood loss is not significantly reduced. Current methods
      of induced hypotension are based on the use of rapid and short-acting
      vasodilators as primary agents (nitroprusside, nitroglycerine, urapidil),
      supplemented by volatile anesthetics (isoflurane) and/or beta-blockers (esmolol)
      to improve effect, reduce dosage and prevent side effects (reflex tachycardia,
      tachyphylaxis, rebound hypertension). Proper positioning of the patient and
      controlled ventilation aid in reducing blood loss. Major risks of induced
      hypotension are a reduction in blood flow (i.e. ischaemia) of vital organs
      (brain, myocardium) and elevation of intracranial pressure in neurosurgical
      patients. Thus, major contraindications of induced hypotension are severe
      coronary artery disease, hypertension combined with arteriosclerosis of cerebral
      vessels and increased intracranial pressure in patients with cerebral disease.
      Complications are rare in otherwise healthy patients, but may be higher in
      elderly patients and those with underlying organ dysfunction. Therefore, careful
      assessment and selection of patients, together with consideration of the
      potential complications, appropriate choice of drugs and invasive beat-by-beat
      monitoring, are essential for the safe practice of induced hypotension.

PMID- 7785760
TI  - Development and application of a fluorometric assay for mammalian membrane
      dipeptidase.
AB  - Membrane dipeptidase (EC 3.4.13.19) is a widely distributed mammalian cell
      surface enzyme involved in the metabolism of glutathione, leukotriene D4, and
      certain beta-lactam antibiotics. In this study we have developed a sensitive and
      rapid assay for membrane dipeptidase based on the fluorometric detection of the D
      Phe released from the model substrate Gly-D-Phe. The released D-Phe is first
      acted on by D-amino acid oxidase in the presence of flavin adenine dinucleotide.
      The resulting hydrogen peroxide is then metabolized by peroxidase in the presence
      of the acceptor substrate p-hydroxyphenylacetic acid which is converted to a
      highly fluorescent compound. The assay configuration is sensitive down to 0.1
      nmol D-Phe and can accurately measure membrane dipeptidase activity even in the
      presence of large amounts of contaminating protein. The membrane dipeptidase
      assay and the subsequent fluorometric detection of the released D-Phe can be
      performed in microtiter plates, thus taking less than 1 h to process 96 samples.
      This sensitive and rapid assay will be useful for the routine measurement of
      membrane dipeptidase activity in a number of different applications.

PMID- 7785761
TI  - Isotopomer study of lipogenesis in human hepatoma cells in culture: contribution
      of carbon and hydrogen atoms from glucose.
AB  - Recent developments in the application of stable isotopes and mass spectrometry
      have permitted the estimation of precursor enrichment and fractional synthesis of
      the product through mass isotopomer analysis. Thus, the application of isotopomer
      analysis in studies with 2H- and 13C-labeled glucose may potentially overcome the
      limitations of traditional methods which can only estimate the fractional use of
      carbon and hydrogen from glucose for lipogenesis. To illustrate this approach,
      isotope incorporation and mass isotopomer distribution were determined in fatty
      acids and cholesterol from a hepatoma cell line (Hep G2) grown in media
      containing specific (C1 or C6) 2H- or 13C-labeled glucose. Using the binomial
      model, the respective precursor enrichment, and fractional synthesis of
      palmitate, stearate and cholesterol were determined using mass isotopomer
      distribution analysis. In 1 week, 80% of palmitate, 65.5% of stearate, and 50% of
      cholesterol molecules in the cell extract were derived from de novo synthesis.
      Under serum-free condition, glucose contributed about 80% of the carbon of the
      newly synthesized lipids. Using the relative isotope yield of [1-13C] and [6
      13C]glucose and a standard formula, the contribution of the pentose pathway to
      glucose catabolism was calculated to be 4.7%. Fractional syntheses of palmitate,
      stearate, and cholesterol determined using [1-2H]glucose agreed well with values
      determined using 13C-labeled glucose. After correcting for the contribution of
      deuterium label from the glycolytic pathway, the deuterium from [1-2H]glucose
      contributed 4.7% of the total reducing equivalents for lipogenesis. Unlike
      radioisotope studies, the stable isotope approach provides information from the
      perspective of the product and insight into the economy of acetyl units and
      reducing equivalents which were otherwise not available.

PMID- 7785762
TI  - A complete platelet system for metabolic studies: pure, defined, and viable over
      8 hours.
AB  - We have been using a human platelet preparation to investigate various aspects of
      cellular metabolism. These experiments require a pure, quantitated platelet
      preparation that is viable for up to 8 h. The purity of the preparation has
      previously been characterized and we have now assessed its viability over 8 h and
      developed a simple spectrophotometric counting method. This method of counting
      results in estimations that are within 6% of those from an electronic cell
      counter (Coulter). Pure platelets stored in a Hepes physiological saline were
      resuspended periodically in autologous plasma to assess function over 24 h. The
      platelets consumed oxygen, changed shape, aggregated, and released dense granule
      ATP at all times. There was a slow and linear decrease in the various processes
      with time, ranging from 1.7% per hour for oxygen consumption to 3.8% per hour for
      percentage aggregation. The preparation is therefore not stable, but the changes
      with time are small and defined and it represents a useful system for the study
      of platelet and cell biology.

PMID- 7785763
TI  - Preparation and characterization of RNA standards for use in quantitative
      branched DNA hybridization assays.
AB  - RNA standards were developed for use in quantitative hybridization assays such as
      the Quantiplex HCV RNA Assay and Quantiplex HIV RNA Assay, which are based on
      branched DNA signal amplification. In vitro transcripts ranging in size from 0.5
      to 9.4 kb were prepared and purified by phenol extraction following gel
      electrophoresis or column chromatography. Aliquots of the transcripts were
      digested to nucleosides and phosphate and then quantified by phosphate analysis
      against the U.S. National Institute of Standards and Technology phosphate
      standard. The quantitation was checked by OD260 and by either hyperchromicity or
      isotopic tracer analysis. The quantitation of each lot of RNA agreed within 20%
      by the three methods. The reproducibility of the methods was tested by preparing
      a total of 13 lots of standard RNAs. The average percentage full-length RNA of
      the 13 lots was 82%, with a range of 59 to 97%. The standard RNAs were used to
      test the ability of the branched DNA hybridization assay to quantify all target
      RNAs accurately regardless of size or slight variations in sequence. Standard
      Hepatitis C virus (HCV) RNAs of 1.3, 2.2, and 3.2 kb showed that size has no
      detectable effect on quantitation in the branched DNA hybridization assay. Three
      different lots of standard 3.2-kb HCV RNA were serially diluted and quantified
      over a thousand-fold range in the branched DNA hybridization assay. The average
      signal per attomole of target varied by less than 20% among the 3 lots. Standard
      HCV RNA transcripts were also prepared from clones of HCV subtypes 1b and 3a to
      study the effects of target sequence diversity and probe design on quantitation
      by hybridization.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785764
TI  - Identification of neutral and sialyl N-linked oligosaccharide structures from
      human serum glycoproteins using three kinds of high-performance liquid
      chromatography.
AB  - The distribution of neutral and sialyl N-linked oligosaccharides from human serum
      glycoproteins has been studied using three kinds of HPLC columns as described
      below. N-linked oligosaccharides were released from chymotrypsin- and trypsin
      digested glycopeptides of human serum by means of glycoamidase (from almond)
      digestion. The reducing ends of the oligosaccharides were derivatized with the
      fluorescent reagent 2-aminopyridine (PA). The mixture of PA-oligosaccharides was
      separated by high-performance liquid chromatography on a diethylaminoethyl column
      according to the sialic acid content. Each fraction separated was then applied on
      an octadecylsilyl (ODS) column, and the elution volume of each peak was recorded
      as a glucose unit on the X-axis. Then, each of the separated oligosaccharides was
      applied to the amide column. Each peak's elution volume was recorded as a glucose
      unit on the Y-axis. The elution volumes from these two columns (ODS and amide)
      provide a unique set of coordinates. The structure of each sialyl oligosaccharide
      fraction was analyzed by the same two-dimensional sugar-mapping technique as
      previously developed for neutral oligosaccharides. This was combined with
      exoglycosidase digestion and high-resolution proton NMR measurement. Fourteen
      neutral, eight mon-sialyl, four di-sialyl, and five tri-sialyl oligosaccharides
      were isolated from human serum and their structures were characterized.

PMID- 7785765
TI  - Fluorescence-based enzymatic assay by capillary electrophoresis laser-induced
      fluorescence detection for the determination of a few beta-galactosidase
      molecules.
AB  - beta-Galactosidase can be assayed by monitoring the generation of the fluorescent
      products, fluorescein-mono-beta-D-galactopyranoside and fluorescein, when the
      fluorogenic substrate fluorescein-di-beta-D-galactopyranoside is used. We have
      used capillary electrophoresis with ultrasensitive laser-induced fluorescence
      detection to monitor the formation of the fluorescent products of off-column
      enzymatic reactions. By analyzing as little as 40 pl of the enzymatic mixture we
      obtain limits of detection of 6.5 x 10(-14) M beta-galactosidase or 1.6 molecules
      based on the detection of fluorescein-mono-beta-D-galactopyranoside.

PMID- 7785767
TI  - An assay for galactosyltransferase-I activity in articular cartilage.
AB  - UDP-D-Galactose:D-xylose galactosyltransferase (Galactosyltransferase-I) is an
      enzyme involved in the synthesis of the linkage region of chondroitin sulfate.
      Measurement of galactosyltransferase-I in mature articular cartilage has depended
      on milling such tissue in liquid nitrogen to break open the cells and enable
      interaction of exogenous substrates with galactosyltransferase-I. This process
      requires large amounts (approximately 1 g wet wt) of cartilage. This paper
      reports the development of an assay for galactosyltransferase-I in articular
      cartilage where 10-25 mg (wet wt) of the tissue was extracted with a buffer
      containing the detergent Thesit. This assay was more time efficient, required
      less tissue, and was linear for up to 6 h. It was effective on both mature bovine
      articular cartilage and embryonic chick epiphyseal cartilage, detecting 100 and
      68% of total galactosyltransferase-I activity, respectively. The higher number of
      measurements available allowed kinetic studies to be conducted on bovine
      articular cartilage explant cultures under conditions of up- and down-regulation.
      Incubation with fetal calf serum resulted in an increase in galactosyltransferase
      I activity. Galactosyltransferase-I activity, however, did not change markedly in
      cartilage cultured in the absence of fetal calf serum or in the presence of
      cycloheximide. A soluble preparation of galactosyltransferase-I, extracted from
      bovine articular cartilage using Thesit, eluted from a Superose-6 column, with a
      molecular mass of about 55 kDa.

PMID- 7785766
TI  - Simplified high-sensitivity sequencing of a major histocompatibility complex
      class I-associated immunoreactive peptide using matrix-assisted laser
      desorption/ionization mass spectrometry.
AB  - Cytotoxic T cells (CTL) are known to recognize small peptide fragments of
      cytoplasmic proteins bound to major histocompatibility complex (MHC) class I
      molecules on cell surfaces. Recent work indicates that tumor antigens are
      processed and presented in a manner similar to viral antigens. Identification of
      the peptides recognized by tumor-specific CTL would provide valuable information
      about their parent proteins, as well as allowing for the development of
      recombinant antigen-specific tumor vaccines. While highly represented MHC-bound
      peptides have been routinely purified by reversed-phase HPLC for Edman
      degradation sequencing, identification and sequencing of infrequent peptides that
      represent the biologically relevant targets of tumor-specific CTL have proved
      elusive. We have combined matrix-assisted laser desorption/ionization mass
      spectrometry with on-slide exopeptidase digestion to successfully identify and
      directly sequence a model tumor-specific peptide antigen derived from an
      integrated viral gene. The enhanced sensitivity of this technique (femtomolar
      range) allows for the sequencing of specific MHC-bound peptides derived from as
      few as 1 x 10(9) cells.

PMID- 7785769
TI  - Correlation between the light scattering and the mitochondrial content of normal
      tissues and transplantable rodent tumors.
AB  - The development of noninvasive optical studies necessitates an understanding of
      the biological parameters which affect light propagation in soft tissues. In the
      present report, we have measured the optical properties of various normal (i.e.,
      perfused liver, brain, skeletal muscle, white adipose tissue) and neoplastic
      rodent tissues (i.e., glioma, hepatoma, mammary adenocarcinoma) by using time
      resolved spectroscopy. The contribution of the hemoglobin (+ myoglobin in the
      case of muscle) to the total light absorption at 780 nm has been determined. This
      contribution varies from about 25% (brain, skeletal muscle) to about 100% (white
      adipose tissue, 13762A mammary adenocarcinoma, 9L glioma). These results are
      explained by different blood volume fractions in the tissues and by the existence
      at 780 nm of other chromophores, such as the mitochondrial cytochrome oxidase.
      Secondly, the dependence of the light scattering of the tissue on both the cell
      and the mitochondrial content has been analyzed. The results indicate that there
      is no correlation between the light scattering and the DNA content, measured as
      an indicator of the cell number in the tissue. The scattering coefficient is
      proportional to both the succinate dehydrogenase activity and the mitochondrial
      protein content of the tissue, which are indicators of the mitochondria content
      of the tissue when based upon estimates of tissue wet weight.

PMID- 7785770
TI  - Separation of neutral asparagine-linked oligosaccharides by high-pH anion
      exchange chromatography with pulsed amperometric detection.

PMID- 7785768
TI  - A bisulfite method of 5-methylcytosine mapping that minimizes template
      degradation.
AB  - The bisulfite method is a highly sensitive approach to 5-methylcytosine mapping
      that utilizes the capability of the polymerase chain reaction to exponentially
      amplify DNA. We have observed that the bisulfite reaction results in a
      significant level of template degradation due to DNA depurination. Furthermore,
      our data suggest that the DNA fragmentation which occurs limits the sensitivity
      of the method. We describe a simple solution to limit degradation of the DNA
      template.

PMID- 7785771
TI  - Acetyl phosphate as an energy source for bacterial cell-free translation systems.

PMID- 7785773
TI  - Quantitative determination of protamines by coomassie blue G assay.

PMID- 7785772
TI  - Localization of epitopes for monoclonal antibodies directed against the adult rat
      skeletal muscle sodium channel (rSkM1) using polymerase chain reaction, fusion
      proteins, and western blotting.

PMID- 7785774
TI  - Reverse electrophoresis to concentrate DNA fractions.

PMID- 7785776
TI  - Reduction of strong lipase-polyclonal antibodies binding by limited proteolysis.
AB  - Initial attempts to purify Geotrichum candidum lipase (EC 3.1.1.3) using
      immunoaffinity chromatography have been hampered by the tight binding of the
      lipase to the immobilized rabbit anti-GCL IgG. Stringent elution conditions were
      unable to release more than a few percent of the antigen. To decrease the tight
      binding, the immunosorbent was treated with minute amounts of different
      proteases, of which elastase proved to be most effective. Using the elastase
      treated immunosorbent both natural and recombinant GCL II were purified to
      homogeneity with 30% of lipase recovered from the immunoaffinity chromatography
      step.

PMID- 7785775
TI  - A comparison of methods for determining total body protein.
AB  - The aim of the study was to find the optimal method (with respect to convenience
      and accuracy) for determining total protein in whole-body homogenates of rats.
      Three different protein extraction methods and five different protein
      concentration methods were assessed. The results were compared against a
      reference value measured by complete amino acid analysis after acid hydrolysis.
      The data demonstrated that extraction with 5% (w/v) sodium dodecylsulfate (SDS)
      in 0.5 N NaOH was far superior to that with water alone or to 6 N guanidine-HCl.
      A comparison of the Biuret, Bradford, and bicinchoninic acid methods on the SDS
      NaOH-extracted samples showed that the Biuret method was optimal, giving a value
      that was 90% of the reference value with a small variation (2.4% of the mean).
      The Kjeldahl method gave the correct protein concentration only when a nitrogen
      factor of 5.51 +/- 0.03 (N = 5) was applied. The results suggest that extraction
      with SDS-NaOH followed by the Biuret procedure is a good method for measuring
      protein concentrations in whole body rat homogenates.

PMID- 7785777
TI  - Precipitation of Hevea brasiliensis latex proteins with trichloroacetic acid and
      phosphotungstic acid in preparation for the Lowry protein assay.
AB  - Many proteins derived from the latex of Hevea brasiliensis that remain soluble in
      trichloroacetic acid (TCA) can be precipitated by phosphotungstic acid (PTA). A
      combination of 5% TCA and 0.2% PTA precipitates a wide range of proteins
      effectively even when they are present in low concentrations (below 1 microgram
      ml-1). In addition to its protein purification function, acid precipitation also
      increases the sensitivity of the subsequent protein assay by allowing the test
      sample to be concentrated. Another advantage of protein precipitation by TCA and
      PTA is that very small amounts of protein (of the order of 10 micrograms) can be
      repeatably recovered without the use of precipitate-bulking agents such as sodium
      deoxycholate. This general procedure of protein purification and concentration is
      simple and rapid, but the use of PTA may not be fully compatible with the
      Bradford protein assay. A modified Lowry microassay is described which enables
      about 3 micrograms ml-1 to be quantitated at the photometric absorbance of 0.05.
      When used in conjunction with protein concentration by precipitating with
      TCA/PTA, approximately 0.4 microgram ml-1 protein present in 6 ml of solution can
      be assayed.

PMID- 7785778
TI  - A double labeling procedure for lipoproteins: independent visualization of dual
      ligand-receptor interaction with colloidal gold- and 125I-labeled ligands.
AB  - The analysis of multiple ligand binding to a single receptor molecule poses a
      methodological challenge. The chicken oocyte 95-kDa receptor for the uptake of
      the two major yolk lipoprotein precursors very low-density lipoprotein (VLDL) and
      vitellogenin (VTG) is such a multipotent transport receptor. Here we describe
      methods for rapid independent and simultaneous analysis of VLDL and VTG binding
      to this receptor, termed VLDL/VTG receptor. First, further development of a one
      step labeling protocol for chicken lipoproteins with colloidal gold (Au) to
      visualize independently the binding of VLDL and VTG to the chicken VLDL/VTG
      receptor is reported. The advantage of this protocol is that the preparation of
      the Au-lipoprotein conjugates is rapid, and utilization of Au-lipoprotein
      complexes in ligand blots does not require their further purification, while
      signal enhancement by silver staining is still applicable. Second, the
      simultaneous use of 125I- and Au-labeled ligands in a one-step ligand blotting
      procedure facilitates the direct demonstration of the competitive interaction of
      VLDL and VTG with the receptor. Following sequential processing of the
      nitrocellulose strips, binding of differently labeled ligands can be studied
      independently. In summary, we describe a procedure for differential labeling of
      lipoproteins and its application toward the analysis of receptors that bind more
      than one ligand.

PMID- 7785779
TI  - Correlation of electrophoretic mobilities of proteins and peptides with their
      physicochemical properties.
AB  - Electrophoretic mobilities, mu, of nine proteins (M(r) 14,200 to 70,000) in 28 mM
      Tris/47 mM glycine buffer at pH 8.77 and 5 mM ionic strength were measured by
      laser Doppler velocimetry and correlated to ratios of charge (q) to molecular
      weight (M(r)) and shape factor (f/f0) by the equation mu(f/f0) = (Aq/Mpr-B). This
      correlation was previously reported for peptides and proteins for mu measured at
      100 mM ionic strength. When A = 6.048 x 10(-3), B = 1.13 x 10(-5), and p = 2/3,
      the correlation fitted 51 measured and literature values over the molecular
      weight range of 178 to 140,000 for components whose electrophoretic mobilities
      ranged from +13.35 x 10(-5) to -19.7 x 10(-5) cm2/(V.s). The experimental
      measurements confirm the general suitability of p = 2/3 and show that the
      familiar charge/mass relation for electrophoresis is applicable to proteins in
      low-ionic-strength buffers which are typical of electrochromatography systems.
      Extrapolation of the correlation to different ionic strengths indicates that a
      low-ionic-strength buffer amplifies differences of electrophoretic mobility as a
      function of charge/mass, while high ionic strength diminishes such differences.

PMID- 7785781
TI  - A continuous spectrophotometric assay for protein phosphatases.
AB  - A continuous spectrophotometric assay for the determination of protein
      phosphatase activity is presented. The assay incorporates the coupled enzyme
      system of Webb (M. R. Webb, 1992, Proc. Natl. Acad. Sci. USA 89, 4884-4887),
      which used purine nucleoside phosphorylase and the chromophoric substrate 7
      methyl-6-thioguanosine for the quantitation of inorganic phosphate. The assay is
      exemplified and validated here for the phosphorylase phosphatase activity of
      protamine-stimulated protein phosphatase 2A1 (PP-2A1). The effects of reaction
      components on the activities of both PP-2A1 and purine nucleoside phosphorylase
      were studied. The application of the coupled assay system to kinetic analysis of
      the phosphorylase phosphatase activity of PP-2A1 and to the assay of the
      catalytic subunits of type 1 and 2A protein phosphatases and a recombinant type 1
      catalytic subunit is demonstrated. The applicability of this coupled enzyme
      system to the assay of other protein phosphatases is discussed.

PMID- 7785780
TI  - Imaging and quantitation of chemiluminescence using photoexcitable storage
      phosphor screen.
AB  - A novel storage phosphor (SrS:Ce,Sm) imaging screen optimized for the detection
      of luminescence has been developed. When coupled with an appropriate scanning
      system, this screen exhibits the following characteristics: (i) a range of
      visible light detection between 400 and 500 nm with a peak response at 450 nm;
      (ii) sensitivity comparable to X-ray film; (iii) 200-microns resolution; (iv)
      linear dynamic range greater than four orders of magnitude; and (v) a uniformity
      of response of +/- 1.32% coefficient of variation. These features facilitate the
      detection and accurate quantitation of light radiation produced from the
      enzymatic catalysis of chemiluminescent substrates such as 1,2-dioxetanes and
      luminol. Its suitability for chemiluminescent applications is demonstrated by the
      analysis of cosmid hybridization and enzyme-linked immunosorbent assay samples.

PMID- 7785782
TI  - Simultaneous determination of enzyme activity and enzyme quantity in single human
      erythrocytes.
AB  - An integrated laser-based fluorescence enzyme assay and particle-counting
      immunoassay system with zeptomole sensitivity has been developed for simultaneous
      determinations of activity and concentration of enzymes in single erythrocytes.
      The product NADPH of the reaction between glucose-6-phosphate and NADP+ catalyzed
      by glucose-6-phosphate dehydrogenase (G6PDH) is monitored. Simultaneously, the
      agglutination of antibody-coated particles in the presence of G6PDH produces
      large particles which are counted by light scattering. The correlation between
      the two parameters indicates that on average only about 35% of the enzyme in
      individual cells is active. There is more than a 10-fold cell-to-cell variation
      in the ratios of the two parameters. This indicates that there are multiple
      mechanisms for the degradation of intracellular enzymes as a function of cell
      age.

PMID- 7785783
TI  - A quantitative test for copper using bicinchoninic acid.
AB  - We describe a direct colorimetric assay for copper in serum and biological
      samples using 2,2'-bicinchoninic acid (BCA), a common reagent in most
      laboratories. BCA offers the advantage of being highly sensitive and specific for
      Cu(I) which rapidly forms an intense purple complex in the presence of BCA. The
      complex has peak absorbances at 562 and 354.5 nm with molar absorptivities of 7.7
      x 10(3) liter mol-1 cm-1 and 4.6 x 10(4) liter mol-1 cm-1, respectively.
      Interference by other metal ions, pH, and detergents is minimal and the results
      correlate strongly with atomic absorption spectrophotometry.

PMID- 7785784
TI  - A microtiter plate-based high-throughput DNA purification method.
AB  - A fast, reliable, inexpensive, and high-throughput method to purify DNA has been
      developed. It is based on DNA amplification by polymerase chain reaction
      utilizing a mini spin-column made from a 96-well membrane-bottomed assay plate.
      With this method, 50% of the DNA is recovered routinely using Sephacryl-500HR as
      filtration media. Purified DNA can then be used in various enzymatic
      manipulations, such as sequencing and hybridization. This provides an economical
      alternative protocol for routine large-scale purification of DNA templates for
      sequencing or other enzymatic manipulations.

PMID- 7785785
TI  - Isolation of pure populations of epithelial and myoepithelial cells from the
      normal human mammary gland using immunomagnetic separation with Dynabeads.
AB  - Monoclonal antibodies to epithelial membrane antigen and common acute
      lymphoblastic leukemia antigen were bound to second antibody-coated magnetic
      microspheres. These specific antibody/bead complexes were then used to directly
      isolate purified epithelial and myoepithelial cells from normal breast organoid
      cell preparations by magnetic separation. Near homogeneous cell populations were
      selected with yields of 10-20 x 10(6) epithelial and myoepithelial cells per
      organoid preparation. Repeated purification steps allowed almost complete
      depletion of myoepithelial cells for RNA studies. Tissue culture of separated
      cell populations in appropriate defined media further ensured purity of cell type
      and was unimpeded by Dynabead attachment.

PMID- 7785786
TI  - Contraction of isolated porcine coronary arteries is inhibited by high
      concentrations of propranolol.
AB  - Isometric tension responses of isolated porcine coronary artery rings were
      studied in the presence of concentrations of propranolol higher than those
      necessary to block effects mediated by beta-adrenergic receptors. Propranolol (50
      300 microM) inhibited contractions induced by 30 mM KCl and by histamine,
      norepinephrine, and acetylcholine in a concentration-dependent, noncompetitive
      fashion. The (+) propranolol isomer and the racemic mixture were equipotent
      inhibitors of contraction. Propranolol inhibition was partly reversed by
      increased extracellular Ca++. These effects of propranolol thus appeared to be
      independent of beta-blockade and could be relevant to some of the drug's observed
      but still unexplained in vivo actions.

PMID- 7785787
TI  - Combined left ventricular wall motion and myocardial perfusion stress imaging in
      the initial assessment of patients with a recent uncomplicated myocardial
      infarction.
AB  - The aim of the study was to examine the ability to simultaneously assess left
      ventricular function and myocardial perfusion by using a single injection of
      technetium-99m sestamibi at rest and during submaximal exercise to identify high
      risk patients with left main, proximal left anterior descending (LAD), or three
      vessel coronary artery disease (CAD) after an uncomplicated acute myocardial
      infarction (AMI). Multiple studies have evaluated the separate value of the
      exercise ECG, myocardial perfusion scintigraphy, and radionuclide
      angiocardiography (RNA) for identifying patients with severe CAD. The
      availability of technetium-99m (Tc99m)-labeled myocardial imaging agents offers
      the opportunity to evaluate simultaneously ventricular function and myocardial
      perfusion during a single exercise session. Only limited data are available about
      the value of this combined technique in the workout of patients early after an
      uncomplicated AMI. Combined first-pass RNA and myocardial perfusion
      tomoscintigraphy (SPECT) at rest and during submaximal exercise were performed in
      52 patients, less than six weeks after an uncomplicated AMI, with use of Tc99m
      sestamibi. Patients were classified in two subgroups according to the presence of
      left main, proximal LAD, or three-vessel CAD. Stepwise logistic regression
      analysis was used to determine the independent predictors of severe CAD. All
      patients underwent the exercise testing without any medical complication. On
      univariate analysis, the global left ventricular ejection fraction (LVEF), wall
      motion score, and myocardial perfusion score, both at rest and at submaximal
      exercise, were significantly associated with the presence of severe CAD. The
      response of LVEF to exercise, and the presence of exercise-induced wall motion or
      myocardial perfusion abnormalities, were not associated with the severity of CAD.
      On multivariant analysis only the wall motion score during exercise was an
      independent predictor for the presence of severe CAD (P < 0.001, r = 0.6). In
      analyzing patients with anterior AMI separately, LVEF at submaximal exercise was
      the most accurate predictive parameter. If a cutoff value of 40% was chosen, the
      LVEF at exercise had a sensitivity of 85% and a specificity of 78% for the
      detection of severe CAD. In patients with inferior AMI, neither LVEF nor wall
      motion or myocardial perfusion scores were useful for differentiating the two
      subgroups. In these patients the presence of an additional perfusion defect
      during exercise in one of the anterior wall segments yielded a sensitivity of 70%
      and a specificity of 75% for the presence of severe CAD. IN CONCLUSION:
      simultaneous evaluation of LV function and myocardial perfusion at submaximal
      exercise, using a single injection of Tc99m-sestamibi, is a safe and accurate
      technique for selecting patients with severe CAD after an uncomplicated AMI.

PMID- 7785788
TI  - Brain infarction developed in hypertensive and normotensive patients during
      hospitalization--hemodynamic factors.
AB  - To determine the effects of changes in blood pressure (BP) on the development of
      ischemic stroke, 17 patients who developed acute brain infarction during
      hospitalization were analyzed in relation to the vascular risk factors such as
      hypertension, previous stroke, diabetes mellitus, and hyperlipidemia. Their BPs
      were retrospectively referred to the onset of stroke. The average values of mean
      arterial blood pressure (MABP) on admission were 137 mmHg in hypertensive
      patients (HT; n = 9) and 101 mmHg in normotensives (NT; n = 8). HT patients
      received antihypertensive treatment after admission and MABP decreased by 22 mmHg
      (14%) prior to the ictus (three to sixty-five days after admission). MABP in NT
      patients remained constant before the attack (-1.4 mmHg, four to one hundred ten
      days after admission). Similarly, MABP decreased by 17 mmHg (four to ninety-three
      days) before the ictus in patients with previous stroke (n = 9), whereas it
      changed only a little in patients without history of stroke (n = 8). BP in each
      group elevated immediately after the stroke and gradually decreased to 90% of the
      resting level after two weeks. An excessive reduction of BP may induce brain
      infarction in HT or chronic stroke patients or cause it to recur.

PMID- 7785790
TI  - Relation between postpacing T wave changes and myocardial scintigraphic
      characteristics in patients with ventricular demand pacemaker.
AB  - The aim of this study was to elucidate the cause of T wave changes after
      ventricular pacing using thallium 201 single photon emission computed tomography
      (Tl-SPECT). Tl-SPECT was performed in 20 patients with sick sinus syndrome who
      had negative T wave after ventricular pacing and had had a ventricular demand
      pacemaker (VVI) implanted. Patients who have stenotic coronary arteries were
      excluded from the study. From the analysis of Tl-SPECT, extent score was
      calculated as the ischemic region. Data in patients with SSS were compared with
      those in 20 normal controls (NC). Thallium perfusion defects in patients with VVI
      were observed and distributed mainly in apex and inferior regions on the polar
      map. The extent score in patients with VVI was significantly higher than that in
      NC (56.4 +/- 21.6% vs 3.2 +/- 6.4%, P < 0.01). The washout rate of thallium 201
      in the defect area was significantly lower in patients with VVI than in NC (27.4
      +/- 10.2% vs 46.8 +/- 12.3%, P < 0.01). These results suggest that T wave changes
      after ventricular pacing are closely related to myocardial ischemia.

PMID- 7785789
TI  - In vivo measurement of regional large artery compliance by intravascular
      ultrasound under pentobarbital anesthesia.
AB  - BACKGROUND: The presence of smooth muscle fibers on the wall of large arteries
      would suggest that arterial compliance might change in response to vasoactive
      substances. The purpose of this study is to determine the basal level of
      vasomotor tone in these arteries in a commonly used animal preparation and to
      learn whether the compliance of large conductance arteries can be altered in vivo
      by vasoactive agents. METHODS: Proximal iliac arterial compliance was measured in
      7 pentobarbital-anesthetized pigs, before and during local infusions of adenosine
      and norepinephrine. Luminal area was measured every forty milliseconds by means
      of a 30 MHz intravascular ultrasound catheter and an automatic edge detection
      program. Simultaneous high-fidelity pressure measurements were obtained by means
      of a catheter-tipped pressure microtransducer positioned at the origin of the
      iliac artery. Linear regression analysis of the area/pressure relationship in two
      consecutive cardiac cycles (systolic phase only) was performed before and during
      adenosine and norepinephrine infusions. The slope of the area/pressure regression
      line was defined as an index of arterial compliance. Measurements after three
      minutes of infusions of adenosine (5-5000 micrograms/minute) and norepinephrine
      (0.001-10 micrograms/minute) were compared with the control measurements.
      RESULTS: Even at the highest infusion rate, adenosine did not significantly
      increase arterial compliance as compared with baseline (25 +/- 7 vs 19 +/- 4
      mm2/mmHg x 10(-3), respectively, P = ns). In contrast, norepinephrine decreased
      arterial compliance as compared with the second baseline control (13 +/- 3 vs 20
      +/- 3 mm2/mmHg x 10(-3), respectively, P < 0.01). CONCLUSIONS: In this animal
      model with pentobarbital anesthesia, arterial compliance may be modified more by
      the acute infusion of norepinephrine than by adenosine in large conductance
      arteries such as the proximal iliac. Thus, in this preparation, smooth muscle
      tone tends to be minimal and arterial compliance near maximal (ie, mostly a
      passive phenomenon). However, in response to norepinephrine, arterial compliance
      can decrease significantly as smooth muscle tone increases. Intravascular
      ultrasound allows continuous and accurate monitoring of these changes of arterial
      dimensions, suggesting that this technique may be useful in the evaluation of
      pharmacologically induced changes in the compliance of large arteries by
      vasoactive agents.

PMID- 7785791
TI  - Unstable angina of crescendo pattern vs new onset: a clinical, coronary
      arteriographic and hemodynamic study.
AB  - Unstable angina includes a variety of clinical presentations with a different
      level of risk for an unfavorable outcome. In this study the authors investigated
      the prognostic significance of crescendo angina and new-onset angina to discuss
      management strategies, paying attention to the relevance of baseline clinical
      characteristics, coronary artery lesions, and left ventricular function, as well
      as their alterations during atrial pacing. Accordingly coronary arteriographic
      anatomy and changes in left ventricular volumes and ejection fraction before and
      during atrial pacing were studied by means of digital subtraction
      ventriculography in 18 patients with crescendo angina and in 18 patients with new
      onset angina. Triple-vessel disease was more frequently observed in crescendo
      angina (56%; P < 0.05) as compared with the patients with new-onset angina (11%).
      Complex coronary morphology was statistically more likely to be found in
      crescendo angina. The angiographic evidence of intracoronary thrombi was found in
      33% (P < 0.05) patients with crescendo angina and in 4% patients with new-onset
      angina. Compared with the patients with new-onset angina, patients with crescendo
      angina had higher end-diastolic and end-systolic volumes and lower ejection
      fraction at rest. At peak pacing, ejection fraction was significantly (P < 0.05)
      lower in crescendo angina (0.48 +/- 0.06) than in new-onset angina (0.66 +/-
      0.04). In crescendo angina, during pacing, the magnitude of velocity of
      circumferential fiber shortening was significantly decreased as compared with new
      onset angina.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785792
TI  - Percutaneous balloon valvuloplasty in severe pulmonary valvular stenosis.
AB  - Percutaneous balloon pulmonary valvuloplasty (PBPV) was achieved successfully in
      20 of 22 patients with severe pulmonary valvular stenosis, aged two days to ten
      years (median four years and two months). The diameters of the balloon for PBPV
      were 88-125% (mean +/- SD = 109.5 +/- 10.0%) of the pulmonary valve annulus. PBPV
      failed in 2 patients because of the inability of the cardiac catheters to cross
      the stenotic valve. A significant reduction of right ventricle-pulmonary artery
      (RV-PA) pressure gradient occurred in all 20 patients (mean +/- SD = 72.1 +/-
      10.3%). The mean RV-PA pressure gradient was reduced from 93.2 +/- 33.1 to 26.3
      +/- 15.6 mmHg (P < 0.0001) and the mean right ventricular peak systolic pressure
      fell from 117.2 +/- 32.4 to 51.6 +/- 17.3 mmHg (P < 0.0001). Five (25%) of 20
      patients had an infundibular gradient before PBPV. Two (10%) developed a new
      infundibular stenosis immediately after PBPV. Four (20%) presented with cyanosis,
      which disappeared after the successful PBPV. Two patients (10%) who showed a
      residual RV-PA pressure gradient of more than 40 mmHg had a significant
      infundibular obstruction initially. Two patients underwent recatheterization
      fifteen months after PBPV owing to a significant residual RV-PA pressure gradient
      and had no reductions in right ventricular pressure and RV-PA pressure gradient,
      but resolution of infundibular obstruction was noted in both. Repeat PBPV was
      successfully performed on these 2 patients. No significant complications were
      noted in any patient.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785793
TI  - Atrial natriuretic peptide and antihypertensive action due to beta-blockade in
      essential hypertensive patients.
AB  - The effects of beta-blocker treatment on hemodynamics were studied in relation to
      plasma atrial natriuretic peptide (ANP) levels in 17 outpatients with essential
      hypertension. Administration of propranolol for twelve weeks to untreated
      subjects resulted in a significant (P < 0.001) rise in plasma ANP levels (from
      37.9 +/- 21.2 to 66.7 +/- 46.2 pg/mL, mean +/- SD). Systolic and diastolic blood
      pressures were significantly decreased (P < 0.05 and P < 0.01, respectively).
      Heart rate was also significantly decreased (P < 0.001). On the other hand, a
      significant reduction of cardiac index was detected (from 4.12 +/- 1.34 to 2.96
      +/- 0.75 L/min/m2, P < 0.01) with chronic administration of propranolol,
      suggesting a reflection of decreased cardiac function. A significant negative
      correlation was observed between %changes in systolic blood pressure and %changes
      in plasma ANP (r = -0.594, P < 0.05). These results suggest that the increased
      plasma ANP levels may contribute to the antihypertensive effect with propranolol.

PMID- 7785794
TI  - Refractory cardiogenic shock and complete heart block after verapamil SR and
      metoprolol treatment. A case report.
AB  - A seventy-eight-year-old woman presented with complete heart block and refractory
      hypotension two days after a therapeutic dose of sustained-release verapamil with
      concomitant use of metoprolol. The patient continued to remain hypotensive with
      complete heart block, even with multiple uses of intravenous atropine as well as
      high doses of pressor agents such as dopamine and dobutamine. However, shortly
      after the use of intravenous calcium chloride, the refractory hypotension and
      complete heart block resolved.

PMID- 7785795
TI  - Acute myocardial infarction shortly after a normal exercise stress test. Case
      reports.
AB  - The authors describe 3 cases of AMI occurring shortly after a negative bicycle
      ergometer stress test. These cases represent an unfortunate but extremely rare
      complication of a relatively safe diagnostic procedure. The authors also focus on
      the pathogenesis of the ischemic event, which may be attributed either to
      intraplaque hemorrhage or to platelet aggregation, both exercise-induced. The
      prevalence of AMI in this paper (0.06%) is similar to the data described in
      literature.

PMID- 7785796
TI  - Myocardial infarction secondary to coronary aneurysm in systemic lupus
      erythematosus. An autopsy case.
AB  - The authors report a thirty-seven-year-old woman with systemic lupus
      erythematosus (SLE), a coronary aneurysm, and myocardial infarction. SLE was
      diagnosed at twenty-three years of age and treated with prednisolone. Seven years
      later, she developed inferior myocardial infarction, and coronary angiography
      showed an aneurysm in the proximal right coronary artery without associated
      stenosis. At the age of thirty-seven years, she died from cerebral infarction and
      sepsis. Autopsy revealed an aneurysm (6 mm in diameter) in the proximal right
      coronary artery and an old inferior myocardial infarction. Histologic examination
      showed recanalization and fibrosis in the media of the aneurysm wall. This case
      suggests that coronary aneurysm may cause myocardial infarction in SLE and that
      aneurysm formation may be a sequela of arteritis.

PMID- 7785797
TI  - Transesophageal echocardiography combined with magnetic resonance imaging for
      detecting venous anomalies in dextrocardia. A case report.
AB  - A fifty-six-year-old woman was admitted to Osaka Rosai hospital because of
      dyspnea, chills, and fatigue. The patient was diagnosed by transthoracic
      echocardiography as having congestive heart failure due to severe
      biatrioventricular valve regurgitation, and cardiac surgery was proposed.
      Preoperative transesophageal echocardiography (TEE) revealed a dilatation of the
      coronary sinus (CS), a right-sided hemiazygos vein (R-AZ), and another great
      vessel lying between the CS and the R-AZ. Magnetic resonance imaging (MRI) was
      also performed, and this showed a persistent right superior vena cava (PRSVC)
      entering the left atrium via the dilatated CS. However, the site of connection
      between the R-AZ and the PRSVC could not be detected by MRI because of inadequate
      slice acquisition. Each method has its limitations, particularly with regard to
      visualizing the extracardiac vascular system. Therefore, the authors demonstrated
      that the combination of TEE and MRI might be more useful than each alone, and the
      combination is as a valuable method as digital subtraction angiography for the
      diagnosis of extracardiac venous anomalies.

PMID- 7785798
TI  - Heart block in dextrocardia with situs inversus. A case report.
AB  - The authors report a case of a forty-one-year-old white woman with dextrocardia
      with situs inversus who presented episodes of prolonged sinus arrest and syncopal
      episodes secondary to possible idiopathic degeneration of the conduction system,
      managed successfully with a permanent bicameral pacemaker. In their literature
      review they found that this case represents a very rare association.

PMID- 7785799
TI  - Cerebral dural sinus thrombosis. A case report.
AB  - Cerebral dural sinus thrombosis is an uncommon syndrome that a patient presents
      with severe headache, which may be associated with complex physical and
      neurologic findings. The authors present a thirty-two-year-old woman with severe
      headache, focal motor seizures, and subsequent hemiparesis when she was ten weeks
      pregnant, diagnosed as having a dural sinus thrombosis by magnetic resonance
      imaging and magnetic resonance angiography. In this report, the application of
      magnetic resonance techniques, including angiography to diagnose and monitor
      therapy for dural sinus thrombosis, is presented.

PMID- 7785800
TI  - Enamel surfaces after orthodontic bracket debonding.
AB  - The enamel surfaces of extracted teeth were studied clinically and with a
      scanning electron microscope following debonding of orthodontic attachments and
      subsequent polishing. Excess orthodontic resin was removed with tungsten carbide
      burs and abrasive discs. Several combinations of polishing agents were evaluated.
      The no. 30 fluted tungsten carbide bur appeared to be the most efficient method
      of removing highly filled resin, and it produced the least amount of scarring. A
      polishing sequence was developed which used resin points and cups followed by a
      water slurry of fine pumice and brown and green cups. This procedure was tested
      clinically and appeared to return the enamel to an acceptable condition. This
      procedure is fast, efficient, and comfortable for the patient.

PMID- 7785801
TI  - In vitro release of nickel and chromium from different types of simulated
      orthodontic appliances.
AB  - Five identical samples, each consisting of a fixed appliance, a headgear and a
      quad-helix for one-half of a dental arch, were immersed in 0.9% sodium chloride
      for 2 hours, 24 hours and 7 days. A control appliance was subjected to dynamic
      test conditions in a specially built "oral simulator" under similar test
      conditions. A significant release of nickel was detected from the quad-helix
      during the first two hours in static conditions, whereas during the following two
      periods significantly less nickel was released from the quad-helix than from the
      other appliances. The fixed appliance with simulated function showed a
      significantly higher cumulative release of nickel than the similar appliance in
      static conditions, 44.2 micrograms (SD 22.8) and 17.1 micrograms (SD 3.4). The
      total amounts of chromium released from the fixed appliance were significantly
      lower than those of nickel. No difference in the release of chromium was seen
      between the static and dynamic conditions. The results indicate certain
      differences in the amount and pattern of nickel release from different stainless
      steel orthodontic appliances in vitro. The release rate of nickel from
      dynamically loaded fixed appliances was found to be accelerated compared with
      that released under static conditions. Caution should be exercised when applying
      the results to the in vivo situation.

PMID- 7785802
TI  - Comparisons of the thermodynamic properties of three nickel-titanium orthodontic
      archwires.
AB  - The unique memory property of thermodynamic wire is only partially understood. It
      is believed to result from the wire's inherent capability to markedly alter its
      atomic bonding forces as a function of temperature. This shape recovery
      phenomenon may be the result of a transition in crystal structure that occurs by
      deformation and cooling. When the transition is reversed, by heating, the
      structure reverts to its original form and abrupt property changes occur. The
      purpose of this study was to determine the transition temperature ranges (TTR) of
      three commercially available thermodynamic archwires and to determine the rate of
      recovery of the wires when bent to a uniform shape. A jig was constructed to hold
      the wires and was suspended in a water bath within a plexiglass box. The
      temperature of the water bath was gradually increased. A program was written to
      acquire a single video frame from a running video tape and then allow the
      operator to graphically overlay the position of each wire specimen. The results
      indicate that the TTRs for the three commercially available thermodynamic wires
      are of similar magnitudes (x = 6.7 degrees C, 6.2 degrees C and 6.7 degrees C).
      The greatest differences were in the standard deviations (1.3 degrees C, 2.2
      degrees C and 3.7 degrees C) which may be a function of manufacturing during
      alloying of the wire and/or its heat treatment.

PMID- 7785803
TI  - Biomechanical behavior of the periodontium before and after orthodontic tooth
      movement.
AB  - This study was designed to investigate the biomechanical behavior of the
      periodontium including the periodontal ligament (PDL) in terms of tooth mobility.
      Tooth mobility was measured in the canines of 10 adolescent patients before and
      after distal movement. Distal movement of the canines was carried out by use of a
      calibrated sectional archwire exerting an initial retraction force of 200 g.
      Tooth mobility was measured immediately before and after canine retraction by use
      of a noncontact displacement sensor when varying distal forces of 0 to 500 g were
      applied to the mesial of the canine. Before tooth movement, tooth mobility
      exhibited a substantial increase in loading with forces ranging from 50 to 150 g.
      The rate of increase gradually decreased up to 500 g. A nonlinear change in tooth
      mobility was similarly observed at the end of tooth movement or 24 days after the
      initiation of movement. Tooth mobility, however, was significantly greater when
      forces above 200 g were loaded. The periodontal tissues--the PDL and alveolar
      bone in particular--become more flexible at the end of tooth movement, indicating
      reduced support by the periodontal tissues. These findings suggest that the
      elastic nature of the PDL and alveolar bone may decrease substantially at the end
      of tooth movement.

PMID- 7785804
TI  - Orthodontic bone remodeling in relation to appliance decay.
AB  - This study examined alveolar bone turnover and orthodontic tooth movement after
      appliance decay. One group of rats (N = 54) received orthodontic force (40 g
      initial activation) while the other (N = 36) was sham-treated. Groups of six rats
      were sacrificed at various times following activation. Tooth movement and
      appliance decay were monitored cephalometrically, and bone turnover was monitored
      locally by histomorphometry and phosphatase chemistries and systemically by serum
      phosphatase and osteocalcin changes. A significant association was found between
      spring forces assessed by direct measurement and by cephalometric images (R2 =
      0.784; p = 0.02). The cephalometric method indicated appliances were at least 93%
      deactivated by day 16. Tooth movement continued beyond the point of appliance
      decay (p < 0.001). This was accompanied by a dramatic decline in osteoblast
      surface (p < 0.0001) and an increase in osteoclast surface to control levels (p <
      0.001). A significant peak in bone formation rate was also noted around appliance
      decay (p = 0.005). Serum acid phosphatase and osteocalcin also increased after
      appliance decay (p < 0.05), but alkaline phosphatase did not. Bone acid
      phosphatase was characterized by a peak after appliance decay (p = 0.0004), but
      alkaline phosphatase remained depressed (p < 0.0001). These data demonstrate that
      significant amounts of alveolar bone turnover continue for an indeterminant
      period following appliance decay.

PMID- 7785805
TI  - Remodeling mechanisms of transseptal fibers during and after tooth movement.
AB  - The remodeling mechanisms of transseptal fibers during and after tooth movement
      were investigated histologically. An autoradiographic study was conducted to
      assess the synthetic response. One hundred fifty male Wistar strain growing rats
      were divided into three groups--one control and two experimental groups. Animals
      in the experimental groups were subjected to tooth movement with 25 g and 150 g
      of force. Maxillary first and second molars were separated and retained
      mechanically. Transseptal fibers were stretched in proportion to the amount of
      force applied for up to 2 days. Dynamic remodeling with proliferation of
      fibroblasts during tooth movement and slow rearrangement during retention periods
      occurred in both experimental groups. Collagen phagocytosis within the
      fibroblasts was observed ultrastructurally during the experimental periods. The
      number of silver grains in fibroblasts in the collagen fibers increased 160% the
      first day and 206% during the first 3 days. Proliferating fibroblasts remodeled
      the transseptal fibers through the synthesization and degradation of collagen
      fibers.

PMID- 7785806
TI  - Statistical analysis of differential lissajous EMG from normal occlusion and
      Class III malocclusion.
AB  - The method of differential lissajous electromyography (DL-EMG) was applied to
      investigate the relationship among the integrated EMG activity, timing, and
      coordination of the bilateral superficial anterior temporal and masseter muscle
      activities in normal occlusion and Class III malocclusion subjects. In both Class
      III malocclusion and normal occlusion subjects, the working side muscles showed a
      higher mean cumulative voltage (MCV) and mean maximum peak voltage (MMPV)
      compared with the balancing side. In addition, a higher MCV and MMPV of the
      working side masseter was observed in the normal occlusion group compared with
      that seen in the Class III group during both right and left side chewing (p <
      0.01). Discriminant analysis applied to examine the distribution, the size and
      the shape of DL-EMG pattern further indicated a statistical difference between
      subject groups (p < 0.01). Finally, there was a significantly higher percentage
      of clockwise DL-EMG pattern-generation in the normal group compared with that
      seen for Class III subjects (p < 0.01). These data indicate that, compared with
      normal subjects, patients with a Class III malocclusion have a demonstrably
      abnormal masticatory muscle balance which is well characterized by the DL-EMG
      method.

PMID- 7785807
TI  - The return of tooth surface luster following bracket removal.

PMID- 7785808
TI  - Crowding: timing of treatment.

PMID- 7785809
TI  - Extraction frequencies.

PMID- 7785810
TI  - Case report MH. Class II, Division 1 malocclusion with anterior openbite.
AB  - This case report was presented at a regular meeting of the Southern California
      Component of the Edward H. Angle Society in 1994. It demonstrates the value of
      two-phase treatment which resulted in effective vertical control.

PMID- 7785811
TI  - In defense of the guidance theory of palatal canine displacement.
AB  - From the foregoing debate it will be quite clear that Peck et al. have provided
      ample evidence that may be used to fuel the arguments of both sides: 1. Their
      material does not contradict the possibility that environmental factors may give
      rise to palatal displacement of canines generated by genetic anomaly of the
      adjacent teeth. 2. The buccally displaced canine finds itself similarly
      environmentally compromised by the different factor of crowding which leads to
      its characteristic buccally ectopic guidance pattern. 3. (a) Canines that are
      transposed with the premolar, (b) others that have erupted ectopically, high in
      the buccal sulcus and in the absence of crowding, and (c) certain palatal canines
      whose root apex is located markedly distant from their designated site, may all
      be labeled as genetically controlled with a fair degree of confidence. 4. In
      between these clearly defined entities there exists a "gray area" in which it is
      probable that the etiology of the individual displaced teeth may be linked to a
      combination of circumstances that obey premise number 1 and premise number 2, to
      varying degrees. The guidance theory cannot provide the complete answer to the
      etiology of the palatally displaced canine. Were this so, we would find PDC every
      time there was an anomalous or missing lateral incisor. Equally, it may not yet
      be discounted out of hand and certainly not on the basis of the evidence provided
      in the article in question.

PMID- 7785812
TI  - Enzyme-linked immunosorbent assay for apolipoprotein A-I in the serum of cattle.
AB  - An ELISA was developed to evaluate the concentration of apolipoprotein A-I, a
      major apoprotein in high-density lipoprotein, in the serum of cattle. Serum
      apolipoprotein A-I was purified electrophoretically, and antibodies to this
      protein were raised in rabbits. The specificity of the antiserum was assessed by
      use of several immunologic techniques including western blotting. The ELISA was
      sensitive (detection limit was 70 ng of apolipoprotein A-I/ml) and reliable
      (coefficients of variance were in the range of 3.5 to 8.2%). By use of this
      method, the serum apolipoprotein A-I concentration was higher in 2- to 6-year-old
      Holstein cows (mean +/- SD, 0.580 +/- 0.304 mg/ml) than in 7- to 15-month-old
      heifers (0.339 +/- 0.237 mg/ml), 6-month-old heifers (0.238 +/- 0.188 mg/ml), and
      6-month-old steers (0.173 +/- 0.146 mg/ml). The concentration, however, is not
      largely different in cows in early, middle, and late lactation and in non
      lactating stages. Results also indicated that apolipoprotein A-I concentration
      was decreased in cows with hepatic lipidosis (fatty liver) induced by
      administration of ethionine, suggesting that this method is a useful tool for the
      pathophysiologic study of lipid metabolism and its impairment in cattle.

PMID- 7785814
TI  - Body weight, heart weight, and heart-to-body weight ratio in greyhounds.
AB  - Heart and body weights were obtained from 230 Greyhounds during necropsy. Sex and
      age were recorded for each Greyhound. Twenty-nine racing and 21 nonracing
      Greyhounds among the 230 dogs were compared. Heart-to-body weight ratio was
      calculated. Statistical analysis was done to determine the effects of age, sex,
      and racing on heart and body weights and heart-to-body weight ratio. In adult
      Greyhounds, mean +/- SD body weight was 28.4 +/- 3.1 and 31.5 +/- 2.8 kg, heart
      weight was 355.6 +/- 52.8 and 381.4 +/- 50.8 g, and heart-to-body weight ratio
      was 1.3 +/- 0.2 and 1.2 +/- 0.2% for females and males, respectively. Heart and
      body weights were significantly different between sex and age groups and among
      nonracing and racing males. However, heart-to-body weight ratio was not
      significantly different among age, sex, or racing groups.

PMID- 7785813
TI  - Comparison of the sensitivity of the caudal fold skin test and a commercial gamma
      interferon assay for diagnosis of bovine tuberculosis.
AB  - A study to determine and compare the sensitivity of the caudal fold tuberculin
      test (CFT) and a commercial gamma-interferon (gamma-IFN) assay for diagnosis of
      bovine tuberculosis was conducted. A dairy herd with approximately a third of the
      cattle infected with Mycobacterium bovis was chosen for this study. All cattle
      from this herd were slaughtered, and tissue specimens for bacteriologic culturing
      and histologic examination were collected. Results of the CFT and gamma-IFN assay
      were compared with results of bacteriologic culturing and histologic examination
      to determine test sensitivity. Results were analyzed, using each of the following
      4 standards to classify cattle as infected: positive test result by bacteriologic
      culturing only; histologic examination only; bacteriologic culturing and
      histologic examination; and bacteriologic culturing or histologic examination.
      Sensitivity of the CFT ranged from 80.4 to 84.4%, depending on the standard of
      comparison. Sensitivity of the gamma-IFN assay ranged from 55.4 to 97.1%,
      depending on the standard of comparison and on the method of interpretation. The
      CFT was significantly (P < 0.001) more sensitive than the gamma-IFN assay for
      diagnosis of bovine tuberculosis when the gamma-IFN assay was conducted and
      interpreted as instructed by the manufacturer. Maximum overall sensitivity was
      achieved when results of the CFT and gamma-IFN assay were interpreted in
      parallel.

PMID- 7785815
TI  - Tissue and serum enzyme activities in the yellow rat snake (Elaphe obsoleta
      quadrivitatta).
AB  - Activities of diagnostically important enzymes were measured in serum and lysates
      of liver, kidney, skeletal muscle, heart, intestine, lung, and pancreatic tissues
      from wild-caught yellow rat snakes, Elaphe obsoleta quadrivitatta. All samples
      were analyzed for alkaline phosphatase, lactate dehydrogenase (LD), aspartate
      transaminase (AST), alanine transaminase, gamma-glutamyltransferase, and creatine
      kinase (CK) activities. The major enzyme activities found in the liver were LD
      and AST. The kidney had moderate activities of LD, AST, alanine transaminase, and
      CK. Skeletal muscle and heart contained high CK activity. Intestine, lung, and
      pancreas had low activities for most enzymes analyzed. Little to no gamma
      glutamyltransferase activity was found in serum or tissues analyzed. Serum enzyme
      activities in yellow rat snakes were similar to those described for other reptile
      species, except for serum CK activity, which was increased in rat snakes.

PMID- 7785816
TI  - Risk of feline infectious peritonitis in cats naturally infected with feline
      coronavirus.
AB  - A longitudinal survey of 820 cats in 73 households was conducted over a period of
      6 years to establish the fate of pet cats that were seropositive after natural
      exposure to feline coronavirus (FCoV). In particular, their risk of developing
      feline infectious peritonitis (FIP) was determined. The seropositive cats were
      assigned to 1 of 3 groups: cats from households in which FIP had recently been
      diagnosed; cats from households in which FIP had not been diagnosed, but from
      which kittens had been relocated and subsequently died of FIP; and cats from
      households in which FIP had not been diagnosed. Cats in the first group were not
      at greater risk of developing FIP than were cats in the other 2 groups.
      Consequently, any household in which seropositive cats live must be considered a
      potential source of FCoV that can cause FIP. There was no evidence that the
      enhanced disease, which has been described after experimentally induced infection
      of seropositive cats, exists in nature. Thus, analysis of the survival of the
      seropositive cats over periods of up to 36 months indicated that their risk of
      developing FIP decreased with time, suggesting the development of immunity rather
      than increased susceptibility to disease. In addition, of 56 cats deemed to have
      been naturally reinfected because their anti-FCoV antibody titers decreased and
      subsequently increased, only 3 developed FIP.

PMID- 7785817
TI  - Complement component C3b and immunoglobulin Fc receptors on neutrophils from
      calves with leukocyte adhesion deficiency.
AB  - Receptors for opsonins, such as complement component C3b (CR1) and
      immunoglobulins, Fc receptors, interact with adhesion glycoproteins in mediating
      immune functions. Defects in expression of the adhesion glycoproteins CD11/CD18
      results in severely hampered in vitro and in vivo adherence-related functions of
      leukocytes. Little is known regarding the effect of leukocyte adhesion deficiency
      (LAD) on ligand binding and receptor expression. We investigated the binding and
      expression of CR1 and Fc receptors by bovine neutrophils isolated from dairy
      calves suffering from LAD, compared with clinically normal (hereafter referred to
      as normal) age-matched calves. Neutrophils were also assayed for endogenously
      bound IgG and IgM and for exogenous binding of C3b, IgG1, IgG2, IgM, and
      aggregated IgG (aIgG), using flow cytometry. Luminol-enhanced chemiluminescence
      (CL) production in response to IgG2 opsonized zymosan was studied, and specific
      inhibition of CL was used to determine the specificity of IgG2 binding.
      Activation of protein kinase C with phorbol myristate acetate was used to
      determine the effect of cellular activation on expression of CR1. A greater
      percentage of neutrophils from normal calves bound C3b than did neutrophils from
      LAD-affected calves. Receptor expression was similar. Activation with phorbol
      myristate acetate resulted in increased expression of CR1 on neutrophils from
      normal and LAD-affected calves, but expression was almost twofold greater on
      neutrophils from normal calves. There was no difference between LAD-affected and
      normal calves in percentage of neutrophils that bound endogenous IgG and IgM. A
      greater percentage of neutrophils from normal calves bound exogenous IgM than did
      neutrophils from LAD-affected calves.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785818
TI  - Use of predictive modeling to evaluate the manipulation of milking frequency,
      temperature, and oxygen tension on growth of Escherichia coli in an artificial
      intramammary environment.
AB  - A method was developed to evaluate frequent milking as a means of controlling
      intramammary infection. An artificial intramammary environment was used to
      determine growth responses of Escherichia coli (P4) to natural changes in the
      mammary gland resulting from bacterial invasion. Physical conditions manipulated
      in this model were growth medium, temperature, and oxygen tension. Mathematical
      modeling was then incorporated to generate predictions concerning growth dynamics
      of the organism when milking frequency was changed. To test accuracy of the
      model, initial predictions were derived from bacterial growth data in which E
      coli was incubated in tryptose soy broth for 12 hours at 37 C and PO2 equal to
      23.3 mm of Hg. These predictions matched closely with experimental data in which
      12-, 4-, and 2-hour milking intervals were simulated in the artificial
      intramammary environment. The mathematical model was then used to characterize
      growth rate data from in vitro experiments in ultra-high temperature-treated milk
      and in vivo experimental infection data generated with E coli (P4). Predictions
      generated from this model suggested that increasing milking frequency to 4 or 6
      times daily controls growth of E coli for a prolonged period and that 12 times
      daily milking may lead to elimination of the bacterium.

PMID- 7785819
TI  - Detection of bovine immunodeficiency virus in blood and milk-derived leukocytes
      by use of polymerase chain reaction.
AB  - Bovine immunodeficiency virus (BIV) is prevalent in beef and dairy cattle, yet
      the mode(s) of BIV transmission are undefined. Using polymerase chain reaction,
      which specifically targeted a 235-bp, highly conserved region of the BIV pol
      gene, BIV-infected leukocytes were detected in the blood and milk of BIV
      seropositive cows. These data confirm the presence of BIV in milk and identify
      the potential for lactogenic transmission of this virus.

PMID- 7785820
TI  - Effect of selenium supplementation on colostral IgG concentration in cows grazing
      selenium-deficient pastures and on postsuckle serum IgG concentration in their
      calves.
AB  - Effects of selenium (Se) deficiency and supplementation on production of
      colostral immunoglobulins by beef cows and transfer of antigen-specific and
      nonspecific immunoglobulins to their calves were examined. Eight beef cows, with
      marginal to deficient Se status (blood Se concentration, 50 micrograms/L), were
      allotted by breed and age to 1 of 4 Se treatment groups (n = 20/group): no
      supplemental Se; parenteral administration of 0.1 mg of Se and 1 mg of vitamin
      E/kg of body weight; ad libitum consumption of 120 mg of Se/kg of salt-mineral
      mix (SMM); and parenteral administration of 0.1 mg of Se and 1 mg of vitamin E/kg
      plus ad libitum consumption of 120 mg of Se/kg of SMM. All cows were inoculated
      IM with lysozyme. Cows consumed Se-deficient pastures or hay (21 to 62
      micrograms/kg) during the study that began at mid-gestation and ended at
      postpartum hour 24. Although the concentration of specific lysozyme antibodies
      was not affected, cows given 120 mg of Se/kg of SMM (treatments 3 and 4) had
      higher colostral IgG concentration (P < 0.002) than did Se-deficient cows
      (treatments 1 and 2). Calves from cows in treatments 3 and 4 had higher
      postsuckle serum concentrations of IgG (P < 0.01) than did calves from cows in
      treatments 1 and 2. Colostral IgM and calf serum IgM concentrations did not
      differ among treatments.

PMID- 7785821
TI  - Specific antibodies in serum and vaginal mucus of heifers inoculated with a
      vaccine containing Tritrichomonas foetus.
AB  - Thirty-five heifers were allotted to 3 groups. Group 1 (control) consisted of 10
      heifers that were not vaccinated and were challenge exposed by breeding to
      infected bulls. Group 2 (natural challenge exposure) consisted of 10 heifers that
      were vaccinated and challenge exposed by breeding to infected bulls. Group 3
      (experimental challenge exposure) consisted of 15 heifers that were vaccinated
      and challenge exposed by breeding to infected bulls and by intravaginal
      inoculation with 10(7) Tritrichomonas foetus. Total immunoglobulin concentrations
      and specific trichomonal antibodies were determined in serum and vaginal
      secretions of heifers, using radial immunodiffusion and ELISA procedures. Control
      heifers remained infected for a mean of 10.6 weeks (range, 0 to 18 weeks), and
      heifers of the natural and experimental challenge-exposure groups remained
      infected for 3.2 and 5.0 weeks, respectively (range, 0 to 12 weeks). Total serum
      and cervicovaginal mucus concentrations of IgM, IgA, IgG1, and IgG2 did not
      change significantly after vaccination or challenge exposure. However, ELISA
      titers of total trichomonal antibodies increased up to 1:10,000 (range, 1:400 to
      1:10,000) in serum after vaccination, and increased approximately tenfold above
      background in cervicovaginal mucus. In serum, the predominant trichomonal
      antibody isotype was IgG1, although trichomonal IgA and IgM antibodies also
      increased. The predominant trichomonal antibody detected in cervicovaginal mucus
      was IgA. Antibody titers in serum and cervicovaginal mucus of vaccinated heifers
      were not increased by infection. However, in control heifers, the total local
      trichomonal antibody response increased three- to fivefold after
      infection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785822
TI  - Efficacy of injectable doramectin against natural Boophilus microplus
      infestations in cattle.
AB  - Three experiments were conducted in Latin America--1 in Brazil, 1 in Venezuela,
      and 1 in Argentina--using a common protocol to investigate the efficacy of a
      single SC injection of doramectin (200 micrograms/kg of body weight) for
      treatment and control of Boophilus microplus infestations in grazing cattle. In
      each experiment, 2 groups of 20 to 27 cattle were allocated on the basis of tick
      burdens present 24 hours before treatment to a treated or control group, which
      received saline solution (1 ml/50 kg). All cattle were injected in the mid-dorsal
      cervical region and examined on treatment day and on posttreatment days (PTD) 8,
      14, 21, and 28. On each observation day, the number of engorged and semiengorged
      ticks on half of each animals was counted and recorded. Doramectin was highly
      efficacious in removing tick burdens and controlling reestablishment of B
      microplus under field conditions of continuous reinfestation. Compared with tick
      counts in the control group, doramectin-treated cattle began to eliminate ticks
      after treatment and efficacy improved on subsequent observation days. In Brazil,
      efficacy was 91% at PTD 8 and 14, and increased to 99% or higher at PTD 21 and
      28. In Venezuela, efficacy was 100% at PTD 8, 14, and 21 and 92% at PTD 28. In
      Argentina, efficacy progressed from 94.5% at PTD 8 to 99 and 98.5% at PTD 21 and
      28, respectively. The reduction of the number of ticks in the doramectin-treated
      cattle was significant (P < 0.05) at each observation day.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7785823
TI  - Efficacy of lufenuron against developmental stages of fleas (Ctenocephalides
      felis felis) in dogs housed in simulated home environments.
AB  - Twenty-four, adult, female Beagles were arranged by body weight from greatest to
      least and allocated to 2 groups of 12 dogs, using random numbers. Dogs were
      housed collectively in 2 adjacent metal buildings, each divided into 4 rooms
      measuring 2.1 x 3.7 m. Each room was paneled and carpeted and had an access door
      to the outside with a connecting run that measured 2.1 x 9.1 m. Each run had a
      surface consisting of 5 cm of pea gravel overlaying 5 cm of sand, and was
      partially covered by an awning that provided shade at its proximal end. For
      placement in room/run units, dogs in each of the treated and control groups were
      alloted to 4 subgroups of 3 dogs each. Each subgroup of dogs was placed in a
      separate room/run unit. Units containing treatment or control subgroups were
      alternated to avoid placing identically treated subgroups adjacent to each other.
      Dogs of subgroups A, C, E, and G were treated with lufenuron monthly at a minimal
      target dosage of 10 mg/kg of body weight; those of subgroups B, D, F, and H were
      treated with excipient tablets. Dogs were treated on study days 7, 37, 68, and
      98. Each dog was infested with 100 newly emerged, unfed, insectary-reared, adult
      Ctenocephalides felis on each of study days 0 and 2. Thereafter, infestations on
      all dogs were dependent on continued development of fleas either in the indoor or
      outdoor environment. Numbers of fleas on each of the treated and control dogs
      were determined, using a nondestructive counting technique on days 6, 14, 21, 28,
      35, 56, 70, 84, 98, 112, and 119.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785824
TI  - Comparative treatment of mares susceptible to chronic uterine infection.
AB  - Four intrauterine treatment strategies were evaluated for effectiveness in mares
      that were confirmed to be susceptible to chronic uterine infection. Pretreatment
      samples were obtained at detection of estrus, and a genital strain of
      Streptococcus zooepidemicus was infused into the uterus when a preovulatory (> 35
      mm) follicle was detected. At 12 hours after inoculation, mares were assigned to
      1 of 4 selected treatment groups: autologous plasma, 100 ml (n = 5); potassium
      penicillin, 5 million U in 100 ml of phosphate-buffered saline solution (PBSS; n
      = 5); 10 mg of prostaglandin F2 alpha in 100 ml of PBSS (n = 5)' and large-volume
      lavage with normal saline solution (1,000 ml increments). A fifth group, treated
      with vehicle alone (100 ml of PBSS), served as a negative control (n = 7). All
      treatments were administered into the uterus. To assess the effectiveness of the
      treatment, samples for culture and cytologic examination were collected at 96
      hours after bacterial inoculation. An effect of treatment was observed on the
      number of uterine neutrophils (P = 0.02) and growth of S zooepidemicus (P <
      0.01). Intrauterine treatment with potassium penicillin, prostaglandin F2 alpha,
      and large-volume uterine lavage significantly reduced the growth of S
      zooepidemicus (P < 0.01) as well as the number of neutrophils (P < 0.02).
      Autologous plasma reduced the number of neutrophils (P < 0.05), but not growth of
      S zooepidemicus. There was significant correlation between the number of uterine
      neutrophils and growth of S zooepidemicus for each treatment group (r = 0.57; P <
      0.05).

PMID- 7785825
TI  - Articular chondrocalcinosis of the humeral head in greyhounds.
AB  - Of 143 Greyhounds necropsied consecutively, 6 (4%) had chondrocalcinosis of the
      scapulohumeral joint; lesions were identified in 6 additional dogs. Lesions were
      seen exclusively in the humeral head, mainly in the plateau region. The lesions
      in the dogs of the initial group were unilateral, but 2 of the 6 additional dogs
      had bilateral lesions. Focal mineralization of articular cartilage appeared as a
      white raised nidus, sometimes surrounded by a translucent halo in the opaque
      cartilage. Circular, small translucent cartilage foci, with or without beginning
      mineralization, were adjacent to definitive chondrocalcinosis lesions.
      Chondrocyte necrosis and matrix degradation were considered to antedate
      appearance of matrical mineral granules; mineralization of the cartilage was
      considered a secondary process, but not necessarily an epiphenomenon. Scanning
      electron microscopy indicated that the chondrocalcinosis lesion was composed of
      deposits of irregularly fused stone material that, in scanning and transmission
      electron micrographs, was composed of irregular spheroids, 0.05 to 0.5 micron in
      diameter. The spheroids contained poorly formed needle-like crystals of apatite.
      Sparse transformation of the mineral phase into hydroxyapatite was considered to
      be attributable to a biological mechanism that inhibited phase transition.
      Cartilage degeneration and chondrocalcinosis of the plateau region of the humeral
      head appear to be unique lesions that develop in young Greyhounds. It is possible
      that these lesions are the result of the biomechanical stress of training and
      racing.

PMID- 7785826
TI  - Ceftiofur distribution in serum and milk from clinically normal cows and cows
      with experimental Escherichia coli-induced mastitis.
AB  - Eight Holstein cows, 4 inoculated intracisternally in 1 quarter of the mammary
      gland with Escherichia coli and 4 noninfected controls, were administered
      ceftiofur sodium (3 mg/kg of body weight, IV, q 12 hours) for 24 hours, beginning
      at 14 hours after inoculation of infected cows. All challenge-exposed cows became
      infected, with mean +/- SEM peak log10 bacterial concentration in milk of 5.03 +/
      0.69 colony-forming units/ml. The infection resulted in systemic signs (mean
      peak rectal temperature, 41.5 +/- 0.3 C; anorexia; signs of depression) and local
      inflammation (mean peak albumin concentration in milk, 7.89 +/- 1.71 mg/ml).
      Ceftiofur was detectable in milk from all challenge-exposed cows, compared with
      only 1 of 4 noninfected cows, and the mean period after inoculation that
      ceftiofur was detectable in milk was longer (P < 0.05) in infected (147.7 +/-
      27.5 hours) than noninfected cows (1.3 +/- 1.3 hours). However, maximal ceftiofur
      concentration attained in milk for all cows was 0.28 microgram/ml, and was 0.20
      microgram/ml or less for all but 2 milk samples collected for 10 days after
      challenge exposure. Mean serum concentration of ceftiofur peaked at 1.0 +/- 0.3
      microgram/ml and 0.7 +/- 0.1 microgram/ml for infected and noninfected cows,
      respectively. After each ceftiofur dose, mean peak and trough concentrations of
      ceftiofur in serum did not differ between groups; however, concentration of
      ceftiofur in serum was higher at 7 hours after each dose in noninfected cows,
      suggesting more rapid clearance of the drug in infected cows.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7785827
TI  - Effect of methacholine on mucociliary transport in bovine trachea in vitro.
AB  - A method is described to evaluate pharmacologic influence on bovine tracheal
      mucus transport in vitro. In this model, cholinergic agonist methacholine
      stimulated transport velocity. Methacholine at concentration of 10(-6)M increased
      velocity by 13.6%, whereas 10(-5)M increased velocity by 26%. Stimulation was
      inhibited by atropine.

PMID- 7785828
TI  - High-performance liquid chromatography method for determination of flunixin in
      bovine plasma and pharmacokinetics after single and repeated doses of the drug.
AB  - A high-performance liquid chromatography method was developed for determination
      of flunixin in bovine plasma. The extraction procedure was easily performed and
      made it possible to detect low concentrations of flunixin with high accuracy. The
      limit of quantitation was 7 ng/ml (relative standard deviation = 18% n = 10). The
      analytic method permits processing of 60 samples/d. Flunixin, as well as the
      internal standard (diclofenac sodium), belong to the group of nonsteroidal anti
      inflammatory drugs, which are known to have a high degree of binding to plasma
      proteins. Therefore, an evaluation of several buffer systems was undertaken to
      optimize analytic conditions. Cattle were given 2.2 mg of flunixin melgumine/kg
      of body weight. In experiment 1, single injections were administered IV to 1 cow
      and IV and IM to 1 heifer (7 days apart), and pharmacokinetic variables were
      calculated. The IV data were best described by a two-compartment model. The half
      life after single IV or IM administration was around 4.0 hours. In experiment 2,
      the decreasing flunixin concentration was determined after the last of either 4
      IM injections daily (n = 3 cows) or 2 IM injections daily (n = 3 cows)
      administered during a 14-day postpartum period. The half-life, determined between
      48 and 96 hours after the last dose, was approximately 26 hours in both groups,
      and flunixin could be detected in plasma up to 8 days, on average. The protein
      binding of flunixin was studied, using the method of equilibrium
      dialysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785829
TI  - Cardiovascular effects of epidurally administered morphine and a xylazine
      morphine combination in isoflurane-anesthetized dogs.
AB  - Cardiovascular effects of epidurally administered morphine, a morphine-xylazine
      combination, and saline solution (control) during isoflurane-maintained
      anesthesia were assessed in 6 healthy dogs. Anesthesia was induced with
      isoflurane in O2 and was maintained at 2.0% end-tidal isoflurane concentration.
      Ventilation was controlled to maintain PaCO2 at 35 to 45 mm of Hg. The dorsal
      pedal artery was cannulated for measurement of systolic, mean, and diastolic
      pressures, and for blood sample collection. Arterial blood pH and gas tensions
      were determined every 30 minutes. Cardiac output was determined by
      thermodilution. The ECG, heart rate, body temperature, central venous pressure,
      mean pulmonary artery pressure, pulmonary capillary wedge pressure, end-tidal
      isoflurane concentration, and CO2 tension were monitored. Systemic and pulmonary
      vascular resistance, arterial HCO3- concentration, base excess, and cardiac index
      were calculated. After baseline measurements were taken, morphine (0.1 mg/kg of
      body weight) in 5 ml of isotonic saline solution, morphine and xylazine (0.1 mg
      of morphine and 0.02 mg of xylazine/kg) in 5 ml of isotonic saline solution, or 5
      ml of isotonic saline solution was injected into the lumbosacral epidural space.
      Data were recorded at 5, 15, 30, 45, 60, 75, 90, 105, and 120 minutes after
      epidural injection. Statistical analysis included ANOVA for repeated measures.
      Significance was set at P < 0.05. None of the measured variables was
      significantly different among the 3 treatments at any time. Results of the study
      indicated that epidural administration of morphine or morphine and xylazine is
      not associated with significant cardiovascular side effects during isoflurane
      maintained anesthesia in dogs.

PMID- 7785831
TI  - Eicosanoid concentrations in digital venous blood from horses with chronic
      laminitis.
AB  - The eicosanoids are a family of lipid-derived autocoids that are released in
      response to a variety of physical and hormonal stimuli. In this study,
      prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) were measured in the digital
      veins of clinically normal horses and horses with chronic laminitis to determine
      whether these arachidonic acid metabolites have a role in mediating signs of hoof
      pain and lesions associated with chronic laminitis. Horses were evaluated at rest
      and after a brief exercise period, to determine whether eicosanoids are released
      into the circulation after mild concussion. Digital vein eicosanoid
      concentrations in horses with signs of hoof pain attributable to chronic
      laminitis were not different than those in clinically normal horses. There was no
      difference in resting and postexercise PGE2 or LTB4 concentrations. Mean digital
      vein PGE2 concentration for the 2 groups was 187.18 pg/ml, whereas mean digital
      vein LTB4 concentration for the 2 groups was 74.71 pg/ml. These data do not
      support the hypothesis that PGE2 and LTB4 have a role in mediating the signs of
      pain and pathologic features of chronic laminitis.

PMID- 7785830
TI  - Pharmacokinetics and residues of enrofloxacin in chickens.
AB  - The pharmacokinetic properties of enrofloxacin were determined in broiler
      chickens after single IV and orally administered doses of 10 mg/kg of body
      weight. After IV and oral administrations, the plasma concentration-time graph
      was characteristic of a two-compartment open model. The elimination half-life and
      the mean +/- SEM residence time of enrofloxacin for plasma were 10.29 +/- 0.45
      and 9.65 +/- 0.48 hours, respectively, after IV administration and 14.23 +/- 0.46
      and 15.30 +/- 0.53 hours, respectively, after oral administration. After single
      oral administration, enrofloxacin was absorbed slowly, with time to reach maximal
      plasma concentration of 1.64 +/- 0.04 hours. Maximal plasma concentration was
      2.44 +/- 0.06 micrograms/ml. Oral bioavailability was found to be 64.0 +/- 0.2%.
      Statistically significant differences between the 2 routes of administration were
      found for the pharmacokinetic variables--half-lives of the distribution and
      elimination phase and apparent volume of distribution and volume of distribution
      at steady state. In chickens, enrofloxacin was extensively metabolized into
      ciprofloxacin. Residues of enrofloxacin and the major metabolite ciprofloxacin in
      fat, kidney, liver, lungs, muscles, and skin were measured in chickens that
      received an orally administered dose of 10 mg/kg once daily for 4 days. The
      results indicate that enrofloxacin and ciprofloxacin residues were cleared
      slowly. Mean muscle, liver, and kidney concentrations of the metabolite
      ciprofloxacin ranging between 0.020 and 0.075 micrograms/g persisted on day 12 in
      chickens after dosing. However, at the time of slaughter (12 days), enrofloxacin
      residues were only detected in liver and mean +/- SEM concentration was 0.025 +/-
      0.003 micrograms/g.

PMID- 7785832
TI  - Adrenocortical function in neonatal and weanling beagle pups.
AB  - Adrenocortical function was assessed in 27 Beagle pups at 2, 4, 6, 8, 10, and 12
      weeks of age by determination of plasma sodium, potassium, and chloride
      concentrations; serum aldosterone and cortisol concentrations; and plasma ACTH
      concentrations. Serum cortisol concentration was measured before and 1 and 2
      hours after IM administration of 2.2 IU of ACTH/kg of body weight. Serum
      progesterone concentration also was determined for all pups at 2, 4, and 6 weeks
      of age. Mean baseline cortisol concentration was lower for pups 8 weeks old or
      younger than for mature dogs. Nevertheless, mean serum ACTH-stimulated cortisol
      concentration in dogs of all age groups increased into the adult reference range
      after administration of ACTH. For pups 4 weeks old or younger, increase in
      cortisol concentration was maximal at 2 hours after ACTH administration. However,
      in pups between 6 and 12 weeks of age, the increase in cortisol concentration was
      maximal 1 hour after ACTH administration in about a third of the pups, whereas
      the remaining pups had peak values at 2 hours. Mean plasma sodium, potassium, and
      chloride concentrations for each age group were within the reference ranges
      established for mature dogs, with the exception of lower mean plasma sodium and
      chloride concentrations in pups 4 weeks old or younger. Mean serum aldosterone
      concentration in pups of each age group was substantially higher than the range
      of aldosterone concentrations for clinically normal mature dogs. Median
      progesterone concentration was uniformly less than 0.2 ng/ml for all pups 6 weeks
      old or younger.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785833
TI  - Laparoscopic anatomy of the equine abdomen.
AB  - Laparoscopy was performed on 6 horses (2 mares, 2 geldings, 2 stallions) to
      determine the normal laparoscopic anatomy of the equine abdomen. After
      withholding feed for 36 hours, horses were examined from the left and right
      paralumbar fossae, and the visceral anatomic structures were recorded by
      videotape and photography. One mare developed emphysema located subcutaneously at
      the primary laparoscopic portal; otherwise, there were no complications. The
      anatomic structures of diagnostic importance that were observed in the left half
      of the abdomen were the hepatic duct; left lateral and quadrate lobes of the
      liver; stomach; spleen; left kidney with the associated nephrosplenic ligament;
      segments of jejunum, descending colon, and ascending colon; left side of the male
      and female reproductive tracts; urinary bladder; vaginal ring; and mesorchium.
      Important structures observed in the right side of the abdomen were portions of
      the common hepatic duct; left lateral, quadrate, and right lobes of the liver;
      caudate process of the liver; stomach; duodenum; right dorsal colon, epiploic
      foramen; omental bursa; right kidney; base of the cecum; segments of jejunum,
      descending colon, and ascending colon; urinary bladder; right half of the male
      and female reproductive tracts; and rectum.

PMID- 7785834
TI  - Ototoxicity assessment of a gentamicin sulfate otic preparation in dogs.
AB  - Vestibulotoxic and ototoxic effects often are seen after long-term, high-dose
      systemic treatment with gentamicin, but toxic effects after topical use have not
      been reported in animals, to the authors' knowledge. Vestibular and auditory
      effects of twice daily otic gentamicin treatment for 21 days were evaluated in 10
      dogs with intact tympanic membranes and in the same 10 dogs after experimental
      bilateral myringotomy. Each dog served as its own control; 7 drops of gentamicin
      sulfate (3 mg/ml in a buffered aqueous vehicle) were placed in 1 ear, and 7 drops
      of vehicle were placed in the opposite ear. Treatment and control ears were
      reversed after myringotomy. Vestibular function was evaluated daily by neurologic
      examination and behavioral assessment. Auditory function was evaluated twice
      weekly by determination of brain stem auditory evoked potentials. Gentamicin
      sulfate placed in the ear of clinically normal dogs with intact or ruptured
      tympanic membranes, in the quantities used in this study, did not induce
      detectable alteration of cochlear or vestibular function. Serum gentamicin
      concentration after 21 days of treatment was detectable in only 2 dogs and was an
      order of magnitude below documented toxic concentrations.

PMID- 7785835
TI  - Enzyme Engineering XII. Conference proceedings. Deauville, France, September 19
      24, 1993.

PMID- 7785836
TI  - Reaction mechanism for the conversion of 5-monosubstituted hydantoins to
      enantiomerically pure L-amino acids.
AB  - The specific conversion of D,L-5-monosubstituted hydantoins to optically pure L
      amino acids by resting cells of Arthrobacter sp. DSM 7330 has been evaluated. A
      new nonstereoselective hydantoinase from Arthrobacter sp. DSM 7330 was isolated
      and characterized. When whole cells were tested, the conversion of D,L-5
      methylthioethylhydantoin (D,L-5-MTEH) led to the optically pure intermediate D
      carbamoylmethionine (D-CM) and to the optically pure amino acid L-methionine.
      After purification of the hydantoin hydrolyzing enzyme, the probable reaction
      mechanism of the conversion of 5-monosubstituted hydantoins to enantiomerically
      pure L-amino acids could be enlightened.

PMID- 7785837
TI  - Random mutagenesis of the substrate-binding site of a serine protease. A new
      library of alpha-lytic protease S1 mutants.

PMID- 7785838
TI  - Micromachining technology and biosensors.

PMID- 7785839
TI  - A novel electropolymerized sensing layer for biosensors involving entrapped
      enzyme-phospholipid vesicles.

PMID- 7785840
TI  - Reconstitution of a functional electron transfer in a biomimetic structure,
      including an electrode interface, phospholipid and ubiquinone molecules, and a
      membrane enzyme.

PMID- 7785841
TI  - In vitro glycosylation of enzymes. Modification of activity and stability.

PMID- 7785842
TI  - Enzymatic polymerization of p-phenylphenol in aqueous micelles.

PMID- 7785843
TI  - In vitro protein biosynthesis using ribosome and foreign mRNA. An approach to
      construct a protein biosynthesizer.

PMID- 7785844
TI  - Stereoselective microbial reduction of 2-keto-3-(N-benzoylamino)-3-phenyl
      propionic acid ethyl ester. Synthesis of taxol side-chain synthon.

PMID- 7785845
TI  - Time course of glutamine in a culture medium during high-density culture of mouse
      C127 transformants.

PMID- 7785846
TI  - The design, synthesis, and activity of a ribozyme that specially cleaves rat 28S
      rRNA.

PMID- 7785847
TI  - Studies on the engineering of human lysozyme.

PMID- 7785848
TI  - Relationships between structures and kinetic properties of pancreatic lipases.

PMID- 7785849
TI  - Structural and functional aspects of an industrial lipase.

PMID- 7785850
TI  - A new method for estimating the selectivity of lipases for fatty acids and fatty
      alcohols in organic solvents.

PMID- 7785851
TI  - DNA-hydrolyzing autoantibodies in autoimmune pathologies.

PMID- 7785852
TI  - Antiidiotypic antibodies as functional internal images of enzyme-active sites.

PMID- 7785853
TI  - Study of the abzyme with peroxidase catalytic activity.

PMID- 7785854
TI  - A new strategy for generating selenium-containing abzyme. Chemical mutation of
      monoclonal antibodies with substrate-binding sites.

PMID- 7785856
TI  - Protein disulfide isomerase reaction kinetics in endoplasmic reticulum for
      monoclonal antibody refolding and assembly.

PMID- 7785855
TI  - Complementary approach for the determination of histidine in the metal-binding
      site of an anti-DTPA-indium monoclonal antibody.

PMID- 7785857
TI  - A multifunctional flow-injection biosensor for the simultaneous determination of
      ammonia, creatinine, and urea.
AB  - A strategy for the multifunctionalization of the FIA biosensor was developed. The
      described multifunctional FIA system offers a fast and simple method for the
      simultaneous determination of ammonia, creatinine, and urea. The hydrolysis of
      creatinine by creatinine deiminase (CRDI) or of urea by urease forms ammonia,
      which is amperometrically detected by an oxygen electrode, based on an enzyme
      conversion system, glutamate dehydrogenase (GLDH)/glutamate oxidase (GLOD). The
      split of the stream into three after sample injection and confluence before the
      GLDH reactor resulted in a three-channel system, into which were set three
      parallel columns, respectively, filled with immobilized CRDI, urease, and CPG. A
      triple-peak recording was obtained by putting two delay coils at the channels
      involving CRDI and urease. Thus the interfering of the endogenous ammonia on the
      creatinine and urea assay is simultaneously compensated. Furthermore, the problem
      of great difference in concentration between urea and the other two components is
      resolved by taking advantage of the differentiated dilution effect for each
      channel caused from the split-stream, flow-injection system. Linear calibration
      ranges for ammonia, creatinine, and urea were 0.1-5, 0.2-10, and 2-40 mM,
      respectively. One run was finished within 5 minutes, and the system was
      reproducibility good (3 to 5%). The results of the urine assay obtained by the
      present method will be described in the near future.

PMID- 7785859
TI  - Enzymatic synthesis of low-calorie sugar substitutes. Cellobiofructose and
      gentiobiofructose.

PMID- 7785858
TI  - Enzymatic production of glucooligosaccharides containing alpha-(1-->2) osidic
      bonds. Potential application in nutrition.

PMID- 7785861
TI  - Application of sucrose synthase from rice grains for the synthesis of
      carbohydrates.

PMID- 7785860
TI  - Transglucosylation of a fungal alpha-glucosidase. The enzyme properties and
      correlation of isomaltooligosaccharide production.

PMID- 7785862
TI  - Enzymatic synthesis of partially acylated sucroses.

PMID- 7785863
TI  - Enzymes from Zymomonas mobilis and their application to glucose determination.

PMID- 7785864
TI  - Design of novel biocatalysts by "bioimprinting" during unfolding-refolding of
      fully dispersed covalently immobilized enzymes.

PMID- 7785865
TI  - New developments in the application of enzymes to synthesis reactions. Peptides
      and oligosaccharides.

PMID- 7785866
TI  - Industrial application of immobilized biocatalysts in Japan.

PMID- 7785867
TI  - 3-Ketoacyl CoA thiolases of a yeast, Candida tropicalis. Properties and
      functions.

PMID- 7785868
TI  - Industrial utilization of a hollow-fiber membrane reactor for the controlled
      lipolysis of butterfat.

PMID- 7785869
TI  - Production of fibrin polymerization inhibitor from collagen by some proteases.

PMID- 7785870
TI  - Production of L-amino acids by applying D-amino acid oxidases.

PMID- 7785871
TI  - Preparation of (R)- and (S)-propylene glycol with baker's yeast.

PMID- 7785872
TI  - Production of bioactive peptides from corn endosperm proteins by some proteases.

PMID- 7785873
TI  - Bioremediation using an immobilized cell generator.

PMID- 7785874
TI  - An integrated bioreactor system for biologically active peptides from isolated
      soybean protein.

PMID- 7785875
TI  - Enhanced subtilisin production with spore mutants of Bacillus subtilis and their
      characterization.

PMID- 7785876
TI  - Peptic hemoglobin hydrolysis in an ultrafiltration reactor at pilot plant scale
      generates opioid peptides.
AB  - Two hemorphins, peptides with opioid activity, have been isolated from a pepsin
      hydrolysate of bovine hemoglobin, by use of gel permeation (GP) and reverse phase
      (RP) high-performance liquid chromatography (HPLC). Their primary structure and
      accurate molecular weights, determined by amino acid analysis and fast atom
      bombardment (FAB) mass spectrometry, were identical to fragments 31-40 (LVV
      hemorphin-7) and 32-40 (VV-hemorphin 7) of the beta-chain of bovine hemoglobin.
      Two other peptides, 34-40 (hemorphin-7) and 34-41 (hemorphin-8) of the beta-chain
      of bovine hemoglobin, have been synthesized and studied. The opioid potency of
      these peptides, exhibited by the use of electrically stimulated muscle of
      isolated guinea pig ileum (GPI), were significant and comparable with some others
      previously described. Studies of opioid activities and primary structure of
      hemorphins led us to postulate the important role of arginine and phenylalanine
      in opioid potency.

PMID- 7785877
TI  - Photosensitizing activity of porphyrinic peptide hydrolysates derived from bovine
      hemoglobin.

PMID- 7785878
TI  - Purification and properties of uricase from Candida sp. and its application in
      uric acid analysis in serum.

PMID- 7785879
TI  - Experimentally targeted thrombolytic therapy. Application of modified thrombin
      conjugated with urokinase.

PMID- 7785880
TI  - Aspergillus ficuum phytase active site: involvement of Arg and Trp residues.

PMID- 7785881
TI  - Determination of the intrinsic Michaelis constant of immobilized heparinase.

PMID- 7785882
TI  - Controlling susceptibility against protease digestion.

PMID- 7785883
TI  - Micellar enzymology for enzyme engineering. Ideas and realization.

PMID- 7785884
TI  - Structural effect of reversed micelles of AOT over a recombinant cutinase from
      Fusarium solani pisi. A steady state fluorescence study.

PMID- 7785885
TI  - Permanent enzyme microencapsulation in reverse micellar media.

PMID- 7785886
TI  - Baroenzymology in reversed micelles.

PMID- 7785887
TI  - Stability and activity of acid phosphatase in reverse micelles.

PMID- 7785888
TI  - Osteopontin: Role in Cell Signalling and Adhesion. Proceedings of a conference.
      New Brunswick, New Jersey, October 21-23, 1994.

PMID- 7785889
TI  - Regulation and function of osteopontin in ras-transformed cells.
AB  - Transformation of nontumorigenic NIH 3T3 fibroblasts with an activated ras
      oncogene produces malignant cells that can metastasize. This induction of
      malignant behavior is due to changes in gene expression induced by Ras-mediated
      signal transduction. Osteopontin expression is induced in response to Ras, due to
      increased osteopontin transcription mediated by Ras-responsive regions in the
      osteopontin gene promoter. The increased expression of osteopontin contributes
      functionally to the malignant ability of the cells. Ras-transformed cells that
      express antisense osteopontin RNA show markedly reduced ability to form tumors
      and to metastasize in experimental animals. Increased osteopontin expression in
      human tumors thus may also contribute to increased malignancy. Site-directed
      mutagenesis of recombinant osteopontin protein indicates that an intact RGD
      sequence is required for cell adhesion and induction of chemotaxis, consistent
      with the idea that integrin-mediated signal transduction is a consequence of
      osteopontin binding to cells. Osteopontin may contribute to malignancy by
      inducing responses in host and/or tumor cells.

PMID- 7785891
TI  - Conformational analyses on soluble and surface bound osteopontin.
AB  - Immunohistology of calvarial sections revealed that staining with monoclonal anti
      osteopontin antibodies (clone MPIIIB10) is minimal unless sections are first
      treated with EDTA. In contrast, following treatment of sections with EDTA, strong
      staining of mineralizing osteoid areas and osteoblast-like cells was noted (Fig.
      1B). Immunostaining for osteopontin appeared to be specific in that controls
      which substituted rabbit IgG or normal mouse ascites fluid for monoclonal
      antibody, or which omitted monoclonal antibody uniformly gave background results
      (Fig. 1C). In an effort to circumvent problems of antibody accessibility we
      examined the immunoreactivity of OP when adsorbed to plastic and hydroxyapatite
      surfaces. Although OP bound to plastic surfaces is reactive with MPIIIB10
      antibodies, OP adsorbed to hydroxyapatite crystal surfaces is not recognized by
      these antibodies as assessed by two detection methods. These results demonstrate
      that most or all of OP bound to hydroxyapatite exhibits a different conformation
      than when bound to plastic surfaces. On the basis of immunohistologic results
      with calvarial sections, we suggest that the conformation of native OP in bone
      and of isolated OP adsorbed to hydroxyapatite may be similar. Finally, solution
      circular dichroism and Fourier-transformed infrared spectroscopic studies
      indicate that the conformation of bone OP is dependent upon its concentration,
      and, secondarily to the presence or absence of calcium ion. With both
      spectroscopic methods, addition of calcium appeared to increase the extent of
      disordered structure. We suggest that these findings support our hypothesis that
      bone matrix proteins exhibit a different conformation when adsorbed on
      hydroxyapatite crystal surfaces. Assumption of a more organized secondary
      structure in concentrated OP solutions (i.e., 15 mg/ml) is consistent with these
      results in that local concentrations of OP within a semisolid matrix may approach
      or exceed levels used here.

PMID- 7785890
TI  - Osteopontin expression in cardiovascular diseases.
AB  - Adhesive interactions are recognized requirements for cellular proliferation,
      migration and differentiation during normal morphogenesis as well as disease. By
      differential cloning, osteopontin was identified as an adhesive protein
      upregulated during vascular remodeling and neointima formation in both rat models
      and human vascular diseases including atherosclerosis and restenosis. In
      functional studies, purified osteopontin promoted adhesion, focal contact
      formation, and migration of vascular smooth muscle and endothelial cells.
      Utilizing neutralizing antibodies, three integrin-type receptors, alpha v beta 3,
      alpha v beta 1, and alpha v beta 5 were found to support cellular adhesion to
      osteopontin. In contrast, only cells containing the alpha v beta 3 integrin could
      migrate towards an osteopontin gradient, demonstrating for the first time that
      different functions of osteopontin are mediated via distinct receptors. These
      results suggest a model whereby osteopontin, via its integrin-type receptors,
      contributes to vascular remodeling during development and disease by facilitating
      smooth muscle migration and simultaneously promoting endothelial coverage of the
      affected area.

PMID- 7785892
TI  - The role of Eta-1/osteopontin in the pathogenesis of immunological disorders.

PMID- 7785894
TI  - Osteopontin and the bone remodeling sequence. Colloidal-gold immunocytochemistry
      of an interfacial extracellular matrix protein.
AB  - Relative to other noncollagenous, extracellular matrix proteins in mineralized
      tissues, colloidal-gold immunocytochemistry has demonstrated that the
      ultrastructural distribution of osteopontin (OPN) is unique in that this protein
      preferentially accumulates at mineralized tissue interfaces. In bone, this
      protein is present as a major component of cell-matrix and matrix-matrix
      interfacial structures called cement lines and laminae limitantes. In the present
      article, the implications of this distinct tissue distribution are discussed in
      terms of the bone remodeling sequence, and a detailed account of the secretion,
      accumulation and potential role of OPN is presented and related to current theory
      on the cellular and extracellular matrix events associated with basic
      multicellular unit (BMU)-based bone remodeling. In this context, a proposal is
      made describing the production of this protein as one of the earliest, and
      latest, secretory activities of the osteoblastic lineage, and that this activity
      manifests itself morphologically as a cement line ('plane') and a lamina
      limitans, respectively, at bone matrix interfaces. When integrated with other,
      known functional characteristics of this protein, the present morphological and
      compositional data indicate that OPN in cement lines and laminae limitantes may
      participate in initial and late extracellular matrix organization and
      mineralization, matrix-matrix/mineral adhesion and/or cell adhesion at bone
      interfaces.

PMID- 7785895
TI  - Interaction of osteopontin with fibronectin and other extracellular matrix
      molecules.

PMID- 7785893
TI  - Localization and expression of osteopontin in mineralized and nonmineralized
      tissues of the periodontium.
AB  - To summarize results from various studies focusing on determining the
      expression/localization of BSP and OPN during tooth root development, there is
      general agreement that OPN is expressed/localized to the root surface during
      cementogenesis and is also seen throughout the PDL region. The
      expression/localization of OPN to odontoblasts and its role in dentinogenesis is
      less apparent. Recent studies directed at establishing odontoblast cell lines
      should help to resolve this conflict. Studies on BSP expression during tooth root
      formation indicate a very precise expression and localization of this molecule
      during cementogenesis indicating that this molecule may play an important role in
      the formation of this mineralized tissue. However, as with OPN, the expression of
      BSP and its role in dentin formation is not clearly defined.

PMID- 7785896
TI  - Regulation of osteopontin expression in osteoblasts.
AB  - Osteopontin (OPN) is a prominent bone matrix protein that is synthesized by
      osteoblastic cells. To elucidate the function of OPN in bone we studied the
      regulated expression of the rat OPN protein during bone formation in vivo and in
      vitro. OPN mRNA is expressed by preosteoblastic cells early in bone formation,
      but the highest expression is observed in mature osteoblasts at sites of bone
      remodelling. A low-phosphorylated, 55-kDa form of OPN is produced by the
      preosteoblastic cells, whereas osteoblasts produce a highly phosphorylated, 44
      kDa protein; the two forms of OPN corresponding to pp69 and pp62 in transformed
      rat cells. The synthesis of the 55-kDa OPN correlates with the formation of a
      'cement' matrix that is synthesized prior to bone deposition, whereas the 44-kDa
      OPN synthesized by osteoblasts associates rapidly with hydroxyapatite, possibly
      regulating crystal growth, and may also provide a substratum for osteoclast
      attachment. Expression of OPN mRNA is upregulated by growth and differentiation
      factors (PDGF, EGF, TGF-beta and BMP-7/OP-1) and by mechanical stress, which
      promote bone formation, as well as by osteotropic hormones (retinoic acid and
      vitamin D3), which can promote bone resorption and remodelling. However, OPN mRNA
      is down-regulated by bisphosphonates, which abrogate bone resorption. Regulation
      of OPN expression is, therefore, consistent with a multiplicity of functions for
      OPN that involve specific structural motifs in both the synthesis and resorption
      of bone.

PMID- 7785897
TI  - Effects of okadaic acid on calcitriol- and phorbol ester-induced expression and
      phosphorylation of osteopontin in mouse JB6 epidermal cells.

PMID- 7785898
TI  - Regulation of osteopontin gene expression in osteoblasts.

PMID- 7785899
TI  - Osteopontin and related phosphorylated sialoproteins: effects on mineralization.
AB  - Osteopontin is one of a family of phosphorylated sialoproteins found in the
      extracellular matrices of mineralized connective tissues. Solution studies from a
      variety of laboratories have shown that while some of these proteins (e.g.,
      osteopontin, dentin sialoprotein) inhibit calcium phosphate production, others,
      such as bone sialoprotein, can act as a nucleator of calcium phosphate formation.
      The differences in the behaviors of these proteins can be related to their
      interactions with mineral crystal nuclei and crystal growth sites. The
      specificity of these interactions, in turn, can be related to differences in the
      primary structures of the sialoproteins and to the extent to which they are
      phosphorylated. In vitro systems for the study of osteopontins and osteopontin
      related protein effects on mineral deposition are described, along with
      mechanisms explaining the contrasting abilities of the polyglutamate-containing
      bone sialoprotein to act as a nucleator, while the polyaspartate-containing
      osteopontin and dentin sialoproteins inhibit calcium phosphate formation and
      growth.

PMID- 7785900
TI  - Osteopontin in urinary stone formation.

PMID- 7785901
TI  - Osteopontin production by cultured kidney cells.

PMID- 7785902
TI  - Expression of osteopontin in the inner ear.

PMID- 7785903
TI  - Phosphorylation of osteopontin by Golgi kinases.

PMID- 7785904
TI  - Expression of antisense osteopontin RNA in metastatic mouse fibroblasts is
      associated with reduced malignancy.

PMID- 7785905
TI  - HL-60 cell differentiation and osteopontin expression.

PMID- 7785906
TI  - The inhibitory activity of osteopontin on hydroxyapatite formation in vitro.

PMID- 7785907
TI  - A monoclonal antibody against osteopontin inhibits RGD-mediated cell adhesion to
      osteopontin.

PMID- 7785908
TI  - The Puerap motif in the promoter of the mouse osteopontin gene.

PMID- 7785909
TI  - Upregulation of osteopontin expression by ischemia in rat kidney.

PMID- 7785910
TI  - The mutagenesis of the RGD sequence of recombinant osteopontin causes it to lose
      its cell adhesion ability.

PMID- 7785911
TI  - Expression of osteopontin in a macrophage cell line and in transgenic mice with
      pulmonary fibrosis resulting from the lung expression of a tumor necrosis factor
      alpha transgene.
AB  - The expression level of osteopontin (OPN) mRNA was found to be increased in a
      macrophage cell line in the presence of recombinant tumor necrosis factor-alpha
      (TNF-alpha). OPN mRNA level was also explored in the lungs of transgenic mice
      which were expressing TNF-alpha in type II pneumocytes, a condition leading to
      pulmonary alveolitis and progressive fibrosis. OPN mRNA was significantly
      increased in the lungs of these transgenic mice. In situ hybridization showed
      that it was localized mostly in alveolar macrophages. Since OPN can be induced in
      macrophages by TNF-alpha stimulation and since on the other hand osteopontin
      appears to decrease the level of nitric oxide synthase, and thus the production
      of nitric oxide, osteopontin might also indirectly have an antifibrotic effect.
      The role played by osteopontin in fibrotic lesions resulting from the release of
      TNF-alpha deserves further study, since it may be involved in the balance of
      opposite effects eventually leading to local tissue damage ending in fibrosis.

PMID- 7785912
TI  - Osteopontin expression in clonal dental pulp cells.

PMID- 7785913
TI  - Regulated expression of osteopontin in human trophoblasts.

PMID- 7785914
TI  - Osteopontin gene expression in avian tibial dyschondroplasia.

PMID- 7785915
TI  - Osteopontin mRNA expression in a chemically-induced model of atherogenesis.

PMID- 7785916
TI  - Identification of the in vivo phosphorylated sites of secreted osteopontin from
      cultured chicken osteoblasts.

PMID- 7785917
TI  - Identification of osteopontin mRNA and protein in rat epididymis and of protein
      on epididymal sperm.

PMID- 7785918
TI  - Phosphorylation, glycosylation, and transglutaminase sites in bovine osteopontin.

PMID- 7785919
TI  - Localization of osteopontin during mouse development.

PMID- 7785920
TI  - Functional analysis of the osteopontin molecule.

PMID- 7785921
TI  - Osteopontin inhibits nucleation of calcium oxalate crystals.

PMID- 7785922
TI  - Effect of recombinant osteopontin on adhesion and migration of P388D1 cells.

PMID- 7785923
TI  - High expression of osteopontin mRNA in human macrophages but not human vascular
      smooth muscle cells in culture.

PMID- 7785924
TI  - Structure of the osteopontin gene and its promoter.
AB  - We cloned the hOPN gene and its 5' upstream region, and analyzed its exon-intron
      structure and potential regulatory sequences of the promoter region in comparison
      with those of mouse and porcine homologues. The hOPN gene consists of 7 exons
      that are similar to those of the mouse gene, although the hOPN gene is longer
      than the mouse homologue. This difference is attributable to an insertion of
      about 1750 bp immediately before exon 4 in the hOPN gene. A region of
      approximately 285 bp immediately upstream of the hOPN transcription initiation
      site was highly conserved and contained a number of potential cis regulatory
      consensus sequences. CAT analysis using SCC-3 cells demonstrated that nucleotides
      at positions -439 to -270, -124 to -80, and -55 to -39 contained cis-acting
      enhancing elements, in which the -124 to -80 element was much more active than
      the others. Deletion of the sequences between -474 and -270 localized the cis
      elements to the sequence at position -439 to -410, whereas the deletion between 
      124 to -80 localized it to -124 to -115, and -94 to -80 (data not shown). Gel
      shift analysis using synthesized double-stranded oligonucleotides corresponding
      to the 30 bp at position -439 to -410 (data not shown), and 10 and 15 bp regions
      at positions -124 to -115 and -94 to -80, respectively, as probes revealed that
      each probe formed one or two bands complexed with a nuclear protein prepared from
      SCC-3 cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7785925
TI  - Characterization of the rat osteopontin gene. Evidence for two vitamin D response
      elements.

PMID- 7785926
TI  - Structural and functional domains of osteopontin.

PMID- 7785928
TI  - [Benign paroxysmal positional vertigo. Apropos of 51 cases].
AB  - 51 cases of benign paroxysmal vertigo have been investigated in 3 years. The
      findings put in evidence: the particular frequency of this pathology (18% of BPPV
      in a vestibulometry consultation), its opportunist character and the possible
      association with other more severe pathologies (meningiomas, multiple sclerosis,
      cerebellar venous angioma, vascular cerebral infarction) or more benign
      pathologies (labyrinth malformation, middle fossa atrophia). Semont liberatory
      maneuver revealed to be much efficient (50% of patients free of disease after a
      single repositioning manoeuvre). Only 3 cases remaining unchanged after 2 years
      and intractable were proposed for surgery. We mention 7% of bilateral forms and
      5% of alternating recurrent forms (sometimes on the right and sometimes on the
      left side). The recurrence is noted in 50% of BPPV followed at least during one
      year. We describe a particular topographic form concerning probably a
      cupulolithiasis of the external canal. 53% of cases beneficiated of CT-scan or of
      magnetic resonance imaging. The frequency and the possibility of pathological
      associations with BPPV bring to a particular vigilance for the diagnosis and to a
      particular care in the affirmation of the benignity in the case of long lasting
      vertigo (superior to 6 months), or when the nystagmus duration in Hallpike
      position is superior to 60 seconds.

PMID- 7785927
TI  - Regulation of avian osteopontin pre- and posttranscriptional expression in
      skeletal tissues.

PMID- 7785929
TI  - [Implantation on the cochlear nucleus. Apropos of a patient with bilateral
      neuroma].
AB  - A new auditory brainstem implant (ABI), manufactured by Cochlear, was implanted
      in a young patient suffering from a large bilateral acoustic neuroma, associated
      with multiple other tumors due to a tuberor sclerosis of Bourneville. The
      operating procedure and the first results are described. A short historical
      summary, the anatomical basis and the difficulties due to side effects of
      stimulation are exposed.

PMID- 7785930
TI  - [Clinical development of acute noise-induced acoustic trauma. An evaluation of a
      study of 250 cases].
AB  - Traumatic damage on Cochlea (250 cases) induced by assault gun (F.A.M.A.S.)
      consists in tinitus and hearing impairement on 6000 Hz. Noise's effects are
      specific to one Cochlea. Dissociated developments of both tinitus and hearing
      loss show that their anatomical sites are different. Acoustic injury entails
      definitive haire cells lesions, cellular biochemical and vascular changes. The
      treatment that reestablishes or raises cochlear blood flow entails recovery in
      80% of cases provided that it is given within 48 hours after the trauma.

PMID- 7785931
TI  - [Short-term reproducibility of acoustic oto-emissions induced by clicks in
      adults].
AB  - Otoacoustic emissions (OAE) are sounds emitted by the cochlea and recordable in
      the external ear canal by a miniature microphone. The OAE reflect the existence
      of an active mechanism within the cochlea. Development of the OAE has spurred
      much interest because they may used as a valid test for screening and monitoring
      cochlear changes. The OAE were recorded in 8 normal hearing subjects (15 ears)
      during nine test sessions under similar conditions. The aim of this work was to
      study the short-term variability in the amplitude of the emissions. Results of
      the study indicate that response levels are stable over time in the same ear
      therefore changes in the response level can be associated with changes in the
      cochlea.

PMID- 7785932
TI  - [Role of modern imaging (tomodensitometry and MRI) in cochlear implantation in
      children].
AB  - Since 1989, 40 patients have received implants in the O.R.L. ward of the Hopital
      d'Enfants Armand Trousseau (Paris). Over the past 2 years, 17 children have
      undergone radiological assessment combining M.R.I. anf high resolution C.T
      scanning. Imagery is not the essential stage, and is only used after assessment
      by a multidisciplinary team. However, the imagery results influence the choice of
      implant, and sometimes the side to be implanted. C.T is always the first stage as
      it detects congenital abnormalities, and, for children with a history of
      bacterial meningitis, it can detect signs of labyrinthine ossification which
      contraindicate cochlear implantation. These signs are not always visible using
      tomodensitometry, especially when fibrosis within the canal has not yet ossified.
      This examination also provides for post-operative confirmation of implant
      position in case of failure or complication. Over the past 3 years, Magnetic
      Resonance Imagery has been combined with tomodensitometry, especially with
      children having a past medical history of meningitis. This examination provides a
      basis for evaluating the liquid nature of the labyrinth. A G.E. Sygna 1.5 T was
      used by the authors, employing sequences of volumetric acquisition (S.S.F.P. with
      1.5 mm image slices and an angle of 15 to 35 degrees). Hence, modern imagery
      plays an important role when the decision to implant has already been taken,
      particularly in the case of profoundly deaf children. M.R.I. is always used in
      combination with a scanner in cases involving children with a past medical
      history of meningitis.

PMID- 7785933
TI  - [Malignant transformation of inverted papilloma of the nasal sinuses.. Apropos of
      a series of 7 cases].
AB  - Seven cases of malignant inverting papillomas are presented (6 men and 1 woman)
      with ages ranging from 31 to 72 years (mean age: 58 years); the minimum follow up
      was 37 months. The diagnosis was based on the histopathologic analysis of biopsy
      in five patients. In two patients the diagnosis was confirmed by the pathological
      analysis of the specimen. Treatment was always surgical: lateral rhinotomy and
      total ethmoidectomy. Neoadjuvant chemotherapy was given to four patients. Post
      operative radiation therapy was delivered in five patients. Five patients on
      seven died: local recurrence and systemic metastases: 3; systemic metastases: 1;
      second primary: 1. Reports from the literature are discussed. The authors
      emphasize the treatment modalities based on complete tumor removal through
      lateral rhinotomy.

PMID- 7785934
TI  - [Dysphonia in adults caused by unilateral pseudohypertrophy of the ventricular
      band with deformation of the thyroid cartilage. Apropos of three cases].
AB  - The association of dysphonia appearing in adulthood with unilateral bulging of
      the false cord associated with a convex deformation of the overlying thyroid
      cartilage is to be remarked in three cases. The origin, which was presumably
      acquired by gradual deformation of the thyroid cartilage with age, is discussed
      in the light of the literature and the clinical history. A past traumatic cause
      can also be implicated (1 case). CT-Scan is essential for the diagnostic of the
      cartilage deformation and eliminates laryngeal tumors. In one of the cases
      reported, we were able to demonstrate the possibility of treatment by CO2 laser
      resection of the false cord hypertrophy.

PMID- 7785935
TI  - [Contribution of L lactate and amino-acid enzymatic biosensors for the analysis
      of Frey syndrome].
AB  - Twelve patients with Frey's syndrome after total parotidectomy for plemorphic
      adenoma were analysed using simultaneously 2 biosensors. Biosensors allowed for
      detection of L lactate and amino acid level on intact skin. The assay procedure
      and the results achieved with the simultaneous use of these 2 biosensors are
      presented. The L lactate biosensor appears to be an interesting tool for Frey's
      syndrome analysis. The sensibility of the amino acid biosensor is not sufficient
      enough to allow its use at time of Frey's syndrome analysis.

PMID- 7785937
TI  - [How to compose an expert report].

PMID- 7785936
TI  - [Scopulariopsis brevicaulis otomycosis after tympanoplasty].
AB  - We report a case of otomycosis due to Scopulariopsis brevicaulis in a patient who
      has undergone tympanoplasty 3 months before. Mycological finding led us to
      consider this fungus as the causative agent. Whereas in vitro studies show a
      better efficiency of azole derivatives, cure was obtained with nystatine after
      two treatment failures in our patient.

PMID- 7785938
TI  - [How to diagnose deafness in a child less than 2 years old].

PMID- 7785939
TI  - Stone analysis is not useful in the routine investigation of renal stone disease.

PMID- 7785940
TI  - Biochemical investigations in renal stone formers.

PMID- 7785941
TI  - Screening for drugs of abuse. I: Opiates, amphetamines and cocaine.
AB  - (1) In order to provide an efficient and reliable service for drugs of abuse
      screening in urine, the laboratory should analyse 20-30 samples per week, and the
      staff should include a scientist with special expertise in the subject. (2)
      Turnaround times should be between 2-3 days of sample collection. To achieve this
      aim it may be necessary to make special arrangements for the delivery of samples
      to the laboratory. Results should preferably be transmitted by electronic mail or
      facsimile with the necessary precautions for security and confidentiality:
      hardcopy reports may also be required. (3) Good communications between the
      requesting clinician and the laboratory are essential. An advisory service should
      be provided by the laboratory and clinicians should be encouraged to discuss
      requests and results with laboratory staff. It is important that the laboratory
      inform doctors of the range of substances detected and the sensitivity and
      specificity of laboratory assays. (4) Assays should be performed according to the
      manufacturer's protocols, or by modified methods that have been rigorously
      validated. Quality control samples should be included in each analytical run and
      participation in an external quality assessment scheme, e.g. UKNEQAS, is
      essential to provide independent confirmation and confidence that results compare
      with those from other laboratories. Other requirements include adequate training
      and supervision of staff, and careful recording of samples and results. (5) Drugs
      to be tested will depend on the drug 'scene' in the area but should include those
      drugs regularly prescribed for maintenance therapy (e.g. methadone,
      dihydrocodeine, benzodiazepines), and drugs frequently misused (e.g. heroin,
      buprenorphine, amphetamines, cocaine). (6) Positive results obtained by
      preliminary screening methods e.g. EMIT, should be confirmed by another
      analytical technique, e.g. TLC, GC or GC-MS. If there are potentially serious or
      legal implications, and in employment and preemployment testing, confirmation of
      positive results is mandatory. In some cases, e.g. checking for methadone or
      benzodiazepine compliance, it may be considered unnecessary to confirm positive
      results although possible spiking of samples cannot be excluded without checking
      for the presence of metabolites by a chromatographic procedure.

PMID- 7785942
TI  - Rapid diagnosis of long chain and medium chain fatty acid oxidation disorders
      using lymphocytes.
AB  - A method based on the release of tritiated water from [9,10(n)-3H] palmitic and
      myristic acids previously described for fibroblasts, was adapted for lymphocytes
      for the rapid diagnosis of fatty acid oxidation disorders. Optimal concentrations
      for both substrates and linearity of the assay were established. Normal values
      were established in control subjects of different age groups (58 children and 117
      adults) and 16 patients with known fatty acid oxidation disorders were tested.
      Tritiated water production from patients' lymphocytes was expressed as a ratio
      between residual oxidations of palmitate and myristate and the results show that
      this method allows good differentiation between long chain and medium chain fatty
      acid oxidation defects.

PMID- 7785943
TI  - Determination of aluminium in serum, dialysate fluid and water by inductively
      coupled plasma optical emission spectrometry.
AB  - Methods for the determination of aluminium in serum, dialysate fluid and water by
      inductively coupled plasma optical emission spectrometry are described and
      validated. Aluminium was measured at 167 nm using an argon purged monochromator.
      Matrix effects in serum and dialysate fluid were overcome by using an yttrium
      internal standard. Serum was found to have a complicated background in the region
      of 167 nm: careful selection of the wavelength used for background correction is
      therefore a pre-requisite for accurate analysis. The method for serum was
      validated by comparison with electrothermal atomization atomic spectrometry and
      the limit of agreement determined to be +/- 0.3 mumol/L. Routine performance in a
      quality assessment scheme has been highly satisfactory for a period of 1 year.
      The method is ideal for fast and accurate monitoring of patients potentially at
      risk from aluminium toxicity.

PMID- 7785944
TI  - A rapid method for measurement of the susceptibility to oxidation of low-density
      lipoprotein.
AB  - Oxidation of low-density lipoprotein (LDL) may be important in the pathogenesis
      of atherosclerosis. We describe a method which measures the oxidation resistance
      of LDL isolated by a rapid procedure without added antioxidants. LDL was isolated
      from heparinized plasma by density gradient ultracentrifugation and desalted by
      gel filtration. The protein concentration was standardized to 50 mg/L and
      oxidation was promoted by copper (2 mumol/L) at 37 degrees C. The total sample
      preparation time was 2.5 h. Conjugated diene production was monitored at lambda =
      234 nm with computation of the lag time. LDL oxidation was inhibited by EDTA but
      not heparin. Albumin inhibited LDL oxidation but only in concentrations greater
      than 50 mg/L. LDL was stable in frozen plasma (-70 degrees C) for 10 weeks, but
      unstable in the isolated and desalted state. The lag time for LDL from patients
      treated with the antioxidant probucol was markedly prolonged compared to normal
      subjects.

PMID- 7785945
TI  - An improved method for the quantitation of apolipoprotein B and apolipoprotein A
      1 in dried blood spots.
AB  - An extraction protocol has been developed to elute apolipoprotein B (apo B) and
      apolipoprotein A-1 (apo A-1) from dried blood spots with assay of the extracted
      apolipoproteins by automated immunoturbidimetry. Various extraction media were
      investigated to assess their elution efficiency and the optimum medium was found
      to be deionized water. Studies on the rate of elution suggested both
      apolipoproteins were eluted readily in less than an hour with a recovery of 71%
      for apo B and 65% for apo A-1. Extracted apo B but not aop A-1 was found to be
      stable for 24 h when kept at 4 degrees C. The within-batch coefficients of
      variation (CV) for the combined extraction and assay of apo B were found to be
      5.9% and 8.5% at 0.6 g/L and 1.2 g/L respectively. The CVs for apo A-1 were found
      to be 7.4% at 0.7 g/L and 8.9% at 1.5 g/L. Antiserum from three sources (Immuno,
      Incstar and Bayer) was investigated for immunoreactivity with apo B and apo A-1
      and cross-reactivity with red blood cells was also assessed. Although the
      antisera from the three companies showed similar immunoreactivity towards apo B
      and apo A-1, antiserum from Bayer was found to cross-react with red cells.

PMID- 7785946
TI  - Long-term physical exercise and lipoprotein(a) levels in a previously sedentary
      male and female population.
AB  - We investigated the effect of long-term physical exercise on serum lipoprotein(a)
      levels. 21 sedentary men and 15 sedentary women were trained three to four times
      a week with increasing intensity during 9 months. After 24 weeks all subjects ran
      a 15 km race and after 36 weeks a half marathon run (21 km). Blood samples were
      drawn before the training programme, 5 days before both races and 5 days after
      the half marathon run. Median (interquartile range) pre-training values in the
      male group were 32 (11-63) mg/L and in the female group 65 (23-199) mg/L. After
      24 weeks of training, serum lipoprotein(a) concentrations had risen significantly
      in both male and female groups. Moreover, after 36 weeks of training, in
      preparation for the half marathon competition, median serum lipoprotein(a) rose
      almost twofold in both groups and was still elevated 5 days later. This study
      demonstrates that an exercise programme which includes running of increasing
      distances significantly increases serum lipoprotein(a) concentration.

PMID- 7785947
TI  - Evaluation of a first-line spectrophotometric screening test for increased urine
      porphyrin excretion.
AB  - We compared a spectrophotometric screening test for urine porphyrin concentration
      with a high performance liquid chromatography (HPLC) method. The screening test
      gave lower values than those obtained by HPLC, but the overall correlation was
      good. Occasionally, spectrophotometry failed to detect porphyrins in the urine
      which were detected by HPLC. The type of porphyria had no influence on the
      efficacy of the screening method. Receiver operating characteristic plot analysis
      of the screening test led to a cut-off value of 110 nmol/24 h with a sensitivity
      of 96% and a specificity of 86%. We conclude that the spectrophotometric
      screening method is useful for detection of increased total urine porphyrin
      concentration.

PMID- 7785948
TI  - The cryopreservation of skin biopsies--a technique for reducing workload in a
      cell culture laboratory.
AB  - A method is described for the cryopreservation of skin biopsies at -70 degrees C
      for subsequent possible reculture. Biopsies stored up to 1 year could be
      successfully recultured without affecting the time to achieve confluence or the
      culture failure rate. This technique has been in operation in our department for
      over 3 years and has resulted in a demonstrable reduction in cell culture costs
      and a greater flexibility in the acceptance of skin biopsies for culture.

PMID- 7785950
TI  - Measurement of markers of tobacco smoking in patients with coronary heart
      disease.
AB  - 591 patients with a history of coronary heart disease had one or more biochemical
      markers of tobacco smoking measured. 26% were self reported smokers and a further
      4% were apparent 'smoking deceivers'. The urinary nicotine metabolite
      concentration is an excellent marker for tobacco smoking; breath CO would be a
      suitable alternative for busy clinics. Half the patients were subjected to
      regular advice on risk factor management but there was no evidence that this
      contributed effectively to smoking cessation. Overall smoking cessation rate was
      poor.

PMID- 7785949
TI  - D-dimer tests detect both plasmin and neutrophil elastase derived split products.
AB  - Both plasmin and elastase, a protease released from neutrophil granulocytes, are
      known to degrade fibrin(ogen). This raises the possibility that elevated plasma
      levels of split products such as D-dimer may in part result from elastase action.
      After incubation in vitro of fibrinogen and fibrin clots with elastase, a
      clearcut increase of D-dimer immunoreactivity was demonstrated by two commercial
      ELISA kits. In the plasma of 79 patients with inflammatory bowel disease, D-dimer
      values measured by one of the ELISA kits were correlated significantly not only
      with markers of thrombin and plasmin activation, but also with elastase-alpha 1
      antitrypsin complexes (r = 0.3555; P = 0.014). Thus, the findings of this study
      suggest that indeed the D-dimer levels in patients with inflammatory disorders
      are influenced by neutrophil elastase. New tests discriminating effects of
      activated haemostasis from proteolysis by neutrophil enzymes might be helpful in
      differential diagnosis and monitoring of therapy.

PMID- 7785951
TI  - A method of relating whole blood cyclosporin A results by HPLC to Abbott TDx
      monoclonal and polyclonal immunoassays.

PMID- 7785952
TI  - Lower values for immunoglobulin M in cerebrospinal fluid when sampled with an
      atraumatic Sprotte needle compared with conventional lumbar puncture.
AB  - Immunoglobulin M (IgM) has a very low concentration in cerebrospinal fluid (CSF)
      compared with serum, and therefore determinations of IgM in CSF are highly
      sensitive to pre-analytical errors caused by contamination with serum or
      interstitial fluid. Capillary attraction causes a thin layer of liquid containing
      serum proteins to be formed inside a conventional (Quincke) needle during
      penetration of tissue. To investigate this source of pre-analytical error, 35
      patients had lumbar punctures using a 22 G atraumatic (Sprotte) or 25 G
      conventional (Quincke) needle according to a randomized scheme, and the IgM
      concentrations in CSF and serum were determined. The CSF IgM concentrations for
      samples taken with a Sprotte needle were significantly lower than those taken
      with a Quincke needle (P < 0.05), whereas the corresponding serum IgM
      concentrations and CSF erythrocyte counts did not differ significantly. The
      difference indicates that CSF IgM concentrations determined after conventional
      sampling may be falsely increased by contamination. We conclude that IgM
      concentrations in CSF samples taken with the atraumatic technique are more
      accurate, and recommend the use of this technique when CSF IgM is to be
      determined.

PMID- 7785953
TI  - Effect of short-term corticosteroid administration on the concentration of serum
      proteins.

PMID- 7785954
TI  - The stability of parathyroid hormone in blood and serum samples at 4 degrees C
      and at room temperature.

PMID- 7785955
TI  - Three different methods for the determination of total homocysteine in plasma.

PMID- 7785956
TI  - Hypercholesterolaemia presenting in a patient with familial defective
      apolipoprotein B-100 and hypothyroidism.

PMID- 7785957
TI  - Hypertriglyceridaemia in a child with hypernatraemia due to a hypothalamic
      tumour.

PMID- 7785958
TI  - Fatal isoniazid poisoning.

PMID- 7785959
TI  - Poor performance of serum separator.

PMID- 7785960
TI  - Calcium metabolism following renal transplantation.

PMID- 7785961
TI  - Diseases related to oxygen-derived free radicals.
AB  - Oxygen-derived free radicals are very important mediators of cell injury and
      death. Not only are these highly reactive chemical species important in the aging
      process, but they are either directly or indirectly involved in a wide variety of
      clinical disorders, such as atherosclerosis, reperfusion injury, pulmonary
      toxicity, macular degeneration, cataractogenesis, and cancer. In addition, they
      play an important role in chronic granulomatous disease and act as secondary
      sources of cellular injury in chronic granulomatous disease and act as secondary
      sources of cellular injury in chronic inflammatory processes and several
      disorders of the central nervous system. Furthermore, a wide variety of drugs and
      xenobiotics are themselves either converted to, or stimulate the formation of,
      free radicals. Prevention and/or treatment of many of these disorders may be
      possible by appropriate antioxidant therapy, either currently available or to be
      discovered through continued research.

PMID- 7785962
TI  - Renal function in the elderly.
AB  - Renal size and volume decrease with age, accompanied by intrarenal vascular
      changes. The number of glomeruli decreases and the mass of the juxtamedullary
      nephrons falls. The result is a decrease in the filtration area of the glomerular
      basement membrane and decreased permeability. The glomerular filtration rate
      (GFR) is reduced with aging. The GFR is approximated by the endogenous creatinine
      clearance, which falls in parallel with the inulin clearance (the true measure of
      GFR) and is always greater because of tubular excretion of creatinine. Analytical
      methods for serum and urine creatinine overestimate its concentration and suffer,
      to varying degrees, from interferences, making the normal range method dependent.
      A further uncertainty arises from the use of a correction to standard surface
      area. Serum creatinine concentration is an insensitive indicator of renal
      function in the elderly. Deduction of creatinine clearance from serum creatinine
      concentration, weight and age using one of many formulae gives only approximate
      values, usually too high, and is unsuitable for debilitated and seriously ill
      patients. Tubular function, in general, is decreased in the elderly. The ability
      of the kidney to concentrate urine maximally after water deprivation decreases
      with age, as does the ability to excrete a water and salt load, particularly
      during the night. Nocturnal polyuria is common in the elderly. The aged kidney
      can maintain acid-base balance under normal conditions, but not when subjected to
      an acid load.

PMID- 7785963
TI  - The influence of zinc on apoptosis.
AB  - This review summarizes the evidence that apoptosis is modulated by intracellular
      excess or deficiency of Zn2+, considers mechanisms whereby Zn2+ may influence
      apoptosis, and delineates gaps in current knowledge and opportunities for
      research. The experimental evidence supports four major conclusions: [1] Zinc
      deficiency, resulting from dietary deprivation of mice, or exposure of cultured
      cells to membrane-permeable Zn(2+)-chelators, can induce apoptosis; [2] Zinc
      supplementation, either by pretreating mice with ZnSO4, or adding Zn2+ to the
      media of cell cultures, can prevent apoptotic death. Zn2+ protects against the
      apoptosis induced by diverse physical, chemical, or immunologic stimuli in
      cultured cells of lymphoid, hepatic, or neoplastic origin; [3] Zn2+ does not
      affect the triggering events or earliest signs of apoptosis, but acts later in
      the apoptotic pathway, preventing endonucleosomal fragmentation and subsequent
      cytolysis; and [4] An intracellular pool of chelatable Zn2+ plays a critical role
      in apoptosis, possibly by modulating the activation or activity of
      endonuclease(s). These conclusions should alert pharmacologists and physicians to
      the potential therapeutic applications of zinc compounds and zinc chelators in
      clinical disorders and diseases that involve apoptosis, and to the relevance of
      zinc nutrition in such conditions.

PMID- 7785965
TI  - An enzyme-linked immunosorbent assay for urinary screening of fentanyl citrate
      abuse.
AB  - An enzyme-linked immunosorbent assay (ELISA) for quantitation of urinary fentanyl
      was evaluated as a screening tool for detecting abuse of this potent narcotic.
      The assay was found to have reproducible calibration curves from 0.5 to 10 ng/mL
      and a limit of detection of 0.5 ng/mL. Interference by proteins, glucose, or pH
      was negligible. The assay was specific for fentanyl with little cross-reactivity
      against despropionyl fentanyl and norfentanyl metabolites, other analgesics and
      common drugs of abuse. To evaluate its use in humans, urines were collected from
      57 normal individuals, 48 patients seen in the Emergency Department, and 18
      surgical patients receiving either low (50 micrograms) or moderate fentanyl
      dosage (200 and 250 micrograms) for routine anesthesia. In patients receiving 50
      micrograms (a dose consistent with early abuse), urinary fentanyl was detectable
      for 3 to 10 h post administration. In patients receiving 200 or 250 micrograms (a
      dose more consistent with addiction), urinary fentanyl was detectable for longer
      time periods (> 24 h). These results indicate that the ELISA is sensitive for the
      detection of recent fentanyl exposure under conditions likely to mimic those in
      abuse and addiction. The assay is simple to perform, reliable, and can be used to
      screen urine specimens prior to gas chromatography/mass spectrometry (GC/MS)
      confirmation.

PMID- 7785964
TI  - Cell proliferation and apoptosis during development and aging of the rabbit
      corpus luteum.
AB  - Corpora lutea (CL) are endocrine ovarian structures that regulate fundamental
      reproductive events in mammals. The functional lifespan of these structures is
      finite as CL regress and cease secreting progesterone after species-dependent
      intervals during nonfertile postovulatory cycles or pregnancy. The signals that
      regulate CL aging are poorly understood. This study investigates cell growth and
      programmed cell death or apoptosis in corpora lutea of New Zealand White rabbits.
      To study cell growth, CL were obtained at various postovulatory days (POD) from
      animals injected with the deoxyribonucleic acid (DNA) precursor analog
      bromodeoxyuridine (BUdR). The BUdR-labeled cells were identified by avidin-biotin
      complex immunocytochemistry, and the mean proliferation index area computed by
      image analysis. Apoptotic cells were scored and further identified by in situ
      demonstration of DNA fragmentation. Proliferation in parenchymal, stromal, and
      endothelial CL cells was significantly elevated at POD 3, 5, 18, and 21 and
      highest at POD 3 (P < 0.001). The number of apoptotic cells was elevated (P <
      0.001) at POD 18 and 21, while 1 percent or less of CL cells were apoptotic at
      POD 3, 5, and 12. Apoptosis was accompanied by shrinkage or vacuolization of CL
      cells and increased mean number (P < 0.001) of heterophilic leucocytes at POD 18.
      These data demonstrate that cell growth is more intense during early luteal
      development and that cell deletion via apoptosis plays an important role in CL
      regression. The role of paracrine signals such as microphagic cytokines in CL
      aging remains to be elucidated.

PMID- 7785967
TI  - Cytogenetic characterization of three cell lines derived from primary cervical
      tumors.
AB  - Braun et al established three cell lines from keratinizing and nonkeratinizing
      cervical carcinomas. These cell lines were subsequently analyzed for growth
      properties and physical state of the human papillomavirus type 16 genome. It was
      found that these cell lines have distinct growth properties in vitro and in vivo.
      Furthermore, they differ in the physical state of the viral genome. TC-140/7,
      derived from a keratinizing cervical tumor, contains primarily human
      papillomavirus type 16 in the episomal state. Both TC-146A and TC-146B, derived
      from a nonkeratinizing large-cell cervical carcinoma, contain exclusively human
      papillomavirus type 16 in the integrated state. The chromosomes of these three
      cell lines were characterized in the present study using GTG-banding analysis.
      The most striking chromosomal abnormalities noted in the TC-140/7 cell line were
      the presence of a small metacentric consistent with the morphology of an i(12p)
      or i(5p), an isochromosome 8q and multiple copies of chromosome 9. For TC-146A,
      the most notable chromosomal abnormalities were in the presence of a derivative
      chromosome 7 with additional material present on its long arm, an i(8q) and
      derivative chromosome 19's. For cell line 146B, the most notable chromosomal
      abnormalities were found to be a marker resembling a derivative X chromosome, a
      derivative chromosome 7 with additional material on its long arms, an i(8q), an
      i(16q) and one or more copies of a marker with morphology resembling i(17q).
      Fluorescent in situ hybridization experiments using select probes further
      corroborate the results of the conventional cytogenetic studies.

PMID- 7785966
TI  - Myoglobin clearance as an early indicator for rhabdomyolysis-induced acute renal
      failure.
AB  - Two cases are described to illustrate the use of the myoglobin clearance rate as
      a predictor of acute renal failure (ARF). Both patients suffered extensive
      skeletal muscle injury characterized by high total creatinine kinase and urine
      myoglobin. In the first case, a high myoglobin clearance at admission (27 mL/min)
      was accompanied by normal serum creatinine and creatinine clearances. This
      patient recovered without renal complications. The second case also had normal
      serum creatinine and creatinine clearances at the initial presentation of
      symptoms, but was accompanied by a very low myoglobin clearance (0.64 mL/min).
      Within 48 h, this patient developed acute renal failure, with creatinine rising
      from 1.5 to 5.8 mg/dL, and creatinine clearance dropping from 270 to 2.8 mL/min.
      Because myoglobin has been recognized as a cause of ARF, these cases help
      illustrate how the myoglobin clearance rate might be used in evaluating patients
      with rhabdomyolysis for the development ARF.

PMID- 7785968
TI  - Poliovirus neutralizing antibody persistence after vaccination with the Sabin
      vaccine: a follow-up study.
AB  - In 1976, a cohort survey on the persistence of neutralizing antibodies in
      children regularly immunized 1 to 4 years earlier with the Sabin attenuated
      vaccine (OPV) was undertaken in the Venice mainland. Subsequent serological
      evaluations in the same cohort were carried out in 1983 and 1993. A
      macroneutralization test using a 1:4 initial serum dilution was utilized in the
      1976 and 1983 survey years. In the 1993 survey a microneutralization test using a
      1:2 initial dilution was utilized. In this survey, however, sera were tested
      using both the latter microneutralization test and the former test. Using the
      former method, the results indicate that the OPV-induced humoral immunity to
      poliovirus 1 and 2 remain fairly stable after the initial decrease, whereas
      antibodies to poliovirus 3 are further declining. Using the latter more sensitive
      method the seropositivity rates were found to be equal or close to 100 percent.
      The results of our follow-up survey thus indicate that the OPV-induced humoral
      immunity is long-lasting when tested with a highly sensitive and reproducible
      method. The clinical protection that ensues after OPV-immunization is probably
      lifelong similar to that which follows the natural infection.

PMID- 7785969
TI  - Pharmacokinetics of high-dose intravenous ciprofloxacin in young and elderly and
      in male and female subjects.
AB  - The effects of age and gender on the pharmacokinetics of high-dose intravenous
      ciprofloxacin in a healthy volunteer study were investigated. Plasma
      ciprofloxacin concentrations were higher in the elderly than in the young, and
      the pharmacokinetic parameters were not significantly different between the
      genders. Ciprofloxacin was well tolerated, with the majority of adverse events
      related to local reactions at the IV site.

PMID- 7785970
TI  - Ribosylation by mycobacterial strains as a new mechanism of rifampin
      inactivation.
AB  - Several fast-growing Mycobacterium strains were found to inactivate rifampin. Two
      inactivated compounds (RIP-Ma and RIP-Mb) produced by these organisms were
      different from previously reported derivatives, i.e., phosphorylated or
      glucosylated derivatives, of the antibiotic. The structures of RIP-Ma and RIP-Mb
      were determined to be those of 3-formyl-23-[O-(alpha-D-ribofuranosyl)]rifamycin
      SV and 23-[O-(alpha-D-ribofuranosyl)]rifampin, respectively. To our knowledge,
      this is the first known example of ribosylation as a mechanism of antibiotic
      inactivation.

PMID- 7785971
TI  - Transferable resistance to beta-lactams in a nosocomial strain of Xanthomonas
      maltophilia.

PMID- 7785972
TI  - Questionable susceptibility reporting in a multicenter trial.

PMID- 7785973
TI  - Ginkgo biloba extract EGb 761 is not active against Mycobacterium avium infection
      in C57BL/6 mice.

PMID- 7785974
TI  - Insights into erythromycin action from studies of its activity as inducer of
      resistance.

PMID- 7785975
TI  - Effect of atovaquone and atovaquone drug combinations on prophylaxis of
      Pneumocystis carinii pneumonia in SCID mice.
AB  - The prophylactic efficacies of atovaquone (ATQ) alone and in combination with
      azithromycin, clarithromycin, rifabutin, proguanil, PS-15, trimethoprim, co
      trimoxazole, or dapsone were investigated in a SCID mouse model of Pneumocystis
      carinii pneumonia (PCP). ATQ alone was shown to have a significant dose-related
      effect, and at 200 mg/kg of body weight per day administered orally, the efficacy
      of ATQ was comparable to that of Septrin (co-trimoxazole). Of the drugs
      investigated orally in combination with ATQ, only dapsone (25 mg/kg/day) and to a
      lesser extent PS-15 (5 mg/kg/day) had any noteworthy antipneumocystis activity
      (at the doses examined) when administered alone. ATQ drug combinations affected
      the prophylactic efficacy of a subcurative dosage of ATQ (50 mg/kg/day given
      orally) in the following ways: dapsone (25 mg/kg/day) or co-trimoxazole (25 mg of
      sulfamethoxazole plus 5 mg of trimethoprim per kg/day) had no significant effect
      on ATQ, azithromycin (200 mg/kg/day) or clarithromycin (200 mg/kg/day) had a
      slight additive effect with ATQ, trimethoprim (100 mg/kg/day) or PS-15 (5
      mg/kg/day) had an additive effect with ATQ, and proguanil (25 mg/kg/day) or
      rifabutin (200 mg/kg/day) had a marked synergistic effect on ATQ. The last result
      was particularly noteworthy as neither proguanil nor rifabutin was effective
      against PCP when administered alone. None of the drugs examined antagonized the
      prophylactic activity of ATQ in experimental PCP in SCID mice. The results
      suggest that clinical trials of ATQ with synergistic drug combinations may now be
      justified, particularly if such drug combinations improve ATQ's efficacy and
      broaden its spectrum of activity.

PMID- 7785976
TI  - Target for bacteriostatic and bactericidal activities of beta-lactam antibiotics
      against Escherichia coli resides in different penicillin-binding proteins.
AB  - The relationship between cell-killing kinetics and penicillin-binding protein
      (PBP) saturation has been evaluated in the permeability mutant Escherichia coli
      DC2 in which the antimicrobial activity of beta-lactams has been described as
      being directly related to the extent of saturation of the PBP target(s).
      Saturation of a single PBP by cefsulodin (PBP 1s), mecillinam (PBP 2), and
      aztreonam (PBP 3) resulted in a slow rate of killing (2.5-, 1.5-, and 0.8-log
      unit decreases in the number of CFU per milliliter, respectively, in 6 h).
      Saturation of two of the three essential PBPs resulted in a marked increase in
      the rate of killing, which reached the maximum value when PBPs 1s and 2 were
      simultaneously saturated by a combination of cefsulodin and mecillinam (4.7-log
      unit decrease in the number of CFU per milliliter in 6 h). Inactivation of all
      three essential PBPs by the combination of cefsulodin, mecillinam, and aztreonam
      further increased the killing kinetics (5.5-log-unit decrease in the number of
      CFU per milliliter), and this was not significantly changed upon additional
      saturation of the nonessential PBPs 5 and 6 by cefoxitin. Similar relationships
      between PBP saturation and killing kinetics were obtained with imipenem and
      meropenem at concentrations which inhibited only one PBP (PBP 2), only two PBPs
      (PBP 1s and 2), or all three essential PBPs. Saturation of one or more PBPs also
      resulted in a different rate of bacteriolysis, the highest rate being obtained by
      the cefsulodin-mecillinam combination and by 5 micrograms of either imipenem or
      meropenem per ml. All of these conditions caused saturation of PBP 2 and
      saturation or extensive binding of PBP 1s. However, none of these conditions
      caused determined the fastest possible rate of killing, which occurred only when
      all three essential PBPs were saturated. It was concluded that the actual killing
      effect of beta-lactams is reflected by killing rates that approach the fastest
      possible rate for the given microorganism and that the targets for the
      bactericidal activity are precisely those PBPs whose saturation or binding occurs
      under conditions.

PMID- 7785977
TI  - Increasing antimicrobial resistance of Shigella isolates in Israel during the
      period 1984 to 1992.
AB  - Recent (1984 to 1992) trends in the antimicrobial resistance of Shigella isolates
      in Israel were studied by analyzing the results of 106,000 stool cultures, 3,511
      of which yielded Shigella spp. Over the study period, resistance to trimethoprim
      sulfamethoxazole (TMP-SMX) increased from 59 to 92% (P = 0.0038) and that to
      ampicillin increased from 13 to 86% (P < 0.0001). Resistances to nalidixic acid,
      chloramphenicol, and broad-spectrum cephalosporins remained low. Shigella sonnei,
      which currently accounts for 90% of Shigella infections, was more resistant than
      S. flexneri to TMP-SMX (81 versus 57%, P < 10(-6)), ampicillin (42 versus 32%, P
      < 10(-5)), and tetracycline (38 versus 28%, P < 10(-5)). S. boydii and S.
      dysenteriae were relatively rare. Seasonality in antimicrobial resistance was
      found, with summer isolates being less resistant to TMP-SMX, ampicillin, or both
      than isolates obtained over the rest of the year (P < 10(-5)). We conclude that
      the resistance of shigellae, especially S. sonnei, to TMP-SMX and ampicillin is
      increasing to approximately 90%. Resistance should be recorded locally, and
      empiric therapy for suspected shigellosis should be changed accordingly.

PMID- 7785979
TI  - Inducible and constitutive expression of resistance to glycopeptides and
      vancomycin dependence in glycopeptide-resistant Enterococcus avium.
AB  - A clinical isolate of Enterococcus avium, Ea1, which exhibited inducible, low
      level resistance to vancomycin and teicoplanin, and two mutants selected from
      this strain, Ea3 and Ea31, were studied. Ea3 was vancomycin dependent and derived
      from Ea1, while Ea31 was not vancomycin dependent, was constitutively resistant,
      and was derived from Ea3. Hybridization studies revealed that vanA was present in
      Ea1 and suggested that it was located on a high-molecular-weight plasmid. In the
      absence of induction, Ea1 synthesized only the natural UDP-MurNAc-pentapeptide
      precursor, and after induction it synthesized an additional precursor identified
      as UDP-MurNAc-tetrapeptide-D-lactate. The latter was the only precursor found in
      Ea3 and Ea31, even after precursor accumulation. From these results, we infer
      that (i) the low level of resistance to glycopeptides in strain Ea1 may be in
      part due to the residual synthesis of the normal precursor and (ii) the
      vancomycin dependence of mutant Ea3 could be due to the fact that this strain
      does not produce any peptidoglycan precursor in the absence of induction.

PMID- 7785978
TI  - Plasmid-mediated dissemination of the metallo-beta-lactamase gene blaIMP among
      clinically isolated strains of Serratia marcescens.
AB  - The distribution of strains producing metallo-beta-lactamase among 105 strains of
      Serratia marcescens was investigated. All of these strains were isolated in seven
      general hospitals located in Aichi Prefecture, Japan, from April to May 1993.
      Southern hybridization analysis suggested that four S. marcescens strains,
      AK9373, AK9374, AK9385, and AK9391, had a metallo-beta-lactamase genes similar to
      the blaIMP gene found by our laboratory (E. Osano, Y. Arakawa, R.
      Wacharotayankun, M. Ohta, T. Horii, H. Ito, F. Yoshimura, and N. Kato,
      Antimicrob. Agents Chemother. 38:71-78, 1994), and these four strains showed
      resistance to carbapenems as well as to the other broad-spectrum beta-lactams. In
      particular, strains AK9373, AK9374, and AK9391 showed an extraordinarily high
      level resistance to imipenem (MICs, > or = 64 micrograms/ml), whereas strain
      AK9385 demonstrated moderate imipenem resistance (MIC, 8 micrograms/ml). The
      imipenem resistance of AK9373 was transferred to Escherichia coli CSH2 by
      conjugation with a frequency of 10(-5). The DNA probe of the blaIMP gene
      hybridized to a large plasmid (approximately 120 kb) transferred into the E. coli
      transconjugant as well as to the large plasmids harbored by AK9373. On the other
      hand, although we failed in the conjugational transfer of imipenem resistance
      from strains AK9374, AK9385, and AK9391 to E. coli CSH2, imipenem resistance was
      transferred from these strains to E. coli HB101 by transformation. A plasmid
      (approximately 25 kb) was observed in each transformant which acquired imipenem
      resistance. The amino acid sequence at the N terminus of the enzyme purified from
      strain AK9373 was identical to that of the metallo-beta-lactamase IMP-1. In
      contrast, strains ES9348, AK9386, and AK93101, which were moderately resistant to
      imipenem (MICs, > or = 4 to < or = 8 micrograms/ml), had no detectable blaIMP
      gene. As a conclusion, 19% of clinically isolated S. marcescens strains in Aichi
      Prefecture, Japan, in 1993 were resistant to imipenem (MICs, > or = 2
      micrograms/ml), and strains which showed high-level imipenem resistance because
      of acquisition of a plasmid-mediated blaIMP-like metallo-beta-lactamase gene had
      already proliferated as nosocomial infections, at least in a general hospital.

PMID- 7785980
TI  - Tolerability, kinetics, and efficacy of subconjunctival pefloxacin in pigmented
      rabbits.
AB  - Pefloxacin has been shown to have good intraocular penetration when given
      systemically. In order to extend its clinical use, we have assessed the
      tolerability, kinetics, and efficacy of subconjunctival pefloxacin in phakic
      pigmented rabbits. The tolerability of a single subconjunctival injection of
      pefloxacin (0.8, 1.6, 8, or 16 mg in 0.2 ml) in the right eyes of eight rabbits
      was evaluated by clinical and histopathological examination. The 0.8-mg dose of
      pefloxacin was well tolerated. The kinetics was evaluated after a single
      subconjunctival injection of 0.8 mg in 18 rabbits. Animals were sacrificed at 1,
      3, 5, 7, 12, or 18 h postinjection. Drug concentrations were measured by high
      performance liquid chromatography. Pefloxacin was found in the cornea (maximum
      concentration, 18.13 micrograms/ml; half-life, 3.92 h) and in the aqueous humor
      (maximum concentration, 3.40 micrograms/ml; half-life, 2.14 h). Pefloxacin did
      not penetrate into the vitreous humor by this route. The efficacy was evaluated
      in an experimental model of staphylococcal corneal ulcers in eight rabbits which
      received two subconjunctival injections of 0.8 mg of pefloxacin at 16 and 24 h
      after intrastromal inoculation. The results (expressed as mean log10 CFU per
      milliliter +/- standard deviation) showed that pefloxacin significantly (P <
      0.001) reduced the bacterial counts (4.39 +/- 0.97) compared with those in
      control eyes (6.46 +/- 0.69). For phakic eyes, subconjunctival pefloxacin might
      be of value for the treatment of corneal ulcers. Further studies are required to
      determine its penetration into the vitreous humor of aphakic eyes.

PMID- 7785981
TI  - Quantitation of slow drug release from an implantable and degradable gentamicin
      conjugate by in vivo magnetic resonance imaging.
AB  - A biodegradable model hydrogel containing a covalently bound aminoglycoside in
      which drug release can be monitored by magnetic resonance imaging (MRI) in vivo
      was developed. The hydrogel consists of the bishydroxysuccinimide ester of
      polyethylene glycol disuccinate cross-linked albumin, to which gentamicin and Gd
      diethylenetriaminepentaacetic acid are covalently attached in stochiometric
      quantities. MRI allowed us to depict the three-dimensional structure of implanted
      gels, to accurately calculate their volumes, and thus to calculate the
      concentration of hydrogel-bound gentamicin. The correlation coefficient for the
      concentration of released gentamicin and the hydrogel volume was 0.965. Free and
      hydrogel-released gentamicin conjugates had similar antibiotic efficacies when
      tested in microbiological agar diffusion assays. In vivo, hydrogel-released
      gentamicin had a longer half-life in plasma than unaltered gentamicin (5.6 versus
      0.7 h), presumably because of residual bound polyethylene glycol residues.
      Hydrogel implants into rats resulted in a prolonged (7 to 10 days) release of
      gentamicin and a decreased 24-h mortality in mice infected with a lethal dose of
      Pseudomonas aeruginosa. The results indicate the feasibility of imaging and
      quantitating therapeutic drug concentrations in vivo by MRI.

PMID- 7785983
TI  - In vitro activity of A-86719.1, a novel 2-pyridone antimicrobial agent.
AB  - This study evaluated the in vitro activity of A-86719.1, a novel 2-pyridone
      antimicrobial agent. The drug inhibited all tested members of the family
      Enterobacteriaceae at < or = 0.5 microgram/ml and all tested Pseudomonas
      aeruginosa, Burkholderia (Pseudomonas) cepacia, and Xanthomonas maltophilia
      strains at < or = 2 micrograms/ml. All but two strains of gram-positive bacteria
      were inhibited by < or = 1 microgram of the new drug per ml, including isolates
      highly resistant to ciprofloxacin.

PMID- 7785982
TI  - Antiviral effect of oryzacystatin, a proteinase inhibitor in rice, against herpes
      simplex virus type 1 in vitro and in vivo.
AB  - Oryzacystatin (OC) is the first-described cystatin originating from rice seed; it
      consists of two molecular species, OC-I and OC-II, which have antiviral action
      against poliovirus in vitro (H. Kondo, S. Ijiri, K. Abe, H. Maeda, and S. Arai,
      FEBS Lett. 299:48-50, 1992). In the experiments reported here, we investigated
      the effects of OC-I and OC-II on the replication of herpes simplex virus type 1
      (HSV-1) in vitro and in vivo. HSV-1 was inoculated onto monolayers of monkey
      kidney epithelial cells (CV-1 cells) at a multiplicity of infection of 0.1 PFU
      per cell. After adsorption of the virus onto cells, the cultures were incubated
      in the presence of either OC-I or OC-II in the concentration range of 1.0 to 300
      microM, and the supernatant virus yield was quantitated at 24 h. The effective
      concentration for 90% inhibition of HSV-1 was 14.8 microM, while a cytotoxic
      effect on CV-1 cells without infection of HSV-1 was not observed below 500 microM
      OC-I. Therefore, the apparent in vitro chemotherapeutic index was estimated to be
      more than 33. In the mouse model of HSV-1-induced keratitis and encephalopathy,
      topical administration of OC-I to the mouse cornea produced a significant
      decrease in virus production in the cornea (mean virus yields: 3.11 log10 PFU in
      the treated group and 4.37 log10 PFU in the control group) and significant
      improvement in survival rates (P = 0.01). The in vivo antiherpetic effect of OC-I
      was comparable to that of acyclovir, indicating that topical treatment of HSV-1
      infection in humans with OC-I might be possible. Our data also suggest the
      importance of some thiol proteinases, which may be derived from either the host's
      cells or HSV-1, during the replication process of HSV-1.

PMID- 7785984
TI  - Evaluation of maduramicin and alborixin in a SCID mouse model of chronic
      cryptosporidiosis.
AB  - Two polyether ionophores, maduramicin and alborixin, were evaluated for
      anticryptosporidial activity in a severe combined immune deficient (SCID) mouse
      model of cryptosporidiosis. Groups of SCID mice were inoculated with 10(6)
      oocysts of bovine origin by oral gavage. Maduramicin or alborixin was
      administered beginning 4 weeks postinfection at 3 mg/kg of body weight per day.
      Maduramicin treatment resulted in a 96% reduction in fecal parasite load over the
      3-week treatment period (P < 0.003). This reduction correlated with decreases in
      tissue parasite loads observed in histological sections of the small intestine (P
      < 0.000002) and the colon (P < 0.000006). A significant decrease in oocyst
      shedding was also observed after a 3-week treatment with alborixin (71%
      reduction, P < 0.01). Maduramicin was also evaluated in a relapsing model of
      cryptosporidiosis in which the infection was observed to recur after treatments
      were discontinued. Some toxicity, as demonstrated by weight loss, was observed
      with both maduramicin and alborixin. Both drugs exhibited significant
      anticryptosporidial activities with concomitant moderate toxicity. These
      polyether ionophores should be valuable as positive controls in compound
      evaluation studies and as lead compounds for chemical optimization
      (modification).

PMID- 7785985
TI  - Alterations in penicillin-binding protein 2B from penicillin-resistant wild-type
      strains of Streptococcus pneumoniae.
AB  - The 1.5-kb transpeptidase-encoding region (TER) of penicillin-binding protein
      (PBP) 2B was amplified and sequenced from 18 penicillin-resistant isolates of
      Streptococcus pneumoniae, with each isolate representing a different DNA
      fingerprint profile of the TER. PBP 2B TERs from penicillin-resistant isolates
      revealed extensive sequence divergence from the penicillin-susceptible R6 strain,
      differing by up to 170 nucleotide substitutions and resulting in up to 38
      alterations in the amino acid sequence of the protein. All penicillin-resistant
      isolates showed sequence divergence within a +/- 300-bp area at the center of the
      PBP 2B TER. Although a number of amino acid substitutions were found within this
      central area of PBP 2B, only two substitutions were common to all resistant
      isolates, namely, Thr-252 replacement by Ala and Glu-282 replacement by Gly.
      These two substitutions appear to be essentially associated with a decreased
      affinity of PBP 2B for penicillin. A second block of divergent nucleotide
      sequence was prominent amongst isolates with high levels of resistance. This was
      a +/- 100-bp area of the TER around nucleotide 1300 and included the substitution
      of Gly for Asp-431, which was the only amino acid substitution within this area
      that was common to all isolates. These data may assist in the definition of the
      structural changes in the penicillin-binding site of PBP 2B associated with
      penicillin resistance in S. pneumoniae.

PMID- 7785986
TI  - In vitro activity of D0870 compared with those of other azoles against
      fluconazole-resistant Candida spp.
AB  - We compared the in vitro activity of a new triazole, D0870, with those of
      fluconazole, itraconazole, and ketoconazole against 41 clinical isolates of
      fluconazole-resistant Candida belonging to nine different species. The 50%
      inhibitory concentrations (IC50s) were determined by a microdilution method with
      morpholinopropanesulfonic acid (MOPS)-buffered RPMI medium and an inoculum of
      approximately 10(4) yeasts per ml. After incubation for 48 h at 37 degrees C the
      optical density at 550 nm was measured. The IC50 was the lowest drug
      concentration which reduced the optical density at 550 nm by > or = 50% compared
      with that for a drug-free control. D0870 had significant activity against many of
      the isolates. Its activity was comparable to that of ketoconazole, slightly
      superior to that of itraconazole, and markedly superior to that of fluconazole
      against Candida albicans. Against Candida glabrata, Candida krusei, and Candida
      inconspicua, it had activity similar to those of itraconazole and ketoconazole
      but had activity superior to that of fluconazole. D0870 IC50s for some isolates
      were increased. This may be due to cross-resistance mechanisms because the IC50s
      of both itraconazole and ketoconazole for these isolates were often high. When
      IC50s and IC80s were compared there was a marked organism and drug variation.
      With C. glabrata much higher endpoints for itraconazole were observed when an
      IC80 endpoint was used. For C. albicans there was also a significant shift upward
      in endpoints for itraconazole and ketoconazole. Values were changed little when
      IC50 and IC80 endpoints of D0870 were compared. For 35 of 41 isolates tested the
      D0870 IC50 was less than the 2.5-mg/liter breakpoint threshold proposed
      previously. Therefore, D0870 may be a useful agent for the therapy of infections
      caused by fluconazole-resistant Candida spp.

PMID- 7785987
TI  - Erythromycin shortens neutrophil survival by accelerating apoptosis.
AB  - Erythromycin is reported to have an anti-inflammatory action, which may account
      for its clinical effectiveness in the treatment of chronic inflammatory diseases
      such as diffuse panbronchiolitis. To evaluate the anti-inflammatory action of
      erythromycin, we examined the survival of isolated neutrophils with and without
      erythromycin. Erythromycin shortened neutrophil survival in a dose-dependent
      fashion, with a maximum effect at 10 micrograms/ml [corrected] and above.
      Survival at 24 h was 63.4% in medium with 10 micrograms of erythromycin per ml
      compared with 82.7% in control medium (P < 0.01). This shortening of survival was
      brought about by acceleration of apoptosis, as evidenced by transmission electron
      microscopy. In a manner similar to that of erythromycin, other macrolide
      antibiotics, i.e., clarithromycin, roxithromycin, and midecamycin, also shortened
      neutrophil survival, but neither the beta-lactams ampicillin and cefazolin nor
      the aminoglycoside gentamicin affected their survival. Erythromycin increased
      intracellular levels of cyclic AMP (cAMP) to 150% of control levels in
      neutrophils. Forskolin, rolipram, and dibutyryl-cAMP, which are known to increase
      intracellular cAMP levels, also shortened neutrophil survival. H-89, an inhibitor
      of cAMP-dependent protein kinase A, partially blocked the survival-shortening
      effect of erythromycin. Our findings suggest that erythromycin shortens
      neutrophil survival at least in part through elevation of intracellular cAMP
      levels.

PMID- 7785988
TI  - Activities of roxithromycin against Mycobacterium avium infections in human
      macrophages and C57BL/6 mice.
AB  - The activity of roxithromycin against three clinical isolates of Mycobacterium
      avium was compared with that of clarithromycin both in a model of infection of
      human monocyte-derived macrophages and in a model of established infection of
      C57BL/6 mice. In the cell culture model, roxithromycin and clarithromycin were
      bactericidal for strains MO-1 and N-92159 and bacteriostatic for strain N-93043.
      For the three strains, the differences between the intracellular activities of
      roxithromycin and clarithromycin were not singificant after 7 days of treatment.
      Mice were infected with the MO-1 strain. Drugs were given by gavage at a dosage
      of 200 mg/kg of body weight 6 days per week for 16 weeks starting 5 weeks after
      infection. At the end of treatment, clarithromycin was more effective than
      roxithromycin in lungs; roxithromycin was as effective as clarithromycin in
      spleens. Thus, the activity of roxithromycin was comparable to that of
      clarithromycin both in vitro and in vivo.

PMID- 7785990
TI  - Primary structure of OXA-3 and phylogeny of oxacillin-hydrolyzing class D beta
      lactamases.
AB  - We determined the nucleotide sequence of the blaOXA-3(pMG25) gene from
      Pseudomonas aeruginosa. The bla structural gene encoded a protein of 275 amino
      acids representing one monomer of 31,879 Da for the OXA-3 enzyme. Comparisons
      between the OXA-3 nucleotide and amino acid sequences and those of class A, B, C,
      and D beta-lactamases were performed. An alignment of the eight known class D
      beta-lactamases including OXA-3 demonstrated the presence of conserved amino
      acids. In addition, conserved motifs composed of identical amino acids typical of
      penicillin-recognizing proteins and specific class D motifs were identified.
      These conserved motifs were considered for possible roles in the structure and
      function of oxacillinases. On the basis of the alignment and identity scores, a
      dendrogram was constructed. The phylogenetic data obtained revealed five groups
      of class D beta-lactamases with large evolutionary distances between each group.

PMID- 7785989
TI  - Anticytomegaloviral activity and safety of cidofovir in patients with human
      immunodeficiency virus infection and cytomegalovirus viruria.
AB  - Cidofovir (HPMPC; (S)-1-[3-hydroxy-2-(phosphonylmethoxy)propyl]cytosine) is a
      nucleotide analog with activity against human cytomegalovirus (CMV). A phase I/II
      dose escalation trial was conducted with asymptomatic human immunodeficiency
      virus (HIV)-infected patients with CMV viruria to determine its pharmacokinetics,
      maximally tolerated dose, and preliminary antiviral activity against CMV.
      Qualitative CMV blood and urine cultures were monitored weekly to assess anti-CMV
      activity. Twenty-one HIV-infected persons with CD4 counts from 0 to 389 cells per
      microliters (median, 39) were enrolled in six dose-ranging groups. The first five
      groups enrolled four patients each to receive cidofovir infusions either weekly
      or biweekly for 4 weeks or every 3 weeks for 12 weeks. The sixth group enrolled
      one patient who received infusions of 5 mg/kg of body weight every other week.
      Patients receiving 0.5 or 1.5 mg/kg twice weekly experienced no serious toxicity.
      The first two patients who received 5 mg/kg twice weekly developed glycosuria and
      2+ proteinuria. Subsequent patients received concomitant probenecid to attempt to
      ameliorate renal toxicity. Seventeen patients experienced proteinuria on one or
      more occasions; 6 of them experienced at least 2+ proteinuria. Four patients did
      not complete the study as planned because of renal toxicity. Positive CMV urine
      cultures reverted to negative in 2 of 8 patients receiving doses of < or = 1.5
      mg/kg twice weekly and 11 of 13 patients receiving higher doses. Cidofovir has in
      vivo anti-CMV activity demonstrated by prolonged clearing of CMV viruria,
      although this observation is tempered by the fact that clearance of viremia could
      not be demonstrated. The dose-limiting toxicity is renal; however, concurrent
      administration of probenecid may be protective. The maximally tolerated weekly
      intravenous dose with probenecid is approximately 5 mg/kg. Efficacy trials with
      CMV disease will define the therapeutic utility and optimal dosing interval for
      cidofovir.

PMID- 7785991
TI  - Chlorhexidine susceptibilities of mutans streptococcal serotypes and ribotypes.
AB  - The susceptibilities of 379 clinical mutans streptococcal isolates to
      chlorhexidine (CHX) were tested by agar dilution according to the standards of
      the National Committee for Clinical Laboratory Standards. Isolates were obtained
      from saliva samples of 34 young mothers who had high or moderate salivary levels
      of mutans streptococci at baseline. Samples were collected on three occasions,
      before childbirth, when each child was 6 months old, and 1 year later. Of these
      isolates, 50% were inhibited at 1 microgram of CHX per ml, 90% were inhibited at
      2.0 micrograms/ml, and all were inhibited at 4.0 micrograms/ml. The MICs for
      Streptococcus mutans isolates (serotypes c, e, and f) were lower than those for
      Streptococcus sobrinus isolates (serotypes d and g). In some subjects, the MICs
      for isolates of the same serotype were different. This phenomenon was studied by
      ribotyping isolates (n = 45) from selected subjects (n = 7). It was found that if
      there were intraindividual differences in the MICs for isolates of the same
      serotype, then the ribotypes of these isolates were different. In order to
      decrease the mutans streptococcal infection risk for children, 24 mothers (test
      group) brushed their teeth periodically with a gel that contained 0.3% CHX
      digluconate and 0.2% NaF, pH 5.8, between the second and third sampling
      occasions. The gel was used twice a day for the first 10 days of each month.
      Development of resistant strains during CHX-NaF gel use was not detected. The
      serotype distribution of isolates from the test group after 1 year of periodic
      CHX-NaF gel use did not differ from that at baseline. Periodic CHX-NaF gel
      brushing did not lead to lower salivary mutans streptococcal counts.

PMID- 7785992
TI  - SHV-7, a novel cefotaxime-hydrolyzing beta-lactamase, identified in Escherichia
      coli isolates from hospitalized nursing home patients.
AB  - Four ceftazidime-resistant Escherichia coli strains were isolated from elderly
      nursing home patients in a New York hospital during 1993. Strains MCQ-2, MCQ-3,
      and MCQ-4 were determined to be identical by pulsed-field gel electrophoresis and
      plasmid profiles, whereas strain MCQ-1 was unique. Strain MCQ-1 was determined to
      produce a TEM-10 beta-lactamase. Strains MCQ-2, MCQ-3, and MCQ-4 were also noted
      to be resistant to cefotaxime. These three strains produced two beta-lactamases
      with pIs of 5.4 (TEM-1) and 7.6. beta-Lactamase assays revealed that the pI 7.6
      enzyme hydrolyzed cefotaxime faster (at a relative hydrolysis rate of 30%
      compared with that of benzylpenicillin) than either ceftazidime or aztreonam
      (relative hydrolysis rates of 13 and 3.3%, respectively). Nucleotide sequencing
      of the gene encoding the pI 7.6 beta-lactamase from strain MCQ-3 revealed a
      blaSHV-type gene differing from the gene encoding SHV-1 at four nucleotides which
      resulted in amino acid substitutions: phenylalanine for isoleucine at position 8,
      serine for arginine at position 43, serine for glycine at position 238, and
      lysine for glutamate at position 240. This novel SHV-type extended-spectrum beta
      lactamase is designated SHV-7.

PMID- 7785993
TI  - Detection of amphotericin B-resistant Candida isolates in a broth-based system.
AB  - Because of the limited ability of the National Committee for Clinical Laboratory
      Standards proposed M27P methodology to detect resistance to amphotericin B by
      Candida isolates, we sought to identify alternative media and pH conditions that
      could reliably identify resistant isolates. Antibiotic Medium 3 broth (also known
      as Penassay broth) buffered to pH 5 or pH 7 produced superior results and readily
      identified a series of resistant isolates.

PMID- 7785994
TI  - Antimicrobial activity of SM-17466, a novel carbapenem antibiotic with potent
      activity against methicillin-resistant Staphylococcus aureus.
AB  - The in vitro and in vivo antibacterial activities of SM-17466, a new 1 beta
      methyl carbapenem, were evaluated against a wide range of clinical bacterial
      isoaltes and compared with the activities of meropenem, imipenem, vancomycin, and
      arbekacin. SM-17466 had a broad spectrum of action against gram-positive
      bacteria, showing especially potent activity against methicillin-resistant
      staphylococci. The MICs of SM-17466, meropenem, imipenem, vancomycin, and
      arbekacin at which 90% of clinical isolates of methicillin-resistant
      Staphylococcus aureus were inhibited were 3.13, 50, 100, 1.56, and 3.13
      micrograms/ml, respectively. This activity of SM-17466 was almost equivalent to
      those of the antibiotics used for the treatment of infections caused by this
      organism. SM-17466 also showed bactericidal activity against methicillin
      resistant S. aureus. In contrast, SM-17466 was less active against gram-negative
      bacteria, especially against Pseudomonas aeruginosa, compared with the other
      carbapenems; however, of the carbapenems, SM-17466 exhibited the highest activity
      against Haemophilus influenzae and Bacteriodes fragilis. SM-17466, at a 50%
      inhibitory concentration of less than 1 microgram/ml, bound to penicillin-binding
      proteins 1 to 4 in methicillin-susceptible S. aureus and also had good binding to
      penicillin-binding protein 2' in a methicillin-resistant strain (50% inhibitory
      concentration, 5.9 micrograms/ml). This high affinity, which was 10 and 20 times
      greater than those for meropenem and imipenem, respectively, was reflected in the
      potent activity of SM-17466 against methicillin-resistant S. aureus. SM-17466
      demonstrated excellent in vivo efficacy against methicillin-susceptible and 
      resistant S. aureus strains in a mouse peritoneal infection model: the efficacy
      of SM-17466 against methicillin-resistant strains was equal to or one-third that
      of vancomycin. This activity was comparable to the in vitro activity of SM-17466.
      The subcutaneous injection of SM-17466 in mice revealed that the half-life of SM
      17466 in serum was about 18 min, intermediate between those of vancomycin and
      arbekacin and 1.5-fold that of imipenem-cilastatin. SM-17466 was resistant to
      hydrolysis by swine renal dehydropeptidase I, to an extent comparable to the
      resistance shown by meropenem.

PMID- 7785996
TI  - Effect of testing method on apparent activities of antiviral disinfectants and
      antiseptics.
AB  - This study was designed to evaluate the independent effects of various test
      methods on the activities of antiviral chemical germicides. The activities of
      germicides against MS2 and phi 6 bacteriophages in a new porcine tissue carrier
      model were compared to those obtained by four other methods (suspension, glass
      carrier, tile carrier, and fingerpad tissue carrier tests). After a 1-min contact
      followed by neutralization (and elution off the carriers), the residual virus in
      the treated samples was quantified and the amount was compared with that in the
      saline controls. Antiviral activity was highly dependent on the test method for
      both viruses and was always greatest in suspension tests and lowest in tissue
      carrier tests. Results obtained for hydrophilic MS2 with the porcine tissue
      carrier were comparable to those from fingerpads, but lipophilic phi 6 was
      subject to spontaneous inactivation on human skin and proved unsuitable for
      fingerpad testing. These data indicate that the activities of germicides in tests
      with nonbiological substrates may overestimate antiviral antiseptic activity on
      skin surfaces. Products intended for use as antiviral antiseptics or hand-washing
      agents should be evaluated in a tissue carrier system. The porcine tissue carrier
      model provides a safe, inexpensive, accurate, and reproducible method for testing
      the activities of antiseptics.

PMID- 7785995
TI  - Trends in susceptibility of Neisseria gonorrhoeae to ceftriaxone from 1985
      through 1991.
AB  - The antimicrobial susceptibilities of 16,441 gonococcal isolates from Seattle
      King County were determined for ceftriaxone, cefoxitin, penicillin G, and
      tetracycline. From 1985 to 1989, ceftriaxone, in combination with doxycycline,
      was increasingly used for treatment of gonorrhea, and by 1989, it was used as
      therapy for > 80% of cases in Seattle-King County. MICs of ceftriaxone correlated
      significantly (P < 0.001) with those of the other beta-lactam antibodies included
      in this study. Geometric mean MICs of penicillin G for isolates that did not
      produce beta-lactamase increased from 1985 to 1991. The geometric mean MICs of
      cefoxitin, ceftriaxone, and tetracycline began to decline in 1987 but increased
      in 1990 and 1991. The percentage of strains with decreased susceptibility to
      ceftriaxone (MIC, 0.06 to 0.25 microgram/ml) rose from 0.3% in 1985 to 5.3% in
      1987 but subsequently declined steadily to 2.6% in 1991, despite increased use of
      ceftriaxone as routine therapy for gonorrhea. Changes in patterns of
      antimicrobial susceptibility may be related not only to antimicrobial selection
      pressures but also to less well understood population shifts among Neisseria
      gonorrhoeae strains within a community.

PMID- 7785997
TI  - Fluconazole, D0870, and flucytosine treatment of disseminated Candida tropicalis
      infections in mice.
AB  - D0870 is a recently developed triazole with characteristics of a broad spectrum
      of activity and slow clearance by nonrenal mechanisms. Herein we have evaluated
      the efficacy of D0870, alone and combined with flucytosine, in a murine model of
      disseminated Candida tropicalis infection. Four isolates of C. tropicalis were
      evaluated. Two were highly susceptible in vitro to fluconazole, and two were
      resistant to fluconazole. All were highly susceptible to flucytosine and D0870.
      Animals were pretreated with 5-fluorouracil 1 day before infection because C.
      tropicalis has reduced virulence in immunocompetent mice. This was done to render
      them neutropenic for > 10 days. Mice were infected intravenously and treated
      orally with D0870 or fluconazole, alone or combined with flucytosine. Survival
      and tissue burden of the spleen and kidneys were used to evaluate the efficacy of
      antifungal therapy. Fluconazole was less effective for treatment of resistant C.
      tropicalis than susceptible C. tropicalis. D0870 was more potent than fluconazole
      and was effective in fluconazole-resistant isolates. Flucytosine was consistently
      effective when used alone but did not consistently add to the benefit of D0870 or
      fluconazole. D0870 has potential in treatment of candidiasis caused by C.
      tropicalis, including fluconazole-resistant isolates.

PMID- 7785998
TI  - Comparison of ampicillin-sulbactam regimens simulating 1.5- and 3.0-gram doses to
      humans in treatment of Escherichia coli bacteremia in mice.
AB  - A mouse model of bacteremia was used to compare the efficacies of 1.5- and 3.0-g
      intravenous doses of ampicillin-sulbactam. Seven strains of Escherichia coli
      producing various levels of TEM-1 beta-lactamase were used as the challenge
      isolates. These strains included six clinical isolates (MICs from 2/1
      micrograms/ml [with 2 and 1 microgram/ml being the respective concentrations of
      ampicillin and sulbactam] to 32/16 micrograms/ml) with similar degrees of
      virulence in mice and a laboratory genetic transformant (E. coli AFE) which
      hyperproduces TEM-1 (MIC = 128/64 micrograms/ml). Human pharmacokinetics were
      simulated by injecting mice subcutaneously twice (1 h apart) with ampicillin
      sulbactam at concentrations of 40 mg/kg of body weight (1.5 g) and 80 mg/kg (3.0
      g). Against two clinical isolates for which ampicillin-sulbactam MICs were < or =
      8/4 micrograms/ml, no difference was observed in either the rate or level of
      killing between the two doses, and both doses were 100% protective against lethal
      infection. Against the four clinical isolates for which ampicillin-sulbactam MICs
      were between 16/8 and 32/16 micrograms/ml, a slight delay in killing was noted
      with three of the strains. This delay was followed by a rapid 2- to 3-log drop in
      the level of bacteremia, and both doses of ampicillin-sulbactam were 100%
      protective against lethal septicemia. With strain AFE, no killing was observed
      with the 40-mg/kg dose compared with a 2-log killing with the 80-mg/kg dose. This
      difference in killing correlated with a decreased protective efficacy of the 40
      mg/kg dose. These data suggest that the 1.5-g preparation of ampicillin-sulbactam
      is as effective as the 3.0-g dose in the treatment of experimentally induced E.
      coli bacteremia, as long as ampicillin-sulbactam MICs are 32/16 micrograms/ml or
      less.

PMID- 7785999
TI  - Prospective randomized comparison of cefepime and cefotaxime for treatment of
      bacterial meningitis in infants and children.
AB  - Ninety infants and children were prospectively randomized to receive cefepime (n
      = 43) or cefotaxime (n = 47) for therapy of bacterial meningitis. The two
      treatment groups were comparable in terms of age, duration of illness before
      enrollment, history of seizures, clinical status on admission, and etiology. Six
      (7%) patients died--two treated with cefepime and four treated with cefotaxime.
      Clinical response, cerebrospinal fluid sterilization, development of
      complications, antibiotic toxicity, and hospital stay were similar for the two
      treatment regimens. Concentrations of cefepime in cerebrospinal fluid varied from
      55 to 95 times greater than the maximal MIC required by the causative pathogens.
      Audiologic and/or neurologic sequelae were found in 16% of the cefepime-treated
      patients and 15% of the cefotaxime-treated patients examined 2 to 6 months after
      discharge. We conclude that cefepime is safe and therapeutically equivalent to
      cefotaxime for management of bacterial meningitis in infants and children.

PMID- 7786000
TI  - Prophylaxis with enteral antibiotics in ventilated patients: selective
      decontamination or selective cross-infection?
AB  - Selective decontamination of the digestive tract (SDD) has been evaluated as a
      method to prevent colonization and infection in ventilated patients in 40 trials.
      On the basis of an assumption that cross-infection would be reduced as a
      consequence of SDD and that this would distort the results of SDD studies that
      used concurrent controls, 14 studies used historic controls. To test this
      assumption, three observations from the two types of studies were compared. (i)
      The differences between observed and expected event rates for each study were
      used to perform a meta-analysis. This revealed that the summary odds ratios for
      bacteremia and respiratory infection were marked by significant heterogeneity (P
      > 0.95) and inconsistencies between those derived from studies with concurrent
      versus studies with historic controls. (ii) Where the data were available, the
      rates of acquisition of colonization in control groups were higher in studies
      with concurrent controls than in studies with historic controls. (iii) At least
      four studies with concurrent controls have shown a pattern of pathogenic isolates
      consistent with cross-infection between groups. These results are contrary to the
      initial assumption and suggest the possibility that SDD represents a major cross
      infection hazard.

PMID- 7786001
TI  - In vitro activities of novel antifolate drug combinations against Plasmodium
      falciparum and human granulocyte CFUs.
AB  - The potency of antimalarial dihydrofolate reductase inhibitors, alone and in
      synergistic combination with dihydropteroate synthetase inhibitors, against the
      Kenyan K39 strain of Plasmodium falciparum (pyrimethamine resistant) and against
      normal replicating human bone marrow cells in in vitro culture has been studied.
      Therapeutic indices and rank order of synergistic potency were derived.
      Trimethoprim, pyrimethamine, and the quinazolines WR159412 and WR158122 had the
      smallest therapeutic indices (1.39, 4.38, 2.56, and 90.0, respectively), while
      the three triazines clociguanil, WR99210, and chlorcycloguanil had the largest
      (3,562, 3,000, and 2,000, respectively). In rank order of decreasing activity
      against P. falciparum, the six most potent drug combinations were WR99210
      dapsone, chlorcycloguanil-dapsone, WR158122-dapsone, WR159412-dapsone, WR159412
      sulfamethoxazole, and chlorcycloguanil-sulfamethoxazole; pyrimethamine
      sulfadoxine was the least potent combination. These experiments form a basis for
      the selection of rapidly eliminated antifolate combinations for further clinical
      testing.

PMID- 7786002
TI  - Treatment of experimental endocarditis due to methicillin-susceptible or
      methicillin-resistant Staphylococcus aureus with trimethoprim-sulfamethoxazole
      and antibiotics that inhibit cell wall synthesis.
AB  - Using two strains of Staphylococcus aureus, one susceptible and one
      heterogeneously resistant to methicillin, for which MICs and MBCs of trimethoprim
      sulfamethoxazole (TMP-SMX) were 0.06 and 0.06 micrograms/ml and 0.06 and 0.25
      microgram/ml, respectively (concentrations are those of TMP), we studied the
      efficacies of TMP-SMX and cloxacillin, teicoplanin, and vancomycin for treatment
      of experimental staphylococcal endocarditis. Rabbits were treated with dosages of
      TMP-SMX selected to achieve concentrations in serum equivalent to that obtained
      in humans treated for Pneumocystis carinii pneumonia. The overall mortality rate
      of rabbits treated with TMP-SMX was 84% at day 3, not different from that of the
      control groups (P > 0.1). No sterile vegetations were observed to be present in
      control groups or in animals treated with TMP-SMX. However, 26, 60, and 75% of
      rabbits treated with teicoplanin, cloxacillin, and vancomycin, respectively,
      showed sterile vegetations. For methicillin-susceptible S. aureus (MSSA), the
      mean vegetation counts were not significantly different between the control group
      and the group treated with TMP-SMX (P > 0.1). For methicillin-resistant S. aureus
      (MRSA), treatment with TMP-SMX was more effective than no therapy, decreasing the
      number of organisms in vegetations (P < 0.01). For both strains, therapy with
      cloxacillin and therapy with teicoplanin or vancomycin were significantly more
      effective than therapy with TMP-SMX. Despite high concentrations of teicoplanin
      in serum which exceeded MBCs for staphylococci more than 50 times at the peak and
      10 times at the trough, therapy with cloxacillin or vancomycin was superior to
      therapy with teicoplanin against both MSSA and MRSA. These data do not support
      the use of TMP-SMX in treatment of endocarditis and other severe staphylococcal
      infections with high bacterial counts.

PMID- 7786003
TI  - Treatment of exogenous Candida endophthalmitis in rabbits with oral fluconazole.
AB  - We investigated the efficacy of oral fluconazole, alone or in combination with
      oral flucytosine (5FC), in treating Candida endophthalmitis using a rabbit model.
      Albino rabbits were infected with an intravitreal inoculation of 1,000 CFU of
      susceptible Candida albicans and randomized 5 days later to receive treatment
      with oral fluconazole alone (80 mg/kg of body weight per day), a combination of
      fluconazole and 5FC (100 mg/kg/12 h), or no treatment. The treatment effect was
      assessed at 2 and 4 weeks after therapy by funduscopy, quantitative vitreous
      culture, and histopathology. Intravitreal levels of fluconazole, 2 to 24 h after
      the first dose, were measured to be > 10 times the MIC of the drug for C.
      albicans. Among rabbits treated with fluconazole for 2 weeks, 67% had a > 90%
      reduction in fungal load (P < 0.05) and 33% were sterile. After 4 weeks, all had
      a > 99% reduction in fungal load (P < 0.05) and 75% were sterile (P = 0.01). This
      treatment effect was unchanged 4 weeks after discontinuation of fluconazole.
      Among rabbits treated with fluconazole and 5FC for 2 weeks, 67% died during
      therapy. Among the surviving rabbits, 75% had a > 90% reduction in fungal load (P
      < 0.05) and 25% were sterile. We conclude that oral fluconazole may be useful for
      treatment of Candida endophthalmitis. Addition of 5FC was associated with high
      toxicity and minimal additional antifungal effect in our rabbit model.

PMID- 7786004
TI  - In vitro evaluation of ABT-719, a novel DNA gyrase inhibitor.
AB  - ABT-719 (A-86719.1) is the first compound of a new class of novel DNA gyrase
      inhibitors, the 2-pyridones, with potent antibacterial activity against gram
      positive, gram-negative, and anaerobic organisms. ABT-719 was more active than
      ciprofloxacin, sparfloxacin, and clinafloxacin against gram-positive bacteria.
      ABT-719 was particularly active against Staphylococcus aureus (MIC at which 90%
      of the isolates were inhibited [MIC90] = 0.015 micrograms/ml) and Streptococcus
      pneumoniae (MIC90 = 0.03 micrograms/ml). ABT-719 was also the most active of the
      compounds tested against ciprofloxacin-resistant S. aureus isolates, with an
      MIC90 of 0.25 micrograms/ml, compared with 64 micrograms/ml for ciprofloxacin.
      Against gram-negative organisms, ABT-719 was as active as or slightly more active
      than ciprofloxacin and was the most active compound against ciprofloxacin
      resistant Pseudomonas aeruginosa (MIC90 = 2.0 micrograms/ml). ABT-719 was also
      the most active compound against both gram-positive and gram-negative anaerobes,
      with MIC90s ranging from 0.12 to 0.25 micrograms/ml.

PMID- 7786006
TI  - Intracellular activities of roxithromycin used alone and in association with
      other drugs against Mycobacterium avium complex in human macrophages.
AB  - Recent reports have shown that roxithromycin possesses significant activity
      against atypical mycobacteria, including the Mycobacterium avium complex (MAC),
      and that its extracellular anti-MAC activity is further enhanced in two- or three
      drug combinations with ethambutol, rifampin, amikacin, ofloxacin, and
      clofazimine. In accordance with the above data, the anti-MAC potential of
      roxithromycin used alone and in combination with the above-mentioned
      antituberculous drugs was screened intracellularly against five clinical MAC
      isolates (from both human immunodeficiency virus-positive and human
      immunodeficiency virus-negative patients), phagocytized by human monocyte-derived
      macrophages. The results showed that roxithromycin used alone and within
      clinically achievable levels was active against all of the MAC isolates tested.
      Screening of two-drug combinations showed that both rifampin and clofazimine
      further increased the intracellular activity of roxithromycin against all five
      isolates by 35 to 80% (ethambutol, ofloxacin, and amikacin resulted in increased
      intracellular activity against one, two, and four isolates, respectively). For
      the three-drug combinations, the combination of roxithromycin plus ethambutol
      used with rifampin or clofazimine was the most uniformly active against all five
      MAC isolates, with activity increases of 42 to 90%, followed by roxithromycin
      plus ethambutol used with amikacin, which resulted in activity increases of 15 to
      90%. The overall level of intracellular killing after 5 days of drug addition, in
      comparison with growth in untreated controls, varied from 1 to 3 log units
      depending on the individual MAC isolate and/or drug combination used.

PMID- 7786005
TI  - Efficacies of ABT-719 and related 2-pyridones, members of a new class of
      antibacterial agents, against experimental bacterial infections.
AB  - The 2-pyridones are a new class of broad-spectrum orally bioavailable
      antibacterial agents. These compounds are potent bacterial DNA gyrase inhibitors
      which differ from fluoroquinolones by placement of the nitrogen atom in the ring
      juncture. ABT-719 is an S isomer and a representative 2-pyridone. ABT-719
      administered orally or subcutaneously was 4- to 10-fold more effective than
      ciprofloxacin against Staphylococcus aureus, Streptococcus pneumoniae, and
      Streptococcus pyogenes infections in normal mice. ABT-719 was equivalent in
      efficacy to ciprofloxacin for treatment of gram-negative bacterial infections
      caused by Pseudomonas aeruginosa or Escherichia coli. The racemate and R forms of
      ABT-719 produced similar results against gram-positive and gram-negative
      bacterial infections. The 50% effective doses of ABT-719 were at least threefold
      lower than those of ciprofloxacin for therapy of intracellular infections caused
      by Salmonella typhimurium or Listeria monocytogenes. In immunosuppressed mice,
      ABT-719 was more effective than ciprofloxacin against quinolone-sensitive S.
      aureus, Enterococcus faecalis, and Enterococcus faecium. The pharmacokinetic
      properties of ABT-719 were consistent with its relative efficacy. The 2-pyridones
      are potent, orally available antibacterial agents with efficacy against gram
      positive and gram-negative bacterial infections in mice.

PMID- 7786007
TI  - Use of 2'-fluoro-5-methyl-beta-L-arabinofuranosyluracil as a novel antiviral
      agent for hepatitis B virus and Epstein-Barr virus.
AB  - A novel anti-hepatitis B virus (anti-HBV) agent, 2'-fluoro-5-methyl-beta-L
      arabinofuranosyluracil (L-FMAU), was synthesized and found to be a potent anti
      HBV and anti-Epstein-Barr virus agent. Its in vitro potency was evaluated in
      2.2.15 and H1 cells for anti-HBV and anti-Epstein-Barr virus activities,
      respectively. In vitro cytotoxicity in MT2, CEM, 2.2.15, and H1 cells was also
      assessed, and the results indicated high antiviral selectivities of L-FMAU in
      these cells.

PMID- 7786009
TI  - Pneumococcal resistance in southwest Virginia.
AB  - Resistance patterns of Streptococcus pneumoniae in southwest Virginia were
      determined for 100 consecutive, hospital-based isolates, mostly from adults.
      Oxacillin disk screening identified all resistant isolates. Sixteen percent of
      the isolates were penicillin resistant (10% were highly resistant). E-strip
      testing revealed the following MICs (in micrograms per milliliter, with
      percentages of isolates in parentheses): cefotaxime, < or = 0.5 (92%);
      ceftriaxone, < or = 0.5 (95%); ceftizoxime, < or = 0.5 (85%); erythromycin, < or
      = 1 (87%); ofloxacin, < or = 2 (80%); vancomycin, < or = 1 (98%).

PMID- 7786008
TI  - Revised interpretation of oxacillin MICs for Staphylococcus epidermidis based on
      mecA detection.
AB  - In 1992 and 1993, at The Ohio State University Medical Center, a larger
      proportion of Staphylococcus epidermidis strains required oxacillin MICs of 1 to
      2 micrograms/ml than did Staphylococcus aureus strains. mecA genotype was
      correlated with antimicrobial susceptibility for selected clinical S. epidermidis
      strains. All 14 strains that required oxacillin MICs of < or = 0.25 microgram/ml
      and 2 of 5 strains that required oxacillin MICs of 0.5 microgram/ml were
      susceptible by 1-microgram oxacillin disk test and were mecA negative. Three of 5
      strains that required oxacillin MICs of 0.5 microgram/ml and all 18 strains that
      required oxacillin MICs of > or = 1.0 microgram/ml were resistant by oxacillin
      disk test and were mecA positive. Current National Committee for Clinical
      Laboratory Standards MIC interpretive criteria may underestimate methicillin
      resistance among S. epidermidis strains.

PMID- 7786010
TI  - In vitro activity of a new fluoroquinolone, CP-99,219, against strains of
      Neisseria gonorrhoeae.
AB  - The susceptibilities of 216 strains of Neisseria gonorrhoeae to a new
      fluoroquinolone, CP-99,219 were determined. For strains for which the MICs of
      ciprofloxacin were < or = 0.06 microgram/ml, the MICs at which 90% of the
      isolates are inhibited (MIC90s) of CP-99,219, ciprofloxacin, and ofloxacin were
      0.008, 0.015, and 0.03 microgram/ml, respectively. For strains for which the MICs
      of ciprofloxacin were 0.125 to 0.5 microgram/ml, the MIC90s of CP-99,219,
      ciprofloxacin, and ofloxacin were 0.06, 0.25, and 0.5 microgram/ml, respectively.
      For strains for which the MICs of ciprofloxacin and ofloxacin were 2.0
      micrograms/ml, the MIC of CP-99,219 was 0.25 microgram/ml.

PMID- 7786011
TI  - Comparative in vitro activities of L-695,256, a novel carbapenem, against gram
      positive bacteria.
AB  - The in vitro activity of a prototype 2-aryl carbapenem, L-695,256, against gram
      positive bacteria was examined. All streptococci and oxacillin-susceptible and 
      resistant staphylococci were inhibited at concentrations of < or = 0.125, < or =
      0.125, and 4 micrograms/ml, respectively. The activity of L-695,256 was superior
      to that of imipenem against other organisms intrinsically resistant to beta
      lactams.

PMID- 7786012
TI  - Treatment of murine pulmonary blastomycosis with SCH 51048, a broad-spectrum
      triazole antifungal agent.
AB  - The in vitro and in vivo activities of a new broad-spectrum triazole derivative,
      SCH 51048, against Blastomyces dermatitidis were evaluated. As determined by
      using the new National Committee for Clinical Laboratory Standards proposed
      standard for susceptibility testing of yeasts, SCH 51048 was the most active of
      the four agents tested in vitro against 13 strains of B. dermatitidis. In a well
      described murine model of acute pulmonary blastomycosis, SCH 51048 was comparable
      to amphotericin B and at least 30 times more active than itraconazole. On the
      basis of these experiments, clinical evaluation of SCH 51048 for the use in
      treatment of human blastomycosis should proceed.

PMID- 7786013
TI  - Chloroperoxidase-catalyzed benzylic hydroxylation.
AB  - Chloroperoxidase oxidizes p-methylanisole and p-ethylanisole to 4-methoxybenzyl
      alcohol and 1-(4'-methoxyphenyl)ethanol, respectively. It ineffectively oxidizes
      toluene to benzyl alcohol but does not appear to oxidize toluene substituted with
      strong electron-withdrawing groups. O-Demethylation is also observed. The enzyme
      is sensitive to substituents at other than the para position and does not
      detectably catalyze benzylic hydroxylation of p-methylanisole if it bears
      additional methyl or methoxy groups. An exception is 1,2-(methylenedioxy)-4
      methylbenzene, which is oxidized to both 3,4-(methylenedioxy)benzyl alcohol and 2
      hydroxy-4-methylphenol. Studies with H2(18)O2 indicate that all the oxygen
      incorporated into the product in the oxidation of p-methylanisole to 4
      methoxybenzyl alcohol derives from the peroxide. The mono- and dideuterated
      methyl analogues of p-methylanisole are oxidized with apparent intramolecular
      isotope effects of 3.51 and 3.34, respectively. Abstraction of a hydrogen from a
      carbon bearing a hydroxyl group competes effectively with benzylic oxidation
      because 2-[1,1-2H2]phenylethanol is oxidized to 2-[1-2H]- rather than 2-[1,2
      2H2]phenylacetaldehyde. Aldehyde formation therefore involves abstraction of the
      carbinol hydrogen rather than hydrogen migration to a benzylic carbocation
      intermediate. Chloroperoxidase resembles cytochrome P450 in that it catalyzes
      benzylic hydroxylation reactions but it has a more limited substrate specificity.

PMID- 7786014
TI  - Tyrosine modification by reactive nitrogen species: a closer look.
AB  - Peroxynitrite (ONOO-) is a powerful oxidant and cytotoxic species formed by the
      rapid reaction between nitrogen monoxide (nitric oxide, .NO) and superoxide (O2.
      ). At neutral pH ONOO- is partly protonated and this protonated form,
      peroxynitrous acid (ONOOH), decomposes rapidly to nitrate, forming (an)
      intermediate(s) with reactivity similar to .OH and .NO2. Peroxynitrite can
      hydroxylate and nitrate aromatic rings, and aromatic nitration of phenols such as
      tyrosine by ONOOH is proposed to proceed via a radical mechanism, with
      intermediate formation of .NO2. Modification of tyrosine by .NO2 also involves
      nitration via a radical mechanism. Aromatic nitration of phenols by ONOO- has
      been shown to be enhanced by superoxide dismutase or Fe(3+)-EDTA, which were
      proposed to catalyze heterolytic cleavage of ONOOH to form a nitrating species
      similar to the nitronium ion (NO2+). We investigated possible mechanisms of
      tyrosine modification by various reactive nitrogen species, including ONOO-, 3
      morpholinosydnonimine (SIN-1), and .NO2. Reaction of tyrosine with ONOO- leads to
      formation of 3-nitrotyrosine and dityrosine, indicating intermediate formation of
      tyrosyl radicals. The pH dependence of formation of both 3-nitrotyrosine and
      dityrosine by ONOO- suggests that intermediate formation of ONOOH is required.
      Qualitatively similar results were obtained when ONOOH was generated continuously
      by H2O2 and NaNO2 at mildly acidic pH or with SIN-1, a compound which at neutral
      pH releases both .NO and O2.-, presumably producing ONOO-. However, relatively
      low yields of nitrotyrosine were obtained with SIN-1, possibly because of
      competing reactions of tyrosyl radicals with .NO or O2.-. Possible involvement of
      .NO2 in tyrosine modification by ONOO- was studied using hydroxyl radical
      scavengers, which can increase the radical yield during decomposition of ONOOH
      and thereby enhance generation of .NO2. Hydroxyl radical scavengers did not
      affect tyrosine modification by .NO2 directly and slightly inhibited tyrosine
      modification by authentic ONOO-. However, when ONOO- was produced at a slower
      rate, either by SIN-1 or by H2O2/NaNO2 at acidic pH, hydroxyl radical scavengers
      were found to significantly enhance tyrosine nitration. Our results suggest that
      ONOO- or ONOO(-)-generating systems induce nitration of tyrosine (or tyrosine
      residues in proteins) via intermediate formation of tyrosyl radicals and .NO2.

PMID- 7786016
TI  - Inhibition of glycosylation by amphomycin and sugar nucleotide analogs PP36 and
      PP55 indicates that Haloferax volcanii beta-glucosylates both glycoproteins and
      glycolipids through lipid-linked sugar intermediates: evidence for three novel
      glycoproteins and a novel sulfated dihexosyl-archaeol glycolipid.
AB  - Arachaebacteria have been recently placed in evolution as a separate kingdom of
      organisms between procaryotes and eucaryotes. Although these organisms contain
      both glycolipids and glycoproteins, they possess no Golgi. No biosynthetic work
      has been published on the complex carbohydrates of these newly reassigned
      organisms. This report describes preliminary results from one member of this
      kingdom, Haloferax volcanii, which suggest that all glycosylation proceeds
      through lipid intermediates. Evidence for novel glycolipid structure was also
      found during this study. H. volcanii plasma membranes contain all of the enzyme
      activities for synthesis of N-linked glycoproteins and archaeol-based
      glycolipids. For glucose transfer, all reactions apparently proceed through
      glucose-phosphopolyisoprenol using UDP-glucose as primary donor. Incorporation of
      D-[3H]glucose from UDP-D-[3H]glucose into glycoproteins and glycolipids of H.
      volcanii was stimulated by addition of C55-polyisoprenol phosphate, but not by
      C85-105 dolichol phosphate, and was inhibited by amphomycin and two recently
      described sugar nucleotide analogs, PP36 (5'-[N-(2-decanoylamino-3-hydroxy-3
      phenylpropyloxy carbonyl)glycyl]amino]-5'-deoxyuridine) and PP55 (5'-O-[[(2
      decanoylamino-3-phenylpropyloxycarbonyl) amino]sulfonyl]uridine). All three
      inhibitors are reported to block transfer of sugar from UDP-sugars to
      phosphopolyisoprenols in eucaryotes. However, in H. volcanii these inhibitors
      apparently block transfer of glucose from polyprenyl intermediates to final
      glycoproteins and glycolipid products. The sulfodihexosyl archaeol glycolipid
      fraction was partially characterized by mass spectrometry and was found to
      contain a previously unreported structure with sulfate on the reducing-end sugar.
      Four major glycoproteins 190, 105, 56, and 52 kDa and an archaeol-based
      glycolipid fraction were labeled by amphomycin-sensitive pathways. Photoaffinity
      labeling of H. volcanii homogenate with 5-azido-[32P]UDP-Glc tagged only one 45
      kDa polypeptide which is a probable glucosyl-phosphorylpolyisoprenol synthase.
      The fact that only one polypeptide band was photoaffinity-labeled indicated that
      no other transferase utilized UDP-glucose directly in H. volcanii. The salt
      requirement of the UDP-glucose-dependent pathways suggests that cytoplasmic
      enzymes function in a high salt environment in H. volcanii. The archaebacterial
      plasma membrane thus expresses many functions for glycosylation of both
      glycoproteins and glycolipids, normally found in the endoplasmic reticulum and
      Golgi of eucaryotes.

PMID- 7786015
TI  - Metabolic inhibition of cardiomyocytes causes an increase in sarcolemmal fluidity
      which may be due to loss of cellular cholesterol.
AB  - We examined whether metabolic inhibition (5 mM NaCN + 10 mM 2-deoxyglucose)
      affects sarcolemmal fluidity in cultured neonatal cardiomyocytes. As a measure of
      sarcolemmal fluidity we determined the fluorescence steady-state anisotropy (rss,
      which is reciprocally related to membrane fluidity) of cardiomyocytes labeled
      with 1-(4-trimethylammoniumphenyl)-6-phenyl-1,3,5-hexatriene, p-toluenesulfonate.
      During metabolic inhibition, membrane fluidity increased progressively: after 30
      min rss had fallen by 6.7 +/- 1.2% (mean +/- SE; n = 9; P < 0.05) compared to
      baseline values, and after 90 min by 14.5 +/- 3.5% (P < 0.05; n = 5). Beyond 90
      min rss did not decrease any further. During control incubations (without
      metabolic inhibition), no significant changes in rss were observed. During
      metabolic inhibition cellular free cholesterol content declined: after 30 min
      free cholesterol content had decreased by 12.2 +/- 3.1% (P < 0.02; n = 4),
      compared to baseline values, and after 90 min by 31.1 +/- 8.3% (P < 0.02; n = 4).
      We conclude that metabolic inhibition induces an increase in sarcolemmal
      fluidity, which may be caused by a decrease in sarcolemmal free cholesterol
      content.

PMID- 7786017
TI  - Limited proteolysis of S-adenosylhomocysteine hydrolase: implications for the
      three-dimensional structure.
AB  - S-Adenosylhomocysteine (AdoHcy) hydrolase was subjected to limited proteolytic
      digestion utilizing the proteases trypsin, V8, and papain. Results of the trypsin
      digest revealed one major susceptible peptide bond between amino acid residues
      103 and 104 which is most likely exposed to solvent. Binding of the substrate
      adenosine substantially reduced the susceptibility of this site, indicating that
      this peptide bond may be located at or near the substrate binding site. Wild-type
      AdoHcy hydrolase (which exists as a tetramer) was completely resistant to V8
      digestion, while a site-directed mutant form (in which Lys at position 426 was
      changed to Glu) of the enzyme that exists primarily as a monomer had one major V8
      protease cleavage site between amino acid residues 198 and 199, suggesting that
      these two amino acid residues may be positioned within the tetramerization region
      of each subunit. Limited papain digestion of AdoHcy hydrolase revealed that the
      enzyme, despite multiple peptide bond cleavages, was able to maintain its
      quaternary structure and remain catalytically functional. This observation
      suggests that AdoHcy hydrolase exists as a very compact enzyme with extensive
      intramolecular bonding. Identification of a surface-exposed peptide bond and one
      located in the tetramerization domain of each subunit may provide some
      constraints on how each subunit can be oriented in space. Results from this study
      support a previously described model (D. B. Ault-Riche, C. S. Yuan, and R. T.
      Borchardt (1994) J. Biol. Chem., 269, 31, 472-31, 478) in which the formation of
      the active site is dependent upon proper quaternary structure and also suggest
      that the active site of the enzyme may be located at or near the tetramerization
      domain of each subunit.

PMID- 7786019
TI  - Glycosaminoglycan addition to proteoglycans by articular chondrocytes--evidence
      for core protein-specific pathways.
AB  - The intracellular compartmentalization of enzyme activities involved in the
      elongation and sulfation of glycosaminoglycans on aggrecan, decorin, and
      fibromodulin was investigated using brefeldin A, a compound with known inhibitory
      action on normal vesicular transport and secretion of macromolecules. Treatment
      of bovine chondrocyte cultures with the compound resulted in greater than 98%
      inhibition of Na35SO4 incorporation into macromolecules, whereas [3H]leucine or
      [3H]glucosamine continued at 60-70% of the levels measured in control cultures.
      The release of newly synthesized products into the medium was also decreased
      markedly by brefeldin A to 7 and 2% of control levels for [3H]leucine- and
      [3H]glucosamine-labeled macromolecules, respectively. Analysis of [3H]
      glucosamine-labeled products in these cultures showed that synthesis of sulfated
      glycosaminoglycans (chondroitin/dermatan sulfate and keratan sulfate) was
      inhibited in response to brefeldin A, whereas hyaluronan synthesis was
      essentially unaffected. Significant amounts of elongated chondroitin continued to
      be synthesized in the presence of brefeldin A. Immunoprecipitation of [3H]leucine
      labeled decorin, aggrecan, and fibromodulin from cells showed that aggrecan and
      fibromodulin were not substituted with glycosamino-glycans, whereas all decorin
      molecules synthesized under these conditions were substituted with chondroitin.
      The results suggest that in articular chondrocytes, elongation of the
      glycosaminoglycan chains on decorin, but not their sulfation, occurs in a Golgi
      compartment unaffected by disruption of vesicular core protein transport. This is
      in contrast to glycosaminoglycan elongation and sulfation on aggrecan and
      fibromodulin, where both processes apparently occur in the trans-Golgi network,
      which becomes inaccessible to these core proteins in the presence of brefeldin A.
      The results further suggest that in brefeldin A-treated cells decorin is
      contained in a discrete ER-Golgi compartment separated from aggrecan; this
      compartment is accessible to p-nitrophenyl-beta-D-xylosides, since beta-xylosides
      become elongated with chondroitin even in the presence of brefeldin A.

PMID- 7786020
TI  - Identification and distribution of peptide:N-glycanase (PNGase) in mouse organs.
AB  - A wide occurrence of peptide:N-glycanase (PNGase) in mouse organs was
      demonstrated. PNGase activities were determined using 14C-labeled fetuin
      glycopeptide I as a substrate by a newly improved enzyme assay based on the paper
      chromatographic and paper electrophoretic analyses. PNGase activities were
      detected in both soluble and membranous (or particulate) fractions, although the
      levels of the activities were different from organ to organ. Soluble PNGases were
      partially purified from brain, liver, kidney, and spleen by TSK butyl-Toyopearl
      650 M hydrophobicity chromatography and characterized for enzymatic properties.
      The soluble enzymes were found to share the following properties: (a) high
      hydrophobicity; (b) sensitivity to metal cations such as Zn2+, Cu2+, and Fe3+;
      and (c) requirement of sulfhydryl group(s) for enzyme activity. Notably, soluble
      PNGases were unable to degrade glycoasparagine substrates and the optimal pH was
      near 7.0, suggesting that they were not lysosomal enzymes, but perhaps being
      involved in basic biological processes in certain intracellular nonlysosomal
      events. All of these enzymatic properties found for mouse organ-derived PNGases
      were the same as those recently found for L-929 PNGase that was highly purified
      as a soluble enzyme from mouse fibroblast L-929 cells (Suzuki, T., Seko, A.,
      Kitajima, K., Inoue, Y., and Inoue, S. (1994) J. Biol. Chem. 269, 17611-17618.

PMID- 7786018
TI  - A new cytochrome P450 form belonging to the CYP2D in dog liver microsomes:
      purification, cDNA cloning, and enzyme characterization.
AB  - A new form of cytochrome P450 (P450 DUT2) was purified from untreated male dog
      liver microsomes. The final preparation (a specific content of 19.1 nmol P450/mg
      protein) showed a single band with an apparent monomeric molecular weight of
      50,000 on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, but was
      further separated into two apoproteins (P450 DUT2a and P450 DUT2b) by reverse
      phase HPLC. Both proteins had identical NH2-terminal amino acid sequences, but
      the first three amino acids of P450 DUT2b were truncated in P450 DUT2a. Purified
      P450 DUT2 showed 5 to 18 times higher catalytic activities than did hepatic
      microsomes toward desipramine, metoprolol, and dextromethorphan. These activities
      in dog liver microsomes were strongly inhibited by anti-P450 DUT2-IgG. A 1.7
      kilobase pair cDNA (cDUT2) encoding a male dog liver P450 of 500 amino acid
      residues (molecular weight 56,400) was isolated and sequenced. The first 35 NH2
      terminal amino acid sequence of P450 DUT2b coincided with the deduced amino acid
      sequence of cDUT2 at 2-36. The deduced total amino acid sequence of cDUT2 shared
      high similarity with the reported 2D forms (with 2D6, 74.6%; 2D14, 75.4%; 2D1,
      65.4%; and 2D9, 63.6%). Moreover, the expressed P450 DUT2 in COS-7 cells had
      catalytic activities similar to those of purified P450 DUT2. Therefore, this
      paper is the first report about dog CYP2D. Furthermore, Northern and Western blot
      analyses indicated that the expressed levels of mRNA and protein were almost
      equal between male and female dogs. Western blot analysis suggested that P450
      DUT2 is a constitutive and major (approximately 20% of the total P450) form,
      indicating that the 2D subfamily P450 in dog liver is quite unique from CYP2D
      members of other species.

PMID- 7786022
TI  - A calorimetric study of binary mixtures of 1-octadecanoyl-2-decanoyl-sn-glycero-3
      phosphoethanolamine and dimyristoyl phosphatidylethanolamine.
AB  - Model membranes composed of 1-octadecanoyl-2-decanoyl-sn-glycero-3-
      phosphoethanolamine and dimyristoyl phosphatidylethanolamine have been studied
      calorimetrically. 1-Octadecanoyl-2-decanoyl-sn-glycero-3- phosphoethanolamine is
      a highly asymmetric mixed-chain lipid, whereas dimyristoyl
      phosphatidylethanolamine is an identical-chain lipid with the same molecular
      weight. Calorimetric results indicate that these two lipids with a common
      molecular weight are completely miscible in the two-dimensional plane of the
      lipid bilayer in the liquid-crystalline state and that they are only partially
      miscible in the gel-state bilayer. Specifically, binary mixtures of these two
      lipids form eutectic phase diagrams at pH 7.4 and 10.0.

PMID- 7786021
TI  - Nitric oxide protects against alkyl peroxide-mediated cytotoxicity: further
      insights into the role nitric oxide plays in oxidative stress.
AB  - Endogenously formed nitric oxide (NO) possesses diverse properties such as
      regulating physiological functions, exerting specific toxic effects, and
      protecting against various toxic substances. Recent studies suggest that in the
      presence of reactive oxygen species, NO can serve as an antioxidant. We show here
      that NO delivered from the NO donor compound, PAPA/NO
      (NH2(C3H6)(N[N(O)NO](C3H7)), protects Chinese hamster V79 lung fibroblasts from
      the cytotoxicity of t-butyl hydroperoxide and cumene hydroperoxide. In contrast,
      the other end products of PAPA/NO degradation in aqueous solution,
      NH2(C3H6)NH(C3H7) and nitrite, did not protect. The NONOate DEA/NO releases NO
      six times faster than PAPA/NO, yet did not afford protection, which implies that
      NO must be present throughout the alkyl hydroperoxide exposure. Measurements of
      NO concentrations released from PAPA/NO suggest that micromolar levels protect
      against cytotoxicity induced by alkyl hydroperoxides. These findings demonstrate
      that the flux of NO sustained over the duration of the peroxide exposure
      determines protection and not the total of NO delivered. These results suggest
      that concentrations of NO produced in the microenvironment of endothelial cells
      are high enough to protect cells from Fenton-type-mediated toxicity and support
      the premise that NO may exert a salutary effect in certain diseases associated
      with membrane damage.

PMID- 7786023
TI  - Purification and characterization of human serum N-acetylglucosamine-1
      phosphodiester alpha-N-acetylglucosaminidase.
AB  - Many lysosomal enzymes are recognized and selected by a unique marker in the form
      of mannose 6-phosphate groups which are present exclusively on their N-linked
      oligosaccharides. Two enzymes act sequentially to catalyze the addition of
      mannose 6-phosphate groups to the proteins: N-acetylglucosamine
      phosphotransferase (GlcNAc phosphotransferase) and N-acetylglucosamine-1
      phosphodiester alpha-N-acetylglucosaminidase (phosphodiester alpha-GlcNAcase). We
      report here the purification and partial characterization of phosphodiester alpha
      GlcNAcase from human serum. The enzyme was purified over 600,000-fold by
      utilizing ammonium sulfate precipitation, fractionation on wheat germ agglutinin
      Sepharose, Fe(3+)-chelating Sepharose, and Cu(2+)-chelating Sepharose, and
      renaturation from gel slices after sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis (SDS-PAGE). The protein observed after renaturation and
      subsequent SDS-PAGE and silver staining had an apparent molecular mass of 118
      kDa, which is slightly smaller than bovine liver phosphodiester alpha-GlcNAcase
      (Mullis et al. (1994) J. Biol. Chem. 269, 1718-1726). Serum enzyme activity does
      not require Triton X-100 and is not stimulated by its addition. These results
      suggest that the enzyme found in serum represents a form secreted after
      proteolysis in the Golgi of the membrane-bound enzyme. The serum enzyme
      hydrolyzed UDP-GlcNAc to UDP and GlcNAc and hydrolyzed GlcNAc-P-Man alpha Me into
      alpha MeMan-P and GlcNAc. The enzyme had no hydrolyzing activity toward UDP
      GalNAc, UDP-Glc, [6-3H]GlcNAc beta 1-3Gal beta 1-4Glc, p-nitrophenyl-alpha-N-
      acetylglucosaminide, p-nitrophenyl-beta-N-acetylglucosaminide, p-nitrophenyl
      alpha-N-galactopyranoside, or p-nitrophenyl-beta-N- galactopyranoside. The enzyme
      activity was strongly inhibited by UDP-GlcNAc and GlcNAc-1-phosphate, had a pH
      optimum between pH 6.0 and 7.0, and was inhibited by FeCl3, FeSO4, and CuSO4. The
      Km values for UDP-GlcNAc and GlcNAc-P-Man alpha Me were 0.94 and 0.45 mM,
      respectively. Over 77% of enzyme activity remained after incubation for 10 min at
      70 degrees C, demonstrating an unusual thermostability of the serum enzyme.

PMID- 7786024
TI  - Isolation and characterization of Cajanus cajan lectin.
AB  - Cajanus cajan lectin was isolated by ammonium sulfate fractionation and affinity
      chromatography on an IgM-Sepharose 6B column. Gel filtration and SDS-PAGE showed
      size homogeneity of the lectin. The lectin with M(r) 18,000 on SDS-PAGE had gel
      filtration behavior which was consistent with a molecular weight of 39 kDa and a
      Stokes radius of 2.74 nm. The results showed that the lectin is a dimer composed
      of identical subunits with N- and C-terminal residues of threonine and alanine,
      respectively. The glycoprotein lectin contained 3% concanavalin A-reactive
      neutral carbohydrates. Its amino acid composition is characterized by high
      contents of acidic amino acids. The number of tyrosine and tryptophan residues
      per mole of the lectin was determined to be 14 and 4, respectively, by
      spectrophotometry. Results on the effects of large numbers of saccharides on
      lectin-mediated hemagglutination and lectin-IgM precipitation showed that the C.
      cajan lectin was specific for mannose and glucose. A comparative study of the
      properties of C. cajan lectin and concanavalin A is also presented.

PMID- 7786025
TI  - Modulation of 2-oxoglutarate dehydrogenase and oxidative phosphorylation by Ca2+
      in pancreas and adrenal cortex mitochondria.
AB  - The effect of external free Ca2+ ([Ca2+]ex) on the 2-oxoglutarate dehydrogenase
      (2-OGDH) activity and the rate of state 3 respiration was studied in dog pancreas
      and adrenal cortex mitochondria. A method for the preparation of mitochondria
      from pancreas, free of zymogen granules, was developed. The mitochondria showed
      high respiratory control values and maintained adequate ADP/O ratios in the
      course of several hours. Half-maximal stimulation (K0.5) of 2-OGDH activity and
      state 3 respiration by Ca2+ was decreased twofold by spermine, in both pancreas
      and adrenal cortex mitochondria incubated with Mg2+; Na+ increased the K0.5 value
      for Ca2+ in both kinds of mitochondria. The matrix Ca2+ content was enhanced by
      spermine at different [Ca2+]ex. The Ca2+ gradient ([Ca2+]m/[Ca2+]ex) determined
      in Fluo 3-loaded pancreas mitochondria was found to be below 1, either in the
      presence of Na+ or in the absence of spermine. The protonmotive force was
      increased by 1 microM Ca2+, in state 3 conditions, by 6-8 mV; lower Ca2+
      concentrations kept the H+ gradient rather constant. An increase in the
      spermine/Mg2+ ratio at constant external Ca2+ resulted in stimulation of the 2
      OGDH activity and state 3 respiration. The data indicate that matrix Ca2+ may
      regulate the rate of ATP synthesis in pancreas and adrenal cortex mitochondria,
      through the modulation of 2-OGDH and the maintenance of a high H+ gradient. In
      addition to changes in external Ca2+, the variation in the spermine/Mg2+ ratio
      may also exert control of oxidative phosphorylation.

PMID- 7786026
TI  - Interaction of retinoblastoma gene product with transcription factors ATFa and
      ATF2.
AB  - Two highly related transcription factors, activating transcription factors a and
      2 (ATFa and ATF2) are able to activate expression in CHO cells of a reporter gene
      driven by the human transforming growth factor beta 2 gene promoter. This action
      is dependent on the intact motif CGTCA which is found as part of the cAMP
      responsive element in a number of promoters and to which both factors can bind in
      vitro. The retinoblastoma gene product also weakly stimulates expression of this
      reporter gene but, in combination with the factors, it exhibits a differential
      action: additive or greater stimulatory effects with ATF2 but strong inhibition
      of the actions of ATFa. Thus, although both of these two related factors are able
      to exert the same apparent effect on this promoter, coexpression of the
      retinoblastoma gene product reveals at least one significant difference in their
      actions.

PMID- 7786027
TI  - Food restriction stimulates conjugation of p-nitrophenol in perfused rat liver.
AB  - Rates of conjugation of p-nitrophenol were studied in livers from normal and food
      restricted rats perfused with either p-nitroanisole or p-nitrophenol. Female
      Sprague-Dawley rats had ad libitum access to a Purina 5001 nonpurified diet
      (control) or were given 65% of the intake of controls for 3 weeks. Livers were
      perfused with oxygenated Krebs-Henseleit buffer using a nonrecirculating system.
      Maximal rates of conjugation of p-nitrophenol, generated either from the O
      demethylation of p-nitroanisole (200 microM) or from the infusion of p
      nitrophenol (70 microM), were elevated significantly nearly twofold by food
      restriction. Thus, food restriction stimulates conjugation in the intact liver
      cell. Specifically, rates of conjugation were increased from 2.1 +/- 0.2 to 3.7
      +/- 0.4 and from 3.3 +/- 0.6 to 5.8 +/- 0.5 mumol/g/h when 200 microM p
      nitroanisole or 70 microM p-nitrophenol were infused, respectively. On the other
      hand, rates of conjugation were not affected by food restriction when low
      concentrations of p-nitroanisole (50 microM) or p-nitrophenol (20 microM) were
      infused. Further, food restriction did not alter rates of conjugation in isolated
      microsomes supplemented with excess UDPGA. Interestingly, both UDP-glucose and
      UDP-glucuronic acid were increased significantly in liver extracts from food
      restricted rats when livers were perfused with high but not low concentrations of
      p-nitrophenol. Under these conditions, the increase in UDP-glucuronic acid was
      threefold. Moreover, food restriction increased carbohydrate release from the
      liver about twofold. Glycogen content was also increased significantly in liver
      extracts from 8.4 +/- 1.9 to 60.4 +/- 13.8 mmol/kg wet weight by food
      restriction. Taken together, these data support the hypothesis that food
      restriction stimulates conjugation of p-nitrophenol concentrations by increasing
      the supply of the pivotal cofactor UDP-glucuronic acid from carbohydrate reserves
      (e.g., glycogen).

PMID- 7786028
TI  - 9-cis-retinoic acid selectively activates the cellular retinoic acid binding
      protein-II gene in human neuroblastoma cells.
AB  - Two families of nuclear retinoid receptors, retinoic acid receptor and retinoid X
      receptor (RAR and RXR respectively), and a family of cellular retinoic acid
      binding proteins (CRABPI and II) participate in the retinoic acid (RA) signaling
      pathway. The presence and function of many of these receptors and cellular
      binding proteins have not been fully explored in RA-responsive human
      neuroblastoma cells. We have previously shown that RAR transcripts and protein
      are present in human neuroblastoma cells, and that all-trans RA induces the
      expression of the RAR beta mRNA. In this paper, we demonstrate that human
      neuroblastoma cells express mRNA for RXR alpha and beta. The mRNA for CRABPI is
      present in untreated human neuroblastoma cells, whereas the mRNA for CRABPII is
      induced in cells treated with either all-trans RA or 9-cis RA. Furthermore, 9-cis
      RA, a ligand that binds to both the RAR and the RXR families, selectively
      activates the CRABPII gene. In contrast, all-trans RA and 9-cis RA are equally
      effective in the induction of RAR beta transcript and inhibition of cell
      proliferation. Since both retinoids inhibit human neuroblastoma cell
      proliferation, it appears that induction of RAR beta rather than of CRABPII is
      more likely linked to the regulation of human neuroblastoma cell growth.

PMID- 7786030
TI  - The DNA binding of purified Ah receptor heterodimer is regulated by redox
      conditions.
AB  - The Ah receptor from rat liver has been purified, using a specific
      oligonucleotide affinity column, in order to characterize the components of the
      receptor and to investigate features that modulate its DNA-binding activity. The
      purified DNA-binding form of rat Ah receptor contains three major components,
      with estimated molecular masses of 108, 98, and 96 kDa. Antibodies to two
      peptides from the mouse Ah receptor bind the 108-kDa protein, but not the 98-kDa
      protein, and bind weakly at the position of the 96-kDa protein. The sequences of
      four peptides from samples containing both the 96- and 98-kDa proteins are all
      highly similar to segments of the human Ah receptor nuclear translocator (Arnt)
      protein. Antibodies to a peptide from the human Arnt protein bind the 96- and 98
      kDa proteins, but not the 108-kDa protein. These data show that the Ah receptor
      itself and two forms of the Arnt protein are the major components of the purified
      DNA-binding form of receptor. In gel shift assays the purified receptor forms two
      specifically bound complexes with a xenobiotic responsive element (XRE), which
      may correspond to Ah receptor heterodimers with either of the two forms of Arnt
      protein. The DNA binding of the purified heterodimer is substantially decreased
      under oxidizing conditions. Oxidation inhibits receptor DNA binding without
      greatly altering the size of the purified heterodimer. This sediments at 5.9S in
      its reduced form and at 6.5S in its oxidized form. Dithiothreitol restores the
      XRE binding of oxidized receptor, with similar effects on both of the receptor
      XRE complexes. In the presence of nuclear extract, reduced thioredoxin also
      restores the XRE binding of oxidized receptor.

PMID- 7786029
TI  - Detection of hydroxyl radicals upon interaction of ozone with aqueous media or
      extracellular surfactant: the role of trace iron.
AB  - As part of a study on mechanisms modulating ozone-induced surfactant
      perturbations, we used the electron paramagnetic resonance (EPR) spin trapping
      technique to determine the type and origin of radicals generated following
      interaction of ozone with aqueous solutions and cell-free bronchoalveolar lavage
      fluid (BAL) fractions. All aqueous media were exposed to ozone at 25 degrees C
      with or without added chelator, 1 mM diethylenetriaminepentaacetic acid, and
      spintrap, 100 mM 5,5'-dimethyl-1-pyrroline-1-oxide (DMPO). Exposure of distilled
      water to 0.5, 1.0, 2.0, and 3.0 ppm ozone for 1 h yielded four-line spectra,
      1:2:2:1, consistent with hydroxyl radical adduct formation (DMPO-OH), the
      amplitudes of which increased with the ozone concentration. No signals were
      obtained from air-exposed samples. Similar four-line spectra were also produced
      following interaction of 3 ppm ozone with Hank's balanced salt solution (HBSS)
      alone or containing BAL fractions. Addition of the hydroxyl radical scavenger
      dimethyl sulfoxide (DMSO) to the incubation medium strongly inhibited formation
      of DMPO-OH adduct during ozone exposure. As an alternate method of demonstrating
      the generation of hydroxyl radicals, aqueous solutions of 1 mM L-phenylalanine
      were exposed to high concentrations of ozone and shown, using ion-exchange
      chromatography, to contain small amounts of L-tyrosine. Production of hydroxyl
      radicals upon interaction of ozone and water was further substantiated using the
      spintrap PBN (phenyl-N-tert-butylnitrone) in the presence of DMSO which reacts
      with the hydroxyl radical resulting in the formation of methyl radical. The
      methyl radical subsequently reacts with spintrap PBN, yielding PBN-methyl adduct.
      In the absence of DMSO there was no detectable formation of methyl radical
      adduct. EPR double distilled water containing DMPO showed a small amount of DMPO
      OH adduct upon exposure to ozone. Addition of 10 microM ferrous sulfate to this
      mixture produced a 10-fold increase of the signal, which was attenuated in the
      presence of 1500 U catalase, strongly attenuated with 50-500 microM deferoxamine
      or 8000 U catalase and abolished by higher concentration of deferoxamine (1 mM).
      The signal was not influenced by 1000 U superoxide dismutase. These results
      indicate that hydroxyl radicals are produced via iron-dependent reactions during
      the initial interaction of ozone with aqueous media, including bronchoalveolar
      fluid.

PMID- 7786032
TI  - Kinetics of cytochrome c2+ oxidation by peroxynitrite: implications for
      superoxide measurements in nitric oxide-producing biological systems.
AB  - Cytochrome c3+ has been extensively used for the detection of superoxide produced
      in biological systems due to its fast superoxide-mediated reduction to cytochrome
      c2+. However, another biomolecule which is sometimes cogenerated with superoxide,
      nitric oxide, reacts with superoxide at almost diffusion-controlled rates (6.7 x
      10(9) M-1 s-1), leading to the production of a highly oxidizing species,
      peroxynitrite anion (ONOO-). In this work we report that peroxynitrite readily
      oxidizes cytochrome c2+ to cytochrome c3+ in an ascorbate-reversible manner. The
      reaction between peroxynitrite and cytochrome c2+ occurs with a second-order rate
      constant of 2.3 x 10(5) M-1 s-1. The pH dependence of the apparent second-order
      rate constants as well as the effect of different scavengers indicated that
      peroxynitrous acid (ONOOH) in the ground state was the actual species responsible
      of cytochrome c2+ oxidation. The activation enthalpy, free energy, and entropy
      were +10.8 kcal mol-1, +11.8 kcal mol-1, and -3.15 cal mol-1 K-1, respectively,
      in agreement with the proposed reaction mechanism. Additionally, our results
      imply that when quantitating superoxide by the cytochrome c3+ reduction method,
      the existence of a simultaneous generation of nitric oxide and peroxynitrite may
      lead to an underestimation of the rates of superoxide production.

PMID- 7786031
TI  - Substrate specificity of human liver aldehyde oxidase toward substituted
      quinazolines and phthalazines: a comparison with hepatic enzyme from guinea pig,
      rabbit, and baboon.
AB  - Partially purified aldehyde oxidase (EC 1.2.3.1) has been prepared from human,
      rabbit, guinea pig, and baboon liver by heat treatment and precipitation with
      ammonium sulfate. The interaction of 35 substituted quinazolines and phthalazines
      with human liver enzyme has been studied using a spectrophotometric assay.
      Fifteen quinazoline and 14 phthalazine derivatives were found to be substrates
      for human liver aldehyde oxidase with Km values ranging from 5 to 500 microM. The
      substrate specificity of the quinazolines toward rabbit, guinea pig, and baboon
      liver aldehyde oxidase has also been investigated; the reaction of substituted
      phthalazines with mammalian liver enzyme has been reported previously (Beedham et
      al., 1990, Biochem. Pharmacol. 39, 1213-1221). Oxidation products of 2
      substituted (4-substituted) quinazolines with rabbit liver aldehyde oxidase were
      identified by MS as 4-oxo (2-oxo)-quinazolines, respectively. In all cases,
      unsubstituted compounds gave the highest oxidation rates and the presence of
      lipophilic substituents presumably facilitated hydrophobic binding to the
      enzymes. However, there were marked differences in substrate specificity between
      human liver aldehyde oxidase and hepatic enzyme from rabbit, guinea pig, and
      baboon with the size of substrate being the differentiating factor. The molecular
      sizes of the substrates, estimated using calculated molar refractivities, ranked
      the size of the binding site of aldehyde oxidase in the order rabbit < guinea pig
      < baboon < man. Isoelectric points of the different aldehyde oxidase isozymes
      ranged from pH 5.10 for rabbit to 6.40 for the human liver isozyme. These results
      indicate that rabbit liver aldehyde oxidase shows marked differences from the
      human liver enzyme in its handling of quinazoline and phthalazine substrates.

PMID- 7786033
TI  - Purification and characterization of tubulin from parental and vincristine
      resistant HOB1 lymphoma cells.
AB  - A multidrug-resistant lymphoma cell line resistant to 1.0 microM vincristine
      (designated HOB1/VCR1.0) was established. The tubulins of parental and resistant
      cell lines were purified by ion-exchange chromatography. Two-dimensional
      polyacrylamide gel electrophoresis of tubulins showed a decrease in the basic
      component of beta-tubulin in the HOB1/VCR1.0 cell line; native isoelectric
      focusing of tubulins showed decreased expression of two more basic tubulin dimers
      in the same cell line. The [3H]vincristine-tubulin binding studies were performed
      by filtration and HPLC and displayed the tubulin of HOB1/VCR1.0 cells having a
      weaker binding affinity to vincristine than those of parental HOB1 and
      HOB1/VCR0.5 cells. The binding constant Ka of purified tubulin to vincristine,
      calculated from the slope of the Scatchard curve, for parental HOB1 cells was 5.6
      x 10(6), and that for HOB1/VCR1.0 cells was 3.1 x 10(6). The Scatchard kinetics
      was also used to determine the binding ability of the purified tubulins to
      [3H]colcemid: the Kas for parental and HOB1/VCR1.0 cells were 3.9 x 10(5) and 2.0
      x 10(5), respectively. The current study suggests that high-level resistant
      cells, HOB1/VCR1.0, tend to express fewer tubulin isoforms of stronger binding
      affinities to antimitotic agents; that is, they preserve weak drug-binding forms
      rather than produce additional species. This may be a mechanism for the cells to
      protect themselves from drug injury when the P-glycoprotein cannot efficiently
      pump out the agent of high concentration within the cells.

PMID- 7786034
TI  - 25-Hydroxy[26,27-methyl-3H]vitamin D3-3 beta-(1,2-epoxypropyl)ether: an affinity
      labeling reagent for human vitamin D-binding protein.
AB  - Vitamin D-binding protein (DBP) is primarily involved in the binding and
      transportation of vitamin D3 and its various metabolites to target organs and
      tissues. This is manifested by the ability of DBP to bind vitamin D3 and its
      metabolites with high affinity. In the present study we developed 25
      hydroxyvitamin D3-3 beta-(1,2-epoxypropyl)ether (25-OH-D3-epoxide) as an affinity
      labeling reagent of human DBP (hDBP). Competitive radioligand binding assays of
      25-OH-D3-epoxide with hDBP demonstrated that the binding affinity of this analog
      was similar to that of 25-hydroxyvitamin D3 (25-OH-D3). Incubation of 25
      hydroxy[26(27)-3H]-vitamin D3-3 beta-(1,2-epoxypropyl)ether [[3H]25-OH-D3
      epoxide] with hDBP covalently labeled the protein. When the incubation was
      carried out in the presence of a large excess of 25-OH-D3, labeling was removed
      completely. When human Cohn IV fraction, containing hDBP, was incubated with
      [3H]25-OH-D3-epoxide a single protein band, corresponding to hDBP, was labeled.
      Labeling was completely obliterated in the presence of a large amount of 25-OH
      D3. However, an equivalent amount of 7-dehydrocholesterol had no effect on
      labeling. These results demonstrated that [3H]25-OH-D3-epoxide most probably
      labeled the vitamin D sterol-binding domain of hDBP.

PMID- 7786035
TI  - Copper, zinc superoxide dismutase in Escherichia coli: periplasmic localization.
AB  - Cu,ZnSOD purified from Escherichia coli has been used to raise antibodies in
      rabbits. The resultant antiserum was found to recognize a single band on Western
      blots of SDS-polyacrylamide gel electropherograms, and that single band coincided
      with the position of the Cu,ZnSOD. Ultrathin sections of fixed E. coli were
      treated with the antibody followed by protein A bearing 10-nm gold particles.
      Electron microscopy revealed that Cu,ZnSOD was largely localized in the periplasm
      in polar bays.

PMID- 7786036
TI  - Growth inhibition and cell killing by N-methyl-N-nitrosourea: metabolic
      alterations that accompany poly(ADP-ribosyl)ation.
AB  - The effect of inhibition of poly(ADP-ribose) polymerase (PARP) on the growth
      arrest and cell killing induced by N-methyl-N-nitrosourea (MNU) was studied in
      L929 fibroblasts. Depletion of NAD and ATP preceded the cell killing by a 1-h
      exposure to 10 or 15 mM MNU. 3-Aminobenzamide (ABA), an inhibitor of PARP, spared
      the depletion of NAD and ATP and prevented the cell killing. With 5 mM MNU, a
      depletion of NAD was promptly reversed, and there was no loss of ATP and no cell
      death. Aphidicolin, a DNA polymerase inhibitor, prevented the restoration of NAD,
      with resulting depletion of ATP and death of the cells, effects that were
      prevented by ABA. Azide together with 2-deoxyglucose depleted ATP, followed by a
      loss of NAD and cell death, changes that occurred in the absence of DNA single
      strand breaks (DNA SSB). ABA prevented the depletion of NAD, but not that of ATP,
      nor the cell killing. MNU (2.5 mM) inhibited cell growth without effect on the
      viability of the cells. ABA potentiated the cell growth inhibition. Thus,
      inhibition of PARP potentiates cell growth inhibition by limiting DNA repair
      mechanisms. Alternatively, inhibition of the DNA repair response to more
      extensive DNA damage prevents cell killing. The ATP depletion caused by poly(ADP
      ribosyl)ation, rather than DNA SSB and the loss of NAD, is the more critical
      event in the cell killing.

PMID- 7786037
TI  - Redox imbalance at the start of each morphogenetic step of Neurospora crassa
      conidiation.
AB  - The conidiation process of Neurospora crassa is characterized by three
      morphogenetic steps: hyphal adhesion, aerial hyphal formation, and production of
      conidia. Total protein oxidation and specific enzyme oxidation coincided with an
      increased oxygen-dependent chemiluminescence and indicated the occurrence of a
      hyperoxidant state at the onset of all three morphogenetic steps. Oxidation of
      NAD(P)H and excretion of glutathione disulfide was detected at the start of
      hyphae adhesion. Here we show that NAD(P)H and glutathione redox imbalance also
      occurred at the beginning of aerial hyphal growth and just before formation of
      conidia in the isolated cell structures. An increased loss and oxidation of
      NAD(P)(H) and glutathione were detected with each morphogenetic transition. These
      results give further support to our proposal that a hyperoxidant state develops
      at the start of each of the three morphogenetic processes during N. crassa
      conidiation.

PMID- 7786038
TI  - Sea urchin ovoperoxidase: solubilization and isolation from the fertilization
      envelope, some structural and functional properties, and degradation by hatching
      enzyme.
AB  - The soft fertilization envelope (SFE) devoid of tyrosine-derived cross-links was
      isolated from the sea urchin Hemicentrotus pulcherrimus embryos fertilized in the
      presence of 2 mM aminotriazole, a reversible inhibitor of ovoperoxidase (OPO).
      Most of the component proteins including OPO were solubilized from SFE by the use
      of a buffer containing 10 mM EDTA. The solubilized OPO was purified by
      chromatographies on Sepharose CL-6B, DEAE-Sephacel, and Superose 12HR columns to
      apparent electrophoretical homogeneity with Mr 70,000. The enzyme accounts for at
      least 3% of the total FE by weight and 10% by gel densitometry. Partial amino
      acid sequences of three proteolytic fragments of OPO, accidentally including the
      distal and proximal His residues, revealed up to 84% homology to mammalian
      thyroid peroxidases, myeloperoxidases, and lactoperoxidases (LPO), but the N
      terminal sequence showed little homology to them. The uv-VIS absorption spectrum
      of OPO has a maximum at 279 nm, Soret band at 415 nm, and a small quartet at 490,
      542, 580, and 642 nm. The tyrosine cross-link profile in the reaction products of
      the OPO/tyrosine/H2O2 system as analyzed by HPLC with uv and fluorescence
      detection was similar to those of LPO and HRPO, with dityrosine as the only major
      component. However, it is different from that of the HCl hydrolysate of normally
      hardened FE that has much higher contents of trivalent cross-links trityrosine
      and pulcherosine. This result reflects the difference in the accessibility of the
      substrates to the enzyme: free tyrosine and OPO in solution vs Tyr residues and
      OPO both immobilized in FE. The enzyme OPO was degraded limitedly by purified
      hatching enzyme (envelysin) after 24 h incubation to mainly a 47-kDa fragment
      with its 67% peroxidase activity retained.

PMID- 7786039
TI  - The role of dietary calcium in the physiology of vitamin D toxicity: excess
      dietary vitamin D3 blunts parathyroid hormone induction of kidney 1-hydroxylase.
AB  - We studied the effects of dietary calcium (Ca) restriction and excess vitamin D3
      on tissue 25-hydroxyvitamin D-1-hydroxylase (1-OHase) and 1,25(OH)2D/25-OH-D-24
      hydroxylase (24-OHase) activities in rats. Effects were studied in four groups of
      rats, with each group receiving one of the following diets: a control diet
      consisting of normal Ca and normal vitamin D3 (NC), NC plus excess (75,000
      IU/week) vitamin D3 (NCT), low Ca and normal vitamin D3 (LC), or LC diet with
      excess vitamin D3 (LCT). Rats fed the low-Ca diets (LC and LCT) had elevated
      plasma parathyroid hormone (PTH) concentrations, increasing > 3-fold relative to
      rats fed the normal Ca diets. The elevated concentrations of PTH in LCT rats did
      not result in increased plasma 1,25-dihydroxycholecalciferol [1,25(OH)2D3] (NC =
      115 +/- 7 pg/ml; LCT = 99 +/- 11 pg/ml). Plasma 1,25(OH)2D in LC rats, however,
      was increased significantly (615 +/- 110, P = < 0.001). There were no differences
      in either plasma Ca or phosphorus between the LC and LCT groups. Dietary Ca
      restriction led to an 18-fold stimulation in renal 1-OHase activity in LC rats (P
      = < 0.01), while 1-OHase in the LCT rats was marginally but significantly
      elevated 2.3-fold (P = < 0.05). The ability of PTH to downregulate renal 24-OHase
      and the 1,25-dihydroxyvitamin D receptor (VDR) during prolonged Ca restriction
      remained intact, irrespective of vitamin D status. Also, the metabolic clearance
      rate for 1,25(OH)2D3 was enhanced by feeding excess vitamin D3, which was likely
      a result of the substantial elevations in intestinal (25-fold) and renal (46
      fold) 24-OHase activities in the LCT and NCT groups, respectively. These data
      indicate that calcium restriction accompanied by excess vitamin D3 is attended by
      impaired responsiveness of renal 1-OHase to PTH and enhanced metabolic clearance
      of 1,25(OH)2D.

PMID- 7786040
TI  - Expression of cytochrome P450 2D6 in Escherichia coli, purification, and spectral
      and catalytic characterization.
AB  - Cytochrome P450 (P450) 2D6 is the classic human liver debrisoquine 4-hydroxylase,
      the first human P450 for which genetic polymorphism was clearly demonstrated. We
      prepared 11 different constructs of P450 2D6, with modification at the N
      terminus, for expression in Escherichia coli with the vector pCW. These varied
      considerably in levels of expression of apo- and holoprotein, with the best yield
      being obtained in a system in which much of the N-terminal hydrophobic segment
      was removed. Production of holoprotein was highly dependent upon the addition of
      delta-aminolevulinic acid and FeCl3 to cultures, even though heme production
      should not be limiting in this system. The expressed protein was not tightly
      bound to the "heavier" membrane fraction but did not appear to behave as a
      soluble protein either. A purification strategy was developed involving
      fractional centrifugation, Triton X-114 phase separation, and flavodoxin affinity
      chromatography, which led to recovery of apparently electrophoretically
      homogeneous protein in good yield. Purified P450 2D6 had the expected N-terminal
      amino acid sequence and catalytic activities toward debrisoquine (4
      hydroxylation) and bufuralol (1'-hydroxylation). The availability of a ready
      source of the recombinant protein should facilitate physical as well as
      functional studies and antibody production for other uses.

PMID- 7786042
TI  - A 55-kDa protein (p55) of the goat uterus mediates nuclear transport of the
      estrogen receptor. II. Details of the transport mechanism.
AB  - A 55-kDa protein (p55) that mediates the transport of the estrogen receptor (ER)
      from the cytoplasm to the nucleus has been purified to homogeneity from goat
      uterine cytosol. Using this pure protein, some of the aspects of the mechanisms
      associated with the transport of the ER to the nucleus have been elucidated. The
      mechanism of ER transport into the nucleus can be separated into two steps: the
      p55-mediated transport and binding of ER to the nuclear membrane, followed by an
      ATP-dependent, 14-kDa protein(s)-mediated translocation of ER into the nucleus.
      The p55 has inherent ATPase activity and it is proposed that the energy released
      during this ATP hydrolysis is utilized in the nuclear transport of the ER.

PMID- 7786041
TI  - A 55-kDa protein (p55) of the goat uterus mediates nuclear transport of the
      estrogen receptor. I. Purification and characterization.
AB  - A 55-kDa protein (p55), purified from the goat uterine cytosol, transports
      estrogen receptor (ER) into the nucleus. Selective elution of this protein from a
      column of estrogen receptor-Sepharose using buffers containing high
      concentrations of lysine and the high affinity with which it binds to poly-L
      lysine-Sepharose indicate that it recognizes a lysine-rich region in the ER. Its
      strong binding to tubulin-Sepharose and actin-Sepharose is indicative of a role
      that the cytoskeletal elements play in the nuclear transport of the ER, mediated
      by p55. This protein can be purified in a single step following chromatography of
      the uterine cytosol on a column of actin-Sepharose. Antibodies raised against
      poly-L-aspartic acid cross-reacted with p55 and inhibited the nuclear transport
      of the ER. The binding of p55 to a heterologous nuclear localization sequence of
      the SV40 large T suggests that it may also be involved in the transport of
      proteins other than the ER.

PMID- 7786043
TI  - Detection of short-lived free radicals by low-frequency electron paramagnetic
      resonance spin trapping in whole living animals.
AB  - We report the direct observation of sulfur trioxide anion free radical (SO3.-)
      from the body of live mice by using a low-frequency (1.2 GHz, L-band) EPR spin
      trapping method. Intraperitoneal injection of 5,5-dimethyl-1-pyrroline-N-oxide
      (DMPO) (15 mmol/kg) used as trapping agent was followed by sequential iv
      injections of sodium sulfate (2-5 mmol/kg) and sodium dichromate (0.3 mmol/kg).
      The mouse was placed in an L-band loop gap resonator. The observed spectra
      consisted of two superposed components: DMPO/SO3.- (alpha N = 14.0, alpha H =
      16.0) and Cr(V) (g = 1.9798). The time course for the generation and reduction of
      DMPO/SO3.- was followed. The signal intensity reached a maximum at about 7 min.
      In vitro experiments carried out at 9.15 GHz confirmed the production of SO3.-
      under the conditions used for in vivo studies; the hyperfine splittings of
      DMPO/SO3.- produced in the in vitro experiments were the same as those produced
      in the in vivo studies. The production of SO.-3 is supported by oxygen uptake
      studies, which show that the prior addition of 300 mM DMPO inhibits oxygen
      consumption by SO3.-.

PMID- 7786044
TI  - Glucokinase of Escherichia coli: induction in response to the stress of
      overexpressing foreign proteins.
AB  - A variety of stressful conditions, such as heat shock, ethanol, osmotic shock,
      glucose deprivation, and oxidative stress, are known to induce the synthesis of
      specific proteins. Here, we report the induction in Escherichia coli of a protein
      elicited in response to a hitherto unidentified stress condition, i.e., the
      overexpression of foreign proteins. The induced protein identified as glucokinase
      (EC 2.7.1.2) is produced at a level > or = 20-fold higher than the level in wild
      type E. coli when foreign proteins are expressed under the control of the
      alkaline phosphatase (phoA) promoter. The bacterial glucokinase is shown to have
      a mass of approximately 47 kDa determined by a "renaturation activity stain
      assay" in situ following sodium dodecyl sulfate-poly-acrylamide gel
      electrophoresis and exhibits a high specificity for the phosphorylation of
      glucose. The apparent Km values for glucose and ATP for the enzyme are 0.15 and
      0.50 mM, respectively, indicating that the E. coli enzyme is a low Km glucose
      hexokinase. The enzyme cross-reacts with rabbit antisera raised against
      hexokinase from higher eukaryotes, implicating some sequence similarity with
      mammalian hexokinases. Under normal conditions, E. coli glucokinase plays a minor
      role in glucose metabolism. However, under anabolic stress conditions, this
      glycolytic enzyme may be required to supplement levels of glucose 6-phosphate.
      Alternatively, glucokinase, which is predicted in analogy to other hexose
      utilizing kinases to have structural folds characteristic of hsp 70, may itself,
      or in combination with other E. coli proteins, function in the stabilization of
      newly synthesized proteins.

PMID- 7786045
TI  - Dental amalgam, low-dose exposure to mercury, and urinary proteins in young
      Swedish men.
AB  - Chronic exposure to inorganic mercury can cause kidney injury. Evidence gained
      from occupational medicine indicates that individuals who are exposed to only
      environmental sources, including amalgam tooth fillings, are at very little risk.
      Animal experiments, however, have revealed glomerular lesions of immunologic
      origin after low-dose exposure to inorganic mercury. In this study, the
      association between the number of amalgam tooth surfaces, urinary mercury, and
      proteinuria was explored in a sample of 48 randomly selected, apparently healthy
      male students who were 17-22 y of age. Presence of any of the following proteins
      in two separate urine samples was considered to be potentially indicative of any
      tubular and/or glomerular lesion: albumin, alpha-1-microglobulin (HC-protein),
      kappa and lambda light chains, and N-acetyl-beta-D-glucosaminidase. No
      significant relationship was found between any of the proteins and amalgam or
      urinary mercury. The results of this study did not suggest that amalgam fillings
      cause kidney dysfunction in humans.

PMID- 7786046
TI  - Symptom clusters in a community with chronic exposure to chemicals in two
      superfund sites.
AB  - Sikes and French, Ltd., two National Priority List sites that are proximal to one
      another, are located approximately 20 mi (32 km) east of Houston, Texas. Dumping
      at Sikes occurred during the early 1960s and continued until 1967. Benzene, 1,2
      dichloroethane, toluene, 1,1,2-trichloroethane, naphthalene, lead, fluorene, and
      pyrene are chemicals that pose a particular public health concern. French, Ltd.,
      commenced operations in 1966, and dumping ceased in 1973. Chemicals of potential
      public health impact at the French, Ltd., site are benzene, benzo(a)anthracene,
      benzo(a)pyrene, copper, chrysene, chromium, dichlorodiphenyltrichloroethane,
      heptachlor, lead, nickel, polychlorinated biphenyls, tetrachloroethylene,
      trichloroethylene, and zinc. During the 1980s, both sites were placed on the
      National Priority List. Barrett Station is a stable black community located near
      the two sites. The question of whether levels of exposure to dumpsite chemicals
      were related to health complaints in the Barrett Station population was examined.
      The prevalence of 29 symptoms reported by 321 individuals who had been highly
      exposed was compared with symptoms reported by a group of 351 persons from the
      same community who had limited exposure. A meaningful difference between the two
      groups emerged for some of the symptoms, the most notable of which symptoms were
      neurologic. Almost twice as many subjects in the high-exposure group reported
      five or more neurologic symptoms, compared with the low-exposure group. This
      excess of neurological symptoms is consistent with the known toxic properties of
      the chemicals at the sites.

PMID- 7786047
TI  - Respiratory conditions among schoolchildren and their relationship to
      environmental tobacco smoke and other combustion products.
AB  - The purpose of this study was to examine possible links between respiratory
      conditions among schoolchildren and exposure to environmental tobacco smoke and
      other home and community exposures. More than 8,000 second- and fifth-grade
      schoolchildren who lived in three towns along the Israeli coast were administered
      pulmonary function tests, and their parents completed standardized health
      questionnaires. The prevalence of the most reported respiratory conditions was
      found to be higher, some of them significantly so, among children whose fathers
      or mothers were smokers, compared with children of non-smoking parents. Most
      respiratory conditions were reported significantly more often for children who
      were growing up in medium- and highly polluted communities than for children from
      low-polluted areas. House heating with kerosene or gas was seldom associated with
      higher prevalence of respiratory conditions among children. No consistent r trend
      of reduced pulmonary function tests was associated with exposure to environmental
      tobacco smoke, with community pollution, or with house heating pollution. In
      conclusion, exposure of schoolchildren to their parents' cigarette smoke and to
      community air pollution is associated with higher prevalence of respiratory
      conditions, whereas house heating does not appear to be a public health problem
      in Israel.

PMID- 7786048
TI  - Chemical sensitivity attributed to pesticide exposure versus remodeling.
AB  - One hundred twelve individuals who reported onset of multiple chemical
      sensitivity following well-documented exposure to either (1) a cholinesterase
      inhibiting organophosphate or carbamate pesticide or (2) remodeling of a building
      completed mail-out/mail-back questionnaires concerning their exposure, symptoms,
      sensitivity to ingestants and inhalants, utilization of health-care resources,
      and impact of their illness on lifestyle. It was hypothesized that if multiple
      chemical sensitivity resulted from neurotoxic exposure, then organophosphate
      exposed respondents should report greater severity of illness resulting from the
      relatively greater neurotoxicity of this class of chemicals. Pesticide-exposed
      and remodeling-exposed multiple chemical sensitivity groups reported similar
      patterns of symptoms and identified similar inhalants and ingestants as triggers
      for their symptoms; these results suggested a common mechanism (biological and/or
      psychological) for their conditions. The pesticide-exposed group, however,
      reported significantly greater symptom severity than did the remodeling-exposed
      group, especially for neuromuscular, affective, airway, gastrointestinal, and
      cardiac symptoms. These findings provide evidence for (1) a possible biological
      basis for multiple chemical sensitivity and (2) a distinct pathophysiology or
      final common pathway for the condition that, while as yet undefined, appears to
      be shared by these two groups. Although subjective multisystem health complaints
      characterize both multiple chemical sensitivity and somatoform disorder, features
      of this multiple chemical sensitivity sample were inconsistent with somatoform
      disorder, i.e., onset after 30 y of age in 83%, the predominance of severe
      cognitive symptoms, and attributions of environmental causation. No group
      differences were found with respect to lifestyle impact. Eighty-one percent of
      respondents said they had been working full-time at the time they were exposed,
      yet at the time of the survey (on average, 7.7 y post exposure) only 12.5% were
      working full-time. The majority said they had quit their jobs, changed jobs, or
      changed careers because of their illness. Approximately 40% reported that they
      had consulted 10 or more medical practitioners. The persistent, disabling
      neuropsychological symptoms reported by these multiple chemical sensitivity
      groups are strikingly similar to those reported among individuals exposed
      occupationally to pesticides and solvents. These parallel findings suggest that
      the types and levels of exposures associated with extermination and remodeling
      may not be inconsequential, at least for a subset of the population. Further
      studies from a variety of perspectives, including human challenge studies and the
      development of animal models, are needed to define the pathophysiological and
      psychological mechanisms underlying this costly condition.

PMID- 7786049
TI  - Urinary cotinine in children and adults during and after semiexperimental
      exposure to environmental tobacco smoke.
AB  - Urinary cotinine (U-cotinine) as a biomarker of environmental tobacco smoke
      exposure was evaluated in 14 children (age 4-11 y) and in 7 adults who were
      exposed to environmental tobacco smoke at an air nicotine level of 110 mg/m3 for
      2 h in a bus. Nicotine in air and U-cotinine were measured by gas
      chromatography/mass spectrometry before, during, and after the experiment. U
      cotinine rose rapidly to a maximum after a median of 6 h following the end of
      exposure; remained at an apparent plateau for half a day; and then decreased
      exponentially, with a mean half-time of 19 h (95% confidence interval 18-20 h; no
      significant difference between children and adults). The maximum U-cotinine was
      higher in the children (mean = 22 mg/l) than in the adults (13 mg/l; p = .005);
      decreased with age among the children (r = -.74; p = .002); and increased as the
      estimated inhaled nicotine dose increased. Therefore, the findings of the present
      study showed that young children had higher U-cotinine than adults at the same
      experimental environmental tobacco smoke exposure, probably because they had a
      higher relative nicotine dose because of a higher relative ventilation rate, and
      possibly also because of metabolic differences; the elimination rate did not
      differ. The long half-time makes U-cotinine a good biomarker of environmental
      tobacco smoke exposure; the time of sampling is not very critical. Dilution
      adjusted concentrations should be employed, and in children, preferably by
      density correction. A certain urinary cotinine level indicates a lower
      environmental tobacco smoke exposure in a small child than in an adult.

PMID- 7786050
TI  - Estimated long-term ambient concentrations of PM10 and development of respiratory
      symptoms in a nonsmoking population.
AB  - Site- and season-specific regressions of particulates less than 10 mu in diameter
      (PM10) on total suspended particulates (TSPs) were formed throughout California
      during years when both were monitored. The regressions were then applied to
      monitored TSPs for the years 1973 to 1987, and indirect estimates of PM10 were
      formed. These estimates of PM10 were validated by interpolating them to other
      monitoring stations. The split-halves correlation between the estimated and
      monitored mean concentrations, obtained when both were first cumulated for a 2-y
      period, was .86. Indirect estimates of PM10 at monitoring stations were
      interpolated, by month, to zip code centroids of home and work location and were
      cumulated for a cohort of 3,914 California Seventh-day Adventist (SDA)
      nonsmokers. Multivariate analyses, adjusted for several covariates, showed
      statistically significant (p < .05), but small, positive associations between
      PM10 and development of (a) definite symptoms of overall airway obstructive
      disease, (b) chronic productive cough, and (c) increased severity of airway
      obstructive disease and asthma. The relative risk (RR) associated with 1,000 h/y
      (42 d) exposure to concentrations of PM10 that exceeded 100 micrograms/m3 for
      development of airway obstructive disease was 1.17 (95% confidence interval [CI]:
      1.02, 1.33); for development of productive cough, the RR was 1.21 (CI 1.02,
      1.44); and for development of asthma, the RR was 1.30 (CI, 0.97, 1.73). Stronger
      associations were observed for those who were exposed occupationally to dusts and
      fumes. The RR of developing airway obstructive disease as an adult for those who
      had airway obstructive disease as a child was 1.66 (CI 1.15, 2.33).

PMID- 7786052
TI  - Air pollution and mortality in elderly people: a time-series study in Sao Paulo,
      Brazil.
AB  - The relationship between daily mortality of elderly (65+ y) persons and air
      pollution in the metropolitan area of Sao Paulo, Brazil, for the period May 1990
      to April 1991 was evaluated by time series regression, controlling for season,
      weather, and other factors. Mortality was associated with respirable particles
      (PM10), nitrogen oxides (NOx), sulfur dioxide (SO2), and carbon monoxide (CO).
      The association with PM10 was most statistically significant, robust, and
      independent of other air pollutants. An increase in PM10 equal to 100
      micrograms/m3 was associated with an increase in overall mortality equal to
      approximately 13%. This association was consistent across various model
      specifications and estimation techniques. The dose-response relationship between
      mortality and respirable particulate pollution was almost linear, with no
      evidence of a "safe" threshold level. The results were similar to those observed
      in London and several U.S. cities. The results were also supportive of recent
      animal studies that have observed adverse health outcomes in experimental animals
      exposed to air pollution in Sao Paulo.

PMID- 7786051
TI  - Pulmonary function response to equivalent doses of ozone consequent to
      intermittent and continuous exercise.
AB  - The effects on pulmonary function of inhaling the same effective dose of ozone,
      as well as subjective responses during continuous exercise and intermittent
      exercise, were studied in 12 aerobically trained men. Each subject completed 1 h
      of continuous exercise at work rates that elicited a mean minute ventilation of
      60 l/min, and two additional 2-h intermittent exercise exposures eliciting a mean
      exercise minute ventilation of 45-47 l/min (i.e., total minute ventilation for
      each protocol was approximately 3,600 l). Subjects were exposed in randomized
      sequence to 0.30 ppm ozone on three occasions and to filtered air on three
      occasions. Forced expiratory volume in 1 s decrements of -17.6%, -17.0%, and 
      17.9%, respectively, for the 1-h continuous exercise exposure and the two 2-h
      intermittent exercise exposures to 0.30 ppm ozone were significantly different.
      Exposure to ozone caused significant differences between postexposure subjective
      symptom responses; that is, responses associated with continuous exercise were
      greater than those for either intermittent exercise protocol. However, the
      overall symptom severity responses during the last minute of exercise for the two
      intermittent exercise protocols (at 90 and 105 min, respectively) were not
      significantly different from the continuous exercise postexposure value. The
      findings indicate that when the ozone effective dose is equivalent at a given
      ozone concentration, there is no difference between pulmonary function responses
      to continuous exercise or intermittent exercise exposures of 2-h duration (or
      less), although subjective symptoms are reduced somewhat during the last rest
      period of intermittent exercise.

PMID- 7786054
TI  - Apparent increased risk of leukemia in their highest category of exposure to
      tetrachloroethylene (PCE) in drinking water.
AB  - The potential human carcinogenicity of PCE has been the subject of study for many
      years, yet the largest and most recent occupational studies have not reported any
      increased risk of leukemia in PCE-exposed groups, let alone a risk of the
      magnitude suggested by Aschengrau et al. The EPA's own Science Advisory Board
      concluded in 1991 that PCE is a chemical "for which there is no compelling
      evidence of human cancer risk, accompanied by animal data of carcinogenicity
      whose extrapolation to humans is ambiguous." Given this background, it is not
      plausible that a leukemia risk of the magnitude reported by Aschengrau et al.
      should exist but not have been found among highly exposed occupational groups.
      Aschengrau et al. could contribute to our understanding of this inconsistency by
      presenting the additional data analysis that I have suggested.

PMID- 7786053
TI  - Lead in inner-city soil and its possible contribution to children's blood lead.
AB  - This study was designed to assess distribution and sources of lead in inner-city
      soils in Washington, D.C. Duplicate soil samples were collected randomly from 239
      unpaved front yards of homes in Washington, D.C. Soil samples were collected 1 m
      from the houses. Lead concentration in soil was determined by flame atomic
      absorption spectrophotometry. Presence of lead detected in soil was correlated
      and traced to the anticipated source of origin. A significantly high
      concentration of lead was present in inner-city soils. Areas of the city in which
      the highest lead concentrations were found (Wards 1, 4, 5, 6, 7, 8) were
      determined to contain a large number of residents who had attained lower
      education levels than most residents in the remaining wards. It was concluded
      that lead concentration in inner-city soil plays a significant role in the
      incidence of lead poisoning in children in the District of Columbia and that
      paint is the main source of soil lead. Demographic characteristics of the
      residents appeared to enhance the distribution of lead poisoning.

PMID- 7786055
TI  - An integrated environmental asthma model.
AB  - Asthma is a significant public health problem in many communities. Symptoms of
      asthma occur as a direct or indirect result of many contributing factors,
      including influences from the natural and built environments, human behavior, and
      the adequacy of techniques used in its management. A model is presented to
      integrate many of these contributing factors, highlighting the characteristics of
      the atmosphere, i.e., climate, irritants, and allergens. The model stresses the
      need for investigators to heed the many contributing triggers and influences,
      including possible synergistic mechanisms, in this disease.

PMID- 7786056
TI  - Community risk perception and waste management: a comparison of three
      communities.
AB  - Three cross-sectional surveys were conducted in different regions of British
      Columbia, using a model of risk perception that divides the community into
      attitudinal and behavioral subgroups based on awareness and concern about waste
      management facilities. The three communities differed with respect to their
      levels of both awareness and concern about facilities, either planned for or
      situated in their region. Surprisingly, the most polarized community, which had
      nevertheless accepted a facility, rated this facility as more desirable than the
      other two communities. The unconcerned group in this community felt well
      informed, was more trusting of siting and operating agencies, and believed that
      the facility would generate benefits. The concerned group in this community also
      felt better informed, was more trusting of siting and operating agencies, and
      believed that its facility would generate benefits, compared with concerned
      groups in the other two communities. Longitudinal studies of the attitudes
      driving the siting process are needed to understand how these relationships
      evolve over time.

PMID- 7786058
TI  - Nephrology clinical outcomes. Part 1: Mortality, morbidity, adequacy of
      treatment, and quality of life.
AB  - In this presentation, Ms. Burrows-Hudson introduces objective outcome
      measurements for the End Stage Renal Disease (ESRD) population. Mortality,
      morbidity, adequacy of treatment, and quality of life are all cited as viable
      indicators of quality in nephrology patient care. Nephrology nurses play key
      roles in improving patient outcomes through ongoing interventions.

PMID- 7786057
TI  - The nephrology nursing practice environment: responding to changes.
AB  - In this session, Ms. Smith and Ms. Sims outlined the practice milieu for today's
      nephrology nurse. The speakers portrayed the end stage renal disease (ESRD)
      environment by defining the providers of care, outlining the changing
      characteristics of the recipients of care, and describing the effects of health
      care reform.

PMID- 7786059
TI  - Nephrology clinical outcomes. Part 2: Transplant, hemodialysis, and peritoneal
      dialysis.
AB  - Part II of the clinical outcome session dealt with treatment-specific issues as
      they relate to outcome. Ms. McNatt and Ms. Kleindienst described cardiovascular
      disease as it influences mortality and morbidity in organ transplant recipients.
      Ms. Hawkins outlined the impact of vascular access on patients undergoing
      hemodialysis treatment while Ms. Currier delineated the problem of infection in
      peritoneal dialysis treatment.

PMID- 7786060
TI  - Nurse's role in achieving patient outcomes.
AB  - Nephrology nursing's influence on patient outcomes has as many facets as there
      are practice roles in nephrology nursing. These speakers discussed the impact on
      patient outcomes from a variety of practice perspectives. The roles of
      administrator, educator, staff nurse, government nurse, research nurse, and
      corporate nurse are each described.

PMID- 7786062
TI  - A nurse entrepreneur making a difference: an interview with Patricia J. Clark..
      Interview by Sally D. McCulloch, Susan T. Perras.
AB  - Nursing leaders have long advocated that nurses should take risks and begin
      operating their own enterprises in which patient care services are delivered. One
      such effort in the U.S. is being undertaken by ANNA member Patricia J. Clark,
      BSN, RN, CNN, a past president of the Keystone Chapter who is president and CEO
      of Nephrology Nursing Service, Inc. (NNSI) in Philadelphia. NNSI, which opened in
      the Fall of 1994, provides any nursing service related to the care of renal
      patients, including consultation to other professionals, hospitals, and dialysis
      facilities. In this interview, Clark details the challenges of forming a nurse
      operated nephrology service, her relationships and dealings with other patient
      care providers, and her company's long-term prospects.

PMID- 7786061
TI  - Consensus development conference draft documents: your opinions are important.

PMID- 7786063
TI  - Efforts in vein: control as a factor in one-site-itis.

PMID- 7786064
TI  - Chylous ascites: an unexpected complication that resembles peritonitis.

PMID- 7786065
TI  - Continuous renal replacement therapy in chronic hemodialysis patients.

PMID- 7786066
TI  - Fluvastatin: pharmakokinetic properties.

PMID- 7786068
TI  - Impact of nursing care on morbidity and mortality in ESRD patients.

PMID- 7786067
TI  - Case study of the anemic patient: epoetin alfa--focus on iron management.
AB  - Optimal maintenance of iron status is the keystone to sustaining normal
      erythrocyte production and function. Despite ongoing educational efforts for
      health care professionals and patients, iron management remains a challenge for
      clinicians managing patients who receive Epoetin alfa therapy. This article
      illustrates how to use a protocol to improve iron management in these patients;
      two case studies provide examples of the clinical application of the protocol.

PMID- 7786070
TI  - President's message: consensus conference helps nephrology nurses to document
      outcomes.

PMID- 7786069
TI  - Working toward consensus.

PMID- 7786071
TI  - Building consensus for nephrology nursing practice.
AB  - Building consensus for nephrology nursing practice was the theme for the American
      Nephrology Nurses' Association's (ANNA's) 1994 Clinical Concerns Meetings in
      Chicago and LaJolla, California respectively. This article emphasizes the
      importance of consensus building, traditional approaches to consensus
      conferences, and the inherent risks in conducting such a conference.
      Additionally, the consensus conference design and steps leading to a final
      working document are presented by members of the Clinical Concerns Planning
      Committee.

PMID- 7786072
TI  - Consensus for practice in the 21st century: setting a framework.
AB  - The American Nephrology Nurses' Association (ANNA) broke ground in specialty
      nursing last Fall by holding two Consensus Development Conferences in La Jolla,
      CA, and Chicago. In this opening presentation to conference attendees,
      Facilitator Anne Keane, EdD, MSN, RN, laid the groundwork to reach consensus for
      practice in the 21st century. Topics explored included how health care reform
      will influence nephrology nursing in the 21st century and what consumers and
      practitioners will expect and demand.

PMID- 7786073
TI  - 1994-1995 president's report: state of the association.

PMID- 7786074
TI  - 1994-1995 national directory of certified nephrology nurses.

PMID- 7786075
TI  - ANNA position statements.

PMID- 7786076
TI  - Creating an environment for positive patient outcomes: an interview with Beverly
      Malone. Interview by Karen E. Schardin.
AB  - With health care reform initiatives sweeping America, nurses must now more than
      ever strive to create environments to enhance positive patient outcomes. In this
      interview, Beverly Malone, PhD, RN, FAAN, dean of the School of Nursing at North
      Carolina A & T State University in Greensboro, NC, describes nurses' roles in
      today's managed care climate. Dr. Malone, who will deliver the keynote address at
      ANNA's 26th National Symposium on June 10 in Philadelphia, discusses future
      recruitment of students, minority issues, transforming the nursing work force,
      validating nursing's worth, and the future of nursing.

PMID- 7786077
TI  - Facilitating a "good death" in patients with end stage renal disease.
AB  - End stage renal disease (ESRD) patients can achieve a "good death" when planning
      is combined with an ethic of care. Advance directives can help to ensure that
      patients who want to participate in their treatment decisions may do so. An ethic
      of care ensures that the actual process of dying incorporates important factors
      such as readiness to die, appropriate interpretation of advance directives in
      terminal clinical situations, and proper timing of death. Nephrology nurses can
      play key roles in ensuring that patients die comfortably.

PMID- 7786078
TI  - Social support and health-related quality of life in black and white dialysis
      patients.
AB  - OBJECTIVES: To identify factors associated with health-related quality of life
      (HRQoL) in end stage renal disease (ESRD) patients treated with dialysis, and to
      identify potential racial differences in HRQoL. DESIGN: Cross-sectional study.
      SAMPLE/SETTINGS: 256 dialysis patients; 72 black women, 59 black men, 61 white
      women, and 64 white men at Piedmont Dialysis Center, a university-affiliated
      dialysis center in northwest North Carolina. METHODS: Information was obtained on
      perceived social support, social networks, blood chemistries, blood pressure,
      cause of renal failure, treatment-related factors, and socioeconomic factors.
      HRQoL indicators included two measures of life satisfaction, limitations in
      leisure-time activities, and Karnofsky's Physical Functioning Scale. RESULTS: On
      all HRQoL indicators, blacks consistently rated their HRQoL better than whites.
      In univariate analyses, lack of social support was consistently related to poorer
      HRQoL. In multivariate regression analyses, good social support and black race
      were the two strongest predictors of more positive responses to each of the HRQoL
      indicators, after controlling for the effects of the other investigated factors.
      With respect to the Karnofsky scale, younger age and fewer medications taken were
      additional significant predictors of better functioning. CONCLUSIONS: HRQoL was
      consistently rated better among blacks than among whites. In addition, perceived
      social support exerted a strong, independent influence on objectively and
      subjectively measured HRQoL of ESRD patients.

PMID- 7786079
TI  - Significance of increasing organ donations by African Americans and implications
      for nursing practice.
AB  - The scarcity of organs donated by African Americans has an important impact on
      the number of organs available for transplantation. An increase in the total time
      African Americans spend on dialysis combined with difficulty in matching human
      leukocyte antigens make increased organ donation by African Americans essential.
      Barriers to organ donation are identified and the implications for nursing
      practice are discussed.

PMID- 7786080
TI  - Peritoneal dialysis technician: a process for role definition.
AB  - Declining reimbursement and rising supply costs have led to use of technicians in
      peritoneal dialysis. This evolution has helped contain costs effectively while
      enhancing quality care. Recommendations for use of unlicensed assistive personnel
      by professional organizations include clear role definition, documented training,
      and delegation criteria. Applications of technician use in peritoneal dialysis
      allow nurses to delegate tasks to technicians in harmony with legal and
      professional standards.

PMID- 7786081
TI  - Use of sodium citrate anticoagulation in a pediatric continuous venovenous
      hemodialysis patient.
AB  - CVVHD therapy in critically ill pediatric patients presents many challenges. The
      ability to maintain hemodynamic stability in the face of multiple fluid and
      medication requirements made this therapy a successful treatment option. The
      difficulties often associated with heparin anticoagulation were avoided through
      the use of citrate, and this was achieved without any bleeding complications.
      Using a collaborative approach of critical care nurses from one facility and
      nephrology nurses from another was a unique experience. The patient benefited
      from the professionals' expert care. All nurses collaborated in meeting jointly
      set patient goals.

PMID- 7786082
TI  - Precautions for sports-minded patients on peritoneal dialysis.

PMID- 7786084
TI  - Advance practice nurses in nephrology: a response to the RPA.

PMID- 7786083
TI  - Case study of the anemic patient: epoetin alfa--focus on improving ventricular
      function.
AB  - Multiple factors, including chronic anemia, can impair left ventricular function
      and lead to serious or fatal consequences. Correcting anemia with Epoetin alfa is
      an important step in improving compromised left ventricular function. Continuous
      management of fluid status, blood pressure, and hematocrit is the best way for
      nephrology nurses to help patients improve their cardiac function and quality of
      life.

PMID- 7786085
TI  - Practice guidelines in cardiothoracic surgery. Ad Hoc Committee for
      Cardiothoracic Surgical Practice Guidelines.

PMID- 7786086
TI  - Inhibin functions in male rats.
AB  - The role of inhibin in modulating FSH secretion at sexual maturation in male rats
      was studied using antibodies against inhibin alpha subunit. An
      immunohistochemical study was performed by immunogold-silver staining; modulation
      of FSH secretion in sexual maturation was studied by immunoneutralization. The
      results show that immunoreactive inhibin alpha subunit is localized in the
      Sertoli cell, especially at young ages. There were no significant differences in
      testes weights and histology between the antibody-administered group and the
      control group. Marked FSH increase was observed in the antibody-administered
      group from 5 to 30 days. No significant difference was detected in the over 50
      days group. It would appear that inhibin plays a role in suppressing FSH
      secretion in infantile male rats, especially before puberty. However, inhibin's
      role might not be particularly important, as shown by the lack of significant
      changes in the gonads of antibody-administered group.

PMID- 7786087
TI  - Correlation between sperm morphology using strict criteria in original semen and
      swim-up inseminate and human in vitro fertilization.
AB  - To study the value of sperm morphology using strict criteria in raw semen and in
      swim-up inseminate of human in vitro fertilization (IVF), 135 cycles of IVF with
      normal sperm concentration and motility were recruited. At least two mature
      oocytes were recovered in each cycle. The correlation between the percentages of
      normal forms and fertilization rates of mature oocytes was analyzed. The results
      demonstrate that the percentage of normal forms in both the raw semen and swim-up
      sample of patients with poor fertilization was significantly lower than in those
      with acceptable fertilization. The percentages of normal forms both in raw semen
      and in swim-up sample were significantly correlated with fertilization rates in
      vitro, however, the former seemed to have a better correlation (r = .51 and .19,
      respectively). Regarding the percentages of normal forms in raw semen, the
      fertilization rate in patients with normal forms < 4% was 6 +/- 11%, for 4-14% it
      was 58 +/- 36%, and for > 14% it was 88 +/- 20%. The fertilization rates were
      significantly different among these three groups of patients. The evaluation of
      sperm morphology using strict criteria in raw semen before IVF is predictive of
      fertilization outcome and may also help doctors to choose an optimal method of
      treatment for patients.

PMID- 7786088
TI  - Quantitative electrophoretic study of the modification of sperm plasma membrane
      by the ampullary gland in the golden hamster.
AB  - Plasma membrane proteins were extracted either from epididymal sperm after
      incubation with ampullary gland secretion or from uterine sperm derived from
      surgically treated males belonging to the following groups: TX, excision of all
      accessory sex glands (ASG); AGX, bilateral excision of ampullary glands; AG,
      excision of all ASG except ampullary glands; and SH, sham-operated. Total
      membrane protein, glycoprotein, and SDS-PAGE of individual polypeptide subunits
      were quantified. After incubation with ampullary gland secretion, both protein
      and glycoprotein concentrations of epididymal sperm membrane were increased. The
      protein profile was also significantly altered, with the removal of the 43- and
      71-kD subunits and the addition of the 36- and 50-kD subunits. The in vitro
      results confirmed this proteolytic effect of ampullary gland and other ASG on the
      43- and 71-kD subunits, despite a reduction in membrane protein concentration.
      Modification of the 17-, 20-, 25-, 28-, 56-, and 66-kD proteins were also
      observed. This report is the first demonstration that the ampullary gland is
      capable of modifying proteins on the sperm surface.

PMID- 7786089
TI  - Stimulation of ejaculated domestic cat sperm motility with caffeine,
      pentoxifylline, and 2'-deoxyadenosine.
AB  - Sperm motility patterns of cryopreserved domestic cat ejaculates treated at 37
      degrees C with 1 mM caffeine, pentoxifylline, or 2'-deoxyadenosine were analyzed
      using computer-assisted semen analysis (CASA). The percent motility (MOT),
      curvilinear velocity (VLC), straight-line velocity (VSL), linearity (LIN), and
      amplitude of lateral head displacement (ALH) were measured for each group
      following 15 min of treatment. Motility indices were examined during a 6-h
      treatment period to determine the effect of each chemical on sperm longevity.
      Caffeine, pentoxifylline, and 2'-deoxyadenosine each increased (p > .05) the MOT
      and VCL of the ejaculates compared to the controls. The longevity of the treated
      and control samples were not significantly different throughout the incubation
      period. These results, similar to previous findings with cryopreserved epididymal
      cat sperm, demonstrate that motility stimulants can significantly elevate the MOT
      and VCL of cryopreserved ejaculated cat sperm without having deleterious effects
      on longevity.

PMID- 7786090
TI  - Effects of time and sperm concentration on reactive oxygen species formation in
      human semen.
AB  - Although generally accepted standards exist for routine semen analysis, recent
      methods of assessing reactive oxygen species (ROS) in human semen lack a
      standardized protocol. The purpose of this study was to investigate (1) the
      relationship between ROS level and the time interval between semen collection and
      analysis, and (2) the effect of sperm concentration on the level of ROS
      formation. Semen specimens from men (n = 40) consulting for infertility treatment
      were divided in two groups: in 20, routine semen analysis was performed and ROS
      formation evaluated at 1, 3, 5, and 24 h after semen collection; in the other 20,
      ROS formation was evaluated at four sperm concentrations (60, 30, 15, and 7.5 x
      10(6)/mL). White blood cell (WBC) concentration was assessed before ROS
      measurement using a myeloperoxidase staining technique (Endtz test). ROS level
      was measured by a chemiluminescence method. ROS formation decreased significantly
      over time. The mean ROS level 343.4 (1 h), 133.5 x 10(4) cpm (3 h, p = .004),
      66.0 x 10(4) cpm (5 h, p < or = .001), and 22.2 x 10(4) cpm (24 h, p < or =
      .001), respectively. In the first group of 20 specimens, 14 were positive for ROS
      formation at 1 h after collection, and 4 of these were positive for the Endtz
      test (> 1 x 10(6) WBC/mL). The number of ROS-positive specimens after 3, 5, and
      24 h was eight, six, and two, respectively. In the second group, eight patients
      were positive for ROS formation at 1 h after collection.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7786091
TI  - Effects of nicotine on sperm attachment and penetration of zona-free hamster
      eggs.
AB  - A previous study from this laboratory showed that nicotine in vitro has
      deleterious effects on sperm motion characteristics. This study was conducted to
      evaluate the effects of nicotine on the ability of human spermatozoa to attach
      and penetrate zona-free hamster eggs. Spermatozoa from fertile donors, washed
      free of seminal plasma, were incubated with medium (control) and 0.1, 1, 5, and
      10 mM concentrations of nicotine (concentrations estimated to approximate
      residual concentrations of nicotine in the testes of heavy smokers) for 18 h at
      37 degrees C in a humid 5% carbon dioxide incubator. The sperm preparations were
      then mixed with enzymatically denuded hamster eggs and incubated for 3 h at 37
      degrees C. The oocytes were examined by phase-contrast microscopy to enumerate
      the rates of sperm attachment and penetration. The data were analyzed by a paired
      t test and repeated measures analysis of variance using the arcsine
      transformation of the percentages. The percentages of eggs with attached
      spermatozoa significantly declined in a dose-dependent manner, the highest
      inhibition being at 10 mM (F = 24). The rate of sperm penetration was even more
      significantly decreased with the increase in nicotine concentrations in the
      following order: 10 mM (F = 56) > 5 mM (F = 30) > 1 mM (F = 44) > 0.1 mM (F =
      12). Nicotine concentrations of 0.1 mM and above negatively affected sperm
      penetration of zona-free hamster eggs.

PMID- 7786092
TI  - Pudendal artery syndrome with erectile dysfunction: treatment by pudendal canal
      decompression.
AB  - Pudendal artery syndrome (PAS) was studied in 10 patients with erectile
      dysfunction (ED). Ages ranged from 38 to 55 years. All had chronic constipation
      and straining at stool, absent nocturnal penile tumescence, low penobrachial
      pressure index (p < .01), low peak flow velocity (p < .001), and a diameter
      increase (p < .0001) upon duplex ultrasonography screening. Four of the 10
      patients had perineal hypoesthesia, prolonged bulbocavernosus reflex (p < .05),
      and pudendal nerve terminal motor latency (p < .05), and weak anal reflex and EMG
      activity of the external anal sphincter. The levator EMG activity was reduced in
      all patients. Intracavernous papaverine injection induced partial erection after
      a period longer than normal. Selective pudendal arteriography showed narrowing or
      obstruction of the distal part of the internal pudendal artery (IPA) on both
      sides with poorly or non-visualized penile arteries. A generalized arterial
      disease was excluded and pudendal artery compression in the pudendal canal (PC)
      was suspected as causing ED. The narrow or obstructed part of the IPA corresponds
      to the part in the PC. Four of the 10 patients had manifestations of pudendal
      neuropathy in addition to IPA compression. Pudendal canal decompression (PCD) was
      performed through a perineal approach. ED improved in 8 of the 10 patients 3-6
      months postoperatively. Two of the 4 patients who had pudendal arteriopathy
      combined with neuropathy did not improve. In conclusion, the 10 patients with ED
      had common clinical and investigative findings that constitute the pudendal
      artery syndrome. PCD effected improvement in 80% of the cases.

PMID- 7786094
TI  - [Bone mineralization in Chilean children determined by dual photon bone
      densitometry].
AB  - In 198 school age children, aged 6 to 13 years, the bone mineral density (BMD)
      and total bone mass (TBM) was measured in total body, lumbar spine and hip, using
      a double beam photon densitometer with a Gd 153 source. An increase with age of
      BMD and TBM was found in all the analyzed areas. At 12 years of age, TBM and BMD
      of total body were higher in girls than in boys. BMD of lumbar spine was
      significantly higher in girls than in boys at ages between 11 to 13 years. BMD of
      lumbar spine and femoral neck of 9 years old females were 36% and 18%
      respectively, lower than values of young adult Chilean females. The importance of
      normal values of bone mineralization for the diagnosis of bone diseases and for
      the evaluation of programmes directed to solve this problems is emphasized.

PMID- 7786093
TI  - Oxidation of polyamines in human seminal plasma: a possible role in immunological
      infertility.
AB  - Sixty-two specimens of seminal plasma obtained from normozoospermic,
      oligozoospermic, azoospermic, and immunologically infertile males were
      investigated. The levels of spermine, basal aldehyde, and aldehyde oxidation
      products were measured, as was the immunosuppressive activity of seminal plasma.
      No immunosuppressive activity was found in the immunologically infertile group;
      all other groups showed immunosuppressive activity. The immunologically infertile
      males showed low aldehyde oxidation products.

PMID- 7786095
TI  - [Relationship between plasmatic lipids and fat soluble vitamins in Guatemalan
      periurban elderly].
AB  - The levels of plasmatic lipids and fat liposoluble vitamins were measured in 107
      elderlies (29% males, 71% females) who were residents of a poor periurban
      neighborhood of Guatemala City. The age ranged between 60-103 years (means +/- sd
      69 +/- 8). The mean and sd for the plasmatic levels of lipids and vitamins were
      (ranges in parenthesis): cholesterol 220 +/- 42 mg/dl (128 to 428);
      triglycerides: 189 +/- 92 mg/dl (54 to 513); retinol 50 +/- 16 ug/dl (4.5 to
      103); beta-carotene 17 +/- 12 ug/dl (12 to 60), tocopherol 1.32 +/- 0.36 mg/dl
      (0.54 to 2.46). A significant correlation was found in both sexes between
      cholesterol and retinol (r = 0.3, p < 0.05) and cholesterol and tocopherol (r =
      0.4, p < 0.05), triglycerides and retinol (r = 0.3, p < 0.05). Cholesterol and
      beta-carotene was also significant in women (r = 0.5, p < 0.05). The correlation
      between triglycerides and beta-carotene by gender was not significant.

PMID- 7786096
TI  - Accurate assessment of the quantitative significance of different sources of salt
      in the diet.
AB  - A metabolic study was conducted to assess the validity of using lithium tagged
      salt as a technique for monitoring the sources of salt in the diet. Discretionary
      sources, table and cooking salt, were separately labelled and studied, the table
      salt being available ad libitum whereas cooking salt intakes were controlled. The
      study showed that lithium excretion in the urine did provide an accurate measure
      of the amount of the labelled salt ingested. Subsequent analysis suggest that Li
      is not excreted readily in sweat or faeces so it can be used on its own to ensure
      the completeness of a series of 24h urines. Latin American studies on salt
      sources in the diet are needed as a base for programmes of primary prevention of
      hypertension.

PMID- 7786097
TI  - [Chemical and nutrition evaluation of whole sorghum flour (Sorghum bicolor, L.
      Moench), complementation with bean and milk whey, application in baking].
AB  - The chemical characteristics nutritive value and technological properties of the
      whole sorghum flour for consumption were studied. The chemical analyses indicated
      11.5% of protein, 2.7% of fat, 1.3% of fiber and 72% of carbohydrate. Major
      mineral in the flour were sulphur 0.25%, phosphorus 0.21%, potassium 0.15%,
      magnesium 0.07% and calcium 0.03%. The amino acid analyses showed lysine as the
      first limiting amino acid (score 31.3%) and as the second treonine (score 61.5%).
      The essential fatty acid contents in the oil were linolenic acid 36.2%, linolenic
      acid 1.4% and trace of arachidonic acid. The tanin content was 0.04%. PER and CEA
      were increased when the whole sorghum flour was supplemented with exception of
      digestibility. It was concluded that whole sorghum flour is a good source of
      calories in the diet (359 Cal/100g) and the protein responded positively to
      complementing with Phaseoulus vulgaris flour, dried milk whey and synthetic
      lysine. The bread baked with 0, 5, 10 and 15% of composite flour (wheat-sorghum)
      showed good volume, good external and internal characteristics and a high
      percentage of acceptability, by a panel of degustation testers.

PMID- 7786098
TI  - [Occurrence of Listeria monocytogenes in raw milk, pasteurized type C milk and
      minas frescal cheese commercialized in Piracicaba-Sao Paulo].
AB  - Samples of raw milk, pasteurized C type milk and minas frescal cheese were
      analyzed for the presence of Listeria monocytogenes by a method developed for
      dairy products by Lovett (1) and by Lovett & Hitchins (2). A total of 20 samples
      of each product and from different commercial brands were analyzed, obtained from
      various retail stores in Piracicaba, SP. According to the pattern of sampling and
      methodology adopted, none of the samples of the aforesaid products was positive
      for the presence of L. monocytogenes or another species of the genus. It was
      possible to observe differences in the degree of selectivity of the selective
      media utilized, notwithstanding the LPM agar showing to be superior to MMA. Based
      on the literature and on the result obtained, becomes evident the need of a more
      suitable method for the detection and isolation of L. monocytogenes from foods,
      even when the patogen appears in low numbers, with purpose to obtain rapid,
      reliable and reproducible results.

PMID- 7786099
TI  - [Sanitary quality of some food distributed by hospital food services of Costa
      Rica].
AB  - The sanitary quality of 100 samples of salad and 100 samples of skinless fruits
      distributed by the Hospital Food Services were studied. Samples were processed
      according to rinse solution method, and the bacteriological determination was
      based in the methodology described by Vanderzant & Splittstoesser. The
      preparation scheme of each product was realized in order to analyze risks and
      determine the critical control points according to ICMSF (International
      Commission on Microbiological Specifications for Foods). Microbiological studies
      on the critical control points (total and fecal coliforms determinations) were
      done according to the surface analysis using the swab contact method as described
      by Vanderzant & Splittstoesser. Our results show that 93% of the salads and 65%
      of the fruits presented contamination of fecal origin. The hands of the operators
      and kitchen utensils also presented important fecal contamination indexes.

PMID- 7786100
TI  - [Nutrient content in raw and processed foods derived from cereals and legumes. I:
      Centesimal composition and energetic value].
AB  - Proximate composition and metabolizable energy of raw and processed foods derived
      from cereals and legumes, were determined. Results can be used to revise the out
      of day national composition table, to incorporate data of ash, new data of
      dietary fiber obtained by an enzimatic hydrolysis method, asimilable
      carbohydrates and metabolizable energy. They also replace the composition of
      various foods which were compiled from foreing tables. Difference observed on
      values of lipids in those foods with low lipid content, are imputed to the
      solvents used in the extraction.

PMID- 7786102
TI  - [Nutrition of children under 6 years old in Latin America. Basis for the
      development of food guidelines].

PMID- 7786101
TI  - Physico-chemical characteristics of the Barinas nut (Caryodendron orinocense
      Karst. Euphorbiaceae) crude oil.
AB  - A proximate analysis of the seed of the C. orinocense K. (Euphorbiaceae) has
      demonstrated that these are a good source of edible oil. The crude oil was
      analyzed to determine its physical and chemical characteristics and the lipid
      composition, using the AOAC methods and gas liquid chromatography. The results
      showed that the oil meets Venezuelan standards for edible vegetable oils, with
      the exception of moisture content and the acid index. It is rich in
      polyunsaturated fatty acids (75.13% lineoleic acid), having a polyunsaturated to
      saturated fatty acid ratio of 6.50, and therefore could be used for human
      consumption.

PMID- 7786103
TI  - [Genetics of hypertrophic cardiomyopathies; towards molecular cardiology?].

PMID- 7786104
TI  - [Demonstration of a fifth locus implicated in familial hypertrophic
      cardiomyopathies].
AB  - Hypertrophic cardiomyopathy is familial in about 50% of cases and is transmitted
      in the autosomal dominant mode. The first morbid gene implicated in the disease
      was the gene coding the beta myosin heavy chain (beta MHC) on chromosome 14.
      However, only 30% of families have this genetic abnormality. Recently, three new
      loci have been identified on chromosomes 1q3, 11p13-q13 and 15q2. In order to
      determine whether other genes could be implicated in the disease a linkage
      analysis study was performed in a West Indian family. The method is based on the
      analysis of the distribution of the disease in the family and the microsatellite
      markers. The microsatellites used were those which recognised the 4 loci
      previously mentioned and 4 new markers situated and arranged with respect to
      known microsatellites. The results show that in the family studied, the disease
      did not concord with the markers of the beta MHC gene or with those recognising
      the loci on chromosomes 1q3, 11p13-q13 and 15q2. There is, therefore, a fifth
      gene implicated in familial HCM. The heterogeneity of the disease seems even
      greater than originally thought.

PMID- 7786105
TI  - [Elastic recoil after transluminal coronary angioplasty; implications of clinical
      and angiographic data].
AB  - Secondary elastic recoil after transluminal coronary angioplasty is a constant
      and immediate phenomenon after successful coronary angioplasty. It was studied by
      quantitative coronary angiography in 75 consecutive patients undergoing
      transluminal coronary angioplasty. This procedure was performed on lesions
      presumed to be responsible for the clinical presentation. The population was
      divided into 3 groups: stable angina (25 patients), unstable angina (25 patients)
      and recent post-infarction ischaemic syndromes (25 patients). There were 57 men
      and 18 women (mean age 59 +/- 11 years) with 31 left anterior descending (LA), 29
      right coronary (RC) and 15 left circumflex (Cx) dilatations. The lesions dilated
      were eccentric in 29 cases and calcified in 37 cases whereas only one thrombus
      was detected at coronary angiography. The elastic recoil appreciated 10 mn after
      the last balloon inflation was 0.97 +/- 0.28 mm for the whole population. There
      was no significant difference between the 3 groups studies (respectively 0.94 +/-
      0.24 mm; 0.96 +/- 0.26 mm; 0.99 +/- 0.33 mm). This appeared to be greater than
      the RC (1.06 +/- 0.30 mm) with respect to the Cx (0.86 +/- 0.23: p < 0.02) or LAD
      (0.92 +/- 0.25 mm: p < 0.04). Overall, a balloon to vessel diameter ratio > 1 and
      a lesion length > 10 mm were parameters predicting greater secondary elastic
      recoil (p < 0.07 and p < 0.001 respectively), whereas the degree of eccentricity
      only played a role in the post-infarction ischaemic syndromes and calcification
      only in unstable angina (p < 0.01 and p < 0.001 respectively).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7786106
TI  - [Cardiac surgery in aged patients; immediate and medium-term results in 100
      patients over 75 years of age].
AB  - With improved operative technique and postoperative care, progressively older
      patients are being referred for cardiac surgery. One hundred out of 633 patients
      operated between September 1990 and December 1992, were over 75 years of age
      (Group I). These patients were compared with the last 100 patients under 75 years
      of age (Group II). Both groups were operated by the same surgical team with the
      same anaesthetic, cardiopulmonary bypass and myocardial protection techniques.
      The average age of the groups was 79.5 +/- 3.1 and 62.1 +/- 9.2 years,
      respectively. The procedures performed were: myocardial revascularisation (Group
      I, 28 cases; Group II, 59 cases), aortic valve surgery alone or associated with
      coronary bypass (56 and 22 cases respectively), and mitral valve surgery alone or
      associated with another procedure (11 and 12 cases). There were no significant
      differences between the two groups with respect to true low output state, the
      duration of mechanical ventilation and of intensive care and hospital stay. On
      the other hand, there were significant differences in: the number of blood
      transfusions (44 cases versus 20, p < 0.001), the occurrence of atrial
      fibrillation (52 cases versus 29, p < 0.001) and neuropsychiatric disturbances
      (27 cases versus 5, p < 0.0001). There were no cases of mediastinitis in either
      group. The hospital mortality was 6% in Group I and 5% in Group II (NS). The
      medium-term mortality after an interval of 5 to 32 months in the over 75 age
      group was 7 cases, including 4 cases of cerebrovascular accident. An enquiry was
      performed in the 87 survivors of Group I.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786107
TI  - [Incidence and prognosis of early primary cardiogenic shock in myocardial
      infarction].
AB  - The aim of this retrospective study was to analyse the results of coronary
      reperfusion on the incidence and short and medium term prognosis of early primary
      cardiogenic shock in acute myocardial infarction. Of 339 consecutive patients
      admitted within 6 hours of the onset of acute myocardial infarction, 25 (7.4%)
      had cardiogenic shock from the onset. The majority of patients (18) underwent
      direct angioplasty with a successful result in 16 cases. Intravenous thrombolysis
      was instituted in 5 cases followed by emergency coronary angiography leading to
      "rescue" coronary angioplasty in 3 cases, which was successful in 2 cases. Two
      patients had no coronary revascularisation because of a double contra-indication
      to thrombolysis and catheterization by the femoral approach. Intra-aortic balloon
      pumping was used in 17 cases. Complementary emergency surgical revascularization
      was necessary in 5 patients (20%). In all, early reperfusion of the infarct
      related artery was obtained in 80% of cases (20 patients). The hospital mortality
      was 72% (18 patients) due to refractory cardiac failure in nearly all cases.
      After an average follow-up of 17 months, 3 of the 7 survivors of the hospital
      period have died and of the 4 remaining patients, 2 are in the NYHA classes III
      or IV. Recent therapeutic advances have not influenced the incidence of
      cardiogenic shock but have significantly increased the proportion of very early
      cardiogenic shock, whereas the late cardiogenic shocks of more progressive onset,
      have nearly disappeared (4/339, 1.2% in this series). The prognosis of these
      early shocks, caused by severe myocardial damage, remains catastrophic and hardly
      improved by emergency coronary reperfusion by angioplasty and intraaortic balloon
      pumping.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786108
TI  - [Effects of repeated and prolonged inflations on immediate angiographic results
      and complications of coronary angioplasty. Prospective and randomized study].
AB  - The effects of the duration of balloon inflation on the immediate and mid-term
      results of angioplasty were assessed in a randomized study initiated in June
      1992. To date, 239 lesions in 224 consecutive patients were allocated randomly
      into 2 groups according to the duration of balloon inflation: short duration (123
      lesions): 3 or 4 successive inflations, each < or = 1 mn, for a total duration <
      or = 3 min; long duration (116 lesions): 3 to 5 inflations, each of 4 to 5
      minutes each for a total duration > or = 12 min. Patients with acute myocardial
      infarction, restenosis and lesions of bypass grafts were excluded. Stenosis (% of
      reduction of the internal diameter) was calculated with a digitalised Philips DCI
      system. Success was defined by < 50% residual stenosis in the absence of severe
      complications: death, emergency bypass surgery, infarction and extensive and/or
      occlusive dissection. The baseline clinical, haemodynamic and angiographic
      parameters of the two groups were comparable. The residual stenosis after
      angioplasty in the "short duration" group was 33 +/- 11% and 29 +/- 11% in the
      "long duration" group (p < 0.05). The primary success rate was 75% in the "short
      duration" compared to 89% in the "long duration" group (< 0.001). Angiographic
      dissection after angioplasty was observed in 38 cases in the "short" but only in
      17 cases in the "long duration" group (p < 0.05).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7786109
TI  - [Isoforms of creatine kinase and myoglobin in myocardial infarct treated by
      thrombolysis].
AB  - The isoforms of creatinine kinase (CK) and myoglobin were analysed by serial
      samplings in 45 patients admitted consecutively for myocardial infarction treated
      by thrombolysis according to the usual indications. Angiographic controls were
      carried out systematically in the first 24 hours, including 20 cases at the end
      of thrombolysis. The patients were divided into two groups according to the
      patency of the infarct related artery: Group I (n = 35) with a patent vessel and
      Group II (n = 10) with an occluded vessel; 4 patients in Group II were
      successfully revascularised by angioplasty. The total CK had a higher peak value
      in Group II (2,393 +/- 1,991 UI/l at 547 +/- 247 min versus 2,888 +/- 2,189 IU/l
      at 584 +/- 395 min) but the difference was not statistically significant. The
      analysis of CK isoforms showed the MM3/MM1 ratio to be higher at the 2nd hour in
      Group I (3.74 +/- 2.37 versus 3.09 +/- 1.43) with a faster increase, without
      attaining statistical significance. A fourth CK MM fraction was observed at the
      2nd hour in 71% of patients in Group I compared with only 20% of patients in
      Group II. Analysis of myoglobin showed a significantly earlier peak value in
      Group I (1,218 +/- 1,117 micrograms/l at 133 +/- 62 min versus 1,309 +/- 1,549
      micrograms/l at 210 +/- 84 min). The sensitivity and specificity of these
      different markers were respectively 40%, 86%, 77%, and 60%, 70% and 67% for the
      CK (peak before 8 hours), the MM3/MM1 ratio (increase of over 35% in the first
      hour) and myoglobin (peak before 2 hours).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786110
TI  - [Right accessory pathways with slow and decremential anterograde conduction.
      Electrophysiological changes during ablation of the proximal atrial poles].
AB  - Right sided accessory pathways with slow and decremential anterograde conduction
      differ from the anatomical substrates of the nodo-ventricular connections
      described by Mahaim. The connection may also be atrio-ventricular or atrio
      fascicular. The authors report a series of 6 patients (2 men, average age 31 +/-
      9 years) with antidromic reciprocating tachycardia implicating accessory pathways
      with decremential conduction (wide QRS complexes with left bundle branch block)
      the radiofrequency ablation of which was centered on the proximal atrial pole.
      The increment of pre-excitation was 75 +/- 18 ms. No nodo-ventricular or nodo
      fascicular connections were observed. One patient had an atrio-ventricular
      connection, the mapping and ablation (5 applications) of which were performed on
      the annulus, as if it were a bundle of Kent. Five patients had a nodo-fascicular
      connection which was masked during sinus rhythm. The localisation of the proximal
      atrial insertion on the tricuspid annulus was initially estimated by studying the
      superior junction of the circuit and by endocavitary stimulation, and then by
      recording the M potential (activation of the accessory pathway). This was
      recorded in 4 patients, either at a specific point on the annulus (lateral or
      postero-lateral) which was the target of ablation (3 patients, 5 +/- 3
      applications) or over a wider region (2 cm) at which ablation failed (1 patient:
      13 applications). The site of the increment was determined in 2 patients and was
      proximal to the M potential. The M potential could not be recorded on the annulus
      in one patient. In 2 patients, the M potential was also recorded along the side
      of the pathway on the antero-lateral wall of the right ventricle of the tricuspid
      valve at its distal pole. In 2 patients, ablation was centered on the distal pole
      in second intention, near to the terminal part of the right bundle where it was
      localised in one of the two (18 applications). Finally, ablation was obtained in
      5 out of 6 patients. They remain asymptomatic after 12 +/- 7 months follow-up.
      These cases show that accessory pathways with slow decremential conduction
      usually behave like a complete conduction pathway with an accessory laterally
      situated atrioventricular node on the tricuspid, an accessory bundle and a distal
      insertion which are all accessible to ablation.

PMID- 7786111
TI  - [Pulmonary arterial hypertension of chronic thromboembolic origin; therapeutic
      indications].
AB  - Chronic thromboembolic pulmonary hypertension is a rare complication of acute
      pulmonary embolism. The therapeutic approach to the disease is addressed, based
      on a series of 81 patients referred to our department between 1984 and 1993.
      Medical treatment associates long-term anticoagulant therapy and, in some cases,
      inferior vena cava interruption. Two surgical procedures are available in
      selected patients: lung transplantation and pulmonary thrombo-endareterectomy.
      Lung transplantation has been performed in 8 patients since 1988 with 6 survivors
      with a maximal follow-up of 5 years. Twelve patients underwent pulmonary
      thromboendareterectomy with in 9 patients a dramatic functional and haemodynamic
      improvement. Chronic thromboembolism should be systematically investigated as the
      cause of pulmonary hypertension considering that in selected cases, curative
      surgery is possible.

PMID- 7786112
TI  - [The causes of intracranial hemorrhagic complications induced by antivitamins K].
AB  - Cerebral haemorrhage is the main life-threatening complication of oral
      anticoagulant therapy. In order to identify a means of prevention, the authors
      undertook a retrospective study of 68 consecutive cases of anticoagulant-related
      intracerebral haemorrhage. The mortality was 38.5%. The respective frequency of
      intracerebral haemorrhage, subarachnoid haemorrhage, acute and chronic subdural
      haematomas was 63.2, 16.2, 10.3 and 10.3%, respectively. On admission, nearly
      half the patients (53%) had prothrombin ratios inferior to 25%. A predisposing
      factor was found in 58% of cases: hypertension (30.6%), head injury (14.5%),
      alcoholism or drug interaction (11.2%), and one case of intracerebral aneurysm. A
      history of a transient ischaemic attack or of a cerebrovascular accident was
      found in 10.2% of cases and 11.7% had a previous anticoagulant related
      extracranial haemorrhage. The initial indications for oral anticoagulation were
      ischaemic heart disease (32%), atrial fibrillation (20.5%), secondary prevention
      of venous thromboembolic disease (17.6%) and primary prevention of venous
      thrombosis (11.7%). The duration of treatment for isolated ischaemic heart
      disease was over 6 months in all cases: the average duration of treatment was
      12.4 months in phlebitis and pulmonary embolism. A critical review of the
      indications of treatment in the light of recent recommendations showed that if
      inappropriate indications were rare, the sometimes unnecessary prolongation of
      treatment was more common. Nearly half of these cases were receiving
      anticoagulants when the potential benefits were questionable at the time of the
      haemorrhagic complication. Clinical and biological follow-up is necessary for
      patients on anticoagulants; minor bleeding complications may be the prelude to
      major haemorrhage. Biological follow-up is based on control of the international
      normalised ratio.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786113
TI  - [Infectious endocarditis induced by Actinobacillus actinomycetemcomitans. 8 new
      cases].
AB  - A commensal organism of the buccal cavity, Actinobacillus actinomycetemcomitans
      (AAC) has been responsible for at least four new cases of infectious endocarditis
      by year in France. This retrospective study was based on 90 new cases of
      infectious endocarditis by AAC, including 8 personal observations. One third of
      patients had no known cardiac disease before their infectious endocarditis, the
      portal of entry of which was usually dental. In cases of suspected infectious
      endocarditis, rapid and severe weight loss (43% of cases) and, less commonly,
      anicteric cholestasis (8%) should alert the physician for the possible
      pathological role of AAC. The echocardiographic appearances are non-specific. The
      diagnosis is confirmed on blood cultures but the organism grows slowly in CO2
      enriched atmosphere. Initially, the course of the disease was favourable in one
      third of patients but, in two thirds of cases, complications were observed almost
      renal (26%), cardiac (24%) and neurological (18%). Two thirds of patients were
      cured by the time they were discharged whereas the remainder had sequellae,
      mainly valvular and neurological. The hospital mortality was 9%; late mortality
      was 6%. Therefore, the prognosis of AAC endocarditis, seems to be better than
      that of other bacteriological forms. A combination of cephalosporin and
      aminoside, or even a simple third generation cephalosporin antibiotic therapy for
      at least 4 weeks are usually effective. The complementary surgical indications
      are the same as for other forms of infectious endocarditis. Prophylaxis depends
      on strict prophylactic amoxicillin therapy for all cardiac patients at risk of
      infectious endocarditis before dental treatment and on good bucco-dental hygiene.

PMID- 7786114
TI  - [Single coronary artery].
AB  - A single coronary artery is a rare abnormality of the coronary circulation (0.09%
      in the authors' experience), a fortuitous finding on coronary angiography. The
      authors report three new cases of this abnormality, including one with a
      ventricular septal defect and another with ischaemic heart disease. Exercise
      stress testing was positive in two patients.

PMID- 7786115
TI  - [Spondylodiscitis disclosing endocarditis on the endocavitary electrodes of
      cardiac pacemakers].
AB  - Permanent pacemaker electrode infection is rare but can be fatal. The authors
      report two cases presenting with spondylodiscitis, a previously described mode of
      presentation of valve endocarditis but not previously reported in this context.
      In one case, recurrent courses of antibiotics did not prevent repeated episodes
      of bacteraemia. In the second, the relapse of infection occurred at different
      sites of the vertebral column until surgical removal of the electrodes: the usual
      features of this pathology were observed: frequent but not constant infection at
      the site of the pacemaker implantation, making the diagnosis more difficult;
      delayed signs of spondylodiscitis after implantation of the pacemaker; recurrence
      of infection when antibiotic therapy alone was prescribed and, therefore, the
      need for surgical ablation of all implanted material. The authors underline the
      diagnostic value of transoesophageal echocardiography.

PMID- 7786116
TI  - [Does syndrome X exist?].
AB  - The syndrome X is an entity characterised by the association of chest pain on
      exercise and a positive exercise stress test in patients with normal coronary
      angiography. However, this diagnosis can only be admitted when all other causes
      of angina with normal coronary arteries have been excluded. They include angina
      secondary to coronary artery spasm and myocardial hypertrophy. A review of the
      literature based on 26 publications recensing 822 patients shows that these
      criteria are not always respected: a really positive exercise stress test is an
      inclusion criterion in only 13 studies and concerns only 313 patients (38.1%);
      myocardial hypertrophy and coronary spasm were formally excluded in only 278
      (33.3%) and 228 patients (27.7%) respectively. Taking into consideration only the
      patients of these 26 series with a positive exercise stress test after exclusion
      of coronary spasm and myocardial hypertrophy, 143 (17.4%) may be considered to be
      due to syndrome X. Syndrome X is a real entity but its incidence is usually
      overestimated. It is appropriate to distinguish it from other conditions
      associating, though the exercise stress test is negative, chest pain on effort
      and the positivity of a test considered to be indicative of myocardial ischaemia.

PMID- 7786117
TI  - [Angioplasty of a single coronary artery. Apropos of angioplasty of a right
      coronary artery arising from the left main coronary artery].

PMID- 7786118
TI  - [Severe aneurysmal dilatation of the left atrium. Apropos of a case].
AB  - The authors report the case of an eleven year old child with aneurysmal
      dilatation of the left atrial appendage and underline the diagnostic value of
      Doppler echocardiography in this affectation. The two signs which led to
      investigation of the patient and the diagnosis of this rare congenital
      abnormality were bulging of the left heart border on chest X-ray and atrial
      fibrillation. In addition to visualising a left para-cardiac chamber
      communicating with the left atrium on transthoracic and transoesophageal
      echocardiography, colour Doppler confirmed an exchange of blood between the two
      chambers. This aneurysm was particularly voluminous and contained echos of
      spontaneous contrast, a possible source of thrombosis. Thoracic CT scan and
      angiocardiography did not provide any further useful information. The surgical
      findings confirmed the presence of a large aneurysm of the left atrial appendage
      and excluded partial agenesis of the pericardium, the main differential
      diagnosis. The aneurysm was excised under cardiopulmonary bypass, and, in
      particular, atrial fibrillation did not recur after surgery.

PMID- 7786119
TI  - [Epidemiology and nosology of atrial fibrillation].
AB  - Atrial fibrillation (AF) is the most commonly encountered arrhythmia in clinical
      practice. It presents as chronic AF (duration > 7 days) or paroxysmal AF with
      intermittence of sinus rhythm giving rise to different clinical patterns which
      require classification. The prevalence of AF depends on the age and health of the
      population under consideration. The arrhythmia is exceptional in children,
      uncommon in young adults, but 3 to 4% of subjects over 60 years of age.
      Underlying cardiac disease is present in nearly 80% of cases. Valvular heart
      disease, though decreasing in frequency, represented 23% of cases in our hospital
      series. Coronary artery disease is commonly associated with AF especially in
      cases with left ventricular dysfunction. The relations between hypertension and
      AF is not clear. This relationship is more significant in the presence of left
      ventricular hypertrophy. Myocardial disease (hypertrophic or dilated
      cardiomyopathy) often underlies AF but the prognosis does not seem to be
      influenced by the arrhythmia. After valvular disease, cardiac failure is the most
      significant predictive factor of AF. Atrial fibrillation doubles the mortality
      and carries a 3-6% risk of systemic embolism per year, usually as a
      cerebrovascular accident. This risk is influenced by age, the presence of
      valvular disease, hypertension, previous history of myocardial infarction or
      cardiac failure. Idiopathic AF is a common entity (about 20% of cases in hospital
      series) and carries an embolic risk of 2 to 5% per year. These observations are
      essential for appropriate therapeutic strategy for this arrhythmia which is less
      benign than previously thought.

PMID- 7786121
TI  - [Atrial fibrillation, restoration of sinus rhythm].
AB  - Conversion to sinus rhythm (cardioversion) is recommended to prevent the
      haemodynamic and thromboembolic complications of atrial fibrillation. Prior
      anticoagulation is compulsory except in emergencies. The duration of
      anticoagulant therapy depends on the terrain and chronicity of the arrhythmia.
      Cardioversion may be proposed for the majority of patients in whom it is thought
      that sinus rhythm can be maintained by appropriate therapy. It may be carried out
      pharmacologically by oral or intravenous antiarrhythmic therapy. Amiodarone is
      the drug of choice. Cardioversion may also be carried out by external or internal
      direct current shock. The success rate of external electrical defibrillation
      depends on the energy administered, the site of the electrodes and a number of
      factors related to thoracic impedence. Internal electrical defibrillation may be
      performed with an endocavitary catheter or by the oesophageal approach, with few
      complications. The main problem resides in maintaining sinus rhythm in the long
      term. When this is not possible, cardioversion is useless, and therapy to slow
      the cardiac rhythm should be instituted.

PMID- 7786123
TI  - [Mechanisms of atrial fibrillation: recent advances].
AB  - Atrial fibrillation (AF) is due to the presence of multiple reentry pathways.
      Although this mechanism has been known for some time, new information has
      recently been acquired about the factors of atrial vulnerability and the
      conditions of myocardial alteration. There are two main factors of atrial
      vulnerability: intra-atrial conduction defects and abnormalities of the
      refractory periods. In addition, the concept of critical mass and the influence
      of the autonomic nervous system have to be taken into consideration. The
      abnormalities of the refractory periods liable to increase atrial vulnerability
      are their shortening, spatial dispersion and poor adaptation to the heart rate.
      All these changes may be demonstrated at cellular level. The product of the intra
      atrial conduction velocity and the duration of the refractory period defines the
      wave length. The risk of developing reentry pathways increases as the wave length
      shortens. Moreover, the more the atrium fibrillates, the greater will be the
      decrease of the refractory periods, atrial fibrillation giving rise to atrial
      fibrillation. Histological lesions of the atrial tissue may be demonstrated, even
      in the absence of underlying cardiac disease. They mainly consist of fibrosis,
      fatty degeneration and myocytic hypertrophy. In the long-term, atrial
      fibrillation leads to a number of structural abnormalities of the atrial, and
      sometimes ventricular tissues, progressing to cardiomyopathy in some cases.

PMID- 7786120
TI  - [Thromboembolic complications of arrhythmia due to atrial fibrillation].
AB  - Fifteen per cent of cerebrovascular accidents have a cardiac origin, two thirds
      of which are due to atrial fibrillation (AF). The Framingham study showed the
      risk of an ischaemic cerebral event to be increased by 5.6 in AF unrelated to
      rheumatic heart disease and by 17.5 when AF is associated with valvular heart
      disease. The risk of embolism is higher in elderly subjects and in those with
      underlying cardiac disease. Other high risk conditions include hypertension,
      diabetes, hyperthyroidism and cases with echocardiographic changes: left atrial
      dilatation, pre-thrombotic state or intra-atrial thrombus, atheroma of the
      ascending aorta. This stratification of risk should be taken into account when
      deciding on treatment. Conscious of the importance of the risk of embolism in AF,
      several authors have undertaken, over the last few years, randomised studies of
      the prevention of thromboembolic complications of AF: the AFASAK, BAATAF, SPAF
      and SPINAF trials. All showed the unquestionable efficacy of warfarin, even at
      low doses, at the price of a haemorrhagic risk of less than 2% per year for
      severe haemorrhages. A more recent study (SPAF II) confirmed the value of aspirin
      at the dosage of 325 mg/day which would seem to be a good alternative to
      anticoagulant therapy when this is contraindicated, although aspirin is less
      effective. The indications for anticoagulant therapy have become clearer since
      the publication of these results. Anticoagulant therapy is essential in permanent
      AF whether or not associated with rheumatic heart disease.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7786122
TI  - [Control of ventricular response in patients with atrial fibrillation].
AB  - The underlying treatment of atrial fibrillation comprises two possible options.
      In the best of cases, sinus rhythm obtained by cardioversion must be maintained
      by appropriate therapy. This solution is the best option for preventing the risks
      of embolism or of myocardial deterioration. In refractory cases, the remaining
      option is to control the ventricular response. The principle is to maintain the
      rhythm within acceptable limits (70 to 90/min at rest), an action which also aims
      to limit the response to effort. This results in a symptomatic improvement and
      protects myocardial function. Digitalis is the commonest drug used for
      controlling the ventricular response. It is usually successful at recommended
      therapeutic doses, but often fails to control the response to effort. Adjustment
      of dosage using plasma concentrations may improve the situation. Another method
      of improving the control of the ventricular response is to associate digitalis
      with beta-blockers or calcium inhibitors. The risk of this option is the
      induction of an excessive bradycardia but, on the other hand, the response to
      exercise can be reduced and the variations of ventricular response decreased over
      a 24 hour period. In forms resistant to pharmacological treatment, it is possible
      to intervene directly on the atrioventricular conduction pathways. Radio
      frequency current is used in this indication. Sometimes, the objective is only to
      alter atrioventricular conduction to reduce the ventricular response to atrial
      fibrillation. In fact, this is often difficult to obtain and a number of cases
      develops complete atrioventricular block. In general, the aim is to create
      complete atrioventricular block which is then associated with implantation of a
      pacemaker.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786124
TI  - [Value of electrophysiological studies in the evaluation of atrial fibrillation].
AB  - Electrophysiological studies of the atrium provide a means of evaluating the
      parameter involved in the process of fibrillation. The study of atrial
      vulnerability, initially limited to the test of provocation of the arrhythmia,
      has widened to include analysis of the substrate. Shortened refractory periods
      and regional conduction defects play a role in the creation of reentry pathways.
      Variations in the heart rate influence these parameters and explain the
      fundamental role of the autonomic nervous system on the uniformity of the
      activation front. The risk of atrial fibrillation is related essentially to
      thrombo-embolism: atrial vulnerability was investigated in 70 patients with
      unexplained cerebrovascular accidents. Globally, one out of two patients had
      pathological substrates. This study of atrial vulnerability showed that it was
      possible to identify a group of patients at risk of atrial fibrillation, even
      before the arrhythmia was recorded. This prognostic approach could also be
      applied to the investigation of preexcitation and syncope, and to the evaluation
      of the effects of pharmacological intervention.

PMID- 7786125
TI  - [Paroxysmal atrial fibrillation: role of autonomic nervous system].
AB  - The electrophysiological properties of the atrial cells (duration of action
      potential and refractory period, conduction speed) are differently influenced by
      vagal and catecholamine stimulation: the first favorising phenomena of
      macroreentry, the second abnormal automatism and induced activity. In the normal
      heart, vagal tone is dominant at atrial level explaining that the clinical entity
      of paroxysmal vagal atrial fibrillation is observed in the absence of detectable
      cardiac disease in relatively young men with ECG appearances of alternating
      atrial flutter and fibrillation. Catecholamine-induced atrial fibrillation is
      usually observed with underlying cardiac disease. Besides the clinical terrain
      and appearances, the observation of the circumstances surrounding the triggering
      of atrial fibrillation and the features of the sinus rhythm and its variability
      before the induction of the episodes are the main factors which demonstrate the
      modalities of the influence of the autonomic nervous system. In cases resistant
      to treatment, the knowledge of these factors provides a guide to treatment,
      indicating which antiarrhythmic agents are poorly adapted or even harmful.

PMID- 7786126
TI  - [Can atrial fibrillation be managed without anti-arrhythmia drugs?].
AB  - Antiarrhythmic drugs are widely used in atrial fibrillation. The demonstration of
      severe pro-arrhythmic effects in recent years has led to the reappraisal of their
      indications in this pathology. Antiarrhythmic agents have three roles: reduction
      of the fibrillation, maintenance of sinus rhythm and, in case of failure, control
      of the ventricular response. In the first indication, although intravenous
      injection of Class Ic antiarrhythmics is effective in 70% of cases, there is an
      alternative: electrical cardioversion, which is effective in 90% of cases with
      the transthoracic method when a certain number of technical conditions are
      respected. The success rate is even better with endocavitary defibrillation.
      Sinus rhythm is sustained in only 25% of patients at one year with placebo and in
      50% of patients with antiarrhythmic therapy. The alternatives in this indication
      are few at present and consist in right atrial pacing in cases of vagal
      fibrillation and biatrial pacing for resynchronizing the activation of the two
      atriae when there is a major interatrial conduction defect. The control of the
      ventricular response, in cases of permanent atrial fibrillation, is usually
      reserved to digitalis, betablockers, amiodarone and some calcium antagonists.
      They are often inadequate and an alternative is radiofrequency catheter ablation
      of the atrioventricular node, which requires permanent ventricular pacing. In
      conclusion, there are a few alternatives to antiarrhythmic drug therapy in atrial
      fibrillation, but they are relatively ineffective in maintaining sinus rhythm.

PMID- 7786128
TI  - [Atrial defibrillator: dream or reality?].
AB  - The experience acquired with the use of automatic ventricular cardiovertor
      defibrillator led to the idea of developing an atrial device capable of
      automatically detecting and reducing atrial fibrillation. The large group of
      patients with paroxysmal atrial fibrillation not responding to pharmacological
      therapy makes this a particularly relevant question. The first problem is to
      define the need of this type of device. There is only one group of patients with
      resistant and/or poorly tolerated paroxysmal atrial fibrillation in whom non
      pharmacological therapy is considered, for example ablation of the AV node with
      implantation of a pacemaker or surgery. The second problem concerns the technical
      feasibility of an atrial defibrillator with the difficulty related to the
      detection of the arrhythmia and atrial defibrillation. The recognition of atrial
      fibrillation may be envisaged from endocavitary signals with satisfactory
      specificity and sensitivity. The problems related to atrial defibrillation with
      low energy shocks have not yet been solved clinically, although experimental
      studies have given promising results. The possible dangers are dominated by a pro
      arrhythmic effect and the risk of ventricular fibrillation, but they could be
      avoided by synchronizing the atrial shock with ventricular activation based on
      results also obtained in the animal. Before the dream becomes reality, trials are
      necessary to develop a safe and effective automatic device. Intermediary stages
      of evaluation of such a device could include a device activated by the physician.

PMID- 7786127
TI  - [Surgical treatment of atrial fibrillation].
AB  - The persistence of atrial fibrillation with a controlled ventricular response
      with medical treatment or ablation of the His bundle, suppresses troublesome
      palpitations but leaves potential haemodynamic problems and the risk of
      thromboembolism. Surgical treatment of this arrhythmia, by leaving an anatomic
      bridge between the sinus and atrioventricular nodes, aims to allow acceleration
      of the ventricular rhythm on exercise whilst preventing by partial, total or
      selective exclusion of atrial tissues, the multiple intra-atrial reentries
      responsible for atrial flutter or fibrillation. The first method proposed was
      isolation of the left atrium (Cox, 1980) which allows acceleration of the
      ventricular rhythm during exercise, leaving little or no haemodynamic
      disturbance, but, in theory, the same risk of embolism. The second method, the
      "corridor" operation (Guiraudon, 1985) consists in isolating both atria, but
      significantly alters the haemodynamic efficacy without reducing the embolic risk,
      and hardly offers any advantage over ablation of the nodo-hisian pathway
      completed by implantation of a ventricular, rate responsive, pacemaker. The
      recently described "maze" procedure (Cox and Boineau, 1991) would seem to be more
      promising with judiciously chosen incisions (at the base of the atria, around the
      pulmonary veins, between the vena cavae, along the interatrial septum, etc.) and
      points of cryoablation in the region of the coronary sinus, allowing modulation
      of the ventricular response with activation of sufficient atrial tissue to
      prevent reentry and recurrence of atrial fibrillation without affecting
      haemodynamic efficacy. The results of this technique are encouraging in the hands
      of its inventors but require confirmation in larger series of patients.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7786129
TI  - [Atrial fibrillation].

PMID- 7786130
TI  - [Current aspects of atrial fibrillation. Proceedings of conference. Paris, 17
      December 1993].

PMID- 7786131
TI  - [Meta-analysis of clinical trials: values and limitations].
AB  - Meta-analysis produces reproductible, qualitative as well as quantitative
      overviews of available evidence. Such a synthesis is a compulsory step in
      conveying information on therapeutics to health care providers. Compared to more
      traditional approaches, meta-analysis has enough advantages to make them no
      longer relevant. Its limitations come from inappropriate use or less than
      required rigorous application of its methodology.

PMID- 7786132
TI  - [Reflections on therapeutic trials].
AB  - The approach of establishing a relationship between cause and effect is a form of
      research contrary to the empirism which characterises many therapeutic trials.
      This empirism may result in certain embarrassing situations when the criteria of
      evaluation do not turn out to have the value that simple correlations attribute
      to them. Evaluating the efficacy of a drug whilst ignoring its mechanisms of
      action is courting danger, especially that of being unable to pursue a line of
      research when the global results are known in advance. These phenomena, observed
      in the example of the prevention of sudden death by antiarrhythmic drugs and
      betablockers, have the effect of impeding research in this complex field and the
      development of new and potentially useful drugs. It has become necessary to
      reevaluate the rules of medical experimentation which, in some cases, have
      reached the limits of feasibility and efficacy.

PMID- 7786133
TI  - [Should substitution criteria be used in hypertensive disease?].
AB  - A number of methods, some of which are still in the development phase, enable
      progressively more accurate assessment of structural and/or functional changes of
      the target organs of hypertension. The notion that these changes may be used as a
      substitution criterion in the evaluation of hypertensive disease is at the heart
      of the concept of preclinical cardiovascular disease: in its theoretical and
      practical aspects, this concept stipulates that the preclinical disease is an
      intermediate stage between exposure to the risk factor of hypertension and the
      advant of morbid or mortal cardiovascular events, and it suggests that the
      evaluation of the preclinical disease leads to a more accurate stratification of
      cardiovascular risk than measurement of the risk factors alone. However, at
      present, none of the parameters proposed (albuminuria, left ventricular mass,
      arterial wall thickness) is a validated substitution criterion; but many
      arguments indicate that the use of these parameters as intermediate criteria is
      justified under certain conditions.

PMID- 7786134
TI  - [Coronary angioplasty: methods of evaluation].
AB  - Coronary angioplasty is sometimes thought to be insufficiently validated
      considering the considerable development it has undergone and its place in modern
      cardiological practice. Nevertheless, several randomised clinical trials
      comparing angioplasty with medical therapy in stable angina (ACME) and with
      surgical treatment in stable and unstable angina (RITA) have provided more
      scientific support for the technique. The serious perioperative complications
      have become rare, the limiting factor being restenosis which is responsible for a
      large number of clinical recurrences and the reappearance of documented
      myocardial ischaemia. It is therefore logical to make restenosis the first
      objective of evaluation of PTCA. There are two possible approaches to this
      problem. The first relies on automatic quantitative operator-independent
      angiography as a gold standard. However, this method is methodologically complex,
      technically fastidious and only takes into consideration the anatomical
      appearances, the correlations with clinical outcome and prognosis of which are
      poor. It allows measurement of the amplitude of the process which is an
      unquestionable advantage, but it is only a partial view of the problem. The
      second method considers that only stenosis causing ischaemia is significant and
      that the criterion of evaluation should be the rate of new events and that the
      necessity of repeated attempts at revascularisation is the criterion of failure
      of the method. This overlooks the possibility of an anti-restenosis drug
      producing clinical results independents of its anatomical effect. Both methods
      have their advantages and drawbacks, which necessitates using them both in all
      trials of new tools or new molecules designed to prevent restenosis.

PMID- 7786136
TI  - [Reading of articles concerning treatment of acute phase of myocardial
      infarction].
AB  - The number of articles concerning the treatment of acute myocardial infarction is
      large, and systematic analysis can improve the comprehension of their results.
      The object of this paper is to propose a method of classifying these articles
      with respect to their qualities and defects in order to orient workers towards
      the use of the most satisfactory articles for bibliographic purposes. The
      questions that have to be addressed are: what is the object of the study; is the
      instrument of measurement adapted to the objective of the study; which patients
      were studied; was the study performed with a double-blind protocol; what was the
      number of cases and does this number allow a valid response to the question; what
      was the plan of the study; what were the judgement criteria and what significance
      can be accorded to these criteria, and finally, what was the type of analysis,
      were there analyses of sub-groups, and if so, are the analyses pertinent. Based
      on examples in the literature, the authors justify why these questions should be
      asked and how the responses to these questions influence the judgement of a given
      article. In conclusion, the quality of therapeutic trials in acute myocardial
      infarction is very variable: systematic analysis allows them to be classified in
      a subjective scale of quality.

PMID- 7786135
TI  - [Nitric oxide, from vascular physiology to therapeutics].
AB  - Nitric oxide (NO) synthesised by endothelial cells, plays a key role in the
      control of vascular tone. Its synthesis from L-arginine is assured by NO
      synthase, the activity of which is dependent on intracellular calcium
      concentrations, which are themselves modulated by pharmacological (acetylcholine,
      serotonin, bradykinin...) or physical factors (shearing forces exerted by blood
      flow). NO acts by stimulating a soluble guanylate-cyclase of the smooth muscle
      cells in the vessel wall. Its vasodilator effect is therefore mediated by an
      increase in intracellular cyclic GMP concentration. The synthesis or liberation
      of NO by the endothelium may be decreased or abolished during many pathological
      processes (hypercholesterolaemia, atherosclerosis, systemic or pulmonary
      hypertension...). The significance of this abnormality of NO-mediated endothelium
      dependent vasodilation in different pathological conditions has not been
      established. However, it is probably significant in view of the different
      properties of NO: vaso-relaxation, antiaggregant and inhibition of vascular
      smooth muscle growth. It is not yet known whether this abnormality is a cause or
      a consequence of the underlying disease. From the therapeutic point of view, NO
      is an active metabolite of nitrate derivatives, sodium nitroprussiate and
      molsidomine which therefore share the same mode of action as the so-called
      "endothelium-dependent" vasodilatoe agents. The inhalation of NO, which is
      increasingly used in neonatal and adult intensive care units, is an alternative
      therapeutic approach in many conditions associated with pulmonary hypertension.

PMID- 7786137
TI  - [Reading of the trials in cardiac insufficiency; preliminary and experimental
      studies (phases I-II)].
AB  - In addition to general consideration concerning the justification and methodology
      of therapeutic trials, the interpretation of the results of evaluation of new
      products in the field of cardiac failure poses a number of problems. In
      experimental studies in the animal, the choice of model of cardiac failure, the
      mode of evaluation of the parameters and the justification of the choice of
      dosage studied require particular attention. In preliminary clinical trials
      (Phases I and II), the choice and number of subjects, the dosage and methodology
      both for recensement and interpretation of data, are factors which influence the
      quality of the information obtained. When these studies have been completed, the
      decisions whether to develop the product and the recommended dosage have to be
      taken. The importance of these decisions justifies the extreme attention which
      has to be taken in the elaboration of these studies and in their interpretation.

PMID- 7786138
TI  - [Reading of the trials in cardiac insufficiency; therapeutic studies (phases II B
      and III)].
AB  - The object of therapeutic trials in cardiac failure is to improve the quality of
      life by controlling the principal symptoms which are dyspnoea and tiredness on
      effort and to improve survival. A critical review of therapeutic trials in
      cardiac failure must examine whether these two objectives have been attained and
      if they are attained simultaneously. In some cases, there is symptomatic
      improvement but with decreased life expectancy whereas in others, survival is
      prolonged without adequate control of symptoms. A critical analysis should
      examine the pertinence of these criteria of efficacy, and confirm that the
      problem of survival has been assessed, that reliable data has been provided, that
      the study population is representative of the real population of the patients to
      be treated, and finally, that the experimental protocol is realistic, i.e. a
      prospective study with analysis of intention to treat.

PMID- 7786139
TI  - [Critical analysis of scales of quality of life in cardiology; applications to
      cardiac insufficiency].
AB  - Scales of quality of life have only recently been imposed in cardiology.
      Essentially an Anglosaxon invention, they have been used for evaluating most
      treatment of cardiac failure. The main qualities of a good quality of life
      questionnaire are its sensitivity, its reproducibility and its validity. The
      contents of the questionnaire, particularly the relationship between items
      concerning symptoms and those concerning the psychological aspects of the
      disease, have a great influence on the quality of results. The "Living with Heart
      Failure Questionnaire" of the University of Minnesota is the most validated
      questionnaire at present. As with most other methods of therapeutic assessment in
      cardiology, the most recently obtained results from large multicenter trials,
      seem to show a much smaller benefit of drugs reputed to be effective in this
      condition, with respect to the quality of life of patients. This justifies: the
      continuation of validation of these questionnaires, a reflection on the efficacy
      of classical management of these patients.

PMID- 7786141
TI  - [Hidden electric phenomena].
AB  - Concealed electrical phenomena are activations which penetrate the specialised
      tissue incompletely, which do not have a direct electrical effect but which
      usually affect the conduction of the following normal impulse. The phenomena are
      extremely common. They arise physiologically in the node of Aschoff Tawara and
      express the relationship between flutter waves and their propagation to the
      ventricle. Any extrasystole or ectopic rhythm may give rise to these phenomena
      and modify conduction in the anterograde or retrograde direction if the ectopic
      rhythm is ventricular, by slowing the rate but also, in some cases, by
      paradoxically improving it. In addition, some reciprocating nodal tachycardias
      are due to a concealed bundle of Kent invisible in sinus rhythm, the presence of
      which may be suspected by the ECG appearances of the reciprocating tachycardia
      (negative P wave in lead 1, phenomenon of delaying bundle branch block or simply
      the auriculogram after the ventriculogram.

PMID- 7786140
TI  - [Subjectivity in the reading of scientific articles].
AB  - With the examples of historical incoherencies in the diagnosis and treatment of
      myocardial infarction and pulmonary embolism, the author shows that it is not
      easy to be an objective reader of "good" scientific articles. Our
      neuropsychological mechanisms do not facilitate an "intelligent" attitude without
      the aid of affectivity. An unwanted thymotic component places the reader in an
      ambiguous position with respect to authority and reality. Though one can never
      know too much, it is difficult, alone, to maintain an intelligent curiosity. Some
      financial interests may awaken it. During his career, the physician has to
      navigate between two slightly contradictory necessities: changing his attitude
      with respect to new information, and according credence to his personal
      experience.

PMID- 7786142
TI  - [Ventricular fibrillation and defibrillation; electrophysiological bases and
      clinical applications].
AB  - During sinus rhythm, the successive responses to the application of electrical
      stimuli of increasing intensity during the vulnerable period are cardiac
      stimulations followed by repetitive ventricular responses and then ventricular
      fibrillation. An impulse of even greater intensity is not followed by ventricular
      fibrillation (shock at the upper limit of vulnerability) suggesting that
      defibrillatory shock is effective only when it does not reinduce fibrillation.
      Two other hypotheses are also proposed in fibrillation, that of critical mass and
      that of extension of the refractory periods, in particular after biphasic shocks.
      Clinically, the measurement of the threshold of defibrillation is difficult as it
      is a random process which does not obey the all or nothing principle. Ideally, a
      graph of efficacy versus energy should be constructed but this is only possible
      under experimental conditions. The effects of different antiarrhythmic drugs have
      been studied in this manner; in general, the sodium channel blockers improve the
      energies of defibrillation.

PMID- 7786144
TI  - [Atrioventricular nodal tachycardia].
AB  - The atrioventricular junction consists of the atrioventricular node and the
      bundle of His up to its division. All tachycardias arising in these structures or
      which depend on these structures for their sustenance are called "junctional".
      There are four main types. The first three correspond to reciprocating rhythms,
      nodal tachycardia, tachycardias using an accessory pathway with unidirectional
      retrograde conduction, and chronic reciprocating atrioventricular nodal
      tachycardia. All varieties of reciprocating atrioventricular nodal tachycardia
      have been well studied and their diagnosis is possible from the standard surface
      electrocardiogram from the position and morphology of the P' wave. They are
      accessible to radical treatment by radiofrequency ablation of the slow pathway or
      accessory pathway, when present. The definitive treatment of ectopic
      atrioventricular nodal tachycardia is not yet established and has to be
      considered case by case, this form of arrhythmia being rare.

PMID- 7786143
TI  - [Mechanisms of action of class III anti-arrhythmia agents].
AB  - Vaughan-Williams class III antiarrhythmic agents act mainly by prolonging the
      duration of the cardiac action potential and, thus, the refractory period. This
      effect may be obtained: 1) by increasing the inward sodium or calcium currents,
      which may lead to an intracellular calcium overload and induce a very
      proarrhythmic situation, or 2) by decreasing the outward potassium currents, the
      objective of the new class III antiarrhythmic drugs under development. They
      selectively block one or several potassium channels regulated by the membrane
      potential (transient outward current Ito, delayed rectifying current IK and
      rectifying inward current IK1). Under physiological conditions the blockade of
      potassium channels regulated by a ligand (for example, ATP-dependent) does not
      lead to a class III effect. Prolongation of ventricular repolarisation is
      accompanied by a slowing of the heart rate and a positive inotropic effect. It is
      attenuated by rapid rhythms and amplified by slow rhythms: this is the reverse
      frequency-dependent phenomenon. However, normal frequency dependence (or "use
      dependence") has been reported with the ionic channel, this paradox apparently
      being related to the complexity of the relations between the relative
      contributions of the ionic currents of repolarisation and their modulation by the
      heart rate. The class III effect confers a proarrhythmic potential and may lead
      to torsades de pointes, favorised by bradycardia, hypokalaemia and
      hypomagnesaemia. Experimentally, it favorises early after depolarisations which
      are presumed to be the cellular trigger event. The comprehension of factors
      influencing the antiarrhythmic and proarrhythmic class III effects has led to the
      establishment of a pharmacological profile of the "ideal" drug conferring the
      least proarrhythmic risk and the best efficacy.

PMID- 7786145
TI  - [Hemiblocks: electrocardiographic diagnosis].
AB  - Left hemiblocks or fascicular blocks are conduction defects which lead to
      asynchronous left ventricular activation. The classical diagnostic criteria must
      be respected, especially the degree of left axial deviation in complete forms.
      Other, less well-known criteria, which include the widening of the QRS complex
      opposite the myocardial walls showing delayed activation, seem very useful for
      making the diagnosis. The real diagnostic difficulties lie in incomplete forms
      because the inferior limits of axial deviation in this type of conduction defect
      are not known and clinical progression is usually the decisive factor. Precise
      understanding of the clinical signs of hemiblock is useful in clinical practice
      for the discussion of the significance of Q waves in the right precordial leads
      or for explaining sudden changes in QRS axis or amplitude.

PMID- 7786146
TI  - [Value of the exercise test in the study of arrhythmia].
AB  - Exercise testing may be used to assess symptoms occurring on effort, to search
      for and evaluate arrhythmias or conduction defects, antiarrhythmic drugs,
      pacemakers or implantable cardioverter defibrillators. Interpretation of exercise
      testing is difficult because of the complexity of the factors in play. Exercise
      itself induces changes in myocardial metabolism and the autonomic nervous system,
      the nature and importance of which are influenced by the underlying cardiac
      disease and the presence of cardiac failure or myocardial ischaemia. This is
      particularly true when studying the behaviour of arrhythmias on effort, which
      depends on many parameters, in that they may appear or disappear during exercise,
      irrespective of their relationship to autonomic nervous system activation. The
      main problem lies in the interpretation of changes in the heart rate before the
      onset of an arrhythmia. The sinus rhythm is both a passive indicator of the vago
      sympathetic equilibrium and one of the determining factor of the arrhythmia
      (relationship to the rate), but it is, itself, dependent on the presence of
      myocardial dysfunction, a source of arrhythmias, and its changes then become
      difficult to interpret. These reasons explain why exercise testing is certainly a
      valuable tool in assessing arrhythmias but the poor reproducibility, especially
      in the evaluation of ventricular arrhythmias, advises prudence in the
      interpretation of results.

PMID- 7786148
TI  - Proceedings of the 1994 EUROTOX Congress. Basel, Switzerland, August 21-24, 1994.

PMID- 7786149
TI  - Inhibitors of the sodium pump: toxins, then drugs, and now hormones.

PMID- 7786147
TI  - [Electrocardiographic aspects of atrial fibrillations].
AB  - The electrocardiographic analysis of atrial fibrillation is usually easy.
      However, some cases may be difficult to interpret: the organisation and voltage
      of the fibrillation waves can be very variable leading to appearances of atypical
      flutter in cases with large "f" waves or, conversely, in cases with low voltage
      fibrillation, to those of sinus mode dysfunction. The ventricular response may be
      slow: the conduction is usually delayed in the atrioventricular node where
      concealed conduction plays an important role in determining the ventricular
      response. Regular ventriculogrammes correspond to a junctional or ventricular
      escape rhythms. Aberrant conduction in the His-Purkinje system may sometimes be
      observed after long diastoles (phase 4 block) but often terminates short,
      preceded by long cycles (phase 3 block). It is usually easy to differentiate them
      from ventricular ectopics or preexcitation by careful examination and application
      of classical diagnostic criteria.

PMID- 7786150
TI  - Rodent responses to peroxisome proliferators--a receptor-mediated phenomenon?

PMID- 7786151
TI  - Role of second messengers in mineral particle-induced production of reactive
      oxygen species by phagocytes.

PMID- 7786152
TI  - Estrogenic effects of some xenobiotics.

PMID- 7786153
TI  - In vitro methods in regulatory toxicology: the crucial significance of
      validation.

PMID- 7786154
TI  - Scientific, ethical and legal aspects of the acceptance of in vitro methods in
      regulatory toxicology.

PMID- 7786155
TI  - The validation and use of in vitro teratogenicity tests.

PMID- 7786156
TI  - In vitro methods in regulatory toxicology.

PMID- 7786157
TI  - In vitro tests in regulatory toxicology: symposium chairman's summing-up.

PMID- 7786158
TI  - Ex vivo and in vitro models in acetaminophen hepatotoxicity studies. Relationship
      between glutathione depletion, oxidative stress and disturbances in calcium
      homeostasis and energy metabolism.

PMID- 7786160
TI  - Neurobehavioral abnormalities induced by prenatal exposure to substances of abuse
      -stating the problems.

PMID- 7786159
TI  - Rabbit renal proximal tubule suspensions as a model for nephrotoxicity evaluation
      of native or in situ metabolized beta-lactam antibiotics.

PMID- 7786161
TI  - Applications for transgenic animals in toxicology.

PMID- 7786163
TI  - Delayed developmental neuro- and immunotoxicity of benzodiazepines.

PMID- 7786162
TI  - Prenatal exposure to marihuana and tobacco during infancy, early and middle
      childhood: effects and an attempt at synthesis.
AB  - Both marihuana and cigarettes appear implicated, in a differential fashion, in
      the neurobehaviour of infants and children born to women who used these
      substances during pregnancy. In a low-risk upper middle class sample, marihuana
      use was associated, in the newborn, with mild withdrawal symptoms and some
      autonomic disruption of nervous system state regulation. However, between 6
      months and 3 years of age no behavioural consequences of marihuana exposure (once
      confounding factors were controlled) were noted. At four years of age, although
      global tests of intelligence did not differentiate exposed from non-marihuana
      exposed children, verbal ability and memory were associated with in utero
      marihuana exposure. At five and six years of age these general areas were also
      noted to be associated with maternal cannabis use as was sustained attention.
      These areas of neurobehavior that appear affected by marihuana exposure during
      fetal development are ones that are consistent with the cognitive construct of
      'executive functioning' which is thought to be a marker of prefrontal lobe
      functioning. Consistent with the observations derived from these children is that
      prefrontal functioning may not be apparent until approximately four years of age
      and that executive functioning is disassociated from measures of global
      intelligence. Exposure to cigarettes during pregnancy appears to be associated
      with neurobehavioural deficits in the auditory domain. In the newborn this is
      manifested by decreased responsivity to sound and altered auditory habituation.
      Between the ages of one and 11 years the performance on auditory related tasks
      (verbal memory, language, auditory processing) were consistently the domains that
      differentiated the cigarette exposed from the non exposed children. The possible
      role of the cholinergic mediated efferent auditory system is discussed. Also
      associated with in utero exposure to cigarettes were general cognitive
      performance and parental reports and objectively derived measures of impulsivity.
      The striking degree of consistency over the years lends strength to the
      interpretation that the observations in childhood have, at least as their partial
      etiology, the prenatal exposure to cigarettes. However, in interpreting the
      evidence presented it must be recognized that the alterations in the child's
      behaviour may well affect the parenting behaviour. This potential transactional
      interaction must remain an integral part of drawing conclusions about both
      marihuana and cigarette's effects.

PMID- 7786164
TI  - Changes in EEG of freely-moving rats caused by three-generation organophosphate
      treatment.

PMID- 7786165
TI  - Developmental neurotoxicity of carbon monoxide.
AB  - The results of recent studies dealing with behavioral and electrophysiological
      dysfunctions induced in rat offspring by prenatal exposure to relatively mild CO
      concentrations (75 and 150 ppm) have been reviewed in the present paper. In
      particular, gestational exposure to CO produced the following behavioral changes:
      (i) reduction in the minimum frequency of ultrasonic calls emitted by rat pups
      removed from their nest; (ii) decrease in ultrasonic responsiveness to a
      challenge dose of diazepam; (iii) alterations in the acquisition of an active
      avoidance task. The electrophysiological changes induced by prenatal CO in
      peripheral nervous system are as follows: (i) increase in time constants of
      sodium current inactivation; (ii) increase in the percentage of the maximum
      number of activatable sodium channels at the normal resting potential; (iii)
      negative shift of sodium current reversal potential. Moreover, results of ongoing
      researches on peripheral myelinogenesis in rats exposed to CO during gestation
      will be also summarized.

PMID- 7786166
TI  - Concepts, potentials and methods for constructing transgenic cells and animals.

PMID- 7786167
TI  - The safety assessment of over-the-counter (OTC) products.
AB  - In recent years many compounds have become available as Over-The-Counter (OTC)
      medicine, for self-medication, which were originally marketed as prescription
      medicines only. This has been coupled with changes in the consumers' behaviour to
      self treatment and the governments commitment to restrict rising health costs.
      The safety and safe use of OTC products are important considerations for their
      wide distribution which is paralleled by diminishing medical supervision. OTC
      products were generally registered when toxicological requirements differed from
      the stringent guidelines of today, and their safety assessment thus often
      involves ongoing evaluation as new data become available. For this, human data
      must also be integrated for these assessments. However, in some areas, such as
      mutagenicity and carcinogenicity testing, human data are hardly obtainable and
      testing in animals or cells, is ultimately the only reliable source for
      extrapolation to man. Routine toxicological methods have mainly been developed
      for the assessment of new pharmaceutical entities and often provide 'yes/no'
      answers only. Data of such tests are, therefore, not directly applicable to the
      safety assessment of OTC products. Additional information on the kinetics in
      animal and man are indispensable for such extrapolation. On the other hand,
      modifications of original test protocols for the assessment of new formulations
      are indispensable. It was the aim of this workshop to discuss general approaches
      of safety assessments within the important new area of OTC products, as well as
      to present specific cases of recently arisen safety issues.

PMID- 7786168
TI  - OTC pharmaceuticals and genotoxicity testing: the paracetamol, anthraquinone, and
      griseofulvin cases.
AB  - Genotoxic effects are hardly assessable in an exposed population but are
      generally considered to be serious due to their unpredictable effects on
      subsequent generations and to the link between genotoxicity and cancer. Lack of
      knowledge about a genotoxic/carcinogenic potential has to be stated for numerous
      compounds which are often in pharmaceutical use known for a long time. A thorough
      testing programme like it is done for new compounds is essential for such
      compounds that are not completely unsuspicious with respect to being reactive
      with macromolecules or that have the potential to generate reactive metabolites
      in the body. Paracetamol, anthraquinone-containing preparations, and griseofulvin
      are examples for pharmaceuticals that have been in use for a long time but for
      which genotoxicity testing revealed a possible deleterious potential only
      recently. The Federal Health Office/Federal Institute for Drugs and Medical
      Devices therefore imposed new studies upon companies marketing these compounds in
      the last years. These studies in part led to a more thorough description of
      possible adverse effects or even restrictions for use. Paracetamol exhibits a
      genotoxic potential in vitro and in vivo probably via indirect, cytotoxicity or
      enzyme inhibition-mediated effects. Further studies will have to clarify whether
      a threshold could be established and whether effects do not occur at therapeutic
      dose levels. Genotoxicity data on the mixed group of anthraquinones reveal
      positive and negative findings. Compounds such as lucidin, danthron, emodin
      supposedly have a genotoxic and carcinogenic potential. Further studies with
      anthraquinone-containing plant preparations will have to clarify the content and
      genotoxic activity of the preparations and the active ingredients. Lucidin- and
      danthron-containing preparations are currently no longer in use now whereas
      restrictions apply for other anthraquinone-containing laxatives. Griseofulvin is
      acknowledged in the meantime as an aneugen for somatic and germ cells. It is in
      vitro effective in concentrations that correspond to therapeutic plasma levels.

PMID- 7786170
TI  - Safety assessment of OTC products--a regulatory view.

PMID- 7786169
TI  - Safety assessment of OTC drugs: doxylamine succinate.

PMID- 7786172
TI  - Species specificity of organ toxicity.

PMID- 7786171
TI  - Drug toxicity findings and no action taken.

PMID- 7786173
TI  - Mechanisms underlying species-specificity in target organ toxicity.

PMID- 7786174
TI  - Principles, benefits and limitations of the NOEL approach.

PMID- 7786176
TI  - Development of OECD Test Guidelines and Hazard Assessment procedures for
      terrestrial effects [Organization for Economic Co-operation and Development].

PMID- 7786175
TI  - Species specificity of organ toxicity: behavioral differences.

PMID- 7786177
TI  - Development of guidance for terrestrial effects assessment. [Organisation for
      Economic Co-operation and Development].

PMID- 7786178
TI  - Application of quick and simple plant bioassays to assess the genotoxicity of
      environmental pollutants--detection of potential health hazards of air, water and
      soil contaminants.

PMID- 7786179
TI  - Comparison of susceptibilities of species used in toxicological and environmental
      risk assessment to chemicals (pesticides).

PMID- 7786180
TI  - Comparison of BMD with NOAEL and LOAEL values derived from subchronic toxicity
      studies.

PMID- 7786181
TI  - Toxicological evaluation of pollutants in soil--concept of the AGU* and
      assessment of tolerable concentrations for metals.

PMID- 7786182
TI  - The SCID (severe combined immunodeficiency) mouse--its biology and use in
      immunotoxicological research.

PMID- 7786183
TI  - The SCID mouse as a tool to bridge the gap between animal and human responses.

PMID- 7786184
TI  - The SCID mouse and its use for immunopharmacological and immunotoxicological
      investigations.

PMID- 7786185
TI  - Chirality--from molecules to organisms.

PMID- 7786186
TI  - Interactions between the in vitro metabolism of xenobiotics and fatty acids. The
      case of ibuprofen and other chiral profens.

PMID- 7786187
TI  - Side effects and toxic reactions of chiral drugs: a clinical perspective.

PMID- 7786189
TI  - Biological behavior of prestages of cancer cells: an introduction.

PMID- 7786188
TI  - Analysis of (S)- and (R)-propranolol in human plasma and urine by a specific
      immunoenzymatic assay versus HPLC.

PMID- 7786190
TI  - Preneoplastic lesions in kidney and carcinogenesis by non-genotoxic compounds.

PMID- 7786192
TI  - The UK approach to the regulation and evaluation of novel foods produced by
      biotechnology.

PMID- 7786191
TI  - Early cellular alterations in chemical liver carcinogenesis as addressed by
      immunohistochemical and molecular biological techniques.

PMID- 7786193
TI  - Biomarkers in ecotoxicology: an overview.

PMID- 7786194
TI  - Use of recombinant cells in metabolic and mechanistic studies.

PMID- 7786195
TI  - Use of cytochrome P450 1A (CYP1A) in fish as a biomarker of aquatic pollution.

PMID- 7786196
TI  - Cellular and molecular biology of aryl hydrocarbon (Ah) receptor-mediated gene
      expression.
AB  - 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) and related compounds elicit diverse
      toxic and biochemical responses in laboratory animals and mammalian cells in
      culture. TCDD induces CYP1A1 gene expression and results of extensive research
      have delineated the molecular mechanism of this response. In target cells, TCDD
      initially binds to the aryl hydrocarbon (Ah) receptor which accumulates in the
      nucleus as an Ah-receptor:aryl hydrocarbon nuclear translocator (Arnt) protein
      heterodimeric complex. The nuclear Ah receptor complex acts as a ligand-induced
      transcription factor which binds to transacting genomic dioxin/xenobiotic
      responsive elements (DREs/XREs) located in the 5'-regulatory region upstream from
      the initiation start site and this interaction results in transactivation of gene
      transcription. DREs have been identified in several other genes which are induced
      by TCDD, including CYP1A2, aldehyde-3-dehydrogenase, NAD(P)H quinone
      oxidoreductase, and glutathione S transferase Ya and similar induction response
      pathways have been observed or proposed. However, TCDD and other Ah receptor
      agonists also inhibit expression of several genes and research in this laboratory
      has investigated inhibition of estrogen (E2)-induced genes including uterine
      epidermal growth factor, c-fos protooncogene, and the progesterone receptor,
      estrogen receptor (ER) and cathepsin D genes in human breast cancer cell lines.
      In MCF-7 human breast cancer cells, E2 induces cathepsin D gene expression and
      this is associated with formation of an ER/Sp1 complex at the sequence in the
      promoter region (-199/-165) of this gene. Within 30 min TCDD causes a rapid
      inhibition of E2-induced cathepsin D gene expression in MCF-7 cells. Moreover,
      using a series of synthetic oligonucleotides which include the wild-type ER/Sp1
      and various mutants, it was shown by gel electromobility shift and transient
      transfection assays that the nuclear Ah receptor complex binds to an imperfect
      DRE located between the ER and Sp1 binding sequences. This interaction results in
      disruption of the ER/Sp1 complex and inhibition of E2-induced gene expression.
      These results illustrate that the nuclear Ah receptor complex also exhibits
      activity as a negative transcription factor via a mechanism which is similar to
      that reported for Ah receptor-mediated induction of gene expression.

PMID- 7786197
TI  - The corneal endothelium and myopic excimer laser photorefractive keratectomy.

PMID- 7786198
TI  - Is a 'favorable' outcome acceptable?

PMID- 7786199
TI  - Oral imipramine and acute angle-closure glaucoma.

PMID- 7786200
TI  - Acute uveitis in patients with acquired immunodeficiency syndrome receiving
      prophylactic rifabutin.

PMID- 7786201
TI  - Choroidal hyperpermeability in central serous choroidopathy: a new concept?

PMID- 7786202
TI  - Transconjunctival entropion surgery.

PMID- 7786203
TI  - The Wisconsin Epidemiologic Study of Diabetic Retinopathy.

PMID- 7786204
TI  - Partial splitting of the anterior lens capsule giving a 'double-ring' sign.

PMID- 7786205
TI  - Management of ablation decentration following excimer photorefractive
      keratectomy.

PMID- 7786207
TI  - Ischemic optic neuropathy during corticosteroid therapy for giant cell arteritis.

PMID- 7786206
TI  - Rifabutin-associated uveitis during prophylaxis for Mycobacterium avium complex
      infection.

PMID- 7786208
TI  - Questions concerning the role of apraclonidine in the management of glaucoma.

PMID- 7786209
TI  - The effectiveness initiative. I. Medical practice guidelines.
AB  - We examined the impact of the "effectiveness initiative" and medical practice
      guidelines on the practice of ophthalmology. The effectiveness initiative asserts
      that much of current medical practice is unnecessary or harmful, too costly, and
      unresponsive to patient desires. It promotes more critical review of the medical
      literature, research on outcomes, and stringent practice guidelines. Whereas
      current practice guidelines are helpful in codifying accepted procedures, they
      tend to sanction interventions of unproved value. Future guidelines will probably
      reject unproved interventions, especially if they are expensive. Although such
      guidelines may limit physicians' freedom of choice, they may protect them against
      capricious malpractice claims and unreasonable patient expectations.

PMID- 7786211
TI  - Teaching ophthalmology to primary care physicians. The Association of University
      Professors of Ophthalmology Education Committee.
AB  - The evolution of our health care system toward managed care has placed primary
      care "gatekeeper" physicians in a position where they must examine and treat
      patients with diseases that are ordinarily treated by medical and surgical
      subspecialists. Many of these physicians may be poorly prepared to accept this
      new responsibility. The Association of University Professors of Ophthalmology
      (AUPO) has published a Policy Statement on Medical Student Education that
      suggests the minimum level of competence expected of general physicians when
      dealing with ophthalmologic problems. A recent survey of directors of residency
      programs in family practice, internal medicine, and pediatrics revealed that the
      training of primary care physicians (as opposed to academicians or
      subspecialists) has become a nearly universal programmatic goal. Most program
      directs believe that less than half of their residents meet the AUPO standard at
      the completion of medical school, and a significant minority do not meet the AUPO
      standard at the completion of their residency. An overwhelming majority of
      program directors believe that additional training in ophthalmology and other
      subspecialties should be incorporated into the training programs of primary care
      physicians. Ophthalmologists and other subspecialists should develop programs at
      the medical student level directed toward the education of primary care
      physicians, and should participate in the training of primary care physicians, as
      well as their own subspecialty residents. In the future, the primary care
      physician must be considered part of the "eye care team." Enhancing the
      ophthalmologic education of primary care physicians is in the best interest of
      quality patient care.

PMID- 7786212
TI  - A comparison of topical diclofenac with prednisolone for postcataract
      inflammation.
AB  - OBJECTIVE: To compare diclofenac sodium with prednisolone acetate for the control
      of postoperative inflammation after cataract surgery. DESIGN: Fifty-two patients
      undergoing phacoemulsification with posterior chamber intraocular lens
      implantation were randomly assigned to receive either 0.1% diclofenac eye drops
      or 1% prednisolone eye drops as their postoperative anti-inflammatory medication.
      The patients were examined 1 day (baseline), 1 week, and 1 month after surgery.
      Postoperative inflammation was evaluated subjectively by slit-lamp assessment of
      cell and flare and objectively by measurement of cell and flare with a laser cell
      and flare meter. RESULTS: At each visit, there was no statistically significant
      difference in postoperative inflammation either by slit-lamp assessment or with
      the laser cell and flare meter for the two treatment groups. CONCLUSION: In the
      dosage used, diclofenac was as effective an anti-inflammatory agent for
      uncomplicated post-cataract inflammation as prednisolone.

PMID- 7786213
TI  - Features of age-related macular degeneration in a black population. The Barbados
      Eye Study Group.
AB  - OBJECTIVE: To report on the frequency of features of age-related macular
      degeneration in a black population based on fundus photograph gradings. DESIGN:
      Population-based study. SETTING: Barbados, West Indies. STUDY POPULATION:
      Residents of Barbados, selected by a random sample of Barbados-born citizens,
      aged 40 to 84 years. MAIN OUTCOME MEASURE: Gradings from 30 degrees stereoscopic
      macular photographs. RESULTS: Black participants (n = 3444) completed
      examinations at the study site and had gradable macular photographs in both eyes.
      Drusen larger than 63 microns occurred with comparable frequency in men and
      women. The frequency of small drusen decreased with age, while medium and large
      drusen were more common in older participants. Frequencies of all age-related
      macular degeneration-related characteristics were similar for men and women
      except for small drusen, which occurred more commonly in women. Confluent drusen
      and pigment atrophy also increased significantly with age. Exudative features
      occurred in 0.5% of the participants. CONCLUSIONS: This study provides population
      based data on the frequency of features of age-related macular degeneration based
      on photographic gradings of a black population. Features of early age-related
      macular degeneration were common, but appeared at a lower frequency than has been
      reported for white populations. Exudative disease was infrequent, occurring in
      about one of 200 participants.

PMID- 7786210
TI  - Socioeconomics viewpoint: the need for an update of the clinical practice
      guideline on cataract.
AB  - In June 1994, the Agency for Health Care Policy and Research (AHCPR), Washington,
      DC, called a meeting to hear opinions on the need for a reconstituted panel to
      revise the recently published clinical practice guideline Cataract in Adults:
      Management of Functional Impairment. The need and timing of a revision depend
      essentially on the answer to two questions: (1) Are there serious flaws in the
      previous panel's work that would necessitate a re-review? or (2) Is there new
      scientific information that can be critically assessed that would substantially
      alter the recommendations of the guideline? It is important to consider these
      questions with care because any revision is likely to be both costly and time
      consuming.

PMID- 7786214
TI  - Sudden visual loss associated with sexual activity.
AB  - OBJECTIVE: To characterize the ocular fundus findings of patients who suffered
      sudden visual loss associated with sexual activity. DESIGN: Case series. SETTING:
      Outpatient ophthalmic practice. PATIENTS: Six patients presented with a
      precipitous decrease in vision in one eye with no apparent predisposing factors.
      After obtaining a careful history, each patient revealed that he or she had been
      engaging in rigorous sexual activity immediately before experiencing the visual
      loss. INTERVENTION: Five of the six patients were followed up without
      intervention. One patient required prophylactic laser photocoagulation of a
      retinal tear to decrease the risk of retinal detachment. RESULTS: Six patients
      aged 24 to 53 years suffered sudden loss of vision secondary to intraretinal,
      preretinal, or vitreous hemorrhaging. Visual acuity in the affected eyes ranged
      from a mild decrease (20/40) to profound visual loss (counting fingers at 6 in).
      Five of the six patients were followed up for at least 1 month and showed
      spontaneous improvement in vision as the blood cleared. Those who returned for
      long-term follow-up enjoyed complete visual recovery without any sequelae.
      CONCLUSIONS: Sudden debilitating visual loss may occur during sexual activity
      from the rupture of retinal blood vessels in the macular region or from the
      development of vitreous bleeding from an induced retinal tear. The long-term
      prognosis after such hemorrhaging appears to be excellent, with good visual
      recovery occurring as the blood resorbs spontaneously.

PMID- 7786215
TI  - Dietary fat and age-related maculopathy.
AB  - OBJECTIVE: To describe the relationship between type and level of fat in the diet
      and the prevalence of age-related maculopathy. DESIGN: Retrospective population
      based study. SETTING AND PARTICIPANTS: Residents of Beaver Dam, Wis, between the
      ages of 45 and 84 years, participating in the Beaver Dam Eye Study and
      Nutritional Factors in Eye Disease Study. DATA COLLECTION: Presence and severity
      of age-related maculopathy were determined from masked grading of fundus
      photographs taken from 1988 through 1990. Diets in the past (1978 through 1980)
      were assessed retrospectively using a food frequency questionnaire during in
      person home interviews. RESULTS: Persons with intake of saturated fat and
      cholesterol in the highest compared with the lowest quintile had 80% and 60%
      increased odds for early age-related maculopathy, respectively, after adjusting
      for age and intake of beer. These relationships were not influenced by adjusting
      for several other potential confounding variables (carotenoid intake, intake of
      vitamins C or E in supplements, smoking, body mass index, time spent outdoors in
      the summer, gender, and history of diabetes, hypertension, or cardiovascular
      disease). Odds ratios for late age-related maculopathy were in similar directions
      but were not statistically significant. CONCLUSIONS: High intake of saturated fat
      and cholesterol is associated with increased risk for early age-related
      maculopathy in the Beaver Dam population. This supports the hypothesis that
      atherosclerosis or its risk factors are related to age-related maculopathy.
      Confirmation of this finding in other populations and in prospective studies is
      needed.

PMID- 7786217
TI  - Outcome of corneal grafting with donor tissue from eyes with primary choroidal
      melanomas. A retrospective cohort comparison.
AB  - OBJECTIVES: To determine if melanomas have occurred in the recipients of corneas
      from donor eyes with primary choroidal melanomas and to determine the success of
      corneal grafting with tissue taken from eyes with primary choroidal melanomas.
      DESIGN: Retrospective cohort comparison and follow-up patient questionnaire.
      SETTING: A tertiary medical center in Rochester, Minn. PATIENTS: In patients who
      received corneal transplants, we reviewed 47 consecutive corneas transplanted
      from donor eyes enucleated for choroidal melanomas and compared them with 47
      corneal grafts from donor eyes without melanomas matched for recipient age (+/-
      10 years), date of operation (+/- 12 months), corneal storage time (+/- 24
      hours), and operation type. RESULTS: No melanomas occurred in either group over a
      mean follow-up of 5.4 years (range, 0.4 to 15 years). There was no significant
      difference between the two groups in corneal thickness and endothelial cell loss
      at 2 months and 1 year after transplantation and in the probability of a
      rejection episode. CONCLUSIONS: There is no evidence of tumor transmission by
      transplantation of corneas from donor eyes with primary choroidal melanomas.
      Corneas transplanted from donor eyes with primary choroidal melanomas have
      similar outcomes to corneas transplanted from donor eyes without melanomas.

PMID- 7786218
TI  - Keratoprosthesis with biocolonizable microporous fluorocarbon haptic. Preliminary
      results in a 24-patient study.
AB  - BACKGROUND: Most complications of a keratoprosthesis occur at the tissue-to
      implant interface. The ideal prosthesis would eliminate this interface by having
      the tissue actually grow into the supporting material. We present a prospective
      clinical human study of a novel biocolonizable keratoprosthesis in 24 eyes of 24
      patients. DESIGN: To promote implant stability, the 9-mm-diameter haptic was
      fashioned using a custom-made microporous fluorocarbon with a 4-mm-diameter, 2.67
      mm-long, central optic made of medical grade polymethylmethacrylate, giving a
      global visual field of 110 degrees to 130 degrees. Only bilaterally blind
      patients with untreatable corneal diseases were included in the study. The haptic
      was inserted into a lamellar pocket delaminated in the stroma, and the optic was
      positioned through a hole trephined in the central cornea. RESULTS: The average
      follow-up was 15.7 months (range, 4 to 28 months). The host corneal fibroblasts
      penetrated and proliferated into the peripheral microporous fluorocarbon and
      provided anchorage between the cornea and prosthesis. Seventeen patients (70.8%)
      had visual acuity improvements. Mean corrected final visual acuity was 20/100
      (range, 20/30 to 20/400). Five anatomic failures occurred in the first 6 months
      (three extrusions, one dislocation of the optic, and one endophthalmitis). We had
      one case (4.1%) of treatable glaucoma. We successfully removed four of five
      retroprosthetic membranes that had occurred. No retinal detachment occurred.
      CONCLUSION: The biocompatible inert microporous polymer did not eliminate all
      mechanical complications associated with a keratoprosthesis.

PMID- 7786216
TI  - The National Basketball Association eye injury study.
AB  - OBJECTIVE: To investigate the epidemiology of eye injuries sustained by
      professional basketball players in the National Basketball Association (NBA).
      METHODS: A prospective study involving all NBA athletes who sustained eye
      injuries between February 1, 1992, and June 20, 1993, was conducted. Twenty-seven
      NBA team athletic trainers, physicians, and ophthalmologists were provided data
      forms to complete for any player examined for an eye injury. Practice and game
      exposures during the preseason, regular season, playoffs, and championships were
      included. RESULTS: Of the 1092 injuries sustained by NBA players during the 17
      month period, 59 (5.4%) involved the eye and adnexa. Eighteen (30.5%) of the
      injuries occurred while the player was in the act of rebounding, and 16 (27.1%)
      while the player was on offense. The most common diagnoses included 30 abrasions
      or lacerations to the eyelid (50.9%), 17 contusions (edema and/or ecchymosis) to
      the eyelid or periorbital region (28.8%), and seven corneal abrasions (11.9%).
      There were three orbital fractures (5.1%). Most injuries were caused by fingers
      (35.6%) or elbows (28.8%). Nine players (15.3%) missed subsequent games because
      of their injury. Fifty-seven players (96.6%) were not wearing protective eyewear
      at the time of injury. CONCLUSIONS: The incidence of eye injuries in NBA players
      during the 17-month period was 1.44 per 1000 game exposures. Frequent physical
      contact in professional basketball players leaves them at great risk for
      sustaining eye injuries. To prevent these injuries, protective eyewear is
      recommended.

PMID- 7786219
TI  - The incidence of corneal abnormalities in the Silicone Study. Silicone Study
      Report 7.
AB  - OBJECTIVE: To determine factors that were prognostic of corneal abnormalities in
      eyes following surgery for severe proliferative vitreoretinopathy. DESIGN:
      Subgroup analysis of the Silicone Study. SETTINGS: Community and university-based
      ophthalmology clinics. MATERIALS: Eyes with attached maculae at the 24-month
      follow-up examination that did not have a pre-existing corneal abnormality.
      INTERVENTIONS: Vitrectomy surgery with long-acting gas or silicone oil. OUTCOME
      MEASURES: Epithelial and/or stromal edema, corneal opacity and/or previous
      corneal transplant. RESULTS: The incidence of corneal abnormalities at 24 months
      was 27% and did not differ significantly between treatment groups. Prognostic
      factors were preoperative aphakia or pseudophakia (P = .003), preoperative iris
      neovascularization (P = .006), reoperation (P = .001), the absence of a fluid/gas
      exchange (P = .03), corneal touch by silicone oil (P = .02), and the presence of
      aqueous cells (P = .009) or aqueous flare (P = .08). In a multivariate analysis,
      independent prognostic factors were iris neovascularization (relative risk [RR] =
      13.1), aphakia or pseudophakia (RR = 3.0), postoperative aqueous flare (RR =
      5.4), and reoperations (RR = 3.4). Corneal abnormalities were correlated with
      poor visual acuity and hypotony (P < .001). CONCLUSIONS: To our knowledge, this
      is the first study to document that the incidence rates of corneal abnormalities
      are equivalent between oil and gas. The incidence of corneal abnormalities in gas
      filled eyes was higher than expected, and remained high in oil-filled eyes,
      despite the use of an inferior iridectomy. Successful surgical repair of the
      retinal detachment with a single operation, and prevention and early management
      of corneal touch by silicone oil should help to prevent corneal abnormalities. If
      rubeosis iridis or severe aqueous flare is present, preoperative treatment with
      intense topical and possibly periocular steroids might reduce inflammation, which
      might mediate corneal damage.

PMID- 7786221
TI  - Epithelial inclusion cyst of the iris.
AB  - We describe the clinical presentation, high-frequency ultrasound biomicroscopic
      characteristics, and pathologic findings associated with a conjunctival inclusion
      cyst within the iris. The patient had undergone an uncomplicated extracapsular
      cataract extraction with posterior chamber intraocular lens insertion 9 months
      prior to presenting with a progressively enlarging iris mass. A clinical
      examination revealed a solid-appearing white tumor within the midiris stroma,
      accompanied by limbal-conjunctival hyperemia and anterior chamber inflammation.
      Ultrasound biomicroscopy revealed an egg-shaped solid iris stromal tumor that
      displaced the pigment epithelium. The mass was composed of three concentric
      layers of different echogenicity: a moderately reflective mantle, a less
      reflective middle zone, and a hyperreflective core. Within 3 days of initiation
      of topical corticosteroid therapy (prednisolone acetate, 0.5 mg per drop four
      times daily), the tumor enlarged and induced a plasmoid aqueous and a hypopyon.
      Histopathologic study revealed a conjunctival inclusion cyst with evidence of
      acute and chronic inflammation. We have found that the diagnosis of epithelial
      inclusion cyst within the iris can be aided by an ultrasound evaluation. This
      case also suggests that it may be preferable to excise these tumors prior to
      topical corticosteroid treatment.

PMID- 7786220
TI  - Prevalence of foveal lesions in type 1 and type 2 Usher's syndrome.
AB  - PURPOSE: To evaluate possible differences in the prevalence of clinically
      detectable foveal lesions between patients with type 1 and type 2 Usher's
      syndrome. METHODS: Records of 48 patients with type 1 and 98 patients with type 2
      Usher's syndrome were retrospectively evaluated for the presence of a foveal
      lesion. The age, gender, and racial distribution of patients were similar in the
      two subtypes. Two investigators reviewed fundus photographs from all patients
      and, when available, fluorescein angiograms. RESULTS: In the 48 patients with
      type 1 Usher's syndrome, 30 (62%) showed a clinically apparent atrophic- or
      cystic-appearing foveal lesion, whereas in the 98 patients with type 2 Usher's
      syndrome, 33 (34%) had either an atrophic- or a cystic-appearing foveal lesion.
      Logistic regression analysis showed that the probability of exhibiting a foveal
      lesion in both type 1 and type 2 Usher's syndrome increases with age and that
      patients with type 1 Usher's syndrome are more likely to have a foveal lesion
      than are patients with type 2 Usher's syndrome. CONCLUSIONS: Patients with type 1
      Usher's syndrome show a greater probability of having either an atrophic- or
      cystic-appearing foveal lesion than do patients with type 2 Usher's syndrome.
      This higher prevalence of foveal lesions is consistent with a previous
      observation that the severity of visual acuity impairment with age is greater for
      patients with type 1 than type 2 Usher's syndrome. These data are useful in
      counseling such patients as to their prognosis for central visual function.

PMID- 7786222
TI  - Calcific phacolysis. Salvageable vision following treatment.
AB  - Calcific phacolysis has been previously described histopathologically in the
      enucleated eyes of three patients with unilateral posttraumatic total blindness.
      Each eye showed dissolution of a mature cataractous lens with dispersion of
      calcific lens material throughout the globe. We studied a patient in whom the
      signs of calcific phacolysis developed 19 months following intraoperative
      dislocation of a cataract into the vitreous. Partial removal of calcific
      particles was achieved by subtotal vitrectomy and lensectomy, with subsequent
      penetrating keratoplasty. Corneal histopathological findings showed a deposition
      of calcified lens particles between Descemet's membrane and retrocorneal fibrous
      membrane. Despite diffuse retinal calcification, the patient's visual acuity was
      20/400. To our knowledge, this is the first report of calcific phacolysis
      occurring after surgical dislocation of a cataract into the vitreous and wherein
      treatment resulted in some preservation of vision. Early diagnosis and aggressive
      therapy may improve the visual prognosis in this condition.

PMID- 7786223
TI  - Retinoblastoma. Cell of origin.
AB  - OBJECTIVES: To apply modern techniques of molecular cell biology and to revisit
      the old question of the cell of origin for retinoblastoma in hopes of gaining a
      better understanding of the retinoblastoma gene's antioncogenic mechanisms.
      METHODS: Twenty-two consecutively accessed retinoblastomas were examined with
      immunocytochemical techniques for numerous retinal proteins. Both single and
      double labeling were used. Enzyme histochemistry for carbonic anhydrase was used
      as well. RESULTS: Differentiated areas of the tumors contained abundant
      Mullerlike cells. Fleurettes stained mostly for red and green cone-specific
      antibodies while features of blue cones and rods predominated in areas with high
      cytoplasmic-to-nuclear ratios but no fleurettes. All of the differentiated
      neoplastic cells were either photoreceptors or Muller's cells. No other retinal
      cell types were found. CONCLUSIONS: The cells of retinoblastoma are capable only
      of bipotential differentiation, ie, Muller's cells and photoreceptors. Given this
      and recent findings concerning retinal embryogenesis, we argue for the rod
      photoreceptor as the cell of origin. A possible role for the retinoblastoma gene
      product is discussed.

PMID- 7786225
TI  - Progressive enlargement of a choroidal osteoma.

PMID- 7786224
TI  - Viability of human corneal endothelium following Optisol-GS storage.
AB  - OBJECTIVES: To evaluate endothelial viability of human corneas stored in glass
      vials and in viewing chambers (Alcon) for extended periods, and to compare
      endothelial viability of Optisol-GS-stored corneas with corneas excised from
      moist chamber-stored globes. METHODS: Endothelial viability was assessed using
      two staining techniques. Endothelium from stored corneas was stained with trypan
      blue combined with alizarin red S or stained with calcein AM-ethidium homodimer.
      Both techniques were used to determine which method is a more sensitive indicator
      of cytotoxic change. RESULTS: Corneas stored 4 to 21 days in Optisol-GS had a
      rate (mean +/- SE) of endothelial cell damage of 0.57% +/- 0.30% per day in vials
      and 0.69% +/- 0.27% in chambers. After storage intervals from 4 to 21 days, the
      Optisol-GS endothelium had an average decrease in viability of 9.5% to 16%. The
      endothelium of moist chamber eyes had a 44% to 59% decrease in viability after 2
      to 5 days. After 24 hours, corneal endothelium of moist chamber eyes had less
      than 15% decrease in viability. Optisol-GS corneas stored for 35 to 56 days had
      greater than 50% decrease in endothelial viability. After 67 days, 95% to 100% of
      endothelial viability was lost. CONCLUSIONS: Corneas stored in Optisol-GS through
      21 days at 4 degrees C maintain a high percentage of viable endothelial cells.
      There was no significant difference of endothelial viability between corneas
      stored in glass vials or in viewing chambers (Alcon). A 50% loss of endothelial
      viability occurred in moist chamber-stored corneas after 2 days and by 35 days in
      corneas stored in Optisol-GS.

PMID- 7786226
TI  - Use of intravitreal autologous blood to identify posterior cortical vitreous in
      macular hole surgery.
AB  - Surgical management of macular holes involves removal of tractional prefovial
      vitreous cortex. Accurately identifying this adherent tissue can potentially
      decrease intraoperative complications. A new, effective technique using
      autologous whole blood can be used to identify and facilitate separation of the
      posterior cortical vitreous.

PMID- 7786227
TI  - An eye for an eye. A simplified model for teaching.
AB  - We developed an easily constructed, inexpensive eye model that consists of a
      Styrofoam head carved out to house a slide holder, a wide-angle, clinical
      photographic fundus slide, a plastic face, and an anatomically correct eye. The
      model can be used by students and residents to learn direct and indirect
      ophthalmoscopy, fundus photography, and laser photocoagulation. This model gives
      students and residents a realistic learning experience without inconveniencing or
      endangering patients.

PMID- 7786228
TI  - Genetic and environmental influences on facial profile.
AB  - Observed variation in facial morphology results from the influences of both
      genetic and environmental factors. To investigate the role of genetic influences
      on variation in facial profile, lateral photographs of 23 male and 19 female
      monozygous (MZ), and 15 male and 22 female dizygous (DZ) twin pairs were selected
      from the records of the South Australian Twin Study. Soft tissue landmarks and
      facial profiles were identified, traced and digitized. Linear and angular
      measures defined by the landmarks were calculated and a series of Fourier
      functions derived to describe the facial profiles. These Fourier amplitudes were
      interpreted in terms of the specific regions which they represented. Correlations
      within MZ pairs were consistently higher than within DZ pairs for both the facial
      dimensions and the Fourier amplitudes, providing evidence of significant genetic
      contribution to facial convexity, facial height and facial depth. Variability in
      nose and lip morphology appeared to be under stronger environmental influence.

PMID- 7786230
TI  - Extrusion of root-filled incisors in beagles--a light microscope and scanning
      electron microscope investigation.
AB  - The response of the periodontal ligament to orthodontic extrusion of the incisor
      of a beagle was examined with light microscope and scanning electron microscope
      techniques. The ligament morphology was slightly altered by the procedure but was
      essentially normal. Teeth that were extruded and retained for 12 weeks exhibited
      partial relapse. Where a full thickness mucogingival flap was raised and
      immediately replaced in lieu of retention, continued extrusion was observed. Root
      resorption was observed at the interproximal region of the cervical third in
      three out of five specimens. The resorption had been repaired with cellular
      cementum.

PMID- 7786229
TI  - Donor variability in the proliferation of human dental pulp fibroblasts.
AB  - Fibroblasts were isolated from human dental pulps of healthy third molars from 49
      donors of ages ranging from 17 to 68. Significant variability was noted in the
      success of obtaining primary cultures from these pulps. Variability between the
      various cultures was also observed in the reliability of maintaining subcultures
      of the primary cultures as well as recovery from frozen stocks of established
      cell lines. Of the original 49 explant cultures studied, only three survived long
      term passage and freezing. In addition to difficulties and variability in
      establishing cell lines, the human pulp fibroblasts also showed great variability
      in proliferative activity which could not be accounted for by donor age, source,
      or passage number. These findings highlight significant difficulties in
      establishing reliable human pulp fibroblast cultures and the need for great care
      in interpreting any in vitro data.

PMID- 7786231
TI  - Degradative enzymes of oral streptococci.
AB  - Members of the Streptococcus sanguis group (SSG) and Streptococcus milleri group
      (SMG) were screened for their ability to produce glycosidase, arylamidase
      (peptidase), protease, dextranase and glycosyltransferase activities. Species
      within each group produced unique patterns of activity. The most commonly
      produced glycosidases were beta-D-glucosidase, beta-D-galactosidase, N-acetyl
      beta-D-glucosaminidase and N-acetyl-beta-D-galactosaminidase and the least
      commonly produced glycosidase activity was beta-fucosidase with Streptococcus
      intermedius (SMG) being the only species capable of producing the activity. For
      arylamidase activity, the most commonly produced type was lysine-arylamidase.
      Glycosidase and arylamidase activities were localized to particular sub-cellular
      fractions. alpha-galactosidase was found only in culture supernatant fluids
      whereas N-acetyl-beta-D-glucosaminidase was found in all fractions; the culture
      supernatant, cell wall, cell membrane and cytoplasm. No arylamidase activity was
      seen in culture supernatants. Phe-arg-arylamidase was found only in cytoplasmic
      fractions whereas val-pro-argarylamidase was found in cell walls, cell membranes
      and cytoplasmic fraction. Protease activity was measured as the degradation of
      bovine serum albumin (BSA) and casein. Casein was degraded by a number of strains
      whereas no species/strains were able to degrade BSA. Streptococcus intermedius,
      Streptococcus constellatus (SMG), Streptococcus mitior and Streptococcus
      defectivus (SSG) were the only species that produced hyaluronidase and no species
      produced chondroitin sulphatase. The groups were also examined for their
      abilities to produce glycosyltransferase and dextranase. Strep. sanguis,
      Streptococcus gordonii, Streptococcus mitis and Streptococcus oralis produced
      glucosyltransferase and, with the exception of the latter species,
      fructosyltransferase. No species within the SMG was capable of producing either
      glycosyltransferase.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786232
TI  - Mouthguard protection in sports injury.

PMID- 7786233
TI  - Effects of splint therapy in TMJ dysfunction: a study using magnetic resonance
      imaging.
AB  - This pilot study was undertaken to correlate clinical and MRI diagnoses in seven
      symptomatic TMJ dysfunction patients and to account, if possible, for the
      clinical improvement in the signs and symptoms after the use of a maxillary
      stabilizing splint. The symptomatic TMJs were evaluated by means of MRI prior to
      splint insertion. Sagittal open/closed, and coronal closed images were obtained
      with a 0.3 T Fonar MR Scanner. A follow-up MRI was taken after three months of
      splint therapy for the purposes of a comparative study. All subjects responded
      positively even at the early phase of splint treatment. By the end of the three
      month period, six subjects experienced full remission of pain in the TMJ and
      associated masticatory muscles with one subject experiencing only partial
      remission following therapy. Baseline MRI study revealed that only three subjects
      had anterior disc displacement while the other four subjects had normal
      disc/condyle relationships and morphology. In the follow-up MRI study, there were
      no signs of recapture of the three anteriorly displaced discs despite there being
      evidence of improved jaw movement and remission of pain symptoms. The use of MRI
      in this preliminary study indicates that some but not all TMJ pain dysfunction
      syndromes are caused by internal derangements of the joint. A larger MRI study
      using the same clinical parameters is indicated for future research.

PMID- 7786234
TI  - A comparison of the effects of Nd:YAG and Ho:YAG laser irradiation on dentine and
      enamel.
AB  - This preliminary study was undertaken to investigate the effects of Nd:YAG and
      Ho:YAG lasers on enamel and dentine of extracted teeth. The Ho:YAG laser (spot
      size 250 microns, energy density 4160 J/cm2) produced a cleaner puncture in
      dentine with less melting of the surrounding tissue than did the Nd:YAG laser
      (spot size 20 microns), energy density 50,000 J/cm2), which produced considerable
      melting and recrystallization of dentine and was more difficult to control. It
      was possible to cut enamel and dentine with both lasers, but considerable melted
      and recrystallized enamel was produced. From the limited observations of this
      study it appears that the Ho:YAG laser is more suitable for cutting both enamel
      and dentine than the Nd:YAG laser. More work needs to be done to ascertain the
      effect on enamel and dentine of modification of the parameters of both lasers.

PMID- 7786235
TI  - The choice of irrigant during hand instrumentation and ultrasonic irrigation of
      the root canal: a scanning electron microscope study.
AB  - The purpose of this study was to investigate the use of 4 per cent sodium
      hypochlorite and 15 per cent EDTAC, either alone or in conjunction, as irrigants
      during hand instrumentation and ultrasonic irrigation of the root canal. Thirty
      six extracted human teeth, each with a single, straight root 21-25 mm long were
      hand-instrumented through a clinical access cavity to file size 40. One
      millilitre of the test irrigant was used after each instrument size. Canal
      debridement was completed with an intermittent flush irrigation technique with
      one or both of the test irrigants activated by ultrasound at a medium effective
      power output. The specimens were sectioned longitudinally, viewed in a scanning
      electron microscope and scored for the presence or absence of debris and smear
      layer at levels less than 1 mm, 5 mm, and 10 mm from the apical seat. Under the
      conditions of this experiment the most effective regime was irrigation with 1 mL
      EDTAC after each instrument size, followed by two 30 second exposures to
      ultrasound+EDTAC then four 30 second exposures to ultrasound + 4 per cent sodium
      hypochlorite. The specimens in this group were free from retained pulp tissue and
      superficial smear layer, had the lowest debris scores at the < 1 mm and 5 mm
      levels, and the lowest total debris score. All of the techniques tested produced
      smear-free canals at the 10 mm level.

PMID- 7786236
TI  - Oral Candida albicans from patients infected with the human immunodeficiency
      virus and characterization of a genetically distinct subgroup of Candida
      albicans.
AB  - Candida albicans has been shown to vary in its phenotypic expression with the
      progression of human immunodeficiency virus (HIV) infection. This study was
      designed to investigate whether in Category IV HIV infected patients (CDC,
      Atlanta, USA) these phenotypic changes were related to changes in the genetic
      strain of the organism. Isolates of C. albicans were obtained from 45 patients
      with HIV infection during the progression of their disease as determined by
      percentage T4 lymphocyte count. Isolates were strain differentiated using two
      methods. In 67 per cent of the patients a single strain of C. albicans, as
      determined by the DNA analysis, was isolated from each individual over the
      experimental period. The phenotypic expression of the genetically identical
      strains isolated from each patient varied considerably over the experimental
      period with the morphotype 754 being predominant. These results showed that the
      genotype of C. albicans isolated persisted in the majority of HIV infected
      individuals, but that the phenotypical expression of this strain changed. A
      finding in this study was that 18 strains of C. albicans had DNA which did not
      hybridize to the probe used. These strains were analysed for the presence of two
      other C. albicans specific DNA segments using PCR. The probe 27A hybridizing
      strains yielded PCR products which differed from the non-hybridizing strains.
      Five of these genetically atypical C. albicans strains and 98 of the C. albicans
      strains were then analysed for purported virulence factors.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7786237
TI  - A questionnaire survey of dentists regarding knowledge and perceived competence
      in resuscitation and occurrence of resuscitation emergencies.
AB  - Little information has been published on the knowledge and perceived competence
      of dentists in resuscitation or the occurrence of resuscitation emergencies in
      dental practice. Further, no such surveys have been done in Australia. A postal
      survey was therefore devised and the names of 350 dentists were randomly selected
      from the Australian Dental Association national membership registry. The response
      rate was approximately 45 per cent and the main results included: just under half
      of the respondents felt they were competent in basic resuscitation at the time of
      graduation, that is, in expired air resuscitation (EAR) and cardiopulmonary
      resuscitation (CPR); just less than two-thirds had undertaken resuscitation
      training since graduation; about three-quarters felt they would be able to
      perform EAR and almost two-thirds felt they would be able to perform CPR; almost
      90 per cent gained a satisfactory score in a Resuscitation Quiz included in the
      survey; and just over 5 per cent had had to resuscitate a patient.

PMID- 7786238
TI  - Smoking-related beliefs and behaviour among adults with asthma in a
      representative population sample.
AB  - BACKGROUND: Smoking and exposure to environmental tobacco smoke are inadvisable
      for adults with asthma. AIMS: To determine the smoking prevalence and daily
      smoking rate of asthmatics and compare smoking-related beliefs and behaviours
      among smokers with and without asthma. To compare beliefs of asthmatics about
      passive smoking and asthma, how many are exposed at home and what they do when
      they are exposed, with people who do not have asthma. METHODS: A representative
      population survey of 3019 South Australian adults aged 15 years and older
      interviewed in their own homes in late 1992. RESULTS: Twenty-eight per cent of
      asthmatics were smokers; mean daily smoking rate was 17.6. Asthmatics had similar
      patterns of smoking, readiness to quit and quit attempt histories as people
      without asthma. More than 40% of smokers with asthma did not perceive that
      smoking had greatly affected their health, over half did not believe they were at
      risk in future and two-thirds did not think future health problems would be
      serious. Among non-smokers, despite being more convinced of the effects of
      passive smoking on asthma, and being more concerned about exposure, those with
      asthma were no more likely to take protective action in response to actual or
      imminent exposure than those without asthma. One in ten non-smokers with asthma
      were exposed to smoking at home. CONCLUSIONS: The smoking habits of adults with
      asthma are cause for concern, with many asthmatic smokers perceiving they are not
      personally at risk from their smoking. Health education principles should be used
      by health professionals caring for asthmatic smokers to guide the selection and
      delivery of smoking cessation strategies. Prevailing restrictions on indoor
      smoking play an important role in protecting the respiratory health of non
      smokers with asthma.

PMID- 7786240
TI  - Comparative hospitalisation and mortality rates of aboriginal and non-aboriginal
      Western Australians in their sixth and seventh decades.
AB  - BACKGROUND: Aboriginals have higher hospitalisation and mortality rates and die,
      on average, about 15 years earlier than non-Aboriginals in Western Australia
      (WA). AIMS: To investigate Aboriginal morbidity and mortality rates in WA in
      comparison with the rest of the population, with particular reference to the ages
      of 50 to 65 years. METHODS: Mortality rates from 1983-1989 inclusive for
      Aboriginals and non-Aboriginals in WA were compared. Major causes of Aboriginal
      mortality in males and females were matched to the ages at which similar rates
      from the same causes occurred in non-Aboriginals. Rate ratios (Aboriginal:non
      Aboriginal) for causes of death at ages 60-64 years were determined.
      Hospitalisation rates for Aboriginal and non-Aboriginal people aged 50-64 years
      in WA in 1988 were used to estimate hospitalisation rate ratios. RESULTS:
      Hospitalisation rates in WA were much higher among 50 to 64 year old Aboriginals
      than non-Aboriginals for most diseases, particularly for infectious and parasitic
      diseases, and injury and poisoning. Admissions for circulatory diseases were
      double to four times as frequent among Aboriginals. The main causes of deaths in
      Aboriginal males were circulatory diseases, injury and poisoning, respiratory
      diseases, neoplasms, and digestive diseases; in Aboriginal females the main
      causes of deaths were circulatory diseases, neoplasms, diabetes, respiratory
      diseases, and injury and poisoning. Except for neoplasms, deaths from these
      causes occurred among 50-54 year old Aboriginals at rates that were experienced
      by non-Aboriginal people ten to 30 years later in life. These results underline
      special needs of the Aboriginal population that have not been adequately met by
      appropriate services.

PMID- 7786239
TI  - Application of the Poincare plot to heart rate variability: a new measure of
      functional status in heart failure.
AB  - BACKGROUND: Conventional methods of quantifying heart rate variability using
      summary statistics have shown that decreased variability is associated with
      increased mortality in heart failure. However, many patients with heart failure
      have arrhythmias which make the 'raw' heart rate variability data less suitable
      for the use of summary statistical measures. AIMS: To examine the clinical
      potential of a new measure of heart rate variability data, presented by the
      Poincare plot pattern, as an adjunct to the summary statistical measures of R-R
      interval variability. METHODS: We used the Poincare plot pattern to display beat
      to-beat heart rate variability data from a group of 23 patients with heart
      failure and compared them with data collected from 20 healthy age-matched control
      subjects. The data, which consists of 2000 consecutive R-R intervals, were
      gathered over 20-40 minutes while the subjects rested supine in a quiet darkened
      room. RESULTS: The morphological classification scheme proposed reflected the
      functional status of patients in heart failure. There was a significant
      difference (chi-square = 27.5, p < 0.0001) in the different pattern types between
      patients with NYHA Class I and II compared to patients with NYHA Class II and IV.
      All healthy subjects displayed a 'cluster' type of pattern characterised by
      normally distributed data. Sixteen of the 23 patients in heart failure also
      produced data which were normally distributed but the remaining seven produced
      data which required careful filtering to make them suitable for analysis using
      summary statistics, but which could be analysed by the Poincare plot.
      CONCLUSIONS: The Poincare plot pattern is a semi-quantitative tool which can be
      applied to the analysis of R-R interval data. It has potential advantages in that
      it allows assessment of data which are grossly non-Gaussian in distribution, and
      is a simple and easily implemented method which can be used in a clinical setting
      to augment the standard electrocardiogram to provide 'real time' visualisation of
      data.

PMID- 7786242
TI  - A prospective study of screening upper gastrointestinal (GI) endoscopy prior to
      and after bone marrow transplantation (BMT).
AB  - BACKGROUND: Upper gastrointestinal (GI) endoscopic abnormalities are common in
      symptomatic bone marrow transplant (BMT) recipients but the incidence of occult
      gastrointestinal disease in these patients is unknown. AIMS: To examine the role
      of screening upper GI endoscopy before and after BMT. METHODS: Endoscopy was
      performed routinely on allogeneic (n = 24) and autologous (n = 17) BMT patients
      before transplant and at 30 and 120 days after transplant. RESULTS: Twenty-one of
      41 patients (51%) had an endoscopic abnormality on one or more occasions which
      necessitated a change in treatment. These abnormalities were present in ten of 41
      (24%) pre-transplant endoscopies, ten of 32 (31%) endoscopies at day 30 after
      BMT, and in seven of 22 (32%) day 120 endoscopies. Abnormalities included mucosal
      erosions or ulcers n = 22 endoscopies), infections (n = 5) or previously
      undiagnosed GI graft-versus-host disease (n = 3). Mucosal erosions or ulcers were
      present in eight of 28 endoscopies despite regular anti ulcer drug therapy.
      CONCLUSIONS: Screening upper GI endoscopy before and after BMT is generally safe
      and detects a high yield of significant GI abnormalities. However, it remains to
      be demonstrated that treatment of these lesions will improve the clinical outcome
      in BMT recipients without GI symptoms.

PMID- 7786241
TI  - Smoking more--enjoying the asthma.

PMID- 7786244
TI  - Anti-neutrophil cytoplasmic antibodies (ANCA) and renal diseases.

PMID- 7786243
TI  - Treatment of haemophilia A by continuous factor VIII infusion.

PMID- 7786246
TI  - Doctoring the planet: health effects of global change.

PMID- 7786245
TI  - The use of a highly purified factor IX (FIX) concentrate in patients with
      'haemophilia B' undergoing surgery.

PMID- 7786247
TI  - A quantification of alcohol-related mortality in New Zealand.
AB  - BACKGROUND: There are no published New Zealand (NZ) studies on alcohol drinking
      and total mortality, despite its importance to alcohol health policy. AIMS: To
      estimate the proportion of NZ deaths caused or prevented by alcohol drinking.
      METHODS: The proportion of current alcohol drinkers from recent NZ surveys, and
      pooled relative risks from a review of the international literature on alcohol
      and mortality, were used to calculate disease-specific population attributable
      risks. The number of deaths caused (or prevented) by alcohol were calculated for
      1987 New Zealand deaths. Person-years of life lost (or saved) were calculated
      using recent NZ life tables. RESULTS: The association between alcohol and total
      mortality was related to age. Alcohol was estimated to have caused 3.0% of all
      deaths among 0-14 year olds and 20.1% of deaths among 15-34 year olds, mostly
      from road injuries. In contrast, alcohol was estimated to have prevented 0.5% of
      all deaths among 35-64 year olds and 3.4% of deaths among > or = 65 year olds due
      to its protective effect against coronary heart disease. For all age groups,
      alcohol was estimated to have prevented 1.5% of deaths. However, the number of
      person-years of life lost among ages less than 35 years was greater than those
      saved in the older age groups, so that alcohol was estimated to have caused the
      loss of 9525 person-years of life for all ages combined. CONCLUSIONS: The adverse
      effects of alcohol on total mortality are confined to age groups less than 35
      years. Public health policy to minimise deaths from alcohol should be
      concentrated on this group.

PMID- 7786248
TI  - Trigeminal sensory neuropathy induced by interferon-alpha therapy.

PMID- 7786249
TI  - Stroke among Australian aboriginals in Perth, WA, 1988-1992.

PMID- 7786250
TI  - Disseminated histoplasmosis: successful maintenance therapy with oral
      fluconazole.

PMID- 7786251
TI  - Severe salicylate poisoning associated with the intake of Chinese medicinal oil
      ('red flower oil')

PMID- 7786253
TI  - Anaphylactic reaction to intravenous cyclophosphamide.

PMID- 7786254
TI  - Interaction of 5-fluorouracil with folates.

PMID- 7786252
TI  - Acute renal failure due to sulphadiazine in a patient with acquired
      immunodeficiency syndrome (AIDS)

PMID- 7786255
TI  - Cytomegalovirus appendicitis in a patient with acquired immune deficiency
      syndrome (AIDS)

PMID- 7786257
TI  - Helicobacter pylori in peptic ulcer disease.

PMID- 7786256
TI  - Asthma spoils from polyunsaturated oils?

PMID- 7786258
TI  - The Royal Australasian College of Surgeons and trauma care.
AB  - This presentation is an account of the involvement of the Royal Australasian
      College of Surgeons in trauma care over the past 25 years. In October 1969 a 3
      day seminar was held at the College entitled 'The Management of Road Traffic
      Casualties'. This was in response to an increasing demand for the College to
      combat the devastating effects resulting from road traffic accidents. By the mid
      60s road trauma in Australia and New Zealand, as seen in other fully motorized
      countries, had reached epidemic proportions. Those directly involved in the care
      of surgical emergencies were aware of the frequency and severity of road trauma
      which was striking all sections of the community. Unlike the USA, Australia was
      not troubled by a high incidence of penetrating injuries due to guns and knives.

PMID- 7786260
TI  - Bone scanning in the multiply injured patient.
AB  - A prospective study was undertaken to evaluate the role of radionuclide bone
      scanning in the management of patients with multiple injuries. During a 7 month
      period, 14 patients with multiple injuries underwent a bone scan in order to
      identify occult skeletal injuries. All of the patients had new injuries
      diagnosed. The majority of new injuries occurred either in a limb in which an
      injury had already been diagnosed at presentation, or in the chest. Such findings
      are consistent with previously published data. Infrequently, there was a change
      in management of the patients in this series following the bone scan.

PMID- 7786259
TI  - Hepatic artery chemotherapy for colorectal liver metastases.
AB  - Fifty per cent of patients with colorectal cancer develop hepatic metastases but
      only a minority are candidates for potentially curative surgical resection.
      Hepatic artery chemotherapy (HAC) has been used to treat patients with non
      resectable metastases confined to the liver. Although response rates to HAC have
      been shown to be higher than response rates to systemic chemotherapy, the
      advantage in terms of survival has been debated. Furthermore, HAC requires
      surgical catheter placement which adds to the cost and morbidity of treatment.
      There have now been eight prospective randomized trials of HAC vs intravenous
      chemotherapy and/or supportive therapy. The present paper analyses the results of
      these trials with particular reference to survival. Surgical morbidity, treatment
      related toxicity and cost are also discussed.

PMID- 7786261
TI  - Penetrating thoracoabdominal injuries with arrows: experience with 63 patients.

PMID- 7786262
TI  - The influence of other diseases upon the outcome of colorectal cancer patients.
AB  - Little attention may be paid during follow up of colorectal cancer patients to
      other medical problems because the follow up is normally focused upon the
      diagnosis of recurrence and the detection of metachronous neoplasms. Attention
      directed at improving the medical condition of patients would be justified if it
      were shown that other diseases had a significant effect upon survival. Review of
      a selected consecutive series of 207 patients included collection of data about
      variables relating to demography, pathology, presentation, smoking, present and
      past health, performance, surgery, complications, length of stay, mortality,
      follow up and cause of death. Significance of relationships between medical and
      surgical problems and the outcome was determined by analyses of variation.
      Medical problems were present in 79% of patients; correlated with advancing age.
      Medical problems were not associated with complications, or with inpatient death.
      Previous cerebrovascular accident, dementia, limited mobility and increasing
      numbers of problems were associated with prolonged stay. Prolongation of stay,
      however, was related mainly to surgical complications. Smoking, which was present
      in 50% of patients, did not alter performance status, stage or substage, stay or
      survival significantly. Smoking and respiratory complications were associated
      significantly. Patients with heart or peripheral vascular disease had
      significantly poorer survival (P = 0.007) than those without those problems.
      Survival was reduced significantly for patients known to have diabetes,
      cardiovascular and cerebrovascular disease and limited mobility. Other malignant
      neoplasms were responsible for 18% of deaths which were unrelated to colorectal
      cancer. Residual or recurrent colorectal cancer had a more rapid adverse
      influence upon outcome than did medical problems.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7786264
TI  - A comparative study of two types of latex surgical gloves in elective orthopaedic
      surgery.
AB  - Glove perforation during surgery represents a potential risk of infection for the
      surgeon. The authors postulated that thicker latex gloves may offer greater
      protection. The perforation rates for the Ansell Gammex glove and the thicker
      Baxter Triflex gloves were compared in single- and double-glove usage and no
      difference was found between the two brands, in either usage. The authors
      recommend double-gloving for all orthopaedic operations with regular glove
      changes during major procedures.

PMID- 7786263
TI  - 99mTechnetium labelled leucocyte scanning in acute lower abdominal pain: can it
      reduce the negative appendectomy rate?
AB  - While the incidence of 'negative' appendectomy has long been justified as a
      necessary evil in the management of acute appendicitis, attempts to improve
      diagnostic accuracy have met with mixed results. In a prospective study of 34
      selected patients who presented with acute lower abdominal pain the potential
      role of 99mTechnetium labelled leucocyte scanning in the diagnosis of acute
      appendicitis has been evaluated. Patient management was not based on the result
      of the nuclear scan. The clinical outcome was correlated with the scan diagnosis.
      There was one false positive and one false negative scan result with respect to
      the clinical diagnosis of appendicitis yielding a sensitivity of 90% and a
      specificity of 96%. 99mTechnetium labelled leucocyte scanning may have an
      important role in the assessment of selected patients presenting with acute lower
      abdominal pain.

PMID- 7786265
TI  - Limb length discrepancy in congenital talipes equinovarus.
AB  - A retrospective analysis was performed to establish the prevalence and clinical
      significance of limb length discrepancy in congenital talipes equinovarus. Of 536
      patients with the diagnosis of congenital talipes equinovarus, 259 were
      unilaterally affected and 277 bilaterally affected. Fifty-eight patients were
      identified with limb length discrepancy greater than 0.5 cm. Forty-six patients
      had unilateral foot deformity and in 12 cases that was bilateral. This
      represented a prevalence of documented limb length discrepancy in 18% of
      unilateral cases and 4% of bilateral cases. The discrepancy resulted in a
      surgical procedure to equalize the limb lengths in fourteen unilateral cases
      (5%). A further six unilateral cases were deemed likely to require limb length
      equalization, increasing the rate to 8%. Only three bilateral cases required or
      will require surgery for equalization (1%). There was a weak but significant
      correlation between the number of operations undergone and the magnitude of
      discrepancy. The tibia was as important in its contribution to the shortening in
      these patients as the foot. A total of 89% unilateral cases studied had at least
      0.3 cm of tibial shortening and 43% had ipsilateral femoral shortening of at
      least 0.3 cm.

PMID- 7786266
TI  - V-Y advancement hamstring myocutaneous island flap repair of ischial pressure
      ulcers.
AB  - Thirty-seven ischial pressure ulcers were repaired in 27 patients (eight
      quadriplegic, 19 paraplegic) between 1988-1993 using the V-Y advancement
      hamstring myocutaneous island flap. Twenty-one ulcers (57%) arose de novo and 16
      were recurrent, with five patients having bilateral ulcers. The average duration
      of the ulcer was 5 months (range 1-30). All ulcers extended through the deep
      fascia (clinical grade IV), with the average diameter being 4.7 cm (range 2-10).
      There were four major flap complications (11%). All but one of the ulcers healed
      at discharge (97%). Mean follow up was 20 months (range 5-54) in 21 patients
      (78%), with six patients being lost to follow up. Seven of the 21 (33%) patients
      developed recurrent ulcers, with four of these having flap re-advancement with
      successful healing, and one patient having two re-advancements. Overall, 18 of
      the 21 (86%) patients with follow up had healed ulcers at time of follow up. The
      V-Y advancement hamstring myocutaneous island flap is versatile, reliable, easy
      to perform, has few complications, and can be re-advanced in the event of
      recurrence.

PMID- 7786267
TI  - Morbidity and mortality after abdominal aortic surgery in a population of
      patients with high cardiovascular risk.
AB  - Postoperative myocardial infarction is a major risk factor in patients undergoing
      abdominal aortic surgery. Correction of cardiac ischaemia prior to abdominal
      aortic surgery improves outcome. The morbidity and mortality of 639 consecutive
      patients were reviewed from an area with poor access to cardiac surgery, operated
      upon in a single tertiary referral hospital for aortic aneurysm or aortobifemoral
      grafting. A total of 101 patients with ruptured aortic aneurysm who survived to
      reach the intensive care unit experienced a hospital mortality of 29%. Multiorgan
      failure was the cause of death in 48% and postoperative myocardial infarction in
      31%. Of the 253 patients with intact aortic aneurysm, which included elective and
      urgent resection, the mortality was 9%. There was a high incidence of uncorrected
      pre-operative ischaemic heart disease and myocardial infarction was the major
      cause of death (62%). Pre-operative myocardial infarction was predictive of
      postoperative cardiac morbidity and mortality. Of the 285 patients undergoing
      aortobifemoral grafting the mortality was 3% despite a high incidence of pre
      operative ischaemic heart disease. Further reductions in postoperative death from
      ruptured aortic aneurysm must await improved screening to diagnose and treat the
      aneurysm before rupture. In patients operated upon electively, improved pre
      operative cardiac screening and coronary bypass grafting where appropriate,
      especially for patients with aortic aneurysm and previous myocardial infarction,
      may further reduce peri-operative mortality.

PMID- 7786268
TI  - Video-assisted thoracoscopic lobectomy: a word of caution.
AB  - Advances in video-assisted thoracoscopic (VAT) surgery allow it to assume an
      increasingly important therapeutic role. Two successful VAT lobectomies (left
      upper lobe and right lower lobe) were performed in patients with stage I
      adenocarcinoma. An 8 cm access minithoracotomy for hilar dissection and
      subsequent specimen delivery was used. Routine mediastinal node sampling was
      performed thoracoscopically as would be done conventionally. Video-assisted
      thoracoscopic lobectomy of the right upper lobe was attempted in another patient
      but he required emergency conversion to open thoracotomy because of bleeding from
      mechanical failure of the vascular staple-cutter. Although VAT lobectomy is
      feasible technically, attention to detail is important when mechanical devices
      are used to minimize the chance of malfunctioning. Once disaster occurs the
      surgeon should be capable of dealing with the consequences.

PMID- 7786269
TI  - 'To record his voice': two memorials to surgeon Walter Scott (1787-1854), first
      surgeon of northern Australia.

PMID- 7786270
TI  - Autologous blood donation in total hip replacement.

PMID- 7786271
TI  - Severe bronchospasm during rectal carcinoid resection.
AB  - The manifestations of carcinoid syndrome result from a variety of hormones
      secreted by the carcinoid tumour. The minority of patients with carcinoid tumour
      suffer bronchospasm and flushing. In this report the possibility of carcinoid
      syndrome in a patient who developed severe bronchospasm during operative
      manipulation of his rectal carcinoid is discussed.

PMID- 7786272
TI  - Sporting 'groin strains': not always muscular!
AB  - A gluteal artery pseudoaneurysm presenting as a 'groin strain' following minor
      trauma is reported. Diagnosis was made by CT scan and arteriography. Treatment
      was with superselective catheterization and microcoil embolization.

PMID- 7786273
TI  - Intracranial invasion from a primary adenocarcinoma arising in the middle and
      external ear.
AB  - Cerumenal adenocarcinoma is a rare neoplasm arising from the modified sweat
      glands of the ear. Before the diagnosis of primary tumour is made, a thorough
      search must be undertaken to exclude the possibility of metastatic disease, which
      occurs more commonly. Benign adenoma can also occur and this may be identical
      histologically to the malignant variety. The presence of local invasiveness may
      be the only differentiating feature. Aggressive local resection followed by
      postoperative radiotherapy form the cornerstone of management. Individuals
      treated with radiotherapy alone have a life expectancy of less than 12 months
      whereas cures have been reported with radical surgery.

PMID- 7786274
TI  - Endoscopic treatment of a giant ileal conduit calculus.
AB  - A giant ileal conduit calculus is an uncommon complication of urinary diversion,
      with few recent reports present in the English literature. To date all described
      instances have necessitated treatment by laparotomy. The first reported
      successful management of such a condition by purely endoscopic means is reported.

PMID- 7786276
TI  - [Two mesenchymal tumor cell lines for the determination of natural killer (NK)
      cell activity in the peripheral blood of dogs].
AB  - The two mesenchymal cell lines K1 and K6 were established from round cell tumours
      located at the lips of two dogs. Both cell lines were characterized as being of
      myelomonocytic origin by morphological, cytochemical, immunocytochemical and
      functional criteria. In the 51chromium release assay (effector/target cell ratio
      100/1) the K6-cell line revealed a mean cytotoxic sensitivity of 53.6% and thus
      showed a susceptibility similar to that of the epithelial CTAC line (57.8%). The
      K1-cell line exhibited less cytotoxic activity (41%) when incubated for 14 h, but
      showed results comparable to the K6-cell line, when the incubation time was
      reduced to 8 h.

PMID- 7786275
TI  - [Mammary carcinoma in female dogs: a new routine diagnosis by the detection of
      occult micrometastases in the regional lymph nodes].
AB  - It was here to find an antibody staining either the epithelial tissues of the
      canine mammary or the tumor cell embolisms and metastases in their regional lymph
      nodes. 77 formalin-fixed and paraffin-embedded mammary carcinomas and their
      regional lymph nodes were examined by immunocytochemical technique, all of them
      free of metastases in routine haematoxylin and eosin (HE) staining. To compare
      the two methods two serial sections were cut of three parts of the lymph nodes.
      One was stained with the antibody AE1, which reacts with cytokeratin subtype I/A,
      in the SEQUENZA by APAAP-method, the other with HE. In 84.4% of all 77 lymph
      nodes tumour cell embolism and/or micrometastases were detected. Comparing the
      two methods we found that in HE-staining it was only possible to detect two
      thirds of all micrometastases containing more than 50 tumor cells. Smaller
      micrometastases were suspicious in a few cases, the majority could not be
      detected at all.

PMID- 7786277
TI  - [Detection of distemper virus N protein RNA in the brain of dogs with spontaneous
      distemper encephalitis using a digoxigenin-labeled, double-stranded DNA probe for
      in situ hybridization].
AB  - A digoxigenin-labelled dsDNA-probe of 287 basepairs length complementary to the
      nucleoprotein-gene of canine distemper virus (CDV) was generated by the
      polymerase-chain-reaction. The dsDNA-probe hybridized specifically with base
      sequences of 8 different CDV strains, whereas no hybridization was observed with
      a porpoise and a canine parainfluenza virus and only a weak signal was obtained
      with measles virus. In formalin-fixed, paraffin-embedded brain sections of 35
      immunohistologically CDV antigen positive dogs with spontaneous distemper
      encephalitis CDV-RNA could be detected in 25 cases by in situ hybridization. The
      reason for the lack of RNA detection in some immunohistologically positive dogs
      may be due to the low stability of DNA-RNA-hybrids. Degradation of RNA by RNAses
      or diffusion out of autolysed cells can not be excluded.

PMID- 7786278
TI  - [Clostridium bifermentans infection in grass carp (Ctenopharyngodon idella)].
AB  - The outbreak of an infection with Clostridium bifermentans in grass carp
      (Ctenopharyngodon idella) from a polyculture fish pond is documented.

PMID- 7786280
TI  - [Pulmonary emboli of skin and hair particles after intravenous injections].
AB  - Among 1422 Sprague-Dawley rats treated daily for 28 consecutive days by i.v.
      injections, 779 animals (55.8%) showed lesions at the site of injection. 381 rats
      (26.8%) had pulmonary emboli with fragments of hair or skin in arterial thrombi
      or in giant cell granulomas. 6 weeks after cessation of treatment lesions were
      still found in lungs from 5 of 90 rats (5.6%) allowed to recover. In 8 of 64
      Himalayan rabbits (12.5%) given 28 injections into ear veins pulmonary embolism
      was observed. Among 184 rhesus and cynomolgus monkeys treated daily for 28
      consecutive days by injection into cephalic or saphenous veins, 167 monkeys (91%)
      showed lesions at the site of injection, 14 animals (7.6%) had pulmonary emboli
      with fragments of hair and skin in arterial thrombi or giant cell granulomas.

PMID- 7786279
TI  - [The significance of FeLV infection for diseases in necropsied cats].
AB  - Persistent FeLV infection was demonstrated in more than 3000 necropsied cats by
      an immunohistological method. The findings were associated with the diagnoses
      established by means of post-mortem examination, histopathological,
      bacteriological, virological, and parasitological investigations. Statistically
      significant differences between FeLV-positive and FeLV-negative cats in the
      relative risk for certain lesions could be demonstrated for the first time. As a
      consequence, the importance of FeLV infection for the development of certain
      lesions in cats is to be seen under new aspects for some diagnoses. The relative
      risk for development of anemia, e.g., is only slightly increased in FeLV-positive
      animals whereas the relative risk for focal myocardial necrosis and coccidiosis
      is elevated tremendously in these cats. The relative risk for some lesions and
      diagnoses is much higher in FeLV-negative cats than in FeLV-positive animals.
      This is true, e.g., for myocardiopathy and hemorrhagic cystitis.

PMID- 7786281
TI  - [Elevation of 7-dehydrocholesterol concentrations in serum and liver and
      pericentral peroxisome proliferation in hepatocytes of rats after inhibition of
      cholesterol biosynthesis by BM 15,766].
AB  - Sprague-Dawley rats of both sexes were treated for three months with BM 15,766,
      an inhibitor of cholesterol biosynthesis in conjunction with standard or high-fat
      and high-cholesterol diets. In serum and livers of all drug-treated rats lowered
      cholesterol concentration associated with an increase of 7-dehydrocholesterol (7
      DHC) was found. Electron microscopy of the liver showed a distinct proliferation
      of peroxisomes and an increase of dumb-bell shaped mitochondria in the
      pericentral zone 3. Abnormal-shaped peroxisomes with DAB-negative loops attached
      to their membranes were found in the intermediate zone 2. These alterations were
      more accentuated in drug-treated rats fed standard diet, then in treated rats
      receiving a high-fat and high-cholesterol diet. The observations demonstrate,
      that the increase of 7-DHC is due to the inhibition of 7-DHC-delta 7-reductase by
      BM 15.766 and emphasize the zonal heterogeneity of hepatocytes. The relevance of
      these observations for the investigation of the human Smith-Lemli-Opitz syndrome,
      in which also decreased plasma-cholesterol levels and an increase of 7-DHC were
      reported, is discussed.

PMID- 7786282
TI  - [Intraosseous epidermoid cysts of the toe phalanx in dogs].
AB  - Out of 1057 amputated canine toes with tumours, tumour-like or other lesions, 17
      cases were histopathologically diagnosed as epidermoid cysts of the terminal
      phalanx (EP). They were accompanied by osteolysis, reactive bone formation and
      chronic inflammation of phalanx 3. Extension of reactive changes to the
      phalangeal joint and phalanx 2 was less frequent. Various breeds were involved.
      There was no breed predisposition. The average age was 10.8 years; the male
      female ratio 2.4:1. Nine EP were located on the forelimbs, 4 on the hindlimbs. In
      4 cases location was unknown. Toes 4 and 5 were most frequently affected. A
      traumatic origin is suspected.

PMID- 7786284
TI  - Precursor cell types in the germinal zone of the cerebral cortex.
AB  - Retroviral lineage tracing experiments suggest that the cortical ventricular zone
      is composed of a mixture of precursor cell types. The majority generate a single
      cell type (neurones, astrocytes or oligodendrocytes) and the remainder generate
      neurones and a single type of glial cell. Pluripotential precursor cells, that
      have the ability to generate all three cell types, are not observed. A recent
      paper, however, reports that when single ventricular zone cells are cultured in
      isolation, a small percentage of these cells are pluripotential. This review will
      discuss what this knowledge tells us about cortical development.

PMID- 7786283
TI  - Specifying the target identity of motoneurons.
AB  - In the vertebrate spinal cord, motoneurons are clustered into longitudinal
      columns in agreement with the targets they innervate. Motoneurons within each
      column acquire properties early in development that ensure their axons navigate
      to appropriate targets, but how this target identity is specified is unknown.
      Recently, Tsuchida et al. described the expression of putative regulatory genes
      within motor columns in the chicken spinal cord. Combinations of LIM-family
      homeobox genes differentially mark columns that project to distinct target
      groups. Expression precedes column formation and axon outgrowth, making these
      genes candidates for specifying the target identity of motoneuron groups.

PMID- 7786286
TI  - Determinants of blastomere identity in the early C. elegans embryo.
AB  - Genetic and molecular studies of development in Caenorhabditis elegans have
      identified regulators that appear to control pattern formation in the
      cellularized nematode embryo. Two genes, skn-1 and pie-1, are required for
      specifying the different identities of two sister blastomeres in a 4-cell embryo,
      called P2 and EMS. The skn-1 gene encodes a DNA binding protein that may control
      blastomere development by regulating transcription in EMS and its descendants.
      ABa and ABp, the other two sisters in a 4-cell embryo, are influenced to develop
      differently by cell signaling events that require the two genes apx-1 and glp-1.
      In this review, I summarize evidence that some or all of these genes may encode
      embryonic determinants of blastomere identity.

PMID- 7786285
TI  - Guanine nucleotide exchange factors: activators of the Ras superfamily of
      proteins.
AB  - Ras proteins function as critical relay switches that regulate diverse signaling
      pathways between cell surface receptors and the nucleus. Over the past 2-3 years
      researchers have identified many components of these pathways that mediate Ras
      activation and effector function. Among these proteins are several guanine
      nucleotide exchange factors (GEFs), which are responsible for directly
      interacting with and activating Ras in response to extracellular stimuli.
      Analogous GEFs regulate Ras-related proteins that serve other diverse cellular
      functions. In particular, a growing family of proteins (Dbl homology proteins)
      has recently been identified, which may function as GEFs for the Rho family of
      Ras-related proteins. This review summarizes our current knowledge of the
      structure, biochemistry and biology of Ras and Rho family GEFs. Additionally, we
      describe mechanisms of GEF activation of Ras in signal transduction and address
      the potential that deregulated GEFs might contribute to malignant transformation
      through chronic Ras protein activation.

PMID- 7786288
TI  - Trichostatin A and trapoxin: novel chemical probes for the role of histone
      acetylation in chromatin structure and function.
AB  - Reversible acetylation at the epsilon-amino group of lysines located at the
      conserved domain of core histones is supposed to play an important role in the
      regulation of chromatin structure and its transcriptional activity. One promising
      strategy for analyzing the precise function of histone acetylation is to block
      the activities of acetylating or deacetylating enzymes by specific inhibitors.
      Recently, two microbial metabolites, trichostatin A and trapoxin, were found to
      be potent inhibitors of histone deacetylases. Trichostatin A reversibly inhibits
      the mammalian histone deacetylase, whereas trapoxin causes inhibition through
      irreversible binding to the enzyme. The histone deacetylase from a trichostatin A
      resistant cell line is resistant to trichostatin A, indicating that the enzyme is
      the primary target. Both of the agents induce a variety of biological responses
      of cells such as induction of differentiation and cell cycle arrest. Trichostatin
      A and trapoxin are useful in analyzing the role of histone acetylation in
      chromatin structure and function as well as in determining the genes whose
      activities are regulated by histone acetylation.

PMID- 7786289
TI  - A radical approach to enzyme catalysis.
AB  - Free radicals are generally perceived as highly reactive species which are
      harmful to biological systems. There are, however, a number of enzymes that use
      carbon-based radicals to catalyse a variety of important and unusual reactions.
      The most prominent example is ribonucleotide reductase, an enzyme which is
      crucial for the synthesis of DNA. In general, radicals are used to remove
      hydrogen from unreactive positions in the substrate, and in this way the
      substrate is activated to undergo chemical transformations that would otherwise
      be difficult to achieve. Several different mechanisms have evolved which allow
      enzymes to generate and maintain radicals in increasingly aerobic environments.
      An unexpected finding is the existence of stable protein-based radicals, residing
      on a variety of amino-acid side chains, which serve to link the radical
      generating and catalytic sites and to store the radical between turnovers.

PMID- 7786287
TI  - Seminal plasmin.
AB  - The importance of seminal plasma in fertilization was appreciated as early as
      1677 and would thus hardly seem a source for the search of antibacterial agents.
      The observation that seminal plasma had the ability to inhibit the growth of
      microorganisms in 1940 led to a systematic search for molecules possessing
      antimicrobial activity in addition to factors that might have a role in
      reproductive physiology. Extensive investigations led to the discovery in bovine
      seminal fluid of a 47-residue peptide, possessing potent antimicrobial activity
      as well as calcium transport modulatory properties in bovine sperm. We describe
      in this article the two, apparently unrelated, biological activities of this
      peptide.

PMID- 7786291
TI  - Model systems in developmental biology.
AB  - The practical criteria by which developmental biologists choose their model
      systems have evolutionary correlates. The result is a sample that is not merely
      small, but biased in particular ways, for example towards species with rapid,
      highly canalized development. These biases influence both data collection and
      interpretation, and our views of how development works and which aspects of it
      are important.

PMID- 7786290
TI  - The channels model of nuclear matrix structure.
AB  - The specificity of eukaryotic DNA organization into loops fixed to the nuclear
      matrix/chromosomal scaffold has been studied for more than fifteen years. The
      results and conclusions of different authors remain, however, controversial.
      Recently, we have elaborated a new approach to the study of chromosomal DNA
      loops. Instead of characterizing loop basements (nuclear matrix DNA), we have
      concentrated our efforts on the characterization of individual loops after their
      excision by DNA topoisomerase II-mediated DNA cleavage at matrix attachment
      sites. In this review the results of applying this mapping approach are compared
      with the results and conclusions from studies of nuclear matrix DNA. An attempt
      is also made to reconsider all data about the specificity of DNA interactions
      with the nuclear matrix and to suggest a model of spatial organization of the
      eukaryotic genome which resolves apparent contradictions between these data.

PMID- 7786292
TI  - A model for repair of radiation-induced DNA double-strand breaks in the extreme
      radiophile Deinococcus radiodurans.
AB  - The bacterium Deinococcus (formerly Micrococcus) radiodurans and other members of
      the eubacterial family Deinococaceae are extremely resistant to ionizing
      radiation and many other agents that damage DNA. Stationary phase D. radiodurans
      exposed to 1.0-1.5 Mrad gamma-irradiation sustains > 120 DNA double-strand breaks
      (dsbs) per chromosome; these dsbs are mended over a period of hours with 100%
      survival and virtually no mutagenesis. This contrasts with nearly all other
      organisms in which just a few ionizing radiation induced-dsbs per chromosome are
      lethal. In this article we present an hypothesis that resistance of D.
      radiodurans to ionizing radiation and its ability to mend radiation-induced dsbs
      are due to a special form of redundancy wherein chromosomes exist in pairs,
      linked to each other by thousands of four-stranded (Holliday) junctions. Thus, a
      dsb is not a lethal event because the identical undamaged duplex is nearby,
      providing an accurate repair template. As addressed in this article, much of what
      is known about D. radiodurans suggests that it is particularly suited for this
      proposed novel form of DNA repair.

PMID- 7786293
TI  - Chance and longevity.

PMID- 7786294
TI  - Use of pure antioestrogens to elucidate the mode of action of oestrogens.

PMID- 7786295
TI  - Inhibition of tumor necrosis factor by curcumin, a phytochemical.
AB  - Curcumin, contained in the rhizome of the plant Curcuma longa Linn, is a
      naturally occurring phytochemical that has been used widely in India and
      Indonesia for the treatment of inflammation. The pleiotropic cytokine tumor
      necrosis factor-alpha (TNF) induces the production of interleukin-1 beta (IL-1),
      and, together, they play significant roles in many acute and chronic inflammatory
      diseases. They have been implicated in the pathogenesis of intracellular
      parasitic infections, atherosclerosis, AIDS and autoimmune disorders. This report
      shows that, in vitro, curcumin, at 5 microM, inhibited lipopolysaccharide (LPS)
      induced production of TNF and IL-1 by a human monocytic macrophage cell line,
      Mono Mac 6. In addition, it demonstrates that curcumin, at the corresponding
      concentration, inhibited LPS-induced activation of nuclear factor kappa B and
      reduced the biological activity of TNF in L929 fibroblast lytic assay.

PMID- 7786296
TI  - Sulphoxide reduction by rat and rabbit tissues in vitro.
AB  - The reduction of sulindac, sulphinpyrazone and diphenyl sulphoxide to their
      thioether analogues has been studied in vitro using rat and rabbit tissues.
      Sulindac reduction was about 10-fold higher in homogenates of rat kidney and
      liver than in other tissues although the tissue differences decreased when
      dithiothreitol was used as a co-factor. The greatest sulindac reducing activity
      in rat liver was in the cytosolic fraction whereas reoxidation of the thioether
      back to the sulphoxide was largely in the microsomal fraction. Studies using
      NADPH/NADH, acetaldehyde and dithiothreitol as cofactors showed that aldehyde
      oxidase was the main sulindac reducing system in rat and rabbit liver cytosols
      but not in renal cytosols where reduction was probably linked to the thioredoxin
      system, as reported previously. Menadione and hydralazine caused essentially
      complete inhibition of sulindac reduction by hepatic but not renal cytosol and
      the inhibition was dependent on preincubation of the enzyme with the inhibitor,
      which is indicative of aldehyde oxidase activity. Little reduction of
      sulphinpyrazone or diphenyl sulphoxide was detected with rat or rabbit kidney or
      renal cytosols, although increased reduction was detected when acetaldehyde was
      added as a cofactor to rabbit and rat liver cytosols. The data indicate that
      different enzyme systems are responsible for sulphoxide reduction in the liver
      and kidney.

PMID- 7786297
TI  - Sulphoxide reduction by rat intestinal flora and by Escherichia coli in vitro.
AB  - The caecal microflora from female rats show a greater ability to reduce the
      sulphoxide group of sulindac than either the liver or kidneys. Studies on
      sulphoxide reduction by Escherichia coli showed that NADH, NADPH and
      dithiothreitol (DTT), but not acetaldehyde could act as cofactors. The cytosolic
      fraction was responsible for about 90%, 80% and 60% of the total reducing
      activity with sulindac, diphenyl sulphoxide and sulphinpyrazone, respectively.
      The main NADPH linked activity in the E. coli cytosol was dependent on
      thioredoxin, since the activity was essentially abolished by passing through a
      G50 column or by the addition of anti-thioredoxin anti-serum. Partial
      purification and separation of sulphoxide reducing activity by DEAE-cellulose
      chromatography separated two main protein bands, each of which possessed sulindac
      reducing activity. The importance of thioredoxin for much of the NADPH dependent
      activity was confirmed but the eluate fractions also showed the presence of other
      activities with NADH, NADPH and DTT that were independent of thioredoxin.
      Incubation of the DEAE-cellulose eluate fractions with flosequinan and
      sulphinpyrazone showed that the reducing activity in the two main protein peaks
      showed different substrate specificities and that there were multiple sulphoxide
      reductase systems present in E. coli cytosol.

PMID- 7786298
TI  - 1-O-hexadecyl-2-metoxy-glycero-3-phosphatidylcholine--a methoxy ether lipid
      inhibiting platelet activating factor-induced platelet aggregation and neutrophil
      oxidative metabolism.
AB  - Whether or not two alkylglycerols could initiate a functional response in human
      platelets or modify responses induced by platelet activating factor (PAF) was
      evaluated. It was found that 1-100 microM 1-O-hexadecyl-2-metoxy-glycero-3
      phosphatidylcholine (Et-16-OCH3) induced platelet aggregation but 1-O-hexadecyl
      sn-glycerol (chimyl alcohol; CA) did not. Et-16-OCH3-induced platelet aggregation
      was abolished by pretreatment with the PAF receptor antagonist WEB 2086. While CA
      had no effect on platelet aggregation induced by PAF, pretreatment with Et-16
      OCH3 (0.1 microM or higher) significantly inhibited platelet aggregation induced
      by PAF, but had no effect on aggregation caused by ADP, thrombin or phorbol
      myristate acetate (PMA). A receptor binding study using radiolabelled [3H]WEB
      2086 showed that Et-16-OCH3 exerts its actions through interaction with the PAF
      receptor. Moreover, Et-16-OCH3 inhibited neutrophil chemiluminescence responses
      induced by PAF, but not reactions to PMA or a formyl peptide. Finally, 1 microM
      Et-16-OCH3 induced a rise in the intracellular calcium concentration in platelets
      equal to that induced by PAF and also had an calcium ionophore-like effect at 100
      microM. Thus, this study shows that Et-16-OCH3 is both a potent inducer of
      platelet aggregation and an inhibitor of PAF-induced platelet aggregation and
      neutrophil chemiluminescence, through interaction with the PAF receptor.

PMID- 7786299
TI  - Effects of the phosphatase inhibitor calyculin A on the phosphorylation of C
      protein in mammalian ventricular cardiomyocytes.
AB  - The effects of inhibitors of protein phosphatase activity on C-protein
      phosphorylation were studied in preparations from mammalian ventricles. Calyculin
      A (CyA), an inhibitor of type 1 and 2A protein phosphatases, was studied. CyA
      concentration- and time-dependency increased the phosphorylation state of C
      protein in isolated 32P-labelled guinea pig ventricular cardiomyocytes. C-protein
      was identified by its reaction with a polyclonal antibody and
      immunoprecipitation. It is concluded that C-protein in intact cardiomyocytes
      could be a substrate for type 1 and 2A protein phosphatases.

PMID- 7786300
TI  - Formation of mono- and diglucuronides and other glycosides of benzo(a)pyrene-3,6
      quinol by V79 cell-expressed human phenol UDP-glucuronosyltransferases of the
      UGT1 gene complex.
AB  - Glucuronidation of quinols of polycyclic aromatic hydrocarbons (PAHs) represents
      an important detoxication pathway preventing toxic quinone/quinol redox cycles.
      Therefore, mono- and diglucuronide formation of benzo(a)pyrene-3,6-quinol was
      investigated and compared to that of structurally related 3,6-dihydroxychrysene
      and simple phenols (1-naphthol and 4-methylumbelliferone) using V79 cell
      expressed human UGT1.6 (= P1) and human UGT1.7 (= P4). Properties of human UGT1.6
      were compared to those of the rat ortholog. Cofactors related to UDP-glucuronic
      acid such as UDP-galacturonic acid and UDP-glucose were also studied. It was
      found that rat and human UGT1.6 and human UGT1.7 catalyse monoglucuronide
      formation of planar PAH quinols. Diglucuronide formation was only detectable with
      human UGT1.7. The UGT isozymes studied also formed galacturonides and, although
      only to a minor extent, glucosides. Rat UGT1.6 (but not the human ortholog)
      catalysed digalacturonide formation of benzo(a)pyrene-3,6-quinol; the in vivo
      significance of galacturonide formation remains to be established. The results
      suggest that planar PAH phenols and quinols are conjugated more efficiently by
      human UGT1.7 than by UGT1.6, which preferentially conjugates simple planar
      phenols.

PMID- 7786301
TI  - Modification of DNA bases by anthralin and related compounds.
AB  - Modification of bases in calf thymus DNA by treatment with the antipsoriatic drug
      anthralin was studied. The products of DNA bases were identified and their yields
      measured by gas chromatography-mass spectrometry with selected ion monitoring.
      Treatment of calf thymus DNA with anthralin significantly enhanced the amount of
      modified bases above control levels. Purine bases were modified to products
      identical with those known to be typical of DNA damage induced by hydroxyl
      radicals. The yields of Fapy-adenine, 8-hydroxyadenine, Fapy-guanine, and 8
      hydroxyguanine were maximally increased at an anthralin concentration of 75
      microM. A variety of structural analogues of anthralin were also tested at 75
      microM were either weaker or stronger hydroxylating agents. It is likely that
      damage to DNA bases induced by anthrones contributes to their antiproliferative
      activity. The pharmacological implications of these characteristics of the action
      of anthralin on DNA bases are discussed.

PMID- 7786302
TI  - Photosensitized inhibition of growth factor-regulated protein kinases by
      hypericin.
AB  - The naphthodianthrone hypericin causes a photosensitized inhibition of protein
      kinases involved in growth factor signalling pathways. Nanomolar concentrations
      of hypericin inhibit the protein tyrosine kinase activities (PTK) of the
      epidermal growth factor receptor and the insulin receptor, while being
      ineffective towards the cytosolic protein tyrosine kinases Lyn, Fgr, TPK-IIB and
      CSK. Photosensitized inhibition by hypericin is not restricted to receptor-PTKs
      since the Ser/Thr protein kinases (protein kinase CK-2, protein kinase C and
      mitogen-activated kinase) are also extremely sensitive to inhibition (IC50 value
      for protein kinase CK-2 = 6 nM). A comparison of the hypericin-mediated
      inhibition of the epidermal growth factor-receptor PTK and protein kinase CK-2
      revealed that the inhibition is irreversible, strictly dependent upon irradiation
      of the enzyme-inhibitor complex with fluorescent light and likely mediated by the
      formation of radical intermediates (type I mechanism). Although the exact
      molecular basis for the selectivity of enzyme inhibition by hypericin remains
      unknown, our results suggest that distantly related protein kinases could still
      share common reactive domains for the interaction with hypericin.

PMID- 7786303
TI  - Antinociceptive activity of calcitonin and central cholinergic system:
      behavioural and neurochemical analyses.
AB  - Behavioural and neurochemical analyses were carried out to investigate the
      relationship between the antinociceptive activity of porcine calcitonin (pCT) and
      central cholinergic system in mice and rats. Behavioural studies revealed that
      the antinociceptive activity of pCT encapsulated in sulphatide-containing
      liposomes injected intravenously into mice was significantly inhibited by
      atropine sulphate, but not by atropine methylnitrate, and potentiated by
      physostigmine, but not by neostigmine. Neurochemical studies using rat brain
      synaptosomes showed that pCT stimulated synaptosomal sodium-dependent high
      affinity choline uptake, which was found to be closely associated with
      acetylcholine (ACh) synthesis (50-60%). This effect was concentration-dependent.
      In addition, pCT elicited a biphasic effect on ACh release from synaptosomes with
      an initial brief period of stimulation and subsequent prolonged inhibition. This
      stimulation was not affected by atropine sulphate, but markedly reduced by
      incubation in the presence of diltiazem or in a calcium-free medium, indicating
      that the modulation of ACh release by the peptide may be mediated by calcium
      fluxes across the synaptosomal membrane independent of cholinergic receptor
      activation. However, pCT does not affect the activity of synaptosomal
      acetylcholinesterase. Therefore, the behavioural study in vivo with the
      neurochemical analysis in vitro suggests that the central cholinergic system may
      be involved in the antinociceptive activity of calcitonin.

PMID- 7786305
TI  - Virtual cofactors for an Escherichia coli nitroreductase enzyme: relevance to
      reductively activated prodrugs in antibody directed enzyme prodrug therapy
      (ADEPT).
AB  - A nitroreductase enzyme has been isolated from Escherichia coli that has the
      unusual property of being equally capable of using either NADH or NADPH as a
      cofactor for the reduction of its substrates which include menadione as well as 5
      (aziridin-1-yl)-2,4-dinitrobenzamide (CB 1954). This property is shared with the
      mammalian enzyme, DT diaphorase. The nitroreductase can, like DT diaphorase, also
      use simple reduced pyridinium compounds as virtual cofactors. The intact NAD(P)H
      molecule is not required and the simplest quaternary (and therefore reducible)
      derivative of nicotinamide, 1-methylnicotinamide (reduced), is as effective as
      NAD(P)H in its ability to act as an electron donor for the nitroreductase. The
      structure-activity relationship is not identical to that of DT diaphorase and
      nicotinic acid riboside (reduced) is selective, being active only for the
      nitroreductase. Irrespective of the virtual cofactor used, the nitroreductase
      formed the same reduction products of CB 1954 (the 2- and 4-hydroxylamino
      derivatives in equal proportions). Nicotinic acid riboside (reduced), unlike
      NADH, was stable to metabolism by serum enzymes and had a plasma half-life of
      seven minutes in the mouse after an i.v. bolus administration. NADH had an
      unmeasurably short half-life. Nicotinic acid riboside (reduced) could also be
      produced in vivo by administration of nicotinic acid 5'-O-benzoyl riboside
      (reduced). These results demonstrate that the requirement for a cofactor need not
      be a limitation in the use of reductive enzymes in antibody directed enzyme
      prodrug therapy (ADEPT). It is proposed that the E. coli nitroreductase would be
      a suitable enzyme for ADEPT in combination with CB 1954 and a synthetic, enzyme
      selective, virtual cofactor such as nicotinic acid riboside (reduced).

PMID- 7786304
TI  - Adenylyl cyclase in SH-SY5Y human neuroblastoma cells is regulated by intra- and
      extracellular calcium.
AB  - Adenylyl cyclase exists as a family of closely related subtypes which differ in
      their tissue distribution and regulatory properties. Submicromolar rises in
      [Ca2+]i produced via activation of phospholipase C (PLC) or Ca2+ channel opening,
      provide a mechanism by which Ca2+/calmodulin (CaM) or protein kinase C (PKC)
      sensitive isoforms of adenylyl cyclase can be regulated. In this study we have
      examined, in detail, the muscarinic (M3) regulation of adenylyl cyclase in SH
      SY5Y cells and report a role for both [Ca2+]e and [Ca2+]i. Carbachol (1 mM) and
      potassium (100 mM) caused a time (T1/2 = 3 and 4 min, respectively) and dose
      (EC50 = 6.95 microM and 34.7 mM respectively) related increase in cAMP formation.
      This amounted to an approximate two-fold increase over basal levels. Carbachol
      and potassium also caused a biphasic increase in [Ca2+]i with basal, peak and
      plateau values of 118.4 nM, 697.6 nM, 253.0 nM and 104.0 nM, 351.6 nM, 181.5 nM,
      respectively. Calcium channel blockade with nickel (2.5 mM) abolished potassium
      stimulated cAMP formation and rises in [Ca2+]i. However, carbachol-stimulated
      cAMP formation was significantly decreased only at the later time points, where
      rises in [Ca2+]i were also essentially abolished. Further evidence for a role for
      [Ca2+]e and [Ca2+]i is provided by the stimulation of cAMP formation by carbachol
      in the absence of added Ca2+, followed by a further increase on its re-addition.
      Carbachol- and potassium-stimulated cAMP formation were inhibited by the CaM
      antagonist trifluoperazine (100 microM). The mu-opiate agonists, morphine and
      fentanyl also inhibited carbachol-stimulated cAMP formation. In addition, cAMP
      formation in SH-SY5Y cell membranes was significantly increased in the presence
      of Ca2+ (1.46 microM), CaM (200 nM) and forskolin (1 microM). PKC inhibition with
      Ro 31 8220 did not affect carbachol-stimulated cAMP formation. Taken
      collectively, these data suggest that SH-SY5Y cells express type 1, and possibly
      type 8 isoforms of adenylyl cyclase, which can be regulated by intra- and
      extracellular Ca2+.

PMID- 7786306
TI  - Peroxyl radical scavenging activity of Ginkgo biloba extract EGb 761.
AB  - Antioxidant mechanisms have been proposed to underlie the beneficial
      pharmacological effects of EGb 761, an extract from Ginkgo biloba leaves used for
      treating peripheral vascular diseases and cerebrovascular insufficiency in the
      elderly. In vitro evidence has been reported that EGb 761 scavenges various
      reactive oxygen species, i.e. nitric oxide, and the superoxide, hydroxyl, and
      oxoferryl radicals. However, the ability of EGb 761 to scavenge peroxyl radicals
      (reactive species mainly involved in the propagation step of lipid peroxidation)
      has not been investigated. To characterize further the antioxidant action of EGb
      761, we measured the protective effects of EGb 761 during: (1) the oxidation of B
      phycoerythrin by peroxyl radicals generated in aqueous solution by 2,2'-azobis (2
      amidinopropane) hydrochloride (AAPH); and (2) the reaction of luminol or cis
      parinaric acid with peroxyl radicals generated from 2,2'-azobis (2,4
      dimethylvaleronitrile) (AMVN) in liposomes or in human low density lipoprotein
      (LDL), respectively. To evaluate the peroxyl radical scavenging activity of EGb
      761 in a more physiologically relevant model of damage to lipid-containing
      systems, we also analyzed the effect of the extract on the oxidation of human LDL
      exposed to the azo-initiators in terms of: (1) accumulation of cholesterol
      linoleate ester hydroperoxides, (2) depletion of alpha-tocopherol and beta
      carotene, and (3) changes in intrinsic tryptophan fluorescence. EGb 761 afforded
      protection against oxidative damage in all the systems we analyzed; thus, it is
      an efficient scavenger of peroxyl radicals. This result extends the oxygen
      radical scavenging properties of the extract and supports the hypothesis of an
      antioxidant therapeutic action of EGb 761.

PMID- 7786307
TI  - Characterization of the independent and combined effects of two inhibitors on
      oxidative drug metabolism in rat liver microsomes.
AB  - To evaluate how two inhibitors influence oxidative drug metabolism, this study
      investigated the inhibitory effects of mexiletine with cimetidine and mexiletine
      with lidocaine, both individually and in combination, on the oxidative metabolism
      of two probe substrates, aminopyrine and aniline in rat liver microsomes.
      Mexiletine was a competitive inhibitor of aminopyrine N-demethylation, whereas
      cimetidine was a mixed type of inhibitor (Ki = 2.00 +/- 0.04 and 0.20 +/- 0.02
      mM, respectively). For aniline hydroxylation, mexiletine exhibited a mixed type
      of inhibition, whereas lidocaine was a noncompetitive inhibitor (Ki = 0.60 +/-
      0.07 and 8.50 +/- 0.12 mM, respectively). The combined inhibition of either
      mexiletine with cimetidine or mexiletine with lidocaine on aminopyrine and
      aniline metabolism was close to the fully additive effects of the individual
      compounds when their individual concentrations were below a 2-fold Ki
      concentration, regardless of the apparent kinetic inhibition type. The combined
      inhibition was less than fully additive when the individual concentrations were
      twice the Ki or above. These results demonstrate that, when two inhibitors of
      oxidative drug metabolism are combined, both the Ki values and the concentrations
      of inhibitors play important roles in determining the extent of additive
      inhibition of enzyme activity.

PMID- 7786308
TI  - Rapid changes in cytochrome P4502E1 (CYP2E1) activity and other P450 isozymes
      following ethanol withdrawal in rats.
AB  - This study describes the effects of chronic ethanol (ETOH) treatment and
      withdrawal on the rat hepatic mixed-function mono-oxygenase system. Male Sprague
      Dawley rats (150-200 g, 10 per group) were administered ETOH as part of the
      Lieber-deCarli liquid diet for 3 weeks. Ethanol was removed, and the animals were
      euthanized at 0, 24, 48, 72 and 168 hr post-withdrawal. Microsomes were prepared,
      and ethanol-inducible cytochrome P4502E1 (CYP2E1) activity was measured using the
      enzyme markers N-nitrosodimethylamine demethylase (NDMAd), p-nitrophenol
      hydroxylase (PNPH) and aniline hydroxylase (AH). Activities were found to be
      induced significantly after chronic ETOH feeding using all three assays (NDMAd, 5
      fold; PNPH, 3.5-fold; AH, 9-fold). Upon ETOH withdrawal, all three activities
      dropped markedly, with NDMAd and PNPH at control values at 24 hr and all
      subsequent time points. AH activity remained 3-fold higher than controls at 24,
      48 and 72 hr. Western blot analyses showed that immunoreactive CYP2E1 returned to
      control at 24 hr, consonant with NDMAd and PNPH activities. The prolonged
      induction of AH activity following ETOH withdrawal indicates that it is not a
      specific marker of CYP2E1-catalyzed reactions. Collectively, these data are
      suggestive of a rapid mechanism of CYP2E1 degradation in the rat liver. Of the
      other parameters investigated in this study, total cytochrome P450 content was
      increased 2.5-fold after ETOH feeding, with levels dropping markedly 24 hr post
      withdrawal. NADPH-dependent cytochrome c reductase activity was unchanged
      throughout the course of the study. CYP1A1, CYP2B1 and CYP3A activities were
      assessed by the substrate probes ethoxyresorufin O-dealkylase (EROD),
      pentoxyresorufin O-dealkylase (PROD) and erythromycin N-demethylase (ERNd). EROD
      and PROD were induced significantly by ETOH administration (2-fold) at 0 hr, with
      EROD remaining elevated over controls 24 hr post-withdrawal. Quantitative western
      blot analysis of CYP1A1 and CYP2B1 revealed a pattern of immunostaining generally
      consistent with but less variable than levels predicted by the respective
      substrate markers. Both proteins were induced significantly by chronic ethanol
      administration (CYP1A1, 1.9-fold; CYP2B1, 4-fold). Induction of these P450
      isoforms persisted for several days following withdrawal. In contrast,
      immunoreactive CYP1A2 was found to decrease significantly (by 30-40%) during
      ethanol withdrawal (24, 48, 72, 168 hr). ERNd activity was induced significantly
      by chronic ETOH feeding (2.5-fold) and remained so for 24 hr into the withdrawal
      period (2-fold). Immunoreactive CYP3A1 was also induced significantly following
      ETOH administration (0 hr) and 24 hr following withdrawal.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 7786309
TI  - Blockade of human neutrophil activation by 2-[2-propyl-3-[3-[2-ethyl-4-(4
      fluorophenyl)-5- hydroxyphenoxy]propoxy]phenoxy]benzoic acid (LY293111), a novel
      leukotriene B4 receptor antagonist.
AB  - Leukotriene B4 (LTB4), a naturally occurring pro-inflammatory product of
      arachidonic acid metabolism, has been associated with human inflammatory disease.
      This study compares the abilities of two LTB4 receptor antagonists, 2-[2-propyl-3
      [3-[2-ethyl-4-(4-fluorophenyl)-5-hydroxyphenoxy]- propoxy]phenoxy]benzoic acid
      (LY293111) and 7-[3-(4-acetyl-3-methoxy-2-propylphenoxy)-propoxy]- 3,4-dihydro-8
      propyl-2H-1-benzopyran-2-carboxylic acid (SC-41930), to displace LTB4 binding and
      their functional blockade of human neutrophil activation. LY293111 inhibited the
      binding of [3H]LTB4 with a Ki of 25 nM; SC-41930 displayed a similar potency (Ki
      = 17 nM). In contrast, LY293111 prevented LTB4-induced calcium mobilization with
      an IC50 = 20 nM, or 40 times more effectively than SC-41930 (IC50 = 808 nM).
      LY293111 was 300 times more potent than SC-41930 in blocking LTB4-induced CD11b
      up-regulation on isolated neutrophils. LY293111 also arrested LTB4-induced up
      regulation of CD11b on neutrophils in whole human blood. LY293111 was not
      effective in blocking human neutrophil activation responses induced by N-formyl
      methionyl-leucyl-phenylalanine (fMLP), platelet-activating factor (PAF), human
      recombinant endothelial interleukin-8 (IL-8) or human recombinant complement
      component 5a (C5a).

PMID- 7786310
TI  - Identification of glutathione S-transferase as a determinant of 4
      hydroperoxycyclophosphamide resistance in human breast cancer cells.
AB  - Aldehyde dehydrogenase (ALDH) is well known for its involvement in the resistance
      of tumor cells to cyclophosphamide (CPA) and its activated derivatives, such as 4
      hydroperoxy-CPA (4HC). The role of other drug-metabolizing enzymes such as
      glutathione S-transferase (GST) in CPA resistance is, however, less certain. In
      the present study of a human breast cancer cell line (MCF-7) exhibiting about 6
      fold resistance to 4HC (MCF/HC), cellular levels of glutathione (GSH) were
      increased 1.4-fold, while cytosolic GST and ALDH activities were increased 2.7-
      and 7.2-fold, respectively, relative to the MCF-7 parental line. No significant
      changes in glutathione peroxidase and NADPH cytochrome P450 reductase activity,
      and no increase in microsomal GST and GST pi mRNAs were found in the resistant
      cells. Treatment with the ALDH substrate octanal sensitized the cells to the
      cytotoxic effects of 4HC to a modest extent in both MCF-7 and MCF/HC cells [dose
      modification factor (DMF) of 1.4 and 1.6, respectively]. Depletion of GSH by
      treatment with the GSH synthesis inhibitor buthionine sulfoximine (BSO) enhanced
      the cytotoxic effect of 4HC to a similar extent in both cell lines. By contrast,
      ethacrynic acid, which inhibited GST activity by > 85% in MCF-7 and MCF/HC cell
      extracts without depletion of GSH, sensitized the resistant but not the parental
      cells to 4HC cytotoxicity, indicating the importance of GST as a determinant of
      4HC resistance in these cells. This conclusion is supported by the observation
      that in MCF/HC cells, ethacrynic acid in combination with BSO increased the DMF 3
      fold higher than did BSO or EA alone, while in the parental MCF-7 cells
      ethacrynic acid with BSO had no significant chemosensitization effect over BSO
      alone. These studies establish that in addition to ALDH, GST overexpression can
      contribute to acquired resistance of tumor cells to 4HC and, furthermore, suggest
      that modulators that target the GSH/GST system could be useful in overcoming CPA
      resistance in the clinic.

PMID- 7786312
TI  - Thermodynamic studies with acetylthiocholine on nicotinic receptors of mammalian
      skeletal muscle in vitro.
AB  - The temperature dependency of binding of acetylthiocholine, a specific nicotinic
      agonist, to the nicotinic receptor of mammalian skeletal muscle was studied using
      isotonic contractions of the rat denervated diaphragm preparation in vitro. The
      dissociation constants at different temperatures (22-39 degrees) were determined
      by the Furchgott method using alpha-bungarotoxin as an irreversible antagonist.
      Both free energy of association (delta G zero = -22.93 kJ/mol at 37 degrees) and
      enthalpy of binding (delta H zero = -58.35 kJ/mol) calculated from Kd
      (dissociation constant) and slope of lnKd versus 1/T (van't Hoff plot)
      respectively were found to be negative. The negative entropy value (delta S zero
      = -0.113 kJ/mol/deg) obtained from the intercept of this van't Hoff plot differs
      from the large positive value obtained earlier employing radioligand binding
      studies of the nicotinic receptor of Electrophorus electricus.

PMID- 7786311
TI  - Effect of eugenol on drug-metabolizing enzymes of carbon tetrachloride
      intoxicated rat liver.
AB  - The chemoprotection extended by eugenol against carbon tetrachloride (CCl4)
      intoxication was established by studies on drug-metabolizing phase I and phase II
      enzymes. An overall decrease in drug-metabolizing enzymes, namely NADPH
      cytochrome c reductase, NADH-cytochrome reductase, coumarin hydroxylase, 7-ethoxy
      coumarin-O-deethylase, UDP-glucuronyltransferase and glutathione-S-transferase,
      was observed with CCl4 intoxication, with a subsequent decrease in cytochrome
      P450 and cytochrome b5 content. CCl4 caused a significant decrease in microsomal
      phospholipids and the marker enzymes glucose-6-phosphatase and 5'-nucleotidase,
      and an increase in thiobarbituric acid reactive substances (TBARS). Simultaneous
      administration of eugenol with CCl4 inhibited the accumulation of TBARS and the
      decrease in the microsomal phospholipids and marker enzymes. Further, the
      chemical onslaught imposed by CCl4 on the drug-metabolizing system was removed
      successfully by eugenol. Eugenol appears to act as an in vivo antioxidant and as
      a better inducer of phase II enzymes than phase I enzymes. It is therefore
      suggested that eugenol could be an interesting basic structure for drug design.

PMID- 7786313
TI  - (-)-R-fenoprofen: formation of fenoprofenyl-coenzyme A by rat liver microsomes.
AB  - The thioesterification of fenoprofen (FPF) by rat liver microsomes has been
      studied using an HPLC method enabling direct quantification of the FPF-CoA
      produced. Over the concentration range studied (5-400 microM), studies showed the
      participation of a single CoA ligase in the formation of FPF-CoA, in contrast
      with the involvement of several isozymes with different affinities, that has been
      found with ibuprofen (IPF). The Km for the reaction was dependent upon the
      presence of non-ionic detergent, a concentration of 0.05% Triton X-100 reducing
      the Km from 397 to 20 microM although the detergent had no effect on Vmax. The
      microsomal long-chain fatty acid CoA ligase was markedly enantioselective towards
      (-)-R-FPF and the formation of (-)-R-FP-CoA was inhibited by both the (+)-S
      enantiomer and palmitic acid.

PMID- 7786314
TI  - [A new differentiation factor from culture media of the HL-60 cell line treated
      with retinoic acid. Isolation and primary structure determination].
AB  - A new 8.2-kDa protein factor was isolated from cell culture of a promyelocyte
      leukemic HL-60 cell line that exhibited a differentiation-inducing effect upon
      the initial cell line. The primary structure of this factor was determined by
      sequencing the protein (N-terminal region) and the corresponding cDNA. A molecule
      of the differentiation factor secreted by HL-60 cells consisted of 54 amino acid
      residues and was glycosylated.

PMID- 7786316
TI  - [Polyacrolein latex as a solid phase carrier for radioimmunoassay. Comparison
      with microcrystalline cellulose and polystyrene test tube surface].
AB  - The immunosorbent obtained through a covalent immobilization of antibodies on a
      polyacrolein latex was studied in comparison with the sorbents based on
      microcrystalline cellulose and with the surface of polystyrene test tubes in a
      two-center radioimmunoassay for ferritin. It was shown that the polyacrolein
      latex provides a covalent binding of up to 75 mg protein per g dry polymer with
      an immobilization efficiency of 50-70% and a high effective association constant
      of immobilized antibodies (Ka = 4.5 x 10(9) M-1). The same parameters for the
      sorbent based on microcrystalline cellulose were 33 mg/g, 25-35%, and 4.3 x 10(8)
      M-1, respectively. In the radioimmunoassay for ferritin, the immunosorbents based
      on polyacrolein latex and cellulose ensured a nearly the same analytical
      sensitivity at the level of (0.7-0.9) x 10(-13) M ferritin and pointed to the
      possibility of eliminating the "hook-effect". Compared to the immunosorbent based
      on polystyrene test tubes, the advantages of the polyacrolein latex are the
      decrease in the minimum detectable concentration (increase in analytical
      sensitivity), the extension of the dynamical range of analysis, and the absence
      of the "hook-effect".

PMID- 7786315
TI  - [Isolation and properties of carboxypeptidase from the Kamchatka crab
      Paralithodes camtshatica].
AB  - Homogeneous carboxypeptidase PC from a hematopancreas of kamchatka crab
      Paralithodes camtshatica was obtained by means of an affinity chromatography on
      sorbents containing arginine, protamine hydrolysate, and phenylalanine as ligands
      with an yield 23% and purification degree 37.4. The isolated enzyme has a
      molecular mass 34 kDa, as evidenced by an SDS-PAGE; pI 3.1; an optimum pH 6.5, as
      estimated for hydrolysis of Dnp-Ala-Ala-Arg; pH-stability range 5-8 in the
      presence of Ca2+; a temperature optimum 55 degrees C; and Km 0.4 mM. The
      carboxypeptidase is activated by Co2+ and Ca2+ ions and is inhibited by EDTA and
      o-phenanthroline, and therefore, it is a metallocarboxypeptidase. The enzyme can
      effectively split off C-terminal residues Phe and Tyr, as well as Arg and Lys.
      Residues Pro, Glu, and Asp cannot be split off, and they stop the cleaving of a
      preceding bond. Thus, the carboxypeptidase PC of kamchatka crab has a mixed
      substrate specificity, which is characteristic of carboxypeptidase from crawfish
      and of microbial carboxypeptidases T and SG. The new carboxypeptidase has an
      amino acid composition
      Asp41Thr24Ser22Glu32Pro15Gly32Ala291/2Cys5Val19Met8Ile14Leu20Ty r18Phe8Lys7His4
      Arg8Trp4. The N-terminal sequence of the enzyme demonstrate a 40% homology with
      the N-terminal sequence of carboxypeptidase from crawfish.

PMID- 7786317
TI  - [Polypeptides from murine peritoneal macrophages recognizing glycosaminylmuramoyl
      dipeptide].
AB  - By means of radioligand analysis, murine peritoneal macrophages were shown to
      express several hundreds cell surface high-affinity GMDP-binding sites with a
      binding constant 350 pM. Photoaffinity labeling followed by SDS-PAGE enabled us
      to identify inside these cells 32-34 and 38 kDa proteins, specifically binding
      GMDP. Proteins 32-34 kDa were also detected by Western blotting analysis using
      biotinylated conjugate of polyacrylamide with immobilized GMDP-Lys [(GMDP-Lys)
      PAA-(Bi)] in cell lysate of murine peritoneal macrophages.

PMID- 7786318
TI  - [Synthesis of a cyclic enkephalin analog with prolonged action].
AB  - A cyclic analog of enkephalin, cyclo(Lys-Tyr-DMet-Gly-Phe-Pro-) and two
      corresponding linear hexapeptides with lysine residue on the N- and C-termini of
      the pentapeptide sequence, Lys-Tyr-DMet-Gly-Phe-Pro and Tyr-DMet-Gly-Phe-Pro-Lys
      were synthesized by classical and solid phase methods of peptide chemistry. The
      cyclic analog exhibited significantly prolonged analgesic effect, evaluated by
      the "tail pinch" method after intracysternal injection to mice. The cycloanalog
      also had a weak influence on the peripheral opiate receptors of the isolated
      segment of guinea pig iliac intestine. Addition of the lysine residue to the N
      terminus of the pentapeptide sequence enhanced by an order of magnitude the
      selectivity of binding of the analog with opiate receptors of mu-type.

PMID- 7786319
TI  - [Dependence of the level of gene expression in E. coli on the structure of the
      translation initiation segment (TIR)].
AB  - The expression levels of genes that are transcribed to give mRNAs with identical
      leader sequences and even with identical extended coding regions may differ
      considerably. In order to determine the mechanism of this phenomenon, secondary
      structures of some mRNAs synthesized from a series of expression plasmids were
      studied. It was shown that the effect of the mRNA secondary structure in the
      translation initiation region on the initiation efficiency is due not only to the
      hairpin formation in this region but also to long-range interactions. When
      complementary structures tighter than those resulted from the interaction of
      regions SD, UB1, UB2, and DB with 16S rRNA are formed, the efficiency of the
      translation initiation and, consequently, the expression level decrease.

PMID- 7786320
TI  - [Modification of pyrimidine nucleosides using nicotinic acid derivatives].
AB  - Interaction of nicotinoyl chloride in situ with 2'-deoxyuridine, its 3'-O-acetyl
      , or 5'-O-trityl derivatives led to 3'-O-nicotinoyl-, 5'-O-nicotinoyl-, 3',5'-di
      O-nicotinoyl-, and N3,3'-di-O-nicotinoyl-2'-deoxyuridine. Similarly, 5'-O
      nicotinoyl-6-azauridine resulted from the reaction of 2',3'-O-ethoxymethylidene-6
      azauridine followed by the deprotection. Reaction of 5'-amino-5'-deoxy-2',3'-O
      ethoxymethylidene-6-azauridine with nicotinic acid in the presence of 2-ethoxy-1
      ethoxycarbonyl-1,2-dihydroquinoline followed by the cleavage of the 2',3'-O
      protecting group gave 5'-deoxy-5'-nicotinamido-6-azauridine. The same compound
      was obtained from 5'-amino-5'-deoxy-6-azauridine and N-succinimidyl nicotinate.
      Structures of the compounds obtained were corroborated by 1H NMR spectra. It is
      shown that 3',5'-di-O-nicotinoyl-2'- deoxyuridine and 5'-deoxy-5'-O-nicotinamido
      6-azauridine are cytotoxic toward CaOv cells in vitro (CE50 10(-5) M).

PMID- 7786321
TI  - [Nonchemical methods of modifying substrates for studying biopolymers with atomic
      force microscopy].
AB  - Two simple procedures of DNA molecule fixation on mica for following imaging by
      the atomic force microscopy were developed. The distinctive features of the
      procedures are their simplicity, absence of chemical modification stages, and the
      possibility to obtain the images in air under relative high humidity. Comparison
      of the features of the images obtained indicated that the procedures developed
      were competitive with the procedures earlier suggested.

PMID- 7786322
TI  - [Open access upper endoscopy. Can the practice be improved?].
AB  - 150 patients who were referred to the open access endoscopical unit in a county
      hospital for upper gastrointestinal examination were evaluated. The aim was to
      answer the following questions: How often is this upper GI-endoscopy of value for
      medical treatment of the patient, and is "open access endoscopy" a practical
      system? In order to obtain a more reliable diagnosis it is necessary to examine
      the patient without delay, and thereby avoid the masking effect of H-2 blockers
      and omeprazole. More attention to anamnestic risk factors would improve case
      selection. In many cases it is possible to rely on X-ray examination, and thus
      reduce the burden on the endoscopy unit and allow for instant endoscopy service.

PMID- 7786323
TI  - [Meta-analyses are necessary but technically difficult. Hard criticism against an
      article on mammography].

PMID- 7786324
TI  - Chromosome mapping and organization of the human beta-galactoside alpha 2,6
      sialyltransferase gene. Differential and cell-type specific usage of upstream
      exon sequences in B-lymphoblastoid cells.
AB  - The human beta-galactoside alpha 2,6-sialyltransferase (EC 2.4.99.1) (SiaT-1)
      gene is localized to human chromosome 3 (q21-q28) by Southern analysis of somatic
      cell hybrids and by in situ hybridization of metaphase chromosomes. Comparative
      analysis between the human and the previously reported rat SiaT-1 genomic
      sequences demonstrates precise conservation of the intron/exon boundaries
      throughout the coding domains. Furthermore, there is extensive inter-species
      sequence similarity in some of the exons that contain information only for the 5'
      leader regions. Human genomic sequences were also analyzed to reconcile reported
      differences in the 5'-untranslated region in SiaT-1 mRNAs. In cultured cell lines
      of the B-lineage, Reh, Nalm-6, Jok-1, Ball-1, Daudi, and Louckes, the study
      demonstrates that three upstream exons, Exons(Y+Z) and Exon(X), are mutually
      exclusively utilized, resulting in at least two distinct populations of SiaT-1
      mRNA being synthesized. None of these exons is present in the SiaT-1 mRNA isotype
      expressed in HepG2 human hepatoma cells. In all B-lymphoblastoid cell lines
      examined, the basal level SiaT-1 mRNA is maintained by the expression of an
      isotype containing the Exons(Y+Z) sequence. The slightly smaller SiaT-1 mRNA,
      which contains the Exon(X) sequence but not Exons(Y+Z) sequence, is synthesized
      at a high level and found only in Jok-1, Daudi, and Louckes, the cell lines with
      mature B-cell phenotype. The study also provides further evidence that induced
      SiaT-1 expression accompanies the appearance of CDw75, a putatively sialylated
      cell surface epitope and a marker of human mature B-lymphocytes. The SiaT-1
      induction is the result of the appearance of a novel form of SiaT-1 mRNA isotype.

PMID- 7786325
TI  - [Smoking and fetal growth. Do nicotine levels in tobacco play a role?].

PMID- 7786328
TI  - [Alternative cancer treatment and informative censorship].

PMID- 7786327
TI  - [Gonadal functional disorders following the therapy of testicular tumors].

PMID- 7786326
TI  - [Consensus diagnosis pulmonary embolism].

PMID- 7786329
TI  - [Oral typhoid vaccination and cross immunity against enteritis-causing
      salmonellae].

PMID- 7786330
TI  - [Open access upper endoscopy. Selection of upper endoscopy].

PMID- 7786331
TI  - [More on normal fees].

PMID- 7786333
TI  - [Abuse potential during use and withdrawal psychosis after treatment with the
      hypnotic zolpidem (Stilnoct)].
AB  - Three cases are presented. Withdrawal symptoms and ultimately psychosis developed
      in two cases following cessation of the hypno-sedative zolpidem. Two cases
      involve dependence upon and abuse of the drug; in one, a well-known alcoholic, it
      was abused in combination with alcohol, the other had prior well-known dependence
      on sedative hypnotics. One patient had chronic dysphoria and one encephalopatia
      toxica. Adverse effects such as withdrawal symptoms, dependence and abuse have
      not previously been reported in relation to zolpidem. Chemically unrelated to
      benzodiazepines, zolpidem is thought to have fewer adverse effects, but shares a
      pharmacokinetic profile with the benzodiazepine triazolam. It is advised that
      normal criteria for the prescription of benzodiazepines also be used when
      prescribing non-benzodiazepine sedatives and hypnotics, as they act upon the same
      receptor, namely the benzodiazepine-GABA-chloride complex.

PMID- 7786332
TI  - Folate status, women's health, pregnancy outcome, and cancer.
AB  - Key observations by Dr. Lucy Wills 65 years ago have led to the identification of
      folate as a nutrient essential for the prevention of megaloblastic anemia of
      pregnancy. The more recently discovered relationships of folate status to
      cervical dysplasia, neural tube defects, and atherosclerosis are reviewed here.

PMID- 7786334
TI  - [Treatment possibilities in basal cell carcinoma].

PMID- 7786335
TI  - [Trained personnel is needed for home care of patients with mental disorders].

PMID- 7786336
TI  - [Guidelines for advanced cardiopulmonary resuscitation of adults].

PMID- 7786337
TI  - [Evaluation shows that centralization of thoracoscopic surgery is unnecessary].

PMID- 7786338
TI  - [Treatment of ischemic heart disease--coronary surgery or angioplasty?].

PMID- 7786339
TI  - [Molecular biology and physiology go hand in hand].

PMID- 7786340
TI  - [Anaphylactic reactions following insect bites: clinical aspects, course and
      treatment].

PMID- 7786341
TI  - Tetanus and botulinum neurotoxins are zinc proteases specific for components of
      the neuroexocytosis apparatus.
AB  - Tetanus and botulinum neurotoxins bind to nerve cells, penetrate the cytosol, and
      block neurotransmitter release. Comparison of their amino-acid sequences shows
      the presence of the highly conserved His-Glu-x-x-His zinc-binding motif of zinc
      endopeptidases (HExxH). Atomic absorption measurements of clostridial neurotoxins
      show the presence of one atom of zinc/toxin molecule bound to the light chain.
      The toxin-bound zinc ion is essential for the neurotoxins inhibition of
      neurotransmitter release in Aplysia neurons injected with the toxins.
      Phosphoramidon, a very specific inhibitor of zinc-endopeptidases, blocks the
      intracellular activity of the clostridial neurotoxins. Highly purified
      preparations of the light chain of tetanus and botulinum B and F neurotoxins
      cleaved specifically VAMP/synaptobrevin, an integral membrane protein of small
      synaptic vesicles, both in vivo and in vitro. From these studies, it can be
      concluded that the clostridial neurotoxins responsible for tetanus and botulism
      block neuroexocytosis via the proteolytic cleavage of specific components of the
      neuroexocytotic machinery.

PMID- 7786342
TI  - [Allopurinol].

PMID- 7786343
TI  - [Personal development and continuing formation. A requirement for maintenance and
      improvement of the professional qualifications of nurses].

PMID- 7786344
TI  - [Pain in children].

PMID- 7786345
TI  - [Anti-inflammatory effects of cromones in asthma].
AB  - The cromone family comprises sodium cromoglycate and the more recently developed
      nedocromil sodium. Nedocromil sodium prevents the bronchial obstruction induced
      by a variety of stimuli, including antigen. When given before antigen inhalation,
      nedocromil sodium prevents the early and late reaction and the increase in
      bronchial hyperresponsiveness. It is still effective in preventing the late phase
      when given after antigen exposure. These effects may result from the action of
      nedocromil sodium on inflammatory cells observed in vitro, particularly mast
      cells and eosinophils. When inhaled regularly, nedocromil sodium improves
      symptoms, especially in moderate asthma, decreases bronchial obstruction and
      reduces bronchial hyperreactivity. Bronchial biopsy studies have shown a decrease
      in activated eosinophils during prolonged nedocromil sodium treatment, suggesting
      that the clinical benefit results from an antiinflammatory effect of the drug.
      More recently, it has been suggested that nedocromil sodium may act on membrane
      chloride channel involved in activation of many cell types. In vitro data have
      shown a decrease in IgE production by isolated mononuclear cells, suggesting new
      therapeutic potential to be studied clinically.

PMID- 7786346
TI  - Antituberculous therapy and acute liver failure.

PMID- 7786347
TI  - Antituberculous therapy and acute liver function.

PMID- 7786348
TI  - Treadmill exercise training and estradiol differentially modulate hypothalamic
      pituitary-adrenal cortical responses to acute running and immobilization.
AB  - It is generally believed that physical fitness promotes health by attenuating
      responsiveness to other stressors. The experimental evidence for this belief is
      limited and does not extend to interactions between the hypothalamic-pituitary
      adrenal cortical (HPA) and hypothalamic-pituitary-gonadal (HPG) axes. We tested
      the hypothesis that treadmill exercise training would lead to an estrogen
      dependent hyporesponsiveness of the HPA axis that would generalize to
      immobilization stress. Ovariectomized female Sprague-Dawley rats (N = 74) that
      had been treadmill trained (TT) or sedentary for 6 weeks received intramuscular
      injections of estradiol benzoate (Eb) or sesame oil on each of 3 days prior to 15
      min of acute treadmill running or immobilization. Plasma (adrenocorticotrophin)
      (ACTH), (corticosterone) (B) and (prolactin) (PRL) were determined from trunk
      blood by radioimmunoassay and compared in a 2 group (TT vs. sedentary)-by-2
      treatment (Eb vs. oil)-by-2 acute stressor (running vs. immobilization) design.
      Home-cage (HC) animals (N = 24) provided baseline hormone levels. ACTH and B
      levels were elevated after stressors in animals treated with either Eb or oil
      compared to HC, but increases in PRL after stressors were dependent on Eb.
      Treadmill exercise training led to an attenuation of ACTH and prolactin to
      running, but the attenuation did not generalize to immobilization. In contrast,
      treadmill exercise training led to a hyperresponsiveness of ACTH. Treadmill
      training did not modulate prolactin responses to immobilization. The modulating
      effects of the estradiol treatment are consistent with an interaction of the HPA
      and HPG axes in response to stress.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786349
TI  - Carbohydrate, fat, and protein condition similar flavor preferences in rats using
      an oral-delay procedure.
AB  - Flavor preferences conditioned by carbohydrate (Polycose), protein (casein
      hydrolysate), and fat (corn oil) were compared using an oral-delay training
      method. In Experiment 1 separate groups of food deprived rats were trained to
      associate a CS+ flavor (e.g., grape-saccharin) with the delayed (10 min)
      presentation of isocaloric carbohydrate, protein, or fat sources. A CS- flavor
      (e.g., cherry-saccharin) was paired with the delayed presentation of an
      unflavored saccharin solution. In subsequent two-bottle tests the carbohydrate,
      protein, and fat trained groups displayed significant preferences for the CS+
      over the CS-. In Experiment 2 each rat was trained to associate two new flavors
      with two of the three nutrients (e.g., orange with carbohydrate, and strawberry
      with protein). In subsequent two-bottle tests the rats equally preferred the two
      nutrient-paired flavors. Experiment 3 compared the preferences for the new CS+
      flavors vs. the original CS-flavor. The rats displayed similar preferences for
      carbohydrate-, protein- and fat-paired CS+ over the CS-. The similar preferences
      obtained with the three different nutrients support the view that preference
      conditioning is mediated by the nutrients' caloric value. Other studies suggest,
      however, that nutrient-specific signals are also involved in the conditioning
      process.

PMID- 7786350
TI  - Anti-tuberculous therapy and acute liver failure.
AB  - The incidence of tuberculosis has been increasing since 1987, exposing a greater
      number of patients to the risks of three potentially hepatotoxic drugs,
      isoniazid, rifampicin, and pyrazinamide. Awareness of potentially severe drug
      hepatotoxic reactions is vital because fulminant hepatic failure is a devastating
      and often fatal condition without liver transplantation. We report four cases of
      fulminant hepatic failure caused by rifampicin, isoniazid, or both. These cases
      highlight the need for stricter adherence to and review of current guidelines on
      liver function tests after starting anti-tuberculous therapies.

PMID- 7786351
TI  - [Toward an integral vision of health reform].

PMID- 7786352
TI  - Current results of lower extremity revascularization with vein grafts.

PMID- 7786353
TI  - Laser assisted surgery: the San Pablo experience.
AB  - Two thousand plus (2,000+) assisted laser surgical procedures were performed
      between July 1986 and November 1993. Multiwavelength specialties: Argon, CO2 and
      NdYAG usage include: general surgery, thoracic surgery, neurosurgery,
      ophthalmology, and gynecology. 65% of the patients were female whose ages range
      from 6 to 105 years. Endoscopic vs. handheld procedures ratios 1:1. In 95% of the
      cases attended, the procedures were performed for benign conditions. The office
      hospital usage distribution was 60-40%. The office morbidity was 0.8% (16 out of
      2,000 cases) and a mortality of 0.15% (3 out of 2,000 cases). A reported 100%
      safety compliance was seen. Laser assisted surgery is a safe, effective and
      reliable option available to the surgeon's armamentarium. It appears that in some
      procedures it will allow shorter hospital stays and an earlier return of the
      patient to his/her normal routine.

PMID- 7786354
TI  - Changing trends in adenotonsillectomy at San Pablo Hospital 1983 vs. 1993.
AB  - The purpose of this paper is to review the changing trends in
      Adenotonsillectomies performed in San Pablo Medical Center during the last ten
      years. We have reviewed using a 25 variable questionnaire all patients undergoing
      this surgical procedure during the first six months in 1983 and compared the
      information with the patients having this procedure during the first six months
      of 1993. We conclude that the number of interventions, the indications, prior
      medical history and cost effects have changed substantially. Our data supports
      the accuracy of some of the trends being reported in the literature regarding
      this surgical intervention.

PMID- 7786355
TI  - Dengue fever with thrombocytopenia: studies towards defining vulnerability of
      bleeding.
AB  - PURPOSE: To define the period of greater vulnerability of bleeding in patients
      with Dengue fever in reference to the onset of their constitutional symptoms and
      the laboratory abnormalities. PATIENTS AND METHODS: In a retrospective study we
      reviewed the records of all patients admitted to San Pablo Medical Center in 1991
      with a diagnosis of Dengue Fever or Hemorrhagic Dengue. All patients with a
      platelet count of less than 125,000 were included for analysis. The exclusion
      criteria included the presence of systemic disorders which may influence the
      platelet count, and patients without documentation regarding the presence of
      constitutional symptoms suggestive of viral illness. RESULTS: A total of 101
      patients were analyzed of which only 74 were included in the study. All patients
      had fever and chills; skin rash, asthenia and general malaise was seen in over
      50% of patients. Over 70% of patients had recovery of their platelet count, and
      most had their maximal thrombocytopenia within the 5th day and 8th day from the
      onset of constitutional symptoms. Leukopenia was seen in over 70% of patients
      with its lowest level within the 5th and 8th day from the onset of the
      constitutional symptoms. Significantly prolonged partial thromboplastin time was
      seen in 11% of the patients. Proteinuria was seen in 22% of the patients, 38% of
      which had it within the first 4 days of the onset of constitutional symptoms and
      also noted on the 5th and 6th day. Alteration in liver enzymes were noted in 47%
      of patients, with a maximal severity distributed in all time frames.
      Hypoalbuminemia was present in 28% of the patients, of these 67% presented within
      the first 4 days from the onset of constitutional symptoms. The pulse rate was
      usually normal in spite of the patient's dehydration and fever. CONCLUSIONS: We
      identified three phases that define the sequence of events seen in the majority
      of patients with Dengue Fever and Thrombocytopenia. These are: 1. proteinuria and
      hypoalbuminemia; 2. maximal cytopenia; 3. bradycardia and liver enzyme elevation.
      We believe this information is useful in the management of patients with Dengue
      Fever and thrombocytopenia.

PMID- 7786356
TI  - Group B streptococcal disease in pregnancy.
AB  - Group B Streptococcal (GBS) infection in the pregnant female represents a
      challenging and often complex scenario which may cause deleterious effects in the
      neonate. In this paper we present three case reports of GBS infection in neonates
      with different outcome. A comprehensive review of the history, microbiology,
      clinical presentation and therapy guidelines is presented. Early diagnosis and
      institution of therapy are the most important factors which may have an impact on
      maternal and neonatal outcome.

PMID- 7786357
TI  - [Risk management in the hospital industry].
AB  - The author provides an introduction to the risk management process in the
      hospital industry as well as explains some of the basic elements in a risk
      management program in such industry. The author also explains the factors to be
      evaluated in a risk management program.

PMID- 7786358
TI  - Rehabilitation of the patient with an anterior cruciate ligament injury: a brief
      review.

PMID- 7786359
TI  - The pediatric inguinal hernia: is contralateral exploration justified?
AB  - To determine if contralateral inguinal hernia exploration is justified we decided
      to study our experience with 161 consecutive cases who underwent bilateral repair
      during a 30 months period. 61% of the population were infants younger than two
      years of age, and 19% premature babies. 69 pts presented with an RIH, 47 with an
      LIH and 45 pts with BIH. 16% suffered an episode of preoperative incarceration
      which were all reduced satisfactorily and operated promptly. A positive
      contralateral finding (either a hernial sac or a patent processus vaginalis) was
      identified in 74% RIH and 72% LIH patients upon exploration. No incidence of
      testicular edema/atrophy, vas deferens injury, or recurrence was reported in the
      six-year follow-up of the study. Statistical analysis of the contralateral
      findings during surgery with sex, gestational age and age at operation showed
      that females and infants younger than two months of age had a higher probability
      of having positive findings. We could not show that prematurity or left-sided
      hernias were associated with a higher positive contralateral rate. The major
      benefit of contralateral exploration is based on the fact that it allows
      discovery and elimination of a patent processus vaginalis so a hernia cannot
      develop subsequently. We conclude by establishing certain criteria that justifies
      the routine contralateral exploration of the pediatric hernia: the surgeon should
      be experienced in child care, associated conditions should not increase the
      surgical risks significantly, time-consuming dissections of the cord structures
      should be discouraged, and the operating time should be kept to a minimum.

PMID- 7786360
TI  - Other attitudes affecting the doctor-patient relationship.

PMID- 7786361
TI  - Who needs history?

PMID- 7786362
TI  - Proposal for a standardized electronic medical student record.

PMID- 7786363
TI  - Compliance with the review requirement for residency program sponsors.

PMID- 7786364
TI  - Training residents to work with diverse populations.

PMID- 7786365
TI  - CQI and planning the expansion of the primary care workforce.

PMID- 7786366
TI  - A reexamination of the NRMP matching algorithm. National Resident Matching
      Program.
AB  - Most graduating medical students in the United States find their first
      professional appointments through the National Resident Matching Program (NRMP).
      This service receives rank-order lists of preferences from students and from
      hospitals, and then generates final assignments of students to hospitals through
      the use of a specific computerized matching algorithm. The author uses recent
      findings from the mathematics and economics literatures to demonstrate three
      difficulties with the NRMP's matching algorithm and the official descriptions
      thereof. First, the algorithm favors hospitals over students, a feature known to
      the NRMP since at least 1976, but, in the author's opinion, not made clear in
      NRMP literature for students. Second, the author argues that the NRMP's
      justification that its algorithm mimics orderly, noncentralized admission
      processes is not correct. Institutions operating under non-centralized procedures
      must typically make more initial offers than there are positions, in the
      realization that some fraction of their offers will be declined. This arrangement
      enlarges the choices available to many applicants, and thereby benefits them,
      whereas the NRMP's algorithm unrealistically assumes that no institution would
      ever send out any extra offers. Third, the NRMP's algorithm contains incentives
      for students to misrepresent their true preferences when constructing their rank
      order lists. This feature is a substantial disadvantage of the current algorithm
      and is incorrectly described in literature distributed to students and in
      published articles from the NRMP.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786367
TI  - The NRMP matching algorithm revisited: theory versus practice. National Resident
      Matching Program.
AB  - The authors examine the algorithm used by the National Resident Matching Program
      (NRMP) in its centralized matching of applicants to U.S. residency programs ("the
      Match"). Their goal is to evaluate the current NRMP matching algorithm to
      determine whether it still fulfills its intended purpose adequately and whether
      changes could be made that would improve the Match. They describe the basic NRMP
      algorithm and many of the variations of the matching process ("match variations")
      incorporated over the last 20 years to meet participants' requirements. An
      overview of the current state of the theory of preference matching is presented,
      including descriptions of the characteristics of stable matches in general,
      program-optimal and applicant-optimal matchings, and strategies for formulating
      preference lists. The characteristics of the current NRMP algorithm are then
      compared with the theoretical findings. Research conducted long after the
      original NRMP algorithm was devised has shown that an algorithm that produces
      stable matches is the best approach for matching applicants to positions. In the
      absence of requirements to satisfy match variations, the NRMP's deferred
      acceptance algorithm produces a program-optimal stable match. When match
      variations, such as those handled by the NRMP, must be introduced, it is possible
      that no stable matching exists, and the resulting matching produced by the NRMP
      algorithm may not be program-optimal. The question of program-optimal versus
      applicant-optimal matchings is discussed. Theoretical and empirical evidence
      currently available suggest that differences between these two kinds of matchings
      are likely to be small. However, further tests and research are needed to assess
      the real differences in the results produced by different stable matching
      algorithms that produce program-optimal or applicant-optimal stable
      matches.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786368
TI  - A model alcohol and other drug use curriculum for pediatric residents.
AB  - While alcohol and other drug (AOD) use is a major health risk for adolescents in
      the United States, there is a paucity of AOD training for pediatric residents. In
      1991-92, the University of Wisconsin Medical School developed an experiential,
      community-based AOD curriculum for pediatrics residents. The curriculum included
      resident participation in a community-based AOD adolescent assessment and
      intervention program, interactive didactic sessions, role-playing practice, and
      interviewing skills sessions. The residents who participated in the curriculum (n
      = 25) were compared with a control group (n = 19). Evaluation included pre- and
      post-curriculum written tests, objective structured clinical examinations, and
      residents' ratings of the curriculum components. The residents who participated
      showed significant gains in AOD knowledge, utilization of screening techniques,
      and clinical management skills as compared with the controls. The residents gave
      positive ratings to all curriculum components. This well-received curriculum can
      serve as a national model both for AOD education in pediatrics and for curriculum
      development in other areas of adolescent health-risk-taking.

PMID- 7786370
TI  - Medicine's relation to homosexuality and for gay people within medicine.

PMID- 7786369
TI  - The potential of computerized representations of anatomy in the training of
      health care providers.
AB  - The purpose of anatomy education is to develop the skills for anatomical
      reasoning, which is a requirement for performing a number of clinical tasks.
      Anatomical reasoning integrates an understanding of the three-dimensional (3-D)
      geometry of the body and its parts (the spatial domain of anatomical information)
      with an understanding of functional, developmental, pathological, and other
      relationships among anatomic entities (the symbolic domain of anatomical
      information). Traditional methods in anatomy have substantial shortcomings for
      representing and integrating these two information domains. Computer-based
      methods of knowledge representation have a great potential for overcoming the
      shortcomings and for promoting anatomical reasoning. To realize this potential,
      there is a need for (1) establishing 3-D electronic atlases of the human body;
      (2) generating models of symbolic anatomical information, and (3) developing
      computer programs (user interfaces) that integrate these knowledge sources and
      serve the needs of trainees and practitioners in different fields of the health
      sciences. The Digital Anatomist Program at the University of Washington has begun
      to build such a client-server framework for anatomical information, and its
      application for biomedical education is being evaluated.

PMID- 7786372
TI  - Validity of three clinical performance assessments of internal medicine clerks.
AB  - PURPOSE: To analyze the construct validity of three methods to assess the
      clinical performances of internal medicine clerks. METHOD: A multitrait
      multimethod (MTMM) study was conducted at the Case Western Reserve University
      School of Medicine to determine the convergent and divergent validity of a
      clinical evaluation form (CEF) completed by faculty and residents, an objective
      structured clinical examination (OSCE), and the medicine subject test of the
      National Board of Medical Examiners. Three traits were involved in the analysis:
      clinical skills, knowledge, and personal characteristics. A correlation matrix
      was computed for 410 third-year students who completed the clerkship between
      August 1988 and July 1991. RESULTS: There was a significant (p < .01) convergence
      of the four correlations that assessed the same traits by using different
      methods. However, the four convergent correlations were of moderate magnitude
      (ranging from .29 to .47). Divergent validity was assessed by comparing the
      magnitudes of the convergence correlations with the magnitudes of correlations
      among unrelated assessments (i.e., different traits by different methods). Seven
      of nine possible coefficients were smaller than the convergent coefficients,
      suggesting evidence of divergent validity. A significant CEF method effect was
      identified. CONCLUSION: There was convergent validity and some evidence of
      divergent validity with a significant method effect. The findings were similar
      for correlations corrected for attenuation. Four conclusions were reached: (1)
      the reliability of the OSCE must be improved, (2) the CEF ratings must be
      redesigned to further discriminate among the specific traits assessed, (3)
      additional methods to assess personal characteristics must be instituted, and (4)
      several assessment methods should be used to evaluate individual student
      performances.

PMID- 7786371
TI  - Indicators of the educational effectiveness of subspecialty training programs in
      internal medicine.
AB  - PURPOSE: To identify markers within the subspecialty educational process in
      internal medicine that are associated with greater improvements in knowledge and
      skill. METHOD: Candidates for the 1991 cardiovascular disease examination of the
      American Board of Internal Medicine (ABIM) were matched to the fellowship
      programs they attended, and their performances on the internal medicine
      examination of the ABIM, demographic data, and performances on the cardiovascular
      disease examination were averaged within each program. Information on the
      programs themselves was also available. The variables were divided according to
      whether they controlled for input to the training programs, were indicators of
      educational process, or served as the outcome measure. Analyses were restricted
      to the 140 programs for which complete information was available and that had
      four or more candidates who took the cardiovascular examination (97 programs were
      excluded). RESULTS: The multiple correlation between all measures and scores on
      the cardiovascular disease examination was .80. Forty-five percent of the
      explained variance is attributable to previous performance on the internal
      medicine examination alone. The remaining 55% is shared by the educational
      indicators and the input measure or explained by the indicators alone. Among the
      indicators, location of medical school, length of fellowship training, ratings of
      overall clinical competence, fellow-to-faculty ratio, and number of
      subspecialties in the same institution made small contributions on their own.
      Program size, university affiliation, and period of approval by the residency
      review committee contributed little. CONCLUSION: The data are clear that
      indicators of educational process such as fellow-to-faculty ratio, longer periods
      of training, and performance during fellowship can generate greater gains in
      knowledge and judgment than would be expected if fellows merely built on their
      abilities at the time of entry to training. Such indicators may be useful if
      changes in health care delivery require reducing the numbers of specialty and
      subspecialty training positions.

PMID- 7786373
TI  - Analysis of the cost of training residents in a community health center.
AB  - BACKGROUND: Currently one federal program funds community health centers (CHCs)
      to provide services in underserved communities, and a second supports development
      of primary care teaching programs. Teaching CHCs respond to both program's goals,
      but their development is hindered by restrictive regulations of the two programs
      and lack of information regarding cost. METHOD: Spreadsheet software was used to
      develop a model that allocates cost components of a CHC-based residency.
      Productivity and staffing data from a teaching CHC program were used to estimate
      the cost of training and its sensitivity to selected variables. Data from 1992
      through 1994 were collected from the family practice residency sponsored by the
      Brown University School of Medicine, the Memorial Hospital of Rhode Island, and
      the Blackstone Valley Community Health Center. RESULTS: An educational supplement
      of $13.21 per visit would be required for the program to be cost-neutral relative
      to staff. The cost of outpatient training for a resident averaged $13,935 per
      year. Residents would "break even" if they saw patients at 19% above the average
      rate recommended by the residency review committee. If staff physicians instead
      of residents had provided the patient care, the CHC would have saved $6,171 per
      resident. Additional savings from improved physician recruiting and decreased
      turnover would increase the value of the program to the CHC. Cost was most
      sensitive to resident productivity, precepting arrangements, nursing staff
      support, and staff turnover. CONCLUSION: Developing graduate medical education
      programs in CHCs can be a cost-effective way of increasing the pool of
      appropriately trained primary care physicians and increasing health care access
      for underserved populations. If teaching CHCs are to expand, provisions will need
      to be made for adequate reimbursement of their costs.

PMID- 7786375
TI  - A prospective, randomized trial of a six-week ambulatory medicine rotation.
AB  - BACKGROUND: Medical schools are placing increased emphasis on training students
      in the ambulatory setting, but few studies show the benefit or academic risk of
      such innovation. The authors studied the effect of such a new rotation with a
      rigorous study design. METHOD: From a group of 166 third-year students at the
      Uniformed Services University of the Health Sciences F. Edward Hebert School of
      Medicine assigned in 1990-91 to do six weeks of their third-year medicine
      clerkship at Walter Reed Army Medical Center, 106 volunteers were randomized to
      six weeks either on the usual rotation on the general medicine wards (69
      students) or to a new ambulatory rotation (37 students). Multiple pre- and
      postclerkship parameters were used to evaluate clerkship skills and knowledge;
      eventual internship choice was determined. RESULTS: The randomization was
      successful. Postclerkship performances were the same in (1) the medicine subject
      examination of the National Board of Medical Examiners, (2) a multiple-choice
      test in interpreting laboratory results, (3) blinded rating by an expert panel of
      the quality of final written histories and physical exams, (4) blinded rating by
      an expert panel of the students' written case analyses of their own patients, and
      (5) a written multiple-step examination of problem-solving ability. Any
      differences between groups favored the ambulatory group. An increase in choice of
      primary care internships among students randomized to the ambulatory rotation was
      not significant. CONCLUSION: It is possible to study innovative rotations using a
      prospective, randomized design. Substituting a six-week block ambulatory
      experience for a ward rotation did not decrease students' abilities to write up
      or analyze complex cases.

PMID- 7786374
TI  - Influence of medical school applicants' demographic and cognitive characteristics
      on interviewers' ratings of noncognitive traits.
AB  - BACKGROUND: Interviews are commonly used to measure noncognitive traits of
      medical school applicants. The present study investigated the influence of
      knowledge of applicants' cognitive abilities on interviewers' ratings of
      noncognitive traits. METHOD: Academic and demographic predictors of interview
      ratings of applicants' noncognitive traits were examined at the Medical
      University of South Carolina College of Medicine during two years: 1992, when
      applicants' Medical College Admission Test (MCAT) total scores and undergraduate
      grade-point averages (GPAs) were available to interviewers; and 1993, when MCAT
      and GPA data were not available. In 1992, 226 applicants met study criteria
      (i.e., they received ratings from three interviewers in addition to having MCAT
      and GPA data on file); in 1993, 245 applicants met the criteria. Step-wise
      regression analyses were conducted to measure the influences of seven independent
      variables on applicants' interview ratings. Two-way analyses of variances and t
      tests were used to determine the effects of gender of applicants and
      interviewers. Cronbach's alpha coefficients were used as measures of
      interviewers' reliability. RESULTS: GPA was the best predictor for both years but
      accounted for double the amount of variance in interview ratings in 1992 (15.7%)
      compared with 1993 (7.4%). The reliability coefficients for the interviewers were
      .496 for 1992 and .473 for 1993. CONCLUSION: If the goal of the medical school
      admission interview is to assess noncognitive traits independently from academic
      skills, the authors recommend that MCAT and GPA data not be available to
      interviewers during interviews. The authors also found that gender and race
      influenced interview ratings in accordance with affirmative-action goals.
      Finally, the authors found that interview scores were only moderately reliable
      across different interviewers. They discuss ways to increase their reliability.

PMID- 7786376
TI  - Inpatient versus outpatient settings: where are the essential medical problems
      seen?

PMID- 7786379
TI  - Results of the National Resident Matching Program for 1995.

PMID- 7786378
TI  - Effect on medical education of computerized physician order entry.

PMID- 7786377
TI  - Medical students' choices of teaching institutions for residency training.

PMID- 7786381
TI  - Influencing factors on the injury severity of restrained front seat occupants in
      car-to-car head-on collisions.
AB  - The results of 319 cases of belt-restrained front seat car occupants (234 drivers
      and 85 passengers) from 241 vehicles in car-to-car head-on collisions were
      examined. Ninety-five occupants were uninjured, 195 sustained a total injury
      severity of Maximum Abbreviated Injury Score (MAIS) 1-3 and 29, MAIS 4-6. There
      were 27 fatalities, and the main causes of death were polytrauma and hemorrhage.
      The main factors influencing occupant injury severity were: the energy equivalent
      speed (EES); the change of velocity (delta upsilon); the maximum deformation
      depth; and the collision angle. With an EES > 50 km/h fatal injuries can be
      expected, and above 60 km/h no occupant remained uninjured. The results of a
      multivariate analysis were: EES influenced the injury severity at all body
      locations except the spinal cord; occupant position effected only head injury
      severity, with drivers being more severely injured; occupant age influenced the
      injury severity at the thorax, abdomen, and extremities and MAIS as well. Age was
      a further factor influencing injury severity, e.g. with an EES of 50 km/h the
      probability of being fatally injured was 30%-45% higher for occupants over 59
      years than those under 20.

PMID- 7786380
TI  - Gender-associated differences in matriculating and graduating medical students.
AB  - Data from the 1993 Matriculating Student Questionnaire (MSQ) and the 1994 Medical
      School Graduation Questionnaire (GQ) of the Association of American Medical
      Colleges were investigated for differences in responses between men and women.
      Notable differences were discovered, particularly with regard to career plans and
      experiences during medical school. Findings from the GQ include that a higher
      proportion of women rated curricular coverage of numerous subjects inadequate and
      that women students more frequently reported mistreatment during medical school.
      Women were also more likely than men to work in clinics serving the indigent and
      to complete a primary care clerkship. Over 30% of the 1994 women seniors,
      compared with 18% of the men, planned to pursue generalist careers. The authors
      discuss the gender-associated differences, with reference to previous studies,
      and conclude that medical educators should ensure that women have access to the
      same skill-development opportunities that men do and to a humane learning
      environment. Moreover, educators should examine what adaptations can encourage
      students of both genders to develop an ethic of "social responsibility."

PMID- 7786382
TI  - Abandonment of mandatory jail for impaired drivers in Norway and Sweden.
AB  - In 1988 and 1990, respectively, Norway and Sweden adopted legal reforms including
      abandonment of mandatory jail sentences for persons driving with BACs above
      specific limits. Interrupted time-series analysis finds that in both countries
      traffic deaths diminished simultaneously with the reforms, consistent with the
      understanding that Scandinavian success in reducing impaired driving does not
      depend upon mandatory jail.

PMID- 7786383
TI  - Who's in the car? Passengers as potential interveners in alcohol-involved fatal
      crashes.
AB  - This article assesses the promise of motor vehicle passengers as interveners to
      prevent drinking and driving. It describes data from the U.S. Fatal Accident
      Reporting System (FARS), which indicate that most alcohol-involved fatally
      injured drivers (70% of males, 66% of females) were not accompanied by "adult"
      passengers (16 or older), and alcohol involvement among those passengers present
      appears to be high (80%). Nonetheless, in approximately 5% to 10% of cases it
      appears that sober or relatively "unimpaired" passengers could have served as
      interveners in alcohol-involved driving incidents. Passenger interveners may hold
      the most promise among teenagers, where passengers in general and unimpaired
      passengers in particular appear to be most prevalent.

PMID- 7786384
TI  - A five-year experience with severe injuries in elderly patients.
AB  - Recent reports of injury in elderly patients document that aggressive care is
      justified. Our experience indicates that geriatric injury differs from that of
      other trauma patients. All patients entered into a large urban trauma center
      registry over a five-year period were analyzed. Variables reviewed included
      demographics, trauma indices, mechanism of injury, mean number of hospital days,
      and morbidity and mortality for patients under 60 years old and for geriatric
      patients defined as those aged 60 and above. There were 3,064 patients in the
      reviewed group, of whom 243 qualified for geriatric analysis. Blunt injuries in
      males were the most typical scenario. Failure to use safety belts and alcohol
      intoxication persist into the geriatric age group (83% and 13%, respectively).
      Trauma indices including Injury Severity Score (ISS) were slightly greater in the
      geriatric group (27 versus 23) as compared to younger patients; plus geriatric
      patients tolerated head injury less well (GCS in those who died 6.7 versus 4.6,
      respectively; p < 0.001). Mortality in the geriatric group was 31% while being
      17.1% in the younger group (p < 0.005). Days in the hospital were 20 for the
      geriatric compared to 13 for the younger group (p < 0.025). Infections and chest
      complications were twice as common in the elderly and dysrhythmias were five
      times more frequent. Elderly patients constitute 8% of the trauma population and
      suffer a magnitude of injury at least comparable to the general population. Their
      mortality is approximately 50% above the population as a whole and morbidity
      twice as common, accounting for the prolonged hospital stay.

PMID- 7786386
TI  - Field observation of advance warning/advisory signage for passive railway
      crossings with restricted lateral sightline visibility: an experimental
      investigation.
AB  - This study evaluated a newly proposed series of signs intended for passive
      crossings with restrictions to lateral sightline visibility. These signs provide
      advance warning of a crossing and the restriction to lateral visibility. In
      addition, the signs advise motorists to come to a complete stop before crossing.
      Motorist behaviour was examined before and after installation of these signs at a
      rural passive crossing. A second site was observed in parallel to control
      partially for any confounding effects. Results indicated that motorists reduced
      speed and searched approach quadrants longer at points in the approachway after
      installation of the signs. However, there was no reliable increase in the number
      of motorists coming to complete stop, engaging in search behaviours, or
      classified as safe. The results are discussed in terms of reasons for the lack of
      compliance with the sign advisory.

PMID- 7786385
TI  - A study of injury-producing crashes on median divided highways in southwestern
      Ontario.
AB  - The University of Western Ontario Accident Research Team investigates every fatal
      crash, and approximately one out of every 50 personal-injury crash, within a
      defined geographic area of three counties. Over a seven-year period, the team
      investigated 107 collisions (62 fatal and 45 personal injury) that occurred on
      median-divided highways. These crashes were representative of over 2,300
      collisions on the highways involving 81 fatalities and injury to over 3,200
      vehicle occupants. Vehicle loss of directional control prior to any impact
      occurred in 55 of the 62 fatal cases and in 36 of the 45 personal-injury cases.
      In 36 fatal cases and 17 personal-injury cases loss of control was initiated
      after a vehicle travelled from the roadway onto the gravel shoulder. Rollover
      collisions were the most frequent collision type investigated and comprised 25
      fatal and 25 personal-injury cases. Unrestrained occupants made up 24 of the 29
      rollover fatalities with 96% of these unrestrained occupants being ejected from
      the vehicle. Collision with an oncoming vehicle after median-crossover occurred
      in 26 fatal cases. These crashes were usually frontal or side impacts
      characterized by extensive vehicle damage and massive intrusion into the occupant
      compartment. Severe head injury (AIS 5 or greater) predominated as the cause of
      death in all collision types.

PMID- 7786388
TI  - Impact of the 65 mph speed limit on accidents, deaths, and injuries in Illinois.
AB  - At the end of April 1987, Illinois raised the speed limit from 55 to 65 mph on
      rural interstates and limited-access highways. This paper examines the effects of
      this change. It applies ARIMA techniques to a monthly time series of accidents,
      injuries, and fatalities dating from five years before the limit increase to four
      years after. Two types of rural highways are examined: those where the speed
      limit was raised and those where it remained at 55 mph. The impact of higher
      limits on mean speeds, speed variance, traffic diversion, traffic generation,
      speed spillover, and issues of benefits and costs are considered. The findings
      suggest the higher limit led to 300 additional accidents per month in rural
      Illinois, with associated increases in deaths and injuries. This impact was
      apparent on both 65 and 55 mph roads. There is some evidence of traffic diversion
      from 55 to 65 mph highways plus traffic generation and speed spillover.

PMID- 7786387
TI  - Preventable death classification: interrater reliability and comparison with ISS
      based survival probability estimates.
AB  - The purpose of the study was to compare the injury-related threat to survival
      estimated by the Injury Severity Score (ISS) and a committee of experts. The
      charts of 116 (73 fatalities and 43 survivors) patients with severe injuries were
      reviewed. A committee of nine clinicians classified each case as survivable,
      potentially survivable, and nonsurvivable based on anatomical descriptors,
      mechanism of injury, and patient's age. Majority was used to determine the final
      committee classification. Based on the ISS values, cases were classified as
      survivable (9-24), potentially survivable (25-49), and nonsurvivable (> 49). The
      results showed poor interrater reliability among the nine clinicians with an
      overall intraclass correlation coefficient of 0.43. The ISS-based classification
      had high agreement with the final committee classification (overall weighted
      kappa = 0.71). Lower agreement was observed for falls and with increasing number
      of injuries. This study has demonstrated no additional benefit for using a
      committee to classify injury severity on the basis of anatomical damage over
      applying ISS-based survival probabilities. The continued use of the ISS is
      supported.

PMID- 7786389
TI  - Bicyclist deaths and fatality risk patterns.
AB  - While there are almost 1,000 bicyclist deaths in the United States every year,
      there has been little formal analysis of the fatal risk patterns of bicyclists.
      In large part, this is because there has been little information available on
      riding exposure. The purpose of this article is to determine and quantify the
      relative risks of death for bicyclists according to age, gender, and daylight
      conditions. Relative risks are estimated by comparing data on the characteristics
      of fatally injured bicyclists with estimates of riding exposure from a recent
      national survey of bicyclists in the United States. The results suggest
      substantially higher fatality risks for males, for bicyclists over the age of 44,
      and for bicyclists who ride after dark. Discussion of the results includes
      implications regarding differences in the fatal and nonfatal injury risks
      associated with bicycle use.

PMID- 7786390
TI  - Safety implications of extending some Canadian Motor Vehicle Safety Standards to
      light trucks and vans.
AB  - The primary objective of this research was to evaluate the implications of
      extending specific Canadian Motor Vehicle Safety Standards (CMVSS) to light
      trucks and vans (LTVs). This was accomplished through the examination of the
      potential safety-related benefits of these standards comparing the injury
      frequencies and severities of the light trucks and vans and the passenger cars
      (PCs). The standards considered, which currently apply to passenger cars but not
      to LTVs, are the head restraint (CMVSS 202), side door strength (CMVSS 214), and
      roof crush strength (CMVSS 216) standards. The comparison was effected by means
      of logit models developed from multidimensional tables with injury frequency and
      severity as dependent variables. There are indications that installing head
      restraints in light trucks and vans could reduce or prevent minor neck injuries
      and that modest benefits could be achieved by extending the roof crush standard
      to the LTVs. It was also determined that the side door strength standard may not
      necessarily be as beneficial to LTVs in conditions in which the vehicle is struck
      on the side by another LTV. It is suggested that the general public be made aware
      of the differences in safety standards between LTVs and PCs.

PMID- 7786391
TI  - Analysis of official economic valuations of traffic accident fatalities in 20
      motorized countries.
AB  - Official economic valuations (costs) of a traffic accident fatality in 20
      motorized countries are described. The economic valuation per fatality varies
      from 0.87 million Norwegian kroner to 17.80 million kroner. The mean value is
      5.69 million kroner. An attempt is made to explain the differences in official
      cost estimates. The valuation method used in estimating the costs has major
      importance for the level of costs. Recently, a number of motorized countries have
      accepted the willingness-to-pay approach as the basis for the economic valuation
      of traffic accident fatalities. In these countries, this has led to major upward
      revisions of previous cost estimates.

PMID- 7786392
TI  - The relationship of the retail availability of alcohol and alcohol sales to
      alcohol-related traffic crashes.
AB  - The research literature on the relationship of alcohol consumption to motor
      vehicle crash risk clearly implicates the importance of minimizing the use of
      alcohol in conjunction with the operation of motor vehicles. However, there has
      been relatively little documentation of the direct impact of changes in beverage
      specific alcohol sales on the most common surrogate for alcohol-involved traffic
      crashes, single-vehicle nighttime fatalities. Similarly, there have been few
      studies of the relationship between the physical availability of alcohol and
      fatal crash rates which have concurrently controlled for differences in alcohol
      sales. Indeed, the possibility that reduced availability might lead to increases
      rather than decreases in fatal crashes (due to increased driving after drinking)
      has not been adequately tested. This paper presents a series of analyses of time
      series cross-sectional data from 38 states over 12 years to evaluate the impact
      of changes in alcohol sales and the physical availability of alcohol upon single
      vehicle nighttime fatal crashes. The results of the study showed, first, that
      independent of a number of economic and demographic covariates, rates of single
      vehicle nighttime fatal crashes were most strongly related to sales of beer and
      less so to sales of spirits and wine. Second, net of beverage-specific alcohol
      sales, the physical availability of alcohol was not related to measurable changes
      in fatal crash rates. Thus, reductions in availability intended to reduce alcohol
      sales and problems would not appear to increase traffic-related crashes through
      increased driving exposure.

PMID- 7786393
TI  - The identification of mistakes in road accident records: Part 1, Locational
      variables.
AB  - The current method of checking police-reported road accident data involves a
      rigorous process of manual and computer validation, with the objective of
      removing all the errors that exist on the accident report forms. This paper shows
      how a geographic information system (GIS) can be used to identify mistakes that
      exist in several locational variables once this process has been undertaken. It
      compares items contained on the accident report form with accurate highway
      feature information obtained from other sources. There were less than 10% of
      mistakes for the variables of district, speed limit, road class, and road number;
      less than 20% for junction control, junction detail, and pedestrian crossing
      facilities; and over 20% for carriageway type. If highway data were routinely
      entered onto a GIS by all British highway authorities, the above variables might
      not need to be entered by the police on their accident report forms.

PMID- 7786394
TI  - The identification of mistakes in road accident records: Part 2, Casualty
      variables.
AB  - It has been acknowledged that there are many mistakes in recording the casualty
      variables on the police accident report forms. This study shows how a computer
      based linkage of police and hospital records can be used routinely to identify
      the mistakes for the variables of casualty age, gender, and severity. The level
      of omissions and misidentifications were 0.4% for gender, 12.2% for severity, and
      15.7% for age. The number of records that had age omitted or coded incorrectly
      was not significantly greater for seriously injured casualties than for those who
      were slightly injured. This system could be effectively used to code casualty
      severity using medical information instead of police judgement.

PMID- 7786395
TI  - Synthesis and biological evaluation of amino-substituted benzo[f]pyrido[4,3-b]
      and pyrido[3,4-b]quinoxalines: a new class of antineoplastic agents.
AB  - In order to study the structure-activity relationships in the series of new
      intercalating polycyclic agents, 1-amino-substituted pyrido[3,4-b]quinoxalines,
      benzo[f]pyrido[4,3-b]quinoxaline derivatives bearing a dibasic side chain and
      their benzo[f]pyrido[3,4-b] isomers have been synthesized. Biological evaluation
      was carried out for topoisomerase I and II inhibition, and for in vitro and in
      vivo antitumor properties in several models. Results demonstrate that
      appropriately substituted benzo[f]pyrido[4,3-b]quinoxaline derivatives are
      inhibitors of topoisomerase I and II, and have significant antitumor properties
      in various experimental models. In addition, the most active compounds appear to
      be minimally recognized by tumor cells expressing the multidrug resistance
      phenotype.

PMID- 7786396
TI  - Antineoplastic agents 322. synthesis of combretastatin A-4 prodrugs.
AB  - Combretastatin A-4 (1a), the principal cancer cell growth-inhibitory constituent
      of the Zulu medicinal plant Combretum caffrum, has been undergoing preclinical
      development. However, the very limited water solubility of this phenol has
      complicated drug formation. Hence, derivatives of the combretastatin A-4 (1a) 3'
      phenol group were prepared for evaluation as possible water-soluble prodrugs. As
      observed for combretastatin A-4, the sodium salt (1b), potassium salt (1c) and
      hemisuccinic acid ester (1e) derivatives of phenol 1a were essentially insoluble
      in water. Indeed, these substances regenerated combretastatin A-4 upon reaction
      with water. A series of other simple derivatives (1d, 1f-j) proved unsatisfactory
      in terms of water solubility or stability, or both. The most soluble derivatives
      evaluated included the ammonium (1l), potassium (1m) and sodium (1n) phosphate
      salts, where the latter two proved most stable and suitable. Both the potassium
      (1m) and sodium (1n) phosphate derivatives of combretastatin A-4 were also found
      to exhibit the requisite biological properties necessary for a useful prodrug.
      Sodium salt 1n was selected for drug formulation and further pre-clinical
      development.

PMID- 7786397
TI  - Synthesis and biological evaluation of basic side chain derivatives of Analog II
      as pure antiestrogens and antitumor agents.
AB  - In an effort to prepare effective non-steroidal antiestrogens without intrinsic
      estrogenicity and with greater antagonism than those of the triarylethylenes
      (tamoxifen; TAM) four N-substituted (Z)-1,1-dichloro-2-[4-(2-aminoethoxy)phenyl]
      3-phenylcyclopropa ne derivatives of the antiestrogen, Analog II, in which the
      basic side chains contain cyclic (piperidino and piperazino) and non-cyclic
      (dimethyl amino and diethyl amino) moieties, were synthesized. These compounds
      were prepared from an intermediate methanesulfonyloxyethoxy side chain ester of
      1,1-dichloro-2,3-cis-diphenylcyclopropane using their respective side chain bases
      in triethylamine and acetonitrile. The gem-dichloro-cis-diarylcyclopropane
      derivatives were tested for their ability to inhibit the growth-stimulating
      effect of estradiol on immature mouse uteri and the growth of estrogen receptor
      (ER)-positive MCF-7E3, ER-negative MDA-MB-231 and the ER-positive MCF-7LY2
      antiestrogen-resistant breast cancer cells in culture. The introduction of the
      various aminoethoxy side chains into Analog II did not improve its ER-binding
      affinity. Like Analog II, the derivatives did not exhibit any intrinsic
      estrogenicity, and compounds 9 and 10 antagonized estradiol action more
      completely than the parent compound. None of the compounds potentiated the
      uterine weight gain from the stimulating dose of estradiol (0.03 micrograms).
      Derivatives 9 (150 micrograms), 10 (150 micrograms) and 11 (150 micrograms) had
      uterine mean weights significantly below the estradiol-treated group, and were
      better antagonists than Analog II and MER25 at the same concentrations. All
      compounds exhibited a statistically significant (P < 0.01) reduction in control
      growth (antitumor activity) from 0.01 to 10 nM concentration in the MCF-7E3
      cells. At 10 nM concentration, 8 (66%) and 9 (64%) had the greater antitumor
      activity over 10 (58%) and 11 (58%). No activity in this cell line was observed
      for Analog II, TAM and ICI 182,780. Antitumor action was also demonstrated in the
      MDA-MB-231 cells for all derivatives at 1.0 microM dose, with 9 having the
      greatest (27%) inhibition of control growth, followed by 8 (20%), 10 (18%) and 11
      (12%). Analog II and ICI 182,780 had no antitumor activity in this cell line,
      while TAM exhibited only 8% inhibition. In the MCF-7E3 cell line at 1.0 microM, 9
      exhibited 86% inhibition of the estradiol-stimulated growth (antiestrogenic
      activity), followed by 8 (64%), 10 (52%) and 11 (21%).(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 7786399
TI  - Novel quinone antiproliferative inhibitors of phosphatidylinositol-3-kinase.
AB  - The inhibition of phosphatidylinositol-3-kinase (PtdIns-3-kinase), protein kinase
      C and c-Src protein tyrosine kinase by a series of halogenated naphthoquinones
      and quinoline quinones related to the plant-derived naphthoquinones juglone and
      methyljuglone, which inhibit protein kinase C, has been investigated. Some of the
      compounds inhibited PtdIns-3-kinase at micromolar concentrations and below.
      PtdIns-3-kinase inhibition was time dependent and could be prevented by
      endogenous thiol. The compounds were only weak inhibitors of PtdIns-4-kinase.
      Some of the compounds inhibited protein kinase C, but c-Src protein tyrosine
      kinase was only weakly inhibited. In intact cells, PtdIns-3-kinase was only
      partly inhibited by concentrations of the halogenated quinones that inhibited
      cell growth. Some halogenated quinones showed in vivo antitumor activity without
      accompanying toxicity, while methyljuglone was without in vivo antitumor
      activity. Halogenated quinones may have multiple biochemical effects in the cell
      that could contribute to their cytotoxic and antitumor effects. Inhibition of
      PtdIns-3-kinase by the halogenated quinones may provide a lead for the
      development of more potent and specific inhibitors.

PMID- 7786398
TI  - Binding to DNA and cytotoxic evaluation of ascididemin, the major alkaloid from
      the Mediterranean ascidian Cystodytes dellechiajei.
AB  - The isolation of ascididemin from the Mediterranean ascidian Cystodytes
      dellechiajei is described. This alkaloid consists of a planar pentacyclic
      chromophore which was investigated for its DNA-binding and cytotoxic properties.
      Spectroscopic measurements provided evidence that the drug intercalates into DNA.
      DNase I footprinting assays indicated that the binding of ascididemin to GC-rich
      sequences is favoured over binding to AT-rich and mixed sequences. Chemical
      probes were used to detect ligand-induced structural changes in DNA. The alkaloid
      induces a hyper-reactivity of the DNA towards potassium permanganate, but not
      towards diethylpyrocarbonate, just as is the case with ethidium bromide; it has
      little effect on the catalytic activities of topoisomerases I and II. Ascididemin
      exhibits marked cytotoxicity towards human leukaemic cells in vitro and appears
      to be practically equally toxic for drug-sensitive and multidrug-resistant cell
      lines. The results suggest that DNA, but not topoisomerases, may represent the
      critical cellular target at which this marine alkaloid exhibits its potent
      cytotoxic properties in vitro.

PMID- 7786400
TI  - Protein malnutrition on suprachiasmatic nucleus cells in rats of three ages.
AB  - The effects of prenatal and postnatal protein malnutrition on the major and minor
      somatic axes of the suprachiasmatic nucleus (SCN) cells of the rat were
      investigated. Female rats were fed either 6%, 8% or 25% casein diet 5 weeks
      before mating, during gestation and lactation. After weaning the pups were
      maintained on the same diet until sacrifice at 30, 90 or 220 days of age. The
      major and minor axes in fusiform, multipolar and ovoid cells were measured in
      Nissl-stained SCN slices. Although the 8% diet group displayed significant
      reductions in fusiform and ovoid cells, the 6% diet group showed the most intense
      reductions in cell size of the three cell types. In the 6% diet group, cell size
      was significantly lower at 30 days but the difference with the other nutritional
      groups ameliorated at 90 days and almost reached control values at 220 days.
      These data suggest that malnutrition maintained during gestation and postnatal
      life reduces the somatic size of SCN cells. This alteration may be a
      morphological substrate underlying sleep and behavioral circadian alterations
      observed in malnourished rats.

PMID- 7786403
TI  - Distribution of mast cells in the tracheal tissue components of the guinea pig
      and its bearing on the Schultz-Dale reaction.
AB  - The distribution of mast cells in the tracheal tissue components and its bearing
      on anaphylaxis was studied in the guinea pig. According to a statistical analysis
      (Nested ANOVA) the density found in the tissue elements showed the following
      gradation (mean +/- SE): muscle (299.7 +/- 61.6 cells/mm3) < serosa (802.7 +/-
      131.2 cells/mm3) < submucosa (24283.5 +/- 2549.2) < mucosa (48066.4 cells/mm3 +/-
      7837.4). Regardless of their location in tissue elements, the cell density in a
      zone far from the muscle was larger than in a zone close to the muscle.
      Considering the histamine release capability of mast cells, the density found
      either in muscle or in its surroundings does not account for the mediation theory
      unless some postulates ad hoc are introduced. A direct biophysical mechanism is
      possibly involved. Another alternative is a reflex to histamine, since there is
      preponderant location of mast cells in mucosa and submucosa.

PMID- 7786401
TI  - Increased oxygen radical and high-dietary-carbohydrate pancreatic damage.
AB  - These data suggest that an improved understanding of the relationship between
      high dietary carbohydrate and the rate of lipid peroxidation may give some
      insight into possible treatment modalities for pancreatic damages and may shed
      light on molecular mechanisms underlying certain pathological processes. High
      dietary carbohydrate lesions are age related and induced alterations on
      ceruloplasmin, phospholipids, total proteins, copper and zinc serum levels.
      Significantly increased serum and pancreatic amylase, and lipoperoxide
      determinations were observed in 20 month old rats. Cu-Zn superoxide dismutase was
      decreased in these animals. Daily injection of Cu-Zn superoxide dismutase
      conjugated with polyethylene glycol (SOD-PEG) prevented the serum and pancreatic
      changes, indicating that superoxide radical is an important intermediate to high
      dietary carbohydrate lesion.

PMID- 7786404
TI  - New electrophysiological approaches to the suprachiasmatic circadian pacemaker.
AB  - Suprachiasmatic nucleus contains the main circadian pacemaker for mammals
      rhythmical behavior and physiology. In this paper we revise recent experimental
      advances on electrophysiological studies to suprachiasmatic circadian pacemaker
      in rodents. Our growing understanding of the electrophysiology of this nucleus
      will help to elucidate the clock organization and its input and output
      mechanisms.

PMID- 7786402
TI  - Preliminary characterization of epithelial root sheath cells in vitro.
AB  - Murine root sheath cells from CD-1 mice were isolated and propagated in culture
      in both monolayer and tridimensional system using basement membrane components as
      substrata. Cells were grown for a period of seven days. The epithelial cells
      cultured in monolayer exhibited the typical cobblestone-like feature and also
      were cytokeratin positive when they were immunostained with the specific
      antibody. The histological analysis of the cells cultured in basement membrane
      components revealed differentiated behavior of the cells, and they organized in a
      round structure with a center of material probably representing keratin. Also the
      cells differentiated and organized into a squamous stratified epithelia, with a
      basal, intermedium and superficial layers. The preliminary data obtained with
      this model could be useful as a new approach to study root formation in the
      murine periodontum.

PMID- 7786405
TI  - The molecular basis for N-glycosylation in the 11S globulin (legumin) of lupin
      seed.
AB  - Ion exchange-HPLC under denaturing conditions was used to purify to homogeneity
      the major M(r) 44,000 alpha subunit of lupin seed (Lupinus albus, L.) 11S storage
      globulin (legumin). The carboxymethylated subunit was digested with trypsin and
      the peptide fragments separated by reverse phase HPLC. Only one glycosylated
      peptide reacting with concanavalin A was identified by dot-blotting. Its amino
      acid sequence allowed the location of this peptide within a highly conserved
      region in proximity to the N-terminus of the alpha subunits of the 11S globulins
      from other seeds. The unique presence of a serine residue in a sequence N-X-S of
      lupin 11S globulin, compared with all other 11S proteins, allows it to be the
      only protein of this class to bear covalently linked carbohydrate.

PMID- 7786406
TI  - Purification and characterization of a 60-kDa protein from oat, formerly known as
      a TCP1-related chaperone.
AB  - Recently, Mummert et al. [Nature 363, 644-648 (1993)] isolated a proposed TCP1
      related chaperone. Here we report several findings concerning the protein which
      they sequenced. Two similar N-terminal sequences were obtained from this abundant
      60-kDa protein. Internal sequences were also acquired by protease digestion.
      Initially it was believed the protein was able to completely inhibit citrate
      synthase aggregation, but later purifications demonstrated that the 60-kDa
      polypeptide lacked both chaperone activity and the previously reported kinase
      activity [Grimm et al., Planta 178, 199-206 (1989)]. It is now our belief that
      this protein is neither a chaperone nor a kinase.

PMID- 7786408
TI  - Expression and purification of recombinant cynomolgus monkey cholesteryl ester
      transfer protein from Chinese hamster ovary cells.
AB  - Cholesteryl ester transfer protein (CETP) mediates the transfer of cholesteryl
      ester from high- and low-density lipoproteins to triglyceride-rich lipoproteins,
      and reciprocally mediates triglyceride transfer. The gene for cynomolgus monkey
      CETP was expressed in serum-free CHO culture with 2 micrograms/ml insulin as its
      only exogenous protein supplement. Cell growth was facilitated by immobilizing
      the CHO cells in alginate beads. Recombinant CETP (rCETP) was purified 176-fold
      with a three-step protocol resulting in a 60% final yield as measured by a
      fluorescent CETP activity assay. Typically, 3.4 mg of rCETP was purified from
      1700 ml of media by affinity-gel chromatography involving Reactive Red 120
      (RR120) followed by concanavalin A Sepharose 4B and rechromatography on RR120.
      SDS-PAGE shows a single broad band of M(r) ranging from 68,000 to 74,000 which
      immunoreacts in Western blot analysis. Amino acid analysis and protein sequencing
      of the purified protein agree with the theoretical amino acid composition and
      sequence of cynomolgus CETP.

PMID- 7786407
TI  - Complete amino acid sequence of Proteus mirabilis PR catalase. Occurrence of a
      methionine sulfone in the close proximity of the active site.
AB  - The catalase of Proteus mirabilis PR, a peroxide-resistant (PR) mutant of Proteus
      mirabilis, binds strongly NADPH, which is a unique property among known bacterial
      catalases. The enzyme subunit consists of 484 amino acid residues for a mass of
      55,647 daltons. The complete amino acid sequence was resolved through the
      combination of protein sequencing, mass spectrometry, and nucleotide sequencing
      of a PCR fragment. The sequence obtained was compared with that of other known
      catalases. Amino acids of the active site are all conserved as well as essential
      residues involved in NADPH binding. Among the amino acids interacting with the
      heme, a methionine sulfone was found at position 53, in place of a valine in most
      other catalases. The origin of oxidation of this methionine is unknown, but the
      presence of this modification could change iron accessibility by large substrates
      or inhibitors. This posttranslational modification was also demonstrated in the
      wild-type P. mirabilis catalase.

PMID- 7786409
TI  - Symmetric interspecies hybrids of mouse and human hemoglobin: molecular basis of
      their abnormal oxygen affinity.
AB  - Interspecies hybrids of HbA and Hb from mouse C57BL/10 [alpha 2M beta 2H and
      alpha 2H beta 2M (H = human, M = mouse)], representing 19 and 27 sequence
      differences per alpha beta dimers (as compared with human alpha beta dimer) have
      been generated in vitro. The efficiency of the assembly of the interspecies
      hybrids by the alloplex intermediate pathway is about twofold higher than the low
      pH-mediated subunit approach. The interspecies hybrids exhibit a cooperative O2
      binding. The intrinsic O2 affinity of mouse Hb is slightly lower than HbA, while
      the 2,3-diphosphoglycerate (DPG) effect is comparable. Interestingly, the
      interspecies hybrid alpha 2M beta 2H has high O2 affinity (compared to either
      human or mouse Hb), while the interspecies hybrid alpha 2H beta 2M exhibits a
      very low O2 affinity. These results suggest that the mouse beta chain generates a
      tetramer with very low oxygen affinity. However, the complementarity of the mouse
      alpha and beta chains generates a set of unique interactions that compensate for
      the low-oxygen-affinity propensity of the mouse beta chain. DPG binds the
      tetramer in the central cavity formed by the two beta subunits, hence the DPG
      effects on the interspecies hybrids should be as in the parent molecule. However,
      the results of the present study demonstrate that the DPG binding pocket is
      influenced by the nature of the alpha chain present in the tetramer. The mouse
      alpha chain reduces considerably the DPG right shift of the O2 affinity of the
      human beta-chain containing hybrid.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786410
TI  - Chemical modification of tryptophan residues in alpha-neurotoxins from
      Ophiophagus hannah (king cobra) venom.
AB  - Two alpha-neurotoxins, Oh-4 and Oh-7, from the king cobra (Ophiophagus hannah)
      venom were subjected to Trp modification with 2-nitrophenylsulfenyl chloride (NPS
      Cl). One major NPS derivative was isolated from the modified mixtures of Oh-4 and
      two from Oh-7 by HPLC. Amino acid analysis and sequence determination revealed
      that Trp-27 in Oh-4, and Trp-30 and Trp-26 and 30 in the two Oh-7 derivatives,
      were modified, respectively. Sulfenylation of Trp-27 in Oh-4 caused about 70%
      drop in lethal toxicity and nicotinic acetylcholine receptor-binding activity.
      Modification of Trp-30 in Oh-7 resulted in the decrease of lethal toxicity by 36%
      and binding activity by 61%. The activities were further lost when the conserved
      Trp-26 in Oh-7 was modified. Sulfenylation of the Trp residues did not
      significantly affect the secondary structure of the toxins as revealed by the CD
      spectra. These results indicate that the Trp residues in these two long alpha
      neurotoxins may be involved in the receptor binding.

PMID- 7786412
TI  - PDI-, PPI- and chaperone-catalyzed refolding of recombinant human IL-2 and GM
      CSF.
AB  - The studies on PDI-, PPI- and chaperone-catalyzed refolding of recombinant human
      IL-2 and GM-CSF show that PDI can prevent the mismatch of disulfide bonds and
      formation of aggregates by interchains linkage; furthermore, PDI can correct the
      mismatching of disulfide bonds in IL-2 isomers. PPI can increase the rate of
      folding reaction while chaperone can prevent the aggregation during the folding
      process. In addition, there is a synergistic effect between them.

PMID- 7786413
TI  - Stable oncogenic transformation induced by microcell-mediated gene transfer.
AB  - Oncogenes have been identified using DNA-mediated transfection, but the size of
      the transferable and unrearranged DNA, gene rearrangement and amplification which
      occur during the transfection process limit the use of the techniques. We have
      evaluated microcell-mediated gene transfer techniques for the transfer and
      analysis of dominant oncogenes. MNNG-HOS, a transformed human cell line which
      contained the met oncogene mapping to human chromosome 7 was infected with
      retroviruses carrying drug resistance markers and used to optimize microcell
      preparation and transfer. Stable and drug-resistant hybrids containing single
      human chromosomes as well as the foci of the transformed cells containing the
      activated met oncogene and intact human chromosomes were obtained. Hybridization
      analysis with probes (i.e. col1A2, pJ3.11) mapping up to 1 Mb away from met shows
      that the cells from the individual foci contain different amounts of apparently
      unrearranged human DNA associated with the oncogene, and the microcell-generated
      transformants retain more distal markers than those observed in either DNA- or
      chromosome-mediated transfers. In conjunction with other techniques, microcell
      fusion should be useful for gene mapping as well as the study of gene function
      and expression in cell transformation and malignancy.

PMID- 7786414
TI  - [Deficiency in public services and breeding of Aedes aegypti in Venezuela].

PMID- 7786415
TI  - [Attitudes of Bolivian pharmacy distributors in a case of diarrhea].
AB  - In order to learn the recommendations given for a case of diarrhea by persons who
      sell medications at pharmacies, interviewers visited pharmacies in three Bolivian
      cities and said they had a child suffering from diarrhea. Less than 2% of the
      vendors recommended using oral rehydration salts, increasing fluid intake, or
      consulting a doctor. Most of them recommended antibiotics, antidiarrheals, or
      both. Oral rehydration salts were not available in nearly two-thirds of the
      establishments visited, and those that had the salts rarely offered them. This
      study revealed the lack of integration of these professionals into the Health
      Secretariat's training program, and as a result activities were initiated to
      solve this problem.

PMID- 7786411
TI  - Tau protein kinase I/GSK-3 beta/kinase FA in heparin phosphorylates tau on
      Ser199, Thr231, Ser235, Ser262, Ser369, and Ser400 sites phosphorylated in
      Alzheimer disease brain.
AB  - Previously, tau protein kinase I/glycogen synthase kinase-3 beta/kinase
      FA(TPKI/GSK-3 beta/FA) was identified as a brain microtubule-associated tau
      kinase possibly involved in the Alzheimer disease-like phosphorylation of tau. In
      this report, we find that the TPKI/GSK-3 beta/FA can be stimulated to
      phosphorylate brain tau up to 8.5 mol of phosphates per mol of protein by
      heparin, a polyanion compound. Tryptic digestion of 32P-labeled tau followed by
      high-performance liquid chromatography and high-voltage electrophoresis/thin
      layer chromatography reveals 12 phosphopeptides. Phosphoamino acid analysis
      together with sequential manual Edman degradation and peptide sequence analysis
      further reveals that TPKI/GSK-3 beta/FA after heparin potentiation phosphorylates
      tau on sites of Ser199, Thr231, Ser235, Ser262, Ser396, and Ser400, which are
      potential sites abnormally phosphorylated in Alzheimer tau and potent sites
      responsible for reducing microtubule binding possibly involved in neuronal
      degeneration. The results provide initial evidence that TPKI/GSK-3 beta/FA after
      heparin potentiation may represent one of the most potent systems possibly
      involved in the abnormal phosphorylation of PHF-tau and neuronal degeneration in
      Alzheimer disease brains.

PMID- 7786417
TI  - [Sixth meeting of Directors of National Reference Laboratories of AIDS].

PMID- 7786416
TI  - [Central American project of local action to prevent violence against women].

PMID- 7786419
TI  - Ruptured intracranial aneurysms.

PMID- 7786418
TI  - Cervical myelopathy caused by pseudogout.
AB  - A case of pseudogout manifesting as a cervical myelopathy is presented. Surgery
      can offer the definitive treatment with removal of the compressing crystalline
      mass. This diagnosis should be considered in a progressive myelopathy in the
      elderly person shown to have extradural compression, even in the absence of other
      stigmata of gout.

PMID- 7786420
TI  - Trigeminal neuralgia treated by microvascular decompression: a long-term follow
      up study.
AB  - Since 1976, 133 patients treated by posterior fossa microvascular decompression
      (MVD) for trigeminal neuralgia (TN) have been followed-up prospectively to
      determine the incidence of recurrent TN. The follow-up period was between 6
      months and 15 years, with 60 patients having been follow-up for more than 5
      years. Of these patients, 71% have remained pain-free, while 29% have suffered a
      major or minor recurrence. Of patients who developed recurrent TN, 90% did so
      within 2 years of operation. No patients who were pain-free up to 5 years after
      operation subsequently developed recurrent TN. Recurrent TN was more likely to
      occur when the operative findings did not show nerve root distortion or
      displacement, or when the age of onset was less than 35 years.

PMID- 7786421
TI  - CT assessment of subarachnoid haemorrhage. A comparison between different CT
      methods of grading subarachnoid haemorrhage.
AB  - A number of different CT classifications of subarachnoid haemorrhage (SAH) were
      applied to a consecutive series of 50 patients with aneurysmal SAH. The best
      correlation with delayed ischaemic deficits (DID) was obtained with a score
      formed by the sum of the individual cisternal grades except that of the cortical
      subarachnoid space. The findings emphasize the significance of the extent of the
      SAH, rather than the presence of a localized cisternal clot with regard to the
      development of DID.

PMID- 7786422
TI  - Post-traumatic brain abscess: experience of 36 patients.
AB  - Thirty-six patients with post-traumatic brain abscess were managed over 18 years.
      They constituted 9.3% of all brain abscesses encountered during the same period.
      The head injury was associated with an external compound fracture in 20, internal
      compounding in three and was closed in 13 patients. The mean interval between the
      time of injury to presentation with an abscess was 113 days. This did not differ
      significantly in patients with closed and compound head injury, and amongst
      patients who had wound sepsis and with clean wounds after the injury. The
      occurrence of focal neurological deficit was more frequent in patients with a
      closed injury (p < 0.05). Twenty patients underwent primary excision of the
      abscess with recurrence of the abscess in one patient. Of the 14 patients in whom
      the abscess was initially aspirated, eight patients required a subsequent
      excision. Excision was required in 18 patients (94.7%) with external compound
      injury, five (50%) of those with closed injury and in all patients with
      internally compound injuries. Two patients had 'coned' and died before they could
      be operated upon. The operative mortality in the absence of signs of herniation
      preoperatively was 12.5% in patient with compound injury and none among patients
      with closed head injury.

PMID- 7786423
TI  - Motivation and internal markets in a National Health Service.

PMID- 7786424
TI  - Fatal postoperative 'pituitary apoplexy': its cause and management.
AB  - Two cases of giant pituitary tumours are reported. The patients underwent
      transcranial operation, one by the pterional and one by the subfrontal route.
      Only partial resection of the tumour was possible in each instance for various
      reasons. Acute worsening of the clinical condition in the immediate postoperative
      phase led to reoperation in both patients. In one case the reoperation was
      carried out within 45 min of the closure of the wound and in the other after 12
      h. Massive swelling of the tumour with evidence of haemorrhagic infarction was a
      surprise finding. After a turbulent postoperative phase, both patients died. We
      postulate that these patients developed pituitary apoplexy of the residual
      tumours.

PMID- 7786426
TI  - The presence of progesterone receptors in arachnoid granulations and in the
      lining of arachnoid cysts: its relevance to expression of progesterone receptors
      in meningiomas.
AB  - Progesterone receptors (PR) were identified with an enzyme immunoassay in
      cytosols from human arachnoid granulations and arachnoid cysts. Meningiomas
      presumably originate from subdural endothelium which is abundantly present in
      these structures. In the three cases studied, oestrogen receptors were absent.
      The presence of PR in subdural endothelium may provide further ground for the
      expression of PR in meningiomas.

PMID- 7786425
TI  - Pituitary function after selective adenomectomy for Cushing's disease.
AB  - This retrospective analysis was undertaken to determine whether selective
      adenomectomy for Cushing's disease can achieve acceptable cure rates while
      causing minimal pituitary dysfunction. Tumour size, histology and pituitary
      function were evaluated in 34 consecutive patients (26 F: 8 M, mean age 33.6
      years) undergoing transphenoidal adenomectomy for Cushing's disease from 1975 to
      1992. Follow-up averaged 5.8 years. Cure was defined as resolution of symptoms
      and signs and normalization of urinary cortisol excretion. Sixty-three per cent
      of patients achieved cure after selective adenomectomy, repeat adenomectomy cured
      an additional four patients. Twenty-eight per cent required bilateral
      adrenalectomy and/or pituitary irradiation. Postoperative pituitary function
      remained completely intact in 81%. Secondary hypogonadism occurred in 8%,
      hypothyroidism in 155 and permanent diabetes insipidus in 4%. There was
      recurrence in 26% after a mean of 4.6 years (range 1-7). It is concluded that
      selective adenomectomy can achieve acceptable cure rates with a low prevalence of
      postoperative hypopituitarism, although an increase of recurrence may be the
      result of conservative surgery.

PMID- 7786428
TI  - Inflammatory pseudotumour of the central nervous system: clinicopathological
      study of one case and review of the literature.
AB  - A 58-year-old male who had been diagnosed as having polymyositis was found to
      have a mass in the fourth ventricle. This mass showed features of an inflammatory
      pseudotumor. This lesion has been described in many parts of the body including
      the central nervous system. This case showed some features different from the
      previously reported cases in the central nervous system (i.e. presence of
      necrosis and association with polymyositis) which may throw some light on the
      pathogenesis of the condition. Inflammatory pseudotumour is most likely to be
      caused by an exaggerated immunological process and is sometimes associated with
      high levels of serum immunoglobulin.

PMID- 7786427
TI  - Rathke's cleft cysts within a growth hormone producing pituitary adenoma.
AB  - Two cases with a unique association of Rathke's cleft cysts and a growth hormone
      secreting pituitary adenoma in the same tumour tissue are reported. The
      embryological pathogenesis, diagnostic evaluation and treatment of these lesions
      are discussed.

PMID- 7786429
TI  - The surgical treatment of Chiari malformation association with atlantoaxial
      dislocation.
AB  - Five cases of Chiari malformation associated with atlantoaxial dislocation are
      presented. A lateral plate and screw fixation was performed in all cases.
      Reversal foramen magnotomy was performed in three cases and two patients
      underwent the conventional posterior bony decompression for Chiari malformation.
      In an average postoperative follow-up period of 8 months (range 3 months to 2
      years) neurological symptoms and signs improved in all patients, with
      radiological and clinical evidence of bony union and stability of the
      craniovertebral region. The surgical problems encountered in such cases where a
      posterior decompression was required in addition to a fixation procedure are
      enumerated in this report. The advantages of the proposed operations are
      described.

PMID- 7786430
TI  - Results of cortical resection for intractable epilepsy using intra-operative
      corticography without chronic intracranial recording.
AB  - Twenty-four patients with intractable partial epilepsy underwent surgery between
      1969 and 1988. Localization was by non-invasive means using scalp EEG and CT. In
      12 cases the focus was temporal and in eight frontal. Craniotomy was undertaken
      with intraoperative electrocorticography (ECoG). Ten cases had a standard
      temporal lobectomy, seven a topectomy, four topectomy with tumour excision and
      one tumour excision alone. Two cases did not have a resection. Pathology revealed
      a mass lesion in 12 cases, hippocampal sclerosis in two and gliosis in six. Mean
      length of follow-up was 7.4 was. Fourteen patients (64%) were seizure free, two
      (9%) almost seizure free, four (18%) had worthwhile improvement and two (9%) no
      improvement. Of the temporal resections, 9 out of 12 (75%) were seizure free and
      of the extratemporal resections 5 out of 10 (50%) were seizure free. Removal of a
      mass lesion carried the most favourable prognosis for seizure outcome: 10 our of
      12 (83%) of the cases with mass lesions, but 3 out of 6 (50%) of the cases with
      gliosis were seizure free. In two of the frontal resections removal of tumour
      resulted in disappearance of contralateral frontal independent spikes. It is
      concluded that where sufficient information exists to localize seizure activity
      by non-invasive means, invasive recording is unnecessary. The utility of
      intraoperative ECoG is discussed. It may be of limited use in cases of standard
      resection of when a mass lesion is present, but ECoG can prove useful to
      delineate the epileptogenic area in cases where there is o mass lesion and the
      results can still be rewarding.

PMID- 7786431
TI  - CT-directed perineural infiltration in the localization of radicular pain in a
      patient with neurofibromatosis.
AB  - Computed tomography-guided infiltration of lumbar or sacral nerve roots with
      local anaesthetic can be a valuable aid in localizing the spinal level from which
      radicular pain originates especially when multiple abnormalities are present.
      This is illustrated by the case of a young woman with neurofibromatosis
      complaining of sciatica.

PMID- 7786432
TI  - Cavernous haemangioma in the cavernous sinus.
AB  - A case of intracavernous sinus cavernous hemangioma is reported. The tumor was
      totally resected en masse. The management of the lesion and technical issues
      concerning the surgery are discussed.

PMID- 7786434
TI  - Subdural empyema in an HIV positive patient.
AB  - A subdural empyema with a Salmonella species as the likely causative organism is
      presented. We believe that this is the first reported case of such an infection
      in an HIV positive patient. The difficulties in treatment and diagnosis are
      discussed.

PMID- 7786435
TI  - Parasellar chondrosarcoma: total excision improves prognosis.

PMID- 7786433
TI  - Supratentorial haemangioblastoma not associated with Von Hippel Lindau complex or
      polycythaemia: case report and literature review.
AB  - Solitary or multiple supratentorial haemangioblastomas are rare and may be
      associated with Von Hippel Lindau complex (VHLC), polycythaemia or a family
      history of VHLC. An extensive review of the literature (1902-1992) has revealed
      112 cases. They account for 2-8% of all haemangioblastomas and are commonly
      intraparenchymatous (86.8%) and infrequently intraventricular (6.6%). However, a
      meningeal location 5.6%) is extremely rare. Only one case of a solitary
      leptomeningeal haemangioblastoma has previously been reported and this was
      associated with a family and personal history of VHLC, cerebellar
      haemangioblastoma and renal carcinoma. We report a solitary solid left parietal
      leptomeningeal haemangioblastoma mimicking a meningioma or a secondary deposit on
      computed tomography in a 72-year-old male. There were no manifestations of or a
      family history of VHLC or polycythaemia.

PMID- 7786436
TI  - Intracerebral haemorrhage due to amphetamine abuse: report of two cases with
      underlying arteriovenous malformations.
AB  - Amphetamine abuse may be complicated by intracerebral, subdural or subarachnoid
      haemorrhage. The causative mechanism is probably a combination of vasculitis and
      induced hypertension. Most cases of intracerebral haemorrhage are subcortical.
      Only one case of amphetamine-induced intracerebral haematoma where there was also
      an underlying arteriovenous malformation has been previously reported. We report
      two cases of intracerebral haematoma due to amphetamine abuse whether an
      underlying AVM was found at the time of surgery. This possibility should be
      considered in cases of amphetamine-induced intracerebral haemorrhage.

PMID- 7786437
TI  - Suprasellar granular-cell tumour, presenting with intraventricular haemorrhage.
AB  - A case of suprasellar granular-cell tumour (GCT), presenting with
      intraventricular haemorrhage is described. The authors emphasize the exceptional
      character of spontaneous haemorrhage for a GCT, although haemorrhagic state
      during surgery has often been reported and may hinder total removal. Preoperative
      arteriography discloses a suprasellar blush in half of the cases. This
      facilitates the preoperative diagnosis. By taking special preoperative and
      operative precautions against haemorrhage complete removal can be carried out
      provided there is no encasement of the optic chiasm.

PMID- 7786438
TI  - Acute promyelocytic leukemia is a distinct subset of acute myelocytic leukemia
      with unique clinicopathologic characteristics including longer duration of
      relapse free survival: experience in 13 cases.
AB  - Acute promyelocytic leukemia(APL) is a subtype of acute myelocytic leukemia(AML)
      associated with unique features such as the presence of atypical promyelocytes
      and bleeding tendency due to disseminated intravascular coagulation(DIC). In a
      retrospective study, we analyzed 96 cases of AML seen at our hospital between
      June, 1989 and December 1993. Thirteen cases of APL(14%) were identified and
      their clinicopathologic characteristics were analyzed. The 86 cases of other
      types of AML served as controls. The distinct clinicopathologic features of APL
      as contrasted to other types of AML included younger age of patients, shorter
      duration of symptom before diagnosis, higher level of albumin at presentation,
      and a higher proportion of patients having coagulation abnormalities (75 vs.
      25%). Bone marrow cellularity was higher in APL when compared to other types of
      AML (100 vs. 90%, P = 0.013). Of 13 patients with APL, 4 died of bleeding/sepsis
      between days 2 to 4 after admission. Seven of 9 patients who received induction
      therapy achieved complete remission(CR). CR rate in APL was similar to other
      types of AML (78 vs. 64%, P = 0.743). Five of seven patients who achieved CR
      remain in continuous CR at 9+ to 42+ months. CR duration is significantly longer
      in APL when compared to other types of AML (P = 0.029). In conclusion, this study
      showed that APL is a distinct entity among subtypes of AML with clinically
      significant bleeding tendency and rapidly fatal course if untreated. With
      appropriate antileukemic therapy, CR can be achieved in the majority of patients
      and the patients show a longer duration of CR when compared to other types of
      AML.

PMID- 7786439
TI  - Familial clustering of hepatitis B and C viruses in Korea.
AB  - In order to evaluate the familial clustering of hepatitis B virus(HBV) and
      hepatitis C virus(HCV) infections and to elucidate the possible routes of HCV
      transmission among Korean adults with chronic liver disease, 137 household
      contacts of 51 chronic carriers of HBsAg and 111 household contacts of 38
      controls, and 181 household contacts of 96 anti-HCV positives and 102 household
      contacts of 76 anti-HCV negatives were tested from July 1990 to March 1994. Of 71
      non-vaccinated household contacts of HBsAg carriers, 10 gave positive result for
      HBsAg(14.1%), but none of the household contacts of the controls were positive
      for HBsAg(p < 0.05). Familial clustering of HBV infection was found, when the
      offspring of carriers and controls were compared. A significantly higher
      percentage of the offspring of carriers were positive for HBV infection(54.6% vs
      15.4%, p < 0.05) with OR of 6.6(95% Cl; 1.3-34.5). No evidence of familial
      clustering of HCV infection was found with 2.2%(4/181) anti-HCV positivity among
      the household contacts of index cases, similar to 1.0%(1/102) among those of
      controls. History of acute hepatitis(OR 3.2), transfusion(OR 3.2), and
      acupuncture(OR 2.5) were associated with an increased risk of HCV infection. In
      conclusion, HBV has strong familial clustering whereas HCV does not in Korea.

PMID- 7786440
TI  - Bilateral primary pigmented nodular adrenocortical disease--a case of report
      describing a rare cause of Cushing's syndrome.
AB  - A case of Cushing's syndrome due to bilateral pigmented nodular adrenal disease
      in a 35-year-old male is presented. The adrenals showed multiple, black, variable
      sized nodules. Histologically the cells contained lipofuscin and either had a
      clear cytoplasm or an eosinophilic cytoplasm with a prominent nucleus.
      Lymphocytic infiltration and fatty metaplasia within the nodules are two of the
      prominent histological features. There is extreme internodular atrophy which
      suggests that primary pigmented nodular adrenocortical disease is a non
      adrenocorticotropic hormone dependent condition. Since the disorder appears to
      involve primarily the cortex of both adrenals, the treatment of choice is
      bilateral adrenalectomy followed by steroid replacement. The characteristic
      clinicopathological manifestations that separate this diagnosis from other types
      of adrenal disease are also discussed. This is the first reported case in Korea
      to be documented with the pertinent clinicopathological findings.

PMID- 7786441
TI  - Adult T-cell leukemia/lymphoma in a Korean--a case report.
AB  - The clinicopathologic features of a Korean patient with adult T-cell
      leukemia/lymphoma(ATLL) are presented. A 51-year-old man, who has lived in Korea
      since birth, had multiple cutaneous nodules and multiple lymphadenopathy for the
      previous two months. A histopathologic study of the lymph node and skin lesion
      revealed T-cell non-Hodgkin's lymphoma of pleomorphic type, medium and large cell
      type. Peripheral blood examination showed leukemic features with 30% of abnormal
      lymphoid cells. HTLV-I proviral DNA pX region was detected in the DNA from
      peripheral blood mononuclear cells(PBMC) and the specific gag, pol, and env HTLV
      I sequences were detected in the lymph node using polymerase chain reaction
      technique. Human T-cell leukemia/lymphoma type I(HTLV-I) antibodies were present
      in the serum. An immunophenotypic study of the lymph node revealed CD4 positive
      and CD8 negative helper/inducer T cell type surface markers. This case is the
      acute type, i.e. prototypic ATLL. He was treated with an intensive chemotherapy
      including cyclophosphamide, etoposide, doxorubicin, vincristine, and prednisone.
      Despite initial transient improvement, the tumor progressed after three cycles of
      the regimen and became refractory to further chemotherapy. These
      clinicopathologic findings, including the immunophenotypic analysis, established
      with certainty the diagnosis of HTLV-I-induced adult T-cell leukemia/lymphoma.

PMID- 7786442
TI  - Ipsilateral synchronous renal cell carcinoma and transitional cell carcinoma.
AB  - The simultaneous occurrence of renal cell carcinoma(RCC) and transitional cell
      carcinoma(TCC) in the same kidney is unusual. We report a 53-year-old man with
      ipsilateral synchronous renal adenocarcinoma and renal pelvic transitional cell
      carcinoma with severe hypercalcemia and a huge staghorn calculus in the opposite
      kidney. The patient was admitted to the hospital because of left flank pain and
      intermittent fever which he had had for 2 months. Computerized tomography
      revealed a huge stone in the right kidney and a mass in the upper pole with an
      irregular calcified pelvis in the left enlarged kidney. Left radical nephrectomy
      was done. A section of the specimen revealed a renal cell carcinoma located at
      the upper pole and a papillary transitional cell carcinoma arising from the renal
      pelvis. This is a rare case of combined renal malignancies.

PMID- 7786443
TI  - Plexiform malignant peripheral nerve sheath tumor(MPNST) in infancy and childhood
      -a case report.
AB  - We present a congenital plexiform cellular tumor with high mitotic activities
      arising in the right thigh of a 3-days-old infant. This subcutaneous tumor
      measured 6.5 x 4.5 cm in diameter with multinodular, whitish, elastic cut
      surface. Microscopically, the tumor was composed of fascicles of closely packed
      uniform spindle cells with frequent nuclear palisadings. The most remarkable
      finding was frequent mitoses(4-5/10 HPF). The tumor cells were strongly positive
      for S-100 protein, myelin basic protein and vimentin, and weakly positive for Leu
      7. On electron microscopic examination, the spindle cells were found to be
      surrounded by continuous basal lamina and had interlocking long cytoplasmic
      processes. Although the prognosis of this tumor is difficult to predict,
      aggressive behavior such as recurrences may be suggested, but it is less likely
      to be metastatic. Further accumulation of similar unusual cases may be helpful in
      evaluation of its biologic behavior.

PMID- 7786444
TI  - Gene cloning of the human cytomegalovirus (HCMV) antigen reactive with the serum
      from a HCMV-infected patient.
AB  - The human cytomegalovirus(HCMV) gene encoding the protein reactive with the sera
      of HCMV-infected patient was cloned and characterized. A reactive phage clone was
      screened from a lambda gt11 expression library of cDNA of HCMV AD169 strain using
      HCMV-infected patient sera. The recombinant protein was expressed as 138 kDa
      fusion protein with beta-galactosidase, which was reactive with IgM or IgG HCMV
      antibody-positive sera, but not with anti-HCMV antibody-negative sera. A homology
      search of the DNA sequence of the cloned gene with HCMV AD169 sequences revealed
      that it was composed of 709 base pairs spanning between 0.174 and 0.177 map units
      of the UL32 region of the HCMV AD169 strain genome. This position corresponded to
      a part of the gene encoding 150 kDa phosphoprotein-(pp150), a major tegument
      protein, which was reported as an immunogenic protein which evoked strong and
      longstanding antibody response and had no sequence homology with the proteins of
      other herpesviruses. These results suggested that pp150 was an immunogenic
      protein in natural HCMV infection and therefore this clone was regarded as a
      useful candidate for developing an antigen for the serodiagnosis of HCMV.

PMID- 7786445
TI  - CYP1A2 activity as a risk factor for bladder cancer.
AB  - CYP1A2, CYP2D6 and N-acetyltransferase activities were estimated in 100 patients
      with bladder cancer and 84 control subjects from measurements of theophylline,
      metoprolol and isoniazid and their metabolites in urine, respectively. The
      frequency of occurrence of slow acetylators of isoniazid and poor metabolizers of
      metoprolol were 16.7% and 1.2% in the control group and 16.3% and 2.0% in the
      cancer patient group. These differences were not significant. The recovery ratio
      of 1-methyluric acid(1-MU) from theophylline was significantly higher in patients
      with bladder cancer than in control subjects(0.340 +/- 0.016 versus 0.260 +/-
      0.020, p < 0.05). The 1-MU recovery ratio was a significant, independent risk
      factor among the metabolic capacities tested as shown by logistic regression
      analysis, controlling for N-acetylation of isoniazid, hydroxylation of
      metoprolol, age, sex, and smoking. We concluded that the capacity for 3
      demethylation of theophylline, as a reflection of CYP1A2 activity, is
      significantly associated with increased risk of nonoccupational urinary bladder
      cancer.

PMID- 7786446
TI  - Modulation of transglutaminase expression in rat skeletal muscle by induction of
      atrophy and endurance training.
AB  - The persistence of muscle fiber number regardless of size reduction in muscle
      atrophy has not yet been fully explained. For the mechanism inherent in skeletal
      muscle tissues for preventing cellular death, the protective function of muscle
      tissue through transglutaminases has been tested, since the enzyme is responsible
      for structural stabilization and participates in signal transduction. In the
      present experiment, hindlimb suspension for two weeks caused a marked muscle
      atrophy in Wistar female rats. Comparison of muscle weight and histological
      analysis showed that suspension-induced atrophy in the hindlimb was more
      prominent in the soleus muscle, comprised mainly of type I fiber than that in the
      plantaris muscle of type II fibers. The immunohistochemical analysis with
      antitransglutaminase C antibody (anti TGase C Ab) showed that some atrophic
      bundles of soleus muscle were positively reacted with the antibody. The anti
      TGase C Ab-reactive substances were observed to disappear significantly after
      endurance exercise, indicating their characteristic atrophy-dependency. The
      enzymatic analysis of transglutaminase showed the increase in activity in the
      atrophic soleus muscle tissue, compared with that in the normal or exercise
      trained muscle tissues. From these results, the expression of TGase in the
      atrophic muscle is suggested to be the possible marker for muscle atrophy and its
      expression is probably related with the protective mechanism of the muscle tissue
      to prevent further cellular damage in the atrophic process.

PMID- 7786448
TI  - Bilateral fractures of Hydroflex penile prostheses: an unusual complication.
AB  - We report bilaterally fractured Hydroflex implants in 2 patients. One fracture
      was complete and three were incomplete. All the fractures occurred at the
      junction of the rear reservoir and the inflation chamber.

PMID- 7786447
TI  - Stimulation of Cl- secretion by AlF4- and vanadate in T84 cells.
AB  - We investigated the mechanism of Cl- secretion by fluoroaluminate(AlF4-) and
      sodium orthovanadate(vanadate) using the human colonic T84 cell line. T84 cell
      monolayers grown on collagen-coated filters were mounted in Ussing chambers to
      measure short circuit current(ISC). Serosal addition of AlF4- or vanadate to T84
      monolayers produced a sustained increase in ISC. Removal of Ca2+ from the serosal
      bathing solution partially inhibited AlF4-(-)and vanadate-induced ISC, and
      readministration of Ca2+ restored AlF4-(-)and vanadate-induced ISC. Carbachol
      application in the presence of forskolin, AlF4- or vanadate induced a synergistic
      increase of ISC. Forskolin and vanadate significantly increased cellular cAMP
      level, while carbachol and AlF4- did not. Carbachol, AlF4- and vanadate
      significantly increased [Ca2+]i. After Na+ in mucosal bathing solution was
      replaced with K+, and the mucosal membrane of T84 cell was permeabilized with
      amphotericin B, AlF4-, vanadate, and carbachol increased K+ conductance, but
      forskolin did not. After sodium chloride in serosal bathing solution was replaced
      with sodium gluconate and the serosal membrane was permeabilized with nystatin,
      forskolin, AlF4-, and vanadate increased Cl- conductance, but carbachol did not.
      AlF4-(-)induced ISC was remarkably inhibited by the pretreatment of pertussis
      toxin(2 micrograms/ml) for 2 hours. These results indicate that AlF4- and
      vanadate can increase Cl- secretion via simultaneous stimulation of Cl- channel
      and K+ channel in T84 cells. However, the AlF4- action is mostly attributed to
      stimulation of pertussis toxin-sensitive G-proteins, whereas the vanadate action
      mostly results from G protein-independent mechanisms.

PMID- 7786449
TI  - Five cases of cytomegalovirus infection detected by in situ hybridization and
      antigenemia assay.
AB  - We report five cases of cytomegalovirus infection in immunocompromised patients
      which were detected by either cytomegalovirus antigenemia assay or in situ
      hybridization. Four cases had leukemia and the other had chronic renal failure.
      All the three BMT recipients suffered from GvHD. Interestingly, there was an
      unique case of CMV disease without a history of BMT, which reminded us that CMV
      could attack immunocompromised patients who had not undergone transplantation,
      too. Four out of five cases died. We think that cytomegalovirus infection or
      disease should not be regarded as a minor problem in post-transplantation
      infection in Korea.

PMID- 7786450
TI  - Job-sharing a clinical teacher's position: an evaluation.
AB  - The aim of this study was to evaluate the effects on staff of having two teachers
      share one clinical teaching position in their intensive care unit (ICU). Three,
      six and 12 months after the job-sharing arrangement was initiated, an 11 item
      questionnaire was distributed to 26 students in post-registration critical care
      courses, 41 clinical staff in ICU and 9 RN-managers with responsibilities for the
      unit. The overall response rate to the three questionnaires was 58%. All groups
      agreed that job-sharing was a viable alternative to full-time work. Three months
      after the shared position was initiated, there was uncertainty about the
      consistency of the teachers' performance and the adequacy of communication
      between them. Nine months later, there was a high level of positive responses to
      all areas of the teachers' performance. Most respondents felt they could approach
      either teacher and that more diverse ideas were generated by having two people in
      the teaching position.

PMID- 7786451
TI  - Measuring pain in neonates: evaluating an instrument and developing a common
      language.
AB  - This paper describes the development and evaluation of the Pain Assessment Tool
      (PAT), a scoring system that was developed by a group of neonatal nurses to
      assess neonates' pain. To test the practical application of the tool and to
      compare the scoring system with nurses' subjective pain assessments, a pilot
      study was conducted with a sample of 20 neonates during the 24 hours following
      their surgery. The study found that PAT effectively quantified neonates' pain and
      that PAT scores reflected nurses' perceptions of the pain experienced by
      neonates. Based on the PAT scores, 15 babies experienced discomfort that required
      nursing comfort measures and eight babies needed both comfort measures and
      analgesia to relieve pain. Recommendations for future use of the Pain Assessment
      Tool are discussed.

PMID- 7786452
TI  - Domestic violence: are we listening? Do we see?
AB  - This article reports on a study of female victims of abuse who had been
      hospitalised for treatment of injuries inflicted by their spouses. A
      phenomenological approach was adopted wherein four women were interviewed to
      elicit their perceptions of their last hospital experience. Four major themes
      emerged from analysis of the interview data, these were that the women
      consistently experienced: disengagement and loss of status; disempowerment and
      lack of control; stigma and social isolation and a sense of being misunderstood.
      The results of the study are discussed in relation to women's expectations of
      nurses' attitudes and nursing interventions.

PMID- 7786453
TI  - The impact of critical incidents in paediatric hospitals: a review.
AB  - Literature addressing critical incidents involving hospitalised children is
      reviewed and circumstances that produce critical incidents are discussed. It is
      argued that critical incidents often have a major impact on children and their
      families and on staff, and particularly nursing staff, in paediatric intensive
      care and burns, oncology and emergency units. Some strategies for assisting
      children, families and staff to cope with severe trauma, life-threatening illness
      and death in paediatric hospitals are presented.

PMID- 7786454
TI  - Peer review--how does it work?

PMID- 7786458
TI  - Relinquishing the sick role: convalescence and rehabilitation.
AB  - This paper examines the problems of patients who have been considered by their
      doctors to have received adequate rehabilitation and to be ready to relinquish
      the sick role. The sick role is discussed in its historical context and
      convalescence and rehabilitation are considered as alternative approaches to
      medical and nursing care. It is argued that many patients leaving hospital are
      frightened because they do not feel well and they will receive little if any
      follow-up or support after discharge. It is the author's belief that many
      patients need to convalesce because the very essence of their being is still ill.

PMID- 7786457
TI  - Blood letting for BSL: the effects of timing and sites on blood volume.
AB  - The purpose of this study was to establish the most appropriate timing and site
      for obtaining an adequate volume of blood for accurate measurement of blood sugar
      levels by blood glucose monitors. The 248 samples of blood used in the study were
      collected from 18 men and 16 women recruited from a group of people with type II
      diabetes mellitus who were attending an outpatient Diabetes Centre. Neither the
      timing between lancing and collecting the blood nor the sites from which blood
      was obtained significantly affected the volume of blood samples. Sufficient blood
      to give an accurate measure of blood sugar levels from monitors requiring 30, 15
      18 and five microlitres of blood was obtained from 37%, 65% and 98% of the
      procedures respectively.

PMID- 7786456
TI  - Gender bias in cardiology: are women missing out on PTCA?
AB  - The purpose of this study was to determine if there were differences in the ages
      of women and men who underwent percutaneous transluminal coronary angioplasty
      (PTCA), in the duration of PTCA procedures performed on women and men and in the
      percentage of women and men treated with PTCA relative to the gender distribution
      of deaths attributed to coronary heart disease. The study was conducted as a
      retrospective audit of the operation records of 959 PTCA procedures performed
      over a two year period in a cardiology clinic in a Sydney teaching hospital.
      Results indicate that, on average, women were older than men when they underwent
      PTCA, that the average duration of the procedure was longer for women than men
      and that disproportionately fewer women aged 65 and over were treated with PTCA.
      The results suggest that gender bias in the delivery of PTCA cannot be discounted
      and that further research is needed on the clinical needs of women with coronary
      heart disease.

PMID- 7786455
TI  - EDPS and clinical depression.

PMID- 7786461
TI  - The clinician and the academic: nursing experience and academic study.
AB  - This study was conducted at an Australian university which uses telephone group
      tutorials to enable off-campus students to link their academic and practice
      worlds. Audiotapes of the content of the 16 teletutorials in one first year unit
      of the university's Bachelor of Nursing course and interviews with the tutor and
      10 of the registered nurses who were student participants were transcribed for
      analysis. Analysis of the tapes and texts revealed that there was discernible
      tension between the students' roles as 'expert' clinicians and 'novice' students
      and, further, that this was a reflection of inherent tension between faculty
      rhetoric, reality/belief and practice. It became evident that these tensions
      would become problematic and impact on both the tutor's and students' perceptions
      of the course.

PMID- 7786462
TI  - Conversations with researchers. Interview by Natalie Newman.

PMID- 7786459
TI  - Patients' experiences of nursing interventions during hospitalisation with an
      AIDS-defining illness.
AB  - The aim of this phenomenologically informed study was to explore the experience
      of being hospitalised with an AIDS-defining illness. Eight men recently
      hospitalised with an AIDS-defining illness were asked at interview to describe
      the meaning of AIDS for them and the nursing interventions they experienced as
      helpful and unhelpful while they were in hospital. The findings pertaining to
      participants' experiences of nursing interventions are highlighted in this paper.
      Overall, the interventions experienced as helpful were those which the
      participants interpreted as being motivated by care. Conversely, the
      interventions described as unhelpful were those that suggested to the
      participants a lack of care on the part of nurses. The main implications of
      patients' experiences for nursing practice are discussed.

PMID- 7786463
TI  - Tracing lost research participants.
AB  - This paper discusses search strategies that were used to locate research
      participants with whom researchers had lost contact during a 13 year longitudinal
      study. The information that proved to be most useful in tracing 'lost'
      participants was a record of correct names and next of kin. The most cost
      effective method of re-establishing contact was via the telephone.

PMID- 7786464
TI  - [Alcohol and traffic safety--study of epidemiology (II. 1990/1991 status].
AB  - With the co-operation of a further 13 institutes and as a continuation of our own
      epidemiological-statistical survey, we recorded the total and relative
      distribution (frequency profile) of the blood alcohol concentration of car
      drivers for the 3rd quarter 1990 and the 1st quarter 1991. The participating
      institutes recorded almost 27,000 blood samples and compared them with results of
      the first part of the study (1989). The survey dealt separately with sex-, age-
      and time of day-distribution of drivers involved and not involved in road
      accidents. One of our repeatedly presented field research into the problem of
      "alcohol and road safety", once again, provided to be a useful method in the run
      up to the unprejudiced alcohol test which we are striving for. We noticed
      characteristic changes in the frequency profiles of the old and the new counties
      (Bundeslander) in Germany in the 1st (1989) and the 2nd (1990/91) report of the
      study. The results of Police supervisory operations in the administrative
      district of Cologne have basically given useful indications as to their
      epidemiological-statistical value as evidence.

PMID- 7786460
TI  - The time has come the Walrus said, to speak of many things...

PMID- 7786465
TI  - [Indicators for alcohol abuse in female drunk drivers. (Comparative study with
      alcohol intoxicated male automobile drivers)].
AB  - Women account for about 12% of all cases of drink driving in German cities.
      Little is known about their drinking behaviour and the extent of their alcohol
      misuse. In order that these questions may be clarified, three major studies were
      evaluated. In these studies, additional indicators for alcohol misuse such as GGT
      or methanol and acetone+isopropanol or indeed CDT, GGT, methanol and
      acetone+isopropanol were measured in blood samples. The results were compared
      with studies of the same kind on male car drivers. There were no significant
      differences in the ages of males and females. However, there were no differences
      at all regarding the frequency of the blood alcohol levels or the CDT. Indicators
      levels of chronic alcohol abuse, such als GGT levels above 70 U/L, methanol
      levels above 10.00 mg/kg or acetone+isopropanol concentrations above 9.00 mg/kg
      were approximately the same with women as they were with men. This demonstrates
      an increasing similarity amongst male and female DWI drivers regarding the
      drinking behaviour and alcohol abuse.

PMID- 7786466
TI  - [Arterial and venous alcohol elimination in 10 polytrauma patients].
AB  - Alcohol elimination was examined in 10 patients involved in accidents while
      intoxicated. The influence of trauma, particularly polytrauma resulting in
      haemorrhage shock and its therapeutic treatment were analysed. The blood alcohol
      concentrations were determined according to the usual forensic criteria (2
      alcohol dehydrogenase and 2 gas chromatography measurements). Observation periods
      ranged from 3 hours 45 minutes to 12 hours 35 minutes, with blood being drawn at
      intervals ranging from 45 minutes to 185 minutes (on average 70 minutes). Results
      of two patients (delta 60 = 0.22/1000/h and 0.28/1000/h) who only had 3 venous
      drawn and results of a deceased patient from whom only four arterial samples
      could be obtained (beta 60 = 0.21/1000/h) were disregarded when working out the
      average values. The blood alcohol curve plateaued in the case of the deceased
      patient as well as in the case of a patient whose hepatic circulation was
      curtailed for approximately half an hour during surgery. The blood alcohol curves
      for the remaining patients for uniformly linear with beta 60 values between
      0.17/1000/h and 0.21/1000/h (mean = 0.18/1000/h +/- 0.01) in arterial samples and
      0.18/1000/h and 0.21/1000/h (mean = 0.18/1000/h +/- 0.01) in venous samples.
      Given our results and the existing literature, we feel that retrograde
      calculations of the BAC can be justified in patients with polytrauma, despite the
      small number of patients included in the study. Naturally, the usual forensic
      criteria have to be taken into account, as well as individual situations.
      Examples that can be mentioned here are liver failure or curtailment of hepatic
      circulation during surgery.

PMID- 7786467
TI  - [Intake of addictive drugs and traffic safety--a report of experiences of the
      Vienna federal police department].
AB  - Urine samples of 27 individuals with extremely conspicuous behaviour in road
      traffic were analysed by means of the Abbott ADx-analyser for cocaine
      metabolites, cannabinoids and opiates. Gas chromatography/mass spectrometry
      (GC/MS) confirmed positive results. 52% of those 26 positive samples confirmed
      the simultaneous consumption of two drugs. In 16% all three drugs tested could be
      found positive, exceeding the threshold values given for the tests hundred fold.
      Without exception, all 25 urine samples found positive in the ADx-analyser
      belonged to young people (22 males, 3 females) with 48% of them born between 1968
      and 1970. 84% of tested people had previous convictions and 68% had drug
      addiction records. We also see this project as the beginning of continuing
      investigations of other drugs and pharmaceuticals. Given the fact that 25 out of
      27 samples were found to be positive we most certainly detected nothing but the
      "tip of the iceberg". We should strive, in conjunction with other European
      countries, for a political solution to the problem of the illegal and legal
      consumption of drugs and pharmaceuticals and their effect on driving performance.

PMID- 7786469
TI  - Potentiometric butyrylcholine sensor for organophosphate pesticides.
AB  - A highly sensitive potentiometric butyrylcholine (BuCh) sensor based on
      plasticized poly(vinyl chloride) membrane was fabricated using tetrakis (3,5
      bis[2-methoxy-hexafluoro-methyl] phenyl) borate (HFPB) as a cation exchanger. The
      sensor showed a Nernstian response from 10(-1) M to 10(-6) M for BuCh. The
      detection limit of the sensor was 1.8 x 10(-7) M. The potential stability,
      lifetime and detection limit of the BuCh-sensor were improved in comparison with
      corresponding parameters of BuCh-sensors using prepared other cation exchangers.
      This improvement was proved to be due to higher hydrophobicity of the cation
      exchanger, HFPB. Enzyme activity of butyrylcholinesterase (BuChE) was determined
      by the BuCh-sensor fabricated. Since the selectivity coefficient of the BuCh
      sensor for BuCh against a product of the enzyme reaction, choline, was as low as
      6.3 x 10(-3), the sensor was not affected by interference from choline even when
      the enzyme reaction proceeded up to about 80%. Michaelis parameters for the BuChE
      reaction were obtained by the sensor. Determinations of organophosphate
      pesticides, 2,2-dichlorovinyldimethylphosphate and o-(4-bromo-2-chlorophenyl)o
      ethyl S-propylphosphothiolate) were conducted by measuring inhibition of enzyme
      activity. The enzyme reaction rate was related to the concentration of
      pesticides. Pesticides were successfully determined between micromole and sub
      nanomole levels by the BuCh-sensor.

PMID- 7786468
TI  - [Unethical advertising?--The promille killer and alcohol tester].

PMID- 7786470
TI  - Retained activities of some membrane proteins in stable lipid bilayers on a solid
      support.
AB  - Highly stable lipid bilayers, composed of biologically relevant lipids such as
      phosphatidylcholine, phosphatidylethanolamine and cholesterol, were formed on
      platinum surfaces. Bacteriorhodopsin isolated from purple membrane (PM) from
      Halobacterium halobium, cytochrome oxidase from bovine heart,
      acetylcholinesterase from bovine brain and the nicotinic acetylcholine receptor
      from Torpedo electric organ were also incorporated into these reconstituted
      membranes. The proteins retained their biological activities. Some of them were
      active several weeks after the reconstitution and after several cycles of assay,
      washing and storage.

PMID- 7786471
TI  - An approach for an immunoaffinity AIDS sensor using the conservative region of
      the HIV envelope protein (gp41) and its monoclonal antibody.
AB  - A monoclonal antibody for the conservative region of gp41, which is one of the
      HIV envelope proteins, was produced. The antigen determining site of gp41 was
      examined using the epitope mapping technique, followed by an enzyme linked
      immunosorbent assay. Some peptides had comparable affinities for the monoclonal
      antibody, but the peptide EGIEE, having a slightly weaker immunoaffinity than
      gp41, was the most preferable for the construction of an immunoaffinity AIDS
      sensor. For the detection of gp41, EGIEE was labelled with catalase and used as a
      mimic antigen; it was bound to the antibody present on an immuno-membrane and,
      due to the replacement reaction of the mimic antigen by gp41, indirect
      quantitative measurement of gp41 was possible using an oxygen electrode. Anti
      gp41 antibody was also detected using a mimic antibody, which was chemically
      modified with polyethylene glycol. An immunoaffinity AIDS sensor was constructed
      using the mimic molecules which were tailored to have a suitable immunoaffinity
      for HIV antigen and/or antibody.

PMID- 7786472
TI  - Integrated implantable device for long-term glucose monitoring.
AB  - In this study we report the development of an integrated implantable device for
      glucose monitoring. The dimensions of the device (5.0 x 7.0 x 1.5 cm) allow
      implantation under the abdominal skin of a large animal for in vivo evaluation of
      sensor performance. The experimental set-up includes amperometric glucose
      biosensor, a miniature potentiostat, an FM signal transmitter, a power supply and
      an antenna and receiver linked to a computer-based data acquisition system. The
      device performance was evaluated in vitro using a ten-day continuous test and
      other long-term operation experiments. The biosensor was tested in different
      model solutions that simulated the physiological environment in which it will be
      ultimately used. A linear response to glucose concentration was obtained up to 25
      mM glucose, with a sensitivity of less than 0.5 microA/mM. The ability of the
      biosensor to measure glucose levels in serum was also tested, and a good
      correlation demonstrated between glucose serum levels measured by routine
      technique and those measured using the biosensor (R2 = 0.993; slope = 0.996).
      Initial results obtained from the short-term subcutaneous implantation of the
      sensor demonstrate its potential for the monitoring of glucose concentration in
      vivo.

PMID- 7786474
TI  - A matter of some sensitivity.
AB  - The development of sensitive chromatographic and spectroscopic techniques for the
      isolation and structure determination of natural products has greatly facilitated
      phytochemical investigations. Chemical investigations of herbarium material have
      resulted in the isolation of indole, quinoline and isoquinoline alkaloids from a
      wide number of plants. Examples of novel natural products from higher plants are
      given and include alkaloids, terpenoids, phenolics and quinones. Some plants
      investigated have not yielded the types of constituents which would have been
      predicted from them. Plant tissue cultures provide alternative sources of
      biologically active compounds and examples investigated include Cinchona,
      Ailanthus, Brucea and Artemisia for antiprotozoal compounds and Datura for
      tropane alkaloids. Biological tests are useful for bioassay-guided fractionation
      of plant extracts and examples of the isolation of a series of natural products
      with antiprotozoal and cytotoxic activities are given. Chemical and biological
      investigations into the traditional medicine Dragon's blood (Croton lechleri)
      from S. America and a Chinese prescription for the treatment of atopic eczema are
      described. The use of radio-ligand binding assays for the detection of a wide
      range of biological activities is discussed. Sensitivity of chemical and
      biological techniques has greatly improved prospects for finding new drug
      entities from plants and for investigating traditional medicines. Basic
      phytochemical investigations should continue to be encouraged especially in view
      of the rapid loss of plant species.

PMID- 7786473
TI  - Specific binding assay for biotin based on enzyme channelling with direct
      electron transfer electrochemical detection using horseradish peroxidase.
AB  - A model 'homogeneous' format enzyme channelling specific binding assay for biotin
      based on peroxide-sensitive horseradish peroxidase mediatorless enzyme electrodes
      is described. The procedure involved the immobilisation of avidin onto the
      surface of printed carbon horseradish peroxidase (HRP) enzyme electrodes and the
      competitive binding of biotin and biotinylated glucose oxidase. Upon addition of
      glucose, hydrogen peroxide was generated via the glucose oxidase label. Direct
      electron transfer between the electrodes and HRP resulted in the detection of
      H2O2 by electroenzymic reduction at +50 mV vs Ag/AgCl. The cathodic current
      response could be measured in the presence of excess biotinylated glucose oxidase
      by incorporation of catalase in homogeneous solution to scavenge H2O2 generated
      in the bulk before it diffused to the electrode surface. The assay showed
      greatest sensitivity over the range of biotin concentrations 0.07 to 2 micrograms
      ml-1 in the presence of 10 micrograms ml-1 excess biotinylated glucose oxidase in
      the bulk solution.

PMID- 7786475
TI  - Diterpenoids from Isodon eriocalyx var. laxiflora.
AB  - Three new, seco-ent-kaurane diterpenoids, laxiflorins A, B and C, together with
      four known diterpenoids eriocalyxin B, oriodonin, and maeocrystals A and B, were
      isolated from the leaves of Isodon eriocalyx var. laxiflora. Their structures
      were assigned by a combination of one- and two-dimensional NMR techniques and
      computer modeling calculations. Laxiflorin C displayed weak cytotoxic activity.

PMID- 7786476
TI  - Polyandrol, a C19 quassinoid from Castela polyandra.

PMID- 7786477
TI  - Triterpenoid saponins from Clematis chinensis.
AB  - From the roots of Clematis chinensis, two new triterpenoid saponins, named
      clematichinenoside A and B, were isolated and their structures were elucidated as
      3-O-beta-D-ribopyranosyl-(1-3)-alpha-L-rhamnopyranosyl-(1-2)-alpha -L-
      arabinopyranosyl oleanolic acid 28-O-beta-D-glucopyranosyl ester and 3-O-beta-D
      glucopyranosyl-(1-4)-beta-D-ribopyranosyl-(1-3)-alpha-L - rhamnopyranosyl-(1-2)
      alpha-L-arabinopyranosyl hederagenin 28-O-alpha-L-rhamnopyranosyl-(1-4)-beta-D
      glucopyranosyl-(1-6)- beta-D-glucopyranosyl ester, respectively. In addition
      oleanolic acid, hederagenin and seven known saponins were obtained.

PMID- 7786478
TI  - Isolation of triterpene saponins from Gypsophila capillaris.
AB  - Four novel triterpenoid saponins have been isolated from Gypsophila capillaris.
      Three were monodesmosidic: 3 beta-hydroxyolean-12-en-23,28-dioic acid 28-O-[beta
      D-glucopyranosyl-(1-->3)-beta-D-glucopyranosyl-(1-->2)] [beta-D
      galactopyranosyl(1-->6)]beta-D-glucopyranoside, 3 beta-hydroxyolean-12-en-23-oxo
      28-oic acid 28-O-[beta-D-glucopyranosyl-(1-->2)-beta-D-galactopyranosyl-(1-->3)]
      [beta-D-glucopyranosyl(1-->6)]beta-D-galactopyranoside, 3 beta-hydroxyolean-12-en
      23,28-dioic acid 28-O-[beta-D-glucopyranosyl-(1-->2)-beta-D-galactopyranosyl-(1-
      >3)] [beta-D-glucopyranosyl(1-->6)]beta-D-galactopyranoside. The fourth was
      bisdesmosidic: 3 beta-hydroxyolean-12-en-23,28-dioic acid 23-O-beta-D
      glucopyranosyl-28-O-[beta-D-glucopyranosyl-(1-->2)-beta-D- galactopyranosyl-(1-
      >3)][beta-D-glucopyranosyl-(1-->6)]beta-D- galactopyranoside. The structures of
      the compounds were elucidated by 1D and 2D NMR techniques and from other
      spectroscopic evidence.

PMID- 7786479
TI  - Triterpene saponins from Aster yunnanensis.
AB  - Four new triterpene saponins, asteryunnanosides A, B, C and D, have been isolated
      from Aster yunnanensis and their structures deduced as 2 alpha,3 beta,23
      trihydroxyolean-12-en-28-oic acid-28-O-alpha-L-rhamnopyranosyl-(1-->2)-beta-D
      glucopyranoside, 2 alpha,3 beta,23-trihydroxyolean-12-en-28-oic acid-28-O-beta-D
      glucopyranosyl-(1-->2)-beta-D-glucopyranoside, 2 alpha,3 beta-dihydroxyolean-12
      en-28-oic acid-28-O-alpha-L-rhamnopyranosyl-(1-->2)-beta-D-glucopyranoside and 2
      alpha,3 beta-dihydroxyolean-12-en-28-oic acid-28-O-beta-D-glucopyranosyl-(1-->2)
      beta-D-glucopyranoside, respectively, by means of spectral and chemical data.

PMID- 7786480
TI  - A bidesmosidic triterpene saponin from Cephalaria transsylvanica.
AB  - The structure of cephalaria saponin B, isolated from Cephalaria transsylvanica
      was elucidated as 3-O-([beta-D-xylopyranosyl(1-->4)-alpha-L-rhamnopyranosyl(1-
      >2)-beta-D- xylopyranosyl]-[28-O-beta-D-glucopyranosyl])-3beta,23-dihydroxy
      12(13)-oleanene-28-oic acid.

PMID- 7786481
TI  - A ferulic acid ester of sucrose and other constituents of Bhesa paniculata.
AB  - A novel derivative of sucrose, beta-(3,6-di-O-feruloyl)-fructofuranosyl-alpha
      (2,3,4,6-tetra-O-ac etyl)- glucopyranoside, was isolated from the wood of Bhesa
      paniculata. Its structure was determined by a combination of 2D 1H-1H and 1H-13C
      correlation NMR spectroscopy. The known compounds, glycerol 1-9',12'
      octadecadienoate, beta-sitosterol, (+/-)-pinoresinol, methyl 3,4
      dihydroxybenzoate, 4-hydroxy-3-methoxybenzoic acid, anofinic acid and 2-(1'
      methylethenyl)-benzofuran-5-carboxylic acid were also isolated.

PMID- 7786483
TI  - (S)-13-hydroxygeranylgeraniol-derived furanoditerpenes from Bifurcaria bifurcata.
AB  - Two new diterpenes were isolated from a sample of the brown alga Bifurcaria
      bifurcata collected from Brittany on the Atlantic coast and their structures
      established by spectroscopic methods. The new diterpenes are derived from (S)-13
      hydroxygeranylgeraniol by terminal cyclization and oxidation leading to a furan-3
      yl ring or a beta,gamma-epoxy-gamma-lactone. One of them showed a cytotoxic
      effect to fertilized sea urchin eggs. The chemical shifts of the methyl groups
      and quaternary carbons in (S)-13-hydroxygeranylgeraniol have been revised to take
      account of the results obtained in a 2D NMR long-range C-H correlation experiment
      and the absolute configuration at C-13 determined for the first time. The
      geographical variation in the diterpenoid composition of B. bifurcata was also
      studied.

PMID- 7786482
TI  - Antiallergic dimeric prenylbenzoquinones from Ehretia microphylla.
AB  - The ethyl acetate-soluble portion of the MeOH extract of Ehretia microphylla
      showed inhibitory activity on exocytosis in antigen-stimulated rat basophils. The
      bioassay-guided separation of this fraction afforded five biologically active
      compounds. By means of chemical and spectroscopic methods, the structures of
      these compounds, which include microphyllone, a unique dimeric
      prenylbenzoquinone, and its congeners, were elucidated.

PMID- 7786484
TI  - Two cytotoxic pentacyclic triterpenoids from Nerium oleander.

PMID- 7786486
TI  - Saponins from Hacquetia epipactis.
AB  - Four new estersaponins were isolated from hacquetia epipactis. Using GC-MS, FAB
      MS and various 2D-NMR techniques they were identified as 3-O-[beta-D
      glucopyranosyl-(1-->2)-[alpha-L-arabinopyranosyl-(1--> 3)]- beta-D
      glucuronopyranosyl-(1-->)]-21-acetyl-22-(2-methylbutyryl)- barringtogenol C
      (hacquetiasaponin 1), the corresponding 21-(2-acetoxy-2-methylbutyryl)-22-acetyl
      derivative (hacquetiasaponin 2), 3-O-[beta-D-glucopyranosyl-(1-->2)-[alpha-L
      arabinopyranosyl- (1-->3)]-beta-D-glucuronopyranosyl-(1-->)]-21-acetyl-22-(2
      methylb utyryl)- R1-barrigenol (hacquetiasaponin 3) and its corresponding 21-(2
      acetoxy-2-methylbutyryl)-22-acetyl-derivative (hacquetiasaponin 4).

PMID- 7786485
TI  - Mazusaponins I-IV, triterpene saponins from Mazus miquelii.
AB  - From whole plants of Mazus miquelii, four new saponins designated as mazusaponins
      I-IV and a known saponin, ilexoside VIII, were isolated and the structures of the
      new compounds elucidated as 3-O-alpha-L-arabinopyranosyl siaresinolic acid 28-O
      beta-D-glucopyranosyl-(1-->6)-beta-D-glucopyranosyl ester, 3-O-alpha-L
      arabinopyranosyl pomolic acid 28-O-beta-D-glucopyranosyl-(1-->6)-beta-D
      glucopyranosyl ester, 3-O-alpha-L-rhamnopyranosyl-(1-->2)-alpha-L
      arabinopyranosyl siaresinolic acid 28-O-beta-D-glucopyranosyl-(1-->6)-beta-D
      glucopyranosyl ester and 3-O-alpha-L-rhamnopyranosyl-(1-->2)-alpha-L
      arabinopyranosyl pomolic acid 28-O-beta-D-glucopyranosyl-(1-->6)-beta-D
      glucopyranosyl ester, respectively, by spectroscopic data and chemical evidence.

PMID- 7786487
TI  - Steroidal glycosides from Cynanchum caudatum.
AB  - The aerial part of Cynanchum caudatum afforded 10 new pregnane glycosides which
      had sarcostin or deacylmetaplexigenin as the aglycone moiety. The structures of
      these compounds were elucidated by spectroscopic methods and from chemical
      evidence.

PMID- 7786488
TI  - Cucurbitacin glycosides from Caput nigri.
AB  - The chemical structures of cabenosides I-L were investigated. These are four of
      the 12 cucurbitacin glycosides isolated from 'Cabeca-de-negro', the roots of
      Caput nigri. By means of chemical analyses the structures of cabenosides I-L were
      elucidated as 10 alpha-cucurbit-5-ene-3 beta,11 alpha,20S,24 xi,25-pentaol [3, 25
      di-O-beta-D-glucopyranoside, and 3-O-beta-D-glucopyranosyl-(1-2)-beta-D
      glucopyranosyl (sophorosyl), 25-O-beta-D-glucopyranoside], and 10 alpha-cucurbit
      5,20,24-triene-11-oxo-3 beta,26-diol [3-O-beta-D-glucopyranosyl-(1-6)-beta-D
      glucopyranosyl (gentiobiosyl), 26-O-beta-D-glucopyranoside and 3,26-di-O
      gentiobioside], respectively.

PMID- 7786489
TI  - Cucurbitacin glycosides from Cabeca-de-negro.
AB  - Five cucurbitacin glycosides named cabenosides D-L were isolated from 'Cabeca-de
      negro', the roots of Caput nigri. Among them, the structures of cabenosides D-H
      were elucidated as 10 alpha-cucurbit-5-en-11-oxo-3 beta,24R,25-triol-3-O-beta-D
      glucopyranoside, 10 alpha-cucurbit-5-en-24-oxo-3 beta, 11 alpha,25-triol-25-O
      beta-D- glucopyranosyl, [3,O-beta-D-glucopyranoside, 3-O-beta-D-glucopyranosyl-(1
      2)-beta-D-glucopyranoside, 3-O-beta-D-glucopyranosyl-(1-6)-beta-D
      glucopyranoside] and 10 alpha-cucurbit-5-en-11,24-dioxo-3 beta,25-diol-25-O-beta
      D- glucopyranosyl, 3-O-beta-D-glucopyranosyl-(1-6)-beta-D-glucopyranoside,
      respectively, on the basis of chemical and spectral evidence.

PMID- 7786491
TI  - Structural features of fungal beta-D-glucans for the efficient inhibition of the
      initiation of virus infection on Nicotiana tabacum.
AB  - Glucans of fungal origin have been shown to inhibit the early stages of infection
      of Nicotiana by numerous viruses of different taxonomic groups. Several glucans
      were isolated from the cell walls of Phytophthora parasitica, Phytophthora
      megasperma f. sp. glycinea (Pmg) and Fusarium oxysporum, and their antiviral
      activity compared on tobacco leaves inoculated with tobacco mosaic virus. These
      polysaccharides consist of a mixture of (1-->3)(1-->6)-beta-D-glucans with M(r)
      varying from 1.1 x 10(3) to 2 x 10(6). Requirements for a prominent antiviral
      activity of the fungal polysaccharides are a beta-(1-->3)(1-->6)-D-glucan
      structure with mono-, di-, tri- or tetra-glucosidic side branches attached to a
      linear main chain of beta-(1-->3)-linked-D-glucose residues. Very high activity
      is correlated with a high degree of branching at position 6 and with the size and
      glycosidic nature of the side chains. The molecular masses and the organized
      structure of fungal beta-D-glucans are not essential for their antiviral
      activity. The structural motif for antiviral activity in Nicotiana is distinct
      from that required for elicitation of phytoalexins in soybean cotyledons.

PMID- 7786492
TI  - Molluscicidal saponins from Catunaregam nilotica.
AB  - Two new saponins were isolated from the fruits of Catunaregam nilotica Stapf,
      syn. Lachnosiphonium nilotica; Randia nilotica; Xeromphis nilotica. Their
      structures were determined mainly by spectroscopic methods as 3- O-[O-alpha-L
      rhamnopyranosyl-(1-->3)-O-[O-beta-D-glucopyranosyl-(1 -->3)]- beta-D
      glucopyranosyl]oleanolic acid and 28-O-beta-D- glucopyranosyl-3-O-[O-alpha-L
      rhamnopyranosyl-(1-->3)-O[O-beta-D- glucopyranosyl]-beta-D
      glycopyranosyl]oleanolate. The monodesmosidic saponin is a potent molluscicide
      against the schistosomiasis transmitting snail Biomphalaria glabrata with a LC50
      value of 3 ppm. In addition two known saponins, 3-O-[2', 3'-di-O-(beta-D
      glucopyranosyl)-beta-D- glucopyranosyl]oleanolic acid and 3-O-[O-beta-D
      glucopyranosyl(1-->3)- beta-D-glucopyranosyl]oleanolic acid, were identified and
      their molluscicidal activity determined, the LC50 values being 26 and 3 ppm,
      respectively. Initial molluscicidal screening of the crude water and ethanol
      extracts revealed 100% snail mortality at concentrations of 100 and 50 ppm,
      respectively. The haemolytic activity of the molluscicidal saponins was
      determined as well and the HC50 values towards bovine erythrocytes found to be 3
      ppm for the new saponin, and 16 and 2 ppm, respectively, for the two known
      saponins.

PMID- 7786493
TI  - Whose genome is it anyway?

PMID- 7786490
TI  - Two cationic peroxidases from cell walls of Araucaria araucana seeds.
AB  - We have previously reported the purification and partial characterization of two
      cationic peroxidases from the cell walls of seeds and seedlings of the South
      American conifer, Araucaria araucana. In this work, we have studied the amino
      acid composition and NH2-terminal sequences of both enzymes. We also compare the
      data obtained from these analyses with those reported for other plant
      peroxidases. The two peroxidases are similar in their amino acid compositions.
      Both are particularly rich in glycine, which comprises more than 30% of the amino
      acid residues. The content of serine is also high, ca 17%. The two enzymes are
      different in their content of arginine, alanine, valine, phenylalanine and
      threonine. Both peroxidases have identical NH2-terminal sequences, indicating
      that the two proteins are genetically related and probably are isoforms of the
      same kind of peroxidase. The amino acid composition and NH2-terminal sequence
      analyses showed marked differences from the cationic peroxidases from turnip and
      horseradish.

PMID- 7786494
TI  - Application of enzymes to the synthesis of surfactants.
AB  - Recent progress in the application of isolated enzymes to the preparation of
      surface-active compounds demonstrates the feasibility of an alternative to
      organosynthetic methods. Processes such as the syntheses of monoglycerides, sugar
      fatty acid esters, (lyso)phospholipids, anomerically pure alkyl glycosides and
      amino acid-based surfactants are discussed, highlighting some of the advantages
      of enzymatic methods over conventional organic syntheses and whole-cell systems.

PMID- 7786495
TI  - Manipulating the immune response in allergic disease: targeting CD4+ T cells.
AB  - CD4+ T lymphocytes play an important role in the induction and maintenance of
      inflammatory responses in allergic diseases. In this review, we examine some of
      the recent developments that have expanded our knowledge of how T cells recognize
      and respond to common environmental allergens. In addition, we discuss the role
      of allergen-derived peptides and their derivatives in the modulation of the
      immunological activity of allergen-specific T cells, and their potential
      application for immune intervention. It appears that the ability to redress the
      balance between qualitatively different subsets of functional components of the
      immune system may guide the development of therapy.

PMID- 7786496
TI  - Microbiological criteria for retail foods. Professional Food Microbiology Group
      (PFMG) of the Institute of Food Science and Technology (IFST).
AB  - This article proposes that microbiological criteria should only be drawn up and
      applied to foods if there is a full understanding and consideration of raw
      material selection, production process, packaging and finished product
      characteristics. The combined knowledge and expertise of public sector
      microbiologists and food industry microbiologists and technologists need to be
      harnessed in the establishment of such criteria. In this manner, microbiological
      criteria could be derived to the overall benefit of the consumer. A meeting of
      the Society for Applied Bacteriology held in November 1994 considered the issue
      of microbiological standards for foods and, in this paper, the recently formed
      PFMG presents an opinion on the 'Provisional microbiological guidelines'
      published by the Food Surveillance Group of the Public Health Laboratory Service.

PMID- 7786497
TI  - An assessment of environmental factors influencing acid tolerance and sensitivity
      in Escherichia coli, Salmonella spp. and other enterobacteria.
AB  - Environmental factors such as temperature, pH and nutrient level affect
      enterobacterial acid sensitivity, as do the presence of phosphate and Na+ and the
      extent of aeration. The mechanisms governing these effects are partially
      understood and the involvement of phoE, fur and atp in acid tolerance, of phoE,
      envZ, tonB, (p)ppGpp and cAMP in salt-induced acid sensitivity and of rpoS in
      stationary-phase acid tolerance are of particular interest. It should be noted
      that surface attachment enhances acid resistance.

PMID- 7786498
TI  - Sensitivity of Campylobacter spp. to irradiation in poultry meat.
AB  - The sensitivity of Campylobacter jejuni (three strains), Camp. coli (three
      strains), Camp. fetus (one strain) and Camp. lari (one strain) to irradiation in
      poultry meat was investigated. There was no significant difference in the counts
      obtained on Blood or Skirrows agar. Preston agar gave a significantly lower
      recovery of the pathogens after irradiation so these results were not included in
      calculations of D10 values. The D10 values ranged from 0.12 to 0.25 kGy and there
      was a significant difference in the radiation sensitivity between different
      Campylobacter spp. and within strains of the same species. These values indicate
      that Campylobacter spp. are more radiation-sensitive than Salmonella and Listeria
      monocytogenes irradiated under similar conditions. Therefore irradiation
      treatments suggested to eliminate the latter from poultry carcasses would also be
      sufficient to remove Campylobacter.

PMID- 7786499
TI  - Efficacy of the E-test in evaluating the antimicrobial susceptibility of
      anaerobic bacteria of veterinary interest.
AB  - A study was made of the sensitivity of 39 clinical isolates of anaerobic bacteria
      to 10 antimicrobial agents. Minimal inhibitory concentrations (MICs) were
      calculated using a new method--the E-test (AB Biodisk, Solna, Sweden)--and
      compared with those obtained using the conventional agar dilution method.
      Agreement between the MICs obtained by the two methods with a variation of +/- 2
      dilutions was 78.7%. The E-test, though less sensitive than the conventional agar
      dilution method, may be of value in clinical veterinary practice when rapid
      selection of treatment for a given infectious process is required.

PMID- 7786500
TI  - X-ray microanalysis of chlorhexidine-treated cells of Saccharomyces cerevisiae.
AB  - The use of energy dispersive analysis of X-rays (EDAX) to identify and quantify
      the presence of chlorhexidine diacetate (CHA) within Saccharomyces cerevisiae
      cells was examined. Chlorine was used as the elemental marker tag. Saccharomyces
      cerevisiae cells exposed to 1000 micrograms ml-1 CHA took up increasing amounts
      of CHA over a time period of 30 s to 30 min. Electron probe micro-analysis was
      employed to examine the specific accumulation of CHA across the treated cells.
      These results showed that CHA was distributed evenly between the cell wall,
      cytoplasm and vacuoles of cells pre-treated with this concentration of CHA for 30
      min. The EDAX system therefore provides a useful tool for examining the
      qualitative and quantitative effects of chlorhexidine on yeast cells, although
      quantitative data must be interpreted with caution.

PMID- 7786501
TI  - Energy dispersive analysis of X-rays study of the distribution of chlorhexidine
      diacetate and cetylpyridinium chloride on the Pseudomonas aeruginosa
      bacteriophage F116.
AB  - Using an energy dispersive analyser of X-rays fitted to a scanning electron
      microscope, chlorhexidine was shown not to bind onto F116 bacteriophage, unlike
      cetylpyridinium chloride, which possibly penetrated the phage. This could explain
      the difference in viricidal activity between the two compounds.

PMID- 7786503
TI  - Differentiation of Yersinia pestis and Y. pseudotuberculosis by SDS-PAGE analysis
      of lipopolysaccharide.

PMID- 7786502
TI  - The detection of Salmonella in skimmed milk powder enrichments using conventional
      methods and immunomagnetic separation.
AB  - Skimmed milk powders were spiked with one of three Salmonella serovars and
      incubated in buffered peptone water for 24 h. No false-negative results were
      obtained by immunomagnetic separation (IMS), compared to seven for selenite
      cysteine, one for Muller-Kauffmann tetrathionate and two for Rappaport
      Vassiliadis enrichment broths. Salmonella virchow was detected and enumerated
      during the pre-enrichment incubation by IMS and indirect conductance techniques.
      The Salm. virchow cell number did not increase after 12 h incubation and remained
      at 3 x 10(6) cfu ml-1. IMS was able to capture Salm. virchow cells at cell
      numbers ca 50 ml-1 in the presence of a 1000 greater number of non-salmonella
      cells.

PMID- 7786504
TI  - Discrepancy between Penner serotyping and polymerase chain reaction
      fingerprinting of Campylobacter isolated from poultry and other animal sources.
AB  - Thirty-four Campylobacter jejuni or coli strains, isolated from various livestock
      and darkling beetles from two Dutch poultry farms during different broiler
      production cycles, were subjected to Penner serotyping and polymerase chain
      reaction (PCR) fingerprint analysis. Ten different Penner serotypes were
      determined in the isolates. Visual scoring of the PCR fingerprints resulted in 14
      clearly different profiles. Some strains with identical Penner serotypes
      exhibited different PCR fingerprints and conversely strains with different
      serotypes produced identical PCR fingerprints. Discrepancies between Penner
      serotyping and PCR fingerprinting were most obvious between isolates from
      different animal sources. Indications for the occurrence of genomic
      rearrangements were found. The inconsistency between serotyping and
      fingerprinting of Campylobacter strains suggests that conventional typing methods
      should be used in combination with fingerprinting if the epidemiological factors
      that contribute to Campylobacter colonization of live chickens are to be assessed
      reliably.

PMID- 7786505
TI  - Evaluation of methods for the isolation and detection of Escherichia coli O157 in
      minced beef.
AB  - This study has evaluated enrichment and detection procedures for the isolation
      and detection of Escherichia coli O157 inoculated into minced beef. The use of a
      24 h enrichment in modified EC broth containing novobiocin allowed low numbers of
      contaminating cells to multiply to levels detectable on culture media and by
      ELISA test kits. Total analysis time was reduced by the use of the Dynabead
      immunomagnetic separation system. The use of the Petrifilm Test Kit-HEC for E.
      coli O157:H7 and Organon Teknika EHEC-TEK system detected low numbers of
      contaminating cells following enrichment and reduced analysis time by 1 d. The
      incorporation of cefixime and tellurite into Sorbitol MacConkey Agar increased
      the rate and ease of isolation of E. coli O157 and its use is therefore
      recommended.

PMID- 7786506
TI  - Formation of viable but nonculturable Salmonella during starvation in chemically
      defined solutions.
AB  - Salmonella enteritidis enters a viable-but-nonculturable state when exposed to
      starvation in aquatic environments. This study determined starvation survival of
      this pathogen in chemically defined solutions and tested the ability of
      nonselective enrichment to detect viable-but-nonculturable cells. Starvation of
      Salm. enteritidis at 7 degrees C in 7.35 mmol l-1 potassium phosphate buffer
      resulted in complete loss of culturability after 5 weeks with maintenance of a
      substrate-responsive population of over 10,000 cell ml-1. Starvation at 21
      degrees C and starvation in saline solutions or lower concentrations of phosphate
      buffer resulted in prolonged survival of a culturable population although this
      population was lower than the total viable population. Enrichment using lactose
      broth did not allow resuscitation of viable-but-nonculturable cells even after 5
      d of incubation at 35 degrees C.

PMID- 7786508
TI  - Virulence factors of Listeria monocytogenes.

PMID- 7786507
TI  - Antimicrobial drug resistance in Staphylococcus aureus isolated from cattle in
      Brazil.
AB  - Isolates of Staphylococcus aureus obtained from apparently healthy cattle in the
      State of Paraiba, Brazil were characterized in relation to resistance to 21
      antimicrobial agents. Among the 46 isolates obtained, resistance to penicillin
      was most frequent, followed by resistance to cadmium, streptomycin, arsenate,
      tetracycline, mercury, erythromycin and kanamycin/neomycin. All isolates were
      susceptible to fusidic acid, ethidium bromide, cetrimide, chloramphenicol,
      benzalkonium chloride, doxycycline, gentamicin, methicillin, minocycline,
      novobiocin, rifamycin, tylosin and vancomycin. Only six isolates were susceptible
      to all the drugs tested. With respect to the antibiotics, multi-resistant
      isolates were uncommon. These results are probably a consequence of the
      peculiarities of local drug usage pressures. In relation to metal ions,
      resistance to mercury was rare while resistance to arsenate was relatively
      frequent, which contrasts with the situation for human Staph. aureus strains.
      After treatment with ethidium bromide, elimination of resistance to penicillin,
      tetracycline, streptomycin, erythromycin and cadmium was observed, which was
      consistent with the genetic determinants being plasmid-borne.

PMID- 7786509
TI  - Detection of FRNA coliphages in groundwater.

PMID- 7786510
TI  - The action of muscles in swimming fish.

PMID- 7786511
TI  - Glutamate-immunoreactivity in identified vagal afferent terminals of the cat: a
      study combining horseradish peroxidase tracing and postembedding electron
      microscopic immunogold staining.
AB  - Using electron microscopic immunohistochemistry we have shown that strong
      glutamate-immunoreactivity (glutamate-ir) is present in neuronal cell bodies of
      the nodose ganglion, axons in the tractus solitarius and afferent terminals in
      the nucleus tractus solitarii. Vagal afferent fibres were specifically labelled
      by transganglionic retrograde transport of horseradish peroxidase (HRP). Fifty
      seven per cent of the HRP-labelled terminals in the dorsomedial medulla were
      found to contain a high level of glutamate-ir, suggesting that a population of
      vagal afferent fibres uses glutamate as a neurotransmitter substance. There were
      no apparent ultrastructural differences between glutamate-ir and non-glutamate-ir
      vagal afferent terminals, both classes mainly containing rounded vesicles and
      forming asymmetric synapses. However, some difference in their preference for
      postsynaptic target was noted. The great majority (83%) of non-glutamate-ir vagal
      afferent terminals made axodendritic synapses, but only just over half (57%) of
      the glutamate-ir vagal terminals made synaptic contact with dendrites.
      Approximately 13% of the HRP-labelled terminals were found to make synaptic
      contact with HRP-labelled dendrites or soma of motoneurones of the dorsal vagal
      motor nucleus, confirming the existence of monosynaptic connections between vagal
      afferent fibres and vagal motoneurones.

PMID- 7786513
TI  - Comparison of synovial PO2 and sympathetic vasoconstrictor responses in normal
      and acutely inflamed rabbit knee joints.
AB  - Experiments were performed to assess the effect of acute inflammation of the
      rabbit knee joint on the partial pressure of oxygen in synovial fluid (Ps,O2) and
      nerve-mediated vasoconstrictor responses of articular blood vessels. With the
      hypodermic needle oxygen electrode sited within the synovial cavity in the
      posterior region of the knee joint, mean (+/- S.E.M.). Ps,O2 was 37.4 +/- 3.6
      mmHg (n = 10) in the inflamed group, which differed significantly (P < 0.05) from
      that occurring in the normal group from a different series (48.2 +/- 3.1 mmHg; n
      = 18). Ps,O2 was found to decrease with increasing depth of penetration of the
      oxygen electrode into the joint cavity of the inflamed knee, as in the normal
      knee. The lowest values were observed close to articular cartilage. Absolute
      blood flow was measured using radiolabelled microspheres whilst relative changes
      in blood flow were assessed using laser Doppler flowmetry. The former technique
      showed that the inflamed joints had a significantly higher blood flow. Electrical
      stimulation of the posterior articular nerve (PAN) of the knee resulted in
      vasoconstriction of knee joint blood vessels, which was accompanied by a
      reduction in Ps,O2. The frequency-response and voltage-response profiles to
      electrical stimulation of the PAN, although differing in magnitude, showed a high
      degree of correlation between blood flow and Ps,O2. The frequency-response
      profile to electrical stimulation of the PAN shifted to the right in inflamed
      joints compared with normal joints, suggesting a reduction in the efficacy of the
      sympathetic nervous system in regulating blood flow to the inflamed joints.
      Although the inflamed joint had a higher blood flow, Ps,O2 was lower compared
      with the normal joint. The results of this study show significantly altered blood
      flow, Ps,O2 and nerve-mediated constrictor responses in the acutely inflamed
      joint. These are related to the inflammatory response and may contribute to the
      pathogenesis of arthritis.

PMID- 7786512
TI  - Composition and viscosity of interstitial fluid of rabbits.
AB  - Open-ended plastic tubes were used as capsules for obtaining interstitial fluid
      from rabbits. The capsule was a 2.5 cm long plastic tube with an inner diameter
      of 6 mm. Three small incisions were made in the dorsal mid-line of the
      anaesthetized rabbit; two capsules were inserted into each incision. A sample of
      capsular fluid was obtained 6 weeks later by inserting a hypodermic needle
      through the skin. The volume of fluid obtained from the capsule was sufficient
      for the analysis of total protein, albumin, albumin:globulin ratio, colloid
      osmotic pressure and the fluid viscosity. Despite the significantly lower total
      protein, albumin, globulin and colloid pressure of intracapsular fluid compared
      with plasma, the intracapsular fluid was found to have a greater viscosity. It is
      our opinion that the increased viscosity of the intracapsular fluid is due to the
      presence of a high molecular weight substance other than albumin and globulin,
      possibly hyaluronan.

PMID- 7786514
TI  - Influence of stretch on excitation threshold of single frog ventricular cells.
AB  - The excitation threshold of enzymatically dissociated single frog ventricular
      myocytes was measured as a function of cell length or sarcomere length. Field
      stimulation with 3 ms duration rectangular current pulses was applied via two
      platinum wire electrodes oriented either parallel or perpendicular to the long
      axis of the cell. Excitation threshold was measured as the amplitude of applied
      current, with an error of less than 1%. Single cells were held isometrically by
      two glass pipettes and wrapped around an optical fibre, which was used to control
      cell length. Sarcomere length was measured using video microscopy and a phase
      locked loop system. Changes in cell length and sarcomere length were induced by
      mechanical stretch and release of the whole cell. The excitation threshold
      decreased with increasing resting length (preload), and increased with decrease
      of the cell length back to its original length, regardless of the orientation of
      the electric field. The measured change in excitation threshold with stretch was
      of the order of 1%/% strain. These results suggest that stretch affects the
      excitation threshold of cardiac cells by factors other than simple shape changes
      in the cell, perhaps through the activity of mechanosensitive ionic channels.

PMID- 7786515
TI  - Recognition of a pharyngo-oesophageal sphincter inhibitory reflex in dogs and its
      role in deglutition.
AB  - The present study describes the 'pharyngo-oesophageal sphincter inhibitory
      reflex' and its clinical significance. The study was performed on twelve
      anaesthetized dogs. A balloon-tipped catheter was placed within the pharyngo
      oesophageal sphincter (POS) and another in the pharynx. The POS response to
      distension of the pharynx with a balloon filled with 2, 4 or 6 ml of water was
      recorded before and after application of local anaesthetic to the POS, and after
      successive section of the anatomical constituents of the POS. Upon pharyngeal
      distension, POS pressure was reduced; the greater the distension, the greater the
      pressure reduction. The anaesthetized POS did not respond to pharyngeal
      distension. Section of the cricopharyngeus muscle did not influence the resting
      POS pressure or the POS response to pharyngeal distension. The POS pressure
      dropped significantly (P < 0.0001) and was unresponsive to pharyngeal distension
      after section of both the cricopharyngeus muscle and the oesophageal circular
      muscle bundles. This shows that the cricopharyngeus muscle is not involved in the
      upper oesophagus sphincter mechanism.

PMID- 7786516
TI  - Depression of ventilation by dopamine in cats: effects of bilateral cervical
      sympathetic and vagal trunk section.
AB  - The contribution of sympathetic and vagal inputs to ventilatory depression
      induced by dopamine was studied in eighteen anaesthetized, spontaneously
      breathing, normoxic cats. Breathing was via a tracheostomy. Dopamine (20
      micrograms (kg body wt)-1) was injected intravenously in the intact animal, then
      after section of the cervical sympathetic trunks, and finally after midcervical
      vagotomy. Dopamine, injected as a bolus, induced depression of ventilation,
      affecting predominantly the volume component of the breathing pattern at all
      experimental stages. The extent of volume reduction was larger and different from
      that in intact animals following section of sympathetic (P < 0.05) and vagal
      trunks (P < 0.01). The respiratory cycle was significantly prolonged (P < 0.01)
      prior to vagotomy, due entirely to the increase in the expiratory time (TE).
      Bilateral section of the carotid sinus nerves performed in six cats virtually
      abolished postdopamine ventilatory depression.

PMID- 7786517
TI  - Responses to reduced water intake, including dehydration natriuresis, in sheep
      excreting sodium predominantly in urine or in faeces.
AB  - Sheep which were predominantly urinary excretors (U) or faecal excretors (F) of
      sodium were exposed to a 75% reduction of water intake for 72 h. The experiment
      was performed on moderate, low or high sodium intakes (0.4, 0.05 or 1.2 mmol kg-1
      day-1) to test the hypothesis that dehydration natriuresis was not a cause of
      sodium depletion but a defence against hypernatraemia. Dehydration caused
      elevation of plasma sodium concentration, osmolality, antidiuretic hormone (ADH)
      and oxytocin but, as in other experiments, a fall in haematocrit. The two higher
      levels of sodium intake were associated with dehydration natriuresis but also a
      smaller increase in faecal sodium excretion in both U and F sheep. On low sodium
      intake, however, neither urinary nor faecal sodium excretion increased in either
      group of sheep although the rise in plasma sodium concentration caused by
      dehydration was similar. Thus, when there is a risk of sodium depletion, due to
      low sodium intake, dehydration natriuresis does not occur, consistent with the
      hypothesis. Active sodium transport inhibitor (ASTI) and atrial natriuretic
      peptide (ANP) fell rather than rose during dehydration. Since aldosterone is
      suppressed by the higher levels of sodium intake, none of these hormones is
      likely to mediate dehydration natriuresis in sheep. F sheep showed more effective
      renal and faecal water conservation when dehydrated. During water restriction,
      the urinary potassium excretion of U sheep was significantly reduced, unlike that
      of F sheep; moreover, the latter maintained an identical plasma potassium
      concentration between baseline and restriction period, whereas in U sheep it was
      0.3 mmol l-1 higher during water restriction. Increased drinking rather than
      reduced urine output was the basis of rehydration when ad lib. water intake was
      restored.

PMID- 7786518
TI  - Renal, endocrine and vascular effects of atrial natriuretic peptide in a novel
      vasopressin-deficient genetically hypertensive strain of rat.
AB  - In the absence of the potentially confounding influence of vasopressin in
      hypertension, the effects of atrial natriuretic peptide (ANP) on arterial blood
      pressure and renal handling of water and sodium were assessed from comparison of
      responses to intravenous ANP infusion in anaesthetized vasopressin-deficient New
      Zealand genetically hypertensive (DI/H) rats and their normotensive substrain
      (DI/N). After 320 min of hypotonic saline infusion, plasma ANP concentration was
      significantly higher in DI/H compared with DI/N rats. ANP administration
      increased circulating ANP concentration in both groups. Plasma angiotensin II
      concentration was higher in DI/H than in DI/N rats; infusion of ANP raised
      circulating angiotensin II in both groups though this achieved statistical
      significance only in DI/N rats. Plasma aldosterone concentrations were initially
      similar in normotensive and hypertensive animals and, in both, were reduced
      markedly by I.V. ANP infusion. Administration of ANP produced sustained
      hypotension in both groups. However, the hypotensive effect of ANP was more
      pronounced in DI/H compared with DI/N rats. Heart rate was initially similar in
      the two groups, and infusion of ANP produced no detectable change. By comparison
      with animals maintained on hormone-free infusate, urine flow increased markedly
      over the 80 min period of ANP infusion in both groups, by 142% in DI/H rats and
      127% in DI/N rats. ANP administration produced a natriuresis in both groups but
      the increase in Na+ excretion was much greater in DI/H (342%) than in DI/N (139%)
      rats. It appears from the current study that vasopressin-deficient hypertensive
      rats are more sensitive to ANP with regard to effects on blood pressure and renal
      excretion than their vasopressin-deficient normotensive substrain. These
      differences may, in part, reflect adjustments to long-term elevation in blood
      pressure and in plasma ANP concentration in hypertension and, in part, rely on
      the associated disturbances in related endocrine systems.

PMID- 7786519
TI  - Haemodynamic responses to an angiotensin II receptor antagonist (GR 117289) in
      maternal and fetal sheep.
AB  - An AT1-specific angiotensin II receptor antagonist (GR117289; 1 mg/kg I.V. bolus)
      was administered daily to ten chronically catheterized, normotensive ewes during
      late pregnancy (from 126 +/- 1 days) until parturition (139 +/- 1 days); five
      control animals received an equivalent volume of vehicle solution. Following drug
      administration, mean maternal blood pressure decreased from 87 +/- 1 mmHg to a
      minimum of 79 +/- 1 mmHg at 0.5 h (P < 0.05; n = 10) and remained low for 4-6 h
      without any concomitant change in fetal blood pressure or maternal and fetal
      heart rates. In animals fitted with flow probes, uterine blood flow decreased
      from 443 +/- 21 to 363 +/- 27 ml/min at 0.5 h post-drug (P < 0.05; n = 6); this
      change was positively correlated with the reduction in maternal blood pressure.
      The mean decrements in uterine and umbilical blood flows measured by steady-state
      infusion of tritiated water were -611 +/- 171 ml/min at 4-6 h (P < 0.05; n = 5)
      and -71 +/- 19 ml/min at 0.5-1 h (P < 0.05; n = 5), respectively. Significant
      reductions (P < 0.05; n = 10) in fetal arterial oxygen tension (-1.6 +/- 0.4
      mmHg), saturation (-6.6 +/- 1.6%) and content (-0.3 +/- 0.1 mumol/ml) were
      evident at 0.5 h post-drug and were maintained for 6-12 h. Umbilical oxygen
      delivery decreased at 0.5-1 h following drug administration (P < 0.01; n = 5),
      but was unaccompanied by any significant change in fetal oxygen consumption.
      Chronic decreases in daily fetal pH and blood oxygen content occurred in GR117289
      treated ewes. There were no significant differences in gestational length or
      neonatal outcome between vehicle- and GR117289-treated groups of ewes with single
      fetuses.

PMID- 7786520
TI  - The effects of attentional factors on an inhibitory jaw reflex in man.
AB  - Electromyographic recordings (EMGs) were made from the active masseter muscle, of
      the inhibitory reflex evoked by application of electrical stimuli to the skin of
      the upper lip in fifteen human subjects. In control sequences, the reflex had a
      mean latency of 42 +/- 1.1 ms and a mean duration of 45 +/- 2.1 ms. The magnitude
      of the reflex (measured by integration of the EMG) was reduced (by 18 +/- 7.0%, n
      = 11; P < 0.05, Student's t test) while the subjects concentrated on a visual
      feedback signal in order to maintain a steady level of EMG activity. It was
      further reduced (by 25 +/- 3.6%, n = 10; P < 0.001, Student's t test) when the
      subjects additionally undertook mental calculations (the 17-times table). These
      effects were predominantly in the later parts of the responses. They occurred
      regardless of whether the baseline activity in the masseter muscle was
      inadvertently raised or lowered during the conditioning procedures. It is
      concluded that attentional factors can modulate jaw reflexes in man by exerting
      an influence on the reflex pathway at a point prior to the motoneurones. The
      underlying mechanism may involve the activation of descending inhibitory pathways
      and/or a facilitation of mechanisms underlying excitatory responses in jaw
      closing muscles.

PMID- 7786521
TI  - Treatment of psoriasis with anthrones-chemical principles, biochemical aspects,
      and approaches to the design of novel derivatives.
AB  - Antipsoriatic anthrones are probably the most commonly used topical agents in the
      treatment of psoriasis. There is growing evidence that the biochemical basis for
      their mechanism of action at the molecular level is related to their redox
      activity leading to the production of active oxygen species, which include
      singlet oxygen, superoxide anion radical, and hydroxyl radical. These species are
      involved in a variety of oxidative effects affecting cellular targets that have
      been implicated both in the mode of action and the skin-irritating properties of
      antipsoriatic anthrones: interaction with DNA, inhibition of various enzyme
      systems associated with cell proliferation and inflammation, such as glucose-6
      phosphate dehydrogenase and inflammation, such as glucose-6-phosphate
      dehydrogenase and 5-lipoxygenase, and destruction of membrane lipids.
      Furthermore, the application of this information to the design of novel
      derivatives is discussed. In particular, compounds with diminished oxygen radical
      generating properties have been developed, which may permit a separation of
      antipsoriatic and inflammatory effects. Some of the novel anthrone analogs which
      produced significantly less amounts of oxygen radicals than dithranol compared
      favorably in biological tests with this known antipsoriatic drug as an
      alternative method of treating psoriasis.

PMID- 7786522
TI  - Inhibitor of the release of mast cell mediators does not improve the psoriatic
      plaque.
AB  - The number of mast cells is increased in psoriatic lesions and this is
      particularly prominent in their early phase. Mediators released by mast cells may
      interfere with various aspects of cutaneous inflammation and epidermal
      proliferation. Therefore, the aim of the present investigation was to find out
      whether a 4-week treatment period with Tiacrilast, a highly potent inhibitor of
      mast cell degranulation, might have antipsoriatic potential. A total of 31
      patients with plaque-type psoriasis were evaluated after treatment with a 3%
      Tiacrilast hydrogel and hydrogel alone, in a double-blind, placebo-controlled,
      within-patient comparative study. No statistically significant improvement of the
      Tiacrilast-treated plaques compared to the hydrogel-treated sites could be
      demonstrated. Therefore, the present study does not provide evidence of a
      potential role of mast cell degranulation in the treatment of psoriasis.

PMID- 7786524
TI  - Regulatory effects of antipsoriatic agents on interleukin-1 alpha production by
      human keratinocytes stimulated with gamma interferon in vitro.
AB  - It is known that keratinocytes produce and secrete interleukin-1 (IL-1) de novo
      and that this process can be enhanced by various stimulators. IL-1 has been shown
      to be a potent proinflammatory cytokine which mediates inflammation in various
      cutaneous disorders. It has also been demonstrated that gamma-interferon (IFN
      gamma) which is released from infiltrated T cells can be detected in inflamed
      lesional sites. In order to understand the effects of IFN-gamma on IL-1
      production by keratinocytes in such inflammatory lesions, normal human
      keratinocytes (NHKs) and human squamous cell carcinoma cell line (HSC-1) cells
      were cultivated with recombinant human IFN-gamma (rIFN-gamma) and IL-1 levels
      were measured by ELISA. The effects of antipsoriatic agents such as
      hydrocortisone (HC), cyclosporin A (CsA), 1,25-dihydroxyvitamin D3 [1,25(OH)2D3]
      and its analogue MC903 on IL-1 production by keratinocytes were also
      investigated. IL-1 release by both NHK and HSC-1 cells was accelerated by
      stimulation with rIFN-gamma dose-dependently, although IL-1 alpha was released
      only transiently by rIFN-gamma-stimulated NHKs in serum-free keratinocyte growth
      medium containing HC. Antihuman IFN-gamma antibody inhibited IL-1 alpha release
      by HSC-1 cells stimulated with rIFN-gamma, suggesting that IL-1 alpha release
      from keratinocytes is upregulated by IFN-gamma. HC (5 micrograms/ml), 1,25(OH)2D3
      (10(-6) M) and MC903 (10(-6) M), but not CsA (5 micrograms/ml), inhibited IL-1
      alpha production by HSC-1 cells stimulated with 100 U/ml of rIFN-gamma.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7786525
TI  - Use of human skin recombinants as an in vitro model for testing the irritation
      potential of cutaneous irritants.
AB  - Two human skin recombinants, the epidermis reconstructed on the deepidermized
      dermis (RE-DED) or on fibroblast-populated collagen matrix (Living Skin
      Equivalent, LSE), were used to study the irritating effect of sodium lauryl
      sulfate (SLS). The extent of cytotoxicity induced after a 24-hour exposure period
      to increasing concentrations of SLS (0-5%) was evaluated on the basis of (1)
      morphological perturbations, (2) changes in the expression of differentiation
      specific protein markers (keratin 1, 10, 6, 16, involucrin and transglutaminase),
      (3) cell membrane integrity (LDH leakage) and (4) release of proinflammatory
      mediators (PGE2, IL-1, IL-6 and IL-8). SLS induced significant changes in
      epidermal morphology and changes in the expression and localization of
      differentiation-specific protein markers when applied topically in concentrations
      higher than 1% on RE-DED and higher than 0.1% on LSE. The exposure of both human
      skin recombinants to SLS resulted in a dose-dependent release of LDH, PGE2 and IL
      1 alpha and in an increase in keratinocyte intracellular IL-1 levels. Upon
      application of 5% SLS on RE-DED the total (intra- and extracellular) IL-1 levels
      remained high but due to cell damage the intracellular IL-1 level was markedly
      decreased and the extracellular IL-1 level increased. Similar observations have
      been made with LSE after application of 0.5% SLS. However, with LSE the
      extracellular IL-1 alpha levels were found to be about 100 times lower than those
      measured with RE-DED. Exposure of LSE to SLS induced a marked increase of IL-6
      production in fibroblasts incorporated in the collagen matrix. Contrary to LSE,
      both intra- and extracellular levels of IL-6 were low in unexposed controls and
      were only marginally modulated by the exposure of the RE-DED to SLS. In addition,
      a dose-dependent increase in IL-8 release was observed upon application of SLS on
      RE-DED. The results of the present study indicate that concentrations of SLS
      required to induce epidermal irritancy in vitro approximate those inducing
      irritation in human skin in vivo. All parameters used in the present study for
      evaluation of toxicity can serve as useful endpoints for screening of contact
      skin irritancy in vitro. Compared to RE-DED, the LSE seems to be more susceptible
      to SLS. The differences in sensitivity between LSE and RE-DEd can be ascribed to
      reported differences in their stratum corneum barrier function.

PMID- 7786523
TI  - Differential utilization of linoleic and arachidonic acid by cultured human
      keratinocytes.
AB  - The essential fatty acid, linoleic acid (LA), is required for the epidermal
      barrier and LA is also the precursor fatty acid for arachidonic acid (AA). Both
      fatty acids are imported from systemic sources, because AA is also not
      synthesized in the epidermis. The present studies were undertaken to compare the
      uptake and incorporation into cellular lipid of these fatty acids and to
      determine whether they compete with one another in these processes in relation to
      keratinocyte differentiation. The incorporation of [14C]LA and/or [14C]AA into
      phospholipids and triglycerides was examined in keratinocytes cultured under
      submerged and lifted conditions. In submerged (less well-differentiated)
      cultures, more LA was incorporated into phospholipids than AA, while AA was
      incorporated into triglycerides to a greater extent. When given together, neither
      fatty acid influenced the total and/or relative uptake and lipid distribution of
      the other. Compared to submerged cultures, the uptake of LA increased 2-fold in
      lifted (differentiated) cultures, while the uptake of AA was unchanged. Lifting
      increased the proportion of AA incorporated into phospholipids, but did not alter
      the distribution of LA among phospholipids or triglycerides. These data suggest
      that the essential fatty acids, LA and AA, which are destined for different
      metabolic roles within the keratinocyte do not compete with one another during
      their uptake and distribution among cellular lipid species. Furthermore, as
      keratinocytes differentiate in culture, their increased requirement for LA for
      the synthesis of barrier lipids may be achieved through the preferentially
      enhanced uptake and lipid incorporation.

PMID- 7786526
TI  - Update in surgical treatment of acute post infarction VSDs and MIs.

PMID- 7786527
TI  - Modified operation technique for orthotopic heart transplantation.
AB  - Atrioventricular (AV) valve dysfunction with tricuspid regurgitation is a common
      finding after orthotopic heart transplantation (HTx). In 20 patients the heart
      transplantation was performed with bicaval anastomoses and the results were
      compared to the precedent 20 patients operated with the standard technique. The
      right atrium of the recipient was completely removed and the caval anastomoses
      were performed on the beating heart during reperfusion. Using an interrupted
      suture line, no stenoses at the venous anastomoses were seen as known from the
      early implantation technique in heart-lung transplantation. Due to a more stable
      sinus rhythm only 15% of the patients in the bicaval group needed prolonged
      pacing (> 30 min) versus 55% (P < 0.01) in the group with standard operation. One
      to 3 months after surgery the transthoracic echocardiographic evaluation of the
      AV valve function showed tricuspid valve regurgitation (TVR) in 20% of the
      patients with bicaval anastomoses versus 75% with a right atrial anastomosis (P <
      0.001). Tricuspid valve regurgitation during the first 2 weeks (in 31% of
      recipients with bicaval and in 70% with atrial anastomoses) improved in all
      recipients with bicaval anastomoses and in 14% of the recipients with atrial
      anastomosis. The modification of the operation technique did not result in
      significantly longer bypass time (75 +/- 14 versus 68 +/- 14 min) and ischemia
      time (44 +/- 12 versus 41 +/- 9 min with local organ procurement and 111 +/- 24
      versus 101 +/- 19 min with distant organ procurement). The AV valve function and
      the postoperative rhythm after orthotopic HTx can be improved by implanting the
      heart with bicaval anastomoses.

PMID- 7786528
TI  - Replacement of the ascending aorta and aortic arch with bovine pericardial
      grafts. A preliminary report.
AB  - Bovine pericardial (BP) grafts have been clinical use at Biocor Hospital since
      1989 for replacement or repair of the ascending aorta (AsAo) and initial segment
      of the aortic arch (AoAr). The main advantages of BP grafts that have justified
      their clinical application are much easier surgical technique, perfect hemostasis
      and low cost. From Feb/89 to Feb/94, 88 BP grafts were implanted in the AsAo or
      the AoAr. There were 33 valved conduits, 47 non-valved conduits and 8 patches.
      The main indication for the procedure was acute dissection of the aorta,
      accounting for 50% of the cases. The total hospital mortality was 20.4%. Follow
      up was obtained in all but two patients. Patients who survived 2 or more years
      postoperatively (n = 31) underwent either an echocardiographic or an angiographic
      study in order to access the behavior of the graft, which was perfect in all of
      them. The current follow-up is short and complications such as calcification may
      still develop. However the present study has clearly shown the superior handling
      and better hemostasis of BP grafts compared to the classical Dacron prosthesis.

PMID- 7786529
TI  - Interrupted warm blood cardioplegia for coronary artery bypass grafting.
AB  - Continuous warm blood cardioplegia has been used with good clinical outcome in
      both antegrade and retrograde delivery. However, the continuous delivery of
      cardioplegia is sometimes interrupted for adequate visualization and flow is not
      constant with heart manipulation during operation. We studied the effects of
      interrupted antegrade delivery of warm blood cardioplegia on myocardial
      metabolism and clinical results after surgery. Fifty-five patients undergoing
      isolated coronary bypass surgery received warm blood cardioplegia (n = 29) or
      cold crystalloid cardioplegia (n = 26) in an antegrade fashion. During
      reperfusion, myocardial oxygen consumption, lactate extraction, creatinine kinase
      isoenzyme (CK-MB), and malondialdehyde (MDA) were measured. Post-operatively,
      serum CK-MB and cardiac output (CO) were determined over a period of time.
      Myocardial oxygen extraction in the warm group was significantly greater than in
      the cold group 1 min after reperfusion (P < 0.02). The results revealed a
      tendency for patients in the warm group to have prior lactate extraction,
      although the difference did not reach statistic difference (P < 0.10). After
      removal of the aortic cross-clamp, the heart returned to sinus rhythm
      spontaneously in 90% of the patients with warm cardioplegia and 15.4% of those
      with a cold heart (P < 0.01). Postoperatively, there was no significant CK-MB or
      MDA release in either group except for one patient with perioperative myocardial
      infarction. After operation inotropic support was required for two and one
      patient in the warm and cold groups, respectively, although there were
      significantly more patients with poor left ventricular function in the warm, than
      in the cold, group (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786530
TI  - Delivery pressure of the cardioplegic solution influences myocardial protection.
AB  - To investigate whether cardioplegic solution (CS) delivery pressure influences
      myocardial protection, intermittent infusions of CS at different pressures were
      used in an isolated Langendorff rat heart preparation. In group 1 the hearts were
      kept arrested for 210 min at 12 degrees C with intermittent infusions of 5 ml CS
      every 20 min at 30 cm H2O (22 mmHg) pressure, in group 2 the same volume of CS
      was infused at 100 cm H2O (73.5 mmHg) pressure, in group 3 at 145 cm H2O (106.5
      mmHg) pressure and in group 4 at 238 cm H2O (175 mmHg) pressure. There was a
      significantly higher coronary resistance in groups 1 and 4 (7.3 +/- 0.2 RU and
      6.9 +/- 0.2 RU) than in groups 2 and 3 (4.2 +/- 0.2 RU and 4.2 +/- 0.2 RU) (P <
      0.05) during the ischemic period. There were no significant differences between
      group 2 and 3 in the reperfusion period. Groups 2 and 3 showed higher coronary
      flow and left ventricle developed pressure than group 1 and 4. Hearts from group
      1 and 4 had lower adenosine triphosphate (7.88 +/- 0.44 mumol.g-1, 5.56 +/- 0.56
      mumol.g-1) (P < 0.05) and creatine phosphate (24.66 +/- 0.47 mumol.g-1, 15.34 +/-
      0.94 mumol.g-1) (P < 0.05) content at the end of the reperfusion period than
      group 2 (10.56 +/- 0.41 mumol.g-1, 30.06 +/- 0.38 mumol.g-1) and group 3 (14.13
      +/- 0.69 mumol.g-1, 35.25 +/- 0.78 mumol.g-1).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786531
TI  - Comparison of propafenone to atenolol for the prophylaxis of postcardiotomy
      supraventricular tachyarrhythmias: a prospective trial.
AB  - To compare the efficacy of propafenone to atenolol in the prevention of
      supraventricular tachyarrhythmias (SVT) following cardiac surgery, 207
      consecutive patients were randomly allocated to receive either propafenone 300 mg
      twice daily (105 patients) or atenolol 50 mg once daily (102 patients) orally for
      7 days after operation. Double blinding was achieved using placebos. The end
      point was the development of a SVT which was symptomatic, recurrent, or lasting
      over 2 minutes, or the occurrence of adverse effects possibly attributable to the
      drugs. The groups were well matched for age, sex, bypass- and cross-clamp times,
      and other data. Thirteen patients in the propafenone group and 11 in the atenolol
      group developed SVT during the first week after operation. (P = 0.89, non
      significant, chi-squared with Yates' correction). In our study propafenone and
      atenolol were of approximately equal efficacy in preventing post cardiotomy SVT.
      Propafenone may have an advantage in being less negatively inotropic than
      atenolol; it could therefore be used in patients with poor left ventricular
      function or marginal haemodynamics when a beta blocker is contraindicated.

PMID- 7786532
TI  - Posterior pericardiotomy reduces the incidence of supra-ventricular arrhythmias
      following coronary artery bypass surgery.
AB  - A prospective study of 100 patients undergoing coronary artery bypass surgery was
      performed to demonstrate the effectiveness of a posterior pericardiotomy in
      reducing the incidence of pericardial effusions and, consequently, reducing the
      incidence of supraventricular arrhythmias in the post-operative period.
      Pericardial effusion occurred in 4 of 50 patients following a posterior
      pericardiotomy, whereas effusion occurred in 20 of 50 patients in whom a
      pericardiotomy was not created (P < 0.0005). Supra-ventricular arrhythmias
      occurred in 4 patients in the pericardiotomy group and 18 in the group treated
      without pericardiotomy (P < 0.005). No complications resulted from this
      procedure. We conclude that pericardiotomy is a simple, safe and effective method
      for reducing the incidence or pericardial effusion and thereby post-operative
      supra-ventricular arrhythmias.

PMID- 7786533
TI  - Incidence of deep and superficial sternal infection after open heart surgery. A
      ten years retrospective study from 1981 to 1991.
AB  - Between January 1981 and December 1991, 4137 adult patients underwent various
      cardiac procedures via a median sternotomy under cardiopulmonary bypass. The
      overall infection rate was 1.33%, including superficial wound infections (SWI)
      (1.18%) and deep sternal infection (DSI) (0.145%). Pericardial and retrosternal
      suction drains with a vent allowed a better drainage of blood and serosities and
      probably contributed to our low DSI rate. Eleven factors predisposing to
      infection were evaluated by Fisher's exact test. Only the operative urgency (P =
      0.006), reexploration for bleeding (P = 0.00001) and preoperative renal failure
      (P = 0.0005) were statistically significant. Twenty of our infected patients had
      no risk factors for infection. When the risk factors described in the literature
      were applied to our infected patients, only one had no risk factor.

PMID- 7786534
TI  - Changes in gastric tissue oxygenation during mobilisation for oesophageal
      replacement.
AB  - We have measured changes in gastric tissue oxygen tension (PtO2, mmHg), with a
      modified Clark oxygen electrode, in eight patients (median age 59 years, range 52
      to 74) undergoing oesophagectomy for carcinoma. Operations were performed with a
      cervical anastomosis and the stomach mobilised on the right gastric and
      gastroepiploic arteries. Tissue oxygen tension was measured in the gastric fundus
      at 4 points: (1) before mobilisation, (2) after mobilisation with the stomach in
      the abdomen, (3) with the fundus lifted to the neck and (4) after anastomosis.
      From a mean of 77 mmHg before mobilisation, PtO2 was halved to 36 mmHg after
      mobilisation with no further fall after transposition to the neck or anastomosis.
      Arterial oxygen concentration (PaO2), mean arterial pressure (MAP) and oxygen
      delivery (DO2) were similar at each point. Tissue oxygen tension was correlated
      with PAO2 at points 1 and 4 but MAP only at point 1 and DO2 not at all. These
      findings document the relationship of gastric PtO2 to mobilisation of the stomach
      and demonstrate the important influence of PaO2 on PtO2.

PMID- 7786535
TI  - Descending necrotising mediastinitis: a case report and review of the literature.
AB  - We report a case of descending necrotising mediastinitis complicating an
      oropharyngeal infection in a 25-year-old male. The clinical presentation, the
      diagnosis and the management of this rare disease and its complications are
      discussed in this case report with a brief review of the literature.

PMID- 7786536
TI  - Pyoderma gangrenosum as a complication of coronary artery bypass grafting.
AB  - A 60-year-old male patient developed progressive wound ulcerations, simulating
      wound sepsis after coronary bypass operation. The condition did not respond to
      intensive antibiotic therapy. Based on clinical signs and biopsy, the diagnosis
      of pyoderma gangrenosum was made and successfully treated with cyclosporin A.
      Pyoderma gangrenosum, although extremely rare, must be considered as a possible
      diagnosis in wound complications unresponsive to traditional therapy.

PMID- 7786538
TI  - Isolated right ventricular unloading for postcardiotomy right ventricular failure
      in a child.
AB  - Severe right ventricular (RV) failure after total correction of double outlet RV
      (DORV) with pulmonary atresia was completely reversed with extracorporeal
      mechanical RV unloading in a 2.5-year-old child. The patient could be weaned
      after 168 h of RV assist device (RVAD) support using a centrifugal Bio-Medicus
      pump and was discharged from the hospital without adverse effects. This
      experience of isolated RV unloading in a child encourages further application of
      RVAD in pediatric patients.

PMID- 7786540
TI  - [Preparation of a levodopa/carbidopa solution in ascorbic acid (citridopa) and
      chromatographic and electrochemical assessment of its stability over 24 hours].
AB  - Levodopa/inhibitor improves motor function in parkinsonian patients. In its usual
      tablet form, however, its efficacy is reduced after several years, partially due
      to absorption deficiencies and changes in plasma kinetics; thus, other
      therapeutic strategies to provide a stable, easy to prepare formula are being
      sought. One such approach could be to dissolve L-dopa/carbidopa in ascorbic acid.
      This report describes the preparation method and demonstrates the stability of
      the sample using High pressure liquid cromatography (HPLC) with electrochemical
      detection. Regardless of the number of tablets the patient takes, the
      concentration of L-dopa/carbidopa/ascorbic acid remains constant (1/0.25/2
      mg/ml). Thus, a patient taking 5 tablets of Sinemet Plus a day, would pulverize
      them in a glass, ceramic or marble mortar and add them to a measuring cup
      containing a 1 gram tablet of vitamin C (Redoxon) dissolved in 500 cc of cold
      water. This would be shaken or stirred until the Sinemet powder had dissolved. A
      few particles remaining in suspension after this process would be of no concern.
      The liquid would be stored in the refrigerator in an opaque or aluminum foil
      covered glass bottle or, if possible, in several small dose-size vials. Using a
      measuring cup, a test tube and a syringe, the correct volume can be drawn out of
      the bottle and shaken well before drinking. The solution would be taken at
      regular intervals throughout the day (which vary from one patient to another) to
      maintain stable plasma L-dopa levels.

PMID- 7786539
TI  - Early degeneration of a Medtronic intact bioprosthesis in aortic position.

PMID- 7786541
TI  - [Classification of head injuries based on computerized tomography: prognostic
      value].
AB  - A new classification system for head injury based on the findings of computerized
      tomography was used in a population of 809 head injured patients. The system
      emphasizes the status of mesencephalic cisterns, the degree of midline shift and
      the presence or absence of mass lesions, allowing high risk patients to be
      identified and outcome to be predicted.

PMID- 7786537
TI  - Congenital pulmonary arteriovenous fistula.
AB  - Pulmonary arteriovenous fistula wherein the malformation has venous drainage
      directly to the left atrium is a rare anomaly. Two case reports present such
      unusual arteriovenous malformations successfully treated by surgery.

PMID- 7786542
TI  - [Lobar dementia].

PMID- 7786543
TI  - [Hemidiaphragmatic paralysis as a manifestation of familial brachial plexus
      neuropathy].
AB  - We present a patient with familial brachial plexus neuropathy (FBPN) who is in
      the second generation of a family found to have this disease. The patient
      suffered phrenic paralysis, which has only been previously described in
      association with FBPN in 4 similar cases, all of which also involved the left
      phrenic nerve. The side of phrenic paralysis's was unrelated to the side where
      brachial plexus lesions occurred. We believe that paralysis of the diaphragm,
      although rare, can be considered a sign of FBPN and that therefore this disease
      should be included in the differential diagnosis of such paralysis. This is
      particularly so whenever family or personal history suggest that the peripheral
      nervous system may be involved, compromising the brachial plexus, or whenever
      facial or digital dysmorphia is present.

PMID- 7786544
TI  - [Multiple entrapments neuropathy in adult polyglucosan body disease].
AB  - Adult polyglucosan body disease (APBD) is a rare condition characterized by
      neuropathy, dementia, upper motor neuron dysfunction and neurogenic bladder. For
      diagnosis, the presence of polyglucosan bodies (PB), or PAS (+) glucose polymers,
      must be demonstrated. In this description of a woman with APBD and multiple
      entrapment neuropathy, we discuss a possible role for morphological changes
      induced by PB in increasing susceptibility to pressure palsies.

PMID- 7786545
TI  - [Palilalia due to thalamic infarctions].
AB  - A 45-years-old woman developed palilalia without other neurologic symptoms or
      signs. Cranial MR and CT scan showed only bilateral thalamic infarcts; the SPECT
      showed bilateral frontoparietal hypoactivity. We conclude that involvement of the
      supplementary motor area by diaschisis after bilateral thalamic lesions may
      produce palilalia.

PMID- 7786546
TI  - [Spontaneous syncope as the only sign of Arnold-Chiari type I malformations].
AB  - We present a patient suffering from spontaneous recurrent syncopes as the sole
      symptom of Arnold-Chiari type I malformation. The syncopes were attributed to
      transient compression of neural and/or vascular structures at the cranio-cervical
      junction by the descended cerebellar tonsils, triggered by an increase in
      intracranial pressure. The disappearance of symptoms after posterior fossa
      decompression confirmed our hypothesis.

PMID- 7786548
TI  - [Acute myelopathy, anti-phospholipid antibodies and S-protein deficiency].

PMID- 7786549
TI  - [Neurology in primary health care].

PMID- 7786547
TI  - [Peripheral neuropathy in progressive systemic sclerosis].
AB  - We report a patient that developed a sensorimotor polyneuropathy more than a year
      before the appearance of the typical clinical signs of progressive systemic
      sclerosis. A sural nerve biopsy showed epineural vasculitis with involvement of
      the basal membrane of the endoneural vessels, without proliferation of the
      connective tissue.

PMID- 7786550
TI  - [Neurology in primary health care].

PMID- 7786551
TI  - [Remarks on Ross syndrome].

PMID- 7786552
TI  - [Remarks on Ross syndrome].

PMID- 7786553
TI  - [Information].

PMID- 7786554
TI  - Sex education in schools: opportunities.

PMID- 7786556
TI  - Tokyo Citizens' Council for Health Promotion, and its action plan.

PMID- 7786555
TI  - An estimate of the prevalence of drug misuse in Liverpool and a spatial analysis
      of known addiction.
AB  - BACKGROUND: The objective of this study was to determine the prevalence and
      distribution of opiate and cocaine misuse in the City of Liverpool in 1991. The
      databases included residents of the city using opiates or cocaine, who were known
      to the Drug Dependency Units or the Infectious Diseases Unit, or who were
      arrested for possession of drugs in 1991. METHODS: A three-sample log-linear
      capture-recapture method was applied to databases containing details of drug
      users with City of Liverpool postcodes, to determine the prevalence of drug
      misuse in 1991. Linear regression analysis was performed to correlate the
      prevalence of known drug misuse with indices of material deprivation in each
      electoral ward. RESULTS: Data on 1427 individuals were analysed, producing an
      estimate of the drug-using population of 2344 [95 per cent confidence interval
      (CI) = 1972-2716] and a period prevalence of 5.2 per 1000 [95 per cent CI = (4.5
      6.0) per 1000]. In the 15-29 year age group, the prevalence of drug abuse was
      16.9 per 1000 [95 per cent CI = (13.9-19.9) per 1000]. There was a negative
      interdependence between the police and Drug Dependency Unit databases with
      attenders at the Unit being 7.2 (95 per cent CI = 4.6-11.4) times less likely to
      be arrested for possession than non-attenders. There was a strong correlation
      between the distribution of known drug use and material deprivation, as measured
      by the Townsend index (r = 0.75; p < 0.001). CONCLUSIONS: The capture-recapture
      method allows the prevalence of drug misuse to be estimated and provides more
      meaningful information than is available from the notification system. The study
      suggests that people in contact with drug services are less likely to commit
      crimes of possession of class A drugs than those not in contact with drug
      services. There is a strong association between drug abuse and deprivation, and
      therefore the purchasing of services for drug misusers should be focused on areas
      of deprivation.

PMID- 7786557
TI  - Quarterly communicable disease review July to September 1994. From the PHLS
      Communicable Disease Surveillance Centre.

PMID- 7786558
TI  - The ethnic health bibliography.

PMID- 7786559
TI  - Fractured neck of femur patients.

PMID- 7786560
TI  - Uptake of breast screening by Asian women.

PMID- 7786561
TI  - Environmental health in Australia.

PMID- 7786562
TI  - Safety and place of birth in Scotland.
AB  - BACKGROUND: The recent publication of policies suggesting women should have
      choice about where they give birth prompted a comparison of stillbirth and
      neonatal mortality rates for three types of maternity unit in relation to changes
      in booking and place of delivery. METHODS: Scottish Maternity Discharge records
      and data from stillbirth and neonatal death reports for Scotland were used to
      analyse stillbirth and neonatal mortality rates according to the level of care,
      birthweight and cause of death for the years 1986-1990. RESULTS: For those
      categories of stillbirths and neonatal deaths which are amenable to prevention by
      perinatal care, intrapartum stillbirth rates were higher in general practitioner
      (GP) units than in consultant units, but these accounted for only 11 stillbirths
      and the difference is compatible with chance variation. Neonatal mortality among
      babies weighting 2500 g or more was independent of type of hospital. Among babies
      weighing under 1500 g or 1500-2499 g, neonatal mortality was significantly higher
      in non-teaching hospitals than in teaching hospitals. CONCLUSIONS: Although the
      differences are compatible with chance variation, there is some suggestion that
      small GP hospitals might have higher rates of intrapartum stillbirths and such
      rates should be monitored. Provided that there are no barriers to transfer to
      hospitals with consultant units when appropriate, there is no evidence that these
      small GP hospitals are unsafe. The high neonatal mortality rates, especially
      among babies weighing 1500-2499 g in non-teaching consultant units, compared with
      teaching units, should be investigated further.

PMID- 7786564
TI  - Whither the NHS?

PMID- 7786563
TI  - Differences in hospital casemix, and the relationship between casemix and
      hospital costs.
AB  - BACKGROUND: The aim of the study was to examine the relationship between hospital
      costs and casemix, and after adjustment for casemix differences, between cost and
      institutional size, number of specialties, occupancy and teaching status.
      METHODS: A retrospective analysis of all admissions to nine acute-care NHS
      hospitals in the Oxford region during the 1991-1992 financial year was
      undertaken. All episodes were assigned to a diagnosis-related group (DRG) and a
      cost weight assigned accordingly. Costs per finished consultant episode, before
      and after adjustment for casemix differences, were analysed at the hospital and
      specialty level. RESULTS: Casemix differences were significant, and accounted for
      approximately 77 per cent of the difference in costs between providers. Costs per
      casemix-adjusted episode were not significantly associated with differences in
      hospital size, scope, occupancy levels or teaching status, but sample size was
      insufficient to investigate these relationships adequately. Specialty costs were
      poorly correlated with specialty casemix. This was probably due to poor
      apportionment of specialty costs in hospital accounting returns. CONCLUSIONS:
      Casemix differences need to be taken into account when comparing providers for
      the purposes of contracting, as unadjusted unit costs may be misleading. Although
      the methods used may currently be applied to most NHS hospitals, widespread use
      would be greatly facilitated by the development of indigenous cost weights and
      better routine hospital data coding and collection.

PMID- 7786565
TI  - Increasing response rates in telephone surveys: a randomized trial.
AB  - BACKGROUND: Sampling frames and mode of contact and administration of
      questionnaires are important factors contributing to response rates and selection
      bias in population-based research. The purpose of this paper is to evaluate
      whether contact by mail before contact by telephone increases response rate, and
      to assess the concurrent validity of telephone surveys for collecting health
      research and service data. METHODS: Two thousand households were randomly
      selected from electronic white pages. Half were randomly allocated to receive or
      not to receive an explanatory letter before telephone contact. Interviewers were
      blinded to whether a household received a letter. Respondents aged 18 years or
      over were randomly selected from within each household using a Kish grid and
      interviewed by telephone. RESULTS: The overall response rate was 68 per cent
      [confidence interval (CI) 66-70]. The response rate of those who received the
      letter was 76 per cent (CI 73-79), and of those who did not receive the letter
      was 60 per cent (CI 56-63). Use of the Kish grid to select randomly a respondent
      decreased the response rate by less than 10 per cent. The internal validity of
      the data was as follows: in a 10 per cent sub-sample, the Kish grid had been
      correctly applied in 93 per cent of households, and in 99 per cent of households
      the exclusion criteria had been correctly adhered to. The external validity was
      as follows: comparisons with data obtained from the same reference population
      using similar instruments administered face-to-face revealed no meaningful or
      significant differences in population estimates. CONCLUSIONS: Mail-out before
      telephone contact greatly increases response rates at low cost. Telephone surveys
      can yield valid, useful data for health research and service evaluation.

PMID- 7786567
TI  - Measuring health status with the SF-36: the need for regional norms.
AB  - BACKGROUND: Normative data on SF-36 scores in populations from Oxford and
      Aberdeen have recently been published. It has been suggested that such data
      provide suitable normative values for the UK population. However, other indices
      of health vary considerably across regions, and tend to be worse in areas such as
      South Wales. The objective of this study was to determine whether population SF
      36 scores in West Glamorgan differ from scores from other parts of the United
      Kingdom. METHOD: The SF-36 health status questionnaire was administered to two
      random samples of adults aged 20-89 years, drawn from the West Glamorgan Family
      Health Services Authority register. One sample (n = 919) received postal
      questionnaires and those in the other sample (n = 1201) were interviewed in their
      own homes. Normative data from this study were compared with published data from
      other areas of the United Kingdom. RESULTS: SF-36 population scores were
      significantly lower in the two West Glamorgan samples; this was not due to
      differences in age, sex, social class, or response rates. CONCLUSION: Health
      status in West Glamorgan, as measured by the SF-36, is lower than in Oxford or
      Aberdeen. A national study would be required to provide appropriate normative
      data for the UK population.

PMID- 7786566
TI  - Does routine child health surveillance reach children most at risk of accidental
      injury?
AB  - BACKGROUND: There is currently an increasing emphasis on accident prevention as
      part of routine child health surveillance, which unlike opportunistic accident
      prevention has the potential to reach the whole population. However, non
      attenders at routine child health surveillance may also be children at higher
      risk of accidental injury, as there is some evidence that non-attenders may be
      more likely to live in socio-economic disadvantage, which is a risk factor for
      accidental injury. METHODS: A case control study was carried out in one general
      practice in Nottingham with 253 cases and 243 controls, aged four years and
      under, obtained from the practice age-sex register. Cases were defined as
      children who had attended the accident and emergency department, the general
      practitioner or the practice nurse after an accidental injury at any time during
      their life. Controls were children who had not had a medically attended
      accidental injury. Attendance at routine child health surveillance, before the
      date of the case's accidental injury, was assessed by attendance at the eight
      month hearing test, immunization status, child health clinic visits and home
      visits by the health visitor. RESULTS: There was no significant difference
      between cases and controls in attendance for the hearing test, or immunization
      status. Cases received significantly more home visits after adjusting for
      confounding variables (odds ratio 2.44, 95 per cent confidence intervals 1.28
      4.66). CONCLUSIONS: These findings suggest that non-attenders at routine child
      health surveillance activities are not at an increased risk of medically attended
      accidental injury. They also suggest that health visitors can identify those
      children most at risk of accidental injury using criteria for classifying
      priorities in caseloads.

PMID- 7786568
TI  - The changing pattern of in-patient care.
AB  - BACKGROUND: A nationally representative longitudinal study presented the
      opportunity to describe National Health Service (NHS) and private in-patient care
      used over seven years by a population of young adults in relation to known risk
      factors for admission and for future health. METHODS: Information on each
      hospital admission between ages 36 and 43 years, comprising length of admission
      and whether under NHS or private care, was collected from 1625 men and 1623
      women, the population of the 1946 birth cohort study. Obstetric care was excluded
      from most analyses. RESULTS: From this population, 22 per cent of men and 39 per
      cent of women were admitted to hospital at least once during the seven-year
      period, for a total of 11,276 days, a mean of 3.5 days (SD 13.1) for each person
      in the study, and 11.6 (SD 21.9) days for those admitted. The proportion of
      admissions not under NHS care rose from 14 per cent of all admissions in 1982 to
      23 per cent in 1989. Employers contributed to health insurance for 25 per cent of
      employed men and 7 per cent of employed women. Risk of admission was greater, and
      admissions were longer, in those least educated and from poorest circumstances;
      men with largest waist-hip ratios were admitted for longer than others. Private
      admissions were proportionately greater in nonmanual classes and among those from
      favourable social and educational backgrounds, that is, those known to be at
      least risk of serious and chronic illness. CONCLUSION: Heaviest users of in
      patient care were those most likely to be at greatest health risk, who were least
      likely to have private health insurance. The rising mid-life uptake of private
      health insurance through employers (25 per cent of employed men by age 43 years)
      may foreshadow a future problem in a return to NHS care on retirement in this
      population, which represents the beginning of the future population bulge in the
      elderly.

PMID- 7786569
TI  - The detection and management of hypertension in the elderly of Northamptonshire.
AB  - BACKGROUND: The aim of this study was to apply recommendations from randomized
      controlled trials and guidelines on the detection and control of hypertension in
      the elderly to a district health authority population. METHODS: A cross-sectional
      audit of Northamptonshire general practitioners' (GPs') records from February to
      June 1993 was carried out. RESULTS: A total of 2428 notes of men and women aged
      65 or over registered with their GP was audited. A large proportion of patients,
      86 per cent (95 per cent CI 84.6-87.4 per cent), had a blood pressure record
      taken in the last 10 years. Of those with raised blood pressure (BP > or = 160/90
      mmHg) 49 per cent (95 per cent CI 46.2-51.8 per cent) were untreated, and 58 per
      cent (95 per cent CI 54-61.9 per cent) of those labelled as hypertensive were not
      adequately controlled. The prevalence of labelled hypertension was 25 per cent
      (95 per cent CI 23.3-26.7 per cent). CONCLUSIONS: From these results it is
      estimated that between 11 and 29 fatal and non-fatal strokes could be prevented
      in the 65-74-year-old age population of Northamptonshire each year if current
      guidelines were followed. Improved detection and management of elderly
      hypertensive patients in primary care could contribute significantly towards the
      target for stroke reduction set in the Health of the nation strategy.

PMID- 7786570
TI  - The state of primary medical care in Bulgaria.
AB  - This paper describes the state of primary medical care in Bulgaria and related
      issues. This component of the state health system is based on the so-called
      principle of the 'district physician'. It is built on the idea of establishing
      long-lasting contact between the physician and the patients. Primary care is
      provided by a district therapist (for populations of up to 3000 inhabitants), a
      paediatrician (for 800-1200 children aged up to 14 years) and an obstetrician
      gynaecologist (for 16,000-18,000 female inhabitants), as well as by numerous
      freely accessible narrow-profile specialists. The main disadvantages of the
      existing system of primary medical care are the lack of opportunity for personal
      choice of physician, division of responsibilities among numerous physicians and
      other medical staff, expensive medical care owing to abundant polyclinical
      specialists, reduced physician's motivation and hampered users' influence on the
      quality of medical care. Questions about the future status of polyclinics and
      both children's and female health centres, as well as about the optimal ratio
      between family physicians and specialists, remain unresolved.

PMID- 7786571
TI  - Access to elective surgery at electoral ward level: the impact of the private
      sector.
AB  - BACKGROUND: Purchasers of health care receive no routine information on the use
      of the private health sector by their residents, and are consequently unaware of
      any resulting differentials in access to health services. This information would
      assist in assessing need for services on a locality basis. METHODS: For the
      period 1990-1992 surgical activity data from the single private hospital in
      Preston were examined by electoral ward of residence and compared with
      corresponding NHS data. RESULTS: For the procedures examined, the private sector
      contributed only 8 per cent to overall surgical activity within Preston. People
      from the more affluent wards were far more likely to use the private sector than
      those from deprived wards. CONCLUSION: The private sector did not introduce any
      inequity of access to surgery within Preston at electoral ward level. However, in
      districts with higher levels of private sector activity significant differentials
      in access may exist.

PMID- 7786572
TI  - An investigation into the default rate at the Fife colposcopy clinic:
      implications for target setting.
AB  - BACKGROUND: High default rates have been reported from the Fife colposcopy clinic
      in recent years. However, it was felt that this rate was misleading, as many
      patients who defaulted initially attended subsequent appointments. It was
      therefore decided to determine the default rate of a cohort of new patients given
      appointments at the clinic. The objective of the study was to determine the
      attendance rates for these new patients, between the dates they were first
      invited to their various appointments and the dates that their notes were
      subsequently examined as part of this study in September 1992. METHODS: A
      retrospective cohort study of new patients invited to the Fife colposcopy clinic
      was undertaken. The notes of 200 new patients who had been invited during the
      eight-month period January-August 1991 were selected by systematic sampling. The
      dates that they had attended for their new patient assessment/treatment, first
      follow-up and second follow-up appointments were recorded. Attendance rates were
      then calculated using an incomplete life-table method. Patients were censored if
      they failed to attend their assessment/treatment or review appointments by 1
      October 1992. RESULTS: The study demonstrated that 96 per cent of patients
      attended their first treatment appointment within six months of their appointment
      date, 91 per cent of first review patients attended within six months, and 88 per
      cent of second review patients attended within four months. CONCLUSIONS: These
      findings suggest that there are two distinct groups of defaulters: those who
      default initially but subsequently re-attend, and those who default completely.
      We have named these type A and type B defaulters, respectively. This means that
      attendance within a certain period of time should also be used to monitor clinic
      attendance in addition to simple mean attendance rates. As patients who default
      completely may be more likely to have a severe histological lesion, further work
      is required to identify factors associated with this type of patient.

PMID- 7786573
TI  - Press coverage of the Cleveland child sexual abuse enquiry: a source of public
      enlightenment?
AB  - BACKGROUND: The objective of this study was to assess national and local
      newspaper reporting of events considered by a Public Enquiry which investigated a
      major crisis involving child protection services. The Judicial Enquiry, held in
      Cleveland, North East England, examined the actions of statutory bodies and the
      professionals working within them following the diagnosis of suspected sexual
      abuse in 121 children. METHODS: This is a descriptive study using analysis of
      legal transcripts and newspaper reports. The data involved a total of 216,360
      lines of transcript evidence given by 111 witnesses and lawyers representing them
      at the Judicial Enquiry which lasted 74 days; together with 344,899 words in
      reports covering 17 newspapers (seven local and ten national). The main outcome
      measures were based on the volume and type of newspaper coverage including that
      for each witness' and lawyer's evidence. A coverage index related the amount of
      newspaper reporting to the extent of evidence given. RESULTS: The highest
      coverage of any single day of the Enquiry in both local and national newspapers
      occurred when Dr Marietta Higgs (one of the two principal paediatricians
      involved) made her first appearance. However, the highest interest (coverage
      index) was shown in evidence given by lawyers for the parents and the least in
      evidence given by public bodies. The evidence of witnesses was used very
      selectively by the press in emotive headlines to imply blame or support for the
      main protagonists or their actions. This sustained several lines of reporting:
      criticism of the doctors and social workers, inter-professional conflicts, damage
      and wrong-doing to the families and the search for someone to blame. CONCLUSIONS:
      The Cleveland crisis occupied newspaper headlines in the United Kingdom for more
      than a year. Much of the newspaper coverage took an adversarial approach which
      sought to apportion blame and take sides. The press appeared to report negative
      issues which were newsworthy and did not give a balanced view. Broader policy
      issues, which formed an important part of the Enquiry report's influence on
      subsequent child protection legislation, were largely ignored.

PMID- 7786574
TI  - Understanding variations in lengths of stay between hospitals for fractured neck
      of femur patients and the potential consequences of reduced stay targets.
AB  - BACKGROUND: Economic incentives exist to scrutinize length of stay variations
      between hospitals. However, the reasons for variations can be complex, and
      without knowing these the feasibility of shorter stay targets, and their
      implications for patient outcome, are unclear. METHODS: This research compared
      care received by patients admitted for fractured neck of femur at an inner-city
      university teaching hospital, an inner-city associated teaching hospital and an
      associated teaching hospital in an urban setting. Multiple regression and
      descriptive analysis were used to examine how in-patient acute stay was affected
      by the severity of cases on admission and the supply of beds beyond the acute
      setting. Data on patient outcome were mortality up to three months post fracture
      and functional ability at in-patient discharge and three months post fracture.
      RESULTS: A total of 492 patients were recruited. Patient outcomes at three months
      were similar at the hospitals. Multiple regression revealed significant
      differences between the patient stay of the inner-city teaching hospital and the
      urban associated teaching hospital. A difference in stay of around 14 days was
      demonstrated, with the urban hospital having the shorter stay. These differences
      were linked it to having a greater supply of non-acute beds. CONCLUSION:
      Significant differences in patient stay between hospitals can be due to factors
      beyond the direct control of the acute unit. Economic incentives may mean that
      purchasers and providers ignore a full analysis of these factors and set length
      of stay targets which are not feasible in the short term. This could reduce the
      quality and impair the outcome of patient care.

PMID- 7786576
TI  - Health services research in the United Kingdom 1990-1992.
AB  - BACKGROUND: Shortly before the National Health Service (NHS) research and
      development (R&D) strategy was launched in April 1991, the Department of Health
      commissioned a study to collect information on current health services research
      and related work in the United Kingdom. The term 'health services research' was
      interpreted as research that could usefully inform the contracting arrangements
      in the reformed NHS. METHODS: The information was collected from funding
      agencies, in particular the UK health departments, the Medical Research Council
      and medical research charities; academic departments and research units and
      centres; NHS authorities; and research registers and directories. A total of 6185
      projects that were either in progress or completed between January 1990 and mid
      1992 were identified. RESULTS: Forty-three per cent of projects were disease
      related; 33 per cent assessed health technologies. Patterns were evident in the
      database. Sixty-three per cent of the projects on diseases were covered by five
      categories: cancer, the largest category with a quarter of the disease projects;
      perinatal medicine; cardiovascular disease and stroke; HIV and AIDS; and mental
      illness. Conditions that cause severe discomfort but are not life threatening
      were poorly represented. Clinical trials formed 25 per cent of the health
      technology projects, but only 6 per cent of the trials assessed surgical
      procedures. Less than 10 per cent of all health technology projects contained a
      costing component. In England, 34 per cent of projects with identified funding
      sources were supported by medical charities and other independent bodies, 31 per
      cent by NHS authorities, 20 per cent by the Department of Health and 15 per cent
      by the research councils. CONCLUSION: This collection of information represents a
      'snapshot' of the scope of health services research against which it will be
      possible to measure the changes promoted by the NHS R&D programme.

PMID- 7786575
TI  - Is a policy of cervical screening for all women attending a genito-urinary
      medicine clinic justified?
AB  - BACKGROUND: The study took place at the Genito-Urinary Medicine Department at the
      University Hospital of South Manchester and the Cytology Department at Christie
      NHS Trust Hospital. There were two main objectives, as follows: (1) to determine
      if patients attending a Genito-Urinary Medicine (GUM) Clinic are less likely to
      have had a cervical smear in the preceding five years than a control group drawn
      from the general population; (2) to compare the prevalence of cytological
      abnormalitity in cases and controls. METHODS: Cases comprised all women attending
      the Withington GUM Clinic, between 1991 and 1993, who had had a cervical smear
      taken at this clinic. Controls were selected from residents of the North West
      Regional Health Authority who had a cervical smear taken either by a general
      practitioner (GP) or in an NHS Community Clinic during the same period. The
      design was a matched case-control study. The main outcome measures considered the
      proportion of women who had had a cervical smear taken by a GP or in an NHS
      Community Clinic during the five years preceding the index smear, and the
      prevalence of abnormal smears in cases and controls. RESULTS: There was no
      significant difference in the screening history of cases and controls; 363 (50.2
      per cent) cases had had a cervical smear taken in the preceding five years as
      compared with 380 (52.6 per cent) controls [chi 2 (1df) = 0.95; p > 0.05; 95 per
      cent confidence interval (CI) on difference in proportions, -7.1 per cent to 2.4
      per cent]. There was a small case-control difference of borderline significance
      in the prevalence of all grades of cytological abnormality: 22.7 per cent of
      cases had abnormal cytology as compared with 18.5 per cent of controls [chi 2
      (1df) = 3.98; 0.01 < p < 0.05; 95 per cent CI on difference in proportions, 1 per
      cent to 8.2 per cent). This excess was largely attributable to differences in the
      prevalence of minor cytological abnormality. There was no significant difference
      in the prevalence of cytological abnormality in those case-control pairs who had
      had a smear in the preceding five years. CONCLUSION: A policy of cervical
      screening of all GUM patients can no longer be sustained. We would recommend
      cervical cytology only for those women who have not been screened in the previous
      three to five years.

PMID- 7786577
TI  - The autumn peak in campylobacter gastro-enteritis. Are the risk factors the same
      for travel- and UK-acquired campylobacter infections?
AB  - BACKGROUND: In the autumn of 1992 there was an excess of campylobacter cases in
      Nottingham compared with the national average. No relative increase was seen for
      salmonella infections. METHODS: A case-control study with a postal questionnaire
      was carried out to determine exposure to possible risk factors. The patients were
      282 laboratory confirmed cases of campylobacter and 318 culture negative controls
      who had submitted a faeces specimen. All patients were aged 18 or older. The main
      outcome measures were relative risks for campylobacter infection compared with
      controls with a negative faeces culture. RESULTS: Twenty-five per cent of cases
      were associated with foreign travel. Eating chicken and handling raw poultry were
      the main risk factors for UK-acquired infections. The number of cases with a
      history of contact with puppies or drinking milk that was either unpasteurized or
      from bottles with bird-damaged tops was small. CONCLUSION: Eating chicken and
      handling raw poultry are the main risk factors for campylobacter infections.
      Contact with puppies or drinking potentially infected milk can explain only a
      small percentage of campylobacter infections. Risk factors for infection acquired
      abroad follow a different pattern compared with UK-acquired cases.

PMID- 7786578
TI  - The inhibitory activity of an HIV type 1 peptide correlates with its ability to
      interact with a leucine zipper structure.

PMID- 7786579
TI  - Human immunodeficiency virus type 1-neutralizing antibodies raised to a
      glycoprotein 41 peptide expressed on the surface of a plant virus.
AB  - An oligonucleotide encoding the amino acids 731-752 of the gp41 envelope protein
      of the human immunodeficiency virus type 1 strain IIIB, which is known to induce
      cross-reactive neutralizing antibodies in humans, was inserted into a full-length
      clone of the RNA encoding the coat proteins of cowpea mosaic virus (RNA 2 of
      CPMV). When transfected together with RNA 1 of CPMV, transcribed RNA 2 was able
      to replicate in plants and form infectious virions (CPMV-HIV). Purified virions
      were injected subcutaneously with alum adjuvant into adult C57/BL6 mice to
      determine their ability to stimulate ELISA and neutralizing antibody specific for
      HIV-1. Antisera to CPMV-HIV obtained after only two injections gave a strong
      ELISA response (mean of 1:25,800) using the free gp41 peptide as antigen, showing
      that the gp41 peptide incorporated into the chimera was immunogenic. The same
      antisera gave 97% neutralization of HIV-1 IIIB at 1:100 dilution, with a highly
      uniform response in all (six of six) animals tested. A third injection barely
      increased the neutralization titer. Normal mouse serum had no neutralizing
      activity. Antisera also strongly neutralized the HIV-1 strains RF and SF2. ELISA
      and neutralizing activity to HIV-1 IIIB declined after the second injection and
      were undetectable after 7 weeks, but were restimulated to the same level after
      the third injection. Neutralization was marginally more stable after the third
      injection. Antibody specific for CPMV epitopes was equally short lived. A bonus
      of this system was unexpected neutralizing activity specifically stimulated by
      unmodified CPMV virions, although this amounted to no more than 10% of the
      neutralizing activity stimulated by the CPMV-HIV chimera.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7786580
TI  - Increase in sensitivity to soluble CD4 by primary HIV type 1 isolates after
      passage through C8166 cells: association with sequence differences in the first
      constant (C1) region of glycoprotein 120.
AB  - Primary isolates of human immunodeficiency virus type 1 (HIV-1) were obtained by
      coculture of peripheral blood lymphocytes (PBLs) from HIV-1-infected people with
      PBLs from uninfected donors. These viral stocks tend to be resistant to
      neutralization/inactivation by soluble CD4 (sCD4). When these stocks were passed
      through the T cell line C8166, virus stocks emerged that were sensitive to sCD4.
      Pre- and post-C8166 stocks maintained their sCD4-resistant and -sensitive
      phenotypes, respectively, with further passage in PBLs. Pre- and post-C8166
      stocks were biologically cloned by two cycles of limiting dilution. The majority
      (14 of 17) of pre-C8166 clones were sCD4 resistant, and, conversely, the majority
      of post-C8166 clones (11 of 12) were sensitive to sCD4. Nucleotide and predicted
      amino acid sequence analysis in the env (gp120) region revealed a limited number
      of differences between the clones. The only differences that sorted with
      biological phenotype were in the first constant (C1) region of gp120. Adaptation
      to growth in C8166 cells and conversion from the sCD4-resistant to the sCD4
      sensitive phenotype represent the emergence to prominence of viral species in the
      pre-C8166 stock that have a replication advantage in C8166 coincident with
      increased sensitivity to sCD4.

PMID- 7786581
TI  - Clinical evaluation of branched DNA signal amplification for quantifying HIV type
      1 in human plasma.
AB  - Quantification of HIV-1 RNA in human plasma has provided unique insight into AIDS
      pathogenesis and promises to hasten progress in antiretroviral therapy and
      vaccine research. However, no generally available HIV-1 RNA assay has yet been
      subjected to rigorous clinical testing or to comparative evaluation with research
      based RNA assays using large numbers of well-characterized clinical specimens. In
      this study, the Chiron Quantiplex branched DNA (bDNA) signal amplification assay
      was used to measure viral RNA in the plasma of 152 HIV-1-positive individuals at
      all stages of infection and in 12 patients before and after initiating zidovudine
      therapy. Eighty-six percent of patients had bDNA assay results above the 10,000
      RNA Eq/ml sensitivity cutoff. Branched DNA values were significantly correlated
      with plasma viral RNA levels determined by quantitative competitive polymerase
      chain reaction (QC-PCR) assay (Spearman rank correlation, r = 0.89), infectious
      plasma virus titers (r = 0.72), p24 antigen levels (r = 0.51), immune complex
      dissociated p24 antigen levels (r = 0.56), and CD4+ lymphocyte counts (r = -0.72;
      p < 0.0001 for all comparisons). Plasma viral RNA determinations by bDNA and QC
      PCR assays were quantitatively similar in the range of 10(4) to 10(7) RNA
      molecules/ml [log bDNA = 0.93 + 0.80 (log QC-PCR); R2 = 0.81, p < 0.0001] and
      declined identically following the institution of zidovudine therapy (68-73%
      decrease from baseline). The close quantitative correlation between bDNA and QC
      PCR results, and their significant association with other viral markers and CD4+
      counts, support the use of plasma viral RNA measurement in HIV-1 clinical trials.

PMID- 7786582
TI  - Coamplification of HIV type 1 and beta-globin gene DNA sequences in a nonisotopic
      polymerase chain reaction assay to control for amplification efficiency.
AB  - The polymerase chain reaction (PCR) fails to detect HIV-1 sequences in 5% of
      infected individuals. To screen for false-negative PCR tests, we developed a
      nonisotopic PCR assay in which sequences from the beta-globin gene and from the
      HIV-1 vpu-env region were coamplified with biotinylated and fluorescein-labeled
      primers, respectively. Coamplified products were reacted with specific internal
      digoxigenin-labeled RNA probes. Hybrids were detected in a microtiter plate
      coated with streptavidin or anti-fluorescein antibody, with enzyme-labeled anti
      digoxigenin antibody. After the optimization of the coamplification conditions,
      the assay could detect 5 proviral DNA copies in a lysate from 100,000 peripheral
      blood mononuclear cells. Fifty-seven samples from 55 HIV-1-seropositive patients
      and 25 samples from 25 seronegative individuals were evaluated. Fifty-two samples
      from HIV-infected individuals were positive for HIV-1 vpu-env sequences. Three of
      the 5 PBMC lysates falsely negative for HIV-1 sequences had reactivities for beta
      globin (3-23 fu) below that of 100,000 cells (304 fu). Nonisotopic
      coamplification allowed for the evaluation of the quality of specimens for PCR
      concurrently with the detection of the presence of viral template sequences.

PMID- 7786583
TI  - Humoral and cellular immune responses in rhesus macaques infected with human
      immunodeficiency virus type 2.
AB  - Eighteen rhesus macaques were inoculated with either an infectious molecularly
      cloned human immunodeficiency virus type 2 (HIV-2)SBL/ISY, or with one of eight
      mutants defective in one or more accessory genes. The immune responses generated
      by the macaques were monitored for up to 2 years postinfection. All the macaques
      except those that received mutants lacking the vpr or vif genes demonstrated low
      to moderate antibody titers. Macaques inoculated with vpx- mutants exhibited a
      persistent serological response, suggesting continuous virus expression even in
      the absence of detectable virus in the peripheral blood mononuclear cells
      (PBMCs). Neutralizing antibodies developed in only four macaques. In general, low
      level cytotoxic T lymphocyte (CTL) activity, not clearly HIV-2 specific, was
      detected in PBMCs. However, one virus-negative macaque exhibited significant HIV
      2-specific CTL activity in an enriched CD8+ cell population from PBMCs,
      suggesting clearance of the viral infection. In addition, CTL activity against
      the Env and Gag/Pol epitopes of HIV-2 by CD8+ lymphocytes from the spleens and
      lymph nodes of two infected macaques, in one case requiring CD8+ T cell
      enrichment and in the other clearly evident in unfractionated tissue lymphocytes,
      was demonstrated for the first time. This sequestration of tissue CTLs occurred
      in the absence of significant levels of circulating CTLs in the blood. Our
      results suggest that routine monitoring of PBMCs may sometimes be inadequate for
      detecting cell-mediated immune responses. Elucidation of immune correlates of
      vaccine protection may therefore require sampling of lymphoid tissues and
      assessment of enriched CD8+ populations.

PMID- 7786584
TI  - Analysis of envelope glycoprotein-specific antibodies from SIV-infected and gp110
      immunized monkeys in ACC and ADCC assays.
AB  - Sera collected from SIV-infected or recombinant glycoprotein-immunized monkeys
      were characterized for antibodies participating in antibody-complement-mediated
      cytolysis (ACC) and antibody-dependent cellular cytolysis (ADCC) in terms of
      their IgG subclass and epitope specificity. In a competitive inhibition ELISA,
      gp110-specific antibody reactivity with nondenatured rgp110 was blocked
      completely by soluble homologous rgp110 and partially inhibited by heterologous
      rgp110, suggesting cross-reactivity between viral strains. However, only partial
      inhibition was observed with denatured recombinant gp140 (rgp140) in selected
      monkeys, indicating that the majority of gp110-specific antibodies recognized
      conformational epitopes. ACC activity against recombinant vaccinia-infected,
      envelope-expressing targets was found in sera from both infected and immunized
      monkeys, whereas ADCC activity was observed only in sera from infected monkeys.
      ACC was blocked with denatured rgp140 as well as nondenatured rgp110, indicating
      that ACC-mediating antibodies recognized mainly linear epitopes. In contrast,
      rgp140 did not compete as effectively as rgp110 in the ADCC assay, indicating
      that the majority of ADCC antibodies recognized conformational epitopes.
      Competitive inhibition using three peptide fragments of gp110 indicated that
      epitopes recognized by ACC antibodies lie within amino acid residues 214-471, a
      region that spans V3, whereas ADCC-reactive epitopes lie between amino acid
      residues 52 and 214 at the N-terminal end of gp110. Column chromatography of
      rhesus IgG resulted in three subclass-enriched fractions, designated IgG-I, IgG
      II, and IgG-III. IgG-I, but not IgG-II or IgG-III, from both infected and
      immunized monkeys mediated ACC, whereas IgG-I and IgG-II from infected monkeys
      mediated ADCC.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786586
TI  - Evaluation of HIV type 1 western blot-indeterminate blood donors for the presence
      of human or bovine retroviruses.
AB  - From 1985 through 1990, 1100 of 500,000 human blood donations in Syracuse, New
      York were repeatedly reactive by ELISA for antibodies to the human
      immunodeficiency virus type 1 (HIV-1). Nine hundred of the ELISA-reactive samples
      were confirmed as negative by Western blot (WB), 40 were confirmed as positive,
      and the remaining 160 sera were indeterminate, reacting mainly with HIV-1 gag
      gene products. Twenty donors with the most reactive indeterminate WB were
      selected for follow-up studies. Four of these 20 donors admitted to retroviral
      risk factors and, interestingly, 12 (60%) had exposure to dairy cattle and drank
      unpasteurized milk. These 20 donors were analyzed over a 3-year period for the
      presence of the pathogenic human retroviruses HIV-1, HIV-2, human T cell
      lymphoma/leukemia virus types I and II (HTLV-I and HTLV-II), as well as bovine
      immunodeficiency virus (BIV) and leukemia virus (BLV). Retroviral analyses
      included serology, plasma antigen capture, virus culture, and the polymerase
      chain reaction. Only one donor seroconverted and was clearly infected with HIV-1.
      None of the other 19 donor serological reactivities to HIV-1 changed, nor were
      they positive for any of the above-mentioned retroviruses. Although we cannot
      ascertain whether these latter 19 HIV-1 WB-indeterminate donors were exposed to
      human or bovine retroviral proteins, it is unlikely that their HIV-1
      seroreactivity was caused by infection with HIV-1, HIV-2, HTLV-I, HTLV-II, BLV,
      or BIV.

PMID- 7786585
TI  - Polyclonal rabbit antisera that detect the Vpr protein of SIVSM and SIVMAC on
      immunoblots of purified virions.
AB  - Antisera suitable for detection of SIVSM or SIVMAC Vpr proteins on Western blots
      of purified virions are currently not available. We have expressed the Vpr
      protein of SIVSMPBj1.9 in a gst-based prokaryotic expression system and used it
      to raise polyclonal antisera in rabbits. Two immune sera were obtained that
      specifically recognized both cell- and virion-associated Vpr protein on
      immunoblots of three different SIV isolates (SIVSMPBj1.9, SIVMACBK28, and
      SIVMAC239). Because Vpr is believed to play an important role in HIV/SIV
      replication and pathogenesis, these reagents will allow the extension of
      functional analyses of this protein to a broader spectrum of viruses. Both
      antisera and the gst-Vpr expression plasmid have been submitted to the NIAID AIDS
      Research and Reagent Program and are available to interested investigators.

PMID- 7786587
TI  - Differential Tax expression in HTLV type I-infected asymptomatic carriers.
AB  - tax gene expression in a family cluster of three HTLV-I-infected asymptomatic
      individuals was investigated. Two carriers had normal tax mRNA, Tax-specific
      humoral antibody, and cell-mediated immune (CMI) response. In one carrier who had
      only weak Tax-specific humoral and no Tax-specific CMI response, an abnormal Tax
      related mRNA product was detected. This product was sequenced and found to
      consist of two exons derived from the LTR gag and pX regions. The abnormal mRNA
      has an ORF predicting a 17-kDa protein, the translation of which is initiated in
      the first exon. The presence of this protein, of antibody to it, and of its
      function remain to be elucidated.

PMID- 7786588
TI  - Characterization of the V3 region of HIV-1 isolates from Sydney, Australia.

PMID- 7786589
TI  - At least five HIV-1 sequence subtypes (A, B, C, D, A/E) occur in England.

PMID- 7786590
TI  - Non-specialist units, clinical trials and survival from testicular cancer.

PMID- 7786591
TI  - Should we still advocate referral to specialist centres for teratoma?

PMID- 7786592
TI  - Long-term prognosis following macroscopic complete response at second-look
      laparotomy in advanced ovarian cancer patients treated with platinum-based
      chemotherapy. The Gruppo Oncologico Nord Ovest.
AB  - Survival (S) and progression-free survival (PFS) were evaluated in 129 advanced
      ovarian cancer patients, who achieved a macroscopic complete response (112
      pathological complete response and 17 microscopic disease) at second-look after
      platinum-based combination chemotherapy with or without doxorubicin (DX). The
      impact on S and PFS of age, performance status (PS), stage, histology, grade (G),
      residual disease after first surgery (RD), chemotherapy regimen, disease status
      at second-look and consolidation therapy were evaluated by univariate and
      multivariate analysis. In the 118 months observation period, median S and PFS
      were 81 and 34 months, respectively. Stage, G, RD, PS and disease status at
      second-look had significant impact on both S and PFS in univariate analysis,
      whereas consolidation therapy did not influence outcome. Cox's regression
      analysis showed that G, RD and PS had an independent impact on PFS. Test for
      interaction demonstrated no statistically significant relationship between RD,
      chemotherapy regimen and outcome. In conclusion, advanced ovarian cancer patients
      with macroscopically complete remission at second-look have a substantial risk of
      relapse after aggressive treatment. The risk of recurrence was estimated to be
      maximal in the first 3 years after restaging, and was correlated with poor PS, RD
      > 2 cm after first surgery and undifferentiated tumour.

PMID- 7786593
TI  - Is neuro-ectodermal differentiation of Ewing's sarcoma of bone associated with an
      unfavourable prognosis?
AB  - Among Ewing's sarcoma (ES) of bone and related entities are tumours with neuro
      ectodermal features that could represent a biologically distinct type. In order
      to assess the prognostic significance of the various forms of ES, a retrospective
      joint study involving three cancer centres in Europe and the U.S.A. was
      initiated. The material from 315 primary ES was reviewed by a panel of five
      pathologists and classified as typical ES (220 cases), atypical ES (48 cases) or
      ES with neuro-ectodermal features (47 cases). Prognostic factor analysis on
      treatment failure-free survival was performed using the Cox model. It included
      histopathological classification, initial patient characteristics, clinical
      presentation and treatment type. After multivariate analysis, in addition to
      treatment type (P < 0.001), metastases (P = 0.003) and proximal tumour location
      (P = 0.006), two histopathological parameters correlated with poor treatment
      failure-free survival, the presence of filigree pattern (P = 0.044) and dark
      cells (P = 0.043). We conclude that ES with neuro-ectodermal features does not
      appear to have a different outcome to the other subtypes.

PMID- 7786595
TI  - Prognostic parameters in localised melanoma: gender versus anatomical location.
AB  - Extremity location and female gender are both considered favourable prognostic
      parameters in primary melanoma, but since they cluster in the same group of
      patients, the question remains as to whether they are both independent variables.
      Multivariate analysis of 695 patients with primary, localised melanoma was used.
      The effects of gender and anatomical location were compared directly by
      sequentially controlling one factor while the other remained free. Following
      multivariate analysis, significant prognostic factors related to survival were
      the thickness of the primary lesion (P < 0.0001), the age of the patient at
      diagnosis (P < 0.0001), the gender of the patient (P = 0.0008) and the anatomical
      location of the primary lesion (P = 0.005). Thicker lesions, patients older than
      50 years, males, and trunk, head and neck locations had poorer prognoses. There
      was a significant difference in survival according to gender within each
      location, extremity (P = 0.002) or trunk, head and neck (P = 0.0004); however,
      there was no significant difference in survival according to anatomical location
      within each gender, male (P = 0.11) or female (P = 0.29). The thickness of the
      primary lesion, the age of the patient at diagnosis, the gender and the
      anatomical location of the melanoma are all significant prognostic parameters in
      localised melanoma. Gender appears to have a more pronounced effect on survival
      than anatomical location.

PMID- 7786594
TI  - Different dose regimens of 5-fluorouracil and interferon-alpha in patients with
      metastatic colorectal carcinoma.
AB  - Three different 5-fluorouracil (5-FU)-interferon-alpha-2b (IFN)-containing
      regimens were designed for treatment of patients with advanced colorectal cancer.
      87 patients with a Karnofsky index > or = 70 were included in three sequential
      non-randomised phase II trials. Regimen A consisted of 5-FU (750 mg/m2/day) given
      as a continuous infusion on days 1-5 followed by weekly 1-h intravenous infusions
      until week 8. IFN (5 MU) was given subcutaneously on days 1, 3 and 5 followed by
      injections (9 MU) every second day until week 8. The cycle was then repeated.
      Regimen B consisted of 5-FU (750 mg/m2/day) given as a continuous infusion on
      days 1-5 followed by 5-min intravenous injections on days 12 and 19. IFN (3 MU)
      was given subcutaneously on days 1-5 followed by injections (5 MU) on days 11-13
      and 18-20. The cycle was repeated every fourth week. Regimen C consisted of 5-FU
      (750 mg/m2/day) given as a continuous infusion on days 1-5. IFN (3 MU) was given
      subcutaneously on days 1-5. The cycle was repeated every third week. The
      objective response rates (complete response (CR) and partial response (PR)) after
      approximately 4 months of therapy or longer were as follows: regimen A (n = 27)
      22% (2 CR, 4 PR), regimen B (n = 33) 42% (4 CR, 10 PR) and regimen C (n = 27) 22%
      (1 CR, 5 PR). The corresponding response figures for previously untreated
      patients were regimen A 50%, regimen B 64% and regimen C 38%. Response durations
      varied from a few weeks up to 142 + weeks. Toxicities were generally mild and
      reversible, and the treatments were convenient for the patients and cost
      effective since the 5-day infusions could be given by a portable pump without
      hospitalisation. Our results are in agreement with those of others showing that 5
      FU/IFN combinations can be highly effective in advanced colorectal cancer, and
      that a number of factors such as doses, dose intensities, infusion rates and
      timing of the two drugs may be crucial for the anti-tumour activity of this drug
      combination.

PMID- 7786596
TI  - Timing of surgery during the menstrual cycle for breast cancer: possible role of
      growth factors.
AB  - Premenopausal patients undergoing surgery for breast cancer were prospectively
      studied. Data regarding menstrual history, pathological parameters and hormone
      receptor status were collected. Serum oestradiol, prolactin and progesterone
      levels, tumour epidermal growth factor receptor (EGFR) levels, tumour epidermal
      growth factor (EGF) levels and flow cytometry were measured. Patients were
      allocated to the follicular or luteal phase of their cycle both by history and
      progesterone level. No significant differences were seen in hormone receptor
      levels, pathological parameters or EGF levels between the two groups. EGFR levels
      were significantly higher in women undergoing surgery during the follicular phase
      of their cycle, when classified by menstrual history. Patients operated on during
      this phase have previously been found to have a poorer prognosis, and these
      results may provide a basis for this finding. This may have implications for
      prognosis and timing of surgery, and further investigation is warranted.

PMID- 7786597
TI  - Expression of retinoblastoma gene protein (Rb) in breast cancer as related to
      established prognostic factors and survival.
AB  - The expression of retinoblastoma gene product (Rb protein) was studied by
      immunohistochemical analysis of 205 cases of breast cancer. Rb protein was
      invariably expressed in non-neoblastic breast epithelium, in dysplastic and
      hyperblastic lesions adjacent to tumours, and none of the breast tumours was
      totally negative for Rb protein. According to the scoring system used, the
      expression of Rb protein was abnormal in 36.6% of cases. Abnormal expression of
      Rb protein was significantly related to grade (P < 0.00004), type (P = 0.0183),
      margin formation (P = 0.0116), DNA ploidy (P < 0.0002) and nuclear pleomorphism
      (P < 0.0001). Abnormal expression of Rb protein was related to high S phase
      fraction (P = 0.004), high mitotic index (P < 0.001) and high morphometric
      nuclear factor values (P < 0.01). The expression of Rb protein had no prognostic
      value in univariate or multivariate analysis. The results show that the tumour
      suppressor gene Rb participates in the growth regulation of breast cancer cells
      in vivo, but immunohistochemical assessment of the expression of Rb protein has
      no prognostic significance in clinical breast cancer over already established
      prognostic factors.

PMID- 7786598
TI  - Parathyroid hormone-related protein (PTHrP) in breast cancer and benign breast
      tissue.
AB  - Parathyroid hormone-related protein (PTHrP) 1-86 was quantified by immunoassay in
      extracts of 132 breast cancers, 27 samples of normal breast tissue and four
      fibroadenomas. PTHrP 1-86, was detected in 68% of primary tumours (range 40
      302,000 fmol/g), 33% of normal breast tissues (range 100-1800 fmol/g), and all
      four fibroadenomas (range 110-11,600 fmol/g). PTHrP displayed molecular
      heterogeneity on gel filtration chromatography, and 1-86, 1-34 and 37-67
      immunoreactivity eluted as 25-27 kDa together with a peak of 19-21 kDA containing
      only 37-67 activity. Tumour PTHrP 1-86 levels correlated inversely with age (P <
      0.05) and were higher in premenopausal women (P = 0.05). The proportion of
      tumours containing PTHrP was higher in axillary node positive premenopausal women
      (P < 0.05). These data suggest that oestrogen may regulate expression of PTHrP in
      breast cancer and that production of PTHrP may be linked to development of
      axillary node metastases.

PMID- 7786600
TI  - A model-based prediction of the impact on reduction in mortality by a breast
      cancer screening programme in the city of Florence, Italy.
AB  - The efficacy of breast cancer screening for women older than 50 years has been
      shown in several studies. Service screening is now ongoing or planned in several
      countries in Europe. MISCAN, a computer simulation programme, has been used to
      analyse data from the Florence District Programme (FDP) breast cancer experience.
      First, the model was fitted to the screening results for the period 1975-1986. A
      good correspondence between the model outcomes and the FDP results was achieved.
      It was then used to predict the impact on mortality of the new starting programme
      of the city of Florence (63,000 women, 50-69 years old). Assuming a 70%
      attendance rate, then for the city of Florence, 2563 screen-detected breast
      cancers are predicted for the period 1991-2020 out of the total number of 9095
      breast cancers for all ages (28%). A total of 3720 deaths for breast cancer are
      expected without screening. An absolute reduction of 472 deaths (13%) is
      predicted for the whole population. The estimated number of years of life gained
      by screening until 2020 is 4354. Simulation by MISCAN has previously been a
      useful support tool for decision-making about screening. The present paper is the
      first based on a southern European experience. The possibility of applying MISCAN
      to predict the impact of a national programme in Italy is discussed.

PMID- 7786601
TI  - Trends in cervical cancer incidence in the district of Florence.
AB  - The trend in cervical cancer incidence in the District of Florence from 1975 to
      1989 was investigated. Tuscany Cancer Registry data were available since 1985.
      Incidence data from 1975 to 1985 were obtained through a retrospective survey of
      all the Departments of Pathology and Gynaecology in the district. Cytological
      screening for cervical cancer has been available in the district since 1973, and
      since 1980 active invitation of residents aged 25 to 59 years has been in use. A
      significant trend in decreasing incidence was evident for the overall population
      (P = 0.003) and for 40-49 (P = 0.028), 50-59 (P < 0.001) and 60-69 (P = 0.002)
      year age groups, whereas no significant trend was observed for the age group 30
      39 years. An association between attendance to screening and reduced incidence
      was evident, in that a greater reduction was evident for those cohorts (ages 50
      59 and 60-69) who had a higher compliance to screening 10-15 years before. If the
      decrease in cervical cancer incidence was spontaneous, a parallel decrease of
      CIN3, which is commonly assumed to be the precursor of invasive carcinoma, would
      be expected. On the contrary, the detection rate of CIN3 at first Pap test showed
      a significant increase in the study period. All these findings suggest that the
      observed reduction in cervical cancer incidence was mostly due to the effect of
      screening, and stress the need for optimising the coverage of the invited
      population.

PMID- 7786599
TI  - Rapidly alternating combination of cisplatin-based chemotherapy and
      hyperfractionated accelerated radiotherapy in split course for stage IIIA and
      stage IIIB non-small cell lung cancer: results of a phase I-II study by the GOTHA
      group. Group d'Oncologie Thoracique des Regions Alpines.
AB  - The prognosis of stage III non-small cell lung cancer (NSCLC) can be improved by
      a combination of radiotherapy (RT) and chemotherapy (CT). In this study, the
      GOTHA group evaluated the feasibility, tolerance, tumour response, pattern of
      failure and effect on survival of a combination alternating accelerated
      hyperfractionated (AH) RT and CT in patients with tumour stage III NSCLC. 65
      patients received 3 cycles of cisplatin 60 mg/m2 and mitomycin C 8 mg/m2 on day
      1, and vindesin 3 mg/m2 on days 1 and 8 in weeks 1-2, 5-6 and 9-10, alternating
      with AHRT, 2 daily 1.5 Gy fractions, 5 days/week, in weeks 2-3 (30 Gy) and weeks
      6-7 (33 Gy). The dose actually delivered was > 98% for RT, and 85-100% for CT.
      Mean duration before last CT cycle was 9.5 weeks. Toxic effects were leucopenia,
      nausea and vomiting, mucositis, diarrhoea, alopecia and peripheral neuropathy. 1
      patient died of bronchial haemorrhage at the end of RT. 1 of 5 patients, who
      underwent secondary pulmonary resections, died of acute respiratory distress
      syndrome. Evaluation of tumour response was hampered by lung condensations in
      radiation fields. Some long-term survivors had an initial tumour response
      assessed as partial response or no change. First failures were more frequent
      outside (34) than within (21) radiation fields. The median survival was 15.7
      months and the 5 year survival rate was 15% (95% CI = 6-26%). 1 patient died of
      bladder cancer and another of myocardial infarction. Alternating CT and AHRT, as
      used in this study, were well tolerated and allowed full dose delivery within
      less than 12 weeks. Initial response was not predictive of survival. The survival
      curve is encouraging and the 5 year survival is superior to the 5% generally
      observed with conventionally fractionated radiotherapy.

PMID- 7786602
TI  - Cycloplatam: a novel platinum compound exhibiting a different spectrum of anti
      tumour activity to cisplatin.
AB  - Cycloplatam is a novel platinum compound which has shown anti-tumour activity in
      murine tumour models. In this study, cycloplatam was found to have anti-tumour
      activity in vitro and in vivo in human tumour models. In 15 cell lines (mainly
      ovarian), cycloplatam showed similar cytotoxicity as cisplatin, using the
      sulphorhodamine B assay. Determination of the resistance factor (IC50 of
      cisplatin-resistant divided by IC50 of parental cell line) clearly showed lower
      values for cycloplatam than for cisplatin. In the parental ovarian cell line CH1
      and the cisplatin-resistant CH1 cisR model, we observed no cross-resistance of
      cycloplatam and cisplatin. The in vitro anti-tumour activity was confirmed in
      human tumour xenografts using the clonogenic assay. Mean IC70 values of
      cycloplatam were 0.54 microgram/ml (1.25 microM) and of cisplatin 0.42
      microgram/ml (1.4 microM), respectively. In the murine subcutaneously implanted
      ADJ/PC6 plasmacytoma in vivo cycloplatam showed less activity than cisplatin,
      with a 2-fold smaller therapeutic index than cisplatin. In ovarian cancer
      xenografts cycloplatam was less active than cisplatin. However, anti-tumour
      activity of cycloplatam in lung cancer xenografts was quite different from
      cisplatin. In LXFS 538, a model moderately sensitive to cisplatin, a partial
      remission was observed, but in LXFL 529, a cisplatin-sensitive model, cycloplatam
      was inactive, cycloplatam thus demonstrating a different spectrum of anti-tumour
      activity. Based on these results, further preclinical investigations with other
      tumours, such as cisplatin-sensitive and -resistant gastric cancer models, are
      warranted with cycloplatam.

PMID- 7786603
TI  - Growth factor requirement, oncogene expression and TP53 mutations of a
      tumorigenic and a non-tumorigenic subline of the human breast carcinoma cell
      line, HMT-3909.
AB  - From a human breast carcinoma cell line, HMT-3909, a tumorigenic and a non
      tumorigenic subline have previously been described. Cells of both sublines have
      been characterised as carcinoma cells. In the present work we examined whether
      differences in growth factor requirements or oncogene expression may explain the
      difference in tumorigenicity. We found that exogenous growth factor dependence
      discriminated between the two sublines. No alterations in oncogenes or tumour
      suppressor genes were demonstrated that could explain the differences in
      tumorigenicity. The lower growth factor requirement and the higher growth rate of
      the tumorigenic subline indicates that, in these cells, growth potential may
      determine the outcome of the tumorigenicity assay.

PMID- 7786604
TI  - Prophylaxis and therapy of mouse mammary carcinomas with doxorubicin and
      vincristine encapsulated in sterically stabilised liposomes.
AB  - This study tested the prophylactic efficacies of doxorubicin hydrochloride and
      vincristine sulphate, encapsulated in sterically stabilised long circulating
      liposomes, against the spontaneous development of mammary carcinomas in C3H/He
      mice. Monthly prophylactic intravenous (i.v.) injections of 6 mg/kg doses of
      liposome-encapsulated doxorubicin (DOX-SL) or 1 mg/kg doses of liposome
      encapsulated vincristine (VIN-SL) were begun when retired breeding mice were 26
      weeks old. Mice that developed a mammary carcinoma while on the monthly
      prophylactic protocols were then given weekly i.v. injections of 6 mg/kg DOX-SL
      or 1 mg/kg VIN-SL to test the therapeutic efficacies of the drugs, and to
      determine whether the tumours were susceptible or resistant to therapy. The
      monthly prophylactic injections reduced the incidence of first mammary carcinomas
      from 87/88 (99%) in untreated mice to 24/42 (57%) in DOX-SL-treated mice and to
      26/32 (81%) in VIN-SL-treated mice. Of the mice that developed a mammary tumour
      while on the prophylactic protocols, 12 of 30 mice were cured by the weekly
      therapeutic use of DOX-SL, and the growth of 18 tumours was inhibited. The weekly
      therapeutic use of VIN-SL cured 3 of 8 mice, and inhibited the growth of five
      tumours. Weekly DOX-SL therapy cured 7 of 22 previously untreated mice. The mean
      survival of tumour-bearing mice was extended from 24 days in untreated mice to 87
      days in DOX-SL-treated mice, which had not received prophylactic treatment.
      Metastases were found in 29 of 54 untreated mice, and in 3 of 72 mice treated
      with DOX-SL and VIN-SL. Toxic side effects were limited to a transient weight
      loss during the weekly treatments. Drug resistance as a result of treatments was
      not observed.

PMID- 7786605
TI  - Opposite effect of miltefosine on the antineoplastic activity and haematological
      toxicity of cyclophosphamide.
AB  - The effect of pretreatment with miltefosine (MIL) on the antineoplastic activity
      of cyclophosphamide (CPA) was evaluated in subcutaneous benzo(a)pyrene-induced
      sarcomas (BPS) of the rat. MIL alone had no antineoplastic effect on this
      autochthonous tumour, but enhanced the chemotherapeutic effect of CPA.
      Conversely, MIL counteracted the myelotoxicity of CPA in normal adult rats.
      Although the nadir of the leucocyte count remained unchanged, the recovery phase
      was considerably shortened, an effect which resembled the pharmacological action
      of GM-CSF.

PMID- 7786606
TI  - KT-5720 reverses multidrug resistance in variant S49 mouse lymphoma cells
      transduced with the human MDR1 cDNA and in human multidrug-resistant carcinoma
      cells.
AB  - T-25-Adh cells, cell variants derived from S49 mouse lymphoma, were transduced
      with a retrovirus containing the human MDR1 cDNA. The resultant cells (HU-1) are
      cross-resistant to colchicine, doxorubicin, vinblastine and actinomycin D, and
      their resistance to colchicine is reversed by verapamil. HU-1 cells were used to
      screen several protein kinase modulators for their ability to reverse multidrug
      resistance. Among the tested indole carbazole (K-252a) family of protein kinase
      inhibitors, only the antibiotic alkaloid KT-5720 (9-n-hexyl derivative of K-252a)
      could overcome the multidrug resistance of HU-1 cells and KB-V1 human carcinoma
      cells. Since other protein kinase A, C and G modulators did not reverse multidrug
      resistance in the tested multidrug-resistant cells, the chemosensitising activity
      of KT-5720 on these cells is apparently independent of its kinase inhibitory
      effects. Since KT-5720 fully reversed multidrug resistance at non-toxic
      concentrations, it might be a candidate for clinical chemosensitisation in
      combination chemotherapy.

PMID- 7786607
TI  - Failure of liposomal encapsulation of doxorubicin to circumvent multidrug
      resistance in an in vitro model of rat glioblastoma cells.
AB  - We studied the capacity of doxorubicin encapsulation in liposomes of various
      lipid compositions to circumvent multidrug resistance in several variants of the
      C6 rat glioblastoma cell line in culture, and to inhibit azidopine binding to
      membranes isolated from these cells. Three formulations of liposomes were
      prepared: (a) phosphatidylcholine (PC)/phosphatidylserine (PS)/cholesterol (cho)
      at a 9/24 ratio; (b) PC/cardiolipin (CL)/cho at 10/1/4 ratio; (c)
      dipalmitoylphosphatidylcholine (DPPC)/cho at 11/4 ratio. Unloaded liposomes
      presented no cytotoxicity against sensitive or resistant cells. Doxorubicin
      encapsulated in PC/PS/cho and PC/CL/cho liposomes had a cytotoxic activity close
      to that of free doxorubicin, whereas doxorubicin encapsulated in DPPC/cho
      liposomes was significantly less active than free doxorubicin in sensitive as
      well as in two of the three multidrug resistant cell lines, and as active as free
      doxorubicin in the third one. Free doxorubicin was able to decrease 50% of
      [3H]azidopine photolabelling to P-glycoprotein at a concentration of 40 microM;
      doxorubicin encapsulated in PC/CL/cho or PC/PS/cho liposomes was able to inhibit
      [3H]azidopine binding similarly as free drug, whereas doxorubicin encapsulated in
      DPPC/cho liposomes had no significant effect on this parameter. Unloaded
      liposomes of either lipid composition had no effect on [3H]azidopine binding.
      Together with physical studies performed in parallel on doxorubicin trapping in
      liposomes (J Liposome Res 1993, 3, 753-766), these results suggest that
      doxorubicin leaked out of fluid liposomes (PC/PS/cho or PC/CL/cho), whereas rigid
      liposomes (DPPC/cho) were able to sequester the drug more efficiently. In that
      case, however, no availability of the drug to the cells was possible and only a
      weak cytotoxicity was exhibited, especially without any favourable effect on
      multidrug resistance. In conclusion, no reversal of doxorubicin resistance was
      found to occur through liposomal encapsulation of the drug.

PMID- 7786608
TI  - Clonal diversity, measured by heterogeneity of Ig and TCR gene rearrangements, in
      some acute leukaemias of childhood is associated with a more aggressive disease.
AB  - The pattern of immune system gene rearrangements in acute leukaemias of childhood
      is heterogeneous. The biological significance of this heterogeneity in childhood
      acute leukaemia is still poorly understood. In this study, we analysed 49
      children with acute leukaemia (29 B-precursor acute lymphoblastic leukaemia
      (ALL), 5 relapsed cALL, 6 T-ALL, 7 acute non-lymphocytic (ANLL) and 2 mixed
      lineage leukaemias), for the presence of different immune system gene
      rearrangements (Ig JH, C kappa, C lambda, TCR J gamma, C beta, J delta and J
      alpha) by Southern blot hybridisation. The most prominent heterogeneity of immune
      system gene rearrangements was observed in the group of B-precursor ALL. The
      results from our study suggest that the heterogeneity of immune system gene
      rearrangement reflects clonal diversity in approximately one-third of patients
      with B-precursor ALL at presentation and in most patients in relapse. The
      observed association of clonal diversity with high white blood cell count, pre-B
      immunophenotype and age under 1 year in B-precursor ALL may have clinical
      significance. There was a significantly shorter disease-free survival in the
      group of B-precursor ALL patients with clonal diversity compared with those
      without clonal diversity. Clonal diversity may, therefore, be a mechanism of
      disease progression common to different types of aggressive B-precursor ALL.

PMID- 7786609
TI  - Revisions of general guidelines for the preclinical toxicology of new cytotoxic
      anticancer agents in Europe. The Cancer Research Campaign (CRC) Phase I/II
      Clinical Trials Committee and the European Organization for Research and
      Treatment of Cancer (EORTC) New Drug Development Office.

PMID- 7786610
TI  - Steroid receptor distribution in 47,892 breast cancers. A collaborative study of
      7 European laboratories. The EORTC Receptor Study Group.
AB  - Seven laboratories of the EORTC Receptor Study Group reported the distribution of
      oestrogen (ER) and progesterone receptors (PR) routinely assayed in breast cancer
      cytosols. A low interlaboratory variability was demonstrated for the median
      values, and for the frequency of positive tumours as measured by enzyme
      immunoassay (EIA). Larger variations were found for the frequency of positive
      tumours, as measured by radioligand binding assay (RLA). They are probably due to
      differences in the cut-off levels and in the sensitivity of the assay. Analysis
      of the variability over time clearly demonstrated that the ER-EIA values
      initially increased compared with RLA. A possible source of variations could be
      the calibration drift in the ER-EIA kit. In conclusion, quality assessment of
      steroid receptors should be monitored by comparison of both common standards and
      distributions routinely obtained in each laboratory. In-house analysis over time
      is also essential for reagent survey.

PMID- 7786611
TI  - Resection of a solitary brain metastasis in a patient with small cell lung cancer
      -long-term survival.

PMID- 7786612
TI  - The metabolite N-4-methoxyphenylretinamide is a major determinant of fenretinide
      induced decline of plasma insulin-like growth factor-1.

PMID- 7786614
TI  - Hepatic angiosarcoma in a patient with essential thrombocythaemia and Budd-Chiari
      syndrome.

PMID- 7786613
TI  - Fotemustine and tamoxifen combination therapy in metastatic malignant melanoma. A
      phase II study.

PMID- 7786615
TI  - Evidence of responsiveness to chemotherapy in aggressive Rosai-Dorfman disease.

PMID- 7786616
TI  - Effective stimulation of thrombopoiesis with interleukin-3 in chemotherapy
      induced myelosuppression--a case report.

PMID- 7786617
TI  - Prospective analysis of the information level of Italian cancer patients.

PMID- 7786618
TI  - [Hippocampus and memory disturbance: study on cases of transient global amnesia
      with dysfunction in the medial temporal lobe].

PMID- 7786619
TI  - [Amnesia due to thalamic lesion].

PMID- 7786620
TI  - [Basal forebrain lesions and memory disorders].

PMID- 7786621
TI  - [Amnesia due to fornix and retrosplenial lesion].

PMID- 7786622
TI  - [Study on the anti-dementia therapies for rats with a unilateral basal forebrain
      lesion--serial changes of the cholinergic markers' activities and event-related
      potentials after the administration of bifemelane hydrochloride or
      autotransplantation of the vagal nodosal ganglion].
AB  - Using rats with a unilateral lesion in the nucleus basalis magnocellularis (NBM),
      we examined electrophysiologically the therapeutic effects of bifemelane (BIF)
      and autotransplantation of the vagal nodosal ganglion (X) on the event-related
      potential (P300) serially for 4 weeks, and also neurochemically their effects on
      cholinergic markers--the specific binding of 3H-QNB (quinuclidinyl benzilate) on
      muscarinic acetyl-choline receptor (mAChR) and the activities of
      acetylcholinesterase (AChE) and choline acetyltransferase (CAT). The latency of
      P300 was continuously delayed and its amplitude remained low voltage until 4
      weeks in the NBM-lesioned rats (No-Tx group). Whereas the latency and amplitude
      returned to normal after 2-3 weeks in the rats given daily intraperitoneal
      injection of 15 mg/kg BIF (BIF group) and autotransplanted ones (X group). The
      cortical CAT and AChE levels on the lesion side did not recover until 4 weeks in
      No-Tx group, but the CAT levels recovered after 3 weeks in both BIF and X group;
      the AChE levels, after 1 week in BIF group and after 3 weeks in X group. The
      cortical mAChR on the lesion side was within or more than normal range in all
      rats. These results might indicate as follows: 1) Compensatory postsynaptic
      process such as cortical mAChR increase and AChE decrease occurred after acute
      cholinergic depletion. 2) Administration of BIF and X autotransplantation
      recovered cortical CAT and AChE levels and normalized cholinergic neuronal
      activity of P300.

PMID- 7786623
TI  - [Subset analysis of tumor infiltrating lymphocytes and peripheral blood
      lymphocytes in malignant glioma patients].
AB  - It has already been reported that T cell infiltration is observed in brain tumor
      tissue but that general cellular immunity is suppressed in malignant brain tumor
      patients. In this report, the subsets of tumor infiltrating lymphocytes (TILs)
      and peripheral blood lymphocytes (PBLs) were analyzed in 8 patients with
      malignant glioma in order to investigate the relationship between the local and
      systemic immunological response in malignant brain tumor patients. TIL subsets in
      surgical specimens were analyzed immunohistochemically using the ABC method and
      monoclonal antibodies of the Leu series (anti-Leu 2a, 3a + b, 4 + 5b, 7, 12 and
      M5), and identified more precisely by double immunofluorescence staining (DIFS)
      using paired fluorescein isothiocyanate (FITC)-Leu 3a + b and phycoerythrin (PE)
      Leu8 or FITC-Leu 2a and PE-Leu 15. PBL subsets were determined preoperatively by
      two-color analysis with a fluorescence-activated cell sorter (FACS) using
      fluorescence-labeled monoclonal antibodies (paired FITC-Leu 4 and PE-Leu 12, FITC
      Leu 3a and PE-Leu 8, or FITC-Leu 2a and PE-Leu 15). Most TILs proved to be T
      lymphocytes containing Leu 3a + b+ (T helper/inducer) cells and Leu 2a+ (T
      suppressor/cytotoxic) cells in almost equal numbers, but there were too few TILs
      to kill the tumor cells. Detailed examination by DIFS revealed that 93% of the
      Leu 3a + b+ cells were helper T cells (Leu3a + b+.Leu8- cells) and that 88% of
      the Leu 2a+ cells were cytotoxic T cells (Leu 2a+.Leu15- cells). Analysis of PBLs
      showed statistically significant decreases in T cells as a whole and in helper T
      cells (Leu 3a+.Leu 8- cells).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786624
TI  - [Jacksonian seizure model induced by a kainic acid microinjection into unilateral
      sensori-motor cortex].
AB  - Kainic acid microinjection into unilateral sensori-motor cortex induced focal
      seizure status and secondarily generalized seizure status for about 4 hours.
      After these seizure status, focal myoclonic jerkings were induced for about 2
      days. EEG demonstrated generalized synchronous periodic spikes with these
      myoclonic jerkings. This phenomenon was very similar to those symptoms of
      epilepsia partialis continua in man. During focal seizure status,
      autoradiographic study with 14C-deoxyglucose demonstrated increased local
      cerebral glucose utilizations in the injected site of the sensori-motor cortex,
      ipsilateral caudate nucleus, globus pallidus, substantia nigra and thalamic
      nuclei. The result suggested that subcortical pathways played an important roles
      in the seizure propagation from the cortical epileptogenic focus.

PMID- 7786626
TI  - [Prognostic evaluation of patients with severe head injury by motor evoked
      potentials induced by transcranial magnetic stimulation--combined analysis with
      brainstem auditory evoked potentials].
AB  - Prognostic evaluation of severe head injury was performed on the basis of
      transcranial magnetic motor evoked potentials (MEPs) and brainstem auditory
      evoked potentials (BAEPs). The subjects were 43 severe head injury patients with
      Glasgow Coma Scale Scores (GCS) of 9 or less. MEPs were recorded within 3 days
      after the injury. Patient outcome at 1, 6 and 12 months after the injury was
      correlated with the MEPs and BAEPs. Differences between MEP and BAEP findings in
      focal lesions and diffuse lesions also were analyzed. MEP wave latencies and
      inter-peak latencies between BAEP waves IV and V and between waves I and V were
      evaluated. There was a closer relationship between MEP latency and GOS,
      especially between the good recovery group and other outcome groups. At 1 month
      after the injury, there was a closer correlation between MEP latency and BAEP
      latency in those who died than in those who survived, and this tendency was more
      evident with regard to focal lesions. However, there was no significant
      correlation between MEP and patient outcome when the lesions were diffuse. There
      was no correlation between BAEP latencies and patient outcome, but there was a
      good, close correlation between prolonged MEP latency and unfavorable outcome at
      1, 6, 12 months after injury. In conclusion, the combined use of BAEPs and MEPs
      induced by transcranial magnetic stimulation is useful in prognostic evaluation
      of acute head injury patients, especially when the brain lesions are focal.

PMID- 7786625
TI  - [The effects of mild hypothermia on expression of stress protein (HSP72) after
      experimental brain injury].
AB  - Recent studies have demonstrated that mild hypothermia protects brain from
      ischemic insults. In the present study, we investigated the effects of mild
      hypothermia on stress responses of the neurons and glia after experimental brain
      injury. We evaluated the immunocytochemical expression of 72kDa molecular weight
      heat shock protein (HSP72) as a marker of cellular injury. Adult male Sprague
      Dawley rats were subjected to a lateral fluid percussive injury. After injury the
      animals were divided into two groups (normothermic and hypothermic groups). Body
      temperature of the normothermic groups was maintained at 37.0-37.5 degrees C
      throughout the experiment. In the latter groups, the rats were exposed to
      hypothermia of 30.0-31.5 degrees C by surface cooling for 150 minutes beginning
      at 15 minutes after injury. Animals in each groups were sacrificed at 24, 48, and
      72 hours after injury. Vibratomed brain sections were provided for
      immunocytochemical staining of HSP72 and hematoxyline-eosin staining. The
      induction of HSP72 was evaluated under the light microscopic level. Results 1)
      The rats that produced HSP72 in the hypothermic group were significantly less
      than those in the normothermic group. 2) HSP72 was expressed in the neurons and
      glia in the various brain regions including the impact site, parasagittal cortex,
      deep cortical layer, hippocampus, caudate-putamen and midbrain in both groups.
      However HSP72 positive cells in each brain region of the hypothermic group were
      significantly less than those in the corresponding regions of the normothermic
      group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786627
TI  - [HTLV-I-associated neuropathy].
AB  - A 70-year-old man was admitted to our hospital because of a 15-year history of
      walking difficulty, disturbance of sensation in the palm for 2 years and hand
      tremor for 6 months. On admission, the scapulohumeral muscles showed
      fasciculation and atrophy. There was action tremor in the upper limb, and the
      proximal lower limb showed atrophy and weakness. Standing and walking were
      impossible. Deep tendon reflexes were decreased in lower limbs. Pathologic
      reflexes were not found. There was distal dominant sensory disturbance, and
      urination was difficult. Needle EMG showed a neurogenic pattern in 4 all limbs.
      MCV and F-latency were delayed. SCV in the median nerve and the amplitude in the
      sural nerve were decreased. Biopsy of the sural nerve revealed both axonal change
      and demyelination. Biopsy of the quadriceps femoris muscle showed neurogenic
      change with helper T-cell infiltration. Anti-HTLV-I antibody and ATL-like cells
      in both blood and CSF were positive. There were HTLV-I provirus DNA with a
      polyclonal pattern and the type of HLA as HAM. The HTLV-I infection was of the
      HAM type. As the present patient showed mainly neuropathy without pyramidal
      signs, was not considered to have HAM.

PMID- 7786628
TI  - [A case of deep sylvian meningioma presenting temporal lobe epilepsy].
AB  - A rare case of deep sylvian meningioma is presented. A 62-year-old woman was
      admitted to our hospital because of one year history of temporal lobe epilepsy.
      She had no neurological deficit except for EEG abnormality. CT scans showed a
      small calcified mass in the left temporal lobe adjacent to the sylvian fissure
      with no enhancement by contrast medium. The mass was low-intense in both T1- and
      T2-weighted MR images. The T1-weighted image after the infusion of gadolinium
      revealed enhancement of the middle cerebral artery adjacent to the mass, similar
      to dural tail sign. Left external carotid angiography did not show any tumor
      stain nor the dilatation of the middle meningeal artery. Left internal carotid
      angiography disclosed enlarged middle cerebral artery without tumor stain. A left
      frontotemporal craniotomy was performed and the mass was totally removed. The
      tumor was located deep in sylvian fissure without any connection to the dura or
      ventricular system, which was firmly adherent to the middle cerebral artery. The
      histological examination of the surgical specimen revealed a psammomatous
      meningioma. Meningiomas are believed to originate from the arachnoid cap cells
      and can arise from various intracranial locations where arachnoid cap cells
      exist. The majority of them are attached to the dura, choroid plexus, or the tela
      choroidea. Only eleven cases of deep sylvian meningiomas have been presented in
      the literature. We have reviewed the clinical and radiological findings in such
      meningiomas. MR findings in deep sylvian meningioma have not been
      described.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786629
TI  - [A 21-year-old man with distal dominant progressive muscle atrophy].
AB  - We report a 21-year-old man with distal dominant progressive muscle atrophy. The
      patient was apparently well until 17 years of age when he noted a decrease in
      exercise tolerance. One year later, he noted difficulty in arising his heels when
      the walked. He was admitted to our service for the work up in June 10, 1992. On
      admission, the patient was rather slender in the body build up; otherwise general
      physical examination was unremarkable. Upon neurologic examination, mental status
      and higher cerebral functions were normal. In the cranial nerves, the
      sternocleidomastoid muscles were atrophic bilaterally; other cranial nerves
      appeared intact. His gait was unstable and he showed steppage gait; walking on
      toes and heels were impossible. Distal dominant muscle atrophy was noted in both
      upper and lower extremities. Muscle strength in the deltoid, biceps brachii and
      triceps brachii was normal. In the lower extremities, both tibialis anterior and
      triceps surae muscles were weak (3/5). The iliopsoas and quadriceps femoris
      muscles were normal, however, the adductor muscles of the thigh showed marked
      weakness (2/5). Myotonia was absent. Deep reflexes were decreased; sensation was
      intact. Routine blood tests were unremarkable; CK was 96 IU/l, lactate 6.9 mg/dl,
      and pyruvate 0.61 mg/dl. After an ischemic forearm exercise test, blood lactate
      level rose to 22.5mg/dl (base line 11.2), and blood ammonia to 88.3 micrograms/dl
      (base line 71.2). EMG showed myogenic changes and myotonic discharges. A
      diagnostic biopsy was performed. The patient was discussed in a neurologic CPC,
      and the chief discussant arrived at the conclusion that the patient had type III
      glycogen storage disease. The differential diagnosis included rimmed vacuole type
      myopathy, Miyoshi type distal muscular dystrophy, Welander type muscular
      dystrophy, adult type acid-maltase deficiency, and lysosomal glycogen storage
      disease with normal acid maltase. However, characteristic clinical presentation
      of initial weakness in the triceps surae muscle associated with atrophy of the
      sternocleidomastoid muscle confirmed best of the clinical characteristics of type
      III glycogen storage disease; the only finding which did not fit with its
      diagnosis was elevation of the blood lactate level after the ischemic exercise
      test. The muscle biopsy specimen showed marked vacuole formation; approximately
      20 to 30% of the vacuoles were rimmed vacuoles, however, the majority was not
      rimmed. PAS staining on an epon-embedded specimen revealed marked accumulation of
      PAS-positive materials in those vacuoles as well as in the interfascular space.
      The non-rimmed vacuoles were not positively stained in the acid-phosphatase
      staining, which exclude the diagnosis of acid maltase deficiency. No
      mitochondrial abnormalities were found.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7786630
TI  - What role does the osteocyte network play in bone adaptation?

PMID- 7786631
TI  - Osteoblasts and osteoclasts in adult human osteophyte tissue express the mRNAs
      for insulin-like growth factors I and II and the type 1 IGF receptor.
AB  - Insulin-like growth factors (IGFs) are among the most abundant growth factors
      present in bone. In vitro, bone-derived cells both produce and respond to IGFs I
      and II, suggesting that these growth factors play an autocrine role in the
      regulation of bone turnover. In vivo, however, particularly in adult bone, their
      sites of expression have not been well documented. We have used, therefore, the
      technique of in situ hybridization to study the expression of the mRNAs for IGFs
      I and II and the type 1 IGF receptor in adult human osteophyte tissue. Throughout
      the developing osteophyte there was a strong association between osteogenesis and
      the expression of all three mRNA transcripts. The highest levels of expression
      were observed in active osteoblasts. Hybridization signals were weak or absent in
      flat cells lining quiescent surfaces and in cells of the bone marrow, including
      those that expressed alkaline phosphatase activity. Osteocytes and cells of the
      periosteum were negative. At sites of endochondral bone formation newly
      differentiated and hypertrophic chondrocytes expressed the mRNAs for IGFs and IGF
      receptor whereas cells of the perichondrium were negative. A striking finding of
      this investigation was that osteoclasts at sites of bone and calcified cartilage
      resorption expressed high levels of all three mRNA transcripts. These results
      support the hypothesis that locally produced IGFs are important regulators of
      bone formation. The differential expression of all three transcripts among cells
      of the osteoblast lineage suggests that IGFs may be involved in the maintenance
      of the mature osteoblast phenotype rather than in inducing the differentiation of
      marrow precursors or controlling the osteoblast-osteocyte transition.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7786632
TI  - Do ultrasound measurements on the os calcis reflect more the bone
      microarchitecture than the bone mass?: a two-dimensional histomorphometric study.
AB  - Few studies have analyzed the relationship between ultrasound measurements (US)
      and corresponding histomorphometric parameters of the calcaneus. To address this
      question we have compared US and histomorphometric parameters in 17 whole human
      os calcis from amputation or necropsy. Speed of sound (SOS), broadband ultrasound
      attenuation (BUA), and bone mineral density (BMD) were measured on the whole foot
      at the calcaneal site using an Achilles device and a DPX-L densitometer (Lunar).
      The os calcis was dissected and a 1-cm-wide transcortical parallelepiped
      extracted with a biopsy needle, focused on the center of the measured area.
      Histomorphometry was performed on undecalcified biopsies. Structural and
      connectivity parameters were measured on 7-microns-thick sections with both
      automatic (Biocom) and semiautomatic analyzers (Ibas 1, Kontron). We found that
      all ultrasonic and densitometric parameters reflected the true amount of bone and
      were correlated with only some of the parameters reflecting bone
      microarchitecture. From stepwise regression analysis, we found that 68%, 67%,
      72%, and 74% of the variance of SOS, BUA stiffness, and BMD, respectively, were
      explained significantly by trabeculae thickness only. Ultrasonic measurements
      appear to reflect bone quantity rather than bone microarchitecture. The current
      conclusion is fairly negative with respect to the ability of ultrasound to assess
      structural parameters, but our limited sample size did not give enough power to
      our study to reach statistically significant correlations. In addition, the
      calcaneus is anisotropic and the ultrasound interaction in bone is a three
      dimensional phenomenon. So, a three-dimensional study rather than a two
      dimensional one should be performed.

PMID- 7786633
TI  - Intervertebral variation in trabecular microarchitecture throughout the normal
      spine in relation to age.
AB  - The vertebral bodies of the complete spine (C-3-L-5) were removed in 26 autopsy
      cases without evidence for primary or secondary bone disease (13 males aged 19-79
      years and 13 females aged 17-90 years). A sagittal segment through the center of
      all vertebral bodies was embedded undecalcified in hydroxyethylmethacrylate and
      processed to so-called surface stained block grindings. Histomorphometric
      analysis of the complete segment was performed using a computer-assisted image
      analysis system (IBAS 2000). The structural parameters investigated were bone
      volume (BV/TV) and trabecular interconnection quantificated by trabecular bone
      pattern factor (TBPf). A close correlation of BV/TV and TBPf was found in all
      vertebral bodies irrespective of vertebral region (r = 0.8, p < 0.001). This
      indicates that the age-related decrease of trabecular bone mass is primarily the
      consequence of the transformation from plates to rods and the loss of whole
      trabecular structures. This basic principle is valid throughout the complete
      spine. However, the systematic analysis of vertebral trabecular bone from C-3 to
      L-5 revealed a significant intervertebral variation of trabecular
      microarchitecture. The density of trabecular structure of cervical vertebrae is
      much higher than that of thoracic and lumbar vertebrae (p < 0.001). The extent of
      age-related loss of trabecular bone mass and structure showed a decrease within
      the spine from the caudal to the cranial region (p < 0.05). The loss of bone
      volume in individuals between the ages of 30 and 80 years in the lumbar spine was
      53%, whereas in the thoracic spine the decrease was 41%, and in the cervical
      spine only 24%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786634
TI  - Stimulation of bone formation by dynamic mechanical loading of rat caudal
      vertebrae is not suppressed by 3-amino-1-hydroxypropylidene-1-bisphosphonate
      (AHPrBP).
AB  - We have recently developed an experimental system whereby pins inserted into the
      seventh and ninth caudal vertebrae of rat tails are used to load the eighth
      caudal vertebrae (C-8) in compression. In this model, a single 5-min period of
      dynamic loading, sufficient to induce strains within the range to which bones are
      exposed under physiological circumstances, stimulates lamellar bone formation in
      the cancellous bone of the vertebrae. The rapidity with which the increase in
      bone formation was induced raised the possibility that this bone formation might
      have occurred without prior resorption. To test the role of bone resorption in
      the response of the bone to mechanical stimulation, we compared the anabolic
      response to a single period of loading, of rats treated with 3-amino-1
      hydroxypropylidene-1-bisphosphonate (AHPrBP) or vehicle. We found that mechanical
      loading caused a significant increase in dynamic and static indices of bone
      formation. The same indices were unaffected by AHPrBP, while the bone formation
      rate in the tibiae was reduced by AHPrBP. These results suggest that the
      increased bone formation induced by mechanical stimulation in the cancellous bone
      of rat vertebrae is not dependent on bone resorption.

PMID- 7786635
TI  - Predicting vertebral deformity using bone densitometry at various skeletal sites
      and calcaneus ultrasound.
AB  - We investigated the usefulness of bone density measurements from multiple
      skeletal sites and calcaneus ultrasound for evaluating the probability of
      vertebral deformation. Bone mineral density (BMD) was measured at the second
      metacarpal and middle phalanges using radiographic absorptiometry of hand
      radiographs, and at the lumbar spine using dual-energy x-ray absorptiometry.
      Distal radius and proximal radius were measured using single-energy x-ray
      absorptiometry (SXA), expressed as bone mineral content (BMC, grams per
      centimeter), and as BMD (grams per square centimeter). The calcaneus was measured
      using both SXA (BMD) and broadband ultrasound attenuation (BUA). Among the women
      in this study (mean age 74, SD = 5), 84 women developed new vertebral
      deformations (57 cases with one and 27 cases with two or more deformations),
      which were identified on serial radiographs during an average of 9 years prior to
      the measurements of bone density. Logistic regression analysis was used to
      calculate odds ratios for risk of deformation corresponding to a 1-SD difference
      in density or ultrasound, adjusted for age. All bone measurements were
      significantly associated with vertebral deformation, with odds ratios (95%
      confidence intervals) ranging from 1.40 (1.10, 1.78) for proximal radius BMD to
      1.88 (1.45, 2.44) for calcaneus BMD measurements. Measurements of calcaneal BUA,
      calcaneal BMD, and hand BMD generally remained significant when included
      simultaneously with another measurement in the same model, suggesting that spine
      or radius BMD may not provide much additional information about risk of
      deformation. It appears that all of the measurements of bone density and
      ultrasound provide useful information regarding the probability of deformation.
      These findings await confirmation in a prospective study.

PMID- 7786637
TI  - Evidence for the synthesis of parathyroid hormone-related protein (PTHrP) by
      nontransformed clonal rat osteoblastic cells in vitro.
AB  - Parathyroid hormone-related protein (PTHrP) is synthesized by a variety of tumors
      and is thought to be the main cause of the clinical syndrome of humoral
      hypercalcemia of malignancy (HHM). In addition to its parathyroid hormone (PTH)
      like actions, novel actions of PTHrP on placental calcium transport and
      inhibition of in vitro osteoclast activity have been demonstrated. The fact that
      osteoblasts act as mediators of osteoclastic bone resorption prompted us to
      investigate whether nontranformed, osteoblastlike cells produce PTHrP. PTHrP has
      been detected in developing human fetal bones and in rat long bones in culture.
      For this study, osteogenic cells, CRP 5/4 and CRP 10/30, were employed. Both cell
      types represent clonal bone cell populations established from 1-day-old rats.
      While CRP 10/30 cells express the osteoblastic phenotype, CRP 5/4 cells resemble
      cells with preosteoblastic properties. With a radioimmunoassay (RIA), utilizing
      antiserum directed against the amino-terminal PTHrP(1-40), it was found that both
      cell types synthesize PTHrP constitutively. CRP 10/30 cells produce about twice
      as much as CRP 5/4 cells. Transforming growth factor-beta (TGF-beta 1) was shown
      to increase the synthesis of PTHrP in CRP 5/4 cells by about 2.5-fold, while in
      CRP 10/30 cells it caused an approximate 50% reduction of PTHrP. Employing the
      reverse transcriptase polymerase chain reaction (RT-PCR) technique it was found
      that both bone cell types express mRNA for PTHrP and that the modulation of the
      PTHrP mRNA levels by TGF-beta 1 in CRP 5/4, and to a lesser degree in CRP 10/30
      cells, was reflected in a change in the level of PTHrP protein in the culture
      medium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786636
TI  - Hypercalciuria in osteogenesis imperfecta: a follow-up study to assess renal
      effects.
AB  - In 1991, we reported that hypercalciuria is a common finding in our pediatric
      patient population with osteogenesis imperfecta (OI) (17 of 47 = 36%). Here, we
      prospectively screened 12 of these hypercalciuric children, on average 4 years
      subsequent to the discovery of elevated urine calcium levels, for adverse effects
      on renal function. Despite an ad libitum decrease since initial investigation of
      about 30% in their previously normal dietary calcium intake (adjusted for body
      weight), 8 of the 12 patients remained hypercalciuric (urine calcium/creatinine >
      0.62 mmol/mmol). We found, once again, that urinary calcium levels significantly
      correlated with the severity of the skeletal disease as assessed by z-score for
      height (r = -0.75, p = 0.005). Evaluation of kidney function, however, revealed:
      (i) normal routine urinalysis in all but 1 subject who had transient microscopic
      hematuria; (ii) unremarkable concentrating ability determined by fasting urine
      osmolality; (iii) normal creatinine clearance, and (iv) unremarkable
      ultrasonography to measure renal size and to screen for nephrocalcinosis or
      nephrolithiasis. Although no significant renal compromise was detected with these
      studies in our hypercalciuric pediatric OI patients, investigation of affected
      adults, especially those severely affected, will be important to assess whether
      this is a long-term problem and if adverse effects on the kidneys do develop.

PMID- 7786639
TI  - Parathyroid hormone restores bone mass and enhances osteoblast insulin-like
      growth factor I gene expression in ovariectomized rats.
AB  - In the osteopenic rat model, estrogen deficiency results in increased bone
      turnover with net bone loss occurring during cancellous modeling. However,
      estrogen-deficient rats treated with parathyroid hormone (PTH) experience a net
      gain of bone tissue due to the anabolic effects of PTH. To evaluate the
      possibility that local insulinlike growth factor I (IGF-I) production modulates
      the in vivo balance of bone formation and resorption in ovariectomized (OVX)
      estrogen-deficient rats and in OVX rats treated with PTH, we have studied the
      expression of IGF-I mRNA in cancellous bone osteoblasts using in situ
      hybridization techniques. Three-month-old virgin rats were subjected to sham
      surgery or OVX. Two weeks later, half the OVX rats began treatment with hPTH(1
      34), 5 micrograms/100 g body weight, 5 days/week for 4 weeks. All animals were
      killed at the same time, providing three groups: sham surgery alone; OVX alone;
      and OVX + PTH. Bone histomorphometry performed in undecalcified sections of
      tibial metaphysis confirmed that OVX rats had significantly (p < 0.05) increased
      bone surface formation rates (BFR/BS, micron 3/micron 2/year) with osteopenia
      while OVX + PTH rats had increased BFR/BS with increased bone volumes compared to
      sham animals (p < 0.05). Decalcified tissue from all three groups contained
      immunoreactive IGF-I. Similar tissue sections were hybridized with an 35S-labeled
      IGF-I antisense riboprobe. Evaluation of the specific signal over cancellous
      osteoblasts allowed a relative estimate of IGF-I mRNA transcript abundance in the
      three groups by counting silver grains per osteoblast, corrected for background
      activity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786638
TI  - Bone resorption induced by a metastatic human melanoma cell line.
AB  - Bone resorption resulting from the metastatic human melanoma cell line (A375) was
      investigated morphologically using an experimental model of bone metastases in
      nude mice. An injection of A375 (1 x 10(5)) in the left ventricle produced
      multiple osteolytic lesions. Many TRAPase-positive multinucleated cells,
      identified by EM as osteoclasts, were observed on the bone surface at the site of
      metastases. The findings suggest that bone resorption was caused by osteoclasts
      developed in the presence of tumor cells. Even where tumor cells were juxtaposed
      to bone surface, small and flat TRAPase-positive cells were shown to exist on the
      bone surface. Thus, bone resorption was mainly associated with the occurrence of
      osteoclasts. A large number of osteoclast progenitor cells were also observed
      adjacent to tumor cells and/or stromal cells located apart from bone, indicating
      possible participation of tumor cells and/or stromal cells in the differentiation
      of osteoclasts. Ultrastructurally, stromal cells and/or extracellular matrices
      were present between tumor cells and osteoclast progenitor cells.
      Immunohistochemical observation clarified the localization of heparan sulfate
      proteoglycan (HSPG) and fibronectin (FN) around osteoclast progenitor cells.
      These findings suggest that they play an important role in providing a
      microenvironment favorable for osteoclast differentiation and activation. The
      immunohistochemical localization of IL-6, PGE2, and TGF-alpha also indicates that
      they are involved in osteoclast differentiation and activation. In conclusion,
      bone resorption at the metastatic sites of A375 is mediated via osteoclasts and
      A375 cells may be involved in the differentiation and activation of osteoclasts
      in association with stromal cells, extracellular matrices (HSPG, FN) and
      osteotropic cytokines (IL-6, PGE2, TGF-alpha).

PMID- 7786640
TI  - Effects of basic fibroblast growth factor (bFGF) on bone formation in growing
      rats.
AB  - The effects of basic fibroblasts growth factor (bFGF) administered intravenously
      at dosages of 0.1 and 0.3 mg/kg per day for 7 days to growing rats are reported.
      Static and dynamic histomorphometry techniques were applied to the
      microradiographs and undecalcified ground sections of the proximal tibiae and
      tibial shafts. The bone histomorphometric analyses in the proximal tibia revealed
      that 0.1 mg/kg per day of bFGF increased longitudinal growth rate, cartilage cell
      production rate, and metaphyseal bone area. In the tibial shaft, the endocortical
      mineral apposition and bone formation rates, total bone area, total osteoid area,
      and medullary bone area were increased, but the periosteal mineral apposition and
      bone formation rates were depressed. Two weeks after the cessation of treatment,
      the increased osteoid bone on the endocortical surface and in the marrow cavity
      was completely calcified, and the total mineralized area in the tibial shaft was
      significantly increased. The rats given 0.3 mg of bFGF/kg per day showed retarded
      weight gain, defective calcification at the growth plate metaphyseal junction,
      and on the endocortical surface. The growth plate width was increased, and the
      longitudinal growth rate, cartilage cell production rate, endocortical labeled
      surface, and bone formation rate were decreased. Two weeks after the cessation of
      treatment, these changes were almost reversed, and the longitudinal growth rate
      and cartilage cell production rate were increased as rebound phenomena. These
      results suggest that a low dose (0.1 mg/kg per day) of bFGF stimulates endosteal
      and endochondral bone formation and depresses periosteal bone formation in
      growing rats.

PMID- 7786641
TI  - Cortical mineral content of the radius assessed by peripheral QCT predicts
      compressive strength on biomechanical testing.
AB  - Our aim was to evaluate the role of cortical bone in resistance to compression in
      the human radius. Thirty-three left cadaver forearms were scanned on an XCT 960
      Stratec CT scanner. Cortical density and cortical thickness were measured at the
      junction of the middle and distal third of the radius. Subsequently, 2-cm-high
      cylindrical specimens, centrated on the level of the CT slice, were cut. After
      removal of the endosteal trabecular bone, the specimens were submitted to
      compressive testing, using an Instron machine, and load deformation curves were
      obtained. Maximal stress (load corrected for cross-sectional area) showed a
      significant relationship with the density (r = 0.78) as well as with the
      thickness (r = 0.74) of the cortex. The closest correlation involved the maximal
      load and the mineral content of the cortex specimens (r = 0.87). We conclude that
      the mineral content of these radius cortex specimens, measured using peripheral
      QCT, predicts their compressive strength on biomechanical testing.

PMID- 7786642
TI  - Validation of wall thickness estimates obtained with polarized light microscopy
      using multiple fluorochrome labels: correlation with erosion depth estimates
      obtained by lamellar counting.
AB  - Numerous methods are currently being employed to estimate completed wall
      thickness and final erosion depth. Conflicting estimates of calculated bone
      balance have been obtained from the estimates of wall thickness and erosion depth
      using these various methods. To assess the utility of two specific methods to
      estimate wall thickness (polarized microscopy) and erosion depth (lamellar
      counts), we conducted a study in normal young adult beagle dogs, a model where
      bone balance should approximate 0. Dogs were administered multiple fluorochrome
      labels in vivo to label activity forming bone pockets. These labels were used to
      confirm the position of the cement line of the bone structural unit (BSU) in
      fluorescent light. Parallel measurements of wall thickness were then collected in
      polarized light. These estimates were compared to estimates of erosion depth
      obtained by lamellar counting and bone balance was calculated. Estimates of wall
      thickness correlated well with estimates of erosion depth with bone balance not
      differing significantly from 0. These data suggest that the combination of these
      two methods is a reasonable approach to obtaining estimates of bone balance at
      the level of the remodeling unit.

PMID- 7786643
TI  - Cross calibration of QDR-2000 and QDR-1000 dual-energy X-ray densitometers for
      bone mineral and soft-tissue measurements.
AB  - Replacement of dual energy X-ray densitometry (DXA) equipment may be necessary in
      many labs with time, or new equipment may be added. In this context we compared
      patient scans between a Hologic QDR-1000W and a QDR-2000 (n = 29-43, depending on
      anatomic region) and between QDR-2000 single beam (SB) and fan beam (FB) modes (n
      = 40-62) as a quality control measure. A total of 83 subjects (79 females and
      four males) with a wide range of bone mineral densities (BMD) were studied. There
      was a linear relationship between results with the QDR-1000W and QDR-2000 in SB
      mode, and between SB and FB mode on the QDR-2000, but the magnitude of the
      coefficients and constants differed for the different anatomic regions. In SB
      mode the QDR-2000 underestimated whole body and forearm BMD by 3% relative to the
      QDR-1000W, even after cross calibration using a spine phantom. Femoral total BMD
      was slightly, but not significantly, underestimated. Thus, additional
      postanalysis correction had to be applied to forearm and whole-body scans. In FB
      with the QDR-2000, spine and whole-body BMD was underestimated by 3%, but femur
      total and neck BMD was overestimated by 2.2 and 2.8%, respectively, compared with
      SB scans on the same device. Soft-tissue composition with FB (enhanced analysis
      protocol) on the QDR-2000 differed greatly from that obtained using SB (standard
      protocol). Lean tissue mass was 4 kg lower and fat mass 4 kg higher in FB
      mode.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786644
TI  - ACE inhibitors after myocardial infarction: selection and treatment for all.

PMID- 7786646
TI  - Medical devices: new regulations, new responsibilities.

PMID- 7786645
TI  - ACE inhibitors after myocardial infarction: patient selection or treatment for
      all?

PMID- 7786647
TI  - Primary angioplasty in myocardial infarction.

PMID- 7786648
TI  - Primary angioplasty is the most effective treatment for an acute myocardial
      infarction.

PMID- 7786651
TI  - Limitations of primary angioplasty in acute myocardial infarction.

PMID- 7786650
TI  - Immediate angioplasty: a conservative view from Europe.

PMID- 7786652
TI  - Primary angioplasty in a community hospital in the USA.

PMID- 7786649
TI  - Primary angioplasty.

PMID- 7786653
TI  - Immediate angioplasty in the United Kingdom.

PMID- 7786654
TI  - Experience of primary angioplasty in the United Kingdom.

PMID- 7786656
TI  - Comparison of five cardiac markers in the detection of reperfusion after
      thrombolysis in acute myocardial infarction.
AB  - OBJECTIVE: To investigate and compare the clinical usefulness of serial
      measurements of five cardiac marker proteins, namely creatine kinase (CK), CK-MB
      mass, myoglobin, troponin T, and myosin light chain 1, in the early detection of
      reperfusion after thrombolytic treatment. METHOD: Serial blood samples were taken
      from 26 patients presenting with acute myocardial infarction. Concentrations of
      the five markers were assayed in each sample. Thrombolytic treatment was given to
      the patients who were divided into those who reperfused (n = 17, group A) and
      those who failed to reperfuse (n = 9, group B) on the basis of clinical signs and
      angiography within 24 h. RESULTS: The release profiles of CK, CK-MB mass,
      myoglobin, and troponin T for patients in group A differed from those of patients
      in group B. No difference was observed in the release profile of myosin light
      chain 1 between the two groups. The time to peak concentration of CK, CK-MB mass,
      myoglobin, and troponin T occurred significantly earlier in patients of group A
      than in those of group B, with myoglobin peaking earlier than the other markers.
      An index, defined as the ratio of the concentration of each marker immediately
      before and 2 h after the start of thrombolytic treatment, was calculated for each
      marker in groups A and B. The 2 h myoglobin and troponin T indices were
      significantly different between groups A and B. The diagnostic efficiency of the
      myoglobin index, however, was best at 85%. CONCLUSIONS: These studies suggest
      that myoglobin has greater potential than the other markers examined in the
      detection of reperfusion after thrombolytic treatment.

PMID- 7786655
TI  - Familial dilated cardiomyopathy in the United Kingdom.
AB  - OBJECTIVES: To determine the frequency and mode of inheritance of familial
      dilated cardiomyopathy in the United Kingdom. BACKGROUND: Two recent prospective
      studies have suggested that familial forms of dilated cardiomyopathy are common
      but have been limited by selective screening methods, inadequate diagnostic
      criteria, and low rates of ascertainment. METHODS: Prospective screening study of
      236 relatives from 40 families of patients with dilated cardiomyopathy. Screening
      consisted of clinical examination, 12 lead electrocardiogram, and two-dimensional
      Doppler echocardiography. Relatives with systemic hypertension and other cardiac
      diseases were excluded from the study. All echocardiograms were performed by an
      experienced echocardiographer who was blinded to clinical information. Relatives
      were classified as having dilated cardiomyopathy, left ventricular enlargement
      (method of Henry), depressed fractional shortening, or as being normal. Relatives
      with abnormal investigations underwent further evaluation as appropriate.
      RESULTS: Twenty five cases of dilated cardiomyopathy were identified and came
      from 10 (25%) of the 40 families screened. Pedigree analysis was most consistent
      with autosomal dominant inheritance and variable penetrance (65-95%). Of the
      remaining apparently healthy relatives, 37 (18%) were found to have left
      ventricular enlargement and nine (4%) depressed fractional shortening; these
      values were significantly higher than those observed in 239 healthy controls (24
      (10%), P = 0.02 and one (0.4%), P = 0.01, respectively). CONCLUSIONS: Patients
      with dilated cardiomyopathy commonly have an affected family member and a high
      proportion of apparently healthy relatives with minor echocardiographic
      abnormalities. Segregation analysis suggests that familial dilated cardiomyopathy
      is the result of the transmission of a rare autosomal dominant gene. Further
      studies are currently underway to characterise the molecular basis of familial
      dilated cardiomyopathy and identify early disease within these families.

PMID- 7786657
TI  - Placebo controlled trial of felodipine in patients with mild to moderate heart
      failure. UK Study Group.
AB  - OBJECTIVE: To compare the effects of felodipine and placebo in patients with New
      York Heart Association functional class II or III and stable congestive heart
      failure despite treatment with an angiotensin converting enzyme inhibitor,
      diuretic, or digoxin, or any combination of these three drugs. PATIENTS AND
      DESIGN: 252 patients were randomised in a double blind, parallel group study
      after a 2-4 week placebo run-in to oral treatment with either felodipine extended
      release formulation or placebo 2.5-10 mg twice daily given in addition to
      existing background medication for a further 12 weeks. METHODS: Patients aged 18
      75 years of either sex with chronic congestive heart failure due to ischaemic
      heart disease, hypertensive heart disease, or dilated cardiomyopathy with or
      without secondary mitral insufficiency that was stable during the preceding two
      months were included in the study. Treadmill exercise tests according to the
      modified Naughton protocol were performed at baseline, and after six, 11, and 12
      weeks of treatment. Signs and symptoms of heart failure were assessed at every
      visit. Physical examination was performed and left ventricular ejection fraction
      measured at baseline and after 12 weeks. RESULTS: Mean (SD) baseline exercise
      test times increased from 434 (162) s and 480 (157) s for felodipine and placebo
      groups respectively to 541 (217) s and 591 (218) s at 12 weeks or the last visit.
      The change in exercise from baseline to last visit was 107 (141) s for patients
      given felodipine and 112 (128) s for those given placebo (P > 0.20). There was
      also no difference between treatments with respect to the other efficacy
      variables. There were few deaths in the study (felodipine n = 3, placebo n = 2).
      More patients who received felodipine were withdrawn from treatment (n = 29) than
      those who received placebo (n = 17). The most common adverse events of the 54 and
      28 cited as reasons for withdrawal in the felodipine and placebo groups
      respectively were increased need for non-study heart failure treatment (n = 10;
      8%)--that is, starting new medication or changes in the dosage of existing
      treatment for patients given felodipine, and nausea (n = 4; 3%) for those given
      placebo. Patients withdrawn from the study due to increased need for non-study
      heart failure treatment rapidly stabilised and recovered. CONCLUSION: Felodipine
      has not been shown to be of benefit in patients with mild to moderate heart
      failure.

PMID- 7786659
TI  - Change in delay of atrioventricular conduction after radiofrequency catheter
      ablation for atrioventricular nodal re-entry tachycardia.
AB  - OBJECTIVE: To monitor atrioventricular conduction after radiofrequency ablation
      for atrioventricular nodal re-entry tachycardia. DESIGN: Measurement of PR
      interval from 12 lead surface electrocardiograms before; at 0, 24, 48, 72, and 96
      hours; and at 1 and 6 months after radiofrequency ablation. PATIENTS: 40
      consecutive patients with atrioventricular nodal re-entry tachycardia. The
      anterior approach was used in 23 patients, the posterior approach in 17. RESULTS:
      With the anterior approach the PR interval increased significantly and
      progressively until 48 hours after ablation (maximum 282 (SD 62.2) ms, before
      ablation 142 (29.5) ms; P < 0.0001). Up to 96 hours no further change was
      observed, but one month after ablation the PR interval had decreased to a value
      not significantly different from that 24 hours after the procedure (231 (51.2)
      ms). In one patient total atrioventricular block developed 24 hours after an
      uncomplicated procedure and a permanent pacemaker was implanted. With the
      posterior approach the PR interval increased slightly in the first 24 hours (156
      (22.7) ms, before ablation 144 (21.2) ms P = 0.004), but it had returned to
      preablation values at 1 month. One patient developed second degree
      atrioventricular block during the first 24 hours after ablation, despite delivery
      of all radiofrequency pulses posterior to Koch's triangle at sites without His
      bundle deflection. PR intervals at 6 months did not differ significantly from the
      values at 1 month. CONCLUSION: After the anterior approach the progressive delay
      in atrioventricular conduction up to 48 hours after radiofrequency ablation for
      atrioventricular nodal re-entry tachycardia warrants continuous in hospital
      monitoring of patients for at least two days after the procedure.

PMID- 7786658
TI  - Peripheral haemodynamic effects of inhibition of prostaglandin synthesis in
      congestive heart failure and interactions with captopril.
AB  - OBJECTIVES: To investigate the role of prostaglandins in maintaining circulatory
      homoeostasis in chronic heart failure and the hypothesis that an increase in
      vasodilatory prostaglandin synthesis may contribute to the actions of angiotensin
      converting enzyme inhibitors in heart failure. DESIGN: Randomised, double blind,
      placebo controlled studies. Cardiac output and renal and limb blood flow were
      measured after oral indomethacin 50 mg or placebo followed by "open" intravenous
      infusion of prostaglandin E2 (study A). In a second study the same measurements
      were made after oral indomethacin 50 mg or placebo was given 30 min before "open"
      captopril (study B). METHODS: Blood pressure was measured using a mercury
      sphygmomanometer. Cardiac output was determined by Doppler interrogation of blood
      flow in the ascending aorta and echocardiographic measurement of aortic root
      diameter. Renal blood flow was calculated from the effective renal plasma flow
      measured by p-aminohippurate clearance and the haematocrit, and glomerular
      filtration rate by endogenous creatinine clearance. Limb blood flow was measured
      by venous occlusion plethysmography using mercury in silastic strain gauges. The
      concentration of plasma prostaglandin E2 was measured by radioimmunoassay.
      SETTING: University department of cardiovascular medicine. PATIENTS: 12 patients
      with chronic stable heart failure before starting treatment with angiotensin
      converting enzyme inhibitors. RESULTS: Indomethacin resulted in adverse effects
      on cardiac output, systemic vascular resistance, renal blood flow, glomerular
      filtration, urinary sodium excretion, and calf vascular resistance. Changes were
      reversed with infusion of prostaglandin E2. Pretreatment with indomethacin
      resulted in the attenuation of the acute increase in cardiac output and decrease
      in systemic vascular resistance that occurred with captopril. Similarly, an
      increase in renal blood flow with captopril was attenuated by indomethacin.
      CONCLUSIONS: The acute adverse effects of indomethacin on central and peripheral
      haemodynamic and renal function suggest that prostaglandins have a significant
      role in the regulation of peripheral blood flow and renal function in patients
      with stable chronic heart failure. The attenuation by indomethacin of captopril
      induced improvements in haemodynamic function and renal blood flow is consistent
      with the hypothesis that captopril may act in part via an increase in
      prostaglandin synthesis.

PMID- 7786660
TI  - Ventilatory responses to exercise in adults after repair of tetralogy of Fallot.
AB  - BACKGROUND: Adult patients with total correction of tetralogy of Fallot may have
      poor exercise capacity associated with impaired right heart function and in
      particular pulmonary regurgitation. The ventilatory responses to exercise were
      studied in a group of such patients to assess relations between ventilation,
      exercise capacity, and right ventricular function. METHODS: 30 patients (7
      female) (aged 27.8 (6.0) years) and 30 (7 female) controls of a similar age range
      were studied prospectively. All underwent exercise testing with metabolic gas
      exchange to determine peak oxygen consumption (peak VO2), and (as indices of the
      ventilatory response) the slope of the relation between both respiratory rate
      (RR) and ventilation (VE) against carbon dioxide production (VCO2). Patients were
      studied with pulsed wave Doppler echocardiography to determine pulmonary arterial
      systolic and diastolic flow characteristics. Patients were defined as having
      restrictive right ventricular function where diastolic pulmonary forward flow was
      seen coincident with atrial systole. RESULTS: In the group with tetralogy of
      Fallot mean (SD) peak VO2 was 35.3 (7.5) ml/kg/min (93.6 (15.3) % of expected for
      age, weight, height and sex). The RR/VCO2 slope was steeper in the Fallot group
      (6.8 (2.6) v 9.6 (4.7), P < 0.02). Those with restrictive right ventricles
      achieved a higher peak VO2 than those without (82.5 (10.1) % v 100.9 (13.8), P <
      0.001). In the Fallot group alone, there was an inverse relation between
      ventilatory response and peak VO2 (RR/VCO2 v peak VO2; r = -0.63, P = 0.003:
      VE/VCO2 v peak VO2; r = -0.62, P < 0.001). CONCLUSIONS: Many of these patients
      with repaired tetralogy of Fallot had near normal exercise capacity, but as
      exercise capacity decreased, the ventilatory response to exercise increased. This
      was not due to alterations in pulmonary function tests or to the effects of
      cardiac size causing decreased lung volume. It may be that the increased
      ventilatory rate at a given level of carbon dioxide production acts as a
      respiratory pump aiding right ventricular function.

PMID- 7786662
TI  - High wall shear stress proximal to myocardial bridging and atherosclerosis:
      intracoronary ultrasound and pressure measurements.
AB  - BACKGROUND: Studies have shown that myocardial bridging may prevent coronary
      atherosclerosis and that the segment proximal to the bridge is often sclerosed.
      The underlying mechanism is still unknown. METHODS: Intracoronary ultrasound and
      pressure measurements were performed in a patient with myocardial bridging in the
      left anterior descending coronary artery. A 3.5 F, 20 MHz probe was used to
      measure the change in cross sectional area of the lumen during the cardiac cycle.
      Intracoronary pressure was measured with a Double tip, end mounted pressure
      transducer system, the catheter having two pressure sensors located at the end of
      the catheter 3 cm apart. Intracoronary pressure was recorded as the catheter was
      slowly advanced and pulled back through the left anterior descending coronary
      artery. RESULTS: Systolic compression of the bridge segment was clearly
      visualised on ultrasonography and an eccentric plaque with calcium deposit was
      found in the segment proximal to the bridge. The pressure in the segment proximal
      to the bridge (160/26 mm Hg) was higher than that of the proximal normal segment
      (126/68 mm Hg). The pressure distal to the bridge was 68/30 mm Hg. A highly
      characteristic "sucking effect" was found in the bridge segment. The pressure in
      the bridge segment was 102/-40 mm Hg. CONCLUSION: The pressure in the segment
      proximal to the myocardial bridging was higher than aortic pressure. Disturbance
      of blood flow and high wall stress proximal to myocardial bridging was a main
      contributor to the development of atherosclerosis in the segment proximal to the
      bridge.

PMID- 7786661
TI  - Effects of type 1 diabetes mellitus on cardiac function: a study of monozygotic
      twins.
AB  - OBJECTIVE: To investigate left ventricular size and function in type 1 diabetes
      and their relation with diabetes duration, glycaemic control, autonomic
      dysfunction, and complications of diabetes. DESIGN: Cross sectional study using a
      pulsed wave Doppler echocardiogram to assess left ventricular dimensions, wall
      thickness, and transmitral blood flow velocity signals. PATIENTS: 40 monozygotic
      twin pairs (23 male, mean age 26 years) discordant for type 1 diabetes and 40 non
      diabetic singleton controls with no clinical evidence of cardiac ischaemia.
      RESULTS: For all Doppler echocardiographic measurements there were strong
      correlations between monozygotic twins but not between twins and control
      subjects. Left ventricular dimensions, wall thickness and systolic function, peak
      E velocity, and the velocity integrals of early left ventricular filling were
      similar in all three groups. Peak A velocity and the velocity integrals of late
      ventricular filling (mean (SD)) were greater in diabetic twins (45 (12) v 38 (8)
      cm/s, P = 0.002; and 32 (11) v 26 (6), P = 0.0002). Diabetic twins had lower E/A
      ratio (1.59 (0.39) v 1.83 (0.39), P < 0.001), greater atrial filling fraction to
      total diastolic filling (28 (6) v 25 (5)%, P = 0.002), and prolonged isovolumic
      relaxation time (72 (12) v 63 (9) ms, P < 0.001). The differences in Doppler
      findings between diabetic and non-diabetic twins were related to disease duration
      whereas the prolongation of the isovolumic relaxation time was related to cardiac
      autonomic dysfunction. CONCLUSIONS: These results show that twins with type 1
      diabetes have left ventricular diastolic dysfunction related to diabetes duration
      and cardiac autonomic dysfunction but not to glycaemic control or microvascular
      complications. In addition, genetic factors contribute to left ventricular
      dimension and function.

PMID- 7786663
TI  - Do radionuclide and echocardiographic techniques give a universal cut off value
      for left ventricular ejection fraction that can be used to select patients for
      treatment with ACE inhibitors after myocardial infarction?
AB  - OBJECTIVE: To determine whether echocardiography and radionuclide angiography
      give comparable results when the left ventricular ejection fraction is measured
      early after myocardial infarction and thus whether, irrespective of the method
      used, a single value for the ejection fraction could be used as a guide for
      starting treatment with an angiotensin converting enzyme inhibitor. DESIGN:
      Prospective comparison of measurement of left ventricular ejection fraction by
      echocardiography and radionuclide angiography. SETTING: Coronary care units of
      two university teaching hospitals in Glasgow. PATIENTS: 99 patients studied
      within 36 hours of acute myocardial infarction. OUTCOME MEASURES: Left
      ventricular ejection fraction assessed by echocardiography and radionuclide
      angiography. RESULTS: 70 (77%) of the 99 patients had ejection fraction measured
      by both echocardiographic and radionuclide techniques, 30 in centre 1 and 40 in
      centre 2. In centre 1 the mean difference (SD) in ejection fraction (radionuclide
      angiography--echocardiography) was -8 (10%); 95% CI -12 to -4%. In centre 2 the
      mean difference was -14 (11%); 95% CI -17 to -11%. If patients had been treated
      with an ACE inhibitor on the basis of a radionuclide ejection fraction of < 40%
      then 93% in centre 1 (28 of 30) and 98% in centre 2 (39 of 40) would have been
      treated. This compares with 63% (19 of 30) and 50% (20 of 40), respectively if
      echocardiography had been used as a guide. CONCLUSION: Measurement of ejection
      fraction is highly dependent on the method used and it is therefore impossible to
      quote a universally applicable figure for left ventricular ejection fraction
      below which an ACE inhibitor should be used after myocardial infarction.

PMID- 7786664
TI  - ACE for whom? Implications for clinical practice of post-infarct trials.
AB  - OBJECTIVE: To determine how many lives would be saved if patients were routinely
      treated with ACE inhibitors after myocardial infarction according to the criteria
      of four recent major clinical trials, and to estimate the costs and benefits of
      these approaches. DESIGN: Retrospective survey. SETTING: The Nottingham Health
      District. PATIENTS: Data from 7855 patients admitted between 1989 and 1990 were
      combined and the selection criteria of four major clinical trials (AIRE, SAVE,
      GISSI-3, and ISIS-4) were applied. RESULTS: Of the patients admitted in
      Nottingham with confirmed myocardial infarcts 39% were eligible for AIRE and 8%
      for SAVE. In patients with suspected myocardial infarction as defined by the
      major trials, 60% would have been eligible for GISSI-3 and 63% for ISIS-4.
      Treating appropriate patients in accordance with these trials would have saved 20
      (AIRE), 3 (SAVE), 4 (GISSI-3) and 5 (ISIS-4) lives each year in Nottingham at a
      drug cost of 5400 pounds, 33 pounds 791, 2730 pounds, and 4116 pounds per life
      per year saved respectively. CONCLUSIONS: Short-term treatment with ACE
      inhibition appears to be cheaper but such an approach would save fewer lives. The
      AIRE study is the most applicable to current clinical practice but ACE inhibitors
      should be offered routinely to patients satisfying the criteria of any of the
      four major clinical trials.

PMID- 7786665
TI  - Permanent pacemaker practice at a Scottish district general hospital between 1987
      and 1993.
AB  - BACKGROUND: Raigmore is a district general hospital offering a permanent
      pacemaker service to its catchment population of 233,500. It has been argued that
      the British public would be better served by a less centralised pacing service.
      There also exists the view, however, that a lower rate of complications and best
      follow up practice are achieved by specialised centres. The pacemaker practice
      over a 79 month period (January 1987 to July 1993) was thus reviewed with these
      issues in mind. METHODS: The pacemaker records of all new implantations for the
      period under observation were reviewed retrospectively. Data were acquired under
      the headings age, sex, symptoms, electrocardiographic (ECG) indications, and
      complications (early and late). Comparison was made with United Kingdom national
      data, a previous audit from Raigmore, and two recently published large series
      from specialist centres (one British and the other French). RESULTS: The mean age
      of patients who underwent implantation was 74 years and 47.5% were male. The most
      common presenting symptoms were syncope (46%), dizzy spells (24.5%), and heart
      failure (11.5%). The most common ECG indications for pacing were complete heart
      block (wide QRS) (28%), atrial flutter/fibrillation with bradycardia (21.6%) and
      complete heart block (narrow QRS) (9.6%). The implantation rate was 184/million
      population/year in 1993. The early and late complication rates were low (2.48%).
      CONCLUSIONS: The presence of a pacing centre in a remote part of the United
      Kingdom fulfils a necessary service and has low complication rates, with
      implantation rates and patterns that are comparable with those in other parts of
      the country.

PMID- 7786666
TI  - Combined atrial and arterial switch procedure for congenital corrected
      transposition with ventricular septal defect.
AB  - OBJECTIVES: A combined atrial and arterial switch procedure was performed in
      selected patients with congenitally corrected transposition to establish the
      morphological left ventricle as the systemic ventricle. Immediate and early
      follow up results are presented. BACKGROUND: Progressive right ventricular
      dysfunction and tricuspid regurgitation are common in patients with congenitally
      corrected transposition who undergo repair of associated lesions. A surgical
      procedure which re-establishes the left ventricle as the systemic ventricle
      should improve functional results. METHODS: Four symptomatic children aged from 9
      months to 3 years 1 month (mean 2 years 3 months) with congenitally corrected
      transposition and ventricular septal defect underwent both an atrial and arterial
      switch procedure and were followed up for a mean of 12 months (range 6-21
      months). RESULTS: There were no early or late deaths. Conduction abnormalities
      worsened in two patients. Hospital stay ranged from 8 to 17 days (mean 13 days).
      The cardiothoracic ratio decreased from a mean (range) of 0.65 (0.6 to 0.71) to
      0.58 (0.52 to 0.6). Currently, three patients are in functional class I and one
      child is in functional class II. CONCLUSIONS: The combination of an atrial and an
      arterial switch procedure in symptomatic children with congenitally corrected
      transposition establishes the left ventricle as the systemic ventricle. The
      initial experience is encouraging with excellent immediate and early follow up
      results.

PMID- 7786667
TI  - Systemic thromboembolism leading to myocardial infarction and stroke after
      fenestrated total cavopulmonary connection.
AB  - Thromboembolic phenomena involving the caval veins, right atrium, and pulmonary
      artery are recognised complications after the Fontan operation and other forms of
      total cavopulmonary connection. A rare case of systemic thromboembolism is
      reported in a 3 year old girl who had repeated coronary and cerebral
      thromboembolic events after a fenestrated total cavopulmonary shunt operation. A
      survey of the 18 paediatric cardiac units in the United Kingdom and Ireland
      showed a wide discrepancy in anticoagulation policies after Fontan-type
      operations. Prevention of thrombotic complications by lifelong postoperative
      anticoagulation may outweigh the risk of haemorrhage.

PMID- 7786669
TI  - Increase in plasma beta endorphins precedes vasodepressor syncope.

PMID- 7786670
TI  - Nocturnal hypoxaemia after myocardial infarction.

PMID- 7786671
TI  - British Cardiac Society annual meeting. North Yorkshire, 23-25 May 1995.
      Abstracts.

PMID- 7786668
TI  - Reversal of haemochromatotic cardiomyopathy in beta thalassaemia by chelation
      therapy.
AB  - Haemochromatotic cardiomyopathy is the main cause of morbidity and mortality in
      patients with beta thalassaemia major. Once congestive heart failure develops
      most patients die in a few months. Congestive heart failure was reversed and
      echocardiographic findings were restored to normal in a 24 year old woman with
      beta thalassaemia who resumed treatment with chelation therapy (desferrioxamine).

PMID- 7786673
TI  - [Modification of the Furnas-Vilkki technic in the reconstruction of congenital or
      traumatic carpal hands].
AB  - A technique is described for reconstruction of a pincer, by a second toe
      transfer, in traumatic and congenital deformities, leaving only the wrist.
      Transfer on the anterior aspect of the radius allows to benefit from the wrist
      mobility to compensate for the limited range of motion of the second toe.
      Proximal situation of the toe gives the possibility of harvesting plenty of
      tendons to balance the toe. Results have been encouraging in two traumatic and 6
      congenital cases of peromelic type of symbrachydactyly.

PMID- 7786672
TI  - [The "die punch" operation in the sequellae of articular fractures of the
      radius].

PMID- 7786674
TI  - [The prognosis of algodystrophic syndrome of the hand. Late results in 47
      patients].

PMID- 7786675
TI  - [A psychological approach to patients undergoing ambulatory surgery].
AB  - 200 patients undergoing outpatient hand surgery were included in a sociological
      and psychological study. Certain points were found to be important: structure
      adapted to outpatient surgery, a single team, availability of the surgeon 24
      hours a day, telephone call on the day after the operation, etc. Only 0.5% of
      operated patients claimed to be unhappy with their outpatient experience, but
      2.5% would have preferred admission to hospital (for comfort reasons). Overall,
      outpatient procedures make the patient and his family responsible, by stimulating
      his cooperation and avoiding regression and dependence, frequently encountered in
      conventional hospitalization. Psychoanalysis has an important place in the pre-
      and postoperative approach to the patient.

PMID- 7786679
TI  - [A salvage technic: the "parrot" surgery].

PMID- 7786677
TI  - [A comparative study of metacarpal resection and translocation after amputation
      of the middle finger].
AB  - The authors studied 43 patients having sustained an amputation of one middle
      finger treated either by simple ray resection or translocation. The index-middle
      translocation was followed by more minor postoperative complications compared to
      all other techniques. A global score, taking into account daily activities,
      cosmetic result lack of mobility, residual pain, decreased strength, time off
      work, and return to work gave 131 points for simple third ray resection compare
      to index middle translocation (-252 points). Surprisingly, reduction of hand span
      on X ray study was minimal but strength was not correlated and translocation gave
      better strength, and therefore appears to be more appropriate for manual workers.
      For ring amputation, the score was definitely better for Leviet translocation
      with intracarpal osteotomy (143 points versus -36 for simple ray resection).
      However, the only drawback is more frequent (but minor) residual pain.

PMID- 7786678
TI  - [Vasomotor disorders of the hand and carpal tunnel syndrome].
AB  - Clinical electrophysiological and chronothermodynamic examinations were performed
      on 71 patients with paresthesiae and pain of the hands. In 35 patients, the
      electromyographic examination confirmed the diagnosis of carpal tunnel syndrome
      on the basis of clear signs of chronic compression of the median nerve at the
      carpal tunnel. In the other 36 patients, the electro-physiological findings were
      normal. Twenty-nine patients with bilateral (n = 24) or unilateral (n = 5) carpal
      tunnel syndrome, and 29 patients without, this syndrome had chronothermodynamic
      abnormalities demonstrating the vascular origin of the disorders of the hands; in
      18 patients, a Raynaud's syndrome was suspected on the basis of severe
      dysthermia. In 7 patients, the origin of pain and paresthesiae remained unknown.
      This study shows that (i) vascular disorders of the hand are very frequent in
      patients with paresthesiae and pain of the hands and may mimic a carpal tunnel
      syndrome, and (ii) clinical examination is insufficient to assess the diagnosis
      of carpal tunnel syndrome. Before deciding on any kind of therapy, this diagnosis
      has to be assessed on electrophysiological and chronothermodynamic examinations
      performed according to precise protocols.

PMID- 7786676
TI  - [Results of flexor tendon repair using the Tsuge technic. Apropos of a series of
      95 fingers].
AB  - The authors review a series of 76 patients with 95 fingers involved, 66.6% of
      them occurring in zone II. The core stitch was performed according to the Tsuge
      technique (type II) combined with a peritendinous running suture. Results based
      on TAM were excellent or good in 60%, fair in 22%, and poor in 18%. Influencing
      factors were associated lesions, mainly vascular and lesions in zone II. Rupture
      occurred in 5% and adhesion in 22% of cases. Providing similar results to those
      of other techniques published in the current literature, the Tsuge techniques is
      preferred because it is simpler and faster to perform.

PMID- 7786681
TI  - Magnesium and lithium antagonism of carbachol- and electrically-induced smooth
      muscle contractions in the rat gastrointestinal tract.
AB  - The pharmacological actions of lithium and magnesium have been investigated using
      isolated smooth muscle preparations from the rat gastrointestinal tract. Tissue
      contraction was evoked by means of carbachol or electrical field stimulation and
      the degree of inhibition of contraction caused by lithium was measured. Lithium
      effects were compared with those of the chemically similar ions, magnesium and
      calcium, by manipulation of the physiological buffer solutions. Lithium
      antagonism was enhanced when tissue contractile mechanisms were dependent on
      extracellular calcium concentration in the bathing fluid. This suggests that
      lithium is acting at the cell membrane by preventing calcium entry via ion
      channels. These results are consistent with evidence from clinical studies which
      indicate low cellular accumulation of lithium at therapeutic concentrations.

PMID- 7786680
TI  - European Association of Cardiothoracic Anaesthesiologists 10th annual meeting.
      Madrid, Spain, 15-17 June 1995. Abstracts.

PMID- 7786682
TI  - Effects of extracellular magnesium and beta adrenergic stimulation on contractile
      force and magnesium mobilization in the isolated rat heart.
AB  - This study investigates the metabolism of the divalent cation, magnesium (Mg2+)
      in the isolated perfused Langendorff's rat heart and ventricular slices in the
      absence and presence of catecholamines including isoprenaline, noradrenaline and
      adrenaline. Perfusion of the isolated rat heart with a physiological salt
      solution containing elevated extracellular Mg2+ [Mg2+]o (2.4 mM-6.0 mM) resulted
      in a marked and progressive decrease in the amplitude of contraction compared to
      control [Mg2+]o (1.2 mM). In contrast, perfusion of hearts with low (0-0.6 mM)
      [Mg2+]o caused a small transient increase in the amplitude of contraction which
      was often accompanied by arrhythmic activity. Perfusion of the heart with a
      nominally Mg2+ free medium resulted in a time-dependent net efflux of Mg2+
      reaching a steady state after approximately 40-50 min of perfusion. This release
      of Mg2+ was associated with a concurrent decrease in total heart Mg2+.
      Stimulation of the heart with the beta adrenergic agonist, isoprenaline (10(-7)
      M) caused large increases in net Mg2+ efflux which was associated with marked
      increased in both rate and the amplitude of contraction. Similar effects on Mg2+
      efflux were also observed during perfusion of the heart with the adenylate
      cyclase activator, forskolin (10(-5) M). Superfusion of paced ventricular
      segments with either isoprenaline, adrenaline or noradrenaline (all 10(-6) M)
      also resulted in a marked transient net efflux of Mg2+. Pre-treatment of segments
      with the beta adrenergic antagonist, propranolol (10(-5) M) competitively blocked
      the Mg2+ efflux evoked by the catecholamines. Similarly, pre-treatment of
      segments with the calcium (Ca2+) channel blocker, verapamil (10(-5) M) caused a
      significant (P < 0.05) decrease in net Mg2+ efflux evoked by isoprenaline. The
      results of this study indicate that (1) the perturbation of [Mg2+]o has an
      important influence on myocardial contractility and (2) the mobilization of Mg2+
      in the heart is associated with beta adrenergic stimulation possibly via an
      elevation in intracellular adenosine 3.5 cyclic monophosphate (cyclic AMP).

PMID- 7786683
TI  - Enhanced contractile response to phenylephrine and increased density of [3H]PN200
      110 binding sites in thoracic aorta isolated from dietary magnesium-deficient
      rats.
AB  - The present study was undertaken to examine whether the enhanced contractile
      response to phenylephrine observed in thoracic aorta isolated from dietary
      magnesium-deficient rats depends on an increased density of alpha 1-adrenoceptor
      or calcium channels. Adult male Wistar rats were fed with a magnesium-deficient
      diet (0.001 per cent magnesium) for 30 days with control groups (0.07 per cent
      magnesium). The contractile response to phenylephrine was significantly inhibited
      by nifedipine in both aortas without endothelium, and the degree of the
      inhibition was significantly greater in magnesium-deficient rats than in
      controls. Membranes were isolated from both thoracic aortas without endothelium,
      and the binding of [3H]PN200-110 or [3H]prazosin to the membranes was studied. A
      single binding site for [3H]PN200-110 or [3H]prazosin was evident for both
      membranes with high affinity. Dietary magnesium-deficiency increased
      significantly the maximal number (Bmax) of [3H]PN200-110 binding sites, but not
      Bmax of [3H]prazosin, and did not alter the binding affinity of both ligands.
      These results suggest that increased density of calcium channels participates in
      the enhanced contractile response to phenylephrine in thoracic aortas isolated
      from dietary magnesium-deficient rats.

PMID- 7786684
TI  - Cholesterol oxides in plasma and lipoproteins of magnesium-deficient rabbits and
      effects of their lipoproteins on endothelial barrier function.
AB  - The cholesterol oxide (ChO) levels in the plasma and low density lipoproteins
      (LDL and VLDL) in four groups of rabbits fed for seven weeks either normal (NC)
      or high cholesterol (HC) with low or normal magnesium (Mg) diets were determined
      and compared with the NC group fed a standard rabbit diet. The plasma from the NC
      group contained low levels of different cholesterol oxides. These cholesterol
      oxides were significantly elevated in the plasma of rabbits fed a HC-normal
      magnesium or a HC-low magnesium diet. In the NC-low Mg group, 7 alpha
      hydroxycholesterol, 7 beta-hydroxycholesterol and 7-ketocholesterol were elevated
      while the other cholesterol oxides remained within the normal range of the NC
      group. When the cholesterol oxides were assayed in the LDL and VLDL fractions as
      micrograms/mg protein, the fractions obtained from the groups fed NC-low Mg, HC
      normal Mg or HC-low Mg diets showed higher levels of cholesterol oxides than the
      fractions obtained from the NC group. When LDL and VLDL fractions from the
      different groups were incubated at equal protein concentration with confluent
      endothelial cell monolayers, transendothelial albumin transfer was significantly
      increased by the lipoproteins from the experimental groups as compared to the
      control group. These results suggest that elevation of cholesterol oxides in
      magnesium deficiency or hypercholesterolaemia may be related to their atherogenic
      effects through decreasing the endothelial barrier function which could enhance
      the deposition of cholesterol rich lipoproteins into the arterial wall.

PMID- 7786685
TI  - Oestrogen but not testosterone increases bone density in orchiectomized rats more
      when fed moderately magnesium-deficient fructose than moderately magnesium
      deficient cornstarch.
AB  - To investigate interactions between circulating sex hormones, dietary fructose
      and magnesium on bone mineral density and numbers of trabeculae, 10 weeks old
      orchiectomized and sham-orchiectomized rats were studied. One-third of the
      orchiectomized animals were injected with beta-oestradiol-3-benzoate twice per
      week in sesame oil; another one-third, testosterone cypionate; the remaining one
      third as well as the sham-orchiectomized animals, sesame oil only. All animals
      were fed either fructose or cornstarch without added magnesium. After 14 weeks, a
      24 h urine sample was collected for measurements of calcium, magnesium,
      phosphorus, and cAMP. Blood was collected for determinations of calcium,
      magnesium, phosphorus, 25-monohydroxy and 1,25-dihydroxycholecalciferols,
      oestrogen, testosterone, and parathyroid hormone. Femurs were used for
      measurements of bone mineral density, and tibiae, for numbers of trabeculae.
      Exogenous testosterone interacted with starch and magnesium deficiency to
      decrease serum calcium concentration significantly, which increased circulating
      parathyroid hormone. High circulating parathyroid hormone raised urinary cAMP and
      serum 1,25-dihydroxycholecalciferol. Increased parathyroid hormone, cAMP and 1,25
      dihydroxycholecalciferol may be responsible for bone resorption which was noted
      in reductions of bone mineral density and the numbers of trabeculae in the group.
      In contrast, exogenous oestrogen interacted with fructose and magnesium
      deficiency to increase serum calcium concentration which caused a reduction of
      circulating parathyroid. Low parathyroid hormone, reduced 1,25
      dihydroxycholecalciferol and cAMP may explain the increased bone mineral density
      and the numbers of trabeculae in this group.

PMID- 7786686
TI  - Influence of high and low dietary magnesium levels on functional, chemical and
      morphological parameters of 'old' rats.
AB  - The effect of dietary magnesium deficiency has so far been studied preferentially
      in rapidly growing rodents or in adult animals. Since magnesium deficiency
      frequently occurs in elderly persons too, magnesium- and calcium-deficient diets
      were offered during 32 and 64 days to 'old' rats (34 months old, spontaneous
      mortality of 15 per cent). The calcium-deficient diet (2.5 per cent of the
      requirement) was well tolerated and no profound biochemical disturbances were
      noted. In contrast, dietary magnesium deficiency (12.5 per cent of the
      requirement) induced loss of body weight, formation of erythema, severe
      hypomagnesaemia and increase of tissue calcium levels. No seizures were noted and
      mortality did not increase, in contrast to growing magnesium-deficient rats.
      Histologically, age effects were present in bone tissues of old rats, however no
      additional dietary effects became visible. Tensile strength of femur and rib did
      not reveal treatment-related changes. Fourteen days preloading with high dietary
      magnesium increased plasma magnesium and also skeletal concentrations, although
      to an only small degree. Nevertheless, time until the appearance of erythema in
      50 per cent of the rats subsequently fed the magnesium-deficient diet was
      significantly delayed.

PMID- 7786687
TI  - Potentiation of magnesium-deficiency-induced foetotoxicity by concomitant iron
      deficiency and its prevention by adequate supply via drinking water.
AB  - Magnesium (Mg) and iron (Fe) deficiency frequently develop during pregnancy.
      Therefore these factors were studied alone (Mg-L, resp. Fe-L) or in combination
      (Mg-L/Fe-L) on 16 female and 8 male adult fertile Sprague-Dawley rats. The
      animals were offered a basal diet containing 30 per cent and 17 per cent of the
      rat's requirement for magnesium and iron, respectively, starting 21 days before
      mating (2:1) until 49 days after mating. Offspring were also kept on this regimen
      during a 3-week lactation period and 7 days post weaning. Drinking water was
      either enriched with 101 ppm Fe2+ (ferrous gluconate): Mg-L, or 365 ppm magnesium
      (magnesium-L-aspartate hydrochloride trihydrate, MAH): Fe-L, or with any: Mg-L/Fe
      L or with both electrolytes: Controls. Fertility remained unaffected under these
      conditions. Clinically, Fe-L induced iron deficiency and growth retardation of
      offspring. Pronounced reproductive toxicity was elicited by Mg-L and was even
      potentiated by Mg-L/Fe-L. In the parental generation, too, adverse effects of Mg
      L were aggravated by Mg-L/Fe-L despite the fact that no iron accumulation
      occurred. Bioavailability of iron was not impaired by magnesium as MAH. With
      respect to human pregnancy magnesium supplementation has higher priority over
      iron supplements. To improve tolerance and compliance both minerals are suggested
      to be taken simultaneously.

PMID- 7786688
TI  - Parenteral magnesium sulphate restores regional contractile function in the post
      ischaemic canine myocardium.
AB  - The effects of parenteral magnesium sulphate (MS) on the regional contractile
      response of stunned myocardium was examined in 45 pentobarbital anaesthetized
      dogs. The hearts were instrumented to measure left ventricular pressure (LVP),
      coronary flow velocity (CFV), mean arterial blood pressure (MAP), and regional
      contractile function (percent segment shortening, %S; and end-diastolic segment
      length, EDL). Stunning was produced by a 10 min occlusion of the first descending
      branch of the left circumflex coronary artery. Immediately upon release of the
      occlusion, either magnesium sulphate or a dextrose vehicle (D5W, n = 15) was
      infused. Magnesium sulphate was given intravenously (IV-MS, 100 mg/kg, n = 15) or
      intracoronarily (IC-MS, 1.5 mg/kg, n = 15). Coronary occlusion was consistently
      associated with significant decreases in coronary flow velocity and %S in all
      groups. Following IV-MS, heart rate (HR) and mean arterial blood pressure
      decreased significantly from preocclusion values, whereas end-diastolic segment
      length tended to increase and left ventricular pressure remained constant. IC-MS
      did not produce any changes in heart rate, mean arterial blood pressure, end-
      diastolic segment length or left ventricular pressure. At the end of the
      magnesium sulphate infusion (IV or IC), and for the next 60 min, %S returned to
      or above pre-occlusion values (P < 0.05 vs. D5W). Dyskinesia and hypokinesia were
      abolished in the magnesium sulphate groups, but were still present in the D5W
      group at the end of the 60 min period (P < 0.05 vs. pre-occlusion). We conclude
      that parenteral magnesium sulphate significantly improves regional contractile
      function in the stunned myocardium. Data from the IC-MS group would suggest a
      direct myocardial effect, independent of changes in preload, afterload, heart
      rate or flow.

PMID- 7786689
TI  - A prospective randomized trial of intravenous magnesium versus intravenous
      propranolol in acute myocardial infarction.
AB  - A total of 266 patients entered into a study comparing the effect of intravenous
      magnesium and propranolol following acute myocardial infarction. Of these, 97
      were able to receive either drug and were therefore randomized into the magnesium
      (n = 51) or propranolol group (n = 46). 88 patients were unable to receive
      propranolol and formed a third group (NR) while a further 81 patients could not
      receive either drug and formed a fourth group (N). The study showed that
      intravenous magnesium was as effective in preventing potentially lethal
      arrhythmias as propranolol and could be given to some 70 per cent of such
      patients whereas propranolol could only be given to 36 per cent.

PMID- 7786690
TI  - Long-term follow-up after acute myocardial infarction in patients randomized to
      treatment with intravenous magnesium or intravenous propranolol in the acute
      phase.
AB  - Ninety-five patients with acute myocardial infarction were followed up for 6
      months to 3 years (mean 25.4 months) in a preliminary study to compare the
      effects of intravenous magnesium (49 patients) with that of intravenous
      propranolol (44 patients) given immediately after admission to the intensive care
      unit. There were four cardiac deaths in the propranolol group and no deaths in
      the magnesium group (P < 0.046) and 27 per cent of patients who received
      propranolol subsequently developed cardiac failure as opposed to 12 per cent of
      those who had received magnesium (P < 0.04). Intravenous magnesium given in the
      early stages of myocardial infarction reduces the subsequent cardiac death rate
      possibly by reducing infarct size.

PMID- 7786691
TI  - Nutritional magnesium supplementation does not change blood pressure nor serum or
      muscle potassium and magnesium in untreated hypertension. A double-blind
      crossover study.
AB  - The aim of this study was to evaluate if a nutritional dose of magnesium given
      orally changes the blood pressure in untreated hypertensive patients and if
      orally-given magnesium had any influence on serum and muscle magnesium and
      potassium. A randomized, double-blind crossover study design was followed with
      magnesium 15 mmol/day or placebo treatment for two months. Thirty-nine patients
      aged 20-59 years, were treated. Samples for magnesium and potassium in blood,
      muscle and urine were taken at entry time, after two months (crossover time) and
      after four months (end of study). Systolic and diastolic supine and standing
      blood pressures were measured at the same times. No significant change in blood
      pressure, serum or muscle concentrations of electrolytes were observed on
      magnesium treatment. Urine magnesium rose significantly on magnesium, and it
      decreased significantly on placebo. Therefore results suggest that 15 mmol
      magnesium/day, given to untreated mild-to-moderate hypertensives does not alter
      blood pressure nor the concentrations of magnesium and potassium in serum and
      muscle, in patients with normal magnesium turnover.

PMID- 7786692
TI  - Selenium and magnesium status in fibromyalgia.
AB  - Muscle pain has been associated with magnesium (Mg) and selenium (Se) deficiency:
      magnesium and selenium status were investigated in fibromyalgia (FM). Erythrocyte
      (E), leucocyte (L) and serum (S) magnesium, serum selenium and zinc, and vitamin
      B1, B2, A or E status were assessed in 22 patients with fibromyalgia and in 23
      age-matched healthy controls. LMg is significantly increased (P < 0.05) and EMg
      slightly decreased in fibromyalgia. These magnesium abnormalities are associated
      with previously-reported impairment of thiamin metabolism. Antioxidant status (as
      well as plasma malondialdehyde) is unchanged in fibromyalgia and serum selenium
      levels, slightly but not significantly correlated with serum magnesium, is
      normal.

PMID- 7786693
TI  - Magnesium status and parenteral magnesium sulphate therapy in acute aluminum
      phosphide intoxication.
AB  - The results of an open randomized study on magnesium status and parenteral
      magnesium sulphate therapy in acute aluminium phosphide intoxication are
      presented. The study was conducted on 105 patients divided into two group (I &
      II). Patients of Group I did not receive parenteral magnesium and acted as blank.
      Magnesium levels were monitored every 6 h for 24 h. Patients of group II received
      magnesium sulphate therapy. It was administered as 1.0 g (8.1 mEq or 4.05 mmol)
      magnesium sulphate dissolved in 100 ml of 5 per cent dextrose intravenously as a
      bolus dose followed by 1.0 g every hour for three successive hours, then 1.0 g
      every 6 h as a maintenance dose for the next 24 h as intravenous infusion in 5
      per cent dextrose. The total dose of magnesium sulphate infused was 30.0 mmol
      over a period of 24 h (initial dose), then 16.0 mmol (4.0 g) daily till final
      outcome or a maximum of five days. All the vital parameters were monitored. All
      the patients were followed till final outcome. The resuscitation methods used
      were the same in both groups. At the end of the study, mortality rates were
      calculated in both groups. Hypomagnesaemia was observed as the constant finding
      in patients of Group I. It was transient and reversed itself without MgSO4. The
      mortality rate was 52 per cent. On the other hand, magnesium levels rose
      immediately after parenteral MgSO4 administration in patients of group II and
      they remained persistently above normal during the observed period.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7786694
TI  - New concepts in the cardioprotective action of magnesium and taurine during the
      calcium paradox and ischaemia of the heart.
AB  - A rise in intracellular sodium during periods of exposure to calcium free media
      would seem to be the critical step that predisposes the mammalian heart to the
      damaging effects of the calcium paradox. The damage which is seen in both single
      cells and multicellular preparations, occurs on reperfusion with calcium
      containing media and results from calcium loading via the sodium/calcium
      exchanger where the rise in intracellular calcium provokes hypercontraction as
      well as activating hydrolytic enzymes. Because the rise in intracellular sodium
      is a critical step in inducing damage, manoeuvres which reduce this rise during
      calcium depletion are expected to protect the heart against the calcium paradox.
      Raising extracellular magnesium concentration is one such manoeuvre which by
      blocking the influx of sodium through the L-type calcium channels, reduces the
      rise in intracellular sodium during calcium depletion. The beta-amino acid
      taurine is another agent capable of opposing a rise in intracellular sodium.
      Taurine is present at high concentration in mammalian heart cells and is
      maintained against high concentration gradient. During calcium depletion, heart
      cells use this energy to efflux taurine and sodium via a taurine/sodium symport
      and therefore protect against the calcium paradox. A similar mechanism may also
      be used by the ischaemic heart to reduce the rise in intracellular sodium. In
      contrast to the changes seen during the calcium paradox the ischaemic heart shows
      a rise in intracellular magnesium concentration. This rise will have several and
      diverse cellular effects including the modulation of intracellular calcium
      mobilisation and of several membrane transporters. The potential significance of
      these effects remains to be evaluated. On the other hand elevated levels of
      extracellular magnesium may protect the ischaemic heart by reducing the influx of
      calcium by suppressing the L-type calcium channels and possibly the
      sodium/calcium exchanger. Finally evidence suggests that the rat heart may not be
      identical to that of other species in its response to the calcium paradox and to
      the protective role of intracellular taurine and extracellular magnesium. The
      reason for this species difference would seem to be due to different metabolic
      activity and the activity of the sodium, potassium-ATPase.

PMID- 7786695
TI  - Magnesium and therapeutics.
AB  - Two different types of therapy with magnesium are used: physiological oral
      magnesium supplementation which is totally atoxic since it palliates magnesium
      deficiencies by simply normalizing the magnesium intake and pharmacological
      magnesium therapy which may induce toxicity since it creates iatrogenic magnesium
      overload. Primary and secondary magnesium deficiencies constitute the sole
      indication of physiological oral magnesium therapy. It is therefore necessary to
      be well acquainted with the clinical and paraclinical pattern of magnesium
      deficit and to discriminate between magnesium deficiency due to an insufficient
      magnesium intake which only requires oral physiological supplementation and
      magnesium depletion related to a dysregulation of the control mechanisms of
      magnesium status which requires more or less specific regulation of its causal
      dysregulation. Physiological oral magnesium load constitutes the best tool for
      diagnosis of magnesium deficiency and the first step of its treatment.
      Physiological oral magnesium supplementation (5 mg/kg/day) is easy and can be
      carried out in the diet or with magnesium salts, with practically only one contra
      indication: overt renal failure. Specific and aspecific treatments of magnesium
      depletion are tricky using for example magnesium sparing diuretics,
      pharmacological doses of vitamin B6, physiological doses of vitamin D and of
      selenium. In order to use the pharmacological properties of induced therapeutic
      hypermagnesaemia, high oral doses of magnesium (> 10 mg/kg/day) are advisable for
      chronic indications and the parenteral route is suitable for acute indications.
      There are 3 types of indications: specific (for the treatment of some forms of
      magnesium deficit i.e. acute), pharmacological (i.e. without alterations of
      magnesium status) and mixed--pharmacological and aetiopathogenic--(for example
      complications of chronic alcoholism). Today pharmacological magnesium therapy
      mainly concerns the obstetrical, cardiological and anaesthesiological fields. The
      main indications are eclampsia, some dysrhythmias (torsades de pointe
      particularly) and myocardial ischaemias. But it is now difficult to situate the
      exact place of the pharmacological indications of magnesium. Magnesium infusions
      can only be envisaged in intensive care units with careful monitoring of pulse,
      arterial pressure, deep tendon reflexes, hourly diuresis, electrocardiogram and
      respiratory recordings. High oral magnesium doses besides their laxative action
      may bring latent complications which may reduce lifespan. There may remain some
      indications of the laxative and antacid properties of non soluble magnesium,
      particularly during intermittent haemodialysis. Lastly local use of the
      mucocutaneous and cytoprotective properties of magnesium is still valid, in
      cardioplegic solutions and for preservation of transplants particularly.

PMID- 7786696
TI  - Primary mitral valve prolapse: a clinical form of primary magnesium deficit.

PMID- 7786697
TI  - Early intravenous magnesium administration in acute myocardial infarction.

PMID- 7786698
TI  - Preliminary evaluation of a technique for inhibiting intimal hyperplasia:
      implantation of a resorbable luminal collagen membrane.
AB  - Pharmacologic control of intimal hyperplasia has been attempted through oral and
      intravenous administration of smooth muscle cell inhibitors. We report a more
      direct method of altering arterial healing using a novel bioresorbable membrane
      that can be applied to the lumen of an artery or anastomosis following
      endarterectomy or vascular reconstruction. Following a standard balloon injury,
      the infrarenal aortas of 3 kg female New Zealand white rabbits were opened and a
      thin membrane composed of collagen/chondroitin 6-sulfate copolymer was sutured to
      the posterior wall of each artery. Animals were killed at intervals of up to 3
      months. All arteries remained patent. By 24 hours the membrane had become
      infiltrated with fibrin and red blood cells. An inflammatory response ensued and
      by 8 days the membrane was filled with mononuclear cells. At 3 months only a
      small remnant of the membrane remained. Intimal hyperplasia developed throughout
      the injured aorta. However, the hyperplastic response beneath the membrane was no
      greater than that observed in the adjacent injured aorta. A bioresorbable
      membrane can be sutured into the lumen of a small-diameter vessel without
      inducing thrombosis and without locally increasing intimal hyperplasia. A
      prosthesis of this type might be used to deliver inhibitors of smooth muscle cell
      proliferation and migration to the injured arterial wall.

PMID- 7786699
TI  - The effect of aging on the transarterial wall oxygen gradient.
AB  - Atherosclerosis is associated with aging based on numerous epidemiologic studies,
      whereas arterial wall hypoxia has been associated with other risk factors for
      atherosclerosis. We studied the effect of age on the transarterial wall oxygen
      gradient in the rat using an oxygen microelectrode. A decrease in oxygen tension
      in the outer 35% of the artery wall was noted in 36- to 40-week-old rats when
      compared to 3- to 4-week-old rats. These findings were noted despite no
      difference in arterial blood oxygen tension between the two groups and prior to
      any histologic evidence of atherosclerotic lesion formation. Our observations
      suggest that aging decreases the delivery of oxygen to the outer artery wall.

PMID- 7786701
TI  - Characteristics of patients at risk for perioperative myocardial infarction after
      infrainguinal bypass surgery: an exploratory study.
AB  - Patients requiring infrainguinal bypass surgery often have diffuse
      atherosclerotic disease, and perioperative myocardial infarction (MI) is a
      potentially lethal complication that is not uncommon in these patients. To
      establish additional clinical characteristics that might be useful in identifying
      patients who require more extensive cardiac evaluation, we conducted an
      exploratory case-control study comparing 22 patients who had a perioperative MI
      following elective infrainguinal bypass surgery with 191 control subjects whose
      bypasses were uneventful. In addition to previously recognized risk factors
      (e.g., history of angina or prior MI), we examined the association of
      perioperative MI with (1) results of common preoperative laboratory tests and
      ECG, (2) preoperative use of certain medications, and (3) intraoperative factors
      that might be anticipated prior to surgery (e.g., duration of surgery or type of
      anesthesia). Perioperative MI was associated not only with a history of angina,
      prior MI, or coronary artery disease but also with the need for certain cardiac
      medications, higher white blood cell (WBC) counts, ST-segment depression, left
      bundle branch block, and lengthy surgical procedures. Multiple logistic
      regression analysis identified the following factors as being independently
      associated with perioperative MI: preoperative antiarrhythmic agents (odds ratio
      [OR] = 26.4, p = 0.006), nitrates (OR = 8.4, p = 0.006), calcium channel blockers
      (OR = 5.5, p = 0.04), and aspirin (OR = 6.8, p < 0.01) and ST-segment depression
      (OR = 11.8, p = 0.01), WBC count (OR = 1.27/1000, p = 0.005), and duration of
      surgery (OR = 2.2/hr, p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786700
TI  - Early inflammatory response to gelatin- and collagen-sealed Dacron prostheses.
AB  - The immediate inflammatory response following aortic reconstruction with two
      types of sealed Dacron grafts was studied in a prospective, randomized manner. C
      reactive protein (CRP) levels were measured before surgery and on days 2 and 8
      postoperatively. In the collagen-sealed group (n = 10) CRP levels were 10 +/-
      9.6, 180.2 +/- 48.3, and 54.3 +/- 34.3 mg/L, respectively. In the gelatin
      impregnated group (n = 10) the values were 10.5 +/- 8.7, 200.7 +/- 27.3, and 80.3
      +/- 30.2 mg/L, respectively. The slight differences were not significant
      according to the analysis of variance test for repeated measurements. These
      findings suggest that implantation of a knitted Dacron graft sealed with collagen
      does not lead to a higher inflammatory reaction compared with a gelatin-sealed
      graft.

PMID- 7786703
TI  - Is infrapopliteal bypass compromised by distal origin of the proximal
      anastomosis?
AB  - Distal origination of the proximal anastomosis (DOPA) of an infrapopliteal bypass
      beyond the adductor hiatus minimizes the length of graft required and optimizes
      use of scarce autogenous conduit. Sixty-two DOPA infrapopliteal
      revascularizations using autogenous vein performed for limb salvage over a 7-year
      period were reviewed and compared with 203 concurrent infrapopliteal bypasses
      originating more proximally (POPA). Life-table analysis revealed no difference at
      54 months between DOPA and POPA bypass with regard to primary patency (57% vs.
      50%, respectively) or secondary patency (67% vs. 65%, respectively). Differences
      in limb salvage at 54 months between DOPA and POPA bypasses did not reach
      statistical significance (53% vs. 66%, p = 0.12), although DOPA fared worse.
      Inferior limb salvage results in all infrapopliteal bypasses were correlated with
      the presence of tissue necrosis (52% vs. 70%, p < 0.001), which was more
      prevalent in patients undergoing DOPA bypass (71% vs. 49%, p < 0.01). The long
      term patency of infrapopliteal bypass appears only marginally affected by DOPA.
      However, the prognosis for limb salvage in this setting is compromised as a
      result of the virulent behavior of the atherosclerotic disease that spares the
      superficial femoral artery while predominantly involving the popliteal and tibial
      vessels.

PMID- 7786704
TI  - Intraoperative fibrinolytic therapy for salvage of limbs with acute arterial
      ischemia: an adjunct to thromboembolectomy.
AB  - The purpose of this prospective study was to determine the value of
      intraoperative intra-arterial fibrinolytic therapy (IIFT) in patients with acute
      arterial ischemia as an adjunct to mechanical thromboembolectomy. Sixty-six
      femoropopliteal or distal acute arterial occlusions were assessed by means of
      arteriography and Doppler imaging pre- and postoperatively. Two groups of
      patients were compared: one (n = 35) in which mechanical thromboembolectomy was
      applied as the single technique and another (n = 31) in which 250,000 IU of
      urokinase diluted in 250 ml of normal saline solution was instilled at the end of
      mechanical thromboembolectomy over a 30-minute period with the arterial inflow
      occluded. Candidates for IIFT were selected according to a nonrandomized method.
      Intraoperative arteriography showed residual thrombus in 20 (30.3%) patients and
      unsuspected arterial lesions in 23 (34.8%). Thrombosis recurrence was associated
      with residual thrombus (p < 0.001) and amputation (p < 0.001). The ankle/brachial
      index increased significantly (p < 0.05) in the patients who received IIFT (0.88
      +/- 0.03) in comparison with those who underwent mechanical thromboembolectomy
      (0.75 +/- 0.05). Although the percentages of distal revascularization and
      amputation did not differ significantly between the two groups, quantitatively
      the results were better in the IIFT group (80.65% success and 9.68% failure)
      compared to the mechanical thromboembolectomy group (60% success and 22.86%
      failure). There was no bleeding due to IIFT. Significant variables in our study
      were diabetes (p < 0.05), the time period of 12 to 24 hours before the surgery (p
      < 0.05), and the severity of the ischemia in association with rest pain (p <
      0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786702
TI  - Hemodynamics of stenotic infrainguinal vein grafts: theoretic considerations.
AB  - We developed a theoretic model of arterial stenosis to study the relationship
      between perfusion pressure and regional hemodynamics in stenotic infrainguinal
      vein grafts in an attempt to identify grafts at high risk for failure. Our model
      was based on the concept of energy and mass conservation of the flowing blood. We
      used the modified Bernoulli equation (delta P = 4 delta V2) to calculate the
      maximum possible intrastenotic peak systolic velocity (PSV) from the systolic
      blood pressure. PSV was measured by means of duplex ultrasonography in
      infrainguinal bypasses up to the time of revision (nine grafts) or spontaneous
      thrombosis (two grafts). We related arm systolic blood pressure, intrastenotic
      PSV, and prestenotic PSV obtained from duplex examinations conducted prior to
      graft thrombosis or revision and applied our model to these stenotic vein grafts.
      Intrastenotic PSV was consistently lower than maximum PSV predicted from the
      Bernoulli equation. The highest measured intrastenotic PSV of 600 cm/sec would
      require a minimum perfusion pressure of 144 mm Hg. The lowest measured PSV (20
      cm/sec) was considered the minimum "thrombotic threshold velocity." This model
      predicts that for parabolic profile flow in an 80% diameter-reducing axisymmetric
      stenosis (96% cross-sectional area reduction), a prestenotic PSV of 20 cm/sec
      would produce an intrastenotic PSV of 500 cm/sec requiring the equivalent
      potential energy of 100 mm Hg systolic blood pressure. Our theory implies that in
      patients with nocturnal hypotension thrombosis of stenotic vein grafts may occur.

PMID- 7786705
TI  - Infrapopliteal polytetrafluoroethylene and composite bypass: factors influencing
      patency.
AB  - Between January 1, 1979, and December 31, 1988, 149 infrapopliteal
      polytetrafluoroethylene (PTFE) bypasses were performed in 145 patients with
      chronic, critical, limb-threatening ischemia. These operations represented 27.9%
      of 534 infrapopliteal bypasses performed during the same period. There were 92
      males and 53 females. Mean age was 71.8 +/- 12.3 years. Signs and symptoms of
      critical ischemia were gangrene, ulceration, and isolated rest pain in 101 (69%),
      23 (15.3%), and 25 (16.7%) cases, respectively. A composite (PTFE-saphenous vein)
      graft was used in 53 (35%) cases. In 96 prosthetic bypasses the distal
      anastomosis was performed using vein patch angioplasty in 65 (44%) cases and
      directly in 31 (21%). The in-hospital mortality rate was 3.3%. Patency, limb
      salvage, and patient survival rates were plotted according to the actuarial
      method and the curves obtained were compared using the log-rank test. Actuarial
      survival rates were 68% +/- 5% and 57% +/- 7% at 3 and 5 years, respectively.
      Primary patency and lower limb salvage rates were 41% +/- 5% and 68% +/- 6% at 3
      years and 35% +/- 9% and 65% +/- 10% at 5 years, respectively. There was no
      statistically significant difference noted in primary patency rates at 3 years
      according to the type of bypass (composite or all-prosthetic: 36% vs. 44%), the
      type of distal anastomosis (direct or vein patch angioplasty: 43% vs. 45%), the
      site of distal anastomosis (upper or lower half of the leg: 38% vs. 46%), lateral
      or medial placement of the bypass (39% vs. 43%), or according to whether or not
      it was a repeat operation (40% vs. 44%). In conclusion, patency rates using
      infrapopliteal PTFE bypasses are low. Certain technical approaches, although they
      do not seem to improve patency, definitely increase the feasibility of bypass and
      in our opinion decrease the risk of early failure in unfavorable anatomic
      settings. The limb salvage rates following infrapopliteal PTFE and composite
      bypass are encouraging and justify the use of routine distal revascularization,
      even in the absence of autogenous vein graft.

PMID- 7786706
TI  - Tumor embolism after pneumonectomy for primary pulmonary neoplasia.
AB  - We report a case of tumor embolism of the lower right extremity after right
      pneumonectomy. This is an infrequent complication and in most cases occurs during
      the intraoperative or immediate postoperative period. Our patient underwent
      surgery for primary pulmonary neoplasia (squamous cell carcinoma) and 4 hours
      later showed clinical signs of acute arterial occlusion in the lower right
      extremity. An emergency embolectomy was performed and a thrombus with tumor
      characteristics was extracted from the right common femoral artery. The
      pathologic features of this thrombus were identical to those of the pulmonary
      tumor.

PMID- 7786707
TI  - Symptomatic subclavian steal syndrome four decades after operation for dysphagia
      lusoria.
AB  - Congenital abnormalities of the aortic arch may lead to signs and symptoms of
      tracheal and esophageal obstruction secondary to a restrictive vascular ring.
      There are many case reports and monographs concerning the surgical management of
      dysphagia lusoria. This case provides the first example of long-term follow-up of
      surgical intervention for relief of dysphagia lusoria. A 45-year-old laborer
      presented with a several year history of episodic bilateral blindness and a more
      recent onset of "drop attacks." Notably this patient had presented at the age of
      18 months with difficulty breathing and eating since birth. The patient also had
      frequent upper respiratory infections and episodes of pneumonia. Workup revealed
      a right-sided aortic arch with a left ligamentum arteriosum. When he was first
      seen in our clinic, history and physical examination revealed claudication and
      diminished pulses in the left upper extremity. Arteriography and duplex studies
      confirmed reversal of flow in the patient's left vertebral artery. The
      arteriogram demonstrated the presence of a right-sided aortic arch and descending
      aorta along with the proximal stump of the previously ligated left subclavian
      artery. He underwent left carotid to left axillary artery bypass for the
      treatment of symptomatic subclavian steal syndrome. His symptoms have resolved
      with return of antegrade vertebral flow and the presence of normal pulses in the
      left arm. Congenital aortic abnormalities that lead to tracheal and esophageal
      compromise are numerous and varied. Surgical management requires a thorough
      understanding of the person's anatomy and preoperative planning. The life
      expectancy of patients with dysphagia lusoria necessitates consideration of the
      long-term consequences of surgical intervention.

PMID- 7786709
TI  - Primary subclavian-axillary vein thrombosis.

PMID- 7786708
TI  - Transperitoneal medial visceral rotation.

PMID- 7786711
TI  - Meningococcal meningitis.

PMID- 7786710
TI  - Expanded programme on immunization. Progress towards poliomyelitis eradication,
      1994.

PMID- 7786712
TI  - Yellow fever. Investigation of an epidemic in Imo State.

PMID- 7786713
TI  - Expanded programme on immunization. Measles elimination by the year 2000 in the
      Americas.

PMID- 7786714
TI  - Dracunculiasis. Global surveillance summary, 1994.

PMID- 7786715
TI  - Expanded programme on immunization. Diphtheria epidemic in the Newly Independent
      States of the former USSR, 1990-1994.

PMID- 7786716
TI  - Surveillance of measles following a national mass immunization campaign.

PMID- 7786717
TI  - Streptococcal infections.

PMID- 7786718
TI  - Ebola haemorrhagic fever.

PMID- 7786719
TI  - British Oncological Association and British Association of Surgical Oncology
      joint meeting. 9-11 July 1995. Abstracts.

PMID- 7786720
TI  - Compulsory HIV testing firmly rejected by official inquiry.

PMID- 7786722
TI  - Chiropody services: a feat for nursing?

PMID- 7786723
TI  - Long-term catheter use in the community.
AB  - This article discusses the advantages and disadvantages of long-term urinary
      catheters and explores patients' attitudes to catheterisation. The author argues
      that, with careful selection of equipment, long-term catheterisation can be
      acceptable to patients and a useful method of management for people whose lives
      are severely restricted by incontinence.

PMID- 7786724
TI  - Learning theories made easy: humanism.
AB  - This is the last of three articles explaining theories of learning with
      particular relevance to clinical areas. In the story so far, the Director of
      Nursing Education at the St Elsewhere Academy of Nursing is trying to create the
      ultimate programme of nursing education. In order to ensure that the very highest
      standards of teaching and learning are achieved, the DNE has decided to employ a
      theorist of learning. She first interviewed the candidate representing the school
      of behaviourism, and last week the cognitivist candidate made his presentation.
      The series now concludes with the humanist candidate--and the final decision.

PMID- 7786721
TI  - Bovine spongiform encephalopathy: something to beef about?

PMID- 7786725
TI  - Traumatic stress: a nurse therapist role?
AB  - The study of people who experience post-traumatic stress disorder (PTSD) is still
      in its infancy. Yet it is already clear that victims of more common traumatic
      events are as much at risk of suffering short- and long-term psychological
      consequences as the victims of major disasters. Nurse therapists and specialists
      clinics could have a key role in working with people experiencing PTSD and in
      educating others about the problems.

PMID- 7786726
TI  - Nurses' attire in a special hospital: perceptions of patients and staff.
AB  - Nurses' uniforms have been the subject of ongoing debate in many areas. Following
      the Ashworth Hospital inquiry, two wards at the hospital piloted the wearing of
      casual clothes by nurses. Patients and nurses in these wards completed
      questionnaires to evaluate the effects of the change. The results showed that the
      patients felt casual clothes helped remove a 'them and us' distinction and
      enhanced nurse/patient relationships. Nurses found casual clothes to be more
      comfortable and practical. Although concern was expressed that, without uniform,
      nurses might not be readily identifiable in an emergency situation, the change to
      casual clothing was generally viewed positively by both patients and nurses.

PMID- 7786727
TI  - Tissue viability. What causes pressure sores?

PMID- 7786728
TI  - Tissue viability. Home nursing equipment needs.

PMID- 7786729
TI  - All a misunderstanding. Interview by Dina Leifer.

PMID- 7786730
TI  - What the public says.

PMID- 7786731
TI  - One nurse's war.

PMID- 7786733
TI  - Child health: modules for the 90s.

PMID- 7786734
TI  - Using care plans to replace the handover.
AB  - This article describes the attempts of an NDU to make better use of written
      nursing care plans. It had been found that care plans were used more as
      historical records than as they were intended--to direct and plan care. The
      author outlines how staff identified the problem and then used primary nursing to
      enable the care plan to replace the oral handover.

PMID- 7786732
TI  - Mental health: a forum for support.

PMID- 7786735
TI  - Identifying the coping behaviours used by nurses in intensive care.
AB  - This study examines the use and perceived effectiveness among nurses of five
      coping styles: problem-focused coping, positive appraisal, help seeking,
      avoidance and aggression. Subjects were asked how they would cope with a conflict
      between themselves and a physician in the ward. The relationship between the
      coping behaviour and subjects' professional characteristics was explored. The
      subjects were 128 intensive cardiac care unit (ICCU) nurses. The results indicate
      that more experienced nurses use coping strategies less and may experience more
      burnout. The study also shows that nurses who participate in professional extra
      curricular activities tend to choose more effective coping strategies.

PMID- 7786736
TI  - Pain management: a review of the uses of epidural analgesia.
AB  - Epidural analgesia can be a valuable method of pain control in a variety of
      situations. It can facilitate early mobilisation and enhance recovery from
      surgery. This article describes the physiology of epidural pain relief and the
      nurse's role in monitoring patients effectively, recognising complications and
      minimising risk.

PMID- 7786738
TI  - One minute wisdom. Changes in nursing are not always good.

PMID- 7786737
TI  - Menorrhagia: care and treatment.
AB  - Approximately one tenth of women in this country experience menorrhagia. This can
      cause considerable discomfort, distress and curtailment of lifestyle.
      Hysterectomy is a common treatment, but morbidity and convalescence can be
      prolonged. Alternative surgical and pharmacological treatments are currently
      being developed which, it is hoped, will be available in the future. In the
      meantime, nurses have an important role to play in investigating, diagnosing and
      treating menorrhagia, and in supporting the women who experience it.

PMID- 7786739
TI  - Sister Susie. New horizons for pioneer New Nurse.

PMID- 7786740
TI  - Media: Messages from the frontline.

PMID- 7786741
TI  - Debate: a help or ... a hindrance.

PMID- 7786743
TI  - Positive action on equal opportunities.

PMID- 7786742
TI  - The really useful guide to portfolios and profiles (continuing education credit).
AB  - It is generally accepted that there is value in developing personal professional
      portfolios within nursing. This assumption is based on its inclusion as one of
      the main features of the UKCC's Standards for Education and Practice Following
      Registration (1): the requirement that all practitioners should maintain a
      personal professional profile. The fundamental purpose of the personal
      professional profiel is to 'provide a means for showing that nurses, midwives and
      health visitors have maintained and developed their professional knowledge and
      competence' (1). However, there is the potential to achieve much more than this
      rudimentary outcome. This Unit is relevant to UKCC Professional Development
      category Educational Development.

PMID- 7786745
TI  - Patient-controlled analgesia (continuing education credit).

PMID- 7786746
TI  - Consent to surgery: the role of the nurse.
AB  - In the first of two articles relating to consent issues, the author examines the
      role of the nurse in helping patients to have a more equal relationship with
      doctors when they sign a consent form. It is based on sociological research
      studies of consent to surgery (1-3). Next week, the author will look at issues
      relating to consent to research.

PMID- 7786744
TI  - Using benchmarking to improve practice.
AB  - Benchmarking is a relatively new addition to NHS quality initiatives. This
      article describes how a group of paediatric nurses set up a project to introduce
      benchmarking across units in the north west of England, and explores the benefits
      and disadvantages of this approach for nursing in general.

PMID- 7786747
TI  - NDUs: cut flowers.

PMID- 7786748
TI  - A day in the life....

PMID- 7786749
TI  - Cardiology update. Thoracic aortic dissection.

PMID- 7786750
TI  - Cardiology update. Electrolytes in cardiac patients.

PMID- 7786751
TI  - Cardiology update. Central venous pressure.

PMID- 7786752
TI  - Cardiology update. Pulse oximetry.

PMID- 7786753
TI  - Concern over HIV testing.

PMID- 7786760
TI  - Viruria during acute Japanese encephalitis virus infection.
AB  - In this study, viruria following Japanese encephalitis virus (JEV) infection in
      mice has been shown to appear earlier in pregnant than in normal mice with
      proteinuria and haematuria. This was related to the production of splenic
      macrophage derived neutrophil chemotactic factor (MDF) following JEV infection.
      Intravenous inoculation of MDF in mice resulted in leakage of cells, proteins and
      erythrocytes in the urine as a result of altered capillary permeability. The
      isolation of virus from kidney did not correlate with the shedding of virus in
      the urine. The histological examination of sections of kidneys showed no
      morphological damage; however, ultrastructural degenerative changes in the
      mesangial cells were observed following JEV infection. These data suggest that
      JEV-induced macrophage derived factor regulates the leakage of proteins,
      erythrocytes and cells into the urine.

PMID- 7786761
TI  - Studies on early events of Borrelia burgdorferi-induced cytokine production in
      immunodeficient SCID mice by using a tissue chamber model for acute inflammation.
AB  - Lyme arthritis, one of the common features of Borrelia burgdorferi infection in
      the human, is associated with the production of various monocyte derived
      cytokines. To investigate the expression and regulation of cytokines during the
      acute phase of spirochete induced inflammation, a perforated Teflon chamber was
      implanted under the dorsal skin of severe combined immunodeficiency (SCID) and
      immunocompetent co-isogenic C.B-17 mice. The histology of the surrounding chamber
      tissue exhibited sterile inflammation with several features reminiscent of an
      inflamed synovium, i.e. infiltration of polymorphonuclear and mononuclear cells,
      fibroblast-like cells and neovascularization. The experimental inoculation of
      Borrelia burgdorferi into the chamber resulted in the production of TNF-alpha, IL
      1 and IL-6 into the chamber exudate, in both the immunodeficient, disease
      susceptible SCID and the immunocompetent, disease resistant C.B-17 mice. Peak
      levels of TNF-alpha were reached at 2 hours and of IL-1 and IL-6 at 6 hours after
      infection; by 24 hours, cytokine levels were only marginal (IL-1, IL-6) or non
      detectable (TNF-alpha). Experimental infection by s.c. injection distant from the
      tissue chamber led to colonization of the spirochetes into the chamber,
      suggesting a tropism of the bacteria for this tissue. Thus, this model provides a
      system for studying acute events of Borellia burgdorferi induced cytokine
      regulation in a complex cellular, synovium-like environment that the bacterium
      encounters in vivo.

PMID- 7786763
TI  - Site of localization of Mycoplasma pulmonis and Mycoplasma hominis in the genital
      tract of female mice demonstrated by culture and scanning and immuno-electron
      microscopy.
AB  - Thirty young adult mice, of strain BALB/c, treated previously with progesterone,
      were inoculated intravaginally (10 mice) or directly into the uterus (10 mice)
      with Mycoplasma pulmonis and 10 mice remained uninoculated. Ten mice not treated
      with the hormone were also inoculated intrauterinely with M. pulmonis. The same
      numbers of mice treated with oestradiol were inoculated in the same ways with M.
      hominis. Vaginal swab specimens were obtained from all mice 7, 14 and 28 days
      after inoculation and samples of genital tract tissue were collected from pairs
      of mice at the same time intervals. Large numbers of M. pulmonis and M. hominis
      organisms were isolated from the vagina throughout the course of the experiments
      and they were cultured also from the cervix and uterine horns. Mycoplasma-like
      bodies were demonstrated by scanning electron microscopy in the cervix and in the
      uterus, but neither mycoplasmal species was found attached to vaginal epithelium.
      The results of silver-enhanced immunogold labelling in conjunction with scanning
      microscopy provided assurance that the mycoplasma-like bodies were, in fact,
      mycoplasmas. The importance of hormone treatment was indicated by the diminished
      susceptibility of untreated mice to M. pulmonis and the almost complete
      insusceptibility to M. hominis, shown by culture and scanning electron
      microscopy.

PMID- 7786762
TI  - Sexually differentiated response to choline in choline deficiency and ethionine
      intoxication.
AB  - A sex difference exists in the response of rats to a choline deficient diet and
      to ethionine intoxication. Female rats are less susceptible than males to the
      acute effects of choline deficiency, such as fatty liver and impaired secretion
      of triglycerides into blood plasma, while they are more susceptible to inhibition
      of liver protein synthesis and triglyceride accumulation by ethionine. These
      differences have been ascribed to sex differences in the biosynthesis of
      phosphatidylcholine in the liver of rats. The available data indicate that
      females are more dependent than males on the stepwise methylation of
      phosphatidylethanolamine rather than the direct incorporation of preformed
      choline. Continuous prefeeding with choline for three weeks was able to shift the
      female pattern of response to choline deficiency and ethionine intoxication
      towards that observed in males; thus, choline caused accumulation of hepatic
      triglycerides and a decrease in plasma triglycerides after choline deficiency,
      while it protected against ethionine induced triglyceride accumulation and
      protein synthesis inhibition in the liver. These results suggest that choline
      prefeeding in females makes them more dependent on choline availability and,
      thus, more susceptible to a choline deficient diet and less sensitive to
      ethionine intoxication, as are males. No effect of choline was observed in either
      choline deficient or ethionine intoxicated male rats.

PMID- 7786764
TI  - Pulmonary capillaries are smaller in the centre than in the periphery of the
      guinea-pig lung lobule: possible contributory mechanism for the centrilobular
      location of emphysema?
AB  - We used scanning electron microscopic morphometry of microvascular corrosion
      casts to compare the capillary structure in the centre and periphery of the lung
      lobule in the guinea-pig. Capillaries in the centre of the lobule had a lesser
      diameter than in the periphery (8.6 +/- 1.6 vs 10.4 +/- 1.9 microns respectively,
      P < 0.001). The polygonal capillary rings differed in structure between the
      centre and periphery of the lobule, although the number of branches remained
      constant. Capillary density in the centre of the lung (0.71 +/- 0.05) was
      significantly less than in its periphery (0.78 +/- 0.06, P < 0.001). We conclude
      that the capillary structure of the centre of the lung lobule is markedly
      different from that seen in the periphery. The smaller capillary diameter seen in
      the centre might be important in trapping polymorphonuclear leucocytes that lose
      the ability to deform after contact with cigarette smoke components; such an
      effect could explain why cigarette smoke induced emphysema tends to involve the
      centre of the lung lobule.

PMID- 7786766
TI  - Anti-glomerular basement membrane glomerulonephritis in the mouse: the role of
      macrophages.
AB  - An immunohistochemical study was undertaken on fixed, paraffin-embedded mouse
      kidney in order to elucidate the role and significance of infiltrating
      macrophages in a mouse model of anti-glomerular basement membrane
      glomerulonephritis (anti-GBM GN). Tissue was available representing the full
      gamut of histological features seen in this model. The mouse macrophage-specific
      antigen F4/80 was detected in tissue sections of glomerulonephritic kidney and
      the pattern and extent of staining was compared with normal mouse kidney. In
      glomerulonephritic kidney, an increase in the number of F4/80-positive cells was
      evident in close proximity to and surrounding Bowman's capsule of those glomeruli
      which were severely damaged, with extensive fibrin deposition and well developed
      cellular crescents. F4/80-positive cells did not feature in the glomerular tuft
      or in the region of the parietal epithelium of Bowman's capsule even when
      extensive cellular crescents were present. Breaks in Bowman's capsule were not
      demonstrated. We conclude that F4/80-positive macrophages are not a major
      constitutive cell type of developing crescents in this mouse model of anti-GBM GN
      but, by virtue of their peri-glomerular localization, may be involved in the
      destructive process, perhaps producing signalling molecules which contribute to
      the inflammatory reaction.

PMID- 7786765
TI  - Mycobacterial granulomatous inflammation in the ulcerated caecum of indomethacin
      treated rats.
AB  - We report mycobacterial granulomatous inflammation in the ulcerated caecum of
      rats that received indomethacin. Two groups of male rats were treated with
      dietary indomethacin 3 mg/kg/day or untreated diet for 3 weeks. Six out of 8
      indomethacin treated rats showed both ulceration and inflammation of the caecal
      mucosa. Two of the rats showing caecal ulceration also showed distinct
      granulomatous inflammation of the caecal mucosa and acid-fast bacilli were
      identified within granulomata. None of the other indomethacin treated or control
      rats contained acid-fast bacilli within caecal tissue sections but they were
      present, in the same sections, within the lumen of most rats in both groups.
      Polymerase chain reaction analysis identified the mycobacterial 65 kDa GroEL gene
      within control and granulomatous caecal tissue. In a repeat of indomethacin
      administration to a third group of rats, culture of both non-granulomatous caecal
      tissue (containing histologically identified luminal acid-fast bacilli) and
      faecal samples for mycobacteria was negative.

PMID- 7786767
TI  - Increased Na+,K(+)-pump activity in erythrocytes of rabbits fed cholesterol.
AB  - Na+,L(+)-pump activity, intracellular sodium, potassium and magnesium
      concentrations and membrane cholesterol content were studied in erythrocytes of
      rabbits fed cholesterol. The average activity of the Na+,K(+)-pump in
      erythrocytes of rabbits with high plasma cholesterol was twice that in
      erythrocytes of control animals. Analysis showed a positive correlation between
      the pump activity and plasma cholesterol. The sodium content in erythrocytes
      correlated negatively with plasma cholesterol, as well as with the Na+,K(+)-pump
      activity. No significant differences in potassium and magnesium concentrations or
      in the membrane cholesterol content were observed between the two groups. The
      results indicate that modulation of the pump activity by cholesterol is not
      necessarily mediated by changes in the membrane viscosity.

PMID- 7786769
TI  - Low molecular weight heparin(s).

PMID- 7786768
TI  - Differential decline of rabbit chondrocytic dehydrogenases with age.
AB  - We have previously found that the restoration of cartilage matrical proteoglycans
      is preceded by markedly increased activity of uridine diphosphoglucose
      dehydrogenase (UDPGD), an enzyme directly associated with glycosaminoglycan (GAG)
      synthesis, and by increased activity of enzymes of the major energy yielding
      pathways (glucose-6-phosphate dehydrogenase (G6PD), glyceraldehyde-3-phosphate
      dehydrogenase (GAPD) and succinate dehydrogenase (SDH)). We did not find an
      increase in lactate dehydrogenase (LDH). In the present longitudinal study of
      rabbits (from 5 weeks to 42 months of age), we looked for age related changes in
      the activity of these enzymes in auricular chondrocytes, as well as for collagen
      and GAG content. Collagen content (micrograms/wet weight) increased up to 12
      months and remained stable; total GAG content (micrograms/wet weight) reached its
      maximal value at growth and then declined gradually, reducing the GAG/collagen
      ratio dramatically from 36 to 8. At any age LDH was two to three times more
      active than either G6PD, aldolase, or GAPD. SDH and UDPGD activities were even
      lower. The age related changes varied: (1) LDH and GAPD were stable and did not
      change with either growing or aging; (2) G6PD and aldolase reached their maximal
      activity at 3-9 months, followed by a sharp drop at 12 months. G6PD remained
      stable, while aldolase continued to decline, although more slowly; (3) Maximal
      activity of SDH and UDPGD was measured at 5 weeks. Thus, the changes in enzyme
      activity in chondrocytes with age were specific for each enzyme. The significant
      decline in G6PD, aldolase, the rate-limiting enzymes of the pentose shunt and
      classic glycolysis, and SDH markedly reduced the ability of chondrocytes to
      generate energy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786770
TI  - Clinical significance of serum thymidine kinase in adult T-cell leukaemia and
      acute myeloid leukaemia.
AB  - To clarify the clinical and biological significance of serum thymidine kinase
      (TK) in adult T-cell leukaemia (ATL) associated with human lymphotropic virus
      type-I (HTLV-I) and in acute myeloid leukaemia (AML), TK was measured in 52
      patients with ATL (acute ATL, 35 patients; lymphoma ATL, two patients; chronic
      ATL, 12 patients; smouldering ATL, three patients), and in 27 patients with AML
      (one FAB MO, one M1, 10 M2, seven M3, five M4, one M5, one M6, one MU). In ATL
      patients, statistical analysis disclosed a close correlation between TK level and
      the leucocyte count (P < 0.01), and absolute number of abnormal lymphocytes (P <
      0.01). However, no correlation was observed between serum lactic dehydrogenase
      (LDH) level and these items. Concerning the therapeutic response, a statistical
      difference was present in TK between complete remission and no response (P <
      0.05), but not in LDH. We also investigated a significant inverse correlation
      between TK level as well as LDH level and the length of survival after the
      initial diagnosis (P < 0.01). In AML patients a close correlation of TK level
      with the count of leucocytes (P < 0.01), percentage of blasts in the blood (P <
      0.05), therapeutic response (P < 0.01) and the length of survival after the
      initial diagnosis (P < 0.05) was present. Therefore the TK level may indicate the
      aggressiveness of leukaemic cells and predict the response to the chemotherapy
      and the length of survival in ATL and AML.

PMID- 7786771
TI  - Prognostic implications of DNA aneuploidy in 156 untreated multiple myeloma
      patients. Castelano-Leones (Spain) Cooperative Group for the Study of Monoclonal
      Gammopathies.
AB  - In this study the incidence of DNA aneuploidy in a large series of untreated
      multiple myeloma (MM) patients was assessed in order to determine its clinical
      and prognostic significance. A total of 156 MM patients were included in the
      study. DNA measurements were performed in all cases at diagnosis using two
      different flow cytometry methods: (1) propidium iodide (PI) staining on isolated
      nuclei, and (2) CD38/PI double staining on whole cells. The DNA ploidy status was
      correlated with the most relevant clinical and haematological disease
      characteristics. From the 156 cases analysed, 91 (58%) were aneuploid (56%
      hyperdiploid and 2% hypodiploid). The correlation between the two techniques on
      the detection of DNA aneuploidy was excellent, although CD38/PI double staining
      would be preferable in cases with < 5% of DNA aneuploid plasma cells (PC). Upon
      comparing the clinical and haematological disease characteristics of hyperdiploid
      versus diploid cases, the former group was characterized by a lower age, reduced
      incidence of anaemia, lower beta 2M levels, higher proliferative activity within
      the residual normal haemopoietic cells, increased expression of CD56 antigen in
      PC, and higher proportion of PB CD4+ T cells. In contrast, diploid cases had a
      higher expression of the CD10, CD20 and CD15 antigens and greater numbers of PB
      CD56+CD3- NK cells (P < 0.05). Circulating PC were identified in six cases, all
      being diploid. Overall survival was significantly longer in hyperdiploid compared
      to diploid MM (P = 0.02). These results show that over 50% of MM patients are
      aneuploid, almost all of them being hyperdiploid. This characteristic is
      associated with better prognosis.

PMID- 7786772
TI  - Idiotypic oligonucleotide probes to detect myeloma cells by mRNA in situ
      hybridization.
AB  - An mRNA in situ hybridization (ISH) method which used non-radioactive idiotypic
      oligonucleotide probes has been used to detect malignant cells in the bone marrow
      and peripheral blood of patients with multiple myeloma. For each of two patients
      with multiple myeloma a pair of biotinylated antisense oligonucleotide probes (18
      22mer) was prepared from non-germline sequences of the rear-ranged immunoglobulin
      heavy chain (IgH) gene. These oligonucleotide sequences were not homologous with
      any previously published sequence. The probes from each patient were specific as
      shown by a failure to hybridize to any cells from six other myeloma patients and
      four normal individuals. Specific staining of IgH gene mRNA occurred only when
      the myeloma cells and the sequence of the probe used were from the same patient.
      Using simultaneous fluorescent immunocytochemistry it was shown that more than
      95% of the ISH-positive cells expressed the malignant light chain in their
      cytoplasm. ISH positive cells were found in 1-4% of the peripheral blood
      mononuclear fraction of these two patients. These studies show that idiotypic
      oligonucleotide IgH gene probes can be used to identify individual cells
      belonging to the malignant clone and offer the possibility of developing
      innovative tumour-specific therapeutic procedures using antisense technology for
      patients with myeloma.

PMID- 7786773
TI  - Der(16)t(1;16)(q11;q11) in myelodysplastic syndromes: a new non-random
      abnormality characterized by cytogenic and fluorescence in situ hybridization
      studies.
AB  - The der(16)t(1;16)(q11;q11) is a frequent recurrent rearrangement in solid
      tumours such as breast carcinomas and Ewings sarcomas. Recently, this abnormality
      was described also in multiple myeloma. We identified a der(16)t(1;16)(q11;q11)
      in three patients with myelodysplastic syndrome, either during preleukaemic phase
      (n = 2) or at the time of blastic transformation (n = 1). Breakpoints were
      ascertained by fluorescence in situ hybridization (FISH) using specific
      centromeric alpha-satellite probes and whole chromosome painting for chromosome 1
      and chromosome 16. These observations, combined with isolated cases of the
      literature, suggest that der(16)t(1;16)(q11; q11) is a nonrandom abnormality
      associated with myelodysplastic syndromes.

PMID- 7786774
TI  - Prognostic relevance of serum thymidine kinase in primary myelodysplastic
      syndromes: relationship to development of acute myeloid leukaemia.
AB  - The aim of this study was to evaluate the possible prognostic relevance of
      thymidine kinase serum levels (s-TK), an indirect marker of proliferative
      activity, in myelodysplastic syndromes (MDS). S-TK levels were monitored by means
      of a radioenzyme assay in 90 patients affected by MDS (22 refractory anaemia, RA;
      17 RA with ring sideroblasts, RARS; 21 RA with blast excess, RAEB; 15 RAEB in
      transformation, RAEB-T; 15 chronic myelomonocytic leukaemia, CMMoL). Mean s-TK
      levels (U/microliter) measured at diagnosis were 11.9 +/- 12.6 for RA, 11.4 +/-
      13.6 for RARS, 19.9 +/- 28.4 for RAEB, 39.6 +/- 34.3 for RAEB-T and 77.7 +/- 69.7
      for CMMoL (normal values < 5 U/microliter). With the only exception of a weak
      relationship with lactate dehydrogenase, no correlation was found between initial
      s-TK values and other clinical or laboratory parameters, such as age,
      haemoglobin, white blood cell or platelet count, percentage of bone marrow
      blasts. MDS patients with s-TK > 38 U/microliters, a cut-off level selected by
      means of ROC statistical analysis, showed a significantly shorter survival than
      those with s-TK < 38 U/microliter (8.2 v 37.4 months, respectively; P < 0.0001).
      In particular, transformation in acute myeloid leukaemia (AML) occurred in 17/21
      (81%) of patients with s-TK > 38 U/microliters and 9/69 (13%) of those with lower
      levels at diagnosis (P < 0.0001), independently of FAB subtype. High s-TK levels
      were also useful to predict evolution in AML during the course of the disease in
      patients with normal initial values. Multivariate analysis confirmed the
      independent prognostic value of s-TK on both overall survival and risk of acute
      transformation. We conclude that s-TK may be an important prognostic factor in
      MDS, strongly correlated with development of AML.

PMID- 7786775
TI  - Clonal analysis of haemopoietic cells in essential thrombocythaemia.
AB  - Essential thrombocythaemia (ET) is a myeloproliferative disease (MPD)
      predominantly involving the platelet lineage, with a diagnosis often difficult to
      establish in practice. The demonstration of a clonal haemopoiesis can contribute
      to diagnosis. The clonal origin of blood cells can be assessed in female patients
      using X-chromosome-linked polymorphisms, assuming a random inactivation of the X
      chromosome. The human androgen receptor gene HUMARA has been used for this
      purpose, taking advantage of a highly polymorphic trinucleotide repeat in the
      first exon. The close proximity of the polymorphic trinucleotide repeat to four
      methylation sites permits a clonal analysis based on the polymerase chain
      reaction. We have used this technique to study the clonality of haemopoietic
      cells in 32 patients with ET and 23 age-matched control heterozygotes for the
      HUMARA polymorphism. A monoclonal pattern of haemopoiesis was detected in
      unfractionated nucleated blood cells from 22 patients, suggesting that
      haemopoiesis is essentially monoclonal in a majority of cases in this disease. In
      some patients a monoclonality of granulocytes was documented, whereas the
      mononuclear fraction had a polyclonal pattern of X-inactivation. Finally, in two
      patients for whom a polyclonality had been found in unfractionated blood,
      analysis of G6PD transcripts in platelets revealed a clonal megakaryocytopoiesis.
      These findings confirm the heterogeneity of haematological abnormalities in ET
      patients and the potential utility of a multifaceted laboratory approach to
      investigate these patients.

PMID- 7786777
TI  - Hemizygous expression of the wild-type p53 allele may confer a selective growth
      advantage before complete inactivation of the p53 gene in the progression of
      chronic myelogenous leukaemia.
AB  - We analysed the expression of the p53 gene in various clinical phases of chronic
      myelogenous leukaemia (CML) by quantitative reverse transcriptase (RT) polymerase
      chain reaction (PCR). Hemizygous expression of the wild-type p53 allele was
      observed in two samples showing the loss of one p53 allele, and affected p53
      expression was associated with p53 allelic loss rather than the clinical phase of
      CML. In four patients with CML showing p53 inactivation, we performed a detailed
      sequential analysis of p53 allelic loss, p53 mutation and expression from the
      onset of the disease to the patients' death. Consequently, we demonstrated that
      the loss of a wild-type p53 allele preceded mutation of the remaining allele, and
      that cells hemizygous for the wild-type p53 allele dominated those with both wild
      type alleles, then were replaced by cells with complete p53 inactivation. These
      observations indicate that not only complete p53 inactivation but also hemizygous
      expression of the wild-type p53 allele may confer a selective growth advantage,
      and that the former is implicated in a more malignant phase than the latter.
      Alternatively, the inactivation of another undefined anti-oncogene on chromosome
      17p may allow selective growth before the p53 mutation occurs.

PMID- 7786776
TI  - Characterization of genomic BCR-ABL breakpoints in chronic myeloid leukaemia by
      PCR.
AB  - In order to understand better the mechanism of translocation between the BCR and
      ABL genes in CML, we have exploited a 'bubble PCR' technique to clone genomic
      breakpoints. BCR-ABL junction fragments were successfully amplified and sequenced
      in 14/32 (43%) patients tested. Breakpoints were dispersed throughout the major
      breakpoint cluster region without any clustering or hot spots. In three cases Alu
      sequences were found at or near the breakpoint on the ABL side of the
      translocation but no other obvious sequence homologies were found either in BCR
      or ABL. The translocation event was characterized further in three other patients
      by amplifying the reciprocal ABL-BCR junction on the 9q+ chromosome and also
      normal ABL around breakpoints. In two of these patients a few nucleotides of BCR
      and ABL were either duplicated or deleted on translocation, suggesting that
      staggered cuts had been made in the DNA strand prior to recombination. In the
      third patient 50 bp of ABL was deleted and 159 bp of M-BCR including exon b3 was
      duplicated, indicating either that the single-stranded cuts may span a larger
      distance than previously thought or that another mechanism, perhaps involving
      gene conversion, may be involved in this instance.

PMID- 7786780
TI  - Analysis of heat-shock protein expression in myeloid leukaemia cells by flow
      cytometry.
AB  - Expression of heat-shock proteins (hsp) was analysed in the leukaemic cells of 12
      patients with acute myeloid leukaemia (AML) and nine patients with chronic
      myeloid leukaemia (CML). Using monoclonal antibodies to hsp70, hsp90 and hsp60
      (ML30, a mycobacterial antigen with homology to human hsp60), we measured hsp
      levels by flow cytometry of permeabilized cells. Mononuclear cells from 10
      healthy volunteers were also examined. The results demonstrate that hsp
      expression is significantly increased (P < 0.01) in the circulating cells of
      patients with AML compared with cells from CML patients, and compared with normal
      peripheral blood mononuclear cells. This increased pattern of expression was
      found for all three heat-shock protein families included in this study.
      Mononuclear cells from leukaemic patients showed a heterogenous pattern of hsp
      expression, between different patients, between cells from individual patients,
      and between the different hsp proteins examined. It is possible that hsp
      expression relates to the differentiation state or proliferative potential of
      these leukaemic cells.

PMID- 7786779
TI  - Evidence for a paracrine pathway of B-cell stimulation in hairy cell leukaemia.
AB  - It is a well-known phenomenon that the growth of malignant B-lymphocytes, i.e.
      hairy cells, is regulated by cytokines. Several investigators have suggested that
      the stimulating cytokines are produced by the malignant B cells themselves,
      indicating an autocrine growth regulation. In this paper we demonstrate that T
      lymphocyte clones produce soluble mediators which stimulate the growth of
      malignant B lymphocytes. The incidence of the growth-stimulating T-cell clones
      derived from peripheral blood is identical in patients with hairy cell leukaemia
      (HCL) and healthy controls. About 50% of the clones stimulate the growth of hairy
      cells, but not the growth of purified B lymphocytes of healthy donors. The
      stimulating activity of a single clone varies when tested on different hairy
      cells. Interferon alpha (IFN alpha), but not antibodies against tumour necrosis
      factor alpha (TNF alpha) or interleukin-2 (IL-2), completely inhibit the growth
      stimulating activity. Our results indicate that a paracrine growth regulation has
      to be considered in addition to the postulated autocrine loop in the growth
      regulation of malignant B cells.

PMID- 7786781
TI  - Attenuated-dose idarubicin in acute myeloid leukaemia of the elderly:
      pharmacokinetic study and clinical results.
AB  - AML in the elderly is characterized by intrinsic biological features implying an
      enhanced chemoresistance. Intensive chemotherapy should be the treatment of
      choice, but the standard doses could induce unacceptable rates of aplastic
      deaths. We evaluated the efficacy of an induction protocol with attenuated-dose
      idarubicin (IDA) 8 mg/m2 for 3 d plus cytarabine and etoposide in 26 AML patients
      aged > 60. 18 patients (69%) achieved CR, five (19%) were non-responders and
      three (12%) died during induction. To compare the pharmacokinetics of IDA between
      elderly and young patients, we assayed daily the serum level of the drug and of
      its metabolite (idarubicinol, IDAol) in a group of eight elderly patients who
      received a dose of 8 mg/m2 (group A) and in a group of nine younger AML patients
      treated with 12 mg/m2 (group B). The apparent terminal half-life of IDAol was
      significantly longer in the elderly than in the younger patients (mean half-life
      59.7 h versus 41.4 h, P < 0.05). The values of the area under the serum
      concentration curve of IDAol indicated that the two patient groups received a
      very similar exposure to the drug despite the different doses. In conclusion,
      this protocol, based on attenuated doses of IDA, compares well with the results
      obtained previously in similar age-matched patient series.

PMID- 7786778
TI  - Effects of interleukin-12 on natural killer cell cytotoxicity and the production
      of interferon-gamma and tumour necrosis factor-alpha in patients with
      myelodysplastic syndromes.
AB  - The effects of interleukin 12 (IL-12) on natural killer (NK) cell cytotoxicity
      and on the production of interferon-gamma (IFN-gamma) and tumour necrosis factor
      alpha (TNF-alpha) were examined in 15 patients with myelodysplastic syndromes
      (MDS), which are well known to have immunologic defects, and in 11 normal
      subjects. The NK cell cytotoxicity of all of the normal subjects was augmented by
      incubation with IL-12 alone, and co-incubation with interleukin 2 (IL-2) further
      augmented it (type A response). The MDS patients showed varied responses to IL
      12/IL-2. Seven patients showed the type A response, resulting in augmented NK
      cell cytotoxicity which was similar to that in the normal subjects. In five other
      patients the cytotoxicity was not increased by IL-12 alone, but the combination
      of IL-12 and IL-2 did augment the cytotoxicity (type B response). The augmented
      cytotoxicity in these type B patients was lower than that in the normal subjects.
      In the final three MDS patients the cytotoxicity was low and not affected by IL
      12 and/or IL-2 (type C response). All patients with refractory anaemia with
      excess blasts (RAEB) and patients with RAEB in transformation showed a type B or
      C response. Conversely, six of eight refractory anaemia patients showed a type A
      response. In MDS patients there was a positive correlation between the percentage
      of CD3- CD56+ cells in pre-incubated cells and the cytotoxicity of cells
      incubated with IL-12/IL-2. The combination of IL-12 and IL-2 augmented IFN-gamma
      and TNF-alpha production by nonadherent mononuclear cells in a synergistic or
      cumulative manner, respectively, in most patients. These results suggest that IL
      12, alone or with IL-2, may modulate these important immunologic functions in
      most MDS patients.

PMID- 7786782
TI  - Evidence for a light chain restriction of glycoprotein Ib/IX and IIb/IIIa
      reactive antibodies in chronic idiopathic thrombocytopenic purpura (ITP).
AB  - To address the assumption of clonally restricted antibodies in immune
      thrombocytopenias we studied sera from 19 patients with chronic ITP known to
      possess antibodies reactive with glycoprotein (GP) Ib/IX and/or GPIIb/IIIa. These
      sera were re-analysed using the standard monoclonal antibody immobilization of
      platelet antigens (MAIPA) assay and 16 patients exhibited IgG antibodies reactive
      with GPIIb/IIIa; seven patients showed also a reactivity with GPIb/IX. Employing
      a light-chain-specific MAIPA assay, 75% (12/16) of these sera displayed
      GPIIb/IIIa-specific antibodies that were light chain restricted; only 13% (2/16)
      of the GPIIb/IIIa reactive sera showed a mixed kappa and lambda phenotype. A
      light-chain-restricted phenotype was also seen for the GPIb/IX reactive
      antibodies. To further substantiate these findings, the MAIPA assay was modified
      in order to avoid interference from human anti-mouse antibodies. A high frequency
      of light-chain restricted platelet antibodies was also found using the modified
      MAIPA technique. These results support the hypothesis of a clonal B-cell
      expansion in immune thrombocytopenias, producing antibodies with a restricted
      idiotype repertoire and reacting with a limited number of epitopes.

PMID- 7786783
TI  - A low M(r) GTP-binding protein, Rap1, in human platelets: localization,
      translocation and phosphorylation by cyclic AMP-dependent protein kinase.
AB  - Subcellular fractions were prepared from human platelet membranes by sucrose
      density gradient centrifugation and the localization of a low M(r) GTP-binding
      protein, rap1 protein (Rap1) was analysed by immunoblotting using a specific
      antibody. Rap1, which has been purified from human platelets, was found to be
      located in plasma membrane and alpha-granule fractions in resting platelets.
      Treatment of isolated alpha-granules with pronase led to proteolysis of Rap1,
      indicating that this protein is exposed to the cytoplasmic face of the granules.
      Degranulation of alpha-granules consists of translocation and subsequent fusion
      of the granules with the open canalicular system. Activation of this process by
      thrombin induced the redistribution of Rap1 on the alpha-granules to plasma
      membranes. On the other hand, Rap1 is known to be phosphorylated by cyclic AMP
      dependent protein kinase (A-kinase) in vitro and in vivo. In intact human
      platelets, phosphorylation of Rap1 by A-kinase in response to prostaglandin E1
      (PGE1) was observed only in Rap1 localized in plasma membranes and not on alpha
      granules, although Rap1 was phosphorylated in a cell-free system when plasma
      membranes and alpha-granule membranes were exposed to A-kinase as substrates.
      These results strongly suggest that Rap1 in plasma membranes and the protein on
      alpha-granules are regulated by different mechanisms, and have different
      functions.

PMID- 7786784
TI  - Fibrin degradation product (FnDP) assays: analysis of standardization issues and
      target antigens in plasma.
AB  - The in vivo formation of fibrin and its subsequent secondary fibrinolytic
      digestion yields a variety of crosslinked fibrin degradation products (XL/FnDP).
      One of these is known as D-dimer and a variety of ELISA-type commercial kits
      using monoclonal antibodies to D-dimer have been developed. We have investigated
      the possibility of establishing a standard such that these various kits might
      indicate the same levels of D-dimer in the same samples. We have concluded that
      because it seems that each individual monoclonal antibody to D-dimer targets a
      unique and distinct epitope in the FnDP fraction the notion of introducing a
      standard D-dimer which will respond uniformly to each D-dimer monoclonal antibody
      is not feasible. Using various monoclonal and polyclonal antibodies in
      conjunction with gel exclusion chromatography we have examined human plasma
      derived from patients with disseminated intravascular coagulation (DIC) which
      contained high levels of fibrin degradation products (FnDP). The data suggested
      that the FnDP fraction in plasma contained mostly high molecular weight (> 2 x
      10(6) daltons) crosslinked fragments which contain high levels of fibrinopeptide
      A. Many of these crosslinked fragments crossreact with antibodies to D-dimer
      because they each contain D-dimer as a structural component. On the basis of this
      data, a novel sequence of events is proposed which may occur during the
      aggregation of fibrin in vivo.

PMID- 7786785
TI  - Resistance to activated protein C activity of an anti-beta 2-glycoprotein I
      antibody in the presence of beta 2-glycoprotein I.
AB  - Some researchers claim that lupus anticoagulant-positive plasma may cause a false
      positive reaction in the test for activated protein C (APC) resistance, a
      hereditary thrombophilic state characterized by abnormal factor V, which
      frequently causes venous thrombosis. We investigated whether anti-beta 2
      glycoprotein I antibody (aGPI), which has recently come to be regarded as an anti
      cardiolipin antibody (aCL) itself, might have an effect on the APC resistance
      test.

PMID- 7786786
TI  - Acquired hypochromic and microcytic sideroblastic anaemia responsive to
      pyridoxine with low value of free erythrocyte protoporphyrin: a possible subgroup
      of idiopathic acquired sideroblastic anaemia (IASA).
AB  - Patients with idiopathic acquired sideroblastic anaemia (IASA) usually show
      macrocytic or normocytic anaemia and increased free erythrocyte protoporphyrin
      (FEP). The mean cell haemoglobin concentration is normal or slightly low. Here we
      report a pyridoxine-responsive IASA patient with microcytic and hypochromic
      anaemia and low FEL level; these features are usually seen in cases of hereditary
      sideroblastic anaemia. Microcytosis increased during therapy. There may be a
      subgroup of IASA with microcytic and hypochromic anaemia, low normal FEP and some
      response to pyridoxine like hereditary sideroblastic anaemia.

PMID- 7786787
TI  - Random X chromosome inactivation in a female with a variant of Wiskott-Aldrich
      syndrome.
AB  - A 15-month-old female presented with eczema, thrombocytopenia, recurrent
      infections and failure to thrive. She had low serum IgM and IgG subclasses and an
      abnormal lymphocyte proliferative response to periodate in vitro. Molecular X
      chromosome inactivation analysis, using the polymorphic HUMARA DNA probe, showed
      that the infant has random X chromosome inactivation. We conclude that she has an
      atypical form of Wiskott-Aldrich syndrome which may be inherited in an autosomal
      recessive manner.

PMID- 7786788
TI  - Successful bone marrow transplantation for idiopathic hypereosinophilic syndrome.
AB  - A 21-year-old man who had an increased number of eosinophils with morphological
      abnormalities, bone marrow fibrosis and multiple organ dysfunction failed to
      respond to methylprednisolone and hydroxyurea. He was diagnosed with
      hypereosinophilic syndrome (HES) probably due to myeloproliferative disorder, and
      underwent allogeneic bone marrow transplantation (allo-BMT) from an HLA-identical
      sibling. The engraftment was confirmed on day 21 after BMT, but the patient
      developed acute graft-versus-host disease (GVHD) with grade I veno-occlusive
      disease, and transient increase of eosinophils of the donor type followed by
      chronic GVHD of the extensive type. These complications were eventually
      controlled with cyclosporin A. The patient survived free of disease for more than
      a year after BMT. Allo-BMT seems to be a possible treatment of HES/MPD.

PMID- 7786789
TI  - Refractory cytopenia with t(1;7),+8 abnormality and dysplastic eosinophils
      showing intranuclear Charcot-Leyden crystals: a fluorescence in situ
      hybridization study.
AB  - A case of refractory cytopenia and marrow eosinophilia showing t(1;7)
      translocation and concomitant trisomy 8 is reported. The eosinophils were
      dysplastic, and showed the unique feature of intranuclear Charcot-Leyden crystal
      formation, giving rise to a 'lip-like' appearance. We speculate that this unusual
      cytologic feature resulted from abnormal precipitation of Charcot-Leyden crystal
      protein in the eosinophils. By fluorescence in situ hybridization using a
      chromosome 8 specific alpha-satellite probe, the abnormal eosinophils were shown
      to have derived from the abnormal clone. We postulate that the dysplastic clone
      might have retained a differentiation potential and be responsive to normal
      haemopoietic stimuli.

PMID- 7786790
TI  - Expression of an erythropoietin-like gene in the trout.
AB  - Cross-species Northern blot hybridization and radioimmunoassay have provided
      evidence for the expression of an erythropoietin (EPO)-like gene in the rainbow
      trout. The principal site of EPO-like mRNA and antigen expression in the adult
      trout appears to be the kidney which also acts as the major erythropoietic organ.
      The data suggest that a locally produced EPO-like factor may regulate renal
      erythropoiesis in bony fish and, furthermore, they identify a possible
      evolutionary origin for renal EPO production in mammals.

PMID- 7786791
TI  - Scintigraphic evaluation of the haemopoietic bone marrow using a 99mTc-anti
      granulocyte antibody: a validation study with 52Fe.
AB  - To specify the validity of bone marrow scanning using a monoclonal anti
      granulocyte antibody labelled with 99mTc (BW 250/183) for the functional
      assessment of haemopoiesis, we compared this method with 52Fe scan in 16 patients
      with haematological disorders. The examinations were performed using a
      rectilinear whole-body scanner and the distribution of the two tracers was
      assessed visually and quantitatively in anatomical bone marrow segments, the
      spleen and liver. Qualitative comparison showed concordance in the bone marrow
      distribution of the two tracers in 83% of the segments. Discrepancies were found
      in six patients with hypoplastic or aplastic marrow. The spleen was visualized in
      all cases with the 99mTc-Moab, including nine patients without splenic
      haemopoiesis (i.e. without spleen uptake of 52Fe). The uptake of the two tracers,
      quantified in bone marrow segments and the spleen, correlated well (P < 0.001),
      but not in the liver (NS). The correlation between the uptake values for each
      patient was excellent, except in cases of aplastic bone marrow. In conclusion,
      bone marrow scanning using a 99mTc labelled anti-granulocyte monoclonal antibody
      enables functional evaluation of the distribution of haemopoiesis. Limitations
      include the evaluation of bone marrow aplasia and identification of splenic
      haemopoiesis, for which 52Fe remains the tracer of choice.

PMID- 7786792
TI  - The fusion of TEL and ABL in human acute lymphoblastic leukaemia is a rare event.
AB  - We have recently identified a common ALL patient which harboured a chromosomal
      fusion between the TEL gene on chromosome 12 and the ABL gene on chromosome 9. We
      designed an RT-PCR assay to screen 186 adult ALL and 30 childhood ALL patients
      for this novel translocation. We were unable to identify any additional cases
      with a TEL/ABL fusion product.

PMID- 7786793
TI  - Detection of the BCR-ABL gene by reverse transcription/polymerase chain reaction
      and fluorescence in situ hybridization in a patient with Philadelphia chromosome
      negative acute lymphoblastic leukaemia.
AB  - The Philadelphia (Ph) chromosome is detected in leukaemia cells in approximately
      20% of adults with acute lymphoblastic leukaemia (ALL). When treated with
      chemotherapy alone, Ph-positive ALL has a poor prognosis, and patients may
      benefit from bone marrow transplantation in first remission. Here we report a
      patient with chromosomally normal bone marrow, in all 60 cells analysed, who was
      found to have the p210-type BCR-ABL chimaeric transcript by RT/PCR. Fluorescence
      in situ hybridization was labelled cosmid probes for BCR and ABL showed the
      presence of BCR-ABL juxtaposition on a normal chromosome 22 in leukaemia cell
      metaphases. We conclude that molecular and cytogenetic methods should be used in
      conjunction to detect the BCR-ABL gene rearrangement in ALL.

PMID- 7786794
TI  - Haemoglobin Dhofar is linked to the codon 29 C-->T (IVS-1 nt-3) splice mutation
      which causes beta+ thalassaemia.
AB  - Investigations of a young man with apparent thalassaemia minor showed that he was
      a heterozygote for a rare abnormal haemoglobin variant, Hb Dhofar. The amino acid
      replacement is in the beta-globin chain (beta 58 Pro-->Arg) and is therefore not
      consistent with the observed proportion of Hb Dhofar, as in both this and the
      original case, it constituted only 15% of the total haemoglobin. We have
      determined the basis of the low expression of this mutant, which is due to its
      linkage to a thalassaemic splicing mutation on the same beta-globin gene at codon
      29 (C-->T). The finding of this thalassaemia mutation linked to Hb Dhofar not
      only explains the low level of Hb Dhofar, but also provides evidence that the
      codon 29 C-->T, IVS-1 splice junction mutation causes a beta+ form of
      thalassaemia.

PMID- 7786796
TI  - Enhanced Mg(2+)-ATPase activity in ghosts from HS erythrocytes and in normal
      ghosts stripped of membrane skeletal proteins may reflect enhanced
      aminophospholipid translocase activity.
AB  - Hereditary spherocytosis (HS) is a congenital haemolytic anaemia which is
      characterized by a great variety of structural defects in the red cell's membrane
      skeleton and/or deficiencies in particular membrane (skeletal) proteins. Enhanced
      (Mg2+)-dependent adenosine triphosphatase (Mg(2+)-ATPase) activities, varying
      from 115% to 160%, were invariably found in erythrocyte ghosts derived from 13 HS
      patients. Similarly, an enhancement of Mg(2+)-ATPase activity by 30% is observed
      in normal red cell ghosts that have been stripped of the greater part of their
      membrane skeletal proteins by treatment with a low ionic strength buffer.
      Reassociation of those stripped ghosts with spectrin reduces the enhanced Mg(2+)
      ATPase activity to its original level. Since in both cases, HS ghosts and
      stripped normal ghosts, the stabilizing effects that the membrane skeleton exerts
      on the maintenance of an endofacial localization of the aminophospholipids are
      impaired, the enhanced Mg(2+)-ATPase activity is interpreted to reflect an
      increased activity of the aminophospholipid translocase. The present observations
      therefore support a role of the membrane skeleton in the stabilization of
      phospholipid asymmetry in the red cell membrane and consequently in reducing the
      energy consumption of the translocase.

PMID- 7786795
TI  - Clonal and non-clonal karyotypically abnormal cells in haemophagocytic
      lymphohistiocytosis.
AB  - We studied chromosomes in bone marrow (BM) or peripheral blood cells of nine
      patients with haemophagocytic lymphohistiocytosis (HLH); three of them had a
      family history of HLH and four others underwent concurrent Epstein-Barr virus
      (EBV) infection. In addition to a large population of normal mitotic cells,
      karyotypically abnormal clonal cells were found in two patients, abnormal clonal
      cells and a nonclonal (single) abnormal cell in one, and nonclonal abnormal cells
      in three. All the six patients with chromosome abnormalities died of progressive
      disease; one of them also had EBV infection and EBV-associated clonal
      proliferation. Two of three patients with EBV infection and only normal mitotic
      cells in BM completely recovered from the disease. Although HLH did not show
      histological and/or haematological evidence of a neoplastic disease, clonal
      chromosome abnormalities and the fatal clinical outcome found in some of the
      patients suggest that the disease may be heterogenous and include malignancy. HLH
      patients with karyotypically abnormal clonal cells in BM should warrant more
      intensive chemotherapy than that presently being applied to them and should be
      considered as candidates for BM transplantation.

PMID- 7786797
TI  - Low plasma heparin cofactor II levels in thalassaemia syndromes are corrected by
      chronic blood transfusion.
AB  - Low plasma heparin cofactor II (HCII) levels are associated with a thrombotic
      tendency, and we have previously shown these to be decreased in a variety of
      haemolytic conditions. The risk of thrombosis is recognized to be increased in
      both thalassaemia major (TM) and intermedia (TI), although the exact mechanisms
      are poorly understood. HCII levels have therefore been compared in 20
      untransfused patients with TI and 20 regularly transfused TM patients to
      determine the influence of transfusion on HCII. Additionally, untransfused TI
      patients have been commenced on regular red cell transfusion and the effects on
      correction of low HCII levels investigated. HCII levels were significantly lower
      in the untransfused TI patients (mean 0.56 +/- 0.06 U/ml) compared to TM patients
      (mean 0.85 +/- 0.1 U/ml; P < 0.001). Levels in TI were significantly less than in
      healthy age-matched controls (P < 0.001) and correlated with Hb values (r = 0.8),
      whereas levels in TM were at the lower end of the normal range. ATIII values were
      within the normal reference range in both TI and TM, and HCII antigen showed a
      parallel reduction to HCII activity, indicating that reduction in HCII is not a
      consequence of increased thrombin consumption. Three patients with TI were
      commenced prospectively on hypertransfusion programmes which resulted in a slow
      normalization of their levels taking 2-3 months. These findings support a
      hypothesis that the low HCII levels are related to increased red cell turnover
      and can be normalized once this turnover has been suppressed by hypertransfusion.
      The thrombotic risk to patients with low HCII levels in the presence of
      haemolysis might in principle be decreased by such transfusion regimes.

PMID- 7786798
TI  - Haemoglobin Tunis-Bizerte: a new alpha 1 globin 129 Leu-->Pro unstable variant
      with thalassaemic phenotype.
AB  - A Leu-->Pro substitution at position 129 of the alpha 1 globin gene was detected
      in three members of a Tunisian family by sequencing the whole alpha 2 and alpha 1
      DNA. The mutation was verified by dot-blot allele-specific hybridization as well
      as by digestion of PCR and RT-PCR products with Nci I, since the alpha 1(129) T-
      >C mutation creates an additional recognition site for the above-mentioned
      enzyme. The alpha 1(129)(H12)Leu-->Pro substitution disturbs helix H resulting in
      alpha-thal trait most probably because the unstable alpha-globin chain variant
      cannot form alpha beta dimers. A search for the abnormal Hb and for the abnormal
      alpha globin chain by isoelectric focusing, carboxymethyl cellulose
      chromatography and electrospray ionization mass spectrometry was negative. In the
      heterozygous state, the alpha 1(129)(H12) Leu-->Pro variant is manifested by
      microcytosis (MCV approximately 73 fl), whereas in the homozygous state there is
      moderate anaemia with marked microcytosis (Hb 11.6 g/dl, MCV 65 fl).

PMID- 7786799
TI  - Leukaemic non-Hodgkin's lymphomas with hyperdiploid cells and t(11;14)(q13;q32):
      a subtype of mantle cell lymphoma?
AB  - The present study describes five patients with leukaemic non-Hodgkin's lymphoma
      (NHL) detected on the basis of particular morphology and cytogenetic findings.
      With respect to histological, immunological and cytogenetic features these NHL
      are closely related to mantle cell lymphoma/intermediate differentiated
      lymphocytic lymphoma. However, the presence of unusual large cells associated
      with the t(11;14)(q13;q32) translocation and numerical chromosome changes, in the
      near triploid or near tetraploid range, could delineate a particular subtype of
      mantle cell lymphoma.

PMID- 7786800
TI  - Modulation of cell kinetics and cell cycle status by treating CD34+ chronic
      myeloid leukaemia cells with p53 antisense phosphorothioate oligonucleotides.
AB  - Mutations of the p53 tumour suppressor gene occur in 20% of chronic myeloid
      leukaemia (CML) patients in blastic crisis, but it is still uncertain whether
      this inactivation plays a role in the pathogenesis of blastic transformation or
      in maintaining the leukaemic proliferation in CML, as it does in several solid
      tumours. We have previously shown that more than 50% of both normal and CML CD34+
      cells express the p53 protein. However, haemopoietic cells at different phases of
      the cell cycle express p53 with different conformations, suggesting that the
      function of p53 may be closely regulated during the cell cycle. In order to
      elucidate the mechanism by which p53 suppresses cell proliferation, we evaluated
      the effects of inhibiting p53 expression on cell cycle and cell kinetics of
      chronic phase CML (n = 12) and normal (n = 7) bone marrow light-density cells and
      purified CD34+ progenitors by using an 18-mer modified antisense oligonucleotide
      which targets the region covering the six base pairs immediately before the first
      codon and the first four coding codons of p53. We found that the number of cells
      positive for the cell cycle-specific nuclear antigen Ki67 and for the BrdU
      monoclonal antibody (McAb) was significantly increased after p53 antisense
      olignucleotide treatment. At the same time, p53 protein expression was completely
      abrogated in both light-density and CD34+ cells. In addition, DNA analysis by
      flow cytometry demonstrated that the number of cells in quiescent phases of the
      cell cycle (G0-G1) was significantly decreased after exposure of light-density
      cells to p53 antisense oligomers, whereas the number of cells in S or G2-M phases
      was increased. Furthermore, the longer the incubation time the higher the
      increase in cell proliferation. Treatment of CML, cells with p53 antisense
      oligomers also resulted in significantly increased numbers of CFU-GM colonies.
      Our data suggest that p53 is a negative regulator of cell proliferation and its
      action is mediated through changes in cell cycle kinetics, mainly before the S
      phase. We can further speculate that the loss of p53 function, at the time of
      blastic crisis of CML, may play a role, in combination with other genetic changes
      (p210 BCR/ABL, Rb gene abnormality, others to be defined), in inducing
      disturbances in cell proliferation, differentiation, and apoptosis.

PMID- 7786801
TI  - Assessment of clonal evolution at Ig/TCR loci in acute lymphoblastic leukaemia by
      single-strand conformation polymorphism studies and highly resolutive PCR derived
      methods: implication for a general strategy of minimal residual disease
      detection.
AB  - Junctional sequences of immunoglobulin (Ig)/T-cell receptor (TCR) gene
      rearrangements are used as patient-specific PCR targets for the detection of
      minimal residual disease (MRD) in acute lymphoblastic leukaemias (ALLs). Clonal
      evolution of gene rearrangements is a major pitfall of this strategy. Using high
      resolution PCR-based analyses (including denaturing gel electrophoresis and
      single-stranded conformation polymorphism (SSCP)) we have compared Ig/TCR gene
      rearrangements at presentation and relapse in a series of ALLs. These methods
      allow an unambigous comparison of rearrangements taking into account junctional
      size and nucleotide sequence information and allow a precise assessment of the
      clonal evolution. V gamma-J gamma and V delta 1-J delta 1 rearrangements were
      analysed in 12 T-ALLs. VH-JH, V gamma-J gamma, V delta 2-D delta 3 and, in
      selected cases, DH-JH rearrangements were studied in 14 B-lineage ALLs. Clonal
      evolution, regarding major rearrangements, occurs for at least one of these loci
      in 2/12 T-ALLs and in 5/14 B-lineage ALLs. Clonal evolution is more marked for
      minor rearrangements than for major ones. As shown using SSCP analysis,
      rearrangements observed at relapse are sometimes found in minor clones at
      presentation which are therefore selected in vivo by a proliferative advantage.
      These data, as well as those from the available literature, suggest the use of at
      least two patient-specific probes to detect MRD in ALLs. A general strategy
      including selected Ig/TCR rearrangements and chromosomal abnormalities as PCR
      targets is proposed.

PMID- 7786802
TI  - Over-expression and amplification of the CDC2 gene in leukaemia cells.
AB  - The expression and structure of the cdc2 gene, one of the master regulators of
      the eukaryotic cell cycle, were investigated in fresh leukaemic cells from 51
      cases of various types of leukaemia. Cdc2 mRNA transcripts were detectable in
      approximately 40% (21/51) of cases by Northern blotting. Over-expression of cdc2
      mRNA as compared to normal bone marrow cells was noted in 10/21 cases with
      detectable cdc2 mRNA transcripts. Amplification of the cdc2 gene was found in
      three cases. Cdc2 mRNA was over-expressed in these three cases, suggesting that
      gene amplification is a direct cause of mRNA over-expression in a subset of
      cases. Cell proliferative capacity was well correlated with the amount of cdc2
      mRNA transcripts, i.e. 3H-thymidine incorporation was highest in cases with cdc2
      mRNA over-expression and was significantly higher in cdc2-positive cases than in
      cdc2-negative cases. These results suggest that over-expression of CDC2, which is
      due to the gene amplification in some cases, might play a role in altered growth
      of leukaemic cells.

PMID- 7786803
TI  - Predicting outcome in the tethered cord syndrome: a study of cord motion.
AB  - Thirty-two children with spinal dysraphism have been studied with phase MRI to
      assess longitudinal cord motion. Seventeen children who were asymptomatic and who
      had normal or slightly decreased motion were not operated. Fifteen had signs and
      symptoms of spinal cord tethering as well as decreased cord motion and underwent
      surgery. None of the nonsurgical patients have become symptomatic. The children
      with markedly decreased cord motion did not improve after surgery. A trend was
      seen toward a better outcome in younger patients with slight or moderate decrease
      in cord motion. All children with worse outcome were previously operated
      meningomyeloceles who had markedly decreased cord motion and who were greater
      than 10 years old.

PMID- 7786804
TI  - Electrophysiological studies on brainstem function in patients with
      myelomeningocele.
AB  - We investigated the brainstem auditory evoked potentials (BAEPs), somatosensory
      evoked potentials (SEPs), and electrically elicited blink reflexes (BRs) to
      evaluate the brainstem function in 31 patients with meyelomeningocele (MMC)
      including 22 with Chiari type-II malformation. The I-III interpeak latency (IPL)
      of the BAEPs and the N9-N13 IPL of the SEPs tended to become gradually prolonged
      from the normal range with increasing age. The III-V IPL of the BAEPs and the N13
      N20 IPL of the SEPs were initially prolonged and decreased progressively to the
      normal range. These findings indicated a gradual latency shortening of the
      brainstem components and latency prolongation of the peripheral components. Thus,
      while primary brainstem dysfunction may improve with age, secondary dysfunction
      due to stretching and elongation of the lower cranial nerves and cervical nerve
      roots may intensify. The BRs showed an abnormal R2 in 90% of the cases,
      disclosing subclinical lesions in the medulla oblongata which were not detected
      by BAEPs alone. BAEPs, SEPs and BRs were combined to yield a functional
      evaluation of the brainstem and lower cranial nerves that could not be done by
      magnetic resonance imaging alone. No close relation was found between
      electrophysiological abnormalities and the degree of hindbrain anomaly by
      neuroimaging.

PMID- 7786805
TI  - Contemporaneous shunting with repair of myelomeningocele.
AB  - The combination of overt hydrocephalus and an open myelomeningocele in a newborn
      has prompted some authors to advocate the repair of the myelomeningocele and the
      performance of a shunt procedure during the same anesthetic procedure. Advocates
      of this approach stress the merits of administering only one anesthetic,
      diminution in incidence of cerebrospinal fluid leaks from the repair, and
      shortened hospital stay and the resultant cost-effectiveness. This study was
      performed to assess the complication rate of shunts inserted at the time of
      myelomeningocele repair as well as of those inserted at a later date as a
      separate procedure. It would later appear that the insertion of a
      ventriculoperitoneal shunt, contemporaneous with the repair of the
      myelomeningocele, does not increase the risks of shunt infection or shunt
      malfunction within the 1st year of life.

PMID- 7786806
TI  - Reflections on the natural history of lipomyelomeningocele.
AB  - A retrospective analysis of patients with lipomyelomeningocele cared for at two
      referral centers was completed to derive relationships between neurological
      function and patient age. Thirty-seven percent of 177 patients had intact
      neurological function on initial examination. Neurological deficits were
      progressive and linked with a logarithmic relationship to increasing patient age.
      Each child with intact examination retained normal bladder function following
      lipomyelomeningocele repair and release of cord tethering; complications of
      surgery were limited. Our analysis suggests that surgery on patients with intact
      function offers greater long-term protection of critical function than is offered
      by conservative management and expectant care. We recommend repair of
      lipomyelomeningocele at the time of diagnosis regardless of patient age or
      neurological function.

PMID- 7786807
TI  - Radiographic imaging requirements following ventriculoperitoneal shunt
      procedures.
AB  - The requirements for radiographic imaging of the ventricles after a ventricular
      shunt procedure are not well defined. At British Columbia's Children's Hospital,
      the standard protocol included an ultrasound examination or CT scan at 6-8 weeks
      postoperatively, and a delayed CT scan at 6 months to 2 years, with additional
      scans only if the patient had symptoms of shunt malfunction. This study was
      performed to determine if the delayed scan could be omitted without compromising
      patient care. The study comprised 86 children with ventriculoperitoneal shunt
      operations, who had early CT scans or ultrasound examinations less than 20 weeks
      postoperatively, delayed postoperative CT scans between 20 weeks and 2 years, and
      who were asymptomatic at the time of these radiographic studies. In 39 of the 86
      patients a change in ventricular size occurred between the early and delayed
      imaging studies, and in these patients the delayed scan was felt to be required.
      In patients in whom the early imaging study was done at more than 12 weeks
      postoperatively, and probably in patients with small ventricles preoperatively,
      there was no added information gained by doing a delayed scan. It is concluded
      that a radiographic examination of ventricular size at 12 weeks after a shunt
      operation may provide an adequate baseline study. If the early postoperative
      radiographic study is done less than 12 weeks after surgery, we would advise that
      in asymptomatic patients, with the exception of patients with very small
      ventricles preoperatively, a CT scan be repeated at a later date to obtain an
      appropriate baseline assessment of ventricular size for the future.

PMID- 7786809
TI  - Spinal intradural arteriovenous fistula: a case with an unusual presentation.
AB  - Spinal intradural arteriovenous fistula is a rare type of spinal vascular
      malformation. It is usually fed by the anterior spinal artery and causes episodic
      myelopathy in young adults. We present a pediatric patient with such a vascular
      malformation which was fed directly by a medullary artery. The clinical course,
      complete radiological study and the excellent outcome will be described in
      detail. This rare subtype of spinal vascular malformation will be discussed.

PMID- 7786808
TI  - Pediatric cervical spine instrumentation using screw fixation.
AB  - From July 1986 to August 1993 we performed 24 pediatric cervical spine screw
      fixation procedures on 23 patients 16 years of age or less. The types of cervical
      instrumentation procedures performed were as follows: anterior cervical plates
      12, posterior C1-2 screw fixations 8, posterior lateral mass plates 2, odontoid
      screw fixations 2. The mean age of all patients was 14.2 years (range 6-16).
      Indications for operation included traumatic instability in 20 cases, congenital
      instability in 1 case, 2 cases of postoperative swan neck deformity, and one
      reoperation for early graft and hardware failure. Six of the 23 patients had
      persistent instability following previous failed fusions (3 with 1 prior surgery,
      2 with 2 prior surgeries, and 1 with 3 prior surgeries). Eight patients had
      improvement of their neurological status following operation and 15 remained at
      their preoperative level of neurological function. No patient was worse
      neurologically after their procedure. There were no long-term instrumentation,
      graft or fusion failures. Two complications occurred. One was the aforementioned
      graft and hardware failure requiring reoperation, the other was a superficial
      wound infection treated successfully with antibiotics. We feel that cervical
      spine fixation techniques have increased our ability to stabilize the pediatric
      cervical spine and have proven to be safe and effective.

PMID- 7786810
TI  - The Sunrise Technique: the correction of occipital plagiocephaly using bandeau
      occipital plate and radial osteotomies.
AB  - Posterior plagiocephaly secondary to lambdoid suture stenosis requires surgical
      release and repair to prevent progressive deformational changes associated with a
      suture stenosis. A surgical technique is described for release of the stenosed
      lambdoid suture and asterion region, followed by occipital reconstruction. This
      technique provides excellent cosmetic results. Using a standard biparietal
      incision, most of the occipital bone is removed en bloc. The asymmetric occiput
      is then reconstructed using an autologous bone bandeau and Marchac forehead
      template graft. The remaining bone is cut into longitudinal strips and placed in
      a centrifugal fashion around this construct. This technique creates a stable unit
      that provides immediate symmetry to the occipital area. The operative time and
      blood loss are comparable to that of similar procedures. With this technique
      there have been no complications or need for reoperation.

PMID- 7786811
TI  - Automated grading of astrocytomas based on histomorphometric analysis of Ki-67
      and Feulgen stained paraffin sections. Classification results of neuronal
      networks and discriminant analysis.
AB  - In stereotactically obtained astrocytoma biopsies, four morphometric nuclear
      parameters were determined with the use of an image analysis system. A special Ki
      67 (MIB1)/Feulgen stain made it possible to quantify the essential
      characteristics of gliomas of the astrocytoma/glioblastoma group: growth pattern,
      cellularity, proliferation tendency and nucleus pleomorphism. A grading scale
      based on a cluster analysis resembling the WHO-scheme, which is suitable for
      automated astrocytoma grading, was developed. Large back propagation neural
      networks were used and their results compared with those of a classical
      multivariate discriminant classification analysis. It is possible to show that
      the neural network technology is superior to the statistical approach for
      automated astrocytoma grading. Based on the results of our study we believe
      neural network technology to be useful for tumour grading problems. The presented
      approach can be generalized for the automated grading of other tumour entities.

PMID- 7786812
TI  - Grading of transitional cell bladder carcinoma by image analysis of histological
      sections.
AB  - Image analysis of histological sections was used to achieve a more objective
      malignancy grading of transitional cell carcinoma of the bladder. Images from
      Feulgen-stained sections from a clinical material of 197 tumours were analyzed.
      Features at various levels of analysis, e.g. mainly related to individual
      objects, neighbouring objects and the entire image, were analyzed. The features
      used were based on relational rather than individual nuclear features. With this
      technique, typical tissue architecture and degree of order/disorder can be
      described. These characteristics were compared by means of multivariate
      statistical methods with the subjective grading of the pathologists at our
      institution. This comparison provided the best subset of features and the
      agreement between the subjective and computer-based classification was 73%. The
      size, orientation and variation of the grey scale of the nuclei were particularly
      powerful. On a continuous scale, from grade 1 to 2A and 2B to 3, the four grades
      formed two distinct classes, low and high grade. In this distribution, the
      intermediate grade 2A was identified as a displaced grade 1 and the other
      intermediate grade 2B as a displaced grade 3.

PMID- 7786813
TI  - Changes in the activities of signal transduction and transport membrane enzymes
      in CEM lymphoblastoid cells by glucocorticoid-induced apoptosis.
AB  - The behaviour of the membrane enzymes PIP2-phospholipase C (PLC), that modulates
      the extracellular signals, and gamma-glutamyltransferase (gamma-GT), involved in
      metabolite transport, was followed during the early and active phases of
      apoptosis induced in CCRF-CEM cells by glucocorticoid (10(-6) M dexamethasone,
      DEX). The activities of gamma-GT and PLC increased significantly at 15 and 30 s
      after dexamethasone addition. Both activities decreased to the control level
      after 2 min but increased again at 5 min. The enzyme activities were high in
      apoptotic cells. Apoptosis was seen after incubation with 10(-6)M dexamethasone
      for 48 h, with decreased cell number, cellular activation (MTT) and S-phase
      percentage; enhanced DNA fragmentation and propidium iodide uptake; and
      ultrastructural changes in the chromatin and cell membranes. The changes in
      enzyme activity are indicators which occur much earlier than the cellular events
      related to the apoptotic death in CD4(+)-T CEM lymphoblastoid cells.

PMID- 7786815
TI  - Topoisomerase I inhibition: a new target or new missiles?

PMID- 7786817
TI  - Critique of the critique: response to the editorial entitled 'Classification of
      lymphoid neoplasms' by Dr. Saul Rosenberg which accompanied the publication of
      the 'Revised European-American Lymphoma Classification Proposal' in the September
      1994 issue of Blood.

PMID- 7786814
TI  - Decreased E-cadherin expression correlates with poor survival in patients with
      gastric cancer.
AB  - E-cadherin, Ca(2+)-dependent intracellular adhesion molecule, is known to be an
      invasion suppressor gene. To elucidate the correlation between E-cadherin
      expression and invasion or metastasis in gastric cancer, we examined E-cadherin
      tissue status immunohistochemically. Ninety-eight primary gastric cancer,
      prepared by AMeX method, were retrospectively analyzed with anti-E-cadherin
      monoclonal antibody. In normal gastric epithelium, E-cadherin is expressed
      homogeneously with a typical membranous staining at cell-cell borders. Decreased
      and heterogeneous expression is found in 70 of 98 tumours. Tumours with decreased
      E-cadherin expression had a tendency to infiltrate more deeply in stomach wall,
      and metastasize in lymph nodes or peritoneal surface. More importantly, decreased
      E-cadherin expression correlates with shorter survival (z = 3.98, P = 0.00086).
      These results may indicate that E-cadherin tissue status is a powerful prognostic
      indicator in gastric cancer. The high malignant potential of tumours with
      decreased E-cadherin expression may be associated with high potential of lymph
      node metastasis and peritoneal dissemination.

PMID- 7786816
TI  - Current position of vinorelbine in cancer chemotherapy.

PMID- 7786818
TI  - The treatment of advanced bladder cancer.

PMID- 7786819
TI  - Tamoxifen chemoprevention: public health goals, toxicities for all and benefits
      to a few.

PMID- 7786820
TI  - Phase II trial of CPT-11 in patients with advanced pancreatic cancer, an EORTC
      early clinical trials group study.
AB  - BACKGROUND: CPT-11 (irinotecan) is a semi-synthetic derivative of camptothecin
      and exerts its activity by inhibiting DNA topoisomerase I. A phase II study of
      this drug was performed in patients with pancreatic cancer. PATIENTS AND METHODS:
      Eligibility criteria included advanced non-chemotherapy-pretreated pancreatic
      cancer. CPT-11 was administered as a 30-minute i.v. infusion at a dose of 350
      mg/m2 diluted in 250 ml normal saline every 3 weeks. RESULTS: Thirty-four
      eligible patients were enrolled in the study, thirty-two of them were evaluated,
      and three achieved partial responses (9%; 95% C.I. = 3%-25%). The duration of
      response was 7.2, 7.5 and 7.8 months, respectively. Thirteen patients had no
      change, fourteen patients had progressive disease and two had early progressive
      disease. The median duration of survival for all patients treated was 5.2 months.
      The main toxicities (CTC grade > or = 3) were diarrhea, leukocytopenia, asthenia,
      nausea and vomiting in, respectively, 7%, 16%, 8%, 6%, 4% of the courses. These
      toxicities were reversible and manageable with anti-emetics and prophylactic or
      curative antidiarrheal agents. CONCLUSION: CPT-11 is an interesting moderately
      effective drug in pancreatic cancer.

PMID- 7786822
TI  - Population pharmacokinetics and pharmacodynamics of irinotecan (CPT-11) and
      active metabolite SN-38 during phase I trials.
AB  - BACKGROUND: Irinotecan (CPT-11) is a novel water-soluble camptothecin derivative
      selected for clinical testing based on its good in vitro and in vivo activity in
      various experimental systems, including pleiotropic drug-resistant tumors. Its
      mechanism of action appears mediated through topoisomerase I inhibition. The
      purpose of this study was to describe CPT-11 and active metabolite SN-38
      population pharmacokinetics, examine patient characteristics that may influence
      pharmacokinetics, and to investigate pharmacokinetic-pharmacodynamic
      relationships that may prove useful in the future clinical management of this
      drug. PATIENTS AND METHODS: As part of 3 Phase I studies including 235 patients,
      pharmacokinetics of CPT-11 and metabolite SN-38 were determined in 107 patients.
      CPT-11 was administered as a 30-min i.v. infusion according to 3 different
      schedules: daily for 3 consecutive days every 3 weeks, weekly for 3 weeks, and
      once every 3 weeks. Patients characteristics were the following: median age 53
      years; 62 men, 45 women; 105 caucasians, 2 blacks; performance status was 0-1 in
      96 patients; tumor sites were predominantly colon, rectum, head and neck, lung,
      ovary and breast; with the exception of 6 patients, all had been previously
      treated with surgery, chemotherapy and/or radiotherapy. CPT-11 and metabolite SN
      38 were simultaneously determined by HPLC using fluorescence detection.
      Pharmacokinetic parameters were determined using model-independent and model
      dependent analyses. RESULTS: 168 pharmacokinetic data sets were obtained in 107
      patients (97 first courses, 43 second courses, 23 third courses, 4 fourth
      courses, and 1 fifth course). Rebound concentrations of CPT-11 were frequently
      observed at about 0.5 to 1 h following the end of the i.v. infusion, which is
      suggestive of enterohepatic recycling of the drug. Model-independent analysis
      yielded the following mean population pharmacokinetic parameters for CPT-11: a
      terminal half-life of 10.8 h, a mean residence time (MRT) of 10.7 h, a volume of
      distribution at steady state (Vdss) of 150 L/m2, and a total body clearance of
      14.3 L/m2/h. Model-dependent analysis disclosed a CPT-11 plasma disposition as
      either biphasic or triphasic with a mean terminal half-life of 12.0 h. The volume
      of distribution Vdss (150 L/m2) and total body clearance (14.8 L/m2/h) yielded
      almost identical values to the above model-independent analysis. The active
      metabolite SN-38 presented rebound concentrations in many courses at about 1 h
      following the end of the i.v. infusion which is suggestive of enterohepatic
      recycling. The mean time at which SN-38 maximum concentrations was reached was at
      1 h since the beginning of the 0.5 h infusion (i.e., 0.5 h post i.v.). SN-38
      plasma decay followed closely that of the parent compound with a mean apparent
      terminal half-life of 10.6 h. Mean 24 h CPT-11 urinary excretion represented
      16.7% of the administered dose, whereas metabolite SN-38 recovery in urine was
      minimal (0.23% of the CPT-11 dose). The number of CPT-11 treatments did not
      influence pharmacokinetic parameters of either the parent compound or metabolite
      SN-38. Although CPT-11 pharmacokinetics presented an important interpatient
      variability, both CPT-11 maximum concentrations (Cmax) and the CPT-11 area under
      the plasma concentration versus time curves (AUC) increased proportionally and
      linearly with dosage (Cmax, r = 0.78, p < 0.001); CPT-11 AUC, r = 0.88, p <
      0.001). An increase in half-life and MRT was observed at higher dosages, although
      this did not influence the linear increase in AUC as a function of dose. The
      volume of distribution at steady state (Vdss) and the total body clearance (CL)
      were not affected by the CPT-11 dose. Metabolite SN-38 AUC increased
      proportionally to the CPT-11 dose (r = 0.67, p < 0.001) and also with the parent
      compound AUC (r = 0.75, p < 0.001) (ABSTRACT TRUNCATED)

PMID- 7786821
TI  - Phase I and pharmacokinetic study of irinotecan (CPT-11) administered daily for
      three consecutive days every three weeks in patients with advanced solid tumors.
AB  - BACKGROUND: We conducted a phase I and pharmacokinetic study to determine the
      maximum tolerable dose (MTD), toxicities, pharmacokinetic profile, and antitumor
      activity of Irinotecan (CPT-11) in patients with refractory solid malignancies.
      PATIENTS AND METHODS: Forty-six patients were entered in this phase I study. CPT
      11 was administered intravenously over 30 minutes for 3 consecutive days every 3
      weeks. Dose levels ranged from 33 mg/m2/day to 115 mg/m2/day on days 1 through 3.
      The pharmacokinetics of total CPT-11 and its active metabolite SN-38 were assayed
      by HPLC. RESULTS: The combination of leukopenia and diarrhea was dose-limiting
      toxicity at 115 mg/m2/day dose level, since 50% of the patients (5/10)
      experienced either grade 3-4 leukopenia, or diarrhea, or both. Leukopenia
      appeared to be a cumulative toxicity, with a global increase in its incidence and
      severity upon repeated administration of CPT-11. Other toxicities included
      nausea, vomiting, fatigue and alopecia. CPT-11 and active metabolite SN-38
      pharmacokinetics were determined in 21 patients (29 courses). Both CPT-11 and SN
      38 pharmacokinetics presented a high interpatient variability. CPT-11 mean
      maximum plasma concentrations reached 2034 ng/ml at the MTD (115 mg/m2). The
      terminal-phase half-life was 8.3 h and the mean residence time 10.2 h. The mean
      volume of distribution at steady state was 141 l/m2/h. CPT-11 rebound
      concentrations were observed in many courses at about 0.5 to 1 hour following the
      end of the i.v. infusion, which is suggestive of enterohepatic recycling. Total
      body clearance did not vary with increased dosage (mean = 14.3 l/h/m2),
      indicating linear pharmacokinetics within the dose range administered in this
      trial. The total area under the plasma concentration versus time curve (AUC)
      increased proportionally to the CPT-11 dose. Mean metabolite SN-38 peak levels
      reached 41 ng/ml at the MTD. A significant correlation was observed between CPT
      11 area under the curve (AUC) and its corresponding metabolite SN-38 AUC (r =
      0.52, p < 0.05). SN-38 rebound concentrations were observed in many courses at
      about 0.5 to 1 hour following the end of the i.v. infusion, which is suggestive
      of enterohepatic recycling. Mean 24-h urinary excretion of CPT-11 accounted for
      10% of the administered dose by the third day, whereas SN-38 urinary excretion
      accounted for 0.18% of the CPT-11 dose. In this phase I trial, the hematological
      toxicity correlated with neither CPT-11 nor SN-38 AUC. Diarrhea grade correlated
      significantly with CPT-11 AUC. Two partial (breast adenocarcinoma and carcinoma
      of unknown primary) and 2 minor (hepatocarcinoma and pancreatic adenocarcinoma)
      responses were observed. CONCLUSION: The MTD for CPT-11 administered in a 3
      consecutive-days-every-3 weeks schedule in this patient population is 115
      mg/m2/day. The recommended dose for phase II studies is 100 mg/m2/day.

PMID- 7786823
TI  - Early versus late alternating chemotherapy in small-cell lung cancer. Swiss Group
      for Clinical Cancer Research (SAKK).
AB  - BACKGROUND: From 1984 to 1989, the Swiss Group for Clinical Cancer Research
      (SAKK) performed a randomized phase III trial comparing early versus late
      alternating chemotherapy in patients with small-cell lung cancer. PATIENTS AND
      METHODS: 406 eligible patients were entered into the trial. Regimen A consisted
      of PAV (cisPlatin, Adriamycin, VP 16-213, and Regimen B of CyMOC
      (Cyclophosphamide, Methotrexate, Oncovin, CCNU). Cycles were repeated as rapidly
      as possible. patients were randomized to receive either ABABAB (early alternating
      chemotherapy) or AAABBB (late alternating chemotherapy). After six cycles
      patients with limited disease in complete or partial remission and those with
      extensive disease in complete remission received irradiation to the primary (45
      Gy) and the CNS (36 Gy). RESULTS: The overall remission rate was 87% with 31%
      complete remissions. The median survival of all 406 eligible patients was 346
      days with 15% of the patients alive at two years. The overall remission rate, the
      rate of complete remission, the median survival and the rate of long-term
      survival were not significantly different in the two treatment arms. In limited
      disease the estimated percentages of survival at 2 years were 33% in the early
      and 24% in the late alternating chemotherapy arms. Patients with extensive
      disease survived significantly longer with late alternating chemotherapy than on
      the early alternation regimen (median survival 336 days versus 301 days, p =
      0.01). In the latter patients the received dose intensities (RDI) of cisplatin,
      adriamycin and etoposide were significantly higher in the late-alternation arm.
      Patients treated with early alternating chemotherapy rated their tumor symptoms,
      functional states, fatigue/malaise and restriction of social activity
      significantly better, reflecting an improved subjective adjustment. CONCLUSIONS:
      Alternating chemotherapy with PAV-CyMOC plus consolidating radiotherapy is a
      feasible and effective treatment for small-cell lung cancer, with acceptable
      toxicity. Whereas patients with early alternating chemotherapy achieve a better
      subjective adjustment, late alternating chemotherapy allows for a higher RDI of
      cisplatin, adriamycin and etoposide, which results in a significantly longer
      median survival of patients with extensive disease.

PMID- 7786824
TI  - ChlVPP therapy for Hodgkin's disease: experience of 960 patients. The
      International ChlVPP Treatment Group.
AB  - BACKGROUND: Combination chemotherapy or combined chemo-radiotherapy is the
      treatment of choice for patients with advanced stage Hodgkin's disease and for
      patients failing curative radiotherapy. Increasingly, particularly in Europe,
      patients with early stage disease with poor prognostic features are also
      primarily treated with chemotherapy or combined chemo-radiotherapy. We analyzed
      the experience of 4 research groups which used ChlVPP, with or without
      radiotherapy, as standard chemotherapy for Hodgkin's disease. PATIENTS AND
      METHODS: Patients with Hodgkin's disease were treated with ChlVPP chemotherapy:
      days 1-14: chlorambucil: 6 mg/m2/day, procarbazine: 100 mg/m2/day, prednisone or
      prednisolone: 40 mg/day; Days 1, 8: vinblastine: 6 mg/m2/day. The use of
      radiotherapy varied across research groups, with many, but not all, patients
      receiving radiotherapy. RESULTS: A total of 960 patients were treated. 60% were
      male, 25% were aged 50+, 59% had nodular sclerosis histology. Failure-free
      survival (time to first occurrence of progression, relapse after response or
      death from any cause) at 5 years by stage was: Stage I/IIA (231 patients), 75%;
      I/IIB (152 patients), 62%; IIIA (180 patients), 67%; IIIB/IV (397 patients), 51%.
      Adverse prognostic factors for all patients included age 50+ and 'B' symptoms.
      Patients aged 50+ of all stages did especially poorly on ChlVPP therapy. The 34
      stage IIIB/IV patients with lymphocyte depleted histology also did poorly.
      CONCLUSIONS: These results compare favorably with other reported series. ChlVPP
      is an appropriate alternative to other chemotherapy regimens for some Hodgkin's
      disease patients, often with a reduced toxicity profile. Other chemotherapy may
      be preferred in patients greater than 50 years of age.

PMID- 7786825
TI  - A phase II trial of vinorelbine and thiotepa in metastatic breast cancer.
AB  - BACKGROUND: Vinorelbine as single-agent has achieved an overall response rate of
      > 20% as second-line treatment and 40%-50% as first-line treatment. The aim of
      this study was to evaluate the activity and toxicity of the combination of
      vinorelbine and thiotepa as second-line treatment in patients with metastatic
      breast cancer. PATIENTS AND METHODS: Thirty-three patients (31: anthracycline
      based chemotherapy, 16: high-dose epirubicin) were given vinorelbine 30 mg/m2 and
      thiotepa 12 mg/m2 d 1 and 8 every 21 days. RESULTS: Among the 32 evaluable
      patients two complete responses and seven partial responses were observed, for an
      overall response rate of 28% (C.I. 12-44). The median duration of response was 9
      months and the median time to progression 6 months. Significant toxicity was
      primarily leukopenia (72%); anemia was also frequent (48%) as well as local
      phlebitis (39%). CONCLUSION: The present study has shown this combination to be
      active as second-line treatment, and its toxic effects have been well tolerated.
      It should be considered a reasonable option for patients with metastatic disease
      who have already been treated with anthracyclines.

PMID- 7786827
TI  - Oregon approves assisted suicide measures.

PMID- 7786826
TI  - Phase I study of weekly high-dose cisplatin combined with long-term oral
      etoposide in advanced solid tumors.
AB  - BACKGROUND: In a previous phase I study we showed that single-agent cisplatin can
      be given weekly for six weeks at a dose of 80 mg/m2/wk. It has been suggested
      that etoposide has synergistic activity with cisplatin and the drug can be given
      orally continuously. We therefore performed a phase I study with weekly cisplatin
      combined with oral etoposide. PATIENTS AND METHODS: Nineteen patients with
      metastases of a solid tumor were entered in the study. Cisplatin was administered
      in hypertonic saline (NaCl 3%). Etoposide was administered as 50-mg capsules.
      RESULTS: The starting dose was cisplatin weekly at a dose of 70 mg/m2 for six
      weeks combined with daily oral etoposide at a dose of 50 mg. At the maximum
      tolerable dose of cisplatin 75 mg/m2/wk and etoposide 50 mg/m2 daily,
      leukocytopenia and thrombocytopenia were dose-limiting toxic effects which
      resulted in frequent treatment delays. Other toxicities were mild. Finally, a
      dose of cisplatin 70 mg/m2/wk weeks 1-2-3 and weeks 5-6-7 in combination with
      etoposide 50 mg orally days 1-15 and days 29-43 combined a high median cisplatin
      dose intensity of 52.5 mg/m2/wk with a good patient tolerance. CONCLUSION: It is
      feasible to administer frequently dosed cisplatin in combination with oral
      etoposide. Leukocytopenia and thrombocytopenia are dose-limiting toxicities. The
      schedule will be explored further in phase II studies.

PMID- 7786828
TI  - Survey on euthanasia in Britain.

PMID- 7786829
TI  - . . . and funding for cancer research must be transparent.

PMID- 7786830
TI  - French minister: "we badly need a cancer plan...".

PMID- 7786831
TI  - Preconditioning with a single short episode of global ischemia in the isolated
      working rat heart: effect on structure, mechanical function, and energy
      metabolism for various durations of sustained global ischemia.
AB  - PURPOSE: Preconditioning in the setting of global ischemia, using functional
      recovery during reperfusion as the endpoint, has recently been demonstrated in
      the isolated perfused rat heart. It has been suggested that its beneficial
      actions have a metabolic basis. The isolated rat heart has not been fully
      characterized with respect to the metabolic, functional, and structural changes
      associated with this phenomenon in the setting of global ischemia. The purpose of
      this study was to determine (1) the time course of protection conferred by a
      single episode (5 minutes) of preconditioning; (2) changes in tissue high energy
      phosphates, lactate, and glycogen levels at different time intervals; and (3)
      morphological appearance of the heart at the end of ischemia as well as after
      reperfusion. METHODS: Isolated perfused working rat hearts were used.
      Preconditioning consisted of a single episode of 5 minutes of global ischemia and
      15 minutes of reperfusion. Preconditioned and non-preconditioned hearts were
      subjected to global ischemia of 20-35 minutes duration. Functional recovery,
      energy metabolism (high energy phosphates, lactate, and glycogen), and structural
      appearance were studied at different stages. RESULTS: The functional recovery of
      the preconditioned hearts was significantly higher than in the corresponding
      nonpreconditioned group during reperfusion for all durations of ischemia longer
      than 25 minutes. The degree of protection observed was less than reported
      previously. A minor degree of energy sparing was reflected by differences in the
      rate of depletion of glycogen and accumulation of tissue lactate during the
      sustained episode of ischemia. Semiquantitative light microscopy evaluation
      revealed that ischemia-induced structural damage was less in the preconditioned
      hearts, both at the end of the sustained ischemic episode as well as after
      reperfusion. CONCLUSIONS: A single episode of global ischemia successfully
      preconditions the isolated working rat heart. The protection elicited was
      demonstrated on a functional and structural level, and was accompanied by a small
      energy-sparing effect.

PMID- 7786832
TI  - Effects of growth hormone in rats with postinfarction left ventricular
      dysfunction.
AB  - Growth hormone may affect cardiac function. In rats, chronic hypersecretion of
      growth hormone leads to increased maximum isometric contractile force of the left
      ventricular papillary muscle in vitro. In humans, administration of growth
      hormone can increase myocardial contractility. However, cardiac effects of growth
      hormone in heart failure or cardiac dysfunction have not been studied to date.
      The current study was to evaluate the cardiac effects of growth hormone in
      conscious rats with postinfarction left ventricular dysfunction and sham
      controls. Ligation of the left coronary artery or sham operation was performed,
      then 4 weeks after surgery, recombinant human growth hormone (2 mg/kg/day, SC) or
      vehicle was administered for 15 days. Catheters were implanted 13 days after
      treatment with growth hormone or vehicle. Hemodynamic parameters were measured in
      conscious rats 2 days after catheterization. In vehicle-treated rats, left
      ventricular systolic pressure, maximum dP/dt, and arterial pressure were
      significantly decreased and left ventricular end-diastolic pressure was
      significantly increased in the ligation group compared with sham controls. Growth
      hormone treatment increased left ventricular systolic pressure (p < 0.05) and
      dP/dt (p < 0.05) and reduced left ventricular end-diastolic pressure (p < 0.05),
      significantly in the ligated rats. In sham rats, growth hormone tended to
      decrease arterial pressure but did not alter ventricular contractility. Neither
      ligation nor growth hormone significantly altered heart rate and right atrial
      pressure. These results suggest that growth hormone treatment may improve cardiac
      function by increasing myocardial contractility in cardiac dysfunction or heart
      failure.

PMID- 7786833
TI  - Effect of beta-blockade on exercise capacity in hypertensive subjects: a one-year
      double-blind study of celiprolol and metoprolol.
AB  - To assess the effect of beta-blocker antihypertensive therapy on exercise
      capacity, 40 patients randomized to celiprolol 200 mg and metoprolol 100 mg daily
      in a double-blind fashion were studied after a month of placebo and a year of
      active treatment. Both drugs normalized office blood pressure and produced
      echocardiographic and electrocardiographic left ventricular hypertrophy
      regression. In symptom-limited maximal stress tests before and after treatment,
      exercise duration increased with (p < 0.0001) celiprolol (513-700 seconds) and
      metoprolol (520-634 seconds), although more with the former (p = 0.02). Resting
      heart rate was reduced with both, more with metoprolol (p < 0.001), while heart
      rate at peak exercise was reduced similarly with both medications (p < 0.005).
      Blood pressure at peak exercise was reduced with both celiprolol (217-184 mmHg; p
      = 0.0002) and metoprolol (218-185 mmHg, p < 0.0001) to a similar degree (p = NS).
      Exercise parameters were not related to patient age or the degree of left
      ventricular hypertrophy regression (p = NS). It is concluded that beta-blocker
      antihypertensive therapy improves exercise capacity, decreasing heart rate and
      blood pressure responses to stress, irrespective of left ventricular structural
      changes.

PMID- 7786834
TI  - Comparative effects of fosinopril and nifedipine on regression of left
      ventricular hypertrophy in hypertensive patients: a double-blind study.
AB  - The effects of fosinopril and nifedipine on left ventricular (LV) mass were
      evaluated in 35 hypertensive patients with LV mass index greater than 110 g/m2 in
      female and 130 g/m2 in male patients. The goal of therapy was also to obtain a
      seated diastolic blood pressure (SDBP) of less than 90 mmHg. The patients were
      studied by echocardiography after 2 weeks of placebo treatment and 4, 12, and 24
      weeks of monotherapy with active drugs. Both fosinopril and nifedipine reduced
      SDBP to a normal level after 6 months of treatment (p < .001). Regression of LV
      hypertrophy was achieved by either agent (p < .001), with fosinopril being more
      effective than nifedipine (p < .002). In conclusion, both fosinopril and
      nifedipine effectively reduce SDBP and achieve important regression of LV
      hypertrophy.

PMID- 7786835
TI  - "Escape" of aldosterone production in patients with left ventricular dysfunction
      treated with an angiotensin converting enzyme inhibitor: implications for
      therapy.
AB  - Despite the findings in randomized trials of a significant effect of angiotensin
      converting enzyme (ACE) inhibitors in reducing morbidity and mortality of
      patients with symptomatic left ventricular dysfunction, the morbidity and
      mortality of these patients remains relatively high. One potential strategy to
      further improve morbidity and mortality in these patients is blockade of a
      aldosterone. Many clinicians have assumed that ACE inhibitors would block both
      angiotensin II and aldosterone. However, there are data to suggest that
      aldosterone production may "escape" despite the use of an ACE inhibitor. An
      escape of aldosterone production has several important consequences, including:
      sodium retention, potassium and magnesium loss, myocardial collagen production,
      ventricular hypertrophy, myocardial norepinephrine release, endothelial
      dysfunction, and a decrease in serum high density lipoprotein cholesterol. Due to
      the potential importance of these mechanisms, the finding that there is a
      significant correlation between aldosterone production and mortality in patients
      with heart failure, as well as evidence that an aldosterone antagonist,
      spironolactone, when administered to patients with heart failure treated with
      conventional therapy including an ACE inhibitor results in increased diuresis and
      symptomatic improvement, an international prospective multicenter study has been
      organized, the Randomized Aldactone Evaluation Study (RALES Pilot Study), to
      evaluate the safety of blocking the effects of aldosterone in patients with heart
      failure treated with an ACE inhibitor.

PMID- 7786836
TI  - Distinct modulation of myocardial performance, energy metabolism, and [Ca2+]i
      transients by positive inotropic drugs in normal and severely failing hamster
      hearts.
AB  - The present study compared the effects of amrinone, dobutamine, dibutyryl cAMP,
      digoxin, and isoproterenol on mechanical performance, the high energy phosphate
      metabolites, and the [Ca2+]i transients in normal and cardiomyopathic hamster
      hearts with severe heart failure. In normal hearts dobutamine, dibutyryl cAMP,
      and isoproterenol increased left ventricular developed pressure, while amrinone
      and digoxin did not. However, the amplitude of [Ca2+]i transients was augmented
      with all drugs. Diastolic [Ca2+]i level was increased with dobutamine and lowered
      with dibutyryl cAMP and isoproterenol. In cardiomyopathic hearts with severe
      heart failure, left ventricular developed pressure, the amplitude of [Ca2+]i
      transients, the phosphorylation potential, and [cAMP]i were significantly
      depressed and left ventricular end-diastolic pressure and diastolic [Ca2+]i were
      significantly elevated when compared with normal hearts. Amrinone, dibutyryl
      cAMP, and isoproterenol improved mechanical performance while increasing [cAMP]i
      and the amplitude of [Ca2+]i transients, and decreasing diastolic [Ca2+]i. On the
      other hand, with dobutamine and digoxin diastolic [Ca2+]i was further increased
      and mechanical performance deteriorated with digoxin. Thus, distinct differences
      exist in modulation of mechanical performance, high-energy phosphate metabolism,
      and [Ca2+]i transients by positive inotropic drugs between normal and
      cardiomyopathic hearts with severe heart failure.

PMID- 7786837
TI  - Muscarinic receptors and drugs in cardiovascular medicine.
AB  - The parasympathetic system and its associated muscarinic receptors have been the
      subject of a renaissance of interest for the following two main reasons: (1) the
      association of endothelial muscarinic receptors and the nitric oxide (NO)
      pathway; (2) the discovery of several muscarinic receptor subtypes and drugs
      interacting with them. In the present survey modern insights into the subdivision
      of muscarinic receptors have been dealt with as the basis for a description of
      the muscarinic receptor agonists and antagonists thus far known. There are at
      least four pharmacologically defined M receptors (M1, M2, M3, M4) in primary
      tissues, and five muscarinic receptors have been cloned (m1, m2, m3, m4, m5).
      Selective agonists for M-receptor subtypes hardly exist, and all classical
      agonists (acetylcholine, carbachol, etc.) are clearly nonselective. A few
      selective antagonists for M1 (pirenzepine) and M2 receptors (AF-DX 116) have been
      introduced, although selective M3 receptors are hardly available. Finally, the
      potential therapeutic use of M-receptor agonists (myocardial ischemia,
      hypertension) and muscarinic antagonists (certain forms of bradycardia, coronary
      spasm) has been critically discussed. Although only in a preliminary stage, this
      development appears to be promising and at least of great fundamental interest.

PMID- 7786838
TI  - Elastic properties and Windkessel function of the human aorta.
AB  - An understanding of the role of the aortic elastic properties indicates their
      relevance at several sites of cardiovascular function. Acting as an elastic
      buffering chamber behind the heart (the Windkessel function), the aorta and some
      of the proximal large vessels store about 50% of the left ventricular stroke
      volume during systole. In diastole, the elastic forces of the aortic wall forward
      this 50% of the volume to the peripheral circulation, thus creating a nearly
      continuous peripheral blood flow. This systolic-diastolic interplay represents
      the Windkessel function, which has an influence not only on the peripheral
      circulation but also on the heart, resulting in a reduction of left ventricular
      afterload and improvement in coronary blood flow and left ventricular relaxation.
      The elastic resistance (or stiffness), which the aorta sets against its systolic
      distention, increases with aging, with an increase in blood pressure, and with
      pathological changes such as atherosclerosis. This increased stiffness leads to
      an increase in systolic blood pressure and a decrease in diastolic blood pressure
      at any given mean pressure, an increase in systolic blood velocity, an increase
      in left ventricular afterload, and a decrease in subendocardial blood supply
      during diastole, and must be considered a major pathophysiological factor, for
      example, in systolic hypertension. The elastic properties of the aortic
      Windkessel can be assessed in vivo in humans in several ways, most easily by
      measuring the pulse wave velocity along the aorta. The higher this velocity, the
      higher the elastic resistance, that is, the stiffness. Other methods depend on
      assessment of the ratio between pulse pressure and aortic volume changes (delata
      P/delta V), which can be assessed noninvasively by ultrasonic or tomographic
      methods. All assessments of vessel stiffness have to take into account the direct
      effect of current blood pressure, and thus judgements about influences of
      interventions rely on an unchanged blood pressure. Alternatively, to derive the
      "intrinsic" stiffness of the aortic wall one has to correct for the effect of the
      blood pressure present. Recently reports about pharmacologic influences on the
      elastic properties of the aorta have emerged in the literature.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 7786840
TI  - Reduction of ischemic events with angiotensin-converting enzyme inhibitors:
      lessons and controversy emerging from recent clinical trials.
AB  - Angiotensin-converting enzyme (ACE) inhibitor therapy has been associated with a
      substantial (> or = 20%) reduction in the risk of major ischemic events in two
      recent clinical trials with long-term follow-up: Studies of Left Ventricular
      Dysfunction (SOLVD) and the Survival and Ventricular Enlargement (SAVE) study.
      Participants in these studies included patients with a low ejection fraction (<
      or = 0.35 in SOLVD and < or = 0.40 in SAVE), generally without symptoms of
      congestive heart failure. Approximately 80% of patients enrolled in SOLVD and all
      participants in SAVE had histories of ischemic heart disease or acute myocardial
      infarction (SAVE). In both SOLVD and SAVE the risk of experiencing a major
      ischemic event such as myocardial infarction was reduced significantly following
      prolonged ACE inhibitor therapy. In the SOLVD trial, this effect was evident
      across a range of patient subgroups, including varying concomitant drug
      therapies. In both studies, several months elapsed before this benefit became
      apparent, suggesting an effect on underlying ischemic pathophysiology. A third
      trial of ACE inhibitor therapy postinfarction, the Acute Infarction Ramipril
      Efficacy (AIRE) Study, demonstrated a 27% reduction in all cause mortality but no
      effect on myocardial infarction after a 15-month mean follow-up. No effect of ACE
      inhibition on risk of survival or reinfarction was reported in the Cooperative
      New Scandinavian Enalapril Survival Study (CONSENSUS-II), which began the drug
      within 24 hours of infarction and terminated follow-up at 6 months, a time not
      likely to demonstrate infarction reduction benefit based on the SOLVD and SAVE
      observations. Neither AIRE nor CONSENSUS-II had objectively determined left
      ventricular dysfunction as an entry criterion, as did SOLVD and SAVE, but AIRE
      mandated "clinical" congestive heart failure prior to randomization. More
      recently, preliminary results from the third Gruppo Italiano per lo Studio della
      Sopravvivenza nell'Infarto Miocardico (GISSI-3), the Fourth International Study
      of Infarct Survival (ISIS-4), and the Chinese Captopril Trial suggested that
      angiotensin-converting enzyme (ACE) inhibitor mortality benefits post-myocardial
      infarction would be detected in these megatrials as early as 35 days after the
      event.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7786839
TI  - Intravenous cibenzoline in the management of acute supraventricular
      tachyarrhythmias.
AB  - Intravenous cibenzoline was evaluated in 37 patients with acute supraventricular
      tachyarrhythmias and a ventricular rate > 120 beats/min. The presenting
      arrhythmia was atrial fibrillation in 15 patients, atrial flutter in 5, ectopic
      atrial tachycardia in 11, and paroxysmal atrioventricular (AV) junctional
      reentrant tachycardia in 6 patients. Intravenous cibenzoline was administered as
      a bolus given over 2 minutes, at a dose of 1 mg/kg in the first 26 patients and
      1.2 mg/kg in the subsequent 11 patients, 15 minutes following failure of placebo
      (isotonic glucose). The results were evaluated 15 minutes after the intravenous
      injection. Restoration of sinus rhythm was obtained in 3 out of 6 patients with
      paroxysmal AV junctional tachycardia (50%) and in 7 out of 31 patients (23%) with
      atrial tachyarrhythmias (5 out of 15 patients with atrial fibrillation and 2 out
      of 16 patients with ectopic atrial tachycardia or atrial flutter). Five
      additional patients with atrial tachyarrhythmias had slowing of ventricular rate
      below 100 beats/min. Therefore, a satisfactory result, that is, restoration of
      sinus rhythm or slowing of ventricular rate, occurred in 15 patients (40.5%).
      Side effects were transient, including visual disturbance (one patient),
      asymptomatic widening of QRS complex (three patients), incessant reciprocating
      tachycardia (one patient), and acceleration of ventricular rate (eight patients),
      resulting in 1:1 flutter, with poor tolerance in two patients.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7786841
TI  - Adaptation aftereffects in single neurons of cat visual cortex: response timing
      is retarded by adapting.
AB  - Extracellular single-unit recordings were made from simple cells in area 17 of
      anesthetized cats. Cells were tested with drifting gratings under control and
      adapted conditions. Response amplitude and phase were measured as a function of
      either contrast or temporal frequency. Adapting not only reduces amplitude, but
      also retards phase. Adaptation alters the responses of simple cells in a
      particular way: the onset of the response to each cycle of a sinusoidally
      modulate stimulus is delayed. Once cells start to respond during each cycle,
      however, they generally recover to control levels, and the offset of the response
      is unaffected by adapting. The timing aftereffects are independent of the
      amplitude aftereffects. Timing aftereffects are tuned around the adapting
      temporal frequency, with a bias toward lower temporal frequencies. Adaptation
      thus modifies cortical responses even more specifically then previously thought.
      Firing rates are depressed primarily at response onset, even after several
      stimulus cycles have occurred following the end of adapting. Because all cells
      appear to adapt in this way, the data offer an opportunity to theorize about
      cortical connectivity. One implication is that inhibition onto a simple cell
      arises from other simple cells with similar response properties that fire a half
      cycle out of phase with the target cell.

PMID- 7786842
TI  - How task-related are the responses of inferior temporal neurons?
AB  - The responses of inferior temporal (IT) neurons may depend on the behavioral
      context of the stimuli; e.g. in Konorski tasks responses to two successively
      presented physically identical stimuli can be markedly different. This effect has
      been interpreted as being linked to the behavioral task, and to be involved in
      short-term memory and/or the temporal comparison of successively presented
      stimuli. We tested whether this behavioral context effect also occurs when the
      monkey is not executing a Konorski task, i.e. no temporal comparison of stimuli
      is being performed. Responses of the same IT neurons under two behavioral
      conditions were compared using the same temporal stimulus sequence (but different
      stimuli): a Konorski task and a Fixation task. We found that the occurrence of
      the behavioral context effect did not depend on the execution of the short-term
      memory task. The observed decline in the level of responses to repeated
      presentation of similar stimuli is interpreted as being a passive mechanism
      involved in recency detection, which occurs even if the recency information is
      not useful for the task. The importance of these results in the interpretation of
      "task-related" neuronal responses is discussed.

PMID- 7786843
TI  - Expression of the proto-oncogene, trk, receptors in the developing rat retina.
AB  - The neurotrophins, including nerve growth factor (NGF), brain-derived
      neurotrophic factor (BDNF), neurotrophin-3 (NT-3) and NT-4/5 are important in a
      variety of developmental processes in the peripheral and central nervous systems.
      These molecules bind to a low-affinity receptor and to distinct high-affinity
      receptors. The high-affinity receptor for NGF is the proto-oncogene product,
      p140trkA(trkA). Isoforms of p140trkA, p145trkB(trkB), and p140trkC(trkC), are the
      primary high-affinity receptors for BDNF and NT-3, respectively. We evaluated the
      developmental regulation of the high-affinity neurotrophin receptors in the rat
      retina using polyclonal antibodies directed to a highly conserved region of the C
      terminus of the p140trkA isoforms (pantrk) and antibodies directed to unique
      amino-acid sequences of p140trkA, p145trkB, and p140trkC. Immunoreactivities for
      trkA and trkB, as well as pantrk, were detected in the developing retina and
      showed similar distributions. At similar antibody concentrations, trkC
      immunoreactivity was not detected. In the embryo, immunoreactivties were present
      in cells located throughout the neuroblastic retina, especially in the inner
      retinal layers, and in fibers in the nerve fiber layer and optic nerve. In the
      newborn retina, immunoreactivities for these two receptor isoforms were localized
      to numerous somata in the inner nuclear layer (INL), as well as to cells in the
      ganglion cell layer (GCL) and axons in the nerve fiber layer and optic nerve. A
      similar pattern of immunostaining persisted throughout the first postnatal week.
      By postnatal day-10, immunostaining was confined to large-diameter cells in the
      GCL, both heavily stained and lightly stained cells in the INL and a plexus of
      processes in the inner plexiform layer (IPL).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786844
TI  - The VEP thresholds for full-field stimuli in dark-adapted infants.
AB  - Dark-adapted adults' electroretinographic b-wave thresholds are approximately 2
      log units below a-wave thresholds and approximately 3 log units above the
      perceptual threshold, and their perceptual and the visually evoked cortical
      potential (VEP) thresholds are similar. Dark-adapted infants' scotopic a- and b
      wave thresholds for full-field stimuli are both about 0.5 log units above those
      of adults, but their scotopic VEP thresholds for such stimuli have not been
      studied. We obtained scotopic VEP thresholds for brief, full-field stimuli from
      dark-adapted, infants and adults to consider the relationships of the cortical
      responses to the responses of more distal structures, namely the rod
      photoreceptors (scotopic a-wave) and ON-bipolars (scotopic b-wave). The median
      VEP threshold of infants is 0.5 log unit above that of adults. Thus, the
      relationships of a- and b-wave and VEP thresholds in infants are similar to those
      in adults. These results are consistent with rod cell immaturities being the
      primary determinant of the difference between infants' and adults' thresholds.

PMID- 7786845
TI  - Effects of wavelength on the timing and laminar distribution of illuminance
      evoked activity in macaque V1.
AB  - Responses to full-field colored flashes (red, blue, and green) were compared with
      those to illuminance-matched white flashes in area V1, optic radiations, and the
      lateral geniculate nucleus of two alert macaques. Laminar profiles of visual
      evoked potentials (VEPs), current source density, and multiunit activity were
      obtained using multicontact electrodes capable of sampling from all layers of
      cortex or lateral geniculate nucleus, simultaneously. In striate cortex,
      stimulation with colored flash enhanced transmembrane current flow dramatically
      in both layer 4c and the supragranular laminae. Stimulation with red evoked the
      largest enhancement in every electrode penetration. The mean peak amplitudes of
      current sinks evoked by red were 203% and 537% of those evoked by white light in
      layer 4c and the supragranular laminae, respectively. Color effects in V1 were
      preceded by an initial epoch of wavelength-insensitive activity. In layer 4c, the
      red effect reached significance, on average, at 47 ms, or approximately 24 ms
      after the onset of transmembrane current flow. In the supragranular layers, the
      red effect reached significance, on average, at 55 ms, or approximately 14 ms
      after the onset of current flow. Recordings from optic radiations in the white
      matter below V1 and from lateral geniculate nucleus showed no significant
      difference in the responses to color and illuminance-matched white light.
      Enhancement of supragranular current flow with color stimulation increased the
      contribution of these laminae to the generation of the surface VEP. Comparison of
      the surface VEP wave forms evoked by white and color stimuli may, therefore, help
      to differentiate the responses of the granular and supragranular laminae.

PMID- 7786846
TI  - Ultrastructural study of the optic nerve in blind mole-rats (Spalacidae, Spalax).
AB  - The optic nerve in two species of subterranean mole-rats (Spalacidae) has been
      examined at the ultrastructural level. The axial length of the eye and the
      diameter of the optic nerve are 1.9 mm and 52.5 microns in Spalax leucodon, and
      0.7 mm and 80.8 microns in Spalax ehrenbergi, respectively. An anti-glial
      fibrillary acidic protein postembedding procedure was used to distinguish glial
      cell processes from axons. In both species, the optic nerve is composed
      exclusively of unmyelinated axons and a spatial distribution gradient according
      to the size or the density of fibers is lacking. The optic nerve of S. leucodon
      contains 1790 fibers ranging in diameter from 0.07-2.30 microns (mean = 0.57
      microns), whereas in S. ehrenbergi, only 928 fibers, with diameters of 0.04-1.77
      microns (mean = 0.53 microns) are observed. In S. ehrenbergi, a higher proportion
      of glial tissue is present and the fascicular organization of optic fibers is
      less obvious. Distribution gradients according to size frequency or density of
      fibers in the optic nerve are absent in both species. Comparison with other
      mammals suggests that although ocular regression in microphthalmic species is
      correlated with a significant decrease in the total number of optic fibers and
      the relative proportion of myelinated fibers, no difference in the absolute size
      range of unmyelinated axons is observed. The total absence of myelinated fibers
      in Spalax may be related to the subcutaneous location of the eyes.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7786848
TI  - The glial ensheathment of the soma and axon hillock of retinal ganglion cells.
AB  - We have studied the glial investment of ganglion cells of the cat's retina,
      orienting the sections taken for electron microscopy so that the investment could
      be traced from the soma along the axon. The soma of each ganglion cell is covered
      by a close-fitting, continuous sheath formed by Muller cells. The axon hillock
      and the first part of the initial segment are invested by an extension of the
      somal sheath, and are thus enclosed in the same glial compartment as the soma.
      The initial segment extends a few microns past the Muller cell sheath; this last
      length of the initial segment is contacted by numerous processes of astrocytes,
      which converge on it in a pattern found also on nodes of the same axons, in the
      optic nerve. Beyond the initial segment, the intraretinal lengths of the axons
      are invested by both Muller cells and astrocytes, but the investment is
      strikingly incomplete. Large areas of axonal membrane have no glial cover, and
      lie close to other axonal membranes. The sequential arrangement of these distinct
      forms of glial wrapping of the soma, initial segment, and axon is described here
      for the first time. It is suggested that this pattern of glial investment
      controls the flow of current between dendrite and initial segment of the ganglion
      cell, defines the site of initiation of action spikes, and controls the formation
      of synapses on the soma and initial segment.

PMID- 7786847
TI  - Characterization and localization of an aldehyde dehydrogenase to amacrine cells
      of bovine retina.
AB  - An enzyme of bovine retina that catalyzes oxidation of retinaldehyde to retinoic
      acid was purified to homogeneity and a monoclonal antibody (mAb H-4) was
      generated. MAb H-4 recognized a single component (Mr = 55,000) in extracts of
      bovine retina and other bovine tissues. The antibody showed no cross-reactivity
      with extracts of rat, monkey, or human retinas. A 2067 bp cDNA was selected from
      a retina cDNA expression library using mAb H-4. The cDNA hybridized with a
      similarly sized, moderately abundant mRNA prepared from bovine retina. Nucleotide
      sequence analysis indicated that the cDNA contained a single open reading frame
      encoding 501 amino acids that have 88% sequence identity with the amino-acid
      sequence of human hepatic Class 1 aldehyde dehydrogenase. Amino-acid sequence
      analysis of purified enzyme demonstrated that the cDNA encodes the isolated
      enzyme. MAb H-4 specifically labeled the somata and processes of a subset of
      amacrine cells in bovine retinal sections. Labeled amacrine somata were located
      on both sides of the inner plexiform layer, and their processes ramified into two
      laminae within the inner plexiform layer. The inner radial processes of Muller
      (glial) cells were weakly reactive with mAb H-4. Weak immunostaining of amacrine
      cells was found in monkey retina with mAb H-4, but no signal was detected in rat
      or human retina. The results provide further evidence for metabolism and function
      of retinoids within cells of the inner retina and define a novel class of retinal
      amacrine cells.

PMID- 7786850
TI  - Receptive-field properties of Q retinal ganglion cells of the cat.
AB  - The goal of this work was to provide a detailed quantitative description of the
      receptive-field properties of one of the types of rarely encountered retinal
      ganglion cells of cat; the cell named the Q-cell by Enroth-Cugell et al. (1983).
      Quantitative comparisons are made between the discharge statistics and between
      the spatial receptive properties of Q-cells and the most common of cat retinal
      ganglion cells, the X-cells. The center-surround receptive field of the Q-cell is
      modeled here quantitatively and the typical Q-cell is described. The temporal
      properties of the Q-cell receptive field were also investigated and the dynamics
      of the center mechanism of the Q-cell modeled quantitatively. In addition, the
      response vs. contrast relationship for a Q-cell at optimal spatial and temporal
      frequencies is shown, and Q-cells are also demonstrated to have nonlinear spatial
      summation somewhat like that exhibited by Y-cells, although much higher contrasts
      are required to reveal this nonlinear behavior. Finally, the relationship between
      Q-cells and Barlow and Levick's (1969) luminance units was investigated and it
      was found that most Q-cells could not be luminance units.

PMID- 7786849
TI  - The cat's pupillary light response under urethane anesthesia.
AB  - Pupillary area was measured in urethane-anesthetized cats as a function of
      retinal illuminance. When appropriate corrections are made for differences in
      experimental procedures, it was found that the pupillary response of the urethane
      anesthetized cat's eyes to light was basically unchanged from that of the alert
      behaving cat. This preparation may therefore be a very satisfactory one in which
      to study the pupillary response pathway in a higher mammal.

PMID- 7786851
TI  - Calbindin D-28K immunoreactivity of human cone cells varies with retinal
      position.
AB  - Calbindin D-28K is a calcium-binding protein found in the cone but not rod
      photoreceptor cells in the retinas of a variety of species. Recent studies of the
      monkey retina indicated that calbindin D-28K may be expressed preferentially in
      non-foveal regions of the retina. In the current studies of human retinas,
      immunohistochemical experiments demonstrated that calbindin D-28K is reduced or
      absent in the fovea and parafovea, but prevalent in the perifovea and periphery.
      These findings were supported by the quantification of calbindin D-28K in 1-mm
      trephine punches obtained from different regions of the human retina. The
      specificity of the anti-calbindin D-28K antibodies used in these studies was
      confirmed by Western blot analysis using purified calbindin D-28K. The protein
      was purified from retinal tissue and its identity confirmed by partial amino-acid
      sequence analysis. The expression of calbindin D-28K did not correlate with the
      spectral properties of the cones, rather to their position in the retina. The
      study of spatially expressed genes, like the one encoding calbindin D-28K, may
      help explain the patterns of retinal degeneration seen in some human cone-rod
      dystrophies.

PMID- 7786853
TI  - Behavioral and neural effects of chromatic isoluminance in the primate visual
      motion system.
AB  - We have previously reported that the responses of individual neurons in macaque
      visual area MT elicited by movement of contrast-reversing heterochromatic
      red/green borders are largest when the two hues are "balanced" or isoluminant
      (Dobkins & Albright, 1994). This "neural" isoluminant point was found to vary
      somewhat across the sample of neurons. Here, we compare the average neural
      isoluminant point in area MT to a behavioral measure of isoluminance, obtained
      using a modification of an oculomotor procedure developed by Chaudhuri and
      Albright (1992). These behavioral estimates of isoluminance closely parallel the
      neuronal data obtained from area MT. In accordance with previous evidence (e.g.
      Lee et al., 1988; Kaiser et al., 1990; Valberg et al., 1992), this correlation
      suggests that activity within the dorsal/magnocellular stream underlies
      behavioral expression of chromatic isoluminance.

PMID- 7786852
TI  - The influence of input from the lower cortical layers on the orientation tuning
      of upper layer V1 cells in a primate.
AB  - The receptive fields of cells in the primary visual cortex (area 17 or V1) show
      clear orientation selectivity, unlike those of the lateral geniculate nucleus
      (LGN) cells which provide their visual input. The intrinsic circuitry of V1 cells
      is believed to be partly responsible for this selectivity. We investigated the
      influence of ascending projections from neurons in the lower layers (5 and 6) of
      V1 on the orientation selectivity of single neurons in the upper layers (2,3, and
      4) by reversibly inactivating ("blocking") lower layer neural activity with
      iontophoretic application of gamma-aminobutyric acid (GABA) while recording from
      upper layer cells in the prosimian primate, Galago crassicaudatus. During lower
      layer blocking, the majority (20/28 = 71.4%) of upper layer neurons exhibited a
      change in the orientation of their preferred stimulus, a reduction in their
      orientation tuning, and/or an increase in their response amplitude. Twelve
      (42.9%) neurons exhibited shifts in their preferred orientation averaging 11 (+/-
      4) deg. These neurons were located on average, 272 (+/- 120) microns tangential
      from the vertical axis of the pipette center. Eleven neurons (39.2%) exhibited an
      average reduced orientation tuning of 52.5%. Their average location was 230 +/-
      (115) microns away from the vertical axis of the pipette. Five (17.9%) neurons
      with average location 145 (+/- 75) microns from the vertical axis exhibited both
      effects. Two (7.1%) neurons that exhibited significant increases in response
      amplitude to stimulus angles within 10 deg of the peak excitatory stimulus
      without changes in orientation selectivity or tuning were located less than 100
      microns from the vertical axis. The effects on the orientation tuning of cells
      were restricted in all cases to within +/- 30 deg of the preferred stimulus
      orientation. This suggests that layer blocking affects cells with preferred
      stimulus orientations similar to those of the recorded neurons. Only cells
      located within 500 microns tangential to the vertical axis of the injection site
      exhibited these effects. These results suggest that cells within layers 5 and 6
      provide organized, orientation-tuned inhibition that sharpens the orientation
      tuning of cells in the upper cortical layers within the same, or closely
      neighboring, cell columns.

PMID- 7786854
TI  - Spectral properties of turtle cones.
AB  - Microelectrodes were used to record from red and green cones of the turtle
      Pseudemys scripta elegans. The purpose of this study was to determine the action
      spectra of the red and green cone photopigments, and to look closely for direct
      interactions between the two cone classes. An isolated retina preparation was
      employed so that cones could be stimulated from the outer segment side, thereby
      avoiding the oil droplets that reside in the inner segments of many cones and
      normally filter incident light. In agreement with some previous
      electrophysiological studies, we found little evidence for significant direct
      connections between red and green cones. Exceptions to this rule are noted and
      discussed. Measurements indicate that this result does not appear to be due to a
      general loss of cone connectivity in the isolated retina preparation. Action
      spectra of the cone photopigments differed markedly from action spectra reported
      for cones in the eyecup preparation. In contrast to cones in the eyecup, cones in
      the isolated retina showed higher short-wavelength sensitivity and had action
      spectra that were adequately described by photopigment nomograms. A model of cone
      optical properties suggests that in the eyecup up to about 40% of the light that
      reaches a cone outer segment may do so without first passing through an oil
      droplet.

PMID- 7786855
TI  - Co-stratification of GABAA receptors with the directionally selective circuitry
      of the rat retina.
AB  - Direction-selective (DS) ganglion cells of the mammalian retina have their
      dendrites in the inner plexiform layer (IPL) confined to two narrow strata. The
      same strata are also occupied by the dendrites of cholinergic amacrine cells
      which are probably presynaptic to the DS ganglion cells. GABA is known to play a
      crucial role in creating DS responses. We examined the types of GABAA receptors
      expressed by the cholinergic amacrine cells and also those expressed by their
      presynaptic and postsynaptic neurons, by applying immunocytochemical markers to
      vertical sections of rat retinas. Double-labelling experiments with antibodies
      against choline acetyltransferase (ChAT) and specific antibodies against
      different GABAA receptor subunits were performed. Cholinergic amacrine cells seem
      to express an unusual combination of GABAA receptor subunits consisting of alpha
      2-, beta 1-, beta 2/3-, gamma 2-, and delta-subunits. Bipolar cells, which could
      provide synaptic input to the DS circuitry, were stained with antibodies against
      the glutamate transporter GLT-1. The axon terminals of these bipolar cells are
      narrowly stratified in close proximity to the dendritic plexus of displaced
      cholinergic amacrine cells. The retinal distribution of synaptoporin, a synaptic
      vesicle associated protein, was studied. Strong reduction of immunolabelling was
      observed in the two cholinergic strata. The anatomical findings are discussed in
      the context of models of the DS circuitry of the mammalian retina.

PMID- 7786857
TI  - Visual latencies in areas V1 and V2 of the macaque monkey.
AB  - Latencies to small flashing spots of light were measured in different layers of
      areas V1 and V2 in anesthetized and paralyzed macaque monkeys. The shortest
      latencies were found in layers 4C alpha and 4B of area V1. Latencies in layer 4C
      beta were on average 20 ms longer than those in 4C alpha and 4B. The shortest
      latencies in area V2 were observed in the infragranular layers and they did not
      differ significantly from those found in the infragranular layers in V1.
      Similarly, latencies in the supragranular layers of V2 were not significantly
      different from those measured in the supragranular layers of V1. These results
      show that, in area V1, neurons of the magnocellular pathway are activated on
      average 20 ms earlier than those of the parvocellular pathway. Our data also
      suggest that much processing begins simultaneously in areas V1 and V2.

PMID- 7786856
TI  - The occurrence of dopaminergic interplexiform cells correlates with the presence
      of cones in the retinae of fish.
AB  - Using light-microscopic immunocytochemistry against tyrosine hydroxylase, we have
      investigated the morphology of dopaminergic cells in 23 species of fishes
      representing various systematic classes and subclasses and which live in very
      different habitats. We have, for the first time, observed teleosts with
      dopaminergic amacrine cells. Thus, in both bony and cartilaginous fishes,
      dopaminergic cells are differentiated as interplexiform and amacrine cells. The
      differentiation of dopaminergic cells into amacrine or interplexiform cells in
      fishes correlates with the absence or presence of cones. In pure-rod retinae,
      they occur as amacrine cells, and in mixed rod/cone retinae, they occur as
      interplexiform cells. We conclude therefore that the differentiation of retinal
      dopaminergic cells in fish does not depend on the evolutionary or systematic
      classification of a given species. Rather, it is correlated with the occurrence
      of rods and/or cones, and thus linked more closely to the habitat. We argue that,
      in fish, the presence of cones and cone-specific horizontal cells may be
      responsible for inducing dopaminergic cells to differentiate as interplexiform
      cells. Possible functions of dopamine in all-rod retinae, which may not require
      adaptation, may include neuromodulation in the inner plexiform layer for the
      sensitization of the rod pathway, the shaping of biological rhythms, and the
      control of eye growth.

PMID- 7786858
TI  - Perceived length across the physiological blind spot.
AB  - Objects falling across the physiological blind spot appear "complete" despite the
      absence of photoreceptors. Completion of objects may occur across the blind spot
      because (1) the blind spot is filled in with the background (the associative
      explanation); (2) the opposite sides of the blind spot may be contiguously
      represented in the cortex (i.e. the blind spot is simply sewn up-the retinotopic
      explanation); or (3) the blind spot may be sewn up, with compensatory expansion
      occurring around the blind spot (the compensation explanation). These theories
      would predict no size distortions regardless of object size; constant size
      distortions regardless of object size; and distortions that depend on the size of
      the object, respectively. To evaluate these explanations, we measured size
      distortions at the blind spot. We measured length distortions at the blind spot
      using a criterion-free two-alternative forced-choice method with feedback.
      Observers compared the lengths of test bars presented across the blind spot with
      lengths of reference bars presented at the corresponding location in the fellow
      eye. Test bar lengths ranged from 7-14 deg. Reference bar lengths were in the
      range of +/- 3 deg of test bar length. From the observers' responses the
      perceived length of each bar at the blind spot was estimated. Estimates of the
      precision of length discrimination at the blind spot were also obtained. Our
      results were consistent with the associative explanation. In all seven observers,
      length distortions at the blind spot were smaller than 1 deg (< 20% of the
      vertical height of the blind spot) for all bar lengths tested. For bars that were
      presented across the blind spot, the precision with which observers could
      discriminate length was comparable to that of normal periphery (Weber fraction
      approximately 20%). Both the veridicality and precision of perceived length are
      preserved around the blind spot.

PMID- 7786859
TI  - Cephalometric analysis of changes produced by a modified Herbst appliance in the
      treatment of Class II division 1 malocclusion.
AB  - This study investigated treatment changes produced by the Herbst appliance in a
      sample of severe Class II division 1 cases, over a period of 8 months. The sample
      consisted of 16 girls, of whom eight were treated by the Herbst appliance, whilst
      eight served as controls. All cases were matched with respect to age, sex,
      skeletofacial morphology, and length of treatment/observation period. Twenty-two
      skeletal and 19 dental parameters were recorded on pre- and post-treatment
      cephalograms. The net treatment effect of Herbst therapy was evaluated, taking
      into account the growth that occurred in the control sample. The study revealed
      that during 8 months of Herbst therapy there was a significant increase in
      mandibular length, along with sagittal repositioning. The skeletal changes in the
      mandible were mainly responsible for overjet and molar relation correction. A
      slight, favourable forward rotation of the mandible was identified. Dentoalveolar
      features included flaring of lower incisors and distalization of upper molars.
      The appliance did not have any retrusive effect on the maxilla. The modified
      splint design differed from the original and was cemented rather than bonded.

PMID- 7786860
TI  - Consent and orthodontic treatment.

PMID- 7786861
TI  - Stability of the lower labial segment following orthodontic treatment--a
      comparison of treatment with Andresen and Begg appliances.
AB  - This retrospective cephalometric study of Class II division 1 malocclusions
      investigates the effects on the lower labial segment of two forms of orthodontic
      treatment. Non-extraction Andresen myofunctional therapy and first premolar
      extraction Begg treatment are compared to the lower incisor changes found in
      appropriate non-extraction and first premolar extraction control groups, which
      also presented with Class II division 1 malocclusions. Using four angular and two
      linear measurements, the lower labial segment was found to procline during
      Andresen therapy (1-2 degrees, 1-2 mm), and on withdrawal of the appliance it
      retroclined by about one-half of the in-treatment proclination (0.4-0.8 degrees,
      0.1-0.5 mm). During extraction Begg mechanics, the lower incisors were found to
      retrocline (1.3-1.5 degrees, 0.4-0.9 mm), and they continued to retrocline
      following removal of the appliance (0.2-3.0 degrees, 0.8-1.1 mm). In general, the
      variables used to measure lower incisor position demonstrated only very small
      changes, and were near method error. The reliability of these changes are
      discussed. It is considered that the axial inclination of the lower incisor in
      relation to the mandibular plane is the most consistent and therefore still the
      most useful clinical measurement of lower incisor change available from
      cephalometric radiographs.

PMID- 7786862
TI  - Effects of cyclic stressing on attachment bond strength using glass ionomer
      cement and composite resin.
AB  - Bonded orthodontic brackets were subjected to cyclic loading in order to simulate
      the effect of occlusal forces. The subsequent effect on bond strength was
      determined. Stainless steel, mesh-based brackets were bonded to extracted teeth
      with either composite resin or glass ionomer cement. A jig was designed to
      subject each bracket to a preselected loading level and the 24-hour shear/peel
      bond strength of both stressed and unstressed brackets was subsequently measured.
      Cyclic loading brought about a comparative decrease in bond strength when using
      both types of material. The potential implications of selecting these different
      types of bonding material for clinical use are discussed.

PMID- 7786863
TI  - An investigation into the fluoride release of a variety of orthodontic bonding
      agents.
AB  - The purpose of this study was to compare the fluoride release from a variety of
      orthodontic bonding agents. Fluoride release into de-ionized water was measured
      over a 20-week period. Material based on the fluoride exchange resin was also
      tested in a saline solution. Fluoride release from a variety of orthodontic
      bonding agents was compared and the amount of release found to be highly
      variable. Glass ionomer-based materials showed substantially greater fluoride
      release when compared with resin-based materials. The presence of anions (Cl-)
      did not improve the release from fluoride exchange resin. Glass ionomer/resin
      hybrid material (Vitrabond) released the greatest amount of fluoride.

PMID- 7786864
TI  - Bond strengths of ceramic brackets using different bonding techniques.
AB  - A series of laboratory investigations was carried out to compare the shear-type
      bond strengths and site of bond failure of ceramic orthodontic brackets bonded to
      etched enamel. When light-cured composite resin was used as the luting agent,
      there was no reduction in bond strength when using 2.5 per cent nitric acid to
      etch the enamel, compared to 37 per cent phosphoric acid. The use of the two
      resin modified glass ionomer cements were found to give rise to significantly
      lower bond strengths than composite resin when used for placing ceramic brackets.
      Significantly less composite resin remained on the enamel surface following
      bracket removal in those samples etched with nitric acid.

PMID- 7786866
TI  - Financial consequences of reducing treatment availability in a publicly-funded
      orthodontic service. A decision analysis problem.
AB  - When a third party is responsible for funding a component of the health service,
      cost/benefit assessments become important. Such assessments become urgent when
      the budget is reduced. In this paper decision analysis has been applied to
      evaluate potential savings by reducing the proportion of children offered free
      orthodontic treatment through the National Health Service in Denmark. Data for
      the development of the decision tree was acquired using the Delphi technique. The
      results suggest that a reduction in the proportion of children offered early
      treatment might ultimately lead to an increased consumption of resources. Further
      investigation of the issue is needed before definitive recommendations can be
      made.

PMID- 7786865
TI  - The effect of artificial saliva on the frictional forces between orthodontic
      brackets and archwires.
AB  - The effect of artificial saliva on the static and kinetic frictional forces of
      stainless steel (Dentaurum) and polycrystalline ceramic (Transcend) brackets in
      combination with 0.018-inch round and 0.019 x 0.025-inch Edgewise archwire sizes
      and stainless steel, nickel-titanium and beta-titanium archwire materials, under
      a constant ligature force were investigated. In all cases, artificial saliva had
      the effect of increasing the frictional force when compared with the dry state.

PMID- 7786867
TI  - The Consultant Orthodontists Group survey of hospital waiting lists and treated
      cases.
AB  - A questionnaire sent to all U.K. hospital orthodontic consultants resulted in an
      88 per cent response rate. The average waiting time for initial consultation was
      31.6 weeks for routine cases and 3.6 weeks for urgent cases. The average waiting
      time for out patient treatment was 68.7 weeks for routine cases and 7.5 weeks for
      urgent cases. Nearly 33 per cent of hospitals used the Dental Health Component of
      the Index of Orthodontic Treatment need (IOTN) as a guide to placing patients on
      waiting lists. 'Urgency' and 'Complexity' were used more frequently than indices.
      Sixty-nine per cent of hospitals exclude some categories of malocclusion from
      treatment in their departments. A prospective survey reported on 2480 completed
      treatments over a six week period and there was an average discontinuation rate
      of 9.2 per cent of all cases finished during the period. Comparison of the
      completed and discontinued groups revealed few significant treatment-related
      factors. There was some evidence that the more senior and experienced the
      operator, the less the rate of discontinuation. A greater rate of discontinuation
      was seen in removable appliance cases when compared with fixed appliance cases.

PMID- 7786869
TI  - A sectional approach to the alignment of ectopic maxillary canines.
AB  - A sectional fixed appliance is described for the alignment of ectopic maxillary
      canines. This system has a number of advantages over conventionally employed
      mechanics. These include both good aesthetics and optimal tooth alignment.

PMID- 7786868
TI  - An evaluation of the views of general dental practitioners who have participated
      in an extended orthodontic training scheme.
AB  - A questionnaire was sent to 255 dental practitioners who had participated in an
      extended orthodontic training scheme, incorporating formal teaching and
      supervised clinical sessions over a period of not less than 24 months. The
      response of the practitioners was good; 78 per cent of the forms returned were
      suitable for analysis. Overall, the practitioners responded favourably to the
      schemes and felt that they had been of benefit to their clinical practice. The
      majority undertook more orthodontic treatment as a result and on average, fixed
      appliances were used in half of these treatments.

PMID- 7786870
TI  - Congenital absence of the atlas posterior arch. A case report.
AB  - A report of a healthy young adult woman with non-pathological congenital absence
      of the lateral and posterior parts of the atlas is presented. This occurred in
      association with a steep mandibular plane angle and an extremely obtuse gonial
      angle. Similar facial features are common in females with hypoplastic dorsal
      arches, and this case illustrates the intimate developmental association between
      the upper part of the cervical spine and the craniofacial complex.

PMID- 7786871
TI  - A new instrument for composite removal after debonding.

PMID- 7786874
TI  - Non-completion of active orthodontic treatment.

PMID- 7786872
TI  - Quality assurance in orthodontic radiography.
AB  - The implementation of a Quality Assurance (QA) programme in orthodontic
      radiography is designed to improve the quality of the resultant radiographs and
      to reduce the number of repeat exposures. This is particularly desirable in
      orthodontic practice where the majority of patients are young and therefore more
      at risk from the detrimental effects of X-rays. A programme is described and QA
      tests are given that may be applied in the surgery. Particular emphasis is placed
      on QA measures for extraoral radiography, since this is frequently undertaken in
      the treatment of the orthodontic patient.

PMID- 7786873
TI  - The thoughts of Chairman Bill: an interview with William Proffit. Interview by O.
      Keith.

PMID- 7786875
TI  - A comparative evaluation of Class II treatment strategies--Lysle Johnston at the
      Royal Berkshire Hospital.

PMID- 7786876
TI  - Dental hygienists in Australia and their employment in orthodontic practice.
AB  - Dental hygienists are the designated dental auxiliary of the future in Australia.
      This article explains how their duties came into existence and why their duties
      in orthodontic practice seem limited in some instances. Dental hygienists, a
      class of operating dental auxiliaries, work in Australian orthodontic practices,
      but their employment is not widespread. The ratio of hygienists to dentists is
      reported to be 1:40 in Australia and 1:10 in South Australia (Pash, personal
      communication).

PMID- 7786877
TI  - Placebo: a potent but misunderstood psychotrope.

PMID- 7786878
TI  - [Sleep, respiration and benzodiazepines: effects of benzodiazepines on nocturnal
      respiration].

PMID- 7786879
TI  - Neuroprotective effect of selenium on iminodipropionitrile-induced toxicity.
AB  - The present investigation was undertaken to study the effect of selenium on
      experimental dyskinesia in rats. The movement disorders were produced in rats by
      intraperitoneal administration of iminodipropionitrile (IDPN) in the dose of 100
      mg/kg per day for 12 days. Selenious acid was administered daily 30 minutes
      before IDPN in the doses of 5 mumol/kg, 10 mumol/kg and 20 mumol/kg bodyweight in
      three different groups of rats. Animals were observed daily for any
      neurobehavioral changes including circling, backwalking, head weaving and
      twitching. Immediately after behavioral studies, blood and brain specimens were
      collected for analysis of thiobarbituric acid reactive substances (TBARS) to
      measure the extent of free radical production. Our results showed that concurrent
      use of selenium significantly inhibited IDPN-induced neurobehavioral changes in a
      dose-dependent manner. Treatment of rats with selenium also reduced the TBARS
      production in blood and different regions of brain. These findings suggest that
      selenium attenuates the IDPN-induced neurotoxicity by inhibiting lipid
      peroxidation.

PMID- 7786880
TI  - Fluoxetine in panic disorder: pharmacologic and tritiated platelet imipramine and
      paroxetine binding study.
AB  - Serotonergic implication in panic disorder has been demonstrated by the efficacy
      of serotonin reuptake blockers in treatment. Fluoxetine, a potent 5-HT reuptake
      blocker, has been suggested to have anti-panic efficacy. This open study examines
      30 patients (eight males and 22 females) with an average age of 36.9 years,
      ranging from 18 to 62, who were treated for eight weeks with fluoxetine (mean
      dose 20 mg per day). All patients fulfilled DSM-III-R criteria of panic disorder
      with agoraphobia as determined in a SCID interview schedule. Out of 28 patients
      who started medication, 64% of the patients completed the clinical trial and 36%
      of the patients dropped out of treatment because of increased anxiety or a lack
      of efficacy. Thirty-two percent of the patients had zero panic attacks by week 3.
      By the end of eight weeks of treatment, 48% of the patients had zero panic
      attacks. There was a significant reduction in anxiety and phobic avoidance and
      panic attacks. Tritiated platelet imipramine and paroxetine bindings revealed
      significantly lower maximal binding for patients with panic disorder in
      comparison with controls. Paroxetine Bmax showed a trend to increase in the
      direction of control values by the end of the trial.

PMID- 7786881
TI  - Temperature gradient gel electrophoresis analysis of the beta-NGF gene in
      schizophrenia.
AB  - Methods for localizing functional polymorphisms in candidate genes are important
      for the elucidation of pathogenesis in complex diseases such as schizophrenia and
      manic depression. Temperature gradient gel electrophoresis (TGGE), a variant of
      denaturing gradient gel electrophoresis (DGGE), can detect single-base mutations
      in a specified region of double-stranded DNA. This technique has been evaluated
      for use with polymerase chain reaction (PCR)-generated DNA fragments containing
      either transitional (A to G) or transversional (T to A) mutations. Single-base
      mutations of both types are detectable in PCR fragments up to 500 bp long. This
      method was then used to examine the coding region of the beta-nerve growth factor
      (NGF) gene for polymorphisms in PCR-generated DNA fragments derived from
      lymphocyte DNA of subjects with schizophrenia and normal subjects. No single-base
      mutations in sequence coding for the mature beta-NGF peptide were found in any of
      the subjects who were examined. If DNA sequence information is available for PCR
      primer design, TGGE detection of DNA polymorphisms can be used to rapidly
      determine whether or not a defect in a gene of interest contributes to the
      pathophysiology of the illness.

PMID- 7786882
TI  - Chronic dopamine antagonism facilitates opiate-induced feeding.
AB  - Chronic interference with dopamine (DA) transmission has been found to facilitate
      opiate reward and opiate-induced behavioral activation derived from the nucleus
      accumbens. This study was aimed at determining the extent to which these effects
      are generalizable to opiate-induced feeding. Rats were tested for their feeding
      response to morphine following chronic interference with DAergic transmission
      with the long-acting neuroleptic, flupenthixol decanoate (FLU). It was found that
      FLU-treated animals showed an enhanced feeding response to morphine following
      three and four weeks of DA blockade, but not on weeks 1 and 2. Neither morphine
      treatment in FLU-control animals nor chronic FLU treatment alone produced any
      such time-dependent facilitation in feeding. The results indicate that the
      increased sensitivity to the rewarding effects of opiates following chronic DA
      blockade is generalizable to opiate-induced feeding.

PMID- 7786883
TI  - Phosphoinositide system-linked serotonin receptor subtypes and their
      pharmacological properties and clinical correlates.
AB  - Serotonergic neurotransmission represents a complex mechanism involving pre- and
      post-synaptic events and distinct 5-HT receptor subtypes. Serotonin (5-HT)
      receptors have been classified into several categories, and they are termed as 5
      HT1, 5-HT2, 5-HT3, 5-HT4, 5-HT5, 5-HT6 and 5-HT7 type receptors. 5-HT1 receptors
      have been further subdivided into 5-HT1A, 5-HT1B, 5-HT1D, 5-HT1E and 5-HT1F. 5
      HT2 receptors have been divided into 5-HT2A, 5-HT2B and 5-HT2C receptors. All 5
      HT2 receptor subtypes are linked to the multifunctional phosphoinositide (PI)
      signalling system. 5-HT3 receptors are considered ion-gated receptors and are
      also linked to the PI signalling system by an unknown mechanism. The 5-HT2A
      receptor subtype is the most widely studied of the 5-HT receptors in psychiatric
      disorders (for example, suicide, depression and schizophrenia) as well as in
      relation to the mechanism of action of antidepressant drugs. The roles of 5-HT2C
      and 5-HT3 receptors in psychiatric disorders are less clear. These 5-HT receptors
      also play an important role in alcoholism. It has been shown that 5-HT2A, 5-HT2C
      and 5-HT3 antagonists cause attenuation of alcohol intake in animals and humans.
      However, the exact mechanisms are unknown. The recent cloning of the cDNAs for 5
      HT2A, 5-HT2C and 5-HT3 receptors provides the opportunity to explore the
      molecular mechanisms responsible for the alterations in these receptors during
      illness as well as pharmacotherapy. This review article will focus on the current
      research into the pharmacological properties, molecular biology, and clinical
      correlates of 5-HT2A, 5-HT2C and 5-HT3 receptors.

PMID- 7786885
TI  - Effect of blood sampling on apomorphine-induced penile tumescence in erectile
      impotence: a case report.
AB  - Apomorphine HCl (Apo) (0.5 mg sc), but not placebo, induced an erectile response
      (monitored with a mercury strain gauge) lasting 40 min in an impotent
      hyperprolactinemic patient. Serial blood sampling modified the 40 min erectile
      response. Prompt detumescence followed by complete or partial restoration of
      tumescence occurred each time blood was drawn. This observation points to the
      sensitivity of the Apo-erectile response to experimental procedures subjectively
      perceived as anxiogenic.

PMID- 7786886
TI  - An open-label study of famotidine as a treatment for schizophrenia.

PMID- 7786887
TI  - Optimization of epoxyeicosatrienoic acid syntheses to test their effects on
      cerebral blood flow in vivo.
AB  - Epoxyeicosatrienoic acids (EETs), normally present in brain and blood, appear to
      be released from atherosclerotic vessels in large amounts. Once intravascular,
      EETs can constrict renal arteries in vivo and dilate cerebral and coronary
      arteries in vitro. Whether EETs in blood will alter cerebral blood flow (CBF) in
      vivo is unknown. In the present study, the chemical synthesis of four EET
      regioisomers was optimized, and their identity and structural integrity
      established by chromatographic and mass spectral methods. The chemically labile
      EETs were converted to a sodium salt, complexed with albumin, and infused into
      anesthetized rats via the common carotid. The objective was to test whether
      sustained, high levels of intravascular EETs alter CBF. The CBF (cortical H2
      clearance) was measured before and 30 min after the continuous infusion of 14,15-
      (n = 5), 11,12- (n = 5), 8,9- (n = 7) and 5,6-EET (unesterified or as the methyl
      ester, n = 5 for each). Neither the CBF nor the systemic blood pressure was
      affected by EETs. Because the infusions elevated the plasma concentrations of
      EETs about 700-fold above normal levels (1.0 nM), it is unlikely that EETs
      released from atherosclerotic vessels will alter CBF.

PMID- 7786884
TI  - The effect of adjunctive light therapy on ameliorating breakthrough depressive
      symptoms in adolescent-onset bipolar disorder.
AB  - Seven adolescents or young adults (aged 16 to 22 years) who met DSM-III-R
      criteria for bipolar disorder were treated for persistent depressive symptoms
      (greater than three weeks) with adjunctive light therapy (10,000 lux given twice
      per day). Patients were evaluated using the Beck Depression Inventory (BDI) and
      Symptoms Check List (SCL-58). Three patients showed a marked response of greater
      than 70% decrease of their baseline score. Two patients had a moderate decrease
      (40% to 74%) and two patients obtained mild to no response. There were no
      reported side-effects. Paired t-tests done on pre- and post-BDI scores (pre mean
      = 21.2 sd +/- 10.0; post mean = 11.1, sd +/- 8.8; paired t = 4.31; p > 0.0051)
      and pre- and post-SCL-58 scores above baseline of 58 (pre mean = 57.4, sd +/-
      24.4; post mean = 28.7, sd +/- 18.6; paired t = 5.50; p > 0.0015) showed
      significant improvement. These preliminary results indicate that some bipolar
      adolescents with breakthrough depressive symptoms could benefit from light
      therapy as an adjunct to their continued thymoleptic treatment.

PMID- 7786888
TI  - The role of calcium influx in cellular proliferation induced by interaction of
      endogenous ganglioside GM1 with the B subunit of cholera toxin.
AB  - The B subunit of cholera toxin, which binds specifically to ganglioside GM1, is
      mitogenic for quiescent Swiss 3T3 fibroblasts. It was previously shown that the B
      subunit had no effect on cAMP, protein kinase C or phosphoinositide turnover, but
      did cause an increase in the influx of calcium from extracellular sources
      (Spiegel, S. and Panagiotopoulos, C. (1988) Exp. Cell Res. 177, 414-427). In
      contrast to the action of known growth factors, the B subunit induced significant
      DNA synthesis after only a 1-3 h treatment. We utilized this unique property to
      determine whether the increase in calcium influx plays a role in B subunit
      induced mitogenicity. Cells were briefly treated with the B subunit in the
      presence of calcium channel blockers, followed by removal of the blockers and
      further incubation in B subunit-free medium for the remaining time required to
      measure DNA synthesis. When 1 mM cobalt was only present during the first 3 h
      incubation. DNA synthesis induced by either the B subunit or fetal bovine serum
      was completely abolished. However, both nickel (1 mM) adn the L-type voltage
      gated calcium channel inhibitor nicardipin (10 microM) inhibited B subunit
      induced cell proliferation without abrogating the response to fetal bovine serum.
      Using a gel retardation assay, we found that the B subunit markedly stimulated
      specific DNA-binding activity of the transcription factor, activator protein-1
      (AP-1), which functions as a major convergence point coupling early events
      induced by a variety of mitogens to long term growth responses. Presence of c-Fos
      protein in the AP-1 complex was demonstrated as a supershift band in the gel
      mobility assay using c-Fos polyclonal antibody. Cobalt, which markedly inhibited
      B subunit-induced DNA synthesis, also completely abolished AP-1 DNA-binding
      activity stimulated by the B subunit. In sharp contrast, cobalt had no effect on
      DNA-binding activity of AP-1 induced by the tumor promoter, 12-O
      tetradecanoylphorbol 13-acetate. Our results suggest that calcium influx is a key
      element for both DNA-binding activity of AP-1 and cell proliferation induced by
      binding of the B subunit of cholera toxin to cell surface ganglioside GM1.

PMID- 7786889
TI  - Phospholipid hydrolysis of mildly oxidized LDL reduces their cytotoxicity to
      cultured endothelial cells. Potential protective role against atherogenesis.
AB  - Oxidized low density lipoproteins (LDL) are cytotoxic to cultured endothelial
      cells and thereby are potentially involved in endothelial cell injury and
      atherogenesis. Oxidized phospholipids of oxLDL undergo spontaneous hydrolysis (PL
      hydrolysis) by LDL-associated phospholipase A2 (PLA2) activities. The present
      study aimed to investigate whether hydrolysis of oxidized phospholipids contained
      in mildly oxLDL could influence their cytotoxicity to cultured endothelial cells.
      PL-hydrolysis (spontaneous or mediated by exogenous PLA2) of mildly oxLDL
      elicited a significant reduction of their cytotoxicity to cultured endothelial
      cells. The reduced cytotoxicity of PL-hydrolysed oxLDL was not due to their
      reduced uptake by cells, but rather to their reduced content of oxidation
      products which are liberated by PL-hydrolysis and released (at least the more
      polar compounds) in the aqueous phase, as shown by ultrafiltration experiments.
      Oxidation products released in the aqueous phase were not or only slightly
      cytotoxic to endothelial cells, probably because a selective uptake of non
      oxidized fatty acids as shown by studies of uptake of oxidized and non oxidized
      [1-14C]linoleic acid. These data suggest that during PL-hydrolysis of mildly
      oxLDL, (i) oxidized phospholipids are hydrolysed; (ii) oxidation products
      liberated from oxLDL particles are released (at least in part) to the aqueous
      phase; (iii) the cytotoxicity of oxLDL to endothelial cells is reduced, probably
      because oxidized free fatty acids (released by PL-hydrolysis towards the aqueous
      phase) are not taken up by the cells. Finally, the possibility of a favourable
      role of PL-hydrolysis of oxLDL against atherogenesis is discussed.

PMID- 7786890
TI  - omega-Hydroxylation of docosahexaenoic acid or arachidonic acid in human colonic
      well differentiated adenocarcinoma homogenate.
AB  - Human colonic well differentiated adenocarcinoma homogenate was incubated with
      NADPH and docosahexaenoic acid (22:6(n-3)) or arachidonic acid (20:4(n-6)) as a
      substrate. On a selected ion monitoring chromatogram obtained with reversed phase
      high-performance liquid chromatography thermospray mass spectrometry, omega
      hydroxydocosahexaenoic acid (omega-HDHE) or omega-hydroxyeicosatetraenoic acid
      (omega-HETE) from an incubation mixture of the homogenate was detected in
      significant amount, compared to that from a colonic region remote from the
      carcinoma. In contrast, epoxydocosapentaenoic acids and the dihydroxy derivatives
      from 22:6(n-3) or epoxyeicosatrienoic acids and the dihydroxy derivatives from
      20:4(n-6) were detected in low amounts, compared to that from a colonic region
      remote from the carcinoma. The results suggest that highly active NADPH-dependent
      omega-oxidations of polyunsaturated fatty acids occur in colonic adenocarcinoma
      homogenate.

PMID- 7786891
TI  - Characterization of specific subcellular 15-hydroxyeicosatetraenoic acid (15
      HETE) binding sites on rat basophilic leukemia cells.
AB  - 15-Hydroxyeicosatetraenoic acid [15-(S)-HETE], a major arachidonic acid
      metabolite produced from the 15-lipoxygenase pathway, has been characterized as
      an antiinflammatory cellular mediator since it can inhibit the in vivo and in
      vitro formation of the proinflammatory leukotrienes via the 5-lipoxygenase
      pathway in various cells. 15-HETE has been confirmed to inhibit the 5
      lipoxygenase in rat basophilic leukemia cell (RBL-1) homogenates with an I50 =
      7.7 microM. The I50 of the 12-HETE isomer was 6 microM whereas prostaglandin F2
      alpha was ineffective. In order to examine the mechanistic basis underlying the
      inhibitory action of 15-HETE, association assays of [3H]-15-HETE with RBL-1
      subcellular fractions were carried out. The presence of the zwitterionic
      detergent CHAPS enhanced specific [3H]-15-HETE binding in the membrane fractions
      three-fold and specific 15-HETE binding was distributed among the nuclear (32%)-,
      granule (19%)-, plasma membrane (35%)-, and cytosol (14%)-enriched fractions.
      Studies using combined granule and plasma membrane enriched-, CHAPS treated
      fractions showed that [3H]-15-HETE binding was time-dependent, specific and
      reversible, sensitive to pertussis toxin treatment, and indicated a single class
      of binding sites with a Kd = 460 +/- 160 nM and Bmax = 5.0 +/- 1.1 nM.
      Competition experiments showed that the order of 15-HETE or analogs in inhibiting
      the binding of [3H]-15-HETE was: 15(S)-HETE > or = 12-(S)-HETE = 5-(S)-HETE > 15
      (R)-HETE > arachidonic acid. Prostaglandin F2 alpha and lipoxin B4 were
      ineffective as competitors. The similar profiles of the binding assays and
      inhibition of the 5-lipoxygenase suggest that 15-HETE binding sites may mediate
      this inhibitory action of 15-HETE.

PMID- 7786893
TI  - Photoaffinity labeling of cottonseed microsomal N-acylphosphatidylethanolamine
      synthase protein with a substrate analogue, 12-[(4-azidosalicyl)amino]dodecanoic
      acid.
AB  - N-Acylphosphatidylethanolamine (NAPE), an unusual acylated derivative of
      phosphatidylethanolamine (PE), is synthesized from free fatty acids and PE in
      cotton seedlings (Chapman and Moore (1993) Plant Physiol. 102(3), 761-769). Here
      we use a photoreactive dodecanoic acid analogue, [12-(4
      azidosalicy)amino]dodecanoic acid (ASD), and its 125I-labeled derivative to
      identify a protein subunit which corresponds to this cottonseed NAPE synthase
      activity. Dodecylmaltoside (DDM)-solubilized microsomal NAPE synthase enzyme was
      irreversibly and progressively inactivated by adding increasing concentrations of
      ASD and illuminating with UV254 light. Protection from this photoinactivation was
      afforded by the natural substrate, palmitic acid. In low light, microsomal NAPE
      synthase utilized ASD as a substrate to synthesize NAPE; palmitic acid competed
      for this activity. NAPE synthase activity was measured directly in gel slices
      following nondenaturing PAGE of DDM-solubilized microsomal membrane proteins. Two
      dimensional electrophoresis (nondenaturing PAGE, followed by SDS-PAGE) of
      photoaffinity-labeled, DDM-solubilized microsomal proteins revealed a 64 kDa
      polypeptide that was associated with the active NAPE synthase enzyme. Also, a 64
      kDa protein was photoaffinity labeled in all NAPE synthase isozyme fractions
      isolated by preparative isoelectric focusing; photoaffinity labeling of this 64
      kDa polypeptide was diminished in the presence of exogenously supplied palmitic
      acid. Collectively, our results demonstrate that ASD specifically interacts with
      NAPE synthase in a manner analogous to its fatty acid substrate and indicate that
      a 64 kDa polypeptide is a component of cottonseed microsomal NAPE synthase. ASD
      will be a useful molecular probe in future studies aimed at understanding the
      physiological role of this NAPE synthase enzyme in membranes of plant cells.

PMID- 7786894
TI  - Purification and characterization of two forms of cytochrome b5 from an
      arachidonic acid-producing fungus, Mortierella hygrophila.
AB  - Two forms of cytochrome b5 have been purified from the microsomes of an
      arachidonic acid-producing fungus, Mortierella hygrophila IFO 5941, after
      detergent solubilization. They have monomeric molecular masses of about 16 kDa
      and 19 kDa. Their absorption spectra are similar to those of mammalian cytochrome
      b5s. Their amino acid compositions show some similarity to those of mammalian
      cytochrome b5s, but the contents of some amino acids (glycine, alanine, aspartic
      acid + asparagine, glutamic acid + glutamine, arginine, proline, histidine,
      leucine and lysine) are unique to the cytochrome b5s of M. hygrophila. Some of
      their internal peptide sequences also show close homology with those of some
      mammals (approx. 65 to 67%), while some others show no or little homology. The
      addition of various acyl-CoAs to NADH-reduced microsomes caused an abrupt
      shiftdown of the steady state reduction level of cytochrome b5. This indicates
      the increased utilization of electrons for the desaturation process and may
      suggest that the cytochrome b5s of this fungus actually take part in its
      microsomal desaturation system for polyunsaturated fatty acid biosynthesis as
      electron carriers.

PMID- 7786892
TI  - Effect of Escherichia coli lipopolysaccharide on surfactant secretion in primary
      cultures of rat type II pneumocytes.
AB  - The purpose of this study is to evaluate the effect of the Escherichia coli
      lipopolysaccharide on the secretion of phosphatidylcholine, the principal
      component of pulmonary surfactant, in primary cultures of rat alveolar type II
      pneumocytes. Lipopolysaccharide stimulated phosphatidylcholine secretion in a
      time- and dose-dependent manner. At a concentration of 200 micrograms/ml,
      lipopolysaccharide stimulated the release of phosphatidylcholine 4-fold over the
      basal secretory rate, and the concentration producing half the maximal response
      was 20 micrograms/ml. The stimulatory effect of lipopolysaccharide on
      phosphatidylcholine secretion was additive to that of the protein kinase C
      activator TPA, which is a potent stimulator of surfactant secretion.
      Lipopolysaccharide did not activate protein kinase C, which suggests that
      stimulation of phosphatidylcholine secretion by the endotoxin was through a
      mechanism independent of protein kinase C activation.

PMID- 7786895
TI  - Suppression of clofibrate-induction of peroxisomal and microsomal fatty acid
      oxidizing enzymes by growth hormone and thyroid hormone in primary cultures of
      rat hepatocytes.
AB  - Using primary cultures of rat hepatocytes on a matri-gel, effects of peroxisome
      proliferator and omega-hydroxydodecanoic acid on cellular levels of acyl-CoA
      oxidase and CYP4A have been studied to determine the hormonal influence in serum
      free media. Peroxisomal acyl-CoA oxidation, microsomal CYP4A content and laurate
      omega-hydroxylation were increased in rat hepatocytes by the addition of 100
      microM clofibrate or Wy14,643 for two days. omega-Hydroxydodecanoic acid (100
      microM) also increased peroxisomal acyl-CoA oxidation, but had no clear effect on
      microsomal CYP4A level and laurate omega-hydroxylation. CYP4A-mediated laurate
      omega-hydroxylation in hepatocytes was suppressed by the addition of pituitary
      growth hormone (0.05 mU/ml), but was not altered by the addition of
      triiodothyronine (30 nM). In contrast, clofibrate-mediated induction of acyl-CoA
      oxidase activity was decreased by the addition of either one of the hormones in
      hepatocytes. Suppression by those hormones was also observed with omega
      hydroxydodecanoic acid-mediated induction of acyl-CoA oxidase activity. These
      results indicate the possibility that GH and T3 exert the suppressive effects on
      peroxisomal acyl-CoA oxidation through plural mechanisms with and without the
      alteration of CYP4A levels in livers.

PMID- 7786897
TI  - Eicosapentaenoic acid causes transient accumulation of lipids in rat myocardium.
AB  - Rats were given eicosapentaenoic acid (EPA) or palmitic acid (PALM) up to 15
      days, and control animals were given carboxymethylcellulose. All suspensions
      which were given by gastric intubation contained tocopherol. Heart
      triacylglycerols, heart cholesterol and heart phospholipids significantly
      increased after one day of EPA treatment, but they were normalized within 15
      days. Both after 2 and 10 days of treatment with palmitic acid the heart
      triacylglycerols were significantly greater than control. The heart cholesterol
      and heart phospholipids were significantly greater than control after 10 days of
      treatment with palmitic acid. Total carnitine palmitoyltransferase (CPT) activity
      in heart was significantly greater in rats treated with EPA for 15 days compared
      to control, but treatment with palmitic acid had no effect. The fatty acyl-CoA
      oxidase activity was greater in rats treated with EPA for 15 days and palmitic
      acid for 10 days compared to control. The fractional volume of lipid droplets in
      myocardial cells was calculated from electronmicrographs and was 0.112 +/- 0.016%
      after 1 day of EPA treatment compared to 0.035 +/- 0.016% in the control group.
      After 5 and 15 days the fractional volume was the same as control. The fractional
      volume of lipid droplets in rats treated with palmitic acid for 10 days was 0.120
      +/- 0.023%. Treatment with EPA caused an immediate accumulation of lipids and
      lipid droplets in the rat heart which after few days normalized in parallel with
      an increased activity of total CPT in the heart.

PMID- 7786896
TI  - Release of aldehydes from rat alveolar macrophages exposed in vitro to low
      concentrations of nitrogen dioxide.
AB  - This study demonstrated that aldehydes are released into the extracellular medium
      when alveolar macrophages (AM) are exposed to nitrogen dioxide (NO2) at
      concentrations that impair cell function but do not cause cell death. Butanal,
      glycolaldehyde, 4-hydroxynonenal, pentanal, pentenal, and hexanal were found.
      Dinitrophenylhydrazine (DNP) derivitization, thin layer chromatography, high
      performance liquid chromatography, and gas chromatography-mass spectrometry were
      used to identify the products. Some of the aldehydes have potential toxicity and
      may be responsible, in part, for altered AM function observed following NO2
      exposure.

PMID- 7786899
TI  - 7 alpha-Hydroxylation of 25-hydroxycholesterol and 27-hydroxycholesterol in human
      fibroblasts.
AB  - The metabolism of 27-hydroxycholesterol and 25-hydroxycholesterol was studied in
      cultures of human diploid fibroblasts. Both steroids underwent 7 alpha
      hydroxylation with subsequent oxidation to 7 alpha-hydroxy-3-oxo-delta 4
      steroids. A minor fraction of the 27-hydroxysteroids was oxidized to acids.
      Competition experiments indicated that both hydroxycholesterols were hydroxylated
      by the same enzyme, different from cholesterol 7 alpha-hydroxylase. 7 alpha,25
      Dihydroxycholesterol suppressed the activity of HMG-CoA reductase at least as
      effectively as 25-hydroxycholesterol whereas 7 alpha,25-dihydroxy-4-cholesten-3
      one was a less effective suppressor. The results suggest that cholesterol might
      be converted to 7 alpha-hydroxylated bile acid precursors in extrahepatic tissues
      in vivo and that the regulation of the activity of HMG-CoA reductase by
      oxysterols might be modulated by 7 alpha-hydroxylation and subsequent oxidation
      by 3 beta-hydroxy-delta 5-C27-steroid dehydrogenase/isomerase.

PMID- 7786898
TI  - Effect of maternal ethanol consumption during pregnancy on the phospholipid
      molecular species composition of fetal guinea-pig brain, liver and plasma.
AB  - The effect of maternal ethanol consumption during pregnancy upon accumulation of
      docosahexaenoic acid (22:6(n - 3)) into developing brain phospholipids was
      determined in a guinea-pig model of fetal alcohol syndrome. Feeding adult guinea
      pigs 6 g/kg per day ethanol both before and throughout pregnancy was associated
      with decreased 22:6(n - 3) concentration in both fetal brain phosphatidylcholine
      (PC) and phosphatidylethanolamine (PE) at 40/68 days gestation and at term. Since
      adequate assimilation of 22:6(n - 3) into fetal brain is critical for optimal
      neuronal development, reduced accumulation of 22:6(n - 3) into phospholipids may
      be one important mechanism for ethanol-induced brain damage. Liver from ethanol
      exposed fetuses contained significantly lower concentrations of both PC and PE
      22:6(n - 3)-containing molecular species. However, there was no difference in
      plasma PC polyunsaturated fatty acid content in ethanol-exposed fetuses compared
      with controls. One possible explanation for impaired 22:6(n - 3) accumulation
      into ethanol-exposed fetal brain phospholipids may be the result of the action of
      inappropriate mechanisms which counteract ethanol-induced increased membrane
      fluidity by reducing the polyunsaturated fatty acid content of brain
      phospholipids.

PMID- 7786900
TI  - In vitro determination by 1H-NMR studies that bile with shorter nucleation times
      contain cholesterol-enriched vesicles.
AB  - Although biliary vesicles are considered to be the primary source of cholesterol
      found in cholesterol gallstones, difficulties in quantitatively separating the
      different cholesterol transport modes in bile still remain. Proton nuclear
      magnetic resonance spectroscopy (1H-NMR) offers an alternative approach.
      Investigations were carried out on both model biles and human gallbladder bile
      samples: (i) to follow the effect of increasing sodium glycocholate
      concentrations on the 1H-NMR spectra of arachidonic acid rich-phospholipid, and
      cholesterol-lecithin vesicles, (ii) to compare the concentrations of total
      phospholipids in bile determined enzymatically with those obtained by integration
      of the phospholipid choline head group resonance peak, and (iii) to examine the
      relationship between biliary cholesterol nucleation time (NT) and the areas of
      the biliary lipid 1H-NMR peaks. It was found that the molecular motions of
      vesicle phospholipid, as determined by 1H-NMR, were restricted by saturation with
      cholesterol. In bile from patients with cholesterol gallstones, the reduced NMR
      fluidity of the phospholipid choline-head group indicated that the proportion of
      cholesterol-phospholipid vesicles containing more than 50% cholesterol, on a
      molar basis, was increased. The ratios of the N+(CH3)3 and = CH proton resonance
      peaks showed no overlap between samples with cholesterol gallstones and shorter
      NT and those with either no gallstones or pigment stones and longer NT. 1H-NMR
      spectroscopy indicates in a non-invasive manner those biles which are prone to
      cholesterol crystal formation.

PMID- 7786901
TI  - Phospholipid interactions affect substrate hydrolysis by bovine brain
      phospholipase A1.
AB  - The specificity of substrate hydrolysis by bovine brain phospholipase A1 (PLA1)
      was examined. In the presence of Mg2+, using pH values of 7 to 9, the purified
      enzyme deacylated 1-palmitoyl-2-[1-14C]arachidonoyl-phosphatidylethanolamine
      yielding 2-[1-14C]arachidonoyl-lysophosphatidylethanolamine at a rate of 70
      mumol/min per mg. In the absence of Mg2+, however, the reaction rate slowed at pH
      values above 7.25. In contrast, brain PLA1 slowly (3.8 mumol/min per mg)
      hydrolyzed 1-palmitoyl-2-[1-14C]arachidonoyl-phosphatidylcholine (PAPC) unless
      phosphatidylserine (PS) was included. Maximal PAPC hydrolyzing activity required
      a PAPC/PS molar ratio of 2.5:1, Mg2+, and a pH value of 8.5-9.5. Replacing PS
      with phosphatidylethanolamine (PE) or phosphatidic acid (PA), but not
      phosphatidylinositol (PI), produced a similar effect. Moreover, hydrolysis of
      either arachidonoyl-substituted or dipalmitoyl-substituted PC at pH 7.5 was
      enhanced by increasing the mol fraction of PE. Brain PLA1 also hydrolyzed 1
      stearoyl-[1-14C]arachidonoyl-PI with high velocity, but only if the substrate was
      dispersed in PE vesicles. In contrast, the velocity of PS, 1-palmitoyl-lyso-PC or
      diacylglycerol hydrolysis was low and unaffected by PE. In summary, PLA1
      hydrolyzed PE with high velocity and specificity, whereas a high rate of PC or PI
      hydrolysis was observed only if PS, PE, or PA was present. In addition, PLA1
      activity was greatly influenced by pH and Mg2+, implying that the substrate
      conformation is important to the catalytic efficiency of PLA1. Finally, the high
      rate of PE, PC or PI hydrolysis suggests PLA1 significantly contributes to the
      turnover of these phospholipids in the brain.

PMID- 7786902
TI  - Biliary lipid output by isolated perfused rat livers in response to cholyl
      lysylfluorescein.
AB  - The biliary output of bile acids and lipids is tightly coupled. The ability of
      the natural bile acid glycocholate to trigger biliary lipid secretion was
      compared with that of the fluorescent bile acid analogue cholyl-lysylfluorescein
      (cholyl-lys-F). When administered as a 5 min pulse of 2.5 mumol/min to bile acid
      depleted rat livers perfused under recycling conditions, glycocholate produced
      well-defined peaks of phospholipid and cholesterol output, and of bile flow,
      which were coincident with the peak of bile acid output. Although cholyl-lys-F
      did trigger biliary lipid secretion, its time course of appearance was delayed
      and well-defined peaks of output were not observed. However, the increased
      biliary output of phospholipid and cholesterol was coincident with that of bile
      acids and, as judged by phospholipid/bile acid and cholesterol/bile acid ratios,
      cholyl-lys-F was as effective as glycocholate in triggering biliary lipid output.
      When administered to livers perfused under single pass conditions, perfusate to
      bile transfer of glycocholate was > 85% at infusion rates of up to 5 mumol/min
      whereas transfer of cholyl-lys-F showed saturation at infusion rates of > 0.2
      mumol/min; the time course of biliary output of both bile acids was similar.
      Thus, under recycling conditions, cholyl-lys-F not taken up during first pass
      will be continually represented for transfer to bile, explaining why bile acid
      and lipid output did not occur as well-defined peaks.

PMID- 7786903
TI  - Rate of release and retentivity of prostaglandin E1 in lipid emulsion.
AB  - The rates of release of prostaglandin E1 (PGE1) from lipid particles into aqueous
      solution were obtained by the dialysis method, for parenteral lipid emulsion
      (Lipo-PGE1) diluted 10-times with buffered solutions of various pH. The findings,
      which were the rates of release of PGE1, were used to calculate the amount of
      PGE1 distributed in lipid particles when Lipo-PGE1, diluted 100-times with
      various pH levels of the buffered solution, was administered by intravenous drip
      infusion. More than 90% of PGE1 was retained in the lipid particles and
      intravenously infused when transfusion fluid pH was less than 5.5 and 2 ml of
      Lipo-PGE1 and 198 ml of transfusion fluid had been mixed and were administered
      over 2 h. Results from simulation showed that half of the PGE1 was retained in
      lipid particles and was infused, if Lipo-PGE1 was diluted 100-times with pH 8
      transfusion fluid. Though PGE1 was sparingly soluble in an aqueous solution,
      these findings demonstrated that a significant amount of PGE1 was retained in
      lipid particles. Thus, this dosage form is expected to be highly effective for a
      drug delivery of PGE1 in clinical treatment.

PMID- 7786905
TI  - Lipase from Chromobacterium viscosum: biochemical characterization indicating
      homology to the lipase from Pseudomonas glumae.
AB  - Previous purification of a commercial lipolytic preparation from Chromobacterium
      viscosum using gel filtration chromatography yielded two enzymatically active
      fractions, named lipases A and B. Characterization of these fractions by sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis revealed that lipase A
      consisted of a high molecular weight aggregate of lipase protein with
      lipopolysaccharides. This complex could be dissociated by treatment with EDTA
      Tris buffer containing the non-ionic detergent n-octyl-beta-D-glucopyranoside and
      subsequent isoelectric focusing in an agarose gel containing the same detergent.
      Both lipases A and B revealed a major peak corresponding to an isoelectric point
      of 7.1. SDS-PAGE analysis of lipases A and B after purification by gel filtration
      or by IEF revealed one major protein band of M(r) of 33 K. Determination of N
      terminal amino acid sequences confirmed that both fractions A and B contained the
      same lipase protein. Furthermore, the N-terminal amino acid sequence of the C.
      viscosum lipase was identical to the one of Pseudomonas glumae lipase.

PMID- 7786904
TI  - Species-specific polymorphism in the promoter of the apolipoprotein A-I gene:
      restoration of human transcriptional efficiency by substitution at positions 
      189, -144 and -48 bp.
AB  - Previous studies indicate that species-specific differences in apolipoprotein A-I
      (apo A-I) expression could be largely explained by cis-acting factors located
      within or near the 5' flanking region (-231 to +223 bp, where +1 is the start
      site of transcription). In the present studies, we have localized 7 sites within
      the (-231 to -15 bp) region of the African green monkey apo A-I gene that differ
      from the human apo A-I gene 5' flanking region. To identify which of the 7
      polymorphic sites were essential for the species-specific differences in apo A-I
      gene expression, mutated promoter constructs were transfected into HepG2 cells
      and reporter gene expression was measured. Each of the 7 sites within a defined
      5' flanking region of the human gene was individually mutated to the African
      green nucleotide sequence found at that position. Three of the sites (-189, -144
      and -48) were found to raise the human apo A-I promoter activity to approx. 60
      65% of the African green promoter. While double mutations (-144/-48 bp and -189/
      144 bp), restored the human apo A-I promoter activity to 100% of that found with
      the African green monkey promoter. Additional studies revealed similar DNA:
      protein interactions with DNA probes from either human or African green monkey
      and HepG2 cell nuclear extract. In conclusion, these studies demonstrate that
      double and triple nucleotide substitutions within the human apo A-I promoter are
      sufficient to restore gene expression in HepG2 cells to levels seen with the
      African green monkey promoter. These data suggest that sites -189, -144 and -48
      bp are involved in significantly altering the binding affinity of a nuclear
      factor determining the species-specific level of apo A-I gene transcription.

PMID- 7786906
TI  - A set of male monozygotic triplets with schizophrenic psychoses: nature or
      nurture?
AB  - A set of schizophrenic male monozygotic triplets is described. At age 20 years,
      within 8 months the three men independently developed acute fulminant
      schizophrenic disorders (DSM-III-R) with auditory hallucinations, bizarre
      delusions, and thought disturbances. There were also great similarities between
      the triplets with regard to the chronic intermittent course of the disorder,
      impairment of social adjustment, and loss of working ability. The psychoses
      responded rapidly to conventional neuroleptic treatment. Neuropsychological
      assessment demonstrated similar marked reductions of attentional, mnestic, and
      executive functions. Magnetic resonance imaging (MRI) showed similar borderline
      ventricular enlargement and widened subarachnoid spaces over frontoparietal and
      basal regions as well as around the pituitary gland (empty sella). All the boys
      also had a right-sided hearing defect with a marked reduction of the ossicular
      bones on the right side. Possible clues as to etiological mechanisms were the
      lack of reported family history for the disorder and a possible influenza
      infection in the mother during the first trimester. It is suggested that a DNA
      aberration being present or occurring at conception initiated a precise time
      programmed series of events that produced the very similar schizophrenic
      phenotypes. Such an aberration might have been induced by an external agent,
      occurred spontaneously, or been inherited by a recessive mechanism. It seems
      possible that the psychoses, the reductions of neuropsychological functions, the
      morphological MRI changes, and the right-sided ossicular reductions may all be
      related to such a DNA alteration.

PMID- 7786908
TI  - Factors affecting public attitudes towards mental health care.
AB  - This study presents a telephone survey of 501 randomly sampled residents of the
      Grand Duchy of Luxembourg older than 15 years of age. The interviewees were
      questioned on their attitudes and judgements towards mental health care in
      Luxembourg. The implementation of a community-based mental-health-services
      delivery system in Luxembourg is in its initial stages. Being the smallest member
      of the European Community Luxembourg offers the opportunity to analyze a whole
      catchment area in transition marked off clearly by national borders. As a general
      rule the people of Luxembourg are undecided when it comes to mental health care.
      Almost half of the sample answered "don't know" when asked about the quality of
      several sectors of mental health care, excluding inpatient care. The factors that
      had a significant influence on the attitude of the people of Luxembourg regarding
      mental health care were nationality, age, class and personal contact with
      mentally ill persons, with a tendency of worse judgements in younger age groups
      and in members of upper social classes. We fitted multivariate models including
      these variables. The results of our study point to entrenched prejudice. The
      findings suggest, however, that attitudes are changeable by direct or indirect
      contact with mentally ill persons. Possible strategies that could change public
      attitudes towards mental health care in a mental health care system that is in
      transition are discussed.

PMID- 7786907
TI  - Intelligence and temperament as protective factors for mental health. A cross
      sectional and prospective epidemiological study.
AB  - The Sjobring system of personality dimensions measuring intellectual capacity,
      activity, impulsivity and sociability was used to study possible "salutogenic"
      (i.e. causes of health) effects. The study comprised 590 subjects investigated in
      1947, 1957, 1972 and 1988-1989 in the Lundby project, an epidemiological study in
      Sweden. Psychiatric diagnoses were made in 1947, 1957 and 1972. Mental health was
      estimated in 1988-1989 using the concept "love well, work well, play well and
      expect well". The Sjobring dimensions were clinically assessed in 1972. Both in
      the concurrent study in 1972 and in the prospective study in 1988-1989 "super
      capacity" (high intellectual function), "super validity" (high activity level)
      and "super solidity" (low impulsivity) were statistically associated with lower
      frequencies of certain psychiatric diagnoses and a higher frequency of positive
      mental health. These variables are proposed to increase coping capacity, and
      therefore increase stress resilience.

PMID- 7786909
TI  - Nonlinear analysis of sleep EEG in depression: calculation of the largest
      lyapunov exponent.
AB  - Conventional sleep analysis according to Rechtschaffen and Kales (1968) has
      provided meaningful contributions to the understanding of disturbed sleep
      architecture in depression. However, there is no characteristic alteration of the
      sleep cycle, which could serve as a highly specific feature for depressive
      illness. Therefore, we started to investigate nonlinear properties of sleep
      electroencephalographic (EEG) data in order to elucidate functional alterations
      other than those obtained from classical sleep analysis. The application of
      methods from nonlinear dynamical system theory to EEG data has led to the
      assumption that the EEG can be treated as a deterministic chaotic process.
      Chaotic systems are characterized by a so-called sensitive dependence on initial
      conditions. This property can be quantified by calculating the system's Lyapunov
      exponents, which measure the exponential separation of nearby initial states in
      phase space. For 15 depressive inpatients (major depressive episodes according to
      DSM-III-R criteria) and 13 healthy controls, matched in gender, age, and
      education, we computed the principal Lyapunov exponents L1 of EEG segments
      corresponding to sleep stages, I, II, III, IV, and rapid eye movement (REM),
      according to Rechtschaffen and Kales, for the lead positions CZ and PZ. We found
      statistically significant decreased values of L1 during sleep stage IV in
      depressives compared with a healthy control group.

PMID- 7786910
TI  - Psychiatric morbidity among repatriated Greek migrants in a rural area.
AB  - This paper reports on psychiatric case identification by the application of the
      Structured Clinical Interview for DSM-III-R (SCID) in a sample of 198 Greek
      migrants repatriated from western europe in a northwestern province of Greece.
      The current (1 month) prevalence of psychiatric morbidity, based on the total
      number of diagnosed cases, was found to be 43.4%. Lifetime prevalence of
      psychiatric disorders was found to be higher (49.4%). The majority of the sample
      were diagnosed as suffering from anxiety disorders and dysthymia. Psychiatric
      disorders were found to be more prevalent among middle-aged respondents. Duration
      of stay in the foreign country was a factor correlated with psychiatric
      morbidity. Of short-term migrants 54% were found to suffer from specific
      nosological entities, whereas 32% of long-term migrants were diagnosed as cases.
      The results are discussed within the framework of the existing sociocultural
      context of emigration and repatriation.

PMID- 7786911
TI  - Dopamine D2 receptor gene polymorphisms in Scandinavian chronic alcoholics: a
      reappraisal.

PMID- 7786912
TI  - Comment to "Dopamine D2 receptor gene polymorphisms in Scandinavian chronic
      alcoholics: a reappraisal".

PMID- 7786914
TI  - Radionuclide ventriculography in dynamic cardiomyoplasty.
AB  - Dynamic cardiomyoplasty improves ventricular function by increasing pump function
      and by limiting cardiac dilatation. The aim of this study was to assess long-term
      myocardial performance by radionuclide ventriculography on dilated cardiomyopathy
      patients subjected to cardiomyoplasty. Thirteen survivors were included.
      Radionuclide ventriculography was performed one week before surgery and one year
      later. Five patients were also studied two years following surgery. The left
      ventricular ejection fraction (LVEF), end-diastolic volume (EDV) and ventricular
      amplitude ratio (VAR) to assess mitral regurgitation were measured. Every case
      after one year showed a non-significant increase in LVEF. However, the decrease
      in EDV and in VAR was significant (p < 0.01). No significant difference in these
      values was found after two years. We conclude that the effects of cardiomyoplasty
      -reduction of cardiac dilatation, wall stress and mitral regurgitation--are more
      evident during the first year after surgery. Thereafter, a certain stabilization
      is observed.

PMID- 7786913
TI  - Nocturnal myoclonus syndrome (periodic movements in sleep) related to central
      dopamine D2-receptor alteration.
AB  - The nocturnal myoclonus syndrome (NMS) consists of stereotyped, repetitive jerks
      of the lower limbs that occur during sleep or wakefulness. NMS is often related
      with restless-legs syndrome (RLS) and can cause severe sleep disturbances and
      daytime sleepiness. The efficacy of dopamine agonists in the treatment points to
      a dopaminergic dysfunction in NMS. We investigated the central dopamine D2
      receptor occupancy with [123I] labeled (S)-2-hydroxy-3-iodo-6-methoxy-([1-ethyl-2
      pyrrolidinyl]methyl) benzamide (IBZM) (a highly selective CNS D2 dopamine
      receptor ligand) ([123I]IBZM) and single photon emission tomography (SPET) in 20
      patients with NMS and in 10 healthy controls. In most of the patients with NMS
      there was a lower [123I]IBZM binding in the striatal structures compared to
      controls. The results indicate that NMS is related to a decrease of central D2
      receptor occupancy.

PMID- 7786915
TI  - Rest distribution of 99mTc-MIBI in patients with coronary artery disease assessed
      by SPECT: comparison with the distribution of [18F]FDG assessed by PET.
AB  - The distribution of 99mTc-methoxy-isobutyl-isonitrile (99mTc-MIBI), assessed by
      single photon emission computed tomography (SPECT) was compared to the
      distribution of 2-[18F]-2-deoxy-D-glucose ([18F]FDG) assessed with positron
      emission tomography (PET) under fasting conditions, in 21 patients with coronary
      artery disease (CAD) and severe left ventricular dysfunction in order to evaluate
      the potential usefulness of SPECT/99mTc-MIBI for the identification of viable
      myocardium. Stress and rest SPECT/99mTc-MIBI studies were scored based on the
      percent of 99mTc-MIBI uptake defined by semi-quantitative circumferential-profile
      analyses. PET metabolic studies with [18F]FDG under fasting conditions, were
      adopted as a standard of viability. The results of the comparison of 99mTc-MIBI
      and [18F]FDG distribution showed that among the segments with stress
      hypoperfusion, [18F]FDG uptake was present in 95% of the segments that had > 40%
      of the peak tracer uptake at the rest SPECT/99mTc-MIBI study. [18F]FDG uptake was
      also present, however, in 25% of the segments that had < 40% uptake at the rest
      SPECT/99mTc-MIBI scintigraphy. We conclude that in patients with CAD the pattern
      of 99mTc-MIBI distribution appears to underestimate the extent of viable
      myocardium but only in those regions that are very severely hypoperfused.

PMID- 7786916
TI  - Locating neuroblastoma in the opsoclonus-myoclonus syndrome.
AB  - We examined the role of various medical imaging modalities, particularly
      metaiodobenzylguanidine (MIBG) scintigraphy in the investigation of patients
      presenting with the opsoclonus-myoclonus syndrome (OMS) who may harbor
      neuroblastomas. A retrospective analysis was therefore performed of all patients
      presenting with OMS in a 5 1/2 year period. Between December, 1988 and May, 1994,
      all 13 patients (mean age 15.2 months, range 3 days-30 months) presenting with
      OMS were extensively studied. A wide range of medical imaging modalities
      including CT, MRI and [131I] or [123I]-metaiodobenzylguanidine (MIBG)
      scintigraphy (total of 21 scans) were examined as a means of detecting a
      structural brain lesion or locating a neuroblastoma, a tumor generally found in
      less than half of patients with OMS. As anticipated a minority of patients (4)
      were eventually found to harbor neuroblastomas. In these four cases, two tumors
      were revealed on preoperative MIBG scintigraphy, one gave a false negative study
      and one tumor was not studied preoperatively. Each patient was also subjected to
      extensive radiological investigations in addition to MIBG scintigraphy, many of
      which were repetitive, redundant or had low clinical yield. The relative merits
      of the various procedures are compared, and an algorithm incorporating MIBG
      scintigraphy and limited central nervous system and abdominal anatomical
      modalities for the investigation of opsoclonus-myoclonus is suggested.

PMID- 7786917
TI  - Determination of glomerular filtration rate with 99mTc-DTPA in clinical practice.
AB  - In order to assess the practical reliability of glomerular filtration rate (GFR)
      determination with 99mTc-DTPA and plasma sampling, the authors compared the
      results obtained with 51Cr-EDTA and 99mTc-DTPA in 50 patients using five easily
      applied methods (two double-plasma-sample methods and three single-plasma-sample
      methods), and two kits with different compositions. It was observed that: 1)
      there is no difference between the results obtained with the two different kits.
      2) Compared with 51Cr-EDTA the 99mTc-DTPA overestimates the result by about 2
      mL/min: precision is slightly lower with 99mTc-DTPA than with 51Cr-EDTA but is
      sufficient for practical use. 3) The method recommended by the authors on the
      basis of this experience is the Russell's method with two samples. 4) The
      simplified methods with one sample give comparable results to the Russell's
      method for GFR levels between 50 and 115 mL/min, while the results are
      unsatisfactory below 50 mL/min. 5) Among the single-sample methods, the authors
      suggest that of Christensen and Groth. 6) A preliminary estimate of GFR (from the
      serum creatinine level, for instance) is useful for the choice between double
      plasma-sample methods and simplified methods. In conclusion, the authors consider
      that the estimation of GFR with 99mTc-DTPA can be performed efficiently in
      clinical practice even when operating in absolutely routine conditions.

PMID- 7786918
TI  - Different tracers and stressors in patients with coronary artery disease: how to
      standardize clinical questions and nuclear cardiology answers.
AB  - The recent introduction of new tracers and stressors has increased the number of
      combinations of techniques that can be used for the diagnostic and prognostic
      stratification of patients with coronary artery disease. However, these new
      techniques still need to be standardized for clinical use. Thallium-201
      scintigraphy is at present the most common method to assess transient ischemia
      and viability in patients. Dynamic exercise and dipyridamole show similar
      incidence of major cardiac complications and their use can be considered
      sufficiently safe. Further experimental and multicenter clinical studies are
      needed for 99mTc-Sestamibi and 99mTc-Teboroxime and for new stressors such as
      adenosine and dobutamine.

PMID- 7786919
TI  - The future of SPECT radioisotopes: technetium-99m or iodine-123?

PMID- 7786920
TI  - 111In-octreotide uptake in granulomatous and tumor lesions in a patient with
      small-cell lung cancer.
AB  - A case of a patient with small cell lung cancer and right submandibular node
      enlargement due to granulomatous lymphadenitis is presented. Diagnostic
      procedures included: biopsy of the cervical node, transmission computed
      tomography of the chest, bronchoscopic examination and biopsy of the pulmonary
      lesion. The patient underwent 111In-octreotide scintigraphy (whole body and
      single photon emission tomography) which revealed both lesions. We conclude that
      granulomatous lesions are to be considered as a possible cause of false positive
      results, when octreotide scintigraphy is used to evaluate distant metastases in
      patients with known cancer.

PMID- 7786921
TI  - A bioimaging integration system implemented for neurological applications.
AB  - A system aimed at the management and fusion of multimodal biomedical images,
      including X-ray computed tomography, magnetic resonance imaging, positron
      emission tomography, and single photon emission computed tomography, has been
      implemented for neurological applications. This bioimaging integration system
      (BIS) consists of a network for image transmission from acquisition machines to
      dedicated image processing workstations, a software library for image
      standardization, and an image registration technique to project multimodal
      volumetric images into a common reference space. The registration procedure was
      evaluated in MRI/PET correlation studies, in which misalignment errors of 2.6 mm
      in the xy transaxial plane and 3.4 mm along the z axis were found. BIS has been
      validated for the anatomical-functional correlation analysis of MRI and PET
      images in neurological research protocols and clinical studies.

PMID- 7786922
TI  - Micronuclei and 3AB-index in patients receiving iodine-131 therapy.
AB  - In 28 blood samples from 21 patients undergoing 131I treatment after surgical
      thyroidectomy for cancer, the micronucleus (MN) frequency observed in peripheral
      blood lymphocytes (MN-test on binucleated cells) had a weighted mean of 0.044 +/-
      0.006 (SEM), which was significantly different (p < 0.001) from that observed in
      93 healthy individuals (0.025 +/- 0.001). The MN frequency (F(MN)) of the
      patients correlated fairly well (R = 0.736) with the modified activity (Amod)
      calculated by the following equation: [formula: see text] where Ai is the 131I
      activity on a determined day, e the logarithm base, di the number of days that
      have passed between the determined day and the day when the blood was drawn, and
      k is a day coefficient, defined in this context as the "daily attenuation
      factor". The use of the value of 0.0003 for k allowed the following equation to
      be obtained: F(MN) = 7.9 x 10(-5) (+/- 1.4 x 10(-5)).Amod + 0.014 (R = 0.736) The
      MN frequency was used to estimate, by our DOSIME program, the dose (Gy) received
      at the individual level in the 131I treatment. In these subjects the calculated
      dose was well correlated with Amod by the relationship: DBio = 0.0009 (+/-
      0.0002).Amod + 0.0675 (R = 0.755) 3-aminobenzamide (3AB), an inhibitor of the
      poly(ADP-ribose)polymerase enzyme involved in DNA repair, induced and increase in
      X-ray cytogenetic damage (MN yields), evaluated at the individual level using the
      3AB-index (I-3AB). The index was obtained from the MN-yield count after x
      irradiation with (MN + 3AB) and without (MN - 3AB) 3AB, using the following
      formula: I = 1-(MN - 3AB/MN + 3AB).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7786923
TI  - Improving radioimmunotargeting of tumors: the impact of preloading unlabeled L6
      monoclonal antibody on the biodistribution of 125I-L6 in rats.
AB  - In the radioimmunotherapy of malignancies the uptake of monoclonal antibodies
      (MoAb) is commonly low in tumors compared with normal tissue. Several methods
      have been suggested to increase the tumor-to-normal tissue (T/N) ratio. In this
      study we have investigated the biodistribution of different amounts of 125I-L6
      biotin MoAb in combination with a preload of unlabeled L6 MoAb. Nude rats were
      injected with 50 micrograms or 250 micrograms of unlabeled L6 24 hours prior to
      the injection of 10 micrograms, 50 micrograms or 250 micrograms of 125I-L6,
      antipancarcinoma MoAb. Dissections were performed 24 hours after the injection of
      radiolabeled MoAb. The maximal enhancement of tumor uptake with simultaneously
      decreased uptake in normal tissues was with 250 micrograms of 125I-L6 preceded by
      a preload of 50 micrograms unlabeled L6. Mean T/N ratios were improved by a
      factor of 2.9 for bone marrow, 3.4 for liver, 3.7 for lungs and 2.3 for kidneys
      as compared with the corresponding controls. This study demonstrated that
      preinjection of optimal amounts of unlabeled L6 MoAb may increase the uptake of
      125I-L6 by tumor and improve the T/N ratios. Based on present data, preloading
      with unlabeled MoAb should be considered in future clinical studies with
      immunoconjugates to improve the radioimmunotargeting of tumors. It is essential
      to titrate an appropriate amount of the preload, thus avoiding possible tumor
      antigen saturation of unlabeled MoAbs but simultaneously decreasing the uptake of
      subsequently injected radiolabeled MoAb in normal tissues.

PMID- 7786924
TI  - Reliability of psychophysiological responding as a function of trait anxiety.
AB  - This study examined the temporal stability of three psychophysiological responses
      (frontal electromyographic activity, hand surface temperature, and heart rate)
      recorded over four sessions (days 1, 2, 8, and 28) on 34 subjects, 17 with high
      Spielberger Trait Anxiety Inventory scores and 17 with low scores. Each session
      consisted of a 20-minute adaptation period, a baseline condition, and two
      stressors (one cognitive, the other physical). Two forms of reliability
      coefficients were employed, intraclass correlations and Pearson Product Moment;
      the two types of reliability coefficients arrived at the same conclusions.
      Results indicated that reliability coefficients for the two anxiety groups did
      not differ on frontal EMG or heart rate responses; however, hand surface
      temperature responding was considerably less reliable for high anxious
      individuals than low anxious individuals. Reliability coefficients on absolute
      scores were, for the most part, reliable. Treating the responses as relative
      measures (percent change from baseline or simple change scores from baseline)
      produced smaller and less reliable coefficients. Magnitudes of the three
      physiological responses did not significantly differ as a function of high or low
      trait anxiety. Findings are discussed in terms of their clinical, as well as
      basic psychophysiological, importance.

PMID- 7786925
TI  - Assessment of lumbar EMG during static and dynamic activity in pain-free normals:
      implications for muscle scanning protocols.
AB  - The purpose of this study was to provide a thorough description of lumbar surface
      integrated electromyography (EMG) in pain-free normals during a standardized
      assessment protocol of static isometric and unresisted dynamic tasks. It has been
      proposed that in pain-free normals, symmetrical tasks that bend the trunk forward
      or extend the trunk backward produce symmetrical paraspinal EMG activity, and
      asymmetrical tasks that rotate or laterally bend the trunk produce asymmetrical
      paraspinal EMG activity. In addition, it has been observed that lumbar EMG
      assessment during static tasks has been more consistent than tasks involving
      dynamic activities. Twenty-eight pain-free normals were assessed during
      symmetrical and asymmetrical tasks in both static and dynamic activities in a
      counterbalanced manner. The assessment of paraspinal EMG patterns was conducted
      while subjects were secured in a triaxial dynamometer, which provided
      standardization of body position and concurrent measurement of torque, range of
      motion, and velocity. The results provided experimental evidence for the above
      stated propositions. An implication derived from this research is that clinicians
      may be better served utilizing local norms when using EMG for classification
      purposes.

PMID- 7786926
TI  - Electromyographic recordings of paraspinal muscles: variations related to
      subcutaneous tissue thickness.
AB  - The aim of this study was to assess the effect on EMG amplitude measures of
      variations in the thickness of underlying tissue between surface electrodes and
      the active muscle. 20 normal subjects with different amounts of subcutaneous
      tissue performed comparable constant force contractions for a 45-second period,
      during which paraspinal EMG recordings were taken. Three measures of subcutaneous
      tissue thickness were obtained from each subject: Body Mass Index, total body fat
      as calculated by Durnin's formula, and skinfold thickness at the recording sites.
      The results show that (i) the greater the thickness of subcutaneous tissue
      between the surface recording site and the contracting muscles, the lower the
      recorded electromyographic activity, and that (ii) up to 81.2% of the variance in
      the EMG measures can be explained by variation in the amount of subcutaneous
      tissue. These findings support the view that the absolute level of surface
      recorded EMG cannot simply be taken at face value. The amplitude of the signal
      will be affected by, for example, the amount of body fat.

PMID- 7786927
TI  - The relationship of expectancies to outcome in stress management treatment of
      essential hypertension: results from the Joint USSR-USA Behavioral Hypertension
      Project.
AB  - Outcome expectancy and efficacy expectancy measures were made during the course
      of a cross-cultural comparison of thermal biofeedback and autogenic training as
      treatments for mild essential hypertension. There were no differences between
      groups at either pre- or posttreatment, and expectancy measures were not related
      to initial success or failure at the completion of treatment. However, both
      outcome and efficacy expectations were related to relapse over the three months
      immediately following the completion of treatment. Treatment failures had lower
      ratings for both outcome and efficacy expectations at the posttreatment
      assessment in comparison to treatment successes. Implications of these results
      are discussed.

PMID- 7786929
TI  - Evaluation of the effectiveness of EEG neurofeedback training for ADHD in a
      clinical setting as measured by changes in T.O.V.A. scores, behavioral ratings,
      and WISC-R performance.
AB  - A study with three component parts was performed to assess the effectiveness of
      neurofeedback treatment for Attention Deficit/Hyperactivity Disorder (ADHD). The
      subject pool consisted of 23 children and adolescents ranging in age from 8 to 19
      years with a mean of 11.4 years who participated in a 2- to 3-month summer
      program of intensive neurofeedback training. Feedback was contingent on the
      production of 16-20 hertz (beta) activity in the absence of 4-8 hertz (theta)
      activity. Posttraining changes in EEG activity, T.O.V.A. performance, (ADDES)
      behavior ratings, and WISC-R performance were assessed. Part I indicated that
      subjects who successfully decreased theta activity showed significant improvement
      in T.O.V.A. performance; Part II revealed significant improvement in parent
      ratings following neurofeedback training; and Part III indicated significant
      increases in WISC-R scores following neurofeedback training. This study is
      significant in that it examines the effects of neurofeedback training on both
      objective and subjective measures under relatively controlled conditions. Our
      findings corroborate and extend previous research, indicating that neurofeedback
      training can be an appropriate and efficacious treatment for children with ADHD.

PMID- 7786928
TI  - Differences in baseline EEG measures for ADD and normally achieving preadolescent
      males.
AB  - This study was designed as a replication of previous studies describing dynamic
      EEG differences between behaviorally dissimilar groups. This study is intended as
      a reference point from which other researchers can continue to establish the EEG
      correlates of "on-task" behavior. Eight Attention Deficit Disordered (ADD)
      children and eight Normally Achieving Controls (NAC) were assessed using dynamic
      EEG measures. Results are reported for the tasks of baseline (eyes open),
      reading, and drawing as recorded from FZ, CZ, PZ, C3, and C4. Significant
      amplitude differences between the groups were demonstrated in the theta band (4-8
      hertz) during all tasks and for all sites. Amplitude differences in the beta band
      (12-20 hertz) were negligible. Differences between groups expressed as a ratio of
      theta/beta revealed significant differences mainly in the parietal region for on
      task conditions. These results are discussed in relation to EEG neuro-feedback
      training paradigms and the importance of establishing normative "on-task" EEG
      values.

PMID- 7786930
TI  - [XII Congress of the Spanish Society of Parenteral and Enteral Nutrition. Madrid,
      3-6 May 1995. Abstracts].

PMID- 7786933
TI  - Perceptions of the contemporary status of smoking-control strategies.

PMID- 7786931
TI  - Towards a population-based screening program for cervical cancer.

PMID- 7786932
TI  - The health of Australians of non-English-speaking background: key concerns.

PMID- 7786935
TI  - Smoking in New Zealand: a census investigation.
AB  - New Zealand may well be unique in that in the 1976 and the 1981 Censuses of
      Population and Dwellings, persons over the age of 15 were asked about their
      cigarette smoking habits. The data are available on the basis of age and
      ethnicity, enabling an examination of the prevalence of ever-smoking by a cohort
      born some 80 years before the censuses were taken, at the end of the last
      century. Thus the effect of ever-smoking on mortality can be calculated. Ever
      regularly smoking reduced the life expectation of males by 11.7 years and females
      by 15.6 years. The corresponding reductions for Maori were 19.3 years and 23.8
      years. The effect of smoking on health has been of epidemic proportions, notably
      for the Maori.

PMID- 7786934
TI  - Increase in the self-reported prevalence of asthma and hay fever in adults over
      the last generation: a matched parent-offspring study.
AB  - The study compared current measures on a population-based cohort of adults with
      past measures on their parents to determine whether the prevalence of self
      reported asthma and hay fever in adults increased between 1968 and the early
      1990s. In 1968, 8585 cohort members (99 per cent of eligible Tasmanian 7-year-old
      school children born in 1961), 16,273 (95 per cent) of their parents (mean age 35
      years) and 20,937 siblings completed a questionnaire about asthma and hay fever.
      In 1991-1993, 1494 members (75 per cent) of a stratified random sample of the
      cohort (aged 29 to 32 years), 75 per cent resident in Tasmania, were surveyed
      again. In 1968, the proportion of parents who reported having ever had asthma or
      attacks of wheezing like asthma was 10.9 per cent, independent of age and sex. In
      1991-1993, the estimated adult prevalence of having ever suffered from attacks of
      asthma or wheezy breathing was 23.2 per cent. The proportion reporting at least
      one asthma attack within the previous 10 years, 5 years, 2 years, 12 months and 6
      months was 17.6 per cent, 16.1 per cent, 14.5 per cent, 13.3 per cent and 10.3
      per cent, respectively. For hay fever, the adult prevalence was 19.2 per cent in
      1968, and 41.3 per cent in 1991-1993. The self-reported lifetime prevalence of
      asthma and hay fever among adults in the 1961 birth cohort of Tasmanians was
      twice as high in 1991-1993 as in their parents 25 years earlier.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7786936
TI  - Quitting smoking: estimation by meta-analysis of the rate of unaided smoking
      cessation.
AB  - The rates (after 12 months' follow-up) of unassisted smoking cessation reported
      in the literature have varied from 13.8 per cent to 8.5 per cent. A meta-analysis
      was conducted of the abstinence rates observed in 14 samples of smokers who
      presented at primary health settings and received either no intervention aimed at
      smoking or usual care (which involved no deliberate intervention for smoking
      cessation). The estimated rate of stopping smoking without intervention, over an
      average 10-month period, was 7.33 per cent. This rate is consistent with others
      reported in the literature when motivation to quit is taken into account. The
      estimate provides a baseline to judge the effects of smoking-cessation
      interventions.

PMID- 7786937
TI  - Predictors of unprotected male-to-male anal intercourse with casual partners in a
      national sample.
AB  - The focus of the paper is the predictors of unprotected anal intercourse with
      casual partners among a national Australian sample of homosexually active men. We
      interviewed by telephone 2583 homosexually active men (sex with a man within the
      last five years) about their sexual practice, type of sexual partners, human
      immunodeficiency virus (HIV) test status, attachment to the gay community,
      knowledge of HIV and acquired immune deficiency syndrome (AIDS) and a range of
      demographic variables. Logistic regression analyses were used to distinguish men
      who practised unprotected anal intercourse with casual partners from those who
      practised safe sex with casual partners. Men who practised unprotected anal
      intercourse with casual partners were less likely to have a regular male sexual
      partner than men who practised safe sex with their casual partners. They were
      less likely to be tertiary educated, more likely to be employed in trade and
      manual occupations and to live in Tasmania and the Northern Territory. They were
      less likely to be culturally or politically attached to the gay community.
      Knowledge of HIV/AIDS also distinguished the men: men with an accurate knowledge
      of HIV transmission were less likely to engage in unprotected anal intercourse
      with their casual partners. Several other variables, including age and HIV test
      status, did not distinguish those who practised safe sex with casual partners
      from those who practised unprotected anal intercourse with casual partners.

PMID- 7786938
TI  - An improved aetiologic fraction for alcohol-caused mortality.
AB  - A method is proposed for estimation of alcohol-caused mortality in which the
      aetiologic fraction of deaths is derived from an exposure contrast between the
      'unsafe' drinker and 'safe' drinker; not between the drinker and the nondrinker.
      The method is consistent with the objectives of public health intervention in the
      alcohol education field. The 'safe' drinker is the reference exposure category
      and aetiologic fractions are obtained for the single categories of a multiple
      level exposure scale, using separate relative risks for the 'unsafe' drinker and
      the nondrinker. Preliminary application of the method to Australian data yields
      an estimate of the number of deaths caused by misuse of alcohol that is larger
      than those obtained under the old conceptual model. Thus, the public health
      importance of unsafe alcohol consumption has been underrepresented.

PMID- 7786939
TI  - A controlled trial of educational visiting to improve benzodiazepine prescribing
      in general practice.
AB  - A randomised controlled trial studied the effect of an educational visit on
      benzodiazepine prescribing. An approximately representative sample of 286 general
      practitioners was allocated to an intervention or a control group. Rates of
      benzodiazepine prescriptions were derived from two comprehensive self-report
      surveys seven months apart. Two months after the first survey the intervention
      group received an educational visit and supporting material from a doctor or
      pharmacist, ostensibly unconnected with the surveys. The overall benzodiazepine
      prescribing rate fell by 23.7 per cent from the first to the second surveys, from
      4.93 to 3.76 prescriptions per 100 encounters (P < 0.001). Anxiety and insomnia
      diagnosis rates also declined from 4.68 to 3.76 per 100 encounters (19.7 per
      cent). After adjusting for confounders, there was a differential downward trend
      in prescriptions per diagnosis of insomnia but not to a statistical level. The
      same was true of initial prescriptions per insomnia diagnosis. In a subsidiary
      analysis selecting only new insomnia diagnoses, the intervention had a strong
      effect in reducing initial prescriptions (odds ratio 0.18, 95 per cent confidence
      interval 0.04 to 0.73). No effect was seen on prescribing for anxiety diagnoses.
      Educational practice visiting for benzodiazepine prescribing in anxiety, as we
      conducted it, is not justified in an unselected population of general
      practitioners. Specific education on prescribing for insomnia is probably useful.
      Our interpretation of the reduction in benzodiazepine prescribing is that
      probably there was an effect from self-monitoring alone which overwhelmed a main
      analysis intervention effect. Retrospective diagnosis may also have obscured a
      real intervention effect.

PMID- 7786940
TI  - Injury from assault in New Zealand: an increasing public health problem.
AB  - Injury purposely inflicted by other persons is a significant public health
      problem accounting for approximately 4 per cent of all injury hospitalisations in
      New Zealand. National injury morbidity data for the years 1979-1988 were
      examined. These data were used to identify the characteristics of victims of
      assault who were hospitalised, the nature of the injuries they sustained, and the
      circumstances in which the injuries were inflicted. The incidence of
      hospitalisations in 1988 was 73.7 per 100,000 persons per year. A significant
      increase in the rate of hospitalisations over the decade 1979-1988 was
      identified. The rates for males were higher than those for females, with males 20
      24 years of age most at risk. Maori had higher rates than non-Maori. Fights or
      brawls were the leading cause of hospitalisation. The most common place of
      occurrence was private homes, followed by streets and highways, and licensed
      premises. The findings with regard to age, sex, employment status and use of
      weapons were consistent with earlier studies. A higher proportion of incidents
      occurring in the home was attributed to differences in selection of cases between
      studies. An indication of underreporting by women was attributed to concealment
      of intentionality, possible owing to fear of reprisal. Standard hospital
      reporting procedures were proposed as a means of improving identification.

PMID- 7786941
TI  - Critical path analysis for the management of fractured neck of femur.
AB  - The aim of this study was to determine the effect of a critical path analysis,
      used as a management tool, on the efficiency of clinical service delivery for
      patients with a fractured neck of femur. It is a before-and-after study of the
      medical records of all patients admitted between October 1992 and October 1993
      with a primary diagnosis of fractured neck of femur, but excluding patients under
      50 years old and those with multiple fractures or metastatic disease. Patients
      fell into two groups: those admitted in the six months before the introduction of
      a clinical management program based on a critical path analysis, and those
      admitted after the introduction of the program in April 1993 (88 program cases
      and 90 nonprogram cases). A medical records administrator blinded to the program
      category of the patients independently coded diagnostic data, while other data
      were abstracted from the clinical notes. The length of stay for a fractured neck
      of femur declined from a mean of 19.3 days to a mean of 11.0 days (P < 0.0001).
      The outcome measures were: the distance walked just before discharge from
      hospital, the discharge destination, and unplanned readmission. These did not
      change significantly, and the wound infection rate declined during the period of
      the intervention. The implementation of a clinical management pathway based on a
      critical path analysis dramatically reduced the length of stay for patients
      admitted with a fractured neck of femur while maintaining quality of outcomes.
      Critical path analysis is a useful management tool to improve the efficiency of
      certain clinical services.

PMID- 7786942
TI  - The SF-36 in an Australian sample: validating a new, generic health status
      measure.
AB  - The SF-36 is a self-reported, 36-item, generic measure of health status that has
      been validated for adult age groups in the United States, the United Kingdom and
      in some non-English-speaking countries. The Australian Bureau of Statistics used
      it in the 1995 National Health Survey and it has been used in health status
      measurement, in monitoring health outcomes and in clinical trials. The validity
      of the SF-36 was examined in the National Centre for Epidemiology and Population
      Health Record Linkage Study using a sample of 555 respondents to the National
      Heart Foundation Risk Factor Prevalence Survey in 1989; they were followed up in
      1992. Items chosen for the scale had been used in health status assessment and
      had stood the test of time. The health concepts measured demonstrated good
      internal consistency. The eight scales of the SF-36 formed factors as predicted
      in the general health dimensions of physical and mental health. The component
      scales of the SF-36 demonstrated good discrimination between people with and
      without health conditions, including those with medical and those with
      psychiatric types of conditions. Although the SF-36 was a valid measure of
      general health status among Australian respondents, further work is needed to
      establish clinical validity and to produce population norms for Australia. Use of
      the SF-36 will allow Australian and international comparison of health status
      from the point of view of the users of health services.

PMID- 7786943
TI  - Cervical screening in general practice.
AB  - This study examined the effect of three interventions for encouraging women to
      have a Pap smear in a general practice: tagging the medical record to remind the
      doctor to offer a Pap smear, sending an invitation to make an appointment for a
      Pap smear, and sending an invitation with an appointment to attend for a Pap
      smear at a special screening clinic staffed by women. The study took place in a
      university general practice at Lockridge, near Perth. A computerised practice age
      sex register provided 2139 women in the age range 36 to 69 inclusive. Of these,
      757 were eligible for inclusion in the study and were allocated randomly to one
      of three intervention groups or a control group. In total, 177 women had a Pap
      smear during the study. Significantly more Pap smears were taken for the
      appointment-letter and letter-only groups than the control group (odds ratio (OR)
      2.13, 95% confidence interval (CI) 1.34 to 3.57, and OR 1.67, CI 1.01 to 2.77
      respectively), but there was no significant difference between the tagged-notes
      and the control groups. Women who attended the screening clinic rated the
      experience positively. Attendance, however, was inadequate for the clinic's
      viability in a private practice.

PMID- 7786944
TI  - A prospective cohort study investigating psychosocial predictors of attendance at
      a mobile breast screening service.
AB  - This study aimed to examine whether knowledge, attitudes and concerns predicted
      attendance at the mobile Breast X-Ray Programme in Sydney. A cohort study design
      was used, whereby women were surveyed prior to the implementation of the program,
      and two years later records were checked to determine whether they had attended
      for screening. Telephone interviews were sought with randomly selected women aged
      45 to 70 years living in the central Sydney area (the screening van's catchment
      area). A total of 285 women was surveyed (response rate: 50 per cent). Of these,
      86 (30 per cent) subsequently attended at the mobile van and 199 did not.
      Attendance did not appear to be related to any of the following factors:
      knowledge; attitudes; prior experience; perceived susceptibility and morbid
      concern in relation to breast cancer; the amount of information about screening
      mammography to which a woman had been exposed. The results are interpreted in
      light of methodological considerations plus findings from our other research.

PMID- 7786946
TI  - Psychological impairment following motor vehicle accidents.
AB  - This study investigated the rate of psychological impairment and stressful life
      events in survivors of motor vehicle accidents. Fifty-six patients who had been
      hospitalised because of motor-vehicle-accident-related injuries were reviewed
      twelve months after the accident. In this sample, 41 per cent of patients
      reported significant levels of psychological impairment. Patients reporting
      psychological disturbance were characterised by having more pain, unemployment,
      substance abuse, avoidance of road transport and compensation claims. Only 44 per
      cent of patients reporting significant psychological impairment had sought
      professional help for their conditions. Psychological dysfunction following motor
      vehicle accidents appears to be a common occurrence, and education of medical
      personnel and survivors is required to enhance identification and management of
      this problem.

PMID- 7786945
TI  - Aboriginal wellbeing and liquor licensing legislation in Western Australia.
AB  - This paper is based on the results of a project undertaken as the basis for a
      submission to the committee established to review the Western Australian Liquor
      Licensing Act 1988. It reports on key issues relating to liquor licensing, as
      identified by members of regional Aboriginal organisations. Among these issues
      are the promotion of alcohol consumption and misuse, discriminatory practices by
      licensees and the police and the need for greater community involvement in liquor
      licensing decisions. To address these issues, members of the participating
      organisations proposed: inclusion of a harm-minimisation objective in the Act,
      education and training programs for the public, licensees and the police, and
      industry funding for harm-minimisation programs.

PMID- 7786947
TI  - Soil lead levels in parks and playgrounds: an environmental risk assessment in
      Newcastle.
AB  - In June 1993 the National Health and Medical Research Council set a national goal
      for blood lead of below 10 micrograms/dl. There is a need to know if the lead
      contamination of the urban environment is so high as to put community health at
      risk. Decisions, including whether soil should be removed and replaced, will have
      to be made. During the second half of 1993, an environmental assessment of lead
      contamination of soil within the City of Newcastle was conducted. Samples, 108
      from surface soil and 10 from subsurface soil, were taken from public parks and
      playgrounds in the city area and analysed for lead content. The proportion within
      and the proportion above the guidelines for soil contamination were reported.
      Lead concentrations ranged from 25 to 2400 parts per million (ppm); 21 per cent
      of samples had concentrations higher than the 300 ppm action level, and the
      geometric mean was 134 ppm. Both the range and the average lead levels were
      typically no more than, or were even less than, soil lead levels documented for
      other cities in Australia, the United States and United Kingdom. Although each
      sampling site was noted, it was not our intention to focus in on individual
      sites. Indeed, to draw health-risk implications from any one result may be
      misleading and inaccurate. The results indicated moderate lead contamination of
      soil that could be controlled by regular top-dressing of soils, the use of bark
      chip on playground surfaces and by government initiatives aimed at lowering lead
      levels in petrol.

PMID- 7786948
TI  - Information for family carers: does it help?
AB  - Family carers in Victoria were identified through a statewide telephone survey in
      1993. A total of 976 carers was interviewed and a random sample of approximately
      one in 10 (n = 103) were offered the Carer Support Kit leaflet. The leaflet
      details the components of the Carer Support Kit (a Federal Government initiative
      developed in 1992-93) and informs carers how to apply for it through the
      Victorian Carers' Association. Approximately three-quarters of these carers
      accepted the offer, and around a third subsequently applied for the kit. Carers
      who applied for the kit reported significantly more overload and lower life
      satisfaction than those who did not apply. Only two-thirds of those mailed the
      kit (just 23 per cent of the eligible study sample) went on to use it. Those who
      had not used it reported significantly more negative emotions and health problems
      than those who used it, suggesting that stress and crises could preclude
      utilisation of the information. A brief evaluation of the components of the kit
      is presented; however, findings need to be treated with caution in view of the
      small sample size.

PMID- 7786949
TI  - Ethnic health workers in primary health care.
AB  - Ethnic health workers were employed to increase the access of communities of non
      English-speaking background to health services, but their role has remained
      unclear in a national health system that has been criticised for being slow to
      respond to the needs of these communities. Interviews and a questionnaire were
      used to survey a convenience sample of 40 South Australian ethnic health workers,
      how they should perform their roles and their ability to fulfil them. Interviews
      with 11 staff from the New South Wales Ethnic Health Worker Program then provided
      a broader perspective to the South Australian findings. High-priority roles were
      to provide help to solve immediate health problems. Roles included providing
      access as well as services. There were pressures on ethnic health workers to
      become service providers: clients from non-English-speaking backgrounds expected
      assistance with a wide range of problems, and mainstream staff lacked competence
      in meeting these needs. Ethnic health workers' involvement in needs assessment
      and health agency change was limited by these pressures, by ethnic health
      workers' separation from the work of mainstream staff and because systematic
      planning of services to non-English-speaking communities was lacking. The
      appropriate role for an ethnic health worker is as an access provider, with a
      greater emphasis on needs assessment and agency change. Agencies need to develop
      culturally appropriate service plans and training so that ethnic health workers
      and mainstream staff are better able to work together.

PMID- 7786950
TI  - Community nutrition education for people with coronary heart disease--who
      attends?
AB  - A qualitative food-frequency questionnaire was administered by mail to a
      representative sample of 137 people previously diagnosed with possible or
      definite myocardial infarct. Seventy-eight percent of subjects returned a
      completed questionnaire and were subsequently invited to attend local tastings of
      foods with the National Heart Foundation Tick of Approval. These tastings were
      organised and promoted with the active involvement of the local branch of the
      Australian Cardiac Association. The purpose of this study was to measure
      voluntary participation by people with coronary heart disease in community
      nutrition education and to identify any self-selection bias with respect to
      eating habits among the participants. A dietary risk score, which was the
      proportion of all food choices that were high in fat, was calculated from the
      data. Eighteen per cent of subjects who answered also participated in the food
      tastings; there was a statistically significant association between membership of
      the Australian Cardiac Association and being a participant. Participants had a
      significantly lower risk score (P < 0.01) after adjustment for age, sex and
      membership of the association. The results suggest that voluntary participation
      by people with heart disease in community nutrition education is low and that
      there is a self-selection bias, with those at highest dietary risk being least
      likely to attend. The use of existing community networks to recruit participants
      is also discussed.

PMID- 7786951
TI  - Notifying women of the results of their cervical smear tests by mail: does it
      result in a decreased loss to follow-up of abnormal smears?
AB  - We undertook a prospective randomised intervention study of the proportions of
      women with abnormal cytology results who were lost to follow-up in 42 general
      practices in urban and rural Queensland over 26 weeks. Practices in the
      intervention group were provided with a redesigned cervical smear request form
      that allowed patients to provide an address for direct notification from the
      laboratory by mail. Satisfaction questionnaires sent to the general practitioners
      in the intervention group showed that most made at least some use of direct
      notification, and most felt it was worthwhile. For women with an initial result
      of cervical intraepithelial neoplasia (CIN), there was a loss to follow-up of 23
      per cent (95 per cent confidence interval (CI) 11 to 39) among the control group
      compared to none in the intervention group (upper CI 7 per cent), a highly
      significant difference (P < 0.001). Mailing cervical screening results to women
      may reduce the loss to follow-up of those with CIN findings.

PMID- 7786952
TI  - Cars, boats, dogs ... why not guns? The case for national gun registration in
      Australia.

PMID- 7786953
TI  - Public health advocacy in the Northern Territory.

PMID- 7786954
TI  - Clozapine: the Yin and Yang of seizures and psychosis.

PMID- 7786955
TI  - Clozapine and seizures.
AB  - Epileptiform EEG changes, myoclonus, and seizures are reported in some patients
      treated with clozapine. Although these are undesirable side effects, the
      excitation of specific neuronal networks by clozapine and other neuroleptics may
      be important for the therapeutic effect of this class of agents. In these
      experiments, intraperitoneal clozapine 2-16 mg/kg produced dose-related myoclonic
      jerks in partially restrained rats. Paroxysmal slow waves and spike activity were
      recorded from implanted electrodes in amygdala, hippocampus, and cortex following
      higher doses of clozapine, but the EEG abnormalities were not correlated with the
      myoclonic jerks. Single doses of chlorpromazine (8 and 16 mg/kg) rarely produced
      myoclonic jerks but provoked generalized tonic seizures in two animals preceded
      by multiple myoclonic jerks in one. Myoclonus and seizures reflect increased
      excitability of the central nervous system. It is possible that clozapine and
      other neuroleptics exert a therapeutic effect by increasing excitability in
      critical subcortical areas of the brain.

PMID- 7786957
TI  - Platelet serotonin markers and depressive symptomatology.
AB  - Dysfunction of brain serotonergic symptoms may be a factor in the mood and
      behavioral disturbances associated with depression. Platelet serotonin measures
      represent indirect but easily obtainable indices of brain serotonin function. To
      examine the specificity of relationships between cognitive and vegetative symptom
      groupings and platelet serotonin measures, we assessed 35 depressed outpatients
      using the Hamilton Rating Scale for Depression and collected platelets after a
      minimum 3-week drug-free period. Platelets were also collected from 14 controls.
      The results showed that depressed patients had lower platelet serotonin (5-HT)
      uptake site density values than controls and that 5-HT uptake site density values
      were inversely correlated with the severity of cognitive symptoms of depression.
      Platelet 5-HT2 receptor density values were higher in depressed patients than
      controls, and there was a trend toward a direct correlation between the cognitive
      symptoms of depression and 5-HT2 receptor density values. Neither platelet
      measure showed any relationship with the severity of the vegetative symptoms of
      depression.

PMID- 7786956
TI  - Estrogen augments serotonergic activity in postmenopausal women.
AB  - To investigate the influence of estrogen replacement on serotonergic activity in
      postmenopausal women, the serotonin agonist meta-chlorophenylpiperazine (m-CPP)
      (0.5 mg/kg) was given orally to 18 normal postmenopausal women, 11 of whom were
      also tested following 30 days' treatment with estrogen transdermal patches
      (estraderm 0.1 mg). Fifteen normal, healthy women of reproductive status served
      as a control group. Cortisol and prolactin responses to m-CPP were measured.
      Without estrogen, the prolactin and cortisol responses of postmenopausal women to
      m-CPP were blunted compared to those of reproductive women. Estrogen replacement
      increased the hormonal responses. It is suggested that decreased serotonergic
      activity in postmenopausal women might contribute to their vulnerability to
      affective disorders. Estrogen replacement therapy might decrease this
      vulnerability and might add to the efficacy of serotonergic antidepressants when
      warranted.

PMID- 7786958
TI  - Diurnal neuroendocrine and autonomic function in acute and remitted depressed
      male patients.
AB  - This study evaluated diurnal data gathered hourly (1000 to 1800 hours) in males
      during acute depression and during remission of depression and in age
      range/gender-matched normal controls. Mean, peak, variability, and time-course of
      the noradrenergic metabolite, plasma 3-methoxy, 4-hydroxyphenylglycol [MHPG]),
      plasma cortisol, and autonomic (mean arterial blood pressure [MAP] and heart
      rate) variables were examined. Compared to controls, acutely depressed, but not
      remitted depressed, patients had 1) an earlier plasma MHPG peak, 2) a greater
      intragroup variability of plasma MHPG, 3) a higher plasma cortisol concentration,
      4) a lower MAP, and 5) tended to increase MAP more slowly than did the normal
      controls. The time course of diurnal heart rate also differed in acutely
      depressed patients from controls: acutely depressed patients started higher and
      converged by midday to normal levels. These diurnal data lend limited support to
      the dysregulation hypotheses of depression that suggest normal circadian
      rhythmicities are altered or disrupted in acute depression and that peripheral
      manifestations of central dysregulation normalize in remission of depression.

PMID- 7786959
TI  - The relationship between tiredness prior to sleep deprivation and the
      antidepressant response to sleep deprivation in depression.
AB  - Recently it was hypothesized that the antidepressant response to total sleep
      deprivation (SD) results from a disinhibition process induced by the increase of
      tiredness in the course of SD. In the present study, the role of tiredness in the
      antidepressant response to SD is further investigated. Seventy-two depressed
      patients scored subjective tiredness and depressed mood three times daily (in the
      morning, afternoon, and evening) on the days preceding and following SD. It was
      found that averaged tiredness on the day prior to SD was related to the SD
      response, when the severity of depression prior to SD had been held statistically
      constant. Also, when both severity of depression and diurnal variation of mood
      prior to SD were partialed out, tiredness showed a positive correlation with the
      SD response: patients who reported a relatively low degree of tiredness on the
      day preceding SD improved by SD. This result suggests that tiredness has an
      influence on SD effects, and that this influence is independent from that of the
      severity of depression. The findings are in accordance with current ideas on the
      role of tiredness as a mediating factor in the induction of the therapeutic
      effects of SD.

PMID- 7786960
TI  - A placebo-controlled trial of L-365,260, a CCKB antagonist, in panic disorder.
AB  - The functional role of cholecystokinin in the central nervous system is unknown.
      The tetra peptide CCK-4 was previously observed to induce panic attacks in a
      majority of normal volunteers and patients with panic disorder. Furthermore, it
      had been demonstrated that pretreatment with 10-50 mg of L-365,260, a selective
      CCKB antagonist, blocked CCK-4 induced panic in patients with panic disorder.
      Therefore, the present multicenter, placebo-controlled, double-blind trial was
      designed to investigate the efficacy of L-365,260, a CCKB antagonist, in patients
      with panic disorder with or without agoraphobia. Following a 1-week, single-blind
      placebo period, 88 patients were randomized to double-blind treatment in which
      they received either L-365,260, 30 mg qid, or placebo for 6 weeks. At the dose
      tested, there were no clinically significant differences between L-365,260 and
      placebo in global improvement ratings, Hamilton anxiety rating scale scores,
      panic attack frequency, panic attack intensity, or disability measures. The
      possible reasons for lack of effect with L-365,260 are discussed.

PMID- 7786961
TI  - Sensory cortical processing and the biological basis of personality.
AB  - Action-oriented personality traits such as sensation seeking, extraversion, and
      impulsivity have been related to a pronounced amplitude increase of auditory
      evoked scalp potentials with increasing stimulus intensity. Dipole source
      analysis represents a crucial methodological progress in this context, because
      overlapping subcomponents of the scalp potentials can be separated and can be
      related to their generating cortical structures. In a study on 40 healthy
      subjects, it was found that sensation seeking is clearly related to the auditory
      evoked response pattern (N1/P2-component, stimulus intensities: 60, 70, 80, 90,
      100 dB SPL) of the superior temporal plane including primary auditory cortex, but
      not to that of secondary auditory areas in the lateral temporal cortex. These
      results support the concept that the serotonergic brain system, which is supposed
      to modulate sensory processing in primary auditory cortices, is an important
      factor underlying individual differences in sensation seeking.

PMID- 7786962
TI  - Anxiolytic effects of chlordiazepoxide blocked by injection of GABAA and
      benzodiazepine receptor antagonists in the region of the anterior basolateral
      amygdala of rats.
AB  - The amygdala is a structure that is often implicated in the regulation of anxiety
      responses. Many studies have shown that injection of benzodiazepines into the
      amygdala produces an anxiolytic effect. The present study was undertaken to
      determine whether the anxiolytic effect of administration of systemic
      benzodiazepine (chlordiazepoxide) might be blocked by local injection of a
      benzodiazepine receptor antagonist (flumazenil) or GABAA receptor antagonist
      (bicuculline methiodide; BMI) into the region of the anterior basolateral
      amygdala (BLA) of rats using an ethologically based test of anxiety, the social
      interaction test. Injection of flumazenil or BMI into the BLA of rats was found
      to reverse the anxiolytic effects of peripherally administered chlordiazepoxide.
      These results suggest a major role for the BLA in mediating the anxiolytic
      effects of benzodiazepines.

PMID- 7786963
TI  - Bipolar affective disorder associated with beta-thalassemia minor.
AB  - A family suggesting cosegregation of beta-thalassemia minor and bipolar affective
      disorder was reported. The monogenic hereditary anemia was surveyed over three
      generations in this family, and three patients with the beta-thalassemia and the
      bipolar affective disorder were observed over two generations. The localization
      of a gene responsible for bipolar affective disorder was discussed on the basis
      of previous reports.

PMID- 7786964
TI  - CSF isatin is elevated in bulimia nervosa.

PMID- 7786965
TI  - No association of a tyrosine hydroxylase gene tetranucleotide repeat polymorphism
      in autism, Tourette syndrome, or ADHD.

PMID- 7786966
TI  - Parallel development of dopamine metabolism tolerance in the rat prefrontal
      cortex, caudate-putamen, and amygdala following haloperidol decanoate
      administration.

PMID- 7786967
TI  - Lateralized attentional abnormality in schizophrenia is correlated with severity
      of symptoms.

PMID- 7786968
TI  - The Office of Research Integrity Biannual Report 1991-1992.

PMID- 7786970
TI  - [Clinical usefulness of questionnaires in primary care].

PMID- 7786972
TI  - [Characteristics of AIDS cases detected at a prison in Barcelona (1991-1993)].
AB  - OBJECTIVE: To describe the cases of AIDS detected in a Barcelona prison. DESIGN:
      A prospective study. SETTING: A penitentiary for men in Barcelona. PATIENTS: All
      those inmates who had AIDS or were diagnosed with the illness during their stay
      in prison during the 36 months between 1/1/1991 and 31/12/93. RESULTS: 220 cases
      of AIDS (91.7% PVDA), 60% of which were diagnosed in prison. The PVDA were
      younger (p < 0.0001). There were a greater number of Spaniards among the UDVP (p
      < 0.01) and among those with tattoos (p < 0.001). The first manifestation of the
      disease in 53% of the cases was extrapulmonary Tuberculosis. CONCLUSIONS: Prisons
      are key places in the prevention and monitoring of HIV infection. The use of care
      programmes, including maintenance programmes using Methadone, for drug-dependent
      patients are recommended. The continuation of programmes tracking Tuberculosis,
      the main illness related to HIV infection in prison, is also recommended.

PMID- 7786969
TI  - Society of Biological Psychiatry 50th annual convention. Miami, Florida, May 17
      21, 1995. Abstracts.

PMID- 7786973
TI  - [Is it possible to improve psychiatric care through the referral process?].
AB  - OBJECTIVE: To evaluate the quality of referral from Primary Care to Mental Health
      and its relationship to the illness referred. DESIGN: A descriptive retrospective
      study over 4 years on the quality of the process. SETTING: Mental Health Centre
      II in the Autonomous Community of Murcia. PATIENTS: 209 patients referred by
      three Primary Care teams. MEASUREMENTS AND MAIN RESULTS: 91.4% of patients (C.I.
      95%: 100%, 81.1%) were accepted with a referral report. 97.9% (C.I. 95%: 100%,
      87.8%) presented a reason for psychiatric consultation. The report included the
      clinical history of the illness in 58.1% of cases (C.I. 95%: 70.3%, 45.9%); a
      diagnostic opinion was given in 79.6% (C.I. 95%: 91.1%, 68%); and 37.2% (C.I.
      95%: 49.3%, 25%) were referred with a request for a specific consultation. 68.4%
      of the referrals (C.I. 95%: 81.8%, 54.9%) coincided with the Mental Health
      diagnosis. It was observed that among the most commonly referred pathologies:
      anxiety disorders (31.6%), affective (28.8%), personality (7.7%), psychotic
      (5.3%), and adaptive disorders (5.3%); diagnoses were commonly made for affective
      or anxiety disorders (p < 0.0001); the specific cause of referral of anxiety
      disorders was recorded (p < 0.01); and in cases of psychotic and personality
      disorders, the diagnoses did not coincide (p < 0.001). CONCLUSIONS: Referral to
      Mental Health can be improved, fundamentally by sending a report which includes
      the clinical history and the reason for referral. It is common to express a
      diagnostic opinion on affective and anxiety disorders, to note a specific reason
      for referral in the case of anxiety disorders and not to specify personality and
      psychotic disorders.

PMID- 7786971
TI  - [Family medicine tutors: attitudes and activities of tutoring].
AB  - OBJECTIVE: To discover the attitude of tutors to tutoring and describe how they
      apply the teaching programme during the period interns spend at the Health
      Centre. DESIGN: Crossover study. Stratified random sampling by Teaching Units.
      SETTING: Primary Care Centres with teaching accreditation. PARTICIPANTS: 258
      tutors from the state-wide Teaching Programme. MEASUREMENTS AND MAIN RESULTS:
      Tutors' attitudes and the activities undertaken with the interns were studied by
      means of a self-filled questionnaire. The attitudes scale revealed a good
      attitude toward tutoring. Above all ability to motivate (73%) was required of the
      good tutor. Shared quotas was the commonest model of tutoring (85%). Clinical
      care was the activity the tutors developed best (70%), with the doctor-patient
      relationship in second place (46%). The majority discussed the Clinical History
      with their intern (75%). Few supervised the carrying out of procedures (36%). 68%
      of interns performed at least one piece of research, although tutors thought they
      should do more investigative work (41%). During the three intern years, the
      relationship was hardly ever maintained (13%). CONCLUSIONS: Tutors' attitude to
      tutoring is adequate. There is agreement with the basic features of the
      Programme, which is best developed in the area of care. The general model is that
      of a shared quota. Teaching must be improved in the non-care aspects, with
      specific training being made available to tutors.

PMID- 7786974
TI  - [Relaxation therapy in patients with anxiety and somatoform disorders in primary
      care].
AB  - OBJECTIVE: To study the effect of relaxation therapy on the symptomology of
      patients with anxiety and somatoform disorders. DESIGN: An experimental
      prospective study, controlled through random assignation, using evaluation
      scales. SETTING: Mn. Jaume Soler Health Centre, Cornella (Barcelona). PATIENTS:
      31 patients (8 men and 23 women), diagnosed with anxiety or previously untreated
      somatoform disorders, for whom combined anti-depressive and relaxation therapy
      over a 5-month period was established. The results were compared with those of a
      control group (n = 17) with identical diagnoses, which only received
      antidepressive medication. MEASUREMENTS AND MAIN RESULTS: The STAI tests and two
      pain scales were administered at 0, 15, 30, 45, 60 and 150 days and the HRS and
      SCL-90-R at 0 and 150 days. The possible impact of the psychiatric diagnosis,
      age, gender, married status, existence of concomitant physical illness, SRE,
      present employment status and the presence of children or not were all
      considered. The results pointed to a significant improvement over the period in
      the analogue-visual scale of pain (p = .009) and in the HRS (p = .046) for the
      group comprised of those complying with the relaxation therapy independently of
      the psychiatric diagnosis. CONCLUSIONS: The benefit of relaxation in anxious and
      somatoform patients, when pain--and not anxiety--is the principal symptom, was
      confirmed. Depression improved when antidepressants were administered
      simultaneously, whereas anxiety varied little, at least during the time the trial
      lasted.

PMID- 7786975
TI  - [Evaluation of the surveillance system of chlorination of public water supply in
      the province of Albacete].
AB  - OBJECTIVE: The aim was to study the reliability of the available data, stemming
      from the concordance between two different observers' measurement of the level of
      free residual chlorine. DESIGN: An observational, crossover study, using
      measurements of the level of free residual chlorine repeated on the same day by
      two different observers. SETTING: Health Area of Albacete. PATIENTS AND OTHER
      PARTICIPANTS: 176 double measurements of chlorine, carried out during the study
      period in 69 networks distributing different waters. MEASUREMENTS AND MAIN
      RESULTS: Concordance between observers on the absence or presence of chlorination
      was low (I.Kappa = 0.261), showing a bias in favour of the presence of
      chlorination in the measurements made by local technicians (McNemar p < 0.01).
      Applying a logistic regression model, it was observed that the risk of
      disagreement was as much as 8.5 times greater when chlorine measurement required
      the local technician to travel. CONCLUSIONS: We concluded that the data available
      was of questionable value and that it would be useful to put forward some new
      proposals to improve the supervision of the network.

PMID- 7786977
TI  - [Something more about adverse reactions to medications].
AB  - OBJECTIVE: To describe adverse drug effects (ADE) and their frequency in primary
      care patients. DESIGN: Descriptive and longitudinal study during 1 year (1990).
      SETTING: Urban Health Center. Primary Care. Madrid (Spain). PATIENTS AND OTHER
      PARTICIPANTS: 15,483 persons, nine general practitioner and one pharmacist.
      INTERVENTIONS: Doctors were invited to register any adverse drug effects they had
      notice in their patients. Doctors registered information and gave notice to the
      pharmacist about medicines, dosage and period of administration, clinical
      manifestations, and improving or not if drug was withdrawal. MEASUREMENTS AND
      MAIN RESULTS: 326 adverse drugs effects were notified, 30.9 ADE per thousand
      attended patients. 117 principles actives were involved, and 415 clinical
      manifestations were registered. The more affected patients were women (2/1). The
      age groups with higher ADE relative frequencies were children under one year and
      older people. CONCLUSIONS: The absolute frequency of medicines involved in ADE
      are different to relative frequencies when ADE per thousand prescription units
      are used. Some of the ADE notified were not referred before in the bibliography,
      so primary care is a good place to research on pharmacosurveillance.

PMID- 7786976
TI  - [Tuberculous infection in the province of Las Palmas (1990-1993)].
AB  - OBJECTIVE: The objective of this study was the study of the parameters of
      tubercular infection (prevalence and RAI) arising from tuberculin surveys of the
      school-age population. DESIGN: A descriptive study of a crossover type, looking
      at each school year. SETTING: The surveys were carried out among the entire
      school population (n = 10,711) of all the public and private schools in Las
      Palmas. PARTICIPANTS: The population under study was a representative sample of
      first-year EGB students (age 6-7) of the 1990-91 (n = 1,951), 1991-92 (n = 2,505)
      and 1992-93 (n = 2,208) school intakes. There was a "no authorisations" index of
      35%, 25% and 33.2%, respectively. The sample selection was made each year, in a
      random manner per conglomerates, after previous stratification by geographical
      areas. The sample unit was those schools with over 45 pupils per class,
      distributed throughout the province of Las Palmas. The confidence level for
      overall data was 95.5% and the margin of error +/- 2. INTERVENTIONS: The
      tuberculin tests were performed by specifically contracted and trained doctors
      and DUE (nurses) at Health Centres, belonging to Primary Care and town councils.
      The technique used for the tuberculin survey was the intradermal injection of 0.1
      ml of PPD which contained 2 units of PPD-RT 23 with Tween-80, with a reading at
      72 hours, when a reaction of 5 mm or over was considered positive. To calculate
      RAI the formula proposed by Styblo was used. RESULTS: The prevalence of
      tubercular infection in the province of Las Palmas was 0.71% (0.52-0.90) in 1990
      and 1.18% (0.75-1.61) in 1993. RAI was 0.11% in 1990 and 0.18% in 1993.
      CONCLUSIONS: It was almost impossible to make any comparisons with other similar
      studies because of the lack of homogeneous criteria. Both the prevalence and the
      risk of tubercular infection in Las Palmas between 1990 and 1993 show an upward
      tendency.

PMID- 7786978
TI  - [Physical exercise and disease (and II)].

PMID- 7786979
TI  - [Management of atrial fibrillation].

PMID- 7786980
TI  - [Arterial hypertension program: new evaluation strategies].

PMID- 7786981
TI  - [Referrals from primary care to rheumatology].

PMID- 7786983
TI  - Modelling progression of CD4-lymphocyte count and its relationship to survival
      time.
AB  - The purpose of this article is to model the progression of CD4-lymphocyte count
      and the relationship between different features of this progression and survival
      time. The complicating factors in this analysis are that the CD4-lymphocyte count
      is observed only at certain fixed times and with a high degree of measurement
      error, and that the length of the vector of observations is determined, in part,
      by the length of survival. If probability of death depends on the true,
      unobserved CD4-lymphocyte count, then the survival process must be modelled. Wu
      and Carroll (1988, Biometrics 44, 175-188) proposed a random effects model for
      two-sample longitudinal data in the presence of informative censoring, in which
      the individual effects included only slopes and intercepts. We propose methods
      for fitting a broad class of models of this type, in which both the repeated CD4
      lymphocyte counts and the survival time are modelled using random effects. These
      methods permit us to estimate parameters describing the progression of CD4
      lymphocyte count as well as the effect of differences in the CD4 trajectory on
      survival. We apply these methods to results of AIDS clinical trials.

PMID- 7786982
TI  - [Suitability of routine screening of tuberculosis at 15 months of age].

PMID- 7786984
TI  - A nonparametric analysis of the transmission rate of human immunodeficiency virus
      from mother to infant.
AB  - Infants born to mothers who are infected with the human immunodeficiency virus
      (HIV) may or may not become infected by perinatal transmission. Unfortunately,
      passively transferred maternal antibodies make it hard to determine the infant's
      infection status from HIV antibody testing, because shortly after birth it is not
      possible to distinguish passively transferred maternal antibodies from antibodies
      produced by an infected infant. Usually, the infection status is unobservable for
      each infant, unless the infant reaches the age of 15 months or develops an HIV
      related disease such as the acquired immunodeficiency syndrome (AIDS).
      Traditionally, statistical analyses of the perinatal transmission rate of HIV are
      based on infants who had been born at least 15 months before the date of
      analysis. Such analyses can be both inefficient and biased. In this note, we
      define a mixture model underlying the onset time of AIDS and then obtain the
      nonparametric maximum likelihood estimators of the HIV transmission rate and of
      the distribution function of AIDS onset time for infected infants. Nonparametric
      tests are also derived for detecting differences in HIV transmission rates among
      different groups of infants. Finally, the methods are applied to the Mothers and
      Infants Cohort Study in New York City. The transmission rate of HIV from infected
      mothers to their infants was estimated to be 30.0% with 95% confidence interval
      (22.3%, 39.1%).

PMID- 7786986
TI  - Exact permutational tests for group sequential clinical trials.
AB  - An efficient numerical algorithm is developed for computing stopping boundaries
      for group sequential clinical trials. Patients arrive in sequence, and are
      randomized to one of two treatments. The data are monitored at interim time
      points, with a fresh block of patients entering the study from one monitoring
      point to the next. The stopping boundaries are derived from the exact joint
      permutational distribution of the linear rank statistics observed across all the
      monitoring times. Specifically, the algorithm yields the exact boundary
      generating function, Pr(W1 < b1, W2 < b2, ..., Wi-1 < bi-1, Wi = wi), where Wj is
      the linear rank statistic at the jth interim time point. The distribution theory
      is based on assigning ranks after pooling all the patients who have entered the
      study, and then permuting the patients to the two treatments independently within
      each block of newly arrived patients. The methods are applicable for an arbitrary
      number of monitoring times, which need not be specified at the start of the
      study. The data may be continuous or categorical, and censored or uncensored. The
      randomization rule for treatment allocation can be adaptive. The algorithm is
      especially useful during the early stages of a clinical trial, when very little
      data have been gathered, and stopping boundaries are based on the extreme tails
      of the relevant boundary generating function. In that case the corresponding
      large-sample theory is not very reliable. To illustrate the techniques we present
      a group sequential analysis of a recently completed study by the Eastern
      Cooperative Oncology Group.

PMID- 7786985
TI  - Evaluation of experiments with adaptive interim analyses.
AB  - A general method for statistical testing in experiments with an adaptive interim
      analysis is proposed. The method is based on the observed error probabilities
      from the disjoint subsamples before and after the interim analysis. Formally, an
      intersection of individual null hypotheses is tested by combining the two p
      values into a global test statistic. Stopping rules for Fisher's product
      criterion in terms of critical limits for the p-value in the first subsample are
      introduced, including early stopping in the case of missing effects. The control
      of qualitative treatment-stage interactions is considered. A generalization to
      three stages is outlined. The loss of power when using the product criterion
      instead of the optimal classical test on the whole sample is calculated for the
      test of the mean of a normal distribution, depending on increasing proportions of
      the first subsample in relation to the total sample size. An upper bound on the
      loss of power due to early stopping is derived. A general example is presented
      and rules for assessing the sample size in the second stage of the trial are
      given. The problems of interpretation and precautions to be taken for
      applications are discussed. Finally, the sources of bias for estimation in such
      designs are described.

PMID- 7786987
TI  - The use of logistic models for the analysis of codon frequencies of DNA sequences
      in terms of explanatory variables.
AB  - The development of the regressive logistic model applicable to the analysis of
      codon frequencies of DNA sequences in terms of explanatory variables is
      presented. A codon is a triplet of nucleotides that code for an amino acid, and
      may be considered as a trivariate response (B1, B2, B3), where Bi (i = 1, 2, 3)
      is a categorical random variable with values A, C, G, T. The linear order of
      bases in the DNA and possible statistical dependence of the bases in a given
      codon make the regressive logistic model a suitable tool for the analysis of
      codon frequencies. A problem of structural zeros arises from the fact that the
      stopping codons (terminators) do not code for amino acids; this is solved by
      normalizing the likelihood function. Codon frequencies may also depend on the
      function of the gene and they are known to differ between genes of the same
      genome. Differences also occur between synonymous codons for the same amino acid.
      Thus, the use of covariates that differ between synonymous codons as well as
      covariates that are constant within codons of the same amino acid may be useful
      in explaining the frequencies. As an illustration, the method is applied to the
      human mitochondrial genome using the following as explanatory variables: (1)
      TSCORE, a measure of the number of single base mutations required for a given
      codon to become a terminator; (2) AARISK, an indicator of a codon's ability of
      changing by a single base substitution to triplets coding for amino acids with
      very different characteristics; (3) AVDIST, a measure of the typicality of the
      amino acid coded for by the triplets. The results indicate that models that
      incorporate dependency structure and covariates are to be preferred to either the
      models comprising covariates alone or dependency structure alone.

PMID- 7786988
TI  - Robust variance estimation for the case-cohort design.
AB  - Large cohort studies of rare outcomes require extensive data collection, often
      for many relatively uninformative subjects. Sampling schemes have been proposed
      that oversample certain groups. For example, the case-cohort design of Prentice
      (1986, Biometrika 73, 1-11) provides an efficient method of analysis of failure
      time data. However, the variance estimate must explicitly correct for correlated
      score contributions. A simple robust variance estimator is proposed that allows
      for more complicated sampling mechanisms. The variance estimate uses a jackknife
      estimate of the variance of the individual influence function and is shown to be
      equivalent to a robust variance estimator proposed by Lin and Wei (1989, Journal
      of the American Statistical Association 84, 1074-1078) for the standard Cox
      model. Simulation results indicate excellent agreement with corrected asymptotic
      estimates and appropriate test size. The technique is illustrated with data
      evaluating the efficacy of mammography screening in reducing breast cancer
      mortality.

PMID- 7786989
TI  - Segregation analysis of case-control data using generalized estimating equations.
AB  - Generalized estimating equations (GEEs) (Liang and Zeger, 1986, Biometrika 73, 13
      22) are used to fit genetic models to binary disease data for families of
      subjects in case-control studies. The GEEs include model specification of both
      the disease probabilities and the two-way (and possibly three-way) correlation
      coefficients of the family disease data. These quantities are modelled as
      nonlinear functions of unobserved genotypes, observed environmental covariates,
      and the unknown parameters; the functions reflect the method used to ascertain
      the family data. Goodness of fit is tested by allowing more flexible forms for
      the correlation coefficients, regressing them against covariates specific to the
      relevant pair (or triple) of family members. The approach is applied to family
      data obtained from simulated and real case-control studies. This semiparametric
      approach is less dependent on unverifiable assumptions and more computationally
      tractable than other methods for segregation analysis.

PMID- 7786991
TI  - Causal nonresponse models for repeated categorical measurements.
AB  - This paper uses causal models for nonresponse (Fay, 1986, Journal of the American
      Statistical Association 81, 354-365) to extend the conditional likelihood
      procedure for repeated categorical outcome variables to allow for nonrandomly
      missing data. The extension based on causal models is similar to the log-linear
      approach presented by Conaway (1992, Journal of the American Statistical
      Association, 87, 817-824), but has the advantage that the parameters are directly
      interpretable in terms of the distribution of the outcome variables. As with log
      linear model approach, all of the computations can be done with standard
      statistical software. The methods are first described in terms of a simple
      example with three binary responses with no covariates and then are applied to a
      more complicated example. A simulation study evaluates the properties of the
      estimates based on the proposed method.

PMID- 7786990
TI  - Operating characteristics of a rank correlation test for publication bias.
AB  - An adjusted rank correlation test is proposed as a technique for identifying
      publication bias in a meta-analysis, and its operating characteristics are
      evaluated via simulations. The test statistic is a direct statistical analogue of
      the popular "funnel-graph." The number of component studies in the meta-analysis,
      the nature of the selection mechanism, the range of variances of the effect size
      estimates, and the true underlying effect size are all observed to be influential
      in determining the power of the test. The test is fairly powerful for large meta
      analyses with 75 component studies, but has only moderate power for meta-analyses
      with 25 component studies. However, in many of the configurations in which there
      is low power, there is also relatively little bias in the summary effect size
      estimate. Nonetheless, the test must be interpreted with caution in small meta
      analyses. In particular, bias cannot be ruled out if the test is not significant.
      The proposed technique has potential utility as an exploratory tool for meta
      analysts, as a formal procedure to complement the funnel-graph.

PMID- 7786992
TI  - Influence diagnostics for generalized linear measurement error models.
AB  - We study influence diagnostics for generalized linear models when the true
      covariates are unobservable but measured with error. Based on the bias-corrected
      estimation of model parameters, diagnostic measures are developed to identify
      outlying and influential observations. The magnitude of influence is then
      assessed via a simulated envelope approach. The proposed diagnostic procedure is
      illustrated on two examples.

PMID- 7786993
TI  - Pooled population parameter from mark-recapture data.
AB  - The reduced capture history (RCH), compiled from complete capture histories of
      uniquely marked animals, for a given pooling interval contains the same
      information as would be obtained from experiments where (i) a single sample lasts
      the duration of the pooling interval; (ii) an identical batch mark is applied to
      animals captured in a series of samples carried out during the pooling interval.
      For stationary populations, biases are calculated for the RCH estimates for all
      parameters in the Jolly-Seber (J-S) model. The results are verified using
      simulation. The biases are functions of the survival and capture probabilities
      and the degree of pooling; they are less than 5% for the total population, birth
      and survival rates, and probability of capture during the pooling interval if the
      mortality and capture probabilities do not exceed about 50% per pooling interval.
      The marked population, marked fraction, and probability of recapture cannot
      estimated directly by the RCH method but can be obtained iteratively from the
      bias formulae. The biases in other parameters can be reduced by the same
      procedure. Alternative estimates are derived that are not detectably biased, for
      any estimate, for mortality and capture probability up to about 60% per pooling
      period. The new estimates have higher sample variances than the RCH estimates,
      but for large populations with high mortalities and capture probabilities the
      difference is small.

PMID- 7786994
TI  - On inconsistency of Breslow's estimator as an estimator of the hazard rate in the
      Cox model.
AB  - In the Cox proportional hazards model, Breslow's estimator of the cumulative
      hazard function is well known. This estimator is sometimes presented in such a
      way that it appears to offer a method of estimating the hazard rate function as
      well. We state and prove an asymptotic result for this estimator of the hazard
      rate, which shows that the estimator is inconsistent, and that it is
      asymptotically unbiased.

PMID- 7786995
TI  - Guidelines for monitoring efficacy and toxicity responses in clinical trials.
AB  - There is currently a need for clinical trial methodology that allows formal
      consideration of toxicity responses. Since a complete evaluation of an
      experimental therapy addresses both relative efficacy and relative toxicity,
      general methods for handling bivariate response data are of interest. A procedure
      for sequentially analysing both efficacy and toxicity data is presented. The
      procedure is designed to allow early termination due to efficacy results,
      toxicity results, or both. The method is based on modified marginal sequential
      analyses, accounting for bivariate correlated responses and multiple analyses
      over time. The theory is presented in the context of normally distributed
      responses. Extensions to bivariate failure time data are indicated and an example
      from a kidney transplant study demonstrates the procedure.

PMID- 7786996
TI  - On a truncation-flexible repeated significance test.
AB  - A repeated significance test for the mean of a normal distribution with
      guaranteed Type I error rate not depending on the truncation point is presented.
      The type of design has the advantage that it may be applied to define a
      sequential test based on accumulating data, applicable to a wide range of
      variables of which the fixed-sample-size test would have been based on the
      standard normal, without the requirement that the covariance structure of the
      sequence by computed explicitly. The test is shown to be especially convenient
      for certain types of ongoing survival studies, and for the problem of testing for
      differences in means or proportions, and appears to have operating
      characteristics similar to those of standard repeated significance tests with
      corresponding truncation points.

PMID- 7786997
TI  - On the likelihood ratio test statistic for the number of components in a normal
      mixture of unequal variances.
AB  - An important but difficult problem in practice is to determine the number of
      components in a normal mixture model with unequal variances. When the likelihood
      ratio test statistic--21og lambda is used, it is unbounded above and fails to
      satisfy standard regularity conditions. A restricted maximization procedure must
      therefore be used, which makes the procedure ad hoc. A consequence of this may
      explain the discrepancies among the simulation results of previous
      investigations.

PMID- 7786998
TI  - A note on the bias of estimators with missing data.
AB  - It is well known that many standard analyses, including maximum likelihood
      estimation and the generalized estimating equation approach (Liang and Zeger,
      1986, Biometrika 73, 13-22) can result in biased estimation when there are
      missing observations. In such cases it is of interest to calculate the magnitude
      of the bias incurred under specific assumptions about the process generating the
      full data and the nonresponse mechanism. In this paper we give a condition that
      identifies the limit in probability of estimators that are solutions of
      estimating equations computed from the incomplete data. With discrete data, this
      condition suggests a simple algorithm to compute the asymptotic bias of these
      estimators that can be easily implemented with existing statistical software. We
      illustrate our approach with asthma prevalence data in children.

PMID- 7786999
TI  - Variance components testing in the longitudinal mixed effects model.
AB  - This article discusses the asymptotic behavior of likelihood ratio tests for
      nonzero variance components in the longitudinal mixed effects linear model
      described by Laird and Ware (1982, Biometrics 38, 963-974). Our discussion of the
      large-sample behavior of likelihood ratio tests for nonzero variance components
      is based on the results for nonstandard testing situations by Self and Liang
      (1987, Journal of the American Statistical Association 82, 605-610).

PMID- 7787000
TI  - Heterogeneity models of disease susceptibility, with application to diabetic
      nephropathy.
AB  - It is not, in general, possible to include all relevant risk factors in a model
      of survival or disease incidence. This heterogeneity must be accounted for in the
      interpretation, as it can imply otherwise unexpected results. This is illustrated
      by diabetic nephropathy, a serious complication experienced by some diabetic
      patients. A mathematical model with varying susceptibility can explain that the
      incidence increases until 20 years duration of diabetes and later decreases. The
      hospital-based data cover patients diagnosed during 1933-1972. They are interval
      censored, because early detection of nephropathy requires chemical analysis of
      urine samples. The data are consistent with a model where less than half of the
      patients are susceptible, and for each of these the hazard is increasing. The
      estimated degree of heterogeneity markedly depends on the assumed model. The
      dependence on age at onset and calendar time of onset is examined. The highest
      risk is seen at onset age 13-17 years, and the risk decreases with calendar time.
      The effect of covariates on the hazard is markedly different for the various
      models, but this is partly a matter of parametrization, as the disagreement is
      reduced by a reparametrization inspired by accelerated failure time models.

PMID- 7787002
TI  - Statistical analysis of food webs.
AB  - The numbers of species in different trophic levels of a food web are modeled as a
      trinomial random vector, with cell probabilities potentially depending on the
      total number of species in the web. A maximum likelihood method is developed to
      test the hypothesis that the fractions of species in different levels are
      independent of the total number of species. The method is applied to a data set
      whose properties have been debated in the literature, and it is shown to be a
      powerful alternative to the simple linear regression approach used in previous
      analyses.

PMID- 7787001
TI  - Testing for segregation distortion in the HLA complex.
AB  - One of the long-standing issues in HLA research is whether there is segregation
      distortion in the HLA complex in human populations. In this paper we study some
      simple statistical models aimed at detecting segregation distortion. We present a
      statistic to test the Mendelian null hypothesis of equal transmission
      probabilities. To assess the possible contribution of multiple alleles to
      segregation distortion, we employ a specific log-linear model for transmission
      probabilities equivalent to the Bradley-Terry model in the literature of paired
      comparisons. We also provide a simple method for detecting a single allele
      effect, if present.

PMID- 7787003
TI  - Regression analysis of censored and truncated data: estimating reporting-delay
      distributions and AIDS incidence from surveillance data.
AB  - AIDS surveillance provides a vital source of information for health departments
      to assess the AIDS epidemic and to plan for future health-care needs. However,
      the use of surveillance data requires proper adjustments for the underreporting
      of AIDS cases caused by the delay in reporting diagnosed AIDS cases to the
      surveillance system. The statistical problem of adjusting for this underreporting
      concerns making inferences about an unobservable random sample of which only a
      portion is observed in a chronologic time interval defined by the analysis. Most
      regression methods for making inferences using right-truncated data employ a
      reverse-time hazard function, which requires that the observed data be
      transformed so that methods for left-truncated data can be applied. In this
      paper, we discuss fitting regression models to data that can be truncated and
      even censored in arbitrary intervals. The proposed methodology was applied to the
      national AIDS surveillance data provided by the Centers for Disease Control to
      analyze the trend of delays over chronologic time and variation among different
      geographic regions as well as across risk groups.

PMID- 7787004
TI  - A cautionary note on applying scores in stratified data.
AB  - When rank tests are used to analyze stratified data, three methods for assigning
      scores to the observations have been proposed: (S) independently within each
      stratum (see Lehmann, 1975, Nonparametrics: Statistical Methods Based on Ranks;
      San Francisco: Holden-Day); (A) after aligning the observations within each
      stratum and then pooling the aligned observations (Hodges and Lehmann, 1962,
      Annals of Mathematical Statistics 33, 482-497); and (P) after pooling the
      observations across all strata (that is, without alignment) (Mantel, 1963,
      Journal of the American Statistical Association 58, 690-700; Mantel and Ciminera,
      1979, Cancer Research 39, 4308-4315). Test statistics are formed for each method
      by combining the stratum-specific linear rank tests using the assigned scores. We
      show that method P is sensitive to the score function used in the case of two
      moderately sized strata. In general, we recommend methods S and A for use with
      moderate to large-sized strata.

PMID- 7787005
TI  - The world of biometry.
AB  - The International Biometric Society is an international society for the
      advancement of biological science through the development of quantitative
      theories and the application, development and dissemination of effective
      mathematical and statistical techniques. We consider some of the nonscientific
      and scientific issues being addressed by researchers in and across Regions and
      Groups of our Biometric world. These run the gamut of theoretical to applied
      mathematics and statistics with the applications spanning many fields and, not
      surprisingly, forming a rich source of new theoretical developments.

PMID- 7787006
TI  - A random-effects ordinal regression model for multilevel analysis.
AB  - A random-effects ordinal regression model is proposed for analysis of clustered
      or longitudinal ordinal response data. This model is developed for both the
      probit and logistic response functions. The threshold concept is used, in which
      it is assumed that the observed ordered category is determined by the value of a
      latent unobservable continuous response that follows a linear regression model
      incorporating random effects. A maximum marginal likelihood (MML) solution is
      described using Gauss-Hermite quadrature to numerically integrate over the
      distribution of random effects. An analysis of a dataset where students are
      clustered or nested within classrooms is used to illustrate features of random
      effects analysis of clustered ordinal data, while an analysis of a longitudinal
      dataset where psychiatric patients are repeatedly rated as to their severity is
      used to illustrate features of the random-effects approach for longitudinal
      ordinal data.

PMID- 7787008
TI  - A parametric model for cluster correlated categorical data.
AB  - A fully parametric copula model for symmetric dependent clustered categorical
      data is discussed. The model accommodates any marginal regression models of
      interest and admits a broad range of within-cluster association. The form of the
      distribution is independent of cluster size and may be used to model data with
      varying cluster sizes. The model contains an association parameter that is
      estimated from the data to give a measure of strength of the within-cluster
      association and also a test of independence. Two examples are given to illustrate
      methods.

PMID- 7787007
TI  - An application of maximum likelihood and generalized estimating equations to the
      analysis of ordinal data from a longitudinal study with cases missing at random.
AB  - Data are analysed from a longitudinal psychiatric study in which there are no
      dropouts that do not occur completely at random. A marginal proportional odds
      model is fitted that relates the response (severity of side effects) to various
      covariates. Two methods of estimation are used: generalized estimating equations
      (GEE) and maximum likelihood (ML). Both the complete set of data and the data
      from only those subjects completing the study are analysed. For the completers
      only data, the GEE and ML analyses produce very similar results. These results
      differ considerably from those obtained from the analyses of the full data set.
      There are also marked differences between the results obtained from the GEE and
      ML analysis of the full data set. The occurrence of such differences is
      consistent with the presence of a non-completely-random dropout process and it
      can be concluded in this example that both the analyses of the completers only
      and the GEE analysis of the full data set produce misleading conclusions about
      the relationships between the response and covariates.

PMID- 7787009
TI  - Exact analysis for paired binary data.
AB  - This paper provides an efficient algorithm to generate exact distributions for
      the bivariate logistic model with common and sub-unit-specific covariates. The
      algorithm can be used to analyze correlated paired binary response data from
      studies lacking a large sample size. Possible applications include a clinical
      trial with two distinct binary outcomes, a binary outcome cross-over or two-time
      point cohort study, and a pair-matched prospective study with binary outcome.
      Analysis of data from an ophthalmologic study is provided to illustrate the
      method. Extension to three or more correlated binary responses is also outlined.

PMID- 7787010
TI  - Multivariate survival analysis using piecewise gamma frailty.
AB  - In this note we propose a frailty model called piecewise gamma frailty for
      correlated survival data with random effects having a nested structure. In
      frailty models, a dependence function defined as a hazard ratio of one member
      given the failure time of another member in a unit is determined by the
      distributional assumptions on frailty. In the piecewise gamma frailty model, the
      nested structure of random effects or frailty allows the dependence function to
      vary over the time periods. This model includes existing models such as the
      piecewise exponential model (Breslow, 1974, Biometrics 30, 89-100) and the gamma
      frailty model (Clayton, 1978, Biometrika 65, 141-151; Oakes, 1982, Journal of the
      Royal Statistical Society, Series B 44, 414-428) as special cases. A study of
      familial aggregation of epilepsy is used to illustrate the proposed method.

PMID- 7787011
TI  - Iterative generalized least squares for meta-analysis of survival data at
      multiple times.
AB  - A method is presented for joint analysis of survival proportions reported at
      multiple times in published studies to be combined in a meta-analysis.
      Generalized least squares is used to fit linear models including between-trial
      and within-trial covariates, using current fitted values iteratively to derive
      correlations between times within studies. Multi-arm studies and nonrandomized
      historical controls can be included with no special handling. The method is
      illustrated with data from two previously published meta-analyses. In one, an
      early treatment difference is detected that was not apparent in the original
      analysis.

PMID- 7787012
TI  - Intracellular calcium levels correlate with speed and persistent forward motion
      in migrating neutrophils.
AB  - The relationship between cytosolic free calcium concentration ([Ca2+]i) and human
      neutrophil motility was studied by video microscopy. Neutrophils stimulated by a
      uniform concentration of an N-formylated peptide chemoattractant (f-Met-Leu-Phe)
      were tracked during chemokinetic migration on albumin, fibronectin, and
      vitronectin. [Ca2+]i buffering with quin2 resulted in significant decreases in
      mean speed on albumin. To further characterize the relationship between [Ca2+]i
      changes and motility we carried out a cross-correlation analysis of [Ca2+]i with
      several motility parameters. Cross-correlations between [Ca2+]i and each cell's
      speed, angle changes, turn strength, and persistent forward motion revealed (i) a
      positive correlation between [Ca2+]i and cell speed (p < 0.05), (ii) no
      significant correlation between turns and calcium spikes, and (iii) the
      occurrence of turns during periods of low speed. Significant negative
      correlations between [Ca2+]i and angle change were noted on the high adhesion
      substrates vitronectin and fibronectin but not on the low adhesion substrate
      albumin. These data imply that there is a general temporal relationship between
      [Ca2+]i, speed, and persistent motion. However, the correlations are not
      sufficiently strong to imply that changes in [Ca2+]i are required proximal
      signals for velocity changes.

PMID- 7787013
TI  - Cell fission and formation of mini cell bodies by high frequency alternating
      electric field.
AB  - We report the use of high frequency alternating electric fields (AC) to induce
      deformation of sea urchin eggs, leading to budding of membrane vesicles or
      fission of cells. Several mini cell bodies can be prepared from a single egg by
      carefully manipulating the frequency and amplitude of the AC field and the ratio
      between the interelectrode spacing and the cell diameter, alpha. alpha values
      between 2.2 and 3.5 have been found to be optimal for inducing fission of sea
      urchin eggs. In a typical experiment, a sea urchin egg (diameter = 75 microns),
      suspended in a low ionic medium (conductance < 2 mS/m), was located under the
      microscope between two platinum wire electrodes, separated by a distance of
      approximately 200 microns. A medium strength AC field (< 100 V/cm at 2 MHz) was
      applied to attract the egg to one of the two electrodes via dielectrophoresis.
      This process took place in a few seconds. The voltage was then slowly increased
      to approximately 1000 V/cm over approximately 30 s. The cell elongated and
      separated into two fragments, the larger one containing the nucleus. When the
      field was turned off, the mother cell and the daughter vesicle retracted to form
      spherical mini cell bodies that appear to be stable as assessed by the absence of
      swelling for the duration of the experiment (approximately 15 min). This
      indicates that membranes of these mini cell bodies were not leaky to ions and
      small molecules. This procedure could be repeated a few times to make several
      mini cell bodies from a single egg. With practice, several minicell bodies could
      also be prepared in a single fission experiment by adjusting the field parameters
      and the a value. Cell fission is a result of the mechanical stress produced by
      the AC field. These procedures may be used to prepare mini membrane vesicles for
      voltage clamp experiments or to perform microsurgical manipulation of cells,
      embryos, or chromosomes.

PMID- 7787014
TI  - Approximating the effects of diffusion on reversible reactions at the cell
      surface: ligand-receptor kinetics.
AB  - We consider the problem of determining the time dependence of the bound ligand
      concentration for the reversible binding of a diffusing monovalent ligand to
      receptors uniformly distributed over the surface of a spherical cell. We start by
      formulating a boundary value problem that captures the essential physics of this
      situation. We then introduce a systematic approximation scheme based on the
      method of weighted residuals. By this means we convert the initial boundary value
      problem into a simpler problem that requires solving only a small number of
      ordinary differential equations. We show how, at the lowest order of
      approximation, the method can be used to obtain modified chemical rate equations
      where, in place of fundamental rate constants, effective rate coefficients
      appear. These rate coefficients are functions of the ligand diffusion
      coefficient, the cell radius, the receptor density and other variables. We
      compare exact and approximate solutions and discuss under what conditions the
      approximate equations can be used. We also apply the method of weighted residuals
      to obtain approximate descriptions of the binding kinetics when (1) there are two
      different cell surface receptor populations that bind the ligand and (2) the cell
      secretes a ligand that can bind back to receptors on the cell (autocrine
      binding).

PMID- 7787015
TI  - Dynamic and elastic properties of F-actin: a normal-modes analysis.
AB  - We examine the dynamic, elastic, and mechanical consequences of the proposed
      atomic models of F-actin, using a normal mode analysis. This initial analysis is
      done in vacuo and assumes that all monomers are rigid and equivalent. Our
      computation proceeds from the atomic level and, relying on a single fitting
      parameter, reproduces various experimental results, including persistence
      lengths, elastic moduli, and contact energies. The computations reveal modes of
      motion characteristic to all polymers, such as longitudinal pressure waves,
      torsional waves, and bending, as well as motions unique to F-actin. Motions
      typical to actin include a "groove-swinging" motion of the two long-pitch
      helices, as well as an axial slipping motion of the two strands. We prepare
      snapshots of thermally activated filaments and quantify the accumulation of
      azimuthal angular "disorder," variations in cross-over lengths, and various other
      fluctuations. We find that the orientation of a small number of select residues
      has a surprisingly large effect on the filament flexibility and elasticity
      characteristics.

PMID- 7787016
TI  - An easy-to-use model for O2 supply to red muscle. Validity of assumptions,
      sensitivity to errors in data.
AB  - An easy-to-use capillary cylinder model of O2 supply to muscle is presented that
      considers all those factors that are known to be most important for realistic
      results: (1) red blood cell (RBC) O2 unloading along the capillary, (2) effects
      of the particulate nature of blood, (3) free and hemoglobin-facilitated O2
      diffusion and reaction kinetics inside RBCs, (4) free and myoglobin-facilitated
      O2 diffusion inside the muscle cell, and (5) carrier-free region separating RBC
      and tissue. In a first approach, a highly simplified yet reasonably accurate
      treatment of the complex three-dimensional oxygen diffusion field in and next to
      capillaries is employed. As an alternative, a more realistic description using
      RBC/capillary diffusing capacity has been included. Model development proceeds
      step by step and is designed to be easily comprehensible for a broad readership.
      In spite of the number of features accounted for, the model is simple to apply,
      even for scientists not specialized in the field of modeling. PO2 distributions
      calculated by the model are in good qualitative agreement with experimental data
      and with former modelling results. By means of suitable extensions to the model
      that are also developed it is shown for a wide range of muscle performances that
      quite generally the following complication may be neglected safely: (1)
      complexity of O2 diffusion field near capillaries, (2) deviations of capillary
      domain cross sections from the circular shape, (3) O2 diffusion parallel to the
      capillary direction, and (4) PO2 dependence of O2 consumption rate. Finally, a
      sensitivity analysis is performed in which propagation of errors in the input
      data into the results is investigated. The interpretation of the calculated
      sensitivities gives insights in the specific dependencies of muscular O2 supply
      on the various input parameters. Moreover, basic interrelations governing carrier
      facilitated diffusional O2 transport to muscle become apparent and are discussed.

PMID- 7787017
TI  - Molecular dynamics study of the 13-cis form (bR548) of bacteriorhodopsin and its
      photocycle.
AB  - The structure and the photocycle of bacteriorhodopsin (bR) containing 13-cis,15
      syn retinal, so-called bR548, has been studied by means of molecular dynamics
      simulations performed on the complete protein. The simulated structure of bR548
      was obtained through isomerization of in situ retinal around both its C13-C14 and
      its C15-N bond starting from the simulated structure of bR568 described
      previously, containing all-trans,15-anti retinal. After a 50-ps equilibration,
      the resulting structure of bR548 was examined by replacing retinal by analogues
      with modified beta-ionone rings and comparing with respective observations. The
      photocycle of bR548 was simulated by inducing a rapid 13-cis,15-anti-->all
      trans,15-syn isomerization through a 1-ps application of a potential that
      destabilizes the 13-cis isomer. The simulation resulted in structures consistent
      with the J, K, and L intermediates observed in the photocycle of bR548. The
      results offer an explanation of why an unprotonated retinal Schiff base
      intermediate, i.e., an M state, is not formed in the bR548 photocycle. The Schiff
      base nitrogen after photoisomerization of bR548 points to the intracellular
      rather than to the extracellular site. The simulations suggest also that leakage
      from the bR548 to the bR568 cycle arises due to an initial 13-cis,15-anti-->all
      trans,15-anti photoisomerization.

PMID- 7787020
TI  - Confinement as a determinant of macromolecular structure and reactivity. II.
      Effects of weakly attractive interactions between confined macrosolutes and
      confining structures.
AB  - The effect of weak, nonspecific interaction between molecules confined within
      restricted elements of volume ("pores") and the boundary surfaces of the pore,
      upon the reactivity and physical state of the confined molecules, is explored by
      means of simple models. A confined molecule is represented by a rectangular
      parallelopiped having one of six orientations aligned with the cartesian
      coordinate axes, and the confining volume element is represented by a pair of
      parallel surfaces (planar pore), a tube of square cross section (square pore), or
      a cubical box (cubical pore). Weak interactions are modeled by square-well
      potentials having a defined range and well depth. Partition coefficients for
      distribution of molecules between the bulk and confined phase are calculated
      using an extension of the statistical-thermodynamic theory of Giddings et al.
      (1968). It is calculated that surface attraction with a potential of only a few
      kcal/mol monomer may result in large increases in the extent of self- or
      heteroassociation of confined molecules (as much as several orders of magnitude
      in favorable cases) linked to adsorption of the oligomeric species onto boundary
      surfaces. Calculations are also presented suggesting that surface attraction can
      lead to deformation of the native structure of adsorbed macromolecules. It is
      suggested that these findings are relevant to an understanding of the structure
      of eukaryotic cytoplasm.

PMID- 7787018
TI  - Distal residue-CO interaction in carbonmonoxy myoglobins: a molecular dynamics
      study of three distal mutants.
AB  - Six 90-ps molecular dynamics trajectories, two for each of three distal mutants
      of sperm whale carbonmonoxy myoglobin, are reported; solvent waters within 16 A
      of the active site have been included. In both His64GIn trajectories, the distal
      side chain remains part of the heme pocket, forming a "closed" conformation
      similar to that of the wild type 64N delta H tautomer. Despite a connectivity
      more closely resembling the N epsilon H histidine tautomer, close interactions
      with the carbonyl ligand similar to those observed for the wild type 64N epsilon
      H tautomer are prevented in this mutant by repulsive interactions between the
      carbonyl O and the 64O epsilon. The aliphatic distal side chain of the His64Leu
      mutant shows little interaction with the carbonyl ligand in either His64Leu
      trajectory. Solvent water molecules move into and out of the active site in the
      His64Gly mutant trajectories; during all the other carbonmonoxy myoglobin
      trajectories, including the wild type distal tautomers considered in an earlier
      work, solvent molecules rarely encroach closer than 6 A of the active site. These
      results are consistent with a recent structural interpretation of the wild type
      infrared spectrum, and the current reinterpretation that the distal-ligand
      interaction in carbonmonoxy myoglobin is largely electrostatic, not steric, in
      nature.

PMID- 7787019
TI  - Seven-helix bundles: molecular modeling via restrained molecular dynamics.
AB  - Simulated annealing via restrained molecular dynamics (SA/MD) has been used to
      model compact bundles of seven approximately (anti)parallel alpha-helices. Seven
      such helix bundles occur, e.g., in bacteriorhodopsin, in rhodopsin, and in the
      channel-forming N-terminal domain of Bacillus thuringiensis delta-endotoxin. Two
      classes of model are considered: (a) those consisting of seven Ala20 peptide
      chains; and (b) those containing a single polypeptide chain, made up of seven
      Ala20 helices linked by GlyN interhelix loops (where N = 5 or 10). Three
      different starting C alpha templates for SA/MD are used, in which the seven
      helices are arranged (a) on a left-handed circular template, (b) on a
      bacteriorhodopsin-like template, or (c) on a zig-zag template. The ensembles of
      models generated by SA/MD are analyzed in terms of their geometry and energetics,
      and the most stable structures from each ensemble are examined in greater detail.
      Structures resembling bacteriorhodopsin and structures resembling delta-endotoxin
      are both represented among the most stable structures. delta-Endotoxin-like
      structures arise from both circular and bacteriorhodopsin-like C alpha templates.
      A third helix-packing mode occurs several times among the stable structures,
      regardless of the C alpha template and of the presence or absence of interhelix
      loops. It is characterized by a "4 + 1" core, in which four helices form a
      distorted left-handed supercoil around a central, buried helix. The remaining two
      helices pack onto the outside of the core. This packing mode is comparable with
      that proposed for rhodopsin on the basis of two-dimensional electron
      crystallographic and sequence analysis studies.

PMID- 7787021
TI  - Kinetic analysis of barium currents in chick cochlear hair cells.
AB  - Inward barium current (IBa) through voltage-gated calcium channels was recorded
      from chick cochlear hair cells using the whole-cell clamp technique. IBa was
      sensitive to dihydropyridines and insensitive to the peptide toxins omega
      agatoxin IVa, omega-conotoxin GVIa, and omega-conotoxin MVIIC. Changing the
      holding potential over a -40 to -80 mV range had no effect on the time course or
      magnitude of IBa nor did it reveal any inactivating inward currents. The
      activation of IBa was modeled with Hodgkin-Huxley m2 kinetics. The time constant
      of activation, tau m, was 550 microseconds at -30 mV and gradually decreased to
      100 microseconds at +50 mV. A Boltzmann fit to the activation curve, m infinity,
      yielded a half activation voltage of -15 mV and a steepness factor of 7.8 mV.
      Opening and closing rate constants, alpha m and beta m, were calculated from tau
      m and m infinity, then fit with modified exponential functions. The H-H model
      derived by evaluating the exponential functions for alpha m and beta m not only
      provided an excellent fit to the time course of IBa activation, but was
      predictive of the time course and magnitude of the IBa tail current. No
      differences in kinetics or voltage dependence of activation of IBa were found
      between tall and short hair cells. We conclude that both tall and short hair
      cells of the chick cochlea predominantly, if not exclusively, express
      noninactivating L-type calcium channels. These channels are therefore responsible
      for processes requiring voltage-dependent calcium entry through the basolateral
      cell membrane, such as transmitter release and activation of Ca(2+)-dependent K+
      channels.

PMID- 7787022
TI  - Trimethyloxonium modification of batrachotoxin-activated Na channels alters
      functionally important protein residues.
AB  - The extracellular side of single batrachotoxin-activated voltage-dependent Na
      channels isolated from rat skeletal muscle membranes incorporated into neutral
      planar lipid bilayers were treated in situ with the carboxyl methylating reagent,
      trimethyloxonium (TMO). These experiments were designed to determine whether TMO
      alters Na channel function by a general through-space electrostatic mechanism or
      by methylating specific carboxyl groups essential to channel function. TMO
      modification reduced single-channel conductance by decreasing the maximal
      turnover rate. Modification increased channel selectivity for sodium ions
      relative to potassium ions as measured under biionic conditions. TMO modification
      increased the mu-conotoxin (muCTX) off-rate by three orders of magnitude.
      Modification did not alter the muCTX on-rate at low ionic strength or Na channel
      voltage-dependent gating characteristics. These data demonstrate that TMO does
      not act via a general electrostatic mechanism. Instead, TMO targets protein
      residues specifically involved in ion conduction, ion selectivity, and muCTX
      binding. These data support the hypothesis that muCTX blocks open-channel current
      by physically obstructing the ion channel pore.

PMID- 7787023
TI  - Characterization of complexes formed in fully hydrated dispersions of dipalmitoyl
      derivatives of phosphatidylcholine and diacylglycerol.
AB  - The phase diagram of fully hydrated binary mixtures of
      dipalmitoylphosphatidylcholine (DPPC) with 1,2-dipalmitoylglycerol (DPG)
      published recently by Lopez-Garcia et al. identifies regions where stoichiometric
      complexes of 1:1 and 1:2 DPPC:DPG, respectively, are formed. In this study, the
      structural parameters of the 1:1 complex in the presence of pure DPPC was
      characterized by synchrotron low angle and static x-ray diffraction methods.
      Structural changes upon transitions through phase boundaries were correlated with
      enthalpy changes observed by differential scanning calorimetry in mixtures of
      DPPC with 5, 7.5, 10, and 20 mol% DPG dispersed in excess water. Phase separation
      of a complex in gel phase could be detected by calorimetry in the mixture
      containing 5 mol% DPG but was not detectable by synchrotron low angle x-ray
      diffraction. Static x-ray measurements show evidence of phase separation,
      particularly in the reflections indexing chain packing. In the mixture containing
      7.5 mol% DPG, two distinct lamellar repeat spacings could be seen in the
      temperature range from 25 to 34 degrees C. The lamellar spacing of about 6.6 nm
      was assigned to pure gel phase DPPC because the change in the spacing corresponds
      with thermal transition of the pure phospholipid, and a longer repeat spacing of
      about 7.2 nm was assigned to domains of the 1:1 complex of DPPC-DPG. In the
      temperature range from 34 to 420C, i.e., in the region of coexistence of the
      ripple phase of DPPC and the gel phase of the complex, a single, rather broad
      lamellar reflection appears because of superposition of two reflections of DPPC
      and the complex; the lamellar spacing of DPPC in the ripple phase is similar to
      that of the gel phase of complex. In the coexistence region of the liquid
      crystalline phase of DPPC and the gel phase of complex (-42-480C), the lamellar
      reflections of the both phases are present. The fluidus boundary lies between the
      coexistence region and the fluid region.In the fluid region (-48-550C), the gel
      state of complex persists up to the fluidus boundary, whereupon the liquid
      crystalline state of complex replaces the gel state of the complex. This
      indicates that the complex is also immiscible with DPPC even above the fluidus
      boundary at least in the temperature range close to the phase boundary. For
      mixtures comprising 10 and 20 mol%DPG in DPPC, complex formation is clearly
      detectable in both the gel region and the coexistence region by x-ray
      diffraction.Synchrotron x-ray measurements indicate phase separation between pure
      DPPC and liquid-crystalline complex just above thefluidus boundary. Static, wide
      angle x-ray measurements also suggest phase separations of the 1:1 complex not
      only from the gel phase but also the liquid-crystalline phase of pure DPPC. Two
      distinct diffraction peaks were detected for the mixture of DPPC with 5, 10, and
      20 mol% DPG. One is due to the chain spacing of the complex, and the other is due
      to that of the pure DPPC. In the coexistence region of the liquid-crystalline
      phase of DPPC and the gel phase of complex, two kinds of diffraction peaks of the
      hydrocarbon chain of the gel phase complex and the broad scattering profile for
      the chain melting of DPPC were observed in the wide angle region. Electron
      density reconstructed from the lamellar reflections indicates that the
      thicknesses of both the bilayer and the water layer of the gel phase complex are
      greater than those of the respective thicknesses of gel phase DPPC.

PMID- 7787024
TI  - Molecular organization and motions of crystalline monoacylglycerols and
      diacylglycerols: a C-13 MASNMR study.
AB  - Six saturated acylglycerols (1-myristoyl-sn-glycerol, 1-palmitoyl-sn-glycerol,
      1,2-dimyristoyl-sn-glycerol, 1,2-dipalmitoyl-sn-glycerol, 1,2-dipalmitoyl-rac
      glycerol, and 1,3-dimyristoylglycerol) were studied in their various polymorphic
      forms (sub-alpha, alpha, beta') by natural abundance C-13 nuclear magnetic
      resonance (NMR) with magic angle spinning (MASNMR). C-13 MASNMR does not require
      single crystals and can observe relatively disordered crystals, distinct
      advantages over crystallographic diffraction methods. Well resolved spectra were
      obtained for each acylglycerol, and the chemical shifts of corresponding carbons
      were different for each crystalline phase and the isotropic liquid phase;
      moreover, in the case of monoacylglycerols, the symmetrically nonequivalent
      molecules in the same crystalline structure gave distinct C-13 resonances for the
      same carbon. The C-13 chemical shifts corresponding to each polymorphic phase
      were interpreted in terms of differences in intramolecular bond distances,
      intermolecular interactions (such as H bonding), and molecular motions.
      Mobilities of the glycerol backbone and acyl chains were assessed by the C-13
      linewidths and the C-H dipolar relaxation rates. The chemical shift
      anisotropy(ies) (delta sigma) of the carbonyl group(s) of each acylglycerol was
      determined from slow-spinning MAS spectra, and was discussed in terms of the
      conformational and/or motional changes for the carbonyl carbon(s).

PMID- 7787027
TI  - Three-dimensional structure of lipid vesicles embedded in vitreous ice and
      investigated by automated electron tomography.
AB  - Automated electron tomography is shown to be a suitable means to visualize the
      shape of phospholipid vesicles embedded in vitrified ice. With a slow-scan charge
      coupled device camera as a recording device, the cumulative electron dose needed
      to record a data set of 60 projections at a magnification of 20,000X can be kept
      as low as 15 e-/A2 (or 1500 electrons/nm2). The membrane of the three
      dimensionally reconstructed vesicles is clearly visible in two-dimensional
      sections through the three-dimensionally reconstructed volume. Some edges
      indicating a polygonal shape of the vesicles, frozen from the gel phase, are also
      clearly recognized. Because of the presently limited tilt angle range (+/- 60
      degrees), the upper and lower "caps" of the vesicles (representing about 35% of
      the surface of the ellipsoidal particles) remain invisible in the three
      dimensional reconstruction.

PMID- 7787026
TI  - Voltage sensitivity of the fluorescent probe RH421 in a model membrane system.
AB  - The voltage sensitivity of the fluorescent styrylpyridinium dye RH421 has been
      investigated in dimyristoylphosphatidylcholine vesicles by inducing an
      intramembrane electric field through the binding of the hydrophobic ion
      tetraphenylborate (TPB). To assess the probability of electrochromic and
      solvatochromic mechanisms for the dye response, the ground-state dipole moment of
      the dye in chloroform solution was determined from dielectric constant
      measurements to be 12 (+/- 1) Debye, and the change in dipole moment upon
      excitation was calculated from measurements of the Stokes shift in solvents of
      varying polarity to be 25 (+/- 11) Debye. As well as causing absorbance and
      fluorescence changes of membrane-bound dye, the TPB-induced electrical field was
      found to reduce significantly the pKa of the dye. The pH at which experiments are
      carried out is, thus, an important factor in determining the amplitude of the
      voltage-induced absorbance and fluorescence changes. The observed absorbance
      changes induced by the field are inconsistent with a pure electrochromic
      mechanism. A reorientation/solvatochromic mechanism, whereby the electrical field
      reorients the dye molecules so that they experience a change in polarity of their
      lipid environment is likely to make a significant contribution to both the
      spectral changes and to the field effect on the acid-base properties of the dye.

PMID- 7787025
TI  - Macro-ripple phase formation in bilayers composed of galactosylceramide and
      phosphatidylcholine.
AB  - As determined by freeze fracture electron microscopy, increasing levels of bovine
      brain galactosylceramide (GalCer) altered the surface structure of 1-palmitoyl-2
      oleoyl-phosphatidylcholine (POPC) bilayers by inducing a striking "macro-ripple"
      phase in the larger, multilamellar lipid vesicles at GalCer mole fractions
      between 0.4 and 0.8. The term "macro-ripple" phase was used to distinguish it
      from the P beta' ripple phase observed in saturated, symmetric-chain length
      phosphatidylcholines. Whereas the P beta' ripple phase displays two types of
      corrugations, one with a wavelength of 12-15 nm and the other with a wavelength
      of 25-35 nm, the macro-ripple phase occurring in GalCer/POPC dispersions was of
      one type with a wavelength of 100-110 nm. Also, in contrast to the extended
      linear arrays of adjacent ripples observed in the P beta' ripple phase, the macro
      ripple phase of GalCer/POPC dispersions was interrupted frequently by packing
      defects resulting from double dislocations and various disclinations and, thus,
      appeared to be continuously twisting and turning. Control experiments verified
      that the macro-ripple phase was not an artifact of incomplete lipid mixing or
      demixing during preparation. Three different methods of lipid mixing were
      compared: a spray method of rapid solvent evaporation, a sublimation method of
      solvent removal, and solvent removal using a rotary evaporation apparatus.
      Control experiments also revealed that the macro-ripple phase was observed
      regardless of whether lipid specimens were prepared by either ultra-rapid or
      manual plunge freezing methods as well as either in the presence or absence of
      the cryo-protectant glycerol. The macro-ripple phase was always observed in
      mixtures that were fully annealed by incubation above the main thermal transition
      of both POPC and bovine brain GalCer before rapid freezing. If the GalCer mixed
      with POPC contained only nonhydroxy acyl chains or only 2-hydroxy acyl chains,
      then the occurrence of macro-ripple phase decreased dramatically.

PMID- 7787028
TI  - Temperature- and pressure-dependent phase behavior of monoacylglycerides
      monoolein and monoelaidin.
AB  - We used x-ray and neutron diffraction to study the temperature- and pressure
      dependent structure and phase behavior of the monoacylglycerides 1-monoelaidin
      (ME) and 1-monoolein (MO) in excess water. The monoacylglycerides were chosen for
      investigation of their phase behavior because they exhibit mesomorphic phases
      with one-, two-, and three-dimensional periodicity, such as lamellar, an inverted
      hexagonal and bicontinuous cubic phases, in a rather easily accessible
      temperature and pressure range. We studied the structure, stability, and
      transformations of the different phases over a wide temperature and pressure
      range, explored the epitaxial relations that exist between different phases, and
      established a relationship between the chemical structure of the lipid molecules
      and their phase behavior. For both systems, a temperature-pressure phase diagram
      has been determined in the temperature range from 0 to 100 degrees C at pressures
      from ambient up to 1400 bar, and drastic differences in phase behavior are found
      for the two systems. In MO-water dispersions, the cubic phase Pn3m extends over a
      large phase field in the T,p-plane. At temperatures above 95 degrees C, the
      inverted hexagonal phase is found. In the lower temperature region, a crystalline
      lamellar phase is induced at higher pressures. The phases found in ME-water
      include the lamellar crystalline Lc phase, the L beta gel phase, the L alpha
      liquid-crystalline phase, and two cubic phases belonging to the crystallographic
      space groups Im3m and Pn3m. In addition, the existence of metastable phases has
      been exploited. Between coexisting metastable cubic structures, a metric
      relationship has been found that is predicted theoretically on the basis of the
      curvature elastic energy approximation only.

PMID- 7787029
TI  - Myosin binding-induced cooperative activation of the thin filament in cardiac
      myocytes and skeletal muscle fibers.
AB  - Myosin binding-induced activation of the thin filament was examined in isolated
      cardiac myocytes and single slow and fast skeletal muscle fibers. The number of
      cross-bridge attachments was increased by stepwise lowering of the [MgATP] in the
      Ca(2+)-free solution bathing the preparations. The extent of thin filament
      activation was determined by monitoring steadystate isometric tension at each
      MgATP concentration. As pMgATP (where pMgATP is -log [MgATP]) was increased from
      3.0 to 8.0, isometric tension increased to a peak value in the pMgATP range of
      5.0-5.4. The steepness of the tension-pMgATP relationship, between the region of
      the curve where tension was zero and the peak tension, is hypothesized to be due
      to myosin-induced cooperative activation of the thin filament. Results showed
      that the steepness of the tension-pMgATP relationship was markedly greater in
      cardiac as compared with either slow or fast skeletal muscle fibers. The steeper
      slope in cardiac myocytes provides evidence of greater myosin binding-induced
      cooperative activation of the thin filament in cardiac as compared with skeletal
      muscle, at least under these experimental conditions of nominal free Ca2+.
      Cooperative activation is also evident in the tension-pCa relation, and is
      dependent upon thin filament molecular interactions, which require the presence
      of troponin C. Thus, it was determined whether myosin-based cooperative
      activation of the thin filament also requires troponin C. Partial extraction of
      troponin C reduced the steepness of the tension-pMgATP relationship, with the
      effect being significantly greater in cardiac than in skeletal muscle. After
      partial extraction of troponin C, muscle type differences in the steepness of the
      tension-pMgATP relationship were no longer apparent, and reconstitution with
      purified troponin C restored the muscle lineage differences. These results
      suggest that, in the absence of Ca2+, myosin-mediated activation of the thin
      filament is greater in cardiac than in skeletal muscle, and this apparent
      cooperativity requires the presence of troponin C on thin filament regulatory
      strands.

PMID- 7787030
TI  - Effects of a non-divalent cation binding mutant of myosin regulatory light chain
      on tension generation in skinned skeletal muscle fibers.
AB  - Each myosin molecule contains two heavy chains and a total of four low-molecular
      weight light chain subunits, two "essential" and two "regulatory" light chains
      (RLCs). Although the roles of myosin light chains in vertebrate striated muscle
      are poorly understood at present, recent studies on the RLC have suggested that
      it has a modulatory role with respect to Ca2+ sensitivity of tension and the rate
      of tension development, effects that may be mediated by Ca2+ binding to the RLC.
      To examine possible roles of the RLC Ca2+/Mg2+ binding site in tension
      development by skeletal muscle, we replaced endogenous RLC in rabbit skinned
      psoas fibers with an avian mutant RLC (D47A) having much reduced affinity for
      divalent cations. After replacement of up to 80% of the endogenous RLC with D47A
      RLC, maximum tension (at pCa 4.5) was significantly reduced compared with
      preexchange tension, and the amount of decrease was directly related to the
      extent of D47A exchange. Fiber stiffness changed in proportion to tension,
      indicating that the decrease in tension was due to a decrease in the number of
      tension-generating cross-bridges. Decreases in both tension and stiffness were
      substantially, although incompletely, reversed after reexchange of native RLC for
      D47A. RLC exchange was also performed using a wild-type RLC. Although a small
      decrease in tension was observed after wild-type RLC exchange, the decrease was
      not proportional to the extent of RLC exchange and was not reversed by reexchange
      of the native RLC. D47A exchange also decreased the Ca2+ sensitivity of tension
      and reduced the apparent cooperativity of tension development. The results
      suggest that divalent cation binding to myosin RLC plays an important role in
      tension generation in skeletal muscle fibers.

PMID- 7787031
TI  - Calibration of indo-1 and resting intracellular [Ca]i in intact rabbit cardiac
      myocytes.
AB  - Fluorescent Ca indicators have been extremely valuable in understanding
      intracellular [Ca] ([Ca]i) regulation in many cell types. The calibration of
      these indicators in the intracellular environment, however, has been a continuous
      challenge. We performed in vivo calibrations of indo-1 in isolated rabbit
      ventricular myocytes loaded with the acetoxymethylester form of indo-1 and used
      the perforated patch variation of whole cell voltage clamp. Voltage, [Na], and
      [K] gradients were eliminated to approach equilibrium. We also took advantage of
      the powerful Na/Ca exchange in cardiac myocytes so that [Ca]i would be
      equilibrated with [Ca]o (because there was no [Na] or voltage gradient). The
      equilibration of [Na] and [Ca] across the membrane was tested by measuring the
      reversal potential of Na current and poking the cell to test for changes in [Ca]i
      dependent fluorescence ratio. The apparent dissociation constant, Kd for indo-1
      in the cellular environment was 844 nM, which is approximately 2-3 times higher
      than that in aqueous solutions. In a separate series of experiments, a null point
      approach was used to determine the [Ca]i in intact cells at rest for very long
      periods (82 +/- 6 nM). This is lower than that measured 15 s after a train of
      steady-state twitches ([Ca]i = 294 +/- 53 nM). These experiments also allowed the
      direct assessment of the shortening versus [Ca]i relationship in intact cells.

PMID- 7787033
TI  - Comparison of rotation models for describing DNA conformations: application to
      static and polymorphic forms.
AB  - A new method, based on a space-fixed rotation axis, or local helix axis, is
      proposed for the calculation of the relative orientation variables for a sequence
      of base pairs. With this method, orientation variables are determined through the
      rotation of a base pair about this axis. These variables uniquely determine a set
      of helical variables, similar to the roll, tilt, and twist, commonly used for a
      description of spatial orientations of internally rigid base pairs. The proposed
      identification of roll and tilt with the direction cosines of the space-fixed
      rotation axis agrees well with their customary definitions as the openings of the
      angles between adjoining base pairs toward the minor groove and toward the
      ascending (5' to 3') backbone strand, respectively. These new variables permit a
      more direct physical comprehension of DNA conformations and also the behavior of
      self-complementary sequences. These direction cosines, together with the rotation
      angle about the space-fixed axis, form a set of three independent orientation
      variables of the bases that afford some advantages over the variously defined
      twist, roll, and tilt angles, either for static or average forms. An example for
      the static form of these variables is shown through their use to interpret
      crystal coordinates. An example for the average of orientation variables is based
      on statistical calculations. In this example, the orientation variables, together
      with the translational variables that describe the relative displacements of a
      pair of adjacent base pairs, form a canonically distributed ensemble in phase
      space spanned by these variables. Two sets of conformational variables are
      generated by using two different methods for performing rotation operations on
      the sequences of base pairs. The first method is based on the new single rotation
      about a space-fixed axis of rotation. This space-fixed axis of rotation is, in
      fact, the local helical axis as constructed previously by others. The second
      method is based on three consecutive rotations by Euler angles. Because of large
      flexibilities and anisotropies along various conformational variables of DNA base
      pairs, the two sets of generated conformational variables, based on these two
      different methods of performing rotation operations, lead to slightly different
      sets of structurally different, but energetically equivalent, spatial
      arrangements of the base pairs.

PMID- 7787032
TI  - Orientational dynamics of indane dione spin-labeled myosin heads in relaxed and
      contracting skeletal muscle fibers.
AB  - We have used electron paramagnetic resonance (EPR) spectroscopy to study the
      orientation and rotational motions of spin-labeled myosin heads during steady
      state relaxation and contraction of skinned rabbit psoas muscle fibers. Using an
      indane-dione spin label, we obtained EPR spectra corresponding specifically to
      probes attached to Cys 707 (SH1) on the catalytic domain of myosin heads. The
      probe is rigidly immobilized, so that it reports the global rotation of the
      myosin head, and the probe's principal axis is aligned almost parallel with the
      fiber axis in rigor, making it directly sensitive to axial rotation of the head.
      Numerical simulations of EPR spectra showed that the labeled heads are highly
      oriented in rigor, but in relaxation they have at least 90 degrees (Gaussian full
      width) of axial disorder, centered at an angle approximately equal to that in
      rigor. Spectra obtained in isometric contraction are fit quite well by assuming
      that 79 +/- 2% of the myosin heads are disordered as in relaxation, whereas the
      remaining 21 +/- 2% have the same orientation as in rigor. Computer-simulated
      spectra confirm that there is no significant population (> 5%) of heads having a
      distinct orientation substantially different (> 10 degrees) from that in rigor,
      and even the large disordered population of heads has a mean orientation that is
      similar to that in rigor. Because this spin label reports axial head rotations
      directly, these results suggest strongly that the catalytic domain of myosin does
      not undergo a transition between two distinct axial orientations during force
      generation. Saturation transfer EPR shows that the rotational disorder is dynamic
      on the microsecond time scale in both relaxation and contraction. These results
      are consistent with models of contraction involving 1) a transition from a
      dynamically disordered preforce state to an ordered (rigorlike) force-generating
      state and/or 2) domain movements within the myosin head that do not change the
      axial orientation of the SH1-containing catalytic domain relative to actin.

PMID- 7787034
TI  - Testing BR photocycle kinetics.
AB  - An improved K absorption spectrum in the visible is obtained from previous
      photocycle data for the D96N mutant of bacteriorhodopsin, and the previously
      obtained M absorption spectrum in the visible and the fraction cycling are
      confirmed at 25 degrees C. Data at lower temperatures are consistent with
      negligible temperature dependence in the spectra from 5 degrees C to 25 degrees
      C. Detailed analysis strongly indicates that there are two intermediates in
      addition to the first intermediate K and the last intermediate M. Assuming two of
      the intermediates have the same spectrum and using the L spectrum obtained
      previously, the best kinetic model with four intermediates that fits the time
      course of the intermediates is rather unusual, with two L's on a cul-de-sac.
      However, a previously proposed, more conventional model with five intermediates,
      including two L's with the same spectra and two M's with the same spectra, also
      fits the time course of the intermediates nearly as well. A new criterion that
      tests an individual proposed spectrum against data is also proposed.

PMID- 7787035
TI  - Deconvolution of C-phycocyanin beta-84 and beta-155 chromophore absorption and
      fluorescence spectra of cyanobacterium Mastigocladus laminosus.
AB  - Absorption and fluorescence spectra of the C-phycocyanin beta-subunit were
      quantitatively deconvoluted into component spectra of the beta-84 and beta-155
      chromophores. The deconvolution procedure was based on a theoretical treatment of
      polarization properties. Four kinds of spectra (absorption, emission, emission
      polarization, and excitation polarization) measured on C-phycocyanin isolated
      from the cyanobacterium Mastigocladus laminosus were used as the experimental
      data set. Without any assumption of spectral shape, the absorption and
      fluorescence spectra of both chromophores were unambiguously resolved and their
      fluorescence quantum yields were evaluated. By combining the spectra of the alpha
      subunit, independently measured, with the resolved spectra of the beta-subunit,
      the fluorescence and fluorescence polarization spectra and the fluorescence
      quantum yield of the monomer were estimated; they agree with experimental values
      to within an acceptable error. Further, the matrix of energy transfer rates in
      the monomer was estimated; it gave a significantly different result (by up to
      40%) from previously estimated ones.

PMID- 7787036
TI  - Rapid pH change due to bacteriorhodopsin measured with a tin-oxide electrode.
AB  - The photocurrent transient generated by bacteriorhodopsin (bR) on a tin-oxide
      electrode is due to pH change and not to charge displacement as previously
      assumed. Films of either randomly oriented or highly oriented purple membranes
      were deposited on transparent electrodes made of tin-oxide-coated glass. The
      membranes contained either wild-type or D96N-mutant bR. When excited with yellow
      light through the glass, the bR pumps protons across the membrane. The result is
      a rapid local pH change as well as a charge displacement. Experiments with these
      films show that it is the pH change rather than the displacement that produces
      the current transient. The calibration for the transient pH measurement is given.
      The sensitivity of a tin-oxide electrode to a transient pH change is very much
      larger than its sensitivity to a steady-state pH change.

PMID- 7787037
TI  - Relationship of proton release at the extracellular surface to deprotonation of
      the schiff base in the bacteriorhodopsin photocycle.
AB  - The surface potential of purple membranes and the release of protons during the
      bacteriorhodopsin photocycle have been studied with the covalently linked pH
      indicator dye, fluorescein. The titration of acidic lipids appears to cause the
      surface potential to be pH-dependent and causes other deviations from ideal
      behavior. If these anomalies are neglected, the appearance of protons can be
      followed by measuring the absorption change of fluorescein bound to various
      residues at the extracellular surface. Contrary to widely held assumption, the
      activation enthalpies of kinetic components, deuterium isotope effects in the
      time constants, and the consequences of the D85E, F208R, and D212N mutations
      demonstrate a lack of direct correlation between proton transfer from the buried
      retinal Schiff base to D85 and proton release at the surface. Depending on
      conditions and residue replacements, the proton release can occur at any time
      between the protonation of D85 and the recovery of the initial state. We conclude
      that once D85 is protonated the proton release at the extracellular protein
      surface is essentially independent of the chromophore reactions that follow. This
      finding is consistent with the recently suggested version of the alternating
      access mechanism of bacteriorhodopsin, in which the change of the accessibility
      of the Schiff base is to and away from D85 rather than to and away from the
      extracellular membrane surface.

PMID- 7787039
TI  - 13C multiplet nuclear magnetic resonance relaxation-derived ring puckering and
      backbone dynamics in proline-containing glycine-based peptides.
AB  - 13CH2-multiplet nuclear magnetic resonance relaxation studies on proline (P)
      containing glycine (G)-based peptides, GP, PG, GPG, PGG, and GPGG, provided
      numerous dipolar auto- and cross-correlation times for various motional model
      analyses of backbone and proline-ring bond rotations. Molecular dynamics
      simulations and bond rotation energy profiles were calculated to assess which
      motions could contribute most to observed relaxation phenomena. Results indicate
      that proline restricts backbone psi 1, psi 2, and phi 2 motions by 50% relative
      to those found for a polyglycine control peptide. psi 1 rotations are more
      restricted in the trans-proline isomer state than in the cis form. A two-state
      jump model best approximates proline ring puckering which in water could occur
      either by the C gamma endo-exo or by the C2 interconversion mechanism. The
      temperature dependence (5 degrees to 75 degrees C) of C beta, and C gamma, and C
      delta angular changes is rather flat, suggesting a near zero enthalpic
      contribution to the ring puckering process. In lower dielectric solvents,
      dimethylsulfoxide and methanol, which may mimic the hydrophobic environment
      within a protein, the endo-exo mechanism is preferred.

PMID- 7787040
TI  - Three-dimensional reconstruction of fibrin clot networks from stereoscopic
      intermediate voltage electron microscope images and analysis of branching.
AB  - Fibrin polymerizes to produce branching fibers forming a three-dimensional
      network, which has been difficult to visualize by conventional microscopy. Three
      dimensional images of whole clots at high resolution were obtained from stereo
      pair intermediate-voltage electron micrographs. Computer software was developed
      to produce three-dimensional reconstructions of the networks in the form of a
      pattern of links that connect branching junctions. Network parameters were
      measured and analyzed to characterize the clots quantitatively. Models in which
      all links were moved to the origin, while preserving their orientation, allowed
      visualization of some network parameters and facilitated comparison of networks.
      Fibrin clots formed in three different conditions were analyzed and compared by
      these methods. Clots formed in 0.20 M saline buffer consist of fibers of uniform
      size, and most of the branching junctions consist of three links. Fibrin clots
      formed in 0.05 M saline buffer are made up of very large diameter fiber bundles
      with far fewer branching junctions and correspondingly longer links. Clots formed
      in 0.40 M saline buffer consist of very fine fibers with numerous branching
      junctions and very short links. In summary, the extent of lateral aggregation is
      directly related to the distance between branching junctions and inversely
      related to the total number of branching junctions. These observations must be
      considered in defining possible mechanisms of fibrin branching.

PMID- 7787038
TI  - Protein sequence randomness and sequence/structure correlations.
AB  - We investigated protein sequence/structure correlation by constructing a space of
      protein sequences, based on methods developed previously for constructing a space
      of protein structures. The space is constructed by using a representation of the
      amino acids as vectors of 10 property factors that encode almost all of their
      physical properties. Each sequence is represented by a distribution of
      overlapping sequence fragments. A distance between any two sequences can be
      calculated. By attaching a weight to each factor, intersequence distances can be
      varied. We optimize the correlation between corresponding distances in the
      sequence and structure spaces. The optimal correlation between the sequence and
      structure spaces is significantly better than that which results from correlating
      randomly generated sequences, having the overall composition of the data base,
      with the structure space. However, sets of randomly generated sequences, each of
      which approximates the composition of the real sequence it replaces, produce
      correlations with the structure space that are as good as that observed for the
      actual protein sequences. A connection is proposed with previous studies of the
      protein folding code. It is shown that the most important property factors for
      the correlation of the sequence and structure spaces are related to helix/bend
      preference, side chain bulk, and beta-structure preference.

PMID- 7787042
TI  - Mesoscopic gel at low agarose concentration in water: a dynamic light scattering
      study.
AB  - Previous work in our laboratory has shown that at very low agarose concentration
      in water gelation still occurs within mutually disconnected, high concentration
      regions generated by spinodal demixing. The freely diffusing particles obtained
      in these conditions are studied in the present work by depolarized dynamic light
      scattering and probe diffusion experiments. These particles are found to behave
      as large (in fact, mesoscopic) polymer fibers entangled in a continuously
      rearranged mesh with scaling parameters typical of partially flexible, neutral
      chains. The present results allow specifying the notion of mesoscopic gelation.
      They also reveal that the same symmetry-breaking mechanism that allows
      macroscopic gelation at polymer concentrations well below the threshold for
      random cross-link percolation generates additional and unexpected phenomena.

PMID- 7787043
TI  - Fluorescence lifetime-based sensing in tissues: a computational study.
AB  - We have numerically solved the photon diffusion equation to predict the
      distribution of light in a tissue model system with a uniform concentration of
      fluorophore. Our results show that time-dependent measurements of light
      propagation can be used to monitor the fluorescent lifetimes of a uniformly
      distributed fluorophore in tissues. With proper referencing, frequency-domain
      measurements of phase-shift, theta, may allow quantitation of fluorescent
      lifetimes, tau, independent of changes in the local absorption and scattering
      properties. These results point to a new approach for noninvasive diagnostic
      monitoring through quantitation of fluorescent lifetime, tau, when the lifetime
      of the fluorophore is comparable with photon migration times.

PMID- 7787041
TI  - Diffusion and partitioning of proteins in charged agarose gels.
AB  - The effects of electrostatic interactions on the diffusion and equilibrium
      partitioning of fluorescein-labeled proteins in charged gels were examined using
      fluorescence recovery after photobleaching and gel chromatography, respectively.
      Measurements were made with BSA, ovalbumin, and lactalbumin in SP-Sepharose (6%
      sulfated agarose), in phosphate buffers at pH 7 and ionic strengths ranging from
      0.01 to 1.0 M. Diffusivities in individual gel beads (D) and in the adjacent bulk
      solution (D infinity) were determined from the spatial Fourier transform of the
      digitized two-dimensional fluorescence recovery images. Equilibrium partition
      coefficients (phi) were measured by recirculating protein solutions through a gel
      chromatography column until equilibrium was reached, and using a mass balance.
      Diffusion in the gel beads was hindered noticeably, with D/D infinity = 0.4-0.5
      in each case. There were no effects of ionic strength on BSA diffusivities, but
      with the smaller proteins (ovalbumin and lactalbumin) D infinity increased
      slightly and D decreased at the lowest ionic strength. In contrast to the modest
      changes in diffusivity, there were marked effects of ionic strength on the
      partition coefficients of these proteins. We conclude that for diffusion of
      globular proteins through gel membranes of like charge, electrostatic effects on
      the effective diffusivity (Deff = phi D) are likely to result primarily from
      variations in phi with only small contributions from the intramembrane
      diffusivity.

PMID- 7787044
TI  - Stark effect spectroscopy of tryptophan.
AB  - The change in permanent dipole moment (magnitude of delta mu) for the transition
      from the 1La state to the ground state of tryptophan is the key photophysical
      parameter for the interpretation of tryptophan fluorescence spectra in terms of
      static and dynamic dielectric properties of the surrounding medium. We report
      measurement of this parameter by means of electric field effect (Stark)
      spectroscopy for N-acetyl-L-tryptophanamide (NATA) in two solvents, the single
      tryptophan containing peptide melittin, and 5-methoxytryptophan. The values
      ranged from 5.9 to 6.2 +/- 0.4 Debye/f for NATA and melittin, where f represents
      the local field correction. The 1Lb magnitude of delta mu was much smaller.
      Application of Stark spectroscopy to these chromophores required decomposition of
      the near-UV absorption into the 1La and 1Lb bands by measurement of the
      fluorescence excitation anisotropy spectrum and represents an extension of the
      method to systems where band overlap would normally preclude quantitative
      analysis of the Stark spectrum. The results obtained for 5-methoxytryptophan
      point out limitations of this method of spectral decomposition. The relevance of
      these results to the interpretation of steady-state and time-resolved
      spectroscopy of tryptophan is discussed.

PMID- 7787045
TI  - Calculation of resonance energy transfer in crowded biological membranes.
AB  - Analytical and numerical models were developed to describe fluorescence resonance
      energy transfer (RET) in crowded biological membranes. It was assumed that
      fluorescent donors were linked to membrane proteins and that acceptors were
      linked to membrane lipids. No restrictions were placed on the location of the
      donor within the protein or the partitioning of acceptors between the two
      leaflets of the bilayer; however, acceptors were excluded from the area occupied
      by proteins. Analytical equations were derived that give the average quantum
      yield of a donor at low protein concentrations. Monte Carlo simulations were used
      to generate protein and lipid distributions that were linked numerically with RET
      equations to determine the average quantum yield and the distribution of donor
      fluorescence lifetimes at high protein concentrations, up to 50% area fraction.
      The Monte Carlo results show such crowding always reduces the quantum yield,
      probably because crowding increases acceptor concentrations near donor-bearing
      proteins; the magnitude of the reduction increases monotonically with protein
      concentration. The Monte Carlo results also show that the distribution of
      fluorescence lifetimes can differ markedly, even for systems possessing the same
      average lifetime. The dependence of energy transfer on acceptor concentration,
      protein radius, donor position within the protein, and the fraction of acceptors
      in each leaflet was also examined. The model and results are directly applicable
      to the analysis of RET data obtained from biological membranes; their application
      should result in a more complete and accurate determination of the structures of
      membrane components.

PMID- 7787046
TI  - Atomic force microscopy of the myosin molecule.
AB  - Atomic force microscopy (AFM) has been used to study the structure of rabbit
      skeletal muscle myosin deposited onto a mica substrate from glycerol solution.
      Images of the myosin molecule have been obtained using contact mode AFM with the
      sample immersed in propanol. The molecules have two heads at one end of a long
      tail and have an appearance similar to those prepared by glycerol deposition
      techniques for electron microscopy, except that the separation of the two heads
      is not so well defined. The average length of the tail (155 +/- 5 nm) agrees well
      with previous studies. Bends in the myosin tail have been observed at locations
      similar to those observed in the electron microscope. By raising the applied
      force, it has been possible locally to separate the two strands of the alpha
      helical coiled-coil tail. We conclude that the glycerol-mica technique is a
      useful tool for the preparation of fibrous proteins for examination by scanning
      probe microscopy.

PMID- 7787048
TI  - A class of parametrically excited calcium oscillation detectors.
AB  - Intracellular Ca2+ oscillations are often a response to external signals such as
      hormones. Changes in the external signal can alter the frequency, amplitude, or
      form of the oscillations suggesting that information is encoded in the pattern of
      Ca2+ oscillations. How might a cell decode this signal? We show that an excitable
      system whose kinetic parameters are modulated by the Ca2+ concentration can
      function as a Ca2+ oscillation detector. Such systems have the following
      properties: (1) They are more sensitive to an oscillatory than to a steady Ca2+
      signal. (2) Their response is largely independent of the signal amplitude. (3)
      They can extract information from a noisy signal. (4) Unlike other frequency
      sensitive detectors, they have a flat frequency response. These properties make a
      Ca(2+)-sensitive excitable system nearly ideal for detecting and decoding Ca2+
      oscillations. We suggest that Ca2+ oscillations, in concert with these detectors,
      can act as cellular timekeepers to coordinate related biochemical reactions and
      enhance their overall efficiency.

PMID- 7787049
TI  - "Surface tensions" in the lung.

PMID- 7787047
TI  - Design and performance of an ultraviolet resonance Raman spectrometer for
      proteins and nucleic acids.
AB  - We describe an ultraviolet resonance Raman (UVRR) spectrometer appropriate for
      structural studies of biological macromolecules and their assemblies. Instrument
      design includes the following features: a continuous wave, intracavity doubled,
      ultraviolet laser source for excitation of the Raman spectrum; a rotating cell
      (or jet source) for presentation of the sample to the laser beam; a Cassegrain
      optic with f/1.0 aperture for collection of the Raman scattering; a quartz prism
      dispersing element for rejection of stray light and Rayleigh scattering; a 0.75-m
      single grating monochromator for dispersion of the Raman scattering; and a liquid
      nitrogen-cooled, charge-coupled device for detection of the Raman photons. The
      performance of this instrument, assessed on the basis of the observed signal-to
      noise ratios, the apparent resolution of closely spaced spectral bands, and the
      wide spectrometer bandpass of 2200 cm-1, is believed superior to previously
      described UVRR spectrometers of similar design. Performance characteristics of
      the instrument are demonstrated in UVRR spectra obtained from standard solvents,
      p-ethylphenol, which serves as a model for the tyrosine side chain, the DNA
      nucleotide deoxyguanosine-5'-monophosphate, and the human tumor necrosis factor
      binding protein, which is considered representative of soluble globular proteins.

PMID- 7787050
TI  - 7th Biophysical Discussions. Molecular motors: structure, mechanics and energy
      transduction. Proceedings of a meeting.

PMID- 7787051
TI  - Distinct molecular processes associated with isometric force generation and rapid
      tension recovery after quick release.
AB  - It was proposed by Huxley and Simmons (Nature 1971, 233:533-538) that force
      generating cross-bridges are attached to actin in several stable positions. In
      this concept, isometric force is generated by the same mechanism as the quick
      tension recovery after an abrupt release of length; i.e., when crossbridges
      proceed from the first postulated stable position to the second and/or subsequent
      positions, resulting in straining of the elastic elements within the cross
      bridges. Therefore, isometric force is generated by cross-bridges in the second
      or even subsequent stable positions. However, through mechanical measurements of
      skinned rabbit psoas muscle fibers, we found that during isometric contraction
      only the first stable state is significantly occupied; i.e., isometric force is
      generated by cross-bridges in the first of the stable states. Thus, isometric
      force and the quick tension recovery appear to result from two distinctly
      different molecular processes. We propose that isometric force results from a
      structural change in the actomyosin complex associated with the transition from a
      weakly bound configuration to a strongly bound configuration before the reaction
      steps in the Huxley-Simmons model, whereas a major component of quick tension
      recovery originates from transitions among the subsequent strongly bound states.
      Mechanical, biochemical, and structural evidence for the two distinct processes
      is summarized and reviewed.

PMID- 7787052
TI  - Function of the N terminus of the myosin essential light chain of vertebrate
      striated muscle.
AB  - All but one (LC3-f; a fast skeletal muscle isoform) of the essential light chain
      isoforms of myosin (ELC) that are expressed in vertebrate striated muscles have
      an extended N terminus that is found neither in invertebrate ELCs nor in the
      majority of vertebrate smooth and nonmuscle myosin ELCs. Studies with
      permeabilized skeletal muscle fibers and in vitro motility assays have
      demonstrated that the presence of the ELC isoform lacking the N-terminal
      extension (LC3-f) is correlated with an increased maximal velocity of filament
      sliding. To examine further this modulatory role of the ELCs, a procedure was
      developed for the exchange of ELCs that is based on a technique for the removal
      of regulatory light chains from permeabilized muscle fibers. Different isoforms
      of the ELCs and mutant ELCs were exchanged into permeabilized skeletal muscle
      fibers from rabbit psoas muscle. The role of the ELCs of myosin in altering the
      shortening Vmax of striated muscle was confirmed. Additionally, experiments with
      mutant ELCs in which lysines at the extreme N terminus were replaced with
      alanines, demonstrated an increased shortening Vmax that coincided with removal
      of the positive charges contributed by the lysines. This suggests that charge
      interactions (i.e., salt bridges) between the N terminus of the ELC and
      negatively charged amino acids on the surface of actin cause a slowing of
      filament sliding. Whether this role in altering shortening velocity is the
      primary function of the extended N terminus of the ELC or whether it is merely a
      consequence of providing a tether between the thick and thin filaments is
      discussed.

PMID- 7787053
TI  - Structural studies on the ribbon-to-helix transition in profilin: actin crystals.
AB  - Knowledge of the structure of actin in its various conformational states is
      important for understanding the diverse motile activities carried out by
      eukaryotic cells. Profilin:actin crystals provide a unique system for studying
      conformational states of actin, because they exhibit a high degree of
      polymorphism in response to environmental conditions while maintaining
      crystalline order. A preliminary comparison of two states of profilin:beta-actin
      crystals shows that crystal polymorphism involves movements of actin subdomains
      at hinge points homologous to those found in hexokinase, a protein whose
      polypeptide fold is related to actin. The homology of the hinge points in actin
      to those in hexokinase suggests that actin subdomain movements in profilin:beta
      actin crystals have functional significance. We discuss how these movements could
      be related to structural transitions between states of filamentous actin in
      muscle contraction.

PMID- 7787054
TI  - Role of skeletal and smooth muscle myosin light chains.
AB  - A persistent problem with the rotating cross-bridge model for muscle contraction
      has been the inability to detect any large conformational changes within the
      myosin molecule to account for a working stroke of 5-10 nm. The recent crystal
      structure of myosin subfragment-1 suggests a solution to this problem by showing
      the presence of two distinct domains: a catalytic or motor domain, from which
      extends a long, 8.5-nm alpha-helix that is stabilized by the regulatory and
      essential light chains. Rayment et al. (1993) proposed that closure of a cleft in
      the motor domain could rotate the light chain-binding domain by a sufficient
      distance to account for the power stroke. With the development of new in vitro
      motility assays, and the ability to prepare unusual myosins by biochemical and
      molecular biological methods, we can now examine this hypothesis and explore the
      role of the light chains in generating force and movement. Here we will review
      some of these recent data and outline a possible mechanism for how light chains
      regulate contractile properties.

PMID- 7787055
TI  - A novel electron paramagnetic resonance spin label and its application to study
      the cross-bridge cycle.
AB  - We have used a novel alpha-iodoketone spin-label (IKSL) to study myosin head
      orientation and cross-bridge dynamics in the putative pre-powerstroke state.
      Possible perturbation of the cross-bridge cycle by the label was assayed by the
      sinusoidal analysis method (Kawai and Brandt, 1980; Kawai and Zhao, 1993), which
      determines the rate constants of the elementary steps in the cycle. A comparison
      of the rates obtained from unlabeled and IKSL fibers revealed small (10-20%)
      changes in the ATP hydrolysis rate and in the rate constants of the elementary
      steps. The labeling induced small changes (< 13%) in the distribution of the
      cross-bridges among the various intermediate states. Pre-powerstroke cross
      bridges were induced by aluminum fluoride in the presence of Ca2+ and ATP. In
      this state, force development is inhibited, but a large proportion (40%) of the
      cross-bridges are still attached to the thin filament. We have used conventional
      electron paramagnetic resonance to measure orientation, and have found that the
      pre-powerstroke heads are as disordered as in relaxation. Their mobility, as
      determined by saturation transfer electron paramagnetic resonance, was
      significantly restricted. Assuming that stiffness is proportional to the fraction
      of strongly attached heads, the rotational correlation time of the bound heads is
      estimated to be tau r = approximately 150-400 microseconds.

PMID- 7787057
TI  - The conformation of the active site of myosin probed using mant-nucleotides.
AB  - Changes in the conformation of the active site of myosin subfragment-1 (S1) may
      be linked to the production of force during the powerstroke. We probed the
      conformation of the nucleotide pocket by measuring the solvent accessibility of
      bound mant-nucleotides. Solvent accessibility was determined by measuring the
      quenching of fluorescence produced by the solvent phase quencher acrylamide. The
      fluorescent mant moiety is attached to the ribose and is located near the outside
      of the pocket where it is likely to be sensitive to opening of the pocket.
      MantADP was highly protected from the quencher when bound to the active site of
      S1. A similar degree of protection was also observed for mantATP during steady
      state hydrolysis by S1, and for mantADP bound to acto-S1 or to myosin in
      myofibrils. Assuming that S1-mantATP and actoS1-mantADP represent states at the
      beginning and the end of the powerstroke, respectively, we conclude that the
      myosin nucleotide pocket does not undergo a large conformational change during
      the powerstroke. However, the high degree of protection seen for mant-nucleotides
      is not easily explained by the open structure of the nucleotide pocket in the S1
      nucleotide complex observed by x-ray diffraction.

PMID- 7787059
TI  - Purification of kinesin-related protein complexes from eggs and embryos.
AB  - We have developed a biochemical screen for the identification of kinesin-related
      proteins (KRPs) in their natural host cells and the subsequent purification of
      these KRPs as native, functional multimeric complexes. The screen involves
      immunoblotting with pan-kinesin peptide antibodies that recognize several
      presumptive KRPs in cytosolic extracts; the antibodies have been used so far to
      monitor the purification of two bona fide kinesin-related motor protein
      complexes. These two KRPs were purified via AMPPNP-induced microtubule affinity
      binding, ATP-induced elution from AMPPNP microtubules, gel filtration
      fractionation, and sucrose density gradient centrifugation. KRP(85/95) from sea
      urchin (Strongylocentrotus purpuratus) eggs behaves as a heterotrimeric complex
      of 85-, 95-, and 115-kDa subunits that moves toward the plus ends of microtubule
      tracks at approximately 0.4 micron/s. KRP(130) from fruitfly (Drosophila
      melanogaster) embryos behaves as a homotetrameric complex of four 130-kDa
      subunits that moves toward the plus ends of microtubule tracks at approximately
      0.04 micron/s. To our knowledge, KRP(85/95) and KRP(130) are the only KRPs to
      have been purified from native tissue as functional multimeric motor complexes.

PMID- 7787056
TI  - The mechanism of force generation in myosin: a disorder-to-order transition,
      coupled to internal structural changes.
AB  - We propose a molecular mechanism of force generation in muscle, based primarily
      on site-specific spectroscopic probe studies of myosin heads in contracting
      muscle fibers and myofibrils. Electron paramagnetic resonance (EPR) and time
      resolved phosphorescence anisotropy (TPA) of probes attached to SH1 (Cys 707, in
      the catalytic domain of the head) have consistently shown that most myosin heads
      in contracting muscle are dynamically disordered, undergoing large-amplitude
      rotations in the microsecond time range. Some of these disordered heads are bound
      to actin, especially in the early (weak-binding, preforce) phase of the ATPase
      cycle. The small ordered population (10-20%) is rigidly oriented precisely as in
      rigor, with no other distinct angle observed in contraction or in the presence of
      intermediate states trapped by nucleotide analogs. These results are not
      consistent with the classical model in which the entire head undergoes a 45
      degree transition between two distinct orientations. Therefore, it has been
      proposed that the catalytic domain of the myosin head has only one stereospecific
      (rigor-like) actin-binding angle, and that the head's internal structure changes
      during force generation, causing the distal light-chain-binding domain to rotate.
      To test this model, we have performed EPR and TPA studies of probes attached to
      regulatory light chains (RLCs) in rabbit and scallop myofibrils and fibers. The
      RLC results confirm the predominance of dynamic (microsecond) rotational disorder
      in both relaxation and contraction, and show that the different mechanisms of
      calcium regulation in the two muscles produce different rotational dynamics. In
      rabbit myofibrils, RLC probes are more dynamically disordered than SH1 probes,
      especially in rigor and contraction,indicating that the light-chain-binding
      domain undergoes rotational motions relative to the catalytic domain when myosin
      heads interact with actin. An SH1-bound spin label, which is sensitive to
      myosin's internal dynamics, resolves three distinct conformations during
      contraction, and time-resolved EPR shows that these transitions are coupled to
      specific steps in the ATPase cycle. We propose that force is generated during
      contraction by a disorder-to-order transition, in which myosin heads first attach
      weakly to actin in a nonstereospecific mode characterized by large-scale dynamic
      disorder, then undergo at least two conformational transitions involving large
      scale structural (rotational) changes within the head, culminating in a highly
      ordered strong-binding state that bears force.

PMID- 7787060
TI  - Torque generation by the flagellar rotary motor.
AB  - A review is given of the structure and dynamics of the flagellar rotary motor.
      Force-generating elements in a motor driving a tethered bacterium (a cell fixed
      to the substratum by a single flagellum) exert forces of order 20 pN while moving
      at speeds of order 1 micron/s. Force-generating elements in a motor driving a
      flagellar filament in a bundle exert forces some 10-fold lower but move at speeds
      more than 10-fold higher. The motor torque-speed relationship has been measured
      over a wide dynamic range. Motors strongly resist being driven backwards and are
      easily broken.

PMID- 7787062
TI  - Pathway of the microtubule-kinesin ATPase.
AB  - We have established pathway of the kinesin ATPase by direct measurement of each
      step in the pathway. Kinesin binds to microtubules with an 8-nm repeat and a
      stoichiometry of one kinesin monomer unit per tubulin dimer. Thus, the dimeric
      kinesin binds with both heads attached to the microtubule and on adjacent tubulin
      subunits. In the steady state, kinesin has a low ATPase activity that is limited
      by the rate of ADP release (< 0.01 s-1) in the absence of microtubules and is
      activated 2000-fold by the addition of microtubules to achieve a maximum rate of
      approximately 20 s-1. Transient-state kinetic analysis has provided direct
      measurement of individual steps of the reaction to define the pathway of the
      microtubule-kinesin ATPase. These studies establish that the rate-limiting step
      in the ATPase pathway is the release of the kinesin-product complex (K.ADP.P)
      from the microtubule following ATP hydrolysis. After phosphate release, the
      rebinding of kinesin-ADP to the microtubule is fast, accounting for the high
      activation of the ATPase at low microtubule concentration. This ATPase cycle
      explains the phenomenological differences between myosin and kinesin observed in
      motility assays. Kinesin remains associated with a microtubule through multiple
      rounds of hydrolysis, because it spends only a small fraction of its duty cycle
      in the dissociated state. The discussion of this paper will focus on the new
      data, their interpretation, and significance for mechanisms of force production.
      The ATPase coupling mechanism will be compared with dynein and myosin.

PMID- 7787058
TI  - Molecular genetic analysis of myoF, a new Dictyostelium myosin I gene.
AB  - Several new members of the Dictyostelium myosin family have been identified by
      physical mapping techniques in combination with PCR. Here we describe the initial
      molecular genetic characterization of one of these, myoF. A 1-kb segment of the
      myoF gene was obtained by the PCR and used as a specific probe for Northern
      analysis and as a vehicle for gene-targeting studies. The myoF gene is expressed
      as a 3.7-kb message, a size consistent with it encoding a myosin I class
      unconventional myosin, bringing the total of myosin is present in Dictyostelium
      to six. Analysis of strains in which the myoF gene has been disrupted reveals
      that loss of the myoF protein does not result in obvious defects either in
      cellular translocation, or in other readily assayed actin-based processes. The
      results of our investigation indicate that the myosin I family is quite large in
      Dictyostelium, and that several members, including myoF, may either be
      functionally redundant or play roles in as yet undescribed actin-based processes.

PMID- 7787061
TI  - Conserved machinery of the bacterial flagellar motor.
AB  - Novel periplasmic and cytoplasmic structural modules of the bases of bacterial
      flagella have been observed in situ and isolated using new biochemical protocols.
      Flagellar rotation may depend upon interactions of these modules with the
      intramembrane particle rings, a ubiquitous feature of flagellar bases necessary
      for torque generation. The outer membrane-associated basal disk of the Wolinella
      succinogenes polar flagellum has architecture well suited for interaction with
      the ring particles. However, antibody against the main W. succinogenes basal disk
      protein did not cross-react with flagella-enriched fractions from Salmonella
      typhimurium and Bacillus firmus; nor have such structures been observed in these
      species thus far. Antibodies against two S. typhimurium proteins, FliG and FliM,
      known to be involved in motor function and part of the cytoplasmic module in this
      species cross-reacted with flagella-enriched fractions from both W. succinogenes
      and B. firmus. In addition, flagellar cytoplasmic structure could be isolated
      from B. firmus. The basal disk may anchor the flagellar motor to the cell wall in
      some polar bacteria, but this does not seem to be a unique strategy. In contrast,
      the data indicate that the cytoplasmic module is conserved.

PMID- 7787063
TI  - Helicase-catalyzed DNA unwinding: energy coupling by DNA motor proteins.
AB  - DNA helicases catalyze the unwinding of double-stranded (ds) DNA to yield the
      single-stranded (ss) DNA intermediates required in DNA replication,
      recombination, and repair. DNA helicases couple the free energy of nucleoside
      triphosphate (NTP) binding and hydrolysis to separate the two complementary DNA
      strands while also translocating vectorially along the DNA substrate. As such,
      helicases are functionally DNA motor proteins. The functional form of helicases
      generally appears to be oligomeric (usually dimers or hexamers), which provides
      the helicase with multiple DNA binding sites that are required for translocation
      and DNA unwinding. The affinity of ss- versus dsDNA for these multiple DNA
      binding sites is modulated allosterically by NTP binding, hydrolysis, and product
      release, which is central to helicase-catalyzed DNA unwinding. The mechanistic
      details of the DNA unwinding, translocation, and NTPase reactions are only
      starting to emerge. We discuss energy coupling by DNA helicases in general, and
      by the dimeric E. coli Rep helicase in particular, focusing on the similarities
      of these enzymes to classical motor proteins.

PMID- 7787064
TI  - Nucleotide binding studies of bacteriophage T7 DNA helicase-primase protein.
AB  - Bacteriophage T7 DNA helicase protein is a hexameric protein that contains
      identical subunits arranged in a ring-like structure. Single-stranded DNA binds
      through the hole of the ring, and the helicase protein translocates and unwinds
      duplex DNA using nucleoside triphosphate (NTP) hydrolysis. In our efforts to
      understand how NTP hydrolysis may be coupled to movement of the helicase on the
      DNA, we have quantitated the equilibrium binding of deoxythymidine triphosphate
      and thymidine 5'-(beta,gamma-methylenetriphosphate) using nitrocellulose binding
      assays. Even though the helicase consists of six identical subunits, each hexamer
      was found to bind only three NTP molecules. These results indicate half-site
      binding or negative cooperativity in NTP binding by the hexamer. Interestingly,
      binding of three NTP molecules to the hexamer was sufficient for stoichiometric
      binding of a single-stranded oligodeoxynucleotide. Similar negative cooperativity
      in NTP binding has also been observed for other helicases, suggesting that it may
      be a general feature of hexameric helicases. The significance of half-site
      binding, however, is not understood at the present time.

PMID- 7787066
TI  - A new method for the time-resolved measurement of phosphate release in
      permeabilized muscle fibers.
AB  - A new method for the measurement of phosphate release in contracting and relaxed
      permeabilized muscle fibers is described. The assay is based on a genetically
      engineered phosphate-binding protein labeled with a coumarin fluorescent probe,
      which binds inorganic phosphate tightly and shows a fourfold increase in
      fluorescence upon binding. Measurements of Pi release on the millisecond time
      scale with sensitivity in the 10 microM range are obtained that provide new
      information about the relationship between ATP hydrolysis and force production.

PMID- 7787065
TI  - Structural studies of myosin:nucleotide complexes: a revised model for the
      molecular basis of muscle contraction.
AB  - The structures of the MgADP-beryllium fluoride and MgADP-aluminum fluoride
      complexes of the truncated myosin head from Dictyostelium myosin II are reported.
      These reveal the location of the nucleotide complex and define the amino acid
      residues that form the active site. The tertiary structure of the beryllium
      fluoride complex is essentially identical to that seen previously in the three
      dimensional structure of chicken skeletal muscle myosin. By contrast, significant
      domain movements are observed in the aluminum fluoride complex. These structural
      findings form the basis of a revised model for the structural basis of the
      contractile cycle. It is now suggested that the narrow cleft that splits the
      central 50-kDa segment of the heavy chain provides not only the communication
      route between the nucleotide-binding pocket and actin but also transmits the
      conformational change necessary for movement.

PMID- 7787068
TI  - The actomyosin interaction and its control by tropomyosin.

PMID- 7787067
TI  - The role of three-state docking of myosin S1 with actin in force generation.
AB  - It has been shown that in solution myosin subfragment 1 binds to actin in three
      principal steps: [formula: see text] The nucleotide bound to myosin has a major
      influence on the equilibrium constant of the third of these steps but little
      effect on the other two. The third step is thought to be coupled to the force
      generating event. Three-step binding and structure: The formation of the
      collision complex is strongly ionic strength dependent but independent of
      temperature. The isomerization to the A state is not strongly dependent on ionic
      strength but is affected by organic solvent and temperature. In contrast the
      isomerization to the R state-is affected by both ionic strength and organic
      solvent but little affected by temperature. The recent docking of the three
      dimensional structures of actin and S1 suggest possible structural correlates of
      these events. These studies lead to predictions for the docking process, which
      may be tested using site-directed mutagenesis or peptide inhibitors. Three-step
      binding and head-head interactions: Studies of HMM binding to actin compared with
      S1 binding show that binding of two heads in the A state are unlikely presumably
      because of strain effects. However, binding of two heads as one A and one R state
      shows little evidence of strain while the isomerization of the second head to
      give two R states is fivefold weaker than for an isolated S1 head. These results
      suggest that in a rapidly shortening muscle only one head is likely to be
      attached at a time. Under isometric conditions, although it is possible for both
      heads to bind to adjacent actins, it is unlikely that both will be in the force
      holding R state simultaneously. Three-step binding and regulation by tropomyosin
      troponin:Our recent solution studies have established that the thin filament can
      exist in three calcium-dependent states which we termed blocked, closed and open.
      A blocked state cannot form the A state with S1 and a closed state cannot form
      the force holding R state nor accelerate product release from S1. Thus control
      operates at two distinct points in the docking process. The docking process
      itself is coupled to hydrolysis of ATP (the A-to-R isomerization is inhibited by
      the presence of the gamma Pi on ATP), and therefore all of these events are
      interrelated.The coming together of these different strands provides a
      biochemical framework that should allow the dynamic properties of the crossbridge
      in muscle to be understood.

PMID- 7787069
TI  - Coordinated hydrolysis explains the mechanical behavior of kinesin.
AB  - The two-headed motor protein kinesin hydrolyzes nucleotide to move
      unidirectionally along its microtubule track at speeds up to 1000 nm/s (Saxton et
      al., 1988) and develops forces in excess of 5 pN (Hunt et al., 1994; Svoboda et
      al., 1994a). Individual kinesin molecules have been studied recently in vitro,
      and their behavior has been characterized in terms of force-velocity curves and
      variance measurements (Svoboda and Block, 1994a; Svoboda et al., 1994b). We
      present a model for force generation in kinesin in which the ATP hydrolysis
      reactions are coordinated with the relative positions of the two heads. The model
      explains the experimental data and permits us to study the relative roles of
      Brownian motion and elastic deformation in the motor mechanism of kinesin.

PMID- 7787070
TI  - Can membrane proteins drive a cell?

PMID- 7787071
TI  - A three-line muscle cross-bridge cycle with strain-dependent ligand releases.

PMID- 7787072
TI  - Nucleotide-binding site of the myosin head is under the influence of thin
      filament proteins.

PMID- 7787073
TI  - The myofibril as a model for muscle fiber ATPase.

PMID- 7787074
TI  - Comparison between tension transients during isometric contraction and in rigor
      in isolated fibers from frog skeletal muscle.

PMID- 7787075
TI  - Mechanochemical coupling of molecular motors to ATP hydrolysis.

PMID- 7787076
TI  - Ciliary beat frequency is controlled by a dynein light chain phosphorylation.
AB  - cAMP-dependent phosphorylation of a 29-kDa axonemal polypeptide (p29) increases
      the swimming speed of permeabilized Paramecium and in vitro translocation
      velocity of bovine brain microtubules over 22S dynein extracted from Paramecium
      axonemes. A quantitative relationship between microtubule translocation velocity
      and beat frequency is developed. We conclude that p29 acts as a regulatory light
      chain of outer arm dynein in the control of ciliary beat frequency.

PMID- 7787077
TI  - The contributions of light chains to myosin function.

PMID- 7787078
TI  - Myosin regulatory light chain phosphorylation and the production of functionally
      significant changes in myosin head arrangement on striated muscle thick
      filaments.

PMID- 7787079
TI  - Characterization of myosin II isoforms containing insertions of amino acids in
      the flexible loop near the ATP-binding pocket.

PMID- 7787080
TI  - Differential phosphorylation in vivo of cytoplasmic dynein in anterograde and
      whole cell compartments.

PMID- 7787082
TI  - Two heads are required for phosphorylation-dependent regulation of smooth muscle
      myosin.

PMID- 7787081
TI  - Essential myosin light chain isoforms and energy transduction in skeletal muscle
      fibers.

PMID- 7787084
TI  - Measurement of the isometric force exerted by a single kinesin molecule.

PMID- 7787083
TI  - Analysis of high resolution recordings of motor movement.
AB  - The development of in vitro motility assays for motor proteins has been
      accompanied by a parallel development of advanced optical instrumentation capable
      of recording motion at the molecular level. Devices now exist that can record
      displacements to better than 0.1 nm at bandwidths in excess of 10 kHz, and that
      can place controlled forces up to many pN on single motors. Ultra-high resolution
      data from experiments are now pouring in. The analysis and subsequent
      interpretation of experimental records, which are inevitably contaminated with
      high levels of thermal noise, remain an ongoing challenge. This essay examines
      selected issues relating to this challenge and discusses some alternative
      approaches.

PMID- 7787085
TI  - The mechanics of force generation by kinesin.
AB  - Several laboratories have developed highly sensitive mechanical techniques for
      studying the movement of purified motor proteins along their associated
      filaments. The aim of these experiments is to test models for force generation,
      such as the powerstroke model and "ratchet" or diffusional models, by 1) directly
      visualizing the path on the filament along which the motor moves, 2) measuring
      the force exerted by the motor against the filament, and 3) characterizing the
      passive mechanical properties (elasticity) of the motor. This paper focuses on
      recently published work on the microtubule-based motor kinesin taking this
      mechanical approach. Related work on myosin is mentioned for comparison.

PMID- 7787086
TI  - Smooth muscle myosin: a high force-generating molecular motor.
AB  - Smooth muscle generates as much force per cross sectional area of muscle as
      skeletal muscle with only one-fifth the myosin content. Although this apparent
      difference could be explained at the tissue or cellular level, it is possible
      that at the molecular level smooth muscle cross-bridges generate greater average
      force than skeletal muscle cross-bridges. To test this hypothesis, we used an in
      vitro motility assay (VanBuren et al., 1994) in which either chicken
      thiophosphorylated gizzard smooth or pectoralis skeletal muscle monomeric myosin
      is adhered to a nitrocellulose surface. A fluorescently labeled actin filament,
      attached to an ultracompliant (50-200 nm/pN) glass microneedle, is brought in
      contact with the myosin surface. Isometric force, being generated by myosin cross
      bridges pulling on the attached actin filament, is calculated from the extent to
      which the calibrated microneedle is deflected. By measuring the density of myosin
      adhered to the surface, we estimated the number of myosin cross-bridges that are
      able to interact with a length of actin filament in contact with the myosin
      surface. In a direct comparison between smooth and skeletal muscle myosin, the
      average force per cross-bridge was 0.8 and 0.2 pN, respectively. Surprisingly,
      smooth muscle myosin generates approximately 4 times greater average force per
      cross-bridge head than skeletal muscle myosin. Because average isometric force is
      the product of the cross-bridge unitary force and duty cycle, we are presently
      using a laser optical trap in an attempt to measure unitary events from single
      myosin molecules. This approach should allow us to determine whether an increase
      in unitary force, duty cycle, or both contribute to smooth muscle myosin's
      enhanced force-generating capacity compared with skeletal muscle myosin.

PMID- 7787088
TI  - Implications of diffusion-controlled limit for processivity of dimeric kinesin
      head domains.
AB  - The diffusion-limited rate for association of the ADP complex of dimeric DKH392
      kinesin head domains with a microtubule was estimated to be 2-3 x 10(7) M-1 s-1
      based on approximation of a microtubule as a highly elongated prolate ellipsoidal
      adsorber of 100% efficiency. This theoretical bimolecular rate is approximately
      100-fold smaller than the experimental rate, kcat/KMT0.5, for DKH392 that was
      determined from the stimulation of the steady-state ATPase rate by microtubules.
      The large difference between these two estimates of the bimolecular rate
      indicates that it is likely that dimeric DKH392 hydrolyzes multiple ATP molecules
      during each diffusional encounter with a microtubule.

PMID- 7787087
TI  - Structural features involved in force generation in the kinesin superfamily.
AB  - In this article, I discuss our current understanding of the structural features
      of the microtubule-dependent motor kinesin and its relatives, which are needed
      for force generation. It has become clear that the motor domain itself is likely
      to be only about 340 amino acids, and that direction of movement is also
      controlled within this region. There is reason, however, to be suspicious that
      elements in the tail that are located immediately adjacent to the motor region
      influence, or in some way contribute to, normal motor activity. Finally, I
      describe recent work designed to identify the regions involved in the kinesin
      microtubule interaction.

PMID- 7787089
TI  - Determinants of motor polarity in the kinesin proteins.
AB  - Many of the proteins that are members of the kinesin family of microtubule motor
      proteins are plus-end motors; however, a few of the kinesin proteins have now
      been found to be minus-end microtubule motors. Overall structural features of the
      proteins can be used to identify further kinesins that are likely to be minus-end
      motors. Structural or biochemical differences that may serve as the basis of the
      "reversed" polarity of a unique subset of the kinesin proteins are discussed.

PMID- 7787090
TI  - Structural and functional features of one- and two-headed biotinated kinesin
      derivatives.
AB  - The oligomeric structure was determined for four recombinant kinesin derivatives
      containing N-terminal fragments of the kinesin alpha-subunit. Some of the
      proteins were dimeric (two-headed) molecules with mechanochemical properties
      similar to those of intact kinesin. Comparison of the primary and quaternary
      structures of the derivatives with those of intact kinesin suggests that
      structures distinct from the long alpha-helical coiled-coil rod domain contribute
      to subunit self-association. Three of the proteins contain a single engineered
      site for post-translational biotination in vivo; this facilitates analysis of
      motility in experiments in which the proteins are specifically bound to
      streptavidin-conjugated microscopic plastic beads. One of the derivatives is
      monomeric (one-headed); like the two-headed derivatives, it is functional in the
      motility assay and is a microtubule-dependent ATPase. Unlike intact kinesin and
      the two-headed derivatives, the one-headed enzyme fails to track microtubule
      protofilaments. This confirms a prediction of proposed "hand-over-hand"
      mechanisms of kinesin movement. The ability of molecules with a one-headed
      solution structure to generate movement is consistent with a translocation
      generating conformational change internal to the kinesin head. A simple set of
      coupling rules can be used to formulate consistent mechano-chemical mechanisms
      that explain movement by both one- and two-headed kinesin molecules.

PMID- 7787091
TI  - Cargo-activated ATPase activity of kinesin.
AB  - We have measured the ATPase activity of squid optic lobe kinesin bound to
      polystyrene beads in the presence of microtubules. We find that there is a
      substantial increase (> 10-fold) in the microtubule-activated ATPase activity for
      bead-bound kinesin over free kinesin. We tentatively attribute such cargo
      activated ATPase activity to the presence of a self-inhibited form of kinesin in
      solution, which becomes activated when bound to a bead in the presence of alpha
      casein. Further experiments are underway to unravel this phenomenon and, in
      addition, to associate the traveling distance of beads with the observed ATPase
      rate to determine the average number of ATP consumed per kinesin-bead per micron
      of travel along microtubule.

PMID- 7787092
TI  - Mechanical measurements of single actomyosin motor force.
AB  - To elucidate the mechanism of force generation by actomyosin motor, a measuring
      system was constructed, in which an in vitro motility assay was combined with an
      optical trapping technique. An actin filament of several micron long was attached
      to a gelsolin-coated polystyrene bead, and was allowed to interact with a small
      number (approximately 1/1 micron actin filament) of rabbit skeletal heavy
      meromyosin (an active subfragment of myosin) molecules bound to a nitrocellulose
      coated coverglass. The bead position was determined at 33-ms intervals. We
      measured the force generation event at relatively low (100-400 nM) ATP
      concentration so that the occurrence of individual force generation events could
      be detected with our time resolution. The actin-bound bead held in the optical
      trap moved in a stepwise manner in the direction of the actin filament only in
      the presence of ATP. At the trap strength of 0.3 pN/nm, the maximum size of the
      step was 11 nm, and the maximum force associated with the movement was 3.3 pN.

PMID- 7787093
TI  - Conformational changes of the myosin heads during hydrolysis of ATP as analyzed
      by x-ray solution scattering.
AB  - We have shown for the first time that the myosin head (subfragment-1, S1), the
      energy-transducing component in the actomyosin motor system undergoes a distinct
      shape change during hydrolysis of ATP using x-ray solution scattering techniques.
      Among various analogs for intermediate states of the S1 ATPase cycle, the
      complexes with MgADP and vanadate (S1.ADP.Vi), MgADP and beryllium fluoride
      (S1.ADP.BeF3), or MgADP and aluminum fluoride (S1.ADP.AIF4) showed a shape change
      similar to that in the presence of MgATP, but the complexes with ATP gamma S
      (S1.ADP gamma S) and MgADP trapped by cross-linking with pPDM (S1.ADP-pPDM)
      seemed to have a shape similar to that of nucleotide-free S1. These results
      indicate that the shape of an S1**.ADP.Pi state is more rounded or bent than in
      other intermediate states of the S1 ATPase cycle. Such changes occur in light
      chain 2-deficient S1 and also in smooth muscle S1. However, MgADP-fluoride
      complexes with smooth muscle S1 (without phosphorylation of a regulatory light
      chain) seemed to have a structure similar to that of nucleotide-free S1. Analysis
      of x-ray scattering data indicated that a conformational change of S1 in the
      presence of MgATP might be caused by a hinge-like bending movement between the
      catalytic and regulatory domains. The global change of S1 is correlated with some
      specific changes of a nucleotide-binding moiety.

PMID- 7787094
TI  - Characterization of single actin-myosin interactions.
AB  - The feedback-enhanced laser trap assay (Finer et al., 1994) allows the
      measurement of force and displacement produced by single myosin molecules
      interacting with an actin filament suspended in solution by two laser traps. The
      average displacement of 11 nm at low load and the average force of 4 pN near
      isometric conditions are consistent with the conventional swinging cross-bridge
      model of muscle contraction (Huxley, 1969). The durations of single actin-myosin
      interactions at low load, 3-7 ms, suggest a relatively small duty ratio. Event
      durations can be increased either by reducing the ATP concentration until ATP
      binding is rate-limiting or by lowering the temperature. For sufficiently long
      interactions near isometric conditions, low frequency force fluctuations were
      observed within the time frame of a single event. Single myosin events can be
      measured at ionic strengths that disrupt weak binding actomyosin interactions,
      supporting the postulate of distinct weak and strong binding states. Myosin
      generated force and displacement were measured simultaneously against several
      different loads to generate a force-displacement curve. The linear appearance of
      this curve suggests that the myosin powerstroke is driven by the release of a
      strained linear elastic element with a stiffness of approximately 0.4 pN nm-1.

PMID- 7787097
TI  - Forces and steps generated by single myosin molecules.

PMID- 7787096
TI  - Are actin filaments moving under unloaded conditions in the in vitro motility
      assay?
AB  - With sliding actin-filament motility assays, filament velocity should be
      independent of changes in the level of actomyosin activation under unloaded
      conditions. Using a simple modification of the motility assay to measure relative
      changes in isometric force (activation), we determined that isometric force
      increased 200-fold with thiophosphorylation of the myosin regulatory light chain,
      and that with thiophosphorylated myosin, isometric force was further increased by
      the addition of saturating smooth-muscle tropomyosin (100%) or tropomyosin plus
      calponin (500%), and decreased with the addition of saturating caldesmon (-100%).
      Under "reducing conditions," filament velocity (2.0 microns/s) was constant for
      mixtures of dephosphorylated and thiophosphorylated myosin containing > 5%
      thiophosphorylated myosin, and was unaffected by the addition of saturating
      concentrations of tropomyosin or caldesmon. In contrast, "standard assay
      conditions" were found to be nonreducing. With fully thiophosphorylated smooth
      muscle myosin, saturating smooth-muscle tropomyosin increased velocity to 150% of
      control, and caldesmon halted all filament motion; with fully dephosphorylated
      myosin (< 0.002 mol/mol) filaments only moved when tropomyosin or tropomyosin
      plus calponin was added. Taken together, these observations suggest that under
      "standard conditions" a mechanical load is present that is eliminated by
      "reducing conditions." Filament velocity was insensitive to changes in cross
      bridge density, under all conditions, suggesting that noncycling cross-bridges,
      generated by photochemical oxidation of myosin, is a likely source of mechanical
      loading.

PMID- 7787095
TI  - Single-molecule mechanics of heavy meromyosin and S1 interacting with rabbit or
      Drosophila actins using optical tweezers.
AB  - Single-molecule mechanical interactions between rabbit heavy meromyosin (HMM) or
      subfragment 1 (S1) and rabbit actin were measured with an optical tweezers
      piconewton, nanometer transducer. Similar intermittent interactions were observed
      with HMM and S1. The mean magnitude of the single interaction isotonic
      displacements was 20 nm for HMM and 15 nm with S1. The mean value of the force of
      single-molecule interactions was 1.8 pN for HMM and 1.7 pN with S1. The stiffness
      of myosin S1 was determined by applying a sinusoidal length change to the thin
      filament and measuring the corresponding force; the mean stiffness was 0.13 pN nm
      1. By moving an actin filament over a long distance past an isolated S1 head, we
      found that cross-bridge attachment occurred preferentially at a periodicity of
      about 40 nm, similar to that of the actin helical repeat. Rate constants for the
      probability of detachment of HMM from actin were determined from histograms of
      the lifetime of the attached state. This gave a value of 8 s-1 or 0.8 x 10(6) M-1
      s-1 for binding of ATP to the rigor complex. We conclude (1) that our HMM-actin
      interactions involve just one head, (2) that compliance of the cross-bridge is
      not in myosin subfragment 2, although we cannot say to what extent contributions
      arise from myosin S1 or actin, and (3) that the elemental movement can be caused
      by a change of shape of the S1 head, but that this would have to be much greater
      than the movements suggested from structural studies of S1 (Rayment et al.,
      1993).

PMID- 7787098
TI  - A single myosin head can be cross-linked to the N termini of two adjacent actin
      monomers.
AB  - Myosin subfragment-1 (S1) can be cross-linked to two actin monomers by 1-ethyl-3
      [3-(dimethylamino)-propyl]-carbodiimide only when F-actin is in excess over S1.
      Electron micrographs of the covalent actin2-S1 complex showed that S1 was cross
      linked to two adjacent monomers of the same actin filament. Cross-linking
      experiments with pre-proteolyzed S1 derivatives in combination with a proteolytic
      dissection of the intact covalent actin2-S1 adduct (m = 265 kDa), revealed that
      two N-terminal segments of actin (residues 1-28) were covalently attached to a
      single S1 molecule. One was cross-linked to either the 20-kDa or the 50-kDa heavy
      chain fragments of S1, and the other only to the 50-kDa region. The doubly cross
      linked product was formed under physiological ionic strength with S1 or with
      reconstituted myosin filaments, regardless of the presence of ADP or the
      regulatory proteins, tropomyosin and troponin. Finally, we found that this cross
      linking could also take place within myofibrils in the rigor state. These results
      demonstrate that under nonsaturating conditions, the actin-S1 interface
      encompasses a much larger region than that recently proposed for the
      nonphysiological, fully saturated actin filaments.

PMID- 7787099
TI  - Is myosin a "back door" enzyme?
AB  - ATP has been modeled into the active site of chicken skeletal myosin subfragment
      1 using the adenylate kinase.Ap5A structure as a starting reference. The
      resulting docked ATP.S1 structure is justified in that it rationalizes the
      photolabeling data from several ATP analogs. The gamma-phosphate of ATP sits at
      the bottom of the active site pocket and is partially visible via a view along
      the prominent 50-kDa cleft of S1 but not when viewed from above the active site.
      It is postulated that actin binding promotes the movement of the P-loop and Arg
      245 to allow Pi from ATP to leave via a "back-door" in the 50-kDa fragment while
      ADP is still bound at the active site. Such a mechanism can explain a number of
      experimental observations, including the kinetics of ATP hydrolysis, the
      nucleotide dependence of Pi exchange into ATP, and the formation of stable
      myosin.ADP.vanadate complexes in muscle fibers.

PMID- 7787100
TI  - Actin's view of actomyosin interface.
AB  - Actomyosin interactions were examined by using yeast actin mutants with alanines
      replacing charged amino acid pairs D24/D25, E99/E100, D80/D81, and E83/K84. In
      the in vitro motility experiments, actin filaments of D24A/D25A or E99A/E100A
      mutants moved in the presence of 0.7% methylcellulose at the velocities of wild
      type actin. Without methylcellulose, these mutant filaments, but not the D80/D81
      or E83/K84 filaments, dissociated from the assay surface upon addition of ATP.
      Measurements of myosin subfragment-1 (S1) binding to D24A/D25A- and E99A/E100A
      polymerized actins in the presence of ATP revealed a three- and twofold decrease
      in their binding constant, respectively, compared with wild-type actin. In
      contrast to this, all monomeric actins had the same binding affinity for S1. The
      rates and extents of polymerization of D24A/D25A and E99A/E100A actins by S1 were
      reduced in comparison to wild-type actin. The local structure of subdomain-2 on
      actin, as probed by subtilisin cleavage, was not altered for either mutant. A
      twofold decrease in nucleotide exchange was detected for the D24A/D25A mutant
      actin. These results demonstrate the involvement of the D24/D25 and E99/E100
      residues in the weak binding of myosin to actin and reveal that residues D80/D81
      and E83/K84 do not modulate actomyosin interactions.

PMID- 7787101
TI  - The working stroke of myosin crossbridges.
AB  - Recent x-ray diffraction measurements of the axial periodicities of the actin and
      myosin filaments in contracting muscles show that they are stretched by small but
      significant amounts by the developed tension, so that at least one half, possibly
      more, of the observed compliance of a sarcomere must reside in the filaments
      themselves. This implies that the movement steps of a crossbridge deduced from
      quick-release experiments may be shorter than some previous estimates,
      necessitating at least two steps to account for current in vitro single-molecule
      measurements. Intensity measurements of the wider angle x-ray reflections also
      show some unexpected features.

PMID- 7787102
TI  - Solution structure of two molecular motor domains: nonclaret disjunctional and
      kinesin.
AB  - The effects of selected ligands on the structure of the truncated heavy-chain
      chemomechanical motor domains of Drosophila ncd and human kinesin were compared
      using the technique of transient electric birefringence. The 366-amino acid C
      terminal motor domain of Drosophila nonclaret disjunctional, ncd(335-700), and
      the 349-amino acid N-terminal motor domain of human kinesin, kinesin(349), were
      studied at 4 degrees C in neutral buffers with ionic strength of 100 mM to form
      complexes with either MgADP or MgADP.Vi. The rotational diffusion time adjusted
      to 20 degrees C and water, tau 20,W, for ncd(335-700).MgADP is 32.8 ns, and for
      ncd(335-700).MgADP.Vi is 34.8 ns, suggesting prolate ellipsoids with dimensions
      9.40 x 3.77 nm and 9.73 x 3.70 nm, respectively. The specific Kerr constant, Ksp,
      of ncd is -1.65 x 10(-12) cm2V-2 for the MgADP complex and -1.15 x 10(-12) cm2V-2
      for the MgADP.Vi complex. The large negative Ksp for a prolate protein suggests
      an unusual charge distribution with two long surfaces with opposite charge. The
      tau 20,W for kinesin(349).MgADP is longer than the corresponding ncd motor and
      shows a decrease with increased electric field. The kinesin(349).MgADP.Vi complex
      has a longer tau 20,W. The Ksp for kinesin(349) is 0.36 x 10(-12) cm2V-2 for each
      complex.

PMID- 7787103
TI  - A single-track fluctuation analysis in the sliding movement by protein motors in
      vitro.

PMID- 7787104
TI  - Fluctuation analysis of kinesin movement.

PMID- 7787105
TI  - Is actin-filament velocity in the in vitro motility assay periodic?

PMID- 7787106
TI  - Force generation in kinesin measured in a centrifuge microscope-based motility
      assay.

PMID- 7787108
TI  - Single-molecule kinetic studies on DNA transcription and transcriptional
      regulation.

PMID- 7787107
TI  - Motility assays using myosin attached to surfaces through specific binding to
      monoclonal antibodies.
AB  - We have analyzed the dependence of actin filament movement on the mode of myosin
      attachment to surfaces. Monoclonal antibodies that bind to three distinct sites
      were used to tether myosin to nitrocellulose-coated glass. One antibody reacts
      with an epitope on the regulatory light chain located at the head-rod junction.
      The other two react with sites in the rod domain, one in the S2 region near the
      S2-LMM hinge, and the other at the C terminus of the myosin rod. These monoclonal
      antibodies were used to provide increasing flexibility in the mode of attachment.
      Fast skeletal muscle myosin monomers were bound to the surfaces through the
      specific interaction with these monoclonal antibodies and the sliding movement of
      fluorescently labeled actin filaments analyzed by video microscopy. Each of these
      antibodies produced stable, myosin-coated surfaces that supported uniform
      movement of actin over the course of several hours. Attachment of myosin through
      the anti-S2 and anti-LMM monoclonal antibodies yielded a maximum velocity of 10
      microns/s at 30 degrees C, whereas attachment through anti-LC2 produced a lower
      velocity of 4-5 microns/s. Each antibody showed a characteristic minimum myosin
      density below which sliding movement was no longer supported and an exponential
      dependence of actin filament velocity on myosin surface density below Vmax.
      Maximum sliding velocity was achieved over a range of myosin surface densities.
      Thus, the specific mode of attachment can influence the characteristic velocity
      of actin filament movement and the surface density needed to support movement.
      These data are being used to analyze the dynamics of sliding filament assays and
      evaluate estimates of the average number of motor molecules per unit length of
      actin required to support movement.

PMID- 7787109
TI  - Single kinesin molecules stressed with optical tweezers.
AB  - Using the optical tweezers to pull on microtubules, we have stretched and twisted
      single kinesin molecules adsorbed to glass surfaces. Preliminary measurements
      suggest that the mechanical system is very compliant, with an apparent stretch of
      120 nm with < 2 pN of force. Although measurements of the series compliance of
      the bead-microtubule structure are still in progress, the kinesin attachment site
      does not slip with stretch. However, under torsional stress, kinesin appears to
      slip. With torques < 2 pN-microns approximately 1 Hz in 2 mM AMP-PNP, there is no
      apparent limit to the number of revolutions that the microtubule can rotate
      around the kinesin attachment site (n = 44). Preliminary data from other
      nucleotide conditions are similar. Although there are rare instances of torsional
      elasticity where the attachment site unwinds, the restoring forces are not
      constant with angular position, also indicating slippage. Mechanisms of
      mechanochemical transduction must account for linear force generation in the
      presence of angular "slippage."

PMID- 7787110
TI  - Mechanical properties of single protein motor of muscle studied by optical
      tweezers.

PMID- 7787111
TI  - Fluorescence polarization from isomers of tetramethylrhodamine at SH-1 in rabbit
      psoas muscle fibers.
AB  - We have used fluorescence polarization to examine orientational changes of the 5-
      and 6-isomers of acetamidotetramethylrhodamine (ATR) covalently bound to SH-1
      (Cys-707 of the myosin heavy chain) in single, skinned fibers from rabbit psoas
      muscle after rapid length steps or photolysis of caged nucleotides. Similar
      results were obtained with both the 5- and 6-isomers of ATR. After the photolysis
      of caged ATP, large and rapid changes in the fluorescence polarization signals
      were observed and were complete well before appreciable force had been generated.
      Changes in the fluorescence polarization signals after the photolysis of caged
      ADP were similar to those after the photolysis of caged ATP, despite an almost
      negligible change in force. The fluorescence polarization signals remained almost
      constant after rapid length steps in both rigor and active muscle fibers. These
      results suggest that structural changes at SH-1 monitored by 5- or 6-ATR are not
      associated directly with the force-generating event of muscle contraction, but
      may be involved in the communication pathway between the nucleotide and actin
      binding sites of myosin.

PMID- 7787112
TI  - Three-dimensional structure of the acrosomal filament of Limulus sperm by 400 kV
      electron cryomicroscopy.
AB  - The acrosomal bundle of Limulus sperm was imaged by electron cryomicroscopy, and
      the three-dimensional structure of a filament computationally isolated from the
      bundle was determined by helical image reconstruction. The actin model of Holmes
      was fit into the map, and its interactions with scruin, the actin-binding and
      cross-linking protein, were studied. Scruin binds to two consecutive actins along
      the helix via subdomains 1 and 3. These interactions involve helix-loop-beta
      motifs that are present in both actin subdomains (in different monomers) in
      positions available for binding by the same scruin molecule as it wraps around
      the actin. Taking first the structural motif homology and then looking for
      sequence pattern similarities, a stretch of 12 out of 20 matches in
      hydrophobicity is found. Scruin itself has been found to have an internal tandem
      homology.

PMID- 7787113
TI  - Transients of fluorescence polarization in skeletal muscle fibers labeled with
      rhodamine on the regulatory light chain.
AB  - Structural changes of the myosin heads were correlated with mechanical events in
      the cross-bridge cycle by measuring fluorescence polarization signals at high
      time resolution from rhodamine probes bound to myosin regulatory light chains in
      skeletal muscle fibers. Motions of the cross-bridges were partially synchronized
      either by applying quick length changes to the fibers during active contractions
      or by activating the fibers from rigor by photolysis of caged ATP in the presence
      of Ca2+. With fibers in rigor, the fluorescence polarization values indicate that
      the probe dipoles are quite well ordered and are directed away from the muscle
      fiber axis. After photorelease of ATP from caged ATP, changes in polarization
      signals are consistent with broadening of the distribution of probe orientations.
      The signal deflections occur when ATP binds to actomyosin or when the cross
      bridges detach, but the orientational distribution changes surprisingly little
      during active force development. In contrast, when staircases of quick releases
      are applied to labeled fibers during active contractions, the fluorescence
      polarization signals suggest a concerted rotation of the probes. The results
      indicate that the light chain region of myosin tilts during the quick release
      and/or during the tension recovery phase within the next few ms.

PMID- 7787114
TI  - Millisecond time resolution electron cryo-microscopy of the M-ATP transient
      kinetic state of the acto-myosin ATPase.
AB  - The structure of the AM-ATP transient kinetic state of the acto-myosin ATPase
      cycle has been examined by electron microscopy using frozen-hydrated specimens
      prepared in low ionic strength. By spraying grids layered with the acto-S1
      complex with ATP immediately before freezing, it was possible to examine the
      structure of the ternary complex with a time resolution of 10 ms. Disordered
      binding of the S1 was observed, suggesting more than one attachment geometry.
      This could be due to the presence of more than one biochemical intermediate, or
      to a single intermediate binding in more than one conformation.

PMID- 7787117
TI  - Fetal cells in maternal blood.
AB  - Fetal cells have been successfully detected in maternal blood in all three
      trimesters of gestation in a substantial proportion of normal pregnancies.
      Various enrichment techniques have been developed for fetal trophoblast cells,
      leucocytes and nucleated red blood cells. Nucleated red blood cells are
      considered to be best suited for noninvasive prenatal diagnosis. Fluorescence in
      situ hybridization detected the first cases of fetal trisomy in maternal blood
      after enrichment of fetal nucleated red blood cells. Despite recent encouraging
      results, accurate and reproducible diagnoses of fetal anomalies by polymerase
      chain reaction or fluorescence in-situ hybridization require further optimization
      of enrichment devices and detection protocols.

PMID- 7787118
TI  - Chorionic villus sampling.
AB  - Chorionic villus sampling (CVS) has the great advantage over mid-trimester
      amniocentesis of producing early results. Moreover, rapid analytic techniques
      have significantly reduced the waiting time between sampling and diagnosis,
      whereas progress in recombinant DNA technology and human gene mapping has led to
      an increase in the range of conditions it can detect. The role of CVS in twin
      pregnancy has been investigated and compared with amniocentesis. Although these
      techniques are equally safe, CVS should be considered the approach of choice
      because of a number of technical advantages, and in relation to selective fetal
      reduction in discordant twins. Confined placental mosaicism has been investigated
      and a list of chromosomes related to adverse pregnancy outcome has been compiled.
      Recent reports have substantially contributed to solving the controversy on the
      hypothetical relationship between limb reduction defects and CVS. Analysis of
      limb reduction defects among more than 130,000 cases reported to the World Health
      Organization CVS registry has been unable to find any relationship between
      sampling and fetal malformations, including limb reduction defects.

PMID- 7787119
TI  - Early amniocentesis.
AB  - Amniocentesis before 15 weeks has been introduced in many prenatal diagnosis
      centres. There are, however, major anatomical differences between the appearance
      of fetus at 15-16 weeks, when amniocentesis has normally been performed, and in
      the first and early second trimester. This is mainly because of the presence of
      extraembryonic coelome and the relatively small amount of amniotic fluid in early
      pregnancy. Several small cohort studies have indicated no increased fetal loss
      rate with early amniocentesis. Others have suggested an increased risk of
      respiratory distress among the newborn. The only randomized study published,
      however, found a significantly increased rate of fetal losses after early
      amniocentesis. This incomplete study indicates the urgency of further randomized
      studies of early amniocentesis. A randomized study comparing early amniocentesis
      with transabdominal chorionic villus sampling is being undertaken at our centre
      in Copenhagen using a filter method that reduces the volume of fluid needed for
      karyotyping.

PMID- 7787115
TI  - Changes in the x-ray diffraction pattern from single, intact muscle fibers
      produced by rapid shortening and stretch.
AB  - Changes in the x-ray diffraction patterns produced by 100-microseconds-length
      steps imposed during tetanic stimulation were recorded from single intact fibers
      of frog tibialis anterior muscle. For shortening steps, a staircase length change
      was applied, with a 20-ms interval between steps. For stretches, each 20-ms cycle
      started with a stretch, followed after 4 ms by shortening to the original length.
      Each shortening step in the staircase and each stretch in the stretch/shortening
      protocol produced a response similar to that of a single step from the isometric
      steady state. The intensity of the 14.5-nm x-ray reflection arising from the
      axial repeat of the myosin heads along their filaments decreased after both
      shortening and stretch; this decrease was not accompanied by broadening along or
      across the meridian. The relationship between the intensity after the length step
      and step amplitude was approximately linear for both stretches and shortening
      steps, extrapolating to zero intensity for 11-nm stretches and 13-nm shortening
      steps, but there was no significant intensity change for the first approximately
      2 nm of shortening. These results are broadly consistent with conventional models
      of muscle contraction in which myosin heads move through about 10 nm during the
      working stroke in the shortening direction, but an additional distortion of the
      myosin heads may be produced by a stretch.

PMID- 7787116
TI  - X-ray evidence that in contracting live frog muscles there exist two distinct
      populations of myosin heads.
AB  - Using synchrotron radiation and whole muscles, 2 ms time-resolved x-ray
      diffraction patterns were recorded at 8 degrees C. The results show that in both
      isotonic and isometric contractions, as well as in length changes imposed at
      maximum tension [Po], the meridional third myosin layer line consists of two
      distinct reflections with different intensities and spacings that measure
      approximately 14,623 and 14,412 nm at Po. Although the intensity behavior of the
      two reflections is strikingly different during quick releases, it is very similar
      during stretches. Study of the time courses indicates that myosin heads
      diffracting at Po with the approximately 14.623 nm periodicity are actively
      involved in tension production. Those diffracting at Po with the periodicity of
      approximately 14.412 nm appear not be associated with tension production during
      isometric contraction and releases, but the results suggest that they are
      recruited during stretches and here contribute to tension production. Our most
      important conclusion is that under all conditions of contraction we have
      investigated there exist two populations of myosin heads, each with a well
      defined axial disposition and configuration.

PMID- 7787121
TI  - Multifetal pregnancy reduction and selective termination.
AB  - Multifetal pregnancy reduction has had a major impact upon perinatal morbidity
      and mortality following iatrogenic multiple pregnancies. There are still residual
      risks, however, that are higher for higher order multiples than for pregnancies
      that started out at lower numbers. There are many, but not complete, parallels
      between reductions for number per se, and selective termination because of
      diagnosed abnormalities.

PMID- 7787120
TI  - Early detection of structural anomalies and markers of chromosomal aberrations by
      transvaginal ultrasonography.
AB  - Transvaginal ultrasonography is emerging as the newest method for the early
      detection of structural malformations and markers of chromosomal aberrations.
      According to a multicenter registry on the onset of fetal anomalies, many defects
      are potentially detectable at an early transvaginal scan. Moreover, cystic
      hygroma and other nuchal signs thought to indicate a very significant risk for a
      genetic problem detected during the first trimester may resolve and not be
      detected at the later abdominal scan. Current research presented in this review
      indicates a possible transition from an abdominal scan at 18-22 weeks to two
      scans: an early transvaginal scan at 12-14 weeks for the detection of gross
      congenital anomalies and markers of chromosomal aberrations, and then an
      abdominal scan at 22 weeks for cardiac and other anomalies.

PMID- 7787124
TI  - The pathophysiology of premature rupture of the membranes.
AB  - Premature rupture of the membranes (PROM) is the condition in which the
      chorioamnion is disrupted before the onset of labor. This condition creates a
      dilemma for the practicing obstetrician, because once the membranes have broken
      the risk of fetal or maternal infection, or both, increases. Preterm PROM adds to
      this management challenge, mainly because of the added problem of prematurity.
      Although the epidemiology of PROM has been well defined, the exact etiology has
      yet to be understood. However, using the associated clinical risk factors of
      PROM, researchers in this field have contributed to our understanding of the
      causes. Various mechanisms have been proposed, including mechanical, as well as
      infectious or inflammatory processes. The purpose of this article is to review
      the various proposed mechanisms of PROM. Maternal risk factors for PROM are
      presented, mainly to place into context the current literature involving both in
      vitro and in-vivo research. It is apparent that a single pathophysiologic
      mechanism is not responsible for all cases of PROM, but rather a combination of
      processes is in operation.

PMID- 7787123
TI  - Low-dose aspirin therapy in obstetrics.
AB  - The results of four large controlled clinical trials, encompassing over 13,000
      pregnant women, indicate that low-dose aspirin is of benefit in the prevention of
      pre-eclampsia in women at high risk. The preventive effect on fetal growth
      retardation seems to be small, and no therapeutic benefits could be established.
      Low-dose aspirin appears to be safe for mother, fetus, and neonate.

PMID- 7787125
TI  - Antepartum fetal surveillance.
AB  - In recent years the advances in prenatal diagnosis of fetal asphyxia have been
      dramatic and increasing at a remarkable pace. Now that a solid base of
      multivariable testing has been accepted as the method of choice for assessment of
      fetal health, the focus of clinical research has shifted towards identification
      of factors and signs that might predict not only risk of death and immediate
      morbid outcome but also the quality of life after delivery. The papers reviewed
      here outline the scope of the problem of cerebral palsy and offer clues as to how
      fetal disease may become manifest as child or adult sustained neurological
      injury. Concurrently, the advances in refinement of the testing methods are
      reviewed. Clearly a better understanding of the etiology, physiology, and range
      of fetal responses to asphyxia will be the key to effecting not only better
      survival rates but also a higher quality of survival.

PMID- 7787127
TI  - Early prenatal diagnosis: a range of diagnostic tools: selection or combination?

PMID- 7787122
TI  - Congenital infection.
AB  - The past year has shed much new light on congenital infection. A key development
      has been the application of polymerase chain reaction technology to the diagnosis
      of intrauterine infection. This technique appears to be the diagnostic tool of
      choice for toxoplasmosis and cytomegalovirus. Pharmacologic treatment appears to
      reduce the sequellae of toxoplasmosis when treated either in utero or
      postnatally. Obstetric interventions may reduce vertical transmission. Education
      has been shown to reduce the incidence of seroconversion for toxoplasmosis, and
      HIV-positive women treated with zidovudine have a dramatically reduced rate of
      transmission to their offspring.

PMID- 7787126
TI  - A large placental venous lake.

PMID- 7787128
TI  - Nutritional supplementation and prevention of congenital abnormalities.
AB  - Recent intervention studies have shown a reduction of occurrence and recurrence
      of neural tube defects caused by the periconceptional supplementation of folic
      acid-containing multivitamins or pharmacological doses of folic acid alone. This
      new primary preventive method can also reduce the occurrence of other major
      congenital abnormalities, mainly the reduction of conotruncal cardiovascular
      malformations, defects of the urinary tract, congenital hypertrophic pyloric
      stenosis and congenital limb deficiencies. The rate of cleft lip, palate, or
      both, was not lowered by periconceptional multivitamin supplementation, however.
      The underlying biologic mechanisms of this protective effect are not still
      understood, but naturally occurring folates (polyglutamates) or synthetic folic
      acid (monoglutamate) have a key role. The debate over supplementation concerns
      which vitamins (folic-acid-containing multivitamins, or folic acid alone); what
      doses (0.4 mg, 0.8 mg or 4 mg folic acid) and to whom (whether it is worthwhile
      differentiating between women at high and low risk). At present there are three
      possibilities: folate- and other vitamin-rich diet, supplementation, and food
      fortification to provide appropriate multivitamin and folic acid consumption for
      all women of childbearing age who are capable of becoming pregnant.

PMID- 7787129
TI  - Pharmacokinetics of amoxicillin coadministered with a saline-polyethylene glycol
      solution in healthy volunteers.
AB  - The pharmacokinetics of orally administered amoxicillin were investigated in 12
      healthy volunteers in a crossover design. They received either a placebo or a
      saline-polyethylene glycol solution (SPG) for 4 d, the last dose being given
      simultaneously with 1 g amoxicillin; blood samples were drawn for the next 12 h.
      Amoxicillin kinetics were similar in the two treatments but small differences in
      some pharmacokinetic parameters reached significance. The mean +/- SD area under
      the curve was lower with SPG (43.8 +/- 6.8 against 47.8 +/- 8.2 mg h L-1, p <
      0.05) but the treatments were equivalent according to Westlake's test (95%
      confidence interval = 14.95%). Analysis of SPG against placebo amoxicillin
      absorption kinetics after fitting the data to a Weibull model revealed a longer
      duration of the absorption, a slower rate of absorption, and a different shape of
      the curve. No clinical consequences are expected from these minor variations but
      possible mechanisms could be relevant to other drugs.

PMID- 7787130
TI  - Pharmacokinetics of dolasetron following single- and multiple-dose intravenous
      administration to normal male subjects.
AB  - Dolasetron, Anzemet, a 5-hydroxytryptamine receptor antagonist, is under
      investigation as an antiemetic agent. The keto-reduced metabolite of dolasetron
      has been identified in human plasma and is probably responsible for the majority
      of the antiemetic activity. This study evaluated the pharmacokinetics of
      dolasetron and the reduced metabolite following single and multiple intravenous
      (IV) infusions of dolasetron mesylate in healthy male subjects. Four groups of
      subjects (six active/two placebo) received either dolasetron mesylate or placebo
      in single IV doses ranging from 0.30 to 0.60 mg kg-1 on day 1 and multiple IV
      doses ranging from 0.60 to 1.20 mg kg-1 d-1 on days 2-9. Dolasetron could be
      detected for less than 1 h, while the reduced metabolite appeared rapidly in the
      plasma, reaching a maximal plasma concentration in less than 1 h. Reduced
      metabolic maximal plasma concentration was proportional to the dose and the area
      under plasma concentration curve was linear based on regression analysis. The
      half-life of reduced metabolite ranged from 3.82 to 7.46 h. The mean renal
      clearance of reduced metabolite was 2.20-4.43 mL min-1 kg-1 and was dose
      independent. All of the evidence supports dose independent pharmacokinetics for
      the reduced metabolite. Upon multiple dosing, the reduced metabolite AUC can be
      predicted from the single-dose pharmacokinetics of this metabolite.

PMID- 7787132
TI  - Pharmacokinetic analysis of diethylcarbonate prodrugs of ibuprofen and naproxen.
AB  - The pharmacokinetics of ibuprofen diethylcarbonate (ibudice) and naproxen
      diethythylcarbonate (napdice), two new diethylcarbonate prodrugs of ibuprofen and
      naproxen, was investigated in dogs. The rationale for the development of ibudice
      and napdice was that esterification of the carboxylic moiety of the parent
      compounds would suppress gastrotoxicity without adversely affecting their anti
      inflammatory activity. In addition the biotransformation of the prodrugs to the
      parent compounds may be utilized to achieve rate and time controlled drug
      delivery of the active entities. Following oral administration the
      diethylcarbonate esters were rapidly biotransformed to the parent compounds and
      no ibudice or napdice was detected in the plasma. The relative bioavailability of
      ibuprofen and naproxen, following oral administration of ibudice and napdice, was
      96% and 74%, respectively, and the rate of absorption was not significantly
      different from that obtained following oral dosing of the parent compound.
      Stability studies in gastric and intestinal juice showed that, unlike napdice,
      ibudice was stable in gastric juice, with both prodrugs undergoing rapid
      biotransformation to their parent compounds in intestinal juice. This rapid
      conversion led to the lack of sustained release performance following oral
      administration of ibudice or napidice.

PMID- 7787131
TI  - The effect of food on the absorption of 14C-SDZ FOX 988, an antidiabetic agent,
      in healthy human volunteers.
AB  - The objective of this study is to examine the effect of food on oral absorption
      of SDZ FOX 988 (FOX 988), an antidiabetic agent, and circulating levels of its
      active metabolite, SDZ 53-450 (53-450). Sixteen normal volunteers received a
      single 10 mg dose of 14C-FOX 988, either as gelatin capsules or in a suspension
      (0.5% CMC). For subjects receiving each formulation, four subjects received a
      meal, consisting of 50% fat by calories, immediately following dosing, while the
      other four received the same meal at 2 h post-dose. Serial blood, urine, and
      fecal samples were collected for 120 h and analyzed for total radioactivity.
      Blood concentrations of 53-450 were analyzed using an HPLC-UV method. Concomitant
      administration with food increased the extent of FOX 988 absorption from either
      suspension or capsule, as shown by an increase in AUC and in urinary recovery of
      radioactivity. Blood concentrations of 53-450 were only detected in subjects
      receiving food at dosing. No difference in absorption was observed between the
      capsule and the suspension. Results from this study showed that oral absorption
      of FOX 988 is enhanced by co-administration of food in normal volunteers.

PMID- 7787133
TI  - Disposition of [3H]fluvastatin following single oral doses in beagle dogs and
      rhesus monkeys with bile fistulae.
AB  - The disposition of [3H]fluvastatin was examined following single oral doses in
      dogs (12.4 mg kg-1) and monkeys (0.48 and 45.5 mg kg-1) with bile fistulae.
      Serial plasma and complete urine, feces, and bile were collected at designated
      intervals for 3 or 4 d, and were analyzed for total radioactivity and unchanged
      fluvastatin. In the dog, peak radioactivity concentrations (Cmax) averaged 7260
      ng equiv. mL-1 and the mean time to peak (tmax) was approximately 9 h. In the
      monkey, the mean radioactivity tmax values were approximately 5 and 13 h
      following the low and high doses, the respective Cmax values being 116 and 10,400
      ng equiv. mL-1. The mean AUC of total radioactivity was proportional to the dose
      while that of fluvastatin was overproportional to dose, suggesting dose
      independent absorption but saturable first-pass effect. The AUC ratio of
      unchanged fluvastatin versus total radioactivity was approximately 63% in the
      dog, and 9% and 13% for the low and high doses, respectively in the monkey. The
      bile was the major excretory route of radioactivity (dog, 56%; low-dose monkey,
      73%; high-dose monkey, 69%) whereas the renal pathway accounted for < 5% of the
      dose in both species. Approximately 12% of the biliary radioactivity in the dog
      was due to intact fluvastatin, compared with 0% and 7.5% after the low and high
      doses in the monkey. These results showed a smaller extent of fluvastatin
      metabolism in the dog than in the monkey, and suggested that metabolism in the
      monkey was saturable in the dose range studied.

PMID- 7787134
TI  - The influence of food intake on the effect of two controlled release formulations
      of furosemide.
AB  - Differences in the urinary excretion rate of furosemide may explain discrepancies
      observed between the bioavailability and the total diuretic effect of different
      formulations of this drug. Furosemide was given at a dose of 60 mg as two oral
      controlled release (CR) formulations (FR and LR), with and without breakfast, in
      a randomized, four-treatment, four-period, crossover design to 28 healthy
      volunteers. Urinary volume, and contents of furosemide and sodium, were measured
      in samples taken over 24 h. The extent and rate of absorption of furosemide from
      FR were decreased after breakfast as compared to fasting: the mean (SD) of total
      furosemide excreted decreased from 11.38 (3.12) to 7.73 (1.67) mg, p < 0.0001,
      and the median (range) mean residence time increased from 6.3 (4.1-9.3) to 9.5
      (5.9-11.8) h, p < 0.001. On the other hand, the extent of absorption of LR was
      increased after breakfast, from 8.04 (3.32) to 9.45 (1.83) mg, p < 0.05, without
      a significant change in MRT. FR had a higher extent and rate of absorption than
      LR during fasting, but its extent of absorption was lower than that of LR in the
      postprandial state. Interestingly, the total fraction of furosemide absorbed, as
      estimated from total furosemide excretion, was not correlated with the total
      diuresis (r2 = 0.079) and the differences in drug response compared among the
      four periods were much smaller than would be expected from the differences in
      amount absorbed. This discrepancy may be explained by differences in urinary
      excretion rate of furosemide and, related to this, differences in efficiency
      profiles between the four treatments. Therefore, the urinary excretion profile of
      a formulation of furosemide may be more important for the cumulated drug effect
      than the amount absorbed.

PMID- 7787135
TI  - The influence of pyruvic acid on the pharmacokinetics of sulphadiazine in
      rabbits.
AB  - During the past few years, acetylation polymorphism has been shown to be a
      proven, established fact, and N-acetyltransferase, an enzyme that transfers an
      acetyl group to the substrate, has been recognized as the main factor in
      acetylation polymorphism. In a recent study, a significant difference between the
      acetylation phenotype and plasma pyruvic acid (PA) concentration in rabbits was
      found. In this report, the influence of PA on the pharmacokinetics of
      sulphadiazine (SDZ), a drug that has been used in pharmacogenetic studies of
      acetylation, was studied. By using a loading dose of 300 mg kg-1, and an infusion
      rate of 7.5 mg min-1 kg-1 of PA, the concentration of PA reached a steady state
      (Css approximately equal to 100 micrograms mL-1) in 30 min. During PA infusion in
      rapid-acetylation rabbits, no significant changes were found in any of the
      pharmacokinetic parameters for SDZ. However, differences were found in the beta
      half-life, AUC, clearance, and k10 of SDZ in slow acetylators: the beta half-life
      decreased from 115.74 +/- 12.47 min to 62.96 +/- 4.36 min (p < 0.001); AUC
      decreased from 10,617.38 +/- 1179.81 micrograms min mL-1 to 6217.14 +/- 391.32
      micrograms min mL-1 (p < 0.001); clearance increased from 0.0044 +/- 0.0008 L min
      1 kg-1 to 0.0068 +/- 0.0007 L min-1 kg-1 (p < 0.001); and k10 increased from
      0.0090 +/- 0.0009 min-1 to 0.0193 +/- 0.0028 min-1 (p < 0.005). The reason for
      this may be that PA influences the elimination of SDZ in slow-acetylation
      rabbits.

PMID- 7787136
TI  - The effect of water deprivation on the pharmacokinetics of methotrexate in rats.

PMID- 7787137
TI  - The effect of dehydration on the disposition kinetics of propranolol in rats.

PMID- 7787138
TI  - Presidential address. Personal views on health care issues.

PMID- 7787139
TI  - Structure-stabilizing forces in the glomerular tuft.
AB  - The glomerular tuft is constantly exposed to considerable expansile forces
      resulting from high capillary pressures. Counterforces must be generated in order
      to maintain structural stability. This review analyzes those structures of the
      glomerular tuft capable of developing such stabilizing forces. Two systems are
      described. A basic system consists of the glomerular basement membrane (GBM) and
      the mesangium. The GBM represents the main skeletal element of the glomerular
      tuft. In general, opposing portions of the GBM are bridged by contractile
      mesangial cell processes, generating inwardly directed forces that balance the
      expansile forces resulting from pressure gradients across the GBM. A second
      structure-stabilizing role of the podocytes appears to be superimposed on this
      system. Podocytes are attached to the GBM by numerous foot processes that contain
      a contractile system. The foot process attachments probably stabilize small
      patches of the underlying GBM, counteracting local elastic distension. In
      addition, podocytes may contribute to the stabilization of the folding pattern of
      the tuft by linking neighboring capillary loops to each other.

PMID- 7787141
TI  - Intravenous immune globulin in the treatment of patients with systemic lupus
      erythematosus and end-stage renal disease.
AB  - Intravenous immune globulin (IVIg) has been advocated as efficacious therapy for
      a variety of disorders including idiopathic thrombocytopenic purpura and Kawasaki
      disease. Several reports have also documented the effectiveness of IVIg in
      systemic lupus erythematosus (SLE). Two patients with symptomatic SLE and ESRD
      were treated with IVIg. Both patients tolerated IVIg administration well and
      demonstrated clinical and serologic improvement. Both individuals also
      experienced a transient decline in serum albumin concentration with IVIg
      treatment. The mechanisms by which IVIg might have effected improvement in these
      patients are varied and are likely related to the immunomodulatory actions of
      IVIg. The reversible change in albumin concentration seen in these individuals
      may be secondary to abrupt alterations in oncotic homeostasis. Despite this
      unusual effect, the documented improvement in these patients suggests that IVIg
      therapy may be of benefit in patients with active SLE and ESRD. Further studies
      are warranted to examine the mechanisms by which IVIg may exert its therapeutic
      effect.

PMID- 7787140
TI  - Rapidly progressive glomerulonephritis after immunotherapy for cancer.
AB  - Cytokines have been used in experimental and standard protocols for immune
      enhancement for cancer. The combination of interleukin-2 and interferon-alpha 2
      beta has been used in experimental protocols for metastatic renal cell carcinoma.
      A man who developed rapidly progressive renal failure after receiving this
      combination therapy is reported. A renal biopsy revealed a pauci-immune
      crescentic glomerulonephritis. Antineutrophil cytoplasmic antibodies and
      antiglomerular basement membrane antibodies were absent. The spectrum of renal
      disease and potentially related extrarenal manifestations associated with
      interleukin-2 and inteferon-alpha are reviewed. A pathogenesis of altered cell
      mediated immunity, consistent with abnormalities in extrarenal organs after
      immune enhancement, is proposed.

PMID- 7787142
TI  - Renal hemodynamics and sodium handling in moderate renal insufficiency: the role
      of insulin resistance and dyslipidemia.
AB  - Insulin infusion during euglycemia causes antinatriuresis and renal vasodilation
      in healthy humans, whereas the effects of acute insulin infusion on tubular
      sodium handling and renal hemodynamics in chronic renal disease are unknown. The
      response to euglycemic insulin infusion was investigated in two homogeneous
      patient groups with a slight renal impairment-one with nephrotic syndrome (GFR,
      64 mL/min; N = 9) and one with non-nephrotic immunoglobulin A nephropathy (GFR,
      70 mL/min; N = 8). In addition, nine renal transplant recipients (GFR, 44 +/- 6
      mL/min) were investigated. The results were compared with those of 12 healthy
      controls (GFR, 105 +/- 4 mL/min). Renal hemodynamics and renal tubular sodium
      handling were estimated with inulin, p-aminohippurate, sodium, and lithium
      clearances. The results showed that patients with nephrotic syndrome (5.0 +/- 0.4
      mg/kg per minute) and renal transplant recipients (4.8 +/- 0.6 mg/kg per minute)
      had a significant lower metabolic clearance of glucose as compared with control
      subjects (7.9 +/- 0.4 mg/kg per minute), whereas patients with immunoglobulin A
      nephropathy (6.7 +/- 0.6 mg/kg per minute) had a metabolic clearance of glucose
      that was similar to that of the controls. Despite insulin resistance to
      carbohydrate metabolism, insulin infusion still induced hypokalemia and
      antinatriuresis in patients with nephrotic syndrome and renal transplant
      recipients. Insulin infusion caused a significant 13% increase in RPF and lithium
      clearance in control subjects, and a positive Spearman rank correlation (Rs =
      0.41; P < 0.05) was observed between the changes in p-aminohippurate and lithium
      clearances during insulin infusion in the combined patient group, suggesting that
      impaired renal vasodilation may contribute to abnormal proximal tubular sodium
      handling and sodium retention. The results also suggest that hypertriglyceridemia
      could be a factor contributing to abnormal proximal tubular sodium handling in
      chronic renal disease.

PMID- 7787144
TI  - Impaired renal autoregulatory ability in dogs with reduced renal mass.
AB  - In normal dogs, the renal autoregulatory mechanism limits the effect of changes
      in renal arterial pressure (RAP) on RBF, renal outer cortical blood flow (OCBF),
      and GFR by adjusting the vascular tone of the preglomerular arterioles. To
      determine the extent to which autoregulatory ability was impaired in remnant
      renal tissue in dogs, the effects of variations in RAP on RBF, OCBF, and GFR were
      studied after sham-operation (Group 1; N = 5), 3/4 nephrectomy (Group 2; N = 5),
      or 7/8 nephrectomy (Group 3; N = 5). In Group 1, the RBF, OCBF, and GFR were not
      significantly affected by variations in RAP between 75 and 125 mm Hg, indicating
      intact renal autoregulatory ability. In contrast, both groups of partially
      nephrectomized dogs exhibited a loss of renal autoregulatory ability below 100 mm
      Hg (P < 0.05). As RAP rose above 100 mm Hg, dogs with 7/8 nephrectomy exhibited a
      greater increase than control dogs in RBF (0.586 +/- 0.211 versus -0.080 +/-
      0.030 percent change in RBF/mm Hg change in RAP; P < 0.05), OCBF (0.408 +/- 0.157
      versus -0.059 +/- 0.054 percent change in RBF/mm Hg change in RAP; P < 0.05), and
      GFR (0.784 +/- 0.230 versus 0.134 +/- 0.049 percent change in RBF/mm Hg change in
      RAP; P < 0.05). The ability of the renal vasculature to maintain renal function
      stable above 100 mm Hg was intermediate in Group 2 and not significantly
      different from corresponding values for Group 1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787143
TI  - Renal hemodynamics and plasma and kidney angiotensin II in established diabetes
      mellitus in rats: effect of sodium and salt restriction.
AB  - Six weeks after the onset of insulin-treated streptozotocin diabetes (STZ) in
      Munich-Wistar rats, the effect of a low-sodium (LNa) and a low-salt (LNaCl) diet
      on renal function and on plasma and kidney tissue angiotensin II (AIIp, AIIk) was
      tested. Clearance experiments were performed in anesthetized rats 7 days after
      starting on LNa or LNaCl. On a control diet, STZ exhibited an increase in GFR,
      RBF, and kidney weight (KW) and a reduction in renal vascular resistance (RVR)
      and AIIk, but no change in AIIp, compared with nondiabetic normal rats (CON).
      Although sodium restriction reduced and salt restriction increased AIIk in CON,
      both diets increased AIIp without affecting renal hemodynamics or KW. In diabetic
      rats, both salt and sodium restriction further increased GFR and RBF by reducing
      RVR, increased KW, and changed AIIk and AIIp in a similar pattern, but at
      significantly lower values compared with CON. Daily treatment of STZ-LNa with the
      AII-receptor blocker losartan (20 mg/L, in drinking water) did not affect the
      reduction in RVR and the increase in KW but slightly reduced RBF because of a
      decrease in mean arterial blood pressure and further increased GFR. It was
      concluded that (1) AIIk but not AIIp is affected differently by LNa compared with
      LNaCl in both CON and STZ; (2) LNaCl and LNa change AIIp and AIIk in a similar
      pattern but at significant lower values in STZ compared with CON; and (3) with
      regard to renal hemodynamics and KW, the response to LNa and LNaCl is different
      in CON compared with rats 6 wk after the onset of diabetes mellitus, the latter
      exhibiting a further increase in renal hyperfiltration and KW by a mechanism that
      is not directly AII receptor dependent.

PMID- 7787145
TI  - The study of the effect of intensity of blood pressure management on the
      progression of type 1 diabetic nephropathy: study design and baseline patient
      characteristics. Collaborative Study Group.
AB  - A randomized, prospective, clinical trial has been initiated to continue follow
      up in a subset of the patients previously enrolled in the recently completed
      Study of Angiotensin-Converting Enzyme Inhibition (ACEi) in Type 1 Diabetic
      Nephropathy. In that study, the use of captopril was associated with a 48%
      reduction in the risk of doubling the serum creatinine and a 50% reduction in the
      risk of experiencing dialysis, transplantation, or death, compared with the use
      of placebo. These effects were independent of captopril's effect on the blood
      pressure. This study is designed to determine whether the level of mean arterial
      blood pressure (MAP), using the ACE inhibitor ramipril as the primary therapy, is
      associated with an improved prognosis of diabetic nephropathy with respect to (1)
      the rate of decline in renal function; (2) the rate of progression to end-stage
      renal failure; (3) the clinical course of proteinuria; (4) morbidity; and (5)
      mortality. Patients are randomized into one of two distinct blood pressure
      control groups, an Intensive Group #1, MAP < or = 92 mm Hg; and a Moderate Group
      #2, MAP 100 to 107 mm Hg. Patients previously enrolled in the "Study of ACEi in
      Type 1 Diabetic Nephropathy" whose serum creatinine was less than 4.0 mg/dL (354
      mumol/L) were eligible for randomization into this study. All patients will
      receive ramipril (2.5 to 10.0 mg/day) as the primary therapy, with the addition
      or removal of other antihypertensive agents as needed to achieve the assigned
      blood pressure goal.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787146
TI  - Prostaglandin F2 alpha- and 12-O-tetradecanoylphorbol-13-acetate-induced
      alterations in the pathways of renal ammoniagenesis.
AB  - The mechanisms whereby prostaglandin F2 alpha (PGF2 alpha) and the phorbol ester
      12-O-tetradecanoylphorbol-13-acetate (TPA) inhibit ammoniagenesis and the reason
      why they behave differently at pH 7.4, were examined with (15N)glutamine to
      assess the metabolic pathways and 2'-7'-bis(2-carboxyethyl)-5-(and-6)
      carboxylfluorescein, acetoxymethylester (BCECF-AM) to evaluate Na+/H+ antiporter
      activity. LLC-PK1 cultures were incubated for 1 h in a Krebs-Hensleit bicarbonate
      buffer of pH 7.4 and pH 6.8 supplemented either with 5-15N- or 2-15N-labeled
      glutamine, followed by the assessment of (15N)ammonia and (15N)amino acid
      formation. Exposure of cells to either PGF2 alpha or TPA completely inhibited the
      low pH-induced increases in (15N)ammonia formation from incubations with 5-15N,
      reflecting reduced flux through the mitochondrial phosphate-dependent
      glutaminase, and from (2-15N)glutamine, reflecting reduced flux through the
      mitochondrial glutamate dehydrogenase pathway. They also qualitatively reversed
      the acute acidosis-induced changes in (15N)alanine formation and (15N)glutamate
      accumulation in the media. By contrast only TPA, but not PGF2 alpha, modified
      glutamine metabolism at pH 7.4. Na+/H+ antiporter activity was assessed under
      both acidified and basal (pH 7.4) conditions by measuring changes in
      intracellular pH in cells loaded with BCECF. TPA and PGF2 alpha both stimulated
      Na+/H+ antiporter activity comparably under acidified conditions. When cells were
      studied at pH 7.4, TPA but not PGF2 alpha stimulated the Na+/H+ antiporter and
      increased steady-state intracellular pH.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787147
TI  - Modifications in glomerular polyanion distribution in adriamycin nephrosis.
AB  - Previous reports have suggested that, in proteinuria induced by adriamycin (ADR),
      the functional size barrier of the glomerular basement membrane (GBM) is altered
      as the result of a sieving defect, whereas the functional charge barrier of the
      glomeruli remains intact. The aim of this study was to reevaluate the effect of
      ADR on anionic constituents in the glomerular capillary wall (GCW). Kidneys of
      nephrotic rats, induced by the injection of 7.5 mg/kg ADR, and controls were
      resected, and cortices were isolated 24 h and 10 days postinjection, fixed with
      formaldehyde, and embedded in paraffin. For the histochemical evaluation of
      sialyl residues, deparafinized sections were treated with biotin-labeled peanut
      agglutinin (PNA), before or after neuraminidase treatment. PNA binding was
      visualized by the avidin-biotin-peroxidase complex and interacted with hydrogen
      peroxide and diaminobenzidine. For electron microscopy, kidney cortices were
      fixed with glutaraldehyde and embedded in araldite or LR-white. The postembedding
      localization of anionic sites was carried out by cationic colloidal gold (CCG),
      directly applied on thin LR-white sections. Although in the 24-h ADR group,
      kidney functions and glomerular morphology were generally unaltered, the 10-day
      ADR group exhibited severe proteinuria, hypoalbuminemia, and massive fusion of
      intercalated foot processes of the podocytes. Intense PNA binding was observed
      after neuraminidase treatment in the GCW of the controls. This was gradually
      decreased in the 24-h ADR kidneys and further decreased in the 10-day ADR,
      indicating a gradual decrease in glomerular sialic acid content.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7787148
TI  - Familial risk, age at onset, and cause of end-stage renal disease in white
      Americans.
AB  - A strong familial clustering of ESRD has been reported among African Americans,
      suggesting that factors predisposing to renal failure, whether genetic,
      environmental, or both, may disproportionately affect certain families. A case
      control study was undertaken to determine if a familial risk of ESRD was present
      among white Americans, if this risk differed among causes of ESRD, and if
      variability in age at onset was attributed to familial factors. Data were
      obtained from 103 white American patients (cases) with ESRD receiving dialysis
      treatments at the Bowman Gray School of Medicine's affiliated dialysis facility
      in Winston-Salem, NC. One hundred three age-, sex- and race-matched non-ESRD
      controls were consecutively selected from the Wake Forest University Physicians
      internal medicine clinic. Odds ratios (OR) and associated 95% confidence
      intervals (CI) were calculated to signify the prevalence of a relative with ESRD
      among cases versus controls. The presence of either a first- or second-degree
      relative increased a white American's risk for developing ESRD nearly threefold
      (OR = 2.7, 95% CI 1.1 to 7.2; P = 0.038), whereas the presence of either a first
      , second- or third-degree relative with ESRD increased the risk nearly fourfold
      (OR = 3.5, 95% CI 1.5 to 8.4; P = 0.004). Cases with chronic glomerulonephritis
      and Type II diabetic nephropathy as the cause of ESRD had relatives with ESRD
      more often than cases with Type I diabetic nephropathy, interstitial nephritis,
      or renal artery stenosis. The average correlation (f) of ages at onset of ESRD
      among individuals in a single family (cases and their relatives) was
      55%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787149
TI  - Dietary vitamin E supplementation ameliorates renal injury in chronic puromycin
      aminonucleoside nephropathy.
AB  - Chronic puromycin aminonucleoside nephropathy (PAN) is an experimental analog of
      focal segmental glomerulosclerosis. Progressive renal damage in this model is
      partly mediated by excessive production of oxidant species. Whether dietary
      supplementation with vitamin E, an endogenous lipophilic antioxidant, ameliorates
      the severity of chronic PAN was tested. PAN was induced by seven serial
      injections of the glomerular epithelial cell toxin puromycin aminonucleoside, 2
      mg/100 g body wt per dose, over a 12-wk period. Experimental animals (N = 8)
      received vitamin E-enriched chow (100 IU/kg), whereas control PAN rats (N = 10)
      were fed standard rodent diet containing vitamin E (30 IU/kg of chow). The
      administration of vitamin E had no effect on somatic growth or blood pressure;
      however, rats with PAN fed the vitamin E-enriched diet had an increased
      hematocrit. In addition, the experimental diet resulted in a 50% reduction in
      urinary total protein and albumin excretion and stabilization of the serum
      albumin, cholesterol, and triglyceride concentrations (P < 0.01). The inulin
      clearance was 69% higher in the vitamin E-supplemented animals (P < 0.001).
      Tubular function, namely, phosphate reabsorption and beta 2-microglobulin
      excretion, was improved in rats with chronic PAN treated with the vitamin E
      enriched diet. There was a significant decrease in glomerulosclerosis and
      glomerular planar area, and tubulointerstitial scarring was diminished in vitamin
      E-treated animals with chronic PAN (P < 0.01). These beneficial effects on renal
      structure and function were associated with reduced malondialdehyde content in
      the kidney and liver.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787150
TI  - Aggressive, long-term cyclosporine therapy for steroid-resistant focal segmental
      glomerulosclerosis.
AB  - Short-term cyclosporine (CsA) has been shown to reduce the proteinuria in
      refractory nephrotic syndrome, but the effect on disease progression has not been
      evaluated. This study was undertaken to evaluate whether maintenance CsA therapy
      in steroid-resistant focal segmental glomerulosclerosis (FSGS) will prevent
      progression to ESRD. Twenty-one black and Hispanic children (mean age, 8.4 +/-
      4.5 yr) with biopsy-proven, steroid/cyclophosphamide-resistant FSGS were treated
      with CsA (initiated at 6 mg/kg per day and titrated to the serum cholesterol
      level to achieve a response). The mean CsA dose was 7 (4 to 20) mg/kg per day,
      the duration of CsA therapy was 27.5 (3 to 97) months, and the duration of follow
      up was 8.5 +/- 4.7 yr. At the end of CsA therapy, the mean (+/- SE) proteinuria
      fell from 6.2 +/- 0.2 to 2.0 +/- 0.1 g/24 h (P < 0.001), the mean albumin rose
      from 1.95 +/- 0.04 to 3.41 +/- 0.04 g/dL (P < 0.001), the mean cholesterol
      decreased from 472 +/- 12.7 to 257 +/- 5.3 mg/dL (P < 0.005), and the mean
      creatinine rose from 0.79 +/- 0.02 to 1.16 +/- 0.03 mg/dL (P < 0.005). Seven
      children continue to receive maintenance CsA therapy, and 14 patients have had
      CsA stopped: 6 for an increase in serum creatinine and/or continued proteinuria,
      5 for sustained remission, 2 for noncompliance, and 1 for pregnancy. Five (24%)
      of the 21 patients progressed to ESRD.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787152
TI  - Comparison of continuous ambulatory peritoneal dialysis-related infections with
      different "Y-tubing" exchange systems.
AB  - Despite several modifications of the continuous ambulatory peritoneal dialysis
      (CAPD) technique over the last decade, peritonitis remains a major source of
      morbidity and is the leading cause of dropout for patients maintained on CAPD
      therapy. Recently, Baxter Healthcare introduced the Ultra Twin bag system, which
      uses drainage and infusion bags both secured to Y connecting tubing. Previous
      nonrandomized studies comparing the Ultra Twin bag system with other systems have
      indicated an improvement in the peritonitis rate with the Ultra Twin bag system.
      In this study, 82 patients were randomized to use the Ultra Twin bag system or
      the Ultra Y-set system, which uses only the drainage bag already attached to the
      Y connecting tubing. Peritonitis rates were significantly lower with the Ultra
      Twin bag system, one episode per 33.9 patient months, compared with the Ultra Y
      set system, one episode per 11.7 patient months (P < 0.05). Furthermore, the 1-yr
      infection-free survival rates with the Ultra Twin bag system and the Ultra Y-set
      system were 71 and 40%, respectively. Exit-site infections were lower with the
      Ultra Twin bag system, one episode per 12.5 patient months, compared with the
      Ultra Y-set system, one episode per 28.3 patient months, although this difference
      was not statistically significant (P = 0.084). The effect of the reduction in the
      infection rate on patient dropout with the Ultra Twin bag system remains to be
      addressed.

PMID- 7787153
TI  - The development of hypertension in the remnant kidney model after either pole
      resection or partial infarction of the kidney.

PMID- 7787154
TI  - Ras oncogene and p53 gene hotspot mutations in colorectal cancers.
AB  - Ras oncogene and p53 gene mutations are frequently observed in colorectal
      cancers. The role of co-operation between these two genes in the tumorigenesis of
      colorectal cancer was evaluated. Point mutations in K-ras oncogene and hotspot
      codons of p53 gene of colorectal cancers were evaluated by naturally created or
      amplified created restriction site method. Nine of 42 cases (21.4%) of colorectal
      cancer showed K-ras oncogene mutations. Six of 42 cases (14.3%) of colorectal
      cancer showed p53 gene hotspot point mutations. The low frequency of p53 gene
      mutation in this series may be due to racial difference or different hotspot
      codons. When six cases with mutated p53 gene were examined, only one (16.7%)
      showed concurrent K-ras oncogene codon 12 and p53 gene codon 248 mutations. We
      concluded that the co-operation between ras oncogene and p53 gene hotspot point
      mutations in the tumorigenesis of colorectal cancer in Chinese was not common.
      Other factors such as adenomatous polyposis coli gene mutations, oncogene
      activation or tumour suppression gene inactivation may be involved.

PMID- 7787155
TI  - The effects of abdominal irradiation for seminoma of the testis on
      gastrointestinal function.
AB  - To evaluate the long-term effects of abdominal irradiation for the treatment of
      seminoma of the testis on gastrointestinal function, 15 randomly selected
      patients who had been treated for stage I seminoma of the testis 2-10 years
      previously had the following parameters of gastrointestinal function evaluated:
      gastrointestinal symptoms; absorption of bile acid; vitamin B12; lactose and fat;
      gastric emptying; small intestinal and total gut transit; and intestinal
      permeability. Results were compared to those obtained in 18 normal volunteers.
      There was an increased prevalence of gastrointestinal symptoms (P < 0.01) in the
      patients and stool frequency was above the control range in two of them. Gastric
      emptying was faster (P < 0.01) in the patients. There were no significant
      differences in vitamin B12, bile acid, lactose or fat absorption, small
      intestinal transit or whole gut transit between the two groups, although faecal
      fat excretion was greater than the control range in three of the patients. At
      least one parameter of gastrointestinal function was abnormal in 11 of the 15
      patients. Patients with right-sided seminoma had a greater bowel frequency when
      compared to those with left-sided seminoma (P < 0.05). We conclude that mild
      abnormalities in gastrointestinal function occur frequently when abdominal
      irradiation is used to treat stage I seminoma.

PMID- 7787151
TI  - Behavioral compliance with dialysis prescription in hemodialysis patients.
AB  - The relationship between compliance and outcome is poorly understood, partially
      because there has been no gold standard for measuring compliance in hemodialysis
      patients. To investigate interrelationships between psychological, medical, and
      compliance factors, hemodialysis (HD) patients were studied with the Beck
      Depression Inventory, and a subset, the Cognitive Depression Index, the
      Perception of Illness Effects scale, and the Multidimensional Scale of Perceived
      Social Support. Behavioral compliance was measured in three ways: (1) percent
      time compliance (signifying "shortening behavior"); (2) percent attendance
      (signifying "skipping behavior) (3) percent total time compliance, assessing
      patients' time on dialysis normalized for prescribed time, including all
      shortenings and absences. Standard compliance indicators (predialysis serum
      potassium and phosphorus concentrations and interdialytic weight gain) were also
      analyzed. The patients' mean Beck Depression Inventory was in the range of mild
      depression. The prevalence of depression was 25.5%. Both depression indices
      correlated with Perception of Illness Effects scale scores. In general, social
      support was related to both measures of depression and perception of illness
      effects. Total time compliance was 95.8 +/- 5.0%. Younger patients were more
      likely to skip treatments compared with older patients. Time compliance comprised
      a wide spectrum, with most patients relatively compliant, whereas a small
      proportion received far less than their prescribed dialysis. Skipping and
      shortening behaviors did not correlate, suggesting that these constitute two
      separate types of noncompliant behaviors. Time compliance parameters did not
      correlate with potassium levels or interdialytic weight gain, but did correlate
      with phosphorus levels. Interrelationships between behavioral compliance measures
      and other parameters varied between units and patients of different gender.
      Finally, behavioral compliance patterns were stable over months in
      patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787156
TI  - Familial juvenile polyposis with adenomatous-carcinomatous change.
AB  - A family tree of 118 members with five members found to have juvenile polyposis
      adenomatous change and four juvenile polyposis-adenomatous-carcinomatous change
      is presented. All the patients developed bleeding per rectum between 10 and 17
      years of age. Four members died of colonic malignancy between 30 and 55 years of
      age. Colonoscopy in five living members revealed typical juvenile polyps
      throughout the whole length of the colon and atypical large lobulated polyps
      containing adenomatous change in juvenile polyps in the rectosigmoid area. An
      autosomal dominant mode of transmission was evident on analysis of the pedigree.
      Gastric hyperplastic polyps were present in three of the five living members.
      Familial juvenile polyposis may have the potential to progress into adenoma
      carcinoma sequence and is not always a benign disorder. Colonoscopic surveillance
      should be done to detect adenomatous change if any member of the juvenile
      polyposis family develops colonic malignancy.

PMID- 7787157
TI  - A single standard nocturnal dose of nizatidine enhances the healing of active
      duodenal ulcers among Chinese.
AB  - Chinese people have a lower maximal acid output and gastrin response to meals
      compared to Western people. The aim of the present study was to assess the
      efficacy of a half-single nocturnal dose of nizatidine (150 mg at bedtime [h.s.],
      n = 40) with a standard full dose given once nightly (300 mg h.s., n = 38) or
      twice daily (150 mg twice a day [b.i.d.], n = 43) in the treatment of Chinese
      patients with active duodenal ulcers. An endoscopy was performed upon entry and
      at 4 week intervals until the ulcer healed (up to 8 weeks). There is no
      statistical difference in healing rates after 4 weeks of treatment (52.5, 52 and
      47% in nizatidine 150 mg h.s., 150 mg b.i.d. and nizatidine 300 mg h.s.,
      respectively) whereas nizatidine 300 h.s. had a significantly higher healing rate
      compared to nizatidine 150 mg h.s. and b.i.d. after 8 weeks of treatment (89 vs
      70 and 67%, P < 0.05) by uni- and multivariate analysis of clinical and
      endoscopic characteristics. Symptomatic response was not significantly different
      in these three treated groups. Our study suggested that a half-single nocturnal
      dose of nizatidine is not ideal for the treatment of duodenal ulcer in Chinese
      patients, whereas a single standard nocturnal dose appears more effective than a
      twice-daily regimen.

PMID- 7787159
TI  - Sulphated macromolecules produced by in vivo labelling in the rat gastric mucosa.
AB  - The aim of this study was to investigate the nature and distribution of sulphated
      macromolecules of the extracellular matrix in rat gastric mucosa. This was
      achieved by developing an in vivo labelling system. An intraperitoneal injection
      of 1 mCi [35S]-sulphate was given for either 4 h (0.01% incorporation into
      macromolecular fraction) or 8 h (0.13% incorporation). At the end of the
      labelling period the stomach was removed and the mucosa and submucosa was either
      taken as a single combined sample or separated into four layers by blunt
      dissection. Each sample was papain digested and analysed by ion-exchange
      chromatography. This analysis revealed sulphated species of differing charge
      existing in differing proportions throughout the mucosa. These sulphated species
      eluted at NaCl concentrations of approximately 0 (A), 0.19 (B), 0.34 (C) and 0.78
      mol/L (D) from a Q-Sepharose ion exchange column. Further analysis by size
      exclusion chromatography and chemical and enzymatic digestion showed that peaks B
      and C had molecular weights of 2.4 x 10(5) and 2.8 x 10(5), respectively and were
      resistant to chondroitinase ABC, heparitinase and nitrous acid digestion. Peak D
      was found to contain a polydisperse population of molecules with a molecular
      weight range of approximately 1 x 10(4) to 6 x 10(4). This sample was susceptible
      to nitrous acid and chondroitinase ABC digestion and was found predominantly in
      the sample isolated from deeper in the tissue. We have thus developed an in vivo
      labelling technique for sulphated macromolecules that can be used in the further
      study of injury to the gastric mucosa.

PMID- 7787158
TI  - Colonic mucosal antioxidant enzymes and lipid peroxide levels in normal subjects
      and patients with ulcerative colitis.
AB  - Oxygen-derived free radicals have been implicated in the pathogenesis of
      ulcerative colitis. Mammalian tissues contain antioxidant systems that offer
      protection from the damaging effect of these active species. In the present
      study, the activity of the antioxidant enzymes catalase, glutathione peroxidase,
      glutathione transferase and glutathione reductase were measured in rectal
      biopsies from patients with ulcerative colitis and compared with that obtained
      from normal subjects. A significant decrease in the activity of glutathione
      transferase was observed in ulcerative colitis (48.32 +/- 6.73 units/mg protein,
      mean +/- s.e.) compared to normal (68.20 +/- 6.83; P = 0.015). There was no
      difference in the activity of other antioxidant enzymes between controls and
      ulcerative colitis. Myeloperoxidase, a marker for neutrophil infiltration, was
      considerably increased in ulcerative colitis while malonaldehyde, the end product
      of lipid peroxidation, was not increased. The reduced activity of glutathione
      transferase in ulcerative colitis may be an additional factor in the pathogenesis
      of mucosal damage in this disease.

PMID- 7787161
TI  - Immunoglobulin G subclass distribution of human anticolon antibodies in
      ulcerative colitis.
AB  - Immunoglobulin G (IgG) subclasses of anticolon antibodies were studied in
      patients with ulcerative colitis (UC) using enzyme-linked immunosorbent assay
      (ELISA). The concentrations of total serum IgG subclasses were also measured by
      ELISA. The values for total serum IgG subclasses in patients with UC were not
      significantly different from those in normal controls, while the ratio of IgG1 to
      IgG2 in the patients was significantly higher than that in normal controls. All
      four IgG subclasses of autoantibodies were demonstrated in the sera of the
      patients. IgG4 anticolon antibodies were detected most frequently (15 out of 18
      patients, 83%). IgG2 was the next most prevalent (9 of 18 patients, 50%). The
      activity of anticolon antibodies in each subclass did not correlate with the
      concentration of the corresponding serum IgG subclass. Seven cell lines producing
      anticolon antibodies were obtained from the colonic mucosa of the patients by
      Epstein-Barr virus (EBV) transformation. IgG subclasses of anticolon antibodies
      secreted by these cell lines were also varied. IgG4 subclass was secreted by
      three EBV transformed cell lines, all of which produced IgG4 anticolon
      antibodies. These results suggest that all four different IgG subclasses could
      respond to the colon antigens and that various antigens in colonic mucosa or
      lumen may contribute to the induction of those autoantibodies. In addition, the
      prominence of IgG4 anticolon antibodies may support the pathogenic role of this
      subclass in UC as in other autoimmune diseases.

PMID- 7787162
TI  - Plasma kallikrein clearance by the liver of chronic carbon tetrachloride-treated
      rats.
AB  - We have previously reported that the endocytosis of rat plasma kallikrein (RPK)
      by hepatocytes is a calcium-independent and beta-galactoside-dependent mechanism.
      We now report the clearance of RPK by the liver of four groups of rats: normal,
      inflamed (48 h ex-turpentine) and two groups chronically treated with CCl4 (52
      mg/kg per week, intragastrically, for 9-12 weeks). Each liver was isolated,
      exsanguinated and perfused at 37 degrees C with 30 mL of BSA-Krebs-Henseleit
      bicarbonate medium containing 10 nmol/L RPK. Although all rats received the same
      mild CCl4 treatment, the liver histology showed that they evolved either to
      severe hepatitis (serum alanine aminotransferase [ALT] 4852 +/- 885 U/L,
      parenchymatous necrosis in the perivenous region) or to compensated cirrhosis
      (serum ALT 209 +/- 42 U/L, vigorous fibrous encircling regeneration nodules);
      neither jaundice nor ascites was noted. The results show that serum albumin was
      not altered among the groups and that: the acute-phase response by itself
      (inflamed group) increased RPK clearance rate (3.01 +/- 0.59 mL/min) as compared
      with the normal group (1.85 +/- 0.14 mL/min); the CCl4 treatment, although
      induced an acute-phase response, decreased (P < 0.01) RPK clearance rates (0.80
      +/- 0.11 mL/min hepatitis group and 0.98 +/- 0.10 mL/min cirrhosis group). These
      findings suggest that the hepatic clearance rate of plasma kallikrein is an early
      indicator of liver injury.

PMID- 7787160
TI  - Correlation between serum pepsinogen concentration and gastric acidity measured
      by 24 h pH monitoring.
AB  - The relationship between the intragastric pH measured by 24 h pH monitoring
      system and the serum pepsinogen I/II ratio was studied in 68 cases. When
      pepsinogen I/II ratio was compared with pH 3.0 holding time (the percentage time
      during which the gastric pH is above 3.0), there was a negative correlation
      between these two parameters (correlation coefficient r = -0.62, P < 0.001).
      Furthermore, there was also a strong negative correlation between the early
      morning (from 03.00 to 06.00 h) gastric pH and pepsinogen I/II ratio (r = -0.76,
      P < 0.001). Accordingly, by simply measuring serum pepsinogen I and II, it may be
      possible to infer gastric acidity and to obtain the information concerning the
      early morning intragastric pH.

PMID- 7787164
TI  - Carbohydrate-deficient transferrin in alcoholics with liver disease.
AB  - To assess the relationship between carbohydrate-deficient transferrin (CDT) and
      alcoholic liver disease, we measured the ratio of carbohydrate-deficient
      transferrin to total transferrin (rCDT) in 32 male alcoholics with liver disease
      (Child-Pugh class A, 8; B, 11; C, 13) and 14 male alcoholics without clinically
      evident liver disease. Twenty of 32 with liver disease and six of 14 without
      clinically apparent liver disease had recent abstinence. The 32 patients with
      liver disease were assessed, in addition to the Child-Pugh class, using a linear
      prognostic score, the Combined Clinical and Laboratory Index (CCLI). Transferrin
      and CDT were measured by isocratic anion exchange chromatography and a radio
      immunoassay. When the total group (n = 46) was divided into those with recent
      abstinence (n = 26) and those without (n = 20), the rCDT was lower in the
      abstainers than non-abstainers (0.7 +/- 0.6 vs 2.9 +/- 2.4, P < 0.005).
      Similarly, abstainers with liver disease (n = 20) had a significantly lower rCDT
      than non-abstainers (n = 12) with liver disease (0.7 +/- 0.7 vs 3.5 +/- 2.8, P <
      0.005). The rCDT in the 20 abstaining patients with liver disease did not differ
      significantly between Child-Pugh classes. Furthermore, there was no correlation
      between the CCLI and rCDT (r = 0.05). We conclude that the relationship between
      rCDT and alcohol abuse is not appreciably altered by the presence of clinically
      severe liver disease in male alcoholics.

PMID- 7787163
TI  - A non-invasive method for evaluating cirrhotic portal hypertension by
      administration of 99mTc-MIBI per rectum.
AB  - A study was performed to evaluate radio-isotopic imaging using technetium-99m
      hexakis 2-methoxyisobutyl isonitrile administered per rectum to assess portal
      collateral circulation. The heart-liver ratios (H/L; mean +/- standard deviation)
      in 15 controls, 13 cases of histologically confirmed viral hepatitis and 57
      cirrhosis patients were 0.27 +/- 0.11, 0.43 +/- 0.14 and 1.00 +/- 0.28,
      respectively (P < 0.001). Among the cirrhosis patients those with the Child-Pugh
      classification A, B and C had H/L of 0.56 +/- 0.14, 1.00 +/- 0.20 and 1.19 +/-
      0.26, respectively (P < 0.001). A high value of H/L was associated with a high
      risk of hepatic encephalopathy (1.25 +/- 0.17, P < 0.01) and oesophageal varices
      (1.02 +/- 0.20, P < 0.01). There were associations between H/L and serum
      bilirubin (P < 0.01), albumin (P < 0.05) and prothrombin time (P < 0.05). The
      results also showed a good correlation between H/L and portal vein pressure
      measured during operation in 13 patients (P < 0.001, r = 0.87). The regression
      equation: y = 6.77 + 32.5 H/L, allowed portal vein pressure to be estimated. The
      prognostic value of the test was supported by the fact that good correlations
      were observed between the H/L ratio and widely accepted prognostic classification
      (Child-Pugh). It is suggested that this new method could be a reliable non
      invasive way to give an indication of the degree of portasystemic shunting to
      evaluate the prognosis and to follow up the effects of medications for reducing
      portal hypertension in patients with cirrhotic portal hypertension.

PMID- 7787166
TI  - Hepatitis B vaccination alone is not adequate for the categorizing of adult
      subjects with isolated anti-HBc.
AB  - To evaluate the meaning of isolated antibody to hepatitis B core antigen (anti
      HBc), 88 Chinese subjects with isolated anti-HBc received rescreening of
      hepatitis B virus (HBV) markers. Eighty (90.9%) of them were still positive for
      this antibody and 29 were also found to be positive for antibody to hepatitis B
      surface antigen (anti-HBs). The remaining 51 subjects (58.0%) were positive for
      anti-HBc alone; 50 of them received a four-dose schedule of hepatitis B (HB)
      vaccine. After the initial dose, only one vaccinee disclosed an amnestic anti-HBs
      response, that is, anti-HBs titre > 1000 miu/mL. Forty-five vaccinees completed
      the vaccination schedule and 44 (97.8%) had anti-HBs response. The anti-HBs
      responses in 25 of these vaccinees were compared with 25 age- and sex-matched
      normal susceptible vaccinees. The anti-HBs response rates in both groups were the
      same (96 vs 96%). However, the geometric mean titre was significantly lower in
      the vaccinees with isolated anti-HBc (512 mIU/mL vs 4688 mIU/mL, P < 0.001).
      Prevaccinated sera were available in 49 vaccinees with isolated anti-HBc for
      detection of antibody to hepatitis B e antigen (anti-HBe) and HBV DNA; 37 (75.5%)
      of them had one or two of these markers. As we regarded the rescreening of HBV
      markers, response to hepatitis B vaccination and presence or absence of anti-HBe
      and/or HBV DNA together for categorizing the 88 subjects with isolated anti-HBc,
      at least three-quarters of them had past infection of HBV. The subjects with
      false positive anti-HBc test were a minor group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787165
TI  - Influence of ascites on the chemotaxis of granulocytes in patients with
      cirrhosis.
AB  - Spontaneous bacterial peritonitis is a specific infectious complication in liver
      cirrhosis. The reasons for the preferred location of infection on the peritoneum
      are not clear. The aims of the present study were to ascertain whether
      hepatogenic ascites fluid is chemotactically effective, what part is played by
      complement factor C3 and whether there are inhibitors of chemotaxis in ascites.
      Chemotaxis of granulocytes in serum and ascites fluid was measured in 18 patients
      with cirrhosis and ascites and in 18 healthy individuals using the Boyden chamber
      method. In the patients, the chemotactic effect of serum was reduced
      significantly. Ascites fluid had lower chemotactic activity than autologous serum
      (P < 0.01), directly correlated to C3 levels (P < 0.025). There was a significant
      correlation between chemotaxis in serum and in ascites fluid (P < 0.005). Adding
      ascites fluid to serum led to reduction of chemotactic activity only in the
      patients (P < 0.025). In conclusion, the chemotactic effect of ascites fluid is
      considerably lower than that of serum and is proportional to local concentrations
      of C3. Chemotaxis-inhibiting factors can also be identified in ascites fluid,
      their pathogenetic relevance being limited.

PMID- 7787168
TI  - Nizatidine and acid-pepsin related gastrointestinal disease.

PMID- 7787167
TI  - Effects of nifedipine on hepatic venous pressure gradient and portal vein blood
      flow in patients with cirrhosis.
AB  - We investigated the effects of nifedipine on splanchnic haemodynamics in 13
      patients with cirrhosis and portal hypertension, and in 10 control subjects using
      hepatic venous catheterization and pulsed Doppler ultrasound. There were no
      significant changes in systemic or splanchnic haemodynamics in control patients.
      In contrast, systemic vasodilatation, evidenced by significant decreases in mean
      arterial pressure and systemic vascular resistance, was observed in patients 20
      min after sublingual application of 10 mg nifedipine. Moreover, hepatic venous
      pressure gradient and portal vein blood flow significantly increased after
      nifedipine administration. There was a significant correlation between the
      percentage increases in portal vein blood flow and in hepatic venous pressure
      gradient. However, no correlation was found between the percentage change in
      cardiac output and that in portal vein blood flow. Thus the increase in portal
      vein blood flow appears to be related to splanchnic arterial vasodilatation by
      nifedipine. Consequently, nifedipine has deleterious effects on portal
      haemodynamics in patients with cirrhosis. As nifedipine may potentially increase
      the risk of variceal haemorrhage in patients with less advanced varices, this
      drug should be used with caution in patients with chronic liver disease.

PMID- 7787169
TI  - A radical perspective on ulcerative colitis.

PMID- 7787170
TI  - Sulphation of proteoglycans and intestinal function.

PMID- 7787171
TI  - Twenty-four hour pH monitoring and serological parameters of gastric secretion.

PMID- 7787172
TI  - The role of gastrin and cholecystokinin in normal and neoplastic gastrointestinal
      growth.
AB  - Gastrin and cholecystokinin (CCK) act as growth factors for the gastric mucosa
      and the pancreas, respectively. CCK is also responsible, via the CCK-A receptor,
      for the pancreatic hyperplasia observed following the feeding of protease
      inhibitors or pancreaticobiliary diversion. Hypergastrinaemia does not increase
      the incidence of spontaneous gastrointestinal carcinoma, but does stimulate the
      proliferation of gastric enterochromaffin-like cells via the gastrin/CCK-B
      receptor, with a consequent increase in the incidence of gastric carcinoids.
      Whether gastrin influences mutagen-induced gastrointestinal carcinogenesis is
      still controversial, but CCK clearly enhances the induction by carcinogens of
      acinar tumours in the pancreas. While gastrin increases xenograft growth of 50%
      of gastrointestinal tumours tested, effects on the proliferation of
      gastrointestinal tumour cell lines in vitro have been more difficult to
      demonstrate, perhaps because many cell lines are already maximally stimulated by
      autocrine gastrin. Gastrin mRNA and progastrin, but not mature amidated gastrin,
      have been detected in all gastrointestinal cell lines tested. Although cell
      proliferation is inhibited by gastrin/CCK receptor antagonists, the spectrum of
      antagonist affinities is not consistent with binding to either CCK-A or
      gastrin/CCK-B receptors. Definition of the molecular structure of the receptor
      involved in the autocrine loop may lead to novel therapies for gastrointestinal
      cancer.

PMID- 7787173
TI  - Successful in vitro fertilization and pregnancy in a patient with autoimmune
      chronic active hepatitis and cirrhosis.
AB  - Fertility is reduced in women with chronic active autoimmune hepatitis (AIH) and
      pregnancy is hazardous. This report describes a 33 year old woman with AIH and
      cirrhosis in whom a successful pregnancy was achieved following in vitro
      fertilization/embryo transfer. Disease exacerbation during pregnancy was
      controlled by azathioprine and an increased dose of prednisone, and a healthy
      child was delivered by Caesarean section at 36 weeks gestation. Since the
      perinatal care of preterm infants and the obstetric care available to women with
      complicated medical problems has improved markedly in recent years and since
      active disease can be controlled by adequate immunosuppressive therapy, we
      propose that it is justified to allow these patients access to in vitro
      fertilization programmes.

PMID- 7787175
TI  - Molecular cloning and characterization of a pea chitinase gene expressed in
      response to wounding, fungal infection and the elicitor chitosan.
AB  - The fungicidal class I endochitinases (E.C.3.3.1.14, chitinase) are associated
      with the biochemical defense of plants against potential pathogens. We isolated
      and sequenced a genomic clone, DAH53, corresponding to a class I basic
      endochitinase gene in pea, Chi1. The predicted amino acid sequence of this
      chitinase contains a hydrophobic C-terminal domain similar to the vacuole
      targeting sequences of class I chitinases isolated from other plants. The pea
      genome contains one gene corresponding to the chitinase DAH53 probe. Chitinase
      RNA accumulation was observed in pea pods within 2 to 4 h after inoculation with
      the incompatible fungal strain Fusarium solani f. sp. phaseoli, the compatible
      strain F. solani f.sp. pisi, or the elicitor chitosan. The RNA accumulation was
      high in the basal region (lower stem and root) of both fungus challenged and
      wounded pea seedlings. The sustained high levels of chitinase mRNA expression may
      contribute to later stages of pea's non-host resistance.

PMID- 7787174
TI  - Features of the hmg 1 subfamily of genes encoding HMG-CoA reductase in potato.
AB  - 3-Hydroxy-3-methylglutaryl coenzyme A reductase (HMGR) catalyzes a key step in
      isoprenoid metabolism leading to a range of compounds that are important for the
      growth, development and health of the plant. We have isolated 7 classes of
      genomic clones encoding HMGR from a potato genomic library. Comparison of nucleic
      acid sequences reveals a high degree of identity between all seven classes of
      clones and the potato hmg 1 gene described by Choi et al. (Plant Cell 4: 1333,
      1992), indicating that all are members of the same subfamily in potato. A
      representative member (hmg 1.2) of the most abundant class of genomic clones was
      selected for further characterization. Transgenic tobacco and potato containing
      the beta-glucuronidase (GUS) reporter gene under the control of the hmg 1.2
      promoter expressed GUS activity constitutively at a low level in many plant
      tissues. High levels of GUS activity were observed only in the pollen. GUS assays
      of isolated pollen, correlations of GUS activity with the HMGR activity of
      anthers, hmg 1.2 promoter deletion studies, and segregation analysis of the
      expression of hmg 1.2::GUS among the R2 pollen of R1 progeny plants demonstrated
      that the hmg 1.2 promoter controls pollen expression.

PMID- 7787176
TI  - Characterization of cDNA clones for differentially expressed genes in embryos of
      dormant and nondormant Avena fatua L. caryopses.
AB  - The molecular regulation of seed dormancy was investigated using differential
      display to visualize and isolate cDNAs representing differentially expressed
      genes during early imbibition of dormant and nondormant Avena fatua L. embryos.
      Of about 3000 cDNA bands examined, 5 cDNAs hybridized with mRNAs exhibiting
      dormancy-associated expression patterns during the first 48 h of inhibition,
      while many more nondormancy-associated cDNAs were observed. Dormancy-associated
      clone AFD1 hybridized with a 1.5 kb mRNA barely detectable in dry dormant and
      nondormant embryos that became more abundant in dormant embryos after 24 h of
      imbibition. Clone AFD2 hybridized with two mRNAs, a 1.3 kb message constitutively
      expressed in dormant and nondormant embryos and a 0.9 kb message present at
      higher levels in dormant embryos after 3 h of imbibition. Nondormancy-associated
      clones AFN1, AFN2 and AFN3 hybridized with 1.5 kb, 1.7 kb and 1.1 kb mRNAs,
      respectively, that were more abundant in nondormant embryos during imbibition.
      Expression patterns of some mRNAs in dormant embryos induced to germinate by GA3
      treatment were different than water controls, but were not identical to those
      observed in nondormant embryos. DNA sequence analysis revealed 76% sequence
      identity between clone AFN3 and a Citrus sinensis glutathione peroxidase-like
      cDNA, while significant sequence similarities with known genes were not found for
      other clones. Southern hybridization analyses showed that all clones represent
      low (1 to 4) copy number genes.

PMID- 7787177
TI  - Expression of Agrobacterium rhizogenes auxin biosynthesis genes in transgenic
      tobacco plants.
AB  - Plant oncogenes aux1 and aux2 carried by the TR-DNA of Agrobacterium rhizogenes
      strain A4 encode two enzymes involved in the auxin biosynthesis pathway in
      transformed plant cells. The short divergent promoter region between the two aux
      coding sequences contains the main regulatory elements. This region was fused to
      the uidA reporter gene and introduced into Nicotiana tabacum in order to
      investigate the regulation and the tissue specificity of these genes. Neither
      wound nor hormone induction could be detected on transgenic leaf discs. However,
      phytohormone concentration and auxin/cytokinin balance controlled the expression
      of the chimaeric genes in transgenic protoplasts. The expression was localised in
      apical meristems, root tip meristems, lateral root primordia, in cells derived
      from transgenic protoplasts and in transgenic calli. Histological analysis showed
      that the expression was located in cells reactivated by in vitro culture.
      Experiments using cell-cycle inhibitors such as hydroxyurea or aphidicolin on
      transgenic protoplast cultures highly decreased the beta-glucuronidase activity
      of the chimaeric genes. These results as well as the histological approach
      suggest a correlation between expression of the aux1 and aux2 genes and cell
      division.

PMID- 7787178
TI  - A corm-specific gene encodes tarin, a major globulin of taro (Colocasia esculenta
      L. Schott).
AB  - A gene encoding a globulin from a major taro (Colocasia esculenta L. Schott) corm
      protein family, tarin (G1, ca. 28 kDa) was isolated from a lambda Charon 35
      library, using a cDNA derived from a highly abundant corm-specific mRNA, as
      probe. The gene, named tar1, and the corresponding cDNA were characterized and
      compared. No introns were found. The major transcription start site was
      determined by primer extension analysis. The gene has an open reading frame (ORF)
      of 765 bp, and the deduced amino acid sequence indicated a precursor polypeptide
      of 255 residues that is post-translationally processed into two subunits of about
      12.5 kDa each. The deduced protein is 45% homologous to curculin, a sweet-tasting
      protein found in the fruit pulp of Curculigo latifolia and 40% homologous to a
      mannose-binding lectin from Galanthus nivalis. Significant similarity was also
      found at the nucleic acid sequence level with genes encoding lectins from plant
      species of the Amaryllidaceae and Lilliaceae families.

PMID- 7787179
TI  - A GCC element and a G-box motif participate in ethylene-induced expression of the
      PRB-1b gene.
AB  - The PRB-1b gene codes for a basic-type pathogenesis-related protein and is
      activated at the transcriptional level by the plant hormone ethylene. To identify
      cis-acting DNA elements essential for ethylene induction, deleted and mutant
      forms of the PRB-1b promoter, fused to the beta-glucuronidase (GUS) coding
      region, were introduced in transgenic tobacco plants. A 73 bp fragment (X1
      region) of the PRB-1b promoter, located between positions -213 and -141, was
      sufficient to confer ethylene responsiveness to the reporter gene. The X1 region
      contains a TAAGAGCCGCC motif (GCC-box) well conserved in several ethylene
      inducible genes. A substitution mutation in this sequence, in the context of a
      213 bp PRB-1b promoter, completely abolished ethylene induction in transgenic
      tobacco, defining this conserved motif as part of a cis-acting element responsive
      to ethylene. Three other mutations in the X1 region caused a pronounced decrease
      in the PRB-1b promoter activity in transgenic plants, but did not affect ethylene
      inducibility. One of them, localized in a G-box like motif (CACGTG), disrupted
      the binding site for a nuclear factor, as observed in gel-shift analysis.
      Interestingly, the mobility of the complex formed on the G-box element was
      dependent on its phosphorylation state. These results suggest that a cis-acting
      element involved in the perception of the ethylene signal resides in a GCC motif
      and acts in concert with additional elements in the regulation of ethylene
      induced PRB-1b expression.

PMID- 7787181
TI  - Expression of three osmotin-like protein genes in response to osmotic stress and
      fungal infection in potato.
AB  - We have characterized three cDNAs encoding osmotin-like proteins from potato
      (Solanum commersonii) cell cultures. These cDNAs (pA13, pA35, and pA81) have
      extensive nucleotide identity in the coding regions but low homology in the 3'
      non-coding sequences, and may encode three isoforms of potato pathogenesis
      related (PR) type 5 proteins. Using gene-specific probes, RNA gel blot analyses
      showed constitutive accumulation of osmotin-like protein mRNAs in cell cultures,
      leaves, stems, roots and flowers, with high abundance in the roots and mature
      flowers. Treatments with abscisic acid (ABA), low temperature, and NaCl increased
      the accumulation of all three mRNAs in S. commersonii cell cultures and plants
      grown in vitro. Salicylic acid (SA), and wounding resulted in a moderate increase
      in the levels of pA13 and pA81 but not pA35 mRNAs. Infection with the fungus
      Phytophthora infestans activated strong and non-systemic expression of all three
      osmotin-like protein genes. The accumulation of osmotin-like proteins, however,
      was detected only in P. infestans-infected tissues but not in plants treated with
      ABA, SA, NaCl, low temperature, or wounding.

PMID- 7787180
TI  - Structural and functional characterization of two wheat histone H2B promoters.
AB  - Two wheat histone H2B genes (TH123 and TH153) were isolated. Nucleotide sequence
      analysis revealed that some characteristic sequence motifs were conserved in both
      the 5'- and 3'-flanking regions. A canonical TATA box and several CCAAT sequences
      were present in the presumed promoter regions. Motifs similar or identical to the
      hexamer (ACGTCA) and octamer (CGCGGATC) motifs that are positive cis-acting
      elements of the wheat H3 (TH012) promoter were also observed in both the H2B
      promoters. A gel mobility shift assay indicated that the hexamer and hexamer-like
      motifs bound the wheat bZIP proteins HBP-1a and/or HBP-1b in vitro. A novel
      sequence motif, (A/T)(G/A)AAAT(A/G), was found downstream of a translational stop
      codon as observed in several plant histone H2B cDNAs. Promoter activity was
      analyzed with H2B promoter-GUS fusion genes in the transient system using tobacco
      protoplasts. Studies of the promoter function in transgenic tobacco plants showed
      that the H2B promoters were preferentially active in meristematic tissues. Taken
      together, our data indicate that the H2B genes are regulated, in part, by the
      same mechanism as found in H3 and H4 gene transcription.

PMID- 7787184
TI  - The location of untranscribed DNA sequences within ras genes essential for
      eliciting plant growth suppression.
AB  - Three heterologous ras DNA-coding sequences and their deletion derivatives were
      introduced into plant cells to investigate the role of the ras-coding sequences,
      especially conserved regions, in eliciting growth inhibition. All three ras
      coding sequences caused a similar inhibition of plant cell growth, and it was the
      conserved coding regions which were responsible for this inhibitory effect. The
      493 bp conserved region within the v-Ha-ras-coding sequence was studied further,
      and was shown to be responsible for the inhibitory effect. This region is
      conserved (over 44%) among the three ras genes studied and encodes a catalytic
      region of the Ras protein. Small deletions at either the 5' or 3' end of this 493
      bp sequence could abolish or dramatically reduce the inhibitory effect. A 36 bp
      region at the 5' end of the 493 bp region was found to be highly conserved
      between v-Ha-ras and eight different plant ras or ras-related genes based upon
      analysis of published sequences. Small deletions affecting this highly conserved
      36 bp region completely abolished the inhibitory effect, while deletion of a
      similar number of base pairs in adjacent regions did not. These results indicate
      that plant growth inhibition by ras DNA requires small regions at both ends of
      the 493 bp conserved region.

PMID- 7787183
TI  - Structural organization and differential expression of carrot beta
      fructofuranosidase genes: identification of a gene coding for a flower bud
      specific isozyme.
AB  - Three genomic clones (Inv*Dc1, Inv*Dc2 and Inv*Dc3) were isolated by using the
      cDNA for carrot cell wall beta-fructofuranosidase as a probe. The expression
      patterns of the three genes differed markedly. High levels of Inv*Dc1 transcripts
      were found in leaves and roots of young carrot, whereas in plants with developing
      tap roots no transcripts were detected. A high level of mRNA of Inv*Dc1 was also
      present in suspension-cultured cells. In developing reproductive organs, only low
      levels of transcripts of Inv*Dc1 were found in flower buds and flowers and none
      at later stages of development. In contrast, Inv*Dc2 and Inv*Dc3 were not
      expressed in vegetative plant organs. Invb1*Dc1 was exclusively and strongly
      expressed in flower buds, and Inv*Dc3 at a very low level in suspension-cultured
      cells.

PMID- 7787182
TI  - The NADP-glutamate dehydrogenase of the cyanobacterium Synechocystis 6803:
      cloning, transcriptional analysis and disruption of the gdhA gene.
AB  - The gdhA gene of Synechocystis PCC 6803, which encodes an NADP-dependent
      glutamate dehydrogenase (NADP-GDH), has been cloned by complementation of an
      Escherichia coli glutamate auxotroph. This gene was found to code for a
      polypeptide of 428 amino acid residues, whose sequence shows high identity with
      those of archaebacteria (42-47%), some Gram-positive bacteria (40-44%) and
      mammals (37%). The minimal fragment of Synechocystis DNA required for
      complementation (2kb) carries the gdhA gene preceded by an open reading frame
      (ORF2) encoding a polypeptide of 130 amino acids. ORF2 and gdhA are co
      transcribed as a 1.9 kb mRNA, but shorter transcripts including only gdhA were
      also detected. Two promoter regions were identified upon transcriptional fusion
      to the cat reporter gene of a promoter probe plasmid. Transcription from the
      promoter upstream of ORF2 was found to be regulated depending on the growth phase
      of Synechocystis, in parallel to NADP-GDH activity. This promoter is expressed in
      Escherichia coli too, in contrast to the second promoter, located between ORF2
      and gdhA, which was silent in E. coli and did not respond to the stage of growth
      in Synechocystis. Disruption of the cyanobacterial gdhA gene with a
      chloramphenicol resistance cassette yielded a mutant strain totally lacking NADP
      GDH activity, demonstrating that this gene is not essential to Synechocystis 6803
      under our laboratory conditions.

PMID- 7787185
TI  - Identification and characterization of genes with unstable transcripts (GUTs) in
      tobacco.
AB  - Plants and other higher eukaryotes have the ability to recognize and target
      specific transcripts for rapid decay from among the majority of relatively stable
      mRNAs present within cells. However, little is known about the nature of unstable
      transcripts in plants, or the mechanisms that facilitate their rapid degradation.
      As a first step toward understanding how plants distinguish between unstable and
      stable transcripts, a novel differential screen was used to identify cDNAs for
      genes with unstable transcripts (GUTs), solely on the basis of the instability of
      their mRNAs. cDNA probes were prepared from tobacco cells that had been depleted
      of highly unstable mRNAs by treatment for 90 min with a transcriptional
      inhibitor, and from control, untreated cells. GUT clones were selected on the
      basis of weak hybridization to the former probe relative to the latter probe.
      Half-life measurements performed on the mRNAs hybridizing to eight GUT clones
      indicated that each was unstable, with a half-life on the order of about an hour
      or less. All eight of the cDNAs corresponded to new tobacco genes, and four
      showed sequence similarity with genes from other species, including the
      eukaryotic family of DNAJ homologs, a tomato wound-inducible protein, and histone
      H3. In addition to providing information about the types of transcripts that are
      inherently unstable in plants, the GUT clones should provide excellent tools for
      the identification of cis- and trans-acting determinants of mRNA instability.

PMID- 7787186
TI  - Isolation of a carrot gene expressed specifically during early-stage somatic
      embryogenesis.
AB  - We report the first successful isolation by subtractive hybridization of a gene
      expressed specifically during somatic embryogenesis. Embryogenic cell clusters,
      32-50 microns in diameter, were isolated by sieving and density-gradient
      centrifugation. The cDNA library was constructed from proglobulars which were
      formed from embryogenic cell clusters 3 days after transfer to auxin-free
      modified Lin and Staba's medium. For use as probe in screening, the same cDNA
      used for library construction was enriched for specific sequences using
      subtractive hybridization. The cDNA used for subtraction was prepared from
      suspension cultures 5 days after subculturing in auxin-containing medium. Nine
      independent differentially expressed cDNA clones were obtained from a screen of
      150,000 recombinant phages. Northern analysis indicated one of these, CEM6, to be
      expressed specifically during somatic embryogenesis. In addition, one hybridizing
      transcript was detected in plantlet cotyledons, and two transcripts were detected
      in hypocotyls. Two separate and distinct hybridizing transcripts are expressed
      specifically in hypocotyl tissue. The amino acid sequence deduced from the
      nucleotide sequence of the CEM6 cDNA indicates that it encodes a glycine-rich
      protein containing a hydrophobic signal-sequence like domain. Its early embryo
      specific expression and sequence characteristics suggest an important role as a
      cell wall protein in embryogenesis.

PMID- 7787188
TI  - Narbonin, a novel 2S protein from Vicia narbonensis L. seeds: cDNA, gene
      structure and developmentally regulated formation.
AB  - cDNA and genomic clones encoding narbonin, a 2S globulin from the seed of narbon
      bean (Vicia narbonensis L.), were obtained using the polymerase chain reaction
      (PCR) and sequenced. The full-length cDNA as well as genomic clones contain a
      single open reading frame (ORF) of 873 bp that encodes a protein with 291 amino
      acids comprising the mature narbonin polypeptide (M(r) ca. 33 100) and an
      initiation methionine. The deduced amino acid sequence lacks a transient N
      terminal signal peptide. The genomic clones do not contain any intron. No
      homology was found to nucleic acid and protein sequences so far registered in
      sequence data libraries. The biosynthesis of narbonin during embryogenesis is
      developmentally-regulated and its pattern of synthesis closely resembles that of
      typical seed storage globulins. However, during seed germination narbonin was
      degraded very slowly, indicating that it may have other function than storage
      protein. Southern analysis suggests the existence of a small narbonin gene
      family. Narbonin genes were also found in four different species of the genus
      Vicia as well as in other legumes such as Canavalia ensiformis and Glycine max.
      In Escherichia coli a recombinant narbonin was produced which yielded crystals
      like those prepared from narbonin purified from seeds.

PMID- 7787189
TI  - Developmental regulation and tissue-specific differences of heat shock gene
      expression in transgenic tobacco and Arabidopsis plants.
AB  - The heat shock (hs) response during plant growth and development was analyzed in
      tobacco and Arabidopsis using chimaeric beta-glucuronidase reporter genes (hs
      Gus) driven by a soybean hs promoter. Fluorimetric measurements and histochemical
      staining revealed high Gus activities in leaves, roots, and flowers exclusively
      after heat stress. The highest levels of heat-inducible expression were found in
      the vascular tissues. Without heat stress, a developmental induction of hs-Gus
      was indicated by the accumulation of high levels of Gus in transgenic tobacco
      seeds. There was no developmental induction of hs-Gus in Arabidopsis seeds. In
      situ hybridization to the RNA of the small heat shock protein gene Athsp17.6 in
      tissue sections revealed an expression in heat-shocked leaves but no expression
      in control leaves of Arabidopsis. However, a high level of constitutive
      expression of hs genes was detected in meristematic and provascular tissues of
      the Arabidopsis embryo. The developmental and tissue-specific regulation of the
      hs response is discussed.

PMID- 7787187
TI  - Chalcone synthase-like genes active during corolla development are differentially
      expressed and encode enzymes with different catalytic properties in Gerbera
      hybrida (Asteraceae).
AB  - Recent studies on chalcone synthase (CHS) and the related stilbene synthase (STS)
      suggest that the structure of chs-like genes in plants has evolved into different
      forms, whose members have both different regulation and capacity to code for
      different but related enzymatic activities. We have studied the diversity of chs
      like genes by analysing the structure, expression patterns and catalytic
      properties of the corresponding enzymes of three genes that are active during
      corolla development in Gerbera hybrida. The expression patterns demonstrate that
      chs-like genes are representatives of three distinct genetic programmes that are
      active during organ differentiation in gerbera. Gchs1 and gchs3 code for typical
      CHS enzymes, and their gene expression pattern temporally correlates with
      flavonol (gchs1, gchs3) and anthocyanin (gchs1) synthesis during corolla
      development. Gchs2 is different. The expression pattern does not correlate with
      the pigmentation pattern, the amino acid sequence deviates considerably from the
      consensus of typical CHSs, and the catalytic properties are different. The data
      indicate that it represents a new member in the large superfamily of chs and chs
      related genes.

PMID- 7787192
TI  - The International Classification of Impairments, Disabilities, and Handicaps
      (ICIDH): perspectives and developments (part I)

PMID- 7787190
TI  - Expression of the CMS-associated urfS sequence in transgenic petunia and tobacco.
AB  - The expression of a 25 kDa protein, encoded by the fused mitochondrial pcf gene,
      is associated with cytoplasmic male sterility (CMS) in petunia. To investigate
      the role of the 25 kDa protein in CMS we have transformed petunia and tobacco
      plants with constructs expressing a portion of the urfS sequence of the pcf cDNA
      which encodes the 25 kDa protein. The urfS sequence was fused with two different
      mitochondrial targeting sequences. The chimeric gene coding region was placed
      under the control of the CaMV 35S promoter or a tapetum-specific promoter.
      Expression of the PCF protein was obtained in mitochondria of transgenic petunia
      and tobacco plants, yet fertility of the plants was not affected. Analysis of the
      location of the urfS-encoded protein revealed that it fractionates primarily into
      the soluble fraction in the transgenic plants whereas the genuine 25 kDa protein
      is found primarily in the soluble fraction but also in the membrane portion of
      immature buds from CMS petunia plants. Fertile transgenic plants were obtained
      which expressed the 25 kDa protein in the tapetal layer of post-meiotic anthers,
      while CMS plants express the endogenous 25 kDa protein in both the tapetal layer
      and sporogenous tissue of pre-meiotic anthers.

PMID- 7787193
TI  - The ICIDH: evolution, status, and prospects.
AB  - The assessment of disability prevalence in populations is a long-standing
      concern. In the mid-1970s the World Health Organization (WHO) introduced a scheme
      for the measurement of the consequences of disease. The classification of the
      long-term non-fatal consequences of disease is structured on three axes,
      corresponding roughly to experiences at the level of organ or function
      (impairment--1009 items), individual action (disability--338 items) and societal
      interaction (handicap/disadvantage--72 items). The International Classification
      of Impairments, Disabilities, and Handicaps (ICIDH) is now well established. This
      paper describes developments in the use of the ICIDH since 1980, in assessing the
      prevalence of disability in populations, in formulating policy decisions, in
      management at institution level, and in the care of individuals. It lists
      problems identified in the use of the ICIDH, such as the need to clarify the role
      and interrelationship of environmental factors in the definition and development
      of the different planes addressed by the ICIDH, problems of overlap between
      disabilities and handicaps, and between impairments and disabilities. Suggestions
      for improvement include a greater emphasis on presenting handicap as a
      description of the interrelation between impairments or disabilities and their
      physical and social environment. It is anticipated that a revised proposal will
      be finalized for 1998 and formally issued in 1999.

PMID- 7787194
TI  - Reflection on the definition of impairment and disability as defined by the World
      Health Organization.
AB  - The International Classification of Impairments, Disabilities, and Handicaps
      (ICIDH) is gaining wide acceptance inside and outside the field of rehabilitation
      medicine. Impairment and disability are concepts which are often used
      interchangeably or defined differently. The World Health Organization (WHO) has
      defined impairment and disability in the ICIDH. In this article an analysis is
      made of these definitions and the characteristics that are given for the
      definitions. Based on this analysis, modifications for the definitions and
      characteristics of impairment and disability are suggested.

PMID- 7787195
TI  - The ICIDH: health problems in a medical and social perspective.
AB  - The ICIDH is a classification of health problems. Impairments, disabilities, and
      handicaps are to be considered as three different interpretations of a person's
      health state. Use of the ICIDH is indicated when a person's health problems need
      to be described at a particular point in time, both in medical and in social
      terms, i.e. including their significance for the daily life functioning of the
      patient. It is argued that the ICIDH is relevant to health problems other than
      just those for disabled and for chronically ill. The ICIDH subtitle and the model
      explaining the relations between disease and impairment-disability-handicap do
      not reflect a clear notion of the perspective of the ICIDH on health problems. An
      overview of ICIDH applications shows that the ICIDH is being used not so much for
      the evaluation of the health-care system but for many other purposes, among these
      the understanding of therapeutic activities.

PMID- 7787191
TI  - Molecular cloning of an ozone-induced 1-aminocyclopropane-1-carboxylate synthase
      cDNA and its relationship with a loss of rbcS in potato (Solanum tuberosum L.)
      plants.
AB  - Acute or chronic exposure of potato plants to ozone (O3) induces ethylene
      production. We isolated a 1586 bp cDNA (pOIP-1) encoding 1-aminocyclopropane-1
      carboxylate (ACC) synthase from a cDNA library constructed with mRNA extracted
      from O3-treated leaves. The clone has a 1365 bp open reading frame and a 221 bp
      trailing sequence. The active site found in all ACC synthases and 11 of the 12
      amino acid residues conserved in aminotransferases are found in pOIP-1. Northern
      analysis showed that the mRNA encoding ACC synthase was detectable 1 h after the
      onset of O3 exposure, and the message increased over time as did ethylene
      production. Concurrent with the increased ACC synthase mRNA was a decrease in the
      message for the Rubisco small subunit (rbcS) with no change in the large subunit
      (rbcL). When the plants were treated with aminooxyacetic acid (AOA), both
      ethylene production and level of ACC synthase transcript were inhibited. The
      decline in rbcS was also inhibited by AOA suggesting a correlation between
      ethylene production and loss of rbcS. Based on nuclear run-on studies it appears
      that the increase in ACC synthase mRNA may result from O3-induced transcriptional
      activity.

PMID- 7787196
TI  - Human experience in disablement: the imperative of the ICIDH.
AB  - The ICIDH recognizes that the perspectives of people whose lives are personally
      shaped by disablement are critical to improving our understanding of disease
      consequences. However, this 'insider's perspective' has received comparatively
      little attention in medical research. This article suggests that the weight of
      medical history mitigates against human experience as a focus of investigation,
      traces the history of the International Classification of Diseases (ICD) from
      this perspective, and suggests that these historical influences are still
      operative in disablement studies. The ICIDH's inclusion of the insider's
      perspective represents a significant departure from traditional ways of thinking
      in medical science, and allows for important changes in the discourse about
      disablement. This article uses phenomenological theory to show how the insider's
      perspective might be more fully integrated into clinical research and theory
      development. Finally, this article suggests modifications to the ICIDH that would
      help to include more explicitly the insider's perspective in its structure.

PMID- 7787197
TI  - Documenting environmental factors for preventing the handicap creation process:
      Quebec contributions relating to ICIDH and social participation of people with
      functional differences.
AB  - This article presents the conceptual origins and the usefulness of an holistic
      model, stressing the role of environmental determinants in the performance of day
      to-day activities and the fulfilment of social roles by persons with
      disabilities. The Quebec Committee on ICIDH contribution to the development of
      knowledge on the clarification of the relationship of disabled individual
      environment and the understanding of the handicap creation process in relation
      with ICIDH experimentations is presented. Finally, on the basis of
      anthropological social research conducted in Quebec, the article illustrates a
      methodology for environmental analysis of the handicap situations of disabled
      clients in rehabilitation and social integration support programmes.

PMID- 7787198
TI  - The ICIDH in the USA: applications and relevance to ADA goals.
AB  - The measurements of disability and environmental barriers have received growing
      nationwide attention and dissemination in the United States, particularly since
      the 1990 passage of the Americans with Disabilities Act (ADA). This article
      presents a brief overview of selected ICIDH uses and applications in the USA.
      Potential contributions of the ICIDH for ADA implementation are discussed, and
      parallel definitions of disability in the ICIDH and the ADA are cited.

PMID- 7787199
TI  - Disability, resources, role demands and mobility handicap.
AB  - Research on disablement highlights a wide variability in the impact of disabling
      conditions on individuals' lives. However, in most of this work, the
      relationships between impairment/disability and features of individuals' social
      and physical environments are not specified conceptually. Recent conceptual work
      in the context of the International Classification of Impairments, Disabilities,
      and Handicaps (ICIDH) suggests that the impact of impairment/disability on
      individuals' lives is contingent on levels of resources and other aspects of
      social context. The research question addressed in this paper is whether selected
      social factors affect the impact of impairment/disability on mobility handicap,
      defined as 'the individual's ability to move about effectively in his/her
      surroundings'. Two types of social factors are considered: resources such as help
      from others or having a car available; and social role obligations such as having
      a job or visiting relatives. Data are derived from a 1986 probability sample of
      570 individuals with disabilities living in communities in Calderdale, Yorkshire,
      England. Multiple-regression models indicate that the impact of walking
      disability on mobility handicap was reduced by availability of a car in the
      household and school or job obligations. Other impairments/disabilities,
      resources and social role demands examined did not act on mobility outcomes in
      this manner. Implications for conceptualizing and testing relationships between
      impairment, disability, handicap and social and physical environments are
      discussed. A critical task for future research is the investigation of personal
      and social resources and barriers that may moderate the impact of disability on
      individuals' lives.

PMID- 7787200
TI  - Rehabilitation Activities Profile: the ICIDH as a framework for a problem
      oriented assessment method in rehabilitation medicine.
AB  - The Rehabilitation Activities Profile (RAP) is an ICIDH-based assessment method
      that covers the domains of communication, mobility, personal care, occupation,
      and relationships. Disabilities and handicaps in these domains are assessed on
      four-point Likert scales for severity. Problems perceived by the patient
      associated with these disabilities or handicaps are also assessed on four-point
      Likert scales for severity. High scores on perceived problems represent a
      patient's priorities. Information is gathered through a semi-structured interview
      with the patient; proxies and observations can be used as additional sources of
      information. Assessment can be performed at two levels. The first level is a
      global one, serving as a screening device. If disabilities or handicaps are
      identified, the second level provides for an in-depth assessment of those
      specific disabilities and handicaps as well as the related perceived problems.
      The method is designed to assist screening, goal-setting, and outcome evaluation
      of individual patients.

PMID- 7787201
TI  - Using the handicap code of the ICIDH for classifying patients by intensity of
      nursing care requirements.
AB  - An 11-class patient classification system (PCS) has been built on a recode of two
      dimensions of the handicap code of the ICIDH: physical independence and mobility
      handicaps. The proposed system, called MAC XI, explains 78% of the variance of
      nursing care hours required by nursing-home residents and extended-care hospital
      patients. This percentage of variation is higher than the one explained by
      traditional dependency grids such as the Exton-Smith, Murphy, Kuntzmann and SMAF.
      MAC XI, based on two dimensions of the handicap code, is thus a powerful tool for
      predicting intensity of nursing care for staffing and budgeting purposes in long
      term care institutions.

PMID- 7787202
TI  - The need for revision of the ICIDH: an example--problems in gait.
AB  - In this article a proposal is formulated for adjustment of the Classification of
      Impairments and the Classification of Disabilities of the International
      Classification of Impairments, Disabilities, and Handicaps (ICIDH). This proposal
      is a product of a project from the Dutch National Institute of Research and
      Postgraduate Education in Physical Therapy. This project is conducted in close
      cooperation with the professional national organizations of five health
      professions. To give an indication of the kind of changes proposed, the
      disabilities and impairments necessary for classifying the complaints, the
      examination findings, the treatment goals and the treatment results in patients
      with gait problems are discussed.

PMID- 7787203
TI  - Application of the ICIDH in survey research on rehabilitation: the emergence of
      the functional diagnosis.
AB  - The International Classification of Impairments, Disabilities, and Handicaps
      (ICIDH) has been hypothesized to be an excellent conceptual framework for the
      functional diagnosis, i.e. the evaluation of health problems by rehabilitation
      specialists. The ICIDH-based functional diagnosis was assessed in a series of
      survey studies on physical therapy, exercise therapy, occupational therapy,
      podiatry, and speech therapy. The results show that the functional diagnosis
      tends to be reliable; that treatment goals, derived from the diagnosis, offer a
      sensible characterization of care given by rehabilitation specialists; and that
      treatment goals validity predict the selection of interventions by rehabilitation
      specialists. It is concluded that the application of the ICIDH in research on the
      functional diagnosis is highly appropriate. In future studies the concept of the
      functional diagnosis and the diagnostic procedures should be further developed.

PMID- 7787204
TI  - Revision of the ICIDH: mental health aspects. WHO/MNH Disability Working Group.
AB  - This article reviews the key issues arising in the revision of the International
      Classification of Impairments, Disabilities, and Handicaps (ICIDH) from a mental
      health perspective, and describes the work of the Disability Working Group of the
      WHO's Division of Mental Health. The ICIDH, which describes the consequences of
      disorders at three levels as impairments, disabilities, and handicaps, is
      generally applicable and useful for mental health purposes. While some
      impairments are mainly a consequence of 'mental' disorders (e.g. cognitive
      impairment), there should be no differences between mental and physical disorders
      in the classification scheme, to avoid a dichotomy between mind and body. There
      is also a need to improve the ways in which interference with the performance of
      social roles is described, since this is often the most obvious consequence of
      mental disorders. This article presents the potentials of the ICIDH in the field
      of mental health, and gives recommendations for the development of the revision
      process of the ICIDH. To stimulate the process of producing a 'common language'
      in the ICIDH related to mental health issues, former and potential users of the
      ICIDH are invited to give comments and suggestions.

PMID- 7787205
TI  - Lymphotropism of hepatitis B and C viruses: an update and a newcomer.
AB  - The mechanisms of viral persistence are complex and include infection of the
      lymphoid cells. In the case of hepatitis B virus, early observations have
      suggested that HBV may infect peripheral blood mononuclear cells (PBMC). In
      animal models studies in chronic hepatitis B patients have further confirmed that
      viral DNA replicative intermediates, as well as viral transcripts and proteins,
      can be detected in PBMC under certain conditions. The consequences of this
      lymphotropism are not fully understood, but it seems likely that PBMC represent
      an extrahepatic reservoir of virus. The ability of hepatitis C virus to infect
      PBMC has been demonstrated in vivo and in vitro. The link between HCV
      lymphotropism and both the natural history of the viral infection and the
      immunological disorders frequently observed in HCV infections still needs to be
      established. In both cases, the infection of PBMC by HBV or HCV may represent the
      source of infection of the liver graft in patients transplanted for end-stage
      liver disease associated with HBV or HCV.

PMID- 7787206
TI  - Cytokines as adjuvants in immunocompromised hosts.
AB  - Vaccination of immunocompromised subjects may be ineffective due to the poor
      immune responses induced. In addition, vaccination with live attenuated organisms
      may also be dangerous due to the possible lack of control of the infection. This
      review describes the protection of cytokines in the vaccination of
      immunocompromised individuals. Cytokines have possible roles as immunological
      adjuvants, enhancing immune responses to vaccination, and can also have effects
      on the growth of live vaccines or vaccine vectors.

PMID- 7787207
TI  - The role of cytokines in the acquired immunodeficiency syndrome.
AB  - HIV replication in vitro is regulated by many factors, including various
      exogeneous stimuli and proteins encoded by either virus or cellular genomes.
      During the asymptomatic period, cells latently or chronically infected with HIV
      gradually express virus, leading to immunosuppression and opportunistic
      infection. These conditions would result in the increased secretion of cytokines,
      especially TNF, from infected and uninfected cells, which can induce HIV and
      killing of infected cells. A vicious circle is then set in motion in which
      heterologous microbial infections directly or indirectly activate HIV and the
      production of cytokines, thereby accelerating lymphocyte depletion and
      immunodeficiency. AIDS is a disorder of the immune network caused by a unique
      retrovirus HIV. However, if the whole story described above is true, this disease
      can also be termed a "cytokine disease". Immunity resembles a "double-edged
      sword", with aspects not only protective, but also deleterious to the host.
      Therefore, it is essential to more extensively investigate the mechanism of
      cytokine regulation of HIV expression in vivo, not only to understand the complex
      pathophysiology of AIDS, but also to design a therapeutic strategy to halt this
      deadly disease.

PMID- 7787208
TI  - Detection of hepatitis D virus RNA in serum by a reverse transcription,
      polymerase chain reaction-based assay.
AB  - We designed a reverse transcription, polymerase chain reaction-based assay for
      serum hepatitis D virus RNA. Amplified hepatitis D virus cDNA was revealed by
      ethidium bromide staining, followed by blotting onto a nylon membrane and
      hybridization with a 32phosphorus-labelled oligonucleotide, or by a DNA enzyme
      immunoassay (DEIA) using a double stranded DNA-specific monoclonal antibody. The
      absolute sensitivity was expressed as number of hepatitis D virus RNA molecules,
      using a serum of known viral RNA concentration. Three sets of primers were used,
      encompassing the base positions 66-686 (variable rod-stabilizing region), 701-962
      (conserved, viroid-like domain) and 886-1,333 (portion of the open reading frame
      5 encoding for the carboxyterminus of the hepatitis D antigen) of the viral
      genome. The lower detection limits, after amplification of the three RNA
      portions, as assessed by ethidium bromide staining, were 7.5 x 10(6), 7.5 x 10(4)
      and 7.5 x 10(2) molecules of hepatitis D virus RNA per assay, respectively. The
      region encompassing bases 886-1,333 was chosen for blotting and hybridization to
      a radiolabelled oligonucleotide probe or for a capture-based DNA enzyme
      immunoassay, where the microplate was coated with this same probe. The two
      procedures showed comparable sensitivity, i.e., about 10 molecules of viral RNA
      per assay. The specificity of the assay was further on a panel of both anti
      hepatitis D-positive and -negative sera. Amplification of serum hepatitis D virus
      RNA by reverse transcription/polymerase chain reaction followed by detection of
      the amplified cDNA by DNA enzyme immunoassay is a promising and feasible routine
      assay for detecting low amounts of circulating virions.

PMID- 7787209
TI  - Insulin-like growth factor-I, interleukin-1 alpha and beta in pancreatic cancer:
      role in tumor invasiveness and associated diabetes.
AB  - We evaluated levels of insulin-like growth factor-I and interleukin-1 alpha and
      beta in patients with pancreatic cancer; the role of these substances in tumor
      spread and in hyperglycemia was also investigated. Thirty pancreatic cancer
      patients (21 with hyperglycemia) were compared with others with diseases causing
      hyperglycemia [liver cirrhosis (14 cases, 12 with hyperglycemia), chronic
      pancreatitis (20 cases, 12 with hyperglycemia), type I diabetes mellitus (13
      cases, all hyperglycemic)]. Insulin-like growth factor-I was significantly
      reduced in patients with liver cirrhosis, probably due to a reduced hepatic
      capacity for synthesis. It was increased in 6 of 30 pancreatic cancer patients;
      in these subjects it was correlated with alanine aminotransferase and C-peptide,
      but not with tumor diameter or the presence of metastases. Interleukin-1 alpha
      and beta were both elevated in pancreatic cancer patients. The former was high,
      while the latter was low when liver metastases were present. Neither was related
      to glucose or C-peptide levels. In summary, insulin-like growth factor-I levels
      are increased in some pancreatic cancer patients but this does not seem to favor
      tumor spread; however IGF-I could be involved influencing glucose homeostasis.
      Interleukin-1 alpha increased, while interleukin-1 beta decreased in pancreatic
      cancer patients with metastases, suggesting a different involvement of these two
      substances in pancreatic cancer spread.

PMID- 7787210
TI  - Orthotopic liver transplantation in a patient with severe hemophilia A: a life
      saving treatment for the first Italian case.
AB  - Clinical cure of hemophilia A by orthotopic liver transplantation has been
      reported in 11 cases. We describe the first successful Italian case. A 27-year
      old man had cirrhosis caused by previous infections with the hepatitis B, C and D
      viruses following life-long treatment with factor VIII concentrates made from
      large plasma pools. He was, however, seronegative for the human immunodeficiency
      virus. In the year before transplantation, life-threatening gastrointestinal
      bleeding due to severe esophageal varices required a large transfusion regimen
      (on average, 13 bags of red cell concentrates and 35,000 U of factor VIII/week).
      To perform orthotopic liver transplantation 8,000 U of factor VIII were given
      during surgery together with 10 bags of red cells and 11 of fresh-frozen plasma.
      Intraoperative bleeding was not different from that of non-hemophilic patients
      undergoing orthotopic liver transplantation. No additional factor VIII was used
      after transplantation and factor VIII levels in plasma were always above 50 U/dl,
      reaching the highest value of 184 U/dl on day 4 post transplantation. He was
      discharged from hospital 10 weeks after transplantation with factor VIII levels
      of 68 U/dl. All virological markers are currently negative, except anti-hepatitis
      C virus antibodies. In this patient orthotopic liver transplantation was a life
      saving treatment for end-stage cirrhosis and a cure for hemophilia A.

PMID- 7787213
TI  - International normalized ratio: merits, limits and improvements.

PMID- 7787212
TI  - Methotrexate therapy and liver fibrosis: are human prolyl hydroxylase and type IV
      collagen reliable and sensitive markers?

PMID- 7787211
TI  - Abundance of guanine, guanosine, inosine and adenosine in human seminal plasma.
AB  - Guanine, guanosine, inosine and adenosine were found in large amounts in seminal
      plasma from 145 men, regardless of whether spermatozoa were present or not. The
      mean guanine level in 61 normozoospermic men was 89.7 +/- 93.1 mumol/l; this was
      significantly lower in 32 vasectomized men (18.9 +/- 31 mumol/l) suggesting the
      involvement of the epididymis in its secretion. Guanine and nucleoside levels
      were significantly higher in the seminal plasma of oligozoo- and azoospermic than
      normozoospermic men. Guanine and nucleoside levels were consistently inter
      related in the seminal plasma of normozoospermic men with the best correlation
      between guanine and guanosine.

PMID- 7787215
TI  - Cholecystokinin in the control of gastric acid and plasma gastrin and
      somatostatin secretion in healthy subjects and duodenal ulcer patients before and
      after eradication of Helicobacter pylori.
AB  - BACKGROUND: Exogenous cholecystokinin (CCK) is known to effect gastric secretory
      and motor functions but its physiological role in the control of these functions
      in healthy subjects and duodenal ulcer (DU) patients is unknown. METHODS AND
      SUBJECTS: In this study involving four series of young healthy normal and DU
      subjects, the gastric secretory tests were performed under basal conditions and
      following stimulation by modified sham-feeding (MSF), i.v. infusion of caerulein,
      gastrin releasing peptide (GRP) or pentagastrin (p-gastrin) (series A), after 500
      ml of standard meal without or with addition of 15% soybean oil (series B) or
      acidification of meal to pH 2.5 (series C), and finally after eradication of
      Helicobacter pylori (HP) (series D). Studies were carried out without or with the
      pretreatment with placebo or loxiglumide, a specific antagonist of type A CCK
      receptors. In series A, the gastric secretion obtained by aspiration technique
      was measured after secretagogues (MSF, caerulein, GRP or p-gastrin), whereas in
      series B, C, and D intragastric pH was measured before and after test meal and
      plasma gastrin, CCK and somatostatin were assayed by specific radioimmunoassays.
      RESULTS: In healthy subjects, MSF increased gastric acid outputs to about 36% of
      p-gastrin maximum and treatment with loxiglumide failed to affect this secretion.
      Standard meal enhanced acid output to about 50% of p-gastrin maximum and raised
      plasma levels of gastrin, CCK but not somatostatin. The pretreatment with
      loxiglumide resulted in further increase both in gastric acid secretion and
      plasma gastrin and CCK, while somatostatin level was significantly reduced.
      Infusion of graded doses of caerulein or GRP resulted in dose-dependent
      stimulation of gastric acid secretion reaching, respectively, 35% and 25% of p
      gastrin maximum. When loxiglumide was added, the acid responses to caerulein and
      GRP were further increased by 2-3 folds, attaining a peak similar to the p
      gastrin maximum. Administration of loxiglumide resulted in a significant increase
      in plasma gastrin and CCK responses to GRP, whereas plasma somatostatin was not
      significantly altered. Addition of fat to standard meal prolonged gastric
      emptying of this meal by about 50% both in healthy subjects and DU patients
      (series B). Fat in healthy subjects significantly increased and prolonged
      intragastric pH after the meal while reducing the increments in plasma gastrin
      and enhancing plasma CCK without alteration of plasma somatostatin. Pretreatment
      with loxiglumide significantly reduced postprandial pH from control 4.8 to 2.5
      and reversed the changes in pH caused by addition of fat. The increments in
      plasma gastrin and CCK were markedly augmented, whereas those of somatostatin
      were attenuated. DU patients showed lower postprandial pH (3.0) in tests with or
      without fat and higher increments in plasma gastrin. CCK antagonism failed to
      affect significantly the pH profile or the increments in plasma gastrin or CCK.
      CCK antagonism failed to affect significantly the pH profile or the increments in
      plasma gastrin. Intragastric application of standard meal of pH 3.0 in healthy
      subjects and DU patients (series C) resulted in significantly lower median 3 h
      intragastric pH as compared to that after meal of pH 6.5. After pretreatment with
      loxiglumide, the median pH after meals of both pHs was significantly lower in
      healthy subjects but not in DU patients. This reduction in pH was accompanied by
      more pronounced increase in plasma gastrin response to a meal of pH 6.5 only in
      healthy controls but not in DU subjects and by a significant increase in plasma
      CCK and decrease in plasma somatostatin.

PMID- 7787214
TI  - Ultrastructural analysis of the development of human basophils and mast cells in
      vitro.
AB  - The ultrastructural analysis of a variety of culture systems of human cord blood
      mononuclear cells (spanning a 10-year research effort) is reviewed. Human
      basophils, eosinophils and mast cells reliably developed from their agranular
      precursors that are present in human cord blood. Suspension cultures and
      cocultures with fibroblasts were used to examine the effects on differentiation
      and maturation of full (fibroblast), interleukin-2-depleted (human T cells), and
      murine inducer T cell culture supernatants, partially purified mouse fibroblast
      factor(s), recombinant human interleukins 3 and 5, and recombinant human and
      murine c-kit ligands (stem cell factor, mast cell growth factor). Together, these
      studies allowed us to define the differentiation and full maturation of the
      basophil and eosinophil lineages and provided evidence for the induction of a
      form of secretion (termed piecemeal degranulation) of the basophil and eosinophil
      lineages in interleukin-3- or -5-supplemented cultures. Mast cells were absent
      from interleukin-3- or -5-containing cultures. The development of fully mature
      mast cells occurred regularly in fibroblast-containing cocultures; partially
      mature mast cells developed in fibroblast culture supernatant-, partially
      purified mouse fibroblast factor(s)-, and either recombinant human or murine c
      kit ligand-supplemented suspension cultures. Small numbers of basophils and
      eosinophils were present in the suspension cultures that received c-kit ligand in
      its recombinant or naturally occurring forms. Ultrastructural immunogold analyses
      confirmed that basophils and eosinophils contained the Charcot-Leyden crystal
      protein (in different subcellular locations) but that mast cells did not. In both
      cocultures and suspension cultures, the primary event recorded for mast cells was
      that of differentiation and maturation, with the ultrastructural correlates of
      synthetic activity and granule building prevailing. Spontaneous secretory events,
      recognizable by ultrastructural analysis, were not evident in either mature or
      partially mature mast cells developing in these cultures.

PMID- 7787217
TI  - A cost-benefit analysis of feeding in female tsetse.
AB  - Three models for feeding in female tsetse are considered. Model I: there is a
      prolonged non-feeding phase after each meal followed by feeding at a constant
      rate, with a constant probability of dying as a consequence of feeding. Model II:
      the feeding rate increases linearly after each meal. Model III: the feeding rate
      increases exponentially after each meal. In Models II and III the feeding hazard
      is a linear function of the probability of feeding. Production of viable female
      offspring is estimated under each model, making allowance for losses of adults
      due to starvation and to background and feeding mortality, losses of pupae due to
      predation and parasitization, and losses of young flies if their mothers take
      insufficient blood during pregnancy. Under Model I, if females require three
      meals to produce viable pupae in 9 days, then for a non-decreasing population
      with a background mortality of 1%/day, and 25% pupal losses due to predation and
      parasitism, the feeding risk must be < or = 5%/feed. At this maximum level the
      non-feeding phase should be 2-2.5 days for optimal productivity, with a mean
      feeding interval of 60-72 h. If the background mortality is 2%/day, feeding
      losses cannot exceed 1%/feed for a non-decreasing population. If four or five
      meals are required for the production of fully viable pupae, the optimal values
      of the non-feeding phase and mean feeding interval tend towards 1 and 2 days
      respectively. Under Models II and III the mean feeding interval is 50-60 h for
      optimal productivity (with variances 3 times as large as for Model I), in good
      agreement with estimates from recent models for feeding and digestion. Field
      evidence suggests that feeding tsetse take greater risks as their fat levels
      dwindle. This should result in feeding (and feeding mortality) rates which
      increase during the feeding phase--as assumed in Models II and III but not in
      Model I. These models allow greater flexibility than Model I, because flies can
      feed early in the hunger cycle, at low probability, as long as the feeding risk
      is also low.

PMID- 7787218
TI  - Isolation and characterization of a trypsin-like enzyme from the buffalo fly,
      Haematobia irritans exigua.
AB  - The incorporation of soybean trypsin inhibitor (SBTI) into the diet of the
      buffalo fly, Haematobia irritans exigua (De Meijere), results in increased
      mortality and reduced fecundity. A trypsin-like enzyme which binds to SBTI was
      isolated by affinity chromatography on a Sepharose-SBTI column followed by ion
      exchange chromatography. The enzyme was inhibited by benzamidine,
      phenylmethylsulfonyl fluoride, ovomucoid, leupeptin and alpha-2 macroglobulin.
      The enzyme was not inhibited by EDTA or p-chloromecuribenzoic acid and had a
      broad pH optimum of pH 7-9. Vaccination of sheep produced antibodies specific for
      the trypsin-like enzyme which inhibited enzyme activity in vitro but did not
      affect the survival of flies maintained in in vitro culture.

PMID- 7787216
TI  - Oviposition aggregation pheromone in the Simulium damnosum complex.
AB  - Communal oviposition by the Simulium damnosum complex of Afrotropical blackflies
      (Diptera: Simuliidae) was investigated under controlled laboratory conditions,
      using wild-caught flies in Sierra Leone. Volatile compounds emitted by Simulium
      eggs were trapped using a closed collection system, and their attractiveness to
      gravid flies was tested in a two-choice behavioural bioassay. Significantly more
      female blackflies oviposited on substrates baited with freshly laid eggs (100%
      chose the baited substrate), or with the volatiles collected from freshly laid
      eggs (85% chose the baited substrate), in preference to the relevant control
      substrates. Substrates baited with volatiles from 12-h-old eggs were not
      significantly more attractive than controls (only 31% chose the baited
      substrates; P = 0.33). Gas chromatographic analysis of the egg volatiles
      consistently showed two peaks emanating from fresh eggs, but significantly lower
      amounts from 12-h-old eggs (P < 0.05). A novel system for collecting the
      volatiles from this and other blackfly species, as they laid eggs on a substrate
      in flowing water, is described. Volatiles collected using this method showed
      identical gas chromatographic profiles to those of fresh eggs alone, indicating
      that the flies themselves produced no other volatile chemical signals during
      oviposition. Evidently communal oviposition by S. damnosum s.l. was mediated by a
      pheromone emanating from fresh eggs. The role of pheromone-mediated egg
      aggregation in blackfly ecology is discussed, and its possible manipulation is
      considered.

PMID- 7787219
TI  - An association between phlebotomine sandflies and aphids in the Peruvian Andes.
AB  - As the composition of natural sugars in the diet of adult sandflies (Diptera:
      Psychodidae: Phlebotominae) may affect the development of Leishmania
      (Kinetoplastida: Trypanosomatidae) in sandfly guts, and so play an important role
      in the epidemiology of leishmaniasis, there is increasing interest in the sources
      of sugars for wild sandflies. Advanced chromatography techniques have provided
      indirect evidence that wild sandflies feed on honeydew, a substance released by
      aphids (Hemiptera: Aphididae) when feeding. Our objective was to determine
      whether sandfly density can be influenced directly by the local density of
      aphids. Aphid density was determined by counting absolute numbers of aphids on
      alfalfa stems in Purisima Valley, Peru, where sandflies transmit Leishmania
      peruviana causing Andean cutaneous leishmaniasis (uta). Sandfly relative
      abundance was measured using sticky trap sampling repeatedly in alfalfa fields.
      Lutzomyia verrucarum accounted for 92% of the total sandflies collected. As there
      was a female bias in sandflies collected close to houses, only the numbers of
      male sandflies were used in analysis. Most of the adult aphids found feeding on
      alfalfa were either Therioaphis trifolii forma maculata (97%) or Acyrthosiphon
      pisum (3%). By regression analysis, a significant relationship was found between
      the density of Lu.verrucarum males and the density of adults of both aphid
      species. This is the first ecological study to support the hypothesis that aphid
      honeydew may be a source of sugar for sandflies.

PMID- 7787224
TI  - Dispersal of the Old World screw-worm fly Chrysomya bezziana.
AB  - Dispersal of the Old World screw-worm fly, Chrysomya bezziana Villeneuve, was
      studied in Papua New Guinea by releasing radio-isotope labelled, laboratory
      reared flies and collecting their labelled egg masses from sentinel cattle. A log
      linear model was developed to describe recapture rate. Distance was found to
      dominate the model and was represented by a bilinear ('broken-stick') term as log
      distance. Further terms in the model such as attractiveness of the site
      (estimated from the number of non-labelled egg masses), the season of the year
      and a time trend were statistically significant but of minor importance. From the
      model, the median distance females dispersed before depositing an egg mass was
      10.8 km. The maximum distance from the release site that egg masses were
      recovered was 100 km. The dispersal ability of C. bezziana is discussed in terms
      of its impact on the prospects of eradicating this species using SIRM if an
      outbreak occurred in Australia.

PMID- 7787220
TI  - Immunosuppression and feeding success of Ixodes ricinus nymphs on BALB/c mice.
AB  - The effect of repeated infestations of Ixodes ricinus (L.) nymphs on BALB/c mice
      was studied. Four successive infectations resulted in an increase of tick feeding
      success. Tick yield and mean engorged weight increased and the length of the
      feeding period was reduced significantly (P < 0.05-0.01). The increase of
      specific anti-tick antibodies was not significant (P > 0.05). The blastogenic
      response of spleen lymphocytes to T-cell mitogens (Con A and PHA-P) was
      unimpaired or slightly enhanced, whereas the response to B-cell activators (LPS
      and PWM) was suppressed, as was the total antibody generation in vitro. The
      numbers of mast cells in murine skin at the tick attachment sites slightly
      decreased during the third infestation. The suppression of B-cell competence and
      of antibody generation, together with decrease of skin mast cell numbers in tick
      attachment sits, are considered to be responsible for enhancement of tick feeding
      success.

PMID- 7787221
TI  - Mosquito control in Dar es Salaam. I. Assessment of Culex quinquefasciatus
      breeding sites prior to intervention.
AB  - In preparation for a trial polystyrene beads and pyriproxyfen for the control of
      Culex quinquefasciatus mosquitoes, surveys of their breeding were carried out in
      two contrasting areas of Dar es Salaam, Mikocheni and Ilala, during the dry
      season. Sanitation structures (latrines, soakage pits, septic tanks and cess
      pits) were the most profilic breeding places, totalling 780 in Mikocheni and 1544
      in Ilala. Those in Mikocheni were estimated to contain about 1.4 times more
      mosquito pupae, per site, than in such structures in Ilala. This was both because
      a higher proportion of sites contained visible water and because sites with water
      were more likely to contain pupae in Mikocheni. The relative importance of the
      different types of structure, in terms of productivity, was the same in both
      areas. Although septic tanks and cess pits made up only 10.5% of the on-site
      sanitation structures in Ilala, they contained 53% of the total number of pupae
      in enclosed sites; they were therefore particularly important targets for
      treatment with polystyrene beads. A survey during the rainy season of sites in
      Ilala revealed little change in the proportion that were wet, or in the frequency
      of breeding in those with visible water. The number, type and area of open
      breeding sites varied greatly between the two study areas. In Mikocheni the area
      of open breeding sites was 100 times greater than in Ilala, with 97% of the
      13,000 m2 being flooded grassland. In Ilala all but four of the sixty-six open
      breeding sites were puddles of sullage water derived from bathrooms.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7787223
TI  - Relationships between host blood factors and proteases in Glossina morsitans
      subspecies infected with Trypanosoma congolense.
AB  - Host blood effects on Trypanosoma congolense establishment in Glossina morsitans
      morsitans and Glossina morsitans centralis were investigated using goat, rabbit,
      cow and rhinoceros blood. Meals containing goat erythrocytes facilitated
      infection in G.m.morsitans, whereas meals containing goat plasma facilitated
      infection in G.m.centralis. Goat blood effects were not observed in the presence
      of complementary rabbit blood components. N-acetyl-glucosamine (a midgut-lectin
      inhibitor) increased infection rates in some, but not all, blood manipulations.
      Cholesterol increased infection rates in G.m.centralis only. Both compounds
      together added to cow blood produced superinfection in G.m.centralis, but not in
      G.m.morsitans. Midgut protease levels did not differ 6 days post-infection in
      flies maintaining infections versus flies clearing infections. Protease levels
      were weakly correlated with patterns of infection, but only in G.m.morsitans.
      These results suggest that physiological mechanisms responsible for variation in
      infection rates are only superficially similar in these closely-related tsetse.

PMID- 7787222
TI  - Mosquito control in Dar es Salaam. II. Impact of expanded polystyrene beads and
      pyriproxyfen treatment of breeding sites on Culex quinquefasciatus densities.
AB  - In two contrasting areas of Dar es Salaam (Ilala and Mikocheni) all enclosed
      breeding sites of Culex quinquefasciatus, such as latrines and septic tanks, were
      treated with a floating layer of expanded polystyrene beads. 7 months later
      checks in both study areas revealed only one site (from which the polystyrene had
      been removed during emptying) containing immature stages of Cx quinquefasciatus.
      Open breeding sites such as areas of flooded land and blocked drains were treated
      with pyriproxyfen (an insect growth regulator) at a concentration of 0.1 ppm.
      Emergence of Cx quinquefasciatus adults from these sites was inhibited for 4
      weeks during the rainy season and for up to 11 weeks during the dry season. The
      problem of mosquito breeding sites caused by bathroom sullage water was addressed
      through a combination of health education and indirect pressure from the Urban
      Malaria Control Project (UMCP) via local community leaders. Households
      responsible for these sites were encouraged to eliminate them by diverting the
      water into an enclosed drainage structure, usually a pit latrine. After two
      weekly visits 64.7% of households had complied and 93.4% had complied after five
      visits. 5 months later, only 15.7% had reverted to allowing sullage water to
      collect into puddles. Densities of Cx quinquefasciatus adults dropped by 76.7% in
      Mikocheni and by 46.2% in Ilala following intervention, but increased by 84.9%
      and 25.6% in two untreated comparison areas. The reasons for differential success
      of the combined interventions in the two treated areas are discussed.

PMID- 7787225
TI  - Pyrethroid-impregnated hessian curtains for protection against mosquitoes indoors
      in south India.
AB  - Hessian curtains impregnated with deltamethrin 50 mg/m2 were hung in the eaves
      and doorways of eight one-roomed huts in Madurai, Tamil Nadu State, South India.
      Statistically significant reductions of indoor-resting and man-biting densities
      of the mosquitoes Anopheles subpictus and Culex quinquefasciatus were observed
      for 14 weeks, in two field trials. Bioassays on curtains in the field showed over
      50% mortality of Cx quinquefasciatus and An.stephensi for up to 8 weeks. The
      curtains were highly acceptable to the community, and cost approximately Rs.33.15
      (US$1.05) for material and Rs.10 ($0.32) for delta-methrin per hut, totalling Rs
      53.15 ($1.70) for two impregnations giving 6 months protection. Comparative costs
      of house-spraying with residual insecticides are estimated as Rs.1.92 ($0.06) for
      two rounds of DDT at 1 g/m2, or Rs.40 ($1.27) for three rounds of malathion at 2
      g/m2. Therefore the relative annual cost of protection using deltamethrin
      impregnated hessian curtains is 28 x or 1.3 x more than for house-spraying with
      DDT or malathion, respectively (excluding operational expenditure).

PMID- 7787226
TI  - Malaria-induced reduction of fecundity during the first gonotrophic cycle of
      Anopheles stephensi mosquitoes.
AB  - Anopheles stephensi mosquitoes which had fed upon mice infected with Plasmodium
      yoelii nigeriensis malaria parasites produced significantly fewer eggs than
      mosquitoes fed on an uninfected mouse. Fecundity reduction was more pronounced
      when the bloodmeal contained malaria gametocytes and the mosquitoes developed
      oocysts. Egg production and haematin excretion were correlated for uninfected
      bloodfed mosquitoes; the presence of P.y.nigeriensis in the blood affected this
      relationship. Reduced fecundity was associated with a significant reduction of
      bloodmeal size (measured by haematin excretion) in mosquitoes which ingested
      gametocytaemic blood. The bloodmeal size in mosquitoes fed on parasitaemic blood
      without gametocytes was not significantly reduced. The use of haematin assays for
      determination of bloodmeal size in mosquitoes is discussed.

PMID- 7787227
TI  - Anopheles culicifacies in Baluchistan, Iran.
AB  - Anopheles culicifacies (probably species A) is the main vector of malaria in
      Baluchistan, southeastern Iran. Adult mosquitoes were collected during 1990-92 by
      five methods of sampling: knock-down pyrethrum space-spray indoors, human and
      animal bait (18.00-05.00 hours), pit shelters and CDC light traps, yielding 62%,
      3%, 6%, 4% and 25% of specimens, respectively. Whereas spray-catches comprised c.
      70% gravid and semi-gravid females, light trap catches were mostly (c. 60%) unfed
      females, while females from pit shelters comprised all abdominal stages more
      equally (13-36%). An.culicifacies populations peaked in April-May and rose again
      during August-November. Densities of indoor-resting mosquitoes were consistently
      greater in an unsprayed village than in villages subjected to residual house
      spraying with propoxur, malathion or pirimiphos-methyl. Monthly malaria incidence
      generally followed fluctuations of An.culicifacies density, usually with a peak
      in May-June.

PMID- 7787229
TI  - Simulium metallicum cytospecies E larval habitat characterization in the Altamira
      focus of onchocerciasis, northern Venezuela.
AB  - Simulium metallicum sibling species E was identified cytotaxonomically from an
      onchocerciasis focus at Altamira in northern Venezuela. S. metallicum E larvae
      were sampled monthly from two small mountain streams over a 15-month period (July
      1990 to September 1991) and eleven habitat variables were measured at two
      altitudes. One stream consistently harboured much higher densities of S.
      metallicum E larvae than the other, with three annual peaks of abundance: during
      the dry season and at the beginning and end of the rainy season. These peak
      densities were correlated with high rainfall 4 months previously. Larvae were
      most abundant on submerged rocks and fallen leaves, in small shallow areas
      characterized by slow water current, high conductivity and sparse terrestrial
      vegetation cover. Stream variables which best explained the temporal changes in
      abundance were water discharge and conductivity. The population dynamics of S.
      metallicum E appeared to be influenced primarily by interactions between stream
      discharge and substrate stability. Relevance of these results to vector control
      with larvicides is discussed.

PMID- 7787228
TI  - Low-volume application by mist-blower compared with conventional compression
      sprayer treatment of houses with residual pyrethroid to control the malaria
      vector Anopheles albimanus in Mexico.
AB  - Village-scale trials were carried out in southern Mexico to compare the efficacy
      of indoor-spraying of the pyrethroid insecticide lambda-cyhalothrin applied
      either as low-volume (LV) aqueous emulsion or as wettable-powder (WP) aqueous
      suspension for residual control of the principal coastal malaria vector Anopheles
      albimanus. Three indoor spray rounds were conducted at 3-month intervals using
      back-pack mist-blowers to apply lambda-cyhalothrin 12.5 mg a.i./m2 by LV, whereas
      the WP was applied by conventional compression sprayer at a mean rate of 26.5 mg
      a.i./m2. Both treatments caused mosquito mortality indoors and outdoors
      (collected inside house curtains) as a result of contact with treated surfaces
      before and after feeding, but had no significant impact on overall population
      density of An. albimanus resting indoors or assessed by human bait collections.
      Contact bioassays showed that WP and LV treatments with lambda-cyhalothrin were
      effective for 12-20 weeks (> 75% mortality) without causing excito-repellency.
      Compared to the WP treatment (8 houses/man/day), LV treatment (25 houses/man/day)
      was more than 3 times quicker per house, potentially saving 68% of labour costs.
      This is offset, however, by the much lower unit price of a compression sprayer
      (e.g. Hudson 'X-pert' at US$120) than a mist-blower (e.g. 'Super Jolly' at
      US$350), and higher running costs for LV applications. It was calculated,
      therefore, that LV becomes more economical than WP after 18.8 treatments/100
      houses/10 men at equivalent rates of application, or after 7.6 spray rounds with
      half-rate LV applications.

PMID- 7787230
TI  - A comparison of susceptibility to stocks of Trypanosoma vivax of Glossina
      pallidipes from allopatric populations in Kenya.

PMID- 7787231
TI  - Borreliae in larval Ixodes ricinus ticks.

PMID- 7787232
TI  - Evaluation of host-targeted applications of permethrin for control of Borrelia
      infected Ixodes ricinus (Acari: Ixodidae).

PMID- 7787233
TI  - A cytoplasmic polyhedrosis virus in the phlebotomine sandfly Lutzomyia
      longipalpis.

PMID- 7787234
TI  - The use of an enhanced ELISA method for the identification of Culicoides
      bloodmeals in host-preference studies.

PMID- 7787235
TI  - Muscle-specific gene expression during myogenesis in the mouse.
AB  - Over the past decade, significant advances in molecular biological techniques
      have substantially increased our understanding of in vivo myogenesis,
      supplementing the information that previously had been obtained from classical
      embryological and morphological studies of muscle development. In this review, we
      have attempted to correlate morphogenetic events in developing murine muscle with
      the expression of genes encoding the MyoD family of myogenic regulatory factors
      and the contractile proteins. Differences in the pattern of expression of these
      genes in murine myotomal and limb muscle are discussed in the context of muscle
      cell lineage and environmental factors. The differences in gene expression in
      these two types of muscle suggest that no single coordinated pattern of gene
      activation is required during the initial formation of the muscles of the mouse.

PMID- 7787237
TI  - Patterns of myosin isoforms in mammalian skeletal muscle fibres.
AB  - The present article attempts to combine existing information on the distribution
      of fast and slow myosin isoforms in histochemically distinct muscle fibres. Four
      myosin heavy chain (MHC) isoforms, MHCI, MHCIIa, MHCIIb, and MHCIId(x), have been
      identified in small mammals and have been assigned to the histochemically defined
      fibre types I, IIA, IIB, and IID(X), respectively. These fibres express only one
      MHC isoform and are called pure fibre types. Hybrid fibres expressing two MHC
      isoforms are regarded as transitory between respective pure fibre types. The
      existence of pure and hybrid fibres even in normal muscles under steady state
      conditions creates a spectrum of fibre types. The multiplicity of fibre types is
      even greater when myosin light chains are taken into account. A large number of
      isomyosins results from the combinatorial patterns of various myosin light and
      heavy chains isoforms, further increasing the diversity of muscle fibres. As
      shown by comparative studies, the distribution of different fibre types varies in
      a muscle-specific, as well as a species-specific manner.

PMID- 7787238
TI  - Expression of myosin heavy chain isoforms and myogenesis of intrafusal fibres in
      rat muscle spindles.
AB  - This review concerns the pattern of expression and regulation of myosin heavy
      chain (MHC) isoforms in intrafusal fibres of rat muscle spindles detected by
      immunocytochemistry. The three types of intrafusal fibres--nuclear bag1, nuclear
      bag2, and nuclear chain fibres--are unique in co-expressing several MHCs
      including special isoforms such as slow tonic and alpha cardiac-like MHC and
      isoforms typical of muscle development, such as embryonic and neonatal MHC. The
      distinct intrafusal fibre types appear sequentially during rat hind limb
      development, the nuclear bag2 precursors being first identifiable at 17-18 days
      in utero as the only primary myotubes expressing slow tonic MHC. Sensory
      innervation is required for the expression of "spindle-specific" MHC isoforms.
      Motor innervation contributes to the diversity in distribution of the different
      MHCs along the length of the nuclear bag fibres. It is suggested that unique
      populations of myoblasts are destined to become intrafusal fibres during
      development in the rat hind limb muscles and that the regional heterogeneity in
      MHC expression is related both to sensory and motor innervation and to the
      properties of the myoblast lineages. These distinct features make intrafusal
      fibres an attractive in situ model for investigating myogenesis,
      myofibrillogenesis, and the mechanisms regulating MHC expression.

PMID- 7787239
TI  - Computer graphics of SEM images facilitate recognition of chromosome position in
      isolated human metaphase plates.
AB  - There is general agreement that at the time of mitosis chromosomes occupy precise
      positions and that these positions likely affect subsequent nuclear function in
      interphase. However, before such ideas can be investigated in human cells, it is
      necessary to determine first the precise position of each chromosome with regard
      to its neighbors. It has occurred to us that stereo images, produced by scanning
      electron microscopy, of isolated metaphase plates could form the basis whereby
      these positions could be ascertained. In this paper we describe a computer
      graphic technique that permits us to keep track of individual chromosomes in a
      metaphase plate and to compare chromosome positions in different metaphase
      plates. Moreover, the computer graphics provide permanent, easily manipulated,
      rapid recall of stored chromosome profiles. These advantages are demonstrated by
      a comparison of the relative position of group A-specific and groups D- and G
      specific chromosomes to the full complement of chromosomes in metaphase plates
      isolated from a nearly triploid human-derived cell (HeLa S3) to a hypo-diploid
      human fetal lung cell.

PMID- 7787236
TI  - Development and postnatal regulation of adult myoblasts.
AB  - The myogenic precursor cells of postnatal and adult skeletal muscle are situated
      underneath the basement membrane of the myofibers. It is because of their unique
      positions that these precursor cells are often referred to as satellite cells.
      Such defined satellite cells can first be detected following the formation of a
      distinct basement membrane around the fiber, which takes place in late stages of
      embryogenesis. Like myoblasts found during development, satellite cells can
      proliferate, differentiate, and fuse into myofibers. However, in the normal,
      uninjured adult muscle, satellite cells are mitotically quiescent. In recent
      years several important questions concerning the biology of satellite cells have
      been asked. One aspect has been the relationship between satellite cells and
      myoblasts found in the developing muscle: are these myogenic populations
      identical or different? Another aspect has been the physiological cues that
      control the quiescent, proliferative, and differentiative states of these
      myogenic precursors: what are the growth regulators and how do they function?
      These issues are discussed, referring to previous work by others and further
      emphasizing our own studies on avian and rodent satellite cells. Collectively,
      the studies presented indicate that satellite cells represent a distinct myogenic
      population that becomes dominant in late stages of embryogenesis. Moreover,
      although satellite cells are already destined to be myogenic precursors, they do
      not express any of the four known myogenic regulatory genes unless their
      activation is induced in the animal or in culture. Furthermore, multiple growth
      factors are important regulators of satellite cell proliferation and
      differentiation. Our work on the role of one of these growth factors [platelet
      derived growth factor (PDGF)] during proliferation of adult myoblasts is further
      discussed with greater detail and the possibility that PDGF is involved in the
      transition from fetal to adult myoblasts in late embryogenesis is brought
      forward.

PMID- 7787240
TI  - Comparison of SEM processing methods for cultured human lens epithelial cells
      grown on flat and microcarrier bead substrates.
AB  - The increasing importance of in vitro models has presented new challenges in SEM
      processing techniques. The present study has evaluated the quality of
      preservation of cultured human lens epithelial cells processed by critical point,
      Peldri II, and tert-butyl alcohol drying. Specimens processed by critical point
      drying produced specimens with severe cracking of cell processes and microcracks
      across cell membrane surfaces. Peldri II and tert-butyl alcohol drying eliminated
      breakage of the filopodia and lamellipodia as well as eliminating the microcracks
      across the apical membrane surface. The morphology of lens epithelial cells grown
      on Cytodex 3 beads appeared rounded with convoluted membrane surfaces. These
      morphological features were present for cells processed by all three methods.
      Cytodex 3 beads were subsequently shown to shrink 52% in diameter during
      dehydration, which results in an 89% reduction in volume for the bead. Cells
      grown on Biosilon beads, which do not shrink, had a morphology similar to the
      cells grown on a flat substrate. These results indicate that Peldri II and tert
      butyl alcohol drying offer an attractive alternative to critical point drying
      when preparing cultured cells for SEM. Interpretation of cultured cell morphology
      must consider shrinkage of the substrate material as a possible contributor to
      artifact.

PMID- 7787241
TI  - Ultrastructural characterization of neurons recorded intracellularly in vivo and
      injected with lucifer yellow: advantages of immunogold-silver vs.
      immunoperoxidase labeling.
AB  - Immunoperoxidase labeling of lucifer yellow provides a sensitive method for
      morphological characterization of neurons recorded intracellularly in vitro or in
      vivo. However, the reaction product is often so dense that it obscures
      ultrastructural details necessary for the analysis of synaptic contacts onto
      individually filled neurons. In the present study, we describe a silver
      intensification procedure using 1 nm gold labeling of lucifer yellow as an
      optimal means for immunocytochemically identifying single physiologically
      characterized neurons at the ultrastructural level. Single neurons in the frontal
      cortex of anesthetized rats were impaled in vivo and filled with lucifer yellow.
      The brains were then perfused with an acrolein fixative. Single vibratome
      sections through the recording site were reacted with a rabbit antibody directed
      against lucifer yellow followed by goat anti-rabbit 1 nm gold-labeled IgG and
      silver intensified. For comparison, additional sections were processed for
      immunoperoxidase detection of lucifer yellow. Labeled sections were processed for
      light microscopy or embedded in plastic for electron microscopy. The immunogold
      silver label as well as peroxidase reaction product of lucifer yellow was readily
      detected in cell bodies, proximal and distal dendrites, and spines. However, in
      contrast to immunoperoxidase, the immunogold-silver reaction did not obscure
      subcellular organelles. Most importantly, the synaptic junctions formed by
      afferents to the filled neuron were more easily identifiable following the
      immunogold-silver procedure. This clear visualization of postsynaptic densities
      is essential for examining synaptic circuitry between afferents and
      physiologically characterized neurons.

PMID- 7787242
TI  - A fluorescent lipid analogue can be used to monitor secretory activity and for
      isolation of mammalian secretion mutants.
AB  - The use of reporter proteins to study the regulation of secretion has often been
      complicated by posttranslational processing events that influence the secretion
      of certain proteins, but are not part of the cellular mechanisms that
      specifically regulate secretion. This has been a particular limitation for the
      isolation of mammalian secretion mutants, which has typically been a slow
      process. To provide a reporter of secretory activity independent of protein
      processing events, cells were labeled with the fluorescent lipid analogue C5-DMB
      ceramide (ceramide coupled to the fluorophore boron dipyrromethene difluoride)
      and its secretion was followed by fluorescence microscopy and fluorescence
      activated cell sorting. Brefeldin A, which severely inhibits secretion in Chinese
      hamster ovary cells, blocked secretion of C5-DMB-ceramide. At high temperature,
      export of C5-DMB-ceramide was inhibited in HRP-1 cells, which have a conditional
      defect in secretion. Using C5-DMB-ceramide as a reporter of secretory activity,
      several different pulse-chase protocols were designed that selected mutant
      Chinese hamster ovary cells that were resistant to the drug brefeldin A and
      others that were defective in the transport of glycoproteins to the cell surface.
      Mutant cells of either type were identified in a mutagenized population at a
      frequency of 10(-6). Thus, the fluorescent lipid C5-DMB-ceramide can be used as a
      specific marker of secretory activity, providing an efficient, general approach
      for isolating mammalian cells with defects in the secretory pathway.

PMID- 7787243
TI  - Molecular cloning and characterization of human kinectin.
AB  - We have identified a human cDNA that is homologous to the chicken kinectin, a
      putative receptor for the organelle motor kinesin. The human cDNA clone
      hybridized to a single 4.6-kb mRNA species that codes for a protein of 156 kDa
      molecular mass. The predicted primary translation product contains an N-terminal
      transmembrane helix followed by a bipartite nuclear localization sequence and two
      further C-terminal leucine zipper motifs. In addition, the aminoacid sequence
      revealed a large region (327-1362) of predicted alpha-helical coiled coils. A
      monoclonal antibody CT-1 raised against a GST-kinectin fusion protein produced a
      perinuclear, endoplasmic reticulum-like staining pattern in diverse cell types
      from different species, indicating evolutionary conservation. Monoclonal antibody
      CT-1 and anti-chicken kinectin antibodies cross-reacted both in Western blotting
      and immunoprecipitation with a 160-kDa protein, confirming the antigenic identity
      of this 160-kDa protein with chicken kinectin. Epitope tagging studies revealed
      that the nuclear localization sequence motif of kinectin is not functional.
      Furthermore, a truncated kinesin cDNA lacking the N-terminal hydrophobic domain
      revealed a nonspecific cytoplasmic staining pattern. Together the data suggest
      that kinectin is an integral membrane protein anchored in the endoplasmic
      reticulum via a transmembrane domain.

PMID- 7787244
TI  - Characterization of kinectin, a kinesin-binding protein: primary sequence and N
      terminal topogenic signal analysis.
AB  - Kinectin is a kinesin-binding protein (Toyoshima et al., 1992) that is required
      for kinesin-based motility (Kumar et al., 1995). A kinectin cDNA clone containing
      a 4.7-kilobase insert was isolated from an embryonic chick brain cDNA library by
      immunoscreening with a panel of monoclonal antibodies. The cDNA contained an open
      reading frame of 1364 amino acids encoding a protein of 156 kDa. A bacterially
      expressed product of the full length cDNA bound purified kinesin. Transient
      expression in CV-1 cells gave an endoplasmic reticulum distribution that depended
      upon the N-terminal domain. Analysis of the predicted amino acid sequence
      indicated a highly hydrophobic near N-terminal stretch of 28 amino acids and a
      large portion (326-1248) of predicted alpha helical coiled coils. The 30-kDa
      fragment containing the N-terminal hydrophobic region was produced by cell-free
      in vitro translation and found to assemble with canine pancreas rough microsomes.
      Cleavage of the N terminus was not observed confirming its role as a potential
      transmembrane domain. Thus, the kinectin cDNA encodes a cytoplasmic-oriented
      integral membrane protein that binds kinesin and is likely to be a coiled-coil
      dimer.

PMID- 7787245
TI  - The cyclosome, a large complex containing cyclin-selective ubiquitin ligase
      activity, targets cyclins for destruction at the end of mitosis.
AB  - The ubiquitin-mediated degradation of mitotic cyclins is required for cells to
      exit from mitosis. Previous work with cell-free systems has revealed four
      components required for cyclin-ubiquitin ligation and proteolysis: a nonspecific
      ubiquitin-activating enzyme E1, a soluble fraction containing a ubiquitin carrier
      protein activity called E2-C, a crude particulate fraction containing a ubiquitin
      ligase (E3) activity that is activated during M-phase, and a constitutively
      active 26S proteasome that degrades ubiquitinated proteins. Here, we identify a
      novel approximately 1500-kDa complex, termed the cyclosome, which contains a
      cyclin-selective ubiquitin ligase activity, E3-C. E3-C is present but inactive
      during interphase; it can be activated in vitro by the addition of cdc2, enabling
      the transfer of ubiquitin from E2-C to cyclin. The kinetics of E3-C activation
      suggest the existence of one or more intermediates between cdc2 and E3-C.
      Cyclosome-associated E3-C acts on both cyclin A and B, and requires the presence
      of wild-type N-terminal destruction box motifs in each cyclin. Ubiquitinated
      cyclins are then rapidly recognized and degraded by the proteasome. These results
      identify the cyclosome-associated E3-C as the component of the cyclin destruction
      machinery whose activity is ultimately regulated by cdc2 and, as such, the
      element directly responsible for setting mitotic cyclin levels during early
      embryonic cell cycles.

PMID- 7787246
TI  - Control of the Cdc2/cyclin B complex in Xenopus egg extracts arrested at a G2/M
      checkpoint with DNA synthesis inhibitors.
AB  - Proliferating eukaryotic cells possess checkpoint mechanisms that block cell
      division in the presence of unreplicated or damaged DNA. Using cell-free extracts
      from Xenopus eggs, we have investigated the mechanisms underlying the inability
      of a recombinant Cdc2/cyclin B complex to induce mitosis in the presence of
      incompletely replicated DNA. We found that the activities of the kinases and
      phosphatases that regulate the major phosphorylation sites on Cdc2 (e.g.,
      tyrosine 15, threonine 14, and threonine 161) are not altered significantly under
      conditions where Xenopus extracts remain stably arrested in interphase due to the
      presence of the replication inhibitor aphidicolin. However, at threshold
      concentrations, a Cdc2/cyclin B complex containing a mutant Cdc2 subunit that
      cannot be phosphorylated on either tyrosine 15 or threonine 14 displays a
      markedly reduced capacity to induce mitosis in the presence of aphidicolin. This
      observation indicates that the replication checkpoint in Xenopus egg extracts
      functions without the inhibitory tyrosine and threonine phosphorylation of Cdc2.
      We provide evidence that the checkpoint-dependent suppression of the Cdc2/cyclin
      B complex involves a titratable inhibitor that is regulated by the presence of
      unreplicated DNA.

PMID- 7787249
TI  - Annexin II marks astrocytic brain tumors of high histologic grade.
AB  - Annexin II is highly expressed in glioblastoma multiforme [Reeves, S. A.; Chavez
      Kappel, C.; Davis, R.; Rosenblum, M.; Israel, M. A. Developmental regulation of
      annexin II (lipocortin 2) in human brain and expression in high grade glioma.
      Cancer Res. 52:6871-6876; 1992] and is a likely second messenger in mitogenic
      pathways known to be important for the growth of these tumors. We have examined
      tumor tissue from patients diagnosed with low-, intermediate-, or high-grade
      astrocytic tumors for expression of annexin II by immunohistochemistry, and found
      that annexin II levels varied significantly among these three tumors (P <
      0.0005). Levels were highest in glioblastoma multiforme, intermediate in
      anaplastic astrocytomas, and lowest in astrocytomas. In contrast to the usual
      cytoplasmic localization of annexin II, distinct nuclear staining was found in
      many of the specimens. Reactive astrocytes found in gliotic brain also stained
      with anti-annexin II antibody. We examined matched specimens for a correlation
      between annexin II staining intensity and the bromodeoxyuridine labeling index
      and found that, while tumors with the most intense annexin II staining had
      highest bromodeoxyuridine labeling indexes, there was not a strong association
      between these two parameters. The association between annexin II staining and
      histologic grade in astrocytic malignancies indicates that annexin II may be an
      important marker of high-grade glial tumors, and suggests that this marker may be
      useful for the pathologic classification of glial tumors and the clinical
      evaluation of brain tumor patients.

PMID- 7787247
TI  - Phosphorylation and activation of the Xenopus Cdc25 phosphatase in the absence of
      Cdc2 and Cdk2 kinase activity.
AB  - The M-phase inducer, Cdc25C, is a dual-specificity phosphatase that directly
      phosphorylates and activates the cyclin B/Cdc2 kinase complex, leading to
      initiation of mitosis. Cdc25 itself is activated at the G2/M transition by
      phosphorylation on serine and threonine residues. Previously, it was demonstrated
      that Cdc2 kinase is capable of phosphorylating and activating Cdc25, suggesting
      the existence of a positive feedback loop. In the present study, kinases other
      than Cdc2 that can phosphorylate and activate Cdc25 were investigated. Cdc25 was
      found to be phosphorylated and activated by cyclin A/Cdk2 and cyclin E/Cdk2 in
      vitro. However, in interphase Xenopus egg extracts with no detectable Cdc2 and
      Cdk2, treatment with the phosphatase inhibitor microcystin activated a distinct
      kinase that could phosphorylate and activate Cdc25. Microcystin also induced
      other mitotic phenomena such as chromosome condensation and nuclear envelope
      breakdown in extracts containing less than 5% of the mitotic level of Cdc2 kinase
      activity. These findings implicate a kinase other than Cdc2 and Cdk2 that may
      initially activate Cdc25 in vivo and suggest that this kinase may also
      phosphorylate M-phase substrates even in the absence of Cdc2 kinase.

PMID- 7787248
TI  - The bulk of unpolymerized actin in Xenopus egg extracts is ATP-bound.
AB  - Non-muscle cells contain 15-500 microM actin, a large fraction of which is
      unpolymerized. Thus, the concentration of unpolymerized actin is well above the
      critical concentration for polymerization in vitro (0.2 microM). This fraction of
      actin could be prevented from polymerization by being ADP bound (therefore less
      favored to polymerize) or by being ATP bound and sequestered by a protein such as
      thymosin beta 4, or both. We isolated the unpolymerized actin from Xenopus egg
      extracts using immobilized DNase 1 and assayed the bound nucleotide. High
      pressure liquid chromatography analysis showed that the bulk of soluble actin is
      ATP bound. Analysis of actin-bound nucleotide exchange rates suggested the
      existence of two pools of unpolymerized actin, one of which exchanges nucleotide
      relatively rapidly and another that apparently does not exchange. Native gel
      electrophoresis of Xenopus egg extracts demonstrated that most of the soluble
      actin exists in complexes with other proteins, one of which might be thymosin
      beta 4. These results are consistent with actin polymerization being controlled
      by the sequestration and release of ATP-bound actin, and argue against nucleotide
      exchange playing a major role in regulating actin polymerization.

PMID- 7787250
TI  - p53 mutations in bladder carcinoma cell lines.
AB  - Point mutations and deletions in the p53 tumor suppressor gene occur frequently
      in advanced stage bladder tumors. To extend these observations to an in vitro
      model of bladder tumorigenicity, we have evaluated the presence of p53 mutations
      in a panel of bladder carcinoma cell lines. p53 alleles were cloned using the
      reverse transcriptase-polymerase chain reaction method, and exons 2-11 were
      sequenced. Of 11 cell lines examined, 5 cell lines had missense point mutations,
      and each overexpressed p53 protein on western blot analysis. Except for the HT
      1197 cell line, these point mutations occurred in evolutionarily conserved
      domains, which are characteristic hot spots for mutations. HT-1197 encodes an
      unusual C-terminal point mutation in codon 365, within the basic motif
      tetramerization domain, suggesting a linkage between induction of a mutant p53
      conformation and alterations in protein oligomerization. Six of 11 cell lines had
      wild-type levels of p53 expression, with 4 producing p53 proteins having either
      internal deletions or truncations, and 2 producing wild-type p53. Presence of
      wild-type p53 was found only in cell lines derived from either a low-grade,
      papillary tumor (RT4) or fetal bladder (FHs 738Bl). The T24 cell line was found
      to contain a novel p53 mutant having an in-frame deletion of tyrosine 126. This
      p53 mutant does not bind SV40 large T antigen, yet is expressed at low levels,
      comparable to cell lines containing wild-type p53 alleles. Our findings
      characterize p53 mutations in a panel of bladder carcinoma cell lines, and
      provide a model for testing the role of wild-type or mutant p53 cDNA to suppress
      or induce tumorigenic properties.

PMID- 7787251
TI  - Enhanced cytotoxicity with interleukin-1 alpha and 5-fluorouracil in HCT116 colon
      cancer cells.
AB  - Recombinant human interleukin-1 alpha (rIL-1 alpha), at concentrations that were
      not growth-inhibitory when given alone (100-10,000 U/ml), enhanced the growth
      inhibition resulting from a 72-h fluorouracil (FUra) exposure in HCT116 colon
      cancer cells. Median-effect analysis of clonogenic assays indicated that rIL-1
      alpha, given 24 h prior to and following a 24-h exposure to FUra, increased
      lethality in a more than additive fashion. rIL-1 alpha did not appear to
      significantly affect [3H]-FUra metabolism, total [3H]-FUra-RNA incorporation or
      RNA retention after drug removal, inhibition of thymidylate synthase, or
      thymidine triphosphate pool depletion. During continuous exposure to rIL-1 alpha,
      transient stimulation of RNA and DNA synthesis was observed at 72 h, with a
      return to normal by 96 h. A 24-h exposure to 10 microM FUra altered the elution
      profile of newly synthesized DNA as monitored by pH step alkaline elution. An
      accumulation of lower-MW single-stranded DNA species was noted with FUra compared
      to control, accompanied by a significantly decreased proportion of DNA retained
      on the polycarbonate filter: 10% retained vs. 32% for control (P = 0.01). A 48-h
      exposure to rIL-1 alpha alone did not affect the elution profile of nascent DNA
      species, nor did it enhance the effects of FUra. Although FUra did not
      appreciably affect pulse [3H]-uridine incorporation into RNA for the initial 8-24
      h of FUra exposure, progressive inhibition of net RNA synthesis was observed
      thereafter. FUra prevented the stimulatory effect of rIL-1 alpha on RNA
      synthesis, and net RNA synthesis was significantly inhibited (by 64-79% after 72
      and 96 h) with the combination compared to rIL-1 alpha alone. Continuous exposure
      to 10 microM thymidine did not rescue cells from the lethality of FUra alone or
      the combination of FUra plus rIL-1 alpha, suggesting that depletion of
      deoxythymidine triphosphate as a consequence of thymidylate synthase inhibition
      was not the most important component of FUra toxicity. In contrast, 1 mM uridine
      provided partial protection against the toxicity of FUra alone or with rIL-1
      alpha. Although uridine did not affect FUra metabolism, it decreased FUra-RNA
      incorporation by 42-60%, presumably as a consequence of the 2-fold expansion of
      UTP pools. [125I]-rIL-1 alpha binding was nonspecific; with a 24-h exposure,
      however, internalized [125I]-rIL-1 alpha exceeded cell surface-bound material by
      2-fold.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787253
TI  - Whole-body autoradiographic study of [3H]-PK 11195 distribution in dunning AT-1
      tumour-bearing rats.
AB  - In vivo binding of [3H]-PK 11195 to peripheral benzodiazepine binding sites in
      Dunning AT-1 prostatic tumour-bearing rats was investigated by whole-body
      autoradiography. Distribution and retention of PK 11195 in tumour and other
      organs was examined at different time intervals. Autoradiograms indicated PK
      11195 binding sites in the periphery of the tumour, whereas no or little binding
      was detected in the prostate. Among other organs, adrenal cortex was most
      intensely radiolabelled. Administration of nonradioactive PK 11195 before [3H]-PK
      11195 blocked binding in all organs more completely than in tumour, kidney, and
      adrenal cortex, where low levels of radioactivity still were present.
      Radioactivity in the tumour, contrary to other organs, seemed to increase with
      time, indicating a slow uptake with large capacity. High performance liquid
      chromatography analysis of extracted radioactivity from the tumour showed that
      almost all radioactivity consisted of intact [3H]-PK 11195. These results
      indicate binding in vivo of PK 11195 to peripheral benzodiazepine receptors in
      Dunning AT-1 rat prostatic tumours and a large capacity for uptake and retention
      of [3H]-PK 11195 in tumours.

PMID- 7787252
TI  - Effect of the local anesthetic bupivacaine on the energy metabolism of Ehrlich
      ascites tumor cells.
AB  - The effect of the local anesthetic bupivacaine on the energy metabolism of
      Ehrlich ascites tumor cells has been investigated. Even at low concentrations,
      bupivacaine decreased the oxygen uptake rate, but its effect was remarkably
      higher on the uncoupled respiration. Experiments on specific segments of the
      respiratory chain have shown that bupivacaine did not inhibit electron transport
      from Q to oxygen. Spectroscopic evidences demonstrated a NAD(P)H oxidation in
      bupivacaine-treated cells respiring on endogenous substrates, indicating that the
      inhibition of oxygen depended on a reduced electron transport from site 1
      entering substrates to respiratory chain. The aerobic glycolysis was stimulated
      by low and inhibited by high bupivacaine concentrations. The increased lactate
      production rate was due to an activation of mitochondrial ATPase, whereas its
      decrease was related to an inhibition of the hexokinase activity.

PMID- 7787256
TI  - Arrhythmias.

PMID- 7787254
TI  - Biological activity of human N-ras and K-ras genes containing the Asn17 dominant
      negative mutation.
AB  - Substitution of asparagine for serine at position 17 of human H-ras results in an
      impaired GTP-binding activity, causing the mutant Ras protein to be locked in a
      constitutively inactive GDP-bound state. Expression of this mutant in NIH 3T3
      cells inhibits cell proliferation by blocking endogenous ras function. Plasmids
      that encode the analogous dominant negative mutation at position 17 in human N-
      and K-ras were constructed. These mutant ras genes, driven by a heavy metal
      inducible sheep metallothionein promoter, were introduced by transfection into a
      variety of animal cell lines. All three mutant ras genes displayed an inhibitory
      phenotype when expressed in NIH 3T3 cells. This inhibition could be overcome by
      cotransfection with either activated H-ras or v-raf. These data indicate that the
      three human Ras proteins probably act through the same signal transduction
      pathway in NIH 3T3 cells and suggest that these mutations may confer similar
      phenotypes to other GTP/GDP-binding proteins.

PMID- 7787255
TI  - Reference listings in cancer research.

PMID- 7787257
TI  - Pediatrics.

PMID- 7787258
TI  - Arrhythmogenic right ventricular dysplasia.
AB  - Arrhythmogenic right ventricular dysplasia is a relatively newly described
      clinical entity that is more and more frequently recognized. It may explain an
      increasing number of unexpected, sudden deaths in young adults that are or are
      not preceded by cardiac symptoms. A genetic transmission of the disease has been
      suggested by the study of familial cases. A location on chromosome 14 appears to
      be responsible for this disease. In some patients, a superimposed inflammatory
      process mixed with the pattern of arrhythmogenic right ventricular dysplasia may
      explain the progressive deterioration of left ventricular function. The
      systematic study of electrocardiograms demonstrates prolongation of the QRS
      complex and repolarization abnormalities in the right precordial leads due to a
      parietal block. Multiple therapeutic approaches are now available. The first line
      of therapy remains antiarrhythmic drugs, which are effective in most cases.
      Ablative techniques, implantable defibrillators, and heart transplantation have
      been used in the most severe examples of the disease.

PMID- 7787259
TI  - Catheter ablation of ventricular tachycardia.
AB  - Endocardial lesions created by radiofrequency catheter ablation are relatively
      small and focal. The application of radiofrequency ablation to patients with
      structural heart disease and ventricular tachycardia is quite limited because the
      substrate for these tachycardias is often diffuse or difficult to localize. In
      contrast, idiopathic ventricular tachycardia often originates from a discrete
      focus and can usually be ablated using radiofrequency energy. The wider
      applicability of ablation therapy for ventricular tachycardia will depend on
      improvements in mapping techniques and the ability to create larger areas of
      injury in patients with coronary artery disease and ventricular tachycardia.

PMID- 7787260
TI  - Antiarrhythmic drug interactions.

PMID- 7787261
TI  - Health care reform and belt tightening: how can we become more cost effective?
      Commentary.

PMID- 7787262
TI  - New insights on anatomical location of components of the reentrant circuit and
      ablation therapy for atrioventricular junctional reentrant tachycardia.
AB  - The success of radiofrequency catheter ablation in the treatment of
      atrioventricular junctional, or atrioventricular nodal, reentrant tachycardia has
      rekindled interest in the electrophysiological and anatomical characteristics of
      the reentrant circuit. We conclude that there is no evidence that within the
      atrioventricular nodal area, which contains both the compact node and
      transitional cells, there are anatomically delineated dual or multiple pathways.
      Rather, the two main atrial inputs into the atrioventricular nodal area
      (posterior and anterior) seem to be the anatomically relevant structures for
      "slow" and "fast" pathways. Two other inputs (sinus septum and left atrial) may
      be the cause for multiple pathways in some individuals. Nonuniform anisotropic
      properties of the zone of transitional cells may account for slow or fast
      conduction in the same area, depending on directional differences of wavefronts.
      We prefer the term atrioventricular junctional reentrant tachycardia rather than
      atrioventricular nodal reentrant tachycardia because of mounting evidence that
      perinodal tissue is involved in the reentrant circuit. Finally, the role and
      origin of double extracellular electrograms is discussed. Further research is
      required to establish whether an anatomical or an electrogram-guided approach for
      catheter ablation is preferred.

PMID- 7787263
TI  - The molecular genetics of cardiovascular disease.
AB  - The following consideration of this past year's published studies uses the cited
      reports as important examples of the ongoing characterization of the molecular
      basis of cardiac disease and the process of cardiac development. Mutations in
      cardiac troponin T and alpha-tropomyosin have been identified in familial
      hypertrophic cardiomyopathy, as have new beta-myosin heavy chain gene mutations.
      The general relation between beta-myosin heavy chain gene mutations that produce
      a charge change versus conservative amino acid replacements and sudden death
      remains unresolved. New fibrillin 1 gene mutations have been identified in
      patients with Marfan syndrome, the neonatal form of Marfan syndrome, and ectopia
      lentis. The same mutation is rarely found in more than one family. The
      association of supravalvar aortic stenosis and elastin gene mutations was further
      strengthened. The complexity of the relation between dystrophin mutations and the
      cell-specific loss of dystrophin expression can result in patients having
      cardiomyopathy and no myopathy. X-chromosome inactivation was shown to be the
      basis of cardiomyopathy in women with a single mutated dystrophin allele. New
      candidate genes that control cardiac morphogenesis and myocyte differentiation
      were proposed. New evidence to support 22q11 microdeletions as a common basis of
      nonsyndromic conotruncal malformations was published. These studies represent an
      important beginning. Although mutant genes have been recognized in affected
      individuals with various syndromes and congenital cardiac abnormalities, our
      understanding of how a genotype yields a given phenotype remains to be
      established.

PMID- 7787264
TI  - Recent insights into the regulation of cardiac Ca2+ flux during perinatal
      development and in cardiac failure.
AB  - Systolic and diastolic cardiac function improve during the transition from fetus
      to newborn to adult. This perinatal maturation is temporally correlated with and
      at least partially dependent on subcellular changes in the expression of several
      gene products that regulate cytosolic Ca2+ concentration. Expression of the Na(+)
      Ca2+ exchanger of the sarcolemma is highest in the fetus, whereas expression of
      the sarcoplasmic reticulum Ca2+ pump and the voltage-dependent Ca2+ channel of
      the sarcolemma increase in conjunction with the perinatal maturation of cardiac
      function. Whereas cardiac relaxation in the normal mature heart depends primarily
      on the sarcoplasmic reticulum Ca2+ pump, relaxation in the fetal heart appears to
      be more dependent on transsarcolemmal Ca2+ flux. Like the fetal heart during
      prolonged relaxation, the failing human heart exhibits impaired relaxation and
      abnormal Ca2+ flux regulation. Although altered expression of several gene
      products has been demonstrated in the failing heart, the responsible factor(s)
      remains unknown.

PMID- 7787266
TI  - Congenital cardiovascular disease and cardiac surgery in childhood: Part 1.
      Cyanotic congenital heart defects.
AB  - The management of congenital heart disease is in a state of evolution, with
      earlier surgical and/or catheter interventions dominating clinical decision
      making. Recent advances in interventional cardiac catheterization techniques, as
      well as continuing advances in the surgical management of complex congenital
      defects, continue to be the focus of attention of cardiologists and surgeons. The
      majority of the papers reviewed document mid- and long-term results of specific
      operative procedures for and address the appropriate role of cardiac
      catheterization techniques in the management of transposition of the great
      vessels, tetralogy of Fallot, total anomalous pulmonary venous connection,
      truncus arteriosus, pulmonary atresia with intact ventricular septum, and the
      univentricular heart. Early definitive intervention has become the standard of
      care for almost all defects reviewed.

PMID- 7787265
TI  - Fetal arrhythmias, pediatric arrhythmias, and pediatric electrophysiology.
AB  - The practice of pediatric electrophysiology has been altered drastically and
      irrevocably over the past 5 years. With the advent of widespread application of
      transcatheter radiofrequency ablative techniques in young patients, decision
      making in the management of childhood arrhythmias has focused less on palliative
      medical therapies and more on the potential for curative, nonsurgical
      interventions. This review examines the published contributions in the area of
      pediatric catheter ablation, antiarrhythmic drug therapy, postoperative
      arrhythmias, fetal arrhythmias, and electrocardiographic phenomena after cardiac
      transplantation.

PMID- 7787267
TI  - Congenital cardiovascular disease and cardiac surgery in childhood: Part 2.
      Acyanotic congenital heart defects and interventional techniques.
AB  - The literature for the period reviewed documents a significant reduction of
      morbidity and mortality for neonatal repairs of atrioventricular septal defects,
      coarctation of the aorta, and ventricular septal defects. Long-term follow-up of
      patients with coarctation of the aorta provides important suggesting that earlier
      repair of asymptomatic coarctation and complete elimination of obstruction in the
      arch as well as at the coarctation site are essential to better long-term
      results. Surgery for complete atrioventricular septal defect has evolved from
      palliation, with poor long-term results, to complete repair within the first 6
      months of life, with minimal morbidity and mortality. Special emphasis is now
      placed on children with Down's syndrome who have complete atrioventricular septal
      defects; data confirm their tendency for earlier development of pulmonary
      vascular obstructive changes. Further refinements in surgical and interventional
      catheterization techniques have resulted in promising advances for many lesions-
      coarctation of the aorta (native and recurrent); valvular, subvalvular, and
      supravalvular aortic stenosis; valvular pulmonary stenosis; patent ductus
      arteriosus; and branch pulmonary artery stenosis--and have prompted provocative
      discourse between cardiologists and surgeons. These refinements in surgical and
      interventional techniques have initiated a new era in the clinical management of
      congenital heart disease in childhood.

PMID- 7787268
TI  - Advances in acquired pediatric heart disease.
AB  - Acquired heart disease in children may result in significant morbidity and
      mortality. Advances continue to be made in understanding Kawasaki disease, acute
      and chronic rheumatic heart disease, infective endocarditis, myocarditis, and
      dilated cardiomyopathy. The role of superantigens, particularly bacterial toxins,
      in the pathogenesis of Kawasaki disease continues to be defined. Intravascular
      ultrasound promises to improve the assessment of coronary arteries in Kawasaki
      disease. Current recommendations for the long-term management of Kawasaki disease
      are discussed. Significant changes in the epidemiology of acute rheumatic fever
      and endocarditis are noted. Updates on the role of echocardiography as well as
      current therapeutic issues in these diseases are addressed. The application of
      immunologic and molecular biologic techniques have implicated genetic and immune
      factors in the pathogenesis of myocarditis and cardiomyopathy. The relationship
      between viral infection and subsequent dilated cardiomyopathy, as well as the
      role of autoimmune mechanisms in the pathogenesis of these disorders, remains
      controversial.

PMID- 7787269
TI  - New perspectives in childhood blood pressure.
AB  - Ambulatory blood pressure monitoring is a new technique available to the
      pediatric cardiologist, and several studies have investigated its usefulness.
      Investigators are now providing data for both normal values and reproducibility.
      Other authors have examined the effects of hypertension in mothers upon their
      offspring, which include small birthweight and possible developmental delay. New
      data, particularly from the Bergen Blood Pressure Study, indicate that maternal
      hypertension may be a precursor for future blood pressure elevation in offspring.
      It is known that obese people are more likely to be hypertensive. A study
      performed in China in a lean population, including individuals who were
      relatively obese, showed the positive relation of body weight to blood pressure.
      Furthermore, data now emerging indicate that both retinal vessels and renal
      arteries in children suffer changes with persistently elevated blood pressure.
      This clearly is something to follow. Other articles examined in this review
      investigate the relation of atherosclerosis to hypertensive disease.

PMID- 7787270
TI  - Identification of patients with hypertrophic cardiomyopathy at high risk for
      sudden death.
AB  - Patients with hypertrophic cardiomyopathy are at increased risk for sudden death.
      Recent studies have improved our ability to risk-stratify such patients and have
      elucidated several potential mechanisms of sudden death and syncope. Certain
      noninvasive tests, such as signal-averaged electrocardiography and measurements
      of cardiac autonomic function and QT/QT dispersion, are often abnormal in
      hypertrophic cardiomyopathy, but are not useful for risk stratification.
      Myocardial ischemia determined by exercise thallium scintigraphy, however,
      identifies young patients with hypertrophic cardiomyopathy who are at high risk
      for cardiac arrest and syncope. Nonsustained ventricular tachycardia on
      ambulatory Holter monitoring in the absence of symptoms of impaired consciousness
      is associated with a benign prognosis and is not predictive of sudden death.
      Conversely, ventricular tachycardia induced at electrophysiologic study
      identifies adult patients with hypertrophic cardiomyopathy who subsequently
      experience sudden death. Finally, characterization of the natural history of the
      genetic defects will increasingly become an integral part of risk evaluation in
      hypertrophic cardiomyopathy.

PMID- 7787271
TI  - Adult congenital heart disease.
AB  - Much of the literature published in 1993 on the topic of adult congenital heart
      disease described long-term follow-up of patients following repair in childhood.
      This report reviews the most important papers published during the past year
      related to long-term follow-up, and also describes new information on the
      noninvasive evaluation of congenital heart disease in adults as well as the
      interventional cardiologic techniques that are currently being applied to treat
      some defects in the catheterization laboratory.

PMID- 7787272
TI  - Valvular heart disease.

PMID- 7787273
TI  - Heart transplantation.

PMID- 7787274
TI  - Advances in noninvasive assessment of valvular heart disease.
AB  - Echocardiography continues to be the noninvasive method of choice in the
      evaluation of valvular heart disease. Important recent developments include
      clinical validation of approaches used to quantify valvular regurgitation, in
      particular the proximal flow convergence zone method; use of transesophageal
      imaging to monitor and evaluate surgical or percutaneous interventions in
      valvular heart disease, in particular mitral valve repair; insight into flow
      related stretch of the orifice area in aortic stenosis; and validation of nuclear
      magnetic resonance imaging in small series for quantification of left-sided
      valvular stenotic and regurgitant lesions.

PMID- 7787275
TI  - Recent developments in the diagnosis and management of mitral valve prolapse.
AB  - Mitral valve prolapse (MVP), which occurs in about 3% of adults, is usually a
      primary, dominantly inherited condition. MVP may be diagnosed by auscultation of
      a mid-systolic click and late-systolic murmur that move dynamically with postural
      maneuvers. M-mode echocardiography confirms MVP by demonstrating late-systolic
      prolapse and two-dimensional echocardiography reveals leaflet billowing into the
      left atrium. Echocardiography identifies severe forms of MVP by documenting
      significant mitral regurgitation, enlargement and thickening of the mitral
      leaflets and annulus, and loss of leaflet apposition. In contrast to early
      reports, true "MVP syndrome" as revealed by controlled studies consists of low
      body weight and blood pressure, minor skeletal abnormalities, orthostatic
      hypotension, palpitations, and mitral regurgitation that is usually mild.
      Complications of MVP include progressive mitral regurgitation, infective
      endocarditis, orthostatic syncope, and possible risks of neurologic ischemia and
      arrhythmic sudden death. Risk factors we have identified for complications among
      patients with MVP include older age, male gender, the presence of mitral
      regurgitation, and possibly, higher weight and blood pressure. The cumulative
      risk of all complications of MVP by age 75 is from 5% to 10% for affected men and
      2% to 5% for affected women. Patients with MVP who have neither a murmur nor
      Doppler evidence of mitral regurgitation may be reassured that their condition is
      benign. For other patients with MVP we have shown that oral antibiotic
      prophylaxis is cost-effective. The presence and severity of mitral regurgitation
      govern the frequency and intensiveness of follow-up.

PMID- 7787276
TI  - Management of valvular stenosis.
AB  - The management of valvular stenosis has changed dramatically over the past 15
      years, largely due to interventional cardiology. At the beginning of the 1980s,
      balloon valvuloplasty was thought by many to represent a definitive new treatment
      for calcific aortic stenosis in the elderly infirm. Before the end of the decade,
      this treatment had gone out of favor, but by that time we had learned that many
      of those same patients could undergo aortic valve replacement relatively safely
      and with excellent results. Unlike aortic stenosis, mitral stenosis is a
      disabling rather than a lethal disease, so the timing of intervention is much
      more difficult, particularly as there are treatment choices. Mortality,
      morbidity, and the possible bonus from proceeding earlier rather than later all
      need to be taken into consideration. Much to many people's surprise, mitral
      balloon valvuloplasty has grown and prospered, especially since the introduction
      of the Inoue balloon. It is the treatment of choice for young patients with
      mobile, noncalcified, stenosed valves, although still offering worthwhile
      palliation for older patients with higher echocardiographically determined valve
      scores. Echocardiography has gradually usurped cardiac catheterization for the
      assessment of valve stenosis and left ventricular function, but in patients with
      concomitant coronary disease that will be treated at the same time, the need for
      coronary angiography remains almost unchallenged.

PMID- 7787277
TI  - Management of valvular regurgitation.
AB  - The principles of the management of left-sided valvular regurgitation, which
      weigh watchful waiting against surgery, have crystallized over the past 15 years.
      While the timing of surgery once was enigmatic, it is now clear that surgery must
      be done prior to the development of prolonged left ventricular dysfunction.
      Fortunately, satisfactory indexes have been developed that allow the clinician to
      detect and avoid such dysfunction. Therefore, patients now undergo surgery
      sooner, resulting in reduced operative mortality and better long-term survival.
      However, there are still several unresolved issues regarding the management of
      valvular regurgitation. For instance, operations for mitral regurgitation that
      preserve the mitral apparatus improve postoperative left ventricular performance
      compared with conventional mitral valve replacement. However, the proper timing
      for these operations is still being examined. Another issue is whether
      vasodilators, which reduce the regurgitant overload, can delay the onset of
      ventricular dysfunction and thus also delay surgery. In contemplating vasodilator
      use there is a paradox between the principle of early surgery to prevent
      dysfunction and use of medical therapy to delay surgery. Several studies which
      have appeared in the literature in the past year help resolve some of these
      issues.

PMID- 7787278
TI  - Recent developments in balloon valvuloplasty techniques.
AB  - The long-term outcome after mitral valvuloplasty is excellent and compares well
      with surgical treatment of mitral stenosis. Compared with the double balloon
      technique, the Inoue method is technically easier and may reduce acute
      complications without any adverse effect on long-term outcomes. Excellent long
      term outcome is also seen after balloon valvuloplasty of aortic stenosis in the
      young and in pulmonary stenosis at all ages. Finally, although balloon aortic
      valvuloplasty in the elderly may not change the terrible prognosis of such
      patients, it does improve functional status and is a useful bridge to surgery in
      selected patients.

PMID- 7787279
TI  - Surgical repair and reconstruction of valvular lesions.
AB  - Thirty-six years have passed since the inception of mitral valve repair by
      Lillehei and McGoon. In the period presently under review it is apparent that
      mitral valve repair and the late results have become more predictable.
      Previously, repair was not attempted because of concern that valve replacement,
      with its attendant problems, might be necessary. This attitude appears to be
      slowly changing. The current issue is whether patients who have severe mitral
      regurgitation but are relatively asymptomatic should be referred for repair
      before ventricular function deteriorates or atrial fibrillation develops. Current
      evidence suggests that approximately 10% of asymptomatic patients will progress
      sufficiently each year to require surgical intervention. Systolic anterior motion
      of the mitral valve causing left ventricular outflow tract obstruction, has,
      since the era of routine intraoperative transesophageal echocardiography, become
      a well-recognized occasional consequence of mitral valve repair. Numerous
      theories have been suggested as to its cause: the most plausible suggest that
      risk factors include the presence of excess valvular tissue, a bulging septum, a
      nondilated hyperdynamic left ventricle, and a narrow mitral-aortic angle. The
      fact that numerous annuloplasty techniques exist, each having its own
      proponent(s), suggests that different techniques or types of annuloplasty are
      equally effective. Reparative techniques for the aortic valve have lagged behind
      those for the mitral valve because of limited previous success. The type of valve
      pathology was recently classified in terms of repair and new techniques, which
      are briefly documented, have been tried.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787280
TI  - Which prosthetic valve should we choose?
AB  - In this review I concentrate on issues related to prosthetic valves themselves:
      their development, performance, and durability. For example, mechanical failure
      or tissue deterioration appear to be intrinsic properties of the valve and are
      therefore central to my topic, whereas the development, diagnosis, and management
      of endocarditis are largely independent of the type of prosthesis and are thus
      not dealt with here. Other outcomes such as stroke are also determined by factors
      other than the choice of valve, as was cogently argued in papers published during
      the past year. The papers on tissue valves have a common theme: they document the
      inevitability of tissue failure, too early for acceptable use other than in old
      age. The mechanical valves that have stood the test of time have done so because
      they do not fail.

PMID- 7787282
TI  - Heart transplantation.

PMID- 7787281
TI  - New developments in infective endocarditis.
AB  - Endocarditis as seen today differs significantly from that outlined by Sir
      William Osler in his famous Gulstonian lectures in 1885. The median age of the
      patients has increased; the spectrum of predisposing cardiac lesions has changed;
      more cases are due to unusual organisms, including gram-negative bacteria and
      fungi; and more cases present acutely and the classic findings of late
      endocarditis are seldom seen. Endocarditis was untreatable and uniformly fatal in
      1885. Although continued advances in medical and surgical therapy have
      significantly increased survival, the recent appearance of multiresistant
      organisms in some cases is reminiscent of the Osler era. Recent advances in the
      diagnosis and management of endocarditis include the identification of a specific
      Staphylococcus aureus receptor protein on endothelial cells, better imaging of
      the cardiac structures using transesophageal echocardiography, improvement in
      clinical diagnostic criteria and surgical techniques, and the use of outpatient
      oral antibiotics for penicillin-sensitive streptococcal endocarditis.

PMID- 7787283
TI  - Candidate evaluation and selection for heart transplantation.
AB  - Because of the increasing discrepancy between the number of identified candidates
      for heart transplantation and available donor organs, appropriate selection of
      patients for heart transplantation is critical. The establishment of a cardiac
      prognosis that is significantly worse than that following heart transplant is
      central in the determination of candidacy for transplantation. However, with
      recent improvements in heart failure management, prognosis must be considered a
      dynamic state involving periodic reassessment to ensure an individual's ongoing
      suitability for transplantation. There have been many descriptions of prognostic
      indexes in heart failure, but care must be used when extrapolating observations
      collected from patients with a broad range of conditions to those with end-stage
      disease. The contraindications to heart transplantation have also evolved with
      the increasing success of the transplant process. Many conditions that precluded
      patients from heart transplant in the past are no longer regarded as absolute.
      Despite less stringent conditions for recipient candidacy, the need to achieve
      optimal results with an increasingly valuable donor resource will necessitate
      careful scrutiny of the posttransplant implications of the various conditions
      currently regarded as contraindications to heart transplant. Determination of
      heart transplantation candidacy therefore continues to remain a highly
      individualized process, requiring clinical judgment and experience.

PMID- 7787284
TI  - Socioeconomic aspects of heart transplantation.
AB  - Heart transplantation is an established treatment modality for end-stage cardiac
      disease. Unfortunately, relative to other health care priorities, heart
      transplantation has fallen into disrepute. Efforts to reform the health care
      system have focused on three fundamental issues--cost, quality, and access. On
      each count, heart transplantation is vulnerable to criticism. Managed care is an
      incremental approach to health care reform that imposes fiscal constraint on
      providers. This constraint is expressed in the form of capitation which, in turn,
      requires providers to assume risk and accept economic responsibility for clinical
      decisions. While the need for transplantation is considerable, there are both
      clinical and economic factors limiting the overall level of activity. In 1993,
      over 2200 heart transplants were performed in the United States on people who
      were dying of end-stage cardiac disease. The total demand for heart
      transplantation was estimated to be about 5900 persons, which was not met due to
      an insufficient supply of donor hearts. Absent donors, the fiscal consequences of
      heart transplantation are minimized. In 1993, actuaries estimated that the total
      charge per heart transplant was $209,100. By designating centers based on price
      and quality considerations, managed care plans have reduced this per procedure
      expense to less than $100,000. While the benefits of transplantation are
      noteworthy, there are still concerns. Sixty percent of patients report that they
      are able to work, but only 30% do so. Employers hope to improve upon this record
      by expanding the designated center approach. In conclusion, the future of heart
      transplantation is unclear. Opportunities for innovation are limited, although
      the management of heart failure is an area of increased interest.

PMID- 7787285
TI  - Clinical follow-up of the heart transplant recipient.
AB  - Long-term survival of heart transplant recipients is now commonplace, due to
      improved perioperative care. It is thus appropriate to review recent studies
      concerning immunosuppression-related clinical problems in heart transplant
      recipients, including infections, malignancies, hypertension, hyperlipidemia, and
      osteoporosis. Hormonal and peripheral vascular responses of the denervated heart,
      exercise tolerance, pulmonary function, and parenting are also discussed.

PMID- 7787286
TI  - Immunopathology of cardiac transplant rejection.
AB  - Transplant rejection represents a diverse series of complex immunological events
      beginning with allorecognition and lymphocyte activation and differentiation,
      followed by interactions of antibodies and activated lymphocytes with the
      vascular endothelium and subsequent cellular infiltration into the allograft,
      and, finally, the inflammatory process leading to tissue injury. This paper
      reviews how these events contribute to the different types of cardiac transplant
      rejection, including cardiac allograft vasculopathy.

PMID- 7787287
TI  - Immunosuppression in cardiac transplantation: a new era in immunopharmacology.
AB  - During the past 5 years, there has been a concerted effort to identify new
      immunosuppressive agents for organ transplantation that have greater efficacy and
      fewer side effects than current therapies (corticosteroids, azathioprine,
      cyclosporine, anti-T cell antibodies). These new drugs can be generally
      classified according to their varying structures or mechanisms of action:
      xenobiotic molecules (FK506, rapamycin, cyclosporine analogues); antimetabolites
      (mycophenolate mofetil, mizoribine, brequinar sodium); and those agents with
      novel or incompletely defined mechanisms of action (leflunomide, 15
      deoxyspergualin). Many of the newer agents offer better therapeutic indexes, and
      some even show promise in the treatment of two of the major obstacles currently
      facing cardiac allograft transplantation: antibody-mediated accelerated humoral
      rejection and chronic vascular rejection (also known as accelerated graft
      coronary artery disease). With the increasing shortage of donor organs in recent
      years, there has been a resurgence of interest in xenotransplantation; some of
      the new immunosuppressants demonstrate efficacy in prolonging xenograft survival.
      Most of these agents will probably find their niches as components of low-dose
      combination regimens designed to maximize effective immunosuppression and
      minimize drug toxicities and opportunistic infections.

PMID- 7787288
TI  - Alternatives to human heart replacement.
AB  - The continuing and increasing discrepancy between the number of available donor
      hearts and the number of patients who might benefit from cardiac transplantation
      has prompted efforts in the development of xenotransplantation, mechanical assist
      devices, and cardiomyoplasty techniques. We briefly review recent work in these
      three fields. The results of experimental xenotransplantation between closely
      related species are improving slowly with currently available drugs, and clinical
      trials in this field may be possible in the near future. Implantable ventricular
      assist devices are also at a stage of development where permanent implantation is
      likely to be followed by a reasonable and worthwhile period of patient survival.
      With regard to cardiomyoplasty, steady progress is being made in clarifying exact
      indications and patient selection, as well as confirming the potential benefits.

PMID- 7787290
TI  - Therapeutic interventions in valvular heart disease: lessons about timing learned
      over time.

PMID- 7787289
TI  - Pediatric heart transplantation.
AB  - Studies from a number of centers have documented the growth and success of
      pediatric heart transplantation. The 1st year of life is the period of greatest
      mortality from congenital heart disease and has now become the single most
      frequent age of pediatric heart transplantation. Appropriately, congenital heart
      disease is the most common diagnosis leading to heart transplantation. Early
      mortality is still greatest in recipients who undergo transplantation during the
      1st year of life. The patients at greatest risk are being identified and new
      maneuvers to lower early mortality are emerging. Long-term follow-up continues to
      indicate excellent late survival with low morbidity. This review focuses on key
      advances in knowledge reported in the last year.

PMID- 7787291
TI  - Systemic release of mucosal mast-cell protease in primed brown Norway rats after
      feeding with beta-lactoglobulin.
AB  - The plasma level of mucosal mast-cell protease was examined to find whether such
      measurements could be an indicator of allergic response to beta-lactoglobulin
      (beta-LG) challenged orally by rats. Brown Norway rats, which had been raised on
      a bovine milk-free diet, were systemically sensitized on day 0 with a low dose of
      beta-LG, and then by an oral administration of beta-LG for 3 h on day 14. The
      oral challenge with beta-LG in saline, when compared to saline alone, resulted in
      a systemic elevation of rat mast-cell protease II (RMCPII), one of the specific
      markers for gut mucosal mast-cell secretion. The challenge with beta-LG in a fat
      emulsion further increased the level of plasma RMCPII. This manipulation,
      however, was not successful for detecting any significant difference in mucosal
      leucotriene C4, another allergic mediator. An oral challenge with polymerized
      beta-LG did not induce any elevation of the protease, but resulted in a lower
      plasma level of beta-LG-specific IgG. This animal model is thus relevant to
      investigate the events regulating the mucosal hypersensitivity and humoral
      immunity to food proteins.

PMID- 7787293
TI  - Mechanism for the inhibition of fat digestion by chitosan and for the synergistic
      effect of ascorbate.
AB  - We investigated the mechanism for the inhibition of fat digestion by chitosan,
      and the synergistic effect of ascorbate. The important inhibition characteristics
      of fat digestion by chitosan from observations of the ileal contents were that it
      dissolved in the stomach and then changed to a gelled form, entrapping fat in the
      intestine. The synergistic effect of ascorbate (AsA) on the inhibition of fat
      digestion by chitosan is thought not to be acid-dependent but due to the
      specificity of AsA itself, according to the data resulting from using
      preparations supplemented with sodium ascorbate (AsN). The mechanism for the
      synergistic effect is considered to be 1) viscosity reduction in the stomach,
      which implies that chitosan mixed with a lipid is better than chitosan alone, 2)
      an increase in the oil-holding capacity of the chitosan gel, and 3) the chitosan
      fat gel being more flexible and less likely to leak entrapped fat in the
      intestinal tract.

PMID- 7787292
TI  - Effect of the viscosity or deacetylation degree of chitosan on fecal fat excreted
      from rats fed on a high-fat diet.
AB  - Several chitosan preparations, either with a comparable degree of deacetylation
      but differing viscosity or with comparable viscosity but a differing degree of
      deacetylation, were examined for their effect on the fecal fat excreted from rats
      fed on a high-fat diet. As the viscosity or deacetylation degree of a chitosan
      preparation increased, the more its effect on the apparent fat digestibility by
      rats became conspicuous. A supplement of ascorbic acid to each chitosan diets
      resulted in a significant depression of fat digestion and absorption in the
      lumen. The chitosan intake caused a higher level of fat to be excreted in the
      feces of the corn oil-receiving rats than the lard-receiving ones, although the
      effect was strong with both diet groups.

PMID- 7787294
TI  - Change in the distribution of alpha-tocopherol stereoisomers in rats after
      intravenous administration.
AB  - Synthetic alpha-tocopherol (alpha-Toc) contains equal amounts of eight different
      stereoisomers arising from three chiral centers in the phytyl tail. Of these, the
      four stereoisomers with the 2R configuration are generally more active than their
      corresponding 2S-isomers. We investigated the change in distribution of alpha-Toc
      stereoisomers in the plasma and tissues after intravenously administering all-rac
      and SRR-alpha-Toc acetate. The concentration of 2R-isomers in the rat plasma
      after administering all-roc-alpha-Toc acetate was higher than that of the 2S
      isomers. On the other hand, the concentration of 2R-isomers in the liver was
      lower than that of 2S-isomers up to 6 h. In the rat plasma after administering
      only SRR-alpha-Toc acetate, no SRR-alpha-Toc was detected after 6 h, although SRR
      alpha-Toc in the liver was retained at a higher level than in the other tissues.
      We presume that the intravenously administered 2R- and 2S-isomers were easily
      transported into the liver from the plasma, the 2R-isomers being preferentially
      released from the liver into the blood, whereas the 2S-isomers remained in the
      liver for up to 6 h.

PMID- 7787296
TI  - Measurement of superoxide dismutase-like activity of natural antioxidants.
AB  - The superoxide dismutase (SOD)-like activity of natural antioxidants was
      evaluated by measuring the inhibition of pyrogallol autoxidation that is
      catalyzed by the superoxide radical. Among 22 water-soluble antioxidants tested,
      L-ascrobic acid, L-ascorbic acid 6-palmitate, glutathione (reduced form), (+)
      catechin, and (-)-epicatechin showed effective SOD-like activity. To analyze
      lipophilic antioxidants, an optically clear organic system composed of diethyl
      ether, surfactant (dioctyl sulfosuccinate, AOT) and water, called reverse
      micelles, was developed. The optimum concentrations of AOT, water and pyrogallol
      for determining SOD-like activity were found to be 50 mM, 1.3 M, and 40 mM,
      respectively. After proving that pyrogallol autoxidation was mediated by the
      superoxide anion in that system, the SOD-like activity of 24 lipophilic
      antioxidants was measured. Cinnamon oil, gamma-oryzanol, extract of rosemary
      leaf, L-alpha-lecithin, and L-alpha-cephalin exhibited activity, although the
      activity of some antioxidants could not be measured because of the intense color
      or low solubility.

PMID- 7787295
TI  - Role of ornithine in urea synthesis in rats treated with thyroid hormone.
AB  - The purpose of this study was to find whether the regulation of urea synthesis
      was mediated through the activation of N-acetyglutamate synthesis by ornithine
      when the thyroid status was manipulated. Experiments were done on three groups of
      rats, given 6-propyl-2-thiouracil (PTU, a thyroid inhibitor) without
      triiodothyronine (T3) treatment, treated with PTU + T3, or neither PTU nor T3
      (control). Urinary excretion of urea and the liver concentrations of ornithine
      and N-acetylglutamate in rats given PTU + T3 were significantly lower than in
      rats given PTU alone. The liver concentration of N-acetylglutamate was correlated
      with the liver concentration of ornithine (r = 0.920, p < 0.001). Ornithine
      administration (0.5 mmol/100 g body wt) elevated the liver concentration of N
      acetylglutamate in all three groups. The results suggest that the greater
      concentration of ornithine in the hypothyroid (PTU alone) rats is likely to
      increase the N-acetylglutamate concentration in liver and stimulate urea
      synthesis.

PMID- 7787298
TI  - The complete amino acid sequence of chitinase-B from the leaves of pokeweed
      (Phytolacca americana).
AB  - The complete amino acid sequence of pokeweed leaf chitinase-B (PLC-B) has been
      determined by first sequencing all 19 tryptic peptides derived from the reduced
      and S-carboxymethylated (RCm-) PLC-B and then connecting them by analyzing the
      chymotryptic peptides from three fragments produced by cyanogen bromide cleavage
      of RCm-PLC-B. PLC-B consists of 274 amino acid residues and has a molecular mass
      of 29,473 Da. Six cysteine residues are linked by disulfide bonds between Cys20
      and Cys67, Cys50 and Cys57, and Cys159 and Cys188. From 58-68% sequence homology
      of PLC-B with five class III chitinases, it was concluded that PLC-B is a basic
      class III chitinase.

PMID- 7787297
TI  - Alpha-subunit of beta-conglycinin, an allergenic protein recognized by IgE
      antibodies of soybean-sensitive patients with atopic dermatitis.
AB  - One of the major allergenic proteins in the soybean 7S-globulin fraction, which
      was recognized by sera of about 25% soybean-sensitive patients with atopic
      dermatitis, was identified as alpha-subunit of beta-conglycinin. The IgE
      antibodies recognizing the alpha-subunit did not show a cross-reactivity against
      both alpha'- and beta-subunits known to be highly homologous to alpha-subunit,
      and also against other allergenic components identified in soybeans [Ogawa et
      al., J. Nutr. Sci. Vitaminol., 35, 555-565 (1993)]. The IgE-binding site(s) was
      estimated to be located on the peptide 232-283 of alpha-subunit.

PMID- 7787299
TI  - Rapid and simple procedure for purifying PAS-4 glycoprotein from bovine milk fat
      globule membrane.
AB  - The isolation and partial characterization of PAS-4 glycoprotein (78 kDa) from
      bovine milk fat globule membrane (MFGM) is described. PAS-4 was selectively
      extracted with Triton X-114 nonionic detergent and then fractionated on DEAE
      Sepharose at pH 7.5. The PAS-4 fraction that was not bound on DEAE-Sepharose gave
      a single band by SDS-PAGE. The recovery of PAS-4 was 57.4% from MFGM. An amino
      acid analysis found a high percentage of nonpolar residues. Approximately 7.2% of
      carbohydrate from PAS-4 was composed of mannose, galactose (Gal), N
      acetylglucosamine, N-acetylgalactosamine (GalNAc), and sialic acid, most of the
      Gal and GalNAc in PAS-4 being released after mild alkaline hydrolysis. This
      indicated that PAS-4 contained both N- and O-linked sugar chains in concordance
      with the results of lectin affinity. PAS-4 had apparent isoelectric points of
      7.45, 7.41, and 7.32, but these were shifted to pI 7.47 by a neuraminidase
      treatment. The apparent molecular weight of PAS-4 after deglycosylation with N
      glycanase was approximately 57,000 by SDS-PAGE.

PMID- 7787300
TI  - Effects of the lipid-saccharide complex and unsaponifiable matter from sunflowers
      on liver lipid metabolism and intestinal flora in rats.
AB  - The effects of the flower lipid-saccharide complex and unsaponifiable matter (1
      g/kg of diet) from the sunflower on liver lipid metabolism and intestinal flora
      was studied in rats given cholesterol-enriched diets. After six weeks of feeding,
      the microsomal cholesterol concentration in the liver had been significantly
      reduced with the sunflower diet. The ratio of cholesterol/phospholipid was also
      reduced by the sunflower diet. The 3-hydroxy-3-methylglutaryl coenzyme A
      reductase activity of the sunflower groups was significantly lower than that of
      the control group. There was no significant difference in the cholesterol 7 alpha
      hydroxylase activity, although this tended to increase with dietary sunflower
      consumption. The number of Bacillus in the cecum flora was significantly higher
      in the lipid-saccharide complex group than in the other groups, while
      Bifidobacterium and Eubacterium in the cecum flora was significantly higher in
      the unsaponifiable matter group when compared to the control group. These results
      suggest that the lipid-saccharide complex and unsaponifiable matter in the
      sunflower are related to liver cholesterol synthesis and intestinal flora.

PMID- 7787301
TI  - Comparison of o-phthalaldehyde modification of alpha-amylases from porcine
      pancreas and Bacillus subtilis with Taka-amylase A.
AB  - A fluorescent reagent, o-phthalaldehyde (OPA), competitively inhibited porcine
      pancreatic alpha-amylase (PPA) with Ki values of 0.7-0.9 mM, while alpha-amylase
      from Bacillus subtilis (BS) was uncompetitively inhibited, with Ki values of 5.8
      7.6 mM. In both cases, OPA gave a time-dependent irreversible inactivation, where
      the amylase activity was lost faster than the maltosidase activity. Zymograms of
      the course of OPA modification showed that PPA was converted into at least six,
      faster moving components and BS gave two components. The OPA modification was
      retarded by the addition of the substrate analog, cyclodextrins, and the OPA
      modified enzymes decreased in affinity for the substrate soluble starch.
      Stoichiometric measurement showed that both PPA and BS was inactivated by the
      incorporation of 1 mol of OPA per mol of enzyme. The role of OPA modification of
      alpha-amylases was discussed in relation to the regulation of catalytic activity
      of enzymes.

PMID- 7787302
TI  - Promoinducin, a novel thiopeptide produced by Streptomyces sp. SF2741.
AB  - Our continued screening to find tipA promoter-inducing substances resulted in the
      isolation of promoinducin from a mycelial extract of Streptomyces sp. SF2741.
      Based on various 1D- and 2D-NMR studies, including field gradient (FG)-COSY,
      HSQC, FG-HMBC, phase-sensitive 13C-decoupled HMBC and NOESY experiments,
      promoinducin's structure was established to be a thiopeptide composed of
      threonine, some unusual amino acids masked at their carboxyl groups by thiazole
      or methyloxazole rings, sulfomycinamate and five dehydroalanine residues.
      Promoinducin induced the tipA promoter at 40 ng/ml, and also exhibited strong
      antibacterial activity against some Gram-positive bacteria.

PMID- 7787303
TI  - Pyromeconic acid and its glucosidic derivatives from leaves of Erigeron annuus,
      and the siderophile activity of pyromeconic acid.
AB  - 3'-O-Caffeylerigeroside (pyromeconic acid 3-O-beta-D-glucoside 3'-O-caffeyl
      ester) was obtained from the leaves of Erigeron annuus as a new pyromeconic acid
      derivative, and its structure was elucidated. Together with the gamma-pyrone
      derivative, pyromeconic acid (3-hydroxy-4H-pyran-4-one) and its beta-glucoside
      (erigeroside) were also isolated from the aerial parts of E. annuus. The
      siderophile activity of pyromeconic acid was also studied.

PMID- 7787304
TI  - Selective use of L-valine and L-isoleucine for the biosynthesis of branched-chain
      fatty acids in rat skin.
AB  - Iso- and anteiso-fatty acids are detected in more than trace amounts in rat skin
      surface lipid. The terminal portion of even carbon number iso- and anteiso-fatty
      acids are synthesized respectively from valine (Val) and isoleucine (Ile) by
      essentially the same reaction sequences established for straight chain fatty
      acids. This paper describes the stereospecific biosynthesis of these branched
      chain fatty acids (BCFAs) and alcohols (BCFALs) in rat skin. Dependence of the
      concentration of these BCFAs on dietary L-Val and L-Ile was studied.
      Concentrations of even carbon number iso- and anteiso-fatty acid increased
      respectively with dietary L-Val and L-Ile. The saturation dose appeared to be 2%
      for L-Val and 1% for L-Ile. Supplementation of the diet with 2% D-Val, however,
      did not affect the concentration of even carbon number iso-fatty acid in rat skin
      surface lipid despite a comparable serum Val level to that of the 2% L-Val group.
      A similar experiment using 1% DL-Ile found that L-isomer, but not D-isomer, in
      the circulation was used for the biosynthesis of anteiso-fatty acids. This view
      was applicable to the incorporation of D-Val and DL-Ile into related BCFALs.

PMID- 7787305
TI  - Cleavage of connectin by calpain and cathepsin D.
AB  - mu-Calpain quickly split the alpha-connectin in myofibrils into beta-connectin,
      and then produced a 1700-kDa component. Cathepsin D also split alpha-connectin
      into beta-connectin, further degrading it to fragments smaller than the 1700-kDa
      component with increasing incubation time. The action of cathepsin D on the
      connectin molecule was distinctly different from that of mu-calpain in terms of
      the splitting rate and manner. When freshly excised muscle was exposed to a
      temperature of 37 degrees C, complete disappearance of connectin (alpha, beta and
      1700-kDa component) was observed within 36 h. In contrast, at 2 degrees C, about
      75% of connectin was retained as beta-form even after 3 weeks. The present data
      suggest that the degradation of connectin in muscle might be caused by mu-calpain
      in the early stage of aging, and then with time, this action is replaced by m
      calpain or cathepsin D. However, the possibility of other intrinsic proteases
      participating in the degradation of connectin still remains.

PMID- 7787306
TI  - A 3-deazauracil-resistant mutant of Bacillus subtilis with increased production
      of cytidine.
AB  - Bacillus subtilis No. 344 is a cytidine-producing mutant strain derived from wild
      type strain No. 122. When 3-deazauracil-resistant mutants were derived from
      strain No. 344, some of the mutants had higher productivities of cytidine. Among
      them, strain No. 428 accumulated 14.2 mg/ml cytidine in the culture. Cytidine 5'
      triphosphate (CTP) synthetase from strain No. 428 changed to be free from
      feedback inhibition by CTP, compared with the enzyme from strain No. 344.

PMID- 7787310
TI  - Isolation of bacteria degrading carbazole under microaerobic conditions, i.e.
      nitrogen gas substituted conditions.
AB  - Microorganisms degrading carbazole (CA), a model substrate of heterocyclic
      nitrogen compounds in crude petroleum oil, were screened under microaerobic
      conditions, i.e. nitrogen gas substituted conditions. Eight bacteria were
      isolated and identified. For example, Bacillus sp. KUKK-4 degraded 31% of CA when
      cultivated for 28 days in a medium initially containing CA at 1000 mg/l with
      shaking under the microaerobic conditions.

PMID- 7787307
TI  - Purification and characterization of membrane-bound hydrogenase from a
      thermophilic hydrogen-oxidizing bacterium, Pseudomonas hydrogenothermophila
      strain TH-1.
AB  - A membrane-bound hydrogenase was purified aerobically by one step using a
      hydroxyapatite column after solubilization by acetone treatment from a
      thermophilic hydrogen-oxidizing bacterium, Pseudomonas hydrogenothermophila
      strain TH-1. The enzyme consists of two polypeptides of 63 and 31 kDa,
      respectively. The amino-terminal amino acid sequences of both subunits were
      homologous to membrane-bound type [Ni-Fe] hydrogenases from other origins. The
      thermostability under a hydrogen gas atmosphere is highly stable at 50 degrees C,
      which is the optimum temperature for the cell growth.

PMID- 7787308
TI  - Functional distinction among structural subsections in the specific priming
      signal for DNA replication of the broad host-range plasmid RSF1010.
AB  - To analyze the functional contribution to the ssiA function of subsections of the
      ssiA-determinant sequence based on their dimensions, we constructed ssiA mutants
      carrying insertions and deletions. Results of the examination of the ssiA mutants
      told us that, in addition to the base sequence, the dimensions were crucial
      factors for the functional contribution of the subsections of ssiA.

PMID- 7787311
TI  - Binding of amino acid pyrolysates and aflatoxins to autoclaved cells of
      Enterococcus faecalis FK-23.
AB  - There was significant binding in autoclaved cells of Enterococcus faecalis FK-23
      toward Trp-P1 and Trp-P2. Although the binding ability towards aflatoxins B1, B2,
      G1, and G2 was less compared with the significant binding toward Trp-P1 and Trp
      P2, higher percentage binding toward these aflatoxins was observed when the
      amount of the cell preparation was increased.

PMID- 7787309
TI  - USF-19A, a new lipoxygenase inhibitor from Streptomyces sp.
AB  - USF-19A, a soybean lipoxygenase (SBL) and human 5-lipoxygenase (5-LO) inhibitor,
      was isolated from Streptomyces sp. USF-19 strain. Its chemical structure was
      determined by spectroscopic evidence to be a new member of the antimycin
      antibiotic family. The IC50 value of USF-19A against 5-LO was 28.0 microM.

PMID- 7787312
TI  - Stimulatory factors for enzymatic biotin synthesis from dethiobiotin in cell-free
      extracts of Escherichia coli.
AB  - The activity of biotin synthesis from dethiobiotin was found in cell-free
      extracts of an Escherichia coli bioB transformant. Among the sulfur compounds
      tested, only S-adenosyl-L-methionine (AdoMet) had a significant effect, while
      methionine and cysteine were inert. The activity was linearly stimulated by
      increasing protein concentration. When the dialyzed cell-free extracts were used
      for the reaction, NADP+, NADPH, and FAD among the well-known cofactors tested
      promoted the activity. Furthermore, in the presence of AdoMet, cysteine was
      apparently effective for biotin synthetic activity.

PMID- 7787313
TI  - The phylogeny of Williopsis salicorniae Hinzelin, Kurtzman et Smith based on the
      partial sequences of 18S and 26S ribosomal RNAs (Saccharomycetaceae)
AB  - Williopsis salicorniae IFO 10733 (type strain), which is characterized by the
      formation of saturn-shaped ascospores, by the incapability of assimilating
      nitrate, and by a lower DNA base composition (36.7 mol% G + C), was examined for
      its partial base sequences of 18S and 26S rRNAs. In the 18S rRNA partial base
      sequencings, it had an identical base sequence with the type strain of Ogataea
      glucozyma (identical to Pichia glucozyma, identical to Hansenula glucozyma),
      which produces hat-shaped ascospores and has the ability to assimilate nitrate
      and methanol and a higher DNA base composition (45.1 mol% G + C). In the 26S rRNA
      partial base sequencings, the base differences were four, and the percent
      similarity was 87 between the type strains of the two species. The data obtained
      are discussed phylogenetically and taxonomically.

PMID- 7787314
TI  - Molecular cloning of a cDNA for proctase B from Aspergillus niger var.
      macrosporus and sequence comparison with other aspergillopepsins I.
AB  - A cDNA for proctase B from Aspergillus niger var. macrosporus was isolated and
      sequenced. The deduced amino acid sequence (394 residues) of the preproform of
      the enzyme was highly homologous (98% identify) with those of aspergillopepsins I
      from A. awamori and A. saitoi, and moderately homologous (68% identity) with that
      of A. oryzae. Most of the sequence differences were found in the carboxyl
      terminal domain.

PMID- 7787316
TI  - Event-related potential components analysis of cognitive impairment in patients
      with multiple lacunar infarcts.
AB  - We measured the visual event-related potentials (ERPs) and reaction time (RT) in
      21 patients with multiple lacunar infarcts and in 8 age-equivalent normal
      subjects. The N2 latency of the infarct patients was significantly longer than
      that of the normal subjects, although the NA and the P3 latencies and RT did not
      differ between the two groups. The N2 latency was negatively correlated with the
      scores of Mini-Mental State Examination or the Hasegawa's dementia scale. These
      results suggest that the impairment of cognitive information processing in these
      patients arises from an uncertainty in the classification of a perceived event.
      In addition, the N2 latency may be more sensitive in detecting cognitive
      impairment in multiple infarct patients.

PMID- 7787315
TI  - Hepatic role in the storage and utilization of fish oil fatty acids in humans:
      studies on liver surgery patients.
AB  - Fish oil fatty acids (FOFA) were analyzed in fresh liver tissue and in
      subcutaneous and omental adipose tissue obtained from 5 patients who underwent
      partial hepatectomy. FOFA were also determined in plasma from 5 patients and in
      10 healthy subjects. There was a high content of FOFA in the liver phospholipid
      (PL) fraction (twice that in our previous autopsy study) suggesting that these
      surgery patients had a hepatic FOFA content of at least 25g. In plasma, FOFA was
      predominantly found in the PL of high density lipoprotein (HDL) and partly in the
      PL of other lipoproteins. Since these lipoproteins are produced by the liver, the
      present findings indicate the role of the liver not only in storage but also in
      the utilization of FOFA to form the biologically important surface PL component
      of circulating lipoproteins.

PMID- 7787317
TI  - TRH stimulation test in healthy elderly: paradoxical response of growth hormone
      is abnormal in normal aging.
AB  - The purpose of this study was to measure TSH (thyrotropin), PRL (prolactin) and
      GH (growth hormone) response to a TRH (thyrotropin releasing hormone) stimulation
      test in 37 healthy elderly male subjects and determine if these responses
      correlate with the incidence of mental decline; and also, to determine if these
      responses occur more frequently in the elderly than in the general population. A
      hyperresponse of TSH was documented in 7 of our 37 elderly male subjects, a
      delayed response of TSH in 4, a low response of PRL in 29 and a significant
      paradoxical response of GH in 2. Those subjects with a significant paradoxical
      response of GH were 82 and 83 years of age and their HDS was 20.0 and 25.5,
      respectively. We did not find a causal relationship between mental decline and
      the paradoxical response of GH, but our data suggests that the paradoxical
      response of GH is not normal in elderly older than 80 years old.

PMID- 7787318
TI  - Portal hypertensive colopathy: endoscopic findings and the relation to portal
      pressure.
AB  - Portal hypertensive colopathy (PHC) is a new clinical entity in patients with
      liver cirrhosis. In this study, colonoscopic findings and clinical features
      including upper gastrointestinal endoscopy and hepatic hemodynamics were
      prospectively investigated among 35 PH patients with a hepatic venous pressure
      gradient (HVPG) of greater than 12 mmHg due to chronic liver diseases.
      Colonoscopy was also performed in 100 patients without liver disease as non-PH
      controls. The colonoscopy revealed vascular ectasias, vascular irregularity,
      vascular dilatation, solitary red spots, diffuse red spots, and hemorrhoids in
      26, 32, 30, 25, 10 and 25, respectively, of 35 PH patients compared to 3, 7, 3,
      11, 0 and 19, respectively, in controls. PHC was endoscopically diagnosed in 27
      of 35 PH patients according to our criteria. These patients with PHC were more
      frequently associated with esophageal varices and portal hypertensive
      gastropathy, and had higher HVPG than PH patients without PHC. Portal
      hypertension is an important factor in the etiology of PHC.

PMID- 7787319
TI  - Thrombomodulin in exercise-induced asthma.
AB  - Thrombomodulin (TM) is a membrane protein present in the vascular endothelium. It
      has also been found in human plasma, within which, however, its pathological
      functions have not been clearly described. In this study, the plasma TM
      concentrations in 19 asthmatic patients were determined by sandwich enzyme
      immunoassay using two monoclonal antibodies for human TM. The concentration of
      plasma TM in exercise-induced asthma (EIA)-positive asthmatic patients was
      significantly increased by exercise challenge. In addition, for these patients a
      positive correlation was found between the severity of EIA and the degree of
      change in plasma TM induced by exercise challenge. These findings suggest that
      the increase in influx of TM into the plasma in EIA-positive asthmatics may be
      due to generalized pulmonary endothelial damage following exercise challenge.

PMID- 7787320
TI  - Parvovirus infection and generalized edema in adults.
AB  - We describe the clinical and laboratory findings of 7 adult patients with
      serological evidence of recent human parvovirus B19 (HPV) infection who presented
      with generalized edema. Six of the 7 patients had household contact with children
      with erythema infectiosum and had flu-like symptoms before visiting hospital. The
      interval between the flu-like episode and the development of edema ranged from 4
      to 13 days (mean 7.0). In all 7 patients, there was serological confirmation of
      recent HPV infection, and all showed the development of edema following HPV
      infection without urine abnormalities or anemia. Two patients presented
      hypocomplementemia, and two patients showed signs of congestive heart failure.
      HPV may be considered a causative agent of generalized edema not only in the
      fetus but also in adults and HPV infection should be included in the differential
      diagnosis of generalized edema formation.

PMID- 7787321
TI  - Cytoplasmic body myopathy with hypertrophic cardiomyopathy.
AB  - A patient with cytoplasmic body myopathy presented muscle hypotonia from birth
      and developed progressive muscular atrophy and weakness, scoliosis, contracture
      of joints and cardiorespiratory failure. At the age of 17, he died of heart
      failure. Post mortem examination revealed severe hypertrophy of cardiac walls and
      generalized muscular atrophy. Microscopic examination showed many cytoplasmic
      bodies in skeletal muscle fibers and myofiber disarray in myocardium. No cases of
      cytoplasmic body myopathy with hypertrophic cardiomyopathy have been reported
      previously. It is suggested that the Z-line component is related to the formation
      of the cytoplasmic body in skeletal muscle and disarray in the cardiac muscle.

PMID- 7787322
TI  - Coronary thrombosis induced by intracoronary acetylcholine injection in a patient
      with normal coronary myocardial infarction.
AB  - A 67-year-old male was admitted with acute myocardial infarction. Coronary
      thrombolysis was carried out because complete occlusion of the obtuse marginal
      branch (OM) in the circumflex artery was detected in emergent coronary
      angiography, and recanalization of the OM was obtained at 3 hours after the onset
      of chest pain. No significant stenosis of the OM was found in coronary
      angiography performed at the recovery stage. After intracoronary acetylcholine
      injection to the left coronary artery, coronary spasm was induced and coronary
      thrombosis was observed in the left anterior descending artery thereafter. These
      findings indicate the possibility that the etiology of myocardial infarction is
      coronary thrombosis induced by coronary spasm.

PMID- 7787323
TI  - Appropriate intravenous doses of L-thyroxine and magnesium in a thyroidectomized
      patient with thyroid and parathyroid carcinomas receiving total parenteral
      nutrition during acute necrotizing pancreatitis.
AB  - A totally thyroidectomized patient with thyroid and parathyroid carcinomas, which
      had developed after neck irradiation in childhood, became hypercalcemic due to
      pulmonary metastases. The hypercalcemia was ameliorated by intermittent iv
      administration of bisphosphonate for 3.5 years, but this gradually became
      refractory to the bisphosphonate treatment. After right thoracotomy for resection
      of pulmonary metastases, acute necrotizing pancreatitis developed. The patient
      was therefore placed on total parenteral nutrition supplemented with T4 and a
      restricted dose of magnesium. Thyroxine(T4) (30 micrograms/day, iv) was not
      sufficient to maintain euthyroidism, but a higher dose (60 micrograms/day)
      elicited mild hyperthyroidism to the same extent as that elicited by an oral dose
      of 100 micrograms/day. The present case showed that the appropriate iv dose of T4
      in this thyroidectomized patient with acute pancreatitis was about 60% of the
      oral dose. Furthermore, bisphosphonates (pamidronate and alendronate) and
      magnesium depletion were very effective in controlling the hypercalcemia.

PMID- 7787324
TI  - Acromegalic gigantism with low serum level of growth hormone and elevated serum
      insulin-like growth factor-I.
AB  - In a case of acromegalic gigantism with hyperprolactinemia is reported, the basal
      serum growth hormone (GH) levels ranged from 1.2 to 1.9 ng/ml. Serum GH response
      to either insulin-induced hypoglycemia or GH-releasing hormone was blunted.
      Frequent blood sampling showed non-pulsatile GH secretion. Serum prolactin and
      insulin-like growth factor-I (IGF-I) levels were elevated. After unsuccessful
      surgery, bromocriptine treatment normalized serum prolactin without affecting
      serum GH and IGF-I levels. Combined administration of octreotide with
      bromocriptine reduced serum GH and IGF-I levels. In this case, non-pulsatile GH
      secretion and enhanced tissue sensitivity to GH may induce hypersecretion of IGF
      I and cause clinical acromegalic gigantism.

PMID- 7787325
TI  - Involvement of the central nervous system in rheumatoid arthritis: its clinical
      manifestations and analysis by magnetic resonance imaging.
AB  - A rheumatoid arthritis (RA) patient showed high signal intensity in the
      subcortical region of the frontal and occipital lobes on T2-weighted magnetic
      resonance imaging (MRI). Histopathological examination in the autopsy specimen
      revealed severe systemic vasculitis. Additional radiological and laboratory
      studies revealed that transient cerebral ischemia induced by vasculitis occurred
      in this patient.

PMID- 7787327
TI  - Collagenous colitis.
AB  - Collagenous colitis is characterized clinically by chronic watery diarrhea and
      pathologically by colonic mucosal subepithelial collagen deposition. We report a
      72-year-old woman who had collagenous colitis associated with chronic watery
      diarrhea. She received a non-steroidal anti-inflammatory agent (sulindac) because
      of rheumatoid arthritis. Histological examination of biopsy showed a thick
      subepithelial collagen layer with lymphocytes, plasma cells, and infiltration of
      a few eosinocytes in the lamina propria. These findings led to the diagnosis of
      collagenous colitis. After treatment with salazosulfapyridine, her bowel movement
      became normalized and mucosal subepithelial collagen deposition disappeared.

PMID- 7787326
TI  - Primary malignant lymphoma of the liver associated with cirrhosis induced by
      hepatitis C viral infection.
AB  - We present a case of primary malignant lymphoma of the liver of B cell origin
      with cirrhosis induced by hepatitis C viral infection. A 75-year-old Japanese
      woman with chronic liver dysfunction was admitted for hepatic tumors. The tumors
      were hypoechoic on ultrasonography and hypodense on computed tomography. Antibody
      to hepatitis C virus was positive. Ultrasonically guided biopsy was performed,
      and we diagnosed hepatic lymphoma with cirrhosis induced by hepatitis C virus
      clinically and immunohistochemically. This case may be the first report of the
      association of these two diseases, and may provide additional evidence of a
      predisposition to malignancy in cirrhosis.

PMID- 7787328
TI  - Aneurysmal dilatation of the pulmonary trunk with mild pulmonic stenosis.
AB  - We present the unusual case of a 72-year-old woman whose chest X-ray showed an
      abnormal left hilar shadow. A pulmonary angiogram revealed an aneurysm in the
      pulmonary artery with a diameter of 55 mm that extended from the main pulmonary
      trunk to its bifurcation. Mild pulmonic stenosis with a systolic pressure
      gradient of 18 mmHg across the pulmonic valve was recognized. Mild dilatation of
      the ascending aorta was also present. The pressure gradient across the pulmonic
      valve was lower than is typical for an aneurysmal dilatation, suggesting that
      this patient represented a case of idiopathic pulmonary artery dilatation. We
      suspected the presence of a congenital structural alteration common to the
      pulmonary artery and the ascending aorta.

PMID- 7787329
TI  - Virus-associated hemophagocytic syndrome due to measles accompanied by acute
      respiratory failure.
AB  - An 18-year-old male who was admitted to hospital due to fever, skin rashes,
      cough, and malaise showed laboratory examination findings of leukopenia,
      thrombocytopenia, mild liver dysfunction, and hypoxia. Bone marrow aspiration
      revealed 2% histiocytes with hemophagocytosis. Chest X-ray showed bilateral
      diffuse interstitial pneumonia. The titer of anti-measles virus antibody was <
      1:4, and that at convalescence stage was 1:64. He was diagnosed as having
      hemophagocytic syndrome and acute respiratory failure due to measles, and was
      treated with methylprednisolone pulse therapy. He promptly recovered from
      thrombocytopenia and acute respiratory distress. Steroid pulse therapy may be
      effective in these conditions due to measles.

PMID- 7787330
TI  - Enlargement of multiple cavernous hemangioma of the liver in association with
      pregnancy.
AB  - Four cavernous hemangiomas were found in a 34-year-old woman after the first
      delivery. All four hemangiomas became enlarged after the second delivery. Due to
      complaints of symptoms of compression, and to rule out malignancy, surgical
      intervention was employed. Histologically, the tumors were typical cavernous
      hemangiomas. Although a relationship between enlargement of hemangiomas and
      estrogen was suggested, estrogen receptors were not detected in the tumors.

PMID- 7787331
TI  - Pneumatosis cystoides intestinalis after chemotherapy for hematological
      malignancies: report of 4 cases.
AB  - Pneumatosis cystoides intestinalis (PCI) is known to be a relatively rare
      condition which is characterized by gas cysts in the gastrointestinal mucosa. We
      treated four cases of PCI accompanied by hematological malignancies during
      chemotherapy treatment. All cases suffered from abdominal discomfort. Abdominal X
      ray films revealed gas cysts in the intestine. PCI was observed during
      leukocytopenic states, and three cases had septicemia. Etoposide was administered
      to three cases, and prednisolone to all cases. It is considered that PCI
      sometimes occurs in patients with hematological malignancies during a period of
      leukocytopenia, and may be caused by intestinal mucosal damage due to
      myelosuppressive agents and immunosuppression from prednisolone.

PMID- 7787332
TI  - Von Hippel-Lindau disease with multiple spinal cord hemangioblastomas,
      syringomyelia and pheochromocytoma.
AB  - A 31-year-old blind man presented with numbness and weakness in the left hand,
      and elevated blood pressure. Multiple hemangioblastomas in the spinal cord
      associated with syringomyelia were well demonstrated by gadolinium-enhanced
      magnetic resonance imaging (MRI). He also had pheochromocytoma in the right
      adrenal gland, which was disclosed by abdominal computed tomography, MRI and 131I
      metaiodobenzylguanidine scintigraphy. MRI screening should be considered for
      patients with von Hippel-Lindau gene to detect the multiple lesions in this
      disease.

PMID- 7787333
TI  - Determination of a common clonal origin of gastric and pulmonary mucosa
      associated lymphoid tissue lymphomas presenting five years apart.
AB  - Mucosa-associated lymphoid tissue (MALT) lymphoma is often mis-diagnosed as a
      benign tumor. Dissemination to other sites occurs in MALT lymphoma. We report a
      60-year-old man with gastric and pulmonary tumors of MALT lymphoma which occurred
      5 years apart. Initially, the gastric tumor had been diagnosed as reactive
      lymphoreticular hyperplasia. To determine whether the two tumors arose from the
      same malignant clone, we amplified and sequenced the complementarity-determining
      region 3 of the immunoglobulin heavy chain gene using the polymerase chain
      reaction (PCR). The sequences were identical except for 11-nucleotide difference,
      suggesting identical clonality.

PMID- 7787334
TI  - Abrupt-onset diabetes mellitus in the elderly.
AB  - We present three elderly Japanese patients with abrupt onset of diabetes
      mellitus: a 61-year-old male with a complete defect of insulin secretion without
      insulin resistance, a 60-year-old male with an incomplete defect of insulin
      secretion associated with insulin resistance, and a 69-year-old female with a
      complete defect of insulin secretion and insulin resistance. The findings in
      these cases indicate the heterogeneity in insulin secretion and sensitivity of
      abrupt onset diabetes mellitus in the elderly. The changes in insulin secretion
      and sensitivity over time due to glucose toxicity may at least partially explain
      the heterogeneity.

PMID- 7787336
TI  - Predicting subsequent employment status of SSA disability applicants with chronic
      pain.
AB  - OBJECTIVE: The study assessed the predictive ability of the standardized
      Multiperspective Multidimensional Pain Assessment Protocol (MMPAP). An assessment
      tool that predicts return to work with chronic pain patients is needed, as
      increasing numbers of disability applications are adjudicated in the courts.
      DESIGN: National randomized validation sample of disability applicants. Each
      MMPAP consisted of physical examinations by two physiatrists and the
      participant's subjective assessment. Criterion standards were Multidimensional
      Pain Inventory and McGill Pain Questionnaire. There was phone follow-up 6 months
      postdecision. SETTING: Six clinical sites were ambulatory referral centers, both
      public and private. PARTICIPANTS: Population-based random national sample of 710
      Social Security disability applicants claiming chronic pain related to their
      disability, stratified by national Social Security Administration (SSA) applicant
      demographics. Seventy-eight were lost to follow-up, and 688 initially refused.
      INTERVENTIONS: No interventions were continued or initiated by the research team
      between assessment and follow-up. MAIN OUTCOME MEASURES: Claimant employment
      status 6 months after disability decision was primary outcome, change in pain
      intensity, and change in employment situation. RESULTS: The MMPAP predicted with
      90% accuracy employment status of SSA disability applicants with chronic pain 6
      months postdecision when assessed at application by two physicians trained in
      Physical Medicine and Rehabilitation (physiatry). Accuracy of employment
      situation change was 93%, and pain intensity change was 65%. Self-report
      measures, physical examination results, psychological status, functional
      limitations, and physician's subjective appraisal predict future employment.
      CONCLUSIONS: The MMPAP accurately predicts future employment of disability
      applicants claiming chronic pain. The introduction of this standardized protocol
      will assist in standardizing disability determination for claimants with chronic
      pain.

PMID- 7787337
TI  - Pain in young adults. II: The use and perceived effectiveness of pain-coping
      strategies.
AB  - OBJECTIVE: The first goal of the study was to determine the internal reliability
      of the Coping Strategies Questionnaire (CSQ) in young adults. The second goal was
      to examine the relation of the CSQ to reported pain levels. The third goal was to
      investigate the relationship between the CSQ and concomitant pain problems. The
      fourth goal was to compare young adults and different chronic pain samples in
      terms of the frequency of coping strategy use and perceived effectiveness of
      coping strategies. DESIGN: The study included 252 undergraduate students who were
      given the CSQ, a demographic and pain level questionnaire, and a concomitant pain
      problem survey. RESULTS: The results indicated that the CSQ was internally
      reliable when used to assess pain coping strategy use among young adults.
      Catastrophizing was found to be associated with both pain level and concomitant
      pain problems, with subjects reporting higher levels of catastrophizing having
      higher levels of pain and a higher frequency of both migraine headaches and low
      back pain. Finally, differences were found when comparing the perceived
      effectiveness in controlling and decreasing pain, and in the use of specific
      coping strategies in the young adult and chronic pain samples. The young adult
      sample reported a greater perceived efficacy in controlling and decreasing pain,
      compared to a sample of low back pain patients and a sample of myofacial pain
      patients. CONCLUSIONS: The results indicate that the CSQ is a reliable measure
      for the study of pain-coping strategies used in this population, and one that
      relates to differences reported in the experience of pain.

PMID- 7787335
TI  - The curate's egg.

PMID- 7787338
TI  - Secondary gain concept: a review of the scientific evidence.
AB  - The "secondary gain" concept originated in the psychoanalytic literature, where
      it was never vigorously examined. The purpose of this review is to determine if
      there are scientific studies that have explored the validity of this concept.
      DESIGN: A computer and manual literature review yielded 166 references in which
      primary, secondary, and tertiary gain were mentioned. Twenty-four (14.5%) of
      these reports were "secondary gain" studies. Fourteen "reinforcement" studies
      were also found. These 38 studies were grouped according to topics and reviewed
      in detail. SETTING: Any medical treatment setting including pain treatment was
      utilized in the review procedure, i.e., no exclusion criteria. PATIENTS: Any
      patient type, including those suffering from chronic pain, were utilized in the
      review procedure, i.e., no exclusion criteria. RESULTS: A significant but limited
      number of studies have investigated the "secondary gain" concept, and the results
      of some of these studies are in conflict. Results of some studies, however, are
      remarkably consistent in supporting the importance of "secondary gain" to
      behavior. Some studies have methodological flaws, usually relating to how the
      presence of secondary gain was established. CONCLUSIONS: Overall the results of
      the reviewed studies support the potential importance of the "secondary gain"
      concept to understanding illness behavior and underscore a need for future
      research in this area.

PMID- 7787339
TI  - Painful neuropathy: C-nociceptor activity may not be necessary to maintain
      central mechanisms accounting for dynamic mechanical allodynia.
AB  - OBJECTIVE: In neuropathic pain states, dynamic mechanical allodynia is mediated
      by large diameter A beta-fibers. We test whether ongoing peripheral C-nociceptor
      input is necessary to maintain central changes hypothetically responsible for A
      beta-mediated allodynia. CASE REPORT: A patient with long-standing diabetes
      mellitus demonstrated generalized signs of painless diabetic small fiber
      polyneuropathy. Following mechanical trauma, the patient additionally developed a
      typical neuropathic pain syndrome at the arm. Despite substantial impairment of
      cutaneous small fiber function, he complained of severe dynamic mechanical
      allodynia confined to a forearm skin area. METHODS AND RESULTS: Marstock test
      revealed a considerably increased cold perception threshold within the allodynic
      area and on the contralateral side. The patient could not perceive any warm
      sensation on either side. Histamine iontophoresis was not followed by any itch or
      pain sensations within the allodynic area or contralaterally. Nociceptive C-fiber
      axon reflex reactions were substantially impaired within the allodynic skin or
      contralaterally. Standard neurophysiological testing and quantitative vibrametry
      showed only mild impairment of large diameter sensory and motor fiber function at
      the arms. Cardiovascular reflex tests showed almost no heart rate variation
      indicating impairment of vagal small fiber function. CONCLUSIONS: (a) Cutaneous
      nociceptive C-fibers do not signal dynamic mechanical allodynia. This symptom may
      hypothetically be due to secondary changes in the central nervous system
      processing that might strengthen the synaptic ties between A beta-fibers and
      central nociceptive pathways, or due to peripheral multiplication of primary
      afferent low threshold mechanoreceptor input. (b) Ongoing nociceptive C-fiber
      input is not necessary to maintain either hypothetical mechanism. (c)
      Hypothetical secondary central hyperexcitability might work autonomously without
      any nociceptive C-fiber input for a long time or even indefinitely in some
      neuropathic patients.

PMID- 7787340
TI  - Is diabetic autonomic neuropathy protective against reflex sympathetic dystrophy?

PMID- 7787341
TI  - The nature of myofascial trigger points.

PMID- 7787343
TI  - MR imaging evaluation of the spine with titanium alloy pedicular screw fixation.
AB  - We studied the cases of 60 patients who underwent magnetic resonance (MR) imaging
      evaluation after fixation with the titanium alloy pedicular screw system. Spine
      stabilization was required in the thoracic and lumbar region for various spinal
      disorders. The images were evaluated for the spinal and adjacent tissues. These
      pedicular screw systems were imaged safely and caused no particular clinical
      problems. The localized signal void artifacts were seen around the implants. This
      artifact did not interfere with the diagnosis for another disease. The spinal
      cord and dura mater appeared in midsagittal and in axial images except for
      regions lying close to the implants. After surgery MR imaging revealed the
      decompressed or the deformed spinal cord. However, the prognosis of spinal
      disorder could not be revealed by the intensity grade of MR imaging because of
      the distortion in the spinal cord.

PMID- 7787342
TI  - The application of Diapason spinal fixator device: a comparison with the Steffee
      VSP plate.
AB  - Twenty-five consecutive patients who had a variety of lumbar disorders and who
      underwent lumbar spinal fusion using the Diapason fixator were followed for a
      mean period of 20 months. The operations included 16 posterior lumbar interbody
      fusion (PLIF), 7 posterolateral fusion (PLF), and 2 combined PLIF and PLF
      (PLIF/PLF). As a control group, 38 patients undergoing PLIF using a Steffee VSP
      plate (VSP) were followed for a mean period of 24 months. There were no
      significant differences between the two groups regarding the operation time,
      blood loss, and improvement of preoperative symptoms. However, incidence of
      incomplete bony union and radiolucent zone around the screws were higher in the
      Diapason group than in the VSP group. Our study suggests that there was a
      possibility of insufficient rigidity of screw-rod fixation in the Diapason
      system.

PMID- 7787345
TI  - Hydroxylapatite-coated Diapason screws: first clinical report.
AB  - We report our preliminary experience with 27 patients who underwent surgery for
      posterior spinal arthrodesis using the hydroxylapatite-coated Diapason screws.
      Each of the patients was considered to have a condition that was mechanically
      risky from the surgical standpoint. The results were good for patients with lytic
      spondylolisthesis and were excellent for patients with osteoporosis, but were
      generally less successful for patients requiring "long lever arm" fixations and
      those with degenerative scoliosis.

PMID- 7787344
TI  - Clinical application of the Diapason hook system: a preliminary case report.
AB  - A preliminary case report of the clinical application of the Diapason hook system
      is discussed. The hooks were implanted in six patients for the fixation of the
      thoracic region (n = 3), the prevention of backout of pedicular screws (n = 3),
      and repair of the pars interarticularis (n = 1); the patients were followed for
      more than 6 months after the surgery. Results indicate that in all of the cases
      the initial purpose of the Diapason hook system was served. The advantages of the
      Diapason screw and hook system are its titanium alloy material and simplicity in
      implanting. Although there have been no instrument failures or any other
      complications, the cases need longer follow-up. In addition, the size of some
      hooks needs to be improved because they were too large to apply to the short
      segments.

PMID- 7787346
TI  - Lumbar spinal fusion using the Diapason system.
AB  - Lumbar spinal fusion with the Diapason system was performed on 58 patients at
      Toho University Ohmori Hospital from November 1991 to November 1994. The first 44
      consecutive patients were followed for more than 1 year, including 34 cases with
      degenerative diseases. Those 34 cases consisted of 22 men and 12 women, ages 19
      78 years (average 47.4), with 49 vertebral levels; these patients were followed
      for an average of 26.3 months. The clinical improvement and rate of bony union
      after 1 year of surgery were examined and the intervertebral angulatory motion
      degree of fused vertebrae was measured using a radiographic functional photo
      image during 1 year. We also performed an experimental study to evaluate the
      rigidity of this system. There were no severe complications. Although there was
      no instrument breakage or screw migration, two cases of rod migration were
      observed in L5-S1 arthrodesis. A mean improvement rate of 84.3% in the Japanese
      Orthopaedics Association (JOA) score was revealed. Thirty-three of 34 (97.1%)
      patients demonstrated successful arthrodesis after their initial procedure. In 10
      segments (20.4%) 3-5 degrees of angulatory mobility were still retained, and no
      angulatory motion was observed in 27 segments (55.1%) 3 months after the surgery;
      however, no angulatory motion was observed in 44 segments (89.8%) 1 year after
      the surgery. In our biomechanical study, we observed that the anterior
      intervertebral space became narrow and mobile with loading, but when the loading
      was removed, the space reverted to the initial site. This movement was thought to
      be due to a certain elasticity in the rod and screw, and not loosening at the
      connection level. This system was evaluated based on the results of both clinical
      and biomechanical study. Notwithstanding the fact that this method has been
      evaluated as semirigid fusion, it does provide satisfactory bony union in
      posterolateral fusion, with excellent clinical results.

PMID- 7787347
TI  - Impact of different patency criteria on long-term results of femoropopliteal
      angioplasty: analysis of 106 consecutive patients with claudication.
AB  - PURPOSE: To assess the impact of different patency criteria on long-term results
      after percutaneous transluminal angioplasty (PTA) of femoropopliteal arteries.
      PATIENTS AND METHODS: The results of femoropopliteal PTA in 106 consecutive
      patients with claudication (140 treated limbs) were analyzed. The treated artery
      segment was considered patent if (a) the ankle-brachial index (ABI) had increased
      by more than 0.10 initially and not deteriorated by more than 0.15 from the
      maximum early postprocedural level and (b) the ABI was consistently at least 0.15
      above the preprocedural level. The third criteria was based on patients'
      subjective assessment of patency. Initial failures were either included or
      excluded and both primary (the outcome of the original PTA) and secondary patency
      (also repeated PTAs included) were determined. RESULTS: When the different
      criteria were applied, the patency rates at 3 years ranged from 42% to 82% in
      this patient population. CONCLUSION: These results stress the importance of
      uniform criteria when results of different kind of vascular interventions are
      reported.

PMID- 7787348
TI  - Percutaneous transluminal angioplasty of visceral arterial stenoses: results and
      long-term clinical follow-up.
AB  - PURPOSE: To determine the efficacy and safety of percutaneous transluminal
      angioplasty (PTA) of the visceral arteries. PATIENTS AND METHODS: We
      retrospectively evaluated the results of PTA performed in 20 visceral arteries in
      19 patients (10 men, nine women; mean age, 63 years). Eleven patients had
      symptoms characteristic of mesenteric ischemia, four had atypical abdominal pain,
      and four were undergoing prophylactic dilation before undergoing another
      procedure involving the abdominal aorta. Clinical follow-up was possible in all
      patients. RESULTS: PTA was technically successful in 15 of 19 patients (79%);
      among these 15 patients, 12 (80%) did well clinically. Of the seven PTA
      procedures that were immediate failures, five failed secondary to an occult
      malignancy or to extrinsic arterial compression by the median arcuate ligament.
      Ten (83%) of the 12 patients in whom the procedures were immediate clinical
      successes are still clinically improved at 4-73 months follow-up (mean, 25
      months). PTA was successful in only one of the four patients who had symptoms
      atypical of mesenteric ischemia, but it was successful in 11 of the 15 patients
      who had symptoms of mesenteric ischemia or who underwent prophylactic dilation.
      Major complications occurred in three (16%) of the 19 patients. CONCLUSION: PTA
      of visceral artery stenoses is effective in patients with symptoms of mesenteric
      ischemia. It is also effective as prophylaxis in patients undergoing additional
      procedures in the abdominal aorta.

PMID- 7787350
TI  - Gastrostomy button placement through percutaneous gastrostomy tracts created with
      fluoroscopic guidance: experience in 27 children.
AB  - PURPOSE: The authors report their experience with skin level (button) gastrostomy
      placement through radiologically created gastrostomy tracts. PATIENTS AND
      METHODS: Fifty-two gastrostomy buttons have been placed in 27 children (average
      age, 73 months; range, 9-235 months). All buttons were placed through tracts
      created during earlier fluoroscopically guided percutaneous gastrostomy. Fifteen
      Bard mushroom-type buttons and 12 MIC-Key balloon-type buttons were initially
      placed. Patients have been followed up for an average of 13.4 months. RESULTS:
      Button placement was successful at the initial attempt in 25 of 27 patients
      (93%). Tract age at button placement averaged 18.5 weeks. The average tract
      length measured 3.5 cm (1.7-6.0 cm). Tract rupture and peritoneal leakage
      occurred in three patients; one patient had the button immediately repositioned
      without sequela, and the remaining two patients underwent replacement of the
      gastrostomy tube into the stomach and successful button placement approximately 1
      week later. There were no major complications. Minor problems (leak, granulation
      tissue, valve malfunction, balloon breakage) occurred in 19 patients. CONCLUSION:
      Button gastrostomy is a useful alternative to the traditional gastrostomy tube
      for the pediatric population. Conversion with use of existing radiologically
      created tracts is possible and safe. Attention to tract integrity and proper
      button position is required to avoid complications.

PMID- 7787349
TI  - Use of the Palmaz stent in primary treatment of renal artery intimal injury
      secondary to blunt trauma.

PMID- 7787351
TI  - Peritoneal abscesses due to bowel perforation: effect of extent on outcome after
      percutaneous drainage.
AB  - PURPOSE: To determine the effect of extent of peritoneal contamination in enteric
      abscesses on final outcome and duration of percutaneous drainage. PATIENTS AND
      METHODS: Results were retrospectively reviewed for 11 patients with varying
      degrees of peritoneal contamination secondary to subacute bowel perforation who
      were primarily treated with percutaneous drainage. Stepwise linear regression
      analysis of duration of drainage was performed with use of patient age and immune
      status, the site of bowel perforation, and the number of peritoneal compartments
      involved in the resultant contamination as independent variables. RESULTS: In 10
      of 11 patients (91%) treatment of the resultant intraperitoneal collections with
      percutaneous drainage was successful irrespective of the extent of peritoneal
      contamination. There was no correlation between duration of drainage and extent
      of peritoneal contamination but good correlation with patient age and site of
      bowel perforation (r = 0.82, P = .02). CONCLUSION: In patients with enteric
      abscesses due to subacute bowel perforation, the duration of drainage and final
      outcome after percutaneous drainage are independent of the extent of peritoneal
      contamination.

PMID- 7787352
TI  - Percutaneous management of external pancreatic fistulas: the use of articulated
      and metal stents.

PMID- 7787355
TI  - Treatment of acute mesenteric venous thrombosis with transjugular intramesenteric
      urokinase infusion.

PMID- 7787353
TI  - Experimental investigation of hypercoagulant conditions associated with
      angiography.
AB  - PURPOSE: To evaluate changes in blood coagulability after high-velocity
      intravascular fluid injections under conditions relevant to angiography.
      MATERIALS AND METHODS: In 101 rabbits, fluids were injected at 1,000 psi (6,890
      kPa) via a multiple-side-hole catheter in the abdominal aorta, while blood was
      simultaneously aspirated via a second downstream catheter. The fluids injected
      included saline, contrast media, blood, tissue plasminogen activator, and
      heparin. The aspirate was evaluated for clotting time with an activated clotting
      time (ACT) device, for elevated levels of plasma hemoglobin to confirm capture of
      at least part of the injection bolus in the sample, and sometimes for hematocrit
      or fibrin degradation products (FDP). RESULTS: A single high-pressure injection
      of 2 mL of saline briefly accelerated the ACT of a blood-saline bolus (mean, 38%
      +/- 4). The mean volume of the hypercoagulable bolus was 15 mL. Systemic FDP
      levels became elevated within a few minutes after initial injection, suggesting
      activation of the fibrinolytic system by intravascular clot formation. Subsequent
      injections produced less hypercoagulability, probably reflecting the
      anticoagulant effects of FDP. Pressure-injected contrast agents had anticoagulant
      effects. The ACT was accelerated by up to 80% after injection of blood that had
      remained within the catheter for 3-10 minutes. Glove powder or gauze lint from
      wiping the guide wire markedly accelerated intracatheter clotting.
      Hypercoagulability after injection of clotting blood was partially prevented by
      injections with contrast agent and was completely inhibited by low-dose systemic
      heparinization. CONCLUSION: A hypercoagulable bolus may occur after
      angiographically relevant high-pressure fluid injections. The major contributing
      factors appear to be high jet velocities and injection of small amounts of
      clotting blood. Heparinization provides a simple and effective means of
      prevention.

PMID- 7787354
TI  - Thrombolytic therapy and balloon catheter thrombectomy in experimental femoral
      artery thrombosis: effect on arterial wall morphology.
AB  - PURPOSE: To determine vessel wall architectural changes after lytic therapy and
      balloon catheter thrombectomy in experimentally thrombosed arteries. MATERIALS
      AND METHODS: Bilateral 5-cm femoral artery occlusions were created by ligation in
      14 dogs. Two dogs served as controls, and 12 animals underwent balloon catheter
      thrombectomy on the left and lytic therapy with urokinase on the right either 24
      hours (group 1, n = 6) or 7 days (group 2, n = 6) after creation of the
      occlusion. After treatment, the area of thrombosis was subjected to light and
      scanning electron microscopy. RESULTS: The IEL was intact in all lysed arteries.
      IEL fractures were present in 11 of 12 arteries treated with thrombectomy. For
      group 1 arteries, average luminal area after thrombectomy was 5.63 mm2 +/- 0.66
      versus 1.94 mm2 +/- 0.7 after lytic therapy (P < .007). Mean control artery
      luminal area was 2.86 mm2 +/- 0.52. Similar differences were found in group 2
      arteries. With lytic therapy, scanning electron microscopy grading revealed
      surfaces to be intact in group 1, but moderate injury was exhibited in group 2.
      All arteries treated with thrombectomy had severe injury. CONCLUSIONS: Lysis of
      acute thrombi (group 1) preserved arterial wall architecture, with an intact IEL
      and no endothelial injury. Lysis of chronic thrombi (group 2) was associated with
      mild to moderate injury. Catheter thrombectomy caused severe injury regardless of
      the time of intervention. These results may help explain the poor long-term
      patency observed after these interventions.

PMID- 7787358
TI  - Angiographic embolization of the distal internal mammary artery as an adjunct to
      regional chemotherapy in inoperable breast carcinoma.

PMID- 7787357
TI  - Bleeding stomal varices: treatment with a transjugular intrahepatic portosystemic
      shunt in two pediatric patients.

PMID- 7787359
TI  - Use of a LeVeen shunt as a percutaneously placed abdominal drainage catheter for
      malignant ascites.

PMID- 7787361
TI  - The misplaced central venous catheter: a long loop technique for repositioning.

PMID- 7787356
TI  - Prevention of significant hemobilia during placement of transhepatic biliary
      drainage catheters: technique modification and initial results.
AB  - PURPOSE: The authors evaluated a technique for the prevention of significant
      hemobilia during placement of transhepatic biliary drainage catheters (TBDCs).
      PATIENTS AND METHODS: Twenty patients with strictures were randomized to two
      groups. In the control group, the biliary tree was accessed with an Accustick
      system and a TBDC was placed routinely. In the experimental group, following
      initial access, a rotating hemostatic valve was attached and the outer sheath was
      pulled back over the wire while contrast material was injected. If a major
      vascular structure was encountered, the tract was not used for TBDC placement.
      However, the outer sheath was re-advanced and used to opacify the ducts. This
      facilitated separate access. Once access was achieved without traversing a major
      vascular structure, a TBDC was placed, and the Accustick system was removed. If a
      portal vein or hepatic vein branch was traversed, no additional maneuvers were
      performed. However, if a branch of the hepatic artery had been traversed, the
      tract and biliary-arterial fistula were embolized with gelatin sponge pledgets.
      Both groups were evaluated for hemobilia for 6 weeks. RESULTS: In the control
      group, there were three cases of significant hemobilia; two were mild, one was
      severe. In the experimental group, the tract communicated with a major vascular
      structure in three patients. In these patients, a second access was used for TBDC
      placement. None of the patients in the experimental group experienced significant
      hemobilia. CONCLUSION: Visualization prevents the usage of tracts that
      communicate with large vascular structures. Initial results indicate that this
      reduces the frequency of significant hemobilia when TBDCs are placed.

PMID- 7787360
TI  - Radiologic placement of long-term central venous peripheral access system ports
      (PAS Port): results in 150 patients.
AB  - PURPOSE: The author reports experience with 150 peripheral access system ports
      (PAS Ports) placed in an interventional radiology suite. Complication rates from
      this series are compared with those of surgically placed tunneled catheters. The
      average cost of placement is compared with that of a surgically placed chest
      port. PATIENTS AND METHODS: Findings were retrospectively reviewed in 150
      patients in whom the PAS Port catheter was implanted. The age range was 26-84
      years (mean, 46 years). The diagnoses in these patients included cancer (n = 68),
      acquired immunodeficiency syndrome (n = 52), osteomyelitis (n = 21), and abscess
      (n = 9). Implantation with use of fluoroscopic guidance and "Cath-finder"
      technology is described. RESULTS: One hundred fifty ports have been indwelling
      for a total of 24,151 patient days (range, 40-220 days; mean duration, 161 days).
      Sepsis occurred in 3.3%, local infection in 5% (early infection 1%, late
      infection 4%), temporary catheter occlusion in 3.3%, postinsertion phlebitis in
      7.3%, and venous thrombosis in 2%. The cost of radiologic PAS Port insertion
      averaged $1,488 versus $3,720 for surgical chest port insertion. CONCLUSION: PAS
      Port central venous catheter placement by an interventional radiologist in this
      series is safe and cost effective and compares very favorably with surgery.
      Radiologists will likely see increasing requests by referring physicians for
      radiologically placed catheters and ports in this era of cost containment.

PMID- 7787362
TI  - Graft-to-vein fistulas associated with polytetrafluoroethylene dialysis grafts:
      diagnosis and clinical significance.
AB  - PURPOSE: To describe the diagnosis and morphology of abnormal fistulas between
      dialysis grafts and adjacent native veins in five patients and to discuss their
      clinical significance. PATIENTS AND METHODS: Five patients with PTFE loop-type
      forearm dialysis grafts were found to have graft-to-vein fistulas in the presence
      of venous outflow stenosis or occlusion. Three patients underwent surgical
      revision and two patients underwent percutaneous angioplasty of the venous
      obstruction. Only one patient required ligation of the abnormal graft-to-vein
      fistula. The clinical history, dialysis records, surgical reports, and subsequent
      radiographs of the fistula were reviewed to determine the clinical significance
      of these fistulas. RESULTS: Two patients presented with partial graft thrombosis;
      the proximal portion of the graft remained patent due to persistent flow through
      the fistulous communication to an adjacent native vein. Two other patients had a
      graft-to-vein fistula arising from a pseudoaneurysm, which itself was originating
      from the graft. After either surgical or percutaneous treatment of the venous
      obstruction, all five grafts remained functional during the follow-up period.
      CONCLUSION: These iatrogenic, small-caliber fistulas are not uncommon but only
      manifest during periods of elevated graft pressure. Once the graft pressure is
      normalized, these fistulas have minimal hemodynamic effect and need not be
      specifically treated.

PMID- 7787363
TI  - Successful restoration of renal allograft function with urokinase thrombolysis in
      the setting of phlegmasia cerulea dolens.

PMID- 7787364
TI  - Phlegmasia cerulea dolens of the upper extremity.

PMID- 7787365
TI  - Endovascular credentialing. Endovascular Surgery Credentialing and Training
      Subcommittee.

PMID- 7787366
TI  - Foreign body retrieval with the braiding maneuver.

PMID- 7787367
TI  - Infusion catheter protection with use of an ostomy bag system.

PMID- 7787368
TI  - [Effects of the Health Structure Regulation on prescribing behavior of
      established physicians].
AB  - In 1992 the German Federal Minister of Health enacted a new law to secure the
      health insurance system by budgeting the expenses for prescriptions among else.
      The data derived from a sample of computer-assisted private practices show a
      significant decline of prescriptions both in natural units and in value since
      1993, but the analysis of the patients' data also reveals a more or less
      deliberate pattern of procedure followed by the GPs with regard to certain groups
      of patients such as elderly or chronically ill patients.

PMID- 7787370
TI  - [Measuring bone density--applications, critique, consequences].
AB  - The supporters of bone density measurement or osteodensitometry claim that it is
      possible to reduce the frequency of fractures if a lack of systemic bone mineral
      content is detected in time. Important topical points of criticism are brought
      forward. Meaningful clinical use is only possible if reference data referring to
      population are accepted, and standardised quality assurance is safeguarded.
      Densitometrical methods do not guarantee sufficient prognostic data neither for
      diagnostic purposes nor for estimating the risk of fracture. In addition, they
      are not reliable enough for assessment of a treatment. The compensation of costs
      by statutory health insurance for bone density measurements as therapeutic aid
      should be restricted to regular controls of bone density after having diagnosed a
      pathological fracture, and to controls of certain secondary forms of
      osteoporosis.

PMID- 7787369
TI  - [Evaluation and utilization of complementary medical procedures--a survey of 793
      physicians in general practice and the clinic].
AB  - It is well known that complementary medicine is demanded by numerous patients and
      used by many doctors. In a representative postal survey of 793 female and male
      doctors working in practices and hospitals in the town and in the district of
      Kassel we could confirm the wide distribution of these procedures, especially as
      far as doctors in practice are concerned. It was the special interest of our
      study to analyse the motives for the use and the indications and to ask for a
      detailed and differential assessment of 18 complementary techniques.

PMID- 7787371
TI  - [Complete nutrition and social assistance].
AB  - Additional supplementary benefits for nutrition are provided by social
      legislation; they are based on recommendations which have to be reconsidered in
      general as regards contents and quantities. The practice of assessment by Public
      Health Offices has no standardized regulations. Surveys have indicated that the
      recommendations are based on low-price calculations. The fundamental basis of
      supplementary benefits cannot guarantee healthy nutrition and therefore ignores
      the aim of prevention which had originally been included in social legislation.

PMID- 7787372
TI  - [Evaluation of impact on health--a central responsibility of the public health
      service].
AB  - Health impact assessment (HIA) is defined in this paper as the adequate coverage
      of health aspects within the context of environmental impact assessment. HIA is a
      typical task for the public health service. A project on HIA undertaken by the
      North Rhine-Westphalian Research Compound for Public Health found out that
      presently the opportunity to use HIA for preventive health purposes is still
      largely neglected. However, in a survey local health departments expressed great
      interest in receiving HIA-training. A workable concept and supporting tools are
      both necessary prerequisites for the practice of HIA becoming routine. This paper
      presents a ten step HIA-conceptl. Supporting tools are presently under
      development and testing.

PMID- 7787373
TI  - [A new method for early detection of neurotoxic diseases (exemplified by
      pyrethroid poisoning)].
AB  - This pilot-study should contribute to the question whether Pyrethroid
      intoxication can be distinguished from other diseases by characteristic clinical
      symptoms. The results show that the characteristics of the intoxication do not
      consist in singular symptoms but in combinations and correlations of symptoms,
      i.e. of central-neurological with peripheral- and autonomic-neurological as well
      as with characteristic immunological disturbances. Neurological symptoms consist
      in cerebro-organic disfunctions, locomotory disorders reminiscent of multiple
      sclerosis or M. Parkinson, and sensory, motoric and vegetative polyneuropathy,
      leading, for instance, to cardiovascular regulatory disorder like sympathicotonia
      or, orthostatic hypotonia. Non-neurological symptoms include immunosuppression
      with consecutive opportunistic infections, like candida albicans, most frequently
      of the alimentary tract, but also dermal and mucosal swellings, lichen-ruber-like
      efflorescences, loss of hair, conjunctivitis. Other symptoms are: hypoglycaemic
      crises inhibition of fertility, disturbances of blood clotting, and most
      frequently in children, suspected hematopoetic disorders.

PMID- 7787374
TI  - [Frequency analysis for achieving health goals--II: Analysis of mortality tables
      for cause of death, expected mortality].
AB  - The article gives algorithms to calculate mean ages at death for specific causes,
      based on life table models. Parameters of interest are death due to a specific
      cause, dying after the "elimination" of the specific cause, or the transition
      into a "new" structure of mortality when a specific cause of death vanishes. The
      setbacks of widely used calculations are discussed in this context. These
      different approaches are demonstrated by means of data pertaining to accident and
      cardiovascular mortality of the male population of Berlin (West). The estimated
      impact on life expectancy varies according to both the mathematical model and the
      specific cause of death: differences are negligible in mortality due to
      accidents, whereas the results differ considerably in cardiovascular causes of
      death. The algorithm suggested allows to constrain the calculations to specific
      age groups. Topics such as "avoidable death" and "health objectives" have to be
      aware of these different methods.

PMID- 7787375
TI  - [Medical aid according to the asylum application regulation--a report of
      experiences after the first year].
AB  - In 1993 the Law Concerning Social and Medical Aid for People Asking for Political
      Asylum in the Federal Republic of Germany (Asylbewerberleistungsgesetz) was
      promulgated. In so far the main political aims of the new law are concerned it is
      to say that in the case of dental treatment they have failed at least in the
      first year. The author believes it to be more serious from a medical point of
      view that there is a tendency towards a medicine having two different "classes".

PMID- 7787376
TI  - [Women and Health--Perspectives in Epidemiology and Public Health Sciences,
      Symposium, Bremen 28 October 1994].

PMID- 7787377
TI  - [Quality assurance in social medicine and as the responsibility of the German
      Society of Social Medicine and Prevention].

PMID- 7787379
TI  - [Graduate education for the physician in public health, theoretical section at
      the Mecklenburg-Vorpommern Academy of Social Medicine].

PMID- 7787378
TI  - [Report on the Physicians' Congress of Thuringen and Hessen Medical Services in
      Health Insurance 5 and 6 December 1994 in Weimar].

PMID- 7787380
TI  - Employment, retirement and elderly persons with an intellectual disability.
AB  - A national Australian study of people with an intellectual disability of 55 years
      of age and over investigated their employment and retirement patterns, attitudes
      to work and retirement, and the degree to which they were involved in leisure or
      recreational programmes. Two cohorts were recruited: one included all known
      members of the target group who agreed to participate in the study in the states
      of Queensland and Western Australia; and the second was a proportional, random
      sample drawn from a national database on a state population basis. A large number
      of the participants had never been involved in full- or part-time employment,
      either in a competitive or supported environment, or in workshops. The majority
      of those who had worked expressed strong positive attitudes toward employment and
      concern about retirement, suggesting the need for pre-retirement programmes
      including transition and choice-making skills to prepare participants for the
      future.

PMID- 7787381
TI  - How do carers assess the severity of challenging behaviour? A total population
      study.
AB  - The severity of management problems of 13 types of problem behaviour presented by
      a total population sample of people with learning disabilities, as reported by
      their primary carers on eight separate assessments over 5 years, was examined.
      Three types of residential setting were represented: hospitals, family homes and
      community houses. The results showed a remarkable consistency in carers'
      assessments of the severity of management problem posed to them. An association
      was found between the reported frequency of occurrence and the assessment of the
      severity of behaviours, with certain behaviours likely to be rated as severe
      regardless of the frequency with which they occurred. Differences between
      residential settings were found, with carers in family homes and community houses
      rating more behaviours as presenting severe management problems than carers in
      hospital. The results from this study and other studies which have examined the
      relative severity of different behaviour topographies are discussed.

PMID- 7787383
TI  - Menopause in women with learning disabilities.
AB  - A brief questionnaire concerning previous and current menstrual status was sent
      to 280 women over the age of 35 on the Wandsworth Register for People with
      Learning Disabilities: 196 questionnaires (70.4%) were returned. One hundred and
      seventy-one were used in the analyses; 45 were from women with Down's syndrome.
      The results suggested that, compared with data on normal women, menopause may
      occur earlier in women with learning disabilities and earlier still in women with
      Down's syndrome.

PMID- 7787382
TI  - Electrophysiological correlates of psychopathology in individuals with mental
      retardation and epilepsy.
AB  - One hundred adults with mental retardation and epilepsy were randomly selected
      from hospital and community settings for a detailed study of psychopathology
      (maladaptive behaviour, psychiatric illness and personality disorder). All of
      them had a recording of interictal EEG within the 12-month study period. Of all
      the EEG recordings, nine were completely normal, 48 showed excessive slow
      background wave, and a further 43 showed epileptiform discharges. Of the 43 with
      epileptiform discharges in the EEG, 12 showed bilateral, diffuse, generalized
      activities (including 3 Hz abnormality), 18 showed temporal lobe focus (five left
      sided, four right-sided and nine bilateral), and the other 13 showed secondary
      generalization from a temporal lobe focus. A comparison of psychopathology
      between the groups with a generalized epileptiform activity in the EEG (n = 12)
      and focal changes (n = 18) did not reveal any significant differences.

PMID- 7787384
TI  - Autism in immigrants: children born in Sweden to mothers born in Uganda.
AB  - Three boys diagnosed as suffering from autistic disorder were born in Sweden to
      mothers born in Uganda. Two were related but the third boy was unrelated to the
      others. The prevalence for autistic disorder in Goteborg children born to mothers
      who were born in Uganda was 15% which is almost 200 times higher than in the
      general population of children. The possible reason for the high autism rate in
      this particular ethnic subgroup is discussed.

PMID- 7787386
TI  - International colloquium on mental retardation and Alzheimer's disease.

PMID- 7787387
TI  - Alterations in replication timing of X-chromosome bands in Rett syndrome.
AB  - A cytogenetic study has been carried out on 30 girls affected with Rett syndrome,
      35 of their family members and 25 unrelated healthy control females. Karyotyping
      at the 850 band level revealed no detectable chromosome abnormalities in either
      the affected girls or their families. Observations on the sequence of the
      appearance of early replicating bands on both the active and the inactive X
      chromosome demonstrated the same replication patterns in all of the groups
      investigated with the exception that band Xp21 appeared with greater frequency in
      the Rett syndrome cells. A degree of variation was detected both between and
      within the subjects when the timing of the latest bands to replicate was
      investigated for the active X, but the same consensus order was obtained for all
      groups. A comparable number of elongated X-chromosomes was found in the girls
      with Rett syndrome (8%) when compared to their mothers (12%) when synchronized
      cells were treated with a short pulse of BrdU. If a disturbance in X-inactivation
      does contribute to the aetiology of Rett syndrome, it is at a level which is not
      detected by observations on the relative timing of replication of chromosome
      bands.

PMID- 7787385
TI  - Urine fetish in a man with learning disabilities.
AB  - Urine fetishes are uncommon. A 30-year-old man with learning disabilities and a
      fetish for observing women urinate is described, and the possible dynamic aspects
      of his paraphilia are discussed.

PMID- 7787389
TI  - [Effects of shi-ka-ron and Chinese herbs in mice treated with anti-tumor agent
      mitomycin C].
AB  - The Shi-ka-Ron, and its constituent Chinese herbs Lithospermum erythrorhizon,
      Astragalus membranaceus and Ligusticum Wallichii were administered with antitumor
      agent, mitomycin C (MMC) to ICR mice, and their effects on murine macrophages and
      lymphocytes were studied. Peritoneal macrophages were significantly inhibited
      both in their number and chemotactic activity by MMC treatment. Splenic weight
      and blastogenic responsiveness to Concanavalin A of spleen lymphocytes also
      decreased significantly in MMC-treated mice. NK cell activity was also suppressed
      by MMC treatment. When these mice were orally treated with extracts of Shi-ka-ron
      or each Chinese herbs mentioned above, it showed protective effects to
      immunosuppressive mice on all 5 items studied. The number of macrophages, and the
      functions of macrophages and lymphocytes maintained the same or more than normal
      levels in MMC plus each group of these extracts treated mice. These results
      suggest that the Shi-Ka-Ron and Chinese herbs could resist immunosuppression
      induced by antitumor agent MMC, and its mechanisms might be correlated with
      stimulation of the RES (reticuloendothelial system), activation of T cell
      blastogenesis and NK cell cytotoxicity.

PMID- 7787388
TI  - Behaviour problems in Angelman syndrome.
AB  - Angelman syndrome (AS) is a genetic disorder that is associated with a deletion
      on chromosome 15, and is characterized by abnormalities or impairments in
      neurological, motor and intellectual functioning. While behaviour problems have
      been reported in clients with AS, relatively little is known about their
      developmental course and outcome. In this study, data on the nature and
      prevalence of behaviour problems among clients with AS were gathered from two
      sources: (1) a review of published case reports; and (2) parent responses to a
      survey of behaviour problems in a small (n = 11) sample of children with AS. Data
      from both sources showed that behaviour problems were present in males and
      females of all ages, and included language deficits, excessive laughter,
      hyperactivity, short attention span, problems with eating and sleeping,
      aggression, noncompliance, mouthing of objects, tantrums, and repetitive and
      stereotyped behaviour. Identification and treatment of severe behaviour problems
      in clients with AS may improve their adaptive functioning.

PMID- 7787390
TI  - [Progress in the study in treating senile dementia with traditional Chinese
      medicine].

PMID- 7787391
TI  - [Progress in the prevention and treatment of ischemic cerebrovascular diseases
      with garlic extract].

PMID- 7787393
TI  - [Study on effect of mediation principle in retarding progression of chronic renal
      failure].
AB  - 100 Patients with chronic renal failure(CRF) were treated mainly by the mediation
      principle (MP). Results showed that the progression of CRF with MP was slower
      than that without MP. There was very significant difference (P < 0.01) between
      the regression coefficient. In addition, the effect of MP on the factors in
      promoting the progression of CRF, e.g., hypertension, albuminuria, hyperlipemia
      and immune function etc. was discussed in detail.

PMID- 7787394
TI  - [Clinical observation on treatment of myelodysplastic syndromes with yisuikang].
AB  - 20 cases of myelodysplastic syndrome (MDS) patients were treated with Yisuikang
      (YSK) including MDS-RA 17 cases, MDS-RAEB 2 cases, MDS-RAEB-T 1 case. 14 patients
      were treated with YSK only, 6 cases were treated with both YSK and Western
      medicine. The result showed that 4 cases were remitted, 5 cases markedly
      improved, 6 cases improved and 5 cases ineffective, the total effective rate was
      75.0%. It was found that YSK was effective in the treatment of MDS-RA or Qi-Blood
      Deficiency and Yu-Re Syndrome in TCM, while any other types were ineffective.
      They also found that types of TCM might be correlated with MDS.

PMID- 7787395
TI  - [Clinical observation on the treatment of ischemic heart disease with Astragalus
      membranaceus].
AB  - 92 patients suffering from ischemic heart disease was successfully treated with
      Astragalus membranaceus (AM). The effect of the treatment was compared with that
      of Nifedipine and Tab. Salviae miltiorrhizae. The clinical practice showed that
      the group treated with AM yielded better results. After having administered the
      drug, the patients were markedly relieved from angina pectoris (heart stroke).
      Meanwhile the improvement of clinical objective index such as electrocardiogram
      (EKG) and impedance cardiogram can also be observed. The effective rate of EKG
      improvement was 82.6%. The treatment of ischemic heart disease with AM was
      significantly more effective in comparing with control group (P < 0.05).

PMID- 7787392
TI  - [Preliminary study on pathophysiology of liver-qi deficiency syndrome].
AB  - The authors advocate a program for diagnosing Liver-Qi Deficiency Syndrome (LQDS)
      based on the TCM theory and clinical practice. Through investigation, LQDS was
      found to be widely existed as latent period or as external manifestation, which
      occupied 18.85% in Qi Deficiency Syndrome. The subjects were divided into four
      groups including normal group, Spleen-Qi Deficiency Syndrome (SQDS) group, LQDS
      with Liver diseases (LD) and LQDS with non-Liver diseases (NLD) group. In order
      to explore the essence, the simultaneous determinations were done on lactate
      dehydrogenase (LDH) and its isoenzyme, dopamine beta-hydroxylase (D beta H),
      trace element Zn and Cu, and other serological indexes such as GPT, TP, Alb, A/G,
      etc. The results were, the content of LDH and trace element Zn in both LQDS-NLD
      and SQDS were significantly lower than that of normal group. D beta H reflecting
      sympathetic nerve function in LQDS-NLD was significantly higher than that of both
      normal and SQDS group; comparing LQDS-LD and LQDS-NLD group, the content of GPT,
      LDH, LDH5 and trace element Cu in former was significantly higher than that of
      the latter, but the content of TP, Alb, A/G, D beta H and Zn in former was
      remarkably lower than that of the latter. In order to avoid confusion, in
      studying this syndrome, one should distinguish LD and NLD.

PMID- 7787396
TI  - [Study of relationship between TCM syndrome-types of malignant tumours and
      thyroid functional test].
AB  - The relationship between the thyroid functional test in 107 malignant tumour
      patients' sera with Deficiency-Excessiveness Syndromes in TCM, was studied. The
      results revealed that there were significant differences between the FT3, FT4 in
      tumour and control groups (P < 0.01) as well as between the rT3, FT3/rT3 in each
      type of tumour and control groups (P < 0.05-0.01). There was also definite
      relationship between the FT3, rT3, FT3/rT3 and the degree of differentiation,
      rate of progression and malignancy of tumours as well. rT3 elevated and FT3
      reduced in accordance with the lowering of body resistance and reinforcing of
      pathogenic factors. FT3, rT3, FT3/rT3 are essential factors that reflecting the
      wax and wane of body resistance in the cases with malignant tumours in modern
      medicine.

PMID- 7787397
TI  - [Study on objective parameters of syndrome differentiation of diabetic
      nephropathy].
AB  - This is a study about objective parameters of Syndrome Differentiation of
      diabetic nephropathy (DN) using radio immunoassay (RIA) technique. The result
      showed that beta 2-microglobulin (beta 2-mG), alpha 1-microglobulin (alpha 1-mG)
      in blood rose significantly in both groups. The group of Spleen-Kidney Deficiency
      and Qi-Blood Deficiency as well as the group of Yang Deficiency caused edema and
      upward gush of turbid Yin, there was significant difference between two groups,
      also there was significant difference between the two groups in measuring on
      atrial natriuretic factor (ANP), pancreatic glucagon (PG) in blood and beta 2-mG.
      Immunoglobulin G (IgG), albumin (Alb), secretory immunoglobulin A(SIg A) in
      urine. So above-mentioned parameters offered us some objective data on Syndrome
      Differentiation of DN. It is vital in guiding the Syndrome Differentiation and
      treatment of DN.

PMID- 7787399
TI  - [Tube pregnancy treated with trichosanthin and followed up by
      hysterosalpingography].
AB  - Twenty cases of unruptured tube pregnancy were treated with Trichosanthin
      intramuscularly given. Only two cases were eventually operated, so the effective
      rate was 90%. The hysterosalpingography was taken in 14 of 18 cases who was
      willing to accept the procedure at 0.5-1.5 year after the conservative treatment.
      Both tubes were patent in 10 of 14 cases, the rate of patency was 71.4%.

PMID- 7787398
TI  - [Effect of shenmai injection on sIL-2R NK and LAK cells in patients with advanced
      carcinoma].
AB  - Serum interleukin-2 receptor (sIL-2R) level activities of natural killer cell
      (NK) and lymphokine activated killer cell (LAK) cells were determined in 60
      patients with advanced carcinoma (AC) before and after treatment with Shenmai
      injection (SMI), 40 healthy persons were taken as non-carcinoma control (NC). The
      results showed that: Serum sIL-2R level in AC were much higher than those in NC
      (P < 0.05) and activities of NK and LAK cells in AC were much lower than those in
      NC (P < 0.05) before treatment. There was no significant difference among gastric
      cancer, colonic carcinoma and lung cancer (P < 0.05). After treatment with SMI we
      also found that the level of sIL-2R in all patients were obviously lower (P <
      0.05) while the activity of NK and LAK cells were significantly higher than that
      prior treatment (P < 0.05). Linear correlation was not found between sIL-2R and
      NK, LAK cells. These data suggested that the immune function was compromised in
      AC. The mechanism of the inhibitory effect of SMI on carcinoma might be related
      to the activity of biological response modifier.

PMID- 7787400
TI  - [Effect of guzhen recipe on glucocorticoid receptor in senile rate thymocyte].
AB  - The effects of Guzhen Recipe (GZ) which composed of Polygonum multiflorum,
      Cistanche deserticole, Rubus chiagii etc, on the number of thymocyte
      glucocorticoid receptor (GCR) sites, the GCR nuclear translocation rate, and the
      activity of serum thymic factors etc in senile rats were observed. The results
      showed: The number of thymocyte GCR sites, the contents of cytoplasmic protein,
      nuclear RNA and DNA, the thymus weight/body weight ratio and the serum thymic
      factors in senile rats were significantly decreased, while thymocyte GCR nuclear
      translocation rate increased obviously than that of young control rats. GZ,
      however, was capable of improving the above-mentioned changes of thymus in senile
      rats markedly, suggesting that GZ might weaken the inhibitory effect of
      glucocorticoid on the thymus by means of suppressing the translocation activity
      of GCR from cytoplasm to nucleus in senile rats, thus enhance thymus-dependent
      immune function in senile rats.

PMID- 7787401
TI  - [Comprehensive study on mechanism of leukocytogenic effect of fuzheng shengbai
      capsule].
AB  - In order to study the mechanism of the therapeutic effect of Chinese medicine in
      raising white blood cells, the effects of multiplication of splenocyte of
      leukopenic mice, the activity of interleukin-2 (IL-2), the lipoperoxidant (LPO)
      content, the concentration of blood serum testosterone of male mice by using
      Fuzheng Shengbai Capsules (FZSBC) were observed. The results showed that the
      multiplication of splenocyte, the activity of IL-2, and testosterone level of the
      experimental group were significantly higher than those of the control group (P <
      0.05-0.01), LPO was decreased slightly, which had no statistic significance.
      Therefore, the increasing of WBC had no relation with the content of LPO but was
      positively correlated with T lymphocytes as well as the activity of IL-2. This
      study showed that the mechanism of leukocytogenic effect of FZSBC might be that
      it was related with promoting the proliferation of T lymphocytes, elevating the
      activity of IL-2 and raising the testosterone level, but was not relevant with
      anti-LPO.

PMID- 7787402
TI  - [Study of treating experimental ulcerative colitis of spleen deficiency type with
      "guben yichang tablet" in guinea pigs].
AB  - Guinea pigs were perfused with the extract of senna (20%). 3 days later glacial
      acetic acid (5%) was given intra-anally so as to replicate the animal model of
      Spleen Deficiency (SD) and ulcerative colitis which is the disease of Western
      medicine combined with the Syndrome in TCM. The model animals showed the symptoms
      of SD such as loose stool, anorexia, wasting, aversion of cold, laziness and loss
      of hair luster and the symptoms of ulcerative colitis such as abdominal
      distension and mucous bloody stool. The colonic lesion were observed by eyes that
      the mucosa were edematous, congestive with ulcerative foci. The pathological
      examinations showed edema and congestion in submucous layers; large amount of
      inflammatory cell infiltration; and the scaling and ulcer formation of epithelium
      mucosae. The above-mentioned symptoms and pathological changes were the same as
      SD and ulcerative colitis in clinical practice. The new medicine "Guben Yichang
      Tablet" against ulcerative colitis was given to guinea pigs for 7 days could
      abate their symptoms, increase their body weights and decrease the size of
      colonic ulcer and edema.

PMID- 7787403
TI  - Protein synthesis in specific tissues during sepsis.
AB  - BACKGROUND: The hypothesis that fractional protein synthesis rates (Ks) are
      tissue-specific and bidirectional during sepsis was tested in an animal model.
      MATERIAL AND METHODS: Ks in liver, triceps muscle, and diaphragm were measured in
      septic (n = 27) and control rats (n = 26). Sepsis was induced by a reproducible
      model established in our laboratory (intraperitoneal injection of sterile NaOH
      0.75 N at 0.075 ml/100 g of body weight). Ks were measured using the flooding
      dose method in tissue obtained from the diaphragm, liver, and from the triceps
      muscle. RESULTS: In hepatic and diaphragmatic tissue, Ks were significantly
      higher in the septic animals (Ks: 112.2 +/- 8 and 5.4 +/- 1.9, respectively) than
      in control animals (Ks: 78.5 +/- 13 and 2.9 +/- 1.7, respectively). In the
      triceps, Ks were significantly lower in septic animals (Ks: 2.9 +/- 1.4) than in
      control animals (Ks: 5 +/- 1.8). CONCLUSION: The results suggest that in septic
      animals the rate of protein synthesis is enhanced in tissues of priority, such as
      the liver, and varies in response to differences in muscle activity.

PMID- 7787404
TI  - [Immunosuppressive effect of parenteral fat emulsions in defined
      immunostimulation].
AB  - BACKGROUND: In the heterotopic rat heart allotransplant model we have previously
      shown that intravenous fat emulsions are to a various extent immunosuppressive or
      immunoneutral, dependent on their n-3/n-6 fatty acid ratio. Safflower oil (n-3: n
      6 = 1:370), fish oil (7.6:1) and soybean oil (1:6.5) prolonged the transplant
      survival time to 13.3, 12.3 and 10.4 days compared to 6.7 days (oil control
      group; 1.2.1) and 7.8 days (saline control group) (p < 0.01), respectively. This
      study presents a correlation of graft survival to immunohistological, cell
      biological and biochemical parameters. MATERIALS AND METHODS: 20% emulsions of
      safflower oil, fish oil, soybean oil and a 1:1 mixture of safflower and fish oil
      (oil control group) were continuously infused (9 g fat/kg body weight/day; n = 10
      each group) after transplantation. Subpopulations of infiltrating and circulating
      immunocompetent cells and leukotriene B4 and B5 release of circulating
      mononuclear cells were analyzed (on the 4th postoperative day). RESULTS: In the 2
      groups with the highest prolongation of graft survival the number of infiltrating
      cells was reduced by up to 40% and the peripheral blood mononuclear cell
      interleukin-6 release by up to 45%. Beyond that, circulating T cells were reduced
      in the fish oil group. Leukotriene B4 was released in all groups to the same
      extent, leukotriene B5 exclusively in the fish oil group. CONCLUSIONS:
      Intravenous fat emulsions show a varying immunomodulatory effect in dependence of
      the n-3/n-6 fatty acid ratio. Both n-6 and n-3 fatty acids, if applied as main
      fatty acid source, exert immunosuppressive effects by a diminished infiltration
      and mobilisation of immunocompetent cells. Soybean oil with a more balanced n-3/n
      6 fatty acid ratio than safflower oil is significantly less immunosuppressive
      than safflower oil, and fat emulsions with a n-3/n-6 fatty acid ratio of 1:2 are
      immunologically neutral.

PMID- 7787405
TI  - [Suitability of monoclonal test sera for determination of blood group markers in
      positive direct Coombs test].
AB  - BACKGROUND: Monoclonal reagents of the IgM type allow to test some red blood cell
      antigens (K; Jka; Jkb) by the tube centrifugation method at room temperature, for
      the examination of which the indirect antiglobulin test was necessary in the
      past. This permits to test antigens also when the direct antiglobulin test is
      positive, provided the sera do not contain too much supplement. MATERIALS AND
      METHODS: We tested a choice of monoclonal reagents of different manufacturers
      (for the ABO system, A subgroups, the Rhesus, MN, Kell, Kidd and Lewis system)
      for their ability to examine antibody-coated erythrocytes. To recognize false
      positive reactions of the reagents, erythrocytes without the particular antigen
      were coated with an incomplete antibody, and then the reagent was tested with
      these self-made Coombs control cells. RESULTS: We found no false-positive
      reactions for all tested anti-A, anti-B, anti-AB, and anti-A1 reagents. Some anti
      C, anti-c, anti-E, anti-e and anti-N reagents showed weak false-positive
      reactions, some anti-H, anti-D, anti-K, anti-Jka, anti-Jkb, anti-Lea, anti-Leb
      and anti-M reagents stronger false-positive reactions.

PMID- 7787406
TI  - The F-cell ratio: a clinically important parameter or just fine tuning?

PMID- 7787407
TI  - GIK in cardiac surgery.

PMID- 7787408
TI  - Amino acid-enriched glucose-insulin-potassium infusion improves hemodynamic
      function after coronary bypass surgery. A double-blind study in patients with
      unstable angina and/or compromised left ventricular function.
AB  - OBJECTIVE: The goal of this study was to assess the effects of a combination of
      glucose-insulin-potassium (GIK) and the amino acids aspartate and glutamate upon
      perioperative hemodynamics in coronary surgery patients with unstable angina
      and/or compromised left ventricular function. DESIGN: Prospective, randomized,
      and double-blind clinical study. SETTING: Operating theatre and intensive care
      unit (ICU) of a university hospital. PATIENTS: 44 coronary artery bypass graft
      (CABG) patients with unstable angina and/or compromised left ventricular
      function. INTERVENTIONS: 22 patients (group A) were given 1l of an infusion with
      250g glucose, 100 I.U. fast-acting human insulin, 72 mmol potassium, 32 mmol
      magnesium, 20 mmol phosphate, 65 mmol aspartate, and 65 mmol glutamate, while
      another 22 patients (group C) were given 1l of an infusion with 50 g glucose, 72
      mmol potassium, 32 mmol magnesium, and 8 mmol phosphate. The infusion rate was
      1.2 ml/kg/h from the anesthesia induction onward to the commencement of
      cardiopulmonary bypass, when it was reduced to 0.8 ml/kg/h. When 11 had been
      infused, but not later than 4 a.m., the infusion was continued by giving 10%
      glucose at the same rate to both groups. Additional insulin (median: 14.2 I.U.,
      range: 0-41.5) or saline was given during bypass to the A and C patients,
      respectively. A blood cardioplegia technique containing aspartate and glutamate
      was used in both groups. RESULTS: At aortic cannulation, the cardiac index (CI)
      had increased from the pre-anesthetic level by 15.3% (mean) (SD: 31.7%) in group
      A and decreased by 7.7% (15.1%) in C patients, p = 0.0069. Also the changes in
      stroke index (SI; p = 0.022), left (LVSWI; p = 0.0037) and right ventricular
      stroke work index (RVSWI; p = 0.0097) were more favorable in group A. Despite
      longer aortic cross-clamp, p = 0.031, and perfusion times, p = 0.042, in A
      patients, the change in cardiac index was also better in this group after bypass:
      At decannulation, the difference between mean values was 31.8%, p = 0.0001, and
      at arrival in the ICU it was 16.1%, p = 0.028. The same was also seen 8 h
      postoperatively and on the 1st and 2nd postoperative mornings; p = 0.034, 0.040,
      and 0.037, respectively (Wilcoxon test). Favorable changes were seen for the A
      patients also regarding SI at decannulation (p = 0.0002) and after 8 h (p =
      0.017); LVSWI at decannulation (p = 0.0002), at arrival in the ICU (p = 0.0023),
      and after 8 h (p = 0.0011); and RVSWI at decannulation (p = 0.0027), at the ICU
      (p = 0.021), after 8 h (p = 0.014), and on the 1st postoperative morning (p =
      0.039). However, the response to a hemodynamic loading test (6% hydroxyethyl
      starch 5 ml/kg) was similar in the 2 groups, and there was no difference in the
      need for inotropic support. CONCLUSIONS: Amino acid-enriched GIK infusion
      improves hemodynamic function in CABG patients with unstable angina and/or
      compromised left ventricular function.

PMID- 7787409
TI  - Is the transfusion requirement predictable in critically ill patients after
      admission to the intensive care unit?
AB  - OBJECTIVE: In intensive care medicine the clinical decision to order and
      transfuse red blood cells (RBC) is usually based on hematocrit or hemoglobin
      levels. The intention of this study was to investigate whether clinical or
      laboratory variables, taken after the admission of patients to the intensive care
      unit (ICU), are able to predict the transfusion requirement of the following 72
      h. DESIGN: The values of initially measured systolic blood pressure, hematocrit
      level, and the values of 2 scores of severity of disease (Acute Physiology And
      Chronic Health Evaluation [APACHE-II], Mortality Prediction Model [MPM]) were
      calculated after the admission of patients to the ICU. The decision for
      transfusion was based on specific criteria. The median values of the scores,
      those of the variables, and the median number of transfused RBC units of the
      surviving group were compared to the values of the group of patients who died
      during hospital stay. The quantity of RBC transfusions was compared to the
      variables and score values by linear regression analysis. Additionally, the
      values of the patients who did not receive blood transfusion were compared to
      those of patients who required RBC. Furthermore, the patient group with
      neurosurgical diseases was compared to the group without neurosurgical diseases.
      PATIENTS: 117 patients were prospectively and consecutively investigated in an 8
      bed ICU of a university hospital. RESULTS: Nonsurvivors required significantly
      more units of RBC during the first 72 h (p < 0.05). Patients who did not require
      transfusion had a higher hematocrit and a lower APACHE-II value at admission (p <
      0.001). In the MPM values no differences were found. Patients with neurosurgical
      diseases had a higher initial hematocrit value, and they required less units of
      RBC in comparison to patients without neurosurgical diseases. In the analysis of
      linear regression neither in the initially measured systolic blood pressure nor
      in the APACHE-II and MPM we found a strong linear correlation to the quantity of
      blood transfusion. CONCLUSIONS: A hematocrit value < or = 20% and a APACHE-II
      score > or = 20 at the time of admission to the ICU referred to a demand for
      blood transfusion. We believe that these parameters are useful as predictive
      instruments. The initially measured systolic blood pressure had no prognostic
      capacity. In the individual patient a number of factors should be taken into
      account to decide whether to transfuse or not.

PMID- 7787410
TI  - Long-term evaluation of a continuous intra-arterial blood gas monitoring system
      in patients with severe respiratory failure.
AB  - OBJECTIVE: The purpose of this study was to evaluate the reliability and accuracy
      of a new continuous intra-arterial blood gas monitoring system (IABG; PB3300,
      Puritan Bennett) over a prolonged period of time (> 7 days). DESIGN: Prospective
      criterion standard study. SETTING: Anesthesiological intensive care unit in a
      university hospital. PATIENTS: 11 sensors were tested in 10 mechanically
      ventilated patients with severe respiratory failure. INTERVENTIONS: PO2, PCO2,
      and pH measured using IABG were compared to values obtained from 2 conventional
      blood gas analyzers. The quality of blood pressure tracings was assessed using a
      scoring system consisting of 5 grades. RESULTS: The median study period was
      205h/sensor (range: 169-506h). 320 blood samples were obtained. The ranges of
      measured parameters were: PO2 = 46-433 mmHg, PCO2 = 25-79 mmHg, pH = 7.25-7.55.
      The mean (SD) differences for the whole study period were: -4.3 (11.9) mmHg for
      PO2, for the clinically important range (PO2 < 150 mmHg) -1.9 (5.4) mmHg, -2.8
      (4.5) mmHg for PCO2, and -0.03 (0.04) for the pH value. The MD (SD) in relation
      to the sensor lifetime were for days 1-3: -1.1 (5.1) mmHg for PO2, -0.4 (3.9)
      mmHg for PCO2, and -0.01 (0.03) for the pH value; for days 4-6: -1.5 (6.0) mmHg
      for PO2, -3.3 (4.0) mmHg for PCO2, and -0.03 (0.03) for the pH value; for days 7
      9: -2.5 (4.7) mmHg for PO2, -5.1 (4.6) mmHg for PCO2, and -0.04 (0.04) for the pH
      value; for days > 9: -4.9 (4.4) mmHg for PO2, -5.3 (4.1) mmHg for PCO2, and -0.05
      (0.03) for the pH value. CONCLUSIONS: The IABG reliably measured blood gases and
      pH values with acceptable clinical performance based on the overall results.
      There was, however, a decline in the agreement of the sensors and conventional
      values with increasing sensor lifetime. The mean differences (bias) and the
      standard deviation of differences (precision) of PO2, PCO2 and the pH values were
      acceptable for clinical purposes up to day 6. The arterial blood pressure
      tracings and blood withdrawal were not adversely affected. No side effects due to
      the sensors occurred. In summary, a prolonged sensor use for a period of up to 6
      days appears to be reasonable. This system offers on-line information on
      oxygenation, ventilation, and acid-base status and allows immediate detection of
      acute and potentially life-threatening events.

PMID- 7787413
TI  - Transcriptional activity of domain A of the rat glucagon G3 element conferred by
      an islet-specific nuclear protein that also binds to similar pancreatic islet
      cell-specific enhancer sequences (PISCES).
AB  - A pancreatic islet cell-specific enhancer element in the rat glucagon gene, Glu
      G3, contains two domains, one of which, domain A, has been shown to be necessary
      for Glu-G3 activity. In the present study, the functions of the isolated domain A
      of Glu-G3 were investigated by using transient reporter fusion gene expression
      and DNA binding assays. A single copy of domain A was transcriptionally inactive
      in glucagon-producing islet cell lines, whereas it did confer activity when
      combined with domain B, suggesting that Glu-G3 may be a bipartite element.
      Multiple copies of domain A did function independently as transcriptional
      enhancer in phenotypically distinct islet cell lines but not in several nonislet
      cell lines. Sequences (PISCES, pancreatic islet cell-specific enhancer
      sequences), similar to that of domain A of Glu-G3 and present in cell-specific
      control elements of the rat insulin I (Ins-E1) and rat somatostatin genes (SMS
      UE), are shown to be required for transcriptional activity of these elements. In
      addition, a protein was detected in islet cell lines that bound to the PISCES
      motifs within Glu-G3, Ins-E1, and SMS-UE. These results support the view that
      cell-specific control elements of the glucagon, insulin, and somatostatin genes
      share a functional regulatory sequence, PISCES, and provide direct evidence for
      the existence of an islet-specific, PISCES-binding transcription factor or
      closely related proteins being involved in the coordinate expression of islet
      hormone genes.

PMID- 7787412
TI  - Overexpression of the E2F-1 transcription factor gene mediates cell
      transformation.
AB  - The E2F transcription factor can regulate expression of numerous cellular genes
      controlling proliferation, including proto-oncogenes and genes regulating cell
      cycle progression. Therefore, genes comprising the E2F gene family could
      potentially contribute to carcinogenesis. To test the potential of E2F to act as
      a transforming gene, a cDNA encoding E2F-1 was constitutively overexpressed in
      established rodent cells using a retroviral vector. Overexpressed E2F-1 was
      functional, as shown by stimulation of a transfected adenovirus E2 promoter
      driving a chloramphenicol acetyltransferase reporter gene in E2F-1 overexpressing
      cells. This stimulation was dependent on functional E2F binding sites in the
      promoter. Examination of phenotype showed that E2F-1 overexpression mediated cell
      transformation as measured by the ability of cells to form colonies in soft agar
      medium. In addition, overexpressed E2F-1 shortened the duration of the G1 cell
      cycle phase in proliferating cells, a property characteristic of other
      transforming genes. These data provide direct evidence that E2F-1 can act as a
      transforming gene and a critical regulator of cell cycle progression and suggest
      the possibility of E2F involvement in carcinogenesis.

PMID- 7787411
TI  - Role of homeodomain protein binding region in the expression of Drosophila
      proliferating cell nuclear antigen gene: analysis with transgenic flies.
AB  - The regulatory region of Drosophila proliferating cell nuclear antigen (PCNA)
      gene consists of a promoter region (-168 to +24 with respect to the transcription
      initiation site) and an upstream region containing three homeodomain protein
      binding sites (HDB) (-357 to -165). The PCNA gene regulatory regions with HDB (
      607 to +137) or without HDB (-168 to +137) were fused with the lacZ and
      transgenic flies were established by P-element-mediated transformation. Male
      transgenic flies were crossed with wild-type females, and zygotic expression of
      the lacZ was monitored by quantitative beta-galactosidase assay, at various
      stages of development. Expression of the lacZ was high in embryos, first and
      second instar larvae, and adult females, and low at other stages of development.
      Only a marginal difference in expression was observed between flies carrying the
      homeodomain protein binding region and those not carrying it. Spatial pattern of
      the lacZ expression in the embryo visualized by immunostaining with the anti-lacZ
      antibody was similar to the distribution of the endogenous PCNA protein. Here,
      too, only a marginal difference was observed between transgenic flies carrying
      two different constructs of the PCNA lacZ. In genetic crossing experiments of
      transgenic flies with those carrying mutation in homeobox genes, no significant
      change in the lacZ expression pattern was observed. However, when male transgenic
      flies were crossed with female flies homozygous for a torso gain-of-function
      allele, repression of the lacZ expression was observed in the central region of
      the embryo. Because these local changes in the lacZ expression depend on the
      homeodomain protein binding region, unidentified homeodomain proteins are
      probably involved. Our results suggest that the promoter region is practically
      sufficient for expression of the PCNA gene and that the homeodomain protein
      binding region functions as a silencer when torso is activated ectopically.

PMID- 7787415
TI  - Transactivation by PPAR/RXR heterodimers in yeast is potentiated by exogenous
      fatty acid via a pathway requiring intact peroxisomes.
AB  - Peroxisome proliferator-activated receptors (PPARs) are orphan members of the
      nuclear hormone receptor superfamily. PPARs bind to cognate response elements
      through heterodimerization with retinoid X receptors (RXRs). Together PPAR/RXR
      regulate the transcription of genes for which products are involved in lipid
      homeostasis, cell growth, and differentiation. PPARs are activated by fatty acids
      and by nongenotoxic rodent hepatocarcinogens called peroxisome proliferators
      through as of yet undefined signal transduction pathways. In an effort to
      elucidate the requirements for PPAR function and the pathways of its activation,
      we expressed mouse PPAR alpha and human RXR alpha in the yeast Saccharomyces
      cerevisiae. Mouse PPAR alpha and human RXR alpha had little activity individually
      in yeast; however, when cosynthesized, they were able to synergistically activate
      transcription via cognate response elements. Transactivation was independent of
      exogenously added activators of either receptor but was potentiated by the
      addition of petroselinic acid, a fatty acid shown to activate PPARs in mammalian
      cells. Similar experiments were carried out in a mutant yeast strain lacking
      peroxisomes entirely or in a mutant strain deficient for 3-ketoacyl-CoA thiolase,
      the final enzyme of the peroxisomal beta-oxidation cascade. The findings showed
      that constitutive transactivation by PPAR/RXR did not require the complete beta
      oxidation pathway or intact peroxisomes but required intact peroxisomes for
      potentiation by exogenously added petroselinic acid. This study demonstrates that
      at least part of the mammalian peroxisome proliferator-signaling pathway can be
      faithfully reconstituted in yeast and that activation of PPAR by at least one
      particular fatty acid requires the integrity of peroxisomes.

PMID- 7787414
TI  - Lineage-specific alternative splicing of the human Fc gamma RIIA transmembrane
      exon requires sequences near the 3' splice site.
AB  - The human Fc gamma RIIA gene produces multiple transcripts, including those with
      (Fc gamma RIIa1) and without (Fc gamma RIIa2) the single exon encoding the
      transmembrane domain (TM). Previously, a fluorescence-based RT-PCR assay showed
      lineage-specific differences in Fc gamma RIIA transcript ratios (Fc gamma
      RIIa2/Fc gamma RIIa1). The mechanism of this lineage-specific expression was
      investigated in this study. Differential transcript stability does not play a
      major role, because transcript ratios remained constant in cells with both low
      (K562) and high (Dami) ratios following actinomycin D treatment. Transient
      expression studies in K562 and Dami cells using a minigene construct containing a
      5.0 kb genomic fragment including the TM exon and adjacent intron and exon
      sequences showed recapitulation of endogenous transcript ratios. The TM exon was
      efficiently spliced in by the constitutive splicing machinery in HeLa cells, an
      Fc gamma RIIA-negative cell line. Lineage-specific TM exon skipping was markedly
      diminished by two independent minigene mutations: a point mutation of the first
      nucleotide of the TM exon, and a five basepair intronic deletion near a putative
      branchpoint. These data demonstrate that cis-acting sequences in or near the TM
      exon 3' splice acceptor site contribute to lineage-specific differences in Fc
      gamma RIIA transcript ratios.

PMID- 7787417
TI  - Overexpression, purification, and characterization of the ADP-ribosyltransferase
      (gpAlt) of bacteriophage T4: ADP-ribosylation of E. coli RNA polymerase modulates
      T4 "early" transcription.
AB  - The bacteriophage T4 Alt gene product is a component of the phage head and enters
      the host cell in the process of infection together with the phage DNA. It
      immediately ADP-ribosylates host RNA polymerase, presumably at only one of the
      two alpha-subunits. Transcription from T4 "early" promoters, therefore, might be
      catalyzed, at least in part, by an altered RNA polymerase. The T4 alt gene was
      cloned into the expression vector pBluescript. E. coli cells, transformed with
      this recombinant vector, overexpressed the 76 kDa Alt gene product, which was
      purified to homogeneity. The purified enzyme not only ADP-ribosylates the alpha
      subunit of RNA polymerase, but also subunits beta and beta', as well as the sigma
      70-factor. The recombinant enzyme behaved like the native enzyme isolated from
      mature phage particles. The effect of the ribosylation reaction on the
      transcription activity of host RNA polymerase was investigated in vivo. It
      results in a modulation of T4 "early" promoter strengths, presumably, in a number
      of cases, leading to an overexpression of T4 "early" genes. The degree of
      overexpression, in some cases, should reach 50%, and seems to be well dosed for
      each promoter, controlling an individual transcription unit.

PMID- 7787416
TI  - Overexpression of initiation factor eIF-4E does not relieve the translational
      repression of ribosomal protein mRNAs in quiescent cells.
AB  - Translation of ribosomal protein (rp) mRNA is selectively repressed in mouse
      erythroleukemia (MEL) cells, which cease to proliferate upon differentiation, and
      in NIH 3T3 cells, for which growth is arrested by either serum starvation,
      contact inhibition, or treatment with the DNA polymerase inhibitor, aphidicolin.
      The efficiency of translation of rp mRNAs correlates with the expression of the
      gene encoding the cap binding protein, eIF-4E, as indicated by the fact that the
      abundance of the corresponding mRNA and protein also fluctuates in a growth
      dependent manner. To examine the hypothesis that eIF-4E plays a role in
      regulation of the translation efficiency of rp mRNAs, we utilized an NIH 3T3
      derived eIF-4E-overexpressing cell line. These cells overproduce eIF-4E to the
      extent that even under conditions of growth arrest, the abundance of the
      respective protein in its active (phosphorylated) form is higher than that found
      in exponentially growing NIH 3T3 cells. Nevertheless, this surplus amount of eIF
      4E does not prevent the translational repression of rp mRNAs when the growth of
      these cells is arrested by blocking DNA synthesis with aphidicolin or
      hydroxyurea. In complementary experiments we used an in vitro translation system
      to compare the competitive potential of mRNAs, containing the translational cis
      regulatory element (5' terminal oligopyrimidne tract) and mRNAs lacking such a
      motif, for the cap binding protein. Our results demonstrate that both types of
      mRNAs, regardless of their translational response to growth arrest, exhibit
      similar sensitivity to the cap analogue m7G(5')ppp(5')G. It appears, therefore,
      that the presence of the regulatory sequence at the 5' terminus of rp mRNAs does
      not lessen its competitive potential for the cap binding protein and that the
      growth-dependent decrease in the activity of eIF-4E does not play a key role in
      the repression of translation of rp mRNAs.

PMID- 7787418
TI  - An upstream activator sequence regulates the murine Pgk-1 promoter and binds
      multiple nuclear proteins.
AB  - The murine Pgk-1 gene is driven by a strong promoter that is regulated by a 304
      bp upstream activator sequence (UAS). The activity of the UAS is high in
      undifferentiated embryonal carcinoma cells but declines when these cells are
      induced to differentiate with retinoic acid. The effect of the UAS on promoter
      activity is particularly striking when the activity of the Pgk-1 promoter is
      assayed following its integration into the genome, suggesting that it may
      function by regulating chromatin structure in the region of the core promoter.
      Three sites on the UAS bind nuclear proteins. Two of these sites bind factors
      present in both embryonal carcinoma cells and their differentiated derivatives
      whereas one site binds factors present only in differentiated cells. There
      appears to be both cooperation and antagonism in the binding of proteins to
      different sites in the UAS, suggesting that the activity of the Pgk-1 promoter is
      determined by the constellation of proteins assembled upstream of its
      transcription start site.

PMID- 7787420
TI  - Chemical shifts and three-dimensional protein structures.
AB  - During the past three years it has become possible to compute ab initio the 13C,
      15N and 19F NMR chemical shifts of many sites in native proteins. Chemical shifts
      are beginning to become a useful supplement to more established methods of
      solution structure determination, and may find utility in solid-state analysis as
      well. From 13C NMR, information on phi, psi and chi torsions can be obtained,
      permitting both assignment verification, and structure refinement and prediction.
      For 15N, both torsional and hydrogen-bonding effects are important, while for
      19F, chemical shifts are primarily indicators of the local charge field. Chemical
      shift calculations are still slow, but shielding hypersurfaces - the shift as a
      function of the dihedral angles that define the molecular conformation - are
      becoming accessible. Over the next few years, theoretical and computer hardware
      improvements will enable more routine use of chemical shifts in structural
      studies, including the study of metal-ligand interactions, the analysis of drug
      and substrate binding and catalysis, the study of folding/unfolding pathways, as
      well as the characterization of conformational substates. Rather than simply
      being a necessary prerequisite for multidimensional NMR, chemical shifts and
      chemical shift non-equivalence due to folding are now beginning to be useful for
      structural characterization.

PMID- 7787419
TI  - Isolation of the human peroxisome proliferator activated receptor gamma cDNA:
      expression in hematopoietic cells and chromosomal mapping.
AB  - The nuclear receptor superfamily of transcription factors, which includes the
      retinoic acid receptors and v-erb A, play important roles in the molecular
      control of hematopoiesis. To identify nuclear receptors expressed in
      hematopoietic cells, we screened a human bone marrow cDNA library using a
      degenerate oligonucleotide and isolated a 1.85-kb full-length cDNA encoding a new
      human member of this superfamily, the peroxisome proliferator activated receptor
      gamma (hPPAR gamma). Two different hPPAR gamma transcripts were expressed in
      hematopoietic cells: a 1.85-kb transcript, which corresponds to the full-length
      mRNA (PPAR gamma 1), and a 0.65-kb transcript (PPAR gamma 2), which cannot encode
      all of the nuclear receptor functional domains. Normal neutrophils and peripheral
      blood lymphocytes, as well as circulating leukemic cells from patients with AML,
      ALL, and CML, express only PPAR gamma 2 on Northern blot analysis. In contrast,
      only the PPAR gamma 1 transcript was detected in a variety of human leukemia cell
      lines and in cultured normal primary bone marrow stromal cells. Both transcripts
      were detected in various fetal and adult nonhematopoietic tissues. We mapped the
      location of the hPPAR gamma gene to human chromosome 3p25 by somatic cell
      hybridization and linkage analysis. PPARs have been shown to be activated by
      peroxisome proliferating agents, long-chain fatty acids and arachidonic acid.
      Human PPAR gamma, although homologous to the PPAR gamma s of other species, has
      unique sequence and amino acid differences. Identification of hPPAR gamma will
      allow further understanding of its role in human cellular leukotriene,
      prostaglandin, and peroxide degradative or synthetic pathways, as well as its
      role in lipid metabolism and regulation of adipocyte differentiation.

PMID- 7787421
TI  - Internal motions of apo-neocarzinostatin as studied by 13C NMR methine relaxation
      at natural abundance.
AB  - Dynamics of the backbone and some side chains of apo-neocarzinostatin, a 10.7 kDa
      carrier protein, have been studied from 13C relaxation rates R1, R2 and steady
      state 13C-(1H) NOEs, measured at natural abundance. Relaxation data were obtained
      for 79 nonoverlapping C alpha resonances and for 11 threonine C beta single
      resonances. Except for three C alpha relaxation rates, all data were analysed
      from a simple two-parameter spectral density function using the model-free
      approach of Lipari and Szabo. The corresponding C-H fragments exhibit fast (tau e
      < 40 ps) restricted libration motions (S2 = 0.73 to 0.95). Global examination of
      the microdynamical parameters S2 and tau e along the amino acid sequence gives no
      immediate correlation with structural elements. However, different trends for the
      three loops involved in the binding site are revealed. The beta-ribbon comprising
      residues 37 to 47 is spatially restricted, with relatively large tau e values in
      its hairpin region. The other beta-ribbon (residues 72 to 87) and the large
      disordered loop ranging between residues 97-107 experience small-amplitude
      motions on a much faster (picosecond) time scale. The two N-terminal residues,
      Ala1 and Ala2, and the C-terminal residue Asn113, exhibit an additional slow
      motion on a subnanosecond time scale (400-500 ps). Similarly, the relaxation data
      for eight threonine side-chain C beta must be interpreted in terms of a three
      parameter spectral density function. They exhibit slower motions, on the
      nanosecond time scale (500-3000 ps). Three threonine (Thr65, Thr68, Thr81) side
      chains do not display a slow component, but an exchange contribution to the
      observed transverse relaxation rate R2 could no be excluded at these sites. The
      microdynamical parameter (S2, tau e and R2ex) or (S(slow)2, S(fast)2 and tauslow)
      were obtained from a straightforward solution of the equations describing the
      relaxation data. They were calculated assuming an overall isotropic rotational
      correlation time tau c for the protein of 5.7 ns, determined using standard
      procedures from R2/R1 ratios. However, it is shown that the product (1-S2) x tau
      e is nearly independent of tau c for residues not exhibiting slow motions on the
      nanosecond time scale. In addition, this parameter very closely follows the
      heteronuclear NOEs, which therefore could be good indices for local fast motions
      on the picosecond time scale.

PMID- 7787422
TI  - Theory and application of the maximum likelihood principle to NMR parameter
      estimation of multidimensional NMR data.
AB  - A general theory has been developed for the application of the maximum likelihood
      (ML) principle to the estimation of NMR parameters (frequency and amplitudes)
      from multidimensional time-domain NMR data. A computer program (ChiFit) has been
      written that carries out ML parameter estimation in the D-1 indirectly detected
      dimensions of a D-dimensional NMR data set. The performance of this algorithm has
      been tested with experimental three-dimensional (HNCO) and four-dimensional
      (HN(CO)-CAHA) data from a small protein labeled with 13C and 15N. These data
      sets, with different levels of digital resolution, were processed using ChiFit
      for ML analysis and employing conventional Fourier transform methods with prior
      extrapolation of the time-domain dimensions by linear prediction. Comparison of
      the results indicates that the ML approach provides superior frequency resolution
      compared to conventional methods, particularly under conditions of limited
      digital resolution in the time-domain input data, as is characteristic of D
      dimensional NMR data of biomolecules. Close correspondence is demonstrated
      between the results of analyzing multidimensional time-domain NMR data by Fourier
      transformation, Bayesian probability theory [Chylla, R.A. and Markley, J.L.
      (1993) J. Biomol. NMR, 3, 515-533], and the ML principle.

PMID- 7787423
TI  - Complete 1H, 13C and 15N NMR assignments and secondary structure of the 269
      residue serine protease PB92 from Bacillus alcalophilus.
AB  - The 1H, 13C and 15N NMR resonances of serine protease PB92 have been assigned
      using 3D triple-resonance NMR techniques. With a molecular weight of 27 kDa (269
      residues) this protein is one of the largest monomeric proteins assigned so far.
      The side-chain assignments were based mainly on 3D H(C)CH and 3D (H)CCH COSY and
      TOCSY experiments. The set of assignments encompasses all backbone carbonyl and
      CHn carbons, all amide (NH and NH2) nitrogens and 99.2% of the amide and CHn
      protons. The secondary structure and general topology appear to be identical to
      those found in the crystal structure of serine protease PB92 [Van der Laan et al.
      (1992) Protein Eng., 5, 405-411], as judged by chemical shift deviations from
      random coil values, NH exchange data and analysis of NOEs between backbone NH
      groups.

PMID- 7787424
TI  - High-resolution solution structure of siamycin II: novel amphipathic character of
      a 21-residue peptide that inhibits HIV fusion.
AB  - The 21-amino acid peptides siamycin II (BMY-29303) and siamycin I (BMY-29304),
      derived from Streptomyces strains AA3891 and AA6532, respectively, have been
      found to inhibit HIV-1 fusion and viral replication in cell culture. The primary
      sequence of siamycin II is CLGIGSCNDFAGCGYAIVCFW. Siamycin I differs by only one
      amino acid; it has a valine residue at position 4. In both peptides, disulfide
      bonds link Cys1 with Cys13 and Cys7 with Cys19, and the side chain of Asp9 forms
      an amide bond with the N-terminus. Siamycin II, when dissolved in a 50:50 mixture
      of DMSO and H2O, yields NOESY spectra with exceptional numbers of cross peaks for
      a peptide of this size. We have used 335 NOE distance constraints and 13 dihedral
      angle constraints to generate an ensemble of 30 siamycin II structures; these
      have average backbone atom and all heavy atom rmsd values to the mean coordinates
      of 0.24 and 0.52 A, respectively. The peptide displays an unusual wedge-shaped
      structure, with one face being predominantly hydrophobic and the other being
      predominantly hydrophilic. Chemical shift and NOE data show that the siamycin I
      structure is essentially identical to siamycin II. These peptides may act by
      preventing oligomerization of the HIV transmembrane glycoprotein gp41, or by
      interfering with interactions between gp41 and the envelope glycoprotein gp120,
      the cell membrane or membrane-bound proteins [Frechet, D. et al. (1994)
      Biochemistry, 33, 42-50]. The amphipathic nature of siamycin II and siamycin I
      suggests that a polar (or apolar) site on the target protein may be masked by the
      apolar (or polar) face of the peptide upon peptide/protein complexation.

PMID- 7787426
TI  - The American Thyroid Association: d'ou venons nous? Que sommes nous? Ou allons
      nous? (Whence do we come? What are we? Where are we going?).

PMID- 7787425
TI  - Three-dimensional structure of gurmarin, a sweet taste-suppressing polypeptide.
AB  - The solution structure of gurmarin was studied by two-dimensional proton NMR
      spectroscopy at 600 MHz. Gurmarin, a 35-amino acid residue polypeptide recently
      discovered in an Indian-originated tree Gymnema sylvestre, selectively suppresses
      the neural responses of rat to sweet taste stimuli. Sequence-specific resonance
      assignments were obtained for all backbone protons and for most of the side-chain
      protons. The three-dimensional solution structure was determined by simulated
      annealing calculations on the basis of 135 interproton distance constraints
      derived from NOEs, six distance constraints for three hydrogen bonds and 16
      dihedral angle constraints derived from coupling constants. A total of 10
      structures folded into a well-defined structure with a triple-stranded
      antiparallel beta-sheet. The average rmsd values between any two structures were
      1.65 +/- 0.39 A for the backbone atoms (N, C alpha, C) and 2.95 +/- 0.27 A for
      all heavy atoms. The positions of the three disulfide bridges, which could not be
      determined chemically, were estimated to be Cys3-Cys18, Cys10-Cys23 and Cys17
      Cys33 on the basis of the NMR distance constraints. This disulfide bridge pattern
      in gurmarin turned out to be analogous to that in omega-conotoxin and Momordica
      charantia trypsin inhibitor-II, and the topology of folding was the same as that
      in omega-conotoxin.

PMID- 7787427
TI  - Suppressive doses of thyroxine do not accelerate age-related bone loss in late
      postmenopausal women.
AB  - To examine whether suppressive doses of thyroxine have any adverse effects on
      bone, we evaluated various bone metabolic markers (lectin-precipitated alkaline
      phosphatase, osteocalcin, carboxyl-terminal region of type I collagen propeptide,
      tartrate-resistant alkaline phosphatase, and urinary excretion of hydroxyproline
      and pyridinium crosslinks), incidence of vertebral deformity, total body and
      regional (lumbar spine and radius) bone mineral densities (BMDs), and rates of
      bone loss in 24 late postmenopausal (more than 5 years after menopause) women who
      were treated with levothyroxine (L-T4) after total thyroidectomy for
      differentiated carcinoma. Depending on the clinical records, including serum TSH
      levels measured by immunoradiometric assay, these patients were divided into two
      groups. One group of patients was given suppressive doses of L-T4 (TSH < 0.1
      mU/L, n = 12) and the other group was given nonsuppressive doses of L-T4 (TSH >
      0.1 mU/L, n = 12). There was no difference in bone metabolic markers and
      incidence of vertebral deformity between the groups. In patients with TSH
      suppression, Z-scores of BMDs calculated from age-matched healthy women (n = 179,
      aged 55 to 80) were nearly in the zero range of values (0.077 at total body,
      0.228 at lumbar spine, and -0.117 at trabecular region of lumbar spine). The rate
      of bone loss in TSH-suppressed patients (-0.849 +/- 0.605%/year) was not
      significantly different from that of nonsuppressed patients (-0.669 +/- 0.659).
      These prospective and cross-sectional data suggest that long-term levothyroxine
      therapy using suppressive doses has no significant adverse effects on bone.

PMID- 7787429
TI  - Role of neck ultrasonography in the follow-up of patients operated on for thyroid
      cancer.
AB  - The aim of the study was to evaluate the role of neck ultrasonography in follow
      up of patients with differentiated thyroid cancer. Sixty-three patients had total
      thyroidectomy and 131I ablation for differentiated thyroid cancer and had a
      negative whole body scan during follow-up. They were admitted for a high
      resolution neck ultrasound examination. Sixteen of 63 patients presented images
      suspicious for lymph node metastasis and/or for local recurrences (4 cases). Fine
      needle aspiration confirmed the suspicion of malignancy in 12 patients: only
      lymph node metastasis in 8 cases, local recurrence and lymph node metastasis in 3
      cases, and in one case only local recurrence. Fine needle aspiration was
      suspicious for lymphadenitis in 4 cases. Thyroglobulin levels were very high in
      all patients with local recurrence and/or lymph node metastasis but undetectable
      in 2 cases presenting node metastasis and in 4 cases with lymphadenitis. All but
      one patient were admitted for surgery and the cytological diagnosis was
      confirmed. Early identification of a pathologic mass in the neck is a desirable
      goal; high resolution echography can play an important role in the follow-up of
      these patients and can detect local recurrences even when there is a negative
      whole body scan or undetectable thyroglobulin level.

PMID- 7787428
TI  - Effects of suppressive doses of levothyroxine treatment on sex-hormone-binding
      globulin and bone metabolism.
AB  - The adverse effects of suppressive thyroxine treatment have previously been
      investigated and conflicting results have been published. This study aimed at
      evaluating the effects of subclinical hyperthyroidism on the liver and bones. We
      investigated the action of thyroxine on the liver by measuring sex-hormone
      binding globulin (SHBG) levels and on bone turnover by evaluating osteocalcin
      (BGP) in both pre- and postmenopausal women. We compared the levels of both
      proteins to those of untreated subjects matched for age, menopausal status, and
      weight. Bone mineral density (BMD) was evaluated by biphotonic absorptiometry
      only in postmenopausal women with estrogen replacement therapy (ERT) and compared
      to two postmenopausal estrogen-treated controls. Forty-five women with
      multinodular goiter (38) or postsurgical thyroid carcinoma (7) were studied. They
      had received LT4 for 3 to 5 years (150 +/- 34 micrograms/day for nontoxic
      multinodular goiter, 184 +/- 46 micrograms/day for thyroid carcinoma). All
      patients had normal free T3 concentrations. No significant difference was found
      in SHBG values between patients and controls whatever the menopausal status and
      the BMI; a significant increase in BGP was noted in premenopausal women (9.6 +/-
      2.2 vs 6.7 +/- 2.3 ng/ml; p < 0.0006). No significant BGP and BMD variations were
      observed in treated postmenopausal women. In summary, the study of carefully
      matched patients and controls revealed that thyroxine treatment has no effect on
      SHBG levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787430
TI  - Thyroid abnormalities among children in the contaminated area related to the
      Chernobyl accident.
AB  - Gradual increases of various radiation-related diseases including thyroid cancer
      following the Chernobyl accident have been recently reported. We have carried out
      systematic thyroid surveys in school children aged 10-15 years in the highly
      contaminated area and compared the results with a similar survey in a nonaffected
      neighboring area as a control. Systematic examinations of the thyroid gland were
      performed in 888 schoolchildren (408 males and 480 females) in the districts of
      Chechelsk city with 5 to over 40 Ci/km2 of radiation level for 137Cs. In the
      control area (Bobruisk city), 521 children with the same age range (229 males and
      292 females) were examined. Thyroid surveys were carried out as follows:
      palpation, ultrasonography, blood examinations of thyroid function, and
      measurements of daily urinary excretion of iodine. Certain thyroid abnormalities
      were observed in the high radioactive fallout area more frequently than in the
      control region. In particular, the prevalence of multiple micronodular lesions in
      diffuse goiter in the contaminated area was significantly higher than in the
      control area. However, endemic goiter due to iodine deficiency was present in
      both districts. The environment factor of iodine deficiency might have resulted
      in the early occurrence of ultrasonographic thyroid abnormalities attributed to
      radioactive contamination.

PMID- 7787432
TI  - Different growth control of the two human thyroid cell lines of adenomatous
      goiter and papillary carcinoma.
AB  - To study the growth control of human thyroid cells in different stages of
      differentiation, we established two human thyroid cell lines of adenomatous
      goiter and papillary carcinoma. A 59-year-old female patient with adenomatous
      goiter was operated in September 1991, and a 27-year-old female patient with
      papillary carcinoma in May 1990. The thyroid cell lines were established by
      successive passage without cellular or genetic manipulations such as fusing other
      cell lines or oncogenic viral infection. These cell lines, human adenomatous
      goiter cells (hAG) and human papillary thyroid carcinoma cells (hPTC), exhibited
      a flattened polygonal shape and proliferated as a monolayer in cell culture. The
      doubling time of the hAG cells was 60 h in Ham's F12 medium supplemented with 10%
      fetal bovine serum, and that of the hPTC cells, 18 h in the same medium. Both
      cell lines expressed mRNA for TSH receptor and secreted cAMP into the medium
      during incubation with thyrotropin (TSH) at concentrations as low as 0.01 mU/mL.
      The effects of activators of protein kinase A (PKA), protein kinase C (PKC),
      tyrosine kinase (TK), and estradiol (E2) on proliferation of the hAG cells and
      the hPTC cells were assessed by measuring cellular DNA content in 24-well plates
      with diaminobenzoic acid. TSH stimulated proliferation of the hAG cells, but it
      inhibited proliferation of the hPTC cells. Since TSH activates two signaling
      pathways, the adenyl cyclase-PKA system and phospholipase C-PKC system, we tested
      effects of dibutylyl cAMP (dBC) and phorbol myristate 13-acetate (PMA),
      separately. dBC stimulated proliferation of the hAG cells, but it inhibited that
      of the hPTC cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787431
TI  - Biphasic effects of thyrotropin on invasion and growth of papillary and
      follicular thyroid cancer in vitro.
AB  - The rationale for TSH suppression in the treatment of follicular thyroid cancer
      (FTC) and papillary thyroid cancer (PTC) is to inhibit tumor growth, prevent
      recurrent disease, and eventually prolong survival. We analyzed the effects of
      TSH on invasion and growth of 3 FTC cell lines from 1 patient (FTC133, primary;
      FTC236, lymph node; FTC238, lung metastasis) and 2 PTC cell lines (PTC-UC1, PTC
      UC3). Cell growth and invasion through an 8-micron pore polycarbonate membrane
      coated with Matrigel were measured using the MTT assay. The dose-response to TSH
      was biphasic, stimulating invasion and growth of FTC and PTC at low
      concentrations (0.1-10 mU/mL), and inhibiting them at high concentrations (100
      mU/mL). Interestingly, the metastatic FTC cell lines had higher basal invasion,
      but were less responsive to TSH than the primary tumor. TSH (1 mU/mL) stimulated
      invasion of FTC133 by 21%, FTC236 by 8%, and FTC238 by 8% (p < 0.01). At 100
      mU/mL, TSH inhibited invasion of FTC133 by 21%, compared to 11% in FTC236 and 12%
      in FTC238. Also, TSH dose-dependently influenced proliferation of follicular
      thyroid cancer cells. At low concentrations it stimulated growth of FTC133 (20%)
      and inhibited it at high concentrations (23%; p < 0.01). Again, the amplitude of
      TSH effects was significantly smaller in the cell lines from metastatic tumors.
      TSH affected invasion and growth of PTC-UC1 and PTC-UC3 also biphasically. These
      results show that TSH may act as a mitogenic and antimitogenic growth factor for
      invasion and proliferation of well-differentiated thyroid cancer cells in vitro.

PMID- 7787433
TI  - An association between acromegaly and thyroid carcinoma.
AB  - Acromegaly has been associated with goiter as well as with benign and malignant
      tumors. Three cases of thyroid carcinoma in patients with acromegaly had been
      reported in the literature. We previously reported two additional cases of
      thyroid carcinoma and now present a third from 100 patients with acromegaly,
      exceeding the expected prevalence. All three thyroid carcinomas were multifocal,
      suggesting a generalized promotion toward malignancy. These patients had elevated
      levels of growth hormone and somatomedin-C [insulin-like growth factor (IGF-1)]
      at the time of thyroid carcinoma diagnosis. We discuss the role of IGF-1 in both
      benign and malignant thyroid growth, including the presence of IGF-1 receptors on
      thyroid cells, stimulation of thyroid cell replication by IGF-1, and paracrine
      secretion of IGF-1 and its binding proteins by thyroid cells. We propose possible
      mechanisms for the development of thyroid carcinoma in patients with acromegaly
      and discuss implications for the physician treating patients with acromegaly.

PMID- 7787434
TI  - Expression of human thyrotropin receptor by recombinant adenovirus.
AB  - We developed a new system for expressing a functional human thyrotropin receptor
      in eukaryotic cells using replication-deficient recombinant human type 5
      adenovirus. COS-7 cells infected with recombinant adenovirus encoding human
      thyrotropin receptor cDNA showed specific thyrotropin binding (Kd = 1.8 x 10(-9)
      M) and cAMP responses after stimulation by human thyrotropin. Cells infected with
      control virus encoding firefly luciferase cDNA did not show thyrotropin binding
      nor cAMP responses following incubation with thyrotropin. This system will be
      useful for analyzing T cell immunity to thyrotropin receptor in patients with
      Graves' disease by expressing human thyrotropin receptor in patients' antigen
      presenting cells.

PMID- 7787436
TI  - Human liver triiodothyronine sulfotransferase: copurification with phenol
      sulfotransferases.
AB  - To ascertain whether triiodothyronine (T3) sulfotransferase coeluted with the
      known phenol sulfotransferases (PSTs) during purification, human liver
      thermostable PST, thermolabile PST, and T3 sulfotransferase were assayed with p
      nitrophenol, dopamine, and T3, respectively. Thermostable PST eluted from an ion
      exchange column in two sequential peaks of activity (Peaks I and II), followed by
      a peak of thermolabile PST activity. There were three peaks of T3
      sulfotransferase with thermostable PST: two within thermostable PST Peak I, and
      one peak of T3 sulfotransferase activity within thermostable PST Peak II. There
      was a minor peak of T3 sulfotransferase with thermolabile PST. Further
      purification of thermostable Peak I showed coelution of T3 sulfotransferase with
      thermostable PST during gel filtration and affinity chromatography. SDS-PAGE
      revealed a major protein band at 31 kDa. Dehydroepiandrosterone sulfotransferase
      comprised only 4% of the final activity. This report demonstrates coelution of T3
      sulfotransferase with thermostable PST, shows a potential additional isozyme of
      T3 sulfotransferase, and points out the apparent minimal role of
      dehydroepiandrosterone sulfotransferase in T3 sulfation. The findings support the
      hypothesis that thermostable PST is the predominant human liver T3
      sulfotransferase activity.

PMID- 7787435
TI  - A novel, nonradioactive in vivo bioassay of thyrotropin (TSH).
AB  - A new and simple in vivo bioassay suitable for routine testing of pituitary and
      recombinant TSH preparations was developed. Male Albino Swiss CF-1 mice were
      given T3 in their drinking water to suppress endogenous TSH. T3, 3.0
      micrograms/mL, given to mice for a period of 4 days decreased plasma total T4
      (TT4) level to less than 10% of the nonsuppressed (control) level. Various doses
      of exogenous pituitary and recombinant TSH preparations were injected
      intraperitoneally and blood samples were obtained from the orbital sinus 6 h
      later. The TT4 level, measured by radioimmunoassay, served as the assay end
      point. The assay required injection of approximately 3.0 micrograms of pituitary
      human TSH (phTSH), 1.0 microgram recombinant human TSH (rhTSH), 0.2 microgram
      bovine TSH (bTSH), and 0.1 microgram rat TSH (rTSH) to attain half-maximal
      response. The maximal level of TT4 after TSH stimulation was similar to that
      observed in normal, nonsuppressed mice. The procedure developed is relatively
      easy to perform, economical, and, unlike earlier TSH bioassays, does not require
      the use of radionuclides. This bioassay showed acceptable sensitivity and
      reliability in structure-function studies of pituitary TSH from different species
      as well as rhTSH.

PMID- 7787438
TI  - The action of methimazole and L-thyroxine in radioiodine therapy: a prospective
      study on the incidence of hypothyroidism.
AB  - Thiourea drugs have been postulated to possess radioprotective property. We
      studied the effect of adjunctive antithyroid drugs (ATD) and L-thyroxine (L-T4)
      on the result of radioiodine (RAI) 131I therapy and determined the incidence of
      hypothyroidism and relapse of hyperthyroidism. One hundred and fifty-nine
      patients with Graves' disease were randomized prospectively to receive either RAI
      alone or adjunctive ATD in a form of block-replacement regimen of methimazole
      (MMI) plus L-T4 for 6 months. The patients were observed for a mean period of 4.6
      (range 2-10) years. The incidence of permanent hypothyroidism was studied and the
      effect of ATD on iodine kinetics was analyzed. The cumulative incidence of
      hypothyroidism in the ATD group was significantly lower than the RAI group (p =
      0.0009), and the difference is accounted by a reduction of early hypothyroidism
      within 12 months from 20.2 to 3.7% (p = 0.003). The incidence of late
      hypothyroidism was similar between the two groups. Treatment with ATD did not
      affect the one dose cure rate with RAI (61.2 vs 55.5%, p = NS), but the time to
      achieve euthyroidism was significantly earlier with adjunctive ATD (2 vs 8 weeks,
      p < 0.02). The incidence of relapse within the first year after one dose was also
      similar between the two groups (38.7 vs 44.5%, p = NS). Comparing the kinetics of
      the therapeutic dose with a tracer dose, patients receiving MMI were found to be
      underdosed by 22% (p = 0.003) and the biological half-life was significantly
      shortened. We conclude that ATD rendered euthyroidism earlier without
      compromising the one dose cure rate of RAI.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787439
TI  - Patient treated solely with thyroid hormone.

PMID- 7787437
TI  - Expression of growth factors and growth factor receptors in normal and tumorous
      human thyroid tissues.
AB  - A number of growth factors have been implicated as stimuli of thyroid cell
      proliferation; overexpression of these growth factors and/or their receptors may
      play a role in the growth of thyroid tumors. To determine if immunohistochemical
      detection of growth factors and/or their receptors correlates with morphological
      alterations in proliferative lesions of thyroid, we examined the localization of
      epidermal growth factor (EGF), transforming growth factor-alpha (TGF-alpha) and
      their common receptor, EGF-receptor (EGF-R), insulin-like growth factor-1 (IGF
      1), IGF-1-receptor (IGF-R) and IGF binding proteins (IGFBP)-1, -2, -3, and -4,
      nerve growth factor (NGF), and its receptor NGF-receptor (NGF-R), transforming
      growth factor-beta (TGF-beta), and basic fibroblast growth factor (bFGF), in
      normal thyroid tissue and various thyroid tumors. We applied the streptavidin
      biotin technique to formalin-fixed, paraffin-embedded tissues. We studied 8-16
      different cases of each of the following: normal human thyroid, multinodular
      hyperplasia, follicular adenoma, papillary carcinoma, follicular carcinoma,
      medullary carcinoma, and anaplastic carcinoma. EGF, TGF-alpha, and their receptor
      EGF-R were widely expressed in normal thyroid and in all the thyroid lesions
      examined. IGF-1 and IGFBP-1 were diffusely present in all different thyroid
      tissues as well. There was no difference in staining intensity or distribution
      that correlated with the pathological process. IGFBP-4 seemed to have a variable
      expression. IGFBP-2 and -3 were detected only in medullary carcinomas.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7787441
TI  - Paul Starr Lectureship.

PMID- 7787440
TI  - Sidney H. Ingbar Distinguished Lectureship.

PMID- 7787442
TI  - Van Meter Award.

PMID- 7787443
TI  - Distinguished Service Award.

PMID- 7787444
TI  - [Echographic morbidity due to Schistosoma haematobium in a peripheral district of
      Bamako in Mali, Missabougou].
AB  - Frequency of urologic lesions was evaluated in 408 children from 6-15 years old
      in a suburban area of Bamako district in Mali, Missabougou; 65.2% from children
      were infected by Schistosoma haematobium, 13% by Schistosoma mansoni and 0.2% by
      Schistosoma intercalatum. Urologic lesions have been demonstrated in 223 cases
      among which 66 cases of urinary bladder lesions, 108 cases of hydronephrosis and
      49 cases of mixed lesions. In order of the frequency we had the following
      uropathic lesions: wall thickening, wall irregularities, localised hypertrophies
      and hydronephrosis. We did not found any lesions in 185 children. Infection due
      to S. haematobium did not varied significantly in spite of age group, sex,
      schooling of children or the profession of the parents. Lesions were strongly
      correlated with age group (47.8 and 61.3% in 6-9 and 10-15 years old
      respectively) (p < 0.01) and with intensity of infection as measured by urinary
      egg counts (p = 0.0017).

PMID- 7787446
TI  - [Malaria and febrile pathology of expatriates in Brazzaville in 1993].
AB  - Between January 1 and December 31, 1993, malaria was found in 22.6% of
      unexplained fever cases among expatriates in Brazzaville, i.e. 0.5% of all
      consulting physicians at the Medico-Social Centre of the Cooperation francaise.
      There are three possible explanations for the small proportion of paludism
      infection among expatriates: the low density of anopheles in the city centre,
      living conditions that restrict possible man-vector contacts and use of
      chemoprophylaxis. Considering the risks of self-treatment which are not
      insignificant, the authors on the importance of taking into account these facts
      when treating cases of fever among European residents in Brazzaville.

PMID- 7787445
TI  - [Variation of cholostase enzymes (5'-nucleotidase and alkaline phosphatase)
      during a specific treatment for malaria in the Gabonese child].
AB  - Biological variations of 5'nucleotidase (5'NU) and alkaline phosphatase (AP) in
      102 Gabonese children with malaria features (MF) and malaria infection (MI)
      receiving treatment are reported. [formula: see text] During the therapeutic
      assay, 5'NU rate decreases faster than AP'S; Fourteen days after the beginning of
      treatment, difference between AP MF and AP M1 is still significant. Enzymes
      decrease is an indication of the malaria drugs tolerance (MSP (*)).

PMID- 7787447
TI  - [Cerebral toxoplasmosis in a hospital environment in Lome (Togo)].
AB  - The authors report the clinical, serological and neuroradiological results of a
      study about 23 cases of cerebral toxoplasmosis in the Teaching Hospital of Lome.
      Response to antitoxoplasmic treatment was rapidly favourable with all patients.
      Cerebral toxoplasmosis was the inaugural manifestation of AIDS in 20 of the 23
      patients.

PMID- 7787448
TI  - [Study of an HIV positive, tropical origin population in a refugee center in
      France].
AB  - The study describes HIV positive refugee patients, who were seen over a 3 years
      period at COMEDE, a dispensary for foreign nationals. COMEDE offered a HIV test
      to every patient, and it followed up on the disease and its prevention. Out of
      5,234 tests, 328 were positive (6.3%). Less than 5% of the patients refused the
      test. All the patients returned for the result; 88.4% were African and 11.3%
      Haitian. The mean age was 31.5 years. The male/female sex ratio was 1.28. In this
      study, 94.5% of the HIV patients were HIV1, 3% HIV2 and 2.5% carried both
      strains; 78% were asymptomatic, 7% had ARC and 12.5% had AIDS. The prevalence of
      tuberculosis was high (10.6%), especially for AIDS patients (65%); Treponematosis
      prevalence was 13% and toxoplasmosis was 62.8%; 40% had intestinal parasites.
      36.4% of the women became pregnant during the study; 41% of the pregnancies were
      terminated, while 27% went full term. The proportion of missing patients after 6
      months was high (57%) because of numerous factors which prevented them from
      returning. This study shows the importance of proposing a HIV test to this
      immigrant population, although follow-up is difficult, due to social and economic
      factors.

PMID- 7787449
TI  - [Epidemiology of schistosomiasis in a suburban school area of Bamako (Republic of
      Mali)].
AB  - Epidemiology of schistosomiasis has been assessed in October, 1990 in three
      primary schools of a suburban district of Bamako: Magnambougou. It was a cross
      sectional study which was carried out on an hazardous sample of 549 pupils of 7
      to 14 years old. The Kato-Katz and urine filtration methods were used to search
      schistosome eggs. The prevalence rate was 50% (256/512) in Schistosoma
      haematobium and 5.6% (26/464) in S. mansoni. Children from 11-14 years old were
      more infected by Schistosoma haematobium (59.4%), than those from 7-10 years old
      (35.2%) (p < 0.005). Among these children, 26.2% excreted more than 100 eggs per
      10 ml of urine. The infection did not varied significantly no matter what the sex
      is (53.7 and 44.8% respectively in boys and girls) (p = 0.05). According to the
      residence, pupils living in Magnambougou were more infected (54.9%) than those of
      others district (31.1%) (p < 0.001). Likewise, S. haematobium infection was more
      important in A and C schools (64.9 and 73.2% respectively) than in B school
      (11.2%) (p < 0.001). Two major snails species which are the intermediate hosts of
      urine schistosomiasis in Mali (Bulinus truncatus and Bulinus globosus) were found
      in the shelters: however, B. truncatus was only infected in 13.1% (19/145).
      Contamination was local and "ruralization" activities (particularly gardening)
      seemed to be the most important displaying factor.

PMID- 7787450
TI  - [Pathogenic approach of thrombopenia in dengue and its hemorrhagic
      complications].
AB  - Dengue is a frequent viral infection in the intertropical countries. The
      frequency and the severe forms of this infection are a real problem of public
      health. The haemorrhagic forms of the disease are constantly associated with
      thrombocytopenia. Its pathophysiology is still unclear. Among the different
      hypothesis, immune mechanisms play the main role. The authors discussed here the
      responsibility of the binding of immune complexes and the role of cytokines.

PMID- 7787451
TI  - [Prevalence of urinary schistosomiasis in a school environment in N'Djamena
      (Chad)].
AB  - A parasitologic investigation, realised between March and November 1993, among
      532 pupils 6-15 years old living in N'Djamena's peripheric quarter and in 5 Chari
      Baguirmi's villages had showed urogenital schistosomiasis infection prevalence is
      11.8%.

PMID- 7787452
TI  - [Trypanosomiasis from Trypanosoma brucei gambiense in the center of north-west
      Uganda. Evaluation of 5 years of control (1987-1991)].
AB  - In Uganda, a case-finding and treatment programme has been implemented by
      Medecine Sans Frontieres (MSF) and the Ministry of Health in the North of West
      Nile province. Data collected in the hospital of Moyo from January 1987 to June
      1991 were analyzed. Forty eight hundred and twenty two cases of trypanosomiasis
      due to T. B. gambiense has been recorded. Cumulative incidence rate for this
      period was 5.6%. Passive and active case-finding strategies were used, both based
      on Card Agglutination Test (CATT) as screening tool, followed by parasitological
      examinations. The mobile teams identified 1906 of the 4,822 cases (39.5%). Case
      fatality rate was 2.6%. This study confirmed the association between social and
      political disruptions, large movements of population and extension of
      trypanosomiasis. Active case-finding seems to quickly reduce disease prevalence
      in hyper-endemic areas. An integrated programme is then necessary to control
      sleeping sickness transmission.

PMID- 7787453
TI  - [Zoonotic cutaneous leishmaniasis to the north of Isfahan. Human infection in
      1991].
AB  - An epidemiological investigation was carried out in 1991 at four villages in
      Borkhar rural district, north of Isfahan, Iran, to obtain baseline data for
      studying the candidate vaccines of zoonotic cutaneous leishmaniasis (ZCL). A
      study of prevalence among 6,284 inhabitants showed a rate of 61.95% for scars and
      2.9% for active lesions. The under 10 years old showed a rate of 42.9% for scars
      and 7.5% for active lesions. The above 10 years old showed a rate of 71.06% for
      scars and 0.7% for active lesions. The highest prevalence of the disease is in
      the seasons of autumn and winter. The incidence of the disease was 68.4 per
      thousand in 1991. Comparing the results of this study with those from the years
      1963-1965 showed that the disease incidence has increased after 28 years and ZCL
      has remained as an important health problem in this area.

PMID- 7787454
TI  - [Prevalence of toxoplasmosis in a population of pregnant women in Antananarivo
      (Madagascar)].
AB  - The prevalence of Toxoplasma antibodies by ELISA was studied in Antananarivo
      area, in the Republic of Madagascar, among a population of 599 pregnant women.
      The overall prevalence is 83.5%. From the age of 19 years old, 75% of the
      pregnant women have already antitoxoplasma antibodies. The ethnic factor, the
      foods habits or the presence of a domestic cat do not seem to have an influence
      on prevalence of toxoplasmosis among the studied population.

PMID- 7787456
TI  - [AIDS. Hypothesis on the origin and emergence of HIV].
AB  - Cross-species transfer of simian immunodeficiency viruses (SIV) may occur
      accidentally. This transfer, with the possible exception of the virus of the
      sooty mangabey monkey, leads to a biological dead-end. Thus, only serial passages
      of the virus from man to man, through blood inoculation, could explain its
      progressive evolution from SIV to HIV. Such an artificial cycle may have been
      initiated, in the 1910s, following the introduction of syringes and needles into
      the region of the African Great Lakes, a region where some communities were
      considering that the inoculation of blood from certain individuals or from
      monkeys was a very powerful magical remedy. The first HIV-1 infection may have
      emerged in the 1940s, in one of these isolated communities among which the virus
      remained at first confined before spreading to other populations.

PMID- 7787457
TI  - [Risk of contamination by Borrelia burgdorferi S. lato in a forest environment.
      Survey during 13 months of abundance of the tick Ixodes ricinus and its level of
      infestation by the Lyme borreliosis agent in Brittany].
AB  - The authors, in a forest in Brittany previously studied for several years, caught
      by flagging, each month from April 1992 to May 1993, nymphs of I. ricinus tick,
      and looked by indirect immunofluorescence, for B. burgdorferi infestation. An
      amount of 1,506 ticks was thus studied. Infestation frequency was varying from 0
      per cent in January and February to 14.4 per cent in August. Standarding of tick
      collecting method allowed to establish, for each month, a tick, "availability"
      index, and, according to the spirochete infestation frequency, to do estimation
      of the risk level, for human visiting the concerned forest, of being infected by
      B. burgdorferi. Obtained results show that this risk is the highest in August,
      and quite non-existent in January and February.

PMID- 7787455
TI  - [Protein profile in malnutrition states of the Ivory Coast child].
AB  - Prospectively assessment of nutritional status, besides anthropometric parameters
      measurements, included determination of the following plasma proteins: albumin,
      transferrin, retinol-binding protein and thyroxine-binding prealbumin, usually
      regarded as useful indices of protein depletion states. Patients' inflammatory or
      infectious diseases were investigated by measuring the two most reliable acute
      phase reactants (orosomucoid and c-reactive protein). This study was conducted on
      a group of 56 pediatric patients malnourished and 54 age- and sex-matched healthy
      subjects as controls. Data showed a higher prevalence of inflammatory process
      during the course of malnutrition as revealed progressive but severe alteration
      of the Prognostic Inflammatory and Nutritional Index (PINI) or CRP x a1-GPA/Alb x
      TBPA. On the other hand, kwashiorkor and marasmus seemed to be a precipitating
      cause of infectious or/and inflammatory process. We, therefore, conclude that the
      PINI scoring system should be for the pediatricians, a sensitive and precious
      tool allowing the correct follow-up of inflammatory pole in nutritional disorders
      in developing countries.

PMID- 7787458
TI  - [Extra-pulmonary tuberculosis and dissemination in patients infected by the human
      immunodeficiency virus in Bujumbura (Burundi)].
AB  - Scattered and extra pulmonary tuberculosis patients coinfected with HIV represent
      in Bujumbura (Burundi) more than 56% of tuberculosis cases. The high prevalence
      of these forms could be explained partly by the hospital recruitment, therefore
      by patients already strongly immunocompromised. Performing further examinations
      as abdominal echography, ganglionic biopsy (or firstly a puncture sucking
      procedure) permit to reveal multifocal affections. These examinations provide
      valuable diagnostic arguments specially among the negative bacteriological forms.

PMID- 7787459
TI  - Embryology and congenital heart disease.

PMID- 7787460
TI  - "Acquired" left ventricular-to-right atrial shunt (Gerbode defect) after
      bacterial endocarditis.
AB  - We present, with echocardiographic and intraoperative findings, a rare case of
      left ventricular-to-right atrial communication (Gerbode defect) after
      endocarditis associated with Staphylococcus aureus. (Tex Heart Inst J 1995;22:100
      2)

PMID- 7787461
TI  - Radiation-induced superior vena cava syndrome.
AB  - A 59-year-old man developed superior vena caval obstruction 20 years after
      receiving a radiation treatment for primary germinal cell tumor of the
      mediastinum. Venous decompression was achieved by anastomosing a 10-mm ringed
      polytetrafluoroethylene graft from the left internal jugular vein to the right
      atrium, which yielded immediate relief of symptoms. A left internal jugular
      venogram demonstrated graft patency 11 months post-operatively, and the patient
      remained free of symptoms of superior vena caval obstruction 29 months
      postoperatively.

PMID- 7787462
TI  - Successful stenting of a superior vena caval bypass graft. Report of a case.

PMID- 7787463
TI  - "Pseudocoarctation" of the aorta.

PMID- 7787464
TI  - Pentalogy of Cantrell vs pentalogy of Fallot.

PMID- 7787465
TI  - Conversion from chronic to acute coronary heart disease syndromes. Role of
      platelets and platelet products.
AB  - Vascular endothelial injury associated with arterial narrowing leads to platelet
      adhesion and aggregation at the site of endothelial injury and to the local
      accumulation of several mediators that promote platelet aggregation and
      vasoconstriction, including thromboxane A2, serotonin, adenosine diphosphate,
      platelet activating factor, oxygen-derived free radicals, activated thrombin, and
      tissue factor. At the same sites of endothelial injury, there is a reduction in
      absolute or relative amounts of the endogenous inhibitors of platelet aggregation
      and vasoconstriction, including prostacyclin, endothelium-derived relaxing factor
      (nitric oxide), and tissue plasminogen activator; the loss of the effects of the
      endogenous inhibitors preventing platelet aggregation and vasoconstriction helps
      to create a prothrombotic and vasoconstrictive environment. Endothelial injury
      occurs as a result of atherosclerotic plaque fissuring or ulceration, flow shear
      stress, hypertension, diabetes mellitus, immune complex deposition, infection,
      and mechanical injury in the form of diagnostic and therapeutic catheterization.
      Endothelial injury and the accumulation of platelet- and other cell-derived
      mediators promotes neointimal proliferation in an exaggerated wound-healing
      response, resulting in further anatomic narrowing of artery in the subsequent
      days and weeks. Future methods that may prove useful in protecting the individual
      with these vascular problems from acute myocardial infarction and its
      consequences are inhibition of multiple mediators of platelet aggregation and
      vasoconstriction, restoration of the presence of the normal endogenous inhibitors
      of platelet aggregation and vasoconstriction, and/or rapid therapeutic
      regeneration of the injured endothelium.

PMID- 7787466
TI  - Coronary angioscopy.
AB  - Coronary angioscopy will not replace angiography as the gold standard for imaging
      atherosclerotic coronary arteries. However, there may well be a clinical niche
      for a technology that gives accurate information regarding a specific lesion, if
      that information can be used to improve the acute or chronic outcome of an
      interventional procedure. Our experience demonstrates that angioscopy indeed
      provides this information. Using angioscopy, we now have access to information
      regarding arterial wall disease that heretofore has been available only at
      necropsy. In addition, whereas angiography has provided only a 2-dimensional,
      gray-scale image of the coronary vessels, angioscopy offers a full-color, 3
      dimensional perspective of the intracoronary surface morphology. These important
      lesion-specific details, not reliably available from angiography alone, may
      ultimately be used to improve patient outcome and to assess risk.

PMID- 7787467
TI  - Recent advances in the treatment of acute myocardial infarction.
AB  - A number of recent major clinical trials have added substantially to the
      understanding of what the current "optimal" therapy for acute myocardial
      infarction may include. This review highlights a number of studies that have been
      published or presented within the last 2 years. Clearly, there is still room for
      improvement, but we have made considerable progress in recent years, and the pace
      of our advances continues to accelerate.

PMID- 7787468
TI  - Dobutamine echocardiography and myocardial contrast echocardiography. Two new
      techniques for the assessment of myocardial viability.
AB  - As investigators have discovered that cardiac regions displaying resting wall
      motion abnormalities are not the necessary equivalent of myocardial scar (and
      therefore of irreversible injury) but are potentially viable regions rendered
      dysfunctional by stunning or hibernation, a new field of medicine has developed
      to identify viable myocardium that can improve in function after
      revascularization. Moreover, improvements in myocardial preservation and
      perfusion during coronary artery bypass grafting and percutaneous transluminal
      coronary angioplasty have enabled patients with poor resting ejection fractions
      to undergo safer revascularization. In this review, we describe briefly the
      diagnostic techniques most commonly used in identifying dysfunctional but viable
      myocardium. We give specific attention to the assets and limitations of these
      techniques and special emphasis to 2 promising new techniques: dobutamine
      echocardiography and myocardial contrast echocardiography.

PMID- 7787470
TI  - Cardiac rehabilitation, exercise training, and preventive cardiology research at
      Ochsner Heart and Vascular Institute.
AB  - We review data from our institution demonstrating the benefits of cardiac
      rehabilitation and exercise training on coronary risk factors, exercise capacity,
      behavioral characteristics, and quality of life in various subgroups of patients.
      In addition, we discuss our research in several other areas of preventive
      cardiology, including lipid disorders, hypertension, left ventricular
      hypertrophy, fish oils, and antioxidants. We believe that we are now in a very
      exciting era in which a multifactorial approach to the primary and secondary
      prevention of coronary artery disease is needed in order to further reduce
      morbidity and mortality rates.

PMID- 7787469
TI  - Use of amiodarone in the postmyocardial infarction patient.
AB  - Amiodarone appears to be an effective antiarrhythmic agent for reducing mortality
      in the postmyocardial infarction patient with ventricular ectopic activity. Such
      activity has long been recognized to have an adverse effect on prognosis after
      acute myocardial infarction. When a strong correlation between ectopic activity
      and left ventricular dysfunction was demonstrated, ventricular ectopic activity
      was thought to be a consequence of underlying myocardial damage. However,
      ventricular ectopic activity is now considered to be an independent risk factor
      for mortality after myocardial infarction. Because of the basic premise that a
      positive correlation existed between arrhythmia suppression and improved
      survival, it had been common practice to use antiarrhythmic agents to treat
      asymptomatic ventricular ectopic activity in the postinfarction patient. After
      the results of the Cardiac Arrhythmia Suppression Trial (CAST) were released,
      this practice was largely abandoned. In the post-CAST era, however, amiodarone
      has appeared to improve survival in patients who have sustained myocardial
      infarctions. In this report, we briefly review the pharmacology of amiodarone and
      discuss the results of relevant clinical trials. Large, multicenter trials
      currently under way may clarify some of the unanswered questions surrounding the
      use of this promising antiarrhythmic agent in postmyocardial infarction patients.

PMID- 7787472
TI  - Effect of IgM-positive crossmatches on survival in heart transplant recipients.
AB  - To determine whether an IgM-positive crossmatch adversely affects the results of
      heart transplantation, we conducted a retrospective study of 125 orthotopic heart
      transplant recipients. A direct donor-recipient crossmatch was performed
      retrospectively on sera from all patients by the standard National Institutes of
      Health (NIH) method and the antihuman globulin (AHG) procedure. The patients were
      then divided into 3 groups as follows. Group 1 comprised 110 patients with a
      negative NIH and AHG crossmatch (control group). Group 2 comprised 5 patients
      with a positive NIH crossmatch and a negative AHG crossmatch. Group 3 comprised
      10 patients with positive NIH and AHG crossmatches. All positive crossmatches in
      group 3 patients converted to negative after treatment of sera with
      dithioerythritol, indicating that the initial result was due to IgM antibodies.
      All patients received standard immunosuppressive treatment. An IgM-positive
      crossmatch did not affect the number or severity of rejection episodes among the
      3 groups, nor did it have an effect on the incidence of infection. Whereas
      coronary artery disease was detected by angiography in 16 of 110 patients (14.6%)
      in group 1 and in 1 of 10 patients (10%) in group 3 (P = NS), no patient in group
      2 was affected. Actuarial survival at 1 and 2 years post-transplant was
      significantly better for patients with an IgM-positive crossmatch (group 2) (100%
      survival at 2 years) than for patients with a negative crossmatch (group 1) (73%
      at 1 year and 71% at 2 years, P < 0.05). Based on our study, the effect of an IgM
      positive crossmatch on survival is difficult to interpret because of the small
      sample size. An IgM-positive crossmatch, however;did not appear to have a
      deleterious effect on survival. It may be that the IgM antibody has an
      immunoregulatory role. A larger series of patients with positive crossmatches and
      longer follow-up will be necessary to evaluate the importance of these results.

PMID- 7787471
TI  - Endomyocardial biopsy in the evaluation of conditions leading to cardiac
      transplantation and in the evaluation of cardiac allograft rejection.

PMID- 7787473
TI  - CardioVascular Care Providers. A pioneer in bundled services, shared risk, and
      single payment.
AB  - In 1984, physicians at the Texas Heart Institute developed CardioVascular Care
      Providers, Inc., the 1st packaged pricing plan for cardiovascular surgery. Under
      this arrangement, all services (including physician and hospital charges) are
      covered by a global payment package (bundled service). The resulting flat fee is
      lower than the sum of the individual charges. Since November 1984, the plan has
      been offered to the non-Medicare (< 65-year-old) population through contracts
      with self-insured corporations, prepaid health plans, union trusts, and foreign
      governments. In 1993, it was extended to Medicare patients who require coronary
      artery bypass grafting. Our experience has shown that the plan lowers costs,
      increases patient access, allows payers to forecast their expenses, and
      streamlines the billing process, while maintaining a high quality of care and
      enabling patients to choose their own providers. Our success with this approach
      is attributed not only to the plan's simplicity but also to the fact that it is
      physician-directed and organ-specific, involving many related specialties.
      Equally important keys to success include our hospital's large patient population
      and extensive database. Similar packaged pricing plans have been adopted by
      several other cardiovascular centers. The approach is now being evaluated by
      Medicare in 6 other hospitals nationwide. With time, this approach is likely to
      become an increasingly popular reimbursement option.

PMID- 7787474
TI  - The Medicare Participating Heart Bypass Demonstration Project in Houston, Texas.
      The experience of St. Luke's Episcopal Hospital, Texas Heart Institute, and
      CardioVascular Care Providers, Inc.
AB  - While passage of a health care bill remains uncertain, the structure of health
      care in the United States is nonetheless changing rapidly. In some cases,
      physicians and hospitals are working more closely with one another to provide
      high-quality care at lower costs. Patients, physicians, hospitals, and insurers
      (including the Federal government) can all benefit from such an arrangement. We
      review here the experience with a program of bundled-free (physician and
      hospital) cardiovascular care for Medicare patients at the Texas Heart Institute
      at St. Luke's Episcopal Hospital in Houston, Texas.

PMID- 7787475
TI  - Scopulariopsis endocarditis associated with Duran ring valvuloplasty.
AB  - Fungal endocarditis is rare and is usually caused by Aspergillus and Candida
      species. We present a patient with endocarditis caused by Scopulariopsis
      brevicaulis. The patient had a history of mitral valve disease and, 1 year
      earlier, had undergone valvuloplasty with the placement of a prosthetic Duran
      ring in the mitral valve position. S. brevicaulis was cultured from samples of a
      large vegetation on the mitral valve apparatus. The mitral valve was replaced
      with a St. Jude mechanical prosthesis. The patient was treated with amphotericin
      B but was later switched to oral itraconazole when antibiotic tests indicated
      susceptibility to that agent. We believe this is the 1st reported case of
      endocarditis caused by Scopulariopsis.

PMID- 7787476
TI  - The epidemiology of prosthetic heart valves in the United States.
AB  - The Center for Devices and Radiological Health of the Food and Drug
      Administration, in collaboration with the National Center for Health Statistics,
      conducted the Medical Device Implant Supplement to the 1988 National Health
      Interview Survey, generating the 1st available population-based estimates of the
      use of prosthetic heart valves in the United States. The 1988 National Health
      Interview Survey was a massive, nationally representative cross-sectional survey
      that encompassed 47,485 households and 122,310 individuals. Data from the Medical
      Device Implant Supplement indicate that an estimated 253,283 persons with 279,175
      heart valves were present in the civilian, non-institutionalized US population
      (population prevalence of 1.1/1,000, 95% CI 0.8-1.3). Prevalence of valve
      prostheses ranged from 0.2 per 1,000 in those age 44 and under to 5.3 per 1,000
      in those 75 years of age and older. Age-adjusted prevalence of valve prostheses
      did not differ significantly according to sex, race, region of residence,
      education, or income of recipients. Two thirds of aortic valve recipients
      identified by the survey were male, compared with only one third of mitral valve
      recipients. Approximately two thirds of both aortic and mitral valve implants
      were reported as mechanical. Reported use of anticoagulative agents was
      significantly more common in recipients of mechanical than of bioprosthetic
      valves. The single most common reported reason for prosthetic valve implantation
      was rheumatic heart disease. These data provide useful epidemiologic and public
      health planning information on prosthetic heart valve use.

PMID- 7787477
TI  - Concomitant cerebral, brachiocephalic trunk, and cardiac revascularization. An
      unusual case.
AB  - Extensive transthoracic brachiocephalic revascularization is rarely performed.
      Instances of this operation performed concomitantly with cardiac
      revascularization and carotid endarterectomy have been reported in fewer than 10
      cases in the literature. We report the case of a patient requiring complex
      brachiocephalic revascularization associated with coronary bypass grafting and a
      left carotid endarterectomy.

PMID- 7787478
TI  - First experience with cardiomyoplasty in Ukraine.
AB  - We have been studying feasible surgical alternatives for treating congestive
      heart failure, including the use of cardiomyoplasty. In this operation, skeletal
      muscles are conditioned, through electrical stimulation, to provide active
      tension on diseased myocardium, which improves left ventricular performance and
      ultimately increases cardiac output. We performed cardiomyoplasty in a 37-year
      old man with severe ischemic cardiomyopathy. He was discharged from the hospital
      2.5 months after the operation, and he did not require medical therapy. We
      believe this to be the 1st cardiomyoplasty performed in Ukraine.

PMID- 7787479
TI  - Family physician maternity care.

PMID- 7787480
TI  - Family practice obstetrics.

PMID- 7787481
TI  - Potential for abuse.

PMID- 7787482
TI  - Guideline interpretation varies.

PMID- 7787483
TI  - External controls limit effectiveness.

PMID- 7787484
TI  - Misconceived ideas.

PMID- 7787485
TI  - Differing diagnostic beliefs.

PMID- 7787486
TI  - Health care clinics in Cambodia.

PMID- 7787487
TI  - Radiology rounds. Tracheoesophageal fistula.

PMID- 7787488
TI  - Dermacase. Contact photodermatitis.

PMID- 7787489
TI  - Consultation in family practice obstetrics.
AB  - PURPOSE: To examine the types of non-low-risk obstetric patients managed by
      family physicians in urban teaching hospitals, and to determine indications for
      consultation for women at low risk when labour began. METHOD: Retrospective chart
      review for all patients delivered by family physicians in three downtown Toronto
      teaching hospitals during 1 year. RESULTS: Of 1710 cases, 595 (34.8%) were
      classified as non-low risk, with the main indications being postdates (> 42
      weeks) (19.9%); pregnancy-induced hypertension (19.3%); and premature labour (<
      37 weeks) (14.8%). Of the 1115 low-risk patients, 363 (32.6%) had an intrapartum
      consultation, usually for failure to progress (50.1%) or fetal distress (12.7%).
      More than 80% of intrapartum consultations were associated with induction and
      augmentation of labour. CONCLUSION: Family physicians can continue to care for
      many non-low-risk women, usually with the help of obstetricians. Consultations
      were obtained for many women at low risk. We need to reevaluate whether some
      mandatory consultations are necessary in family practice obstetrics.

PMID- 7787490
TI  - Family medicine in a tertiary care hospital. Obstetrical outcomes and
      interventions.
AB  - OBJECTIVE: To examine the rates of obstetrical complications and interventions
      among patients managed or comanaged by family physicians. DESIGN: Case series.
      Retrospective review of hospital records. SETTING: Victoria Hospital, a tertiary
      care centre affiliated with the University of Western Ontario in London, Ont.
      PARTICIPANTS: Five hundred forty-two women in labour admitted consecutively by
      family physicians from October 1, 1990, to September 31, 1991. There were no
      exclusions based on antenatal risk. MAIN OUTCOME MEASURES: Degree of risk on
      admission, and rates of cesarean sections, inductions, epidurals, forceps
      deliveries, episiotomies, perineal tears, postpartum hemorrhages, and postpartum
      fever for mothers. For newborns, Apgar scores and rate of need for a pediatric
      critical care unit or special observation nursery. RESULTS: Except for rates of
      inductions and episiotomies, which were lower than those reported elsewhere,
      results were all comparable to those in previous North American studies of low
      risk family medicine obstetric patients. CONCLUSION: Family physicians care for
      women with a range of antenatal risks. Even when practising in tertiary care
      environments, family physicians can minimize many obstetrical interventions while
      maintaining good maternal and neonatal outcomes.

PMID- 7787491
TI  - Family practice obstetrics in a teaching hospital. Does a tertiary care
      environment make a difference?
AB  - OBJECTIVE: To determine referral rates, to study the nature of consultations with
      obstetricians, and to examine how both patient and physician characteristics
      affect referrals. DESIGN: Case series. Retrospective review of hospital records.
      SETTING: Victoria Hospital, a tertiary care centre affiliated with the University
      of Western Ontario in London, Ont. PARTICIPANTS: Five hundred forty-two women
      admitted consecutively for delivery under the care of family physicians from
      October 1, 1990, to September 31, 1991. OUTCOME MEASURE: The number and types of
      obstetrical consultations obtained for the study population. RESULTS: Of the
      50.7% of cases requiring consultation, half were delivered by obstetricians. The
      most common reasons for consultation were failure to progress in labour,
      induction of labour, posterior presentation, fetal distress, and pregnancy
      induced hypertension. The most common reasons for obstetricians to attend
      delivery were to perform forceps rotations and cesarean sections. CONCLUSIONS:
      Parity and risk classification were the two most important factors for predicting
      whether consultation would occur. The high rate of consultation in this study
      might relate to ease of access to consultation in a tertiary care environment.
      More study is needed to examine the reasons for consultation because it seems
      that some of the situations for which obstetricians were consulted could have
      been safely managed by family physicians.

PMID- 7787492
TI  - Family practice obstetrics in a community hospital.
AB  - OBJECTIVE: To review obstetric care provided by family physicians and to
      determine why they transfer patients to obstetricians. DESIGN: Retrospective
      chart review. SETTING: Obstetrics department of a regional non-academic community
      hospital PATIENTS: Of 683 women booked with family physicians for obstetrical
      care, 601 were admitted by family physicians and 82 were transferred to
      obstetricians before admission. MAIN OUTCOME MEASURES: Risk score, induction,
      augmentation, consultation, forceps delivery, cesarean section, episiotomy,
      epidural anaesthesia, narcotic analgesia, neonatal birth weight and Apgar scores,
      and maternal complications. RESULTS: Family physicians' patients had good
      maternal and neonatal outcomes; spontaneous delivery rate was 82%; cesarean
      section rate was 9%. Women transferred from family physicians to obstetricians
      before admission for delivery had a cesarean section rate of 63%. CONCLUSIONS:
      Family physicians provided total obstetric care to most women in this community
      and transferred patients to obstetricians for expected reasons. Community
      hospitals with family physicians highly involved in providing obstetric care are
      likely ideal institutions for training future family physicians.

PMID- 7787493
TI  - Hypertension in pregnancy.
AB  - Hypertension occurs in 7% to 10% of pregnancies. It is associated with increased
      risk of maternal and fetal complications. Early diagnosis in the office by
      careful attention to signs and symptoms could result in adequate management.
      Delivery provides the only care for this disease process. Recently, low-dose
      acetylsalicylic acid has been used in high-risk situations to prevent the
      development of preeclampsia.

PMID- 7787494
TI  - Postpolio syndrome. Unusual disease in rural family practice.
AB  - Postpolio syndrome is a sequela of paralytic poliomyelitis seen in approximately
      25% of polio victims. Because the symptoms are nonspecific, it can be difficult
      to diagnose. Getting information about diagnosis and treatment of unusual
      conditions in rural and remote regions can be difficult, and physicians sometimes
      find themselves in the position of being the on-site "expert." Physicians must
      make difficult decisions with patients and their families about life-giving
      therapies, advance directives, and the like.

PMID- 7787495
TI  - Cardiopulmonary resuscitation. Not for all terminally ill patients.
AB  - Where there are clear clinical indications that a patient suffering from a
      terminal illness would not benefit from cardiopulmonary resuscitation, there is
      no legal or ethical requirement that CPR be discussed with the patient as a
      treatment option or that CPR be administered if the patient stops breathing or
      suffers cardiac arrest.

PMID- 7787496
TI  - Sotalol-induced bradycardia reversed by glucagon.
AB  - Glucagon is considered the drug of choice for treating bradycardia and
      hypotension encountered during beta-blocker poisoning. Its potential usefulness
      in reversing adverse effects encountered during therapeutic dosing with beta
      blockers has not been well characterized. We present a case of sotalol-induced
      bradycardia reversed by glucagon.

PMID- 7787497
TI  - Practical tips on postpolio syndrome.

PMID- 7787498
TI  - A public/private partnership in the quest for quality: development of
      cerebrovascular disease practice guidelines and review criteria.
AB  - The development of Uniform Clinical Data Set (UCDS) algorithms for
      cerebrovascular disease can serve as a model for cooperation between government
      agencies and physician organizations in the development of clinical guidelines
      and the translation of practice guidelines into review criteria. UCDS is a
      computerized system of data collection and case finding developed by the Health
      Care Financing Administration (HCFA) to standardize the Peer Review Organization
      screening process for potential utilization and quality problems. Input on the
      cerebrovascular disease algorithms was provided through the American Medical
      Association UCDS Advisory Panel and the American Academy of Neurology Task Force
      on Hospital Utilization for Stroke. Physician organizations were successful in
      identifying problematic areas, improving the original algorithms, suggesting new
      issues for development, and deleting inappropriate or misdirected algorithms.
      Since HCFA modified the cerebrovascular disease algorithms in response to
      feedback, physician organizations have had an important impact on algorithm
      development. Unfortunately, the process for algorithm review was often
      complicated, inefficient, and slow. This process is reviewed, problems and
      constraints are discussed, and specific recommendations are given for improving
      the process.

PMID- 7787499
TI  - The legal status of clinical practice parameters: an updated annotated
      bibliography.
AB  - In response to extensive speculation about the probable liability implications
      for health care providers of the formal creation and dissemination of explicit
      practice parameters of guidelines, I prepared several years ago an annotated
      bibliography of emerging literature on that topic (1). Since preparation of that
      catalogue, little meaningful clarification of these issues has emerged from the
      courts, legislatures, or regulatory agencies.

PMID- 7787500
TI  - Reengineering quality for health care reform.

PMID- 7787501
TI  - An empirical test of the structure, process, and outcome quality paradigm using
      resident-based, nursing facility assessment data.
AB  - This study distinguishes between organizational characteristics, regarded as
      exogenous structural indicators of quality, and those identified as endogenous
      indicators of structural care (SC), and investigates the degree to which measures
      of SC vary by ownership mode (defined by four combinations of chain affiliation
      and profit status) for 142 certified and licensed nursing facilities (NFs) in a
      southern state. Structural care measures include: licensed and unlicensed
      staffing, licensed therapists, and case mix-adjusted direct care expenditures. In
      addition, seven (four process and three outcome) facility-level, risk-adjusted
      process, and outcome quality scales are developed from 39 resident-level quality
      indicators. A causal mode of NF quality arranged according to the structure,
      process and outcome paradigm is specified and estimated using path analysis.
      Organizational data derive from the 1991 Medicaid Cost Report; process and
      outcome quality measures were developed from the Minimum Data Set Plus Resident
      Assessment Instrument. Using the percentage of Medicaid and private pay residents
      as covariates, there was a significant overall multivariate effect due to
      ownership mode on the SC measures. Although there were several significant direct
      effects, the overall path model was unconfirmed. The multivariate results suggest
      that some organizational characteristics of structure quality may be more
      appropriately considered exogenous to causal quality models and therefore have
      indirect (versus direct) effects on process or outcome quality indicators. The
      path analysis implies that the structure-process-outcome paradigm may not
      accurately capture the way NF health care is delivered. Research which considers
      alternate NF quality paradigms needs to be done with samples that are more
      representative of national proportions of each ownership mode.

PMID- 7787502
TI  - Severity-adjusted differences in hospital utilization by gender.
AB  - Gender-based differences in hospital use may result from biological differences
      or may suggest problems of access to health services and quality of care. We
      hypothesized that there should be no difference in hospital care between men and
      women, given the same diagnosis. Hospitalizations were characterized by severity
      of illness, as this may indicate the timeliness of hospital care.
      Hospitalizations may be too late (with higher severity of illness) resulting in
      long stays and high costs, or too early (with lower severity of illness)
      resulting in care that could be given in alternative treatment settings. Three
      abdominal conditions were examined which could be misdiagnosed or confused with
      other diseases involving the female reproductive system: appendicitis,
      diverticulitis, and cholecystitis. The National Hospital Discharge Survey (NHDS)
      was used for analysis. Disease staging was used to assign a severity of illness
      indicator, ranging from stage 1 (conditions with no complications) to stage 3
      (multiple site involvement, poor prognosis). For each disease, the percentage of
      discharges and the age-adjusted discharge rate per 1000 population was examined
      by stage of illness and gender. For appendectomy, there was a significantly
      greater percentage of men at stage 1 (lower severity) compared to women (73%
      versus 67%). For diverticular disease, women had higher proportions of stage 2/3
      discharges than men for both medical and surgical hospitalizations. For
      cholecystitis, women had a greater percentage of hospitalizations at stage 1 than
      men, notably for surgical treatment (63% compared with 38%), although more men
      were admitted at stage 2 for both medical and surgical treatment.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7787503
TI  - Use of follow-up services by patients referred from a walk-in unit: how can
      patient compliance be improved?
AB  - Timely use of necessary follow-up services is an important dimension of
      ambulatory care quality. Using a hospital-based walk-in center, this study
      identified patients who were referred for follow-up care and examined factors
      related to compliance with these referrals. The participants were 696 adults seen
      in a hospital-based walk-in unit between June 1, 1992, and December 1, 1992.
      Patients completed a self-administered questionnaire including questions about
      sociodemographic characteristics, prior use of health services, and the Medical
      Outcomes Study (MOS) 36-Item Health Survey. Medical findings, follow-up
      recommendations, insurance status, and compliance with follow-up referrals were
      ascertained using chart review, the hospital's computing system, and clinic
      records. Fifty percent of the patients were referred for follow-up medical care;
      55% of these complied with follow-up referrals. Factors associated with referral
      for follow-up care included older age, inability to afford a physician, longer
      duration of chief complaint, the patient's belief that follow-up care would be
      needed, and worse MOS pain score. The most important factor associated with
      compliance with follow-up referral was scheduling appointments while patients
      were still in the walk-in unit. Patients with such scheduled appointments were
      almost 10 times more likely than others to receive follow-up (adjusted odds ratio
      = 9.6, 95% confidence interval = 4.4-21.2). The most important step a provider
      can take to improve compliance with follow-up referral is to schedule
      appointments before patients are sent home. This should presumably improve
      quality of ambulatory care.

PMID- 7787504
TI  - Emergency department utilization in a large pediatric group practice.
AB  - The effect of a triage and care system, which employs continued patient
      education, alternatives to emergency department (ED) care for nonemergent
      problems, and close cooperation between ED staff and the primary care physician
      on inappropriate ED use, was analyzed for three groups of patients: (a) Medicaid
      patients, all of whom had unrestricted access to the ED; (b) group A patients who
      required prior physician approval and copayments for all ED services; and (c)
      patients enrolled in group B who were responsible for copayments only and did not
      require prior physician approval for ED use. Two hundred ninety-nine (299) charts
      were prospectively reviewed for age, payer status, date, time of visit,
      diagnosis, outcome of visit, and severity of illness. Medicaid patients utilized
      the ED much more than expected, compared to either group A or B patients (P <
      0.001). Expected rates of utilization were based upon that particular group's
      representation in a medical associate's patient panel, which was based upon
      patient billing data. Medicaid patients were significantly younger than group A
      or B patients (P < 0.001) and had lower severity scores (P = 0.04). Our triage
      and care system failed to alter patterns of ED utilization for Medicaid patients.

PMID- 7787505
TI  - A managed care model for home infusion therapy.
AB  - Home infusion therapy began in response to the medical needs of the patients. In
      the traditional model, products and services were delivered in the home on a
      physician's prescription. Limitations related to medical quality management and
      cost were recognized in this model. Because of these limitations, the changes
      that continue to occur in health care delivery and the increase in number and
      acuity of patients requiring non-hospital services, a managed care model was
      conceived and implemented at the University of Minnesota Medical School and
      Hospital. This model emphasizes physician-based case management, total quality
      management, a point of contact medical information system, outcomes assessment
      and management, and research and education activities designed to evaluate and
      improve home infusion therapies. The model was implemented through a public
      private partnership. This application of managed care to home infusion therapies
      is described in this communication.

PMID- 7787506
TI  - [Industrial hygiene and occupational diseases in chemical industry at present].
AB  - The working conditions of workers engaged in chemical industry today make them be
      at risk of an occupational disease whose early manifestation can be detected by
      modern techniques of medical investigations, such as electromyography, electron
      spirometry, allergic, immunological and neuropsychological tests. The preventive
      trend in occupational medicine should be in progress by developing the system of
      biological and hygienic monitoring techniques for those getting in contact with
      noxious chemicals and by improving the legal bases for creating safe working
      conditions with allowance made for new economic relations.

PMID- 7787507
TI  - [Health status of dwellers of cities and towns with developed chemical industry].
AB  - Assessing the physical development of children residing in the developed chemical
      industrial town has revealed that more than a fourth of the children examined are
      abreast of their biological age and that there is a trend for reducing the number
      of those who have the level of biological development which corresponds to their
      age. In the total morbidity pattern among children, respiratory diseases rank
      first, whose proportion increases in the higher air-polluted areas. A
      comprehensive assessment shows that the overwhelming majority (88-93%) belong to
      Health Groups II-IY, which is indicative of the unfavourable environmental
      factors of the town. The predictive calculation makes it possible to determine
      possible changes in the morbidity rates due to the identified diseases. The
      morbidity rate shows 4-6 increases per each unit of changes in the complex
      indicator of environmental pollution.

PMID- 7787508
TI  - [Dioxins in the environment].

PMID- 7787511
TI  - [Ecological hygiene--a science of global health].
AB  - The paper defines ecological hygiene, a science that combines a preventive trend
      and comprehensive ecological analysis of man-made changes occurring in the
      biosphere. Ecological hygiene may be regarded as a science of global human health
      in relation to ecological situations, of modes of its maintenance, promotion, and
      improvement. As for its application, ecological hygiene may be determined as a
      complex of medical preventive research subjects whose purpose is to maintain and
      promote health by preventing diseases and premature aging. To apply this
      approach, ecological hygiene studies the environment and its influence on the
      human body, reveals unfavourable environmental factors and defines the maximum
      acceptable levels of their influence, works out recommendation how to eliminate
      unfavourable factors and how to rationally apply useful ones.

PMID- 7787510
TI  - [Probability of health impairment by exposure to chemicals at the level of
      sanitary standards and the problem of individual sensitivity].
AB  - The paper briefly outlines the problems in estimating the probability of the
      population's health impairments caused to the individual person's
      hypersensitivity due do their genetic and their acquired properties when it is
      chemically exposed at the level of the maximum allowable concentrations. In
      connection with the environmental situation, it is quite necessary to concentrate
      everybody's attention on palliative antichemical protective measures.

PMID- 7787509
TI  - [Effects of chemical agents on the immunity status of workers at Novomoskovsk
      enterprises].
AB  - A comprehensive study was made of the body's immunological and microbiological
      responses to industrial health hazards at chemical enterprises. For this, a total
      of 284 workers from the Novomoskovsk Bytchim and Orgsintez Production
      Associations were investigated by the conventional procedures. The workers were
      found to have immunological changes at the cellular and humoral levels as
      compared with the persons who were not engaged in chemical industry. There are
      also changes in the structure of the intestinal microflora at the expense of
      higher quantities of opportunistic microbes. The findings suggest that the
      workers of chemical enterprises experience great immunological influences of
      chemical compounds in their working places, despite the existing safety and
      protection measures. A number of proposals have been introduced to prevent
      immunological and microbiological changes in this group of persons.

PMID- 7787512
TI  - [Interactions of various amino acids, dipeptides and glutathione with
      hypochlorite anion (CLO-)].
AB  - The specific features of interaction between sodium hypochlorite and various
      amino compounds were examined. It is shown that in the first reaction munite,
      methionine and glutathione are the most active in neutralizing hypochlorite
      anion, while histidine, glycine, alanine, dipeptides and taurine are less active.
      The chloroamino complexes formed by dipeptides and taurine are the most
      resistant.

PMID- 7787514
TI  - [Free and esterified epidermal cholesterol in psoriasis].
AB  - The levels of epidermal total, free and esterified cholesterol were studied in
      psoriatic patients. Lipids were isolated from the areas of psoriatic lesions and
      from the normally appearing epidermis by the authors' non-invasive surface
      extractive method. The quantity of cholesterol was given in microgram per square
      centimeter. Fifty six and 11 healthy persons were examined. The skin cholesterol
      levels were twice-four-fold higher in the patients than in the healthy subjects.
      The same levels were noted from the areas of lesion and from normally appearing
      epidermis. The proportion of an esterified fraction decreased mainly in the
      normally appearing epidermis areas, especially in severe psoriasis. The role of
      the findings was also discussed.

PMID- 7787513
TI  - [Molecular mechanisms of the effects of sodium hypochlorite on thrombocytes and
      lipoproteins].
AB  - Hypochlorite seems to inhibit platelet aggregation in the platelet-rich plasma
      (PRP) by modifying fibrinogen receptors. The hypochlorite-inactivated isolated
      platelets are completely repaired by native plasma. Platelet aggregation in PRP
      is suppressed by hypochlorite by its direct interaction with cells and indirectly
      due to plasma modification. The indirect action of hypochlorite is a reversible
      reaction between the platelet active groups and the products of plasma
      modification. The reaction may involve sulphur-containing groups. The spin-probe
      method shows that hypochlorite penetrates into the lipid phase of human blood
      lipoproteins. It initiates lipid peroxidation and causes the disturbance of the
      lipid structure and the protein please.

PMID- 7787515
TI  - [Specific hemosorption, kinetics and physiological effects].
AB  - The paper covers the physicochemical and clinicophysiological aspects of
      hemosorption. It proposes mathematical models of blood elimination kinetics of
      substances which have different affinities for plasma proteins and cellular
      receptors. It also describes the processes occurring onto the surface of
      hemosorbents on their contact with blood. It is attempted to associate these
      processes with some immunomodulating effects of hemoperfusion.

PMID- 7787516
TI  - [Methodical approaches to the assessment of population's domestic exposure to
      chemicals].
AB  - The paper deals with the specific action of biocidal agents of household
      chemistry as part of population's chemical loading. A concept of evaluation of
      disinfectants on human health was formulated and its guidelines are
      substantiated. For this, the author proposes to use criteria for membrane
      damaging and immunodepressive effect based on the non-invasive test-systems to
      identify the immunometabolic status of the body. He also defines the ways of
      searching the approaches to identifying a life-threatening abnormality in either
      prenosological status.

PMID- 7787517
TI  - [Mechanisms of natural detoxication and antioxidant protection].
AB  - This paper considers the mechanisms of energy-dependent and synchronized
      detoxication and antioxidative defense (AOD) when synchronized detoxication and
      antioxidative defense (AOD) when the body is exposed to chemicals. It emphasizes
      the role of glutathione as a binder of this system involving in the regulation of
      this activity. It also discusses the mechanisms that define the reliability and
      efficiency of detoxication and AOD. The paper discusses whether the body's
      resistance to technogenic toxicants can be enhanced by using metabolic precursors
      of glutathione and other natural and (or) synthetic agents activating natural
      detoxication and AOD.

PMID- 7787518
TI  - BMJ on the internet.

PMID- 7787519
TI  - Ebola virus.

PMID- 7787520
TI  - Spinal cord injuries in rugby union players.

PMID- 7787521
TI  - Primary care at last for Brazil?

PMID- 7787522
TI  - Corneal transplantation in Britain.

PMID- 7787523
TI  - Recertifying general practitioners.

PMID- 7787524
TI  - Cooperating, not competing, to improve health care.

PMID- 7787526
TI  - First "no win, no fee" case to go to Lords.

PMID- 7787525
TI  - US religious groups oppose gene patents.

PMID- 7787527
TI  - Britain ranks poorly for cancer survival rates.

PMID- 7787528
TI  - Ebola threat eases.

PMID- 7787529
TI  - Britain to boost competitiveness and science.

PMID- 7787530
TI  - Traffic victims call for help.

PMID- 7787531
TI  - Overseas doctors coming to Britain need language test.

PMID- 7787532
TI  - Spanish doctors strike over pay.

PMID- 7787533
TI  - Consent is not always essential, say Dutch experts.

PMID- 7787534
TI  - New infection control measures miss the point.

PMID- 7787535
TI  - Patient packs to come on stream in Britain.

PMID- 7787536
TI  - Influence of vitamin D receptor genotype on bone mineral density in
      postmenopausal women: a twin study in Britain.
AB  - OBJECTIVES: To investigate the possible association between vitamin D receptor
      genotype and bone mineral density in a large group of postmenopausal twins.
      DESIGN: Cross sectional twin study. SETTING: Twin population based in Britain.
      SUBJECTS: 95 dizygotic (non-identical) pairs of twins and 87 monozygotic
      (identical) pairs of twins aged 50-69 years, postmenopausal, and free of diseases
      affecting bone, recruited from a national register of twins and with a media
      campaign. MAIN OUTCOME MEASURES: Bone mineral density measured at the hip, lumbar
      spine, forearm, and for the whole body by dual energy x ray absorptiometry in
      relation to differences in the vitamin D receptor genotype. RESULTS: At all sites
      the values of bone density among dizygotic twins were more similar in those of
      the same vitamin D receptor genotype than in those of differing genotype, and the
      values in the former were closer to the correlations seen in monozygotic twins.
      Women with the genotype that made them at risk of osteoporotic fracture had an
      adjusted bone mineral density that was significantly lower by SD 0.5 to 0.6 at
      the hip, lumbar spine, and for the whole body. The results could not be explained
      by differences in age, weight, years since menopause, or use of hormone
      replacement therapy. CONCLUSIONS: The findings that in postmenopausal women in
      Britain bone density-particularly at the hip and spine-is genetically linked and
      specifically associated with the vitamin D receptor genotypes should lead to
      novel approaches to the prevention and treatment of osteoporosis.

PMID- 7787538
TI  - Prevalence and outcome of symptomatic carotid lesions in young adults. National
      Research Council Study Group.
AB  - OBJECTIVE: To estimate the prevalence and outcome of symptomatic internal carotid
      artery lesions in young adults. DESIGN: Multicentre hospital based observational
      study with five year follow up. SETTING: Seven neurological departments in
      northern and central Italy. SUBJECTS: 240 patients (115 men) aged 15-44 with a
      recent transient ischaemic attack or stroke in the carotid territory. MAIN
      OUTCOME MEASURES: (a) Prevalence of symptomatic internal carotid artery stenosis
      or occlusion detected by continuous wave Doppler ultrasonography at entry; (b)
      incidence rates of cerebral, cardiac, and non-vascular death; non-fatal stroke;
      and non-fatal myocardial infarction. RESULTS: Carotid stenoses of 50-99% and
      occlusions were found in 38 patients (15.8%). Both conditions were significantly
      more frequent in patients aged over 35 and in those with hypertension, diabetes
      mellitus, and stroke at entry. The standardised mortality ratio at five years was
      10.5 (95% confidence interval 5.0 to 19.3). Survival of patients with stenoses of
      0-49% and occlusions was significantly better than that of patients with stenoses
      of 50-99%. Carotid stenosis of 50-99% was an independent predictor of death
      (hazard ratio 7.9; 95% confidence interval 2.2 to 29) and non-fatal stroke
      (hazard ratio 7.4; 1.5 to 37.4). CONCLUSIONS: The prevalence of carotid stenosis
      or occlusion in young adults after a cerebrovascular event is low. Though
      patients with high grade symptomatic carotid stenosis are at risk of non-fetal
      and fetal events, patients with internal artery occlusion apparently have a
      benign prognosis.

PMID- 7787539
TI  - Mental disorders in young and middle aged men who commit suicide.

PMID- 7787537
TI  - Oral versus intravenous antibiotics for community acquired lower respiratory
      tract infection in a general hospital: open, randomised controlled trial.
AB  - OBJECTIVE: To see whether there is a difference in outcome between patients
      treated with oral and intravenous antibiotics for lower respiratory tract
      infection. DESIGN: Open controlled trial in patients admitted consecutively and
      randomised to treatment with either oral co-amoxiclav, intravenous followed by
      oral co-amoxiclav, or intravenous followed by oral cephalosporins. SETTING: Large
      general hospital in Dublin. PATIENTS: 541 patients admitted for lower respiratory
      tract infection during one year. Patients represented 87% of admissions with the
      diagnosis and excluded those who were immunocompromised and patients with severe
      life threatening infection. MAIN OUTCOME MEASURES: Cure, partial cure, extended
      antibiotic treatment, change of antibiotic, death, and cost and duration of
      hospital stay. RESULTS: There were no significant differences between the groups
      in clinical outcome or mortality (6%). However, patients randomised to oral co
      amoxiclav had a significantly shorter hospital stay than the two groups given
      intravenous antibiotic (median 6 v 7 and 9 days respectively). In addition, oral
      antibiotics were cheaper, easier to administer, and if used routinely in the 800
      or so patients admitted annually would lead to savings of around 176,000 pounds a
      year. CONCLUSIONS: Oral antibiotics in community acquired lower respiratory tract
      infection are at least as efficacious as intraveous therapy. Their use reduces
      labour and equipment costs and may lead to earlier discharge from hospital.

PMID- 7787541
TI  - Balti curries and iron.

PMID- 7787540
TI  - Children who miss immunisation: implications for eliminating measles.

PMID- 7787543
TI  - Sociodemographic variables for general practices: use of census data.

PMID- 7787542
TI  - Need and demand for primary health care: a comparative survey approach.
AB  - OBJECTIVE: To develop general practice profiles of needs and demand for primary
      health care. DESIGN: Postal survey of a stratified random sample of 3478 people
      registered with five general practices. Data from a single practice were compared
      with data from the remaining four to identify areas of comparative need. SETTING:
      Five general practices in Lothian. MAIN OUTCOME MEASURES: Differences between the
      single practice and the comparison practices in terms of social and economic
      circumstances, limiting long term illness, specific ongoing conditions, minor
      illness or symptoms, psychosocial problems, discussion of lifestyle, associated
      use of services. RESULTS: Respondents from the single practice reported higher
      rates than those in the four comparison practices of ongoing mental health and
      respiratory problems and use of antidepressants, tranquillisers, or sleeping
      tablets. Although rates of limiting long term illness and other specific ongoing
      conditions were comparable, the rates of minor illness or symptoms and
      psychosocial difficulties were higher in the single practice. Respondents from
      the single practice were more likely to consult frequently, to have contacted the
      practice out of normal working hours, and to have discussed psychosocial
      difficulties with a general practitioner. For any specific ongoing condition or
      "minor" illness, respondents from the single practice were no more likely to
      consult. CONCLUSIONS: A comparative survey approach is a useful method of
      developing an understanding of patterns of need and demand among general practice
      populations. It has the potential to inform planning within individual general
      practices and the process of commissioning among general practices within a given
      area.

PMID- 7787544
TI  - Diagnosis and management of Clostridium difficile infection.

PMID- 7787545
TI  - Medical informatics.

PMID- 7787546
TI  - The death of biomedical journals.

PMID- 7787547
TI  - Telemedicine: lessons remain unheeded.
AB  - Telemedicine, the delivery of health care with the patient and health
      professional at different locations, has been around for over 30 years. Its
      driving force has been developments in communications technology, and as new
      communications systems are developed health applications are proposed such as
      supporting the delivery of primary health care to geographically remote areas or
      regions underserved through the maldistribution of professional expertise.
      Despite rapid technological advances, evaluations of such systems have been
      largely superficial, and more thorough evaluations have failed to show
      significant advantages for more advanced and expensive technology over older
      technology such as the telephone. Methods for evaluating the impact of particular
      technologies on the health care system need to be developed and clearer benefits
      shown in terms of improved standards of care.

PMID- 7787548
TI  - Teleradiology.
AB  - Advances in telecommunications and computer software have led to the development
      of radiology image transfer systems. Radiologists may now report radiographs at a
      site distant from that of the examination, in some cases almost instantaneously.
      Computed tomography, magnetic resonance imaging, and ultrasonography may also be
      supervised from afar. Developments over the past few decades are reviewed,
      allowing an understanding of the systems currently available. These include
      systems that transmit static images and real time video systems that enable
      interactive supervision from a radiologist at a distant site. The implications
      for the practice of radiology are discussed and the main areas of development
      over the next few years explored.

PMID- 7787550
TI  - South Africa's health. Restructuring South Africa's health care: dilemmas for
      planners.

PMID- 7787551
TI  - ABC of asthma. Chronic asthma--general management.

PMID- 7787549
TI  - Smuggling and cross border shopping of tobacco in Europe.
AB  - Governments have recently become concerned about cross border shopping and
      smuggling because it can decrease tax revenue. The tobacco industry predicted
      that, with the removal of border controls in the European Union, price
      differences between neighbouring countries would lead to a diversion of tobacco
      trade, legally and illegally, to countries with cheaper cigarettes. According to
      them this diversion would be through increased cross border shopping for personal
      consumption or through increased smuggling of cheap cigarettes from countries
      with low tax to countries with high tax, where cigarettes are more expensive.
      These arguments have been used to urge governments not to increase tax on tobacco
      products. The evidence suggests, however, that cross border shopping is not yet a
      problem in Europe and that smuggling is not of cheap cigarettes to expensive
      countries. Instead, more expensive "international" brands are smuggled into
      northern Europe and sold illegally on the streets of the cheaper countries of
      southern Europe.

PMID- 7787552
TI  - Increasing the number of organ transplants. Opting out scheme for donors has
      support in Britain.

PMID- 7787553
TI  - Increasing the number of organ transplants. Professionalisation of organ
      procurement in Spain has increased donors.

PMID- 7787554
TI  - Establishing a minor illness nurse in a busy general practice. May reduce
      doctors' workload.

PMID- 7787555
TI  - Preregistration house officers in general practice. Problems will arise over who
      pays.

PMID- 7787556
TI  - Preregistration house officers in general practice. Regulations limit approved
      institutions for training.

PMID- 7787557
TI  - Preregistration house officers in general practice. Training in general practice
      is also important for postregistration doctors.

PMID- 7787558
TI  - Preregistration house officers in general practice. Posts are purely educational.

PMID- 7787560
TI  - The fibromyalgia syndrome. Electroacupuncture is a potentially valuable
      treatment.

PMID- 7787559
TI  - Services for cleft lip and palate. Surgical caseload is only one variable that
      influences outcome.

PMID- 7787561
TI  - The fibromyalgia syndrome. Outcome is good with minimal intervention.

PMID- 7787562
TI  - Private prescribing of controlled drugs needs closer scrutiny.

PMID- 7787563
TI  - Unreliability of reports of hypoglycaemia by diabetic patients. Hundreds of case
      reports suggest a problem with human insulin.

PMID- 7787564
TI  - Unreliability of reports of hypoglycaemia by diabetic patients. Hypoglycaemia was
      validated.

PMID- 7787565
TI  - Drug users' views on general practitioners.

PMID- 7787566
TI  - Methadone maintenance treatment.

PMID- 7787567
TI  - Environmental lead and children's intelligence. Studies included in the meta
      analysis are not representative.

PMID- 7787568
TI  - Environmental lead and children's intelligence. Britain must replace its lead
      pipes to meet WHO standards for drinking water.

PMID- 7787569
TI  - Emergency care in general practice.

PMID- 7787570
TI  - Childhood antecedents of schizophrenia.

PMID- 7787572
TI  - Reperfusion injury after myocardial infarction.

PMID- 7787571
TI  - Limitations of randomised controlled trials.

PMID- 7787573
TI  - Sleep related vehicle accidents.

PMID- 7787574
TI  - Screening overseas students for tuberculosis.

PMID- 7787575
TI  - A global health disaster network is needed.

PMID- 7787576
TI  - GPs accept patients' vote on fundholding.

PMID- 7787577
TI  - Rationing intensive care. Data from one high dependency unit supports their
      effectiveness.

PMID- 7787578
TI  - Torture in Israel.

PMID- 7787579
TI  - Does debriefing after psychological trauma work?

PMID- 7787580
TI  - New equities of information in an electronic age.

PMID- 7787581
TI  - Reliability of the Snellen chart.

PMID- 7787582
TI  - Genetic traits in common diseases.

PMID- 7787583
TI  - Health care rationing.

PMID- 7787584
TI  - Dutch drop plans for contraceptive pill payments.

PMID- 7787585
TI  - Audit commission defines NHS management costs.

PMID- 7787586
TI  - 14,000 preventable deaths in Australian hospitals.

PMID- 7787587
TI  - Israeli smoking ban succeeds in 80% of adults at work.

PMID- 7787588
TI  - Children affected by HIV need more help.

PMID- 7787589
TI  - EU's alcohol subsidies come under attack.

PMID- 7787590
TI  - Funding to follow students into the community.

PMID- 7787591
TI  - Report criticises French AIDS "charlatans".

PMID- 7787592
TI  - Republicans turn health reform into a revolution.

PMID- 7787593
TI  - Evidence of an association between non-Hodgkin's lymphoma and skin cancer.
AB  - OBJECTIVE: To investigate a possible link between exposure to ultraviolet light
      and the almost epidemic increase in non-Hodgkin's lymphoma worldwide. Because
      ultraviolet light is known to cause skin cancers, the association between non
      Hodgkin's lymphoma and skin cancer was studied. DESIGN: Secondary occurrence of
      either malignant melanoma or squamous cell skin cancer in cohorts of patients
      with a first diagnosis of either non-Hodgkin's lymphoma or chronic lymphocytic
      leukaemia, and vice versa, were studied. Expected numbers of subsequent cancers
      were calculated by sex, age, and period specific national incidence rates
      multiplied by the person years under observation in the cohorts. SETTING: Denmark
      (1943-89) and Sweden (1958-89). SUBJECTS: Four population based cohorts
      identified in the nationwide cancer registries (34,641 people with non-Hodgkin's
      lymphoma, 17,400 with chronic lymphocytic leukaemia, 34,989 with malignant
      melanoma, 25,980 with squamous cell skin cancer). A total of 562,085 person years
      were accrued for the analysis. MAIN OUTCOME MEASURES: The ratios of observed to
      expected cancers (the standardised incidence ratio) served as a measure of the
      relative risk. RESULTS: The relative risk for developing squamous cell skin
      cancer was 5.5 (95% confidence interval 4.6 to 6.6) among patients with non
      Hodgkin's lymphoma and 8.6 (7.2 to 10.3) among patients with chronic lymphocytic
      leukaemia. The relative risks remained high over more than 15 years of follow up.
      Relative risks for malignant melanoma were 2.4 (1.8 to 3.2) for patients with non
      Hodgkin's lymphoma and 3.1 (2.1 to 4.4) for patients with chronic lymphocytic
      leukaemia. After squamous cell skin cancer had been diagnosed there was a twofold
      excess risk for non-Hodgkin's lymphoma and chronic lymphocytic leukaemia. By
      contrast, in each of the cohorts the general cancer risks excluding skin and
      lymphoproliferative malignancies were close to the expected. CONCLUSIONS: The
      occurrence of non-Hodgkin's lymphoma and skin cancer are strongly associated;
      this supports the hypothesis that the secular increase in exposure to ultraviolet
      light may have contributed to the increasing incidence of non-Hodgkin's lymphoma
      in recent decades.

PMID- 7787595
TI  - The analgesic effect of sucrose in full term infants: a randomised controlled
      trial.
AB  - OBJECTIVE: To evaluate the effects of different sucrose concentrations on
      measures of neonatal pain. DESIGN: Randomised, double blind, placebo controlled
      trial of sterile water (control) or one of three solutions of sucrose--namely,
      12.5%, 25%, and 50% wt/vol. SETTING: Postnatal ward. PATIENTS: 60 healthy infants
      of gestational age 37-42 weeks and postnatal age 1-6 days randomised to receive 2
      ml of one of the four solutions on to the tongue two minutes before heel prick
      sampling for serum bilirubin concentrations. MAIN OUTCOME MEASURE: Duration of
      crying over the first three minutes after heel prick. RESULTS: There was a
      significant reduction in overall crying time and heart rate after three minutes
      in the babies given 50% sucrose as compared with controls. This was maximal one
      minute after heel prick in the 50% sucrose group and became statistically
      significant in the 25% sucrose group at two minutes. There was a significant
      trend for a reduction in crying time with increasing concentrations of sucrose
      over the first three minutes. CONCLUSION: Concentrated sucrose solution seems to
      reduce crying and the autonomic effects of a painful procedure in healthy normal
      babies. Sucrose may be a useful and safe analgesic for minor procedures in
      neonates.

PMID- 7787594
TI  - Somatostatin v placebo in bleeding oesophageal varices: randomised trial and meta
      analysis.
AB  - OBJECTIVE: To study whether somatostatin or its derivative octreotide is more
      effective than placebo for treating bleeding oesophageal varices. METHODS:
      Randomised, double blind trial and meta-analysis with blinded analysis of data
      and writing of manuscripts. SETTING: Departments of medical and surgical
      gastroenterology in Copenhagen. SUBJECTS: Patients suspected of bleeding from
      oesophageal varices and of having cirrhosis of the liver. MAIN OUTCOME MEASURES:
      Survival, number of blood transfusions, and use of Sengstaken-Blakemore tube.
      RESULTS: 86 patients were randomised; in each group 16 died within six weeks (95%
      confidence interval for difference in mortality--19% to 22%). There were no
      differences between those treated with somatostatin or placebo in median number
      of blood transfusions (8 v 5, P = 0.07, 0 to 4 transfusions) or in numbers of
      patients who needed balloon tamponade (16 v 13, P = 0.54, -11% to 28%). In a meta
      analysis of three trials involving 290 patients somatostatin had no effect on
      survival compared with placebo (P = 0.59, odds ratio 1.16; 0.67 to 2.01). For
      blood transfusions and use of balloon tamponade there was heterogeneity between
      the trials with no convincing evidence in favour of somatostatin. No placebo
      controlled trials have been performed with octreotide. CONCLUSION: Within the
      limited power of this study and meta-analysis we were unable to show a clinical
      benefit of somatostatin in the emergency treatment of bleeding oesophageal
      varices.

PMID- 7787597
TI  - Effect of physical activity on femoral bone density in men.

PMID- 7787596
TI  - Occurrence of different cancers in patients with Parkinson's disease.

PMID- 7787598
TI  - The time of death after trauma.

PMID- 7787600
TI  - Bone densitometry in clinical practice.

PMID- 7787599
TI  - Community care for demented and non-demented elderly people: a comparison study
      of financial burden, service use, and unmet needs in family supporters.
AB  - OBJECTIVE: To measure and compare perceived financial burden, use of services,
      and perceived unmet service needs of supporters of demented and non-demented
      elderly people. DESIGN: Comparison study of age and sex matched demented and non
      demented elderly people and their supporters. SETTING: 25 primary health care
      teams in Dundee. SUBJECTS: 114 community resident elderly (age over 65) people
      with dementia, 114 age and sex matched comparators, and the main informal
      supporter of each elderly person. MAIN OUTCOME MEASURES: Carers' perceptions of
      financial impact of looking after an old person, service use (from a list of
      locally available services), unmet service needs, and needs for three types of
      generic service (help with supervision, housework, or personal care). RESULTS:
      Financial impact was low, except for extra household expense in the dementia
      group. There was significantly greater use of mainstream domiciliary and day care
      services in the dementia group. Dementia was nevertheless associated with a high
      level of unmet need, mainly for more mainstream support and help with supervision
      of the elderly person. CONCLUSION: Supervisory care for demented elderly people
      should be further developed within an expanded domiciliary service to meet
      supporters needs.

PMID- 7787602
TI  - The future of the GMC: an interview with Donald Irvine, the new president.
      Interview by Richard Smith.

PMID- 7787603
TI  - World Health Organisation: change and progress.

PMID- 7787601
TI  - Using data from the 1991 census.
AB  - The 1991 census for England and Wales provides a substantial amount of data on
      demography, ethnicity, housing tenure, employment status, and other social
      factors for geographical areas ranging in size from enumeration districts
      upwards. Many in the health service and in the academic community are making use
      of the data in the 1991 census. However, users of census data need to be aware of
      the problems and limitations of these data, which include the format of the data,
      data modification and suppression, sampling error, and underenumeration. An
      important innovation of the 1991 census was that the census form included a
      question on the postcode of respondents; this allowed the Office of Population
      Censuses and Surveys to produce a postcode-enumeration district look up table
      which overcomes many of the problems previously encountered in trying to assign
      postcodes to enumeration districts. The new look up table also includes the grid
      reference of postcodes, and this will improve the geographical referencing of
      census data.

PMID- 7787605
TI  - ABC of asthma. Asthma in children: treatment.

PMID- 7787604
TI  - Minocycline and pulmonary eosinophilia.

PMID- 7787606
TI  - Anti-therapeutic community mental health law. Chief medical officer defends the
      Mental Health Bill.

PMID- 7787607
TI  - Medical schools and racial discrimination. Comparison between medical schools is
      unjustified.

PMID- 7787608
TI  - Medical schools and racial discrimination. Cambridge reveals results.

PMID- 7787609
TI  - Medical schools and racial discrimination. Sixth formers gamble over medical
      school choices.

PMID- 7787611
TI  - Doctors from ethnic minority groups.

PMID- 7787612
TI  - Investigating racial discrimination in the NHS.

PMID- 7787610
TI  - Medical schools and racial discrimination. The London Hospital Medical College
      denies selection bias.

PMID- 7787614
TI  - Dornase alfa for cystic fibrosis. Patients should not be denied a safe, effective
      treatment.

PMID- 7787613
TI  - National measles and rubella vaccination campaign.

PMID- 7787615
TI  - Screening sperm donors for cystic fibrosis.

PMID- 7787616
TI  - Dornase alfa for cystic fibrosis. Evidence supporting use of this drug has not
      yet been published.

PMID- 7787617
TI  - Assessing health needs in primary care. Morbidity study from general practice
      provides another source of information.

PMID- 7787618
TI  - Pain in the hand and wrist. Picture of injection is misleading.

PMID- 7787619
TI  - Pain in the hand and wrist. Pyridoxine supplements may help patients with carpal
      tunnel syndrome.

PMID- 7787620
TI  - Pain in the hand and wrist. Treatment of fractures of the scaphoid.

PMID- 7787621
TI  - Assessing health needs in primary care. Standardised methods of data collection
      are required.

PMID- 7787622
TI  - Assessing health needs in primary care. Chronic diseases need to have standard
      definitions.

PMID- 7787623
TI  - Assessing health needs in primary care. Tailor data collection to needs.

PMID- 7787624
TI  - Babies' deaths linked to suboptimal care.

PMID- 7787625
TI  - Bullying in schools.

PMID- 7787626
TI  - Smoking and death.

PMID- 7787627
TI  - Errors in administration of intravenous drugs.

PMID- 7787629
TI  - Suppression of medical conditions by Cushing's syndrome.

PMID- 7787628
TI  - Protection of the individual in biomedical research in Africa.

PMID- 7787630
TI  - Lord Moran's prescriptions for Churchill.

PMID- 7787631
TI  - Childhood thyroid cancer since accident at Chernobyl.

PMID- 7787633
TI  - Psychiatric services for people with learning disabilities.

PMID- 7787632
TI  - Lessons from the Pearce affair: handling scientific fraud.

PMID- 7787634
TI  - Family mediation.

PMID- 7787636
TI  - Consultant struck off for fraudulent claims.

PMID- 7787637
TI  - Disabled people take care issues to court.

PMID- 7787638
TI  - Peers define best and worst of NHS research.

PMID- 7787635
TI  - Their lordships on medical research.

PMID- 7787639
TI  - India moves towards equal rights for disabled people.

PMID- 7787640
TI  - Abortion laws cause problems in Poland.

PMID- 7787641
TI  - Academics call for review of National Lottery's funding.

PMID- 7787642
TI  - Health ministers to help orphan drugs.

PMID- 7787643
TI  - Interrelation of vitamin C, infection, haemostatic factors, and cardiovascular
      disease.
AB  - OBJECTIVE: To examine the hypothesis that the increase in fibrinogen
      concentration and respiratory infections in winter is related to seasonal
      variations in vitamin C status (assessed with serum ascorbate concentration).
      DESIGN: Longitudinal study of individuals seen at intervals of two months over
      one year. SETTING: Cambridge. SUBJECTS: 96 men and women aged 65-74 years living
      in their own homes. MAIN OUTCOME MEASURES: Haemostatic factors fibrinogen and
      factor VIIC; acute phase proteins; respiratory symptoms; respiratory function.
      RESULTS: Mean dietary intake of vitamin C varied from about 65 mg/24 h in winter
      to 90 mg/24 h in summer; mean serum ascorbate concentration ranged from 50
      mumol/l in winter to 60 mumol/l in summer. Serum ascorbate concentration was
      strongly inversely related to haemostatic factors fibrinogen and factor VIIC as
      well as to acute phase proteins but not to self reported respiratory symptoms or
      neutrophil count. Serum ascorbate concentration was also related positively to
      forced expiratory volume in one second. An increase in dietary vitamin C of 60 mg
      daily (about one orange) was associated with a decrease in fibrinogen
      concentrations of 0.15 g/l, equivalent (according to prospective studies) to a
      decline of approximately 10% in risk of ischaemic heart disease. CONCLUSION: High
      intake of vitamin C has been suggested as being protective both for respiratory
      infection and for cardiovascular disease. These findings support the hypothesis
      that vitamin C may protect against cardiovascular disease through an effect on
      haemostatic factors at least partly through the response to infection; this may
      have implications both for our understanding of the pathogenetic mechanisms in
      respiratory and cardiovascular disease and for the prevention of such conditions.

PMID- 7787644
TI  - Vitamin C and risk of death from stroke and coronary heart disease in cohort of
      elderly people.
AB  - OBJECTIVES: To determine whether vitamin C status, as measured by dietary intake
      and plasma ascorbic acid concentration, is related to mortality from stroke and
      coronary heart disease in people aged 65 and over. DESIGN: A 20 year follow up
      study of a cohort of randomly selected elderly people living in the community who
      had taken part in the 1973-4 Department of Health and Social Security nutritional
      survey and for whom dietary and other data had been recorded. SETTING: Eight
      areas in Britain (five in England, two in Scotland, and one in Wales). SUBJECTS:
      730 men and women who had completed a seven day dietary record and who had no
      history or symptoms of stroke, cerebral arteriosclerosis, or coronary heart
      disease when examined by a geriatrician in 1973-4. RESULTS: Mortality from stroke
      was highest in those with the lowest vitamin C status. Those in the highest third
      of the distribution of vitamin C intake had a relative risk of 0.5 (95%
      confidence interval 0.3 to 0.8) compared with those in the lowest third, after
      adjustment for age, sex, and established cardiovascular risk factors. The
      relation between vitamin C intake and stroke was independent of social class and
      other dietary variables. A similar gradient in risk was present for plasma
      ascorbic acid concentrations. No association was found between vitamin C status
      and risk of death from coronary heart disease. CONCLUSION: In elderly people
      vitamin C concentration, whether measured by dietary intake or plasma
      concentration of ascorbic acid, is strongly related to subsequent risk of death
      from stroke but not from coronary heart disease.

PMID- 7787645
TI  - Risk factors for acanthamoeba keratitis in contact lens users: a case-control
      study.
AB  - OBJECTIVE: To investigate reasons for an increase in cases of Acanthamoeba
      keratitis related to contact lenses. DESIGN: Case-control study. Cases were
      contact lens related acanthamoeba keratitis patients treated between 1 September
      1989 and 31 August 1992. Controls were lens users without lens related disease
      who presented as new patients to the casualty department from 1 March 1992 to 31
      August 1992. All subjects completed a questionnaire detailing lens use and
      hygiene practices. SETTING: Eye hospital. SUBJECTS: 35 cases with acanthamoeba
      keratitis and 378 controls. MAIN OUTCOME MEASURES: Relative risks comparing
      different contact lens types, socioeconomic classification, age, sex, lens use,
      lens wearing experience, hygiene compliance, and hygiene systems. RESULTS: The
      crude relative risk for developing acanthamoeba keratitis with the use of daily
      wear disposable lenses was 49.45 (95% confidence interval 6.53 to 2227; P <
      0.001) compared with conventional soft lenses (the referent). Multivariable
      analysis showed that this increased risk could be largely attributed to lack of
      disinfection (relative risk 55.86 (10 to 302); P < 0.001) and use of chlorine
      based disinfection (14.63 (2.8 to 76); P = 0.001) compared with other chemical
      systems (the referent). None of the other outcome measures showed a significant
      association. CONCLUSIONS: Both failure to disinfect daily wear soft contact
      lenses and the use of chlorine release lens disinfection systems, which have
      little protective effect against the organism, are major risk factors for
      acanthamoeba keratitis. These risks have been particularly common in disposable
      lens use. Over 80% of acanthamoeba keratitis could be avoided by the use of lens
      disinfection systems that are effective against the organism.

PMID- 7787646
TI  - Macular degeneration and early menopause: a case-control study.

PMID- 7787647
TI  - Lower respiratory infection and inflammation in infants with newly diagnosed
      cystic fibrosis.

PMID- 7787648
TI  - Extracontractual referrals: safety valve or administrative paperchase?
AB  - OBJECTIVE: To describe the extracontractual referrals of residents of a health
      authority during a six month period in 1994, identifying the number and cost of
      emergency and non-emergency referrals, including the number of cases costing more
      than 20,000 pounds and those cases when payment was refused. DESIGN: Descriptive
      analysis of all extracontractual referrals submitted to the health authority
      between 1 April and 30 September 1994. SETTING: A health authority covering a
      population of 614,000. RESULTS: Payment of 2,583,693 pounds was made to 263
      different providers for 2400 episodes of care, of which 1469 were emergencies and
      931 were elective or tertiary referrals. Authorisation was granted for an
      additional 1376 referrals for future treatment but was refused in 713 instances,
      mostly for technical reasons. Sixteen extracontractual referrals together
      accounted for over a fifth of total expenditure during the study period.
      CONCLUSIONS: Handling large numbers of episodes of care on an individual cost per
      case basis imposes an enormous administrative burden on both purchasers and
      providers, diverting money away from patient care. Extracontractual referrals
      also expose health authorities to considerable financial risk and may undermine
      commissioning strategies. Measures are proposed to limit the number of episodes
      handled in this way.

PMID- 7787649
TI  - Hospital investigation of men and women treated for angina.

PMID- 7787650
TI  - Integrating undergraduate and postgraduate education in general practice:
      experience in Tayside.
AB  - Several forces have resulted in the creation in Tayside of the first formally
      integrated unit of undergraduate and postgraduate education in general practice
      in the United Kingdom. Forces that helped this integration included the desire
      for change, national developments in education, financial support through funds
      set aside to cover the additional cost of teaching, and a management structure
      which concentrates on shared leadership. Forces that hindered the integration
      included uneasiness about ideas for reforming traditional structures,
      institutional inertia, the complexity of financial arrangements, and tensions
      over priorities. The experience of managing institutional changes in Tayside has
      been invaluable and will lead to a more cohesive approach to undergraduate
      teaching, postgraduate training, and the provision of services relevant to the
      development of general practice.

PMID- 7787651
TI  - Where should health services go: local authorities versus the NHS?
AB  - The Association of Metropolitan Authorities has recently proposed that
      responsibility for the NHS should pass from health authorities to local
      authorities. One of the fiercest debates at the outset of the NHS was whether the
      hospitals should be run by local authorities. In the end the minister for health,
      Aneurin Bevan, decided against local democracy and in favour of a national health
      service. His arguments included the fact that equality of treatment could not be
      guaranteed if facilities varied with local finances and that even the largest
      authorities were not big enough to pool risks and expertise. All these arguments
      still apply today, and the recent changes in community care provide an insight
      into how a market model of local authority control might work. The changes have
      been accompanied by a shift from public to private sector provision and the
      introduction of charges for services that the NHS once provided free. As
      important, the willingness and ability of local authorities to raise extra
      revenue from local taxes and charges affect the service they can provide, so
      leading to inequalities of provision. Local authorities have yet to make the case
      that they can preserve the fundamental principles and benefits of the NHS,
      including its reliance on central taxation and unified funding formulas.

PMID- 7787652
TI  - Local government and health care: the historical perspective.

PMID- 7787653
TI  - The case for closer cooperation between local authorities and the NHS.

PMID- 7787655
TI  - Female genital mutilation in France.

PMID- 7787654
TI  - Female genital mutilation in Britain.

PMID- 7787656
TI  - Female genital mutilation in Britain. Why the problem continues in Britain.

PMID- 7787658
TI  - The shaken infant syndrome. Serious effects of shaking were described in 1971.

PMID- 7787659
TI  - The shaken infant syndrome. Deal with minor episodes of abuse to prevent more
      serious injuries.

PMID- 7787657
TI  - Respiratory medicine.

PMID- 7787660
TI  - The shaken infant syndrome. Shaking alone may not be responsible for damage.

PMID- 7787661
TI  - Maternal haemoglobin and birth weight in different ethnic groups. Figure for
      lower end of range of maximal haemoglobin is too low.

PMID- 7787662
TI  - Maternal haemoglobin and birth weight in different ethnic groups. Lower
      haemoglobin may be the result rather than the cause of larger fetuses.

PMID- 7787663
TI  - Maternal haemoglobin and birth weight in different ethnic groups. Methods used do
      not support conclusions.

PMID- 7787664
TI  - Outcomes of neonatal intensive care.

PMID- 7787665
TI  - Water births. Could saline in the pool reduce the potential hazards?

PMID- 7787666
TI  - Trends in sudden infant death. The few remaining sudden infant deaths are likely
      to be explicable and avoidable.

PMID- 7787667
TI  - Trends in sudden infant death. Infant respiratory death rates mirror sudden
      infant deaths.

PMID- 7787668
TI  - Misleading meta-analysis. Public policy is based on results of epidemiological
      meta-analyses that contradict common sense.

PMID- 7787670
TI  - Misleading meta-analysis. Registers for clinical trials already exist.

PMID- 7787672
TI  - Advance directives. Law Commission's report makes no provision for dissenting
      doctors.

PMID- 7787671
TI  - Misleading meta-analysis. Variability among studies should be investigated.

PMID- 7787669
TI  - Fish oils and cardiovascular disease.

PMID- 7787673
TI  - Accident and emergency radiology. "Rule of two" is outmoded and unhelpful.

PMID- 7787674
TI  - Advance directives. Incompetence develops gradually.

PMID- 7787675
TI  - Keyhole surgery.

PMID- 7787676
TI  - Elderly people and the 1990 act.

PMID- 7787677
TI  - Failing sick doctors. National Counselling Service for Sick Doctors offers
      support and help.

PMID- 7787678
TI  - Medical schools and racial discrimination.

PMID- 7787679
TI  - Treating mental health problems in health care workers.

PMID- 7787680
TI  - Failing sick doctors. British Doctors' and Dentists' Group will provide an
      intervention service from 1 July.

PMID- 7787681
TI  - Treatment in the air.

PMID- 7787683
TI  - Trust withdraws allegations against consultant. Trust fostered traditional gender
      culture.

PMID- 7787682
TI  - Trust withdraws allegations against consultant. Suspension was waste of talent.

PMID- 7787684
TI  - [The prediction of the individual chemosensitivity of human malignant tumors: the
      biological patterns and clinical results].
AB  - Individual laboratory prediction of the sensitivity of human neoplasms to
      chemicals is justified on the basis of the authors' own data and those available
      in the literature. The potentialities and limitations of methods for individual
      prediction, as well as clinical results are discussed. Data are given on some
      biological mechanisms responsible for tumor growth which have been obtained in in
      vitro and in vivo tests with human tumor tissue and carcinoma cells. Further
      perspectives of this line of studies are discussed.

PMID- 7787685
TI  - [Nootropic substances enhance the N-methyl-D-aspartate-induced short-term
      potentiation of synaptic transmission in rat hippocampal slices].
AB  - The nootropic agents pyracetam, ethymisole, N-5-oxynicotinoyl glutamate and beta
      carboline derivative--ambocarb--enhance short-term potentiation of populational
      EPSP's amplitude of area CA1 pyramidal neurons in the slices of the rat
      hippocampus, which is evoked by NMDA. The inhibitors of protein kinases diminish
      the effect of pyracetam and ethymisole (tolbutamide), as well as all the studied
      nootropic drugs (polymyxin B and trifluoroperazine).

PMID- 7787686
TI  - [The effect of calcium channel blockers on animal behavior in tests to study
      their anxiolytic activity].
AB  - The anxiolytic activity of calcium channel blockers (verapamil, nifedipine,
      cinnarizine, fendiline, and diltiazem) versus diazepam (relanium) was tested in
      experiments on male [correction of female] mice. Only verapamil (1 mg/kg) and
      nifedipine (5 mg/kg) were found to increase the number of transitions and reduced
      the animals' stay in the dark compartment. All the agents in the used doses
      failed to substantially affect the animals' behavior in the plus-maze. It is
      suggested that conditions for modelling pathological anxiety rather than natural
      states are required in the experiments where antianxiety properties are studied.
      The model of pathological anxiety states is possible in the examination of the
      action of agents on the effects of routine anxiogenic agents.

PMID- 7787687
TI  - [The effect of clofelin on the pain syndrome in mandibular trauma].
AB  - Oral clopheline (0.000075) noticeably alleviates the pain syndrome and
      circulatory hyperdynamic state of patients with mandibular fracture. The agent is
      superior to the conventional combination of 50% analgin (2 ml) and 1% dimedrolum
      (1 ml) in its efficiency and duration of action.

PMID- 7787688
TI  - [A comparative study of the anticonvulsant action of a new table salt
      substitute].
AB  - Murine experiments have demonstrated that excess sodium chloride intake has an
      aggravating effect on the course of convulsions caused by corazolum,
      thiosemicarbaside and maximum electric shock rather than strychnine. The new
      sodium chloride substitute hyposol given to animals ad libitum for a fortnight
      produces an anticonvulsant effect which is more pronounced in corazolum-induced
      convulsions and potentiates the anticonvulsant effect of diazepam. The official
      drug sanasol is antagonistic to strychnine and corazolum, but it displays a
      proconvulsant activity on a thiosemicarbaside model.

PMID- 7787689
TI  - [The effect of ximedon on cholesterol metabolism and experimental atherosclerosis
      in rabbits].
AB  - The effects produced by the two pyrimidine derivatives pyridinol carbamate
      (parmidine) and xymedon on cholesterol metabolism and experimental
      atherosclerosis were comparatively studied in rabbits. The rabbits were fed
      either a chow containing cholesterol (200 mg/kg body weight) or the same diet
      also containing xymedon (30 mg/kg body weight) or pyridinol carbamate (30 mg/kg
      body weight). Total plasma cholesterol showed 5.5- and 4.7-fold increases in the
      rabbits receiving only cholesterol or cholesterol + pyridinol carbamate,
      respectively, as compared with that in the animals on a standard laboratory chow.
      In the rabbits given cholesterol+xymedon, cholesterol levels were 24% less than
      that in the animals taking cholesterol alone. In these animals, the aortic
      atherosclerotic damage index (ADI) was equal to 24.1%, which was 1.8-fold less
      than that in the cholesterol-fed rabbits. In the rabbits given
      cholesterol+pyridinol carbamate, ADI was decreased by 1.7 times, but it did not
      differ from that in the hypocholesterolemic rabbits. At the same time xymidone
      and pyridinol carbamate reduced the hepatic levels of total and esterified
      cholesterol. To elucidate the mechanism of action of xymedon, it was studied for
      effects on cholesterol metabolism in cultured rabbit hepatocytes and murine
      macrophage J774. Xymedon did not alter the esterification and other parameters of
      cholesterol metabolism in the cultured hepatocytes. It is suggested that the
      hypocholesterolemic effect was realized at the level of intestinal rather than
      hepatic cholesterol metabolic changes. The investigations made on the murine
      macrophage J744 showed that xymedone reduced cholesterol esterification in
      macrophages, evidently by inhibiting the activity of the enzyme acyl-CoA:
      cholesterol acyltransferase. The anti-atherosclerotic effect of xymedon seems to
      result from reductions in plasma cholesterol levels and cholesterol
      esterification in blood vascular cells.

PMID- 7787690
TI  - [The effect of the mineral composition of the diet on cholesterol metabolic
      indices and the experimental correction of propranolol-induced atherogenic
      dyslipoproteinemia].
AB  - Rat experiments have revealed that surplus sodium chloride intake causes
      dyslipoproteinemia and intensifies the atherogenic action of propranolol. The new
      antihypertensive and antiedematous table salt substitute, as sanasole exerts its
      hypocholesterolemic effect. Both dietary salt mixtures eliminates the atherogenic
      action of beta-adrenoblocker. The application of table salt substitutes may
      become a convenient and effective agent against risk for atherogenesis.

PMID- 7787692
TI  - [A mathematical analysis of the cardiac activity indices in patients with
      ischemic heart disease undergoing antianginal pharmacotherapy].
AB  - Taking into account various parameters of heart rhythm variability makes it
      possible to differentiate patients with ischemic heart disease by their response
      to antianginal pharmacotherapy. The cardiointervalographic method may be used to
      predict therapeutical effects in making clinical and pharmacological decisions.

PMID- 7787691
TI  - [The principles for creating drug preparations of natural origin that stimulate
      hematopoiesis].
AB  - The paper outlines the principles in designing hemostimulators by using
      glycosamineglycans. Hemostimulating properties of the tested agents is likely to
      be primarily due to the presence of D-glucuronic acid in their structure. The
      homotypic mechanisms are largely responsible for all agents' effect in
      stimulating hemopoiesis. Thus, they all virtually activate the function of the
      hemopoiesis-inducing microenvironment. In addition, they directly or indirectly
      stimulate the processes of proliferation and differentiation of precursor cells
      of erythro- and granulomonocytopoiesis.

PMID- 7787693
TI  - [The epithelium-dependent mechanism of the bronchodilating action of adrenaline].
AB  - The involvement of the epithelium in the adrenergic reactions of airways smooth
      muscles was studied. The epithelium-dependent pathway of the bronchodilating
      action of catecholamines, which played a minor role was found to become decisive
      in some cases. In that case the epithelial inflammatory lesion could be a cause
      of reducing the response of the bronchi to catecholamines.

PMID- 7787694
TI  - [The interaction of the converting-enzyme inhibitor captopril with cardiac
      glycosides in the rat kidney].
AB  - Strophanthin (0.1 mg.kg, i.v.) and digoxin (0.1 mg/kg, i.v.) moderately increase
      blood supply of the renal cortical and medullary layers in unconscious rats and
      enhance renal excretion of sodium and water. Preadministration of the converting
      enzyme inhibitor captopril (10 mg/kg/day, per os, for 6 days) promoted vascular
      dilatation in the inner and outer areas of the medulla, which occurred under the
      action of these agents and substantially increased their natriuretic and diuretic
      effects. It is concluded that the renin-angiotension system is directly involved
      into the mechanism of action of cardiac glycosides in the kidneys, acting as a
      modulator that prevents their vasodilating and tubular effects.

PMID- 7787695
TI  - [An evaluation of the efficacy of chronotheray with heparin and kurantil in
      patients with chronic pyelonephritis].
AB  - The effectiveness of traditional therapy (TT) and chronotherapy (CT) with heparin
      and curantyl was comparatively studied in 80 patients suffering from chronic
      pyelonephritis. The blood clotting variables were determined every 4 hours before
      and 2.5-3 weeks after TT and CT in combination with antibacterial therapy. The
      findings suggest that CT is more effective than TT with heparin and curantyl.
      With CT, steady-state clinical effects, positive dynamics of laboratory findings
      and a greater trend to normalization of the circadian organization of
      hemocoagulation were achieved in earlier periods when lower daily and course
      doses of the agents were used.

PMID- 7787696
TI  - [The effect of thalicoside on reproductive function in an experiment].
AB  - Talicoside, a triterpene glycoside from Thalictrum minus L., given in an oral
      dose og 1 mg/kg for 5 days was demonstrated to cause ovulation stimulation
      induced by intravenously injecting 1.2% solution of copper acetate into the
      rabbits. The agent enterally administered in a dose of 1 mg/kg to rats for 5 days
      reduced the levels of luteinizing hormone and elevated serum follicle-stimulating
      hormone in proestrous and estrous.

PMID- 7787697
TI  - [The cytochrome P-450-dependent mono-oxygenase system of the liver and
      interleukin-1 production by the macrophages in adjuvant arthritis in rats under
      the influence of beta-carotene].
AB  - A relationship between the production of interleukin 1 (IL-1) by macrophages from
      adjuvant-induced arthritic rats and cytochrome P-450-dependent hepatic microsomal
      monooxygenase was studied. The synthesis of IL-1 by splenic and peritoneal
      macrophages on day 17 postadjuvant treatment was not altered, but the hepatic
      cytochrome P-450 levels and monooxygenase activity were significantly decreased.
      Beta-carotene treatment of arthritic rats reduced hind paw swelling and
      concurrently stimulated the ability of macrophages to secrete IL-1 and increased
      the cytochrome P-450 levels and the activity of hepatic monooxygenase. The
      findings did not establish a definite relationship between the production of IL-1
      by systemic macrophages on the one hand, and the hepatic cytochrome P-450 levels
      a and monooxygenase activity on the other hand. It thus appears that IL1 is
      unable to play a role of a mediator between the immune system and the hepatic
      cytochrome P-450-dependent monooxygenase system of rats with adjuvant-induced
      arthritis.

PMID- 7787699
TI  - [The limitation of glucose catabolism as a factor in protection during hypoxia].
AB  - Violuric acid was first shown to have antihypoxic and antioxidative properties,
      to exert protective action in sodium nitrite-induced hemic hypoxia. Hepatic
      glucose and glucogen levels increased, the activity of glucose-6-
      phosphodihydrogenase enhanced, while that of lactate dehydrogenase and alkaline
      phosphatase decreased, the content of cAMP restored, whereas cGMP and 2,3
      diphosphoglycerate levels decreased to a greater extent. The action of violuric
      acid was especially evident at the ultrastructural level-the ultrastructure of
      brush receptor elements in anoxia in the presence of violuric acid's action
      retained all the features characteristic for intact animals, which was
      accompanied by a significant accumulation of glycogen in the neuroplasm.

PMID- 7787700
TI  - [The pharmacokinetics of the new Russian prolonged-action form of diclofenac
      sodium--Ortopek--in a single oral dose].
AB  - Ortopak tablets, 100 mg, were investigated. The pharmacokinetics of Ortopak was
      studied in 10 rheumatoid arthritis patients after a single oral dose of 100 mg.
      Ortophenum and voltaren-retard (Ciba-Geigy) were used for comparison. Diclophenac
      sodium was measured in the patient's plasma by using high performance liquid
      chromatography. Ortopak was shown to be eliminated from the patient's body much
      slower than Ortophenum. The bioequivalence of Ortopak versus Ortophenum was
      62.7%. The pharmacokinetic properties of Ortopak were similar to those of
      Voltaren-retard, which were close to those of diclophenac-sodium in the blood
      plasma within the therapeutic range.

PMID- 7787698
TI  - [The pharmacological correction of the activity of lipid peroxidation processes
      in the dynamics of craniocerebral trauma].
AB  - Rat experiments have shown that free radical oxidation processes are activated in
      the cerebral mitochondrial fraction in the dynamics of craniocerebral injury,
      which appears as accumulation of malonic dialdehyde and disturbed functional
      interaction of antiradical protection enzymes. These changes are most marked 24
      hours after injury. Some GABA-positive drugs and opioid receptor agonists prevent
      lipid peroxidation activation. The highest efficiency is displayed by piracetam
      (1 g/kg) and the synthetic enkephalin analogue DSLET (0.1 mg/kg).

PMID- 7787701
TI  - [The effect of D-penicillamine on the metabolism of the basic substance of the
      connective tissue and the indices of the liver parenchyma in experimental
      cirrhosis in rats].
AB  - While examining the effects of D-penicillamine [correction of D-penicillin] on
      the formation of hepatic toxic damage in mature male Wistar rats from the stage
      of developing cirrhosis to that of the developed one, the author revealed a high
      antifibrotic activity of the drug which significantly normalized the metabolism
      of the major agent of the hepatic connective tissue; there was a slight
      improvement of parenchymal metabolism when the agent was taken for 2 months.
      There were apparently healthy animals in the experimental group following 4-month
      course of the therapy. Control rats developed hepatic damage, as evidenced by
      electron microscopic studies.

PMID- 7787703
TI  - [The participation of the epiphysis in the organization of resistance to
      neurotropic agents].

PMID- 7787702
TI  - [An experimental evaluation of the behavioral characteristics in the formation of
      a predilection for alcohol].
AB  - A set of correlating indices has been developed to assess alcohol craving in rats
      who has a free access to it for 24 months. The set includes the estimation of
      voluntary daily alcohol intake before and after ethanol deprivation and the
      assessment of rats' behavior in a conflict situation and a plus-maze. The
      increased intake of alcohol after its deprivation has been established to
      correlate with a number of punished ethanol lickings in the conflict paradigm and
      functional locomotor asymmetry in the plus-maze.

PMID- 7787704
TI  - [The role of the GABAergic system in regulating uterine contractile function and
      the direction of the search for effective pregnancy-protective agents].

PMID- 7787705
TI  - [The sequelae of cytochrome P-450 induction].

PMID- 7787706
TI  - [The microsomal system of the liver and cholepoiesis].

PMID- 7787707
TI  - [New hepatoprotective agents of natural origin].

PMID- 7787709
TI  - Periduodenal panniculitis due to spontaneous rupture of a pancreatic pseudocyst
      into the duodenum.
AB  - We report a patient with transient periduodenal panniculitis due to spontaneous
      rupture of a pancreatic pseudocyst into the duodenum. He developed sudden onset
      of severe epigastric and back pain with jaundice, mimicking the symptoms of acute
      pancreatitis. However, the serum and urinary amylase levels did not increase. CT
      scans showed disappearance of his pseudocyst and periduodenal panniculitis
      without any evidence of acute pancreatitis. The CT findings of periduodenal
      panniculitis and his symptoms both improved within 3 weeks. A duodenal fistula
      leading to the remnant pseudocyst and narrowing of the periduodenal portion of
      the common bile duct were demonstrated by endoscopic retrograde
      cholangiopancreatography.

PMID- 7787708
TI  - Clinical evaluation of gastric fundic gland polyps without familial polyposis
      coli.
AB  - BACKGROUND: Assessments were made of 63 cases of fundic gland polyposis (FGP)
      unassociated with adenomatosis coli. These cases were evaluated by radiological
      examination over 2 years follow-up. All polyps were pathologically confirmed by
      endoscopic biopsies. METHODS: Most cases were asymptomatic when diagnosed during
      mass radiological surveys of the upper gastrointestinal tract. The majority of
      patients ranged in age from 40-60 years, and the polyps numbered fewer than 20 in
      55 cases (87.3%). Polyps were detected in the fundic glands using the congo red
      test and by biopsies. RESULTS: All serum gastrin values were within the normal
      range. During the course of this study, the polyps of 13 cases (20.6%) increased
      and those of three cases (4.8%) decreased or resolved completely. CONCLUSION:
      From these findings it is considered that FGP are observed in stomachs with less
      atrophy, and that polyps follow courses in which they increase, decrease,
      disappear, along with atrophy.

PMID- 7787711
TI  - Intrahepatic bile duct dilatation secondary to hepatocellular carcinoma: CT
      features in 10 patients.
AB  - BACKGROUND: To determine the computed tomographic (CT) features of bile duct
      obstruction secondary to hepatocellular carcinoma (HCC). METHODS: CT examinations
      of 10 patients (mean age, 58 years) with bile duct obstruction secondary to HCC
      were retrospectively reviewed. RESULTS: All tumors were intrahepatic. Eight
      tumors were well-delineated and two were ill-defined. The largest diameters of
      tumor ranged from 1.5-6.0 cm (mean, 3.6 cm). All tumors were hypodense before
      contrast and did not contain calcification. After contrast, four tumors became
      hypodense, three were isodense, and three were hyperdense to the liver. No tumor
      demonstrated encapsulation. Diffuse intrahepatic bile duct dilation was observed
      in seven patients. One patient had extrahepatic bile duct dilatation. Localized
      bile duct dilatation was observed in three patients, in the hemi-liver which
      contained the tumor. No tumor invaded the portal vein. CONCLUSION: Although rare,
      HCC should be included in the differential diagnosis of bile duct obstruction.
      This diagnosis should be suggested in patients with bile duct obstruction when CT
      shows an associated intra- or extrahepatic mass. Our results suggest that HCC
      responsible for bile duct obstruction is remarkable for the absence of
      encapsulation.

PMID- 7787710
TI  - Primary sclerosing cholangitis: sonographic findings.
AB  - BACKGROUND: To determine the value of sonography of the upper abdomen in primary
      sclerosing cholangitis (PSC). METHODS: In a prospective study of 23 patients with
      PSC we performed upper abdominal sonography. Sonographic findings of the bile
      ducts were correlated with endoscopic retrograde cholangiographic (ERC) findings.
      Signs of advanced disease and complications were also sought. RESULTS: The major
      limitation of ultrasound was its inability to exclude intrahepatic duct disease.
      In six patients with multiple strictures and pruning but without dilatations on
      ERC, sonography showed no intrahepatic duct abnormalities. Extrapheptic duct
      disease was adequately demonstrated on ultrasound. Mural thickening of the common
      bile duct (CBD), the hallmark of PSC in the appropriate clinical setting, was
      demonstrated in 17 of 18 cases with a stenosis on ERC. Ultrasound confirmed
      advanced disease manifested by signs of portal hypertension in seven patients.
      Marked nonsegmental intrahepatic duct dilation and the presence of a mass lesion
      occurred in two of three cases in which complicating cholangiocarcinoma was
      found. CONCLUSION: Despite its inability to exclude intrahepatic duct disease,
      sonography is useful in diagnosing and following PSC.

PMID- 7787713
TI  - Dynamic contrast-enhanced MR imaging of fibrolamellar hepatocellular carcinoma.
AB  - The magnetic resonance (MR) appearance of fibrolamellar hepatocellular carcinoma
      (FL-HCC) on T1- and T2-weighted and dynamic serial postgadolinium-DTPA images is
      reported. Both tumors were large (> 7 cm in shortest dimension) and had central
      regions of low signal intensity on T1- and T2-weighted images. Diffuse
      heterogeneous enhancement of the tumors occurred on immediate postcontrast
      images. Lesions became more homogeneous in enhancement over time, but lack of
      enhancement of central portions of the tumor persisted. Although persistent lack
      of enhancement of the tumor scar on late postcontrast MR images may be
      characteristic of FL-HCC compared with delayed enhancement in focal nodular
      hyperplasia, the potential similarities between these tumors is stressed.

PMID- 7787712
TI  - Bile duct involvement in hepatocellular carcinoma: MR demonstration.
AB  - BACKGROUND: To determine the magnetic resonance (MR) features of hepatocellular
      carcinoma (HCC) with associated bile duct involvement. METHODS: MR examinations
      of six patients (mean age, 62 years) demonstrating bile duct involvement due to
      HCC were retrospectively reviewed and compared to surgical and pathologic
      findings. RESULTS: Three of the tumors were solitary, and three were multifocal.
      In two patients, MR showed direct biliary duct invasion by tumor. On T1-weighted
      MR images, four tumors were hypointense compared to the liver and two were
      isointense. On T2-weighted MR images, four tumors were hyperintense, and two were
      isointense. The two tumors studied with dynamic T1-weighted MR images obtained
      after intravenous administration of a gadolinium chelate, displayed enhancement
      similar to that of the liver. There was no evidence of a tumor capsule on either
      unenhanced or enhanced MR images. Intrahepatic bile duct dilatation was seen in
      five patients. The extrahepatic bile duct was normal in all cases. CONCLUSION:
      Although rare, HCC should be included when considering the etiology of
      intrahepatic bile duct obstruction. Imaging features suggestive of the diagnosis
      by MR include intrabiliary tumor or bile duct obstruction with an associated
      hepatic mass.

PMID- 7787714
TI  - MR imaging of intrahepatic cholangiocarcinoma.
AB  - BACKGROUND: The purpose of this study was to determine the magnetic resonance
      (MR) features of intrahepatic cholangiocarcinoma. METHODS: MR imaging studies of
      seven cases of pathologically proven intrahepatic cholangiocarcinoma were
      retrospectively reviewed. RESULTS: On MR images the tumors presented as a single
      mass (N = 5) or multiple nodules (N = 2), as well-delineated (N = 5) or ill
      defined (N = 2), and as nonencapsulated (N = 7). Mean tumor diameter ranged from
      6-14 cm (mean, 10 cm). On T1-weighted (TR/TE = 400-600/10-17 msec) images, the
      tumors were hypointense compared to the liver. The five tumors studied with
      dynamic MR imaging showed progressive centripetal filling-in after intravenous
      administration of a gadolinium chelate. On T2-weighted (TR/TE = 2000-2500/80-100
      msec) images, all tumors were hyperintense compared to the liver; five were
      markedly hyperintense and two moderately hyperintense. Vascular encasement, bile
      duct dilatation within the tumor, and central scar were depicted on MR images in
      four, three, and two tumors respectively. CONCLUSION: The typical MR appearance
      of intrahepatic cholangiocarcinoma is a large well-delineated nonencapsulated
      tumor associated with intrahepatic venous encasement.

PMID- 7787715
TI  - Cystic peripheral cholangiocarcinoma: sonography and CT.
AB  - A case of cystic peripheral cholangiocarcinoma is presented. Both sonography and
      computed tomography (CT) demonstrated a large intrahepatic cystic neoplasm
      containing an enhancing solid portion. Despite the very rare incidence of this
      tumor, we believe that cystic degeneration of peripheral cholangiocarcinoma
      should be considered with these radiologic findings.

PMID- 7787717
TI  - Chylous ascites: CT and ultrasound appearance.
AB  - An unusual but pathognomonic appearance of chylous ascites was observed on
      computed tomographic (CT) and ultrasound examinations of the abdomen in a patient
      with AIDS and disseminated tuberculosis. The images showed gradual development of
      fat-fluid level in the peritoneal collection when the patient maintained a
      recumbent position. The explanation for this phenomenon is provided together with
      a brief review of pertinent literature.

PMID- 7787716
TI  - Undifferentiated embryonal sarcoma of the liver treated with chemotherapy: CT
      imaging in four patients.
AB  - BACKGROUND: The purpose of this study was to describe the computed tomography
      (CT) findings of undifferentiated embryonal sarcoma after chemotherapy and to
      correlate the CT imaging findings with pathologic findings. METHODS: Ten CT
      images obtained before and after chemotherapy in four patients with hepatic
      undifferentiated embryonal sarcoma were retrospectively reviewed and correlated
      with pathologic findings. RESULTS: After chemotherapy, tumor volume decreased by
      50-90% and initially nonresectable tumor or gross residual tumor was successfully
      excised in three patients. In all patients, enhancing peripheral solid portions
      and septations changed to low-attenuation areas, and in three patients increased
      or de novo calcifications were found at the periphery of the tumor. Resected
      pathologic specimen after chemotherapy showed well-encapsulated masses with
      central necrosis, fibrosis, and dystrophic calcifications. CONCLUSIONS: These CT
      findings will be useful in monitoring the treatment response of hepatic
      undifferentiated embryonal sarcoma during chemotherapy.

PMID- 7787718
TI  - Direct spread of subperitoneal disease into solid organs: radiologic diagnosis.
AB  - The subperitoneal space is the continuous space interconnecting the peritoneum
      and retroperitoneum and the abdominal organs. This report expands the concept of
      direct spread of disease via the subperitoneal space to include direct extension
      into the solid abdominal viscera (i.e., liver, kidneys, and spleen). Discussion
      of the anatomy, case presentations, and imaging with computed tomography,
      ultrasound, and magnetic resonance are presented. This unifying concept provides
      an understanding for direct spread of disease presenting clinically or being
      imaged within a solid abdominal organ.

PMID- 7787719
TI  - Sonography of acute appendicitis in pregnancy.
AB  - BACKGROUND: Clinical evaluation of acute appendicitis is difficult in pregnant
      patients. Delay in diagnosis is associated with increased fetal mortality. The
      purpose of our study was to assess the value of sonography in the diagnosis of
      acute appendicitis in pregnant women. METHODS: We obtained sonograms in 22
      pregnant women suspected of acute appendicitis. All sonograms were performed
      using graded-compression to detect an enlarged appendix. The sonographic criteria
      for acute appendicitis were detection of a noncompressible blindended and tubular
      multilayered structure of maximal diameter greater than 6 mm. RESULTS: The
      sonographic findings were correlated with surgical findings in seven cases and
      clinical follow-up in 15 cases. Acute appendicitis was diagnosed by sonography in
      three of 22 patients, and in all but one was confirmed by surgical and pathologic
      findings. In the remaining 19 patients, 15 improved on clinical followup; three
      were shown to have a normal appendix at surgery and one had focal acute
      inflammation at the tip of the appendix. CONCLUSIONS: Our experience suggests
      that graded-compression sonography is a useful procedure in pregnant patients
      suspected of acute appendicitis and has a similar accuracy as in nonpregnant
      women, especially in the first and second trimester.

PMID- 7787721
TI  - Turcot's syndrome: a new case in the first decade of life.
AB  - A case of Turcot's syndrome is described in an 8-year-old girl. Turcot's syndrome
      is a rare hereditary disease in which malignant glioma of the central nervous
      system is associated with colonic polyposis. The patient initially presented with
      a left parietal glioblastoma diagnosed by computed tomography (CT), and was
      subsequently found to have nonfamilial colonic polyposis.

PMID- 7787720
TI  - Nonpalpable rectus sheath hematoma clinically masquerading as appendicitis: US
      and CT diagnosis.
AB  - Within a period of 5 years, we encountered three patients with a small rectus
      sheath hematoma, presenting with clinical signs of appendicitis. The rectus
      sheath hematoma was diagnosed by ultrasound (US) in all three cases and confirmed
      by computed tomography (CT) in two. None of the hematomas was palpable and in two
      of three cases in which the patient did not receive anticoagulant therapy. In
      patients who are sonographically examined for suspected appendicitis, the
      abdominal wall should be studied as well, to exclude a nonpalpable rectus sheath
      hematoma. In cases in which a hematoma is found, an unnecessary appendectomy can
      be prevented.

PMID- 7787722
TI  - Niemann-Pick disease type C: nodular splenomegaly.
AB  - Niemann-Pick type C disease (NPCD) is an autosomal recessive storage lipidosis
      due to a disorder of cholesterol esterification leading to the accumulation of
      sphingomyelin and cholesterol in the brain, liver, and spleen. The disease is
      usually diagnosed when neurological symptoms appear. We report an unusual
      presentation of NPCD in a young asymptomatic adult with isolated nodular
      splenomegaly.

PMID- 7787724
TI  - Multilocular cystic renal cell carcinoma presenting as a solid mass: radiologic
      evaluation.
AB  - BACKGROUND: Multilocular cystic renal cell carcinomas (MCRCCs) are a recently
      described variety of renal cell carcinoma with characteristic pathological and
      clinical features. We found that the radiologic appearances of MCRCCs of smaller
      size did not fulfill the previously documented criteria of the MCRCCs. This study
      was conducted to analyze the radiologic characteristics of MCRCCs of smaller
      sizes. METHODS: The radiologic findings of 13 multilocular cystic renal cell
      carcinomas of diameter ranging from 10-32 mm (average 22 mm) seen in nine
      patients were analyzed in correlation with pathologic findings. RESULTS: On US,
      the tumors were predominantly hyperechoic (11 of 13 tumors) with or without small
      anechoic areas. Precontrast CT showed the lesions to be either hypodense or
      hyperdense depending on the presence of hemorrhage. Degree of contrast
      enhancement was usually slight. The mean increase in CT attenuation was 28 +/- 19
      (mean +/- standard deviation) at dynamic phase and 12 +/- 10 at delayed phase. On
      MR imaging, signal intensities of the tumors were high both on T1- and T2
      weighted images (7 of 9 tumors) due to proteinaceous fluid or hemorrhage. Dynamic
      enhanced MR imaging revealed irregular contrast enhancement within the tumor (5
      of 6 tumors). Angiography failed to reveal neovascularity. CONCLUSION: Although
      multiple cysts were seen within the tumors pathologically, MCRCCs of smaller
      sizes appeared solid on radiologic examinations. However, contrast enhancement or
      neovascularity was very slight.

PMID- 7787723
TI  - Herniation of small bowel through the falciform ligament: CT demonstration.
AB  - A case of intestinal obstruction with strangulation due to a hernia through a
      rent in the falciform ligament is presented to emphasize the diagnostic role of
      CT imaging in patients without previous surgery.

PMID- 7787725
TI  - Emphysematous pyelonephritis with resultant emphysematous cholecystitis secondary
      to hematogenous dissemination.
AB  - Both emphysematous pyelonephritis and emphysematous cholecystitis are uncommon,
      but potentially fatal, clinical entities. The simultaneous diagnosis of these two
      entities in the same patient has not previously been reported. In this paper, we
      describe a 68-year-old diabetic male who presented acutely with emphysematous
      pyelonephritis and emphysematous cholecystitis. This case demonstrates several
      important diagnostic and treatment considerations. Additionally, the unique
      circumstances of this case offer support for the proposal that emphysematous
      cholecystitis may often be secondary to hematogenous seeding/embolic phenomena
      rather than obstruction of the cystic duct. Prompt diagnosis is essential, as
      prompt intervention can minimize mortality and morbidity.

PMID- 7787726
TI  - Ureteral lymphoma: MRI demonstration.
AB  - A case of ureteral lymphoma with no other areas of involvement was incidentally
      discovered on MRI examination. Bilateral ureteral soft tissue infiltration,
      asymmetrical hydronephrosis, and abnormal enhancement of lymphomatous tissue were
      noted. A follow-up MRI after chemotherapy demonstrated significant decrease in
      the size of the periureteral disease and improvement in the extent of
      hydronephrosis.

PMID- 7787727
TI  - MRI of pelvic neurofibromatosis.
AB  - Pelvic neurofibromatosis is a rare disease and rarely involves the prostate. A 19
      year-old male presented with irritative and obstructive voiding symptoms.
      Magnetic resonance imaging showed a large mass extending from the sacral
      promontory to the perirectal and perivesical spaces and to the proximal root of
      the penis. The mass also involved the prostate. The characteristics of the mass
      were highly suggestive for neurofibroma. Prostate biopsy showed neurofibroma, and
      the immunohistochemistry stain for S-100 protein was positive.

PMID- 7787728
TI  - Cricopharyngeal bar: myth and reality.

PMID- 7787729
TI  - Compensatory renal hypertrophy.

PMID- 7787730
TI  - Barium studies in esophageal cicatricial pemphigoid.
AB  - BACKGROUND: Cicatricial pemphigoid (CP) (benign mucous membrane pemphigoid) is a
      rare, blistering disease of skin and mucous membrane. The disease rarely extends
      to involve the esophagus, and there are only a few cases reported in the
      radiological literature. The aims of this study were to document the frequency of
      esophageal involvement and to describe the findings on upper GI barium studies.
      METHODS: A total of 197 patients with CP were seen at our institution from 1981
      to 1991. The clinical and radiological findings of these patients were reviewed
      and compared with findings reported in the literature. RESULTS: Esophageal
      involvement was documented in seven patients. Cervical esophageal webs were found
      in five of the seven patients. Two patients had single esophageal webs while
      three had multiple webs. Frank strictures of the esophagus were also seen in five
      patients. These were most common in the cervical esophagus, but strictures were
      also found in the mid and lower esophagus. Two of the strictures resulted in
      significant dysphagia and required multiple endoscopic dilatations. One of the
      dilatations was complicated by mucosal injury, and follow-up barium examination
      showed dissection of the esophageal mucosa from the cervical esophagus to the
      esophagogastric junction. One patient demonstrated intramural
      pseudodiverticulosis in the cervical esophagus. Functional disturbances
      demonstrated on barium studies included tracheal aspiration in two patients and
      nasopharyngeal reflux in three. CONCLUSIONS: CP involves the esophagus in
      approximately 5% of cases. The hypopharynx and cervical esophagus are most
      commonly involved, but any portion of the esophagus may be involved, and multiple
      levels of involvement may be seen. Cervical esophageal webs, often multiple or
      complex, are the most common appearance on barium studies, but frank strictures
      are also found. Secondary manifestations of esophageal involvement include
      nasopharyngeal reflux, tracheal aspiration, and intramural pseudodiverticulosis.

PMID- 7787731
TI  - Expression of S100 beta in sensory and secretory cells of the vertebrate inner
      ear.
AB  - We evaluated anti-S100 beta expression in the chick (Gallus domesticus) inner ear
      and determined that: 1) the monomer anti-S100 beta is expressed differentially in
      the vestibular and auditory perikarya; 2) expression of S100 beta in the afferent
      nerve terminals is time-related to synapse and myelin formation; 3) the
      expression of the dimer anti-S100 alpha alpha beta beta and monomer anti-S100
      beta overlaps in most inner ear cell types. Most S100 alpha alpha beta beta
      positive cells express S100 beta, but S100 beta positive cells do not always
      express S100 alpha alpha beta beta. 4) the expression of S100 beta is diffused
      over the perikaryal cytoplasm and nuclei of the acoustic ganglia but is
      concentrated over the nuclei of the vestibular perikarya. 6) S100 beta is
      expressed in secretory cells, and it is co-localized with GABA in sensory cells.
      7) Color thresholding objective quantitation indicates that the amount of S100
      beta was higher (mean 22, SD +/- 4) at E19 than at E9 (mean 34, SD +/- 3) in
      afferent axons. 8) Moreover, S100 beta was unchanged between E11-E19 in the
      perikaryal cytoplasm, but did change over the nuclei. At E9, 74%, and at E21, 5%
      of vestibular perikarya were positive. The data suggest that S100 beta may be
      physically associated with neuronal and ionic controlling cells of the vertebrate
      inner ear, where it could provide a dual ionic and neurotrophic modulatory
      function.

PMID- 7787732
TI  - Ileum brush border alkaline phosphatase activity in an experimental model of
      chronic alcoholism after small bowel proximal resection in the rat.
AB  - Literature reports that chronically ingested ethanol induces changes in the
      morphology of the small bowel mucous membranes. It has a topical toxic effect on
      the epithelium of the proximal jejunum and a blood-borne effect on the epithelium
      of the ileum because its absorption is almost complete in the stomach, duodenum
      and proximal jejunum. In addition there are also reports showing stimulation of
      enterocyte proliferation after segmental intestine resection. In this report we
      compare a group of rats submitted to resection of the proximal jejunum and fed a
      liquid diet containing 35% of the total calories intake as ethanol for four weeks
      to its control pair-fed group. In both groups we studied the mucosal alkaline
      phosphatase (APase) activity by histochemical as well as biochemical methods. We
      found a decreased APase activity in the homogenate of the intestinal mucous
      membrane in the alcoholic group and a reduced enzymatic activity in the brush
      border of the ileum enterocytes, as demonstrated by histochemical qualitative and
      densitometric assays. The result suggests that this change in APase activity of
      the brush border may represent enterocyte immaturity induced by long-standing
      ethanol intake in the remnant ileum after proximal resection.

PMID- 7787733
TI  - Mixed culture of pericytes and endothelial cells from fetal microvessels of the
      human placenta.
AB  - To explore the role of perivascular cells in angiogenesis and vasomotricity,
      placental cultures of perivascular cells were performed from calibrated villi
      excised from term placentas. Microvessels were isolated using repeated digestion
      of villi by collagenase-dispase and purification by Percoll gradients. Plated on
      Petri dishes, the microvessels became adherent to the gelatin matrix permitting
      to cells to proliferate. Cells were harvested and subcultured. Endothelial and
      pericyte cell lines were identified by phase contrast microscopy. Pericyte number
      predominated rapidly, the endothelial cells remaining visible. After seven days,
      cells started to cluster, thus piled up and built numerous nodules. Medium-size
      oval endothelial cells were stained by anti-von Willebrand factor and anti-IgG
      coupled to fluorescein. Large cells with irregular border reacted to smooth
      muscle anti-alpha-actin and anti-IgG coupled to fluorescein. There was no cross
      reaction of these two cell types with the antibodies. In contrast, nodules were
      stained by both immunostainings. Endothelial cells reacting to von Willebrand
      factor antibody were frequently associated to the nodule. The isolation of
      microvessels from the human placenta described in this study allowed the
      establishment of cultures of endothelial cells and pericytes that show: i) rapid
      predominance of pericytes over endothelial cells, ii) formation of nodules, iii)
      participation of endothelial cells and pericytes to nodules formation.

PMID- 7787735
TI  - Differential expression of c-fos proto-oncogene in two subclones derived from a
      human ovarian cancer cell line.
AB  - The expression of the c-fos proto-oncogene was studied in two sublines of the
      human ovarian cancer cell line SW626. One subline (SW/B) presents the typical 2.0
      kb mRNA which is detectable within 15 min. after serum stimulation of quiescent
      cells, is inducible by protein synthesis inhibitors and has a half-life of
      approximately 10-15 min. The other subline (SW/A) does not show the 2.0 kb mRNA,
      but instead presents a mRNA of higher molecular weight capable of hybridizing
      with the c-fos probe. This bigger mRNA is neither serum inducible nor sensitive
      to protein synthesis inhibitors. The presence of this transcript is not due to
      any gross alteration in the gene structure. Differences were found in the DNA
      binding proteins obtained from nuclei of the two sublines. A protein able to bind
      the promoter of c-fos was found in SW/B but not in SW/A. In the latter subline no
      amplification products were observed using two different sets of primers covering
      the 3' coding region of the human gene. Conversely, the expected fragments were
      amplified from mRNA obtained from the SW/B subline.

PMID- 7787734
TI  - Hypoxia and reoxygenation of brain endothelial cells in vitro: a comparison of
      biochemical and morphological response.
AB  - Reactive oxygen species are thought to be important for a variety of pathological
      processes in the brain. Endothelial cells have been proposed as both a
      significant source of oxidants and targets of oxidative damage. Therefore, lipid
      peroxidation (LPO) was investigated and compared to biochemical and morphological
      alterations in cultured pig brain capillary endothelial cells after hypoxia (120
      min. 95% N2/5% CO2) and reoxygenation (30 min. 95% O2/5% CO2). The content of
      thiobarbituric acid reactive substances (TBARS) representing radical-induced LPO
      was 2.50 +/- 0.46 after hypoxia and 5.92 +/- 0.54 nmol/mg protein after
      reoxygenation (p < 0.05 each, vs. normoxic control 1.79 +/- 0.21). During
      hypoxia, ATP content decreased to 7.9 +/- 1.6 nmol/mg protein; lactate
      dehydrogenase activity in the incubation solution increased to 0.17 +/- 0.03 U/mg
      protein; (p < 0.05 vs. control 15.7 +/- 3.1 and 0.09 +/- 0.02, respectively).
      After hypoxia, morphological changes in lysosomes, multivesicular bodies and
      vacuoles were observed in contrast to normoxic cells. During reoxygenation, the
      ATP values were normalized; electron micrographs showed increasing amounts of
      lysosomes, multivesicular bodies, vacuoles, blebs and lipofuscin granula and
      lyzed cells. Comparing the biochemical and morphological observations, a sequence
      of disturbances occurred, in which energy depletion was accompanied and followed,
      respectively, by membrane destruction, cellular disintegration and an increase in
      LPO products. These results support the assumption that the damage of brain
      endothelial cells caused by hypoxia and reoxygenation is accompanied by
      peroxidation of membrane lipids.

PMID- 7787736
TI  - Scanning ion microscopy mapping of basement membrane elements and arterioles in
      the kidney after selenium-silver interaction.
AB  - The effects of selenium and silver salts was studied by scanning ionic microscopy
      during experimental argyria mapping of the different basement membrane elements.
      The ionic microscope (IMS 4F) was equipped with a high resolution spectrometer
      giving high spatial resolution on the image obtained. After long-term treatment
      with silver salt alone, silver and sulphur deposits were observed in the
      membranes. After administration of selenium and silver salt, it was possible to
      map nitrogen, sulphur, selenium and silver to the glomerular basement membrane as
      well as to the wall of the kidney arterioles. In the latter, sulphur, selenium
      and silver were localized only in the elastic laminae of the walls. This process
      of precipitation of silver deposits in the membrane can be interpreted as process
      of selenium "detoxification" of the organism.

PMID- 7787737
TI  - Subcellular localization of gadolinium injected as soluble salt in rats: a
      microanalytical study.
AB  - The rare earth gadolinium (Gd) is used in modern industry. Solubilized DTPA Gd
      and DOTA Gd complexes are used as contrast media in nuclear magnetic resonance
      imaging. In order to determine the subcellular localization of Gd, rats were
      injected intraperitoneally with Gd nitrate. Two microanalytic methods, ion
      microanalysis and electron microprobe, enabled the distribution and the
      intracellular localization of Gd to be determined in the liver, spleen, bone
      marrow, kidneys and lung. The results showed: a) a punctual distribution of Gd in
      the tissues (liver, spleen, bone marrow and lung) as observed by ion microscopy;
      b) a selective concentration of Gd in the lysosomes of macrophages of the liver
      (hepatocytes), spleen (macrophages), bone marrow (macrophages) and lung
      (phagocyte cells), as determined by electron probe X-ray microanalysis. In all
      these sites the Gd is associated to phosphorus. Results are compared to those
      found for other rare earths and metal elements.

PMID- 7787738
TI  - A new procedure for the preparation of highly active melonin from the dry seeds
      of Cucumis melo L.
AB  - Melon (Cucumis melo L.) dry seeds contain melonin, a protein that strongly
      inhibits ribosomes from different prokaryotic and eukaryotic sources including
      those from melon. The protein was purified by a new method to yield highly active
      and stable protein preparations that involves chromatography through S-Sepharose
      Fast Flow, CM-Sepharose, Superdex 75 and Mono-S. Melonin shows important
      functional properties: 1) its inhibitory effects on translation were
      irreversible; 2) it is a single unglycosylated polypeptide chain with an apparent
      M(r) of 22000; 3) it degrades RNA in a dose-dependent way without affecting DNA.
      In the light of present results melonin can be considered as a new plant RNase of
      unusual properties.

PMID- 7787739
TI  - Correlation between membrane potential changes and proliferation of murine
      peritoneal lymphocytes stimulated by Nocardia water soluble mitogen.
AB  - A comparative study of Nocardia water soluble mitogen (NWSM) action on membrane
      potential and proliferation rate of murine peritoneal lymphocytes was performed
      at various incubation times. The membrane surface charge was evaluated by laser
      doppler velocimetry (LDV) through the measurement of the cell electrophoretic
      mobility at different pH values (from pH 5 to 9). We demonstrated that NWSM
      treatment decreases the lymphocyte membrane potential. This variation reached a
      maximal level after 24 hrs. at pH 7 and remained unchanged during the 72 hrs.
      observation. A significant stimulation of lymphocyte proliferation was noted
      after a 24 hrs. incubation. However, the highest rate of [3H]-thymidine
      incorporation was observed at 48 hrs. with a subsequent decrease at 72 hrs. On
      the basis of these data, it is suggested, that membrane potential changes may
      represent an early important step in the mechanism of lymphocyte activation by
      NWSM, as it has been shown for some mitogenic compounds.

PMID- 7787740
TI  - Internalization of Candida albicans and cytoskeletal organization in macrophages
      and fibroblasts treated with concanavalin A.
AB  - This paper investigates the ability of macrophages and of non-typically
      phagocitic cells such as fibroblasts to internalize 51Cr-labelled C. albicans in
      presence or in absence of lectin concanavalin A (Con A). The results obtained
      demonstrate that fibroblasts are also able to internalize C. albicans and that
      this property is potentiated by the presence of Con A. Lectin modifies only the
      phenotype of the fibroblast, which, poorly attached to the substrate, is globular
      in shape. Despite reduced cellular spreading, phagocytosis is stimulated by the
      lectin. In both cell populations, changes in the organization of some
      cytoskeletal proteins such as tubulin, actin and alpha-actinin are evident during
      the C. albicans infection; such rearrangements are more evident and longlasting
      in the fibroblasts treated with Con A.

PMID- 7787741
TI  - Morphological changes in human erythrocytes induced in vitro by antiarrhythmic
      drugs.
AB  - Several hypotheses suggest that the molecular mechanism of action of class I
      antiarrhythmic drugs (AAD) involve non-specific interactions of these compounds
      with phospholipid bilayers of the myocardial membrane that surround and
      functionally modulate ion transport by sodium channels. As a result of these
      interactions the channel function would be altered. To probe the validity of
      these hypotheses three AAD with different degrees of lipophilicity were made to
      interact in vitro with human erythrocytes in a wide range of concentrations. The
      most lipophilic drug was asocainol (ASOC), the least one was procainamide (PROC)
      while the lipophilicity of the third, quinidine (QUIN), lay somewhere between the
      other two. The observations made by scanning electron microscopy (SEM) showed
      that the three AAD produced profound shape alterations to the incubated
      erythrocytes. However, the type and intensity of these changes were dependent on
      the drug under study and its concentration.

PMID- 7787742
TI  - Electron microscopic lectin histochemistry of the trabecular meshworks in human
      eyes.
AB  - Ten normal human trabecular meshworks were examined by electron microscopy using
      avidin-biotin complex in order to investigate the localization of binding sites
      of eight lectins. The tissue specimens were fixed in paraformaldehyde and
      glutaraldehyde mixture and embedded in Lowicryl K4M at low temperature. The
      ultrathin sections were stained with biotin labelled lectins and colloidal gold
      labelled streptoavidin and were observed with the conventional transmission
      electron microscope. Some lectins such as ABA, ConA and DSA were localized on
      fine fibrils underneath the endothelium of the trabecular wall of the Schlemm's
      canal, electron-dense cores of elastic fibers, fine granular like materials,
      basement membranes, collagen fibers and the long-spacing fibers. However, the
      other lectins such as DBA, SBA, Lotus, UEA-I and RCA60 were not specifically
      localized in these tissues. From the results it was demonstrated that the
      differential ultrastructural localization of glycoconjugate residues in the human
      trabecular meshworks can be revealed using this lectin staining.

PMID- 7787744
TI  - Spontaneous lipid peroxidation and sperm metabolism during incubation in media
      simulating the oviductal microenvironment.
AB  - It has been suggested that along the female genital tract spontaneous lipid
      peroxidation regulates the limit of the lifetime of spermatozoa. We have studied
      some aspects of rabbit and mouse spermatozoal metabolism during spontaneous lipid
      peroxidation in the course of the incubation in media which simulate the
      oviductal environment. The spermatozoa collected at regular intervals after the
      beginning of incubation were processed for cytochemical detection of cytochrome
      oxidase, lactate dehydrogenase and glucose-6-phosphate dehydrogenase activities.
      Quantitative cytochemical assays were made in situ in individual spermatozoa by
      microdensitometry. The cytochrome oxidase activity significantly decreased in
      both species because of damage to mitochondrial enzymes and membranes by radical
      and non-radical products of lipid peroxidation. The change in lactate
      dehydrogenase activity indicates that under our experimental conditions the lipid
      peroxidation process damages membrane permeability more markedly in mouse
      spermatozoa. The glucose-6-phosphate dehydrogenase activity, which should
      influence the concentration of reduced glutathione through production of NADPH,
      is more extensively enhanced in mouse spermatozoa than in rabbit spermatozoa.
      This is in agreement with the fact that in mouse spermatozoa the glutathione
      system is the major protective defence against oxidative damage while in rabbit
      spermatozoa it is superoxide dismutase.

PMID- 7787743
TI  - Effects of preservation solutions on cortical and medullary mitochondria of rat
      kidney.
AB  - The mitochondria isolated from cortex and medulla of rat kidneys were examined
      after storage in either Euro-Collins solution, in Bretschneider's histidine
      tryptophan-ketoglutarat solution or in Belzer's University of Wisconsin solution
      at 25 degrees C or at 4 degrees C for a maximum of 4 to 24 hrs. Independently to
      the preservation of the solution used, the storage of the kidneys led to a
      decrease in state 3 respiration and uncoupled respiration as well as to an
      increase in the rate of state 4 respiration. The decrease in state 3 respiration
      ran parallelly to a decrease in adenine nucleotides. For the homogeneous
      protection of the mitochondria as well from the cortex as from the medulla, the
      Bretschneider's solution had the best preservative effect at a storage
      temperature of 25 degrees C as shown by the measured mitochondrial parameters. At
      4 degrees C storage temperature, the differences in action with the various
      examined solutions were markedly smaller. However, compared to the other two
      solutions, the Euro-Collins solution showed a more favourable protective effect
      on cortical and medullary mitochondria.

PMID- 7787745
TI  - Immunosuppression-associated lymphoproliferative disorders in rheumatic patients.
AB  - The association between rheumatic disease and the occurrence of hematolymphoid
      neoplasms has been a subject of investigation for many years. Recently, we and
      others have reported the development in rheumatic patients of lymphoproliferative
      disorders that are similar to those occurring in patients with known
      immunocompromised states. The lymphoid neoplasms that develop in patients with
      immunosuppression are characterized by several features including the presence of
      EBV genome in the neoplastic cells. The fact that lymphomas with features of
      those occurring in immunosuppressed patients can occur in patients with rheumatic
      disease suggests that immune system impairment secondary to the rheumatic
      disease, the treatment given for the rheumatic disease, or to a combination of
      these factors, might play a role in the development of lymphoma in these
      patients. This review will first describe the characteristics of
      lymphoproliferative disorders that occur in patients with known immunocompromised
      states. It will then review general aspects of lymphomas in rheumatic patients
      with a focus on more recent reports that have described the development of
      immunosuppression-associated lymphoproliferative disorders in rheumatic patients.
      Studies that investigate the relative contribution of the rheumatic disease
      versus therapy for rheumatic disease in the development of lymphoma in this
      patient group are still needed.

PMID- 7787746
TI  - Acute leukemia with structural rearrangements of chromosome 3.
AB  - Cytogenetic investigations have distinguished at least 3 distinct clinical
      cytogenetic syndromes of hematopoietic malignancy with structural rearrangement
      of 3q. The majority of cases have breakpoints at both 3q21 and 3q26, frequently
      associated with monosomy 7, abnormal thrombopoiesis, and adverse outcome. Cases
      with only one of these breakpoints may have milder features of the syndrome. A
      subgroup with t(3q;5q) occurs in younger patients, occasionally with
      megakaryocytic dysplasia but rarely having thrombocytosis. The t(3;21) is
      encountered in secondary leukemias or after chemotherapy of myeloproliferative
      disorders. The genetic deregulations associated with each of these syndromes
      involve distinct genes on 3q. The majority of cases of acute leukemias with 3q
      rearrangements have a poor prognosis and do not respond to current modes of
      therapy.

PMID- 7787748
TI  - Biopathologic features of Hodgkin's disease.
AB  - The neoplastic nature of Hodgkin's disease (HD) is suggested by several lines of
      evidence, including aggressive clinical course, presence of proliferating
      atypical cells morphologically recognized as Hodgkin's and Reed-Sternberg cells
      (H-RS), aneuploidy, and, in the minority of cases, clonality. Nevertheless, the
      etiopathogenesis of HD still remains elusive, and probably diverse. This
      uncertainty is partly due to the peculiar histology of HD lesions, characterised
      by the paucity of the putative neoplastic cell component, i.e. H-RS cells,
      admixed to a variety of reactive cells which prevent an exhaustive investigation
      at molecular level. Nevertheless, the possible involvement of different molecules
      with oncogenic potential has been recently suggested on the basis of
      immunohistological and molecular biology studies. These include oncogenes such as
      bcl-2 and MDM2 and anti-oncogenes such as p53. In addition, a large amount of
      data has accumulated on the possible role of EBV infection in HD. The
      colonization of lymphoid tissues by immortalized H-RS cells can account for the
      derangement of cytokine networks leading to microenvironmental and systemic
      abnormalities. In addition, a variety of soluble receptors (sIL-2R, sCD30, sTNF
      R), and adhesion molecules (sICAM-1) are abnormally produced at sites of disease
      involvement. Some of these molecules still retain the ability to bind their
      ligands and can potentially contribute to the derangement of immune mechanisms
      observed in HD. Many of these soluble molecules can also be found in the
      patient's sera providing new potential prognostic and follow-up parameters in HD
      patients. The comparative analysis of the same molecules within the tissue, using
      immunohistochemistry, and in the blood, using immunochemical assays, appears as a
      promising informative approach.

PMID- 7787747
TI  - Differential usage of an autoantibody-associated VH gene, VH4-21, by human B-cell
      tumors.
AB  - Selection of immunoglobulin variable region genes for recombination in B cells
      takes place from among those VH and VL gene segments available in the
      unrearranged germ line repertoire. In the case of neoplastic B cells, there is
      apparent deviation in the use of V-genes from that expected on a random basis,
      both for VH and for VL. Also, the preferred V-genes, and their patterns of
      mutation, differ among the various categories of B-cell tumor possibly reflecting
      the distinct origins and clonal histories on the individual tumor cells. This
      review focuses on a single VH gene, VH4-21, which is a member of the VH4 family,
      and which appears selectively to encode immunoglobulins with autoantibody
      activity, particularly anti-red cell antibodies. The pattern of usage of this VH
      gene by B-cell tumors demonstrates clear asymmetry among different tumor types.
      Also, the mutations detected in this relatively non-polymorphic gene indicate
      that antigen, possibly autoantigen, may influence the behavior of the tumor cell.

PMID- 7787750
TI  - Adhesion properties of adult T cell leukemia cells.
AB  - The interaction between neoplastic as well as normal T cells and vascular
      endothelial cells which is mediated by adhesion molecules play a key role in
      their trafficking, localization and infiltration. This brief article reviews our
      studies on the expression of adhesion molecules on leukemic cells isolated from
      patients with adult T cell leukemia (ATL) and HTLV-I-infected T cell line cells
      and on their adhesion to human umbilical vein endothelial cells (HUVEC). Fresh
      ATL cells expressed lymphocyte function-associated antigen-1 (LFA-1), but the
      expression of very late antigen-4 (VLA-4) and sialyl-Lewis(x) (SLex) was
      variable. Sialyl Lewis(a) (SLea) was not detected. Cell adhesion assays using
      HUVEC and adhesion-blocking antibodies revealed the consistent E-selectin
      mediated adhesion and variable VLA-4-mediated adhesion of ATL cells to HUVEC. The
      studies on HTLV-I-infected T cell lines confirmed the above data. These results,
      together with the detection of E-selectin expression on the endothelium of the
      skin infiltrated with ATL cells, indicate that E-selectin-mediated adhesion is
      the major pathway for the adherence of ATL cells to endothelial cells. The
      possible role of such adhesion in the formation of skin lesions and other
      clinical manifestations of ATL which result from the infiltration of leukemic
      cells is discussed.

PMID- 7787749
TI  - Is there a place for immunotherapy with interleukin-2 to prevent relapse after
      autologous stem cell transplantation for acute leukemia?
AB  - Chemotherapy-resistant cells cause disease recurrence in a significant proportion
      of patients with acute leukemia treated with autologous stem cell transplantation
      due to the lack of immune-mediated effects which contribute significantly to the
      prevention of post-treatment disease recurrence. This conclusion is based on the
      observation that relapse after high dose chemotherapy supported by a stem cell
      transplant from a twin donor is 3-4 times higher than after transplant from an
      allogeneic donor. This anti-leukemic mechanism of transplanted donor cells has
      been termed graft-versus-leukemia (GVL) effect, and efforts are being directed
      toward utilizing such an immune-mechanism after autologous transplantation. Since
      interleukin-2 (IL-2) can induce remissions in selected patients with advanced
      leukemia, it has become a candidate cytokine to be used in attempts to introduce
      GVL after autologous stem cell transplantation. Here we review the available
      clinical data with IL-2 and critically evaluate whether IL-2 has a place as
      adjunct treatment to prevent relapse after autologous transplantation for acute
      leukemia.

PMID- 7787751
TI  - Cytokine gene expression after allogeneic bone marrow transplantation.
AB  - Cytokines produced by T lymphocytes, monocytes/macrophages, and fibroblasts play
      a central role in the immune response and in the development of graft-versus-host
      disease (GVHD). Also, it has been reported that dysregulated production of
      cytokines maybe the primary mediator of clinical manifestation of acute GVHD.
      Regarding cytokine gene expression after human allogeneic bone marrow
      transplantation (allo BMT), we have demonstrated increased IL-1 beta, IL-6, and
      TNF-alpha mRNA expression in peripheral blood mononuclear cells during the
      development of acute and chronic GVHD and that the degree of the increase was
      dependent on the severity of the disease. Furthermore, overexpression of these
      cytokine mRNAs could be detected before the clinical manifestations of GVHD
      developed. In contrast, IL-2 mRNA expression was not detected in peripheral blood
      mononuclear cells in GVHD patients. On the other hand, we have reported that
      increased mRNA expression and protein product of IL-2 and IFN-gamma were evident
      in the mixed lymphocyte culture of the cases who developed severe lethal
      transplantation-related complications. Therefore, the detection of increased IL-2
      and IFN-gamma gene expression in MLC appeared to be useful for predicting
      transplantation-related complications in BMT patients. Furthermore, we found
      increased IL-2 receptor alpha subunit mRNA expression in the peripheral blood
      mononuclear cells during GVHD. These findings may indicate the important role of
      inflammatory cytokines such as IL-1 beta, IL-6 and TNF-alpha in the development
      of the clinical manifestation of GVHD and also may be indicative of the important
      role of IL-2 and the IL-2 receptor in allo response perhaps mainly as an
      autocrine effect.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787752
TI  - Epstein-Barr virus-associated hemophagocytic syndrome.
AB  - A virus-associated hemophagocytic syndrome (VAHS) is a non-neoplastic,
      generalized histiocytic proliferation with prominent hemophagocytosis associated
      with a systemic viral infection. Epstein-Barr virus (EBV) is one candidate for
      this association but serologic and molecular biologic studies have been lacking
      in many cases. Although VAHS is generally a benign process, EBV-associated
      hemophagocytic syndrome (EBV-AHS) is often fatal and has a relatively high
      mortality rate. Therefore, EBV-AHS must be distinguished from VAHS caused by
      other viruses. Recent evidence indicates that the pathophysiology in EBV-AHS
      appears to be mediated by the unrestricted release of cytokines produced by the
      EBV-infected T cells. Clinical and laboratory findings, the differential
      diagnosis, virology studies, pathophysiology, and treatment in EBV-AHS are
      reviewed.

PMID- 7787754
TI  - Treatment of acute promyelocytic leukemia in patients presenting at Vancouver
      General Hospital from 1983 to 1992.
AB  - Between 6/83 and 8/92, 23 of 361 patients (6.4%) presenting at Vancouver General
      Hospital with acute myelogenous leukemia had acute promyelocytic leukemia (APL).
      Treatment plan was: 1) induction with high-dose cytosine arabinoside and an
      intercalator; and 2) consolidation with allogeneic bone marrow transplantation
      (BMT) for those aged < or = 50 years with a sibling donor or repeat of induction
      for the the others. Complete remission (CR) was achieved in 20 patients (87%).
      Eleven patients in CR were eligible for allogeneic BMT; 4 were considered
      unsuitable, 2 refused, and 5 underwent this treatment--1 died of acute graft
      versus-host disease, 1 relapsed and 3 are leukemia-free and well 1.6, 3.3 and 3.9
      years after diagnosis. Fifteen patients did not undergo allogeneic BMT in CR; 4
      received no further treatment and all died, 2 relapsed before consolidation
      therapy and both died, 1 underwent autologous BMT and died of complications, and
      8 received consolidation treatment as planned--1 died of sepsis, 2 relapsed and 5
      are leukemia-free and well 1.0, 3.8, 4.5, 4.9 and 8.5 years after diagnosis. The
      actuarial overall survival for all 23 patients was 38% (95% confidence interval
      [CI] 18-57%). The actuarial 2-year leukemia-free survival was 60% (95% CI 20-85%)
      for the 8 patients who underwent consolidation chemotherapy as planned and 53%
      (95% CI 68-86%) for the 5 patients who underwent allogeneic BMT in CR. These
      results suggest that patients with APL who are able to undergo consolidation
      chemotherapy have a relatively good prognosis and allogeneic BMT may reasonably
      be held in reserve for salvage therapy.

PMID- 7787753
TI  - Treatment of newly diagnosed acute promyelocytic leukemia (APL) by all
      transretinoic acid (ATRA) combined with chemotherapy: The European experience.
      European APL Group.
AB  - All transretinoic acid (ATRA) gives complete remission (CR) rates of 80 to 90% in
      newly diagnosed acute promyelocytic leukemia (APL). However, it has two major
      drawbacks (1) a rapid rise in WBC in some patients, with potentially fatal ATRA
      syndrome (2) rapid relapse with maintenance therapy using ATRA alone or low dose
      chemotherapy. The French APL group therefore designed a treatment approach with
      ATRA followed by intensive chemotherapy. The latter was administered after CR
      achievement with ATRA, or was rapidly added to ATRA in case of rapid rise in
      leukocyte counts. This combined approach, in a pilot study and in a randomized
      trial, proved superior to intensive chemotherapy alone, by slightly increasing
      the CR rate but more importantly by reducing the relapse rate. These results were
      confirmed by the Chinese, Japanese and New York groups. Our group (and other
      European groups) are now testing in a new randomized trial the better timing of
      ATRA and chemotherapy administration (ATRA followed by chemotherapy or ATRA plus
      chemotherapy) and the role (after an intensive consolidation) of maintenance
      treatment with intermittent ATRA, continuous low dose chemotherapy or both.

PMID- 7787755
TI  - Cutaneous lymphocytic vasculopathy in lymphoproliferative disorders--a
      paraneoplastic lymphocytic vasculitis of the skin.
AB  - In this report the histopathology and the natural history of cutaneous
      lymphocytic vasculopathy (lymphocytic vasculitis) in patients with
      lymphoproliferative diseases, is described. Between January 1986 and June 1992,
      116 patients with non-Hodgkin lymphomas (NHL) and chronic lymphocytic leukemias
      (CLL) were followed. Among them 3 patients with NHL, one with angioimmunoblastic
      lymphadenopathy/lymphoma and 7 with CLL developed cutaneous vasculitic changes
      during the course of their disease (incidence of 9.5%). All patients had advanced
      stage disease. Lymphomas were of B-cell origin and either low or intermediate
      grade. The median time between the diagnosis of NHL or CLL and the appearance of
      skin manifestations was 18 months. Recurrent vasculitic changes involving
      exclusively the skin, was characterized by a (maculo)papular rash, most commonly
      found in the upper and lower extremities. Pruritus of varying intensity was
      present in 82% of the patients. In the biopsy, all had perivascular and/or vessel
      wall lymphocytic infiltration of the dermis with occasional red cell
      extravasation. Immunohistochemical staining revealed that these infiltrates were
      mainly composed of T-lymphocytes. We conclude, that cutaneous lymphocytic
      vasculopathy is a relatively common paraneoplastic skin manifestation in patients
      with lymphoproliferative diseases and histologically is characterized as
      lymphocytic vasculitis with (peri)vascular infiltration by non-malignant T
      lymphocytes.

PMID- 7787756
TI  - Establishment and characterization of a new Ph1-positive chronic myeloid leukemia
      cell line MC3 with trilineage phenotype and an altered p53 gene.
AB  - A new Ph1-positive leukemic cell line (MC3) expressing the P210bcr/abl
      oncoprotein was established from a patient with CML in blast crisis. The MC3
      cells showed the trilineage phenotype of myeloid, lymphoid (CD19) and
      megakaryocytoid lineages, and had a proliferative response to rhIL-1 and rhIL-3
      in the serum-free culture. These results and the expression of CD34 indicated
      that the MC3 cells have characteristics of hematopoietic progenitor cells.
      Recently, it has been documented that alterations of the p53 gene in leukemic
      cells are frequently detected during the blast crisis of CML. The MC3 cells
      contained the altered p53 gene. In addition, the original leukemic cells showed
      the point-mutational activation of the N-ras gene and an additional chromosomal
      abnormality inv(3q), but the MC3 cells contained no such abnormalities,
      indicating that not all of the original leukemic cells had these abnormalities.
      Thus, the MC3 cell line may provide several insights into investigations of the
      blast crisis in CML as well as hematopoietic progenitor cells.

PMID- 7787757
TI  - Acute myeloblastic leukemia associated with an intermediate state between the
      healthy carrier state and adult T-cell leukemia.
AB  - This report describes an intermediate state between the human T-cell lymphotropic
      virus type I (HTLV-I) healthy carrier and adult T-cell Leukemia (ATL) who
      developed acute myeloblastic leukemia (AML, FAB subtype M2). The polyclonal
      integration of HTLV-I proviral DNA was demonstrated in the peripheral blood
      lymphoid cells, whereas AML cells had no HTLV-I proviral DNA. The patient
      achieved remission after combination chemotherapy but cells with lobulated nuclei
      persist at a low level and the polyclonal integration of HTLV-I proviral DNA is
      still demonstrated. We suggest that the patients with the integration of HTLV-I
      proviral DNA might develop secondary neoplasms more frequently than healthy
      carriers and this case stresses the need to exercise caution with these patients.
      The relationship between HTLV-I and AML is briefly discussed.

PMID- 7787760
TI  - Receptors on astrocytes--what possible functions?
AB  - Receptors for transmitters, as varied as those expressed by neurons, have been
      described on primary astrocyte cultures prepared from new-born rats and mice. A
      variety of functional effects and considerable cell-to-cell and regional
      heterogeneity have been observed for such receptors in vitro. The various systems
      available for studying the presence and properties of receptors on astrocytes in
      situ, and the results from these studies, are discussed. Much fewer studies using
      these more difficult systems have been done. So far, some resemblances and
      differences between in situ and in vitro work have been observed. More of these
      in situ studies, to supplement the ongoing in vitro work, are needed to enable us
      to determine unequivocally which receptors are present on astrocytes, and their
      functions in vivo. If there is cell-to-cell and CNS regional heterogeneity in
      vivo comparable to that seen in vitro, these analyses will be very complex. To
      illustrate the importance and variety of receptor-linked functions, a number of
      suggestions are made in this commentary, based on current proposals for the roles
      of astrocytes. However, it is argued that we need to have a more complete
      understanding of astrocyte functions in vivo, before we can really understand the
      functional significance of astrocyte receptors.

PMID- 7787759
TI  - Kinins and kinin receptors in the nervous system.
AB  - Kinins, including bradykinin and kallidin, are peptides that are produced and act
      at the site of tissue injury or inflammation. They induce a variety of effects
      via the activation of specific B1 or B2 receptors that are coupled to a number of
      biochemical transduction mechanisms. In the periphery the actions of kinins
      include vasodilatation, increased vascular permeability and the stimulation of
      immune cells and peptide-containing sensory neurones to induce pain and a number
      of neuropeptide-induced reflexes. Mechanisms for kinin synthesis are also present
      in the CNS where kinins are likely to initiate a similar cascade of events,
      including an increase in blood flow and plasma leakage. Kinins are potent
      stimulators of neural and neuroglial tissues to induce the synthesis and release
      of other pro-inflammatory mediators such as prostanoids and cytotoxins
      (cytokines, free radicals, nitric oxide). These events lead to neural tissue
      damage as well as long lasting disturbances in blood-brain barrier function.
      Animal models for CNS trauma and ischaemia show that increases in kinin activity
      can be reversed either by kinin receptor antagonists or by the inhibition of
      kinin production. A number of other central actions have been attributed to
      kinins including an effect on pain signalling, both within the brain (which may
      be related to vascular headache) and within the spinal dorsal horn where primary
      afferent nociceptors can be stimulated. Kinins also appear to play a role in
      cardiovascular regulation especially during chronic spontaneous hypertension.
      Presently, however, direct evidence is lacking for the release of kinins in
      pathophysiological conditions of the CNS and it is not known whether spinal or
      central neurones, other than afferent nerve terminals, are sensitive to kinins. A
      more detailed examination of the effects of kinins and their central pharmacology
      is necessary. It is also important to determine whether the inhibition of kinin
      activity will alleviate CNS inflammation and whether kinin receptor antagonists
      are useful in pathological conditions of the CNS.

PMID- 7787758
TI  - Anaplastic myeloma.
AB  - Anaplastic myeloma (AM) represents a rare variety of multiple myeloma (MM) with
      poor prognosis. One case with special interest is reported, which presented with
      manifestations due to the extramedullary localization and arose in the absence of
      an initial diagnosis of MM. In addition, differential diagnosis was based on
      morphological and immunocytochemical findings while treatment with radio
      chemotherapy had no effect on the extramedullary sites.

PMID- 7787761
TI  - Interaction between [3H]flunitrazepam and [3H]GABA binding in the cerebellum of
      reeler mice.
AB  - It has been shown that in the cerebellum of reeler mutant mice GABA levels and
      GABA uptake increase while GABA binding decreases. This study shows that in the
      cerebellum of these mutants there is also an increase of benzodiazepine
      receptors. This increase is observed in cerebellar homogenates, in nuclei and in
      membranes. The increase in the density of central (i.e. clonazepam displacable)
      benzodiazepine receptors is primarily reflected in binding sites located in the
      GABA-receptor complex. In comparison to wild-type, GABA-modulin extracted from
      reeler cerebellum inhibits with a greater potency [3H]GABA binding. The increase
      in the central-type of benzodiazepine binding and its interaction with GABA
      binding, observed in cerebellar membranes, is interpreted as a functional
      response to the decrease in GABA binding and may reflect benzodiazepine receptor
      condensation and/or changes of subunit composition of the GABA/benzodiazepine
      receptor complex. The enhanced activity of reeler GABA-modulin reflects a
      functional response to the increased GABA levels in reeler cerebellum. The
      increase of the peripheral-type (i.e. PK 11195 displacable) of benzodiazepine
      receptors is probably due to metabolic changes that may accompany reeler
      cerebellar mutation. Differences in nuclear benzodiazepine binding between reeler
      and wild-type mice add a physiological importance to the nuclear binding of this
      drug.

PMID- 7787762
TI  - Novel halogenated analogs of tomoxetine that are potent and selective inhibitors
      of norepinephrine uptake in brain.
AB  - Halogenated analogs of the potent norepinephrine (NE) uptake inhibitor,
      tomoxetine, were synthesized and their affinities for the serotonin (5HT) and NE
      uptake sites evaluated. One of the most potent was the 2-iodo substituted analog
      (289306) that inhibited [3H]tomoxetine binding to rat cerebral cortex with a Ki
      of 0.37 nM. The compound also inhibited the uptake of [3H]NE into rat
      hypothalamic synaptosomes with a Ki of 3.5 nM. This analog was significantly less
      potent at the 5HT uptake site, as exhibited by a Ki of 25 nM in the inhibition of
      [3H]paroxetine binding and a Ki of 121 nM in [3H]5HT uptake. The resolved (R)
      enantiomer (303926) was 10 times more potent as a [3H]NE uptake inhibitor and 29
      times more potent as an inhibitor of [3H]tomoxetine binding than the (S)
      enantiomer (303884). Administration of 289306 to rats prior to an i.c.v.
      injection of 6-hydroxydopamine prevented the depletion of hypothalamic NE and Epi
      with ED50 values of 0.28 and 0.47 mg/kg, respectively. Thus, 289306 was a potent
      inhibitor of NE uptake in vitro and in vivo. In addition, these compounds provide
      structures for potential ligands for the study of NE uptake sites by
      autoradiography, PET or SPECT imaging.

PMID- 7787763
TI  - Inhibitory effects of antidepressants on NMDA-induced currents in Xenopus oocytes
      injected with rat brain RNA.
AB  - Although it has been reported that desipramine affects ion-channel activity of
      NMDA receptor/ion-channel complexes, the binding sites remain unclear. To
      identify the binding site, influences of desipramine on NMDA-induced current were
      examined in Xenopus oocytes injected with rat brain RNA and compared with those
      of blockers, MK-801, Zn2+ and Mg2+. Application of 100 microM desipramine
      irreversibly inhibited NMDA-induced inward current as well as 1 microM MK-801.
      Mg2+ and Zn2+ showed a reversible inhibition. Pretreatment with Mg2+ or Zn2+
      abolished the irreversible inhibition of desipramine. In contrast, the
      irreversible inhibition of desipramine was still observed after application of
      Mg2+ and Zn2+. These results suggest that Mg2+/Zn2+ and desipramine bind on
      different sites from each other and affect the cation permeability via different
      mechanisms. Regarding inhibitory effects of other antidepressant drugs,
      imipramine and setiptiline were found to markedly inhibit NMDA current, while
      maprotiline, amitriptyline and lofepramine slightly inhibited the current.
      Mianserin, a potent antagonist of 5-HT1c receptors, however, had no influence.

PMID- 7787764
TI  - Interaction of rat brain phosphofructokinase with Alzheimer's beta A4-amyloid.
AB  - One of the key functional disturbances in incipient dementia of Alzheimer type is
      the reduction of cerebral glucose utilization. Morphologically the brains of
      Alzheimer patients are characterized by multiple depositions of beta A4-amyloid
      mainly within extracellular senile plaques and in the walls of cerebral blood
      vessels, but also attached to intracellular neurofibrillary tangles.
      Intracellular beta A4-amyloid may bind to other cellular components. The
      interaction of beta A4-amyloid with phosphofructokinase, one of the key enzymes
      in glycolysis, was studied in vitro under various conditions. beta A4-amyloid was
      found to bind in nanomolar concentrations to phosphofructokinase and decrease its
      activity. Binding was demonstrated by enzyme linked immunoassays and by gel
      filtration studies. Inactivation of phosphofructokinase by beta A4-amyloid could
      only partially be prevented by fructose 6-phosphate. In control experiments no
      interaction was detectable between lactate dehydrogenase and beta A4-amyloid.

PMID- 7787765
TI  - Methamphetamine-induced nuclear c-Fos in rat brain regions.
AB  - To explore the possible robust changes in neuronal activity in dopamine-poor
      brain regions after an indirect dopamine agonist, methamphetamine, we have
      investigated its effects on c-fos expression in rat brain using
      immunocytochemistry of c-Fos. Intraperitoneal injection of methamphetamine (1.6
      4.8 mg/kg), but not of saline, induced a widespread nuclear c-Fos-like
      immunoreactivity in the pyriform cortex and olfactory tubercle with greatest
      density followed by the II-VI layers of the neocortex, amygdala, hypothalamus,
      thalamus, nucleus accumbens and striatum. These expression patterns resemble
      those elicited by amphetamine and suggest that not only the dopamine-rich
      subcortical regions but also the cerebral cortex may play a crucial role in
      behavioral abnormality induced by methamphetamine.

PMID- 7787766
TI  - Rapid and gentle extraction, reconstitution and characterization of microfilament
      and glia filament from rat astrocytes.
AB  - We developed gentle and rapid methods for depolymerization and extraction of both
      microfilament and glia filament separately from a crude cytoskeletal fraction of
      rat astrocytes. Electron microscopy revealed that the filament reconstituted from
      the microfilament extract closely resembled F-actin that was formed from G-actin
      of rabbit skeletal muscle. It was found by immunoblotting analysis that even the
      reconstituted microfilament-like filaments, which had been purified by affinity
      chromatography with heavy meromyosin subfragment 1 (S1)-conjugated Sepharose,
      contained vimentin and glia fibrillary acidic protein (GFAP) besides actin,
      inferring the interaction between microfilament and glia filament. The filaments
      (9-10 nm thick) reconstituted from the glia filament extract were composed of
      actin and other minor components in addition to vimentin and GFAP. Actin, GFAP,
      101, 34, 32.5, 30.5, 29.5 and 28 kDa proteins found in the reconstituted glia
      filament-like filaments were suggested to be glia filament-associated proteins.

PMID- 7787768
TI  - Glutamatergic receptor kinetics are not altered by perinatal exposure to
      aspartame.
AB  - Observation of reduced levels of glutamic acid and aspartic acid in brain of
      weanling rats exposed perinatally to aspartame prompted a study of the effect of
      this food additive on glutamatergic receptor kinetics. Aspartame 500 mg/kg/day in
      drinking water was administered to Sprague-Dawley rats throughout gestation and
      lactation. Brain was excised from weanlings 20-22 days old, and kinetics of the N
      methyl-D-aspartate receptor and total glutamatergic binding in cerebral cortex
      and hippocampus were found to be unaffected by perinatal exposure to high levels
      of aspartame. Glutamic acid was decreased in both brain regions studied, and
      aspartic acid was decreased in hippocampus following perinatal aspartame
      exposure. These changes were reversible when aspartame administration was
      terminated. It is concluded that perinatal exposure to high doses of aspartame
      does not alter glutamatergic neurotransmission in cerebral cortex or hippocampus
      from weanling rats.

PMID- 7787767
TI  - Dephosphorylation of abnormal sites of tau factor by protein phosphatases and its
      implication for Alzheimer's disease.
AB  - The abnormally phosphorylated forms of tau factor are major constituents of
      neurofibrillary tangles in Alzheimer's disease brain. In order to investigate
      protein phosphatases which are related to dephosphorylation of abnormal
      phosphorylation sites, we examined the dephosphorylation of tau factor
      phosphorylated by three proline-directed type protein kinases. Tau factor
      phosphorylated by cdc2 kinase and tau protein kinase II was dephosphorylated by
      the holoenzyme of protein phosphatase 2A and calcineurin, while either the
      catalytic subunit of protein phosphatase 2A or protein phosphatase 2C could not
      catalyze the dephosphorylation. From the kinetic analysis, we concluded that tau
      factors phosphorylated by the protein kinases serve as good substrates for
      protein phosphatase 2A and calcineurin. On the other hand, tau factor
      phosphorylated by glycogen synthase kinase 3 alpha was dephosphorylated by the
      catalytic subunit of protein phosphatases 2A as well as the holoenzyme of protein
      phosphatase 2A and calcineurin. It has been reported that serines 199, 202 and
      396 according to the numbering of the longest human tau isoform are among the
      major abnormal phosphorylation sites of tau factor. We synthesized two
      phosphopeptides which contained phosphoserines 199 and 202 or phosphoserine 396
      and prepared the polyclonal antibodies specific for the phosphopeptides. Using
      these antibodies, we confirmed that the holoenzyme of protein phosphatase 2A and
      calcineurin could dephosphorylate phosphoserines 199, 202 and 396 in tau factor.
      The catalytic subunit of protein phosphatase 2A could dephosphorylate
      phosphoserine 396 but not phosphoserines 199 and 202. Neurofibrillary tangles in
      Alzheimer's disease brain were immunostained with both antibodies but the normal
      neurons in the normal aged brains were not. The results suggest that protein
      phosphatase 2A and calcineurin can be involved in the dephosphorylation of
      abnormal phosphorylation sites in tau factor and that the dephosphorylation of
      phosphoserine 396 is differently regulated from phosphoserines 199 and 202.

PMID- 7787769
TI  - Differential characteristics and regulation of arylamine and arylalkylamine N
      acetyltransferases in the frog retina (Rana perezi).
AB  - Arylamine N-acetyltransferase activity (A-NAT: E.C.2.3.1.5) from Rana perezi
      retina was studied using p-phenetidine as specific substrate. Enzyme
      characteristics and regulation were compared with respect to the arylalkylamine N
      acetyltransferase (AA-NAT: E.C.2.3.1.87) from the same tissue. A-NAT activity is
      distributed in both neural retina and choroid-pigmented epithelium complex,
      showing a 10-fold higher specific activity in neural retina. In contrast, AA-NAT
      activity is restricted to neural retina. Subcellular localization in neural
      retina indicated that both enzymatic activities are in the supernatant fraction
      (39,000 g, 20 min). p-Phenetidine acetylation was linear as a function of the
      neural retina amount in the assay (1/16 to 1 retina), and it is insensitive to
      phosphate buffer pH in the range 6.5-8.4. A-NAT kinetic showed a hyperbolic shape
      for both cosubstrates. Kinetic constants were KM = 11.2 microM, Vmax = 0.49
      nmol/h/mg prot. for p-phenetidine (50 microM acetyl-CoA), and KM = 113.4 microM,
      Vmax = 3.1 nmol/h/mg prot. for acetyl-CoA (5 mM p-phenetidine). The additivity
      test for both enzymatic activities in retina homogenates demonstrated that both
      acceptor amines do not compete for the catalytic sites. Serotonin addition in the
      assay modifies differentially the kinetic characteristics of both enzymes.
      Serotonin acted as a strong mixed inhibitor, mainly competitive in nature
      (competitive Ki = 18.1 microM; non-competitive Ki = 1.9 mM) for AA-NAT. However,
      it acted as a weak inhibitor with respect to A-NAT, mainly non-competitive,
      (competitive Ki = 5.7 mM; non-competitive Ki = 8.7 mM).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7787770
TI  - Inhibitory effects of lithium ion on intracellular Ca2+ mobilization in the rat
      hippocampal slices.
AB  - Lithium is well established as a treatment of manic-depressive illness. As for
      the mechanism of action of lithium, it is proposed that lithium has effects on
      intracellular calcium ion (Ca2+) movement. But there are few reports in which the
      effects of lithium on intracellular Ca2+ movement are observed in the mammalian
      brain. We therefore examined the effects of lithium on intracellular Ca2+ changes
      in the rat hippocampal slices with a Ca2+ sensitive dye fura-2, and analyzed by
      means of a fluorescence microscope, a video-camera and photometrical devices.
      From the results of treatment with various noradrenergic agonists or antagonists,
      noradrenaline (NA)-induced intracellular Ca2+ change appears to be mainly
      mediated by alpha 1-adrenoceptors (AR) rather than alpha 2- or beta-AR.
      Furthermore, they are considered to be mediated by both alpha 1A-AR and alpha 1B
      AR, and to be partly dependent on extracellular Ca2+. Lithium decreased NA
      induced intracellular Ca2+ mobilization by attenuation of T1/2 rather than a
      change in the peak value, and antagonized ouabain-induced intracellular Ca2+
      increase. Lithium may therefore suppress intracellular Ca2+ movement by enhancing
      the extrusion of intracellular Ca2+.

PMID- 7787771
TI  - Single cell RT-PCR proceeds without the risk of genomic DNA amplification.
AB  - We have previously described a method for detection of mRNAs expressed in single
      cells after patch-clamp recordings. The method, termed single cell RT-PCR,
      involves aspiration of the cell content, a reverse transcription (RT) step, and a
      polymerase chain reaction (PCR) using specific primers. Since the nucleus is
      frequently harvested together with the cytosol, genomic DNA may generate false
      positive results. Thus, we demonstrated that dilutions containing a few copies of
      plasmid could be detected by PCR in a range which, according to the Poisson law,
      suggests that the PCR method can amplify from the two genomic alleles. We
      performed single cell RT-PCR of intronless GluR2 or GluR5 fragments by comparing
      cerebellar cell types where these mRNAs are known to be present or absent. For
      each cell the nucleus was harvested together with the cytosol. Following RT-PCR
      with GluR5 primers, all Purkinje cells (n = 6) yielded the expected PCR product,
      whereas it was not generated from any of the granule cells (n = 5). In
      corresponding experiments with GluR2 primers, we obtained the GluR2 product from
      all Purkinje cells (n = 5), but not from any of the glial cells (n = 5). These
      results are in agreement with the known cellular expression of GluR2 and GluR5
      mRNAs. We conclude that the single cell RT-PCR method does not amplify the
      genomic DNA when the nucleus is aspirated together with the cytosol. We suggest
      that genomic DNA amplification is avoided, because the genomic alleles are not
      exposed during the procedure.

PMID- 7787772
TI  - Increased axonal regrowth of lesioned rat sciatic nerve by veratrylguanidine
      methane sulfonate.
AB  - Neurotrophic factors appear as essential factors for normal development and
      repair of the nervous tissue. Veratrylguanidine methane sulfonate, has been shown
      to induce important neurite outgrowth of cultured dorsal root ganglia isolated
      from newborn rats. Its action was similar to that of NGF and was found to be
      additive to that of NGF. In order to see if this compound was able to stimulate
      axonal growth in adult animals, we examined the effect of this substance on the
      regeneration of the lesioned sciatic nerve. Using histochemical,
      immunohistochemical and ultrastructural studies, it is shown that a single
      intraperitoneal injection of veratrylguanidine methane sulfonate significantly
      increases the axonal growth during repair of the adult rat sciatic nerve. The
      efficiency of this substance is explained by its good targeting and long life
      time in the sciatic nerve.

PMID- 7787773
TI  - The effect of insulin and insulin-like growth factor-1 on the expression of
      calretinin and calbindin D-28k in rat embryonic neurons in culture.
AB  - In a primary culture of rat embryonic neurons, insulin (5 mg/ml) promoted neurite
      formation between neuron clusters in serum/glial-free simplified medium with a
      high concentration of transferrin (100 micrograms/ml). Insulin growth factor-1
      (IGF-1) exerted a similar effect in the same culture system at a lower dose (100
      ng/ml) of insulin. Calretinin has recently been identified as a calcium binding
      protein expressed predominantly in sensory neurons, which has six calcium binding
      domains and shows molecular similarity to calbindin D-28k, an intestinal calcium
      transporter protein also found in the CNS. The effects of insulin and IGF-1 on
      the expression of calretinin and calbindin D-28k were investigated in rat
      embryonic neuronal cell culture. When cells were cultured for 2 days, insulin and
      IGF-1 promoted the expression of both proteins; when cultured for more than 2
      days, IGF-1 still exerted a growth factor effect, but insulin decreased the
      expression of calretinin. Using the present culture system, we demonstrated that
      the effects of closely related molecules, insulin and IGF-1 which share receptors
      reciprocally, differed in calretinin and calbindin D-28k expression. Therefore,
      these two calcium binding proteins may play different physiological roles in the
      nervous system based either on different molecular mechanisms or switching roles
      at different stages of CNS development. Amplification based on Western blot
      employing the streptoavidin-horseradish peroxidase method was applied to detect
      calretinin and calbindin D-28k in the culture system by an immunoblotting
      technique.

PMID- 7787774
TI  - Ascorbate/Fe(3+)-induced peroxidation and inhibition of the binding of A1
      adenosine receptor ligands in rat brain membranes.
AB  - The effect of peroxidation induced by the ascorbate/Fe3+ system on the binding
      properties of the A1 adenosine receptor, was studied in rat brain membranes,
      using the agonist, [3H]R-N6-phenylisopropyladenosine ([3H]R-PIA), and the
      antagonist, [3H]1,3-dipropyl-8-cyclopentylxanthine ([3H]DPCPX). For the agonist,
      as well as for the antagonist, the number of binding sites (Bmax) was
      significantly (P < 0.05) reduced after pretreatment of the membranes with
      ascorbate/Fe3+. The affinity of the agonist for the binding sites was not
      statistically modified (P > 0.05) after ascorbate/Fe3+ pretreatment, whereas the
      Kd value of the antagonist was increased (P < 0.05) by a factor of 2.
      Ascorbate/Fe3+ pretreatment affected agonist binding in the presence of GTP in a
      similar way as that observed in the absence of GTP, suggesting that peroxidation
      also affects agonist binding to A1 adenosine receptors uncoupled to G-proteins.
      The results suggest that when brain membranes suffer free radical oxidative
      damage, the adenosine modulation of neuronal activity through A1 receptors could
      be less efficient.

PMID- 7787776
TI  - Thiamine homeostasis in neuroblastoma cells.
AB  - We recently showed that thiamine uptake by neuroblastoma cells is mediated by two
      saturable transport system: the first with high affinity for thiamine (Km = 35
      nM) is blocked by veratridine; the other, with low affinity is blocked by Ca2+.
      The driving force for thiamine uptake is its phosphorylation to thiamine
      diphosphate (TDP) by thiamine pyrophosphokinase and subsequent binding of this
      cofactor to apoenzymes. Our results suggest that cells of neuronal origin possess
      mechanisms regulating the intracellular concentration of thiamine. At low
      external thiamine, the vitamin is taken up by a high-affinity transporter and
      pyrophosphorylated in thiamine diphosphate (TDP): this is the TDP pool of slow
      turnover. An intraover extracellular concentration gradient of free thiamine is
      observed at low external concentration of the vitamin. At higher external
      thiamine concentration, TDP accumulation is limited by the binding capacity to
      the apoenzymes and unbound TDP (i.e. a small pool of fast turnover) is quickly
      hydrolyzed. Thiamine is slowly released by the cells by at least two different
      mechanisms. The first, accounting for a maximum of 50% of total thiamine release,
      is stimulated by external thiamine and is blocked by veratridine, suggesting that
      it is a self-exchange mechanism catalyzed by the high affinity thiamine
      transporter. The remaining thiamine efflux is neither sensitive to veratridine
      nor to Ca2+ and its mechanism is unknown. About 25% of intracellular thiamine is
      not released, even after treatment of the cells with digitonin, thus maintaining
      an apparent gradient. This suggests a binding or sequestration in intracellular
      compartments.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787775
TI  - Multiple neurotrophic factors including NGF-like activity in nerve regeneration
      chamber fluids.
AB  - Silicone nerve regeneration chambers were implanted between the cut ends of the
      sciatic nerve of adult rats. Neurotrophic activities in cell-free fluids
      collected from the chambers were determined using bioassays for survival of
      embryonic chick ciliary and sympathetic neurons in culture. Separation by
      molecular exclusion HPLC of the components of fluids collected 1, 2 or 3 days
      after implantation revealed the presence of a multitude of neurotrophic factors
      differing in their molecular weights, specificity towards the two types of
      neurons, and time course. Antiserum to nerve growth factor partially blocked
      sympathetic activity of fluids collected at 1 day. Affinity purified antibody was
      also effective and completely eliminated bioactivity of HPLC fractions
      corresponding to the molecular weight of nerve growth factor. The presence in the
      fluids of 13-18 and 20-32 kD components active towards ciliary neurons is
      consistent with the release of fibroblast growth factor and ciliary neurotrophic
      factor respectively. The stimulation of sympathetic neurons by the 13-18 kD
      material, and also by 4-6 and 7-11 kD components cannot be entirely accounted for
      by known factors. This study demonstrates that a number of neurotrophic factors,
      which differ in their specificity towards sympathetic and parasympathetic
      neurons, are made available to the region of axonal regrowth over the first few
      days of regeneration. Contrary to earlier reports, nerve growth factor-like
      activity was shown to be present in nerve regeneration chambers.

PMID- 7787778
TI  - rHuGM-CSF after high-dose chemotherapy in post-remission acute leukemia.
AB  - Post-remission high-dose chemotherapy has been an important advance in the
      treatment of adult acute leukemia (AAL). Without the use of colony-stimulating
      factors (CSFs) in this program, the mortality rate varies from 5 to 17%, and
      infectious complications arise in more than 50%. These findings limit the
      widespread use of such forms of therapy. The use of high-dose ara-C (HIDAC) alone
      or in combination with other drugs is the most common regimen studied, however
      neither other drug combinations nor the addition of supporting CSFs have been
      extensively explored. For this reason we studied the effect of high-dose
      cyclosphosphamide-etoposide (CECY) plus recombinant human granulocyte-macrophage
      (rHuGM)-CSF with the intention of decreasing morbimortality and prolonging
      disease-free survival (DFS). Since 1992 we have included 51 complete remission
      patients with AAL in the CECY plus rHuGM-CSF protocol. The maximal
      myelosuppression occurred in a mean of 6.4 days, and the mean days required for
      absolute neutrophil count recovery was 13 days and for platelets 21 days (p <
      0.0001). No toxic deaths occurred and only two serious infectious complications
      were seen. After two years of follow-up, 50% of de novo acute myelogenous
      leukemia patients had relapsed at 13 months, and 50% of de novo adult acute
      lymphocytic leukemia patients had relapsed at 15 months. In a recent update, we
      have not seen a significant difference when compared to historic groups. The CECY
      protocol does not appear to be superior in prolonging DFS compared to HIDAC as a
      post-remission strategy for newly diagnosed AAL. The main difference was the
      absence of toxic deaths and minimal serious infectious complications in the CECY
      protocol. Therefore, we suggest that the use of rHuGM-CSF in post-remission
      programs should be included in future studies.

PMID- 7787780
TI  - Unstable triplet repeat sequences: a source of cancer mutations?
AB  - Numerous mutations have been related to various types of cancer. Short tandem
      repeats (STRs) are repetitive DNA elements that are often polymorphic in normal
      populations. Triplet repeat expansion has been related pathogenetically to six
      diseases: fragile X syndrome, fragile X E syndrome, spinobulbar muscular atrophy,
      myotonic dystrophy, Huntington's disease, and spinocerebellar ataxia type 1. The
      characteristics of the GC-rich repeat expansion are diverse and result in
      profound changes in phenotype, sometimes within a single generation in affected
      families. We expect that simple repeat expansion will cause some cancers based on
      our knowledge of these unstable DNA sequences in the previously mentioned genes.
      This may occur by alteration of tumor suppressor gene expression, alteration in
      coding features of proteins, or change in bystander oncogene expression such as
      that which occurs with DNA methylation. The demonstrated meiotic instability
      could link this mechanism of mutation of familial cancer syndromes. The recent
      discovery of STR instability at multiple sites in hereditary nonpolyposis colon
      cancer suggests sequence instability may be a factor in cancer progression.
      Continued identification of candidate genes containing triplet repeats should
      allow a ready testing of the hypothesis that unstable simple repeat sequences can
      cause cancer.

PMID- 7787779
TI  - Platelet glycoprotein IIb gene expression as a model of megakaryocyte-specific
      expression.
AB  - Glycoprotein (GP)IIb/IIIa is an integrin complex normally restricted in its
      expression to platelets and the megakaryocytes from which they are derived. This
      complex functions as a receptor for fibrinogen and other ligands and is involved
      in platelet aggregation. The receptor complex is expressed at high levels during
      final megakaryocyte differentiation. Further, while GPIIIa is expressed in other
      tissues as part of the vitronectin receptor, GPIIb is only expressed on maturing
      megakaryocytes and the platelets derived from them. Thus studies of the GPIIb
      gene may serve as a model of gene regulation during this process. Over the past
      several years, the genes for both GPIIb and IIIa have been cloned and analyzed.
      The GPIIb gene contains 30 exons over 18 kilobases (kb). The transcriptional
      start site has been determined and there does not appear to be a TATA-box
      immediately upstream of this site. Studies have been done to define regulatory
      elements upstream of the transcriptional start site. Most of these studies
      focused on the human promoter and on studies using megakaryocytic cell lines.
      These studies have defined several important tissue-specific promoter elements
      including a GATA454 site (454 basepairs upstream of the transcriptional start
      site that involves a GATA-binding consensus sequence), a GATA54 site and an Ets35
      site (that involves an Ets-binding consensus sequence). Expression studies with
      megakaryocytic cell lines suggest that each of these sites effects expression
      approximately threefold. Further, an Ets510 site was also described that had a
      similar effect. While these studies were underway, we pursued studies of the rat
      5'-flanking region using a rat primary marrow expression system. Qualitatively,
      our data support the human data; however, quantitatively, we found significant
      differences from the human studies done in cell lines. We found that the major
      tissue-specific promoter element was the GATA454 site. Mutations altering this
      site result in an approximately fiftyfold drop in expression. In comparison,
      eliminating the Ets510 site by truncation or point mutation had only a twofold
      effect on expression. Mutations at the Ets35 site did effect expression at a high
      level, decreasing expression approximately fifteenfold, while mutations at the
      GATA54 site effected expression by approximately ninefold. In addition, using 50
      bp deletions, we have preliminarily defined two domains from -450 to -351 bp and 
      150 to -101 bp upstream of the transcriptional start site that effected
      expression. The former appears to contain a positive regulatory element, while
      the latter appears to be a silencer element.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7787777
TI  - Retention and multilineage expression of human hematopoietic stem cells in human
      sheep chimeras.
AB  - We have taken advantage of the permissive environment of the early gestational
      age fetus to engraft human hematopoietic stem cells (HSC) into preimmune fetal
      lambs. The resulting chimeras exhibit long-term multilineage engraftment of human
      cells in the bone marrow (BM) and peripheral blood (PB). Long-term multilineage
      reconstitution of second generation recipients by human cells isolated from
      chimeric sheep BM indicates that the engraftment in this model involved long-term
      repopulating human HSC. The model appears to be sensitive enough to detect
      relatively small numbers of transplanted HSC from pre- and postnatal human
      sources. Finally, transplantation of mature T lymphocyte-containing cells from a
      variety of sources results in lethal graft-versus-host disease (GVHD), analogous
      to clinical BM transplantation, suggesting that, at least in some respects, the
      model is biologically relevant. The human-sheep model is promising and may have
      important advantages over murine models for the in vivo study of normal and
      abnormal hematopoiesis and as a potential assay system for human HSC.

PMID- 7787781
TI  - Hematopoietic growth factors for the treatment of severe chronic neutropenia.
AB  - Severe chronic neutropenia (SCN) is a rare but important cause of recurrent
      fevers, oropharyngeal ulcerations and severe infections. In three forms of SCN,
      i.e., congenital neutropenia (Kostmann's syndrome and related syndromes),
      idiopathic neutropenia (both childhood and adult), and cyclic neutropenia, it is
      now established that long-term treatment with the hematopoietic growth factor,
      recombinant human granulocyte colony stimulating factor (rHuG-CSF or Filgrastim),
      can elevate blood neutrophil counts to the normal range in most patients, with a
      concomitant reduction in infection-related events including fever, oral
      ulcerations, antibiotic use and symptoms of inflammation. Treatment with this
      growth factor causes an increase in the number and maturity of marrow cells of
      the neutrophilic series; other cell lines are largely unaffected. Marrow
      stimulation and expansion are reflected by the occurrence of bone pain early in
      therapy, as well as some increase in spleen size in most cases. Adverse effects
      of therapy are infrequent in both children and adults, and long-term treatment
      with daily or every-other-day s.c. injections of rHuG-CSF are well accepted.
      Because of the risk that some patients with chronic neutropenia may have or
      develop myelodysplasia and/or leukemia, careful pretreatment evaluations (blood,
      bone marrow and cytogenetics) and long-term observations are extremely important.
      An international registry for patients with SCN has been established to maintain
      records and further investigate these conditions.

PMID- 7787782
TI  - [Dynamics of the distribution of biological age for various species].

PMID- 7787783
TI  - [Mutual position of chromosome 1 homologs in human interphase lymphocyte nuclei].

PMID- 7787784
TI  - [Comparative morphometric analysis of neuroglial cells].

PMID- 7787785
TI  - [Effect of bioresonance therapy on protein synthesis in human blood lymphocytes].

PMID- 7787786
TI  - [Paternal age and lifespan of the offspring].

PMID- 7787787
TI  - [The effect of halogenated dibenzo-p-dioxins on the growth of grasses and
      assessment of the danger of contaminated phytomasses for mammals].

PMID- 7787788
TI  - [The effect of methylating lysine residues on properties of complexes of myosin
      subfragment-1 with ADP and phosphate analogs].

PMID- 7787789
TI  - [Binding of the M2-selective antagonist AF-DX 116 with frog myocardial muscarinic
      receptors].

PMID- 7787790
TI  - [Genetic analysis of sterile hybrid D. virilis x D. lummei males].

PMID- 7787791
TI  - Proceedings of the SIMEC 94, 3rd Brazilian Symposium on Extracellular Matrix. Rio
      de Janeiro, Brazil, September 11-14, 1994.

PMID- 7787792
TI  - On the monophyletic evolution of the metazoa.
AB  - 1. The shift from unicellular life to multicellular, integrated organisms has
      been accompanied by the acquisition of adhesion proteins. Recently we succeeded
      in cloning some genes coding for such proteins from the lowest multicellular
      animals, the marine sponges (model: the siliceous sponge Geodia cydonium). 2. G.
      cydonium contains several lectins and cDNA for two of them (termed LECT-1 and
      LECT-2) was cloned. Both lectins have a framework sequence of 38 conserved amino
      acids which are characteristic for the carbohydrate-binding site of vertebrate S
      type lectins. Next, we have isolated and characterized a cDNA coding for a
      receptor tyrosine kinase of class II (GCTK). The deduced amino acid sequence
      shows two characteristic domains: i) the tyrosine kinase domain and ii) an
      immunoglobulin-like domain. The latter part shows high homology to the vertebrate
      type immunoglobulin domain. This result, together with the lectin data,
      demonstrates that binding domains of such adhesion proteins are not recent
      achievements of higher animals but exist already in animals (sponges) which have
      diverged from other organisms about 800 million years ago. 3. Considering the
      fact that during embryogenesis of sponges a typical anteroposterior organization
      pattern is seen, a "homeotic" organ-like transformation has been postulated. The
      subsequent search for genes provided with the homeodomain sequence was
      successful. The deduced amino acid sequence of G. cydonium showed high homology
      to chicken and to the Antennapedia sequence from Drosophila melanogaster. 4.
      These data support the view that the kingdom Animalia is of monophyletic origin.

PMID- 7787793
TI  - Sequencing of heparan sulfate proteoglycans: identification of variable and
      constant oligosaccharide regions in eight heparan sulfate proteoglycans of
      different origins.
AB  - The sequence of the disaccharide units of eight heparan sulfate proteoglycans of
      different origins is described. All heparan sulfates contain 5 variable regions
      made of oligosaccharide blocks of disaccharides, namely, GlcUA(1-4)GlcNAc,
      GlcUA(1-4)GlcNS, IdoUA (1-4) GlcNS,6S,IdoUA-GlcNAc,6S, and IdoUA,2S(1-4)GlcNS,6S,
      besides two constant regions made of an internal tetrasaccharide (IdoUA-GlcNAc
      IdoUA-GlcNS) and monosaccharides (GlcNS, and GlcNS,6S) at the non-reducing
      terminal. The N-acetylated region of the heparan sulfates is linked to the serine
      of the protein core through a trisaccharide of Xyl-Gal-Gal. Heparan sulfates
      differ from one another in terms of the number of disaccharides that compose each
      block.

PMID- 7787794
TI  - Proteoglycans in skeletal muscle.
AB  - 1. Proteoglycans are macromolecules composed of a protein and one or more chains
      of sulfated carbohydrates, the glycosaminoglycans. Proteoglycans are found on the
      cell surface and in the extracellular matrix participating in the cell-cell and
      cell-extracellular matrix interaction. In this review I present the information
      accumulated in the past years regarding the presence, characteristics,
      localization, control of expression and alteration in some pathological states of
      skeletal muscle proteoglycans. 2. This review presents and discusses current
      information in this area and some projections for the future in four sections:
      first, the proteoglycans present in embryonic cells and cell lines from skeletal
      muscle. Second, the presence of proteoglycans in adult skeletal muscles. Third,
      the regulation of the expression of skeletal muscle proteoglycans, and fourth,
      skeletal muscle proteoglycans in pathological conditions.

PMID- 7787795
TI  - Detection of a small proteoglycan present in xiphoid cartilage regions submitted
      to different biomechanical forces.
AB  - 1. The effect of biomechanical forces on large proteoglycans and collagen of
      cartilage has deserved intensive study, enhancing the importance of these
      molecules to support a better distribution of compressive forces especially in
      articular cartilage. In the present study, other extracellular matrix components,
      non-collagenous proteins and small proteoglycans, have been evaluated in terms of
      biomechanical tension. 2. Different parts of chicken xiphoid cartilage, lateral
      (R and L) and central (C) portions, which bear different biomechanical tensions,
      were analyzed. DEAE-cellulose chromatography profiles were similar for R and L
      portions. SDS-PAGE analyses revealed proteins of 29, 60 and 70 kDa for R and L.
      The 20- and 70-kDa proteins were not detected in the C portion while the 60-kDa
      protein was present at a high level. 3. The differences found between lateral (R
      and L) and central portions of the xiphoid cartilage may be related to the
      structure of the cartilage which bears higher tension forces than the lateral
      parts.

PMID- 7787796
TI  - Matrix in signal transduction and growth factor modulation.
AB  - The extracellular matrix (ECM) is indispensable for the survival of multicellular
      organisms. It provides the adherent cells with crucial clues for migration,
      proliferation and differentiation. These clues are transmitted to the interior of
      the cell by ECM receptors like the integrins. Signaling by the ECM occurs by
      induction of assembly and disassembly of cytoskeletal structures or by modulation
      of classical signal transduction pathways such as activation of
      phosphatidylinositol-proteases, growth factors and cytokines that are
      specifically bound to its constituents and thereby stored, localized and
      modulated in terms of their biological activities. Finally, both the quantity and
      the quality of growth factor signaling appear to be dependent on the temporal and
      spatial activation of ECM receptors, supporting the requirement of a crosstalk
      between matrix and growth factor receptors.

PMID- 7787797
TI  - Myelopoietic competence of stroma composed of hepatic granuloma-derived
      connective tissue cells or skin fibroblasts.
AB  - 1. Connective tissue cells isolated from hepatic granulomas (GR cells), induced
      in mouse liver tissue by schistosomal infection, are able to sustain
      myelopoiesis, while other connective tissue cells such as skin fibroblasts (SF)
      are not. 2. We compared the ability of SF and GR cells to sustain in vitro
      proliferation of the FDC-P1 myeloid cell line, dependent upon IL-3 or GM-CSF. 3.
      Only the GR stroma sustained the proliferation of co-cultured FDC-P1 cells. RT
      PCR analysis showed that both cell lines expressed the message for GM-CSF, but
      not for IL-3. We showed that GM-CSF was produced by, and remained bound to the
      cell layer through heparan sulfate; this growth factor could be released by high
      salt treatment in a biologically active form from both cell types. The same
      activity could be restored to NaCl-treated GR cells, but not to SF, by incubation
      with recombinant murine GM-CSF. 4. These results indicate that the ability of
      connective tissue cells to sustain myelopoiesis depends directly upon the
      capacity of their heparan sulfate-bearing molecules to bind and present the GM
      CSF to the target cells in a biologically active form. Alternatively, a yet
      unidentified set of cell layer-associated molecules may be required for the
      positive or negative control of the membrane-bound GM-CSF.

PMID- 7787798
TI  - Thrombospondin: relationship to protease and growth factor/cytokine activity.
AB  - 1. The finding in the last two years of different proteins presenting structural
      homology with platelet thrombospondin (TSP-1) has permitted to establish the
      existence of a set of related genes referred to as thrombospondin family. While
      much work remains to be done concerning the characterization of the newly
      described members of the family, careful studies carried out on TSP-1 have been
      implicating this high molecular weight molecule (420-450 kDa) in a variety of
      aspects of cellular physiology. 2. The present text discusses the implications of
      the matrix-bound and fluid TSP-1 forms for cell adhesion and protease activity
      generation. Their relationships with growth factors in matrices are also
      discussed.

PMID- 7787799
TI  - The kinetics of chondroitin 4-sulfate release from stimulated platelets and its
      relation to thromboxane A2 formation and granule secretion.
AB  - 1. In platelet rich plasma (PRP), chondroitin 4-sulfate release from platelets
      occurred after stimulation with ADP (5 microM), collagen (5-10 micrograms/ml), or
      adrenaline (10 microM). Release started within 60 s and maximum release (0.7-2.0
      mg/l) was reached within 180 s. TXA2 formation and dense granule release reached
      a maximum within 90 s after stimulation. 2. Using washed platelets (1.5 x 10(8)
      cells/ml), the platelet responses were faster. Release of chondroitin 4-sulfate
      and TXA2 started within 20-30 s after thrombin addition (100 mU/ml). Maximum
      release was reached within 60 s in both cases. Dense granule release started in
      the first 5 s of stimulation (34.6 +/- 12.4%) reaching maximum secretion (74.4 +/
      8.7%) within 60 s. 3. Our results demonstrate that maximal chondroitin 4-sulfate
      release occurs after the dense granule release reaction in both PRP and washed
      platelets. This observation suggests that chondroitin 4-sulfate is unlikely to be
      stored in the dense granules but may be stored in the alpha-granules.

PMID- 7787802
TI  - Heparan sulfate proteoglycan and control of cell proliferation: enhanced
      synthesis induced by phorbol ester (PMA) during G(1)-phase.
AB  - The effect of phorbol 12-myristate-13-acetate (PMA), a tumor-promoting phorbol
      ester, on the synthesis of proteoglycans of endothelial cells in culture was
      investigated. This phorbol activates protein kinase C (PKC) when added to cells
      in culture. PKC, in turn, modulates the activity of growth factors. Using [35S]
      sulfate or [3H]-glucosamine to label the proteoglycans we have observed a 4-24
      fold increase of the heparan sulfate (HS) synthesis in a dose-dependent manner (0
      100 ng/ml). Chondroitin sulfate (CS) synthesis was not affected by PMA. The
      effect of PMA could be completely abolished by a calcium ionophore (A23187). By
      the use of synchronized cells and PMA pulses at different periods of the cell
      cycle, as well as [3H]-thymidine incorporation, we were able to show that the
      enhancement of heparan sulfate synthesis is most prominent during G1. Our data
      suggest that the release of HS to the medium could be one of the responses of the
      cell to a mitogenic stimulus.

PMID- 7787801
TI  - Adhesion to laminin is down-regulated upon retinoic acid-induced F9 cell
      differentiation: a role for alpha 6/beta 1 integrin.
AB  - F9 mouse teratocarcinoma cells have a high capacity to adhere to laminin and we
      identified alpha 6/beta 1 integrin as the principal laminin-binding protein
      present in these cells. F9 cells differentiated into parietal endoderm when
      monolayer cultures were treated with retinoic acid and dibutyryl cyclic AMP. In
      this process a decreased adherence to laminin was observed due to a lower
      expression of alpha 6/beta 1 integrin on the cell surface.

PMID- 7787800
TI  - Carbohydrate-binding proteins in cell-matrix interactions.
AB  - 1. Carbohydrate-dependent interactions have been more extensively studied during
      the last decade. Although the roles of carbohydrates in cellular functions are
      still poorly understood, the finding of carbohydrate-binding proteins in animal
      cells opened a great number of perspectives. 2. Animal lectins are associated
      with tumor progression, playing a key role in neoplastic cell interactions with
      endothelial cells and extracellular matrix glycoproteins such as laminin. 3.
      Here, we review the role of animal lectins in the migrating phenotype of
      neoplastic cells and normal cells such as T-lymphocytes.

PMID- 7787803
TI  - Binding of heparin and compound Y to endothelial cells stimulates the synthesis
      of an antithrombotic heparan sulfate proteoglycan.
AB  - The mechanism by which heparin and antithrombotic agents, including a cyclic
      octaphenolsulfonic acid (compound Y), stimulate the synthesis of an
      antithrombotic heparan sulfate by endothelial cells in culture was investigated.
      Compound Y increases the amount of heparan sulfate from the cell surface and
      secreted to the medium by endothelial cells by three-fold. Binding experiments
      have shown saturation of the endothelial cell receptors at a concentration of
      0.16 microM for heparin and 2.7 microM for compound Y. The kinetic binding
      constants (Ks) for compound Y and heparin were 1,333 nM and 42 nM, respectively.
      It was also shown that both compounds bind to the same receptors. The Scatchard
      plots indicated that 1,319 nmoles compound Y and 35 nmoles heparin bound per
      microgram cell protein, indicating that 40-fold more molecules of compound Y
      bound to the receptors when compared to heparin. No significant internalization
      of the compounds was observed.

PMID- 7787804
TI  - Scanning electron microscopy of acinar cells of rat submandibular salivary
      glands.
AB  - 1. The submandibular salivary gland of rats was observed by high-resolution
      scanning electron microscopy employing the aldehyde-osmium-DMSO-osmium method. 2.
      The intracellular membranous components and sponge-like structures of basement
      membrane containing the fine collagen fibrils of acinar cells were clearly
      identified in three-dimensional images. The granular endoplasmic reticulum and
      Golgi apparatus showed the luminal surface. The mitochondria were small, ranging
      in diameter from 0.3 to 0.5 microns, and revealed their cristae. The secretory
      granules ranged in diameter from 0.3 to 1.4 microns. Ribosome granules were
      attached to the surfaces of cisterns, and measured 20 to 25 nm in diameter. 3.
      The contact areas between the acinar cells revealed numerous cytoplasmic
      protrusions. In the striated duct cells, the mitochondria were arranged
      vertically and surrounded by basal infoldings of the plasma membranes. At high
      magnification, the mitochondrial cristae were visualized in their three
      dimensional characteristics.

PMID- 7787805
TI  - Biomatrix effect on Sertoli cells phospholipids.
AB  - In order to investigate the influence of biomatrix on Sertoli cell morphology and
      on the phospholipids content, these cells were isolated from testes of 15-day old
      Wistar rats and plated onto plastic coated with extracellular matrix extracted
      from seminiferous tubules, here denoted biomatrix. When the Sertoli cells were
      cultured on biomatrix they did not form a monolayer until day 7 of culture, while
      cells plated onto plastic did so 48 h after plating. On day 5 of culture, Sertoli
      cells were incubated for 48 h with 5 microCi/ml 32P. There was no difference in
      32P incorporation into lipids of cells plated onto biomatrix or plastic. However,
      there was a larger amount of phospholipid phosphate in cells plated onto
      biomatrix than onto plastic. When the phospholipids were analyzed by
      bidimensional thin-layer chromatography, no differences were detected in their
      distribution; however, there was a significant decrease in the percentage of
      sphingomyelin in cells plated onto biomatrix when compared to plastic. These
      results showed that the cells cultured on biomatrix change their phospholipids
      content, but not their distribution. The importance of a small reduction in
      sphingomyelin content remains to be investigated.

PMID- 7787807
TI  - Altered deposition of extracellular matrix components in the skeletal muscle and
      lymph node of the MDX dystrophic mouse.
AB  - 1. MDX mice derived from a colony of C57BL/10ScSn mice develop an X-linked
      recessive muscular dystrophy, thus providing an adequate model to study the
      pathogenesis of muscular dystrophy. 2. Skeletal myofibers of MDX mutant mice were
      heterogeneous, with disorganization of myofilaments and the absence of
      immunolabelling for dystrophin with monoclonal antibody DY4/6D3. 3. Marked
      deposition of reticulin, collagenic fiber (types, I, IV) and laminin (LN) were
      consistently present mostly around lesioned and necrotic myofibers associated
      with an intense inflammatory reaction, whereas strong immunolabelling for TIII-C,
      TIV-C and FN was often associated with regenerated fibers. 4. During the onset (3
      weeks of postnatal life) of disease and height of myonecrosis (5-6 weeks of
      postnatal life), popliteal lymph nodes showed dense argyrophilic meshwork,
      intense immunolabelling for collagens types I and IV, FN, LN and enlargement of
      the hili which were packed with mononuclear cells. Such alterations, albeit less
      intense, were still observed in MDX mice with 20 weeks of postnatal life. 5. The
      results support the view that ECM components might be influencing the migration
      of inflammatory cells and the process of myonecrosis in the skeletal muscle of
      MDX dystrophic mice.

PMID- 7787806
TI  - Cell adhesion in muscle.
AB  - 1. Attachment to extracellular matrix is thought to be particularly important for
      striated muscle cells, since skeletal and heart muscle have to withstand
      considerably strong forces. 2. We have recently shown that a defect in a protein
      of the muscle basement membrane, M-laminin, is correlated with muscular dystrophy
      in human and mouse. The disease associated with defects in M-laminin is thus
      analogous to that caused by defects in the cytoskeletal protein, dystrophin, the
      Duchenne/Becker muscular dystrophy. 3. One may propose the hypothesis that a
      pathway of interacting proteins is required to connect the cytoskeleton of the
      muscle fiber to the extracellular matrix, and that a defect in any protein in
      this chain would result in severe impairment of muscle cell attachment with
      resulting muscle damage upon use of the muscle. The existence of such chains of
      proteins may be expected from known mutations in muscle proteins in Drosophila
      and Caenorhabditis elegans. Some of these mutations cause phenotypes resembling
      muscular dystrophy in mammals. 4. It will be important to identify all the
      proteins that are participants in muscle cell attachment, including receptors for
      M-laminin and proteins associated with these receptors.

PMID- 7787808
TI  - Use of lectins to evaluate the effects of GaAs softlaser on dog tendon.
AB  - 1. Lectins labeled with colloidal gold particles were used for the
      ultrastructural evaluation of the biological effects of GaAs softlaser
      irradiation on the healing of dog tendon wounds. 2. Six dogs were submitted to
      tenotomy and tenorrhaphy on the right and left hind legs. All animals received
      laser irradiation (4 J/cm2) daily for ten days only on the left leg, and the
      right leg of the same animal was used as control. Biopsies were taken 11, 22 and
      40 days after surgery. 3. Laser-irradiated and control tendon tissues were
      embedded in L.R. White resin and thin sections were incubated in the presence of
      gold-labeled Arachis hypogaea (PNA), Canavalia ensiformes (Con A) and Triticum
      vulgare (WGA). 4. In general, the control and laser-irradiated tissues presented
      homogeneous and similar labelling of heterochromatin, rough endoplasmic reticulum
      and extracellular matrix. 5. We conclude that GaAs softlaser irradiation does not
      produce significant changes in the glycosylation of healing tendons.

PMID- 7787809
TI  - Glycosaminoglycan structure and content differ according to the origins of human
      tumors.
AB  - The glycosaminoglycans of the tumor mass and from the urine of patients with a
      nephroblastoma of embryonic origin (Wilms' tumor) and hypernephroma were
      analyzed. The urine of patients with Wilms' tumors prior to treatment, and two
      patients with metastasis contained high levels of hyaluronic acid (2-5 mg/l of
      urine) when compared to patients after surgery or chemotherapy where the content
      of hyaluronic acid was less than 0.1 mg/l. Urine of patients with hypernephroma
      and normal individuals contained even smaller amounts of hyaluronic acid. Normal
      kidneys contain mainly dermatan sulfate and heparan sulfate, while the
      hypernephroma and Wilms' tumor contain substantial amounts of chondroitin
      sulfate. The amount of glycosaminoglycans isolated from Wilms' tumor and
      hypernephroma were 10 times and 3 times, respectively, greater than normal
      kidneys. The amounts of hyaluronic acid in Wilms' tumor varied from 56 to 73%
      whereas normal kidneys contained about 13%. Chondroitin sulfate was also
      increased in Wilms' tumor and hypernephroma. It corresponded to 11% and 42%,
      respectively, of the total glycosaminoglycans. These and other findings indicate
      that the glycosaminoglycans of Wilms' tumors resemble those present during
      embryonic development of normal tissues whereas those in hypernephroma are
      typical of other carcinomas of different origins.

PMID- 7787811
TI  - Extracellular matrix degradation in parasitic diseases.
AB  - 1. Fibrosis is an important manifestation of several parasitic diseases, but is
      not irreversible. A marked degree of extracellular matrix degradation can occur
      after cure of parasitism. Patients with the hepatosplenic form of schistosomiasis
      undergo considerable resorption of portal fibrosis months or years after curative
      treatment as demonstrated by ultrasonography and pathological examination. 2.
      Studies of the post-treatment degradation of extracellular matrix in schistosomal
      periovular granulomas have demonstrated two forms of collagen degradation: in
      hepatic granulomas formed during early infection a rapid process occurs, with the
      extracellular breakdown of fibers and internalization of collagen fragments,
      whereas during late infection, degradation is slow and is accompanied by focal
      electrondense and/or lytic changes. 3. Extensive extracellular matrix degradation
      and resorption occurring after curative treatment was recently described in the
      liver of a man with advanced visceral leishmaniasis and in the heart of mice with
      chronic Chagas' disease.

PMID- 7787812
TI  - Proteoglycans and glycosaminoglycans synthesized by the hepatic granulomas
      isolated from schistosome-infected mice and by a granuloma-derived connective
      tissue cell line.
AB  - 1. This paper summarizes our studies on proteoglycans and glycosaminoglycans in
      the hepatic fibrosis occurring in schistosomiasis. 2. We have compared
      proteoglycans and glycosaminoglycans isolated from schistosomal fibrotic
      granulomas with those obtained from the cellular and extracellular compartments
      of a murine cell line derived from schistosome-induced granulomas, the primary
      cell line "GR". 3. Our results have shown some biochemical and structural
      similarities between proteoglycans and glycosaminoglycans extracted from
      granulomas and those synthesized and secreted by GR cells, suggesting that these
      cells may be the major cell population involved in synthesis and accumulation of
      these molecules in the schistosomal periovular granulomas in liver. Furthermore,
      we have shown that GR cells can function as an extramedullary myelopoietic stroma
      that mediates a long-term myeloid proliferation through an autocrine mechanism
      where the interaction between myelopoietic growth factors and cell-surface
      heparan sulfate proteoglycans was characterized.

PMID- 7787810
TI  - Integrin receptors and TGF-beta expression in chronic myeloid leukemia cells.
AB  - To understand the relationship between transforming growth factor beta-1 (TGF
      beta 1) and the integrin profile presented by chronic myeloid leukemia cells, we
      have studied, using Northern analysis, the expression of TGF-beta 1 messenger RNA
      (TGF-beta mRNA) in myeloid cell lines and in patients with acute myeloid leukemia
      (AML) and chronic myeloid leukemia (CML). In addition we determined the
      positivity for alpha 4 and alpha 5 integrin molecules in those cells using
      specific monoclonal antibodies and flow cytometry. CML patients (N = 3) presented
      mean values of alpha 4 and alpha 5 higher (alpha 4: 60 +/- 20%; alpha 5: 70 +/-
      41%) than AML (N = 10) blast cells (alpha 4: 25 +/- 23%; alpha 5: 18 +/- 16%).
      Northern analysis revealed an almost four-fold higher expression of TGF-beta mRNA
      in K562 (derived from a patient with chronic myeloid leukemia) compared to the
      myeloblastic cell line HL60. The highest TGF-beta mRNA levels were seen in the
      U937 lineage. CML leukemic cells (N = 3) showed high TGF-beta mRNA levels
      comparable to the levels expressed by K562 which was paralleled by high beta 1
      integrin mRNA. AML blast cells presented a variable degree of expression of TGF
      beta mRNA when compared to HL60. One patient with acute megakaryoblastic leukemia
      (FAB subtype M7), usually associated with myelofibrosis, presented the highest
      TGF-beta mRNA levels. We conclude that studying TGF-beta 1 and its mechanisms of
      action will help in understanding fibrosis in leukemic patients, and perhaps to
      design treatments for such conditions.

PMID- 7787813
TI  - Fibrosis patterns of lesions developed by athymic and euthymic mice infected with
      Paracoccidioides brasiliensis.
AB  - Athymic and euthymic mice with BALB/c background were used to study the patterns
      of fibrosis during ip infection with a virulent isolate of Paracoccidioides
      brasiliensis. Specimens from various organs were collected from the animals at 1,
      4 and 7 weeks after infection and observed under light microscopy using various
      histologic staining methods. Lesions from the first week of infection, in both
      animal groups, presented a predominance of collagen III over I, carboxylated
      proteoglycans, and a tendency to encapsulation. From 4 weeks onward, the lesions
      of nu/+ mice tended to involute to macrophage-pseudoxanthomatous aggregates or to
      encapsulation with an increase of collagen I and sulfated proteoglycans. On the
      contrary, with the evolution of the infection, the nu/nu mice displayed
      permanently active lesions, rich in reticular fibers and carboxylated
      proteoglycans, with varied amounts of collagens III and I, without or with
      minimal encapsulation. However, independent of the type of mice, or of the type
      of lesions, the minimal P. brasiliensis-ECM unit was formed by a fibrillar cocoon
      of reticular fibers that encloses an individual yeast or a "family" composed of a
      mother cell plus one or various peripheral daughter cells, alone or engulfed by
      macrophages or giant cells. The overall difference of the lesions of nude and
      normal mice was not in isolated aspects of their components, but in the general
      architecture of the lesions. Those of nu/+ mice were either of involutive or of
      encapsulated type (slightly active), and those of nu/nu mice were of the
      sustained-expansive type (very active), without or with minimal encapsulation.

PMID- 7787814
TI  - Characterization of glycoprotein gp43, the major laminin-binding protein of
      Paracoccidioides brasiliensis.
AB  - We have demonstrated that laminin mediates the adhesion of P. brasiliensis to
      monolayers of epithelial cells through specific binding to the surface
      glycoprotein gp43. This binding seems to be related to the fungal pathogenesis.
      We now report the confirmation of these findings by scanning electron microscopy
      and show that some isolates that do not secrete gp43 do express the protein as
      seen by studying whole cell extracts. These results confirm the ability of these
      strains to produce paracoccidioidomycosis but should not be used for serological
      purposes since the absence of gp43 in exoantigens may lead to false negative
      results.

PMID- 7787815
TI  - Trypanosoma cruzi binds to laminin in a carbohydrate-independent way.
AB  - The binding of 125I-laminin to trypomastigotes is specific and 2-5 x 10(3)
      laminin-binding sites were calculated to be present on the surface of a live
      trypomastigote. Anti-laminin antibodies were able to inhibit the invasion of
      cultured cells by trypomastigotes (62-75%), suggesting that laminin may be
      involved in the adhesion of the parasite to host cells. By affinity
      chromatography, an 85-kDa glycoprotein was isolated (laminin-binding
      glycoprotein, LBG) from trypomastigote lysates, but not from epimastigote
      lysates. It is suggested that at least fragment E8 (but not E1') from laminin
      could be involved in the reaction which is independent of the carbohydrate
      moieties from both ligand and receptor. It is also shown that LBG is a member of
      the Tc-85 family, previously shown to be related to the invasion process of the
      parasite.

PMID- 7787817
TI  - Seroprevalence of hepatitis A antibodies in travellers at the Edmonton
      Travellers' Health Clinic--Alberta.

PMID- 7787818
TI  - Hepatitis A in downtown Montreal, Quebec, 1990-1992.

PMID- 7787816
TI  - 1995 Membership list.

PMID- 7787819
TI  - Cohort study of the relationship between air pollution and short term health
      effects as determined by peak expiratory flow measurements.
AB  - The aim of the study was to establish if air pollution has short term effects on
      health and well-being for individuals living in an industrialized area of Norway.
      A cohort study was designed so that two groups (one randomly selected from the
      general population and one with preexisting lung disease) were followed hour by
      hour during two months in the winter and in the summer of 1988. In order to
      minimize the problems of confounding factors, each individual served as her/his
      own control. Each participant described through the use of a diary the presence
      of symptoms from the upper and lower respiratory tract as well as general
      symptoms of ill health. Measurements of lung function by the use of peak
      expiratory flow meters were done four times a day. In addition, every second week
      the participants were subjected t a full spirometric test. Samples of urine and
      blood were examined, and bacteriological test from the throat was performed at
      the beginning and at the end of the study. A comprehensive measurement program of
      outdoor air contaminants (including nitrogen oxides, sulphur dioxide) is
      presented. Estimation of each participant's exposure was performed hour by hour
      based on detailed modelling of the measured levels, known emissions of pollutants
      and meteorological conditions, as well as diary information on the participant's
      movements through the various micro-environments. The estimated exposures were
      generally low. In this presentation, a linear regression model and their
      corresponding parameter estimates were applied on an individual basis to evaluate
      any effect of air contamination on lung function.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7787820
TI  - Salmonellae in gulls and other free-living birds in the Czech Republic.
AB  - Cloacal swabs, collected from 756 wild synanthropic and exoanthropic birds of 57
      species in the Czech Republic, yielded 32 strains of Salmonella typhimurium
      [phage types (PT) 141, 104 and 41], six isolates of S. enteritidis (PT 8, 4 and
      6e), and one each of S. panama and S. anatum. Except for one S. enteritidis
      isolate from a grey-lag goose (Anser anser) and one S. typhimurium isolate from a
      coot (Fulica atra), all of the other strains were derived from black-headed gulls
      (Larus ridibundus), of which 24.7% were found to be infected. The black-headed
      gull might play a role in the dispersal of pathogenic salmonellae.

PMID- 7787821
TI  - Effect of stressful environmental factors upon neonatal immune system.
AB  - To examine the effects of stressful environmental conditions upon the immune
      system of the newborn (neonates), we analyzed the neonatal serum immunoglobulin
      levels in a total of 67 neonates from tribal families living in a rural community
      of eastern India. These cases were grouped into three categories, based upon the
      predominance of one of the three factors being analyzed, and the reasonable
      absence of the other two factors. The three factors as determined by the
      prevailing environmental conditions, which were the basis for forming the three
      groups, were: 1. indoor air pollution; 2. hygienic conditions, and 3. the
      cohabitation of domesticated animals in the same household as the infants's
      families. Presence of indoor air pollution or unhygienic conditions resulted in
      the disturbance and depression of the levels of serum immunoglobulins of
      different classes. There was no discernible correlation found between the levels
      of immunoglobulins of different classes from the neonates (except IgM) and the
      cohabitation of domesticated animals in the same households. However the
      incidence of GIT and RT infections was higher in all the three experimental
      groups, as compared to the control group. These results suggest that unfavorable
      environmental conditions can adversely affect the immune system at neonatal
      stages, and can increase their susceptibility to subsequent acute or chronic
      events.

PMID- 7787822
TI  - Industrialization and environmental health in Poland.
AB  - There has been enormous pollution and biodegradation of environment in Poland as
      the consequence of industrialization developed regardless the principles of
      sustainable development. In the recent years, the decrease of total emission of
      air pollution caused by gases and dust, the decrease of emission of unprocessed
      sewage and industrial waste can be seen. These facts are the consequences of
      economic recession which have appeared in Poland along with economic
      transformation. However, there is still significant escalation of environmental
      pollution, in so-called areas of ecological hazards. There are heavily
      industrialized and urbanized areas covering about 10% of the total country area
      but inhabited by over 30% of the total country population. The significant
      environmental pollution goes together with deterioration of the country's health
      situation what can be seen in shortening the average lifetime expectancy,
      increased frequency of cardiovascular diseases and cancers and higher infants
      death rate in comparison to other European countries. Considering the complexity
      of the factors affecting the population's health status, the basis of the health
      and environmental policy conceived in order to stop and alter the unwanted health
      condition tendencies and the environmental quality have been shown here.

PMID- 7787823
TI  - A resistance of head lice (Pediculus capitis) to permethrin in Czech Republic.
AB  - An outbreak of pediculosis at primary schools was recorded in the Czech Republic
      in 1992. Almost 20% of children in some schools were infested. This outbreak can
      be attributed to the resistance of head lice to permethrin, which has not been
      mentioned in literature yet. The resistance factors established in three towns
      range between 2 and 385 and between 5 and 557 for LC50 and LC90 values,
      respectively. This resistance has developed after exclusive use of pyrethroids
      lotion and shampoo in the Czech Republic since 1978, and it was accompanied by a
      cross-resistance to d-phenothrin and bioalethrin. But the susceptibility of head
      lice to malathion and pirimiphos-methyl in 1992 was very similar to that found in
      1981. The lotion containing 0.3% of malathion (Diffusil H92 M) has been fully
      effective against the resistant lice. When introduced into the practice, it
      quickly reduced the infestation of children in primary schools. The other lotion
      and shampoo containing 0.3% and 0.7% of pirimiphos-methyl respectively were found
      to be effective as well.

PMID- 7787824
TI  - Natural foci of tick-borne encephalitis in central Europe and the relationship of
      the incidence of Ixodes ricinus to original ecosystems.
AB  - Based on reports of the national epidemiological service on tick-borne
      encephalitis (TBE) morbidity in 1953-1987, data in the literature, and results of
      the author's own field research on the occurrence of the common tick, Ixodes
      ricinus, foci of this disease have been identified on the territory of
      Czechoslovakia. In Bohemia a significant focus of TBE in the Central Bohemian
      Region is located in the Krivoklat area with forests and in the Berounka, mid
      Vltava, and lower-Sazava river basins, in the Brdy area and the Czech Karst
      continuing southwards via the Vltava basin to foci in the South Bohemian region
      in the districts of Pisek and Ceske Budejovice and west of the Berounka river
      basin to a focus in the central part of the West Bohemian region. In the North
      Bohemian and East Bohemian regions only smaller isolated foci of TBE were
      detected. In Moravia foci of TBE are in the districts of Opava and Bruntal in the
      North Moravian region and in the central and southern areas of the South Moravian
      region. The foci in Bohemia are isolated from foci in neighboring countries,
      those of Moravia are connected with foci in Poland and Austria. On the territory
      of the Czech Republic foci of TBE are found in localities of pristine oakwood
      agglomerations. Original beechwood agglomerations even when located below the
      upper limit of occurrence of the common tick, i.e. less than 700 meters above sea
      level, do not offer favourable conditions for this arthropod and they do not
      harbour natural foci of TBE.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787825
TI  - The prevalence of environmental mycobacteria in drinking water supply systems in
      Olomouc County, north Moravia, Czech Republic, in the period 1984-1989.
AB  - The presence of environmental mycobacteria was studied in drinking water supply
      systems in Olomouc County, Czech Republic, in order to detect the possible spread
      of M. kansasii from the neighbouring region in Ostrava County. Drinking water
      samples from water supply systems of 16 localities were investigated. The samples
      of running water, and tap swabs or tap scrapings were collected twice a year, in
      the spring and in the autumn. The most common cultivated and identified species
      were M. gordonae (20.4%), M. flavescens (13.8%), rapidly growing mycobacteria
      (5.0%) and then by occasional identification of M. fortuitum, M. terrae, M.
      scrofulaceum. M. kansasii was not detected. The prevalence rates showed no time
      trend over the period 1984-1989. We conclude that there is no evidence at present
      that endemic M. kansasii, isolated repeatedly from neighbouring region, has
      spread to Olomouc County. Different environmental and nutritional constituents in
      soil and coal mine dust in the endemic regions seem to be the most probable
      limiting environmental factor of the endemic occurrence of M. kansasii in its
      endemic locality in Ostrava and Karvina regions.

PMID- 7787826
TI  - Exposure and impact assessment of emissions from mercury recycling using domestic
      rabbits.
AB  - A biomonitoring study using domestic rabbits (Chinchilla) aimed at the exposure
      and impact risks assessment of emissions released into the ambient air from a
      mercury-recycling plant has been carried out. Groups of rabbits were exposed to
      the emissions during 6 months at biomonitoring stations built up in two
      localities (Rudnany and Matejovce) in the distance of about 3 and 6 km around and
      downwind from the mercury-producing plant. The aim of the biomonitoring was to
      trace the translocation of inhaled inorganic Hg in body tissues and the
      immunotoxic impact of the emissions in the exposed mammalian organism in
      comparison to a non-exposed animals living outside the polluted area. The content
      of mercury (as a major pollutant in the ambient air in that area) in body tissues
      was done spectrometrically using a Trace Mercury Analyser TMA-254. Content of
      mercury and the other metals in the rabbits' hairs was determined by neutron
      activation analysis. A statistically significant increase of the inorganic Hg
      content in the specimens of kidneys, lungs, liver, thigh bone, heart muscle and
      brain was observed. Concerning the hairs, a statistically significant elevation
      of Hg and other elements (As, Cd, La, Zn, Na, K, W, Sr) has been found. The body
      tissue reaction to the increased accumulation of mercury has been investigated by
      a direct immunofluorescent method to search for body tissue immune complexes. The
      significant increase of Hg content determined in the organs (especially in
      kidneys and liver) of the exposed animals was also traced by the presence of
      immunofluorescent antibodies. In addition, the immunofluorescent antibodies in
      the myocardium have been proved.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787827
TI  - Distribution and metabolism patterns of plasma 7S- and beta-NGF in the adult male
      rat.
AB  - There is a great deal of controversy on the existence of NGF in body fluids and
      tissues. To date it remains unknown whether this peptide accumulates
      preferentially at significant levels in different organs. Thus we undertook the
      evaluation of kinetic parameters of the disappearance of blood of 125I-7S-NGF and
      125I-beta-NGF after intravenous injection in male adult rats. Our results
      indicate that the plasma half-life of 125I-7S-NGF is approximately twice as long
      as for 125I-beta-NGF (respectively 61.7 +/- 11.7 min and 36.3 +/- 2.2 min) while
      the distribution volume is not significantly different between both peptides.
      Furthermore, the uptake of radioactive NGF by different tissues seems very low as
      shown by 125I-7S-NGF and 125I-beta-NGF content of the sampled organs compared to
      the plasma concentration at the same time. These results indicate that the tissue
      uptake of circulating 7S and beta-NGF is very low in the adult rat. Thus in these
      animals NGF did not cross the blood-brain barrier and did not accumulate in
      peripheral organs which are known to contain subsequent amounts of this peptide.
      This lack of deposition might be due to a binding with plasma proteins (probably
      alpha 2-macroglobulin).

PMID- 7787828
TI  - A behavioral and electrophysiological study of the comparison of size-discrepant
      shapes.
AB  - An experiment was performed to find an electrophysiological correlate of the way
      objects of different sizes are perceived as identically shaped. The subjects were
      presented with pairs of geometrical figures and were instructed to decide whether
      the two polygons of a pair were identical in shape regardless of size. In
      addition to event-related potentials (ERPs), reaction times and error rates were
      recorded. Reaction times increased approximately linearly with increasing size
      ratios. The subtraction between the ERPs of 'test' and 'control' conditions
      showed two main activities: a positivity localized on the occipitotemporal scalp
      areas in the 200-450 ms range, and a negativity localized on the posterior scalp
      areas in the 500-750 ms range. These different results were discussed with
      respect to size ratio.

PMID- 7787829
TI  - Neural network models of cortical functions based on the computational properties
      of the cerebral cortex.
AB  - We describe a biologically plausible modelling framework based on the
      architectural and processing characteristics of the cerebral cortex. Its key
      feature is a multicellular processing unit (cortical column) reflecting the
      modular nature of cortical organization and function. In this framework, we
      describe a neural network model organization and function. In this framework, we
      describe a neural network model of the neuronal circuits of the cerebral cortex
      that learn different functions associated with different parts of the cortex: 1)
      visual integration for invariant pattern recognition, performed by a cooperation
      between temporal and parietal areas; 2) visual-to-motor transformation for 3D arm
      reaching movements, performed by parietal and motor areas; and 3) temporal
      integration and storage of sensorimotor programs, performed by networks linking
      the prefrontal cortex to associative sensory and motor areas. The architecture of
      the network is inspired from the features of the architecture of cortical
      pathways involved in these functions. We propose two rules which describe neural
      processing and plasticity in the network. The first rule (adaptive tuning if
      gating) is an analog of operant conditioning and permits to learn to anticipate
      an action. The second rule (adaptive timing) is based on a bistable state of
      activity and permits to learn temporally separate events forming a behavioral
      sequence.

PMID- 7787830
TI  - Estrogen-receptor occurrence in the female mouse brain: effects of maternal
      experience, ovariectomy, estrogen and anosmia.
AB  - Maternal behavior (ultrasound-induced pup-searching and retrieving) was studied
      in eight groups of female house mice with various hormonal backgrounds,
      experience with pups and function of the olfactory system. In their brains,
      estrogen receptor immunoreactive (ER-IR) cells were localized and quantified. All
      animals of all groups had ER-IR cells in a 'reliable subset' of brain areas, the
      medial preoptic area (MPOA) and ventromedial (VMH) and arcuate nucleus (ARH) of
      the hypothalamus. In another subset of brain areas, the anterior hypothalamic
      area (AHA) and cortical (CA) and medial (MA) amygdaloid nucleus, ER-IR cells can
      be expected in at least some animals of all experimental groups ('expected
      subset'). In a variable subset of additional brain areas (bed nucleus of the
      stria terminalis, BNST; suprachiasmatic nucleus, SC; lateral septal nuclei, LS;
      paraventricular nucleus of the hypothalamus, PVH; entorhinal and piriform cortex,
      ENT, PIR; subiculum, SUB; hippocampus, HPC; periventricular gray of the midbrain,
      PVG), ER-IR cells occurred only in some animals of some groups. Numbers of ER-IR
      cells in a given brain area, volumes occupied by these cells, and cell densities
      varied considerably among the groups. A covariation of cell counts and volumes
      was significant for most brain areas indicating that increases of numbers of ER
      IR cells relate mainly to volume increases within a given brain area. Experience
      with pups correlated with an increase of ER presence in the AHA, VMH, ENT, PIR,
      SUB, HPC and PVG, however, only in the presence of estrogen. Estrogen and pup
      experience together led to an increased ER presence in mainly the VMH, ENT and
      PIR, however, only in females with intact olfaction. Full maternal behavior
      (retrieving, ultrasound recognition) occurred after the high pregnancy- or
      experience-induced ER content was reduced to lower levels. The ER occurrence in
      lactating and experienced virgin females differed, however, in the AHA, BNST, SC,
      PVH, ENT, PIR, SUB, HPC and PVG showing that the maintenance of maternal behavior
      can run under different profiles of ER content in the brain. Ovariectomy and/or
      prolonged high blood-estrogen levels correlated significantly with decreased
      levels of ER-IR cells in most brain areas which could not be increased by pup
      experience.

PMID- 7787832
TI  - Cognitive moderators of outcome following traumatic brain injury: a conceptual
      model and implications for rehabilitation.
AB  - This paper presents a conceptual model describing the relationships between
      quality of life outcomes following traumatic brain injury (TBI), coping patterns,
      and beliefs regarding self-efficacy to assist health-care professionals in
      understanding the complexity of social and psychological sequelae of TBI. The
      mode hypothesizes that long-lasting cognitive, behavioural, emotional
      psychiatric, and interpersonal after-effects of TBI may create a real life
      'learned helplessness' with consequent deficits in coping, and altered locus of
      control beliefs. As a result, TBI patients are at risk for developing self
      limiting belief systems about their effectiveness in altering significant events
      that may result in over-generalizing the effects that TBI has in their day-to-day
      lives. Subsequently, a feedback loop may be set up where their beliefs in not
      being able to influence outcomes are not tested, life chances are further
      restricted, outcomes are suboptimal, and quality of life is reduced. The clinical
      and theoretical implications of this model are discussed, and an expanded model
      with future research directions is suggested.

PMID- 7787831
TI  - D1 receptors modulate striatal dopamine release induced by the stimulation of
      both D1 and D2 receptors: in vivo voltammetric data revisited.
AB  - Here we re-examine previous data that demonstrated lasting effects of the
      selective D1 receptor agonist SKF 38393, the selective D2 receptor agonist LY
      171555, and of mixed SKF 39383 + LY 171555 upon striatal DA release. We
      demonstrate that the administration of mixed SKF 38393 + LY 171555 and of SKF
      38393 administered alone induced similar time-course effects upon striatal DA
      release that showed significant parallel developments. We discuss these data in
      the light of the current literature and we suggest that D1 receptors could play a
      modulating role on the striatal DA activity and the release of DA in the caudate
      putamen.

PMID- 7787833
TI  - Self-concept, marital vulnerability and brain damage.
AB  - The present study investigated the influence of a man's brain injury on both his
      and his wife's self-concept and perception of marital vulnerability. Thirty-six
      couples in which the husbands had brain damage and twenty-nine couples without
      disability filled out the Tennessee Self-concept Scale [1], and the Marital
      Vulnerability Scale [2]. Marital vulnerability of husbands with brain damage was
      found not to differ from that of the husbands in the control group. However, the
      marital vulnerability of the wives of the former husbands was lower than that of
      the other wives. Both men with brain damage and their wives exhibited a decrease
      in self-esteem and an increase in conflict and pathology. Brain damage appears to
      affect both the extent and direction of the relations between aspects of the self
      concept and marital vulnerability differentially for husbands with brain damage
      and their wives. Practical and theoretical implications of the negative impact of
      brain damage upon the person with the damage, upon his wife, and upon their
      marital relationship are discussed.

PMID- 7787835
TI  - Perseveration. Part I: a review.
AB  - Perseveration refers to the inappropriate continuation or repetition of a
      response or activity. It is associated with a variety of neurological disorders
      and, when pronounced, is thought to be pathognomonic of brain damage.
      Perseveration manifests itself in several different forms which have had various
      labels applied, and many hypotheses have been proposed to explain the mechanisms
      underlying these perseverative behaviours. In this article we review descriptions
      and classifications of perseveration as it occurs in various neurological
      disorders, and then discuss some of the neurobehavioural and neuropathological
      mechanisms thought to account for it.

PMID- 7787834
TI  - Self-reported social networks and interpersonal support 2 years after severe
      traumatic brain injury.
AB  - Fifty-four patients with traumatic brain injury (TBI) consecutively admitted to a
      rehabilitation hospital were examined 2 years post-injury. Social interaction and
      support, subjective complaints, and functional status were assessed. A large
      variability in social interaction and support patterns was found. Most patients
      had more interaction and received more support from family members than from
      friends and neighbours. Thirty-one patients (57.4%) reported that their social
      networks had markedly declined subsequent to injury. Relatively short duration of
      coma (< 1 week) and severe sequelae in terms of low functional status and poor
      emotional adjustment at follow-up, especially in terms of deficits in initiating
      behaviour, were found to be related to little interaction and support. The
      importance of both provider and patient initiative in order to establish and
      preserve a social support network is suggested, and clinical implications briefly
      discussed.

PMID- 7787836
TI  - Perseveration. Part II: A study of perseveration in closed-head injury.
AB  - This study examines the nature and extent of perseveration in 15 individuals with
      closed-head injury (CHI) by (a) identifying and describing the types of
      perseveration that occurred on verbal and non-verbal tasks, (b) examining the
      possible underlying neuropsychological mechanisms of perseverative behaviour and
      (c) exploring neuroanatomical correlates of perseveration. Performance of the 15
      CHI patients was compared with 15 neurologically normal subjects matched for sex,
      age, handedness and educational level. The CHI subjects produced significantly
      more perseverations than did normals, and 'recurrent' perseveration was the most
      frequently occurring type. A test of verbal learning elicited the greatest number
      of recurrent perseverations. Overall test performance of the CHI group suggested
      that memory dysfunction and impaired attention were most likely responsible for
      perseverative errors. CT scan analyses showed that the three most perseverative
      CHI subjects evidenced left temporal lobe damage.

PMID- 7787837
TI  - Developmental models of social cognition in assessing the role of family stress
      in relatives' predictions following traumatic brain injury.
AB  - The present study extended the utilization of developmental models of social
      cognition to the investigation of stress and relatives' perception of traumatic
      brain injury (TBI) survivors. Structured interviews were conducted with 21 TBI
      survivors utilizing interpersonal negotiation strategies (INS) and self
      understanding (self) in the framework of Selman's model of social perspective
      taking and Damon and Hart's multidimensional model of self understanding. A
      relative group composed of 21 participants was interviewed and their predictions
      of the responses of the TBI survivors to the action domain of the INS stories
      were obtained. The relative participant group was also administered the Beck
      Anxiety and Depression Inventories and Leeds Scales of Depression and Anxiety.
      The relationships among relative groups' predictive scores, INS and self domains
      and stress levels were analysed. The result of the survivor groups responses on
      INS and self were in agreement with the previous findings that TBI survivors
      respond at psychosocially immature levels. Comparison of INS action scores
      obtained by the survivor group and predicted by relative group were within one
      developmental level of each other in 87.4% of the cases. Fifty-two per cent of
      the relative group scored in mild to moderate or greater depression and 48%
      scored in the mild to moderate range of anxiety on the Beck scales. Person
      correlation coefficients indicated significant negative correlations between Beck
      scores and predictive INS scores. ANOVA indicated significantly higher Beck
      depression scores in relatives of TBI survivors living in residential facilities
      than relatives of TBI survivors in an outpatient treatment programme. The study
      supports the view that developmental social cognition methods appear to advance
      our understanding of psychosocial adjustments and relatives' perceptions of
      social cognition in TBI survivors.

PMID- 7787838
TI  - Head injuries in the elderly.
AB  - Two hundred and sixty-three consecutive head-injured patients aged over 65 years,
      admitted to a neurosurgical service, are reported. In contrast to younger age
      group the main cause was falls concomitant with a high rate of cardiovascular pre
      existing disorders. The distribution of causes and grim results justify, in our
      opinion, regarding head injury in the elderly as a distinct entity requiring
      special surgical, medical, organizational and ethical considerations.

PMID- 7787839
TI  - Subpopulations in closed-head injury: preliminary results.
AB  - The classification systems currently utilized to categorize closed-head injury
      (CHI) patients are all based on severity levels. However, these scales are unable
      to account for the wide variability among CHI patients. Another way to classify
      these patients is to use the clinical picture independent of the overall severity
      level. That approach is used with aphasic patients but not with the CHI
      population. These preliminary data indicate that there are distinct subgroups in
      the CHI population. These subgroups can be identified by their overall pattern of
      performance on a battery of tests covering language, memory, visuospatial,
      cognitive and discourse skills. The characteristics of the tentative subgroups
      are described, but a more extensive study is needed to confirm the robustness of
      this classification.

PMID- 7787841
TI  - Synthetic pheromone biosynthesis activating neuropeptide gene expressed in a
      baculovirus expression system.
AB  - A synthetic gene of the pheromone biosynthesis activating neuropeptide (PBAN) of
      corn earworm Helicoverpa zea, with and without a signal sequence of the cuticle
      protein of Drosophila melanogaster, was cloned behind the polyhedrin promoter of
      AcMNPV. Two recombinant baculoviruses were constructed and used to infect a
      number of insect cell lines including Sf9 and 5B1-4. High pheromonotropic
      activity was consistently obtained from 5B1-4 cell culture that was infected with
      the recombinant baculovirus vINV-4 containing the signal sequence. The PBAN gene
      product was isolated by HPLC and analyzed by electrospray ionization mass
      spectrometry. Low levels of biological activity obtained from Sf9 cells infected
      with the recombinant virus vPBAN may be due to lack of proper amidation at the C
      terminus of the expressed peptide or rapid proteolytic degradation of the
      product.

PMID- 7787840
TI  - Biotin-containing proteins of the insect nervous system, a potential source of
      interference with immunocytochemical localization procedures.
AB  - When the biotinylated Manduca sexta adipokinetic hormone gene was used as a probe
      for in situ hybridization, the intrinsic neurosecretory cells were stained with a
      biotin detection system that contained streptavidin or avidin. Further
      experiments showed that the DNA probe was not necessary for staining these cells
      by streptavidin-alkaline phosphatase, and that they were not stained by alkaline
      phosphatase alone. Similarly, the intrinsic neurosecretory cells were stained
      directly by streptavidin conjugated to a fluorescent dye. Other parts of the
      central nervous system could also be stained with streptavidin-alkaline
      phosphatase but not as readily as the intrinsic neurosecretory cells of the
      corpora cardiaca. Further analysis demonstrated three biotin-containing proteins
      in the intrinsic neurosecretory cells of the corpora cardiaca and in the brain.
      The most abundant of these proteins, when analyzed by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis, was found to have a molecular weight of
      130,000, which is the size of the subunits of pyruvate carboxylase, a biotin
      containing enzyme. The same protein was recognized by an antiserum against an
      insect pyruvate carboxylase, indicating that this protein is probably pyruvate
      carboxylase. The results reported here indicate that the intrinsic neurosecretory
      cells of the corpora cardiaca may contain pyruvate carboxylase in a concentration
      higher that other cells of the central nervous system. We also note that caution
      is necessary to avoid false positive results if an avidin containing detection
      system is used for in situ hybridization or immunocytochemistry.

PMID- 7787842
TI  - Multiple phosphorylation of ribosomal protein S6 and specific protein synthesis
      are required for prothoracicotropic hormone-stimulated ecdysteroid biosynthesis
      in the prothoracic glands of Manduca sexta.
AB  - Prothoracicotropic hormone (PTTH)-stimulated protein phosphorylation leads to
      ecdysteroidogenesis (molting hormone biosynthesis) in the prothoracic glands of
      the tobacco hornworm, Manduca sexta. The phosphorylation of 34 and 50 kDa
      peptides (p34 and p50) paralleled the increase in ecdysteroidogenesis, and the
      dephosphorylation of p34 and p50 preceded a decrease in ecdysteroidogenesis.
      Inhibition by rapamycin of p34, but not p50, phosphorylation prevented PTTH
      stimulated ecdysteroidogenesis in a dose-dependent manner, suggesting that p34
      phosphorylation is requisite for PTTH-stimulated ecdysteroidogenesis. Two
      proteins whose synthesis was rapidly stimulated by PTTH were p50 and p70. The
      time-course of PTTH-stimulated synthesis of p50 paralleled that of p34
      phosphorylation and that of ecdysteroidogenesis. Rapamycin inhibited PTTH
      stimulated synthesis of p50 and p70, suggesting that specific protein synthesis
      is also required for PTTH-stimulated ecdysteroidogenesis, confirming the results
      of Rybczynski and Gilbert [(1994) Insect Biochem. Molec. Biol. 24, 175-189], and
      that p34 phosphorylation may regulate the downstream synthesis of p50 and p70,
      possible key regulatory proteins leading to ecdysteroidogenesis. Results from two
      dimensional (2D)-PAGE analysis of the ribosomal proteins purified from
      prothoracic glands, demonstrated that p34 is indeed ribosomal S6, and is
      phosphorylated at up to five sites (P1-5) upon PTTH stimulation. The multiple
      phosphorylation of S6 was inhibited completely by rapamycin as shown in 2D gel
      maps, further confirming that p34 is ribosomal protein S6. Temporal analysis of
      PTTH-stimulated S6 phosphorylation by 2D-PAGE revealed that phosphorylation of S6
      at the P1 site was temporally correlated with the initiation of
      ecdysteroidogenesis, and that multiple phosphorylation at all five sites (P1-5)
      was correlated with the maximal synthesis of ecdysteroids. Dephosphorylation of
      S6 was accompanied by a decrease in ecdysteroidogenesis. These data demonstrate
      that p34 is ribosomal protein S6 and that both the phosphorylation of S6 and
      specific protein synthesis are required for PTTH-stimulated ecdysteroidogenesis
      in the prothoracic gland.

PMID- 7787845
TI  - Microsomal juvenile hormone binding proteins in the follicle cells of Tenebrio
      molitor.
AB  - The microsomal fraction of Tenebrio molitor follicle cells has been found to
      contain both high and low affinity binding sites for juvenile hormone (JH) III.
      Using Scatchard analysis, the equilibrium dissociation constants, Kd, were
      calculated as 1.0 x 10(-8) and 4.3 x 10(-7) M respectively. Kinetic data support
      a rapid binding of the hormone to the site(s), with rate constants of ka = 3.77 x
      10(8) M-1 min-1 and kd = 0.0075 min-1. Affinity of the binding site(s) for JH III
      was higher than for either JH I or methoprene. The significance and possible
      function of such microsomal binding proteins are discussed, with reference to the
      perturbance of vitellogenesis found in beetles parasitized by Hymenolepis
      diminuta.

PMID- 7787844
TI  - Characterization of a salivary gland-specific esterase in the vector mosquito,
      Aedes aegypti.
AB  - Esterase enzymatic activity was investigated in salivary gland lysates of adult
      Aedes aegypti. Esterases in lysates made from female glands had higher specific
      activity than those in lysates from male glands towards beta-naphthyl acetate but
      showed no difference with alpha-naphthyl butyrate as a substrate. Female salivary
      gland lysates showed no difference in activity to alpha- and beta-forms of
      naphthyl acetate and no discernable activity towards alpha-naphthyl caprate. Both
      female and male salivary gland lysates exhibited phosphatase enzymatic activity
      but the specific activities were lower than those seen for the esterase enzymatic
      activity. Salivary gland esterase activity was inhibited completely by paraoxon,
      para-hydroxymercurobenzoate, tetraethylammonium iodide and moderately by
      diisopropylfluorophosphate. Eserine and phenylmethylsulfonylfluoride had no
      effect on enzyme activity. In a probing assay, adults of both sexes were shown to
      secrete esterase in saliva. Esterase activity was present in the saliva of
      females probing for either a sugar meal or a blood meal. Furthermore, esterase
      was secreted from female salivary glands in culture. Histochemical analysis of
      dissected salivary glands showed that the majority of the esterase enzymatic
      activity was in the distal-lateral lobes of the female tissues, although the
      proximal-lateral and medial lobes also had activity. Male salivary glands stained
      uniformly over all of the lobes. A salivary gland-specific esterase, designated
      SG-EST, appears to account for the majority of enzyme activity in the glands. SG
      EST was partially purified by electroelution of an active protein from native
      polyacrylamide gels, and has an approximate molecular weight of 65,000 Da. In
      separate experiments, affinity chromatography independently identified a single
      65,000 Da protein likely to be SG-EST. Native electrophoretic analysis of
      salivary glands revealed that, while most enzyme activity is due to SG-EST, there
      are two other esterases present. One of these minor moieties is present in adult
      tissues in addition to the salivary gland, and the other is present throughout
      development. Possible functions of the salivary gland esterase are discussed.

PMID- 7787843
TI  - Characterization of Aphidius ervi (Hymenoptera, Braconidae) ribosomal genes and
      identification of site-specific insertion elements belonging to the non-LTR
      retrotransposon family.
AB  - We performed a molecular analysis of the Aphidius ervi ribosomal gene structure.
      This insect belongs to a set of closely related Aphidiinae species of the genus
      Aphidius Nees, of relevant interest in biological control. We constructed A. ervi
      genomic libraries, cloned and characterized several rDNA repeating units and
      sequenced different regions of the rDNA cistrons. We have found that insertion
      sequences interrupt the A. ervi 28S rDNA genes: the sequences of the two 5' and
      3' insertion-28S junctions show that the elements are present at the position
      where R1 elements have been found in various insect species. In addition, the
      insertion of the element produces a duplication of the 14 nt target region. The
      sequence analysis indicates that the A. ervi elements belong to the R1
      retrotransposon family with a highly conserved reverse transcriptase domain.

PMID- 7787846
TI  - Phylogenetic position of yeast-like symbiotes of rice planthoppers based on
      partial 18S rDNA sequences.
AB  - The rice planthoppers, Nilaparvata lugens, Sogatella furcifera, and Laodelphax
      striatellus, harbor intracellular yeast-like symbiotes (YLS) in the fat body. The
      YLS are obligated endosymbiotes and are transovarially inherited. Nucleotide
      sequences of the 18S rRNA genes from the YLS were analyzed by direct sequencing.
      The YLS of the three species of planthoppers were monophyletic and their
      taxonomic positions were in the class Pyrenomycetes in the subphylum
      Ascomycotina.

PMID- 7787847
TI  - A Drosophila gene that encodes a member of the protein disulfide
      isomerase/phospholipase C-alpha family.
AB  - Screening of a Drosophila genomic DNA library at reduced stringency hybridization
      conditions using a rat PLC alpha cDNA probe yielded a gene which encodes a member
      of the protein disulfide isomerase/PLC alpha family. The gene has been localized
      to band 74C on the left arm of the third chromosome and has been designated dpdi.
      Northern analysis shows that the dpdi gene encodes a transcript that is 2.3 kb in
      length and is present throughout development as well as in both heads and bodies
      of adults. The deduced dpdi protein is 496 amino acids in length and contains two
      domains exhibiting high similarity to thioredoxin, two regions that are similar
      to the hormone binding domain of human estrogen receptor, and a sequence of four
      amino acids (KDEL) at the C-terminus which has been described by others as being
      responsible for retention of proteins in the endoplasmic reticulum. Overall, dpdi
      contains a higher similarity to rat protein disulfide isomerase (53% identical)
      than to rat PLC alpha (30% identical). However, it is unclear whether dpdi
      functions in vivo as a PDI or as a PLC, or both. Drosophila, with its well
      characterized genetics and the ability to generate mutants in a gene that has
      been cloned, provides an excellent system in which to resolve this issue.

PMID- 7787848
TI  - Proximal tibiofibular subluxation relationship to lateral knee pain: a review of
      proximal tibiofibular joint pathologies.
AB  - Proximal tibiofibular subluxation is the symptomatic hypermobility of the
      proximal tibiofibular joint. Pain along the lateral aspect of the knee must be
      carefully evaluated as the anatomy and biomechanics of this region are very
      complex. Anatomical variants of the proximal tibiofibular joint may be key to
      understanding the pathomechanics and, thus, treatment of this joint. The
      "horizontal" proximal tibiofibular joint has a higher degree of mobility, while
      the "oblique" joint is relatively immobile to rotational forces on the fibula.
      Increased fibular external rotation will result in injury to the anterior capsule
      and ligaments of the proximal tibiofibular joint causing common complaints of
      "popping" and lateral knee pain. Treatment of proximal tibiofibular subluxation
      will involve modifications of a patient's activity level and training programs,
      utilization of a supportive strap, lower leg strengthening, and modifications in
      the lower kinetic chain biomechanics.

PMID- 7787849
TI  - The effect of two types of foot orthoses on rearfoot mechanics.
AB  - Little experimental data exist regarding the comparative biomechanical of various
      foot orthoses. This study evaluated the comparative effect of biomechanical
      orthoses and over-the-counter arch supports on controlling rearfoot pronation.
      Twenty-four patients with forefoot varus deformity were studied while walking on
      a treadmill. Two-dimensional, videotape motion analysis was used for studying
      rearfoot mechanics with three experimental conditions: 1) shoes only, 2) shoes
      plus arch supports, and 3) shoes plus biomechanical orthoses. The variables
      studied were: maximum pronation, calcaneal eversion, maximum pronation velocity,
      time-to-maximum pronation, and total pronation. No difference was noted in
      maximum pronation, calcaneal eversion, and total pronation between the three
      conditions. The data for maximum pronation velocity and time-to-maximum pronation
      were not reliable. Based on the results of this study, padded arch supports nor
      biomechanical orthoses can be preferentially recommended for their ability to
      control maximum pronation, calcaneal eversion, and total pronation during
      walking. Additional research is necessary to: 1) identify the biomechanical
      effects that are responsible for the clinical success of foot orthoses, and 2)
      determine better designs for controlling rearfoot movement.

PMID- 7787851
TI  - Patellofemoral joint compressive forces in forward and backward running.
AB  - The use of backward running is becoming more common in the rehabilitation
      setting. In particular, backward running has been suggested as a treatment
      modality in patients experiencing patellofemoral pain syndrome. To date, no study
      has examined the loads at the patellofemoral joint during backward running. The
      purpose of this study was to compare patellofemoral joint compressive forces
      during forward and backward running. Ground reaction force and kinematic data
      were collected on five male joggers during free speed forward and backward
      running. A floor reaction force vector model was used to calculate the stance
      phase knee extension moments. The distance used for the extensor muscle lever arm
      was 4.9 cm. Patellar mechanism angle was calculated based on knee joint angle.
      There was a reduction in the peak patellofemoral joint compressive forces in
      backward compared with forward running (2277 +/- 192N vs. 4253 +/- 1292N; p <
      0.05) at self-selected speeds. Peak patellofemoral joint compressive force
      occurred significantly later (p < 0.05) in the stance phase of backward running
      (52 +/- 4%) than in forward running (35 +/- 3%). The peak patellofemoral joint
      compressive force normalized to subject body weight was 5.6 +/- 1.3 body weight
      in forward running and 3.0 +/- 0.6 body weight in backward running. The results
      suggest that backward running at a self-selected speed may reduce patellofemoral
      joint compressive forces and, coupled with the quadriceps strengthening that has
      previously been reported, may be beneficial in the rehabilitation of
      patellofemoral pain syndrome in runners. However, constant speed comparisons or
      other models may yield different results.

PMID- 7787852
TI  - The effects of therapeutic application of heat or cold followed by static stretch
      on hamstring muscle length.
AB  - Hamstring stretching is an important part of treatment programs aimed at
      decreasing the likelihood of hamstring injury. Few studies have examined the use
      of superficial thermal modalities in conjunction with hamstring stretching. The
      purpose of this study was to determine if the application of a superficial
      heating or cooling modality, followed by static stretch, increased the efficacy
      of static stretching of the hamstring muscles. This study examined 12 male and 12
      female subjects, ages 18-38. All subjects received each of the following
      treatments: heat followed by static stretch, cold followed by static stretch, and
      static stretch alone. Each treatment was separated by at least 1 week. Pre- and
      post-treatment measurements of hamstring length were obtained using the Active
      Knee-Extension (AKE) test. The data were analyzed via a 2 x 3 analysis of
      variance experimental design. Results indicated that there was an increase in
      hamstring length regardless of stretch treatment used, with F(1,23) = 35.49, p <
      .001. However, no significant differences were detected among stretch treatments,
      F < 1.0, nor among interaction effects, F < 1.0. The results of this study
      suggest that adequate hamstring stretching can occur without the use of a
      superficial thermal modality.

PMID- 7787853
TI  - Posture in patients with shoulder overuse injuries and healthy individuals.
AB  - Assessment of posture is an integral component of patient evaluation with
      shoulder overuse injuries. However, the professional literature contains
      relatively few studies that have assessed the relationship between posture,
      function, and injury. The purpose of this study was to determine the relationship
      and differences in postural variables within and between subjects with overuse
      injuries to the shoulder of healthy subjects. Thirty patient subjects and 30
      healthy subjects matched for age and gender were recruited. Scapular protraction
      and rotation, forward head position, midthoracic curvature, and passive humeral
      elevation in the plane of the scapula were measured randomly in standing. All
      measurement techniques were standardized and validated. Intrarater and interrater
      reliability for all clinical measures were established before data collection.
      Forward head position was significantly greater (p < .001) in the patient group
      than the healthy group; humeral elevation was significantly greater (p < .001) in
      the healthy group than in the patient group and in the uninvolved shoulders (p <
      .01) than the involved shoulders within the patient group. Scapular protraction,
      rotation, midthoracic curvature, and scapular symmetry were not significantly
      different between groups. Scapula protraction and rotation were significantly
      related (p < .05) in the patient group. No other postural variables were related.
      Conclusions regarding the influence of posture to shoulder injury are
      inconclusive based on several confounding variables that may have affected the
      outcome.

PMID- 7787850
TI  - Energy expenditure of below-knee amputees during harness-supported treadmill
      ambulation.
AB  - Traditional rehabilitation of amputees is primarily aimed at strengthening
      remaining musculature necessary for prosthetic use and gait training. Available
      gait training time, however, is often limited by pain, residual limb skin
      tolerance, and the patient's cardiovascular endurance. Harness-supported
      treadmill ambulation is a rehabilitation technique being used by physical
      therapists to decrease an individual's body weight by a given percentage during
      exercise. This, theoretically, allows an amputee to ambulate on a prosthesis at a
      lower energy cost. The purpose of this study was to compare the energy
      expenditure of healthy below-knee amputee volunteers with healthy able-bodied
      volunteers during harness-supported treadmill ambulation in order to determine if
      energy conservation is achieved. Subjects were tested on a treadmill, walking at
      .67 m/sec (1.5 mph) and 1.34 m/sec (3.0 mph) during each of the following
      randomized harness-supported treadmill ambulation situations: full body weight,
      20% body weight supported, and 40% body weight supported. During the last minute
      of each trial, rate of perceived exertion, heart rate, and standardized indirect
      calorimetry oxygen consumption (VO2, ml/kg/min) measures were collected. Caloric
      expenditure (kl/min) was calculated using metabolic conversion equations. Peak
      heart rate, peak VO2, and peak kl/min were measured after the conclusion of the
      last walking trial by taking each subject to volitional fatigue. Data were
      analyzed for each harness-supported treadmill ambulation situation and group
      using analysis of variance (ANOVA). The researchers identified significantly
      lower ratings of perceived exertion, heart rates, and VO2s for able-bodied
      subjects vs. below-knee amputees for all trials. Both groups demonstrated
      significantly lower heart rates, VO2s, and kl/min at 1.34 m/sec with 40% body
      weight supported.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787854
TI  - [Our experience with the orthotopic continent colonic neobladder].
AB  - In the last years particular surgery operations became refined for the techniques
      and therapeutics progresses also developed in this field. This has allowed with
      major security to accomplish engagemently reconstruction operations after removal
      of the bladder, especially for cases of neoplastic pathology, to offer the
      patients a more normal quality of life avoiding urinary derivations that should
      change the performance of "EGO". After the operations of radical
      cystoprostatovesciculectomy different methods have been presented for the
      construction of heterotopical and orthotopical neobladder; among these the
      continent colic orthotopical neovesica of Goldwassern which uses the
      detubulization right colon, in our opinion could offer best functional and clinic
      results in virtue of easier execution and to use of minor number of intestinal
      segments. Moreover, for the peculiar characteristics of colic segment, allow to
      make a wide tank at low pression with perfect diurnal and nocturnal continence.
      We have, therefore, presenting the results of our experience regarding 12 cases
      of continent colic orthotopical neovesica, by Goldwasser, with a follow-up of 1-6
      years which have comforted us with the results predicted. Although other
      techniques may offer similar results we believe that the Goldwasser method is
      still valid for all the above reasons.

PMID- 7787855
TI  - [Abnormal production of oxygen free radicals by low leukocytospermia in purified
      fractions of semen from infertile patients].
AB  - Seminal leucocytes (WBC) play an important role, whereas this is still unknown.
      Quantitative normal threshold-value for leucocytospermia (Ls) (WBC < or = 1
      million/ml) seems not to be a safety predictive marker of male accessory gland
      infection (MAGI) and/or MAGI-related adverse effects on semen quality and/or
      fertility because several drawbacks: a) inadequate staining techniques are
      responsible of an underestimated WBC concentration in spermatic fractions (100%)
      obtained from high-density Percoli gradient (Pc 100%); b) Ls could be correlated
      far better to the clinical findings and/or outcomes if some biochemical data on L
      metabolism are also studied (Radical Oxygen Species-ROS-generation, phagocytosis,
      leucotoxins). In order to point out importance about an joint
      morphological/biochemical analysis about Ls, we recruited 76 selected infertile
      (from 2-7 yrs) patients (aged 32-45 yrs) who, in their 50% Percoli fractions, had
      previously produced WBC-ROS > 95th percentile values registered from our control
      group (n = 28, fertile men). In all infertile population we have analysed through
      Pc100 fraction either the percentage of WBC-negative patient's specimens (group
      A) and within WBC-positive ones if a significant difference was present in the
      maximal WBC-ROS production among different subgroups at WBC concentrations (group
      B:0.01-0.09, group C:1-10, group D: > 10 x 10(4) WBC/10(7) spermatozoa).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7787856
TI  - [Lymphocyte levels before treatment with subcutaneous interleukin-2 and during
      maintenance treatment in relation to the clinical efficacy in metastatic renal
      carcinoma].
AB  - AIMS AND BACKGROUND: the antitumor activity of IL-2 is mediated by an increase in
      lymphocyte number. Moreover, our previous studies have shown that therapy for 1
      week/month with low-dose subcutaneous IL-2 is sufficient to maintain high levels
      of lymphocytes in cancer patients who have had tumor regression or stable disease
      (SD) in response to IL-2 immunotherapeutic cycles. This study was performed to
      establish whether tumor progression in cancer patients chronically treated with
      IL-2 may be associated with lymphocyte number decline. METHODS: the study
      included 60 metastatic renal cell patients, who were treated with 2 induction
      cycles of IL-2 subcutaneous immunotherapy (6 million IU/day for 5 days/week for 6
      weeks, corresponding to one cycle). Tumor regression occurred in 17/60 patients,
      23 patients a SD, and the remaining 20 cases progressed. Non-progressed patients
      (n = 40) underwent a maintenance therapy consisting of one week of therapy every
      month. After a median follow-up of 18 months, 29/40 patients with response or SD
      had progressed. The immune investigation consisted of lymphocyte, T lymphocytes,
      NK cell number determination and sCD25 level detection. RESULTS: the mean number
      of lymphocytes, T lymphocytes and NK cells observed on IL-2 maintenance therapy
      was significantly higher than that seen before beginning the immunotherapy.
      Moreover, mean number of lymphocytes and mean levels of sCD25 observed at the
      time of tumor progression were respectively lower and higher than those seen on
      maintenance therapy in the same patients, without, however, significant
      differences. CONCLUSION: despite the importance of lymphocytes in mediating the
      antitumor activity of IL-2, this study shows that tumor progression in cancer
      patients chronically treated with low-dose IL-2 after response or SD during IL-2
      induction cycles is not associated with a significant decline in lymphocyte, T
      lymphocyte or NK cell numbers. Further studies, carried out to analyze the
      functional status of immune cells at the time of tumor progression, will be
      necessary to define the role of immunity in cancer patients progressing under IL
      2 chronic therapy.

PMID- 7787857
TI  - [Prognostic predictive factors of the clinical response to immunotherapy with
      subcutaneous interleukin-2, in patients with metastatic renal carcinoma: analysis
      of 60 cases].
AB  - The intravenous immunotherapy with high-dose interleukin-2 (IL-2) would
      constitute one of the most effective treatments of metastatic renal cell
      carcinoma (RCC). More recently, IL-2 subcutaneous therapy has also appeared
      active, either alone or in association with interferon, with results comparable
      to those found with the intravenous route of injection, but with a lower
      toxicity. On this basis, we have designed a protocol of treatment with low-dose
      IL-2 alone given subcutaneously as a first or a second line therapy in metastatic
      RCC. The study included 60 consecutive patients (pts) (M/F: 39/21, median age 56
      years, range 26/74). IL-2 was given at a dose of 3 millions IU twice/day for 5
      days/week, for 6 weeks, corresponding to one cycle. In non progressed pts a
      second cycle was repeated after a 28-day rest period. Dominant metastasis sites
      were, as follows: soft tissues: 8; bone: 11; lung: 29; liver: 3; liver plus lung:
      7; adrenal: 2. The minimum follow-up was 18 months and the median follow-up was
      34 months (range 18-48). A complete response (CR) was achieved in 2/60 (3%) pts.
      A partial response (PR) was obtained in 15/60 (25%). Therefore, tumor objective
      rate (CR + PR) was 17/60 (28%). The median duration of response was 13 months (4
      33).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787859
TI  - [Correlation between ultrasonography imaging and surgical findings in scrotal
      trauma].
AB  - The Authors report their experience of 20 cases of scrotal trauma. The
      etiopathogenesis of lesions are stressed as well as the importance of an early
      diagnosis, in order to plan a correct treatment avoiding immunological and
      atrophic outcomes. All of the patients underwent a diagnostic ultrasonographic
      examination. Eighteen of them were surgically treated, whereas last two recovered
      by means of a week antibiotic and anti-inflammatory medical therapy. The scrotal
      sonography showed a 100% sensibility for testis injuries and a 80% specificity
      for albuginea fractures. In fact a fracture of the tunica albuginea was found in
      two cases although they showed a normal scrotal sonogram. It is worth of mention
      that in the authors' experience the ultrasonography generally understages the
      testis damages. Only the surgical exploration is believed to be able to make a
      sure diagnosis of type and seriousness of the scrotal injury.

PMID- 7787858
TI  - [Bladder hernia: a clinical case].
AB  - The Authors report a case of inguinal bladder hernia and briefly refer about the
      different kinds of this rare pathology which is often associated to the commonest
      inguinal hernia. They, moreover, point out the surgical treatment which has to
      aim to the repositioning of the bladder and to solve the cervicovesical
      obstruction.

PMID- 7787860
TI  - [Transrectal echography in laser treatment of incidental prostatic carcinoma].
AB  - This report is concerning on our experience in the management of the incidental
      prostatic cancer treated by laser irradiation and transrectal ultrasounds (TRUS).
      22 patients, with stage A incidental prostatic cancer, underwent preliminary TRUS
      to evaluate suspected areas of residual tumor and/or the capsule thickness. 5
      patients, before the laser irradiation, have been treated with 2nd look TURP
      because residual tumor or much residual prostatic tissue was present. Following
      TRUS evaluation all the patients underwent a laser irradiation with TRUS
      guidance. During the laser irradiation TRUS evaluation allows to recognize the
      anatomy of the prostatic capsule, the thickness of the capsule and to perform a
      safety and complete laser irradiation of the prostatic capsule with a depth laser
      irradiation. In the postoperative follow-up the TRUS demonstrated, in 18
      patients, a complete laser induced fibrosis of the capsule. In conclusion the
      TRUS represents a good technique for pre and postoperative evaluation in the
      patients of stage A prostatic cancer treated with laser irradiation.

PMID- 7787861
TI  - [Echo-guided percutaneous treatment of intraprostatic cysts].
AB  - Diagnostic and therapeutic values regarding echoguided percutaneous treatment of
      intraprostatic cysts are reviewed and discussed. Since 1987 we have detected by
      ultrasonography 48 intraprostatic cysts, 22 asymptomatic patients were evaluated
      periodically. A ultrasound guided percutaneous puncture was performed in 26
      symptomatic patients. 10 patients affected by dysuria were treated by aspiration
      and injection of antibiotics. 14 oligospermic patients underwent cyst aspiration
      followed by introduction of sclerosing agents (aethoxysclerol or alcohol). In one
      communicating cyst simple aspiration has been performed. A giant cystoadenoma has
      been resolved by surgical procedure. In the follow-up (2 months - 6 years) we
      observed: 5 recurrences (50%) in the cysts treated with antibiotics and 6 (43%)
      recurrences in the cysts treated with sclerosing agents. However, 8 patients out
      of 10 obtained a resolution of the urinary symptoms and 8 patients out of 14
      improved their seminal parameters. On our experience, percutaneous echoguided
      treatment of prostatic cysts is a suitable and safe technique because of the
      possibility to resolve some clinic problems, although an high recurrence rate.

PMID- 7787862
TI  - [The acquitted obese].

PMID- 7787863
TI  - [Protective effects of glutamine and elemental diet in acute actinic
      enterocolitis: histological evaluation].
AB  - Radiotherapy plays nowadays an important role in malignancies treatment. However,
      collateral effects and severe complications owing to cellular damage of
      peritumoral tissues may occur. Different nutritional resources have been recently
      indicated to achieve intestinal protection during cancer irradiation. PURPOSE-
      The aim of this study was to set the role of glutamine and elemental diets in
      acute actinic enteritis prevention. METHOD--Sixty-five adult male Wistar rats
      with average weight of 200g were maintained in individual metabolic cages; daily
      body weight and food ingestion were carefully monitored. The animals were
      randomized into three groups and fed isocaloric and isonitrogenous diets: 1) CRt
      polymeric-casein diet; 2) GRt-polymeric-casein diet supplemented with 2%
      glutamine and 3) ERt-elemental diet supplemented with 2% glutamine. After an
      adaptation period (seven days), all rats received abdominal radiation in five
      daily doses of 300cGy. Four days after the rats were operated on to resect the
      small intestine and colon for histological evaluation. RESULTS--Small intestine
      histological data in ERt and GRt rats were better than CRt rats, by preserving
      mucosal cellularity and increasing mitosis number and villi length.
      Simultaneously, ERt group had greater number of rats with normal villus-crypt
      relation than CRt or GRt groups. Large intestine histological data showed that
      the average crypts length in ERt and GRt rats were greater than in CRt ones.
      CONCLUSION--Glutamine-supplemented polymeric or elemental diets given to rats
      before, during and after abdominal radiotherapy showed protective effects against
      radiation injury, by supporting mucosal structure and recovery.

PMID- 7787864
TI  - [Placenta: a barrier for renotrophic factor?].
AB  - BACKGROUND: To evaluate if the renotrophic factor can pass through the placenta
      and act on the fetal kidney. MATERIAL AND METHODS: Twenty pregnant rats were
      divided into 4 groups of 5 animals: 1-control; 2-sham operated animals; 3-right
      nephfrectomy; 4-right nephrectomy--left polar nephrectomy. All rats were operated
      on during the 14 or 15 day of pregnancy. Maternal weight, serum urea and
      creatinine, number of fetal rats, fetal body and renal weight; DNA, RNA, protein
      and the amount of water in fetal kidneys were evaluated. RESULTS: Fetal kidneys
      showed a fall in weight in groups 3 and 4. In these groups tissue water
      concentration was lesser than groups 1 and 2. Fetal kidneys amounts of DNA, RNA
      and protein were similar in all groups. CONCLUSIONS: This study suggest that
      renotrophin could be a multifactorial system that can cross the placenta. The
      fall in renal fetal weight following maternal nephrectomy was consequent to a
      lesser tissue water content. Hypoplasia or hypotrophy did not play a role in this
      event. However, the fall in fetal kidney water was independent of the amount of
      maternal renal tissue that was removed.

PMID- 7787865
TI  - [Ophthalmological manifestations in AIDS: evaluation of 445 patients in one
      year].
AB  - The authors prospectively evaluated 445 HIV positive patients for the presence of
      ophthalmological manifestations. PURPOSE--To evaluate patients HIV positive with
      or without AIDS and correlate the data with the ocular findings mentioned in the
      literature. METHODS--445 HIV positive patients (66% with AIDS) were evaluated in
      one year at the Paulista School of Medicine, Sao Paulo Hospital, Brazil. There
      was a predominance of males (87%) and homosexuals (58.2%). RESULTS--Of the 445
      patients, 52% presented ocular findings secondary to HIV infection at the first
      examination. The diagnosis included: CMV retinitis (25%), ocular toxoplasmosis
      (8.5%), herpes retinitis (3.6%), papilledema (2.2%), optic atrophy (1.6%),
      phthisis bulbi (1.5%), multifocal choroiditis (1.2%), retinal hemorrhages (0.9%),
      syphilitic uveitis (0.6%) and central vein occlusion (0.2%). CONCLUSION--The
      incidence of ophthalmic manifestations of AIDS in Brazil is similar to that found
      in the international literature. We found though a higher incidence of ocular
      toxoplasmosis than that in other countries. No ocular pneumocystosis was presents
      in the population evaluated by us.

PMID- 7787866
TI  - [Pharmacokinetics of cyclosporine and its metabolites in patients undergoing
      kidney transplantation].
AB  - Pharmacokinetics of cyclosporine shows high inter and intra-individual
      variability and changes in several parameters are often found after kidney
      transplantation. PURPOSE--Evaluate serial studies of the pharmacokinetics of
      cyclosporine and its metabolites in patients undergoing kidney transplantation.
      METHODS--The pharmacokinetics of cyclosporine and its metabolites were analyzed
      in 70 studies performed in 29 patients, 26 before and 44 after kidney
      transplantation. The blood cyclosporine concentration was determined in 17
      samples obtained after is oral or intravenous administration, using
      radioimmunoassay with specific (RIE-MoSP) and nonspecific (RIE-MoNP) monoclonal
      antibodies. RESULTS--The values of area-under-the-time-concentration curve (AUC),
      bioavailability (F), peak concentration (Cmax) and the 12 and 24 trough levels
      (C12 and C24), determined with RIE-MoSP, were lower than that obtained with RIE
      MoNP, and the clearance (CL) and the volume of distribution (Vd) were higher. The
      elimination half-lives (t1/2) for both methods were not different. The absorption
      followed a zero order kinetic, demonstrating an inverse correlation between
      cyclosporine dose (mg/kg) and AUC/dose (r = -0.55, RIE-MoSP and r = -0.42, RIE
      MoNP). Bioavailability ranged between 18% and 68% (RIE-MoSP) and were
      overestimated when calculated using RIE-MoNP (38% to 100%) owing to extensive
      cyclosporine metabolization during the first passage through the intestine and
      the liver. The metabolic rate analyzed by the ratio of blood concentrations
      determined with RIE-MoNP and RIE-MoSP (NP/SP), increased during the first 12
      hours after cyclosporine administration, and was higher after oral dosing. The
      hematocrit and the serum lipoproteins concentrations significantly correlated
      with several pharmacokinetics parameters, mainly when they were determined with
      RIE-MoSP. The correlation between one sample obtained at any time after
      cyclosporine administration and the AUC were unsatisfactory, even the trough
      levels of 12 and 24 hours. AUCs calculated with 3 selected samples chosen by
      multiple linear regression correlated with AUC calculated using 17 samples, with
      a determination coefficient higher than 0.95 (RIE-MoSP, r = 0.975; RIE-MoNP, r =
      0.974). CONCLUSION--Among all the parameters calculated, parameters of total
      exposure to the drug (AUC, AUC/dose, Cssav) showed the best correlation with the
      dose of cyclosporine, hematocrit and serum lipoproteins concentration. The
      methodology simplification, reducing the number of samples to calculate AUC,
      could be a good strategy to apply routinely these parameters in clinical
      transplantation.

PMID- 7787867
TI  - [Serum beta 2 microglobulin (beta 2M) following renal transplantation].
AB  - Although there was an important improvement in graft and patient survival the
      last 10 years, graft rejection continues to be a major barrier to the success of
      renal transplantation. Identification of a laboratory test that could help to
      diagnose graft rejection would facilitate the management of renal transplanted
      patients. PURPOSE--To evaluate the utility of monitoring serum beta 2M in
      recently transplanted patients. METHODS--We daily determined serum beta 2M levels
      in 20 receptors of renal grafts (10 from living related and 10 from cadaveric
      donors) and compared them to their clinical and laboratory evolution. RESULTS-
      Eight patients who presented immediate good renal function following grafting and
      did not have rejection had a mean serum beta 2M of 3.7 mg/L on the 4th day post
      transplant. The sensitivity of the test for the diagnosis of acute rejection was
      87.5%, but the specificity was only 46%. Patients who presented acute tubular
      necrosis (ATN) without rejection had a progressive decrease in their serum levels
      of beta 2M, while their serum creatinine changed as they were dialyzed. In
      contrast, patients with ATN and concomitance of acute rejection or CSA
      nephrotoxicity presented elevated beta 2M and creatinine serum levels. CONCLUSION
      -Daily monitoring of serum beta 2M does not improve the ability to diagnose acute
      rejection in patients with good renal function. However, serum beta 2M levels
      seemed to be useful in diagnosing acute rejection or CSA nephrotoxicity in
      patients with ATN.

PMID- 7787868
TI  - Anatomical terms of Yanomani Indians translated into Portuguese and English.
AB  - The authors translated into Portuguese and English the basic anatomical
      terminology used by the Yanomani indians. The knowledge of the names of organs
      and other parts of the human body and of a few having a clinical meaning should
      help those interested in the study of and in interaction with the Yanomanis.

PMID- 7787869
TI  - [Practicability of cataract surgery at university hospitals: searching for an
      economic model].
AB  - Resources available for health care all over the world are not enough to cover
      all the demand in this sector. Cataract Free Zones conducted in many regions of
      the country show that only 10% to 20% of blind patients caused by senile cataract
      can get operated on. PURPOSE: To demonstrate feasibility of a model for cataract
      surgery with intraocular lens implantation at the Clinical Hospital from the
      University of Campinas, Unicamp, Sao Paulo, when considering the remuneration
      payed by the government for universitary services. METHODS: Costs with disposable
      material were collected for extracapsular cataract surgery, with posterior
      intraocular lens implant, at the Clinical Hospital, Unicamp. The model includes
      outpatient surgery under local anesthesia, and costs rationalization in
      acquisition and wear of material. University Hospitals have a different situation
      in the health system, where fixed costs and part of the variable costs of
      cataract surgery are subsidized by the State government. RESULTS: Cataract
      surgery performed under the proposed methodology is economically feasible,
      considering disposable components only, and the price achieved was US$ 77 with
      government payment of US$ 474. More surgical interventions increases the
      efficiency of the institution, provides more surgical training to residents and
      better community health care. CONCLUSION: The authors consider that it is an
      obligation of University Hospitals, regard their commitment with training,
      research and quality of eye care deliverance, to increase the number of cataract
      surgeries for the lowest possible price.

PMID- 7787870
TI  - [Microneurography: technique to study cardiovascular regulation by the
      sympathetic nervous system in humans].
AB  - Microneurography is a valuable and safe method for direct intraneural recording
      of sympathetic nerve activity to muscle and skin in humans. The technique and its
      application for the study of autonomic function will be briefly discussed. The
      regulation of muscle sympathetic nerve activity will be focused in different
      clinical situations and or stimuli, such as: essential hypertension,
      mineralocorticoid induced hypertension, exercise mental arithmetic stress, cold
      pressor test, hyperinsulinemia, oral alcohol ingestion.

PMID- 7787871
TI  - [Leprosy and pregnancy].
AB  - We followed 20 cases of pregnant women with leprosy: eight lepromatous (L), seven
      "borderline", four turbeculoid and only one indeterminate (I) and their newborns.
      Three patients showed the first symptoms during pregnancy and another one in
      postpartum. One patient was sick during sixteen years and another one was treated
      during fourteen years. The bacterioscopic examination was positive in thirteen
      and negative in seven patients. The Mitsuda test was negative in sixteen,
      positive in two and in two others was not performed. The treatment in fourteen
      patients was polychimiotherapy (diamino diphenylsulfone, rifampicin and
      clofazimine). Three patients received dapsone monotherapy. Three women started
      the treatment postpartum. Reactions states were treated with corticosteroids and
      acetylsalicylic acid. The therapy was Irregular in nine and Regular in eight
      cases. Ten patients showed reactions: eight during pregnancy, one in puerperium
      and one in the lactation period. Eight showed erythema nodosum leprosum and two
      reversal reaction. One patient showed false positive biologic test for syphilis
      and another one had positive bacterioscopic examination in the lactation period.
      One patient showed false positive biologic test for syphilis and another had
      positive bacterioscopic examination in the lactation period. One newborn showed
      exfoliative dermatitis in the first hours of life and his mother had used sulfone
      during pregnancy. Among the twenty babies five had less than 2,500g in weight and
      four were premature. CONCLUSION: The reaction states of patients and low birth
      weight of premature babies occurred in lepromatous and "borderline" cases.

PMID- 7787873
TI  - [Indications of exploration and repair of the orbital floor in fractures of the
      maxillozygomatic complex].
AB  - Patients with orbital fractures may develop late complications like enophthalmos,
      orbital dystopia or diplopia, as a result of untreated orbital floor lesions,
      with herniation of orbital fat. Clinical and radiological findings are not enough
      for diagnostic and indication of orbital floor repair. PURPOSE: To evaluate the
      indication of repair of the orbital floor, during the surgical treatment of
      maxillozygomatic or zygomatic-maxillary compound fractures, by means of systemic
      exploration and to compare clinical with surgical findings. METHODS: 112 patients
      with unilateral zygomatic-maxillary compound fracture were submitted to
      exploration of the orbital floor, during the surgical treatment of the fracture.
      Open reduction and rigid internal fixation was performed with steel wire or
      miniplates. An autogenous conchal cartilage graft was used to repair the floor
      lesion, when there was bone loss of the inferior orbital wall and periorbita
      discontinuity, with fat herniation. RESULTS: The repair of the orbital floor was
      indicated in 46.4% of the patients. Early diplopia (before surgery) was observed
      in 26.6% and enophthalmos in 3.30% of the cases. Among patients with early
      diplopia, 60% needed repair, while 36.6% of the patients without early diplopia
      received cartilage graft. No important complications was observed. CONCLUSION:
      Orbital floor exploration is a complementary maneuver for the treatment of
      zygomatic-maxillary compound fractures that permits the precise diagnostic of the
      lesion and the correct indication of repair.

PMID- 7787874
TI  - [Deprofessionalization or reprofessionalization: a study comparing law and
      medicine].
AB  - The author discusses and compares the transformations in the profession of
      lawyers in the United States of America and the doctors in Brazil according to a
      theoretical analysis based upon the classical theory of the Sociology of the
      Professions. The discussion about the deprofessionalization of Medicine is
      conducted along some of the characteristics outlined by the theory. The author
      concludes that the challenge that faces medicine is a kind of re-organization
      that will change necessarily the profession as we know it today, but this change
      will not affect the professional autonomy or any other of its essential
      characteristics.

PMID- 7787872
TI  - [Transduodenal endoscopic drainage of pancreatic pseudocysts and peripancreatic
      collection].
AB  - Until recently, the treatment of pancreatic pseudocysts was mainly surgical.
      However, two non-surgical invasive approaches are now possible: percutaneous
      aspiration under ultrasonic or CT monitoring and endoscopic drainage. PURPOSE--To
      report the result obtained using endoscopic drainage of pancreatic pseudocysts.
      METHODS--11 consecutive patients admitted with pancreatic pseudocyst had chronic
      pancreatitis and 1 patient had a well defined paraduodenal collection originated
      from acute necrotising pancreatitis. Endoscopic cystoduodenostomy was performed
      in the area of close contact with the digestive wall. A standard Olympus
      duodenoscope was used to reach the bulging wall and to allow the diatermic
      fistula. RESULTS--The success rate was 91.7%. Hemorrhage occurred in 1 patient
      (8.3%) controlled without blood transfusion. Endoscopic cystoduodenostomy was the
      definitive treatment in 10 patients 36 months after the procedure. One patient
      underwent gastrojejunostomy after 14 months for duodenal obstruction following
      relapsing pancreatitis. There was no relapsing cyst. There was no death following
      the endoscopic procedure. CONCLUSION--the endoscopic cystoduodenostomy
      constitutes an alternative procedure for the drainage of paraduodenal pseudocysts
      whenever restricted to the precise morphological indication of paraintestinal
      pseudocyst bulging into the duodenal lumen.

PMID- 7787876
TI  - [Leptospirosis and pulmonary hantavirus syndrome].

PMID- 7787875
TI  - [Molecular aspects of erythrocyte membrane disorders].

PMID- 7787877
TI  - [Osteocalcin].

PMID- 7787878
TI  - Apoptosis and the cell cycle.
AB  - This brief review examines the strict relationships between cell apoptosis and G1
      cyclins. It has been shown that the basic role of G1 cyclins is in regulating G1
      progression and G1/S transition (the critical cycle point for cell program
      decisions, including apoptosis) a fatal program for cells unable to bypass G1/S
      checkpoint 1. Notably, both of the two giant regulators of checkpoint 1 (i.e.,
      p105RB [retinoblastoma oncosuppressor-encoded protein] and p53 dependent
      WAF1/CIP1) are influenced by or influence G1 cyclins: cyclin E/cdk2 kinase
      complexes hyperphosphorylate p105RB, induce E2F release, and free G1 exit. On the
      other hand, p21-WAF1/CIP1 is an inhibitor of cyclin-dependent kinases blocking
      cells at G1/S. Thus, G1 cyclin activity appears as a conditio sine qua non for G1
      exit and apoptosis escape.

PMID- 7787879
TI  - The tyrosinase gene family--interactions of melanogenic proteins to regulate
      melanogenesis.
AB  - Several genes critical to the regulation of melanin production in mammals have
      recently been cloned and characterized. They map to the albino, brown, and slaty
      loci in mice, and encode proteins with similar structures and features, but with
      distinct catalytic capacities. The albino locus encodes tyrosinase, an enzyme
      with three distinct melanogenic functions, the brown locus encodes TRP1
      (tyrosinase-related protein-1), and the slaty locus encodes TRP2, another
      tyrosinase related-protein. TRP2 functions as DOPAchrome tautomerase, an enzyme
      that preserves the carboxylic acid content of melanins, which would be
      spontaneously lost in its absence, while TRP1 is able to oxidize the DHICA
      produced by TRP2. In this study we have used three different systems (immune
      affinity purified melanogenic enzymes, mutant melanocytes, and transfected cells)
      to examine the enzymatic interactions of these proteins, and their stabilization
      in a complex which significantly increases their physiological half-life. When
      extrapolated to the melanocyte, our results demonstrate the catalytic functions
      of these proteins and suggest how they might stably interact within a melanogenic
      complex in the melanosome to regulate the quantity and quality of melanin
      synthesized.

PMID- 7787880
TI  - Identification of a rat protein tyrosine phosphatase gene preferentially
      expressed in the embryonal brain.
AB  - We have identified a novel protein tyrosine phosphatase gene from an embryonal
      rat brain by reverse transcription-based polymerase chain reaction. Its
      transcription is specific to brain and is developmentally regulated, as it is
      expressed at high levels in embryonal and neonatal stages but scarcely in an
      adult. Southern blot analysis indicates that the gene exists as a single copy and
      is conserved among various species. Homology search of the deduced amino acid
      sequence suggests that this gene belongs to the same family of the membrane-type
      tyrosine phosphatase gene of Drosophila (DPTP10D), whose expression is specific
      to an central nervous system of fly embryo.

PMID- 7787881
TI  - Translational regulation of the mammalian growth-related protein P23: involvement
      of eIF-4E.
AB  - Synthesis of the mammalian growth-related protein P23 is rapidly induced after
      serum stimulation of mouse fibroblasts and Ehrlich ascites tumour cells. This
      induction occurs at the translational level. Growth-induction leads also to an
      increase in phosphorylation of the rate-limiting initiation factor eIF-4E. Here,
      we present the following evidence indicating the involvement of eIF-4E in the
      regulation of P23 synthesis: 1) P23 synthesis is induced by the same mitogenic
      stimuli which lead to enhanced eIF-4E phosphorylation. 2) Upon heat shock
      treatment of Ehrlich ascites cells (which results in immediate dephosphorylation
      and concomitant inactivation of eIF-4E), P23 synthesis is rapidly shut off. 3) In
      control NIH 3T3 cells, P23 synthesis is readily induced by growth stimulation.
      This response is strongly diminished in cells overexpressing eIF-4E, and the
      basal level of P23 synthesis is elevated in these cells. Overexpression of a
      nonfunctional mutant of eIF-4E diminishes the basal level of P23 synthesis as
      well as the serum-response of the cells with respect to P23 induction. 4) Cells
      transformed by overexpression of the ras or src genes in which eIF-4E is highly
      phosphorylated do not show any inducibility of P23 synthesis. 5) HeLa cells
      expressing antisense RNA of eIF-4E, have reduced levels of eIF-4E/F and show
      reduced rates of growth and protein synthesis. In these cells the total amount of
      P23 protein is about 50% compared with control cells. The results suggest that
      P23 is one of the gene products, the synthesis of which is regulated by eIF-4E
      activity.

PMID- 7787882
TI  - In vivo binding of proteins to stably integrated MMTV DNA in murine cell lines:
      occupancy of NFI and OTF1 binding sites in the absence and presence of
      glucocorticoids.
AB  - Activation of expression at the mouse mammary tumor virus (MMTV) promoter is
      thought to be controlled by nucleosome positioning. On stably integrated MMTV
      DNA, the long terminal repeat (LTR) region is organized in a phased array of
      nucleosomes which allegedly occludes transcription factors such as NFI from
      binding. NFI only binds to the promoter region when the ordered nucleosome
      structure is apparently disrupted by activated steroid hormone receptors in
      hormone induced transcription. In certain cell lines, binding sites for the
      transcription factors NFI and OTF1 are however required for hormone-independent
      expression of MMTV. We have used stably transfected mouse NIH3T3 and GR cells
      that exhibit detectable MMTV expression in the absence of hormone for in vivo
      determination of proteins binding to the MMTV promoter. Here, we present in vivo
      dimethyl sulfate footprinting data that show that the NFI and OTF binding sites
      are permanently occupied in vivo in these cells. The contacting guanine residues
      identified in vivo were demonstrated in in vitro methylation interference assays
      to correspond to binding by NFI and OTF1. These results demonstrate a novel
      feature of transcription factor occupancy at the MMTV LTR promoter.

PMID- 7787883
TI  - TGF-beta 1 augments expression of the TIS10/prostaglandin synthase-2 gene in
      intestinal epithelial cells.
AB  - Treatment of nontransformed rat intestinal crypt epithelial IEC-6 cells with
      tetradecanoyl phorbol acetate (TPA) + calcium ionophore (A23187) induces both the
      synthesis of prostacyclin and the expression of the TIS10/PGS-2 gene, a primary
      response gene encoding a second form of prostaglandin synthase (PGS). In addition
      to pharmacological induction by TPA + A23187, TIS10/PGS-2 message is also induced
      by the inflammatory cytokine interleukin 1-beta (IL-1 beta). Transforming growth
      factor beta 1 (TGF-beta), a potent cytokine known to modulate a variety of
      biological responses, does not by itself induce either prostanoid accumulation or
      TIS10/PGS-2 gene expression. TGF-beta does, however, augment both induced
      prostacyclin accumulation and the induced synthesis and accumulation of TIS10/PGS
      2 protein and message in IEC-6 cells. TGF-beta concentrations in the range of 0.1
      1.0 ng/ml (4.0-40 pM) maximally augment accumulation of TIS10/PGS-2 message. In
      contrast, dexamethasone attenuates prostacyclin production, TIS10/PGS-2 protein
      accumulation, and TIS10/PGS-2 message induction in IEC-6 cells. These results
      suggest that steroids and cytokines such as TGF-beta may (i) modulate intestinal
      epithelial cell growth and differentiation and (ii) influence gastrointestinal
      diseases such as gastric ulcers and colon cancer by modulating eicosanoid
      production.

PMID- 7787884
TI  - Emergence of antigenic variants of simian immunodeficiency virus (SIVmac) in a
      seronegative macaque after SIVmac239 infection.
AB  - Infection with the macaque strain of the simian immunodeficiency virus (SIVmac)
      induces simian immunodeficiency syndrome in rhesus macaques. This report
      describes the isolation and identification of antigenic variants of SIVmac in one
      of the infected monkeys (macaque #22803). Eight naive rhesus monkeys were
      inoculated with a titered viral stock of the molecularly cloned SIVmac239.
      Standard serological analysis revealed that all but two were seroconverted.
      Western blot analysis confirmed the seronegativity of macaque #22803. In
      addition, sera recovered from this monkey were not able to neutralize the parent
      SIVmac239. However, virus could be isolated from all of the infected animals,
      including macaque #22803. Sera recovered were reactive to the autologous virus.
      The results suggest that the virus from macaque #22803 may have undergone
      extensive antigenic shift in vivo. To test this hypothesis, a portion of the gag
      gene was amplified by the polymerase chain reaction (PCR), cloned, and sequenced.
      Sequence analysis revealed amino acid changes that were clustered between amino
      acids 200-245. Evaluation of the possible selective pressures contributing to the
      observed viral mutation revealed that in comparison with the other SIVmac239
      infected monkeys, macaque #22803 produced an unusually high T cell proliferative
      response toward mitogen stimulation before infection, and continued to display a
      persistently high plasma viremia titer after infection.

PMID- 7787885
TI  - Characterization of the interactions between double-stranded RNA and the double
      stranded RNA binding domain of the interferon induced protein kinase.
AB  - The interferon-inducible protein kinase, PKR, requires double-stranded (ds) RNA
      for its activation. We have previously mapped its dsRNA-binding domain (DRBD) to
      the amino terminal 170 residues (Patel and Sen, 1992). In the present study, we
      have characterized in detail the interactions between dsRNA and DRBD. For this
      purpose, DRBD was produced in bacteria as a polyhistidine-tagged protein and
      purified by affinity chromatography. A polyclonal antibody was raised against
      purified DRBD. For studying dsRNA-DRBD interactions, a Northwestern assay and an
      electrophoretic mobility shift assay (EMSA) using a radiolabeled in vitro
      transcribed 82 bp dsRNA probe was developed. The antiserum reacted with both DRBD
      and PKR but did not prevent their interactions with dsRNA. DRBD, on the other
      hand, blocked the activation of PKR by dsRNA. DRBD and the dsRNA probe formed
      multimeric complexes which were separable by EMSA. The antibody could interact
      with these complexes and supershift their mobility. Competition with unlabeled
      dsRNA revealed that the dimeric DRBD-dsRNA complex was much more stable than the
      monomeric complex. Similar competition assays using 11 different synthetic and
      natural RNA molecules revealed that only authentic dsRNA molecules could
      effectively compete with the probe for binding DRBD in a sequence-independent
      fashion.

PMID- 7787886
TI  - Dinucleotide repeat polymorphisms at nine loci in sporadic colorectal cancer.
AB  - Genomic instability in the form of microsatellite alterations at nine loci on
      chromosomes 2p, 8p, 10p, 11p, and nm23-H1 locus on 17q21.3 were studied in
      sporadic colorectal tumors. Alterations in dinucleotide repeats in tumor DNA as
      larger allele, smaller allele, or loss of heterozygosity (LOH) were observed.
      Forty percent of tumor showed an RER+ phenotype. A significantly high number of
      alterations was detected at loci of chromosome 8p. The markers on chromosomes 2p,
      10p, and 11p did not show such significant alteration. LOH was found to be
      associated with the nm23-H1 locus. No correlation was found between the age, site
      of tumor occurrence, or metastasis and the microsatellite instability.

PMID- 7787889
TI  - Bibliography of cellular and molecular biology research.

PMID- 7787887
TI  - Cloning of the chandipura virus phosphoprotein encoding gene and its expression
      in Escherichia coli.
AB  - Chandipura (CHP) virus, a member of the vesiculovirus genus within the
      Rhabdoviridae family, was first isolated from human patients in India. The full
      length phosphoprotein P gene of CHP have been cloned and expressed in Escherichia
      coli using the T7 polymerase-based pET-3 series of expression vectors. Under
      optimal conditions of induction with IPTG, the recombinant P protein constituted
      35% of the total bacterial protein. The bacterially expressed protein was found
      to be phosphate-free. Deletion analysis suggested that the anomalous mobility of
      the P protein was due to its high acidity. The expressed protein can be
      phosphorylated in vitro by the extracts prepared from baby hamster kidney cells
      or rabbit reticulocytes. The cellular kinase involved in phosphorylation appears
      to be casein kinase II.

PMID- 7787890
TI  - Birthing the placenta. Tear prevention.

PMID- 7787888
TI  - Position and orientation independent transactivation by c-Myc.
AB  - The c-myc oncogene c-Myc is commonly activated in cancer and transactivates gene
      expression by binding to CACGTG DNA sequences as a heterodimeric complex with
      Max. The ornithine decarboxylase (ODC), p53, prothymosin alpha and ECA39
      promoters are transactivated by c-Myc, and are considered direct targets, as
      activation is mediated by CACGTG sequences. Interestingly, the c-Myc-responsive
      CACGTG sequences in the p53, prothymosin alpha, ECA39 and murine ODC genes are
      all downstream of the RNA CAP site, suggesting that downstream sequences are
      preferred c-Myc targets. Using a series of heterologous reporter constructs, we
      have tested the effects of position and orientation of c-Myc-responsive CACGTG
      sequences on c-Myc's ability to activate transcription. A single binding site
      conferred c-Myc-responsiveness independent of position and orientation, and over
      distances of 1.7 kbp. The extent of transactivation was not significantly
      influenced by position of the responsive elements. By contrast, the extent of
      transactivation was dependent upon the number of c-Myc binding sites. The results
      demonstrate that c-Myc activates transcription independent of position and
      orientation and that considerable flexibility exists in the interaction of c-Myc
      transactivation domains with the general transcription machinery.

PMID- 7787891
TI  - Wisdom from generations past.

PMID- 7787893
TI  - Sage femme.

PMID- 7787892
TI  - Crucial timing.

PMID- 7787894
TI  - The grand finale to birth.

PMID- 7787895
TI  - The last minutes before parenthood.

PMID- 7787896
TI  - Alexander.

PMID- 7787897
TI  - Unraveling toxemia.

PMID- 7787898
TI  - One diaper at a time.

PMID- 7787899
TI  - Signs to watch.

PMID- 7787900
TI  - The physiology of fetal transformation at birth.

PMID- 7787901
TI  - Dance with life.

PMID- 7787902
TI  - Little black book pages for third stage and postpartum.

PMID- 7787903
TI  - Traditional Chinese medicine: integrating it into modern midwifery practice.

PMID- 7787904
TI  - Meconium aspiration syndrome: diagnosis and care guidelines.

PMID- 7787906
TI  - Expelling clots.

PMID- 7787905
TI  - Postpartum hemorrhage: prevention and treatment.

PMID- 7787907
TI  - TCM terminology.

PMID- 7787908
TI  - Tips for bimanual compression.

PMID- 7787909
TI  - A chance to define our future.

PMID- 7787910
TI  - Lessons from history and from down under.

PMID- 7787911
TI  - Acute care nurse practitioner curriculum: content and development process.
AB  - Curriculum development for preparation of acute care nurse practitioners requires
      a comprehensive process. To develop a program for their preparation at a large
      university, the faculty examined needs of the target patient population and care
      delivery system; scope of acute care nurse practitioner practice; current
      guidelines for the education of primary care nurse practitioners; evolving
      guidelines for the didactic and clinical education of acute care nurse
      practitioners; educational requirements of governing or licensing and certifying
      bodies; and placement of this new role within the existing healthcare team
      structure. A curriculum was then developed using a collaborative,
      multidisciplinary approach.

PMID- 7787912
TI  - Effect of a standardized rewarming protocol and acetaminophen on core temperature
      after coronary artery bypass.
AB  - BACKGROUND: Cardiac surgical patients who require hypothermic cardiopulmonary
      bypass experience hypothermia, normothermia, and hyperthermia during the early
      postoperative period. Research-based rewarming protocols are needed to manage
      temperature variations. OBJECTIVE: To describe the effect of a standardized
      rewarming protocol and acetaminophen on the following outcome variables: core
      temperature, peak core temperature, rewarming time, and hyperthermia. METHODS:
      Patients (N = 60) were rewarmed using a standardized rewarming protocol. Electric
      heating blankets were used for subjects with core temperatures less than 36
      degrees C on admission to the intensive care unit; other subjects were covered
      with cotton bath blankets. Subjects were also assigned to one of three
      acetaminophen groups (650 mg at 38.1 degrees C, 650 mg at 37 degrees C, 1300 mg
      at 37 degrees C). RESULTS: Using the protocol, subjects warmed to normothermia in
      3.6 to 6 hours. The 16-hour core temperature thermal curves of heating blanket
      versus cotton bath blanket subjects differed significantly; thermal curves of the
      acetaminophen groups were similar. Peak core temperature was significantly lower
      in heating blanket subjects and unaffected by acetaminophen group. The onset of
      hyperthermia was not significantly affected by the method of rewarming (electric
      heating blanket versus cotton blankets) or acetaminophen group. Rewarming time
      was significantly longer for electric heating blanket subjects. CONCLUSIONS: Our
      results indicate that mildly hypothermic subjects rewarmed with electric heating
      blankets during the early postoperative period have lower peak core temperatures
      and longer rewarming times than those rewarmed with cotton bath blankets.
      Acetaminophen administration at normothermia does not significantly affect peak
      core temperature or the onset of hyperthermia.

PMID- 7787913
TI  - Comparison of nasogastric tube securing methods and tube types in medical
      intensive care patients.
AB  - BACKGROUND: Nasogastric tube displacement can result in serious complications
      such as aspiration and inadvertent migration of the tube into the lungs.
      Replacement of the tubes is costly, time- and effort-intensive, uncomfortable for
      the patients, and potentially dangerous. OBJECTIVE: To determine the best of
      three methods for securing nasogastric tubes in a medical intensive care
      population and to identify variables related to the failure of tube securing
      methods. METHODS: A convenience sample of 103 patients requiring duodenal or
      standard gastric tubes for feeding, medication delivery, or decompression were
      randomly assigned to one of three taping methods: pink tape, clear tape, or
      "butterfly," for a total of 264 taping episodes. Data collection included the
      mean time until failure of the securing methods as well as variables such as
      patient alertness and mobility. RESULTS: The mean time until failure was 100
      hours with pink tape versus 56 hours with clear tape and 30 hours with the
      "butterfly." Differences were significant. Duodenal tubes stayed secured longer
      than standard sump tubes (mean time until failure was 86 vs 41 hours) for all
      taping methods, but not significant relationship was demonstrated between mean
      time until failure and variables such as alertness, sedation, confusion,
      mobility, and the use of restraints. CONCLUSION: Our results showed that the pink
      tape method was superior. Nasogastric tube securing methods in adult critical
      care patients vary in efficacy and should be selected carefully.

PMID- 7787914
TI  - Infectious complications associated with ventricular assist devices.
AB  - Improvements in technology, patient selection, and patient management have led to
      a wider clinical application of mechanical circulatory support. Critically ill
      patients often develop multiorgan ischemia and are prone to multiple
      complications. Despite these advances, infection is a common and sometimes lethal
      complication of support with ventricular assist devices. This article provides
      guidelines for the prevention and management of infection in patients who require
      such support.

PMID- 7787915
TI  - Postoperative circadian rhythms and cortisol stress response to two types of
      cardiac surgery.
AB  - BACKGROUND: Although endocrine stress responses of coronary artery bypass
      patients have been reported, similar studies have not been conducted in patients
      undergoing implantation of an automatic cardioverter/defibrillator device.
      OBJECTIVES: To compare patterns and magnitudes of intra- and postoperative
      cortisol stress responses in patients undergoing two types of surgery; rate at
      which postoperative cortisol levels return to presurgical levels; and whether
      stressors associated with these two procedures affect postoperative circadian
      rhythms of cortisol, heart rate, and body temperature. METHODS: A time-series,
      small-group design was used to investigate 16 coronary artery bypass graft and 9
      automatic cardioverter defibrillator patients. For the cortisol stress study,
      blood samples were obtained pre-, intra-, and postoperatively until day 6. For
      the circadian rhythm aspect, cortisol circadian rhythm aspect, cortisol levels,
      heart rate, and oral temperatures were measured every 2 hours for 24 hours
      beginning on postoperative day 1. RESULTS: Plasma cortisol levels increased
      significantly toward the latter part of surgery. Generally, no significant group
      differences were found in cortisol magnitude during and after surgery.
      Postoperative cortisol levels were significantly elevated from preoperative
      levels for both groups; however, the automatic cardioverter defibrillator group's
      cortisol levels declined at a slower rate. The stressors associated with these
      surgeries were sufficient to disrupt or abolish circadian rhythms for the
      measured variables. CONCLUSIONS: The elevated postoperative cortisol levels and
      altered circadian rhythms may contribute to increased vulnerability by dampening
      patients' anti-inflammatory and immunologic responses and adversely affecting
      their sense of well-being. The clinical significance of these findings is yet to
      be determined; more research is warranted.

PMID- 7787916
TI  - A randomized clinical trial of the effect of bed position after PTCA.
AB  - BACKGROUND: After percutaneous transluminal coronary angioplasty, prolonged
      supine bedrest with the bed flat frequently causes back pain. This study was
      conducted to examine whether percutaneous transluminal coronary angioplasty
      patients could adjust their bed position to make themselves comfortable without
      increasing the frequency or severity of bleeding complications. OBJECTIVES: To
      determine whether the risk of bleeding increased in patients who were allowed to
      use their bed controls to make themselves comfortable, and if the difference in
      comfort was significant between patients who controlled and elevated their bed
      position and patients who remained flat in bed. METHOD: A randomized clinical
      trial was conducted; 54 patients undergoing percutaneous transluminal coronary
      angioplasty were randomly assigned to either the control group, in which patients
      remained flat in bed, or the experimental group, in which they controlled their
      bed position. Outcome measures included amount of bleeding at the catheter sites
      and patient comfort. RESULTS: No difference in the amount of bleeding at catheter
      insertion sites was found between the two groups. Few subjects reported pain at
      any time. Back pain at dinner and bedtime was higher in the control group, but
      only the bedtime difference was statistically significant. CONCLUSION: We
      conclude that patients may be allowed to adjust their bed position to 30 degrees
      for comfort without incurring increased risk of catheter entry site bleeding and
      that requiring patients to remain flat in bed has no scientific basis.

PMID- 7787917
TI  - The unconscious experience.
AB  - BACKGROUND: Although considerable research has been done on pathophysiology,
      metabolic and physical causes, and prognostic indicators, little is known about
      unconsciousness or coma from the perspective of the patient. OBJECTIVE: To
      describe the experiences of patients who were once documented as being
      unconscious. METHODS: Phenomenologic interviews were conducted with 100 patients
      whose records indicated that they had been unconscious during hospitalization.
      Interviews were also attempted with primary family members, significant others,
      or other external observers. Chart audits documenting the unconscious episode,
      medications, and diagnoses were also carried out. Data were compared, using van
      Kaam's method, and contrasted. RESULTS: Patients experienced one or more of five
      states: unconsciousness, inner consciousness, perceived unconsciousness,
      distorted consciousness, and paranormal experiences. They described hearing,
      understanding, and responding emotionally to what was being said when it was
      assumed they were not aware. In addition, 23 subjects reported near-death
      experiences or visits, out-of-body experiences, or some other paranormal
      experience. CONCLUSION: Patients' unconscious experiences can cause long-term
      effects. Patients often need reassurance that other patients subjected to similar
      conditions also have these experiences.

PMID- 7787918
TI  - Psychophysiologic responses of mechanically ventilated patients to music: a pilot
      study.
AB  - BACKGROUND: Although mechanically ventilated patients experience numerous
      stressors, they have not been included in music therapy stress reduction and
      relaxation studies. OBJECTIVE: To examine selected psychophysiologic responses of
      mechanically ventilated patients to music. METHODS: A two-group experimental
      design with pretest, posttest, and repeated measures was used. Twenty
      mechanically ventilated patients were randomized to a music-listening group or a
      nonmusic (headphones only) group. Physiologic dependent measures--heart rate and
      rhythm, respiratory rate, systolic and diastolic blood pressure, oxygen
      saturation, and airway pressure--were collected at timed intervals. Psychologic
      data were collected before and after intervention using the Profile of Mood
      States. RESULTS: Using repeated measures analysis of variance, results for heart
      rate and respiratory rate over time and over time between groups were
      significant. Between-group differences were significant for respiratory rate.
      Significant differences were found via t test for the music group's Profile of
      Mood States scores. No adverse cardiovascular responses were noted for either
      group. CONCLUSIONS: Data indicated that music listening decreased heart rate,
      respiratory rate, and Profile of Mood States scores, indicating relaxation and
      mood improvement.

PMID- 7787919
TI  - Sudden death in athletes.
AB  - HCM, as well as coronary and myocardial structural abnormalities, is the most
      common pathology leading to SCD in young athletes. Furthermore, SCD from fatal
      arrhythmia seems to be the most common mechanism of death. In this population,
      however, data are insufficient to support either invasive or noninvasive
      approaches to clarify risk stratification for SCD. Because of the large
      population, variants of normal found within the athletic population, and the
      rarity of the disease, screening for individuals at risk is neither practical nor
      cost-effective. Not all athletes with HCM are at the same risk for SCD; a
      thorough history and physical examination should alert the health professional to
      potential risk factors. Efforts are under way to stratify athletes at risk for
      SCD to determine who can participate in competitive sports and who should not.
      However, until research can accurately define variables of hemodynamic and
      electrical instability that permit reliable identification of athletes with HCM
      who are at risk for SCD, the recommendation is to disqualify athletes with
      confirmed HCM from moderate- to high-intensity competitive sports. This
      recommendation includes athletes with or without symptoms or left ventricular
      outflow obstruction. Due to the decreased risk of SCD in older athletes,
      individual judgment of eligibility may be used. Athletes thought to have had
      myocarditis should be withdrawn from all competitive sports for a convalescent
      period of approximately 6 months, with thorough cardiac assessment and testing
      performed before returning to training. Athletes with atrial or ventricular
      tachyarrhythmia must be screened for structural abnormality, heart response
      during exercise, and the frequency and duration of the arrhythmia.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7787920
TI  - Outcome of an exercise to notify patients treated by an
      obstetrician/gynaecologist infected with HIV-1.
AB  - Experience with hepatitis B suggests that the risk of HIV transmission from a
      health care worker infected with HIV to a patient will be greatest during major
      surgical procedures. The number of patients worldwide who are known to have
      undergone such procedures, been notified, and subsequently tested is still too
      small to be confident that the risk of HIV transmission in these circumstances is
      negligible. We describe a patient notification exercise, undertaken in the United
      Kingdom in 1991. Attempts were made to contact 1217 patients, in three health
      districts (A, B, and C), who had undergone surgical procedures performed by an
      obstetrician/gynaecologist who was infected with HIV. The exercise aimed to offer
      the patients reassurance, counselling and--if they wished--HIV testing. One
      thousand one hundred and forty-two patients (94%) were contacted, and all 520 who
      elected to be tested were negative for anti-HIV. The proportion of identified
      patients tested was 63% in district A, 35% in district B, and 61% in district C.
      Surgical procedures were classified retrospectively according to the likely risk
      (none, possible, or high) of exposure to the doctor's blood and, therefore, risk
      of HIV transmission. One hundred and ninety-five of those tested had undergone a
      procedure that carried a high risk of exposure; 179 had undergone a procedure
      thought to carry no risk. Patients in districts A and C who had undergone a
      procedure that carried a high risk of exposure were more likely to be tested than
      those who had not; 206 patients overall had undergone procedures that carried a
      high risk of exposure but were not subsequently tested.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7787921
TI  - COVER (COVER of vaccination evaluated rapidly): 31.

PMID- 7787922
TI  - A case control study of infection with an epidemic strain of multiresistant
      Salmonella typhimurium DT104 in England and Wales.
AB  - Laboratory reports of a multiresistant strain of Salmonella typhimurium
      definitive type (DT) 104 rose in 1993; this led the Public Health Laboratory
      Service to investigate cases and identify possible risk factors for infection.
      Information derived from questionnaires, and details of previous isolations of S.
      typhimurium DT104 from food and animals, were used to design an unmatched case
      control study. Eighty-three cases whose isolations were of the same plasmid
      profile type (the 'epidemic strain') and 235 controls were included in the
      analysis. Illness was independently associated with the consumption of several
      food items and contact with animals, particularly ill farm animals. The number of
      isolations of this organism continues to rise, and control measures may include
      reducing infection in animals used for food, reducing the risk of contamination
      at all stages of the food chain, and raising awareness of measures to prevent
      food poisoning among food handlers and the general public.

PMID- 7787923
TI  - Associations between human and farm animal infections with Salmonella typhimurium
      DT104 in Herefordshire.
AB  - Reports of human infection with Salmonella typhimurium definitive type (DT) 104
      have generated considerable interest. We undertook a descriptive study of
      infections with S. typhimurium DT 104 infection in humans and farm animals in
      Herefordshire between 1991 and 1993. Laboratory reports of human salmonellosis,
      sent to the consultant in communicable disease control, were compared with cases
      identified using Statutory Incident Reports of salmonella in animals, birds and
      their products, received from the Ministry of Agriculture, Fisheries and Food.
      Six separate associations of infection between farming families and their
      livestock were identified. Nine out of 23 human cases, including three family
      outbreaks, were associated with animal infection. This study suggests that
      occupationally acquired infection in farmers and their families may be
      contributing to the national increase in cases, and shows the value of drawing
      together data from human and animal sources for the surveillance, investigation,
      and control of human infection with S. typhimurium DT104.

PMID- 7787924
TI  - Viral haemorrhagic fever: outbreak in Zaire.

PMID- 7787925
TI  - Fetal toxicology of environmental tobacco smoke.
AB  - During the past decade, new evidence has been collected regarding the fetal risks
      of environmental tobacco smoke. Throughout gestation, the unborn baby is exposed
      to increasing concentrations of nicotine through maternal blood and
      gastrointestinal and skin absorption of the nicotine in the amniotic fluid.
      Recent research shows measurable concentrations of cotinine in the hair of
      infants born to passively smoking mothers. This exposure has been recently
      associated with effects on fetal growth.

PMID- 7787926
TI  - Cerebral perfusion, metabolism, and outcome.
AB  - Factors contributing to brain damage and an adverse outcome are complex. Both
      severe hypoxia-ischemia and prolonged hypoxia of lesser severity may cause brain
      damage. Compromised cerebral perfusion leads to ischemia. Fetal brain damage may
      begin because of a redistribution rather than reduction of cerebral blood flow.
      Normal newborn cerebral blood flow is low; fetal asphyxia at birth causes delayed
      cerebral hyperperfusion in the neonate. The threshold of newborn cerebral blood
      flow that is associated with brain damage has not yet been established. Hypoxia
      ischemia will disrupt cerebral metabolism. The fetus can compensate for hypoxia
      up to a point; however, decompensation will occur when acidosis becomes severe.
      Normal newborn cerebral oxygen consumption is low compared with that in the
      adult; however, asphyxia, causing brain damage, is associated with abnormal
      newborn cerebral metabolism. Supplementary glucose may have a protective effect
      in the newborn brain. Hypoxia-ischemia will cause brain damage in the human fetus
      and neonate. There is a threshold of fetal asphyxia at birth when brain damage
      may occur. Sustained neonatal hypotension and hypoxemia are associated with brain
      damage and an adverse outcome.

PMID- 7787927
TI  - Potential for treatment of anemia of prematurity with recombinant human
      erythropoietin.
AB  - Anemia of prematurity (AOP) results from several interacting processes, including
      phlebotomy losses, a temporary failure to release erythropoietin in response to
      anemia, a short life span of erythrocytes, and rapid growth of body mass and,
      hence, blood volume after the first few weeks of life. Infants with AOP have
      erythroid progenitors that respond to erythropoietin in vitro, suggesting that
      treatment with recombinant erythropoietin might reduce the need for transfusions
      for AOP. Many pilot studies were needed to define the dose of recombinant
      erythropoietin (500 to 750 U/kg/wk) that stimulated the early onset of
      erythropoiesis in infants with AOP. Three large controlled trials have
      demonstrated that recombinant erythropoietin therapy reduces transfusions in AOP
      and is apparently safe. Unresolved issues include the ideal dose, the optimal
      nutrition needed during therapy, the target population, and timing of the start
      of treatment.

PMID- 7787929
TI  - A neonate with meconium aspiration syndrome and severe respiratory distress.

PMID- 7787928
TI  - Nutrition in the neonate.
AB  - Good nutrition is of great importance for all living individuals, especially for
      the rapidly growing newborn infant. Nutrition is needed not only for the
      maintenance of physiologic functions but also for growth. Despite extensive
      research in this field, numerous questions remain regarding the nutrition of the
      term as well as the preterm infant. It should be stressed that the requirements
      of term infants are different from those of preterm infants, and a further
      distinction has to be made between very low birth weight and extremely low birth
      weight infants. In this review, the following issues are addressed: breastfeeding
      versus formula feeding, the role of polyunsaturated fatty acids, nutrition of the
      infant with bronchopulmonary dysplasia, and parenteral nutrition.

PMID- 7787930
TI  - Management of children with serious renal disorders in the era of managed care.
      Commentary.

PMID- 7787931
TI  - Hemolytic uremic syndrome in children.
AB  - The majority of postdiarrheal hemolytic uremic syndrome is caused by Escherichia
      coli O157:H7. The organisms are carried in the intestines of cattle; partially
      cooked contaminated hamburger is the single most common vector. The E. coli
      produce a potent cytotoxin that gains access to the circulation, is taken up by
      glycolipid receptors on glomerular endothelial cells, is internalized, and causes
      cell death. Associated phenomena include the activation of platelets, leukocytes,
      and the coagulation cascade, as well as the production of cytokines. Although
      some patients experience a mild or incomplete syndrome, life-threatening
      multisystem involvement can occur. Treatment is supportive, but plasma exchange
      may be useful in selected high-risk subsets. Efforts to prevent colitis from
      evolving into hemolytic uremic syndrome include the oral administration of
      material to bind the toxin in the gut. Mortality remains at 5% to 10%; about 4%
      are left with end-stage renal failure, and approximately 50% suffer mild chronic
      kidney damage.

PMID- 7787932
TI  - Reflux nephropathy, urinary tract infection, and voiding disorders.
AB  - Urinary tract infection (UTI), vesicoureteral reflux (VUR), and certain voiding
      disorders result in renal damage. In the past few years, the increasing use of
      99mTc-dimercaptosuccinic acid renal scans, urodynamic testing, and antenatal
      sonography have helped shed light on the interrelationship of these disorders.
      Renal parenchymal involvement during acute febrile UTI and subsequent renal
      scarring are quite commonly observed in the absence of VUR, suggesting that the
      presence of reflux is not a prerequisite for renal damage. In infants with gross
      VUR, renal damage is often present at birth even before the development of any
      UTI. High intravesical pressures during bladder filling and voiding are commonly
      observed in infants with gross VUR, reflecting an underlying voiding dysfunction.
      High voiding detrusor pressures are also commonly observed in infants presenting
      with symptomatic UTI who do not have VUR. Children with dysfunctional voiding
      states are at risk for development of VUR and UTI. Renal damage in these children
      may occur in the absence of one or the other. This review elucidates how voiding
      dysfunction predisposes children to bacterial colonization of the bladder, the
      development or perpetuation of VUR, and renal damage.

PMID- 7787933
TI  - Chronic renal disease and growth in childhood.
AB  - Growth failure, sometimes of a severe nature, has been recognized for many years
      as a consequence of chronic renal insufficiency (CRI) in childhood. The factors
      associated with growth failure, including renal osteodystrophy, anorexia and
      malnutrition, acidosis, salt wasting, and anemia, have also been recognized for
      many years. Despite vigorous treatment of these factors, patients with CRI
      continue to grow poorly. It was hoped that, with modern dialysis and
      transplantation, these patients would have normal growth or even catch-up growth
      and therefore overcome the height deficit that accrued during the time they had
      CRI. Unfortunately, this has not been the case. Although normal growth may be
      seen after transplantation, catch-up growth is rare. In the past year, studies
      have been reported demonstrating that supraphysiologic doses of growth hormone
      will produce catch-up growth in children with CRI. These reports are encouraging
      and are reviewed here.

PMID- 7787934
TI  - Focal segmental glomerulosclerosis in children.
AB  - Idiopathic focal segmental glomerulosclerosis is a histologic diagnosis that
      usually presents as the nephrotic syndrome but, unlike minimal change disease,
      often leads to renal failure in children. Standard therapies used to treat the
      proteinuria are often futile, and thus patients are at risk for the multiple
      complications resulting from persistent, severe proteinuria. Eventually, end
      stage renal failure ensues, and the possibility of the disease recurring in the
      transplanted renal allograft is worrisome. This report reviews the clinical
      features and outcomes of idiopathic focal segmental glomerulosclerosis in
      children, the response to newer treatment options, and new insights into
      understanding what factors may be involved in causing the disorder.

PMID- 7787936
TI  - Status of drug approval processes and regulation of medications for children.
AB  - The term therapeutic orphan was coined in 1968 to describe the exclusion of
      infants and children from approved indications for use of the majority of drugs
      approved by the US Food and Drug Administration (FDA). Although the 1962 Kefauver
      Harris amendments to the Food, Drug, and Cosmetic Act were designed to insure the
      efficacy and safety of drugs approved for human use, infants and children have
      largely been excluded from the protection of the law. Approximately 80% of the
      drugs approved by the FDA during the past 30 years have been approved with a
      labeling disclaimer for use by children. This high percentage is due largely to
      the lack of studies in children to document safety and efficacy or a failure to
      use available data to amend labeling to include pediatric indications. Recently,
      several initiatives by the FDA and the National Institute of Child Health and
      Human Development have been implemented that promise to increase the number of
      drugs studied and labeled for children. These initiatives may introduce a new era
      of drug development for children in which pediatric investigators, the FDA, the
      National Institutes of Health, and the pharmaceutical industry join together to
      bring the same level of pharmacotherapeutic safety and efficacy to children that
      adult patients enjoy.

PMID- 7787935
TI  - Genetic renal diseases in children.
AB  - In this review, a survey is given of genetic renal diseases in which recent
      progress has been made regarding the study of their molecular genetics. Diseases
      in which the responsible gene has been identified are discussed first, followed
      by a description of diseases in which successful chromosomal mapping has been
      achieved. The recent progress in this field will lead to advances in the
      diagnosis and understanding of the pathogenic mechanisms of genetic renal
      diseases and, potentially, will have implications for therapeutic interventions.
      The International Studies of Genetic Renal Diseases, which promotes the study of
      genetic renal disease, has recently provided an international database called
      kidbase, which is accessible via the Internet.

PMID- 7787937
TI  - Pharmacotherapy of depression in children.
AB  - Depression can interfere with the overall functioning of children and
      adolescents. It can impair normal cognitive and social development. The use of
      antidepressant medications in children and adolescents has grown in the past
      decade. Newer antidepressant agents, the selective serotonin reuptake inhibitors,
      appear very promising, but their safety and efficacy have not been established
      for children. This review focuses on depression and the design of studies for its
      treatment with newer antidepressant drugs in children.

PMID- 7787938
TI  - Renal toxicity of cancer chemotherapeutic agents in children: ifosfamide and
      cisplatin.
AB  - Ifosfamide and cisplatin are two commonly used cancer chemotherapeutic agents
      associated with significant acute and chronic renal toxicity. The clinical
      characteristics of ifosfamide-induced renal injury are proximal tubular wasting
      of glucose, phosphate, bicarbonate, sodium, potassium, and amino acids;
      proteinuria; and decreased glomerular filtration rate. Cisplatin administration
      may result in a dose-dependent reduction of glomerular filtration rate,
      hypomagnesemia, hypokalemia, and polyuria. The characteristics of renal toxicity
      associated with each of these agents are discussed with attention to possible
      mechanisms of injury and long-term clinical outcome.

PMID- 7787939
TI  - Therapy of pediatric AIDS.
AB  - Therapy of pediatric AIDS utilizes antiretroviral compounds; antibiotic,
      antifungal, and antiparasitic agents; and both active and passive immunization in
      a multifactorial approach. Currently, newly diagnosed pediatric AIDS cases are
      acquired predominantly through vertical transmission from HIV-infected mothers.
      Pediatric AIDS research is focused on strategies to prevent vertical transmission
      of HIV infection as well as therapy against opportunistic and progressive HIV
      disease. Zidovudine remains first-choice therapy for HIV infection and can reduce
      the rate of vertical transmission of HIV. Didanosine is also approved to treat
      HIV infection in pediatric AIDS. Other reverse transcriptase inhibitors are under
      investigation as alternative or combination therapies because of HIV resistance
      to zidovudine and didanosine. Alternative therapies for opportunistic infections
      are being investigated. Passive immunity with intravenous immunoglobulin is being
      reevaluated to determine efficacy in combination with other therapies. Finally,
      vaccination against usual childhood diseases with standard immunization schedules
      produces limited immunity, and alternative vaccination protocols warrant further
      investigation.

PMID- 7787940
TI  - Pharmacogenetics and development: are infants and children at increased risk for
      adverse outcomes?
AB  - Over the past two decades, pharmacokinetic data have clearly demonstrated that
      development can markedly influence the absorption, distribution, excretion, and
      metabolism of xenobiotics. With respect to many of the processes that govern drug
      metabolism, the underlying pharmacogenetic determinants that may control either
      the affinity or the capacity of a drug or toxicant substrate for the enzymes
      responsible for its biotransformation appear to be altered as a function of
      development by mechanisms that are, for the most part, not well defined.
      Nonetheless, for many xenobiotics, the pharmacogenetic-developmental interface
      produces a "pattern" for drug metabolism that, when characterized, supports the
      pharmacokinetic properties (eg, drug clearance) reported for many agents across
      the pediatric age spectrum. With the exception of a few relatively well
      characterized adverse drug effects (eg, toxicity of 6-mercaptopurine in patients
      with absent thiopurine methyltransferase activity, increased incidence of
      hepatotoxicity to valproic acid in young infants), the relationship of
      development and pharmacogenetics to enhanced toxicity risk from xenobiotic
      exposure is poorly defined. However, failure to adequately appreciate the
      pharmacokinetic consequences of the pharmacogenetic-developmental interface and
      to individualize therapy accordingly may lead to a clinically significant risk of
      drug therapy, namely, over- or underdosing.

PMID- 7787941
TI  - Child abuse, sudden infant death syndrome, and attention-deficit hyperactivity
      disorder.
AB  - A review of recent literature helps to clarify normal variations in the physical
      examination of children who are thought to have been sexually abused. In many
      instances, no abnormal physical findings are discovered. Clinicians must continue
      to pay careful attention to the history and work with other professionals to
      implement appropriate management, despite the lack of physical findings.
      Guidelines for evaluating sudden and unexpected infant deaths are reviewed. The
      current recommendations of the American Academy of Pediatrics for infant sleep
      positions are discussed in light of epidemiologic studies in the United States
      and other countries. Attention-deficit hyperactivity disorder appears to respond
      best to a combination of stimulant medication, parent training in coping with
      behavior of affected children, and social skill training for the affected
      children themselves. A review of recent research failed to reach consistent
      correlations between resistance to thyroid hormone and attention-deficit
      hyperactivity disorder.

PMID- 7787942
TI  - Dentate gyrus destruction and spatial learning impairment after corticosteroid
      removal in young and middle-aged rats.
AB  - We investigated the functional and behavioral implications of chronic
      corticosteroid removal in young and middle-aged rats. Prepubertal and 13-month
      old rats were adrenalectomized (ADX) or sham operated (SHAM). The young ADX rats
      were divided further into three groups: ADX with no hormone replacement, ADX
      given corticosterone chronically, (chCORT), and ADX given corticosterone acutely
      at the time of Morris water maze testing (acCORT). All rats were run on the
      Morris water maze 12 weeks after surgery. They were then sacrificed and the
      brains were removed for histological analysis. The results showed that prolonged
      corticosteroid absence caused major damage to the dentate gyrus and learning
      impairment on the Morris water maze. The chCORT rats had little dentate gyrus
      cell loss and were as efficient as the controls in Morris water maze performance,
      whereas the acCORT rats had dentate gyrus cell loss and were impaired in the
      spatial acquisition task. Furthermore, exogenously administered corticosterone
      had an interactive effect on ADX rats. Water maze performance was improved in
      dentate gyrus damaged rats (acCORT) compared to ADX rats not given
      corticosterone, whereas ADX rats with very little dentate gyrus damage (chCORT)
      did not exhibit better water maze performance relative to controls. Middle-aged
      ADX rats lost cells only in the dorsal blade of the dentate gyrus but they did
      not show a learning impairment in the Morris water maze relative to the middle
      aged controls. These results indicate that corticosteroids are trophic for the
      dentate gyrus, that mature granule cells are less affected by adrenalectomy, that
      corticosteroid absence is responsible for some water maze impairment in ADX rats,
      but that in addition to corticosteroid absence, a substantial amount of dentate
      gyrus damage is necessary to impair spatial learning.

PMID- 7787943
TI  - Interhippocampal synthesis of lateralized place navigation engrams.
AB  - Rats were trained in a water maze in a dark room with the extramaze cues
      restricted to only dimly back-lit shapes. We used lidocaine to reversibly lesion
      the dorsal hippocampus and this controlled-cue room in order to examine
      interhippocampal synthesis of lateralized place engrams. Experiment 1 showed that
      lidocaine injected into both hippocampi effectively abolished place navigation
      for up to 25 min but not at 45 min. In experiment 2, each day under lidocaine
      blockade of one hippocampus, pretrained rats were trained in the water maze to
      locate the target according to two cues (e.g., AB). Two hours later, the
      contralateral hippocampus was inactivated and the rats were trained to the same
      location with two other cues (CD). On day 5, intact brain retrieval was tested in
      one of three conditions: ACQ (e.g., AB), one of the pairs of cues used in
      acquisition training; SYNTH (e.g., AC), one cue from each of the pairs used in
      acquisition; CONT (e.g., AE), one cue that was used in acquisition training and a
      novel cue. The results show that the hippocampi learned the two tasks
      independently and similarly [latency (L) at the asymptote = 7 s]. Retrieval
      performance was at the asymptote for ACQ (AB) and SYNTH (AC) (L = 6 and 7,
      respectively) but was disrupted for CONT (L = 12). In experiment 3 as in
      experiment 2, the rats were trained, under unilateral blockade, to a new place
      for 4 days. On day 5, retrieval with the trained hippocampus blocked was worse (L
      = 11) than with the untrained side blocked (L = 5).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7787944
TI  - Correlation of anoxic neuronal responses and calbindin-D28k localization in
      stratum pyramidale of rat hippocampus.
AB  - Immunohistochemical staining for the calcium-binding protein calbindin-D28k
      (CaBP) was combined with Lucifer Yellow (LY) identification and intracellular
      recording of changes in membrane parameters of pyramidal neurons in CA2, CA1, and
      the subiculum of rat hippocampal slices during brief exposure (4.0 +/- 0.19 min)
      to N2. Anoxia evoked either a depolarization or hyperpolarization of membrane
      potential (VM) (+21.5 +/- 2.79 mV above VM = -70.5 +/- 1.50 mV, n = 30 and -7.2
      +/- 0.72 mV below VM = -68.2 +/- 1.34 mV, n = 24, respectively) and a fall in
      membrane resistance of approximately 20%. Differences in the response could be
      correlated with the presence or absence of CaBP and the localization of neurons
      in different layers of stratum pyramidale and sectors of the hippocampus. For
      neurons immunopositive for calbindin (CaBP(+)), depolarization was observed more
      frequently (83%) than hyperpolarization (17%); in contrast, 44% of responses of
      calbindin-negative (CaBP(-)) neurons were depolarizing and 56% were
      hyperpolarizing. Depolarizations of CaBP(+) neurons were more gradual in slope,
      and more rapidly reached a plateau in comparison with those recorded in CaBP(-)
      neurons. Responses of neurons in the superficial layer of stratum pyramidale (in
      which 79% of CaBP(+) pyramidal neurons were situated) were mainly depolarizing
      (91%), while for those in the deep layer (which contained 89% of the CaBP(-)
      cells) such responses were observed less often (45%). Depolarization was also
      more common than hyperpolarization for cells located in CA2/CA1c/CA1b (63%) than
      in the CA1a/subicular region (37%). The depolarizing response of the majority of
      pyramidal neurons which are CaBP(+), superficial, and closer to CA3 may reflect
      an efficient buffering of intracellular Ca2+, which maintains a low [Ca2+]i,
      steep gradient for Ca2+ influx and may facilitate the movement of Ca2+ away from
      points of entry. The neurons which are CaBP(-), deep, and closer to subiculum and
      in which N2 evokes hyperpolarization, on the other hand, may have a sustained
      elevation/accumulation of cytosolic Ca2+ which could activate K+ conductance,
      inhibit Ca2+ influx, and stabilize the membrane potential. These experiments
      provide a functional correlate for CaBP and suggest that it may have a
      significant role in Ca2+ homeostasis and the determination of selective neuronal
      vulnerability.

PMID- 7787945
TI  - Activation of somatostatin-synthesizing neurons in the hippocampal formation
      through kindling-induced seizures.
AB  - The present study was designed to determine if and to what extent somatostatin
      (SST) synthesizing neurons of the hippocampal formation are activated during
      seizures, elicited through kindling of the perforant pathway. Tissue was used and
      analyzed from animals which had experienced a single after discharge, or a stage
      3 or stage 5 seizure. The protein expression of the oncogene c-fos in activated,
      depolarizing neurons was utilized to identify seizure-activated SST-synthesizing
      neurons. Combined immunocytochemical and in situ hybridization methods were used
      to identify these double-labeled, Fos protein, and SST mRNA-containing neurons.
      The results were quantified and compared across seizure stages. The resulting
      data demonstrate that at every stage of seizure development, a majority of SST
      synthesizing neurons is activated, but that these activated SST mRNA-containing
      neurons represent only a minority of all seizure-activated, Fos-expressing
      neurons in the hippocampal formation. The data further reveal a numerical
      hierarchy in which the majority of double-labeled neurons is present in the hilus
      of the dentate, followed by the stratum oriens of CA1. It is concluded that SST
      synthesizing neurons represent an integral component of the kindling activated
      neuronal network and, since the SST synthesizing neurons represent the minority
      of all seizure-activated neurons in the hippocampal formation, that this neuronal
      network is likely to be of considerable neurochemical complexity.

PMID- 7787946
TI  - Reduction of the threshold for long-term potentiation by prior theta-frequency
      synaptic activity.
AB  - Activation of the lateral perforant path input to the dentate gyrus with theta
      patterned conditioning trains produced LTP of synaptic efficacy that changed in
      magnitude as an inverted U-shaped function of the number of trains. The LTP
      induction function was not fixed, however, and could be shifted to the left by
      administering 5 Hz "priming" stimulation to the lateral path 10 min prior to the
      conditioning trains. The priming effect was input specific and selective to a
      narrow window of stimulus frequencies. The shift to the left of the LTP induction
      function by priming stimulation was blocked by the muscarinic receptor antagonist
      atropine sulphate. Nimodipine, an antagonist of L-type voltage-sensitive calcium
      channels, did not mimic the priming effect but instead produced a general
      facilitation of LTP induction. These data demonstrate that the degree to which
      LTP is induced in the lateral path is a non-linear function of afferent activity,
      and that this function, including LTP threshold, can be shifted to the left by
      prior synaptic activity at hippocampal theta-rhythm frequencies.

PMID- 7787947
TI  - NADPH diaphorase-positive neurons in the lizard hippocampus: a distinct
      subpopulation of GABAergic interneurons.
AB  - We analyzed the distribution and light-microscopic features of the NADPH
      diaphorase-containing structures in the lizard hippocampus, likely to correspond
      to nitric oxide synthase-containing cells and fibers, and thus likely to release
      nitric oxide. We also studied co-localization of NADPH diaphorase with the
      neurotransmitter GABA, the calcium-binding protein parvalbumin, and the
      neuropeptide somatostatin, in order to examine whether putative nitric oxide
      synthesizing neurons represent a different subpopulation of GABA cells, on which
      the authors recently reported in lizards. We also studied co-localization of
      NADPH diaphorase with parvalbumin or somatostatin in mice to ascertain whether
      the characteristics of this population in reptiles parallel the situation in
      mammals. Most of the positive NADPH diaphorase neurons were stained in a Golgi
      like manner and were in the plexiform layers of the lizard hippocampus with
      morphologies ranging from bipolar to multipolar. Co-localization with GABA was
      100%, and NADPH diaphorase-positive neurons in the lizard hippocampus did not
      contain parvalbumin or somatostatin. The results indicate that putative nitric
      oxide-synthesizing neurons represent a distinct subpopulation of GABA
      interneurons in the lizard hippocampus. Two different types of fibers were
      described in the plexiform layers: one type bearing thick varicosities, and the
      other thinner ones. We discuss the possibility that at least part of the positive
      fibers arise from a hypothalamic aminergic nucleus contacting the third
      ventricle, the periventricular hypothalamic organ. Most radial glia were stained
      almost completely and formed typical end-feet both at the pia and around
      capillaries. The results of this study confirm that the capacity for synthesizing
      nitric oxide is linked to a determined set of neuronal markers depending on the
      specific brain region, and they provide new resemblances between hippocampal
      regions in different classes of vertebrates.

PMID- 7787948
TI  - Adenosine antagonists have differential effects on induction of long-term
      potentiation in hippocampal slices.
AB  - How adenosine leakage and tetanic release might affect long-term potentiation
      (LTP) was investigated by applying adenosine antagonists 8(p
      sulfophenyl)theophylline (8SPT) or 8-cyclopentyl-3,7-dihydro-1,3-dipropyl-1H
      purine-2,6-dione (DPCPX) to slices, while recording CA1 field EPSPs and
      population spikes. In the first series of experiments, we applied weak double
      tetani (at 100 Hz, for 1 s) that were subliminal for evoking LTP in initial
      control runs. In the presence of 8SPT--at concentrations (10-50 microM) which
      block both A1 and A2 receptors--the same tetani consistently evoked LTP of
      population spikes but not of excitatory postsynaptic potentials (EPSPs), whereas
      DPCPX (50 nM), which blocks only A1 receptors, facilitated LTP of both EPSPs and
      population spikes. These results are consistent with previous evidence that
      tetanic adenosine release on the one hand depresses LTP via A1 receptors but on
      the other facilitates LTP via A2 receptors. In a second set of experiments, 8SPT
      (50-100 microM) did not prevent the induction of LTP of both EPSPs and population
      spikes by stronger tetanic stimulation. Therefore A2 receptor activation is not
      essential for the induction of LTP when stronger tetani are applied. Overall, the
      main effect of endogenous adenosine release is to oppose LTP induction.

PMID- 7787950
TI  - Simultaneous blockade of non-NMDA ionotropic receptors and NMDA receptor
      associated ionophore partially protects hippocampal slices from protein synthesis
      impairment due to simulated ischemia.
AB  - A large body of evidence exists to demonstrate that excitatory amino acids (EAA)
      and their receptors are involved in the pathophysiological mechanisms linking
      several acute brain insults, such as cerebral ischemia, to neuronal degeneration
      and death. Accordingly, the use of EAA receptor antagonists can be beneficial in
      attenuating or preventing the neuronal irreversible damage subsequent to various
      neuropathological syndromes. We have investigated the effect of 15 min of
      simulated ischemic conditions, i.e., oxygen/glucose deprivation, on hippocampal
      slices preparation measuring, as neurotoxicity indexes, both the amino acids
      efflux in the incubation medium, detected by HPLC, and the inhibition of protein
      synthesis, evaluated as 3H-Leucine incorporation into proteins. Accumulation of
      neurotransmitter amino acids was measured in the medium during the "ischemic"
      period. Glutamate increased 30-fold over the basal level while aspartate was
      sevenfold and GABA 12-fold higher than in normal conditions. After a
      reoxygenation period of 30 min, the rate of protein synthesis of hippocampal
      slices subjected to "ischemia" was reduced to 35-50% of controls. The non
      competitive NMDA antagonist MK-801 (100 microM) and the competitive NMDA
      antagonist CGP 39551 (100-250 microM) as well as the non-NMDA receptor
      antagonists NBQX (100 microM) and AP3 (300 microM) were unable to counteract the
      metabolic impairment when they were present alone in the incubation fluid during
      simulated "ischemia." An incomplete, but highly significant (p < 0.001),
      protection from protein synthesis impairment was achieved in the presence of an
      equimolar concentration (100 microM) of MK-801 and NBQX.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7787951
TI  - Regulation of penile venous outflow. Experimental studies on endogenous control
      mechanisms.

PMID- 7787949
TI  - Intracellular correlates of hippocampal theta rhythm in identified pyramidal
      cells, granule cells, and basket cells.
AB  - The cellular-synaptic generation of rhythmic slow activity (RSA or theta) in the
      hippocampus has been investigated by intracellular recording from principal cells
      and basket cells in anesthetized rats. In addition, the voltage-, coherence-, and
      phase versus depth profiles were examined by simultaneously recording field
      activity at 16 sites in the intact rat, during urethane anesthesia, and after
      bilateral entorhinal cortex lesion. In the extracellular experiments the large
      peak of theta at the hippocampal fissure was attenuated by urethane anesthesia
      and abolished by entorhinal cortex lesion. The phase versus depth profiles were
      similar during urethane anesthesia and following entorhinal cortex lesion but
      distinctly different in the intact, awake rat. These observations suggest that
      dendritic currents underlying theta in the awake rat may not be revealed under
      urethane anesthesia. The frequency of theta-related membrane potential
      oscillation was voltage-independent in pyramidal neurons, granule cells, and
      basket cells. On the other hand, the phase and amplitude of intracellular theta
      were voltage-dependent in all three cell types with an almost complete phase
      reversal at chloride equilibrium potential in pyramidal cells and basket cells.
      At strong depolarization levels (less than 30 mV) pyramidal cells emitted calcium
      spike oscillations, phase-locked to theta. Basket cells possessed the most
      regular membrane oscillations of the three cell types. All neurons of this study
      were verified by intracellular injection of biocytin. The observations provide
      direct evidence that theta-related rhythmic hyper-polarization of principal cells
      is brought about by the rhythmically discharging basket neurons.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7787952
TI  - Private health insurance and a healthy personality: new risk factors for
      obstetric intervention?
AB  - In this study 242 nulliparous pregnant women completed standardized psychometric
      questionnaires and semi-structured interviews in the latter half of pregnancy and
      again 4-6 weeks postpartum. Discriminant function analysis revealed that the use
      of operative obstetric interventions was measurably influenced by psychosocial
      factors. Privately insured women were significantly more likely to experience
      instrumentally assisted (relative risk = 1.53, 95% CI: 1.05, 2.25) and Caesarean
      (relative risk = 1.91, 95% CI: 1.05, 3.46) deliveries than those receiving care
      in the public hospital system. The likelihood of experiencing these procedures
      was increased further among those who in late pregnancy were thinking clearly,
      had high self-esteem, mature means of dealing with anxiety, were confident in
      their knowledge of childbirth procedures and in secure partnerships with highly
      educated men. There was no evidence that either elevated anxiety or abnormalities
      of personality contributed to obstetric outcome. These findings indicate that
      obstetric decision-making is significantly influenced by patient personality and
      socioeconomic circumstances. In particular, they suggest that fear of malpractice
      litigation, physician convenience factors and the response of obstetricians to
      assured, well pregnancy-educated pregnant women may be influencing the use of
      operative intervention in delivery.

PMID- 7787953
TI  - Non-traditional mothers: single heterosexual/lesbian women and lesbian couples
      electing motherhood via donor insemination.
AB  - The purpose of the project was to explore the motivation, reproductive and
      postdelivery experiences, and future concerns of single heterosexual and lesbian
      women and lesbian couples who attempted conception via donor insemination (DI).
      All women who had completed at least one cycle of DI between 1987 and 1992 at a
      large medical school infertility program were mailed a comprehensive 'Motherhood'
      questionnaire. Forty-five women completed the survey (response rate = 88%) of
      whom 14 were lesbians, 28 were heterosexuals, two were bisexual and one was
      celibate. The only major differences between the heterosexual women and the
      lesbian women were that the heterosexual women were older and had started DI
      attempts at an older age than the lesbian women. The majority of women reported
      that four major considerations prompted their decision to initiate DI when they
      did: feeling secure in their employment, the sense that time was running out,
      feeling that they had 'worked through' concerns about parenting, and that they
      had sufficient social support. Three characteristics were deemed moderately or
      very important in their selection of sperm donors: ethnicity, education and
      height. After achieving a pregnancy, most women wished to know more detailed
      information about their donor. Unlike heterosexual couples, all single and
      lesbian women planned to disclose the fact of DI to their offspring but were
      uncertain of when or how to accomplish this. The greatest worry reported by
      respondents was how their child would deal with the absence of a known designated
      father. Overall, the women were gratified with their experience of DI, and the
      majority would 'absolutely' recommend it to a friend.

PMID- 7787954
TI  - Medical history in women with premenstrual syndrome.
AB  - This study was designed to identify significant factors in the medical history of
      women with premenstrual syndrome (PMS). Medical history variables of 190 women
      with PMS were compared with those of a group of 182 women without premenstrual
      symptoms who sought gynecological care (control group). All the participants were
      carefully selected by interview and designated questionnaires. Women with a past
      or present psychiatric history were excluded. The results showed that age, number
      of children, age of menarche, smoking history and family history of psychiatric
      disorders of the women with PMS and the controls were similar. Women with PMS
      exhibited a significantly greater frequency of postpartum depression (43% versus
      12%), past birth control pill use (91.6% versus 45.9%), alcohol use (39.5% versus
      14.8%) and drug use (48.4% versus 14.1%) than did the controls respectively; all
      p values were < 0.05). Our data suggest an association between these factors and
      PMS. They should be identified in women with premenstrual complaints during the
      initial visit, and the roles of these factors in the pathophysiology of PMS need
      to be further investigated.

PMID- 7787955
TI  - Premenstrual complaints: an idiosyncratic syndrome.
AB  - The two issues of premenstrual syndrome (PMS) symptom heterogeneity and symptom
      severity are addressed in an examination of the idiosyncratic nature of
      premenstrual complaints. Analyses of PMS symptoms reported during the first
      assessment month by a group of treatment-seeking women revealed that when
      presented with a prepared list of symptoms (Menstrual Distress Questionnaire),
      they select many more symptoms than when self-reporting their complaints in
      ranked order of severity. In this study of a sample of 98 women, most of the
      women reported only four rank-ordered symptoms. Symptom profiles from five
      symptom categories were constructed for each of the women and from a possible 86
      different profiles 84 were discovered. Of these, psychological profiles dominated
      the total reports. These findings, together with results of previous research,
      lead to two conclusions. First, that PMS, though multidimensional, may be defined
      for each woman by a limited number of symptoms; and second, that PMS is highly
      idiosyncratic in nature.

PMID- 7787956
TI  - University students' subjective experiences of oral contraceptive use.
AB  - A substantial proportion of women who commence oral contraceptive discontinue
      usage due to unwanted side-effects. In investigations of side-effects in current
      users, such women are excluded, and hence such studies will tend to underestimate
      the prevalence of side-effects. One hundred and forty-five female university
      students (both former and current users) completed a questionnaire focusing on
      their experiences of the impact of oral contraceptives upon their psychological
      and physical well-being. Although, on average, over half the women reported no
      effect, the vast majority of those who did report a change in well-being deemed
      this to be negative. The only exception was pelvic pain which was reported to be
      improved by oral contraceptive use.

PMID- 7787958
TI  - Public reporting of performance measures in home care.
AB  - BACKGROUND: In 1992 DependiCare Home Health, Inc (Broadview, Ill), a 62-employee
      home medical equipment/respiratory therapy (HME) business in the Chicago
      metropolitan area, discovered that managed care organizations need quantifiable
      data from vendors in the form of measurements or outcomes. In response to this
      need, DependiCare developed its "Under the Microscope" program. This program
      provides quarterly reports (starting in April 1994) on service efficiency,
      patient satisfaction, and outcome statistics to referral sources, including
      physicians, discharge planners, and hospital executives. MEASUREMENTS:
      Performance measures, which represent information from DependiCare's internal
      operations, can be viewed as the company's quarterly report card. Areas reported
      on include target-time performance, same-day and under-two-hour delivery, patient
      (and referral source) satisfaction, equipment breakdown, and fillrate statistics.
      Outcome statistics include discontinuation of service by diagnosis and number of
      months on oxygen by diagnosis. USE OF RESULTS: Measurements help to identify
      weaknesses that need to be addressed by organizational or operational changes, as
      well as to uncover strengths that can be capitalized on for sales and marketing.
      Hospital-based discharge planning departments, a substantial referral source,
      most often use the Under the Microscope program to justify referring patients to
      DependiCare. Little is known about managed care customers' use of the data.
      CONCLUSIONS: In the long term, an integrated, automated way to track individual
      patients across the continuum of care from the physician, to the hospital, and to
      home care is needed. A centralized database of patient experience, including
      outcomes, could assist in health care decision making.

PMID- 7787957
TI  - Prognostic factors for preoperative consultation of women desiring sterilization:
      findings of a retrospective analysis.
AB  - In this exploratory study, 37 sterilized women applying for sterilization
      reversal were questioned thoroughly to establish why they had decided to undergo
      sterilization and why they now wished for it to be reversed. Taking an
      interactive behavioral model as our starting point, we concentrated on the
      psychosocial circumstances leading to the definitive decision to be sterilized. A
      relationship crisis at the time of sterilization was found to be a prognostically
      unfavorable factor. Furthermore, 20 of the 37 patients cited new partnerships as
      their main reason for seeking reversal. Those who felt pressurized by their
      gynecologist or partner into undergoing sterilization had significantly more
      problems in overcoming the psychological stress accompanying such an operation
      than those who, through a series of consultations on contraception, had had
      sufficient time and opportunity to make their own decisions. Sterilization
      performed for medical reasons was found to have particularly problematical
      consequences, especially where the doctor had made the decision largely on his
      own, failing to give an adequate explanation for the medical necessity of the
      operation. Regarding the time chosen for sterilization, the study revealed that
      the patient's postoperative psychological condition was significantly worse when
      sterilization was carried out immediately after a delivery, after abortion or
      after Caesarean section, rather than in the interval between pregnancies. The
      resulting increase in the incidence of psychosomatic complaints and depressive
      states is also confirmed in the literature. The findings of this study offer
      practical suggestions for improved preoperative consultation and should help to
      determine the course of action to be taken when a patient wishes to be
      sterilized.

PMID- 7787959
TI  - Computer-assisted quality improvement in an ambulatory care setting: a follow-up
      report.
AB  - BACKGROUND: The Quality Care Program (QCP), introduced into the Swedish Family
      Medicine Clinic in 1992, is a comprehensive computer-assisted program of quality
      improvement for the medical office. Its goal is to improve specific aspects of
      ambulatory patient care: disease prevention, cancer detection, immunization
      compliance, risk management, outcomes monitoring, and patient education.
      METHODOLOGY: The QCP uses a computer-generated worksheet that is attached to the
      medical record at each patient visit. It is a multipurpose worksheet that
      displays important clinical information and functions as part of an overall
      strategy to manage key aspects of the patient's care. The system enhances patient
      and physician performance of health maintenance and continuity of care, and it
      allows for the quantification and display of performance indicators without
      exclusive reliance on chart review. RESULTS: Physician reliability in
      recommending health maintenance interventions has improved to nearly 100%, and
      patient compliance with these recommendations has significantly increased. The
      test results tracking system has found test data that would have otherwise been
      lost, and the outcomes monitoring has resulted in measurable system improvements.
      There has been a modest increase in provider workload to meet these aggressive
      QCP goals, but measures of provider satisfaction have increased nonetheless.
      CONCLUSIONS: Ambulatory care, increasingly the focus of attention in the United
      States, can be difficult to perform well. The QCP, part of an overall quality
      improvement initiative, gathers and displays clinical information, reminds
      patients and physicians to do health maintenance, and refuses to let physicians
      and patients forget about specific aspects of patient care.

PMID- 7787960
TI  - Ombudsmen, patient complaints, and total quality management: an examination of
      fit.
AB  - BACKGROUND: In response to mounting health care costs in the United States and
      Canada, there is considerable national discussion of health care quality,
      including the importance of assessing and monitoring patient satisfaction and of
      responding to complaints. Many physicians and health care administrators cringe
      at the mention of using patient complaints and satisfaction levels as quality
      measures; others perceive the need to develop multiple source indicators of
      patient care. At the same time, leaders are seeking programs and methods that
      contribute to the continuous improvement of all aspects of health care
      organizations. DISCUSSION: The use of patient ombudsmen and patient complaints in
      quality management programs is reviewed and the relation between the two
      functions--ombudsmen/complaint handling and total quality management--is
      discussed. Purposes, objectives, problem-solving processes, program operations,
      data use, and the outcomes of ombudsmen efforts are reviewed. Since ombudsmen
      programs value patient feedback, empower customers, and help contribute to the
      diagnosis of organizational areas for improvement, they are consistent with the
      intent and workings of quality teams. The activities of ombudsmen can contribute
      to the broader effort to manage the whole organization toward the continuous
      improvement of quality.

PMID- 7787961
TI  - Ending the QA/CQI confusion. Interview by Steven Berman.

PMID- 7787962
TI  - Psoriatic arthritis.

PMID- 7787963
TI  - Intravenous immunoglobulin therapy.

PMID- 7787964
TI  - Orthotic treatment of the hand. What's new?
AB  - Keeping abreast of the latest orthotic products is challenging. Commercial
      orthoses need to be critically evaluated for their applicability to the person
      with rheumatic disease. Custom-made orthoses play an invaluable role in achieving
      a wide range of therapeutic goals: improving function and pinch, stabilizing
      individual joints, preventing positional contractures, protecting joints from
      trauma, stretching the intrinsic muscles, correcting joint- and soft-tissue
      contractures, and controlling inflammation.

PMID- 7787965
TI  - Kinetics of irreversible inhibition of creatine kinase during modification by o
      phthaldehyde.
AB  - It has been previously reported that, with a fluorescence probe formed from o
      phthaldehyde (OPTA) and the thiol and amino groups at or near the active site of
      creatine kinase, inactivation and exposure of the probe take place simultaneously
      and well before unfolding of the molecule as a whole. In this study, the
      inactivation and modification kinetics of purified rabbit muscle creatine kinase
      by OPTA have been compared, the former by following the substrate reaction in the
      presence of a previously described inactivator. The microscopic rate constants
      for the reaction of the inactivator with the free enzyme and with the enzyme
      substrate complexes were determined. From the results obtained it appears that
      OPTA is noncompetitive with respect to both substrates. The inactivation kinetics
      is monophasic with OPTA, and neither ATP nor creatine alone affect the rate
      constant of inactivation of the enzyme, indicating that the irreversible
      inhibition of creatine kinase by OPTA is of the noncompetitive type.

PMID- 7787966
TI  - A sensitive enzyme-linked immunosorbent assay of serum ornithine
      carbamoyltransferase.
AB  - Ornithine carbamoyltransferase (OCT), a urea cycle enzyme, is located almost
      exclusively in liver mitochondria. We designed a sensitive enzyme-linked
      immunosorbent assay (ELISA) of serum OCT protein using an antibody against
      purified bovine enzyme. OCT protein measured using this method showed a good
      correlation with OCT activity (r = 0.961), and was much higher in patients with
      liver diseases than in the controls. Measurements of serum OCT protein in 442
      healthy blood donors gave the upper limit of normal range of 23 ng Eq/ml
      (equivalent to the bovine enzyme) for males, 8 ng Eq/ml for females, and 16 ng
      Eq/ml for males plus females. The values differ significantly between the sexes
      and depending on ages. This ELISA system is expected to be used as a pertinent
      liver function test.

PMID- 7787967
TI  - Clinical evaluation of serum ornithine carbamoyltransferase by enzyme-linked
      immunosorbent assay in patients with liver diseases.
AB  - We developed a sensitive enzyme-linked immunosorbent assay (ELISA) for serum
      ornithine carbamoyltransferase (OCT) protein, and examined serum OCT
      concentrations in patients with various liver diseases. OCT concentrations were
      markedly elevated in cases of hepatic encephalopathy, 'acute on chronic', and
      those with the acute phase of acute hepatitis, moderately in chronic hepatitis,
      liver cirrhosis, hepatocellular carcinoma, primary biliary cirrhosis, and
      slightly in those with a fatty liver. High percentages (92-98%) of patients with
      chronic hepatitis, liver cirrhosis and hepatocellular carcinoma had higher than
      normal concentrations of serum OCT protein. There was a close correlation with
      aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities
      and moderate correlations with those of mitochondrial AST, glutamate
      dehydrogenase and gamma-glutamyltranspeptidase. The OCT/ALT ratio was higher in
      patients with liver cirrhosis than in those with chronic hepatitis (p < 0.001),
      and was still higher in cases of hepatocellular carcinoma (p < 0.05). In 2
      patients with 'acute on chronic' disease, OCT concentrations decreased similarly
      with or more rapidly than AST or ALT activities after admission. In 2 patients
      with hepatic encephalopathy, the OCT concentrations changed similarly with AST
      and ALT activities. This OCT ELISA system will aid in diagnosing various liver
      diseases and in the follow-up of the patients, and the OCT/ALT ratio may serve
      for a differential diagnosis of liver diseases.

PMID- 7787968
TI  - Structural characterization of cytosolic NADP(+)-dependent isocitrate
      dehydrogenase from rat ovary.
AB  - Cytosolic NADP(+)-dependent isocitrate dehydrogenase was purified to homogeneity
      from superovulated rat ovaries. Amino acid sequence information was obtained by
      analyzing peptides generated by digestion with either cyanogen bromide or
      trypsin. Eleven peptides were sequenced and a total of 146 amino acids were
      identified. Nine of these peptides were found to be 60-100% identical with
      sequences from mitochondrial NADP(+)-dependent isocitrate dehydrogenase.
      Conservation of amino acids was observed for residues that were previously
      identified as potentially binding isocitrate-Mg2+. Circular dichroism
      measurements showed that the structure is composed of approximately 35% alpha
      helix and 21% beta-sheet segments. Temperature denaturation studies indicated
      that the enzyme is more stable in the presence of isocitrate.

PMID- 7787969
TI  - Induced expression of alpha-enolase in differentiated diffuse large cell
      lymphoma.
AB  - A unique protein has been detected that is associated with the differentiation of
      diffuse large cell lymphoma (DLCL). The WSU-DLCL human cell line was cultured in
      the absence or presence of the biological agent, Bryostatin 1 (Bryo1). Cellular
      proteins of parent and differentiated WSU-DLCL cells were analyzed using one- and
      two-dimensional polyacrylamide gel electrophoresis (1D and 2D PAGE). In the 1D
      PAGE, a unique protein band of molecular mass approximately 47 kD was detected in
      the differentiated, but not the parent cells. Amino acid sequence of the band
      indicated the presence of more than one protein. The 2D PAGE analysis showed that
      one of the proteins of interest had an isoelectric point of 7.4. Partial amino
      acid sequencing of the spot by tryptic digest showed 100% homology with alpha
      enolase. alpha-Enolase is a nonneuronal enzyme involved in the glycolytic
      pathway. This is the first report on the induction of alpha-enolase in human DLCL
      after treatment with the natural biological agent, Bryo1. We suggest that alpha
      enolase may play a significant role in the differentiation of lymphoma in man.

PMID- 7787970
TI  - Purification of human and rat kidney aldose reductase.
AB  - In the present study we report on a rapid two-step affinity chromatographic
      procedure to purify aldose reductase from human and rat kidney papilla and inner
      medulla. This enzyme, which is responsible for sorbitol formation in the kidney,
      was purified 145-fold from rat and 76-fold from human kidneys by consecutive Blue
      Sepharose and Matrex Orange chromatography. SDS-PAGE showed a single band of 38
      kD for the human enzyme and a doublet of similar molecular weight for the rat
      kidney aldose reductase. The enzyme was characterized by substrate specificity
      and kinetic constants found identical to that of other organs purified
      previously.

PMID- 7787974
TI  - Distal tibia bone graft for arthrodesis of the foot and ankle.
AB  - Forty patients since 1988 have had distal tibial bone grafting for 41 arthrodeses
      of the foot and ankle. Bone graft is obtained through a cortical window made just
      above the medial metaphyseal distal tibial flare. Average follow-up was 23.3
      months. Forty of 41 arthrodesis sites fused; there was only one nonunion. There
      were no delayed unions. There were no complications at the donor site based on
      patient examination and radiographs. Ipsilateral ankle motion was not affected by
      the bone graft procedure. Cited complications from iliac crest bone graft include
      donor site pain, blood loss, heterotopic bone formation, pelvic instability,
      iliac hernia, infection, fracture, and deformity. Complications with allografts
      include disease transmission and immune response. These are avoided by using
      locally obtained distal tibia autograft for arthrodeses in the foot and ankle.

PMID- 7787973
TI  - The short oblique fracture of the distal fibula without medial injury: an
      assessment of displacement.
AB  - Eighteen patients with ankle injuries presenting as short oblique fractures of
      the distal fibula with no clinical or radiographic evidence of injury to the
      medial ankle were studied for fracture displacement. Plain radiographs and
      computed tomography were used for analysis. All fractures were clinically
      diagnosed as supination-external rotation stage 2 (SE-II) injuries under the
      Lauge-Hansen scheme. All exhibited slight displacement on plain radiographs and
      were treated nonoperatively. Computerized tomography using axial cuts across the
      fracture site and ankle mortise revealed normal positioning of the talus beneath
      the tibial plafond, as evidenced by no abnormality of the medial joint space in
      all patients. In the majority of patients, the relationship between the talus and
      distal fibula also appeared undisturbed, with fracture displacement being
      confined to a change in position of the proximal fibular fragment relative to the
      tibia as compared with the contralateral ankle. In a minority of cases, in
      addition to the above-described displacement of the proximal fibular fragment,
      the distal fibular fragment was noted to shift slightly laterally relative to the
      talus, with mild widening of the lateral joint space. Occult-associated avulsion
      fractures off the distal tibia were present in 39% of the cases.

PMID- 7787971
TI  - Effect of grape seed tannins on the activity of some rat intestinal enzyme
      activities.
AB  - The present study was designed to investigate the effects of grape seed tannins
      on rat intestinal alkaline phosphatase (AP), sucrase and dipeptidyl peptidase IV
      (DPP IV) activities. An experiment was performed in vivo by dietary
      supplementation with 2% tannins; this diet was tested on an experimental group of
      rats; a control group received a diet without tannins. After 31 days, tannins
      intake significantly decreased middle-jejunal AP from 123 to 45 mU/mg protein and
      sucrase activities from 310 to 195 mU/mg protein, while no significant difference
      appeared at the duodenal stage (p < 0.05). Ileal DPP IV activity was also
      significantly reduced (p < 0.05) from 190 to 110 mU/mg protein after tannin
      intake. Using in vitro experiments on purified brush border membranes, AP
      activity was found to be inhibited by grape tannins; this inhibition was
      prevented by the detergent Triton X-100. The addition of pancreatic-biliary (PB)
      juice to the incubation medium prevented or reversed the tannin-inhibited enzyme
      activity. The present data indicate that in the duodenal lumen, alkalinity and
      detergency from the PB secretion neutralized the ability of tannins to inactivate
      brush border hydrolase activities and suggest that enzyme inhibition took place
      once bile salts were reabsorbed while moving down the gut. This was confirmed by
      in vitro experiments where sucrase and DPP IV activities inhibited by grape seed
      tannins were largely recovered after the addition of PB juice to the incubation
      medium.

PMID- 7787975
TI  - The strength of Achilles tendon repair: an in vitro study of the biomechanical
      behavior in human cadaver tendons.
AB  - Eighteen fresh frozen human Achilles tendons were used to test the ultimate
      strength of repaired tendon "ruptures." Three methods, the Kessler, the Bunnell,
      and the locking loop, were used to test the initial strength of Achilles tendon
      repair. The Kessler and Bunnell methods are current standard clinical
      configurations described for Achilles tendon repair. Under uniform and
      standardized laboratory conditions, the specimens were loaded to failure. The
      locking loop suture method was substantially stronger than either of the other
      two standard configurations. The latter two did not differ significantly from
      each other. The results of this study may be clinically relevant in terms of the
      choice of the repair method for surgically treated Achilles tendon ruptures.

PMID- 7787972
TI  - Hallux valgus correction using a modified Hohmann technique.
AB  - In 181 patients presenting with hallux valgus (247 toes), we performed a modified
      Hohmann procedure with Kirschner wire fixation of the osteotomy. Follow-up by a
      questionnaire was possible in 159 patients representing 217 operated toes (21
      reoperations), and roentgenograms of bony healing were assessed in all these
      patients. The questionnaire was returned by 91% (145/159) of the patients. The
      average observation time was 52 months (25-97 months). The average correction of
      the hallux valgus angle was 10 degrees, ranging from 31.4 degrees before surgery
      to 21.4 degrees after surgery. Eighty-eight percent of the patients stated that
      they had an excellent or good/fair result, and 12% had pain or problems with
      footwear. We found a positive correlation among the correction of the valgus
      angle, the lateral displacement, shortening of the first metatarsal, and the
      overall result. No correlation was found among the plantar displacement,
      correction of the intermetatarsal angle and the result. The modified Hohmann
      procedure is, in our opinion, a safe and reliable procedure for treating hallux
      valgus deformity of the foot.

PMID- 7787976
TI  - Distraction osteogenesis for congenitally short lesser metatarsals.
AB  - Six lesser metatarsal lengthening procedures were performed in three patients
      using a miniature external fixator to perform distraction osteogenesis. The
      metatarsals were lengthened an average of 15.5 mm. The external fixator was left
      in place for an average of 15.5 weeks, with additional time in a cast or cast
      shoe. Complications included five occurrences of infection, two cases of
      premature healing of the osteotomy, one nondisplaced fracture through the new
      bone formation, and hypertrophic granulation at a pin site. While all metarasals
      were successfully lengthened, two rays (one patient) had symptomatic stiffness at
      the metatarsophalangeal joint with continued metatarsalgia.

PMID- 7787977
TI  - Gait analysis of the donor foot in microsurgical reconstruction of the thumb.
AB  - Clinical and step evaluations by a piezoelectric system board were performed in
      54 patients who underwent microsurgical reconstruction of the thumb by great or
      second toe transfer. Forty-four patients were male and 10 were female. In 13
      cases, the thumb was reconstructed by the Morrison wrap-around technique. In 27
      cases, an extended variant of the Morrison technique was used in which the whole
      distal phalanx was harvested with skin and nail apparatus. Four patients were
      treated by great toe transfer and 10 were treated by second toe transfer. Follow
      up ranged from 2 to 144 months. The group of patients treated by the wrap-around
      technique presented hallux rigidus in 38.5% of cases. The group of patients
      treated by the extended variant of the Morrison technique presented a lesser
      tendency to hallux rigidus but a clear reduction of the pushing phase of hallux.
      The group of patients treated by second toe transfer presented a third and fourth
      metatarsal bone overload that was confirmed by a statistical Wilcoxon test:
      overload was linked to a plantar hyperkeratosis at the third metatarsal (20%),
      fourth metatarsal (10%), or fifth metatarsal bone (20%). A claw deformity of the
      third and fourth toes was observed in 20% of these patients. The four patients
      who underwent microsurgical reconstruction of the thumb by great toe transfer
      exhibited an overload of central and lateral metatarsal bones. Second toe
      transfer is not associated with the functional or cosmetic changes seen in great
      toe transfer and is therefore preferred.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787978
TI  - Fibular osteochondroma presenting as chronic ankle sprain.
AB  - A 19-year-old baseball player was referred for assessment of recurrent sprains of
      the right ankle. This was found to be secondary to a palsy of the common peroneal
      nerve that was compressed by an osteochondroma of the fibular neck. The lesion
      was resected from the fibula and the patient made a complete recovery. We present
      this case as an example of a rare underlying problem in a patient who was
      initially diagnosed as having a sports-related ankle injury.

PMID- 7787979
TI  - Idiopathic hallux varus.

PMID- 7787980
TI  - Arthroscopic removal of an osteoid osteoma of the talus: a case report.
AB  - This article describes a patient with a 10-year history of persistent ankle pain.
      Differential diagnosis included osteoid osteoma and anterior ankle impingement.
      This patient subsequently underwent arthroscopic excision of a lesion on the
      talar neck following a complete radiographic work-up, which was nondiagnostic.
      The diagnosis of osteoid osteoma was finalized upon pathologic study of the
      arthroscopic shavings. The use of a motorized instrument for excision did not
      preclude pathologic evaluation of the specimen. Therefore, in an accessible
      location on the talar neck, arthroscopic excision of an osteoid osteoma can be
      performed.

PMID- 7787981
TI  - Salter-Harris type IV epiphyseal fracture of the proximal phalanx of the great
      toe: a case report.
AB  - Epiphyseal fractures account for about one fifth of pediatric fractures.
      Approximately 10% cause major growth disturbances, depending on the location and
      type of the fracture and the skeletal maturity of the child. Intraarticular
      Salter-Harris type IV fractures are rare, carry a poor prognosis, and almost
      always need surgical reduction to prevent deformity. We present a case report of
      a pediatric patient who returned to normal function after the successful surgical
      reduction of a Salter-Harris type IV fracture in the proximal phalanx of the
      great toe.

PMID- 7787982
TI  - Spindle cell lipoma of the foot: a case report and literature review.
AB  - Lipomas are among the most commonly encountered soft tissue tumors in clinical
      practice, though they are rare in the foot. Although a presumptive diagnosis is
      typically made clinically, those tumors with atypical clinical features may
      require radiological consultation. Difficulty arises when radiographic features
      are not typical of lipoma. We present a fatty soft tissue tumor of the foot with
      nonadipose elements on magnetic resonance imaging evaluation. Differentiation of
      lipoma variants (e.g., spindle cell lipoma, atypical lipoma, pleomorphic lipoma,
      lipoblastoma, angiolipoma) from liposarcoma based on imaging features is not
      possible, necessitating surgical resection for definitive histological diagnosis.

PMID- 7787983
TI  - Partial rupture of the flexor hallucis longus tendon in a tennis player: a case
      report.
AB  - A 39-year-old woman sustained a forced dorsiflexion injury to the left great toe
      while pivoting to the right during tennis activity. Posteromedial ankle pain was
      reproduced with active plantarflexion and passive dorsiflexion of the great toe
      and, to a smaller extent, the lesser toes. Symptoms persisted for 9 months
      despite nonoperative treatment. Magnetic resonance imaging 5 months after injury
      revealed evidence of fluid surrounding the flexor hallucis longus (FHL) tendon.
      Operative findings 9 months after injury included scar tissue and tenosynovitis
      of the FHL and flexor digitorum longus tendon sheaths, with impingement of distal
      FHL muscle fibers and a longitudinal split tear (partial rupture) of the FHL
      tendon. Tenolysis, tenosynovectomy, excision of the distal muscle fibers, and
      repair of the partial tendon rupture were performed, resulting in resolution of
      symptoms. Partial rupture of the FHL tendon as a single-impact injury, or in
      activity other than ballet, has not been documented previously.

PMID- 7787985
TI  - A modified Keller resection arthroplasty.

PMID- 7787984
TI  - Hallux flexion deformity secondary to entrapment of the flexor hallucis longus
      tendon after fibular fracture.
AB  - This article presents a case of entrapment of the flexor hallucis longus tendon
      after open reduction and internal fixation of a Weber C ankle fracture resulting
      in interphalangeal joint contracture of the hallux. Pathology involving other
      tendons at the foot and ankle associated with ankle fractures is reviewed. Other
      scenarios of flexor hallucis longus pathology are discussed. Flexor hallucis
      longus anatomy, as related to distal fibular fractures, is outlined, and a
      recommendation is made to consider flexor hallucis longus entrapment as a cause
      of hallux dysfunction after open reduction and internal fixation of an ankle
      fracture.

PMID- 7787986
TI  - Aiming guide for accurate placement of subtalar joint screws.
AB  - Accurate placement of rigid fixation of the subtalar joint in arthrodesing
      procedures (triple, subtalar, or pantalar arthrodesis) can be difficult. We have
      found that the "bottom-up" method simplifies this procedure and eliminates many
      potential problems. A technique is described incorporating the bottom-up method
      utilizing the combined aiming device (Synthes, Paoli, PA).

PMID- 7787987
TI  - Small hepatocellular carcinoma: its relationship to multistep
      hepatocarcinogenesis.
AB  - Recent advances in imaging techniques have led to the discovery of small
      hepatocellular carcinomas (HCC). The small HCC most often exhibit low-grade
      malignant (LGM) or extremely well differentiated features, which are different
      from those of advanced, full-blown HCC. The LGM-HCC present a serious diagnostic
      challenge to pathologists and must be differentiated from benign (reactive) and
      atypical (borderline) hyperplastic nodules. Analysis of small HCC revealed that
      hepatocarcinogenesis frequently occurs stepwise from atypical hyperplasia to LGM
      HCC and subsequently to advanced HCC. The HCC arise in irregular regeneration in
      chronic liver disease and in the essentially normal liver after steroid
      administration. Although the tumor suppressor gene, p53, is revealed to be often
      mutated in advanced HCC, the genetic events corresponding to each stage of
      multistep hepatocarcinogenesis are not clarified at all.

PMID- 7787988
TI  - Immunohistochemical detection of macrophage-derived foam cells and macrophage
      colony-stimulating factor in pulmonary atherogenesis of cholesterol-fed rabbits.
AB  - In order to investigate the role of monocyte/macrophages and their relationship
      to the expression of macrophage colony-stimulating factor (MCSF) in pulmonary
      atherosclerosis, lungs were excised from rabbits that had been fed for 60 and 90
      days on a diet containing 0.5% cholesterol. In the lungs, fatty streaks and
      elevated foam cell lesions predominated in the large or medium-sized elastic
      pulmonary arteries, while massive accumulation of foam cells in the intima of
      muscular arteries produced marked luminal narrowing and nearly complete
      occlusion. In these lesions, most of the foam cells were reactive with RbM2, a
      monoclonal antibody (mAb) against rabbit macrophages, while smooth muscle cell
      derived foam cells were detected by mAb against smooth muscle actin in the deeper
      area of elevated foam cell lesions of elastic arteries. Ultrastructural
      observation confirmed the presence of monocytes in the intima, their
      differentiation into macrophages, and their transformation into foam cells in the
      atherosclerotic lesions. Immunohistochemical expression of MCSF was demonstrated
      in the endothelial cells, smooth muscle cells and foam cells. A minor macrophage
      derived foam cell population was demonstrated to possess a proliferative
      capacity. These data suggest that MCSF is involved in the differentiation of
      monocytes into macrophages, their transformation into foam cells, and their
      proliferation during pulmonary atherogenesis.

PMID- 7787989
TI  - Strain combination-dependent genesis of necrotizing arteritis in anti-ICAM-1
      antibody-perfused renal allografts in the rat.
AB  - Rat kidneys were perfused with anti-intercellular adhesion molecule-1 (anti-ICAM
      1) monoclonal antibody prior to allotransplantation. In the two strain
      combinations examined, LEF-to-WKAH transplants resulted in accelerated graft
      loss, and no prolongation of graft survival. The accelerated graft loss was the
      result of frequent occurrence of necrotizing arteritis within the grafts. In
      contrast, TO-to-WKAH transplants resulted in no change in graft survival and no
      arteritis. Necrotizing vasculitis in the LEJ-to-WKAH grafts was characterized by
      fibrinoid necrosis, collection of cellular infiltrates and serum macromolecular
      protein entrapment. The F(ab1)2 form of anti-ICAM-1 antibody partially preserved
      the antibody's capacity to accelerate graft loss. Therefore, although endothelial
      injury by Fc-mediated cytotoxicity may be involved in vascular damage, other
      mechanisms also come into play. The amount and distribution pattern of ICAM-1
      antigen were identical in both TO and LEJ strains. Intravenous anti-ICAM-1
      antibody administration combined with lipopolysaccharide, Poly(I)-Poly(C), warm
      ischemia to the kidney, or subcutaneous immunization with allogeneic spleen
      cells, but without renal transplantation, did not generate necrotizing vasculitis
      or proteinuria. These observations plus our previous data on the rat liver
      transplantation model clearly show that graft perfusion with anti-ICAM-1
      monoclonal antibody invokes extensive vascular damage within allografts by Fc
      mediated and Fc-independent mechanisms, depending on the donor-to-host
      combination.

PMID- 7787990
TI  - Transferrin receptor distribution and iron deposition in the hepatic lobule of
      iron-overloaded rats.
AB  - Under the condition of obvious iron-overload, there is a zonal hemosiderin (iron)
      deposition in hepatic lobules. The deposition is heaviest in the periportal (zone
      1) and lightest in the perivenous (zone 3) hepatocytes. However, the mechanism
      for this pattern of iron deposition is obscure. Hepatic tissues from control,
      iron-deficient or iron-overloaded Wistar rats were used to study its
      pathogenesis. Iron-deficiency was induced by a low iron regimen. Iron-overload
      was produced by repeated intraperitoneal injections of ferric nitrilotriacetate
      (Fe(3+)-NTA) for 1-4 months. Liver tissues of the rats were immunohistochemically
      and histochemically stained for transferrin receptor (TfR), transferrin (Tf),
      ferritin (Ft), and iron. The staining intensity of TfR, Tf and Ft increased in
      hepatocytes of iron-deficient rats and decreased in that of the iron-overloaded
      in comparison with the control rats. TfR staining was strong in zone 1, with
      gradual transition into weak staining in zone 3 hepatocytes of the rat liver. TfR
      located primarily on the hepatocyte membrane. Tf had both membranous and
      cytoplasmic distribution. Many hepatocytes in group B had strong cytoplasmic Tf
      staining. Conversely, only a few hepatocytes had weakly stained cytoplasmic Tf in
      group C. Hepatocytes and Kupffer cells were Ft positive in control rats. Ft was
      distributed only in the cytoplasm. The staining intensity of Ft was stronger in
      zone 3 than in zone 1 hepatocytes of iron-deficient rats. In iron-overloaded
      rats, the iron deposition was severe in zone 1 and mild in zone 3
      hepatocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7787991
TI  - Saikosaponin A-induced cell death of a human hepatoma cell line (HuH-7): the
      significance of the 'sub-G1 peak' in a DNA histogram.
AB  - Saikosaponin A (SSA) induced cell death in the human hepatoma cell line (HuH-7)
      was investigated. Shortly after exposure to SSA, a DNA histogram showed a 'sub-G1
      peak', which was recently reported as suggestive of apoptosis by other
      researchers. However, the electrophoresis of DNA indicated that such was not the
      case in the present experiment. The decreased intake of rhodamine 123 and the
      swelling of mitochondria were remarkable shortly after SSA exposure. These data
      seem to support the idea that the sub-G1 peak represents necrosis rather than
      apoptosis. Interestingly, the DNA electrophoresis revealed the smear pattern of
      small DNA fragments shortly after SSA-exposure, although it did not show the
      apoptotic ladder pattern. This finding and the appearance of the 'sub-G1 peak' is
      thought to have been a result of the degradation of the nuclear DNA in the early
      stages of cell death. Because these findings are different not only from
      apoptosis, but also from typical necrosis, a distinct mechanism of cell death
      caused by SSA is suggested.

PMID- 7787992
TI  - Antigenicities of enteropathogenic Escherichia coli, lysozyme, and alpha-1
      antichymotrypsin on macrophages of genitourinary malacoplakia.
AB  - Seven cases of genito-urinary malacoplakia were analyzed histologically,
      ultrastructurally and immunohistochemically in a comparison with two cases of
      xanthogranulomatous pyelonephritis. Immunohistochemically, von Hansemann cells
      and Michaelis-Guttmann bodies, both hallmarks for the diagnosis of malacoplakia,
      showed a common antigenicity for enteropathogenic Escherichia coli as cytoplasmic
      granules of varying sizes. These microscopic manifestations corresponded
      ultrastructurally to a series of phagolysosomal degradations of coliform bacilli.
      Serogroups against E. coli OK antigens, which were positive for malacoplakic
      cells, were not confined to a particular group. Macrophages of
      xanthogranulomatous pyelonephritis did not show the E. coli antigenicity.
      Antigenicity of lysozyme and alpha-1-antichymotrypsin on the von Hansemann cells
      was equivocal, but these enzymes were strongly positive on macrophages of
      xanthogranulomatous pyelonephritis. The macrophages of both malacoplakia and
      xanthogranulomatous pyelonephritis were positive for antihuman macrophage
      antibody. These results indicate that malacoplakia depends mainly on infection by
      a non-specific strain of enteropathogenic E. coli and may arise from defective
      digestive enzyme activity of infiltrating macrophages. Immunohistochemical
      analysis using antisera against E. coli OK antigens, lysozyme and alpha-1
      antichymotrypsin was useful in identifying the prediagnostic stage of
      malacoplakia and in differentiating the lesion from xanthogranulomatous
      pyelonephritis.

PMID- 7787993
TI  - Interphase cytogenetics of gastric carcinoma: fluorescence in situ hybridization
      (FISH) applied to cells obtained from formalin-fixed paraffin-embedded tissues.
AB  - The interphase cytogenetics in formalin-fixed and paraffin-embedded gastric
      cancer tissues were examined by fluorescence in situ hybridization (FISH) with
      alpha-satellite DNA probes. Two gastric carcinoma cell lines, TMK-1 and MKN-28,
      were first analyzed cytogenetically. Of 25 TMK-1 cell karyotypes, chromosome 7
      showed trisomy and chromosome 17 showed disomy in 18 cells. Most MKN-28 cells
      showed disomy of both chromosomes 7 and 17. Suspensions of singly isolated TMK-1
      and MKN-7 cells were obtained from the cultured cells, and from paraffin-embedded
      tissue specimens fixed with formalin for 0, 1, 3 and 5 days obtained from
      xenotransplanted tumors in nude mice. The numbers of chromosomes 7 and 17
      analyzed with the karyotypic preparations coincided well with those determined by
      FISH, even in the paraffin-embedded specimens. The number of tumor cells showing
      no signals, however, increased in the specimens after 5 days formalin fixation.
      In 10 surgically removed gastric carcinomas, the predominant signal number for
      chromosomes 7 and 17 in the cells of paraffin-embedded tissues was two (disomy),
      except in one papillary carcinoma, which was trisomic for chromosome 7. Large
      subpopulations (more than 20%) showing trisomy were found in four cases for
      chromosome 7 and in five cases for chromosome 17. A higher frequency of trisomy
      was found in well differentiated than in poorly differentiated carcinomas. These
      findings suggest that the FISH technique is a useful tool for detecting
      chromosomal aberrations in gastric adenocarcinoma cells, even in paraffin
      embedded specimens, as long as the tissues are fixed with formalin for an
      appropriate time.

PMID- 7787994
TI  - Mucin antigens expression and Ki-67 labeling in breast cancer: the peculiarity in
      scirrhous carcinoma.
AB  - The expression of mucin-related antigens (Tn, T, Sialosyl-Tn [STn], DF3 [mammary
      type apomucin related antigen], and intestinal-MRP [intestinal-type apomucin
      related antigen]) as well as Ki-67 labeling was examined in 58 mammary invasive
      ductal carcinomas (IDC) divided into 26 scirrhous subtype (SC) and 32 non
      scirrhous subtype comprising papillotubular carcinoma and solid-tubular carcinoma
      (PT-ST). These data were analyzed in connection with the various pathological
      prognostic factors such as nodal status, tumor size, estrogen receptor status and
      histological grading of carcinomas. The results were as follows: (a) in SC, the
      expression rate of Tn was significantly higher in the cases with positive lymph
      node metastasis or with large tumor size (> 2 cm) than in those with negative
      lymph node metastasis or with small tumor size (< or = 2 cm); (b) in PT-ST, the
      expression rate of STn was higher in the cases with positive lymph node
      metastasis or with large tumor size than in those with negative lymph node
      metastasis or with small tumor size; (c) in SC, Ki-67 labeling was significantly
      higher in the cases with positive lymph node metastasis than in those with
      negative lymph node metastasis; and (d) in PT-ST, Ki-67 labeling was lower in the
      cases with positive lymph node metastasis than in those with negative lymph node
      metastasis. In conclusion, Tn antigen expression was correlated with pathological
      prognostic factors in SC but not in PT-ST, whereas STn antigen expression was
      correlated with pathological prognostic factors in PT-ST but not in SC.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7787995
TI  - Adrenocorticotropic hormone-independent bilateral macronodular adrenocortical
      hyperplasia associated with Cushing's syndrome.
AB  - A case of adrenocorticotropic hormone independent bilateral adrenocortical
      macronodular hyperplasia (AIMAH) is reported. A 59 year old male was admitted to
      hospital because of hypertension. Subsequently, hypercortisolism, low plasma
      adrenocorticotropic hormone (ACTH), loss of diurnal rhythm of ACTH, lack of
      suppression with high dose dexamethasone were found and bilateral adrenal
      enlargement was detected by abdominal computerized tomography and adrenal
      scintigraphy. Bilateral total adrenalectomy was performed under a diagnosis of
      bilateral adrenal hyperplasia associated with Cushing's syndrome. Both adrenal
      glands were enlarged in size and weight. Bulging nodules were found at the cut
      section. Microscopically, a variegated histologic pattern including trabecular,
      adenoid and zona glomerulosa-like (ZG-like) structures was revealed in the
      nodules. Immunohistochemical examination disclosed positive staining of
      cytochrome P-450 17 alpha, negative of 3 beta-HSD in the ZG-like structure.
      Ultrastructurally, the cells composing the ZG-like structure were similar to
      those of the ZG in normal adrenal cortex. The authors agree that AIMAH is one of
      the entities causing Cushing's syndrome, and advise pathologists to keep this
      disorder in mind when they examine the adrenals in Cushing's syndrome.

PMID- 7787996
TI  - Adenolipoma of the thyroid gland.
AB  - A rare case of adenolipoma (thyrolipoma) of the thyroid gland is reported.
      Previously reported cases are reviewed and the pathogenesis of this unusual
      thyroid lesion is discussed.

PMID- 7787998
TI  - Coexistence of focal segmental glomerulosclerosis and diabetic glomerulopathy.

PMID- 7787997
TI  - Adenosquamous carcinoma of the gall-bladder with gastric foveolar-type
      epithelium.
AB  - An 80 year old Japanese man had adenosquamous carcinoma of the gall-bladder
      characterized by an adenocarcinoma (AC) in the gall-bladder lumen and a squamous
      cell carcinoma (SCC) in the invaded region of the liver. In the AC, the tumor
      cells consisted of atypical columnar epithelium with pseudostratification,
      mimicking gastric foveolar epithelium, while atypical signet-ring cells were
      scattered within the SCC. There was an abrupt transition between the AC and SCC
      areas. The tumor cells in the AC area were intensely positive for galactose
      oxidase-Schiff staining, and paradoxical concanavalin A staining revealed these
      tumor cells to have Class II mucins. Immunohistochemically, the tumor cells in
      foveolar-type adenocarcinoma were diffusely positive for cathepsin D. Flow
      cytometrical analysis of DNA content showed the AC area to be diploid and the SCC
      area to be aneuploid. The S-phase fraction of the SCC area (46.9%) was larger
      than that of the AC area (19.5%). The positive rate of immunostaining for
      proliferating cell nuclear antigen in the SCC area (mean 50.627%) was larger than
      that of the AC area (mean 3.048%, P < 0.01). These results suggest that the AC
      area of this tumor, histochemically and immunohistochemically, showed gastric
      foveolar-type characteristics, the SCC component was squamous cell metaplasia of
      the pre-existing AC, and that the SCC area had a greater proliferating capacity
      than the AC area.

PMID- 7787999
TI  - Physiological role of the insulin-like growth factor binding proteins.

PMID- 7788000
TI  - Acquired growth hormone resistance.

PMID- 7788001
TI  - Is repeated fine-needle aspiration cytology indicated in (benign) thyroid
      nodules?

PMID- 7788003
TI  - Serum levels of interleukin 6 and tumor necrosis factor-alpha in hyperthyroid
      patients before and after propylthiouracil treatment.
AB  - Contrary to the usual inhibitory role of tumor necrosis factor-alpha (TNF-alpha)
      in thyroid metabolism, it also has specific stimulatory effects in autoimmune
      thyroid disorders, including induction of HLA class II antigen-presenting cell-T
      cell interaction. Despite high intrathyroidal concentrations, various studies
      were not able to demonstrate high serum levels of TNF-alpha in patients with
      Graves' disease. To investigate this discrepancy we determined TNF-alpha and
      interleukin 6 (IL-6) levels in 25 hyperthyroid patients who responded to
      propylthiouracil treatment (16 with Graves' disease and nine with toxic
      multinodular goiter) and compared them with the levels found in euthyroid
      patients with simple diffuse goiter (n = 15) and normal healthy controls (n =
      15). Median IL-6 levels were high in both Graves' disease and toxic multinodular
      goiter patients before propylthiouracil treatment (23 and 26.5 pg/ml,
      respectively). After restoring euthyroidism there was a statistically significant
      decline to near-normal levels (3 and 10 pg/ml, respectively). On the other hand,
      median serum TNF-alpha levels were high only in Graves' disease patients (20
      pg/ml) and could not be normalized with antithyroid medication (20 pg/ml)
      compared to that of controls (5 pg/ml). Tumor necrosis factor-alpha, but not IL
      6, was found to be high in the sera of Graves' disease patients when euthyroid,
      which may be due to an ongoing antigen-antibody interaction, a feature of
      autoimmune attack. It remains to be determined whether the degree of TNF-alpha
      and/or IL-6 elevation will be a predictor of disease recurrence.

PMID- 7788002
TI  - Decreased serum testosterone and free triiodothyronine levels in healthy middle
      aged men indicate an age effect at the pituitary level.
AB  - In an attempt to study further the age-specific influence on the hypothalamo
      pituitary-gonadal axis as well as the hypothalamo-pituitary-thyroid axis, we have
      now investigated young and middle-aged men, considering possible confounding
      factors. Both serum total testosterone, free testosterone and the total ratio of
      testosterone to sex-hormone binding globulin were significantly lower among
      middle-aged men as compared with young men (p = 0.02, p = 0.002 and p = 0.0003,
      respectively). In accordance with these findings there was also a decrease in the
      luteinizing hormone response to gonadotrophin-releasing hormone in the middle
      aged men (p = 0.02). Free testosterone was correlated significantly with the
      luteinizing hormone response (r = 0.32, p = 0.02). Serum free triiodothyronine
      was significantly higher among young men as compared with middle-aged men (p =
      0.002) and the thyrotrophin-releasing hormone-stimulated thyrotrophin response
      was also higher in the young group compared with the middle-aged group. The
      present results may indicate that the age effect on serum levels of testosterone
      and free triiodothyronine is mediated at the pituitary level.

PMID- 7788004
TI  - Thyroid hormones in fibrocystic breast disease.
AB  - This study was undertaken to evaluate the role of thyroid hormones in fibrocystic
      breast disease. The concentrations of thyroid-stimulating hormone (TSH),
      thyroxine (T4), free T4 and free triiodothyronine (T3) were determined in serum
      of 50 women with fibrocystic breast disease without macrocysts (cysts of over 3
      mm diameter) and in the serum and breast cyst fluid (BCF) of 60 women with
      fibrocystic breast disease and macrocysts. Possible relationships between thyroid
      hormones and estradiol, dehydroepiandrosterone sulfate, testosterone,
      progesterone and 17-hydroxyprogesterone in the BCF also were analyzed. Serum
      thyroid hormone levels did not differ between the two groups. Free T3 levels were
      higher in BCF than in serum (p < 0.001), whereas T4, free T4 and TSH
      concentrations were lower in BCF as compared to serum (p < 0.001). Cysts were
      divided according to their K+/Na+ ratio because a ratio above 3 represents a
      predictor of malignant transformation. Free T3 concentrations were higher in BCF
      than in serum, in both low K+/Na+ cysts and in cysts with a K+/Na+ ratio above 3;
      those cysts with a high K+/Na+ ratio had the highest free T3 concentration. Free
      T3 in cysts correlated positively to the K+/Na+ ratio (r = 0.831; p < 0.001).
      Multiple linear regression analysis demonstrated that the concentration of free
      T3 in BCF was predicted statistically by the positive regression coefficient for
      the estradiol concentration. No candidate variable was included in the model to
      predict concentrations of TSH, free T4 or T4 in BCF. These data suggest an
      important role of free T3 in the physiology of fibrocystic breast disease.

PMID- 7788005
TI  - Fine-needle aspiration cytology of benign nodular thyroid disease. Value of re
      aspiration.
AB  - Fine-needle aspiration cytology (FNAC) has become a widespread procedure for the
      study of thyroid nodules (TN). Some authors recommend the practice of repeated
      punctures for their follow-up. This study was done to determine the usefulness of
      repeated FNAC in patients with benign nodular thyroid disease. We have studied
      251 fine-needle re-aspirations performed on 116 females aged 45.6 +/- 14 years
      with benign nodular thyroid disease. The time elapsed between each consecutive
      FNAC was 1 year. No patients presented any changes in the size or consistency of
      their nodular goiters during this period; all FNACs were carried out by the same
      physician in the same thyroid area according to the Lowhagen technique, with a
      minimum of two or three aspirations of each nodule, and processed in the same way
      and valued by the same cytologist without any knowledge of previous cytological
      diagnoses. These were done using strictly classical criteria (Lowhagen). One
      hundred and five out of 116 patients (90.51%) with two consecutive FNACs (210)
      showed identical cytological diagnoses in the two specimens studied. The
      remaining 11 patients (9.48%) with two FNACs were diagnosed with colloid goiter
      and cyst alternately. Fifteen out of 19 patients (78.94%) with three FNACs showed
      identical cytological diagnoses in the three samples and the rest (21%) also
      demonstrated alternate diagnoses of colloid goiter and cyst. Our results show
      that the routine performance of repeated FNAC in the follow-up of females with
      benign nodular thyroid disease, without any clinical changes, is of limited
      usefulness.

PMID- 7788006
TI  - Urinary excretion rate of ceruloplasmin in non-insulin-dependent diabetic
      patients with different stages of nephropathy.
AB  - The level of ceruloplasmin, which is a more negatively charged protein than
      albumin, was measured by an immunoradiometric assay in timed overnight urine and
      serum samples from patients with non-insulin-dependent diabetes mellitus and
      healthy controls. None of the plasma proteins examined showed any cross
      reactivity in this assay. A linear correlation was seen between the ceruloplasmin
      level and the serial dilution of the sample. Western blot analysis using
      concentrated urine samples showed that the molecular weight of ceruloplasmin in
      the urine sample was the same as that of ceruloplasmin in the serum and standard
      samples. These findings indicated that the substance detected by this assay was
      truly ceruloplasmin. The urinary ceruloplasmin excretion rate (CER) and clearance
      of ceruloplasmin increased in parallel with the progression of albuminuria. The
      highest CER was found in macroalbuminuric patients, followed by micro- and
      normoalbuminuric patients and the healthy control subjects, the differences
      between the groups being significant. In view of the fact that the isoelectric
      point of ceruloplasmin (4.4) is more acidic than that of albumin, the present
      findings suggested that an enhanced CER was due either to the alteration of
      charge selectivity in the glomerular basement membrane with unaltered tubular
      function or to a defect of the non-discriminatory pores (shunt pathway) with
      unaltered tubular function.

PMID- 7788007
TI  - Cardiovascular effects of long-term L-thyroxine therapy for Hashimoto's
      thyroiditis in children and adolescents.
AB  - Morphology and function of the left ventricle were evaluated by echo and Doppler
      examination in 16 females affected by Hashimoto's thyroiditis, aged 13.3 (4.5)
      years (range 7.9-24.6). They were on L-thyroxine (L-T4) treatment for a period of
      2.8 (2.8) years (range 0.8-7.6) with a mean daily dose of 77 (18) micrograms/m2.
      Left ventricular mass, systolic and diastolic function, cardiac output and
      systemic vascular resistance did not differ from a control group matched for age,
      sex and body size. A further analysis of the patients according to thyrotrophin
      serum levels (less or more than 0.1 mU/l) gave similar results. Moreover, no
      relationship was found between echocardiographic findings and age, L-T4 daily
      doses, duration of treatment and serum level of thyroid hormones. We can
      therefore conclude that chronic L-T4 treatment for Hashimoto's thyroiditis at the
      given doses did not affect cardiac function and morphology in children and
      adolescents; however, a longer follow-up is needed before confirming the safety
      of this therapy in the long term.

PMID- 7788008
TI  - Effects of acute hyperinsulinemia on plasma atrial and brain natriuretic peptide
      concentrations.
AB  - Impaired renal sodium excretion and increased plasma atrial natriuretic peptide
      (ANP) levels have been reported in patients with hypertension associated with
      insulin resistance and hyperinsulinemia. To clarify the interrelationship between
      hyperinsulinemia and plasma natriuretic peptides, we investigated the effects of
      physiological and non-physiological hyperinsulinemia on the plasma ANP and brain
      natriuretic peptide (BNP) levels. Plasma immunoreactive insulin (IRI), ANP and
      BNP levels were determined by a euglycemic-hyperinsulinemic glucose clamp in 20
      patients with non-insulin-dependent diabetes mellitus, by a glucose challenge
      test in 22 normal subjects and by an insulin challenge test in six normal
      subjects. Both in the glucose clamp and the glucose challenge test, plasma ANP
      showed a significant increase in association with increased plasma IRI and plasma
      volume. However, there was no significant correlation between the changes in
      plasma ANP levels and plasma IRI levels in view of the peak values and the area
      under the curve of their responses. In addition, the plasma ANP did not show any
      significant change despite the marked elevation of plasma IRI in the insulin
      challenge test. There was no significant change in plasma BNP under any of the
      hyperinsulinemic conditions. These findings provide in vivo evidence for the lack
      of a direct effect of acute hyperinsulinemia on natriuretic peptides, although
      the chronic effects of hyperinsulinemia remain to be elucidated.

PMID- 7788009
TI  - Treatment of central precocious puberty with depot leuprorelin. French
      Leuprorelin Trial Group.
AB  - We evaluated the pituitary and gonadal suppression in 40 girls and nine boys
      treated with depot leuprorelin (3.75 mg sc if body weight > or = 20 kg, 1.87 mg
      if body weight < 20 kg) every 28 days for central precocious puberty. Gonadal
      suppression was obtained in most of the children with this dose: 3 months after
      initiation of the treatment, 85% of children had a peak plasma luteinizing
      hormone response to gonadotropin-releasing hormone < 3 IU/l and the gonadal axis
      remained suppressed throughout the duration of the study (up to 24 months). Four
      patients required higher doses of leuprorelin to achieve suppression. In two
      girls, a cutaneous reaction to the drug was associated with incomplete
      suppression and the treatment had to be interrupted. Plasma leuprorelin levels
      tended to increase from day 3 to day 28 after injection. Residual leuprorelin
      levels measured 28 days after injection were stable during the first year of the
      study. We conclude that an initial dose of depot leuprorelin of 3.75 mg sc every
      28 days is efficient in most children with central precocious puberty.

PMID- 7788010
TI  - Effects of age and gender on pituitary-adrenocortical responsiveness in humans.
AB  - This study compared plasma concentrations of adrenocorticotropin (ACTH) and
      cortisol in young men (N = 10, mean age 24.4 years), young women (N = 10, mean
      age 25.4 years), old men (N = 8, mean age 81.6 years) and old women (N = 8, mean
      age 83.5 years) under basal resting conditions and after stimulation with either
      human corticotropin-releasing hormone (hCRH, 100 micrograms iv) or a combined
      injection of hCRH (100 micrograms) and arginine vasopressin (VP, 0.5 IU iv).
      Basal secretion of cortisol did not differ among groups, but basal concentrations
      of ACTH were diminished in young women (p < 0.01), indicating an enhanced adrenal
      sensitivity to ACTH in these subjects. Pituitary responses to hCRH did not differ
      between young men and women. However, responses to hCRH/VP were stronger in the
      young females (p < 0.01), suggesting an enhanced pituitary responsiveness to the
      augmenting effect of VP on ACTH release in this group. Pituitary-adrenal
      secretory responses were greater in old than in young men after sole injection of
      hCRH (p < 0.05) and even more so after combined injection of hCRH/VP (p < 0.01).
      In old women, pituitary-adrenal secretory responses were also greater than in
      young women (p < 0.05). But, in particular for responses to hCRH/VP, these
      effects were less distinct than within the men. Results indicate an enhancing
      effect of age on pituitary responsiveness to the hypothalamic secretagogues hCRH
      and VP, modulated by the subject's gender.

PMID- 7788012
TI  - Growth hormone response to growth hormone-releasing hormone (GHRH), insulin,
      clonidine and arginine after GHRH pretreatment in obese children: evidence of
      somatostatin increase?
AB  - To clarify the possible neuroendocrine mechanisms underlying the impairment in
      growth hormone (GH) secretion present in obesity, the GH response to GH-releasing
      hormone (GHRH, N = 6), insulin hypoglycemia (N = 6), clonidine (N = 7) and
      arginine (N = 8) after GHRH pretreatment (1 microgram/kg iv 2 h before the tests)
      was evaluated in 27 obese peripubertal children and in a group of normal-weight
      short-normal children (N = 26). Growth hormone-releasing hormone pretreatment and
      all further stimuli elicited a statistically significant GH response in both
      obese and short-normal children; in the latter group arginine did not induce a
      significant GH response. No differences were found among the GH responses after
      the second stimuli in obese children, while in short-normal children the arginine
      peak and area values were lower than after GHRH and clonidine. Comparison between
      the two groups showed similar baseline but higher stimulated GH levels in normal
      weight children after all tests except arginine, after which no difference was
      present. In conclusion, the neuroregulation of GH release seems to be similar
      qualitatively in normal-weight and obese youngsters; the different behavior
      observed after arginine, which is supposed to act through somatostatin
      inhibition, might be due to a chronic increase in somatostatinergic tone
      responsible for the lower stimulated GH levels in obesity.

PMID- 7788011
TI  - Growth hormone (GH) responses to the combined administration of GH-releasing
      hormone plus GH-releasing peptide 6 in adults with GH deficiency.
AB  - In recent years the health problems of adults with growth hormone deficiency
      (GHD) and the benefits of GH replacement therapy have received considerable
      attention. However, the reliability of conventional GH tests in the assessment of
      pituitary GH reserve in this group of patients is still controversial. In this
      study, we assessed GH secretion after the combined administration of GH-releasing
      hormone (GHRH) (1 microgram/kg iv) and GH-releasing peptide 6 (GHRP-6, 1
      microgram/kg iv) in adult patients diagnosed with GHD by conventional GH testing,
      and correlate this response with insulin-like growth factor I levels. Twenty-one
      subjects (13 male, 8 female) with long-standing diagnosis of GHD aged 21-54 years
      were studied. In 13 subjects GH responses to GHRH plus GHRP-6 were markedly
      reduced (peak GH response < 10 mU/l), whereas in the remaining eight the response
      was greater (range 11-100 mU/l). In conclusion, our data show that combined
      administration of GHRH plus GHRP-6 elicited a significant increase in plasma GH
      levels in about 40% of patients diagnosed with GHD by conventional GH testing.

PMID- 7788014
TI  - Which iodolipids are involved in thyroid autoregulation: iodolactones or
      iodoaldehydes?

PMID- 7788013
TI  - Diagnosis and selective cure of Cushing's disease during pregnancy by
      transsphenoidal surgery.
AB  - The diagnosis of Cushing's Disease during pregnancy is complex because the
      biochemical features are obscured by changes in the normal hypothalamo-pituitary
      adrenal axis that occur during gestation. To date, treatment has not been
      successful and there is a high incidence of maternal and fetal complications. We
      report the case of a 24-year-old woman with Cushing's disease who presented
      during her 16th week of pregnancy. Diagnosis was confirmed by the finding of
      elevated serum and urinary free cortisol levels with loss of the normal circadian
      rhythm of serum cortisol. Cortisol levels failed to suppress after a low-dose
      dexamethasone test but suppressed after a high-dose test. There was an
      exaggerated serum cortisol and plasma adrenocorticotrophin (ACTH) response to
      corticotrophin-releasing hormone (CRH). Magnetic resonance (MR) scanning
      demonstrated a pituitary tumour and cure was effected by transsphenoidal surgery
      where tumour immunostaining for ACTH was removed. Postoperatively the patient
      made an uncomplicated recovery; serum cortisol and plasma ACTH levels were
      undetectable at 9 days following surgery and recovery of the hypothalamo
      pituitary axis occurred at 99 days after surgery. Caesarean section was performed
      at 38 weeks of pregnancy and a healthy but small female infant was delivered.
      This case illustrates the biochemical features of Cushing's disease during
      pregnancy and is the first report of the use of CRH testing and MR scanning in
      this clinical situation. The cure by surgery and successful outcome for mother
      and infant, with preservation of normal anterior pituitary function, suggest that
      transsphenoidal surgery may be the treatment of choice.

PMID- 7788015
TI  - delta-Iodolactones decrease epidermal growth factor-induced proliferation and
      inositol-1,4,5-trisphosphate generation in porcine thyroid follicles--a possible
      mechanism of growth inhibition by iodide.
AB  - delta-Iodolactone (6-iodo-8,11,14-eicosatrienoic delta-lactone, delta-IL), an
      iodinated derivative of arachidonic acid, has been shown to be synthesized in
      thyroid tissue and to inhibit thyroid cell proliferation. It is discussed as a
      potential mediator of the autoregulatory pathway of iodide in cyclic adenosine
      3',5'-monophosphate (cAMP)- and thyrotropin (TSH)-independent growth. We
      therefore further localized the action of iodide and of delta-IL in isolated
      porcine thyroid follicles. Epidermal growth factor (EGF) and 12-O
      tetradecanoylphorbol-13-acetate (TPA) dose dependently stimulated thyroid cell
      proliferation, which could be inhibited by staurosporin (0.1-10 nmol/l). Iodide
      (2.5-40 mumol/l) as well as delta-IL (0.5-2 mumol/l) also dose dependently
      inhibited EGF- and TPA-induced proliferation. As the calcium ionophor A23187 (100
      pmol/l) completely abolished the inhibitory effects of iodide and of delta-IL,
      this may indicate a mechanism of delta-IL at or proximal to the calcium-dependent
      activation of protein kinase C. The growth inhibitory effect was restricted to
      delta-iodolactones when delta-IL was compared to 6-iodo-8,11,14,17
      eicosatetraenoic delta-lactone and 5-iodo-7,10,13,16,19-docosapentaenoic gamma
      lactone. It could not be prevented with propylthiouracil and therefore
      deiodination and a different iodide action is unlikely. Inositol-1,4,5
      trisphosphate (IP3) and cAMP were measured in extracts from isolated porcine
      thyroid follicles stimulated with EGF (10 ng/ml) or TSH (1.0 U/l) revealing
      comparable kinetics in IP3 generation, while cAMP formation was only stimulated
      by TSH. delta-Iodolactone (2 mumol/l) only decreased EGF-induced IP3 formation,
      whereas TSH-induced IP3 and cAMP formation was unchanged.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7788016
TI  - Hypoglycemia in a dog with a leiomyoma of the gastric wall producing an insulin
      like growth factor II-like peptide.
AB  - A 12-year-old mixed-breed male dog was referred to the Clinica Medica Veterinaria
      of Bologna University for recurrent episodes of seizures due to hypoglycemia with
      abnormally low plasma insulin levels (18 pmol/l). Resection of a large leiomyoma
      (780 g) of the gastric wall resulted in a permanent resolution of the
      hypoglycemic episodes. Insulin-like growth factors I and II (IGF-I and -II) were
      measured by RIA in serum before and after surgery and in tumor tissue. Results
      were compared to the serum concentration of 54 normal and to the tissue
      concentration observed in eight non-hypoglycemic dog gastric wall extracts.
      Before surgery, circulating immunoreactive IGF-I was 0.92 nmol/l, which is
      significantly lower than the control values (16.92 +/- 8.44 nmol/l, range 3.53
      35.03), while IGF-II was 152 nmol/l, which is significantly higher than the
      control values (42.21 +/- 3.75, range 31.99-50.74). After surgery, IGF-I
      increased to 6.80 nmol/l while IGF-II decreased to 45.52 nmol/l. Tumor tissue IGF
      II concentration was higher than normal (5.66 nmol/kg tissue as compared to a
      range in normal gastric wall tissue of 1.14-3.72 nmol/kg), while IGF-I was 0.08
      nmol/kg tissue, which is close to the lowest normal value (range in controls,
      0.08-1.18 nmol/kg). Partial characterization of IGF-II immunoreactivity extracted
      from tissue evidenced a molecular weight similar to that of mature IGF-II, thus
      excluding that peptide released by the tumor is a precursor molecule.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7788017
TI  - Long-lasting effects of Triac and thyroxine on the control of thyrotropin and
      hepatic deiodinase type I.
AB  - The purpose of this study was to investigate the relation between the serum
      levels of thyroid hormones and their biological effects. For this purpose,
      hypothyroid rats were studied after stopping treatment with a long-acting thyroid
      hormone, thyroxine (T4) and a short-acting one, triiodothyroacetic acid (Triac).
      Based on preliminary experiments with different doses of T4 and Triac,
      hypothyroid rats (N = 84) received over 6 days' injections of 10 nmol Triac or 2
      nmol T4/100 g body wt per day. Biological effects of Triac and T4 were measured
      in the pituitary, liver and kidney up to 8 days after stopping treatment. With
      Triac, serum thyrotropin (TSH) levels were inhibited completely 6 h after
      injection, yet after 24 h they were 4.9 +/- 1.8 micrograms/l (hypothyroid 14.5 +/
      0.8 micrograms/l). The rapid changes in serum TSH levels were followed by a more
      gradual increase in serum TSH levels were followed by a more gradual increase in
      serum TSH, which was similar to that after T4 injection. Even 8 days after Triac
      treatment, serum TSH levels did not reach the hypothyroid control levels. Changes
      in beta-TSH mRNA levels also showed a prolonged inhibition after both treatments
      and a slow return to hypothyroid values, which was not complete 8 days after
      stopping treatment. A second parameter was hepatic 5'-deiodinase type I (5'D-I).
      The 6-day treatment with Triac had a markedly stronger effect on 5'D-I enzyme
      activity and mRNA levels than treatment with T4.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788018
TI  - Follicle-stimulating hormone-testosterone interaction in modulating
      steroidogenesis in bovine granulosa cells. I. Effect on progesterone production.
AB  - The aim of this study was to investigate the effects of testosterone on basal and
      follicle-stimulating hormone (FSH)-induced progesterone production by cultured
      bovine granulosa cells. Granulosa cells were isolated from small (< 5 mm) and
      large (> 8 mm) follicles and cultured for 48 h in 1 ml of Medium-199 with
      different concentrations of FSH (0.1, 1, 10 and 35 mg/l). In addition, the
      combined effects of different amounts of testosterone (1 nmol-10 mumol) and 1
      mg/l FSH for 48 h on progesterone production by granulosa cells of both groups of
      follicles were studied; progesterone production during the subsequent 24-h
      incubation period was evaluated in the absence of hormones. In a third
      experiment, granulosa cells were treated with 500 micrograms of dibutyryl-cAMP
      and 10 mumol of testosterone for 48 h. At the end of each incubation period, the
      progesterone content in the culture media was determined by a validated
      radioimmunoassay. Basal progesterone release during the 48-h incubation period
      was higher in granulosa cells from small as compared to cells from large
      follicles; in both groups of cells, progesterone production was stimulated
      maximally by 1 mg/l FSH. The treatment with 10 mumol of testosterone induced a
      decrease of progesterone production in both groups of cells, while lower amounts
      exerted an inhibitory effect only in cells from large follicles. Furthermore, 10
      mumol of testosterone inhibited FSH-induced progesterone release, while lower
      dosages were ineffective. Dibutyryl-cAMP stimulated significantly the
      progesterone output by granulosa cells of both groups and testosterone was
      effective in suppressing this increase.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788019
TI  - Effect of pinealectomy and melatonin treatment during pregnancy on the sexual
      development of the female and male rat offspring.
AB  - Sexual development of female and male rat offspring of control, pinealectomized
      (PIN-X) or melatonin (MEL 250 micrograms/100 g body wt)-treated mother rats
      during pregnancy was studied. Newborns were studied at the following phases of
      sexual development: neonate (5 days old), infantile (15 days old), juvenile (25
      and 30 days old) and pubertal phase (55 days). In female offspring, MEL treatment
      during pregnancy significantly increased plasma luteinizing hormone (LH) in 15-
      and 25-day-old rats; however, at the end of the prepubertal period (30 days) the
      concentration of plasma LH decreased significantly as compared to control rats.
      This hormonal pattern was different from that observed in offspring of control
      and PIN-X rats, which had low LH levels at 25 days of age and higher LH levels at
      30 days of age. Follicle-stimulating hormone (FSH) did not vary significantly
      among the three groups. Plasma prolactin levels were affected by PIN-X of the
      mother, showing significantly higher levels in the 5-day-old offspring than in
      the controls; plasma prolactin levels were also affected by MEL treatment of the
      mother, producing hyperprolactinemia in the 30-day-old female offspring. In male
      offspring, sexual development in control male rats progressed rapidly with
      significantly increased LH and FSH levels at 25 and 30 days compared to those
      measured during the neonatal and infantile periods.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7788021
TI  - Nurse heroes in Oklahoma City.

PMID- 7788023
TI  - Nursing gets a stamp of approval.

PMID- 7788020
TI  - Changes in mRNA levels of a pituitary-specific trans-acting factor, Pit-1, and
      prolactin during the rat estrous cycle.
AB  - The present study examined the changes in mRNA levels of a pituitary-specific
      trans-acting factor, Pit-1, and prolactin during the rat estrous cycle. Total
      cytoplasmic RNA was analyzed by Northern blot and slot-blot hybridization to
      examine the prolactin mRNA level. Reverse transcription-polymerase chain reaction
      (RT-PCR) was performed to examine the Pit-1 mRNA level. Proestrous and estrous
      prolactin mRNA levels were significantly higher than the metestrous and diestrous
      levels, whereas Pit-1 mRNA levels of the estrous and metestrous stages were about
      two- to threefold higher than those of the proestrous and diestrous stages.
      Proestrous Pit-1 mRNA levels increased gradually from 10.00 h to 20.00 h, while
      prolactin mRNA levels slightly decreased until 14.00 h but increased later until
      20.00 h. During the rat estrous cycle, especially in the afternoon of the
      proestrous day, changes of prolactin mRNA levels seem to follow a prior increase
      of Pit-1 mRNA. Therefore, Pit-1 may be partly involved in the regulation of
      prolactin gene expression according to the rat estrous cycle. Estradiol
      administration to ovariectomized rats significantly increased both the mRNA
      levels of prolactin and Pit-1, which suggests that the gene expression of Pit-1
      is regulated by estrogen through indirect extracellular pathways.

PMID- 7788022
TI  - Walls of memories.

PMID- 7788024
TI  - Colors of the spectrum. Mental health care nursing in the home.

PMID- 7788025
TI  - Heroes on the homefront.

PMID- 7788026
TI  - Management perspectives. What common qualities are necessary for nurses to
      continue to successfully provide for patients and families in the future?

PMID- 7788027
TI  - Taking home health nursing into the 21st Century.

PMID- 7788028
TI  - Looking in a mirror: a nurse's experience with breast cancer.

PMID- 7788029
TI  - Olsten Kimberly QualityCare.

PMID- 7788030
TI  - Congenital coronary arterial anomalies of clinical relevance.

PMID- 7788031
TI  - Kawasaki disease.

PMID- 7788032
TI  - Arteritis associated with systemic disease.

PMID- 7788033
TI  - Small coronary artery disease in cardiomyopathy: hypertrophic cardiomyopathy
      resembling dilated cardiomyopathy.

PMID- 7788034
TI  - Coronary artery and peripheral vascular disease in cocaine users.

PMID- 7788035
TI  - Accelerated graft coronary artery disease in heart-transplant recipients.

PMID- 7788037
TI  - Modification of the circadian variation of symptom onset of acute myocardial
      infarction in diabetes mellitus.
AB  - BACKGROUND: The effects of diabetes mellitus and its treatment on the circadian
      variation of symptom onset in acute myocardial infarction were examined. METHODS:
      We obtained the time of symptom onset in 336 patients who had suffered acute
      myocardial infarction. RESULTS: As in earlier studies, the peak of symptom onset
      occurred in the late morning, between 6:01 a.m. and 12:00 noon. Although a
      similar circadian variation was observed in non-diabetic patients, the late
      morning peak was less prominent in diabetic patients. In diabetic patients
      receiving treatment, however, the circadian pattern was well preserved, whereas
      in untreated diabetic patients there were no peaks in the distribution of symptom
      onset of acute myocardial infarction. CONCLUSION: These findings suggest that
      autonomic disturbances in diabetes mellitus may blunt the late-morning peak in
      the frequency of onset of acute myocardial infarction.

PMID- 7788036
TI  - Association of lipoprotein levels with atherosclerotic changes in patients with
      coronary artery spasm and insignificant coronary artery stenosis.
AB  - BACKGROUND: Coronary artery spasm readily occurs at sites of atheromatous plaque.
      Some lipid profiles are related to the genesis of coronary artery spasm. In
      Korean patients, it is frequently observed in grossly normal coronary arteries,
      in contrast to the situation in western patients, who frequently have coronary
      artery spasm superimposed on significant coronary artery stenosis. Intravascular
      ultrasound examination has shown that mild or diffuse atherosclerotic changes in
      patients with focal vasospasm, even in the absence of angiographic coronary
      disease. OBJECTIVES: We studied prospectively 104 patients in order to find out
      which lipid profiles were associated with atherosclerotic changes in patients
      with coronary artery spasm. METHODS: Patients were grouped as follows: group I,
      control, 50 patients (34 men, 16 women); group II, 35 patients (26 men, 9 women)
      with significant coronary artery disease; group III, 19 patients (13 men, six
      women) with significant coronary artery spasm and either no coronary artery
      stenosis or insignificant stenosis. There was no significant difference in age
      (group I 55 +/- 1 years, group II 56 +/- 2 years, group III 54 +/- 2 years) or
      sex among the groups. The following parameters were evaluated: hypertension,
      cigarette smoking, diabetes mellitus, and lipid profile. RESULTS: The incidence
      of hypertension in group II patients was higher than in group I or III (P <
      0.05). No significant difference was found in the percentage of cigarette smokers
      and patients with diabetes mellitus among three groups. The lipid profiles of
      each group were analysed. Group II patients had higher lipoprotein (a) levels (39
      +/- 6 mg/dl) than those in group I (21 +/- 3 mg/dl) or group III (13 +/- 3 mg/dl)
      (P < 0.05). Other lipid profiles were not significantly different among the
      groups. CONCLUSION: Our results indicate that the atherosclerotic changes in the
      coronary arteries of group III patients were not associated with lipid profiles,
      including lipoprotein (a).

PMID- 7788038
TI  - Reduction of exercise-induced myocardial perfusion defects by isosorbide-5
      nitrate: assessment using quantitative Tc-99m-MIBI-SPECT.
AB  - BACKGROUND: Although nitrates were introduced more than 100 years ago and have
      been used for the treatment of angina pectoris, there are still some open
      questions concerning the mechanism of their action on myocardial ischemia. There
      are also insufficient data regarding the influence of any anti-ischemic
      medication on the results of myocardial perfusion scintigraphy. METHODS: To
      assess the influence of a mononitrate, 30 patients with stable angina pectoris,
      coronary stenosis > or = 70% and normal left ventricular function were examined
      using quantitative Tc-99m-MIBI exercise-single photon emission computed
      tomography (SPECT). On the same day, 5 h after a randomized double-blind dose of
      60 mg sustained-release isosorbide-5-nitrate or placebo, SPECT was repeated with
      identical stress protocol. The results were analyzed using a semi-automatic polar
      coordinate program that allows definition of areas with significant decreased
      blood flow expressed as a percentage of standard vessel area. RESULTS: In the
      vessel areas with the largest perfusion defects, the mean defect size decreased
      after isosorbide-5-nitrate from 38.2 +/- 31.0% to 29.1 +/- 33.8% (reduction by
      24%; P < 0.05) and increased from 35.2 +/- 27.6% to 36.6 +/- 27.4% after placebo
      (increase by 4%; P = NS). The difference between defect size changes was also
      significant (P < 0.05). CONCLUSION: Acute administration of sustained-release
      isosorbide-5-nitrate significantly reduces the size of exercise-induced perfusion
      defects as assessed using quantitative Tc-99m-MIBI-SPECT.

PMID- 7788039
TI  - Long-term effect of gemfibrozil on coronary heart disease risk profile of
      patients with primary combined hyperlipidaemia.
AB  - BACKGROUND: The purpose of the present study was to assess the effect of
      gemfibrozil on 12 independent coronary heart disease risk factors in patients
      with primary combined hyperlipidaemia. METHODS: One hundred and five patients (62
      men and 43 women), aged 53.2 +/- 4.8 years, were studied. The 10-year probability
      of myocardial infarction for the patients was calculated using the TYPMI (Ten
      Year Probability for Myocardial Infarction) computer program, which is
      constructed to co-evaluate 12 independent coronary artery disease risk factors.
      All patients followed a lipid-lowering diet and placebo for 3 months. At month 0,
      the patients received 1200 mg gemfibrozil daily, divided into two equal doses,
      for a period of 12 months. At months -3, 0, 1, 3, 6, and 12, total cholesterol,
      high-density lipoprotein (HDL) cholesterol, triglycerides [only if the low
      density lipoprotein (LDL) cholesterol to high-density lipoprotein cholesterol
      ratio was above 5], systolic blood pressure, plasma glucose, left ventricular
      mass index, and plasma fibrinogen were measured. Smoking habits, sex, age,
      physical activity and family history of coronary heart disease were also
      evaluated. The mean 10-year probability of myocardial infarction of all 105
      patients at month 0 was 27.8%. This was significantly higher than the anticipated
      probability (10.4%, P < 0.001), resulting from an age- and sex-matched group of
      general population. RESULTS: During the third month of treatment, the following
      changes were recorded: total cholesterol -17%, LDL cholesterol -18%, very-low
      density lipoprotein (VLDL) cholesterol -45%, HDL cholesterol 20%, triglycerides 
      43%, apoprotein B -12%, apoprotein A-I 9% and plasma fibrinogen -21%. The
      estimated risk for myocardial infarction was reduced to 13.5% (delta m = -51%).
      All changes were significant and sustained until the twelfth treatment month.
      None of the patients were withdrawn from the study because of adverse effects of
      the treatment. CONCLUSION: Gemfibrozil reduces the estimated risk for myocardial
      infarction in patients with primary combined hyperlipidaemia at a level no
      different from the one of the general population. This beneficial effect of
      gemfibrozil, which was expressed by the third month and was evident for some time
      afterwards, was attributed to a significant reduction of triglyceride and
      fibrinogen levels, an increase of HDL cholesterol concentrations and a moderate
      decrease of total cholesterol and LDL cholesterol levels.

PMID- 7788041
TI  - Bibliography of the current world literature.

PMID- 7788042
TI  - Supreme court vs nurses--an unacceptable decision.

PMID- 7788040
TI  - Comparison of a low-molecular-weight heparin (nadroparin calcium) and
      unfractionated heparin as adjunct to coronary thrombolysis with alteplase and
      aspirin in dogs.
AB  - BACKGROUND: Low-molecular-weight heparins may have a higher benefit to risk ratio
      than unfractionated heparin in preventing perioperative thrombosis. The
      antithrombotic effects of low-molecular-weight heparins, given as adjunctive
      therapy to alteplase and aspirin, have not previously been compared with those of
      unfractionated heparin in experimental models of coronary artery thrombosis.
      METHODS: Occlusive coronary thrombosis was induced in 5 groups of 10 dogs by
      placing a copper coil into the left anterior descending coronary artery. After 1
      h of occlusion, intravenous alteplase (0.1 mg/kg bolus followed by 0.01 mg/kg/min
      for 30 min), and aspirin (bolus of 5 mg/kg) were administered in combination with
      one of the following study treatments given intravenously for 2 h: placebo (group
      1); unfractionated heparin (200 IU/kg bolus followed by 100 IU/kg/h, group II);
      the low-molecular weight heparin, nadroparin calcium, in three different doses
      (100 IU/kg bolus followed by 50 IU/kg/h, group III; 200 IU/kg bolus followed by
      100 IU/kg/h, group IV; and 300 IU/kg followed by 150 IU/kg/h, group V). Coronary
      patency was assessed with angiography at 10 min intervals and hemostasis
      parameters were measured at baseline, after 1 h of occlusion, and 30 and 120 min
      after commencing drug administration. RESULTS: Optimal reperfusion [Thrombolysis
      in Myocardial Infarction (TIMI) flow grade 3 without reocclusion] was more
      frequently observed in groups II (6/10), IV (8/10) and V (9/10) than in groups I
      (1/10) and III (3/10) (P < 0.05). Groups II and IV had similar patency rates (P =
      NS) and were therefore assumed to represent equivalent antithrombotic doses. Both
      nadroparin calcium and unfractionated heparin effectively prevented new thrombin
      generation as shown by repeated measurements of thrombin-antithrombin III complex
      levels in plasma. At equivalent antithrombotic doses, nadroparin calcium (group
      IV) was associated with significantly lower steady state values than standard
      heparin (group II) for activated partial thromboplastin time (41.3 +/- 48.9
      versus 134.7 +/- 61.6 s), anti-Xa levels (2.4 +/- 0.5 vs 3.4 +/- 0.9 U/ml) and
      anti-IIa levels (0.8 +/- 0.1 versus 2.1 +/- 0.7 U/ml). CONCLUSION: Both
      nadroparin calcium and unfractionated heparin significantly enhance alteplase
      induced thrombolysis in aspirin-treated dogs. At equivalent antithrombotic doses,
      nadroparin calcium was associated with less prolongation of the activated partial
      thromboplastin time and lower steady-state anti-Xa and anti-IIa activities.

PMID- 7788043
TI  - No exit--what the Clinton healthcare plan will do for you.

PMID- 7788044
TI  - Top 10 myths about hospital restructuring and healthcare reform.

PMID- 7788045
TI  - Stuck somewhere between fight and flight.

PMID- 7788046
TI  - Oppressed group behavior: implications for nursing.

PMID- 7788048
TI  - Stearley's slant on nursing. Restructuring and the A.N.A. Who's side are they on?

PMID- 7788047
TI  - "When the going gets tough, the tough get going" --let's get going!

PMID- 7788049
TI  - Stearley's slant on nursing. Defensive nursing.

PMID- 7788050
TI  - Pulling from Peter to save Paul: is "floating" administratively or professionally
      sound?

PMID- 7788051
TI  - Handicaps to advantages--obstacles to opportunities.

PMID- 7788052
TI  - Sexual harassment in the workplace.

PMID- 7788053
TI  - Blowing the whistle on emergency department violence and aggression.

PMID- 7788054
TI  - A "capitol" idea for a trip.

PMID- 7788055
TI  - Nurse in the newsroom: visibility is key.

PMID- 7788056
TI  - Infectious disease exposure--a job hazard that can change a nurse's life forever!

PMID- 7788057
TI  - A voice in the dark.

PMID- 7788059
TI  - Employers, contracts, fees-for-service: but where are the nurses?

PMID- 7788058
TI  - Revolution follows the breast cancer epidemic. Macrobiotic mettle.

PMID- 7788060
TI  - The nurse paradigm.

PMID- 7788061
TI  - Self-care: the greatest challenge for nurses.

PMID- 7788062
TI  - Parliamentary select committees: democracy and the NHS.

PMID- 7788063
TI  - Multidrug-resistant tuberculosis.

PMID- 7788064
TI  - Sick and dying neurones: how to look at them and how to try and make them better.

PMID- 7788065
TI  - Neuroreceptor mapping with in-vivo imaging techniques: principles and
      applications.
AB  - Functional imaging techniques can now be used to map neuroreceptor distribution
      in the living human brain. This permits direct investigation of neurochemical
      abnormalities in neuropsychiatric disorders and opens possibilities for the
      development of more specific pharmacological treatments for these conditions.
      This article reviews the basic principles of neuroreceptor imaging and recent
      research findings in the area.

PMID- 7788066
TI  - Current therapies in motor neurone disease.
AB  - Motor neurone disease (MND) is a fatal neurological disorder, characterised by
      progressive weakness and wasting of muscles. The variety of hypotheses for its
      aetiopathogenesis are reflected in the large number of drugs tried in an attempt
      to modify disease progression. Although MND was first described by Charcot in the
      1870s, there is as yet no known cure for the disease.

PMID- 7788067
TI  - The cervical spine in neurofibromatosis.

PMID- 7788069
TI  - Glomerular disease made easier: 2.

PMID- 7788068
TI  - Airway management in myasthenia gravis.

PMID- 7788070
TI  - Physiology of postoperative nausea and vomiting.
AB  - Postoperative nausea and vomiting remains a common cause of morbidity. This is a
      complex reflex involving multiple inputs via diverse receptor pathways which are
      integrated in the brainstem emetic centre. Factors related to the patient, the
      surgery, the anaesthetic and the recovery period are known to influence an
      individual's risk of vomiting.

PMID- 7788071
TI  - Decision-making in surgery: the surgical management of a raised serum calcium.
AB  - Successful surgical management of a raised serum calcium depends on an accurate
      preoperative diagnosis of hyperparathyroidism and an understanding of parathyroid
      pathology, combined with logical step-wise exploration of the neck.

PMID- 7788072
TI  - ECG clinic. 1. Atrial fibrillation 2. Onset ventricular tachycardia.

PMID- 7788074
TI  - Management of pulmonary Kaposi's sarcoma: new perspectives.
AB  - Pulmonary Kaposi's sarcoma is a frequent complication of human immunodeficiency
      virus infection. This article reviews the current approaches to the management of
      this difficult condition.

PMID- 7788073
TI  - Current issues in hypertension research and therapy.
AB  - Essential hypertension is one of the most common cardiovascular diseases and
      treatment is based on reducing overall cardiovascular risk. This article reviews
      current growth areas in hypertension research and practice.

PMID- 7788075
TI  - Community care.
AB  - On 1 April 1993 the community care legislation was implemented, heralding a new
      approach to the assessment of people's needs in the community. This article
      outlines how community care is working in practice and explores some of the key
      issues affecting clinicians.

PMID- 7788076
TI  - Infection with non-tuberculous mycobacteria.

PMID- 7788077
TI  - Stress in doctors: a personal view.

PMID- 7788078
TI  - Abdominal surgery in a patient with previous failed intubations.

PMID- 7788079
TI  - [The clinical utility of measuring the health-related quality of life].

PMID- 7788080
TI  - [Measuring the health-related quality of life in pneumology: why and how].

PMID- 7788081
TI  - [The Spanish translation and evaluation of a quality-of-life questionnaire in
      patients with chronic obstructive pulmonary disease].
AB  - The Chronic Respiratory Disease Questionnaire (CRDQ), proposed by Guyatt et al,
      is a specific instrument used to assess quality of life in patients with chronic
      obstructive pulmonary disease (COPD). Our aim was to translate the questionnaire
      and validate it so that it could then be used as a measurement instrument in
      programs of respiratory rehabilitation. Sixty-five patients with COPD who were
      candidates for breathing therapy were enrolled in the study. Mean age was 64 +/-
      7 years and all had severe air flow limitation, with FEV1 33 +/- 13% over
      reference values but not respiratory failure (pO2 70 +/- 10 mmHg). The
      questionnaire was subjected to a process of translation/back translation and
      disagreements over wording were discussed by a panel of bilingual speakers and
      the author himself. The validation process involved the following steps: 1) a
      comprehension study with a group of 5 patients, which revealed no special
      difficulties; 2) analysis of internal consistency or reliability by way of
      Crombach's alpha coefficient, which gave and overall score of 0.92 and area
      scores of 0.51 for dyspnea, 0.8 for fatigue, 0.86 for emotional factors and 0.84
      for disease control, and 3) analysis of correlation between various lung function
      parameters and exercise test results (6 min of increasing effort and a stationary
      cycle), which showed weak but statistically significant correlations that were
      comparable to those found by the author of the original CRDQ.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7788082
TI  - [The quality of life in asthma: an evaluation of the AQLQ questionnaire for its
      use on a Spanish population. Asthma Quality of Life Questionnaire].
AB  - The study of morbidity in asthma requires consideration not only of standard
      physiopathologic and function parameters, but also of the impact the disease has
      on the patient's life-style as he or she perceives it and evaluates it. The
      quantification of this factor, known as health-related quality of life (HRQL), is
      achieved by administering questionnaires specially designed for the purpose. We
      analyzed the reliability, content validity and construct validity (convergence
      and divergence) of one instrument, the Asthma Quality of Life Questionnaire
      (AQLQ) designed by Marks and colleagues. This questionnaire covers 4 dimensions
      (breathlessness, mood, social limitation and worrying) and gives a total score.
      After a process of translation and back translation the AQLQ was administered to
      102 adult asthmatics living in an urban center, all of whom had been stable for
      at least the preceding 4 weeks. The following data were recorded: age, sex,
      duration of disease, FEV1, medication, dyspnea, hospital visits, nighttime
      symptoms and severity of disease (from the patient's own point of view and
      according to the scale of the International Consensus Report [ICR]). The
      reliability study (internal consistency with Crombach's alpha coefficient and
      inter-item correlation analysis) gave satisfactory results in all cases (range of
      r = 0.39 to 0.78; alpha = 0.78 to 0.91). Content validity (factorial analysis of
      the main components, oblique and orthogonal rotations) was less satisfactory,
      although 4 factors were found; these factors adjusted relatively well to one of
      the proposed sub-scales and together explained 65.2% of the total
      variance.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788083
TI  - [The quality-of-life questionnaire with asthma patients: the Spanish version of
      the Asthma Quality of Life Questionnaire].
AB  - This paper describes the translation to Castilian and adaptation of a quality of
      life measurement instrument: the Asthma Quality of Life Questionnaire (AQLQ). The
      AQLQ, developed by Juniper et al, contains 32 items, 5 of which relate to
      habitual activities that the patient can choose from among a list of 26
      possibilities. Answers are given on a scale of 7 points. To adapt this instrument
      for use in Spain, we subjected it to a process of translation/back translation by
      bilingual informants. The translated and original versions of each item, activity
      and answer option were evaluated as being totally equivalent (A), fairly
      equivalent but with some questionable wording (B), or of questionable equivalence
      (C). The naturalness and correctness of the Spanish version were also evaluated
      on a scale of 1 to 10. Three (9%) items and 1 (4%) activity were considered to be
      of questionable equivalence (C) and 12 (37%) items and 1 activity (4%) were
      considered to be of type B equivalence. The questionable aspects of types B and C
      equivalence were discussed in 2 meetings, along with expressions that were
      equivalent but unnatural or grammatically incorrect; the first meeting involved
      researchers and translators and the second was held with a group of 6 asthmatics.
      Consensus was finally obtained for each item and activity included in the second
      draft. That draft was then administered to another group of 7 patients in order
      to check comprehension and equivalence, after which a definitive version was
      produced by the researchers.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788085
TI  - [On how Galen corrected a diagnosis of pleurisy].

PMID- 7788084
TI  - [The use of fibrinogen-thrombin via endoscope in the treatment of massive
      hemoptysis].
AB  - We assessed the efficacy of fibrinogen-thrombin instillation through the
      fiberoptic bronchoscope to treat massive hemoptysis in patients to whom
      embolization of bronchial arteries was not available, was contraindicated or had
      failed. The fibrinogen-thrombin solution used was Tissucol, which in addition to
      2% fibrinogen and 4 U/ml of thrombin, also contained factor XIII an aprotinin.
      The fibrinogen-thrombin solution was instilled with the aid of the Duplojec
      system and a 70 cm x 2 mm 4-way catheter. In 53 of the 628 fiberoptic
      bronchoscopies performed during the study, the indication was hemoptysis > or =
      150 ml/12 h. Of these, bronchoscopic instillation of fibrinogen-thrombin was
      indicated in 5 cases because bronchial artery embolization was impossible. The
      point of bleeding was located by bronchoscopy in all cases and fibrinogen
      thrombin instillation controlled hemoptysis immediately and throughout the follow
      up period, which ranged 4 to 10 months. Morning expectoration of blood (< 10 ml)
      was observed in only 1 patient in the 3 days after treatment. The mean time taken
      for bronchoscopic exploration was 3 minutes (range, 2-7). In all cases fiberoptic
      bronchoscopy was performed without complications that might have required the
      procedure to be suspended. We conclude that the local use of fibrinogen-thrombin
      or fibrin glue instilled through the fiberoptic bronchoscope to the point of
      bleeding is a simple, fast and cheap way to control massive hemoptysis on a short
      and long-term basis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788086
TI  - [Interventional radiology in pneumology. State of the art].

PMID- 7788087
TI  - [Primary Mycobacterium avium respiratory infection in nonimmunocompromised
      children].
AB  - Mycobacterium avium is a common pathogen in barnyards, where it infects poultry
      and pigs. In human beings M. avium is most often found to cause disease in
      immunocompromised individuals, although it is also described fairly often as
      affecting patients with tuberculosis or chronic obstructive pulmonary disease; in
      recent years lung infections by M. avium have even been reported in elderly women
      with no underlying disease. Respiratory infection by this mycobacterium is
      unusual, however, in healthy children. We describe the case of a previously
      healthy 2-year-old boy with pneumonia whose course was complicated. After 6
      months of treatment with various broad spectrum antibiotics there was no
      clinically or radiologically observable improvement. Other underlying diseases
      were ruled out, including infection by germs that cause atypical pneumonia. When
      all tests were negative, we investigated the possibility of primary infection by
      an atypical mycobacterium. A skin test was positive for M. avium. Acid-alcohol
      resistant bacilli were isolated from lung biopsy samples and the presence of
      tuberculoid granulomas were confirmed. Our patient then responded favorably after
      tuberculostatic treatment with 3 drugs (isoniazid, rifampicin and pyrazinamide).

PMID- 7788089
TI  - [Fulminant pneumonia caused by Streptococcus milleri: rare or not diagnosed?].
AB  - Streptococcus milleri is increasingly isolated in laboratory samples and is
      worthy of consideration as a differential diagnosis in pyogenic infections,
      particularly in adults with underlying infections. We describe a well-documented
      case of pleuropulmonary infection in a young man with no known risk factors. We
      analyze the diversity of microbiological features of these bacteria in culture,
      as well as their clinical importance as pathogens.

PMID- 7788090
TI  - [A study of primary resistances to antitubercular drugs in Galicia].

PMID- 7788088
TI  - [Pleuropericarditis as the only manifestation of Legionella pneumophila
      infection].
AB  - Pleural effusion caused by Legionella is seen fairly frequently but is hardly
      ever of great clinical significance. Pericardial involvement has been described
      only rarely. We present a case of pleuropericarditis as the only sign of
      infection by Legionella pneumophila in a 66-years-old man with no prior history
      of disease. The patient came to the hospital with chest pain suggestive of
      pleurisy, low-grade fever, dry cough and dyspnea. The etiology was not suspected
      and the diagnosis was made retrospectively based on indirect immunofluorescence.
      After 3 weeks of treatment with high dose of erythromycin the patient recovered
      and remains asymptomatic to date. We conclude that infection by Legionella
      pneumophila should be suspected in patients with pleurisy or pericarditis of
      unknown cause.

PMID- 7788092
TI  - [The superior vena cava syndrome and juxtamediastinal bullae].

PMID- 7788091
TI  - [Tartrazine-induced rhinitis?].

PMID- 7788093
TI  - [Are inhaled steroids useful in pulmonary sarcoidosis?].

PMID- 7788094
TI  - A global optimization method based on variable target functions for fitting of
      the experimental and calculated NOESY spectra.
AB  - A new method for structure refinement, based on optimization of the variable
      target function (Sugar and Xu, Prog. Biophys. Mol. Biol. 58, 61, 1992), is
      examined in order to explore the conditions of high-resolution polypeptide
      structure determination. The method of variable target function was used to
      analyze simulated NOESY spectra of different spectral resolutions, of different
      signal/noise ratios, and of different number of mixing times. The goodness of the
      results was assessed by comparing the known polypeptide conformation with the
      optimized ones, as well as by comparing the simulated experimental spectra with
      the spectra back-calculated from the optimized structures. According to the test
      calculations, in order to get high-resolution polypeptide structures, the number
      of constraints should be larger than the number of dihedral angles, and the
      constraints should be distributed over the dihedral angles more or less
      homogeneously. The success rate of the variable-target-function method in finding
      high-resolution structures was high until a critical signal/noise ratio, while
      below this threshold the success rate was low. The critical signal/noise ratio
      could be decreased, however, by increasing the number of mixing times. The test
      calculations show that the variable-target-function method is capable of high
      resolution polypeptide structure determination with a success rate of 85-90%
      under common experimental conditions, such as 10 constraints/residue, 40%
      noise/signal ratio, and six mixing times.

PMID- 7788095
TI  - Model-based maximum-likelihood estimation for phase- and frequency-encoded
      magnetic-resonance-imaging data.
AB  - A maximum-likelihood (ML)-based magnetic-resonance-imaging (MRI) reconstruction
      algorithm is established, based on frequency- and phase-encoded data. The model
      on which the ML method is based is a superposition of exponentially decaying,
      sinc-modulated sinusoids, arising from the basic Bloch equations for MR
      spectroscopy, modified to account for the distribution of resonance frequencies
      and phases used for spatial localization in the image field. Spatial-localizing
      gradients are assumed to be known linear functions of spatial coordinate
      position, with the x-encode (frequency) gradient applied continuously during the
      full duration of data collection, and the y-encode (phase) gradient applied
      during varying time periods before data collection. A single-voxel emitter
      becomes sinc-modulated in the x, y directions at rates proportional to voxel size
      and gradient strengths in the x-encode and y-encode directions. The full two
      dimensional MRI signal becomes a superposition of sinc-modulated, exponentially
      decaying, single-sinusoid emitters, one for each voxel. The ML estimation of spin
      density and spin-spin relaxation decay time images becomes a nonlinear least
      squares optimization problem; it is solved using an iterative expectation
      maximization algorithm for estimating multiple modulated sinusoids in noise.
      Phantom studies are presented, demonstrating the accuracy of the model and the
      application of the algorithm to spin-density and spin-spin relaxation decay time
      profiles.

PMID- 7788096
TI  - Breakthrough of single-quantum coherence and its elimination in double-quantum
      filtering.
AB  - Breakthrough of single-quantum coherence is shown to occur after application of a
      double-quantum filter with the conventional four-step phase-cycling scheme. This
      single-quantum breakthrough is due to the intersequence stimulated echo which has
      been generated by the radiofrequency pulses in the preceding pulse sequence and
      appears at the same time as the double-quantum coherence signal in the current
      pulse sequence. Moreover, the phase of the intersequence stimulated echo is the
      same as the phase of the double-quantum coherence signal; i.e., the phase of the
      intersequence stimulated echo is twice the phase change of the radiofrequency
      pulses in the creation period when their phase is rotated in accordance with the
      conventional four-step phase-cycling scheme. Consequently, the intersequence
      stimulated echo passes through the double-quantum filtration in the conventional
      four-step phase-cycling scheme and gradient pulses. A new phase-cycling scheme
      which can filter out the single-quantum breakthrough signal is proposed here and
      its effectiveness is verified experimentally and by computer simulations.

PMID- 7788097
TI  - Identification and quantitation of phenylalanine in the brain of patients with
      phenylketonuria by means of localized in vivo 1H magnetic-resonance spectroscopy.
AB  - Localized proton MR spectroscopy was used to identify phenylalanine (PHE) and to
      quantitate its cerebral concentration in patients with type I phenylketonuria
      (PKU). Data acquisition was optimized for the detection of low-concentration
      metabolites, using a short TE (20 ms) double Hahn-echo localization sequence for
      large volumes within the head coil and for smaller volumes using a surface coil.
      Previously described methods to quantitate localized MR spectra were extended to
      cover the case of low-concentration metabolites, unevenly distributed in three
      brain compartments and measured in difference spectra only. PHE content was
      determined in difference spectra of four PKU patients with respect to normals and
      in one patient before and after an oral load of L-PHE. PHE concentrations of 0.3
      to 0.6 mmol/kg brain tissue were obtained, resulting in a concentration gradient
      for PHE between blood and brain tissue of 2.4 to 3.0. No significant changes were
      found for the abundant metabolites in gray or white matter. Previously reported
      MRI changes were confirmed to be due to increased cerebro-spinal-fluid-like
      spaces.

PMID- 7788099
TI  - Randomization approach to water suppression in multidimensional NMR using pulsed
      field gradients.

PMID- 7788098
TI  - Broadband SQUID NMR with room-temperature samples.
AB  - Superconducting quantum interference devices (SQUIDs) are the most sensitive
      detectors of magnetic fields. We have used an untuned broadband SQUID detector to
      detect transverse nuclear magnetic-resonance signals from samples of mineral oil,
      salt water, and animal tissue at room temperature. Proton NMR signals have been
      detected from about 20 to 450 kHz. We have also detected fluorine, sodium, and
      possibly phosphorus NMR signals. SQUID NMR shows promise in NMR imaging, since
      the SQUID's sensitivity and broad bandwidth make it ideal for low-field imaging.
      SQUID NMR may also be useful for low-field spectroscopy in biology, chemistry,
      and materials science.

PMID- 7788100
TI  - Band-selective heteronuclear cross polarization in liquids.

PMID- 7788101
TI  - Relative effects of protein-mediated and ligand-mediated spin-diffusion pathways
      on transferred NOESY, and implications on the accuracy of the bound ligand
      conformation.

PMID- 7788102
TI  - The impact of direct refinement against proton chemical shifts on protein
      structure determination by NMR.

PMID- 7788103
TI  - Neurontin--1 year on. London October 1994.

PMID- 7788104
TI  - Withdrawal of antiepileptic drugs (AEDs) in seizure-free patients, risk factors
      for relapse with special attention for the EEG.
AB  - When a patient has remained free from seizures for several years while taking
      antiepileptic drugs (AED) the question arises whether or not the medication can
      be withdrawn. Therefore it would be desirable to be able to identify reliably
      those patients who will remain seizure-free without treatment. Numerous variables
      might be of prognostic importance but our knowledge about the significance of
      demographic, genetic, aetiological, pathophysiological and treatment-related
      factors remains extremely poor. Although an abnormal inter-ictal EEG has been
      repeatedly cited as predictive of relapse during and after AED withdrawal, there
      is little evidence to support this view. There is a need for more precise
      individual prediction of risk but as long as patients with forms of epilepsy with
      widely varying prognosis are grouped together in AED withdrawal trials the
      outcome of these trials will never reach consensus about the relapse risk and
      about the possibility of predict relapse in individual patients.

PMID- 7788106
TI  - Vigabatrin in the management of generalized seizures in children.
AB  - The interpretation of the results of the use of vigabatrin (VGB) in generalized
      seizures and epilepsies in children has been difficult. Most studies have
      assessed patients on the basis of both seizure type and epilepsy syndrome and the
      numbers of patients have been small. Some 'generalized' epilepsy syndromes
      (specifically the Lennox-Gastaut syndrome) are characterized by multiple seizure
      types which are frequently not analysed individually in terms of drug response.
      By contrast West syndrome is easier to evaluate as the spasms are the only, and
      characteristic, seizure type. Vigabatrin has been used as both add-on, and
      monotherapy in the treatment of spasms. The results of add-on studies suggest
      that symptomatic spasms respond best, with 40-100% of children becoming spasm
      free and many others showing a reduction in seizures of over 50%. The limited,
      reported data on VGB-monotherapy in West syndrome have been encouraging with over
      50% of patients experiencing a total and sustained control of seizures with
      minimal or no adverse events; however, the pattern of response (symptomatic cases
      responding better than cryptogenic cases), has not, as yet, been confirmed. The
      'non-progressive' myoclonic epilepsies tend to be exacerbated with 25-50% of
      patients experiencing an increase in seizure frequency; this is an interesting
      observation in view of the improvement seen in infantile spasms, which are also
      classified as a myoclonic seizure. The use of VGB in other generalized seizures
      and epilepsy syndromes has been neither assessed, nor reported. This reflects the
      fact that these seizures/syndromes are easily and well controlled using the
      'older' anti-epileptic drugs.

PMID- 7788105
TI  - Adjunctive therapy in epilepsy: a cost-effectiveness comparison of alternative
      treatment options.
AB  - A pharmaco-economic study of the administration of adjunctive therapy in patients
      with chronic epilepsy is described. A decision-analytic model has been used,
      which represents the consequences of treatment over a 1-year time period, when
      one of three drugs is used first. The cost-effectiveness ratio for clobazam,
      lamotrigine and vigabatrin have been calculated. The expected cost per patient of
      treatment over the 1-year period was up to 50% higher with vigabatrin and
      lamotrigine compared with clobazam, with a cost-effectiveness ratio around 40%
      higher.

PMID- 7788107
TI  - Changes of central benzodiazepine receptor density in the course of
      anticonvulsant treatment in temporal lobe epilepsy.
AB  - The first investigation of the central-type benzodiazepine (BZ) receptor density
      before and following 2 months successful treatment with carbamazepine (CBZ) in a
      patient with temporal lobe epilepsy (TLE) using 123I-labelled Iomazenil (a
      specific lipophile central BZ receptor compound) and single photon emission
      tomography (SPET) is reported. First, a focal slowing of the EEG in the left
      temporal area was noted and a corresponding reduction of the central BZ density
      of the left temporal lobe was found. After 2 months of treatment the patient was
      symptom-free, and a normal BZ receptor density and no pathological EEG signs were
      found. The increase in central BZ receptor binding sites might be related to the
      anticonvulsant effects of CBZ mediated by the so-called peripheral BZ receptor
      sites.

PMID- 7788108
TI  - New antiepileptic drugs--an explosion of activity.
AB  - The low therapeutic index of established antiepileptic drugs coupled with a
      better understanding of the pathophysiology of seizure production has led to the
      development of a range of new therapeutic agents for the treatment of epilepsy.
      In this review, the three drugs recently licensed in the UK (vigabatrin,
      lamotrigine and gabapentin) are profiled, together with several of the more
      promising up-and-coming compounds (oxcarbazepine, felbamate, tiagabine,
      stiripentol, remacemide and topiramate). Future avenues for clinical research in
      the pharmacological management of the epilepsies involve their rational use both
      singly and in combination.

PMID- 7788109
TI  - Epilepsy and associated effects on adaptive behaviour in adults with Down
      syndrome.
AB  - A total of 201 adults with Down syndrome were investigated, of whom 32 (15.9%)
      had epilepsy. A bimodal age distribution for seizure onset in childhood and later
      in middle-age was found. Good seizure control was associated with early onset
      epilepsy. Down syndrome adults with epilepsy scored significantly higher overall
      on the adaptive behaviour profile but did not have significantly greater
      maladaptive behaviours.

PMID- 7788110
TI  - Vigabatrin monotherapy in resistant neonatal seizures.
AB  - Seizures in a term infant with Ohtahara syndrome, associated with polymicrogyria,
      and a pre-term neonate with similar clinical features, failed to respond to
      conventional anticonvulsants, but were controlled with vigabatrin monotherapy.
      Another infant with Aicardi syndrome improved with vigabatrin. Autopsy in the
      first infant showed no evidence of intramyelinic oedema. The developmental
      outcome in the two survivors was better than expected for their condition.

PMID- 7788113
TI  - Epilepsy in people with learning disabilities.

PMID- 7788111
TI  - Seizures and 'disappearing' brain lesions.
AB  - BACKGROUND--Patients with seizures may have abnormal brain imaging. Lesions
      demonstrated on computerized tomography or magnetic resonance imaging often
      suggest the underlying cause of the seizures, and may prompt an invasive
      investigation for diagnosis and treatment. In an increasingly recognized subset
      of patients however, the imaged lesions spontaneously resolve. While poorly
      understood, these 'disappearing' lesions may in fact be the consequence of
      seizures, rather than the cause. Two patients with 'disappearing' lesions are
      presented: the first patient had a proven cause, the second a probable one. Case
      1. A patient with new onset seizures had an abnormal MRI. An angiogram confirmed
      thrombosis of the straight sinus. On follow-up, she was doing well; repeat
      imaging was normal with resolution of the lesion. Case 2. A patient with a long
      seizure history had been well controlled on medications, and had no change in
      frequency of her seizures. She was found to have a left homonymous hemianopsia.
      MRI revealed a right parieto-occipital lesion. The patient refused further work
      up and was lost to follow-up. She returned almost a year later; repeat imaging
      was normal. CONCLUSION--Patients with seizures and abnormal imaging suggestive of
      structural lesions may occasionally have lesions that resolve spontaneously.
      While some diagnoses remain elusive, an important consideration to exclude in
      these patients is venous thrombosis.

PMID- 7788112
TI  - Rechallenge with lamotrigine after initial rash.
AB  - Eight patients rechallenged with lamotrigine after initial exposure which
      resulted in a skin rash are reported. On reintroduction of the lamotrigine, six
      of the patients had no recurrence of the rash. Of the other two patients, one had
      the occurrence of a mild fluctuating and qualitatively different skin rash on
      rechallenge. The other patient had developed a dose-related rash on initial
      challenge resulting in a dose reduction. The first attempt to re-increase the
      dose resulted in reappearance of the rash which again disappeared on dose
      reduction. However a further attempt to re-increase the dose did not result in
      reappearance of a rash. It is suggested that patients who experience a rash but
      good therapeutic response to lamotrigine might be considered for re-dosing.

PMID- 7788114
TI  - The revised classification of non-convulsive status epilepticus.

PMID- 7788115
TI  - Multiple personality disorder and false memory syndrome.

PMID- 7788116
TI  - Religious experience within mental illness. Opening the door on research.

PMID- 7788117
TI  - Thought disorder or communication disorder. Linguistic science provides a new
      approach.

PMID- 7788118
TI  - Use of drugs in child and adolescent psychiatry.
AB  - BACKGROUND: The prescription of psychotropic drugs for children is a sensitive
      and highly contentious subject which may explain the apparent lack of uniformity
      and consistency in clinical practice. METHOD: This review is based on Medline and
      manual search of the literature. RESULTS: More than 1000 relevant references were
      found, and information has been culled from all these. Fifty particularly
      relevant articles have been selected for the reference list. CONCLUSION: Recent
      years have seen considerable research in this field, and a clearer picture of the
      benefits and limitations of drug use in children is emerging.

PMID- 7788119
TI  - The future of adolescent psychiatry.
AB  - BACKGROUND: Appraisal of the future of adolescent psychiatry is required
      urgently, in view of the increasing scrutiny of mental health service priorities
      and the need for informed planning of psychiatric training and manpower
      requirements. METHOD: Future developments are set in the context of the changing
      concept and connotations of adolescence, the history and present position of
      adolescent psychiatry, and the rationale for separate services. RESULTS:
      Predictions are derived using trend extrapolation, in relation to a number of
      factors likely to determine the future. These include the social value attached
      to adolescence and youth, the status of adolescent medicine, the definition of
      clinical boundaries, the upper age-limit of services, investment in prevention,
      postgraduate training, research, the evaluation and marketing of adolescent
      psychiatry and, finally, its recognition as a separate sub-specialty.
      CONCLUSIONS: Predictions suggest that adolescent psychiatry will assume an
      expanding clinical role and increasing academic influence in the 21st century.

PMID- 7788120
TI  - Adolescent psychiatry services.
AB  - BACKGROUND: The way in which psychiatric services for adolescents in the UK are
      developing will be affected by recent changes in the organisation of the National
      Health Service. METHOD: The history of these services, and the different
      opportunities for development are reviewed. RESULTS: Ways in which high-quality
      clinical care can still be provided are indicated. CONCLUSION: Adolescent
      psychiatric services should be judged on their ability to provide such care, not
      merely on their ability to survive.

PMID- 7788121
TI  - Late-life depressive disorder in the community. I. The relationship between MMSE
      score and depression in subjects with and without psychiatric history.
AB  - BACKGROUND: In previous studies cognitive impairment in depressed elderly in
      patients tends to be associated with a late onset of depression. This study tests
      the hypothesis that cognitive impairment is associated with depression only in
      elderly individuals with no history of psychiatric illness. METHOD: We
      investigated an age-stratified sample of 4051 elderly people living in the
      community, aged between 65 and 84 (AMSTEL). The relationship between depression
      (GMS-AGECAT diagnosis) and scores on the Mini Mental State Examination was
      studied in subjects with and without a reported psychiatric history (CAMDEX
      questionnaire). RESULTS: Low MMSE scores (MMSE < or = 25) were only associated
      with depression in subjects with no psychiatric history (young/old: OR = 2.75,
      95% CI = 1.83, 4.19; old/old: OR = 2.21, 95% CI = 1.61, 3.03). CONCLUSIONS: We
      concluded that the combination of cognitive impairment and first-episode
      depression in elderly individuals may indicate cerebral deterioration. Depression
      as such may not be associated with cognitive impairment.

PMID- 7788123
TI  - Prevalence of depression after stroke: the Perth Community Stroke Study.
AB  - BACKGROUND: The Perth Community Stroke Study (PCSS) was a population-based study
      of the incidence, cause, and outcome of acute stroke. METHOD: Subjects from the
      study were assessed initially, by examination and interview, and at four- and 12
      month follow-ups to determine differences in prevalence of depression between the
      sexes and between patients with first-ever and recurrent strokes. RESULTS: The
      prevalence of depressive illness four months after stroke in 294 patients from
      the PCSS was 23% (18-28%), 15% (11-19%) major depression and 8% (5-11%) minor
      depression. There were no significant differences between the sexes or between
      patients with first-ever and recurrent strokes. With a non-hierarchic approach to
      diagnosis of those with depression, 26% of men and 39% of women had an associated
      anxiety disorder, mainly agoraphobia. Nine per cent of male and 13% of female
      patients interviewed had evidence of depression at the time of the stroke. Twelve
      months after stroke 56% of the men were still depressed (40% major and 16%
      minor), as were 30% of the women (12% major and 18% minor). CONCLUSION: The
      prevalence of depression after stroke was comparable with that reported from
      other studies, and considerably less than that reported from in-patient and
      rehabilitation units.

PMID- 7788125
TI  - Positive life change and recovery from depression and anxiety. A three-stage
      longitudinal study of primary care attenders.
AB  - BACKGROUND: The objective was to examine the relationship between positive life
      change (PLC) and recovery from depression and anxiety. Following Brown et al
      (1988, 1992), we hypothesised: (a) that an excess of PLC would be found in the 3
      month period before recovery compared with base rates ('excess hypothesis') and
      (b) that fresh-start and anchoring subtypes of PLC would trigger recovery from
      depression and anxiety respectively ('specificity hypothesis'). METHOD: One
      hundred and seventy primary care patients with a depressive and/or anxiety
      disorder, selected from 1994 consecutive attenders, were assessed at baseline and
      at 1-year and 3.5-year follow-ups on life change (LEDS) and psychopathology (PSE
      and Course Interview). RESULTS: Our results appeared to confirm the excess
      hypothesis regarding depression and anxiety (twofold excess was found prior to
      recovery), but not regarding mixed anxiety/depression. They did not support the
      specificity hypothesis. CONCLUSIONS: PLC facilitates recovery but is neither a
      necessary nor sufficient condition for remission. Difficulty reduction is the
      most important recovery-enhancing factor.

PMID- 7788122
TI  - Late-life depressive disorder in the community. II. The relationship between
      psychiatric history, MMSE and family history.
AB  - BACKGROUND: In previous studies, dementia was linked to a family history of
      dementia and Down's syndrome. This study tested the hypothesis that late-life
      depression accompanied by cognitive impairment in elderly individuals with no
      history of psychiatric illness is also associated with these family histories.
      METHOD: We investigated an age-stratified sample of 4051 elderly people in the
      community aged 65-84 (AMSTEL). The relationship between family history (CAMDEX
      questionnaire) and depression (GMS-AGECAT diagnosis) was studied. RESULTS: A
      family history of mental health problems was associated with all subtypes of
      depression. Family history of dementia was associated with depression in subjects
      with a psychiatric history, but a family history of Down's syndrome was only
      associated with the combination of depression and cognitive impairment in
      subjects with no history of psychiatric illness. CONCLUSIONS: The heritability
      pattern confirms the concept of a dementia-related subtype of late-life
      depression.

PMID- 7788124
TI  - Anxiety disorders after stroke: results from the Perth Community Stroke Study.
AB  - BACKGROUND: The prevalence of anxiety disorders in 294 patients who survived to
      four months in the Perth Community Stroke Study (Perth, Australia), and a follow
      up of these patients at 12 months, are presented. METHOD: Diagnoses are described
      both in the usual DSM hierarchic format and by a non-hierarchic approach.
      Adoption of the hierarchic approach alone greatly underestimates the prevalence
      of anxiety disorders. RESULTS: Most cases were of agoraphobia, and the remainder
      were generalised anxiety disorder. The prevalence of anxiety disorders alone was
      5% in men and 19% in women; in community controls, it was 5% in men and 8% in
      women. Adopting a non-hierarchic approach to diagnosis gave a prevalence of 12%
      in men and 28% in women. When those who showed evidence of anxiety disorder
      before stroke were subtracted, the latter prevalence was 9% in men and 20% in
      women. CONCLUSION: One-third of the men and half of the women with post-stroke
      anxiety disorders showed evidence of either depression or an anxiety disorder at
      the time of the stroke. At 12 month follow-up of 49 patients with agoraphobia by
      a non-hierarchic approach, 51% had recovered, and equal proportions of the
      remainder had died or still had agoraphobia. The only major difference in outcome
      between those with anxiety disorder alone and those with comorbid depression was
      the greater mortality in the latter.

PMID- 7788126
TI  - A comparison of community-based care for schizophrenia in south Verona and south
      Manchester.
AB  - BACKGROUND: The community-oriented mental illness services providing care to
      defined populations in south Verona, Italy (17,628 adults) and south Manchester,
      England (12,021 adults) have been compared to explore relationships between
      service organisation and patterns of service use. METHOD: The composition and
      function of the two services and the sociodemographic characteristics of the two
      centres are described and related to epidemiological data on service use in the
      community, out-patient clinic, day hospital and in-patient care. RESULTS: Treated
      incidence of all psychiatric diagnoses and of schizophrenia were significantly
      higher in south Manchester than south Verona, indicating that the referral filter
      between primary and secondary care is more permeable in Manchester. Patients
      known to the service were more likely to be admitted and to have shorter in
      patient stays in south Verona, indicating that the filter between in-patient care
      and the community is more permeable in Verona than Manchester. CONCLUSIONS: The
      organisation of services in Verona results in a smaller load on the mental health
      service; the shorter hospital stays can be related to better integration between
      hospital and community resources. The organisation of services in Manchester
      provides care for a greater proportion of the population, but would be likely to
      require increased resources for the mental health services over time.

PMID- 7788127
TI  - Cultural dimensions of psychiatric diagnosis. A comparison of DSM-III-R and
      illness explanatory models in south India.
AB  - BACKGROUND: Cross-cultural research to examine the cultural validity of
      diagnostic categories and underlying concepts requires methods that integrate
      epidemiological and anthropological frameworks. METHOD: The Explanatory Model
      Interview Catalogue (EMIC) and Structured Clinical Interview for DSM-III-R (SCID)
      were used to study 80 psychiatric out-patients with depressive neurosis at a
      clinic in south India. RESULTS: Summary kappa values of 0.75 for the EMIC and
      0.68 for the SCID confirmed interrater reliability. Comparison of patient
      explanatory models and SCID diagnoses showed that patients emphasised somatic
      experience while clinicians emphasised depressive diagnoses. More than half the
      patients (55%) received a non-specific or dual diagnosis. CONCLUSIONS: These
      findings raise questions about the distinctiveness of depressive, anxiety, and
      somatoform (DAS) disorders for this population.

PMID- 7788128
TI  - Organised violence and the stress of exile. Predictors of mental health in a
      community cohort of Vietnamese refugees three years after resettlement.
AB  - BACKGROUND: The prevalence and course of mental disorders among Vietnamese
      refugees were studied, using a model including variables from different research
      traditions. METHOD: A consecutive community cohort of 145 Vietnamese boat
      refugees aged 15 and above were personally interviewed on their arrival in Norway
      and three years later. RESULTS: Three years later, there was, unexpectedly, no
      decline in self-rated psychological distress (SCL-90-R), almost one in four
      suffered from psychiatric disorder and the prevalence of depression was 17.7%
      (Present State Examination). Female gender, extreme traumatic stress in Vietnam,
      negative life events in Norway, lack of a close confidant and chronic family
      separation were identified as predictors of psychopathology. CONCLUSIONS: The
      effects of war and persecution were long-lasting, and compounded by adversity
      factors in exile. A uniform course of improvement in mental health after
      resettlement cannot be expected in all contexts. The affected refugees need
      systematic rehabilitation.

PMID- 7788129
TI  - The illusion of reality or the reality of illusion. Hallucinations and culture.
AB  - BACKGROUND: The aim of this review is to integrate research findings on the role
      of sociocultural factors in hallucinations and to relate these factors to current
      psychological theory and research. METHOD: The literature was surveyed by manual
      search, and the more reliable studies selected for the review. RESULTS: One
      hundred and thirteen publications were scrutinised and 30 of them were included
      in this review. CONCLUSIONS: Cross-cultural concepts of reality are related to
      the development and the threshold of hallucinations. Attitudes toward
      hallucinations tend to affect the emotional reaction to, and the degree of
      control of, these experiences. Awareness of these attitudes may help the
      diagnostician to distinguish between pathological and culturally sanctioned
      hallucinations. It is important that therapists consider the functional
      significance and meaning of hallucinations as well as the social context and the
      stimuli associated with them.

PMID- 7788131
TI  - Comparison of carbamazepine and lithium in the prophylaxis of bipolar disorders.
      A meta-analysis.
AB  - BACKGROUND: This meta-analysis assessed the equipotency of carbamazepine and
      lithium prophylaxis in bipolar disorder. METHOD: We selected only randomised,
      double-blind, controlled studies comparing carbamazepine with lithium from a
      manual and computerised search, and subjected them to a quality inventory. Their
      statistical results were weighted by their quality score and combined. RESULTS:
      Four studies met our criteria, yielding, overall, P = 0.15. This result is not
      straightforward because the studies showed significant heterogeneity (P < 0.01).
      CONCLUSION: Differences in statistical power and sensitivity of outcome measure
      explain this heterogeneity and the conflicting results of the studies. Therefore,
      the prophylactic efficacy of carbamazepine remains questionable.

PMID- 7788130
TI  - Effectiveness of zuclopenthixol compared with haloperidol in the treatment of
      behavioural disturbances in learning disabled patients.
AB  - BACKGROUND: We compared the efficacy of two neuroleptics with different receptor
      profiles (zuclopenthixol and haloperidol) in learning disabled patients with
      behavioural disturbance. METHOD: A double-blind crossover study (2 x 8 weeks; n =
      34), interrupted by a two-week single-blind washout period, was employed.
      Assessments included the Schedule for Handicaps, Behaviour, and Skills (SHBS) and
      Clinical Global Impression (CGI). RESULTS: The SHBS score was significantly
      reduced for the zuclopenthixol cohort only. End-point analysis between the two
      drugs also showed an enhanced effect for zuclopenthixol over haloperidol. CGI
      scores did not reveal significant differences between the two drugs. CONCLUSION:
      Zuclopenthixol may be superior to haloperidol for the treatment of behavioural
      disturbances in mentally retarded subjects.

PMID- 7788132
TI  - Recurrent affective syndromes in bipolar and unipolar mood disorders at follow
      up.
AB  - BACKGROUND: It is in dispute whether affective relapse disrupts psychosocial
      functioning to the same extent in depressed and manic patients. METHOD: A
      prospective, naturalistic, longitudinal follow-up of 84 unipolar and bipolar
      affectively disordered in-patients was conducted to examine the extent of
      recurrent affective syndromes and their relationship to overall outcome. Global
      adjustment relative to relapse was assessed at 2- and 4.5-year follow-ups.
      RESULTS: Nearly half of the bipolar patients had subsequent syndromes, which were
      often associated with uniformly poor psychosocial functioning. Fewer than one
      quarter of those with recurrences had steady work performance. Bipolar patients
      taking lithium alone had fewer recurrences than those taking lithium as well as
      neuroleptics (P < 0.05). Bipolar and unipolar patients relapsed with equal
      frequency, but unipolar relapse was less often associated with readmission to
      hospital, work impairment, or uniformly poor functioning. CONCLUSION: Affective
      relapse in bipolar disorders was more detrimental to overall functioning than was
      recurrence in unipolar depression.

PMID- 7788133
TI  - Post-viral onset of anorexia nervosa.
AB  - BACKGROUND: The pathogenesis of anorexia nervosa (AN) is controversial. METHOD: A
      retrospective case series was studied to investigate the post-viral onset of AN.
      RESULTS: Four consecutive in-patients with severe restrictive AN spontaneously
      volunteered histories of 'glandular fever'-like illnesses immediately before the
      onset of their eating disorder. This association has not previously been
      described. Possible pathogenic pathways include both non-specific and specific
      viral disruptions in central homeostasis, particularly involving corticotrophin
      releasing hormone (CRH) regulation. CONCLUSION: Such mechanisms are speculative,
      but biologically and historically plausible.

PMID- 7788134
TI  - Neuropsychiatry and SPECT of an acute obsessive-compulsive syndrome patient.
AB  - BACKGROUND: A 71-year-old man with no previous psychiatric history presented with
      an acute onset of obsessive-compulsive disorder (OCD) symptoms associated with a
      right inferior parietal infarct. There were no abnormal neurological signs. There
      were no noteworthy abnormalities on neuropsychological testing. METHOD: Whereas a
      computerised tomography scan showed only a right inferior parietal infarct, a
      single photon emission computerised tomography (SPECT) scan revealed that in
      addition to the infarct there was decreased regional cerebral blood flow in the
      right basal ganglia and temporal areas. There was higher activity in the right
      orbitofrontal area than in the left. RESULTS: The patient improved with standard
      drug therapy and psychotherapy. CONCLUSIONS: SPECT is effective in the diagnosis
      of neuropsychiatric disorders such as OCD, and the pathological changes in brain
      metabolism detected by SPECT may be reversed by both drug therapy and
      psychotherapy.

PMID- 7788135
TI  - Characteristics of fire-setters. A study and proposed multiaxial psychiatric
      classification.
AB  - BACKGROUND: The study set out to review the relationship between mental disorder
      and fire-setting. METHOD: Sociodemographic, psychiatric, and medical data were
      retrospectively obtained from case notes of a group of 36 fire-setters referred
      to the North West Thames Forensic Psychiatry Service over a four-year period.
      RESULTS: Of the sample, 28% were female and one-third had no mental illness; 28%
      had a previous medical history of possible relevance. Psychoactive substance
      abuse was common. There was a significant disturbance of interpersonal
      relationships. Eighty-five per cent lived alone, and 44% of the female fire
      setters had a history of sexual abuse. CONCLUSION: On the basis of this study, a
      multiaxial classification system of fire-setting is proposed.

PMID- 7788137
TI  - ECT seizure duration and efficacy.

PMID- 7788136
TI  - Economics of treatment of depression.

PMID- 7788138
TI  - Toxic serotonin syndrome or extrapyramidal side-effects?

PMID- 7788140
TI  - Daniel Hack Tuke. 1895.

PMID- 7788139
TI  - Suicide prevention in Gotland.

PMID- 7788141
TI  - Diagnostic features of ankylosing spondylitis.

PMID- 7788142
TI  - They turned down my abstract again...

PMID- 7788143
TI  - Relationship between serum cartilage oligomeric matrix protein levels and disease
      progression in osteoarthritis of the knee joint.
AB  - The value of serum cartilage oligomeric matrix protein (COMP) as a marker of
      disease progression was investigated in 81 hospital out-patients with clinical
      knee osteoarthritis (OA). Progressing patients were defined by a decrease of > or
      = 2 mm in joint space on X-ray or requiring knee surgery during the 5 yr of
      follow-up. Of the 57 patients for whom full data were available, 20 progressed
      and 37 did not progress. Serum COMP levels increased during the first year in
      those who progressed (mean 6.42 micrograms/ml) (S.D. 6.64) compared to those who
      did not progress [mean 0.07 microgram/ml (S.D. 4.99); P < 0.001]. Changes in COMP
      during the first year were related to baseline COMP (r = -0.672, P < 0.001) and
      weight-to-height ratio (r = 0.272, P = 0.47). After allowing for these variables,
      serum COMP increased during the first year in progressive patients by 5.04
      micrograms/ml [95% confidence interval (CI): (2.61, 7.46)] more than in non
      progressive patients. Discriminant analysis gave a sensitivity of 70% and
      specificity of 78% at a cut-off value of 3.17 micrograms/ml. Baseline serum COMP
      levels did not differ between the groups but were related to late phase
      scintigraphy scan abnormalities. These observations suggest that the changes in
      serum COMP may have prognostic significance and are consistent with a model of OA
      in which early signs of episodic clinical progression can be found in the
      cartilage as well as in subchondral bone.

PMID- 7788144
TI  - Bcl-2 expression is unaltered in unfractionated peripheral blood mononuclear
      cells in patients with systemic lupus erythematosus.
AB  - It has been postulated that the high levels of autoantibodies observed in
      systemic lupus erythematosus (SLE) patients could result from abnormal longevity
      of polyclonally activated B-cells. This increased survival could be due to
      dysfunction of apoptosis, the normal regulatory process governing their life
      span. The protein product of the bcl-2 gene can enhance lymphoid cell survival by
      interfering with apoptosis. Moreover, transgenic mice overexpressing bcl-2 in
      their B-cells developed an autoimmune syndrome resembling SLE. To determine
      whether overexpression of bcl-2 occurs in SLE patients, bcl-2 protein was
      measured in peripheral blood mononuclear cells from 73 SLE patients, 20 healthy
      individuals and 47 patients with other autoimmune diseases. Only three lupus
      patients had raised levels of bcl-2 and there were no statistically significant
      differences in the mean bcl-2 levels measured in SLE patients compared to
      controls. Bcl-2 levels did not correlate with overall disease activity in SLE
      patients.

PMID- 7788145
TI  - Interleukin-6 (IL-6) induces the proliferation of synovial fibroblastic cells in
      the presence of soluble IL-6 receptor.
AB  - A number of investigators have reported that there are detectably elevated levels
      of interleukin-6 (IL-6) and soluble IL-6 receptor (sIL-6R) in the synovial fluids
      of rheumatoid arthritis (RA) patients. However, the precise role of IL-6 and sIL
      6R in the pathogenesis of RA remains unclear. In the present study we examined
      whether IL-6 and/or sIL-6R could induce the proliferation of synovial
      fibroblastic cells (SFC) obtained from a RA patient. Co-existence of IL-6 and sIL
      6R induced SFC proliferation without needing any further stimulation. This
      proliferation was completely blocked by either anti-IL-6 or anti-sIL-6 antibody.
      In contrast, neither IL-6 nor sIL-6R alone induced SFC proliferation. Although
      sIL-6R alone could not induce SFC proliferation, it did however augment IL-1 beta
      induced SFC proliferation in a dose-dependent manner, but not tumour necrosis
      factor alpha-, platelet-derived growth factor-AB- or b-fibroblast growth factor
      induced proliferation. This augmentation was completely neutralized by the
      addition of anti-IL-6 or anti-sIL-6R antibodies. This may be explained by the
      fact that an amount of IL-6 sufficient to induce SFC proliferation in the
      presence of sIL-6R was found to be detectable in the IL-1 beta-stimulated-culture
      supernatant. This evidence suggests that IL-6 is very likely to be involved in
      synovial cell proliferation in the synovium of RA patients in co-operation with
      sIL-6R.

PMID- 7788146
TI  - Cytokine mRNA expression in the labial salivary gland tissues from patients with
      primary Sjogren's syndrome.
AB  - The pattern of cytokine mRNA expression in frozen minor salivary gland tissues
      from patients with primary Sjogren's syndrome (pSS) (n = 12) and controls (n = 8)
      using an in situ hybridization technique and oligonucleotide probes of
      interleukin-1 beta (IL-1 beta), tumour necrosis factor alpha and beta (TNF-alpha
      and TNF-beta), interleukin-6 (IL-6), interleukin-2 (IL-2) and its receptor (IL
      2R), interleukin-4 (IL-4), interleukin-10 (IL-10), interferon-gamma (IFN-gamma)
      and transforming growth factor-beta (TGF-beta) was examined. In addition to in
      situ hybridization, immunohistochemistry was used to identify the subset of cells
      expressing IL-2 and IL-4 mRNA. Mononuclear cells involved in the minor salivary
      gland lesions of pSS patients were found to express mRNA for pro-inflammatory
      cytokines such as TNF-alpha and IL-1 beta, and cytokines involved in the
      regulation of B- and T-cell function (IL-2 and IL-6). In contrast, only three
      biopsies from patients with pSS express mRNA of inhibitory cytokines such as IFN
      gamma and TGF-beta. Furthermore mRNA for IL-6 and IL-1 beta was also detected in
      the glandular epithelial cells suggesting that these cells may play a role in the
      pathogenesis of autoimmune lesion in Sjogren's syndrome. IL-10 mRNA was not
      detected while IL-4 mRNA was primarily detected in naive T-lymphocytes of
      patients with a mild and early lesion. These results suggest that local
      production of cytokines by both mononuclear and epithelial cells may be involved
      in the immune-mediated destruction of exocrine glands in patients with pSS.

PMID- 7788147
TI  - The therapeutic effects of an engineered human anti-tumour necrosis factor alpha
      antibody (CDP571) in rheumatoid arthritis.
AB  - Pro-inflammatory cytokines such as tumour necrosis factor alpha (TNF alpha) have
      been implicated in the pathogenesis of rheumatoid arthritis (RA), and have
      therefore become therapeutic targets. An engineered human antibody, CDP571, that
      neutralizes human TNF alpha was administered intravenously in single doses of
      0.1, 1.0 or 10 mg/kg to patients with active RA (n = 24). The effects of the
      antibody were compared in a double-blind fashion with those of placebo (n = 12).
      In an open continuation phase patients were given either 1.0 or 10 mg/kg. We
      found that CDP571 was well tolerated and caused reductions in markers of disease
      activity such as erythrocyte sedimentation rate (ESR) and serum C-reactive
      protein (CRP): this was confirmed by a reduction in the disease activity score
      (DAS). There was a reduction in the number of tender joints, maximal in degree
      and duration after 10 mg/kg. Patients also documented a reduction of pain and
      relief of arthritis symptoms. The effects of 10 mg/kg CDP571 on ESR, CRP, tender
      joints, pain and symptom relief compared to placebo were statistically
      significant at weeks 1 or 2. The continuation phase, although open, confirmed
      both the safety and the beneficial effects of CDP571 in active RA. In conclusion
      CDP571, an engineered human anti-TNF alpha antibody, is well tolerated and, after
      a single dose of 10 mg/kg, provides improvements in symptoms, signs and
      serological markers of disease activity in patients with active RA.

PMID- 7788148
TI  - Human leucocyte antigen phenotypes and gold-induced remissions in patients with
      rheumatoid arthritis.
AB  - To assess possible associations between human leucocyte antigens (HLA) and the
      achievement of remission during gold treatment, HLA typing was performed in 67
      rheumatoid arthritis (RA) patients with a gold-induced remission and in 25
      control RA patients who discontinued gold therapy because of lack of efficacy.
      Both groups of RA patients showed a significantly higher frequency of DR4 antigen
      and lower frequency of DR6 than a control population. There were no significant
      differences in HLA antigens between remission-responders and non-responders. It
      is concluded that HLA typing is not helpful in predicting the therapeutic
      response to parenteral gold therapy.

PMID- 7788150
TI  - Antibodies to the 65 kDa mycobacterial stress protein in west Africans with
      rheumatoid arthritis, tuberculosis and malaria.
AB  - We have studied IgG antibodies to recombinant mycobacterial 65 kDa heat-shock
      protein in West African rheumatoid arthritis (RA) patients and local control
      groups, including those with tuberculosis or malaria. Mean levels were higher
      among the patients with RA than among healthy controls, but did not achieve
      statistical significance. Our findings may relate to the level of mycobacterial
      exposure in West Africa.

PMID- 7788149
TI  - Oral steroids as bridge therapy in rheumatoid arthritis patients starting with
      parenteral gold. A randomized double-blind placebo-controlled trial.
AB  - The efficacy of oral prednisone as bridge therapy in rheumatoid arthritis (RA)
      was studied. Forty patients starting aurothioglucose were randomized to receive
      either prednisone or placebo for 18 weeks. The dose was 10 mg/day in the first 12
      weeks, 7.5 mg/day in weeks 13 and 14, 5 mg/day in weeks 15 and 16, and 2.5 mg/day
      in weeks 17 and 18. Patients were followed for 44 weeks. We found that disease
      activity was significantly lower in the prednisone group as early as week 1 and
      continued up to week 12. Response to prednisone was noticed in 60% of the
      patients. After tapering prednisone, a rebound deterioration was noticed at weeks
      20 and 24 in 58% of the responders. No significant differences in X-ray
      progression were found between the two groups. We concluded that oral prednisone
      (10 mg/day) significantly reduces short-term disease activity in 60% of patients
      with active RA. The rebound deterioration after tapering the dose means that
      bridge therapy with prednisone using this dose-reduction scheme is not
      recommended.

PMID- 7788152
TI  - Thyroid autoimmunity in systemic lupus erythematosus: the clinical significance
      of a fluctuating course.
AB  - A number of studies have demonstrated an association between thyroid autoimmune
      disease and systemic lupus erythematosus (SLE), but there is little information
      on the course of thyroid autoimmunity over time in SLE patients. We reviewed the
      thyroid serology of 150 SLE patients tested at or soon after diagnosis of SLE,
      and examined the follow-up data on those found to have positive thyroid serology.
      Thirty-one (21%) were thyroid autoantibody positive. Follow-up data were
      available on 20 of these patients, over an average of 7.9 yr. Twelve of the 20
      patients (60%) were persistently thyroid autoantibody positive, but eight (40%)
      were thyroid autoantibody negative on at least one occasion during follow-up. All
      five cases of clinical thyroid disease that were diagnosed, and two out of three
      cases of subclinical elevation of thyroid-stimulating hormone (TSH), occurred in
      the group with persistently positive thyroid serology. We also retested the
      thyroid serology of 46 of the 119 patients who originally tested thyroid
      autoantibody negative, with an average of 6.2 yr between the two tests, and found
      that four (9%) now had positive thyroid serology. One had an elevated TSH. We
      conclude that thyroid serology follows a fluctuating course in a subgroup of SLE
      patients who are found to have positive thyroid serology on a single occasion.
      Although the number in this subgroup of our series was small, and the trend did
      not reach statistical significance, our findings suggested that this subgroup of
      patients is unlikely to develop clinical or subclinical thyroid disease.

PMID- 7788151
TI  - Muscle strength in healthy people and in patients suffering from recent-onset
      inflammatory arthritis.
AB  - Neuromuscular function was compared among 20 patients with relatively recent
      onset (symptomatic period 17 +/- 24 months) rheumatoid arthritis (RA)
      (experimental group; EG), and 20 age- and sex-matched healthy people (control
      group; CG). The comparison was repeated after a period of 6 months, when 16
      patients had carried out progressive strength training. At baseline maximal grip
      strength and maximal dynamic unilateral strength of the knee extensors in the EG
      were significantly (P < 0.05) lower in comparison to the CG. The groups did not
      differ from each other in maximal isometric strength of the trunk flexors and
      extensors or the knee extensors. The 6-month dynamic strength training in the EG
      resulted in significant increases in maximal dynamic strength of the knee
      extensors (P < 0.001), in isometric grip strength (P < 0.001) and in isometric
      strength of the trunk flexors (P < 0.05) and extensors (P < 0.05) to the level of
      the healthy controls. Only minor changes took place in explosive strength and
      maximal isometric strength of the knee extensors. Erythrocyte sedimentation rate
      (P < 0.001), Ritchie's articular index (P < 0.01) and modified health assessment
      questionnaire (P < 0.01) improved significantly during the training period. The
      results suggest that inflammatory arthritis decreases dynamic and/or isometric
      muscle strength in selected muscle groups of the body already in the early stages
      of disease. However, progressive dynamic strength training rapidly increases the
      neuromuscular performance capacity of the patients even to the level of healthy
      people without detrimental effects on disease activity.

PMID- 7788153
TI  - Symptomatic enlarged iliopsoas bursae in the presence of a normal plain hip
      radiograph.
AB  - The clinical and radiological features of seven cases of enlarged iliopsoas
      bursae are presented, all of which had normal plain hip radiographs. Two cases
      had rheumatoid arthritis, one had septic arthritis diagnosed by synovial biopsy
      and the remaining four cases occurred as isolated findings, in the absence of any
      recognized hip pathology. A communication with the hip joint was demonstrated in
      one case associated with septic arthritis. All patients presented with symptoms
      of hip pain and limitation of movement. Two patients had a groin mass, one of
      which produced localized pressure symptoms and retroperitoneal extension. All
      patients had an arthrogram or bursogram performed. In the two cases where a mass
      was palpable, ultrasound and computed tomography were performed. We conclude
      that, in the presence of persistent hip pain or reduced range of movement, an
      enlarged iliopsoas bursa should be considered as a potential diagnosis, even in
      cases where the plain hip radiograph is normal.

PMID- 7788154
TI  - Inner ear involvement in mixed cryoglobulinaemia patients.
AB  - In order to evaluate the nature and prevalence of audiovestibular disturbances in
      mixed cryoglobulinaemia (MC), 32 consecutive MC patients were studied by a wide
      audiological and vestibular examination. Pure tone audiometry, impedance
      audiometry, brainstem response audiometry and vestibular function were performed.
      Patients with a previous history of ear damage due to other well-known agents
      were excluded from the study. In MC patients we found a rather frequent
      audiovestibular involvement (34.3%). Bilateral sensorineural hearing loss was
      found in seven MC patients (22%) and altered vestibular function test values in
      other seven subjects (22%). Moreover, anamnestic and clinical data revealed a
      high incidence of benign positional paroxysmal vertigo in our MC series. We can
      suppose that immune complex-mediated microvascular involvement of the
      labyrinthine vessels may be responsible for inner ear damage in MC. Thus,
      audiovestibular disturbances may be included among various organ involvement of
      the MC.

PMID- 7788155
TI  - Assessing clinical competence: recognition of case descriptions of rheumatic
      diseases by general practitioners.
AB  - The objective of this study was to detect strengths and weaknesses in the
      diagnosis of rheumatic diseases by general practitioners in order to set up post
      graduate training accordingly and to assess whether open-ended questions give
      results comparable with multiple choice-type questions. Fifty-one general
      practitioners were given eight written cases: rheumatoid arthritis (RA),
      ankylosing spondylitis (AS), reactive arthritis, psoriatic arthritis (PsA),
      systemic lupus erythematosus (SLE), gout, polymyalgia rheumatica and pseudogout.
      Only signs and symptoms were provided. All cases were derived from real patients
      with a definite diagnosis. Each case was presented in both types of question
      formats. The cases were also presented to 23 rheumatologists. We found that in
      the open-ended question format 57.1% of the general practitioners gave the
      correct answers. Cases of RA, AS, gout and PsA were correctly diagnosed by > 70%
      of the general practitioners. Cases of polymyalgia rheumatica and reactive
      arthritis were correctly diagnosed by 55 and 39% of the general practitioners,
      respectively. The cases of pseudogout and SLE were correctly diagnosed by less
      than 11% of the general practitioners. Fifty-two per cent of the general
      practitioners gave the correct answers to the multiple choice-type questions.
      There was no statistical difference in the correct answers between the open-ended
      questions and the multiple choice-type questions. We concluded that assuming
      generalization of the results, training of general practitioners should include
      polymyalgia rheumatica, reactive arthritis, SLE and pseudogout.

PMID- 7788156
TI  - Role of prophylactic antibiotics in the prevention of late infection of
      prosthetic joints. Results of a questionnaire and review of the literature.
AB  - A postal survey has revealed wide variation in attitudes towards the need for
      prophylactic antibiotics in patients with implants who develop intercurrent
      infections, or who undergo surgical procedures. The available evidence is
      insufficient to reach any firm conclusions, however any patient who has an
      implant should receive swift treatment for intercurrent infections.

PMID- 7788157
TI  - Sulphasalazine-induced lupus in psoriatic arthritis.
AB  - Lupus syndromes have been described in rheumatoid arthritis and inflammatory
      bowel diseases treated with sulphasalazine. We describe two cases of lupus with
      clinical and serological disease, developing in seronegative, immunologically
      nude psoriatic arthritis following sulphasalazine treatment. On cessation of
      sulphasalazine the clinical and serologic features of lupus disappeared. This
      suggests that the lupus syndrome was induced by sulphasalazine rather than
      unmasked by it.

PMID- 7788158
TI  - Steroid myopathy induced by epidural triamcinolone injection.
AB  - Epidural steroid injections are widely used for the treatment of lumbago and
      sciatica although their efficacy has not yet been demonstrated in a convincing
      way. Moreover, systemic complications, although rare, have been documented. The
      present case report illustrates that even a single low-dose epidural injection
      may induce Cushing's syndrome and even steroid myopathy.

PMID- 7788159
TI  - Multiple joint avascular necrosis: beware of tuberculosis and human
      immunodeficiency virus--a rare but important cause.

PMID- 7788160
TI  - Lyme borreliosis presenting as a polymyalgia rheumatica-like syndrome.

PMID- 7788161
TI  - Musculoskeletal complaints in patients with hyperlipoproteinaemia.

PMID- 7788162
TI  - A further possible cause of diarrhoea caused by oral gold.

PMID- 7788163
TI  - Staphylococcal arthritis in human immunodeficiency virus infection.

PMID- 7788166
TI  - The place of acupuncture in medicine today.

PMID- 7788165
TI  - Evidence-based medical practice: the Cochrane Collaboration and osteoarthritis.

PMID- 7788164
TI  - Minocycline-related lupus.

PMID- 7788167
TI  - Frequency of autoantibodies to a major epitope on the carboxyl terminal fragment
      of CENP-B in patients with autoimmune disease.
AB  - The carboxyl-terminal fragment of CENP-B contains a major epitope for anti
      centromere antibodies (ACA). We have developed an enzyme-linked immunoassay
      (ELISA) for measuring antibodies to the 147-carboxyl-terminal amino acids of CENP
      B expressed as a beta-galactosidase fusion protein. The ELISA was 98% sensitive
      and 95% specific for detecting ACA in a population which included 46 patients
      with ACA detected by other means. Therefore, the CENP-B ELISA should prove a
      valuable tool in screening for ACA in populations at risk of developing systemic
      sclerosis, such as those with Raynaud's phenomenon. Levels of anti-CENP-B
      antibodies were not increased in unaffected relatives of probands with ACA.

PMID- 7788168
TI  - Antibodies to Klebsiella pneumoniae, Escherichia coli and Proteus mirabilis in
      the sera of patients with axial and peripheral form of ankylosing spondylitis.
AB  - IgM, IgG and IgA class serum antibodies against the whole Klebsiella pneumoniae,
      Escherichia coli and Proteus mirabilis bacteria, as well as against K. pneumoniae
      and E. coli lipopolysaccharides (LPSs) were studied earlier in two separate
      patient populations of 99 and 85 patients with ankylosing spondylitis (AS) and in
      102 healthy blood donors by enzyme immunoassay. In this study the patients were
      divided into groups according to the presence or absence of peripheral arthritis.
      The patients with peripheral type AS had increased levels of IgM and IgA class
      antibodies against K. pneumoniae, whereas the patients with axial type AS had
      increased levels of IgG and IgA class antibodies to K. pneumoniae, as well as IgA
      class antibodies against E. coli and P. mirabilis bacteria. Sulphasalazine
      treatment decreased the IgM and IgA class antibodies in peripheral AS and IgA
      class antibodies in axial AS against K. pneumoniae LPS. The antibody levels were
      also decreased against E. coli and P. mirabilis bacteria in the sera of patients
      with axial AS. The immunological findings in patients with peripheral and axial
      form of AS were different from each other and thus may reflect different
      aetiopathogenetic mechanisms for these two types of AS.

PMID- 7788169
TI  - Antibodies to Klebsiella pneumoniae, Escherichia coli and Proteus mirabilis in
      the sera of ankylosing spondylitis patients with/without iritis and enthesitis.
AB  - IgM, IgG and IgA class serum antibodies against the whole Klebsiella pneumoniae,
      Escherichia coli and Proteus mirabilis bacteria, as well as against K. pneumoniae
      and E. coli lipopolysaccharides (LPSs) were studied earlier in the sera of 98
      patients with ankylosing spondylitis (AS) and in 102 healthy blood donors by
      enzyme immunoassay. In this study the patients were divided into groups according
      to the clinical picture, i.e. presence or absence of iritis and enthesitis. The
      previous major finding of increased IgA class antibody levels against the whole
      K. pneumoniae bacteria in AS patients when compared to the healthy controls was
      not specifically associated with any single patient group in the present study.
      However, the patients with iritis had higher levels of IgA class antibodies to
      LPS of K. pneumoniae and E. coli when compared to the patients without iritis. In
      addition, the patients without enthesitis had higher level of IgG class
      antibodies against whole K. pneumoniae bacteria compared to the patients with
      enthesitis. The increased IgA class antibody levels against K. pneumoniae and E.
      coli LPS in AS patients with iritis may reflect an inflammatory process in the
      gut area. Furthermore, there were certain other differences in the immunological
      parameters between the AS patients with and without iritis or enthesitis and the
      possibility that they reflect different mechanisms involved in the disease
      processes cannot be excluded.

PMID- 7788170
TI  - Total and free methotrexate pharmacokinetics, with and without piroxicam, in
      rheumatoid arthritis patients.
AB  - The pharmacokinetic profile of total and free methotrexate (MTX) and the effect
      of piroxicam on MTX pharmacokinetics was studied in 20 rheumatoid arthritis
      patients receiving a stable dosage of MTX (10 mg/week). Plasma protein binding
      ranged from 25 to 55%. To describe the variations with time of the unbound
      fractions a mathematical characterization relationship between the total and free
      MTX was used. Total and free MTX were correlated with the sigmoid maximum effect
      model. The slope factor (gamma) was proportional to the number of binding sites.
      The free fraction for a given patient can be evaluated from this relationship.
      Total clearance of MTX was not statistically different with piroxicam (8.0 l/h
      for total MTX, 13.7 l/h for free MTX) vs without piroxicam. Likewise, there were
      no significant difference in tmax, area under the plasma concentration vs time
      curve, distribution and elimination half-lives, mean resonance time, and volumes
      of distribution. Although the highest observed total MTX concentration was
      significantly lower with piroxicam, there were no significant pharmacokinetic
      interactions between low-dose MTX and piroxicam.

PMID- 7788171
TI  - Adult onset Still's disease in northern India: comparison with juvenile onset
      Still's disease.
AB  - The present study compared the clinical and laboratory picture, the disease
      course and outcome in 31 patients having adult onset Still's disease (AOSD) with
      23 patients having juvenile onset Still's disease (JOSD). The median age at
      disease onset was 20 and 7 yr for AOSD and JOSD patients, respectively. On
      analysing and comparing our data on these two groups, no significant differences
      emerged except that adults had a significantly lower time interval from disease
      onset to remission as compared to juveniles. Upon comparison of data on our AOSD
      patients with that published from abroad, rash, adenopathy and sore throat were
      less frequent. No clinical or laboratory variables were found to predict the
      subsequent disease course and outcome in either group. The functional outcome was
      good in about 70% of both groups and mortality was low. It is concluded that the
      clinical picture and outcome in AOSD is similar to that of JOSD.

PMID- 7788172
TI  - Sulphasalazine-induced autoimmune abnormalities in patients with rheumatic
      disease.
AB  - Sulphasalazine is a commonly used second line agent in rheumatoid arthritis (RA)
      and other inflammatory joint diseases and is reported to be one of the least
      toxic of this group of drugs. Recently a severe allergic reaction and cases of
      lupus-like disease have been described in patients with RA after treatment with
      sulphasalazine. We describe five patients, all with inflammatory arthropathy who
      developed cutaneous vasculitis, lupus-like disease or atypical serology after
      exposure to sulphasalazine. Three of four cases investigated were found to have
      the slow acetylator phenotype. These reactions can complicate the diagnosis and
      delay discontinuation of the drug. Moreover, present guidelines for the diagnosis
      of drug-induced lupus do not apply to the majority of patients with
      sulphasalazine-induced lupus.

PMID- 7788173
TI  - Shoulder pain in a community-based rheumatology clinic.
AB  - The objective of this study was to assess the prevalence of different shoulder
      disorders likely to be experienced by a rheumatologist in a community-based
      rheumatology clinic. We assessed patients with shoulder pain presenting to a
      large general practice at a community-based rheumatology clinic. It was found
      that the more common conditions seen were rotator cuff lesions (65%),
      pericapsular soft tissue pain (11%), acromioclavicular joint pain (10%) and
      referred pain from cervical spine (5%). In conclusion this study has established
      the spectrum of shoulder disorders referred from general practice to a highly
      accessible community-based rheumatology clinic. The diagnostic processes to
      distinguish the different conditions rely chiefly on an accurate history and
      directed examination.

PMID- 7788174
TI  - The foot and ankle in rheumatoid arthritis.

PMID- 7788175
TI  - Intra-articular and soft tissue injections: a survey of current practice.
AB  - Intra-articular and soft tissue injections are the two most frequently used
      procedures in rheumatological practice. A questionnaire completed by 172
      consultant rheumatologists aimed to ascertain the techniques used in these
      procedures. The results showed a wide divergence of practice in almost every
      aspect of technique. Respondents were willing to undertake injections in almost
      any location, but differed widely regarding personal and patient preparation
      before injection. About one-quarter used no local anaesthetic, the majority using
      local anaesthetic before or with the corticosteroid. Admission overnight or as a
      day case for injection of weight-bearing joints was practised by 18%. Post
      injection advice was extremely variable. The results suggest that there is at
      present no single consensus technique for intra-articular and soft tissue
      injections amongst British consultant rheumatologists.

PMID- 7788176
TI  - Inflammatory cytokine responses in juvenile chronic arthritis.
AB  - The inflammatory cytokines interleukin 1 beta (IL-1 beta) interleukin 6 (IL-6),
      tumour necrosis factor alpha (TNF alpha) and the anti-inflammatory peptide--the
      interleukin 1 (IL-1) receptor antagonist--were measured in the plasma of children
      with juvenile chronic arthritis (JCA). In the two subgroups studied
      (polyarticular JCA and systemic JCA), there was good correlation between
      laboratory measures of disease activity C-reactive protein (CRP), erythrocyte
      sedimentation rate and clinical scores for disease activity. Despite higher
      levels of CRP in the systemic group IL-1 beta levels were lower and regression
      analysis recorded a difference in the relationship between CRP and IL-1 beta
      within the two clinical groups. In contrast, IL-6 levels were high in the
      systemic group and correlated with disease activity. No such correlation was
      observed in the polyarticular group. Five children with systemic JCA were studied
      during the febrile phase of their illness. IL-6 levels rose and fell with the
      fever. TNF alpha levels also rose and fell but out of phase with the fever. In
      contrast IL-1 beta levels were either undetectable throughout the febrile episode
      or only became detectable as the temperature reduced to normal. The IL-1 receptor
      antagonist was usually found in 1000-fold excess over IL-1 beta, levels rising
      and falling with the fever. These results demonstrate difference in the cytokine
      profiles and acute phase protein responses in polyarticular and systemic JCA.
      This would suggest different pathogenic mechanisms for these two groups of JCA
      with IL-6 being the more important cytokine in systemic JCA.

PMID- 7788178
TI  - Increase of activated factor VIIA and haemostatic molecular markers in juvenile
      chronic arthritis.
AB  - Activated factor VIIa (FVIIa), von Willebrand factor antigen (vWF:Ag), D-dimer
      and thrombin-antithrombin III complex (TAT) were measured to monitor coagulation
      status in patients with juvenile chronic arthritis (JCA). Subjects included 14
      patients with systemic JCA, 16 with pauciarticular JCA and 16 with polyarticular
      JCA without disseminated intravascular coagulopathy, thrombosis or liver
      dysfunction. All types of JCA showed an increase of FVIIa, D-dimer and TAT,
      indicating enhanced activation of coagulation. In systemic JCA only there was
      also characteristically an elevation of vWF:Ag. We conclude that all types of JCA
      constitute a state of subclinical hypercoagulopathy caused by tissue damage and
      that additionally systemic JCA involves a prothrombotic state associated with or
      precipitated by vasculitis.

PMID- 7788177
TI  - Antinuclear antibodies in early onset pauciarticular juvenile chronic arthritis
      (JCA) are associated with HLA-DQB1*0603: a possible JCA-associated human
      leucocyte antigen haplotype.
AB  - A panel of 43 early onset pauciarticular (EOPA) juvenile chronic arthritis (JCA)
      patients have been typed for human leucocyte antigens (HLA) DRB1, DPB1, DQA1
      alleles, and DQB1*0603 status using molecular-based methods. Increased
      frequencies of DRB1*08 [odds ratio (OR) 7.7, 95% confidence interval (CI) 2.6
      22.3], DRB1*11 (OR 3.1, 95% CI 1.2-8.1), DRB1*1301 (OR 7.7, 95% CI 2.6-22.3),
      DPB1*0201 (OR 3.5, 95% CI 1.6-8.0), DQA1*0103 (OR 4.4, 95% CI 1.5-13.3),
      DQA1*0501 (OR 2.9, 95% CI 1.3-6.6), DQA1*0601 (OR 30, 95% CI 3.6-241) and
      DQB1*0603 (OR 7.3, 95% CI 3.0-17.6) were found in the EOPA-JCA group compared
      with Caucasoid controls. Stratification of the EOPA-JCA group into antinuclear
      antibody (ANA) positive (n = 18) and ANA negative (n = 25) individuals revealed
      that ANA positivity was only associated with DRB1*1301 (OR 4.2, 95% CI 1.0-17.3),
      DPB1*0201 (OR 4.0, 95% CI 1.0-15.7) and DQB1*0603 (OR 11.5, 95% CI 2.5-53.4).
      Further analysis of the relative contributions of HLA antigens to ANA status
      revealed that DQB1*0603 determined the primary HLA effect. No apparent
      interaction between DQB1*0603 and DRB1*1301 or between DQB1*0603 and DPB1*0201
      was found to contribute to the association with ANA. We suggest that those ANA
      positive individuals with a restricted HLA background, (DQB1*0603 positive),
      defines a group of EOPA-JCA patients which will be especially valuable in the
      characterization of the ANA associated with EOPA-JCA.

PMID- 7788180
TI  - Chronic abdominal sepsis and migratory polyarthritis.

PMID- 7788179
TI  - The association between physical function and psychological problems in children
      with juvenile chronic arthritis.
AB  - Twenty-nine children with juvenile chronic arthritis, aged from 7 to 16 yr were
      studied using the Juvenile Arthritis Functional Assessment Report for Children
      and Parents questionnaires (JAFAR-C and JAFAR-P). The results showed that JAFAR-C
      and JAFAR-P were highly correlated (P < 0.001) with each other and also with a
      predicted JAFAR score (P < 0.05). The JAFAR score correlated with the arthritic
      joint count at the time of the study (P < 0.01), Steinbrocker classification (P <
      0.001), pain score (P < 0.01) and stiffness score (P < 0.005). Evidence of
      psychological dysfunction was found in eight of the 29 children (27%). Six
      children (21%) scored 13 or more on the Rutter A(2) for parents and one patient
      scored more than nine on the Rutter B(2) for teachers. Only one child had a score
      on the Birleson self-rating scale that was high enough to suggest a likely
      diagnosis of depression. The median Lipsitt self-concept scale score was 86, that
      expected for a healthy population. There was no correlation between the
      psychological scores and any of the other functional measurements, although the
      numbers affected were small. There was no significant difference between type of
      arthritis at onset with regard to any of the scores obtained.

PMID- 7788181
TI  - Pamidronate and uveitis.

PMID- 7788182
TI  - Complementary therapies, the baby, and the bath water.

PMID- 7788183
TI  - Brachial plexitis in a patient with acute parvovirus B19 infection.

PMID- 7788184
TI  - Management of gout in patients with renal insufficiency and a gastrointestinal
      bleed--an answer to Dr Dunne's letter.

PMID- 7788185
TI  - Primary pyomyositis. Two more cases with atypical presentation in diabetic hosts.

PMID- 7788188
TI  - Is interferon alpha a therapy for hepatitis B-associated polyarteritis nodosa?

PMID- 7788186
TI  - Abducent and trochlear palsies in a patient with Sjogren's syndrome.

PMID- 7788187
TI  - Churg-Strauss syndrome with inflammatory orbital pseudotumour.

PMID- 7788189
TI  - Disseminated penicillinase-producing Neisseria gonorrhoeae in a patient infected
      with human immunodeficiency virus.

PMID- 7788191
TI  - Case reports of anesthesia complications.

PMID- 7788190
TI  - Tarsal tunnel syndrome in ankylosing spondylitis.

PMID- 7788192
TI  - The physiological effect of CO2 pneumoperitoneum in pediatric laparoscopy.
AB  - BACKGROUND: The physiological effect of CO2 pneumoperitoneum during laparoscopy
      is a great concern of the anesthesiologists. Its effect in pediatric laparoscopy
      has not been previously reported. The purpose of this study was to examine the
      physiological alteration of pediatric patients during CO2 pneumoperitoneum.
      METHODS: One hundred and twenty six children aged from 11 mon to 13 yr undergoing
      laparoscopic inguinal exploration were divided into three groups based on age
      orientation: group I comprising 40 children with age from 11 mon to 2 yr; group
      II 46 children with age between 2 to 5 yr; and group III 40 children aged from 5
      to 13 yr. All patients received endotracheal anesthesia with halothane-N2O in 50%
      O2 and atracurium for muscle relaxation. Respiration was controlled by an Ohmeda
      7000 ventilator with constant minute ventilation to maintain baseline end-tidal
      CO2 tension (PETCO2) between 32-33 mmHg. After anesthesia, CO2 was insufflated
      into the peritoneal cavity via the opened hernia sac. The intraabdominal pressure
      exerted by CO2 was 10 mmHg and the duration of pneumoperitoneum and laparoscopy
      was 15 min. We recorded airway pressure, PETCO2, body temperature, blood
      pressure, heart rate, heart rhythm, and oxygen saturation simultaneously at 1 min
      interval before, during, and after laparoscopy. RESULTS: The airway pressure and
      PETCO2 showed significant increases during laparoscopy (15-18% and 18-20%
      respectively) in all cases, but the percentage of increases were not
      significantly different among groups. However, the PETCO2 change in terms of time
      lag were different between groups: (1) the time lag from CO2 insufflation to the
      emergence of PETCO2 change (latent period) was respectively 0.7 +/- 0.1 (mean +/-
      SD) min in group I, 0.9 +/- 0.2 min in group II and 1.5 +/- 0.2 min in group III
      (p < 0.05); (2) the PETCO2 change from baseline to a plateau (ascending period)
      was respectively 4.2 +/- 0.6 min in group I, 6.3 +/- 1.0 min in group II and 9.1
      +/- 1.1 min in group III (p < 0.05); (3) the PETCO2 decline from plateau to
      baseline after CO2 deflation (descending period) was respectively 6.2 +/- 0.5 min
      in group I, 8.3 +/- 0.8 min in group II and 12.0 +/- 1.3 min in group III (p <
      0.05). The body temperature and hemodynamics including blood pressure, heart
      rate, heart rhythm, oxygen saturation were not significantly changed during
      laparoscopy in all groups. CONCLUSIONS: The changes of PETCO2 during laparoscopy
      did not influence the hemodynamic stability in our study. The younger children
      give a faster reaction time of PETCO2 change after CO2 insufflation than do the
      older children which may be related to the variation of physiological exhibition
      at different state of development.

PMID- 7788193
TI  - [The thermoregulatory threshold during surgery with propofol-nitrous oxide
      anaesthesia].
AB  - BACKGROUND: Thermoregulatory responses are thought to be drastically suppressed
      by general anesthesia. In previous studies, it was shown that halothane,
      isoflurane and fentanyl-N2O combination decrease the threshold of
      vasoconstriction in general anesthesia. Propofol is a recently introduced
      intravenous anesthetic. The thermoregulatory threshold of its administration
      during surgery has not been quantified. MATERIALS: Fourteen unpremedicated ASA
      class I patients were anesthetized with N2O (67%) and propofol (2 mg/kg in bolus
      followed by 6 mg/kg/h infusion) during elective surgery of free flap. Patients
      were randomly assigned either to receive additional warming (n = 5) or standard
      (n = 9) management. Significant vasoconstriction was prospectively defined as the
      temperature gradient between forearm surface and finger-tip surface is > or = 4
      degrees C, and the thermoregulatory threshold was defined as the esophageal
      temperature (core temperature) at a point where the skin temperature gradient
      between two tested zones exceeds 4 degrees C. RESULTS: Vasoconstriction did not
      occur in patients who received additional warming and they remained in nearly
      normothermia. The average minimum core temperature was 36.3 +/- 0.4 degrees C. In
      patients who underwent standard management the core temperature ranged from 32.8
      to 34.6 degrees C (33.6 +/- 0.7 degrees C), signifying significant
      vasoconstriction. CONCLUSIONS: General anesthesia with propofol/N2O during
      surgery drastically inhibits thermoregulatory vasoconstriction. This effect
      should also be noted during long-term use of propofol (e.g. ICU-sedation).

PMID- 7788194
TI  - Use of a single lumen endotracheal tube and continuous CO2 insufflation in
      transthoracic endoscopic sympathectomy.
AB  - BACKGROUND: Transthoracic endoscopic sympathectomy (TES) is an accepted standard
      surgical treatment for palmar hyperhidrosis. For anesthetic management, a double
      lumen endobronchial tube is usually used to deflate the lung on the operative
      side. Recently we have applied continuous insufflation of carbon dioxide (CO2)
      into the pleural cavity to merely compress one lung while ventilating both lungs
      with a conventional single lumen endotracheal tube. METHODS: We have studied 45
      patients (ASA I and II) who underwent bilateral TES, Thirty-three were ventilated
      by single lumen tube and the other 12 by double lumen endobronchial tube with one
      lung ventilation. In both groups I and II, CO2 was insufflated slowly through the
      scope to a intrapleural pressure of 20 cm H2O. Both lungs were ventilated with
      peak pressure of less than 20 cmH2O at tidal volume of 5-12 ml/kg at 10-16
      beats/min. RESULTS: In these patients, no CO2 retention was noted. Oxygenation
      and cardiovascular stability were maintained and there were no complications. In
      the double lumen series, we found that oxygen saturation was less uniform and
      less stable than those in the single lumen series. CONCLUSIONS: It is concluded
      that the use of single lumen endotracheal tube with continuous insufflation of
      CO2 in TES is easy, simple and safe.

PMID- 7788195
TI  - Prior epidural injection of 10 ml normal saline reduces the incidence of
      inadvertant venous puncture in epidural catheterization.
AB  - BACKGROUND: Anesthetically, epidural neural blockade is widely used in the fields
      of surgery and obstetrics as well as in diagnosis and management of acute and
      chronic pain. However, inadvertent epidural venous puncture might be a serious
      problem, or even life-threatening particularly when drug is erronaneously
      injected and prompt diagnosis is not made correct and treatment is not
      instituted. Although many anesthesiologists suggested that injection of fluid
      into the epidural space before catheter insertion could prevent an epidural
      venous puncture, some others did not agree to it. This study aimed a assess the
      effect of injection of different volumes of saline into the epidural space before
      catheter insertion on the incidence of epidural venous puncture. METHODS: Three
      hundred ASA I or II patients receiving Extracorporeal Shock Wave Lithotripsy
      (ESWL) were randomly divided into three groups: group A (no saline), group B (5
      ml of saline) and group C (10 ml of saline). After the injection of different
      volume of saline into the epidural space, an epidural catheter was inserted into
      the epidural space via a Touhy needle. The incidence of epidural venous puncture
      in each group was compared. RESULTS: The incidence of epidural venous puncture in
      group A and B was 14% and 11%, respectively. However, the incidence in group C
      (1%) was significantly lower than the other two groups. CONCLUSIONS: Our results
      suggest that injection of 10 ml saline into the epidural space before catheter
      insertion could significantly diminish the incidence of epidural venous puncture.

PMID- 7788196
TI  - [Clinical experience of laryngeal mask airway in lateral position during
      anesthesia].
AB  - BACKGROUND: The laryngeal mask airway (LMA), inserted blindly into hypopharynx in
      patients in supine position, has been reported to be successful in the management
      of the airway and can provide adequate ventilation during anesthesia. In our
      study, we used LMA to maintain airway during anesthesia in patients in lateral
      position. METHODS: Eighty surgical patients, ASA class I-II, undergoing
      hemorrhoidectomy, were placed in lateral surgical position before induction. The
      induction agents were propofol (2 mg/kg), fentanyl (2 micrograms/kg) and
      atracurium (0.5 mg/kg, i.v.). When mouth opening can be done passively, a LMA was
      inserted into the mouth and advanced blindly over the tongue into the pharynx
      until resistance was felt. The rim was immediately inflated with air and several
      manual positive pressure ventilatory breaths were given to the patient to check
      for leaks in the LMA system. Chest movement was observed and bilateral lung
      ausculation was performed to confirm the adequacy of ventilation. Once the LMA
      was in place, enflurane with oxygen was administered until operation was
      completed. During the anesthetic course, EKG, blood pressure, pulse oximeter, end
      tidal CO2 and inspiratory pressure were monitored. RESULTS: Blind insertion of
      LMA in lateral position was successful in the first attempt in 70% (56/80) of
      patients. Twenty (18/80) patients required a second or third trial making the
      total successful rate of LMA insertion as high as 90% (74/80). In four patients,
      airway control through LMA was unsatisfactory due to large air leakage during
      manual ventilation. In two patients the LMA could not be inserted in proper
      position for maintaining airway. In six cases, the LMA was immediately removed
      and was substituted by face-mask for anesthesia. Two patients complained of
      postoperative sore throat. No other specific complications such as cough,
      laryngospasm and aspiration was noted. CONCLUSION: We demonstrated that LMA can
      be easily inserted and can provide effective patency of airway during anesthesia
      even in lateral position. It can be used as a substitute for face-mask in
      anesthesia in this position to prevent complications such as pressure injury that
      a face-mask may cause.

PMID- 7788197
TI  - Anesthesia for elective cardioversion: a comparison of thiopentone and propofol.
AB  - BACKGROUND: Cardioversion is still a trend of therapy for cardiac dysrhythmias.
      With the application of new intravenous anesthetics, cardioversion can be
      performed safely and effectively with rapid onset of and quicker recovery from
      anesthesia. We compared the anesthetic effects of a new synthetic agent,
      propofol, with thiopentone which was mostly used in the past. METHODS: Twenty
      four ASA class II to III adult patients scheduled for elective cardioversion in
      the coronary care unit were included in this study. All patients were given
      fentanyl (2 micrograms/kg, i.v.) three min before induction and were randomly
      assigned to receive either thiopentone 1.5 mg/kg (group 1) or propofol 1 mg/kg
      (group 2) for induction of anesthesia. Supplementary oxygenation was administered
      throughout. RESULTS: Both drugs could provide satisfactory anesthesia for
      elective cardioversion without major complications. Recovery time was shorter
      with propofol (p < 0.05). Comparing with previous reports, a higher incidence of
      apnea and prolonged sedation were noted in this study. This might be due to the
      additive effect of thiopentone or propofol with fentanyl. CONCLUSIONS: Both
      anesthetics were suitable for elective cardioversion with negligible side effects
      in hemodynamically stable patients.

PMID- 7788198
TI  - Foley catheter used as bronchial blocker for one lung ventilation in a patient
      with tracheostomy--a case report.
AB  - Anesthesia with one-lung ventilation is a good anesthetic technique for patients
      receiving thoracotomy in various underlying diseases. One lung ventilation can be
      achieved successfully by the application of a double-lumen endotracheal tube
      through the oral route. However, there are several situations such as low body
      weight, young age, difficult intubation, anatomic anomaly, and tamponading
      endobronchial bleeding in some adult patients, etc., in which lung separation by
      a double-lumen endotracheal tube may be relatively contraindicated because
      insertion is either difficult or dangerous. Bronchial blocker with a Fogarty
      embolectomy catheter has been used successfully for such situations. Here, we
      reported the clinical experience in using the Foley catheter as the bronchial
      blocker in a patient with tracheostomy.

PMID- 7788200
TI  - Tracheal stenosis following brief endotracheal tube intubation--a case report.

PMID- 7788201
TI  - [Complications of massive blood transfusion after intrathoracic hemorrhage--a
      case report].
AB  - Acute hemorrhage leading to acute hypovolomic shock is a medical emergency
      carrying high mortality. It therefore requires prompt and effective treatment. We
      reported a case of lung tumor receiving lobectomy at our hospital. Repeated
      internal bleeding due to subclavian artery perforation occurred three times
      within three weeks after the surgery. During the period of resuscitation, the
      patient received emergently massive blood transfusion. Some complications of
      massive blood transfusion. Some complications of massive blood transfusion were
      noted later. A total of 89 units of whole blood, 34 units of fresh frozen plasma
      and 28 units of platelet was given.

PMID- 7788202
TI  - An urgent technique of applying high frequency jet ventilation in patients with
      extreme periglottic stenosis.
AB  - Applying high frequency jet ventilation (HFJV) to patients with extreme
      periglottic stenosis (EPS) carries high risk of barotrauma or severe circulatory
      depression, since the stenotic airway will result in inadequate outflow tract
      obstructing the passage of the expired gas. We encountered with emergent
      obstruction of the outflow tract in 13 patients with EPS during HFJV in
      endolaryngeal microsurgery (ELM) procedures. The phenomenon of progressive gas
      trapping occurred within seconds in all patients. Barotrauma and disastrous
      circulatory depression would occur if we had not recognized them and then taken
      some measures immediately. We surmounted these potentially lethal events without
      interrupting the surgical procedures and found neither hypoxia nor barotrauma in
      all these patients. This may attribute to an urgent technique, i.e., intermittent
      disconnecting the jet conduit at the junction of the proximal end of the
      insufflation catheter and the distal end of the patient connecting tube of jet
      ventilator during HFJV.

PMID- 7788203
TI  - Fat embolism syndrome following bilateral total knee replacement with total
      condylar prosthesis--a case report.

PMID- 7788204
TI  - Inhaled fenoterol pretreatment attenuates airway resistance response to
      endotracheal intubation.
AB  - BACKGROUND: Endotracheal intubation may induce vagal mediated
      bronchoconstriction. As fenoterol possesses bronchodilation effects, we studied
      the efficacy of fenoterol pretreatment on the increased resistance of total
      respiratory system (Rrs) caused by reflex bronchoconstriction in endotracheal
      intubation. METHODS: Fifty patients were randomly allocated into two groups;
      group A (n = 25) with fenoterol inhaled and group B (n = 25) with placebo inhaled
      10 min before induction. Patients were induced with sodium thiopental and
      vecuronium and resistance was measured 2 and 5 min after intubation with a Bicore
      pulmonary function monitor. Suctioning of the airway was performed 1 min before
      each measurement. Patients were further categorized into four conditions by
      smoking history and the presence of sputum in the suctionings. Condition I
      included patients that were smokers with no sputum collected. Condition II had
      non-smokers with no sputum collected. Condition III had patients with sputum
      collected but with no smoking history and condition IV were patients who had
      sputum collected and had a smoking history. RESULTS: Patient who received
      fenoterol have significant lower total respiratory after intubation than those
      receiving placebo. There were no significant differences in post-intubation Rrs
      between smokers and non-smokers. Patients with sputum had the highest resistance
      after intubation with the placebo group. Heart rate and blood pressure were
      augmented in both groups. CONCLUSIONS: Fenoterol pretreatment produced lower post
      intubation Rrs after intubation when compared with the placebo group suggesting
      of a protective effect in vagal mediated bronchoconstriction.

PMID- 7788199
TI  - [Arytenoid subluxation following endotracheal intubation--a case report].
AB  - A previously healthy 39-yr-old man was scheduled for exploratory laparotomy due
      to acute abdomen. There was no sign of difficult intubation. After induction of
      anesthesia with thiopental and succinylcholine, the trachea was easily intubated
      with a 7.0 mm cuffed endotracheal tube. Surgery for a ruptured appendix with 2
      drainage tubes lasted for 75 min was uneventful. At the end of surgery, the
      endotracheal tube was removed without difficulty. On the 1st postoperative day,
      the patient developed stridor. The symptom persisted even after conservative
      treatment and removal of NG tube. On the 12th postoperative day, a telescopic
      videolarygoscopy revealed immobile right vocal cord with anterior and medial
      displacement to the right. Arytenoid cartilage was moderately edematous. A
      diagnosis of right arytenoid subluxation was then made. On the 17th postoperative
      day, a closed reduction of right arytenoid cartilage using direct laryngoscope
      was performed successively under general anesthesia. Eight weeks after the
      reduction, his voice and laryngoscopic findings were normal. There has been only
      18 reports with 27 cases of this complication found in the literature. However,
      it is generally believed that it is not so unusual. The post-intubation
      syndromes, such as sore throat, dysphonia, odynophagia, difficulty in swallowing
      or breathing which persists beyond 5 days warrant ENT consultation. Abnormal
      mobility of vocal cord, edema over arytenoid area found by indirect laryngoscopy
      should suggest the complication. Further confirmation is then needed. Although
      the result of our case is good, the reduction should ideally be done within 24-48
      h after the incidence to avoid unfavorable long-term sequelae.

PMID- 7788205
TI  - [The history and present status of biotechnology in the Czech Republic].
AB  - The paper outlines the historical milestones in the development of biotechnology
      in the Czech Republic in the fields of research, education and manufacture. The
      section dealing with the present state describes fundamental research carried out
      in the institutes of the Academy of Sciences of the Czech Republic and the
      universities and technical colleges, the institutes of applied research
      subsidized by the pertinent ministries as well as privatized institutes. The
      numbers of institutes and researchers before and after the political changes in
      1989 are compared and the grant agencies for support of science and research are
      listed. The section dealing with biotechnological industry characterizes the
      firms manufacturing the products and devices for pharmacy, agriculture, food
      industry and ecology.

PMID- 7788206
TI  - [Pharmaceutical services in theory and practice in the Czech Republic].

PMID- 7788208
TI  - Bungee running: a further report.
AB  - Further to the report from Queen Mary's NHS Trust on bungee running affecting
      children, we present three cases of injury in adults. Two cases of injury
      presented to Noble's (Isle of Man) Hospital and one to Whiston Hospital,
      Merseyside. In all three cases, the competitors were trying to stretch the
      'bungee' to grasp a pint of beer as a prize, much enthusiasm being shown by
      spectators. All injuries occurred when the competitors were catapulted backwards
      with some force.

PMID- 7788207
TI  - Surgical stabilization of spondylolisthesis in a wrestler.
AB  - Sporting activity in wrestlers operated on for spondylolisthesis is not well
      documented in the literature. We present the case of a wrestler with a grade I L5
      S1 spondylolisthesis who was L4-S1 arthrodesed due to pain not relieved by
      conservative methods. One year after surgery he had returned to full wrestling
      activity, including competitions. Two years later, he continues to wrestle at the
      same level of competition.

PMID- 7788209
TI  - Physical and physiological profiles of Malaysian dragon boat rowers.
AB  - Maximal oxygen consumption (VO2max) and maximal workload attained (WLmax) were
      determined in 28 Malaysian dragon boat rowers who were exercised to exhaustion on
      an arm ergometer. Mean VO2max was 2.75 l min-1 at a mean WLmax of 195.5 W.
      Anaerobic endurance power of the arms, determined by cranking at 100 RPM at a
      workload of 400 W and the time taken to maintain the cadence until it fell to 75
      RPM, was 34.9(+/- 2.3) s. Leg performance, as determined by standing long jump
      and vertical jump, was 140.0(+/- 4.5) kg m and 100.3(+/- 3.1) kg m s-1
      respectively. Right hand grip strength was significantly (p < 0.001) greater than
      the left hand. Percentage body fat of the rowers was 11.8(+/- 0.6)%. These values
      represent the first measurements of their kind performed on dragon boat rowers in
      Malaysia.

PMID- 7788210
TI  - Do the competition rules of synchronized swimming encourage undesirable levels of
      hypoxia?
AB  - Recent anecdotal reports that some synchronized swimmers have become dizzy or
      disorientated towards the end of their performance, and in the worst cases
      fainted underwater, have caused concern. However, the rules of synchronized
      swimming encourage slow performance of compulsory figures, and an analysis of the
      competition placings and duration of underwater sequences showed that the highest
      rankings were gained by slowly performed compulsory figures and free programmes
      containing a long underwater sequence. The combination of breath-holding and the
      vigorous exercise involved suggests that some of the symptoms complained of by
      the swimmers might be due to hypoxia. We therefore studied the alveolar gas
      tensions in nine members of the Great Britain National Squad immediately
      following the performance of set figures and the initial underwater sequence of
      their free routine in a swimming-bath. All were cyanosed after the underwater
      sequences of the free routine and reported being mildly confused. The mean(s.d.)
      alveolar PO2 at this stage was 5.07(1.1) KPa, while three girls had an alveolar
      PO2 below 4 KPa, the lowest being 3.67 KPa. These gas tensions suggest that
      potentially dangerous levels of hypoxia may develop during competitive
      synchronized swimming and that prolonged underwent sequences should not be
      encouraged.

PMID- 7788212
TI  - Monitoring altitude acclimatization--a case study of an elite woman athlete.
AB  - A simple study monitoring altitude acclimatization, which is not intrusive to the
      athlete's training, is described. Particular attention is drawn to the change in
      production of lactate in response to steady state exercise, before and after
      altitude. The results suggest that a more thorough assessment of aerobic ability
      at altitude is required than that described in the British Association of Sports
      and Exercise Science (BASES) guidelines. It is also relevant to note that
      elevations in haemoglobin, promoted by altitude, can mask iron abnormalities. It
      is therefore recommended to assay for iron in addition to haemoglobin.

PMID- 7788211
TI  - Prediction of endurance running performance for middle-aged and older runners.
AB  - The purpose of this study was to develop regression equations that would
      sufficiently predict the endurance running performance (ERP) of middle-aged and
      older runners (n = 55, 43-79 years). Among many independent variables which were
      selected as possible predictors of the ERP, oxygen uptake corresponding to the
      lactate threshold (VO2@LT), or age was found to be the single best predictor.
      Some variables representing training habits correlated significantly but only
      moderately with the ERP. Linear multiple regression equations developed in this
      study were: V5km = 4.203 + 0.054X1 - 0.028X2 (r = 0.87) V5km = 4.436 + 0.045X1 -
      0.033X2 + 0.005X3 (r = 0.89) V10km = 4.252 + 0.042X1 - 0.026X2 (r = 0.79) V10km =
      4.371 + 0.037X1 - 0.031X2 + 0.005X3 (r = 0.82) VM = 3.207 + 0.048X1 - 0.022X2 (r
      = 0.91) VM = 3.707 + 0.038X1 - 0.031X2 + 0.005X3 (r = 0.93) where V5km, V10km and
      VM are the mean running velocity at 5 km, 10 km and marathon races, respectively,
      and X1 = VO2@LT (ml kg-1 min-1), X2 = age (year), and X3 = average running
      duration per workout (min). We suggest that the ERP of middle-aged and older
      runners can be predicted from a linear combination of VO2@LT and age or a
      combination of these variables plus average running duration per workout.

PMID- 7788214
TI  - At last?

PMID- 7788213
TI  - Amino acid metabolism in tennis and its possible influence on the neuroendocrine
      system.
AB  - To investigate amino acid metabolism during endurance exercise as well as its
      influence on plasma prolactin (PRL) we subjected eight nationally ranked tennis
      players (mean(s.d.) age 25.6(2.8) years, mean(s.d.) weight 83.9(5.7) kg,
      mean(s.d.) height 184.4(4.6) cm) to 4h of continuous tournament tennis. Venous
      and capillary blood samples were taken before and after the exercise. Amino acids
      were measured by HPLC-fluorescence detection as o-phthalaldehyde derivatives;
      nonesterified fatty acids (NEFA), ammonia, total protein, glucose insulin and PRL
      by enzymatic methods. Exercise caused a decline of branched-chain amino acids
      (BCAA) by 28(14)%. Elevation of NEFA resulted in a significant mean(s.d.)
      increase of free tryptophan (TRP) (9.7(2.6) [pmol/microliter] vs 17.8(6.4)
      [pmol/microliter]. The mean(s.d.) ratio of free TRP:BCAA increased by 165%(90)
      which favours entry of free TRP into the brain. However, PRL did not change
      significantly. We conclude that during long-lasting interval sports BCAA
      contribute as energy substrates. Alterations in competition of amino acids at the
      blood-brain barrier favour entry of free TRP into the brain. PRL changes cannot
      be explained by the increase in plasma level of free TRP or the ratio of free
      TRP:BCAA.

PMID- 7788215
TI  - Pain and pain tolerance in professional ballet dancers.
AB  - Pain experience in sport had been the subject of increasing research in recent
      years. While sports professionals have generally been found to have higher pain
      thresholds than control subjects the reasons for this are not entirely clear. The
      present study seeks to investigate one possible explanatory factor, the
      importance of the popular image of the physical activity and of the self-image of
      its participants, by examining pain experience in professional ballet dancers.
      Like sports professionals, dancers were found to have higher pain and pain
      tolerance thresholds than age matched controls in the Cold Pressor Test. However,
      they also reported a more acute experience of the sensory aspects of the pain.
      Explanations of this apparent paradox are discussed both in terms of the
      neuroticism scores of the two groups and in terms of the dancers' greater
      experience of pain and its relationship with physical activity. The results
      illustrated the importance of using multidimensional measures of pain in this
      type of investigation.

PMID- 7788216
TI  - Personal health benefits of Masters athletics competition.
AB  - Questionnaires (750 respondents, 44.4% response rate) examined the long-term
      health value of endurance exercise training in older age-classed competitors
      ('Masters Athletes', 551 men and 199 women) over a 7-year period (1985-1992). The
      majority had initially completed maximal exercise tests. The weekly time devoted
      to training, competition and exercise-related travel was 10 to 30 h, and the
      annual expenditure on clothing, equipment and entrance fees was typically in the
      range Canadian $500-1500. Despite their age (mean(s.d.) 58(10), current range 40
      81 years), only 1.4% reported sustaining a non-fatal heart attack and 0.6% had
      required bypass surgery over the 7-year interval. The majority (90%) were very
      interested in good health; 76% considered themselves as less vulnerable to viral
      illnesses than their peers, and 68% regarded their quality of life as much better
      than that of their sedentary friends. The majority of former smokers had stopped
      smoking before they began training, but 37% indicated that exercise had helped
      them in smoking withdrawal. In keeping with their health-conscious attitude, 59%
      had regular medical check-ups, and 86% obeyed legislation requiring use of a seat
      belt when driving. In contrast with many older people, 88% slept well or very
      well. Slightly over half of the sample (57%) had sustained some injury which had
      limited their training for one or more weeks over the 7-year study. Although
      participation in Masters competition appears to carry considerable health
      benefits, gains may in part reflect an overall healthy lifestyle.

PMID- 7788217
TI  - The physiological demands of Gaelic football.
AB  - Match-lay demands of Gaelic football and fitness profiles were assessed at club
      competitive level. English Gaelic football club championship players (n = 11)
      were assessed for anthropometry, leg strength and time to exhaustion on a
      treadmill run. A similar test battery was administered to a reference group of
      University competitive soccer players (n = 12). Heart rate was recorded during
      match-play using radio telemetry and blood lactate concentrations were determined
      at half-time and after full-time. No differences (p > 0.05) were observed between
      the Gaelic and soccer players in: body mass (70.7 +/- 10.3 vs 76.6 +/- 10.3 kg);
      height (176 +/- 5.9 vs 177.7 +/- 6.4 cm); leg to trunk ratio (0.53 +/- 0.01 vs
      0.54 +/- 0.03); adiposity (12.2 +/- 2.1 vs 13.5 +/- 3.2% body fat); mean
      somatotype (2.8 - 4.3-2.0 vs 2.4-4.2-2.4); leg strength measures; and performance
      on the treadmill. The percentage muscle mass values were lower for the Gaelic
      players compared to the soccer players (41.9 +/- 5.4 vs 47.3 +/- 5.2%; p >
      0.005). For the Gaelic and soccer players, respectively, mean heart rate recorded
      during each half of match-play were (157 +/- 10 and 158 +/- 12 beats/min) and
      (164 +/- 10 and 157 +/- 11 beats/min), whilst blood lactates measured at the end
      of each half, were (4.3 +/- 1 and 3.4 +/- 1.6 mmol/l) and (4.4 +/- 1.2 and 4.5 +/
      2.1 mmol/l). Gaelic footballers at English club championship level seem to
      exhibit similar fitness profiles, and are subject to broadly similar
      physiological demands as University-level competitive soccer players.

PMID- 7788218
TI  - The estimation of body density in rugby union football players.
AB  - The general regression equation of Durnin and Womersley for estimating body
      density from skinfold thicknesses in young men, was examined by comparing the
      estimated density from this equation, with the measured density of a group of 45
      rugby union players of similar age. Body density was measured by hydrostatic
      weighing with simultaneous measurement of residual volume. Additional
      measurements included stature, body mass and skinfold thicknesses at the biceps,
      triceps, subscapular and suprailiac sites. The estimated density was
      significantly different from the measured density (P < 0.001), equivalent to a
      mean overestimation of relative fat of approximately 4%. A new set of prediction
      equations for estimating density was formulated from linear regression using the
      logarithm of single and sums of skinfold thicknesses. Equations were derived from
      a validation sample (n = 22) and tested on a crossvalidation sample (n = 23). The
      standard error of the estimate (s.e.e.) of the equations ranged from 0.0058 to
      0.0062 g ml-1. The derived equations were successfully crossvalidated.
      Differences between measured and estimated densities were not significant (P >
      0.05), total errors ranging from 0.0067 to 0.0092 g ml-1. An exploratory
      assessment was also made of the effect of fatness and aerobic fitness on the
      prediction equations. The equations should be applied to players of similar age
      and playing ability, and for the purpose of identifying group characteristics.
      Application of the equations to individuals may give rise to errors of between 
      3.9% to +2.5% total body fat in two-thirds of cases.

PMID- 7788219
TI  - Implications of health and safety legislation for the professional sportsperson.
AB  - There are a large number of injuries in most professional sports every year, and
      research interest has usually centred around the medical aspects of these
      injuries. However, health and safety legislation also applies to professional
      sport, and it is important, as with any other occupation, to understand the
      underlying causes of the incidents leading to the injuries and to take steps to
      minimize future injuries. The introduction of the Management of Health and Safety
      at Work Regulations 1992 formalized a risk assessment approach to health and
      safety issues; an approach that has always been implicit in the Health and Safety
      at Work etc. Act 1974. This review assesses how the relevant UK health and safety
      legislation impacts on the professional sportsperson.

PMID- 7788220
TI  - Validity of conventional anthropometric techniques for predicting body
      composition in healthy Chinese adults.
AB  - There is little information on the application of generalized prediction
      equations to ethnic groups other than Europeans and groups of European descent.
      The purpose of this study was to crossvalidate conventional equations on a group
      of 56 Chinese adults. Body density was assessed by underwater weighing and also
      predicted by equations which use a combination of selected skinfolds-biceps,
      triceps, pectoral, subscapular, abdominal, suprailiac, thigh and calf. There were
      significant correlations (P < 0.01) between the various methods of predicting
      percentage fat. However, analysis of variance revealed significant differences (P
      < 0.01) between mean values. In the men, the Jackson and Pollock equation
      underestimated, and the Durnin and Womersley equation overestimated, the
      percentage fat predicted by underwater weighing. The best predictor site in this
      group was the medial calf skinfold (r = 0.81), which is not included in either
      equation. In the women, the best predictor sites were the triceps, suprailiac and
      thigh. As these sites are also used in the Jackson et al. equation, it is not
      surprising that there was no difference between the prediction of percentage fat
      by this equation and underwent weight. It is concluded that the Durnin and
      Womersley and Jackson and Pollock equations tend to overestimate and
      underestimate, respectively, the percentage fat in Chinese men. Alternative
      equations which use the calf skinfold may be more appropriate for this ethnic
      group. In Chinese women, there appears to be good agreement between Jackson and
      Pollock and hydrodensitometric estimations of percentage fat.

PMID- 7788221
TI  - Rating of perceived exertion and heart rate relative to ventilatory threshold in
      women.
AB  - Forty women took part in a study designed to investigate self-selected exercise
      intensity relative to ventilatory threshold during circuit weight training (CWT)
      and exercise-to-music (ETM) sessions. Subjects were assigned to one of two groups
      which were beginners (B) or habitual exercisers (HE) on the basis of their
      exercise habits. All subjects first underwent a laboratory cycle ergometer test
      involving a continuous incremental exercise protocol from which ventilatory
      threshold (VT) was determined using piecewise linear regression analysis. This
      point was expressed in terms of heart rate (VTHR) and rating of perceived
      exertion (VTRPE). These points were then compared with those determined during
      exercise training sessions (TRAHR and TRARPE respectively). The results showed
      that mean(s.d.) TRARPE (13.5(1.1) was not significantly different to mean(s.d.)
      VTRPE (12.8(0.5); P > 0.05) but that mean(s.d.) VTHR (134.8(13.5) beats min-1)
      and TRAHR (154.9(12.0) beats min-1) were different (P < 0.05). Beginners trained
      at a significantly higher percentage above VTHR than habitual exercisers
      (118(3.1) versus 111(2.8)% P < 0.05). During CWT the mean(s.d.) TRAHR for
      beginners (143.2(7.6) beats min-1) was significantly lower than that for habitual
      exercisers (152.5(10.1) beats min-1; P < 0.05), but not different during ETM (P <
      0.05). When these TRAHR values were expressed relative to an estimated maximum
      heart rate (EMHR) they represented 86.5% in ETM and 80.5% in CWT which were
      different (P < 0.05). These results suggest that regardless of habitual exercise
      level and training mode, these women selected a common intensity of effort that
      was compatible with the described RPE.

PMID- 7788222
TI  - Leucocyte and erythrocyte counts during a multi-stage cycling race ('the Milk
      Race').
AB  - Venous blood samples were taken from eight competitors in mid-evening after a
      racing day, and in the early morning before the next day's race, three times
      during the course of the Milk Race, 1992. These were used to gather information
      about the changes in circulating leucocyte levels in response to the
      exceptionally high sustained daily workload required during a major multi-stage
      race. The primary objective was to provide knowledge of 'normal' values against
      which future clinical judgements of abnormality might be made in these unusual
      circumstances. During the race, estimated energy output was about 25 MJ (6000
      kCal)/day. The mean total circulating leucocyte numbers (per litre of blood), and
      those of individual leucocyte classes (neutrophil, lymphocyte, monocyte,
      eosinophil and basophil) were all inside the normal range both in the morning and
      in the evening. Evening counts were, however, 30-50% higher than morning counts,
      for all classes except eosinophils. We conclude that individual clinical
      decisions about leucocyte levels can best be made using normal (sedentary man)
      values if a morning sample is taken.

PMID- 7788224
TI  - Sports medicine on the line?

PMID- 7788223
TI  - Reproducibility of cardiorespiratory measurements during submaximal and maximal
      running in children.
AB  - With the increased use of oxygen consumption measurements in clinical and
      sporting studies, measurement variability has become more important to both the
      paediatric clinician and the sports scientist. In this study we assessed the
      reproducibility of cardiorespiratory measurements during submaximal and maximal
      running in children. Ten healthy, physically active boys (mean(s.d.) age
      10.7(0.71) years) performed two submaximal and two maximal running tests within a
      4 week period. The submaximal protocol consisted of three 6 minute runs at 7.2,
      8.0 and 8.8 km/h. Every attempt was made to minimize the sources of non
      biological variability at each testing session. During submaximal exercise,
      oxygen consumption (VO2), heart rate (HR) and fractional utilization appeared to
      be the most reliable measures accounting for over two-thirds of the total
      variation (coefficients of reliability (CR) of 68%, 94% and 82% respectively).
      Ventilation (Ve) and respiratory exchange ratio (RER) proved to be only
      moderately reliable accounting for less than half of the total variation (CR 50%
      and 45% respectively). At maximal exercise, VO2, Ve and time to exhaustion were
      most reliable, accounting for approximately two-thirds of the total variation (CR
      65%, 63% and 63% respectively). Within this test environment, a two visit
      submaximal assessment was capable of estimating VO2 with a standard error of +/-
      1.25 ml/kg/min. Similarly, for maximal testing a two visit assessment estimated
      peak VO2 with a standard error of +/- 2.28 ml/kg/min. On the evidence of these
      results a two visit assessment for submaximal and maximal exercise testing seems
      adequate to estimate the stability of submaximal cardiorespiratory measures and
      peak VO2 in healthy, normally active boys.

PMID- 7788225
TI  - Some experiments upon the biological effects of fast neutrons. 1940.

PMID- 7788226
TI  - Predicting local recurrence by correlating pre-operative mammographic findings
      with pathological risk factors in patients with breast cancer.
AB  - The pre-operative mammograms for 231 patients undergoing conservation surgery for
      breast cancer between March 1988 and September 1992 were analysed for features
      that may predict the presence of pathological risk factors of local recurrence
      (residual microscopic disease, extensive intraduct carcinoma (EIC) and
      lymphatic/vascular invasion). Residual microscopic disease was detected in 40% of
      patients and was associated with a DY mammographic pattern (p = 0.03), casting
      calcification (p = 0.0002) and absence of mammographic nidus (p = 0.0006).
      Residual microscopic disease was found in 75-88.9% of patients when two of these
      preoperative mammographic features were present in combination. The mean
      lumpectomy diameter was significantly smaller for patients with DY compared to N1
      mammographic pattern on Wolfe grade (p = 0.039). Both residual disease and Wolfe
      grade were related to age (p = 0.0032 and p < 0.0001). EIC was found in 22% of
      patients and was associated with casting (p < 0.0001) and non-casting (p = 0.04)
      calcification, absence of mammographic nidus (p < 0.0001) and stellate
      mammographic nidus (p = 0.02). No significant association was found between
      mammographic features and lymphatic/vascular invasion. Pre-operative mammographic
      features can predict patients likely to have residual microscopic disease or EIC
      following conservation surgery for breast cancer. These patients should be
      selected for wider primary excision.

PMID- 7788227
TI  - Mammographic features of invasive lobular and invasive ductal carcinoma of the
      breast: a comparative analysis.
AB  - The mammographic appearances of 86 invasive lobular carcinomas were compared with
      those of 86 invasive ductal carcinomas of no special type matched for age, size
      and stage. There was no significant difference in the frequency of a mammographic
      abnormality consistent with malignancy between the lobular carcinoma (90%) and
      ductal carcinoma (96%) groups. A spiculate mass was the commonest feature in both
      groups (69% and 63%, respectively). There were no differences in the imaging
      features of masses in the two groups. In the lobular carcinoma group any
      mammographic abnormality was more likely to be seen on only one view and
      calcifications were less frequently observed. Multiple lesions were more frequent
      in the ductal carcinoma group. However, although these differences appeared to
      reach statistical significance, as they were only apparent in a study with a
      large number of comparisons, it is unlikely that these differences are
      practically significant. Analysis of the lobular invasive group failed to
      demonstrate any significant differences in the imaging features of the classical
      and mixed sub-types, a spiculate mass being the most common single abnormality in
      both. No mammographic differences of practical use to distinguish invasive
      lobular from invasive ductal carcinoma of no special type were demonstrated.

PMID- 7788228
TI  - Ultrasound of the Achilles tendon after surgical repair: morphology and function.
AB  - Ultrasound is a well established method for the examination of the Achilles
      tendon. The objective of the study was to provide answers to the following
      questions: What ultrasonographic structural changes are long lasting after
      surgical repair? How important is ultrasound with regards to the functional
      evaluation of late results? 60 patients were examined at an average 11 years (2
      19) after surgical repair of Achilles tendon rupture. In only four patients
      sonographic morphology of the tendon was according to the non-injured side. A
      variety of distinct basic alterations in ultrasound morphology was found: a
      hypoechogenic ribbon ventrally to the dorsal paratenon (n = 40), spots of
      hypoechogenic areas in the tendon (n = 18), dishomogeneous hyperechogenicity with
      preservation (n = 12) or dissolving (n = 22) of its fibrillar components along
      the longitudinal axis. In most of the cases the paratenon was thickened or could
      not be differentiated. In the dynamic ultrasound examination gliding mechanism of
      the achilles tendon was limited in 41 patients. Extensive functional subjective
      and objective parameters of all patients were evaluated in an Achilles tendon
      score. The results were rated as excellent (n = 18), good (n = 29), satisfactory
      (n = 12) and poor (n = 1). There was no statistical correlation between
      ultrasound morphology and clinical outcome. Therefore, it was concluded that
      ultrasound examination is able to reveal long-lasting alterations in echogenicity
      of the tendon but is only of limited value with regards to evaluation of the
      functional results after surgical repair.

PMID- 7788229
TI  - Prediction of gall stone composition by ultrasound: implications for non-surgical
      therapy.
AB  - Oral cholecystography is the basic radiodiagnostic procedure required to assess
      chemical composition of gallstones as well as functional status of gall bladder
      prior to non-surgical management of gallstones. However, the value of ultrasound
      in non-surgical management of gallstones is yet to be proved. In this study we
      attempt to establish sonographic criteria which will predict the composition of
      gallstones prior to their non-surgical treatment. For this purpose the
      ultrasonographic characteristics of 233 patients with gallstone disease and
      functioning gall bladders were studied and an effort was made to correlate
      cholesterol and calcium content of different types of stones (as estimated by X
      Ray powder diffraction study and atomic absorption spectrophotometry) with their
      ultrasonographic characteristics. Sonographic criteria for the presence of
      cholesterol stones were those which were floating and gallstones producing
      acoustic shadowing without internal echoes from within the stone. In detecting
      findings which would predict the presence of cholesterol stones on ultrasound,
      ultrasound had a sensitivity of 72.90% and a specificity of 100%. The predictive
      values of positive findings and negative findings were 100% and 93.4%,
      respectively. The demonstration of typical features of cholesterol stones on
      ultrasound obviates the need for oral cholecystography.

PMID- 7788230
TI  - Magnetic resonance imaging in the detection of focal liver lesions: comparison of
      dynamic contrast-enhanced TurboFLASH and T2 weighted spin echo images.
AB  - In a previous study using dynamic contrast-enhanced TurboFLASH (DCETF) for
      demonstration of the portal venous system we found that this technique showed
      more liver lesions than T2 weighted spin echo (T2WSE) imaging in the same
      patients. In this study we have formally compared axial T2WSE images (TR 2000, TE
      45/90) with TurboFLASH images (TR 135, TE 4, FA 80 degrees) acquired immediately
      after bolus injection of Gd-DTPA (0.1 mmol kg-1) in 41 patients referred for
      hepatic magnetic resonance imaging (MRI) prior to surgery for liver lesions. The
      images of each sequence were independently reviewed by two observers. The lesions
      were counted and each sequence was scored for conspicuity, level of artefact and
      subjective image quality. Contrast-to-noise ratios using user defined regions of
      interest were calculated. Significantly more lesions were seen on DCETF (n = 186)
      images than on T2WSE (n = 123) images (p < 0.001). Lesion conspicuity was equal
      in 53% of cases, better on DCETF in 36% and better on T2WSE in 11%. Contrast-to
      noise ratios were significantly higher on DCETF images (p < 0.05). DCETF imaging
      provided a substantial improvement in lesion detection compared with T2WSE
      imaging.

PMID- 7788231
TI  - Measurement of human pancreatic perfusion using dynamic computed tomography with
      perfusion imaging.
AB  - Absolute quantification of pancreatic perfusion in man has been extremely
      difficult to date. This paper describes a relatively simple application of
      dynamic computed tomography to provide perfusion imaging of the human pancreas.
      Values for perfusion in eight normal pancreases ranged between 1.25 and 1.66 ml
      min-1 ml-1 (mean: 1.52 ml min-1 ml-1). Increased perfusion values were present in
      a patient with an islet cell tumour (overall perfusion 2.11 ml min-1 ml-1) and a
      patient with Wilson's disease (3.43 ml min-1 ml-1). Pancreatic perfusion was
      reduced in a patient with diabetes (0.60 ml min-1 ml-1) and in a failing
      pancreatic transplant (0.97 ml min-1 ml-1). The combination of functional
      information and good spatial detail afforded by computed tomography (CT)
      perfusion imaging means the technique is well suited for the evaluation of the
      human pancreas. It is currently the only technique which allows non-invasive
      absolute quantification of pancreatic perfusion.

PMID- 7788232
TI  - Ultrasound in the evaluation of osteoporosis: a comparison with bone mineral
      density at distal radius.
AB  - It is proven that, from a technical point of view, ultrasound transmission
      velocity (UTV) measurement can easily be taken at the distal end of the radius.
      The reproducibility of UTV is good (coefficient of variation 0.3% intraoperator
      and 0.5% interoperator). 248 normal and 65 osteoporotic women were then studied
      to establish the range of UTV values and to compare the ability of UTV and bone
      mineral density (BMD) measurement, taken at the same skeletal sites, to detect
      osteoporotic fragility. Osteoporosis was defined by the presence of atraumatic
      vertebral fractures on an X-ray of the spine. Ultrasound velocity averaged 1570.5
      +/- 43.3 m s-1 in normal and 1519.2 +/- 15.2 m s-1 in osteoporotic women; the
      difference is also statistically significant (p < 0.01) for BMD. Both BMD and UTV
      decline after menopause and are significantly correlated with age. A weak
      correlation (r = 0.68) was found between UTV and BMD; this supports the thesis
      that ultrasound velocity measures bone mass as well as other fragility components
      of bone distinct from the decrease of mass. Receiver operating characteristic
      (ROC) curve analysis showed that UTV discriminates between normal and
      osteoporotic patients at least as well as radial BMD, indicating that UTV is a
      new available diagnostic modality which can be used to screen osteoporotic
      subjects.

PMID- 7788234
TI  - Entrance doses during lateral lumbar spine and antero-posterior abdomen
      examinations: generator waveform dependence.
AB  - In North Trent, UK, an entrance dose survey of lateral lumbar spine and antero
      posterior (AP) abdomen examinations has been carried out in 17 radiology
      departments. The survey comprised 294 lateral lumbar spine and 322 AP abdomen
      entrance dose measurements. The mean entrance doses were found to be
      approximately half of the relevant national reference entrance dose levels of 30
      mGy and 10 mGy, respectively. The effect of generator waveform on entrance dose
      was studied by separating the generators into two types: "pulsating potential"
      (PP) generators and "constant potential" (CP) generators for each examination. PP
      generators comprised 23% of the total number of examinations. The mean entrance
      dose and radiographic exposure factors from CP generators were found to be
      significantly lower than those from PP generators. The use of CP type generators,
      together with low attenuation components can significantly reduce patient
      entrance doses for these examinations.

PMID- 7788233
TI  - Dosimetric considerations in 131I-MIBG therapy for neuroblastoma in children.
AB  - Dosimetric calculations have been made for organ doses in patients receiving 131I
      MIBG therapy as treatment for neuroblastoma. As well as whole body and liver
      dose, consideration has been given to dosimetry of organs (lung, urinary bladder)
      whose tolerance may become treatment limiting when 131I-MIBG is given as part of
      combined modality therapy. Data from both adults and children receiving
      radiolabelled MIBG for diagnostic or therapeutic purposes have been compared in
      constructing dosimetry models for children. A recently published urodynamic model
      has been used in the estimation of radiation dose to the bladder. The results
      show that liver and lung may receive doses greater than the average total body
      dose (0.58 mGy MBq-1 and 0.35 mGy MBq-1, respectively, as compared with 0.25 mGy
      MBq-1 to the whole body). The organ dose estimates do not differ greatly from
      previous analyses except in the case of the bladder for which the new modelling
      studies have resulted in lower dose estimates (0.76 mGy MBq-1 administered, for
      dose to bladder surface from bladder contents) than in some published series.
      This may result from differing assumptions regarding parameters such as bladder
      content and urine flow rate, an enhanced fluid intake being assumed in the
      present bladder dose estimates. Average doses to the bladder wall from the
      contents were estimated to be 7.4-11.3% of the surface doses. The urodynamic
      modelling analysis shows that the bladder could receive a much greater dose (by
      an order of magnitude) in patients who were inadequately hydrated or had impaired
      renal function.

PMID- 7788235
TI  - Patient and staff dosimetry in neuroradiological procedures.
AB  - Cerebral angiography provides valuable information for use in the clinical
      management of patients but can result in relatively high radiation doses to
      patients and staff due to the extended fluoroscopy time and number of images
      acquired during an examination. In this study, extremity doses to radiologists
      and scrub nurses working in a neuroradiological centre were monitored during a 3
      month period using thermoluminescent dosemeters (TLDs). Electronic personal
      dosemeters were also used to monitor doses above the lead apron at chest height
      to the radiologists, radiographers and the scrub nurses. Patient doses were
      recorded using a dose-area product meter whilst patient thyroid dose was measured
      using TLDs. Two types of examination were studied: cerebral angiography and
      arterial embolization. It was deduced from the results of the study that the
      radiologist may expect to receive a mean dose above the lead apron at chest
      height of 11 microSv and 25 microSv per examination when performing cerebral
      angiography and arterial embolization, respectively. A radiologist mean hand dose
      of 19.3 microSv per examination was found, whilst the average eye dose for both
      radiologist and scrub nurse was 13.4 microSv per examination. The patient
      dosimetry results revealed a mean thyroid dose of 1.7 mSv and a dose-area product
      of 48.5 Gy cm2 for cerebral angiography. Average dose-area product for arterial
      embolization was 122.2 Gy cm2 along with a mean patient thyroid dose of 3.3 mSv.
      More detailed patient dosimetry was also performed using a Rando anthropomorphic
      phantom loaded with TLDs to measure organ doses and hence estimate effective
      dose. A typical four vessel angiogram was found to result in a patient effective
      dose of 3.6 mSv.

PMID- 7788236
TI  - Assessment of organ radiation doses and associated risk for digital bifemoral
      arteriography.
AB  - An assessment has been made of the absorbed dose associated with femoral
      arteriography using a digital imaging system. A bilateral femoral arteriogram was
      performed on 17 patients, using a filmless 1024 matrix digital image acquisition
      system with a discrete stepping tube-stand and 40 cm image intensifier. A
      standardized protocol of manual patient/tube-stand positioning under fluoroscopic
      control and automatic stepping digital acquisition was followed. Skin entry doses
      were measured with a dose-area product meter for each stage of the procedure, and
      the total gonad dose was assessed with thermoluminescent dosimeters (TLDs).
      Published Monte Carlo simulations were supplemented with further calculations to
      evaluate organ doses from the dose-area products measured. Comparison with the
      TLD measurements indicated that this technique over-estimated organ doses by
      about 30%. A mean effective dose of 3.1 +/- 1.8 mSv was calculated for the
      procedure, with the greatest dose burden being imposed by fluoroscopy during
      catheter manipulation. The related radiation detriment is 0.018%, which is
      insignificant when compared with the overall mortality from peripheral vascular
      disease.

PMID- 7788237
TI  - Analysis of patient doses for myelogram and discogram examinations and their
      reduction through changes in equipment set-up.
AB  - Patient doses for myelogram and discogram examinations performed on two C-arm X
      ray units have been measured using dose-area product meters. Contributions to the
      dose from fluoroscopy and radiography have been obtained from analysis of results
      for a selection of examinations. Information was recorded about the individual
      beam projections used, in order to allow estimates of effective dose. Effective
      doses for lumbar myelograms were 3-4 mSv and for cervical myelograms and
      discograms were 1 mSv. The doses on the two units were similar, but contributions
      from the various parts of the examinations were different. Quality assurance (QA)
      measurements of dose variables were used to determine reasons for these
      differences in performance. Fluoroscopic doses are influenced by image
      intensifier dose rate and by the way in which exposure factor selection has been
      set up for the automatic exposure control (AEC) system. Doses from digital
      fluorography on units for specialized applications may be greater than those with
      standard film/screen systems. Recommendations have been made concerning ways in
      which doses on each unit might be reduced. Detailed assessments of doses
      resulting from AEC set-up options, made during QA tests, can help to ensure that
      the optimum balance between patient dose and image quality is achieved.

PMID- 7788238
TI  - Technical note: compression stockings and posture: a comparative study of their
      effects on the proximal deep veins of the leg at rest.
AB  - Graduated compression stockings have been shown to reduce the incidence of deep
      venous thrombosis. While they are thought to act primarily by increasing venous
      flow velocity, their mode of action remains uncertain. Doppler ultrasound was
      employed to study the relative effects of three types of support stocking on the
      deep venous diameter, flow velocity and pulsatility in 10 non-pregnant female
      subjects. In addition, the effect of altered posture on the same parameters was
      assessed. Significant effects of the graduated stockings were found at the level
      of the popliteal vein, where a reduction in both the diameter and the amplitude
      of respiratory phasicity was recorded (p < 0.05). No significant increase in flow
      velocities was recorded. Adopting the left lateral position significantly
      increased flow velocity in the right common femoral vein (p < 0.05). The
      application of stockings in this position produced no additional increase in flow
      velocities, but did alter the amplitude of respiratory phasicity. These data do
      not support the widely held view that graduated compression stockings increase
      flow velocities at rest. Adopting a lateral recumbent position significantly
      increases flow velocity in the non-dependent leg.

PMID- 7788239
TI  - Technical note: maxillofacial biomodelling--preliminary result.
AB  - A new technique of manufacturing three-dimensional (3D) hard tissue biomodels is
      described. The models, derived from computed tomography data, were constructed by
      a computer-controlled manufacturing device known as stereolithography apparatus
      (SLA). Selected cases of patients with facial deformities were presented to
      illustrate clinical applications of the SLA biomodelling. Physical demonstration
      of the bony internal anatomy in these patients promoted better conceptualization
      of the disease process, allowing optimal input into the management decision, pre
      operative planning and choice of surgical technique with a consequent reduction
      in operating time and potential reduction in peri-operative morbidity.
      Limitations of the solid modelling technique include cost, a lengthy production
      time which renders it unsuitable for emergency cases, and radiation exposure of
      the patient. With wider use and further technological development, these
      drawbacks will be minimized. The 3D SLA biomodels may in future become an
      adjunct, not only to maxillofacial surgery, but also to other medical
      specialties.

PMID- 7788240
TI  - Technical note: a radiological education system--organization of an image
      library.
AB  - A successful radiological library and teaching system should be easy to compile,
      user-friendly, dynamic and flexible. Nowadays it must be amenable to
      incorporation into digitally-based communication systems such as personal
      computers (pc) and picture archiving and communication systems (PACS). This
      article describes the structural organization and capabilities of such a digital
      radiological education system, and demonstrates how it fulfils these aims.

PMID- 7788241
TI  - Technical note: digital radiographic pelvimetry--a novel, low dose, accurate
      technique.
AB  - A technique is described for lateral pelvimetry which results in a lower
      radiation dose than that resulting from conventional film-screen pelvimetry and
      computed tomography (CT) pelvimetry. It uses digital radiographic imaging thereby
      closely matching conventional techniques yet additionally providing post
      processing facilities including distance measurement and contrast adjustment. The
      digital technique was evaluated with an anthropomorphic phantom and compared with
      the conventional technique by measuring entrance surface doses on two groups of
      post-natal patients. Digital radiography gave radiation doses 10 times lower than
      those using conventional techniques.

PMID- 7788242
TI  - Case report: computed tomography in the investigation of bilateral mandibular
      coronoid hyperplasia.
AB  - Bilateral mandibular coronoid hyperplasia is characterized by restricted mouth
      opening due to impingement of the coronoid processes on the zygomatic arches. The
      condition is unfamiliar to many clinicians and may be significantly under
      reported. The presented case highlights the benefits of computed tomography (CT)
      in the diagnosis and surgical evaluation of this disorder.

PMID- 7788243
TI  - Case report: septic arthritis of the hip following ureteric stent insertion.
AB  - Urinary infection is a recognized complication of ureteric stent insertion. We
      present a case of pelvic abscess and avascular necrosis of the hip following
      insertion of a stent for ureteric obstruction.

PMID- 7788244
TI  - Case report: volvulus of the splenic flexure in a patient with systemic
      sclerosis.

PMID- 7788245
TI  - Case report: variable imaging appearances of angiomyolipomas of the liver.
AB  - Angiomyolipomas of the liver are rare benign tumours. We describe the variable
      imaging appearances of these tumours in three women. The first two patients
      underwent ultrasound, computed tomography (CT) and angiography, which
      demonstrated lesions resembling focal nodular hyperplasia and hepatocellular
      carcinoma, respectively. Both had histologically-proven liver angiomyolipomas
      surgically resected. The third patient was incidentally found to have typical
      features of multicomponented liver angiomyolipoma on CT. Variable proportions of
      fatty tissue in these tumours are the most likely explanation for their different
      imaging appearances on CT.

PMID- 7788246
TI  - Case of the month: " ... or plat du jour".

PMID- 7788247
TI  - Contrast media, endothelin, angioplasty and restenosis.

PMID- 7788249
TI  - Ketoprofen in Pain. Proceedings of Actron International Experts Meeting.
      Interlaken, Switzerland, 20-23 March 1994.

PMID- 7788250
TI  - Nocturnal enuresis.
AB  - Nocturnal enuresis is common. Although its aetiology remains unclear recent
      evidence increasingly supports the lack of a normal nocturnal increase in ADH
      leading to nocturnal polyuria exceeding functional bladder capacity. Sleep
      patterns are probably normal although an arousal disorder might be a factor.
      Treatment should follow careful evaluation to determine if one is dealing with
      'uncomplicated' or 'complicated' enuresis. Complicated enuresis requires further
      investigation. 'Uncomplicated enuresis' always requires reassurance and patient
      and parent education. Resource centres such as ERIC can provide information and
      advice. Active treatment should be tailored to the patients age, motivation and
      parental wishes. Behavioural modification techniques yield the highest long-term
      cure rate but require the most commitment and are rarely successful before the
      age of 7-8 years. Pharmacotherapy has been revolutionized by DDAVP which gives a
      response rate of up to 70% relatively free from side-effects but at the price of
      a high relapse rate after medication. Imipramine is less expensive than DDAVP but
      may be fatal in overdose. Anticholinergics should be reserved for those patients
      with significant diurnal symptoms or those who fail first-line pharmacotherapy.
      Overall patients and parents should be reassured by the high spontaneous cure
      rate.

PMID- 7788251
TI  - Extracorporeal piezoelectric shock wave lithotripsy as mono and multiple therapy
      of large renal calculi including staghorn stones in unanaesthetized patients
      under semi-ambulant conditions.
AB  - OBJECTIVE: To examine the effectiveness and complication rate of extracorporeal
      piezoelectric shock wave lithotripsy (EPL) as monotherapy for the treatment of
      large renal calculi. PATIENTS AND METHODS: Treatment consisted of semiambulant
      EPL as monotherapy combined with protective ureteric stenting in 84 patients.
      Three groups were established according to stone volume (borderline-stone,
      partial and complete staghorn). An average of 18,230 shock waves was applied in
      3.76 sessions to each patient. RESULTS: No major complications were observed but
      there were minor complications in 33% of patients. Invasive auxiliary methods
      were necessary in only 12%. After a mean follow-up of 9 months (n = 72), 54% of
      patients were stone-free and in 22% the fragments passed spontaneously. Thus the
      success rate was 76%. Analysis of the three groups showed no difference in stone
      status during follow-up. There was no relation between the outcome of treatment
      and stone volume. Analysis of the patients who failed to respond to treatment
      showed that they were treated for longer than the stone-free group, with
      significantly fewer sessions per week (0.71 vs 1.28 sessions/week). It appears
      that higher rates of stone removal can be achieved with more frequent treatment
      sessions at shorter intervals. CONCLUSION: We consider semi-ambulant EPL
      monotherapy to be a minimally invasive alternative treatment in patients with
      large renal calculi, including staghorn stones.

PMID- 7788252
TI  - Involvement of the inferior vena cava by renal tumour: surgical excision using
      hypothermic circulatory arrest.
AB  - OBJECTIVE: To evaluate the immediate and long-term results of a radical surgical
      technique in the treatment of renal tumours with extensive involvement of the
      inferior vena cava (IVC). PATIENTS AND METHODS: Seven patients with extensive
      involvement of renal tumours into the IVC were operated upon using a
      cardiopulmonary by-pass, hypothermia and cardiac arrest to facilitate surgery.
      Wide exposure of the IVC in a bloodless field permitted complete removal of all
      visible tumour in each case. Histological sections confirmed renal cell cancer in
      six patients and Wilms tumour in a 15-year-old girl. RESULTS: All patients
      recovered well from their surgery with no major complications and spent one or
      two days in the Intensive Treatment Unit and an average of 13 days in hospital
      after the operation. Of the seven patients, four are alive and well with no
      obvious disease after an average follow-up time of 30 months (range 8-54). The
      other three patients have died from disseminated renal cancer. CONCLUSION: This
      procedure provides good local control of the tumour and offers the only hope of
      cure in patients with this disease. In collaboration with the surgical cardiac
      team it can be safely carried out with acceptable morbidity and mortality.

PMID- 7788248
TI  - Potential gonadal dose from leakage radiation?

PMID- 7788253
TI  - Surgery of lung metastases in renal cell carcinoma.
AB  - OBJECTIVE: To examine the impact on survival of pulmonary resection in the
      treatment of renal cell carcinoma that has metastasized to the lung. PATIENTS AND
      METHODS: From June 1986 to July 1991, 19 patients were submitted to synchronous
      or asynchronous lung metastasectomy. Histological examination confirmed the
      presence of lung metastases from renal cell carcinoma in 16 cases (six
      synchronous and 10 asynchronous with a mean disease-free interval of 23 months).
      In the other three cases, histological examination revealed tuberculomas,
      chondroid hamartoma and foci of anthracosis. RESULTS: To date, among the six
      patients with synchronous lung metastases, three have died, two are progressing
      and one has no evident disease after a mean survival of 24 months. Among the 10
      patients who underwent surgical resection of metachronous lung metastases, one
      has died, three are progressing and six have no evident disease (mean survival
      time, 43 months). CONCLUSION: While the presence of synchronous lung metastases
      is an unfavourable prognostic factor even after surgical removal (five out of six
      patients died or are in progression shortly after metastasectomy), the results
      after surgery of asynchronous lung metastases are encouraging, although the real
      efficacy of this treatment is still to be confirmed.

PMID- 7788254
TI  - Different susceptibilities of lymphokine-activated killer cells (LAK cells) among
      primary and metastatic renal cell carcinoma derived from the same patient.
AB  - OBJECTIVE: To investigate the susceptibility of primary renal cell carcinoma
      (RCC) and metastatic RCC to lymphokine-activated killer (LAK) cells using three
      RCC cell lines derived from the primary and metastatic tumours in a male patient
      with advanced RCC. MATERIALS AND METHODS: Three RCC cell lines (named HANKS) were
      derived from a 44-year-old man with advanced RCC. HANKS-Pr, HANKS-Lu and HANKS-LN
      were established from the primary lesion and the metastatic lung and lymph node
      lesions, respectively. The susceptibility of HANKS cell lines to 18 different LAK
      cells obtained from either patients with urological cancer or from healthy
      volunteers was studied. The three groups of LAK cells were divided as follows:
      (A) LAK cells from RCC patients (n = 6); (B) LAK cells from patients with
      transitional cell carcinoma (TCC)/prostatic carcinoma (CaP) (n = 4) and (C)
      healthy volunteers (n = 8). A 51Cr-releasing cytotoxic assay was used to
      determine susceptibility. RESULTS: The mean percentage lysis of the HANKS cell
      lines to the 18 allogenic LAK cells were 28.1% in HANKS-Pr, 20.2% in HANKS-Lu and
      10.4% in HANKS-LN. The susceptibility of HANKS-LN to LAK cells was significantly
      lower than that of HANKS-Pr and HANKS-Lu in all three groups (P < 0.05). In
      contrast, the susceptibility of HANKS-Pr was significantly higher than HANKS-Lu
      in group A only (P < 0.01). CONCLUSION: This is the first report to describe the
      different susceptibilities of primary RCC and metastatic RCC derived from the
      same patient. HANKS-LN itself might be the least susceptible to LAK cells because
      it was not related to the source of LAK cells. Furthermore, RCC may affect the
      cytotoxicity of LAK cells to HANKS-Pr. These data indicate there are at least two
      different types of mechanisms leading to the different susceptibilities of HANKS
      cells to LAK cells.

PMID- 7788256
TI  - Should Stamey colposuspension be our primary surgery for stress incontinence?
AB  - OBJECTIVE: To evaluate the outcome of the Stamey procedure for stress
      incontinence and to decide if it is an acceptable first-line option for the
      treatment of patients. PATIENTS AND METHODS: Between June 1987 and March 1993 67
      women had Stamey bladder neck suspension carried out for the treatment of stress
      incontinence. In September 1993 all patients received a detailed questionnaire to
      ascertain their present status. RESULTS: Immediately after surgery 70% of
      patients were dry and 15% were much improved. At 6 months 56% of patients were
      dry and 21% were much improved. More than 1 year following surgery, of 58
      patients responding only 31% were dry and 28% were much improved. More than 5
      years after surgery only 18% of the 28 women responding were dry. The factors
      which were significantly associated with failure were obesity (P < 0.005) and the
      number of pads used per day (P < 0.05). Previous surgery may also be an important
      factor. CONCLUSION: The Stamey vesical neck suspension has a good early success
      rate but the results in the longer term are not acceptable. This operation should
      not be used as a first-line treatment for stress incontinence and should be
      reserved for specific patient subgroups.

PMID- 7788255
TI  - Trospium chloride versus oxybutynin: a randomized, double-blind, multicentre
      trial in the treatment of detrusor hyper-reflexia.
AB  - OBJECTIVE: To compare trospium chloride (TCl), a quaternary ammonium derivative
      with atropine-like effects and predominantly antispasmodic activity, with
      oxybutynin (Oxy) in terms of efficacy and adverse effects. PATIENTS AND METHODS:
      In a randomized, double-blind, multicentre trial, 95 patients with spinal cord
      injuries and detrusor hyper-reflexia were studied. Treatment consisted of three
      doses per day over a 2 week period, with either Oxy (5 mg three times daily) or
      with TCl (20 mg twice daily) with an additional placebo at midday. The results
      were evaluated with regard to changes in objective (urodynamic) data and
      subjective symptoms as well as the incidence/severity of adverse effects.
      RESULTS: With both drugs there was a significant increase in maximum bladder
      capacity, a significant decrease in maximum voiding detrusor pressure and a
      significant increase in compliance and residual urine; there were no
      statistically significant differences between the treatment groups. The
      percentage of patients who reported severe dryness of the mouth was considerably
      lower (4%) in those receiving TCl 2 x 20 mg/day than in those receiving Oxy (23%)
      3 x 5 mg/day. Withdrawal from treatment was also less frequent in those receiving
      TCl (6%) than in those receiving Oxy (16%). CONCLUSION: Trospium chloride and
      oxybutynin, judged in terms of objective urodynamic parameters, are of
      substantially equal value as parasympathetic antagonists. However, assessment of
      tolerance in terms of adverse drug effects showed that TCl had certain
      advantages.

PMID- 7788257
TI  - Ploidy and Tn-antigen expression in the detection of transitional cell neoplasia
      in non-tumour-bearing patients.
AB  - OBJECTIVE: To study the effectiveness of combining DNA ploidy and the blood-group
      related membrane antigen Tn as bladder tumour markers which have been
      individually associated with high tumour grade and poor prognosis. In particular
      to (i) determine whether use of these two markers would improve tumour detection
      compared with either alone, particularly of high grade disease and (ii) determine
      whether intermediate rates of marker expression would occur in bladder cancer
      patients with no current tumour compared with those with a tumour and a control
      group with benign prostatic hypertrophy. PATIENTS AND METHODS: A total of 102
      patients undergoing cystoscopic monitoring for either benign prostatic
      hyperplasia (BPH) or for transitional cell carcinoma (TCC) at the Repatriation
      Hospital and Flinders Medical Centre were included in the study. The patients
      comprised three study groups, those with BPH (n = 37), with TCC but no tumour
      present (n = 38) and those with TCC and a tumour present at cystoscopy (n = 27).
      Exfoliated cells obtained from bladder washings at cystoscopy were double
      labelled using a monoclonal antibody to the Tn antigen and a DNA stain, propidium
      iodide and examined by flow cytometry. RESULTS: Rates of marker expression in 27
      patients with tumours were 30% for Tn antigen, 30% for aneuploidy and 48% for
      either marker. Marker expression was strongly associated with tumour grade, with
      no expression at grade 1, 38% (3/8) tumours at grade 2 and 90% (9/10) at grade 3.
      In patients with a history of bladder tumours but no current tumour, rates were
      intermediate (30%) compared with patients with current transitional cell
      carcinoma (42%) and control patients (19%). CONCLUSION: The use of Tn antigen
      combined with DNA flow cytometry can increase tumour detection, particularly of
      high grade, aggressive disease. Gradation of expression of these markers across
      patient groups at increasing risk of a tumour, with intermediate expression in
      patients with no current tumour, suggests that marker expression may be detecting
      a preneoplastic stage of the disease, which is not possible with cytology. Given
      two parallel disease processes for superficial papillary and for high grade
      disease with invasive potential, the expression of high grade tumour markers in
      cells from cystoscopically normal bladders may represent a pre-clinical stage of
      aggressive disease. The identification of patients at risk of invasive disease
      using combinations of tumour markers may offer advantages in clinical management,
      particularly when no tumour is present and therefore no histopathological
      assessment is made.

PMID- 7788258
TI  - Numerical chromosome aberrations in bladder cancer detected by in situ
      hybridization.
AB  - OBJECTIVE: To investigate the relationship between interphase cytogenetics and
      the grade and stage of bladder cancer in patients with transitional cell
      carcinomas of the urinary bladder. PATIENTS AND METHODS: By use of in situ
      hybridization with chromosome-specific DNA probes, the copy number of
      pericentromeric sequences on chromosomes 7, 10, 11, 17, 18, X and Y was detected
      within interphase nuclei in formalin-fixed and paraffin-embedded sections of the
      routinely processed bladder cancers from 20 patients. The percentage of
      hyperdiploid cells (three or more spots) was estimated using light microscopy.
      RESULTS: The percentage of hyperdiploid cells for chromosomes 7, 11 and 17 was
      highly correlated with increasing tumour grade (P < 0.01, Spearman rank
      correlation) or increasing pathological stage (P < 0.01). The percentage of
      hyperdiploid cells for chromosome Y was not correlated with either grade or stage
      (P > 0.05). As high tumour grade and stage are both indicative of more aggressive
      tumour behaviour and a worse prognosis, these findings suggest that the
      percentage of hyperdiploid cells, especially for chromosomes 7, 11 and 17, may be
      highly predictive of bladder tumour aggressiveness. CONCLUSION: These preliminary
      results suggest that measurement of numerical chromosome aberrations using in
      situ hybridization in bladder cancer may offer a new objective and quantitative
      assay of the biological potential of individual tumours.

PMID- 7788259
TI  - Is there a role for in vivo methylene blue staining in the prediction of bladder
      tumour recurrence?
AB  - OBJECTIVE: To assess the role of in vivo staining with intravesical methylene
      blue in predicting tumour recurrence. PATIENTS AND METHODS: Thirty-nine patients
      (27 men and 12 women, age range 43-75 years) newly diagnosed with bladder tumours
      were prospectively studied and followed for a minimum of 2 years. Potential
      biopsy sites were identified by staining intravesically with a 1% methylene blue
      solution and compared with random biopsy sites. RESULTS: Biopsy directed by
      methylene blue staining detected carcinoma in situ more often than random biopsy.
      Rates of recurrence were similar in both stained and unstained groups.
      CONCLUSION: Methylene blue staining does not add significantly to the management
      of patients presenting with bladder tumours.

PMID- 7788260
TI  - Correlation of morphometry, nucleolar organizer regions, proliferating cell
      nuclear antigen and Ki67 antigen expression with grading and staging in urinary
      bladder carcinomas.
AB  - OBJECTIVE: To investigate the correlation of four different indicators of
      proliferation--mean nuclear area (MNA) morphometry, nucleolar organizer region
      (NOR) count, proliferating cell nuclear antigen (PCNA) and Ki67 antigen
      expression--in specimens of invasive and non-invasive urinary bladder carcinomas
      with the grading and staging of the tumour and to determine which indicator is
      most suitable for discriminating between non-invasive and invasive carcinomas.
      MATERIALS AND METHODS: Biopsies of 58 urinary bladder carcinomas of different
      grade and stage (38 invasive, 20 non-invasive) and 11 carcinomata in situ were
      included in the study. Ten specimens of normal bladder mucosa served as controls.
      Analysis of indicators was performed on sequential serial paraffin sections of
      the same tissue, applying each test once to one of four serial sections. RESULTS:
      In comparison to normal bladder mucosa the values of the four indicators were
      significantly greater (P < 0.001) in all carcinomata in situ and in carcinomas.
      Values also increased from grade 1 to grade 3 carcinomas, but indicator values
      were similar for carcinomata in situ and grade 2 carcinomas. All indicators
      correlated with each other and allowed a significant discrimination between grade
      1 and 2 or grade 2 and 3 carcinomas. Non-invasive carcinomas (Ta) showed a
      significantly lower proliferative activity (P < 0.001) than invasive carcinomas
      but there were overlapping values within the invasive carcinomas (T1,T2 and
      T3/4). CONCLUSIONS: MNA, NOR count, PCNA index and Ki67 index could be correlated
      with tumour grade, but not with stage, of transitional bladder carcinoma. Of the
      indicators studied the Ki67 antigen was the most useful in differentiating
      between invasive and non-invasive carcinomas. This could be of prognostic
      relevance, especially for the heterogeneous group of grade 2 carcinomas.

PMID- 7788261
TI  - Computerized analysis of transrectal ultrasonography images in the detection of
      prostate carcinoma.
AB  - OBJECTIVE: To report on the use of automated image analysis in the interpretation
      of transrectal ultrasonographic images of the prostate. PATIENTS AND METHODS:
      During transrectal ultrasonography, images were recorded from biopsies performed
      in 127 patients. Subsequently in the image, the puncture place was marked and
      analysed. Analysis of the images was performed with the Automated Urologic
      Diagnostic Expert (AUDEX) system, consisting of a personal computer connected to
      the ultrasound machine. From the images collected, parameters can be calculated
      for image classification. The parameters obtained with this procedure were
      correlated with the histological result. RESULTS: Evaluation showed a sensitivity
      of 84.8% and specificity of 87.5%. The positive and negative predictive values,
      to predict prostate carcinoma, were 84.8% and 87.5%, respectively. CONCLUSION:
      Automated image analysis can help in the diagnosis of prostate carcinoma. In
      patients with non-palpable lesions or with poorly visualized tumours, image
      analysis is superior to the standard current diagnostic techniques.

PMID- 7788262
TI  - Kinetic analysis of prostatic volume in patients with stage D prostatic cancer
      treated with LHRH analogues in relation to prognosis.
AB  - OBJECTIVE: To evaluate the clinical usefulness of the kinetic analysis of
      prostatic volume in the prognosis of patients with Stage D prostatic cancer
      treated using luteinizing hormone-releasing hormone (LHRH) analogues. PATIENTS
      AND METHODS: The reduction of prostatic volume was monitored in 12 patients with
      Stage D prostatic cancer using transrectal ultrasonography (TRUS) after treatment
      with LHRH analogues. Data obtained from the kinetic analysis of prostatic volume
      were compared with the prognosis. RESULTS: All the patients having a reduction
      time, tau (derived from the kinetic analysis of prostatic volume change with
      time), of less than 41 days had neither clinical progression within 15 months nor
      death caused by prostatic cancer during the 5-year follow-up, while the disease
      specific 5-year survival rate in patients having a tau of greater than 42 days
      was as low as 17%. The difference in both the progression and disease-specific
      survival between these groups was statistically significant (P < 0.05) despite
      the limited number of patients. In contrast, conventional prognostic parameters
      showed no significant predictability for prognosis with the exception of
      prostatic acid phosphatase, which correlated strongly with the occurrence of
      progression within 15 months. CONCLUSION: The kinetic analysis of the change of
      prostatic volume using TRUS shows promise in the prognosis of the patients with
      Stage D prostatic cancer.

PMID- 7788263
TI  - Nitric oxide and cyclic GMP formation following relaxant nerve stimulation in
      isolated human corpus cavernosum.
AB  - OBJECTIVE: To investigate further the role of the nitric oxide (NO)-cyclic GMP
      pathway as the mediator of relaxant neurotransmission in human corpus cavernosum
      and to establish whether impaired activity of this pathway contributes to the
      pathophysiology of impotence. PATIENTS AND METHODS: Samples of cavernosal tissue
      were obtained from 59 men undergoing penile operations. The controls comprised
      four men with penile carcinoma and 17 with Peyronie's disease. Of the impotent
      men, 35 had clinical evidence of penile vascular disease on pre-operative
      investigation, whilst three had non-vascular impotence. Each biopsy was divided
      into two strips which were then suspended under tension in organ bath chambers.
      The relaxant innervation of one strip of each pair was stimulated electrically
      whilst the other strip was left unstimulated. The formation of NO and cyclic GMP
      was calculated by comparing their respective tissue content in the stimulated and
      unstimulated strips. RESULTS: Overall, stimulation of the relaxant innervation
      produced significant increases in the tissue content of both NO and cyclic GMP.
      Incubation with an inhibitor of NO biosynthesis abolished the mechanical relaxant
      response and the formation of both NO and cyclic GMP. The magnitude of relaxant
      response and the formation of NO was diminished in tissue from men with vascular
      impotence compared to controls. The increase in cyclic GMP content was similar in
      both these groups. Relaxant response, NO formation and cyclic GMP formation in
      tissue from men with non-vascular impotence was similar to controls. CONCLUSIONS:
      This study provides further evidence that the NO-cyclic GMP pathway acts as the
      mediator of nerve-evoked smooth muscle relaxation in human corpus cavernosum.
      Diminished NO formation following relaxant nerve stimulation may account for
      impaired relaxant responses found in tissue from men with vascular impotence and
      may contribute to the cause of their erectile dysfunction.

PMID- 7788264
TI  - Laparoscopic varicocelectomy: technique and results.
AB  - OBJECTIVE: To determine the safety and efficacy of laparoscopic varicocelectomy
      in the treatment of symptomatic varicocele. PATIENTS AND METHODS: Indications for
      surgery were subfertility in 98 patients and pain in nine. All varicoceles were
      confirmed on Doppler ultrasound. Seventy-two per cent of the patients had left
      sided varicoceles and bilateral varicoceles were seen in 27%. A three-puncture
      technique was used with carbon dioxide insufflation. The spermatic vessels were
      individually identified and clips were used to ligate the veins. The spermatic
      artery was preserved in all cases. The operation was performed on a day surgery
      basis with an average operative time of 61.4 min (56.6 min for unilateral and
      75.8 min for bilateral varicocelectomy). RESULTS: Morbidity was low, with
      pneumoscrotum in two patients and wound infection in two others. Sixty-one
      patients for whom pre- and post-operative seminal analyses were available showed
      improvement in sperm count and motility, with a concomitant fall in the
      percentage of abnormal sperm forms. CONCLUSION: Laparoscopic varicocelectomy is
      safe and effective, causing minimal discomfort and allowing patients an early
      return to activity.

PMID- 7788265
TI  - 'Congenital' hydronephrosis: limitations of diagnosis by fetal ultrasonography.
AB  - OBJECTIVE: To determine whether children presenting clinically with pelvi
      ureteric junction obstruction had fetal hydronephrosis. PATIENTS AND METHODS:
      Forty-three children, born during or after 1985, presented clinically with pelvi
      ureteric junction obstruction. Records of the maternal pregnancies were reviewed
      with reference to the findings of any fetal ultrasonography. RESULTS: In 25
      patients fetal ultrasonography was performed at or beyond 30 weeks' gestation
      (mean 33.2). None had significant fetal hydronephrosis. CONCLUSION:
      Hydronephrosis due to pelvi-ureteric obstruction is not necessarily congenital
      and patients presenting clinically may differ inherently from those detected
      fetally.

PMID- 7788268
TI  - Delayed management of posterior urethral disruption in children.
AB  - OBJECTIVE: To review the results of delayed operative treatment of total
      disruption of the posterior urethra in children. PATIENTS AND METHODS: Twelve
      boys (3-12 years, mean 7.5) with a suprapubic catheter were referred after
      primary management in other hospitals. All but one had been involved in road
      traffic accidents. In addition to their urethral injury, they all had pelvic
      fractures and the majority also had other major associated injuries. Six to 14
      months after injury, abdominoperineal transpubic urethroplasty was performed in
      11 patients according to Turner-Warwick. In one case a perineal anastomotic
      urethroplasty was performed. RESULTS: After the operation, voiding cysto
      urethrography showed a wide anastomosis in all cases. After 3 to 45 months follow
      up, there were no strictures. Eight boys were continent, two were totally
      incontinent, two had stress incontinence and one nocturnal enuresis. All patients
      with confirmed erections after injury also had erections after their operation.
      CONCLUSION: Primary suprapubic cystostomy and delayed repair can be used
      successfully for the treatment of posterior urethral disruption in children.

PMID- 7788267
TI  - Endoscopic treatment of vesico-ureteric reflux and urinary incontinence:
      technical problems in the paediatric patient.
AB  - OBJECTIVE: Bovine collagen has been successfully used for the endoscopic
      treatment of urinary incontinence (UI) and vesico-ureteric reflux (VUR) in
      children for more than 8 years, although its long-term efficacy has sometimes
      been questioned. Its failure is generally ascribed either to technical
      difficulties or to instability of collagen at the site of the implant. To assess
      the efficacy of the procedure we evaluated the children treated at this hospital
      between 1990 and 1993. PATIENTS AND METHODS: A total of 156 children, aged 5
      months to 13 years, were treated for VUR. Over the same period, 25 patients aged
      between 2 and 14 years (nine with neuropathic bladder and 16 with exstrophy
      epispadias complex who were still incontinent after bladder neck reconstruction)
      had periurethral or pericervical glutaraldehyde cross-linked bovine collagen
      injection for UI. Five more children with exstrophy-epispadias complex (aged 1-3
      years) underwent periurethral collagen injection to stimulate bladder enhancement
      and allow subsequent bladder neck reconstruction. RESULTS: In children treated
      for VUR, a single injection proved successful in 72.2% of cases (127 ureters); a
      second collagen injection raised the success rate to 81%. Continence improved in
      all nine neuropathic bladders and in 10 of 16 children with exstrophy-epispadias
      complex treated for UI after bladder neck reconstruction. In four of the five
      exstrophy-epispadias complex patients who were treated to stimulate bladder
      enhancement, bladder capacity increased by 25%. CONCLUSIONS: Endoscopic treatment
      of VUR seems to be a valid alternative to open surgery, even though concerns
      remain about the long-term efficacy of collagen implantation. An important
      distinction should be made between early and late failure of the procedure. Early
      failure, which we define as persistence of reflux, is usually due to incorrect
      technique or technical difficulties. Late failure, or recurrence of reflux, which
      has previously been attributed to the biodegradability of collagen, seems to be
      due to the displacement of the injected collagen. Micturition itself or high
      bladder pressure (such as detrusor instability) could be responsible for the
      displacement of the injected collagen medially and distally, where it can no
      longer support the submucosal ureteric tunnel. In the treatment of urinary
      incontinence, both the implant technique and the choice of the site of injection
      seem to have a considerable effect on the results. In our experience, endoscopic
      collagen injection is effective in the treatment of both urinary incontinence and
      VUR in paediatric patients. Accurate selection of patients and technical
      adjustments and refinements are essential to obtain the best results.

PMID- 7788266
TI  - Natural filling cystometry in infants and children.
AB  - OBJECTIVE: To evaluate natural filling cystometry in infants and young children.
      PATIENTS AND METHODS: The study group comprised 37 infants and young children
      (mean age, 4.1 years) with various urological conditions. Suprapubic catheters
      were used in all patients with urethral sensation. Natural filling urodynamic
      (NFU) studies were performed using an ambulatory recorder and with an observer
      present throughout. For comparison, 17 of the 37 patients also had slow filling
      conventional cystometry (CMG). RESULTS: All NFU studies were successfully
      completed and the great majority of patients were unaffected by the investigation
      procedures. In comparison with conventional cystometry there were significant
      differences. For NFU, there was a lower bladder capacity (means, NFU 122 mL vs
      CMG 188 mL, P < 0.03); lower pressure rise on filling (means, NFU 5.7 cmH2O vs
      CMG 16.1 cmH2O, P < 0.001) and higher maximum detrusor pressures during
      micturition (means, NFU 130 cmH2O vs CMG 78 cmH2O, P < 0.01). Voiding efficiency
      was also slightly greater with NFU compared with CMG. Detrusor instability was
      recorded in five patients only during NFU and in two other patients only during
      CMG. CONCLUSION: A natural filling cystometry method which incorporates an
      unobtrusive recording system is likely to be superior to conventional CMG for
      assessing bladder function in infants and children. This is because (i) bladder
      function is investigated in near to natural conditions, (ii) the patients are
      mostly unaffected by the investigation procedures, (iii) there are significant
      differences between NFU and CMG in the measurements obtained, indicating that CMG
      may give false indices of bladder function.

PMID- 7788269
TI  - A drip-stand hook for the catheter bag to enable easy ambulation.

PMID- 7788270
TI  - Emergency laparoscopic repair of spontaneous and traumatic bladder rupture.

PMID- 7788272
TI  - Splenic-gonadal fusion: a case report of the discontinuous type.

PMID- 7788271
TI  - Giant hydronephrosis in a solitary pelvic kidney.

PMID- 7788273
TI  - Multicystic epididymes and seminal vesicles in a patient with polycystic kidney
      disease.

PMID- 7788274
TI  - Inverted papillary tumour of the ureter.

PMID- 7788275
TI  - Kaposi's sarcoma of the urethral meatus: management by urethral dilatation.

PMID- 7788277
TI  - Pseudo-haematuria caused by utero-urethral fistula from Mayer-Rokitansky-Kuster
      Hauser syndrome.

PMID- 7788276
TI  - Pelvic fibromatosis (desmoid)--treatment with steroids and tamoxifen.

PMID- 7788278
TI  - Renal plasmacytoma.

PMID- 7788279
TI  - The wider spectrum of megalourethra.

PMID- 7788280
TI  - Electron microscopic studies on intracellular phage development--history and
      perspectives.
AB  - This review is centered on the applications of thin sections to the study of
      intracellular precursors of bacteriophage heads. Results obtained with other
      preparation methods are included in so far as they are essential for the
      comprehension of the biological problems. This type of work was pioneered with
      phage T4, which contributed much to today's understanding of morphogenesis and
      form determination. The T4 story is rich in successes, but also in many
      fallacies. Due to its large size, T4 is obviously prone to preparation artefacts
      such as emptying, flattening and others. Many of these artefacts were first
      encountered in T4. Artefacts are mostly found in lysates, however, experience
      shows that they are not completely absent from thin sections. This can be
      explained by the fact that permeability changes induced by fixatives occur. The
      information gained from T4 was profitably used for the study of other phages.
      They are included in this review as far as electron microscopic studies played a
      major role in the elucidation of their morphogenetic pathways. Research on phage
      assembly pathways and form determination is a beautiful illustration for the
      power of the integrated approach which combines electron microscopy with
      biochemistry, genetics and biophysics. As a consequence, we did not restrict
      ourselves to the review of electron microscopic work but tried to integrate
      pertinent data which contribute to the understanding of the molecular mechanisms
      acting in determining the form of supramolecular structures.

PMID- 7788281
TI  - Pathology of the transmissible spongiform encephalopathies with special emphasis
      on ultrastructure.
AB  - The transmissible spongiform encephalopathies are a group of genetic and
      infectious disorders which are exemplified by scrapie in animals and Creutzfeldt
      Jakob disease in humans. The spongiform encephalopathies are characterized by
      symmetrical vacuolation of neurons and neuropil. Amyloid plaque formation similar
      to that found in Alzheimer's disease is conspicuous in many, but not all, of
      these diseases. The sub-cellular pathology features of the spongiform
      encephalopathies have been studied by conventional transmission electron
      microscopy, scanning electron microscopy, freeze fracture, negative staining and
      most recently by application of immunogold labelling methods. Although these
      studies have revealed many unusual structures, convincing virus-like particles
      have not been demonstrated. Considerable data, including important transgenic
      mouse studies, now suggest that a single cellular protein, designated prion
      protein, is necessary for infection. Ultrastructural immunogold studies have
      shown that prion protein is released from the surface of neurons and neurites,
      diffuses through the extracellular space around infected cells where it
      accumulates and finally becomes aggregated as amyloid fibrils. It is likely that
      the accumulation of prion protein within the extracellular space is instrumental
      in causing nerve cell dysfunction and, ultimately, neurological disease.

PMID- 7788282
TI  - The surgical approach to endocrine tumors of the pancreas.

PMID- 7788284
TI  - Multiple endocrine neoplasia type I.

PMID- 7788283
TI  - Recent advances in the treatment of metastatic pancreatic endocrine tumors.

PMID- 7788285
TI  - Diagnosis and treatment of pancreatic neuroendocrine tumors.

PMID- 7788286
TI  - Diagnosis and management of Zollinger-Ellison syndrome.

PMID- 7788287
TI  - Localization of pancreatic endocrine tumors.

PMID- 7788288
TI  - Annexins: a novel family of calcium- and membrane-binding proteins in search of a
      function.
AB  - Although the annexins have been extensively studied and much detailed structural
      information is available, their in vivo function has yet to be established.

PMID- 7788289
TI  - Thioredoxin structure and mechanism: conformational changes on oxidation of the
      active-site sulfhydryls to a disulfide.
AB  - The recent high-resolution solution structures of human and Escherichia coli
      thioredoxin in their oxidized and reduced states support a catalytic model of
      protein disulfide reduction involving binding of a target protein and
      nucleophilic attack by the active-site Cys32 thiolate to form a transition state
      mixed disulfide.

PMID- 7788290
TI  - Thioredoxin--a fold for all reasons.
AB  - The thioredoxin fold is a characteristic protein structural motif that has been
      found in five distinct classes of proteins that have the common property of
      interacting with cysteine-containing substrates.

PMID- 7788291
TI  - Hyperthermophiles: taking the heat and loving it.

PMID- 7788292
TI  - Crystal structure of the MS2 coat protein dimer: implications for RNA binding and
      virus assembly.
AB  - BACKGROUND: The coat protein in RNA bacteriophages binds and encapsidates viral
      RNA, and also acts as translational repressor of viral replicase by binding to an
      RNA hairpin in the RNA genome. Because of its dual function, the MS2 coat protein
      is an interesting candidate for structural studies of protein-RNA interactions
      and protein-protein interactions. In this study, unassembled MS2 coat protein
      dimers were selected to analyze repressor activity and virus assembly. RESULTS:
      The crystal structure of a mutant MS2 coat protein that is defective in viral
      assembly yet retains repressor activity has been determined at 2.0 A resolution.
      The unassembled dimer is stabilized by interdigitation of alpha-helices, and the
      formation of a 10-stranded antiparallel beta-sheet across the interface between
      monomers. The substitution of arginine for tryptophan at residue 82 results in
      the formation of two new inter-subunit hydrogen bonds that further stabilize the
      dimer. Residues that influence RNA recognition, identified by molecular genetics,
      were located across the beta-sheet. Two of these residues (Tyr85 and Asn87) are
      displaced in the unliganded dimer and are located in the same beta-strand as the
      Trp-->Arg mutation. CONCLUSIONS: When compared with the structure of the coat
      protein in the assembled virus, differences in orientation of residues 85 and 87
      suggest conformational adjustment on binding RNA in the first step of viral
      assembly. The substitution at residue 82 may affect virus assembly by imposing
      conformational restriction on the loop that makes critical inter-subunit contacts
      in the capsid.

PMID- 7788293
TI  - Crystal structure of the C2 fragment of streptococcal protein G in complex with
      the Fc domain of human IgG.
AB  - BACKGROUND: Streptococcal protein G comprises two or three domains that bind to
      the constant Fc region of most mammalian immunoglobulin Gs (IgGs). Protein G is
      functionally related to staphylococcal protein A, with which it shares neither
      sequence nor structural homology. RESULTS: To understand the competitive binding
      of these two proteins to the Fc region, the crystal structure of a single Ig
      binding domain of streptococcal protein G was determined at 3.5 A resolution in
      complex with the Fc fragment of human IgG and compared with the structures of
      protein A:Fc and protein G:Fab complexes. Protein G binds to the interface
      between the second and third heavy chain constant domains of Fc, which is roughly
      the same binding site used by protein A. Protein G comprises one alpha-helix
      packed onto a four-stranded beta-sheet. Residues from protein G that are involved
      in binding are situated within the C-terminal part of the alpha-helix, the N
      terminal part of the third beta-strand and the loop region connecting these two
      structural elements. The identified Fc-binding region of protein G agrees well
      with both biochemical and NMR spectroscopic data. However, the Fc-binding helices
      of protein G and protein A are not superimposable. CONCLUSIONS: Protein G and
      protein A have developed different strategies for binding to Fc. The protein G:Fc
      complex involves mainly charged and polar contacts, whereas protein A and Fc are
      held together through non-specific hydrophobic interactions and a few polar
      interactions. Several residues of Fc are involved in both the protein G:Fc and
      the protein A:Fc interaction, which explains the competitive binding of the two
      proteins. The apparent differences in their Fc-binding activities result from
      additional unique interactions.

PMID- 7788294
TI  - Structure of uncomplexed and linoleate-bound Candida cylindracea cholesterol
      esterase.
AB  - BACKGROUND: Candida cylindracea cholesterol esterase (CE) reversibly hydrolyzes
      cholesteryl linoleate and oleate. CE belongs to the same alpha/beta hydrolase
      superfamily as triacylglycerol acyl hydrolases and cholinesterases. Other members
      of the family that have been studied by X-ray crystallography include Torpedo
      californica acetylcholinesterase, Geotrichum candidum lipase and Candida rugosa
      lipase. CE is homologous to C. rugosa lipase 1, a triacylglycerol acyl hydrolase,
      with which it shares 89% sequence identity. The present study explores the
      details of dimer formation of CE and the basis for its substrate specificity.
      RESULTS: The structures of uncomplexed and linoleate-bound CE determined at 1.9 A
      and 2.0 A resolution, respectively, reveal a dimeric association of monomers in
      which two active-site gorges face each other, shielding hydrophobic surfaces from
      the aqueous environment. The fatty-acid chain is buried in a deep hydrophobic
      pocket near the active site. The positioning of the cholesteryl moiety of the
      substrate is equivocal, but could be modeled in the hydrophobic core of the dimer
      interface. CONCLUSIONS: The monomer structure is the same in both the complexed
      and uncomplexed crystal forms. The dimers differ in the relative positions of the
      two monomers at the dimer interface. Of the 55 residues that are different in CE
      from those in C. rugosa lipase 1, 23 are located in the active site and at the
      dimer interface. The altered substrate specificity is a direct consequence of
      these substitutions.

PMID- 7788295
TI  - Solution structure of human thioredoxin in a mixed disulfide intermediate complex
      with its target peptide from the transcription factor NF kappa B.
AB  - BACKGROUND: Human thioredoxin is a 12 kDa cellular redox protein that plays a key
      role in maintaining the redox environment of the cell. It has recently been shown
      to be responsible for activating the DNA-binding properties of the cellular
      transcription factor, NF kappa B, by reducing a disulfide bond involving Cys62 of
      the p50 subunit. Using multidimensional heteronuclear-edited and hetero-nuclear
      filtered NMR spectroscopy, we have solved the solution structure of a complex of
      human thioredoxin and a 13-residue peptide extending from residues 56-68 of p50,
      representing a kinetically stable mixed disulfide intermediate along the reaction
      pathway. RESULTS: The NF kappa B peptide is located in a long boot-shaped cleft
      on the surface of human thioredoxin delineated by the active-site loop, helices
      alpha 2, alpha 3 and alpha 4, and strands beta 3 and beta 4. The peptide adopts a
      crescent-like conformation with a smooth 110 degrees bend centered around residue
      60 which permits it to follow the path of the cleft. CONCLUSIONS: In addition to
      the intermolecular disulfide bridge between Cys32 of human thioredoxin and Cys62
      of the peptide, the complex is stabilized by numerous hydrogen-bonding,
      electrostatic and hydrophobic interactions which involve residues 57-65 of the NF
      kappa B peptide and confer substrate specificity. These structural features
      permit one to suggest the specificity requirements for human thioredoxin
      catalyzed disulfide bond reduction of proteins.

PMID- 7788297
TI  - Appraisal of a glycopeptide cloaking strategy for a therapeutic oligopeptide:
      glycopeptide analogs of the renin inhibitor ditekiren.
AB  - Among the limitations to the practical therapeutic oligopeptide are low oral
      availability, indifferent aqueous solubility, and an astonishing efficient
      sequestration and biliary elimination by a multi-capacity liver transporter.
      Given the purposed use of N- and O- linked saccharides as functional appendages
      of eukaryotic peptides and proteins, a strategy of glycopeptide mimicry was
      examined for the oligopeptide renin inhibitor, ditekiren. The anticipation was
      that the saccharide would impart significant aqueous solubility, and might impact
      beneficially on the remaining two limitations. Execution of this approach was
      achieved by the removal of the (dimethylethoxy)carbonyl amino terminus of
      ditekiren, and its substitution by Boc-L-asparagine N-linked mono- and
      disaccharides. Potent hypotensive activity, as measured by a human renin-infused
      rat assay, is observed for virtually all of these structures (N-linked beta
      pyranose D-N-acetyglucosaminyl, D-glucosaminyl, D-N-acetylgalactosaminyl, D
      mannosyl, D-galactosyl, D-maltosyl, D-cellobiosyl, D-chitobiosyl, but not L
      fucosyl). The basis for this dramatic improvement (relative to ditekiren in the
      same assay) is the diversion of the peptide clearance from rapid liver biliary
      clearance to slower urinary clearance (Fisher, J. F.; Harrison, A. W.; Wilkinson,
      K. F.; Rush, B. R.; Ruwart, M. J. J. Med. Chem. 1991, 34, 3140). Guided by the
      human renin-infused rat hypertension assay, an evaluation of the linker
      saccharide pairing was made. Loss of hypotensive activity is observed upon
      substitution of the Boc-L-asn by Boc-D-asn, and by removal of the Boc amino
      terminus of the glycopeptide. Potent hypotensive activity is preserved by
      replacement of the Boc-L-asn linker by succinate, malate, tartrate, and adipate
      linkers. With the longer adipate spacer, attachment of the saccharide to the P-3
      phenylalanine--with omission of the P-4 proline--retains activity. These data
      suggest value to the glycopeptide guise for preserving the in vivo activity, and
      for the beneficial manipulation of pharmacodynamics, of this renin inhibitory
      oligopeptide. This strategy may have general applicability.

PMID- 7788298
TI  - Potential radioprotective agents--IV. Schiff bases.
AB  - Twelve Schiff bases were prepared using salicylaldehyde, one with 5
      chlorosalicylaldehyde, one with benzaldehyde, and a series of anilines
      substituted in the m- or p-positions. They were assayed for radioprotective
      activity in male, Swiss mice irradiated with a nearly lethal dose (950 cGy) of 6
      mV photons produced by a linear accelerator, and were compared with the parent
      amines. Schiff base formation reduced toxicity of the parent amines; its effect
      on radioprotective activity was erratic, increasing activity in some cases,
      decreasing activity in others, and having no effect in still others.
      Radioprotective activity appears to be unrelated to a number of molecular
      descriptors. The highest radioprotection (100%) was observed for mixtures of p
      aminopropiophenone with its Schiff base, or with the Schiff base of 1-(p
      aminophenyl)-1-propanol (95%).

PMID- 7788296
TI  - The catalytic site of serine proteinases as a specific binding cavity for xenon.
AB  - BACKGROUND: Under moderate pressure, xenon can bind to proteins and form weak but
      specific interactions. Such protein-xenon complexes can be used as isomorphous
      derivatives for phase determination in X-ray crystallography. RESULTS:
      Investigation of the serine proteinase class of enzymes shows that the catalytic
      triad, the common hydrolytic motif of these enzymes, is a specific binding site
      for one xenon atom and shows high occupancy at pressures below 12 bar. Complexes
      of xenon with two different serine proteinases, elastase and collagenase, were
      analyzed and refined to 2.2 A and 2.5 A resolution, respectively. In both cases,
      a single xenon atom with a low temperature factor is located in the active site
      at identical positions. Weak interactions exist with several side chains of
      conserved amino acids at the active site. Xenon binding does not induce any major
      changes in the protein structure and, as a consequence, crystals of the xenon
      complexes are highly isomorphous with the native protein structures. Xenon is
      also found to bind to the active site of subtilisin Carlsberg, a bacterial serine
      proteinase, that also has a catalytic triad motif. CONCLUSIONS: As the region
      around the active site shows conserved structural homology in all serine
      proteinases, it is anticipated that xenon binding will prove to be a general
      feature of this class of proteins.

PMID- 7788299
TI  - A novel biotinylated heterobifunctional cross-linking reagent bearing an aromatic
      diazirine.
AB  - The synthesis of a p-[(3-trifluoromethyl)diazirine-3-yl]benzoic acid derivative
      is described as a new carbene generating heterobifunctional cross-linking
      reagent. The cross-linker carries a biotin moiety in order to make use of avidin
      biotin technology for specific manipulation of cross-linked components. To
      evaluate the ability of this reagent, the inter-subunit cross-linking of egg
      white avidin tetramer was investigated. As a typical application of avidin-biotin
      technology for cross-linking experiments, a chemiluminescent detection method was
      examined to identify photobiotinylated components. A cross-linked dimeric product
      with an apparent molecular mass of 38 kDa was clearly visualized by the combined
      use of a horseradish peroxidase-streptavidin conjugate and a luminol-based
      chemiluminescent system.

PMID- 7788300
TI  - Synthesis, absolute configuration, conformational analysis and binding affinity
      properties of enantiomeric forms of DAU 5750, a novel M1-M3 muscarinic receptor
      antagonist.
AB  - Both the enantiomeric forms of DAU 5750, a novel muscarinic receptor antagonist,
      have been synthesized in order to assess the relevance of
      configurational/conformational features for high affinity binding to muscarinic
      receptor subtypes. The attribution of absolute stereochemistry and conformational
      analysis by means of molecular modelling and NMR techniques are also reported.

PMID- 7788302
TI  - Synthesis of novel water-soluble 7-(aminoacylhydrazono)-formyl camptothecins with
      potent inhibition of DNA topoisomerase I.
AB  - Eighteen new water-soluble 7-(aminoacylhydrazono)-formyl camptothecins were
      synthesized and evaluated for their ability to cause protein-linked DNA breaks
      and to inhibit topoisomerase I activity. Compared with camptothecin, five of the
      compounds were as potent or more potent in these tw assays but were less toxic in
      several cancer cell lines. The results suggest that the 7 position in the B ring
      is a suitable location for introducing a polar moiety into camptothecin producing
      analogues with enhanced topoisomerase I inhibiting activity.

PMID- 7788301
TI  - Iron(II)/reductant(DH2)-induced activation of dioxygen for the hydroxylation and
      ketonization of hydrocarbons; mimics for the cytochrome P-450
      hydroxylase/reductase system.
AB  - Several metal complexes [(FeII(DPAH)2 (DPAH2 = 2,6-dicarboxyl pyridine),
      FeII(PA)2 (PAH = picolinic acid), FeII(bpy)2(2+), FeII(OPPh3)4(2+),
      (Cl8TPP)FeIIIX (X = Cl, OH, SCH2Ph) [Cl8TPP = tetrakis (2,6
      dichlorophenyl)porphyrin], (TPP) FeIIICl (TPP = tetraphenylporphyrin), and
      CuI(tpy)2+ (typ = 2,2'-6,2"-terpyridine)] in combination with one of several
      reductants [DH2; PhNHNHPh (mimic of dihydroflavin), PhNHNH2, ascorbic acid
      (H2asc), and PhCH2SH (model ligand for cysteine residue)] catalytically activate
      O2 (1 atm) for the hydroxylation of saturated hydrocarbons (e.g. c-C6H12-->c
      C6H11OH). This chemistry closely parallels that of cytochrome P-450 proteins, and
      both appear to involve a Fenton-like reactive intermediate), [LxFeOOH(DH)]. With
      cyclohexane as the substrate the dominant product is its ketone (as well as
      significant amounts of its hydroperoxide). 1,4-Cyclohexadiene (with two double
      allylic carbon centers) undergoes dehydrogenation to give benzene, but also
      yields substantial amounts of phenol via ketonization of an allylic carbon. The
      1:1 FeII(bpy)2(2+)/(PhNHNH2 or H2asc), FeII(PA)2/H2asc, and
      (Cl8TPP)FeIIICl/PhNHNH2 combinations initiate the autoxidation of 1,4
      cyclohexadiene with turnover numbers (moles of product per mole of reductant)
      from 71 to 26, respectively (alpha-tocophenol reduces the turnover numbers by 20
      80%). With respect to aerobic biology, the present results indicate that
      dysfunctional transition metals (degradation products of metalloproteins) in
      combination with biological reductants activate O2 for reaction with organic
      substrates. The level of activation is similar to that for Fenton reagents and
      cytochrome P-450 hydroxylases. Hence, dysfunctional transition metals,
      reductants, and O2 are a hazardous combination within a biological matrix.

PMID- 7788304
TI  - Phage display of catalytically active staphylococcal nuclease.
AB  - Staphylococcal nuclease (SNase), a 14 kD enzyme that catalyzes the hydrolysis of
      single- and double-stranded nucleic acid, was fused to the N-terminus of the gene
      III (pIII) protein of filamentous phage fdtet. The SNase-pIII protein is
      infective and the catalyzes DNA hydrolysis, demonstrating that functional SNase
      can be displayed on the phage surface.

PMID- 7788305
TI  - Structurally designed novel furogamma lactams as inhibitors for bacterial
      propagations.
AB  - Some novel furogamma lactams have been synthesised by one step condensation of
      arylaminomalonates with substituted furyl acryloyl chlorides. The annulation of
      substituted monocyclic gammalactams followed by cyclization produced novel
      tricyclic furogamma lactams. Some of these furogammalactams are found to exhibit
      Gram-positive and Gram-negative antibacterial activity at very high
      concentrations.

PMID- 7788303
TI  - Antiproliferative actions of 7-substituted 1,3-dihydroxyacridones; possible
      involvement of DNA topoisomerase II and protein kinase C as biochemical targets.
AB  - 7-Chloro-1,3-dihydroxyacridone (1) reversibly inhibited growth of KB and vero
      cell lines with IC50's of 35 and 40 microM, respectively, and a topoisomerase II
      mediated multidrug resistant KB sub-clone was found to be about three-fold more
      susceptible to 1. In contrast, two cell lines of lymphoid origin were killed
      following treatments with 60 microM and at higher concentrations of 1. KB cell
      growth inhibition correlated with a rapid, reversible suppression of thymidine
      incorporation. Uridine but not leucine incorporation was also rapidly suppressed.
      The in vitro activities of DNA topoisomerase II and novel protein kinase C
      subtype delta were inhibited at effective concentrations in tissue-culture, but 1
      did not stimulate intracellular protein-associated DNA breaks nor interfere
      initially with topoisomerase II-mediated DNA cleavage in KB cells. In addition to
      antiproliferative effects against cells, the compound was weakly virustatic for
      herpes simplex virus type I with an IC50 of 8 microM. Limited studies comparing
      three 1-congeners and citpressine-I, an acridone alkaloid with reported
      antiherpes activity, demonstrated that 7-substituted 1,3-dihydroxyacridones are
      novel antiproliferative agents which share similar biological and biochemical
      properties.

PMID- 7788306
TI  - Structure-activity studies leading to potent chloride channel blockers: 5e-tert
      Butyl-2-[4-(substituted-ethynyl)phenyl]-1,3-dithianes.
AB  - 5e-tert-Butyl-2e-[4-(substituted-ethynyl)phenyl]-1,3-dithianes+ ++ with selected
      functional groups (R) on the ethynyl moiety are potent blockers of the GABA-gated
      chloride channel measured as inhibitor concentration (IC50) for 4-n-[3H]propyl-1
      (4-ethynylphenyl)-2,6,7- trioxabicyclo[2.2.2]octane binding to bovine brain
      membranes. The terminal R substituents were introduced by coupling 5e-tert-butyl
      2e-(4-iodophenyl)-1,3-dithiane with HC identical to CR or 5e-tert-butyl-2e(4
      ethynylphenyl)-1,3-dithiane with XR. The potency of the parent compound (R = H)
      with an IC50 of 21 nM is equaled or exceeded by up to 7-fold (i.e. IC50 = 3-21
      nM) by several carboxylic acids [R = (CH2)nCO2H (n = 0-3), (CH2)nOCH2CO2H (n = 1
      3), and CH2SCH2CO2H] and their esters and two phosphonic acids (CH2CH2PO3H2 and
      CH2OCH2PO3H2) but not their esters. These carboxylic and phosphonic acids (and
      their salts) include the most potent water-soluble chloride channel blockers
      known. Conversion to the monosulfones increases the activity of the R = H and
      CH2OH analogs by 1.2- to 3-fold but decreases that of the R = CH2CH2CO2R' (R' = H
      or CH3) derivatives by 3- to 13-fold. Quantitative structure-activity analyses
      for 44 2-[4-(substituted-ethynyl)phenyl]-dithianes suggests that the principal
      feature of the R substituent for high activity is its polarizable volume modeled
      as molecular refractivity, i.e. this substituent is not a well-defined
      pharmacophore and undergoes a structurally non-specific interaction with the
      receptor. These observations lay the background for preparing candidate affinity
      probes.

PMID- 7788308
TI  - Bilateral spontaneous patellar tendon rupture in the absence of concomitant
      systemic disease or steroid use.

PMID- 7788307
TI  - On implants and tumors.

PMID- 7788309
TI  - On recycling in the operating room.

PMID- 7788310
TI  - Wrist arthroscopy.
AB  - Miniaturization of arthroscopic equipment has allowed wrist arthroscopy to emerge
      as a powerful surgical tool in orthopedic surgery. The magnified view of the
      arthroscope has provided a new understanding of carpal anatomy and disease.
      Arthroscopy improves surgeons' ability to diagnose wrist disorders and enables
      them to perform operative procedures with less morbidity than would occur in open
      procedures.

PMID- 7788311
TI  - Carcinogenicity and metallic implants.
AB  - The literature related to the carcinogenetic potential of metallic implants was
      reviewed. There were 20 cases described in which tumors were identified in
      proximity to metallic implants. These cases occurred over a 34-year period.
      Investigators have identified a 70% increased incidence of lymphomas and
      hematopoietic tumors over that in the general population in patients who had
      received total hip arthroplasties. Carcinogenicity theories include the potential
      direct toxicity of materials, the effects of surface properties, the
      electromotive potential created by dissimilar metals in contact, the immunologic
      response to implants, and finally, the sustained presence of low-grade infection.
      Corrosion is a well-documented phenomenon and occurs with any type of metal. The
      rate of formation of corrosion products and their toxicity varies with the
      implant composition. Toxic effects of metals, such as malignant potential and
      other adverse effects, have been demonstrated in animal models. The published
      information on this controversial and very poignant issue of metallic
      carcinogenesis is useful for all orthopedic surgeons.

PMID- 7788312
TI  - In search of the perfect ACL brace.
AB  - Following my own acute anterior cruciate ligament (ACL) tear and reconstruction,
      I embarked on a subjective evaluation of ACL functional braces voluntarily
      supplied by vendors. Both custom and off-the-shelf braces were evaluated during
      daily activities and running. Scored subjectively on an ascending scale of 1 to 3
      were Comfort (including freedom from slippage, abrasions, and pressure
      phenomena), Convenience (ease of application), Control (perceived resistance to
      anterior tibial translation), and Cosmesis (appearance, profile). On this rating
      scale, 1 represents below average, 2 is average, and 3 is above average. The
      Comfort score was doubled, as this feature determined whether the brace would be
      worn. The individual scores were then totaled for an overall rating. To avoid
      bias, I did all trials prior to reviewing the literature. Scores for custom
      braces were: Townsend, 14; Omni Scientific Elite, 11; Innovation Sports C.Ti.2,
      10; 3M Lenox Hill Spectralite, 9; Orthotech Performer, 9; DonJoy Defiance, 9; and
      Sutter Talon, 9. Scores for OTS braces were: DonJoy Goldpoint, 13; Orthotech
      Controller, 11; Bledsoe Force III Light, 11; 3M Lenox Hill OTS, 10; Innovation
      Sports MVP, 8; Bledsoe Force II, 8; Bledsoe Force II Light, 8; Omni Scientific
      Spectrum, 7; Townsend OTS, 7; and DonJoy Playmaker, 6. This study does not
      validate the requirement for a functional orthosis following ACL reconstruction,
      but if one is desired, I prefer the custom Townsend and the OTS DonJoy Goldpoint.
      Two other higher scoring OTS braces also proved satisfactory (OTS Orthotech
      Controller and OTS Bledsoe Force III Light). To accommodate the majority of
      patients, orthopedic surgeons may need to provide a variety of OTS
      braces.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788313
TI  - Femoral varus derotational osteotomy in cerebral palsy.
AB  - The records concerning 64 hips in 36 cerebral palsy patients treated with varus
      derotational osteotomy (VDO) alone (2 hips), VDO with muscle releases (adductors,
      iliopsoas, hamstrings; 46 hips), and VDO, soft-tissue release, and innominate
      bone osteotomy (16 hips) were reviewed. There were 23 quadriplegic and 13
      diplegic patients. Average age at surgery was 7 years. Average follow-up period
      was 3.8 years. All hips that had VDO, soft-tissue release, and innominate
      osteotomy were stable at follow-up. Nine hips of the 44 treated with VDO and
      muscle release alone dislocated, and required second osteotomies.

PMID- 7788314
TI  - Clinical significance of leg-length inequality after total hip arthroplasty.
AB  - Sixty-eight patients were interviewed and examined after total hip arthroplasty
      (THA) to determine the clinical consequences (patient satisfaction, shoe lift
      use, gait abnormalities, etc) of leg-length inequality. No patient met clinical
      or radiographic criteria for revision THA. Minimum follow-up was 2 years, and
      average follow-up was 6.6 years (range, 2 to 20.5 years). A questionnaire, with
      specific questions about leg-length inequality, was completed by each patient.
      Leg-length inequality was determined by orthoroentgenography and compared with
      clinical measurements of leg length. The average inequality in this series of
      patients was 9.7 mm. A significant number (32%) of patients were aware of this
      inequality; the average leg-length inequality in this group was 14.9 mm. More
      than half of these patients were disturbed by the inequality. The magnitude of
      leg-length inequality closely correlated with awareness of the inequality,
      abnormal gait, use of ambulatory assistive devices, the need for a shoe lift,
      prior leg-length inequality, and revision THA. Clinical measures of leg-length
      inequality correlated poorly with values determined orthoroentgenographically.
      The high rate of dissatisfaction among patients with a leg-length inequality and
      the untoward results associated with this inequality indicate that surgeons
      performing THA should familiarize themselves with a reliable method for
      equalizing leg lengths intraoperatively.

PMID- 7788315
TI  - Spontaneous rupture of the tibialis anterior tendon.
AB  - Spontaneous rupture of the tibialis anterior tendon is an uncommon occurrence
      that most often affects men in their fifth to seventh decades. These ruptures
      occur through abnormal tendons, but may cause little disability. Early repair
      does seem to improve the likelihood of a good result, however. The following is a
      case report, and the English literature is reviewed.

PMID- 7788316
TI  - A technique for cementing of the patellar component in total knee arthroplasty.
AB  - A technique is described for cementing of the patellar component in total knee
      arthroplasty that involves pressurization of cement into the patellar-component
      lug holes, which are drilled in the bone prior to cementing the component. A
      radiographic comparison of cement penetration with this method versus that
      obtained by using conventional techniques is illustrated.

PMID- 7788317
TI  - A 7-year-old girl with a growth disturbance in the extremities.
AB  - The following case describes the roentgenographic and clinical findings of a
      condition of interest to the orthopedic surgeon. Initial history, physical
      findings, and roentgenographic examinations are found on this page. The final
      clinical and roentgenographic differential diagnosis can be found on the pages
      that follow.

PMID- 7788318
TI  - Are classification criteria for spondylarthropathy useful as diagnostic criteria?
AB  - The authors used data from a study conducted under the auspices of the Societe
      Francaise de Rhumatologie to evaluate the sensitivity and specificity of the
      individual items of two sets of criteria for spondylarthropathy. The study
      included 124 patients with spondylarthropathy and 1,964 controls. They found that
      the spondylarthropathy criteria with the highest sensitivities and specificities
      were useful not only for classifying patients but also for assisting in the
      diagnosis of spondylarthropathy.

PMID- 7788319
TI  - Polyarthritis in HTLV-1-infected patients. A review of 17 cases.
AB  - A retrospective study was conducted in Martinique to identify patients with
      polyarthritis and positive serologic tests for the human T-cell lymphotropic
      virus Type I (HTLV-1). Patients with metabolic or bacterial causes of
      polyarthritis were excluded. We found 17 cases of HTLV-1-positive polyarthritis
      (6.7% of the total of polyarthritis patients followed in our department); there
      were 14 females and three males, and all the patients were West-Indian blacks.
      Mean age at diagnosis was 50 years. Five patients also had tropical spastic
      paraparesis. The polyarthritis was the inaugural manifestation of T-cell leukemia
      in one patient. Four patients had received blood transfusions. Fever, myalgia,
      and/or skin lesions were present at onset of the polyarthritis in seven cases.
      All 17 patients had peripheral, bilateral, symmetric polyarthritis; the most
      commonly involved sites were the hands (17/17) and knees (14/17). Three patients
      had rheumatoid factor and five had antinuclear antibody. Ten patients met at
      least four American Rheumatism Association criteria for rheumatoid arthritis;
      they accounted for 6.7% (10/150) of all polyarthritis patients managed in the
      same hospital department during the same period. We compared these ten patients
      with 20 HTLV-1-negative rheumatoid arthritis patients matched on gender, ethnic
      origin, and disease duration. There were no significant differences between the
      two groups for any of the parameters studied.

PMID- 7788320
TI  - Cervical epidural infection. Four case-reports.
AB  - The authors report four cases of cervical epidural infection, in two females
      (aged 58 and 82 years) and two males (aged 41 and 51 years). Risk factors were
      noninsulindependent diabetes mellitus in one patient and multiple myeloma treated
      by chemotherapy in another. Duration of cervical pain at evaluation was five to
      15 days. Three patients had a fever and a neurologic deficit: one had brachial
      diplegia; the myeloma patient developed brachial diplegia after a lumbar puncture
      and the diabetic patient developed quadriplegia with respiratory disorders also
      after a lumbar puncture. Cerebrospinal fluid studies showed elevated protein
      levels with approximately 20 cells per mm3 and no pathogens in smears or
      cultures. Roentgenograms were normal at admission. The diagnosis was established
      by myelography (n = 2) and/or computed tomography (n = 2) and/or magnetic
      resonance imaging (n = 2). The infected area was anterior in three cases and
      posterolateral in one. Two to seven vertebral levels were affected. A
      Staphylococcus aureus was recovered from the blood cultures in all four cases and
      from a local specimen in one of the two patients who had a laminectomy. Of the
      two patients who did not have surgery, one had a normal neurologic evaluation and
      the other was an elderly patient with myeloma. In both, antimicrobial and
      corticosteroid therapy ensured complete resolution of the infection, and the
      myeloma patient recovered normal neurologic function. Residual neurologic loss
      was seen in one of the two surgically-treated patients. Two patients developed
      discitis.

PMID- 7788321
TI  - Calcitonin and osteoporosis. Fact and fiction.

PMID- 7788322
TI  - Rehabilitation of low back pain patients. A review.
AB  - Numerous methods have been developed for the rehabilitation of low back pain
      patients, including spinal flexion and extension exercises, lumbar spine locking
      in an intermediate position, enhancement of spinal and pelvic proprioceptive
      sensibility, swimming pool therapy, back schools, and functional restoration.
      Each seeks to achieve a goal assumed to be central to the prevention of a first
      or recurrent episode of low back pain. Goals include short-term pain relief, an
      improved ability to achieve self-sedation, abdominal and lumbar muscle
      strengthening, increased hip and lumbar spine mobility, improved lumbar and
      pelvic proprioceptive sensibility, intervertebral joint stabilization, lumbar
      posture modification and improved general fitness. Less than 30 studies meeting
      widely accepted validity and applicability criteria for therapeutic trials have
      addressed the clinical efficacy of rehabilitation in low back pain patients. Most
      studies of the back school approach have found no benefit. Spinal flexion and
      extension exercise programs have yielded short-lived improvements, with no
      differences across methods. There is evidence that functional restoration
      programs based on graded activity may provide long-term benefits including better
      social and occupational outcomes. We have evaluated the physical therapy methods
      most commonly taught to and used by physical therapists in France.

PMID- 7788323
TI  - Monostotic Paget's disease involving the calcaneus. Diagnostic and therapeutic
      problems. Two case-reports.
AB  - The authors report the cases of two patients who had chronic incapacitating heel
      pain unresponsive to standard therapy. They were both found to have Paget's
      disease of the calcaneus. The diagnosis was difficult because the typical
      roentgenological changes required time to develop and because no other sites were
      involved. Local corticosteroid injections, elimination of weight-bearing, and
      standard analgesic therapy were ineffective. Bisphosphonate therapy (pamidronate)
      given as intravenous infusions ensured prompt lasting pain relief, making
      ambulation possible.

PMID- 7788325
TI  - Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) as the
      first manifestation of periarteritis nodosa. Report of a case.

PMID- 7788324
TI  - Longitudinal insufficiency fractures of the femoral shaft.
AB  - Most insufficiency fractures of the femur are transverse fractures of the femoral
      neck. We report two 77-year-old female patients with longitudinal fractures of
      the femoral shaft; one had a vertical fracture line in the proximal part of the
      shaft and the other a spiroid line in the middle third of the shaft. Both
      patients experienced apparently spontaneous onset of incapacitating mechanical
      pain in the hip or thigh; duration of the pain at evaluation was ten days in one
      case and six months in the other. Potential risk factors were osteoarthritis of
      the hip and the presence of metalwork in the knee. Increased radionuclide
      activity at the fracture site was seen on the bone scans. In one patient,
      roentgenographic and computed tomography findings were normal and the diagnosis
      was established by magnetic resonance imaging. In the other, the fracture line
      was seen clearly on computed tomography sections. Longitudinal fractures often
      escape diagnosis initially because roentgenographic changes are delayed.
      Hyperactivity on the bone scan is suggestive but sometimes so extensive as to
      mislead the diagnosis. The callus and, less frequently, the fracture line are
      sometimes seen on computed tomography sections. The role of magnetic resonance
      imaging remains to be determined.

PMID- 7788326
TI  - Lumbar intraspinal juxtaarticular cyst. Report of a case with MRI findings.

PMID- 7788327
TI  - Post traumatic seronegative polyarthritis.

PMID- 7788328
TI  - Disseminated leiomyosarcoma of the bone with progesterone receptors.

PMID- 7788329
TI  - Sjogren's syndrome revisited.

PMID- 7788330
TI  - Chondrometry. Quantitative evaluation of joint space width and rate of joint
      space loss in osteoarthritis of the hip.

PMID- 7788331
TI  - Parathyroid hormone related-peptide: how much do we know after seven years?

PMID- 7788332
TI  - HLA-DPB1*0201 is associated with particular clinical features of rheumatoid
      arthritis.
AB  - AIMS: to determine the effect of HLA-DPB1 status on rheumatoid arthritis (RA)
      susceptibility and disease expression. METHODS: HLA-DPB1 alleles were identified
      in 158 RA patients and 106 controls using PCR-sequence specific oligonucleotide
      probing. HLA-DPB1 allele frequencies were compared between patient and control
      groups and the strength of associations assessed using odds ratios and with 95%
      confidence intervals (CI). Associations observed in the total RA group were
      confirmed using a relative predispositional effect (RPE) analysis. RESULTS: an
      association between DPB1*0201 and RA was observed (OR 1.8, 95% CI 1.0-3.4). By
      contrast, negative associations were found with DPB1*0301 (OR 0.5, 95% CI 0.3
      1.0) and DPB1*1101 (OR 0.06, 95% CI 0.001-0.5). These associations were confirmed
      using RPE analysis. On further analysis the increase in DPB1*0201 and decrease in
      DPB1*0301 frequencies in RA was found to be independent of DR4 status. The
      association of DPB1*0201 with RA appears to be most pronounced in male patients
      (OR 3.3, 95% CI 1.3-8.3), seronegative patients (OR 2.6, 95% CI 0.9-7.3) those
      with non-erosive disease (OR 2.6, 95% CI 0.9-7.3) or in patients with high titre
      antinuclear antibodies (OR 2.4, 95% CI 0.8-7.1). CONCLUSIONS: HLA-DPB1 alleles
      may be associated with the pattern of disease expression in certain RA patients
      and in some cases confer protection against disease.

PMID- 7788333
TI  - Sensitivity to change of various roentgenological severity scoring systems for
      osteoarthritis of the hip.
AB  - RATIONALE: joint space assessment on roentgenograms is considered reliable for
      evaluating the anatomic severity of hip osteoarthritis. Methods for measuring
      this parameter include the scoring system developed by Kellgren and Lawrence,
      joint space width measurement, and joint space surface area measurement after
      digitalization of roentgenograms. OBJECTIVE: to compare the sensitivity to change
      of the three above-listed methods. PATIENTS AND METHODS: the study included
      patients with hip osteoarthritis meeting ACR criteria for whom two roentgenograms
      showing evidence of hip osteoarthritis taken 10 to 15 months apart were
      available. Roentgenograms were read by a single investigator who was unaware of
      the chronological order of films. Sensitivity to change of the three measurement
      techniques was determined by calculating standardized response mean (mean
      change/standard deviation of change). RESULTS: the study evaluated 34 hips (68
      roentgenograms) in 22 patients (12 females and ten males, mean age 63 +/- 10
      years) with osteoarthritis of one (n = 10) or both (n = 12) hips. Standardized
      response mean were 0.37, 0.33, and 0.16 for joint space width, joint space
      surface area, and the Kellgren-Lawrence score, respectively. CONCLUSION: this
      study suggests that joint space width or surface area may be more sensitive than
      the Kellgren-Lawrence score for monitoring the course of hip osteoarthritis.

PMID- 7788334
TI  - Adult-onset idiopathic phosphate diabetes. I. Chronic pseudoinflammatory back
      pain and osteopenia.
AB  - STUDY OBJECTIVE: to investigate clinical, laboratory test, and bone mineral
      density abnormalities in 19 adults with phosphate diabetes of unknown etiology
      diagnosed in a rheumatology department on the basis of a maximal rate for tubular
      reabsorption of phosphate (TmPO4/GFR) of 0.77 or less. RESULTS: there were 14
      males and five females with a mean age of 36.7 years (range 20 to 68 years) at
      symptom onset and 43.9 years (24-70) at diagnosis. Seventeen patients (90%) had
      back pain and 13 (68%) had nerve root pain. The pain was nocturnal only or both
      nocturnal and diurnal in 14 cases (74%). Other manifestations were fatigue (n =
      7, 37%), myalgia (n = 6, 32%), fracture (n = 6, 32%), renal colic (n = 4, 21%),
      and pseudodepression (n = 10, 53%). Laboratory test abnormalities were as
      follows: serum phosphate, 0.72 mmol/L (0.58-0.89); rate for tubular reabsorption
      of phosphate, 74% (54-84%); maximal rate for tubular reabsorption of phosphate,
      0.58 (0.4-0.76); urinary calcium/urinary creatinine > 0.48 in nine patients
      (47%); and fractional potassium excretion > 20% in seven patients (37%). Normal
      values were found for serum levels of Ca++, Na++, Mg++, creatinine, cortisol, T3,
      T4, TSH, 25(OH)D3, and 1,25(OH)2 D3. Tests for glycosuria and amino aciduria were
      negative. Bone mineral density measurements showed z-scores of -2.13 (+0.9 to 
      4.25) at L2-L4, and -1.34 (+1.5 to -3.2) at the femoral neck. Bone histology
      showed osteoporosis with a mild increase in osteoid deposition. CONCLUSIONS:
      idiopathic adult-onset phosphate diabetes manifests as chronic back pain and
      nerve root pain, sometimes with fatigue and depression. Bone mineral density
      values are decreased and histology shows osteopenia. Differential diagnoses
      include spondyloarthropathy, disk disease, fibromyalgia, and depression.
      Determination of the maximal rate for tubular reabsorption of phosphate is the
      only means of establishing the diagnosis.

PMID- 7788335
TI  - Adult-onset idiopathic phosphate diabetes. II. Time-course of clinical,
      laboratory test, and bone mineral density abnormalities under combined phosphate
      and calcitriol therapy.
AB  - STUDY OBJECTIVE: to investigate the time-course of clinical, laboratory test, and
      bone mineral density abnormalities in patients with mild phosphate diabetes
      treated for at least one year with calcitriol, 0.5 to 1.5 micrograms, and oral
      phosphate, 788 to 2300 mg per day, in three divided doses. PATIENTS AND METHODS:
      we studied eight patients with mild phosphate diabetes defined as a rate for
      tubular reabsorption of phosphate of less than 18% with a maximal rate for
      tubular reabsorption of phosphate (Tm) of less than 0.77 in the absence of any
      detectable cause of secondary tubular disease. Treatment efficacy was evaluated
      on the basis of pain severity, pain-related functional disability, serum
      phosphate and calcium levels, maximal rate for tubular reabsorption of phosphate,
      and dual-photon absorptiometry-measured bone mineral density. RESULTS: three
      patients experienced complete relief of pain and fatigue and were able to resume
      their normal activities. Partial relief was seen in two other patients. The three
      remaining patients had no response to treatment. Renal colic occurred in one
      patient. None of the patients developed hypercalcemia.

PMID- 7788336
TI  - Contribution of parathyroid hormone-related peptide to the evaluation of
      hypercalcemia.
AB  - Hypercalcemia of malignancy is due either to local osteolysis at the site of bone
      metastases or to production by the malignancy of parathyroid hormone-related
      peptide, which shares some of the effects of parathyroid hormone. We used a
      radioimmunoassay (antiserum specific to the amino-terminus) to measure serum
      parathyroid hormone-related peptide levels in controls (n = 61), chronic renal
      failure patients (n = 10), patients with primary hyperparathyroidism (n = 19),
      cancer patients with (n = 35) or without (n = 57) hypercalcemia and/or bone
      metastases (n = 53 and n = 39, respectively), and patients with hematologic
      malignancies (n = 15). We set the upper limit of normal of the parathyroid
      hormone-related peptide assay at 2.7 pmol/L. The peptide was undetectable in two
      thirds of healthy controls. Renal failure did not interfere with the assay.
      Eighteen of the 19 patients with primary hyperparathyroidism had normal levels.
      In contrast, 82% of patients with humoral hypercalcemia of malignancy (i.e.,
      without detectable bone metastases) had increased levels; in this subgroup there
      was a significant inverse correlation between serum levels of the peptide and
      phosphorus. Elevation of parathyroid hormone-related peptide levels was less
      common among hypercalcemic patients with metastatic bone disease (38%). Four of
      the seven hypercalcemic patients with hematologic malignancies had elevated
      parathyroid hormone-related peptide levels. In our overall study population,
      serum calcium levels were weakly but significantly correlated with parathyroid
      hormone-related peptide levels. In conclusion, elevated parathyroid hormone
      related peptide in a patient with hypercalcemia suggests a malignant
      disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788337
TI  - Bone tissue in rheumatoid arthritis (1). Bone mineral density and fracture risk.
AB  - Rheumatoid arthritis is associated with locoregional decalcification, which can
      be clearly demonstrated at the distal radius using single-photon absorptiometry.
      Bone loss at this site is probably due to the predominant involvement of the
      hands and wrists during rheumatoid arthritis. Estimates of the frequency of
      generalized bone loss have varied with the measurement technique used and the
      study design. Studies using dual-photon absorptiometry with a radioactive source
      have yielded conflicting data. The most recent studies of bone mineral density
      used dual energy X-ray absorptiometry, which is currently the best method in
      terms of reproducibility and precision; results suggested bone loss in the
      proximal femur, whereas lumbar spine measurements were usually normal or very
      slightly decreased. Findings from the few longitudinal studies are discordant;
      this may be ascribable to differences in bone mass measurement techniques, study
      population characteristics, and follow-up duration. Whereas bone loss was not
      demonstrated in the earliest longitudinal studies, recent investigations
      suggested that bone mineral density was decreased in rheumatoid arthritis
      patients as compared with controls. Corticosteroid therapy, even in daily dosages
      of less than 10 mg/d prednisone-equivalent, was associated with an approximately
      10% decrease in bone mass after six months, in both cross-sectional and
      longitudinal studies. Rheumatoid arthritis patients had a two-fold increase in
      fracture risk, independently from their bone mass. Factors associated with higher
      fracture risks were corticosteroid therapy, physical inactivity, and female
      gender.

PMID- 7788338
TI  - Bone tissue in rheumatoid arthritis (2). Pathophysiologic data, pathologic
      findings, and therapeutic implications.
AB  - The occurrence of bone decalcification during rheumatoid arthritis is well
      documented, despite discrepancies among published data. The most recent studies
      support a decrease in bone mass, especially at the proximal femur, although
      estimations of the extent of bone loss ascribable to rheumatoid arthritis vary.
      The fracture risk is increased by approximately 100% in rheumatoid arthritis
      patients. Bone mass is negatively correlated with functional impairment, joint
      motion restriction and disease activity as assessed by laboratory tests for
      inflammation. Increased physical activity can reduce bone loss. Markers for bone
      formation (osteocalcin, procollagen type I carboxy-terminal propeptide) are
      normal or decreased, whereas markers for bone resorption (hydroxyproline,
      pyridinoline, and deoxypyridinoline) are elevated. This decoupling of bone
      formation and resorption may be responsible for bone loss. Although estrogen
      therapy can keep in check menopause-related bone loss, earlier findings
      suggesting that estrogens may have beneficial effects on the joint disease itself
      have been disproven. The value of preventive bisphosphonate therapy is currently
      under debate.

PMID- 7788339
TI  - Intrasacral meningocele. Report of a case.
AB  - A case of intrasacral meningocele with low back pain and sciatica as the
      presenting manifestations in a 47-year-old male is reported. Magnetic resonance
      imaging established the diagnosis. Surgical treatment was successful.

PMID- 7788340
TI  - Aspergillus arthritis of the shoulder in a renal transplant recipient. Failure of
      itraconazole therapy.
AB  - We report a case of Aspergillus arthritis of the shoulder in a renal transplant
      recipient. Cultures of three joint fluid specimens grew Aspergillus fumigatus.
      Itraconazole as sole treatment resulted in initial clinical and roentgenographic
      improvements but failed to prevent deterioration in joint function. A relapse
      with fatal neurologic involvement occurred. Immune deficiency-inducing risk
      factors for aspergillosis include neutropenia and corticosteroid therapy.
      Previously published cases of Aspergillus arthritis of limb joints are reviewed.
      The advantages and limitations of itraconazole as single drug therapy are
      outlined.

PMID- 7788342
TI  - Rheumatic manifestations of pseudomembranous colitis.

PMID- 7788341
TI  - Calcium pyrophosphate dihydrate crystal deposition disease in the elderly.
AB  - Calcium pyrophosphate dihydrate deposition disease can mimic a large number of
      joint diseases. We report on three patients with predominantly systemic symptoms.
      Diagnostic pitfalls and treatment delays in these patients are discussed. Once
      the diagnosis is considered, confirmation is readily obtained by examination of
      the joint fluid and treatment promptly relieves symptoms.

PMID- 7788343
TI  - Reactive arthritis ascribed to Chlamydia pneumoniae. Report of a case.

PMID- 7788344
TI  - Hypothesis on the nature of comprehension deficit in a patient with transcortical
      mixed aphasia with preserved naming.
AB  - Patients with poor comprehension and preserved naming have been occasionally
      described. Such patients, who are affected by transcortical aphasia, have been
      taken as evidence of the possibility of naming an object while bypassing the
      semantic system. We describe a patient affected with mixed transcortical aphasia
      who presented a clear dissociation between ability in naming and difficulties in
      performing word-picture matching tasks. The pattern is explained by the existence
      of covert compulsory automatic naming that interferes with less automatic
      procedures involved in word-picture matching. In fact, when we tried to oppose
      automatic naming by using, in word-picture matching tasks, pictures difficult to
      name, the comprehension improved. This finding excludes a semantic deficit at the
      basis of poor comprehension of our patient. We suggest that the dissociation
      between naming and comprehension could be an expression of a computational
      limitation within the processes involved in word-picture matching, due to the
      competition for limited processing resources by automatically activated
      hyperactive naming.

PMID- 7788345
TI  - Decline in homophone spelling associated with loss of semantic influence on
      spelling in Alzheimer's disease.
AB  - The homophone spellings of 20 subjects with Alzheimer's disease (AD) and mild
      dementia were compared to those of matched normal controls. Both groups were
      tested once (Time 1) and then again 9 months to 1 year later (Time 2). At Time 1,
      AD subjects misspelled more homophones than the control group and the discrepancy
      between the two groups' performances significantly increased by Time 2. Two types
      of errors were tabulated: homophone confusions (i.e. an inappropriate yet
      correctly spelled homophone given the context, such as spelling doe, given the
      context "bake the bread dough") and other spelling errors (e.g. doue, dogh). The
      relationship between homophone confusions and confrontation naming increased from
      Time 1 to Time 2. In contrast, the relationship between the number of spelling
      errors (that were not homophone confusions) and confrontation naming performance
      was not significant at Time 2. One subgroup of 3 subjects showed an increase in
      homophone confusions and confrontational naming errors and not more spelling
      errors. Another subgroup of 4 subjects showed neither an increase in homophone
      confusions nor in confrontational naming errors, but did show an increase in
      spelling errors. Based on these results, we suggest that homophone confusions are
      primarily due to impairment of semantic access to a functional orthographic
      output lexicon. Other spelling errors may reflect post-linguistic spelling
      deficits without a significant change in the use of semantic input for spelling
      homophones.

PMID- 7788346
TI  - Syntactic processing in agrammatic aphasia by speakers of a Slavic language.
AB  - It is widely believed that agrammatic aphasics have lost the ability to assign
      complete syntactic representations. This view stems from indications that
      agrammatics often fail to comprehend complex syntactic structures, as for
      example, some types of relative clauses. The present study presents an
      alternative account. Comprehension by Serbo-Croatian-speaking agrammatic aphasics
      was tested on four types of relative clause structures and on conjoined clauses.
      The relative clauses varied in type of embedding (embedded vs. nonembedded) and
      in the location of the gap (subject position vs. object position). There were two
      control groups: Wernicke-type aphasics and normal subjects. The findings from a
      sentence-picture matching task indicated that agrammatic aphasics were able to
      process complex syntactic structures, as evidenced by their well-above chance
      performances. The success rate varied across different types of relative clauses,
      with object-gap relatives yielding more errors than subject-gap relatives in all
      groups. Each group showed the same pattern of errors: agrammatic subjects were
      distinguished from Wernicke subjects and normal subjects only in quantity of
      errors. These findings are incompatible with the view that the agrammatics are
      missing portions of the syntax. Instead, their comprehension deficits reflect
      varying degrees of processing impairment in the context of spared syntactic
      knowledge.

PMID- 7788347
TI  - Visual word activation in pure alexia.
AB  - A patient with pure alexia (DM) is shown to perform rapid and accurate lexical
      decisions for common words without the ability to recover their complete
      identity. We provide evidence using a speeded decision task that DM is not forced
      to rely on a laborious analysis of individual letter forms when judging the
      lexical status of orthographic patterns varying in length, though he clearly must
      use this approach to fully identify a word for explicit report. By contrast, the
      ability to rapidly classify a word apparently does not extend to judgements of
      its superordinate category. DM makes semantic decisions for visual words by
      adopting the same inefficient procedure he uses for verbal report of their
      identity. The results provide further constraints on the functional deficit
      responsible for pure alexia. We argue that DM is able to monitor the overall
      activation of word units without achieving full identification and that such a
      process may be a characteristic of the normal reading mechanism.

PMID- 7788348
TI  - Acclimation of a non-indigenous sub-Arctic population: seasonal variation in
      thyroid function in interior Alaska.
AB  - Total, as well as free, T4 and T3 levels were obtained over four seasons for
      young male infantry soldiers assigned to interior Alaska. Significant seasonal
      variations were found in both T3 and T4. Total T4 and T3 levels were highest in
      winter, while free T4 and T3 levels were highest in early spring. Correlations
      with melatonin levels from a concurrent study showed an association between late
      day (17.00) mean spot melatonin levels during the preceding summer and T3 levels
      in winter and spring. Differences in seasonal T4 and T3 levels between indigenous
      and newly arrived people in the sub-Arctic may be related not only to cold
      acclimation but also to light.

PMID- 7788349
TI  - Calcium-dependent regulation of membrane ion permeability in a cell line derived
      from the equine sweat gland epithelium.
AB  - We measured the rates of 125I- and 86Rb+ efflux from preloaded, cultured equine
      sweat gland cells. The calcium ionophore ionomycin increased the efflux of both
      isotopes. Anion efflux was unaffected by Ba2+, but this cation inhibited 86Rb(+)
      efflux, suggesting that [Ca2+]i-activated potassium channels were present.
      Activation of these channels was not, however, important for the efflux of
      anions. We measured 125I- efflux from valinomycin-depolarised cells in which
      anion cotransport was inhibited. Changes in 125I- efflux reflect changes in anion
      permeability under these conditions, and ionomycin caused a clear permeability
      increase that was abolished by the anion channel blocker diphenylamine-2
      carboxylate. ATP and UTP increased the efflux of both isotopes, suggesting that
      type P2U purine receptors allow these nucleotides to regulate membrane
      permeability.

PMID- 7788350
TI  - In situ degradation and absorption of [15N]urea in chicken ceca.
AB  - [15N]Urea was introduced (in situ) into a ligated cecal pouch of chickens to
      determine if it is degraded therein and absorbed into the blood as ammonia during
      the following 60 min. A mean of 49% of the introduced urea-15N was recovered from
      the blood of the mesenteric vein draining the cecal pouch and 26% was recovered
      from the cecal lumen fluid. Of the urea-15N introduced into the pouch, 4%, 2%,
      15% and 5% were detected as urea, ammonia and non-protein fractions, except urea
      and ammonia, and proteins in the lumen fluid, respectively. Non-protein-15N,
      except urea and ammonia, protein-15N, urea-15N and ammonia-15N values recovered
      in the cecal venous blood were 10%, 19%, 18% and 2% of the introduced 15N,
      respectively. Urea concentration in the cecal venous blood increased from 0.71 mg
      to 3.13 mg per 100 ml for the first 15 min after introduction of urea-15N (P <
      0.01) then decreased until 60 min. No significant change was found in blood
      ammonia concentration, however, despite a small increase during the period 15-45
      min after urea-15N introduction. Ammonia-15N increased in the caecal venous blood
      for the first 30 min then decreased to a plateau level of 43% of the peak level.
      The rates of increase of urea-15N and non-protein-15N concentrations attained
      maxima in the blood as early as 15 min, then decreased linearly (P < 0.05). It is
      concluded that, although urea is actively degraded to ammonia in the ceca, it is
      mostly absorbed from the ceca, not in the form of ammonia, but as protein, urea
      and amino acids.

PMID- 7788351
TI  - Outward chloride/potassium co-transport in insect neurosecretory cells (DUM
      neurones).
AB  - The mechanism underlying outward chloride transport in the cell body and in the
      neuritic field of cockroach Dorsal Unpaired Median (DUM) neurones was assessed
      using the intracellular microelectrode technique. The chloride equilibrium
      potential was indirectly estimated from the reversal potentials of responses to
      gamma-aminobutyric acid (GABA) pressure ejections and of inhibitory postsynaptic
      potential (IPSP) evoked by electrical stimulation of the anterior connectives.
      Changes in intracellular chloride concentration [Cl-]i following various
      treatments were estimated from the amplitude changes of soma GABA responses and
      IPSP. Decreasing external Cl- concentration reduced the amplitude of GABA
      mediated inhibitory events without affecting the membrane potential. Cl-/K+ co
      transport was assessed by increasing external K+ concentration. The rate of
      outward Cl- movement was reduced furosemide but not by SITS or DIDS. All these
      results suggest that Cl- is not passively distributed in DUM neurones and that an
      active outwardly directed Cl-/K+ co-transport is implicated in the regulation of
      [Cl-]i.

PMID- 7788352
TI  - Effect of sera from lean and obese pigs on the differentiation of porcine adipose
      stromal-vascular cells in culture.
AB  - Primary cultures of stromal-vascular (S-V) cells from adipose tissue of new-born
      pigs were used to evaluate the characteristics of four sera obtained from male
      and female genetically lean or obese pigs weighing 50-60 kg. (2) Lean pig sera
      (LPS) stimulated greater levels of sn-glycerol-3-phosphate dehydrogenase (GPDH)
      activity in cultured cells than obese sera (OPS). Male LPS tended to promote
      higher GPDH specific activity than female LPS or male and female OPS. When GPDH
      was expressed on a per DNA basis, male LPS significantly (P < 0.05) increased
      GPDH per unit DNA compared with female LPS or male and female OPS.

PMID- 7788354
TI  - Protecting your baby against infection.

PMID- 7788353
TI  - A simulated insect diet as a water source for quail: effects on body mass and
      reproduction.
AB  - Compared with control birds receiving ad libitum free-water, the total water
      intake of male and female northern bobwhite declined when only mealworms were
      available as a source of water. Male northern bobwhite sustained tissue mass and
      reproductive function with mealworms as their only source of water. Female
      northern bobwhite could not sustain body, ovary, and oviduct mass, and rate of
      egg production with mealworms as their only source of water. We suggest that,
      without free-water, breeding females require a diet with a water:dry matter ratio
      of greater than 1:1.29 (> 44% water).

PMID- 7788356
TI  - Misdiagnosis, abortion and pregnancy.

PMID- 7788355
TI  - Demystifying the research process in education.
AB  - A well-developed base of empirical research is essential for accountable
      midwifery practice. Midwives need to develop 'research confidence'. The research
      process is explained sequentially from identification of the research problem,
      through literature review, research design, methodology, data collection and
      analysis. Research will enable the midwifery profession to develop further by
      uncovering the knowledge embedded in practice and in the education and management
      of midwives.

PMID- 7788358
TI  - Natural family planning.
AB  - Natural family planning (NFP) methods can be effective if taught well and
      practised by well-motivated couples. Midwives should be able to give couples an
      understanding of the basic principles of the methods. The observable signs of the
      fertile cycle are changes in basal body temperature, in the consistency of
      cervical mucus and in the texture and position of the cervix. Practised properly
      the ovulation method can have a failure rate of as little as 2.2 pregnancies per
      100 woman-years. The ovulation method is a suitable method for mothers who have
      breastfed to detect the onset of ovulation.

PMID- 7788357
TI  - Brave new world?
AB  - Arguments in favour of embryo research Prevention of congenital defects.
      Reduction in number of miscarriages. Better understanding of infertility.
      Arguments against embryo research Morally unacceptable to take potential human
      life. The 14-day limit on research is arbitrary. Fears about the creation of
      'superspecies' and 'designer babies'. Fear of embryo 'trade' in which embryos are
      bought and sold.

PMID- 7788360
TI  - Degree courses--why tread the academic path?

PMID- 7788359
TI  - Intention and reality in infant feeding.
AB  - Eighty women in a Nottingham practice completed antenatal and postnatal
      questionnaires about breastfeeding: 94% agreed that breastmilk was better than
      infant formula, but only 76% intended to breastfeed. The study confirms previous
      reports that primiparous women have a higher breastfeeding failure rate (45% had
      stopped by eight weeks). Women who gave later first feeds, or who were offered
      supplementary feeds in the postnatal ward, were more likely to be bottlefeeding
      at eight weeks. Hospital stays of less than 24 hours were strongly associated
      with successful feeding. Mothers receive little breastfeeding support from family
      or friends in the immediate postnatal period.

PMID- 7788362
TI  - The maternity care of Muslim women.
AB  - There are approximately 1.7 million Muslims in the UK. Followers of Islam observe
      certain religious and cultural practices during pregnancy and childbirth which
      midwives need to know and understand. Husband or children should not be used as
      interpreters as it is culturally unacceptable for many Muslim women to talk about
      intimate matters in front of their families. Midwives should not make assumptions
      when offering pain relief - in Islam pain is accepted as a natural part of
      childbirth. There may be some misconceptions about breastfeeding (for example,
      that colostrum is 'unclean'), and Muslim mothers - like all new mothers - need
      education and support.

PMID- 7788361
TI  - Ultrasound--routine practice or practised routine?

PMID- 7788363
TI  - Getting ready for the big day.

PMID- 7788364
TI  - Choice and control for the disabled mother.
AB  - One-to-one maternity care is most appropriate to the disabled woman's needs. The
      midwife should find out about the sources of help available to the disabled
      mother--lay sources of support and information should be tapped as well as
      professional expertise. Vaginal delivery should not be ruled out and is possible
      in the majority of cases. While tiredness is a problem for any new mother,
      midwives should guard against 'taking over' too much responsibility from the
      disabled mother in the mistaken belief that they are 'helping'.

PMID- 7788365
TI  - Getting to know your client.
AB  - Continuity is important in many aspects of life, but particularly during
      pregnancy and childbirth when a woman is experiencing physical and emotional
      upheaval. Midwives need to explore the allocation of resources to ensure
      continuity of care. A caseload system in which a midwife takes on about 36 women
      a year offers the client continuity and the midwife a satisfying working style
      which fits in with her own needs. A caseload may include high-risk pregnancies,
      which may provide the midwife with learning experience. Teaming up with others is
      the best way to run a caseload, and would leave enough midwives to provide expert
      staff on labour and postnatal wards.

PMID- 7788366
TI  - Continuing education--a choice between affluence and deprivation.
AB  - The study sought to identify reasons why initial enthusiasm for in-service
      training was not reflected in actual attendance. An interview and questionnaire
      survey of 61 midwives in a London health authority assessed their perceptions of,
      motivation for and participation in continuing professional education (CPE). The
      midwives surveyed appreciated the need for CPE, kept up with professional reading
      and took part in a wide range of educational activities. Managers and staff
      midwives were the poorest attenders at study days and training sessions, which
      may have adverse consequences for their development. It is suggested that CPE
      improves clinical standards and raises morale (a cycle of affluence) and that it
      may also prevent stress and 'burnout'.

PMID- 7788367
TI  - Vaginal birth after lower segment caesarean section.
AB  - One delivery in eight in the UK is by caesarean section. Women who have had a
      previous caesarean section may approach a midwife in subsequent pregnancies
      because they want more control over their labour. Vaginal birth after caesarean
      section (VBAC) is a safe option for women with a lower segment scar. Factors
      associated with a favourable outcome include spontaneous labour and freedom of
      movement during labour. Factors hindering successful outcome include reduced
      mobility, use of oxytocin, and time limits set on progress of labour.

PMID- 7788368
TI  - Diet and atopic eczema.

PMID- 7788369
TI  - Good nutrition for the vegetarian mother.
AB  - A pregnant or nursing vegetarian mother needs to be aware of the need to vary her
      diet because the nutrients that she would otherwise get from meat or fish are
      more widely scattered in foods of plant origin. Diets which exclude dairy
      products require more careful planning. Particular attention needs to be made to
      the mother's intake of iron, calcium, vitamin B12 and vitamin D. Vegetarian
      mothers do not show a higher incidence of complications of pregnancy, but there
      are some links between vegetarians and lower birthweight and earlier labour. On
      weaning the infant's diet should not be too bulky and should provide adequate
      vitamin D and B12.

PMID- 7788370
TI  - Midwifery in Mexico.
AB  - In Mexico, traditional midwives maintain the customs and rituals that have
      surrounded pregnancy and childbirth since pre-Hispanic times. 'Empirical'
      midwives are allowed to practise on the basis of experience and a minimal two
      week training programme. Graduate nurse-midwives usually go into general nursing
      and few practise midwifery, despite taking a year's specialist training in their
      four-year course. A project with graduate nurse-midwives demonstrated safe
      practice--the nurse-midwives delivered 1,500 babies with no maternal deaths and
      only two infant deaths in the five-year period.

PMID- 7788371
TI  - Insurance--why single out the independent midwife?

PMID- 7788372
TI  - Preconception care--are midwives in danger of missing the boat?

PMID- 7788373
TI  - The midwife and risk management at work.

PMID- 7788374
TI  - Midwives' invasive cuts.

PMID- 7788375
TI  - Reliable or liable?

PMID- 7788376
TI  - Your baby's first solid foods.

PMID- 7788377
TI  - Breastfeeding--midwives' personal experiences.
AB  - 99% of midwife mothers surveyed had a positive attitude to breastfeeding. 82% of
      these midwives considered that they had been successful in their attempt to
      breastfeed their own babies. 66% felt that the theory of breastfeeding they
      learned was applicable in practice. Of those for whom theory was applicable in
      practice, 76% felt that their theoretical knowledge also contributed to a
      positive personal experience of breastfeeding. The factors which contributed to
      successful breastfeeding were a relaxed approach, a positive attitude,
      determination and good support from partners and other midwives. The factors
      which contributed to unsuccessful breast-feeding were breast problems, fatigue,
      and poor milk supply. Midwife mothers would have appreciated more support with
      breastfeeding-many felt that they were left to cope on their own because they
      were health professionals.

PMID- 7788379
TI  - Handle with care.
AB  - 25% of all midwives have taken sick leave because of back injury. The onus is on
      the employer to see that employees are not made to undertake risky manual
      handling work. The place of confinement should be checked beforehand for
      suitability and safety. Temporary staff are covered by the risk assessment
      process, but independent midwives are not.

PMID- 7788378
TI  - How effective is antenatal education?
AB  - Ideal opportunities exist to offer women information during routine antenatal and
      postnatal care. Within the present antenatal system the midwife may not be using
      her teaching skills, or those skills may be out of date with modern developments.
      Education about childbirth could begin in schools. The midwife could also fulfil
      another valuable role, as mediator, providing parents with links with each other.
      Midwives should remember that parents have a lot to offer them as a resource.

PMID- 7788381
TI  - Individualised care--from blueprint to practice.
AB  - The first task was to develop a midwifery model, which initially meant
      establishing a philosophy of midwifery care. The next task was to consider
      documentation to support the system. The third part of the working group's remit
      was to educate their peers about the system. After implementation of the system,
      evaluation will be necessary.

PMID- 7788380
TI  - Maternity care for the visually impaired.
AB  - Midwives should not express doubts about a blind woman's ability to cope but try
      to boost the woman's confidence and encourage her to build on her skills. The
      mother needs to understand that as her abdomen enlarges and her centre of gravity
      shifts, she may find it more difficult to assess her own body space and her
      relationship to other objects. Blind women appreciate continuity of care from a
      small number of known professionals and may prefer a home birth or domino scheme.
      For those who go to hospital, help with negotiating busy waiting areas, pulling
      up chairs and getting into bed is likely to be welcomed. The support of another
      blind mother is invaluable as experiences can be shared.

PMID- 7788382
TI  - Caesareans on the rise--a cause for concern?
AB  - The number of caesarean sections performed in the UK has increased nearly
      threefold since 1973. Improvements in the safety of the procedure and in neonatal
      intensive care may account for this increase. Caesareans are being performed
      increasingly for breech presentations. Fear of litigation has been cited as a
      reason for the increase. Midwives should be working with the pregnant woman long
      before the question of a caesarean arises.

PMID- 7788383
TI  - Improving management of miscarriage and stillbirth.

PMID- 7788384
TI  - Maternal death--new figures.

PMID- 7788385
TI  - The Baby Friendly Hospital Initiative UK.

PMID- 7788386
TI  - The midwives' birthday.

PMID- 7788387
TI  - How to make your home safe for your new arrival.

PMID- 7788388
TI  - Safe motherhood in the United Kingdom.
AB  - The Safe Motherhood Initiative (SMI) is a global effort to reduce maternal
      mortality and morbidity. The target is to reduce maternal deaths by at least half
      by the year 2000. The SMI aims to enhance the quality and safety of women's lives
      through the adoption of a combination of health and non-health strategies. The
      SMI places special emphasis on the need for better and more widely available
      maternal health services, the extension of family planning education and
      services, and effective measures aimed at improving the status of women. Activity
      within the SMI may take many forms: Increasing awareness of the dimensions of the
      problem and the need for action. Strengthening maternal health services. Training
      of health workers and others. Facilitating educational and economic opportunities
      for women. Research, particularly operational research. Partners within the SMI
      are governments, agencies, non-governmental organisations and other groups and
      individuals who stimulate and participate in efforts likely to reduce the number
      of women suffering and dying as a result of pregnancy and childbearing.

PMID- 7788389
TI  - The Southampton Wave.
AB  - The course planning team at Southampton University College of Midwifery wanted to
      offer a diploma course which reflected the realities of midwifery education in
      the clinical setting. For this a curriculum model--The Wave--was developed. The
      Wave is not a static model, but reflects the changes a midwifery curriculum must
      absorb in context and circumstances. Allocation of students to clinical areas is
      linked with course content, allowing direct application of theory to practice and
      practice to theory.

PMID- 7788390
TI  - Slimming and fertility.
AB  - Severe reducing diets cause low levels of progesterone, slowing down follicular
      growth, inhibiting the surge of luteinising hormone (LH) and preventing
      ovulation. If less severe, slimming may depresses hormone levels by producing too
      small a corpus luteum and may result in a miscarriage. A reducing diet over a
      longer period may also affect fertility. Women planning pregnancy should be
      advised on the regularity as well as the adequacy of meals during the
      preconception period. A woman's nutritional status may be adequate for fertility
      but inadequate to produce a baby in the optimum birthweight range. There is a
      recovery period from amenorrhoea when it is wise not to conceive.

PMID- 7788391
TI  - The duration of the second stage of labour.
AB  - Fetal outcomes following extended second-stage labour include respiratory
      acidosis, lower umbilical vein and artery pH, lactacidaemia and early neonatal
      seizures. Maternal outcomes following extended second-stage labour include
      postpartum haemorrhage, puerperal fever, backache, musculoskeletal problems,
      stress incontinence and denervation of the pelvic floor. It is suggested that
      intervention should be based on the use of judgement and skill rather than strict
      adherence to timetables.

PMID- 7788393
TI  - Mothers in prison.

PMID- 7788394
TI  - Self-administration of castor oil.

PMID- 7788392
TI  - Alternative therapies offer more say in care.
AB  - Alternative medicine is holistic in its approach to the individual. Orthodox
      medicine, in contrast, is biomedical, viewing the body mechanistically.
      Alternative therapies are not without risk, and many are an unknown quantity.
      Mothers often feel that their own wants and values are disregarded because of
      professional or administrative pressure. Midwives should not prescribe
      alternative medicines or practise any therapies unless properly trained and then
      only if it is not in breach of hospital or health authority policy. Increasingly,
      midwives are involved in formulating new policies, so enabling the promotion of
      beneficial change.

PMID- 7788395
TI  - Midwifery-managed units.
AB  - Midwives involved in the establishment of a midwifery-managed unit were given the
      opportunity to express their concerns anonymously. The principal areas of concern
      they identified were: Risks to mother and baby. Transfers from the unit to the
      district general hospital. Refusals by clients. Indemnity, litigation and
      protection by management. Prescribing, training and updating.

PMID- 7788396
TI  - Choice, informed choice or no choice?

PMID- 7788397
TI  - What PREPP means to midwives.

PMID- 7788398
TI  - Look after yourself.

PMID- 7788399
TI  - Sound choices: part 1: principles and process.

PMID- 7788400
TI  - Child sexual abuse, labour and delivery.

PMID- 7788402
TI  - Welcome to the antenatal day unit.

PMID- 7788403
TI  - The Optical Memory Card.

PMID- 7788401
TI  - Antenatal screening for Down's syndrome.

PMID- 7788405
TI  - The midwives' voice.

PMID- 7788407
TI  - LTC law: nursing documentation in the courtroom.

PMID- 7788404
TI  - What happens when the midwife is ignored?

PMID- 7788408
TI  - TQM in action ... the experience of a nursing documentation project team.
AB  - This is the second article in a two-part series that describes the implementation
      of TQM at the Jewish Home of Rochester, New York, a 362 bed long term care
      facility. The first article gave an overview of the implementation process in the
      organization. This article describes the work of one of the initial project
      teams.

PMID- 7788406
TI  - Midwifery in Indonesia: a professional snapshot.
AB  - In 1988, Indonesia had the highest maternal mortality rate in South East Asia,
      but the Government's commitment to reducing this has already demonstrated a
      measure of success. Initiatives include: use of voluntary healthcare workers
      (kaders) in the local community family planning initiatives raising awareness of
      the status of women in society by the appointment of a Minister for Women's
      Affairs. The commitment of both the government and midwives to promoting safe
      motherhood in Indonesia should make a significant contribution to achieving the
      WHO aim of halving the maternal mortality rate by the year 2000.

PMID- 7788409
TI  - Across the world ... notes from China. Part III.

PMID- 7788410
TI  - Medicare cuts can affect us all--as citizens and as health care professionals.

PMID- 7788411
TI  - AIDS in the nursing facility ... staff considerations.

PMID- 7788412
TI  - Managing the front line of infection control: handwashing.

PMID- 7788414
TI  - Is anyone watching?

PMID- 7788413
TI  - Do we still need the rules?

PMID- 7788415
TI  - Evaluating nursing home employees: using the information to improve employee
      performance.

PMID- 7788416
TI  - Director's dialogue.

PMID- 7788417
TI  - New draft guidelines for isolation precautions.

PMID- 7788418
TI  - Across the world.

PMID- 7788419
TI  - Nurses raise their voices for safety of patient care and conditions of practice!

PMID- 7788420
TI  - Post-accident communication: practical tips designed to diffuse anger.

PMID- 7788421
TI  - Multiple superinfections fail to activate defective human immunodeficiency virus
      1 (HIV-1) infection of rabbits.
AB  - Superinfection of human immunodeficiency virus (HIV)-1-infected rabbits with
      Treponema pallidum, Mycobacterium avium, herpes simplex, Candida albicans,
      Mycoplama incognitus, and malignant catarrhal fever virus, as well as irradiation
      or cortisone treatment, fails to activate production of infectious virus. For up
      to 6 months after infection of rabbits with HIV-infected cells or free virus,
      there are neither clinical symptoms nor positive laboratory tests for detection
      of HIV. However, after superinfection with other agents, HIV sequences may be
      transiently found in peripheral blood mononuclear cells by polymerase chain
      reaction (PCR), and multiple antibodies to HIV antigens may be detected by
      Western blotting. Both the PCR positivity and Western blot reactivity become
      negative with time after superinfection. Other than delayed healing of the skin
      lesions produced by T. pallidum and vaccinia in HIV-infected rabbits, there is no
      evidence of any immune abnormality. After death, gag sequences are detectable in
      the splenocytes of essentially every HIV-infected rabbit, and the splenocytes of
      eight of 25 infected rabbits responded by proliferation to HIV peptides. In
      addition, gag sequences are detectable in rabbits that are injected with lymphoid
      cells from HIV-infected rabbits. However, after multiple testing of both
      peripheral blood of living rabbits and organs of rabbits that died or were killed
      (spleen, brain, lymph nodes, liver, and gastrointestinal tract), no viable virus
      has ever been convincingly detected by in vitro cultivation with indicator cells.
      In contrast to some other published reports, these data indicate that HIV-1
      infection of rabbits does not provide a model for AIDS pathogenesis therapy or
      prevention, but it may be useful as a model to study the relative resistance of a
      small fraction of the human population to development of AIDS after HIV
      infection.

PMID- 7788423
TI  - The prognostic value of plasma viremia in HIV-infected patients under AZT
      treatment: a two-year follow-up study.
AB  - To determine the prognostic value of plasma viremia in long-term zidovudine (AZT)
      treated HIV-infected patients, HIV-1 plasma viremia (PV) was quantified in 28 HIV
      infected patients before and during AZT long-term treatment; the follow-up also
      included p24 antigenemia and CD4 cell counts. The variations of these markers
      during the follow-up period, the correlation with the clinical outcome
      (progressors versus nonprogressors), and the discrepancies between PV and
      surrogate markers were then analyzed. A significant and stable decrease in PV
      titer was observed in only nonprogressors (Friedman test, p < 0.005). At the end
      of follow-up, 11 (73%) of the 15 non-progressors were PV responders (patients who
      remained or became PV- long-term), whereas all the 13 progressors were PV
      nonresponders (patients who remained or became PV+). These results indicated a
      strong correlation between PV and clinical outcome (Fischer's exact test, p <
      0.0001). The persistence, increase, or reappearance of viral replication appeared
      to be an important predictor of poor clinical outcome in HIV-infected patients
      under AZT treatment. This finding could provide a rational basis to help the
      clinician's decision in the clinical treatment of HIV-infected patients.

PMID- 7788422
TI  - A prospective study of mother-to-infant HIV transmission in tribal women from
      India.
AB  - The transmission of human immunodeficiency virus type 1 from infected mothers to
      their babies was assessed by serologic, virologic, and clinical means. Of the 160
      antibody-positive women enrolled at the beginning of the study, 13 had overt
      clinical symptoms (CDC stage III/IV). Termination of pregnancy was done, on
      request, in seven of these cases. The rest delivered prematurely. A total of 143
      parturient women and their infants were followed prospectively until the babies
      were 18 months of age. Fifteen infants (9%) died of AIDS before 14 months of age.
      The remaining 128 children (91%) were alive at the end of the study period.
      Seventy-four seropositive children (46%) became seronegative and were considered
      noninfected. None of the seronegative children reverted to seropositive status
      despite the fact that they were breast-fed. The majority of the seropositive
      children (63%) became symptomatic and clinically ill during infancy. The overall
      mother-to-infant vertical transmission rate was 48%.

PMID- 7788424
TI  - Clinical evaluation of Amplicor HIV-1 test for detection of human
      immunodeficiency virus type 1 proviral DNA in peripheral blood mononuclear cells.
AB  - We report here the clinical evaluation of Amplicor polymerase chain reaction
      (PCR) assay for the detection of the human immunodeficiency virus type 1 (HIV-1)
      in peripheral blood mononuclear cells (PBMCs). Results obtained with Amplicor HIV
      1 test were compared to serological status and a standard PCR assay using
      SK38/SK39 and oligomer hybridization with SK19. A panel of 208 well-characterized
      specimens was analyzed, including PBMC lysates from 47 antibody-negative high
      risk individuals, eight antibody-negative low-risk subjects, two subjects with
      acute retroviral disease, 35 asymptomatic seropositive subjects (59 samples) with
      CD4 counts > 400/mm3, 31 patients (46 samples) with AIDS-related complex (ARC),
      30 patients (40 specimens) with AIDS, and six seropositive patients with unknown
      clinical status. Amplicor demonstrated a specificity of 100% and a sensitivity of
      98.7%. Of the two false-negative samples with Amplicor, one was negative for beta
      globin amplification, whereas a dilution of the other sample turned positive for
      HIV-1. Inhibitors of Taq polymerase were thus believed to be responsible for the
      negative results. This study demonstrates that commercialized nonisotopic PCR
      assays reach adequate levels of sensitivity and specificity for diagnosis of HIV
      1 infection and could be considered in clinical situations in which serology is
      not helpful.

PMID- 7788425
TI  - A phase I evaluation of concomitant rifabutin and didanosine in symptomatic HIV
      infected patients.
AB  - It has been suggested that didanosine (ddI) may undergo hepatic metabolism.
      Rifabutin is an inducer of drug metabolism. Fifteen human immunodeficiency virus
      infected patients whose conditions were stabilized on twice-daily doses of ddI
      participated in a Phase I, open-label, pharmacokinetic and safety drug
      interaction study between rifabutin and ddI. Twelve patients completed the study.
      All patients received their regular ddI dose (167-375 mg) on day 1. On days 2-13
      they received once-daily rifabutin (600 mg, three patients; 300 mg, nine
      patients) with their regular twice-daily ddI regimen. On days 14-16 they received
      rifabutin alone. Serial blood and urine samples were collected for 12 h on day 1
      and for 24 h on days 13 and 16, and safety evaluations were made throughout the
      study. Average day 1/day 13 ddI pharmacokinetic ratios and 95% confidence
      interval values for Cmax, AUC0-infinity, Cls/F, and t 1/2, lambda z were 1.17
      (0.96-1.38), 1.13 (0.99-1.27), 0.91 (0.81-1.01), and 0.97 (0.79-1.15),
      respectively (p > 0.05 for all comparisons; paired t test). A 20% difference in
      AUC0-infinity could be detected with 90% power. Also, there were no significant
      changes in laboratory values or electrocardiograms, or in rifabutin
      pharmacokinetic parameters when the two agents were coadministered. Based on the
      safety and pharmacokinetic assessments, rifabutin did not appear to interact with
      ddI.

PMID- 7788426
TI  - Clinical experience with atovaquone on a treatment investigational new drug
      protocol for Pneumocystis carinii pneumonia.
AB  - The clinical experience of human immunodeficiency virus (HIV) + patients treated
      with oral atovaquone for acute Pneumocytstis carinii pneumonia (PCP) under a
      Treatment Investigational New Drug (IND) protocol (mild or moderate PCP) and an
      Open-Label Study protocol (severe PCP) was evaluated. A total of 940 patients
      intolerant of or unresponsive to trimethoprimsulfamethoxazole were enrolled from
      private practices, clinics, and institutional HIV treatment centers in the United
      States. Demographics data and the history and severity of PCP were collected at
      enrollment. The number of therapy days, adverse experiences, clinical response to
      therapy, and mortality were collected at day 21. Reporting of serious, unexpected
      adverse experiences attributable to therapy was required. Of the 760 (96%)
      patients with mild to moderate disease for whom follow-up observation was
      complete, 591 (78%) responded clinically to treatment, 177 patients (23%)
      discontinued treatment prematurely, and 50 patients (7%) died. Of the 140
      patients (95%) with severe PCP with follow-up data, 79 (56%) responded to
      treatment, 45 (32%) discontinued treatment early, and 53 patients (38%) died.
      Adverse events that resulted in temporary or permanent discontinuation of therapy
      included diarrhea, vomiting, elevated liver enzyme levels, nausea, and fever. No
      serious unexpected adverse events attributable to the drug were reported. The
      treatment IND mechanism enabled a large number of patients with acute PCP to be
      treated with this experimental therapy while the drug was under regulatory view.

PMID- 7788427
TI  - Score cards for AIDS care.

PMID- 7788428
TI  - Recent infection with human immunodeficiency virus and possible rapid loss of CD4
      T lymphocytes.
AB  - To assess a hypothesized trend that persons recently infected with the human
      immunodeficiency virus (HIV) may have more rapid declines in absolute CD4 T
      lymphocyte (CD4+ cell) counts than those who were HIV-infected in earlier years,
      sequential CD4+ cell counts in three groups who had definable dates of HIV
      seroconversion between 1978 and 1992 were reviewed. The CD4+ cell counts examined
      were from some of the longest extant studies in the United States: 100 homosexual
      and bisexual men engaged in ongoing observational cohort studies in San
      Francisco, Denver, and Chicago since 1978 (Group 1); 89 persons in South Carolina
      infected after 1986 (Group 2); and 155 injecting drug users participating in an
      observational cohort study in Baltimore since 1988 (Group 3). For all groups,
      individually and in the aggregate, mean CD4+ cell counts declined rapidly in the
      first year after HIV infection and then stabilized. However, there was no clear
      trend for lower (or higher) CD4+ cell counts by fixed time after HIV
      seroconversion among those seroconverting in recent compared with earlier
      calendar years. These data do not support a hypothesized trend for more rapid
      loss of CD4 T lymphocytes--and, by implication, more pathogenic strains of HIV-1-
      among persons acquiring HIV infection in recent years.

PMID- 7788429
TI  - Incubation period of vertically acquired AIDS in Europe before widespread use of
      prophylactic therapies.
AB  - European surveillance data on vertically acquired (VA) AIDS cases were used to
      investigate the incubation period of AIDS in the absence of widespread
      prophylactic treatment and to assess the uncertainty associated with parametric
      estimates based on retrospective data. Nonparametric and parametric analyses,
      taking into account the effects of data truncation, were based on a total of 792
      children diagnosed with AIDS between July, 1982, and June, 1990, inclusive. Among
      HIV-infected children who develop AIDS within 8 years, the nonparametric estimate
      of the median age at diagnosis was 34 months. If 20% of children are assumed to
      develop AIDS by the age of 1 year (a plausible estimate on the basis of published
      cohort data), the estimated median among all maternally HIV-infected children is
      4.4 years, with 26% of children expected to remain AIDS free by 8 years of age.
      Results from the parametric (double Weibull) model support the hypothesis of a
      bimodal distribution, with a subgroup of children progressing rapidly to AIDS at
      a median age of approximately 5 months. However, neither the relative size of
      this group nor the median age at which AIDS develops in the remaining children
      can yet be estimated with any reasonable precision.

PMID- 7788431
TI  - Frequency of human herpesvirus type 6 (HHV-6) genome detection in AIDS-related
      lymphoproliferative disorders.

PMID- 7788432
TI  - Surveillance for the acquired immunodeficiency syndrome in Japan.

PMID- 7788430
TI  - Virologic and immunologic characterization of symptomatic and asymptomatic
      primary HIV-1 infection.
AB  - To define virologic and immunologic differences in patients with acute
      symptomatic and asymptomatic primary human immunodeficiency virus type 1 (HIV-1)
      infection, sequential plasma specimens were obtained longitudinally for 1-2 years
      postseroconversion from subjects with well-documented time of seroconversion.
      Thirteen of them had an acute symptomatic primary infection, eight subjects had
      asymptomatic primary infection and long-term follow-up, and 27 had asymptomatic
      seroconversion and short-term follow-up. Quantitative plasma HIV-1 RNA levels,
      CD4+ lymphocyte counts, and levels of antibodies to gp120, p66, p41, p31, p24,
      and p17 were measured. At the time of seroconversion, there was no significant
      difference in HIV-1 RNA levels and CD4+ counts between symptomatic (n = 13) and
      asymptomatic (n = 27) subjects. Subsequently, however, establishment of low
      levels of plasma HIV-1 RNA was seen significantly more frequently in asymptomatic
      (n = 8) than in symptomatic (n = 13) primary infection; this correlated with
      higher levels of some (anti-gp120 and anti-p31) anti-HIV-1 antibodies and a
      slower decline in CD4+ lymphocyte counts. These results indicate that immunologic
      control of viremia early after infection may be a critical determinant to
      subsequent clinical course of HIV-1 infection. They also suggest that persons
      with acute symptomatic primary infection may generally progress to having
      acquired immune deficiency syndrome (AIDS) more rapidly than people with low
      grade symptoms or asymptomatic primary infection.

PMID- 7788433
TI  - Risk for Kaposi's sarcoma among Italian women with AIDS.

PMID- 7788434
TI  - The nonlinear effect of the initial period of high infectivity on the spread of
      HIV in the United States.

PMID- 7788435
TI  - Non-placebo controlled HIV experimental trials in prisoners.

PMID- 7788436
TI  - [Magnetic Resonance Imaging study of the role of the blood-brain barrier in the
      pathogenesis of experimental allergic encephalomyelitis: application to multiple
      sclerosis].
AB  - Nuclear magnetic resonance imaging (MRI) proved to be, from the first, a very
      sensitive method, allowing the visualisation of multiple sclerosis lesions, yet
      which never permitted to establish a non equivocal relationship between the
      semeiology of such lesions and the clinical signs. The multifocal aspect of
      disseminated multiple sclerosis lesions is probably one of several factors
      accounting for this discrepancy. The study of an autoimmune disease, experimental
      allergic encephalomyelitis (EAE), regarded as a suitable model for multiple
      sclerosis in humans, has been performed using MRI in order to unravel the
      pathogenesis of the disease and apprehend the mechanisms responsible for the
      formation of multiple sclerosis lesions. The study focused on the part played by
      the blood-brain barrier (BBB) in the induction process of an autoimmune disease,
      since the central nervous system is normally screened from immunological
      supervision, by this barrier. Models both of acute EAE, induced by active or
      passive transfer of the antigen (myelin basic protein-MBP)--and chronic EAE,
      induced by passive transfer of MBP-specific T cells and myelin glycoproteins or
      MOG-specific monoclonal antibodies, have been reproduced, and their evolution
      followed up using high field MRI. Every time, the crucial role of the BBB was
      evidenced by the synchronism existing between the clinical signs, the appearance
      of lesions, preferentially in the most sensitive or permeable areas, and the BBB
      breakdown encouraged by the action of adjuvants. The physiopathological study of
      EAE using MRI is suggestive of the concept of systemic disease for multiple
      sclerosis, according to a two-step process, involving, in a first stage some
      primary viral or bacterial infection, causing T-cells to be sensitized to the
      host's own proteins by molecular mimicry, and in a second stage some bacterial
      infection or accidental circumstances which, resulting in a BBB breakdown, would
      provide immunocompetent cells with an opportunity to reach their target.

PMID- 7788437
TI  - [Origin of allergens in the cat].
AB  - Danders and animal products have long been recognized as major allergens. One of
      the most common animals responsible for allergy is cat. Fel d I the major
      allergen has been detected in fur and a number of authors have claimed that
      saliva is the principal source of this major allergen and that pelt is
      contaminated as a result of licking during grooming. We could demonstrate that
      one of the major sources of Fel d I present on the skin are sebaceous glands and
      that the production of Fel d I is under hormonal control at least in male cats.
      Castration decreases significantly the level of Fel d I on the skin and the
      injection of testosterone reverses the phenomenon. These data lead to continue
      the work about the regulation of this protein and the knowledge of its biological
      function.

PMID- 7788438
TI  - [History and tradition of the military service of ambulance transportation].

PMID- 7788439
TI  - [Production and proinflammatory activity of tumor necrosis factor alpha in the
      glomerulus].
AB  - The production and the effects of tumor necrosis factor alpha (TNF alpha) have
      been studied in isolated glomeruli and cultured glomerular cells from animal or
      human origin. Glomeruli from rats injected with E. coli lipopolysaccharide (LPS)
      and glomeruli exposed to LPS in vitro release TNF alpha into the medium. The
      glomerular cells responsible for TNF alpha synthesis are mesangial cells.
      Production of TNF alpha is controlled by other locally produced mediators.
      Prostaglandin E2 and interleukin-10 are inhibitory. Hydroxyl radicals stimulate
      the transformation of the transmembrane form of TNF alpha into its soluble form
      which is secreted into the medium. TNF alpha acts on its producing cells and on
      the neighbouring cells. It induces contraction of mesangial cells, increases the
      synthesis of a variety of local mediators including prostaglandins, platelet
      activating factor and chemotactic agents, particularly interleukin-8. Synthesis
      of this cytokine implies activation of tyrosine kinase and of transcription
      factors, essentially NFkB. Taken together, these results suggest that TNF alpha
      plays a marked role in the development of glomerular injury and incite us to
      search for treatments inhibiting its synthesis and its effects.

PMID- 7788440
TI  - [Sexual mutilation in women].
AB  - The sexual mutilations, a fairly topical subject, remain very frequent (between
      80 and 100 millions). The excisions are in practice mainly in Africa (in at last
      20 countries), but also in the Far-East and Indonesia. In some cases, such
      practices are very mutilative (Pharaonic infibulation). They may drag to the
      death, through haemorrhage or infection. The short and long term medical
      complications are fearful, tetanus, vesicovaginal fistulae, vaginal or vulvar
      sclerosis, forbidding any sexual involvement and hampering delivery. The grounds
      of these practices are basically customary and not religious. Women shall be
      subservient to men and any manhood mark, embodied by the clitoris, shall
      disappear. However these manoeuvres are decreasing, due to the women
      emancipation, and, particularly, in Africa, some leaders are aware of their
      graveness and are punishing heavily the excision, taking model of the French
      Penal Code. The immigrants, who, in France, have these mutilations undertaken,
      are incurring imprisonment sentences (precedents are frequent). They must comply
      with the French laws.

PMID- 7788442
TI  - [Criteria for brain death].

PMID- 7788441
TI  - [Reconstruction by free jejunal transplant after circular pharyngolaryngectomy
      (functional results and survival)].
AB  - One hundred and ninety seven patients with cancer of the hypopharynx underwent
      after circular resection, reconstruction with a free jejunal graft. The quality
      of free jejunal grafts is controlled by many investigations: clinical
      examination, radiography, electromyography, fibroscopy with biopsy. These
      investigations show that technically jejunal grafts must be short and linear to
      give the best functional results. Average resumption of oral intake was 14 days.
      Oral feeding was possible in 92% of cases. The free jejunal grafts with
      microsurgery are one of the more reliable procedures for reconstruction of
      pharynx and cervical esophagus after resection for cancer. (2 post-operative
      deaths and 8 grafts necrosis on 197 cases). The cumulative survival rate of 5
      years was 35% for free jejunal graft. Survival depends on selection of the
      patients for local and nodes invasion. The quality of survival has improved. This
      operation must be reserved for the hypopharyngeal cancers which need a circular
      resection and do not invade the esophagus. The surgery is performed for a
      curative aim. The distant follow up of the patients is imperative: consultation
      every four months and then every six months: clinical examination, endoscopic,
      E.N.T., bronchial, and esophageal investigation. Chemotherapy and radiotherapy
      have specific indications.

PMID- 7788443
TI  - [Food-induced anaphylaxis. A new French multicenter study].
AB  - The frequency of food-induced anaphylactic shocks (FIAS) has been investigated
      beside 46 emergency departments, 29 departments of Dermatology, and 19
      departments of Intern Medicine or Pneumology. 794 A.S. have been reported. FIAS
      represent 10.2% of the etiologies. More than a third of them are relapsing
      anaphylaxis. Food allergy had been previously identified in 23.4% of cases. The
      allergen was present as a hidden allergen or inadvertently consumed in 30.8% of
      FIAS. 9.9% of the patients were asthmatic. An enhancing factor was heightened in
      25.9% of cases: alcohol, exercise, simultaneous intake of aspirin, beta-blockers,
      conversion enzyme inhibitors. Other factors predisposing to food anaphylaxis were
      a cross-reactivity shared by pollens and fruit, latex and exotic fruit, house
      dust mites and snails, or mastocytosis. More than 15 allergens were detected: egg
      (11.6%), fish (10.4%), crustaceans (10.4%), milk (6.5%), fruit-latex group
      (6.5%), peanut and other legumes (soy, peas, lentils, guar gum...), celery,
      garlic, etc... The food allergen still remained unknown in 25% of cases. However,
      the rate of efficiency of the diagnosis reached 94% in the Allergy Units. In
      addition 10.2% of A.S. were considered idiopathic, raising the hypothesis of
      allergy to masked food allergens. Compared to a previous study from the 1982's,
      this survey shows a striking increased prevalence of FIAS. The frequency of
      recurrent anaphylaxis, occurring in one-third of cases, is also highlighted and
      makes plausible once more the role of masked food allergens. The authors insist
      upon the need of a thorough allergologic investigation in all the cases of A.S.
      An informative labelling about the presence or absence of food proteins which are
      mostly allergenic should be recommended. The need of a thorough allergologic
      investigation is supported not only by the incidence of FIAS but also by the
      incidence of idiopathic anaphylaxis: 10.2%.

PMID- 7788445
TI  - [Venous angiography: importance in the diagnosis of brain death. 125 cases].
AB  - According to many ethical and humanitarian arguments, the diagnosis of "brain
      death" is more and more an emergency. The forensic criteria include abolition of
      consciousness, abolition of brain stem reflexes, abolition of spontaneous
      breathing joined to electrocerebral silence. However using EEG criteria of
      electrical silence may be unreliable because of technical artefacts or depressed
      electrical activity due to drug intoxication and hypothermia. Venous angiography
      was used in 125 cases: our experience proves reliability and efficiency of
      angiographic criteria for diagnosis of brain death. For organ transplant, it is
      better to be as fast as possible: transplanted organ will be better and it
      reduces the cost of a long useless intensive care. When it is necessary, we
      suggest to allow the choice between EEG and angiography.

PMID- 7788446
TI  - [Validity of cerebral angiography via venous route in the diagnosis of brain
      death].
AB  - The success of transplantations relies on uninjured organs i.e., harvested before
      circulatory failure. At present, french law concerning cerebral death criteria
      (circulaire ministerielle n. 3 du 21.01.91) requires the association of clinical
      patterns and 2 repeated, unreactive and flat electroencephalographic (EEG)
      tracings. Blood and urinary samples also need to be free from any nervous system
      depressant drug, the patient has not to be hypothermic. These obligations are not
      always compatible with patients status or local organization. The consequence
      might be organ loss or delay in harvesting schedule. A review of the literature
      points out the trap in realization and analysis of EEG in this kind of intensive
      care patients. Angiogram, on the opposite, is influenced neither by nervous
      system depressant drug nor by hypothermia. As it is in some other western
      countries, it should be proposed as the reference.

PMID- 7788444
TI  - [Controlled hypercapnia: a new strategy in the treatment of severe respiratory
      insufficiency].
AB  - Permissive hypercapnia (PHY) represents an interesting approach in critically ill
      ventilated patients, because it allows to ensure adequate gas exchange while
      avoiding the adverse effects related to excessive airway pressures. Its objective
      is to improve oxygenation while reducing the risk of barotrauma and circulatory
      impairment. This concept is all the more important when considering that in
      majority of lung diseases for which MV is applied, lung involvement is highly
      inhomogeneous, meaning that the functionally normal or near normal areas are the
      most exposed to the deleterious effects of overdistension. Undesired
      physiological effects of non massive respiratory acidosis (PaCO2 < or = 80 mmHg,
      arterial pH > or = 7.15) are reversible and mostly minor. This good tolerance
      legitimizes two strategies: firstly to accept hypercapnia in conditions such as
      acute severe asthma for which enforced normalization of PaCO2 would imply
      potentially lethal complications, and secondly to deliberately induce respiratory
      acidosis while using very low airway pressures and alveolar ventilation to limit
      or prevent overdistension lung damage in injured as well as in normal areas. When
      the cerebral vasodilation induced by CO2 might aggravate a preexisting
      intracranial disorder, PHY is obviously contraindicated.

PMID- 7788447
TI  - [Malignant lymphoma with medium-sized macronucleolated cells in the dog:
      involvement of an original cell from the marginal zone of the reactive lymph
      node].
AB  - Among the non-Hodgkin's malignant lymphomas of the dog, which are largely
      dominated by the centroblastic heterogeneous type, there is an original form of
      malignant lymphoma which is homogeneous and diffuse, with macronucleolated medium
      sized cells. These cells seem to be morphologically very similar to those which
      constitute the majority population in the marginal zone of the secondary follicle
      of the lymph node in the dog, and which appear in the course of certain
      conditions: systemic lupus erythematosus, leishmaniasis, satellite lymph nodes in
      benign or malignant tumors. The aim of this study was twofold: on the one hand to
      establish, in the canine species, the identity of the lymphomatous cells and the
      reactive cells that make up the marginal zone, i.e. the filiation between the
      hyperplastic marginal zones and the macronucleolated malignant lymphoma with
      medium-sized cells, and, on the other hand, to compare this type of malignant
      lymphoma with those which are reputed to originate in the marginal zone in
      humans, for example the malignant lymphoma of the lymphoid tissue associated with
      the mucous membranes, and the monocytoid malignant B-cell lymphomas. Ninety four
      malignant lymphomas were observed between 1989 and 1994 at the Veterinary School
      in Lyon; these consisted of 71 cases showing medium or high-grade malignancy, 17
      cases with small cells, of low-grade malignancy, and 6 cases of mycosis
      fungoides. Among the 71 cases of medium and high-grade malignancy, 8 were
      immunoblastic, 5 centroblastic homogeneous, 50 centroblastic heterogeneous, and 8
      homogeneous with macronucleolated medium-sized cells. The methods used in these
      94 cases were of a morphological type: cytology, histology, transmission
      microscopy and immunohistochemistry. The cytohistological, ultrastructural and
      immuno-phenotypical characteristics (CD3-, CIg-, Ki-67- phenotype) of the
      lymphomatous cells and the cells of the marginal zone were found to be identical,
      in the dog; this strongly suggests B-lineage cells which do not secrete
      cytoplasmic immunoglobulins and are not involved in the cell cycle. Finally,
      these cells seem to us to be morphologically very similar to the minority
      population described by Van den Oord in the marginal zone of the secondary
      follicles in the lymph node in humans, in certain reactive situations.

PMID- 7788448
TI  - [Importance of measuring exposure to the principal indoor allergens in allergic
      asthma].
AB  - Domestic allergens, such as mite and cat allergens, are a leading cause of
      allergic asthma. Allergen exposure is a risk factor for sensitization. Allergens
      also play a major role in the development of inflammation and non specific
      bronchial hyperreactivity as well as in the apparition and modulation of
      symptomatic asthma. The development of new means of detecting allergens (i.e.
      immunochemical assays including monoclonal antibodies, quantitative and
      semiquantitative guanine measurements for mite allergens) has made possible to
      identify allergens sources and reservoirs. The form in which domestic allergens
      become airborne is important. The group I and II allergens from mites, the major
      cockroach allergens are carried on large particles (mean size > 10 microns
      diameter); in contrast, the major cat allergens are airborne on small particles
      (40% < 5 microns). Guanine, a metabolic excretion product of mites, is used as a
      marker for mite feces and is correlated with the presence of major allergens from
      mites. A colorimetric method (Acarex-TestR) provides a simple and inexpensive
      method of assaying indoor mite allergen exposure for both doctor and patient
      alike. By using Acarex-TestR it is possible to evaluate the mite allergen
      exposure for a population in a particular country. The detection of allergens
      sources and reservoirs, the quantification of domestic allergens has enabled the
      evaluation of the effect of a reduction in allergen exposure to be better
      assessed. Recognition of the risks, environmental control and reduction in
      allergen loads, should be among the objectives of asthma management.

PMID- 7788449
TI  - [Activity of adenosine in relation to tumor necrosis factor (TNF). Therapeutic
      outlook].
AB  - At physiological and pharmacological doses, adenosine protects tissues against a
      varieties of injuries: ischemia-reperfusion, convulsions, inflammation.... We
      tested the hypothesis that the antiinflammatory properties of adenosine occur via
      a down-regulation of TNF. Agonists of adenosine receptors (ARA) and agents
      potentiating endogenous adenosine (APA) were evaluated for their effects on TNF
      production by endotoxin-stimulated human monocytes. Additionally, one of the most
      potent agonists, R-phenylisopropyladenosine (R-PIA), was tested on two
      experimental models of acute phase response, endotoxin shock and carrageenan
      induced plantar oedema. Several ARA and APA inhibited monocyte TNF production in
      a concentration-dependent manner. R-PIA and other ARA were active at micromolar
      concentrations. The property is pharmacologically relevant since rats receiving a
      lethal dose of endotoxins were protected by R-PIA and endotoxin-induced serum TNF
      levels were abolished by a pretreatment with R-PIA. Inhibitory effects on serum
      TNF production were obtained with similar doses of dexamethasone sodium phosphate
      and one hundred-fold higher doses of pentoxifylline. R-PIA was also found active
      on carrageenan-induced oedema. The anti-oedematous properties of R-PIA were
      associated with a marked reduction of locally-produced TNF and were also observed
      after the administration of dexamethasone, pentoxifylline and a neutralizing anti
      TNF antibody. Our results indicate that adenosine is a potent inhibitor of TNF
      production induced by different stimuli. This property could lead to therapeutic
      applications in inflammatory diseases and other in which TNF is known to play a
      pathogenic or aggravating role. Comparison between ARA and APA in terms of
      tolerance and efficacy merits further attention.

PMID- 7788450
TI  - A 12-step recovery program for community psychiatrists.

PMID- 7788451
TI  - A managed care ethical credo: for clinicians only?

PMID- 7788452
TI  - Protecting staff from assaults by patients: OSHA steps in.

PMID- 7788454
TI  - The role of primary care physicians in managed mental health care.

PMID- 7788453
TI  - The psychiatrist in the nursing home, Part II: Consultation, primary care, and
      leadership.

PMID- 7788455
TI  - A psychiatrist-rated battery of measures for assessing the clinical status of
      psychiatric inpatients.
AB  - Despite the increasing demand for outcome assessment measures, no published
      reports have provided a standardized way to assess psychiatric inpatients that
      includes diagnosis and observer ratings of psychopathology. This paper reviews
      general principles for selecting outcome assessment measures, proposes a battery
      of instruments based on already available measures to assess clinical status in
      psychiatric inpatients, reviews methods of implementing the battery in an
      academic inpatient psychiatric setting, and presents preliminary data on its
      interrater reliability, construct validity, and range of response to acute
      hospitalization. Preliminary results suggest that the battery may be useful for
      resident and medical student education and for enhancing quality assurance and
      continuous quality improvement.

PMID- 7788456
TI  - Relationships between psychiatric symptomatology, work skills, and future
      vocational performance.
AB  - OBJECTIVE: Experts do not agree on what, if any, relationships exist between
      diagnosis, symptomatology, work skills, and the future vocational performance of
      persons with severe mental illness. The objective of this study was to
      longitudinally examine such relationships, using a sample of clients who were
      attending psychosocial rehabilitation programs. METHODS: Subjects were 275
      clients of three psychosocial rehabilitation programs who had expressed a
      vocational goal. They were assessed at intake into the study and then quarterly
      until they left the rehabilitation program. The variables examined included
      symptoms, measured by the Brief Psychiatric Rating Scale; diagnosis; work skills,
      measured by the Griffiths Work Behavior Scale; and vocational status at end
      point. RESULTS: Among subjects remaining in the study for one year, both
      symptomatology and work skills improved significantly. Moderately significant
      negative correlations were found between symptoms and work skills; subjects who
      became employed had lower symptom scores and higher work skills than persons who
      never became employed. CONCLUSIONS: Although a moderate relationship was found
      between symptomatology and work skills, symptoms should not be considered a proxy
      measure for vocational functioning among persons with severe mental illness.
      Participation in psychosocial rehabilitation programs appeared to have a salutary
      effect on symptoms and work skills.

PMID- 7788457
TI  - Disability compensation and work among veterans with psychiatric and
      nonpsychiatric impairments.
AB  - OBJECTIVE: This study examined the relationship of Department of Veterans Affairs
      disability compensation payments and employment among veterans with psychiatric
      disorders and veterans whose impairments were nonpsychiatric. METHODS: Data from
      a 1987-1988 national survey of Vietnam-era veterans (N = 1,634) were used to
      evaluate the relationship between compensation payments and employment. The
      employment activity of veterans whose application for benefits was rejected was
      compared with that of veterans who were awarded benefits. Multivariate analytic
      techniques were used to control for health status and other factors that also
      influence an individual's decision to work. RESULTS: Veterans who received
      compensation of less than $500 a month were no less likely to work than were
      rejected applicants. Overall, the effect of compensation payment was significant
      but modest: each additional $100 a month was associated with a 2 percent decline
      in the number of veterans who worked, a decline of an hour a week in the number
      of hours worked, and a reduction of $1,000 a year in estimated employment income.
      No significant differences were observed in the relationship between disability
      payments and employment among veterans with psychiatric disorders and those with
      other functional impairments. CONCLUSIONS: The association of disability
      compensation with nonparticipation in the labor force is generally small, except
      at high levels of payment, and is no greater for veterans with psychiatric
      disorders than for those with nonpsychiatric impairments.

PMID- 7788459
TI  - Evaluating the effectiveness of a residential rehabilitation program for homeless
      veterans.
AB  - OBJECTIVE: This study sought to evaluate the effects of a residential
      rehabilitation program for homeless mentally ill veterans on several measures of
      subjects' community adjustment. METHODS: Subjects' housing status, financial and
      vocational status, psychological stability, utilization of coping resources, and
      extent of social contacts were measured at entry into the program and at follow
      up six months after discharge. Data were available for 58 subjects at follow-up.
      Outcomes for subjects who successfully completed the program were compared with
      outcomes for those who did not. RESULTS: As a group, subjects assessed at follow
      up showed significant improvement in housing, financial, and vocational status,
      in severity of several symptoms of psychological and emotional distress, in
      utilization of some types of coping resources, and in measures of social contacts
      and satisfaction. However, subjects who completed the program were more likely to
      have improved their housing, financial, and vocational situations. CONCLUSIONS:
      Comprehensive residential rehabilitation programs can help homeless veterans
      improve several aspects of their lives and maintain stability in those areas
      after discharge.

PMID- 7788458
TI  - Service utilization and costs of care for severely mentally ill clients in an
      intensive case management program.
AB  - OBJECTIVE: The study evaluated the effects of an intensive case management model
      on clients' use of inpatient and outpatient psychiatric care and on the costs of
      care. METHODS: Ninety clients of a county mental health system who were frequent
      users of inpatient services were randomly assigned to either an intensive case
      management group, a traditional case management group, or a control group who
      received no particular services. Outcome variables measured over a two-year
      period were number of units used by clients and costs of inpatient care in county
      and private facilities and various types of outpatient care, including day
      treatment and use of an emergency psychiatric unit. RESULTS: Clients who received
      intensive case management had fewer inpatient days and reduced overall costs for
      mental health services. CONCLUSIONS: Assertive outreach and intensive case
      management can reduce hospitalizations of clients who are frequent users of
      inpatient care and can reduce overall mental health care costs. Mental health
      consumers employed as case management aides can play an important role in the
      delivery of mental health services, particularly with frequent users of inpatient
      care.

PMID- 7788460
TI  - Effects of social skills training and social milieu treatment on symptoms of
      schizophrenia.
AB  - OBJECTIVE: The study compared the effects of social skills training and social
      milieu treatment on symptoms of schizophrenia, particularly on negative symptoms.
      METHODS: Thirty-three patients aged 18 to 55 years with a diagnosis of
      schizophrenia were randomly assigned to a nine-week program of social skills
      training or social milieu treatment. Patients were assessed at three-, six-, and
      nine-week intervals during treatment and at follow-up using the Positive and
      Negative Syndrome Scale (PANSS), which measured both positive and negative
      symptoms of schizophrenia and general psychopathology. RESULTS: Fifteen patients
      completed social skills training, and 13 completed social milieu treatment.
      Comparison of PANSS scores at different assessment times showed that both
      treatments were effective in reducing symptoms, but social skills training
      appeared to be more effective in reducing negative symptoms. No differences were
      found between treatment groups in relapse rates or in symptom measures at three
      month follow-up. However, six-month follow-up data available only for the social
      skills training group showed that improvement in negative symptoms had begun to
      decline. CONCLUSIONS: Psychosocial approaches are a necessary component in the
      treatment of patients with schizophrenia, and social skills training appears to
      be particularly helpful. The gradual decline in improvement in negative symptoms
      at six-month follow-up suggests the need for more extended treatment.

PMID- 7788462
TI  - 18-month outcome of clozapine treatment for 100 patients in a state psychiatric
      hospital.
AB  - OBJECTIVE: The atypical antipsychotic medication clozapine is an effective
      treatment for refractory psychosis; however, the efficacy of clozapine when used
      in public mental health programs has yet to be fully characterized. This study
      assessed the outcome of clozapine treatment in a state hospital. METHODS: The
      medical records of the first 100 patients to receive clozapine in a state
      hospital, from six months before clozapine treatment through 18 months of
      treatment, were reviewed. RESULTS: The patients had chronic psychotic disorders
      that had responded poorly to treatment with conventional antipsychotic
      medication. Eighteen months after beginning clozapine, 45 patients were much
      improved, and 18 were somewhat improved. All except one of the improved patients
      were continuing clozapine treatment. Forty patients were living in community
      settings, 59 remained hospitalized, and one had died of an illness unrelated to
      clozapine. Violent episodes in the hospital decreased during the first six months
      of clozapine treatment. Thirteen patients had one or two seizures while taking
      clozapine, 12 of whom successfully continued clozapine treatment. One patient
      developed agranulocytosis, and one developed leucopenia; each recovered fully
      after clozapine treatment was discontinued. CONCLUSIONS: Clozapine was an
      effective treatment for refractory psychotic disorders when given as a part of
      routine state hospital treatment.

PMID- 7788461
TI  - New directions in research on involuntary outpatient commitment.
AB  - OBJECTIVE: Involuntary outpatient commitment has been used as a method of
      improving tenure in community programs for individuals with severe and persistent
      mental illness. This paper reviews literature on research about involuntary
      outpatient commitment and suggests questions and methods for future research.
      METHODS: Literature describing research studies of involuntary outpatient
      commitment, located by searching MEDLINE and following up references cited in
      relevant articles, was reviewed with attention to patient characteristics and
      diagnostic, treatment, and outcomes measures. RESULTS: Involuntary outpatient
      commitment appears to provide limited but improved outcomes in rates of
      rehospitalization and lengths of hospital stay. Variability in community
      treatment makes interpretation of other types of outcome difficult. Few studies
      specifically identify results among patients with severe and persistent mental
      illness. CONCLUSIONS: No studies have examined the extent to which outpatient
      commitment affects compliance and treatment when essential community services
      such as case management are consistently and aggressively provided, nor have
      studies controlled for potentially confounding factors such as treatment and
      nontreatment effects, including informal coercion. A randomized trial of
      involuntary outpatient commitment should be useful in evaluating the
      effectiveness of this type of intervention.

PMID- 7788463
TI  - Projections of housing disruption among adults with mental illness who live with
      aging parents.
AB  - OBJECTIVE: The need to plan for the future housing needs of adults with serious
      mental illness who reside with aging parents is an issue of increasing importance
      to mental health policy makers as well as family members. This study provides
      estimates of the number of adults with severe and persistent mental illness in
      New York State who could be expected to experience housing disruption because of
      their parents' death. METHODS: Demographic modeling methods were applied to data
      from a variety of sources, including surveys of mentally ill adults receiving
      public mental health services in New York State and demographic statistics on the
      general state population. RESULTS: An estimated 13,400 to 49,600 adults with
      severe and persistent mental illness who receive services from the public mental
      health system in New York State reside with one or both parents. Within this
      group, between 300 and 1,200 adults could have been expected to experience
      housing disruption due to parental death each year between 1990 and 1994.
      Demographic trends indicate that through 2009, these disruptions will increase at
      a faster rate than growth in the state's general adult population. CONCLUSIONS:
      Additional housing with mental health supports and other programs will be needed
      to accommodate the growing number of severely mentally ill adults whose housing
      may be disrupted because of the death of their parents.

PMID- 7788464
TI  - A survey of new long-stay hospital patients in an Irish health board area.
AB  - OBJECTIVES: The aims of this study were to determine the number and rate of
      accumulation of new long-stay hospital patients in one of Ireland's eight health
      board areas, to describe their demographic and clinical features, and to assess
      their needs in relation to possible community placement. METHODS: Demographic and
      clinical information was obtained on all patients over age 17 who had been
      continuously hospitalized in area hospitals for more than one year and less than
      six years on the census day of March 1, 1992. The Community Placement
      Questionnaire was used to rate the patients' social functioning, problem
      behavior, physical disability, social contact, and needs for accommodation and
      day care. RESULTS: The survey identified 175 new long-stay patients, mainly
      middle aged to elderly. Schizophrenia was the most common psychiatric diagnosis.
      The bed occupancy rate for these patients was 14 per 100,000 population, and the
      annual accumulation rate was 2.3 per 100,000 population. CONCLUSIONS: New long
      stay patients were chronically ill with significant psychiatric and social
      disabilities. Involuntary patients were overrepresented in the group. Two-thirds
      could be placed in the community if facilities were available and had
      sufficiently high staffing levels.

PMID- 7788465
TI  - Depression and anxiety disorder among older male inmates at a federal
      correctional facility.
AB  - The conditions of incarceration and the sociodemographic and health
      characteristics of 95 older male inmates of a federal correctional facility were
      studied to determine the relationship of such variables to rates of psychiatric
      disorder among older male inmates. A total of 51 inmates (53.7 percent) met one
      month criteria for psychiatric disorder, a much higher rate than among a
      community sample of men in the same geographic area. Compared with inmates
      without such disorders, inmates with disorders were likely to be younger, to have
      a history of psychiatric disorder and substance abuse, to have poorer physical
      health, to have impaired social support, and to be serving a determinate sentence
      with no possibility of parole. Few were receiving treatment while incarcerated.

PMID- 7788466
TI  - Prevalence and symptoms at onset of bipolar illness among adolescent inpatients.
AB  - The records of 236 adolescents (116 males and 120 females) admitted to an
      inpatient psychiatric unit over an eight-year period were retrospectively
      reviewed to determine the characteristics of patients with a discharge diagnosis
      of bipolar disorder. Forty-two patients had a diagnosis of an affective disorder,
      including 18 patients (nine males and nine females) with bipolar disorder. Mean
      age at onset of illness for patients with bipolar disorder was 15.7 years, and
      their onset of illness was likely to have been associated with psychotic
      symptoms. On admission, they were more likely to show symptoms of mania than of
      depression.

PMID- 7788467
TI  - Age as a factor in identifying young adult chronic patients who are difficult to
      treat.
AB  - Age younger than 35 years has been used as a factor in identifying young adult
      chronic mentally ill patients, a group considered difficult to treat due to their
      rebelliousness, lack of insight about their mental illness, and increased
      likelihood of showing symptoms of borderline or antisocial personality disorder.
      In a sample of psychiatric outpatients, the authors found that a subgroup of
      patients under age 35 fit this profile, while other patients under age 35 and
      nearly all patients over age 35 did not. The authors conclude that age is a
      legitimate factor in identifying a subgroup of challenging patients and that such
      patients may outgrow many troublesome characteristics as they age.

PMID- 7788468
TI  - Violence and mental illness.

PMID- 7788469
TI  - Studying violent behavior.

PMID- 7788470
TI  - Containing patient violence.

PMID- 7788471
TI  - Ethical managed care.

PMID- 7788472
TI  - 19th-century medicines.

PMID- 7788473
TI  - Research funding for child and adolescent mental disorders falls well below goals
      in national plan.

PMID- 7788474
TI  - Clinton's 1996 budget proposal would consolidate most SAMHSA programs, give
      states more control.

PMID- 7788475
TI  - NAMI outlines national standards for protecting research subjects with serious
      mental illness.

PMID- 7788476
TI  - Research collaboration on HIV dementia.

PMID- 7788477
TI  - Clinical Research Meeting. San Diego, California, May 5-8, 1995. Abstracts.

PMID- 7788478
TI  - Competencies and problems reported by parents of Greek and American children,
      ages 6-11.
AB  - This study compared parent-reported competencies and behavioral/emotional
      problems in demographically-matched samples of Greek and American children, ages
      6-11. Parents of 356 children of each nationality completed the Child Behavior
      Checklist (CBCL). Competence scores were higher for American children, except on
      Academic Competence, where scores were higher for Greek children. Greek scores
      were significantly higher than American scores on the Withdrawn,
      Anxious/Depressed, Attention Problems, Delinquent Behavior, Aggressive Behavior,
      Internalizing, Externalizing, and Total Problem scales. On the Anxious/Depressed
      syndrome, nationality accounted for 14% of the variance. There were few main
      effects for sex and age and fewer interactions. The higher problem scores in the
      Greek sample were partly due to the tendency of Greek parents to use extreme item
      scores. When items were scored present v. absent, Greek scores were higher only
      on Withdrawn, Anxious/Depressed, Internalizing, and Total Problems, while
      American scores were higher on Somatic Complaints and Thought Problems.
      Nationality differences in rates of referral for mental health services and
      sample differences in exclusion criteria for prior mental health services may
      have contributed to differences in problem scores. Results are compared to
      findings from other cross-cultural studies.

PMID- 7788479
TI  - Behavioral problems of adolescents with chronic physical illness: a comparison of
      parent-report and self-report measures.
AB  - This study reports on the extent of behavior problems in Israeli adolescents
      suffering from chronic illness. A comparison was made between parent-reported and
      self-reported behavioral symptomatology using the Child Behavior Checklist (CBCL)
      and the Youth Self-Report (YSR). 103 outpatients, aged 11-16 years, suffering
      from cystic fibrosis (CF), asthma, or hematological/oncological conditions were
      assessed. Healthy adolescents and adolescents referred for psychiatric assessment
      comprised the comparison groups. Parent- and self-reports were significantly
      positively correlated in each group (all chronically ill children r = .22;
      Healthy group r = .27; psychiatric group r = .50), but the correlations were
      particularly low (and non-significant) in younger adolescents with
      hematological/oncological conditions or HCF., pointing to the need for physicians
      to include parents' and adolescents' viewpoints in their assessments of these
      adolescents' psychosocial state. The mean number of parent-reported and self
      reported behavior problems in the illness groups was no different from that of
      the Healthy group but significantly lower than that of the psychiatric group.

PMID- 7788480
TI  - Family stress, family functioning and emotional/behavioural problems following
      child psychiatric treatment.
AB  - This study assesses family stress, family functioning and emotional/behavioural
      problems in a sample of 80 formerly daytreated or residentially treated boys
      after a mean discharge period of four years. Family stress was assessed with a
      Questionnaire of Life Events (QLE) and family functioning with the Family
      Adaptability and Cohesion Evaluation Scales (FACES). Emotional/behavioural
      problems were measured with the Child Behavior Checklist (CBCL). The results
      showed that there were significant relationships between the QLE, FACES and CBCL
      scores. In particular, experiencing less negative life events and a more rigid
      type of family functioning appeared favourable with respect to several types of
      behavioural problems. When the interrelationships between the family factors and
      other factors such as age and socio-economic status were taken into account
      statistically, the number of negative life events appeared the most influential
      family factor.

PMID- 7788481
TI  - An epidemiological and clinical approach to adolescent suicide. A comparison
      between suicidal and non-suicidal clinical groups in a health foundation center
      for French students.
AB  - Suicidal behaviour among young people represents a major public health problem.
      This study seeks to compare the major sociological, clinical, schooling and
      family features of suicidal and non-suicidal subgroups of adolescents
      hospitalised in the Health Foundation Center for French Students of neufmoutiers
      en Brie (France). All these adolescents suffered from the severe mental
      disorders. The adolescents from the suicidal subgroup presented significantly
      fewer psychoses and more mood disorders than those of the non-suicidal subgroup.
      Half of the patients from the suicidal subgroup presented some features of
      personality disorders, mostly borderline personality disorders. Nevertheless,
      their global functioning was more frequently improved between admission and
      discharge than was the case for the non-suicidal group.

PMID- 7788482
TI  - Case report: successful treatment of a case of extreme isolation.
AB  - Tom, aged 10, presented as a stiff, plump boy with a very awkward gait and a
      completely blank facial expression. He was terrified of other children and could
      allow no one closer than an arm's length away from him. It transpired that for
      most of his life he had been kept "safe" in his bare room by his parents whose
      firstborn child had died. After 8 years of treatment he is now studying at a
      university and although he lives at home he seems to have made some friends. His
      facial expressions and tone of voice are now appropriate.

PMID- 7788484
TI  - 5th Vienna Shock Forum. Vienna, Austria, May 7-11, 1995. Abstracts.

PMID- 7788483
TI  - Case report: concordant traumatic brainstem contusion delayed diagnosis in a
      young man with Wilson's disease.
AB  - Wilson's disease is a hereditary autosomal recessive disorder of copper
      metabolism. The corresponding gene locus has been localized on the long arm of
      chromosome 13. Three different clinical variants of the disease can be
      distinguished: hepato-cerebral, abdominal/hepatic, and central nervous type. The
      heterogeneity of symptoms can cause problems in differential diagnosis,
      especially when another concordant disorder can also explain the pathogenesis of
      symptoms. The case report of a young man who suffered from brainstem contusion
      demonstrates the possibilities of misinterpretation because presenting symptoms
      could be attributed either to traumatic brain injury followed by adjustment
      disorder or Wilson's disease. Clinical signs included leftsided hemiparesis,
      bilateral gaze direction nystagmus, marked dysarthria with consecutive pervasive
      mutism, choreo-athetoid movements, spasmodic torticollis and diplopia dependent
      on gaze direction. Slit lamp examination showed Kayser-Fleischer's corneal ring.
      EEG- and computer assisted tomography investigations revealed non-specific
      findings. The patient was treated with D-Penicillamine. Alternative treatment
      with oral zinc preparations is discussed.

PMID- 7788485
TI  - What is a perinatal cardiologist?

PMID- 7788486
TI  - Study of the early development of the hindbrain.

PMID- 7788487
TI  - Training in invasive fetal procedures.

PMID- 7788488
TI  - Early development of the hindbrain: a longitudinal ultrasound study from 7 to 12
      weeks of gestation.
AB  - Twenty-nine healthy pregnant women were examined by transvaginal ultrasound to
      evaluate embryonic development in vivo between 7 and 12 weeks of gestation. The
      rhombencephalon with its fourth ventricle, the cerebellum and the choroid
      plexuses of the fourth ventricle were identified and measured. The cavity of the
      rhombencephalon, the future fourth ventricle, was always visible from 7 weeks,
      initially lying superiorly in the head of the embryo. The cerebellum and the
      choroid plexuses of the fourth ventricle became distinguishable during week 8.
      The volume of the rhombencephalic cavity was estimated. The shape and size of
      these rhombencephalic structures, their position in relation to each other and
      their relation to other brain structures changed specifically during the
      embryonic and early fetal period. This sonoembryological development corresponded
      to the descriptions in classical embryological literature.

PMID- 7788489
TI  - First-trimester ultrasound screening for fetal aneuploidies in women over 35 and
      under 35 years of age.
AB  - In a prospective screening study, the utility of the thickness of first-trimester
      simple hygroma in sonographic screening for fetal chromosomal aberrations was
      examined. A total of 3380 women, 1280 of whom were 35 years or over, and 2100 of
      whom were under 35 years, were screened by ultrasound at 9-12 weeks of gestation.
      The thickness of fetal nuchal simple hygroma was measured. Women over 35 years of
      age underwent transabdominal chorionic villus sampling (CVS). In women under 35
      years of age, CVS was offered only if the thickness of nuchal hygroma was at
      least 3 mm, or in cases of parental chromosomal abnormalities. A total of 46
      chromosomal anomalies were detected, of which 43 (93.5%) showed simple hygroma.
      The incidence of first-trimester simple nuchal hygroma in pregnancies of women
      over 35 and under 35 years of age was 5.4% (69 cases) and 1.28% (27 cases),
      respectively, and the percentage of chromosomal abnormalities was 2.9% and 0.43%,
      respectively. The risks of trisomies and poor pregnancy outcome were increased at
      larger sizes of first-trimester simple hygroma. A sensitivity of 93.5% and a
      specificity of 98.4% of the method were found. Using a measurement of first
      trimester simple hygroma of > or = 3 mm to identify pregnancies at risk for
      chromosomal anomalies at 9-12 weeks of pregnancy is a useful method for selection
      of women with high and low risk for aneuploidy.

PMID- 7788490
TI  - Fetal suprarenal masses: sonographic appearance and differential diagnosis.
AB  - We present eight cases of suprarenal masses detected sonographically in fetuses
      of 20-41 weeks. The appearances of the masses included hyperechoic (n = 2, both
      pulmonary sequestrations), solid isoechoic (n = 1, a neuroblastoma), purely
      cystic (n = 3, two neuroblastomas, one enteric cyst) and mixed or complex (n = 2,
      one neuroblastoma and one renal cyst). Three of the fetuses with neuroblastoma
      had normal scans in the second trimester, and in all four the neuroblastomas were
      detected after 36 weeks. This study demonstrates the differential diagnosis of
      suprarenal masses in fetuses. Neuroblastomas can have a solid, purely cystic or
      complex sonographic appearance. Although not all suprarenal masses are
      neuroblastomas, the newborn with a prenatally detected suprarenal mass should be
      evaluated for the possibility of a neuroblastoma, since early diagnosis of this
      malignancy can be curative.

PMID- 7788491
TI  - Routine prenatal ultrasound screening for fetal abnormalities: 22 years'
      experience.
AB  - We describe the results of routine obstetric ultrasound examination over a period
      of 22 years (1970-91) at the Institut Universitari Dexeus, Barcelona, Spain. A
      total of 1006 malformed fetuses or neonates were identified at abortion or
      delivery. The prevalence of fetal abnormalities was 3.03%. Fetal anomalies were
      diagnosed antenatally in 788 (78.33%) cases. Early prenatal diagnosis (before 22
      weeks of gestation) was made in 598 (59.44%) cases. The detection of malformed
      fetuses increased from 19.75% in the first phase of the study (1970-74) to 96.33%
      in the last phase (1990-91). The specificity of the method was over 99%
      throughout the study period. The most frequently diagnosed anomalies were urinary
      tract anomalies (22.86% of cases), followed by head and neck anomalies (18.68%),
      musculoskeletal anomalies (8.64%), heart anomalies (7.35%) and gastrointestinal
      anomalies (7.35%). The earliest diagnosed malformations were those of the
      thoracoabdominal wall (81.08%), followed by defects of the urinary tract (70.86%)
      and of the diaphragm (70.83%).

PMID- 7788492
TI  - Development of a training model for ultrasound-guided invasive procedures in
      fetal medicine.
AB  - Training in ultrasound-guided procedures in fetal medicine is currently available
      in a few major fetal medicine units. Unlike elective surgical procedures,
      cordocentesis is usually performed without sedation as an outpatient procedure
      and active supervision of the trainee intensifies the anxiety already felt by the
      patient. In addition, the complication rate is higher in the initial few
      procedures or when the procedure is not regularly practiced. We have developed a
      comprehensive method of training for transabdominal invasive procedures using a
      medical model that simulates the in vivo situation.

PMID- 7788493
TI  - Doppler studies of the placental and fetal circulation in pregnancies with
      preterm prelabor amniorrhexis.
AB  - This study has investigated the effect of intrauterine infection on placental
      perfusion, fetal circulation and fetal oxygenation in patients with preterm
      prelabor amniorrhexis. In 69 pregnancies with preterm prelabor amniorrhexis,
      Doppler ultrasound studies of the uterine and umbilical arteries and the fetal
      middle cerebral artery and thoracic aorta were performed. Within 1 h after the
      Doppler studies, cordocentesis and amniocentesis were carried out for
      microbiological investigations and measurement of blood pO2 and pH. In the
      amniorrhexis group, there were no significant differences from the appropriate
      normal mean for gestation in any of the Doppler indices or blood gas results.
      Furthermore, there were no significant differences between the groups with
      positive fetal blood or amniotic fluid cultures and those with no evidence of
      infection. These data demonstrate that, in preterm prelabor amniorrhexis,
      microbial invasion of the amniotic cavity and fetal bacteremia are not associated
      with detectable changes in placental perfusion, fetal circulation or fetal
      oxygenation.

PMID- 7788494
TI  - Doppler flow velocimetry of the umbilical artery, uteroplacental arteries and
      fetal middle cerebral artery in prolonged pregnancy.
AB  - A total of 153 pregnant women, of at least 287 days' menstrual age, were studied
      in a prospectively designed cross-sectional trial. In addition to the non-stress
      test, contraction stress test, sonographic estimate of amniotic fluid and grade
      of placental maturation, Doppler measurements of the resistance index (RI) were
      taken in the umbilical artery, the uteroplacental arteries in the region of
      placental implantation and the fetal middle cerebral artery. Data were analyzed
      with regard to asphyxia and otherwise complicated fetal outcome. Furthermore, a
      possible relationship between grade of placental maturation, Doppler flow
      velocity waveforms and fetal outcome was investigated. Doppler resistance indices
      in the umbilical artery, uteroplacental arteries in the region of placental
      implantation and fetal middle cerebral artery did not change significantly with
      increasing gestation from 41 to 43 weeks. The grade of placental maturation on
      ultrasound examination was not related to fetal outcome or Doppler indices in the
      first two vessels. In all vessels examined in this study, the majority of Doppler
      measurements in pregnancies with subsequent asphyxia or otherwise complicated
      fetal outcome were within the 95% prediction interval for patients with normal
      fetal outcome. None of the patients showed absent diastolic flow in the umbilical
      artery. With the use of a cut-off value of RI = 0.62 in the umbilical artery,
      asphyxia could be predicted with 37% sensitivity and 75% specificity.
      Oligohydramnios and antpartum cardiotocography predicted asphyxia with 16% and 8%
      sensitivity and 95% and 96% specificity, respectively. Sensitivity for prediction
      of otherwise complicated fetal outcome by umbilical artery Doppler was only
      7%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788495
TI  - Characterization of placenta accreta using transvaginal sonography and color
      Doppler imaging.
AB  - The safe use of transvaginal sonography in patients with placenta previa has been
      confirmed, and has revolutionized precise placental localization. The aim of our
      study was to evaluate the efficacy of transvaginal sonography and color-coded
      blood flow in the prediction of placenta accreta. Twenty-one patients with
      persistent placenta previa were scanned using transvaginal sonography and color
      coded flow. Suspicion for placenta accreta consisted of total placenta previa at
      term with several placental lacunae exhibiting marked or turbulent blood flow, as
      seen with color Doppler transvaginal sonography from within the placenta,
      extending into the surrounding tissues. Five of the patients exhibited
      sonographic placental patterns suspicious for placenta accreta and one patient
      exhibited placental and cervical blood flow described as lacunar. Five Cesarean
      hysterectomies were performed for placenta accreta. Every placenta accreta was
      correctly diagnosed sonographically by the use of color flow studies. One patient
      with suspicion of placenta accreta delivered at another institution, a Cesarean
      hysterectomy was performed, and the pathology was confirmed. The one placenta
      previa exhibiting turbulent lacunar flow in the cervical area only was not
      confirmed to be an accreta at Cesarean section, although hemostasis was difficult
      at the placental bed. The remaining 15 patients with placenta previa and who on
      sonography were not suspicious for placenta accreta underwent uncomplicated
      Cesarean section. Transvaginal sonography and color Doppler imaging improve the
      diagnostic accuracy in the prediction of placenta accreta in patients with
      persistent placenta previa. A pattern of turbulent blood flow extending from the
      placenta into the surrounding tissues should alert the physician to the
      possibility of placenta accreta.

PMID- 7788496
TI  - Early fetal endocardial fibroelastosis and critical aortic stenosis: a case
      report.
AB  - Endocardial fibroelastosis is characterized by an abnormal thickening of the
      endocardium of one or both ventricles; the disorder may occur with or without
      other cardiac anomalies. A diagnosis of endocardial fibroelastosis in utero using
      fetal echocardiography may be made on the basis of increased echodensity of the
      endocardium and poor contractility of the ventricle. We describe a case of very
      early diagnosis of fibroelastosis and aortic valve stenosis observed in utero at
      14 weeks' gestation by transvaginal echocardiography.

PMID- 7788497
TI  - Cerebellar hypoplasia in the second trimester associated with microcephaly at
      birth.
AB  - The antenatal diagnosis of microcephaly is most commonly made in the third
      trimester. Biometric measurements of the head of three or four standard
      deviations below the mean are suggestive of microcephaly. We report a case of
      microcephaly where abnormalities in intracerebral architecture, i.e. cerebellar
      hypoplasia, were noted early in the second trimester.

PMID- 7788498
TI  - Presentation of the 1994 Ian Donald Gold Medal.

PMID- 7788499
TI  - LIM domain proteins.
AB  - The LIM domain is a cysteine-rich domain composed of 2 special zinc fingers that
      are joined by a 2-amino acid spacer. Some proteins are constituted by LIM domains
      only while others contain a variety of different functional domains. LIM proteins
      form a diverse group which includes transcription factors and cytoskeletal
      proteins. The primary role of LIM domains appears to be in protein-protein
      interaction, through the formation of dimers with identical or different LIM
      domains or by binding distinct proteins. In LIM homeodomain proteins, LIM domains
      seem to function as negative regulatory domains. LIM homeodomain proteins are
      involved in the control of cell lineage determination and the regulation of
      differentiation, and LIM-only proteins may have similar roles. LIM-only proteins
      are also implicated in the control of cell proliferation since several genes
      encoding such proteins are associated with oncogenic chromosome translocations.
      In analyzing sequence relationships between LIM domains we suggest that they may
      be arranged into 5 groups which appear to correlate with the structural and
      functional properties of the proteins containing these domains.

PMID- 7788500
TI  - Hammerhead ribozyme: a three dimensional model based on photo-crosslinking data.
AB  - The hammerhead ribozyme is a small catalytic RNA motif made up of 3 base-paired
      stems connected by conserved sequences which are essential for catalysis. We have
      modelled its 3 dimensional structure, taking advantage of proximity data between
      several substrate and ribozyme residues determined by photo-crosslinking
      experiments. It is characterized by an Y shape of the 3 stems stabilized in the
      central core by a network of hydrogen bonds involving in particular 2 non Watson
      Crick G:A base-pairs. The 5' conserved sequence CUGA makes a sharp turn, the G
      residue exchanging hydrogen bonds with a conserved base-pair of stem III. The
      substrate is stretched at the cleavage site. Overall this structure is consistent
      with that deduced from X-ray crystallography but differences are observed at the
      level of the CUGA turn.

PMID- 7788501
TI  - Tat-induced lesions in transgenic mice do not correlate with the HIV-1 LTR
      transactivation.
AB  - The product of the tat gene is the most potent transcriptional trans-activator of
      the HIV-1 LTR (Human Immunodeficiency Virus type 1 Long Terminal Repeat) and
      might be predicted to be one of the HIV-1 proteins involved in the pathogenesis
      of AIDS-associated tumors. Deciphering its role in vivo may imply generation of
      transgenic mouse models displaying different spectra of tat expression. However,
      it remains difficult to correlate the mRNA expression, the protein production and
      the eventual pathological consequences in the animal. Our goal in this work was
      to elaborate a binary transgenic system allowing such an approach, the
      correlation of the transgene expression in different tissues and the production
      of the Tat protein, tested as a trans-activator in vivo, with its pathogenic
      effects. No direct linkage was evident between the degree of transactivation and
      pathogenesis. Indeed, only benign lesions were observed in malpighian epithelia,
      where the production of the Tat protein was clearly evidenced by its
      transactivating property.

PMID- 7788502
TI  - Ultrastructural localization of cellular prion protein (PrPc) in synaptic boutons
      of normal hamster hippocampus.
AB  - The cellular prion protein (PrPc) is a membrane sialoglycoprotein synthesized in
      the central nervous system and extraneural tissues. Its post-translational
      modification produces an accumulation of abnormal isoform PrPsc found in brains
      of transmissible neurodegenerative disorders in animals (scrapie and bovine
      spongiform encephalopathy) and humans (Kuru, Creutzfeldt-Jakob disease, Gerstmann
      Straussler-Scheinker syndrome). One major unanswered question relative to PrPc
      concerns its physiological role in brain neurons, depending largely on the
      limited knowledge of its subcellular localization. Using a highly-sensitive
      immunogold electron microscopy technique, we reported that in the hamster dentate
      gyrus, the synaptic boutons constituted the submicroscopic site where PrPc was
      observed. This detection was obtained with 2 highly-specific polyclonal
      antibodies for prion protein. PrPc localization was assigned, both on structural
      basis and on its co-localization with synaptophysin. The presence of PrPc in
      synaptic terminals should provide additional informations on its possible role in
      neuronal transmission and on the implication of synapses in the pathogenesis of
      spongiform encephalopathies.

PMID- 7788503
TI  - 7 Alpha-hydroxylation of 27-hydroxycholesterol in rat brain microsomes.
AB  - 27-hydroxycholesterol is shown to be 7 alpha-hydroxylated by microsomal
      preparations of rat brain. The apparent Km was about 2 microM and Vmax about 15
      pmol/min x mg protein. The reaction might modulate biological functions of 27
      hydroxycholesterol, such as its suppressive effect on the activity of 3-hydroxy-3
      methylglutaryl-coenzyme A reductase, and supports the possibility of bile acid
      formation in the brain.

PMID- 7788504
TI  - Mycobacterial polar glycopeptidolipids enhance resistance to experimental murine
      candidiasis.
AB  - Intraperitoneal administration of polar glycopeptidolipids extracted from
      Mycobacterium chelonae (pGPL-Mc) greatly increased the resistance of mice against
      a lethal disseminated Candida albicans infection. This enhanced resistance was
      demonstrated by an increase in the number of survivors and the prolongation of
      the mean survival time of animals following a lethal challenge. These effects
      were dependent upon the infective dose of Candida albicans, the dose of pGPL-Mc
      and the timing of its administration. This enhanced resistance was correlated
      with the development and persistence of a hyperleukocytosis, associated with a
      long lasting increase in the number of polymorphonuclear neutrophils. On the
      contrary, no candidacidal effect of the serum collected from pretreated mice was
      observed; suggesting that the ability of pGPL-Mc to increase resistance against
      Candida albicans infection is likely to be mediated by polymorphonuclear
      neutrophils. These results confirm previously described immunostimulating
      properties of pGPL-Mc and open the way for the evaluation of its effect in the
      prevention of opportunistic infections in neutropenic patients.

PMID- 7788505
TI  - Activation of human thymocytes induces the phosphorylation of protein tyrosine
      phosphatase 1C.
AB  - Phosphorylation of docking proteins is essential for signal transduction. In this
      report we provide evidence that activation of human thymocytes in culture induces
      the phosphorylation of the protein tyrosine phosphatase 1C (PTP 1C). Thymocytes
      were activated with Con A, PMA or Con A+PMA. The enzyme is phosphorylated on its
      serine and threonine residues. Phosphorylation occurs within 5 min and lasts for
      24 h. PTP 1C is phosphorylated by PKC in vivo and in vitro; however,
      phosphopeptide mapping suggests that in addition to PKC other kinases
      phosphorylate the enzyme. On the maps of tryptic digests of cultured thymocytes
      more radiolabeled phosphopeptides are visualized than on the maps of digests of
      PTP 1C phosphorylated with partially purified PKC alpha or beta. Phosphorylation
      of PTP 1C decreases its activity, whereas dephosphorylation increases its
      activity, suggesting that phosphorylation of PTP 1C takes part in the regulation
      of signal transduction.

PMID- 7788506
TI  - Cortical memory in Paramecium: a theoretical approach to the structural heredity.
AB  - Structural heredity is frequently encountered in ciliates. In particular, during
      division of Paramecium the cortical characteristics of the 2 daughter cells are
      inherited from those of the mother cell. Genesis of new structures is therefore
      only possible if there are pre-existing older structures. We attempted to
      simulate this phenomenon with a model already used to describe the structure and
      morphogenesis of the cortex of Paramecium. We show that to initiate spatial
      organization it is enough to choose special starting conditions which comprise
      the primer of the structure, even if highly localized and at a low concentration
      of morphogens. This property does not question the basic concepts of genomic
      heredity.

PMID- 7788507
TI  - Factors regulating megakaryocyte progenitor commitment to polyploidization.
AB  - Recognizable megakaryocytes are polyploid cells generated by a clonogenic,
      diploid progenitor, termed CFU-MKC (colony forming unit, megakaryocyte). In order
      to quantify polyploidization, ploidy histograms of megakaryocytes determined by
      microphotometric or flow cytometric measurements of megakaryocyte DNA have
      generally been used. However these techniques provide no information on the rate
      of commitment of CFU-MKC to polyploidy. Using a technique of clonal analysis
      determining the distributions of the number of doublings (NbD) undergone by CFU
      MKC before committing to polyploidization, the polyploidization probability of
      CFU-MKC could be derived. This probability was found to be a constant independent
      from CFU-MKC mitotic history, since NbD distributions are exponential functions
      characterized by a constant rate of decay per doubling. By studying the effects
      of growth factors on polyploidization probability, it was also shown that: (1)
      this parameter is negatively regulated by growth factors contained in poke-weed
      or WEHI conditioned media, as well as by erythropoietin; (2) commitment to
      polyploidization does not require prior CFU-MKC division; (3) bipotent erythroid
      megakaryocyte progenitors have a lower polyploidization probability than CFU-MKC;
      (4) determination of polyploidization probability reflects the activity of growth
      factors with greater accuracy than megakaryocyte colony count.

PMID- 7788508
TI  - Enzymes for enhancing bioremediation of petroleum-contaminated soils: a brief
      review.
AB  - During the 1950s and 1960s, hundreds of thousands of underground storage tanks
      (and above-ground storage tanks) containing petroleum products and hazardous
      chemicals were installed. Many of these tanks either have been abandoned or have
      exceeded their useful lives and are leaking, thereby posing a serious threat to
      the nation's surface and groundwater supplies, as well as to public health.
      Cleaning up releases of petroleum hydrocarbons or other organic chemicals in the
      subsurface environment is a real-world problem. Biological treatment of
      hydrocarbon-contaminated soil is considered to be a relatively low-cost and safe
      technology; however, its potential for effectively treating recalcitrant wastes
      has not been fully explored. For millions of years, microorganisms such as
      bacteria, fungi, actinomycete, protozoa, and others have performed the function
      of recycling organic matter from which new plant life can grow. This paper
      examines the biological treatment technology for cleaning up petroleum product
      contaminated soils, with special emphasis on microbial enzyme systems for
      enhancing the rate of biodegradation of petroleum hydrocarbons. Classifications
      and functions of enzymes, as well as the microbes, in degrading the organic
      contaminants are discussed. In addition, the weathering effect on biodegradation,
      types of hydrocarbon degraders, advantages associated with enzyme use, methods of
      enzyme extraction, and future research needs for development and evaluation of
      enzyme-assisted bioremediation are examined.

PMID- 7788509
TI  - Effectiveness of smokeless ashtrays.
AB  - Most environmental tobacco smoke (ETS) issues from the tips of smoldering
      cigarettes between puffs. Smokeless ashtrays are designed to reduce ETS exposure
      by removing particulate and/or gas-phase contaminants from this plume. This paper
      describes an experimental investigation of the effectiveness of four smokeless
      ashtrays: two commercial devices and two prototypes constructed by the authors.
      In the basic experimental protocol, one or more cigarettes was permitted to
      smolder in a room. Particulate or gas-phase pollutant concentrations were
      measured in the room air over time. Device effectiveness was determined by
      comparing pollutant concentrations with the device in use to those obtained with
      no control device. A lung deposition model was applied to further interpret
      device effectiveness for particle removal. The commercial ashtrays were found to
      be substantially ineffective in removing ETS particles because of the use of low
      quality filter media and/or the failure to draw the smoke through the filter. A
      prototype ashtray using HEPA filter material achieved better than 90% particle
      removal efficiency. Gas-phase pollutant removal was tested for only one prototype
      smokeless ashtray, which employed filters containing activated carbon and
      activated alumina. Removal efficiencies for the 18 gas-phase compounds measured
      (above the detection limit) were in the range of 70 to 95%.

PMID- 7788510
TI  - Adverse drug effects and the spectrum of eosinophilic pulmonary disorders.

PMID- 7788512
TI  - Chronic fatigue in a 43-year-old woman.

PMID- 7788511
TI  - Bronchial hyperreactivity revisited.
AB  - OBJECTIVE: The purpose of this article is to review bronchial reactivity: how it
      is detected, what are the clinical and pathologic correlates and what treatment
      modulates it. Is it a good diagnostic test for a disease such as asthma? Is it a
      reasonable parameter to follow in assessing disease severity and response to
      treatment? DATA SOURCES: Recent studies on human subjects in the English language
      medical literature involving bronchial hyperreactivity. In particular all studies
      were sought that correlated indices of inflammation obtained either by
      bronchoalveolar lavage or biopsy with degree of bronchial hyperresponsiveness.
      Pertinent studies reviewing disease association with presence of bronchial
      hyperreactivity were sought. All studies of treatment with inhaled
      corticosteroids were reviewed and those in which the subjects could be classified
      as having either mild or moderately severe asthma on the basis of the clinical
      information given were used to provide data on correlation of bronchial
      reactivity and disease severity. RESULTS: The relationship of bronchial
      reactivity and any disease state is not straightforward. It is not clear what
      causes hyperreactivity of the airways but there must be other factors besides
      inflammation as bronchial hyperreactivity can occur without microscopic evidence
      of inflammation. Hyperresponsiveness does not appear to be as sensitive or
      specific for the diagnosis of asthma as previously thought, or as closely related
      to the severity of asthma. Effects of treatment appear to be somewhat independent
      of their impact on bronchial responsiveness. CONCLUSIONS: Airway
      hyperresponsiveness can be found in many circumstances. Its relationship to
      symptom production and clinical course in any disease is not clear. Further
      studies are needed to elucidate the relationship between airways hyperreactivity,
      asthma, and other lung diseases and the factors that lead to increased bronchial
      reactivity.

PMID- 7788513
TI  - Phenytoin-related immunodeficiency associated with Loeffler's syndrome.
AB  - BACKGROUND: Phenytoin is one of the most commonly prescribed drugs in the United
      States. Its use is associated with a myriad of adverse reactions, including:
      eosinophilia, selective IgA deficiency and panhypogammaglobulinemia,
      pseudolymphoma, Stevens-Johnson syndrome, and interstitial pneumonia. OBJECTIVE:
      To report a case of immunodeficiency manifest by panhypogammaglobulinemia and a
      low helper-to-suppressor ratio secondary to phenytoin crossreactivity with
      phenobarbital and carbamazepine complicated by hepatotoxicity, eosinophilia, and
      fleeting pulmonary infiltrates. METHODS: Case report; immunoglobulin levels, T
      and B cell studies, and radiologic evaluation of patient. RESULTS: A 37-year-old
      Oriental female taking phenytoin and phenobarbital for seizure prophylaxis after
      resection of a grade IV astrocytoma of the left frontal lobe, developed a rash,
      elevated liver function tests, and cervical lymphadenopathy with parotid gland
      enlargement. The abnormalities resolved with discontinuation of the drugs and the
      patient was discharged on carbamazepine. Eight weeks later the patient was
      readmitted with fever, slowed mentation, elevated liver function tests, and
      panhypogammaglobulinemia. Clonazepam was substituted for carbamazepine and the
      patient subsequently developed a rash and further elevation of her liver function
      tests. The clonazepam was discontinued and the patient was treated with
      methylprednisolone. She subsequently developed Loeffler's syndrome and a T cell
      deficiency with a decreased helper-to-suppressor cell ratio. She was treated with
      increased doses of methylprednisolone and granulocyte stimulating factor with
      complete resolution of her symptoms. CONCLUSIONS: Phenytoin is associated with a
      myriad of side effects, including, rash, eosinophilia, panhypogammaglobulinemia,
      pseudolymphoma, Stevens-Johnson syndrome, immunosuppression in brain tumor
      patients, and rarely, pulmonary complications such as Loeffler's syndrome. Cross
      reactivity with other anticonvulsant agents capable of forming arene oxide
      intermediates occurs in the cytochrome P-450 system.

PMID- 7788515
TI  - Major inhalant allergens in Mauritius.
AB  - BACKGROUND: Bronchial asthma appears to be an important but neglected problem in
      tropical countries. There is little information about the role of atopy in
      tropical climates and how atopy is related to asthma there. OBJECTIVE: The
      present work was aimed at determining the pattern of total serum IgE-titers among
      a group of patients suffering from asthma in Mauritius. METHOD: Twenty-five
      asthmatic patients and ten controls who met the criteria for the study were
      registered. A comprehensive clinical evaluation was followed by allergy skin
      testing (prick test) to common aeroallergens. Serum total IgE levels were
      measured in all 35 participants. RESULTS: Of 22 patients studied, 22 had
      significant levels of IgE when tested to airborne allergens. Positive skin tests
      against Dermatophagoide pteronyssinus and Dermatophagoide farinae correlated well
      with the presence of serum total IgE. Sixteen patients also had had moderate to
      severe exacerbations throughout the year. CONCLUSIONS: The results suggest that
      house dust mite is an important allergen producing symptoms throughout the year
      in our patients.

PMID- 7788514
TI  - Soluble serum interleukin 2 receptors in patients with asthma and allergic
      bronchopulmonary aspergillosis.
AB  - BACKGROUND: When T cells are activated, they produce two distinct surface
      receptors for interleukin 2 (IL2). One of these surface receptors is a 55-kD
      protein called IL2Ra which is released into peripheral blood following T cell
      activation. This soluble protein (sIL2R) can be measured in peripheral blood
      utilizing an ELISA, and thus provides an indirect indicator of T cell activation.
      OBJECTIVE: The purpose of this study was to determine whether allergic
      bronchopulmonary aspergillosis (ABPA) was associated with increased soluble
      interleukin 2 receptors (sIL2R). METHODS: We used the Immunoenzymometric Assay
      Kit (Immunotech International, Marseille, France) which had a monoclonal antibody
      to sIL2R to sensitize wells. To determine the degree of T cell activation in
      patients with asthma and ABPA, we have evaluated the concentration of sIL2R in
      the peripheral blood in four groups: (1) 26 nonatopic patients, (2) 39 patients
      skin test positive to Aspergillus who did not have serologic evidence of ABPA,
      (3) 14 patients with quiescent ABPA, and (4) 13 patients who had a new
      roentgenographic infiltrate from ABPA. RESULTS: The mean concentration of sIL2R
      in the four groups were 24.5 pM (+/- 16.7), 38.4 pM (+/- 27.2), 48.4 pM (+/-
      28.2), and 64.8 pM (+/- 33.0), respectively. Group 4 was greater than groups 1
      and 2 (P < .05), and group 3 was greater than group 1 (P < .05). CONCLUSIONS: In
      patients with ABPA that is flaring, there is greater T cell activation than in
      either nonatopic controls or in patients who have asthma. Patients with ABPA in
      remission also had significantly greater T cell activation than nonatopic
      controls.

PMID- 7788516
TI  - Cerebral toxoplasmosis in childhood and adult HIV infection treated with 1-4
      hydroxynaphthoquinone and rapid desensitization with pyrimethamine.
AB  - BACKGROUND: We describe a child and an adult infected with the human
      immunodeficiency virus (HIV) who developed cerebral lesions consistent with
      toxoplasmosis. A biopsy in the child and IgG ELISA in both patients confirmed the
      diagnosis of Toxoplasma gondii. The patients were initially treated with
      pyrimethamine, however, computerized tomography studies (CT scan) revealed
      progression of a left frontal and temporoparietal lesion. Therapy in the child
      was changed to pyrimethamine, clindamycin, and azithromycin. Repeat CT scan
      showed further disease progression and therapy was changed to high-dose
      pyrimethamine (3 mg/kg/d) and azithromycin. A subsequent CT scan disclosed
      further radiologic progression with increasing edema. The adult patient developed
      a maculopapular rash during attempted treatment with pyrimethamine. METHODS:
      Introduction of 2 (trans-4[4 chlorophenol] cyclohexy[3-hydroxy-1, 4
      naphthoquinone] (HNPQ) an experimental antiparasitic compound previously used
      only in adult HIV clinical trials, was instituted in the child and rapid oral
      desensitization to pyrimethamine was initiated in the adult patient. RESULTS:
      HNPQ resulted in resolution of the cerebral lesion in the child and rapid oral
      desensitization to pyrimethamine produced an excellent clinical response in the
      adult. To our knowledge, these are the first cases of childhood and adult
      cerebral toxoplasmosis treated successfully with HNPQ and rapid oral
      desensitization to pyrimethamine. CONCLUSION: HNPQ and pyrimethamine
      desensitization should be considered as alternate modes of therapy in patients
      who become intolerant or fail to respond to traditional therapy for
      toxoplasmosis.

PMID- 7788517
TI  - Clinical and immunologic surveys of Hymenoptera hypersensitivity in Japanese
      forestry workers.
AB  - BACKGROUND: The increased incidence of bee-sting allergy among beekeepers is well
      known, whereas Hymenoptera hypersensitivity among forestry workers, who are
      frequently stung by Hymenoptera, is not well understood. OBJECTIVE: To elucidate
      the nature of Hymenoptera hypersensitivity among forestry workers and analyze the
      mechanism involved in Hymenoptera-induced systemic reactions. METHODS: A
      questionnaire was administered and yellow jacket venom-specific IgE antibody
      titers measured in 323 forestry workers and 100 age-matched office workers with
      little occupational exposure to Hymenoptera stings as a control group. RESULTS:
      From the questionnaire it was found that the percentage of systemic reactions to
      Hymenoptera stings was significantly greater in the forestry workers than in the
      control subjects (P < .01). The number of sting exposures was significantly
      higher in the forestry workers than in the control subjects (P < .01) and was
      closely correlated with episodes of systemic reaction. Yellow jacket venom
      specific IgE antibody titers were significantly higher in forestry workers with
      episodes of systemic reaction compared with those with only local or large local
      reactions to Hymenoptera (P < .05), although more than half of these subjects had
      undetectable IgE antibody titers to yellow jacket venom. IgE antibody titers
      against yellow jacket venom were closely correlated with those of paper wasp (rs
      = .802, P < .001), which is another frequent source of Hymenoptera stings. In
      workers with episodes of sting exposure within the most recent 3 years, the
      period from the last sting was not correlated with yellow jacket venom-specific
      IgE antibody titers. CONCLUSIONS: The number of sting exposures may contribute to
      systemic reactions to Hymenoptera sting, and some mechanism other than IgE
      mediated hypersensitivity may also be involved in Hymenoptera-induced systemic
      reactions.

PMID- 7788518
TI  - Nedocromil sodium versus theophylline in the treatment of reversible obstructive
      airway disease.
AB  - BACKGROUND: Previous clinical therapeutic research has shown that inhaled
      nedocromil sodium can replace maintenance oral sustained release theophylline in
      the management of asthma patients. OBJECTIVE: To compare directly the efficacy
      and safety of nedocromil sodium and sustained release theophylline. METHODS:
      Using a randomized, double-blind, double-dummy, parallel-group design, 105
      patients with reversible obstructive airways disease (77 asthmatic patients)
      recruited from four referred-care clinics received, in addition to their existing
      therapy, 4 mg nedocromil sodium four times daily or sustained release
      theophylline (maximum daily dose 13 mg/kg) for 6 weeks. Patients with serum
      theophylline levels within the therapeutic range of 10 to 20 micrograms/mL were
      retained for efficacy analysis. All were included in a tolerability analysis. Day
      and nighttime symptoms, inhaled bronchodilator use, morning tightness, cough, and
      twice daily peak flows were recorded on diary cards. Disease severity, lung
      function and unusual events were evaluated bi-weekly, and opinion of treatment
      after 6 weeks. RESULTS: Both treatments improved symptoms, inhaled bronchodilator
      use and lung function to the same extent. Both treatments were very to moderately
      effective in > 70% patients. The occurrence of gastrointestinal (P < .05) and
      central nervous system (P < .01) unusual events was significantly lower for
      nedocromil sodium compared with theophylline treated patients. CONCLUSIONS:
      Nedocromil sodium and theophylline were equally effective in this group of
      patients but nedocromil sodium treatment was associated with significantly fewer
      side effects, and therefore may be the treatment of choice.

PMID- 7788519
TI  - Asthma and related atopic disorders in outpatients attending an urban HIV clinic.
AB  - BACKGROUND: Drug hypersensitivity and pruritic cutaneous disorders are common in
      human immunodeficiency virus (HIV)-infected patients. Systematic cross-sectional
      studies, detailing the pattern of atopic disease, however, have not been
      performed in patients with HIV infection. OBJECTIVE: To analyze the relationships
      between atopic disease and factors relating to lifestyle, environment, gender,
      genetics, and HIV disease-associated immune cell depletion. METHODS: CD4 cell
      counts and interview data were recorded in a survey of 136 adult patients
      attending a community hospital-based HIV outpatient clinic. The reported presence
      of various atopic and related conditions (including asthma, hay fever, otitis,
      sinusitis, and dermatitis) were analyzed for prevalence and associations with CD4
      cell depletion, family atopy, and other factors using logistic regression.
      RESULTS: Seventeen percent and 15% of patients claimed to have asthma and hay
      fever, respectively. Eleven percent claimed chronic nasal symptoms without known
      hay fever. A recent CD4 count > or = 200 cells/dL was significantly associated
      with current asthma (P = .01) and this association remained after adjusting for
      other significant factors. The mean recent log CD4 count for patients with
      current asthma was significantly higher than other patients (5.63 +/- .73 versus
      4.92 +/- 1.38, P = .001). There was no association between rhinitis and CD4 cell
      depletion. Histories of recent sinusitis (24%) and ear infections (16%) were
      common, and were significantly associated with current hay fever +/- chronic
      nasal symptoms (P < .05). Chronic pruritic rashes or eczema were reported in 29%
      and were more frequent in those with CD4 counts < 200/dL. Family histories of
      either asthma or hay fever were significantly associated with several condition
      including hay fever +/- chronic nasal symptoms, otitis, drug allergy, chronic
      pruritic rashes or eczema, and asthma. CONCLUSIONS: Although atopic disorders in
      the setting of HIV infection appear to have some clinical associations similar to
      that reported for the general population, asthma appears to have a predilection
      towards less severe CD4 cell depletion. The potential role of chronic rhinitis +/
      family atopy as risk factors for sinusitis and otitis may be important because
      treatment of selected individuals with rhinitis may potentially decrease some
      paranasal disease-related morbidity in HIV infection.

PMID- 7788520
TI  - Spontaneous variations in congestion of the nasal mucosa.
AB  - BACKGROUND: Nasal patency shows spontaneous variations but is also influenced by
      exercise and allergic conditions. These variations have not been described in
      detail with regard to allergy. OBJECTIVES: The purpose of this study was to
      examine whether these variations are different in nonallergic subjects and in
      subjects with nasal allergy to pollen out of the pollen season. METHODS: We
      examined 12 of each type of subject in the winter on two days for seven hours in
      a climatic chamber with constant temperature and relative humidity, one day for
      examination of spontaneous variations and one day for examination of exercise
      response. Every 15 minutes the volume of the nasal cavities, minimum cross
      sectional areas, and areas at fixed distances from the nostril were measured by
      acoustic rhinometry. Symptoms were scored by a questionnaire. RESULTS: There were
      more pronounced spontaneous variations expressed as the coefficient of variation
      of nasal volume in allergic than in nonallergic subjects (14% against 9%, P =
      .004). A nasal cycle was observed in four of the nonallergic subjects and three
      of the allergic subjects. In the postexercise period, the spontaneous variations
      in the nonallergic subjects were increased but decreased in the allergic
      subjects. Exercise increased nasal patency more in the allergic subjects but only
      significantly for the cross-sectional area at 3.3 cm (105% compared with 43% in
      the nonallergic subjects, P = .05). In contrast, pharmacologic decongestion in
      the allergic subjects showed a tendency to be more pronounced for the nasal
      cavity volume (55% increase versus 42%, P = .08). There was no difference between
      the groups in nasal symptom scores. CONCLUSION: Allergic subjects out of the
      pollen season have more congested and more sensitive nasal mucosa than
      nonallergic subjects.

PMID- 7788521
TI  - Onychomycosis, Trichophyton allergy and asthma--a causal relationship?

PMID- 7788522
TI  - 4th European Symposium on the Application of Saliva in Clinical Practice and
      Research. Berlin, March 22-24, 1995. Abstracts.

PMID- 7788523
TI  - Cloning and identification of the hemG gene encoding protoporphyrinogen oxidase
      (PPO) of Escherichia coli K-12.
AB  - Cells of the VSR751 strain, which was previously isolated as a photoresistant
      revertant of the visA-deleted (hemH-deleted) strain of Escherichia coli K-12,
      accumulated uroporphyrin (uro), coproporphyrin (copro) and protoporphyrin IX
      (proto), but did not accumulate as much protoporphyrin as cells of the parental
      strain (hemH-deleted). Therefore, we concluded that strain VSR751 must be
      defective in protoporphyrinogen oxidase (PPO), the product of the hemG gene. By
      complementation analysis using VSR751, we isolated and identified this gene. The
      hemG gene is located at 86 mim on the E. coli chromosome, just upstream of the
      rrnA operon, and is transcribed clockwise in the same direction as the rrnA
      operon. This gene encodes a 181-amino acid protein with a calculated molecular
      mass of about 21 kDa. Sequence analysis revealed the presence of flavodoxin
      motif, suggesting tha a cofactor of this enzyme is flavin mononucleotide, which
      is consistent with the previous report that the mammalian PPO had the flavin
      cofactor.

PMID- 7788525
TI  - cDNA sequences of three kinds of beta-tubulins from rice.
AB  - Complete nucleotide sequences of three kinds of rice beta-tubulin cDNA clones
      (pTUB22, R1623 and R2242) were determined. Southern hybridization indicated that
      these beta-tubulins consist of one gene family. Using RFLP mapping, these three
      beta-tubulin cDNAs were mapped to different chromosomes indicating at least three
      loci for the beta-tubulin gene. The deduced amino acid sequences of these cDNAs
      showed a high similarity to other plant beta-tubulins. The asparagine residue
      located at the 100th amino acid from the N-terminus of plant beta-tubulins was
      also conserved with these three beta-tubulins. This asparagine is thought to be
      responsible for the sensitivity against rhizoxin, the toxin of the pathogen of
      rice seedling blight, Rhizopus sp. a soil-borne microorganism. Expression of the
      three beta-tubulin genes was analyzed by Northern blotting and all three clones
      were expressed in root, the possible target tissue of rhizoxin. These results
      suggest that these clones are candidates of beta-tubulins targeted by rhizoxin.

PMID- 7788524
TI  - Cloning and sequencing of sulfite reductase alpha subunit gene from Saccharomyces
      cerevisiae.
AB  - A DNA fragment of 2.1 kb was specifically amplified by PCR with primers based on
      the amino acid sequences obtained from the N-terminal region and the cyanogen
      bromide-derived peptide of the sulfite reductase alpha subunit in Saccharomyces
      cerevisiae. With this fragment as a probe, the gene coding for the sulfite
      reductase alpha subunit was isolated from a genomic library of S. cerevisiae.
      Sequencing analysis revealed that the gene contains a 3105-bp open reading frame,
      which is large enough to code for a protein of 1035 amino acid residues. The
      transcript of the sulfite reductase alpha subunit gene was detected by Northern
      analysis after methionine deprivation, but the amount of the transcript did not
      directly correlate with the enzyme activity. The DNA fragment containing the
      sulfite reductase alpha subunit gene rescued the met10 phenotype by
      complementation.

PMID- 7788526
TI  - Comparative analysis of mouse NotI linking clones with mouse and human genomic
      sequences and transcripts.
AB  - NotI cleavage sites are frequently associated with CpG islands that identify the
      5' regulatory sites of functional genes in the genome. Therefore we analyzed a
      sample of 22 NotI linking clones prepared from mouse brain DNA, to determine
      whether these mouse NotI site associated clones could be used for comparative
      analysis of mouse and human genomes by cross-reaction with both mouse and human
      genomic DNA and RNA in Southern and Northern hybridization. We further examined
      whether we could establish the identity of these clones with known genes by
      comparing the nucleotide sequences surrounding the NotI site with the GenBank
      database. We observed that 70% of the clones cross-hybridized with human DNA and
      that 4 of 11 tested clones (36%) detected a transcript in human HeLa cells RNA
      whereas 73% clones (8/11) detected transcripts in mouse RNAs from one or more
      organs. Single pass sequence analysis was successful on 16 of 19 clones. The GC
      content in these sequence was very high (48.8% to 73.8%) suggesting that 12 of 16
      sequenced clones contained a CpG island. Three out of 19 clones showed
      significant similarity with previously analyzed mouse gene sequences in GenBank,
      including the mouse rRNA gene family, cathepsin and the scip POU-domain genes. In
      addition, two sequences showed significant similarity to the human and rabbit
      protein phosphatase 2A-beta subunit and the human transforming growth factor
      beta. Thus, 5 of 16 clones showed homology with identified genes. These results
      and the recent work of using RLGS methods for genetic mapping indicate that NotI
      linking clones can be used to efficiently cross reference a comparative analysis
      of the mouse and human genomic maps.

PMID- 7788527
TI  - Prediction of the coding sequences of unidentified human genes. III. The coding
      sequences of 40 new genes (KIAA0081-KIAA0120) deduced by analysis of cDNA clones
      from human cell line KG-1.
AB  - We isolated full-length cDNA clones from size-fractionated cDNA libraries of
      human immature myeloid cell line KG-1, and the coding sequences of 40 genes were
      newly predicted. A computer search of the GenBank/EMBL databases indicated that
      the sequences of 14 genes were unrelated to any reported genes, while the
      remaining 26 genes carried some sequences with similarities to known genes.
      Significant transmembrane domains were identified in 17 genes, and protein motifs
      that matched those in the PROSITE motif database were identified in 11 genes.
      Northern hybridization analysis with 18 different cells and tissues demonstrated
      that 10 genes were apparently expressed in a cell-specific or tissue-specific
      manner. Among the genes predicted, half were isolated from the medium-sized cDNA
      library and the other half from the small-sized cDNA library, and their average
      sizes were 4 kb and 1.4 kb, respectively. As judged by Northern hybridization
      profiles, small-sized cDNAs appeared to be expressed more ubiquitously and
      abundantly in various tissues, compared with that of medium-sized cDNAs.

PMID- 7788528
TI  - Cloning and characterization of rat cellular nucleic acid binding protein (CNBP)
      cDNA.
AB  - We cloned and sequenced the cDNAs which code for rat cellular nucleic acid
      binding protein (CNBP). In-frame insertion/deletion differences were found among
      the clones at two sites in the open reading frame, suggesting alternative
      splicing of the message or the presence of multiple genes which code for this
      protein. The deduced amino acid sequence revealed that one rat CNBP sequence was
      completely identical to its human counterpart. This striking conservation,
      together with the fact that homologous genes have been found in various organisms
      including Schizosaccharomyces pombe, suggests that CNBP plays a basic biological
      role in eukaryotic cells. The recombinant GST-CNBP fusion protein produced in
      Escherichia coli bound to a G-rich single-stranded RNA and DNA in a sequence
      specific manner.

PMID- 7788529
TI  - Prediction of the coding sequences of unidentified human genes. III. The coding
      sequences of 40 new genes (KIAA0081-KIAA0120) deduced by analysis of cDNA clones
      from human cell line KG-1 (supplement).

PMID- 7788530
TI  - In vitro processing of heteroduplex loops and mismatches by endonuclease VII.
AB  - Endonuclease VII is a Holliday-structure resolving enzyme of phage T4 which
      cleaves at junctions of branched DNAs and at mispairings. In extension of these
      findings we report the following: i) Endonuclease VII can discriminate between a
      large heteroduplex loop and a TT mismatch arranged in tandem, 6 nt distant from
      each other, in the same heteroduplex molecule. The enzyme cleaves two nucleotides
      3' from the base of the loop or the TT mismatch. ii) Similar to its reactions
      with mismatches cleavage of heteroduplex loops by endonucleave VII can also
      initiate correction of perfect double-strandedness by T4 DNA polymerase and T4
      DNA-ligase in vitro. Loops of 8 nt and 20 nt were repaired efficiently. iii) For
      the first time endonuclease VII cleavage sites were also mapped in single
      stranded DNA if it was part of the 20-nt loop. This suggests that looping of
      single-stranded DNA can induce formation of secondary structures, which are
      recognizable by endonuclease VII.

PMID- 7788531
TI  - The abdomen as source of sepsis in critically ill patients.
AB  - Among patients with life-threatening sepsis that has no clear site of origin, the
      abdomen continues to be a probable and tractable possibility. The cavity has the
      microbiologic and anatomic potential for sudden or indolent sepsis and the cause
      may be either obvious or obscure. The abdomen or the various structures may be
      primary sources that are secondary and independent of disease that brought the
      patient to peril. They also could be secondary and dependent upon an abdominal
      operation complicated by sepsis. The partnership of intensivist and surgical
      consultant, addressing possibilities and challenges, must identify the most
      probable cause and the most timely response for positive intervention in the
      critically ill patient threatened by sepsis.

PMID- 7788532
TI  - Biliary tract emergencies. Endoscopic and medical management.
AB  - The application of therapeutic ERCP and interventional radiology has
      significantly altered the treatment of biliary tract emergencies. Although
      surgery is the principal treatment for acute cholecystitis, nonoperative
      alternatives exist for high-risk patients. New, prospective, randomized trials
      have demonstrated that endoscopic management of severe cholangitis is superior to
      surgery, and that endoscopic sphincterotomy and stone extraction are superior to
      conservative treatment in severe gallstone pancreatitis. ERCP allows nonoperative
      management of postoperative bile leaks as well.

PMID- 7788533
TI  - Acute pancreatitis. Medical management.
AB  - The medical management of acute pancreatitis is primarily supportive and involves
      making the patient nulla per os, providing adequate intravenous hydration, and
      controlling pain with analgesics. Systems to identify patients with severe
      pancreatitis at risk for morbidity and mortality are available but require
      supplementation with frequent, experienced clinical observation. A number of
      modalities to inhibit pancreatic secretion or pancreatic proteases have not been
      successful in clinical trials, although larger studies in patients with more
      severe pancreatitis are required to ultimately assess their effectiveness. The
      empiric use of imipenem and long-term peritoneal lavage in patients with severe
      or necrotizing pancreatitis appear promising but further studies are needed. The
      removal of impacted gallstones in patients with severe pancreatitis or
      cholangitis is useful, provided an expert endoscopist is available. Improvements
      in our ability to document pancreatic infection early by CT-directed aspiration
      have markedly improved our ability to manage pancreatic infection.

PMID- 7788534
TI  - Acute pancreatitis. Surgical management.
AB  - In general, the best approach to pancreatitis is to recognize its presence early,
      resuscitate the patient aggressively, and employ nutritional and medical therapy
      to avoid complications. Nonetheless, either because of trauma or failure of
      medical therapy, some patients develop complications (e.g., hemorrhagic or
      necrotizing pancreatitis, abscess, pseudocyst, or fistula) that require operative
      intervention. Expert surgical judgment is required to decide which patients
      require surgery, when to operate, and what operation(s) to perform. Many of these
      patients require multiple surgical procedures and are critically ill, requiring
      careful attention to nutritional support, ventilatory management, and
      surveillance for sepsis. The care of these patients requires a multidisciplinary
      approach involving personnel in internal medicine, gastroenterology, radiology,
      surgery, anesthesiology, and nursing. Pancreatitis does not respect the
      boundaries of class, race, creed, gender, or traditional specialty interests;
      only by using a collegial approach, which shares expertise in a multidisciplinary
      fashion, is it possible to optimize patient care and salvage critically ill
      patients with this deadly disease.

PMID- 7788535
TI  - Stress-related mucosal disease. Pathophysiology, prevention, and treatment.
AB  - The advent of gastrointestinal endoscopy has allowed us to follow the morphologic
      results of severe stress on the gastrointestinal mucosa. It has become clear,
      however, that the presence of mucosal abnormalities does not always correlate
      with the presence of overt bleeding, or with the effect of bleeding on the
      overall outcome of such patients. In fact, the incidence of severe
      gastrointestinal hemorrhage, secondary to stress-related mucosal disease, has
      been decreasing over the past decade, as the care of these critically ill
      patients has improved. In patients who do have overt hemorrhage, however, the
      mortality rate is extremely high. It therefore remains the duty of the clinician
      to identify patients who are at high risk of having overt hemorrhage, and ensure
      that they receive adequate prophylactic therapy.

PMID- 7788536
TI  - The critical care management of nonvariceal upper gastrointestinal bleeding.
AB  - Upper gastrointestinal hemorrhage, although accounting for more than 300,000
      annual hospital admissions in the United States, continued to have about a 10%
      mortality rate over the past 50 years. Whether this is secondary to the
      increasing age of patients admitted with UGI hemorrhage, and their comorbid
      diseases, is unknown. The major approach to these patients includes volume and
      cardiovascular resuscitation, as well as surgical and gastroenterology
      consultation. Both clinical signs and endoscopic features in patients aid in
      predicting those at high risk of either rebleeding or dying, allowing for more
      aggressive steps, including endoscopic therapy of the bleeding site and surgery.
      Improved intensive care measures and endoscopic therapies for these patients may
      account for the signs of a recent decline in this mortality rate during the past
      10 years.

PMID- 7788537
TI  - Lower intestinal hemorrhage.
AB  - Lower intestinal hemorrhage, defined as bleeding originating below the ligament
      of Treitz, is a common clinical problem frequently requiring hospital admission.
      The two chief causes, vascular ectasia and diverticulosis, are degenerative
      diseases usually found in the elderly. This article focuses on those disease
      entities that potentially can result in significant lower intestinal blood loss.
      It also discusses a generalized approach to the diagnostic evaluation leading to
      specific management of the patient presenting with this problem.

PMID- 7788538
TI  - Variceal hemorrhage.
AB  - Variceal hemorrhage is a complication of portal hypertension that has high
      mortality and high recurrence rates. Management of variceal bleeding involves
      three areas: treatment of active hemorrhage, prevention of rebleeding, and
      prevention of first variceal bleeding. There are two main therapeutic avenues:
      methods directed at reducing portal pressure, such as pharmacologic therapy,
      shunt surgery, and TIPS; and methods that act locally by decreasing or
      interrupting blood flow through a specific varice, such as sclerotherapy,
      banding, and balloon tamponade. The relative effectiveness of each of these
      interventions is discussed in this article.

PMID- 7788539
TI  - Fulminant hepatic failure.
AB  - Fulminant hepatic failure is a devastating complication of viral hepatitis,
      hepatotoxic exposures, and a variety of other acute liver diseases. Although this
      syndrome is associated with high mortality, liver transplantation can be life
      saving. This article discusses the medical management of fulminant hepatic
      failure and emphasizes complications, determinants of survival, and patient
      selection for liver transplantation.

PMID- 7788540
TI  - Complications of chronic liver disease.
AB  - The patient with advanced cirrhosis presents unique challenges to the critical
      care physician, in great measure because of the protean functions attributable to
      the liver and the multiplicity of derangements that may occur. Portal
      hypertension, once it develops, is the source of potentially devastating
      complications that include life-threatening hemorrhage, infection, renal failure,
      and coma. Parenchymal disease can result in coagulopathy as well as altered
      handling of both endogenous (hormones, metabolites) and exogenous (drugs)
      substances. Cirrhosis also can be complicated by the development of HCC, which
      may worsen portal hypertension, deplete parenchymal reserves, and result in
      catastrophic complications. The prospect of cure by liver transplantation in
      selected cases serves to underscore the importance of prompt and vigilant
      management of patients with decompensated cirrhosis in the critical care setting.

PMID- 7788541
TI  - Diarrhea in the intensive care patient.
AB  - Approximately one third of patients admitted to the ICU develop diarrhea during
      their hospitalization. Diarrhea can lead to further complications, such as volume
      depletion and wound infection, and can significantly increase medical costs. The
      most common causative factors are medications, enteral feedings, and C. difficile
      infections. These may be implicated alone or in combination. Further
      investigations of the pathophysiology of ICU diarrhea as well as potential
      therapies are needed to clarify the proper approach to this important and complex
      problem.

PMID- 7788543
TI  - Emergencies in inflammatory bowel disease.
AB  - Ulcerative colitis and Crohn's disease, the principal IBDs, are characterized
      most often by a chronic relapsing course. Despite the protracted nature of these
      disorders they can present in an acute manner as gastrointestinal emergencies.
      The urgent manifestations include both intestinal and extraintestinal disease.
      Extraintestinal emergencies can be ocular, rheumatologic, hematologic, and
      urologic. Intestinal emergencies often are more severe and can be life
      threatening. These may include obstruction, abscesses, perforation, and
      hemorrhage. The successful management of such complications depends on early
      diagnosis and the judicious and timely use of both medical and surgical
      therapies.

PMID- 7788542
TI  - Acute mesenteric ischemia.
AB  - The term acute mesenteric ischemia (AMI) is applied to a wide spectrum of bowel
      injury within the distribution of the superior mesenteric vessels, ranging from
      reversible alterations in bowel function to transmural necrosis of the bowel
      wall. Intensivists not only are called upon to manage this catastrophic disease
      but also may be faced with AMI as a consequence of other illnesses that they
      treat.

PMID- 7788544
TI  - Gastrointestinal emergencies in the patient with AIDS.
AB  - The clinical importance of gastrointestinal disorders among patients with
      acquired immunodeficiency syndrome (AIDS) is enormous. Estimates of
      gastrointestinal complaints among AIDS patients range from 30% to 90%. Many of
      these patients may be chronically ill and have multiple simultaneous
      opportunistic pathogens and neoplasms. The diagnosis and management of serious
      gastrointestinal complications that often occur in the setting of chronic illness
      represent major challenges in the care of patients with AIDS.

PMID- 7788545
TI  - [Molecular biology and clinical nephrology].

PMID- 7788546
TI  - [Different expressions of alpha 2 (IV) and alpha 3 (IV) collagen mRNAs in renal
      glomeruli of IgA nephropathy].
AB  - The levels of extracellular matrix protein mRNAs were increased prior to the
      appearance of histological glomerulosclerosis in isolated glomeruli from several
      animal models. Striker studied renal biopsies (Seminar in Nephrology,
      13:508,1993). We made a comparable study in human renal biopsies to assess the
      levels of glomerular alpha 2 (IV) and alpha 3 (IV) collagen gene expressions in
      renal biopsies. Renal biopsy specimens were obtained from 11 patients (7 IgA
      nephropathy and 4 mesangial proliferative glomerulonephritis). Glomerular lesion
      was divided into 5 grades. The amount of collagen type IV in glomerular matrix
      was evaluated by immunoperoxidase staining using a monoclonal antibody to type IV
      collagen. For gene expression analysis, glomeruli were dissected out from about
      10% of each biopsy specimen. The expressions of alpha 2 (IV) and alpha 3 (IV)
      collagen mRNAs were analyzed by using in situ reverse transcription coupled with
      polymerase chain reaction. Each PCR reaction contained an amount of cDNA template
      equivalent to that obtained from 1/10 of a glomerulus, alpha 2 (IV) and alpha 3
      (IV) collagen mRNAs were detected in all specimens. All 3 cases of IgAN with
      grade III glomerular lesion had a more marked increment of glomerular alpha 2
      (IV) collagen cDNA than that of the other 3 IgAN patients with grade II lesion
      (the intensity of PCR product, grade III 0.54 +/- 0.12, VS grade II 0.25 +/-
      0.08, P < 0.05). No discrepancies were detected in the level of glomerular alpha
      3 (IV) collagen cDNA and the intensity of collagen IV staining between these two
      groups of IgAN. Interestingly, in MsPGN patients there was no difference in the
      expression of glomerular alpha 2 (IV) collagen mRNA between grade II and grade
      III glomerular lesions. The results suggested that the detection of glomerular
      alpha 2 (IV) collagen mRNA level in IgAN patients may help to define the
      pathological classification.

PMID- 7788547
TI  - [In situ expression of intercellular adhesion molecule-1 in human
      glomerulonephritis].
AB  - We conducted immunocytochemical analysis with in situ hybridization technique to
      investigate the presence and role of intercellular adhesion molecule-1 (ICAM-1)
      in normal and diseased kidneys. A total of 64 renal biopsy specimens were
      classified in three groups according to the degree of cellular proliferation in
      glomerulus. Group A presented no or mild proliferation (n = 38). Group B showed
      definite proliferation (n = 21). Group C had glomerular sclerosis (n = 5). The
      ratio of cases exhibiting increased glomerular ICAM-1 expression in lupus
      nephritis (9/10) was significantly different from that in minimally changed
      disease (1/5) (P = 0.017). Glomerular ICAM-1 expression level correlated well
      with the cellular proliferation and infiltration in glomerulus (B&A: P < 0.001;
      C&B: P < 0.05). The percentage of cases with tubular ICAM-1 positivity in group B
      (81.0%) and group C (100%) was greater than that in group A (52.6%), which was
      also correlated with that of interstitial cell infiltration. In situ
      hybridization of 9 renal biopsies with digoxigenin labelled oligo probe proved
      immunocytochemical findings. We conclude that glomerular ICAM-1 expression level
      is correlated with inflammatory degree of glomerulus and that tubular ICAM-1
      expression is associated with interstitial cell infiltration.

PMID- 7788548
TI  - [Image analysis for intercellular adhesion molecule-1 expression in MRI/lpr mice:
      effects of Chinese herb medicine].
AB  - To clarify the role of intercellular adhesion molecule-1 (ICAM-1) on pathogenesis
      of autoimmune lupus nephritis in MRL/lpr mice and the effects of Chinese herb
      medicine (stragalin), a computer image analysis system was used to study
      immunodepositions of ICAM-1, immunoglobulins and C3 in renal tissue sections of
      the mice. ICAM-1 was found in the mesangial area and deposited along the
      glomerular capillary walls in MRL/lpr mice. The distribution intensity of ICAM-1,
      immunoglobulins and C3 were significantly decreased after treatment with
      stragalin in form of decoction per os in the mice. We found that ICAM-1 might
      play an important role in pathogenesis of autoimmune lupus nephritis in MRL/lpr
      mice and Chinese herb medicine has some inhibition effects on immunodepositions
      in renal tissue of MRL/lpr mice.

PMID- 7788549
TI  - [Inhibition of growth factor stimulation of mitogen-activated protein kinase by
      prostaglandin E2 in rat renal mesangial cells].
AB  - Activation of the mitogen-activated protein kinase (MAPK) pathway is believed to
      play a critical role in normal and pathophysiologic proliferation of mesangial
      cells. Recent studies have shown that MAP kinase activation by growth factors in
      other cell types involves activation of the low molecular weight G-protein ras
      and the protooncogene serine kinase c-raf-1. In this study the role of this
      pathway in rat renal mesangial cells was assessed. 20ng/ml of platelet-derived
      growth factor (PDGF), 10(-8) mol/L epidermal growth factor (EGF) as well as
      phorbol ester (10(-6) mol/L PMA) rapidly activated MAP kinase by 3-4 fold in
      these cells. PDGF and EGF, but not PMA were able to activate c-raf-1 and ras
      activity. Stimulation with inflammatory mediator PGE2 (50 mumol/L) or elevation
      of Intracellular cAMP by treatment of cells with forskolin (25 mumol/L) markedly
      blunted activation of MAP kinase induced by PDGF and EGF, but not PMA. Consistent
      with this observation, PGE2 abolished growth factor induced activation of c-raf
      1. However, ras activation induced by growth factor was not affected by PGE2 and
      forskolin. These results suggest that MAP kinase activation can occur by at least
      two separate pathways in mesangial cells. Tyrosine kinase receptors activate MAP
      kinase through activation of ras and raf. This pathway can be blocked by PGE2 and
      elevation of cAMP, presumably by interfering with the ability of ras to activate
      raf. In addition, activation of protein kinase C by phorbol esters can activate
      MAP kinase in a ras/raf-independent manner. This pathway is not sensitive to
      inhibition by PGE2 or cAMP. It is likely that activation of each of these
      pathways, both resulting in a stimulated MAP kinase, will have different
      physiologic consequences in mediating mesangial cells growth.

PMID- 7788550
TI  - [Expression and loss of heterozygosity of DCC gene in human lung cancer].
AB  - The level of DCC mRNA expression was evaluated in tissue specimens from lung
      cancer patients by semiquantitative reverse transcription-polymerase chain
      reaction (RT-PCR) combined with Southern blot analysis. Obvious reduction of DCC
      gene expression was observed in 4 of 7 specimens (55%). In two specimens DCC
      transcript could only be detected after Southern blot hybridization of RT-PCR
      product. The average level of DCC expression in cancer tissue was about 45% of
      normal tissue as estimated by laser densitometer. We also studied DNA samples for
      loss of heterozygosity (LOH) at DCC locus at two polymorphic sites. Among the 15
      specimens including 7 samples for RT-PCR, 9 (60%) were informative at either of
      two polymorphic sites. LOH was observed in 5 (55%). Two at the MspI-RFLP
      (restriction fragment length polymorphism) site and 3 at the site of VNTR
      (variable number of tandem repeat). These results suggest that allele loss and
      decreased expression of DCC gene are frequent events and the possible involvement
      of DCC gene in the pathogenesis of human lung cancer.

PMID- 7788552
TI  - [Experimental study on in vivo hematopoietic regulation of interleukin-6 gene
      therapy].
AB  - Interleukin-6 (IL-6), a pleiotropic cytokine, is involved in extensive immune
      regulation and hematopoietic regulation. We observed the effect of fibroblast
      mediated human IL-6 gene therapy on hematopoiesis. The platelet counts started to
      increase at day 4 after implantation of IL-6 highly secreting fibroblast cells
      and peaked at day 10 and lasted at high level for 22 days. The neutrophil counts
      were elevated after their implantation, but WBC did not show any remarkable
      increase. The CFU-GM and CFU-MK in bone marrow and spleen were also increased
      significantly. The results demonstrated that fibroblasts mediated human IL-6 gene
      therapy can significantly augment in vivo hematopoietic functions in bone marrow
      and spleen and elevate the number of nuetrophils and platelets. This study
      provides a new approach to treat thrombopenia and chemotherapy or radiotherapy
      induced hematopoietic suppression.

PMID- 7788551
TI  - [Detection of c-myc translocation in human lung cancer cells by fluorescence in
      situ hybridization (FISH)].
AB  - c-myc gene amplification has been found in lung cancer, however, it can not
      explain all cases of lung cancer with c-myc gene overexpression. Gene
      translocation is one of the ways by which oncogene is activated. But the old
      methods for detecting gene mutations are not so effective for the detection of
      gene translocation, especially in solid tumors. Fluorescence in situ
      hybridization (FISH) can be used to detect gene translocation more efficiently.
      Using FISH, we discovered c-myc gene translocation in a lung adenocarcinoma cell
      line GLC-82 and SV40T-transformed human bronchial epithelial cells. In GLC-82, c
      myc gene translocated to the short arm of a C group marker chromosome. In the
      SV40T-transformed epithelial cells, c-myc gene translocated to 14q32, which was
      the same as that found in Burkitt's lymphomas. Translocation was related to
      oncogene activation. c-myc translocation may play an important role in the
      carcinogenesis of lung cancer.

PMID- 7788553
TI  - [Clinicopathologic characteristics of primary liver cancer in patients younger
      than 35 years].
AB  - To investigate clinicopathologic characteristics of primary liver cancer (PLC) in
      young adults, 77 patients younger than 35 years were compared with 603 patients
      older than 35 years during the same period. In the young patients, PLC showed a
      low incidence of PLC detected at mass survey (young 15.6% versus older 28.7%, P <
      0.05); a low incidence of hepatitis history (young 36.8% versus older 66.3%, P <
      0.01); a high incidence of positive hepatitis B virus surface antigen (HBsAg)
      (young 79.2% versus older 67.6%, P < 0.05); a low incidence of associated
      cirrhosis (young 64.9% versus older 90.7%, P < 0.01); larger tumor size (PLC >
      5cm; young 87.0% versus older 73.0%, P < 0.01); a more advanced stage of the
      disease in TNM classification (stage III; young 29.9% versus older 18.2%, P <
      0.05). It is suggested that hepatitis B virus (HBV) may play an important role in
      the development of PLC without associated liver cirrhosis in the young patients.
      A close periodic surveillance of young adults with a positive HBsAg is important
      to detect PLC at an early stage.

PMID- 7788555
TI  - [Affection of growth of zinc deficiency growing rats].
AB  - Fifty male Sprague-Dawley rats with an average live mass of 42 +/- 4g were
      divided into 5 groups of 10 animals each. An artificial semi-systhesis diet was
      given to the animals. Group 1 received a control diet (32.2 mg Zn/kg DM), and
      group 2 a zinc deficient diet (3.4 mg Zn/kg DM) ad libitum. The animals of group
      3 were pair fed to group 2 with a diet (84.9 mg Zn/KgDM). Diets of group 4 and 5
      contained zinc (4.4 and 5.5 kg Zn/micrograms DM), respectively. The two groups
      also pair fed to group 2. The food intake and live mass gain were observed every
      day. After 26 days of experiment, the animals were decapitated; the blood samples
      were collected for the analysis of serum zinc, zinc binding capacity, and
      alkaline phosphatase.

PMID- 7788554
TI  - [Hemofiltration ameliorating reperfusion injury after complete cerebral ischemia:
      an experimental study].
AB  - The effects of hemofiltration on cerebral resuscitation were studied by using
      resuscitation model of potassemia-induced cardiac arrest and cardiopulmonary
      bypass. Sixteen rabbits were divided into control group (CG) and hemofiltration
      group (HFG). Blood lactic acid, lipid peroxidant (LPO), serum iron, middle
      molecular substance (MMS) were determined. Neurologic deficit score (NDS) system
      was used to evaluate neurologic function. The level of blood lactic acid was
      increased in both CG and HFG. It was higher in CG than in HFG (P > 0.05). Serum
      iron was increased in CG, however, it was decreased in HFG. The difference
      between the two groups was significant (P < 0.01). LPO was increased
      significantly in CG and there was no obvious changes in HFG. MMS was increased
      gradually during reperfusion in CG, whereas it was decreased in HFG. There was
      significant difference in the corresponding times of the two groups. NDS of CG
      was higher than that of HFG (32 +/- 12 vs 18 +/- 10) (P < 0.01). These data
      demonstrate that hemofiltration is able to eliminate ischemic and reperfusional
      toxic products quickly. Additionally, free iron, agonist factor of catalyzing
      free radical reaction, does not increase because free radicals and lactic acid
      are eliminated quickly, inhibiting free radical tissue injury and improving
      cerebral resuscitation.

PMID- 7788556
TI  - [Advance in the research of promotive effects of growth factors on the repair of
      acute kidney tubular injuries].

PMID- 7788558
TI  - Determination of carbonic anhydrase-III by enzyme-immunoassay in liver, muscle
      and serum of male rats with streptozotocin-induced diabetes mellitus.
AB  - Insulin has a plethora of metabolic effects but its action on carbonic anhydrase
      III (CA-III), a key enzyme in acid-base regulation, has been little studied. The
      present studies examined the effects of streptozotocin induced diabetes on the
      concentrations of CA-III. The concentration of CA-III in the liver, muscles and
      serum of rats with experimental diabetes mellitus was measured by the method of
      enzyme-immunoassay. Streptozotocin-induced diabetes mellitus resulted in a
      reduction in concentration of CA-III in the liver and serum, but not in skeletal
      muscles, of adult male rats. A 98% reduction in hepatic CA-III content relative
      to control values was observed. The reduction in CA-III content in the liver was
      restored to control value by administration of insulin. The CA-III content in
      serum of diabetic rats declined to approx. 25% of control values, but the
      reduction was unaffected by administration of insulin. The concentration of CA
      III in the liver and serum of diabetic rats was not influenced by administration
      of methyltestosterone. Although the content of CA-III in m. rectus femoris, m.
      tibialis craniaris and m. soleus differed, no significant difference of CA-III
      content was found between diabetes mellitus and control rats. The effect of
      chronic diabetes mellitus on CA-III content was obviously different between liver
      and muscle, suggesting that the regulation of CA-III biosynthesis differs between
      these two tissues. These results suggest that biosynthesis of CA-III in
      hepatocytes of rats is influenced by irregular patterns of GH secretion brought
      about by diabetes mellitus.

PMID- 7788557
TI  - Absorption spectroscopy of the complexation between superpotent guanidinium
      sweeteners and specific monoclonal antibodies.
AB  - Spectroscopic studies of antibody-antigen interactions can provide useful
      information about the interactive motifs and energetics involved in the
      intermolecular association process. In this study we used absorption spectroscopy
      to examine the interactions between five different monoclonal antibodies (mAb)
      and four superpotent ligand sweeteners. Quantitative changes in the absorption
      spectra in the wavelength range of 230-800 nm were utilized for the determination
      of intrinsic association constants and thermodynamic parameters of the mAb-ligand
      complexes. The intrinsic association constants for the mAb-ligand complexes were
      found to be in the range of 10(7)-10(5) lM-1 and were in agreement with previous
      radioimmunoassay determinations. For two mAb, qualitative changes in the spectra
      in the 340 nm range could be identified and were related to the presence of
      charge-transfer interaction between the guanidinium ligand and aromatic residues
      in the binding site of the mAb. A charge transfer spectra was observed in mAb
      NC10.8 with two different sweetener ligands. The thermodynamic parameters of the
      ligand-mAb interactions were analyzed by van't Hoff plots and in almost all cases
      the reactions were found to be enthalpically driven. The determinations of
      intrinsic affinity and thermodynamic parameters may be useful in computer-aided
      molecular modelling studies of the antibody binding pocket and predicted ligand
      docking orientations. Antibody NC6.8 was found to react with this set of
      sweetener ligands in a rank order that is related to their sweetness potencies
      and the spectroscopic findings for NC6.8 are in agreement with the X-ray
      diffraction data of the Fab-ligand crystal structures.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7788559
TI  - Brain mRNA from infants of aluminium-exposed lactating rabbits.
AB  - The neurotoxicity of aluminium (Al) involves bundling of neurofilaments,
      increased chromatin binding and decreased protein synthesis in Al injected
      rabbits. Thus, using an amphipathic Al ligand, maltol, experiments were carried
      out to examine whether or not administration of Al to lactating mother rabbits
      reduces brain protein synthesis in their offspring. Lactating mother rabbits
      received s.c. injections 3 times weekly of aluminium (Al) maltolate (1 mg Al/kg
      body wt) or an equivalent weight of maltol, for 4 weeks post-partum. Polysome
      preparations were obtained from the brain of their infants in order to assess
      mRNA translation in cell-free protein synthesizing systems. The brain polysomes
      showed a statistically significant reduction in the incorporation of [14C]leucine
      into protein. The poly (A)+ and poly (A)- fractions obtained from these polysomes
      showed reductions of 44% or more in the incorporation of [35S]methionine into
      protein. A variety of products separated by SDS-polyacrylamide gel
      electrophoresis all exhibited decreased labelling. These experiments suggest that
      infant rabbits exposed to a highly neurotoxic form of Al in milk exhibit changes
      in brain protein synthesis which resemble those in infants injected directly with
      Al.

PMID- 7788560
TI  - Expression of stress proteins in cultured HT29 human cell-line; a model for
      studying environmental aggression.
AB  - The current study was undertaken to investigate the expression of stress proteins
      (HSP) in cultured human HT29 cells submitted to stressing events under in vitro
      conditions. Heat shocks (45 degrees C, for 15-60 min) or cold shocks (+ 1 degree
      C for 4 hr) were found to modify cell growth (growth curves) and to enhance HSP
      expression. In most cases, changes in HSP expression are much more pronounced
      than changes in cell growth. Exposure to 8% ethanol for 15 min resulted in both
      growth inhibition and HSP overexpression. Propanol-1 was found to be more toxic
      since 5% concentration given for 15 min stops cell growth. 2.5% propanol-1 for 15
      min induces a slight reduction of cell growth but a clear-cut overexpression of
      stress proteins. We conclude that expression of stress proteins, especially those
      of the HSP68/70 family, constitutes a more sensitive response than changes in
      growth rate in case of external aggression. This could make our model an
      interesting biological sensor to environmental physical or chemical pollutants.

PMID- 7788561
TI  - The purification and properties of glutathione reductase from the cestode
      Moniezia expansa.
AB  - Glutathione reductase has a central role in glutathione metabolism and as such is
      a potential target for chemotherapy. The aim of the work was to purify and
      characterise glutathione reductase from the cestode Moniezia expansa and to
      compare the properties of the helminth enzyme with its mammalian counterpart. The
      enzyme was purified by a combination of anion exchange and affinity
      chromatography and further characterized by chromatofocusing and gel
      electrophoresis. Analysis revealed a single isoenzyme of glutathione reductase in
      Moniezia expansa, with a pI of 5.8. The enzyme was a homodimer of native
      molecular weight 114 kDa, subunit weight 63 kDa. Enzyme activity was affected by
      buffer concentration and the presence of monovalent sodium salts. The pH optimum
      was 7.4 with NADPH as cofactor and 5 with NADH. The Kma for oxidized glutathione
      was 76 microM and for NADPH and NADH, 21 and 350 microM respectively. In addition
      to oxidized glutathione only the mixed disulphide between CoA and glutathione
      (CoASSG) showed any significant activity as substrate. The cestode enzyme was
      inhibited by a variety of compounds including arsonic derivatives, 2,4,6
      trinitrobenzene sulfonate 1,3-bis (2-chlorethyl)-1-nitrosourea and oxidized
      glutathione. In conclusion the glutathione reductase of M. expansa resembles the
      mammalian enzyme in its general physical properties and its substrate and
      inhibitor profile. However, the parasite enzyme shows an unusually high activity
      with the mixed disulphide of coenzyme A and glutathione (CoASSG) and appears to
      be more sensitive to inhibition by sodium ions.

PMID- 7788562
TI  - Effect of dietary fiber at weaning on protein glycosylation in the rat small
      intestine.
AB  - Changes in protein glycosylation which can be modulated by dietary factors are
      observed in the rat intestinal mucosa at the weaning period. Experiments were
      performed to evaluate the involvement of dietary fibers in the regulation of such
      modifications. Groups of rats were abruptly weaned at 19 days of age on semi
      synthetic diets differing in dietary fiber content (fiber-free, 10% pectin or 10%
      cellulose) given for 4 and 10 days. Glycoprotein sugars, activities of the
      fucosylation pathway and caecal contents were analyzed. Neutral sugar contents in
      glycoproteins of the small intestinal mucosa were increased in teh fiber-fed
      groups as compared to fiber-free group, only after 4 days but not after 10 days
      of diet. Diet-induced modifications in the glycoprotein fucose content of the
      small intestinal mucosa are partly explained by the coordinated evolution of
      different activities involved in the fucosylation pathway (GDP-fucose production
      and breakdown, fucosyltransferase and fucosyltransferase inhibitor). Caecal
      contents of short chain fatty acids were significantly different between the
      three groups after 4 but not after 10 days of diet. There was no correlation
      between caecal short chain fatty acid contents and activities involved in the
      fucosylation pathway. The introduction of dietary fibers at weaning induced
      marked but transient changes in glycoprotein sugars and the fucosylation pathway.
      The results demonstrate that fucosylation is regulated in several ways including
      changes in fucosyltransferase activity but that caecal fermentation of dietary
      fibers was not directly responsible for the observed changes.

PMID- 7788563
TI  - Purification and identification of two distinct isoforms of rabbit pancreatic
      cholesterol esterase.
AB  - Cholesterol esterase (CEases; E.C. 3.1.13) has been purified to homogeneity from
      rabbit pancreas. The method of purification consists of homogenization of total
      pancreas, high speed centrifugation, anion exchange column chromatography on S
      Sepharose, size exclusion on Sephacryl followed by affinity chromatography on
      heparin agarose. During the purification procedure, two distinct isoforms of
      CEases have been identified. Both forms are similar in their molecular weights,
      bile salt requirement and pH optima but differ in their sensitivity to heparin.
      Isoform-I is resistant and isoform-II is sensitive to heparin. In the normal
      pancreas of the adult rabbit, the amount of each of the enzymes appears to be in
      equimolar concentrations. Physiological significance of the existence of heparin
      sensitive and resistant forms by the same tissue is unclear. In view of the
      significant role played by heparin in the modulation of CEase activity and
      several other physiological functions, these two isoforms may have different
      mechanisms of action on the hydrolysis of carboxyl esters of cholesterol and
      vitamins.

PMID- 7788564
TI  - Latex allergy.

PMID- 7788565
TI  - Plant allergens on pauci-micronic airborne particles.

PMID- 7788566
TI  - IgE, smoking and lung function.

PMID- 7788567
TI  - Atopic dermatitis--the skin manifestation of atopy.

PMID- 7788568
TI  - Topical levocabastine--an effective alternative to oral antihistamines in
      seasonal allergic rhinoconjunctivitis.

PMID- 7788570
TI  - Seasonal appearance of grass pollen allergen in natural, pauci-micronic aerosol
      of various size fractions. Relationship with airborne grass pollen concentration.
AB  - In a study during the 1993 grass pollen season at Leiden, the relationship
      between atmospheric pollen allergen carried by five size fractions of pauci
      micronic (few microns) particles and the grass pollen count was investigated.
      Sampling was carried out on dry days, and atmospheric pollen allergen in the
      particle fractions was assessed by a RAST-inhibition assay while grass pollen
      quantities were measured with a volumetric pollen trap. It appears that the
      atmospheric presence of grass pollen allergen in all size fractions is restricted
      mainly to the period of presence of grass pollen grains. Before and after the
      grass pollen season atmospheric grass pollen allergen quantities are generally
      very low. It is concluded that a routinely performed grass pollen count is a
      reliable measurement for the estimation of the amount of atmospheric grass pollen
      allergen, also in the pauci-micronic particle fraction.

PMID- 7788569
TI  - The allergen of Ficus benjamina in house dust.
AB  - Ficus benjamina, a member of the Moraceae family, is a tropical, non-flowering
      green plant which is widely used for ornamental purposes. It is an occupational
      allergen in plant keepers but sensitization is also increasingly found in non
      occupationally exposed atopic and non-atopic patients. The allergen of Ficus
      benjamina is located in the plant sap, a so-called latex. By radioallergosorbent
      test-(RAST)-inhibition studies allergen could also be demonstrated in the dust
      collected from the leaf surface and in dust samples from the floor of rooms where
      the plant was placed. These findings could result in more extensive preventive
      measures in patients sensitized to Ficus benjamina. In addition there is some
      evidence that possibly a crossreactivity between latex of Ficus benjamina and
      latex from the rubber tree Hevea brasiliensis, a member of the Euphorbiaceae
      family, may exist.

PMID- 7788571
TI  - House dust mite allergen levels in two cities in Canada: effects of season,
      humidity, city and home characteristics.
AB  - The homes of 120 patients with asthma, 57 in Vancouver and 63 in Winnipeg, were
      studied. The characteristics of the homes were assessed by a questionnaire. Dust
      samples were collected and the indoor relative humidity was measured four times
      during the year covering all four seasons in both cities. Mite allergen levels
      were determined using monoclonal antibodies against Der p I and Der f I by the
      ELISA method. The mean levels of both mite allergens in mattress and floor
      samples in the homes in Vancouver and in Winnipeg were relatively low for all
      seasons. Mite allergen levels were found to be associated with city, season and
      individual home differences. They were significantly higher in Vancouver than in
      Winnipeg. Der p I and Der f I in mattress samples in both cities and Der f I in
      floor samples in Vancouver, varied by season. The indoor relative humidity level
      in the homes in Vancouver were also significantly higher than those in Winnipeg.
      There was, however, no significant association between the levels of indoor
      relative humidity and the levels of mite allergens after adjusting for variations
      in city, season and individual home. Although individual home differences were
      highly associated with mite allergen levels, only a few home characteristics were
      found to be related to mite allergen levels such as the type and the age of the
      home, the type of heating, the use of feather pillows and the number of occupants
      in the homes. Whether low levels of mite allergens are partially responsible for
      the relatively low prevalence of childhood asthma in Canada remains to be
      investigated.

PMID- 7788572
TI  - Differences between specificities of IgE and IgG4 antibodies: studies using
      recombinant chain 1 and chain 2 of the major cat allergen Felis domesticus (Fel
      d) I.
AB  - IgE- and IgG4 antibodies were compared for reactivity with recombinant chain 1
      and chain 2 of the cat allergen Felis domesticus (Fel d) I. Recombinant chain 1
      and chain 2 were coupled to sepharose and tested in IgE- and IgG4
      radioallergosorbent test (RAST) experiments. Substantial IgE- and IgG4 binding
      was found. The fraction of Fel d I-specific antibody that bound to the
      recombinant chains was calculated. For chain 1, the mean value of this fraction
      was 0.30 for IgE and 0.23 for IgG4 (P = 0.05). For chain 2, the mean value of
      this fraction was 0.19 for IgE and 0.13 for IgG4 (P = 0.02). These results
      indicate that differences in fine specificity exist between IgE and IgG4
      antibodies. Moreover, these findings support our results with chemically prepared
      peptides derived from these two chains and suggest that the B cells producing IgE
      antibodies are more likely to recognize a less 'native' form of Fel d I, compared
      with IgG4.

PMID- 7788574
TI  - Immunological study of Melkersson-Rosenthal syndrome. Lack of response to food
      additive challenge.
AB  - A study was made of six patients with Melkersson-Rosenthal syndrome (MRS) to
      establish the aetiological role of foodstuffs and/or additives and the possible
      associated immunological alterations. In all cases Melkersson-Rosenthal syndrome
      (MRS) was diagnosed both clinically and histologically, excluding other causes of
      orofacial granulomatosis (OFG). A detailed study of possible triggering factors
      was performed in all patients. Blood analysis, x-rays and cultures, were always
      within normal limits, with the exception of the finding of circulating immune
      complexes (CICs) in three patients with facial palsy associated, and C-reactive
      protein positivity in two patients who presented persistent labial oedema. All
      patients were subjected to skin-prick tests with common inhalant allergens and
      with foods when sensitization to foods were suspected, and patch tests with
      European Standard Series and pastry components, organic dyes, perfumes and
      fragrances series. The results were negative in all cases. When asymptomatic, the
      patients were subjected to a double-blind oral challenge, under placebo control,
      with additives (monosodium glutamate, tartrazine, sulfites, erythrosine,
      paraoxybenzoate, sodium benzoate, lactose, aspirin, and annate), which was again
      negative. In no case did the patients refer the appearance of outbreaks with
      exposure to foods or contactants, and the course of the disease was unaffected by
      exclusion diets and the elimination of contactants. To conclude, we observed no
      sensitization to foods, additives or contactants in our patients. Likewise, there
      were no antecedents of atopy or hereditary predisposition related to the
      aetiopathogeny of MRS. The significance of the CIC encountered only in patients
      with facial paralysis remains to be established, due to the limited number of
      patients studied.

PMID- 7788573
TI  - HLA-DR expression is induced on keratinocytes in delayed hypersensitivity but not
      in allergen induced late-phase reactions.
AB  - In view of increasing evidence suggesting an active immunoregulatory role of the
      skin keratinocytes and the observation that the differentiation of allergen
      specific T lymphocytes is critical in the development of allergy, we evaluated
      epidermal expression of HLA-DR antigen in skin reactions induced with an atopen
      (house dust mite) and with an non-atopic antigen (Hemocyanin). Two groups of
      patients with house dust mite (Dermatophagoides pteronyssinus [Der p]) allergy
      were compared, one group was skin tested with Der p, the other group was
      immunized and subsequently skin tested with Helix pomatia Hemocyanin (HPH).
      Biopsy specimens taken at 48 h after the HPH (n = 11) and Der p (n = 11) tests
      were analysed immunohistologically. Reactions in both groups were comparable in
      size. Immunohistological analysis showed domination by CD4+ lymphocytes.
      Expression of HLA-DR antigen by epidermal keratinocytes was observed in six out
      of 11 of the HPH induced reactions, but in none of the Der p induced reactions.
      Eosinophils were spotted only throughout the Der p induced reactions, showing a
      good correlation with the number of CD4 positive lymphocytes. The lack of HLA-DR
      expression by keratinocytes during the allergen-induced reaction, compared with
      the Hemocyanin induced reaction can be the result of a difference in cytokine
      profile of the lymphocytes dominating the dermal infiltrate. On the other hand
      evidence exists that defective HLA-DR expression by keratinocytes enhances
      antigen induced lymphocyte activation, and may thus contribute to the development
      of allergen-specific T-lymphocytes.

PMID- 7788576
TI  - [Isolating fetal cells from maternal blood for noninvasive prenatal diagnosis-
      from patent to clinical application].

PMID- 7788575
TI  - Comparative study between European and American species of Polistes using sera
      from European sensitized subjects.
AB  - Although the different vespid species of the genus Polistes are found all over
      the world, studies about allergy sensitization to these species have been made
      mainly in North America. We studied the specific IgE in a large group of sera
      from patients sensitized to Polistes dominulus (PD) and determined the
      crossreactivity with another important European Polistes (P. gallicus [PG]) and
      with five American relevant species of this genus: P. exclamans (PE), P. fuscatus
      (PF), P. metricus (PM), P. annularis (PAN) and P. apachus (PAP). Studies
      indicated that 96.7% of sera with IgE positive to PD were positive to PG. No case
      positive to just PG was found. The comparison of these two European species with
      the American relatives indicated that most cases were positive to all the insects
      although there were significant differences in the radioallergosorbent test
      (RAST) value. These results were confirmed by RAST inhibition studies, and
      indicate that although the European and American species are closely related,
      species specific allergenic differences exist. These data suggest that in vivo
      studies should be carried out in order to determine the sensitivity and
      specificity of the European venoms compared with the American species.

PMID- 7788577
TI  - [Discriminant analytic model for prognostic assessment of pregnancies at risk for
      premature labor].
AB  - We examined 114 women with preterm labor using discriminance analysis to assess
      predictive values in terms of prolongation of gestational age and gestational age
      at the time of delivery. We used parameters like medical history, clinical
      features, infections, Doppler sonography and cardiotocography. Maternal
      temperature, cardiotocographic findings, premature rupture of membranes, number
      of abortions and pregnancy terminations and cervical dilatation at the time of
      admission contribute significantly to predict prolongation of pregnancy (< or =
      as well as > 7 days). Our results from this analysis showed sensitivity and
      specificity of 0.70 and 0.97 and positive and negative predictive values of 0.89
      and 0.91, respectively. We observed significant differences concerning parameters
      like preterm rupture of membranes, cervical dilatation, pathological bacteria in
      the vagina and pathological Doppler values between subsequent preterm and term
      deliveries in pregnancies with a prolongation of > 7 days was. Upon reclassifying
      our results, we obtained sensitivity and specificity of 0.69 and 0.89 and
      positive and negative predictive values of 0.78 and 0.84, respectively. Early
      prognostic assessment of preterm labor can be made with discriminance analysis.
      The results inspire us to perform a prospective examination of the therapy plan
      that we have obtained.

PMID- 7788579
TI  - [Premature labor in HIV infected women. Swiss "HIV and Pregnancy" Study Group].
AB  - In the Swiss Study "HIV and pregnancy" we observed 153 singleton pregnancies of
      HIV-positive women. 23 (15%) of those ended with a premature delivery. For drug
      addicts (n = 100), the incidence of prematurity, 20%, significantly higher than
      in those free of drugs (n = 53) with 5.6%. The most frequent cause of prematurity
      was premature labor or rupture of the membranes (n = 13), followed by maternal
      illness (n = 8) and fetal complications (n = 2). Women with premature delivery
      tended to have lower CD4 cell counts than those with term delivery (29.4% vs
      12.0% with < 200 CD4 cells/microliters). Low CD4 cell counts and drug consumption
      are two independent but cumulative risks for severe infections. 16 of the 153
      women (12 with, 4 without drug consumption) had severe infections during
      pregnancy; in 4 cases (25%), this led to prematurity. The most common infection
      was pneumonia (14/16), further one case of pyelonephritis and one of cerebral
      toxoplasmosis. Two of these 16 infants (12.5%) were HIV-positive. We could not
      confirm a relationship between prematurity and vertical HIV transmission. Of the
      HIV-classified children, 3/18 (16.7%) premature infants and 16/74 (21.6%) term
      infants were infected.

PMID- 7788578
TI  - [Morbidity and mortality of retarded and normal weight premature infants].
AB  - Differences of fetal outcome between appropriate for gestational age (AGA) and
      small for gestational age (SGA) preterm newborns with birth weight below 2500 g
      and gestational age ranging from 27 to 36 weeks have been evaluated. As described
      by Rohrer SGA have been divided into symmetrical retarded and asymmetrical
      retarded newborns using ponderal index. Therefore distribution of ponderal index
      on our local population has been analysed. SGA more often had an Apgar score
      below 6 five minutes post partum (p = 0.01) and their mothers more often
      announced abuse of nicotine during pregnancy. AGA have been on respiratory
      ventilation significantly longer than SGA (p = 0.001) and photo therapy because
      of hyperbilirubinaemia more often had to be performed on AGA (p = 0.02). AGA have
      spent a longer time at the neonatal intensive care unit than SGA (p = 0.0006). No
      differences could be found in mortality between AGA and SGA. Preterms with low
      ponderal index had no different outcome than SGA with normal ponderal index.

PMID- 7788580
TI  - [Rate of prematurity and perinatal mortality in the Yaounde (Cameroon) University
      Gynecologic Clinic 1982-1992> An analysis of 680 cases].
AB  - The authors made an analysis of perinatal mortality on 680 cases of premature
      births recorded between 1982 and 1992 in the CHU maternity, Yaounde (Cameroon).
      During this period, 13,555 births were recorded. The frequency of premature
      births stood at 5%. The most important etiological factors responsible for these
      680 premature cases were depicted as malaria infection and anemia (22.2%),
      premature rupture of the membranes (13%), multiple pregnancies (11.9%),
      preeclampsia (10.2%), antepartnal bleeding (5.7%), and urogenital infections
      (5.0%). The perinatal mortality rate was 16.7% (114 cases). There were 37 cases
      of antepartual foetal deaths (5.4%), 24 cases of intrapartual foetal deaths
      (3.2%) and 31 cases of neonatal deaths (4.5%). Perinatal mortality reduced with
      an increase in the gestation period and the weight of the foetus. The authors
      noted with astonishment that perinatal mortality was twice as high in cases of
      non ruptured membranes (19.5%) when compared to premature ruptures of the
      membrane (10.2%). A plus 30 minutes duration of the expulsion phase was estimated
      to be a factor that increases perinatal mortality. Breech presentation with a
      32.8% perinatal mortality, when compared to cephalic presentation (7.5%),
      portrays an important risk factor in premature births. Perinatal mortality of
      premature babies in cases of spontaneous births is two time higher (16.2%) than
      in cases of caesarean section (7.8%).

PMID- 7788581
TI  - [Results of neonatal hearing screening with transitory evoked otoacoustic
      emissions].
AB  - From 1. 10. 1992-31. 12. 1993 a hearing screening was performed in 994 preterm
      and term babies (765 healthy neonates and 229 neonates with risk factors for
      hearing loss) by means of transient evoked otoacoustic emissions (TEOAE). There
      was a bilateral absent of emissions in 4.3% of the healthy neonates and 11.8% of
      the risk babies. 8 from 32 healthy neonates and 10 from 22 risk babies also had a
      negative test result in the control investigation. 16 of these children showed in
      7 cases a severe hearing impairment in expanded pedaudiological investigations.
      The registration of TEOAE is a recommendable method for a hearing screening in
      neonates.

PMID- 7788582
TI  - [Comparison of surface tension with determination of the L/S ratio in amniotic
      fluid for prediction of fetal lung maturity].
AB  - In 83 specimen of amniotic fluid both a dynamic measurement of the surface
      tension by the Wilhelmy-balance and a determination of the lecithin-sphingomyelin
      ratio were performed in 1987-1992 in order to predict a respiratory-distress
      syndrome (RDS) of the newborn. 7 cases showed divergent results of both methods.
      In comparison with the measurement of surface tension by the Wilhelmy-balance,
      determination of the lecithin/sphingomyelin-ratio showed more false positive
      results (4:1). Both methods provided false negative results in two cases each. In
      two cases both methods showed false positive results, with RDS occurring in spite
      of predicted lung maturity. In our high risk-collective 5 of 83 newborns
      developed a severe RDS. All of them were delivered by caesarean section. A
      secondary deficiency of surfactant as a result of fetal hypoxia or acidosis as
      well as a possible influence of the way of delivery might be responsible for the
      development of RDS. The Wilhelmy-balance, which can be used as a bed-side-method,
      provides similar results in the prediction of fetal lung maturity compared to the
      L/S-ratio.

PMID- 7788584
TI  - Canadian Ophthalmological Society annual meeting and exhibition. Victoria,
      British Columbia, June 24-27, 1995. Abstracts.

PMID- 7788585
TI  - History of nursing in British Columbia captured on tape.

PMID- 7788583
TI  - [Development of a plastic capillary tube for Saling fetal blood analysis.
      Evaluation of pH-metry with standard references].
AB  - In order to avoid mouth suction and danger of glass breakage during collection
      and to avoid mixing of the sample with a piece of wire and an external magnet
      immediately after collection, an unbreakable plastic capillary tube was designed
      with increased heparin coating and surface and reduced diffusion distance. For
      assessing agreement between pH measurements of blood samples obtained with the
      new plastic capillary tube and a commercial glass capillary tube, umbilical blood
      pH-values of 41 births were analyzed simultaneously by both methods. The mean
      difference between paired pH-values, the corresponding 95%-confidence interval
      and the true limits of agreement were calculated. The pH-values obtained with the
      plastic capillary tube are systematically lower, with a mean pH decrease of 0.009
      units, and there is an additional random variation with a standard deviation of
      0.009 pH units. The true limits of agreement: [-0.031, 0.013] represent the
      interval of the worst expected pH difference. The increased heparin availability
      in the plastic capillary tube may be the reason for the systematic pH deviation
      of -0.009 units. However this difference does not seem to be clinically relevant
      and the statistical evaluation shows a sufficiently good agreement between the pH
      measurements.

PMID- 7788586
TI  - The voice of nursing has to be loud and clear.

PMID- 7788587
TI  - Between women: nurses and family caregivers.

PMID- 7788589
TI  - Some reflections on the nurse practitioner movement: potential danger, exciting
      possibilities.

PMID- 7788590
TI  - Nurses' work: balancing personal and professional caregiving careers.
AB  - Forty full-time nurses who were also responsible for providing care to
      individuals in their private lives volunteered for a qualitative study of
      combined caregiving careers. Each respondent kept a diary of caregiving
      activities during two representative 24-hour periods, and was interviewed prior
      to, and after diary-recording. Most nurses experienced high levels of stress
      associated with caregiving in both their professional and private lives. In
      general, they were relatively satisfied with their lives in both spheres, and
      felt a slightly greater sense of control in their work lives than in their home
      lives. Regarding the tensions/conflicts they alluded to, the following themes
      emerged: an ethic of high expectation, feeling torn between two worlds, a sense
      of working in isolation, and working in overdrive. The rewards/benefits included
      remuneration, recognition and self-esteem, opportunities for personal growth, and
      opportunities for family growth.

PMID- 7788588
TI  - Women's paid/unpaid work and health: exploring the social context of everyday
      life.
AB  - Literature from various disciplines was reviewed to obtain a description of the
      working lives of Canadian women. This analysis drew on the work of Smith (1987,
      1990) and other feminist and critical theorist authors who have argued that much
      of women's work remains invisible and undervalued. Patterns of normative thought
      or social ideology may obscure the extent and value of women's contributions. It
      is suggested here that an "ideology of separate spheres" operates in the
      designation of paid activity in the public sphere as work, whereas activities
      pursued in the private sphere of the home are overlooked. It is further argued
      that women's heavy involvement in unpaid activities that support and sustain
      others results in a state of lesser citizenship, and women's own prerequisites of
      health are often compromised. Women's work often takes place outside the formal
      economy, within a "shadow" or subsistence economy (Illich, 1981) which is
      essential for the continued health of others.

PMID- 7788591
TI  - Mothers of children with chronic conditions: supportive and stressful
      interactions with partners and professionals regarding caregiving burdens.
AB  - Ninety mothers appraised the specific sources and types of social support they
      received in relation to specific types of demands of caring for a child with a
      chronic condition. Qualitative data were collected during home interviews with
      the mothers of children with diabetes, spina bifida, or cystic fibrosis.
      Virtually all of the mothers described primary caregiver demands that were
      directly related to the child's condition, such as physical care, health care in
      illness situations, and the child's psychological and social development. Many
      mothers also reported secondary demands related to their own needs, family roles
      and relationships, and the mother's activities outside the home. Mothers
      experienced gaps in the support provided for specific caregiving burdens and
      encountered stressful interactions with their partners and health professionals
      in particular.

PMID- 7788592
TI  - Women's health.

PMID- 7788593
TI  - Leadership: a nursing perspective.
AB  - The Task Force for Collaborative Nursing Education Models was a successful
      collaboration involving female nurse administrators. The nature of leadership in
      the Task Force was studied as part of a larger research project examining the
      process of collaboration that evolved over the 40 months of its existence
      (October 1987-February 1991). A retrospective qualitative case study approach was
      used. Data were collected from an analysis of documents that had been generated
      by the group, and from 36 semi-structured interviews with the 28 Task Force
      members. Findings and conclusions about leadership were validated during a final
      group interview with eight selected members. Findings of this study support the
      following contentions: women lead differently than men, and leadership is a
      collective process rather than a specialized role assumed by a single person who
      influences the work of other group members. Leadership was also found to rotate
      among group members according to the issue being considered and the expertise of
      those present. These findings did not support the positivist theories of
      leadership prevalent in current nursing management text books.

PMID- 7788594
TI  - 30th Meeting of the Canadian Congress of Neurological Sciences. Victoria, British
      Columbia, June 20-24, 1995. Abstracts.

PMID- 7788596
TI  - Necessity is the mother of invention.

PMID- 7788595
TI  - The dysvascular lower limb in blunt trauma: a multidisciplinary challenge.

PMID- 7788597
TI  - Peutz-Jeghers syndrome.

PMID- 7788598
TI  - Radiology for the surgeon. Case 3. Presentation. Meckel's diverticulum.

PMID- 7788599
TI  - The traumatized ischemic lower limb: a search for the optimal treatment.
AB  - OBJECTIVE: To improve the surgical results of closed injuries of the
      femoropopliteal arterial axis. DESIGN: A retrospective study over 20 years.
      SETTING: A university-affiliated hospital. PATIENTS: Fifty-nine patients (95%
      male, mean age 29 years) with 63 blunt injuries to the femoropopliteal arterial
      axis, treated by eight surgeons. INTERVENTIONS: Thrombectomy with saphenous vein
      patch arterioplasty; primary end-to-end anastomosis, saphenous vein interposition
      and saphenous vein bypass. MAIN OUTCOME MEASURES: Death rate, incidence and
      causes of amputation and late outcome of salvaged limbs. RESULTS: The death rate
      was 8.5%, the amputation rate was 25% and the long-term disability of salvaged
      limbs was 80%. Earlier ablation of two infected extremities and of another one
      responsible for acute renal failure would have reduced the death rate to 3% at
      the expense of increasing the amputation rate to 35%. The level of arterial
      disruption, the degree of soft-tissue damage and the ischemia time greatly
      influenced limb survival and long-term disability. The ischemia time is the
      single factor that can be modified by the medical team. If its duration is less
      than 15 hours, the amputation rate decreases. However, the ischemia time should
      be reduced to less than 7 hours to assure limb salvage without sequela.
      CONCLUSIONS: Early diagnosis and priority of the arterial repair over associated
      orthopedic injuries are essential to reduce the ischemia time. Despite successful
      revascularization, early amputation is the only means of saving life in some
      cases.

PMID- 7788600
TI  - Management of the compromised lower extremity.
AB  - Musculoskeletal injury associated with vascular compromise is a limb-threatening
      situation. When these injuries are associated with open fractures, the risk of
      limb loss is increased. In the case of an open fracture of the tibia associated
      with vascular compromise distal to the popliteal artery trifurcation, limb
      salvage is rarely indicated. Attempts at limb salvage in open tibial fractures
      are associated with a high risk of complication, prolonged recovery and poor
      function. Early amputation is more effective than delayed amputation.

PMID- 7788601
TI  - Reconstructive surgery for lower limb salvage.
AB  - The authors review the principles of reconstructive surgery for lower limb
      salvage after severe lower limb trauma to determine factors that have been used
      as decision-making criteria for limb salvage or amputation in severe lower
      extremity injuries and the methods of reconstruction and their outcome. The use
      of scoring systems and their value in acute decision making (primary amputation
      or limb salvage) are described. Soft-tissue reconstructive techniques, with
      emphasis on the use of flaps and the importance of selecting the best technique
      and time for the reconstruction are reviewed. Skeletal reconstructive techniques
      are described, including available options and currently held views on
      indications and use of the best contemporary methods. It is essential for the
      physician to make a good initial decision on the need for primary amputation or
      limb salvage. A multidisciplinary approach is fundamental to successful salvage.

PMID- 7788602
TI  - The history of vascular surgery in Canada.
AB  - The clinical specialty of vascular surgery in Canada began before the Second
      World War with the introduction of heparin into clinical practice by Gordon
      Murray of Toronto. He showed that heparin could prevent thrombosis during the
      repair of blood vessels and was useful in the treatment of spontaneous arterial
      and venous occlusion. The unfavourable war experience with arterial ligation for
      trauma led to an interest in the direct repair of vascular injuries by surgeons
      returning to civilian practice. Embolectomy, first performed in the late 1940s,
      was the other early vascular operation. Aortic surgery initially depended upon
      the use of cadaver homografts, and a number of programs were started in the early
      1950s, only to be abandoned as synthetic grafts became available. Infrainguinal
      bypass grafting with saphenous vein evolved in clinics set up to treat varicose
      veins and varicose ulcers. The first in-situ grafts were done by Paul Cartier of
      Montreal in 1960. By this time, reconstruction for aneurysmal and occlusive
      disease was well established throughout Canada. Specific fellowships in vascular
      surgery were first offered in the 1970s, as clinical units were set up in
      teaching hospitals. Surgeons concentrating on vascular disease founded the
      Canadian Society for Vascular Surgery (CSVS) in 1978 and approached the Royal
      College of Physicians and Surgeons of Canada to establish training requirements
      in their specialty. The first qualifying examination was held in 1983, and by
      1994 certificates of special competence had been awarded to 178 candidates. The
      pioneers in Canadian vascular surgery are acknowledged and their contributions
      summarized.

PMID- 7788603
TI  - Ancrod as prophylaxis or treatment for thromboembolism in patients with multiple
      trauma.
AB  - OBJECTIVE: To report the initial clinical experience with fibrinogen depletion
      using ancrod as prophylaxis and treatment for deep vein thrombosis and pulmonary
      embolism (DVT/PE) in patients with multiple trauma. DESIGN: A series of cases,
      selected because of their extreme risk of DVT/PE or because of the appearance of
      thromboembolic complications despite prophylaxis using conventional methods.
      SETTING: University teaching hospital. PATIENTS: A referred sample comprising 30
      patients with multiple blunt trauma. The mean injury severity score was 30. Most
      cases involved a combination of lower extremity, pelvic and chest injuries.
      INTERVENTIONS: Fibrinogen was slowly depleted over 24 to 36 hours and the
      concentration maintained at 0.2 to 0.5 g/L thereafter. Ancrod was continued
      prophylactically (22 patients) or for established DVT/PE (8 patients) until the
      patients were mobilized or until there was no longer a contraindication to
      heparin, or until treatment with warfarin became practical. MAIN OUTCOME MEASURE:
      Monitoring for DVT by duplex ultrasonography or iodine-125-labelled-fibrinogen
      scanning, whichever could be applied. RESULTS: Twenty patients were treated with
      ancrod for prophylaxis from the outset because it offered theoretic and practical
      benefits over other methods. No patient treated with ancrod for prophylaxis
      suffered a clinically significant DVT/PE. Patients in whom heparin prophylaxis
      failed and who experienced thromboembolic complications were effectively managed
      with ancrod. There were no deaths and no bleeding complications specifically due
      to the therapy. CONCLUSIONS: Slow depletion of fibrinogen with ancrod may provide
      a safe and effective means to prevent DVT/PE in multiple trauma patients or to
      treat DVT/PE when the risk of bleeding from heparin is great. This initial
      experience should be evaluated by a randomized controlled trial.

PMID- 7788604
TI  - Reoperation for cysts of the thyroglossal duct.
AB  - OBJECTIVE: To determine the causes of recurrence of thyroglossal duct cysts
      (TDCs). DESIGN: A case series. SETTING: A university-affiliated children's
      hospital. PATIENTS: Between 1974 and 1990, 121 children were treated for TDCs.
      They ranged in age from 1 month to 18 years. Of these 121 children, 23 had
      recurrent TDC. INTERVENTIONS: Simple aspiration of the cyst, incision and
      drainage, cystectomy without hyoidectomy and the Sistrunk operation. MAIN OUTCOME
      MEASURES: Initial procedures that led to recurrence and procedures that resulted
      in cure. RESULTS: Six children had recurrence of TDCs after simple cystectomy
      without hyoidectomy; all were cured by the Sistrunk operation. Fourteen children
      with infected cysts initially underwent a variety of procedures with recurrence
      and were eventually managed by the Sistrunk operation. TDCs recurred in eight of
      these. Three children without infected cysts had recurrence after the Sistrunk
      operation. Of 34 TDCs infected initially, 40% recurred, whereas of 87 TDCs that
      were not infected initially, only 8% recurred. CONCLUSION: Simple cystectomy
      without hyoidectomy and pre-existing infection are the main causes of recurrence
      of TDCs.

PMID- 7788605
TI  - Routine outpatient laparoscopic cholecystectomy.
AB  - OBJECTIVE: To determine what proportion of patients booked for elective
      cholecystectomy can be treated on an outpatient basis and what criteria will
      predict the need for hospital admission. DESIGN: A prospective analysis. SETTING:
      A 306-bed, nonteaching, acute-care community hospital on the outskirts of a major
      urban centre. PATIENTS: One hundred consecutive patients in private referral
      practice scheduled for outpatient laparoscopic surgery between November 1992 and
      January 1994. INTERVENTION: Laparoscopic cholecystectomy. MAIN OUTCOME MEASURES:
      The proportion of patients who successfully avoided hospital admission, the
      degree of discomfort, complications and the objective criteria that assist in
      predicting the need for initial or eventual hospital admission. RESULTS:
      Outpatient cholecystectomy was successful in 87% of the patients, and patient
      acceptance of the procedure was good. Advanced age, major associated health
      problems, acute cholecystitis and longer operations were the criteria most likely
      to lead to hospital admission, although none of these factors, alone or in
      combination, was a contraindication to outpatient cholecystectomy. CONCLUSIONS:
      Outpatient laparoscopic cholecystectomy can be performed successfully in most
      patients. There are four criteria that increase the likelihood of hospital
      admission after this procedure.

PMID- 7788606
TI  - Modern war surgery: the experience of Bosnia. 1: Deployment.
AB  - In the first of two papers on the experience of a Canadian military surgical team
      in the former Yugoslavia, the authors describe the deployment of the field
      surgical hospital, the medical structure that supported the Canadian battle
      group. The hospital was made up of tent sections erected within an unfinished
      concrete factory building. The hospital comprised a treatment area for sick
      parades and reception, a pharmacy, a resuscitation area for nonambulatory
      casualties, a laboratory, an x-ray section, an operating room and sterilization
      section and a ward. The hospital could be mobilized if necessary. The setup
      proved to be functional for the treatment of injured soldiers. Although long
      delays were expected because of difficulties in transporting the injured, the
      patients reached the hospital in a reasonable time after injury and could be
      treated satisfactorily. During the period of its deployment, this hospital was
      used more than any other Canadian hospital in the United Nations mission. This
      experience allowed the authors to identify deficiencies and to correct them
      quickly.

PMID- 7788607
TI  - Pulsatile buttock mass: report of two cases and a review of the literature.
AB  - The presence of any pulsatile mass suggests an underlying aneurysm. When such
      masses occur in the buttock, the differential diagnosis includes aneurysms
      arising from branches of gluteal vessels or aneurysms developing in a persistent
      sciatic artery (PSA). The investigation and management of two patients with
      pulsatile masses are described. Review of the embryologic aspects of these masses
      and the important literature on the subject led to the conclusions that when a
      pulsatile buttock mass is encountered, an anomalous PSA should be suspected. A
      gluteal artery aneurysm can be treated by ligation or occlusion, but for a
      sciatic artery aneurysm surgical ablation is necessary and distal perfusion must
      be achieved postoperatively.

PMID- 7788608
TI  - Perforation of the small bowel: a case report.
AB  - Nontraumatic perforation of the small bowel is rare. A 71-year-old man presented
      with a perforated jejunum 8 weeks after receiving streptokinase therapy for acute
      myocardial infarction. This was complicated by a bleeding duodenal ulcer, renal
      failure, ischemia of one toe and confusion. Renal biopsy showed cholesterol
      emboli. Examination of the resected specimen of jejunum revealed multiple
      cholesterol emboli but no other disorder. Cholesterol embolization has been
      associated with angiography, vascular surgery and thrombolytic therapy for
      myocardial infarction. Acute renal failure and ischemia of the digits as seen in
      this patient is also a common presentation of cholesterol embolization syndrome.

PMID- 7788609
TI  - Long-term central venous access through the inferior epigastric vein.

PMID- 7788610
TI  - Radiology in surgical journals.

PMID- 7788611
TI  - Pelvic lymphadenectomy: laparoscopy or laparotomy?

PMID- 7788612
TI  - [Atypical depression: evolution toward a specific pharmacologic and efficacious
      treatment?].
AB  - The present article reviews different concepts of atypical depression. Of these,
      major depression associated with panic disorder would have a specific meaning
      according to some pharmacological and prognosis studies. It seems that this type
      of depression is quite frequent and has a significantly worse prognosis than
      major depression alone. Controlled studies comparing the efficacy of tricyclic
      antidepressants to phenelzine concluded in favour of the latter in general. It is
      generally thought that atypical depression would respond better to monoamine
      oxidase inhibitors (MAOI), but it would seem that it is mainly major depression
      associated with panic disorder that could predict this kind of response to
      treatment. Second generation antidepressants have not been studied systematically
      for this purpose even though preliminary reports seem promising.

PMID- 7788613
TI  - Symptoms of post-traumatic stress disorder in 11 police officers.

PMID- 7788614
TI  - RE: The need for research and ethical safeguards in special populations.

PMID- 7788615
TI  - Desipramine plasma levels and treatment response in panic disorder.

PMID- 7788616
TI  - Organic depression associated with flunarizine.

PMID- 7788618
TI  - The mental health of immigrant and refugee children.

PMID- 7788617
TI  - Insula and obsessive-compulsive disorder.

PMID- 7788619
TI  - Learning how to differ: agreement and reliability statistics in psychiatry.
AB  - Whenever two or more raters evaluate a patient or student, it may be necessary to
      determine the degree to which they assign the same label or rating to the
      subject. The major problem in deciding which statistic to use is the plethora of
      different techniques which are available. This paper reviews some of the more
      commonly used techniques, such as Raw Agreement, Cohen's kappa and weighted
      kappa, and shows that, in most circumstances, they can all be replaced by the
      intraclass correlation coefficient (ICC). This paper also shows how the ICC can
      be used in situations where the other statistics cannot be used and how to select
      the best subset of raters.

PMID- 7788620
TI  - Immigrant and refugee children in Canada.
AB  - In view of Canada's commitment to immigration, understanding the sources of
      successful adaptation by immigrant and refugee children is vital. This paper
      reviews the literature on the mental health of migrant children and suggests an
      agenda for future research.

PMID- 7788621
TI  - Alcohol and polysubstance abuse among women.
AB  - A review of the literature in this relatively new field highlights the legitimacy
      of gender-specific research on substance abuse in women. Consistent findings
      compared to men include a higher physical vulnerability to alcohol, a higher risk
      of assortative mating, the reported association of traumatic events with the
      onset of substance abuse, a higher psychiatric comorbidity and a shorter interval
      between first problem and first treatment episode. Intravenous drug use remains
      the major source of growth of HIV infection among women. Family assessment and
      treatment as well as the involvement of female role models are critical to the
      recovery process. Gender-specific services may be recruiting women who might not
      otherwise have sought treatment for their substance abuse. Further investigation
      is required in order to distinguish the relative significance of the genetic
      versus environmental vulnerability of women, the impact of rapidly changing
      social mores on the onset, pattern and course of substance abuse, possible gender
      specific alcohol typologies, the validity of the recall of traumatic events as
      well as the program variables required in reaching out and engaging women on the
      path to recovery.

PMID- 7788622
TI  - Screening for post-partum depression in a community sample.
AB  - OBJECTIVE: This study undertook to estimate the prevalence of post-partum
      depression in the community by means of telephone screening. Demographic
      correlates of post-partum depression were also investigated. METHOD: The sample
      was identified through two community health centres. Over a period of 17 months,
      1559 childbearing women were screened at six weeks post-partum, using the ten
      item Edinburgh Postnatal Depression Scale (EPDS). RESULTS: The prevalence of post
      partum depression was estimated to be 6.2%, using a cut point of 10 on the EPDS,
      and 3.4% using the more stringent cut point of 12. Women who were not working or
      those with lower occupational status, were at greater risk for depression. Recent
      immigrants, particularly those who were not working or who had given birth to a
      second child, were also at higher risk. CONCLUSION: Telephone screening for post
      partum depression is feasible, and can aid in the identification of women at
      risk.

PMID- 7788623
TI  - Behavioural inhibition, attachment and anxiety in children of mothers with
      anxiety disorders.
AB  - OBJECTIVE: This study examined the relationship between behavioural inhibition,
      insecure mother-child attachment and evidence of anxiety in the offspring of
      mothers with anxiety disorders. METHOD: Twenty children aged 18 to 59 months who
      were born to 18 mothers with diagnosed anxiety disorders were examined for
      behavioural inhibition (Kagan's measures) and mother-child attachment (Strange
      Situation Procedure). Child anxiety was assessed using DSM-III-R criteria and the
      Child Behavior Checklist (CBCL). RESULTS: Sixty-five percent of the children were
      behaviourally inhibited. They showed more somatic problems and fewer destructive
      behaviours than those who were not inhibited. Eighty percent of the children were
      insecurely attached. They had higher CBCL internalizing scores than secure
      children and three of them met diagnostic criteria for anxiety disorders.
      CONCLUSION: Though preliminary, this work suggests a need to identify children of
      anxious mothers as being at risk for anxiety, especially in the presence of
      inhibited temperament or attachment difficulties.

PMID- 7788624
TI  - Neuroendocrine assessment of serotonin (5-HT) function in chronic fatigue
      syndrome.
AB  - Prolactin and cortisol responses to dl-fenfluramine challenge were examined in 11
      patients with chronic fatigue syndrome and in 11 healthy controls who were age
      and gender matched. After obtaining two baseline samples, each subject was given
      60 mg of dl-fenfluramine orally and further blood samples were drawn hourly
      during the following five hours in order to measure prolactin and cortisol
      levels. There was no difference in either baseline or fenfluramine-induced
      hormonal responses between patients with chronic fatigue syndrome and controls.
      There was also no correlation between depression scores on HAM-D and hormonal
      responses in patients with chronic fatigue syndrome. The findings of this study
      do not support a role for 5-HT in chronic fatigue syndrome.

PMID- 7788625
TI  - Evidence-based psychiatry.
AB  - OBJECTIVE: To apply the evidence-based medicine paradigm to the domain of
      psychiatric practice and to bring out the consequences for psychiatry of this
      approach in order to foster the emergence of an evidence-based psychiatry.
      METHODS: The basic assumptions of traditional and evidence-based paradigms, as
      delineated by the Evidence-Based Working Group, are used to structure an
      exploration of the evidence-based approach to psychiatry. Theoretical and
      practical issues are considered and an example of evidence-based decision making
      is given. RESULTS: An evidence-based approach to psychiatry is described as one
      that emphasizes the importance of systematic observation and the use of rules of
      evidence in hypothesis testing. It is suggested that psychiatrists using this
      approach will be in a position to provide superior patient care. DISCUSSION: The
      application of scientific method to psychiatric problems is discussed as the
      essence of an evidence-based approach. The common error of "scientism" is
      described. The authors identify advantages and limitations of an evidence-based
      approach to psychiatric practice and advocate a decision-making process that
      balances individualized clinical acumen (phronesis) and information derived from
      empirical study of groups of patients (techne).

PMID- 7788626
TI  - Laser angioplasty of peripheral arteries: an epilogue?
AB  - This review gives a short overview of the results of 15 years of experimental and
      clinical work on laser angioplasty. Experimentally, photothermal and
      photomechanical ablation of plaque could be demonstrated. However, laser
      angioplasty did not cause reduction of platelet adhesion and intimal hyperplasia.
      Clinically, the technique of laser angioplasty was continuously improved until
      the initial recanalization rates and long-term patency rates in femoropopliteal
      artery occlusions were the same as the success rates of percutaneous transluminal
      angioplasty (PTA). This was proven by various randomized studies. Currently,
      laser angioplasty cannot be proposed as a routine procedure because it is an
      expensive technology. However, laser recanalization and debulking of total
      occlusions should be further developed, especially in combination with
      endoluminal graft placement.

PMID- 7788627
TI  - Iatrogenic dissection of the celiac artery and its branches during transcatheter
      arterial embolization for hepatocellular carcinoma: outcome in 40 patients.
AB  - PURPOSE: To study the sequelae of iatrogenic dissection of the celiac axis and
      its branches in a large patient population. METHODS: We analyzed 40 patients with
      hepatocellular carcinoma (HCC) whose celiac artery or its branches were dissected
      during transcatheter arterial embolization (TAE) and underwent follow-up
      angiography within 2 months. RESULTS: The two most common sites of dissection
      were the celiac artery in 13 patients (32.5%) and the proper hepatic artery in 11
      patients (27.5%). Follow-up angiography revealed complete recanalization in 32.5%
      (13/40), irregularity and narrowing of the lumen in 40% (16/40), and complete
      obstruction in 27.5% (11/40). Therefore, 72.5% (29/40) of the dissected arteries
      recanalized. Pseudoaneurysm formation of the dissected artery was observed in
      32.5% (13/40). Subsequent TAE was possible via the dissected arteries in 79%
      (27/34) of patients in this series. CONCLUSION: Iatrogenic dissection of the
      celiac and proximal hepatic arteries heals spontaneously in the majority of
      patients, and in most instances allows subsequent TAE.

PMID- 7788628
TI  - Malignant biliary obstruction treated by Wallstents and Strecker tantalum stents:
      a retrospective review.
AB  - PURPOSE: To evaluate retrospectively the role and the effectiveness of self
      expandable Wallstents and balloon-expandable Strecker stents in patients with
      inoperable malignant obstruction of the biliary tree. METHODS: Fifty patients
      with malignant biliary obstruction were treated from August 1991 to August 1992
      by percutaneous placement of 55 metallic endoprostheses (39 Wallstents, 16
      Strecker stents). All patients were followed by clinical evaluation, laboratory
      data, and ultrasonographic examination until death. RESULTS: Wallstent placement
      was successful in 36 patients without procedure-related complications. One
      partial occlusion after 1 year was resolved by percutaneous balloon dilatation.
      Fourteen patients were treated with 16 Strecker stents. Stenting was unsuccessful
      in four cases; four occlusions (after 6 h, 48 h, 2 and 6 months) were
      encountered. CONCLUSION: Wallstent endoprostheses have good results and long-term
      patency. There were some problems with Strecker stents during the placement and
      there was a higher occlusion rate.

PMID- 7788630
TI  - Analysis of particle size generated during plaque ablation with a flashlamp
      pumped pulsed dye laser.
AB  - PURPOSE: To examine debris size generated during in vitro plaque ablation by
      laser energy and estimate the risk of peripheral embolization following laser
      angioplasty. METHODS: A flashlamp pumped pulsed dye laser of 480-nm wavelength
      was used to ablate calcified arteriosclerotic plaque, fibrous fatty plaque, and
      normal aortic wall on samples of human cadaver aortas. Each tissue sample was
      immersed in saline solution and treated with the same amounts of laser energy
      transmitted by a 320 microns-diameter glass fiber in direct tissue contact. The
      debris generated during plaque ablation was then separated from the supernatant
      and the particles were counted and analyzed for size. RESULTS: Depending on the
      underlying type of tissue and the setting of laser energy, a wide range of
      particles with sizes between 5.3 mm2 and 64 microns 2 was found in samples. The
      largest particles were found after ablation of calcified atherosclerotic plaque,
      whereas fibrous, fatty plaque and normal aortic wall showed smaller particles and
      a lesser amount of debris. CONCLUSION: Our study demonstrates that a considerable
      amount of debris is generated during laser angioplasty at 480 nm and that
      particle size is sufficient to cause potentially symptomatic embolic occlusions
      of mid- and small-sized peripheral arteries.

PMID- 7788629
TI  - Transcatheter arterial embolization as a method of cisplatin-retention
      enhancement on the VX2 tumor uterus transplants.
AB  - PURPOSE: Enhanced cisplatin (Pt) retention using transcatheter arterial
      chemoembolization (TAE) with Gelfoam particles was studied in rabbit uterine
      tumors. METHODS: Ten rabbit uteri were inoculated with 5 x 10(7) cells of VX2
      carcinoma. Three to four weeks later cisplatin, 1 mg/kg, was injected, either
      with (TAE group) or without (IA group) being mixed with small Gelfoam particles,
      into the aortic bifurcation over 5 s. Blood and tissue concentration of cisplatin
      were determined. RESULTS: Slower arterial blood clearance of Pt was observed in
      the TAE group compared with the IA group, whereas the venous blood Pt clearance
      curves were similar for both groups. The uterine tumor Pt concentration at 80 min
      was found to be 2.52-fold higher after TAE compared with IA (p < 0.01). In the
      pelvic metastatic lymph nodes, the Pt concentration was 4.63 times higher after
      TAE than after IA (p < 0.01). CONCLUSION: These data indicate that TAE is an
      effective means of increasing tissue concentration in uterine tumors.

PMID- 7788631
TI  - Persistent iliac endarteritis with pseudoaneurysm formation following balloon
      expandable stent placement.
AB  - We present a patient who developed endarteritis and pseudoaneurysm formation
      complicating iliac artery stent placement. Blood cultures grew Staphylococcus
      aureus. Three weeks after antibiotic treatment, the aortic bifurcation and the
      stents were removed, together with the left common iliac artery pseudoaneurysm.
      As with any other implantable device, septic complications are dreaded and should
      be recognized and treated early. Consideration may be given to the use of
      appropriate prophylactic antibiotics.

PMID- 7788632
TI  - Chronic aortoiliac dissection treated by self-expanding stent placement.
AB  - A 47-year old male patient presented with claudication from a right-sided
      aortoiliac dissection secondary to transfemoral cardiac angiography. Placement of
      two self-expanding stents led to immediate compression of the false channel. The
      patient has been free of symptoms for 18 months.

PMID- 7788633
TI  - Percutaneous hepatic venous reanastomosis in a patient with Budd-Chiari syndrome.
AB  - A 33-year-old woman with Budd-Chiari syndrome for 9 years presented with
      worsening right upper quadrant pain and progressive liver dysfunction. Hepatic
      venography demonstrated hepatic vein occlusions, without significant IVC
      obstruction. Attempts at stenting a stenotic middle hepatic vein were
      unsuccessful. Transjugular access, however, allowed puncture from the stump of
      the right hepatic vein into the engorged right intrahepatic vein that had been
      demonstrated by retrograde hepatic venography. Two Palmaz stents were used to
      form the veno-venous reanastomosis. Initial success was documented
      angiographically and by pressure measurements before and after shunting. Followup
      at 7 and 16 months confirmed patency of the anastomosis without intimal
      hyperplasia. The patient noted near-complete resolution of her pain, and her
      liver function stabilized.

PMID- 7788634
TI  - A new use of the Simpson percutaneous atherectomy catheter: resection of retained
      valve cusps of an in-situ vein graft.
AB  - An in-situ saphenous vein graft occluded because of retained valve cusps. After
      aspiration thrombectomy, percutaneous transluminal balloon angioplasty was
      performed, but reocclusion occurred 11 months later. Following a second
      aspiration thrombectomy, the restenosed retained cusps were resected using the
      Simpson percutaneous atherectomy catheter. The graft remained patent until the
      patient's death from unrelated causes 6 months later.

PMID- 7788635
TI  - Wallstent misplacement into the paraumbilical vein during TIPS from the left
      hepatic vein: correction by placing a second stent through the mesh of the first
      stent.
AB  - During a TIPS procedure using the left hepatic vein approach, a Wallstent was
      misplaced into a dilated paraumbilical vein instead of the left portal vein. The
      correct shunt direction from the left portal vein to the left hepatic vein was
      restored by coaxially inserting a second Wallstent through the stretched mesh of
      the misplaced stent. To prevent such stent misplacement, it seems useful to
      emphasize the importance of maintaining the exchange guidewire within the distal
      portion of the splenic or mesenteric vein throughout dilatation and stenting of
      the liver parenchyma.

PMID- 7788636
TI  - Embolization of a ruptured middle colic artery aneurysm.
AB  - Middle colic artery aneurysms are very uncommon. A few cases of occlusion of
      superior mesenteric artery aneurysms without bowel ischemia are reported. We
      describe successful uncomplicated embolization of a ruptured middle colic artery
      aneurysm with a Gelfoam plug.

PMID- 7788637
TI  - Percutaneous retrieval of a surgical laparotomy sponge from the peritoneal
      cavity.
AB  - Percutaneous retrieval of an extravascular foreign body is an uncommon procedure.
      This report describes the successful retrieval of a 46 x 46-cm laparotomy sponge
      from the peritoneal cavity using a Nitinol Gooseneck Snare system. This technique
      can eliminate the need for exploratory surgery and may be particularly useful in
      poor operative candidates.

PMID- 7788638
TI  - Use of a cutting balloon for dilatation of a resistant venous stenosis of a
      hemodialysis fistula.
AB  - In a 71-year-old patient with a Brescia-Cimino hemodialysis fistula, high
      pressure balloon dilatation failed to open the stenosis completely and a constant
      waist of the balloon was found. The use of a 3.5-mm coronary cutting balloon
      (Barath balloon) was helpful in preparing the stenosis for subsequent successful
      dilatation.

PMID- 7788639
TI  - Hemiazygos continuation of a left inferior vena cava draining into the right
      atrium via persistent left superior vena cava: demonstration by helical computed
      tomography.
AB  - We report an unusual case of hemiazygos continuation of a left inferior vena cava
      draining into the right atrium via the persistent superior vena cava. Spiral
      computed tomography (CT) showed the course and the flow direction of this vena
      caval anomaly in a real-time manner, obviating conventional venography.

PMID- 7788640
TI  - Effect of ionophores on the processing of the beta-amyloid precursor protein in
      different cell lines.
AB  - 1. Alzheimer's disease is characterized by the deposition in the brain of
      extracellular amyloid plaques and vascular deposits consisting mostly of amyloid
      beta-peptide (A beta). A beta, a polypeptide of 39-43 amino acids (M(r),
      approximately 4 kDa), is derived proteolytically from a family of proteins of 695
      770 amino acids (M(r), approximately 110-140 kDa) called beta-amyloid precursor
      protein (beta APP). 2. beta APP, an integral membrane glycoprotein, is
      extensively posttranslationally modified within the endoplasmic reticulum (ER)
      and various Golgi compartments. beta APP is cleaved by proteases in either the
      trans-Golgi network or the post-Golgi apparatus and then secreted as a truncated
      soluble form into the conditioned media of cultured cells and cerebrospinal fluid
      samples from human subjects. beta APP can be processed either by an
      antiamyloidogenic secretory pathway or by an endosomal/lysosomal pathway. 3. I
      studied the effect of two ionophores on the processing of beta APP in cultured
      cells. Monensin and, in some cases, ammonium chloride increase the intracellular
      accumulation of beta APP in several cell lines and may alter its processing.
      Monensin, which had the most consistent effects, also inhibited secretion of beta
      APP in a differentiated (growth factor mediated) cell line. Nigericin, with
      greater K+ selectivity, was less able to alter the accumulation and possible
      processing of the protein. 4. These results suggest that the increase in the
      accumulation of intracellular beta APP observed after treating cells with
      ionophores has some specificity. The selective effect of these ionophores on the
      metabolism of beta APP may provide a model system to analyze the pathways for
      studying maturation, secretion, and degradation of beta APP.

PMID- 7788641
TI  - Concomitant protein phosphorylation and endogenous acetylcholine release induced
      by nicotine: dependency on neuronal nicotinic receptors and desensitization.
AB  - 1. Nicotine stimulated two Ca(2+)-dependent processes in rat frontal cortex
      synaptosomes: the phosphorylation of an 80-kDa protein band and the release of
      endogenous ACh.3 Both effects were mediated by neuronal nAChRs and coincided with
      depolarization of the synaptosomal plasma membrane induced by the drug. Changes
      in the state of phosphorylation of the 80-kDa band (presumed to contain synapsin
      I) were correlated with changes in the release of ACh as follows, from 2 to 4. 2.
      Blockade of predominant, nerve terminal P-type Ca2+ channels with omega-agatoxin
      IVA, did not prevent nicotine from stimulating ACh release. In contrast, exposure
      to the toxin partially inhibited the release promoted by the depolarizing agent
      veratridine and attenuated protein phosphorylation induced by either nicotine or
      veratridine. Taken together, these data suggest that, upon nicotine stimulation.
      Ca2+ enters nerve terminals through two distinct pathways. The first, via Ca2+
      channels, is necessary (but not sufficient) for both nicotine-induced
      phosphorylation and ACh release. The second, both necessary and sufficient for
      nicotine-induced phosphorylation and release, is the neuronal nAChR itself. 3.
      Preincubation of the synaptosomes with a subeffective concentration of nicotine
      inactivated both nicotine-induced ACh liberation and phosphorylation. This shows
      that diminished release is associated to decreased phosphorylation of the 80-kDa
      protein band, most likely as a consequence of nicotine-promoted nAChR
      desensitization. 4. Augmented ACh release and phosphorylation of the 80-kDa
      protein band were achieved by using the protein phosphatase inhibitor okadaic
      acid. However, okadaic acid did not summate with either nicotine or veratridine
      to increase ACh release further. This is probably because okadaic acid, as in
      other neurons, increases intracellular Ca2+ (Cholewinski et al., 1993), thus
      promoting desensitization of ACh release.

PMID- 7788642
TI  - Selective postmortem degradation of inducible heat shock protein 70 (hsp70) mRNAs
      in rat brain.
AB  - 1. Altered mRNA levels in postmortem brain tissue from persons with Alzheimer's
      disease (AD) or other neurological diseases are usually presumed to be
      characteristic of the disease state, even though both agonal state (the
      physiological state immediately premortem) and postmortem interval (PMI) (the
      time between death and harvesting the tissue) have the potential to affect levels
      of mRNAs measured in postmortem tissue. Although the possible effect of
      postmortem interval on mRNA levels has been more carefully evaluated than that of
      agonal state, many studies assume that all mRNAs have similar rates of
      degradation postmortem. 2. To determine the postmortem stability of inducible
      heat shock protein 70 (hsp70) mRNAs, themselves unstable in vivo at normal body
      temperature, rats were heat shocked in order to induce synthesis of the hsp70
      mRNAs. hsp70 mRNA levels in cerebellum and cortex were then compared to those of
      their heat shock cognate 70 (hsc70) mRNAs, as well as to levels of 18S rRNAs, at
      0 and at 24 hr postmortem. 3. Quantiation of northern blots after hybridization
      with an hsp70 mRNA-specific oligo probe indicated a massive loss of hsp70 mRNA
      signal in RNAs isolated from 24-hr postmortem brains; quantitation by slot-blot
      hybridization was 5- to 15-fold more efficient. Even using the latter technique,
      hsp70 mRNA levels were reduced by 59% in 24-hr-postmortem cerebellum and by 78%
      in cortex compared to mRNA levels in the same region of 0-hr-postmortem brain.
      There was little reduction postmortem in levels of the hsp70 mRNAs or of 18S
      rRNAs in either brain region. 4. In situ hybridization analysis indicated that
      hsp70 mRNAs were less abundant in all major classes of cerebellar cells after 24
      hr postmortem and mRNAs had degraded severalfold more rapidly in neurons than in
      glia. There was no corresponding loss of intracellular 18S rRNA in any cell type.
      5. We conclude from these results that the effect of postmortem interval on mRNA
      degradation must be carefully evaluated when analyzing levels of inducible hsp70
      mRNAs, and perhaps other short-lived mRNAs, in human brain.

PMID- 7788644
TI  - Midazolam and the N-methyl-D-aspartate (NMDA) receptor antagonist 2-amino-7
      phosphonoheptanoic acid (AP-7) attenuate stress-induced expression of c-fos mRNA
      in the dentate gyrus.
AB  - 1. The effects of restraint stress on c-fos mRNA expression in the dentate gyrus
      were investigated by in situ hybridization. 2. Confirming previous findings, c
      fos mRNA expression increased after 30 min of forced restraint. 3. This effect
      was attenuated by a previous i.c.v. injection of the anxiolytic benzodiazepine
      midazolam (20 nmol/2 microliters) or the N-methyl-D-aspartate (NMDA) receptor
      antagonist 2-amino-7-phosphonoheptanoic acid (AP-7; 5 nmol/2 microliters). 4.
      These results suggest that the dentate gyrus is activated during restraint stress
      and that this activation may be modulated by benzodiazepine gamma-aminobutyric
      acidA (GABAA) or NMDA receptors.

PMID- 7788643
TI  - Heterogeneity and differential expression of the gamma-aminobutyric acidA
      (GABAA)/benzodiazepine receptor in the avian brain during development.
AB  - 1. The changes in the GABAA/benzodiazepine receptor in chicken brain during
      development has been studied by using 3H-flunitrazepam as the probe for the
      benzodiazepine modulator site and the antibodies recognizing the receptor
      protein. In the telencephalon and optic tectum, the proteins of 48, 50, and 51 kD
      were markedly labeled by 3H-flunitrazepam from embryonic day 18 to postnatal
      days, as revealed by photoaffinity labeling and SDS-PAGE of the brain membranes;
      the 51-kD protein appeared to be the predominant one in labeling intensity except
      at embryonic day 18 and postnatal days 14 and 28, whereas the 47- and 50-kD
      proteins were dominant in the cerebellum. However, the 47- and 48-kD proteins
      were faintly seen after postnatal day 28 in the three regions examined. 2.
      Immunoblotting using a monoclonal antibody against the 50- and 51-kD proteins
      showed that the straining pattern in the developing telecephalon or optic tectum
      was similar to the 50 kD/51 kD pattern obtained from fluorography. The antibody
      also stained the 50- and 51-kD proteins in the cerebellum despite the fact that
      the 51-kD protein was barely seen in the fluorogram. Moreover, the 50-kD protein
      was recognized by an antiserum raised against a partial sequence of the alpha 1
      subunit of the receptor expressed in bacteria. The staining levels for the 50-kd
      protein by the antiserum on immunoblots of the brain regions were low in
      embryonic animals but higher during postnatal stages, consistent with that seen
      in fluorograms. 3. Receptor binding autoradiography using 3H-flunitrazepam
      exhibited that varying degrees of labeling intensity occurred among various brain
      areas at different ages. High densities of binding were present in the olfactory
      bulb, paleostriatum, optic tectum, and midbrain. These results support the
      diversity of the GABAA/benzodiazepine receptor in the vertebrate CNS.

PMID- 7788646
TI  - [Free radicals in the pathogenesis of selected diseases].
AB  - Free radicals are chemical substances which contain one or more unpaired
      electrons, which is the cause of their high reactivity with a series of
      biologically important substances such as fatty acids, DNA, RNA, amino acids. The
      source of radicals are immunological reactions and reactions in the endoplasmatic
      reticulum during detoxication of xenobiotics. Free radicals can act on the
      organism by a number of reactions, the most frequent on being lipid peroxidation
      when important toxic products are formed such as 4-hydroxy 2,3 trans-nonenal (4
      HNE) and malondialdehyde. Direct assessment of free radicals due to their short
      life span is difficult in clinical practice. The majority of measurements is
      based on the assessment of substances which are formed by the reaction of free
      radicals in the organism. The most frequent method is assessment by means of
      thiobarbituric acid. Oxidative stress (the reaction produced by the action of
      free radicals) of tissues and cells is caused by the increased formation of free
      radicals and/or reduced capacity of antioxidant systems. Free radicals are
      involved in the process of ageing, cancerogenesis, inflammatory and degenerative
      diseases, atherogenesis, and play a part in the ischaemic and toxic damage of the
      organism. During evolution antioxidant defence mechanisms developed which under
      physiological conditions are sufficient to inactivate free radicals. Antioxidant
      systems can be divided into two groups--antioxidant enzymes (superoxide
      dismutase, glutathione peroxidase, catalase etc) and antioxidant substrates
      (tocopherols, carotenoids, ascorbic acid, glutathione, transferrin, ceruloplasmin
      etc).

PMID- 7788647
TI  - [The role of central catecholamines and dopaminergic receptors in the development
      of estrogen-induced adenohypophyseal hypertrophy].
AB  - Estrogens and thyroid hormones contribute importantly to cell proliferation and
      tumor transformation in the pituitary gland. The purpose of the present article
      is provide review about neurotransmitters, chemicals, and receptors that are
      involved in estrogen-induced anterior pituitary growth. Central dopaminergic and
      noradrenergic systems are thought to be the most important systems in regulation
      of pituitary growth and function. For this purpose authors discuss some of their
      past and present data suggesting that estrogen-induced anterior pituitary
      pituitary growth is associated with decreased synthesis and metabolism of central
      catecholamines and increased adenohypophyseal dopamine 2 receptors. Treatment
      with thyroid hormones prevents both estrogen-induced catecholaminergic inhibition
      and dopamine D2 receptor increment in the anterior pituitary gland. Further
      studies focusing on central catecholaminergic systems, pituitary receptor
      equipment and mechanisms of intracellular signal transduction will be of value to
      better understand pituitary tumor formation and possibly to find new approaches
      toward treating patients with these tumors.

PMID- 7788645
TI  - Developmental changes in the brain-stem serotonergic nuclei of teleost fish and
      neural plasticity.
AB  - 1. During early ontogeny, the serotonergic neurons in the brain stem of the three
      spined stickleback shows a temporal and spatial developmental pattern that
      closely resembles that of amniotes. 2. However, in the adult fish, only the
      midline nuclei of the rostral group (dorsal and median raphe nuclei) and the
      dorsal lateral tegmental nucleus are consistently serotonin-immunoreactive (5
      HTir), whereas the groups of the upper and lower rhombencephalon (raphe pontis,
      raphe magnus, and raphe pallidus/obscurus nuclei) are variable and, when present,
      contain relatively small numbers of 5-HTir neurons. 3. Using specific antisera
      against tryptophan 5-hydroxylase and aromatic L-amino acid decarboxylase, we have
      shown that the lateral B9 group and the groups of the upper and lower
      rhombencephalon are consistently present in adult sticklebacks. The results are
      discussed in relation to other known instances of neurotransmitter plasticity or
      transient neurotransmitter expression in teleost fish. 4. While there are several
      instances of transient expression of neurotransmitter markers by discrete
      neuronal populations, there is so far no evidence of changes from one
      neurotransmitter phenotype to another in the brain of teleost fish. However,
      there are indications of plasticity of expression of catecholamines and
      indoleamines, and their respective synthesizing enzymes, as reflected in age
      dependent changes and variation between individuals of different physiological
      status. 5. As the brain grows continuously in teleost fish, and new neurons are
      added from proliferative regions, synaptic connections may be expected to undergo
      remodeling in all brain regions throughout life. Thus, the teleostean brain may
      be considered a suitable model for experimental studies of different aspects of
      neural plasticity.

PMID- 7788648
TI  - [DNA cytometry analysis in childhood tumors].
AB  - BACKGROUND: DNA contents in cells may be determined by flow cytometry. The
      relationship between malignant cell aneuploidy and prognosis is known in many
      types of neoplasms in adults and in children. In some situations, demonstration
      of an aneuploid clone verifies presence of malignant cells. Aneuploidy is rare in
      benign diseases. This report summarizes our first experiences with cytometric DNA
      analysis and shows the method's abilities to other potential users. METHODS AND
      RESULTS: We investigated DNA contents in blood and bone marrow (BM) specimens of
      25 children with leukemia, in 41 unfixed solid tumors after biopsy and in 24
      specimens of paraffin embedded neuroblastoma tissue. We also investigated 5
      specimens of cerebrospinal fluid (CSF) of patients with medulloblastoma, 18
      specimens of CSF from patients with leukemia or lymphoma, 4 pleural exudates
      suspected from malignancies, and 45 specimens of possibly infiltrated BM from
      primary solid tumors. As the purpose of this study was to test the method on a
      relatively small number of specimens, we did not perform statistical analysis of
      our data. As reported previously, aneuploidy was frequent in CALLA + acute
      lymphoblastic leukemia and in types of neuroblastoma with favorable prognosis
      (lower clinical stages and less than 2 years of age). CONCLUSIONS: Our results
      show that DNA ploidy may be tested by flow cytometry in an easy and fast way. The
      source of the material may be unfixed tumors, deparaffinized tumors, BM, blood,
      CSF and pleural exudates.

PMID- 7788649
TI  - [Decrease in common carotid artery intimal thickness after hypolipemic therapy].
AB  - BACKGROUND: In recent years evidence was provided that it is possible to assess
      sonographically the thickness of the intima of the common carotid artery, whereby
      an increase of the thickness of the intima is considered an early stage of
      atherosclerosis. In the submitted work the authors tried to assess whether it is
      possible to influence the thickness of the intima by therapy. METHOD AND RESULTS:
      In 32 patients with familial hyperlipoproteinaemia sonographic control
      examinations of the common carotid artery were performed after 27 months of
      comprehensive treatment. In 21 subjects with familial hypercholesterolaemia the
      thickness of the intima decreased from 0.83 mm to 0.68 mm (p < 0.01), in 8
      subjects with familial combined hyperlipoproteinaemia from 0.77 mm to 0.74 mm (a
      decline was recorded in half the subjects). In the whole group the greatest
      decrease was recorded in subjects treated with statins and a smaller decrease in
      those treated with fibrates. CONCLUSIONS: The authors assume that the decrease of
      the thickness of the intima of the common carotid artery recorded in
      hyperlipoproteinaemic patients after hypolipidaemic treatment is a manifestation
      of regression of atherosclerosis.

PMID- 7788650
TI  - [Simvastatin in the treatment of familial hypercholesterolemia].
AB  - BACKGROUND: The association between hypercholesterolemia and premature
      atherosclerosis is almost universally accepted. Treatment of
      hyperlipoproteinemias represents a reasonable approach in preventive cardiology.
      The aim of the study was to prove a hypolipidemic effect of simvastatin, Zocor
      tablets a 10 mg, produced by MSD, U:S.A. in patients with familial
      hypercholesterolemia. METHODS AND RESULTS: 29 familial hypercholesterolemia
      heterozygotes have been treated with increasing dose of simvastatin (10 and 20
      mg/day with the evening meal) for three months. All patients have been on AHA
      step I diet. The basic parameters of lipid and lipoprotein metabolism have been
      measured, as well the concentrations of apolipoproteins A-I and B, and the level
      of lipoprotein(a). Concentration of total cholesterol decreased after treatment
      with 10 and 20 mg of simvastatin by 20%, resp. 26%. The hypolipidemic effect was
      even more pronounced in LDL-cholesterol level, which was reduced by 24%
      respectively 34%. On the other hand therapy with simvastatin did not influence
      HDL-cholesterol at all. Also triglycerides concentration did not changed very
      significantly after administration of simvastatin (triglycerides levels were
      reduced by 7% respectively by 18%). Decline of LDL-cholesterol has been
      accompanied by decrease of apolipoprotein B concentration by 24%, resp. 26%. The
      concentration of lipoprotein (a) has not been statistically significantly
      influenced, even its level increased slightly. The body weight of the patients
      did not changed during the study. Simvastatin treatment has been well tolerated
      by the patients. CONCLUSIONS: Simvastatin, Zocor, seems to be powerful
      hypolipidemic drug, which is to be used even in the treatment of familial
      hypercholesterolemia heterozygotes, who are usually very resistant to the
      therapy. The dose of 10 mg of simvastatin is usually sufficient to influence
      plasma lipids and lipoproteins. A double dose intensifies the hypolipidemic
      effect but this additional effect is not so expressive. Zocor is tolerated well
      by the patients and in safety laboratory we did not notice any important
      undesirable result.

PMID- 7788651
TI  - [The human genome--chromosome 10 and the collagen genes].
AB  - In relation to locuses of the 10th chromosome at present the following are in the
      focus of interest: tumours of endocrine glands, medullary carcinoma of the
      thyroid gland (MTC) and multiple endocrine neoplasias (MEN). It seems that the
      unifying basis is the oncogene RET, responsible for the development of
      Hirschsprung's disease HSCR. The authors mentions also metabolically important
      locuses for choline acetyltransferase (CHAT), uriporphyrinogen synthase (UROS)
      and methyl guanine methyltransferase (MGMT). A special paragraph is devoted to a
      list of collagenous genes COL1-COL18 and diseases associated with them.

PMID- 7788652
TI  - [Introductory remarks on the problem of the battered, abused and neglected child
      syndrome].

PMID- 7788654
TI  - [Aspects of genealogy of the use of force on children].
AB  - The quality of the parent-child relationship and the contents of the concept of
      childhood cannot be separated from the general social situation. The
      understanding of the child world and its perception of as equivalent to the world
      of adults is associated as an integral part with humanization and spiritual
      advances of civilization and depends on the economic standard of society and our
      ability to understand the spiritual heritage of our civilization. There exists
      still a deeply rooted mechanism where many families under conditions of stress
      (social, economic etc.) ventilate their tension and aggressiveness on the child.
      Battering and abuse of children (except for pathological personality of the
      parent) is an atavistic remnant of the perception of childhood as a period of
      incompetence of the individual. The basic manifestations shifted, however, from
      the transparent and socially tolerated victim of the child to the present--latent
      and hidden refined "victim" which tortures the child in particular from the
      mental and emotional aspect. Today we no longer sacrifice the child but much more
      frequently his childhood. Because of his physical weakness and mental lability
      even today children are still considered a suitable object for ventilating
      aggression, temptation to abuse power. In addition to refuting any abuse,
      battering and neglect of children it must be admitted that this "socially
      unacceptable behaviour" is encountered less than formerly. An important role is
      also played by the economic and cultural standard of society. Similarly as
      certain economic prerequisites are necessary for democracy, economic conditions
      play an important part in an emancipated concept of childhood and empathic
      upbringing.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788653
TI  - [The battered, abused and neglected child and the Crisis Center for Children].
AB  - The syndrome of the battered, abused and neglected child is becoming manifest
      also in our country with increasing frequency and severity, not only because much
      more attention is paid to it than ever before. Our system of child care and
      protection is, however, by far not yet ready to resolve this serious problem in
      the life of children, families and society as a whole and therefore ways and
      means must be sought how to face it, how to recognize it, treat it and in
      particular how to prevent it. One of the important means how to tackle this
      dangerous social phenomenon is a specialized department concerned in a
      comprehensive way on an interdisciplinary basis, with skilled and effective
      clinical work with every single abused child and its family in close association
      with all disciplines and institutions interested in the problem as well as by
      conceptual work, research, training and expert opinions etc. The crisis centre
      for children in Prague 4-Michle wants to serve with its experience and findings
      as a model workplace for building special institutions within the framework of a
      rational, interdisciplinary network of child care and protection in this country.
      The results of its two-year work and the great interest in it on the part of many
      localities and regions justify its efforts.

PMID- 7788655
TI  - [Prevention of child abuse].
AB  - The concept of "child abuse" comprises as a rule physical damage, neglect of the
      child and sexual abuse of the child. Prevention in the widest sense of the word
      comprises all three negative social phenomena-in the narrower sense of the word
      it has for every phenomenon its specific goals, procedures and means. Greatest
      attention must be paid to primary prevention. The latter has several layers,
      above all purposeful enlightenment of the public and extensive measures for the
      benefit of families with children, secondly training and education of primary
      educators of the child, and thirdly detection of so-called risk groups of the
      population. From the aspect of prevention we have to take into account the
      potential risk on the part of the children as well as risk situations in life
      encountered by children and adults.

PMID- 7788656
TI  - [Diagnosis and therapy of child sexual abuse].
AB  - In the crisis centre for children cases of force used on children cumulate, incl.
      sexually abused children. The interdisciplinary team of the centre is faced with
      the task to diagnose and treat this phenomenon and with the protection of the
      child from possible further damage (secondary victimization). In the submitted
      paper the author analyzes the period from October 1992 to the middle of September
      1994, using uniform indicators. Special attention is devoted to psychic and
      somatic symptoms of the sexually abused child.

PMID- 7788657
TI  - [Causes of death in fatal cases of child abuse 1964-1988].
AB  - BACKGROUND: Abuse and/or neglect of children can lead not only to serious health
      damage but in extreme cases to death. A lethal outcome in the abused child is an
      incomplete group of seriously damaged children; it, however, makes possible not
      only numerical comparison but also assessment of trends. The objective of the
      present work was an analysis of deaths of children who died in conjunction with
      the use of force in the family. METHODS AND RESULTS: The author analyzed a group
      of 75 children, 47 boys (63%) and 28 girls (37%) aged less than five years: it
      covers the period of 25 years (1964-1988) and administrative area of the capital
      of Prague and former Central Bohemian region with a total number of 2 million
      population. Newborn babies killed by the mother during delivery or immediately
      after delivery (63 subjects) were not included in the group. According to
      analysis by age the following number of deaths was recorded in different groups:
      0-1 year 45 deaths (60%), 1-2 years 13, 2-3 years 11, 3-4 years similarly as 4-5
      years 3 deaths each. The ratio of boys:girls was 47:28. The most frequent cause
      of death were head injuries (31-41%), followed by suffocation 15x, injury of
      abdominal organs 6x, intoxications (4x, incl. 3x carbon monoxide), multiple
      injuries 4x, injuries of thoracic organis 3x, starvation 2x, hypothermia 2x,
      thermal damage 1x. The findings on necropsy are not useful only for assessing the
      cause of death, the mechanism of damage and the time when the damage was
      inflicted but the spectrum of types of damage can help clinical and social
      workers in the prevention of the battered child syndrome. CONCLUSIONS: Child
      abuse and neglect in families can lead not only to serious health damage but it
      can be also fatal. In an area with a population of 2 millions in the course of
      1964-1988 75 deaths of children aged less than five years were recorded (ratio:
      2.5:1 million per year). Mechanical injuries predominate (89%) in particular head
      injuries (41%).

PMID- 7788658
TI  - [2 years' activity of the Crisis Center for Children in the care of battered,
      abused and neglected children].
AB  - The crisis centre for children in Prague 4-Michle was established as the first
      workplace to resolve problems of battered, abused and neglected children. Its
      main task is clinical work with thus suffering children, based above all on a
      comprehensive, interdisciplinary approach in diagnosis, therapy and
      rehabilitation and also prevention of this adverse phenomenon in the population.
      In the course of two years 502 cases were dealt with (on average with 3-4
      clients) during 2814 consultations. Most frequently physical and mental abuse was
      encountered (40%), gross neglect in 17.5% and sexual abuse (in 10%-with a marked
      relative increase between the first and second year of the activities of the
      centre). Other problems of child suffering for various reasons (psychiatric or
      other diseases of the parents, handicapped child, child running away from family
      etc.) in 32.5%. In addition to clinical work the centre tries to generalize its
      findings, train workers interested in the above problems, participate in the
      concept of care of battered children and its implementation in this country.

PMID- 7788659
TI  - [Munchausen syndrome].
AB  - The authors present their own observation of five child patients with
      Munchhausen's syndrome and Munchausen's syndrome by proxy resp. Both these units
      are included in the wider framework of the syndrome of the battered child. Four
      boys and one girl are involved, aged 12-16 years. In all instances the reason for
      admission to hospital was macroscopic haematuria. The children were prior to
      hospitalization subjected to a series of various invasive examinations, incl.
      repeated examinations under anaesthesia to elucodate the cause of macroscopic
      haematuria. The uncommon course of the "disease" and results of the examinations
      led in four of the five children to suspicion of Munchhausen's syndrome. Based on
      this suspicion after immobilization of the patients associated with prevention of
      manipulation with the hands, macroscopic haematuria disappeared as well as
      haematuria in general. In the fifth patient Munchhausen's syndrome by proxy was
      involved. The patient was referred because of repeated attacks of macroscopic
      haematuria a renal biopsy. The authors analyze in more details the individual
      case-histories and in the conclusion to they raise their objections to the
      opinion that these two syndromes are extremely rare.

PMID- 7788660
TI  - [Problems in placing the abused child in foster home care].
AB  - Children for whom foster parents are found include also abused and battered
      children. Is such a child able to establish a satisfactory emotional relationship
      with the foster parents or adoptive parents? The case of a boy repeatedly exposed
      to cruel corporal punishment in the original family. Attempts of the law court to
      return the child from a children's home to the original family. Finally complete
      refusal of the boy by his own parents. Placement of the boy in a new family and
      his successful adaptation in the new environment.

PMID- 7788661
TI  - [The human genome--chromosome 11].
AB  - The eleventh human chromosome is one of the most intensely studied and as regards
      the number of known genes it holds the third place after chromosomes 1 and X. The
      best known ones located on it are e.g. loci of the beta-globulin family which are
      associated with the best known and most widely distributed molecular disease
      sickle-cell anaemia and beta-thalassaemia. From knowledge of the causes of these
      diseases at the genome level so-called DNA diagnostics are derived which can be
      applied also to the prenatal period. On chromosome 11 are the loci of two
      complementary groups (C, D) which are extremely sensitive to ionizing radiation-
      ataxia teleangiectasia, the proinsulin locus the mutations of which, however, are
      not the cause of common types of diabetes. Development of the urogenital tract as
      indicated by some of its disorders (WAGR, Denys-Drash syndrome) is controlled by
      WT genes.

PMID- 7788662
TI  - [Pulse therapy in diffuse connective tissue diseases].
AB  - Methods of i.v. pulsed treatment using methyl prednisolone, cyclophosphamide or
      polyvalent immunoglobulin made it possible to suppress rapidly and effectively
      the activity of prognostically serious (clinical and laboratory) manifestations
      in diffuse connective tissue diseases (systemic autoimmune diseases). The author
      presents a general justification of this therapeutic method with emphasis on the
      immunogenetics of pathological autoimmunity (autogenes, apoptosis), he describes
      methodical aspects, the asset and partial clinical indications in rheumatoid
      arthritis, systemic lupus erythematosus, polymyositis and dermatomyositis, and
      primary systemic vasculitis. The author mentions also prerequisites of further
      development of i.v. pulsed treatment in diffuse connective tissue diseases.

PMID- 7788663
TI  - More recent trends in infant and child mortality in Zimbabwe and possible
      explanations.
AB  - The paper uses published results from the 1992 census to describe more recent
      trends in infant and child mortality in Zimbabwe. It is shown that the period
      1986 to 1988 provided the turning point in the gradual decline in infant and
      child mortality in the provinces. After this period, several provinces
      experienced a slow-down in mortality decline while some even experienced
      reversals. Using correlation analysis, it was suggested that the factors which
      affected infant mortality could be the same ones affecting child mortality. The
      paper then proceeds to formulate hypotheses on possible explanations for the slow
      down in mortality decline.

PMID- 7788664
TI  - Organophosphate exposure in pesticide formulation and packaging factories in
      Harare, Zimbabwe.
AB  - A cross sectional study was conducted in September 1989 in order to estimate the
      prevalence of organophosphate exposure and to identify factors associated with
      increased organophosphate exposure in pesticide producing factories in Harare,
      Zimbabwe. Sixty five workers entered the study with 45 of them providing blood
      specimens. The mean cholinesterase level was 75.3 pc (standard deviation 21.07
      pc). Twenty (44.4 pc) workers had cholinesterase levels of less than 75 pc. The
      workers had adequate knowledge (75 pc+) of the importance of protective devices
      but had less knowledge of about 50 pc of health effects of pesticides. Smoking (t
      = 3.49; degrees of freedom (df) = 43; p < 0.01) and eating (t = 2.14; df = 43; p
      < 0.05) at work place were associated with increased exposure to organophosphate.
      The number of symptoms was not correlated with cholinesterase levels (Spearman's
      rank correlation coefficient--0.70; p = 0.12). We conclude that a significant
      number of workers were exposed to organophosphate. Increased personal hygiene
      such as washing hands before eating or smoking should reduce the amount of
      exposure.

PMID- 7788665
TI  - Hydatidiform mole: a study of 40 patients admitted at Harare Central Hospital,
      Zimbabwe.
AB  - Hydatidiform mole contributes to a significant numbers of hospital admissions at
      Harare Hospital. The characteristics, diagnosis, management and follow up of the
      women with molor pregnancy admitted to Harare Hospital are presented. The follow
      up of these women was grossly inadequate.

PMID- 7788666
TI  - Plasma levels of retinol, ascorbic acid and alpha-tocopherol in sickle cell
      anaemia.
AB  - The plasma concentrations of the antioxidant vitamins A (retinol), C (ascorbic
      acid) and E (alpha-tocopherol) were determined in sickle cell anaemia (SCA). It
      was found that the concentrations of ascorbic acid and alpha-tocopherol were
      significantly depressed while that of retinol was only slightly reduced. The
      depletion in the levels of these antioxidant vitamins may account for some of the
      observed manifestations of SCA such as increased susceptibility to infection and
      haemolysis.

PMID- 7788667
TI  - Non-traumatic spinal cord diseases in Ibadan, Nigeria: aetiology and prognostic
      factors.
AB  - In this hospital based study, we analysed the clinical records of 104 patients
      having various spinal cord diseases seen between 1988 and 1993 with a view to
      delineating diagnostic and prognostic features. The patients comprised 80 males
      and 24 females with a mean age of 45 years. The mean duration of disease at
      presentation was 11 months and the average duration of stay in hospital was five
      months. Spondylotic myelopathy (31 subjects) predominated. It showed cervical
      predilection, infrequent sphincteric dysfunction and low ESR. Tuberculous disease
      of the spine (26 subjects) was next in frequency. The presentation of the TB
      cases was similar to those of neoplastic causes but the latter had a worse
      prognosis. There was a predilection for the dorsal spine and a high ESR. Myelitis
      occurred in the younger age group, showed dorsal spine predilection and
      relatively low ESR. The prognostic factors include duration of disease at entry,
      duration of hospital stay, presence of complication, motor power above grade
      three and absence of flacidity. The preventable causes of death include: deep
      vein thrombosis with subsequent pulmonary embolism and septicaemia.

PMID- 7788668
TI  - Acute bacterial meningitis in Enugu, Nigeria. 1 April 1989 to 31 March 1993.
AB  - A total of 84 cases of meningitis confirmed by isolation of the organisms at the
      University of Nigeria Hospital (UNTH) Enugu, Nigeria between 1 April 1989 and 31
      March 1993 are presented. The cases are analysed by diagnosis, seasonal
      distribution, age and sex distribution and age specific case fatality rate. The
      most common type of meningitis was pneumococcal meningitis 32 cases, followed by
      coliform meningitis 31 cases and meningococcal meningitis, six cases. Other
      bacterial causes of meningitis accounted for 15 cases. The majority of cases
      occurred in infants, followed by children, with all cases occurring sporadically.
      Mortality was high with Streptococcus pneumoniae having the highest case fatality
      rate of 28.13 pc followed by coliforms, 25.78 pc. Fifty pc of the patients had
      pre-medication before presentation at the hospital, and many of the patients
      could not receive appropriate therapy because they were unable to afford the cost
      of the drugs. This probably contributed to the high mortality.

PMID- 7788669
TI  - Haemophilia in northern Nigeria.
AB  - Thirteen patients from 11 families were diagnosed as cases of haemophilia A or B
      during 1977 to 1984. The majority presented with post circumcisional bleeding.
      Cryoprecipitate and packed red cells were used in the management. Haemophilia and
      other inherited bleeding disorders are not as rare as otherwise assumed. This is
      the first report from Northern Nigeria.

PMID- 7788671
TI  - A Zimbabwean approach to a Zimbabwean problem.

PMID- 7788670
TI  - Three consecutive ipsilateral tubal pregnancies in a nulliparous African woman:
      the role of conservative treatment.
AB  - A very rare case of three consecutive ipsilateral tubal pregnancies, in a 31 year
      old nulliparous Malawian woman is presented. The three pregnancies occurred over
      a four year period between 1989 and 1993, and were treated at three different
      hospitals in Malawi and Britain. The first two were treated conservatively by
      "milking" the ectopic out in Malawi and Britain respectively while the third was
      treated by partial salpingectomy in Malawi. All three were confirmed clinically,
      ultrasonographically, at surgery and histopathologically. The rarity of such a
      condition, the role and value of conservative treatment of tubal pregnancy in
      Africa, especially in the light of the probable aetiological and/or predisposing
      factors are discussed.

PMID- 7788672
TI  - Medical audit in Zimbabwe in 1898.

PMID- 7788673
TI  - Legal aspects of medical research and the way forward.
AB  - The main thrust of this article is to examine critically the laws and ethics
      governing medical research in this country--Zimbabwe. The article is divided into
      two parts. The first part starts with an introduction which highlights the need
      for medical research and the hazards related thereto. This is followed by stating
      the general legal position aimed at controlling medical research, the emphasis
      being on law, the international codes of medical ethics intended to fill the wide
      gaps not covered by our legislations and individual ethical considerations. The
      other topics covered in the first part include confidentiality in research and
      compensation for those who suffer injuries while undergoing a clinical trial. The
      second part covers the following topics; informed consent, stressing on the need
      for informed consent from both adults and children when carrying out medical
      research; embryo research and researchers carried out by n'angas and finally the
      conclusion suggesting the need to re-examine laws relating to medical research in
      this country which seem to be wholly inadequate. In brief the article is intended
      to stimulate more public debate on the law relating to medical research. For
      example a question is often asked: Does the law adequately protect those who
      carry out medical research and conversely those upon whom medical research (or
      clinical trials) is done?

PMID- 7788674
TI  - Neonatal haematology in Zimbabwe. II: The red cell and white cell parameters.
AB  - Red cell and white cell parameters were determined in 600 (310 male and 290
      female) normal Black Zimbabwean neonates with a mean +/- sd birth weight of 3.0
      +/- 0.4 (range 2.04 to 4.50, median 3.0) kg using a Coulter Counter Model S Plus.
      Cord anaemia (cord Hb < 13.5 gdl-1) was detected in 60 (10 pc) of the neonates.
      Although the male babies were significantly heavier than the females (p = 0.004),
      there were no significant differences (p > 0.05) in the red cell and white cell
      indices between the two sexes. When the haematological parameters of the 540 (90
      pc) non-anaemic (cord Hb > or = 13.5 gdl-1) neonates were analysed, the mean +/-
      sd values which may serve as local reference standards were: Hb 15.2 +/- 1.8
      (range 13.5 to 19.4) gdl-1, Hct 47.3 4.9 (range 38.6 to 60.3) pc, MCV 107.8 +/-
      9.4 (range 88.8 to 134.3) fl, MCH 31.9 +/- 3.4 (range 25.2 to 45.2) pg, MCHC 32.9
      +/- 1.3 (range 30.0 to 38.3) gdl-1, nucleated red blood cells 6.1 +/- 5.9 (range
      0 to 55) per 100 white blood cells, reticulocyte count 5.0 +/- 1.9 (range 0 to
      24.0) pc, total leucocyte count 13.8 +/- 4.4 (range 4.6 to 132.8) x 10(9)l-1;
      differential count: neutrophils 7.30 +/- 2.90 (range 1.72 to 18.02) x 10(9) l-1,
      lymphocytes 5.67 +/- 2.47 (range 0.98 to 16.14) x 10(9) l-1, monocytes 0.81 +/-
      0.83 (range 0 to 5.58) x 10(9) l-1, 1 and eosinophils 0.08 +/- 0.13 (range 0 to
      0.72) x 10(9)l-1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788675
TI  - In vitro activity of several antimicrobial agents against Neisseria gonorrhoeae
      and comparison of cost of treatment.
AB  - During a cross sectional study on the prevalence and incidence of gonorrhoea,
      Neisseria gonorrhoeae was isolated from 185 people aged between 16 and 60 years.
      In vitro activity of six antimicrobial antibacterial agents, penicillin,
      erythromycin, tetracycline, cotrimoxazole, ceftriaxone and norfloxacin on the
      isolated N. gonorrhoeae were carried out. The results obtained showed that, of
      all 111 isolates, 48 (43.2 pc) were penicillinase producing N. gonorrhoeae (PPNG)
      and 63 (56.8 pc) were non PPNGs. Over 90 pc of both PPNG and non PPNG isolates
      were sensitive to tetracyline and erythromycin. Seventy five pc of the PPNG and
      45 pc non-PPNG were not sensitive to two units of penicillin. Both PPNG and non
      PPNG were less sensitive to cotrimoxazole 25 micrograms. Norfloxacin and
      ceftriaxone were over 70 pc effective but were extremely expensive for most
      people who got infected.

PMID- 7788676
TI  - Splenic and hepatic trauma: a three year review.
AB  - We present a three year study of 22 consecutive patients treated for splenic and
      liver injuries at Mpilo Central Hospital between 1988 and 1990. A total of eight
      patients died giving an overall mortality rate of 36 pc. There was no mortality
      recorded in nine patients (41 pc) treated for splenic injuries. However, of the
      nine patients (41 pc) treated for liver injuries four patients died giving a
      mortality rate of 44 pc in this group. The highest mortality rate was recorded in
      the group of patients with both splenic and liver injuries because these injuries
      were invariably associated with other severe multiple injuries. We admitted four
      patients (18 pc) in this group and they all died.

PMID- 7788677
TI  - Prevalence of Campylobacter enteritis in children from Yaounde (Cameroon).
AB  - A cross sectional study on the prevalence of Campylobacter jejuni/coli and its
      possible aetiologic role in childhood diarrhoea in Yaounde was undertaken in 272
      children presenting with diarrhoea and 157 age matched controls from April 1989
      to October 1990. Stool cultures were performed according to standard techniques
      for Campylobacter jejuni/coli shigella and salmonella species. Rotavirus was
      detected using a latex agglutination test. Campylobacter jejuni/coli was isolated
      from 21 (7,7 pc) of 272 patients with diarrhoea and five of 157 (3,2 pc) controls
      (p > 0.05), all aged zero to four years old. Shigella and salmonella species were
      cultured from 2,2 pc and 1,1 pc of 272 patients respectively while rotavirus
      antigen was detected in 19,6 pc of 204 patients. Twenty eight pc of children with
      Campylobacter enteritis were exposed to chickens while 23,8 regularly drank water
      from streams which probably were contaminated. Our results indicate a high
      prevalence of campylobacter enteritis in children living in Yaounde and also
      suggest that a high rate of carriage of Campylobacter jejuni/coli could exist in
      children zero to four years without diarrhoeal illness. to four years without
      diarrhoeal illness.

PMID- 7788678
TI  - Appendicitis in south eastern Nigerian children.
AB  - One hundred and sixty nine cases of acute appendicitis were seen among 760
      children aged to zero to 15 years treated for a variety of acute abdominal
      emergencies in the University of Calabar Teaching Hospital (UCTH), Calabar,
      during the period January 1982 to 1991. This condition ranks second among cases
      of acute abdominal emergencies in this group of patients. Those aged 13 to 15
      years formed the majority (59 pc) of the children undergoing appendicectomy. As
      is the experience of other authors, appendicitis is rare under the age of three
      years. A female preponderance is observed in our study with a male: female ratio
      of 1:1,6 in contrast to reports elsewhere. The reason for this reversal is not
      clear. Parasitic infestation due to Ascaris lumbricoides involved 3 pc of our
      cases. This may be of significance in the aetiology of this disease. Despite the
      long delay in surgical intervention, no death was reported. Complications such as
      gangrene and perforation with peritonitis were recorded in only 8 pc of the
      patients. This favourable outcome despite a delay in initiating treatment may be
      related to self-medication with antimicrobials before reporting to the hospital.

PMID- 7788679
TI  - A case of psychotic mood disorder in an AIDS patient.
AB  - The following case is reported not because it is uncommon, but rather because
      cases like it will become more common as the AIDS endemic in sub-Saharan Africa
      progresses. This is a case of a young woman previously undiagnosed as being HIV
      positive who was admitted to a psychiatric unit. She clinically presented with a
      manic episode. The case is remarkable in that it demonstrates the complicated
      differential diagnosis that needs to be considered in evaluating immune
      compromised patients who present primarily with disturbances of mood, cognition,
      or behaviour.

PMID- 7788680
TI  - A community based investigation of causes of maternal mortality in rural and
      urban Zimbabwe. Maternal Mortality Study Group.
AB  - Most data on maternal mortality in Zimbabwe has been urban hospital based. Using
      a network of informants and sensitized health workers an attempt was made to
      identify and investigate all maternal deaths in rural Masvingo and urban Harare
      over a two year period. The present report discusses place of death and the
      medical causes in both populations. Results gave maternal mortality rates of 168
      and 85 per 100,000 live births for Masvingo and Harare respectively. These rates
      are significantly higher than those from conventional reporting systems
      especially in the rural area where 27 pc of deaths occurred at home or in
      transit. The leading medical causes of death were haemorrhage in Masvingo (25 pc
      of deaths) and eclampsia in Harare (26 pc), with puerperal and post abortal
      sepsis as the next most common causes in both cases. Malaria featured as the
      major indirect cause in Masvingo (7.6 pc). There were four suicides committed
      following unwanted pregnancy. The rural/urban variation in causation of death is
      discussed and the study results compared with other community based studies
      internationally. SYNOPSIS: This community based study revealed higher maternal
      mortality rates (MMR) than conventional statistics, especially in the rural area
      where deaths occurred at home or in transit. In the rural area the MMR was higher
      and the leading cause of death was haemorrhage, compared to eclampsia in the
      urban area. Strategies to reduce maternal deaths should include factors both
      within and outside health service structures.

PMID- 7788681
TI  - Who are the Zimbabwean loop users? The social and demographic characteristics of
      Zimbabwean IUCD users.
AB  - As part of a study into the reasons for the low utilization of the intra-uterine
      contraceptive device (IUCD) among Zimbabwean women, a records' review of IUCD
      users over the period 1985 to 1989 was carried out. A 10 pc sample of the records
      of women inserted over this period was taken. This paper reports on the social
      demographic and selected screening characteristics of these women. A total of
      1,179 records were reviewed. The IUCD users had a higher socio-economic status
      than the Zimbabwean population as a whole. Nearly 20 pc of the IUCD users were
      professional, technical and related workers, (mostly nurses and teachers),
      compared to 4.3 pc among the general population. Clients had apparently better
      reproductive histories than the population as a whole, probably reflecting their
      socio-economic status and possibly the screening process. The women were in their
      mid to late twenties in age at the time of insertion, and had been married an
      average of nine years. A quarter of the clients did not want any more children.
      They were using the IUCD to suspend their conception indefinitely after
      completion of their families. About 74 pc of the women had learnt about the
      family planning clinic from the local clinic/nurses or the community based
      distributor, indicating the importance of these sources of information. Eighty pc
      of the women were previous acceptors of modern contraceptives, but only 6 pc had
      apparently used the IUCD before.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788682
TI  - Effects of ACE inhibition on left ventricular dimensions and haemodynamics in
      systemic hypertension: a radionuclide and echocardiographic study.
AB  - The aim of this study was to assess the effects of Angiotensin Converting Enzyme
      (ACE) inhibition on cardiac systolic and diastolic parameters and left
      ventricular muscle mass in hypertensive patients. For this purpose 30 patients
      (22 female and eight male) with mild to moderate essential hypertension, aged 47
      +/- 2 years, were treated with enalapril maleate (MK 421, an ACE inhibitor) for
      six weeks. They underwent M-mode and Doppler echocardiography and radionuclide
      ventriculography at the beginning and after six weeks of enalapril treatment. In
      this study all patients treated with the ACE inhibitor enalapril responded with a
      significant decrease in mean arterial pressure (p < 0.001). A significant
      reduction in left ventricle and mass index were shown after six weeks of
      treatment with enalapril (p < 0.01). Total peripheral resistance and end-systolic
      stress decreased in the same time course (p < 0.001). Ejection fraction increased
      in both examinations after six weeks of therapy with enalapril, but this increase
      was not statistically significant. In radionuclide examinations, time to peak
      filling rate decreased significantly after six weeks of enalapril therapy (p <
      0.02). Despite these improvements in cardiac systolic and diastolic parameters,
      cardiac output and stroke volume decreased slightly after enalapril treatment. We
      concluded that enalapril improves diastolic and systolic parameters in LV
      function but causes slight decreases in cardiac output and stroke volume in
      addition to lowering blood pressure.

PMID- 7788683
TI  - Effect of Plasmodium falciparum malaria on plasma fibrinopeptide-A (FpA)
      concentration.
AB  - Plasma Fibrinopeptide-A (FpA) concentrations were determined using Enzyme-linked
      Immunosorbent Assay (ELISA) in patients with acute Plasmodium falciparum malaria
      infection and in 30 healthy controls. The mean FpA levels of the malaria patients
      were significantly raised (p < 0.001). The patients' FpA level correlated
      positively with malaria parasitaemia, but negatively with plasma fibrinogen
      concentration. A week after commencement of chloroquine therapy and subsequent
      disappearance of malaria parasites from the thick blood films, the patients' FpA
      levels decreased significantly from pre-treatment values. It is suggested that
      the elevated FpA and reduced plasma fibrinogen levels in the patients probably
      indicate a more widespread existence of overt coagulation defect in acute malaria
      infection.

PMID- 7788684
TI  - Legal article II: legal aspects of medical research and the way forward.

PMID- 7788685
TI  - Antimicrobial susceptibilities of Shigella dysenteriae type 1 isolated in
      Zimbabwe--implications for the management of dysentery.
AB  - Shigella dysenteriae type 1 was cultured from 56/170 (33 pc) rectal swab
      specimens collected from patients presenting to hospitals in Harare, Zimbabwe
      with dysentery. All of the isolates were resistant in vitro to trimethoprim
      sulfamethoxazole, with MICs > 32 mg/l, and all except one were resistant to
      ampicillin, most with an MIC > 256 mg/l. One isolate was resistant to nalidixic
      acid (MIC > 256 mg/l), but all of the others were sensitive, most with an MIC of
      2 mg/l or less. Using antibiotic disks, 96 pc isolates were resistant to
      chloromphenicol and 94 pc to tetracycline. All isolates were sensitive in vitro
      to gentamicin. On the basis of these findings, we suggest that commonly available
      antibiotics including ampicillin, cotrimoxazole, chloramphenicol or tetracycline
      should not be used for the treatment of dysentery. The most appropriate
      antimicrobial agent at the present time would be nalidixic acid. Resistance to
      this is, however, likely to emerge and data on susceptibilities to
      fluoroquinolones as well as to cephalosporins should be obtained so that further
      recommendations can be given timeously.

PMID- 7788686
TI  - Preliminary laboratory trial of Neem on anopheles and culex larvae in Zambia.

PMID- 7788687
TI  - Prolonged urokinase infusion for chronic total native coronary occlusions:
      clinical, angiographic, and treatment observations.
AB  - Prolonged intravascular infusion of urokinase has proven beneficial in
      reestablishing patency of chronically occluded peripheral arteries and saphenous
      vein grafts. This study was performed to assess the efficacy and safety of
      prolonged urokinase infusion as a prelude to angioplasty in chronically occluded
      native coronary arteries, that had failed standard angioplasty techniques. Twenty
      five patients with objective evidence for ischemia in the distribution of a
      chronic coronary occlusion were referred for percutaneous intervention. Patients
      were assessed for any potential exclusions from lytic therapy. Urokinase infusion
      through both a SOS wire and a stable guiding catheter was continued at 100,000
      240,000 units/hr for 8-25 hr; patients then underwent attempted balloon
      angioplasty. Mean duration of urokinase infusion was 20.6 +/- 7.7 hr (total dose
      163,000 +/- 52,447 units/hr). Fibrinogen levels dropped slightly with this (300
      +/- 129 to 203 +/- 81 mg/dl, P = 0.02). Angiography posturokinase showed
      improvement in 7 (28%) with regard to coronary flow (> or = 1 TIMI-grade).
      Angioplasty was successful in 13 (52%), with final angiographic result revealing
      thrombus in 5 (20%), or dissection 8 (32%). The infusions were well-tolerated
      with a low incidence of chest pain, 2 (8%) or ischemic ECG response, 2 (8%);
      myocardial infarction, 2 (8%); or significant bleeding 2 (8%). All patients
      survived the procedure, with a length-of-hospital stay = 5.1 +/- 4 days. Use of
      prolonged preangioplasty intracoronary urokinase infusion can be done safely with
      success in roughly one-half of patients with chronic total native coronary
      occlusions who have failed prior attempts at percutaneous intervention.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7788688
TI  - Transluminal extraction catheter for the treatment of diseased saphenous vein
      grafts: a multicenter experience.
AB  - To evaluate the efficacy, safety, and long-term results of atherectomy using the
      Transluminal Extraction catheter (TEC), patients with diseased saphenous vein
      grafts were enrolled in a prospective nonrandomized trial. Patients were followed
      to hospital discharge for acute complications and underwent routine 6-mo
      reevaluation with repeat cardiac catheterization to assess restenosis.
      Atherectomy was performed on 650 graft lesions in 538 consecutive patients (male
      81%; mean age 66 yr; range 37-81). Mean graft age was 8.3 yr; (range 0.3-20) with
      85% of grafts > 3 yr of age. Complex lesion morphology included thrombus (28%),
      ulceration (13%), and eccentricity (50%). Lesion success was achieved in 606
      lesions (93%) with clinical success in 479 patients (89%). Lesion success was
      achieved in 90% of thrombus containing lesions, 97% of ulcerated lesions, and 97%
      of grafts > 3 yr. Complications included nonfatal myocardial infarction in 4
      (0.7%) of patients, emergency bypass surgery in 2 (0.41%), and in-hospital death
      in 17 patients (3.2%). Angiographic follow-up at 6 mo was obtained from 268
      lesions in 227 patients. The overall lesion angiographic restenosis rate was 60%.
      TEC atherectomy can be performed in patients with diseased saphenous vein grafts
      with high primary success and low complication rates. It is suitable for use in
      aged grafts, particularly in the presence of thrombus and ulcerations, and may be
      superior to balloon angioplasty alone in this group of patients.

PMID- 7788689
TI  - Stenting with the half (disarticulated) Palmaz-Schatz stent.
AB  - A total of 110 half (disarticulated) Palmaz-Schatz coronary stents were implanted
      in 102 patients. Procedural success rate was 98%. Elective stenting was performed
      in five patients. The others received half stents for bail-out situations,
      including short dissections, relapsing stenoses, dissections not adequately
      covered by a full stent, ostial stenoses, and thrombus containing lesions.
      Seventeen patients received no anticoagulation except aspirin. Complications
      included one procedural death, three acute occlusions (resulting in one Q and two
      non-Q wave myocardial infarctions), and one non-Q wave infarction related to side
      branch closure. Stenting with the half Plamaz-Schatz coronary stent is an
      effective technique. It allows stenting in situations where a full stent may not
      be ideally suited. Use of only half a stent reduces thrombogenicity and halves
      costs.

PMID- 7788691
TI  - Percutaneous transradial coronary Palmaz-Schatz stent implantation, guided by
      intravascular ultrasound.
AB  - Intravascular ultrasound (IVUS) allows accurate assessment of stent deployment,
      its use being confined to the use of 8 French (F) guiding catheters. We evaluated
      the feasibility of combining transradial artery Palmaz-Schatz stent implantation
      through 6F guiding catheters with IVUS for assessment of stent diameter after
      delivery at moderate inflation pressures (10-12 atmospheres [atm]) with compliant
      balloons and after high pressure dilatations with balloons of intermediate
      compliance. In 8 consecutive patients, 12 stents were delivered with Scimed
      Express balloon catheters at 10-12 atm followed by IVUS (EndoSonics CathScanner;
      Visions FX 3.5F 20 MHz transducer). An ultrasound study was repeated after high
      pressure dilatations (16-20 atm) with Schneider Magical Speedy balloon catheters.
      The balloon diameters were derived from manufacturer provided specifications. In
      all patients the transducer could easily be advanced through the guiding
      catheters. Reference diameter of the stented segment was 3.7 +/- 0.5 mm (2.7-4.5)
      and the diameter of Scimed Express balloons during inflation was 4.0 +/- 0.3 mm
      (3.6-4.7). Stent diameter was 3.0 +/- 0.1 mm (2.8-3.2) (P < 0.001 compared to the
      reference and the balloon diameter). The diameter of the Schneider Magical Speedy
      balloons at secondary dilatations with 16 +/- 3 atm (14-20) was 4.1 +/- 0.4 mm
      (3.3-4.5) (P = 0.50 compared to the initial balloon diameter). Final stent
      diameter was 3.3 +/- 0.4 mm (2.9-4.1) (P = 0.02 compared to the initial stent
      diameter). All stents were symmetrically deployed and well apposed. No damage to
      vessel or stents was detected after passage of the transducer.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7788692
TI  - Coronary stenting without anticoagulation.
AB  - Stents are useful bail-out devices in coronary angioplasty. They are also used
      electively for situations associated with poor angioplasty results (e.g.,
      restenotic lesions, venous grafts) and may reduce restenosis rates. However, the
      significant incidence of stent thrombosis necessitated aggressive anticoagulation
      with associated hemorrhagic complications. This remains a major limitation of
      stenting. We present our experience of stenting with half (disarticulated) Palmaz
      Schatz coronary stents in eight consecutive patients, managed with aspirin alone.
      No patient experienced acute or subacute stent thrombosis.

PMID- 7788690
TI  - Emergency endoluminal stenting for abrupt vessel closure following coronary
      angioplasty: a randomized comparison of the Wiktor and Palmaz-Schatz stents.
AB  - In order to compare the efficacy of two different stent types in case of bailout
      stenting, 65 patients, with abrupt or threatened vessel closure following
      coronary angioplasty, were randomly assigned to either Wiktor (Medtronic Inc.,
      Minneapolis, MN, 33 patients) or Palmaz-Schatz (Johnson & Johnson Interventional,
      Warren, NJ, 32 patients) stent implantation. Stenting was technically feasible in
      all except one patient and immediately successful in reverting ischemia and
      vessel closure in 60 patients (92%). At hospital discharge, complication rates
      were comparable: early vessel closure, 18% (Wiktor) versus 13% (Palmaz-Schatz) (P
      = 0.53); any clinical event (such as death, myocardial infarction, and surgical
      revascularization): 18% (Wiktor) versus 22% (Palmaz-Schatz) (P = 0.71). At 6
      months follow-up, these complication rates remained equal: restenosis, 38%
      (Wiktor) versus 27% (Palmaz-Schatz) (P = 0.42); any clinical and angiographic
      (vessel closure and restenosis) event: 45% (Wiktor) and 41% (Palmaz-Schatz) (P =
      0.69). Baseline, direct postprocedural, and follow-up quantitative coronary
      analysis data were similar, with, however, an exception for the postprocedural
      residual stenosis [28% (24-32%) (Wiktor) and 21% (18-23%) (Palmaz-Schatz] (means
      and 95% confidence intervals). In conclusion, despite a discrete postprocedural
      angiographic benefit observed with the Palmaz-Schatz stent, the long-term
      clinical and angiographic outcome is similar in both treatment groups. The choice
      whether to implant a Wiktor or Palmaz-Schatz stent may probably be left to the
      discretion of the operator and his experience with one particular device.

PMID- 7788693
TI  - Coronary artery stenting for acute closure complicating primary angioplasty for
      acute myocardial infarction.

PMID- 7788694
TI  - Treatment of acute stent thrombosis with local urokinase therapy using catheter
      based, drug delivery systems: a case report.
AB  - Abrupt thrombotic stent closure remains a difficult problem to treat in the
      cardiac catheterization laboratory. A 63-yr-old white female initially underwent
      successful placement of a Palmaz-Schatz biliary stent in the proximal RCA
      following failed coronary angioplasty. One week later, the patient represented
      with an acute inferior infarction and thrombotic occlusion of the stent site in
      spite of adequate anticoagulation. A new, local drug infusion catheter (the
      Dispatch catheter) was placed at the angioplasty site and 150,000 units of
      urokinase were locally infused, with immediate restoration of normal distal flow
      and a subsequent marked decrease in angiographic thrombus. A small, residual
      thrombotic filling defect was further treated with a urokinase-coated hydrogel
      balloon (Hydro Plus). Following local urokinase delivery with the Dispatch
      catheter and hydrogel balloon, there was complete resolution of angiographic
      thrombus with TIMI 3 flow and no evidence of distal embolization or no-reflow.
      Local urokinase delivery directly to the site of thrombus with catheter-based
      drug delivery systems may be a useful technique for rapidly lysing intracoronary
      clot and re-establishing coronary flow in the setting of acute stent thrombosis.

PMID- 7788695
TI  - Sequential implantation of dissimilar tandem stents for long dissections
      complicating percutaneous transluminal coronary angioplasty.
AB  - Acute closure remains a significant complication of percutaneous angioplasty, and
      coronary artery stenting serves as a useful bail-out device. We describe two
      cases of sequential implantation of dissimilar tandem stents, a Gianturco-Roubin
      (4 x 20mm) stent and a Palmaz-Schatz (4 x 15mm) stent, for long dissection
      complicating percutaneous transluminal coronary angioplasty.

PMID- 7788696
TI  - Retrieval of occluding unexpanded Palmaz-Schatz stent from a saphenous aorto
      coronary vein graft.
AB  - The Palmaz-Schatz coronary stent is used frequently to reduce the rate of
      restenosis of balloon angioplasty in saphenous vein grafts. In many European
      centers, the stent, manually crimped on a balloon, is advanced across the
      stenosis without a protective sheath. This report describes a patient in whom an
      attempt to deploy a stent in the orifice of a saphenous vein graft was
      complicated by dislodgement of the unexpanded stent from the balloon. The
      unexpanded stent caused immediate occlusion of the vein graft and severe ischemic
      symptoms. The stent was retrieved by inflation of another balloon in the graft,
      distal to the stent, pulling the balloon toward the guiding catheter, and then
      withdrawing the whole system.

PMID- 7788697
TI  - Successful transcatheter management of Palmaz Stent embolization after superior
      vena cava stenting.
AB  - A 34-year-old patient with benign superior vena cava syndrome (SVCS) was treated
      with thrombolytic therapy, balloon angioplasty, and placement of two peripheral
      Palmaz stents. Embolization of one stent to the right atrium occurred 10 min
      after successful implantation. This serious complication was successfully managed
      by percutaneous transcatheter technique with retrieval from the right atrium and
      subsequent deployment into the right external iliac vein of the lost stent.
      Complete resolution of SVCS symptoms occurred within 24 hr and moderate superior
      vena cava restenosis was successfully dilated 8 months later. At 12-month follow
      up the patient continues to be asymptomatic.

PMID- 7788698
TI  - Collateral flow velocity alterations in the supply and receiving coronary
      arteries during angioplasty for total coronary occlusion.
AB  - The unique observations of contralateral and ipsilateral coronary artery
      collateral supply before and after angioplasty suggest highly responsive conduits
      to hemodynamic conditions. The study of collateral supply system is not only
      significant for our current understanding of the dynamic behavior of the
      collateral circulation, but may also have important clinical implications for the
      treatment of patients with a chronic coronary occlusion.

PMID- 7788699
TI  - Effect of data compression on quantitative coronary measurements.
AB  - Digital coronary and left ventricular angiography demand high transfer rates and
      very large data storage if all the clinical data are to be achieved. If
      appropriate compression schemes were available without compromising the quality
      and resolution of the image data, such demands could be lessened. In this study
      we compared the influence of different compression factors of the Adaptive Real
      Time Image Compression (ARTIC) scheme used on the Philips DCI-SX systems on
      coronary measurements assessed with the Automated Coronary Analysis (ACA)
      package. Loss-free acquired images of size 512(2) x 8 bits, which had been stored
      digitally on tape, were reloaded into the DCI with compression factors of 2, 3,
      and 4; only the factor 2 is loss free. To evaluate the effect of the different
      data compressions on the accuracy of the measurements, the diameters of a vessel
      phantom (tube sizes ranging from 0.687 to 5.062 mm) were determined. To evaluate
      the reproducibility of the results, the intraobserver variability was determined
      for the different compression factors from 40 coronary obstructions. The
      differences in the reference diameter measurements of the vessel phantom were 
      0.03 +/- 0.06 mm, 0.01 +/- 0.07 mm, and 0.04 +/- 0.08 mm for the compression
      factors 2 (loss free), 3, and 4, respectively. The results were not statistically
      significantly different. The intraobserver variabilities in the obstruction
      diameter measurements of the coronary obstructions were -0.04 +/- 0.13 mm, 0.00
      +/- 0.14 mm, and 0.02 +/- 0.13 mm for the compression factors 2, 3 and 4,
      respectively. The intraobserver variabilities in the reference diameter
      measurements were -0.02 +/- 0.12 mm, 0.01 +/- 0.09 mm, and 0.03 +/- 0.09 mm for
      the compression factors 2, 3, and 4, respectively. The intraobserver
      variabilities of the percent diameter stenosis were 0.96 +/- 4.19%, -0.01 +/-
      4.88% and -0.04 +/- 4.68% for the compression factors 2, 3, and 4, respectively.
      None of these differences were statistically significant. Both from a qualitative
      and quantitative point of view, data compression factors 3 and 4 are acceptable
      in digital coronary arteriography.

PMID- 7788700
TI  - Caution in use of beta blockers during pregnancy.

PMID- 7788701
TI  - Terumo Glidewire: the wire of choice for chronic total occlusion.

PMID- 7788702
TI  - Unstable angina pectoris associated with Imitrex therapy.

PMID- 7788703
TI  - Stents: reenforcement to the interventionalist.

PMID- 7788705
TI  - [Nomenclature and classification of membrane receptors and their subtypes].
AB  - Present rapid growth of information about receptors for endogenous ligands and
      drugs requires changes in definitions, nomenclature and classifications of
      receptors and their subtypes. Receptors are defined as such membrane structures
      for which we have sufficiently reliable characterization of their structure,
      transducing mechanisms (mediation of intracellular effects), and selectively
      acting drugs (operational criterion). This characterization is based on the
      integrated approach to classification that relies on all three essential
      criteria. The current classification of membrane receptors is organized by
      International Union of Pharmacology Committee on Receptor Nomenclature and Drug
      Classification (NC-IUPHAR). Their conclusions about receptor classifications are
      regularly published in pharmacological journals and in special publications. List
      of presently known membrane receptors and their subtypes is provided in this
      review.

PMID- 7788706
TI  - [Adrenergic receptors--nomenclature and classification of the types and
      subtypes].
AB  - The purpose of this review is to present current knowledge regarding adrenergic
      receptors and their subtypes. These receptors belong to the superfamily of
      structures with seven transmembrane domains. They are coupled with G-regulatory
      proteins. Similarly to other membrane receptors, their division is based on three
      criteria: structural, transductional, and operational. At present, adrenergic
      receptors are divided into three main groups, depicted as alpha 1, alpha 2 a beta
      receptors. Receptors alpha 1 and alpha 2 are further divided into additional 4
      subtypes, which are marked with upper case subscripts A-D. Receptors beta are
      subdivided into three types, marked with subscripts 1-3. Classification of
      adrenergic receptors can be considered as a prototype for classification of other
      membrane receptors. The significance of all known receptors subtypes is not yet
      known. Multiple subtypes of adrenergic and also other receptor types exist
      simultaneously not only in one tissue but also frequently in a single cell where
      they can exert both synergistic as well as antagonistic effects. The discovery of
      functions and interactions of individual receptor subtypes represents a big
      challenge for future studies. Introduction of new selective agonists and
      antagonists not only helps to classify various receptor subtypes but it also has
      a big therapeutic potential.

PMID- 7788704
TI  - Systemic anaphylactoid reactions to iodinated contrast media during cardiac
      catheterization procedures: guidelines for prevention, diagnosis, and treatment.
      Laboratory Performance Standards Committee of the Society for Cardiac Angiography
      and Interventions.
AB  - This report represents the first guidelines for prevention, diagnosis, and
      treatment of anaphylactoid reactions to contrast media occurring specifically
      during cardiac catheterization. The incidence of contrast media complications in
      the catheterization laboratory is 0.23% with 1 death per 55,000. Anaphylactoid
      reactions are nonimmune mediated, but histamine release and other mediators
      produce a clinical presentation indistinguishable from anaphylaxis. In patients
      with known previous reactions, pretreatment with steroids and diphenhydramine and
      the use of nonionic contrast media have significantly reduced the potential of
      recurrent reaction. Minor reactions such as limited urticaria may be watched for
      progression or treatment with diphenhydramine, whereas more serious reactions
      such as angioedema or laryngeal edema require airway stability and ephinephrine
      administration. Shock should be vigorously treated simultaneously with
      intravenous epinephrine and large volumes of normal saline. If the patient can be
      stabilized, the study should be completed as histamine, leukotrienes, and other
      vasoactive products should be relatively depleted.

PMID- 7788707
TI  - [Do the kidneys play an important role in the pathogenesis of "essential"
      hypertension?].
AB  - The Prague Hypertensive Rat (PHR) is a model of genetic hypertension derived from
      the Wistar strain, in which a normotensive parallel, the Prague Normotensive Rat
      (PNR), was also bred from the same parent pair. Thus, it is possible to transfer
      organs between both parallels without signs of rejection and without the use of
      immunosuppressive drugs. Unilateral nephrectomy and transplantation of one kidney
      within the PHR and PNR groups did not affect the systolic blood pressure (SBP).
      Transplantation of one kidney from PNR to a bilateral nephrectomized (BNX) PHR
      normalized the high SBP; and transplantation of one kidney from PHR to BNX PNR
      led to an elevation of SBP: hypertension "travels" with the kidney. When the
      development of high SBP in PHR was prevented for 2 months after weaning by
      antihypertensive drugs, transplantation of one kidney from these rats to BNX PNR
      always induced a sustained hypertension in the recipient. If a PHR was left with
      one original kidney in situ after transplantation of a "normotensive" kidney, the
      high blood pressure persisted until the original "hypertensive" kidney was
      removed. These results support the view that the kidney of PHR produces a
      "hypertensinogenic" substance, the secretion of which is genetically determined
      and is not influenced by the magnitude of the SBP.

PMID- 7788708
TI  - [The carotid body--mechanisms of hypoxia sensing].
AB  - The carotid body is a peripheral chemoreceptor monitoring arterial blood gas
      tension and pH and contributing to the regulation of breathing. The molecular
      mechanism of oxygen sensing is unknown. However, it is hypothesised that lowering
      of arterial oxygen tension detected by O2 sensitive K+ channels, evokes a
      selective inhibition of K+ current of glomus cells, with an increase of cellular
      excitability. Hydrogen peroxide production within the glomus cells may serve as a
      messenger which regulates potasium channels or gene expression.

PMID- 7788712
TI  - Interactions among mutations affecting spontaneous mutation, mitotic
      recombination, and DNA repair in yeast.
AB  - The mutant alleles mms9-1, mms13-1, or mms21-1 of Saccharomyces cerevisiae confer
      pleiotropic effects, including sensitivity to the alkylating agent methyl
      methanesulfonate, elevations in spontaneous mutation and mitotic recombination,
      defects in meiosis, and cross-sensitivity to radiation. We constructed double
      mutant strains containing an mms mutation and a defect in either excision repair,
      mutagenic repair, or recombinational repair and measured the levels of
      spontaneous mutation and mitotic recombination. Double mutants lacking excision
      repair show elevations in spontaneous mutation but with predominantly unchanged
      levels of mitotic recombination. RAD52 function was required for the expression
      of the hyper-recombination phenotype of the mms9-1, mms13-1, and mms21-1 alleles;
      double mutants displayed the very low recombination levels characteristic of
      rad52 mutants. Phenotypes of double mutants containing one of the mms alleles and
      either of the hyper-recombination/mutator rad6-1 or rad3-102 alleles suggest that
      the mutagenic lesions in mms strains may not be identical to the recombinogenic
      lesions.

PMID- 7788714
TI  - Molecular cloning of Rab-related genes in the yeast Yarrowia lipolytica. Analysis
      of RYL1, an essential gene encoding a SEC4 homologue.
AB  - Small GTP-binding proteins of the Rab family are involved in the vesicular
      traffic inside eukaryotic cells. A gene library from the yeast Yarrowia
      lipolytica was screened with an oligonucleotide deduced from a highly conserved
      sequence in the Rab family. Four different genes were isolated. One of them,
      RYL1, was shown to be essential for cell viability. RYL1p displayed a high
      similarity with and tight phylogenetic relationships to SEC4p. When placed under
      the control of the GAL10 promoter, RYL1 was able to specifically relieve the
      thermosensitivity of a sec4-8 mutant of Saccharomyces cerevisiae. Therefore, it
      is proposed that RYL1 is a functional homologue of the S. cerevisiae SEC4 gene
      and is involved in the fusion of secretory vesicles with the plasma membrane in
      the general protein secretion pathway.

PMID- 7788713
TI  - Control of glucose influx into glycolysis and pleiotropic effects studied in
      different isogenic sets of Saccharomyces cerevisiae mutants in trehalose
      biosynthesis.
AB  - The GGS1/TPS1 gene of the yeast Saccharomyces cerevisiae encodes the trehalose-6
      phosphate synthase subunit of the trehalose synthase complex. Mutants defective
      in GGS1/TPS1 have been isolated repeatedly and they showed variable pleiotropic
      phenotypes, in particular with respect to trehalose content, ability to grow on
      fermentable sugars, glucose-induced signaling and sporulation capacity. We have
      introduced the fdp1, cif1, byp1 and glc6 alleles and the ggs1/tps1 deletion into
      three different wild-type strains, M5, SP1 and W303-1A. This set of strains will
      aid further studies on the molecular basis of the complex pleiotropic phenotypes
      of ggs1/tps1 mutants. The phenotypes conferred by specific alleles were clearly
      dependent on the genetic background and also differed for some of the alleles.
      Our results show that the lethality caused by single gene deletion in one genetic
      background can become undetectable in another background. The sporulation defect
      of ggs1/tps1 diploids was neither due to a deficiency in G1 arrest, nor to the
      inability to accumulate trehalose. Ggs1/tps1 delta mutants were very sensitive to
      glucose and fructose, even in the presence of a 100-fold higher galactose
      concentration. Fifty-percent inhibition occurred at concentrations similar to the
      Km values of glucose and fructose transport. The inhibitory effect of glucose in
      the presence of a large excess of galactose argues against an overactive
      glycolytic flux as the cause of the growth defect. Deletion of genes of the
      glucose carrier family shifted the 50% growth inhibition to higher sugar
      concentrations. This finding allows for a novel approach to estimate the
      relevance of the many putative glucose carrier genes in S. cerevisiae. We also
      show that the GGS1/TPS1 gene product is not only required for the transition from
      respirative to fermentative metabolism but continuously during logarithmic growth
      on glucose, in spite of the absence of trehalose under such conditions.

PMID- 7788715
TI  - Molecular genetic properties of the yeast Torulaspora pretoriensis:
      characterization of chromosomal DNA and genetic transformation by Saccharomyces
      cerevisiae-based plasmids.
AB  - Chromosomal DNA banding patterns were obtained for three strains of Torulaspora
      pretoriensis by contour-clamped homogeneous-electric-field gel electrophoresis.
      Chromosomes were resolved into six or seven bands in the range of 800 to 2000 kb,
      and a polymorphism of these lengths was observed. By Southern-blot analysis, the
      three strains were shown to lack the DNA sequences homologous to the URA3, LEU2,
      TRP1, and HO genes of Saccharomyces cerevisiae. A uracil auxotrophic mutant
      derived from T. pretoriensis was transformed with three plasmids (YEp24, YRpHI,
      and YCp50) carrying the URA3 gene of S. cerevisiae by the lithium acetate method.

PMID- 7788716
TI  - Expression cloning, purification and characterization of a beta-1,4-galactanase
      from Aspergillus aculeatus.
AB  - Expression cloning has been used to isolate a cDNA encoding beta-1,4-galactanase
      from the filamentous fungus Aspergillus aculeatus. A cDNA library was prepared
      from mycelia, inserted in a yeast expression vector and transformed into
      Saccharomyces cerevisiae. Thirteen clones secreting galactanase activity were
      identified from a screening of approximately 2.5 x 10(4) yeast colonies. All
      clones expressed transcripts of the same galactanase gene. The cDNA was re-cloned
      in an Aspergillus expression vector and transformed into Aspergillus oryzae. The
      recombinant enzyme had a molecular weight of 44,000 Da, an isoelectric point of
      pH 2.85, a pH optimum of pH 4.0-4.5, and a temperature optimum of 45-65 degrees
      C, which is similar to values obtained for a beta-1,4-galactanase purified from
      A. aculeatus. The enzyme degraded unsubstituted galactan to galactose and
      galactobiose. The deduced primary sequence of the enzyme showed no apparent
      homology to any known enzyme, in accordance with this being the first reported
      beta-1,4-galactanase cDNA. However, the deduced amino-acid sequence of a Bacillus
      circulans DNA sequence containing an open reading frame (ORF) with no known
      function, showed 36% identity and 60% similarity to the galactanase amino-acid
      sequence.

PMID- 7788717
TI  - Sequence analysis of the Aspergillus nidulans pectate lyase pelA gene and
      evidence for binding of promoter regions to CREA, a regulator of carbon
      catabolite repression.
AB  - The nucleic acid and deduced amino-acid sequences of the pectate lyase gene
      (pelA) from Aspergillus nidulans are presented. The pelA gene contains two short
      introns, 68 and 49 bp in length, and encodes a peptide of 326 amino acids. Five
      transcriptional start sites are clustered between 65 and 79 bp upstream of the
      start codon as determined by primer extension. Comparison of the amino-acid
      sequences of pectate or pectin lyases from bacteria, fungi and plants revealed
      less than 30% overall identity. However, five regions within these enzymes, in
      particular domains associated with the active site, are highly conserved with
      amino-acid similarities greater than 50%. Phylogenetic analysis using the
      principle of parsimony (PAUP 3.1.1) showed that pelA is most closely related to
      pectate lyases from plants rather than pectin lyases from other fungi.
      Previously, pelA was shown to be induced by polygalacturonic acid and repressed
      in the presence of preferred carbon sources, such as glucose. Gel mobility shift
      analysis indicates that a PstI-SphI fragment from the pelA promoter binds to a
      fusion protein composed of the N-terminal part of CREA, a protein involved in
      carbon catabolite repression, and glutathione-S-transferase. This result suggests
      CREA may contribute to the regulation of pelA expression.

PMID- 7788718
TI  - Molecular cloning and analysis of nre, the major nitrogen regulatory gene of
      Penicillium chrysogenum.
AB  - We have isolated the Penicillium chrysogenum nre gene which is homologous to the
      major nitrogen regulatory genes areA from Aspergillus nidulans and nit-2 from
      Neurospora crassa. Overall, nre shows 60% identity to areA and 30% identity to
      nit-2 at the amino-acid level. The gene encodes a protein of 835 amino-acid
      residues and contains a single Cys2/Cys2-type zinc finger with an adjacent basic
      region and a putative acidic activation region. In the DNA-binding domain, 98% of
      the amino-acid residues are identical in nre, areA and nit-2. The nre gene has
      been shown to be functional in N. crassa by heterologous complementation of a nit
      2 mutant. Growth tests indicated that transformants could utilize nitrate, amino
      acids, purines and amides as sole nitrogen sources. Nitrate reductase activity
      assays performed with transformants demonstrated that nitrogen control was
      completely normal. Complementation of N. crassa nit-2 mutants with 5'-deletion
      clones of nre suggests the possible presence of an internal promoter within the
      coding region. Northern analysis and ribonuclease protection assays of total
      cellular RNA indicated that nre encodes a 3.2-kb transcript which is reduced in
      content under conditions of nitrogen repression.

PMID- 7788719
TI  - Molecular cloning and sequence analysis of the scpZ gene encoding the serine
      carboxypeptidase of Absidia zychae.
AB  - Carboxypeptidase Z is a serine carboxypeptidase secreted by Absidia zychae NRIC
      1199. The cDNA and genomic DNA carrying the scpZ gene encoding carboxypeptidase Z
      were cloned and sequenced. The nucleotide sequences of the cDNA (1.4 kb) and the
      genomic DNA (3.3 kb) were analyzed and the intervening sequences were located by
      a comparison of the two. It was found that the scpZ gene was interrupted by 11
      short introns, 50-75 nucleotides in length. Genomic Southern analysis showed that
      there was only one scpZ gene in the genome of A. zychae. The gene encoded a
      putative pre-pro-enzyme composed of 409 amino-acid residues of the mature
      carboxypeptidase Z (M(r) 45,421) and an additional N-terminal sequence of 51
      amino-acid residues. The amino-acid sequence around the active serine residue of
      carboxypeptidase Z (-G-E-S-Y-G-G-) differed from the consensus (-G-E-S-Y-A-G-)
      which is conserved in most of the serine carboxypeptidases so far analyzed.

PMID- 7788720
TI  - A group-I intron in the mitochondrial small subunit ribosomal RNA gene of
      Sclerotinia sclerotiorum.
AB  - A 1,380-bp intervening sequence within the mitochondrial small subunit ribosomal
      RNA (mt SSU rRNA) gene of the fungus Sclerotinia sclerotiorum has been sequenced
      and identified as a group-I intron. This is the first report of an intron in the
      mt SSU rRNA gene. The intron shows close similarity in secondary structure to the
      subgroup-IC2 introns from Podospora (ND3i1, ND5i2, and COIi5) and Neurospora
      (ND5i1). The intron has an open reading frame (ORF) that encodes a putative
      protein of 420 amino acids which contains two copies of the LAGLI-DADG motif. The
      ORF belongs to a family of ORFs identified in Podospora (ND3i1, ND4Li1, ND4Li2,
      ND5i2, and COIi5) and Neurospora (ND5i1). The putative 420-aa polypeptide is also
      similar to a site-specific endonuclease in the chloroplast large subunit
      ribosomal RNA (LSU rRNA) gene of the green alga Chlamydomonas eugametos. In each
      clone of S. sclerotiorum examined, including several clones which were sampled
      over a 3-year period from geographically separated sites, all isolates either had
      the intron or lacked the intron within the mt SSU rRNA gene. Screening by means
      of Southern hybridization and PCR amplification detected the intron in the mt SSU
      rRNA genes of S. minor, S. trifoliorum and Sclerotium cepivorum, but not in other
      members of the Sclerotiniaceae, such as Botrytis anamorphs of Botryotinia spp.,
      or in other ascomycetous and basidiomycetous fungi.

PMID- 7788721
TI  - In vitro self-splicing reactions of chloroplast and mitochondrial group-I introns
      in Chlamydomonas eugametos and Chlamydomonas moewusii.
AB  - The self-splicing activity of nine chloroplast group-I introns (CeLSU.1 to
      CeLSU.6, CepsbC.1, CepsbC.2 and CmpsaB.1) and of one mitochondrial group-I intron
      (CmmtLSU.1) from the interfertile green algae Chlamydomonas eugametos and C.
      moewusii was examined using RNA templates produced by in vitro transcription of
      cloned DNA sequences. All introns, with the exception of the mobile intron
      CeLSU.5 encoding the site-specific I-CeuI endonuclease, were found to catalyze
      their own splicing in the absence of proteins. The introns that proved to be the
      best substrates under the conditions employed are CeLSU.1, CeLSU.3, CeLSU.4,
      CepsbC.1 and CmmtLSU.1. The implications of our results for the origin and spread
      of group-I introns in the organellar genomes of green algae are discussed.

PMID- 7788722
TI  - The rps3-rpl16-nad3-rps12 gene cluster in rice mitochondrial DNA is transcribed
      from alternative promoters.
AB  - The two gene clusters rps3-rpl16 and nad3-rps12 are separated from each other in
      the mitochondrial genome and are expressed as the individual transcription units
      in many plants. In rice mitochondrial DNA (mtDNA), the four genes rps3, rpl16,
      nad3 and rps12 are located within a region of 6 kbp. Northern-blot analysis
      revealed that a large transcript (6.6 kb) hybridized to both the rps3-rpl16 and
      the nad3-rps12 gene clusters. Using RT-PCR, we amplified a fragment of
      anticipated size (790 bp) from two primers that corresponded to sequences in the
      coding regions of rpl16 and nad3, demonstrating that at least two of the four
      genes, namely rpl16 and nad3, were co-transcribed. These results together
      indicated that all four genes, namely, rps3, rpl16, nad3 and rps12, were co
      transcribed in rice mitochondria. Transcription initiation sites were determined
      by an in vitro capping/ribonuclease protection assay and primer extension
      analysis. Two initiation sites were identified in the rps3-rpl16-nad3-rps12 gene
      cluster: one was located upstream of rps3 and the other was located between rpl16
      and nad3. This evidence indicates that the rps3-rpl16-nad3-rps12 gene cluster is
      transcribed from two alternative promoters.

PMID- 7788725
TI  - [Serum amyloid protein A--a new kind of apoproteins Apo SAA].

PMID- 7788726
TI  - [Progress in the molecular pathology of the clonal origin of hepatocellular
      carcinoma].

PMID- 7788723
TI  - Calmodulin-dependent protein kinase II and calmodulin are required for induced
      thermotolerance in Saccharomyces cerevisiae.
AB  - We show here that yeast mutants lacking calmodulin-dependent protein kinase II
      fail to fully acquire induced thermotolerance. A similar result was also obtained
      with mutants depending solely on either the N-terminal half or the C-terminal
      half of calmodulin. These findings indicate that both calmodulin-dependent
      protein kinase II and calmodulin are required for induced thermotolerance.

PMID- 7788727
TI  - [A comparison between astrocytoma cells and the developing astrocytes in human
      embryo brain by electron microscopy].
AB  - 60 cases of astrocytoma of brain and 8 human embryo brains were studied with
      light and electron microscopy. The 5 types of tumor cells in astrocytoma include
      the undifferentiated, pre-astrocyte, astrocyte gemistocyte and tumor giant cells.
      Some similarities were found between the ultrastructure of astrocytoma and that
      of the developing astrocyte, the tumor cells somewhat resembling the cells of
      developing astrocytes. But certain differences were observed, the tumor cells
      were usually polymorphic with increased chromatin in nucleus, and asynchronism
      between nucleus and cytoplasm differentiation was sometimes found. The current
      nomenclature and classification of astrocytoma were evaluated and discussed, the
      author's opinion on classification was presented.

PMID- 7788724
TI  - The mcm2-1 mutation of yeast causes DNA damage with a RAD9 requirement for
      repair.
AB  - The minichromosome maintenance mutation, mcm2-1, has been found to synthesize
      damaged DNA at 35 degrees C. Growth at this temperature rendered the mutant
      strain more sensitive to killing by ultraviolet irradiation. DNA damage could
      also be detected by pulsed-field gel electrophoresis, where a higher fraction of
      the DNA loaded was retained in the inserts at the wells. During the exponential
      phase of growth at this temperature about 50% of the cells had large buds, with
      the nucleus at or near the neck of the bud in most cases. The incorporation of
      the rad9 deletion in the mcm2-1-carrying strain caused a reduction in the
      percentage of large-budded cells and a moderate loss of cell viability. The
      results are consistent with mcm2-1 causing DNA damage leading to the arrest of
      cells in the S/G2 phase of the cell cycle, which was partially dependent on the
      RAD9 gene product.

PMID- 7788728
TI  - [Expression of Epstein-Barr virus encoded small RNA-1 and latent membrane protein
      1 in midline T-cell lymphomas].
AB  - Nine cases of midline T-cell lymphoma (MTL) were studied for expression of
      Epstein-Barr virus (EBV) encoded small RNA-1 (EBER-1) and EBV latent membrane
      protein-1 (LMP-1) using in situ hybridization and immunohistochemistry
      respectively. EBER-1 was detected in nuclei of tumor cells in 8/9 cases of MTL
      and LMP-1 was found on membrane and in cytoplasm of tumor cells in 7/9 cases of
      MTL. The results show: (1) There is a strong association between EBV and MTL. EBV
      may play an important role in the pathogenesis of MTL. (2) The detection
      frequency of EBV in MTL is higher than peripheral T-cell lymphoma from other
      sites of the body. (3) EBER-1 in situ hybridization and LMP-1
      immunohistochemistry are sensitive and reliable in detection of EBV in MTL and
      the latter is more economic and convenient.

PMID- 7788729
TI  - [Malignant rhabdoid tumor of kidney: a clinicopathologic and immunohistochemical
      study of 15 patients].
AB  - The clinical and pathological features of 15 infants with malignant rhabdoid
      tumors of kidney are presented. These tumors were identified among 391 primary
      renal neoplasms in this hospital. The male/female ratio was 2.8:1.0, mean age at
      diagnosis was 18 months with a range from 4 to 55 months. Of the 10 patients with
      follow-up records, 8 have died, 2 were alive and free of disease 15 and 55 months
      after the diagnosis respectively. A wide histologic spectrum was encountered. All
      tumors exhibited classical morphology in at least some areas, characterized by
      solid proliferation of monotonous tumor cells with vesicular nuclei and prominent
      nucleoli, abundant cytoplasm and intracytoplasmic inclusions. Immunohistochemical
      studies were performed in all 15 cases. Vimentin was positive in all tumors, ENA
      in 12, cytokeratin in 8, desmin in 2 and myoglobin in one. All cases were
      negative for presence of lysozyme, NSE and neurofilament. Our results show that
      this tumor is a distinctive and highly malignant neoplasm of the infant kidney
      with considerable morphological and immunohistochemical diverse phenotypes.

PMID- 7788730
TI  - [Transferrin receptor and iron deposition pattern in the hepatic lobules of the
      iron-deficient and iron-overloaded rats].
AB  - Wistar rats were made iron deficient by a low iron regimen. Iron overload was
      produced by repeated intraperitoneal injections of ferric nitrilotriacetate
      (Fe(3+)-NTA) for one to four months. Hepatic tissues from these iron deficient,
      overloaded and control rats were examined for transferrin receptor (TfR),
      transferrin (Tf) and iron after immunohistochemical staining. TfR and Tf were
      mainly distributed in the peripheral part of the lobule (zone 1) in the normal,
      iron deficient and iron-overloaded rats. The staining intensity decreased from
      zone 1 to zone 3. The staining intensity of TfR was strongest in iron-deficiency
      rat hepatic cells, weakest in iron-overloaded rat hepatic cells when compared
      with controls. The difference of Tf staining between the three groups of rats was
      similar to that of TfR. In the iron-overloaded rats, the staining intensity of
      iron was stronger in zone 1 than in zone 2 and 3, similar to the distribution
      pattern of TfR and Tf. These findings suggest that (1) iron uptake in hepatic
      cells in vivo is regulated and mediated by TfR and Tf, (2) the expression pattern
      of TfR and Tf in zone 1 to zone 3 liver cells may result in the progressive
      decrease of iron deposition in the hepatic lobules of the iron overloaded rats.

PMID- 7788731
TI  - [Detection of the apoptosis-suppressing oncoprotein bcl-2 in ameloblastomas].
AB  - The product of apoptosis-suppressing oncoprotein bcl-2 can block apoptosis and
      result in the development of tumors. In this study, the expression of bcl-2 was
      observed in 40 cases of ameloblastomas by immunohistochemical staining. The
      results showed that the epithelium and reduced enamel epithelium of the enamel
      organ, the odontoblasts, basal cells of odontogenic cysts, normal oral epithelium
      and 90% (36/40) of ameloblastomas were positive for bcl-2, indicating that the
      expression of bcl-2 in odontogenic epithelium may be related to the degree of
      differentiation and proliferation of cells, the overexpression of bcl-2 may be
      associated with the development of ameloblastoma.

PMID- 7788732
TI  - [Congenital pulmonary lymphangiectasis].
AB  - Six rare cases of congenital pulmonary lymphangiectasis were presented. The
      macroscopic characteristic of the lungs was honeycomb appearance due to extreme
      dilatation of the lymphatic spaces in the subpleural, interlobular, peribronchial
      and perivascular connective tissue. They had thin walls lined by endothelium. The
      dilated lymphatics may be due to congenital developmental defects or obstruction
      of major lymphatics, but they appeared to be associated only with pulmonary
      venous hypertension.

PMID- 7788733
TI  - [Tuberculous lymphadenitis: a sarcoidosis-like variation].
AB  - By means of polymerase chain reaction technique to amplify DNA sequence specific
      for mycobacterium tuberculosis (M. TB-PCR), BCG immunohistochemistry (BCG-IHC) as
      well as acid fast stain (AF), mycobacterium other than tuberculosis (MOTT) and
      mycobacterium tuberculosis (M. TB) were detected in paraffin blocks from 12 cases
      diagnosed by consultant pathologists as lymph node "sarcoidosis". Of the 5 cases
      which consulting pathologists unanimously agreed to the lymph node "sarcoidosis"
      diagnosis, 1 case showed BCG-IHC (+) and M. TB-PCR (+); Of the 7 cases which most
      of the consulting pathologists agreed to be "sarcoidosis", 1 case showed AF (+),
      BCG-IHC (+) and M. TB-PCR (+). The results suggest: (1) some tuberculous
      lymphadenitis cases may present as "sarcoidosis"-like lesions; (2) lymph node
      sarcoidosis may be related to MOTT and M. TB infection.

PMID- 7788734
TI  - [The relationship of intraacinar pulmonary arterial structural remodelling with
      pulmonary hypertension].
AB  - Pulmonary hypertension (PHT) was induced in rats by a single subcutaneous
      injection of monocrotaline (MCT). Light and electron microscopy,
      immunohistochemistry and morphometry were applied to investigate the different
      pathological changes of the intraacinar pulmonary arteries (IAPA) and their
      relationship with PHT. The results showed that pulmonary function was related to
      the morphological structure and indicated that the remodelling in the IAPA
      structure was the pathological basis of PHT. The results further suggested that
      the proliferation and myoid differentiation of the pericyte play an important
      role in the muscularization of the nonmuscular pulmonary artery in IAPA.

PMID- 7788735
TI  - [Expression of c-erbB-2 protein and EGF receptor in hepatitis B, cirrhosis and
      hepatocellular carcinoma].
AB  - The expressions of c-erbB-2 oncogene and epidermal growth factor receptor (EGFR)
      were investigated immunohistochemically in specimens from 184 cases of hepatitis
      B, cirrhosis and hepatocellular carcinoma (HCC) and 29 normal liver specimens.
      EGFR was expressed in 36% (48/134) of the hepatocellular carcinoma and chronic
      liver disorder specimens and it was immunolocalized mainly in the sinusoidal
      endothelial cells. No significant difference was found between EGFR expression in
      HCC and in benign chronic liver disorders. These results indicate that EGFR may
      have some role in the proliferation of the sinusoidal epithelial cells in chronic
      liver disease. Low level c-erbB-2 expression was observed in 5/29 (17%) of normal
      liver specimens. In chronic hepatitis B and liver cirrhosis, its expression was
      found in all specimens. c-erbB-2 protein was immunolocalized mainly in small
      polygonal liver cells (SPLCs) and hepatocytes in small-cell dysplasia (SCD) and
      in ductular metaplasia (DM); c-erbB-2 expression in HCC cells was found to be
      weaker than in SPLCs, the hepatocytes in SCD and in DM. These results indicate
      that activated c-erbB-2 oncogene may have a role in human HCC genesis through
      promoting the development of SCD from SPLC proliferation and the progression of
      SCD. The close relation between the expression of c-erbB-2 and HBxAg imply that
      the activation of c-erbB-2 in human liver tissues may be related to HBV X gene.

PMID- 7788737
TI  - [Analysis of the quality of special charts].

PMID- 7788736
TI  - [Implementing the theories of management to evaluate nursing quality].

PMID- 7788739
TI  - [Psychological care for psychogenic patients].

PMID- 7788738
TI  - [Care of arteriovenous fistula constructed with titanium ring nails].

PMID- 7788740
TI  - [Care of drilling skull drainage for intracranial hematoma].

PMID- 7788742
TI  - [Functional rehabilitation of burns of the neck].

PMID- 7788741
TI  - [Care of ovarian cancer treated with intraperitoneal chemotherapy].

PMID- 7788744
TI  - [Study on the influence of patients' posture on hemodynamics].

PMID- 7788745
TI  - [Pre- and post-nursing care of endoscopic retrograde cholangiopancreatography in
      children].

PMID- 7788743
TI  - [Life events and personal emotional reaction correlated to psychosomatic health].

PMID- 7788746
TI  - [Retrospective analysis of the examination record of the field range of the eye].

PMID- 7788747
TI  - [The influence of students' reports on "My viewpoint of children" on pediatric
      nursing teachers].

PMID- 7788748
TI  - [Setting up nursing process course for technical nursing education].

PMID- 7788750
TI  - [How long to keep the urinary catheter after abdominal gynecological surgery].

PMID- 7788749
TI  - [Management of rehabilitation in Japan].

PMID- 7788751
TI  - [Study on disposable infusion equipment].

PMID- 7788752
TI  - [The function of OPD clients' nurse guide].

PMID- 7788753
TI  - [Role assignment and continuing education for college graduate nurses].

PMID- 7788754
TI  - [How to cultivate students' interest in basic nursing teaching].

PMID- 7788755
TI  - [Diarrhea and pseudomembranous enteritis after major abdominal surgery].

PMID- 7788756
TI  - [Clinical study on Huo Xue San Je Gao in treating scleroma caused by
      intramuscular injections].

PMID- 7788757
TI  - [Study on childrens' health ideas in the Shanghai area].

PMID- 7788758
TI  - [The after effect of r-HuEPO in treating anemic hemodialysis patients].

PMID- 7788759
TI  - [Cognition behavior therapy of anorexia nervosa].

PMID- 7788760
TI  - [Care of epidemic hemorrhagic fever complicated by bradycardia].

PMID- 7788761
TI  - [Care of broncho-biliary fistula caused by hydatidosis].

PMID- 7788762
TI  - [Care of entercutaneous fistula].

PMID- 7788763
TI  - [How to protect the intravenous chemotherapy blood vessels].

PMID- 7788764
TI  - [Visual acuity test of children in the strabismus clinic].

PMID- 7788766
TI  - [Care of eye patients during ERG examination].

PMID- 7788765
TI  - [Study on early eyedrops after cataract surgery].

PMID- 7788767
TI  - [Comprehensive evaluation of nursing with weighted composite index number
      methods].

PMID- 7788768
TI  - [Analysis of anthropometry of hospitalized medical patients].

PMID- 7788769
TI  - [The clinical significance of taking body temperature for burn patients by mouth,
      axilla and rectum].

PMID- 7788770
TI  - [Study of the influence of axillary temperature by the length of time of the
      thermometer in the axilla].

PMID- 7788771
TI  - [Study on the need of nurses on the job for continuing education to renew their
      knowledge].

PMID- 7788772
TI  - [Care of body surface malignant tumors with electrochemotherapy].

PMID- 7788773
TI  - [Care of acute myocardial infarction complicated with cardiac rupture].

PMID- 7788775
TI  - [Analysis and comparison of different methods in topical treatment of herpes
      zoster].

PMID- 7788776
TI  - [Care of dental implant during operation].

PMID- 7788774
TI  - [Respiratory exercise for chronic respiratory system diseases of senile
      patients].

PMID- 7788777
TI  - [Style of management and personal quality of managers].

PMID- 7788778
TI  - [The extra degree courses open in Sichuan Province].

PMID- 7788780
TI  - [Continuing education of nursing ethics for nurses on the job].

PMID- 7788779
TI  - [Experience in classroom teaching].

PMID- 7788781
TI  - [Review of nursing articles from military hospitals at command level appearing in
      the Chinese Nursing Journal].

PMID- 7788782
TI  - [Study on the rational composition of intravenous penicillin compound solutions].

PMID- 7788784
TI  - [Study on the effect of using moistened oxygen to treat chronic obstructive lung
      diseases].

PMID- 7788783
TI  - [Study on close insulin wet compresses in treating bedsores].

PMID- 7788785
TI  - [Clinical observation and care of repair of gastroschisis using autologous
      umbilical cord].

PMID- 7788786
TI  - [Care of phimosis treated with balloon dilatation].

PMID- 7788787
TI  - [Coordination during osseo-integrated implant surgery].

PMID- 7788788
TI  - [Defects of primary nursing records and measures for control].

PMID- 7788789
TI  - [Study on construction of secluded treatment rooms].

PMID- 7788790
TI  - [Teaching new concepts of modern nursing theory to technical nursing students].

PMID- 7788791
TI  - [Teaching plan of nursing practice in a psychiatric hospital].

PMID- 7788792
TI  - [Treating skin infections of neonates with Xin-Qing lotions].

PMID- 7788793
TI  - Determining one or more change points.
AB  - A statistical method is presented for determining whether a line has one or more
      change points at unknown locations. A change point is a point where a line
      suddenly changes its slope but is continuous, i.e. it does not jump. Change
      points are also referred to as break points or join points. A step-wise procedure
      is suggested which starts by fitting a straight line without points. Next a line
      with a single change point is fit to the data, and a statistical test is used to
      determine if the line with a single change point provides a significantly better
      fit to the data than the line with no change points. This can then be followed by
      fitting a line with two change points, etc. The problem of determining the number
      of change points that best fits the data is discussed. A modified version of
      Akaike's information criterion (AIC) is used to select the best number of change
      points to avoid over fitting. An example of fluorescence anisotropy measurements
      of the total phospholipid from the liver of a marine fish as a function of
      temperature is presented.

PMID- 7788794
TI  - Ganglioside GD1a generates domains of high curvature in phosphatidylethanolamine
      liposomes as determined by solid state 31P-NMR spectroscopy.
AB  - We have studied the effects of gangliosides on the polymorphic behaviour of
      phosphatidylethanolamines. The ganglioside GD1a promotes the formation of phases
      which give rise to isotropic 31P-NMR resonance lines, particularly in the
      temperature range of the L alpha to HII transition. In addition, higher mol
      fractions of ganglioside raise the L alpha to HII phase transition temperature.
      Our results demonstrate that small mol fractions of gangliosides can have
      profound effects on the molecular organization of phosphatidylethanolamines.

PMID- 7788795
TI  - Cholesteryl hemisuccinate-cholesterol interaction: miscibility properties of the
      sterols.
AB  - Miscibility of cholesterol and cholesteryl hemisuccinate was investigated by
      differential scanning calorimetry and small-angle X-ray scattering. In an excess
      of cholesterol, above 2:1 mol ratio, phase separation takes place into a mixed
      phase and an almost pure cholesterol phase.

PMID- 7788796
TI  - Exclusion of SP-C, but not SP-B, by gel phase palmitoyl lipids.
AB  - The interactions of the hydrophobic pulmonary surfactant proteins, SP-C and SP-B,
      with lipid bilayers were assessed by fluorescence energy transfer. SP-C and SP-B
      were labeled with the fluorescent probe, succinimidyl nitrobenzoxadiazolyl amino
      hexanoate (NBD). Fluorescence energy transfer from NBD-SP-C and NBD-SP-B to four
      distinct indocarbocyanine probes (CnDiI) was utilized to determine the
      association of the surfactant proteins with various lipid acyl chains. In lipid
      mixtures including DPPC and DPPG, SP-C was associated with shorter chain and
      unsaturated lipids below the bulk lipid phase transition. Longer chain saturated
      CnDiI were excluded from SP-C aggregates. In contrast, SP-B demonstrated little
      acyl chain preference. The association of SP-C with shorter chain and unsaturated
      lipids below the bulk phase transition is interpreted to arise from a mismatch in
      the length of the hydrophobic region of the SP-C alpha-helix relative to the
      length of the hydrophobic region of dipalmitoyl lipids in the gel phase.

PMID- 7788798
TI  - Photo-effect in phospholipid liposome containing riboflavin.
AB  - The photovoltage developed in a photoelectrochemical cell consisting of
      riboflavin (RFN), a neutral dye and phospholipid (PL) liposome in aqueous
      solution has been found to correlate with the Stern-Volmer constant (KSV) or
      quenching-rate constant (Kq) of RFN-PL studied by fluorescence spectra. A
      possible mechanisms of photovoltage generation suggests the photo-induced
      electron transfer from PL to RFN in liposome through the excited state molecular
      interaction.

PMID- 7788797
TI  - Phase behaviour of novel phospholipid analogues.
AB  - The phase behaviour of phospholipid analogues containing a phosphoramide moiety
      was investigated using polarized light microscopy. A complex liquid-crystalline
      polymorphism consisting of lamellar, and normal topology hexagonal and
      intermediate phases was observed and found to depend on the structure of the
      phosphoramide headgroup and its methylation. In addition, a lower consolute phase
      boundary in the micellar solution part of the phase diagram was observed in some
      systems. The aggregation behaviour of these novel amphiphiles was compared with
      that of quaternary ammonium and oligo-ethylene oxide amphiphiles.

PMID- 7788799
TI  - Microdomain formation in phosphatidylethanolamine bilayers detected by 2H-NMR.
AB  - In deuterium NMR spectra of phosphatidylethanolamine bilayers with an extremely
      high content of saturated fatty acids, each C1 deuteron of the glycerol backbone
      gave rise to a doublet [Yoshikawa et al., (1988) Biochim. Biophys. Acta 944, 321
      328]. This suggests the presence of two backbone conformations, the exchange
      between which is slow on an NMR time-scale. The origin of the two conformations
      has been investigated in this work using saturated 1,2-diacyl-sn-glycero-3
      phosphoethanolamine specifically deuterated in the glycerol backbone. The results
      showed that the two conformations originate from different domains, which have
      different fatty acid compositions. The differential scanning calorimetry of the
      bilayers suggested that the size of the domain is not large enough to show an
      independent phase transition. Thus, the formation of microdomains in the
      phosphatidylethanolamine bilayers has been concluded. Conformational difference
      in different domains was shown to be restricted to the C1 position of the
      glycerol backbone. The microdomains of phosphatidylethanolamine were retained
      even in the presence of other phospholipids.

PMID- 7788800
TI  - Monolayer study of mixtures of diacetylenic phosphatidylcholine and phospholipids
      containing metal-chelating iminodiacetic acid headgroup.
AB  - The mixing behavior of polymerizable diacetylenic phosphatidylcholine (1) with
      two diacetylenic phospholipids containing the iminodiacetic acid (IDA)
      functionality in the headgroup region was studied at the air-water interface. All
      three phospholipids contained tricosa-10,12-diynoyl acyl chains. In phospholipid
      2, the choline group (-CH2-CH2-NMe3) was replaced by an -CH2-CH2-N-(CH2-COOH)2
      functionality. In phospholipid 3, the IDA unit was linked to the phosphate
      headgroup via a sulfonate linker, -CH2-CH2-OS(O2)-O-CH2-CH2-. Monolayers were
      prepared by mixing polymerizable 1,2 bis(tricosa-10,12-diynoyl)-sn-glycero-3
      phosphocholine (1) with metal-chelating IDA phospholipids (2, 3) on a 10 mM CuCl2
      subphase. Studies of monolayer properties of mixtures of 2 and 3 with 1
      demonstrated that mixtures of 2 with 1 had better mixing behavior than mixtures
      of phospholipids 1 and 3.

PMID- 7788801
TI  - Kinetics and thermodynamics of emulsion delivery of lipophilic antioxidants to
      cells in culture.
AB  - Oil-in-water emulsions are being used increasingly for the delivery of lipophilic
      drugs, but the fundamental physicochemical principles governing such delivery
      have not been explored. We determined the kinetics and thermodynamics of delivery
      from emulsions to cells in culture for two lipophilic compounds, U74006 and
      U74500. Two fundamental properties dominate the delivery, (a) the concentration
      of the compound in the lipid phase of the emulsion is directly proportional to
      the concentration of the compound in cells at equilibrium, and (b) the rate of
      transfer is directly proportional to the concentration of particles in contact
      with the cells. Thus, the transfer is consistent with direct partitioning from
      the lipid phase of the emulsion to cells and occurs by the direct collision of
      emulsion particles with cells. The details of the mechanism of delivery differ
      between the two compounds. Specifically, delivery of U74006 is first-order with
      respect to the drug accumulating in the cells. The transfer of U74500 is best
      described as a sum of two simultaneous pseudo first-order processes consistent
      with delivery from a single donor compartment to two receiver compartments.
      Furthermore, two molecules of U74500 appear to be involved in each transfer
      event. Our results show that relatively simple principles govern the delivery of
      compounds from oil-in-water emulsions to cells.

PMID- 7788802
TI  - Sterol carrier protein-2 stimulates intermembrane sterol transfer by direct
      membrane interaction.
AB  - It is unclear how the cytosolic sterol carrier protein-2 (SCP-2) binds sterols
      and enhances sterol transfer between membranes. Therefore, human recombinant SCP
      2 was used in conjunction with phase fluorometry, dialysis, and chemical labeling
      techniques to show if a direct membrane effect accounted for this activity. SCP-2
      directly interacted with L-cell fibroblast plasma membrane vesicles as determined
      by increased fluorescence anisotropy of coumarin-labeled protein (CPM-SCP-2).
      Furthermore, a new fluorescence lifetime component due to plasma membrane-bound
      CPM-SCP-2 was observed. Dialysis studies with 3H- cholesterol loaded plasma
      membranes indicated that SCP-2, added to the donor compartment, stimulated sterol
      transfer whether or not the dialysis membrane was permeable to SCP-2.
      Nevertheless, ligand-binding experiments indicated that chemically blocking the
      SCP-2 sterol binding site inhibited the ability of SCP-2 to enhance sterol
      transfer between plasma membrane vesicles. SCP-2 did not stimulate plasma
      membrane fusion. Addition of SCP-2 to plasma membranes increased the anisotropy
      plasma membrane proteins covalently reacted with CPM, but not that of lipids
      labeled with the fatty acid analogue octadecyl rhodamine B. In conclusion, the
      data are consistent with SCP-2 stimulating intermembrane sterol transfer by
      direct interaction with sterol in the membrane and enhancing its desorption from
      the membrane.

PMID- 7788803
TI  - Phase behavior of mixtures of cholesterol and saturated phosphatidylglycerols.
AB  - The interaction of cholesterol with a series of saturated phosphatidylglycerols
      was investigated using differential scanning calorimetry and X-ray diffraction.
      We find that the miscibility of cholesterol in phosphatidylglycerol bilayers is
      lower than in the corresponding phosphatidylcholine bilayers and decreases with
      increasing acyl chain length of the phospholipid. The influence of the negative
      charge of the phosphatidylglycerol on cholesterol miscibility is discussed.

PMID- 7788804
TI  - Sphincter preserving techniques in rectal cancer and their limitations.
AB  - For a patient with a tumour in the anal canal or with the inferior margin 5 cm or
      less from the anal verge an abdominoperineal rectal excision with permanent
      sigmoid colostomy is the only available treatment. The Turnbull-Cutait pull
      through technique involved full mobilization of the rectum, complete eversion of
      the anorectal stump and pull-through of the colon, the excess of which was
      resected in the second stage of the operation, followed by suture of the colonic
      and rectal mucosa. Abdomino sacral resection has been practised by a few surgeons
      only. Abdominotransanal resection with sutured colo-anal sleeve anastomosis was
      the operation developed by Sir Alan Parks. In this operation the anorectal stump
      is not everted through the anus as in the Turnbull-Cutait operation. There has
      been a great revival of interest in low anterior resections with the introduction
      of the EEA instrument for stapling the colorectal anastomosis and there is still
      today a great enthusiasm for this technique. In an attempt to improve the results
      trial are going on at present to evaluate the importance of a J-configured neo
      rectum constructed from the sigmoid or descending colon and stapled to the top of
      the anal canal or handsutured to the pectinate line after endoanal mucosectomy.
      Many patients with rectal carcinoma are old and often suffer from intercurrent
      diseases such as hypertension, diabetes etc. There is considerable postoperative
      complication. An abdominoperineal resection with a colostomy is by no means
      outdated for an ultralow or low sited rectal cancer.

PMID- 7788805
TI  - [Conservative surgery in rectal cancer].
AB  - The Authors analyse their experience about 387 cases operated for rectal cancer.
      The choice of the operation was not related to tumour's features, but was related
      to the location of the neoplasia. The safety margin of rectal resection was
      reduced up to a minimum of 2 cm. in lower tumours, where it was not possible to
      meet this condition an abdomino-perineal resection was performed. A lumbo-aortic
      lymphadenectomy with high ligature of inferior mesenteric artery was always
      performed; in 17 cases it was extended to the pelvic nodes. In all the patients
      the whole mesorectum was removed and a wide pelvic dissection was performed to
      avoid the so called cone effect. Since 1991 all the B2-C patients undergo
      preoperative radiotherapy. Recurrence rate and survival are similar both after
      abdomino-perineal and sphincter-saving resections. Among the different risk
      factors, the Authors have found a statistically significant relation only with
      the stage. The Authors, therefore, conclude that sphincter-saving resection is
      the best surgical procedure because of the god quality of life. They stress the
      importance of a lumboarotic lymphadenectomy with high ligature of inferior
      mesenteric artery. As far as the complementary therapy is concerned, the
      discussion is still open, especially about the timing and the choice of the
      adjuvant treatment.

PMID- 7788806
TI  - The leaking colorectal anastomosis; why does it happen and how do we prevent it?
AB  - The ingredients predisposing for an anastomotic leak can be attributed both to
      the patient and to the surgeon. Some causative elements can be remedied; others
      cannot be changed very much. In cancer surgery the quest for cure involves
      ligation of the inferior mesenteric artery in the treatment of left-sided
      tumours. This obviously creates a conflict with the goal of constructing a well
      circulated anastomosis. In the treatment of rectal cancers total mesorectal
      excision has in recent years been put forward as the crucial step in avoiding
      local recurrences. The use of drains is a matter of controversy. The rationale
      for using them is to avoid pelvic collections with subsequent infection. The
      anastomosis is the point of least resistance so this is where a pelvic abscess is
      liable to break through, thus creating a leak. The choice of anastomosis, single
      layer or double layer, has been extensively dealt with and is beyond the scope of
      this presentation. My opinion is that you should stick to the type of anastomosis
      you are familiar with and try to refine your technique as much as possible.
      Continuous surgical audit and improved surgical training are likely the most
      important measures to lower the complication rates in colorectal surgery.

PMID- 7788807
TI  - Colorectal cancer emergencies.
AB  - From the variety of operative choices for colorectal cancer emergencies, it is
      difficult to select the best one for the individual patient, who is often old and
      frail. Appropriate handling of the emergency situation is essential. Treatment of
      the patient's malignant disease is secondary. The choice of surgical procedure in
      colorectal cancer emergencies must be based on sound clinical judgement and
      should be in keeping with the technical skill and experience of the individual
      surgeon. Surgical failures have major negative consequences not only for the
      immediate postoperative course, but also for long-term survival and quality of
      life of these patients.

PMID- 7788808
TI  - [Local excision of rectal tumors: Y. Mason's operation].
AB  - Twenty-nine patients with cancer of the low rectum were treated by local excision
      performed by a transsphincteric approach (Mason's operation). Patient's selection
      requires a careful digital examination, biopsy, CT or MR and intraluminal
      ultrasound. In our series an accurate and strictly selection provides low
      recurrence rates with no mortality and low postoperative complications. Mason's
      operation, when criteria for appropriate patients selection are followed, is a
      valid alternative to mayor surgical procedures as APR.

PMID- 7788809
TI  - [Continence in low resections].
AB  - Anorectal function is an important problem after low anterior resection
      procedure. This paper reports the results from 14 patients undergoing to low
      resection at Surgical Pathology Institute of the University of Verona. In 12
      cases the restoration of the bowel continuity has been obtained by colon-anal
      anastomosis (Parks Operation) and in 3 cases by colo-rectal anastomosis at the
      anorectal ring level. The patients have been examined in the preoperative and in
      the postoperative period by clinical and manometric study. The results confirm
      that low resection does not involve faecal continence.

PMID- 7788810
TI  - [Malignant tumors of the small intestine. Clinical and therapeutic considerations
      on 23 observed cases].
AB  - Small bowel tumours observed by the Authors at the IInd Surgical pathology of
      Pavia University between 1974 and 1992 were reviewed. There were found 23 cases;
      istopathologic findings, clinical presentation, diagnostic aspects and
      therapeutic options are discussed. The primary role of surgery in the treatment
      of these cancers is emphasized, but this can be curative only if diagnosis has
      been timely.

PMID- 7788811
TI  - [Current trends in the treatment of perforated colonic diverticulitis].
AB  - The authors, after having examined the cases of complicated diverticulitis
      operated between 1985 and 1993, confirm that the surgical treatment for this
      particular pathology is strictly dependent on the local or general seriousness.
      In the light of this they consider an operation for resection and anastomosis 1st
      stage justifiable only in selected cases; colostomy and drainage in particularly
      serious cases, preferring Hartmann's method of operation for the 3rd and 4th
      stages of Chappuis and Chon. The results obtained agree in a satisfactory manner
      with the data in the literature.

PMID- 7788812
TI  - [Ogilvie syndrome: a case report].
AB  - The Authors report a case of Ogilvie's syndrome observed directly. Remembering
      this disease is extremely rare, they review the pathogenic hypotheses and
      clinical picture, describing particularly therapeutic, conservative and surgical
      management.

PMID- 7788813
TI  - [Primary non-Hodgkin's lymphomas of the colon: apropos of a case with double
      localization].
AB  - A case of non-Hodgkin's lymphoma involving the caecum and the rectum was
      resected. The disease occurs in 1-4% of gastrointestinal neoplasms and comprises
      0.2-0.65% of colorectal tumours. The caecum is frequently involved while primary
      malignant lymphoma localized to the caecum and the rectum is more uncommon. The
      most representative histological types are histiocytic or lymphocytic tumours.
      The disease commonly presents as a painful abdominal mass and is associated with
      weight loss and diarrhoea. Barium enema and pancolonoscopy are sufficient for
      diagnosis, but echotomography and Tc scan are useful for staging. Surgery is the
      treatment of choice and overall 5-years survival is 30-40%. The role of adjuvant
      therapy has not yet been clearly defined, although data from some studies
      indicate increased survival in those patients given adjuvant therapy compared
      with patients treated with surgical resection alone.

PMID- 7788814
TI  - [Tumor markers in malignant anorectal pathology].
AB  - The Authors note the limits and the more rational directions of using the several
      tumour markers that they utilized in the study of the neoplastic pathology of the
      anus-rectum. They particularly point out the benefit as "dynamic indices" of
      variation of the tumor mass during the neoplasm's progress and treatment. For
      these neoplasies any new marker offers advantages of diagnostic accuracy and a
      greater specificity more CEA. Nevertheless other markers used appear interesting
      as biochemical parameters for tumour growth. The study and the tumour marker's
      development supported, in recent years, the introduction of new diagnostic
      methods that include the utilization of monoclonal localization of the tumour
      mass.

PMID- 7788815
TI  - [Dysplasia and colorectal neoplasms in a group of patients with ulcerative
      rectocolitis (URC)].
AB  - In our Medical Department we examined 74 patients with ulcerative colitis between
      January 1987 and December 1992. All the patients have been controlled by
      colonoscopy and multiple rectal byopsies. As started by different studies, the
      ulcerative colitis is predictive of mucosal dysplasia alterations and colo-rectal
      carcinoma. Our experience confirms that the occurrence is not so high as reported
      by some preliminary studies. These results could probably attributed to better
      diagnostic and therapeutic strategies now available.

PMID- 7788817
TI  - [General international bibliography: colorectal carcinoma (1994)].

PMID- 7788816
TI  - [Nuclear DNA in neoplastic pathology of the thyroid gland].
AB  - We have analysed the nuclear DNA content in a series of 33 thyroid tumours (18
      carcinomas and 15 adenomas) and, for comparison, in 189 nodular strumas and 17
      tissue samples of normal thyroids, calculating cell cycle parameters and presence
      of aneuploid DNA. Cell suspensions were prepared for each of three tissue
      fragments taken for different areas of the surgical specimens. Cell
      subpopulations with aneuploid DNA content were present in 39% of carcinomas, 27%
      of adenomas, 20% of strumas, but were absent in the samples from normal thyroids.
      The presence of hyperdiploid DNA was much more frequent than that of hypodiploid
      DNA in all pathologic tissues. The mean proliferation index was 14.1 in the
      carcinomas, 6.6 in the adenomas, 7.1 in the strumas and 6.1 in normal thyroid
      tissues. The percent of histograms with a coefficient of variation of the G0-G1
      peak greater than 5 was highest in the carcinomas (26%). The significance and
      implications of the reported data are discussed for the interpretation of thyroid
      neoplastic pathologies.

PMID- 7788818
TI  - Early diagnosis of colorectal cancer.
AB  - It is reasonable to suggest that survival in colorectal cancer is closely linked
      to the anatomical stage of the tumour, implying that detection and removal of
      less advanced cancers will lead to a prolongation of survival. Early diagnosis of
      colorectal cancer therefore should be an important goal to strive for. An effort
      to achieve early diagnosis may be based on identification of high risk patients,
      and screening of groups at intermediate risk of developing colorectal cancer.
      Patients with well defined precancerous conditions should be included in
      surveillance programme. Prophylactic surgical treatment should be considered in
      longstanding ulcerative colitis and familial polyposis syndrome. Improved methods
      of genetic mapping and identification of the genetic defects that predisposed to
      cancer will probably be of great importance in the future. To reach groups of the
      population for early diagnosis of colorectal cancer large-scale screening is
      probably necessary. A change towards less advanced cancers is likely to be the
      result of mass screening. Improved survival with acceptable cost-benefit ratio
      remains to be shown.

PMID- 7788819
TI  - [Reedition of the first Bulletin of the Society of Medical Sciences].

PMID- 7788820
TI  - Are antiemetics cost-effective for children?

PMID- 7788821
TI  - The Virtual Anesthesiology Training Simulation System.

PMID- 7788822
TI  - Nitrous oxide does not increase vomiting in children after myringotomy.
AB  - The aim of this study was to establish whether nitrous oxide has a clinically
      important effect on postoperative vomiting in children after myringotomy. We
      studied 320 healthy children of ages 0.5-13 yr undergoing elective myringotomy
      and tube insertion. Induction and maintenance of anaesthesia were randomized to
      inhalation with either 70% N2O/30% O2/halothane or 100%O2/halothane. Surgical
      technique and postoperative management were not influenced by this study.
      Vomiting in the recovery room (PAR) and Day Care Surgical Unit (DCSU) was
      recorded by nurses unaware of the anaesthetic technique. Parents were contacted
      24-48 hr after surgery to ascertain the incidence of vomiting after discharge.
      The groups were similar with respect to demographic data, except that the
      anaesthesia time was greater among the 158 patients in the N2O-treated group (11
      +/- 4 vs 12 +/- 4 min, mean +/- SD). The incidence of vomiting was 13% in both
      groups. Most of the 42 patients that had emesis only vomited once or twice. The
      incidence of vomiting was not altered by sex (13% vs 13%) or duration of
      anaesthesia. The incidence of vomiting increased with increasing age. The
      children aged less than 3 yr vomited 4% of the time, those aged 3-5 vomited 11%
      of the time, those aged 6-8 yr vomited 17% of the time, while the incidence of
      vomiting among those aged 9-13 yr was 31%. Vomiting prolonged the postoperative
      hospital stay from 75 to 92 min, P < 0.001, ANOVA. In summary, we have been
      unable to demonstrate that N2O induces vomiting by children after a brief general
      anaesthetic for myringotomy.

PMID- 7788823
TI  - Oral ondansetron decreases vomiting after tonsillectomy in children.
AB  - Vomiting is a common, unpleasant aftermath of tonsillectomy in children.
      Intraoperative intravenous ondansetron (OND) reduces vomiting after this
      operation. Our double-blind, placebo-controlled, randomized investigation studied
      the effect of the oral form of OND on vomiting after outpatient tonsillectomy in
      children. We studied 233 healthy children age 2-14 yr undergoing elective
      tonsillectomy. Subjects were given placebo (PLAC) or OND 0.1 mg.kg-1 rounded off
      to the nearest 2 mg one hr before surgery. Anaesthesia was induced with either
      propofol or halothane/N2O. Vecuronium 0.1 mg.kg-1 was administered at the
      discretion of the anaesthetist. Anaesthesia was maintained with halothane/N2O, 50
      micrograms.kg-1 midazolam iv and 1-1.5 mg.kg-1 codeine im. At the end of surgery,
      residual neuromuscular blockade was reversed with neostigmine and atropine. All
      episodes of in-hospital emesis were recorded by nursing staff. Rescue antiemetics
      in the hospital were 1 mg.kg-1 dimenhydrinate iv for vomiting x 2 and 50
      micrograms.kg-1 droperidol iv for vomiting x 4. Parents kept a diary of emesis
      after discharge. Postoperative pain was treated with morphine, codeine and/or
      acetaminophen. The two groups were similar with respect to demographic data,
      induction technique and anaesthesia time. Oral OND (n = 109) reduced
      postoperative emesis from 54% to 39%, P < 0.05. This effect was most dramatic in
      hospital, where 10% of the OND-patients and 30% of the PLAC-group vomited, P <
      0.05. The OND-subjects required fewer rescue antiemetics, 7% vs 17%, P < 0.05. In
      conclusion, oral ondansetron decreased the incidence of vomiting after outpatient
      tonsillectomy in children.

PMID- 7788824
TI  - Incidence of malignant hyperthermia reactions in 2,214 patients undergoing muscle
      biopsy.
AB  - To determine the incidence of malignant hyperthermia (MH) reactions after trigger
      free anaesthesia in a large population of MH-susceptible (MHS) patients, the
      charts of 2,214 patients who underwent elective muscle biopsy for malignant
      hyperthermia were reviewed. Either general or regional anaesthesia with non
      triggering drugs was used. For general anaesthesia, the trachea was intubated in
      the absence of muscle relaxants. The halothane/caffeine contracture test was
      performed on the biopsied muscle. Suspected MH reactions were identified
      according to their site of occurrence (in the operating room, recovery room or
      ward). Ninety-seven percent of patients received a general anaesthetic; 3%
      received a regional anaesthetic or field block. Of the 2214 patients whose
      muscles were biopsied, 1082 patients were biopsy-positive for MH. Five patients
      in whom MH reactions were diagnosed in the recovery room were all subsequently
      proved to be biopsy-positive for MH. Four of the five received intravenous
      dantrolene as part of their therapy; the fifth received only symptomatic therapy
      as parenteral dantrolene was not commercially available. All patients recovered
      completely from their reactions. We conclude that the incidence of MH reactions
      in biopsy-positive patients who receive a trigger-free anaesthetic for minor
      surgery is small (0.46%, (0.15-1.07%, 95% CI)). These reactions occur in the
      immediate postoperative period.

PMID- 7788825
TI  - Self-administered intranasal meperidine for postoperative pain management.
AB  - Recent studies have demonstrated that intranasal is comparable to intravenous
      opioid titration in its pain-relieving effect. In these studies, however, the
      intranasal opioid titration was performed by the investigator, and the treatment
      period was two hours or less. The purpose of this randomized, prospective study
      was to investigate whether intranasal opioid administration by the patients
      themselves for a prolonged postoperative period may be regarded as a therapeutic
      alternative for postoperative pain management. Forty-four orthopaedic patients
      were studied over a 12-hr period on the first day after surgery. Twenty-two had
      free access to intranasal meperidine (nasal group) and were allowed to administer
      six intranasal puffs (27 mg per dose). The next self-administration was only
      permitted after a delay of at least ten minutes. Another 22 patients received
      intermittent subcutaneous meperidine injections (25 or 50 mg) on request (sc
      group). Pain intensity was recorded at 30-min intervals with the aid of the 101
      point numerical rating scale. The pain score was lower in the nasal than in the
      sc group at the 30, 150 to 330, 420 to 480 and 540 to 600 min measuring points (P
      = < 0.05). The meperidine requirement was 112.9 +/- 81.3 mg in the nasal and
      103.4 +/- 41.5 mg in the sc group (NS). Two patients in each group complained of
      nausea and vomiting. Thirteen of the 21 nasal and nine of the 15 sc patients who
      completed the final questionnaire rated the pain management as excellent or good
      (NS).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788826
TI  - Thoracic epidural clonidine and morphine for postoperative pain relief.
AB  - This study was undertaken to evaluate the potentiation of the postoperative
      analgesic effect of thoracic epidural morphine by coadministration of thoracic
      epidural clonidine in a randomized double-blinded design. Twenty patients
      underwent radical gastrectomy under combined general anaesthesia (enflurane and
      nitrous oxide/oxygen) and epidural anaesthesia with local anaesthetics. They
      received a thoracic epidural bolus injection of either 0.05 mg.kg-1 morphine plus
      3 micrograms.kg-1 clonidine (M+C group; n = 10) or 0.05 mg.kg-1 morphine alone (M
      group; n = 10) immediately before completion of surgery. All patients received iv
      morphine via patient-controlled analgesia (PCA) equipment for 24 hr postoperative
      period, and the PCA iv consumption of morphine was the primary variable of
      efficacy of the analgesic regimen. In addition, data analyses included mean
      arterial blood pressure, heart rate, respiratory rate, arterial blood gas
      measurement, sedation score, and visual analogue pain scale score (VAS). The
      cumulative number of iv morphine injections via PCA was less in the M+C group
      than in the M group at each hour for 24 hr postoperative period (P < 0.05), while
      the numbers of PCA morphine injections per hour beyond nine hours after surgery
      were higher in the M group than in the M+C group (P < 0.05). Sedation score was
      higher, and VAS and mean blood pressure were lower in the M+C group only at one
      hour after surgery compared with the M group. We conclude that the combined
      single thoracic epidural administration of morphine plus clonidine produces a
      more potent and longer lasting analgesia than does morphine alone.

PMID- 7788827
TI  - Modification of the haemodynamic responses to induction of anaesthesia and
      tracheal intubation with alfentanil, esmolol and their combination.
AB  - The purpose of this double-blind randomized work was to study the effect of
      alfentanil and esmolol and their half-dose combination on the increases of heart
      rate and arterial pressure and on the prolongation of the QTc interval of the ECG
      occurring during anaesthetic induction. Sixty ASA class I-II patient with mean
      age ranging from 26 to 32 yr among the groups. Patients were allocated to one of
      four equal groups to receive saline, esmolol 2 mg.kg-1, alfentanil 0.03 mg.kg-1
      and alfentanil 0.015 mg.kg-1+esmolol 1 mg.kg-1. Anaesthesia was induced with
      thiopentone. Succinylcholine was used to facilitate tracheal intubation.
      Haemodynamic variables were measured non-invasively and the QTc interval with the
      aid of a microcomputer. Comparisons between the groups were performed using two
      way analysis of variance with repeated measures. Both alfentanil and alfentanil
      esmolol prevented the increase of heart rate and arterial pressure caused by
      intubation whereas esmolol prevented only the increase of the heart rate. None of
      the treatments prevented prolongation of the QTc interval after intubation and
      only alfentanil prevented that after succinylcholine. The present results suggest
      that in the prevention of the haemodynamic responses to tracheal intubation, the
      half-dose combination of alfentanil and esmolol is as effective as alfentanil and
      superior to esmolol. The combination is preferable to relatively large doses of
      either drug in circumstances where side effects, such as respiratory depression
      due to alfentanil or bradycardia due to both drugs should be minimized.

PMID- 7788829
TI  - Maternal death following epidural anaesthesia for caesarean section delivery in a
      patient with unsuspected sepsis.
AB  - Sepsis in the parturient may be difficult to recognize in light of the
      physiological changes associated with pregnancy. The purposes of this report are
      to highlight the signs and symptoms which indicate an underlying septic process
      and the management of these patients in the peripartum period. This 32-yr-old GII
      PI woman with twin gestation presented at 36 wk in labour. Her temperature was
      35.3 degrees C, she was normotensive and had a normal white blood cell count.
      After epidural anaesthesia was administered for Caesarean section, she became
      apnoeic, pulseless and unresponsive. Despite aggressive cardiopulmonary
      resuscitation, neither she nor her twin babies survived. Post mortem blood work
      revealed a considerable left shift of her white blood count (> 60% bands) and an
      anion gap acidosis. Autopsy revealed evidence of widespread Group A beta
      haemolytic streptococcal sepsis. Diagnosis of sepsis in the parturient involves
      assessment of the patient's temperature, WBC and differential and acid-base
      status. Evaluation of the intravascular volume must precede anaesthetic
      intervention. Epidural anaesthesia may be considered in the labouring and
      Caesarean section patient who has been fluid-resuscitated. Emergency operative
      delivery may result in cardiovascular compromise in the patient with severe
      sepsis.

PMID- 7788830
TI  - Alternating nitroglycerin and syntocinon to facilitate uterine exploration and
      removal of an adherent placenta.
AB  - Nitroglycerin (NTG) has been demonstrated to provide uterine relaxation in the
      management of various obstetric complications. A 32-yr-old woman presented 40 min
      postpartum for manual removal of a retained placenta. Repeated, alternating doses
      of NTG 250 micrograms and syntocinon (SYN) 10U iv were used over 15 min to
      produce periods of uterine relaxation and contraction respectively for uterine
      exploration. Multiple attempts to extract the placenta failed and a diagnosis of
      placenta accreta was made. There were no major side effects from this combination
      of drugs apart from a transient 20% decrease in blood pressure after NTG, which
      responded to ephedrine 10-15 mg iv. The rapid change in uterine tone was believed
      to be due not only to the short duration of action of NTG and SYN, but also to
      the possible physiological antagonism between the two drugs. The mechanism of
      interaction may involve calcium mobilization and myosin light chain
      phosphorylation. We conclude that NTG and SYN can be used to produce alternating
      periods of uterine relaxation and contraction rapidly and consistently with
      little sustained effects from either agents.

PMID- 7788828
TI  - Paediatric cardiac catheterization: innovations.
AB  - In recent years interventional procedures have been introduced to the field of
      paediatric cardiac catheterization. These procedures continue to develop in
      complexity and increasingly are being applied to patients with reduced
      cardiovascular reserve, as an alternative to cardiac surgery or when cardiac
      surgery with cardiopulmonary bypass is contraindicated. More frequently
      anaesthetists are being called upon to provide support in sedating,
      anaesthetizing or/and resuscitating these patients. The purpose of this review is
      to give a comprehensive update of the interventional procedures and to review the
      anaesthetic management techniques as they apply to the catheterization
      laboratory. We will discuss possible complications and management strategies from
      our own experience and the experience of others. We have observed that as more
      complicated procedures are performed the anaesthetist plays a pivotal role in the
      management of the patient from arrival to departure from the cardiac
      catheterization laboratory, and in preventing mortality and major morbidity.
      Although the economic consequences of interventional cardiological techniques
      remain unclear, the field continues to expand and more complex procedures are
      continually being introduced.

PMID- 7788831
TI  - Placental transfer of lidocaine hydrochloride after prolonged continuous maternal
      intravenous administration.
AB  - We treated a patient with arrhythmia during pregnancy with prolonged intravenous
      administration of lidocaine hydrochloride. This was a case of twin-to-twin
      transfusion syndrome and the arrhythmia was caused by ritodrine therapy. In
      total, 14.1 g lidocaine (50 mg.hr-1 for 282 hr) were used. Since there are no
      descriptions of human placental transfer of lidocaine after such a prolonged
      continuous intravenous administration, we measured lidocaine concentrations in
      maternal and fetal serum, and in the amniotic fluid (AF) at delivery. Fetal serum
      lidocaine concentrations (donor: 0.83 microgram.ml-1; recipient: 0.82
      microgram.ml-1) were lower than in the maternal serum (1.6 micrograms.ml-1),
      while the AF lidocaine concentrations (donor: 1.05 micrograms.ml-1; recipient:
      1.04 micrograms.ml-1) were higher than those of the fetal sera. The
      fetal/maternal concentration ratios of lidocaine were 0.52 for the donor and 0.51
      for the recipient, which were similar to those described previously after
      administration of lidocaine in labour.

PMID- 7788832
TI  - Pressure support ventilation with the laryngeal mask airway: a method to manage
      severe reactive airway disease postoperatively.
AB  - The use of a laryngeal mask airway (LMA) and a bi-level positive airway pressure
      (BiPAP) machine is described in a post-operative thoracotomy patient with
      reactive airway disease. The LMA was placed to avoid reintubation of the trachea
      after a double lumen tube was no longer necessary. Placement in an awakening
      patient and positive-pressure ventilatory support were well tolerated and did not
      trigger a bronchospastic response. The patient was able to cough and breathe
      deeply with the LMA while receiving ventilatory assistance in the post
      anaesthesia care unit (PACU). The LMA is a therapeutic option to tracheal
      reintubation in patients who need postoperative ventilatory support after one
      lung anaesthesia.

PMID- 7788833
TI  - Upper airway involvement in Parkinson's disease resulting in postoperative
      respiratory failure.
AB  - A 71-yr-old man with a six-year history of Parkinson's disease (PD), Type II
      diabetes mellitus, myocardial infarction, and remote 20 pack-year smoking
      history, underwent an anterior resection of the rectum for carcinoma. Sixty hours
      later, the patient suffered a respiratory arrest; his antiparkinsonian
      medications had not been resumed. Preoperative flow-volume loops showed the
      characteristic saw-tooth pattern of PD indicating dysfunction of the striated
      muscle of the upper airway. Although postoperative respiratory distress was
      managed as lower airway obstruction, at the time of intubation there were no
      signs of lower airway pathology. Upper airway dysfunction and obstruction
      secondary to PD is thought to have been a contributing factor to the
      postoperative respiratory distress and failure. This case is presented to draw
      attention to the risk of upper airway dysfunction in Parkinson's Disease,
      especially with the withdrawal of antiparkinsonian medications.

PMID- 7788835
TI  - Donald A. Warren (1899-1971).

PMID- 7788834
TI  - Canadian anaesthesia physician resource planning--is it possible?
AB  - This study was undertaken with the objective of assessing current sources of
      information for anaesthesia Physician Resource Planning (PRP). Four major data
      bases, the annual reports of Health and Welfare Canada (H&W), the education
      statistics from the Canadian Post-M.D. Education Registry (CAPER), the Royal
      College of Physicians and Surgeons of Canada (RCPSC) and the Physician Resource
      Data System of the Canadian Medical Association (PRDS), were examined for the
      period 1982 to 1991. The ratio of the number of surgical (S) to anaesthesia (A)
      clinicians decreased over this period despite an increase in the S:A ratios for
      trainees and certificants. The number of female anaesthetists has progressively
      increased. A steady decline in the number of rural anaesthetists has occurred.
      Age distribution of active certified anaesthetists revealed marked inter-regional
      differences. Little change was noted in the total mean hours worked per week.
      Each database provided valuable, but limited, data. The PRDS data is useful in
      assessing trends (age, sex and practice activity). Information provided by H&W
      tends to underestimate anaesthesia resource information by at least 10%. While
      information obtained from RCPSC and CAPER is accurate, the current mode of
      presentation of data limits their usefulness. Integrating data from all the
      databases appears to provide a meaningful assessment for PRP rather than
      assessing each database in isolation. Interpretation of the information and its
      value must take into account the limitations of the data being provided.
      Assessing present and planning future needs based on the current information
      structure will prove extremely difficult.

PMID- 7788836
TI  - Laryngeal mask airway for anaesthesia for cryopexy in low birth weight infants.

PMID- 7788837
TI  - Unusual regional block.

PMID- 7788838
TI  - Vasopressors and hypotension.

PMID- 7788839
TI  - Plasma cholinesterase deficiency in a neonate: a follow-up.

PMID- 7788841
TI  - DNA repair synthesis and DNA fragmentation in primary cultures of human and rat
      hepatocytes exposed to cyproterone acetate.
AB  - Cyproterone acetate (CPA), a synthetic steroid used in human therapy, has
      recently been shown to cause DNA damage in cultured rat hepatocytes and in rat
      liver. In the present study we have investigated whether CPA also induces
      genotoxic effects in human hepatocytes. Genotoxicity of CPA was determined by
      measuring the capability of the compound for inducing DNA repair synthesis and
      for causing the formation of DNA single-strand breaks. Autoradiography and
      alkaline elution were used to quantitate DNA repair and DNA fragmentation,
      respectively. Exposure of hepatocytes to CPA for 20 h induced DNA repair
      synthesis in two hepatocyte preparations derived from males and in four of the
      five preparations derived from females. In cultures from some donors, induction
      of repair was detected at 1 microM CPA, the lowest concentration tested. The
      maximum effect generally occurred at 10-20 microM. Only a very slight increase in
      the frequency of DNA single-strand breaks was found following exposure of the
      hepatocytes to 50 microM CPA for 20 h. For comparative purposes, the effects of
      CPA on DNA repair and DNA fragmentation were also determined in cultured rat
      hepatocytes. A strong induction of DNA repair synthesis, but only a slight
      enhancement in DNA fragmentation was observed in CPA-treated hepatocytes derived
      from female rats. These results indicate that the measurement of repair is a more
      sensitive indicator for the genotoxicity of CPA than the measurement of DNA
      fragmentation. No genotoxic effects of CPA were detectable in hepatocyte cultures
      derived from male rats. The present findings show that CPA is genotoxic in human
      hepatocytes and that the striking sex difference in the genotoxicity of CPA in
      rat cells is not observed with human cells.

PMID- 7788840
TI  - Role of GSTT1 and GSTM1 genotypes in determining individual sensitivity to sister
      chromatid exchange induction by diepoxybutane in cultured human lymphocytes.
AB  - The individual genotoxic response of cultured human lymphocytes to diepoxybutane
      (DEB), an epoxide metabolite of 1,3-butadiene, shows a bimodal distribution.
      Blood donors can be classified as either DEB-sensitive or DEB-resistant on the
      basis of the frequency of sister chromatid exchanges (SCEs) induced by DEB in
      whole-blood lymphocyte cultures. The genetic basis of this phenomenon has thusfar
      been unknown. To investigate if differences in the ability of individuals to
      detoxify DEB could explain the bimodal response, sister chromatid exchanges
      (SCEs) induced by a 48-h treatment with DEB (2 and 5 microM) were analyzed in
      whole-blood lymphocyte cultures of 20 human donors with known genotypes of two
      polymorphic glutathione S-transferases (GSTs), GSTT1 and GSTM1. Both
      polymorphisms include a homozygous null genotype lacking the respective GST gene
      and isozyme. The mean frequency of SCEs/cell was 1.6 times higher among GSTT1
      null donors (n = 8) than GSTT1 positive donors (n = 12) at both 2 microM DEB
      (mean 67.3 versus 40.9) and 5 microM DEB (mean 123.2 versus 77.5), with no
      overlapping in DEB-induced individual SCE frequencies between the two genotypes.
      Thus, all DEB-sensitive individuals were of the GSTT1 null genotype, while all
      DEB-resistant persons had a detectable GSTT1 gene. A significant (P < 0.05)
      negative correlation (r = -0.65 at 5 microM, r = -0.56 at 2 microM) was obtained
      in the GSTT1 positive donors between DEB-induced individual SCE frequency and RBC
      GSTT1 activity, measured by formaldehyde formation from dichloromethane; the
      GSTT1 null individuals showed no GSTT1 activity. At 5 microM DEB, the lymphocyte
      cultures of the GSTT1 null donors also had a significantly decreased replication
      index, indicating an impact of GSTT1 genotype on the cytotoxicity of DEB. No
      influence on DEB-induced SCEs or cytotoxic effects was observed for GSTM1
      genotype. It is concluded that sensitivity to in vitro SCE induction by DEB is
      explained by the lack of GSTT1.

PMID- 7788842
TI  - Inhibition of apoptosis during 2,3,7,8-tetrachlorodibenzo-p-dioxin-mediated
      tumour promotion in rat liver.
AB  - The effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on cell division and
      cell death (apoptosis) in glutathione S-transferase (GST-P)-positive liver foci
      were analyzed in diethylnitrosamine-initiated female Wistar rats that were
      treated with TCDD, either acutely for 3 days or chronically for 115 days.
      Apoptotic bodies were quantitated in liver sections simultaneously stained for
      GST-P expression and H&E using a novel fluorescence microscopic detection method
      which greatly facilitates recognition of apoptotic bodies due to their high level
      of eosin fluorescence. While TCDD treatment only marginally affected cell
      division in GST-P-positive liver foci, as estimated by 5-bromo-2'-deoxyuridine
      labelling, apoptotic indices were decreased to approximately 60% and
      approximately 10% of control values after acute and chronic TCDD treatment,
      respectively. In normal liver tissue, apoptotic indices were only slightly
      reduced by TCDD treatment, suggesting selective inhibition of apoptosis in the
      enzyme-altered cell population by the dioxin. Since inhibition of apoptosis in
      GST-P-positive liver foci was by far more pronounced than changes in cell
      division, our data suggest that the promoting activity of TCDD is preferentially
      mediated by a decrease of apoptosis in enzyme-altered liver foci.

PMID- 7788843
TI  - Detection of O6-methylguanine, O4-methylthymine and O4-ethylthymine in human
      liver and peripheral blood leukocyte DNA.
AB  - O6-Methylguanine, O4-methylthymine and O4-ethylthymine were determined by a
      recently developed, highly sensitive and specific method (PREPI, pre
      fractionation, 32P-post-labeling and immunoprecipitation) in human liver DNA
      obtained from 15 autopsy specimens and in 15 peripheral blood leukocyte DNA
      samples obtained from healthy volunteers. All the cases had no obvious history of
      recent occupational or therapeutic exposure to alkylating agents. In the human
      liver DNA O6-methylguanine was detected in 13 cases at levels of 1.1-6.7
      adducts/10(7) guanine; two cases were below the detection limit of approximately
      1.1 x 10(-8). O4-Methylthymine and O4-ethylthymine were detected in all the liver
      samples at levels of 0.1-14 adducts and 0.5-140 adducts/10(7) thymine
      respectively. The mean value of the ratio of O6-methylguanine to O4-methylthymine
      was about 6. Among the three DNA adducts measured there was no significant
      correlation between any two combinations of adducts. In peripheral leukocytes of
      healthy volunteers O6-methylguanine was detected at 0.7-4.6 adducts/10(8)
      guanine, this being approximately 3-6% of that in livers. Neither O4
      methylthymine nor O4-ethylthymine was above the detection limits. These results
      suggest that humans are exposed to exogenous and/or endogenous methylating and
      ethylating agents in daily life.

PMID- 7788844
TI  - Spectrum of mutations induced by methyl and ethyl methanesulfonate at the hprt
      locus of normal and tag expressing Chinese hamster fibroblasts.
AB  - This work describes the isolation and characterization of methyl methanesulfonate
      (MMS) and ethyl methanesulfonate (EMS) induced 6-thioguanine-resistant mutants in
      normal and Escherichia coli tag gene expressing Chinese hamster fibroblast, RJKO,
      cells. It was previously shown that increased removal of 3-alkylated adenine,
      effected by 3-methyladenine DNA glycosylase I (Tag), reduces the frequencies of
      hprt mutations induced by alkylating agents which produce mostly N-alkylation
      (MMS and EMS) to half the normal rate. In order to identify which type of
      mutation is suppressed by increased 3-alkyladenine repair we have determined the
      DNA base sequence changes of the hprt cDNA in 61 independent MMS- and EMS-induced
      mutant clones. For both cell types and irrespective of the agent used, the
      majority of mutations were GC to AT transitions originating in the non
      transcribed strand. Only 6/55 base substitutions occurred at AT base pairs: five
      AT to GC transitions and one AT to CG transversion. Six mutations were found to
      be deletions. These results indicate that 3-alkylated adenines in DNA are not
      directly premutagenic. The fact that the mutation frequency is reduced by
      increased 3-alkyladenine removal might be explained by postulating the existence
      in mammalian cells of an SOS-like response turned on by cytotoxic lesions like 3
      alkyladenine, or, alternatively, that increased removal of 3-alkyladenine
      increases the number of single-strand breaks in DNA, which stalls DNA replication
      and allows a prolonged time for DNA repair by the alkyltransferase.

PMID- 7788845
TI  - Aberrant expression of gap junction proteins (connexins) is associated with tumor
      progression during multistage mouse skin carcinogenesis in vivo.
AB  - To elucidate what changes in the expression of gap junction proteins (connexins)
      occur at what stages during multistage mouse skin carcinogenesis in vivo, we
      immunohistochemically and morphometrically analyzed the expression of connexin 26
      (Cx26) and connexin 43 (Cx43) in papillomas, well-, moderately- and poorly
      differentiated squamous cell carcinomas, as well as in squamous cell carcinomas
      at invasion sites and those metastasized into lymph nodes in female CD-1 mice as
      a result of treatment with dimethylbenz[a]anthracene and 12-O
      tetradecanoylphorbol-13-acetate. In papillomas, no clear reduction of the two
      connexins was observed; however, Cx26 and Cx43 were frequently co-localized in
      the same gap junction plaques, whereas the two kinds of Cxs were differentially
      expressed in normal and surrounding non-tumorous epidermis. In squamous cell
      carcinomas, the expression of both Cx26 and Cx43 significantly decreased compared
      with surrounding non-tumorous epidermis and papillomas. The Western blot analysis
      confirmed that both Cx26 and Cx43 proteins were reduced in squamous cell
      carcinomas compared with papillomas. Furthermore, the expression of Cx26 was
      reduced as cancer cells became morphologically less differentiated, while that of
      Cx43 did not change. Squamous cell carcinomas at invasive sites showed clear
      reduction of Cx26 and Cx43. In squamous cell carcinomas metastasized into lymph
      nodes, Cx26 was expressed, but few carcinoma cells expressed Cx43. The
      localization of E-cadherin on the plasma membrane between cancer cells was
      maintained even at invasive and metastatic sites. Our data suggest that
      quantitative and qualitative changes in connexin expression are associated with
      tumor progression, including the loss of differentiation, and invasion and
      metastasis, during multistage mouse skin carcinogenesis.

PMID- 7788846
TI  - DNA damage as assessed by 32P-postlabelling in three rat strains exposed to
      dietary tamoxifen: the relationship between cell proliferation and liver tumour
      formation.
AB  - Tamoxifen was administered in the diet (420 p.p.m.) to female F344 (Fischer),
      Wistar (LAC-P) and LEW (Lewis) rats to determine for each strain the early
      morphological and biochemical changes associated with the subsequent development
      of liver cancer. Hepatic DNA damage, as determined by 32P-postlabelling, showed a
      cumulative increase with time from 500 adducts/10(8) nucleotides at 30 days to
      almost 3000 adducts/10(8) nucleotides after 180 days, with little difference
      between strains at this time point. A significant strain difference was found in
      the number of adducts present in the Fischer rats at 90 days, compared to the
      Wistar and Lewis strains. There was a marked strain differences in the time to
      development of liver tumours. After 6 months treatment, both Wistar and Lewis
      rats had tumours while none were seen in the Fischer animals. After 11 months,
      all of the Wistar and Lewis rats had developed liver carcinoma, while the Fischer
      rats developed liver carcinoma by 20 months. Depression in cell proliferation,
      relative to age-matched controls, was seen in the livers of Fischer rats after
      six months of exposure to tamoxifen, in contrast to an increase in the Wistar and
      Lewis rats. This observation is consistent with the promotion of foci to tumours
      and the subsequent progression of tumours to carcinomas in the latter two
      strains. These data may assist in establishing the possible risk factors, such as
      extent of DNA damage and increased liver cell proliferation, to women with long
      term prophylactic exposure to tamoxifen.

PMID- 7788847
TI  - Transplacental transfer of environmental genotoxins: polycyclic aromatic
      hydrocarbon-albumin in non-smoking women, and the effect of maternal GSTM1
      genotype.
AB  - Transplacental transfer of genotoxic material has been determined by measuring
      the polycyclic aromatic hydrocarbon-albumin adduct level in serum isolated from
      the mother and the umbilical cord using a competitive ELISA assay and the
      antibody (8E11) against benzo[a]pyrene (B[a]P) tetrols. Smoking women (median
      5.54 fmol B[a]P equiv/microgram albumin; 21 cases) and non-smoking women living
      in rural areas (median 4.99; 30) had higher adduct levels than non-smoking women
      living in suburbia (median 4.09; 37), whereas non-smoking women living in the
      city of Aarhus had an intermediate level (median 4.82; 40). Exposure to passive
      smoking did not modify the adduct levels. When all non-smoking cases were
      combined, the transport time to/from the home became a major contributing factor
      to the adduct level. The median adduct level in umbilical cord blood was
      significantly lower than in maternal blood, the maternal/fetal ratio being
      approximately 1.3, and a positive association between the adduct levels in the
      mother and umbilical cord blood was observed. The frequency of the GSTM1 null
      genotype in the study population, females aged 19-44, was 55.4%, but the GSTM1
      genotype did not significantly alter the serum albumin adduct level. This study
      indicates that the competitive ELISA to detect B[a]P bound to serum albumin is
      sensitive enough to detect differences in the burden of genotoxic compounds in
      non-occupational exposed individuals. The lower adduct level in people living in
      suburbia suggests that local production of incomplete combustion products, like
      vehicle exhaust or heat generation, is the major contributing factor to genotoxic
      compounds in the general environment.

PMID- 7788848
TI  - Induction at high incidence of ductal prostate adenocarcinomas in NBL/Cr and
      Sprague-Dawley Hsd:SD rats treated with a combination of testosterone and
      estradiol-17 beta or diethylstilbestrol.
AB  - This study determined the incidence of prostate adenocarcinoma following long
      term treatment of NBL and Sprague-Dawley rats with estradiol-17 beta or
      diethylstilbestrol (DES) plus testosterone and it defined the origin of these
      tumors. NBL and Sprague-Dawley rats were treated with two Silastic tubing
      implants (i.d. 1.6 mm, o.d. 3.2 mm) containing a 2 cm long filling of
      testosterone and one implant containing a 1 cm long filling of estradiol-17 beta
      or DES. Control animals received empty implants. Treated animals were killed when
      moribund and controls were killed at 91 (NBL) or 75 (Sprague-Dawley) weeks after
      initiation of treatment and accessory sex glands were sampled for
      histopathological examination of multiple step sections. Prostatic adenocarcinoma
      occurred in 100% of NBL rats after treatment with estradiol-17 beta or DES plus
      testosterone for 44 and 59 weeks (group means) respectively. Adenocarcinoma
      incidences were lower in Sprague-Dawley rats. The adenocarcinomas were small,
      microscopic, invasive tumors and they were spatially closely associated with the
      periurethral ducts of the dorsal, lateral and/or anterior (= coagulating gland)
      prostate, but never with the ducts of the ventral lobe and seminal vesicles. One
      adenocarcinoma was of uncertain origin. Duct-acinar dysplastic lesions occurred
      in the periphery of the dorsal and lateral prostate of all hormone-treated NBL
      and many Sprague-Dawley rats, but did not appear to give rise to carcinoma.
      Although some adenocarcinomas were contiguous with dysplastic ducts of the
      peripheral dorsolateral prostate, the main mass of these neoplasms was located in
      the periurethral area. Also, most adenocarcinomas were only connected with the
      periurethral ducts, in which atypical hyperplasia occurred following hormone
      treatment for 36 weeks or longer. Thus atypical hyperplasia of the periurethral
      prostate ducts, but not peripheral duct-acinar dysplasia, appeared to be the
      likely precursor of the induced carcinomas. Testosterone plus DES, but not
      estradiol-17 beta, induced marked dysplasia-like lesions in the acini of the
      ventral prostate of all NBL and many Sprague-Dawley rats. These lesions had
      progressed to carcinoma in situ (or adenoma) in 46% of NBL rats.

PMID- 7788849
TI  - Rat CYP1B1: an adrenal cytochrome P450 that exhibits sex-dependent expression in
      livers and kidneys of TCDD-treated animals.
AB  - The broad spectrum of biological responses associated with exposure to 2,3,7,8
      tetrachlorodibenzo-p-dioxin (TCDD, dioxin) is believed to be due to the
      alteration in expression of TCDD-inducible genes. The aim of this study was to
      investigate the effects of TCDD on the in vivo tissue-specific expression of the
      recently identified TCDD-inducible cytochrome P450 CYP1B1 [Sutter et al. (1994)
      J. Biol. Chem., 269, 13092-13099] in Sprague-Dawley rats. We cloned the 5.0 kb
      rat homolog of CYP1B1 from a TCDD-treated rat liver cDNA library and showed that
      the rat and human CYP1B1 predicted amino acid sequences are 80% identical. RNA
      hybridization analysis showed that CYP1B1 is constitutively expressed in the
      adrenal glands and also in the testes of untreated rats. This tissue distribution
      suggests that CYP1B1 may be a physiological steroid hydroxylase. Seventy-two
      hours post-administration of 25 micrograms/kg body wt TCDD by gavage, steady
      state levels of the 5.1 kb CYP1B1 RNA were increased > 50-fold in liver, and to a
      lesser extent in kidneys, lung, heart and ovaries. Average CYP1B1 RNA levels were
      significantly higher in the kidneys and livers of TCDD-treated females than in
      those from similarly treated males. In contrast, no significant sex-difference
      was observed in the levels of CYP1A1 in these tissues in TCDD-treated animals. In
      Sprague-Dawley rats, TCDD is a more potent hepatocarcinogen in females than in
      males. The induction of CYP1B1 in TCDD rat liver may be a contributing factor to
      the carcinogenic action of this persistent environmental pollutant.

PMID- 7788850
TI  - Effects of testosterone, testosterone propionate, 17 beta-trenbolone and
      progesterone on cell transformation and mutagenesis in Syrian hamster embryo
      cells.
AB  - Testosterone, testosterone propionate, 17 beta-trenbolone and progesterone, which
      represent the main endogenous and synthetic androgens and a progestin, were
      evaluated for possible cell transformation and genetic effects in Syrian hamster
      embryo (SHE) cells. Cell growth was reduced by treatment with the steroids at 10
      30 micrograms/ml in a dose-related manner. Testosterone and testosterone
      propionate were less toxic than the other two steroids. Testosterone,
      testosterone propionate and progesterone induced morphological transformation of
      SHE cells with similar transformation frequencies. The most potent effects were
      observed with testosterone propionate, which induced cell transformation at 1-30
      micrograms/ml in a dose-related manner. Testosterone and progesterone transformed
      cells only at the highest dose (30 micrograms/ml). 17 beta-Trenbolone did not
      induce a statistically significant level of cell transformations at any dose
      tested (up to 30 micrograms/ml). The transformation frequencies induced by
      testosterone, testosterone propionate and progesterone were less than one-half
      that induced by benzo[a]pyrene at 1 microgram/ml. None of these steroids induced
      significant increases in frequencies of chromosome aberrations or aneuploidy.
      Gene mutations were not observed for testosterone at the HPRT or Na+/K+ ATPase
      locus. Because these steroids are also associated with carcinogenic activity in
      vivo, these in vitro findings provide a model and new insights into the study of
      the mechanisms of androgen- and progestin-induced cell transformation.

PMID- 7788851
TI  - Cells transfected with transferrin receptor cDNA lacking the iron regulatory
      domain become more sensitive to the DNA-damaging action of oxidative stress.
AB  - Chinese hamster V79 cells were transfected with human transferrin receptor cDNA,
      lacking the 3' untranslatable regulatory sequence. One of the clones obtained was
      investigated completely. It exhibited the cDNA sequences recombined into the
      genome, transcribed the corresponding mRNA and became partially constitutive in
      iron uptake from transferrin. The rate of iron uptake was significantly higher in
      these cells than in the parental ones, as was the intracellular iron content,
      assessed indirectly by measuring the activation of the regulatory protein
      responsible for iron homeostasis control. The transfected cells were more
      sensitive to the DNA-damaging action of H2O2. This corroborates the important
      role that iron plays as a mediator of DNA damage by reactive oxygen species. It
      also points to the possibility that mutations at the regulatory sequences of
      transferrin receptors, leading to partial disturbance in iron homeostasis, might
      render the cells more prone to further mutations and malignant transformations by
      reactive oxygen species.

PMID- 7788852
TI  - Activation of phosphorylation of plasma membrane insulin-like growth factor-I
      receptors in the kidney of Syrian hamsters by diethylstilbestrol.
AB  - In the present work we have investigated activation of phosphorylation of plasma
      membrane insulin-like growth factor-I receptors (IGF-IR) by diethylstilbestrol
      (DES). Insulin-like growth factor-I (IGF-I) stimulated the activity of membrane
      protein tyrosine kinase(s) (PTK) in both normal and DES-treated hamster kidneys.
      The level of IGF-I-stimulated PTK(s) almost doubled after 15 days of DES
      treatment. Autophosphorylation experiments revealed that phosphorylation of a 95
      kDa band (presumably the beta subunit of IGF-IR) was 2-fold higher in the
      membranes of kidney from DES-treated animals compared with controls. To
      understand the mechanism of activation of IGF-I-dependent PTK by DES, we
      investigated the relationship between the binding capacity of IGF-I to membrane
      proteins and the level of IGF-IR. The binding of [125I]IGF-I to membranes from
      the DES-treated group was 30% higher than that of age-matched normal kidney (P <
      0.001). Scatchard analysis of the binding data for both normal and DES-treated
      hamster kidney revealed a single class binding site for IGF-I with a dissociation
      constant (Kd) of 4.1 and 4.6 nM and a maximum binding capacity (Bmax) of 1786 and
      2086 fmol/200 micrograms protein respectively. Therefore, the difference observed
      in [125I]IGF-I binding between DES-treated and normal kidney membranes may be
      partially due to an increase in the number of IGF-I binding sites, with no change
      in the affinity of the receptors for IGF-I. An enhanced level of IGF-IRs in
      membranes from DES-treated animals was visualized by autoradiography following
      affinity labeling of membrane proteins subjected to SDS-PAGE. Under reducing
      conditions a molecular band of 132 kDa was evident. The 132 kDa band represents
      the alpha-subunit of IGF-IRs. Northern blot analyses revealed that DES treatment
      increased the level of IGF-IR mRNA 2-fold compared with that of controls. These
      findings suggest that an enhanced level of IGF-IR coupled with qualitative
      changes may be responsible for the activation of IGF-I-dependent PTK on DES
      exposure. Whether the stimulation of IGF-IR phosphorylation by exposure to a
      carcinogenic dose of DES may be a factor in the induction of renal cancer in
      Syrian hamsters is not clear.

PMID- 7788853
TI  - Promotion of N-nitrosodimethylamine-initiated mouse lung tumors following single
      or multiple low dose exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin.
AB  - The environmental contaminant, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), is
      highly toxic to several rodent species and may have adverse health effects in
      exposed human populations. Further, TCDD has been shown to be a potent liver
      tumor promoter in the rat after repeated administration. These studies were
      conducted to determine the tumor promoting capability of TCDD in the Swiss mouse
      following single or multiple exposures. Following tumor initiation with N
      nitrosodimethylamine (NDMA; 25 mg/kg), animals were given either a single dose
      (1.6, 16 or 48 micrograms/kg) or repeated injections (0.05 microgram/kg/week for
      20 weeks) of TCDD and sacrificed at 52 weeks of age. Neither NDMA nor TCDD caused
      an increase in incidence of liver tumors. NDMA induced lung tumors in 100% of
      animals, with 12 +/- 0.1 tumors/mouse. The multiplicity of lung tumors was
      significantly increased by low dose TCDD treatment, with 20 +/- 2.6 tumors/mouse
      following a single 1.6 micrograms/kg dose (P = 0.016) and 18 +/- 1.7 (P = 0.031)
      following repeated 0.05 microgram/kg doses (x 20). Higher doses of TCDD did not
      increase multiplicity of lung tumors and, in fact, may have been toxic to the
      lungs of NDMA-treated mice, as evidenced by the infiltration of pigmented
      macrophages. These data demonstrate the potent tumor promoting capability of TCDD
      in mouse lung.

PMID- 7788854
TI  - Dose dependence of diethylnitrosamine-induced nuclear enlargement in embryonal
      turkey liver.
AB  - Avian embryos (turkey) were exposed to diethylnitrosamine in ovo. On the first
      day of incubation doses of 0.5-5.0 mg/egg were injected into the white of the
      fertilized egg. The experiment was terminated 4 days before hatching. Livers were
      removed and prepared for subsequent histological examination. In haematoxylin and
      eosin stained sections the areas of hepatocyte nuclear profiles were measured by
      semi-automatic image analysis. In liver samples of diethylnitrosamine-exposed
      embryos hepatocyte nuclei of more than twice the size of normal hepatocyte nuclei
      were found. The incidence of the enlarged nuclei was clearly dose dependent. An
      increase in the size of hepatocyte nuclei was observed after low doses of
      diethylnitrosamine that did not induce common signs of non-specific toxic
      effects, e.g. cell death, fat vacuoles or loss of glycogen. The slope of the dose
      response curve was rather steep. A 10-fold increase in the dose of the carcinogen
      resulted in a 100-fold increase in the incidence of enlarged hepatocyte nuclei.
      In combination with preneoplastic foci of altered hepatocytes, the quantification
      of nuclear enlargement can provide a valuable complementary parameter for the
      evaluation of carcinogen-induced effects in ovo.

PMID- 7788855
TI  - Mutagenicity and specific mutation spectrum induced by 8-methoxypsoralen plus a
      low dose of UVA in the hprt gene in diploid human fibroblasts.
AB  - Exposure of cells to 8-methoxypsoralen plus a low dosage of UVA (365 nm)
      generates mainly monoadducts (PUVA-I treatment), while further irradiation of
      PUVA-I treated cells after removal of 8-methoxypsoralen (PUVA-II treatment)
      converts a high frequency of monoadducts to crosslinks. In this study, a
      comparison was made of the cytotoxicity and mutagenicity of PUVA-I-treated cells
      obtained here with those induced by PUVA-II treatment in our previous report.
      PUVA-I treatment slightly affected the colony-forming ability of cells. However,
      the 6-thioguanine-resistant cells were markedly increased from 3/10(6) clonable
      cells in UVA-irradiated populations to 47/10(6) clonable cells in PUVA-I-treated
      populations. Those results indicated that PUVA-I was more mutagenic than PUVA-II
      at equal cytotoxic doses, implying that psoralen monoadducts are less cytotoxic
      and as mutagenic as crosslinks. Mutations in the hypoxanthine (guanine)
      phosphoribosyltransferase gene of independent PUVA-I mutants were characterized
      by direct sequencing of cDNA and/or genomic DNA that were amplified by polymerase
      chain reaction. All the 30 sequenced mutants had single base substitutions. Of
      those mutations, 21 occurred in the coding region and the others were in the
      consensus sequences at exon-intron boundaries, thereby resulting in aberrant
      cDNA. The majority of base substitutions were T to A transversions (23/30); 22
      were located at the thymine of 5'TA sites. All of the 24 T.A base pair
      substitutions (including one T to C) had thymine located on the non-transcribed
      strand. Five of the six G.C base substitutions were located at the 5' TG or 5' CA
      sites on the non-transcribed strand. The frequencies of mutations at 5'TA and
      5'TG/5'CA sites were similar in PUVA-I- and PUVA-II-induced mutants. However, the
      specific kind of T.A base pair substitutions induced by PUVA-I is strikingly
      different from that induced by PUVA-II. While the transient misalignment
      realignment model could account for PUVA-II-induced T.A base substitutions, the
      low cytotoxic effect and the specific T to A substitutions of PUVA-I treatment
      might be a result of rapid incorporation of nucleotides after insertion of an
      adenine or a thymine opposite the psoralen monoadducts on the template by DNA
      polymerases.

PMID- 7788856
TI  - Effect of three tumour promoters on the stability of hepatocyte cultures and
      apoptosis after transforming growth factor-beta 1.
AB  - Tumour promoters like the anti-androgen cyproterone acetate (CPA), the peroxisome
      proliferator nafenopin (NAF) and phenobarbital (PB) stimulate liver growth in
      rodents. Transforming growth factor-beta 1 (TGF-beta 1) is expressed in livers
      after treatment with CPA (Oberhammer et al., submitted) and some peroxisome
      proliferators. In this paper we describe the influence of CPA, NAF and PB on the
      stability of hepatocyte cultures and induction of apoptosis by TGF-beta 1. All
      three tumour promoters had a stabilizing effect on confluent monolayers of
      hepatocytes, partially preventing the usually occurring dedifferentiation and
      detachment processes. CPA on its own was able to induce apoptosis at the high
      dose of 10 microM. No induction of apoptosis could be observed after PB and NAF.
      At any dose above 0.01 microM CPA enhanced TGF-beta 1-induced apoptosis (5.8-fold
      increase with 10 microM CPA). Thus the combination of 10 microM CPA and 1 ng/ml
      TGF-beta 1 induced apoptosis in 90% of the plated hepatocytes. At a high dose (10
      microM) NAF produced a 35% reduction in apoptosis induced by TGF-beta 1, in
      parallel with a stabilizing effect on cell number. PB did not affect the rate of
      apoptosis induced by TGF-beta 1. As demonstrated by immunohistochemical detection
      of PCNA, TGF-beta 1 prevented induction of PCNA by epidermal growth factor (EGF).
      No induction of PCNA was observable in CPA-treated cultures. In untreated and EGF
      treated cultures TGF-beta 1 was able to induce apoptosis to the same extent
      within 30 h. In CPA-treated cultures this period was shortened to 12 h. Thus CPA
      shortens the lag phase of induction of apoptosis by shifting hepatocytes to a
      point before S phase, where they are highly susceptible to TGF-beta 1-induced
      apoptosis.

PMID- 7788857
TI  - Anti-benzo[a]pyrene diolepoxide--DNA adduct levels in peripheral mononuclear
      cells from coke oven workers and the enhancing effect of smoking.
AB  - The level of (+/-)-r-7,t-8-dihydroxy-t-9,10-oxy-7,8,9,10-tetrahydrobenzo[a]pyrene
      (anti-BPDE) bound to DNA of lymphocytes plus monocytes in 39 coke oven workers
      exposed to polycyclic aromatic hydrocarbons (PAH) and 39 non-exposed persons
      (controls) were investigated, each of the groups consisting of smokers and non
      smokers. The adduct level was measured by an improved HPLC/fluorescence method
      (Rojas, M., Alexandrov, K., van Schooten, F. J., Hillebrand, M., Kriek, E. and
      Bartsch, H., Carcinogenesis, 15, 557-560, 1994) through the release of the
      corresponding benzo[a]pyrene (B[a]P) tetrols. The anti-BPDE-DNA adduct was
      detected in 51% of coke oven workers exposed to PAH and in 18% of the non-exposed
      (control) subjects. The mean level of anti-BPDE-DNA adducts/10(8) nucleotides in
      coke oven workers (15.7 +/- 37.8) was approximately 8 times higher than in non
      exposed subjects (2.0 +/- 8.7). The interindividual variation of adduct levels
      was approximately 100-fold in coke oven workers and approximately 50-fold in
      controls respectively. Smokers in the exposed group had 3.5 times more DNA
      adducts than non-smokers. With the exception of one non-smoker with very high
      adduct levels (52.8 adducts/10(8)), the control subjects showed the presence of
      barely detectable adducts in only 16% of the samples examined. The increased in
      vivo formation in some smokers and high variability of anti-BPDE-DNA adducts in
      coke oven workers suggests variations in genetically controlled
      activation/inactivation reactions of PAH metabolism.

PMID- 7788858
TI  - Metabolism of the food-derived carcinogen 2-amino-3,8-dimethylimidazo[4,5
      f]quinoxaline (MeIQx) in nonhuman primates.
AB  - The metabolism and disposition of the food mutagen and rodent carcinogen 2-amino
      3,8-dimethylimidazo[4,5-f]quinoxaline was investigated in cynomolgus monkeys.
      Monkeys were administered a single dose of radiolabeled [14C]MeIQx (2.2 or 50
      mumol/kg). Peak blood levels of radioactivity were observed within 1-3 h after
      dosing and declined rapidly thereafter. By 72 h after dosing, approximately 50%
      and 70% of the 2.2 mumol/kg, and 50 mumol/kg dose, respectively, was excreted in
      the urine. Approximately 15-20% of either dose was recovered in the feces. Eight
      metabolites and the parent compound were detected in urine by HPLC. The parent
      compound accounted for approximately 15-25% of the dose excreted in the urine.
      Seven MeIQx urinary metabolites were identified. Five metabolites were identical
      to MeIQx metabolites previously found in rats: MeIQx-N2-glucuronide, MeIQx-N2
      sulfamate, MeIQx-5-sulfate, MeIQx-5-O-glucuronide, and 8-CH2OH-MeIQx-5-sulfate.
      Cynomolgus monkeys, however, metabolized MeIQx to a novel glucuronide conjugate
      of MeIQx not found in rats. Based upon mass spectroscopy and proton NMR analyses,
      the structure of this metabolite was consistent with an N1-glucuronide of MeIQx.
      This metabolite was the major urinary metabolite found in monkeys, accounting for
      31-37% of the dose excreted in the urine over a 24 h period. One additional
      metabolite identified in urine and feces of MeIQx treated cynomolgus monkeys,
      that has not been found previously in any other animal model, was 7-oxo-MeIQx, a
      likely enteric bacterial metabolite of MeIQx. 7-Oxo-MeIQx accounted for 20-25% of
      the dose of MeIQx found in the urine and was the major fecal metabolite. The N2
      glucuronide conjugate of the carcinogenic metabolite 2-hydroxyamino-3,8
      dimethylimidazo[4,5-f]quinoxaline (NHOH-MeIQx) was not detected in urine or bile
      of monkeys, even after 10 daily doses of MeIQx (100 mumol/kg) were given. The
      results indicate that MeIQx is metabolically processed in monkeys via multiple
      pathways of detoxification. However, MeIQx is poorly metabolically activated via
      cytochrome P450 mediated N-oxidation. The in vivo metabolism of MeIQx in
      cynomolgus monkeys is different from that of the structurally related food
      derived mutagen 2-amino-3-methylimidazo[4,5-f]quinoline (IQ), which is readily
      metabolically activated by this species and in contrast to MeIQx, has been shown
      to be a powerful hepatic carcinogen.

PMID- 7788859
TI  - Localization of methylation sites in the human O6-methylguanine-DNA
      methyltransferase promoter: correlation with gene suppression.
AB  - Adducts of O6-alkylguanine in DNA that are induced by cytotoxic, carcinogenic or
      mutagenic alkylating agents can be removed by the DNA repair enzyme O6
      methylguanine-DNA methyltransferase (MGMT). Human tumor cell lines that do not
      express this enzyme (Mer-) are hypersensitive to the effects of such alkylating
      agents, although the molecular basis of MGMT gene suppression is not yet
      understood. Previous studies suggested that Mer- cells deficient in this enzyme
      lack neither the gene nor the trans-acting factors necessary for normal
      transcription. Methylation of CpG dinucleotides is an attractive mechanism to
      account for suppression of the MGMT gene; however, there have been reports of
      both direct and inverse correlations between methylation and MGMT expression. We
      previously demonstrated an inverse correlation between methylation at a single
      SmaI site in the human MGMT promoter and gene expression. To substantiate this
      observation, we examined additional CpGs in the promoters of three Mer+ and three
      Mer- cell lines, using rare methylation-sensitive restriction sites, and then
      sought to identify the region where methylation correlated with gene expression.
      Six CpGs in the region from -245 bp to +225 bp (relative to the transcription
      start site) were completely unmethylated in all Mer+ cells, whereas in Mer- cells
      were at least partially methylated. The methylation status of CpGs further
      upstream did not correlate with MGMT expression. We conclude, therefore, that the
      association between CpG methylation and suppressed MGMT gene activity extends to
      sites other than SmaI but is limited to a core region of the promoter.

PMID- 7788861
TI  - Expression of Ah receptor (TCDD receptor) during human monocytic differentiation.
AB  - We have previously found a high expression of human Ah receptor (TCDD receptor)
      mRNA in peripheral blood cells of individuals. In this paper, the expression of
      this gene in blood cells was first investigated in fractions of nucleated cells,
      revealing predominant expression of the Ah receptor gene in the monocyte
      fraction. Then the expression levels of AhR mRNA in various hematopoietic cell
      lines were examined together with those of Arnt and P450IA1. AhR was expressed at
      high levels in monocytoid U937, THP1, and HEL/S cells, and at moderate levels in
      promyelocytic HL60 cells and erythroblastic HEL cells. However, it was not
      detected in lymphoid cells MOLT4 (T cell) and BALL1 (B cell), nor in K562
      erythroblasts. Furthermore, a specific induction of AhR during monocytic
      differentiation was investigated in HL60 and HEL cells. HL60 cells were induced
      to differentiate toward monocytes-macrophages by incubation with phorbol ester,
      showing a 5- to 2-fold increase of AhR mRNA. The incubation with transforming
      growth factor beta 1 and 1 alpha,25-dihydroxyvitamin D3 resulted in a 5- to 7
      fold increase of AhR mRNA. The HEL cells also exhibited a similar elevation of
      AhR mRNA level, when they had differentiated toward monocyte-macrophage cells by
      these combined inducers, but little change in the mRNA level was observed when
      the cells were induced to differentiate into other cell types. Treatment of the
      differentiated HL60 cells with 3-methylcholanthrene, a ligand of AhR, induced the
      expression of the P450IA1 gene. These results indicated that expression of AhR
      mRNA was significantly induced during monocytic differentiation and that the
      differentiated cells were responsive to xenobiotics. Our results suggest that AhR
      may play an important role in the function of monocytes and also in the eventual
      activation of environmental carcinogens.

PMID- 7788860
TI  - Expression of cytochrome P450 and microsomal epoxide hydrolase in cervical and
      oral epithelial cells immortalized by human papillomavirus type 16 E6/E7 genes.
AB  - Epidemiological evidence suggests that the presence of human papillomaviruses
      (HPV), when combined with smoking behaviors, considerably enhances the risk of
      developing oral, cervical, vulvar, and/or anal carcinomas. It is well established
      that the cytochrome P450 (CYP), microsomal epoxide hydrolase (mEH), and other
      biotransformation enzymes are important modulators of the bioactivation and
      detoxification of many environmental chemicals, including constituents of tobacco
      smoke such as certain nitrosamines and polycyclic aromatic hydrocarbons (PAH).
      Since there is little information regarding oral and cervical epithelial-specific
      expression of these genes, established primary and HPV-immortalized oral and
      cervical epithelial cell lines were analyzed for morphology, mRNA and protein
      expression patterns of specific CYPs and mEH. Primary human oral and cervical
      epithelial cells were immortalized using retroviral infection with HPV-16 E6/E7
      genes. Primary human keratinocyte cells were immortalized by transfection of HPV
      18 and made tumorigenic with nitrosomethylurea treatment. Expression profiles for
      mEH, CYP1A1, CYP1A2, CYP2A6, CYP2B6, CYP2D6, CYP3A, and CYP2E1 were evaluated in
      these cultures in the presence or absence of a PAH inducer, using reverse
      transcriptase-coupled polymerase chain reaction analysis. mEH gene expression was
      evident in all cultures, while CYP2A6 mRNA was not detected in any of the cell
      lines, regardless of culture conditions. CYP2E1 mRNA expression was greatest in
      the oral epithelial cultures and detectable in all other epithelial cultures
      except for the HPV-18 immortalized keratinocyte cell line. Elevated levels of
      CYP2D6 mRNA existed in both oral epithelial cell lines and the HPV-16
      immortalized cervical epithelial cells when compared to the other cell lines
      examined. CYP1A1 and CYP1A2 mRNAs were detected in all the cells and several
      cultures were inducible by PAH exposure. To corroborate the RT/PCR data, Western
      immunoblotting experiments were conducted on selected samples. Using these
      methods, CYP1A1 and CYP2E1 proteins were detected in primary and HPV-immortalized
      oral and cervical epithelial cultures. These data indicate that both primary and
      HPV immortalized cells appear to express certain biotransformation enzymes
      necessary for the activation of tobacco-specific nitrosamines and PAHs. Although
      the overall impact of HPV gene infection on expression of these systems remains
      to be fully elucidated, as in vitro system is characterized which should prove
      useful in examining interactive mechanisms of HPV with xenobiotic activation in
      the etiology of squamous cell carcinomas.

PMID- 7788862
TI  - Metabolism of aflatoxin B1 by rabbit and rat nasal mucosa microsomes and purified
      cytochrome P450, including isoforms 2A10 and 2A11.
AB  - The nasal mucosa of some mammalian species are susceptible to the toxicity of
      aflatoxin B1 (AFB1), a potent hepatocarcinogen, but little is known about the
      nasal enzymes involved in the metabolic activation of AFB1 or the metabolites
      produced. In the present study, the metabolism of AFB1 was studied with nasal
      microsomes from rats and rabbits and with several purified isozymes of rabbit
      P450 in a reconstituted enzyme system. The rates of AFB1-N7-guanine DNA adduct
      formation with rabbit and rat nasal microsomes are over 3- and 10-fold higher,
      respectively, than with liver microsomes from the same species. On the other
      hand, the rates of formation of AFM1 (9a-hydroxy-AFB1) and AFQ1 (3-hydroxy-AFB1)
      products known to be less toxic, are lower with nasal than with liver microsomes.
      Of particular interest, nasal microsomes produce high levels of six unidentified
      polar metabolites that are not formed by microsomes from liver or several other
      tissues. These same products are also generated by P450 NMa purified from rabbit
      nasal microsomes in a reconstituted system, but not by five other isozymes of
      cytochrome P450 (1A2, 2B4, 2E1, 2G1, 3A6) that are known to be present in nasal
      microsomes. AFB1-DNA adducts are formed by P450 NMa at a rate 3-fold higher than
      that by nasal microsomes. The DNA adducts are formed at much slower rates by
      P450s 2G1, 2B4, and 1A2, and adducts are not formed at measurable rates by P450s
      2E1 and 3A6. Moreover, AFB1-DNA adduct formation is also catalyzed by cDNA
      derived, heterologously expressed P450s 2A10 and 2A11, both of which are known to
      be present in the purified P450 NMa preparation. The Km and Vmax values of the
      two isozymes for DNA adduct formation are comparable to those for nasal
      microsomes. Furthermore, the formation of AFB1-DNA adducts by nasal microsomes is
      decreased by nicotine, a known inhibitor of P450 NMa. These data indicate that
      members of the P450 2A gene subfamily play an important role in the metabolic
      activation of AFB1 in rabbit and rat nasal mucosa and suggest a molecular basis
      for assessing the health risk associated with inhalation exposure to this
      procarcinogen in humans.

PMID- 7788863
TI  - DNA adduct formation in B6C3F1 mice and Fischer-344 rats exposed to 1,2,3
      trichloropropane.
AB  - 1,2,3-Trichloropropane (TCP) is a multispecies, multisite carcinogen which has
      been found to be an environmental contaminant. In this study, we have
      characterized and measured DNA adducts formed in vivo following exposure to TCP.
      [14C]TCP was administered to male B6C3F1 mice and Fischer-344 rats by gavage at
      doses used in the NTP carcinogenesis bioassay. Both target and nontarget organs
      were examined for the formation of DNA adducts. Adducts were hydrolyzed from DNA
      by neutral thermal or mild acid hydrolysis, isolated by HPLC, and detected and
      quantitated by measurement of radioactivity. The HPLC elution profile of
      radioactivity suggested that one major DNA adduct was formed. To characterize
      this adduct, larger yields were induced in rats by intraperitoneal administration
      of TCP (300 mg/kg). The DNA adduct was isolated by HPLC based on coelution with
      the radiolabeled adduct, and compared to previously identified adducts. The
      isolated adduct coeluted with S-[1-(hydroxymethyl)-2-(N7-guanyl)
      ethyl]glutathione, an adduct derived from the structurally related carcinogen 1,2
      dibromo-3-chloropropane (DBCP). Analysis by electrospray mass spectrometry
      suggested that the TCP-induced adduct and the DBCP-derived adduct were identical.
      The 14C-labeled DNA adduct was distributed widely among the organs examined.
      Adduct levels varied depending on species, organ, and dose. In rat organs, adduct
      concentrations for the low dose ranged from 0.8 to 6.6 mumol per mol guanine and
      from 7.1 to 47.6 mumol per mol guanine for the high dose. In the mouse, adduct
      yields ranged from 0.32 to 28.1 mumol per mol guanine for the low dose and from
      12.2 to 208.1 mumol per mol guanine for the high dose. The relationship between
      DNA adduct formation and organ-specific tumorigenesis was unclear. Although
      relatively high concentrations of DNA adducts were detected in target organs,
      several nontarget sites also contained high adduct levels. Our data suggest that
      factors in addition to adduct formation may be important in TCP-induced
      carcinogenesis.

PMID- 7788864
TI  - Site specific reduction of colon cancer incidence, without a concomitant
      reduction in cryptal cell proliferation, in 1,2-dimethylhydrazine treated rats by
      diets containing 10% pectin with 5% or 20% corn oil.
AB  - The effects of specific dietary interventions on incidence of carcinogen-induced
      cancer and on cryptal cell proliferation in areas of the colon located either
      over aggregates of lymphoid nodules (ALN) or away from ALN was investigated.
      Groups of dimethylhydrazine (DMH) treated rats or non-DMH-treated rats were fed a
      basal AIN-76 diet less fiber of any type, or the basal fiber free diet
      supplemented with 10% pectin and with 5%, 10%, or 20% corn oil. The
      adenocarcinoma (AC) incidence was determined in regions of the colon, i.e.
      ascending, descending, descending over the ALN and descending away from the ALN.
      The results indicate that: (i) factors associated with ALN promote AC formation,
      (ii) dietary modifications (addition of pectin and of 20% corn oil to the diet)
      each cause significant site specific suppression of AC incidence, (iii) DMH
      treatment rendered crypts non-responsive to the suppression of cryptal cell
      proliferation which occurred in the rats not treated with DMH (suggestive of a
      DMH-induced loss in the regulation of cell proliferation) and (iv) reduction of
      AC incidence was not always accompanied by reduction in crypt cell proliferation.
      Studies of intervention procedures designed to prevent colon cancer should take
      into account the colon site specific tumorigenic response to the preventive agent
      and should not rely on a single biomarker to predict the efficacy of the
      intervention.

PMID- 7788865
TI  - Mammary carcinogenicity in female CD rats of a diol epoxide metabolite of
      fluoranthene, a commonly occurring environmental pollutant.
AB  - We examined the mammary carcinogenicity in CD rats of anti-2,3-dihydroxy-1,10b
      epoxy-10b,1,2,3-tetrahydro-fluoranthene (FDE), a genotoxic metabolite of the
      environmental pollutant fluoranthene. FDE (2 mumol or 10 mumol) in 0.1 ml
      dimethyl sulfoxide (DMSO) was injected beneath each of the three left thoracic
      nipples of groups of 20 rats each, with 0.1 ml DMSO alone being injected under
      the right nipples. On the next day, the procedure was repeated for the three
      inguinal nipples on each side. anti-3,4-Dihydroxy-1,2-epoxy-1,2,3,4
      tetrahydrobenzo[c]-phenanthrene (BcPDE, 2 mumol per nipple) was used as a
      positive control and DMSO alone as a negative control. Tumor development was
      assessed weekly by palpation and the experiment was terminated after 41 weeks.
      Eighty five percent of the rats in each of the FDE treated groups developed
      histologically confirmed mammary tumors, compared to 11% in the DMSO treated
      animals (P < 0.01). Most tumors were on the left side. The lower dose of FDE
      induced a significant number of adenomas while the higher dose induced
      significant incidences of both adenomas and adenocarcinomas compared to controls.
      BcPDE was a powerful mammary carcinogen, confirming our previous observation. The
      results of this study demonstrate the carcinogenicity of FDE to the CD rat
      mammary gland. Since FDE is a potentially transportable human metabolite of
      fluoranthene, its possible role as an etiologic factor in breast cancer deserves
      further study.

PMID- 7788866
TI  - Non-specific inhibition of cytochrome P450 activities by chlorophyllin in human
      and rat liver microsomes.
AB  - Chlorophyllin, a copper/sodium salt of chlorophyll used in the treatment of
      geriatric patients, inhibits the mutagenicity of 2-amino-3-methylimidazo[4,5
      f]quinoline (IQ), 3-amino-1-methyl-5H- pyrido[4,3-b]indole (Trp-P-2), aflatoxin
      B1 and benzo[a]pyrene (B[a]P). Recent in vitro and in vivo studies have shown
      that a molecular complex is formed between IQ and chlorophyllin, suggesting that
      this complex formation might be responsible for the antigenotoxic effect of
      chlorophyllin observed. Cytochrome P450 (P450) enzymes appear to be the major
      catalysts in the bioactivation of these carcinogens. We have investigated the in
      vitro effects of chlorophyllin on several P450 activities including
      ethoxyresorufin O-deethylation, benzyloxyresorufin O-debenzylation, coumarin 7
      hydroxylation, 7-ethoxycourmarin O-deethylation, B[a]P 3-hydroxylation, and
      chlorzoxazone 6-hydroxylation. Chlorophyllin non-specifically inhibited all of
      P450 activities observed. Spectrally detectable P450 was also destroyed in
      microsomes and purified P450 in a reconstituted system in the presence of
      chlorophyllin and an NADPH-generating system. These results suggest that the
      antigenotoxic effect of chlorophyllin might be due to inhibition of P450 enzymes
      involving bioactivation of carcinogens in addition to molecular complex formation
      between carcinogens and chlorophyllin. Comparison of the apparent Ki for P450
      inactivation with previously estimated constants for chlorophyllin-IQ
      complexation suggest that P450 inhibition should be the dominant mechanism of
      inhibition.

PMID- 7788867
TI  - Molecular regulation of atrioventricular valvuloseptal morphogenesis.
AB  - The majority of congenital heart defects arise from abnormal development of
      valvuloseptal tissue. The primordia of the valve leaflets and membranous septa of
      the heart are the cardiac cushions. Remodeling of the cushions is associated with
      a transitional extracellular matrix that includes sulfated proteoglycans and the
      microfibrillar proteins fibulin and fibrillin. Cushion formation is restricted to
      the AV canal and ventricular outflow tract regions of the primary heart tube. The
      proper placement of the cushions may be the result of the development of the
      primary heart tube as a segmented organ, as well as the subsequent looping of the
      heart. Segmentation of the heart tube may be demonstrated by the alternating
      molecular expression pattern along the longitudinal axis. In support of this
      hypothesis is the restricted expression of BMP-4 and msx-2 to the AV canal and
      ventricular outflow tract. The importance of looping for cushion positioning may
      imply that the iv and inv genes and retinoic acid are important for the proper
      patterning of the heart. The cells of the cushions evolve from endocardial cells
      that undergo an epithelial-to-mesenchymal transformation. This developmental
      event is regulated by the myocardium and is probably due to the production of
      protein complexes, present within the cardiac jelly of the cushion-forming
      regions, that consist of fibronectin and the ES proteins. Both the cushion
      mesenchyme and its endocardial cell antecedents express JB3, an ECM protein. JB3
      expression is also featured within the heart-forming fields of the primary
      mesoderm, from which the endocardial progenitors of the cushion cells
      originate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788868
TI  - Effects of Levosimendan, a cardiotonic agent targeted to troponin C, on cardiac
      function and on phosphorylation and Ca2+ sensitivity of cardiac myofibrils and
      sarcoplasmic reticulum in guinea pig heart.
AB  - A new cardiotonic agent, (R)-[[4-(1,4,5,6-tetrahydro-4-methyl-6-oxo-3
      pyridazinyl)-phenyl] hydrazono]propanedinitrile (Levosimendan), has been
      developed and screened for its ability to bind to cardiac troponin C. In perfused
      hearts, low concentrations of 0.03 or 0.1 mumol/L Levosimendan increased +dP/dt,
      but did not affect the speed of relaxation and produced only a slight increase in
      spontaneous heart rate in the hearts perfused with 0.1 mumol/L of the drug. In
      these same hearts, perfusion with 0.03 mumol/L Levosimendan did not alter the 32P
      incorporation into troponin I or C protein, whereas a slight but significant
      increase was noted for phospholamban, with no detectable change in tissue cAMP
      levels. Administration of 0.1 or 0.3 mumol/L Levosimendan significantly increased
      myocardial cAMP levels as well as the phosphorylation of phospholamban, troponin
      I, and C protein. Levosimendan (0.03 to 10 mumol/L) reversibly increased force
      generated by detergent-extracted fiber bundles over a range of submaximally
      activating free Ca2+ concentrations with no significant effect on maximum force
      or on Ca2+ binding to myofilament troponin C. There was no direct effect of
      Levosimendan on Ca2+ uptake by vesicles of sarcoplasmic reticulum (SR). In
      contrast, under conditions optimal for cAMP-dependent phosphorylation,
      Levosimendan slightly but significantly lowered the concentration of Ca2+,
      yielding half-maximal uptake rates by the SR vesicles. Our results indicate that
      at low concentrations Levosimendan acts preferably as a Ca2+ sensitizer, whereas
      at higher concentrations its action as a phosphodiesterase inhibitor contributes
      to the positive inotropic effect.

PMID- 7788869
TI  - Alpha 1-adrenergic receptor stimulation decreases maximum shortening velocity of
      skinned single ventricular myocytes from rats.
AB  - alpha 1-Adrenergic agonists have negative inotropic effects on mammalian
      myocardium under some conditions, and biochemical experiments measuring the
      Ca(2+)-activated actomyosin ATPase activity of myofibrillar preparations suggest
      that this may result from a decrease in cross-bridge cycling rate caused by
      phosphorylation of myofilament proteins. Experiments with intact ventricular
      preparations, however, have failed to demonstrate a mechanical manifestation of a
      decrease in cycling rate. The present study examined the effect of alpha 1
      adrenergic receptor stimulation on maximum shortening velocity in skinned single
      ventricular myocytes from rats. Enzymatically isolated myocytes were incubated
      with the beta-receptor antagonist propranolol in the presence or absence of the
      alpha 1-adrenergic receptor agonist phenylephrine and were then rapidly skinned
      to preserve the phosphorylation state of myofilament proteins. The velocity of
      unloaded shortening (Vo) was determined by use of the slack-test method and
      compared between skinned control and phenylephrine-treated cells. The
      relationship between isometric tension and [Ca2+] was also assessed for each
      myocyte. Vo was significantly lower in the alpha 1-adrenergic receptor agonist
      treated cells than in the control cells, but there was no effect on Ca2+
      sensitivity of isometric tension. In addition, the myosin heavy chain isoform
      composition accounted for a significant amount of the variation in Vo within the
      treatment groups. On the basis of these and previous results we propose that
      alpha 1-adrenergic receptor stimulation inhibits cross-bridge cycling rate at the
      level of myofilament proteins by a mechanism that may involve phosphorylation of
      troponin I by protein kinase C.

PMID- 7788870
TI  - [Ca2+]i inhibition of K+ channels in canine renal artery. Novel mechanism for
      agonist-induced membrane depolarization.
AB  - The patch-clamp technique was used to examine the inhibition of delayed rectifier
      K+ channels by agents that release intracellular Ca2+. During voltage-clamp
      experiments on isolated myocytes with 4-aminopyridine (4-AP, 10 mmol/L) and
      niflumic acid (100 mumol/L) present to inhibit delayed rectifier K+ current
      (IK(dr)) and Ca(2+)-activated Cl- current (ICl(Ca)), angiotensin II (Ang II) and
      caffeine increased Ca(2+)-activated K+ current (IK(Ca)) between -25 and 80 mV (n
      = 5). Conversely, with charybdotoxin (ChTX, 100 nmol/L) and niflumic acid (100
      mumol/L) present to inhibit IK(Ca) and ICl(Ca), Ang II and caffeine only caused
      inhibition of IK(dr). Block was achieved within 15 seconds of drug application
      and was reversible upon washout (n = 5). The effects of Ang II on IK(Ca) and
      IK(dr) were inhibited by the specific Ang II receptor antagonist losartan (1
      mmol/L, n = 3). Intracellular BAPTA (10 mmol/L) also abolished the effects of Ang
      II and caffeine on both IK(Ca) and IK(dr). In current-clamp experiments, the
      application of ChTX (100 nmol/L) and niflumic acid (100 mumol/L) caused little
      change in resting membrane potential; however, subsequent application of caffeine
      (10 mmol/L) caused a 26 +/- 2.9 mV depolarization from -54 +/- 3.1 to -28 +/- 1.7
      mV (n = 6). 4-AP (10 mmol/L) blocked the caffeine-induced depolarization. When
      isolated cells were loaded with the Ca2+ indicator indo 1 (100 mumol/L), Ang II,
      caffeine, and 4-AP increased [Ca2+]i and depolarized the cells. Both Ang II and
      caffeine caused an increase in [Ca2+]i that preceded membrane depolarization,
      whereas 4-AP depolarized the cell first and then caused an increase in [Ca2+]i (n
      = 4). In inside-out patches, with 200 nmol/L ChTX in the patch pipette to block
      large-conductance Ca(2+)-activated K+ channels, a 45 +/- 7-picosiemen 4-AP
      sensitive K+ channel was identified that was sensitive to cytoplasmic Ca2+ (n =
      6). Increasing intracellular Ca2+ decreased channel opening probability
      [NxP(open), where N is the number of functional channels in a patch and P(open)
      is the opening probability] at all membrane potentials examined. At 0 mV,
      increasing Ca2+ from < 5 to 200 and 600 nmol/L free Ca2+ decreased NxP(open) by
      52 +/- 3% and 73 +/- 7%, respectively (n = 6). The decrease in opening
      probability of the delayed rectifier K+ channel resulted from a concentration-
      and voltage-dependent decrease in mean open time. The decrease in mean open time
      reflected significant decreases and increases in open and closed time constants,
      respectively.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7788871
TI  - [Ca2+]i inhibition of K+ channels in canine pulmonary artery. Novel mechanism for
      hypoxia-induced membrane depolarization.
AB  - Experiments were performed on smooth muscle cells isolated from canine pulmonary
      artery to identify the type of K+ channel modulated by hypoxia and examine the
      possible role of [Ca2+]i in hypoxic K+ channel inhibition. Whole-cell patch-clamp
      experiments revealed that hypoxia (induced by the O2 scavenger, sodium
      dithionite) reduced macroscopic K+ currents, an effect that could be prevented by
      strong intracellular buffering of [Ca2+]i. The inhibitory effects of hypoxia were
      mimicked by acute exposure of cells to caffeine and could be prevented by
      caffeine pretreatment, suggesting an important obligatory role of [Ca2+]i in
      hypoxic inhibition of K+ currents. Exposure of cells to low concentrations of 4
      aminopyridine (4-AP, 1 mmol/L) prevented hypoxic inhibition of macroscopic K+
      currents, whereas low concentrations of tetraethylammonium were without effect,
      suggesting that the target K+ channel inhibited by hypoxia is a voltage-dependent
      delayed rectifier K+ channel, which is inhibited by [Ca2+]i. Hypoxia failed to
      consistently modify the activity of large-conductance (118 picosiemens [pS] in
      physiological K+) Ca(2+)-activated K+ channels in inside-out membrane patches but
      reduced open probability of smaller-conductance (25-pS) delayed rectifier K+
      channels in cell-attached membrane patches. In inside-out membrane patches, 1
      mumol/L Ca2+ added to the cytoplasmic surface significantly reduced open
      probability of small-conductance (25-pS) 4-AP-sensitive delayed rectifier K+
      channels. Whole-cell current measurements using symmetrical K+ to increase
      driving force for small currents active near the cell's resting membrane
      potential revealed the presence of a 4-AP-sensitive K+ current that activated
      near -65 mV and was inhibited by hypoxia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788872
TI  - Two components of the delayed rectifier K+ current in ventricular myocytes of the
      guinea pig type. Theoretical formulation and their role in repolarization.
AB  - Two distinct delayed rectifier K+ currents, IKr and IKs, were found recently in
      ventricular cells. We formulated these currents theoretically and investigated
      their roles in action potential repolarization and the restitution of action
      potential duration (APD). The Luo-Rudy (L-R) model of the ventricular action
      potential was used in the simulations. The single delayed rectifier K+ current in
      the model was replaced by IKr and IKs. Our results show that IKs is the major
      outward current during the plateau repolarization. A specific block of either IKr
      or IKs can effectively prolong APD to the same degree. Therefore, either channel
      provides a target for class III antiarrhythmic drugs. In the simulated guinea pig
      ventricular cell, complete block of IKr does not result in early
      afterdepolarizations (EADs). In contrast, > 80% block of IKs results in abnormal
      repolarization and EADs. This behavior reflects the high IKs-to-IKr density ratio
      (approximately 8:1) in this cell and can be reversed (ie, IKr block can cause
      EADs) by reducing the ratio of IKs to IKr. The computed APD restitution curve is
      consistent with the experimental behavior, displaying fast APD variation at short
      diastolic intervals (DIs) and downward shift at longer DIs with the decrease of
      basic drive cycle length (BCL). Examining the ionic currents and their underlying
      kinetic processes, we found that activation of both IKr and IKs is the primary
      determinant of the APD restitution at shorter DIs, with Ca2+ current through L
      type channels (ICa) playing a minor role. The rate of APD change depends on the
      relative densities of IKr and IKs; it increases when the IKr-to-IKs density ratio
      is large. The BCL-dependent shift of restitution at longer DIs is primarily
      attributed to long-lasting changes in [Ca2+]i. This in turn causes different
      degrees of Ca(2+)-dependent inactivation of ICa and different degrees of Ca(2+)
      dependent conductance of IKs at very long DIs (> 5 s) for different BCLs. This
      BCL dependence of ICa and IKs that is secondary to long-lasting changes in
      [Ca2+]i is responsible for APD changes at long DIs and can be viewed as a "memory
      property" of cardiac cells.

PMID- 7788873
TI  - Arrhythmia and delayed recovery of cardiac action potential during reperfusion
      after ischemia. Role of oxygen radical-induced no-reflow phenomenon.
AB  - The role of reactive metabolites of oxygen, oxygen radicals (O-Rs), as mediators
      of potentially arrhythmogenic alterations in cellular electrical properties and
      contractile dysfunction of cardiac muscle during reperfusion after ischemia was
      investigated. Electrical and mechanical activities of arterially perfused guinea
      pig right ventricular walls were recorded simultaneously with intracellular
      microelectrodes and a force transducer. Preparations were maintained in Krebs
      Henseleit solution (perfusion rate, 1.5 mL/min) and subjected to 30 minutes of no
      flow ischemia followed by 60 minutes of reperfusion or pretreated with O-R
      scavengers (superoxide dismutase, 50 U/mL; catalase, 600 U/mL; and mannitol, 2
      mmol/L) for 10 to 20 minutes, followed by 30 minutes of ischemia and 60 minutes
      of reperfusion. Reperfusion in untreated preparations caused (1) depolarization
      of resting membrane potential by 8 to 10 mV and slow recovery of action potential
      duration requiring 60 minutes to attain the preischemic duration, (2)
      tachyarrhythmias and premature action potentials, (3) postischemic contractile
      dysfunction, and (4) increased coronary perfusion pressure in untreated
      preparations. Pretreatment with scavenger cocktail affected neither electrical
      nor contractile activity before or during no-flow ischemia, but it (1)
      accelerated recovery of resting membrane potential and action potential duration,
      (2) reduced the incidence of tachyarrhythmia, (3) improved contractile function,
      and (4) inhibited the rise in perfusion pressure on reflow. Reperfusion with an
      exogenous O-R-generating system containing xanthine/xanthine oxidase (X/XO, 2
      mmol/L:10 mU/mL) inhibited recovery of action potential duration and
      contractility. Treatment of normoxic arterially perfused right ventricular walls
      with X/XO caused a decline in action potential duration by approximately 20%
      within 30 minutes. In contrast, X/XO caused a 30% increase in the duration of
      action potentials in superfused papillary muscles or small strips of right
      ventricular walls over the same time period. Pretreatment with sodium
      nitroprusside (10 mumol/L) inhibited the decline in duration induced by X/XO in
      normoxic right ventricular walls but was without effect on prolongation due to
      X/XO in papillary muscles. Reperfusion with nitroprusside after no-flow ischemia
      caused (1) accelerated recovery of preischemic action potential configuration,
      (2) a significant decline in the incidence of reperfusion arrhythmias, (3)
      improved postischemic contractile performance, and (4) inhibition of the increase
      in perfusion pressure associated with reflow. The data indicate that slow
      recovery of the action potential duration caused by O-Rs in reperfusion cannot be
      explained by the direct effects of O-Rs on cardiac myocytes.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 7788874
TI  - Role of atrial contraction in diastolic pressure elevation induced by rapid
      pacing of hypertrophied canine ventricle.
AB  - The mechanism of diastolic pressure elevation induced by acute rapid pacing in
      pressure-load hypertrophied left ventricles (LVs) remains incompletely
      understood. It has been ascribed to abnormalities of coronary flow, metabolism,
      and calcium cycling. However, rapid pacing also alters the timing of atrial and
      ventricular stimulation relative to the diastolic filling period, and this could
      also influence diastolic pressures. To test the role of such mechanical factors,
      LV pressure-volume hemodynamics were measured in closed-chested anesthetized dogs
      during and after abrupt cessation of rapid atrial pacing. Twenty-one dogs were
      studied: 6 dogs with LV hypertrophy (LVH) induced by perinephritic hypertension,
      5 sham-operated normotensive dogs, and 10 acute normotensive control dogs. In LVH
      dogs, but not in sham-operated or control dogs, end-diastolic pressure rose
      progressively with increasing heart rate from 5.6 +/- 3.1 mm Hg at baseline to
      22.6 +/- 8.1 mm Hg at 220 beats per minute. In all hearts, rapid pacing shifted
      the timing of left atrial contraction so that it occurred near the onset of LV
      filling rather than at end diastole. However, in LVH hearts, early LV diastolic
      pressure and peak atrial pressure were also markedly elevated. Most striking,
      immediately after terminating the pacing, diastolic pressure declined to near
      baseline. This rapid pressure decline occurred just when atrial systole would
      have ensued and before ventricular activation would have followed had pacing
      continued. Thus, diastolic pressure elevation resolved before a change in
      ventricular pacing rate. The role of atrial contraction was further explored by
      simultaneous atrioventricular pacing. This shifted the time of atrial systole so
      that it occurred during LV isovolumic contraction, while maintaining the
      identical LV pacing rate. This change eliminated the diastolic pressure elevation
      found previously. Further analysis revealed that the pressure increase during
      rapid pacing was not due simply to partial LV filling imposed on a relaxing
      ventricle or to hypertension or an intact pericardium. These data indicate that
      mechanical effects of atrioventricular interaction play an important role in
      tachycardia-induced diastolic dysfunction in this model of LVH and can be more
      causative than ischemia or metabolic factors in this setting.

PMID- 7788875
TI  - Dithionite increases radical formation and decreases vasoconstriction in the
      lung. Evidence that dithionite does not mimic alveolar hypoxia.
AB  - Dithionite is a powerful reducing agent used to deoxygenate hemoglobin and create
      anaerobic conditions in vitro. Recently, dithionite has been used as a convenient
      means of creating "hypoxia" in experiments studying the O2 sensor in the
      pulmonary circulation and carotid body. We evaluated the hypothesis that hypoxia
      created by hypoxic ventilation and that created by dithionite have different
      effects on the pulmonary circulation. In vitro, dithionite (10(-5) to 10(-3)
      mol/L), added to oxygenated Krebs' solution, rapidly created superoxide anion in
      a dose-dependent manner. Dithionite consumed O2 in parallel with the generation
      of superoxide radical, with both processes peaking within seconds. Anoxia was
      sustained only if resupply of O2 was prevented. In isolated rat lungs (whether
      perfused with autologous blood or Krebs' solution), hypoxic ventilation alone
      lowered perfusate PO2 from approximately 140 to 40 mm Hg and decreased lung
      levels of activated oxygen species (AOS), measured by luminol-enhanced
      chemiluminescence, before the onset of hypoxic pulmonary vasoconstriction.
      Constrictor responses to angiotensin II and KCl were not impaired by intermittent
      hypoxic challenges, and lung weight did not increase. In contrast, dithionite
      impaired constrictor responses of the Krebs' solution-perfused lungs to all
      vasoconstrictors tested and increased lung weight. When given as a bolus (5 x 10(
      3) mol/L) into the pulmonary artery during normoxic ventilation, dithionite
      caused no vasoconstriction and only briefly lowered PO2 (because of constant
      resupply of O2 from the alveoli). When superimposed on hypoxic ventilation,
      dithionite further lowered PO2 from approximately 40 to approximately 0 mm Hg and
      caused additional constriction. Unlike hypoxic ventilation, dithionite increased
      AOS production. Antioxidant enzymes diminished dithionite-induced radical
      production and diminished the loss of vascular reactivity and lung edema. In
      conclusion, unlike hypoxic ventilation, dithionite causes edema and loss of
      vascular reactivity in the lung by generating superoxide anion and hydrogen
      peroxide. Hypoxia elicited by dithionite is not equivalent to authentic hypoxia
      because of the obligatory associated generation of AOS. Dithionite usage should
      not be substituted for authentic hypoxia in studies of O2 sensing.

PMID- 7788876
TI  - Transverse shear along myocardial cleavage planes provides a mechanism for normal
      systolic wall thickening.
AB  - Recent studies in humans and other species show that there is substantial
      transverse shear strain in the left ventricular myocardium, and others have shown
      transverse myocardial laminae separated by cleavage planes. We proposed that
      cellular rearrangement based on shearing along myocardial cleavage planes could
      account for > 50% of normal systolic wall thickening, since < 50% can be
      explained by increases in myocyte diameter. To test this hypothesis, we measured
      strains at two sites with different cleavage-plane anatomy in eight open-chest
      dogs. Columns of radiopaque markers were implanted in the left ventricular
      anterior free wall and septum. Markers were tracked with biplane cineradiography,
      and strains were quantified by using finite deformation techniques. Hearts were
      perfusion-fixed with glutaraldehyde, and cleavage-plane orientations at the bead
      sites were measured in three orthogonal planes. At subendocardial sites of the
      anterior left ventricular wall, where the cleavage planes approach the
      endocardium obliquely from the apical side of the surface normal in the
      longitudinal-radial plane (-67 +/- 11 degrees), systolic longitudinal-radial
      transverse shear (E23) was positive (0.14 +/- 0.08). At the septal sites where
      the subendocardial cleavage planes approach the endocardium obliquely from above
      the surface normal (44 +/- 12 degrees), E23 was negative (-0.12 +/- 0.08). The
      differences in cleavage-plane angle and E23 at the two sites were each highly
      significant (P < .0005). At both sites, the transverse shear strain accompanied
      substantial systolic wall thickening at the subendocardium (anterior, E33 = 0.44
      +/- 0.16; septum, E33 = 0.22 +/- 0.14). These data are not representative of the
      behavior in midwall and outer wall sites, where cleavage-plane orientation was
      not consistently different between anterior left ventricle and septum. Our data
      indicate that rearrangement of myocytes by slippage along myocardial cleavage
      planes is in the correct direction and of sufficient magnitude in the
      subendocardium (inner third) to account for a substantial proportion (> 50%) of
      systolic wall thickening. Furthermore, three-dimensional reconstruction of the
      myocardial laminae and local comparison with maximum strain vectors indicate that
      for the inner third of the ventricular wall the maximum shear deformation is a
      result of relative sliding between myocardial laminae.

PMID- 7788877
TI  - Binding of A1 adenosine receptor ligand [3H]8-cyclopentyl-1,3-dipropylxanthine in
      coronary smooth muscle.
AB  - Vascular smooth muscle has been reported to contain the A1 subtype of adenosine
      receptors, but the existence of such receptor(s) in coronary smooth muscle has
      not been established. In the present study, the 3H-labeled A1-selective
      antagonist [3H]8-cyclopentyl-1,3-dipropylxanthine ([3H]DPCPX) was used to
      demonstrate the specific binding in porcine coronary artery smooth muscle
      membranes. The binding was saturable with a Bmax of 6.43 +/- 1.02 fmol/mg
      protein. Scatchard analysis of the binding data provided a single binding site
      with a Kd of 0.21 +/- 0.025 nmol/L. In the competition experiments, adenosine
      receptor agonists and antagonists showed the following order of potency (nmol/L):
      S-N6-(2-endonorbornyl)adenosine (S-ENBA) 0.11 = R(-)-N6-phenylisopropyladenosine
      0.32 > DPCPX 3.2 = xanthine amine congener 2.4 = N6-cyclopentyladenosine 2.67 >
      5'-(N-ethylcarboxamido)-adenosine 7.35 >> 2-[p-(2-carboxyethyl)-phenethyl-amino]
      5'-(N-ethylcarboxamido)- adenosine 1000 > theophylline 83,000. This order of
      potency fits the criteria for the A1 adenosine receptor. S-ENBA, a highly
      selective A1 receptor agonist, was used to investigate the effect on
      isoproterenol-mediated vasorelaxation and cAMP accumulation. S-ENBA (0.1 to 10
      nmol/L) dose-dependently shifted the isoproterenol-mediated (10(-8) to 10(-5)
      mol/L) vasorelaxation to the right in vascular rings. S-ENBA (10 nmol/L)
      inhibited the basal cAMP levels by 36% and attenuated the isoproterenol (10(-5)
      mol/L)-stimulated cAMP by 25% in the coronary rings. These inhibitory effects of
      S-ENBA on isoproterenol-mediated cAMP-accumulation and vasorelaxation were
      abolished by pertussis toxin (100 ng/mL, overnight) treatment of the
      arteries.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788878
TI  - Osmotic compression of single cardiac myocytes eliminates the reduction in Ca2+
      sensitivity of tension at short sarcomere length.
AB  - According to the Frank-Starling relation, cardiac output varies as a function of
      end-diastolic volume of the ventricle. The cellular basis of the relation is
      thought to involve length-dependent variations in Ca2+ sensitivity of tension;
      ie, as sarcomere length is increased in cardiac muscle, Ca2+ sensitivity of
      tension also increases. One possible explanation for this effect is that the
      decrease in myocyte diameter as muscle length is increased reduces the lateral
      spacing between thick and thin filaments, thereby increasing the likelihood of
      cross-bridge interaction with actin. To examine this idea, we measured the
      effects of osmotic compression of single skinned cardiac myocytes on Ca2+
      sensitivity of tension. Single myocytes from rat enzymatically digested
      ventricles were attached to a force transducer and piezoelectric translator, and
      tension-pCa relations were subsequently characterized at short sarcomere length
      (SL), at the same short SL in the presence of 2.5% dextran, and at long SL. The
      pCa (-log[Ca2+]) for half-maximal tension (ie, pCa50) increased from 5.54 +/-
      0.09 to 5.65 +/- 0.10 (n = 7, mean +/- SD, P < .001) as SL was increased from
      approximately 1.85 to approximately 2.25 microns. Osmotic compression of myocytes
      at short length also increased Ca2+ sensitivity of tension, shifting tension-pCa
      relations to [Ca2+] levels similar to those observed at long length (pCa50, 5.68
      +/- 0.11). These results support the idea that the length dependence of Ca2+
      sensitivity of tension in cardiac muscle arises in large part from the changes in
      interfilament lattice spacing that accompany changes in SL.

PMID- 7788880
TI  - Acetylcholine-sensitive intracellular Ca2+ store in fresh endothelial cells and
      evidence for ryanodine receptors.
AB  - In a freshly isolated endothelial cell preparation from rabbit aorta, the
      regulation of the acetylcholine (ACh)-sensitive intracellular Ca2+ store and the
      effects of the Ca(2+)-induced Ca2+ release agonists ryanodine and caffeine were
      studied using fura 2 imaging fluorescence microscopy. ACh (10 mumol/L) caused a
      transient release of Ca2+ from an intracellular store, presumably via an inositol
      tris-phosphate-sensitive mechanism. This ACh response could be repeated in the
      presence of extracellular Ca2+ but was obtained only once in Ca(2+)-free bathing
      solution, which shows that a depleted intracellular Ca2+ store can be rapidly
      refilled from the extracellular space. Refilling can be prevented by the
      endoplasmic reticulum Ca(2+)-ATPase inhibitor cyclopiazonic acid (10 mumol/L),
      implying that Ca2+ enters the cytoplasm before accumulation in the endoplasmic
      reticulum. Ionomycin (10 mumol/L) caused a large Ca2+ release even after the ACh
      releasable store had been emptied, indicating the existence of other ACh
      insensitive stores, perhaps including the mitochondria. In one third of the cells
      studied, ACh induced oscillations in [Ca2+]i that were dependent on extracellular
      Ca2+. Also investigated were the effects of caffeine and ryanodine. In this cell
      preparation neither caffeine nor ryanodine induced a Ca2+ transient but instead
      slowly increased [Ca2+]i. It was observed that both caffeine and ryanodine were
      able to slowly deplete the ACh-sensitive store. These results indicate the
      presence of functional ryanodine receptors in native endothelial cells and
      demonstrate overlap between the caffeine and agonist-sensitive Ca2+ stores. We
      also found that caffeine was able to directly inhibit the process of ACh-induced
      Ca2+ release.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788879
TI  - Functional identification of histamine H3-receptors in the human heart.
AB  - Norepinephrine release contributes to ischemic cardiac dysfunction and
      arrhythmias. Because activation of histamine H3-receptors inhibits norepinephrine
      release, we searched for the presence of H3-receptors directly in sympathetic
      nerve endings (cardiac synaptosomes) isolated from surgical specimens of human
      atria. Norepinephrine was released by depolarization with K+. The presence of H3
      receptors was ascertained because the selective H3-receptor agonists (R) alpha
      methylhistamine and imetit reduced norepinephrine release, and the specific H3
      receptor antagonist thioperamide blocked this effect. Norepinephrine release was
      exocytotic, since it was inhibited by the N-type Ca(2+)-channel blocker omega
      conotoxin and the protein kinase C inhibitor Ro31-8220. Functional relevance of
      these H3-receptors was obtained by showing that transmural electrical stimulation
      of sympathetic nerve endings in human atrial tissue increased contractility, an
      effect blocked by propranolol and attenuated in a concentration-dependent manner
      by (R) alpha-methylhistamine. Also, thioperamide antagonized the effect of (R)
      alpha-methylhistamine. Our findings are the first demonstration that H3-receptors
      are present in sympathetic nerve endings in the human heart, where they modulate
      adrenergic responses by inhibiting norepinephrine release. Since myocardial
      ischemia causes intracardiac histamine release, H3-receptor-induced attenuation
      of sympathetic neurotransmission may be clinically relevant.

PMID- 7788881
TI  - Endothelial cell interactions with synthetic peptides from the carboxyl-terminal
      heparin-binding domains of fibronectin.
AB  - Fibronectin (FN) plays an important role in endothelial cell adhesion, spreading,
      and motility. Within FN, a number of functional domains have been identified,
      including the 33/66-kD carboxyl-terminal heparin-binding fragments, which support
      the adhesion of vascular endothelial cells. A number of synthetic peptides
      representing amino acid sequences within the 33/66-kD fragments have been shown
      to promote the adhesion, spreading, and migration of a variety of cell types. Our
      working hypothesis is that one or more of these sequences may also mediate
      vascular endothelial cell adhesion, spreading, and migration to the 33/66-kD
      fragments. In support of this hypothesis, we have demonstrated that endothelial
      cells from various sources adhered in a concentration-dependent manner to
      surfaces coated with FN, the 33/66-kD fragments, and synthetic peptides derived
      from the 33/66-kD fragments of FN. FN and the 33/66-kD fragments also promoted
      endothelial cell spreading and migration. Although each of the six synthetic
      peptides tested supported endothelial cell adhesion, only one of these peptides
      within the carboxyl-terminal heparin-binding domain (FN-C/H-V) promoted
      endothelial cell spreading and migration. Cell spreading on FN-C/H-V, as well as
      on FN and the 33/66-kD fragments, was associated with the formation of a well
      developed actin cytoskeleton and the formation of focal contacts. FN-C/H-V (but
      not scrambled FN-C/H-V) inhibited cell spreading on FN and the 33/66-kD fragments
      in a concentration-dependent manner. FN-C/H-V had a modest effect on the adhesion
      of a clonal population of rat heart endothelial cells (RHE-1A) to the 33/66-kD
      fragments of FN and no effect on RHE-1A cell adhesion to FN. These findings
      suggest that peptide FN-C/H-V is unique among this group of peptides derived from
      the 33/66-kD heparin-binding fragments of FN in its ability to promote the
      adhesion, spreading, and migration of vascular endothelial cells and further
      suggest that the sequence defined by this peptide plays an important role in
      vascular endothelial cell interactions with the 33/66-kD fragments of FN.

PMID- 7788882
TI  - Measurement of platelet-activating factor in a canine model of coronary
      thrombosis and in endarterectomy samples from patients with advanced coronary
      artery disease.
AB  - Platelet-activating factor (PAF, 1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine)
      is a potent phospholipid mediator of numerous inflammatory and thrombotic
      responses. The purpose of this study was to determine if PAF synthesis is
      elevated in damaged coronary arteries after a sustained period of cyclic flow
      variation (CFV), a phenomenon caused by alternating periods of thrombosis and
      reperfusion at sites of endothelial injury. Cyclic flow was established and
      maintained in the left anterior descending coronary arteries (LADs) of 10 dogs.
      After 8 hours of CFV, the section of damaged LAD containing the thrombus and
      control sections of the circumflex artery, carotid artery, and saphenous vein was
      excised, and the total lipids were extracted. The PAF was then purified by silica
      column chromatography and high-performance liquid chromatography and assayed by
      both a rabbit platelet bioassay and a PAF radioimmunoassay. With the platelet
      bioassay, PAF levels of 8.9 +/- 4.0 (range, 4.8 to 15.5) pg/mg wet wt were found
      in the damaged LADs from the 10 dogs. This PAF bioactivity was completely
      inhibited by a PAF receptor antagonist. When the radioimmunoassay was used,
      slightly higher PAF levels of 16.3 +/- 12.9 (range, 4.5 to 41.8) pg/mg wet wt
      were observed in the LADs. Overall, these PAF levels were 3- to 64-fold higher
      than in the control vessels when either assay method was used. Although increases
      in PAF were observed in the damaged LADs, measurements of PAF in blood samples
      taken from the LAD and the aorta (control) failed to demonstrate any site
      specific increase of PAF in the blood. In related experiments, PAF was also
      measured in 23 endarterectomy samples taken from the coronary arteries of 16
      patients with severe atherosclerosis. The PAF levels in these samples were highly
      variable (2.9 +/- 2.2 [range, 0.3 to 8.5] pg/mg wet wt) and showed no correlation
      with tissue mass, suggesting that PAF is affected by factors other than the
      simple presence of atherosclerotic tissue in the vessel. These findings provide
      direct evidence that PAF is synthesized locally at the site of endothelial injury
      during thrombosis and that PAF accumulates in the atherosclerotic plaque of some
      patients with advanced coronary artery disease.

PMID- 7788883
TI  - Localization of atrial natriuretic factor receptors in the mesenteric arterial
      bed. Comparison with angiotensin II and endothelin receptors.
AB  - Although receptors for atrial natriuretic factor (ANF) and angiotensin II (Ang
      II) have been reported in rat mesenteric arteries, both peptides induce weak
      biological responses. Endothelin-1 (ET-1) evokes a potent vasoconstriction in the
      mesenteric artery. To identify the tissue localization of ANF, Ang II, and ET-1
      receptors, radioligand binding experiments with 125I-ANF, 125I-[Sar1,Ile8]Ang II,
      and 125I-ET-1 were performed in defatted mesenteric arteries and in the
      surrounding adipose tissue. 125I-ANF binding assays in adipose tissue showed a
      single class of high-affinity binding sites (Bmax, 420 +/- 16 fmol/mg protein;
      Kd, 343 +/- 16 pmol/L). In vascular membranes, most 125I-ANF binding was
      nonspecific. The majority of receptors present in adipose tissue recognized ANF,
      C-type natriuretic peptide (CNP), and des-[Gln18,Ser19,Gly20,Leu21,Gly22]ANF-(4-
      23) (C-ANF) with close affinities, with C-ANF competing for > 98% of the binding
      sites. In adipocytes, ANF and CNP stimulated cGMP generation. cGMP production by
      mesenteric arteries was stimulated by sodium nitroprusside but not by ANF or CNP.
      Autoradiographic localization of 125I-ANF and 125I-ET-1 showed that in the case
      of ANF, most specific binding occurred in adipocytes, whereas for ET-1, specific
      binding was present in both adipose tissue and mesenteric arteries. Cross-linking
      of 125I-ANF followed by SDS-PAGE revealed two receptor species of 130 and 70 kD
      in adipose membranes and none in vascular tissue. Both were completely displaced
      by ANF, CNP, and C-ANF. 125I-[Sar1,Ile8]Ang II binding assays in adipose tissue
      exhibited a single class of binding sites (Bmax, 211 +/- 4 fmol/mg protein; Kd,
      520 +/- 10 pmol/L.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788884
TI  - Regulation of aldosterone biosynthesis by adrenal renin is mediated through AT1
      receptors in renin transgenic rats.
AB  - The transgenic (TG) rat (mREN2)27 is characterized by overexpression of the
      additional mouse Ren-2d gene in the adrenal cortex with marked suppression of
      renal renin. We have previously shown that in salt-depleted TG rats enhanced
      activation of mineralocorticoid biosynthesis is associated with selective
      stimulation of adrenal renin. To investigate whether the local renin-angiotensin
      system regulates aldosterone biosynthesis in the adrenal cortex of TG rats, we
      studied the effects of the AT1-angiotensin subtype receptor antagonist DuP 753 on
      aldosterone production in 5-week-old TG rats during salt restriction. All the
      rats (n = 56) were shifted from regular chow to a diet containing only 0.04% NaCl
      for 1 week. The AT1-receptor antagonist DuP 753 (10 mg/kg per day in drinking
      water) was administered to 27 of these rats during low-salt diet. Subgroups of
      rats were killed at 0,4, and 7 days. Low-salt diet increased both adrenal renin
      activity (from 31 +/- 3 to 77 +/- 4 and 85 +/- 2 ng angiotensin I.h-1.mg protein
      1 at 4 and 7 days, respectively; P < .001) and mRNA (by 68.4 +/- 10% and 80 +/-
      17% from baseline, P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788885
TI  - L-methionine augments mammalian myocardial contraction by sensitizing the
      myofilament to Ca2+.
AB  - L-Methionine is an essential amino acid that has been reported to have a potent
      positive inotropic effect on the mammalian myocardium. We studied the mechanisms
      of the inotropic effect in ventricular myocardium from the rabbit. In the
      isolated coronary-perfused whole heart, L-methionine in a millimolar range
      exerted concentration-dependent positive inotropic effects on the isovolumic left
      ventricle, which were associated with negative lusitropic effects (prolonged time
      course of relaxation). The chronotropic state and the coronary perfusion pressure
      were not affected. These complex effects on the isolated whole heart were not
      blocked by pretreatment with (mumol/L) propranolol 1, prazosin 1, carbachol 3,
      staurosporine 1, or [Ser1,Ile8]angiotensin II 0.1. To further study the
      subcellular mechanisms, isolated ventricular papillary muscles from the same
      species were loaded with a bioluminescent indicator, aequorin, to monitor
      [Ca2+]i. In the presence of 3 mmol/L L-methionine, the isometric tension showed a
      similar combination of the positive inotropic and negative lusitropic effects as
      observed in the whole heart. In contrast, the simultaneously recorded
      intracellular Ca2+ signals did not increase in amplitude but instead decreased.
      The [Ca2+]i-tension relation shifted to the left compared with that obtained in
      response to [Ca2+]o. In saponin (250 micrograms/mL)-treated skinned preparations,
      3 mmol/L L-methionine also shifted the force-pCa curve to the left by 0.16 pCa
      units. This is the first demonstration that an essential amino acid directly acts
      on the myofilaments and modulates their responsiveness to Ca2+, thereby producing
      a positive inotropic effect.

PMID- 7788887
TI  - Expression of a mutation causing hypertrophic cardiomyopathy disrupts sarcomere
      assembly in adult feline cardiac myocytes.
AB  - Mutations in the beta-myosin heavy chain (beta MyHC) induce hypertrophic
      cardiomyopathy (HCM), cardiac hypertrophy, and sarcomere disarray, with the
      latter being the characteristic hallmark. Thus, we sought to determine whether
      expression of mutant beta MyHC in adult feline cardiac myocytes, a species known
      to develop HCM with a phenotype identical to that in humans, induces sarcomere
      disarray. A full-length beta MyHC cDNA was cloned from a human heart cDNA
      library, and an HCM-causing mutation (Arg403Gln) was induced in the beta MyHC
      cDNA by site-directed mutagenesis using polymerase chain reaction (PCR). The
      normal and mutant beta MyHC cDNAs were cloned into p delta E1spIB shuttle vector,
      downstream from a cytomegalovirus (CMV) promoter. Replication-deficient
      recombinant adenoviral constructs (Ad5/CMV/beta MyHC-N and Ad5/CMV/beta MyHC-403)
      were generated through homologous recombination of p delta E1spIB/CMV/beta MyHC-N
      or Ad5/CMV/beta MyHC-403 and pBHG10 after cotransfection in 293 host cells.
      Infection of COS-1 cells with the beta MyHC construct resulted in the expression
      of a full-length myosin protein. Efficiency of infection of isolated adult
      cardiac myocytes was > 95%. Expression of the beta MyHC constructs into mRNA at
      48 hours after infection of feline cardiac myocytes was confirmed by reverse
      transcription-PCR. The net total protein and beta-myosin synthesis were
      determined by using the amount of incorporation of [3H]phenylalanine into total
      protein and beta-myosin, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788888
TI  - [Nationwide survey of the distribution of human parasites in China--infection
      with parasite species in human population].
AB  - The infection rate of main species of parasites and their character by first
      nationwide survey of human parasites was made. The overall infection rate of
      human intestinal parasite and the infection rate of most species of parasites
      were higher in females than that in males. The infection rate according to the
      age group, the highest infection rate was found in the group aged 5-14 years.
      With regard to the relation between parasitic infections and occupations of the
      infected persons, the highest infection rates of Ascaris lumbricoides were
      exhibited in school children, of hookworm and Clonorchis sinensis were in
      halfpeasants and halfmerchant and vegetable grower; of Trichuris trichiura were
      in fishers, of Giardia lamblia, Entamoeba histolytica and Taenia were in herdsmen
      and halfherdsmen and halfpeasants. In this survey it is also shown that each
      nationality has their main species of parasites. The family clustering of some
      main parasites were proved by some province/autonomous region/municipality.

PMID- 7788886
TI  - Functional coupling between glycolysis and sarcoplasmic reticulum Ca2+ transport.
AB  - To investigate whether the energy derived from glycolysis is functionally coupled
      to Ca2+ active transport in sarcoplasmic reticulum (SR), we determined whether
      glycolytic enzymes were associated with SR membranes and whether metabolism
      through these enzymes was capable of supporting 45Ca transport. Sealed right-side
      out SR vesicles were isolated by step sucrose gradient from rabbit skeletal and
      cardiac muscle. Intravesicular 45Ca transport was measured after the addition of
      glycolytic substrates and cofactors specific for each of the glycolytic reactions
      being studied or after the addition of exogenous ATP and was expressed as
      transport sensitive to the specific Ca(2+)-ATPase inhibitor thapsigargin. We
      found that the entire chain of glycolytic enzymes from aldolase onward, including
      aldolase, GAPDH, phosphoglycerate kinase (PGK), phosphoglyceromutase, enolase,
      and pyruvate kinase (PK), was associated with SR vesicles from both cardiac and
      skeletal muscle. Iodoacetic acid, an inhibitor of GAPDH, eliminated 45Ca
      transport supported by fructose-1,6-diphosphate, the substrate for aldolase, but
      transport was completely restored by phosphoenolpyruvate (the substrate for PK),
      indicating that both of the ATP-producing glycolytic enzymes, GAPDH/PGK and PK,
      were associated with the SR and functionally capable of providing ATP for the
      Ca2+ pump. Addition of a soluble hexokinase ATP trap eliminated 45Ca transport
      fueled by exogenous ATP but had markedly less effect on 45Ca transport supported
      by endogenously produced ATP (via glycolysis). Similarly, at very low
      concentrations of ATP and ADP (10 to 50 nmol/L), ATP that was produced
      endogenously from ADP and phosphoenolpyruvate supported 15-fold more 45Ca
      transport than ATP that was supplied exogenously at the same concentration. These
      results are consistent with functional coupling of glycolytic ATP to Ca2+
      transport and support the hypothesis that ATP generated by SR-associated
      glycolytic enzymes may play an important role in cellular Ca2+ homeostasis by
      driving the SR Ca2+ pump.

PMID- 7788889
TI  - [Research on the factors influencing the sporogonic multiplication of Plasmodium
      vivax in the mosquito vector].
AB  - Volunteers with no previous malaria history infected with northern Guangdong
      isolate of Plasmodium vivax and mosquito vector, Anopheles stephensi, were the
      objects and materials used in the research. Totally there were 16 volunteers,
      half of them were infected by mosquito-bite and another half by blood
      inoculation. Blood was drawn when parasitemia reached a certain level and the
      erythrocytic forms developed into large trophozoites. Mosquitoes fed on infected
      blood from 5 and 4 donors of the two groups gave high gland infection rate and
      high gland indices respectively, but the highest gland indices were got from
      volunteers infected by mosquito-bite. The time of blood-feeding is important,
      only those blood samples taken from the people 3 to 8 days after the first onset
      gave good sporozoite harvest and the gland infection was greatly reduced on the
      9th day. During this period (d3-8), the density of gametocyte had obvious
      influence on the intensity of mosquito infection. When the sex ratio of
      gametocyte (female:male) was 4:1 or less, the result would be good. For the
      purpose of reflecting more perfectly the circumstance of the sporogonic
      multiplication of plasmodium in the mosquito vector, we suggest the concept of
      gut/gland infection intensity which equals the product of the infection rate and
      the index of oocyst/positive gland.

PMID- 7788890
TI  - Purification of 31/32 kDa proteins of adult Schistosoma japonicum as antigens (Sj
      31/32) for ELISA and IHA.
AB  - Major diagnostic proteins of 31/32 kDa were purified from soluble adult worm
      homogenate of Schistosoma japonicum using AcA ultragel chromatography and
      additional treatments. The purity of the isolated antigenic proteins (Sj 31/32)
      was demonstrated by SDS-PAGE and Western blotting technique. The antigens showed
      a negative reaction when stained by PAS and remained active after treatment with
      sodium periodate, moving toward anode in the electrophoretic field. These
      purified antigens were used for detecting the specific antibody in sera from
      patients with schistosomiasis japonica by ELISA and IHA. As compared with SEA, Sj
      31/32 kDa was found as sensitive as but much more specific than SEA in
      immunodiagnosis.

PMID- 7788892
TI  - [Dynamics of IL-2 and IFN-gamma levels induced by sea or Con A in spleen cells of
      Schistosoma japonicum-infected mice].
AB  - The capacity of mitogen Con A and SEA-stimulated spleen cells to produce
      cytokines IFN-gamma and IL-2 was studied in S. japonicum-infected mice every two
      weeks from 0 to 14 wk after infection. The results showed that the levels of
      these two cytokines began to rise at the 4th wk after infection and reached a
      peak level at 6-8 wk, then declined to the levels similar to those pre-infection
      at 12-14 wk after infection. The IFN-gamma level reached the peak earlier than
      the IL-2 level. The dynamics of cytokine level in both mitogen and antigen
      stimulated group was similar. The results suggest that IL-2 and IFN-gamma might
      be the essential cytokines involved in egg granuloma formation in schistosomiasis
      japonica.

PMID- 7788891
TI  - [In vitro effect of metronidazole ester on Trichomonas vaginalis and Entamoeba
      histolytica].
AB  - Metronidazole ester, a new nitroimidazole drug, was synthesized by the Department
      of Physical Chemistry, School of Pharmacy, Shanghai Medical University. The
      trichomonadicidal and amoebicidal activity of metronidazole ester was evaluated
      in vitro by the cultivation of Trichomonas vaginalis and Entamoeba histolytica at
      different drug concentrations. The results indicated that the 100% lethal
      concentration for T. vaginalis and E. histolytica was 2.6 micrograms/ml and 40
      micrograms/ml, respectively after incubation with metronidazole ester for 48 h.
      In comparison with metronidazole, the effect of metronidazole ester for both
      protozoa was similar.

PMID- 7788893
TI  - [Studies on amino acid and chemical element in five species of filariae].
AB  - Five species of human and domestic animal filariae (B. m, S. d, S. l, S. e, D. i)
      after lyophilization and hydrolysis were resolved using HPLC and type WFX-IB AAS
      to determine amino acid (AA) and microelement (ME) content, respectively. The
      results showed that there were 16 and 17 AA in B. malayi and the animal filariae,
      respectively. Among AA, the total amount (microgram/mg dry wt.) was markedly
      higher in animal filariae than that in B. malayi in which the content of acidic
      and aliphatic AA was significantly higher than those of basic and aromatic AA,
      respectively. Among five ME (Zn, Cu, Fe, Mn, Cd) and two microelements (Ca, Mg)
      found in all these filariae. Zn Content was the predominant ME and Ca was much
      more than Mg.

PMID- 7788894
TI  - [Preparation and characterization of monoclonal antibodies against esterase of
      malathion-resistant Culex quinquefasciatus].
AB  - Five clones of monoclonal antibodies (McAbs) were generated from BALB/c mice
      which were activized with PPD and immunized with esterases extracted from
      malathion-resistant Culex quinquefasciatus. All 5 clones of McAbs belonged to the
      IgG1 subtype, additive index (A.I.) of every two McAbs did not exceeded 50%.
      After a 1 h of incubation, the McAbs at the titer of 1:1,000 completely inhibited
      the activity of the amplified esterases. Of 8 strains of adult mosquitoes studied
      by Western-blot assay, all exhibited the 64 kDa esterase band recognized by the
      McAbs, six (SP, FS, SH, CD, RD, RM) showed more bands of different MW (43-60
      kDa), the higher the organophosphorus resistant level, the more and the denser
      the bands. The above McAbs had little or no effect against the esterases of
      dimethrin-resistant strain and the larva stage of malathion-resistant Culex
      quinquefasciatus.

PMID- 7788895
TI  - Scanning electron microscope observation on tegumental alteration of Schistosoma
      japonicum induced by levo- and dextro-praziquantel.
AB  - When mice infected with Schistosoma japonicum for 35 d were treated ig with levo
      praziquantel (L-Pra) 150 mg.kg-1 or dextro-praziquantel (D-Pra) 150-600 mg.kg-1,
      the alterations of the worm tegument were examined by scanning electron
      microscopy within 1-24 h after administration. The results showed that L-Pra
      induced apparent and extensive damage on the worm surface including severe
      swelling, fusion, erosion and peeling of tegument accompanied by attachment of
      the host leukocytes. The discoid-like sensory structures usually showed swelling,
      deformation and collapse. With D-Pra 150 mg.kg-1, only slight damage of tegument
      was seen. When the dose was increased to 600 mg.kg-1, the damage of worm tegument
      was similar to that induced by L-Pra 150 mg.kg-1 but the intensity of the damage
      was slighter as compared to that induced by L-Pra. The results suggested that the
      actions of the 2 optical enantiomers of praziquantel were different in quantity
      but not in quality.

PMID- 7788896
TI  - [Pathological changes in the livers of rabbits infected with schistosome
      cercariae and treated with artemether or praziquantel in the early stage of
      infection].
AB  - When rabbits infected with Schistosoma japonicum cercariae for 7 d were treated
      ig with artemether (Art) 30 mg.kg-1, and repeated at 1-wk intervals (i.e. on d
      14, 21, 28 after infection) for 4 times, dead worms were found in the liver
      sections, but no egg or egg granuloma was detected. In infected rabbits treated
      repeatedly with the above-mentioned dosage of Art at 2-wk intervals (i.e. on d
      21, 35, 49) after the first dosing on d 7 after infection, few eggs and egg
      granulomas were seen occasionally. In another experiment, praziquantel (Pra) 40
      mg.kg-1 was given ig to rabbits on d 21 after infection and the same dosage was
      administered repeatedly at 1- or 2-wk intervals for 2 times, the numbers of eggs
      and egg granulomas detected in the liver sections of these 2 groups were much
      less as compared with the control. In the latter group treated at 2-wk intervals,
      only degenerated eggs and egg granulomas were detected occasionally in the liver
      sections. The results indicate that if Art or Pra was given to rabbits in the
      early stage after infection, no apparent or only slight damage of the liver
      induced by the eggs was seen due to the fact that most or even all of the female
      worms were killed.

PMID- 7788897
TI  - [Observation on antibody levels of rabbits infected with single sex cercariae of
      Schistosoma japonicum].
AB  - Nine rabbits infected with male S. japonicum cercariae (worm recovery 15-133,
      mean 53.1) and 9 rabbits infected with female cercariae (worm recovery 1-102,
      mean 36.1) were bled periodically until 1 year post-infection. The sera were
      tested by ELISA, LA and CHR for antibody detection. Results showed that the
      positive rates were 88.9%, 55.6% and 83.3%, respectively. The duration of
      positive reaction was 3-51 wk post-infection for ELISA, 4-17 wk for LA and 2-35
      wk for CHR and the fluctuated results were obtained in ELISA while positive CHR
      and LA results usually remained stable. The above-mentioned results suggest that
      antibody detection methods should not be neglected due to its sensitivity
      although antigen detection methods are considered more favorable. For the
      surveillance of schistosomiasis in endemic areas where schistosomiasis is under
      control, antibody detection methods are still worthy of recommending for case
      finding of new infections.

PMID- 7788898
TI  - [Efficacy of praziquantel combined with albendazole in the treatment of
      clonorchiasis].
AB  - This paper reported on the clinical efficacy of praziquantel-albendazole
      combination in the treatment of clonorchiasis in Guangxi. Two hundred and two
      cases were divided into three groups. The first group comprised 66 cases who were
      treated with praziquantel at 180 mg/kg bwt for three days. The second group
      consisted of 62 cases who were treated with albendazole at 90 mg/kg bwt for three
      days. In the third group, 74 cases were treated with 90 mg/kg bwt praziquantel
      plus 45 mg/kg albendazole for three days. The results showed that the negative
      conversion rates were 98.5%, 61.3% and 87.8% in groups one, two and three,
      respectively, one month after treatment. In some cases who continued to be egg
      positive, the reduction rates in faecal egg counts were 99.7%, 65.0% and 97.3%,
      respectively. Although the cure rate in group three was not as high as in group
      one, the side effects were more mild and transient and the cost of treatment
      could be reduced by 60% as compared with group one. In cases with light and
      moderate infections, the praziquantel-albendazole combination proved more
      effective. In addition, the praziquantel-albendazole combination was also highly
      effective for treating those cases who were infected with Ascaris, Trichuris or
      hookworm.

PMID- 7788899
TI  - [A clinicopathological study of eighteen autopsy cases with acquired
      toxoplasmosis].
AB  - Eighteen autopsy cases of acquired toxoplasmosis in New York City were studied.
      Seventeen cases were with acquired immunodeficiency syndrome (AIDS) and one
      patient with Hodgkin's disease. All 18 cases involved the brain and nine of them
      disseminated to the heart (8 cases), lung (4 cases), pancreas (3 cases),
      alimentary tract (2 cases) and urogenital organs (3 cases). The authors divided
      the acquired toxoplasmosis into (1) immunocompetent, (2) immunocompromised and
      (3) immunodeficient types. The autopsy findings showed that the brain, heart and
      lung were the most susceptible organs. Pseudocysts were also found in lungs and
      alimentary tract, suggesting an autoinfection by swallowing sputum containing
      Toxoplasma. Toxoplasma in the urogenital organs might become a source for sexual
      transmitted toxoplasmosis.

PMID- 7788900
TI  - [Effects of different fixatives for Trichomonas vaginalis in indirect fluorescent
      antibody test].
AB  - This paper dealt with the effects of different fixatives for Trichomonas
      vaginalis in indirect fluorescent antibody test. T. vaginalis fixed by formalin,
      methanol or alcohol displayed clear flagella. The parasites fixed by methanol and
      alcohol showed specific ring-like fluorescence with 1-2 bright dots. Antigen
      slides prepared from different Trichomonas strains, different number of parasites
      and anti-Trichomonas vaginalis McAb strains in IFA presented different results.
      Antigen slides showed the best results when using parasites at concentrations of
      1.2 x 10(6) cells/ml or 2.4 x 10(5) cells/ml. Antigen preparations stored at 4
      degrees C or -20 degrees C remained reactive throughout the experimental period
      of three months.

PMID- 7788901
TI  - [Current malaria stratification in China].
AB  - During the past 30 years since 1958 when malaria stratification was first made, a
      great change in malaria situation has occurred. The original stratification can
      not represent the current status of malaria distribution. Therefore, it needs to
      be redivided so as to provide basis for future malaria control work. Taking
      species of mosquito vector and malaria incidence as the main indices and making
      reference to the natural geographical division, the current malaria endemic area
      in China can be divided into four regions, i.e. (1) Western region: it is mostly
      a natural non-endemic area, except some limited areas with sporadic cases in
      Xinjiang Autonomous Region; (2) Northern region: the whole north-eastern and
      partial northern China belong to the areas where malaria has been basically
      eliminated; but sporadic occurrence still exist in most part of the northern
      China; (3) Central region: it is mostly a hypo-endemic area, only a small part
      has meso-endemicity; (4) Southern region: nearly 50% has meso-endemicity and the
      other 50% has hypo-endemicity. The demarcation line of natural non-endemic areas
      and the areas where malaria has been basically eliminated has been defined.

PMID- 7788902
TI  - AHA president's letter.

PMID- 7788903
TI  - Role of endogenous endothelin-1 in experimental renal hypertension in dogs.
AB  - BACKGROUND: Endothelin-1, a vasoconstrictive peptide released by endothelium, may
      be involved in the pathophysiology of hypertension. The goal of the present study
      was to evaluate the role of endogenous endothelin-1 in renal hypertension in
      dogs. The model of hypertension consisted of silk tissue wrapping of the left
      kidney, which produced hypertension associated with perinephritis after 6 to 8
      weeks. METHODS AND RESULTS: Thirty-two anesthetized open chest dogs were studied
      randomly: 8 dogs with perinephritic hypertension received the nonpeptidic ETA-ETB
      receptor antagonist bosentan (group 1); 8 other hypertensive dogs received the
      vehicle solution (group 2); 8 healthy dogs received bosentan (group 3); and 8
      healthy dogs received the vehicle solution (group 4). Bosentan was injected as an
      intravenous bolus (3 mg/kg) followed by a 1-hour infusion at a rate of 7 mg.kg
      1.h-1. In hypertensive dogs, bosentan produced a similar decrease (P = .0001) of
      both left ventricular systolic and mean aortic pressures, which averaged 38 mm Hg
      (-22% and -24%, respectively). These parameters remained unchanged with the
      vehicle solution. Left ventricular end-diastolic and left atrial pressures also
      declined significantly with bosentan (P = .0005 and P < .05, respectively). Left
      ventricular lengths tended to decrease. The other cardiovascular parameters
      (heart rate, peak [+]dP/dt, time constant of relaxation, and coronary vascular
      resistance) did not change significantly. In healthy dogs, bosentan decreased
      mean aortic pressure by 19 mm Hg (P = .004). Vehicle solution had no effect.
      Plasma endothelin-1 levels, similar under basal conditions in healthy and
      hypertensive dogs, increased 30-fold with bosentan (P = .0001). CONCLUSIONS:
      Specific endothelin-1 receptor antagonism markedly lowers blood pressure in
      experimental hypertension but is less effective on blood pressure of healthy
      animals. This suggests that endothelin-1 plays a role in the pathophysiology of
      hypertension but contributes to a lesser extent to the maintenance of normal
      blood pressure. This role of endothelin-1 is unrelated to its plasma levels. The
      increase of plasma endothelin-1 with bosentan, due either to a displacement of
      endothelin-1 from its receptor or to a feedback mechanism, does not prevent this
      blood pressure reduction.

PMID- 7788904
TI  - Basic fibroblast growth factor upregulates the expression of vascular endothelial
      growth factor in vascular smooth muscle cells. Synergistic interaction with
      hypoxia.
AB  - BACKGROUND: Vascular endothelial growth factor (VEGF) is a hypoxia-inducible
      direct angiogenic factor. Upregulation of VEGF is thought to mediate many of the
      angiogenic effects of growth factors that are not direct endothelial cell
      mitogens. Like VEGF, basic fibroblast growth factor (bFGF) is considered to
      induce angiogenesis by a direct effect on endothelial cells. This study
      investigated the possibility that bFGF may also act indirectly by regulating VEGF
      expression in vascular smooth muscle cells (VSMCs). METHODS AND RESULTS:
      Incubation of confluent and quiescent cultures of rabbit VSMCs with bFGF caused a
      time- and concentration-dependent increase in steady-state levels of VEGF mRNA,
      as analyzed by Northern blot hybridization. Exposure of VSMCs to a threshold
      hypoxic stimulus (2.5% O2) caused a modest increase in VEGF mRNA levels. However,
      the combination of 2.5% O2 with bFGF had a marked synergistic effect. This effect
      was specific for VEGF as hypoxia did not enhance bFGF-induced expression of the
      proto-oncogene c-myc. Synergistic upregulation of VEGF mRNA expression also was
      observed between hypoxia and TGF-beta 1. CONCLUSIONS: These results suggest that
      bFGF may promote angiogenesis both by a direct effect on endothelial cells and
      also indirectly by the upregulation of VEGF in VSMCs. The synergy demonstrated
      between hypoxia and either bFGF or TGF-beta 1 suggests that multiple diverse
      stimuli may interact via the upregulation of VEGF expression in VSMCs to amplify
      the angiogenic response.

PMID- 7788905
TI  - Role of endothelin-1 in beagles with dehydromonocrotaline-induced pulmonary
      hypertension.
AB  - BACKGROUND: Although plasma levels of endothelin-1 (ET-1) increase in patients
      with pulmonary hypertension (PH), its role in PH is unknown. We investigated the
      contribution of endogenous ET-1 to cardiopulmonary changes in beagles with
      dehydromonocrotaline (DMCT)-induced PH. METHODS AND RESULTS: Eight 3-month-old
      beagles were given a single injection of 3 mg/kg DMCT via the right atrium.
      During the 8 weeks after injection, the mean pulmonary arterial pressure (PAP)
      and plasma ET-1 level increased significantly from 11.6 +/- 2.3 to 35.9 +/- 7.1
      mm Hg and from 1.24 +/- 0.25 to 3.25 +/- 0.94 pg/mL, respectively. In controls,
      ET-1 infusion elevated the systemic arterial pressure (SAP) but did not alter
      PAP. In PH beagles, ET-1 infusion increased SAP, which was attenuated by FR139317
      (an endothelin type [ET] A receptor antagonist), and produced a dose-dependent
      decrease in PAP, which was attenuated by RES-701-1 (an ETB receptor antagonist).
      In PH beagles, FR139317 infusion decreased PAP, and RES-701-1 infusion increased
      PAP. Sarafotoxin S6c (an ETB agonist) infusion decreased PAP in PH beagles.
      CONCLUSIONS: These results suggest that endogenous ET-1 is elevated in PH disease
      and may mitigate PH by acting on ETB receptors.

PMID- 7788906
TI  - Heterogeneities in [K+]o and TQ potential and the inducibility of ventricular
      fibrillation during acute regional ischemia in the isolated perfused porcine
      heart.
AB  - BACKGROUND: The relation between the inducibility of ventricular fibrillation
      (VF) and heterogeneity of the extracellular potassium concentration ([K+]o) and
      of TQ potential is unknown. METHODS AND RESULTS: Data from 78 epicardial DC
      electrodes or from up to 32 intramural K+ electrodes were acquired
      simultaneously. Induction of VF was attempted with one or two ventricular
      premature beats induced in normal myocardium in isolated porcine hearts during
      (1) regional perfusion of the left anterior descending artery (LAD) with a
      normoxic, hyperkalemic solution ([K+] 6 to 19.6 mmol/L), (2) simulated ischemia,
      ie, LAD perfusion with a glucose-free, hypoxic solution ([K+] 4 to 16 mmol/L, PO2
      < 5 mm Hg, pH 6.98), and (3) regional ischemia produced by stopping LAD flow.
      During normoxic, hyperkalemic LAD perfusion, no VF could be induced (12
      interventions, 7 hearts). During simulated ischemia (27 interventions), VF could
      be induced only when [K+]o was between 8 and 13.5 mmol/L. After 5 minutes of true
      regional ischemia, more sites with [K+]o between 8 and 13.5 mmol/L were present
      than after 10 minutes. VF could be induced with 1 ventricular premature beat in
      11 of 17 interventions after 5 minutes and in 0 of 14 interventions after 10
      minutes of ischemia (P < .001). Regional simulated ischemia presents a relatively
      homogeneous condition compared with 5 minutes of regional ischemia (SD +/- SEM of
      TQ potential in LAD tissue, 0.9 +/- 0.05 versus 2.1 +/- 0.13 mV, respectively).
      True ischemia superimposed on regional simulated ischemia caused the rapid
      development of heterogeneities in [K+]o and TQ potential and caused VF after 45
      +/- 7 seconds in all interventions. Activation maps of induction of VF suggest a
      different mechanism of unidirectional block during simulated ischemia from that
      in true ischemia. CONCLUSIONS: (1) In the presence of hypoxia and acidosis, [K+]o
      between 8 and 13.5 mmol/L provides the conditions necessary for the induction of
      VF; (2) after 5 minutes of ischemia, these conditions are present in a larger
      area and inducibility of VF is higher than after 10 minutes of ischemia; and (3)
      small heterogeneities within the intermediate K(+)-concentration domain (8 to
      13.5 mmol/L) are associated with high inducibility of VF.

PMID- 7788907
TI  - Effects of load manipulations, heart rate, and contractility on left ventricular
      apical rotation. An experimental study in anesthetized dogs.
AB  - BACKGROUND: Left ventricular twist or torsion has been defined as the
      counterclockwise rotation of the ventricular apex with respect to the base during
      systole. We have recently shown that since base rotation is minimal, measurement
      of apex rotation reflects the dynamics of left ventricular (LV) twist. Since the
      mechanisms by which load and contractility affect twist are controversial, we
      aimed to determine the relation between apex rotation and volume, contractility,
      and heart rate under conditions in which dimensions and pressures were accurately
      measured. METHODS AND RESULTS: Using our optical device coupled to the LV apex,
      apex rotation was recorded simultaneously with LV pressure, ECG, LV segment
      length, and minor-axis diameters (sonomicrometry) in 12 open-chest dogs. Using
      vena caval occlusion and volume loading, a linear end-diastolic (ED) relation
      between apex rotation and LV area index was obtained (slope, 0.61 +/- 0.06
      degrees/percent change; intercept, -60.1 +/- 6.2 degrees; n = 10) that differed
      from the end-systolic (ES) relation (slope, 1.36 +/- 0.27 degree/percent change;
      intercept, -132.5 +/- 24.9 degrees; P < .005). With changes in contractility,
      afterload, or heart rate, for both ED and ES the apex rotation-volume points fell
      within the range of the relations established by changing preload, suggesting
      that volume is the major determinant of twist. Vena caval occlusion (preload and
      afterload decrease) caused an increase in amplitude of apex rotation, with
      maximal apex rotation occurring earlier in ejection. In contrast, acute volume
      loading (predominant preload increase) caused a small decrease in the amplitude
      of apex rotation, and twist relaxation was delayed into the isovolumic relaxation
      period. Likewise, with single-beat aortic occlusion (increased afterload), there
      was a slight decrease in the amplitude of apex rotation, and maximal apex
      rotation was delayed into the isovolumic relaxation period. Paired pacing
      (increased contractility) increased the total amplitude of apex rotation by 42%
      and caused a delay in untwisting until the end of the isovolumic relaxation
      period. An increase in heart rate over 150 beats per minute resulted in a
      significant decrease in the amplitude of apex rotation with a similar delay of
      twist relaxation into the isovolumic relaxation period. CONCLUSIONS: The effects
      of load, contractility, and heart rate manipulations on LV twist as measured
      throughout the cardiac cycle by the optical apex rotation method are manifested
      by changes in both the amplitude and dynamics of torsion. LV twist at ED and ES
      is primarily a function of volume; this relation appears to be unaltered by heart
      rate, afterload, and contractility. Whereas decreased load caused early
      untwisting, increases in preload, afterload, heart rate, and contractility caused
      a consistent pattern of delay in twist relaxation.

PMID- 7788908
TI  - Genetic approaches to cardiovascular disease. Supravalvular aortic stenosis,
      Williams syndrome, and long-QT syndrome.
AB  - BACKGROUND: Although family history can be an important risk factor for
      cardiovascular disease, relatively little is known about the nature of specific
      genetic risk factors. One approach to this problem is to identify and
      characterize genes responsible for inherited disorders in the hope that this
      information will also provide mechanistic insight into common forms of
      cardiovascular disease. METHODS AND RESULTS: Over the last decade, it has become
      possible to identify genes that cause human disease by use of the techniques of
      molecular genetics, specifically genetic linkage analysis, positional cloning,
      and mutational analyses. We have used these techniques to study three inherited
      cardiovascular disorders: supravalvular aortic stenosis, Williams syndrome, and
      long-QT syndrome. We have discovered that the vascular pathology of supravalvular
      aortic stenosis and Williams syndrome results from mutations involving the
      elastin gene on chromosome 7q11.23. These mutations include intragenic deletions,
      translocations, and complete deletion of the elastin gene, suggesting that a
      quantitative reduction in elastin during vascular development is pathogenically
      important. To date, only the elastin gene has proved important for supravalvular
      aortic stenosis. By contrast, genetic linkage analyses in families with long-QT
      syndrome indicate that at least four distinct genes can cause this disorder. We
      have identified three LQT loci: LQT1 on chromosome 11p15.5, LQT2 on 7q35-36, and
      LQT3 on 3p21-24. Recently, we demonstrated that mutations in a putative cardiac
      potassium channel gene, HERG, are responsible for the chromosome 7-linked form of
      long-QT syndrome, whereas mutations in the cardiac sodium channel gene SCN5A
      cause the chromosome 3-linked form of this disorder. HERG mutations and potassium
      channel biophysics suggest a dominant-negative molecular mechanism and reduced
      repolarization currents. By contrast, SCN5A mutations probably cause subtle
      alterations of cardiac sodium channel function and prolonged depolarizing
      currents. CONCLUSIONS: Molecular genetic analyses of long-QT syndrome,
      supravalvular aortic stenosis, and Williams syndrome have begun to unravel the
      mechanisms underlying these inherited disorders. Rapid genetic testing for
      Williams syndrome is now available using a simple cytogenetic test, fluorescence
      in situ hybridization, but additional work will be required for long-QT syndrome
      and autosomal-dominant supravalvular aortic stenosis. Improved diagnosis and
      mechanistic understanding of these disorders should lead to rational treatment
      and prevention.

PMID- 7788909
TI  - Images in cardiovascular medicine. Permanent pacemaker wire vegetation in the
      right atrium.

PMID- 7788910
TI  - Quantitative measurements of cardiac phosphorus metabolites in coronary artery
      disease by 31P magnetic resonance spectroscopy.
AB  - BACKGROUND: 31P metabolite measurements in the human heart by magnetic resonance
      spectroscopy (MRS) have been reported previously. By use of a method in which
      metabolite content was quantified with reference to a standard located outside
      the chest, it has become possible to measure the content of phosphocreatine (PCr)
      and ATP in vivo in the human heart. In this study, PCr and ATP contents were
      measured by 31P MRS and compared in human myocardium with reversible ischemia or
      scar diagnosed by exercise thallium scintigraphy. METHODS AND RESULTS: Forty-one
      subjects with stenosis of the left anterior descending coronary artery (> 50%)
      and 11 healthy control subjects (C) composed the present study group. Patients
      were divided into two groups on the basis of exercise 201Tl scintigraphy: a
      reversible 201Tl defect group (RD[+], n = 29) who demonstrated redistribution at
      late image and a fixed 201Tl defect group (RD[-], n = 12). While the subjects lay
      supine within the magnet, 31P MR spectra were obtained from the anterior and
      apical regions of the left ventricle by slice-selected one-dimensional chemical
      shift imaging. For metabolite quantification, a standard was placed at the center
      of the surface coil. ANOVA revealed significant differences among the three
      groups with respect to the mean (+/- SD) PCr at rest (C, 12.14 +/- 4.25 > RD[+],
      7.64 +/- 3.00 > RD[-], 3.94 +/- 2.21 mumol/g wet heart tissue, P < .05) as well
      as a significant decrease in ATP in the RD(-) group (C, 7.72 +/- 2.97; RD[+],
      6.35 +/- 3.17 > RD[-], 4.35 +/- 1.52 mumol/g wet heart tissue, P < .05).
      CONCLUSIONS: Compared with healthy control subjects, PCr content decreased
      significantly in patients with both reversible and fixed 201Tl defects, and ATP
      content decreased significantly in subjects with fixed thallium defects. These
      results suggest that the measurement of ATP content in the human heart by 31P MRS
      is a clinically important method for the evaluation of myocardial viability.

PMID- 7788911
TI  - Preventing heart attack and death in patients with coronary disease.

PMID- 7788912
TI  - 17 beta-Estradiol attenuates acetylcholine-induced coronary arterial constriction
      in women but not men with coronary heart disease.
AB  - BACKGROUND: Women are protected from coronary artery disease until the menopause.
      Ovarian hormones are vasoactive substances that influence both hemodynamic
      parameters and atheroma formation. Intravenous ethinyl estradiol has been shown
      to reverse acetylcholine-induced vasoconstriction in cynomolgus monkeys and
      humans, and 17 beta-estradiol improves exercise-induced myocardial ischemia in
      female patients. We investigated the effect of the naturally occurring estrogen
      17 beta-estradiol on the coronary circulation in postmenopausal women and men
      with coronary artery disease. METHODS AND RESULTS: We studied nine postmenopausal
      women 59 +/- 3 years old, mean +/- SEM, and seven men 52 +/- 4 years old with
      proven coronary artery disease. They underwent measurement of coronary artery
      diameter and coronary blood flow after intracoronary infusion of acetylcholine
      1.6 and 16 micrograms/min before and 20 minutes after intracoronary
      administration of 2.5 micrograms of 17 beta-estradiol into atherosclerotic,
      nonstenotic coronary arteries. Changes in coronary artery diameter were measured
      by quantitative angiography, and changes in coronary blood flow were measured
      with an intracoronary Doppler catheter. In female patients, acetylcholine 1.6 and
      16 micrograms/min caused constriction before the administration of 17 beta
      estradiol (-6 +/- 2% and -8 +/- 5%, respectively, compared with baseline). This
      constrictor response was converted to dilatation after intracoronary
      administration of 17 beta-estradiol (+8 +/- 2% and +9 +/- 3%, respectively; P <
      .01 before versus after estrogen). Acetylcholine 1.6 and 16 micrograms/min
      increased coronary blood flow before and after the infusion of 17 beta-estradiol.
      However, the mean acetylcholine-induced increases in coronary flow were
      significantly greater (P < .009) after (126 +/- 37% and 248 +/- 89%,
      respectively) than before (94 +/- 31% and 143 +/- 49% mL/min, respectively) the
      administration of 17 beta-estradiol. 17 beta-Estradiol alone had no significant
      effect on coronary diameter or coronary blood flow (P > .05). Isosorbide
      dinitrate (1 mg) caused dilatation of the coronary arteries by 11 +/- 2% (P <
      .005). In men, acetylcholine 1.6 and 16 micrograms/min caused constriction both
      before and after the administration of 17 beta-estradiol and caused similar
      increases in coronary blood flow both before and after the intracoronary
      administration of 17 beta-estradiol. Infusion of intracoronary placebo in six
      female control patients 55 +/- 3 years old and six male control patients 56 +/- 3
      years old did not change coronary diameter responses or coronary blood flow
      responses to acetylcholine. CONCLUSIONS: 17 beta-Estradiol modulates
      acetylcholine-induced coronary artery responses of female but not male
      atherosclerotic coronary arteries in vivo. These human data confirm reports from
      studies in cynomolgus monkeys that estrogen modulates the responses of
      atherosclerotic coronary arteries. An enhancement of endothelium-dependent
      relaxation by natural estrogen (as used in most hormone replacement therapy) may
      be important in postmenopausal women with established coronary heart disease and
      may contribute to the acute effect of 17 beta-estradiol on blood flow and its
      long-term protective effect on the development of coronary artery disease.

PMID- 7788913
TI  - Fibrinogen after coronary angioplasty as a risk factor for restenosis.
AB  - BACKGROUND: Fibrinogen is a risk factor for cardiovascular disease and is related
      to the severity of coronary atherosclerosis. Its role in restenosis after
      coronary angioplasty remains unknown. Although platelets and thrombosis
      contribute to the pathogenesis of restenosis, few clinical data are available
      concerning the relations between restenosis and proteins of the coagulation and
      fibrinolytic systems. METHODS AND RESULTS: In 107 consecutive patients undergoing
      coronary angioplasty, we measured plasma levels of tissue-type plasminogen
      activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), von Willebrand
      factor, and fibrinogen before and immediately after angioplasty and at a 6-month
      follow-up. The individual changes of intraluminal diameter were measured by
      quantitative coronary angiography, and patients were classified according to four
      definitions of restenosis: (1) a final stenosis > 50%, (2) a loss of minimal
      luminal diameter during the follow-up period greater than the measurement
      variability in our laboratory (> 0.52 mm), (3) a loss of at least 50% of the gain
      in luminal diameter achieved by angioplasty, and (4) the combination of
      definitions 1 and 2. The relations between coagulation variables and each
      definition of restenosis were assessed univariately; then with the clinical
      variables included, the relations were analyzed multivariately. Angiographic
      follow-up was obtained in 92% of patients with a primary success of angioplasty.
      Global restenosis rates were 38%, 43%, 48%, and 30% for definitions 1 through 4,
      respectively. Plasma levels of t-PA antigen and PAI-1 antigen were not associated
      with any of the four definitions of restenosis. Multivariate analysis
      demonstrated that von Willebrand factor measured immediately after angioplasty
      predicted restenosis according to definitions 2 and 3. Fibrinogen measured within
      6 months of follow-up was significantly increased in all restenosis groups of the
      four definitions. Patients with a fibrinogen concentration > 3.5 g/L at follow-up
      had higher restenosis rates than patients with a concentration < 3.5 g/L: 55%
      versus 22% (P = .001), 68% versus 31% (P = .002), 63% versus 37% (P = .01), and
      74% versus 26% (P = .002) for definitions 1 through 4, respectively. The loss
      index was lower (P = .003) and the net gain higher (P = .03) in patients with a
      fibrinogen level < 3.5 g/L. There was a significant correlation between
      fibrinogen level and angiographic loss index (r = .41; P < .0001). Multivariate
      analysis confirmed that the fibrinogen level predicted restenosis with all
      definitions. CONCLUSIONS: An independent relation exists between von Willebrand
      factor measured immediately after angioplasty and restenosis defined by the
      degree of intraluminal renarrowing. An elevated fibrinogen level during follow-up
      is a strong biochemical predictor of restenosis. Therefore, fibrinogen should be
      considered at least as an independent marker of restenosis and perhaps as a
      common risk factor for both spontaneous coronary atherosclerosis and
      postangioplasty restenosis, which is an accelerated form of atherosclerosis.

PMID- 7788914
TI  - Relation between myocardial fractional flow reserve calculated from coronary
      pressure measurements and exercise-induced myocardial ischemia.
AB  - BACKGROUND: Myocardial fractional flow reserve (FFRmyo) is a functional index of
      stenosis severity that can be derived from intracoronary pressure measurements
      performed during maximal vasodilatation. It is defined as the maximal myocardial
      perfusion during hyperemia in the presence of a stenosis in the epicardial artery
      expressed as a fraction of its normal maximal expected value. To determine
      threshold values of FFRmyo, of hyperemic translesional pressure gradient (delta
      P(max)), and of resting translesional pressure gradient (delta P(rest)) that are
      uniformly associated with exercise-induced ischemia, we studied the relation
      between these pressure-derived indexes and the results of exercise ECG. METHODS
      AND RESULTS: We studied 60 patients with an isolated lesion in one major
      epicardial coronary artery, normal left ventricular function, and no left
      ventricular hypertrophy. Maximal exercise ECG (off anti-ischemic medication) was
      performed within 6 hours before catheterization. Intracoronary pressure
      measurements were taken at rest and during hyperemia with a pressure monitoring
      guide wire. ST-segment depressions at peak exercise (considered abnormal when >
      or = 0.1 mV) were compared with FFRmyo, delta P(max), and delta P(rest). Thirty
      seven patients had an abnormal and 23 patients a normal exercise ECG. A
      significant linear correlation was found between the magnitude of ST-segment
      depressions and both FFRmyo and delta P(max) (r = -.75, SEE = 0.53; r = .71, SEE
      = 0.56). A weaker correlation was noted between ST-segment depressions and delta
      P(rest) (r = .53, SEE = 0.67). Sensitivity and specificity curves were
      constructed for the prediction of an abnormal exercise ECG for the three pressure
      derived indexes. The values that most accurately predicted an abnormal exercise
      ECG were 66% for FFRmyo, 31 mm Hg for delta P(max), and 12 mm Hg for delta
      P(rest). No patient with a FFRmyo value > 72% showed an abnormal exercise ECG. In
      addition, receiver operating characteristic curves demonstrated a greater
      accuracy of FFRmyo and of delta P(max) than of delta P(rest) for predicting the
      results of the exercise ECG. CONCLUSIONS: In the present study, cutoff values of
      FFRmyo and translesional pressure gradients are established from the relation
      between intracoronary pressure-derived indexes and ECG signs of myocardial
      ischemia during maximal exercise. These values can be helpful for clinical
      decision making in cases with dubious angiographic results. Furthermore, our data
      support the concept that stenosis physiology is better reflected by hyperemic
      than by basal measurements.

PMID- 7788915
TI  - Dissociation between exertional symptoms and circulatory function in patients
      with heart failure.
AB  - BACKGROUND: Patients with heart failure frequently report exertional dyspnea and
      fatigue. These symptoms are usually attributed to circulatory dysfunction and
      therefore are typically treated with cardiovascular medications. Serial
      assessment of exertional symptoms has also become the principal method used to
      assess drug efficacy in heart failure. Nevertheless, the relation between
      exertional symptoms in heart failure and circulatory dysfunction remains
      uncertain. METHODS AND RESULTS: This study was undertaken to investigate the
      relation between exertional symptoms, ventilatory and skeletal muscle
      dysfunction, and circulatory function in patients with heart failure. To this
      end, 52 ambulatory patients with heart failure underwent hemodynamic monitoring
      during maximal treadmill exercise testing. During exercise, the severity of
      dyspnea and fatigue was evaluated on a scale of 6 to 20 (Borg scale). The level
      of perceived exercise intolerance during daily activities was evaluated with the
      Minnesota Living With Heart Failure Questionnaire and the Yale Dyspnea-Fatigue
      Index. Maximal treadmill exercise increased the VO2 to 13.4 +/- 2.8 mL.min-1.kg
      1, the dyspnea score to 15.7 +/- 2.3, the fatigue score to 14.8 +/- 3.4, the
      pulmonary wedge pressure to 28 +/- 11 mm Hg, and the pulmonary artery lactate
      concentration to 34.5 +/- 16.3 mg/dL and decreased the pulmonary artery
      hemoglobin oxygen saturation to 30 +/- 9%. The level of perceived dyspnea had no
      relation to the pulmonary wedge pressure and correlated only minimally with the
      level of excessive ventilation (r = 39). The level of perceived fatigue
      correlated only weakly with blood lactate concentration (r = .55). Eleven
      patients (21%) exhibited a normal cardiac output and wedge pressure < 20 mm Hg
      during exercise, 22 (42%) exhibited a normal cardiac output but wedge pressure >
      20 mm Hg during exercise, and 19 (37%) exhibited reduced cardiac output and wedge
      pressure > 20 mm Hg during exercise. Despite these markedly different hemodynamic
      responses, all three groups exhibited similar levels of fatigue and dyspnea at
      comparable workloads and had comparable total scores for the Minnesota Living
      With Heart Failure Questionnaire and the Yale Dyspnea-Fatigue Index. There was no
      relation between the Living With Heart Failure Questionnaire and peak exercise
      VO2 and only a weak correlation between the Dyspnea-Fatigue Index and peak VO2 (r
      = .48). CONCLUSIONS: The level of exercise intolerance perceived by patients with
      heart failure has little or no relation to objective measures of circulatory,
      ventilatory, or metabolic dysfunction during exercise. In patients who report
      severe exertional symptoms, it may be desirable to directly measure hemodynamic
      response to exercise to ensure that these symptoms are due to circulatory
      dysfunction.

PMID- 7788916
TI  - How do we explain the clinical benefits of estrogen? From bedside to bench.

PMID- 7788918
TI  - Results of the international study of the implantable pacemaker cardioverter
      defibrillator. A comparison of epicardial and endocardial lead systems. The
      Pacemaker-Cardioverter-Defibrillator Investigators.
AB  - BACKGROUND: The purpose of the present report was to document clinical experience
      derived from the implantation of 2834 epicardial and endocardial cardioverter
      defibrillators (ICDs) in 2807 patients who were followed for almost 1 year and to
      compare the results obtained with the two systems. METHODS AND RESULTS: Patients
      in the two groups had similar clinical characteristics. More than half of the
      patients had a total of almost 50,000 spontaneous ventricular tachyarrhythmias
      that were terminated with equal success (approximately 98%) by epicardial and
      endocardial ICDs. Lead dislodgement and pocket infection occurred more often with
      the endocardial than with the epicardial ICD, whereas perioperative mortality was
      higher with the epicardial ICD than with the endocardial ICD. Mortality from
      sudden cardiac death was 1.4% in the epicardial ICD group and 0.6% in the
      endocardial ICD group at 1 year (P = .069). Overall mortality at 1 year was 12.2%
      and 6.9% for the epicardial and endocardial groups, respectively (P < .001),
      reflecting the higher surgical mortality for the epicardial system. CONCLUSIONS:
      The endocardial ICD is as effective as the epicardial ICD but incurs lower
      perioperative mortality.

PMID- 7788917
TI  - Provocation of hypotension during head-up tilt testing in subjects with no
      history of syncope or presyncope.
AB  - BACKGROUND: Head-up tilt test is increasingly being used to evaluate patients
      with syncope. This study was designed to evaluate the specificity of head-up tilt
      testing using different tilt angles and isoproterenol infusion doses in normal
      volunteers with no prior history of syncope or presyncope. METHODS AND RESULTS:
      One hundred fifty volunteers were randomized to two groups of 75 each. In group
      1, subjects were further randomized to have head-up tilt testing at a 60, 70, or
      80 degree angle at baseline followed by repeat tilt testing during a low-dose
      isoproterenol infusion that increased the heart rate by an average of 20%. In
      group 2, after having a baseline head-up tilt test at a 70 degree angle for a
      maximum of 20 minutes, subjects were randomized to have a repeat tilt table
      testing at a 70 degree angle during a low-dose, 3 micrograms/min, or 5
      micrograms/min isoproterenol infusion. In group 1, syncope or presyncope along
      with hypotension developed in 2 subjects during the baseline test at 60 and 70
      degrees of tilt and in 5 subjects during tilting at 80 degrees. The addition of
      low-dose isoproterenol reduced the specificity minimally from 92% to 88% at both
      60 and 70 degrees of tilt but substantially to 60% at an 80 degrees angle.
      However, 6 of the 10 subjects with a positive test at an 80 degree angle had an
      abnormal response after 10 minutes of tilt testing. In group 2, using various
      isoproterenol doses with tilt table testing at a 70 degree angle, low-dose (mean
      infusion dose, 1.5 +/- 0.45 microgram/min), 3 micrograms/min, and 5
      micrograms/min isoproterenol infusions elicited an abnormal response in 1 (4%), 5
      (20%), and 14 (56%) of the subjects, respectively. Using multiple logistic
      regression analysis, head-up tilt testing at an 80 degree angle (P = .01) or
      during 3 micrograms/min (P = .02) and 5 micrograms/min isoproterenol infusion
      rates (P < .001) was the most significant predictor of an abnormal response.
      CONCLUSIONS: Head-up tilt testing at a 60 or 70 degree angle with or without low
      dose isoproterenol infusion provides an adequate specificity. Caution is needed,
      however, in interpreting the results if the head-up tilt test at 80 degrees is
      extended beyond 10 minutes or if high doses of isoproterenol are used.

PMID- 7788919
TI  - Electrophysiological manifestations of the excitable gap of slow-fast AV nodal
      reentrant tachycardia demonstrated by single extrastimulation.
AB  - BACKGROUND: Although AV nodal reentrant tachycardia (AVNRT) is a well-known
      rhythm disorder, its anatomic substrate and electrophysiological mechanism remain
      to be defined. Previously, the description of the excitable gap (EG) of AVNRT was
      based on electrical stimulation performed from sites remote from the reentrant
      circuit. In the present study, we characterized the EG of AVNRT by atrial
      extrastimulation close to the putative reentrant circuit in the AV junction.
      METHODS AND RESULTS: In 16 patients (3 men, 13 women; mean age, 45 +/- 13 years)
      with inducible slow-fast AVNRT (mean cycle length, 353 +/- 52 ms), single
      extrastimuli with a 10-ms decrement in the premature coupling interval were
      delivered from the anterosuperior interatrial septum (fast pathway area) and the
      posteroinferior interatrial septum (slow pathway area) from late diastole until
      atrial refractoriness. An EG was considered present when resetting or termination
      of AVNRT was induced by single atrial extrastimulation. The study showed that the
      duration of the EG of AVNRT was wide, measuring 121 +/- 56 and 123 +/- 47 ms and
      occupying 33 +/- 11% and 34 +/- 9% of the tachycardia cycle length during single
      extrastimulation from the slow pathway area and the fast pathway area,
      respectively. The resetting pattern most commonly manifested as the sum of the
      coupling interval and the return cycle being less than a fully compensatory pause
      (two times the basic tachycardia cycle length). However, patterns equal to and
      greater than a fully compensatory pause were also observed. Of note, in 2 of the
      16 patients, atrial extrastimulation from either the fast or slow pathway area
      also affected the preceding tachycardia cycle length (HH interval), indicating
      alteration of the anterograde input. In all patients, the curve derived from
      plotting the coupling interval of extrastimuli against the return cycle during
      resetting exhibited an "increasing" pattern. The mode of tachycardia termination
      usually occurred when the premature atrial impulse was orthodromically blocked in
      the anterograde slow pathway. CONCLUSIONS: The EG of slow-fast AVNRT is
      relatively wide, as demonstrated by single atrial extrastimulation from the
      interatrial septum near the AV junction. Overall, the electrophysiological
      manifestations of the EG of AVNRT are very similar to those described in AV
      reciprocating tachycardia incorporating an accessory connection. These findings
      lend further support to the notion that, in humans, AVNRT involves a reentrant
      mechanism with a wide excitable gap.

PMID- 7788920
TI  - Atrial electrogram characteristics in patients with and without atrioventricular
      nodal reentrant tachycardia.
AB  - BACKGROUND: Multicomponent atrial electrograms and "slow pathway potentials" are
      helpful in identifying target sites for radiofrequency catheter ablation of the
      slow pathway in patients with atrioventricular (AV) nodal reentrant tachycardia.
      The purpose of this study was to compare the atrial electrograms recorded at
      various locations in the right atrium in patients with and without AV nodal
      reentrant tachycardia to assess the specificity of multicomponent atrial
      electrograms and possible slow pathway potentials both for the posteroseptal
      right atrium and for patients with AV nodal reentrant tachycardia. METHODS AND
      RESULTS: In 25 patients with AV nodal reentrant tachycardia and 23 control
      patients without AV nodal reentrant tachycardia or dual AV nodal physiology,
      atrial electrograms with an AV ratio of < or = 1:2 were recorded at the
      posteroseptal right atrium near the coronary sinus ostium and in the right atrium
      near the posterior, lateral, and anterior aspects of the tricuspid annulus.
      Attempts were made to identify broad, multicomponent, and double atrial
      electrograms. There were no significant differences between the patients with and
      without AV nodal reentrant tachycardia in the mean number of deflections in the
      atrial electrograms or in the mean duration of the atrial electrograms recorded
      at any of the atrial sites. In all patients, the number of atrial electrogram
      deflections and the atrial electrogram duration were significantly greater at the
      posteroseptal position than at the other three atrial sites. The prevalence of
      potentials with the appearance of slow pathway potentials in the posterior septum
      was similar in patients with and without AV nodal reentrant tachycardia (68% and
      70%, respectively). The prevalence of these potentials was 6% to 25% at the other
      three atrial sites (P < .005 compared with the posterior septum). CONCLUSIONS:
      The atrial electrogram characteristics that have been found to be useful in
      identifying effective posteroseptal slow pathway ablation sites in patients with
      AV nodal reentrant tachycardia are equally prevalent in patients without AV nodal
      reentrant tachycardia or dual AV nodal physiology. Atrial electrograms in the
      posteroseptal area are broader and contain more deflections than at other areas
      in the right atrium, possibly because of conduction properties of the posterior
      transitional zone that are independent of the presence of AV nodal reentrant
      tachycardia.

PMID- 7788922
TI  - Angiotensin II type 1 receptor blockade inhibits the expression of immediate
      early genes and fibronectin in rat injured artery.
AB  - BACKGROUND: Vascular injury activates various kinds of genes, including proto
      oncogenes, growth factors, and extracellular matrix proteins. However, the
      significance of activation of these genes in neointimal formation is poorly
      understood. Angiotensin II type 1 (AT1) receptor antagonist is shown to prevent
      neointimal formation after vascular injury, although the mechanism is unclear. To
      understand the molecular mechanism of vascular thickening, we examined the
      effects of AT1 receptor blockade on the gene expression of proto-oncogenes,
      transforming growth factor-beta 1 (TGF-beta 1), and extracellular matrix proteins
      after vascular injury. METHODS AND RESULTS: Endothelial denudation of the left
      common carotid artery in Sprague-Dawley rats was performed with a Fogarty 2F
      balloon catheter. TCV-116 (10 mg.kg-1.d-1), a selective nonpeptide AT1 receptor
      antagonist, or vehicle was administered orally to rats from 1 day before to 14
      days after balloon injury. Injured left and uninjured right common carotid
      arteries were removed from rats at 1, 6, and 24 hours and 3, 7, and 14 days after
      balloon injury. Tissue mRNA levels were measured with Northern blot analysis
      using specific cDNA probes and corrected for 18S ribosomal RNA value. Arterial
      mRNAs for c-fos, c-jun, jun B, jun D, and Egr-1 increased significantly at 1 hour
      after balloon injury and decreased rapidly. At 6 hours, ornithine decarboxylase
      (ODC) mRNA expression reached the maximal levels. TGF-beta 1 and fibronectin mRNA
      levels started to increase at 6 hours after injury and remained enhanced until 7
      days after injury. On the other hand, collagen types I, III, and IV and laminin
      mRNA levels were not significantly increased over 7 days. Treatment with TCV-116
      significantly inhibited the induction of mRNAs for c-fos, c-jun, Egr-1, ODC, and
      fibronectin in injured artery, whereas the increase in TGF-beta 1 gene expression
      after injury was not prevented by TCV-116. Immunohistological studies indicated
      that TCV-116 decreased not only the intimal thickening but also the amount of
      these extracellular matrix proteins in the intima. CONCLUSIONS: The results
      indicate that AT1 receptor blockade inhibits the induction of immediate-early
      genes, ODC, and fibronectin in rat injured artery. Thus, inhibition of intimal
      thickening by AT1 receptor blockade may be mediated at least in part by
      suppression of multiple genes related to cell growth and migration in the very
      early phase after vascular injury.

PMID- 7788923
TI  - Is 31P-NMR spectroscopic imaging a viable approach to assess myocardial
      viability?

PMID- 7788921
TI  - Cardiac allograft survival in mice deficient in intercellular adhesion molecule
      1.
AB  - BACKGROUND: Intercellular adhesion molecule-1 (ICAM-1, CD54) is a cell adhesion
      molecule that interacts with the leukocyte beta 2 integrins, lymphocyte function
      associated antigen-1, and macrophage antigen-1. ICAM-1 is postulated to play a
      key role in several cell-cell interactions that are important in allograft
      rejection, including antigen presentation, transendothelial migration of
      leukocytes, and leukocyte-medicated myocyte injury. METHODS AND RESULTS: Mice
      homozygous for a gene-targeted mutation of ICAM-1 were used in two different
      cardiac transplant models to further define the role of ICAM-1 in the process of
      allograft rejection. In the first model, hearts from newborn mice were implanted
      in the ear pinnae of H-2-incompatible recipients. In the second model, intra
      abdominal transplantation by direct vascular anastomosis was performed. Time to
      rejection was defined by the loss of pulsatile activity assessed by visual
      inspection in the ear model or by cessation of palpable cardiac impulse in the
      abdominal model. Allograft survival did not differ significantly between control
      groups that express normal levels of ICAM-1 and those groups using ICAM-1
      deficient mutants as either donors or recipients. Histological examination of
      rejection of both normal and mutant (ICAM-1-deficient) cardiac allografts
      revealed similar patterns of infiltration of mononuclear and granulocytic
      leukocytes and myocyte necrosis. Immunostaining with anti-ICAM-1 antibodies
      showed ICAM-1-positive infiltrating cells in both mutant (ICAM-1-deficient) and
      normal allografts, with the graft endothelium negative for ICAM-1 staining in the
      mutant allografts. CONCLUSIONS: The absence of surface expression of ICAM-1 in
      the donor allograft or recipient is insufficient to produce a significant impact
      on cardiac allograft survival. This study highlights the need to understand more
      precisely the mechanism of action whereby monoclonal antibodies to ICAM-1 prolong
      cardiac allograft survival before new therapeutic strategies based on gene
      transfer technology or small molecule inhibitors are developed. Mutant mice with
      targeted mutations in cell adhesion molecules provide powerful tools to study the
      complex role that cell adhesion molecules play in the cellular interactions
      between donor graft tissue and the recipient that culminate in graft rejection.

PMID- 7788925
TI  - General practitioner follow-up of children undergoing grommet insertion. Can it
      work?

PMID- 7788924
TI  - Role of blood doping in the coronary vasoconstrictor response to cocaine.
AB  - BACKGROUND: The mechanism by which cocaine induces myocardial ischemia remains
      controversial. Most prior studies have postulated that cocaine-induced coronary
      vasoconstriction limits myocardial oxygen delivery during times of increased
      myocardial oxygen demand. METHODS AND RESULTS: To determine the contribution of
      altered myocardial metabolic demands to the coronary vasoconstrictor effects of
      intravenous cocaine (COC 1 mg/kg), we studied 13 conscious, chronically
      instrumented dogs in the intact state and with heart rate held constant with
      atrial pacing in the presence and absence of beta-adrenergic blockade with
      propranolol (2 mg/kg) to limit the inotropic and chronotropic effects of cocaine
      on associated increases in myocardial oxygen consumption. In the intact state,
      COC caused a prompt increase in coronary blood flow (+30 +/- 3%, P < .01) that
      returned rapidly to baseline within 10 minutes, whereas coronary vascular
      resistance did not increase significantly (+17 +/- 6%, P < .05) until 15 minutes
      after COC. Notably, myocardial oxygen consumption increased (+57 +/- 4%, P < .01)
      to a greater extent than oxygen delivery (+42 +/- 3%, P < .01) during the first
      2.5 minutes, requiring increased oxygen extraction (from 75 +/- 1% to 80 +/- 1%,
      P < .01), although only transiently. Thereafter, enhanced oxygen delivery matched
      the required oxygen consumption without further need to extract additional
      oxygen. Surprisingly, the enhanced oxygen delivery associated with COC in
      conscious dogs did not depend on persistent increases in coronary blood flow but
      rather was due to enhanced arterial oxygen content (+22 +/- 4%, P < .01) as a
      result of a significant "blood doping" effect with associated increases in
      circulating hemoglobin from 12.1 +/- 0.4 to 14.2 +/- 0.6 g/dL (P < .01), which
      persisted for 60 minutes. CONCLUSIONS: The myocardial oxygen requirements
      associated with COC administration have a significant impact on both the
      magnitude and the mechanism of the coronary vasoconstrictor effects of COC in
      conscious dogs. Furthermore, the enhanced myocardial oxygen delivery associated
      with COC administration is not dependent solely on coronary blood flow responses
      but is due to a significant "blood doping" effect associated with COC.

PMID- 7788926
TI  - Day case myringoplasty using tragal perichondrium.
AB  - Day surgery has an ever-increasing role to play in otology. In this study of
      myringoplasty, tragal perichondrial grafts were placed permeatally as a day case
      procedure in 32 patients. These are compared with a control group, matched for
      age and for the size of their perforations, in whom temporalis fascia was grafted
      via an endaural or postaural incision. The success rate was 94% in the
      perichondrial group as compared with 84% in the control group (no significant
      difference P > 0.05). Day case myringoplasty produced less morbidity for the
      patients and a 40% reduction in theatre time as well as the more obvious savings
      resulting from a shorter hospital stay.

PMID- 7788927
TI  - Establishment and characterization of a human cell line from a squamous carcinoma
      of the tongue.
AB  - A human squamous carcinoma cell line, PWH-S1, has been established from the
      metastatic lymph node of a Chinese patient with a squamous cell carcinoma of the
      tongue. The fibroblast-free culture has been propagated in DMEM supplemented with
      10% fetal bovine serum for more than 100 passages. PWH-S1 cells showed anchorage
      independent growth in 0.3% agar solution. PWH-S1 cell line exhibited a monolayer
      growth and loss of contact inhibition. The in vitro doubling time of the PWH-S1
      cell line was approximately 28 h. PWH-S1 was tumourigenic after inoculation into
      nude mice. Karyotype analysis showed the chromosome abnormality with a modal
      number of 69. Electron microscopy demonstrated poorly differentiated neoplastic
      cells with some features of squamous cell differentiation. No human
      papillomavirus (type 6, 11, 16, 18, 31) was detected in the PWH-S1 cell line by
      the polymerase chain reaction.

PMID- 7788928
TI  - Delay in the diagnosis of oral squamous cell carcinoma.
AB  - Delay in diagnosis was recorded prospectively in 167 patients with an oral
      squamous cell carcinoma. The median total delay was 4 months of which two-thirds
      was patient delay. The corrected survival did not correlate with the total delay.
      The patient delay was not significantly correlated with tumour or patient factors
      and the unreliable nature of patient delay information makes such data clinically
      unusable. In contrast, the professional delay correlated significantly with some
      of these factors. The delay was longer for women than for men and the older the
      patient, the longer the delay. The professional delay was longest in patients
      with small tumours. Thus, registration of the professional delay provides
      information to be used to improve the diagnostic efficiency of the health care
      system.

PMID- 7788930
TI  - Clinical coding in ENT surgery: the Read Codes and clinical terms project.

PMID- 7788929
TI  - Efficacy of topical corticosteroid powder for nasal polyps: a double-blind,
      placebo-controlled study of budesonide.
AB  - Budesonide has been used for a number of years as a topical nasal corticosteroid
      in the treatment of nasal allergy and nasal polyps. Recently, a new device for
      powder insufflation where no constituents or preservatives are included has been
      developed (Rhinocort Turbuhaler, Astra Draco AB, Sweden). The present
      investigation was designed in order to study the efficacy of topical budesonide
      powder as the only treatment of nasal polyps. A total of 126 patients entered the
      study. The medical history and clinical recordings included symptoms and signs, a
      semiquantitative test of smell and measurement of nasal expiratory peak flow
      index. Medication was either 200 or 400 micrograms of budesonide powder b.i.d. or
      placebo. After 1 month an overall assessment of treatment efficacy was made to
      determine whether the treatment had been a success or a failure. The results
      showed a statistically significant improvement of symptoms and signs in the
      actively treated groups. The increase in expiratory peak flow index was about 60%
      in the actively treated groups as opposed to 16% in the placebo group. The
      overall assessment of treatment efficacy showed success in about 82% of actively
      treated patients as opposed to about 43% in the placebo group. It is concluded
      that budesonide powder is useful in the treatment of nasal polyps.

PMID- 7788932
TI  - A 3-D finite element analysis of the natural frequencies of vibration of a stapes
      prosthesis replacement reconstruction of the middle ear.
AB  - In this work, the natural frequencies of vibration of two different stapes
      prosthesis replacement reconstructions have been analysed using the finite
      element method. Prosthesis 1 was constructed of fine stainless steel wire and a
      Teflon base, while prosthesis 2 was made entirely of Teflon. The results have
      indicated that generally, the first natural frequency of vibration falls as the
      prostheses become larger and more bulky. However, the fall in the first natural
      for prosthesis 1 was modest when compared with that of the isolated tympanic
      membrane. An important variable influencing frequencies and mode of vibration of
      the reconstruction was the tightness of fit of the prostheses within the
      remaining ossicular chain. The tightness of fit in this work was modelled as a
      range of spring constants applied at the stapes pseudo footplate, together with a
      series of joint elements at the incus tip/prosthesis head for the Teflon implant.
      When these spring constraints were below approximately 10 N/mm, the
      reconstruction exhibited normal mode 1 vibration behaviour, but at larger spring
      values, an abnormal mode 1 became established resembling the normal mode 2
      vibration characteristics. The formation of new geometries and surfaces following
      reconstruction, introduces new constraints between umbo and stapes footplate
      particularly at the natural/artificial interfaces. These unnatural constraints
      may inhibit and modify the natural movements normally occurring at the stapes
      footplate leading to abnormal modes of vibration.

PMID- 7788931
TI  - Bone-anchored hearing aids in patients with sensorineural hearing loss and
      persistent otitis externa.
AB  - Recently, a new bone-conduction hearing aid has become available which can be
      connected percutaneously to the skull: the bone-anchored hearing aid or BAHA.
      Several clinical trials have shown its efficacy in patients with a conductive or
      mixed hearing loss. A second group of potential candidates are patients who
      suffer from an almost instantaneous skin reaction to any kind of earmould. Three
      such patients with a predominant sensorineural hearing loss were fitted with a
      BAHA. The aided free-field thresholds proved to be poor compared with the desired
      values using prescriptive rules. Speech recognition measured objectively (with
      tests) and subjectively (with a questionnaire) was comparable or better than with
      conventional bone-conduction hearing aids. Two patients were using their BAHA all
      day, whereas the third patient was only using it for a few hours per day.
      Although it did not produce optimal results, the BAHA seems to be the best
      solution for these patients.

PMID- 7788933
TI  - Short- and long-term outcomes of uvulopalatopharyngoplasty for snoring.
AB  - Uvulopalatopharyngoplasty is a well established and highly successful operation
      in the treatment of snoring. However, most published data are based on relatively
      short-term follow-up results. Anecdotal cases of late recurrence of snoring after
      an initially successful surgical result have been reported but few formal studies
      have been performed to determine the true magnitude of this problem. We compared
      the short-term and long-term results on our patients and found the late
      recurrence rate after a minimum follow-up period of 12 months (range: 12-84
      months, mean 31.3 months) to be in the region of 13%. The risk of recurrence was
      directly related to the body mass index.

PMID- 7788934
TI  - Over-expression of tumour suppressor gene p53 in laryngeal squamous cell
      carcinomas and its prognostic significance.
AB  - p53 is a nuclear phosphoprotein which acts as a tumour suppressor factor,
      regulating cell growth and division. Mutations in the p53 gene appear to be the
      most common genetic alterations in human cancer. The aim of this study was to
      investigate p53 expression in laryngeal squamous cell carcinomas and to assess
      its role as a marker of prognostic significance. Using immunohistochemical
      staining techniques, a series of laryngeal carcinomas (n = 87) were examined for
      expression of the mutant form of p53 phosphoprotein using the monoclonal antibody
      PAB 1801. p53 over-expression was noted in 50 biopsies of laryngeal carcinomas
      (57.5%) but not in any of the non-neoplastic laryngeal mucosa which were used as
      the control. There was no statistical correlation between p53 immunoreactivity
      and the clinicopathological parameters of the cancers including: site of tumour,
      TNM staging, differentiation grading and tumour recurrence. These findings
      indicate that p53 expression is strongly associated with carcinoma cells and not
      with normal cells in the larynx. However, p53 expression is probably unrelated to
      the biological aggressiveness of these tumours.

PMID- 7788935
TI  - Genetics of familial and non-familial skull base tumours.
AB  - Many tumours of the skull base, including schwannomas, paragangliomas,
      meningiomas and anterior pituitary tumours occur both as sporadic tumours and in
      clear cut familial syndromes. These cancers' highly penetrant dominantly
      inherited syndromes have proven to be a rich resource for locating tumour genes,
      most of which are of the tumour suppressor type. Recently, the gene for type 2
      neurofibromatosis (NF2) was isolated by the technique of positional cloning. The
      NF2 gene has now been demonstrated to be involved in the pathogenesis of both
      familial and non-familial vestibular schwannomas as well as meningiomas. The
      presence of inactivating mutations within this gene suggests that it acts as a
      tumour suppressor and the mechanism has been shown to comply with a 'two hit'
      mutation model. Hereditary tumours constitute a small proportion of all cases,
      but evidence from studies of tumours such as vestibular schwannoma and meningioma
      have shown that their genes are also relevant to the much more common non
      familial forms of the same tumour. This paper briefly describes the approach to
      locating tumour genes, and reviews our current knowledge regarding the
      chromosomal location and function of genes responsible for familial tumours
      involving the skull base. The genetic mechanisms of tumourigenesis are discussed
      as are the prospects for the development of novel forms of diagnosis and
      treatment.

PMID- 7788936
TI  - Chondrosarcoma of the temporal bone.
AB  - Eight patients with a chondrosarcoma of the temporal bone have been treated at
      the National Hospital for Neurology and Neurosurgery over a 16-year-period.
      Patients usually presented with symptoms and signs of lower cranial nerve
      palsies, though in most cases these resolved after surgery. This result, combined
      with the fact long-term survival can be achieved, makes surgical treatment of
      these tumours the best option, as the response to primary radiotherapy is
      uncertain. Surgical access is difficult, but an infratemporal approach is
      probably the most satisfactory. The use of post-operative adjuvant radiotherapy
      may provide some benefit. Long-term follow-up is necessary, and for this magnetic
      resonance imaging (MRI) is preferable to computed tomography (CT) scanning.

PMID- 7788937
TI  - Speech discrimination in patients with Bell's palsy and a paralysed stapedius
      muscle.
AB  - The contraction of the stapedius muscle results in a frequency dependant
      attenuation of sound through the middle ear. Idiopathic facial nerve paralysis
      (Bell's palsy) usually results in a paralysis of the stapedius muscle. This
      prospective study included 119 patients presenting with Bell's palsy over an 18
      month period. After applying exclusion criteria, 80 patients with normal pure
      tone audiograms underwent speech audiometry. This was performed on presentation
      and after recovery of the facial nerve palsy. Fifty-six patients (70%) with an
      absent stapedius reflex showed marked 'roll-over' from means of 98-49% on their
      speech audiogram. This resolved completely with recovery of the facial nerve
      palsy and return of the stapedial reflex. To determine whether this effect was
      due primarily to the paralysis of the stapedius muscle or to an associated
      polyneuropathy, a second study on six normal patients was done. These patients
      had both ears (12 in total) tested with speech filtered to simulate a paralysed
      stapedius muscle. This resulted in a mean 'roll-over' from 90.9 to 59.9%. The
      magnitude of this roll-over (31%) was only two-thirds of that seen in Bell's
      palsy patients (49%) with the difference between these means statistically
      significant (P < 0.05). This suggests that Bell's palsy, usually considered a
      mononeuropathy, involves certain of the auditory fibres of the eighth nerve and
      is a polyneuropathy. Stapedius function is important in speech discrimination at
      higher levels of sound intensity such as speech in noise and severing the
      stapedius tendon in stapes surgery may affect speech discrimination after
      successful surgery.

PMID- 7788939
TI  - The Glasgow benefit plot used to assess the effect of bilateral stapedectomy.
AB  - The Glasgow benefit plot has encouraged surgeons to look at the results of their
      surgery from a more functional standpoint rather than in purely technical terms.
      Our aim was to use the plot to examine the efficacy of second side stapedectomy.
      A retrospective study of 17 second side stapedectomies showed that the addition
      of the second operation significantly increased the chances of achieving at least
      one 'normal' hearing ear and made 'normal' and symmetrical hearing possible.

PMID- 7788938
TI  - Is otoscopy reliable? A structured teaching method to improve otoscopic accuracy
      in trainees.
AB  - Otoscopy is an important skill for primary care physicians and otologists. Until
      now, training has been by repeated exposure to patients with ear disease.
      Structured instruction in how to assess an ear has not previously been reported.
      Not-diseased ears and those with varying types of chronic (suppurative) otitis
      media were chosen to be photographed as this is an important condition to be able
      to diagnose and in which pneumatic otoscopy has no role. Two sets of 30 slides of
      equal difficulty were shown to 10 trainees, one before and one after structured
      teaching. The overall error rate fell from 44 to 21% (P < 0.001). Most
      importantly, the error rate in assessing ear activity fell from 35 to 17% (P <
      0.05). In conclusion, a structured approach to otoscopy has been shown to improve
      the diagnostic ability of trainess tested with photographs of ears with chronic
      otitis media. Such a teaching approach is likely to be equally beneficial to
      other otological conditions and to live otoscopy.

PMID- 7788940
TI  - Piriform aperture surgery for alar collapse.
AB  - The region of maximum resistance in the respiratory tract is in the anterior part
      of the nose, and this area has been termed the nasal valve. Inspiratory narrowing
      of this area, known as alar or nasal valve collapse can produce the symptom of
      obstruction, and may be very difficult to correct. The anatomy and physiology of
      the nasal valve are discussed followed by the author's technique for correction
      of a common problem leading to alar collapse; a narrow piriform aperture, which
      is often associated with a prominent web at the muco-cutaneous junction.

PMID- 7788941
TI  - Referral patterns in vestibular schwannomas.
AB  - The investigation and treatment of vestibular schwannomas is an increasingly
      specialized area in which major advances have been seen over recent years. The
      effect of these advances on the referral patterns to a centre specializing in
      such surgery is reviewed. The proportion of referrals with a known diagnosis has
      increased substantially, allowing the specialist centre to focus on appropriate
      management rather than diagnosis. The vast majority of vestibular schwannomas are
      referred by otolaryngologists. The caseload referred by neurologists or
      neurosurgeons have different presenting symptoms. The incidence of vestibular
      schwannoma in the Cambridge district is found to be 1 per 50,000 population per
      year. This is a higher incidence than that recorded in other studies. This may be
      due to a tight diagnostic strategy and the high level of clinical awareness of
      the local general practitioners.

PMID- 7788942
TI  - General primer-mediated polymerase chain reaction for simultaneous detection and
      typing of human papillomavirus DNA in laryngeal squamous cell carcinomas.
AB  - The aim of this study was to investigate the prevalence of different human
      papillomavirus (HPV) types in laryngeal squamous cell carcinomas using general
      primer-mediated polymerase chain reaction (PCR). Tumour sections from 42 patients
      with laryngeal carcinomas were investigated. For HPV DNA amplification, consensus
      primers were used which were directed to the L1 coding region of the HPV genome.
      Analysis of the PCR products was done using 2% agarose gel electrophoresis
      followed by restriction enzyme analysis to identify different HPV types.
      Amplification of the human TGF-beta 1 DNA was successfully performed in 36/42
      (85.7%) of samples confirming the presence of sufficient DNA for viral
      amplification. HPV DNA was detected in 8/36 (22.2%) of the tumours examined
      (three HPV-6, two HPV-16, one HPV-11, two unknown HPV types). HPV DNA was not
      detected in any of the non-neoplastic laryngeal mucosa which was used as control
      (n = 15). Fifty per cent of women had HPV-positive tumours compared with 8% of
      men (chi2 = 5.8, P < 0.05). Our data indicate that while the overall prevalence
      of HPV in laryngeal carcinomas is fairly high (22.2%), the frequency of high-risk
      types (HPV-16 & HPV-18) is low (5.5%). HPV probably acts as a promoter in the
      multistep process of carcinogenesis in squamous mucosal cells of the larynx.

PMID- 7788943
TI  - Mastoidectomy audit: results of the Royal College of surgeons of England
      comparative audit of ENT surgery.
AB  - This paper presents the results of a national comparative audit of mastoid
      surgery, retrospectively analysing 611 operations by 55 consultants.
      Confidentiality for both patient and surgeon was assured. For cholesteatoma 80%
      of mastoidectomies performed were open cavity procedures and for other middle ear
      disease 58% used an intact canal wall technique. Thirty-two surgeons used only an
      open cavity mastoidectomy for cholesteatoma during the period of the audit. There
      was a statistically significantly greater number of wet ears with open cavities
      than with closed cavities, but the frequency of the operator did not correlate
      with the dry ear rate. Ten serious complications (facial palsy and dead ear) were
      recorded. All occurred in open cavity mastoidectomies. The post-operative hearing
      status was unknown in 40% of patients.

PMID- 7788944
TI  - Unstable angina: cost of conservative and invasive strategies using TIMI3 B as a
      model.
AB  - Obviously, conservative therapy would be less expensive than invasive therapy if
      patients were held in the conservative category and received only medical therapy
      along with exercise test with thallium. However, based on the TIMI 3 B outcomes,
      costs are similar (but not equal) even if one attempts a conservative strategy
      since a significant number of patients in the early conservative arm underwent
      angiography (64 patients) and PTCA (26 patients) or surgery (24 patients) and the
      number of days for rehospitalization was greater in the early conservative than
      in the early invasive group. I believe the TIMI 3 B study reflects the reality of
      clinical practice in 1995. It seems to me that either strategy is acceptable both
      from the medical and economic outcome standpoints. Given the model used here, I
      do not think that the early invasive strategy will ever be cheaper than the early
      conservative strategy unless all of the patients in the early conservative
      strategy who eventually are revascularized have CABG, and all of the patients in
      the early invasive strategy who are revascularized have PTCA.

PMID- 7788945
TI  - Sudden cardiac death in patients with hypertrophic cardiomyopathy: from bench to
      bedside with an emphasis on genetic markers.
AB  - Hypertrophic cardiomyopathy (HCM) is the most common cause of death in the young,
      particularly in young competitive athletes. Death often occurs suddenly in
      asymptomatic, apparently healthy individuals. Several clinical parameters as well
      as genetic factors have been characterized that can identify those HCM patients
      who are at high risk for sudden cardiac death (SCD). The clinical parameters that
      have some predictive values for SCD in HCM patients are the following: a prior
      history of SCD, a family history of SCD, history of syncope, symptomatic
      ventricular tachycardia on Holter monitoring, inducible ventricular tachycardia
      during electrophysiologic studies, and myocardial ischemia in children with HCM.
      Recent identification of mutations in the beta myosin heavy chain gene and
      genotype-phenotype correlation in HCM patients have shown that the beta myosin
      heavy chain mutations are also prognosticators in HCM families. Several mutations
      such as Arg403Gln and Arg719Gln are associated with a high incidence of SCD,
      while Leu908Val mutation is associated with a benign course and a low incidence
      of SCD in HCM families. Additional genetic factors such as a polymorphism in
      angiotensin-converting enzyme I gene may also contribute to a high incidence of
      SCD in HCM families. Identification and characterization of HCM patients at high
      risk for SCD provide the opportunity to render prophylactic therapeutic
      interventions, such as implantation of defibrillators, in these individuals.

PMID- 7788946
TI  - Prognostic significance of right ventricular dysfunction in patients with acute
      inferior myocardial infarction and right ventricular involvement.
AB  - Little is known about the influence of right ventricular (RV) dysfunction on
      prognosis of patients with acute inferior myocardial infarction (IMI) and RV
      involvement. Therefore, 99 consecutive patients (mean age 56.6 +/- 3.4 years)
      with RV involvement during acute IMI were followed for a 12-month period to
      clarify the influence of acute RV dysfunction on short- and long-term survivals.
      Forty-one patients with IMI evolved with severe arterial hypotension due to RV
      dysfunction, while 58 patients had no hemodynamic impairment due to RV
      involvement. Basal hemodynamic data (mean +/- SD) for patients with RV
      dysfunction were blood pressure (BP) 92/59 +/- 22/20 mmHg, systemic vascular
      resistance (SVR) 2314 +/- 252 dynes.s.cm-5, and cardiac index (CI) 1.3 +/- 0.3
      l/min/m2. Patients without RV dysfunction demonstrated BP 113/74 +/- 20/16 mmHg
      (p < or = 0.05), SVR 1324 +/- 354 dynes.s.cm-5 (p < or = 0.01), and CI 2.6 +/-
      0.5 l/min/m2 (p < or = 0.05). Angiographic differences noted were that
      hemodynamically compromised patients showed lower RV ejection fractions (0.27 +/-
      0.08) than patients without hemodynamic disturbance [0.41 +/- 0.11 (p < or =
      0.05)]; however, left ventricular ejection fractions were 0.48 +/- 0.10 and 0.52
      +/- 0.12, respectively. Short- and long-term mortality rates were assessed during
      the follow-up period. Patients with hemodynamic impairment due to RV infarction
      had a higher mortality rate for the first month and for 11 subsequent months post
      MI than patients without hemodynamic impairment, that is 24.4 vs. 6.9 and 14.6 (p
      <or = 0.05) vs. 3.4 (p < or = 0.05), respect ively.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7788947
TI  - The influence of angiographically demonstrated coronary collaterals on the
      results of stress echocardiography.
AB  - Previous studies using thallium-201 scintigraphy have suggested that angiographic
      coronary collaterals can protect against the development of stress-induced
      perfusion abnormalities, but the effect of collaterals on stress echocardiography
      (SECHO) has not been determined. In this study, 21 consecutive patients referred
      for cardiac catheterization underwent SECHO and coronary angiography. Of the 21
      study patients, there was a total of 16 significantly obstructed coronary
      arteries (> or = 70% stenosis) in 14 patients. SECHO revealed stress-induced wall
      motion abnormalities in the distribution of seven of nine obstructed coronary
      vessels without angiographic collaterals, but in only one of seven vessels with
      collaterals (p < 0.05). Six of eight obstructed vessels not associated with a
      stress-induced wall motion abnormality had collaterals, whereas only one of eight
      obstructed vessels associated with a stress-induced wall motion abnormality had
      collaterals. We conclude that (1) angiographically demonstrated coronary
      collaterals can protect against the development of stress-induced wall motion
      abnormalities despite the presence of a high-grade coronary artery obstruction,
      and (2) the lack of a stress-induced wall motion abnormality on SECHO in the
      perfusion territory of an obstructed vessel may suggest the presence of adequate
      collateral perfusion.

PMID- 7788948
TI  - Effects of treatment with lovastatin and pravastatin on daytime cognitive
      performance.
AB  - The HMG-CoA reductase inhibitors lovastatin and pravastatin have both proven to
      be effective and well tolerated in the treatment of hypercholesterolemia. To
      evaluate whether lovastatin or pravastatin might affect daytime cognitive
      function, a double-blind, placebo-controlled, two-period, incomplete block,
      crossover study was performed in 36 patients (24 per treatment) with primary
      hypercholesterolemia. Patients received placebo, lovastatin (40 mg), or
      pravastatin (40 mg) for 4 weeks. Following a 1-week washout period, patients were
      crossed over to either lovastatin, pravastatin, or placebo for an additional 4
      weeks. Mental performance tests (digit symbol substitution, choice reaction time,
      auditory vigilance, selective reminding word recall, finger tapping), visual
      analogue rating scales, and the Profile of Mood States were administered before
      test drug administration and after 2 and 4 weeks of each treatment. After 4
      weeks, no statistically significant differences between treatments in changes
      from baseline were observed on any parameter with the exception of digit symbol
      substitution, for which lovastatin and pravastatin were both significantly better
      than placebo but did not differ from each other. Low-density lipoprotein
      cholesterol was reduced 38% by lovastatin and 30% by pravastatin. In summary,
      neither of these chemically distinct HMG-CoA reductase inhibitors impaired
      daytime cognitive performance after 4 weeks of treatment in patients with primary
      hypercholesterolemia.

PMID- 7788949
TI  - Transesophageal echocardiographically guided atrial transseptal catheterization
      in patients with normal-sized atria: incidence of complications.
AB  - The incidence of cardiac complications from atrial transseptal catheterization
      has never been quantified in patients with normal-sized atria. Series defining
      the complication rate are derived from diseased hearts with structural changes
      that may alter the complication rate of the procedure. The generation of a
      standardized incidence of perforation in a population of structurally normal
      atria has important implications. A total of 46 atrial transseptal
      catheterizations guided by transesophageal echocardiography (TEE) for
      radiofrequency ablation of left-sided accessory pathways was performed in 42
      patients during a 3-year period (1990-1993). Clinical and echocardiographic data
      were analyzed, with special attention given to TEE reports pre- and post
      transseptal catheterization. Only one complication occurred in the 46 procedures
      (2.2%): a perforation of the left atrium that led to pericardial effusion and
      cardiac tamponade. In a small series of patients with normal sized atria, we have
      demonstrated that TEE-guided transseptal catheterization in a procedure with a
      low complication rate.

PMID- 7788950
TI  - Effect of precordial electrocardiographic electrode placement on ST-segment
      measurement during exercise.
AB  - Research protocols often utilize serial exercise testing to examine the efficacy
      of anti-ischemic therapies. These tests, however, are prone to multiple sources
      of bias. This investigation sought to determine the influence of varying
      precordial electrocardiographic (ECG) electrode placement on the detection of
      exercise-induced ST-segment shifts. Fifteen coronary artery disease patients with
      abnormal exercise tests were studied. Based on the previous exercise test, the
      precordial electrode position exhibiting the greatest ST-segment shift was
      selected as the reference electrode. Four additional electrodes were placed
      around this reference electrode and exercise testing was performed. ECG strips
      were recorded every minute. The time-to-onset and -offset of ischemic-type ST
      segment depression was recorded. ST-segment depression was recorded during
      exercise from the reference electrode in 12 of 15 patients. Ischemic-type ST
      depression was also recorded in each of these 12 patients with the surrounding
      electrodes; however, the time-to-onset detected by all four surrounding
      electrodes concurred in only 5 of 12 (42%) patients. The time-to-offset of the ST
      segment depression concurred in 9 of 12 (75%) patients. Serial ECGs recorded from
      similar but not exactly the same precordial ECG electrode position should yield
      similar results for the detection of ischemia, but time-to-onset or -offset of
      ischemia may differ by 60 s or more. Small changes in the time-to-onset and 
      offset of ischemia should not be considered reliable indicators of anti-ischemia
      efficacy.

PMID- 7788951
TI  - Pathology of tricuspid valve stenosis and pure tricuspid regurgitation--Part III.
AB  - This three-part article examines the histologic and morphologic basis for
      stenotic and purely regurgitant tricuspid valves. In Part III, morphometric
      analysis of tricuspid valve annular circumference, leaflet area, and the product
      of annular circumference and leaflet area are shown to be useful in establishing
      etiology for the purely regurgitant tricuspid valves and in assessing the
      anatomic basis of pure tricuspid regurgitation in the presence of mitral
      stenosis.

PMID- 7788952
TI  - Pulmonary venous flow in constrictive pericarditis.
AB  - A 35-year-old white female patient presented with radiation-induced constrictive
      pericarditis. Intraoperative transesophageal echocardiography revealed a
      uniphasic diastolic flow pattern. This pulmonary flow pattern reverted to a
      normal biphasic systolic/diastolic profile immediately following radical
      pericardiectomy. This abnormal flow pattern was previously described as typical
      for restrictive cardiomyopathy. However, in this case it is most likely due to a
      marked decrease in left atrial compliance induced by the thick fibrous scar
      encasing the atrial.

PMID- 7788954
TI  - John Forbes.

PMID- 7788953
TI  - A case of cardiac sarcoidosis with remarkable atrophy of the left ventricular
      septum on two-dimensional echocardiography.
AB  - Sarcoidosis is a multisystem granulomatous disorder of unknown etiology which
      mainly affects the lungs, skin, the lymphoreticular system, and the heart. We
      report a case of cardiac sarcoidosis in which a remarkably thin ventricular
      septum was demonstrated on two-dimensional echocardiography.

PMID- 7788955
TI  - Evaluation of acute haemodynamic response to high-dose naloxone in young
      hypertensive and normotensive humans.
AB  - Cardiac output is increased in many young subjects with mild essential
      hypertension. The purpose of these experiments was to determine if activation of
      endogenous endorphin systems contributes to this increase. We investigated the
      acute effects of the opioid antagonist, naloxone, on Doppler-derived stroke
      volume, cardiac output and systemic blood pressure in young hypertensive (n = 9)
      and normotensive (n = 9) subjects. On two separate sessions, naloxone (0.4 mg/kg)
      was administered intravenously over 10 min to resting subjects according to a
      random, double-blind study design. Stroke volume and cardiac output were
      determined before and 10 min after the injection; heart rate and blood pressure
      were measured at 1 min intervals before and up to 20 min after the injection.
      Baseline blood pressure, stroke volume, and cardiac output were higher in
      hypertensive than in normotensive subjects. Naloxone had no immediate effect on
      blood pressure, heart rate, stroke volume, or total peripheral resistance in
      either group. These results indicate that: (1) naloxone has no immediate
      haemodynamic effect in young hypertensive or normotensive subjects, and (2) the
      higher stroke volume and cardiac output of young subjects with mild essential
      hypertension cannot be attributed to activation of endogenous opioid systems that
      are antagonized by naloxone.

PMID- 7788956
TI  - Inhaled nitric oxide monitoring.
AB  - Recently, inhaled nitric oxide (NO) became clinically available for the treatment
      of persistent pulmonary hypertension of the newborn. Such use requires
      administration and continuous monitoring of a very low concentration of NO to
      prevent potential toxicity. Since limited data on the reliability of NO
      monitoring devices are available, we evaluated the performance of a
      chemiluminescent and electrochemical sensor NO analyzer in a patient ventilator
      circuit. RESULTS: The chemiluminescence analyzer readings were significantly
      altered by the oxygen concentration in the ventilator circuit. When the FiO2 was
      increased from 0.21 to 1, a 4.5% +/- 0.3 decrease in the NO readings was found (p
      < 0.01). Similarly, adding humidity to the circuit, reduced the NO readings by
      4.8% +/- 0.9 (p < 0.01). The effect of gas pressure was proportional to its
      magnitude but independent of whether a pulsatile or continuous gas flow was
      provided. At a mean airway pressure of 15 cm H2O, the NO readings increased by
      3.94% +/- 0.05 (NO = 10 parts per million) and 3.97% +/- 0.02 (40 parts per
      million) (p < 0.01). The electrochemical sensor NO readings were directly
      proportional to the ventilator circuit pressure but independent of whether a
      pulsatile or continuous gas flow was provided. At a mean airway pressure of 15 cm
      H2O, the NO reading was increased by 25.39% +/- 0.04 (NO = 40 parts per million)
      (p < 0.01) and 1.07% +/- 0.16 (NO = 10 parts per million) (p NS). The greatest
      difference with NO = 10 parts per million from baseline was found at a mean
      airway pressure of 6 cm H2O (6.67% +/- 0.23; p < 0.01).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7788957
TI  - Allogeneic bone marrow transplantation for severe aplastic anemia: the Vancouver
      experience.
AB  - We report a retrospective analysis of the experience of a single centre in
      treating severe aplastic anemia (SAA) with allogeneic bone marrow transplant
      (BMT). Between 1982 and 1992, we transplanted 21 patients with SAA (14 males, 7
      females); median age at BMT was 15 y (range 2-40 y); median time from diagnosis
      of SAA to BMT was 29 d (range 6 d-5.5 y). Thirteen patients had received multiple
      transfusions before BMT. Patients were conditioned with cyclophosphamide 50 mg/kg
      for 4 d, +/- total body irradiation 300-500 cGy as a single fraction; 1 patient
      received total nodal irradiation (750 cGy) plus antithymocyte globulin. Sixteen
      patients received bone marrow from human leucocyte antigen (HLA)-identical
      siblings, 3 from haplo-identical parents, and 2 from unrelated volunteer donors;
      graft-versus-host disease (GVHD) prophylaxis was variable. Three patients failed
      to fully engraft following BMT; 2 achieved successful engraftment following a
      second BMT. Six of 20 evaluable patients (30%) developed grade II-IV acute GVHD,
      of whom 3 died; 3 patients developed limited and 5 patients (31%) developed
      extensive chronic GVHD, of whom 1 died. Fourteen patients (67%) are alive and
      well following BMT with a median follow-up of 6 y (range 2.1-11 y). Survival was
      superior in patients receiving sibling-donor BMT (75%) compared with those
      receiving parent- or unrelated-donor BMT (40%). We conclude that allogeneic BMT
      remains an important mode of treatment for SAA, but long-term survival remains
      limited by graft failure and GVHD.

PMID- 7788958
TI  - Clarithromycin versus cefaclor in lower respiratory tract infections. The
      Canadian Bronchitis Study Group.
AB  - A randomized study was done to compare the efficacy of clarithromycin 250 mg or
      500 mg b.i.d., vs. cefaclor 250 mg or 500 mg t.i.d. for 7-14 d in 197 evaluable
      patients with lower respiratory tract infection. Ninety-five patients received
      clarithromycin, 88 with acute bronchitis or exacerbation of chronic bronchitis,
      and 7 with pneumonia. One hundred and two patients received cefaclor, 86 with
      bronchitis and 16 with pneumonia. Ten patients (10.5%) in the clarithromycin
      group did not complete the trial, 5 (5.3%) because of adverse event, and 3 (3.2%)
      because of clinical failure. Similarly, 11 patients (10.8%) did not complete
      cefaclor, 2 (2%) because of adverse event, and 7 (6.9%) because of clinical
      failure. Clinical cure or improvement was observed in 90 (94.7%) of patients on
      clarithromycin vs. 92 (90.2%) on cefaclor, p = 0.66. Bacteriologic cure was seen
      in 26/36 patients (72.2%) on clarithromycin vs. 28/40 patients (70%) on cefaclor,
      p = 0.28. Clarithromycin is just as effective as cefaclor for lower respiratory
      tract infections and is well tolerated.

PMID- 7788960
TI  - Production of acyl-carnitines from the metabolism of [U-14C]3-methyl-2
      oxopentanoate by rat liver and skeletal muscle mitochondria.
AB  - A sensitive method of continuous on-line radio-high performance liquid
      chromatography (HPLC) was used to detect the specific radio-labelled acyl
      carnitine esters derived from the oxidation of [U-14C]3-methyl-2-oxopentanoate by
      rat liver and muscle mitochondrial fractions. The recoveries of carnitine, acetyl
      carnitine, propionyl-carnitine, 2-methylbutyryl-carnitine, and hexanoyl-carnitine
      were 98.7% (+/- 5.4; SEM, n = 3), 91.4% (+/- 7.6), 89.4% (+/- 5.2), 84.6% (+/-
      6.8), and 87.9% (+/- 7.8), respectively, from quenched mitochondrial incubations.
      This method demonstrated that rat liver and muscle mitochondria generate acetyl
      carnitine, propionyl-carnitine and 2-methylbutyryl-carnitine when incubated with
      [U-14C]3-methyl-2-oxopentanoate in the presence of carnitine. The production of
      acetyl-carnitine was almost similar in the 2 tissues. Muscle mitochondria
      produced higher amounts of propionyl-carnitine and 2-methylbutyryl-carnitine than
      liver mitochondria. These observations suggest a limited utilization of propionyl
      CoA by muscle mitochondria which, through a mechanism of feed-back inhibition,
      may have contributed to the accumulation of 2-methylbutyryl-CoA. This study
      provides further evidence for the importance of carnitine in the modulation of
      the mitochondrial [acyl-CoA/[CoA] pool.

PMID- 7788959
TI  - Does injectable gold retard radiologic evidence of joint damage in psoriatic
      arthritis?
AB  - The aim of this investigation has been to assess whether gold therapy prevents
      radiologic progression of psoriatic arthritis (PsA) over a period of 2 y.
      Eighteen patients (11 males, 7 females, mean age 42 y, DD 6.5 y) who were
      initiated on intramuscular gold during their attendance at the Psoriatic
      Arthritis Clinic were studied. For each gold-treated patient, 2 matched control
      patients, who had never had gold therapy, were identified from the PsA database.
      The control patients were similar to the patient population in gender, age,
      disease duration, number of actively inflamed joints, radiologic score and other
      medications used, and were followed in the clinic for at least 24 months.
      Actively-inflamed joint count decreased by > or = 40% in 9 of 18 gold-treated
      patients at 12 months. Seven patients continued gold for 24 months, while 11
      discontinued gold for either lack of efficacy (4) or side effects (7). A
      comparison of the change in radiographic evidence of damage in the peripheral
      joints between the 18 gold-treated patients and the 36 controls revealed that
      there was no statistical difference in disease progression. These results suggest
      that gold therapy does not prevent the progression of damage in patients with
      psoriatic arthritis.

PMID- 7788961
TI  - The effect of interleukin-2 on suppressor T lymphocytes in autoimmune thyroid
      disease.
AB  - We have investigated the effects of interleukin-2 (IL-2) on the activation of
      suppressor T lymphocytes in autoimmune thyroid disease (AITD), with insulin
      dependent diabetes mellitus (IDDM) as an autoimmune disease control; this was
      accomplished by measuring the expression of major histocompatibility complex
      class II (HLA-DR), CD25 (IL-2 alpha receptor (R)), and IL-2 beta R expression on
      their surfaces by flow cytometric analysis. Peripheral blood mononuclear cells
      (PBMC), obtained from 10 patients with Graves' disease (GD), 11 with Hashimoto's
      thyroiditis (HT), 9 with insulin-dependent diabetes mellitus (IDDM), and 10
      normal persons (N), were cultured for 7 d in the presence or absence of IL-2 at a
      final concentration of 50 U/mL. CD8+ cells were isolated from cultured PBMC with
      immunomagnetic beads, and were stained with fluorescent-conjugated monoclonal
      antibodies (anti-CD11b, anti-IL-2 alpha R, anti-IL-2 beta R, and anti-HLA-DR);
      the activation of CD8+CD11b+ ("suppressor") T cells (Ts) by IL-2 was then
      analyzed on a flow cytometer. In the absence of IL-2, i.e., in the autologous
      mixed lymphocyte reaction (AMLR), Ts from patients with GD, HT, and IDDM showed
      significantly lower activation as compared to N when analyzed by HLA-DR
      expression, but were not significantly different when IL-2R expression was
      measured. We determined the Stimulation Index (SI) of the activation of T
      lymphocytes by IL-2 for comparison between N and patients. With stimulation of 50
      U/mL of IL-2, SI of HLA-DR+ Ts was significantly (p < 0.05 to 0.01) lower in GD,
      HT, and IDDM as compared with N.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7788963
TI  - An early-onset recessive cerebellar disorder with distal amyotrophy and, in two
      patients, gross myoclonia: a probable ataxia telangiectasia variant.
AB  - We report a family of 4 siblings from a non-consanguineous marriage, presenting
      with an early onset recessive cerebellar ataxia and progressive distal limb
      wasting. Ocular or other telangiectasias were absent. There were neither frequent
      infections nor immunodeficiencies. The two youngest patients exhibited an
      incapacitating myoclonus which abated markedly after 20 years. Late onset
      diabetes was demonstrated in 3 patients. Hypogonadism was not a feature and there
      was a prolonged survival in the 4 patients. The oldest sibling died of a
      pancreatic adenocarcinoma. alpha-Fetoprotein was elevated with normal
      carcinoembryonic antigen values in three patients. Cytogenetic analysis and
      radioresistant DNA synthesis was compatible with the diagnosis of ataxia
      telagiectasia. This family probably represents a rare variant of ataxia
      telangiectasia.

PMID- 7788962
TI  - Higher in-hospital mortality in female patients following coronary artery bypass
      surgery: a population-based study. Provincial Adult Cardiac Care Network of
      Ontario.
AB  - This study examined the relationship between gender and in-hospital mortality
      using data from patients undergoing coronary artery bypass surgery (CABS) in the
      province of Ontario. All patients who underwent CABS between April 1, 1991 and
      March 31, 1992 at the 9 cardiac surgery institutions were included for study (n =
      5,175). The unadjusted in-hospital mortality rate was 3.3% and was higher among
      females (5.3%) than males (2.8%). Using logistic regression analysis to adjust
      for several predictors of in-hospital mortality the odds ratio estimate (OR) for
      female sex was 1.55 and was statistically significant (95% confidence interval
      (CI) 1.09 to 2.20). Women experienced rates of in-hospital mortality that are 1.6
      times greater than males following bypass surgery after case-mix adjustment for
      age, anatomical disease severity, anginal class, and comorbid conditions. Severe
      unstable angina had the greatest potential contribution to in-hospital mortality
      (OR = 7.51, 95% CI = 3.71-15.23) and was more prevalent in women, indicating that
      excess mortality may be due to delayed diagnosis in women.

PMID- 7788965
TI  - Anti-tumour therapy in paraneoplastic neurological disease.
AB  - Paraneoplastic neurological syndromes have attracted attention in recent years.
      Detection of auto-antibodies directed against CNS and PNS structures have
      suggested an autoimmune etiology. This review is based on reports from the past
      10 years and summarizes the therapeutic results in 258 patients suffering from
      paraneoplastic neurological disease including paraneoplastic encephalomyelitis,
      sensory neuronopathy, cerebellar degeneration, motor neurone disease and stiff
      man syndrome. The results show that in some entities such as Lambert-Eaton
      syndrome successful treatment can be expected. In other syndromes such as
      subacute sensory neuronopathy or paraneoplastic cerebellar degeneration
      therapeutic success varies from 5 to 10%.

PMID- 7788964
TI  - Trial to establish an animal model of paraneoplastic cerebellar degeneration with
      anti-Yo antibody. 2. Passive transfer of murine mononuclear cells activated with
      recombinant Yo protein to paraneoplastic cerebellar degeneration lymphocytes in
      severe combined immunodeficiency mice.
AB  - Passive transfer of serum IgG or mononuclear cells from peripheral blood of a
      patient with paraneoplastic cerebellar degeneration (PCD) to rodents was carried
      out in order to examine the role of anti-Purkinje cell antibody (anti-Yo
      antibody) present in serum and cerebrospinal fluid of PCD patients. After a
      single injection of IgG into mouse brain, it was taken up by Purkinje cells and
      remained there for more than 36 h without Purkinje cell loss. Injection of PCD
      IgG together with complement or lipopolysaccharide-activated human macrophages or
      rat mononuclear cells into rat ventricles did not cause Purkinje cell loss. We
      also studied passive transfer of the PCD patient's lymphocytes to mice with
      severe combined immunodeficiency (SCID). We constructed a recombinant Yo fusion
      protein that has the leucine-zipper protein (Yo protein), the common epitope for
      anti-Yo antibody for immunizing mice, and that resulted in production of
      significant amounts of anti-Yo antibody. Spleen cells from these Yo protein
      immunized mice were injected intravenously or intracerebrally into naive mice
      that subsequently showed no neurological symptoms or loss of Purkinje cells. We
      conclude that the anti-Yo antibody, either in combination with or without
      complement or activated mononuclear cells, cannot be the sole cause of Purkinje
      cell loss.

PMID- 7788966
TI  - Immune modulation of paraneoplastic neurologic disorders.

PMID- 7788967
TI  - 'Lewy body disease': clinico-pathological correlations in 18 consecutive cases of
      Parkinson's disease with and without dementia.
AB  - One of the characteristic histological features of Parkinson's disease (PD), with
      or without dementia, is the presence of Lewy bodies (LBs) in the brainstem and
      neocortical and limbic structures. They are often accompanied by Alzheimer type
      pathology (ATP). In the present retrospective study the clinical features and
      post-mortem findings of 18 consecutive and unselected PD patients were compared,
      with special reference to the frequent but not exclusive association of LBs with
      ATP in Lewy body disease (LBD). LBD is the term applied to a particular pattern
      of neuronal degeneration associated with LBs. In this study of idiopathic PD
      patients ATP seems to be the major determinant of the cognitive decline in most
      patients. Cortical Lewy Bodies (CLBs) were present in all patients reviewed,
      whether or not dementia was present. It was not possible to distinguish a
      specific pattern in the cognitive or psychopathological symptoms of dementia that
      would differentiate LBD from Alzheimer's disease (AD). Although in most cases
      hippocampal CA2-3 ubiquitin immunoreactive neurites were observed, here again
      there was no correlation with the presence of dementia.

PMID- 7788968
TI  - An unusual case of central nervous system cryptococcosis.
AB  - Opportunistic infections of the central nervous system (CNS) in immunocompromised
      patients often represent a diagnostic and therapeutic challenge due to the
      variety of possible infectious agents causing CNS disease. We report the case of
      a severely immunocompromised 43-year-old woman presenting with headache,
      confusion, abnormal CSF findings (cell count 237/mm3 with 50% eosinophils and
      elevated protein), multiple contrast enhancing lesions on CT and MRI in the basal
      ganglia, and serologic findings compatible with latent or reactivated
      toxoplasmosis with high IgA and IgG antibody titers against Toxoplasma gondii in
      whom a final diagnosis of CNS cryptococcosis was made. This case illustrates the
      considerable difficulties in the differential diagnosis of opportunistic CNS
      infection in the immunocompromised host. We conclude from our report that (1) the
      diagnosis of toxoplasma encephalitis should not be based on serological findings
      but rather be proven by either PCR, mouse inoculation or brain biopsy, (2) CNS
      cryptococcosis can be associated with marked CSF eosinophilia and multiple
      cryptococcomas, and (3) cryptococcomas can persist on CT and MRI despite
      successful antifungal treatment.

PMID- 7788969
TI  - Positron emission tomography in spastic diplegia.
AB  - In this study, three patients with spastic diplegia were examined with magnetic
      resonance imaging (MRI) and positron emission tomography (PET), using the steady
      state technique with 15O. Two of them had untractable seizures and mental
      retardation. On MRI the cortical structures were normal; increased T2 signals in
      the periventricular white matter in the second patient were the main findings.
      PET scan showed in the two patients with a seizure disorder and mental
      retardation a large left cortical area of decreased regional blood flow and
      oxygen consumption during the interictal phase. The third patient without
      epileptic spells had a normal PET scan examination. It is concluded that the
      epileptic disorder in two of our cases is due to an additional cortical lesion,
      while the spastic diplegia is caused by subcortical white matter destruction.

PMID- 7788971
TI  - Seizures with negative phenomena.
AB  - Somatic inhibitory seizures and amnesic seizures are thought to occur rarely. We
      describe a patient with both types of seizures who initially presented with a
      clinical picture of transient ischemic attack. Neuroradiological investigations
      revealed a lesion probably a cavernoma located above the parietooccipital sulcus
      in the isthmus of cingulate gyrus. Anticonvulsant therapy eliminated both types
      of seizure.

PMID- 7788970
TI  - Desmoplastic low grade astrocytoma: a case report and review of literature.
AB  - A 7-year-old girl presented with focal seizures without symptoms of raised
      intracranial tension. Routine histological, immunocytochemical and
      ultrastructural methods revealed a desmoplastic low grade cerebral astrocytoma.
      Follow up for 2 years after biopsy did not show recruitment of neurological
      symptoms or signs. Biphasic tumours containing glial and mesenchymal elements
      have been described in the literature under various diagnostic headings. As the
      histologically benign variants of mixed glial and mesenchymal tumours appear to
      have a good prognosis, identification of these as separate entities seems
      imperative. With a review of literature we propose a pathological classification
      of mixed glial and mesenchymal tumours.

PMID- 7788972
TI  - Complete callosal disconnection after closed head injury.
AB  - We report a patient with complete callosal disconnection syndrome after severe
      closed head injury. MRI showed a complete destruction of the corpus callosum
      throughout its length. Although traumatic callosal lesions are a frequent finding
      in autopsy studies, as well as in some recent MRI studies, clinical signs of
      callosal disconnection are rarely observed after head injuries and a complete
      disconnection syndrome has not been reported yet. This case study and the review
      of other reported cases suggest that posttraumatic callosal disconnection is
      probably often overlooked. Our patient had also a severe memory disorder that
      might be partly related to the bilateral involvement of the fornix, as this
      structure is closely adjacent to the posterior corpus callosum, and was also
      shown by MRI to be very probably damaged.

PMID- 7788973
TI  - Ossifying fibroma of the occipital bone.
AB  - A case of occipital ossifying fibroma in a 13-year-old girl is presented.
      Ossifying fibroma is a rare, benign, primary bone tumour that occurs most
      commonly in the mandible. Cranial vault location is extremely rare. To our
      knowledge, our patient is the second case of occipital location reported. Total
      surgical excision is the treatment of choice.

PMID- 7788974
TI  - Racemose neurocysticercosis after chronic meningitis: effect of medical
      treatment.
AB  - A patient affected by racemous neurocysticercosis, occurring 5 years after the
      onset of chronic meningitis and followed by sequential MRI studies, is described.
      After ventriculo-peritoneal shunt, he was successfully treated with Praziquantel
      and Albendazole. This case may contribute to understand the natural history of
      the disease and stress the efficacy of medical versus surgical treatment of this
      lifethreatening disease.

PMID- 7788975
TI  - Post-heatstroke parkinsonism and cerebellar dysfunction.
AB  - A case is presented of a 45-year-old woman who developed parkinsonism, cerebellar
      dysfunction, aphasia and flaccid paralysis secondary to heat stroke. Magnetic
      resonance imaging revealed irregular patchy areas of increased signal intensity
      in the white matter of both cerebral hemispheres and the left striatum, remaining
      unchanged over a follow-up period of two years. Cerebellar atrophy, while not
      seen on initial examination, was present on the follow-up study done one year
      later and became more marked after two years.

PMID- 7788976
TI  - Unusual peripheral blood-count and CSF content during an outburst of Echo-30
      meningitis.

PMID- 7788977
TI  - Paraneoplastic Neurological Disease, Recent Developments in Immune Diagnosis and
      Therapy. Proceedings of a symposium. Rotterdam, Netherlands, October 23, 1994.

PMID- 7788978
TI  - Clinical enigmas of paraneoplastic neurologic disorders.

PMID- 7788979
TI  - Immune diagnosis of paraneoplastic neurological disease.
AB  - A continuous stream of new information on clinical, pathological and
      immunological aspects of paraneoplastic neurological syndromes has been published
      in recent years. In this survey, we will discuss current opinions on the value of
      anti-neuronal antibody detection for establishing a diagnosis of one of the
      paraneoplastic syndromes of the central nervous system.

PMID- 7788980
TI  - Intradural tumors of the cauda equina: a single institution review of clinical
      characteristics.
AB  - A retrospective review of 106 cases of intradural tumors of the cauda equina are
      presented, subdivided into 5 groups according to their histological
      characteristics. For each group the clinical course and long-term postoperative
      results were analyzed: it emerged that differential diagnosis between neurinomas,
      meningiomas or non-tumoral lesions is not possible based on clinical findings
      alone and that neuroradiological diagnosis is more accurate when MRI is employed.
      Long-term prognosis was always favorable with the exception of the group of
      ependymomas. Nevertheless, early diagnosis in the latter group of tumors gives
      excellent results because prognosis is apparently directly correlated to the
      length of preoperative clinical history.

PMID- 7788981
TI  - Trial to establish an animal model of paraneoplastic cerebellar degeneration with
      anti-Yo antibody. 1. Mouse strains bearing different MHC molecules produce
      antibodies on immunization with recombinant Yo protein, but do not cause Purkinje
      cell loss.
AB  - Passive transfer of anti-Yo antibody from patients with paraneoplastic cerebellar
      degeneration (PCD) associated with gynecological or breast carcinoma has not been
      successful in inducing an animal model. We used active immunization with
      recombinant Yo protein of four strains of mice bearing different MHC molecules:
      BALB/c (H-2d), C3H (H-2k), C57BL/6 (H-2b), SJL/J (H-2s). All the strains produced
      high anti-Yo antibody titer but none developed cerebellar ataxia or showed
      Purkinje cell loss. Spleen cells from the immunized mice also reacted with
      recombinant protein. Because C57BL/6(nu/nu) mice produce no anti-Yo antibody,
      mature helper T cells are required for its production. Results suggest that
      antibody production in peripheral blood alone is not sufficient for the
      development of PCD and that MHC class II molecules function in the activation of
      T cells to help B cells to help B cells produce antibodies.

PMID- 7788982
TI  - Characterization of chest masses by FDG positron emission tomography.
AB  - Radiographic imaging techniques have proved to be of limited value in
      characterizing chest masses. Likewise, scintigraphic techniques with tumor
      seeking single photon emitting agents have shown marginal practical benefit. In
      contrast, high resolution PET with [F-18]-2-fluoro-2-D-deoxyglucose (FDG) offers
      a unique opportunity to distinguish benign from malignant processes by
      determining metabolic characteristics. PET scan results, including graphical
      analysis of tumor transfer constants (Patlak plot) in 21 patients with primary
      lung cancer, were compared to clinical outcome (histologic proof or clinical
      follow-up of longer than 1 year) in 54 patients who had chest masses identified
      by CT and/or plain film. The patients were categorized into three groups. The
      first group (N = 23) had primary, unknown, lung masses. Differentiation of benign
      from malignant tumors by PET had a sensitivity of 100% and a specificity of 67%.
      The second group (N = 13) had proven lung carcinoma or lymphoma and post-therapy
      PET scanning for recurrent tumor. In this setting, PET had a sensitivity of 83%
      and a specificity of 80%. The third group (N = 18) had extrathoracic malignancies
      and suspected pulmonary metastases. Metastatic lesions were identified with a
      sensitivity of 87% and specificity of 83%. Glucose uptake by normal tissue is
      variable and inflammatory/infectious processes can have high FDG uptake and
      overlap with the glucose uptake of malignant tissue. FDG PET is useful in
      characterizing chest tumors based on the level of their metabolic activity.
      Malignant tissue has a high glucose uptake. Elevated FDG uptake by an active
      inflammatory process may produce overlapping results.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7788984
TI  - Comparison of planar, SPECT, and 3-D synthetic reprojection images. A case study.
AB  - A case study is presented in which three types of images from a Ga-67 study are
      compared. The Ga-67 study was performed on a patient with fever of unknown origin
      (FUO). Planar and SPECT images were obtained. Planar data were presented as
      standard 2-D images on radiographic film. The SPECT data were used to generate
      two sets of images: standard 2-D multiple 'slice' images presented on
      radiographic film and a rotating 3-D synthetic reprojection displayed on a
      computer monitor. Compared to the planar and SPECT images, three sites of
      inflammation and the path of an oblique sinus tract were best seen in the 3-D
      synthetic reprojection. Recognition of anatomic structures and their spatial
      relationships was most readily apparent when viewing the 3-D synthetic
      reprojection, and this method of display facilitated the rapid recognition of
      abnormal findings.

PMID- 7788983
TI  - Prominent uptake of Tl-201 by duodenal leiomyosarcoma after exercise myocardial
      perfusion study.
AB  - Thallium-201 SPECT performed preoperatively for the evaluation of myocardial
      ischemia in a 72-year-old man with duodenal leiomyosarcoma demonstrated prominent
      focal uptake in the abdomen. Comparing a transaxial slice of SPECT through the
      abdominal uptake to the CT scan, the uptake was confirmed to be corresponding to
      the tumor. The tumor was delineated clearly, in good contrast to the surrounding
      normal intestine, which showed far less Tl-201 uptake than the tumor. In the
      delayed SPECT performed 3 hours after injection, although the intestinal activity
      became perceptible, the tumor still could be differentiated from the surrounding
      normal intestine. In this case, the exercise might be attributable to the initial
      low Tl-201 uptake by the normal intestine, which might otherwise have been an
      obstacle to Tl-201 scintigraphy for abdominal tumor detection. This case suggests
      the use of exercise for avoiding unfavorable intestinal activity, and the
      possibility of Tl-201 SPECT for abdominal tumor imaging.

PMID- 7788985
TI  - Eurysternum (extra-wide sternum)--a rarely recognized developmental anomaly.
      Scintigraphic appearances.
AB  - A rarely recognized extra-wide sternum was demonstrated by Tc-99m methylene
      diphosphonate bone scans in two adult patients. One patient was a 53-year-old man
      with prostate cancer who had no sternal symptoms or known sternal deformity. The
      second patient was a 41-year-old man with carcinoma of the lung whose extra-wide
      sternum was associated with a pectus excavatum deformity involving the lower half
      of the mesosternum (corpus sternum). A proper name for this developmental
      abnormality, "eurysternum" (eury-Greek word meaning broad; wide), is suggested.
      Two other patients, one with another type of wide sternum and another with a
      mesosternal foramen (fenestra sternii) deformity are also described. Related
      embryology and developmental anatomy of the sternum are reviewed.

PMID- 7788986
TI  - Evaluation of bone metastases by Tc-99m MDP imaging in patients with stomach
      cancer.
AB  - The authors conducted a retrospective review of 234 bone scans of stomach cancer
      patients who had been diagnosed at the Seoul National University Hospital. In 106
      of the 234 cases (45.3%), there were abnormal bone scan results, suggestive of
      bone metastases. The most common site of bone metastases was the spine, followed
      by the ribs, pelvis, femur, and skull. These sites were similar to those known
      for other malignant diseases. The incidence of bone metastases increased
      according to the duration of disease, especially within 12 months after diagnosis
      in patients with stage III gastric cancer. The incidence of bone metastases
      increased as the clinical stage increased. However, the incidence of metastases
      did not relate to gastric cancer pathologic type. The authors found 6 cases of
      "superscan" in the 234 bone scans (2.6%). The bone scan findings correlated
      positively with the level of serum alkaline phosphatase.

PMID- 7788987
TI  - Discordant findings between krypton-81m gas and Tc-99m labeled ultrafine aerosol
      lung ventilation SPECT in two patients with idiopathic pulmonary fibrosis.
AB  - Technegas, a newly developed ultra-fine dry dispersion of Tc-99m labeled carbon
      with a particle size of approximately 5 nm to 20 nm, possesses the properties for
      lung ventilation imaging using SPECT. The authors observed a discrepancy between
      krypton-81m gas and technegas lung ventilation SPECT in two patients with
      idiopathic pulmonary fibrosis who demonstrated heterogeneously decreased
      distribution of technegas without regions of high count density (focal hot spots)
      of tracer in their lungs in spite of the almost homogenous distribution of
      krypton-81m gas. This finding could be explained by the duration of radioactive
      gas inhalation. Technegas lung ventilation SPECT images reflected lung
      ventilation with tidal breathing. Conversely, Kr-81m gas lung ventilation SPECT
      images reflected not only lung ventilation, but also lung volumes. These two
      radioactive agents for lung ventilation SPECT show different findings.

PMID- 7788990
TI  - Tc-99m galactosyl-neoglycoalbumin hepatic scintigraphy in fulminant hepatic
      failure.
AB  - Tc-99m galactosyl-neoglycoalbumin (NGA) is a new liver imaging agent that
      specifically binds to a hepatocyte specific membrane receptor, the hepatic
      binding protein. Scintigraphy with Tc-99m NGA is a noninvasive method that
      provides functional images of the liver. This report deals with one case of
      fulminant hepatic failure in which hepatic scintigraphy with Tc-99m NGA predicted
      hepatic recovery before clinical and biochemical parameters, being a prognostic
      index in this patient.

PMID- 7788988
TI  - Efficacy of hepatobiliary scintigraphy in demonstrating cholangio-colic fistulae.
      Is formation of internal biliary fistula related to external leak closure?
AB  - The authors present four cases of internal biliary fistulae (IBF) identified on
      hepatobiliary scintigraphy. All of the cases share common history of external
      biliary leak closure. Scintigraphy in all four cases showed a similar pattern of
      direct visualization of transverse colon without any significant small bowel
      activity. This suggests an increased frequency of IBF formation in cases with
      external fistulous tract closure. Retrospectively, it appears that spontaneous
      closure of external leak may be pathological consequence of formation of IBF
      involving hepatic flexure.

PMID- 7788989
TI  - Utility of Tc-99m GSA SPECT imaging in estimation of functional volume of liver
      segments in health and liver diseases.
AB  - The authors examined whether there was a difference in liver function among
      hepatic segments in liver cirrhosis cases, and in cases of hepatocellular
      carcinoma (HCC) associated with liver cirrhosis. If the average counts in the
      lateral segment of the left lobe were set at 1, the average counts in the right
      upper and lower segment of the liver were 0.75 approximately 1.02 (0.89 +/- 0.09,
      mean +/- SD) in normal cases, 0.38 approximately 2.24 (1.01 +/- 0.39) in liver
      cirrhosis cases, and 0.61 approximately 2.85 (1.15 +/- 0.58) in HCC cases. There
      is a significant difference between normal cases and liver cirrhosis cases or HCC
      cases (P < 0.001). Also, in HCC cases, if the average counts in the cancer
      bearing segment of the liver were set at 1, the average counts in the
      noncancerous segment of the liver were 0.55 approximately 2.85 (1.23 +/- 0.58),
      and many average counts in the cancer-bearing segment were equal to, or lower
      than those in the noncancerous segment. It has been found that there were
      significant differences in function among hepatic segments in liver cirrhosis
      cases, and in HCC cases. Furthermore, the liver function in the cancer-bearing
      segment tended to be worse due to the existence of carcinoma compared with that
      in the noncancerous segment.

PMID- 7788991
TI  - Localization of infection in HIV antibody positive patients with fever.
      Comparison of the efficacy of Ga-67 citrate and radiolabeled human IgG.
AB  - Patients who are human immunodeficiency virus (HIV) antibody positive are at
      increased risk of life threatening infection. Scintigraphic imaging with Ga-67
      citrate has been used to identify the presence and site of focal infection.
      However, focal accumulation of Ga-67 is not specific for infection. A
      retrospective study was performed to compare the accuracy of Ga-67 citrate and
      pooled human polyclonal immunoglobulin G (HIG) labeled with Tc-99m HIG and In-111
      HIG in identifying infection in HIV antibody positive patients. Twenty-five
      studies were performed using Ga-67 and Tc-99m HIG were compared with a second
      group of 25 studies using In-111 HIG in HIV antibody positive patients presenting
      with fever, but without localizing symptoms or signs. In-111 HIG identified 20 of
      22 sites of infection and also accumulated in 5 sites without infection (accuracy
      = 90%). This was significantly more accurate (X2, P < 0.05) than Ga-67 which
      identified 19 of 20 sites of infection, but accumulated in 18 sites without
      infection (accuracy = 74%) and Tc-99m HIG which identified infection in 11 of 20
      sites, but accumulated in 8 sites without infection (accuracy = 77%). There was
      no significant difference between the accuracy of Ga-67 and Tc-99m HIG. From this
      preliminary study In-111 HIG would seem to be the best agent for identifying
      infection in HIV antibody positive patients with fever.

PMID- 7788992
TI  - An approach to cerebral vasodilatory capacity in unilateral and bilateral
      cerebrovascular diseases using radiolabeled human serum albumin.
AB  - The acute cerebrovascular response to acetazolamide was assessed using a blood
      pool agent and planar dynamic imaging to evaluate cerebral vasodilatory capacity.
      Ten normal subjects and 12 patients with unilateral or bilateral cerebrovascular
      disease were studied. After the injection of radiolabeled human serum albumin,
      dynamic imaging of the anterior view of the head was started. Ten minutes later,
      1000 mg of acetazolamide was infused. The dilatation index (the percent increase
      in activity at the peak response) was obtained for each cerebral hemisphere. The
      mean dilatation index in normal subjects was 17.1 +/- 3.2% (N = 20). The value
      was significantly lower in patients with multiple infarcts (7.7 +/- 1.1%, N = 8,
      P < 0.001), and below the normal range in two involved hemispheres of five
      patients with unilateral occlusive carotid artery disease and in three
      hemispheres of three patients with moyamoya disease. It was suggested that this
      simple method may be useful in assessing cerebral vasodilatory capacity in both
      unilateral and bilateral diseases.

PMID- 7788993
TI  - Use of Tc-99m HMPAO brain SPECT to evaluate cerebral collateral circulation
      during Matas test.
AB  - Five patients with traumatic carotid-cavernous fistulae and two patients with
      internal carotid artery aneurysms inside the cavernous sinus are presented. A
      quantitative method was used for the evaluation of brain collateral circulation
      in the anterior and middle cerebral artery territories by using Tc-99m HMPAO
      SPECT before and during the Matas test. It affords a more reliable quantitative
      measurement of reduced activity than conventional carotid angiography during the
      Matas test. In this study, a reduction of radioactivity of less than 15% during
      the Matas test did not reveal any postoperative neurological deficit after a
      carotid artery trapping procedure. This noninvasive method seems to be useful to
      determine the appropriate surgical treatment.

PMID- 7788994
TI  - Tc-99m sestamibi uptake by malignant lymphoma and slow washout.
AB  - Tc-99m sestamibi has been used to detect primary brain tumors, lung tumors, and
      breast cancers. The authors report a patient who had superior vena cava (SVC)
      syndrome and underwent Tc-99m sestamibi and Tl-201 SPECT to differentiate the
      tumor from thrombus in the mediastinum because of an abnormal mass lesion on a
      contrast enhanced CT scan. An abnormal area of increased Tc-99m sestamibi uptake
      in the supra azygos area was demonstrated on early and delayed SPECT imaging. The
      washout of tumor uptake was slow. The removed tumor was confirmed to be malignant
      lymphoma.

PMID- 7788995
TI  - I-123 MIBG imaging of metastatic carcinoid tumor from the rectum.
AB  - I-131 MIBG, a specific radiopharmaceutical agent for scintigraphic imaging and
      treatment of pheochromocytoma and neuroblastoma may be useful for detection of
      apudomas. Scintigraphy with I-123 radiolabeled MIBG was performed in a patient
      with metastatic carcinoid tumor from the rectum. I-123 MIBG scintigraphic
      findings showed multiple areas of abnormal tumor uptake of hepatic and bone
      metastases from the rectal carcinoid. Bone scintigraphy demonstrated multiple
      metastatic lesions. Computed tomography revealed multiple solid tumors of the
      liver. This report describes accumulation of I-123 MIBG in the liver and bone
      metastases from the rectal carcinoid. Radioiodine MIBG scintigraphy may be useful
      for detecting metastatic lesions, for evaluating postoperative recurrence, and
      also for the treatment of the carcinoid tumor.

PMID- 7788996
TI  - Diagnostic value of Tc-99m (V) DMSA for chondrogenic tumors with positive Tc-99m
      HMDP uptake on bone scintigraphy.
AB  - Technetium-99m (V) DMSA scintigraphy was performed in 17 patients with 37
      chondrogenic tumors (13 osteochondromas, 14 enchondromas, and 10 chondrosarcomas)
      that had previously shown uptake of Tc-99m HMDP. Technetium-99m (V) DMSA showed
      high uptake by all chrondrosarcomas, but low or no uptake always indicated benign
      chondrogenic tumors. Technetium-99m (V) DMSA scintigraphy may be superior to Tc
      99m HMDP scintigraphy for distinguishing benign and malignant chondrogenic
      tumors, and could also be useful for diagnosing the malignant transformation of
      chondrogenic tumors.

PMID- 7788997
TI  - Parathyroid adenoma localized in the lower neck in a patient with lingual thyroid
      demonstrated with Tl-201/Tc-99m pertechnetate scintigraphy.

PMID- 7788998
TI  - Scintigraphic detection of localized small bowel abnormality.

PMID- 7788999
TI  - A potential false-positive posttherapy radioiodine scan secondary to I-131
      excretion in perspiration.

PMID- 7789000
TI  - Perfusion lung scanning with Tc-99m MAA in the assessment of Churg-Strauss
      syndrome.

PMID- 7789001
TI  - Fatty infiltration of the liver. An unusual presentation.

PMID- 7789002
TI  - Incidentally visualized hepatic hemangioma during dynamic renoscintigraphy.

PMID- 7789003
TI  - Hepatic angiosarcoma mimicking cavernous hemangioma.

PMID- 7789004
TI  - Bone scintigraphic appearances of massive bone allograft and local recurrence of
      sarcoma.

PMID- 7789005
TI  - Renal cell carcinoma extension into the inferior vena cava detected by Ga-67
      citrate imaging.

PMID- 7789006
TI  - Tc-99m MIBI accumulation in remnant thymus. A cause of false-positive
      interpretation in parathyroid imaging.

PMID- 7789007
TI  - Papillary carcinoma arising in sublingual ectopic thyroid concentrating both Tc
      99m pertechnetate and I-131. Diagnosis by fine needle aspiration cytology.

PMID- 7789008
TI  - Improving the diagnostic accuracy of Tl-201 imaging of intracranial tumors.

PMID- 7789009
TI  - Concepts of illness causality in a pediatric sample. Relationship to illness
      duration, frequency of hospitalization, and degree of life-threat.
AB  - In this study, we evaluated whether previous medical experience is associated
      with more sophisticated conceptions of illness causality among 64 children ages 4
      to 16 years old. Although age and prorated IQ were found to be strongly related
      to children's illness causality concepts, duration of medical condition, total
      hospitalization days, and higher life-threat medical conditions were not
      associated with more sophisticated illness concepts in this pediatric sample.
      Using multiple regression analysis, age and IQ accounted for 59% of the variance
      in illness causality scores; contrary to expectations, medical experience
      variables (i.e., diagnosis, illness duration, hospitalizations) were not
      significant predictors of children's illness concepts. These findings highlight
      the need for pediatricians to guard against overestimating the illness concepts
      of children with prior medical experience.

PMID- 7789010
TI  - Children's conceptualization of illness: translating data into practice.

PMID- 7789011
TI  - Kawasaki syndrome masquerading as bacterial lymphadenitis.
AB  - We present two case reports of older children who initially presented with
      cervical lymphadenitis and who were eventually diagnosed and treated for Kawasaki
      syndrome (KS). Both children presented with unilateral cervical lymphadenopathy
      and fever and later developed additional clinical features of KS, including
      cardiac aneurysms in one of the patients. Of the five KS clinical criteria which
      accompany fever for 5 days, cervical lymphadenopathy of > or = 1.5 cm is the
      least commonly found. Both patients were treated as having bacterial adenitis
      prior to the diagnosis of KS. We hope to illustrate that in the case of atypical
      cervical lymphadenitis, KS should be carefully considered in the differential
      diagnosis.

PMID- 7789012
TI  - Marked heterogeneity in Niemann-Pick disease, type C. Clinical and
      ultrastructural findings.
AB  - Niemann-Pick disease type C (NP-C) is an autosomal recessive lysosomal lipid
      storage disorder of unknown etiology. Diagnosis of NP-C is based on
      characteristic clinical findings and reduced fibroblast esterification of LDL
      derived cholesterol. We describe three patients who demonstrate the NP-C spectrum
      of clinical heterogeneity in age of onset, presenting signs, pattern of organ
      system involvement, and natural history. In addition, electron microscopic
      analysis of skin biopsy specimens from these patients revealed marked variability
      in the extent and cellular distribution of intralysosomal storage and was
      suggestive of the correct diagnosis in only one case. These cases demonstrate
      both the limitations of electron microscopy for diagnosis of NP-C and the marked
      clinical variability in patients with this disorder. Practical clinical
      guidelines for appropriate suspicion of NP-C are presented.

PMID- 7789013
TI  - Infective endocarditis in neonates.
AB  - We studied retrospectively the predisposing factors and signs of infective
      endocarditis (IE) in neonates and infants younger than 3 months of age, and we
      suggest diagnostic criteria. The charts of 16 infants less than 3 months of age,
      diagnosed with IE during a 5-year period, were reviewed for possible maternal and
      infant risk factors and for pathognomonic clinical and laboratory features. No
      apparent maternal risk factors were noted. Infant risk factors were congenital
      heart disease (4), patent ductus arteriosus (PDA) (5), and the use of central
      venous catheters (14). The main clinical findings were cardiac murmurs (12),
      petechiae (2), skin abscesses (7), arthritis (2), hepatomegaly (9), and
      splenomegaly (2). Echocardiography revealed a mass or vegetation in nine
      patients. Of the 27 microorganisms isolated from blood, the most common were
      staphylococci (15) and Candida sp. (6). Urine cultures were positive in six
      patients and cerebrospinal fluid cultures were positive in one. Other laboratory
      findings were not of diagnostic value. We conclude that the main risk factors for
      neonatal IE are central venous catheters and congenital heart disease, including
      PDA. The main causative microorganisms are staphylococci and Candida sp. The main
      investigations of diagnostic value are blood and urine cultures and
      echocardiography. We propose the diagnostic categories of definite, probable, and
      possible cases of neonatal IE, based primarily on clinical, blood culture, and
      echocardiographic data.

PMID- 7789014
TI  - Wolman disease and its treatment.

PMID- 7789015
TI  - Recombinant human erythropoietin (r-HuEPO) increases total bilirubin production
      in premature infants.

PMID- 7789016
TI  - Neonatal candidal meningitis in a full-term infant with congenital cutaneous
      candidiasis.

PMID- 7789017
TI  - Neonatal hemolytic-uremic syndrome.

PMID- 7789018
TI  - Serial changes of cystic air spaces in fibrosing alveolitis: a CT-pathological
      study.
AB  - In patients with cryptogenic fibrosing alveolitis (CFA), subpleural large cysts
      are sometimes seen within honeycombing on computed tomography (CT). These cysts
      may be interpreted as bullae and the coexistence of emphysema with CFA might be
      assumed. We evaluated whether cystic spaces in honeycombing become larger in
      patients with CFA on serial CT scans. CT scans were obtained in 16 patients with
      CFA, who had undergone two CT examinations (6 to 43 months, mean 25.1 months
      apart), were reviewed focusing on the changes in size of the cystic spaces in
      honeycombing. The mechanism of enlargement of cystic spaces was investigated
      using microscopic serial sections of autopsied specimens. In 15 of 16 patients,
      the cystic spaces in honeycombing were larger on the second examination.
      Histologically, stenosis of bronchioles and slit-like structures between cysts
      and bronchioles were detected in addition to alveolar septal dissolution and
      bronchiolectasis. Both the bronchiolar stenosis and the slit-like gaps have the
      potential to work as check-valves and increase the volume of cystic spaces.
      Therefore, in the evaluation of CFA, large cysts should be interpreted with
      caution to avoid misinterpretation of the cysts as bullae associated with
      emphysema. From the results of this correlative study, we suggest that a check
      valve effect is an important mechanism in the formation of large cysts in
      honeycomb lung.

PMID- 7789019
TI  - Delayed CT findings in acute renal infection.
AB  - The computed tomography (CT) findings in twelve patients with acute renal
      infection examined immediately and 3 h after i.v. contrast medium are reported.
      Three patients also had delayed scans at 6 h. Three main features were observed
      on the delayed scans: 1 a delayed nephrogram with streaky, wedge shaped or round
      high density areas. The areas of high density were at the same sites of the
      inhomogeneous areas of reduced density on the early scans; 2 focal contrast
      medium staining or a rim of increased density around abscesses; 3 focal areas of
      increased density at sites distant from the low density areas seen on the early
      scans. It is postulated that the delayed areas of increased density replace early
      areas of reduced density caused by ischemia due to vasospasm and/or compressing
      oedema of the vascular bed or by tubular obstruction. Delayed CT appears to be
      useful because it improves diagnostic confidence and gives a more exact
      evaluation of the extent of infection.

PMID- 7789020
TI  - Normal variation in the magnetic resonance imaging appearances of the sacroiliac
      joints: pitfalls in the diagnosis of sacroiliitis.
AB  - The purpose of this paper is to define the normal and variable appearances of the
      sacroiliac joints and adjacent subchondral marrow on unenhanced and enhanced
      Magnetic Resonance Imaging (MRI). Twenty subjects were imaged with spin-echo T1
      weighted (T1), fast spin-echo T2-weighted (T2), T1-weighted with fat suppression
      (T1FS) and fast short tau inversion recovery (Fast STIR) sequences. Five of these
      subjects were imaged following intravenous Gd-DTPA administration, and the
      enhancement factor of the synovial compartment of the sacroiliac joint and
      subchondral marrow was calculated. The appearance of the cartilage of the
      synovial compartment on T1 and T2 images is of an intermediate signal bounded by
      signal void of bone cortex. On T1FS and Fast STIR images the cartilage has an
      intermediate to high signal. The marrow on T1, T2 and T1FS images has a
      homogeneous intermediate signal. T1FS images demonstrate the synovial compartment
      with greater clarity than T1 images. Cortical erosions and subchondral sclerosis
      were not demonstrated in our subjects, and partial volume artifact between the
      synovial and ligamentous compartments should not be interpreted as erosions. On
      Fast STIR images there is normally a region of high signal from the immediate
      subchondral marrow, which should not be interpreted as early sacroiliitis. Seven
      subjects demonstrated a patchy distribution of fat within the bone marrow, an
      appearance which alone does not indicate sacroiliitis. One subject had an
      accessory articular facet of the sacroiliac joint. The percentage maximal
      enhancement factor of the synovial compartment of the sacroiliac joint and
      adjacent subchondral marrow is 52% and 94% on T1FS images respectively. These
      figures redefine the normal maximal enhancement factors in this region of the
      body.

PMID- 7789021
TI  - Signal changes in the intervertebral discs on MRI of the thoracolumbar spine in
      ankylosing spondylitis.
AB  - Contrary to standard teaching in magnetic resonance imaging (MRI), recent reports
      have documented calcification appearing as areas of increased signal intensity
      (SI) on T1-weighted images. Intervertebral disc calcification is a frequent
      finding on radiographs in chronic ankylosing spondylitis (AS). This study was
      performed to investigate the appearance of variable degrees of disc calcification
      in MRI. Thirty-six patients with AS of variable duration underwent an MRI scan of
      the thoraco-lumbar spine and the MR appearances, particularly of the discs, were
      compared with plain radiographs. Increased SI of the discs on T1-weighted images
      were found in 17 of 36 patients, occurring over a range of disc levels, and
      correlating with disc calcification on the radiographs in 78% of cases. This
      group tended to be older and have a longer duration of disease than those with
      normal appearing discs. Four different patterns of increased signal within the
      discs termed Type A (marginal), Type B (annular), Type C (central) and Type D
      (solid) were identified. In those with less than six discs involved Type A was
      the most common pattern. In those with more than six discs involved Type D was
      the most common pattern, suggesting a progression of disc involvement with more
      advanced disease. Although these findings will not affect the management of the
      disease, they do highlight the recently described phenomenon of calcification
      appearing as increased SI on T1-weighted images, likely to be related to the
      surface area of the calcium crystal. This should lead to the consideration of
      calcium in the differential diagnosis of increased SI on T1-weighted images. End
      plate marrow changes were a relatively frequent finding in this study but did not
      correlate with the signal changes seen within the discs; in a number of cases
      they related to variable degrees of bony bridging.

PMID- 7789023
TI  - The application of ultrasound criteria for malignancy in differentiating
      tuberculous cervical adenitis from metastatic nasopharyngeal carcinoma.
AB  - Tuberculous adenitis and metastatic nodes from Nasopharyngeal carcinoma may have
      a similar clinical presentation. Clinical examination and laboratory tests alone
      are unable to differentiate the two. However, ultrasound is a useful initial
      investigation in differentiating these two conditions. We present ultrasound
      appearances in 33 patients with proven tuberculous cervical adenitis and 32
      patients with proven metastatic nasopharyngeal carcinoma. The ultrasound features
      we found useful were the distribution of the nodes, cystic change, matting and
      surrounding soft tissue oedema. The size, shape and internal architecture of the
      nodes, previously described criteria in differentiating benign from malignant
      nodes, did not help.

PMID- 7789022
TI  - Can MRI predict the histopathological response in patients with osteosarcoma
      after the first cycle of chemotherapy?
AB  - The magnetic resonance (MR) changes after one cycle of chemotherapy were compared
      with the prechemotherapy studies in 39 patients with osteosarcoma, in order to
      identify MR changes which can be used to assess early response to chemotherapy.
      Measurements of total tumour volume, signal intensity, and tumour enhancement of
      the intra- and extraosseous tumour component were performed. Change in the amount
      of oedema was subjectively assessed. Changes observed were correlated with
      histopathological response. Changes in tumour volume and of the signal intensity
      of the extraosseous tumour component on T2-weighting were the only two parameters
      which correlated significantly (P < 0.05) with histopathological response.
      Increase of tumour volume is the most significant parameter and indicates poor
      response (sensitivity 89%, specificity 73%). Only one good responder showed
      increase of tumour volume. Decreased or stable tumour volume was observed in both
      good and poor responders. Increase of signal intensity was found exclusively in
      five poor responders (sensitivity 100%, specificity 23%). Decreased or stable
      signal intensity was observed in both good and poor responders. Changes in the
      amount of oedema and contrast enhancement could not predict response at an early
      stage. We conclude that increase of tumour volume and increase of T2 signal
      intensity of extraosseous tumour can be predictive for poor response. MR criteria
      are not helpful in the early identification of good responders.

PMID- 7789024
TI  - The prevalence and clinical significance of lymphadenopathy in primary biliary
      cirrhosis.
AB  - We present the results of a retrospective review of abdominal computed
      tomography, ultrasound, and magnetic resonance examinations of 12 patients with
      primary biliary cirrhosis undertaken to determine the prevalence and clinical
      significance of previously reported coexistent intra-abdominal lymphadenopathy in
      patients with this disorder. Lymphadenopathy, in the form of bulky periportal and
      retroperitoneal nodes, was identified in a single patient secondary to an occult
      metastatic adenocarcinoma. We conclude that coexistent intra-abdominal
      lymphadenopathy occurring in patients with primary biliary cirrhosis is uncommon.
      Although it may represent a benign component of the primary disease, it may
      equally be due to unsuspected coexistent occult malignancy.

PMID- 7789025
TI  - V/Q defects and deep venous thrombosis following total hip replacement.
AB  - Seventy-two patients undergoing elective total hip replacement were studied with
      bilateral venography, pre-operative and post-operative lung scans. Twelve
      belonged to a control group that received placebo injections and 60 patients to
      treatment groups that received low molecular weight heparin. The incidence of
      deep venous thrombosis was 11 (92%) of 12 patients in the control group and 18
      (30%) of 60 patients in the treatment group (X2: P < 0.001). The incidence of
      pulmonary embolism (new unmatched perfusion defects) was five (42%) of the 12
      patients in the control group and five (8.3%) of the 60 patients in the treatment
      groups (X2: P < 0.002). The incidence of pulmonary embolism (new unmatched
      perfusion defects) was eight (27.5%) of 29 patients with deep venous thrombosis
      and two (4.6%) of 43 without deep venous thrombosis (X2: P < 0.02). Of the ten
      patients who had pulmonary embolism according to this study's criteria (one or
      more new defect on perfusion, unmatched on the ventilation scan), eight would
      have been classified as high probability by the Biello criteria, and only five by
      the PIOPED criteria, if the pre-operative scans were not available. We conclude
      that having a pre-operative lung scan improves ability to interpret the
      postoperative lung scans in high risk patients.

PMID- 7789026
TI  - Demonstration of popliteal artery entrapment on leg muscle scintigraphy with
      99mTc MIBI and single photon emission tomography.
AB  - Popliteal artery entrapment is difficult to diagnose even at surgery. Early
      diagnosis is important as the prognosis is better if detected before the onset of
      complications. There is no sensitive method for the evaluation of this condition.
      We describe three cases detected by a new technique using 99mTc methoxy isobutyl
      isonitrile (MIBI) with single photon emission tomography. The scintigraphic
      features of entrapment and the advantage of MIBI leg scintigraphy over other
      methods are discussed.

PMID- 7789028
TI  - Laryngeal chondroma: an unusual cause of upper airway obstruction.
AB  - Cartilaginous tumours of the larynx should be considered in the differential
      diagnosis of upper airway obstruction. We report two cases of chondroma of the
      thyroid cartilage and discuss the radiological findings in each case.

PMID- 7789027
TI  - Amyloid goitre: CT and MR findings.
AB  - Two cases of amyloid goitre presented as an enlarged thyroid mass with cystic
      components. Solid parts of the goitre showed high attenuation on computed
      tomography (CT) and moderate hypointensity on T1 and T2-weighted images. Fine
      needle aspiration was negative for amyloid, but pathological studies of surgical
      specimens demonstrated amyloid infiltration of the thyroid interstitium and
      regressive colloid cysts. In a patient at risk for systemic amyloidosis, thyroid
      enlargement with a cystic component suggests amyloid goitre. In this case, needle
      biopsies should be directed to solid areas of the mass because amyloid material
      may not be present in the cysts.

PMID- 7789029
TI  - Case report: multiple epidermoid cysts of the testes--the ultrasound appearances.
AB  - Epidermoid cysts are uncommon tumours of the testes representing approximately 1%
      of all testicular tumours. Their importance lies in the fact that they are
      completely benign and can be treated by local excision, thereby saving the
      patient an orchidectomy. We describe a case in which the patient had multiple
      epidermoid cysts involving both testes and faced possible bilateral orchidectomy.

PMID- 7789031
TI  - Case report: calcified stones in right-sided colonic diverticula stimulating
      gallstones.
AB  - Right-sided colonic diverticulosis, though unusual in the Western population, is
      common in the Orient. Calcified stones are rarely found within colonic
      diverticula. Standard textbooks of diagnostic radiology do not list calcified
      stones within caecal or ascending colonic diverticula as possible causes of
      calcification in the right hypochondrium or right iliac fossa. We present a
      patient with multiple laminated right-sided diverticular concretions mimicking
      gallstones. This possibility should be included in the differential diagnosis of
      gallstones or calcifications on the right side of the abdomen.

PMID- 7789030
TI  - Case report: symptomatic metastasis from a sacrococcygeal chordoma.
AB  - Chordoma is generally thought to be a locally invasive tumour of low metastatic
      potential. Review of the literature suggests that metastatic spread from chordoma
      is not an uncommon occurrence, but that the metastases are usually clinically
      silent. We present an unusual case where a metastasis from a sacrococcygeal
      chordoma produced a syndrome of lumbar root compression after resection of the
      primary lesion.

PMID- 7789032
TI  - Case report: a variant of the subclavian steal syndrome. Demonstration by duplex
      Doppler imaging.
AB  - The subclavian steal syndrome results from occlusion of the proximal subclavian
      or innominate artery which causes reversal of blood flow in the ipsilateral
      vertebral artery. We describe a case where a further occlusion of the ipsilateral
      common carotid artery (CCA) resulted in an intermittent reversal of flow in the
      ipsilateral external carotid artery (ECA), to siphon blood up the internal
      carotid artery (ICA) and down the ipsilateral vertebral artery.

PMID- 7789033
TI  - Acoustic attenuation in breast: a normal variant?

PMID- 7789034
TI  - Hodgkin's disease of the gastrointestinal tract.

PMID- 7789035
TI  - Corticosteroid prophylaxis for patients with increased risk of adverse reactions
      to intravascular contrast agents.

PMID- 7789036
TI  - Percutaneous antegrade ureteric stent insertion in malignant disease.

PMID- 7789037
TI  - The influence of trans fatty acids on health.

PMID- 7789038
TI  - The influence of trans fatty acids on health: a report from the Danish Nutrition
      Council.
AB  - Trans fatty acids constitute 0-30% of the fat in Danish margarines, most in
      industry and bakery margarines and usually less in table margarine. The trans
      fatty acids make margarines more solid at room temperature and therefore provide
      an economical storage advantage. In British and U.S. reports from 1984-1989, the
      trans fatty acids were more or less acquitted of unhealthy effects. During the
      last 5-6 years, however, a series of new studies has been published regarding
      both the connection between the consumption of trans fatty acids and the
      occurrence of coronary heart disease and the impact on the lipoprotein level in
      plasma. Studies suggest that the consumption of trans fatty acids from margarine
      is equally, or perhaps more, responsible for the development of arteriosclerosis
      than saturated fatty acids. In addition, it is now clear that both the fetus and
      the breast-fed baby are exposed to trans fatty acids in relation to the mother's
      consumption. A couple of recent studies suggest a possible restrictive influence
      of the trans fatty acids on the weight of the fetus. The average consumption of
      trans fatty acids from margarine in Denmark in 1991 was approximately 2.5 g/day
      per person. For about 150,000 adult Danes, the consumption is assumed to be more
      than 5 g/day per person. On this basis, the Danish Nutrition Council recommend
      that the consumption of trans fatty acids is reduced as much as possible. This
      can be done by reducing the fat content in food and by reducing the trans fatty
      acid content in all Danish margarine products to 5% or less. Thereafter, the
      group of adult Danes, including pregnant and breast-feeding women, with a large
      consumption of margarine and margarine-containing products, will on average only
      consume 2 g of vegetable trans fatty acids/day. This corresponds to the
      consumption in the low-risk groups in the above-mentioned epidemiological
      studies. In addition, the Danish Nutrition Council encourage the producers of
      margarines to make products that can be marketed as 'free of trans fatty acids'.

PMID- 7789039
TI  - Chemokines and human infection.

PMID- 7789040
TI  - Combined intestinal trefoil factor and epidermal growth factor is prophylactic
      against indomethacin-induced gastric damage in the rat.
AB  - 1. The availability of recombinant epidermal growth factor provides a potentially
      exciting development for the treatment of gastrointestinal ulceration. However,
      because of its potent mitogenic activity, there is a need for strategies which
      reduce the dose required. Intestinal trefoil factor stimulates mucosal healing
      without increasing proliferation. Studies were undertaken to examine the
      biological effects of rat intestinal trefoil factor and/or human epidermal growth
      factor upon gastrointestinal epithelial cell functions pertinent to mucosal
      protection, using two wounding models. 2. The study of epithelial restitution in
      vitro demonstrated a marked synergistic effect on the rate of migration of the
      wound edge when intestinal trefoil factor was used in combination with epidermal
      growth factor. There was no increased cellular proliferation due to the addition
      of intestinal trefoil factor to the cells when given alone, or to the stimulatory
      effect of cells treated with epidermal growth factor. In the rat model of gastric
      ulceration, the presence of both epidermal growth factor and intestinal trefoil
      factor protected against the development of indomethacin-induced gastric lesions.
      3. We conclude that combination therapy of epidermal growth factor with
      intestinal trefoil factor could provide a more potent, safer approach to the
      treatment of human gastrointestinal ulceration.

PMID- 7789041
TI  - Metabolic acidosis is a potent stimulus for cellular inorganic phosphate
      generation in uraemia.
AB  - 1. During metabolic acidosis, significant fluxes of inorganic phosphate (Pi) may
      occur from cellular to extracellular fluid. In this study Pi was measured in
      erythrocytes of uraemic patients before and after haemodialysis and was related
      to their plasma pH (acidosis), plasma Pi (hyperphosphataemia) and cellular
      organic phosphate concentrations. 2. Before dialysis, the ratio of cellular to
      extracellular Pi concentration correlated inversely with plasma pH, increasing
      2.5-fold as pH fell from 7.4 to 7.2. 3. An increase in cellular Pi similar to
      that seen in the patients was observed within 90 min of adding acid to normal
      erythrocytes in vitro. 4. The total Pi content of the cell suspension increased
      25% on decreasing plasma pH from 7.4 to 7.2, largely as a result of generation of
      Pi from 2,3-bisphosphoglycerate in the cells. This was accompanied by net efflux
      of Pi into plasma. 5. In addition, the increase in the steady-state cellular Pi
      concentration on adding a constant extracellular Pi load was 50% greater at pH
      7.2 than at 7.4, implying that alterations in the regulation of the transmembrane
      Pi gradient also contribute to the rise in cellular Pi observed at low pH. 6. At
      normal plasma Pi concentration (1 mM), glycolytic flux (lactate production) was
      inhibited by 20% when pH was lowered from 7.4 to 7.2. However, this inhibition
      was blocked when cellular Pi was increased by adding Pi to the plasma in vitro.
      7. Metabolic acidosis is therefore a potent stimulus for Pi generation in
      erythrocytes, and this Pi may serve to stimulate glycolysis which is normally
      inhibited by low pH.

PMID- 7789042
TI  - Participation of endogenous atrial natriuretic peptide in the regulation of
      urinary protein excretion in experimental diabetic rats.
AB  - 1. In order to determine whether atrial natriuretic peptide might play a role in
      the development of glomerular hyperfiltration in diabetes mellitus, we examined
      the effects of administration of glucose, albumin, atrial natriuretic peptide and
      an atrial natriuretic peptide receptor antagonist on renal function in rats with
      streptozotocin-induced diabetes mellitus and vehicle-treated control rats. 2.
      Four weeks after treatment, rats with diabetes mellitus had a higher mean plasma
      atrial natriuretic peptide concentration than controls [152 +/- 5 (SE) versus 115
      +/- 6 pg/ml, P < 0.01] and a higher glomerular filtration rate (3.3 +/- 0.1
      versus 2.7 +/- 0.2 ml min-1 kg-1, P < 0.05). 3. Infusion of albumin or glucose
      caused significant increases in atrial pressure, plasma atrial natriuretic
      peptide concentration and urinary excretion of sodium and protein in both groups
      of rats. 4. Increasing plasma atrial natriuretic peptide concentration by 60% via
      atrial natriuretic peptide infusion increased urinary excretion of sodium and
      protein in both control rats and rats with diabetic mellitus. 5. Administration
      of the atrial natriuretic peptide receptor antagonist HS-142-1 to diabetic rats
      resulted in diminished urinary excretion of both sodium (-61 +/- 14%, P < 0.02)
      and protein (-51 +/- 17%, P < 0.05). These changes were associated with a
      significant reduction in glomerular filtration rate (-32 +/- 11%, P < 0.05) and
      urinary cGMP excretion (-40 +/- 14%, P < 0.05). No significant effects of HS-42-1
      on renal function were observed in control rats.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789043
TI  - Selective enhancement of alpha 2-adrenoceptor-mediated vasoconstriction in
      insulin-dependent diabetic patients with microalbuminuria.
AB  - 1. Microalbuminuria, the earliest clinical marker of microvascular disease, is an
      important predictor of early death in insulin-dependent diabetes, and abnormal
      vascular reactivity may contribute to microvascular disease. We have previously
      found that vasoconstrictive responses to noradrenaline are exaggerated in insulin
      dependent diabetic patients with microalbuminuria as compared with both
      normoalbuminuric insulin-dependent diabetic patients and non-diabetic control
      subjects. 2. To determine whether this is due to increased sensitivity at alpha 1
      or alpha 2-adrenergic receptors, we compared vascular responses to the alpha 1
      adrenergic agonist phenylephrine and the alpha 2-adrenergic agonist clonidine. 3.
      We studied 15 insulin-dependent diabetic patients with microalbuminuria, 15
      insulin-dependent diabetic patients with normal urinary albumin excretion and 14
      non-diabetic subjects. Vascular constrictive responses were measured in dorsal
      hand veins. 4. No difference in vasoreactivity to phenylephrine was demonstrated
      between any of the three groups. However, enhanced vascular responsitivity to
      clonidine at infusion rates of 16-2048 ng/min (analysis of variance, P < 0.001)
      was found in insulin-dependent diabetic patients with microalbuminuria as
      compared with both non-diabetic control subjects and normoalbuminuric insulin
      dependent diabetic patients. There were no significant differences between the
      dose-response curves of the diabetic group with normal urinary albumin excretion
      and the non-diabetic group. 5. Vasoconstriction mediated by alpha 2-adrenergic
      receptors is therefore enhanced in normotensive insulin-dependent diabetic
      patients with microalbuminuria. If also present at the level of the peripheral
      resistance arterioles or the efferent glomerular arterioles, this could lead to
      systemic and intraglomerular hypertension, factors which may contribute to the
      development of diabetic nephropathy.

PMID- 7789044
TI  - Comparison of intraperitoneal and subcutaneous insulin administration on insulin
      sensitivity and serum lipids in type I diabetic patients on continuous ambulatory
      peritoneal dialysis treatment.
AB  - 1. The metabolic effects of intraperitoneal and subcutaneous insulin delivery
      were compared in a cross-over manner in six C-peptide-negative diabetic patients
      with end-stage renal disease on continuous ambulatory peritoneal dialysis. Each
      treatment period lasted at least 3 months. Hyperinsulinaemic euglycaemic clamp
      was performed and glucose turnover assessed using [3-(3)H]glucose as a tracer. 2.
      During intraperitoneal delivery the daily insulin dose was 2.4 times higher than
      during subcutaneous administration and glycaemic control was significantly better
      (HbA1c 7.63% +/- 0.46% and 9.52% +/- 0.51% during intraperitoneal and
      subcutaneous insulin respectively, P < 0.01). The number of hypoglycaemic
      episodes was lower during intraperitoneal insulin than during subcutaneous
      therapy. 3. Intraperitoneal insulin resulted in an enhanced glucose disposal rate
      (P < 0.01) and reduced fasting hepatic glucose production (P < 0.01). High
      density lipoprotein-cholesterol decreased and the ratio of low-density
      lipoprotein/high-density lipoprotein-cholesterol increased significantly (P <
      0.05) during intraperitoneal insulin delivery. 4. The results suggest that
      intraperitoneal insulin, while resulting in better glycaemic control and improved
      insulin sensitivity than subcutaneous insulin, increases serum triacylglycerol
      and total cholesterol and reduces high-density lipoprotein-cholesterol, possibly
      via a direct effect on the liver.

PMID- 7789045
TI  - Investigation of the mechanism of beta 2-agonist-induced activation of the renin
      angiotensin system.
AB  - 1. We have previously described activation of the renin-angiotensin system in
      asthma, and also by high-dose nebulized beta 2-agonists. In this study we sought
      to determine the mechanism responsible. 2. The influence of the angiotensin
      converting enzyme inhibitor, lisinopril, on the response of the renin-angiotensin
      system and serum potassium to nebulized salbutamol was investigated in a
      randomized, double-blind, crossover study in eight healthy volunteers using a
      factorial block design. On study days, subjects received lisinopril 20 mg orally
      or identical placebo tablets followed 3 h later by nebulized salbutamol or
      placebo inhalation; plasma renin, angiotensin II, serum angiotensin-converting
      enzyme and potassium were measured at intervals for 120 min after inhalation. 3.
      Following salbutamol, plasma renin and angiotensin II concentrations were
      increased significantly compared with placebo [mean (SEM) plasma renin of 61.7
      (15.6) mu-units/ml and angiotensin II of 17.7 (5.4) pg/mol 15 min after
      salbutamol, P < 0.05 versus placebo]. Baseline plasma renin concentrations were
      increased [160.1 (20.6) mu-units/ml] and baseline plasma angiotensin II
      concentrations were reduced [1.4 (0.1) pg/ml] by lisinopril, P < 0.05 versus
      placebo in each case. Inhibition of angiotensin-converting enzyme completely
      inhibited this salbutamol-induced rise in plasma angiotensin II [mean (SEM)
      plasma angiotensin II of 1.5 (0.4) pg/ml 15 min after salbutamol, P < 0.05 versus
      placebo] but had no effect on the changes in plasma renin concentrations after
      the beta 2-agonist [mean (SEM) plasma renin of 198.4 (18.9) mu-units/ml 15 min
      after salbutamol].(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789046
TI  - Sympathoadrenal responses to bronchoconstriction in asthma: an invasive and
      kinetic study of plasma catecholamines.
AB  - 1. Bronchoconstriction does not seem to be a stimulus for sympathoadrenal
      activation, as judged by venous plasma concentrations of noradrenaline,
      adrenaline or neuropeptide Y-like immunoreactivity. However, venous measurements
      have methodological drawbacks. In the present study arterial and mixed venous
      (pulmonary arterial) levels of these variables were determined before and after
      histamine-induced bronchoconstriction in non-medicated asthmatic subjects. In
      addition, noradrenaline kinetics in plasma (isotope dilution) and the pulmonary
      overflows of noradrenaline and neuropeptide Y-like immunoreactivity were
      determined. 2. Histamine inhalation induced bronchoconstriction; forced
      expiratory volume in ls decreased by 38.7% +/- 4.1% (SE) and arterial PO2 by 3.0
      +/- 0.9 kPa. This acute bronchoconstriction induced significant elevations of
      arterial and mixed venous plasma noradrenaline from < or = 1.18 nmol/l to > or =
      1.40 nmol/l. The clearance of NA from plasma increased marginally. Thus, the
      arterial plasma NA response was due to increased spillover of noradrenaline to
      plasma (from 1.80 +/- 0.18 to 2.52 +/- 0.36 mmol min-1/m2 at maximal
      bronchoconstriction, with a subsequent further increase). There were no
      elevations of adrenaline or neuropeptide Y-like immunoreactivity in arterial
      plasma. 3. No sympathetic activation could be demonstrated in the lungs
      (pulmonary noradrenaline or neuropeptide Y-like immunoreactivity overflow), and
      no alterations in pulmonary vascular resistance or cardiac output were observed.
      Neither arterial nor mixed venous plasma concentrations of adrenaline were
      influenced by bronchoconstriction. 4. Acute bronchoconstriction thus leads to
      peripheral sympathetic activation (possibly due to the increased work of
      breathing) which does not involve the lungs.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789047
TI  - Effects of inhaled nebulized morphine on ventilation and breathlessness during
      exercise in healthy man.
AB  - 1. Nebulized inhaled morphine has been reported to increase exercise endurance in
      patients with chronic lung disease and to relieve dyspnoea in patients with
      malignant disease. Potential mechanisms include a central effect occurring after
      systemic drug absorption or a local action mediated by receptors in the lung. 2.
      The ventilatory effects of nebulized morphine (10 and 25 mg) were therefore
      compared with those of intravenous morphine (1.0 and 2.5 mg) and placebo in a
      double-blind study involving 12 young healthy males. Submaximal cycle ergometry
      with respiratory gas analysis was performed 15 min after drug administration and
      breathlessness assessed using a linear visual analogue scale. 3. Neither dose of
      inhaled morphine had statistically significant effects on spirometry, heart rate,
      ventilation, respiratory gases or breathlessness at any level of exercise. The
      slopes and intercepts of the lines relating ventilation to breathlessness were
      also unaffected. 4. Intravenous morphine 2.5 mg reduced breathlessness slightly
      at the highest equivalent workload [mean (least significant range) 33 mm (26-40
      mm)] compared with placebo [41 mm (34-48 mm), P < 0.05] but had no other
      significant effects. 5. These results do not support the hypothesis that
      intrapulmonary opiate receptors modulate the sensation of breathlessness in
      healthy man. The possibility that inhaled morphine may affect breathlessness
      caused by other factors, such as disease, has not been excluded.

PMID- 7789048
TI  - Is voluntary control of breathing impaired in patients with chronic obstructive
      pulmonary disease?
AB  - 1. To assess whether voluntary control of breathing is impaired in patients with
      chronic obstructive pulmonary disease, a group of such patients performed a
      tracking task, requiring volitional control of respiratory muscles. 2. Eight
      patients (mean age 60 years; mean ratio of forced expiratory volume in 1 s to
      forced vital capacity = 31%) took part in the study. Five of the seven patients
      in whom blood gas measurements were made were mildly hypoxaemic (PaO2 = 53-71
      mmHg), and one of these was hypercapnic (PaCO2 = 55 mmHg). Each subject performed
      a compensatory ventilatory tracking task using a tracking system which comprised
      a fixed target displayed on a monitor screen and a cursor moving in a line
      bisecting the target. The position of the cursor was perturbed by a forcing
      function and patients were required to keep the cursor on the target by breathing
      in and out of a spirometer. 3. To allow for any non-specific deficiency in motor
      control, patients performed a similar manual tracking task, using their dominant
      arm to move a joystick. As a control group, 11 healthy subjects (mean age 58
      years; mean ratio of forced expiratory volume in 1 s to forced vital capacity =
      77%) underwent an identical experimental protocol. 4. Motor control performances
      were measured in terms of the error between the target position and the subject's
      positioning of the cursor. Indices of performance were the root mean square of
      the error and the averages of the zero errors (i.e. end expiration/arm movement
      towards the trunk) and the peak errors (i.e. end inspiration/arm movement from
      the trunk).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789049
TI  - Relationship between plasma volume, carotid baroreceptor sensitivity and
      orthostatic tolerance.
AB  - 1. Studies were carried out on 43 otherwise healthy patients referred for
      investigation for attacks of syncope of unknown cause and on six healthy
      volunteers. 2. Plasma volume was determined by Evans Blue dye dilution and blood
      volume was estimated using haematocrit. Carotid baroreceptor sensitivity was
      determined from the changes in pulse interval in response to subatmospheric
      pressures applied to the neck overlying the carotid sinuses, and orthostatic
      tolerance was assessed as the time to presyncope in a test of head-up tilt,
      followed by the addition of graded lower body suction. 3. Eight patients and one
      volunteer fainted during head-up tilt alone, 23 patients and two volunteers
      fainted during tilt with lower body suction at -20 mmHg and 12 patients and three
      volunteers either fainted during suction at -40 mmHg or tolerated the entire
      procedure. 4. Although plasma and blood volumes were higher in males than
      females, the values normalized for either body weight or for calculated lean body
      mass were not different between male and female patients and asymptomatic
      volunteers. The subjects showing the greatest resistance to syncope were found to
      have significantly larger plasma and blood volumes (P < 0.0001) and significantly
      smaller baroreceptor sensitivities (P < 0.0002) than those who fainted
      earlier.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789050
TI  - Demonstration of hypomethylation of proteins in the brain of pigs (but not in
      rats) associated with chronic vitamin B12 inactivation.
AB  - 1. Pigs treated with nitrous oxide for periods of 1, 2 and 4 months demonstrated
      markedly reduced levels of methionine synthase and concomitant reduction in the
      ratio of S-adenosylmethionine to S-adenosylhomocysteine, the methylation ratio,
      at all time intervals. 2. Both 'O' and 'N' methylations were significantly
      reduced in pigs after 4 months in nitrous oxide but not after shorter periods. 3.
      Hypomethylation correlated with the development of clinical ataxia, but was
      absent when the pigs were clinically normal. It also only occurred when the S
      adenosylmethionine level fell. 4. Rats maintained in nitrous oxide for 4 months
      showed a marked reduction of methionine synthase but no reduction in the
      methylation ratio or in brain hypomethylation. None of the rats became clinically
      ataxic. 5. Using an exogenous protein as a methyl group acceptor, it was
      demonstrated in an in vitro assay that the methyltransferase enzymes responsible
      for brain 'O' and 'N' methylation were not affected per se by nitrous oxide
      treatment. 6. It is concluded that reduction of the methylation ratio in the
      brain of pigs as a consequence of methionine synthase inhibition leads to brain
      hypomethylation. This hypomethylation could affect critical components of nerve
      tissue, inducing the vacuolar myelopathic changes seen in the spinal cord of
      these animals, which mimic those of subacute combined degeneration in man.

PMID- 7789051
TI  - n-Butyrate mediation of ganglioside expression of human and murine cancer cells
      demonstrates relative cell specificity.
AB  - 1. n-Butyrate, a short chain fatty acid produced by colonic fermentation, induces
      differentiation in human neoplastic cell lines, and reduces expression in vitro
      of a sialyltransferase that glycosylates N-linked glycoproteins in hepatoblastoma
      cells. Gangliosides are amphipathic, sialylated glycosphingolipids that undergo
      profound changes in many transformed cells and may protect neoplastic cells from
      host immune surveillance. Colonic mucosal cells are exposed to luminal short
      chain fatty acid concentrations of up to 80 mmol/l, and there is some evidence
      that short-chain fatty acids may alter ganglioside expression in colon cancer
      cells. 2. Because of the importance of gangliosides in cancer pathogenesis, we
      investigated the effects of n-butyrate on ganglioside expression of colonic
      (human and murine) and non-colonic cancer cells. 3. Three separate colon cancer
      cell lines (LS174T, T84 and MCA-38), when butyrate treated, demonstrated striking
      amplification of specific individual gangliosides. However, the total lipid-bound
      sialic acid content of gangliosides of butyrate-treated LS174T cells diminished.
      In contrast to earlier reports, n-butyrate did not mediate expression of all
      gangliosides and specifically did not mediate expression of GM3. This effect
      persisted even after removal of butyrate. 4. In contrast, exposure of
      extracolonic cells to butyrate, including cervical cancer (HeLa) and laryngeal
      cancer (HEp-2) cell lines in this study and hepatoblastoma cells (Hep G2) in our
      previous work, caused no detectable changes in ganglioside expression. 5. In
      conclusion, our results indicate a relative tissue specificity of butyrate
      mediated alterations in ganglioside expression that is not universal but is
      limited to specific gangliosides.

PMID- 7789052
TI  - Sensitivity versus specificity of phonoarthrography as an indicator for cartilage
      degeneration.
AB  - In an attempt to update the idea of recording knee sounds, 400 osteoarthritic
      (OA) knees, 100 knees from a young age group (18-31 years) and 100 knees from an
      age-matching group (45-60 years) were recorded by a computerized device using a
      special program that enabled the conversion of sounds--recorded in a fixed lapse
      of time--to waves which were then analysed in terms of frequency/second and
      average amplitude. Radiological grading was done for all groups in order to
      compare both parameters. Reproducibility of the recordings for each knee was
      confirmed statistically. Phonoarthrography was found to be 100% sensitive for
      radiological changes and for clinically felt crepitus, simultaneously diagnosing
      early OA in 32.5% of subjects with no radiological changes and in 7.5% of
      subjects with no clinically felt crepitus. From the work it can be deduced that
      computerized phonoarthrography can diagnose early cases of OA and is excellent
      for assessing and following up cases. It may be regarded as an indicator for
      cartilage degeneration.

PMID- 7789053
TI  - Medical, physical and psychological status related to early rheumatoid arthritis.
AB  - As part of an international European research project, a longitudinal study was
      started by the end of 1990 in the northern part of The Netherlands. The study
      concentrated on recently diagnosed RA patients (N = 292), i.e., incident cases up
      to four years. According to the duration of the disease, five groups of patients
      had been formed. The early influence of rheumatoid arthritis on medical
      parameters, on functional status, on physical condition and on psychological well
      being was evaluated. From the results, an overall statistically significant
      pattern related to the duration of the disease could not be distinguished.
      However, patients recently diagnosed did face activity restrictions, a decline in
      physical condition and social functioning. On medical parameters this
      deterioration is less profound. Furthermore, across and within the five patient
      groups, it seems that males and females respond differently to the influence of
      early RA. Based on cross-sectional data from the five onset cohorts, the present
      findings do not significantly suggest a steady worsening in medical, physical and
      psychological condition.

PMID- 7789054
TI  - The diagnosis value of beta 2-microglobulin and immunoglobulins in primary
      Sjogren's syndrome.
AB  - Salivary and serum concentrations of beta 2-microglobulin, salivary levels of the
      immunoglobulins, and salivary flow (as measured by a gravimetric method) were
      assessed in 34 patients and 11 controls. Of the 34 study patients, 16 had a
      primary form of Sjogren's syndrome (pSS) and 18 had sicca syndrome. The salivary
      and serum concentrations of beta 2-microglobulin and salivary levels of IgA and
      IgG were much higher in the patients with pSS than in controls or those with
      sicca syndrome (p < 0.001). Similarly, the salivary IgM levels of patients with
      pSS were higher (although at a lower degree of statistical significance) as
      compared to those of patients with sicca syndrome (p < 0.01) or controls (p <
      0.05). No correlation was observed among the salivary flow and the salivary IgG
      and IgM levels, while there was a negative relationship (p < 0.01 with salivary
      IgA levels in all 45 patients considered as a whole. In 12 patients with pSS, the
      coefficient of correlation between the salivary gland biopsy focus score and the
      salivary (but not serum) concentration of beta 2-microglobulin was highly
      significant (p < 0.001). A similar relationship was observed with the IgG (p <
      0.001) and IgM (p < 0.05) levels, but not IgA. In the diagnosis of pSS, the
      salivary IgA level demonstrates high sensitivity and low specificity. In
      contrast, serum and salivary concentrations of beta 2-microglobulin, salivary
      IgG, and to a lesser degree, salivary IgM have high specificity and positive
      predictive value.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789055
TI  - Effect of oestrogen replacement on bone metabolism and cytokines in surgical
      menopause.
AB  - The effect of oestrogen replacement on bone metabolism and serum cytokine levels
      (IL1,IL6) was investigated in surgical menopause. The study included 40 female
      subjects; 10 healthy premenopausal women underwent total hysterectomy without
      oophorectomy. Thirty healthy premenopausal women underwent total hysterectomy
      with bilateral oophorectomy. They were randomly divided into 3 groups of 10
      subjects. The first group received natural estradiol (0.05 mg/day) for 6 months;
      the second group received natural estradiol (0.05 mg/day) and medroxyprogesteron
      acetate (10 mg/day) for 6 months, the third group received no therapy. Calcium
      phosphorus metabolism, inflammatory indices, serum IL1 and IL6 levels were tested
      before and 6 months after surgery in all patients. A significant increase in
      serum alkaline phosphatase, urinary cross-links, serum PTH and IL1-IL6 was
      observed in the untreated women with total hysterectomy and oophorectomy. No
      significant variation in any of the parameters considered was observed in
      patients treated with oestrogen, in those treated with oestrogens and
      medroxyprogesteron nor in patients without oophorectomy. These results in human
      "in vivo" confirm that ovarian steroids play an important role in regulating the
      production of IL1 and IL6 which could regulate bone resorption.

PMID- 7789056
TI  - Left ventricular wall motion abnormalities in 80 patients with systemic
      sclerosis.
AB  - Segmental analysis of left ventricular wall motion was performed in 80 patients
      with systemic sclerosis by echocardiography. Half of the cases showed normal wall
      motion. Eighteen of the 57 patients with limited cutaneous systemic sclerosis
      (31.6%) exhibited hypokinetic wall motion abnormalities, while five of the 23
      cases with diffuse cutaneous systemic sclerosis (21.7%) had similar findings. The
      three cases showing akinesis also belonged to the limited scleroderma subgroup.
      Our findings show that hypokinetic wall motion abnormalities can be detected in a
      remarkably high proportion of cases with limited cutaneous systemic sclerosis.

PMID- 7789057
TI  - Multidisciplinary approach to fibromyalgia. A pilot study.
AB  - The aim of the study was to instruct a group of fibromyalgia patients how to
      solve problems related to activities of daily life. Sixteen female fibromyalgia
      patients completed a ten week multidisciplinary program, consisting of a
      cognitive and an exercise part. After ten weeks a reduction in general pain
      intensity (p < 0.05) was found. At six months follow-up sensory (somatic) pain
      intensity was reduced compared to baseline recordings (p = 0.05). All patients
      had made adjustments to their everyday life after ten weeks. Eight patients
      reported that they regularly practised relaxation techniques, and seven patients
      had undertaken dietary changes. Thus, the study shows that adjustment of
      activities in daily living may reduce pain in patients with fibromyalgia.
      Controlled studies are needed in the future.

PMID- 7789058
TI  - Characterization of systemic lupus erythematosus in patients in U.A.E.
AB  - Twenty-eight SLE patients (Arabs and Asians) in the UAE were studied in this
      report. The F:M ratio was markedly high; 27:1 in the group as a whole and 21:1
      among Arabs. Local patients (Emirians) developed the disease at an earlier age
      compared to their expatriate Arab compatriots. Arthropathy occurred in 86% and
      nephropathy in 43% of cases. Next in frequency were leucopenia, mucocutaneous
      manifestations and serositis. Apart from lupus headache, the other neuro
      psychiatric LE were uncommon or not encountered. Anti-cardiolipin syndrome,
      Sneddon's syndrome, shrunken lung syndrome, sicca complex, thyrotoxicosis and
      myasthenia gravis were also present in this small group of patients. Their
      presence reflects the marked heterogeneity displayed by the disease irrespective
      of the number of cases involved. An unusually high prevalence of anti ds (DNA)
      antibodies (92.5%) as compared to ANF (82.5%) was detected (P = NS). Anti-Sm
      antibody occurred in 30% of cases particularly in those patients with
      lymphadenopathy and fever. There was a relative paucity in the prevalence of anti
      RNP, Ro and La antibodies in this group. Differences with and similarities to
      previous reports concerning other populations are also presented.

PMID- 7789059
TI  - Risk factors for the development of acute disseminated intravascular coagulation
      in patients with systemic lupus erythematosus.
AB  - Since acute disseminated intravascular coagulation (DIC) often contributes to a
      fatal outcome in patients with systemic lupus erythematosus (SLE), prediction of
      its development is important to prevent the occurrence of such an event. To
      analyze the risk factor(s) contributing to the development of acute DIC in SLE,
      we carried out a retrospective study of a series of 129 SLE patients, eight of
      whom developed DIC during the course of this disease, to assess which of the
      easily assessable parameters, present at the time of first medical examination,
      were of predictive significance. The important individual variables, determined
      by univariate analysis, were male sex, leukopenia, and infection. These factors
      were placed in a multivariate logistic regression model, and only one factor,
      infection at first medical examination, was found to have predictive significance
      for the development of acute DIC in SLE patients. The prevention and control of
      infection in SLE patients might have implications for preventing the development
      of acute DIC.

PMID- 7789060
TI  - Long-term performance in vitro and in vivo of dual-energy X-ray absorptiometry.
AB  - Dual-energy X-ray absorptiometry (DXA) is actually considered as one of the most
      appropriate techniques for measuring bone mineral content (BMC) and bone mineral
      density (BMD). An anthropomorphic phantom and a 25-year-old girl were repeatedly
      measured, 160 times and 50 times respectively, over an 18-month period to
      investigate performance in vitro and in vivo of a commercial DXA equipment
      (HOLOGIC QDR 1000). DXA is a highly accurate technique, the BMC and BMD
      determinations only overestimated the exact value of the phantom by 0.20% and
      0.51% respectively. In vivo long-term (18 months) reproducibility of BMD of the
      spine is characterized by an interassay coefficient of variation (CVt) of 0.8%
      while, for the different regions of interest of the hip, BMD CVt varies from 1.1%
      (total zone) to 5.3% (Ward's triangle). In the subject tested, BMD sensitivity
      for changes of 2.2% at the lumbar spine and 3% at the hip were recorded.

PMID- 7789062
TI  - Cogan's syndrome: a new possible complication of antiphospholipid antibodies?
AB  - A 55-year-old woman with a six-year history of Sjogren's syndrome (SS) and the
      positivity of IgG and IgM antiphospholipid antibodies (aPL) developed a sudden
      onset of sensorineural hearing loss associated with vertigo. This suggested the
      presence of an atypical Cogan's syndrome (CS), which might be a focal,
      neurological complication of aPL.

PMID- 7789061
TI  - Anticardiolipin antibodies in the polymyalgia rheumatica-temporal arteritis
      syndromes.
AB  - A series of seven patients with the polymyalgia rheumatica-temporal arteritis
      (PMR-TA) complex is presented, each of whom during the clinical course
      demonstrated the presence of anticardiolipin antibodies (ACLs). Presenting
      symptoms consisted of proximal myalgias and stiffness characteristic of PMR in
      five patients and of visual symptoms and headache suspicious for TA in two
      patients. Two of the five PMR patients later developed jaw claudication
      characteristic of TA. Six of the seven cases demonstrated clinical evidence of a
      vasculopathic process such as a cerebrovascular infarct or a vasculitic syndrome.
      Previous studies have suggested an association between ACLs and PMR-TA, and this
      series of patients appears to provide more supporting evidence. Even patients who
      only manifested PMR symptoms without suggestion of accompanying TA developed
      vascular complications. An increasing range of symptoms have been recognized in
      association with ACLs, and the vasculitic syndromes of PMR-TA should be included
      as a possible association. While this series together with previous studies may
      suggest that the presence of ACLs in patients with PMR-TA symptoms may serve as a
      marker for the development of vascular complications, larger longitudinal studies
      will be necessary in the future.

PMID- 7789063
TI  - A case of Werner's syndrome associated with systemic lupus erythematosus.
AB  - The case of a 40-year-old woman with Werner's syndrome associated with systemic
      lupus erythematosus (SLE) is reported. The patient exhibited short stature,
      slender extremities, thinned hair, high-pitched voice, cataracts, ulceration of
      the fingers, and mental retardation. Malar erythema, photosensitivity, and
      proteinuria had been noted since age 34. The serum contained high titers of
      antibodies to dsDNA, Sm, nRNP, and SS-A/Ro. The simultaneous presence of Werner's
      syndrome and SLE could be a coincidental occurrence of the two diseases, although
      it might be due to an abnormality in replication or degeneration of DNA leading
      to the development of both diseases.

PMID- 7789064
TI  - Campylobacter jejuni arthritis in secondary amyloidosis.
AB  - We describe a case of infectious arthritis caused by C. jejuni which developed
      after C. jejuni enteritis in a patient with rheumatoid arthritis and
      hypogammaglobulinaemia. Extraintestinal infections of this enteropathogen are
      rare, but in patients with hypogammaglobulinaemia C. jejuni bacteriaemia is
      relatively common. The present patient suffered from hypogammaglobulinaemia due
      to a nephrotic syndrome in secondary amyloidosis. C. jejuni infection must be
      considered in patients with hypogammaglobulinaemia and arthritis.

PMID- 7789065
TI  - Adult polyomyositis/dermatomyositis associated with acute myeloid leukemia. A
      case report.
AB  - Reports of PM/DM associated with haematologic disorders are rare. We describe a
      62-year-old man suffering from PM/DM who developed acute myeloid leukemia. The
      possible paraneoplastic nature of PM/DM in this patient is discussed.

PMID- 7789066
TI  - Asplenism and systemic lupus erythematosus.
AB  - Although functional hyposplenism, secondary to Fc-receptor blockage by
      circulating immune complexes saturation, has been described in systemic lupus
      erythematosus (SLE), only few cases of complete asplenism have been reported. We
      observed a 60-year-old woman with congenital asplenism who presented with active
      SLE. The course and the clinical characteristics of such patients are reviewed
      and the relationship between the asplenic state and initiation and severity of
      SLE are discussed. These patients are at high risk for fatal pneumococcemia and
      pneumococcal vaccine is recommended even if long term results are still
      conflicting.

PMID- 7789067
TI  - Cauda equina syndrome in ankylosing spondylitis: a case report and review of the
      literature.
AB  - The cauda equina syndrome (CES) is an infrequently recognised and poorly
      understood complication of ankylosing spondylitis (AS). We report a case of CES
      with enlarged caudal sac and multiple posterior arachnoid diverticula eroding the
      laminae and spinous processes of the lumbosacral vertebrae in a patient with long
      standing AS. The diagnosis was established using computerised tomography (CT) and
      magnetic resonance imaging (MRI).

PMID- 7789068
TI  - Secretory component deficiency in Behcet's disease.

PMID- 7789069
TI  - Clinical variability and life expectancy in osteogenesis imperfecta.

PMID- 7789071
TI  - 15th European Workshop for Rheumatology Research. Erlanger/Bamberg, March 16-19,
      1995. Abstracts.

PMID- 7789070
TI  - Rheumatological manifestations of lipoatrophic diabetes.

PMID- 7789072
TI  - [Role of polychemoembolization in the treatment of primary and secondary tumors
      of the liver].
AB  - Unresectable primary hepatocellular carcinoma (HC) and liver metastases (LM) of
      abdominal tumors (AT) in progression after systemic chemotherapy (CT) have a poor
      prognosis and few therapeutic options. From 12/91 to 10/93 we treated 20 patients
      (PTS) 11 men and 9 women, with HC (10) and AT (10) with the following PCE:
      percutaneous placement of intraarterial hepatic catheter, superselective
      embolization with lipiodol (5 cc), infusion, mixed with lipiodol, of epirubicine
      40 mg/m2, 5-fluorouracil 700 mg/m2, mitomycin-C 10 mg/m2 in 30'. After infusion,
      the arterial tree was embolized with Ivalon until an almost complete slowing of
      arterial blood-flow, every 5-6 weeks (W). After a median follow-up of 28 W a
      total of 35 courses had been administered to 20 PTS. Median (M) age was 69 years.
      M PS was 2. Okuda stage in HC PTS: 1 stage I, 9 stage II. in 10 HC PTS, positive
      for hepatitis B virus, CT and b-IFN had failed, while 10 AT PTS (5 colorectal, 2
      gastric, 1 uterine, 1 larynx, 1 choledochus) had progressed, after, at least, 2
      CT regimens, and had only LM. Median time from the diagnosis of LM in AT PTS was
      32 W (12-68). TOXICITY: liver enzyme elevation and LDH elevation were 3 times
      baseline values, 4 PTS had fever for 6 days, 3 PTS had ileus for 3 days. No
      myelosuppression was observed. M alpha-fetoprotein value decreased from 468
      ng/ml, to 56 ng/ml after PCE.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789074
TI  - [High resolution computerized tomography in cystic fibrosis. Clinico-radiologic
      correlations in 25 patients].
AB  - Twenty five patients with a clinical and radiological diagnosis of cystic
      fibrosis underwent high resolution Computed Tomography (HRCT) with the aim to
      study pulmonary parenchymal localization of disease. Both patients with initial
      pulmonary alterations and patients in a more advanced phase of the disease were
      studied. HRCT proved an excellent method for detecting very early lesions such as
      bronchiolar ectasia and bronchiolar obstruction by mucous accumulation. Moreover,
      HRCT proved to be very useful in detecting centrolobular and panlobular
      parenchymal lesions, with diagnostic information on axial and peripheral
      interlobular connective tissue. HRCT provided a better spatial definition of
      bronchiectasia and subpleural air if compared to conventional radiology. It also
      allowed for correct diagnosis of pneumothorax and detection of pleural fibrosis
      as a result of iatrogenic complications.

PMID- 7789073
TI  - [Diphosphonates in the treatment of osteoporosis and in the prevention of
      associated fractures].
AB  - Diphosphonates are capable to increase vertebral bone mineral mass in
      postmenopausal osteoporosis. Because the risk of fractures is related to the
      reduction of bone mass, the positive effect of diphosphonates most probably
      produced a decrease in fracture rate. At present these drugs represent a rational
      option for the treatment of postmenopausal osteoporosis.

PMID- 7789075
TI  - [Significance of cobalt in living organisms. Biochemical, clinical, and
      therapeutic considerations].

PMID- 7789076
TI  - [Individual arterial pressure variability in newborn infants, adults, and the
      elderly].
AB  - The complexity of the cardiovascular function is related to a wide
      interindividual variability (VA) that changes with age. The aim of our study was
      to investigate the spontaneous blood pressure (BP) VA in 3 groups of 20 healthy
      subjects (S) each, 10 M and 10 F: Group I newborns 24 hours old; Group II 30-40
      yrs; Group III 70-80 yrs. Each S underwent BP monitoring in a comfortable
      condition for 15'. Our data show an increase, with age, of both the average
      systolic and diastolic BP, paralleled by a simultaneous decrease of their
      standard deviations. Furthermore, the three distributions show a reasonably
      gaussian behaviour (maximum absolute value of the skewness was 0.21). These
      results emphasize the age-dependent reduction in functional flexibility of the
      cardiovascular system. A major pool of subjects is required to confirm our
      preliminary data.

PMID- 7789077
TI  - Candida chorioretinitis in meningococcal meningitis.
AB  - A case of Candida chorioretinitis in a patient suffering from meningococcal
      meningitis, admitted to the Infectious Disease Department of Frosinone Hospital,
      Italy, is reported. Five days after the onset of meningitis during antibiotic and
      cortisone treatment the patient experienced oropharyngeal candidiasis, ocular
      pain and blurring of vision; two days later positive scotoma appeared.
      Ophthalmoscopic examination revealed probable Candida chorioretinitis. Treatment
      with intravenous fluconazole at high doses was employed with complete recovery of
      the right eye, while visual acuity of the left eye was 2/10. The use of long-term
      fluconazole at the doses reported, commonly employed in the treatment of systemic
      mycoses, improves prognosis.

PMID- 7789078
TI  - [Risk in vascular surgery].

PMID- 7789080
TI  - [Cystic fibrosis of the pancreas. Historical notes, sweat test, and neonatal
      screening].
AB  - Chronologic milestones in cystic fibrosis (CF) are reported. The value of the
      sweat test and the most recent advances on neonatal CF screening are described.

PMID- 7789079
TI  - [Toxicology of reproduction and development. Pregnancy and periods of risks from
      drugs].
AB  - The authors discuss the possibilities of drug interference with the reproductive
      system and especially during various stages of pregnancy: from the sequence of
      neurochemical events that condition the release of pituitary gonadotrophines at
      the level of the central nervous system to late events that may occur during
      development. After listing the periods of risk, drug-induced changes in the
      conceptus are illustrated on the basis of data registered in the literature. In
      this context, it is stressed that the dysmorphogenic effect is limited to the
      period of differentiation and organogenesis whereas it is becoming more and more
      obvious that drugs may also have variable effects on other stages of pregnancy
      where frequently they have specific pharmacodynamic actions on the fetus. The
      knowledge of these effects may be useful in order to avoid untoward actions on
      pregnancy or on embryo, fetus, neonate or postnatal development, but may also
      create a basis for in utero drug treatments of fetal pathologies.

PMID- 7789081
TI  - [The use of colchicine in the treatment of alcoholic liver fibrosis in the
      elderly. Report of 80 cases].
AB  - Having briefly analyzed the metabolism of ethanol in elderly subjects and the
      evidence of great resistance of the senile liver to alcohol-induced damage, the
      Author describes histological, clinical, biohumoral features of fibrosis and the
      necessary therapeutic measures. Eighty clinical cases of hepatic fibrosis are
      also illustrated, studied and observed during five years.

PMID- 7789082
TI  - [Lamotrigine: first experience in Italy].
AB  - LTG, lamotrigine is a new antiepileptic agent chemically unrelated to any
      established drugs in use. The safety and the efficacy of LTG (564.5 +/- 74.4)
      mg/day was evaluated as add-on therapy (plus CBZ) in a placebo controlled study
      of 34 patients with refractory partial complex and/or partial secondary
      generalized seizures. The incidence of adverse effects of the drug is low and the
      unwanted effects are reversible. The long half-life and lack of effect on other
      AEDs will render LTG an easily dosable addiction to a patient's existing regimen.
      Reduction in the total number seizures was recorded in 61.4% of patients. We
      conclude that LTG is an effective AED for treatment of therapy-resistant partial
      seizure.

PMID- 7789084
TI  - [C0Q10 in the prevention and treatment of primary osteoporosis. Preliminary
      data].
AB  - Preliminary data are reported of an as yet uncompleted clinical study aimed at
      evaluating the therapeutic efficacy of C0Q10 for primary osteoporosis. In spite
      of the small number of subjects treated (only 5) the results obtained are
      evidence of the efficacy of this agent which had never before been used in the
      therapy of osteoporosis. The possible mechanisms of action C0Q10 are discussed in
      the light of an original interpretation of the etiopathogenesis of this very
      complex bone disease. Details of the study will be reported once the trial has
      been completed.

PMID- 7789083
TI  - [Treatment of chronic obliterative arteriopathy of the legs in the second
      Fontaine's stage. Personal experience with a buflomedil-pentoxifylline
      defibrotide combination].
AB  - The authors provide evidence for the efficacy of the buflomedil-pentoxifylline
      defibrotide combination for treatment of lower limb chronic obstructive arterial
      disease, Fontain stage II. Improvement of walking autonomy obtained with these
      agents ranged from 50 to 100% in 29 of 36 patients (relative frequency = 0.80).

PMID- 7789085
TI  - [Uremic encephalopathy and oligo-elements].
AB  - The author reports the probable pathogenetic connexions between oligo-elements
      and uremic encephalopathy. Acquired data concerning this rare pathology of the
      CNS are reported as well as those of more doubtful scientific validity. The
      behavior of the neuro-psychic sphere and the symptomatology deriving from both
      deficit and excess of Al, As, Mg, Cr, Mn, Se, etc. are subject to special
      attention. The result of these changes is a complex of syndromes that are
      difficult to identify, also because uremia is beset by a large number of
      complications which more or less directly involve the central and peripheral
      nervous system.

PMID- 7789086
TI  - [A case of a patient with multiple primary neoplasms: ileal leiomyosarcoma and
      bronchial carcinoid].
AB  - Small bowel leiomyosarcoma and lung carcinoid are uncommon neoplasms, and the
      association of these two neoplasms has never been reported in the literature. In
      the present article we report the case of a man who developed carcinoid of the
      lung three years after being operated for leiomyosarcoma of the small intestine.
      The short time elapsed between the two diagnoses adds further interest to this
      case.

PMID- 7789087
TI  - [For your well-being: a healthy diet and adequate physical exercise].

PMID- 7789088
TI  - British Diabetic Association medical and scientific section spring meeting.
      Coventry, 30-31 March, 1995. Abstracts.

PMID- 7789089
TI  - Soar and the case for unified theories of cognition.
AB  - Despite the potential importance to cognitive psychology of unified theories no
      attempt has been made to assess concretely the methodological problems that such
      theorising produces. This paper addresses this issue of unified theorising, and
      in particular the arguments for unified theories put forward by Newell (1990).
      Close examination of these arguments reveals that Newell's approach does not
      adequately counter the difficulties which beset the grand theories of the 1930s,
      nor the problems of irrelevant specification which arise in modern computational
      psychological work. These difficulties do not prevent the development of unified
      theories, but they do pose serious problems, problems which it is argued can only
      be met by rigorous empirical testing together with extreme methodological
      sensitivity. The methodological concerns lead us to examine Soar, perhaps the
      most well-developed unified theory, from methodological, computational, and
      empirical perspectives. Our conclusions are that, whilst Soar represents an
      impressive body of research, its methodological foundations are insecure, it is
      ill specified as a computational/psychological theory, and under empirical
      testing it does not stand up to close scrutiny as a unified theory. The Soar
      research programme as it currently stands thus fails to meet the necessary
      methodological demands imposed by unified theorising.

PMID- 7789090
TI  - Phonological recoding and self-teaching: sine qua non of reading acquisition.
AB  - The self-teaching hypothesis proposes that phonological recoding functions as a
      self-teaching mechanism enabling the learner to independently acquire an
      autonomous orthographic lexicon. Successful decoding encounters with novel letter
      strings provide opportunities to learn word-specific print-to-meaning
      connections. Although it may not play a central role in skilled word recognition,
      phonological recoding, by virtue of its self-teaching function, is regarded as
      critical to successful reading acquisition. This paper elaborates the self
      teaching hypothesis proposed by Jorm and Share (1983), and reviews relevant
      evidence. Key features of phonological recoding include an item-based rather than
      stage-based role in development, the progressive "lexicalization" of the process
      of recoding, and the importance of phonological awareness and contextual
      information in resolving decoding ambiguity. Although phonological skills have
      been shown to be primary in reading acquisition, orthographic processing appears
      to be an important but secondary source of individual differences. This implies
      an asymmetrical pattern of dissociations in both developmental and acquired
      reading disorders. Strong relationships between word recognition, basic
      phonological processing abilities and phonemic awareness are also consistent with
      the self-teaching notion. Finally, it is noted that current models of word
      recognition (both PDP and dual-route) fail to address the quintessential problem
      of reading acquisition-independent generation of target pronunciations for novel
      orthographic strings.

PMID- 7789091
TI  - Development, characterization, and initial evaluations of S1. A new chromogenic
      cephalosporin for beta-lactamase detection.
AB  - A novel, chromogenic cephalosporin reagent (S1) for beta-lactamase testing was
      produced that shares physicochemical characteristics with nitrocefin (formerly
      87/312). S1 and nitrocefin in a disk-testing format for beta-lactamase performed
      at 100% agreement for detecting enzyme-producing isolates of Bacteroides fragilis
      group, Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae,
      Staphylococcus aureus, and selected Enterobacteriaceae. The time required to
      achieve an initial color change or a strong positive reaction was comparable for
      both chromogenic reagents for all organisms except the Gram-positive species. S1
      reaction times were approximately 50% faster than nitrocefin for beta-lactamase
      positive enterococci and S. aureus. These results from the developmental studies
      and a commercially prepared disk lot indicate that S1 is a promising beta
      lactamase disk test reagent with the ability to detect all significant enzyme
      producing species strains, some significantly earlier than the nitrocefin disk
      method.

PMID- 7789092
TI  - Recovery of Coccidioides immitis from blood and abscess fluid using the
      BacT/alert system.
AB  - We report the recovery of Coccidioides immitis from the blood and abscess fluid
      of two separate patients by using two automated blood culture systems. In the
      first case, an aspirate from a neck abscess containing C. immitis spherules was
      serially diluted and inoculated into liquid media used by the BacT/Alert and the
      Bactec NR660 blood culture systems. BacT/Alert bottles inoculated with 10(5),
      10(4), 10(3), 10(2), 10 and two spherules produced a positive signal at 19, 24,
      35, 42, 57, and 62 h postinoculation, respectively. Bactec NR660 bottles
      containing > 10(2) shperules and 10 spherules produced a positive signal after
      approximately 72 and 96 h of incubation, respectively. In the second case, a
      blood specimen incubated in BacT/Alert blood culture both was signaled positive
      after 82 h of incubation. No organisms were detected by Gram stain of the broth,
      but C. immitis grew after blind subculture. Our observations demonstrate that
      these rapid blood culture systems are capable of supporting growth of C. immitis.
      To our knowledge, this report is the first to detect C. immitis by these blood
      culture systems.

PMID- 7789094
TI  - Susceptibility of ciprofloxacin-resistant staphylococci and enterococci to
      clinafloxacin.
AB  - Clinical isolates of methicillin-resistant Staphylococcus aureus (MRSA) and
      Enterococcus faecalis obtained from the Ann Arbor Veterans Affairs Medical Center
      within the last decade were tested for susceptibility to ciprofloxacin and
      clinafloxacin. For MRSA isolates, the minimum inhibitory concentrations (MICs) of
      ciprofloxacin were several fold higher than those noted with clinafloxacin. Prior
      to the introduction of the fluoroquinolones (1984-1985), all MRSA isolates were
      susceptible to ciprofloxacin and clinafloxacin. By 1993, virtually all MRSA
      isolates were resistant to ciprofloxacin and a 50-fold increase in the MIC50 and
      MIC90 for clinafloxacin was seen. In 1985-1986, most enterococcal isolates were
      susceptible to ciprofloxacin and clinafloxacin. By 1993, one-third of all
      enterococci were resistant to both ciprofloxacin and clinafloxacin.
      Fluoroquinolone resistance developed more quickly in enterococci that
      demonstrated high-level gentamicin resistance. Thus, cross-resistance between
      clinafloxacin and ciprofloxacin was seen; however, the lower MICs of
      clinafloxacin for MRSA may allow the use of this drug for some MRSA infections.

PMID- 7789093
TI  - Comparison of three commercially available monoclonal antibodies directed against
      pp65 antigen for cytomegalovirus antigenemia assay.
AB  - A total of 102 blood samples were used in a prospective parallel and blind study
      to evaluate three commercially available anti-pp65 monoclonal antibodies for
      cytomegalovirus antigenemia assay, at the dilutions recommended by their
      manufacturers. Cytomegalovirus was detected in 42 samples (41.2%), by either
      culture (32 samples; 76.2% of positive samples) or antigenemia (38 samples;
      90.6%). Of the antigenemia-positive samples, 37 were detected by Monofluo kit
      CMV, which showed statistically significant differences when compared with the
      other reagents (Biosoft 1C3 and Clonab C10/C11), in either positivity rates (P <
      0.004) or positive cell counts (P < 0.001). This reagent also gave better results
      in fluorescence quality than 1C3 and C10/C11. However, technical differences were
      not reflected in the clinical relevance of the antigenemia results.

PMID- 7789095
TI  - Multicenter in vitro comparative study of fluoroquinolones against 25,129 gram
      positive and gram-negative clinical isolates.
AB  - In vitro activities of fleroxacin, ciprofloxacin, ofloxacin, and lomefloxacin
      were evaluated against 25,129 fresh bacterial isolates from 51 US hospital or
      medical center laboratories, beginning in October of 1990. Susceptibility rates
      were > or = 85% against most species of Gram-negative bacteria. Notable
      exceptions were Pseudomonas, Acinetobacter, Xanthomonas, and Providencia. The
      study drugs displayed similar activity against most Gram-negative species. At
      least 90% of oxacillin-susceptible staphylococci were susceptible but, of
      oxacillin-resistant strains, only approximately 60% of Staphylococcus epidermidis
      and 25% of Staphylococcus aureus were susceptible to the quinolones tested.
      Staphylococcus saprophyticus strains were less susceptible to fleroxacin (42%)
      than to the other compounds (79%-97%). Ofloxacin and ciprofloxacin were more
      active against streptococci, and none of the compounds demonstrated appreciable
      activity against enterococci. Thus, the spectra of activity of fluoroquinolones
      illustrate that they remain effective agents for the treatment of many types of
      infections caused by Gram-negative pathogens.

PMID- 7789096
TI  - In vitro antimicrobial susceptibility of glycopeptide-resistant enterococci.
AB  - The results of susceptibility testing of 48 phenotyped strains of glycopeptide
      antibiotic-resistant enterococci are reported. Minimum inhibitory and
      bactericidal concentrations (MICs and MBCs) were determined for 27 vanA, 17 vanB,
      and 4 vanC strains. Antibiotics exhibiting the greatest activity included
      novobiocin (MIC90 = 8 micrograms/ml and MBC90 = 32 micrograms/ml), ramoplanin
      (MIC90 = 2 micrograms/ml and MBC90 = 4 micrograms/ml), and the streptogramin
      RP59500 (MIC90 = 4 micrograms/ml and MBC90 = 32 micrograms/ml). These antibiotics
      warrant further investigation as potentially useful agents, either alone or in
      combination, for treating enterococcal infections.

PMID- 7789098
TI  - Comparison of one-day versus two-day incubation of urine cultures.
AB  - The value of incubating urine cultures for 1 versus 2 days was evaluated
      prospectively for 1526 consecutive specimens. A total of 507 cultures (33.2%)
      were positive after 1 day; 41 (2.7%) showed different results after 2 days. Only
      yeasts and corynebacteria were detected more often with longer incubation.
      Patient charts were available for review from 27 of 41 late positives; in only
      three instances (11.1%) was action taken by physicians based on these results.

PMID- 7789097
TI  - Cross-resistance analysis for DU-6859a, a new fluoroquinolone, compared to six
      structurally similar compounds (ciprofloxacin, clinafloxacin, fleroxacin,
      levofloxacin, ofloxacin, and sparfloxacin).
AB  - Emerging resistance to the current fluoroquinolones has encouraged synthesis of
      new compounds in this class. We have evaluated the activity of DU-6859a, a novel
      halogenated quinolone, against a panel of 300 bacteria, relative to the activity
      of ciprofloxacin, clinafloxacin, fleroxacin, levofloxacin, ofloxacin, and
      sparfloxacin. DU-6859a was the most active of the fluoroquinolones studied and
      retains potentially useful activity against 80% of isolates resistant (minimum
      inhibitory concentration, > or = 4 micrograms/ml) to ciprofloxacin. Continued
      clinical investigation of DU-6859a and similar new quinolones is urged.

PMID- 7789099
TI  - Interpretive errors using an automated system for the susceptibility testing of
      imipenem and aztreonam.

PMID- 7789101
TI  - Illness and cures in the Greek propitiatory inscriptions and dedications of Lydia
      and Phrygia.
AB  - The propitiatory inscriptions of Lydia and Phrygia (of the second and third
      centuries AD) manifest the belief that illness is a divine punishment for a sin
      (usually for a religious offence); cure can thus be achieved through expiation.
      Although scientific medicine was not unknown, the high costs of doctors, the
      belief in the omnipotence of gods, and the attribution of illness to divine
      intervention led the villagers to the local sanctuaries, where they received
      instructions by means of dreams and oracles. Some priests had medical experience,
      but they usually practised a 'religious healing' (incantations, purifications,
      sacrifices, the ritual transfer of the sin and the illness to animals).

PMID- 7789100
TI  - Variations in DNA subtype, antifungal susceptibility, and slime production among
      clinical isolates of Candida parapsilosis.
AB  - Candida parapsilosis is an important nosocomial pathogen that can proliferate in
      high concentrations of glucose and form biofilms on prosthetic materials. We
      investigated the genotypic diversity, slime production, and antifungal
      susceptibility among 60 isolates of C. parapsilosis from 44 patients and 10
      patient care providers from five different medical centers. Molecular typing was
      performed using macrorestriction digest profiles with BssHII followed by pulsed
      field gel electrophoresis (REAG) and by electrophoretic karyotyping (EK). Slime
      production was evaluated by growing the organisms in Sabouraud broth with 8%
      glucose and examining the walls of the tubes for the presence of an adherent
      slime layer. Antifungal susceptibility to amphotericin B, 5-fluorocytosine,
      fluconazole, and itraconazole was determined using National Committee for
      Clinical Laboratory Standards proposed standard methods. Overall 28 different DNA
      types were identified by REAG and EK methods. MIC90 values ranged from 0.12
      microgram/ml for itraconazole to 1.0 microgram/ml for fluconazole and
      amphotericin B. Sixty-five percent of the isolates produced slime: 37% were
      moderately to strongly positive, 28% were weakly positive, and 35% were negative.
      Overall, 83% of blood and catheter isolates were slime positive versus 53% of
      isolates from all other sites (P < 0.05). These data underscore the genetic
      diversity and susceptibility of C. parapsilosis to antifungal agents. Slime
      production may be important in enabling C. parapsilosis to cause catheter-related
      bloodstream infections.

PMID- 7789102
TI  - Ancient medicine in its socio-cultural context. Papers read at the congress.
      Leiden, 13-15 April 1992.

PMID- 7789104
TI  - The healing event in Graeco-Roman folk-medicine.
AB  - The inexplicit character of Graeco-Roman folk-medicine, together with the
      distorted and haphazard nature of our evidence, has led to easy denigration of
      its aims and methods. Analysis of the structure of the healing event, especially
      its spoken component, the charm, provides some insight into tacit beliefs about
      illness, and into the skills through which folk-practitioners won reputations for
      competence. Just as in school medicine, the basic aim is acquisition of the
      authority to intervene: correct diagnosis, drawing upon folk-categories, is
      followed by the reassertion of order through setting the present contingency into
      the context of a natural law or regularity, drawing upon the stock of shared
      knowledge.

PMID- 7789103
TI  - [Anatomia sacra. Religiously motivated interventions on human or animal bodies].
AB  - Controlled surgery in the interior of human or animal bodies in classical
      antiquity was allowed only under certain circumstances. Bloody animal sacrifice
      and its rules for the interpretation of entrails as well as the rare examples of
      'ritual anatomy' presented a religious framework for the opening of bodies. Greek
      mythology provided several examples of medical operations, for example, the
      Caesarean section, transplantations and plastic surgery. Great cultic
      significance was given to organ votives or reproductions of human inner organs
      which were offered in temples ex voto or with request for their curing. The
      anatomical knowledge transported along with these offerings represents a separate
      tradition different from the state of anatomical knowledge found in medical
      literature of the period.

PMID- 7789105
TI  - Tatian's 'rejection' of medicine in the second century.
AB  - The question why Tatian, often misrepresented as an opponent of medicine per se,
      chose to condemn only pharmacology, has never been directly raised. His
      conviction that pharmakeia was a demonic lure can only be explained in the
      context of both popular and medical attitudes toward drugs. The basic meaning of
      pharmaka ranges from sorcery to poison to medicinal drugs. Some people regarded
      them as categorically similar to substances used by brute beasts to cure
      themselves, a minority of physicians refused to administer them at all, whereas
      many revered them as virtually divine, 'hands of the gods'. Hence, in Tatian's
      view, they were spiritually dangerous for Christians.

PMID- 7789106
TI  - Athumia and philanthropia. Social reactions to plagues in late antiquity and
      early Byzantine society.
AB  - Thucydides' description of the plague at Athens stands as a paradigm that
      influenced eyewitness accounts throughout Greek and Byzantine history. Christian
      authors in Late Antiquity use his dark picture as heathen background against
      which they highlight Christian virtues of charity and mercy. The descriptions of
      the Justinianic plague of AD 542 rely on Thucydides not only stylistically but
      also in substance, as the early Byzantine society reacts like the people of
      ancient Athens rather than early Christian communities.

PMID- 7789107
TI  - [Intelligent man and medicine].
AB  - In this article, three definitions of the ideal of the pepaideumenos (learned
      man) are examined in their mutual relations. In the pseudo-Platonic dialogue
      Amatores, the culture of the pepaideumenos is conceived as exhaustive as regards
      content, whereas it is attributed a merely 'formal' character in Plato's
      Charmides. However, on the theoretical level both solutions appear to be
      unsatisfactory. Aristotle's proposal is more convincing. He considers the
      pepaideumenos as the man who is able to assess the technicians' preparation
      adequately, since he knows the endoxa either with reference to knowledge as a
      whole or to individual technai. In all three cases, the example of the iatrike
      (medicine) is the means to test the validity of the proposed resolutions.

PMID- 7789108
TI  - [Non-Hippocratic references in Plato's dialogues].
AB  - Plato's references to contemporary medicine are of a twofold nature. They
      initially concern Hippocratic medicine, first as an epistemological model in
      opposition with sophistic arguments, secondly as an instrument to define
      'political art'. But in the later dialogues, Plato's references to medicine
      appear to evolve into a 'non-Hippocratic', magical type. This second type of
      reference-mostly in the Laws-is no longer metaphorical or analogical: it serves
      to determine the procedures that must be followed by the Law-Giver to establish a
      theocratic order.

PMID- 7789109
TI  - Medicine and the Lyceum.
AB  - Although Aristotle reveals a far higher degree of empirical observation than does
      Plato, he is fundamentally in agreement with him that the first principles of
      medicine should be drawn from philosophy. Like Plato, he adopts the four element
      theory, but prefers a system correlating 'elements' with binary combinations of
      opposites. It is argued that his biological and medical interests have influenced
      this general theory. It is also suggested that Diocles influenced considerably
      the development of anatomy and physiology within the Lyceum. Because of doctrinal
      affinities between Praxagoras and Diocles it has been maintained that the Lyceum
      exercised a dominant influence upon the subsequent history of Greek medicine; but
      caution must be enjoined.

PMID- 7789110
TI  - Aristotle on 'distinguished physicians' and on the medical significance of
      dreams.
AB  - This article studies the way in which Aristotle deals with the view-attributed by
      him to the 'distinguished physicians'-that dreams may be significant as clues for
      imminent diseases of the body of the dreamer. Aristotle is thinking of
      philosophically minded physicians (such as the author of De victu) who base their
      practice on principles derived from the study of nature in general and who take
      into account the constitution of the whole body. He accepts their view, but
      justifies it with his own theory of sleep and dreams; however, his attempt to
      incorporate the medical view into his own account brings him into conflict with
      his own presupposition that dreams are not actual perceptions, but experiences of
      the remnants of perceptions received during the waking state.

PMID- 7789111
TI  - [The epistemology of Erasistrate and Hellenistic technology].
AB  - Erasistratus tried to build a coherent system of medicine founded on anatomical
      discoveries from which both physiology and pathology could be consistently
      derived. In this system, the so-called logoi theoreta are not merely theoretical
      constructions, but models (and/or metaphors) transferred to medicine from the two
      branches of contemporary Hellenistic technology, artillery and pneumatics.
      However, this system could not stand to the criticism of Empiricist medicine,
      both because of its oversimplification of pathology and therapy and because of
      its exceedingly heavy epistemological requirements.

PMID- 7789112
TI  - Alexander of Aphrodisias on medicine as a stochastic art.
AB  - Medical practice in antiquity was conspicuous for its failures, which seriously
      challenged medicine's status as an art. Ancient philosophers and doctors tried to
      explain how a whole group of arts including medicine, the so-called stochastic
      arts, was characterised by the fact that even the most competent exercise of the
      art could not guarantee a successful outcome. This paper focuses on Alexander of
      Aphrodisias' (second century AD) explanation and compares it to some other
      ancient views, in particular to Galen's. The central feature of Alexander's
      suggestion is a distinction between the end of an art and its function. In the
      case of medicine end and function do not coincide; for the end is to heal the
      patient, whereas the function consists solely in doing artfully what is possible
      to attain the end.

PMID- 7789113
TI  - Dialectic and science: Galen, Herophilus and Aristotle on phenomena.
AB  - This paper examines the nature of Galen's argument in the De placitis Hippocratis
      et Platonis, books 2-3, concerned with the location of the psychic functions
      within the body. To this question Galen applies a coherent set of methodological
      principles, integrating Aristotelian dialectic and scientific demonstration based
      on anatomical experiments. Galen disagrees with Aristotle in that he relegates
      the endoxa from the realm of dialectic to that of rhetoric. His attitude is
      marked by a distinctive emphasis on perceptible phenomena as the starting point
      for scientific inquiry. This and other features can be traced back to the
      Hellenistic scientist Herophilus.

PMID- 7789114
TI  - Science as text, science as history: Galen on metaphor.
AB  - This paper addresses three related questions: (1) What is Galen's theory of
      metaphor, and why is metaphor so important to him? (2) What is the place of
      metaphor in Galen's general theory of the language of science? (3) What is the
      relation of his theory of metaphor to his views on the historical dimension of
      language and to the historicity of science?

PMID- 7789116
TI  - Structure and style in the Hippocratic treatise Prorrheticon 2.
AB  - Bearing in mind both the capacity of man and his limits, the author of
      Prorrheticon 2 states his opposition to irrational prognoses and brings forward
      the semeia as the only basis for a correct prognostic. He does so by enhancing
      his statements by means of structure (ring-composition, psychological structure
      of recurrence) and style: in this field he uses several devices aimed to attract
      the reader's attention, putting together colloquial and high-level expressions.
      In this paper a similar stylistic technique is intended in order to illustrate
      the points of the Greek author.

PMID- 7789115
TI  - The embarrassment of imperfection: Galen's assessment of Hippocrates' linguistic
      merits.
AB  - In antiquity the 'higher' study of medicine shared with many other disciplines a
      pronounced philological character. Galen both exploited this 'philological
      paradigm' and underwent its influence. He exploited it in that it enabled him to
      invest the Corpus Hippocraticum with a dignity comparable to that of Homer only.
      But his philological instrumentarium, originally designed for the study of
      literary texts, also forced him to pose and answer certain questions that shed no
      light whatsoever on the informational content of Hippocrates' writings, questions
      about Hippocrates' language and style. Galen disentangles himself from the
      ensuing embarrassment by claiming that Hippocrates' style was ideal for the
      specific didactic genre he was involved in. This special style necessitates a
      reassessment of customary grammatical and rhetorical values: correctness recedes
      into the background, clarity and brevity become the predominant virtues of style.

PMID- 7789117
TI  - Notes on the syntax of Celsus.
AB  - This paper discusses five remarkable syntactic features of the language of
      Celsus' De medicina: praedicativa, the anaphoric pronoun is, instructive
      expressions, word order, and complex noun phrases. It is shown that these
      features should not be explained as 'vulgarisms', but as functional linguistic
      characteristics that are appropriate to the subject matter of the text and the
      requirements of scientific and technical exposition.

PMID- 7789118
TI  - [Technical medicine in ancient comedy].
AB  - The texts of Greek comedy offer a panoramic vision of the evolution of medicine
      between the fifth and the third centuries. They provide an excellent way to
      understand the prejudices and the bases of technical medicine and its
      relationship with popular medicine. Comedy also shows us a vivid portrait of the
      physician and his position in Greek society.

PMID- 7789119
TI  - The longing for order: Oregon's medical advance directive for mental health
      treatment.

PMID- 7789120
TI  - Mental health case management: characteristics, job function, and occupational
      stress.
AB  - Although case management is an important component of treatment for persons with
      major mental illnesses, little is known about who works in case management, what
      functions are performed and how much occupational stress case managers
      experience. Mental health care managers (CM's) throughout the state of Oregon (N
      = 216) completed an inventory of case management functions and the job
      dissatisfaction and occupational stress scales of the Medical Personnel Stress
      Survey-Revised. The average expected tenure for a CM was 11 years, although one
      fifth expect to be a CM for four years or less. CM's spend 36% of their time
      performing administrative tasks, 20% in therapy, 17% with skills training, and
      18% in case coordination tasks. CM level of education was associated with a
      different distribution of effort across case management functions. Greater job
      dissatisfaction was associated with specialized training, larger case load size
      and greater intention to leave the position. Consumer CM's demonstrated
      equivalent levels of job satisfaction as their non-consumer colleagues. The
      relevance of the project's findings for human resource management are discussed.

PMID- 7789121
TI  - The relationship of service individualization to client functioning in programs
      for severely mentally ill persons.
AB  - A measure of service individualization, derived from the goals in clients'
      treatment plans, was developed and used to evaluate this treatment process
      variable for 141 severely mentally ill persons served by three psychosocial
      rehabilitation programs. Relatively few of the 364 goals reviewed were highly
      individualized. Level of service individualization was inversely related to
      clients' functional skills, residential independence, level of education, and a
      primary diagnosis of an affective disorder, but positively related to a diagnosis
      of schizophrenia or another psychotic disorder. The goal individualization
      measure differentiated both between programs and among staff members, even after
      controlling for differences on client variables.

PMID- 7789122
TI  - Housing choice and community success for individuals with serious and persistent
      mental illness.
AB  - Consumer choice is a central principle of psychosocial rehabilitation and
      supported housing approaches. This study assessed level of housing choice and the
      relationship of choice to community success in supported housing demonstration
      projects in five states. Assessment of level of choice about housing revealed
      very limited housing options and a high degree of influence from service
      providers over housing choice. Despite few options, most respondents liked their
      housing option(s) and felt they had enough information to make a good housing
      decision. The relationship of choice to community success over time demonstrated
      that choice was positively related to housing satisfaction, residential
      stability, and psychological well-being. Discussion focuses on implications of
      the findings for mental health services and public policy.

PMID- 7789123
TI  - Innovative programming in a community service center.
AB  - A Community Center in a downtown urban area offers comprehensive services that
      provide continuity and choice to homeless and poor people. Emphasis is on
      outreach, through a Day Treatment Program for severely, persistently mentally ill
      homeless, a mobile outreach team, and neighborhood services, and/or employment,
      including a restaurant and Employment Reintegration Program. The Center is an
      example of how professionals, community and business leaders, and citizens can
      unite to assist clients and how programs can evolve from clients' requests and
      participation in services. The Center's programming can be followed in any
      community in this health care reform era.

PMID- 7789124
TI  - Living with chronic mental illness: understanding the role of work.
AB  - This paper is based upon an exploratory study designed to examine the role of
      work within the lives of those with severe, persistent mental illness (SPMI). In
      depth, open ended interviews were conducted with a small number of consumers (n =
      10) who attend a clubhouse for those with SPMI where emphasis is placed upon
      preparation for work. Given that little is known about how work impinges upon or
      enriches the lives of consumers we asked consumers about their experience of
      mental illness and work throughout their life trajectories. This paper describes
      these work experiences, the effect of mental illness and treatment compliance
      upon their ability to work, and the relationship of work to stress. We found that
      in general some kind of meaningful activity was important to these consumers, but
      many had found work experiences to be stressful and were cautious about their
      subsequent abilities to sustain meaningful employment. We suggest that subsequent
      research needs to examine the nature of the work environment, and that work
      environments may be usefully distinguished in terms of level of expressed
      emotion.

PMID- 7789125
TI  - Around-the-clock mobile psychiatric crisis intervention: another effective
      alternative to psychiatric hospitalization.
AB  - This retrospective study evaluates the effect of the addition of a mobile
      psychiatrist to a 24-hour crisis intervention team, on the number of admissions,
      to the local state and private hospitals, of residents of the team's catchment
      area. During the Program period, the psychiatrist was available at the site of
      the crisis to provide immediate psychiatric treatment. The number of admissions
      to the hospitals during the Program period was then compared to those of the
      corresponding periods of the two previous years and of the year after, by means
      of a time series statistical analysis. When the on-site services of a
      psychiatrist were added to the mobile crisis intervention program a sharp
      decrease in state hospital admissions took place, without any increase in private
      hospital admissions. This decrease was followed by a definite rebound, after the
      on-site services of the psychiatrist were terminated, and throughout the
      following year.

PMID- 7789126
TI  - Some thoughts on: "around-the-clock mobile psychiatric crisis intervention".

PMID- 7789127
TI  - Use of neural networks as medical diagnosis expert systems.
AB  - A major bottleneck in building expert systems is the process of acquiring the
      required knowledge in the form of production rules. A novel class of neural
      networks is proposed to articulate the knowledge it learned from a set of
      examples. It provides an appealing solution to the problem of knowledge
      acquisition. After training, the knowledge embedded in the numerical weights of
      trained neural networks can be easily extracted and represented in the form of
      production rules. The approach is demonstrated by an example of a hypothesis
      regarding the pathophysiology of diabetes.

PMID- 7789129
TI  - Minimization of EOG artefacts from corrupted EEG signals using a neural network
      approach.
AB  - In this paper, we propose a neural network (NN) approach to the enhancement of
      EEG signals in the presence of EOG artefacts. We recast the EEG enhancement
      problem into the optimization framework by developing an appropriate cost
      function. The cost function is nothing but the energy in the enhanced EEG signal
      obtained through a nonlinear filter formulation, unlike the conventionally-used
      linear filter formulation. The minimization property of feedback-type neural
      networks is exploited to solve this problem. An analysis has been performed to
      characterize the stationary points of the suggested energy function. The hardware
      set-up of the developed neural network has also been derived. The optimum
      nonlinear filter coefficients obtained from this minimization algorithm are used
      to estimate the EOG artefact which is then subtracted from the corrupted EEG
      signal, sample by sample, to get the artefact minimized signal. The time plots as
      the LP spectrum show that the proposed method is very effective. Thus the power
      and efficacy of the NN approach have been exploited for the purpose of minimizing
      EOG artefacts from corrupted EEG signals.

PMID- 7789128
TI  - Connectionist networks in auditory system modeling.
AB  - Understanding how complex sounds, such as speech, are processed and eventually
      perceived in the brain is essential for building more effective speech
      processors. The echolocating bat provides an animal model for complex-sound
      processing of identified stimulus features at higher levels of the auditory
      pathway. In this paper, we present the use of connectionist models for modeling
      cortical neurons that play a key role in our auditory system model of a species
      of FM bat, Myotis lucifugus. The influence of network related parameters on
      modeling accuracy is presented, and the response of these models is explained in
      a behavioral context.

PMID- 7789130
TI  - Real-time multichannel abdominal fetal ECG monitor using digital signal
      coprocessor.
AB  - A real-time multichannel fetal ECG monitor based on a personal computer (PC) and
      a MOTOROLA DSP56001 Digital Signal CoProcessor (DSP) is introduced. The DSP board
      is plugged into the PC, which functions as a HOST computer. An analog 8 Leads
      Interface and Analog to Digital circuits module is connected to the DSP through a
      synchronous, optical-isolated communication channel. The fetal ECG detection is
      based on a cross-correlation technique. An averaged maternal ECG waveform is
      generated using a cross-correlation alignment procedure and a user-defined
      template. The fetal ECG signals present in the maternal waveform is suppressed
      during the averaging procedure, since both are uncorrelated. The average maternal
      ECG waveform is then subtracted from the abdominal real time signals, and
      maternal-free fetal ECGs signals are obtained, including fetal QRS complexes that
      coincide with maternal ones. Using the abdominal ECGs signals after subtraction,
      an averaged fetal waveform is generated. The maternal and the fetal heart rate
      are calculated during the process. The algorithm described above can be performed
      in real time on up to eight abdominal ECG traces by the DSP, and the desired
      results are passed to the HOST PC, to be stored and displayed. Electrodes
      positioning procedures for detecting the fetal QRS complexes with the best signal
      to noise ratio are not needed. Using the multichannel system, the user can select
      the best channel for fetal QRS detection, and accurate results for the heart rate
      signal are obtained. Averaged fetal waveforms are obtained from all the leads.

PMID- 7789132
TI  - Model analysis of time duration in a medication order entry system with attention
      to do-medication orders.
AB  - To investigate the relative time length needed for a medication computer order
      entry in comparison with the handwritten prescription system, we made a model,
      focusing our attention on the "do-medication order entry function." In the model
      analysis, we conducted a statistical analysis using the Nagoya University
      Hospital Information System. From the results and our model, if the time needed
      to make one (drug) item medication order entry is less than 1.9-3.0 times the
      time needed for handwriting one item prescription, computer order entry is faster
      on average.

PMID- 7789131
TI  - Improvements in accuracy and reproducibility of quantitative clotting factor
      assays by use of a novel approach for modeling reference curves.
AB  - A method for creating a reference model in the quantitative assay of specific
      clotting factor activities is described. This method incorporates the use of a
      piecewise function with two component polynomials. This function allows more
      accurate representation of the global coagulation reaction, a sequential
      activation of multiple serine protease enzymes and cofactors, leading to
      improvements over traditional methods in range, accuracy, precision and
      robustness in reported activity levels. Clotting factor assay results using this
      method are compared with traditional and other candidate methods.

PMID- 7789134
TI  - Computer acquisition, analysis and presentation of results from a Cobas Bio
      analyser.
AB  - Two computer programs for Macintosh computers have been developed in the LabVIEW
      programming language to perform data acquisition, analyses and presentation of
      results originating from a Cobas Bio analysing machine. One program is very
      flexible in its human interface, and is intended for research use. The program
      allows the results to be combined in a variety of ways, and allows the user to
      generate graphs to highlight the results. The other program is intended for
      routinely follow-up of analyses of proteases. It only allows the user to follow
      strict instructions, and only limited flexibility is built-in.

PMID- 7789133
TI  - PC program for assessing the relationship between rate of change and initial
      value.
AB  - A menu-driven PC program implementing Blomqvist's [J. Am. Stat. Assn. 72, 746
      749, 1977] method for assessing the relationship between rate of change and
      initial value is described, illustrated and made available. It is shown that the
      naive approach to this problem--computing the correlation between the initial
      value and either the amount or rate of change--results in a negatively biased
      estimator. The extent of this bias can be dramatic and may lead investigators to
      conclude that a negative correlation is present when none exists; or that there
      is no correlation when in fact the correlation is positive. Blomqvist's (maximum
      likelihood) estimator avoids this bias, and is obtained by a transformation of
      the naive estimator.

PMID- 7789135
TI  - Design and analysis of multiarm clinical trials with survival endpoints.
AB  - The clinical trials literature has paid relatively little attention to the design
      and analysis of K-sample trials with survival endpoints where K is 3 or greater.
      Following the least-significant-difference approach proposed by Makuch and Simon
      [1], we derive sample size formulas by working with the logrank test and
      proportional hazards model directly. This approach ensures the type I error rate
      to be the nominal value when the global null hypothesis is true. For power
      considerations, planning the study based on the least favorable alternative is
      recommended. The resulting sample size requirements are presented in graphic form
      for K = 3 and 4. Assuming that there is a control group and considering only the
      alternative that the survival of the experimental treatments is at least as good
      as that of the control group, power investigations indicate that the proposed
      strategy has good power for detecting the difference between the control and the
      best treatment. The "overall power," defined as the chance of the global test and
      subsequent pairwise comparisons all being correct, is good when all treatments
      are similar to either the control or the best treatment. Overall power is poor
      when the hazards are more evenly spread out between the control and the best
      group because the sample size is inadequate to detect such differences.

PMID- 7789136
TI  - Stopping a clinical trial early because of toxicity: the Bayesian approach.

PMID- 7789137
TI  - Note on large, simple, widely representative trials.

PMID- 7789138
TI  - Requirements for controlled clinical trials of preoperative cardiovascular risk
      reduction.
AB  - Although controlled clinical trials have had a major impact in many areas of
      cardiovascular disease management, they have had little influence on preoperative
      cardiac risk reduction. Over the past 2 years, we have conducted the Reduction of
      Cardiac Operative Risk (RCOR) Trial, a pilot study designed to determine
      enrollment and event rates for a definitive trial evaluating a strategy to reduce
      cardiac risk associated with noncardiac surgery. This experience indicates that a
      successful, definitive trial will require recognition of the multiple questions
      to be answered, accurate identification of the study population, a large sample
      size, cooperation between internists, surgeons, and anesthesiologists, and
      strategies to minimize cost. The high costs and difficulties of such a trial are
      likely to be outweighed by the enormous benefit of identifying the proper
      strategy for the use of the expensive testing methods that are currently
      employed.

PMID- 7789140
TI  - Data quality assurance, monitoring, and reporting.
AB  - In conclusion, the quality assurance and monitoring program is an integral and
      continuing part of study operations. A system must be devised and implemented by
      the coordinating center investigators, with the endorsement of the study
      leadership and support of the field site and resource center personnel. Proactive
      mechanisms for promoting high-quality data acquisition and reporting must be
      implemented. Data quality monitoring must address the entire process by which the
      data are gathered, transmitted, stored, and analyzed. Data quality should be
      monitored continually, with summary reports prepared and distributed to the study
      leadership. Appropriate training and certification enhance data quality, and site
      visits allow data collection and storage processes to be observed directly. The
      quality assurance and monitoring system must be documented. It should be flexible
      enough so that new means of quality assurance or monitoring can be added when
      necessary during the course of the study. At the completion of the study, quality
      monitoring results should be summarized in a final report regarding the level of
      quality achieved by the study investigators and personnel. Finally, for a quality
      assurance and monitoring program to be successful, the coordinating center
      investigators and personnel must provide prompt feedback and suggestions for
      corrective action whenever a data quality problem is discovered. This need can be
      met only when the coordinating center staff understand data quality goals and are
      up to date with all phases of data management and reporting. Delays in initiating
      any stage of data management and quality monitoring may result in uncorrectable
      data problems. Thus, knowledgeable and efficient coordinating center personnel
      are essential to achieving good data quality studywide.

PMID- 7789139
TI  - Statistical design of the Child and Adolescent Trial for Cardiovascular Health
      (CATCH): implications of cluster randomization.
AB  - This paper describes some statistical considerations for the Child and Adolescent
      Trial for Cardiovascular Health (CATCH), a large-scale community health trial
      sponsored by the National Heart, Lung, and Blood Institute. The trial involves
      randomization of entire schools rather than individual students to the
      experimental arms. The paper discussed the implications of this form of
      randomization for the design and analysis of the trial. The power calculations
      and analysis plan for the trial are presented in detail. The handling of
      outmigrating and immigrating students is also discussed.

PMID- 7789141
TI  - Interim reports, participant closeout, and study archives.

PMID- 7789142
TI  - Approaches to data management.

PMID- 7789143
TI  - Functions and organization of coordinating centers for multicenter studies.

PMID- 7789144
TI  - Data collection and transcription.

PMID- 7789145
TI  - Mitral regurgitation: an overview.

PMID- 7789146
TI  - Molecular biology of Borna disease virus.

PMID- 7789147
TI  - Human infections with Borna disease virus and potential pathogenic implications.

PMID- 7789148
TI  - Natural and experimental Borna disease in animals.

PMID- 7789149
TI  - A Borna-like disease of ostriches in Israel.

PMID- 7789150
TI  - Borna disease--neuropathology and pathogenesis.
AB  - Natural BD is a nonpurulent acute/subacute encephalitis of horses and sheep with
      a propensity to involve the olfactory and limbic systems, and the brain stem. The
      inflammation is concentrated primarily in the gray matter, but subcortical white
      matter may also be affected. Experimental BD can be produced in a series of
      animals from birds to primates. The neuropathology after experimental infection
      is similar to that in natural disease but the inflammatory changes are more
      diffuse. In the rat and mouse, a persistent/tolerant infection can also be
      induced, in which inflammatory changes are conspicuously absent. In the course of
      persistent infection of the rat, an elective, focal degeneration ensues that
      involves the dentate gyrus, retina, and, less frequently, the magnocellular part
      of the hippocampus. The cytopathic destruction of the dentate gyrus is the likely
      anatomical substrate of learning deficiencies and behavioral changes, prominent
      features of chronic infection. Later in infection, more diffuse and random
      degeneration of neurons can be found. In all species infected, viral antigens are
      produced in excess and fill all neuronal processes. Beside neurons, glial cells
      are infected as well. The agent spreads in the nervous system axonally and
      transsynaptically (transneuronally). The type of neurotransmitter receptors in
      the synapse and their interaction with viral proteins may modulate the spread of
      infection (Gosztonyi et al. 1994). Virus particles have not been visualized in
      the brain in any phase of the disease. During persistent infection of the rat,
      production of viral proteins has a phasic character. Some rats survive acute
      infection and develop an obesity syndrome. The anatomical basis of this syndrome
      is not fully clarified; inflammatory destruction of the infundibular region,
      vacuolar degeneration of the paraventricular nucleus of the hypothalamus and
      severe, progressive involution of the hippocampal formation most probably play an
      important role in the production of this neuroendocrine syndrome. In the acute
      disease, inflammatory reaction can severely aggravate virus-induced
      cytopathology, but cannot be the sole cause of the neurological disease, since
      infection with high passage virus can lead to a similarly severe disease in the
      absence of inflammatory changes.

PMID- 7789152
TI  - Behavioral disturbances and pharmacology of Borna disease.

PMID- 7789153
TI  - Clinical spectrum of measles.

PMID- 7789151
TI  - Immunopathogenesis of Borna disease.

PMID- 7789154
TI  - Measles virus gene expression in neural cells.

PMID- 7789155
TI  - Immune responses during measles virus infection.
AB  - The characteristic disease features of measles--fever and rash--are associated
      with the immune response to infection and are coincident with virus clearance. MV
      specific antibody and CD4 and CD8 T cell responses are generated and contribute
      to virus clearance and protection from reinfection. During this same phase of
      immune activation immunologic abnormalities are also apparent. There is a
      generalized suppression of cellular immune responses that may contribute to
      increased susceptibility to other infections. Autoimmune disease may appear in
      the form of acute disseminated encephalomyelitis. If virus-specific immune
      responses are inadequate infection may progress with pulmonary or CNS
      manifestations, but without a rash. The pathogenesis of the rare disease SSPE,
      that occurs many years after primary infection is not clear, but immune responses
      show increased antibody to measles and cellular immune responses similar to those
      seen after uncomplicated infection.

PMID- 7789156
TI  - The epidemiology of measles: thirty years of vaccination.
AB  - Measles is a highly infectious disease which has a major impact on child
      survival, particularly in developing countries. The importance of understanding
      the epidemiology of this disease is underlined by its ability to change rapidly
      in the face of increasing immunization coverage. Much is still to be learned
      about measles epidemiology and the best strategies for administering measles
      vaccines, as well as about the biological mechanisms of action of measles
      vaccines. However, it is clear that tremendous progress can be made in preventing
      death and disease from measles with existing knowledge about the disease, and by
      using the presently available vaccines and applying well tried methods of
      treating cases. Research in the coming decade may provide improved strategies and
      more effective vaccines for use in immunization programmes.

PMID- 7789157
TI  - Monkeys in measles research.

PMID- 7789158
TI  - Measles virus infections in rodents.

PMID- 7789159
TI  - The paradigms of measles vaccinology.

PMID- 7789160
TI  - Appendix: measles virus antigenome and protein consensus sequences.

PMID- 7789161
TI  - Structure, transcription, and replication of measles virus.

PMID- 7789162
TI  - Functional aspects of envelope-associated measles virus proteins.

PMID- 7789163
TI  - Measles virus strain variations.

PMID- 7789164
TI  - Measles virus-mononuclear cell interactions.

PMID- 7789165
TI  - Report and abstracts of the Fifth International Workshop on Human Chromosome 21
      Mapping 1994. Tsukuba, Japan, November 9-11, 1994.

PMID- 7789166
TI  - Determination of the gene order of the three loci CD2, NGFB, and NRAS at human
      chromosome band 1p13 and refinement of their localisation at the subband level by
      fluorescence in situ hybridisation.
AB  - The three loci NRAS, NGFB, and CD2 map to human chromosome band 1p13. Using
      fluorescence in situ hybridisation (FISH) to simultaneously DAPI-banded metaphase
      chromosomes, we have further refined the localisation of these three genes to
      specific subbands. NRAS localises to subband 1p13.2 and CD2 and NGFB to 1p13.1.
      Also, with the use of multicolour FISH, we have determined the order and
      orientation of the three loci in relation to the centromere. The order is cen-CD2
      NGFB-NRAS.

PMID- 7789167
TI  - Assignment of alpha 1-acid glycoprotein gene (ORM1) to swine chromosome region
      1q210-->q212 by fluorescence in situ hybridization.
AB  - The porcine gene for alpha 1-acid glycoprotein (ORM1) was localized to chromosome
      region 1q210-->q212 by fluorescence in situ hybridization. From this result and
      published gene mapping data, it was concluded that the syntenic group comprised
      of ORM1, IFNA1, and GRP78 in the human genome is also conserved in the pig.

PMID- 7789168
TI  - Sequence identity locates CEBPD and FGFR1 to mapped human loci within proximal
      8p.
AB  - The gene loci for human CEBPD (CCAAT enhancer binding protein, delta chain) and
      FGFR1 (fibroblast growth factor receptor) have been identified within two
      genetically mapped cosmids by sequence homology between rare cutter site regions
      and data base sequences for these loci. Cell hybrid and fluorescence in situ
      hybridization mapping places both of these loci within the chromosome region
      8p11.2-->p11.1.

PMID- 7789169
TI  - Partial nucleotide sequence and chromosomal localization of a bovine zinc finger
      gene ZNF164.
AB  - A clone carrying an open reading frame coding for a novel zinc finger protein of
      the Kruppel family was isolated from a bovine genomic library and designated ZNF
      164 (zinc finger protein 164). Partial sequencing revealed that it contained at
      least 13 zinc finger motifs preceded by a lysine-rich region of 60 amino acids.
      The ZNF164 protein shared approximately 60% similarity with several zinc finger
      proteins but did not appear to be orthologous with a previously identified gene.
      Using fluorescence in situ hybridization, the ZNF164 gene was mapped to bovine
      chromosome band 17q24.

PMID- 7789170
TI  - The human S-adenosylmethionine decarboxylase gene: nucleotide sequence of a
      pseudogene and chromosomal localization of the active gene (AMD1) and the
      pseudogene (AMD2).
AB  - S-adenosylmethionine decarboxylase (AdoMet-DC) is a key enzyme in polyamine
      biosynthesis. The human genome contains at least two loci for the AdoMetDC gene
      (AMD), one of which (AMD1) has previously been mapped to chromosome 6 and the
      other (AMD2) to the X chromosome. The locus on chromosome 6 is the
      transcriptionally active gene. We now report characterization of the AMD2 locus
      (GenBank Accession No. U02035) on the X chromosome, which contains sequences that
      cross-hybridize with human AdoMetDC cDNA. This DNA lacks all of the introns
      present in AMD1 and has numerous mutations in the protein-coding region. Its
      overall nucleotide sequence identity with AdoMetDC cDNA is about 90%. AMD2 is
      therefore a processed pseudogene, which, because of multiple mutations, cannot be
      translated to an active AdoMetDC enzyme, even if it were transcribed. Chromosomal
      loci for human AMD sequences were determined by in situ hybridization to
      metaphase chromosomes, with genomic DNAs from the active gene and the pseudogene
      loci as probes. AMD1 was localized to chromosome region 6q21-->q22 and AMD2 to
      band Xq28.

PMID- 7789171
TI  - Sequence of mouse Odf1 cDNA and its chromosomal localization: extension of the
      linkage group between human chromosome 8 and mouse chromosome 15.
AB  - The mouse cDNA encoding the major protein of the outer dense fibers in sperm
      tails was isolated by reverse transcription of testicular RNA and amplification
      with sequence-specific primers. Sequencing of a genomic clone obtained by inverse
      PCR yielded the 5' untranslated region. The transcription starting point was
      verified by primer extension. The putative proteins encoded by Odf1 in mouse and
      by ODF1 in rat and man are very similar. A total of 15 amino acids in the C
      terminal region were deleted in the mouse protein, compared with the rat protein.
      Through in situ hybridization to metaphase chromosomes, the Odf1 gene was
      localized to mouse chromosome 15 region B2-C. The chromosomal localization of the
      Odf1 gene extends the hitherto known linkage group consisting of MYC (Myc), PVT1
      (Pvt1), GPT (Gpt), and TG (Tg) common to human chromosome 8 and mouse chromosome
      15 in the proximal direction of both chromosomes. The linkage group now extends
      from band q24 to band q22 of human chromosome 8 and from region D2-E to region B2
      C of mouse chromosome 15.

PMID- 7789172
TI  - Chromosome painting analysis of early oogenesis in human trisomy 18.
AB  - We have used chromosome 18-specific painting probes to analyze early stages of
      oogenesis in two human trisomy 18 fetuses. At leptotene, a diffuse, nonlinear
      chromosomal fluorescence was detected as one (27%), two (42%), or three (31%)
      signals in 534 cells. The variation in size of these signals implies the
      possibility of associations between homologs prior to zygotene. At pachytene,
      about 75% (339/453) of the cells had a trivalent configuration, and almost half
      of these cells exhibited almost complete triple synapses. Approximately 24% of
      the pachytene cells demonstrated a bivalent:univalent configuration, and 1%
      exhibited complete asynapsis. Our data imply that triple synapses may be a
      regular feature of meiosis involving multivalents.

PMID- 7789173
TI  - The human gonadotropin-releasing hormone receptor gene (GNRHR) maps to chromosome
      band 4q13.
AB  - A cDNA representing the high-affinity gonadotropin-releasing hormone (GnRH)
      receptor has been molecularly cloned from the human pituitary gland, a breast
      tumor cell line (MCF 7), and an ovarian tumor. The nucleotide sequence of this
      cDNA was determined, and its expression in various human tumors and tumor cell
      lines was demonstrated. In this study, we localized the gene encoding the GnRH
      receptor to human chromosome 4, using polymerase chain reaction (PCR) analysis of
      genomic DNA from human x hamster somatic cell hybrids. The gene was sublocalized
      to chromosome band 4q13 using fluorescence in situ hybridization with the GnRH
      receptor gene (GNRHR).

PMID- 7789174
TI  - Isolation and mapping of the human beta-signal sequence receptor gene (SSR2).
AB  - We have isolated a human cDNA clone homologous to the canine beta-signal sequence
      receptor gene, which codes for an endoplasmic reticulum (ER) membrane protein
      associated with protein translocation across the ER membrane. Northern blot
      analysis revealed its ubiquitous expression in all organs examined. We also
      localized the human beta-signal sequence receptor gene (SSR2) to chromosome bands
      1q21-->q23 by fluorescence in situ hybridization.

PMID- 7789175
TI  - Localization of the human AHNAK/desmoyokin gene (AHNAK) to chromosome band 11q12
      by somatic cell hybrid analysis and fluorescence in situ hybridization.
AB  - Using a panel of somatic cell hybrids, we have mapped the locus for the
      AHNAK/desmoyokin gene (AHNAK) to human chromosome 11. Fluorescence in situ
      hybridization experiments independently confirmed the chromosomal localization
      and refined it to band 11q12.

PMID- 7789176
TI  - Chromosomal assignment of the human deoxyribonuclease I gene, DNASE 1 (DNL1), to
      band 16p13.3 using the polymerase chain reaction.
AB  - To localize the human deoxyribonuclease I (DNase I) gene, DNASE1 (DNL1), we
      performed a polymerase chain reaction (PCR) using DNA extracted from a panel of
      cloned human x rodent hybrid cell lines carrying different human chromosomes and
      screened for the presence of the expected PCR products. Two different sets of
      oligonucleotide primers specific for human DNase I cDNA sequences were used to
      amplify unique fragments in the human DNase I gene. Based on this work, DNL1
      could be assigned to human chromosome 16. Furthermore, regional localization of
      the gene to 16p13.3 was performed by PCR analysis of a high-resolution mouse x
      human somatic cell hybrid panel that contained defined portions of human
      chromosome 16.

PMID- 7789177
TI  - PCR amplification and physical localization of the genes for pig FSHB and LHB.
AB  - Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are members of
      the glycoprotein hormone family and play essential roles in gametogenesis and
      sexual development of mammals. Fragments of the porcine genes coding for the beta
      subunits of FSH and LH were amplified by PCR and used as probes for radioactive
      in situ hybridization in order to map these loci in the pig. Primers were chosen
      on the genomic DNA nucleotide sequences of FSHB and LHB as published in GenBank.
      Fragments of 1,127 bp (FSHB) and 1,239 bp (LHB) were cloned and verified by
      sequencing. FSHB was localized to pig chromosome bands 2p1.6-->p1.2 and LHB to
      pig chromosome band 6q2.1. The localization of LHB to the so-called halothane
      region of chromosome 6 could be expected from comparative mapping data. For FSHB,
      no conclusions can be drawn in this respect since, up to the present, too few
      genes are located on porcine chromosome 2.

PMID- 7789178
TI  - Hemizygosity at the insulin-like growth factor I receptor (IGF1R) locus and
      growth failure in the ring chromosome 15 syndrome.
AB  - The ring chromosome 15 syndrome is characterized by mild-to-severe growth
      failure. We evaluated the status of the insulin-like growth factor I receptor
      (IGF1R) gene, which had previously been assigned to band 15q26 in several
      patients with de novo ring 15 chromosomes, to investigate a possible correlation
      between disruption or loss of the IGF1R gene with the severe growth failure
      phenotype. The presence or absence of the IGF1R gene on the ring 15 chromosomes
      of five patients was ascertained by in situ hybridization and gene-dosage
      (Southern) blotting. The location of the breakpoints was determined by typing
      polymorphic markers from the distal end of the long arm of chromosome 15 in both
      the probands and their parents. Deletion mapping determined that all breakpoints
      were distal to D15S100 and that the IGF1R gene is located between D15S107 and
      D15S87. Three patients who had suffered severe growth failure in early childhood
      were hemizygous at the IGF1R locus, while one patient with borderline short
      stature had two copies of the IGF1R gene. The correlation between IGF1R gene
      dosage and growth retardation demonstrated here in our ring chromosome 15
      patients suggests a possible role for heterozygous IGF1R gene mutations or
      deletions in other cases of unexplained growth failure.

PMID- 7789179
TI  - Molecular cloning, characterization, and chromosomal mapping of a novel human
      gene (GTF3A) that is highly homologous to Xenopus transcription factor IIIA.
AB  - We have isolated a novel human cDNA that is highly related to Xenopus
      transcription factor IIIA (TFIIIA). This clone contains an open reading frame of
      1,269 nucleotides encoding 423 amino acids, including nine repeats of the
      Cys2His2-type of zinc-finger domain. A comparison of its sequence with Xenopus
      TFIIIA revealed 63% identity in nucleic acids and 58% identity in amino acids
      over a large portion of the gene and predicted peptide, indicating that the human
      homologue is likely to function as a transcription factor. The zinc-finger
      domains of the predicted protein also showed homology with those of human genes
      such as WT1, transcriptional repressor YY1, and MYC-associated zinc-finger
      protein (MAZ). Northern analysis showed expression in various tissues examined.
      The human TFIIIA gene (GTF3A) was localized to chromosome band 13q12.3-->q13.1 by
      fluorescent in situ hybridization (FISH).

PMID- 7789180
TI  - Comparative mapping of the immunoglobulin C epsilon 1 gene (IGHE) in five species
      of nonhuman primates by fluorescence in situ hybridization.
AB  - The orthologous immunoglobulin C epsilon 1 gene (IGHE) of the common chimpanzee,
      pygmy chimpanzee, orangutan, white-handed gibbon, and Japanese macaque was
      assigned to the human chromosome 14 homologue in each species and regionally
      mapped by fluorescence in situ hybridization to PTR15q32 (common chimpanzee),
      PPA15q32 (pygmy chimpanzee), PPY15q32 (orangutan), HLA17qter (white-handed
      gibbon), and MFU7q29 (Japanese macaque). The gene localized to the terminal
      region of the chromosome in each species, and so this probe provides a new
      telomeric DNA marker for nonhuman primates.

PMID- 7789181
TI  - Clarification of dubious karyotypes in Hodgkin's disease by simultaneous
      fluorescence immunophenotyping and interphase cytogenetics (FICTION).
AB  - Cytogenetic studies on Hodgkin's disease (HD) typically reveal very complex
      karyotypes with a variety of numerical and structural abnormalities. The
      confusing thing is that about 10% of cases contain relatively discrete chromosome
      aberrations, for example a simple trisomy or loss of one single chromosome.
      Whether these karyotypes really correspond to Hodgkin and Reed-Sternberg (HRS)
      cells is uncertain. They could, for example, represent early stages in the
      evolution of the karyotype of the pathognomonic HRS cells. On the other hand,
      they could be artificial events that occur during the cytogenetic procedure. In
      our experience, isolated loss of the Y chromosome is the most frequent finding of
      this type. This aberration is usually considered to be a preparation artifact.
      However, if one takes into account that in HD up to 50% of male cases with
      complex karyotypes also lack the Y chromosome, a possible relation to HRS cells
      must be considered. The technique of simultaneous fluorescence immunophenotyping
      and interphase cytogenetic analysis (referred to as FICTION) is a powerful tool
      for studying the nature of cytogenetically abnormal cells. With the FICTION
      technique we studied four cases of HD in which the chromosome analysis had shown
      only the loss of the Y chromosome. Our aim was to clarify whether these
      karyotypes corresponded to the CD30-positive HRS cells. In two cases we found
      that HRS cells actually lacked the Y chromosome. There was strong evidence,
      however, that the HRS cells additionally had other chromosome aberrations and
      thus could not correspond to the cytogenetically determined karyotypes.

PMID- 7789182
TI  - The human calcitonin receptor gene (CALCR) at 7q21.3 is outside the deletion
      associated with the Williams syndrome.
AB  - The human calcitonin receptor (CTR) is a transmembrane peptide with dual action
      as a receptor for the hormone calcitonin and as an extracellular calcium sensor.
      Therefore, CTR dysfunction could lead to disorders of calcium metabolism
      associated with hypercalcemia, such as the Williams syndrome (WS). WS is a
      developmental disorder caused by a deletion at chromosome 7q11.23 that includes
      the elastin locus (ELN). We have mapped the CTR gene (CALCR) to chromosome band
      7q21.3 by polymerase chain reaction and single-strand conformation analysis of
      somatic cell hybrids as well as fluorescence in situ hybridization (FISH) to
      metaphase chromosome spreads. Two-color FISH cohybridizing CTR and ELN probes
      confirmed that CALCR maps telomeric to ELN. Subsequent analysis of chromosome
      spreads from four WS patients revealed deletion of the ELN locus in all of them
      and normal hybridization of CTR probes to both chromosome 7 homologues,
      indicating that CALCR lies outside the deleted region.

PMID- 7789183
TI  - Chromosomal mapping of the genes GPRK5 and GPRK6 encoding G protein-coupled
      receptor kinases GRK5 and GRK6.
AB  - G protein-coupled receptor kinases (GRKs) play an important role in
      phosphorylating and regulating the activity of a variety of G protein-coupled
      receptors. Chromosomal mapping of the human genes for the two most recently
      identified members of the GRK family, GRK5 (GPRK5) and GRK6 (GPRK6), was
      accomplished by correlation of the presence of the GPRK5 and GPRK6 loci with
      specific chromosome regions in a rodent-human hybrid panel. These analyses
      revealed that GPRK5 maps to chromosome region 10q24-->qter while GPRK6 maps to
      5q35. A GPRK6 related locus maps to 13pter-->q21.

PMID- 7789184
TI  - Localization of the human stem cell tyrosine kinase-1 gene (FLT3) to 13q12-->q13.
AB  - We have previously reported the cloning of stem cell tyrosine kinase-1 (STK-1,
      gene symbol FLT3), the human homolog of the mouse Flk2/Flt3 gene (Small et al.,
      1994). This growth factor receptor is expressed in CD34+ human bone marrow
      (stem/progenitor) cells. We have mapped the gene for STK-1 using PCR screening of
      a human-rodent somatic cell hybrid panel, and fluorescence in situ molecular
      hybridization (FISH) of STK-1 genomic probes to mitotic chromosomes of normal
      human lymphocytes. The results of both analyses show that the gene for STK-1
      (FLT3) localizes to chromosome 13q12-->q13.

PMID- 7789186
TI  - Chromosomal localization of a gene, GF1, encoding a novel zinc finger protein
      reveals a new syntenic region between man and rodents.
AB  - The Gfi1 gene encodes a zinc finger protein which binds DNA and is involved in
      transcriptional regulation. Gfi1 was assigned to the central portion of mouse Chr
      5 by interspecific backcross mapping and to human chromosome band 1p22 and rat
      chromosome band 14p22 by fluorescence in situ hybridization (FISH). Comparative
      mapping data presented here describes a new syntenic region between man and
      rodents.

PMID- 7789187
TI  - Identification of p and q arms of the blesbok (Damaliscus dorcas phillipsi,
      Alcelaphinae) RBG-banded chromosomes with comparison to other wild and domestic
      bovids.
AB  - The RBG banded karyotype (2n = 38) of the blesbok (Damaliscus dorcas phillipsi)
      comprises 8 pairs of metacentric, 3 pairs of submetacentric and 7 pairs of
      acrocentric autosomes. The X and Y chromosomes are acrocentric. The 11 pairs of
      biarmed chromosomes correspond to Robertsonian translocations involving the
      chromosomes equivalent to goat and cattle chromosomes: 1;10, 4;5, 8;17, 7;9,
      6;14, 13;15, 12;16, 20;22, 3;19, 2;27 and 11;23. The comparison of Blesbok
      karyotype with that of other species of Alcelaphinae and Hippotraginae reveals a
      high level of homoeology.

PMID- 7789185
TI  - Rabl orientation of CENP-B box sequences in Tupaia belangeri fibroblasts.
AB  - The chromosomes of the tree shrew Tupaia belangeri exhibit highly localized CENP
      B box sequences in the centromeric regions of most chromosomes. Telomeric
      sequences are present at the ends of all chromosomes and, in addition, at
      specific interstitial chromosomal sites that likely represent remnants of
      ancestral telomeres. This suggests that Robertsonian and tandem chromosome fusion
      events have occurred in the karyotypic evolution of Tupaiidae. In Tupaia skin
      fibroblasts CENP-B boxes are almost always clustered together at one pole of the
      interphase nucleus, whereas the telomeric domains are relatively evenly
      distributed throughout the whole nuclear volume. The observed orientation of the
      centromeres is reminiscent of the Rabl polarization of chromosomes; this is the
      first mammalian cell substrate in which such an higher-order chromosomal
      organization has been observed. CENP-B box sequences are found in several other
      mammalian species. The implications for recent parallel evolution of CENP-B
      binding motifs and concerted evolution of these sequences are discussed.

PMID- 7789188
TI  - Viability, development and incidence of chromosome anomalies of preimplantation
      embryos from XO mice.
AB  - We examined the viability and developmental status of XO embryos at
      preimplantation stage (day 3 of gestation) by assessing blastocyst formation and
      counting cell number using our XO mouse colony. We also examined the incidence of
      chromosome anomalies. Embryos from XO mice (XY, XX and XO) developed more slowly
      (in cell numbers and blastocoele formation) than those from XX mice (XY and XX).
      XO embryos also tended to develop more slowly than XX embryos in the XO group.
      Although litter size at the preimplantation stage of gestation was almost twice
      as large (12.7) as those at mid-gestation (7.6) and near-term (7.2) in this
      colony, the adjusted XY:XX:XO ratio (2.8:2.0:1.0) did not differ greatly. This
      indicates that almost half of the embryos must have been eliminated during the
      first half of gestation in the XO group, probably regardless of sex chromosome
      complements. Thus, we consider that maternal XO sex chromosome constitution is
      disadvantageous for the intrauterine development of the embryo during the early
      period of gestation. This may be related to precocious aging of XO mice. Further,
      we confirmed that a high incidence of abnormal karyotypes occurs in embryos from
      our XO mouse colony.

PMID- 7789189
TI  - Assignment of the gene (GLCLC) that encodes the heavy subunit of gamma
      glutamylcysteine synthetase to human chromosome 6.
AB  - Assignment of the human gene (GLCLC) that encodes the heavy or catalytic subunit
      of gamma-glutamylcysteine synthetase (glutamate-cysteine ligase; EC 6.3.2.2) to
      human chromosome 6 was accomplished by hybridization to Southern blotted somatic
      cell hybrid DNA. This assignment was confirmed by PCR from somatic cell hybrid
      DNAs.

PMID- 7789191
TI  - Function and content of maternal demands: developmental significance of early
      demands for competent action.
AB  - The sources and effects of mothers' demands upon children were examined during
      naturalistic interactions of 70 mothers and their 1 1/2-3 1/2-year-olds. Demands
      were categorized in terms of immediate function (e.g., do's vs. don'ts) and
      content area emphasized by mothers (e.g., competent action, appropriate behavior,
      caretaking). Children's age and oppositional behavior influenced the nature of
      mothers' demands. Mothers with authoritative child-rearing attitudes emphasized
      proactive, competence-oriented demands and avoided regulatory controls. Maternal
      demands for competent action (prosocial behavior, chores, cognitive/play)
      predicted enhanced compliance and fewer behavior problems at age 5. Demands
      focused on the regulation of personal and social behavior predicted more behavior
      problems at age 5. We propose that children's personal and social competence
      emerges from pressures for instrumentally competent behavior in a harmonious
      interactive context.

PMID- 7789190
TI  - Molecular characterization and refined genomic localization of three human
      potassium ion channel genes.
AB  - Potassium ion (K+) channels are essential for a variety of cellular functions in
      both excitable and non-excitable cells and are likely to be involved in the
      pathogenesis of some cardiovascular and neurological disorders. To be useful in
      candidate gene analysis of inherited diseases it is important to identify new K+
      channel genes and localize these sequences on the human physical and genetic
      maps. Using fluorescence in situ hybridization (FISH), we mapped two new K+
      channel gene containing cosmids, c2-3a and c9-2a, to chromosomes 1 and 19,
      respectively. Partial DNA sequencing (c2-3a) and restriction enzyme site analysis
      (c9-2a) established the uniqueness of each clone. We refined the localization of
      c2-3a, c9-2a and a previously described K+ channel gene KCNA5, (c7-2), by
      performing contour length measurements of hybridized metaphase chromosomes and
      determining the average FLpter% value (fractional length relative to the fixed
      reference point pter x 100%). When compared to ideograms of banded metaphase
      chromosomes, these FLpter% values correspond to 12p13.31-->p13.33, 1p13.1-->p21.1
      and 19q13.32-->q13.33, respectively. Using FISH, each of these clones has been
      finely mapped to a different human chromosome indicating a significant dispersion
      of K+ channel sequences in the human genome.

PMID- 7789192
TI  - The determinants of coparenting in families with toddler boys: spousal
      differences and daily hassles.
AB  - In order to advance understanding of the phenomenon of coparenting, naturalistic
      observations of firstborn sons were undertaken when they were 15 months of age at
      a time when both parents were home and family life was demanding. Narrative
      records of coparenting events were scored to determine the frequency with which
      parents supported and undermined each other and to test two hypotheses pertaining
      to individual differences in coparenting: that greater differences between
      spouses in demographic factors, personality, styles of relatedness and child
      rearing attitudes would forecast more unsupportive and less supportive
      coparenting; and that the adverse effects of such spousal differences would be
      amplified by high levels of family stress, as indexed by frequency and intensity
      of daily hassles. Both hypotheses received support and are discussed in turn.

PMID- 7789193
TI  - Developmental change in infants' responses to stress.
AB  - Infant stress responses to a well-baby physical examination and inoculation were
      observed longitudinally at 2, 4, and 6 months of age. In general, there were
      cortisol increases over base to the procedures. Cortisol level and cortisol
      response decreased with age. These data indicate a developmental shift in
      adrenocortical functioning between 2 and 6 months of age. Further evidence for
      this shift was seen in the stability of individual responses between 4 and 6
      months of age. Individual differences in both cortisol and behavioral responses
      showed the most stability between these 2 ages. Moreover, diurnal variation in
      baseline cortisol level was present only at 6 months of age. While a sizable
      minority of infants showed stress-related cortisol decreases to the procedures at
      a given age, there was no evidence for cross-age consistency in individual
      infants showing these cortisol decreases.

PMID- 7789194
TI  - What do children worry about? Worries and their relation to anxiety.
AB  - This study examined worry in elementary school aged children and its relation to
      anxiety. The study also examined whether parameters of excessive or dysfunctional
      worry could be delineated. Children from second through sixth grades (ages 7-12
      years) were interviewed using a structured approach and completed several child
      anxiety measures. Parameters of worry assessed included: number of worries, areas
      of worry, intensity of worries, and perceptions of the frequency of worry events.
      Findings revealed few age-related differences but found that girls reported more
      worries than boys and that African-Americans reported more worries than white or
      Hispanic children. The three most common areas of worry involved School, Health,
      and Personal Harm. Anxiety was significantly associated with worry, providing
      empirical support for a link between these two constructs. Worry parameters,
      especially number and intensity of worries, could differentiate high and low
      anxious children in a normal school sample. Implications of these findings for
      understanding the role of worry in childhood anxiety are discussed.

PMID- 7789195
TI  - Priming of perceived control in young children as a buffer against fear-inducing
      events.
AB  - Young children (aged 5 and 6) watched videotaped fairy tales that acted to prime
      child control versus adult control over frightening events. Subsequently, they
      watched an ambiguous videotape of a child having a medical exam; tapes were
      varied for presence or absence of fear cues (facial expressions shown by actors).
      We predicted that children primed for child control versus adult control would
      show information-processing error patterns that paralleled those previously found
      for children who were dispositionally high or low in perceived control. As
      expected, children primed for child control showed processing enhancement whereas
      those primed for adult control showed processing deficits after witnessing fear
      cues. Attentional disengagement was found to mediate processing errors. Perceived
      control--dispositional or temporary--was interpreted as an important organizer of
      attention to and processing of potentially threatening events.

PMID- 7789196
TI  - Young children's understanding of the causes of anger and sadness.
AB  - This study investigated kindergarten children's understanding of the causes of
      anger and sadness. Previous research has shown that before 6 or 7 years of age,
      children have difficulty distinguishing hypothetical situations designed to evoke
      anger from those designed to evoke sadness. In this project, 80 kindergarten
      children (ages 5-1 to 6-5, M = 5-10) predicted and explained protagonists'
      emotional responses to a variety of hypothetical events. The results showed that
      intentional harm was not the feature young children used to distinguish anger
      from sadness. Children predicted anger most often when they believed that
      protagonists could change undesirable situations and reinstate their goals and
      when children focused on the person or conditions that brought about undesirable
      situations. Children predicted sadness most often when they believed that goal
      reinstatement was impossible and focused on the losses that would ensue as a
      result.

PMID- 7789197
TI  - Relational aggression, gender, and social-psychological adjustment.
AB  - Prior studies of childhood aggression have demonstrated that, as a group, boys
      are more aggressive than girls. We hypothesized that this finding reflects a lack
      of research on forms of aggression that are relevant to young females rather than
      an actual gender difference in levels of overall aggressiveness. In the present
      study, a form of aggression hypothesized to be typical of girls, relational
      aggression, was assessed with a peer nomination instrument for a sample of 491
      third-through sixth-grade children. Overt aggression (i.e., physical and verbal
      aggression as assessed in past research) and social-psychological adjustment were
      also assessed. Results provide evidence for the validity and distinctiveness of
      relational aggression. Further, they indicated that, as predicted, girls were
      significantly more relationally aggressive than were boys. Results also indicated
      that relationally aggressive children may be at risk for serious adjustment
      difficulties (e.g., they were significantly more rejected and reported
      significantly higher levels of loneliness, depression, and isolation relative to
      their nonrelationally aggressive peers).

PMID- 7789199
TI  - Mother-child interaction quality as a partial mediator of the roles of maternal
      depressive symptomatology and socioeconomic status in the development of child
      behavior problems. Conduct Problems Prevention Research Group.
AB  - This investigation examined the relation between maternal depressive
      symptomatology and the development of externalizing behavior problems in children
      by incorporating mother-child interaction quality into a series of models. A
      representative sample of 376 first-grade boys and girls (mean age = 6.52) from
      diverse backgrounds (234 from the lowest 2 socioeconomic classes) and their
      mothers completed an interaction task designed to measure the quality of mother
      child interaction. Latent variable structural equations analyses revealed that
      mother-child interaction quality partially mediated the relation between maternal
      depressive symptomatology and child behavior problems even when the effects of
      socioeconomic status on both variables were taken into account. Although this
      model held for boys, girls, and Caucasians, the relation between maternal
      depression and interaction quality was not significant for African-Americans.
      Further investigation is required to understand the lack of generalizability of
      the model to African-American mother-child dyads.

PMID- 7789198
TI  - Meeting goals and confronting conflict: children's changing perceptions of social
      comparison.
AB  - It was proposed that previously observed grade-related changes in children's
      social comparison behavior could be explained by the changing goals and meanings
      children assign to this behavior. Specifically, it was suggested that, as
      children progress through the school system, they become increasingly aware of
      the negative and positive aspects of social comparison and adjust their behavior
      in response to this awareness, as well as to increasingly salient self-evaluation
      goals. To examine these propositions, 106 elementary school children were
      observed in their classrooms and interviewed once a year for 3 years. Consistent
      with previous research, overt forms of social comparison were most frequent among
      younger children, whereas subtle forms of social comparison were most frequent
      among older children. Furthermore, with increasing grade children were likely to
      view overt forms of social comparison negatively and subtle forms as useful in
      meeting self-evaluation goals. Additional analyses revealed little association
      between perceptions of social comparison and actual social comparison behavior,
      except that perceiving subtle social comparison as useful for self-evaluative
      goals predicted engagement in such behavior 2 years later.

PMID- 7789200
TI  - The academic lives of neglected, rejected, popular, and controversial children.
AB  - The purposes of this study were to examine academically relevant characteristics
      of different sociometric status groups and to learn about the academic
      orientations of behavioral subgroups of rejected children. Results from a sample
      of 423 sixth and seventh graders (ages 11-13) suggested that sociometrically
      neglected children have quite positive academic profiles. When compared with
      average status children, these students reported higher levels of motivation,
      were described by teachers as more self-regulated learners, as more prosocial and
      compliant, and as being better liked by teachers. Analyses of two behavioral
      subgroups of rejected children indicated that aggressive-rejected but not
      submissive-rejected children have problematic academic profiles. Relations of
      neglected and aggressive-rejected status to academic adjustment in young
      adolescents' lives is discussed.

PMID- 7789201
TI  - Socioeconomic disadvantage, proximal environmental experiences, and
      socioemotional and academic adjustment in early adolescence: investigation of a
      mediated effects model.
AB  - This study investigated interrelations among conditions of household
      socioeconomic disadvantage, proximal environmental experiences, and adaptational
      outcomes in a sample of 398 middle grade, early adolescents from a predominantly
      poor, rural area. Findings indicated that levels of disadvantage were related to
      both socioemotional and academic adjustment, with those from relatively
      disadvantaged backgrounds faring most poorly. Specifically, youth from homes in
      which adults were employed in low-income, unskilled occupations were found to
      have lower levels of school performance and achievement compared to those from
      homes in which adults were employed in higher paying semi-skilled or
      skilled/professional occupations. Further, youth from families in which neither
      parent had graduated from high school exhibited significantly worse
      socioemotional and academic adjustment than did those whose parents had higher
      educational levels. Youth who lived in relatively disadvantaged homes also
      reported more negative experiences of proximal environmental conditions relating
      to family and school contexts and greater exposure to stressful life events. Most
      notably, findings provided support for employing an ecological-mediational
      perspective to understand patterns of linkage between socioeconomic disadvantage
      and levels of adjustment. Support for this viewpoint included the finding that
      proximal environmental experiences were significant predictors of adolescent
      adjustment, independent of shared variance with conditions of household
      disadvantage, whereas conditions of disadvantage in several instances were no
      longer related significantly to indices of adjustment once their association with
      proximal environmental conditions was taken into account. The discussion
      considers implications for the targeting and scope of ecologically oriented
      approaches to preventive intervention.

PMID- 7789202
TI  - A contextual-moderator analysis of emotional autonomy and adjustment in
      adolescence.
AB  - This study investigated the relation between emotional autonomy, as measured by
      Steinberg and Silverberg's Emotional Autonomy Scale (EA), and adolescent
      adjustment as moderated by several individual, familial, and cultural contexts.
      Subjects were 96 adolescents (10-18 years old) and their mothers and teachers.
      Results indicate that when the affective nature of the parent-adolescent
      relationship is positive (e.g., maternal warmth is high or intensity of parent
      adolescent conflict is low), positive adolescent adjustment is more likely when
      adolescents report less emotional autonomy. On the other hand, when the family
      environment is more stressful, emotional autonomy is positively associated with
      adolescent adjustment. Findings suggest that higher scores on the EA scale index
      emotional detachment from parents and that such detachment is detrimental in
      supportive familial environments but adaptive in less supportive familial
      environments. That emotional detachment from parents appears to serve a
      protective function in certain stressful situations is viewed as analogous to the
      adoption of an avoidant attachment strategy during infancy.

PMID- 7789203
TI  - A twin-sibling study of observed parent-adolescent interactions.
AB  - Numerous behavioral genetic studies call attention to the strong and pervasive
      genetic influence on developmental characteristics. However, this research has
      been criticized for its use of poor environmental measures and a failure to
      examine the complex processes that are a hallmark of research in child
      development. This study addresses this criticism by examining the genetic and
      environmental components of parent-child interactions. Mother, father, and 2
      adolescent siblings (10-18 years) from each of 675 families were observed
      interacting in 10-min dyadic problem-solving sessions. 6 groups of siblings that
      differed in genetic relatedness were examined (MZ and DZ twins, full siblings in
      nondivorced families; full, half, and unrelated siblings in stepfamilies).
      Results suggest a greater genetic component to adolescent behavior than to parent
      behavior. Both adolescent and parent behavior showed strong effects of nonshared
      environment, even after error of measurement was removed.

PMID- 7789204
TI  - The role of age and verbal ability in the theory of mind task performance of
      subjects with autism.
AB  - A number of studies have reported that most children with autism fail theory of
      mind tasks. It is unclear why certain children with autism pass such tests and
      what might be different about these subjects. In the present study, the role of
      age and verbal ability in theory of mind task performance was explored. Data were
      pooled from 70 autistic, 34 mentally handicapped, and 70 normal young subjects,
      previously tested for a number of different studies. The analysis suggested that
      children with autism required far higher verbal mental age to pass false belief
      tasks than did other subjects. While normally developing children had a 50%
      probability of passing both tasks at the verbal mental age of 4 years, autistic
      subjects took more than twice as long to reach this probability of success (at
      the advanced verbal mental age of 9-2). Possible causal relations between verbal
      ability and the ability to represent mental states are discussed.

PMID- 7789205
TI  - The organization of reactivated memory in infancy.
AB  - The specificity of memory retrieval by 3-month-old infants was examined in 3
      experiments. All infants were trained in the mobile conjugate reinforcement
      paradigm to kick their feet to produce movement in an overhead crib mobile and
      were tested 2 weeks later. 24 hours prior to the test, subjects received a 3-min
      reminder treatment. The results of Experiment 1 demonstrated that only the moving
      training mobile alleviated forgetting after the 2-week retention interval;
      forgetting was not alleviated by exposure to the stationary training mobile or to
      the mobile stands and ribbon alone. The results of Experiments 2 and 3
      demonstrated that, once retrieved, the reactivated memory was highly specific to
      the conditions of original training. Furthermore, the memory attributes that were
      the last to be forgotten (e.g., the general or global features) were the first to
      be retrieved following the reminder treatment. Conversely, those memory
      attributes that were forgotten first (e.g., the specific or local details) were
      the last to be retrieved. These findings have important implications for infant
      memory retrieval, reminiscence, and infantile amnesia.

PMID- 7789206
TI  - Leprosy control in China. Achievements and prospect.

PMID- 7789207
TI  - Progress of research on in vitro fertilization and embryo transfer in China.

PMID- 7789208
TI  - Progress of trauma research in China.

PMID- 7789209
TI  - Progress in lymphatic filariasis control in China.

PMID- 7789210
TI  - Structure-function interrelation and clinical effect of atrial natriuretic
      peptide (ANP).
AB  - Atriopeptin III (AP III) and its six analogues were synthesized by solid phase
      method and their diuretic and hypotensive activities were determined. Among these
      analogues, analogue [D-Ala-5, D-Arg-23] AP III was nearly 10 times as potent as
      AP III in diuretic activity while its hypotensive activity increased only 50% of
      that of AP III. Analogue des [Ser-15Gly-16Leu-17Gly-18Asn-20Ser-21] AP III was
      15% as potent as AP III in diuretic activity, but it still maintained about 60%
      of the hypotensive activity of AP III. Meanwhile, we tried analogue [D-Ala-5, D
      Agr-23] AP III for the treatment of hypertensive syndrome in pregnancy and
      obtained some good results.

PMID- 7789211
TI  - Neurohypophysial AVP concentration in stroke patients.
AB  - Neurohypophysial arginine vasopressin (AVP) concentrations were determined by RIA
      in 9 patients with cerebral infarction, 11 patients with intracerebral
      hemorrhage, 5 patients with subarachnoid hemorrhage and 5 control subjects. The
      results showed that neurohypophysial AVP concentration in patients with cerebral
      infarction increased by 225.8% as compared with the control subjects (P < 0.05),
      and the AVP concentrations in patients with intracerebral and subarachnoid
      hemorrhage did not change significantly. Brain herniation as a result of
      intracranial hypertension, gastrointestinal bleeding and hyperglycemia (two
      clinical manifestations of stress) was seen more frequently in hemorrhagic stroke
      patients than in ischemic stroke patients. These findings suggest that the
      ischemic brain damage may contribute to the elevation of neurohypophysial AVP
      concentration in patients with cerebral infarction.

PMID- 7789213
TI  - Effects of daurisoline on cytosolic free calcium in fetal rat cerebral cells.
AB  - Cytosolic free Ca2+ ([Ca2+]i) was measured in dissociated cerebral cells isolated
      from fetal rats with the fluorescent indicater fura-2. Increase in [Ca2+]i
      occurred rapidly following exposure of the cells to 50 mmol/L KCl, 10(-7) mol/L
      Bay K 8644 or 200 mumol/L glutamate (Glu). [Ca2+]i elevated by K(+)
      depolarization was attenuated by pretreatment with 10(-7), 10(-6) mol/L
      daurisoline (Dau). The response of [Ca2+]i to K(+)-depolarization did not change
      when 10(-8) mol/L Dau was added. When 10(-8)-10(-6) mol/L Dau was added to the
      cell suspensions prior to exposure to Glu, the Glu-stimulated rises in [Ca2+]i
      were reduced significantly. However, Dau (10(-6), 10(-7) and 10(-8) mol/L) did
      not alter the response to Bay K 8644. These results indicate that Dau can inhibit
      the increase of [Ca2+]i in fetal rat cerebral cells induced by certain Ca2+
      agonists, especially Glu, suggesting that this drug may have a protective effect
      against cerebral cellular injury.

PMID- 7789212
TI  - GM1 antibody in Guillain-Barre syndrome after Campylobacter jejuni infection.
AB  - Fecal culture of Campylobacter jejuni was prepared by the method of Skirrow, and
      serum class specific antibodies (IgG, IgM and IgA) to Campylobacter jejuni and
      serum class specific antibodies (IgG IgM) to GM1 were prepared with solid phase
      enzyme linked immunasorbent assay in 16 cases of Guillain-Barre syndrome (GBS),
      32 controls with other neurological diseases (disease controls) and 90 normal
      controls. The results showed that the incidence of Campylobacter jejuni
      infection, especially recent infections, in the group with Guillain-Barre
      syndrome was much higher than that in the two control groups, and that the
      positive rate of GM1 antibody was also much higher in the GBS group than in the
      two control groups. The results suggest that Campylobacter jejuni infection may
      be one of the important precipitating factors of Guillain-Barre syndrome and play
      an important role in the epidemiological pattern of Guillain-Barre syndrome in
      China. It damages the myelin of peripheral nerves through induction of GM1
      antibody production.

PMID- 7789214
TI  - Identification and classification of Neisseria gonorrhoeae by RAPD
      fingerprinting.
AB  - Using the RAPD method, we identified and classified Neisseria gonorrhoeae on the
      basis of the DNA level. Except OPG20 the other 19 primers of OPG arbitrary primer
      kit showed informative arrays of amplified prominent segments. Most of the
      segments were common to all three Neisseria gonorrhoeae groups; some segments
      were amplified from two groups or only one group so that the fingerprint maps of
      different Neisseria gonorrhoeae groups were distinctive. Based on these findings,
      i.e. on the genomic level, we can classify the three Neisseria gonorrhoeae
      groups. Using OPG10 and OPG11 to amplify the five Neisseria species, we found
      marked diversity among them, which made it easy for us to identify Neisseria
      gonorrhoeae from four other Neisseria species. The use of the RAPD method needs
      some special reaction conditions, e.g. annealing temperature that should not be
      too low or too high and should be consistently stable. The quality of Taq
      polymerase is also very important. The reproducibility of the results under these
      conditions was very good.

PMID- 7789215
TI  - Extensive wound excision in shock stage in patients with major burns.
AB  - To stop excessive plasma loss, alleviate noxious effects of devitalized tissues
      on the body and shorten the hospitalization time, we performed extensive
      escharectomy during the shock period in extensively burned patients. Group A
      consisted of 21 patients aged 9-45 years (26.1 +/- 7.9 years), with a mean total
      burn area of 63.2% +/- 18.1% TBSA, and full-thickness injury involving 35.9% +/-
      19.6% TBSA. The first escharectomy was done at 24.1 +/- 13.9 hours postburn, and
      excision area averaged 32.3% +/- 6.7% TBSA (24%-46%). In 15 of them, Swan-Ganz
      catheter was introduced to monitor the hemodynamic changes. It was found that
      RAP, PAP, PAWP, ABP, HR, CO and CI were all stable during and after the
      operation. Group B consisted of 29 patients aged 11-50 years (30.4 +/- 11.7
      years), in whom escharectomy was begun 4-5 days postburn. The mean healing time
      of the patients in group A was 33.1 days, shorter than that of group B patients
      (40.1 days). The duration of hemoconcentration was shorter in group A. The amount
      of blood transfusion was almost 700 ml less in group A during the first two
      weeks. Less antibiotics were used with fewer visceral complications in group A.
      We believe that escharectomy during the burn shock stage is feasible.

PMID- 7789216
TI  - Changes of gastric acid secretion and somatostatin after Roux-en-Y
      cholangiojejunostomy.
AB  - The authors studied the changes of gastric acid secretion and determined the
      levels of somatostatin (SS) and gastrin (Gn) in blood, gastric juice and pyloric
      antrum in 28 patients Roux-en-Y with cholangiojejunostomy (CJR-Y). Gastric acid
      hypersecretion was identified, and the level of SS was found dropped while the
      content of Gn increased in these specimens. It was considered that the reduction
      of SS synthesis and secretion might have a key effect on the mechanism of
      secondary gastric acid hypersecretion in patients after CJR-Y.

PMID- 7789217
TI  - Endogenous porphyrins in murine skin and transplanted PAM-212 squamous cell
      carcinoma tissues after injection of delta-aminolevulinic acid.
AB  - After intraperitoneal (IP) injection of delta-aminolevulinic acid (ALA), the
      endogenous porphyrins in murine skin and tumor tissues were determined by a
      method involving solvent and acid extractions. The results showed that the total
      amount of porphyrins in the tumor tissues after ALA injection was much higher
      than that in the skin from the same mice, although the amount of porphyrins in
      the skin from the ALA-injected mice was higher than that from the saline-injected
      (control) mice. The porphyrins in the tumor were mostly protoporphyrin and
      coproporphyrin, with only a small amount of uroporphyrin. The optimum period for
      porphyrin accumulation in the tumor as well as in the skin was 1 hour after the
      injection of ALA. As the period was extended to 3 and 6 hours, the amount of
      porphyrins in these tissues decreased considerably. These findings could be
      valuable for further application of ALA in the photodynamic therapy of skin
      cancer.

PMID- 7789218
TI  - The safety and efficacy of streptokinase in coronary reperfusion in patients with
      acute myocardial infarction.

PMID- 7789219
TI  - Progress in surgical treatment of hydatid diseases in China. A clinical analysis
      of 22,005 surgical cases.
AB  - Altogether 27,716 cystic hydatid cases and 445 alveolar hydatid cases clinically
      diagnosed and surgically treated in China were retrospectively studied. In
      accordance with the parasitic sites of the hydatid cysts and the various
      pathological types, different surgical procedures were adopted. In an attempt to
      prevent intraoperative accidents and postoperative complications, continued
      improvements in operational techniques have been made. Different surgical
      procedures were evaluated for their advantages and disadvantages as well as their
      indications. According to the pathological changes of the residual cavities of
      ectocysts, different measures were adopted. In screening operations, injection of
      antihydatid drug into hydatid cysts followed by oral administration of this drug
      was used to prevent relapses. The therapeutic effect of all these measures has
      been proved satisfactory by follow-up studies. This indicates that the progress
      in surgical treatment of cystic hydatid disease during the recent 10 years has
      been attaining to the objectives of shortening the duration of treatment,
      decreasing the postoperative recurrence rate and increasing the cure rate. In
      some hospitals, no operative death and relapse of cyst growth have been reported
      in nearly 1,000 surgical cases of cystic hydatid disease. Only 10.8% of the 445
      alveolar hydatid cases underwent radical operations and the prognoses were
      unfavourable. This was due to the absence of symptoms in early stages of the
      disease which often made the patients miss the chance for radical operation in
      hospitals.

PMID- 7789220
TI  - Serological survey of nasopharyngeal carcinoma in 21 cities of south China.
AB  - This paper reports the results of serological survey of 318,912 persons for
      nasopharyngeal carcinoma (NPC) in 21 cities and counties of south China. There
      were 8,441 persons with positive VCA-IgA antibody (single item positive) of EB
      virus (EBV), with a rate of 2.65%. In these VCA-IgA positive persons, 287 persons
      also had positive EA-IgA (double items positive) of EBV. The overall positive
      rate was 0.09%. 100 cases of NPC were found and 87 of them (87.0%) were in early
      stage. NPC found in the group with single item positive accounts for 1.19%, but
      the rate in the group with double items positive was 19.16% (55 cases). In NPC
      patients with double items positive, 49 cases were in early stage (89.1%). In 100
      cases of NPC found, 45 cases appeared with negative EA-IgA, only with positive
      VCA-IgA, which indicated that for diagnosis of NPC, sensitivity of EA-IgA was
      lower than that of VCA-IgA, but its specificity was higher. Therefore, both can
      increase the detecting rate and early diagnosis rate of NPC. The age of people
      checked varied with different antibody positive rate and NPC detecting rate. The
      three items showed a positive correlation. The results are compatible with those
      of the prospective study for NPC in Wuzhou City, Guangxi, China. The method for
      NPC serological diagnosis can be extended and applied to raise the NPC detecting
      rate and early diagnosis rate at secondary prevention. And, it is further proved
      that there is a close relationship between NPC and EBV.

PMID- 7789221
TI  - Epidemiology of Helicobacter pylori infection in the People's Republic of China.
AB  - This paper presents a general review of the studies on the epidemiology of H.
      pylori infection in China. Among 3,519 dyspeptic individuals presenting for
      endoscopy, H. pylori detectable rate was 61.2%. A higher prevalence of infection
      was found in patients with peptic ulcer. The prevalence of gastric metaplasia was
      82.5% in patients with duodenal ulcer, 53.1% in duodenitis and 34.5% in normal
      duodenal mucosa. H. pylori infection is significantly more common in gastric
      cancer patients (58.9%) than in the matched controls (42.5%). Endoscopic studies
      performed on asymptomatic volunteers aged 10-25 showed that the prevalence of
      gastritis and H. pylori was 45%-84% and 42%-67% respectively. Large scale
      prospective studies of the possible role of H. pylori in gastric cancer in
      populations with various gastric cancer mortality rates using ELISA assays showed
      a significant geographical association between gastric cancer mortality and the
      prevalence of H. pylori infection. H. pylori infection is acquired at an earlier
      age and has a higher prevalence in the high gastric cancer risk areas than in the
      low risk areas. H. pylori was detected in human saliva and dental plaque by PCR.
      H. pylori-like organisms were successfully isolated by culture and detected by
      nested PCR in the gastric mucosa of pigs and cats. Intrafamilial clustering of H.
      pylori infection was observed.

PMID- 7789222
TI  - The changing cancer spectrum and incidence in Shanghai area.

PMID- 7789223
TI  - Cognitive impairment in multiple cerebral infarction.

PMID- 7789224
TI  - [Experimental study on immediate endosseous implantation].
AB  - Screw type implants (ITI series) were implanted into the socket of extracted
      teeth of adult dogs to investigate the histologic recovery process of
      implantation. Two groups of immediate implantation. (with or without filling of
      cancellous bone chips) were performed, with a follow-up period of one month and
      three months. Results showed that marked immature new bone formation was found
      one month later after implantation. The amount of new bone in the group with
      cancellous bone implantation was much more than that in the group without bone
      chips. Mature new bone was observed three month later after operation, no marked
      difference was found in the amount of new bone between the two groups.

PMID- 7789225
TI  - [The changing of orofacial structure by bite opening with Begg technique].
AB  - Cephalometric study of 30 deep-bite cases treated with extraction of four first
      premolars and Begg stage I appliance shows that the bite opening consists of not
      only intrusion of the upper and lower incisors but also extrusion of the upper
      and lower molars, furthermore, the lower incisors depressed more than the upper
      ones and the lower molars are elevated more than the upper ones. The moving type
      of teeth, the changing of base bone and soft tissue profile are also discussed in
      this article.

PMID- 7789226
TI  - [A primary study of classification of functional speech problem after cleft
      palate repair].

PMID- 7789227
TI  - [Expression of proliferating cell nuclear antigen (PCNA) in squamous cell
      carcinoma of the oral cavity].
AB  - Proliferating cell nuclear antigen (PCNA) was identified by immunohistochemistry
      in 52 cases. PCNA-positive cells had been detected in the basal cells of normal
      epithelium known to contain proliferating cells. PCNA scores of normal epithelium
      was 1 as "low", and carcinomas were 3 or 4 as "high". The PCNA scores of high
      grade carcinoma was significantly higher than the low-grade carcinoma. The study
      shows that expression of PCNA correlated with carcinoma grade.

PMID- 7789228
TI  - [Mandibular drift-orthodontics after first premolar extraction].

PMID- 7789229
TI  - [Evaluation of presurgical orthodontic correction of the mandibular prognathism].
AB  - The aim of this study was to evaluate the effects of presurgical orthodontic
      correction of the mandibular prognathism. The sample consisted of two groups of
      surgical cases. The cases of the mandibular prognathism in group I with lower
      anterior dental compensation received presurgical orthodontic decompensation, and
      the cases in group II without lower anterior dental compensation did not receive
      presurgical orthodontic decompensation. The results showed that before
      presurgical orthodontic treatment, significantly differences existed between the
      two groups variable ILi/OL and ANB. After presurgical orthodontic correction
      lower incisors position in group I was very close to that in the group II, this
      means that the presurgical orthodontic treatment significantly changed the
      position of the lower incisors.

PMID- 7789230
TI  - [Application of T-subgroup cells assay in the immunology of oral-maxillofacial
      cancer].
AB  - We report on T-subgroup cells in 70 cases of oral-maxillofacial cancer determined
      by T-monoclone antibody-OKT system. The results are as follows: CD3, CD4/CD8
      value of cancer patients was decreased significantly, compared with that of
      health or oral benign tumor patients. CD8 was significantly increased (P <
      0.001); however, CD8 was decreased and CD4/CD8 ratio was increased after
      operation. 20 cases underwent the dynamic testing, determined in 1 week, 1 and 3
      month. The results are as follows: CD3, CD4, CD4/CD8 values were increased
      gradually and CD8 was decreased gradually in 17 cases of curative patients, but
      CD4, CD4/CD8, values were decreased and CD8 was increased significantly in 3
      cases of metastased patients. Our conclusion is that determination of T-subgroup
      cells is of reference value for monitoring and treating cancer patients.

PMID- 7789231
TI  - [The effect of sagittal split ramus osteotomy advancement and setback mandible on
      occlusal force and masticatory efficiency].
AB  - 21 patients (mandibular prognathism = 11, mandibular retrognathism = 10) whose
      occlusal force and masticatory efficiency were measured and analysed
      preoperatively, three and six months following sagittal split ramus osteotomy.
      The result shows that, in individuals with mandibular retrognathism treated by
      lengthening of the mandible, the occlusal force and masticatory efficiency would
      decrease, in individuals with mandibular prognathism treated by reduction in
      mandibular length, the occlusal force and masticatory efficiency would increase.
      There is no linear correlation relationship between the change of the occlusal
      force and the movement of the angle and the distance of the mandible.

PMID- 7789233
TI  - [A preliminary evaluation of bone matrix gelatin in clinical application to oral
      and maxillo-facial surgery].

PMID- 7789234
TI  - [Relations between human papillomavirus and oral cancers using of nucleic acid
      hybridization].

PMID- 7789232
TI  - [The effect of measuring the curvature of soft palate to determine the position
      of posterior peripheral seal].
AB  - This study was undertaken to determine the feasibility of the surveyor of
      curvature in fabricating a full upper denture. 48 cases were investigated to
      determine the position of the posterior peripheral seal with the instrument. The
      results showed that the retention of the full upper denture was greater than that
      of the control-team. This method is more suitable for the patients with lower
      flat or higher palatal vault.

PMID- 7789235
TI  - [Relationship between levels of aspartate aminotransferase in gingival crevicular
      fluid and periodontal disease activity].
AB  - This paper describes a longitudinal study in which clinical parameters and
      aspartate aminotransferase (AST) in gingival crevicular fluid (GCF) were
      monitored bimonthly over a 6-12 months period in 970 sites from 7 treated
      periodontitis patients. In this study, 21 out of 970 sites exhibited new
      attachment loss (AL) of at least 2mm between two consecutive visits. The GCF-AST
      levels and clinical parameters at sites with active tissue destruction (> or =
      2mm AL within two months) were significantly higher than those at control sites
      on the same tooth. The GCF-AST levels and clinical parameters at sites with
      active tissue destruction decreased significantly after re-treatment. The
      measurement of GCF-AST could be an useful adjunctive criterion for detection of
      disease activity. However, it seems to be unsatisfactory in predicting disease
      activity.

PMID- 7789236
TI  - [HPLC monitoring and pharmacokinetic study of crevicular fluid concentrations
      after a single oral dose metronidale].

PMID- 7789237
TI  - [Computerized tomography diagnosis of cervical node metastasis in head and neck
      cancers].

PMID- 7789238
TI  - [Usage of the geno-toxicological studies in the biological evaluation of dental
      materials].
AB  - The salmonella mutagenicity test (Ames test), the Bacillus subtilis repair test
      and SOS chromotest are three sorts of sort-term mutagenic test, which were
      developed recently and had their individual terminal point to examine genotoxins.
      A battery of short-term tests was made up of these three mutagenic tests to
      examine the mutagenicity of formaldehyde, glutaraldehyde and resorcinal. The
      results verified formaldehyde and glutaraldehyde were genetoxins, and discovered
      resorcinal not only had no mutagenicity, but also had the antimutagenicity to
      some genotoxic agents. In addition, the methods of three tests were described and
      the use of the battery was introduced and evaluated.

PMID- 7789239
TI  - Bridging the gap between cytopathology and surgical pathology.

PMID- 7789240
TI  - Diagnosis of lymphoma, leukemia, and metastatic tumor involvement of the
      cerebrospinal fluid by cytology and immunocytochemistry.
AB  - Fifty-five cerebrospinal fluid (CSF) specimens from 42 patients with suspected
      meningeal tumor involvement were reviewed. Cytology in conjunction with
      immunocytochemistry identified 26 CSF specimens as malignant. There were fifteen
      cases of lymphoma, four cases of leukemia, two cases of carcinoma, and two cases
      of melanoma. A monoclonal light chain expression was demonstrated in nine out of
      eleven B cell lymphomas. The three T-cell lymphomas all expressed pan T markers
      (CD 3) and two the T-helper antigen (CD 4). One patient had meningeal involvement
      of a true histiocytic lymphoma which was identified by its large atypical cells
      which were positive for alpha-1-anti-trypsin and muramidase. In four patients
      with a primary diagnosis of acute lymphoblastic leukemia, CSF involvement was
      confirmed by the demonstration of blasts with CD 10 (cALLA) or light chain
      restriction. Epithelial or melanocytic markers were demonstrated on the tumor
      cells in CSF from the remaining four patients. In 29 CSF specimens a diagnosis of
      reactive lymphocytosis was made using cytomorphology which mostly was
      characterized by macrophages mixed with small mature lymphoid cells. Immunologic
      evaluation showed that these mature cells were CD 10 negative T-cells and only
      few specimens contained polyclonal B-cells. The subsequent clinical course of
      these patients showed no evidence of CNS malignancy. It is concluded that
      cytology should be used in conjunction with immunocytochemistry to accurately
      evaluate CSF specimens from patients with possible malignant meningitis.

PMID- 7789241
TI  - Tuberculous lymphadenitis: extended cytomorphologic features.
AB  - In tuberculous lymphadenitis, FNAC smears sometimes reveal only caseous necrosis
      without epithelioid cell granuloma. They pose a diagnostic problem, if AFB
      staining is negative. The diagnostic clue noticed in these cases was presence of
      multiple pink, homogenous structures with irregular shape and well-defined
      margins: "eosinophilic structures" (ES). The purpose of the present study is to
      find out the nature of ES and their role in the diagnosis of tuberculosis.
      Seventy FNAC smears from documented cases of tuberculous lymphadenitis were
      classified according to their cytomorphological features. The association and
      relation of ES with other morphological criteria was noted. Immunoperoxidase
      staining was performed to find out the reactivity of ES to tuberculous antigen.
      Its intensity of positivity was compared with epithelioid cell granuloma and
      degenerating granuloma. It was concluded that ES are degenerated granuloma and
      thus form an extended diagnostic criterion.

PMID- 7789242
TI  - Effusion cytology in Burkitt's lymphoma.
AB  - The American form of Burkitt's lymphoma is a high-grade malignancy which usually
      involves the abdomen in children and young adults. There is only a limited
      literature which describes the cytologic features of Burkitt's lymphoma in serous
      effusions. We present three children with Burkitt's lymphoma initially diagnosed
      by effusion cytology. The first patient, an 11-yr-old boy, presented with
      bilateral pleural effusions, ascites, and abdominal masses and had diagnostic
      pleural fluid cytology without tissue confirmation (ultrastructural examination
      was performed on the effusion specimen). He died 7 months after the initial
      diagnosis. The second patient, a 9-yr-old boy, presented with ascites and
      abdominal masses and had diagnostic peritoneal fluid cytology with a subsequent
      confirmatory chest wall biopsy. The third patient, a 16-yr-old girl, presented
      with a 2-month history of irregular menses, a large pelvic mass, lymphadenopathy,
      and liver masses. Although an ovarian malignancy was clinically suspected,
      cytologic examination of her peritoneal fluid revealed Burkitt's lymphoma.
      Surgical exploration revealed involvement of her right ovary, cecum, and terminal
      ileum. The second and third patients are currently alive with no apparent disease
      following chemotherapy. In all three patients, effusion cytology revealed
      Burkitt's lymphoma, characterized by a uniform population of non-cohesive
      lymphoid cells with noncleaved nuclei, prominent multiple nucleoli, and scanty-to
      moderate basophilic cytoplasm. Cytoplasmic and/or nuclear vacuoles were also
      seen, more prominent in Diff-Quik-stained, air-dried smears. These cases
      demonstrate the importance of recognizing the cytologic features of Burkitt's
      lymphoma, as serous fluid may be the initial diagnostic specimen.

PMID- 7789243
TI  - Pulmonary lymphoma in cardiac transplant patients treated with OKT3 for
      rejection: diagnosis by fine-needle aspiration.
AB  - At Hines VA Hospital, three out of 38 cardiac transplant patients, who were 9,
      10, and 14 mo post-surgery and treated with immunosuppressive drugs, including
      OKT3 prophylaxis for acute rejection, developed a solitary pulmonary nodule. Fine
      needle aspiration biopsy of the nodules in these three patients revealed a
      hypercellular, monotonous population of large lymphoid cells. These abnormal
      cells were isolated, with small aggregates occasionally seen. The nuclear
      membranes were irregular, the chromatin was finely granular, nucleoli were
      prominent, and mitotic figures were frequently noted. The cells were
      immunoreactive to leukocyte common antigen and B-lymphocyte. Lambda light chain
      immunoglobulin was positive in one case, kappa in the second case, and neither
      light chains in the third patient. By electron microscopy in one case, the cells
      were large immature lymphoid cells with immunoblastic features. Subsequent tissue
      studies, complemented by frozen section immunostaining, flow cytometry, and
      phenotyping, reaffirmed the diagnosis of malignant lymphoma. It appears that OKT3
      therapy increases several fold the risk of lymphoma's developing in cardiac
      transplant patients. Preliminary published reports have also recommended close
      surveillance of patients receiving OKT3 for early indications of
      lymphoproliferative disorder and a reevaluation of the risk vs. benefit for the
      prophylatic use of OKT3.

PMID- 7789244
TI  - Antigen expression of alveolar macrophages in smokers and patients with lung
      diseases.
AB  - Alveolar macrophage function was studied immunocytochemically using three
      monoclonal antibodies--macrophage CD 68 KP 1 (M), protein CD 11C (P), and anti
      elastin (EL)--and three polyclonal antibodies--lysozyme (LZ), alpha-1-antitrypsin
      (AAT), and alpha-1-antichymotrypsin (AACT). The material for study was smears
      obtained from bronchial washings from 15 healthy persons and 60 patients with
      respiratory infections or primary or secondary malignant lung infiltration. Eight
      of the healthy group and 40 of the patient group were smokers (SM). The
      percentage of cells obtained from the washings which were macrophages was also
      measured. The intensity of staining reactions for each of the six antigens was
      noted and in general more intense staining was noted in smokers than in non
      smokers. More intense staining was observed in patients with pulmonary infections
      (group II PI) and metastatic pulmonary infiltrations (group IV MP Ca) than in
      controls (group IC), while patients with primary lung cancer (group III PP Ca)
      had highly reduced staining reactions. The number of macrophages was similarly
      increased in all groups in comparison with the IC group for non-smokers and in
      all groups except III PP Ca for smokers. It is concluded that smoking, pulmonary
      infections, and metastatic infiltration of the lung are associated with an
      increase in the number and activity of alveolar macrophages, while patients with
      primary lung cancer have an increase in the number of macrophages which are
      functionally incompetent.

PMID- 7789246
TI  - Confocal microscopy: a new horizon for cytology.

PMID- 7789245
TI  - Confocal microscopy of false-negative breast aspirates.
AB  - Even when using a novel optimized FNA-21 for breast fine-needle aspiration
      biopsy, our series of 163 breast lesions with consecutive histology, including
      110 carcinomas, contained eight cancer cases with a negative cytologic diagnosis.
      Two consisted exclusively of thick, undiagnosable epithelial fragments and were
      devoid of detached malignant cells on which the proper diagnosis could have been
      made. Optical sectioning of the original smears by the confocal microscope
      allowed us to reclaim from these epithelial fragments the diagnostic abnormal
      chromatin patterns, even in the air-dried smears. In the thin optical sections
      the cancerous tubular or cribriform growing pattern was visualized. The high
      spatial resolution of the confocal microscope can be further exploited with the
      application visualization system (AVS). The AVS three-dimensional reconstructions
      allow us to see the surface of these malignant cells in a detail approaching that
      of scanning electron microscopy. Furthermore, the internal aspects of the
      malignant nuclei can be visualized with these techniques.

PMID- 7789247
TI  - Mycoses of the breast: diagnosis by fine-needle aspiration.
AB  - Fungal infections of the breast are unusual and may clinically mimic carcinoma.
      When studied by fine-needle aspiration (FNA), such masses may yield necrosis,
      granulomatous inflammation, reactive histiocytes, and atypical epithelial cells.
      Cohesive groups of atypical epithelial cells featured nuclear enlargement and
      overlapping, as well as prominent nucleoli. The organisms may be widely
      scattered, so that careful evaluation was required for their identification. In
      concert with provocative clinical findings, these features may lead to an
      erroneous diagnosis of malignancy. We describe three women with mycotic masses of
      the breast initially studied by FNA. The first patient presented at age 31 with a
      large, firm breast mass, chest wall extension, and radiographic evidence of
      vertebral bone involvement. FNA was requested to confirm the clinical diagnosis
      of advanced breast carcinoma. In addition to the atypia described above, the
      smears showed yeast forms indicative of blastomycosis surrounded by neutrophils.
      She remains well, following antifungal treatment. The second case of
      Blastomycosis was diagnosed by FNA of a breast mass in a 64-yr-old woman, who
      also responded to treatment. The third patient's preoperative needle aspiration
      showed granulomas, but no organisms were identified, even with special stains;
      silver stains of surgically excised tissue showed histoplasmosis.

PMID- 7789248
TI  - Nocardiosis diagnosed by lung FNA: a case report.
AB  - A 63-yr-old woman with systemic lupus erythematosus (SLE) diagnosed 12 mo
      previously and treated with prednisolone and cyclophosphamide presented with
      recent fever and dyspnoea. The etiology of a 3 cm diameter centrally cystic coin
      lesion in the lower lobe of the left lung was obscure. Blood cultures and sputum
      examination had been non-contributory, and the diagnosis of Nocardia asteroides
      infection was initially made by cytologic examination of material obtained by
      lung fine-needle aspiration (FNA). It is notoriously difficult to detect this
      organism by conventional sputum examination or with histologic sections, and it
      has rarely been detected by lung FNA. If this organism is demonstrated,
      appropriate microbiologic cultures for confirmation and susceptibility testing
      should be instituted. Long-term antimicrobial therapy is needed. In this case,
      complete resolution of the lung lesion followed 5 mo of therapy.

PMID- 7789249
TI  - Diagnosis of metastatic appendiceal adenocarcinoid in liver by fine-needle
      aspiration cytology.
AB  - A 70-yr-old woman presented with symptoms clinically attributed to acute
      appendicitis. An adenocarcinoid tumor of the appendix was resected, followed by
      right hemicolectomy with negative lymph nodes. Seven years later, a fine-needle
      aspiration biopsy was performed on one of multiple hepatic nodules, revealing
      metastatic adenocarcinoid. The cytopathologic features of the metastatic tumor
      are described.

PMID- 7789250
TI  - Glycogen-rich clear cell carcinoma of the breast: report of a case with fine
      needle aspiration cytology and immunocytochemical and ultrastructural studies.
AB  - Fine-needle aspiration cytology, immunocytochemistry, and electron microscopic
      findings are described in a case of glycogen-rich clear cell carcinoma of the
      breast. The aspirate contained many small and large papillary cell groups and
      numerous single tall columnar cells with apical cytoplasmic projections and mild
      to moderate degree of nuclear pleomorphism. Cytochemical localisation of glycogen
      and immunostaining on air-dried smears with CEA and actin monoclonal antibodies
      permitted the correct identification and differential diagnosis of the tumor.
      Electron microscopic examination of the resected specimen confirmed the diagnosis
      of glycogen-rich clear cell carcinoma. The differential diagnosis and potential
      diagnostic pitfalls are discussed, and recommendation are offered to prevent
      misdiagnosis.

PMID- 7789251
TI  - Calcium oxalate crystals in benign breast cyst fluid.
AB  - We have recently observed a strongly birefringent material of varying shapes and
      sizes in a benign breast cyst fluid specimen from a 52-yr-old woman with
      suspicious mammographic microcalcifications. The finding of calcium oxalate
      crystals in the breast cyst fluid should be regarded as a recognition of a
      particular type of calcification, easily overlooked with the conventional light
      microscopy. To date, we are unaware of any cytologic reports of this type of
      calcification in the breast.

PMID- 7789252
TI  - Calcifying epithelial odontogenic tumor (Pindborg's tumor) on fine-needle
      aspiration biopsy smears: a case report.
AB  - A 44-yr-old woman with a long-standing history of painful mandibular swelling was
      hospitalized for the diagnostic evaluation of an osteolytic mandibular lesion in
      the premolar-canine area. Fine-needle aspiration biopsy (FNAB) was performed and
      cytologic smears were characterized by clusters, sheets, and rare isolated
      pleomorphic cells of the squamoid type, blocks of amorphous material encircled by
      fibroblasts, and occasional calcifications. A cytological diagnosis of Pindborg's
      tumor was made, which was confirmed by histopathological examination. Evaluation
      of DNA ploidy by semiautomated image cytometry produced an aneuploid histogram.
      The patient is free of residual neoplasm at a 12-mo post-operative interval. The
      cytological differential diagnosis of this rare odontogenic neoplasm is discussed
      briefly.

PMID- 7789253
TI  - Sialadenitis with crystalloid formation: a report of six cases diagnosed by fine
      needle aspiration.
AB  - Six cases of sialadenitis diagnosed by fine-needle aspiration contained large
      numbers of crystalloids. Light microscopy, ultrastructure, and chemical analysis
      suggest that the crystalloids represent crystallized salivary alpha-amylase. The
      inflammatory swelling may mimic benign and/or malignant neoplasms of the salivary
      glands. Drainage and/or antibiotic therapy may allow surgery to be avoided in
      these patients.

PMID- 7789254
TI  - Utilization of fine-needle aspiration biopsy in the diagnosis of metastatic
      tumors to the pancreas.
AB  - There is relatively little information concerning the use of fine-needle
      aspiration biopsy (FNAB) to diagnose a mass in the pancreas that is secondary to
      metastatic tumor. This study reviews the incidence and types of neoplasms which
      metastasize to the pancreas and assesses the contribution FNAB can make in their
      diagnosis. Of 117 radiologically guided FNABs of the pancreas, 11% (n = 13)
      showed metastatic malignancy. Nine patients had a previous history of malignancy
      while four patients presented with a pancreatic mass and were subsequently found
      to have wide-spread malignant disease. The majority of metastatic lesions were
      epithelial (77%, n = 10). Patient outcomes were generally poor (mean survival 2.8
      mo). Metastases to the pancreas occur from a variety of primary sites and should
      be considered in patients with a pancreatic mass and a history of prior
      malignancy. FNAB is useful in diagnosing these metastases and this is clinically
      important because of their poor prognosis.

PMID- 7789255
TI  - OV632 as a possible marker for malignant mesothelioma: high expectations; low
      specificity.

PMID- 7789256
TI  - Aspiration cytodiagnosis of crystalloids in a sudden swelling of parotid gland.

PMID- 7789257
TI  - Clear cell carcinoma of the minor salivary gland metastasizing to the thyroid.

PMID- 7789258
TI  - A Dutch view on American cytology in the headlines.

PMID- 7789259
TI  - The C. elegans neuronally expressed homeobox gene ceh-10 is closely related to
      genes expressed in the vertebrate eye.
AB  - We describe the homeobox gene ceh-10 from the nematode Caenorhabditis elegans.
      The homeodomain of ceh-10 is closely related to the homeodomains of two genes
      recently cloned from the vertebrate retina, Chx10 from mice and Vsx-1 from
      goldfish. We show that the sequence conservation extends well beyond the
      homeodomain and includes a region (named the CVC domain) of roughly 60 amino
      acids immediately C-terminal to the homeodomain. As assayed in transgenic worms,
      the promoter region of ceh-10 directs expression of a lacZ reporter gene to a
      small number of neurons. We draw a parallel between the bipolar cells of the
      inner nuclear layer of the vertebrate retina, which express Chx10 and Vsx-1, and
      an interneuron in C. elegans called AIY, which expresses ceh-10. AIY receives
      synaptic input from a sensory cell, just as do bipolar cells of the vertebrate
      retina. In C. elegans, the sensory cell AFD is not known to be photosensitive but
      is known to be thermosensitive; moreover, a cell with similar position in the
      amphids of other nematodes has been suggested indeed to be photosensitive. Our
      results emphasize the highly conserved nature of sensory regulatory mechanisms
      and suggest one way in which photosensitive organelles might have originated in
      evolution.

PMID- 7789260
TI  - Wingless induces transdetermination in developing Drosophila imaginal discs.
AB  - Drosophila imaginal discs, the precursors of the adult fly appendages, have been
      the subject of intensive developmental studies, particularly on cell
      determination. Cultured disc fragments are recognized not only for the ability to
      maintain their determined state through extra cell divisions but also for the
      ability to transdetermine, or switch to the determined state of a different disc.
      An understanding of transdetermination at a molecular level will provide further
      insight into the requirements for maintaining cell determination. We find that
      ectopic expression of the Drosophila gene wingless induces transdetermination of
      foreleg imaginal disc cells to wing cells. This transdetermination occurs in
      foreleg discs of developing larvae without disc fragmentation. The in situ
      transdetermining cells localize to the dorsal region of the foreleg disc. This
      wingless-induced transdetermination event is remarkably similar to the leg-to
      wing switch that occurs after leg disc culture. Thus we have identified a new
      approach to a molecular dissection of transdetermination.

PMID- 7789261
TI  - Targeted disruption of the low-affinity leukemia inhibitory factor receptor gene
      causes placental, skeletal, neural and metabolic defects and results in perinatal
      death.
AB  - The low-affinity receptor for leukemia inhibitory factor (LIFR) interacts with
      gp130 to induce an intracellular signal cascade. The LIFR-gp130 heterodimer is
      implicated in the function of diverse systems. Normal placentation is disrupted
      in LIFR mutant animals, which leads to poor intrauterine nutrition but allows
      fetuses to continue to term. Fetal bone volume is reduced greater than three-fold
      and the number of osteoclasts is increased six-fold, resulting in severe
      osteopenia of perinatal bone. Astrocyte numbers are reduced in the spinal cord
      and brain stem. Late gestation fetal livers contain relatively high stores of
      glycogen, indicating a metabolic disorder. Hematologic and primordial germ cell
      compartments appear normal. Pleiotropic defects in the mutant animals preclude
      survival beyond the day of birth.

PMID- 7789262
TI  - Neurotrophins affect the pattern of DRG neurite growth in a bioassay that
      presents a choice of CNS and PNS substrates.
AB  - Neurons can be categorized in terms of where their axons project: within the
      central nervous system, within the peripheral nervous system, or through both
      central and peripheral environments. Examples of these categories are cerebellar
      neurons, sympathetic neurons, and dorsal root ganglion (DRG) neurons,
      respectively. When explants containing one type of neuron were placed between
      cryosections of neonatal or adult sciatic nerve and neonatal spinal cord, the
      neurites exhibited a strong preference for the substrates that they would
      normally encounter in vivo: cerebellar neurites generally extended only on spinal
      cord, sympathetic neurites on sciatic nerve, and DRG neurites on both. Neurite
      growth from DRG neurons has been shown to be stimulated by neurotrophins. To
      determine whether neurotrophins might also affect the substrate preferences of
      neurites, DRG were placed between cryosections of neonatal spinal cord and adult
      sciatic nerve and cultured for 36 to 48 hours in the presence of various
      neurotrophins. While DRG cultured in NGF-containing media exhibited neurite
      growth over both spinal cord and sciatic nerve substrates, in the absence of
      neurotrophins DRG neurites were found almost exclusively on the CNS cryosection.
      To determine whether these neurotrophin-dependent neurite patterns resulted from
      the selective survival of subpopulations of DRG neurons with distinct neurite
      growth characteristics, a type of rescue experiment was performed: DRG cultured
      in neurotrophin-free medium were fed with NGF-containing medium after 36 hours in
      vitro and neurite growth examined 24 hours later; most DRG exhibited extensive
      neurite growth on both peripheral and central nervous system substrates.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7789263
TI  - Nonequivalent requirements for PS1 and PS2 integrin at cell attachments in
      Drosophila: genetic analysis of the alpha PS1 integrin subunit.
AB  - We report on the generation and phenotype of mutant alleles of multiple edematous
      wings (mew), the gene encoding the alpha PS1 subunit of the PS1 integrin of
      Drosophila. None of the six alleles examined makes detectable protein, and one
      allele results from a chromosome break near the middle of the translated
      sequence, so we are confident that we have described the null phenotype. In
      contrast to if (alpha PS2) and mys (beta PS) mutants, most mutant mew embryos
      hatch, to die as larvae. Mutant mew embryos display abnormal gut morphogenesis
      but, unlike mys or if embryos, there is no evidence of defects in the somatic
      muscles. Thus, the complementary distributions of PS1 (alpha PS1 beta PS) and PS2
      (alpha PS2 beta PS) integrin on tendon cells and muscle, respectively, do not
      reflect equivalent requirements at the myotendinous junction. Dorsal herniation,
      characteristic of the mys lethal phenotype, is not observed in mew or in mew if
      embryos. Clonal analysis experiments indicate that eye morphogenesis is disrupted
      in mew clones, but if clones in the eye are relatively normal in morphology.
      Adult wings display blisters around large dorsal but not ventral mew clones. In
      contrast to dorsal mys clones, small mew patches do not necessarily display
      morphogenetic abnormalities. Thus, another integrin in addition to PS1 appears to
      function on the dorsal wing surface.

PMID- 7789264
TI  - CSF-1 and mouse preimplantation development in vitro.
AB  - The effects of macrophage colony stimulating factor on the development of the
      zygote to the blastocyst stage of an outbred strain of mouse have been studied in
      KSOM, an improved medium that supports a high rate of in vitro development.
      Macrophage colony stimulating factor accelerates the formation of the blastocyst
      cavity by day 4 (96 hours post-hCG). It also increases overall embryonic cell
      number through a differential increase in the number of trophoblast cells, with
      no significant effect on the number of inner cell mass cells. By day 5 of culture
      (120 hours post-hCG), colony stimulating factor-treated embryos have about 20
      more trophoblast cells than control embryos, an increase of about 30 percent of
      the total number of cells in a control blastocyst. The maximum response of
      embryos was obtained at a concentration around 540 U ml-1 colony stimulating
      factor (identical to 918 Stanley units ml-1), and the cytokine can produce the
      same effects even if it is present in the medium for only part of the culture
      period. This in vitro stimulation of preimplantation development with macrophage
      colony stimulating factor is compatible with continued normal fetal development
      in vivo.

PMID- 7789265
TI  - Muscle sensory neurons require neurotrophin-3 from peripheral tissues during the
      period of normal cell death.
AB  - To determine if muscle sensory neurons require neurotrophin-3 (NT3) during the
      period of normal cell death, we used an NT3-specific antiserum to deplete NT3
      from peripheral tissues during this period in chick embryos. DiI staining of
      dorsal roots indicated that limb injections of anti-NT3 reduced the spinal
      projection of muscle spindle afferents. In contrast, injection of the antiserum
      into the spinal cord had no demonstrable effect, indicating that the reduced
      projection following limb injection was due to peripheral blockade of NT3
      signaling. Counts of neurons retrogradely labeled from muscle and cutaneous
      nerves showed that peripheral blockade of NT3 selectively reduced the survival of
      muscle sensory neurons without affecting the survival of cutaneous sensory
      neurons or motoneurons. In situ hybridization with trkC probes indicated that,
      during the period of cell death, most large diameter muscle sensory neurons
      express trkC transcripts, whereas few cutaneous neurons express this receptor for
      NT3. We conclude that large diameter muscle afferents, including spindle
      afferents, require NT3 from peripheral tissues to survive the normal period of
      sensory neuron death in vivo.

PMID- 7789266
TI  - Patterning of the mesoderm in Xenopus: dose-dependent and synergistic effects of
      Brachyury and Pintallavis.
AB  - Widespread expression of the DNA-binding protein Brachyury in Xenopus animal caps
      causes ectopic mesoderm formation. In this paper, we first show that two types of
      mesoderm are induced by different concentrations of Brachyury. Animal pole
      explants from embryos injected with low doses of Xbra RNA differentiate into
      vesicles containing mesothelial smooth muscle and mesenchyme. At higher
      concentrations somitic muscle is formed. The transition from smooth muscle
      formation to that of somitic muscle occurs over a two-fold increase in Brachyury
      concentration. Brachyury is required for differentiation of notochord in mouse
      and fish embryos, but even the highest concentrations of Brachyury do not induce
      this tissue in Xenopus animal caps. Co-expression of Brachyury with the secreted
      glycoprotein noggin does cause notochord formation, but it is difficult to
      understand the molecular basis of this phenomenon without knowing more about the
      noggin signal transduction pathway. To overcome this difficulty, we have now
      tested mesoderm-specific transcription factors for the ability to synergize with
      Brachyury. We find that co-expression of Pintallavis, but not goosecoid, with
      Brachyury causes formation of dorsal mesoderm, including notochord. Furthermore,
      the effect of Pintallavis, like that of Brachyury, is dose-dependent: a two-fold
      increase in Pintallavis RNA causes a transition from ventral mesoderm formation
      to that of muscle, and a further two-fold increase induces notochord and neural
      tissue. These results suggest that Pintallavis cooperates with Brachyury to
      pattern the mesoderm in Xenopus.

PMID- 7789267
TI  - Cell fate control in the Drosophila retina by the orphan receptor seven-up: its
      role in the decisions mediated by the ras signaling pathway.
AB  - Drosophila seven-up is an orphan receptor of the steroid receptor family that is
      required to specify photoreceptor neuron subtypes in the developing compound eye.
      Expression of seven-up is confined to four of the eight photoreceptor precursors,
      R3/R4/R1/R6. We show that misexpression of seven-up in any of the other cell
      types within the developing ommatidium interferes with their differentiation.
      Each cell type responds differently to seven-up misexpression. For example,
      ectopic expression in the non-neuronal cone cells using the sevenless
      promoter/enhancer (sev-svp) causes the cone cells to take on a neuronal identity.
      Ectopic expression of seven-up in R2/R5 using the rough enhancer (ro-svp) causes
      these neurons to lose aspects of their photoreceptor subtype identity while
      remaining neuronal. Each cell type appears to have a different developmental time
      window that is sensitive to misexpressed seven-up. The temporal order of
      responsiveness of each cell type to misexpressed seven-up is similar but not
      identical to the order of neuronal differentiation. This suggests that there are
      processes of specification that are distinct from the specification to become a
      photoreceptor neuron. We have identified members of the ras signaling pathway as
      suppressors of the cone cell to R7 neuron transformation caused by sev-svp.
      Suppression of the sev-svp phenotype can be achieved by decreasing the gene
      dosage of any of the members of the ras-pathway. This suggests that the function
      of seven-up in the cone cells requires ras signaling. However, a decrease in ras
      signaling results in enhancement of the phenotype caused by the ro-svp transgene.
      We discuss the relationship between decisions controlled by seven-up and those
      controlled by ras signaling.

PMID- 7789268
TI  - Hoxa 11 structure, extensive antisense transcription, and function in male and
      female fertility.
AB  - Hoxa 11 is a murine Abdominal-B-type homeobox gene. The structure of this gene is
      presented, including genomic and cDNA sequence. The cDNA includes the complete
      open reading frame and based on primer extension results is near full length.
      Surprisingly, the antisense strand of Hoxa 11 was found to be transcribed.
      Moreover, these antisense transcripts were processed and polyadenylated. The
      developmental expression patterns for both sense and antisense transcripts were
      examined using serial section and whole-mount in situ hybridizations. Hoxa 11
      transcription patterns were defined in the limbs, kidney and stromal cells
      surrounding the Mullerian and Wolffian ducts. Of particular interest, in the
      developing limbs, the sense and antisense transcripts showed complementary
      expression patterns, with antisense RNAs increasing in abundance in regions where
      sense RNAs were diminishing in abundance. Furthermore, targeted mutation of Hoxa
      11 is shown to result in both male and female sterility. The female mutants
      produce normal ova, which develop properly post-fertilization when transferred to
      wild-type surrogate mothers. The Hoxa 11 homozygous mutants are shown to provide
      a defective uterine environment. The mutant males exhibited a malformation of the
      vas deferens that resembles a partial homeotic transformation to an epididymis.
      In addition, the mutant testes fail to descend properly into the scrotum and,
      likely as a result, spermatogenesis is perturbed.

PMID- 7789269
TI  - Ectoderm induces muscle-specific gene expression in Drosophila embryos.
AB  - We have inhibited normal cell-cell interactions between mesoderm and ectoderm in
      wild-type Drosophila embryos, and have assayed the consequences on muscle
      development. Although most cells in gastrulation-arrested embryos do not
      differentiate, they express latent germ layer-specific genes appropriate for
      their position. Mesoderm cells require proximity to ectoderm to express several
      muscle-specific genes. We show that ventral ectoderm induces mesoderm cells to
      express nautilus (a MyoD homologue) and to differentiate somatic myofibers,
      whereas dorsal ectoderm induces mesoderm cells to express visceral and cardiac
      muscle-specific genes. Our findings suggest that muscle determination in
      Drosophila is regulated by induction between germ layers during gastrulation.

PMID- 7789270
TI  - Multiple roles for FGF-3 during cranial neural development in the chicken.
AB  - FGF-3 has been implicated in the development of the hindbrain and otocyst in
      vertebrate embryos. Since the chicken embryo offers a favourable system in which
      to study the development of these structures, we have isolated and characterised
      cDNAs for chicken Fgf-3 and determined its pattern of expression in chick embryos
      from stage 3 (primitive streak) to stage 25 (early organogenesis). Within the
      developing cranial neural tube, Fgf-3 exhibits dynamic spatial and temporal
      expression. During extension of the head process, RNA is detected in the midline
      of the developing neural plate. In neurulating embryos, transcripts are observed
      initially in rhombomeres 4 and 5 of the hindbrain and later, in rhombomere 6.
      During hindbrain development, expression is lost from these rhombomeres, but
      becomes restricted to rhombomere boundaries, providing an intracellular marker
      which distinguishes a population of cells within boundary regions. Fgf-3
      expression is elevated in ventral and medial boundary regions and is greatly
      reduced in dorsal parts. Studies of regenerating rhombomere boundaries show that
      Fgf-3 expression is induced in reforming boundaries when even-numbered rhombomere
      tissue is grafted next to odd, but not when like is juxtaposed to like. Fgf-3
      disappears from boundary regions just prior to the loss of the morphological
      boundaries suggesting a boundary-associated function. Other sites of expression
      have also been identified. At early stages of development Fgf-3 is expressed in
      the epiblast and mesendoderm of the primitive streak, in mesoderm lateral to the
      streak and in Hensen's node. In older embryos transcripts are detected in the
      endoderm of the pharyngeal pouches, the ectoderm of the second and third
      pharyngeal arches and the stomodeum. Expression was also detected in the
      segmental plate and in the posterior half of the three most-recently generated
      somites.

PMID- 7789271
TI  - The Drosophila E74 gene is required for the proper stage- and tissue-specific
      transcription of ecdysone-regulated genes at the onset of metamorphosis.
AB  - The steroid hormone ecdysone directly induces a small set of early genes, visible
      as puffs in the larval salivary gland polytene chromosomes, as it signals the
      onset of Drosophila metamorphorsis. The products of these genes appear to
      function as regulators that both repress their own expression and induce a large
      set of secondary-response late genes. We have identified recessive loss-of
      function mutations in the early gene E74, a member of the ets protooncogene
      family that encodes two related DNA-binding proteins, E74A and E74B. These
      mutations cause defects in pupariation and pupation, and result in lethality
      during metamorphosis. Here we extend our phenotypic characterization of the E74A
      and E74B mutant alleles to the molecular level by examining their effects on the
      transcription of over 30 ecdysone-regulated genes. We show that the transcription
      of most ecdysone primary-response genes during late larval and prepupal
      development is unaffected by the E74 mutations. Rather, we find that E74 is
      necessary for the appropriate regulation of many ecdysone secondary-response
      genes. E74B is required for the maximal induction of glue genes in mid third
      instar larval salivary glands, while E74A is required in early prepupae for the
      proper timing and maximal induction of a subset of late genes. E74 activity is
      also necessary for the correct regulation of genes expressed predominantly in the
      fat body, epidermis or imaginal discs. These observations confirm that E74 plays
      a critical role in regulating transcription during the early stages of Drosophila
      metamorphosis. In addition, the widespread effects of the E74 mutations on
      transcription indicate that E74 functions in regulatory hierarchies not only in
      the larval salivary gland, but throughout the entire organism.

PMID- 7789272
TI  - Terminal diversification of the myocyte lineage generates Purkinje fibers of the
      cardiac conduction system.
AB  - The rhythmic contraction of the vertebrate heart is dependent on organized
      propagation of electrical excitation through the cardiac conduction system.
      Because both muscle- and neuron-specific genes are co-expressed in cells forming
      myocardial conduction tissues, two origins, myogenic and neural, have been
      suggested for this specialized tissue. Using replication-defective retroviruses,
      encoding recombinant beta-galactosidase (beta-gal), we have analyzed cell lineage
      for Purkinje fibers (i.e., the peripheral elements of the conduction system) in
      the chick heart. Functioning myocyte progenitors were virally tagged at embryonic
      day 3 of incubation (E3). Clonal beta-gal+ populations of cells, derived from
      myocytes infected at E3 were examined at 14 (E14) and 18 (E18) days of embryonic
      incubation. Here, we report that a subset of clonally related myocytes
      differentiates into conductile Purkinje fibers, invariably in close spatial
      association with forming coronary arterial blood vessels. These beta-gal+
      myogenic clones, containing both working myocytes and Purkinje fibers, did not
      incorporate cells contributing to tissues of the central conduction system (e.g.
      atrioventricular ring and bundles). In quantitative analyses, we found that
      whereas the number of beta-gal+ myocyte nuclei per clone more than doubled
      between E14 and E18, the number of beta-gal+ Purkinje fiber nuclei remained
      constant.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789274
TI  - Axonal guidance in the chicken retina.
AB  - During retina development, ganglion cells extend their axons exclusively into the
      innermost tissue layer, but not into outer retina layers. In order to elucidate
      guiding mechanisms for axons, tissue strips of embryonic chicken retinae were
      explanted onto retinal cryosections (cryoculture). Ganglion cell axons
      originating from the explant grew preferentially on the innermost retina layer of
      cryosections, whereas outer tissue layers were avoided, very much as in vivo.
      Stereotropism, interaction with laminin of the basal lamina and axonal
      fasciculation did not significantly affect oriented axonal outgrowth, so that
      stereotropism as a guidance mechanism could be excluded. Ganglion cell axons were
      not directed by physical barriers, e.g. microstructured silicon oxide chips.
      Similarly, UV induced protein inactivation revealed that laminin present in the
      inner retina did not provide a guidance cue. Even in the absence of ganglion cell
      axons in retinal cryosections due to prior optic nerve transection in ovo, the
      growth preference for the innermost retina layer was maintained in cryocultures.
      However, oriented elongation of axons along the innermost retina layer was lost
      when radial glial endfeet were selectively eliminated in retinal cryosections. In
      addition, glial endfeet provided an excellent growth substratum when pure
      preparations of endfeet were employed in explant cultures. The preference for
      glial endfeet positioned at the inner retina surface was accompanied by the
      avoidance of outer retina layers, most likely because of inhibitory components in
      this region. This assumption is corroborated by the finding that addition of
      exogenous growth-promoting laminin to cryosections did not abolish the
      inhibition. Laminin on glass surfaces provided an excellent substratum. Axonal
      outgrowth was also seriously hampered on specifically purified cells of the outer
      retina. Most notable, however, in cryocultures aberrant innervation of outer
      retina layers could be induced by prior heat or protease treatment of
      cryosections, which pointed to proteins as potential inhibitory components. In
      summary the data substantiate the hypothesis that within the retina, ganglion
      cell axons are guided by a dual mechanism based on a permissive and an inhibitory
      zone. Radial glia is likely to be instructive in this process.

PMID- 7789273
TI  - The role of Pax-6 in eye and nasal development.
AB  - Small eye (Sey) mice homozygous for mutations in the Pax-6 gene have no lenses
      and no nasal cavities. We have examined the ontogeny of eye and nasal defects in
      Sey/Sey embryos and have related the defects seen to the pattern of Pax-6 mRNA
      expression in the mouse during normal eye and nasal development. There are two
      principal components of the early eye, the neural ectoderm of the optic vesicle,
      which forms the retina, and the overlying surface ectoderm, which forms the lens
      and cornea. By studying these interacting tissues in normal and Sey/Sey embryos,
      we have identified processes for which Pax-6 is important and can thus suggest
      possible roles for the Pax-6 gene. Pax-6 is essential for the formation of lens
      placodes from surface ectoderm. In normal development, early Pax-6 mRNA
      expression in a broad domain of surface ectoderm is downregulated, but expression
      is specifically maintained in the developing lens placode. Moreover, other Pax-6
      expressing tissues are frequently those that have can transdifferentiate into
      lens. Thus, phenotype and expression together suggest a role for Pax-6 in lens
      determination. At least some functions of Pax-6 can be separated from the
      influence of other tissues. Early Sey/Sey optic vesicles are abnormally broad and
      fail to constrict proximally. These defects occur prior to the time of lens
      placode formation and probably reflect a requirement for Pax-6 in neural
      ectoderm. In surface ectoderm domains, where Pax-6 expression is known to be
      independent of the presence of an optic vesicle, Pax-6 function is required for
      the maintenance of its own transcription. The mutual dependency of lens and optic
      vesicle development can also be studied using the Small eye mutation. Using
      region-specific markers we find that, in the morphologically abnormal Sey/Sey
      optic vesicles, aspects of normal proximo-distal specification nevertheless
      persist, despite the complete absence of lens. Like the lens, the nasal cavities
      develop from ectodermal placodes that normally express Pax-6 mRNA, fail to form
      in Sey/Sey mice and show Pax-6-dependent Pax-6 mRNA regulation. Analysis of
      patterns of programmed cell death and absence of nasal region expression from an
      Msx-1 transgene in Sey/Sey embryos suggest a requirement for Pax-6 in the
      transition from presumptive nasal ectoderm to placode, and that Msx-1, or genes
      regulating it, are possible targets for Pax-6.

PMID- 7789275
TI  - The Drosophila E74 gene is required for metamorphosis and plays a role in the
      polytene chromosome puffing response to ecdysone.
AB  - The steroid hormone ecdysone initiates Drosophila metamorphosis by reprogramming
      gene expression during late larval and prepupal development. The ecdysone
      inducible gene E74, a member of the ets proto-oncogene family, has been proposed
      to play a key role in this process. E74 is encoded within the 74EF early puff and
      consists of two overlapping transcription units, E74A and E74B. To assess the
      function(s) of E74 during metamorphosis, we have isolated and characterized
      recessive loss-of-function mutations specific to each transcription unit. We find
      that mutations in E74A and E74B are predominantly lethal during prepupal and
      pupal development, consistent with a critical role for their gene products in
      metamorphosis. Phenotypic analysis reveals that E74 function is required for both
      pupariation and pupation, and for the metamorphosis of both larval and imaginal
      tissues. E74B mutants are defective in puparium formation and head eversion and
      die as prepupae or cryptocephalic pupae, while E74A mutants pupariate normally
      and die either as prepupae or pharate adults. We have also investigated the
      effects of the E74 mutations on gene expression by examining the puffing pattern
      of the salivary gland polytene chromosomes in newly formed mutant prepupae. Most
      puffs are only modestly affected by the E74B mutation, whereas a subset of late
      puffs are sub-maximally induced in E74A mutant prepupae. These observations are
      consistent with Ashburner's proposal that early puff proteins induce the
      formation of late puffs, and define E74A as a regulator of late puff activity.
      They also demonstrate that E74 plays a wide role in reshaping the insect during
      metamorphosis, affecting tissues other than the salivary gland in which it was
      originally identified.

PMID- 7789276
TI  - Linkage of cardiac left-right asymmetry and dorsal-anterior development in
      Xenopus.
AB  - The left-right body axis is defined relative to the dorsal-ventral and anterior
      posterior body axes. Since left-right asymmetries are not randomly oriented with
      respect to dorsal-ventral and anterior-posterior spatial patterns, it is possible
      that a common mechanism determines all three axes in a coordinate manner. Two
      approaches were undertaken to determine whether alteration in dorsal-anterior
      development perturbs the left-right orientation of heart looping. Treatments
      known to decrease dorsal-anterior development in Xenopus laevis, UV irradiation
      during the first cell cycle or Xwnt-8 DNA injections into dorsal blastomeres,
      caused an increase in cardiac left-right reversals. The frequency of left-right
      reversal was correlated with the severity of dorsal-anterior perturbation and
      with the extent of anterior notochord regression. Injection of Xwnt-8 DNA into
      dorsal midline cells resulted in decreased dorsal-anterior development and a
      correlated increase in cardiac left-right reversals. In contrast, injection of
      Xwnt-8 DNA into cardiac progenitor blastomeres did not result in left-right
      reversals, and dorsal-anterior development and notochord formation were normal.
      Disrupting development of dorsal-anterior cells, including cells that give rise
      to the Organizer region and the notochord, results in the randomization of
      cardiac left-right asymmetry. These results suggest dorsal-anterior development
      and the regulation of left-right orientation are linked.

PMID- 7789277
TI  - Role of MAP kinase in mesoderm induction and axial patterning during Xenopus
      development.
AB  - We have examined the role of MAP kinase during mesoderm induction and axial
      patterning in Xenopus embryos. MAP Kinase Phosphatase (MKP-1) was used to
      inactivate endogenous MAP kinase and was found to prevent the induction of early
      and late mesodermal markers by both FGF and activin. In whole embryos, MKP-1 was
      found to disrupt posterior axial patterning, generating a phenotype similar to
      that obtained with a dominant inhibitory FGF receptor. Overexpression of either
      constitutively active MAP kinase or constitutively active MAP kinase (MEK) was
      sufficient to induce Xbra expression, while only constitutively active MEK was
      able to significantly induce expression of muscle actin. When MAP kinase
      phosphorylation was used as a sensitive marker of FGF receptor activity in vivo,
      this activity was found to persist at a low and relatively uniform level
      throughout blastula stage embryos. The finding that a low level of MAP kinase
      phosphorylation exists in unstimulated animal caps and is absent in caps
      overexpressing a dominant inhibitory FGF receptor provides a basis for our
      previous observation that overexpression of this receptor inhibits activin
      induction. These results indicate that FGF-dependent MAP kinase activity plays a
      critical role in establishing the responsiveness of embryonic tissues to mesoderm
      inducers.

PMID- 7789278
TI  - Tissue non-specific alkaline phosphatase is expressed in both embryonic and
      extraembryonic lineages during mouse embryogenesis but is not required for
      migration of primordial germ cells.
AB  - Mouse primordial germ cells express tissue non-specific alkaline phosphatase
      (TNAP) during development, but the widespread expression of another alkaline
      phosphatase gene in the early embryo limits the potential use of this marker to
      trace germ cells. To attempt to identify germ cells at all stages during
      embryonic development and to understand the role of TNAP in germ cell ontogeny,
      mice carrying a beta geo (lacZ/neor) disrupted allele of the TNAP gene were
      generated by homologous recombination in embryonic stem cells. Using beta
      galactosidase activity, the embryonic pattern of TNAP expression was examined
      from the blastocyst stage to embryonic day 14. Results indicate that primordial
      germ cell progenitors do not express TNAP prior to gastrulation although at
      earlier times TNAP expression is found in an extraembryonic lineage destined to
      form the chorion. In homozygous mutants, primordial germ cells appear unaffected
      indicating that TNAP is not essential for their development or migration.

PMID- 7789279
TI  - Autonomous and non-autonomous differentiation of ectoderm in different sea urchin
      species.
AB  - During early embryogenesis, the highly regulative sea urchin embryo relies
      extensively on cell-cell interactions for cellular specification. Here, the role
      of cellular interactions in the temporal and spatial expression of markers for
      oral and aboral ectoderm in Strongylocentrotus purpuratus and Lytechinus pictus
      was investigated. When pairs of mesomeres or animal caps, which are fated to give
      rise to ectoderm, were isolated and cultured they developed into ciliated
      embryoids that were morphologically polarized. In animal explants from S.
      purpuratus, the aboral ectoderm-specific Spec1 gene was activated at the same
      time as in control embryos and at relatively high levels. The Spec1 protein was
      restricted to the squamous epithelial cells in the embryoids suggesting that an
      oral-aboral axis formed and aboral ectoderm differentiation occurred correctly.
      However, the Ecto V protein, a marker for oral ectoderm differentiation, was
      detected throughout the embryoid and no stomodeum or ciliary band formed. These
      results indicated that animal explants from S. purpuratus were autonomous in
      their ability to form an oral-aboral axis and to differentiate aboral ectoderm,
      but other aspects of ectoderm differentiation require interaction with vegetal
      blastomeres. In contrast to S. purpuratus, aboral ectoderm-specific genes were
      not expressed in animal explants from L. pictus even though the resulting
      embryoids were morphologically very similar to those of S. purpuratus.
      Recombination of the explants with vegetal blastomeres or exposure to the
      vegetalizing agent LiCl restored activity of aboral ectoderm-specific genes,
      suggesting the requirement of a vegetal induction for differentiation of aboral
      ectoderm cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789280
TI  - Sulphated proteoglycan is required for collecting duct growth and branching but
      not nephron formation during kidney development.
AB  - Kidney epithelia have separate origins; collecting ducts develop by ureteric bud
      growth and arborisation, nephrons by induced mesenchyme-epithelium transition.
      Both express sulphated glycosaminoglycans (GAGs) which are strikingly upregulated
      during nephron differentiation. However, sodium chlorate, an inhibitor of GAG
      sulphation, and the GAG-degrading enzymes heparitinase plus chondroitinase, did
      not prevent nephron development. In contrast, ureteric bud growth and branching
      were reversibly inhibited by the above reagents, the inhibition correlating
      quantitatively with sulphated GAG deprivation caused by a range of chlorate
      concentrations. Growth and branching could be independently restored during GAG
      deprivation by hepatocyte growth factor and phorbol-12-myristate acetate (PMA)
      respectively. Together these signalling effectors stimulated both branch
      initiation and growth. Thus growth and morphogenesis of ureteric bud involve
      distinct signalling pathways both regulated by GAGs.

PMID- 7789281
TI  - Arabidopsis gynoecium structure in the wild and in ettin mutants.
AB  - The gynoecium is the female reproductive structure of flowering plants. Here we
      present a description of the Arabidopsis thaliana gynoecium at anthesis. The
      cylindrical organ can be broken down into three longitudinal regions arranged in
      an apical-basal order: stigma, style, and ovary. Each region can be distinguished
      histologically and morphologically. The transmitting (pollination) tract is
      axially positioned along the center of the gynoecium and spans stigma, style and
      ovary. Histochemistry, scanning electron microscopy and a style-specific reporter
      gene are used to compare the wild-type pattern of gynoecium cell types and
      regions, with patterns formed in gynoecia of individuals homozygous for a series
      of allelic mutations at the ETTIN locus. ettin gynoecia show morphological and
      histological alterations that appear to result from the merging of apical and
      basal regions and the development of abaxial into adaxial tissues. These
      developmental abnormalities result in a reduction of the ovary region, an
      expansion of the stylar and stigmatic regions, and the abaxial (outward)
      proliferation of transmitting tract tissue. The alterations in the mutants can be
      interpreted as resulting from misspecifications of position along the
      longitudinal and transverse axes during gynoecium development. The results
      suggest that early patterning events underlie wild-type gynoecium development,
      and that ETT functions during this early programming.

PMID- 7789282
TI  - Notch1 is required for the coordinate segmentation of somites.
AB  - Members of the Notch family of transmembrane receptors mediate a number of
      developmental decisions in invertebrates. In order to study Notch function in a
      vertebrate organism, we have mutated the Notch1 gene of the mouse. Notch1 gene
      function is required for embryonic survival in the second half of gestation. In
      the first half of gestation, we have found no effect of the mutation on the
      normal programs of neurogenesis, myogenesis or apoptosis. We conclude that Notch1
      function is not essential for these processes, at least in early postimplantation
      development. However, we have found that somitogenesis is delayed and
      disorganized in Notch1 mutant embryos. We propose that Notch1 normally
      coordinates the process of somitogenesis, and we provide a model of how this
      might occur.

PMID- 7789283
TI  - Specification of anterior-posterior differences within the AB lineage in the C.
      elegans embryo: a polarising induction.
AB  - In a C. elegans embryo the third cleavages of descendants of the anterior
      blastomere AB of the 2-cell stage create pairs of blastomeres that develop
      differently. By laser ablation experiments we show that the fates of all the
      posterior daughters of this division depend on an induction occurring three
      cleavages before these blastomeres are born. The time of induction precludes a
      direct effect on cell fate. Alternatively, we suggest that the induction creates
      a heritable cell polarity which is propagated through several divisions. We
      suggest a model to demonstrate how a signal could be propagated through several
      rounds of cell division. An important implication of our observations is that
      this early induction acts to specify blastomere identity, not tissue type. A
      detailed lineage analysis revealed that altering the inductive signal alters
      complex lineage patterns as a whole. The induction described here, together with
      two inductions described previously can be used to illustrate how the anterior
      portion of the C. elegans embryo can be successively subdivided into blastomeres
      with unique developmental potential.

PMID- 7789284
TI  - Adrenomedullin. Implications for hypertension research.

PMID- 7789285
TI  - Drug therapies for sexually transmitted diseases. Clinical and economic
      considerations.
AB  - Sexually transmitted diseases (STDs) are common, and result in immense social and
      economic costs. In some countries they have a major demographic impact. Because
      many STDs facilitate the transmission of HIV, the consequences of STDs are
      further increasing. At the same time, this association between STDs and HIV
      provides one of the ways in which drug therapy should be very cost effective. The
      perspective taken in this article is a societal one, and broader issues than
      those directly related to drug costs and benefits are discussed. However, it is
      the availability of drugs that has the potential to most quickly and most
      reliably make a major difference to overall health sector and societal costs as
      they relate to STDs. For those STDs for which curative therapy is available
      (particularly Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum,
      and Trichomonas vaginalis) there have been large decreases in prevalence in many
      parts of the world. In contrast, those STDs for which curative therapy is not
      available (particularly HIV, genital herpes and genital human papillomavirus
      infection) have had stable or increasing prevalence. For these latter infections,
      each new case increases the overall prevalence. Numerous features of STDs make
      clinical and economic evaluation difficult. These include the sensitive nature of
      the topic, the changing epidemiology and drug susceptibility of individual STDs,
      the fact that a large proportion of those infected are asymptomatic, difficulties
      in making specific diagnoses, the fact that often consequences are recognised
      late, sexual re-exposure and reinfection, and inadequate data on which to do
      clinical and economic evaluations. Furthermore, risk of acquiring an STD roughly
      correlates inversely with socioeconomic status, and countries or places with the
      highest rates of STDs may have the least ability to deal effectively with their
      diagnosis and management. Most of the direct and indirect costs are incurred by
      women, since they experience the vast majority of the complications of STDs. Many
      of these only become apparent years later, which makes it very hard to attribute
      costs and benefits to a specific episode of infection, and to its treatment. The
      late and indirect costs, plus the costs of prevention, are hard to quantify. That
      the major burden of STDs is in adolescents and young adults, socioeconomically
      disadvantaged groups and women has important implications, including for
      pharmacoeconomic studies.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7789287
TI  - Controversies in selection of epoetin dosages. Issues and answers.
AB  - Epoetin (recombinant human erythropoietin) is now a widely available though
      expensive treatment for the anaemia of chronic renal failure, and is effective in
      more than 95% of patients. Complications of epoetin in this context include
      hypertension in a third of cases, including hypertensive encephalopathy in a few,
      and thrombosis of shunts or vascular access devices. Fears that epoetin would
      cause progression of renal failure have not generally been confirmed, but
      hyperkalaemia may be a problem in the initial phase of treatment. Epoetin is up
      to twice as effective when administered subcutaneously rather than intravenously.
      Responding patients will normally do so within 3 months of starting epoetin.
      Failures to respond are usually due to iron deficiency or intercurrent disease.
      Other diseases associated with anaemia and an inappropriately low serum epoetin
      level include prematurity, the anaemia of cancer and rheumatoid arthritis. The
      baseline serum endogenous erythropoietin may provide a guide to response in some
      of these cases. Some encouraging results are being published. Situations where
      the serum erythropoietin levels are normal or elevated where epoetin has been
      employed include boosting of haematocrit presurgery as an adjunct to autologous
      blood donation, treatment of anaemic patients with myelodysplastic syndromes, and
      improvement of athletic performances.

PMID- 7789288
TI  - Optimal treatment of erectile failure in patients with diabetes.
AB  - Erectile failure, although a common problem in male diabetic patients, is one of
      the most neglected complications of diabetes. The availability of drugs like
      alprostadil (prostaglandin E1; PGE1) and papaverine for intracavernosal injection
      and the development of vacuum tumescence devices, while making therapy simple,
      have also reduced the necessity for specialised investigations. In the past 10
      years, alprostadil has been shown to be the safest and the most effective of the
      intracavernosal self-injection treatments of erectile dysfunction. Vacuum
      tumescence devices are an acceptable noninvasive alternative in those who fail to
      achieve a satisfactory response to self-injection. Surgical techniques are being
      improved every day, and revascularisation procedures and prosthetic implants are
      available to couples in specialised centres. At present, systemic drug therapy
      has been largely ineffective for treatment in diabetic patients but progress is
      being made in this field. Whatever the option, involvement of the partner in
      decision making is of major importance for the treatment to be successful, and
      psychosexual counselling is a useful adjunct to medical or surgical therapy.

PMID- 7789289
TI  - Hypertension in pregnancy. Practical management recommendations.
AB  - Hypertension is a common and potentially serious complication of human pregnancy.
      It can be a marker of underlying maternal disease processes aggravated by
      pregnancy, or it can be directly related to the pregnancy (pre-eclampsia). It is
      associated with increased risks of fetal growth retardation and, if severe, can
      cause both maternal and fetal problems. The risks to both mother and neonate can
      be reduced by appropriate supervision and therapy. Close monitoring of maternal
      and fetal welfare will help to determine the optimum time for delivery. Maternal
      hypertension should be controlled with agents considered to be well tolerated in
      pregnancy. Following the index pregnancy, all patients with early and/or severe
      hypertension should be investigated for an underlying cause. Provided that there
      is clinical resolution of acute pregnancy-related hypertension, investigations
      are usually postponed until at least 3 months following delivery.

PMID- 7789286
TI  - Choosing the right ACE inhibitor. A guide to selection.
AB  - To find out if there are one or more criteria to guide selection among the ACE
      inhibitors for the treatment of arterial hypertension, we have reviewed the
      principal pharmacokinetic and pharmacodynamic aspects of the more frequently used
      agents of this class of antihypertensive drugs. Among the pharmacokinetic aspects
      that we have considered, terminal half-life, as related to the duration of the
      antihypertensive effect, and the route of elimination may have an impact in the
      clinical selection among the various ACE inhibitors. On the other hand, all the
      other characteristics have no pragmatic clinical relevance or may be corrected by
      dosage adjustment. Among the pharmacodynamic aspects, the antihypertensive
      efficacy of the different ACE inhibitors seems to be very similar, and some of
      the differences found in different studies are probably due to the population
      investigated and to the protocol of the study (time of blood pressure
      measurements, diet, drug dosage etc.). However, some differences can be found
      among the various ACE inhibitors when the antihypertensive efficacy is evaluated
      also as trough to peak ratio of blood pressure reduction. Indeed, in respect of
      the administration schedule of each ACE inhibitor not all the agents of this
      class have a trough to peak ratio above 50 to 60%, as suggested by the Food and
      Drug Administration of the US. According to this criterion, especially when blood
      pressure is measured with 24-hour noninvasive ambulatory blood pressure
      monitoring, some drugs such as lisinopril, enalapril and trandolapril should be
      preferred for their higher trough to peak ratios. Left ventricular hypertrophy is
      significantly reduced by antihypertensive agents, the ACE inhibitors being the
      most effective. Indeed, the reduction of left ventricle mass for each 1 mm Hg
      reduction in mean blood pressure is greater for ACE inhibitors than for other
      classes of antihypertensive agents. However, this effect seems more class related
      than characteristic of one or more among the various ACE inhibitors. Insulin
      resistance is elevated in hypertensive patients and it has been thought
      responsible for or associated with other metabolic abnormalities. ACE inhibitors
      seem to correct the insulin resistance of hypertensive patients, but this effect
      also appears to be class related more than limited to one ACE inhibitor or
      another. Our knowledge of this field is still limited and more studies are
      necessary, especially to understand the prognostic impact of insulin resistance
      and/or insulin resistance improvement.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7789290
TI  - Trimetrexate. A review of its pharmacodynamic and pharmacokinetic properties and
      therapeutic potential in the treatment of Pneumocystis carinii pneumonia.
AB  - Trimetrexate is a folinic acid analogue structurally related to methotrexate,
      whose primary mechanism of action is believed to be inhibition of dihydrofolate
      reductase. This reduces the production of DNA and RNA precursors and leads to
      cell death. Trimetrexate is lipophilic and can passively diffuse across cell
      membranes including those of Pneumocystis carinii and its mammalian host. To
      minimise toxicity, trimetrexate must be coadministered with calcium folinate
      (leucovorin calcium), a reduced folate coenzyme, which is transported into, and
      protects, mammalian host cells but not P. carinii cells. In noncomparative trials
      trimetrexate was effective in the treatment of P. carinii pneumonia (PCP) in
      patients with AIDS who were intolerant of or refractory to cotrimoxazole
      (trimethoprim/sulfamethoxazole) and pentamidine treatment. In these patients, 2-
      to 4-week survival rates of 48 to 69% were reported. In a comparative trial in
      the initial therapy of PCP, trimetrexate was less effective than cotrimoxazole in
      moderate to severe disease as evidenced by a significantly higher failure rate.
      Trimetrexate was better tolerated than cotrimoxazole when used in this setting,
      however. Significantly fewer patients receiving trimetrexate plus calcium
      folinate discontinued treatment because of adverse events than did patients
      receiving cotrimoxazole. The most common adverse effect associated with
      trimetrexate is myelosuppression (neutropenia and thrombocytopenia); this is
      mitigated by coadministration of calcium folinate and is generally reversible
      upon dosage reduction or discontinuation. Other adverse effects include increases
      in serum aminotransferase levels, anaemia, fever, rash/pruritus, and increased
      alkaline phosphatase or serum creatinine levels. Further research into the use of
      trimetrexate, including its efficacy as prophylaxis, in combination with other
      agents and as an oral formulation, is needed to clearly define its role in the
      treatment of PCP and to identify patients most likely to benefit. Currently,
      trimetrexate should be considered as an alternative treatment option in
      immunocompromised patients with moderate to severe PCP who have not responded to
      or are intolerant of first-line therapy.

PMID- 7789293
TI  - Cumulative index: author and subject, volumes 25-40.

PMID- 7789295
TI  - [Specialization in epidemiology: strategy for the development of health services
      in Minas Gerais, Brazil, from the perspective of the single health system].

PMID- 7789294
TI  - [Subject and action in public health].

PMID- 7789296
TI  - [Multidisciplinary training program in the field of integral care for
      adolescents].

PMID- 7789297
TI  - [Health reform and human resources of local health services: the case of Vargen
      Grande Paulista].

PMID- 7789298
TI  - [Educational innovations in health personnel training in Mexico in the context of
      the transformations in Latin America].

PMID- 7789299
TI  - [Elements for the analysis of the innovations in medical education in Mexico].

PMID- 7789300
TI  - [Concept, actors, and variables of the medical job market].

PMID- 7789292
TI  - Isradipine. An update of its pharmacodynamic and pharmacokinetic properties and
      therapeutic efficacy in the treatment of mild to moderate hypertension.
AB  - Since the earlier review in Drugs substantial additional data have accumulated
      regarding the antihypertensive efficacy of isradipine in various clinical
      situations, as well as data on its clinical effects in atherosclerosis. Recent
      therapeutic trials confirm that the efficacy of isradipine in the treatment of
      patients with mainly mild to moderate hypertension, when administered orally as a
      conventional or modified release preparation, is similar to that of titrated
      dosages of amlodipine, felodipine, nifedipine, diltiazem, captopril, methyldopa,
      metoprolol, prazosin and hydrochlorothiazide. A further decrease in blood
      pressure can be expected when isradipine is combined with another
      antihypertensive drug in patients who have not responded adequately to
      monotherapy. Initial studies have shown that intravenous isradipine is effective
      in controlling hypertension following coronary artery bypass graft surgery and
      that it appears useful in the treatment of intraoperative hypertension and
      hypertensive crisis, and in hypertensive disorders in pregnancy, when
      administered orally or intravenously. A large study, the Multicentre Isradipine
      Diuretic Atherosclerosis Study (MIDAS), was designed to compare the efficacy of
      isradipine and hydrochlorothiazide in reducing the rate of progression of carotid
      artery wall thickness, measured by B-mode ultrasound, as a surrogate for early
      atherosclerosis. Results indicated that wall thickness increased significantly
      less with isradipine than hydrochlorothiazide after 6 months of therapy.
      Thereafter the rate of progression remained parallel for the remainder of the 3
      year trial. The confirmation of its antihypertensive efficacy, along with its
      favourable haemodynamic profile and reversal of left ventricular hypertrophy,
      minimal effect on glucose and lipid metabolism, preservation of quality of life
      and good tolerability, makes isradipine a suitable drug for the treatment of most
      patients with mild to moderate hypertension.

PMID- 7789301
TI  - [Health promotion and equity: a new concept for action in public health].

PMID- 7789302
TI  - [Educational bases of workshops for teaching professors of the Dentistry School
      of the Pontificia Universidad Javeriana, Santafe de Bogota, Colombia].

PMID- 7789303
TI  - Thyrotropin-releasing hormone and corticotropin-releasing hormone--what's the
      message?

PMID- 7789304
TI  - Changes in adrenal status affect hypothalamic thyrotropin-releasing hormone gene
      expression in parallel with corticotropin-releasing hormone.
AB  - Glucocorticoids are well known to influence the secretion of TSH from the
      anterior pituitary gland, although it is uncertain whether its site of action is
      on the hypothalamus, pituitary, or both. To determine whether glucocorticoids can
      modulate the concentration of pro-TRH gene expression in hypothalamic
      hypophysiotropic neurons, we measured the content of pro-TRH messenger RNA (mRNA)
      in the paraventricular nucleus (PVN) of adrenalectomized and corticosterone- and
      dexamethasone-treated rats compared to that in control populations using in situ
      hybridization histochemistry. Adrenalectomy resulted in the expected increase in
      corticotropin-releasing hormone mRNA in the PVN and was accompanied by a parallel
      rise in pro-TRH mRNA (68.3%; P < 0.05). Conversely, corticosterone and
      dexamethasone both resulted in profound reduction in corticotropin-releasing
      hormone mRNA in the PVN and a parallel reduction in pro-TRH mRNA (43.2% and 73.2%
      respectively; P < 0.05). No significant differences were observed in pro-TRH mRNA
      in the lateral hypothalamus in any of the groups. These data suggest that
      glucocorticoids can influence the concentration of pro-TRH mRNA in a cell
      specific manner and thereby could result in changes in the biosynthesis and
      release of TRH in hypophysiotropic neurons of the PVN.

PMID- 7789305
TI  - Expression of gonadotropin-releasing hormone (GnRH) receptor gene is altered by
      GnRH agonist desensitization in a manner similar to that of gonadotropin beta
      subunit genes in normal and castrated rat pituitary.
AB  - It was previously established that the administration of a potent GnRH agonist
      such as triptorelin (D-Trp6-GnRH) induced desensitization of pituitary
      gonadotropic cells, resulting in decreased expression of gonadotropin beta
      subunit genes and the suppression of LH and FSH synthesis and release. Binding of
      GnRH to the pituitary is also affected by agonist treatment. To examine the
      desensitizing effects of GnRH agonist on the expression of the pituitary GnRH
      receptor (GnRH-R) gene, male rats were given triptorelin (long-acting
      formulation, 300 micrograms/kg), and levels of GnRH-R messenger RNA (mRNA) were
      determined by Northern and dot blot hybridization to a 32P-labeled rat
      complementary DNA probe. Abundances of gonadotropin alpha-subunit, LH beta, and
      FSH beta mRNAs were examined in parallel, using appropriate probes. A rapid time
      dependent decrease in the level of GnRH-R mRNA was observed in rats after
      triptorelin administration. A minimum residual level of mRNA, in the range of 20
      25% of the initial value, was attained as early as 5 h after treatment. Levels
      further stabilized to 25-30% after a small transient increase to 45% on day 5. A
      single injection was effective for at least 30 days, after which GnRH-R mRNA
      levels slowly returned to normal, suggesting a progressive abolition of agonist
      effects. A concomitant acute depletion of mRNA levels was observed for LH beta
      and FSH beta (50% decrease in about 48 and 3 h, respectively), whereas the alpha
      subunit message increased (rapidly reaching a level 1.8-fold that in control rats
      after 1-2 days). Castration induced a 3.8-fold elevation in the amounts of GnRH-R
      mRNA after 3 weeks, whereas alpha, LH beta, and FSH beta mRNAs increased by 6.2-,
      7.9-, and 4.2-fold, respectively, compared to corresponding values in intact
      animals. Administration of the GnRH agonist readily prevented, for as long as 3
      weeks, the stimulatory effects of castration on the GnRH-R mRNA and mRNAs for the
      beta-subunit of gonadotropins, but not for the alpha mRNA, which remained at a
      high level. When triptorelin was administered 3 weeks postoperatively, the
      castration-induced increase in LH beta and FSH beta was totally abolished, and no
      significant effect was noted on alpha-subunit mRNA. In conclusion, these data
      demonstrate that expression of the GnRH-R gene is subject to regulation and
      depends on GnRH stimulation, in a manner that indicates susceptibility to
      desensitizing action by the long-acting GnRH analog, triptorelin.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 7789291
TI  - Ceftazidime. An update of its antibacterial activity, pharmacokinetic properties
      and therapeutic efficacy.
AB  - Ceftazidime is a third generation cephalosporin antibacterial agent which, since
      its introduction in the early 1980s, has retained a broad spectrum of in vitro
      antimicrobial activity and clinical utility in serious infections. However,
      increasing resistance to ceftazidime and other third generation cephalosporins,
      particularly among Enterobacteriaceae, due to the emergence of plasmid-mediated
      extended spectrum beta-lactamases and the class I chromosomally mediated beta
      lactamases, is of concern. There is now a wealth of information on the
      pharmacokinetics of the drug. enabling ceftazidime to be used predictably, and
      with a low potential for adverse effects, in a diversity of patient populations.
      Overall, ceftazidime remains an effective agent for the treatment of serious
      infection, particularly those due to major nosocomial pathogens, and respiratory
      infections in patients with cystic fibrosis. Ceftazidime-containing regimens also
      remain an important option for the empirical therapy of febrile episodes in
      neutropenic patients. The tolerability profile of ceftazidime makes the drug a
      useful option in seriously ill patients who are at risk of developing adverse
      events with other antibacterial agents. Although patterns of bacterial resistance
      have changed in the ensuing years since its introduction, judicious use of this
      important agent will help maintain its present clinical utility.

PMID- 7789306
TI  - Regulation of glutamine:fructose-6-phosphate amidotransferase gene transcription
      by epidermal growth factor and glucose.
AB  - In preparation for the cellular proliferation stimulated by growth factors, the
      rate of macromolecular synthesis must be increased to allow for the enlargement
      of the cell that proceeds mitosis. The increased glycoprotein synthesis that
      follows growth factor stimulation would consume the hexosamines required for
      protein modification. Glutamine:fructose-6-phosphate amidotransferase (GFAT) is
      the rate-limiting enzyme controlling the synthesis of the hexosamines used in
      these biosynthetic pathways. We tested the idea that growth factors might
      activate the transcription of the GFAT gene to increase the cellular content of
      this rate-limiting enzyme in hexosamine synthesis. We employed a human breast
      cancer cell line, MDA468 cells, which express high numbers of epidermal growth
      factor (EGF) receptors, to determine whether EGF could stimulate transcription of
      the GFAT gene. Our experiments showed that EGF stimulated the accumulation of
      GFAT messenger RNA (mRNA) to a level 4-fold higher than that in unstimulated
      cells. This accumulation could be largely accounted for by an increase in
      transcription, as assessed by nuclear run-on experiments. Furthermore, the GFAT
      mRNA was highly stable and not further stabilized by EGF. This effect of EGF on
      GFAT gene transcription required stimulation for 12-16 h with EGF. Interestingly,
      when cells were exposed to 25 mM glucose instead of 5 mM glucose, this effect of
      EGF was blocked. Glucose had no effect on the stability of the GFAT mRNA,
      implying that the effect of glucose was to antagonize the transcriptional effect
      of EGF on the GFAT gene. Glucosamine had an effect opposite that of glucose, in
      that it stimulated GFAT mRNA accumulation and had an additive effect with EGF on
      the accumulation of this mRNA. These results demonstrate that the GFAT gene
      undergoes a late transcriptional response to EGF and that the provision of high
      glucose concentrations to the cells blocks this EGF activation. This effect of
      glucose does not appear to result from its metabolism through GFAT to
      glucosamine.

PMID- 7789307
TI  - Electron microscopic visualization of insulin translocation into the cytoplasm
      and nuclei of intact H35 hepatoma cells using covalently linked Nanogold-insulin.
AB  - Insulin affects numerous metabolic processes as well as nuclear events such as
      gene transcription. Our previous ultrastructural and biochemical studies
      demonstrated insulin accumulation in nuclei of cultured and rapidly proliferating
      cells, and biochemical evidence suggested that insulin entered the cell cytoplasm
      before accumulating in the nucleus. The present study was undertaken to develop a
      covalently linked electron-dense insulin complex that could be used to visualize
      the intracellular translocation of insulin and confirm that insulin enters the
      cytoplasm of cells. Insulin was cross-linked to 1.4-nm diameter Nanogold
      particles. The complex binds to the plasma membrane insulin receptor, is
      biologically active, and is degraded by cellular insulin-degradative enzymes.
      Ultrastructural analysis after silver intensification of the gold particles
      confirmed that insulin internalization culminates in the translocation of some
      internalized insulin to the cytoplasm and nuclei. When cytoplasmic insulin
      degrading enzyme (IDE) activity was inhibited with 1,10-phenanthroline, an
      increase in the number of cytoplasmic and nuclear Nanogold-insulin particles was
      observed. The results of this and previous studies suggest that 1) the
      translocation of insulin to the cytoplasm, 2) the regulation of insulin
      degradation in the cytoplasm by IDE, 3) the possible interaction of insulin with
      cytoplasmic proteins other than IDE, and 4) the subsequent accumulation of intact
      insulin or insulin complexed with cytoplasmic proteins in nuclei may play a role
      in insulin's regulation of gene transcription and cell proliferation.

PMID- 7789308
TI  - Regulation of polymeric immunoglobulin A receptor messenger ribonucleic acid
      expression in rodent uteri: effect of sex hormones.
AB  - Previously we have shown that estradiol stimulates the production of secretory
      component, the external domain of the polymeric immunoglobulin A (IgA) receptor
      (pIgR) responsible for transporting IgA from tissues into secretions. In the
      present study, levels of pIgR messenger RNA (mRNA) in uterine tissues of rats
      were correlated with pIgR expression in epithelial cells and secretory component
      in uterine secretions. Analysis of uterine pIgR mRNA and pIgR expression in
      epithelial cells during the estrous cycle indicated that levels were high at
      proestrus and estrus and low at diestrus. When ovariectomized rats were treated
      with estradiol for 3 days, and pIgR mRNA was measured 4 and 12 h after the last
      injection, levels of uterine pIgR mRNA were significantly greater than those in
      saline-treated controls. High levels of pIgR were also detected in uterine
      epithelial cells and uterine secretions. When estradiol and progesterone were
      given in combination, progesterone partially reversed the effect of estradiol on
      pIgR mRNA levels and expression of pIgR in epithelial cells. These studies
      demonstrate that changes in uterine pIgR mRNA levels correlate with pIgR
      expression during the estrous cycle and in response to estradiol and
      progesterone. These findings suggest that mucosal immune responses in the
      reproductive tract are regulated in part by the actions of estradiol and
      progesterone on pIgR mRNA expression.

PMID- 7789309
TI  - Studies on the repression of basal transcription (silencing) by artificial and
      natural human thyroid hormone receptor-beta mutants.
AB  - Thyroid hormone receptors (TRs) are ligand-dependent transcription factors that
      regulate target gene transcription. Interestingly, in the absence of ligand, TRs
      also can repress basal transcription of positively regulated target genes,
      suggesting that unliganded TR may have a distinct role in gene regulation. In
      this paper, DNA binding, truncation, and natural human TR beta mutants were used
      in cotransfection and electrophoretic mobility shift assays to study various
      aspects of TR-mediated basal repression. Presently, little is known about the
      role(s) of natural human TR beta mutants on basal repression. These results show
      that: 1) TR binding to DNA likely is required for basal repression; 2) the amino
      terminal region of TR is not required for basal repression; 3) TR homodimer
      binding is not absolutely required for basal repression, as TR mutants that
      selectively form TR-retinoid X receptor heterodimers can mediate basal
      repression; and 4) TR mutants with poor T3-binding affinity likely have
      constitutive basal repression, even in the presence of ligand. These findings
      provide new insight on the mechanism of basal repression by unliganded TRs.

PMID- 7789310
TI  - 1,25-Dihydroxyvitamin D3 evokes oscillations of intracellular calcium in a
      pancreatic beta-cell line.
AB  - The steroid hormone 1 alpha,25-dihydroxyvitamin D3 [1,25-(OH)2D3] can elicit
      biological responses via a nongenomic pathway that involves rapid opening of the
      plasma membrane Ca2+ channels. There is also evidence that 1,25-(OH)2D3
      influences insulin secretion in the pancreatic beta-cell, which is primarily
      mediated by a rapid rise in the concentration of intracellular free Ca2+
      ([Ca2+]i). We employed fluorescent digital ratiometric video imaging at the
      single cell level to study the effects of 1,25-(OH)2D3 on [Ca2+]i in a pancreatic
      beta-cell line, RINr1046-38. In RIN cells equilibrated at a steady state glucose
      concentration (5.5 mM), 1,25-(OH)2D3 (2-20 nM) rapidly, within 5-10 sec,
      increased [Ca2+]i and evoked sinusoidal [Ca2+]i oscillations with a frequency of
      1.87 +/- 0.13 min-1 and an amplitude of 236 +/- 3 nM (from the initial basal
      level of 110 +/- 2 nM). The [Ca2+]i oscillations were acutely dependent on
      extracellular Ca2+, but not on extracellular glucose. Further, we investigated
      the mechanisms of activation by 1,25-(OH)2D3 of the Ca2+ entry pathway in the
      plasma membrane and analyzed the relationship between 1,25-(OH)2D3-stimulated
      Ca2+ entry and Ca2+ release from intracellular stores. The 1,25-(OH)2D3-evoked
      [Ca2+]i oscillations were mediated by nonselective Ca2+ channels, which are
      permeable to Mn2+ and suppressed by extracellular La3+. Blockage of voltage
      dependent Ca2+ channels by nifedipine significantly decreased the amplitude of
      the oscillations. Depletion of intracellular Ca2+ stores with thapsigargin did
      not affect the 1,25-(OH)2D3-stimulated Ca2+ entry estimated by the Mn2+ entry and
      fura-2 fluorescence quench, which implies that the hormone directly activates
      nonselective Ca2+ channels. The 1,25-(OH)2D3-evoked increase in the background
      Ca2+ influx appears to generate [Ca2+]i oscillations by triggering Ca2+ release
      through the ryanodine receptor/Ca2+ release channel, but not through activation
      of the inositol 1,4,5-triphosphate receptor. Our findings are consistent with a
      role of the plasmalemmal vitamin D receptor coupled to the plasma membrane Ca2+
      channels in mediating rapid effects of the hormone. We propose that the 1,25
      (OH)2D3-mediated Ca2+ signaling pathway may be involved in the regulation of
      insulin secretion from the pancreatic beta-cell.

PMID- 7789311
TI  - Characterization of newly established testicular peritubular and prostatic
      stromal cell lines: potential use in the study of mesenchymal-epithelial
      interactions.
AB  - Testicular peritubular and prostatic stromal cells produce extracellular matrix
      elements and paracrine factors that modulate the cytodifferentiation and function
      of the corresponding epithelial cells. The present paper describes the
      establishment and characterization of five rat testicular cell lines with
      peritubular characteristics and one prostatic stromal cell line. Four peritubular
      cell lines were isolated after transfection of a mixed peritubular-Sertoli cell
      culture with a v-myc-containing plasmid. The same immortalization procedure
      applied to prostatic stromal cells yielded one cell line. An additional
      testicular cell line arose by spontaneous immortalization during serial
      subculture. Except for one testicular cell line (RTC-8T1), the morphology of all
      of the immortalized cell lines strongly resembled that of primary cultures of
      peritubular and stromal cells. Flow cytometric analysis demonstrated that all
      cell lines scored positive for alpha-smooth muscle isoactin and negative for
      cytokeratins, confirming their myofibroblast-like nature. None of the cell lines,
      however, stained positive for alkaline phosphatase, and androgen receptor
      expression was also lost. Typical Leydig cell characteristics, such as
      steroidogenesis, and Sertoli cell markers, such as transferrin secretion, were
      absent. Coculture of the cell lines with Sertoli cells resulted in the formation
      of tubular structures. A cell attachment assay and an enzyme-linked immunosorbent
      assay for fibronectin confirmed the production of extracellular matrix elements
      by all of the established cell lines. Media conditioned by the cell lines
      stimulated Sertoli cell transferrin production. The active principle was
      partially purified and resembled the P-MOD-S-like factors produced by primary
      cultures of peritubular and stromal cells. It is concluded that the immortalized
      cell lines have retained several of the characteristics of primary cultures of
      peritubular and stromal cells and may be useful for further studies on
      mesenchymal-epithelial interactions in testis and prostate.

PMID- 7789312
TI  - N-methyl-D-aspartic acid receptor messenger ribonucleic acid levels and
      luteinizing hormone release in immature female rats: effects of stage of pubertal
      development and exposure to ethanol.
AB  - This research was designed to determine 1) whether changes occur in the levels of
      N-methyl-D-aspartic acid (NMDA) receptor (NMDA-R) messenger RNA (mRNA) in the
      reproductive hypothalamus of female rats as they approach puberty, 2) whether
      NMDA-R stimulation would promote differential LH responses during the specific
      stages of peripubertal development, and 3) whether ethanol (ETOH), which is known
      to affect the NMDA-R in other brain systems, can alter NMDA-R-activated LH
      secretion at puberty. In the first experiment, female rats were killed at 15, 20,
      25, and 34-36 days of age to determine the levels of mRNA that code for the NMDA
      R, specifically NMDA-R1, in the arcuate nucleus-median eminence (AN-ME) and
      preoptic area (POA) during pre- and peripubertal development by a ribonuclease
      protection assay. Results indicate that in juvenile animals, NMDA-R mRNA levels
      in the AN-ME increased at 25 days (P < 0.01). In the POA, the levels increased at
      20 days (P < 0.05), but were unchanged at 25 days. During the peripubertal
      period, NMDA-R gene expression in the AN-ME did not change; however, gene
      expression in the POA increased (P < 0.05) during first proestrus, then declined
      during first estrus. In the second experiment, NMDA-R stimulation with N-methyl
      D,L-aspartic acid (NMA; 2.5 mg/kg) produced differential stimulatory effects on
      LH release depending upon the stage of pubertal development. In this regard,
      significant post-NMA percent increases in LH released over pre-NMA (basal) levels
      occurred during anestrus (46%; P < 0.01) and first proestrus (95%; P < 0.01),
      with nonsignificant increases of 18% and 28% during first estrus and diestrus,
      respectively. Finally, a 3 g/kg dose of ETOH given intragastrically 90 min before
      the NMA challenge blocked (P < 0.05) NMA-induced LH release during first
      proestrus. In conclusion, these findings demonstrate regional differences in the
      timing of NMDA-R gene expression in the reproductive hypothalamus during pubertal
      development, show differential responses of LH to NMDA-R activation during the
      peripubertal period, and continue to demonstrate the vulnerability of the
      hypothalamic-pituitary axis to the detrimental effects of ETOH at this critical
      time of development.

PMID- 7789314
TI  - Regulation of follistatin messenger ribonucleic acid in steroidogenic rat
      granulosa cell lines.
AB  - Follistatin is a 35-kilodalton monomer isolated from follicular fluid that acts
      on pituitary gonadotropes to suppress the production of FSH. Transfection of rat
      granulosa cells with specific oncogenes, such as simian virus 40 (SV40) DNA and
      Ha-ras oncogene, leads to their immortalization concomitant with preservation of
      their capacity for inducible steroidogenesis. Experiments were designed to
      investigate the regulation of follistatin messenger RNA (mRNA) accumulation upon
      stimulation with forskolin, 2-O-tetradecanol-phorbol-13-acetate (TPA), FSH, and
      hCG in four different granulosa cell lines. Granulosa cells were transfected with
      SV40 DNA alone (POGS5); with SV40 DNA and Ha-ras oncogene (POGRS1); with SV40
      DNA, Ha-ras oncogene, and LH/CG receptor (GLHR15); or with FSH receptor (GFSHR17)
      expression plasmid. Cells were cultured to reach confluence and then stimulated
      for 6 or 24 h with ovine FSH (oFSH; 0.004-4 nM), hCG (9 nM), forskolin (50
      microM), and TPA (50 nM), alone or in combination. In the POGS5 cell line,
      forskolin caused a 15-fold stimulation of follistatin mRNA after 24-h incubation.
      The POGRS1 cell line showed a time-dependent stimulation of follistatin gene
      expression induced by both forskolin (5.7-fold) and TPA (9.4-fold). In the
      GFSHR17 cells, forskolin, oFSH, and TPA induced an increase in follistatin mRNA.
      When oFSH (1.6 nM) was added to cells treated with forskolin (50 microM) or TPA
      (50 nM), no additional stimulation was observed. The GLHR15 cell line treated
      with hCG showed a 2.7-fold increase in follistatin mRNA accumulation within 6 h.
      Our data demonstrate that 1) follistatin mRNA is detectable and induced by
      forskolin and TPA in transformed granulosa cell lines that do not express the FSH
      or LH receptors; 2) in the GFSHR17 cell line, FSH, forskolin, and TPA caused a
      time- and dose-dependent regulation of the gene; and 3) follistatin gene
      expression is up-regulated by hCG in the GLHR15 cell line. We conclude that these
      transformed steroidogenic cell lines can serve as a useful model to study the
      regulation of follistatin gene expression, a peptide known to regulate pituitary
      and ovarian hormone secretion and differentiation of granulosa cells by its
      activin-binding action. Moreover, this gene can be regulated in immortalized
      granulosa cells by both the protein kinase A and protein kinase C pathways,
      although these cells express the large T antigen and the Ha-ras oncogenic
      proteins.

PMID- 7789313
TI  - Rapid protection of rat spermatogenic stem cells against procarbazine by
      treatment with a gonadotropin-releasing hormone antagonist (Nal-Glu) and an
      antiandrogen (flutamide).
AB  - GnRH antagonist (Nal-Glu) treatment combined with the antiandrogen flutamide was
      used to suppress rat spermatogenesis to achieve protection of spermatogonial stem
      cells against the anticancer drug procarbazine. Daily injections with Nal-Glu
      alone suppressed spermatogenesis in a dose-responsive manner. However, it was
      necessary to combine Nal-Glu (600 micrograms/kg.day) with flutamide at 20
      mg/kg.day to decrease testicular weight in 2 weeks to less than 0.6 g, a level
      previously demonstrated sufficient to protect stem cells in our model system. The
      Nal-Glu-flutamide pretreatment suppressed serum gonadotropin levels and
      intratesticular testosterone levels (6% of control) and action, resulting in a
      reversible decrease in the number of late spermatids to 1% of control levels.
      When rats were given Nal-Glu-flutamide for 2 weeks before a 250 mg/kg dose of
      procarbazine, recovery of spermatogenesis, as measured by testis weight,
      testicular sperm head counts, and repopulation indexes, was significantly better
      than in control rats (no hormonal pretreatment). The protection achieved with Nal
      Glu-flutamide was better than that achieved with 2 weeks of testosterone and
      estradiol treatment. The present results show that Nal-Glu-flutamide protects
      spermatogonial stem cells against procarbazine and suggest a method of hormonal
      pretreatment to achieve rapid and efficient protection of spermatogenesis in
      humans.

PMID- 7789315
TI  - Retinoid X receptor alpha binds with the highest affinity to an imperfect direct
      repeat response element.
AB  - The regulation of gene expression by retinoids is mediated by two classes of
      receptors, retinoic acid receptors and retinoid X receptors (RXR). RXR can bind
      to specific target genes as homodimers, and these homodimers can activate gene
      expression in the presence of the ligand 9-cis-retinoic acid. A direct repeat of
      AGGTCA with a 1 base pair spacer (DR1) acts as a RXR homodimer response element
      in the presence of 9-cis-retinoic acid. However, it is not known if this
      represents the highest affinity binding site for the RXR homodimer. To
      investigate this question, we used a nonbiased strategy to isolate from a pool of
      random DNA those sequences that have the highest affinity for RXR alpha
      homodimers. The imperfect DR1 sequence 5'-GGGGTCAAAGGTCA displayed the highest in
      vitro binding affinity for RXR alpha homodimers. Transient transfection studies
      confirmed that this sequence is a more potent response element than is a perfect
      DR1 of either AGGTCA or GGGGTCA. The results also indicate that for RXR alpha
      homodimers, the receptor bound to the 5' half-site dislays different DNA binding
      specificity than that bound to the 3' half-site. Thus, DNA binding specificity is
      determined not only by the amino acid sequence of the protein but also by its
      protein-protein interactions and its position on the response element (5' vs.
      3').

PMID- 7789316
TI  - Growth hormone (GH) receptor and GH-binding protein messenger ribonucleic acids
      with alternative 5'-untranslated regions are differentially expressed in mouse
      liver and placenta.
AB  - Two 5'-untranslated regions (5'UTRs) with distinctly different sequences,
      designated 5'UTR L1 and 5'UTR L2, were obtained by amplification of complementary
      DNA from mouse liver and placenta with primers complementary to sequences from
      the hormone-binding domain common to GH receptor (GHR) and GH-binding protein
      (GHBP) messenger RNAs (mRNAs). The presence of an open reading frame in the 5'UTR
      L2 and the high GC content of this sequence suggest that mRNAs containing this
      5'UTR may be translated with a lower efficiency than those containing 5'UTR L1.
      Expression studies showed that 5'UTR L1 and 5'UTR L2 are present in GHR and GHBP
      mRNAs in both tissues. However, the relative expression of the two 5'UTRs differs
      between liver and placenta and in liver from different physiological states. The
      different expression patterns of the L1 and L2 5'UTRs predict that the
      corresponding 5'-noncoding exons of the GHR/GHBP gene are associated with
      different regulatory elements. The expression patterns of the 5'UTRs also
      indicate that there is a linkage between the 5'UTR present in GHR/GHBP gene
      transcripts and the alternative splicing of these transcripts to yield either GHR
      or GHBP mRNAs. The 5'-noncoding exon used for transcription of the GHR/GHBP gene,
      therefore, may be involved in regulating both the ratio of GHR to GHBP
      transcripts and the efficiency of translation of these transcripts. Transcription
      from the different 5'-noncoding exons of the GHR/GHBP gene thus may be a critical
      element in the regulation of the expression of GHR and GHBP and thereby in the
      control of the responses of different tissues to GH.

PMID- 7789318
TI  - The role of sodium in mediating adrenocorticotropin secretion by perifused rat
      anterior pituitary cells.
AB  - We studied the role of sodium ions in mediating basal and stimulated ACTH release
      from perifused rat anterior pituitary cells by exposing the cells to the sodium
      channel opener veratridine or the Na+/K(+)-adenosine triphosphatase inhibitor
      ouabain to increase the intracellular Na+ concentration or, conversely, by
      omitting Na+ from the perifusion medium or blocking Na+ entry into the cell with
      tetrodotoxin, a voltage-dependent sodium channel blocker, to decrease the
      intracellular Na+ concentration. Neither tetrodotoxin nor Na(+)-free medium had a
      significant effect on 100 nM arginine vasopressin (AVP) or 10 nM ovine
      corticotropin-releasing hormone (CRH)-induced ACTH secretion. Veratridine
      increased basal ACTH secretion by 122% (41.3 +/- 2.9 vs. 18.6 +/- 0.4 pg/min; P <
      0.001), the initial spike phase of the response to AVP by 65% (0.28 +/- 0.01 vs.
      0.17 +/- 0.03 ng/3 min; P < 0.005), the subsequent sustained phase to AVP by 129%
      (0.16 +/- 0.01 vs. 0.07 +/- 0.01 ng/7 min; P < 0.005), and the total response to
      CRH by 70% (0.39 +/- 0.01 vs. 0.23 +/- 0.04 ng/10 min; P < 0.05). Ouabain
      increased basal ACTH secretion by 39% (45.7 +/- 2.8 vs. 32.9 +/- 2.1 pg/min; P <
      0.05), the initial spike phase of the response to AVP by 88% (0.32 +/- 0.02 vs.
      0.17 +/- 0.01 ng/3 min; P < 0.005), the sustained phase response to AVP by 67%
      (0.10 +/- 0.01 vs. 0.06 +/- 0.01 ng/7 min; P < 0.05), and the total integrated
      response to CRH by 49% (0.88 +/- 0.09 vs. 0.59 +/- 0.03 ng/10 min; P < 0.05).
      However, the effects of both veratridine and ouabain on basal ACTH secretion were
      significantly attenuated in Ca(2+)-free EGTA-containing medium, suggesting that
      this effect was indirect, due to membrane depolarization and consequent influx of
      extracellular Ca2+. Dexamethasone (100 nM) had no effect on the ACTH response to
      either veratridine or ouabain. We conclude that changes in the intracellular Na+
      concentration and sodium channel activity are not directly involved in AVP- or
      CRH-induced ACTH secretion.

PMID- 7789317
TI  - Differential pathways of insulin action upon the hepatitis B surface antigen gene
      expression and cell proliferation in human hepatoma cells.
AB  - We have shown previously that insulin at the physiological concentration
      suppresses hepatitis B surface antigen (HBsAg) gene expression in cultured human
      hepatoma Hep3B cells, and this suppression phenomenon is concomitant with the
      stimulation of cell proliferation. We have now examined whether these two
      distinct insulin actions on the Hep3B cells are mediated through the same or
      different signaling pathways. After prolonged treatment with high concentration
      of tumor promoter, 12-O-tetradecanoyl phorbol-13-acetate (TPA), the protein
      kinase C-alpha (PKC-alpha) level in the Hep3B cells was diminished and could not
      be detected by Western blot analysis. Under this condition, TPA treatment has no
      effect on the number or affinity of the insulin receptor on Hep3B cells. However,
      insulin-stimulated cell proliferation was completely abolished in the PKC-alpha
      depleted cells. In contrast, insulin still suppressed HBsAg gene expression with
      the same ED50 (approximately 0.5 nM) as the control cell. The induction of proto
      oncogene egr-1 (early-growth-regulatory-1) by insulin and TPA under similar
      conditions were also examined. Both insulin and TPA stimulated egr-1 gene
      expression up to 10-fold in the control cell, but neither of these two agents
      showed any effect on egr-1 gene expression in the PKC-alpha down-regulated Hep3B
      cells. These observations indicate that the PKC-alpha may be involved in the
      insulin induced egr-1 expression and cell proliferation but not in the insulin
      suppressed HBsAg gene expression in human hepatoma cells.

PMID- 7789319
TI  - Relaxin acts directly on rat mammary nipples to stimulate their growth.
AB  - Previously, we demonstrated that endogenous circulating relaxin promotes growth
      of the mammary nipples during the second half of pregnancy in the rat. The
      objective of this study was to determine whether relaxin acts directly on rat
      nipples to promote their growth. Initially, specific relaxin-binding cells were
      identified to assure that relaxin binds to the same cell types in the nipples of
      nonpregnant rats as those we previously described in pregnant rats. To examine
      relaxin-induced growth of the mammary nipples, 5 days after ovariectomy, 48
      nonpregnant rats were assigned (12 rats/group) to 1 of the following 4 treatment
      groups: ovariectomized controls, estrogen treated, relaxin treated, and estrogen
      plus relaxin treated. Estrogen (0.05 micrograms 17 beta-estradiol) or estradiol
      vehicle (0.1 ml stripped corn oil) was administered sc on the dorsal side of the
      neck daily for the entire 10-day treatment period. Porcine relaxin (12.5
      micrograms) or relaxin vehicle (0.05 ml 5% beeswax in corn oil) was administered
      sc at the base of the left abdominal nipple daily for the last 5 days of the 10
      day treatment period. After hormone treatments, the lengths and wet weights of
      the left (relaxin-treated) and right (untreated) abdominal nipples were measured.
      There were three findings. First, the presence of specific relaxin binding in the
      epithelial cells of the lactiferous duct, smooth muscle cells, and skin of the
      nipples in nonpregnant rats was identical to the sites of specific relaxin
      binding in the nipples of pregnant rats. Second, relaxin-induced increases in
      nipple length and wet weight were mediated at least in part by the direct effects
      of relaxin in the nipple. Third, estrogen was not required for relaxin-induced
      increases in nipple length and wet weight. We conclude that relaxin stimulates
      the growth of rat mammary nipples at least in part through direct actions in the
      nipples, and that estrogen is not required for these actions.

PMID- 7789320
TI  - Spontaneous oscillations of intracellular calcium in single bovine parathyroid
      cells may be associated with the inhibition of parathyroid hormone secretion.
AB  - PTH secretion is tightly regulated by extracellular calcium ([Ca2+]e) and in turn
      regulates calcium homeostasis through its action on target tissues. We
      investigated the mechanism and physiological significance of intracellular
      calcium ([Ca2+]i) levels in relation to the secretion of PTH in single bovine
      parathyroid cells. [Ca2+]i was recorded using digital imaging microscopy, and
      secretion of PTH was correlated in the same cell using the reverse hemolytic
      plaque assay. In individual parathyroid cells, oscillations of [Ca2+]i were
      present in response to specific stimuli. Like secretory activity, response to
      [Ca2+]e concentrations was heterogeneous. Oscillations of [Ca2+]i occurred
      spontaneously in 22% of cells at inhibitory concentrations of [Ca2+]e.
      Oscillations were present only in high [Ca2+]e (> or = 1.8 mM) and not noted at
      lower concentrations of [Ca2+]e. The interval and amplitude of [Ca2+]i
      oscillations were 42 +/- 2 sec, and 20 +/- 1 nM (mean +/- SE), respectively.
      Oscillations were rapidly abolished when [Ca2+]e was removed by EGTA, and this
      effect was reversible. Addition of Mg2+ or polycationic antibiotics such as
      neomycin resulted in an [Ca2+]i spike, but oscillations were absent. Lanthanum,
      which blocks Ca2+ influx through calcium channels in various cells, rarely caused
      oscillations even in the presence of high concentrations of [Ca2+]e. To test the
      role of cAMP in [Ca2+]i oscillations, we added the beta-agonist isoproterenol.
      The addition of isoproterenol, however, did not cause oscillations. The number of
      cells that released PTH was significantly lower in cells with oscillations
      compared with cells without oscillations. We suggest that spontaneous [Ca2+]i
      oscillations are due to the influx of [Ca2+]e through ion channels rather than
      release from [Ca2+]i stores and may be a specific intracellular signal associated
      with inhibition of PTH secretion.

PMID- 7789321
TI  - Modulation of adenosine triphosphate-sensitive potassium channel and voltage
      dependent calcium channel by activin A in HIT-T15 cells.
AB  - The ATP-sensitive potassium channel (KATP channel) determines the membrane
      potential of pancreatic beta-cells and plays a critical role in the regulation of
      insulin secretion. The present study was conducted to investigate the effect of
      activin A, a member of the transforming growth factor-beta supergene family, on
      the KATP channel in HIT-T15 clonal hamster insulinoma cells. In an excised inside
      out patch, ATP-sensitive currents with a single channel conductance of
      approximately 20 picosiemens were observed. In an outside-out patch, currents
      with identical unitary conductance were also observed. In either case, the
      currents were augmented by diazoxide and blocked by glibenclamide, verifying that
      they were KATP channel currents. When KATP channel currents were monitored in an
      outside-out patch, activin A added to the bath solution inhibited KATP channel
      currents. Upon removal of activin A, the KATP channel currents were restored,
      suggesting that the inhibition was not due simply to spontaneous disappearance of
      channel activity (run-down). The KATP channel activity was markedly reduced after
      the addition of activin A and was reversed by diazoxide. Besides the inhibition
      of KATP channel, activin A increased, in a perforated patch, the amplitude of the
      inward Ba2+ current in response to a depolarizing pulse from -40 to +10 mV. Under
      the current clamp condition, activin A induced gradual depolarization, followed
      by a burst of action potentials. Activin-mediated action potentials were
      accompanied by an elevation of the cytoplasmic free calcium concentration. These
      results indicate that activin A causes depolarization of the plasma membrane by
      inhibiting the activity of the KATP channel. In addition, activin A directly
      modulates the voltage-dependent calcium channel and augments calcium entry.

PMID- 7789322
TI  - Histamine directly stimulates gonadotropin-releasing hormone secretion from GT1-1
      cells via H1 receptors coupled to phosphoinositide hydrolysis.
AB  - It is unclear whether the central stimulating effect of histamine on GnRH
      secretion is exerted directly on GnRH neurosecretory neurons or indirectly via
      multisynaptic pathways, and controversy exists about the nature of the receptors
      involved. The current studies were undertaken to examine whether GnRH secretion
      from immortalized GnRH cell lines is directly regulated by histamine and, if so,
      to determine the identity of the receptors and the signaling pathways coupling
      this action. Histamine stimulated GnRH release from GT1-1 cells in a sustained
      and reversible manner and in a dose-dependent fashion. This effect was blocked by
      the selective H1 histamine receptor antagonist, mepyramine, but not by the H2 or
      H3 antagonists, ranitidine or thioperamide, respectively. Saturable and specific
      binding sites for [3H]mepyramine were demonstrated in GT1-1 cells, showing high
      affinity (apparent Kd, 37.8 nM) and density (apparent binding capacity, 279
      fmol/mg protein) comparable to respective values in brain tissue. Competition of
      [3H]mepyramine binding was achieved with mepyramine at concentrations 3 orders of
      magnitude lower than those of ranitidine. Histamine also increased the production
      of inositol phosphates in GT1-1 cells in a dose- and time-dependent manner. This
      response was mimicked by the selective H1 receptor agonist 2-thiazolylethylamine
      and blocked by the H1 antagonists mepyramine, chlorpheniramine, and triprolidine.
      In contrast, histamine did not alter the formation of cAMP in GT1-1 cells. The
      present results show a direct action of histamine on immortalized GnRH neurons,
      suggesting that histamine may stimulate the reproductive axis by activation of H1
      receptors on the surface of GnRH neurons coupled to the formation of inositol
      phosphates.

PMID- 7789323
TI  - Retinoic acid inhibits estrogen-induced uterine stromal and myometrial cell
      proliferation.
AB  - Retinoic acid, a potent natural derivative of vitamin A, influences proliferation
      in many cell types. However, little is known about the role of retinoic acid in
      estrogen-induced proliferation in normal physiological systems. In this study we
      sought to determine if in vivo administration of retinoic acid influences the
      proliferation of a normal estrogen target tissue, the immature rat uterus. The
      results indicate that treatment of animals with 30 mg/kg all-trans-retinoic acid
      for 3 days before 17 beta-estradiol (E2) administration diminishes DNA synthesis
      and cell division by approximately 50% in uterine stromal and myometrial cells.
      Luminal epithelial cell proliferation is not inhibited, indicating that the
      antiproliferative effects of all-trans-retinoic acid treatment are cell type
      specific. The inhibition is retinoid-specific and fully reversible 1 week after
      discontinuing all-trans-retinoic acid treatment. The inhibitory effect of all
      trans-retinoic acid is not due to a change in E2 receptor levels assessed by
      ligand binding. E2 induction of c-jun, a gene expressed primarily in myometrial
      cells, is unaffected in retinoid-treated animals. This is the first demonstration
      that retinoic acid inhibits estrogen-induced proliferation of uterine stromal and
      myometrial cells in a physiological setting.

PMID- 7789324
TI  - Differential effects of dimethylsulfoxide on steroidogenesis in mouse MA-10 and
      rat R2C Leydig tumor cells.
AB  - The effects of dimethylsulfoxide (DMSO) on steroidogenesis in MA-10 mouse Leydig
      tumor cells and R2C rat Leydig tumor cells were compared. MA-10 cells produce low
      basal levels of progesterone (as the major steroid synthesized), which increase
      several hundred-fold when stimulated with tropic hormone or the cAMP analog
      (Bu)2cAMP. R2C cells, on the other hand, constitutively produce high levels of
      progesterone in the absence of hormone stimulation of any kind. When incubated in
      the presence of 5% DMSO, MA-10 cells demonstrated an almost complete inhibition
      of progesterone production, whereas the synthesis of this steroid was virtually
      unaffected in R2C cells. The inhibition of steroid production in the MA-10 cell
      could not be attributed to an effect on protein synthesis, because this was
      unaffected by DMSO during the course of the incubations. The activity of the
      cholesterol side-chain cleavage enzyme was also unaffected by DMSO, as
      demonstrated by incubation of the cells with 22R-hydroxycholesterol. The
      production of cAMP in response to tropic hormone (hCG) and forskolin stimulation
      was significantly inhibited in MA-10 cells, but was much less affected in R2C
      cells in response to forskolin treatment. However, DMSO appeared to have no
      effect on the overall phosphorylation of proteins when tested either in a
      completely in vitro system or when MA-10 cell homogenates were used as a source
      of exogenous protein. Strikingly, DMSO treatment resulted in the highly specific
      inhibition of a series of 30-kilodalton mitochondrial proteins (named StAR for
      Steroidogenic Acute Regulatory protein), which we have recently shown to be
      indispensable for the production of steroids in MA-10 cells. The synthesis of
      these same proteins was much less affected in R2C cells. Although the mechanism
      of action by which DMSO inhibits steroidogenesis remains unknown, these results
      show that its action results in the complete cessation of synthesis of the StAR
      protein, which is required for the acute regulation of steroidogenesis in MA-10
      cells.

PMID- 7789325
TI  - Photoperiod effects on neurohypophyseal and tuberoinfundibular dopamine
      metabolism in the male hamster.
AB  - Exposure of golden hamsters to a short photoperiod (< 12.5 h light/day) leads to
      suppression of gonadal function secondary to reduced gonadotropin and PRL
      secretion. PRL secretion is decreased despite a reduction of tuberoinfundibular
      dopaminergic activity. In the present study, the ability of photoperiod to affect
      tuberohypophyseal dopamine (DA) turnover was evaluated in long day (LD; 16 h of
      light, 8 h of darkness) and short day (SD; 8 h of light, 16 h of darkness) male
      hamsters. Exposure to SD led to decreases in testicular weight within 10 weeks
      and decreases in plasma PRL levels within 1 week. DA turnover in the
      neurointermediate lobe of the pituitary, as estimated by measuring the depletion
      of DA 60 min after tyrosine hydroxylase inhibition with alpha-methyl-p-tyrosine
      (250 mg/kg), was significantly elevated 1 and 4 weeks after transfer to SD, but
      returned by 10 weeks to the levels seen in LD animals. After 14 days of SD
      exposure an enhanced lactotroph sensitivity to DA was demonstrated and may also
      have contributed to suppression of PRL levels. Similarly to the findings of
      previous studies, DA turnover in the median eminence was depressed in animals
      housed in SD. The DA content of the anterior pituitary was not significantly
      affected by photoperiod. The data from this study suggest that decreases in PRL
      secretion associated with the transfer of hamsters from LD to SD conditions are
      at least in part caused by an increase in DA turnover by neurohypophyseal
      neurons. However, the involvement of other PRL-inhibiting or -stimulating factors
      in mediating the effects of photoperiod on PRL secretion cannot be ruled out.

PMID- 7789326
TI  - Cellular localization of estradiol-induced c-fos messenger ribonucleic acid in
      the rat uterus: c-fos expression and uterine cell proliferation do not correlate
      strictly.
AB  - Estrogens stimulate DNA synthesis and cell proliferation in the uterus. All major
      uterine cell types (luminal and glandular epithelium, stroma, and myometrium)
      respond to 17 beta-estradiol in the immature animal, whereas primarily epithelial
      cells of the uterine endometrium respond in the mature animal. Rapid activation
      of the c-fos protooncogene by estrogen precedes the uterine growth, suggesting
      that c-fos plays a role in amplifying the hormonal signal. The specific uterine
      cell types in which estrogen induces c-fos messenger RNA (mRNA) expression,
      however, have not been identified in either mature or immature animals. In this
      study, in situ hybridization was used to determine the cell type-specific
      location of mRNA encoding c-fos in the uterus. In both immature and mature
      castrated rats at 3 h after 17 beta-estradiol administration, c-fos expression
      was detected primarily in uterine luminal and glandular epithelia. Expression of
      c-fos returned to baseline levels by 24 h post 17 beta-estradiol treatment. There
      was no apparent difference in the uterine cell type-specific pattern of c-fos
      expression stimulated by estradiol in mature vs. immature animals. Nuclear run-on
      transcription assay in isolated luminal epithelial cell nuclei showed that c-fos
      gene transcription increased rapidly in the uterus after estradiol stimulation.
      Treatment of adult rats with a single injection of 16 alpha-estradiol, a short
      acting, nonmitogenic estrogen, induced c-fos primarily in the uterine glandular
      epithelia. Progesterone is known to modify the action of estrogen on the uterus
      by redirecting the proliferative response from epithelia to stroma. To determine
      if progesterone modulation of estrogen action involves shifting of c-fos
      expression to stromal cells, rats were treated with progesterone for 48 h and
      then killed 0, 3, 6, or 12 h after an estradiol injection. In situ hybridization
      analysis revealed that c-fos mRNA remained localized in the uterine luminal and
      glandular epithelia, and expression was not shifted to the stroma. Although these
      results support the idea that c-fos plays a role in proliferation of uterine
      epithelial cells, they also invite reassessment of the role played by c-fos in
      both epithelial and nonepithelial uterine cell types.

PMID- 7789327
TI  - Further evidence for a novel receptor for amino-terminal parathyroid hormone
      related protein on keratinocytes and squamous carcinoma cell lines.
AB  - PTH and PTH-related peptides (PTHrPs) interact with a common PTH/PTHrP receptor
      (type I), which is expressed in many tissues, including bone and kidney. Amino
      terminal PTH and PTHrPs also recognize receptors in several nonclassical PTH
      target tissues, and in some of these, the signaling mechanisms differ
      qualitatively from those of the classical type I receptor. In normal
      keratinocytes and squamous carcinoma cell lines, PTH and PTHrP stimulate a rise
      in intracellular calcium, but not cAMP, suggesting the existence of an alternate,
      type II PTH/PTHrP receptor. SqCC/Y1 squamous carcinoma cells stably expressing
      the type I receptor displayed sensitive intracellular cAMP responses to PTHrP and
      PTH, indicating that these cells express functional GS proteins and that the type
      I receptor is capable of signaling through adenylyl cyclase in this cell line.
      Therefore, the endogenous type II receptor in SqCC/Y1 cells differs from the
      cloned type I receptor. We next examined whether messenger RNA (mRNA) from
      keratinocytes and squamous cell lines could hybridize to a human type I PTH/PTHrP
      receptor complementary DNA [1.9 kilobases (kb)]. No type I receptor mRNA (2.3 kb)
      was detected in polyadenylated RNA from any of the squamous cell lines. However,
      squamous cell lines did express several mRNA transcripts that hybridized with the
      type I receptor probe, yet were smaller (1 and 1.5 kb) or larger (3.5-5 kb) than
      the cloned receptor mRNA. The predominant mRNA in two squamous carcinoma cell
      lines and normal keratinocytes was a 1-kb transcript. Northern analysis with five
      different region-specific probes that span the entire coding region of the human
      type I receptor was used to map homologous regions within each of the
      transcripts. Several of the transcripts identified in squamous lines are also
      present in polyadenylated RNA from SaOS-2 human bone cells, but a unique 1-kb
      transcript hybridizing to probe 2 (nucleotides 490-870) was observed only in
      squamous cells. The smaller 1- and 1.5-kb transcripts did not hybridize to probes
      corresponding to the extreme 5'- and 3'-coding regions of the type I receptor
      complementary DNA. Ribonuclease protection analysis employing riboprobes that
      correspond to the five region-specific DNA probes revealed strong RNA signals of
      the expected size in SaOS-2 cells, but no hybridization with squamous cell RNA.
      Several smaller, but minor, bands that were unique to squamous cells were
      observed with riboprobe 2 only, suggesting partial homology of this region with
      the type I receptor.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7789328
TI  - The hemodynamic basis for the cardiac effects of parathyroid hormone (PTH) and
      PTH-related protein.
AB  - PTH and PTH-related protein (PTHrP) have been regarded to have positive inotropic
      effects on the heart as well as positive chronotropic and vasodilator effects.
      However, inotropy due to a direct effect of these peptides has not heretofore
      been distinguished from an indirect inotropic effect as a result of altered heart
      rate or coronary flow. The aim of this study was to determine whether PTH and
      PTHrP have direct inotropic effects in isolated perfused rat hearts. Three groups
      of hearts were studied; in all groups, hearts contracted isovolumically and were
      perfused with a constant coronary pressure. In the control group, heart rate,
      coronary flow, peak pressure (LVPmax), peak rate of rise of LV pressure
      (dP/dtmax), and peak intracellular calcium (measured by aequorin) all increased
      with PTH and PTHrP in a dose-dependent manner. When heart rate was fixed by
      pacing in a second group of rats, PTH and PTHrP increased coronary flow, LVPmax,
      and dP/dtmax significantly, indicating that inotropic actions were not mediated
      solely by chronotropic effects. However, when heart rate was fixed by pacing and,
      additionally, coronary flow was held constant (by maximal prevasodilation with
      nitroprusside) in a third group of rats, there was no significant effect of
      either PTH or PTHrP on LVPmax, dP/dtmax, or peak intracellular calcium. To
      demonstrate the responsiveness of this latter preparation to inotropic
      stimulation, the beta-adrenergic agonist, isoproterenol, increased LVPmax,
      dP/dtmax, and peak calcium even when heart rate was fixed and vasodilation was
      maximal. Thus, PTH and PTHrP are inotropic agents by virtue of their influence on
      coronary flow and heart rate, but not by any direct effect on contractile
      elements in the heart.

PMID- 7789329
TI  - Transient transfection of GGH3-1' cells [GH3 cells stably transfected with the
      gonadotropin-releasing hormone (GnRH) receptor complementary deoxyribonucleic
      acid] with the carboxyl-terminal of beta-adrenergic receptor kinase 1 blocks
      prolactin release: evidence for a role of the G protein beta gamma-subunit
      complex in GnRH signal transduction.
AB  - G proteins consist of heterotrimeric alpha-, beta-, and gamma-subunits. To assess
      the role of the beta gamma-subunit complex in GnRH receptor-mediated signal
      transduction, GGH3-1' cells were transfected with plasmids PRK5-beta ARK1 (495
      689) containing complementary DNA (cDNA) of the carboxyl-terminal (Gly495-Leu689)
      of beta-adrenergic receptor kinase 1 (beta ARK1). GGH3-1' cells are GH3 cells
      that have been stably transfected with rat GnRH receptor cDNA. The carboxyl
      region of beta ARK1 (Gly495-Leu689) binds to the beta gamma complex and thereby
      inhibits its action. Twenty-four hours after stimulation, PRL release, cAMP
      release, and inositol phosphate (IP) production were measured in these cells and
      in control cells transfected with vector PRK5 cDNA alone. In cells expressing the
      beta ARK1-(495-689) sequence there was inhibition of basal PRL release (69.3%),
      cAMP release (61.2%), and IP production (75.5%) compared to cells containing
      vector only. When cells expressing the beta ARK1 fragment were stimulated with a
      GnRH analog (Buserelin; 10(-7) M), maximal responses were inhibited (66.1% for
      PRL release, 52.3% for cAMP release, and 79.1% for IP production). Scatchard
      analysis of GnRH analog binding was also performed in the two groups of
      transfected cells. No significant differences in Kd or receptor numbers were
      found between beta ARK1-(495-689)-transfected cells and control cells containing
      the vector alone. These data suggest a role for the beta gamma complex in
      mediation of cAMP release, IP production, and hormone release in response to
      agonist occupancy of the GnRH receptor.

PMID- 7789330
TI  - Tissue-specific expression of novel messenger ribonucleic acids cloned from a
      renin-expressing kidney tumor cell line (As4.1).
AB  - As4.1 cells are derived from a renin-expressing kidney tumor induced by tissue
      specific oncogene-mediated tumorigenesis in transgenic mice. These cells express
      high levels of renin messenger RNA (mRNA) and synthesize prorenin and renin; they
      were therefore used as a model to further investigate the molecular biology of
      renin-producing kidney cells by cloning and characterizing novel mRNAs expressed
      in these cells. One clone, designated 1.5, was randomly selected from an As4.1
      complementary DNA (cDNA) library, and two other cDNA clones, designated 4.9 and
      6.9, were obtained by screening the cDNA library using a strategy to identify
      As4.1 cell-specific mRNAs. Each clone exhibited a highly restricted tissue
      specific expression profile, including high level expression in As4.1 cells and
      low level expression in kidney. No homology was found between the sequence of the
      partial 1.5 and 4.9 cDNAs and sequences in Genbank. Southern blot analysis
      revealed that clone 4.9 is encoded by a single copy gene containing at least two
      separate exons. A homology search of the sequence of clone 6.9 revealed it to
      encode a cDNA to serum amyloid A protein; consistent with this identification,
      expression of 6.9 mRNA was highly induced in both kidney and liver after
      treatment of mice with Escherichia coli lipopolysaccharide.

PMID- 7789331
TI  - Role of specific response elements of the c-fos promoter and involvement of
      intermediate transcription factor(s) in the induction of Sertoli cell
      differentiation (transferrin promoter activation) by the testicular paracrine
      factor PModS.
AB  - A mesenchymal-epithelial cell interaction exists in the testis between the
      Sertoli cells that form the seminiferous tubule and the mesenchymal-derived
      peritubular myoid cells that surround the tubule. Analysis of the mesenchymal
      epithelial interactions between these cells revealed the local production of a
      mesenchymal factor, PModS. PModS modulates the differentiated functions of
      Sertoli cells in vitro, including stimulation of the iron-binding protein
      transferrin (Tf). Previous results have indicated that PModS-induced Tf gene
      expression involves the activation of immediate early genes. One of the immediate
      early genes was identified as c-fos. The importance of c-fos was demonstrated in
      the current study when a c-fos antisense oligonucleotide was found to inhibit the
      ability of PModS to induce the expression of a Tf promoter-chloramphenicol
      acetyltransferase (CAT) construct. The regulation of c-fos by PModS was
      investigated with various CAT constructs containing segments of the c-fos
      promoter, such as the serum response element (SRE), sis-inducible element (SIE),
      cAMP response element (CRE), and phorbol ester/TPA response element (TRE),
      transfected into cultured Sertoli cells. PModS has no effect on cAMP response
      element-CAT or TRE-CAT, suggesting that PModS does not act through stimulation of
      cAMP and protein kinase C pathways. PModS was found to activate the c-fos SRE-CAT
      construct and the SIE-CAT construct. A construct containing both SIE and SRE was
      stimulated to the same degree as either element alone. Gel mobility shift assays
      using nuclear extracts from PModS-stimulated Sertoli cells and a radiolabeled SRE
      oligonucleotide resulted in retarded mobility of a DNA-protein complex. A gel
      shift with a SRE oligonucleotide containing an ETS domain resulted in a unique
      shift only detected in PModS stimulated cells. PModS also promoted a gel shift
      with the SIE that is adjacent to the SRE on the c-fos promoter. The data imply
      that PModS can activate the c-fos promoter through the SRE and SIE. PModS caused
      a labeled activating protein 1 (AP1) oligonucleotide to form a DNA-protein
      complex, indicating activation of the c-fos gene and binding of the c-fos/jun
      complex. To study the downstream regulation of Sertoli cell differentiation, Tf
      gene expression was examined. CAT constructs containing deletion mutants of a 3
      kilobase (kb) mouse Tf promoter were used. When transfected into Sertoli cells
      the 581-base pair Tf minimal promoter had only a slight response to PModS, but
      was activated by FSH. The 2.6-kb Tf promoter construct responded to
      PModS.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7789332
TI  - Simultaneous block of interleukin-1 and tumor necrosis factor is required to
      completely prevent bone loss in the early postovariectomy period.
AB  - Considerable evidence supports the hypothesis that estrogen prevents bone loss by
      blocking the production of cytokines in bone or bone marrow. However, controversy
      remains on the role of candidate factors, such as interleukin-1 (IL-1), IL-6, and
      tumor necrosis factor (TNF). As IL-1 and TNF have many additive and/or
      synergistic effects in bone, we tested the hypothesis that the simultaneous block
      of IL-1 and TNF is required to prevent the initial phase of rapid bone loss that
      follows ovariectomy (ovx). To this aim, rats were ovariectomized and treated for
      2 weeks with either IL-1 receptor antagonist (IL-1ra), an inhibitor of IL-1, or
      TNF-binding protein (TNFbp), an inhibitor of TNF. Ovx increased bone marrow cell
      secretion of IL-1 and TNF and decreased the bone density of the distal femur, as
      measured by dual energy x-ray absorptiometry. Ovx-induced bone loss was decreased
      by both IL-1ra and TNFbp and completely prevented by simultaneous treatment with
      IL-1ra and TNFbp. Combined treatment with IL-1ra and TNFbp decreased urinary
      pyridinoline cross-links, a marker of bone resorption that reflects osteoclast
      number and osteoclast activity, whereas treatment with either inhibitor alone was
      less effective. Both IL-1ra and TNFbp decreased the number of osteoclasts on the
      endocortical surfaces and stimulated bone formation, but the two inhibitors had
      no additive effects on these indexes, suggesting that inhibition of
      osteoclastogenesis and stimulation of bone formation do not account for the
      additive bone-sparing effects of IL-1ra and TNFbp. These inhibitors had no effect
      in sham-operated rats, indicating that they specifically blocked estrogen
      dependent events. In conclusion, these data indicate that in the early post-ovx
      period, IL-1 and TNF play a critical causal role in inducing bone loss and do so
      by stimulating bone resorption and inhibiting bone formation.

PMID- 7789333
TI  - Effect of human growth hormone and insulin on [3H]thymidine incorporation, cell
      cycle progression, and cyclin D expression in 3T3-F442A preadipose cells.
AB  - Cellular growth- and cyclin D expression-regulating activities of GH and insulin
      were investigated in 3T3-F442A preadipose cells under serum-free culture
      conditions. The present report provides evidence that the proliferative potential
      of 3T3-F442A cells is reduced by GH in a time- and concentration-dependent manner
      based on [3H]thymidine incorporation assay and cell cycle analysis. In contrast,
      treatment of 3T3-F442A cells with insulin resulted in cellular proliferation. The
      insulin-induced proliferation of 3T3-F442A cells was diminished in the presence
      of GH. In an effort to define biochemical events relevant to the regulatory
      activities of GH and insulin on the proliferation of 3T3-F442A cells, the effects
      of these peptides on the expression of cyclin D were studied using Western
      blotting. Treatment of 3T3-F442A cells with insulin led to an increase in cyclin
      D expression relative to that in untreated cells. The insulin-elicited expression
      of cyclin D was time and dose dependent. In addition, the ability of insulin to
      induce cyclin D expression was reduced by GH. Our experimental results indicate
      that proliferation of 3T3-F442A cells was regulated by GH and insulin. The
      regulatory effects of GH and insulin are mediated at least in part by the
      alternating expression of cyclin D protein.

PMID- 7789334
TI  - Residual bodies activate Sertoli cell interleukin-1 alpha (IL-1 alpha) release,
      which triggers IL-6 production by an autocrine mechanism, through the
      lipoxygenase pathway.
AB  - Interleukin-1 (IL-1) and IL-6 are produced by Sertoli cells. As IL-1 stimulates
      IL-6 production in some tissues, the cascade of events that results in IL-6
      secretion by Sertoli cells was studied. The addition of IL-1 alpha to Sertoli
      cells resulted in a time-dependent increase in IL-6 secretion. Incubation of
      Sertoli cells with two known stimulators of IL-1 production, lipopolysaccharide
      (LPS) and residual bodies, resulted in a significant increase in IL-1 release
      into the medium several hours before IL-6 release. That IL-1 is essential for IL
      6 production from Sertoli cells was established by blocking the actions of LPS
      and residual bodies with an anti-IL-1 alpha antibody. An increase in the release
      of IL-1 before IL-6 was also observed in medium obtained from staged segments of
      intact seminiferous tubules; IL-1 reached a maximum level at stage VIII, when
      mature spermatozoa are released and residual bodies are formed and phagocytosed.
      The secretion of IL-6 was low during this stage and then increased progressively
      from stage IX onward, consistent with IL-1 stimulation of IL-6. The pathway of IL
      1 alpha-induced release of IL-6 was studied in the presence of agents that
      influence arachidonic acid release and metabolism. IL-1 alpha was found to
      stimulate arachidonic acid release by Sertoli cells. Furthermore, a phospholipase
      A2 inhibitor, aristolochic acid, significantly decreased IL-1-, LPS-, and
      pyrularia pubera thionin-induced IL-6 secretion from Sertoli cells. Indomethacin,
      a specific inhibitor of the cyclooxygenase pathway, had no significant effect on
      basal, but enhanced IL-1- and LPS-stimulated IL-6 production. The involvement of
      arachidonic acid metabolites produced in the lipoxygenase pathway on the release
      of IL-6 was investigated indirectly, using nordihydroguaiaretic acid. This
      inhibitor reduced basal and IL-1 alpha- and LPS-stimulated IL-6 production.
      Ethacrynic acid, an inhibitor of peptido-leukotriene synthesis, also reduced
      basal IL-6 levels and blocked IL-1 alpha- as well as LPS-induced IL-6 secretion.
      It is concluded that IL-1 produced by Sertoli cells in response to LPS or
      residual bodies induces IL-6 through the lipoxygenase pathway.

PMID- 7789335
TI  - The reduced responsiveness of cultured bovine parathyroid cells to extracellular
      Ca2+ is associated with marked reduction in the expression of extracellular
      Ca(2+)-sensing receptor messenger ribonucleic acid and protein.
AB  - PTH secretion from dispersed bovine parathyroid cells maintained in culture
      becomes progressively less responsive to changes in the extracellular Ca2+
      concentration (Ca2+o) over several days. We have now investigated whether this
      change in secretory control is associated with alterations in the expression of
      the Ca2+o-sensing receptor (BoPCaR) recently cloned from bovine parathyroid,
      which plays a central role in Ca2+o-regulated PTH secretion. BoPCaR messenger RNA
      levels dropped rapidly in cultured bovine parathyroid cells, as assessed by
      Northern analysis, decreasing by 78% within 18 h and remaining low for at least 4
      days. The level of receptor protein decreased to a comparable extent
      (approximately 72-82%) after 3-4 days in culture, as determined by
      immunocytochemistry with specific antibodies directed at the extracellular domain
      of the receptor. The half-time for the reduction in receptor protein
      (approximately 2 days) was considerably longer, however, than that for BoPCaR
      messenger RNA, but was comparable to that for the loss of sensitivity of PTH
      secretion to Ca2+o. Indeed, there was a close linear correlation between maximal
      suppressibility of PTH secretion and the intensity of staining for the receptor
      protein (r = 0.88; P = 0.004). We conclude that alterations in the expression of
      BoPCaR could explain much of the reduced responsiveness of cultured bovine
      parathyroid cells to Ca2+o.

PMID- 7789336
TI  - Identification of two classes of prolactin-releasing factors in intermediate lobe
      tumors from transgenic mice.
AB  - Targeted tumorigenesis, using the POMC gene promoter ligated to the simian virus
      40 large T antigen, generated transgenic mice with massive tumors of the
      intermediate lobe (IL) of the pituitary. Inoculation of nude mice with the IL
      tumor cells resulted in very large secondary tumors. As the IL from several
      species produces a potent PRL-releasing factor (PRF), it was of interest to
      determine whether IL tumors from these mice also contain PRF. The objectives were
      to 1) measure serum PRL levels in mice with IL tumors, 2) determine whether these
      tumors contain PRF and examine its chromatographic properties, and 3) analyze
      whether this PRF is related to POMC, its derivatives, or other PRL secretagogues.
      Serum PRL levels were 5- to 6-fold higher in transgenic than in control mice.
      Primary and secondary IL tumors were acid extracted and successively fractionated
      using Sephadex G-100 gel filtration and reverse phase and gel permeation HPLC.
      PRF activity was determined using short term incubation of tissue extracts or
      column fractions with GH3 cells. Crude tumor extracts exhibited a strong and dose
      dependent PRF activity. Upon chromatography, the PRF activity from either primary
      or secondary tumors resolved into two classes of compounds: a big PRF with an
      estimated mol wt of 70-80 kilodaltons and two small, very hydrophobic peptides.
      The elution profiles of the three PRFs differed from those of beta-endorphin,
      alpha MSH, beta MSH, ACTH, TRH, oxytocin, angiotensin II, vasoactive intestinal
      polypeptide, or corticotropin-like intermediate peptide. In summary, we have
      identified an animal model with IL tumors that has hyperprolactinemia and
      overproduces PRF. Two classes of PRFs, big and small, were resolved which differ
      from POMC derivatives and known regulators of PRL release. These data suggest
      that PRF is produced by melanotrophs, but is not a product of the POMC gene. The
      IL tumors should provide an excellent source for the purification and structural
      elucidation of PRFs.

PMID- 7789337
TI  - Combined magnetic fields increase insulin-like growth factor-II in TE-85 human
      osteosarcoma bone cell cultures.
AB  - In vitro exposure to low-energy, combined magnetic fields (CMF) increased the
      release of insulin-like growth factor (IGF)-II from human TE-85 osteosarcoma
      cells. Short-term CMF exposure of only 10 min increased IGF-II levels in
      conditioned medium 1 h post CMF exposure. IGF-II levels were measured with a
      radioreceptor assay using H-35 cells that contain abundant IGF-II but not IGF-I
      receptors. This assay also uses a recently validated BioGel P-10 acid gel
      filtration method to remove IGF binding protein before quantitation of either IGF
      I or IGF-II. In addition to an increase in IGF-II levels, DNA synthesis, as an
      index of cell proliferation, was increased during the 24-h period post CMF
      exposure. A monoclonal antibody against IGF-II blocked the increase in cell
      proliferation following CMF exposure, whereas a control monoclonal antibody
      against osteocalcin did not attenuate the mitogenic action of CMF exposure. The
      effect of CMF exposure to increase both cell proliferation and IGF-II was cell
      density dependent with greater stimulation by CMF observed at lower densities.
      Together, these data are consistent with the hypothesis that CMF exposure
      stimulates release/production of IGF-II from bone cells and that increased IGF-II
      then promotes an increase in cell proliferation.

PMID- 7789338
TI  - Glucocorticoid and/or glucocorticoid antagonist effects in inflammatory disease
      susceptible Lewis rats and inflammatory disease-resistant Fischer rats.
AB  - Lewis (LEW/N) and Fischer (F344) rats are inbred strains that respond
      antithetically to administration of several inflammatory stimuli. Thus, in
      response to streptococcal cell wall-derived peptidoglycan/polysaccharide, 6-week
      old female Lewis rats develop acute and chronic polyarthritis, whereas age- and
      sex-matched Fischer rats are arthritis-resistant. The susceptibility of Lewis
      rats to development of chronic severe inflammatory disease has been attributed to
      their inability to appropriately activate their hypothalamic-pituitary-adrenal
      axis in response to inflammatory stimuli, leading to a functional glucocorticoid
      deficiency. To investigate whether the acute neurogenic inflammatory response was
      also different in the two strains, we studied the air-pouch model of carrageenin
      induced neurogenic inflammation in adult male Lewis and Fischer rats. Both the
      volume and the leukocyte concentration of the inflammatory exudate were
      significantly higher in Lewis than in Fischer rats, suggesting that the known
      differences in the handling of chronic inflammation between the two strains
      pertain to the acute neurogenic type of inflammation as well. To confirm that
      glucocorticoids play a major role in the differential response of the two strains
      to this inflammatory stimulus, we administered graded doses of the glucocorticoid
      agonist dexamethasone or antagonist RU 486 to both strains and examined their
      responses to concomitantly administered carrageenin. RU 486 increased, whereas
      dexamethasone decreased, the inflammatory response of Fischer and Lewis rats,
      respectively, to approach the magnitude of each other's natural response,
      suggesting that glucocorticoids are involved in this phenomenon as well. To rule
      out any differences in end-organ sensitivity to glucocorticoids between the two
      strains, we evaluated dose-response relations of whole body, thymus, spleen, and
      adrenal weights after 1 week daily administration of graded doses of
      dexamethasone. We found similar ED50 for both Lewis and Fischer rats. We conclude
      that the differences in the susceptibility to acute, carrageenin-induced,
      neurogenic inflammation between the LEW/N and F344 rat strains are similar to
      those of chronic inflammatory responses in these strains and likewise
      glucocorticoid-dependent. No apparent major differences exist in the sensitivity
      of target tissues to exogenous glucocorticoids between Lewis and Fischer rats.

PMID- 7789339
TI  - Regulation of the cell-cell adhesion protein, E-cadherin, in dog and human
      thyrocytes in vitro.
AB  - E-cadherin, a cell-cell adhesion protein specifically expressed at the
      basolateral membrane of thyrocytes, is variably dysregulated in thyroid
      carcinomas in parallel to the dedifferentiation of the tumors. No data are
      currently available on the regulation of E-cadherin in messenger RNA (mRNA)
      expression by physiological stimulators of thyroid proliferation and
      differentiation. The present study investigated the control of E-cadherin steady
      state mRNA levels and protein expression in primary cultures of dog and human
      thyrocytes under the influence of physiological regulators of thyroid
      differentiation and dedifferentiation using Northern blot analysis and
      immunohistochemistry. Following dedifferentiation by epidermal growth factor and
      fetal calf serum in primary cultures of dog and human thyrocytes, E-cadherin
      steady state mRNA expression was low but easily detectable. Stimulation of the
      cells by TSH (1 mU/ml) or forskolin (10 microM) induced an increase in E-cadherin
      mRNA levels with a maximal effect after 20 h. An up-regulation of E-cadherin
      protein levels are also observed by immunostaining with anti-E-cadherin
      antibodies. A concentration-response relation determined for TSH stimulation (10
      microU/ml to 10 mU/ml) led to a concentration-dependent stimulation of E-cadherin
      mRNA levels and a parallel increase in protein expression with a minimal
      effective concentration of 10-30 microU/ml. These effects depend on protein
      synthesis as they are completely blocked by the presence of 10 micrograms/ml
      cycloheximide. Treatment with EGF did not markedly alter E-cadherin mRNA
      expression, whereas removal of insulin from the medium slightly decreased E
      cadherin mRNA and protein levels. There is, therefore, a qualitative parallelism
      between the effect of the various factors on E-cadherin protein and mRNA levels.
      These results suggest that the cell-cell adhesion protein E-cadherin is under the
      control of the TSH-cAMP-dependent pathway and may play an important physiological
      role on the action of this pathway in proliferation and differentiation.

PMID- 7789340
TI  - Activation of the Na+/H+ exchanger by cellular pH and extracellular Na+ in rat
      adipocytes; inhibition by isoproterenol.
AB  - The activity of the Na+/H+ exchanger was studied by measuring the effects of
      intracellular pH (pHi) and extracellular Na+ [(Na+)o] on pHi recovery and 22Na
      uptake in rat adipocytes. The resting pHi was acidified from 7.30 +/- 0.02 to
      6.99 +/- 0.01 with nigericin in the absence of (Na+)o. pHi recovery induced by 30
      mM NaCl was blocked by 100 microM amiloride. The reversibility of the exchanger
      was studied by Na+ loading, which raised the pHi from 7.30 +/- 0.02 to 7.50 +/-
      0.01, and by removing (Na+)o, which decreased pHi to 6.97 +/- 0.01. Both
      functions of the exchanger, forward and backward, were inhibited by amiloride.
      The Na+/H+ exchanger was inactive at pHi higher than 7.1 and became increasingly
      active as pHi decreased to 6.2 (22Na+ uptake, 0.029 +/- 0.003 vs. 0.155 +/- 0.009
      nmol/10(5) cells.2.5 min; P < 0.001); this 5-fold stimulation was largely
      abolished by amiloride (0.025 +/- 0.002; P < 0.001). Na+ influx was also
      increased as a function of (Na+)o, with an apparent Km of 35 mM. Respective 5-
      and 44-fold stimulations at 5 mM (0.135 +/- 0.007) and 140 mM (Na+)o (1.228 +/-
      0.046 nmol/10(5) cells.2.5 min; P < 0.001) were inhibited by
      ethylisopropylamiloride. Isoproterenol (Iso; 100 nM) and agents that stimulate
      cAMP production, such as forskolin (10 microM) and theophyline (1 mM), inhibited
      the activity of amiloride-sensitive 22Na+ uptake by 85%. Iso inhibited the Na+/H+
      exchanger, without affecting the Na+/K(+)-adenosine triphosphatase-dependent and
      the Na+/K+/Cl- cotransport mechanisms. (Bu)2cAMP (1 mM), a membrane-permeant cAMP
      analog, mimicked the effects of Iso on the exchanger. The inhibitory effect of
      Iso was blocked by propranolol, but not by metoprolol, a beta 1-antagonist. In
      addition, the alpha-adrenergic agonists, phenylephrine (alpha 1) and clonidine
      (alpha 2), and the alpha-antagonists, prazocin (alpha 1) and yohimbine (alpha 2),
      did not prevent Iso-induced inhibition of the exchanger. In conclusion, rat
      adipocytes possess a reversible Na+/H+ exchange mechanism, which is activated by
      low pHi and normal (Na+)o and is inhibited by Iso via a beta 2-adrenergic
      receptor stimulation and a cAMP-dependent mechanism.

PMID- 7789341
TI  - Alternative splicing and differential targeting of fibroblast growth factor
      receptor 1 in the pregnant rat uterus.
AB  - Recent studies suggest that steroid effects on uterine cell proliferation may be
      moderated by polypeptide growth factors. We now provide evidence that high
      affinity fibroblast growth factor (FGF) receptors are present temporally and
      spatially in the pregnant rat uterus (days 4-6) to support the idea that basic
      FGF action occurs via binding to its high affinity FGF receptor 1 (FGFR1).
      Reverse transcription-polymerase chain amplification indicates that both the full
      length transcript and an alternatively spliced messenger RNA are present in the
      uterus. Western immunoblot analysis confirms that rat uterine membrane proteins
      contain two receptor isoforms, and these receptors bind basic FGF with high
      affinity and specificity. Immunolocalization of FGFR1 revealed receptor-positive
      cells in both the uterine stroma and epithelia on days 4-6 of pregnancy. However,
      the receptor was differentially localized in the disparate cell types. The nuclei
      of stromal cells were positive for FGFR1, whereas epithelial cell nuclei were
      negative. Together, these results suggest that FGF signal transduction in uterine
      stromal cells is mediated by activation of FGFR1.

PMID- 7789342
TI  - The thyrotropin (TSH) receptor transmembrane domain mutation (Pro556-Leu) in the
      hypothyroid hyt/hyt mouse results in plasma membrane targeting but defective TSH
      binding.
AB  - The hyt/hyt mouse is hypothyroid because of a mutation in the TSH receptor (TSH
      R). In this report, we confirm the presence of a Pro to Leu mutation in amino
      acid 556 of the fourth transmembrane domain (TM4) of the TSH-R. This Pro is
      highly conserved in members of the G protein-coupled seven-transmembrane family
      of receptors. Insertion of this mutation into the wild-type rat receptor
      eliminated TSH binding and receptor function in transfected 293 and COS cells.
      Wild-type TSH-R conferred a 7.4-fold increase in cAMP and a 2.3-fold stimulation
      of a cAMP-responsive reporter gene. The P556L mutant receptor elicited no
      increase in cAMP or the reporter gene. Cells transfected with wild-type receptor
      bound TSH with a Kd of 3.3 x 10(-10) M, whereas no TSH binding was detected with
      the P556L mutant. Because the P556L mutation occurs in a receptor region (TM4)
      that is not expected to alter the binding of TSH, additional studies were
      performed to examine receptor processing and cellular localization. Mutant
      receptors from solubilized membranes also failed to bind TSH, indicating that the
      absence of binding to intact cells was not accounted for intracellular trapping
      of the mutant receptor. Western blot analyses demonstrated that the mutant and
      wild-type receptors were processed through a similar series of precursors and
      that a mature 95-kilodalton form of the mutant TSH-R was produced, consistent
      with its insertion into the plasma membrane. Immunofluorescence studies confirmed
      expression of the P556L mutant on the cell surface of transfected cells and in
      thyroid tissue from hyt/hyt mice. Although the extracellular domain of the TSH-R
      is sufficient for high affinity binding of TSH, we conclude that the hyt mutation
      in the fourth transmembrane domain eliminates TSH binding. These results suggest
      interactions between the extracellular and transmembrane domains of the TSH-R and
      indicate that this highly conserved proline is required for normal receptor
      structure and function.

PMID- 7789343
TI  - Presence of nerve growth factor and its receptors in an in vitro model of islet
      cell development: implication in normal islet morphogenesis.
AB  - In vivo, the differentiation of pancreatic islet stem cells depends on unknown
      soluble factors produced by the mesenchyme surrounding these cells. We have
      previously demonstrated that, like some neuronal cells, different beta-cell lines
      express functional nerve growth factor (NGF) receptors and can respond to NGF by
      extending neurite-like processes. NGF receptors are also expressed in vivo in
      mature rat islets and early during development in pancreatic ductular cells,
      which represent putative beta-stem cells. In this study, we have further
      characterized an in vitro model of islet development and studied the expression
      of NGF receptors and its ligand in this model. We have demonstrated the
      expression of Trk-A messenger RNA coding for the high affinity NGF receptor in
      islet cells and the localization of Trk protein in both alpha- and beta-islet
      cells. Moreover, the cells, from which islet cells "bud," also express Trk-A.
      Furthermore, NGF is produced and secreted by the nonendocrine cells surrounding
      the islets, suggesting a possible paracrine mode of action of NGF on the adjacent
      islet cells. Finally, islet morphogenesis is significantly retarded in the
      presence of K252a, an inhibitor of the tyrosine kinase activity of the family of
      Trk receptors, suggesting an implication of the neurotrophin-neurotrophin
      receptor axis in islet development.

PMID- 7789344
TI  - Effects of psychosocial interventions with adult cancer patients: a meta-analysis
      of randomized experiments.
AB  - Meta-analytic methods were used to synthesize the results of published
      randomized, controlled-outcome studies of psychosocial interventions with adult
      cancer patients. Forty-five studies reporting 62 treatment-control comparisons
      were identified. Samples were predominantly White, female, and from the United
      States. Beneficial effect size ds were .24 for emotional adjustment measures, .19
      for functional adjustment measures, .26 for measures of treatment- and disease
      related symptoms, and .28 for compound and global measures. The effect size of
      .17 found for medical measures was not statistically significant for the few
      reporting studies. Effect sizes for treatment-control comparisons did not
      significantly differ among several categories of treatment: behavioral
      interventions, nonbehavioral counseling and therapy, informational and
      educational methods, organized social support provided by other patients, and
      other nonhospice interventions.

PMID- 7789345
TI  - Effects of decreasing sedentary behavior and increasing activity on weight change
      in obese children.
AB  - Obese children 8-12 years old from 61 families were randomized to treatment
      groups that targeted increased exercise, decreased sedentary behaviors, or both
      (combined group) to test the influence of reinforcing children to be more active
      or less sedentary on child weight change. Significant decreases in percentage
      overweight were observed after 4 months between the sedentary and the exercise
      groups (-19.9 vs. -13.2). At 1 year, the sedentary group had a greater decrease
      in percentage overweight than did the combined and the exercise groups (-18.7 vs.
      -10.3 and -8.7) and greater decrease in percentage of body fat (-4.7 vs. -1.3).
      All groups improved fitness during treatment and follow-up. Children in the
      sedentary group increased their liking for high-intensity activity and reported
      lower caloric intake than did children in the exercise group. These results
      support the goal of reducing time spent in sedentary activities to improve weight
      loss.

PMID- 7789346
TI  - Relationship between obesity and the metabolic effects of smoking in women.
AB  - The influence of cigarette smoking on resting energy expenditure (REE) in normal
      weight and obese smokers was investigated. Participants were 20 normal-weight and
      20 obese female smokers assessed over a 2-day period. The results indicated that
      REE increased in both obese and normal-weight smokers after smoking, but the
      increase was greater for normal-weight participants. The normal-weight group
      showed a 9.7%, 5.8%, and a 3.6% increase in REE during the three 10-min blocks
      constituting the 30-min postsmoking phase. However, the obese group showed a 3.9%
      and a 0.7% increase in REE and a 0.8% decrease in REE during this postsmoking
      phase. Between-group comparisons revealed a differential rate of change in REE
      after smoking, indicating that the obese group's change of REE at every
      postsmoking time point was on average 70 kcal/day below that of the normal-weight
      group. The metabolic effect of smoking is reproducible, and the obese smokers
      reliably show an attenuated effect. However, the reliability of the change is
      lower for both normal-weight and obese smokers. The results have potential
      implications for discouraging obese persons from taking up smoking and
      intervening among those who already smoke.

PMID- 7789347
TI  - The effect of smoking and light activity on metabolism in men.
AB  - This experiment examined the metabolic effects of smoking during rest and light
      activity under naturalistic conditions. Thirty-nine male subjects first completed
      a submaximal graded exercise treadmill test to standardize activity level. Then 3
      groups of subjects--smokers smoking (SS), smokers not smoking (SNS), and
      nonsmokers (NS)--were exposed to 3 stages of rest or 3 stages of light activity
      with order of rest or activity randomly determined over 2 different days. Energy
      expenditure was monitored continuously during these sessions. Significant
      increases in smokers' energy expenditure were observed during light activity when
      compared with smokers not smoking and nonsmokers. No differences were identified
      among groups at rest. These findings strengthen the conclusion that smoking or
      its components contribute to metabolic changes during typical levels of daily
      activity and suggest a mechanism for the frequently observed relationship between
      smoking status and body weight.

PMID- 7789348
TI  - Resistance of personal risk perceptions to debiasing interventions.
AB  - The tendency to believe that one's own risk is less than that of others may
      reduce interest in health-protective behaviors. This article describes 4 attempts
      to reduce such optimistic biases. In Study 1, New Jersey residents (N = 222) were
      provided with lists of risk factors for several health problems. This
      manipulation was strengthened in Study 2 by presenting risk factors in such a way
      that participants (164 undergraduates) might see their own standing as inferior
      to that of others. In Study 3, risk factors were presented one at a time, and
      participants (190 undergraduates) incorporated them into a mental image of a high
      risk individual. Finally, 374 undergraduates in Study 4 generated lists of
      personal attributes that they believed increased their risk. Optimistic biases
      were found in each study, but none of the manipulations reduced these biases
      consistently. In contrast, conditions using opposite manipulations often
      exacerbated the biases.

PMID- 7789349
TI  - Negative affective consequences of thinking about disease detection behaviors.
AB  - It was proposed that thinking about disease-detection behavior would lead to more
      negative moods than thinking about health-promotion behavior. Detection behaviors
      produce more negative moods because they can threaten perceptions of good health.
      In a laboratory study, the initial mood states of 121 participants recruited from
      undergraduates and the general community were measured using a neutral-words
      rating procedure. Then participants were randomly assigned to think about
      performing a disease-detection behavior or a health-promotion behavior.
      Subsequently, they wrote down their responses to the behavior and evaluated these
      as either positive, negative, or neutral. Finally, the participant's mood was
      remeasured using both a neutral words-rating procedure and a more traditional
      bipolar rating measure. Results indicated that thought about disease-detection
      behavior produced more negative affective responses and more negative mood change
      than did thought about health-promotion behavior.

PMID- 7789350
TI  - Magical thinking about illness virulence: conceptions of germs from "safe" versus
      "dangerous" others.
AB  - AIDS-related research has documented overreactions to casual contact and
      underreactions to sexual risk. This contradiction is explained by "magical
      contagion", a principle of thinking common in traditional societies, wherein
      contagion is considered socially discriminating, such that harmfulness depends on
      the nature of the relationship between source and recipient. In Study 1, 100
      undergraduate participants drew germs described as their own, a stranger's, their
      lover's, or a disliked peer's. Lovers' germs were depicted as less threatening
      than disliked peers' germs. In Study 2, scenarios described contact with a flu
      infected lover, stranger, or disliked peer. New undergraduate participants (N =
      133) rated how likely they were to become ill and how severely. Although
      likelihood ratings did not differ, severity ratings followed a linear trend,
      effects of lover contact being least severe and contact with disliked peer most
      severe. Behavioral implications of the blurring of feelings about germ source
      with estimates of germ virulence are discussed.

PMID- 7789352
TI  - Walking to meet health guidelines: the effect of prompting frequency and prompt
      structure.
AB  - This study assessed the effects of frequency of prompting (phone calls once a
      week versus once every 3 weeks) and structure of prompting (high versus low
      structure) in 135 participants (132 women and 3 men) in a walking program
      designed to meet the American College of Sports Medicine's cardiovascular
      exercise goals. Survival analysis using 6 months of data points and using the
      criteria of walking at least 20 min a day for at least 3 times per week indicated
      an effect for more frequent versus less frequent prompting (46% and 13%) but not
      for high- versus low-structure prompting (30% and 31%). The results suggested the
      efficacy of frequent prompting delivered in inexpensive ways as a means to
      increase exercise adherence and the further parametric study of other basic
      behavior change strategies.

PMID- 7789353
TI  - Visual discrimination of pigmented skin lesions.
AB  - Three experiments explored human performance in discrimination of pigmented skin
      lesions from photographic slides. Experiment 1 showed that latent ability in
      identifying early melanoma was low, and some benign lesions tended to be falsely
      identified as serious. Performance overall did not decline when viewing time was
      reduced, suggesting that judgments could be made on the general appearance of
      lesions. Experiment 2 showed that enlargement of stimuli had no effect.
      Experiment 3 showed that performance was better with pictorial examples than with
      written descriptions for some classes of lesion, but for melanoma performance
      improved with longer viewing time when information was provided, suggesting that
      an opportunity to scrutinize could be beneficial. Guidelines to the public should
      distinguish melanoma from benign lesions and stress the importance of seeking
      prompt medical attention for suspicious lesions.

PMID- 7789351
TI  - Social support, coping, and depressive symptoms in a late-middle-aged sample of
      patients reporting cardiac illness.
AB  - This study tests a 1-year predictive model of depressive symptoms in a late
      middle-aged sample of patients reporting diagnoses of cardiac illness. Results
      based on 325 individuals (248 men and 77 women) diagnosed with chronic cardiac
      illness, 71 individuals (52 men and 19 women) diagnosed with acute cardiac
      illness, and 219 healthy controls (129 men and 90 women) strongly supported the
      hypotheses. Compared with healthy persons, individuals with chronic and those
      with acute cardiac illness reported more depressive symptoms at follow-up. Women
      overall showed more depressive symptoms than did men, and women with cardiac
      illness were particularly vulnerable to behavioral manifestations of depressive
      symptoms. Integrative time-lag and prospective structural equation models
      indicated that, for individuals with cardiac illness, social support and adaptive
      coping strategies predicted fewer depressive symptoms.

PMID- 7789354
TI  - The effects of message framing on mammography utilization.
AB  - This experiment compared the effectiveness of gain-versus loss-framed messages to
      persuade women to obtain mammography screening. One hundred and thirty-three
      women 40 years and older and not adhering to current guidelines for obtaining
      mammography screening were assigned randomly to view either gain-framed
      (emphasizing the benefits of obtaining mammography) or loss-framed (emphasizing
      the risks of not obtaining mammography) persuasive videos that were factually
      equivalent. Attitudes and beliefs were measured before and immediately following
      the intervention. Mammography utilization was assessed 6 and 12 months later.
      Consistent with predictions based on prospect theory, women who viewed the loss
      framed message were more likely to have obtained a mammogram within 12 months of
      the intervention. These findings suggest that loss-framed messages may have an
      advantage in the promotion of detection behaviors such as mammography.

PMID- 7789355
TI  - Behavioral research in cancer as a model for health psychology.

PMID- 7789356
TI  - Influence of heredity on human sensitivity to environmental chemicals.
AB  - Hereditary peculiarities in individual responses to environmental chemicals are a
      common occurrence in human populations. Genetic variation in glutathione S
      transferase, CYP1A2, N-acetyltransferase, and paraoxonase exemplify the
      relationship of metabolic variation to individual susceptibility to cancer and
      other toxicants of environmental origin. Heritable receptor protein variants, a
      subset of proteins of enormous pharmacogenetic potential that have not thus far
      been extensively explored from the pharmacogenetic standpoint, are also
      considered. Examples of interest that are considered include receptor variants
      associated with retinoic acid resistance in acute promyelocytic leukemia, with
      paradoxical responses to antiandrogens in prostate cancer, and with retinitis
      pigmentosa. Additional heritable protein variants of pharmacogenetic interest
      that result in antibiotic-induced deafness, glucocorticoid-remediable
      aldosteronism and hypertension, the long-QT syndrome, and beryllium-induced lung
      disease are also discussed. These traits demonstrate how knowledge of the
      molecular basis and mechanism of the variant response may contribute to its
      prevention in sensitive persons as well as to improved therapy for genetically
      conditioned disorders that arise from environmental chemicals.

PMID- 7789357
TI  - Uniparental disomy and genomic imprinting as causes of human genetic disease.
AB  - The existence of parent-of-origin differences in the expression of some genes, a
      process known as genomic imprinting, has been recognized and documented over the
      past several years. This epigenetic marking process results in the differential
      expression of normal genes depending upon whether they were inherited from the
      mother or the father. A number of human disorders have been identified as
      resulting from alterations in genomic imprinting. One process which can unmask
      genomic imprinting is uniparental disomy, in which both members of a chromosome
      pair are contributed by one sex parent. When uniparental disomy is present,
      genetic abnormality can result either from homozygosity of a single mutant allele
      which is present in two doses, or from the presence of two copies of an imprinted
      unexpressed gene or genes, rather than the usual one expressed and one
      unexpressed. Examples of human genetic disorders that are the consequence of
      genomic imprinting, and a discussion of current knowledge about the mechanisms of
      imprinting and the causes of uniparental disomy, are reviewed.

PMID- 7789358
TI  - Mutagenesis and human genetic disease: an introduction.
AB  - This special issue attempts to provide a fresh perspective on the importance of
      germ-cell mutagenesis studies and restate the questions and challenges inherent
      in efforts to minimize the incidence of human genetic diseases. We are working in
      a time when rapidly advancing molecular technologies provide the tools that
      permit a more detailed understanding of germ-cell mutagenesis and genetic
      disease. Meanwhile, discoveries of new genetic disease phenomena challenge our
      abilities to conceive and develop research models for their study. It is hoped
      that the collection of articles in this issue will serve to stimulate interest in
      scientists of varied disciplines and help focus those interests on the issues
      surrounding the relationship between environmental mutagens and human genetic
      disease.

PMID- 7789359
TI  - Mosaicism: the embryo as a target for induction of mutations leading to cancer
      and genetic disease.
AB  - Mosaicism, the existence of "patches" of cells with a genetic constitution that
      differs from that of other cells of an organism, has been observed in both
      germinal and somatic tissues of several species, including humans. Mutational
      events occurring during early embryogenesis can give rise to an organism with a
      significant number of cells with the mutant genotype in one or more tissues. If
      this event occurs in a precursor of the germ cells, the mutation can be
      transferred to subsequent generations. In the F1 generation, this event will
      usually be perceived as a de novo germinal mutation rather than a transmitted
      variant allele, unless significant effort is directed toward detecting the
      mosaicism. Similarly, mutations in oncogenes and tumor-suppressor genes in
      proliferating somatic cells can generate populations of cells that are at
      increased risk of transforming into tumor cells. The number of potential
      preneoplastic cells is larger when the mutagenic event occurs in early
      development than if it occurs in the mature adult. Experimental data confirm that
      treatment of the developing embryo or fetus with carcinogenic and mutagenic
      agents increases the cancer incidence in these animals and the frequency of
      mutations in the offspring of the animals that were exposed in utero. The
      available data are conclusive that the developing organism is at risk from
      exposure to mutagenic and carcinogenic agents. However, the data are insufficient
      to estimate the level of risk associated with exposures in utero, relative to
      either the background (spontaneous) level of risk or risk associated with similar
      exposures to the adult organism.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789360
TI  - Mitochondrial mutations and human disease.
AB  - The mitochondrial genome is essential for producing ATP (adenosine 5'
      triphosphate) via oxidative phosphorylation. The gradual decline of mitochondrial
      function with age has long been postulated as a factor in aging. More recently, a
      variety of diseases have been related to molecular defects in human mitochondrial
      DNA. In both the cases of aging and disease, symptoms were generally
      neuromuscular, reflecting the tissues most dependent upon mitochondrial function.
      Also, in both cases novel features of mitochondrial genetics led to complex
      relations between genotype and phenotype. Little information is yet available
      about the role of environmental agents in these interactions.

PMID- 7789361
TI  - Etiology of nondisjunction in humans.
AB  - Aneuploidy is the most common class of chromosome abnormality in humans,
      occurring in at least 0.3% of newborns and approximately 50% of spontaneous
      abortions. Considered as a class, it is the most common known cause of mental
      retardation and the leading cause of pregnancy loss. Despite the high frequency
      of aneuploidy, its obvious clinical importance, its severe impact on human
      reproduction, and the 35 years of research since the first human chromosome
      abnormality was described, we still know very little about its causes, let alone
      the contribution of environmental exposures. Recently, however, with the advent
      of molecular and molecular cytogenetic techniques and advances in reproductive
      biology, a body of evidence has been generated that is beginning to shed light on
      the incidence, origin, and etiology of human aneuploid conditions. The bulk of
      this evidence comes from two sources: 1) studies of the incidence of aneuploidy
      in the cells of origin, namely oocytes and sperm; and 2) examinations of meiotic
      stage, parent of origin, and meiotic recombination in trisomic conceptuses, both
      liveborn and abortuses. Using a multicolor fluorescence in situ hybridization
      (FISH) approach, it is now possible to screen on extremely large number of human
      sperm to determine chromosome-specific rates of disomy. Likewise, because of the
      introduction in the past decade of in vitro fertilization technology, a
      population of human oocytes suitable for aneuploidy screening became available.
      The examination of the cells of origin of aneuploidy, the sperm and oocytes, has
      provided data on the incidence of chromosome aberrations and valuable insight
      into possible mechanisms of nondisjunction. Additionally, the recent
      identification of multiple, highly informative DNA polymorphisms on all human
      chromosomes has made the determination of parental origin and the analysis of
      recombination a straightforward matter. We now know that the vast majority of
      trisomic conceptuses are maternal in origin, that increased maternal age is
      associated with nondisjunction, and that the amount and position of recombination
      on nondisjoined chromosomes is altered. In this review we will restrict
      discussions to these recent developments and to new models of the mechanism(s) of
      human nondisjunction based on the molecular cytogenetic analyses. Additionally,
      we will discuss the direction of future epidemiological research made possible
      through the development of molecular and molecular cytogenetic techniques. These
      technological advances have now allowed for a systematic search for genetic and
      environmental components to human nondisjunction.

PMID- 7789362
TI  - Biological basis of germline mutation: comparisons of spontaneous germline
      mutation rates among drosophila, mouse, and human.
AB  - Spontaneous mutation rates per generation are similar among the three species
      considered here--Drosophila, mouse, and human--and are not related to time, as is
      often assumed. Spontaneous germline mutation rates per generation averaged among
      loci are less variable among species than they are among loci and tests and
      between gender. Mutation rates are highly variable over time in diverse lineages.
      Recent estimates of the number of germ cell divisions per generation are: for
      humans, 401 (30-year generation) in males and 31 in females; for mice, 62 (9
      month generation) in males and 25 in females; and for Drosophila melanogaster,
      35.5 (18-day generation) in males and 36.5 (25-day generation) in females. The
      relationships between germ cell division estimates of the two sexes in the three
      species closely reflect those between mutation rates in the sexes, although
      mutation rates per cell division vary among species. Whereas the overall rate per
      generation is constant among species, this consistency must be achieved by
      diverse mechanisms. Modifiers of mutation rates, on which selection might act,
      include germline characteristics that contribute disproportionately to the total
      mutation rates. The germline mutation rates between the sexes within a species
      are largely influenced by germ cell divisions per generation. Also, a large
      portion of the total mutations occur during the interval between the beginning of
      meiosis and differentiation of the soma from the germline. Significant genetic
      events contributing to mutations during this time may include meiosis, lack of
      DNA repair in sperm cells, methylation of CpG dinucleotides in mammalian sperm
      and early embryo, gonomeric fertilization, and rapid cleavage divisions.

PMID- 7789363
TI  - Population genetics of induced mutations.
AB  - The contribution of induced mutations to the burden of genetic disease in the
      context of population genetics is considered. A clear distinction is made between
      the effects of genetic disease and mutational events. Much of the existing burden
      of genetic disease is a consequence of mutations that occurred in the past. The
      problem of distinguishing between spontaneous and induced mutations is discussed.
      Molecular genetics techniques are blurring the definitions of these terms.
      Classical population genetics shows that the frequency of affected individuals
      will reach an equilibrium depending on the mutation rate and the selective
      pressure against affected individuals. Increasing the mutation rate or reducing
      the selective pressures would result in a new equilibrium with an increase in the
      frequency in subsequent generations of affected individuals with dominant and X
      linked mutant alleles. The increase in the number of recessive mutant alleles
      would be much slower and take many generations to reach the new equilibrium
      level. One assumption behind such equilibria is random mating. Changes in human
      demography with a rapid increase in population size, the breakup of small,
      relatively inbred subpopulations, and relaxed selective pressures will lead to a
      new equilibrium for recessive genes at probably higher frequencies. These factors
      will be the major contributors to increasing the burden of recessive genetic
      disease by increasing the total numbers of cases. The proportion of the
      population with a genetic disease will also continue to grow as a greater
      proportion of the population survives to late middle age and succumbs to diseases
      associated with old age, such as cancer, circulatory disease, dementias, and
      diabetes, each of which is likely to have a genetic component.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7789364
TI  - The new human genetics.
AB  - This overview for the special issue of Environmental and Molecular Mutagenesis
      devoted to recent advances in human genetics relevant to mutagenesis briefly
      surveys the advances in the field. We present the evidence that trinucleotide
      repeat expansion can cause anticipation in human inherited disease. The finding
      that transposons are active in humans, as they are in other organisms, is
      reviewed. We present an example of two different diseases being caused by
      mutations in one gene. The role of mitochondrial mutations and parent-specific
      gene origin effects ("imprinting") are briefly reviewed; fuller reviews are
      provided in other articles in this special issue. Finally, the relevance of
      epigenetic inheritance by protein-protein interaction is included.

PMID- 7789365
TI  - Lessons learned from epidemiologic studies of environmental exposure and genetic
      disease.
AB  - The induction of germ cell mutations with ionizing radiation and chemicals has
      been clearly demonstrated in experimental animal test systems. Less is known
      about the effects of environmental and other exposures on human germ cells.
      Epidemiologic studies of atomic bomb and childhood cancer survivors and their
      offspring have generally not indicated an excess risk for a variety of adverse
      reproductive outcomes and childhood diseases, including those due to germ cell
      mutations. Other epidemiologic studies, including the investigation of cancer
      among the offspring of fathers employed at the Sellafield nuclear facility in
      Great Britain and studies of paternal occupation and birth defects, have found
      associations. This paper reviews these studies and the methodologic problems
      inherent in the epidemiologic approach to evaluating environmentally induced germ
      cell mutagenesis in humans. Epidemiologic studies incorporating newly developed
      techniques for the detection of mutations and abnormalities in sperm may provide
      the sensitivity needed to determine precisely the magnitude of risk.

PMID- 7789366
TI  - Mutagenesis and human genetic disease: dominant mutation frequencies and a
      characterization of mutational events in mice and humans.
AB  - Dominant deleterious traits are generally regarded to be the most relevant
      genetic endpoints when the expected increased mutational load of genetic diseases
      associated with exposure to mutagenic agents is considered in humans. At present,
      human risk estimation procedures rely on results from laboratory mammal germ-cell
      mutagenicity experiments as well as on data from human epidemiology and medical
      genetics. A comparison of the mouse and human data indicates that a small subset
      of loci, which when mutated result in a dominant phenotype, is contributing
      disproportionately to the observed mutation frequency. This is likely due to the
      fact that those loci with an observed high mutation frequency are inherently
      unstable, the function of such loci is critical, and/or the wild-type phenotype
      requires two copies of the normal gene (haploinsufficiency). The locus
      specificity of the observed spontaneous and induced mutation frequencies implies
      that efforts must be made to closely match those genetic endpoints screened in
      the mouse with the human genetic endpoints considered relevant in estimating the
      genetic risk after exposure to mutagenic agents. The contributions to our
      understanding of the organization, function, and stability of the mouse and human
      genomes provided by molecular biological techniques should make compliance with
      this restriction feasible.

PMID- 7789367
TI  - Perspectives on molecular assays for measuring mutation in humans and rodents.
AB  - The original idea for this article was to examine the new molecular techniques
      for detection of mutation directly at the DNA level in exposed individuals or
      their offspring and to assess their relative advantages and disadvantages for
      mutation monitoring in humans and rodents. However, an examination of the
      articles and a comparison of the technology indicated that our constant quests
      for methods improvement were leading to some loss of insight into the important
      health-related questions that should be guiding these endeavors. As a result,
      individual methods are not covered here in great technical detail. Instead, a few
      molecular methods are presented in a general overview, along with some of the
      biological issues related to the detection of induced mutations within
      individuals and populations. Some hypothetical scenarios are also presented
      because molecular approaches will continue to change rapidly, and we must
      continually adjust our thinking to combine the useful attributes of each current
      and future technical approach with the most appropriate biological questions.

PMID- 7789368
TI  - The Marlboro man is still marching.

PMID- 7789370
TI  - Chaos in the prediction of sudden death.

PMID- 7789369
TI  - Ambulatory ischaemia.

PMID- 7789371
TI  - Atrial fibrillation and anticoagulant therapy.

PMID- 7789372
TI  - Acute myocardial infarction in the young--the role of smoking. The Investigators
      of the International Tissue Plasminogen Activator/Streptokinase Mortality Trial.
AB  - Patients who received thrombolytic therapy for acute myocardial infarction in a
      large international trial were divided into two groups on the basis of age; those
      < or = 40 years (n = 269) and those > 40 years (n = 7787). The younger group
      included more men (89.9% vs 75.9%, P = 0.009) and fewer patients had a history of
      coronary artery disease, hypertension, and diabetes mellitus. A family history of
      cardiovascular disease was significantly more prevalent among the young patients
      (53.4% vs 41.9%, P = 0.0002). Significantly more younger patients than older
      patients were smokers at the time of infarction (76.2% vs 42.9%, P < 0.0001) and
      the average number of cigarettes smoked per day was also significantly higher in
      young patients (27.8 +/- 14.3 vs 19.9 +/- 12.9, P < 0.01). Younger patients had a
      better outcome, with lower rates of cardiogenic shock (1.1% vs 7.0%, P = 0.0002),
      stroke (0.0% vs 1.9%, P = 0.02) and haemorrhage (1.9% vs 5.9%, P = 0.006), as
      well as a better Killip class at discharge (Killip > 1 in 4.5% vs 8.0%, P <
      0.001), and lower hospital and 6-month mortality (0.7% and 3.1% vs 8.3% and 12%,
      P < 0.001, respectively). The better outcome of younger patients with acute
      myocardial infarction is related to their better baseline characteristics. Young
      patients with acute myocardial infarction have a strong family history of
      cardiovascular disease and a high prevalence of smoking. Smoking is the most
      important modifiable risk factor in these patients.

PMID- 7789373
TI  - Detection of ambulatory ischaemia is not of practical clinical value in the
      routine management of patients with stable angina. A long-term follow-up study.
AB  - It has been reported that medically treated patients with stable angina and
      positive exercise test for ischaemia have an adverse 1-2 year outlook if they are
      shown also to have transient, and predominantly silent, ischaemic episodes
      detected by ambulatory ST segment monitoring during their daily activities: it
      has been suggested that this investigation could be used to identify patients
      more likely to benefit from early investigation and treatment. We assessed the
      long-term (up to 65 months) prognostic significance of transient ischaemic
      episodes during daily activities in 172 patients routinely attending cardiac
      outpatients with medically treated stable angina who had undergone exercise
      testing and 48 h of ambulatory ST segment monitoring between February 1988 and
      August 1989 for this purpose. A positive exercise test for ischaemia was not a
      prerequisite for inclusion. One hundred and four patients (60.5%) had a positive
      exercise test for ischaemia and 72 (42%) had transient ischaemia during daily
      activities (63 had both tests positive). Over a median 50-month follow-up period
      54 patients suffered at least one cardiac event (primary event: cardiac death n =
      7; non-fatal myocardial infarction n = 11; unstable angina n = 18; elective
      CABG/PTCA n = 18). Two further patients suffered non-cardiac death. Cardiac
      events, either objective (cardiac death or non-fatal myocardial infarction) or
      subjective (unstable angina or revascularisation) were no more likely to occur in
      those with transient ischaemia during daily life when compared with those
      without, at follow-up times up to 65 months.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789374
TI  - Pre-hospital triage of patients with suspected myocardial infarction. Evaluation
      of previously developed algorithms and new proposals.
AB  - OBJECTIVE: To evaluate previously developed algorithms for the improvement of pre
      hospital triage of patients with suspected acute cardiac disease. DESIGN:
      Prospective study. SUBJECTS: Patients with symptoms of possible cardiac origin,
      who were seen by a general practitioner and subsequently referred to hospital in
      the municipality of Rotterdam. METHODS: Prior to hospital admission, patients
      with suspected acute coronary disease recorded their symptoms by standardized
      questionnaire and a computerized ECG was made. All patients were hospitalized and
      a final diagnosis was established. Algorithms proposed by other investigators to
      distinguish patients with, from those without, acute cardiac disease were tested.
      MAIN OUTCOME: Identification of patients whose likelihood for acute cardiac
      pathology was low (stable angina, atypical chest pain, other pathology) or high
      (myocardial infarction, unstable angina). RESULTS: A total of 1005 patients were
      studied. Forty-two percent had myocardial infarction or unstable angina pectoris.
      Evaluation of previously developed algorithms showed that their diagnostic
      accuracy was poor in the pre-hospital setting. In a separate multivariate
      analysis, six characteristics from the clinical history and an electrocardiogram
      appeared to be independently and significantly associated with acute cardiac
      pathology. The presence of an abnormal ECG proved to be the most important
      predictor. CONCLUSIONS: The hospital-based algorithms were unsuitable as a
      predictor for pre-hospital acute cardiac pathology. A new practical hospital
      admission model was developed, based on six clinical predictors, including
      analysis of an electrocardiogram. Following appropriate validation, this out-of
      hospital protocol may lead to better triage decisions by the general
      practitioner.

PMID- 7789375
TI  - Outcome after thrombolytic therapy of nine cases of myopericarditis misdiagnosed
      as myocardial infarction.
AB  - Anecdotal reports have suggested that cardiovascular complications may occur if
      thrombolytic therapy is performed in cases of pericarditis misdiagnosed as acute
      myocardial infarction. From 1980 to 1993, 47 cases of myopericarditis mimicking
      myocardial infarction have been admitted to our institution. The misdiagnosis was
      made because of clinical onset characterized by a typical chest pain, and/or
      localized ST segment elevation. Since 1987, nine (9/9 males, age 40 +/- 14 years)
      out of the 47 patients (19%) have been treated with a thrombolytic agent
      (streptokinase 4/9, rt-PA 5/9) followed by intravenous heparin. This treatment
      was started during the pre-hospital phase (2/9) and while in hospital (7/9). No
      pericardial rub was present; ST segment elevation was mainly localized in
      inferior and lateral leads; no Q wave developed; median creatine kinase rise was
      268 units (range 38 to 1280), and only one patient had a small pericardial
      effusion. The mean level of fibrinogen after thrombolysis was 1.72 g.l-1 (range
      0.10 to 4.50). In all cases, typical ECG changes were present suggesting
      pericarditis with a subsequent return to a normal ECG. No severe cardiac or
      pericardial complication or arrhythmia occurred; only one patient developed a non
      compressive and resolvable pericardial effusion. Cardiac catheterizations
      (coronary and left ventricular angiographies) were normal when performed (5/9).
      Long-term follow-up (mean 46 +/- 29 months) was favourable without any coronary
      events. In conclusion, thrombolytic therapy was uncomplicated in our patients
      with myopericarditis simulating evolving myocardial infarction.

PMID- 7789376
TI  - Continuous monitoring of energy metabolites using microdialysis during myocardial
      ischaemia in the pig.
AB  - A diagonal branch of the left anterior descending artery was occluded for 80 min.
      One microdialysis probe was inserted in the ischaemic area and two in the non
      ischaemic areas. In six animals radiolabelled microspheres were injected before
      and during ischaemia and after reperfusion to monitor flow. Arterial and
      pulmonary artery pressures, pulmonary capillary wedge pressure and cardiac output
      were followed-up. Radiolabelled microsphere distribution confirmed the reduction
      of myocardial blood flow during coronary artery occlusion, with flow returning to
      normal values upon reperfusion. Rate pressure product as an index of heart work
      was stable throughout the 80 min ischaemic period, but increased at reperfusion.
      Dialysates from non-ischaemic tissue showed stable baseline values. In ischaemic
      tissue, lactate increased by 300% and pyruvate levels decreased by 50% within 15
      min. Adenosine increased rapidly five-fold, but started to decline after 15 min
      of ischaemia. Inosine showed a slower but a marked 20-fold increase, decreasing
      at the end of the ischaemic period. Hypoxanthine increased five-fold during the
      first 30 min. Finally, guanosine showed a slow increase to about four times above
      basic values. Microdialysis was an excellent tool for the continuous monitoring
      of myocardial metabolites during ischaemia. Adenosine appeared to be a more
      sensitive marker of early ischaemia than lactate, although interestingly,
      adenosine levels had decreased already after 15 min, most probably due to
      intracellular accumulation of protons and Pi.

PMID- 7789377
TI  - Medical treatment of myocardial infarction in France and Northern Ireland.
      Results from the ECTIM study. Enquete cas-Temoins de l'Infarctus du Myocarde.
AB  - As part of the ECTIM Study, the medical treatment given to male patients (25-64
      years) 3 to 9 months after myocardial infarction (MI) were analysed in France and
      Northern Ireland. On univariate analysis, hypolipidaemic drugs, angiotensin
      converting enzyme inhibitors and antiarrhythmic drugs were found to be prescribed
      more frequently in France, while beta-blockers were more common in Northern
      Ireland. No differences were found for diuretics, calcium channel blockers,
      antithrombotic and anti-anginal drugs, although the Northern Irish patients were
      mainly on antiplatelet drugs and nitrates, while the French patients received
      nitrates and non-nitrates, as well as oral anticoagulants and antiplatelet drugs
      in similar amounts. These differences remained after adjustment for personal
      history of diabetes, hyperlipidaemia, hypertension, and previous myocardial
      infarction, but the beta-blocker prescription was no longer significant. When the
      French centres were analysed, patients from Strasbourg were more frequently on
      oral anticoagulants and diuretics and less frequently on antiplatelet drugs,
      while patients from Toulouse had fewer anti-anginal drugs. Hence, although the
      current guidelines for secondary prevention of myocardial infarction are
      generally well applied in France and Northern Ireland, significant differences
      exist regarding the choice of the active drug.

PMID- 7789378
TI  - Exercise producing alterations in the signal-averaged electrocardiogram in
      patients after myocardial infarction.
AB  - Late potentials are considered to be a marker for regional slow conduction which
      might predispose to reentrant ventricular arrhythmias. Since these arrhythmias
      may be induced by ischaemia it may be speculated that exercise-induced myocardial
      ischaemia may trigger late potentials. Exercise testing was performed in 53
      patients early after myocardial infarction and in 20 healthy controls. Typical 12
      lead ECG and signal averaged ECG (SA-ECG) from 12 leads were recorded before and
      after exercise testing. Changes in filtered QRS (QRS) and low amplitude signal
      durations, and in the root mean square voltage of the last 40 ms of the QRS
      complex (RMS40) were analysed. Thirty patients developed ST changes, consistent
      with transient ischaemia, that persisted during the SA-ECG recording after
      exercise. There were significant differences between baseline SA-ECG and SA-ECG
      after exercise in patients with positive exercise tests (QRS, 102 +/- 15 ms vs
      114 +/- 15 ms (P < 0.01). LAS, 36 +/- 12 ms vs 42 +/- 11 ms (P < 0.05), and
      RMS40, 29 +/- 14 microV vs 20 +/- 13 microV (P < 0.01). No differences were
      observed in SA-ECG parameters in either patients with negative exercise tests or
      in controls. During follow-up, four patients died suddenly; all four had positive
      exercise tests and in three of them late potentials were induced by exercise. We
      conclude, that in post-infarction patients with positive exercise tests SA-ECG
      parameters deteriorate after exercise. This suggests that exercise-induced
      ischaemia triggers development of late potentials.

PMID- 7789379
TI  - Heart rate variability and functional severity of congestive heart failure
      secondary to coronary artery disease.
AB  - To investigate the behaviour of heart rate variability (HRV) with the advancing
      severity of heart failure (CHF) we studied 20 normal subjects and 80 coronary
      artery disease (CAD) patients in sinus rhythm. CAD patients were selected
      consecutively in order to form four equal groups of 20 subjects with different
      degrees of CHF according to the New York Heart Association (NYHA) functional
      classification. In each subject a 24 h ECG Holter tape was recorded and
      subsequently analysed to obtain measures of heart rate and HRV. We used several
      measures of HR and both spectral and non-spectral measures of HRV. Among these we
      employed the width of the R-R interval distribution over 24 h at three different
      heights (TV, 10%Var, 50%Var). The CAD group showed significantly lower HRV counts
      and smaller spectral components than controls. However, these differences were
      due to the presence of CHF rather than to CAD. Indeed, a progressive and
      significant increase in heart rate and a contemporary decrease in HRV was
      observed with the advancing severity of CHF. Class IV patients had the smallest
      HR variation; the spectral composition in this group was barely detectable. The
      decrease in time domain measures of HRV followed the increase in NYHA Class in a
      progressive and regular pattern, while the low frequency and high frequency
      spectral power showed the largest reduction from NYHA Class I to NYHA Class II
      patients. No significant change was demonstrated in NYHA Class I patients as
      compared to Controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789381
TI  - Clinical implications of pleomorphic ventricular tachycardias on oral sotalol
      therapy.
AB  - In 90 consecutive patients with coronary artery disease and sustained monomorphic
      ventricular tachycardia, who were treated with oral sotalol and underwent
      programmed stimulation to determine drug effectiveness, the influence of sotalol
      on induced ventricular tachycardia morphology was retrospectively examined. In 54
      patients (60%) sotalol rendered the tachycardia non-inducible. However, contrary
      to drug-testing with class I antiarrhythmic agents, induction of multiple
      morphologies at baseline study did not predict failure of subsequent drug-testing
      with sotalol. In the remaining 36 patients (40%), in whom sotalol did not modify
      inducibility, 21 patients (i.e. a total of 23%) manifested at least one new
      morphology during electropharmacological testing on sotalol. This effect was
      independent of the degree of left ventricular dysfunction, infarct location and
      numbers of morphologies at baseline, but corresponded with drug-induced changes
      in refractoriness. This observation may be related to a proarrhythmic effect of
      sotalol. Slowing of ventricular tachycardia rate and changes in morphology may
      have implications in patients receiving implantable cardioverter-defibrillators
      or those undergoing ablative procedures.

PMID- 7789380
TI  - Sudden cardiac death in hypertrophic cardiomyopathy. Variability in phenotypic
      expression of beta-myosin heavy chain mutations.
AB  - BACKGROUND: Recent identification of mutations in the beta-myosin heavy chain
      gene (MYH7), a major responsible gene for HCM, has provided the opportunity to
      characterize genotype-phenotype correlation in HCM families. In this study we
      analysed the phenotypic expression of two beta-myosin heavy chain (beta MHC)
      mutations in three unrelated HCM families. METHODS: Living individuals from three
      unrelated HCM families (Families 1, 2, and 3) were screened by history, physical
      examination, electrocardiography, and two-dimensional echocardiography. Blood was
      collected from all individuals for DNA extraction. Polymerase chain reaction
      (PCR), restriction endonuclease digestion and chemical cleavage were utilized for
      detection of mutations. All mutations were confirmed by sequence analysis.
      RESULTS: Identification of mutations: A missense mutation in exon 13 of the beta
      MHC gene (Arg403 Gln) was detected in HCM patients from Families 1 and 2. PCR
      amplification of the exon 13 DNA, followed by Ddel digestion of the PCR product
      and gel electrophoresis, showed two fragments of 84 and 70 bp in normal
      individuals and four fragments of 84, 70, 52 and 32 bp in HCM patients. Sequence
      analysis showed substitution of an adenine for guanine at coding position 1208.
      In Family 3, a missense mutation in exon 16 of the beta MHC gene (Val606 Met) was
      detected in HCM patients. Chemical cleavage of the PCR products showed an
      uncleaved product of 337 bp in the normal individuals, while in the affected
      individuals, in addition to the uncleaved product, a 90 bp cleaved product was
      also detected, indicating the presence of a mismatch in one allele. Sequence
      analysis showed substitution of an adenine for guanine in coding position 1817.
      CLINICAL CHARACTERISTICS: Seven members of Family 1 had HCM, of whom five are
      alive. One patient died from sudden cardiac death (SCD) and another from
      recurrent cerebral emboli. In Family 2, 15 individuals had HCM of whom nine have
      died, seven from SCD. The mean age at the time of SCD was 33 years. The third
      family is comprised of 11 affected individuals and one obligate carrier, of whom
      one patient died at age 17 from progressive heart failure. Two additional
      individuals in this family have also succumbed to SCD to age 60. A variety of
      clinical and echocardiographic manifestations of HCM were present in each family.
      Logrank test of Kaplan-Meier survival curves indicates that Arg403 Gln mutation
      was associated with a poor prognosis in HCM families as compared to Val606 Met (P
      = 0.034). CONCLUSIONS: beta MHC mutations despite showing variable clinical and
      echocardiographic manifestations of HCM are predictors of survival in HCM
      families.

PMID- 7789382
TI  - Velocity distributions in the left ventricular outflow tract in patients with
      valvular aortic stenosis. Effect on the measurement of aortic valve area by using
      the continuity equation.
AB  - The cross-sectional velocity distribution in the left ventricular outflow tract
      was studied in 40 patients with valvular aortic stenosis. Doppler colour flow
      mapping and a time-interpolation method were used to construct the cross
      sectional velocity and time-velocity integral (TVI) profiles at different levels.
      By using pulsed Doppler, the subaortic flow velocity was sampled from the
      anterior, middle and posterior regions along the diameter of the left ventricular
      outflow tract (at 0.5 to 1.0 cm proximal to the aortic anulus) in the apical long
      axis view. Thus, for each patient, three aortic valve areas were calculated by
      using the continuity equation. Each patient was assigned to one of three
      subgroups according to the left ventricular ejection fraction (EF): subgroup I
      with EF < or = 25% (n = 10), subgroup II with 25% < EF < or = 50% (n = 17) and
      subgroup III with EF > 50% (n = 13). Velocity distributions in the three
      subgroups were compared to each other. RESULTS: (1) The velocity distribution in
      the left ventricular outflow tract was skewed with the highest velocities and
      TVIs along the anterior wall and septum. The skewness of the velocity
      distribution was more pronounced in the apical long axis view than in the four
      chamber view (P < 0.05). The extent of skewness of the TVI profile was positively
      correlated to the left ventricular EF both in the long axis view (r = 0.63; P <
      0.001) and in the four chamber view (r = 0.57; P < 0.001). (2) Pulsed Doppler
      sampling from different regions along the diameter produced different TVIs, and
      therefore yielded significantly different calculated aortic valve areas,
      especially in subgroup III. Due to the skewness of the velocity distribution in
      the left ventricular outflow tract, location of the pulsed Doppler sample volume
      significantly affects the accuracy of aortic valve area calculation by using the
      continuity equation, especially in patients with relatively high left ventricular
      EF. In patients with low EF, selection of pulsed Doppler sampling site is less
      important.

PMID- 7789383
TI  - Characteristics of infective endocarditis in France in 1991. A 1-year survey.
AB  - OBJECTIVE: To update data on incidence and characteristics of infective
      endocarditis in France. BACKGROUND: Numerous studies have shown that the
      incidence and course of infective endocarditis remain stable in spite of advances
      in treatment and of prophylactic recommendations. METHODS: A survey of all
      consecutive cases of infective endocarditis was conducted over 12 months in all
      the institutions of three French regions. RESULTS: Data were collected from 415
      cases of definite (32%), probable (53%), and possible (15%) infective
      endocarditis. The adjusted annual incidence was 24.3 cases per million
      inhabitants. Thirty-four percent of the patients had no previously known heart
      disease, 33% had native valve disease, 22% had a prosthetic valve, and 11% had
      miscellaneous underlying conditions. Infective endocarditis was located solely on
      the mitral valve in 39%, solely on the aortic valve in 36%, and on the tricuspid
      valve in 6%. Echocardiography showed a vegetation on the mitral valve in 39%, on
      the aortic valve in 29%, and on the tricuspid valve in 8%. The causal
      microorganism was identified in 92%; it was a Streptococcus in 58%, and a
      Staphylococcus in 23%. Twenty patients were intravenous drug users, and 45 had
      had a medical or a surgical procedure, which might be associated with the
      occurrence of infective endocarditis. During the first 2 months after admission,
      24% of the patients underwent surgery, and 17% of all patients died. CONCLUSIONS:
      Despite medical and surgical advances, infective endocarditis remains frequent
      and severe in France.

PMID- 7789384
TI  - Transoesophageal echocardiographic follow-up of patients with surgically treated
      aortic aneurysms.
AB  - In the present study, biplane transoesophageal echocardiography (TEE) was
      scheduled as part of an aneurysm surveillance programme during routine ambulatory
      follow-up of 37 patients following aortic aneurysm surgery. Time from surgery
      ranged from 3-72 months. Twenty-two patients had had aortic dissection and 15 non
      dissecting aneurysms. Nineteen patients received an interposition graft of the
      ascending aorta, 12 valved conduit and six an interposition graft of the
      descending thoracic aorta. TEE showed enlargement of the sinus of Valsalva > 45
      mm in seven patients. Dilatation > 45 mm of one or more aortic segments was found
      in four patients. An intimal flap was present in all patients, with primary
      aortic dissection if the initial dissection extended beyond the replaced segment.
      This was the case in 17 of 22 patients with aortic dissection. One to four
      intimal tears were identified in 15 of these patients. In all patients with
      intimal tears, flow was detected by colour flow Doppler in the false lumen.
      Thrombus formation was nil or minimal in the false lumen in 12 patients. TEE
      significantly influenced further management in 14 of 37 patients (38%). More
      frequent follow-up was scheduled in eight patients. Aortic surgery was performed
      electively for the second or third time in six patients based on TEE findings. We
      conclude that after surgical repair of aortic aneurysm, the incidence of
      pathological findings by TEE is high. These may have significant influence on
      further patient management and emphasize the need for careful follow-up.

PMID- 7789385
TI  - Assessment of aortic regurgitation severity by magnetic resonance imaging of the
      thoracic aorta.
AB  - A new method of assessing the severity of aortic regurgitation severity by
      magnetic resonance imaging has been developed. Two groups were studied: 20
      controls (age = 58 +/- 19 years) without valvular aortic disease, and 24 patients
      (age = 62 +/- 13 years) with chronic aortic insufficiency evaluated by magnetic
      resonance and aortic root cineangiography within 1 week of each other. A magnetic
      resonance sequence (TR = 35 ms/TE = 12 ms/flip angle = 20 degrees/magnet = 1.5 T)
      was acquired in a plane containing the thoracic aorta. A transverse saturation
      band 30 mm wide was positioned 30-40 mm above the aortic valve. Aortic
      insufficiency was graded; the importance of end-diastolic retrograde movement in
      the saturation band in the descending aorta was noted. Magnetic resonance was
      also compared to Doppler echocardiography in 20 patients. In the controls, we
      found that retrograde blood flow was absent (18/20) or mild (2/20). In contrast,
      the presence of marked retrograde movement in a saturation band across the
      thoracic aorta was always associated with severe aortic regurgitation
      (angiographic grade III or IV). This rapid method (imaging time less than 20 min)
      can be applied in most patients with aortic regurgitation and is likely to be
      helpful when echocardiography is not possible or gives inconclusive results.

PMID- 7789386
TI  - Clinical value of immediate thallium-201 reinjection imaging for the detection of
      ischaemic heart disease.
AB  - Immediate reinjection of thallium-201 after acquisition of the stress images
      followed by imaging 60 min later has been proposed as a novel time-saving and
      patient-convenient approach for the evaluation of myocardial ischaemia and
      viability. The objective of this study was to establish the clinical value of
      thallium-201 stress immediate reinjection imaging in the evaluation of patients
      with suspected and known coronary artery disease. Quantitative planar thallium
      201 stress immediate reinjection imaging was performed in 138 patients with
      undiagnosed chest pain, of whom 114 underwent cardiac catheterization and 24 had
      a < 5% likelihood for coronary artery disease; 56 patients had previously
      suffered a myocardial infarction. Sensitivities and accuracies were determined
      for coronary artery disease, reversible myocardial ischaemia, and myocardial
      viability. Of the 138 patients studied for coronary artery disease, thallium
      stress scintigraphy identified 85 of 93 patients with angiographically proven
      coronary artery lesions (overall sensitivity 91%). The normalcy rate in the low
      likelihood patients was 88% (21 of 24 patients) and the overall diagnostic
      accuracy was 83%. In the 56 patients who had suffered a previous myocardial
      infarction, and in whom the suitability for reversible ischaemia was sought, the
      overall patient-related sensitivity and accuracy were 93% and 92% respectively.
      In the 56 patients with a previous myocardial infarction a total of 168 vessel
      regions were studied to detect viability. Of the 142 normal or hypokinetic
      regions, 127 regions were scintigraphically identified as viable (sensitivity
      89%). The thallium stress immediate reinjection imaging protocol is an
      appropriate clinical approach in patients with undiagnosed chest pain. The
      combined identification of stress-induced ischaemia and viability by thallium
      stress immediate reinjection imaging provides adequate algorithms allowing
      optimal management and risk assessment in the individual cardiac patient.

PMID- 7789387
TI  - Cyanosis and clubbing in a patient with iatrogenic Lutembacher syndrome.
AB  - A patient with rheumatic mitral and aortic stenosis is described in whom balloon
      dilatation of the mitral valve was complicated by an iatrogenic atrial septal
      defect with a small left to right shunt. Over the course of 4 years, the patient
      became progressively cyanosed and clubbed and was found to have reversed the
      shunt across the atrial septal defect due to the occurrence of severe tricuspid
      stenosis. The tricuspid valve was successfully dilated with re-establishment of a
      net left to right shunt. This syndrome, the first of its kind, should be
      appropriately termed the reversed Lutembacher syndrome.

PMID- 7789389
TI  - Tuberculous cardiac tamponade and AIDS.
AB  - Tuberculosis, usually extrapulmonary, is often associated with AIDS but
      tuberculous pericarditis is a rare manifestation in this group. We report three
      patients with tuberculous pericarditis as the first manifestation of AIDS.

PMID- 7789388
TI  - Multiplane transoesophageal echocardiography detection of a papillary
      fibroelastoma of the aortic valve causing myocardial infarction.
AB  - Primary aortic valve tumours are rare. A patient is reported with a papillary
      fibroelastoma attached to the edge of the right coronary aortic cusp. This tumour
      was diagnosed by multiplane transoesophageal echocardiography after the patient
      experienced an acute inferolateral myocardial infarction. Multiplane
      transoesophageal echocardiography was useful to visualize and identify the
      precise point of attachment of the tumour, enabling cardiac surgeons to plan
      aortic valve repair rather than replacement.

PMID- 7789390
TI  - Nuclear medicine in cardiology: a position paper for an open debate. EANM
      Executive Committee.

PMID- 7789391
TI  - Quantitative assessment of technetium-99m methoxyisobutylisonitrile planar
      perfusion heart studies: application of multivariate analysis to patient
      classification.
AB  - A quantified evaluation of planar cardiac perfusion scintigrams (the objective of
      the study), obtained using technetium-99m methoxyisobutylisonitrile (MIBI) was
      performed on the basis of an analysis of circumferential profile curves,
      representing the perfusion as seen in three typical projections. The analysis
      involved the curves obtained both at rest and after stress, and was based on a
      comparison of their shape (trend) with the normal trend (normative evaluation).
      The latter was obtained by means of an original method of iterative fitting of
      individual curves into the database. The base consisted of curves recorded in 53
      patients (separately in males and females) with normal perfusion of the left
      ventricle (group I, the reference group). A group of 90 patients suspected of
      having coronary artery disease (group II) was subdivided into two subgroups on
      the basis of coronary arteriography: (a) those with and (b) those without
      critical stenosis of at least one artery. Profile curves characterising the LV
      perfusion were obtained at rest and after stress. Defects of perfusion were
      quantified by comparison of individual curves with the normal trends. By means of
      multivariate analysis it was demonstrated that vectors of mean values
      characterising the scintigraphically assessed defects of LV perfusion in the two
      subgroups of group II differed very significantly (P < 10(-5)). Applying methods
      of discriminant analysis, a classification of patients from group II was
      performed into those with probable defects of perfusion and those free of such
      defects. The sensitivity, specificity and accuracy of diagnosis of coronary
      ischaemia, based on quantified planar 99mTc-MIBI scintigraphy, reached 86%, 87%
      and 87%, respectively.

PMID- 7789392
TI  - Indium-111 octreotide scintigraphy in neurofibromatosis.
AB  - Scintigraphy with the radiolabelled somatostatin analogue indium-111-DTPA-D-Phe-1
      octreotide has recently been proposed for the imaging of CNS neoplasms expressing
      somatostatin receptors. While meningiomas are imaged with high sensitivity,
      neurinomas do not take up octreotide owing to the lack of somatostatin receptors.
      Neurofibromatosis is a relatively uncommon disorder in which meningiomas and
      neurinomas often occur in the same patient. Differential diagnosis between these
      two tumours by computed tomography and magnetic resonance imaging can be
      difficult. This study reports on 111In-octreotide scintigraphy in four patients
      with neurofibromatosis. 111In-octreotide scintigraphy was shown to be very
      helpful in the in vivo differential diagnosis: all four meningiomas showed
      intense tracer uptake, while all 15 neurinomas were negative (P < 0.001 by
      Fisher's exact test). It may be concluded that scintigraphy with 111In-octreotide
      is a useful diagnostic procedure in neurofibromatosis, complementing standard
      neuroradiological imaging procedures.

PMID- 7789393
TI  - Dissociation of indium from indium-111-labelled diethylene triamine penta-acetic
      acid conjugated non-specific polyclonal human immunoglobulin G in inflammatory
      foci.
AB  - Several investigators have reported retention of indium-111 in infectious foci
      after intravenous injection of 111In-labelled immunoglobulin G (IgG). With this
      study we intended to test the hypothesis that, upon administration of 111In
      diethylene triamine penta-acetic acid (DTPA-IgG), 111In is retained in the
      infectious foci after dissociation from IgG. Therefore we measured the tissue
      distribution of double-labelled 111In-DTPA-IgG-(carbon-14) in rats with a focal
      infection and compared the results with corresponding data for DTPA-IgG-(14C).
      DTPA-conjugated IgG was labelled with 111In via citrate transchelation. 111In
      DTPA-IgG and DTPA-IgG were labelled with 14C through methylation. High
      performance liquid chromatography (HPLC) and instant thin-layer chromatography
      analysis were performed to test the in vitro stability of the labelled proteins.
      Young Wistar rats with a Staphylococcus aureus infection of the left calf muscle
      were injected intravenously with 0.2 ml of a solution containing either 0.4 MBq
      111In and 30 kBq 14C or 30 kBq 14C labelled to 80 micrograms IgG. Groups of five
      rats were sacrificed at 2, 6, 24, and 48 h. p.i. Activity uptake was determined
      for plasma, urine, abscess, muscle and various other tissues. Averages and
      standard deviations were calculated for groups of five rats. HPLC analysis was
      performed on plasma and urine samples taken up to 48 h p.i. The radiochemical
      purity of the IgG preparations was > 95%. The labelled preparations appeared
      stable in vitro.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789394
TI  - Regional ventilatory evaluation using dynamic SPET imaging of xenon-133 washout
      in obstructive lung disease: an initial study.
AB  - Regional ventilatory abnormalities in obstructive lung disease were evaluated by
      dynamic single-photon emission tomography (SPET) of pulmonary washout of xenon
      133 (133Xe) gas. The subjects included seven healthy volunteers. 17 patients with
      obstructive lung disease, and seven patients with restrictive lung disease.
      Following 6 min of inhalation of 133Xe gas (60-72 MBq/l), equilibrium and
      subsequent washout SPET images during spontaneous breathing were sequentially
      acquired every 30 s for 6-7 min, using a triple-head SPET system with the return
      mode of continuous repetitive rotating acquisition. A gravity-induced gradient of
      ventilation was demonstrated in the volunteers' lungs. Compared with the normal
      subjects, all the patients with obstructive disease showed abnormal 133Xe
      retention on the washout SPET images, with or without abnormalities on chest X
      ray computed tomography, whereas the patients with restrictive disease did not
      show any significant delays in washout. This modality may assist in the
      evaluation of the three-dimensional dynamic process of ventilatory abnormalities
      in obstructive lung disease.

PMID- 7789395
TI  - Evaluation of results of the prostigmine-morphine test with quantitative
      hepatobiliary scintigraphy: a new method for the diagnosis of sphincter of Oddi
      dyskinesia.
AB  - Attempts have long been made to use the prostigmine-morphine provocation test for
      the selection of postcholecystectomy patients suffering from sphincter of Oddi
      (SO) dyskinesia. Since the whole procedure is based upon the evaluation of
      subjective complaints, this test has frequently been criticized. To improve the
      diagnostic value of this method, we have visualized SO spasms during prostigmine
      morphine provocation by means of quantitative hepatobiliary scintigraphy (QHBS).
      Twenty-two cholecystectomized patients with typical postprandial biliary pain
      were included in this study. In the first series of studies, QHBS with technetium
      99m 2,6-diethylphenylcarbamoylmethyl-diacetic acid was performed in each patient
      2 days before prostigmine-morphine provocation. The time to peak activity (Tmax)
      and the half-time of excretion (T1/2) over the liver parenchyma (LP), hepatic
      hilum (HH) and common bile duct (CBD), and the duodenum appearance time (DAT),
      were determined and served as control values. In the second series of
      experiments, sphincter spasms were evoked by prostigmine-morphine administration
      and visualized by means of QHBS. The same parameters were evaluated and serum
      levels of aspartate aminotransferase (AST) were determined simultaneously at
      regular intervals. In 12 patients who responded to prostigmine-morphine
      provocation with typical biliary pain and a significant AST elevation (Nardi
      positive group) the hepatobiliary scintigram demonstrated a marked biliary
      obstruction. Tmax and T1/2 over the LP, HH and CBD were significantly increased,
      while DAT was significantly longer relative to the corresponding data obtained
      without provocation. Four of the remaining ten patients indicated atypical
      abdominal pain during prostigmine-morphine provocation, but the AST level
      remained unchanged in all ten (Nardi negative group).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7789397
TI  - Reverse redistribution on planar thallium scintigraphy: relationship to resting
      thallium uptake and long-term outcome.
AB  - Reverse redistribution (RR) of thallium-201 has been associated with both acute
      and healed myocardial infarction, and with recent thrombolysis. The physiologic
      basis for RR in coronary artery disease (CAD) is unclear but may be related to an
      admixture of viable and scarred myocardium within the RR segment. We performed
      thallium reinjection imaging at rest to better characterize RR defects in
      patients with chronic CAD. We found enhanced uptake of 201Tl in 52% of RR
      segments after reinjection, consistent with significant regional viability that
      was not evident on redistribution images. We then used a logistic multiple
      regression analysis to determine whether RR alone or in combination with other
      scintigraphic findings could predict patient outcome. The results showed that
      severe RR was an independent predictor of patient outcome. We conclude that RR
      may have prognostic significance in chronic CAD.

PMID- 7789396
TI  - Preparation and biodistribution of yttrium-90 Lipiodol in rats following hepatic
      arterial injection.
AB  - In this study, we labelled Lipiodol with yttrium-90 and analysed the
      biodistribution in rats after intrahepatic arterial injection. An RP-18 column
      (E. Merck) was used to separate 90Y from strontium-90. 90Y was retained on the
      column, which had been pretreated with yttrium-selective extraction reagent, di(2
      ethylhexyl) phosphate, while 90Sr was washed out. A hexadentate nitrogen-donor
      chelating ligand N,N,N',N'-tetrakis(2-benzymidazolylmethyl)-1,2-ethanediamine
      (EDTB) was synthesized by condensation of 1,2-benzenediamine and ethylene diamine
      tetra-acetic acid (EDTA). Lipiodol was covalently conjugated with EDTB. The final
      product was obtained by eluting the retained 90Y from the RP-18 column with EDTB
      Lipiodol. Sixteen male rats (Sprague-Dawley) were sacrificed at 1 h, 24 h, 48 h
      and 72 h (four rats at each time) after injection of approximately 0.1 mCi 90Y
      Lipiodol via the hepatic artery. Samples of liver, spleen, muscle, lung, kidney,
      bone, whole blood and testis were obtained and counted to calculate the tissue
      concentrations. In addition, labelling efficiency and in vitro stability were
      determined by ITLC methods. We found that at 1 h after intrahepatic injection,
      most of the radiotracer was retained in the liver, but it was eliminated
      gradually over a few days. The radioactivity level in the lung was fair at 1 h
      and remained at roughly the same level throughout the study. Radioactivity in the
      kidney and spleen reached a relatively high level at 24 h, but declined
      rapidly.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789398
TI  - Spatial registration of echocardiographic and positron emission tomographic heart
      studies.
AB  - A method has been developed to match corresponding heart regions from functional
      echocardiographic (Echo) and metabolic fluorine-18-fluoro-2-deoxy-D-glucose
      ([18F]FDG) positron emission tomography (PET) studies in individual patients.
      Echo and PET images are spatially correlated by determining homologous anatomical
      landmarks (the two papillary muscles and the inferior junction of the right
      ventricle), identifiable in images obtained by both acquisition modalities. Echo
      PET image registration is first performed in the plane identified by the three
      landmarks, using a rigid rotate-translate scale model. The registration
      parameters are then used to transform the whole PET volume. This allows a
      consistent Echo-PET regional analysis, according to a segmental subdivision of
      the heart. The technique was tested on patients. The overlay of Echo and PET
      registered images proved the reliability of realignment of the three markers and
      a good spatial correlation of myocardial walls. This approach to image
      registration could be applied to other acquisition modalities (such as magnetic
      resonance imaging and single-photon emission tomography), provided that the three
      anatomical landmarks are visualized.

PMID- 7789401
TI  - Per operative localization of a carcinoid tumour of the breast using indium-111
      pentetreotide and a nuclear surgical probe.
AB  - A 69-year-old woman presented with a single enlarged lymph node in the left
      axilla. Clinical examination and other investigations, including various imaging
      methods, failed to reveal the primary tumour. However, indium-111 pentetreotide
      scan revealed a site of uptake in the anterior region of the left thorax.
      Peroperative imaging with 111In-pentetreotide confirmed the tumour uptake and use
      of a nuclear surgical probe allowed precise localization of the tumour, which was
      completely resected.

PMID- 7789402
TI  - 1994 recipient of the Paul Kayser International Award of Merit in Retina
      Research.

PMID- 7789400
TI  - Nitroimidazoles and imaging hypoxia.
AB  - Decreased tissue oxygen tension is a component of many diseases. Although hypoxia
      can be secondary to a low inspired pO2 or a variety of lung disorders, the
      commonest cause is ischemia due to an oxygen demand greater than the local oxygen
      supply. In tumors, low tissue pO2 is often observed, most often due to a blood
      supply inadequate to meet the tumor's demands. Hypoxic tumor tissue is associated
      with increased resistance to therapy. In the heart tissue hypoxia is often
      observed in persistent low-flow states, such as hibernating myocardium. In
      patients with stroke, hypoxia has been associated with the penumbral region,
      where an intervention could preserve function. Despite the potential importance
      of oxygen levels in tissue, difficulty in making this measurement in vivo has
      limited its role in clinical decision making. A class of compounds known to
      undergo different intracellular metabolism depending on the availability of
      oxygen in tissue, the nitroimidazoles, have been advocated for imaging hypoxic
      tissue. When a nitroimidazole enters a viable cell the molecule undergoes a
      single electron reduction, to form a potentially reactive species. In the
      presence of normal oxygen levels the molecule is immediately reoxidized. This
      futile shuttling takes place for some time, before the molecule diffuses out of
      the cell. In hypoxic tissue the low oxygen concentration is not able to
      effectively compete to reoxidize the molecule and further reduction appears to
      take place, culminating in the association of the reduced nitroimidazole with
      various intracellular components. The association is not irreversible, since
      these agents clear from hypoxic tissue over time. Initial development of
      nitroimidazoles for in vivo imaging used radiohalogenated derivatives of
      misonidazole, such as fluoromisonidazole, some of which have recently been
      employed in patients. Two major problems with fluoromisonidazole are its
      relatively low concentration within the lesion and the need to wait several hours
      to permit clearance of the agent from the normoxic background tissue (contrast
      between lesion and background typically < 2:1 at about 90 min after injection).
      Even with high-resolution positron emission tomographic imaging, this combination
      of circumstances makes successful evaluation of hypoxic lesions a
      challenge.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7789399
TI  - Radiolabeling with technetium-99m to study high-capacity and low-capacity
      biochemical systems.
AB  - After a brief review of the history of the development of technetium-99m-labeled
      radiopharmaceuticals, the use of technetium chelates in high-capacity systems is
      discussed. The latter are used in the study of five organ systems, the kidneys,
      liver, bone, brain, and heart. The chemical characterization of 99mTc complexes
      is also reviewed, followed by discussion of the various approaches to the
      labeling of proteins with direct labeling, the preformed chelate approach, and
      the antibody chelator conjugate approach. Thereafter, the labeling of
      biochemicals with 99mTc for use with easily saturated sites, e.g., receptors and
      enzymes, is considered. Finally, attention is given to factors that affect the
      preparation of high specific activity, high affinity 99mTc-labeled biochemicals.

PMID- 7789403
TI  - Nuclear light scattering, disulfide formation and membrane damage in lenses of
      older guinea pigs treated with hyperbaric oxygen.
AB  - Nuclear cataract, a major cause of loss of lens transparency in the aging human,
      has long been thought to be associated with oxidative damage, particularly at the
      site of the nuclear plasma membrane. However, few animal models have been
      available to study the mechanism of the opacity. Hyperbaric oxygen (HBO) has been
      shown to produce increased nuclear light scattering (NLS) and nuclear cataract in
      lenses of mice and human patients. In the present study, older guinea pigs
      (Initially 17-18 months of age) were treated with 2.5 atmospheres of 100% O2 for
      2-2.5-hr periods, three times per week, for up to 100 times. Examination by slit
      lamp biomicroscopy showed that exposure to HBO led to increased NLS in the lenses
      of the animals after as few as 19 treatments, compared to lenses of age-matched
      untreated and hyperbaric air-treated controls. The degree of NLS and enlargement
      of the lens nucleus continued to increase until 65 O2-treatments, and then
      remained constant until the end of the study. Exposure to O2 for 2.5 instead of 2
      hr accelerated the increase in NLS; however, distinct nuclear cataract was not
      observed in the animals during the period of investigation. A number of
      morphological changes in the experimental lens nuclei, as analysed by
      transmission electron microscopy, were similar to those recently reported for
      human immature nuclear cataracts (Costello, Oliver and Cobo, 1992). O2-induced
      damage to membranes probably acted as scattering centers and caused the observed
      increased NLS. A general state of oxidative stress existed in the lens nucleus of
      the O2-treated animals, prior to the first appearance of increased NLS, as
      evidenced by increased levels of protein-thiol mixed disulfides and protein
      disulfide. The levels of mixed disulfides in the experimental nucleus were
      remarkably high, nearly equal to the normal level of nuclear GSH. The level of
      GSH in the normal guinea pig lens decreased with age in the nucleus but not in
      the cortex; at 30 months of age the nuclear level of GSH was only 4% of the
      cortical value. HBO-induced changes in the lens nucleus included loss of soluble
      protein, increase in urea-insoluble protein and slight decreases in levels of GSH
      and ascorbate; however, there was no accumulation of oxidized glutathione.
      Intermolecular protein disulfide in the experimental nucleus consisted mainly of
      gamma-crystallin, but crosslinked alpha-, beta- and zeta-crystallins were also
      present.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7789404
TI  - Ciliary ganglion choline acetyltransferase activity in avian macrophthalmos.
AB  - While present evidence fails to support an etiologic mechanism for myopia based
      on accommodation or choroidal blood flow, atropine exhibits anti-myopia activity
      in many species. Accordingly, we studied choline acetyl transferase (ChAT)
      activity in the ciliary ganglion, uvea and retina of chicks with experimental
      macrophthalmos to identify a potential pathway for the moderation of eye growth
      by cholinergic neurons. Following unilateral lid suture or goggle, chicks were
      reared for 1 week under one of four lighting conditions known to induce
      macrophthalmos or myopia. Ocular tissues and ciliary ganglia were assayed for
      ChAT activity by measuring the conversion of 14C-acetyl CoA to 14C-acetylcholine.
      For some chicks, the goggles were removed at 1 week, and ChAT activity was
      measured 2 or 7 days later. Depending on the rearing condition, ciliary ganglion
      ChAT activity was depressed from 16 to 28% ipsilateral to the lid suture; enzyme
      activity also was reduced in the choroid of visually deprived eyes under most
      conditions. In contrast, lid suture resulted in no consistent trend in ChAT
      activity in either the anterior uvea or retina. For chicks wearing a unilateral
      goggle and reared under a 12:12 hr light/dark cycle, ChAT activity was depressed
      in the ciliary ganglion, anterior uvea and choroid on the visually deprived side.
      Following goggle removal to allow recovery from myopia. ChAT activity in the
      ciliary ganglion and uvea was returned toward that of the control side. The
      ciliary ganglion may participate in a neural pathway influencing the development
      of form-deprivation myopia.

PMID- 7789405
TI  - Quantitative analysis of the lens cell microstructure in selenite cataract using
      a two-dimensional Fourier analysis.
AB  - Using two-dimensional (2-D) Fourier methods, we analysed the cellular
      microstructure of three rat lenses: normal transparent, selenite-induced
      cataractous and selenite-treated plus a phase separation inhibitor (PSI) to
      prevent cataract. 2-D Fourier analysis of electron micrographs of the lens cells
      quantified the dimensions of the spatial fluctuations in electron density of the
      lens cell microstructure. The 2-D Fourier spectra of the transparent normal and
      PSI-treated lens cells were remarkably similar while those of the opaque selenite
      treated lens cells were dramatically different. In the opaque cells the
      contributions of large Fourier components (larger than half the wavelength of
      light) in the 2-D Fourier spectra were much greater than in the transparent
      cells. The results of the 2-D Fourier analysis of electron micrographs are
      consistent with the theory of transparency of the eye.

PMID- 7789406
TI  - Hippocalcin in rat retina. Comparison with calbindin-D28k, calretinin and
      neurocalcin.
AB  - The post-natal developmental expression in rat retina of four calcium-binding
      proteins belonging to the calmodulin-troponin-C family was investigated by
      immunohistochemistry using anti-calbindin-D28k, anti-calretinin, anti-hippocalcin
      and anti-neurocalcin polyclonal antibodies on paraffin sections from Wistar rat
      retinae aged from post-natal days 1 (P1), 5 (P5), 10 (P10), 20 (P20) to adulthood
      (8 weeks). Immunoblot using anti-hippocalcin and homogenates proteins from
      retina, cerebellar cortex, hippocampus and cerebellum was also performed.
      Hippocalcin immunoreactivity in adult rat retina was demonstrated by both
      immunohistochemistry and Western blot. During post-natal development, calbindin
      D28k, calretinin and neurocalcin immunoreactivity were detected at P1 in ganglion
      cells, whereas hippocalcin immunoreactivity was seen later at P5 in this cell
      layer. In the amacrine cell layer, neurocalcin immunoreactivity was detected at
      P5 and hippocalcin at P10. Calbindin-D28k was labelling the immature horizontal
      cell, calretinin was detected in nearly all ganglion cells and in some amacrine
      cells since P1. These three calcium-binding proteins do not seem to play a role
      in synaptogenesis which takes place later. We confirmed that calbindin-D28k
      appeared to be a good marker for horizontal cells. The presence of hippocalcin, a
      myristoylated calcium-binding protein belonging to the recovering subfamily and
      previously localized in few brain areas has been detected for the first time in
      retina.

PMID- 7789407
TI  - The effect of arterial pressure on the ocular pressure-volume relationship in the
      rabbit.
AB  - The purpose of this study was to quantify the effect of mean arterial pressure
      (MAP) on the ocular pressure-volume relationship. The experiments were performed
      in pentobarbital anesthetized rabbits instrumented with occluders on the thoracic
      aorta and inferior vena cava to control MAP which was measured via a cannula in
      the central ear artery. To vary the ocular volume and measure the intraocular
      pressure (IOP), two 23 gauge needles were inserted through the pars plana into
      the vitreous: one needle was connected to a saline-filled syringe and the other
      needle was connected to a pressure transducer. In one group of animals (n = 5),
      pressure-volume curves were determined at MAPs of 100, 80, 60, 40 and 20 mmHg and
      post mortem by cumulative saline injections (2 microliters) every 1-1.5 sec. In a
      second group (n = 7), pressure-volume curves were obtained at MAPs of 80, 60 and
      40 mmHg and post mortem by saline infusion at 0.5 microliter sec-1 until the IOP
      reached 100 mmHg. The infusion protocol was repeated in a third group (n = 11)
      where the choroidal flux and the concentration of moving blood cells (CMBC) were
      measured by a laser Doppler flowmeter as indices of choroidal blood flow and the
      blood volume, respectively. MAP had three primary effects on the ocular pressure
      volume relationship: (1) the baseline IOP varied exponentially with MAP, (2) the
      steepness of the initial portion of the pressure-volume curves was MAP-dependent
      and (3) the curves exhibited a 'plateau' as the IOP approached the prevailing MAP
      at MAPs > or = 40 mmHg. All of the curves in the living eye intersected and
      became indistinguishable from the post mortem curve when the IOP exceeded the
      prevailing MAP. The flux and CMBC measurements indicated that the MAP-dependence
      of the initial portion of the curves was due to failure of choroidal
      autoregulation and diminished increases in choroidal blood volume at the lower
      MAPs, and that the plateau portion of the curves was due to expulsion of blood
      from the eye. It is concluded that MAP has a significant effect on the ocular
      pressure-volume relationship.

PMID- 7789408
TI  - Metabolism of omega-3 fatty acids in patients with autosomal dominant retinitis
      pigmentosa.
AB  - Abnormalities in lipid metabolism have been reported in numerous patients with
      retinitis pigmentosa. As an initial step in evaluating these anomalies, two
      trials of fatty acid intervention were conducted with autosomal dominant
      retinitis pigmentosa (adRP) patients and controls. The first trial addressed
      absorption and incorporation of omega 3 long-chain fatty acids from a fish-oil
      concentrate into red blood cell (RBC) lipids. The utilization of omega 3 long
      chain fatty acids by adRP patients was found to be equivalent to that of
      controls. The second trial addressed the conversion of precursor,
      eicosapentaenoic acid (EPA, 20:5 omega 3), to end-product, docosahexaenoic acid
      (DHA, 22:6 omega 3), following oral supplementation of EPA ethyl ester. Although
      the levels of EPA and the intermediate, docosapentaenoic acid (22:5 omega 3),
      were both elevated by EPA supplementation in RBCs of adRP patients with rhodopsin
      gene mutations and controls, DHA production was elevated only in controls. Based
      on these results, we suggest the presence of a metabolic defect in the final
      stages of DHA biosynthesis.

PMID- 7789409
TI  - Effect of dietary fat and environmental lighting on the phospholipid molecular
      species of rat photoreceptor membranes.
AB  - We have previously shown that retinas of albino rats adapt to bright cyclic light
      (500-800 lx) by lowering the levels of docosahexaenoic acid (22:6n-3) in their
      rod outer segment (ROS) phospholipids. In the present study, we addressed the
      role of dietary fat in this process. Pregnant rats were kept in 1 lx or 250 lx
      cyclic illuminance (12L:12D) and fed diets containing 10% (by weight) of either
      hydrogenated coconut oil (COC, no n-3 or n-6 fatty acids), linseed oil (LIN, n-3
      and n-6 fatty acids), or safflower oil (SAF, only n-6 fatty acids), starting 4
      days before delivery. Pups were weaned at 3 weeks of age and continued on the
      same diet and light regime. At 12 weeks of age, 3 or 4 animals in each diet-light
      group were killed and the remaining animals were stressed continuously with 2000
      lx light for 24 hr and then kept in 1 lx cyclic light for 10 days. Fatty acids
      and phospholipid molecular species (PLMS) of ROS membranes were determined. For
      prestressed groups, those animals fed the LIN diet had high levels of 22:6n-3 and
      PLMS containing 22:6n-3, with little 22:5n-6. Compared to the LIN group, the COC
      and SAF groups had lower levels of 22:6n-3- and 22:6n-3)-containing PLMS and
      higher levels of 22:5n-6 and molecular species containing 22:5n-6, such as 22:5n
      6/22:6n-3, 16:0/22:5n-6 and 18:0/22:5n-6. Within each dietary group, animals
      raised in 250 lx cyclic illuminance had lower levels of 22:6n-3 and 22:5n-6
      compared to those raised at 1 lx. This light effect was greater for 22:6n-3 in
      the LIN group than for 22:5n-6 in the SAF group. After the acute light stress,
      those animals raised in 1 lx showed dramatic reduction in PLMS containing 22:6n-3
      and 22:5n-6, especially polyenoic species such as 22:6n-3/22:6n-3 in the LIN
      group and 22:5n-6/22:6n-3 in the COC and SAF groups. In contrast, animals raised
      in 250 lx showed much smaller changes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789410
TI  - Effect of dietary fat on the response of the rat retina to chronic and acute
      light stress.
AB  - We designed an experiment to study the role of light history and polyunsaturated
      fatty acids (PUFA) on the susceptibility of the albino rat retina to light
      damage. Albino rats were born to dams that had been kept in either 1 lx or 250 lx
      cyclic light for 0-4 days prior to delivery and fed one of three diets containing
      either 10% (by weight) hydrogenated coconut oil (COC, no n-3 nor n-6 fatty
      acids), safflower oil (SAF, high n-6, < 0.1% n-3 fatty acids), or linseed oil
      (LIN, high n-3, low n-6 fatty acids). After weaning, the rats were maintained in
      the same light environment and fed the same diets for 9 weeks, at which time some
      were killed and their retinas processed for morphometric analysis. Animals raised
      in bright cyclic light had shorter ROS lengths and thinner outer nuclear layers
      (ONL) than rats raised in dim cyclic light. The LIN animals had a thinner ONL
      than animals of the SAF or COC groups. Rats from each diet and light rearing
      groups were exposed to constant illumination of 2000 lx for 24 hr, after which
      they and non-exposed controls were placed in 1 lx cyclic light for 10 days and
      analysed for changes in ONL thickness. In the 250 lx (bright; B) groups, there
      was no effect of acute light stress on ONL thickness, although both control and
      stressed LIN animals had a thinner ONL than the corresponding COC and SAF groups.
      However, in the rats raised in 1 lx cyclic light, acute stress resulted in
      significant retinal damage (i.e. decrease in ONL thickness) in the three diet
      groups combined. The superior region was damaged the most and the severity was
      dependent on diet, as evidenced by the LIN group having a greater reduction in
      ONL thickness than the SAF group after light stress. From these results we
      conclude that rats on diets high in n-3 fatty acids are more susceptible to
      photoreceptor cell loss than animals fed n-6 or no polyunsaturated fatty acids
      when raised in dim cyclic light. These results show that both diet and light
      history play a role in the susceptibility of the retina to acute and chronic
      effects of light and suggest a role for lipid peroxidation in retinal light
      damage.

PMID- 7789411
TI  - Age-related changes in ganglioside composition in human lens.
AB  - We previously reported that human lens accumulates gangliosides in association
      with aging and senile cataract progression. Structural analysis revealed that
      gangliosides in human cataractous lenses were composed of ganglio-series
      gangliosides, such as GM3, GM2, GM1 and GD1a, and sialyl-Lewisx-containing
      neolacto-series gangliosides. Although Lewisx-containing neolacto-series
      glycolipid was found to accumulate in association with aging and cataract
      progression, the sialyl-Lewisx gangliosides did not show much accumulation in
      individual lenses from subjects between 16 and 80 years old. The content of
      sialyl-Lewisx gangliosides was about two to four times higher than that of Lewisx
      glycolipids, suggesting the possibility that the increase in Le(x) glycolipid is
      partly due to the desialylation of sialyl-Le(x) gangliosides. On the other hand,
      the expression of ganglio-series gangliosides increased in an age-related manner.
      Thus, age-related changes in lens glycolipids may modify the cell-to-cell
      interaction induced by cell surface sugar chains, leading to the initiation and
      progression of cataract.

PMID- 7789412
TI  - Age-related response of human lenses to stretching forces.
AB  - Five human lenses of varying ages were subjected to radial stretching forces
      which mimic the action of the ciliary muscle in vivo. Although the number of
      lenses was small, it was found that the human lens becomes more resistant, with
      age, to radial stretching forces and that lenses over the age of 50 years showed
      very little response to stretch. In prepresbyopic lenses, stretching has a
      greater effect on the shape of the anterior surface than it does on the shape of
      the posterior surface. The five lenses studied showed individual variations in
      lens size and shape and a trend to increased curvature with age, particularly
      marked for the anterior surface.

PMID- 7789413
TI  - Evidence of a difference in photoreceptor cell loss in the peripheral versus
      posterior regions of the vitiligo (C57BL/6J-mi(vit)/mi(vit)) mouse retina.

PMID- 7789414
TI  - Effect of the topical application of nitroglycerin on intraocular pressure in
      normal and glaucomatous monkeys.

PMID- 7789415
TI  - Characterization of native pathogenic antigens of Onchocerca volvulus:
      identification of high molecular mass protein antigens eliciting interstitial
      keratitis in a guinea pig model.
AB  - Sclerosing keratitis is the predominant cause of blindness due to onchocerciasis
      which is a major human parasitic disease caused by the filarial parasite
      Onchocerca volvulus. In the present investigation, native pathogenic antigens of
      O. volvulus which are particularly potent in causing interstitial keratitis were
      characterized utilizing a guinea pig model. Following demonstration of the
      protein nature of these antigens using pronase digestion, the crude O. volvulus
      antigen extract was subjected to stepwise procedures of protein purification. At
      each stage of purification, pooled antigen fractions were injected into one
      cornea of presensitized guinea pigs followed by clinical evaluation of stromal
      inflammation and vascularization at different intervals of time after
      intrastromal challenge. Initial purification of the pathogenic antigens was
      carried out in the following order: molecular sieve chromatography on Bio-gel A
      5m. anion exchange chromatography on Mono Q followed by DEAE-Sepharose CL-6B and
      cation exchange chromatography on Mono S. Two out of six different pools from the
      Mono S column (pool a eluted unbound at 10 mM-NaCl and pool e eluted between 130
      mM and 475 mM-NaCl) were found to be most pathogenic. Further purification of
      Mono S pool a and pool e separately by gel filtration chromatography using
      Superose 12 demonstrated that the fractions which were most potent in inducing
      interstitial keratitis contained proteins with approximate molecular masses
      between 100 and 200 kDa. These results show that minor subfractions of total
      crude antigens of O. volvulus are largely responsible for induction of
      experimental interstitial keratitis. We have demonstrated the presence of these
      antigens in O. volvulus microfilariae by their cross-reactivities with anti
      microfilarial antibodies, and hence the relevance of the purified antigens to
      ocular onchocerciasis in man since sclerosing keratitis is associated with
      invasion of the cornea by O. volvulus microfilariae. Isolation of these two
      pathogenic antigen pools represents the practical limits of purification and
      subsequent animal experiments possible with the available amounts of native
      parasite material obtained from infected human individuals in the absence of a
      suitable non-human host or of an in vitro culture system for O. volvulus.

PMID- 7789416
TI  - Selective targeting of trabecular meshwork cells: in vitro studies of pulsed and
      CW laser interactions.
AB  - The purpose of the present study was to selectively target pigmented trabecular
      meshwork cells without producing collateral damage to adjacent non-pigmented
      cells or structures. The ability to selectively target trabecular meshwork cells
      without coagulation, while preserving the structural integrity of the meshwork,
      could be a useful approach to study whether the biological response of non
      coagulative damage to the trabecular meshwork and trabecular meshwork cells is
      similar to that seen with coagulative damage to the trabecular meshwork which
      occurs with argon laser trabeculoplasty. This approach also may be useful to non
      invasively deplete trabecular meshwork cells while preserving the structural
      integrity of the trabecular meshwork in an animal model. A mixed cell culture of
      pigmented and non-pigmented trabecular meshwork cells were irradiated with Q
      switched Nd-YAG and frequency-doubled Nd-YAG lasers, microsound pulsed dye
      lasers, and an argon ion laser in order to define a regime where laser absorption
      would be confined to pigmented trabecular meshwork cells, thereby permitting
      selective targeting of these cells without producing collateral thermal damage to
      adjacent non-pigmented cells. Pulse durations ranged from 10 nsec to 0.1 sec. A
      fluorescent viability/cytotoxicity assay was used to evaluate laser effects and
      threshold energies, and cells were examined morphologically by light and TEM.
      Selective targeting of pigmented trabecular meshwork cells was achieved with
      pulse durations between 10 nsec and 1 microsec and 1 microsec without producing
      collateral thermal or structural damage to adjacent non-pigmented trabecular
      meshworks cells when examined by light and transmission electron microscopy.
      Pulse durations greater than 1 microsec resulted in non-selective killing of non
      pigmented trabecular meshwork cells. Threshold radiant exposures were as low as
      18 mJ cm-2, and increased at longer wavelengths, longer pulse durations and lower
      melanin contents within the cells. It is concluded that selective targeting of
      pigmented trabecular meshwork cells can be achieved using pulsed lasers with low
      threshold radiant exposures avoiding collateral thermal damage to adjacent non
      pigmented trabecular meshwork cells. This approach can be readily applied in
      vivo.

PMID- 7789417
TI  - Non-contact, two-dimensional measurement of tissue circulation in choroid and
      optic nerve head using laser speckle phenomenon.
AB  - A new apparatus has been developed using the laser speckle phenomenon for non
      contact, two-dimensional analysis of tissue circulation in the choroid and optic
      nerve head (ONH). The fundus was illuminated by a diode laser spot and its image
      speckle was detected by an image sensor. The difference between the average of
      the speckle intensity (Imean) and the speckle intensity for successive scannings
      was calculated, and the ratio of Imean to this difference was defined as
      normalized blur (NB), which is a quantitative index of blood velocity. The
      results were displayed on color graphic monitors showing the two-dimensional
      variation of the NB level in the measurement field. In the rabbit, this apparatus
      was used to study the relationship between the results of NB measurement and the
      choroidal blood flow determined by the microsphere technique, the relationship
      between NB obtained from the ONH tissue free of visible surface vessels and the
      ocular perfusion pressure (OPP) after a lethal injection of pentobarital, and the
      effect of intraocular pressure (IOP) on the NB in the choroid or in the ONH. A
      stepwise reduction in the OPP was introduced by elevating the IOP manometrically.
      The relative decrease in the average NB over the field measured, NBav, in the
      choroid with the reduction in OPP showed a significant correlation with the
      relative change in the blood flow rate determined using the microsphere technique
      (r = 0.60, P < 0.001). NBav in the ONH had a good correlation with the OPP after
      a lethal injection of pentobarbital (r = 0.98, P < 0.001). NBav in the choroid
      decreased with reduction in the OPP. Although NBav in the ONH was little affected
      by OPP change when OPP was above 40 mmHg, at OPP levels below 40 mmHg, NBav in
      the ONH decreased along with a reduction in the OPP. These results suggest that
      by using the present apparatus, the blood velocity in the choroid or ONH under
      various conditions can be studied non-invasively in the living eye.

PMID- 7789418
TI  - Class III beta-tubulin in human retinal pigment epithelial cells in culture and
      in epiretinal membranes.
AB  - The class III beta-tubulin isotype (beta III) is expressed exclusively by neurons
      within the normal human retina and is not present in normal retinal pigment
      epithelial (RPE) cells in situ or in 1 day-old primary cultures; however, beta
      III is present in RPE cells in 5-day primary cultures and in passaged RPE cells
      grown in monolayer cultures as determined by immunohistochemistry and Western
      blotting. beta III-positivity in cultured RPE cells is not affected by cell
      density or hydroxyurea- or retinoic-acid-mediated growth inhibition, but only a
      few cells weakly express beta III in cyclohexamide-treated cultures and RPE cells
      maintained in serum-free medium fail to produce beta III. When monolayer-cultured
      RPE cells grown in normal, serum-containing medium, are transferred to irradiated
      bovine vitreous, beta III is undetectable in most cells. Cultured RPE cells
      coexpress beta III with keratin and cellular retinaldehyde-binding protein (both
      RPE cell markers), but not with glial fibrillary acidic protein. Some cultured
      RPE cells also express neuron-specific (gamma) enolase, which is neuron
      associated but not neuron-specific, and occasional cells in confluent or super
      confluent cultures contain the 200-kDa neurofilament protein. Retinal glia,
      fibroblasts, endothelial cells, and smooth muscle cells do not express beta III
      under the same culture conditions. We have detected beta III in 45 of 56
      epiretinal membranes, frequently in cells with a bipolar or dedifferentiated
      morphology, where its expression coincides with other RPE cell-associated
      antigens. Cells with morphological features resembling normal RPE cells in
      epiretinal membranes are usually negative for beta III, but RPE cells appearing
      to be in the early stages of dedifferentiation express the isotype weakly.
      Electron microscopic immunocytochemistry localizes beta III to microtubules,
      ribosomes and cytoplasm. beta III may be a useful marker for recognizing the
      fraction of RPE cells in epiretinal membranes that are no longer identifiable by
      morphological criteria or other RPE cell markers. These findings demonstrate that
      mature human RPE cells have the capacity to express a neuron-associated gene in
      response to conditions that promote dedifferentiation.

PMID- 7789419
TI  - Alternative splicing in human retinal mRNA transcripts of an opsin-related
      protein.
AB  - An opsin-related gene encodes a putative RPE-retinal G-protein-coupled receptor
      (RGR) that is most homologous to the visual pigments and invertebrate
      retinochrome. A splice variant of human RGR mRNA can be demonstrated by the
      sequence of isolated cDNA clones and by the amplification and analysis of human
      retinal mRNA. The shortened transcript contains a deletion of 114 nucleotides
      that correspond exactly to the sequence of exon 6 in the human rgr gene. The
      predicted RGR variant lacks the putative sixth transmembrane domain and has a
      calculated molecular weight of 27,726. Variable amounts of a 28-kDa protein were
      found in the retinas of some individuals by immunoblot assay. Since a similar
      shortened RGR transcript was not detected in bovine retina or RPE, the RGR
      variant is not essential for vertebrate vision. Analysis of the structure of the
      rgr gene and of the sequences of cDNA clones indicates that the truncated mRNA
      may be produced through alternative splicing of pre-mRNA from which a cassette
      exon is removed and the predicted RGR variant is radically altered in primary
      structure.

PMID- 7789420
TI  - Variations in refractive index and absorbance of 670-nm light with age and
      cataract formation in human lenses.
AB  - A newly-developed fibre-optic sensor (wavelength of 670 nm) was used to measure
      the index gradient in 16 human lenses ranging in age from 38 to 78 years. Two of
      these lenses had nuclear cataract. The refractive index, calculated from the
      proportion of reflected light at the sensor/sample interface, appeared to
      increase with age and further with cataract formation. This was not consistent
      with previous studies. The increased losses of reflected light, which gave
      apparent increased values of refractive index, were reconsidered to be resulting
      from light absorption and an estimate of relative absorption was made by
      deducting excess light loss from a base level expected to yield the maximum index
      value. The characteristics of the relative absorption are similar to those of a
      red fluorophor reported in other studies.

PMID- 7789421
TI  - Oxygen modulates production of bFGF and TGF-beta by retinal cells in vitro.
AB  - Vasoproliferative retinopathies result from retinal capillary non-perfusion and
      consequent inner retinal hypoxia. However, it is not known whether oxygen
      mediates vasoproliferation directly (at the nuclear level) or indirectly by
      regulating the production of growth factors. We have investigated the effect of
      oxygen on the production of basic fibroblast growth factor and transforming
      growth-factor-beta by a variety of retinal cell types in culture. Confluent
      cultures were maintained for 48 hr under varying oxygen tensions ranging from 135
      to 18 mmHg. A reduction in basic fibroblast growth factor levels was observed in
      the cell lysates and extracellular matrix from retinal microvascular endothelial
      cell, retinal microvascular pericyte and retinal pigment epithelial cell cultures
      when the oxygen tension of the medium was reduced from 135 to 18 mmHg. Levels of
      basic fibroblast growth factor in conditioned media from microvascular
      endothelial and retinal pigment epithelial cell cultures also decreased when the
      oxygen tension of the medium was reduced from 135 to 18 mmHg. Total transforming
      growth-factor-beta (and specifically isoforms 1 and 2) in the conditioned media
      from all three cell types was similarly modulated by oxygen i.e. it decreased as
      the oxygen tension of the medium was reduced from 135 to 18 mmHg. In contrast,
      the steady state messenger RNA levels for both basic fibroblast growth factor and
      transforming-growth-factor-beta 1 genes in RPE cells increased significantly when
      the oxygen tension of the medium was reduced from 135 to 18 mmHg. These results
      support the putative role of oxygen in influencing the balance of growth factors
      during the development of preretinal new vessels.

PMID- 7789422
TI  - Effect of acetazolamide on intracellular pH and bicarbonate transport in bovine
      corneal endothelium.
AB  - Carbonic anhydrase inhibitors are known to inhibit fluid transport by the corneal
      endothelium. This phenomenon could be due to a combination of effects involving
      disruption of intracellular pH regulation, reduced gradients for diffusion of
      CO2, substrate limitation to HCO3- transport systems or direct inhibition of
      membrane HCO3- transport. We examined the effects of the carbonic anhydrase
      inhibitor, Acetazolamide (ACTZ), on intracellular pH (pHi) and HCO3- transport in
      cultured bovine corneal endothelium. The pHi was measured utilizing the pH
      sensitive fluorescent dye, BCECF. Na+:HCO3- cotransport and Cl-/HCO3- exchange
      activities were studied by measuring the HCO3(-)-dependent flux of Na+ and Cl-,
      respectively. Na+ and Cl- fluxes were measured using the ion-sensitive dyes SBFI
      and SPQ, respectively. Application of 100 or 500 microM ACTZ to cells perfused
      under HCO3(-)-rich conditions, significantly reduced steady-state pHi by 0.06 +/-
      0.01 (n = 14, P < 0.05). ACTZ also eliminated rapid pHi transients due to CO2
      diffusion, significantly slowed the initial rate of pHi changes (50 +/- 10% of
      control, n = 7, P < 0.05) secondary to Na+:HCO3- cotransport or Cl-/HCO3-
      exchange (37 +/- 1% of control, P < 0.05, n = 7). However, the flux of the
      cotransported ions, Na+ and Cl-, and the steady-state levels of these ions were
      not affected by ACTZ. We conclude that the drop in steady-state pHi, the
      elimination of CO2 induced pHi transients and the slowed pHi changes secondary to
      HCO3- transport were due to inhibition of cytosolic carbonic anhydrase by ACTZ,
      i.e. slowing the equilibrium among CO2, HCO3- and H+ and not due to limitation of
      substrate availability or direct inhibition of the membrane transporters.

PMID- 7789423
TI  - Regulation of retinal glial cell proliferation by antiproliferative molecules.
AB  - Glial cells normally do not proliferate in the adult retina despite the presence
      of glial mitogens. In this study, we examined the hypothesis that endogenous
      antiproliferative molecules inhibit the effects of glial mitogens. Using cultures
      of glial cells obtained from the adult human retina, we found that transforming
      growth factor beta 2 (TGF beta 2) and a metabotrophic glutamate agonist (t-ACPD)
      inhibit the mitogenic effects of basic fibroblast growth factor, platelet-derived
      growth factor, epidermal growth factor and insulin-like growth factor-1. These
      antiproliferative effects may involve activation of protein kinase C (PKC) since
      chelerythine, a specific PKC inhibitor, blocks the antiproliferative effects of
      TGF beta 2 and t-ACPD. Furthermore, exposure of the glia to a phorbol ester
      mimics the inhibitory effects of TGF beta 2 or t-ACPD. Although TGF beta 2 and t
      ACPD markedly inhibit a number of mitogens, they do not alter the mitogenic
      response of retinal glia to thrombin and glutamate. A common characteristic of
      the mitogens sensitive to TGF beta 2 or t-ACPD is activation of tyrosine kinase
      linked receptors. In contrast, thrombin acts at a G-protein-linked receptor, and
      glutamate stimulates retinal glial proliferation via activation of an NMDA
      receptor. It appears that TGF beta 2 and t-ACPD may selectively inhibit retinal
      glial mitogenesis mediated by activation of tyrosine kinase-linked receptors. Our
      experiments support the idea that endogenous antiproliferative molecules play a
      role in preventing glial proliferation in the retina.

PMID- 7789425
TI  - Large optic discs in large eyes, small optic discs in small eyes.
AB  - The optic disc area, varying interindividually by a factor of 1:7, is correlated
      with the count of the retinal ganglion cell axons and photoreceptors. This study
      evaluated whether the variations in the disc size are additionally correlated
      with those of the coronary diameters of the globe. Fifty-three normal human donor
      eyes with a mean age of 54.2 +/- 19.6 years were included in the study. After
      performing a 16-mm corneoscleral trephination, the globes were fixed and the
      horizontal and vertical diameters of the globes were measured. We cut the globes
      into meridional slices sticking together at the posterior fundus region. The
      areas of the whole retina and the optic disc were planimetrically evaluated on
      photographs with a millimeter scale aligned. We found that the horizontal and
      vertical diameters of the globe were correlated with the optic disc size and the
      retinal surface area. Eyes with long horizontal and vertical diameters had a
      larger optic disc and a larger retinal surface area than eyes with short
      diameters. The results suggest the combination of large optic discs in large eyes
      and of small optic discs in small eyes. Taking into account the relatively low
      correlation coefficients of 0.3 and 0.4, the study also suggests the existence of
      other not-evaluated factors influencing the occurrence of large optic discs. The
      results go along with the reported association between a large optic disc area
      and a large cornea size.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789426
TI  - Relationship between the organization of the forepaw barrel subfield and the
      representation of the forepaw in layer IV of rat somatosensory cortex.
AB  - We studied the organization of the forepaw barrel subfield (FBS) in layer IV of
      adult rat somatosensory cortex using the mitochondrial marker cytochrome oxidase
      and related this organization to the representation of the forepaw. The FBS is an
      ovoid structure consisting of barrels and barrel-like structures, the most
      conspicuous of which form four centrally located medio lateral running bands.
      Each band contains three to four barrels. These centrally located bands are
      bordered along their entire lateral side by a nebulous zone of undifferentiated
      labeling. At the anterior border, two small barrels are located laterally and one
      or two larger barrels are located medially. Medial to the central zone are three
      well-defined barrels. The posterior border consists of a nebulous field of
      labeling and occasional barrel-like structures. The results from our
      electrophysiological recording and mapping revealed that the forepaw
      representation was topographically organized into a single map and that the
      forepaw map matches almost precisely with individual barrels and barrel-like
      structures in the FBS. Each of the four central bands is associated with the
      representation of a single glabrous digit. Digit two (D2) is represented
      anteriorly and followed posteriorly by D3 through D5. Within each digit band the
      digit is somatotopically organized, with the skin over the distal phalanx
      represented in the two lateral barrels and the middle and proximal phalanges
      represented in the medial barrel(s). The dorsal hairy digit skin and dorsal hand
      are represented in the lateral zone. D1 is represented by two small anteriorly
      located barrels. Medial to the representation of the glabrous digits is the
      representation of the palmar pads. The representation of these pads, in turn,
      lies between the representations of the thenar (located anteriorly) and
      hypothenar (located posteriorly) pads. Posterior to the hypothenar pad
      representation lie the representations of the wrist and forearm. While the
      present results support the conclusion that individual barrels are associated
      with discrete locations on the forepaw, examples were found where the recording
      site was not precisely located within the predicted barrel. Some of these errors
      may be accounted for by limitations in the mapping techniques; nevertheless, the
      FBS offers an excellent model system to study relationships between cortical
      structure and function.

PMID- 7789424
TI  - Distribution of F-actin, vinculin and integrin subunits (alpha 6 and beta 4) in
      response to corneal substrata.
AB  - Our goal was to determine the early response of corneal epithelial cells to
      living modified stromal substrates. We examined the distribution of integrin
      subunits (alpha 6 and beta 4), vinculin and the organization of F-actin in
      epithelial cells after cell-matrix and cell-cell hypothesized that the
      distribution of proteins in the cell matrix attachment complex would be altered
      if the substrate was modified. Integrin subunits, alpha 6 and beta 4, were chosen
      as they play a role in cell matrix adhesion and adhesion site formation. Corneal
      epithelial cells were cultured from explants and seeded on three corneal
      substrates (a stroma containing an intact basal lamina, a cornea lacking a basal
      lamina and a cornea treated with alkali). After 3 h of incubation, the tissue was
      fixed and stained with monoclonal antibodies specific for vinculin and for the
      integrin subunits alpha 6 and beta 4. The organization of F-actin was assessed
      using rhodamine phalloidin. The localization of the proteins was recorded with
      confocal laser scanning microscopy. Filamentous actin delineated the lateral cell
      membranes of corneal epithelial cells. The organization of actin and distribution
      of vinculin and integrin subunits of epithelial cells cultured on stromal
      substrates containing a basal lamina mimicked a simple epithelial organization.
      In contrast, when cells are cultured on the substrate lacking a basal lamina and
      alkaline treated corneal substrates the distribution of the specific proteins
      examined was altered. Vinculin and alpha 6 were present along membranes of cells
      cultured on substrates lacking a basal lamina and were diffuse in cells cultured
      on the alkaline substrates. These studies demonstrate that changes in the
      distribution of adhesion and cytoskeletal proteins in response to different
      surfaces may contribute to the healing dynamics in different wounds.

PMID- 7789428
TI  - Express saccades in cat: effects of task and target modality.
AB  - Saccadic eye movements to visual, auditory, and bimodal targets were measured in
      four adult cats. Bimodal targets were visual and auditory stimuli presented
      simultaneously at the same location. Three behavioral tasks were used: a fixation
      task and two saccadic tracking tasks (gap and overlap task). In the fixation
      task, a sensory stimulus was presented at a randomly selected location, and the
      saccade to fixate that stimulus was measured. In the gap and overlap tasks, a
      second target (hereafter called the saccade target) was presented after the cat
      had fixated the first target. In the gap task, the fixation target was switched
      off before the saccade target was turned on; in the overlap task, the saccade
      target was presented before the fixation target was switched off. All tasks
      required the cats to redirect their gaze toward the target (within a specified
      degree of accuracy) within 500 ms of target onset, and in all tasks target
      positions were varied randomly over five possible locations along the horizontal
      meridian within the cat's oculomotor range. In the gap task, a significantly
      greater proportion of saccadic reaction times (SRTs) were less than 125 ms, and
      mean SRTs were significantly shorter than in the fixation task. With visual
      targets, saccade latencies were significantly shorter in the gap task than in the
      overlap task, while, with bimodal targets, saccade latencies were similar in the
      gap and overlap tasks. On the fixation task, SRTs to auditory targets were longer
      than those to either visual or bimodal targets, but on the gap task, SRTs to
      auditory targets were shorter than those to visual or bimodal targets. Thus, SRTs
      reflected an interaction between target modality and task. Because target
      locations were unpredictable, these results demonstrate that cats, as well as
      primates, can produce very short latency goal-directed saccades.

PMID- 7789427
TI  - Saccade-related Purkinje cell activity in the oculomotor vermis during
      spontaneous eye movements in light and darkness.
AB  - Saccade-related Purkinje cells (PCs) were recorded in the oculomotor vermis
      (lobules VI, VII) during spontaneous eye movements and fast phases of optokinetic
      and vestibular nystagmus in the light and darkness, from two macaque monkeys. All
      neurons (n = 46) were spontaneously active and exhibited a saccade-related change
      of activity with all saccades and fast phases of nystagmus. Four types of neurons
      were found: most neurons (n = 31) exhibited a saccade-related burst of activity
      only (VBN); other units (n = 7) showed a burst of activity with a subsequent
      pause (VBPN); some of the units (n = 5) paused in relation to the saccadic eye
      movement (pause units, VPN); a few PCs (n = 3) showed a burst of activity in one
      direction and a pause of activity in the opposite direction. For all neurons,
      burst activity varied considerably for similar saccades. There were no activity
      differences between spontaneous saccades and vestibular or optokinetically
      elicited fast phases of nystagmus. The activity before, during, and after
      horizontal saccades was quantitatively analyzed. For 24 burst PCs (VBN, VBPN),
      the burst started before saccade onset in one horizontal direction (preferred
      direction), on average by 15.3 ms (range 27-5 ms). For all these neurons, burst
      activity started later in the opposite (non-preferred) direction, on average 4.9
      ms (range 20 to -12 ms, P < 0.01) before saccade onset. The preferred direction
      could be either with ipsilateral (42% of neurons) or contralateral (58%)
      saccades. Nine burst PCs had similar latencies and burst patterns in both
      horizontal directions. The onset of burst activity of a minority of PCs (n = 5)
      lagged saccade onset in all directions. The pause for VBPN neurons started after
      the end of the saccade and reached a minimum of activity some 40-50 ms after
      saccade completion. For all saccades and quick phases of nystagmus, burst
      duration increased with saccade duration. Peak burst activity was not correlated
      with saccade amplitude or peak eye velocity. PCs continued to show saccade
      related burst activity in the dark. However, in 59% of the PCs (VBN, VBPN), peak
      burst activity was significantly reduced in the dark (on average 28%, range 15
      36%) when saccades with the same amplitude (but longer duration in the dark) were
      compared. For VBP neurons, the pause component after the saccade disappeared in
      the dark.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7789429
TI  - Kinematic analysis of wing and leg movements for type I motility in E9 chick
      embryos.
AB  - Based on studies using direct observation methods, type I motility, the first
      motility pattern to emerge in chick embryos, is characterized as random,
      uncoordinated movement. Yet, electromyographic (EMG) studies indicate that leg
      muscles are recruited in orderly patterns of alternating flexor and extensor
      activity during type I motility. It has been suggested that this apparent paradox
      may be attributable to perturbations arising during movement in ovo under buoyant
      conditions. It is also possible that direct observation methods are insufficient
      to detect the extent of coordination between body parts during type I motility.
      To address the apparent discrepancy between random features reported in
      observational studies and reliable features reported in EMG studies, embryos were
      video recorded continuously for 60 min at embryonic day 9 and criteria were
      established to obtain homogeneous samples of motility for kinematic analysis of
      synchronous wing and leg movements. Limited to a single camera attached to a
      stereomicroscope, methods were developed to correct for out-of-plane movements of
      the ipsilateral wing and leg. Also, amniotic fluid was extracted from the egg in
      some recordings to test the possibility that movement under buoyant conditions
      may mask coordinated movement. Extended sequences of activity were digitized and
      analyzed. Results indicated that within a limb (wing or leg), direction and
      timing of excursions at adjacent joints co-varied and limb excursions were
      characterized by reliable patterns of alternating flexion and extension
      consistent with EMG studies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789430
TI  - Effects of eye position on saccadic eye movements and on the neuronal responses
      to auditory and visual stimuli in cat superior colliculus.
AB  - Many neurons in the deeper layers of the superior colliculus (SC) respond to
      multiple sensory inputs--visual, auditory, and somatic--as well as provide
      signals essential for saccadic eye movements to targets in different modalities.
      When the eyes and pinnae are in primary position, the neural map of auditory
      space is in rough topographic alignment with the map of visual space, and if the
      auditory map is based solely on headpinna coordinates, any changes in eye
      position in the orbit will cause misalignment of the maps. We investigated the
      effects of eye position on the response of sound-sensitive neurons in the SC of
      cats because previous work on cats and on monkeys had suggested the possibility
      of species differences in the representation of auditory signals in the SC. We
      also investigated the effects of eye position on the accuracy of saccades to
      auditory, visual, and bimodal stimuli. All studies were conducted in alert,
      trained cats with the head restrained in a fixed position. Neuronal and
      behavioral responses were studied during periods when the eyes were steadily
      directed to different positions relative to the position of the sound. Cats
      showed partial compensation for eye position in making saccades, regardless of
      the modality of the target, and they showed similar patterns of error in saccades
      to auditory and visual targets. These behavioral data are consistent with coding
      the location of visual and auditory targets in the same coordinate system. In the
      vast majority of intermediate-layer neurons, eye position significantly affected
      the number of spikes evoked by sound stimuli. For most of these neurons, changes
      in eye position produced significant shifts in the speaker location producing
      maximal response. In some neurons, eye position significantly facilitated the
      magnitude of neuronal response evoked by sounds from a variety of speaker
      locations. Because few pinna movements could be detected, in is unlikely that
      these changes in neuronal response could be due to changes in the position of the
      pinnae. Our results indicate that the deep layers of the SC contain an eye
      centered representation of sound location. Because eye position did not affect
      the percentage of neurons exhibiting multimodal integration, visual and auditory
      maps appear to remain integrated in the SC even when the eyes are directed
      eccentrically.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7789431
TI  - Nerve injury in adult rats causes abnormalities in the motoneuron dendritic field
      that differ from those seen following neonatal nerve injury.
AB  - Disruption of neuromuscular contact by nerve-crush during the early postnatal
      period causes increased activity and abnormal reflex responses in affected
      motoneurons, but such changes are not found after nerve-crush in adult animals.
      We found previously that neonatally lesioned cells develop an abnormal dendritic
      field, which may explain the functional changes. Here we have studied the
      dendritic morphology of the same motoneuron pool after nerve-crush at maturity in
      order to correlate the observed alterations in morphology with physiological
      findings. One to two months after sciatic nerve-crush in adult animals,
      motoneurons supplying the extensor hallucis longus muscles of the rat were
      retrogradely labelled with cholera toxin subunit-B conjugated to horseradish
      peroxidase. The dendritic tree of labelled cells was then analysed. Following
      adult nerve-crush, the dendritic tree of the motoneurons was smaller but did not
      display the localised increase in dendritic density seen after neonatal nerve
      crush. These findings support the view that such specific morphological changes
      contribute to the physiological abnormalities seen only after neonatal nerve
      injury.

PMID- 7789432
TI  - Cross-correlation of augmenting expiratory neurons of the Botzinger complex in
      the cat.
AB  - Ipsilateral and contralateral pairs of augmenting expiratory neurons were
      recorded simultaneously from the Botzinger complex using glass-coated tungsten
      microelectrodes in pentobarbitone-anaesthetized cats. The neurons were identified
      both by firing pattern and by antidromic activation from the contralateral site
      of the dorsal respiratory group. Cross-correlation histograms of the
      extracellularly recorded action potentials were calculated in order to detect
      short time-scale synchronizations of firing indicative of synaptic connections
      between the neurons. The cross-correlation histograms for 40 ipsilateral pairs of
      neurons less than 1 mm apart showed eight (20%) narrow troughs (mean half
      amplitude width +/- SD, 1.1 +/- 0.37 ms) at short latencies (mean latency +/- SD,
      1.0 +/- 0.35 ms) suggestive of monosynaptic inhibition. These included two cross
      correlation histograms which showed troughs on both sides of time zero,
      indicating a mutual inhibition. For another four pairs of neurons (10%), a
      central broad peak suggestive of common activation due to either excitation or
      release from inhibition was evident. Contralateral pairs of expiratory neurons of
      the Botzinger complex were examined in a similar manner. The cross-correlation
      histograms for 43 pairs of neurons showed five (12%) narrow troughs (mean half
      amplitude width +/- SD, 1.2 +/- 0.67 ms) at short latencies (mean latency +/- SD,
      2.7 +/- 1.47 ms) suggestive of monosynaptic inhibition. These included one cross
      correlation histogram which showed troughs (one not statistically significant) on
      both sides of time zero, indicating a mutual inhibition. For another two pairs of
      neurons (4.6%) a central, broad peak suggestive of common activation due to
      either excitation or release from inhibition was evident. We conclude that
      inhibitory interconnections exist between augmenting expiratory neurons of the
      Botzinger complex ipsilaterally and contralaterally. These connections may
      synchronize the expiratory burst of activity within this population and assist in
      the patterning of the burst.

PMID- 7789433
TI  - Human eye movement response to z-axis linear acceleration: the effect of varying
      the phase relationships between visual and vestibular inputs.
AB  - We investigated the effect of systematically varying the phase relationship
      between 0.5-Hz sinusoidal z-axis optokinetic (OKN) and linear acceleration
      stimuli upon the resulting vertical eye movement responses of five humans.
      Subjects lay supine on a linear sled which accelerated them sinusoidally along
      their z-axis at 0.4 g peak acceleration (peak velocity 1.25 m/s). A high
      contrast, striped z-axis OKN stimulus moving sinusoidally at 0.5 Hz, 70 degrees/s
      peak velocity was presented either concurrently or with the acceleration stimulus
      or alone. Subjects' vertical eye movements were recorded using scleral search
      coils. When stimuli were paired in the naturally occurring relationship (e.g.,
      visual stripes moving upward paired with downward physical acceleration), the
      response was enhanced over the response to the visual stimulus presented alone.
      When the stimuli were opposed (e.g., visual stripes moving upward during upward
      physical acceleration, a combination that does not occur naturally), the response
      was not significantly different from the response to the visual stimulus
      presented alone. Enhancement was maximized when the velocities of the visual and
      motion stimuli were in their normal phase relationship, while the response took
      intermediate values for other phase relationships. The phase of the response
      depended upon the phase difference between the two inputs. We suggest that linear
      self-motion processing looks at agreement between the two stimuli-a sensory
      conflict model.

PMID- 7789434
TI  - The role of haptic cues from rough and slippery surfaces in human postural
      control.
AB  - Haptic information is critically important in complex sensory-motor tasks such as
      manipulating objects. Its comparable importance in spatial orientation is only
      beginning to be recognized. We have shown that postural sway in humans is
      significantly reduced by lightly touching a stable surface with a fingertip at
      contact force levels far below those physically necessary to stabilize the body.
      To investigate further the functional relationship between contact forces at the
      hand and postural equilibrium, we had subjects stand in the tandem Romberg stance
      while being allowed physically supportive (force contact) and non-physically
      supportive (touch contact) amounts of index fingertip force on surfaces with
      different frictional characteristics. Mean sway amplitude (MSA) was reduced by
      over 50% with both touch and force contact of the fingertip, compared to standing
      without fingertip contact. No differences in MSA were observed when touching
      rough or slippery surfaces. The amplitude of EMG activity in the peroneal muscles
      and the timing relationships between fingertip forces, body sway and EMG activity
      suggested that with touch contact of the finger or with force contact on a
      slippery surface long-loop "reflexes" involving postural muscles were stabilizing
      sway. With force contact of the fingertip on a rough surface, MSA reduction was
      achieved primarily through physical support of the body. This pattern of results
      indicates that light touch contact cues from the fingertip in conjunction with
      proprioceptive signals about arm configuration are providing information about
      body sway that can be used to reduce MSA through postural muscle activation.

PMID- 7789435
TI  - Timing of finger opening and ball release in fast and accurate overarm throws.
AB  - How precisely does the CNS control the timing of finger muscle contractions in
      skilled movements? For overarm throwing, it has been calculated that a ball
      release window of less than 1 ms is needed for accuracy in long throws. The
      objective was to investigate the timing precision of ball release and finge
      opening for 100 overarm throws made using only the arm. Subjects sat with a fixed
      trunk and threw balls fast and accurately at a 6-cm-square target when it was
      1.5, 3.0 and 4.5 m away. Three-dimensional angular positions in space of the
      clavicle, upper arm, forearm, hand and distal phalanx of the middle finger were
      simultaneously recorded at 1000 Hz using the magnetic-field search-coil
      technique. Ball release was determined by pressure-sensitive microswitches on the
      proximal and distal phalanges of the middle finger (proximal and distal
      triggers). Variability of ball release, defined in terms of the standard
      deviation (SD) of the means of release times, was different when synchronized to
      different hand kinematic parameters. It was highest to the start of movement
      (when the hand started rotating vertically forward and up around a space-fixed
      horizontal axis) and was lowest when synchronized to the moment near ball release
      when the hand was vertical. These values did not depend on target distance. When
      throws were synchronized to vertical hand position, and SDs were averaged across
      the 10 subjects, the average interval for 95% of the throws (4xSD) was 9.6 ms for
      ball release and 10.0 ms for onset of finger opening. Thus, two independent
      measures of timing precision gave similar results. It is concluded that for 100
      fast and accurate throws made by male recreational ball players, timing of finger
      opening and ball release was controlled precisely but not to fractions of a
      millisecond.

PMID- 7789436
TI  - Effects of warning signals and fixation point offsets on the latencies of pro-
      versus antisaccades: implications for an interpretation of the gap effect.
AB  - The present study was designed to evaluate whether fixation point offsets have
      the same effects on the average latencies of prosaccades (responses towards
      target) and antisaccades (responses away from target). Gap and overlap conditions
      were run with and without an acoustic warning signal. The 'gap effect' was taken
      to be the difference in mean reaction time between gap and overlap trials. This
      effect was dramatically reduced by the presentation of the warning signal.
      Without this signal, fixation offsets can serve as warning signals themselves,
      which artifactually inflates the magnitude of the gap effect. The warning effect
      of fixation offsets was equivalent for pro and antisaccades. A significant gap
      effect is still evident with the acoustic warning signal; however, in this case
      it is associated primarily with prosaccades. These results replicate and extend
      our previous work demonstrating that, if their warning effects are controlled,
      the facilitatory effects of fixation point offsets are response dependent, and
      suggesting the existence of a component process (fixation release) which is
      closely linked with the processing architecture underlying target-directed
      saccades.

PMID- 7789437
TI  - Independent contributions of the orienting of attention, fixation offset and
      bilateral stimulation on human saccadic latencies.
AB  - In a series of experiments we examined the effects of the endogenous orienting of
      visual attention on human saccade latency. Three separate manipulations were
      performed: the orienting of visual attention, the prior offset of fixation (gap
      paradigm) and the bilateral presentation of saccade targets. Each of these
      manipulations was shown to make an independent contribution to saccade latency.
      In experiments 1 and 2 subjects were instructed to orient their attention
      covertly to a location by a verbal pre-cue; targets could appear in the attended
      hemifield (valid) or in the non-attended hemifield (invalid) together with a no
      instruction (neutral) condition. Saccades were made under fixation gap and
      overlap conditions, to either single target or two bilaterally presented targets
      which appeared at equal and opposite eccentricities in both hemifields. The
      results showed a large increase (cost) of saccade latency to invalid targets and
      a small non-significant decrease (benefit) of saccade latency to valid targets.
      The cost associated with invalid targets replicates the "meridan crossing effect"
      shown in manual reaction time experiments and is consistent with the hemifield
      inhibition and premotor models of attentional orienting. The use of a "gap"
      procedure produced a generalised facilitation of saccade latency, which was not
      modified by the prior orienting of visual attention. The magnitude of the gap
      effect was similar for saccades made to attended and non-attended stimulis. This
      suggests that the gap effect may be due to ocular motor disengagement, or a
      warning signal effect, rather than to the prior disengagement of visual
      attention. When two targets were presented simultaneously, one in each hemifield,
      saccade latency was slowed compared with the single target condition. The
      magnitude of this slowing was unaffected by the prior orienting of visual
      attention or by the fixation condition. The slowing was examined in more detail
      in experiment 3, by presenting targets with brief offset delays. The latency
      increase was maximal if the two targets were presented simultaneously and
      decreased if the distractor appeared at short intervals (20-80 ms) before or
      after the saccade target onset. If the non-attended stimulus was presented at
      greater intervals (160, 240 ms) before the saccade target, then a facilitation
      effect was observed. This demonstrates that the onset of a distractor in the non
      attended hemifield can have both an inhibitory and a facilitatory effect on a
      saccade production.

PMID- 7789438
TI  - Oculo-manual coordination control: respective role of visual and non-visual
      information in ocular tracking of self-moved targets.
AB  - We evaluated the role of visual and non-visual information in the control of
      smooth pursuit movements during tracking of a self-moved target. Previous works
      have shown that self-moved target tracking is characterised by shorter smooth
      pursuit latency and higher maximal velocity than eye-alone tracking. In fact,
      when a subject tracks a visual target controlled by his own arm, eye movement and
      arm movement are closely synchronised. In the present study, we showed that, in a
      condition where the direction of motion of a self-moved visual target was
      opposite to that of the arm (same amplitude, same velocity, but opposite
      direction of movement), the resulting smooth pursuit eye movements occurred with
      low latency, and continued for about 140 ms in the direction of the arm movement
      rather than in the direction of the actual visual target movement. After 140 ms,
      the eye movement direction reversed through a combination of smooth pursuit and
      saccades. Subsequently, while arm and visual target still moved in opposite
      directions, smooth pursuit occurred in pace with the visual target motion.
      Subjects were also submitted to a series of 60 tracking trials, for which the arm
      to-target motion relationship was systematically reversed. Under these conditions
      subjects were able to initiate early smooth pursuit in the actual direction of
      the visual target. Overall, these results confirm that non-visual information
      produced by the arm motor system can trigger and control smooth pursuit. They
      also demonstrate the plasticity of the neuronal network handling eye-arm
      coordination control.

PMID- 7789439
TI  - Directional specificity of postural muscles in feed-forward postural reactions
      during fast voluntary arm movements.
AB  - Healthy subjects performed bilateral fast shoulder movements in different
      directions while standing on a force platform. Anticipatory postural adjustments
      were seen as changes in the electrical activity of postural muscles as well as
      displacements of the center of pressure and center of gravity. Postural muscle
      pairs of agonist-antagonist commonly demonstrated triphasic patterns starting
      prior to the first electromyographic (EMG) burst in the prime-mover muscle.
      Proximal postural muscles demonstrated the largest anticipatory increase in the
      background activity during movements in one of the two opposite directions
      (forward or backwards). These changes progressively decreased when movements
      deviated from the preferred direction and frequently disappeared during movements
      in the opposite direction. The patterns in distal muscles varied across subjects
      and could demonstrate larger anticipatory changes during movements forward and
      backwards as compared to movements in intermediate directions. Bilateral addition
      of inertial loads to the wrists did not change the general anticipatory patterns,
      while making some of their features more pronounced. Anticipatory postural
      adjustments were followed by later changes in the activity of postural muscles,
      also reflected in the mechanical variables. Changes in leg joint angles revealed
      a "hip-ankle strategy" during shoulder flexions and an "ankle strategy" during
      shoulder extensions. The study demonstrates different behaviors of proximal and
      distal muscles during anticipatory postural adjustments in preparation for fast
      arm movements. We suggest that the proximal muscles produce a general pattern of
      postural adjustments, while distal muscles take care of fine adjustments that are
      more likely to vary across subjects.

PMID- 7789440
TI  - Influence of opioids and naloxone on rhythmic motor activity in spinal cats.
AB  - The effects of L-DOPA, naloxone, and the opioids (D-Ala2,N-Me-Phe4,Gly5-ol)
      enkephalin (DAGO) and D-Ser2-Leu-enkephalin-Thr6 (DSLET) on spinal motor rhythm
      generation were compared in anemically decapitated high spinal cats. After
      premedication with nialamide, DOPA caused the well-known, slow rhythmic motor
      activity with a locomotor pattern. The cycle duration of the evoked rhythm was
      usually between 3.9 and 5.0 s. The opioids DAGO and DSLET, injected intravenously
      (1.2-2 mg/kg) or suffused over the lumbar spinal cord (10(-3)-10(-4) M in
      Ringer's solution), severely depressed the DOPA-induced rhythmic activity,
      sometimes completely abolishing efferent motor activity. Naloxone (0.5-1 mg/kg
      i.v.) exerted different rhythm-facilitating effects, depending on the
      experimental condition. In the acute phase after spinalization, without paralysis
      and without nialamide and DOPA, naloxone induced rhythmic movements with a main
      frequency of 1.2-2 Hz. In the same preparation with paralysis, naloxone induced a
      rhythmic motor activity with a distinctly higher frequency (main range 4.3-5.8
      Hz). After premedication with nialamide and DOPA, naloxone facilitated or, if a
      rhythm was absent, induced the slow-frequency DOPA type of rhythm. Given after
      i.v. or topical opioid application, naloxone antagonized the rhythm-depressing
      action of the opioid and caused an additional facilitation of rhythmic activity.
      Dopa and naloxone facilitated the long-latency, segmental reflex pathways from
      flexor reflex afferents (FRA), while the opioids depressed them. The short
      latency FRA pathways were depressed by DOPA and opioids but were facilitated by
      naloxone. The influence of the different drugs on spinal motor rhythm generation
      is discussed in relation to their influence on short- and long-latency segmental
      pathways from FRA. If the rhythm generation induced by DOPA is based on the
      release of the long-latency FRA pathways, as has been proposed before, the rhythm
      depressing action of opioids may be due to the suppression of these pathways, and
      the particular rhythm-generating function of naloxone may be related to its
      facilitation of short- and long-latency FRA pathways.

PMID- 7789441
TI  - Somatostatin-mRNA expression in brainstem projections into the medial preoptic
      nucleus.
AB  - The medial preoptic nucleus plays an important role in the regulation of
      neuroendocrine processes, vegetative functions, sexual behaviour and the
      modulation of the somatomotoric system. The connections of the medial preoptic
      nucleus to other areas of the central nervous system are very complex, and the
      area receives afferents using numerous transmitters and neuropeptides. Previous
      investigations have shown that this nucleus receives afferents from various
      brainstem nuclei that also contain somatostatinergic neurons. This study was
      carried out to investigate if somatostatin-projecting neurons of the brainstem
      are afferents to the medial preoptic nucleus. This was approached by combining
      somatostatin-mRNA in situ hybridisation with True Blue retrograde tracing. Our
      results demonstrate somatostinergic brainstem projections into the medial
      preoptic nucleus mainly in the pedunculopontine nucleus and in the nucleus of the
      solitary tract (50% together). Other important somatostatinergic afferents into
      the medial preoptic nucleus originate in the cuneiform area, the dorsal
      parabrachial nucleus and in the lateral reticular nucleus (37% together). Less
      important are the somatostatinergic projections coming from the central grey, the
      laterodorsal tegmental nucleus, the locus coeruleus and the nucleus raphe magnus.
      Considering that these areas are involved in diverse functions such as
      cardiovascular regulation (nucleus of the solitary tract), transmission of
      visceral sensibility (dorsal parabrachial nucleus), modulation of the
      somatomotoric system (pedunculopontine nucleus) and in the regulation of
      neuroendocrine mechanisms (locus coeruleus), it seems tenable that the
      somatostatin projections demonstrated here also have a diverse functional quality
      within the medical preoptic nucleus where they terminate.

PMID- 7789442
TI  - A comparison of the behavioural effects of embryonic nigral grafts in the caudate
      nucleus and in the putamen of marmosets with unilateral 6-OHDA lesions.
AB  - The behaviour of marmosets with unilateral 6-hydroxydopamine lesions of the
      nigrostriatal bundle and grafts of embryonic mesencephalon in either the caudate
      nucleus or the putamen was compared with that of lesion-alone and unoperated
      controls. The grafts comprised injections of cell suspensions prepared from
      marmoset ventral mesencephalon (i.e. allografts) targeted at four sites either
      entirely within the caudate nucleus or entirely within the putamen. Behavioural
      tests, including measures of amphetamine-induced rotation, neglect and use of
      each arm to retrieve food from inside tubes, were given before and after the 6
      hydroxydopamine lesion and at regular intervals for 6 months after
      transplantation surgery. Grafts in the caudate nucleus reduced the ipsilateral
      rotation induced by amphetamine, whereas grafts in the putamen did not. Despite
      the absence of an effect on rotation, the putamen grafts were effective in
      reducing lesion-induced deficits on the task in which the marmosets were required
      to reach into tubes. In this latter task, the caudate grafts were also effective
      when the monkeys were given a free choice of which hand to use. However, when
      constrained to use the hand contralateral to the lesion and graft, the
      performance of the marmosets with caudate grafts was not significantly improved
      compared with that of lesion-alone controls. Neither the grafts in the caudate
      nucleus nor the grafts in the putamen abolished the contralateral somatosensory
      neglect induced by the lesion, although there was a trend for the marmosets with
      putamen grafts to contact the label on the contralateral side more quickly than
      those with caudate grafts or the lesion-alone controls. These results demonstrate
      that the location of embryonic nigral grafts within the primate striatum
      influences the profile of functional recovery.

PMID- 7789443
TI  - Brainstem modulation of signal transmission through the cat dorsal lateral
      geniculate nucleus.
AB  - We studied changes in retinogeniculate transmission that occur during variation
      of modulatory brainstem input and during variation of stimulus contrast.
      Responses of single cells in the dorsal lateral geniculate nucleus (dLGN) to a
      stationary flashing light spot of varying contrast were measured with and without
      electrical stimulation of the peribrachial region (PBR) of the brainstem. PBR
      stimulation increased the contrast gain (slope of response versus contrast curve)
      and the dynamic response range (range between spontaneous activity and maximal
      firing). Lagged and nonlagged X-cells reached the midpoint of the dynamic
      response range at lower contrasts during PBR stimulation than in the controls. No
      comparable change was seen for Y-cells. Only minor changes of threshold contrast
      were seen. The characteristics of the retinogeniculate transmission were directly
      studied by comparing the response of dLGN cells with their retinal input (slow
      potentials, S-potentials). With increasing contrast there was a marked increase
      in the transfer ratio (proportion of impulses in the input that generates action
      potentials in the dLGN cell). The transfer ratio seemed to be primarily
      determined by the firing rate of the retinal input. The transfer ratio increased
      with increasing input rates from low values near threshold to values that could
      approach 1 at high-input firing rates. PBR stimulation increased the transfer
      ratio, particularly at moderate input firing rates. The increased transfer ratio,
      caused by increasing input firing rates, enhanced the response versus contrast
      characteristics through an increase in contrast gain and dynamic response range.
      The modulatory input from the PBR further enhanced these characteristics.

PMID- 7789444
TI  - Electron microscopic study of synaptogenesis and myelination of the olfactory
      centers in developing rats.
AB  - Development of the central olfactory system was studied in the rat with an
      electron microscope at three main structures: the olfactory bulb, the lateral
      olfactory tract, and the primary olfactory cortex (the piriform cortex). As a
      parameter of development, the synaptic density was examined quantitatively in the
      bulbar glomerulus and layer Ia (termination of bulbofugal fibers) of the piriform
      cortex. which are the key stations of the olfactory pathway. The synaptic
      densities in the glomerulus and those in layer Ia were 5.7% and 4.6% on embryonic
      day 19, 15.8% and 12.5% on postnatal day (P) 0, and 57.3% and 37.2% on P10, as
      compared with the adult (100%). As another parameter of development, the density
      of myelinated axons in the lateral olfactory tract was examined quantitatively.
      The densities of myelinated axons in the tract were 0% on P5, 15.1% on P10, and
      73.5% on P21 of the adult density. Maturation in the tract was still progressing,
      even at P21, in terms of bundle formation and the thickness of myelin sheaths.
      The results show that synaptogenesis in the bulbar glomerulus is followed by
      synaptogenesis in layer Ia of the piriform cortex, and that myelination in the
      lateral olfactory tract occurs over a prolonged period, even in the stages after
      P21.

PMID- 7789445
TI  - Influence of eye motion on adaptive modifications of the vestibulo-ocular reflex
      in the rat.
AB  - While sustained retinal slip is assumed to be the basic conditioning stimulus in
      adaptive modifications of the vestibulo-ocular reflex (VOR) gain, several
      observations suggest that eye motion-related signals might also be involved. We
      oscillated pigmented rats over periods of 20 min around the vertical axis, at 0.3
      Hz and 20 degrees/s peak velocity, in different retinal slip and/or eye motion
      conditions in order to modify their VOR gain. The positions of both eyes were
      recorded by means of a phase-detection coil system with the head restrained. The
      main findings came from the comparison of two basic conditions--including their
      respective controls--in which one or both eyes were reversibly immobilised by
      threads sutured to the eyes. In the first condition the animals were rotated in
      the light with one eye immobilised and the other eye free to move but covered.
      Rotation in the light in this open-loop condition immediately elicited high-gain
      compensatory eye movements of the non-impeded, covered eye. At the end of this
      training procedure, the VOR gain increased by 43.2%. In the second condition,
      both eyes were immobilised and one eye was covered. The result was an increase in
      the VOR gain of 26.3%. These two conditions were similar as to the visuo
      vestibular drive during the exposure, but different as to the resulting--and
      allowed--eye motion, showing that the condition where the larger eye movements
      occurred yielded the larger VOR gain change. Our data support the idea proposed
      by Collewijn and Grootendorst (1979, p. 779) and Collewijn (1981, p. 146) that
      "[retinal] slip and eye movements seem to be relevant signals for the adaptation
      of the rabbit's visuo-vestibular oculomotor reflexes".(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7789446
TI  - The colocalization of parvalbumin and calbindin-D28k with GABA in the subnucleus
      caudalis of the rat spinal trigeminal nucleus.
AB  - The colocalization of two calcium-binding proteins, parvalbumin (PV) and
      calbindin-D28k (CaB), which have been reported to be markers of specific
      subpopulations of neurons in the central nervous system, with the inhibitory
      amino acid neurotransmitter gamma-amino-butyric acid (GABA) was investigated in
      neurons of laminae I-IV of the subnucleus caudalis of the rat spinal trigeminal
      nucleus by using post-embedding immunocytochemical methods. Cells immunoreactive
      for PV, CaB, and GABA were found in all four laminae of the subnucleus caudalis.
      A substantial proportion of PV-immunoreactive perikarya were also stained for
      GABA in laminae II and III (44.8% and 39.8%, respectively). However, the majority
      of PV-containing neurons in laminae I and IV (100% and 86%, respectively), as
      well as CaB-immunoreactive cells in all four laminae (98.4%), were GABA-negative.
      These results show that, in contrast to higher brain centers, PV-, CaB-, and GABA
      immunoreactive perikarya represent significantly different populations of neurons
      in the subnucleus caudalis of the rat. In the light of the present findings, the
      differences in the neurochemical properties of the subnucleus caudalis of the
      spinal trigeminal nucleus and the spinal dorsal horn are also discussed.

PMID- 7789448
TI  - The curvature of human arm movements in the absence of visual experience.
AB  - It has been suggested that the spatial path of the hand is an important
      controlled feature of normal human arm movements and that the desired path is a
      straight line through external space. Recent experiments have suggested that
      distortions in visual perception of external space may lead to errors in its
      representation and thus influence the curvature of movements. The movements of
      blind and normal blind-folded subjects were therefore compared in a task
      requiring point-to-point hand movements in six directions across a horizontal
      worktop. Movement curvature varied with direction in both groups but was
      significantly higher for the blind-folded control subjects. Thus, the normals'
      distorted visual experience of straight lines in some orientations may lead them
      to make curved movement paths. The perception of curvature was also tested in the
      two groups in a task in which they traced the curved edge of a ruler. The blind
      group were slightly better at this task, although the difference was not
      significant. We conclude that visual experience influences point-to-point hand
      movements, leading to higher curvature for movements made in the fronto-parallel
      plane by sighted subjects due to visual distortions. These data therefore support
      the hypothesis that the spatial path followed by the hand is influenced by
      sensory inputs and is a controlled feature of human reaching movements. The data
      argue against the hypothesis that movement curvature is a result of optimising
      only the dynamics of the limb control.

PMID- 7789447
TI  - The responses of single neurons in the temporal visual cortical areas of the
      macaque when more than one stimulus is present in the receptive field.
AB  - Neurons in the temporal visual cortical areas of primates have large receptive
      fields, which can show considerable selectivity for what the stimulus is
      irrespective of exactly where it is in the visual field. This is called
      translation invariance. However, such results have been found when there is only
      one stimulus in the visual field. The question arises of how the visual system
      operates in a cluttered environment. To investigate this we measured the
      responses of neurons with face-selective responses in the cortex in the anterior
      part of the superior temporal sulcus of rhesus macaques performing a visual
      fixation task. We found that the response of neurons to an effective face centred
      8.5 degrees from the fovea was decreased to 71% if an ineffective face stimulus
      for that cell was present at the fovea. In a similar way, introduction of a
      parafoveal ineffective face stimulus decreased the responses of these neurons to
      an effective face stimulus at the fovea to 75%. In addition to these
      interactions, it was found that an effective stimulus object at the fovea
      produced a larger response than when it was parafoveal, and that this weighting
      towards an object at the fovea was also seen when more than one object was
      present in the visual field. The implication of this weighting of the responses
      of neurons towards objects at the fovea, even in an environment with more than
      one object present, is that the output of the visual system provides information
      to subsequent systems particularly about objects at the fovea, so that learning
      about these objects (and less about other objects elsewhere in the visual field)
      is facilitated.

PMID- 7789449
TI  - Movement-related potentials preceding voluntary movement are modulated by the
      mode of movement selection.
AB  - In two experiments movement-related cortical potentials preceding voluntary
      movement were recorded. In experiment 1, subjects performed four motor tasks
      involving joystick movements. The four tasks differed in complexity (single vs
      sequential movements) and in the mode of movement selection, i.e., whether a
      movement or movement sequence was made in fixed or in self-determined directions.
      The choice of these tasks was based, firstly, on previous electrophysiological
      studies suggesting an effect of task-complexity on the amplitude of the readiness
      potential (RP) and, secondly, on previous positron emission tomography (PET)
      studies showing that activity of the supplementary motor area (SMA) is influenced
      by the mode of movement selection. The results show that, for single movements,
      RP amplitude is higher preceding freely selected movements than preceding
      movements in a fixed direction. In experiment 2 this effect was replicated using
      button presses instead of joystick movements. The results converge with PET
      evidence obtained in similar tasks and establish that the RP is modulated by the
      mode of movement selection. This modulation is probably related to differential
      involvement of the SMA.

PMID- 7789450
TI  - The relationship between control, kinematic and electromyographic variables in
      fast single-joint movements in humans.
AB  - Two versions of the hypothesis that discrete movements are produced by shifts in
      the system's equilibrium point are considered. The first suggests that shifts are
      monotonic and end near the peak velocity of movement, and the second presumes
      that they are nonmonotonic ("N-shaped") and proceed until the end of movement.
      The first version, in contrast to the second, predicts that movement time may be
      significantly reduced by opposing loads without changes in the control pattern.
      The purpose of the present study was to test the two hypotheses about the
      duration and shape of the shift in the equilibrium point based on their
      respective predictions concerning the effects of perturbations on kinematic and
      EMG patterns in fast elbow flexor movements. Subjects performed unopposed
      flexions of about 55-70 degrees (control trials) and, in random test trials,
      movements were opposed by spring-like loads generated by a torque motor. Subjects
      had no visual feedback and were instructed not to correct arm deflections in case
      of perturbations. After the end of the movement, the load was removed leading to
      a secondary movement to the same final position as that in control trials
      (equifinality). When the load was varied, the static arm positions before
      unloading and associated joint torques (ranging from 0 to 80-90% of maximum
      voluntary contraction) had a monotonic relationship. Test movements opposed by a
      high load (80-90% of maximal voluntary contraction) ended near the peak velocity
      of control movements. Phasic and tonic electromyographic patterns were load
      dependent. In movements opposed by high loads, the first agonist burst was
      significantly prolonged and displayed a high level of tonic activity for as long
      as the load was maintained. In the same load conditions, the antagonist burst was
      suppressed during the dynamic and static phases of movement. The findings of
      suppression of the antagonist burst does not support the hypothesis of an N
      shaped control signal. Equally, the substantial reduction in movement time by the
      introduction of an opposing load cannot be reconciled in this model. Instead, our
      data indicate that the shifts in the equilibrium point underlying fast flexor
      movements are of short duration, ending near the peak velocity of unopposed
      movement. This suggests that kinematic and electromyographic patterns represent a
      long-lasting oscillatory response of the system to the short-duration monotonic
      control pattern, external forces and proprioceptive feedback.

PMID- 7789451
TI  - Influence of joint interactional effects on the coordination of planar two-joint
      arm movements.
AB  - We have examined EMG-movement relations in two-joint planar arm movements to
      determine the influence of interactional torques on movement coordination.
      Explicitly defined combinations of elbow movements (ranging from 20 to 70
      degrees) and wrist movements (ranging from 20 to 40 degrees) were performed
      during a visual, step-tracking task in which subjects were specifically required
      to attend to the initial and final angles at each joint. In all conditions the
      wrist and elbow rotated in the same direction, that is, flexion-flexion or
      extension-extension. Elbow movement kinematics were only slightly influenced by
      motion about the wrist. In contrast, the trajectory of the wrist movement was
      significantly influenced by uncompensated reaction torques resulting from
      movement about the elbow joint. At any given wrist amplitude, wrist movement
      duration increased and peak velocity decreased as elbow amplitude increased. In
      addition, as elbow amplitude increased, wrist movement onset was progressively
      delayed relative to this elbow movement. Surprisingly, the changes between joint
      movement onsets were not accompanied by corresponding changes between agonist EMG
      onsets at the elbow and wrist joints. The mean difference in onset times between
      elbow and wrist agonists (22-30 ms) remained unchanged across conditions. In
      addition, a basic pattern of muscle activation that scaled with movement
      amplitude was observed at each joint. Phasic agonist activity at the wrist and
      elbow joints remained remarkably similar across conditions and thus the changes
      in joint movement onset could not be attributed to changes in the motor
      commands.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789452
TI  - Are arm trajectories planned in kinematic or dynamic coordinates? An adaptation
      study.
AB  - There are several invariant features of point-to-point human arm movements:
      trajectories tend to be straight, smooth, and have bell-shaped velocity profiles.
      One approach to accounting for these data is via optimization theory; a movement
      is specified implicitly as the optimum of a cost function, e.g., integrated jerk
      or torque change. Optimization models of trajectory planning, as well as models
      not phrased in the optimization framework, generally fall into two main groups
      those specified in kinematic coordinates and those specified in dynamic
      coordinates. To distinguish between these two possibilities we have studied the
      effects of artificial visual feedback on planar two-joint arm movements. During
      self-paced point-to-point arm movements the visual feedback of hand position was
      altered so as to increase the perceived curvature of the movement. The
      perturbation was zero at both ends of the movement and reached a maximum at the
      midpoint of the movement. Cost functions specified by hand coordinate kinematics
      predict adaptation to increased curvature so as to reduce the visual curvature,
      while dynamically specified cost functions predict no adaptation in the
      underlying trajectory planner, provided the final goal of the movement can still
      be achieved. We also studied the effects of reducing the perceived curvature in
      transverse movements, which are normally slightly curved. Adaptation should be
      seen in this condition only if the desired trajectory is both specified in
      kinematic coordinates and actually curved. Increasing the perceived curvature of
      normally straight sagittal movements led to significant (P < 0.001) corrective
      adaptation in the curvature of the actual hand movement; the hand movement became
      curved, thereby reducing the visually perceived curvature. Increasing the
      curvature of the normally curved transverse movements produced a significant (P <
      0.01) corrective adaptation; the hand movement became straighter, thereby again
      reducing the visually perceived curvature. When the curvature of naturally curved
      transverse movements was reduced, there was no significant adaptation (P > 0.05).
      The results of the curvature-increasing study suggest that trajectories are
      planned in visually based kinematic coordinates. The results of the curvature
      reducing study suggest that the desired trajectory is straight in visual space.
      These results are incompatible with purely dynamic-based models such as the
      minimum torque change model. We suggest that spatial perception--as mediated by
      vision--plays a fundamental role in trajectory planning.

PMID- 7789454
TI  - Aftereffects from jogging.
AB  - After running on a treadmill, runners who attempted to jog in place on solid
      ground inadvertently jogged forwards. One-legged hopping on the treadmill
      produced an aftereffect in the same leg, but not in the other leg. This non
      transfer suggests a peripheral neural site. Judgments of velocity and slope were
      affected; running on a backward-moving treadmill made a stationary test treadmill
      seem to move forwards, and running on an uphill-sloping treadmill made a
      horizontal test treadmill seem to slope downhill. These aftereffects suggest an
      automatic gain control process.

PMID- 7789453
TI  - Compensation of the human vertical vestibulo-ocular reflex following occlusion of
      one vertical semicircular canal is incomplete.
AB  - The vestibulo-ocular reflex (VOR) was studied in nine human subjects 2-15 months
      after permanent surgical occlusion of one posterior semicircular canal. The
      stimuli used were rapid, passive, unpredictable, low-amplitude (10-20 degrees),
      high-acceleration (3000-4000 degrees/s2) head rotations in pitch and yaw planes.
      The responses measured were vertical and horizontal eye rotations, and the
      results were compared with those from 19 normal subjects. After unilateral
      occlusion of the posterior semicircular canal, the gain of the head-up pitch
      vertical VOR--the vertical VOR generated by excitation from only one and
      disfacilitation from two vertical semicircular canals--was reduced to 0.61 +/-
      0.06 (normal 0.92 +/- 0.06) at a head velocity of 200 degrees/s. In contrast the
      gain of the head-down pitch vertical VOR--the VOR still generated by excitation
      from two, but disfacilitation from only one vertical semicircular canal--was
      within normal limits: 0.86 +/- 0.11 (normal 0.96 +/- 0.04). The gain of the
      horizontal VOR in response to yaw head rotations--ipsilesion 0.81 +/- 0.06
      (normal 0.88 +/- 0.05) and contralesion 0.80 +/- 0.11 (normal 0.92 +/- 0.11)--was
      within normal limits in both directions (group means +/- two-tailed 95%
      confidence intervals given in each case). These results show that occlusion of
      just one vertical semicircular canal produces a permanent deficit of about 30% in
      the vertical VOR gain in response to rapid pitch head rotations in the excitatory
      direction of the occluded canal. This observation indicates that, in response to
      a stimulus in the higher dynamic range, compensation of the human VOR for the
      loss of excitatory input from even one vertical semicircular canal is incomplete.

PMID- 7789455
TI  - On the metabolism of apolipoprotein E and the Alzheimer diseases.

PMID- 7789456
TI  - Systemic administration of GM1 ganglioside increases choline acetyltransferase
      activity in the brain of aged rats.
AB  - In the brain of aged rats (22-24 months old) choline acetyltransferase (ChAT)
      activity in striatum and frontal cortex is lower than in young rats (4-5 months
      old). In contrast, ChAT activity in the hippocampus is similar in the two groups.
      Treating old animals with GM1 ganglioside, 30 mg/kg ip, for 30 or 45 days
      enhances ChAT activity in the striatum and frontal cortex, but has no effect on
      activity in the hippocampus. ChAT activity remains elevated in the striatum and
      frontal cortex for 15 days after discontinuing treatment with GM1.

PMID- 7789458
TI  - Plasticity of complex terminals in lamina II in partially deafferented spinal
      cord: the cat spared root preparation.
AB  - Projections to the dorsal horn change in adult mammals in response to complete or
      partial deafferentation. The number of synaptic terminals remains constant after
      complete lumbosacral deafferentation, indicating replacement of lost dorsal root
      terminals by newly formed terminals from spared intrinsic systems. The density of
      a spared central projection of a dorsal root is increased in dorsal horn after
      partial deafferentation, consistent with sprouting by the axons in the spared
      root. In this study, we have used electron microscopy to study morphological
      changes in a specific class of terminals in the dorsal horn induced by partial
      deafferentation. Complex terminals (CTs) in the dorsal horn originate exclusively
      from dorsal roots and are readily distinguished morphologically. The CTs and the
      postsynaptic densities (PSDs) associated with CTs were measured in lamina II at
      L5 and L6 in cats subjected to unilateral spared root (L6) dorsal rhizotomies and
      compared to CTs in the control side. Acutely following partial deafferentation,
      the number of CT profiles decreased. At more chronic survivals, the number of CT
      profiles were restored to normal levels, and both the number and the length of
      PSDs were increased. The changes in CTs and PSDs suggest sprouting and
      synaptogenesis by the spared dorsal root fibers that produce changes in the
      postsynaptic neuron. Spared root deafferentation thus elicits compensatory
      changes in presynaptic terminals of the spared root and also in their
      postsynaptic target neurons.

PMID- 7789457
TI  - Early association of reactive astrocytes with senile plaques in Alzheimer's
      disease.
AB  - The fibrillar beta-amyloid protein (A beta) plaques of Alzheimer's disease (AD)
      are associated with reactive astrocytes and dystrophic neurites and have been
      suggested to contribute to neurodegenerative events in the disease. We recently
      reported parallel in vitro and in situ findings, suggesting that the adoption of
      a reactive phenotype and the colocalization of astrocytes with plaques in AD may
      be mediated in large part by aggregated A beta. Thus, A beta-mediated effects on
      astrocytes may directly affect disease progression by modifying the degenerative
      plaque environment. Alternatively, plaque-associated reactive astrocytosis may
      primarily represent a glial response to the neural injury associated with plaques
      and not significantly contribute to AD pathology. To investigate the validity of
      these two positions, we examined the differential colocalization of reactive
      astrocytes and dystrophic neurites with plaques. Hippocampal sections from AD
      brains--ranging in neuropathology from mild to severe--were triple-labeled with
      antibodies recognizing A beta protein, reactive astrocytes, and dystrophic
      neurites. We observed not only plaques containing both or neither cell type, but
      also plaques containing (1) reactive astrocytes but not dystrophic neurites and
      (2) dystrophic neurites but not reactive astrocytes. The relative proportion of
      plaques colocalized with reactive astrocytes in the absence of dystrophic
      neurites is relatively high in mild AD but significantly decreases over the
      course of the disease, suggesting that plaque-associated astrocytosis may be an
      early and perhaps contributory event in AD pathology rather than merely a
      response to neuronal injury. These data underscore the potentially significant
      contributions of reactive astrocytosis in modifying the plaque environment in
      particular and disease progression in general.

PMID- 7789460
TI  - The relationships among the severity of spinal cord injury, residual neurological
      function, axon counts, and counts of retrogradely labeled neurons after
      experimental spinal cord injury.
AB  - Substantial residual neurological function may persist after spinal cord injury
      (SCI) with survival of as few as 5-10% of the original number of axons. A
      detailed understanding of the relationships among the severity of injury, the
      number and origin of surviving axons at the injury site, and the extent of
      neurological recovery after SCI is of importance in understanding the
      pathophysiology of SCI and in designing treatment strategies. In the present
      study, these relationships were examined in rats with graded severity of clip
      compression injury of the cord at T1. The rats were randomly assigned to one of
      the following injury groups (n = 5 each): normal (laminectomy only), 2-, 18-, 30
      , 50-, and 98-g clip injuries. Neurological function was assessed by the inclined
      plane method and by the modified Tarlov technique. A morphometric assessment of
      axons at the injury site was performed by a computer-assisted line sampling
      technique. The origin of descending axons at the injury site was determined by
      retrograde labeling with horseradish peroxidase. The inclined plane scores varied
      as a negative linear function of the closing force of the clip used to inflict
      SCI (r = -0.93; P < 0.0001). The mean axon count was 367,000 +/- 59,000 in normal
      rats and decreased as a negative exponential function of injury force (r = -0.92;
      P < 0.0001). As well, SCI caused preferential destruction of large axons as
      reflected by the change in mean axon diameter from 1.74 +/- 0.06 microns in
      normal cords to 1.46 +/- 0.04 microns in injured cords (pooled mean for all
      injuries).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789459
TI  - Transgenic neural plate contributes neuronal cells that survive greater than one
      year when transplanted into the adult mouse central nervous system.
AB  - Neural plate cells from the early embryo may have a number of important
      advantages as donor material for the delivery of foreign genes into the diseased
      adult central nervous system (CNS). Mesencephalic neural plate from transgenic
      GT4-2 mice was used as a source of marked donor cells to determine whether
      transgene-expressing embryonic CNS progenitor cells can be used as donor material
      for implantation into the adult mouse brain. Transgenic mouse embryos from this
      line express the Escherichia coli beta-galactosidase (beta-gal) gene throughout
      early CNS development. At the early somite stage (Embryonic Day 8.5),
      mesencephalic neural plate tissue from heterozygous embryos was dissected out and
      either transferred into culture for characterization or immediately implanted
      into the striatum or lateral ventricle of adult wild-type CD-1 mice. Explants of
      neural plate tissue possessed intense beta-gal activity and produced extensive
      outgrowth of neurofilament-positive processes after 6 days in vitro. Many beta
      gal-positive cells migrated away from the explanted tissue mass. Grafts of
      transgenic neural plate tissue in the normal adult mouse striatum, sampled 2
      weeks to 1 year after implantation, possessed healthy beta-gal-positive cells.
      More detailed analysis of grafts 3 months after implantation indicated that most
      beta-gal-positive cells were also immunoreactive for neurofilament and
      microtubule-associated proteins, two neuron-specific markers. In addition,
      extensive neurofilament-positive axonal tangles were evident within the grafts
      among the beta-gal-positive cells. Electron microscopic (EM) findings of
      implanted tissue stained with Bluo-Gal revealed many beta-gal-positive neurons
      received synaptic contacts from other cells. A few donor-derived astrocytes were
      also found in the grafts by EM analysis. No obvious signs of immunological
      rejection, or of significant decrease in graft volume, were observed at any age.
      Some beta-gal-positive cells were observed to lie up to 230 microns away from the
      main graft mass in both striatal and intraventricular implantations. These data
      suggest that the neural plate can contribute a long-surviving population of
      neuronal and astrocytic cells when transplanted into the adult CNS.

PMID- 7789461
TI  - Regrowth of optic fibers and behavioral recovery after optic chiasm transection.
AB  - We studied the effect of optic chiasm midline transection on visually guided
      behavior and retinotectal fiber regrowth in frogs. After complete transection,
      frogs do not respond to visually presented prey and looming stimuli. Beginning
      about 2 months later there is recovery of visual function. However, unlike
      recovery after optic nerve transection, animals respond as if the stimulus were
      not at its actual position, but at the symmetric position in the contralateral
      field. For instance, if a prey stimulus is located 5 cm away from the recovered
      frog at an eccentricity of 40 degrees to the left of the midline, the animal will
      respond as if the stimulus were 5 cm away at 40 degrees right. Further, these
      animals typically respond to looming stimuli not by jumping away from the
      stimulus, but by either colliding with the stimulus or jumping toward the side
      from which the stimulus approaches. These behaviors persist throughout the
      testing period, up to 17.5 months postlesion. Electrophysiological recordings
      reveal that visual activity in the optic tectum is retinotopically organized but
      driven primarily by stimuli to the ipsilateral eye. HRP histochemistry reveals
      that some regenerated retinal fibers are found to cross at the midline of the
      chiasm. Thus, the midline is not impenetrable to crossing retinal fibers. Frogs
      with cut of 3/4 of the chiasm respond normally to prey stimuli initially but
      later respond as if the stimuli are at mirror image locations. In these animals
      most retinotectal fibers project to the ipsilateral tectum despite the presence
      of intact contralaterally projecting retinotectal fibers during the recovery
      period.

PMID- 7789462
TI  - Transganglionic degeneration in the gustatory system consequent to chorda tympani
      damage.
AB  - The chorda tympani taste nerve is prone to damage in humans. Chorda tympani
      damage results in taste loss accompanied by altered taste sensations, e.g.,
      phantom tastes. To understand taste alterations this study explores the central
      and peripheral anatomical consequences of taste nerve injury in an animal model.
      The chorda tympani was severed in the middle ear of hamsters and the animals were
      allowed to survive for 2-161 days when sections of the brain were stained for
      degenerating axons with the Fink-Heimer method. Degenerating axons were present
      in the chorda tympani termination zone in the nucleus of the solitary tract of
      every case. Thus, peripheral nerve damage in the taste system results in
      degeneration of central axonal endings as in other sensory systems (e.g.,
      trigeminal, vestibular). To evaluate whether the central degeneration results
      from ganglion cell death, geniculate ganglion cells were labeled with Fast blue
      by tongue injections before neurotomy, and the cells were counted 13-48 days
      after neurotomy. Numbers of labeled cells from experimental ganglia did not
      differ significantly from those in control ganglia. Moreover, the experimental
      cells could be double-labeled by tongue injections with a second marker,
      diamidino yellow or nuclear yellow, after 40 days postneurotomy. We conclude that
      degeneration of central axons after taste nerve section represents a long-lasting
      transganglionic process that likely disrupts the synaptology of the central taste
      system. The altered synaptology could relate to taste phenomena of central origin
      reported for nerve-injured patients. Geniculate ganglion cells generally survive
      neurotomy and can regenerate axons to the tongue.

PMID- 7789463
TI  - Peripheral target reinnervation following orthotopic grafting of fetal allogeneic
      and xenogeneic dorsal root ganglia.
AB  - The sensory reinnervation of dermal papillae and epidermis of glabrous skin,
      interosseal Pacinian corpuscles, and muscle spindles of the soleus and extensor
      digitorum longus muscles has been examined 1, 3, and 8 months (allografts) or 3
      and 5 weeks (xenografts) following orthotopic grafting of fetal allogeneic or
      xenogeneic (mouse) dorsal root ganglia (DRG) into ganglionectomized adult rats.
      Sensory axons in target tissues were identified immunohistochemically by
      monoclonal antibodies against growth-associated peptide (GAP-43), heavy
      neurofilament protein (RT-97), anti-mouse-specific membrane glycoprotein Thy-1.2,
      and polyclonal antibody to calcitonin gene-related peptide (CGRP). Absence of
      axonal marker staining in target structures of control animals 10 days or 3
      months following ipsilateral enucleation of the L3-L6 DRG without grafting
      indicated an elimination of host normal (intact), regenerating, or collaterally
      sprouting nerve fibers. The consistent finding of immunolabeled axons ending free
      and in encapsulated structures in the target tissues of both allo- and
      xenografted rats indicates that grafted primary sensory neurons can survive and
      send axonal processes down the full length of the hind limb, to terminate in host
      target tissues. Axons of xenografted fetal mouse sensory neurons grow in adult
      rat hosts for distances of 4 cm or more, attaining lengths far greater than
      called for by their normal developmental programs.

PMID- 7789464
TI  - Changes of compound action potentials in retrograde axonal degeneration of rat
      optic nerve.
AB  - Electrophysiological recordings of compound action potentials (CAPs) were made
      from the optic nerve (ON) following unilateral optic tract (OT) transection in
      adult rats. In response to optic chiasm stimulation CAPs recorded from the ON
      ipsilateral to the transected OT, i.e., the ON of control side, revealed three
      positive waves, termed n1, n2, and n3 components, corresponding to fast-,
      intermediate-, and slow-conducting fibers. Two weeks after OT transection, CAPs
      recorded from the ON contralateral to the transected OT, i.e., the ON of cut
      side, were generally smaller in amplitude than those recorded from the ON of
      control side. The degree of amplitude reduction was different among three
      components; n3 component was severely reduced and n2 component was moderately
      reduced, whereas n1 component relatively persisted. These tendencies were more
      marked in CAPs recorded at 4 weeks after OT transection; n3 component
      disappeared, whereas n1 and n2 components decreased in amplitude with elongation
      of latency. Cross sections of the ON after unilateral OT transection were
      examined electron microscopically, in which significant decrease in fiber
      density, demyelination, and distorted fibers were verified in the cut side. The
      present study suggests that slower-conducting ON fibers, that is, smaller
      diameter ON fibers are initially and remarkably thrown into retrograde
      degeneration, while larger-diameter ON fibers are relatively resistant to
      axotomy.

PMID- 7789465
TI  - Anticonvulsants suppress c-Fos protein expression in spinal cord neurons
      following noxious thermal stimulation.
AB  - The expression of the nuclear immediate-early gene-encoded protein c-Fos in
      spinal cord dorsal horn neurons of the rat following noxious thermal stimulation
      was compared in carbamazepine-, valproate- and phenytoine-treated animals. Single
      intraperitoneal injection of carbamazepine (50 mg/kg), valproate (300 mg/kg) or
      intravenous injection of phenytoine (20 mg/kg) before noxious stimulation reduced
      the number of c-Fos immunoreactive neurons to 65-80% of control levels in
      superficial laminae and to 30-60% in deep laminae of the dorsal horn.
      Pretreatment with carbamazepine or valproate for 4 or 8 days combined with an
      injection immediately before noxious stimulation further significantly decreased
      the number of c-Fos neurons in the deep dorsal horn only in animals treated with
      valproate. The observation that activity-dependent gene expression in the spinal
      cord is effectively modulated by anticonvulsants discloses a novel therapeutic
      potential of these compounds. Presumably via an acute suppression of high
      frequency repetitive firing and/or altered synaptic transmission of intraspinal
      or descending neurotransmitter systems these drugs gain access to neuroplastic
      mechanisms which might be relevant for the restoration of physiological levels of
      neuronal excitability in the central nervous system.

PMID- 7789466
TI  - Coenzyme Q10 and nicotinamide and a free radical spin trap protect against MPTP
      neurotoxicity.
AB  - 1-Methyl-4-phenyl-1,2,5,6-tetrahydropyridine (MPTP) produces Parkinsonism in both
      experimental animals and in man. MPTP is metabolized to 1-methyl-4
      phenylpridinium, an inhibitor of mitochondrial complex I. MPTP administration
      produces ATP depletions in vivo, which may lead to secondary excitotoxicity and
      free radical generation. If this is the case then agents which improve
      mitochondrial function or free radical scavengers should attenuate MPTP
      neurotoxicity. In the present experiments three regimens of MPTP administration
      produced varying degrees of striatal dopamine depletion. A combination of
      coenzyme Q10 and nicotinamide protected against both mild and moderate depletion
      of dopamine. In the MPTP regimen which produced mild dopamine depletion
      nicotinamide or the free radical spin trap N-tert-butyl-alpha-(2-sulfophenyl)
      nitrone were also effective. There was no protection with a MPTP regimen which
      produced severe dopamine depletion. These results show that agents which improve
      mitochondrial energy production (coenzyme Q10 and nicotinamide) and free radical
      scavengers can attenuate mild to moderate MPTP neurotoxicity.

PMID- 7789467
TI  - Monitoring of endotoxin, interleukin-6 and C-reactive protein serum
      concentrations in neutropenic patients with fever.
AB  - Serum endotoxin, interleukin-6 (IL-6) and C-reactive protein (CRP) were serially
      determined in 26 patients with hematological malignancies and chemotherapy
      induced neutropenia who developed fever. Endotoxin in serum was detected in 69%
      of the patients, with the highest values being recorded in patients with gram
      negative (Gr-) bacteremia. High levels of IL-6 were found after start of fever,
      and in 6/9 patients with Gr- bacteremia levels exceeded 200 ng/l in samples drawn
      within the first 72 hours. However, only in 2/17 patients with gram-positive
      bacteremias and blood culture-negative fever episodes did IL-6 exceed this
      concentration (p < 0.05). High CRP values (exceeding 100 mg/l) did not
      discriminate between Gr- and non-Gr- episodes (7/9 versus 10/17, respectively).
      In patients with fever at day 3-5 (n = 15), IL-6 values > 100 ng/l were
      associated with fever continuing for more than 7 days after start of the episode;
      contrarily, CRP values did not indicate the persistence of fever. Determination
      of IL-6 may be a better test than CRP in monitoring the acute response to
      infection in the neutropenic patient. A combination of high endotoxin and IL-6
      values may indicate a Gr- bacteremia. This could have therapeutic implications
      before results of blood cultures are obtained.

PMID- 7789468
TI  - Increased peripheral blood normal myeloid progenitor cells (CFU-GM) in chronic
      lymphocytic leukemia: a perspective for autologous peripheral blood stem cell
      transplantation.
AB  - We assayed granulocyte-macrophage committed progenitor cells (CFU-GM) in the
      peripheral blood of 34 patients with chronic lymphocytic leukemia (CLL) and 12
      normal individuals. The patients were divided into separate groups on the basis
      of previous therapy (i.e. analysis performed at diagnosis, during and after
      chemotherapy) and clinical features of the disease (i.e. disease stage, pattern
      of bone marrow infiltration, peripheral blood lymphocytosis). The mean CFU-GM
      colony count of the patients was 30 times higher than that of the controls (206.4
      +/- 197.8 (SD) CFU-GM per 5 x 10(5) cells plated versus 6.5 +/- 3.6). There was
      no statistical difference in the numbers of circulating CFU-GM between the
      patients studied at diagnosis (257 +/- 215.4 CFU-GM/5 x 10(5) cells) and those
      studied during (117.6 +/- 169.2 CFU-GM/5 x 10(5) cells) or after chemotherapy
      (207.5 +/- 105.9 CFU-GM/5 x 10(5) cells), although a trend towards a higher
      recovery of myeloid progenitors was observed as a function of time elapsing from
      the last treatment. In addition, we found no significant difference in the in
      vitro CFU-GM growth of patients grouped according to their disease stage, pattern
      of bone marrow infiltration and degree of peripheral blood lymphocytosis. In
      conclusion, our data indicate that intensification with peripheral blood stem
      cell support may be feasible in CLL, since progenitor cells of myeloid-monocytic
      series are markedly increased in the peripheral blood of these patients.
      Moreover, it is possible to extend this kind of therapy to patients who have
      undergone previous extensive chemotherapy and who might have persisting bone
      marrow infiltration.

PMID- 7789469
TI  - Refractory anemia with excess of blasts: a multivariate analysis of prognostic
      factors in 91 patients and a simplified scoring system for predicting survival.
AB  - Prognosis in myelodysplastic syndromes is extremely variable. The prognostic
      value of the FAB classification has been demonstrated in many studies. However,
      within the same FAB subtype, some patients may experience prolonged survival,
      whereas others die in a few weeks. This prognostic heterogeneity makes the
      therapy decision difficult. In an attempt to identify significant prognostic
      factors for survival in refractory anemia with excess of blasts (RAEB), clinical
      and hematological characteristics were analyzed in 91 patients. Multivariate
      regression analysis showed that bone marrow total blast cells percentages, sex
      and hemoglobin level were the characteristics significantly associated with
      survival. A scoring index based upon these three characteristics may be proposed
      and had a great prognostic value (p < 0.00001). It allows us to separate patients
      into three groups with low, intermediate and high score with a median survival of
      239, 133 and 45 days for each group respectively. This scoring index may be
      useful in the design of therapy and analysis of future clinical trials. However,
      its predictive value needs to be confirmed in other series.

PMID- 7789470
TI  - The frequently low cobalamin levels in dementia usually signify treatable
      metabolic, neurologic and electrophysiologic abnormalities.
AB  - Cobalamin levels are frequently low in patients with dementia, but it is unclear
      if they represent definable deficiency and what the mechanisms are. Therefore,
      patients being evaluated for dementia who had low cobalamin levels but no obvious
      evidence of deficiency were studied hematologically, neurologically and with
      metabolic tests and were re-evaluated after cobalamin treatment. Abnormalities
      suggestive of or diagnostic for deficiency were documented in most of the 16
      demented and nondemented patients. Metabolic results: 50% of patients tested had
      abnormal deoxyuridine suppression and 44% had increased serum methylmalonic acid
      and/or homocysteine levels; these test results correlated with each other.
      Neurologic results: 73% of patients had clinical abnormalities, primarily mild
      neuropathies, not attributable to other causes, 75% had electroencephalographic
      abnormalities, 77% had abnormal visual evoked potentials and 33% had abnormal
      somatosensory potentials. Metabolic and neurologic dysfunction were present
      together or absent together in all but 2 cases. Cobalamin therapy improved 50
      100% of the various types of abnormalities, although it did not improve cognitive
      function in the 13 demented patients. Food-cobalamin malabsorption was found in
      60% of the patients. Despite the absence of megaloblastic anemia and rarity of
      traditional malabsorption of free cobalamin, low cobalamin levels in demented
      patients frequently represent mild cobalamin deficiency and are often associated
      with food-cobalamin malabsorption. Perhaps most importantly, this is accompanied
      not only by metabolic changes but by evidence of mild neurologic dysfunction.
      Their frequent reversibility by cobalamin confirms that these defects indeed
      arise from cobalamin deficiency. Although the long-standing dementia does not
      improve, treating such patients with cobalamin has other concrete benefits.

PMID- 7789471
TI  - Separate clones in concomitant multiple myeloma and a second B-cell neoplasm
      demonstrated by molecular and immunophenotypic analysis.
AB  - The occurrence of multiple myeloma (MM) and a second B-cell neoplasm in the same
      patient is a rare event. We present 2 such patients, and provide evidence to
      support the presence of separate clones in these coexisting neoplasms. In the
      first case, MM became evident 14 months after the diagnosis of chronic
      lymphocytic leukemia (CLL). In past reports, most occurrences of this
      association, when investigated, have been regarded to be biclonal disease
      processes; however, with few exceptions, most were documented by immunologic
      studies alone. To establish the clonality in our case of CLL with MM, we examined
      both immunophenotypic data obtained by standard two-color flow cytometric
      analysis, and patterns of immunoglobulin gene rearrangement, using standard
      Southern analysis and hybridization with 32P-labelled JH and JK probes. This
      provided evidence for the presence in this patient of two separate monoclonal
      populations of B cells, manifested as light chain restrictions and gene
      rearrangements which differed in blood (CLL) and bone marrow (MM) samples. In the
      second case, MM presented simultaneously with bone marrow lymphocytosis and
      abnormal peripheral lymphocytes. Clonality studies on blood were not done. Bone
      marrow B-cell gene rearrangement studies, however, revealed the presence of three
      bands in the JK blot of significantly different intensities, suggestive of two
      monoclonal populations. A monoclonal population of small cells with surface B
      markers and surface IgM was demonstrated by flow cytometry, while a second
      population of larger cells with intracytoplasmic IgG matching the patient's serum
      monoclonal protein was detected by immunofluorescence microscopy. The results in
      these 2 cases expand previous findings of the rare association of MM with a
      second B-cell neoplasm, and demonstrate the usefulness of molecular diagnostic
      investigation.

PMID- 7789472
TI  - Chronic myelomonocytic leukemia preceding high-grade immunoblastic lymphoma.

PMID- 7789473
TI  - Erythrocyte glucose 6 phosphate dehydrogenase deficiency in east Andalusia
      (Spain)

PMID- 7789474
TI  - Omeprazole-associated agranulocytosis.

PMID- 7789476
TI  - Prospective study of risk factors for early and persistent wheezing in childhood.
AB  - The object of this study was to determine the relative importance of low birth
      weight, preterm birth, low maternal age, household size, exposure to maternal
      smoking, personal smoking at 16 yrs of age, early termination of breastfeeding
      and socioeconomic status in the aetiology of wheezing illness in the first 5 yrs
      of life, and on the persistence of this illness at 16 yrs of age. In 15,712
      children born in Britain during one week of April 1970, the occurrence of
      wheezing by 5 yrs of age, and of wheezing in the past year at 16 yrs of age
      within this group were analysed in multivariate logistic regression against each
      potential risk factor. The independent determinants of wheezing by 5 yrs of age
      were male sex, maternal smoking during pregnancy (odds ratio (OR) for 15+
      cigarettes.day-1 = 1.39; 95% confidence interval (95% CI) 1.22-1.58) and low
      birthweight (OR for birthweight < 2.5 kg = 1.26; 95% Cl 1.07-1.50). Of children
      who had wheezed by 5 yrs of age, 15% reported wheezing in the past 12 months at
      16 yrs of age. The persistence of symptoms at 16 yrs of age was independently
      related to low maternal age (OR for 20 vs 40 yrs of age = 1.96; 95% CI 1.08-3.45)
      and to high social status (OR for most vs least advantaged = 1.95; 95% CI 1.13
      3.38). We conclude that low birth weight and maternal smoking in pregnancy are
      independent risk factors for early childhood wheezing, but in 85% of children
      with early wheezing it resolves by 16 yrs of age.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7789475
TI  - Theophylline and phosphodiesterase inhibitors.

PMID- 7789477
TI  - Effect of altitude on urinary leukotriene (LT) E4 excretion and airway
      responsiveness to histamine in children with atopic asthma.
AB  - Asthmatic subjects who are resident at altitude may experience a deterioration in
      lung function following a stay at sea level. To determine whether measurement of
      urinary leukotriene E4 (LTE4) reflects changes in asthma severity and airway
      responsiveness, 14 allergic asthmatic subjects resident at altitude (1560 m,
      Davos, Switzerland) were studied. Subjects were randomly divided into two groups.
      Measurements of baseline forced expiratory volume in one second (FEV1), the
      concentration of histamine producing a 20% decrease in FEV1, (PC20 FEV1), serum
      total immunoglobulin E (IgE), eosinophil count, and urinary LTE4 concentration
      were determined prior to and following a 2 week stay in The Netherlands (sea
      level) in eight subjects (4 males and 4 females, aged 14 +/- 0.5 yrs) (mean +/-
      SEM) and over a similar time period in six subjects (4 males and 2 females, aged
      15 +/- 0.3 yrs) resident in Davos, Switzerland. There was no significant
      difference in total IgE and eosinophil count, and no significant correlation
      between urinary LTE4 and PC20FEV1 histamine, FEV1, total IgE, and eosinophil
      count. In subjects returning to Davos from The Netherlands there was a
      significant increase in urinary LTE4 from a baseline value of 16.9 pg.mg-1
      creatinine (GM, range 0.3-101.7 pg.mg-1 creatinine) to 52.3 pg.mg-1 creatinine
      (GM, range 8.8-301.6 pg.mg-1 creatinine), a significant decrease in PC20FEV1 from
      1.7 mg.ml-1 (GM, range 0.3-16.4 mg.ml-1) to 0.9 mg.ml-1 (GM, range 0.1-->32 mg.ml
      1), and a significant fall in FEV1 from 3.0 +/- 0.3 to 2.8 +/- 0.3 l (mean +/-
      SEM).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789478
TI  - The measurement of methacholine responsiveness in 5 year old children: three
      methods compared.
AB  - The aim of this study was to compare the feasibility of three techniques for
      measuring the response to bronchial challenge in young children: a direct airway
      measurement, the forced oscillation technique (FOT) for determining respiratory
      system resistance at 6 and 8 Hz (Rrs6 and Rrs8), and two indirect methods, the
      change in transcutaneous oxygen tension (PtcO2) and the detection of wheeze on
      auscultation of the chest. Thirty children aged 5 yrs, with a history of wheeze,
      and six asymptomatic controls, took part in a bronchial challenge test using
      methacholine administered by Wright nebulizer by the tidal-breathing method. The
      provocative concentration which produced a 35% increase in Rrs6 (PC35Rrs6) and a
      15% decreases in PtcO2 (PC15PtcO2) were determined by interpolation, and the
      chest was ausculated after each dose of methacholine. The FOT was found to be
      unreliable in this age group: in seven children, the data were technically
      unsatisfactory in the presence of induced bronchoconstriction, whilst in three
      children, changes in Rrs were inconsistent after challenge. The use of Rrs8 did
      not improve the detection of positive responses. PC15PtcO2 was measurable in 29
      of 30 children, and in 18 of these PC35Rrs6 was also measurable. In no subject
      did a significant, sustained increase in Rrs occur during challenge in the
      absence of a significant change in PtcO2. Wheeze was audible in only 4 of 25
      (16%) of the positive and in no negative challenges. With this protocol, we found
      the FOT to be unreliable and the auscultation method valueless and potentially
      dangerous, since marked falls in PtcO2 of up to 33% sometimes occurred in the
      absence of wheeze.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789479
TI  - Variability of FVC and FEV1 due to technician, team, device and subject in an
      eight centre study: three quality control studies in SAPALDIA. Swiss Study on Air
      Pollution and Lung Disease in Adults.
AB  - Lung function testing of a random population sample in the eight SAPALDIA (Swiss
      study on air pollution and lung diseases in adults) centres had to be performed
      simultaneously, within one year, by eight teams and 23 technicians. We conducted
      quality control studies to test for technician, team and device related
      systematic measurement errors. To assess technician effects, each centre
      conducted a study involving 12-19 subjects. Two studies with 13 participants each
      addressed team and device effects. In all studies, volunteers repeatedly
      performed spirometry with different technicians or devices. Effects due to
      technician, team or device were estimated (analysis of variance). Neither
      "technician" within any of eight teams nor "team" accounted for significant
      differences of forced vital capacity (FVC) or forced expiratory volume in one
      second (FEV1). The Device Effect Study revealed 10% lower FVC values for device
      No. 1 due to a technical problem occurring during the test day but not in the
      main SAPALDIA study. Further investigations revealed potential hardware and
      software sources of error which are not recognizable by trained technicians.
      These studies gave no evidence for systematic errors due to technician, team or
      device during the main SAPALDIA study. However, they revealed potential sources
      of error in modern devices, which function as "black boxes". Manufacturers should
      improve spirometry software to further enhance the technicians' attempts at
      accurate assessment.

PMID- 7789480
TI  - Latent pulmonary function abnormalities in children with Crohn's disease.
AB  - Recently, latent pulmonary involvement has been described in adult patients with
      inflammatory bowel disease. It is unknown, however, whether this also occurs in
      children, and whether the pulmonary abnormalities differ between the acute phase
      and remission. The incidence of pulmonary abnormalities has been investigated in
      26 children with acute or quiescent Crohn's disease in terms of the following
      parameters: clinical pulmonary symptoms, chest roentgenograms and pulmonary
      function tests, including lung transfer factor for carbon monoxide (TLCO). One
      child had a severe digital clubbing. Chest radiographs were normal in all
      subjects. No significant differences were found between acute and quiescent phase
      for pulmonary volumes and expiratory flows, but TLCO (% predicted) was
      significantly decreased during the active phase of the disease as compared to
      remission (53 +/- 15 vs 81 +/- 19% predicted). These data suggest that latent
      pulmonary involvement is also present in a paediatric population with active
      Crohn's disease, despite a short disease history and absence of smoking. Although
      the nature of this abnormality remains unclear, this extradigestive epiphenomenon
      should be taken into account with respect to the aetiopathogenesis of Crohn's
      disease.

PMID- 7789481
TI  - Dose-dependent in vitro effect of recombinant human DNase on rheological and
      transport properties of cystic fibrosis respiratory mucus.
AB  - Recombinant human deoxyribonuclease (rhDNase) has been demonstrated to reduce the
      viscosity of purulent cystic fibrosis (CF) respiratory mucus, to improve
      pulmonary function and to reduce the risk of respiratory tract infectious
      exacerbations, but its effect on mucus transportability has not so far been
      investigated. The dose-dependent effect of rhDNase was analysed in vitro on mucus
      transport rate (tr) by ciliary activity and by simulated cough (cough transport
      (ct)), as well as on mucus viscosity and surface properties. Purulent CF sputa (n
      = 15) were incubated for 30 min at 37 degrees C with either rhDNase at three
      different concentrations (final concentrations 0.2, 2 or 20 micrograms.ml-1 of
      mucus) or placebo. No significant dose-dependent effect of rhDNase on the
      mucociliary transport rate was observed when the samples wer statistically
      analysed together. However, in the larger group of mucus samples (n = 11) with a
      low initial mucociliary transport rate, the latter was improved at each rhDNase
      concentration (tr0.2 = 0.69, tr2 = 0.88 and tr20 = 0.87) as compared to placebo
      (trp = 0.58). In the smaller group of mucus samples (n = 4) with high initial
      transport rate, a decrease in mucociliary transport rate was observed,
      particularly at the highest concentration rhDNase assayed, i.e. 20 micrograms.ml
      1 of mucus (tr20 = 0.58) as compared to placebo (trp = 0.86). The mucus cough
      transport was increased by rhDNase (ct0.2 = 25 mm, ct2 = 27.5 mm and ct20 = 31
      mm) as compared to placebo (ctp = 23.5 mm).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789482
TI  - Activation of the transcription factor NF-kappa B in human tracheobronchial
      epithelial cells by inflammatory stimuli.
AB  - Recent studies have shown that surface epithelial cells play a major role in the
      defence and inflammatory reactions of the airways. How extracellular stimuli lead
      to increased gene expression in these epithelial cells is not well known. In this
      study, we asked whether the multiunit transcription factor, nuclear factor (NF)
      kappa B, which regulates the expression of genes involved in defense and immune
      processes, is activated in airway epithelial cells following stimulation with
      inflammatory mediators and hydrogen peroxide. In addition, we studied whether
      this would be followed by upregulation of the NF-kappa B target gene product
      granulocyte-macrophage colony-stimulating factor (GM-CSF). Activation of NF-kappa
      B in the SV40 transformed human tracheobronchial epithelial cell line 1HAEo- was
      measured by electrophoretic mobility shift assays. GM-CSF concentrations in cell
      culture supernatants were determined by enzyme-linked immunosorbent assays. NF
      kappa B was rapidly activated by exposure of cells to interleukin-1 beta (IL-1
      beta), phorbol myristate acetate (PMA), and tumour necrosis factor-alpha (TNF).
      Exposure to H2O2 platelet activating factor (PAF) and lipopolysaccharide (LPS)
      did not lead to increased NF-kappa B activation. Co-stimulation of IL-1 beta with
      H2O2 led to augmentation and prolongation of the effect on NF-kappa B activation
      compared to stimulation with IL-1 beta alone. GM-CSF concentrations increased
      following stimulation with IL-1 beta and H2O2, and the effect of IL-1 beta/H2O2
      co-stimulation on GM-CSF concentrations was additive. These results suggest that
      NF-kappa B may represent an important transcription factor, controlling the
      expression of cytokine genes in airway epithelial cells.

PMID- 7789483
TI  - Prognostic analysis and predictive rule for outcome of hospital-treated community
      acquired pneumonia.
AB  - In community-acquired pneumonia (CAP) mortality may be reduced by early
      identification of patients requiring intensive care treatment. The purpose of
      this study was to determine prognostic factors of outcome in patients with CAP in
      order to establish a clinically applicable discriminant rule. Ninety three
      episodes of CAP in 92 patients were retrospectively reviewed with regard to
      epidemiological, clinical, laboratory and microbiological data. The prognostic
      analysis included a univariate as well as a multivariate approach, in order to
      identify parameters associated with death using the Cox regression hazard
      function in a backward stepwise selection model. The three parameters found to
      contribute most to the significance of the model were used in a discriminant rule
      for classification of outcome. The parameters found to be significantly different
      between survivors and non-survivors were heart rate, systolic and diastolic as
      well as mean blood pressures, leucocyte count, percentage of lymphocytes, and
      lactate dehydrogenase (LDH) values. The multivariate analysis revealed that heart
      rate, systolic arterial pressure, and LDH serum levels were most closely
      associated with fatal outcome. A prognostic rule composed of the variables heart
      rate > or = 90 beats.min-1, systolic arterial blood pressure < or = 80 mmHg, and
      LDH > or = 260 U.l-1 achieved a sensitivity of 77%, a specificity of 75%, and
      positive and negative predictive values of 42 and 93%, respectively. It was
      associated with a six fold increased risk of fatal outcome. In conclusion, heart
      rate, systolic blood pressure, and LDH values were most closely associated with
      death in a multivariate analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789484
TI  - Efficacy of a three day course of azithromycin in moderately severe community
      acquired pneumonia.
AB  - This study was designed to evaluate the efficacy of a 3 day course of
      azithromycin in low to moderately severe community-acquired pneumonia. Forty
      patients with low to moderately severe community-acquired pneumonia (29 males, 11
      females, mean age 46 +/- 17 yrs; 20 pretreated with betalactams for 2-10 days
      with no results before admission to hospital; 18 with evidence of co-morbidity)
      were enrolled in an open, randomized study with azithromycin, 500 mg q.d. oral
      therapy for 3 days, versus clarithromycin, 250 mg b.i.d. oral therapy for 10 +/-
      2 days. The aetiology of pneumonia was identified in 18 patients by serology
      (nine Mycoplasma pneumoniae, four Chlamydia pneumoniae, five Legionella
      pneumophila; one patient with chlamydial infection also had Klebsiella pneumoniae
      bacteraemia). A presumptive aetiological diagnosis was obtained with sputum
      culture in three other patients (one Haemophilus influenzae, two Haemophilus
      parainfluenzae), all strains were sole isolates with 10(8) Colony forming units
      (CFU), and with Gram stain in one patient with Streptococcus pneumoniae. All
      patients in the azithromycin group (one after a second 3 day course), and all but
      two (of those available for evaluation) of the clarithromycin group were cured.
      Defervescence occurred after 2.6 +/- 1.6 days, and chest roentgenogram cleared
      after 8.9 +/- 3.3 days, with no difference between the two groups. Tolerance was
      good, and there were no withdrawals from therapy.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7789485
TI  - Lung surfactant protein-A and carcinoembryonic antigen in pleural effusions due
      to lung adenocarcinoma and malignant mesothelioma.
AB  - Lung surfactant protein-A (SP-A) is a major phospholipid-associated glycoprotein
      in surfactant, and is a useful immunohistochemical marker for lung
      adenocarcinoma. Carcinoembryonic antigen (CEA) has not been immunohistochemically
      detected in mesothelioma. In pleural effusions due to malignant mesothelioma,
      very low concentrations of SP-A and CEA can be expected. We studied the value of
      combined determinations of CEA and SP-A in pleural fluid to distinguish between
      lung adenocarcinoma and mesothelioma. SP-A and CEA concentrations were measured
      in pleural effusions from 78 patients with lung adenocarcinoma and 10 with
      malignant mesothelioma. SP-A concentrations in pleural effusions due to lung
      adenocarcinoma and mesothelioma were 516 +/- 140 and 16.9 +/- 3.6 ng.ml-1 (mean
      +/- SEM), respectively. CEA concentrations in pleural effusions due to lung
      adenocarcinoma and mesothelioma were 239 +/- 92.4 and 1.7 +/- 0.3 ng.ml-1,
      respectively. SP-A values did not exceed 100 ng.ml-1 in any of 10 mesotheliomas,
      whilst in 37 of 78 lung adenocarcinomas they did. CEA values did not exceed 10
      ng.ml-1 in any of 10 mesotheliomas, whilst in 53 of 78 lung adenocarcinomas they
      did. Increased values of SP-A and/or CEA were found in pleural effusions from 67
      of 78 lung adenocarcinomas. It is concluded that a combination of CEA and SP-A
      assays in pleural effusions will be helpful for discriminating lung
      adenocarcinoma from mesothelioma.

PMID- 7789486
TI  - Prostaglandin D2-induced bronchoconstriction is mediated only in part by the
      thromboxane prostanoid receptor.
AB  - Prostaglandin D2 (PGD2) is a potent bronchoconstrictor, and is thought to have a
      role in the pathogenesis of asthma. PGD2 causes vasodilation acting via the
      prostaglandin (DP) receptor on vascular smooth muscle, and myocontraction acting
      via the thromboxane (TP) receptor on bronchial smooth muscle. To determine the
      relative contribution of these mechanisms we have studied the degree to which a
      potent TP receptor antagonist inhibits PGD2-induced bronchoconstriction. Twelve
      atopic asthmatic subjects underwent baseline PGD2 bronchial challenges to
      determine the cumulative concentration of PGD2 required to reduce forced
      expiratory volume in one second (FEV1) by 20%. At four subsequent randomized
      visits, subjects received this concentration of PGD2 90 min after dosing with
      placebo or 20, 50 or 100 mg of BAY u 3405, a potent competitive TP receptor
      antagonist. Serum was taken for drug assay at 90 min. After each dose of PGD2,
      FEV1 was measured for 30 min, and the area under the percentage fall in the
      FEV1/time curve (AUC) was calculated. The mean +/- SEM AUC for placebo was 414 +/
      68, and for the 20, 50 and 100 mg doses of BAY u 3405 was 169 +/- 33, 173 +/- 59
      and 135 +/- 63, respectively. There were no significant differences between the
      AUCs for any of the drug doses, whilst all three doses were significantly
      different from placebo. The plateau response achieved with increasing doses of
      the antagonist suggests complete blockade of the TP receptor. These data
      demonstrate that thromboxane receptor blockade only partially inhibits the airway
      narrowing response to PGD2, and support the existence of a vascular component to
      PGD2-induced acute airway narrowing in asthma.

PMID- 7789489
TI  - Haemodynamic effects of nasal continuous positive airway pressure in severe
      congestive heart failure.
AB  - Nasal continuous positive airway pressure (NCPAP) during sleep may be a useful
      adjunct to medical therapy in patients with stable severe congestive heart
      failure (CHF), particularly when there is a coexisting respiratory sleep
      disorder. However, the direct haemodynamic effects of NCPAP in patients with
      severe stable CHF have not yet been adequately assessed. Right heart catheter
      studies were performed in seven awake males (aged 51-75 yrs) with stable CHF,
      before, during and after the application of 5 cmH2O NCPAP over 3 h. All patients
      had left ventricular ejection fractions < or = 30% and baseline pulmonary
      capillary wedge pressures > 12 mmHg, and six patients were in atrial
      fibrillation. Cardiac index fell from baseline in all patients whilst on NCPAP,
      with the greatest fall at 2 h (from 3.3 +/- 0.3 (mean +/- SEM) at baseline to 2.8
      +/- 0.2 l.min-1.m-2) and rose back to baseline after NCPAP withdrawal. Systemic
      vascular resistance (SVR) increased during NCPAP application (1,268 +/- 108 to
      1,560 +/- 82 dyn.s-1.cm5), with baseline SVR showing a significant negative
      correlation vs percentage fall in cardiac index (CI) at 2 h on multiple linear
      regression analysis (r2 = 0.8). These data indicate that domiciliary nocturnal
      NCPAP should not be prescribed as part of the therapy in severe CHF without first
      determining the individual patient's cardiac response to such therapy.

PMID- 7789488
TI  - Effect of protriptyline, 10 mg daily, on chronic hypoxaemia in chronic
      obstructive pulmonary disease.
AB  - A daily dose of 20 mg of protriptyline can improve daytime arterial blood gas
      tensions in chronic obstructive pulmonary disease (COPD). Its usefulness is
      limited by anticholinergic side-effects. This study examined whether a daily dose
      of 10 mg of protriptyline improved daytime arterial oxygen tension (PaO2) and
      quality of life in patients with stable mild or moderate hypoxaemia caused by
      COPD. Twenty six patients were randomized to receive protriptyline or placebo in
      a double-blind parallel-group trial for 12 weeks, following a run-in period of 4
      weeks, in order to assess the stability of hypoxaemia. Patients with a change in
      PaO2 of > 0.7 kPa during the run-in were excluded. Spirometry, quality of life
      and dyspnoea score were measured at randomization and after 12 weeks, whilst
      arterial blood gas tensions were also measured 2 and 6 weeks after randomization.
      No improvement in arterial blood gas tensions, spirometry values, dyspnoea score,
      or quality of life was found in either the protriptyline or the placebo group.
      The majority of patients receiving protriptyline experienced anticholinergic side
      effects, which necessitated the withdrawal of the drug in one patient. We
      conclude that there was no evidence that a daily dose of 10 mg of protriptyline
      had a significant effect on daytime arterial oxygen tension in stable mild and
      moderate hypoxaemia caused by COPD. Despite the low dose, anticholinergic side
      effects occurred in most patients.

PMID- 7789487
TI  - The effect of 1 ppm nitrogen dioxide on bronchoalveolar lavage cells and
      inflammatory mediators in normal and asthmatic subjects.
AB  - Several studies have suggested that patients with bronchial asthma are more
      susceptible to the potential effects of nitrogen dioxide (NO2) than healthy
      subjects, with respect to airway responsiveness and lung function. We
      investigated whether these differences are paralleled by differences in the
      cellular and biochemical response within the airway lumen. Twelve subjects with
      mild extrinsic asthma and eight normal subjects breathed either filtered air or 1
      ppm NO2 in a single-blind manner during intermittent exercise for 3 h.
      Bronchoscopy with bronchoalveolar lavage (BAL) was performed one hour after each
      exposure, and on a third day without exposure (baseline day). Prostanoids,
      leukotrienes and histamine were analysed in BAL fluid, and the cellular
      composition of BAL fluid was assessed. In the asthmatic subjects, NO2 induced a
      small mean drop in forced expiratory volume in one second (FEV1). Differential
      cell counts in BAL fluid did not reveal significant effects of NO2. Levels of 6
      keto-prostaglandin1 alpha (6-keto-PGF1 alpha) were decreased, and levels of
      thromboxane B2 (TxB2) and prostaglandin D2 (PGD2) in BAL fluid were increased
      after NO2 compared to filtered air exposure; whereas, prostaglandin E2 (PGE2),
      prostaglandin F2 alpha (PGF2 alpha), histamine and leukotriene levels did not
      change significantly. The normal subjects showed no change in lung function
      parameters and a small increase in TxB2 after breathing NO2. We conclude that in
      subjects with mild asthma NO2 is capable of inducing an activation of cells,
      which is compatible with enhancement of airway inflammation, even if lung
      function parameters and cellular composition of BAL fluid are not markedly
      affected.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789490
TI  - Nocturnal assisted ventilation using bilevel positive airway pressure: the effect
      of expiratory positive airway pressure.
AB  - Increasing expiratory positive airway pressure (EPAP) has theoretical advantages
      during overnight nasal ventilation. We wanted to evaluate the effect of the
      addition of EPAP upon the control of nocturnal hypoventilation. Seven patients
      with neuromuscular/skeletal (NMS) disorder (mean +/- SD forced vital capacity
      (FVC) 1.06 +/- 0.28 l, arterial oxygen tension (PaO2) 9.1 +/- 0.6 kPa, and
      arterial carbon dioxide tension (PaCO2) 6.9 +/- 0.9 kPa), and seven patients with
      chronic obstructive pulmonary disease (COPD) (FEV1 0.46 +/- 0.14 l, PaO2 6.2 +/-
      0.6 kPa, and PaCO2 8.4 +/- 1.1 kPa) all underwent full polysomnography on two
      nights during bilevel positive airway pressure (BiPAP) ventilation, with and
      without the addition of expiratory positive airway pressure, which was matched to
      the level of dynamic positive end-expiratory pressure (PEEP) or set at a minimum
      value of 5 cmH2O. In the group with neuromuscular/skeletal disorders the maximum
      transcutaneous carbon dioxide tension (PtcCO2) overnight was lower (inspiratory
      positive airway pressure (IPAP) 8.1 +/- 1.4 kPa, IPAP/EPAP 7.3 +/- 0.9 kPa) and
      the minimum level of arterial oxygen saturation (SaO2 min) increased (IPAP 77.1
      +/- 6.7%, IPAP/EPAP 83.6 +/- 4.2%) when expiratory positive airway pressure was
      added. There were no differences in mean PtcCO2 or mean oxygen saturation, but
      sleep quality was worse (non-rapid eye movement (non-REM) sleep IPAP 266 +/- 44
      min, IPAP/EPAP 226 +/- 32 min). In the patients with COPD, expiratory positive
      airway pressure conferred no advantage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789492
TI  - Lung elastic recoil in normal young adult Chinese compared with Caucasians.
AB  - Chinese people have smaller total lung capacity (TLC) compared with Caucasians of
      similar age, sex and height. One possible reason would be a higher lung elastic
      recoil in Chinese. Most published values for lung elastic recoil viz static lung
      compliance (CLst), shape constant K, and maximal static transpulmonary pressure
      (PLmax) have been from Caucasian subjects. The aim of our study was to obtain
      values for lung elastic recoil in normal young adult Chinese subjects. Static
      expiratory pressure-volume (P-V) curves were studied in 22 healthy Chinese
      subjects (12 males and 10 females). The P-V curve was fitted using an iterative
      least mean squares regression on a computer, according to an exponential
      equation: V = A-Be-KP, where V is lung volume, P is transpulmonary pressure, and
      A, B and K are constants. Mean values +/- SD for K, CLst and PLmax were 0.12 +/-
      0.04, 230 +/- 103 ml.cmH2O-1 and 27.5 +/- 7.5 cmH2O, respectively. The values of
      CLst and K were similar to that of normal Caucasian subjects, whereas values of
      PLmax were lower. We attributed the lower PLmax partly to weaker inspiratory
      muscles in Chinese compared with Caucasians. We conclude that lung elastic recoil
      in normal young adult Chinese is similar to that of healthy young adult
      Caucasians. Hence, lung elasticity is unlikely to explain the racial differences
      in static lung volumes.

PMID- 7789491
TI  - Activity of latissimus dorsi muscle during inspiratory threshold loads.
AB  - The ability of the latissimus dorsi muscle (LD) to participate as an accessory
      inspiratory muscle has been the subject of controversy. Electromyographic (EGM)
      activity of LD was evaluated in 11 healthy subjects (aged 30 +/- 2 yrs; forced
      expiratory volume in one second (FEV1) 106 +/- 5% predicted; maximal inspiratory
      pressure (Pmax), 120 +/- 6 cmH2O) under different breathing conditions. The
      ipsilateral biceps brachii was chosen as the control muscle. The EMG was recorded
      from surface electrodes, but needle electrodes were also used for LD evaluation
      in a subset of three subjects. The EMG signal from both muscles was recorded
      simultaneously, rectified and integrated, with subtraction of the
      electrocardiographic signal. Situations evaluated were: 1) maximal voluntary
      contraction (MVC); 2) apnoea; and 3) breathing under progressive inspiratory
      threshold loads (20-100% Pmax, at 20% intervals). A close relationship was
      evident between LD recordings from surface and needle electrodes (r = 0.975).
      Activity of LD at baseline was 1.8 +/- 0.4% MVC, and showed a phasic increase
      during inspiration under loads. This change had a linear tendency and was
      significant for loads corresponding to 40, 60, 80 and 100% of Pmax when compared
      to the control muscle. At this latter level, LD activity was equivalent to 32 +/-
      5% MVC (range 11-61%), whereas mean activity of the control muscle was less than
      7.5% MVC.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789493
TI  - Biochemical characteristics of lungs in senescence-accelerated mouse (SAM).
AB  - This study examined age-related biochemical changes of the lung in an animal
      model of senile lung, senescence-accelerated mouse (SAM). Bronchoalveolar lavage
      (BAL) was performed on two strains of SAM, the senescence-prone strain (SAM P2)
      and the senescence-resistant strain (SAM R1), as well as on normal ageing C57
      black mice (C57BL), aged 1-24 months. Elastase-like and elastase inhibitory
      activity of BAL fluid (BALF), glutathione (GSH) and oxidized GSH (GSSG) content
      both of BALF and lung tissue, and oxygen radical generation of free lung cells
      obtained by BAL were examined in the three strains of mice. Cell populations did
      not change throughout the life in SAM strains and C57BL. The elastolytic activity
      in SAM was greater than in C57BL, but there was no change with age. Both a
      decreased content of GSH and an increased oxidation of the GSH in BALF were
      markedly observed with ageing in SAM P2. In the lung tissue, the GSSG/GSH ratio
      in SAM strains was consistently greater than that in C57BL, suggesting that the
      GSH redox cycle of the lung may be impaired in SAM strains. The oxygen radical
      generation by free lung cells increased with age in all three strains, but the
      increase was earlier and more pronounced in SAM P2 than in the other two strains.
      In conclusion, an impaired GSH redox cycle and an increased formation of oxygen
      radicals are observed in the lungs of SAM with increasing age.

PMID- 7789495
TI  - A threshold loading device for testing of inspiratory muscle performance.
AB  - Threshold loading is a method of incrementally loading the inspiratory muscles,
      which requires development of an adjustable threshold pressure (Pth) before air
      will flow. In the ideal device, flow is independent of pressure once Pth is
      exceeded. A "weighted plunger" apparatus is commonly used, but devices described
      previously perform unreliably at high inspiratory load. We have modified this
      apparatus using the diaphragm and valve seating from a threshold valve used to
      deliver positive airway pressure (AMBU 10, AMBU International, Denmark) to yield
      improved pressure-flow characteristics. With this device, there was a linear
      relationship between Pth and weight on the plunger (r = 0.998), and flow was
      largely independent of pressure once Pth was exceeded: pressure developed at an
      inspiratory flow of 1.3 +/- 0.1 l.s-1 was 13.6 +/- 7.0% below Pth. Our modified
      weighted plunger apparatus allows consistent and reliable threshold loading of
      inspiratory muscles, even at high inspiratory loads.

PMID- 7789494
TI  - Cyclic nucleotides and phosphodiesterases and airway function.
AB  - The cyclic nucleotides, cyclic adenosine monophosphate (cAMP) and cyclic
      guanosine monophosphate (cGMP) play an important role in the regulation of airway
      smooth muscle tone and activation of inflammatory cells. Intracellular
      concentrations of these nucleotides are tightly regulated by phosphodiesterases
      (PDEs). Several families of PDEs are now recognized and, within each isoenzyme
      family, molecular cloning has revealed multiple members. PDE III and IV are
      important in the breakdown of cAMP; PDE III is involved in the regulation of
      airway smooth muscle tone, whereas PDE IV is more important in inflammatory
      cells, including mast cells, macrophages, eosinophils, T-lymphocytes and
      epithelial cells. PDE V is involved in the breakdown of cGMP in airway and
      vascular smooth muscle. Regulation of PDE expression in health and disease is now
      under investigation. Several selective PDE inhibitors have recently been
      developed, and experimental studies indicate that PDE IV inhibitors may be useful
      as anti-inflammatory treatments in asthma. Clinical trials in asthma are now in
      progress.

PMID- 7789496
TI  - Occupational asthma, rhinitis and urticaria due to piperacillin sodium in a
      pharmaceutical worker.
AB  - A 28 year old man with no history of atopy was referred to our hospital for
      possible work-related asthma. He had been employed in the production section of a
      pharmaceutical company for 2 yrs, and in the last 2 months he had complained of
      dyspnoea, wheezing, chest tightness, symptoms of rhinitis and a cutaneous rash
      when exposed to powdered antibiotics. Symptoms disappeared after being
      transferred to the packaging section. When the subject was admitted to our
      department he was asymptomatic. Basal lung function tests were in the normal
      range. Bronchial challenges with methacholine and with ultrasonically-nebulized
      distilled water were negative. Skin-prick test with piperacillin sodium gave a
      strong positive response at a very low concentration. Specific inhalation
      challenge with piperacillin sodium resulted in an immediate asthmatic reaction,
      and also reproduced rhinitis symptoms and the cutaneous rash. A control challenge
      with lactose, and the specific challenge test with cefuroxime sodium (another
      antibiotic to which the patient was exposed at the workplace) were negative. We
      conclude that piperacillin sodium is an agent that can cause occupational asthma.

PMID- 7789497
TI  - Bronchiolitis obliterans organizing pneumonia secondary to amiodarone: a rare
      aetiology.
AB  - Bronchiolitis obliterans organizing pneumonia (BOOP) is a clinicopathological
      entity with well-defined diagnostic criteria, the aetiology of which is generally
      unknown. Among the adverse pulmonary effects of the drug amiodarone, BOOP is the
      least commonly reported in the literature. In this article we describe a case of
      amiodarone-induced BOOP.

PMID- 7789498
TI  - Association of histologically proven rheumatoid arthritis with pulmonary
      sarcoidosis.
AB  - The association of rheumatoid arthritis proven by means of synovial biopsy with
      pulmonary sarcoidosis proven by means of bronchial biopsy, occurred in a 58 year
      old woman. Corticosteroid therapy resulted in complete resolution of sarcoidosis
      but only slight improvement of the rheumatoid arthritis, which was secondarily
      treated with methotrexate with a successful outcome. Only two similar cases have
      been reported with simultaneous histological proofs of both diseases.

PMID- 7789500
TI  - Three cases of bronchial stump aspergillosis: unusual clinical presentations and
      beneficial effect of oral itraconazole.
AB  - Bronchial stump aspergillosis (BSA), i.e. Aspergillus infection of bronchial
      granulation tissue surrounding endobronchial suture threads, is a very rare
      variant of localized suppurative bronchial Aspergillus infection. The majority of
      reported cases have occurred within one year after lung surgery. We present three
      more patients, in whom BSA occurred very late (4.5, 6 and 7 yrs) after pulmonary
      resection. Other unusual features were: complete absence of symptoms in one
      patient, and simultaneous occurrence of aspergilloma in another. Removal of the
      endobronchial suture probably constitutes the key therapy for BSA. In all three
      of our patients oral itraconazole resulted in clinical, histological and
      microbiological improvement. In conclusion, BSA should be considered in the
      differential diagnosis of haemoptysis occurring up to 7 yrs after lung surgery,
      although an asymptomatic presentation is possible. Furthermore, BSA can be
      associated with other clinical presentations of Aspergillus infection, e.g.
      aspergilloma. Finally, long-term oral itraconazole therapy may represent a valid
      alternative when removal of the suture is not feasible.

PMID- 7789499
TI  - Systemic sarcoidosis initially presenting as an orbital tumour.
AB  - A 73 year old woman presented with redness, itching and painless proptosis of the
      left eye. Clinical examination and computed tomographic (CT) scan of the orbit
      revealed a postero-ocular mass, the biopsy of which showed a noncaseating, giant
      cellular, epithelioid granuloma compatible with sarcoidosis. The patient had no
      respiratory complaints, but the thoracic CT scan showed multiple bilateral hilar
      and mediastinal adenopathies. Gallium scan showed increased uptake in both hilar
      regions, in the left orbit and in the right parotid gland. Multiple bronchial
      biopsies revealed sarcoid granulomas, with a bronchoalveolar lavage (BAL)
      cytological pattern of active sarcoidosis. The evolution was favourable with
      prednisolone given at a dose of 0.5 mg.kg-1 daily. It is suggested that in an
      unusual presentation of sarcoidosis, a thorough search should be made for
      localization at other sites, lungs in particular, even in the absence of
      respiratory complaints.

PMID- 7789501
TI  - Haemoptysis and a cavity in a young man.

PMID- 7789502
TI  - International Study of Asthma and Allergies in Childhood (ISAAC): rationale and
      methods.
AB  - The aetiology of asthma and allergic disease remains poorly understood, despite
      considerable research. The International Study of Asthma and Allergies in
      Childhood (ISAAC), was founded to maximize the value of epidemiological research
      into asthma and allergic disease, by establishing a standardized methodology and
      facilitating international collaboration. Its specific aims are: 1) to describe
      the prevalence and severity of asthma, rhinitis and eczema in children living in
      different centres, and to make comparisons within and between countries; 2) to
      obtain baseline measures for assessment of future trends in the prevalence and
      severity of these diseases; and 3) to provide a framework for further
      aetiological research into genetic, lifestyle, environmental, and medical care
      factors affecting these diseases. The ISAAC design comprises three phases. Phase
      1 uses core questionnaires designed to assess the prevalence and severity of
      asthma and allergic disease in defined populations. Phase 2 will investigate
      possible aetiological factors, particularly those suggested by the findings of
      Phase 1. Phase 3 will be a repetition of Phase 1 to assess trends in prevalence.

PMID- 7789504
TI  - Relationship of dietary fish intake to level of pulmonary function.

PMID- 7789503
TI  - Reference values for residual volume, functional residual capacity and total lung
      capacity. ATS Workshop on Lung Volume Measurements. Official Statement of The
      European Respiratory Society.

PMID- 7789505
TI  - Structural analysis and comparison of the C-terminal transport signal domains of
      hemolysin A and leukotoxin A.
AB  - NMR spectroscopy was used to study the structure of the C-terminal signal
      sequences of the bacterial toxins, hemolysin A(HlyA) and leukotoxin A (LktA). The
      two signals share little sequence homology; however, both can direct toxin
      transport with equal efficiency. We report here that in a membrane mimetic
      environment both peptides form two short non-interacting alpha-helices separated
      by a short loop. This higher order structure may be a common feature of C
      terminal signals and may be required for interaction with the membrane associated
      transporter complex.

PMID- 7789506
TI  - Lysophosphatidic acid-induced activation of protein Ser/Thr kinases in cultured
      rat 3Y1 fibroblasts. Possible involvement in rho p21-mediated signalling.
AB  - Renaturation kinase assay was used to detect protein kinases activated by
      lysophosphatidic acid (LPA) in cultured rat 3Y1 fibroblasts. LPA activated
      several Ser/Thr protein kinases with apparent molecular weights of 145K, 85K, 64
      65K (a doublet), and 60K (each named p145, p85, p64165 and p60, respectively) in
      addition to p43 mitogen activated protein (MAP)-kinase. Experiments using
      pertussis toxin and botulinum C3 exoenzyme showed that p145, p85, and p64165
      kinases were activated by a pertussis toxin-insensitive rho p21-dependent pathway
      and that the activation of MAP-kinase was mediated by both the pertussis toxin
      sensitive rho p21-independent and the pertussis toxin-insensitive rho p21
      dependent pathways.

PMID- 7789507
TI  - On the distribution of ligands within the asymmetric chaperonin complex,
      GroEL14.ADP7.GroES7.
AB  - In the presence of MgATP or MgADP the E. coli chaperonin proteins, GroEL and
      GroES, form a stable asymmetric complex with a stoichiometry of two GroEL7:one
      GroES7: seven MgADP. The distribution of the ligands between the two heptameric
      GroEL rings is crucial to our understanding of the mechanism of chaperonin
      assisted folding, being either cis (i.e. [GroEL7.MgADP7.GroES7]-[GroEL7]) or
      trans (i.e. [GroEL7.MgADP7]-[GroEL7.GroES7]. On the basis of cross-linking
      experiments with 8-azido-ATP and the heterobifunctional reagent, N-succinimidyl 3
      (2-pyridyldithio) propionate (SPDP), it was suggested that GroES and MgADP are
      bound to the same GroEL ring which resists proteinase K digestion [Nature 366
      (1993) 228-233]. However, we find that the SPDP-promoted cross linking of GroES
      and GroEL occurs in the absence of Mg2+, ADP or ATP, which are required for the
      formation of the asymmetric complex. Cross-linking is shown to occur only when
      the SPDP-modified GroES is co-precipitated with GroEL by trichloracetic acid.
      Furthermore, there are structural grounds for questioning whether SPDP can
      crosslink, in a physiologically relevant manner, an amino group of GroES with any
      of the cysteinyl groups of GroEL.

PMID- 7789508
TI  - Properties of omega conotoxin MVIIC receptors associated with alpha 1A calcium
      channel subunits in rat brain.
AB  - Solubilized 125I-omega conotoxin MVIIC receptors from rat cerebellum were
      immunoprecipitated by antibodies directed against the calcium channel alpha 1A
      subunit. Anti-alpha 1A antibodies recognized a 240-220, 180 and 160 kDa proteins
      in immunoblots of cerebellar membranes. Disuccinimidyl suberate cross-linked 125I
      omega conotoxin MVIIC to an alpha 2 delta-like 200-180 kDa subunit, which
      migrated at 150-140 kDa after disulfide reduction. These observations are
      consistent with a heteromeric structure in which high affinity omega conotoxin
      MVIIC binding sites formed by alpha 1A subunits are located in close proximity to
      peripheral alpha 2 subunits.

PMID- 7789509
TI  - Receptor of trans-zeatin involved in transcription activation by cytokinin.
AB  - Zeatin-binding protein (67 +/- 2 kDa) was isolated from the cytosol of the first
      leaf of 10-day-old barley plants. The protein fits to all requirements for a
      zeatin receptor: (i) it binds [3H]trans-zeatin reversibly and specifically, (ii)
      it is recognized by anti-idiotype antibodies from antiserum raised against trans
      zeatin, (iii) in concert with 10(-8) M trans-zeatin it activates rRNA synthesis
      in vitro in a transcription elongation system containing chromatin from barley
      leaves associated with RNA-polymerase I. In the presence of trans-zeatin, the
      protein activates also RNA synthesis directed by RNA-polymerase I and RNA
      polymerase II in isolated nuclei from barley leaves.

PMID- 7789510
TI  - ATP synthesis catalyzed by the mitochondrial F1-F0 ATP synthase is not a reversal
      of its ATPase activity.
AB  - The ADP(Mg2+)-deactivated oligomycin-sensitive F1-F0 ATPase of coupled
      submitochondrial particles treated with the substoichiometric amount of
      oligomycin was studied to test whether ATP synthesis and hydrolysis proceed in
      either direction through the same intermediates. The initial rates of ATP
      hydrolysis, oxidative phosphorylation, ATP-dependent, succinate-supported NAD+
      reduction, and ATP-induced delta microH+ generation were measured using
      deactivated ATPase trapped by azide [Biochem. J. (1982) 202, 15-23]. Three ATP
      consuming reactions were strongly inhibited when azide was present in the assay
      mixtures, whereas ATP synthesis was not altered by azide. The unidirectional
      effect of azide is not consistent with three alternating binding sites mechanism
      operating in ATP synthesis and support our hypothesis on the existence of
      nucleotide(Mg2+)-controlled 'synthase' and 'hydrolase' states of the
      mitochondrial F1-F0 ATPase.

PMID- 7789511
TI  - The third nucleotide of the Gly coding triplet remembers the periodicity of the
      collagen chain.
AB  - Collagen is a fibrous protein with a primary structure with complex periodical
      features. We show using symbolic Fourier transform of the collagen cDNA sequence
      that basic periodical patterns appear there also. Strikingly they are present in
      the third position of triplets encoding Gly, which occupies each third position
      in the sequence of the protein, and to which selection on the protein level does
      not applied. Thus, the gene of collagen seems to appear due to pra-gene
      multiplication.

PMID- 7789513
TI  - Human prothymosin alpha inhibits division of yeast Saccharomyces cerevisiae
      cells, while its mutant lacking nuclear localization signal does not.
AB  - Effect of human prothymosin alpha and its mutant over-produced in S. cerevisiae
      on yeast cell division was studied. Wild-type prothymosin alpha appeared to block
      division of yeast cells. Its inhibitory action could be abolished by deletion of
      the last nine carboxy-terminal amino acids of prothymosin alpha containing
      nuclear localization signal, thus pointing to the nucleus as a compartment, where
      prothymosin alpha performs its action.

PMID- 7789512
TI  - Primary structures of two homologous subunits of PA28, a gamma-interferon
      inducible protein activator of the 20S proteasome.
AB  - The primary structures of two proteins that comprise PA28, an activator of the
      20S proteasome, have been determined by cDNA cloning and sequencing. These
      protein subunits, termed PA28 alpha and PA28 beta, are about 50% identical to one
      another and are highly conserved between rat and human. PA28 alpha and PA28 beta
      are homologous to a previously described protein, Ki antigen, whose function is
      unknown. PA28 alpha, but neither PA28 beta nor Ki antigen, contains a 'KEKE
      motif', which has been postulated to promote the binding of proteins having this
      structural feature. PA28 alpha and PA28 beta were coordinately regulated by gamma
      interferon, which greatly induced mRNA levels of both proteins in cultured cells.
      The mRNA level of the Ki antigen also increased in response to gamma-interferon
      treatment, but the magnitude of the increase was less than that for the PA28s,
      and the effect was transient. These results demonstrate the existence of a new
      protein family, at least two of whose members are involved in proteasome
      activation. They also provide the basis for future structure/function studies of
      PA28 subunits and the determination of their relative physiological roles in the
      regulation of proteasome activity.

PMID- 7789514
TI  - The nucleotide sequence of the bacteriophage T5 ltf gene.
AB  - The nucleotide sequence of the bacteriophage T5 Bg/II-BamHI fragment (4,835 bp in
      length) known to carry a gene encoding the LTF protein which forms the phage L
      shaped tail fibers was determined. It was shown to contain an open reading frame
      for 1,396 amino acid residues that corresponds to a protein of 147.8 kDa. The
      coding region of ltf gene is preceded by a typical Shine-Dalgarno sequence.
      Downstream from the ltf gene there is a strong transcription terminator. Data
      bank analysis of the LTF protein sequence reveals 55.1% identity to the
      hypothetical protein ORF 401 of bacteriophage lambda in a segment of 118 amino
      acids overlap.

PMID- 7789515
TI  - Preliminary microwave irradiation of water solutions changes their channel
      modifying activity.
AB  - Earlier we have shown that millimetre microwaves (42.25 GHz) of non-thermal
      power, upon direct admittance into an experiment bath, greatly influence
      activation characteristics of single Ca(2+)-dependent K+ channels (in particular,
      the channel open state probability, Po). Here we present new data showing that
      similar changes in Po arise due to the substitution of a control bath solution
      for a preliminary microwave irradiated one of the same composition (100 mmol/l
      KCl with Ca2+ added), with irradiation time being 20-30 min. Therefore, due to
      the exposure to the field the solution acquires some new properties that are
      important for the channel activity. The irradiation terminated, the solution
      retains a new state for at least 10-20 min (solution memory). The data suggest
      that the effects of the field on the channels are mediated, at least partially,
      by changes in the solution properties.

PMID- 7789516
TI  - Arachidonic acid binds to apolipoprotein D: implications for the protein's
      function.
AB  - The lipocalin apolipoprotein D (ApoD) is associated in human plasma with lecithin
      cholesterol acyl transferase. It has also been found in high concentration in the
      fluid of gross cystic disease of the mammary gland. Using protein fluorescence
      quenching, it is shown that ApoD binds arachidonic acid (Ka of 1.6 x 10(8) M-1)
      and as previously known progesterone (Ka of 2.5 x 10(6) M-1), but neither
      cholesterol nor any of the other prostanoid molecules examined had measurable
      affinity. This specific binding of arachidonate, also observable directly,
      suggests a role for ApoD in the mobilisation of arachidonic acid, and hence
      prostaglandin synthesis.

PMID- 7789517
TI  - Human influenza virus recognition of sialyloligosaccharides.
AB  - Sialic acids are essential components of cell-surface receptors utilized by
      influenza viruses. To evaluate the recognition of asialic sugar parts of the
      receptor, three representative strains of human influenza A and B viruses were
      tested for their binding of a panel of sialyloligosaccharides. The highest
      affinity binding carbohydrate determinants recognized by the viruses in a context
      of different core structures were Neu5Ac alpha 2-3Gal for the type B virus,
      Neu5Ac alpha 2-6 Gal for the H3 subtype virus, and Neu5Ac alpha 2-6Gal beta 1
      4GlcNAc for the H1 subtype virus. Penultimate to these determinants parts of the
      sialyloligosaccharides studied either contributed less significantly to the
      binding affinity, or interfered with the binding.

PMID- 7789518
TI  - Interaction of urea with an unfolded protein. The DNA-binding domain of the 434
      repressor.
AB  - Experimental techniques are presented for the observation of the solvation of the
      unfolded form of a globular protein, the N-terminal 63-residue polypeptide from
      the 434 repressor, in 7 M aqueous urea solution by both water and urea. With the
      use of 15N-labelled urea it is demonstrated that the cross sections through two
      dimensional nuclear Overhauser enhancement (NOE) spectra at the chemical shifts
      of H2O and urea both contain direct NOEs with the protein, under conditions where
      exchange peaks are observed only in the water cross section. A preliminary
      analysis of the data showed that the residence times of urea molecules in
      solvation sites near the methyl groups of Val, Leu and Ile are significantly
      longer than those of water molecules in the same sites.

PMID- 7789519
TI  - Human glucose-6-phosphate dehydrogenase. Lysine 205 is dispensable for substrate
      binding but essential for catalysis.
AB  - By site-directed mutagenesis of the cloned human glucose-6-phosphate
      dehydrogenase cDNA, lysine 205 (the residue that after reacting with pyridoxal-5'
      phosphate renders inactive enzyme) was mutated to threonine (K205T) to remove the
      amino group, or to arginine (K205R) to displace the position of the amino group,
      in order to analyze the role of its nucleophilic group in position epsilon.
      Compared to the wild-type enzyme, the K205T and K205R mutants retain a specific
      activity of 2.6 and 11.4%, respectively; their catalytic specificity (Kcat/Km) is
      drastically decreased, whereas the Km values for both substrates are only
      slightly increased. These findings in the light of the 3D structure of G6PD
      suggest that the epsilon-amino group of lysine 205 can favour a hydrogen bond
      within the active pocket essential for catalysis.

PMID- 7789520
TI  - Co-operative regulation of endocytosis by three Rab5 isoforms.
AB  - Rab proteins are small GTPases involved in the regulation of membrane traffic.
      Rab5a has been shown to regulate transport in the early endocytic pathway. Here
      we report the isolation of cDNA clones encoding two highly related isoforms,
      Rab5b and Rab5c. The two proteins share with Rab5a all the structural features
      required for regulation of endocytosis. Rab5b and Rab5c colocalize with the both
      transferrin receptor and Rab5a, stimulate the homotypic fusion between early
      endosomes in vitro and increase the rate of endocytosis when overexpressed in
      vivo. These data demonstrate that three Rab5 isoforms cooperate in the regulation
      of endocytosis in eukaryotic cells.

PMID- 7789522
TI  - Structural requirements for oxidation of low-density lipoprotein by thiols.
AB  - Oxidation of low-density lipoprotein (LDL) by macrophages, endothelial cells and
      smooth muscle cells, may be mediated by production of free thiols in the presence
      of transition metals. We examined the structural requirements, within a series of
      cysteinyl derivatives, for oxidation of thiols and of LDL in Hams F10 medium. The
      primary mechanism by which such thiols mediate oxidation of LDL is largely
      independent of superoxide production, but strongly correlated with the
      susceptibility of each thiol to iron-catalysed auto-oxidation. These effects are
      compared and contrasted with thiol-dependent oxidation of LDL by stimulated human
      monocytes and macrophages.

PMID- 7789523
TI  - Analysis of the core components of Alzheimer paired helical filaments. A gas
      chromatography/mass spectrometry characterization of fatty acids, carbohydrates
      and long-chain bases.
AB  - We have carried out a fatty acid and carbohydrate compositional analysis of the
      protease-resistant core of paired helical filaments (prcPHF) isolated from six
      Alzheimer's diseased brains. Fatty acids, long-chain bases and monosaccharides
      were characterized by gas chromatography/mass spectrometry (GC/MS) of fatty acid
      methyl esters, trimethylsilylated long-chain bases, peracetylated alditol
      acetates and trimethylsilyl methyl glycosides. Glucose and mannose were found to
      be the only carbohydrate components. Four of the six prcPHF samples contained
      only glucose while the remaining two samples contained between 30-40% mannose in
      addition to glucose. None of the samples were found to contain either
      hydroxylated fatty acids or long-chain bases. The average fatty acid profile of
      prcPHF was highest in stearic (C18:0) and palmitic acids (C16:0) with less than
      10% unsaturated fatty acids. By comparing the carbohydrate and lipid composition
      of prcPHF to similar data for other brain glycolipids, it was determined that
      prcPHF is a unique glycolipid, distinct from cerebrosides, gangliosides or brain
      phospholipids. The fatty acid and carbohydrate composition of a glycolipid
      isolated from a population of normal brains according to the prcPHF protocol was
      found to be identical to that of prcPHF glycolipid. It is possible that subtle
      differences in structure or indigenous factors are responsible for the initiation
      of PHF formation in vivo.

PMID- 7789521
TI  - Monomeric human cathepsin E.
AB  - Cathepsin E is a homodimer, consisting of two monomers linked by an inter
      molecular disulphide bond. The cysteine residue involved is located near to the N
      terminus of the mature proteinase. By mutating this residue to alanine, a
      monomeric form of human cathepsin E was engineered and purified. The activity of
      the resultant enzyme was not altered significantly (in terms of its ability to
      hydrolyse two chromogenic peptide substrates; and its susceptibility to
      inhibition by pepstatin). However, the stability of the mutant enzyme to alkaline
      pH and to temperature was markedly reduced.

PMID- 7789524
TI  - NMR studies of the methionine methyl groups in calmodulin.
AB  - Calmodulin (CaM) is a ubiquitous Ca(2+)-binding protein that can regulate a wide
      variety of cellular events. The protein contains 9 Met out of a total of 148
      amino acid residues. The binding of Ca2+ to CaM induces conformational changes
      and exposes two Met-rich hydrophobic surfaces which provide the main protein
      protein contact areas when CaM interacts with its target enzymes. Two-dimensional
      (1H,13C)-heteronuclear multiple quantum coherence (HMQC) NMR spectroscopy was
      used to study selectively 13C-isotope labelled Met methyl groups in apo-CaM,
      Ca(2+)-CaM and a complex of CaM with the CaM-binding domain of skeletal muscle
      Myosin Light Chain Kinase (MLCK). The resonance assignment of the Met methyl
      groups in these three functionally different states were obtained by site
      directed mutagenesis (Met-->Leu). Chemical shift changes indicate that the methyl
      groups of the Met residues are in different environments in apo-, calcium-, and
      MLCK-bound-CaM. The T1 relaxation rates of the individual Met methyl carbons in
      the three forms of CaM indicate that those in Ca(2+)-CaM have the highest
      mobility. Our results also suggest that the methyl groups of the unbranched Met
      sidechains in general are more flexible than those of aliphatic amino acid
      residues such as Leu and Ile.

PMID- 7789526
TI  - Cloning and controlled overexpression of the gene encoding the 35 kDa soluble
      lytic transglycosylase from Escherichia coli.
AB  - The lytic transglycosylases of Escherichia coli are involved in peptidoglycan
      metabolism and resemble the lysozymes not only in activity, but in the case of
      the 70 kDa soluble lytic transglycosylase (Slt70), also structurally. Here we
      report the cloning of the gene that encodes the 35 kDa soluble lytic
      transglycosylase (Slt35) of E. coli. Based on the sequence of the full-length
      gene, Slt35 is very likely to be a proteolytically truncated form of a slightly
      larger protein. The homology between Slt35 and Slt70, albeit poor, indicates that
      the active site architecture of both proteins may be alike. Using the T-7
      promoter system, Slt35 was overproduced in large quantities and purified to
      homogeneity for crystallographic purposes.

PMID- 7789525
TI  - The GLUT4 glucose transporter and the alpha 2 subunit of the Na+,K(+)-ATPase do
      not localize to the same intracellular vesicles in rat skeletal muscle.
AB  - The GLUT4 glucose transporter and the alpha 2 subunit of the Na+,K(+)-ATPase of
      rat skeletal muscle are two proteins which redistribute from intracellular
      membranes to plasma membranes following in vivo insulin stimulation. Here we show
      that although both proteins co-segregate after subcellular fractionation of
      unstimulated rat hindlimb muscles, they do not share the same intracellular
      residence inside the muscle fibre. By immunogold single- and double-labeling on
      ultrathin muscle cryosections with specific antibodies, the GLUT4 glucose
      transporter and the Na+,K(+)-ATPase alpha 2 subunit were observed on different
      vesicular structures within the cell. GLUT4 was detected on subsarcolemmal and
      perinuclear membranes, and at the junction between myofibrillar A and I bands
      where triads are localized. The alpha 2 subunit of the Na+,K(+)-ATPase was
      observed at the plasma membrane and in distinct subsarcolemmal vesicles and
      intermyofibrillar membranes. Quantitative analysis of double-labeling of GLUT4
      and Na+,K(+)-ATPase alpha 2 subunit revealed that less than 6% of the two
      proteins co-localize in the same continuous vesicular structures. The
      differential intracellular localization of the two proteins was further confirmed
      by immunopurification of GLUT4-containing membranes from muscle homogenates, in
      which the alpha 2 subunit of the Na+,K(+)-ATPase was found only at the same
      extent as the alpha 1 subunit of the enzyme, a protein exclusively present at the
      plasma membrane.

PMID- 7789527
TI  - Underevaluation of complex I activity by the direct assay of NADH-coenzyme Q
      reductase in rat liver mitochondria.
AB  - We have shown that the rate of NADH-coenzyme Q reductase in rat liver
      mitochondria, assayed using the decyl-ubiquinone analog DB, is underevaluated,
      probably as a result of its low water solubility. In view of drawbacks
      encountered using other more soluble acceptors in this system, we demonstrate
      that the most reliable assay of the physiological rate of CoQ reduction by
      Complex I is the indirect calculation from the total rate of NADH oxidation and
      the rate of ubiquinol oxidation, using the pool equation of Kroger and
      Klingenberg [(1973) Eur. J. Biochem. 34, 358-368].

PMID- 7789528
TI  - IL-13 and IL-4 share signal transduction elements as well as receptor components
      in TF-1 cells.
AB  - IL-13 and IL-4 are growth factors for the human erythroleukemia cell line TF-1.
      In these cells both cytokines share overlapping binding sites, but the number of
      sites for IL-13 is half of that for IL-4. Two monoclonal antibodies against the
      extracellular domain of the IL-4R alpha chain completely abolish the binding of
      IL-13, although IL-13 does not bind to this chain. Following receptor triggering,
      IL-13 and IL-4 induce the phosphorylation of a 170 kDa protein, probably the IL-4
      induced phosphotyrosine substrate. In addition the phosphorylation of the 170 kDa
      protein results in its tight association with phosphatidylinositol-3-kinase.

PMID- 7789529
TI  - L-arginine depletion by arginase reduces nitric oxide production in endotoxic
      shock: an electron paramagnetic resonance study.
AB  - Nitric oxide (NO) synthesis was measured in the liver, lung, spleen and kidney of
      lipopolysaccharide-treated male rats using the nitric oxide spin trap, iron (II)
      diethyldithiocarbamate (FeDETC2). Nitric oxide formation in vivo was determined
      by the increase in intensity of the characteristic triplet hyperfine EPR spectrum
      of [NO-FeDETC2]. Intravenous bovine liver arginase, at a dose which completely
      depleted circulating arginine, significantly reduced the formation of nitric
      oxide in these tissues. The general decrease in NO levels was confirmed by the
      decrease in plasma nitrite levels. These results directly demonstrate that NO
      formation in endotoxic shock depends on extracellular arginine; depletion of
      plasma arginine may be a useful therapeutic strategy.

PMID- 7789530
TI  - The depolarization response element in acetylcholine receptor genes is a dual
      function E box.
AB  - All acetylcholine receptor subunit genes contain E boxes and are blocked by
      membrane depolarization. We have used transfected C2C12 myogenic cells to
      investigate the response, to electrical stimulation and KCl, of wildtype and
      mutant regulatory regions of the chick acetylcholine receptor alpha, gamma and
      delta subunit, and the mouse MLC genes. Point mutations revealed that E boxes
      function as activating elements targeted by the depolarization signal. These
      experiments suggest, and insertion of a depolarization response element into an
      unrelated promoter confirms, that plasma membrane depolarization switches the
      depolarization response element from an activating to a repressive mode.

PMID- 7789531
TI  - Cloning and disruption of the YNR1 gene encoding the nitrate reductase apoenzyme
      of the yeast Hansenula polymorpha.
AB  - The nitrate reductase gene (YNR1) from the yeast H. polymorpha was isolated from
      a lambda EMBL3 genomic DNA library. As probe a 350 bp DNA fragment synthesized by
      PCR from H. polymorpha cDNA was used. By DNA sequencing an ORF of 2,577 bp was
      found. The predicted protein has 859 amino acids and presents high identity with
      nitrate reductases from other organisms. Chromosomal disruption of YNR1 causes
      inability to grow in nitrate. Northern blot analysis showed that YNR1 expression
      is induced by nitrate and repressed by ammonium.

PMID- 7789532
TI  - Selective preservation of protein kinase C-zeta in the chemoprevention of
      azoxymethane-induced colonic tumors by piroxicam.
AB  - While nonsteroidal anti-inflammatory drugs have been shown to exert preventive
      effects against the development of colonic tumors in humans and in chemically
      induced tumors in animal models, the mechanism(s) involved in this phenomenon is
      unclear. We have recently demonstrated that one such agent, piroxicam, when
      supplemented (75 ppm) in the diets of rats administered azoxymethane, reduced the
      incidence of rats bearing tumors. To date, the effects of piroxicam on protein
      kinase C, a family of serine/threonine kinases which may be intimately involved
      in the colonic malignant transformation process, have not been examined. It was,
      therefore, of interest to determine whether piroxicam altered the expression of
      one or more isoforms of this kinase in these tumors. The present studies
      demonstrate that dietary piroxicam selectively preserved the expression of
      protein kinase C-zeta in azoxymethane-induced tumors; suggesting that this is at
      least one mechanism involved in this agent's chemopreventive actions in this
      organ.

PMID- 7789533
TI  - Phosphorothioate oligonucleotides bind in a non sequence-specific manner to the
      nucleolar protein C23/nucleolin.
AB  - To design optimal strategies for intracellular delivery of antisense
      phosphorothioate oligonucleotides, it may be useful to understand their
      interaction with cellular macromolecules. Nuclear extracts from LOX amelanotic
      myeloma cells were studied for protein binding to phosphorothioate
      oligonucleotides using a Southwestern protocol. Multiple nuclear proteins bound
      to the phosphorothioate oligonucleotides but no detectable protein binding was
      found to phosphodiester oligonucleotides. The protein with the strongest binding
      signals was shown by immunoprecipitation to be nucleolar C23/nucleolin, a 110 kDa
      protein. With glutathione S-transferase/nucleolin fusion protein constructs, the
      region of nucleolin containing the RNA recognition motifs had binding activity to
      phosphorothioate oligonucleotides.

PMID- 7789534
TI  - A stress-associated citrus protein is a distinct plant phospholipid hydroperoxide
      glutathione peroxidase.
AB  - A protein whose level is markedly increased upon exposure of cultured citrus
      cells and whole plants to NaCl, was shown to specifically catalyze the reduction
      of phosphatidylcholine hydroperoxide in the presence of glutathione. This
      enzymatic activity was shown to be independent of a similar activity exhibited by
      glutathione S-transferase in plants. This finding corroborates the significant
      homology (52%) accounted between the deduced amino acid sequence of the gene
      encoding for this protein and that of mammalian phospholipid hydroperoxide
      glutathione peroxidases. While the mammalian enzyme is known and well
      investigated, this study establishes the presence of this key protein also in
      plants.

PMID- 7789535
TI  - Dissociation constants and thermal stability of complexes of Bacillus intermedius
      RNase and the protein inhibitor of Bacillus amyloliquefaciens RNase.
AB  - Binase, the extracellular ribonuclease of Bacillus intermedius, is inhibited by
      barstar, the natural protein inhibitor of the homologous RNase, barnase, of B.
      intermedius. The dissociation constants of the binase complexes with barstar and
      its double Cys40,82Ala mutant are about 10(-12) M, only 5 to 43 times higher than
      those of the barnase-barstar complex. As with barnase, the denaturation
      temperature of binase is raised dramatically in the complex. Calorimetric studies
      of the formation and stability of the binase-barstar complex show that the binase
      reaction with barstar is qualitatively similar to that of barnase but some
      significant quantitative differences are reported.

PMID- 7789536
TI  - Interleukin-1 beta antagonizes phenobarbital induction of several major
      cytochromes P450 in adult rat hepatocytes in primary culture.
AB  - We have investigated the effects of interleukin (IL)-1 beta and IL6 on expression
      and phenobarbital (PB) induction of ethoxyresorufin O-deethylase (EROD) and
      pentoxyresorufin O-deethylase (PROD) activities, as well as on mRNA levels of
      cytochromes P450 (CYP) 1A, 2B, 2C, 2E and 3A, in rat hepatocytes in primary
      culture. IL6 slightly antagonized PB-induced PROD activity. Strikingly, IL1 beta
      strongly inhibited basal EROD and PROD activities, and fully blocked their
      induction by PB in a dose-dependent fashion. Furthermore IL1 beta completely
      suppressed PB induction of all CYP mRNAs analyzed. Our results demonstrate that
      IL1 beta can suppress basal CYP activities, as well as PB-inducible expression of
      five CYP mRNAs in rat hepatocytes in primary culture.

PMID- 7789537
TI  - Lack of correlation between mRNA expression and enzymatic activity of the
      aspartate aminotransferase isoenzymes in various tissues of the rat.
AB  - Little is known about control of expression of basal levels of the aspartate
      aminotransferases which are ubiquitous 'house keeping' enzymes in vertebrates. We
      have measured both mRNA and activity levels for both isoenzymes in various rat
      tissues as a function of age. Patterns of mRNA expression for the two isoenzymes
      were similar in a particular tissue about differed widely between tissues.
      Surprisingly, there was no simple correlation between mRNA levels and specific
      activities of the enzyme products. We conclude that translation for mRNA for
      these two isoenzymes is subject to tissue-specific, and in some cases age
      related, regulation.

PMID- 7789538
TI  - Detection of a sub-set of polysomal mRNAs associated with modulation of hypusine
      formation at the G1-S boundary. Proposal of a role for eIF-5A in onset of DNA
      replication.
AB  - S phase entry, i.e. start of DNA replication, is a crucial step in proliferation.
      Inhibition of S phase entry correlates with inhibition of hypusine formation, an
      event affecting only the eukaryotic initiation factor 5A (eIF-5A). Its hypusine
      containing sequence was postulated to authorize polysomal utilization of specific
      transcripts for proteins necessary to enable DNA replication. Using mimosine to
      reversibly suppress the hypusine-forming deoxyhypusyl hydroxylase (E.C.
      1.14.99.29) in cells while differentially displaying their polysomal versus non
      polysomal mRNA populations, we report the detection and classification of several
      mRNA species that indeed disappear from and reappear at polysomes in concert with
      inhibition and disinhibition, respectively, of hypusine formation. Based on
      initial sequence data, two translationally controlled enzymes, both critical for
      proliferation, are identified as candicate products of such mRNAs, methionine
      adenosyltransferase (E.C. 2.5.1.6) and cytochrome-c oxidase (EC 1.9.3.1) subunit
      I. The existence of such putative hypusine-dependent messenger nucleic acids
      (hymns) provides the basis for a proposal on their molecular function in onset of
      multiplication.

PMID- 7789539
TI  - Complement assembly of two fragments of the streptococcal protein G B1 domain in
      aqueous solution.
AB  - We examined the complementation of various pairs of fragments derived from the
      streptococcal protein G B1 domain by NMR and CD. Most were not associated;
      however, one pair of fragments (1-40) and (41-56) interacted sufficiently enough
      to regenerated a stable 1:1 complex, Kd = 9 x 10(-6) M. A 2D-NMR analysis showed
      that the structure of the complex resembled that of native domain. Here we
      discuss the complementation from the viewpoint of the folding pathway of the
      protein.

PMID- 7789541
TI  - Federal Trade Commission staff concerns with assisted reproductive technology
      advertising.

PMID- 7789540
TI  - Assisted fertility using electroejaculation in men with spinal cord injury--a
      review of literature.
AB  - OBJECTIVE: To review the effectiveness of rectal probe electroejaculation in
      terms of pregnancy in treatment of anejaculatory males due to spinal cord injury.
      The characteristics of electroejaculates also are examined. DATA IDENTIFICATION:
      All English language studies reporting pregnancies as a result of
      electroejaculation from men with spinal cord injury and related publications on
      electroejaculation were identified through MEDLINE search and manual scanning of
      recent relevant journals. RESULTS: Electroejaculation has become an accepted mode
      of semen procurement in anejaculatory individuals, with a success rate of
      approximately 60% to 90% varying among different centers. In general these
      electroejaculates exhibit high sperm counts but low motility and poor sperm
      function. Retrograde ejaculation is also common. Pregnancies using
      electroejaculates have been documented since 1975 in the form of case reports and
      small series. Assisted reproductive technology recently has been used in
      conjunction with electroejaculation. Although results are encouraging, pregnancy
      rates, however, cannot be accurately estimated because of the lack of large
      series in the literature. CONCLUSIONS: An increasing number of spinal cord
      injured patients desiring fertility can achieve pregnancy through combined use of
      electroejaculation and assisted reproductive techniques. Larger series are needed
      to establish an accurate pregnancy rate. Elucidation by further studies on
      etiology of sperm dysfunction of these individuals may improve their prognosis.

PMID- 7789542
TI  - A controlled assessment of the in vitro fertilization performance of British
      women of Indian origin compared with white women.
AB  - OBJECTIVE: To compare the reproductive performance of Indian versus white women
      in IVF. DESIGN: Controlled comparative clinical study. SETTING: In vitro
      fertilization center based in university department in large tertiary level
      hospital. PATIENTS: Results from first IVF treatment cycles in 44 Indian patients
      were compared with results from 88 white patients, matched by age and body mass
      index, over the same treatment year. The patients were selected from a
      prospectively collected IVF databank. INTERVENTIONS: Standard luteal-phase start
      long GnRH analogue regime. Ovarian stimulation with FSH and hMG. Transvaginal
      ultrasound-guided oocyte recovery. In vitro fertilization and ET following
      established protocols. MAIN OUTCOME MEASURES: Rates of abandoned cycles, egg
      retrievals, ETs, clinical pregnancies, miscarriages, and live births were
      compared in the first IVF treatment cycle. Cumulative pregnancy rates (PRs) over
      three cycles in the two groups of patients were also compared. RESULTS: More
      cycles were abandoned in the Indian than in the white group: 22.7% versus 9.1%.
      The Indian live birth rate per cycle was worse: 9.1% versus 22.7%. The
      performance of the two groups was otherwise similar: ovarian stimulation with hMG
      and FSH required 26.0 required 26.0 ampules in the Indian group versus 24.6
      ampules in the white group, mean number of follicles on the day of egg retrieval
      8.7 versus 8.7, mean number of eggs 5.9 versus 5.8, fertilization rate 82.4%
      versus 82.5%; ET rate 73.5% versus 82.5, mean number of embryos transferred 2.1
      versus 1.8, and clinical PR per cycle started 18.2% versus 27.3%. CONCLUSIONS:
      Under the same IVF regime, Indians performed worse than whites at the stage of
      ovarian stimulation (higher rate of abandoned cycles for poor response) and in
      live birth rate. Cumulative conception and live birth rates also tended to be
      worse in Indians than in whites.

PMID- 7789543
TI  - High-order oocyte transfer in gamete intrafallopian transfer patients 40 or more
      years of age.
AB  - OBJECTIVE: To analyze whether a policy of high-order oocyte transfer would be
      effective in women > or = 40 years of age who are undergoing GIFT, and further,
      whether a specific subgroup of these patients could be identified where clinical
      pregnancy was more likely to occur. DESIGN: Prospective descriptive study.
      SETTING: Patients in a university-based reproductive endocrinology and
      infertility practice. PATIENTS: Infertile women > or = 40 years of age who
      underwent GIFT cycles between January, 1990 and December, 1993 after not having
      achieved pregnancy with at least three previous cycles of superovulation and
      intrauterine insemination. INTERVENTIONS: Gamete intrafallopian transfer was
      performed after controlled ovarian hyperstimulation with hMGs. High-order oocyte
      transfer was employed. MAIN OUTCOME MEASURES: Clinical pregnancy rates (PRs).
      RESULTS: The overall clinical PR was 24.5% per retrieval (12/49) and 25.5% per
      transfer (12/47). A significantly higher number of oocytes were retrieved in
      patients who became pregnant than those who did not. Patient age, cycle day 3 FSH
      level, E2 level on the day of hCG administration, number of oocytes transferred,
      and total number of motile sperm transferred did not differ significantly between
      the two groups. The clinical PR per transfer was significantly higher in patients
      with more than five oocytes transferred (10/27, 37%) versus those with five or
      less oocytes transferred (2/20, 10%). No multiple gestations were obtained.
      CONCLUSION: The number of oocytes retrieved in women > or = 40 years of age
      undergoing GIFT is the main determinant predicting clinical pregnancy. High-order
      oocyte transfer seems to lead to a favorable PR while the risk of multiple
      gestation is limited.

PMID- 7789544
TI  - Pregnancy in women 50 or more years of age: outcomes of 22 consecutively
      established pregnancies from oocyte donation.
AB  - OBJECTIVE: To describe the reproductive and obstetric outcomes of women > or = 50
      years attempting pregnancy using donor oocytes. SETTING: The IVF program at the
      University of Southern California. PATIENTS: Thirty-six postmenopausal women aged
      50 to 59 years, mean 52.3 +/- 2.6 years (mean +/- SD) were screened medically,
      reproductively, and psychologically and enrolled in a trial of oocyte donation.
      INTERVENTIONS: Recipients underwent hormone replacement therapy using oral
      micronized E2 and IM administered P. Oocytes were provided by designated gamete
      donors (mean age 30.5 +/- 4.4 years). Embryos (4.3 +/- 1.2) were transferred
      transcervically. MAIN OUTCOME MEASURES: Rates for embryo implantation,
      spontaneous abortion, ongoing and delivered pregnancies, as well as the
      gestational age at delivery, birthweights, complications, and postpartum
      outcomes. RESULTS: Forty-five aspirations resulted in 22 pregnancies (48.9%): 3
      preclinical, 2 ending in spontaneous abortion, and 17 viable pregnancies (37.8%).
      The embryo implantation rate was 20.6%. Nine of 17 pregnancies (52.9%) were
      multiple gestations (6 twins; 1 triplet; and 2 quadruplets, selectively
      terminated to twins). All pregnancies delivered beyond 32 weeks: mean gestational
      age for singletons was 38.4 +/- 1.9 weeks (range 35 to 41 weeks); mean
      gestational age for twins was 36.3 +/- 1.4 weeks (range 34 to 38 weeks); the
      triplet pregnancy delivered at 32 weeks. Complications occurred in eight
      patients; gestational hypertension (n = 7), preterm labor (n = 3), gestational
      diabetes (n = 2), and pre-eclampsia (n = 1). One infant was trisomy-21.
      CONCLUSION: Patients > or = 50 years experience similar pregnancy rates after
      oocyte donation as younger women and are at equal risk for multiple gestation.
      Antenatal complications were experienced by the majority of patients,
      underscoring the importance of high risk obstetric surveillance and care.

PMID- 7789545
TI  - Fertilization and pregnancy with acrosome intact sperm by intracytoplasmic sperm
      injection in patients with disordered zona pellucida-induced acrosome reaction.
AB  - OBJECTIVE: To determine whether fertilization and pregnancy could be obtained by
      injection of acrosome-intact sperm into the cytoplasm in patients with persistent
      failure of fertilization in IVF-ET associated with disordered zona pellucida (ZP)
      induced acrosome reaction (AR). DESIGN: Sperm-ZP binding and penetration and ZP
      induced AR were compared between patients and fertile donors. Acrosome-intact
      sperm removed from the ZP were injected into the cytoplasm of the oocytes.
      SETTING: Reproductive Biology Unit, Royal Women's Hospital. MAIN OUTCOME
      MEASURES: The proportion of ZP penetrated and ZP-induced AR and fertilization and
      pregnancy after intracytoplasmic sperm injection were analyzed. RESULTS: Most
      (7/8) of the patients had consistently normal sperm characteristics including
      concentration, motility and velocity, acrosomes, and morphology. Mean number of
      sperm bound to the ZP was not significantly different between patients (97
      sperm/ZP) and fertile donor controls (100 sperm/ZP). However, AR of sperm bound
      to the ZP was significantly lower in the patients (4%) than in controls (61%).
      None of the ZP (n = 32) were penetrated by patient sperm whereas all (n = 32) ZP
      were penetrated by control sperm. Acrosome intact sperm removed from the ZP were
      used for intracytoplasmic sperm injection. All patients had > or = 50% normal
      fertilization and embryo development. Three pregnancies (one early aborted, two
      ongoing) were achieved after the transfer of fresh or frozen embryos. CONCLUSION:
      Acrosome-intact human sperm can produce a high fertilization rate and pregnancies
      after intracytoplasmic sperm injection in patients with disordered ZP-induced AR.
      The acrosome reaction is unlikely to be important for fertilization with
      intracytoplasmic sperm injection.

PMID- 7789546
TI  - The use of zona-free aged unfertilized human oocytes as a predictor for
      successful subzonal insemination.
AB  - OBJECTIVE: To examine the reliability of the zona-free aged (1 day old) human
      unfertilized oocyte sperm penetration assay for assessing sperm fertilizing
      ability and to determine the predictive value of this assay for subsequent
      subzonal insemination (SUZI) outcomes. DESIGN: A total of 253 unfertilized
      oocytes from total fertilization failure patients and from good fertilization
      rate (> 70%) patients in standard IVF were inseminated with donors' spermatozoa,
      and penetration rates were compared in each group. Two hundred seventy-two
      unfertilized oocytes from total fertilization failure, poor fertilization (<
      30%), and normal fertilization (> 30%) were inseminated with husbands'
      spermatozoa, and penetration rates were compared between the three groups. In 29
      patients, the results of the zona-free assay performed in previous IVF were
      compared with the fertilization rates of subsequent SUZI. RESULTS: In the zona
      free assay using donors' spermatozoa, there was no difference in penetration
      rates between the two groups (109/122, 89.3% versus 114/131, 87.0%). Penetration
      rates using partners' spermatozoa were positively correlated with fertilization
      rates in standard IVF (total fertilization failure 34/75, 45.3%; poor
      fertilization 56/77, 72.7%; normal fertilization 108/120, 90.0%). There was a
      significant difference in fertilization rates after SUZI between the patients
      with negative and positive penetration in zona-free assay (4/53, 7.5%, versus
      54/174, 31.0%). CONCLUSION: The zona-free human oocyte assay may primarily
      reflect sperm fertilizing ability. This asssay also could be a reliable predictor
      for subsequent SUZI outcome.

PMID- 7789547
TI  - High progesterone levels adversely affect embryo quality and pregnancy rates in
      in vitro fertilization and oocyte donation programs.
AB  - OBJECTIVE: To assess the effect of P levels on oocyte and embryo quality and
      pregnancy rates (PRs) in IVF and oocyte donation. DESIGN: Retrospective analysis
      of PRs in ovum donors and their recipients with regard to P levels on day of hCG
      administration. SETTING: In Vitro Fertilization Units, oocyte donation programs.
      PATIENTS: In vitro fertilization patients who agreed to donate oocytes were
      treated by hMG alone (53 cycles) or in combination with a GnRH analog (122
      cycles). INTERVENTIONS: Uterine preparation in oocyte recipients consisted of 6
      mg/d E2 valerate. Progesterone (100 mg/d) was added when oocytes became
      available. Hormonal treatment was continued until 12 weeks of gestation. RESULTS:
      Using a series of Fisher's Exact Tests, a critical threshold for P was identified
      at 1.9 ng/mL (conversion factor to SI units, 3.185). With elevated P levels (>
      1.9 ng/mL), lower PRs were noted for the donors (7.1% versus 17%), as well for
      the recipients (8.3% versus 26.7%). CONCLUSIONS: Exposure to elevated P levels
      resulted in lower PRs for the donors and significantly lower PRs in the
      recipients. Because the endometria in the recipients were prepared uniformly, we
      conclude that this is the result of detrimental effects of P on oocyte or embryo
      quality.

PMID- 7789548
TI  - Assisted reproductive technology in the United States and Canada: 1993 results
      generated from the American Society for Reproductive Medicine/Society for
      Assisted Reproductive Technology Registry.
AB  - OBJECTIVE: To summarize the procedures and outcomes of assisted reproductive
      technology (ART) initiated in the United States in 1993. DESIGN: Data were
      collected on an annual summary form and submitted to the American Society for
      Reproductive Medicine/Society for Assisted Reproductive Technology Registry.
      PARTICIPANTS: Two hundred sixty-seven programs submitted data on procedures
      performed in 1993. Data were collected in October 1994 so that outcome of all
      pregnancies established would be known. MAIN OUTCOME MEASURES: The outcomes
      measured included clinical pregnancy, ectopic pregnancy, abortion, stillbirth,
      delivery, and congenital abnormality. RESULTS: Programs reported initiations of
      41,209 cycles of ART treatment, excluding frozen embryo and donor oocyte cycles.
      Of these, 33,543 cycles initiated were IVF (standard, with micromanipulation, and
      for host uterus transfer) with 18.3% deliveries per retrieval; 4,992 were cycles
      of GIFT with 28.1% deliveries per retrieval; 1,792 were cycles of ZIFT with 24.4%
      deliveries per retrieval; and 882 were combination cycles, combining IVF and one
      of the tubal transfer techniques, resulting in 27.8% deliveries per retrieval. In
      addition to these cycles initiated in 1993, 6,869 frozen ET procedures were
      reported, either as separate procedures or in combination with another ART
      procedure with 13.3% deliveries per procedure, and 2,766 donor oocyte cycles were
      initiated with an overall success of 30.2% deliveries per retrieval. As a result
      of all procedures, a total of 8,741 deliveries were reported. CONCLUSIONS: In
      1993, there were more programs offering more treatment cycles of ART. Overall
      average success rates (deliveries per procedures) exhibited only a small increase
      compared with previously reported summaries.

PMID- 7789549
TI  - Extracellular matrix interactions in early human embryos: implications for normal
      implantation events.
AB  - OBJECTIVE: To study the role of the extracellular matrix (ECM) proteins in
      supporting the development and implantation competence of human embryos. DESIGN:
      Expression of an implantation site adhesive glycoprotein, oncofetal fibronectin,
      and basement membrane collagen-degrading matrix metalloproteinase-2 and -9 were
      studied in cultured human embryos. The ability of exogenously added laminin and
      fibronectin to enhance hatching and matrix metalloproteinase-2 expression was
      quantitated also. PATIENTS: Fifty-four women with tubal factor infertility
      enrolled in the IVF program at the University Hospital of Oulu agreed to
      participate by providing 20 residual oocytes and 227 residual early embryos for
      this study. MAIN OUTCOME MEASURES: The presence of oncofetal fibronectin
      immunoreactive protein was assayed by immunocytochemical staining with two
      specific monoclonal antibodies, FDC-6 and X18A4. These antibodies bind to
      specific and distinct epitopes within tumor and trophoblast-derived oncofetal
      fibronectin. Changes in embryo matrix metalloproteinase-2 production were
      measured by zymography and confirmed by immunocytochemical staining. RESULTS:
      Intracellular oncofetal fibronectin was identified within blastomeres of early
      stage embryos. The immunoreactivity of oncofetal fibronectin in the zona
      pellucida was associated with fragmentation and dissolution of the zona.
      Exogenously added laminin or adult-type fibronectin significantly increased the
      hatching rate of the cultured embryos. Embryos cultured with added adult-type
      fibronectin or trophoblast-derived oncofetal fibronectin stimulated the matrix
      metalloproteinase-2 production (72-kd type IV collagenase) by 2.25 +/- 0.16-fold
      when compared with control embryos (mean +/- SD). CONCLUSIONS: Embryonic
      production of specific ECM proteins, such as oncofetal fibronectin, appears to be
      important for the morphological and biochemical development of human
      preimplantation embryos. Moreover, ECM proteins promote acquisition of the
      adhesive and degradative properties required by human embryos for successful
      implantation.

PMID- 7789551
TI  - Pentoxifylline improves sperm binding to the zona pellucida in the hemizona
      assay.
AB  - OBJECTIVE: To evaluate the effect of pentoxifylline on sperm binding capacity to
      zona pellucida (ZP) using the hemizona assay (HZA). DESIGN: The fertility
      potential of 82 men was evaluated by routine semen analysis. Each ejaculate was
      incubated with or without pentoxifylline (3 mM) in Ham's F-10 medium (Flow
      Laboratories, Irvine, Scotland) before the HZA. The effect of the pentoxifylline
      treatment on sperm-binding capacity to ZP was assessed by the hemizona index.
      RESULTS: The mean hemizona indexes with medium or pentoxifylline treatment were
      23% +/- 2.1% (mean +/- SE) and 41% +/- 3.4%, respectively. Taking into
      consideration a significant change of the hemizona index on rising above the
      intra-assay coefficient of variation (+/- 8%) after pentoxifylline treatment,
      73.1% of specimens improved, 19.5% deteriorated, and 7.4% remained unchanged.
      Using a threshold hemizona index of 23% as a discriminator between fertile and
      infertile specimens, 43.5% of the "pentoxifylline-improved" samples ascended to
      the fertile zone (> 23%). No correlations were found between sperm variables in
      the raw semen and the effect of pentoxifylline on sperm binding capacity.
      CONCLUSION: Pentoxifylline may improve the binding capacity of human spermatozoa.
      However, this effect is confined to a selected group of patients and cannot be
      predicted by the basic sperm variables. Thus, to avoid uncertain or damaging
      effects of pentoxifylline while preparing sperm suspension for assisted
      reproductive techniques, it is recommended that its effect be tested by the HZA
      system before its use.

PMID- 7789550
TI  - Dose effects of the gonadotropin-releasing hormone antagonist, Nal-Glu, combined
      with testosterone enanthate on gonadotropin levels in normal men.
AB  - OBJECTIVE: To test the hypothesis that over a 4-week treatment period, Nal-Glu
      GnRH antagonist ([AcD2Nal1, D4ClPhe2, D3Pal3, Arg5, DGlu6 [AA], DAla10] GnRH) at
      a dose of 200 micrograms/kg per day SC would suppress levels of immunologically
      active and biologically active LH and FSH more completely than a dose of 100
      micrograms/kg per day. DESIGN: Placebo controlled clinical study. SETTING: A
      university community. SUBJECTS: Thirty normal male volunteers. INTERVENTIONS: We
      administered Nal-Glu at doses of 0, 100, and 200 micrograms/kg body weight per
      day in combination with T enanthate, 50 mg IM weekly, to separate groups of men
      (9 or 10 men per group) for 4 weeks. RESULTS: Serum levels of immunologically
      active and biologically active gonadotropins were suppressed similarly in both
      groups of men who received Nal-Glu; this suppression was significantly greater
      than in the men who received placebo + T. Local side effects were more severe in
      the Nal-Glu 200 micrograms/kg per day group. CONCLUSIONS: Administration of Nal
      Glu in combination with T suppresses gonadotropins more completely than does T
      alone, but at doses > 100 micrograms/kg, gonadotropins are not suppressed
      additionally with larger doses of Nal-Glu. Subjects experienced greater local
      discomfort and side effects with the higher dosage. These findings suggest that
      dosages of Nal-Glu of > 100 micrograms/kg per day may have no advantage over the
      100-micrograms/kg dose in a male contraceptive regimen.

PMID- 7789552
TI  - Spermatozoa selected by a discontinuous Percoll density gradient exhibit better
      motion characteristics, more hyperactivation, and longer survival than direct
      swim-up.
AB  - OBJECTIVE: To determine if a discontinuous Percoll density gradient selects
      spermatozoa with different motion characteristics than direct swim-up. DESIGN:
      Controlled prospective study of the effect of two preparation techniques on
      spermatozoa from normal semen samples using computer-aided sperm analysis (CASA).
      SETTING: The Fertility laboratory, Queen Charlotte's Hospital, London, United
      Kingdom. PATIENTS: Eighteen male patients. INTERVENTIONS: Semen samples were
      divided into two equal parts. The first part was prepared by a direct swim-up
      whereas the other half was subjected to a three-layer discontinuous Percoll
      density gradient centrifugation. The separated samples were then examined at 30
      minutes and 3, 6, and 24 hours by CASA. RESULTS: Although swim-up selected a
      higher proportion of motile spermatozoa, Percoll produced a greater yield of
      motile cells. Straight line velocity was similar for both methods throughout
      study. In contrast, spermatozoa isolated by Percoll exhibited a significantly
      higher curvilinear velocity and amplitude of lateral head displacement, which
      lasted for > or = 6 hours. These changes were accompanied by a significant
      reduction in linearity of progression. The most dramatic effect of Percoll was to
      produce significantly greater numbers of spermatozoa expressing hyperactivation.
      After both swim-up and Percoll there was a decline in progressive motility over
      the 24 hours, although this was only significant for swim-up. CONCLUSIONS: In
      normal semen, a discontinuous Percoll density gradient selects spermatozoa with
      better motion characteristics, more hyperactivation, and improved longevity
      compared with direct swim-up. In view of the relationship between sperm motion
      characteristics and fertilizing ability, we conclude that the three-layer
      discontinuous Percoll density gradient be adopted as the preferred method for the
      preparation of spermatozoa for assisted reproduction.

PMID- 7789553
TI  - Oxidative stress and interleukins in seminal plasma during leukocytospermia.
AB  - OBJECTIVE: To quantify the levels of reactive oxygen species, superoxide
      dismutase (SOD), and interleukins (IL) 2 and 8 in seminal plasma of infertile
      patients as well as to examine the possible relationship between oxidative stress
      and proinflammatory cytokines. DESIGN: Semen collected from normal fertile
      donors, infertile men without symptoms of genitourinary (GU) inflammation, and
      infertile men with symptoms of infection-inflammation of the GU tract was
      evaluated for the levels of granulocyte elastase, reactive oxygen species, SOD,
      IL-2, and IL-8. Any correlation between the levels of reactive oxygen species and
      other parameters in these population was analyzed statistically. RESULTS:
      Significantly high levels of granulocyte elastase (18.32 +/- 1.52 U/L), reactive
      oxygen species (6 x 10(5) cpm), IL-8 (3.7 +/- 0.10 microgram/L), and IL-2 (18.32
      +/- 1.47 ng/L) were observed in semen of infertile patients with leukocytospermia
      compared with the other two groups. In leukocytospermic samples, the activity of
      SOD was significantly lower (624.89 +/- 41.16 NU/mL) compared with
      nonleukocytospermic samples (787.85 +/- 24.26 NU/mL) or fertile donors (816.29 +/
      50.16 NU/mL). A significant positive correlation was observed between the levels
      of reactive oxygen species and IL-8. CONCLUSIONS: These findings suggest that
      increased oxidative stress observed during leukocytospermia may modulate the
      level of proinflammatory cytokines. The increased oxidative stress may be due to
      a defect in the reactive oxygen species scavenging system.

PMID- 7789554
TI  - The effects of immunosuppression on development and progression of endometriosis
      in baboons (Papio anubis).
AB  - OBJECTIVE: To test the hypothesis that immunosuppression increases the
      development and progression of endometriosis in baboons. DESIGN: Experimental
      controlled study. SETTING: Institute of Primate Research, Nairobi, Kenya.
      PARTICIPANTS: Thirty-two baboons (8 with normal pelvis, 10 with spontaneous
      endometriosis, and 14 with endometriosis induced by intraperitoneal seeding of
      menstrual endometrium). INTERVENTION: Daily injection of 0.8 mg/kg IM
      methylprednisolone and 2 mg/kg azathioprine for 3 months in 16 baboons (4 with
      normal pelvis, 5 with spontaneous endometriosis, and 7 with induced
      endometriosis). No treatment was given to the remaining 16 primates. MAIN OUTCOME
      MEASURES: The change in number and surface area (mm2) of endometriotic lesions
      was evaluated by laparoscopy in all baboons after 3 months, in 8 animals with
      induced endometriosis and in 9 primates with spontaneous disease after 7 and 12
      months, respectively. RESULTS: Immunosuppressed baboons with spontaneous
      endometriosis had a significantly higher number and larger surface area of
      endometriotic lesions than nontreated animals. However, immunosuppressed and
      nontreated primates with induced endometriosis were comparable with respect to
      both number and surface area of implants. A transient decrease in typical lesions
      was noted during immunosuppression. Immunosuppression did not cause the
      development of endometriosis in baboons with previously documented normal pelvis.
      CONCLUSION: Immunosuppression may increase the progression of endometriosis in
      baboons with spontaneous disease.

PMID- 7789556
TI  - A new selection criterion for fimbriectomy reversal.
AB  - OBJECTIVE: To assess a new criterion for selection of patients who request
      reversal of fimbriectomy sterilization. DESIGN: Prospective study. SETTING:
      Division of reproductive endocrinology and infertility in an academic center.
      PATIENTS: Eight patients undergoing reversal of fimbriectomy using microsurgical
      techniques. The prerequisite inclusion criterion was the presence of more than
      50% ampulla as shown at hysterosalpingography. This is easily determined, because
      the isthmic length approximates one half the ampullary length. RESULTS: The
      cumulative intrauterine pregnancy rate was 50%. There were no ectopic
      pregnancies. CONCLUSION: Similar pregnancy rates for reversal of fimbriectomy
      have been reported based upon different absolute selection criteria (viz., tubal
      length of > or = 8 cm and ampullary width of > or = 1 cm). By contrast, our new
      selection criterion is based upon the more readily determined proportion of
      ampulla that is available for surgical neostomy.

PMID- 7789555
TI  - Development of a new alloplastic spermatocele demonstrating successful sperm
      retrieval in an animal model.
AB  - OBJECTIVE: To create an alloplastic spermatocele capable of repeated sperm
      aspiration. The alloplastic spermatocele has long been a theoretical solution to
      infertility for those patients with congenital absence of the vas deferens or
      irreversible obstruction of the male reproductive ductal system. Recent studies
      have suggested that sperm from efferent ducts are capable of fertilization.
      Clinical use of alloplastic spermatoceles for collection of epididymal sperm has
      resulted in unacceptably low pregnancy rates. Improvement in spermatocele
      function may occur if a microsurgical anastomosis is performed to the epididymis.
      DESIGN: A newly designed alloplastic spermatocele was implanted in 17 mature male
      rabbits. The faceplate of the device had a 0.7-mm orifice, allowing direct
      precise microsurgical anastomosis to a specific loop of the epididymal tubule.
      RESULTS: Sperm retrieval was possible in 16/17 (94%) animals. Repeated successful
      aspirations (total of 73) were performed in all but one animal. The total number
      of sperm collected per spermatocele averaged 115 x 10(6) (range 0 to 734 x
      10(6)). The sperm motility varied widely between animals and specimens, with a
      maximum average of 21.6% motile sperm/aspirate per animal. All spermatoceles
      eventually occluded (mean time of occlusion 14 days; range 3 to 30 days). The
      prostheses with the attached epididymides were examined histologically.
      CONCLUSIONS: This prototype alloplastic spermatocele allows repeated high density
      sperm retrieval over a short period of time. Low sperm motility may be less
      problematic clinically as new techniques of IVF become available.

PMID- 7789557
TI  - Regression of uterine leiomyomata to the antiprogesterone RU486: dose-response
      effect.
AB  - OBJECTIVE: To study the response of uterine leiomyomata to three daily doses of
      RU486 (5, 25, and 50 mg). DESIGN: Prospective nonrandomized trial of women with
      symptomatic leiomyomata. SETTING: Patients from the clinical practice of the
      authors at the University of California, San Diego Medical Center. PATIENTS: Ten
      patients with symptomatic leiomyomata previously reported after treatment with 50
      mg of RU486 daily for 3 months. Eleven patients treated with 25 mg of RU486 daily
      and nine patients placed on 5 mg of RU486 daily for 12 weeks. MAIN OUTCOME
      MEASURES: Changes in leiomyomata volume as measured with vaginal ultrasounds at
      baseline and monthly thereafter. Frequent blood samples for hematology,
      chemistry, and hormone levels were obtained. Twenty-four-hour urine collections
      for free cortisol and creatinine were obtained at baseline and at 12 weeks.
      RESULTS: All three doses induce ovarian acyclicity. Administration of 50 mg of
      RU486 decreases leiomyomata volume to 78.1% +/- 4.8% of baseline at 4 weeks,
      60.5% +/- 6.6% at 8 weeks, and 51.0% +/- 9.2% after 12 weeks of treatment.
      Regressive response in patients treated with 25 mg of RU486 daily was 76.3% +/-
      5.0% of baseline at 4 weeks, 54.0% +/- 5.1% at 8 weeks, and 44.0% +/- 5.0% after
      12 weeks. At 5 mg of RU486 leiomyomata volume was 80.6% +/- 8.3% of baseline
      after 4 weeks, 63.7% +/- 14.6% after 8 weeks, and 74.4% +/- 19.8% after 12 weeks
      of therapy. CONCLUSIONS: Although acyclicity is seen at all three doses, an
      effective dose to cause a clinically significant (50%) decrease in leiomyomata
      volume appears to be 25 mg daily.

PMID- 7789558
TI  - Fibroid growth in response to high-dose progestogen.
AB  - OBJECTIVE: To challenge the conventional belief that leiomyomata are estrogen
      dependent tumors by presentation of a case report suggesting high-dose
      progestogen therapy is associated with a dramatic increase in size of a fibroid
      uterus. DESIGN: Case report. SETTING: British university hospital. PATIENT: One
      white woman treated with tamoxifen and high-dose megestrol acetate for breast
      carcinoma. INTERVENTIONS: Megestrol acetate therapy withdrawn. MAIN OUTCOME
      MEASURE: Uterine size. RESULTS: While taking tamoxifen and high-dose megestrol
      acetate, the patient suffered a dramatic increase in size of her fibroid uterus,
      which reversed when the progestogen was withdrawn. CONCLUSION: This case report
      suggests that P may be important in fibroid growth.

PMID- 7789559
TI  - Subendometrial contractility in menstrual phase visualized by transvaginal
      sonography in patients with endometriosis.
AB  - OBJECTIVE: To describe the propagation direction of the subendometrial myometrial
      contractile wave in menstrual phase sonographically assessed in patients with and
      without endometriosis. DESIGN: Prospective study. SETTING: Patients and normal
      volunteers in a university hospital. PATIENTS: Sixteen women with (study group)
      and 21 without (control group) endometriosis. INTERVENTIONS: Patients were
      examined by transvaginal sonography (midsaggital plane of the uterus) and
      recorded on videotape for a 5-minute period. MAIN OUTCOME MEASURE: Direction of
      propagation of contraction waves. RESULTS: The endometriosis group showed a
      predominant retrograde pattern whereas the control group showed a normal
      antegrade. CONCLUSION: This abnormal cervix-to-fundus myometrial activity could
      well increase the amount of peritoneal shedding of endometrial menstrual debris,
      increasing the probabilities of its heterotopic implantation.

PMID- 7789561
TI  - Toward reducing risks and costs of egg donation: a preliminary report.
AB  - OBJECTIVE: To use clomiphene citrate for ovarian stimulation of egg donors as a
      means of reducing the risk, discomfort, and inconvenience for egg donors and
      reducing costs for recipients. DESIGN: Prospective nonrandomized clinical study.
      SETTING: Private reproductive center. PATIENTS: Egg donation recipients and their
      anonymous donors. INTERVENTION: Clomiphene citrate was administered to egg donors
      rather than a GnRH agonist and gonadotropins before oocyte retrieval. MAIN
      OUTCOME MEASURE: Pregnancy. RESULTS: Eleven oocyte retrievals were performed and
      conception occurred in four cycles, three of which delivered. CONCLUSION:
      Clomiphene citrate appears to be a reasonable less expensive method of ovarian
      stimulation for egg donation in normospermic males and appears more acceptable to
      potential donors.

PMID- 7789560
TI  - Semen leukocytes: friends or foes?
AB  - OBJECTIVE: To test the hypothesis that male reproductive tract leukocytes
      function in the elimination of abnormal spermatozoa from ejaculated semen.
      DESIGN: Semen specimens with > or = 2 x 10(6) nonspermatozoal cells/mL were
      examined for leukocytes and for mature sperm with ideal morphology. SETTING:
      Andrology laboratory of a Center of Assisted Reproductive Technology. RESULTS:
      Semen specimens with elevated concentrations of leukocytes contained a
      significantly higher frequency of sperm with ideal morphology than semen
      specimens with elevated numbers of immature germ cells and low numbers of
      leukocytes. CONCLUSIONS: The direct correlation between leukocyte density and
      sperm with ideal morphology supports the concept that sperm surveillance is a
      normal function of male reproductive tract leukocytes. Understanding such germ
      cell-leukocyte interactions may provide valuable new insights into immunologic
      control mechanisms in male reproductive tract tissues.

PMID- 7789562
TI  - Polycystic kidney disease and infertility.
AB  - OBJECTIVE: To analyze the cause of infertility in a patient with polycystic
      kidney disease. SETTING: General hospital. PATIENT: A 32-year-old man known with
      adult polycystic kidney disease, complaining of infertility and testicular pain.
      INTERVENTIONS: Testicular biopsy; imaging. RESULTS: Examination revealed
      bilateral severe congestion of the epididymis. The semen contained no spermatozoa
      and practically no fructose. Testicular biopsy, however, showed normal
      spermatogenesis. Transrectal ultrasonography and computer tomography revealed
      severe congestion and extensive cystic changes in the seminal vesicles.
      CONCLUSION: The dilated cysts in the seminal vesicles had led to obstructive
      azoospermia, probably through compression of the ductal system.

PMID- 7789563
TI  - Laparoscopic sterilization in the supine position using the Ramathibodi uterine
      manipulator.
AB  - OBJECTIVES: To investigate the usefulness of the Ramathibodi uterine manipulator
      (AMZURA Enterprises, Freeport, NY) in performing laparoscopic sterilization
      procedures in the supine position under local anesthesia. DESIGN: Descriptive
      prospective study. SETTING: Ambulatory surgical unit of university-affiliated
      hospital. PATIENTS: Women presenting for elective sterilization and weighing <
      110 kg. INTERVENTION: The Ramathibodi uterine manipulator was used to provide
      uterine manipulation in 85 cases of laparoscopic sterilization, all performed in
      the supine position as local anesthesia-sedation sterilization operations.
      Because such procedures are becoming more common worldwide, we propose the
      acronym "LASSO" (Local Anesthesia-Sedation Sterilization Operation) for this
      class of operations. Although commonly used in minilaparotomy procedures, use of
      this uterine manipulation device in laparoscopic procedures has not been
      published previously. MAIN OUTCOME MEASURE: Successful tubal occlusion. RESULTS:
      Among the 85 cases reported here there were no failures to manipulate the uterus
      successfully, to identify the tubes, and to occlude them. CONCLUSIONS: The
      simplicity of the Ramathibodi uterine manipulator provided several advantages
      over other means of uterine manipulation, notably [1] constant easy-to-learn
      maneuvers, [2] no tenaculum or balloon requirement, [3] the procedure could be
      performed in the supine position, and [4] there are no working parts, screws, or
      springs that could be lost or broken by operating room staff. Our experience with
      this device leads us to recommend it to colleagues as an inexpensive, safe, and
      effective alternative to currently available instruments for providing uterine
      elevation during laparoscopic sterilization procedures.

PMID- 7789565
TI  - Recombinant follicle-stimulating hormone and luteinizing hormone--mimicking
      nature and beyond.

PMID- 7789564
TI  - Repeatability of measurements on human, rabbit, and bull sperm by computer
      assisted sperm analysis when comparing individual fields and means of 12 fields.
AB  - OBJECTIVE: To compare repeatability of measurements of human, rabbit, and bull
      sperm on two Hamilton Thorne Integrated Visual Optical System (IVOS) units,
      software version 10. DESIGN: Semen samples from seven normal human subjects, six
      rabbits, and eight bulls were obtained at regular intervals. The samples were
      diluted, two chambers were filled, and 12 fields were recorded, using high
      resolution recorders. Computer-assisted sperm analysis (CASA) was performed
      nearly simultaneously with two Hamilton Thorne IVOS units. SETTING: Reproduction
      Research Laboratories, Cornell University and Hamilton-Thorne Research, Beverly,
      Massachusetts. RESULTS: Optimal settings were established for evaluating by CASA
      sperm from three species. Fifteen variables were analyzed. The correlation
      coefficients for most variables characterizing sperm motion and concentration,
      when means of 12 fields were calculated, were 0.95 to 1.00. There were too few
      hyperactive sperm to obtain a reliable correlation for human sperm (r = 0.63) and
      repeatability of elongation was lower only for human sperm (r = 0.75).
      CONCLUSIONS: Two units of Hamilton Thorne IVOS, software version 10, were capable
      of providing nearly identical estimates of many CASA variables of human, rabbit,
      and bull sperm. Correlations for the paired estimates of many motion
      characteristics and sperm concentration usually exceeded 0.97.

PMID- 7789566
TI  - New frontiers in the treatment of male infertility.

PMID- 7789567
TI  - "Leaky randomization" standard practice--but is it correct?

PMID- 7789568
TI  - Fluorescence in situ hybridization aficionados and rater variation.

PMID- 7789569
TI  - The prognosis for live birth among untreated infertile couples.
AB  - OBJECTIVE: To estimate the likelihood of live birth and the impact of prognostic
      factors among untreated infertile couples. DESIGN: Cohort follow-up study.
      SETTING: Eleven infertility clinics in academic medical centers. PATIENTS: Two
      thousand one hundred ninety-eight couples with infertility of > 1 year in
      duration. Untreated months of observations on 873 untreated couples (18,364
      months) were combined with observations before the first treatment among 1,325
      treated couples (9,761 months). INTERVENTIONS: Diagnostic tests as indicated.
      MAIN OUTCOME MEASURES: Time to conception for live birth; effect of baseline
      characteristics estimated by means of proportional hazards analysis. RESULTS:
      There were 263 live birth conceptions during 28,125 months of untreated
      observations. The cumulative rate of conceptions leading to live birth was 14.3%
      at 12 months. The relevant prognostic factors were pregnancy history, duration of
      infertility, female partner's age, male defect, endometriosis, and tubal disease.
      A prediction score based on these factors would be accurate in approximately 62%
      of cases. CONCLUSIONS: The estimation of live birth among untreated infertile
      couples is sufficiently accurate to be useful in the clinical management of
      infertility and in the planning of clinical trials.

PMID- 7789570
TI  - "Part of the primordial soup".

PMID- 7789572
TI  - Screening for ovarian reserve.

PMID- 7789571
TI  - Outpatient hysteroscopy--paracervical block.

PMID- 7789573
TI  - Intracytoplasmic sperm injection--"pushing the envelope".

PMID- 7789574
TI  - Endometriosis and gamete intrafallopian transfer.

PMID- 7789575
TI  - Terminology for luteinizing hormone-releasing hormone antagonists.

PMID- 7789576
TI  - Killer cell activity, statistics, and endometriosis.

PMID- 7789577
TI  - Predictors of success of reversal of sterilization.
AB  - OBJECTIVE: To determine the prognostic variables effecting the successful
      pregnancy outcome of reversal of sterilization. DESIGN: Demographic and clinical
      history data were collected prospectively. SETTING: Division of Infertility and
      Reproductive Endocrinology, Department of Obstetrics and Gynecology, University
      of British Columbia, Vancouver, Canada. PATIENTS AND INTERVENTION: Between 1981
      and 1992, 217 consecutively referred patients underwent reversal of sterilization
      by a single surgeon using microsurgical techniques. MAIN OUTCOME MEASURES:
      Prognostic variables associated with success were examined using logistic
      regression and expressed as odds ratios with corresponding 95% confidence
      intervals. RESULTS: Age at reversal was a significant factor with the odds of a
      successful outcome for those < or = 35 years compared with those > 35 years being
      2.3 with a 95% confidence interval of 1.3 to 4.1. There was some evidence that
      average tubal length as categorized in 2-cm intervals was a significant
      prognostic factor with the odds of a successful outcome for those with an average
      length of > 4 cm to those < or = 4 cm being 5.3 with a 95% confidence interval of
      1.4 to 20.0. CONCLUSIONS: Nonsubjective analysis of the prognostic variables of
      reversal of sterilization associates only age and tubal length of > 4 cm with
      intrauterine pregnancy.

PMID- 7789578
TI  - Decremental follicle-stimulating hormone and dominant follicle development during
      the normal menstrual cycle.
AB  - OBJECTIVE: To study the relationship between decreasing serum FSH levels in the
      follicular phase of the normal menstrual cycle and follicle development by means
      of transvaginal sonography and E2 production. DESIGN: Daily blood samples were
      taken and transvaginal sonography was performed every other day in 16 normal
      regularly cycling female volunteers. MAIN OUTCOME MEASURE: Serum levels of FSH,
      LH, E2, and P and follicle diameter by transvaginal sonography. RESULTS: A
      distinct variability in individual maximal early follicular phase FSH plasma
      levels was observed (range 4.4 to 11.2 mIU/mL [conversion factor to SI unit,
      1.000]). Differences in maximum FSH levels did not correlate with other endocrine
      or sonographic follicular phase characteristics. The follicular phase FSH
      decrease (from median 6.6 to 2.9 mIU/mL [conversion factor to SI unit, 1.000])
      took place between cycle day 5 and 13 and was linear (0.5 +/- 0.05 mIU/mL per
      day; mean +/- SD). A significant correlation was found between serum FSH decrease
      and E2 increase. The day of sonographic appearance of a dominant follicle (median
      cycle day 8) did correlate with the first rise of the E2 plasma concentration.
      CONCLUSIONS: The present study suggests that even in women exhibiting normal
      ovarian function a 2.5-fold difference in FSH threshold concentrations for
      follicle recruitment does occur. Moreover, the magnitude of decrease in serum FSH
      concentrations during the follicular phase affects dominant follicle E2
      production. The sonographic appearance of the dominant follicle is associated
      with a rise in serum E2 levels.

PMID- 7789579
TI  - Evaluation of cytogenetic analysis for clinical preimplantation diagnosis.
AB  - OBJECTIVE: To evaluate the feasibility of using cytogenetic analysis in
      preimplantation diagnosis. DESIGN: Two different biopsy protocols (chemical
      drilling and zona cutting) and two fixation methods were tested in a mouse model.
      Afterwards, the efficiency of obtaining chromosome preparations from
      untransferable human embryos depending on the method used to obtain the
      blastomeres (embryos biopsy or removal of the zona pellucida and blastomere
      disaggregation) was determined. The chances of obtaining chromosome preparations
      depending on the type of embryo (haploid, diploid, triploid, and apparently
      unfertilized) were also evaluated. RESULTS: Results from the mouse model showed
      that chemical drilling yields better results than cutting in terms of metaphases
      per biopsied embryo and surviving rate after biopsy. In human embryos, biopsy of
      diploid embryos produced 46.6% chromosome preparations, while 29% were obtained
      after blastomere disaggregation and 20.4% when biopsying triploid embryos.
      CONCLUSIONS: These results suggest that the disaggregating procedure and triploid
      embryos cannot be considered as good models to assess the feasibility of
      cytogenetic analysis in preimplantation diagnosis. Poor chromosome quality and
      loss during fixation are the main problems to use cytogenetics in preimplantation
      diagnosis; a combination of cytogenetics and other techniques is suggested in
      cases of balanced translocations.

PMID- 7789580
TI  - The psychological effects of multifetal pregnancy reduction.
AB  - OBJECTIVE: To study the psychological effects of multifetal pregnancy reduction.
      DESIGN AND SETTING: Hour-long semistructured telephone interviews with both
      multifetal pregnancy reduction patients and control subjects. PATIENTS: Forty-two
      multifetal pregnancy reduction patients were contacted within 1 year of
      undergoing the procedure. Forty-four control subjects had become pregnant after
      infertility evaluation or treatment but conceived only a single fetus or twins
      and thus did not consider fetal termination. MAIN OUTCOME MEASURES: Standardized
      measures of depressive disorder and current psychiatric symptoms, as well as
      questions about emotional reactions to multifetal pregnancy reduction. RESULTS:
      Reduction patients who were pregnant or postpartum at the time of the interview
      (n = 34) were no more likely than pregnant or postpartum controls (n = 34) to
      report episodes of depression or high psychiatric symptom levels. The same
      proportion (14.7%) of both reduction patients and controls with a successful
      pregnancy outcome met criteria for an episode of major depressive disorder
      occurring during the 9 months before the interview. In contrast, the 8 reduction
      patients who spontaneously aborted the entire pregnancy and the 10 controls who
      spontaneously aborted reported significantly higher rates of the full depressive
      syndrome. CONCLUSIONS: Multifetal pregnancy reduction is experienced as stressful
      and distressing. However, when pregnancy outcome is successful, the medical
      intervention does not put women at significant risk for affective illness or
      elevated levels of psychiatric symptoms.

PMID- 7789581
TI  - De novo formation of adhesions in endometriosis: the role of iron and free
      radical reactions.
AB  - OBJECTIVE: To show that raised iron levels in the peritoneal fluid (PF) of
      patients with endometriosis catalyze free radical reactions that results in the
      tissue destruction and fibrosis seen in these patients. DESIGN: A case-controlled
      study of the iron levels (microgram/mL) in the pelvic PF of 12 patients with
      moderate-to-severe disease, 15 patients with minimal-to-mild disease and in 17
      women with normal pelvises were compared. As an index of free radical reactions
      through lipid peroxidation, the levels of malondialdehyde levels (ng/mL) were
      assessed simultaneously in the same specimens. RESULTS: Controlling for the phase
      of the menstrual cycle, significantly higher levels of iron were seen in patients
      with endometriosis, the levels being correlated with the severity of the disease.
      However no such corresponding relationship was seen in the malondialdehyde levels
      in the PF. CONCLUSIONS: These results suggest that raised iron levels in the PF
      do not play a role in catalyzing free radical reactions as judged by the degree
      of lipid peroxidation.

PMID- 7789582
TI  - Immunoreactive endothelin plasma levels in severe ovarian hyperstimulation
      syndrome.
AB  - OBJECTIVE: To determine the plasma levels of immunoreactive endothelin in
      patients with severe ovarian hyperstimulation syndrome (OHSS). DESIGN:
      Prospective longitudinal study. SETTING: Assisted Reproduction Unit of the
      Hospital Clinic i Provincial in Barcelona, a tertiary care setting. PATIENTS:
      Sixteen IVF patients with severe OHSS. MAIN OUTCOME MEASURES: Measurement during
      the syndrome and 4 to 5 weeks after recovery of the following: mean arterial
      pressure, hematocrit, plasma renin activity, plasma aldosterone, norepinephrine,
      antidiuretic hormone, atrial natriuretic peptide, and immunoreactive endothelin
      concentrations. RESULTS: During the syndrome patients showed decreased mean
      arterial pressure (70.0 +/- 1.1 versus 85.2 +/- 1.6 mm Hg), increased mean
      hematocrit values (45.5% +/- 1.1% versus 38.1% +/- 0.4%), oliguria (630.6 +/-
      40.7 versus 1,306.2 +/- 43.9 mL/d), and very high plasma levels of renin (36.0 +/
      9.1 versus 1.2 +/- 0.08 ng/mL per hour), aldosterone (190.6 +/- 28.4 versus 14.8
      +/- 1.5 ng/dL), norepinephrine (602.1 +/- 91.0 versus 220.5 +/- 12.1 pg/mL),
      antidiuretic hormone (4.1 +/- 0.7 versus 1.0 +/- 0.1 pg/mL), and atrial
      natriuretic peptide (10.9 +/- 1.6 versus 4.7 +/- 0.2 fmol/mL). Immunoreactive
      endothelin plasma levels were increased significantly during OHSS (8.9 +/- 0.9
      versus 3.9 +/- 0.2 pg/mL) and all patients had elevated values during the
      syndrome. CONCLUSIONS: Circulating plasma levels of immunoreactive endothelin are
      elevated in patients with severe OHSS in parallel with other neurohormonal
      vasoconstrictor systems. It may represent a homeostatic response to maintain
      blood pressure.

PMID- 7789585
TI  - Cumulative number and morphological score of embryos resulting in success:
      realistic expectations from in vitro fertilization-embryo transfer.
AB  - OBJECTIVE: To define statistical thresholds for the number and morphological
      score of embryos transferred that would be predictive of reproductive success in
      an IVF program. DESIGN: A retrospective review of patient records. SETTING: The
      Mount Sinai Medical Center Assisted Reproductive Technologies Program.
      PARTICIPANTS: One hundred women who underwent IVF-ET for a diagnosis of tubal
      occlusion and later delivered viable infants. RESULTS: The mean number of embryos
      transferred before achieving live birth was 10.7 +/- 7.9 (mean +/- SD), with one
      half of patients achieving success within the first seven embryos transferred,
      and 95% achieving success within 25 embryos. For high quality embryos, the
      numbers were 7.5 +/- 6.3, 5, and 17, respectively, and, for the cumulative embryo
      score, a measure of both embryo morphology and metabolic activity, were 114.2 +/-
      86.0, 83, and 280, respectively. Greater than 50% of live births occurred within
      the first two ET attempts. CONCLUSIONS: Although more than half of patients
      achieved reproductive success within the first two ETs and the first five high
      quality embryos transferred, after this threshold, fecundity declined rapidly.
      The calculation of cumulative embryo scores offered additional prognostic
      information. While all prior attempts to define IVF-ET failure have done so by
      including patients who did not become pregnant, we have found an analysis of our
      successes to be a useful adjunct in counseling patients.

PMID- 7789583
TI  - Modifications in uterine and intraovarian artery impedance in cycles of treatment
      with exogenous gonadotropins: effects of luteal phase support.
AB  - OBJECTIVE: To determine the effects of induction of multiple ovulation and of
      luteal P supplementation on the impedance to blood flow in the uterine and
      intraovarian arteries during the luteal phase. DESIGN: A prospective study using
      transvaginal color flow Doppler imaging. SETTING: A university-based infertility
      center. PATIENTS: Fifty-six women with unexplained or male factor-related
      infertility undergoing IUI. INTERVENTIONS: The patients were studied either
      during spontaneous cycles (n = 16) or in cycles of induction of multiple
      follicular development with purified FSH (n = 40). In 18 treated cycles, the
      luteal phase was supplemented with natural P. MAIN OUTCOME MEASURES: The
      pulsatility index was recorded from uterine and intraovarian arteries on the day
      of E2 peak and 5 and 10 days thereafter. On the same days, E2 and P plasma levels
      were measured by RIA. RESULTS: The intraovarian pulsatility index was
      significantly lower in FSH-treated than in spontaneous cycles on the day of E2
      peak. Also, the uterine pulsatility index was significantly lower in treated
      cycles than in spontaneous cycles on the day of E2 peak and 5 days thereafter. In
      the late luteal phase, P supplementation was correlated with a significant
      decrease in uterine pulsatility index as compared with both spontaneous cycles
      and FSH-treated cycles without luteal support. CONCLUSIONS: Multiple follicular
      development is associated with a significant reduction in the impedance to
      perifollicular blood flow. Progesterone, as well as E2, seems able to decrease
      the impedance to blood flow in uterine arteries in women.

PMID- 7789584
TI  - Regulation of 72-kd type IV collagenase-matrix metalloproteinase-2 by estradiol
      and gonadotropin-releasing hormone agonist in human granulosa-lutein cells.
AB  - OBJECTIVE: To examine the hormonal regulation of 72-kd type IV collagenase
      gelatinase-matrix metalloproteinase-2 in human granulosa-lutein cells. DESIGN:
      The effect of E2 and GnRH agonist (GnRH-a) on matrix metalloproteinase-2 amount
      was examined on a long-term granulosa-lutein cell cultures. PATIENTS: The
      preovulatory follicles from women participating in our IVF program were aspirated
      through the vaginal wall. Follicular fluids were centrifuged and the granulosa
      cells were separated and pooled for culturing. MAIN OUTCOME MEASURES: Matrix
      metalloproteinase-2 enzyme activity was assayed with type IV collagen degradation
      assay and zymography. The matrix metalloproteinase-2 immunoreactive protein was
      studied by using specific antibodies. RESULTS: Matrix metalloproteinase-2 was the
      predominant form of gelatinase in cultured granulosa-lutein cells. The enzyme
      activity as well as the immunoreactive protein increased in the culture medium of
      the granulosa-lutein cells in the presence of E2. The effect of E2 was abolished
      by GnRH-a. CONCLUSIONS: Estradiol regulates the matrix metalloproteinase-2 enzyme
      amount in granulosa-lutein cells; the effect may be antagonized by GnRH-a.

PMID- 7789586
TI  - The results of in vitro fertilization-embryo transfer in couples with unexplained
      infertility failing to conceive with superovulation and intrauterine
      insemination.
AB  - OBJECTIVE: To determine the results of IVF-ET in couples with long-standing
      unexplained infertility who had failed to conceive with four to six cycles of
      superovulation and IUI. DESIGN: Retrospective case control series. SETTING:
      University IVF-ET center. PATIENTS: One hundred seventeen couples with
      unexplained infertility who had failed to conceive with superovulation and IUI
      underwent 157 cycles of IVF-ET. Results were compared with 194 tubal factor
      couples subjected to 250 IVF-ET cycles within the same time period. RESULTS:
      Total fertilization failure events were more common (20.4% versus 7.6%) and
      tended to be repetitive in couples with unexplained infertility. When total
      fertilization failure events were excluded, fertilization rates (57.8% versus
      60.9%) and cumulative clinical pregnancy rates over three cycles (55.4% versus
      46.5%) were similar in unexplained infertility and tubal disease groups.
      CONCLUSIONS: Couples with unexplained infertility failing to conceive with
      superovulation and IUI have a favorable outcome when treated subsequently with
      IVF-ET. Conception rates similar to couples with tubal disease may be expected
      despite a higher incidence of total fertilization failure events.

PMID- 7789587
TI  - The pregnancy rates of cohorts of idiopathic infertility couples gives insights
      into the underlying mechanism of infertility.
AB  - OBJECTIVES: To determine causes of "idiopathic" infertility, the IVF-ET
      experience of three cohorts of couples with this diagnosis was examined. DESIGN:
      Three cohorts of idiopathic infertility couples undergoing IVF-ET: a "failed IUI"
      group, three previous controlled ovarian hyperstimulation (COH)-IUI cycles with
      no pregnancies; a "conversion" group, patients converted during a COH-IUI cycle
      to IVF-ET because of excess follicle numbers; and a "direct IVF" group, patients
      proceeding directly to IVF-ET were compared. SETTING: A tertiary referral
      reproductive medicine unit. PARTICIPANTS: Forty-one idiopathic infertility
      couples. INTERVENTION: In vitro fertilization-ET. MAIN OUTCOME MEASURES: Number
      of oocytes retrieved, percent oocytes fertilized, number embryos per ET,
      implantation rate, percent pregnancy per cycle. RESULTS: The cohorts had similar
      fertilization rates and mean (+/- SD) number of pre-embryos transferred. The
      conversion group demonstrated a higher pregnancy rate (PR) per cycle and a higher
      E2 concentration than the other groups. The PR of 35.0% in the direct IVF group
      appeared higher than the 16.7% rate observed in the failed IUI group.
      CONCLUSIONS: Our observation of a lower PR in couples in the failed IUI group
      (16.7%) than in couples in the direct IVF group (35.0%) suggests pre-embryo
      developmental problems or implantation problems as likely important etiologies
      for a large proportion of idiopathic infertility couples. However, as the
      conversion group demonstrated both a significantly higher E2 concentration ([E2])
      and per cycle PR than the other cohorts with similar fertilization and pre-embryo
      transfer rates. Subjects converted in a COH-IUI cycle to IVF-ET are thus either
      more likely to produce pre-embryos more genetically capable of continued
      development to implantation stage (i.e., better oocytes recruited and fertilized)
      or due to the higher [E2] to have endometrium more receptive to implantation.
      Neither undiagnosed tubal factors nor fertilization problems appear to be major
      etiologic contributors.

PMID- 7789588
TI  - Endometriosis, 1995--confusion or sense?
AB  - OBJECTIVE: To review current understanding of endometriosis. METHOD: A review of
      etiology, pathogenesis, relationship with infertility, medical and surgical
      treatment. RESULTS: It is likely that endometriosis occurs in most women at some
      stage in their reproductive years. Exposure to menstruation and estrogen are
      important etiologically. Current evidence suggests that implantation of menstrual
      endometrium is the commonest mechanism of pathogenesis. Clinical symptoms and
      signs are important in the diagnosis while laparoscopy remains the prime
      diagnostic technique. Treatment is not indicated for infertility but is for
      symptoms. Danazol and progestogens represent the best first-line therapy although
      gonadotropin-releasing hormone agonists are appropriate if economically
      justifiable. Both open and laparoscopic surgery are important especially in
      reconstructive work. The value of laser ablation in the treatment of infertility
      is unknown but it is effective in pain. The disease should be regarded as a
      recurrent problem and treatment strategies designed appropriately. CONCLUSION:
      Endometriosis still represents an intellectual and therapeutic challenge but
      successful treatment is possible especially if it is individualized for each
      patient.

PMID- 7789591
TI  - Antepartum vibroacoustic stimulation in patients with low fetal heart rate
      variability.
AB  - OBJECTIVE: The purpose of this study was to examine the effect of vibroacoustic
      stimulation during low fetal heart rate (FHR) variability. METHODS: FHR was
      analyzed 30 min before and 30 min after computerized vibroacoustic stimulation
      using the Oxford Sonicaid system 8000. The study comprised 32 healthy pregnant
      women with low antepartum FHR variability. The significance of difference of the
      median values was examined using Wilcoxon's matched-pairs signed-ranks test.
      RESULTS: Vibroacoustic stimulation of the fetus during low FHR variability evoked
      a significant increase in the number of accelerations (> 10 bpm) and an increase
      in long- and short-term variation. CONCLUSION: Our findings indicate that
      vibroacoustic stimulation during low FHR variability produces an abrupt change
      from a quiet to an active fetal state.

PMID- 7789592
TI  - Sonographically detected abnormalities of the umbilical cord.
AB  - OBJECTIVES: This study was undertaken as a retrospective chart review to evaluate
      the range of umbilical cord abnormalities detected by prenatal sonography, as
      well as the outcome and pathologic correlation. METHODS: We identified 13 cases
      of umbilical cord abnormalities detected sonographically over a 46-month period.
      We evaluated the ultrasound appearance, size, location, and color Doppler
      characteristic in each case. RESULTS: There were 4 instances of clear cysts on
      the umbilical cord, 8 with complex masses, and 1 with complete, cystic encasement
      of the cord throughout its length. The pathology included vascular abnormalities
      (hemangioma, hematoma, varicosity), edema of the umbilical cord with pseudocysts,
      and syncytial knots. There was 1 known karyotypic abnormality (trisomy 13).
      Twelve of the 13 newborns survived; the neonatal death occurred in the fetus with
      trisomy 13. CONCLUSION: The presence of umbilical cord abnormalities may
      represent a variety of pathologic entities. Clinical outcome is usually
      favorable.

PMID- 7789589
TI  - Stroke and pregnancy.
AB  - OBJECTIVE: To study the controversial relationship between pregnancy and stroke.
      Old studies and those from developing countries suggest that pregnancy
      considerably increases the risk of stroke. METHODS: The records of 946
      consecutive cases of stroke observed in Saudi patients in 10 years were reviewed.
      Cases which occurred during pregnancy or during the first 15 days postpartum were
      included in the study. RESULTS: Twelve patients (1.3%) were pregnant or in
      postpartum at stroke onset. They constituted 27% of women of childbearing age.
      Cerebral infarction was diagnosed in nine cases and cerebral hemorrhage in three.
      Four patients died. CONCLUSION: The risk of stroke is only marginally increased
      (x 1.5) in pregnant compared with non-pregnant Saudi women. Many factors
      including peripartum cardiomyopathy, patent foramen ovale, changes in clotting
      factors, peripartum angiopathy and vasoactive steroid hormones, could be
      responsible for this increased risk.

PMID- 7789593
TI  - A clinical, mammographic, sonographic and histologic evaluation of breast cancer.
AB  - OBJECTIVE: To evaluate histologic tumor size in comparison with preoperative
      determination of tumor diameter by palpation, mammography and sonography.
      METHODS: In a retrospective analysis we compared the histologic, clinical,
      mammographic and sonographic findings obtained from 160 patients with breast
      carcinoma. RESULTS: The histologically determined tumors showed an average
      diameter of 25.7 mm. By comparison, the average tumor diameter determined by
      mammography, sonography and palpation was 23.8, 26.1 and 30.6 mm, respectively.
      Mammography was capable of detecting 94.5% of breast carcinomas, breast
      sonography 91% and palpation 87%. The combinations of mammography and sonography
      or mammography and palpation detected 99% of carcinomas, and sonography and
      palpation 95% of carcinomas. CONCLUSION: As supplementary methods to preoperative
      clinical examination, mammography and breast sonography are mutually
      complementary, high-resolution imaging techniques of utmost importance in the
      preoperative diagnosis and surgical treatment of breast cancer patients.

PMID- 7789594
TI  - Ruptured intracranial aneurysm complicating pregnancy.
AB  - Three cases of ruptured intracranial aneurysm during pregnancy are presented.
      Rupture occurred near term in all three cases. Simultaneous elective cesarean
      section and clipping of the aneurysm was performed in two cases. Successful
      maternal and perinatal outcome was achieved in all three patients. The diagnosis
      and management of the cases are described and discussed.

PMID- 7789590
TI  - Induction of labor utilizing vaginal vs. intracervical prostaglandin E2.
AB  - OBJECTIVE: To compare the efficacy of intracervical vs. vaginal prostaglandin E2
      (PGE2) gel for induction of labor. METHOD: Sixty-eight women scheduled for
      elective induction of labor at term were randomized to receive either 0.5 mg
      intracervical PGE2 (I/C group, n = 37) or 2 mg vaginal PGE2 gel (Vag group, n =
      31) on a 6-hourly basis for a maximum of three doses. RESULTS: Three participants
      who delivered by cesarean section soon after gel administration were excluded
      from further analysis. Twenty-nine of 30 (97%) in the Vag group were successfully
      induced compared with 23 of 35 (66%) in the I/C group (P < 0.01). The induction
      active labor intervals were 8.0 +/- 5.4 h for the Vag group and 23.1 +/- 27.6 h
      for the I/C group (P = 0.002). The induction-delivery intervals were 12.4 +/- 6.3
      h for the Vag group and 29.8 +/- 29.1 h for the I/C group (P = 0.001). Uterine
      hyperstimulation and perinatal outcome were similar in both groups. CONCLUSION:
      Vaginal PGE2 was more efficacious than intracervical PGE2 in inducing labor.

PMID- 7789595
TI  - Aggressive angiomyxoma of the vagina.
AB  - Aggressive angiomyxoma is a recently described pathological condition which
      affects mainly the soft tissues of the pelvis and perineum in women. It is
      neither encapsulated nor circumscribed and has a tendency for local recurrence.
      We report a 50-year-old woman who presented with a mass arising within the
      vaginal wall and extending to the perineum which appeared cystic on ultrasound.
      The mass was excised and there is no evidence of recurrence 40 months after
      surgery.

PMID- 7789596
TI  - The unfavorable cervix: improving the Bishop score using the Foley catheter.

PMID- 7789598
TI  - Hydatidiform mole co-existing with a normal fetus.

PMID- 7789597
TI  - Magnesium toxicity and resuscitation--an unusual cause of postcesarean
      evisceration.

PMID- 7789599
TI  - Endometriosis causing very high early first trimester serum CA 125 levels.

PMID- 7789600
TI  - Administration of heparin inhalations for correction of blood antithrombin
      activity in pregnant women with IDDM.

PMID- 7789601
TI  - GnRHa and steroid add-back therapy for uterine myoma.

PMID- 7789602
TI  - Tuberculosis of Bartholin's gland.

PMID- 7789603
TI  - Chondrosarcoma: an uncommon pelvic mass.

PMID- 7789604
TI  - Bowen's disease and Bowenoid papulosis of the vulva.

PMID- 7789605
TI  - Perforation of the uterus and colon by copper-T intrauterine contraceptive
      device.

PMID- 7789606
TI  - ACOG technical bulletin. Blood component therapy. Number 199--November 1994
      (replaces no. 78, July 1984). Committee on Technical Bulletins of the American
      College of Obstetricians and Gynecologists.
AB  - Component therapy is the standard method for most transfusion needs and has made
      the use of whole blood rarely necessary. By giving only the specific component
      that is needed, blood component therapy usually provides better treatment.
      Because blood and blood products are in short supply and most carry some risk of
      infection, the National Institutes of Health guidelines for the use of each
      component should be followed closely. When significant blood loss is anticipated,
      autologous predonation should be considered and discussed with the patient.

PMID- 7789608
TI  - ACOG committee opinion. Laparoscopically assisted vaginal hysterectomy. Number
      146--November 1994. Committee on Gynecologic Practice. American College of
      Obstetricians and Gynecologists.

PMID- 7789607
TI  - ACOG committee opinion. Sexual misconduct in the practice of obstetrics and
      gynecology: ethical considerations. Number 144--November 1994. Committee on
      Ethics. American College of Obstetricians and Gynecologists.

PMID- 7789610
TI  - Blocking K+ channels with TEA induces plasmalemma depolarization, increased
      [Ca2+]i, and ACTH secretion in AtT-20 cells.
AB  - Blocking K+ channels induces hormone secretion in various pituitary cell lines by
      a mechanism which is not completely delineated. In the present study, we employed
      the mouse pituitary tumor-derived AtT-20 cell as a model to evaluate this
      phenomenon. We correlated the effect of the K+ channel-blocker,
      tetraethylammonium (TEA), on K+ current and membrane potential utilizing whole
      cell recording, on cytosol Ca2+ ([Ca2+]i) concentration utilizing fura-2, and on
      ACTH secretion utilizing a perifusion system. TEA inhibited voltage-dependent K+
      current and initiated membrane depolarization in a dose-dependent fashion.
      Divergences in the sensitivity to TEA between voltage-dependent K+ currents and
      membrane depolarization indicate that voltage-dependent K+ channels are not
      responsible for TEA-induced depolarization TEA (1-30 mM) also induced a
      concentration-dependent rise in [Ca2+]i concentration and ACTH secretion, both of
      which were inhibited by removing medium Ca2+. Our data indicate that TEA inhibits
      K+ currents and induces membrane depolarization; this opens Ca2+ channels in the
      plasmalemma, causing a rise in [Ca2+]i which initiates ACTH secretion. Alteration
      of K+ channel permeability by hormones or neurotransmitters may thus play an
      important regulatory role in controlling pituitary hormone secretion.

PMID- 7789609
TI  - Quantitative differences in androgen and glucocorticoid receptor DNA binding
      properties contribute to receptor-selective transcriptional regulation.
AB  - Androgen receptor (AR) and glucocorticoid receptor (GR) belong to the same
      subfamily of steroid/nuclear receptors and have been shown to bind qualitatively
      to the same hormone response element (HRE) DNA sequences. Despite this similarity
      in target gene recognition, AR and GR have differential affects on the
      transcriptional regulation of genes containing both simple and complex HRE
      control regions. Using HREs from the mouse mammary tumor virus (MMTV), tyrosine
      aminotransferase (TAT), prostatein (C3) or sex-limited protein (SLP) genes,
      linked to the thymidine kinase promoter, we found receptor-selective differences
      in the ability of rat AR and rat GR to induce transcription of these various
      reporter genes. Since AR and GR have a 20% amino acid sequence difference in
      their DNA binding domains (DBDs), which could result in altered DNA binding
      affinities, we measured the ability of purified AR and GR DBDs to bind
      selectively and with high affinity to these HRE sequences in vitro. Gel shift
      mobility assays showed that the GR DBD had a higher affinity for a consensus HRE
      than did the AR DBD, and quantitative DNase I footprinting revealed that AR and
      GR DBDs bound to the MMTV, TAT, C3 and SLP HREs with different affinities. It was
      found that AR had a dissociation constant (Kd) that was 2-3 times higher than GR
      on the TAT, C3 and SLP HREs and that the Kd of AR for the C3 and SLP HREs
      differed by an order of magnitude (43 nM and 460 nM, respectively). Taken
      together, these data suggest that amino acid differences in the AR and GR DBDs
      contribute to altered receptor-DNA interactions, however it is likely that non
      receptor factors are involved in further modulating receptor-selective DNA
      binding and transactivation functions.

PMID- 7789611
TI  - The antioxidant beta-carotene prevents covalent cross-linking between cholesterol
      side-chain cleavage cytochrome P450 and its electron donor, adrenodoxin, in
      bovine luteal cells.
AB  - Steroid hormones are an important class of hormones synthesized from cholesterol
      by a number of endocrine organs; including ovaries, placenta, testes and adrenal
      glands. The first and rate-limiting step in steroidogenesis is the cleavage of
      the side-chain of the cholesterol molecule, catalysed by a cytochrome P450
      enzyme, cholesterol side-chain cleavage enzyme. This enzyme, as with other P450
      enzymes, produces oxygen radicals. Oxygen free radicals can cause deleterious
      effects such as cross-linking and aggregation of proteins. Cells can protect
      against such damage with the use of antioxidants. The corpus luteum, or 'yellow
      body', of the ovary is very steroidogenic and is exceedingly rich in the yellow
      antioxidant, beta-carotene. The corpus luteum produces the steroid hormone
      progesterone that is needed to support pregnancy. Here we have shown that by
      depleting, or conversely repleting, luteal cells of their beta-carotene content
      in vitro that P450 side-chain cleavage enzyme became covalently non-disulfide
      cross-linked to its electron donor, adrenodoxin, and hence inactivated. Bovine
      luteal cells were cultured in 10% fetal calf serum with or without additional
      treatments for up to 72 h. Under control conditions the cellular levels of beta
      carotene and alpha-tocopherol fell by 50% within 24 h and remained low. P450 side
      chain cleavage enzyme become non-disulfide covalently cross-linked to its
      electron donor, adrenodoxin, as determined by Western immunoblotting (N = 18).
      Aminoglutethamide inhibited this cross-linking. The addition of beta-carotene at
      levels found in bovine serum, but not alpha-tocopherol or ascorbic acid,
      inhibited the degree of the cross-linking.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789612
TI  - Human placental endothelin: expression of endothelin-1 mRNA by human placental
      fibroblasts in culture.
AB  - Endothelin-1 (ET-1) mRNA is expressed by the human placenta in a developmentally
      regulated manner and has been shown to stimulate the growth of placental
      mesenchymal cells. The ability of placental fibroblasts to express preproET-1
      mRNA was studied to determine if ET-1 could potentially participate via autocrine
      mechanisms in the proliferation of placental fibroblasts. Fibroblasts were
      isolated from normal placentae at various gestational ages (7-19 weeks and term)
      and their abilities to express preproET-1 mRNA in culture evaluated by Northern
      analysis. Sparse, rapidly growing cultures of placental fibroblasts expressed
      preproET-1 mRNA at each gestational age in the presence of 10% FBS. The
      regulation of preproET-1 expression in placental fibroblasts was studied by
      exposing cells to known mitogenic stimuli. Quiescent, confluent monolayers of
      placental fibroblasts expressed no detectable levels of preproET-1 mRNA under
      basal conditions. Epidermal growth factor (EGF, 10 mg/ml), transforming growth
      factor-beta 1 (TGF-beta 1, 5 ng/ml), or interleukin 1 beta (IL-1 beta) alone, had
      no significant effect on steady state preproET-1 mRNA levels. Cycloheximide, an
      inhibitor of protein synthesis, increased the steady state levels of preproET-1
      mRNA at a concentration of 10 micrograms/ml. In the presence cycloheximide, IL-1
      beta markedly stimulated preproET-1 mRNA expression, whereas EGF was less
      effective. TGF-beta 1 had no effect in the presence or absence of cycloheximide.
      In contrast, 12-O-tetradecanoylphorbol 13-acetate (TPA, 20 nM) exerted a small
      stimulatory effect on preproET-1 mRNA expression which was not influenced by
      cycloheximide.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789613
TI  - Immunochemical and flow cytometric analysis of androgen receptor expression in
      thymocytes.
AB  - A variety of evidence suggests that the cells of the immune system are targets
      for the actions of gonadal steroids. Experiments in both normal animals and in
      autoimmune disease models have established that androgens exert immunomodulatory
      effects at the level of the thymus. We have attempted to define precisely the
      potential target cells for androgen action in the thymus using recently developed
      antibodies to the androgen receptor. We report here that these antibodies reveal
      AR expression in all classes of thymocytes defined by surface markers CD4 and
      CD8. The highest levels of AR expression were observed in the CD4-CD8+ and CD4
      CD8- subsets that include the most immature cells. These experiments establish
      that thymocytes are potential targets for direct actions of androgens. The data
      further suggest AR expression in thymocytes may be developmentally regulated in
      these cells, and that androgen effects early in the process of thymocyte
      selection may contribute to the sexual dimorphism of immune responsiveness.

PMID- 7789614
TI  - Rainbow trout estrogen receptor presents an equal specificity but a differential
      sensitivity for estrogens than human estrogen receptor.
AB  - The estrogen receptor is a transcription factor that mediates the actions of
      estrogens which plays a major role in salmonid vitellogenesis. Previously, we
      cloned and described the estradiol receptor in rainbow trout. To study the
      transactivation characteristics, the full length cDNA was inserted in an
      expression vector and tested by transfection on an estrogen-dependent promoter
      (pERE-TK-CAT). For the first time, direct comparison between the trout receptor
      (rtER) and human receptor (hER) in an analogous system has been possible. We
      demonstrate that rtER can, like hER, transactivate transcription in a strictly
      hormone-dependent manner. The specificity and sensitivity of the rtER response to
      different steroids have been studied. With rtER, the E2 concentration needed for
      half maximal activation is 10 times higher than with hER. In addition, we show
      that rtER has a weak affinity for androgens and transactivation could be induced
      using high testosterone concentration. Experiments show that both rtER and hER
      have an equal specificity for estrogens but that the rtER binds its ligand with a
      lower sensitivity than hER. Several hypotheses concerning the role of main amino
      acids within the receptor protein are proposed based on the different properties
      of the receptors and comparison of sequences.

PMID- 7789615
TI  - In situ gene expression of growth hormone (GH) receptor and GH binding protein in
      adult male rat tissues.
AB  - Pituitary growth hormone (GH) acts as a growth promoter in a wide range of
      tissues after binding to its specific GH receptor (GHR) or to a cytosolic
      circulating GH binding protein (GHBP). To further characterize GH target cells in
      the rat, in situ hybridization was used to investigate the tissue and cell
      distribution of mRNAs encoding GHR and GHBP, and their hepatic developmental
      expression was examined. Cryostat sections of adult male rat tissue were
      hybridized with [35S]dATP-labeled oligonucleotide antisense probes, one directed
      against a specific sequence of the intracellular domain of rat GHR mRNA, the
      other against the hydrophilic tail of rat GHBP mRNA. Several tests were carried
      out to validate the in situ detection of mRNA. Co-expression of the two
      transcripts in liver, spleen, thymus, kidney, adrenal, skin, muscle, heart, and
      pituitary was autoradiographically detected. However, relative expression levels,
      as demonstrated by computer-assisted microdensitometry, appeared to be variable.
      Both transcripts showed higher levels of expression in the liver, anterior and
      intermediate pituitary lobes, outer kidney medulla, adrenal cortex, skin
      epidermis, heart and muscle, but lower levels in spleen, thymus, hypodermis,
      adrenal medulla and posterior pituitary lobe. As a physiological control, hepatic
      levels of expression were examined during development, and the two forms of mRNA
      were found to be present at low levels in fetal liver, increasing considerably
      after birth. These results permit the identification in the adult male rat of
      cells that might be directly responsive to GH, and demonstrate the differential
      expression of rGHR and rGHBP transcripts.

PMID- 7789616
TI  - Dexamethasone recruits atrial natriuretic peptide secretory cells in the rat left
      atrium and apex of the ventricle.
AB  - The response of the atrial natriuretic peptide (ANP) secreting cells from both
      rat atria and the apex of the ventricles to dexamethasone (DEX) was analyzed by
      the plaque assay. In right atrial cardiocytes, 25% of the cells secreted ANP
      basally; DEX treatment did not alter this percentage. However, in the left atrial
      secretory population, a discordance between the basal (15%) and DEX stimulated
      (25%) percent plaque formation was found. ANP secreting cells from the
      ventricular apex responded similarly to DEX exposure (26%), with 8% of the cells
      basally releasing the hormone. These data suggest that in both the left atria and
      apex of the rat ventricles, exposure to DEX recruits ANP secretory cells from a
      non-secreting population. Consequently, the release of ANP from these tissues
      would increase after glucocorticoid stimulation.

PMID- 7789617
TI  - Effect of tyrosine kinase inhibitors on luteinizing hormone-releasing hormone
      (LHRH)-induced gonadotropin release from the anterior pituitary.
AB  - A range of selective tyrosine kinase inhibitors, piceatannol, methyl-2,5
      dihydroxycinnamate (MDC), genistein, psi-tectorigenin and lavendustin A, all
      reduced luteinizing hormone-releasing hormone (LHRH)-induced luteinizing hormone
      (LH) and follicle-stimulating hormone (FSH) release from pro-oestrous rat
      hemipituitaries incubated in vitro. In general, both 'initial' release and the
      augmented release resulting from LHRH self-priming, were reduced in parallel in a
      concentration-dependent fashion. The effects of piceatannol were independent of
      the steroidal status of the pituitary tissue. Both piceatannol and MDC greatly
      reduced LH release by ionomycin and a protein kinase C (PKC) activator, phorbol
      12,13-dibutyrate (PDBu), suggesting that the tyrosine kinase(s)-dependent step is
      in the later stages of the stimulus-secretion pathway activated by the LHRH
      receptor. These data were supported by immunoblots for phosphotyrosine showing
      that in the gonadotrope-derived alpha T3-1 cell line, treatment with LHRH caused
      piceatannol-sensitive increases in specific tyrosine phosphorylation of several
      proteins (major bands at 65-75 and 120-130 kDa). Treatment of cells with PDBu
      mimicked the tyrosine phosphorylations evoked by LHRH whereas the PKC inhibitor,
      GF109203X, partially reduced both LHRH- and PDBu-induced tyrosine
      phosphorylations. Direct effects of MDC and piceatannol on PKC were assessed in
      an in vitro PKC assay; piceatannol, but not MDC, inhibited PKC activity but at
      considerably higher concentrations than required for inhibition of LHRH-induced
      gonadotropin secretion. These data support a role for tyrosine kinase activation
      in LHRH-induced secretion.

PMID- 7789618
TI  - Retinoic acid receptor alpha 1 isoform is induced by estradiol and confers
      retinoic acid sensitivity in human breast cancer cells.
AB  - Retinoic acid (RA) inhibits proliferation of estrogen receptor (ER)-positive
      human breast cancer cells, but not the growth of ER-negative cells. We have shown
      previously that ER-positive cells express higher levels of retinoic acid receptor
      (RAR) alpha, suggesting that RAR alpha gene expression may be regulated in breast
      cancer cells by estrogens. We here report that estradiol (E2) increases RAR alpha
      mRNA in a time- and concentration-dependent manner resulting in a marked increase
      in RAR alpha protein expression, and present evidence that RAR alpha 1 is the
      only known isoform of RAR alpha regulated by E2 in breast cancer cells. In
      parallel we demonstrate that ER-positive cells exhibit greater RA sensitivity in
      the presence of E2, suggesting that E2-induced expression of RAR alpha 1 is
      involved in growth inhibition by RA. To directly investigate the role of RAR
      alpha 1 in RA-mediated growth inhibition, we introduced RAR alpha 1 expression
      vectors into RA-resistant and ER-negative MDA-MB-231 cells. The RAR alpha 1
      transfected cells were growth inhibited by RA, while mock- and untransfected
      cells were unresponsive. Together, our data indicate that adequate levels of RAR
      alpha 1, either generated by introduction of expression vectors or endogenously
      induced by estrogens, are required for growth inhibition of breast cancer cells
      by RA.

PMID- 7789619
TI  - Possible sites of dopaminergic inhibition of gonadotropin release from the
      pituitary of a teleost fish, tilapia.
AB  - The present study is an attempt to find sites of dopaminergic inhibition along
      the transduction cascades culminating in gonadotropin (GtH) release in a teleost
      fish, tilapia. Experiments were carried out on perifused pituitary fragments and
      in primary culture of trypsinized pituitary cells. Salmon GnRH, chicken GnRH I
      and II stimulated GtH release in culture with estimated ED50 values of 15.56 pM,
      2.55 nM and 8.65 pM, respectively. Apomorphine (APO; 1 microM) totally abolished
      this stimulation. Dopamine (DA; 1 microM) reduced both basal and GnRHa-stimulated
      GtH release from perifused pituitary fragments but did not alter the formation of
      cAMP. In a similar perifusion experiment DA abolished GtH release in response to
      forskolin (10 microM) with no reduction in cAMP formation. This indicates that
      one site of the dopaminergic inhibition is distal to cAMP formation, an
      indication not compatible with the classic characteristic of DA D2 type mode of
      action. The inhibition of GtH release in culture, caused by 1 microM APO, the
      specific DA D2 agonists LY 171555 (LY) or bromocryptine (BRCR) could not be
      reversed by activating protein kinase C (PKC) by DiC8 or the phorbol ester TPA.
      This would indicate a site for DA action distal to PKC. However, the stimulatory
      effect of arachidonic acid (AA; 50 microM) in perifusion was not reduced by DA (1
      microM) or by APO, LY or BRCR in culture, which suggests a site for DA action
      proximal to AA formation. APO, LY and BRCR reduced GtH release in response to the
      Ca2+ ionophore A23187, however, their inhibitory effect was reversed by 10 microM
      ionomycin.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789620
TI  - Regulation of steroidogenesis in crayfish molting glands: involvement of protein
      synthesis.
AB  - The involvement of continuous protein synthesis in the mechanisms of crustacean
      steroidogenesis was investigated using crayfish molting glands (Y-organs). During
      intermolt, Y-organ steroidogenic activity is low. Eyestalk ablation initiates
      premolt which is characterized by a rapid increase in the production of
      ecdysteroids. In vitro incorporation of [14C]leucine into TCA-precipitable
      proteins was measured in Y-organs. A significant increase of de novo protein
      synthesis within 2 h and simultaneously led to a strong inhibition of the
      ecdysteroid synthesis. Sinus gland extracts (containing molt inhibiting hormone)
      also induced both a limited but reproducible inhibition of Y-organ protein
      synthesis and a pronounced inhibition of ecdysteroid production within 2 h. The
      results suggest a functional link between protein synthesis in the Y-organ and
      sustained ecdysteroid production. The analysis of autoradiographs from one
      dimensional gel electrophoreses revealed an overall increase in de novo synthesis
      of glandular proteins in early premolt but also a more specific effect on
      distinct proteins (increase of 150, 140, 50-60, 22 and 15-18 kDa proteins) which
      may be more directly involved in the regulation of ecdysteroidogenesis.

PMID- 7789621
TI  - Role of blood flow and impaired autoregulation in the pathogenesis of diabetic
      retinopathy.
AB  - Several mechanisms are implicated in the pathogenesis of diabetic retinopathy.
      They include biochemical, hemodynamic, and hormonal factors, all of which have an
      important role in the development of diabetic retinopathy. These factors are not
      independent of each other, but rather they interact and together are responsible
      for the well-known lesions of vascular occlusion, microaneurysms, hemorrhages'
      hard exudates, and eventually new vessel formation.

PMID- 7789622
TI  - HLA-DQB1*0602 is associated with dominant protection from diabetes even among
      islet cell antibody-positive first-degree relatives of patients with IDDM.
AB  - HLA-DQB1 alleles confer susceptibility and resistance to insulin-dependent
      diabetes mellitus (IDDM). We investigated whether the susceptibility alleles
      DQB1*0302 and DQB1*0201 affect progression to diabetes among islet cell antibody
      positive (ICA+) first-degree relatives of IDDM patients and whether the
      protective allele DQB1*0602 can be found and is still protective among such
      relatives. We human leukocyte antigen-typed and periodically tested beta-cell
      function (first-phase insulin release [FPIR] during the intravenous glucose
      tolerance test) in 72 ICA+ relatives, of whom 30 became diabetic on follow-up
      (longest follow-up 12 years); 54 (75%) relatives carried DQB1*0302 and/or
      DQB1*0201. The frequency of DQB1*0302 and DQB1*0201 and of the high-risk genotype
      DQB1*0302/DQB1*0201 did not differ significantly between diabetic relatives and
      those remaining nondiabetic. On follow-up, progression to IDDM was not
      statistically different for relatives with or without the DQB1*0302/DQB1*0201
      genotype. However, those relatives with the DQB1*0302/DQB1*0201 genotype had a
      tendency to develop diabetes at an earlier age (log-rank P = 0.02). We found
      DQB1*0602 in 8 of 72 (11.1%) ICA+ relatives. Relatives with DQB1*0602 did not
      develop diabetes or show any decline of FPIR versus 28 of 64 DQB1*0602- relatives
      who developed IDDM (log-rank P = 0.006; Wilcoxon's P = 0.02). The protective
      allele DQB1*0602 is found in ICA+ relatives who have minimal risk of progression
      to IDDM. Therefore, DQB1*0602 is associated with protection from IDDM both in
      population studies and among relatives with evidence of autoimmunity who should
      not enter prevention trials.

PMID- 7789623
TI  - Genetic linkage of thymic T-cell proliferative unresponsiveness to mouse
      chromosome 11 in NOD mice. A possible role for chemokine genes.
AB  - Thymic and peripheral T-cells from NOD mice display a proliferative
      unresponsiveness on stimulation through the T-cell receptor/CD3 complex.
      Interleukin 4 reverses NOD T-cell unresponsiveness in vitro and prevents the
      onset of diabetes in vivo, suggesting a causal relationship between the T-cell
      unresponsiveness and diabetes susceptibility in NOD mice. Both quantitative trait
      loci analysis of BXD recombinant inbred mice and linkage analysis of NOD outcross
      populations reveal that the control of NOD thymic T-cell proliferative
      unresponsiveness genetically maps to a central region on mouse chromosome 11,
      which includes the beta-chemokine gene family. This finding raises the
      possibility that a beta-chemokine(s) may regulate T-cell unresponsiveness as well
      as diabetes susceptibility in NOD mice.

PMID- 7789624
TI  - Insulin gene region-encoded susceptibility to IDDM maps upstream of the insulin
      gene.
AB  - The gene region on chromosome 11p15.5 known to be involved in insulin-dependent
      diabetes mellitus (IDDM) susceptibility was recently mapped to a 4.1-kilobase
      region including the insulin gene. The region contains 10 candidate polymorphisms
      that are in strong linkage disequilibrium. By genotyping 7 of these 10
      polymorphisms and the tyrosine hydroxylase microsatellite in Finnish Caucasoid
      IDDM patients and control subjects, we demonstrate that many of the polymorphisms
      found to be associated with IDDM in other Caucasoid populations do not show any
      association in this Finnish population. Of the polymorphisms typed, only those at
      -23 Hph I and the variable number of tandem repeats (VNTR) sites confer
      significant relative risk. Furthermore, we have demonstrated that the -23 Hph I
      polymorphism cannot explain the association. Comparison of the genotypic patterns
      observed here and previously suggests that the VNTR is the most likely candidate
      for IDDM2. The VNTR is located adjacent to defined regulatory DNA sequences
      affecting insulin gene expression, which suggests a possible effect on expression
      of insulin or one of the neighboring genes, tyrosine hydroxylase or insulin-like
      growth factor 2.

PMID- 7789625
TI  - Glucagon-like peptide I reduces postprandial glycemic excursions in IDDM.
AB  - Effects of human glucagon-like peptide I (GLP-I)(7-36)amide were examined in
      volunteers having insulin-dependent diabetes mellitus (IDDM) with residual C
      peptide (CP) secretion (n = 8, 7 men and 1 woman; age, 31 +/- 1.4 years; body
      mass index, 24.7 +/- 0.7 kg/m2; duration of diabetes, 3.2 +/- 0.8 years; insulin
      dose, 0.41 +/- 0.05 U.kg-1.day-1; meal-stimulated CP, 1.0 +/- 0.2 nmol/l [means
      +/- SE]). After a mixed meal (Sustacal, 30 kJ/kg body wt), intravenous injection
      of GLP-I, 1.2 pmol.kg-1.min-1 through 120 min, virtually abolished increments of
      plasma glucose, CP, pancreatic polypeptide (PP), and glucagon concentrations,
      with no significant effect on plasma gastrin levels during the infusions. At
      reduced dosage (0.75 pmol.kg-1.min-1), GLP-I had lesser effects on plasma glucose
      and CP levels. On cessation of intravenous GLP-I infusions after the meals,
      plasma glucose, CP, PP, and glucagon concentrations rebounded toward control
      levels by 180 min, and the response of plasma gastrin was prolonged. These
      rebound responses are consistent with intestinal delivery of food retained in the
      stomach on escape from inhibition of gastric emptying by GLP-I. Infusion of 1.2
      pmol.kg-1.min-1 GLP-I with 20 g glucose (10% dextrose in water) injected
      intravenously over 60 min enhanced plasma responses of immunoreactive CP; the
      mean incremental areas under concentration curves (0-60 min) increased sixfold,
      but the glycemic excursion was not affected. Thus, in CP-positive IDDM,
      pharmacological doses of GLP-I reduce glycemic excursions after meals by a
      mechanism(s) not dependent on stimulation of insulin secretion, presumably
      involving delayed gastric emptying.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789626
TI  - Comparison of estimates of insulin sensitivity from minimal model analysis of the
      insulin-modified frequently sampled intravenous glucose tolerance test and the
      isoglycemic hyperinsulinemic clamp in subjects with NIDDM.
AB  - Minimal model (MINMOD) analysis of the frequently sampled intravenous glucose
      tolerance test (FSIVGTT) is dependent on an adequate insulin response to the
      glucose load. As this is characteristically deficient in subjects with non
      insulin-dependent diabetes mellitus (NIDDM), the technique has been modified by
      the use of an intravenous bolus of insulin. Previous validation of this
      modification in humans has relied on agreement between insulin sensitivity
      indexes (SI) estimated from tolbutamide- and insulin-modified tests and not on
      direct comparison with estimates derived from the isoglycemic glucose clamp. We
      have compared estimates of insulin sensitivity derived from minimal modeling of a
      4-h insulin-modified FSIVGTT and the glucose clamp in subjects with NIDDM. Twelve
      subjects underwent an insulin-modified FSIVGTT and an isoglycemic
      hyperinsulinemic clamp in random order 2-4 weeks apart. Fasting plasma glucose
      (8.4 vs. 9.0 mmol/l) and immunoreactive insulin (IRI) concentrations (104.5 vs.
      101.5 pmol/l) were not different between the 2 study days. SI(clamp) was derived
      from the steady-state glucose infusion rate during the 3rd h of the clamp,
      corrected for the ambient insulin and glucose concentrations. SI(ivgtt) was
      derived using MINMOD. SI(ivgtt) was 1.06 +/- 0.18 min-1.mU-1.ml x 10(4), and mean
      SI(clamp) was 4.97 +/- 0.69 l.min-1/pmol.l-1 x 10(4) (mean +/- SE). SI(ivgtt) was
      positively correlated with SI(clamp) (r = 0.73, P = 0.004) and negatively
      correlated with body mass index (r = -0.7, P = 0.005) and fasting IRI(ivgtt) (r =
      -0.64, P = 0.008). In summary, MINMOD analysis of the insulin-modified FSIVGTT
      provides a valid measure of insulin sensitivity in subjects with NIDDM.

PMID- 7789627
TI  - Disease sensitivity and specificity of 52 assays for glutamic acid decarboxylase
      antibodies. The Second International GADAB Workshop.
AB  - There is increasing interest in the use of glutamic acid decarboxylase antibodies
      (GADAbs) for identification of subjects at increased risk of developing insulin
      dependent diabetes mellitus (IDDM). However, considerable variation exists
      between laboratories in the reported frequency of GADAb in various clinical
      situations, and disease sensitivity and specificity have not yet been compared
      between assays. An international workshop was held in which 101 coded freeze
      dried sera, including 39 from subjects with newly diagnosed IDDM, 32 from healthy
      control subjects, 4 from nondiabetic subjects with Graves' disease, and 4 from
      islet cell antibody-positive subjects, were analyzed in 52 assays (radiobinding
      assay [RBA], 26; enzyme-linked immunosorbent assay [ELISA], 19; and enzymatic
      immunoprecipitation assay [EIP], 7). The mean sensitivity for RBAs (76.2%) was
      higher than for ELISAs (36.5%) and EIPs (49.9%) (P < 0.01). The mean specificity
      was similar for each assay format (RBA, 89.4%; ELISA. 89.4%; and EIP, 92.3%). The
      lower sensitivities of the ELISA and EIP were predominantly due to the inability
      of these assays to detect low levels of GADAb in IDDM. To convert results to
      standard units, standard curves were constructed using duplicate dilutions of the
      anti-glutamic acid decarboxylase monoclonal antibody MICA 3 and serum from a
      patient with stiff-man syndrome (SMS). Curves could be derived in 28 assays using
      the MICA 3 serum and in 29 using the SMS serum. The mean coefficients of
      variation between assays for disease and control samples were 45% when results
      were converted to MICA units, 77% for SMS units, and 76% for SD scores.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7789628
TI  - Insulin-induced sympathetic activation and vasodilation in skeletal muscle.
      Effects of insulin resistance in lean subjects.
AB  - Insulin-induced stimulation of blood flow and sympathetic nerve activity in
      skeletal muscle tissue is impaired in obesity, but the underlying mechanism is
      unknown. To determine whether insulin resistance alters sympathetic and
      vasodilatory responses to euglycemic hyperinsulinemia, in eight healthy subjects
      we measured calf blood flow and muscle sympathetic nerve activity (MSNA) (n = 5)
      during insulin/glucose infusion (euglycemic hyperinsulinemic [6 pmol.kg-1.min-1]
      clamp) performed alone and performed during concomitant fat emulsion infusion, a
      maneuver designed to induce insulin resistance. The major new finding is that fat
      emulsion infusion, which attenuated insulin-induced stimulation of carbohydrate
      oxidation by 39 +/- 7% (P < 0.01), did not have any detectable effect on insulin
      induced vasodilatory and sympathetic responses: at the end of the 2-h clamp,
      blood flow and MSNA had increased by 35 +/- 6% (P < 0.01) and 152 +/- 58% (P <
      0.01), respectively, during insulin infusion alone and by 35 +/- 7% (P < 0.01)
      and 244 +/- 90% (P < 0.01), respectively, during insulin infusion superimposed on
      free fatty acid infusion. These observations in lean healthy subjects indicate
      that induction of resistance to the stimulatory effects of insulin on
      carbohydrate metabolism does not attenuate muscle blood flow and MSNA responses
      evoked by acute euglycemic hyperinsulinemia. These findings provide further
      evidence that hyperinsulinemia per se is the primary stimulus that triggers
      stimulation of muscle blood flow and MSNA during insulin/glucose infusion in
      humans and suggest that the impaired insulin-induced vasodilation in obese
      subjects is not related primarily to impaired stimulation of muscle carbohydrate
      metabolism.

PMID- 7789629
TI  - Acute hyperglycemia provides an insulin-independent inducer for GLUT4
      translocation in C2C12 myotubes and rat skeletal muscle.
AB  - GLUT4 translocation and activation of glucose uptake in skeletal muscle can be
      induced by both physiological (i.e., insulin, nerve stimulation, or exercise) and
      pharmacological (i.e., phorbol ester) means. Recently, we demonstrated that high
      glucose levels may mimic the effects of phorbol esters on protein kinase C (PKC)
      and insulin receptor function (J Biol Chem 269:3381-3386, 1994). In this study,
      we tested whether the previously described effects of phorbol esters on
      translocation of GLUT4 in myotubes in culture and also in rat skeletal muscle
      might be mimicked by glucose. We found that stimulation of C2C12 myotubes with
      both insulin (10(-7) mol/l, 5 min) and glucose (25 mmol/l, 10 min) induces a
      comparable increase of the GLUT4 content in the plasma membrane. To test whether
      this effect occurs in intact rat skeletal muscle as well, two different model
      systems were used. As an in vitro model, isolated rat hindlimbs were perfused for
      80 min with medium containing 6 mmol/l glucose +/- insulin (1.6 x 10(-9) mmol/l,
      40 min) or 25 mmol/l glucose. As an in vivo model, acute hyperglycemia (> 11
      mmol/l glucose, 20 min) was induced in Wistar rats by intraperitoneal injection
      of glucose under simultaneous suppression of the endogenous insulin release by
      injection of somatostatin. In both models, subcellular fractions were prepared
      from hindlimb skeletal muscle, and plasma membranes were characterized by the
      enrichment of the marker enzyme alpha 1 Na(+)-K(+)-ATPase.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7789630
TI  - A prospective study of the role of coxsackie B and other enterovirus infections
      in the pathogenesis of IDDM. Childhood Diabetes in Finland (DiMe) Study Group.
AB  - Coxsackievirus B infections have been associated with clinical manifestation of
      insulin-dependent diabetes mellitus (IDDM) in several studies, but their
      initiating role in the slowly progressing beta-cell damage is not known. This is
      the first prospective study designed to assess the role of coxsackie B and other
      enterovirus infections in the induction and acceleration of this process. Three
      separate series were studied: 1) an intrauterine exposure series comprising 96
      pregnant mothers whose children subsequently manifested IDDM and 96 control
      mothers whose children remained nondiabetic; 2) a cohort of 22 initially
      unaffected siblings of diabetic children who were followed until they developed
      clinical IDDM (mean observation time, 29 months) and 110 control siblings who
      remained nondiabetic; 3) a case-control series comprising 90 children with newly
      diagnosed IDDM and 90 control subjects. Enterovirus infections were identified on
      the basis of significant increases in serum IgG, IgM, or IgA class antibodies
      against a panel of enterovirus antigens (capture radioimmunoassay). Enterovirus
      antibodies were significantly elevated in pregnant mothers whose children
      subsequently manifested IDDM, particularly in cases in which IDDM appeared at a
      very young age, before the age of 3 years (P < 0.005). Serologically verified
      enterovirus infections were almost two times more frequent in siblings who
      developed clinical IDDM than in siblings who remained nondiabetic (mean, 1.0 vs.
      0.6 infections/follow-up year; P < 0.001). This difference was seen both close to
      the diagnosis of IDDM and several years before diagnosis.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7789631
TI  - Effects of angiotensin-converting enzyme inhibitors, Ca2+ channel antagonists,
      and alpha-adrenergic blockers on glucose and lipid metabolism in NIDDM patients
      with hypertension.
AB  - We compared the effects of captopril, nifedipine, and doxazosin on glucose and
      lipid metabolism in 30 hypertensive non-insulin-dependent diabetes mellitus
      (NIDDM) patients (age = 50 +/- 3 years; body mass index = 30 +/- 1 kg/m2). Of
      these patients, 9 were treated with captopril, 11 with nifedipine, and 10 with
      doxazosin for 12 weeks. Blood pressure, fasting plasma glucose (FPG)
      concentration, HbA1c, oral glucose tolerance test (OGTT), euglycemic insulin
      clamp, and plasma lipids were measured before and after a 3-month period. Mean
      arterial blood pressure (114 +/- 2 mmHg) was similar in all groups before
      initiating antihypertensive therapy and declined to 102 +/- 2 (captopril), 103 +/
      1 (nifedipine), and 103 +/- 2 (doxazosin) mmHg (P < 0.001). Baseline FPG (148 +/
      11 mg/dl) and HbA1c (6.3 +/- 1%) were similar in all groups and did not change
      significantly with treatment. Plasma glucose, insulin, and free fatty acid (FFA)
      concentrations during the OGTT were similar in all groups before antihypertensive
      treatment and did not change with captopril and nifedipine; after doxazosin,
      plasma glucose and FFA concentrations during the OGTT decreased (both P < 0.05)
      without change in plasma insulin response. Insulin-mediated glucose uptake (144
      +/- 11 mg.m-2.min-1), glucose oxidation (76 +/- 4 mg.m-2.min-1), and nonoxidative
      glucose disposal (71 +/- 6 mg.m-2.min-1) were similar in all groups before the
      start of antihypertensive treatment and did not change in captopril and
      nifedipine groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789633
TI  - Okadaic acid, vanadate, and phenylarsine oxide stimulate 2-deoxyglucose transport
      in insulin-resistant human skeletal muscle.
AB  - In response to insulin, several proteins are phosphorylated on tyrosine and on
      serine/threonine residues. Decreased phosphorylation of signaling peptides by a
      defective insulin receptor kinase may be a cause of insulin resistance.
      Accordingly, inhibition of the appropriate phosphatases might increase the
      phosphorylation state of these signaling peptides and thereby elicit increased
      glucose transport. The purpose of this study was to examine the effect of the
      serine/threonine phosphatase inhibitor okadaic acid and the tyrosine phosphatase
      inhibitors phenylarsine oxide and vanadate on 2-deoxyglucose transport in insulin
      resistant human skeletal muscle. All three phosphatase inhibitors stimulated 2
      deoxyglucose transport in insulin-resistant skeletal muscle. These data suggest
      that these compounds have bypassed a defect in at least one of the signaling
      pathways leading to glucose transport. Furthermore, maximal transport rates
      induced by the simultaneous presence of insulin and phosphatase inhibitor in
      insulin-resistant muscle were equal to insulin-stimulated rates in lean control
      subjects. However, both vanadate alone and vanadate plus insulin stimulated 2
      deoxyglucose transport significantly more in insulin-sensitive tissue than in
      insulin-resistant tissue. These results demonstrate that although vanadate is
      able to stimulate glucose transport in insulin-resistant muscle, it is not able
      to normalize transport to the same rate achieved in insulin-sensitive muscle.

PMID- 7789632
TI  - Effects of an acute increase in epinephrine and cortisol on carbohydrate
      metabolism during insulin deficiency.
AB  - This study was undertaken to investigate the effects of an acute increase in the
      plasma epinephrine level, with or without an accompanying increase in the plasma
      cortisol level, during selective insulin deficiency on glycogenolysis and
      gluconeogenesis in conscious overnight-fasted dogs. Experiments consisted of an
      80-min tracer and dye equilibration period, a 40-min basal period, and a 180-min
      experimental period. In all protocols, selective insulin deficiency was created
      during the experimental period by infusing somatostatin peripherally (0.8
      micrograms.kg-1.min-1) with basal replacement of glucagon intraportally (0.65
      ng.kg-1.min-1). In EPI+SAL (n = 6), an additional infusion of epinephrine (0.04
      micrograms.kg-1.min-1) was infused during the experimental period along with
      saline. In EPI+CORT (n = 6), hydrocortisone (3.0 microgram.kg-1.min-1) was
      infused in addition to epinephrine during the experimental period. In SAL+CORT (n
      = 5), hydrocortisone was infused during the experimental period. In SALINE (n =
      5), neither epinephrine nor cortisol was infused. [3-3H]glucose, [U-14C]alanine,
      and indocyanine green dye were used to assess glucose production (rate of
      appearance [Ra]) and gluconeogenesis using tracer and arteriovenous difference
      techniques. During selective insulin deficiency in SALINE, the arterial plasma
      glucose level increased from 6.0 +/- 0.1 to 15.8 +/- 1.1 mmol/l; Ra increased
      from 14.7 +/- 0.7 to 24.9 +/- 1.7 mumol.kg-1.min-1. Gluconeogenic efficiency and
      the conversion of alanine and lactate to glucose increased to 300 +/- 55 and 355
      +/- 67% of basal. In EPI+SAL and EPI+CORT, plasma glucose increased from 6.2 +/-
      0.1 to 19.8 +/- 0.9 mmol/l and from 6.3 +/- 0.1 to 19.5 +/- 0.9 mmol/l. In
      EPI+SAL and EPI+CORT, Ra increased from 16.5 +/- 1.1 to 29.3 +/- 3.2 mumol.kg
      1.min-1 and from 15.4 +/- 1.3 to 28.3 +/- 2.5 mumol.kg-1.min-1. The rise in
      gluconeogenic efficiency was similar to the rise that occurred in SALINE, but
      gluconeogenic conversion increased 17-fold in each of the two epinephrine groups.
      During the epinephrine infusion, gluconeogenesis accounted for a maximum of 55%
      of total glucose production as opposed to 31% during insulin deficiency alone. An
      increase in cortisol alone during insulin deficiency (SAL+CORT) had no effect on
      glucose level, glucose production, or gluconeogenesis. These results suggest that
      small increases in the plasma epinephrine level during insulin deficiency can
      significantly worsen the resulting hyperglycemia through stimulation of both
      glycogenolysis and gluconeogenesis.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7789635
TI  - Hypoxia stimulates glucose transport in insulin-resistant human skeletal muscle.
AB  - Insulin and muscle contraction stimulate glucose transport into muscle cells by
      separate signaling pathways, and hypoxia has been shown to operate via the
      contraction signaling pathway. To elucidate the mechanism of insulin resistance
      in human skeletal muscle, strips of rectus abdominis muscle from lean (body mass
      index [BMI] < 25), obese (BMI > 30), and obese non-insulin-dependent diabetes
      mellitus (NIDDM) (BMI > 30) patients were incubated under basal and insulin-,
      hypoxia-, and hypoxia + insulin-stimulated conditions. Insulin significantly
      stimulated 2-deoxyglucose transport approximately twofold in muscle from lean (P
      < 0.05) patients, but not in muscle from obese or obese NIDDM patients.
      Furthermore, maximally insulin-stimulated transport rates in muscle from obese
      and diabetic patients were significantly lower than rates in muscle from lean
      patients (P < 0.05). Hypoxia significantly stimulated glucose transport in muscle
      from lean and obese patients. There were no significant differences in hypoxia
      stimulated glucose transport rates among lean, obese, and obese NIDDM groups.
      Hypoxia + insulin significantly stimulated glucose transport in lean, obese, and
      diabetic muscle. The results of the present study suggest that the glucose
      transport effector system is intact in diabetic human muscle when stimulated by
      hypoxia.

PMID- 7789634
TI  - Characterization of the LIM/homeodomain gene islet-1 and single nucleotide
      screening in NIDDM.
AB  - Islet-1 (Isl-1) is a unique transcription factor that binds to the enhancer
      region of the insulin gene. To evaluate this gene in non-insulin-dependent
      diabetes mellitus (NIDDM), a full-length human Isl-1 cDNA was isolated and the
      genomic structure was characterized. The cDNA [2,395 bp plus additional poly(A)
      residues] contained an open reading frame from an initiator methionine at
      nucleotide 240 to an opal stop codon at nucleotide 1,286 (GenBank accession
      number UO7559), encoding a predicted protein of 349 amino acids (39 kDa). From
      their ends, 23 additional clones were sequenced, revealing 15 incomplete cDNAs
      and 8 intron-containing partially processed precursors. As determined by Northern
      blotting and reverse transcriptase-polymerase chain reaction analysis, Isl-1 was
      most abundantly expressed as a 2.4-kb mRNA in human islets, with a restricted
      pattern of expression in other adult human tissues. Analysis of genomic clones
      revealed that Isl-1 is encoded by six exons, varying in size from 168 bp (exon 5)
      to 1,230 bp (exon 6). Exons 2 and 3 each encode a LIM domain, while the
      homeodomain is completely contained within exon 4.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7789636
TI  - Altered insulin secretory responses to glucose in subjects with a mutation in the
      MODY1 gene on chromosome 20.
AB  - This study was undertaken to test the hypothesis that the diabetes susceptibility
      gene on chromosome 20q12 responsible for maturity-onset diabetes of the young
      (MODY) in a large kindred, the RW family, results in characteristic alterations
      in the dose-response relationships between plasma glucose concentration and
      insulin secretion rate (ISR) that differentiate this form of MODY from MODY in
      subjects with glucokinase mutations. Ten marker-positive subjects and six matched
      nondiabetic marker-negative subjects from the RW family received graded
      intravenous glucose infusions on two occasions separated by a 42-h continuous
      intravenous glucose infusion designed to prime the beta-cell to secrete more
      insulin in response to glucose. ISR was derived by deconvolution of peripheral C
      peptide levels. Basal glucose and insulin levels were similar in marker-negative
      and marker-positive groups (5.3 +/- 0.2 vs. 5.0 +/- 0.2 mmol/l, P > 0.2, and 86.1
      +/- 3.9 vs. 63.7 +/- 12.1 pmol/l, P > 0.1, respectively). However, the marker
      positive subjects had defective insulin secretory responses to an increase in
      plasma glucose concentrations. Thus, as the glucose concentration was raised
      above 7 mmol/l, the slope of the curve relating glucose and ISR was significantly
      blunted in the marker-positive subjects (13 +/- 4 vs. 68 +/- 8 pmol.min-1.mmol-1
      x 1, P < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789637
TI  - Lilly Lecture 1994. The beta-cell in diabetes: from molecular genetics to
      clinical research.
AB  - Pancreatic insulin secretion rates can be accurately derived by mathematical
      deconvolution of peripheral C-peptide concentrations either by using individual C
      peptide kinetic parameters obtained by analysis of the decay curve of
      biosynthetic human C-peptide or by using published group parameters with
      appropriate adjustments for age and degree of obesity. Since the cross-reactivity
      of proinsulin and related peptides is low (< 10%) in many C-peptide assays, this
      experimental approach avoids the spurious increase in insulin immunoreactivity
      resulting from cross-reactivity with proinsulin and related peptides in the
      insulin assay. Application of this technique has demonstrated that the phenotypic
      expression of beta-cell dysfunction differs in subjects with different genetic
      mechanisms of non-insulin-dependent diabetes mellitus (NIDDM). Subjects who have
      maturity-onset diabetes of the young (MODY) due to mutations in the glucokinase
      gene demonstrate different patterns of altered insulin secretion when compared
      with subjects who have mutations in the MODY1 gene on chromosome 20. Glucokinase
      mutations affect the ability of the beta-cell to detect and respond to small
      increases in glucose above the basal level. However, compensatory mechanisms
      operative in vivo, which include a priming effect of glucose on insulin
      secretion, limit the severity of the observed insulin secretory defect, resulting
      in a generally mild clinical course in these subjects. In contrast, mutations in
      the MODY1 gene are associated with an inability to increase insulin secretion as
      the plasma glucose concentration increases above 7-8 mmol/l and the normal
      priming effect of glucose on insulin secretion is lost. These characteristics of
      the dose-response relationships between glucose and insulin secretion result in a
      more severe degree of hyperglycemia than observed in subjects with glucokinase
      mutations, and these subjects more frequently need insulin treatment. These
      alterations are evident in prediabetic subjects with normal glucose levels who
      carry the MODY1 mutation, suggesting that defective beta-cell function is the
      primary pathogenetic defect in the diabetic syndrome in these subjects. Studies
      performed in the classic form of NIDDM demonstrate that subjects with mild
      glucose intolerance and normal fasting glucose concentrations and glycosylated
      hemoglobin levels consistently demonstrate defective beta-cell function. These
      results are consistent with studies in the Zucker diabetic fatty rat, an animal
      model of NIDDM in which prediabetic animals demonstrate extensive alterations in
      expression of multiple genes involved in the regulation of insulin secretion. It
      thus appears that abnormal beta-cell function is present at a relatively early
      stage in the evolution of NIDDM, even before the onset of overt hyperglycemia.

PMID- 7789638
TI  - Amelioration of high-fat feeding-induced insulin resistance in skeletal muscle
      with the antiglucocorticoid RU486.
AB  - Fat feeding produces whole-body insulin resistance and decreased glucose uptake
      in muscle tissue of rats. To examine the effect of glucocorticoid blockade on the
      insulin resistance caused by high-fat feeding, four groups of rats were fed diets
      high in starch (70% of calories) or fat (59% of calories) for 4 weeks with or
      without the antiglucocorticoid RU486 (69.8 mumol.kg-1.day-1) in the food. Whole
      body insulin action was assessed by the euglycemic clamp technique at an upper
      physiological insulin level with bolus 2-[3H]deoxyglucose to determine individual
      tissue insulin-stimulated glucose uptake. Whole-body glucose utilization (clamp
      glucose infusion rate [GIR]) was decreased by high-fat feeding (GIR 68.3 +/- 12.2
      vs. 182.6 +/- 12.8 mumol.kg-1.min-1 for the starch-fed group; P < 0.001).
      Addition of RU486 to the diet significantly improved (GIR 133.9 +/- 12.8 mumol.kg
      1.min-1; P < 0.01), but did not fully reverse, the insulin resistance caused by
      fat feeding. RU486 was without effect in the starch-fed rats. In skeletal
      muscles, RU486 ameliorated 62 and 68% of the insulin resistance produced by fat
      feeding in red quadriceps and extensor digitorum longus hindlimb muscles,
      respectively, but had no effect in heart or white adipose tissue. These results
      suggest that glucocorticoids play, in a tissue-specific manner, a role in the
      maintenance and/or production of insulin resistance produced by high-fat feeding.

PMID- 7789639
TI  - Microvascular function in human diabetes. A physiological perspective.
AB  - The late complications of diabetes represent in large part microvascular
      dysfunction. The development of techniques to measure microvascular function has
      resulted in a clearer picture of the stages of development of microangiopathy and
      the key pathophysiological processes involved. Considerable evidence supports the
      hemodynamic hypothesis of pathogenesis, which argues that early insulin-dependent
      diabetes is characterized by increased microvascular pressure and flow. Resultant
      injury to the microvascular endothelium causes adaptive microvascular sclerosis
      contributing to a loss of vasodilatory reserve and autoregulatory capacity with
      increasing disease duration. High susceptibility to microangiopathy appears to be
      characterized by both high capillary pressure and increased permeability,
      although the interrelationship between these variables needs to be better
      defined. In normotensive non-insulin-dependent diabetes subjects, a different
      pattern of microvascular functional abnormalities is apparent; it is hypothesized
      that these differences represent the impact of a prediabetic insulin-resistant
      phase on microvascular behavior and may in part explain the differential
      expression of vascular pathology in the two major types of diabetes. The
      physiological framework that has been defined reveals those pivotal processes
      upon which scientific attention should be centered and facilitates the generation
      of plausible molecular and cellular mechanisms that fit the physiological facts.

PMID- 7789640
TI  - An (A-C)n dinucleotide repeat polymorphic marker at the 5' end of the aldose
      reductase gene is associated with early-onset diabetic retinopathy in NIDDM
      patients.
AB  - To study the relationship between the aldose reductase gene and diabetic
      complications, an (A-C)n dinucleotide repeat sequence 2.1 kb upstream of the
      transcription start site of this gene was identified and studied. There are seven
      alleles at this locus with a polymorphism information content of 0.73 and a
      heterozygosity of 0.77 among the Chinese population in Hong Kong. One of the
      alleles (Z-2) was found to be associated with early onset of retinopathy in
      patients with non-insulin-dependent diabetes (P = 0.007), suggesting that aldose
      reductase or a gene in the close vicinity may be involved in the pathogenesis of
      this diabetic complication.

PMID- 7789641
TI  - Unchanged incidence of diabetic nephropathy in IDDM patients.
AB  - Recently, a dramatic decline in the cumulative incidence of diabetic nephropathy
      (< 10% after 25 years of diabetes) has been reported in insulin-dependent
      diabetes mellitus (IDDM) patients diagnosed before the age of 15 years between
      1961 and 1980. In a clinic-based study, we assessed recent trends in the
      incidence of diabetic nephropathy. All 356 patients in whom IDDM was diagnosed
      before the age of 41 years between 1965 and 1979, identified in 1984, were
      followed until 1991 or until death. All patients were Caucasians and resided in
      Copenhagen. The cumulative incidences (life-table method) of diabetic nephropathy
      (urinary albumin excretion > or = 300 mg/24 h in two out of three consecutive
      samples) after 15 years of diabetes and in 1991 were 18 +/- 4 and 35 +/- 5%
      (cumulative incidence +/- SE; onset of diabetes 1965-1969, n = 113), 20 +/- 4 and
      35 +/- 5% (onset of diabetes 1970-1974, n = 130), and 16 +/- 5% (onset of
      diabetes 1975-1979, n = 113), respectively (NS at 15 years). The prevalence of
      persistent microalbuminuria (31-299 mg/24 h) at time of follow-up was 24% (95%
      confidence interval: 16-33) in the group with onset of diabetes in 1965-1969, 28%
      (20-36) with onset of diabetes in 1970-1974, and 19% (13-28) with onset of
      diabetes in 1975-1979 (NS). The mean +/- SE HbA1c measured yearly beginning in
      1984 was higher in patients with nephropathy (9.4 +/- 0.1%) and persistent
      microalbuminuria (8.9 +/- 0.1%) than in patients with normoalbuminuria (8.5 +/-
      0.1%; P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789642
TI  - Expression of intercellular adhesion molecule 1 on pancreatic beta-cells
      accelerates beta-cell destruction by cytotoxic T-cells in murine autoimmune
      diabetes.
AB  - Intercellular adhesion molecule 1 (ICAM-1) plays an important role in the
      pathogenesis of insulin-dependent diabetes mellitus (IDDM) by being involved in
      the extravasation of lymphocytes from the circulation into the inflamed pancreas.
      However, the mechanism of beta-cell destruction by which expression of ICAM-1 on
      beta-cells may facilitate adhesion of effector cells still remains to be
      elucidated. Several lines of evidence suggest that this adhesion molecule is
      involved in the destruction of pancreatic beta-cells by killer lymphocytes in the
      NOD mouse, which shows an autoimmune diabetic syndrome similar to that of human
      IDDM. Immunohistochemical study under light microscopy demonstrated that all of
      the mononuclear cells infiltrating the islets strongly expressed ICAM-1 and
      leukocyte function-associated antigen 1 (LFA-1), a counterreceptor of ICAM-1,
      whereas ICAM-1 expression on islet cells was not apparent. However,
      immunohistochemical staining under electron microscopy revealed that islet beta
      cells adjacent to infiltrating lymphocytes were clearly stained by an anti-ICAM-1
      monoclonal antibody (mAb). Flow cytometric analysis showed that the ICAM-1
      expression on NOD islet cells and NOD-derived insulinoma cells (MIN6N8a) was
      inducible by interferon (IFN)-gamma or tumor necrosis factor-alpha. These
      cytokines had an additive effect on the ICAM-1 induction. Susceptibility of
      MIN6N8a cells to lysis by a NOD islet-derived CD8+ cytotoxic T-cell clone was
      greatly enhanced by IFN-gamma pretreatment, and this enhancement was abolished by
      anti-ICAM-1 and anti-LFA-1 mAbs. When both mAbs were administered into NOD mice
      with spontaneous or adoptively transferred diabetes, the development of diabetes
      was significantly prevented.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789643
TI  - Glomerular mesangial cell altered contractility in high glucose is Ca2+
      independent.
AB  - In diabetes, loss of renal arteriolar smooth-muscle cell contractility leads to
      intraglomerular hypertension. In glomeruli isolated from streptozotocin (STZ)
      induced diabetic rats, the mesangial cells (smooth muscle-like) display loss of
      contractile responsiveness to angiotensin II. This study examines the mechanistic
      relationship between altered mesangial cell contractility and vasopressor hormone
      stimulated Ca2+ signaling in high glucose. Glomeruli were isolated from normal or
      STZ-induced diabetic rats to observe ex vivo mesangial cell contractile function.
      Also, rat mesangial cells were cultured (10-20 passages) in normal (5.6 mmol/l)
      or high (10-25.6 mmol/l) glucose for 1-5 days. Reduction of glomerular volume and
      decreased planar surface area of cultured mesangial cells in response to
      vasoconstrictor stimulation over 60 min were measured by videomicroscopy and
      personal computer-based morphometry. Contraction of glomeruli isolated from STZ
      administered rat in response to endothelin (ET)-1 (0.1 mumol/l) or the Ca2+
      ionophore A23187 (5 mumol/l) was impaired significantly compared with that in
      normal glucose. In the presence of arginine vasopressin (AVP) (1.0 mumol/l) or ET
      1 (0.1 mumol/l), mesangial cells demonstrated a dose-dependent loss of
      contractile response to increasing glucose concentrations (5.6-25.6 mmol/l)
      within 24 h of high-glucose exposure, which was sustained for 5 days. Mesangial
      cells in high glucose were consistently smaller in size compared with those in
      normal glucose. Mesangial cells were preloaded with myo-[2-3H]inositol and
      intracellular [3H] inositol phosphate release in response to AVP (1.0 mumol/l)
      was analyzed by Dowex chromatography. Comparing cells in normal (5.6 mmol/l)
      verus high (25.6 mmol/l) glucose, we observed no significant difference in
      stimulated inositol phosphate levels from 10 to 60 s.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7789644
TI  - Glucagon-like peptide I increases cytoplasmic calcium in insulin-secreting beta
      TC3-cells by enhancement of intracellular calcium mobilization.
AB  - In the insulin-secreting beta-cell line beta TC3, stimulation with 11.2 mmol/l
      glucose caused a rise in the intracellular free Ca2+ concentration ([Ca2+]i) in
      only 18% of the tested cells. The number of glucose-responsive cells increased
      after pretreatment of the cells with glucagon-like peptide I (GLP-I)(7-36)amide
      and at 10(-11) mol/l; 84% of the cells responded to glucose with a rise in
      [Ca2+]i. GLP-I(7-36)amide induces a rapid increase in [Ca2+]i only in cells
      exposed to elevated glucose concentrations (> or = 5.6 mmol/l). The action of GLP
      I(7-36)amide and forskolin involved a 10-fold increase in cytoplasmic cAMP
      concentration and was mediated by activation of protein kinase A. It was not
      associated with an effect on the membrane potential but required some (small)
      initial entry of Ca2+ through voltage-dependent L-type Ca2+ channels, which then
      produced a further increase in [Ca2+]i by mobilization from intracellular stores.
      The latter effect reflected Ca(2+)-induced Ca2+ release and was blocked by
      ryanodine. Similar increases in [Ca2+]i were also observed in voltage-clamped
      cells, although there was neither activation of a background (Ca(2+)-permeable)
      inward current nor enhancement of the voltage-dependent L-type Ca2+ current.
      These observations are consistent with GLP-I(7-36) amide inducing glucose
      sensitivity by promoting mobilization of Ca2+ from intracellular stores. We
      propose that this novel action of GLP-I(7-36)amide represents an important factor
      contributing to its insulinotropic action.

PMID- 7789645
TI  - Bone loss and bone turnover in diabetes.
AB  - There have been conflicting reports about the effect of diabetes on bone density.
      In 1978, we studied 109 patients, 46 with type I and 63 with type II diabetes;
      approximately 12 years later we restudied 35 of the 66 surviving patients. In the
      original study, radial bone density did not differ significantly between patients
      with either type of diabetes but was significantly lower than in nondiabetic
      control subjects. In eight osteopenic patients, bone formation rate and other
      histological indexes of osteoblast recruitment and function were markedly
      depressed compared with those in nondiabetic control subjects. In patients
      remeasured approximately 2.5 years (41 patients) and approximately 12.5 years (35
      patients) after baseline, bone loss had continued at the expected rate in
      patients with type I diabetes, with maintenance of the same deficit, but was
      slower than expected in patients with type II diabetes, such that the initial
      deficit had been completely corrected. In six of the eight patients who had
      undergone bone biopsy, one with type I and five with type II diabetes, the mean
      bone mineral density z-score of the spine and femoral neck approximately 12 years
      later was > 0 and in one subject was significantly higher than normal at both
      sites. Based on these data and on previous studies, we propose that in patients
      with diabetes, low bone formation retards bone accumulation during growth,
      metabolic effects of poor glycemic control lead to increased bone resorption and
      bone loss in young adults, and low bone turnover retards age-related bone
      loss.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789646
TI  - On the mechanisms of blunted nocturnal decline in arterial blood pressure in
      NIDDM patients with diabetic nephropathy.
AB  - Nondiabetic hypertensive patients lacking the normal nocturnal decline in
      arterial blood pressure have enhanced cardiovascular complications. Since
      cardiovascular morbidity and mortality are increased in non-insulin-dependent
      diabetes mellitus (NIDDM), we performed a prospective cross-sectional case
      controlled study comparing the diurnal variation in arterial blood pressure,
      prevalence of dippers, cardiac autonomic nervous function (beat-to-beat variation
      during deep breathing), and extracellular fluid volume (51Cr-labeled EDTA) in 55
      NIDDM patients with diabetic nephropathy (group 1), 55 NIDDM patients with
      normoalbuminuria (group 2), and 22 nondiabetic control subjects (group 3). All
      antihypertensive treatments were withdrawn at least 2 weeks before the study. The
      nocturnal blood pressure reduction (daytime-to-nighttime)/daytime (mean +/- SE)
      was impaired in group 1 (6.6 +/- 1.5%) and group 2 (11.1 +/- 1.4%) as compared
      with group 3 (17.6 +/- 1.7%), and it was impaired in group 1 as compared with
      group 2 (P < 0.05 for each comparison). The prevalence of dippers (95% confidence
      interval) was lower in group 1 (42% [29-56]) as compared with group 2 (58% [44
      71]; P = 0.08) and group 3 (86% [65-97]; P < 0.001) and in group 2 as compared
      with group 3 (P < 0.01). Abolished beat-to-beat variation was more prevalent in
      group 1 (63% [50-76]) as compared with group 2 (15% [7-27]) and with group 3 (5%
      [0-23]) (P < 0.001). Nocturnal blood pressure reduction was associated with beat
      to-beat variation during deep breathing (r = 0.22, P < 0.01). Extracellular fluid
      volume (mean +/- SE) was higher in group 1 (15.9 +/- 0.5 l/m2) as compared with
      group 3 (14.1 +/- 0.8 l/m2) (P < 0.05) with group 2 between the two (15.1 +/- 0.4
      l/m2).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789647
TI  - Diabetic ketoacidosis in obese African-Americans.
AB  - Our preliminary data indicate that 15% of African-American patients presenting
      with diabetic ketoacidosis (DKA) are obese. To determine underlying mechanisms,
      we analyzed the clinical characteristics and indexes of insulin secretion and
      insulin sensitivity in 35 obese patients with DKA, 22 obese patients with
      hyperglycemia, 10 lean patients with DKA, and 10 obese nondiabetic subjects.
      Studies were performed 1 day after resolution of DKA and after 12 weeks of follow
      up. At presentation, both obese DKA and obese hyperglycemic patients had no
      detectable insulin response to intravenous glucose, but they did respond to
      glucagon administration. The acute insulin response (AIR) to glucagon in obese
      DKA patients (0.9 +/- 0.1 ng/ml, P < 0.01), but significantly greater than in
      lean patients with DKA (0.1 +/- 0.1 ng/ml, P < 0.01). After 12 weeks of follow
      up, the AIR to glucose improved in both groups of obese diabetic patients but
      remained significantly lower than in nondiabetic control subjects (both P <
      0.01). In contrast, the AIR to glucagon was not significantly different from that
      in obese control subjects. Insulin sensitivity was decreased in both groups of
      obese diabetic patients at presentation and improved after follow-up to levels
      similar to those in obese nondiabetic control subjects. Reactivity with islet
      cell antibodies was not detected in any of the patients. During follow-up, 25 of
      35 obese DKA and 16 of 22 hyperglycemic patients were able to discontinue insulin
      therapy, with continued good metabolic control. Our results indicate that in
      African-Americans, obese patients with DKA represent a subset of type II
      diabetes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789648
TI  - The Wisconsin Epidemiologic Study of Diabetic Retinopathy. XVI. The relationship
      of C-peptide to the incidence and progression of diabetic retinopathy.
AB  - The relationship between plasma C-peptide and the 6-year incidence and
      progression of diabetic retinopathy was examined in a population-based study in
      Wisconsin. Individuals with younger-onset (n = 548) and older-onset (n = 459)
      diabetes were included. C-peptide was measured by radioimmunoassay with Heding's
      M1230 antiserum. Retinopathy was determined from stereoscopic fundus photographs.
      Younger- and older-onset insulin-using individuals with undetectable or low
      plasma C-peptide (< 0.3 nmol/l) at baseline had the highest incidence and rates
      of progression of retinopathy, whereas older-onset individuals with C-peptides >
      0.3 nmol/l had the lowest incidence and rates of progression of retinopathy.
      However, within each group (younger-onset using insulin, older-onset using
      insulin, and older-onset not using insulin), after we controlled for other
      characteristics associated with retinopathy, there was no relationship between
      higher levels of C-peptide at baseline and lower 6-year incidence or progression
      of retinopathy. These data suggest that glycemic control, and not C-peptide, is
      related to the incidence and progression of diabetic retinopathy.

PMID- 7789649
TI  - 31P-nuclear magnetic resonance evidence of an activated hexose-monophosphate
      shunt in hyperglycemic rat lenses in vivo.
AB  - Using 31P-nuclear magnetic resonance spectroscopy, we have identified elevated
      concentrations of sedoheptulose-7-phosphate (S-7-P) in lenses from three animal
      models of hyperglycemia: streptozotocin-induced diabetic rats, galactose-fed
      rats, and xylose-fed rats. This observation provides a unique and independent
      confirmation of the activation of the hexose monophosphate shunt (HMPS) pathway
      in the hyperglycemic lens in vivo. While the elevation in concentration of S-7-P
      was very dramatic, the other HMPS metabolites in these tissues were below the
      threshold of detection, as expected for the HMPS pathway near equilibrium. In
      terms of nonenzymatic glycation, these results suggest that the only HMPS
      metabolite of importance in the hyperglycemic rat lens is S-7-P. Although in the
      diabetic lens its role appears to be relatively minor, in the galactosemic lens
      this compound may be an important contributor to the increased production of
      advanced glycosylation end products.

PMID- 7789650
TI  - Formation of immunochemical advanced glycosylation end products precedes and
      correlates with early manifestations of renal and retinal disease in diabetes.
AB  - Elevated levels of advanced glycosylation end products (AGEs) have been found in
      multiple tissues in association with diabetic vascular complications and during
      the microalbuminuric phase of diabetic nephropathy. In this study, we have used
      an AGE-specific enzyme-linked immunosorbent assay (ELISA) to measure skin AGEs to
      determine whether elevated levels can be detected before the onset of overt
      microangiopathy. Subjects with type I diabetes (n = 48) were graded for the
      degree of nephropathy (normal [23], microalbuminuria [12], or macroalbuminuria
      [12]) and retinopathy (none [13], background [20], or proliferative [15]).
      Subgroups with a premicroalbuminuric phase of albumin excretion (< or = 28 mg/24
      h, n = 27) or with the earliest stages of retinopathy (n = 27) were identified. A
      significant increase in tissue AGEs was found as urinary albumin increased during
      the premicroalbuminuric phase of nephropathy even when the data were adjusted for
      age and duration of diabetes (P = 0.005). Immunoreactive AGEs also increased as
      normal renal status advanced to microalbuminuria and macroalbuminuria (P = 0.0001
      across groups). Significant elevation of AGEs was also found in association with
      the earliest stages of clinically evident retinopathy (early background versus
      minimal grades). In addition, higher AGE levels were found in subjects with
      proliferative retinopathy when compared with those with less severe retinopathy
      (P < 0.004 across groups). In contrast, no significant differences were found in
      tissue AGE levels between groups with or without early retinopathy based on
      pentosidine or fluorescent AGE measurements, although fluorescent AGEs correlated
      with albumin excretion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789651
TI  - The pseudotetrasaccharide acarbose inhibits pancreatic islet glucan-1,4-alpha
      glucosidase activity in parallel with a suppressive action on glucose-induced
      insulin release.
AB  - The pseudotetrasaccharide acarbose, previously known as a potent inhibitor of
      intestinal alpha-glucoside hydrolases, was investigated with regard to its
      influence on islet lysosomal enzyme activities and the insulin secretory
      processes. We observed that acarbose was a potent inhibitor of mouse islet
      lysosomal acid glucan-1,4-alpha-glucosidase activity, EC50 approximately 5
      mumol/l, as well as of acid alpha-glucosidase activity. In contrast, acarbose did
      not influence other lysosomal enzyme activities such as acid phosphatase and N
      acetyl-beta-D-glucosaminidase. Neutral alpha-glucosidase (endoplasmic reticulum)
      was only moderately inhibited in homogenate and was unaffected in intact islets.
      Incubation of isolated mouse islets with acarbose revealed that the
      pseudotetrasaccharide was a strong inhibitor of glucose-induced insulin
      secretion, EC50 approximately 500 nmol/l, and a significant inhibition was
      already observed at a concentration of acarbose as low as 100 nmol/l. The
      acarbose analogue maltotetrose did not influence either glucose-induced insulin
      release or islet lysosomal enzyme activities. Further, acarbose as well as two
      other alpha-glucoside hydrolase inhibitors, the deoxynojirimycin derivatives
      miglitol and emiglitate, did not affect islet glucose oxidation at low or high
      glucose levels. Acarbose also inhibited insulin release induced by the
      sulfonylurea glibenclamide, whereas insulin secretion stimulated by the
      cholinergic muscarinic agonist carbachol or the phosphodiesterase inhibitor
      isobutylmethylxanthine was unaffected by the drug. Moreover, complementary in
      vivo experiments showed that pretreatment of mice with acarbose to allow for
      endocytosis of the compound markedly suppressed the insulin secretory response to
      an intravenous glucose load.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789652
TI  - Defective insulin action on protein and glucose metabolism during chronic
      hyperinsulinemia in subjects with benign insulinoma.
AB  - The ability of chronic endogenous hyperinsulinemia to induce a resistance to
      insulin action on protein and glucose metabolism was studied in 10 subjects
      affected by a benign (functioning) insulinoma and 18 healthy subjects by means of
      infusions of [1-(14)C]leucine and [3-(3)H] glucose. The insulinoma subjects were
      divided into two groups with moderate (139 +/- 12 pmol/l) (n = 5) and marked (438
      +/- 42 pmol/l) (n = 5) hyperinsulinemia and were studied during a euglycemic
      dextrose infusion. Control subjects were studied postabsorptively and during a
      low-dose (0.3 mU.kg-1.min-1) (n = 3) and a high-dose (1 mU.kg-1.min-1) (n = 15)
      euglycemic insulin clamp to match peripheral insulin concentrations with those of
      insulinoma subjects. In insulinoma subjects there was no correlation among plasma
      insulin concentration and leucine concentration (r = 0.05), endogenous leucine
      flux (r = 0.44), hepatic glucose production (r = 0.47), and glucose uptake (r =
      0.05). Insulinoma subjects with marked hyperinsulinemia demonstrated a defective
      suppression of leucine concentrations (100 +/- 11 vs. 65 +/- 5 mumol/l, P <
      0.01), endogenous leucine flux (50.1 +/- 6.3 vs. 27.1 +/- 0.9 mumol.m-2.min-1, P
      < 0.01), and hepatic glucose production (5.4 +/- 2.0 vs. 0.6 +/- 0.6 mumol.kg
      1.min-1, P < 0.05), and a defective stimulation of glucose uptake (13.5 +/- 1.6
      vs. 41.1 +/- 2.8 mumol.kg-1.min-1, P < 0.001) with respect to normal subjects at
      a comparable degree of hyperinsulinemia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789653
TI  - Estimation of beta-cell sensitivity from intravenous glucose tolerance test C
      peptide data. Knowledge of the kinetics avoids errors in modeling the secretion.
AB  - Parametric models of insulin secretion are used to measure indexes of beta-cell
      function from plasma C-peptide concentration during an intravenous glucose
      tolerance test (IVGTT). Since the models have been usually assessed against
      plasma C-peptide data, both secretory and kinetic parameters need to be
      simultaneously estimated. However, undesired compensations between the two sets
      of parameters may arise. In this study, in order to evaluate IVGTT insulin
      secretion models, we have analyzed IVGTT data from seven normal subjects for whom
      individual C-peptide kinetics were known from a separate experiment. Three
      different beta-cell models have been examined: the minimal model M1 (Diabetes
      37:223-231, 1988); a variation of a published model, M2 (Math Biosci 27:319-332,
      1975); and a new one, M3. A two-compartment model was used to describe C-peptide
      kinetics. The results suggest the inadequacy of M1 since kinetic parameter
      estimates were consistently biased versus the known individual values, and
      systematic errors were present in the prediction of C-peptide data when kinetic
      parameters were fixed to the known individual values. M2 performs better than M1
      since it reproduces C-peptide data satisfactorily when the individually known
      description of the kinetics is adopted. M3 retains the second-phase description
      of M2 but improves the description of first-phase release. M3 is thus proposed to
      reconstruct the insulin secretion time course and to estimate parameters of first
      and second-phase sensitivity to glucose. We also show the robustness of M3,
      i.e., standard values of C-peptide kinetic parameters can be used when individual
      values are not available without a loss of accuracy in the estimated secretion
      parameters. Finally, the shortcomings of using a simplified single-compartment
      description of C-peptide kinetics are discussed.

PMID- 7789654
TI  - Human obese gene expression. Adipocyte-specific expression and regional
      differences in the adipose tissue.
AB  - The obese (ob) gene, the mutation of which results in severe hereditary obesity
      and diabetes in mice, has recently been isolated through positional cloning. In
      this study, we isolated a full-length human ob complementary DNA (cDNA) clone and
      examined the tissue distribution of ob gene expression in humans. The nucleotide
      sequences of the human ob cDNA coding region were 83% identical to those of the
      mouse and rat ob cDNA coding regions. Analysis of the deduced amino acid
      sequences revealed that the human ob protein is a 166-amino acid polypeptide with
      a putative signal sequence and is 84 and 83% homologous to the mouse and rat ob
      proteins, respectively. Northern blot analysis using the cloned human ob cDNA
      fragment as a probe identified a single messenger RNA (mRNA) species 4.5 kb in
      size found abundantly in the adipose tissues obtained from the subcutaneous,
      omental, retroperitoneal, perilymphatic, and mesenteric fat pads. However, no
      significant amount of ob mRNA was present in the brain, heart, lung, liver,
      stomach, pancreas, spleen, small intestine, kidney, prostate, testis, colon, or
      skeletal muscle. The ob mRNA level in the adipose tissue varied from region to
      region even in the same individual. Furthermore, in the human adipose tissue, ob
      gene expression occurred in mature adipocytes rather than in stromal-vascular
      cells. This study is the first report of the elucidation of ob gene expression in
      human tissues, thereby leading to better understanding of the physiological and
      clinical implications of the ob gene.

PMID- 7789656
TI  - Disclosure.

PMID- 7789655
TI  - The prevention of IDDM. Injecting insulin into the cytokine network.

PMID- 7789658
TI  - Nature of the brain lesion in fetal allo-immune thrombocytopenia.
AB  - Study of three fetuses with allo-immune thrombocytopenia, one with autopsy
      findings, and comparison with existing data have permitted speculation on the
      nature of the initial lesion within the brain. The commonest first bleeding site
      is probably underneath the molecular layer of the cerebral cortex, often within
      the temporal lobe. Small haemorrhages may appear to be (sub)pial, but expansion
      will lead to so-called subarachnoid haematoma. Communication with the adjacent
      lateral ventricle will contribute to post-haemorrhagic hydrocephalus.
      Occasionally, the initial haemorrhage is within the ventricle; such a pattern may
      lead to post-haemorrhagic hydrocephalus, often with a porencephalic component. In
      utero follow-up of fetuses at risk for allo-immune thrombocytopenia will have to
      focus on superficial cerebral haemorrhage for early detection of brain
      involvement.

PMID- 7789659
TI  - Visual function in Rett syndrome.
AB  - The authors examined refractive error, pattern onset visual evoked potentials,
      ocular posture and they performed internal and external eye examinations in 11
      subjects with Rett syndrome (aged between four and 24 years) and 18 normal
      controls (aged between six and 20 years). Substantial refractive errors were
      common in the Rett syndrome group. Spectacle correction had never previously been
      worn and glasses were provided where appropriate. No subjects had nystagmus or
      optic nerve pallor and only one was strabismic. All subjects had recognisable and
      reproducible pattern-onset VEPs and latencies and amplitudes did not differ
      significantly from those of the controls. All demonstrated VEP thresholds of at
      least 24'. In contrast to other populations with profound disabilities, people
      with Rett syndrome have good function of the afferent visual pathways and, in
      view of their substantial refractive errors, are likely to benefit from spectacle
      correction.

PMID- 7789657
TI  - Prevention by magnesium of excitotoxic neuronal death in the developing brain: an
      animal model for clinical intervention studies.
AB  - Excitotoxic disturbances during brain development were studied in the mouse using
      intracerebral injections of ibotenate, a glutamatergic agonist of the N-methyl-D
      aspartate (NMDA) complex receptor, to analyse the protective effect of a systemic
      bolus of MgSO4, a non-competitive antagonist of the NMDA ionophore-complex
      receptor. MgSO4 did not prevent microgyia, induced by ibotenate when injected at
      P0 immediately after the post-migratory settlement of layer V, but did prevent
      ulegyrias, porencephalic cysts, and other cortical and cortical-subcortical
      hypoxic-like lesions arising after completion of the neocortical cyto
      architectonic development at P5. Protection was optimal in 80 per cent of mice at
      600mg/kg, with no mortality due to MgSO4; thereafter mortality increased with
      dosage. The protective effect appears after the developmental acquisition of two
      properties of the excitotoxic cascade, namely the coupling of the massive calcium
      influx with NMDA-receptor overstimulation and the predominance of magnesium
      obliterable calcium channels. This animal model supports the clinical
      intervention studies with magnesium in hypoxias/perfusion failures and has
      implications for their design. If maturation of the excitotoxic cascade follows
      the same sequence in humans, protection is probably low before 26 weeks of
      gestational age.

PMID- 7789660
TI  - The maturation of linear acuity and compliance with the Sonksen-Silver Acuity
      System in young children.
AB  - The compliance and maturation of visual acuity of 1245 2 1/2- to nine-year-olds
      was investigated. Testing was undertaken as part of routine surveillance. Ability
      to letter match, to achieve a binocular measure and to achieve monocular measures
      for children under three years was 89, 78 and 37 per cent, for children aged
      three to four years 97, 91 and 66 per cent, and for children over four years
      99.9, 99.9 and 99, respectively. A statistical model was developed to give acuity
      norms by age for use by surveillance and diagnostic teams.

PMID- 7789661
TI  - Measures of acuity in primary-school children and their ability to detect minor
      errors of vision.
AB  - 492 five to nine year old children participated in a study of the ability of
      three tests of linear acuity --the Sonksen-Silver Acuity System (SSAS), the
      Sheridan Gardiner 7-letter chart and the Keelers MK2 chart to identify children
      requiring specialist visual examination. The ability of the three tests to detect
      children with visual defects at 6m and of the SSAS in several test test
      conditions (3m and 6m, monocular and binocular) was investigated at two acuity
      levels for referral (3/4.5 or 6/9 and 3/6 or 6/12). Although specificity was very
      high for all tests and test conditions using a 3/6 or 6/12 cut-off for referral,
      the sensitivity and yield were disappointingly low; higher levels of the latter
      were achieved at the expense of a degree of specificity using a 3/4.5 or 6/9 cut
      off. Similarly, sensitivity and yield were greater for the monocular than
      binocular condition and for the 6m than 3m condition. A test of near vision
      (SSAS) did not detect any children not already identified by a distance measure.
      The optometric and developmental rationale behind the differences is discussed.

PMID- 7789663
TI  - A study of a dynamic proximal stability splint in the management of children with
      cerebral palsy.
AB  - This paper describes a study of the UPsuit, a proximal stability splint
      fabricated from Lycra, in the management of children with cerebral palsy. The
      splint improved posture and reduced involuntary movement immediately. The amount
      of functional improvement depended on the type and severity of impairments, the
      subject's attitude, their capacity for purposeful intent and compliance.
      Compromised lung function and pre-existing hypoactivity were medical contra
      indications to UPsuit wear whilst a limited capacity for purposeful intent or a
      negative attitude restricted benefits. The Upsuit was of great value to one
      quarter of subjects, but Lycra splinting may benefit a wider spectrum of persons
      with cerebral palsy in the form of less intrusive splints applied to the limbs.

PMID- 7789662
TI  - Effect of oral sensorimotor treatment on measures of growth, eating efficiency
      and aspiration in the dysphagic child with cerebral palsy.
AB  - Twenty-seven children (mean age 5.1 years) with cerebral palsy and moderate
      eating impairment were studied to determine frequency of aspiration and the
      effect of 10 and 20 weeks of oral sensorimotor therapy on eating efficiency and
      measures of growth (weight, skinfold thickness). The eating efficiency of the
      children did not change markedly in response to oral sensorimotor therapy.
      Children maintained their centile rank in weight-for-age and skinfold-for-age
      measurements. However, there was no catch-up growth. The findings suggest that
      eating efficiency is not a good estimator of treatment outcome, but rather a
      diagnostic indicator of the severity of eating impairment. Monitoring of these
      children's growth is essential in order to provide nutritional rehabilitation as
      soon as their eating skills can no longer keep up with growth demands.

PMID- 7789664
TI  - Prenatal brain damage and placental infarction--an autopsy study.
AB  - The histopathological abnormalities seen at autopsy in the brains and
      corresponding placentas of a consecutive four-year series of stillborn infants
      are presented. After excluding stillbirths with major cerebral malformations, the
      brains of 175 cases and the corresponding placentas in 165 cases were available
      for assessment. 70 of the 175 brains (40 per cent) showed microscopic evidence of
      ischaemic cerebral injury, using a combination of haematoxylin-eosin and glial
      fibrillary acid protein stains. In 62 of these 70 brains, the periventricular
      white matter was the main site of damage. 46 (28 per cent) of the corresponding
      165 placentas showed macroscopic and microscopic evidence of infarction, 39 of
      which were associated with ischaemic cerebral lesions. It was concluded that
      placental infarcts are commonly associated with prenatal cerebral ischaemic
      lesions.

PMID- 7789665
TI  - Relation between Asperger syndrome and prosopagnosia.

PMID- 7789666
TI  - Cross-talk in otoacoustic emission probes.
AB  - OBJECTIVE: Several commercial otoacoustic emission probes (Virtual 330, Etymotic
      Research ER-10 and ER-10B, and Otodynamics ILO88 and ILO92) were tested for
      internal coupling (cross-talk) between the sound source and probe microphone.
      DESIGN: The response of the probe under test was measured, in a cavity that
      simulates the human ear canal, first in its normal configuration and then with
      either the sound source tube or the microphone inlet blocked with modelling clay.
      Cross-talk was indicated if the pressure failed to drop substantially in the
      "blocked" condition. RESULTS: Cross-talk in the Virtual 330 and Etymotic ER-10B
      was found to be severe enough to compromise the accuracy of "in the ear" acoustic
      calibrations. In both cases the cause was the radiation of sound through the
      walls of the flexible silicone tubing used to conduct the stimuli through the
      body of the probe. Substituting harder-walled sound source tubing reduced cross
      talk to levels acceptable for routine application. The probes used in the
      otodynamics ILO88 and ILO92 systems and the original Etymotic ER-10 probes all
      have acceptably low cross-talk as supplied from the manufacturers. CONCLUSIONS:
      For the two probes where excessive cross-talk was found, most of the cross-talk
      was acoustic and/or mechanical, rather than electromagnetic. Artifacts due to
      cross-talk have undoubtedly contaminated data collected with these units.
      Manufacturers of emission probes are urged to adopt a standard for specifying
      cross-talk levels and include this specification in product literature.

PMID- 7789667
TI  - Growth of the 2f1-f2 distortion product otoacoustic emission for low-level
      stimuli in human neonates.
AB  - Distortion product otoacoustic emissions (DPOAEs) for low stimulus levels (< 60
      dB SPL) have been reported in adult humans under ideal conditions. In neonates,
      DPOAEs have been reported only for high-level stimuli. The purpose of this paper
      was to determine characteristics of the 2f1-f2 DPOAE for low-level stimuli in
      neonates and to assess the feasibility of obtaining such measures in a noisy
      environment. Subjects were 19 premature neonates presumed to have normal hearing
      based on systematic pneumatic otoscopy measures and evoked auditory brainstem
      responses. For stimuli centered at 2000 and 6000 Hz and presented over a range of
      30 to 75 dB SPL, DPOAEs were measured employing linear time averaging for up to
      128 time frames at each level. In quiescent subjects, the level of the noise
      floor was as low as that reported in cooperative adults under ideal conditions
      (approximately -30 dB SPL), and the functions were identical. That is, valid
      measures were obtained for very low stimulus levels (30 dB SPL), the rate of
      growth approached 1 dB/dB, and identical nonmonotonicities (saturation, plateaus,
      and notches) were observed as those reported for adults. When the noise floor was
      elevated due to subject activity, no valid data could be obtained for low-level
      stimuli even though the DPOAEs were at expected levels for high-level stimuli.
      These results have important implications for the use of such measures in this
      population because the DPOAEs associated with the metabolically active nonlinear
      cochlear processes at low stimulus levels may be contaminated with DPOAEs
      associated with other processes at high stimulus levels.

PMID- 7789668
TI  - Quantifying improvement with amplification.
AB  - We employed a nonparametric measure, the randomization test, to evaluate,
      statistically, a variety of speech understanding measures used to quantify the
      efficacy of different intervention strategies in five clinical patients. The
      flexibility of the approach was demonstrated by comparing monaural with binaural
      amplification, a conventional aid with an assistive listening device, and a
      cochlear implant alone versus a cochlear implant supplemented by visual cues. The
      randomization test allows statistical analysis of differences in performance at
      the level of the individual subject. This approach may be useful in addressing
      accountability when recommending a specific intervention strategy for a
      particular hearing-impaired individual.

PMID- 7789669
TI  - The abbreviated profile of hearing aid benefit.
AB  - OBJECTIVE: To develop and evaluate a shortened version of the Profile of Hearing
      Aid Benefit, to be called the Abbreviated Profile of Hearing Aid Benefit, or
      APHAB. DESIGN: The Profile of Hearing Aid Benefit (PHAB) is a 66-item self
      assessment, disability-based inventory that can be used to document the outcome
      of a hearing aid fitting, to compare several fittings, or to evaluate the same
      fitting over time. Data from 128 completed PHABs were used to select items for
      the Abbreviated PHAB. All subjects were elderly hearing-impaired who wore
      conventional analog hearing aids. Statistics of score distributions and
      psychometric properties of each of the APHAB subscales were determined. Data from
      27 similar subjects were used to examine the test-retest properties of the
      instrument. Finally, equal-percentile profiles were generated for unaided, aided
      and benefit scores obtained from successful wearers of linear hearing aids.
      RESULTS: The APHAB uses a subset of 24 of the 66 items from the PHAB, scored in
      four 6-item subscales. Three of the subscales, Ease of Communication,
      Reverberation, and Background Noise address speech understanding in various
      everyday environments. The fourth subscale, Aversiveness of Sounds, quantifies
      negative reactions to environmental sounds. The APHAB typically requires 10
      minutes or less to complete, and it produces scores for unaided and aided
      performance as well as hearing aid benefit. Test-retest correlation coefficients
      were found to be moderate to high and similar to those reported in the literature
      for other scales of similar content and length. Critical differences for each
      subscale taken individually were judged to be fairly large, however, smaller
      differences between two tests from the same individual can be significant if the
      three speech communication subscales are considered jointly. CONCLUSIONS: The
      APHAB is a potentially valuable clinical instrument. It can be useful for
      quantifying the disability associated with a hearing loss and the reduction of
      disability that is achieved with a hearing aid.

PMID- 7789670
TI  - Use of test-retest measures to evaluate performance stability in adults with
      cochlear implants.
AB  - OBJECTIVE: This study was designed to evaluate performance stability with test
      retest measures of electrical thresholds, electrical maximum acceptable loudness
      levels, sound-field thresholds, and audition-only speech tests. The hypothesis
      was that the standard error of measurement differs from one individual to another
      for each test, and therefore test-retest measures need to be obtained from each
      subject. DESIGN: Test-retest data were obtained in three sets. For the first two
      sets, data were obtained over 4 successive weeks to determine day-to-day
      variability. The third set was obtained on 2 successive days, 2 to 10 months
      later at each subject's annual evaluation. The seven subjects were recipients of
      the Nucleus cochlear implant and used the Mini Speech Processor at least one
      year. They were selected because they were available for research testing.
      RESULTS: The ranges of electrical thresholds and maximum acceptable loudness
      levels obtained from each subject during the first two sets were substantially
      larger on some electrodes than on others. Between set 1 and set 2 for each
      subject, there were significant differences between thresholds and between
      maximum acceptable loudness levels on some electrodes. For thresholds as well as
      maximum acceptable loudness levels, the standard error of measurement across the
      three sets and 10 electrodes differed among subjects. The group standard error of
      measurement for sound-field thresholds was small (2 dB). The group standard error
      of measurement for the NU-6 word test scored according to phonemes (2.75%) was
      less than half that for the vowel (6.06%) and consonant (5.67%) tests. The
      standard error of measurement for each speech test differed among subjects.
      CONCLUSIONS: The standard error of measurement for thresholds as well as maximum
      acceptable loudness levels varies among electrodes in the same subject and among
      subjects across electrodes. The standard error of measurement also varies among
      speech tests for the group as well as among subjects for each speech test. There
      is little variation in test-retest measures of sound-field thresholds among
      subjects. These results suggest the clinical importance of obtaining test-retest
      measures for evaluating the stability of electrical thresholds, electrical
      maximum acceptable loudness levels, and speech tests.

PMID- 7789671
TI  - Comparison of two multichannel tactile devices as supplements to speechreading in
      a postlingually deafened adult.
AB  - OBJECTIVE: The purpose of this study was to conduct a single-subject comparison
      of the effectiveness of two multichannel vibrotactile devices that encode
      different classes of speech information. One device, the Portapitch, is designed
      to convey fundamental frequency (F0) and its variation over time. The other, the
      TACTAID 7, is designed to convey the first two formant frequencies (F1 and F2)
      and their variation over time. DESIGN: The subject, a postlingually deafened
      adult, underwent an intensive 17-wk training and testing protocol with the
      Portapitch and then completed a similar 17-wk protocol with the TACTAID 7.
      Performance measures were obtained on phonetic-contrast perception by
      speechreading alone, tactile device alone, and speechreading plus tactile device,
      and on open-set word and sentence recognition by speechreading alone and
      speechreading plus tactile device. RESULTS: On phonetic-contrast testing, the
      subject demonstrated some ability to perceive voicing, stress, and intonation
      contrasts using the Portapitch, but gave little evidence of phonetic-contrast
      perception with the TACTAID 7. On open-set word recognition testing, no
      significant improvements were seen with either device. On open-set sentence
      recognition testing, the subject showed a significant 9 percentage point
      enhancement effect using the Portapitch; the mean 5 percentage point enhancement
      effect provided by the TACTAID 7 was not statistically significant. CONCLUSIONS:
      A small advantage was seen in favor of the tactile display of F0 relative to the
      tactile display of formant frequency information on both phonetic-contrast
      testing and open-set sentence recognition. The difference, however, was of
      questionable significance and could have been confounded with an order effect.
      Nevertheless, the subject's preference was for the tactile formant frequency
      display.

PMID- 7789672
TI  - Articulation accuracy of children using an electrotactile speech processor.
AB  - OBJECTIVE: Use of wearable tactile speech perception devices is suggested to help
      overcome the difficulties in speech production resulting from severe and profound
      hearing impairment in children. This suggestion is based on the assumption that
      subjects can use tactile input in isolation, or in combination with information
      from residual aided hearing, to monitor and modify their speech. The present
      study evaluated the benefits to articulation provided through use of a
      multichannel electrotactile device ("Tickle Talker"). DESIGN: Six profoundly
      hearing-impaired children were videotaped speaking with the Tickle Talker on and
      with the Tickle Talker off during conversations with their audiologist. Five of
      the subjects also wore their binaural hearing aids during all recorded
      conversations. The number of vowels, consonants, and overall phonemes correctly
      articulated by each child in the two conditions were compared. RESULTS: One
      subject improved articulation of initial consonants and initial phonemes; one
      subject improved articulation of total vowels, total consonants, initial
      consonants, total phonemes, and initial phonemes; and a third subject improved
      articulation of total vowels and medial phonemes. CONCLUSIONS: Use of on-line
      tactile feedback from the Tickle Talker may benefit the articulation accuracy of
      some children, and the device may therefore be suitable to use with children who
      have not responded to more traditional speech training techniques.

PMID- 7789673
TI  - A test of virtual auditory localization.
AB  - OBJECTIVE: The purpose of this study was to evaluate a test of virtual auditory
      localization including assessment of its ease of administration and its
      sensitivity to differences in binaural performance in children and adults. This
      test eliminates many potential problems inherent in any free-field localization
      test such as calibration problems, problems replicating source and listener
      locations, and issues associated with head movements. DESIGN: Binaural
      performance was measured using the virtual localization test and a simple
      binaural detection task, the masking-level difference (MLD), for three groups of
      subjects: adults, children with a negative history of otitis media, and children
      with a positive history of otitis media. There were five subjects in each group.
      The adults were all student volunteers; the children were recruited first and
      subsequently placed into groups based on their medical histories obtained from
      their physicians and parental reports. RESULTS: Results indicate that this test
      of virtual auditory localization is useful for measuring binaural performance in
      children and adults and is sensitive to differences in binaural processing.
      Performance of the adults and children with a negative history of otitis media
      was comparable on both of the binaural tests, and on the binaural detection task,
      was similar to that reported in the literature for normal-hearing listeners; but
      the children with a positive history of otitis media performed more poorly on
      both tests. CONCLUSIONS: The results of this study indicate that the virtual
      localization test described here is easy to administer to children and adults.
      The signal processing techniques used in this virtual auditory localization test
      lend themselves to straightforward comparisons across different laboratories and
      clinics and make this test a potentially useful clinical tool. The development of
      such a clinical test is currently under study.

PMID- 7789674
TI  - Central auditory processing in Alzheimer's disease.
AB  - OBJECTIVE: This investigation was designed to determine whether people in the
      early to middle phases of Alzheimer's disease (AD) show impaired central auditory
      processing as compared with nondemented elderly. DESIGN: A peripheral and central
      auditory test battery was administered to 10 subjects diagnosed with mild-to
      moderate AD based on a neuropsychological test battery and radiographic
      techniques, and a control group of 10 subjects with no evidence of dementia,
      matched for age, gender, and average degree of hearing loss. Immittance
      audiometry, pure-tone and speech audiometry, and otoacoustic emissions were
      recorded in all subjects. Central auditory assessment included the synthetic
      sentence identification with ipsilateral competing message, dichotic digits,
      dichotic sentence identification, pitch patterns, and duration patterns. RESULTS:
      Peripheral auditory status was statistically similar between subject groups.
      Neither average high frequency hearing sensitivity nor mean speech recognition
      ability was significantly different. However, a significant difference was noted
      between groups for average low frequency hearing sensitivity in the left ear (p <
      0.05). Subjects with AD showed slightly poorer low frequency thresholds versus
      matched controls. Based on analysis of performance on each measure of the central
      auditory test battery, the AD group scored significantly lower than the matched
      control group on four of the five measures utilized. Differences for right versus
      left ear performance were found among AD subjects. CONCLUSIONS: Overall patterns
      in findings cannot be easily explained as artifacts of cognitive decline. Results
      support screening for central auditory dysfunction in the AD population, since
      impaired processing could influence psychiatric assessment of cognitive deficit
      as well as audiologic management of peripheral hearing loss in this population.

PMID- 7789675
TI  - Prospective randomized comparison of polyvinyl bougies and through-the-scope
      balloons for dilation of peptic strictures of the esophagus.
AB  - We prospectively compared the efficacy of polyvinyl bougies (Savary type) passed
      over a guide wire and through-the-scope balloons for the dilation of peptic
      esophageal strictures in a randomized study. Thirty-four patients, 17 in each
      treatment arm, were studied. At entry, dysphagia was assessed according to a six
      point scale (0, unable to swallow; 5, normal). The end-point for dilation was to
      size 45F or 15 mm. Discomfort during the procedure was graded on a four-point
      scale (0, no discomfort; 1, mild; 2, moderate; 3, severe discomfort). Follow-up
      visits were at 1 week, 1 month, 3 months, and every 3 months thereafter for 2
      years. At the 1-week visit, the size of esophageal lumen was measured by 8-, 10-,
      and 12-mm pills. Both devices effectively relieved dysphagia. By life-table
      analysis, stricture recurrence during the first year of follow-up was similar in
      both groups, but during the second year, the risk of recurrence was significantly
      lower in patients whose strictures were dilated with balloons. Other advantages
      of balloons included the need for fewer treatment sessions to achieve the defined
      end-diameter for dilation (1.1 + 0.1 versus 1.7 + 0.2, p < .05), and less
      procedural discomfort (p < .05). The differences in luminal size after dilation,
      measured by the barium pill test, were not significant. Ability to pass the 12-mm
      pill and absence of dysphagia were correlated. Our results indicate that both
      devices are effective in relieving dysphagia, but balloons may have a long-term
      advantage.

PMID- 7789676
TI  - Corrosive esophageal strictures: predictors of response to endoscopic dilation.
AB  - Twenty-one patients with corrosive esophageal strictures underwent contrast
      enhanced CT of the chest to determine (1) the esophageal wall thickness at the
      stricture site and (2) its correlation with number of sessions required for
      adequate dilation. Average esophageal wall thickness was defined as the mean
      thickness of all four walls at the site of the stricture, whereas the size of the
      thickest wall was taken as maximal esophageal wall thickness. Average esophageal
      wall thickness (8.52 +/- 0.61 mm; range, 5.4 to 13.5 mm) and maximal esophageal
      wall thickness (11.63 +/- 0.83 mm; range, 5.4 to 20 mm) were significantly higher
      in patients with corrosive esophageal strictures than normal esophageal wall
      thickness (2.70 +/- 0.04 mm, p < .01). These patients required a mean of 5.70 +/-
      1.42 sessions for achieving adequate dilation. Age, sex, grade of dysphagia, and
      cause and site of the stricture did not influence the number of sessions required
      for adequate dilation. On multivariate analysis, maximal esophageal wall
      thickness (p < .01) but not average esophageal wall thickness or stricture length
      was independently associated with the number of sessions required for adequate
      dilation. Patients with maximal esophageal wall thickness of 9 mm or more
      required a significantly higher number of sessions for adequate dilation than did
      those with wall thickness of less than 9 mm (7.57 +/- 1.80 versus 1.42 +/- 0.27,
      p < .05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789677
TI  - Randomized, prospective study of cyanoacrylate injection, sclerotherapy, or
      rubber band ligation for endoscopic hemostasis of bleeding canine gastric
      varices.
AB  - The purpose of this randomized, nonblinded study was to compare the
      effectiveness, safety, and technical ease of three different endoscopic
      techniques for the treatment of bleeding gastric varices in a canine model.
      Twenty dogs with large, bleeding gastric varices underwent endoscopic hemostasis
      with rubber band ligation, sclerotherapy, and cyanoacrylate injection. The time
      and number of attempts required to achieve definitive hemostasis were evaluated
      for each technique, and each method was assessed for ease of use. Ulceration
      rates, ulcer size and depth, and stigmata of ulcer hemorrhage were assessed at 1
      week. Intravariceal sclerotherapy was the fastest and easiest to perform. Rubber
      band ligation was intermediate in technical ease, but it caused the largest and
      deepest ulcers and had the highest rates of stigmata of ulcer hemorrhage and
      secondary bleeding. Cyanoacrylate injection was the most cumbersome endoscopic
      method to perform. All three treatments were effective for controlling gastric
      variceal bleeding. Intravariceal sclerotherapy had the most favorable results
      overall because of its technical ease, efficacy, and modest complication rates.

PMID- 7789678
TI  - Randomized, controlled study of various agents for endoscopic injection
      sclerotherapy of bleeding canine gastric varices.
AB  - The purpose of this study was to compare the relative efficacy and technical ease
      of use of eight different agents for endoscopic hemostasis and obliteration of
      bleeding gastric varices in a canine model, as no comparative data are available
      on gastric variceal sclerotherapy. Large bleeding gastric varices in 20
      heparinized dogs were randomized to endoscopic injection treatment with one of
      the following agents: cyanoacrylate; a 1:1:1 mixture of sodium tetradecyl sulfate
      3%, ethanol 98%, and normal saline solution; ethanolamine oleate 5%; sodium
      morrhuate 5%; sodium tetradecyl sulfate 1.5%; polidocanol 1%; normal saline
      solution with epinephrine 1:10,000; or normal saline solution (control). The
      number and volume of injections and the time required to achieve complete
      hemostasis were evaluated; follow-up endoscopy was performed at 1 month to assess
      gastric variceal obliteration. Cyanoacrylate was the best agent overall in terms
      of immediate efficacy, low volume requirement, time required for initial
      hemostasis, and reduction of gastric variceal size. Cyanoacrylate, tetradecyl
      sulfate, and polidocanol were the most effective agents for reducing gastric
      variceal size. Epinephrine was effective for controlling induced or secondary
      bleeding caused by puncture of the gastric varices with the sclerotherapy needle
      during intravariceal injections. Ongoing studies are evaluating combinations of
      agents with different mechanisms of action, such as epinephrine (for
      vasoconstriction to minimize secondary bleeding) plus alcohol, and/or tetradecyl
      sulfate (for variceal thrombosis and sclerosis).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789680
TI  - Infrared video imaging of subsurface vessels: a feasibility study for the
      endoscopic management of gastrointestinal bleeding.
AB  - The feasibility of infrared video imaging of subsurface vessels in the stomach
      was investigated both experimentally and in more detail using computer
      simulations of light propagation. Infrared video imaging was first attempted in
      several experimental situations. Images of a human arm illuminated with infrared
      light (wavelength > 700 nm) revealed subcutaneous venous structures not revealed
      by visible light (wavelength of 500 to 600 nm). An infrared-sensitive video
      endoscope was used to view both a human arm and normal stomach wall. Infrared
      illumination within the stomach enhanced only the larger subsurface vessels.
      Infrared transillumination of a rat skin flap window chamber allowed video
      recording of images during injection of an absorbing dye, indocyanine green, into
      the blood volume and showed that indocyanine green can enhance the contrast in
      infrared images of small vessels. Computer simulations of vessels of varying
      depths and sizes indicated successful detection was possible by infrared imaging.
      Computer simulations demonstrated that the shadow caused by an imaged subsurface
      vessel has two characteristics: (1) the central loss of reflectance, which
      indicates the size of the vessel, and (2) the full-width half-maximum of the
      reflectance loss, which indicates the depth of the vessel. The simulations
      further suggested that images of small vessels can be dramatically enhanced (68
      fold) by indocyanine green, which attenuates the transmittance of scattered light
      from behind the vessels to the surface for observation. On the other hand,
      indocyanine green enhances the contrast of large vessels to a lesser degree (2.6
      fold). The ultimate goal is to develop an endoscopic video imaging system capable
      of capturing reflected light from the stomach wall.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7789679
TI  - Evaluation of the effects of esophageal varicosclerosants on local vascular
      occlusion and systemic blood coagulation.
AB  - The efficacy and safety of the various sclerosants available for esophageal
      sclerotherapy have not been adequately investigated. In the present study, we
      experimentally evaluated the effects on local vascular occlusion and systemic
      blood coagulation of five sclerosants: 5% ethanolamine oleate, 99.5% ethanol, 2%
      aethoxysclerol, thrombin, and n-butyl-2-cyanoacrylate. The effects were tested
      after injection into the auricular vein of rabbits. Prothrombin time, activated
      partial thromboplastin time, plasma fibrinogen level, and peripheral blood
      platelet count were measured before injection and 5 minutes, 1 hour, 1 day, and 7
      days later. Histologic examinations were then made of the auricular vein, lungs,
      liver, spleen, and kidneys. In the initial period after injection of ethanol or
      thrombin, fibrinogen level and platelet count were significantly reduced. Except
      for thrombin, none of the drugs affected prothrombin time or partial
      thromboplastin time. Local thrombosis took place after the injection of
      ethanolamine oleate, ethanol, and aethoxysclerol, whereas thrombin injection did
      not result in local thrombosis or vascular occlusion. Cyanoacrylate produced no
      local thrombus formation but caused vascular occlusion. Over-dosing of thrombin
      and ethanol led to sudden death of animals. These findings suggest that it is
      necessary to assess further the safety of intravascular use of thrombin, that the
      other drugs seem to be usable, and that careful consideration should be given to
      the excess use of ethanol in clinical settings. The present animal model may be
      useful for evaluating various sclerosants, although findings may not be
      applicable to humans because of differences in vascular size.

PMID- 7789681
TI  - Endoscopic ultrasonography-guided fine-needle aspiration biopsy of lesions in the
      upper gastrointestinal tract.

PMID- 7789683
TI  - Simulated sphincterotomy in a pig model.

PMID- 7789684
TI  - Determining required stent length in endoscopic retrograde biliary stenting.

PMID- 7789682
TI  - The feasibility of three-dimensional endoscopic ultrasonography: a preliminary
      report.

PMID- 7789685
TI  - A sphincterotome with variable-length wire for easier endoscopic sphincterotomy
      and quicker biliary drainage.

PMID- 7789686
TI  - A tapered balloon with hydrophilic coating to dilate difficult hilar biliary
      strictures.

PMID- 7789687
TI  - Esophageal squamous papilloma associated with adenocarcinoma.

PMID- 7789690
TI  - Endoscopic features of mucosa-associated lymphoid tissue lymphoma of the
      duodenum.

PMID- 7789689
TI  - Malacoplakia of the colon.

PMID- 7789691
TI  - Ventricular asystole during upper gastrointestinal endoscopic electrocoagulation.

PMID- 7789692
TI  - Definitions, diagnoses, and documentation.

PMID- 7789688
TI  - Lymphangioma of the colon diagnosed with an endoscopic ultrasound probe and
      dynamic CT.

PMID- 7789693
TI  - Endoscopic therapy of bleeding varices: do studies in animal models give us the
      answers we need?

PMID- 7789694
TI  - Periodic exchange of biliary stents.

PMID- 7789695
TI  - Guillotining the polypectomy snare: a proposed method for avoiding this
      complication.

PMID- 7789696
TI  - Acute suppuration of the pancreatic duct.

PMID- 7789697
TI  - Infrared transillumination gastroscopy.

PMID- 7789698
TI  - Percutaneous cholecystolithotomy: is gall stone recurrence inevitable?

PMID- 7789699
TI  - Endosonographically guided fine-needle aspiration puncture of paraesophagogastric
      mass lesions: preliminary results.

PMID- 7789700
TI  - [Risk, odds and significance--from the jungle book of medical statistics].

PMID- 7789701
TI  - [Sterility--a women's issue?].

PMID- 7789702
TI  - [The burnout syndrome. Etiology, possibilities for detection and help for
      prevention].

PMID- 7789703
TI  - [Obstetrical management of prolonged pregnancy].

PMID- 7789704
TI  - [Age specific and age corrected mortality in gynecological carcinoma--including
      breast carcinoma].
AB  - Quality of life and life span are parameters which characterise a successful
      tumour diagnosis and therapy. We found out that the age-specific death rate and
      standardised death rate concerning gynaecological cancers and carcinoma of the
      breast in Bavaria increased and we compared different years. The standardized
      mortality ratio increased between 1977 and 1990 from 91 to about 108% Neither
      diagnostics using update equipment nor an individualised therapy improved the
      situation. The slightly increasing incidence rate does not explain the present
      rate of deaths in cancer. An important factor is the younger age and the
      endocrine situation of women at the time of the primary disease. 50% of our
      patients are less than 55 years old and pre- or perimenopausal. Estrogen-gestagen
      combinations used in contraceptives and hormone replacement therapy (HRS) seem to
      have a stimulating effect (Henderson). The significant decrease in cervical
      cancer is encouraging, but does not compensate the increase in breast cancer. No
      significant change is seen in ovarian cancer.

PMID- 7789705
TI  - [Multivariate analysis of clinico-pathologic predictors of axillary lymph node
      metastasis in invasive breast carcinoma].
AB  - The aim of this study was to find both predictors of axillary lymph node
      involvement and predictors of level II or III involvement. With these predictors
      patients should be selected who can be spared axillary lymph node dissection or
      who qualify for removal of only first-level lymph nodes. 239 consecutive patients
      with invasive breast cancer stage I-III treated with total axillary dissection
      were evaluated. In multiple logistic regression analysis 17 clinical and
      histopathological variables were included. We found 4 multivariate significant
      predictors for metastatic axillary involvement: Clinically positive axilla,
      peritumoural lymphatic vessel invasion, multicentric or multifocal tumours and a
      large number of past pregnancies. Multivariate significant predictors of
      involvement of level II or III were peritumoural lymphatic vessel invasion,
      younger age, larger tumour size, multicentric or multifocal tumours and
      postmenopausal patient. The metastatic involvement of more than 3 nodes was
      associated with young age and clinically positive axilla. With these easily
      available predictors a reliable assessment of risk of metastatic involvement of
      the upper levels of the axillary nodes could be defined. The binary logistic
      regression model to axillary node involvement had a rather unsatisfactory
      predictive value. CONCLUSIONS: The risk calculation of level II or III
      involvement with these predictors may help the surgeon to find the adequate
      extent of axillary clearance needed in the individual patient. Multiparity proved
      to be an independent predictor of metastatic axillary node involvement.

PMID- 7789706
TI  - [Prognostic differentiation of ovarian carcinomas by immunohistochemical analysis
      of estrogen receptor expression].
AB  - Analogous to breast cancer, the expression of estrogen receptors (ER) by human
      ovarian cancers is thought to be of prognostic significance. This prospective
      study was designed to evaluate the ability of immunohistochemistry (IHC) for ER
      to define prognostic subgroups in this disease and to possible characterize the
      group of patients that would benefit from ER analysis. The IHC technique for
      localising ER was published by Press and Green (1984). In IHC the percentage of
      cells stained was determined as well as the staining intensity that was graded on
      a 4 step scale. Tissue from the primary focus of 61 ovarian cancers was sampled
      during surgery and frozen immediately. FIGO Stage 1 disease was observed in 7
      patients, stage 2 in 2, stage 3 in 36 and stage 4 in 16 women. Tumours of
      histological grade 1 were found in 3 cases, grade 2 in 20 and grade 3 in 38
      specimen. Serous carcinoma was diagnosed in 43 lesions, mixed cell types in 10,
      mucinous and endometrioid each in 4. Minimal follow-up was 8 years. Statistical
      analysis was performed using the Wilcoxon Rank and Log-Rank test of Kaplan Meier
      curves. The median survival was 10.62 +/- 1.83 years for stage 1, 5.83 +/- 0.39
      years for stage 2, 2.38 +/- 0.39 years for stage 3, and 3.71 +/- 0.76 years for
      stage 4. Tumour stage (p < 0.05), grade (p < 0.05) and cell type (p < 0.01) were
      predictors of survival. Age was of borderline significance (p = 0.058). The
      relative amount of stained cells was no predictor of prognosis.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7789708
TI  - [Immune reactions and survival of patients with ovarian carcinomas after
      administration of 131I-F(Ab)2 fragments of the OC 125 monoclonal antibody].
AB  - The activation of the idiotypic network seems to be a beneficial approach to the
      immunological therapy of ovarian cancer. In a retrospective study 62 patients
      with ovarian carcinoma (of which 57 could be evaluated) received 1 mg of 131J
      F(Ab)2 OC 125 MAb one to five times after radical surgery and polychemotherapy.
      In twenty-eight patients (49%) a remarkable anti-idiotypic antibody (Ab2)
      response arose. The anti-idiotypic antibody (Ab2) plasma levels increased with
      increasing number of F(Ab)2 OC 125 MAb applications. The twenty patients (35%)
      who developed Ab2-concentrations > 10,000 U/ml had a significantly higher
      survival rate than the patients who showed weak (Ab2-concentrations < 10,000
      U/ml) or no immunological response to 131J-F(Ab)2 OC 125 MAb treatment (p <
      0.05).

PMID- 7789707
TI  - [Value of the TAG-72 (CA 72-4) tumor marker in primary diagnosis of ovarian
      carcinoma. A comparison with the established CA-125 marker].
AB  - The value of the TAG-72 (CA 72-4) serum marker in primary diagnosis was
      investigated in 110 patients with histologically diagnosed ovarian cancer. A
      reference group consisted of 103 patients with benign pelvic masses. Compared to
      the well-established CA-125, TAG-72 showed a low sensitivity of 42% in the
      detection of ovarian cancer. By contrast, when the cut-off level for TAG-72 was
      set at 6 U/ml, it showed a very high specificity of 99%. When the measurement of
      TAG-72 was combined to that of CA-125, improvements in both the specificity (as
      compared to a single CA-125 determination) and the sensitivity (as compared to a
      single TAG-72 assay) were observed. In such a combined assay, our results suggest
      that the best predictive value (positive and negative) was obtained if CA-125 is
      assigned a relatively high cut-off value (65 U/ml) in conjunction with a low cut
      off level (3.2 U/ml or 4 U/ml) for TAG-72. In the present study, at threshold
      values of 65 U/ml respectively, a sensitivity of 86%, a specificity of 83% and a
      positive and negative predictive value of 85% were obtained. In mucinous
      carcinomas of the ovary, however, the additional TAG-72 determination did not
      lead to a better predictive power than did CA-125 measurement alone.

PMID- 7789709
TI  - [Monitoring umbilical cord puncture and intravascular transfusions with Doppler
      ultrasound].
AB  - Complications of percutaneous umbilical blood samplings and intravascular
      transfusions can be detected rapidly, easily and efficiently by Doppler
      ultrasound and therefore the operator can react as early as possible. In addition
      to real-time sonography Doppler ultrasound allows for assessment of
      haemodynamical changes due to intravascular transfusions both on the venous and
      arterial side of umbilical perfusion. Because of immediate recognition of
      bradycardia and other fetal cardiac frequency alterations as well as increase of
      resistance to blood flow on the arterial side the operator can react promptly. On
      the venous side correct application of transfused volume is monitored
      continuously by changes of flow velocity waveforms during injection and allows to
      assess dislocation of the needle.

PMID- 7789710
TI  - [Doppler echocardiographic analysis of blood flow through the fetal aorta and
      pulmonary valve in the second half of pregnancy].
AB  - Pulsed Doppler velocimetry of the fetal aortic and pulmonary valves derived in
      the five-chamber-view and short-axis view were performed in 88 uncomplicated
      pregnancies between the 20th and 40th week of gestation. The maximal and mean
      velocities were assessed for both semilunar valves. Considering the valve
      diameters and heart rate the stroke volume and cardiac output for both ventricles
      were calculated. Furthermore, the common stroke volume, common cardiac output and
      the ratio of right to left cardiac output were calculated. Normal ranges for all
      these parameters were constructed and correlated with gestational age. The
      maximal velocities were higher in the aorta than in the pulmonary trunk, but no
      differences were found in the mean velocities. The stroke volume and cardiac
      output of the right ventricle were in higher ratio 1.3:1 than that of the left
      ventricle as an expression of the right ventricular dominance in the fetus.
      Intracardiac Doppler flow velocimetry gives an insight into the physiology of
      fetal circulation and is a basis for the analysis of blood flow under
      pathological conditions.

PMID- 7789711
TI  - [Prenatal management of fetofetal transfusion syndrome].
AB  - The twin-twin transfusion syndrome is a rare but severe complication in
      monozygotic twins. A total of 172 twin pregnancies were investigated in our
      hospital between January 1990 and August 1993. The patients were divided into 4
      groups: Group I: Normal twin pregnancy, treatment only in our hospital. Group II:
      Twin-twin transfusion syndrome, treatment only in our hospital. Group III: Normal
      twin pregnancy, delivery in another hospital. Group IV: Twin-twin transfusion
      syndrome, after treatment and therapy delivery in another hospital. These cases
      were analysed concerning prenatal management and perinatal outcome. The perinatal
      mortality rate in group I-IV was 17%, 58%, 18% and 60%, respectively. A benefit
      of aggressive amniocentesis in case of polyhydramnios, administration of digoxin
      and timing of labour could be demonstrated.

PMID- 7789712
TI  - [Preventive anti-D after massive fetomaternal hemorrhage].
AB  - In the 36th week of gestation intrauterine death of both twins occurred in a 31
      year old primigravida. The examination of the C- and the D-antigen of the
      mother's blood (result of previous testing: AB Rhesus negative) immediately
      before delivery showed a mixed field agglutination which pointed to a
      fetomaternal macrotransfusion. Fetal haemoglobin in the mother's circulation was
      7.8% of her total haemoglobin, so that a fetomaternal haemorrhage of about 440 ml
      whole blood had to be suspected. For Rhesus-prophylaxis 17 standard doses of anti
      D-immunoglobulin were administered intramuscularly distributed over 4 days. No
      adverse effects were seen; fetal haemoglobin dropped to 2.0% 5 days and to 0.1%
      15 days after the beginning of the treatment. A control examination after 9
      months showed no signs of a Rhesus-(D)-sensitisation of the patient.

PMID- 7789713
TI  - [Psammoma bodies in cytological vaginal smears in metastatic ovarian carcinoma].
AB  - The case of a 37-year old patient with ovarian cancer stage FIGO IV and vaginal
      metastasis is reported. The vaginal smear showed psammoma bodies, which are
      rarely found. The value of the diagnosis "psammoma bodies" is discussed, via a
      review of the literature.

PMID- 7789714
TI  - [Vaginal hemorrhage after hysterectomy].
AB  - We report on two cases of vaginal bleeding after hysterectomy. These patients
      suffered from cyclical therapy resistant vaginal bleeding and complaint in the
      lower abdomen. The final diagnosis and therapy of a vaginal cuff endometriosis
      made it possible to eliminate the persistent clinical symptoms. These cases show
      the need for a discussion on the necessity of a special operative procedure in
      case of endometriosis genitalis interna and externa.

PMID- 7789715
TI  - [An unusual case: vaginal foreign body (forceps) as an incidental finding during
      primary operation for breast cancer].
AB  - A 29 year-old patient was admitted for surgery because of two breast lumps. One
      of these was suspicious for malignancy by a mammogram and palpation. When her
      history was taken, the patient mentioned putrid vaginal discharge and denied any
      previous gynaecologic examination. After initial hesitancy, the patient agreed to
      have a pelvic examination. This revealed an oxydized iron rod protruding 2 cm out
      of the vagina. The object was identified by x-ray examination as one handle of
      iron forceps often used for cutting metal wires. The patient had been carrying
      this foreign body for fifteen years. She was not willing to relate any
      information about the cause of the manipulation or any eventual culprit. She was
      consistent and her personality was dominated by introverted behaviour. The
      foreign body was removed under the same anaesthesia as that used for the
      operation on the breast cancer.

PMID- 7789716
TI  - Dermatan sulfate as a potential therapeutic agent.
AB  - 1. Dermatan sulfate is a linear, sulfated polysaccharide and is a
      glycosaminoglycan component of several important proteoglycans. This minireview
      discusses the biosynthesis, structure and biological function of dermatan sulfate
      proteoglycans. 2. Dermatan sulfate and its derivatives are being investigated as
      a new class of anticoagulant and antithrombotic agents. 3. The preparation,
      chemistry and structure-activity relationship of dermatan sulfate is described.
      4. Dermatan sulfate, low molecular weight dermatan sulfate and glycosaminoglycan
      mixtures containing dermatan sulfate have been used clinically. 5. The future
      prospects of these agents and other new, potentially useful dermatan sulfate
      based therapeutics are discussed.

PMID- 7789717
TI  - The in vivo and in vitro protective properties of taurine.
AB  - 1. Taurine is a ubiquitous, free amino acid found in mammalian systems. 2. The
      biological functions of taurine are unclear. 3. Various in vivo data suggest that
      taurine has a variety of protective functions and deficiency leads to
      pathological changes. 4. Depletion in rats of taurine increases susceptibility to
      liver damage from carbon tetrachloride. 5. Susceptibility to a variety of
      hepatotoxicants correlates with the estimated hepatic taurine level. 6. In vitro
      data suggest that taurine can protect cells against toxic damage. 7. Taurine
      protects isolated hepatocytes against carbon tetrachloride, hydrazine and 1,4
      naphthoquinone but not against allyl alcohol, alpha-naphthylisothiocyanate (ANIT)
      or diaminodiphenyl methane (DAPM) cytotoxicity. 8. The mechanisms of protection
      are unclear but may include modulation of calcium levels, osmoregulation and
      membrane stabilization.

PMID- 7789718
TI  - Aspects of the thromboxane receptor system.
AB  - 1. The aim of this review is to establish what is known about the thromboxane
      (TP) receptor, and to identify where future research is headed. In addition, the
      impact of the recent advances at the molecular level on resolving pharmacological
      controversies, such as possible subtypes of the TP receptor, is discussed and
      what molecular information is known about the TP receptor presented. 2. The
      clinical status of TP receptor antagonists is considered particularly in relation
      to the potential role of epi prostaglandins. 3. Basic information about TP
      agonists, antagonists and signal transduction pathways is also given.

PMID- 7789719
TI  - Nitracrine and its congeners--an overview.
AB  - 1. An anticancer drug, nitracrine 1-nitro-9(3'3'
      dimethylaminopropylamino)acridine (Ledakrin, C-283) exhibits potent cytostatic
      effects which can be ascribed to interactions of the drug with DNA. 2. The
      reduction of the nitro group of nitracrine is one of the activation steps leading
      to the drug covalent binding to DNA and proteins both in subcellular systems and
      in the cell. 3. DNA-drug non-covalent interactions and covalent complexes are
      examined in several model systems and compared with the properties of a number of
      derivatives with programmed structural changes. 4. DNA-protein crosslinks and
      interstrand crosslinks are detected in the cells following exposition to the
      drug. 5. The drug exhibits selective toxicity and radiosensitization effects to
      hypoxic mammalian cells.

PMID- 7789721
TI  - Effects of chronic treatments with SM-9018, a potential atypical neuroleptic, on
      behavioral dopaminergic and serotonergic sensitivities in rats.
AB  - 1. Changes in behavioral dopaminergic and serotonergic sensitivities were studied
      in rats after withdrawal of the chronic treatments with SM-9018 (0.1 mg/kg/day),
      a potential atypical neuroleptic, and with haloperidol (0.3 mg/kg/day) using
      continuous infusion pumps. 2. Administration of SM-9018 inhibited the rat
      locomotor activities to an extent similar to that of haloperidol during the
      course of the 2 weeks treatment. 3. The incidence of the apomorphine-induced
      stereotyped behaviors (e.g., sniffing, chewing, licking and biting) was
      negligibly affected by SM-9018 treatment, but was markedly enhanced by
      haloperidol treatment. 4. The incidence of the 5-hydroxytryptophan-induced wet
      dog shakes and 8-hydroxy-2-(di-n-propyl-amino)tetralin-induced flat body posture
      was unaffected by either treatment with SM-9018 or haloperidol. 5. These findings
      suggest that SM-9018 is weaker than haloperidol in inducing the behavioral
      dopaminergic hypersensitivity after its chronic treatment and has a lower
      propensity to cause tardive dyskinesia.

PMID- 7789723
TI  - Taurine-induced hyperpolarizing shift of the reversal potential of the fast Na+
      current in embryonic chick cardiomyocytes.
AB  - 1. Effects of taurine on the reversal potential of Na+ channel (INa) in isolated
      17-day-old embryonic chick ventricular cardiomyocytes were examined using whole
      cell voltage clamp technique. Experiments were performed at room temperature (22
      degrees C). 2. Test pulses were applied between -60 and +50 mV from a holding
      potential of -90 mV. Addition of taurine (1-20 mM) to the bath solution inhibited
      the INa at -30 mV in a concentration-dependent manner; by 38.8 +/- 3.7% (n = 14,
      P < 0.01) at 10 mM and by 49.5 +/- 4.6% (n = 12, P < 0.001) at 20 mM. 3.
      Simultaneously, the reversal potential was shifted in the hyperpolarizing
      direction by 10.6 +/- 2.9 mV (n = 10, P < 0.05) at 10 mM and by 12.6 +/- 2.2 mV
      (n = 9, P < 0.01) at 20 mM. The shift was also produced concentration
      dependently. Even when taurine at low concentrations (1 and 5 mM) enhanced INa,
      the shift occurred. 4. Intracellular taurine level decreased in Langendorff
      perfused guinea-pig hearts with Ca(2+)- and Mg(2+)-free solution, but not with
      Ca(2+)-free and 20 mM Mg2+ solution. 5. These results indicate that taurine
      shifts the reversal potential of the INa due to Na(+)-taurine cotransport, which
      might play an important role for the cell functions.

PMID- 7789722
TI  - Inhibitory action of SKPYMRFamide on acetylcholine receptors of Helix aspersa
      neurons: role of second messengers.
AB  - 1. SKPYMRFamide, a novel FMRFamide-like endogenous peptide reversibly decreases
      excitatory responses (depolarization and inward current) evoked by local
      ionophoretic application of acetylcholine (ACh) onto the soma of identified
      neurons F1, F2, F4 and F5/6 of the land snail, Helix aspersa. 2. Threshold
      concentrations of SKPYMRFamide for an inhibitory action on ACh-induced responses
      are 0.5-1 mumoll-1. This modulatory action of peptide is dose- and time
      dependent. 3. It is concluded that SKPYMRFamide inhibits ACh receptors through
      activation of specific binding sites on the plasma membrane. 4. The possible role
      of different second messengers in the modulatory influence of SKPYMRFamide on ACh
      receptors was tested using 13 modulators of different second messenger systems.
      5. The results indicate that SKPYMRFamide may inhibit ACh receptors through
      activation of one or more of the following systems: phospholipases C, A2, NO
      synthase, soluble guanylate cyclase and lipoxygenases which elevate basal
      intracellulal levels of NO, cGMP, arachidonic acid, acyclic eicosanoids, inositol
      1,4,5-trisphosphate (I(1,4,5)P3), I(1,4,5)P3-dependent Ca(2+)-mobilization
      followed by activation of calmodulin and Ca2+/calmodulin-dependent protein kinase
      II. Protein kinases A, C and cyclic eicosanoids do not appear to participate in
      modulatory action of SKPYMRFamide.

PMID- 7789720
TI  - Dietary ginsenosides improve endothelium-dependent relaxation in the thoracic
      aorta of hypercholesterolemic rabbit.
AB  - 1. Endothelium-dependent relaxation to acetylcholine was impaired in aortic rings
      from cholesterol-fed rabbits as compared to rabbits fed with a control diet. 2.
      The dietary treatment of rabbits with ginsenosides did not affect endothelium
      dependent relaxation to acetylcholine but did effect the relaxation in
      cholesterol-fed rabbits. 3. Dietary treatment of rabbits with ginsenosides did
      not alter the relaxations to sodium nitroprusside and the contractions to
      norepinephrine in rings without endothelium from both control and cholesterol-fed
      rabbits. 4. Ginsenoside feeding had no significant effect on the plasma lipid
      levels in both control and cholesterol-fed rabbits. 5. These results suggest that
      dietary supplementation of rabbits with ginsenosides improve the endothelium
      dependent relaxation to acetylcholine in the aortic blood vessels in cholesterol
      fed rabbits. This beneficial effect of ginsenosides feeding cannot be explained
      by a facilitation of the cyclic GMP effector pathway in the smooth muscle or by
      an enhanced cholesterol metabolism but may involve an increased production of
      nitric oxide by endothelial cells.

PMID- 7789724
TI  - Chronic effects of azidothymidine and acyclovir on pregnant rats.
AB  - 1. The antiviral effect of azidothymidine (AZT) can be potentiated by acyclovir
      (ACV), and this drug association has been used in the management of HIV-infected
      patients. In the present study we examined the effects of such an association on
      rat pregnancy. 2. AZT (60 mg/kg b.w.) and ACV (60 mg/kg b.w.) were given to
      groups of pregnant rats once a day from the 1st to the 20th day of gestation. 3.
      Maternal body weight gain was severely affected by ACV; this effect was
      attenuated in rats treated with AZT+ACV and was virtually absent with AZT alone.
      4. The abortive action of ACV was markedly diminished in the group treated with
      the association AZT+ACV. 5. The deleterious effects of ACV on rat pregnancy are
      presumably due to its extraplacental actions, and these are, at least in part,
      counteracted by concomitant treatment with AZT.

PMID- 7789726
TI  - Effect of nifedipine treatment (imprinting) of rat feti and newborns on the
      responsiveness of adult rat's uterus. Extension of the imprinting theory.
AB  - 1. The uterus of adult progeny of rats treated with nifedipine during the late
      phase of pregnancy react in vitro to oxytocin less and the contractility of ones
      treated with higher dose (100 micrograms) disappears. 2. There is a more
      pronounced deficiency or lack of responsiveness in five week old animals treated
      with nifedipine neonatally. 3. The experiments demonstrate that perinatal
      imprinting can be developed not only on hormone receptors and enzymes but on ion
      (Ca2+) channels of the plasma membrane. Consideration of this fact might have an
      importance in clinical aspects too.

PMID- 7789725
TI  - Effects of alpha,beta-unsaturated sulphones and phosphonium salts on ecto-ATPase
      activity and contractile responses mediated via P2 chi-purinoceptors.
AB  - 1. In the guinea-pig urinary bladder and vas deferens, several alpha,beta
      unsaturated sulphones and phosphonium salts that were tested inhibited ecto
      ATPase activity. The sulphones were more active in the bladder but the
      phosphonium salts were more effective in the vas deferens. 2. These compounds
      either potentiated or inhibited purinergic contractile responses in the guinea
      pig urinary bladder and vas deferens. 3. alpha,beta-Unsaturated sulphones and
      phosphonium salts represent a new promising class of compounds, capable of
      modulating purinergic neurotransmission.

PMID- 7789727
TI  - Effect of etofibrate on bile production in the normolipidemic rat.
AB  - 1. The effect of etofibrate, the ethandiol-1,2 diester of nicotinic and clofibric
      acids on bile production was studied in male rats that received a daily dose of
      300 mg of etofibrate/kg body weight by stomach tube for 10 days and were compared
      with control rats receiving the medium. 2. The bile duct was cannulated, animals
      were intravenously given 1 microCi (4-14C)-cholesterol/100 b.w. and bile was
      collected at different intervals for a total of 4 hr. 3. Etofibrate treatment
      decreased plasma cholesterol and triglyceride concentrations and increased the
      bile flow. The cummulative amount of both bile volume and total bile
      radioactivity secreted increased linearly in all the animals; the respective
      slopes being higher in etofibrate treated rats than in controls. 4. The main
      labelled component found in the bile was always bile acids rather than
      cholesterol and the proportion of each of these compounds was similar in both
      groups. Neither was any difference between the groups found in the concentration
      of bile acids, cholesterol and phospholipids nor in the
      cholesterol/(bile+phospholipid) ratio. 5. Besides other factors, the present
      results indicate that an increase in bile flow and biliary cholesterol excretion
      in its free form and after its conversion into bile acids should contribute to
      the hypocholesterolemic effect of etofibrate.

PMID- 7789728
TI  - 5-HT receptors on identified Lymnaea neurones in culture: pharmacological
      characterization of 5-HT3 receptors.
AB  - 1. The selective agonist, 1-(m-chlorophenyl)-biguanide (m-CPBG) and antagonist, 3
      tropanyl-3,5-dichlorobenzoate (MDL 72222) were used to characterize the 5-HT3
      receptors in cultured identified neurones; the serotonin-containing cerebral
      giant cells (CGCs) and some follower neurones in the buccal ganglia of Lymnaea
      stagnalis. 2. 5-HT and its agonists were pressure ejected, while the 5-HT
      antagonists were bath applied. 3. Although m-CPBG evoked mostly depolarizing
      responses, hyperpolarizing responses were sometimes evoked. 4. At 10(-4) M, m
      CPBG failed to mimic the responses of 5-HT, but at a concentration higher, 10(-3)
      M, pressure-ejected m-CPBG mimicked most 5-HT responses. 5. The 5-HT2 antagonist
      ketanserin failed to block the m-CPBG-evoked responses, whilst partially blocking
      the 5-HT responses. 6. These results suggest the presence of 5-HT3 receptors
      similar to those found in mammalian neurones, and that multiple subtypes of these
      receptors may be present in Lymnaea neurones.

PMID- 7789729
TI  - Barium enhances the excitability of a motoneurone from the cockroach (Periplaneta
      americana).
AB  - 1. An isolated ganglion preparation was used to investigate the effects of barium
      ions (Ba2+) on excitability of the soma of the 'fast' coxal depressor motoneurone
      (Df) from the cockroach Periplaneta americana. 2. Under current-clamp, short (50
      ms) depolarising pulses applied to the soma of Df elicited damped membrane
      oscillations in normal external solution. In the presence of 10 mM Ba2+, similar
      pulses produced all-or-none action potentials (n = 12). 3. Under voltage-clamp,
      addition of Ba2+ to the external solution suppressed the Ca-dependent K+
      conductance (IC) in Df (n = 4). 4. Modulation of IC may offer a means of altering
      the excitability, and therefore output, of motoneurone Df.

PMID- 7789730
TI  - A non-invasive method for distinguishing central from peripheral nervous system
      effect of respiratory depressant drugs in conscious rats.
AB  - 1. A simple, non-invasive method for distinguishing the central from peripheral
      effects of respiratory depressant drugs was developed in conscious rats. 2. The
      procedure involves exposing rats for 5 min to an air mixture containing 8% CO2
      (central stimulant) followed by an i.v. bolus injection of 300 micrograms/kg
      sodium cyanide (peripheral stimulant) and comparing the changes in minute volume
      and mean inspiratory flow (respiratory drive) before and after drug treatment. 3.
      The central depressant drugs morphine, xylazine, L-2-phenylisopropyladenosine (L
      PIA) and gamma-hydroxybutyric acid. (GHBA) inhibited the CO2-induced increase in
      minute volume and enhanced the sodium cyanide-induced increase in mean
      inspiratory flow. 4. Peripheral depression produced by carotid body denervation
      had no effect on the CO2-induced increase in minute volume and inhibited the
      sodium cyanide-induced increase in mean inspiratory flow.

PMID- 7789731
TI  - Effect of prostaglandins on tyrosylprotein sulfotransferase activity in rat
      submandibular salivary glands.
AB  - 1. Tyrosylprotein sulfotransferase (TPST) is a key enzyme in the processing of
      several secretory proteins, including those found in saliva. In this report, the
      effect of prostaglandins (PG) on TPST activity in submandibular salivary gland
      was investigated. 2. The results revealed that PGE2 exhibited TPST stimulatory
      activity with a 1.5-fold stimulation at 100 microM concentration and a half
      maximal stimulation at 50 microM. The PGE2 stimulation was accompanied by an
      increase in the affinity of TPST towards sulfate acceptor (Km 1.4 microM-->0.12
      microM) with little change in Vmax. 3. The TPST activity was also stimulated by
      two other major prostaglandins of salivary glands, PGF2 alpha and 6-Keto-PGF 1
      alpha, however to lesser extent, 22 and 23%, respectively. Arachidonic acid, an
      intermediate prostaglandin precursor, had no effect on TPST activity. 4. The
      results suggest that prostaglandins and in particular PGE2 may play a role in the
      regulation of TPST catalyzed secretory protein tyrosine sulfation in salivary
      glands.

PMID- 7789732
TI  - Role of T-type Ca2+ channel inhibitors in the pacemaker depolarization in rabbit
      sino-atrial nodal cells.
AB  - 1. Effects of T-type Ca2+ channel inhibitors, Ni2+ and tetramethrin, on the
      spontaneous action potentials in rabbit sino-atrial nodal cells were examined. 2.
      The firing rate of spontaneous activity was 201 +/- 11 beats/min (n = 18).
      Experiments were performed at 36 degrees C. 3. Ni2+ (10(-5) to 10(-4) M) and
      tetramethrin (10(-7) to 5 x 10(-5) M) caused a negative chronotropic effect. Both
      inhibitors did not affect the maximum diastolic potential, and slowed the rate of
      depolarization during the diastole. 4. In the presence of TTX (10(-7) M), both
      inhibitors caused a stronger negative chronotropic effect, and hyperpolarized the
      maximum diastolic potential. The maximum rate of depolarization was enhanced, and
      the action potential duration (at 50% repolarization) was prolonged. The action
      potential amplitude was unaffected. Ni2+ had more potent actions than
      tetramethrin. 5. T-type and other Ca2+ channel inhibitors affected only the late
      phase of pacemaker potential, resulting in a negative chronotropic effect. 6.
      These results indicate that T-type Ca2+ channel inhibitors (Ni2+ and
      tetramethrin) slow the pacemaker depolarization at the late phase (but not at the
      initial phase), resulting in a negative chronotropic effect in the sino-atrial
      nodal cells.

PMID- 7789733
TI  - Diazoxide blocks the morphine induced lengthening of action potential duration on
      guinea-pig papillary muscle.
AB  - 1. Intracellular microelectrodes were used to evaluate the possible involvement
      of potassium currents in the action potential prolongation induced by morphine.
      To this purpose we investigated the electrophysiological effect of morphine on
      the isolated guinea pig right ventricular papillary muscle in the presence of the
      potassium channel opener and inhibitor diazoxide and glibenclamide respectively.
      2. Diazoxide (1 microM), which is devoid of effect on its own, blocks the
      lengthening of action potential duration (APD) induced by morphine (5 mM). 3.
      However, in the presence of glibenclamide (1 microM), morphine (5 mM) prolonged
      APD in approximately the same proportion as that observed when used alone. 4.
      These results suggest that diazoxide but not glibenclamide sensitive potassium
      channels could mediate the APD prolongation induced by morphine.

PMID- 7789734
TI  - The effects of veratridine and BDF 9148 on the action potentials and
      contractility of the rat right ventricle.
AB  - 1. The effects of veratridine, BDF 9148 and lignocaine on the action potentials
      and contractile force of the electrically-driven rat right ventricle have been
      determined. 2. Veratridine at 10(-7)-10(-6) M and BDF 9148 at 10(-7)-10(-5) M had
      no effect on the threshold potential or amplitude but prolonged the ventricular
      action potentials. 3. In contractility studies, veratridine at 10(-7)-10(-6) M
      augmented the cardiac stimulation responses and the augmenting effects with 3 x
      10(-7) and 10(-6) M were greater at 2 than 4 Hz. In the presence of veratridine
      at 3 x 10(-6) M, the ventricle would not pace. 4. BDF 9148 at 10(-7)-10(-5) M
      augmented the cardiac stimulation responses and the augmenting effects with 10(
      7) and 3 x 10(-7) M were greater at 2 than 4 Hz and the effect was maximal at 3 x
      10(-7) M and submaximal at 10(-5) M. The effects of BDF 9148 at 10(-5) were not
      readily reversible. 5. Lignocaine at 10(-4) M had no effect on the ventricular
      action potential duration but decreased the threshold potential and amplitude and
      also reduced the cardiac stimulation force responses. In the presence of
      lignocaine, the augmenting effects of veratridine and BDF 9148 on ventricular
      force were reduced. 6. In summary this study has shown that BDF 9148 prolongs the
      action potential and augments the contractile force responses of the rat right
      ventricle by a lignocaine-sensitive mechanism. BDF 9148 or similar drugs may have
      potential as positive inotropes in the treatment of heart failure.

PMID- 7789735
TI  - Effects of different inotropes with antioxidant properties on acute regional
      myocardial ischemia in isolated rabbit hearts.
AB  - 1. The antiischemic properties of the flavonoids acetylvitexin-rhamnoside (AVR)
      and luteolin-7-glucoside-(LUT), combining phosphodiesterase (PDE)-inhibitory and
      antioxidant properties, were studied in comparison to amrinone (AMR) or
      superoxide dismutase (SOD). The effects of the new dihydropyridine-type calcium
      agonist Bay T 5006 were studied in comparison to Bay K 8644. 2. In isolated
      Langendorff-rabbit hearts perfused at constant pressure, acute regional ischemia
      (MI) was induced by coronary artery occlusion (CAO) and quantitated from
      epicardial NADH-fluorescence photography. Drugs were applied either before or
      after CAO (pre-treatment or treatment) to permit distinguishing the influence of
      functional and direct cytoprotective actions in the poorly collateralized rabbit
      hearts. 3. SOD did not affect left ventricular pressure (LVP) or coronary flow
      (CF) and reduced MI only if applied before CAO. LVP and CF were enhanced by LUT
      or AMR but not by AVR. MI was reduced to a similar extent in hearts treated with
      either drug. Cardioprotection by LUT was not improved by starting drug
      application before CAO. 4. Bay K 8644 reduced LVP and particularly CF, whereas
      Bay T 5006 did not affect functional parameters. MI was enlarged by Bay K 8644
      and remained unaffected by treatment or pretreatment with Bay T 5006. 5. AMR, LUT
      and AVR possess antiischemic properties related to an improvement of myocardial
      perfusion. Although oxygen free radicals contribute to ischemic tissue injury, as
      shown by the cardioprotective effectiveness of SOD, antioxidant properties of the
      flavonoids LUT and AVR do not seem to be relevant for the antiischemic effects.
      Our findings also give no evidence for antioxidant properties of dihydropyridines
      relevant for cardioprotection.

PMID- 7789736
TI  - Lipid peroxidation and antioxidant enzyme activity in aspirin-treated rats.
AB  - 1. Malondialdehyde formation and antioxidant enzyme activity after oral or
      intraperitoneal treatment of rats with various doses of aspirin was studied. 2.
      Aspirin, orally, had no effect on spontaneous, Fe(II)- or Fe(II)/ascorbate
      induced malondialdehyde formation in liver homogenates; orally, ascorbate-induced
      malondialdehyde production was inhibited but only after 5-day treatment with 500
      mg/kg aspirin; after intraperitoneal injection, the drug inhibited ascorbate- and
      Fe(II)/ascorbate-induced production of malondialdehyde. 3. Aspirin had no effect
      on malondialdehyde formation in erythrocytes, irrespective of the dose and route
      of drug administration. 4. Aspirin increased glutathione peroxidase activity in
      liver after 5-day treatment with an oral dose of 500 mg/kg and decreased enzyme
      activity in both liver and erythrocytes, 24 hr after a single injection of the
      same dose. 5. Aspirin, in vivo slightly affected lipid peroxidation and
      antioxidant enzyme activity.

PMID- 7789739
TI  - Different calcium dependencies of contractile activity of prostatic and
      epididymal portions of rat vas deferens.
AB  - 1. The effects of some organic calcium entry blockers and different
      concentrations of extracellular calcium on electrically-evoked contractions of
      isolated epididymal and prostatic portions of rat vas deferens were investigated.
      2. Both epididymal and prostatic parts of rat vas deferens responded to single
      pulse or train electrical field stimulation, with twitch contractions of
      submaximal amplitude. 3. Verapamil showed a biphasic action on the contractions
      produced by single pulse electrical stimulation. In concentrations < 10(-5) M, it
      potentiated the responses of both portions, but at higher concentrations, the
      excitatory action was overcome by a concentration-dependent inhibitory effect. 4.
      Nifedipine reduced the amplitude of electrically-evoked contractions of both
      portions in a concentration-dependent manner. The ED50 of nifedipine was 3.6 x
      10(-8) M and 2.1 x 10(-6) M in prostatic and epididymal portions, respectively.
      5. Dantrolene sodium reduced the amplitude of electrically-evoked contractions of
      both portions in a concentration-dependent manner. The ED50 of dantrolene was
      1.55 x 10(-4) M and 9.1 x 10(-4) M in prostatic and epididymal portions,
      respectively. 6. Reduction of Ca2+ concentration in medium reduced the amplitude
      of contractions of both portions significantly. This calcium dependence was more
      apparent in low frequencies of electrical stimulation.

PMID- 7789738
TI  - Studies on protective effect of Cyperus scariosus extract on acetaminophen and
      CCl4-induced hepatotoxicity.
AB  - 1. The hepatoprotective activity of aqueous-methanolic extract of Cyperus
      scariosus (Cyperaceae) was investigated against acetaminophen and CCl4-induced
      hepatic damage. 2. Acetaminophen produced 100% mortality at a dose of 1 g/kg in
      mice while pretreatment of animals with plant extract (500 mg/kg) reduced the
      death rate to 30%. 3. Acetaminophen at a dose of 640 mg/kg produced liver damage
      in rats as manifested by the rise in serum levels of alkaline phosphatase (ALP),
      glutamate oxaloacetate transaminase (GOT) and glutamate pyruvate transaminase
      (GPT) to 430 +/- 68, 867 +/- 305 and 732 +/- 212 IU/l (n = 10) respectively,
      compared to respective control values of 202 +/- 36, 59 +/- 14 and 38 +/- 7. 4.
      Pretreatment of rats with plant extract (500 mg/kg) significantly lowered (P <
      0.05) the respective serum ALP; GOT and GPT levels to 192 +/- 31, 63 +/- 9 and 35
      +/- 8. 5. The hepatotoxic dose of CCl4 (1.5 ml/kg; orally) raised serum ALP, GOT
      and GPT levels to 328 +/- 30, 493 +/- 102 and 357 +/- 109 IU/l (n = 10)
      respectively, compared to respective control values of 177 +/- 21, 106 +/- 15 and
      47 +/- 12. 6. The same dose of plant extract (500 mg/kg) was able to
      significantly prevent (P < 0.05) CCl4-induced rise in serum enzymes and the
      estimated values of ALP, GOT and GPT were 220 +/- 30, 207 +/- 95 and 75 +/- 38,
      respectively. 7. The plant extract also prevented CCl4-induced prolongation in
      pentobarbital sleeping time confirming hepatoprotectivity.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7789737
TI  - 3-(3-Hydroxyphenyl)-N-(1-propyl)piperidine elicits convulsant effects in mice.
AB  - 1. The behaviour and EEG effects of the dopamine and sigma (sigma) ligands (+) 3
      (3-hydroxyphenyl)-N-(1-propyl)piperidine ((+)3-PPP) were studied in mice. 2. (+)
      3-PPP dose-dependently (60-100 mg/kg i.p.) produced behavioural and electrical
      tonic-clonic seizures. 3. The incidence of the tonic seizures elicited by 100
      mg/kg of the drug was significantly (P < 0.05) prevented by spiperone (0.5 mg/kg
      i.p.) and haloperidol (0.5 mg/kg i.p.). 4. The results show an influence on the
      behavioural and electrical threshold of convulsions by (+) 3-PPP depending on a
      prevalent interference on dopamine receptors.

PMID- 7789740
TI  - Analgesic effect of two calcitonins and in vitro interaction with opioids.
AB  - 1. When the analgesic effect of salmon-calcitonin (S-CT) and of eel-calcitonin (E
      CT), as well as their influence on the morphine-analgesia were compared, no
      significant differences were found. 2. While on isolated tissues, E-CT induced a
      significant increase on the effect of bremazocine, [D-Pen2,D-Pen5]enkephalin and
      [Met5]enkephalin and no changes were observed on the effect of DAMGO, suggesting
      that E-CT increases the effects of opioids acting on delta or kappa receptors but
      not on mu receptors. 3. These findings corroborate the possibility of
      interactions between calcitonin and the opioid system.

PMID- 7789741
TI  - Renal failure during acute toxicity produced by tullidora ingestion (Karwinskia
      humboldtiana).
AB  - 1. Acute effects of Karwinskia humboldtiana (Kh) were studied in some renal
      functions and structural patterns of renal tissue. 2. Haemodynamic changes were
      observed with decrements of the glomerular filtration rate, renal plasma flow and
      filtration fraction during acute intoxication. 3. A marked increment in the
      fractional excretion of sodium was observed in the rats treated with tullidora
      fruits (Kh). 4. Cloudy swelling and hydropic degeneration was seen 72 hr after
      intoxication, mainly in the proximal convoluted tubules.

PMID- 7789743
TI  - Preliminary evidence of a synergistic alpha 1- and beta 1-adrenoceptor regulation
      of rat pineal hydroxyindole-O-methyltransferase.
AB  - The activity of serotonin N-acetyltransferase in the rat pineal is regulated
      through a synergistic action of norepinephrine on alpha 1- and beta 1
      adrenoceptors. Rat pineal hydroxyindole-O-methyltransferase (HIOMT) activity is
      also responsive to the beta 1-adrenoceptor, while melatonin synthesis and
      indoleamine release in certain species is apparently under alpha 1-adrenoceptor
      control. The present study reports that the simultaneous administration of
      doxazosin (a selective alpha 1-adrenergic antagonist) and metoprolol (a selective
      beta 1-adrenergic antagonist) reduces peak HIOMT activity significantly more than
      either agent alone, indicating that rat pineal HIOMT is also subject to
      synergistic alpha 1- and beta 1-adrenergic regulation. The relationship between
      alpha 1-adrenoceptor stimulation, serotonin release, and HIOMT activity is
      considered, following the observation that nocturnal HIOMT activity is elevated
      in serotonin-depleted pineal glands.

PMID- 7789742
TI  - Ethane 1,2-dimethane sulfonate effects on the testis of the lizard, Podarcis s.
      sicula Raf: morphological and hormonal changes.
AB  - Ethane 1,2-dimethane sulfonate (EDS) destroys Leydig cells in the testis of some
      rodents (mice excluded), disrupts interstitial and germinal compartments in the
      frog, Rana esculenta, while it stimulates testicular activity in the teleost,
      Gobius paganellus. In the Japanese quail the toxin removes mature spermatozoa.
      There is no information on EDS effects in reptiles. The present study examines
      the effect of EDS treatment in the lizard Podarcis s. sicula Raf during two
      different periods of the testicular cycle (winter stasis and breeding season).
      Animals received a single EDS injection (100 mg/kg body wt) and were sacrificed
      at 0 and 24 hr and 3, 5, 7, 11, and 28 days after injection. Androgens were
      measured in plasma and right testes, while left testes were examined
      histologically. Plasma androgen levels decreased 5-7 days after EDS injection,
      alongside interstitial tissue destruction and mast cell appearance, with slight
      but significant increases on Days 11 and 28. Testicular androgen levels did not
      change. On Day 11 metaphases were present in the interstitial tissue which
      regenerated on Day 28. Between Days 5 and 7 some pycnotic nuclei of spermatocytes
      appeared, mitotic activity of spermatogonia was normal, but germ cell stages were
      disorganized and empty spaces appeared at the boundary of the tubule. These data
      show that a single EDS injection results in destruction and repopulation of the
      interstitial cells in a reptile. Moreover, the effects of EDS in the lizard
      suggest that P. s. sicula Raf testis responds to the toxin in a similar fashion
      to the rat testis.

PMID- 7789744
TI  - Gonadotropin-releasing activities of the three native forms of gonadotropin
      releasing hormone present in the brain of gilthead seabream, Sparus aurata.
AB  - Three forms of gonadotropin-releasing hormone (GnRH) have been recently
      identified in the brain of gilthead seabream (Sparus aurata): salmon GnRH
      (sGnRH), chicken GnRH-II (cGnRH-II), and a novel form, Ser8-mammalian GnRH, named
      seabream GnRH (sbGnRH). sbGnRH is the most abundant form in the pituitaries of
      sexually mature seabream during the spawning season. The present study
      investigated the gonadotropin-releasing activities of the three native forms of
      GnRH found in seabream brains, as well as of two structural analogs of sbGnRH.
      All native forms of GnRH stimulated gonadotropin-II (GtH-II) secretion in
      preovulatory female seabream. cGnRH-II was found to be 7 to 8 times more potent
      than sbGnRH and 2 times more potent than sGnRH in inducing GtH-II release. sGnRH
      was found to be 3.5 to 5 times more potent than sbGnRH in inducing GtH-II
      secretion. These data demonstrate that cGnRH-II, which is not present in
      pituitaries of sexually mature seabream, is the most potent GtH-II releaser,
      whereas sbGnRH, 500 times more abundant than sGnRH in the pituitary of maturing
      fish, is the least potent. The lower potency of sbGnRH may suggest faster
      enzymatic breakdown, more rapid clearance from the circulation, or a lower
      binding affinity to the pituitary GnRH receptor. The lower bioactivity of sbGnRH
      may be compensated for by its high levels in the pituitary. The two analogs of
      sbGnRH, [D-Nal(2)6,Pro9-NEt]-sbGnRH and [D-Arg6,Pro9-NEt]-sbGnRH, were equipotent
      to each other and 5 times more potent than sbGnRH in inducing GtH-II release in
      preovulatory seabream. However, they were 5 to 6 times less active than the
      analog of mammalian GnRH, [D-Ala6,Pro9-NEt]-mGnRH. Strategies for designing
      superactive analogs of sbGnRH are discussed.

PMID- 7789745
TI  - The occurrence and distribution of GnRH in the brain of Atlantic hagfish, an
      agnatha, determined by chromatography and immunocytochemistry.
AB  - In Atlantic hagfish (Myxine glutinosa), chromatographic and immunocytochemical
      evidence showed that the brain contains a gonadotropin-releasing hormone (GnRH)
      like molecule that is closely related to lamprey GnRH-III. The chromatographic
      studies (HPLC) used specific antisera directed against mammalian GnRH and lamprey
      GnRH-I. In addition to these antisera, other specific antisera were tested in
      immunocytochemical studies, including chicken GnRH-I, chicken-GnRH-II, salmon
      GnRH, and lamprey GnRH-III. Using a lamprey GnRH-I antiserum, an early eluting
      GnRH form coeluted on HPLC with lamprey GnRH-III standard and an unknown form
      coeluted with the chicken GnRH-II standard. Radioimmunoassay of brain tissue
      detected GnRH immunoreactivity only when the lamprey GnRH-I antibody was used. A
      GnRH-like immunoreactivity was also obtained immunocytochemically in the
      neurohypophysis with the use of antisera against chicken GnRH-II, salmon GnRH,
      lamprey GnRH-I, and lamprey GnRH-III. These studies indicate that, contrary to
      earlier reports, hagfish do have a GnRH-like molecule that is more closely
      related, in terms of immunological determinants, to lamprey GnRH-III than to
      other currently known vertebrate GnRH molecules.

PMID- 7789746
TI  - Effect of induced metamorphosis on the immune system of the axolotl, Ambystoma
      mexicanum.
AB  - Metamorphosis was induced in neotenic axolotls by immersion of the animals in a
      solution of thyroid hormone. Hematology of the axolotls was examined before,
      during, and after metamorphosis. There was a transient decrease in numbers of
      certain white blood cells during metamorphic climax and a permanent shift in the
      pattern of circulating cells. The eosinophilic granulocyte was the dominating
      leukocyte type in neotenes and in metamorphosing animals up to midclimax.
      Lymphocytes and neutrophilic granulocytes (polymorphs) significantly decreased
      during midclimax. In postmetamorphic axolotls, lymphocytes and polymorphs
      predominated. The observed decrease of some leukocytes in metamorphosing animals
      accords with a transient immunosuppression at metamorphic climax. Metamorphosed
      axolotls showed a humoral immune response (increase in circulating plasma cells)
      after repeated antigen challenge, whereas neotenic axolotls did not. Alterations
      in both cellular and humoral immunity are suggested to occur in both young and
      adult axolotls following experimental induction of metamorphosis.

PMID- 7789747
TI  - Effects of prolactin and fish pituitary extract on plasma calcium levels in
      common carp, Cyprinus carpio.
AB  - The effects of prolactin (PRL) from both mammalian and piscine sources on plasma
      calcium levels in common carp, Cyprinus carpio, were investigated. Injections of
      ovine prolactin (oPRL) or homologous fish pituitary extract or partially purified
      prolactin of murrel, Channa punctatus pituitary (mPRL), caused significant
      increases in total and ultrafiltrable plasma calcium. Larger hypercalcemic
      responses were observed in fish kept in high-calcium fresh water and normal tap
      water than in fish in low-calcium fresh water. Injections of oPRL caused dose
      dependent increases in plasma calcium level. The highest dose (1 mg/kg body wt)
      of oPRL had a reduced hypercalcemic effect. Administration of EGTA (200 microM/kg
      body wt) reduced the stimulatory effects of daily injections of oPRL or mPRL on
      plasma calcium in freshwater common carp under laboratory conditions. These
      results indicate that PRL may be involved in regulating plasma calcium levels in
      fish.

PMID- 7789748
TI  - Timed daily administrations of hormones and antagonists of neuroendocrine
      receptors alter day-night rhythms of allograft rejection in the gulf killifish,
      Fundulus grandis.
AB  - Immune activity during scale allograft rejection, measured by melanophore
      destruction, is two to three times greater at night (12-hr scotophases) than
      during the day (12-hr photophases) in gulf killifish (Fundulus grandis). In the
      present study of killifish, hormones and antagonists of neuroendocrine receptors
      were administered daily at 0800 or 2000 hr during either 12-hr photoperiods
      (light onset: 0800 hr) or continuous light to examine possible neuroendocrine
      regulation of the allograft rejection rhythm. Immune activity peaked 0-12 hr
      after the time of daily growth hormone injections (0800 or 2000 hr) in fish held
      under continuous light and examined twice daily (0800 and 2000 hr) for
      melanophore breakdown. Immune activity peaked 12-24 hr after the time of day when
      cortisol-supplemented meals were provided (light onset or light offset) whether
      fish were treated throughout the days of melanophore examinations or pretreated
      for 3 days only prior to melanophore examinations. Daily rhythms of immune
      activity were not observed in fish treated with propranolol or naloxone at light
      offset only, growth hormone or atropine at light onset only, or prolactin at
      either light onset or light offset; these timed-treatments also reduced
      (prolactin or growth hormone) or prolonged (propranolol or naloxone) the length
      of time needed to destroy all melanophores within an allograft compared with
      controls. These results demonstrate that neuroendocrine factors can modulate a
      daily rhythm of immune function in fish.

PMID- 7789749
TI  - Estrogen downregulation of albumin and a 170-kDa serum protein in the turtle,
      Trachemys scripta.
AB  - We examined changes in serum protein composition after estradiol-17 beta
      treatment of ovariectomized female Trachemys scripta, with the objective of
      identifying proteins that are repressed by estrogen. The experimental protocol
      was validated by measuring serum estradiol-17 beta levels with a specific
      radioimmunoassay. Control turtle sera contained little or no estradiol-17 beta
      (mean = 25.8 pg/ml) while estrogen-treated turtle sera had elevated estradiol-17
      beta levels (mean = 333.3 pg/ml). Estrogen treatment resulted in a significant
      increase in serum protein concentration. The increase was due largely to a 213
      kDa protein that was abundant in estrogen-treated animal sera but was low or
      absent in control animal sera. This protein was identified as vitellogenin based
      on its biochemical characteristics (molecular weight, elution profile from DEAE,
      precipitation in the presence of Mg2+/EDTA). Several proteins were decreased in
      the sera of estrogen-treated animals. One of these had a molecular weight of 66
      kDa and was determined to be serum albumin. This protein crossreacted in Western
      blot analyses with polyclonal antisera against chicken and human serum albumins.
      Also, amino acid sequence analysis revealed substantial homology between the 66
      kDa turtle protein and serum albumins from other vertebrate species. Another
      protein decreased by estrogen treatment had a molecular weight of 170 kDa. Both
      albumin and the 170-kDa protein were reduced in estrogen-treated turtles to
      levels about 50% of those present in control turtles. Using [35S]methionine
      labeling and denaturing (SDS) polyacrylamide gel electrophoresis, we detected the
      presence of newly labeled albumin and the 170-kDa protein in T. scripta liver
      cube cultures, indicating that these proteins are derived from the liver. Data
      from this study reveal that estrogen downregulates several serum proteins in T.
      scripta, while upregulating serum vitellogenin. The response to estrogen in this
      reptile is similar to that in the amphibian Xenopus laevis, suggesting that
      estrogen downregulation of serum proteins during vitellogenesis may be widespread
      among oviparous vertebrates.

PMID- 7789751
TI  - Serum steroid hormones and the reproductive cycle of the female bonnethead shark,
      Sphyrna tiburo.
AB  - The bonnethead shark Sphyrna tiburo reproduces by placental viviparity with one
      of the shortest gestation periods (4.5-5 months) known in sharks. In southwest
      Florida, mating in this species occurs in November, sperm is stored until
      ovulation/fertilization the following March-April, and parturition occurs in
      August. Serum concentrations of four steroid hormones (17 beta-estradiol,
      progesterone, testosterone, and dihydrotestosterone) were determined by
      radioimmunoassay over a complete reproductive cycle in mature females from a wild
      population. Serum 17 beta-estradiol and testosterone levels are high during
      mating and preovulatory stages. Preovulatory concentrations of testosterone are
      greater in female S. tiburo than in any other female elasmobranch previously
      studied. Progesterone levels are significantly elevated during preovulatory,
      ovulatory, and postovulatory stages, while serum dihydrotestosterone levels
      increase significantly during the preovulatory stage. Our study is the first to
      demonstrate a sustained rise in progesterone during gestation in a placental
      shark and suggests a regulatory role for this hormone during the period prior to
      implantation of the embryos in the uterus.

PMID- 7789750
TI  - Gonadotropin releasing hormone stimulation of cyclic 3',5'-AMP in the pituitary
      cell of a teleost (Channa punctatus, Bloch) requires extracellular calcium: its
      relationship to gonadotropin release.
AB  - Pituitary cells were prepared by enzymatic dispersion and incubated in vitro. To
      observe the effect of gonadotropin releasing hormone (GnRH) and Ca2+ on the
      murrel pituitary cyclic 3',5'-AMP (cAMP), cells were dispersed by 0.3%
      collagenase plus 0.05% trypsin in Earle's minimum essential medium without Ca2+
      and a considerably high yield of viable cells were obtained. Addition of a
      murrel, Channa punctatus, GnRH (cGnRH, 10 micrograms/incubation) to pituitary
      cell incubation (6 x 10(4) cells/well) containing 4 mM theophylline, a
      phosphodiesterase (PDE) inhibitor, stimulated cAMP accumulation in the pituitary
      cell 2.4-fold and its release into the medium about 2-fold as compared to
      control. The extent of stimulation was greatly increased on addition of Ca2+ (2
      mM/incubation) with cGnRH: accumulation 5.8-fold and release 3.7-fold,
      respectively, in comparison to control. A time-course study with cGnRH (20
      micrograms/incubation) plus Ca2+ (2 mM/incubation) on pituitary cell cAMP
      accumulation showed that the peak of cAMP level was reached at 15 min and
      remained at the same level until 60 min in the presence of theophylline; this
      peak was drastically reduced (5-fold) at 30 min in the absence of theophylline,
      indicating rapid hydrolysis of cAMP by PDE. Ca(2+)-augmented cGnRH stimulatory
      effect on cAMP accumulation and release could be significantly (P < 0.01)
      inhibited by verapamil (3 microM/incubation), a specific calcium channel blocker,
      suggesting requirement of extracellular Ca2+ influx in this process. Calmodulin
      (CaM), a Ca2+ carrier protein, addition to cGnRH and Ca2+ incubation further
      augmented the increase of cellular accumulation of cAMP and its release by 39.5
      and 45%, respectively, in comparison to cGnRH and Ca2+ (both were statistically
      significant, P < 0.01). CaM effect could be blocked by calmidazolium (1
      microM/incubation), a specific inhibitor of CaM, indicating specificity of the
      stimulatory action of CaM. Addition of radioiodinated 125I-CaM, in the presence
      of Ca2+ or cGnRH plus Ca2+ resulted in the binding of 125I-CaM to pituitary cells
      and to the pellet of the lysed cells. 125I-CaM specifically binds to pituitary
      cell plasma membrane preparation and saturation of 125I-CaM binding occurred at 9
      ng of 125I-CaM. To investigate whether cGnRH plus Ca(2+)-stimulation of pituitary
      cells cAMP is linked to gonadotropin (GtH) release, similar protocols were
      followed. It was found that GtH release was augmented to 7-fold by cGnRH plus
      Ca2+, which was inhibited by verapamil and stimulated by CaM in a similar manner
      as observed in the case of cAMP.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7789752
TI  - Vicious circles: looking back on resistance plasmids.

PMID- 7789753
TI  - Involvement of the host initiator function dnaA in the replication of coliphage
      lambda.
AB  - We demonstrate that the initiation of coliphage lambda DNA replication is
      dependent on the host initiator function dnaA, provided that the lambdoid
      prophage Rac is absent. Presence of Rac compensated the absence of dnaA function,
      causing initiation of replication. In dnaAts rac+ cells at 43 degrees, most of
      parental phage DNA molecules, after one round of theta replication, switched to a
      replication with features of the sigma mode and produced progeny at high yield.
      Initiation of replication of the lambda Pts1 mutant at 43 degrees was blocked by
      dnaA function; however, under dnaA-rac+ conditions all parental phage DNA
      molecules, after one round of theta replication, switched to the sigma mode and
      produced progeny at high yield. Taking into account our recent finding that
      transcriptional activation of ori lambda seems to be dnaA-regulated (to be
      published elsewhere), we suggest that the DnaA-lambda Pts1 incompatibility occurs
      at the insertion of the ori lambda-bound lambda O-lambda P-DnaB preprimosome
      between the complementary lambda DNA strands. The role of Rac and the mechanism
      of the switch from theta to sigma mode of lambda phage DNA replication are
      discussed.

PMID- 7789754
TI  - The mechanism of recA polA lethality: suppression by RecA-independent
      recombination repair activated by the lexA(Def) mutation in Escherichia coli.
AB  - The mechanism of recA polA lethality in Escherichia coli has been studied.
      Complementation tests have indicated that both the 5'-->3' exonuclease and the
      polymerization activities of DNA polymerase I are essential for viability in the
      absence of RecA protein, whereas the viability and DNA replication of DNA
      polymerase I-defective cells depend on the recombinase activity of RecA. An
      alkaline sucrose gradient sedimentation analysis has indicated that RecA has only
      a minor role in Okazaki fragment processing. Double-strand break repair is
      proposed for the major role of RecA in the absence of DNA polymerase I. The
      lexA(Def)::Tn5 mutation has previously been shown to suppress the temperature
      sensitive growth of recA200(Ts) polA25::spc mutants. The lexA(Def) mutation can
      alleviate impaired DNA synthesis in the recA200(Ts) polA25::spc mutant cells at
      the restrictive temperature. recF+ is essential for this suppression pathway.
      recJ and recQ mutations have minor but significant adverse effects on the
      suppression. The recA200(Ts) allele in the recA200(Ts) polA25::spc lexA(Def)
      mutant can be replaced by delta recA, indicating that the lexA(Def)-induced
      suppression is RecA independent. lexA(Def) reduces the sensitivity of delta recA
      polA25::spc cells to UV damage by approximately 10(4)-fold. lexA(Def) also
      restores P1 transduction proficiency to the delta recA polA25::spc mutant to a
      level that is 7.3% of the recA+ wild type. These results suggest that lexA(Def)
      activates a RecA-independent, RecF-dependent recombination repair pathway that
      suppresses the defect in DNA replication in recA polA double mutants.

PMID- 7789755
TI  - Mutations affecting donor preference during mating type interconversion in
      Saccharomyces cerevisiae.
AB  - Homothallic strains of Saccharomyces cerevisiae can convert mating type from a to
      alpha or alpha to a as often as every generation, by replacing genetic
      information specifying one mating type at the expressor locus, MAT, with
      information specifying the opposite mating type. The cryptic mating type
      information that is copied and inserted at MAT is contained in either of two
      loci, HML or HMR. The particular locus selected as donor during mating type
      interconversion is regulated by the allele expressed at MAT. MATa cells usually
      select HML, and MAT alpha cells usually select HMR, a process referred to as
      donor preference. To identify factors required for donor preference, we isolated
      and characterized a number of mutants that frequently selected the nonpreferred
      donor locus during mating type interconversion. Many of these mutants were found
      to harbor chromosome rearrangements or mutations at MAT or HML that interfered
      with the switching process. However, one mutant carried a recessive allele of
      CHL1, a gene previously shown to be required for efficient chromosome segregation
      during mitosis. Homothallic strains of yeast containing a null allele of CHL1
      exhibited almost random selection of the donor locus in a MATa background but
      were normal in their ability to select HMR in a MAT alpha background. Our results
      indicate that Chl1p participates in the process of donor selection and are
      consistent with a model in which Chl1p helps establish an intrinsic bias in donor
      preference.

PMID- 7789756
TI  - Meiotic chromosome pairing in triploid and tetraploid Saccharomyces cerevisiae.
AB  - Meiotic chromosome pairing in isogenic triploid and tetraploid strains of yeast
      and the consequences of polyploidy on meiotic chromosome segregation are studied.
      Synaptonemal complex formation at pachytene was found to be different in the
      triploid and in the tetraploid. In the triploid, triple-synapsis, that is, the
      connection of three homologues at a given site, is common. It can even extend all
      the way along the chromosomes. In the tetraploid, homologous chromosomes mostly
      come in pairs of synapsed bivalents. Multiple synapsis, that is, synapsis of more
      than two homologues in one and the same region, was virtually absent in the
      tetraploid. About five quadrivalents per cell occurred due to the switching of
      pairing partners. From the frequency of pairing partner switches it can be
      deduced that in most chromosomes synapsis is initiated primarily at one end,
      occasionally at both ends and rarely at an additional intercalary position. In
      contrast to a considerably reduced spore viability (approximately 40%) in the
      triploid, spore viability is only mildly affected in the tetraploid. The good
      spore viability is presumably due to the low frequency of quadrivalents and to
      the highly regular 2:2 segregation of the few quadrivalents that do occur.
      Occasionally, however, quadrivalents appear to be subject to 3:1 nondisjunction
      that leads to spore death in the second generation.

PMID- 7789757
TI  - Interaction of Mre11 and Rad50: two proteins required for DNA repair and meiosis
      specific double-strand break formation in Saccharomyces cerevisiae.
AB  - A temperature-sensitive mre11-1 mutation of Saccharomyces cerevisiae causes
      defects in meiotic recombination and DNA repair during vegetative growth at a
      restrictive temperature. We cloned the MRE11 gene and found that it encodes a 643
      amino acid protein with a highly acidic region containing a heptad repeat of Asp
      at its C-terminus and is located downstream of YMR44 near the RNA1 locus on the
      right arm of chromosome XIII. Transcripts of the MRE11 gene increased transiently
      and showed the same kinetics as that of the RAD50 gene during meiosis. In a mre11
      disruption mutant (mre11::hisG), meiosis-specific double-strand break (DSB)
      formation is abolished. A comparison of the properties of mre11::hisG and a rad50
      deletion mutant (rad50 delta) indicated that both mutants exhibited similar
      phenotypes in both meiosis and mitosis. Characterization of two double mutants,
      mre11::hisG rad50 delta and mre11::hisG rad50S, showed that MRE11 and RAD50
      belong to the same epistasis group with respect to meiotic DSB formation and
      mitotic DNA repair. Using a two-hybrid system, we found that Mre11 interacts with
      Rad50 and itself in vivo. These results suggest that Mre11 and Rad50 proteins
      work in a complex in DSB formation and DNA repair during vegetative growth.

PMID- 7789759
TI  - Some property of the nucleus determines the competence of Neurospora crassa for
      transformation.
AB  - In Neurospora, transformation of spheroplasts is quite efficient and usually
      occurs with the transforming DNA integrated at ectopic sites in the chromosome.
      However, only a small fraction of the spheroplasts is actually competent for
      transformation. To distinguish whether the limitation to competence is at the
      level of the plasma membrane or at the level of the nucleus, we performed
      experiments in which heterocaryotic spheroplasts were required to integrate two
      different plasmids in one transformation procedure. The cotransformants were then
      analyzed to determine into which nucleus or nuclei the separate plasmids had
      integrated. Results of such experiments confirm that successful ectopic
      transformation in Neurospora crassa requires a competent nucleus. The integration
      patterns of the two separate plasmids indicate that the availability of
      appropriate chromosomal sites for ectopic integration may be an aspect of nuclear
      competence.

PMID- 7789758
TI  - Ectopic integration of transforming DNA is rare among neurospora transformants
      selected for gene replacement.
AB  - In a variety of organisms, DNA-mediated transformation experiments commonly
      produce transformants with multiple copies of the transforming DNA, including
      both selected and unselected molecules. Such "cotransformants" are much more
      common than expected from the individual transformation frequencies, suggesting
      that subpopulations of cells, or nuclei, are particularly competent for
      transformation. We found that Neurospora crassa transformants selected for gene
      replacement at the am gene had not efficiently incorporated additional DNA,
      suggesting that nuclei that undergo transformation by homologous recombination
      are not highly competent at integration of DNA by illegitimate recombination.
      Spheroplasts were treated with DNA fragments homologous to am and with an
      Escherichia coli hph plasmid. Transformants were initially selected for hph
      (hygromycinR), allowed to conidiate to generate homokaryons and then selected for
      either Am- (gene replacements) or hph. Surprisingly, most am replacement strains
      were hygromycinS (124/140) and carried no extraneous DNA (116/140). Most
      transformants selected for hph also had ectopic copies of am DNA and/or multiple
      copies of hph sequences (32/35), generally at multiple sites, confirming that
      efficient cotransformation could occur. To test the implication that
      cotransformation involving gene replacement and ectopic integration is rare, we
      compared the yields of am replacement strains with or without prior selection for
      hph. The initial selection did not appreciably help (or hinder) recovery of
      strains with replacements.

PMID- 7789760
TI  - sli-1, a negative regulator of let-23-mediated signaling in C. elegans.
AB  - By screening for suppressors of hypomorphic mutations of let-23, a receptor
      tyrosine kinase necessary for vulval induction in Caenorhabditis elegans, we
      recovered > or = 12 mutations defining the sli-1 (suppressor of lineage defect)
      locus. sli-1 mutations suppress four of five phenotypes associated with
      hypomorphic alleles of let-23 but do not suppress let-23 null alleles. Thus, a
      sli-1 mutation does not bypass the requirement for functional let-23 but rather
      allows more potent LET-23-dependent signaling. Mutations at the sli-1 locus are
      otherwise silent with respect to vulval differentiation and cause only a low
      penetrance abnormal head phenotype. Mutations at sli-1 also suppress the vulval
      defects but not other defects associated with mutations of sem-5, whose product
      likely interacts with LET-23 protein during vulval induction. Mutations at sli-1
      suppress lin-2, lin-7 and lin-10 mutations but only partially suppress lin-3 and
      let-60 mutations and do not suppress a lin-45 mutation. The sli-1 locus displays
      dosage sensitivity: severe reduction of function alleles of sli-1 are
      semidominant suppressors; a duplication of the sli-1(+) region enhances the
      vulvaless phenotype of hypomorphic mutations of let-23. We propose that sli-1 is
      a negative regulator that acts at or near the LET-23-mediated step of the vulval
      induction pathway. Our analysis suggests that let-23 can activate distinct
      signaling pathways in different tissues: one pathway is required for vulval
      induction; another pathway is involved in hermaphrodite fertility and is not
      regulated by sli-1.

PMID- 7789761
TI  - Genes that regulate both development and longevity in Caenorhabditis elegans.
AB  - The nematode Caenorhabditis elegans responds to conditions of overcrowding and
      limited food by arresting development as a dauer larva. Genetic analysis of
      mutations that alter dauer larva formation (daf mutations) is presented along
      with an updated genetic pathway for dauer vs. nondauer development. Mutations in
      the daf-2 and daf-23 genes double adult life span, whereas mutations in four
      other dauer-constitutive genes positioned in a separate branch of this pathway
      (daf-1, daf-4, daf-7 and daf-8) do not. The increased life spans are suppressed
      completely by a daf-16 mutation and partially in a daf-2; daf-18 double mutant. A
      genetic pathway for determination of adult life span is presented based on the
      same strains and growth conditions used to characterize Daf phenotypes. Both
      dauer larva formation and adult life span are affected in daf-2; daf-12 double
      mutants in an allele-specific manner. Mutations in daf-12 do not extend adult
      life span, but certain combinations of daf-2 and daf-12 mutant alleles nearly
      quadruple it. This synergistic effect, which does not equivalently extend the
      fertile period, is the largest genetic extension of life span yet observed in a
      metazoan.

PMID- 7789763
TI  - P-element-induced male recombination can be produced in Drosophila melanogaster
      by combining end-deficient elements in trans.
AB  - Male recombination, not normally present in Drosophila melanogaster, can be
      produced at high rates when target P elements at homologous sites are combined in
      the presence of transposase protein. We have produced a set of elements by in
      situ deletion of a particular insertion and have found elements that have
      deletions stretching into either end. Elements were tested in pairs to see
      whether they complement each other in their ability to induce recombination. The
      combination of elements that are deficient for the same end produces very little
      recombination, but the combination of a right-end and a left-end element can
      generate recombination values higher than given by two complete P[CaSpeR]
      elements at homologous sites. This strongly suggests that "hybrid" P elements,
      containing ends from two different elements, can be recognized by transposase
      protein. We have also examined genotypes containing a normal and an end-deficient
      element and found that they yield reasonably high levels of recombination. We
      interpret the resultant gametes from such genotypes as showing that the majority
      of events in this genotype derive from the association of complementary ends from
      the same element, whereas the complementary ends from elements in trans associate
      in only a minority of cases.

PMID- 7789762
TI  - Horka, a dominant mutation of Drosophila, induces nondisjunction and, through
      paternal effect, chromosome loss and genetic mosaics.
AB  - Fs(3)Horka (Horka) was described as a dominant female-sterile mutation of
      Drosophila melanogaster. Genetic and cytological data show that Horka induces
      mostly equational nondisjunction during spermatogenesis but not chromosome loss
      and possesses a dominant paternal effect: the X, second, third and the fourth
      chromosomes, but not the Y, are rendered unstable while undergoing
      spermatogenesis and may be lost in the descending zygotes. The frequency of Horka
      induced chromosome loss is usually 2-4% but varies with the genetic background
      and can be over 20%. The X chromosome loss occurs during the gonomeric and the
      initial cleavage divisions. Loss of the X and fourth chromosomes shows no
      correlation. We propose, based on similarities in the mutant phenotypes with the
      chromosome destabilizing mutations nonclaret disjunctional and paternal loss,
      that the normal Horka+ product is required for function of the centromeres and/or
      nearby regions. Horka is a convenient tool for the generation of gynandromorphs,
      autosome mosaics and for the study of gene expression in mosaics.

PMID- 7789764
TI  - Hypomorphic mutations in the larval photokinesis A (lphA) gene have stage
      specific effects on visual system function in Drosophila melanogaster.
AB  - Of the many genes that are expressed in the visual system of Drosophila
      melanogaster adults, some affect larval vision. However, with the exception of
      one X-linked mutation, no genes that have larval-specific effects on visual
      system structure or function have previously been reported. We describe the
      isolation and characterization of two mutant alleles that define the larval
      photokinesis A (lphA) gene, one allele of which is associated with a P-element
      insertion at cytogenetic locus 8E1-10. Larvae that express lphA mutations are,
      like normal animals, negatively photokinetic, but they are less responsive to
      white light than lphA + controls. Larvae that are heterozygous in trans for a
      mutant lphA allele and a deficiency that uncovers the lphA locus are blind, which
      indicates that the mutant allele is hypomorphic. lphA larvae respond normally to
      odorants and taste stimuli. Moreover, the lphA mutations do not affect adult
      flies' fast phototaxis or visually driven aspects of male sexual behavior, and
      electroretinograms recorded from the compound eyes of lphA/deficiency
      heterozygotes and lphA1/lphA2 females are normal. These observations suggest that
      the lphA gene affects a larval-specific aspect of visual system function.

PMID- 7789765
TI  - A physical map of the X chromosome of Drosophila melanogaster: cosmid contigs and
      sequence tagged sites.
AB  - A physical map of the euchromatic X chromosome of Drosophila melanogaster has
      been constructed by assembling contiguous arrays of cosmids that were selected by
      screening a library with DNA isolated from microamplified chromosomal divisions.
      This map, consisting of 893 cosmids, covers approximately 64% of the euchromatic
      part of the chromosome. In addition, 568 sequence tagged sites (STS), in
      aggregate representing 120 kb of sequenced DNA, were derived from selected
      cosmids. Most of these STSs, spaced at an average distance of approximately 35 kb
      along the euchromatic region of the chromosome, represent DNA tags that can be
      used as entry points to the fruitfly genome. Furthermore, 42 genes have been
      placed on the physical map, either through the hybridization of specific probes
      to the cosmids or through the fact that they were represented among the STSs.
      These provide a link between the physical and the genetic maps of D.
      melanogaster. Nine novel genes have been tentatively identified in Drosophila on
      the basis of matches between STS sequences and sequences from other species.

PMID- 7789766
TI  - A genetic analysis of intersex, a gene regulating sexual differentiation in
      Drosophila melanogaster females.
AB  - Sex-type in Drosophila melanogaster is controlled by a hierarchically acting set
      of regulatory genes. At the terminus of this hierarchy lie those regulatory genes
      responsible for implementing sexual differentiation: genes that control the
      activity of target loci whose products give rise to sexually dimorphic
      phenotypes. The genetic analysis of the intersex (ix) gene presented here
      demonstrates that ix is such a terminally positioned regulatory locus. The ix
      locus has been localized to the cytogenetic interval between 47E3-6 and 47F11-18.
      A comparison of the morphological and behavioral phenotypes of homozygotes and
      hemizygotes for three point mutations at ix indicates that the null phenotype of
      ix is to transform diplo-X animals into intersexes while leaving haplo-X animals
      unaffected. Analysis of X-ray induced, mitotic recombination clones lacking ix+
      function in the abdomen of diplo-X individuals indicates that the ix+ product
      functions in a cell-autonomous manner and that it is required at least until the
      termination of cell division in this tissue. Taken together with previous
      analyses, our results indicate that the ix+ product is required to function with
      the female-specific product of doublesex to implement appropriate female sexual
      differentiation in diplo-X animals.

PMID- 7789767
TI  - P-element mutations affecting embryonic peripheral nervous system development in
      Drosophila melanogaster.
AB  - The Drosophila embryonic peripheral nervous system (PNS) is an excellent model
      system to study the molecular mechanisms governing neural development. To
      identify genes controlling PNS development, we screened 2000 lethal P-element
      insertion strains. The PNS of mutant embryos was examined using the neural
      specific marker MAb 22C10, and 92 mutant strains were retained for further
      analysis. Genetic and cytological analysis of these strains shows that 42
      mutations affect previously isolated genes that are known to be required for PNS
      development: longitudinals lacking (19), mastermind (15), numb (4), big brain
      (2), and spitz (2). The remaining 50 mutations were classified into 29
      complementation groups and the P-element insertions were cytologically mapped.
      The mutants were classified in five major classes on the basis of their
      phenotype: gain of neurons, loss of neurons, organizational defects, pathfinding
      defects and morphological defects. Herein we report the preliminary phenotypic
      characterization of each of these complementation groups as well as the embryonic
      lacZ expression pattern of each P-element strain. Our analysis indicates that in
      most of the P-element insertion strains, the lacZ reporter gene is not expressed
      in the developing PNS.

PMID- 7789768
TI  - Cytogenetic and molecular localization of tipE: a gene affecting sodium channels
      in Drosophila melanogaster.
AB  - Voltage-sensitive sodium channels play a key role in nerve cells where they are
      responsible for the increase in sodium permeability during the rising phase of
      action potentials. In Drosophila melanogaster a subset of temperature-sensitive
      paralytic mutations affect sodium channel function. One such mutation is
      temperature-induced paralysis locus E (tipE), which has been shown by
      electrophysiology and ligand binding studies to reduce sodium channel numbers.
      Three new gamma-ray-induced tipE alleles associated with either visible deletions
      in 64AB or a translocation breakpoint within 64B2 provide landmarks for
      positional cloning of tipE. Beginning with the flanking cloned gene Ras2, a 140
      kb walk across the translocation breakpoint was completed. Germline
      transformation using a 42-kb cosmid clone and successively smaller subclones
      localized the tipE gene within a 7.4-kb genomic DNA segment. Although this
      chromosome region is rich in transcripts, only three overlapping mRNAs (5.4, 4.4,
      and 1.7 kb) lie completely within the smallest rescuing construct. The small
      sizes of the rescuing construct and transcripts suggest that tipE does not encode
      a standard sodium channel alpha-subunit with four homologous repeats. Sequencing
      these transcripts will elucidate the role of the tipE gene product in sodium
      channel functional regulation.

PMID- 7789769
TI  - Structure and regulation of a complex locus: the cut gene of Drosophila.
AB  - The cut locus encodes a homeobox protein that is localized in the nuclei of a
      variety of tissues and is required for proper morphogenesis of those tissues. Cut
      protein is required in embryonic and adult external sensory organs, where its
      absence results in conversion of the organs to chordotonal organs. Expression of
      cut also occurs in the Malpighian tubules, spiracles, central nervous system, and
      a number of other tissues. Gypsy transposon insertions upstream of the cut
      promoter block expression in subsets of these tissues. The effect of the gypsy
      insertions is polar, with those farthest from the promoter affecting the fewest
      tissues. The hypothesis that gypsy insertions block a series of tissue-specific
      enhancer elements that are distributed over a region of 80 kb upstream of the
      promoter predicts the location of the enhancers for cut expression in each of the
      tissues in which it is active in embryos. DNA fragments from this region drive
      expression of a reporter gene in each of the embryonic tissues in which
      endogenous cut gene is expressed. Each tissue has its own enhancer, and none of
      the enhancers require the activity of the endogenous cut gene to function.

PMID- 7789770
TI  - A genetic analysis of the 63E-64A genomic region of Drosophila melanogaster:
      identification of mutations in a replication factor C subunit.
AB  - We have performed an F2 genetic screen to identify lethal mutations within the
      63E-64A genomic region. We have isolated 122 mutations in 20 different
      complementation groups. Of these groups, 16 are represented by multiple alleles.
      We have also established that the Rop and Ras2 genes are located within the 63E
      64A genomic domain at 64A10,11. We have sequenced 10.2 kb of DNA surrounding this
      gene pair and find that in addition to Rop and Ras2 there is another gene located
      within this DNA sequence. The gene product, which we have named Rfc40, shows 68%
      identity to the 40-kDa subunit of replication factor C. We find that the members
      of one complementation group (13 alleles) derived from our screen correspond to
      mutations in the Rop gene, whereas the members of another (five alleles)
      correspond to mutations in the Rfc40 gene. In addition we have isolated 11 new
      mutant alleles of the disembodied gene.

PMID- 7789771
TI  - Restriction fragment length polymorphism mapping of quantitative trait loci for
      malaria parasite susceptibility in the mosquito Aedes aegypti.
AB  - Susceptibility of the mosquito Aedes aegypti to the malarial parasite Plasmodium
      gallinaceum was investigated as a quantitative trait using restriction fragment
      length polymorphisms (RFLP). Two F2 populations of mosquitoes were independently
      prepared from pairwise matings between a highly susceptible and a refractory
      strain of A. aegypti. RFLP were tested for association with oocyst development on
      the mosquito midgut. Two putative quantitative trait loci (QTL) were identified
      that significantly affect susceptibility. One QTL, pgs[2,LF98], is located on
      chromosome 2 and accounted for 65 and 49% of the observed phenotypic variance in
      the two populations, respectively. A second QTL, pgs[3,MalI], is located on
      chromosome 3 and accounted for 14 and 10% of the observed phenotypic variance in
      the two populations, respectively. Both QTL exhibit a partial dominance effect on
      susceptibility, wherein the dominance effect is derived from the refractory
      parent. No indication of epistasis between these QTL was detected. Evidence
      suggests that either a tightly linked cluster of independent genes or a single
      locus affecting susceptibility to various mosquito-borne parasites and pathogens
      has evolved near the LF98 locus; in addition to P. gallinaceum susceptibility,
      this general genome region has previously been implicated in susceptibility to
      the filarial nematode Brugia malayi and the yellow fever virus.

PMID- 7789772
TI  - Alternative models for allozyme-associated heterosis in the marine bivalve
      Spisula ovalis.
AB  - Correlations between allozyme heterozygosity and fitness-related traits,
      especially growth, have been documented in natural populations of marine
      bivalves. However, no consistent pattern has been exhibited, because heterotic
      effects on size vary with age and individual growth parameters are generally
      unknown. No consensus has emerged on the genetic basis of allozyme-associated
      heterosis. The species studied here, Spisula ovalis, displays annual shell growth
      lines, which allows us to compute individual age and growth dynamics over the
      whole life span. Our morphological study was coupled to a protein electrophoresis
      study at seven polymorphic loci. While the maximum size gained is not related to
      heterozygosity, the age at half maximum size, t1/2, is significantly negatively
      correlated with heterozygosity, indicating an heterotic effect on initial growth.
      The correlation between heterozygosity and size is expected to vanish when age
      increases, due to the form of the growth function. This decreasing correlation is
      consistent with previous studies. We compare the relative performances of five
      linear models to analyze the genetic basis of heterosis. Surprisingly, the
      largest part of variance in t1/2 is due to additive effects, the overdominant
      components being much weaker. Heterosis is therefore due to general genomic
      effects rather than to local overdominance restricted to allozymes or small
      neighboring chromosomal segments. A significant dependence of individual
      heterotic contributions of the enzyme loci upon expected heterozygosities, rather
      than metabolic function, further supports the hypothesis of enzymes acting as
      markers. General genomic effects can hold only if allozyme heterozygosity is
      positively correlated with heterozygosity at fitness-related genes scattered
      throughout the genome. This hypothesis is supported here by heterozygosity
      correlations between enzymatic loci.

PMID- 7789773
TI  - Half-tetrad analysis in zebrafish: mapping the ros mutation and the centromere of
      linkage group I.
AB  - Analysis of meiotic tetrads is routinely used to determine genetic linkage in
      various fungi. Here we apply tetrad analysis to the study of genetic linkage in a
      vertebrate. The half-tetrad genotypes of gynogenetic diploid zebrafish produced
      by early-pressure (EP) treatment were used to investigate the linkage
      relationships of two recessive pigment pattern mutations, leopard (leo) and rose
      (ros). The results showed that ros is tightly linked to its centromere and leo
      maps 31 cM from its centromere. Analysis of half-tetrads segregating for ros and
      leo in repulsion revealed no homozygous ros individuals among 32 homozygous leo
      half-tetrads--i.e., a parental ditype (PD) to nonparental ditype (NPD) ratio of
      32:0. This result shows that ros is linked to leo, a mutation previously mapped
      to Linkage Group I. Investigation of PCR-based DNA polymorphisms on Linkage Group
      I confirmed the location of ros near the centromere of this linkage group. We
      propose an efficient, generally useful method to assign new mutations to a
      linkage group in zebrafish by determining which of 25 polymerase chain reaction
      (PCR)-based centromere markers shows a significant excess of PD to NPD in half
      tetrad fish.

PMID- 7789774
TI  - Interval mapping of high growth (hg), a major locus that increases weight gain in
      mice.
AB  - The high growth locus (hg) causes a major increase in weight gain and body size
      in mice. As a first step to map-based cloning of hg, we developed a genetic map
      of the hg-containing region using interval mapping of 403 F2 from a C57BL/6J-hghg
      x CAST/EiJ cross. The maximum likelihood position of hg was at the chromosome 10
      marker D10Mit41 (LOD = 24.8) in the F2 females and 1.5 cM distal to D10Mit41 (LOD
      = 9.56) in the F2 males with corresponding LOD 2 support intervals of 3.7 and 5.4
      cM, respectively. The peak LOD scores were significantly higher than the
      estimated empirical threshold LOD values. The localization of hg by interval
      mapping was supported by a test cross of F2 mice recombinant between the LOD 2
      support interval and the flanking marker. The interval mapping and test-cross
      results indicate that hg is not allelic with candidate genes Igf1 or decorin
      (Dcn), a gene that was mapped close to hg in this study. The hg inheritance was
      recessive in females, although we could not reject recessive or additive
      inheritance in males. Possible causes for sex differences in peak LOD scores and
      for the distortion of transmission ratios observed in F2 males are discussed. The
      genetic map of the hg region will facilitate further fine mapping and cloning of
      hg, and allow searches for a homologous quantitative trait locus affecting growth
      in humans and domestic animals.

PMID- 7789775
TI  - Genetics of male sterility in gynodioecious Plantago coronopus. I. Cytoplasmic
      variation.
AB  - Inheritance of male sterility was studied in the gynodioecious species Plantago
      coronopus using five plants and their descendants from an area of approximately
      50 m2 in each of six locations. The crosses were planned to test for cytoplasmic
      inheritance of male sterility. In four locations significant differences between
      reciprocal crosses were observed. The progenies of these reciprocal crosses were
      used in a crossing scheme designed to test whether these reciprocal differences
      were caused by different cytoplasmic types between the plants. In all four
      locations, the existence of at least two cytoplasmic types could be shown.
      Moreover, the results of the crosses between locations showed that the same two
      cytoplasmic types were present in all four locations. We therefore argue that
      there is only limited cytoplasmic variation in P. coronopus. In each cytoplasmic
      type a series of intermediate sex forms occurred. A marked difference in
      restoration level existed between the two cytoplasmic types. Plants with
      cytoplasmic type 2 hardly segregated male steriles, in contrast to plants with
      cytoplasmic type 1.

PMID- 7789776
TI  - Genetics of male sterility in gynodioecious Plantago coronopus. II. Nuclear
      genetic variation.
AB  - Inheritance of male sterility was studied in the gynodioecious species Plantago
      coronopus using five plants and their descendants from an area of approximately
      50 m2 from each of four locations. In each location, crosses between these five
      plants yielded the entire array of possible sex phenotypes. Both nuclear and
      cytoplasmic genes were involved. Emphasis is placed on the nuclear (restorer)
      genetics of two cytoplasmic types. For both types, multiple interacting nuclear
      genes were demonstrated. These genes carried either dominant or recessive
      restorer alleles. The exact number of genes involved could not be determined,
      because different genetic models could be proposed for each location and no
      common genetic solution could be given. At least five genes, three with dominant
      and two with recessive restorer allele action, were involved with both
      cytoplasmic types. Segregation patterns of partially male sterile plants
      suggested that they are due to incomplete dominance at restorer loci. Restorer
      genes interact in different ways. In most instances models with independent
      restorer gene action were sufficient to explain the crossing results. However,
      for one case we propose a model with epistatic restorer gene action. There was a
      consistent difference in the segregation of male sterility between plants from
      the two cytoplasmic types. Hermaphrodites of cytoplasmic type 2 hardly segregated
      male steriles, in contrast to plants with cytoplasmic type 1.

PMID- 7789777
TI  - Genetic characterization of the Mutator system in maize: behavior and regulation
      of Mu transposons in a minimal line.
AB  - Most Mutator lines of maize harbor several different classes of Mu transposons,
      each of which may be present in high copy number. The regulatory element is also
      often found in high copy number, and it is this element's behavior that is
      presumed to cause the non-Mendelian inheritance of Mutator activity. Using a very
      simple Mutator line, we demonstrate tha MuDR-1, a regulator of the Mutator
      system, can functionally replace standard non-Mendelian Mutator activity and that
      MuDR-1 is associated with the loss of methylation of the termini of another Mu
      transposon. Further, we show that Mu transposons can transpose duplicatively,
      that reinsertion tends to be into unlinked sites, and that MuDR-1 frequently
      suffers deletions. Changes in chromosomal position and the mode of sexual
      transmission are shown to be associated with changes in the frequency of MuDR-1
      duplication and with the activity of MuDR-1 as monitored by the excision
      frequency of a reporter transposon of the Mu family, Mu1. Our data are derived
      from a Minimal Mutator Line in which there are relatively few Mu transposons,
      including one MuDR-1 regulator and as few as one Mu1 reporter. The seemingly
      enigmatic results that have been obtained using more complicated Mu genotypes are
      reinterpreted using simple Mendelian principles. We have borrowed a gap-repair
      model from Drosophila biologists to explain both duplications and deletions of
      MuDR-1.

PMID- 7789778
TI  - Quantitative genetics of 4x-2x hybrid populations with first-division restitution
      and second-division restitution 2n gametes produced by diploid parents.
AB  - A model is proposed to describe the genetic value of 4x-2x hybrids resulting from
      crosses between tetraploid genitors and diploid genitors that produce 2n gametes.
      The model takes into account the genetic consequences of the First Division
      Restitution (FDR) and Second Division Restitution (SDR) meiosis, particularly on
      the homozygosity level that 2n gametes contribute to 4x-2x hybrids. As genes can
      be identical by descent, numerous parameters are needed in the classical approach
      to describe the inbreeding effects on the mean and variance of 4x-2x hybrids.
      Using the concept of test value, the model allows a large decrease in the number
      of required parameters. The model gives the components of genetic variance and
      usual covariances between relatives using these synthetic parameters. The model
      is then used to study the efficiency of a recurrent breeding scheme to improve
      diploid genitors for their combining ability with tetraploid genitors. It appears
      that, in presence of dominance, ignoring the meiosis pattern will lead to an
      overestimation of additive variance and then of genetic advance. Some genetic
      considerations on the differences between FDR and SDR mechanisms lead us to
      suggest an experimental comparison of their respective advantages and
      disadvantages for the type of considered recurrent selection. An experimental
      crossing design is proposed to obtain estimates of the genetic parameters needed
      for this comparison.

PMID- 7789779
TI  - The population genetics of speciation: the evolution of hybrid incompatibilities.
AB  - Speciation often results from the accumulation of "complementary genes," i.e.,
      from genes that, while having no deleterious effect within species, cause
      inviability or sterility when brought together with genes from another species.
      Here I model speciation as the accumulation of genic incompatibilities between
      diverging populations. Several results are obtained. First, and most important,
      the number of genic incompatibilities between taxa increases much faster than
      linearly with time. In particular, the probability of speciation increases at
      least as fast as the square of the time since separation between two taxa.
      Second, as Muller realized, all hybrid incompatibilities must initially be
      asymmetric. Third, at loci that have diverged between taxa, evolutionarily
      derived alleles cause hybrid problems far more often than ancestral alleles.
      Last, it is "easier" to evolve complex hybrid incompatibilities requiring the
      simultaneous action of three or more loci than to evolve simple incompatibilities
      between pairs of genes. These results have several important implications for
      genetic analyses of speciation.

PMID- 7789780
TI  - Among-environment heteroscedasticity and genetic autocorrelation: implications
      for the study of phenotypic plasticity.
AB  - The impact of among-environment heteroscedasticity and genetic autocorrelation on
      the analysis of phenotypic plasticity is examined. Among-environment
      heteroscedasticity occurs when genotypic variances differ among environments.
      Genetic autocorrelation arises whenever the responses of a genotype to different
      environments are more or less similar than expected for observations randomly
      associated. In a multivariate analysis-of-variance model, three transformations
      of genotypic profiles (reaction norms), which apply to the residuals of the model
      while preserving the mean responses within environments, are derived. The
      transformations remove either among-environment heteroscedasticity, genetic
      autocorrelation or both. When both nuisances are not removed, statistical tests
      are corrected in a modified univariate approach using the sample covariance
      matrix of the genotypic profiles. Methods are illustrated on a Chlamydomonas
      reinhardtii data set. When heteroscedasticity was removed, the variance component
      associated with the genotype-by-environment interaction increased proportionally
      to the genotype variance component. As a result, the genetic correlation rg was
      altered. Genetic autocorrelation was responsible for statistical significance of
      the genotype-by-environment interaction and genotype main effects on raw data.
      When autocorrelation was removed, the ranking of genotypes according to their
      stability index dramatically changed. Evolutionary implications of our methods
      and results are discussed.

PMID- 7789781
TI  - Satisfaction with and effectiveness of medical care in relation to anxiety and
      depression. Patient and physician ratings compared.
AB  - This study examined 1) patient ratings of satisfaction with and effectiveness of
      medical care, and 2) physician ratings of treatment effectiveness, taking into
      account personal characteristics, health and mental health of 75 clinic attenders
      who scored below a cutoff on a screening questionnaire for hypochondriasis.
      Patients above the cutoff on this instrument, and a random sample of all those
      below the cutoff, then returned at a later date to undergo a research battery
      consisting of self-report questionnaires, and structured and semistructured
      interviews, including the Diagnostic Interview Schedule (DIS). About three
      fourths of the patients were very satisfied with their medical care, and over
      half considered the medical care they received effective. Patients and physicians
      did not concur on the effectiveness of care (r = 0.029, p = 0.81; Kappa = 0.025).
      Depression was negatively correlated with satisfaction with medical care, r = 
      0.42, p = 0.0001; anxiety negatively correlated with perceived effectiveness of
      care, r = -0.41, p = 0.003. Physician rating of effectiveness of care correlated
      with physician rating of depression, age, and gender (more effective for older
      and male), (R2 = 0.27, p = 0.0388). We conclude that the lack of agreement
      between patients and physicians on effectiveness of care suggests the need for
      better communication. The finding that a depressive diagnosis is associated with
      dissatisfaction suggests more generally that psychiatric disorder may be an
      important determinant of patient satisfaction with medical care.

PMID- 7789782
TI  - Doctor-shopping patients and users of alternative medicine among Japanese primary
      care patients.
AB  - To describe the clinical characteristics of patients with doctor-shopping
      behavior (doctor-shopping patients) and users of alternative medicine among
      Japanese primary care patients, 1088 patients from the general medicine
      outpatient clinic of a medical school hospital answered an original questionnaire
      and 30-item General Health Questionnaire (GHQ). A random sample of patients was
      questioned in accordance with the Diagnostic Interview Schedule modified for use
      in Japan (DIS-JM). Twenty-three percent of these patients met our criteria for
      doctor-shopping patients, and 7.9% had used alternative medicine. Multivariate
      analysis showed no significant difference between the two groups of patients with
      regard to sex, age, residence, occupation, education, or marital status. The most
      striking characteristics of doctor-shopping patients were chronicity of illness
      (p < 0.005), inability to understand doctors' explanations (p < 0.005), disbelief
      of the doctor's diagnosis and treatment (p < 0.005), and high GHQ scores (p <
      0.05). The major factor for alternative medicine users was high expectations of
      medical school hospitals (p < 0.01). DIS-JM interviews showed that doctor
      shopping patients had a high lifetime prevalence of mental disorders. The
      lifetime prevalence of DSM-III somatization disorders was significantly higher in
      the two study groups. These results suggest that the risk factors for doctor
      shopping are strongly associated with chronic conditions and the doctor-patient
      relationship. Also, users of alternative medicine had high expectations of
      medical school hospitals as the symbol of modern medicine. Therefore, we
      emphasize the importance of accurate explanations and maintenance of good doctor
      patient relationships by physicians providing care. We also suggest that when
      obtaining the patient's medical history, doctors ask how many prior visits the
      patient has made to medical facilities with the same complaint, and how many
      times the patient has used alternative medicine.

PMID- 7789783
TI  - Psychological responses to malignant melanoma. An investigation of traumatic
      stress reactions to life-threatening illness.
AB  - A cross-sectional study of 95 individuals with malignant melanoma was conducted
      to investigate posttraumatic stress responses to a diagnosis of melanoma and to
      validate the use of the Impact of Event Scale (IES) as a measure of the response
      to the trauma of life-threatening disease. The diagnosis and progression of
      malignant disease are likely to present a range of acute and chronic trauma to
      the individual and the individual's family. The findings suggest that the IES is
      a reliable and valid measure of this distress, with scores varying according to
      disease progression and prognostic status of nonmetastatic disease patients. This
      indicates the importance of clinical attention to the specific symptoms that may
      best reflect the traumatic impact of life-threatening illness and its
      progression, and the applicability of posttraumatic stress syndromes in
      understanding the psychological distress of this clinical population.

PMID- 7789784
TI  - Psychiatric aspects of progressive supranuclear palsy.
AB  - Progressive supranuclear palsy (PSP) is characterized by supranuclear
      ophthalmoplegia mainly affecting vertical gaze, nuchal dystonia in extension,
      pseudobulbar palsy, and mental changes. The literature on PSP has been
      neurologically oriented whereas the psychiatric aspects have been relatively
      neglected. A review of the literature shows that psychiatric disturbance in PSP
      is common but with no characteristic pattern. Cognitive impairment, nonspecific
      affective and behavioral disturbances are commonly found, whereas frank psychosis
      or bipolar disorder are rare. Misdiagnoses with psychiatric disorders are common
      and a heightened awareness of the condition is necessary for early diagnosis.

PMID- 7789785
TI  - Depression and anxiety in an 85-year-old woman with a toxic nodular goiter.
AB  - Depression is commonly encountered in medical settings and often may be a symptom
      of an underlying medical illness. This case report illustrates the disabling
      symptoms of anxiety and depression that can accompany a toxic nodular goiter, and
      underscores the importance of both accurate psychiatric diagnosis and appropriate
      medical evaluation in the assessment of psychiatric disorders in the elderly.

PMID- 7789786
TI  - Sexual and physical abuse history and medical practice.

PMID- 7789787
TI  - Further analyses of the Delirium Rating Scale.
AB  - The Delirium Rating Scale is a clinician-rated, 10-item symptom rating scale for
      assessment of delirium severity. In order to better understand the relationship
      between items of the scale and whether they reflect one or more underlying
      groupings or dimensions, further analyses of the originally published scale data
      were performed. Factor analysis revealed a strong single underlying dimension
      that could be further divided into two components: one comprising delusions,
      psychomotor behavior, cognition, sleep-wake cycle disturbance, and mood lability;
      the other comprising temporal onset of symptoms, perceptual disturbances,
      hallucinations, and fluctuation of symptoms. Implications for improved
      phenomenological understanding of delirium are discussed.

PMID- 7789788
TI  - The ethical limits of confidentiality in the therapeutic relationship.
AB  - The author explores the moral underpinnings of psychiatric confidentiality in an
      attempt to define its ethical limits. Knowledge of this standard assumes growing
      importance as third party incursions into the patient-therapist dyad become
      increasingly common in day-to-day practice. The APA's AIDS policy on
      confidentiality and disclosure is offered as an illustrative example of the
      profession's ability to successfully translate moral deliberation into clinical
      policy.

PMID- 7789789
TI  - Medical and psychiatric symptoms in female gastroenterology clinic patients with
      histories of sexual victimization.
AB  - Several recent retrospective reports have associated prior sexual victimization
      and long-term medical sequelae such as increased medical clinic utilization and
      reports of physical symptoms. However, methodological constraints have limited
      the generalizability of these findings. Our study was designed using structured
      interviews with a sequential sample of 89 female gastroenterology clinic
      patients, who were classified by severity of sexual trauma and studied for
      differences in lifetime psychiatric diagnoses, physical abuse, and medically
      unexplained symptom patterns. Compared with the 46 women who had experienced less
      severe or no prior sexual trauma, the 43 patients with severe victimization had
      significantly higher life-time and current rates of several selected psychiatric
      disorders as well as significantly higher mean numbers of lifetime psychiatric
      disorders, medically unexplained physical and anxiety symptoms, greater harm
      avoidance and dissociation scores, and increased functional disability. A
      logistic regression showed that the main predictors of a history of severe sexual
      abuse were the number of medically unexplained symptoms, adult physical abuse,
      and lifetime dysthymic disorder. We concluded that women with prior severe sexual
      trauma episodes may express medically unexplained physical symptoms as part of
      the long-term adaptation to their victimization.

PMID- 7789791
TI  - The dihydrofolate reductase-encoding gene dyrA of the hyperthermophilic bacterium
      Thermotoga maritima.
AB  - The structural gene (dyrA) encoding dihydrofolate reductase (DHFR) of Thermotoga
      maritima has been cloned, sequenced and expressed in Escherichia coli. The dyrA
      gene, located immediately upstream from the gene encoding aspartate
      carbamoyltransferase (pyrB), encodes a highly thermostable enzyme with a distinct
      thermophilic activity profile. Important structural features are conserved among
      all bacterial DHFR, yet the DHFR of T. maritima appears unique in a number of
      insertions and deletions, some of which are reminiscent of eukaryotic DHFR.

PMID- 7789790
TI  - Recognizing and managing depression in primary care.
AB  - Depression is a common disorder in the primary care setting; it is associated
      with considerable distress and dysfunction. The management of depressed primary
      care patients can be complicated by the fact that these patients may lack insight
      into the cause of their symptoms and report only the somatic manifestations of
      their disorder to their physicians. Primary care patients may also be reluctant
      to accept a diagnosis of depression or referral to a mental health specialist.
      Primary care physicians may feel they lack the time or the training to adequately
      address their patients' depressive disorders. This paper presents a model for
      identifying, evaluating, and treating depression which has been specifically
      developed to help primary care physicians overcome these barriers.

PMID- 7789792
TI  - Cloning and characterization of the lipase operon from Mycoplasma mycoides
      subspecies mycoides LC.
AB  - Lipases, serine esterase enzymes, play an essential role in the mycoplasmal
      nutritional requirement for long-chain fatty acids. Although the lipase(s)
      activity in different mycoplasma species has been investigated, the molecular
      biology of the corresponding genes has not been studied. Using a single-primer
      PCR technique combined to more classical cloning systems, an operon containing
      three open reading frames (ORF), each of which could encode a lipase protein of
      264, 264 or 269 amino acids (aa), was identified from Mycoplasma mycoides subsp.
      mycoides LC. Analysis of aa sequences of the encoded polypeptides showed that
      they display high aa similarity between each other (65-79%) and 28-31% identity
      to other prokaryotic lipases. Moreover, a lipase-esterase activity could be
      detected when the mycoplasmal lipase-encoding genes were expressed in a strong
      opal-suppressor-bearing Escherichia coli strain.

PMID- 7789793
TI  - Gene disruption with PCR products in Saccharomyces cerevisiae.
AB  - We describe here the generation of gene disruption constructs using PCR
      amplification of selectable markers with primers that provide homology to the
      target gene of interest. We find that regions of homology as short as 38 to 50 bp
      suffice to mediate homologous recombination in yeast. We describe applications of
      this technology to three specific yeast genes that would have been difficult to
      disrupt with current methods. By dispensing with the  need to either clone the
      gene of interest or engineer a standard disruption construct, this method should
      facilitate analysis of sequenced genes of unknown function, which will soon
      include the entire yeast genome.

PMID- 7789794
TI  - A mini-promoter lacZ gene fusion for the analysis of fungal transcription control
      sequences.
AB  - A system for the in vivo analysis of fungal transcription control sequences,
      based on a mini-promoter, was designed. The mini-promoter, providing all
      sequences necessary and sufficient for transcription initiation, was derived from
      the Aspergillus nidulans gpdA promoter region. Transcription initiation was not
      affected by the introduction of transcription control sequences directly upstream
      from the mini-promoter. Furthermore, the expression of the mini-promoter was not
      affected by wide-domain carbon or nitrogen control circuits. Using the mini
      promoter vector, a previously identified upstream activating sequence from the A.
      nidulans gpdA gene was further characterized.

PMID- 7789795
TI  - Cloning, characterization and functional expression of an endoglucanase-encoding
      gene from the phytopathogenic fungus Macrophomina phaseolina.
AB  - An endoglucanase-encoding clone (egl2) was isolated from the phytopathogenic
      soilborne deuteromycete fungus Macrophomina phaseolina (Mp). Clones were obtained
      from a cDNA library by functional expression in Escherichia coli. The egl2 clone
      hybridized to a 1.3-kb mRNA. Expression is induced by carboxymethylcellulose
      (CMC) and repressed by glucose. The deduced amino acid (aa) sequence revealed
      strong similarity to the egl3 from Trichoderma reesei (Tr) (72% for identical
      residues and 81% with conservative substitution over a span of 324 aa). The Mp
      egl2 lacks the cellulose-binding domain and linker region found in the Tr egl3.
      Different codon usage between the two fungi resulted in a much shorter span of
      nucleotide homology. The Egl2 protein cleaves cellodextrins with continguous
      beta, 1-4 linkages of four and larger, and shows activity against CMC and
      birchwood xylan.

PMID- 7789796
TI  - Sequences at four termini of the giardiavirus double-stranded RNA.
AB  - The linear double-stranded RNA (dsRNA) genome of giardiavirus (GLV) was estimated
      to be 6100 nucleotides (nt) [Wang et al., Proc. Natl. Acad. Sci. USA 90 (1993)
      8585-8599]. As the 5'- and 3'-untranslated regions (UTR) of viral genomes are
      known to contain critical information for viral replication, we reexamine the
      sequences at all four termini of GLV dsRNA by (i) direct RNA sequencing with RT,
      (ii) tailing GLV dsRNA with UTP or CTP in addition to ATP in 3' rapid
      amplification of cDNA ends (RACE) and (iii) adding poly(dG) to the products of
      primer extension in 5'-RACE. The results confirmed the reported sequence for the
      5'-terminus of the GLV sense strand RNA, but uncovered an additional 177 nt at
      the 3'-terminus. The new study also showed conclusively that there are no
      protruding overhangs at either terminus of GLV dsRNA.

PMID- 7789798
TI  - Isolation and characterization of a new restriction endonuclease, Sru30DI, from
      Selenomonas ruminantium.
AB  - The restriction endonuclease (ENase) Sru30DI, an isoschizomer of StuI, which
      recognizes the sequence 5'-AGG/CCT-3', was purified from a natural isolate of
      Selenomonas ruminatinum. The ENase was isolated from cell extracts using single
      step purification by phosphocellulose column chromatography. Activity of Sru30DI
      is inhibited by overlapping Dcm methylation. The ENase is extremely stable at 37
      degrees C and is active over a wide range of pH, temperature and salt
      concentrations.

PMID- 7789797
TI  - Cloning of a new cation ATPase from Plasmodium falciparum: conservation of
      critical amino acids involved in calcium binding in mammalian organellar Ca(2+)
      ATPases.
AB  - In order to study molecules that may be involved in pH gradient formation in
      Plasmodium, we have identified a novel cation-translocating ATPase (P-type
      ATPase) gene from P. falciparum (Pf). We report the full-length nucleotide and
      deduced amino acid (aa) sequences of this gene that we called PfATPase4. The
      PfATPase4 protein shares features with the different members of eukaryotic P-type
      ATPases, such as a similar transmembrane (TM) organization and aa identity in
      functionally important regions. Interestingly, the PfATPase4 protein possesses
      conserved aa involved in calcium binding in mammalian organellar Ca(2+)-ATPases.

PMID- 7789799
TI  - An arabinose-inducible expression vector, pAR3, compatible with ColE1-derived
      plasmids.
AB  - Arabinose-inducible genetic elements from the Salmonella typhimurium arabinose
      operon were inserted into pACYC184. The resultant plasmid, pAR3, is compatible
      with ColE1-derived plasmids and allows efficient expression of recombinant (re)
      genes upon induction with arabinose. These features make it convenient for use in
      combination with standard gene expression vectors for the independently
      controlled production of two or more re-polypeptides in Escherichia coli.

PMID- 7789800
TI  - Nucleotide sequence of a small plasmid isolated from Acetobacter pasteurianus.
AB  - A 1440-bp plasmid named pAP12875 was isolated from Acetobacter pasteurianus and
      its nucleotide sequence determined. An open reading frame was found capable of
      coding for a protein that has similarity with the replication protein of pVT736-1
      from Actinobacillus actinomycetemcomitans and the 32-kDa protein of phage Pf3
      from Pseudomonas aeruginosa.

PMID- 7789802
TI  - Cloning and sequencing of the neutral protease-encoding gene from a thermophilic
      strain of Bacillus sp.
AB  - The neutral protease-encoding gene (npr) from the thermophilic strain Bacillus
      sp. BT1 was cloned and sequenced. A possible means of regulation of npr
      expression is suggested.

PMID- 7789801
TI  - Diversity of the transferrin-binding protein Tbp2 of Neisseria meningitidis.
AB  - In order to investigate the genetic basis for the observed polymorphism amongst
      meningococcal transferrin-binding proteins, Tbp2, the corresponding genes of
      different Neisseria meningitidis strains were cloned and sequenced. Comparison of
      the deduced amino acid (aa) sequences indicated that the Tbp2 were 76.6 to 81.2%
      homologous. Several stretches of aa have been found repeated both in the N- and C
      terminal halves of the molecule.

PMID- 7789803
TI  - Sequence of a P-methyltransferase-encoding gene isolated from a bialaphos
      producing Streptomyces hygroscopicus.
AB  - The nucleotide sequence of the Streptomyces hygroscopicus gene encoding P
      methyltransferase, catalyzing the formation of a carbon-phosphorus bond, involved
      in bialaphos biosynthesis, has been determined. The amino-acid sequence deduced
      from the nt sequence, shows homology with those of magnesium-protoporphyrin IX
      monomethyl ester oxidative cyclase (Mg-ProtoMe cyclase) of Rhodobacter capsulatus
      and the enzyme catalyzing the methylation of the aldehyde carbon of
      phosphonoacetaldehyde in fosfomycin biosynthesis.

PMID- 7789804
TI  - An improved system for gene replacement and xylE fusion analysis in Pseudomonas
      aeruginosa.
AB  - A novel pUC19-based gene replacement vector has been developed. This vector
      incorporates (i) the counterselectable sacB marker, (ii) a lacZ alpha allele for
      blue-white screening, (iii) an oriT for conjugation-mediated plasmid transfer and
      (iv) unique cloning sites for SmaI and the rare-cutting meganuclease I-SceI.
      These rare restriction sites are also present on the helper plasmid pUC19Sce. The
      replacement vector is engineered to contain few restriction sites to gain greater
      access to restriction sites within cloned DNA fragments, thus facilitating their
      genetic manipulation. The usefulness of the system was demonstrated by
      chromosomal integration of a newly constructed xylE::GmR fusion cassette into the
      glpD gene of Pseudomonas aeruginosa.

PMID- 7789805
TI  - Cloning and sequencing of the Bordetella pertussis cpn10/cpn60 (groESL) homolog.
AB  - The nucleotide sequence downstream from the Bordetella resistance to killing
      (brk) locus in Bordetella pertussis was determined. Analysis of the sequence
      revealed an operon consisting of two highly predicted open reading frames (ORFs).
      The deduced amino-acid sequence of each ORF has strong homologies to the heat
      shock proteins/chaperonins Cpn60 and Cpn10. The promoter contains consensus
      sequences for both sigma 32 and sigma 70 binding, and it possesses the CIRCE
      regulatory inverted repeat. A potential Rho-independent terminator was identified
      and appears to be shared with the brkA gene.

PMID- 7789806
TI  - The nitrate and nitrite reductase-encoding genes of Leptosphaeria maculans are
      closely linked and transcribed in the same direction.
AB  - The 5' flanking region and the first 704 bp of the nitrite reductase-encoding
      gene (niiA) of Leptosphaeria maculans has been sequenced. The niiA start codon is
      1438 bp downstream from the stop codon of the nitrate reductase-encoding gene
      (niaD) and the two genes are transcribed in the same direction.

PMID- 7789807
TI  - The gene encoding the beta-1,4-endoglucanase (CelA) from Myxococcus xanthus:
      evidence for independent acquisition by horizontal transfer of binding and
      catalytic domains from actinomycetes.
AB  - The celA gene encoding a beta-1,4 endoglucanase (CelA) from Myxococcus xanthus
      has been cloned in Escherichia coli and sequenced. The C-terminal region of CelA
      displayed a high level of similarity with the catalytic domain of several Egl
      belonging to the glycosyl hydrolases family 6 (CenA from Cellulomonas fimi, CelA
      from Microbispora bispora, E2 from Thermonospora fusca, CasA from Streptomyces
      KSM9 and CelA1 from Streptomyces halstedii) and less similarity to the
      cellobiohydrolases of the fungi Trichoderma reesei and Agaricus bisporus. Using
      PCR amplification we found in another myxobacterium, Stigmatella aurantiaca, a
      part of a glycosyl hydrolase belonging to the same family. The N-terminal part of
      CelA displayed significant similarities with the cellulose-binding domain of
      other cellulases belonging to a rare subset of family II, such as the avicelase I
      from Streptomyces reticuli, both tandem repeats N1 and N2 of the cellulase CenC
      from Cellulomonas fimi, and the N-terminal part of the Egl E1 from Thermonospora
      fusca. Analyses of the multiple alignments and reconstruction of phylogenetic
      trees strongly suggest that both domains of CelA were acquired by independent
      horizontal transfers between Gram+ soil bacteria and scavenging myxobacteria
      followed by domain shuffling.

PMID- 7789808
TI  - A mutualistic fungal symbiont of perennial ryegrass contains two different pyr4
      genes, both expressing orotidine-5'-monophosphate decarboxylase.
AB  - A fragment of the Claviceps purpurea pyr4 gene, encoding orotidine-5'
      monophosphate decarboxylase (OMP decarboxylase), was used to screen a genomic
      library from an isolate of a fungus, Acremonium sp. (designated Lp1), which grows
      as an endophyte in perennial ryegrass (Lolium perenne). Three positive clones,
      lambda MC11, lambda MC12 and lambda MC14, were isolated. Two of these clones,
      lambda MC12 and lambda MC14, were overlapping clones from the same locus, while
      lambda MC11 was from a different locus. Fragments of these clones which
      hybridised with C. purpurea pyr4 were sequenced and found to have similarity with
      pyr4 from other Pyrenomycete fungi. The pyr4 gene from lambda MC12 and lambda
      MC14 was designated pyr4-1 and that from lambda MC11 was designated pyr4-2. The
      predicted ORFs of the two genes were highly conserved, with 97.5% identity at the
      nucleotide level, the 5' non-coding sequences were the least conserved with 88.5%
      identity and the 3' non-coding sequences had 93.0% identity. RT-PCR analysis of
      total RNA from Lp1 demonstrated that transcripts from the two genes were present
      at similar levels, and hybridisation of pyr4-1 to Northern blots of total RNA
      from Lp1 showed that full-length transcripts were being produced. Genomic
      fragments containing pyr4 were transformed into a strain of Aspergillus nidulans
      which has a mutation in pyrG (encoding OMP decarboxylase). Both pyr4-1 and pyr4-2
      complemented the pyrG mutation in A. nidulans, indicating that both encode
      functional OMP decarboxylases. It has been proposed [Schardl et al., Genetics 136
      (1994) 1307-1317] that the two pyr4 in Lp1 arose by interspecific hybridisation,
      most likely between the ryegrass choke pathogen, Epichloe typhina, and another
      endophyte from perennial ryegrass, Acremonium lolii. Analysis by PCR
      amplification and direct sequencing of the variable 5' non-coding regions of
      pyr4, from possible ancestors to Lp1 supports this hypothesis. Comparisons of
      these sequences to the 5' non-coding sequences from pyr4-1 and pyr4-2
      demonstrated that E. typhina and A. lolii were the most likely ancestors of the
      two pyr4 found in Lp1.

PMID- 7789810
TI  - The pTugA and pTugAS vectors for high-level expression of cloned genes in
      Escherichia coli.
AB  - Plasmids pTugA and pTugAS, designed for expression of cloned genes in Escherichia
      coli, possess the features of high-level inducible transcription, enhanced RNA
      translation, portability, high copy number, stability and versatility. In
      addition, pTugAS can be used to produce fusion proteins comprising a target
      protein and a cellulose-binding domain. Such fusion proteins can be purified in a
      single step by affinity chromatography on cellulose. Expression of two model gene
      fusions using the pTug plasmids resulted in yields of 500 mg of intracellular and
      250 mg of extracellular recombinant protein per liter.

PMID- 7789809
TI  - Analysis of a family of ypt genes and their products from Chlamydomonas
      reinhardtii.
AB  - Small G-proteins encoded by the ras-like ypt genes are ubiquitous in eukaryotic
      cells. They have been shown to play an essential role in membrane vesicle
      transport. We have isolated four ypt genes, yptC1, yptC4, yptC5 and yptC6, from
      Chlamydomonas reinhardtii (Cr) genomic and cDNA libraries. Three of them, yptC1,
      yptC4 and yptC5, are close homologues of ypt genes previously found in the
      multicellular alga Volvox carteri (Vc), the fourth, yptC6, is new. Each yptC gene
      is present as a single copy in the genome. Comparisons of genomic and cDNA
      sequences revealed that the coding regions are interrupted by five (yptC5), six
      (yptC6), seven (yptC4) and eight (yptC1) introns, respectively. Cr ypt genes and
      the closely related Vc ypt genes have identical exon-intron structures, but the
      corresponding intron sequences are completely different. Polyadenylation is
      signalled by UAUAA, UGUAG and UGUAA. The deduced amino acid (aa) sequence of
      YptC6 exhibited 79% identity with HRab2; YptC1, YptC4 and YptC5 exhibited over
      90% identity with their Vc homologues. Primary structures of the 9-aa 'effector
      domain' and the contiguous 'helix3-loop7' motif (approx. 30 aa) are 'diagnostic'
      features for functional assignment. Recombinant YptC proteins, overproduced in
      Escherichia coli and purified to near homogeneity, displayed strong and specific
      binding of GTP, but not of GMP or ATP. The four Cr Ypt proteins showed
      immunochemical cross reactions to their Vc counterparts. Moreover, Western blots
      demonstrated at least six types of Ypt in both Cr and Vc, suggesting that these
      Ypt are used for household functions responsible for vesicle transport rather
      than for cellular differentiation.

PMID- 7789811
TI  - A point mutation in a murine immunoglobulin V-region strongly influences the
      antibody yield in Escherichia coli.
AB  - Recombinant DNA technology has made it possible to produce specific Fab and scFv
      antibody (Ab) fragments in prokaryotic host cells. Using vectors designed for
      periplasmic expression of encoded Ab fragments, we have been studying how the
      sequence and genetic localization of the light chain (L-chain) variable region
      gene of a mouse Ab (CB-Nm.1) determined the level of Ab production. The variable
      region was shown to belong to the V kappa V family and contained a previously
      unreported Ile72. Nine different Ab constructions were tested in monocistronic
      (scFv) or dicistronic (Fab) operons for their ability to affect the synthesis
      level of the L-chain. When the gene coding for the L-chain was located downstream
      from the Fd fragment gene, the substitution of codons encoding Ile by a codon
      encoding Thr was found to be crucial for any expression of the L-chain fragment.
      This was, however, not accompanied by an increase in L-chain-specific mRNA,
      neither was there any change in the size of the mRNA. The fact that the unmutated
      L-chain protein was produced from cells transformed with certain other
      constructions indicated that the protein as such was not incompatible with the
      prokaryotic environment. Together, this suggested that the translation process
      was involved in the restricted production of the L-chain. Thus, surprisingly
      small substitutions significantly affected the expression level, a fact that will
      have important implications on the library size expressed in prokaryotic hosts,
      including phage-displayed Ab libraries.

PMID- 7789813
TI  - Characterization of an open reading frame involved in site-specific integration
      of filamentous phage Cf1t from Xanthomonas campestris pv. citri.
AB  - Cf1t is a single-stranded DNA filamentous phage; a 1.9-kb segment of DNA from
      Cf1t was found to be responsible for site-specific integration into Xanthomonas
      campestris pv. citri (XW47), in the absence of any Xanthomonas origin of
      replication. Deletion analysis and introduction of amber stop codons into this
      fragment from Cf1t revealed an open reading frame (ORF344) which was involved in
      the integration function. The predicted amino-acid sequence of ORF344 bears no
      homology with conserved sequences of the integrase family.

PMID- 7789812
TI  - Isolation and characterization of ompS1, a novel Salmonella typhi outer membrane
      protein-encoding gene.
AB  - We have isolated a novel outer membrane protein (OMP)-encoding gene from
      Salmonella typhi (St), termed ompS1, using the ompF gene of Escherichia coli (Ec)
      as a heterologous probe. The structural ompS1 gene codes for an OmpS1 polypeptide
      that consists of 373 amino acids (aa) in the mature product, with a putative 21
      aa leader sequence, containing highly conserved aa residues that have been
      implicated in pore formation. Mature OmpS1 (41 kDa) is larger than the OmpC, OmpF
      and PhoE St and Ec porins. In contrast to the major porins, it is undetectable in
      Coomassie-stained OMP preparations; although, when ompS1 was cloned into a high
      copy-number plasmid under the control of the inducible tac promoter, it was
      detectable along with major OMPs. The 5' regulatory region of ompS1 has five
      putative binding sites for OmpR, a positive transcriptional regulator. The ompS1
      gene shows restriction-fragment length polymorphism (RFLP) among Salmonellae.

PMID- 7789814
TI  - Cloning and study of the genetic organization of the exe gene cluster of
      Aeromonas salmonicida.
AB  - The Aeromonas salmonicida (As) exe gene cluster, an additional member of the pul
      related operon family required for general signal-sequence-dependent secretion of
      proteins from Gram- bacteria, was cloned in the broad-host-range cosmid pLAFR3.
      Twelve genes, exeC-N, were identified by partial nucleotide (nt) sequence
      analyses (exeE-N) or determination of the complete sequence (exeC and exeD). The
      organisation of the exeC-N genes is similar to that of several other operons of
      this family. These genes are arranged contiguously and are apparently transcribed
      in the same direction. On alignment of As and A. hydrophila exe sequences a 73-bp
      'silent' deletion was identified close to the end of the As exeF gene. No gene
      encoding prepilin peptidase (the PulO homolog) was detected in this region. The
      exeN gene is evidently the last gene of this operon; it is followed by an ORF
      encoding a putative transcription regulator.

PMID- 7789815
TI  - Cloning and sequencing of a beta-lactamase-encoding gene from the insect pathogen
      Bacillus thuringiensis.
AB  - A beta-lactamase (Bla)-encoding gene (bla) from Bacillus thuringiensis (Bt) was
      cloned and the nucleotide (nt) sequence was determined. Both the nt sequence and
      deduced amino acid sequences reveal that the Bt Bla is very similar to that of B.
      cereus and other group A Bla. The transcription start point was also determined.
      Comparison of the upstream region of Bt bla with that of other genes suggested
      the presence of three sequence elements that might be involved in promoter
      function: the -10 (TCGGTGAT) and -35 (TTAT) sequences, an A+T-rich region
      (5'TACTAGCTATAATTTTTTAGT) and an inverted repeat sequence (5'
      GAGATAGAGGC[GCTACTATCTC).

PMID- 7789816
TI  - Cloning and sequence determination of the aspartase-encoding gene from
      Brevibacterium flavum MJ233.
AB  - A 2.5-kb EcoRI fragment containing the aspartase-encoding gene (aspA) of
      Brevibacterium flavum MJ233 was cloned into plasmid pUC18 using Southern
      hybridization with the Escherichia coli aspA gene as a probe. The complete
      nucleotide (nt) sequence of the cloned DNA indicated that the deduced gene
      product of the Br. flavum aspA is composed of 526 amino acids (aa). Comparison of
      the aa sequence to the corresponding sequences from E. coli, Bacillus subtilis
      and Pseudomonas fluorescens revealed 63, 47 and 57% homology, respectively. The
      aspA product was determined to have a size of approx. 57 kDa by SDS-PAGE.

PMID- 7789817
TI  - Gene disruption in Escherichia coli: TcR and KmR cassettes with the option of Flp
      catalyzed excision of the antibiotic-resistance determinant.
AB  - Two cassettes with tetracycline-resistance (TcR) and kanamycin-resistance (KmR)
      determinants have been developed for the construction of insertion and deletion
      mutants of cloned genes in Escherichia coli. In both cassettes, the resistance
      determinants are flanked by the short direct repeats (FRT sites) required for
      site-specific recombination mediated by the yeast Flp recombinase. In addition, a
      plasmid with temperature-sensitive replication for temporal production of the Flp
      enzyme in E. coli has been constructed. After a gene disruption or deletion
      mutation is constructed in vitro by insertion of one of the cassettes into a
      given gene, the mutated gene is transferred to the E. coli chromosome by
      homologous recombination and selection for the antibiotic resistance provided by
      the cassette. If desired, the resistance determinant can subsequently be removed
      from the chromosome in vivo by Flp action, leaving behind a short nucleotide
      sequence with one FRT site and with no polar effect on downstream genes. This
      system was applied in the construction of an E. coli endA deletion mutation which
      can be transduced by P1 to the genetic background of interest using TcR as a
      marker. The transductant can then be freed of the TcR if required.

PMID- 7789818
TI  - A promoter-screening plasmid and xylose-inducible, glucose-repressible expression
      vectors for Staphylococcus carnosus.
AB  - We describe a series of plasmid vectors for DNA cloning in staphylococci. pPS11
      is a promoter probe plasmid containing a promoterless lipase (Lip)-encoding gene
      (lip). Insertion of a promoter-bearing DNA fragment at the single BamHI site
      turns on lip expression. Lip activity can be easily determined to estimate the
      strength of the inserted promoter. pPS11 served also as a basis for the
      construction of vectors which allow xylose-inducible gene expression in
      Staphylococcus carnosus (Sc). Using plasmid pCX15, we studied xylose-inducible
      lip expression in Sc. The lip expression is under transcriptional control of the
      repressor, XylR. The xylR gene, the XylR target sequence and the xylA
      promoter/operator sequence with the cis-acting catabolite-responsive element
      (cre) are derived from the xyl operon of S. xylosus. The single BamHI site in
      front of the lip ribosome-binding site (RBS) also makes it possible to put other
      promoterless genes under transcriptional control of XylR. To facilitate the
      controlled expression of genes which merely start with the start codon and have
      no RBS, or to insert genes with their own RBS, pCX26 and pCX26 delta lip were
      constructed. The influence of xylose and glucose on lip expression was studied
      both in a batch culture and in a fermentor under controlled pH conditions. With
      pCX15, the presence of xylose led to a 40-fold increase in extracellular Lip
      activity, while the presence of glucose caused a repression of lip expression.
      The results suggest that the xylA promoter is subject to two different regulatory
      mechanisms, one of which involves the repression of the xylA promoter by XylR in
      the absence of xylose, and the other involves a glucose-mediated catabolite
      repression which dominates over the xylose induction.

PMID- 7789819
TI  - Complementation of a Streptomyces lividans Leu- mutant by the Actinoplanes
      teichomyceticus leuC gene.
AB  - A leucine auxotroph of Streptomyces lividans (Sl), designated PC196, was unable
      to convert alpha-isopropylmalate into the beta-isomer. A DNA fragment from
      Actinoplanes teichomyceticus (At) cloned into the Streptomyces vector pIJ702
      complemented PC196. Sequence analysis of the 3.0-kb insert revealed one complete
      ORF with high similarity to other leuC genes encoding the large subunit of
      isopropylmalate isomerase (IPMI), and the 5' end of a second ORF corresponding to
      leuD, which encodes the smaller subunit of IPMI. Further subcloning established
      that Sl strain PC196 is defective in the large subunit of IPMI.

PMID- 7789820
TI  - [Current approaches to the prevention of cochlear disorders during periodic
      physical examination of workers, exposed to noise].

PMID- 7789821
TI  - [Predicting skin allergy in workers exposed to chemical allergens].
AB  - A system for predicting the risk of contact dermatosis in workers handling
      chemical allergens (epoxy resins) was developed. The accuracy of forecast is up
      to 86 per cent due to use of anamnestic, clinical, and immunological data. This
      system can be useful for prophylaxis of contact dermatitis at enterprises where
      chemical allergens are used.

PMID- 7789823
TI  - [Factual nutritional status in workers of a machine-building factory].
AB  - Physical development, energy expenditures, morbidity, and supply with the main
      food-stuffs were studied in machine-building workers. Peculiarities of alimentary
      status of workers were basis for development of hygienic recommendations on
      rationalization of their nutrition.

PMID- 7789822
TI  - [Changes of regional hemodynamics in lead manufacturing workers].

PMID- 7789824
TI  - [Evaluation of reserved potentials of respiration, cardio- and hemodynamics in
      young athletes].

PMID- 7789825
TI  - [Pedagogic and hygienic aspects of utilization of computer-assisted automated
      instructions].

PMID- 7789827
TI  - [Methods of development of a data bank on ecologic and hygienic characteristics
      of chemical environmental pollutants].

PMID- 7789828
TI  - [Methods of correlation of population health and hygienic and other factors].

PMID- 7789829
TI  - [New hygienic methods of blockage of climate disadaptation and climate-related
      reactions].

PMID- 7789826
TI  - [Radiation status in Moscow and Moscow region effected by radiation fallout
      during 1989 -- 1993 gg].

PMID- 7789830
TI  - [Visual productivity of near-sighted computer users working with various colored
      display screens].

PMID- 7789831
TI  - [Basic goals of psychological hygiene in connection with distraction of the
      chemical weapon].

PMID- 7789832
TI  - [Evaluation of maximal permissible concentration of 2-allyl oxyethanol in the
      atmospheric air].
AB  - The threshold irritable concentration of 2-allyl oxyethanol (2-AOE) in ambient
      air was determined at the level of 0.68 mg/m3. The threshold of chronic effect of
      2-AOE is 0.075 mg/m3. The mean daily permissible concentration of 2-AOE is
      suggested at the level of 0.01 mg/m3.

PMID- 7789833
TI  - [Effect of electric field of industrial frequency on the changes of micronucleus
      test and electric conductivity in laboratory animals].

PMID- 7789834
TI  - [Social and hygienic monitoring].

PMID- 7789835
TI  - [Memorable dates and anniversaries in the history of hygiene and sanitation in
      1995].

PMID- 7789837
TI  - [Modernization of equipment and methods of its utilization for evaluation of air
      microbiology].

PMID- 7789838
TI  - [Organization of quality control of an accredited laboratory].

PMID- 7789836
TI  - [Evaluation of toxic substances in vodka and drinking alcohols by gas liquid
      chromatography].

PMID- 7789839
TI  - [Effect of sanitary and hygienic conditions of populated placed on the incidence
      of intestinal diseases].
AB  - Data on the relationship between the incidence of intestinal infections,
      including hepatitis A, and communal conditions of settlements and quality of
      drinking water are presented.

PMID- 7789841
TI  - [Commemorative centenary of Felix Marchand's description of gestational
      trophoblastic tumors].

PMID- 7789840
TI  - [Anionic surface active substances used for prevention of salt concentration in
      irrigated lands of hot regions].
AB  - Anionic surfactant PO-ID at the level of 10, 25 and 50 kg/ha did not depress
      biological activity of soil and stimulated nitrogen metabolism. Water-migration
      and translocation indexes of this surfactant should be studied.

PMID- 7789842
TI  - [Management of pregnant women with human immunodeficiency virus (HIV) infection].

PMID- 7789843
TI  - [Treatment of puerperal endometritis].

PMID- 7789844
TI  - [Placenta praevia. Maternal and perinatal repercussions. Analysis of 170 cases].
AB  - One hundred and seventy cases with placenta previa, at Instituto Nacional de
      Perinatologia, from 1989 to 1993, were reviewed. Incidence in our population was
      0.62%; average maternal age was 31 years; the greater amount of cases was among
      nulliparae; in 72% of them there was the antecedent of uterine scar. Ultrasound
      diagnosis was done in 81% of the patients, and most frequent placental insertion
      type was the low one in 49%, and in 31%, total, central placenta. The first
      hemorrhagic episode occurred at a gestational age of 34 weeks. Most frequent
      complication was threatening pre-term delivery, and ethinyl adrianol was used as
      uterine inhibitor. All pregnancies were interrupted, via abdominal. Placental
      accretion was a frequent complication. Hemorrhage during the second half of
      gestation is one of the main causes of perinatal morbidity-mortality. Frequency
      of this complication is from 3% to 5%, of all pregnancies in an open population;
      and when it appears, is one of the most serious urgencies; so its early diagnosis
      and opportune treatment will diminish maternal and perinatal morbidity-mortality.
      Etiology is unknown, but diminished endometrial vascularization, at fundus and
      body, may be the causal factor. There are other predisposing causes as age,
      advanced maternal age, multiparity, tumours, scars and smoking. The objective of
      this study, was to analyze maternal and perinatal repercussions, of placenta
      previa, based on the experience at Instituto Nacional de Perinatologia.

PMID- 7789845
TI  - [Perinatal morbidity and mortality in pregnant women with diabetes mellitus].
AB  - The purpose of this study was to investigate the perinatal morbidity and
      mortality in all the diabetic pregnancies seen at the HGO-"LCA" from January 1992
      to December 1993. In that period 186 women (mean age 31 yr) were diagnosed as
      having diabetes during pregnancy: 54% of them had DMG, 40% DM-II and 6% DM-I,
      with serum glucose concentration of 133 +/- 41 mg/dL. Neonatal morbidity was
      given by macrosomia (17%), prematurity (14%), hyperbilirubinemia (11%),
      hypoglycemia (8%), congenital malformation (6%) and hypocalcemia (4%). Perinatal
      mortality was 5.3%. The principal causes of maternal morbidity were preeclampsia
      (17%), polyhydramnios (16%), pyelonephritis (4%) and ketoacidosis (0.05%).
      Cesarean section was performed in 62% of all diabetic patients. There was not any
      maternal death. This results showed a high perinatal morbidity-mortality in
      pregnancies complicated by diabetes mellitus which reclaim a better metabolic
      control during gestation period.

PMID- 7789846
TI  - [Perinatal mortality].
AB  - Eighty six cases of perinatal mortality at Hospital de Ginecoobstetricia, Garza
      Garcia, N.L. Subsecretaria Estatal, from january, 1992 to December, 1993, were
      reviewed. Perinatal mortality was 12.0 by one thousand births, less than in other
      reports. The highest incidence was in young patients, 20 to 29 years old, with
      47.7% and with parity of 1 to 3, 80.2%; highest frequency in term pregnancies, 37
      to 42 weeks, 39.6%; 35% of the products with weight over 2,500 g; and 65% with
      lesser weight; fetal death occurred most frequently during pre-partum, 55.8%, and
      less during intra-partum, 19.8%. Most frequent causes of peri-natal death were
      placental failure, 27.9% and fetal immaturity, with 24.4%. It is concluded that
      an adequate pre-natal control and delivery surveillance produce a diminution in
      fetal mortality.

PMID- 7789847
TI  - [Brucellosis in pregnancy: course and perinatal results].
AB  - Brucellosis is a zoonosis that affect cows, goats and pigs, but in endemic zones
      human beings are frequently infected. Brucella infection in animals is associated
      with a high incidence of abortion, in humans a cause-effect relationship has not
      been proven. We present four cases of pregnant women with Brucella infection, all
      were treated only with rifampin, the patients had adequate obstetric evolution,
      the deliveries were at term and there were not birth defects or intrauterine
      growth retardation. One woman had a relapse during her puerperium. In the medical
      literature review there were not enough support to attribute to brucellosis as
      causal factor of abortion in humans. The treatment during pregnancy must include
      the combination of rifampin with another antibiotic with intracellular action.

PMID- 7789849
TI  - [Advanced cervix uteri carcinoma in a patient with acquired human
      immunodeficiency virus infection. Case report and review of the literature].
AB  - A case of cervix uterine carcinoma concomitant with HIV infection was described.
      The patient was treated with radical radiation therapy and the course of the
      neoplastic disease was not modified for the HIV infection. The tolerance and
      final result of the treatment, and the importance of the early screening of the
      HIV infection and the carcinoma of the cervix uterine was discussed.

PMID- 7789848
TI  - [Triple mechanical heart valve prosthesis and pregnancy].
AB  - A very unusual case, of a multiparous, 36 year-old, woman, she had previous
      mechanical replacement of her mitral, aortic and tricuspid valves, and was with
      coumarins. Her 6th pregnancy was uneventful, with no cardiovascular
      decompensation and delivered a healthy baby girl, weighing 1,700 g. without
      congenital malformations. We discuss here, her medical management during and
      after pregnancy as well as, the factors influencing an optimal result for both,
      mother and baby.

PMID- 7789850
TI  - [Scuba diving and pregnancy. A case report and review of the literature].
AB  - The number of women in childbearing age participating in SCUBA dividing is
      increasing. Some dives during first trimester before pregnancy is confirmed. The
      preoccupation of both parents, is that the child could have any damage in the
      embryonal stage. This is a review of the literature and we present one case of a
      patient 28 years old with one immersion of 25 meters, at 28 days of gestation.
      The child did not present any congenital deformity at birth and his growth and
      development in the eighteen months have been normal.

PMID- 7789852
TI  - [Modified sling operation: institutional experience].
AB  - We report the retrospective experience in the treatment of six patients with
      recurrent or severe stress urinary incontinence or low urethral pressure. They
      were treated with sling modified procedure with polytetrafluoroethylene (Gore
      Tex); in the National Institute of Perinatology (INPer) at 1992-1994. The
      morbidity was highest, the patients in the post operatory present detrusor
      instability, voiding problems and tissue reaction to polytetrafluoroethylene. The
      patients are continent in the actuality. They were observed by 8-32 months. This
      surgery is easy to make and not required of more experience than the necessary
      for realizing the cysto-urethropexy with needle, but, the selections criteria
      must be carefully analyzed.

PMID- 7789854
TI  - [HELLP syndrome. 7-year experience at the National Institute of Perinatology].
AB  - We studied 36 patients with Hellp syndrome and her newborn during seven years in
      the National Institute of Perinatology (INPer). The objective of this study is
      show the epidemiology and clinic features, unite diagnostic criteria and
      classification, furthermore establish morbidity and mortality maternal and
      perinatal. The 44.6% (16/36) was type I, and 55.6% (20) was type II. The average
      of pregnancies was 3. The 38.9% (14/36) received regular prenatal control. Both
      types were more common in patients with preterm pregnancies, between 28-36 weeks.
      The patients with severe preeclampsia and eclampsia were more common. The cases
      with type I had more complications and stayed on hospital more time. The maternal
      mortality was 5.55%. Perinatal outcomes were unsatisfactory, with high incidence
      of asphyxiated newborn. The newborn of patients with type I had more severe
      complications and stayed more time on the hospital. The perinatal mortality was
      32.43%.

PMID- 7789853
TI  - [Urinary retention secondary to surgical treatment of stress urinary
      incontinence].
AB  - A retrospective, descriptive study at the National Institute of Perinatology
      (INPer), was carried out. 401 records of patients with stress urinary
      incontinence who underwent surgical treatment, were reviewed. The objective of
      this study was to know the urinary retention rate. Urinary retention was present
      in 103 of 401 patients (25.68%). In modified Pereyra's procedure it was present
      in 67 of 195 (34.35%); in modified Burch's procedure, in 25 of 131 (19.08%); in
      Kelly's procedure in 9 of 70 (12.85%) and in 2 of 5 patients with sling procedure
      with polytetrafluoroethylene (Goretex). The problem of urinary retention was
      observed more frequently in vaginal surgery (modified Pereyra procedure and/or
      sling procedure).

PMID- 7789851
TI  - [Feasibility study: concurrent 13-cis-retinoic acid, alfa-2a interferon and
      radiotherapy in the treatment of 23 patients with advanced cervix uteri
      epidermoid carcinoma].
AB  - The important therapeutic activity of 13-cRA and IFN-alpha-2a in carcinoma of
      squamous cells, cervical, without previous treatment, is confirmed. An unexpected
      result was the early toxicity of the biologic agents on the colon mucosa when
      they are combined with radiotherapy.

PMID- 7789855
TI  - [Skin endometriosis in abdominal scar after cesarean section. Case report and
      review of the literature].
AB  - Scan endometriosis is a rare entity, commonly related after operation on the
      uterus or uterine tubes or a laparotomy procedure or other no pelvic surgical
      procedure, when transplantations of endometrial fragments were shed into the
      peritoneal cavity. We present a case of a 31 year woman, who had the clinical and
      histopathological diagnosis of scar endometriosis following cesarean section,
      treated with local surgical excision of the abnormal tissue, with a satisfactory
      response. And a review of world literature, was done.

PMID- 7789856
TI  - [Evaluation of carbohydrate metabolism in women with previous gestational
      diabetes mellitus].
AB  - 70 women with previous (1983-1993) history of gestational diabetes mellitus (GDM)
      were examined in order to assess their present carbohydrate metabolism. The
      through examination together with oral glucose tolerance test (OGTT) according to
      WHO were performed. Also the level of glycosylated hemoglobin HbA1c was measured.
      The following risk factors were analysed: obesity; arterial hypertension; family
      history of diabetes; number of past pregnancies; time that passed since the
      pregnancy with GDM; trimester in which GDM was diagnosed. In result 54% of all
      subjects were diagnosed as having diabetes mellitus, 19% had impaired glucose
      tolerance (IGT). The presence of diabetes or IGT significantly correlated with
      the number of past pregnancies, observation time and indirectly with family
      history of diabetes. Using both measurements of fasting blood glucose and
      glycosylated hemoglobin enables to diagnose nearly 80% of diabetes following GDM
      and as a diagnostic method is worth recommending for screening. Women who had GDM
      should be subjected to control examinations towards diabetes mellitus at least
      once a year.

PMID- 7789857
TI  - [Evaluation of the influence of placental localization on qualitative estimation
      of waveforms of blood flow velocity in uterine and arcuate arteries in third
      trimester physiologic pregnancy].
AB  - We presented in our study methods and results of blood flow measurements with
      Doppler ultrasound in uterine and arcuate arteries in relation to localization of
      placenta in physiological pregnancy. We performed examinations in 154 pregnant
      women with pregnancy age of 32-42 wk. On the basis of qualitative analysis of
      blood flow waveforms we discovered the difference in the blood flow in utero
      placental compartment in relation to placental localization and we proved that
      this change takes place in uterine as well an in arcuate arteries.

PMID- 7789858
TI  - [Fluoride in the organism of mother and fetus. II. Fluoride cumulation in the
      organism of the fetus].
AB  - The authors present the results of measuring the content of fluoride, calcium and
      phosphates performed on material comprising 66 thigh bones of human fetus in 4
      age groups. In the studies the division into epiphysis and metaphysis parts was
      taken into consideration. A prepared complication furnishes the ratios of calcium
      to fluoride and calcium to phosphates in epiphysis and metaphysis parts, as well
      as ratio of calcium in epiphysis to calcium in metaphysis parts of the studied
      bones in the respective age groups. It has been disclosed that the increasing
      fluoride cumulation in fetal bones is a signal that the human organism is likely
      to be exposed to fluorine action already during the fetal life period. The
      fluoride content in thigh bones of fetus does not correlate with the content of
      calcium and phosphates, which may be evidence that there is a lack of significant
      influence of the determined fluoride content on the mineralization process taking
      place in bones at this period of life.

PMID- 7789859
TI  - [Evaluation of the effect of oxytocin use for labor induction on frequency of
      occurrence and severity of neonatal jaundice].
AB  - Authors conducted analysis of effect of method used (which consisted of use of
      oxytocin, vit B, oestradiol) for labour induction on frequency of occurrence and
      severity of neonatal jaundice on 3rd day of neonatal life. Analysed material
      consisted of 1154 deliveries between the years 1990 to 1992 in IInd Department of
      Obstetrics AM Wroclaw. Only completely physiological pregnancies qualified for
      analysis. The above mentioned sum of analysed deliveries was divided into 2
      groups. Ist group consisted of 801 normal deliveries without any oxytocin use 2nd
      group consisted of 353 normal deliveries during which i.v. oxytocin drip was used
      either for induction of labour or to intensify uterine contraction during labour.
      Evaluation of the above data do not show significant increase in cases with
      hyperbilirubinemia in group with labour induction (7%) in comparison with
      deliveries without oxytocin use (5%). Moreover eliminating from the analysis
      cases of jaundice with normal bilirubin level (12 mg%), I degree jaundice, the
      actual count of cases of hyperbilirubinemia in group without oxytocin use in 26
      (3.24%) and in group with oxytocin use is 13 (3.67%) cases (Tab. IV) which is not
      a significant difference and does not permit us to conclude that oxytocin use for
      labour induction is responsible for increased frequency of neonatal
      hyperbilirubinemia.

PMID- 7789860
TI  - [The concentration of n-terminal propeptide of type III procollagen in umbilical
      cord serum--biochemical marker of newborn maturity].
AB  - The concentration of N-terminal propeptide of type III procollagen (PIIINP) in
      umbilical cord serum was estimated in preterm and term newborns. The mean
      concentration of PIIINP was significantly higher in preterm infants, despite
      their lower body mass. This indicates higher rate of collagen biosynthesis in
      early gestation. The highest PIIINP were found among the most immature infants,
      which suggest the usefulness of PIIINP as an biochemical marker of newborn
      maturity.

PMID- 7789861
TI  - [CO2 laser in treatment of uterine cervix dysplasia in women with infertility].
AB  - The authors presented use of carbon dioxide laser in treatment of dysplasia of
      the uterine cervix in women with malreproduction. Between November 1991 and
      September 1993 in the Department of Reproduction, Institute of Gynecology and
      Obstetrics, Academy of Medicine, Poznan the CO2-laser vaporisation in 21 women
      was done. In 19 patients the healing was achieved. In two of 21 women in control
      examination CIN was diagnosed. They were treated with electroconisation. In
      control examination no signs of dysplasia in all women were observed. The
      patients are still under control in our department.

PMID- 7789862
TI  - [Beeswax pessary in conservative treatment of uterine prolapse].
AB  - The own method of uterine prolapse treatment with the use of beeswax pessary is
      presented. The described method is applied in cases where general health
      conditions do not allow to perform the surgery. The study revealed that the
      beeswax is a good material to make a vaginal pessary. It's great plasticity
      allows individual modelling in compliance with anatomical conditions of treated
      patient. That provides the proper stability of uterine position. The risk of
      possible urinary stress incontinence due to uterine reposition is also
      diminished.

PMID- 7789863
TI  - [Transfer RNA (tRNA) in primary and metastatic endometrial cancer tissue].
AB  - Two dimensional polyacrylamide gel electrophoresis of 3' end labeled total tRNA
      from primary and secondary (metastatic) endometrial cancer was used to obtain
      mapping of isoacceptors. In tRNA from primary tumor 87 isoacceptors were found
      whereas in metastatic cancer only 52 spots corresponding to isoacceptors were
      detected. Normal myometrial tRNA used as a control contained 51 isoacceptors. The
      isoacceptors specific for neoplasia were observed in both cancer tRNAs.

PMID- 7789864
TI  - [Breast cancer in women under the age of 35].
AB  - A retrospective analysis of a group of 102 women younger than 36 years is
      reported. All patients were treated initially only surgically by Halsted or Patey
      mastectomy. Disease-free 10-year survival was noted in 39.2% of the patients. The
      effectiveness of the treatment proved to be the same in the group of women under
      and over the age 35. For all patients with breast cancer, despite their age,
      identical prognostic factors were observed.

PMID- 7789865
TI  - [Combined calculation of dosage for brachytherapy and external beam therapy in
      radiation treatment of cervix cancer].
AB  - In this paper authors present complex doses of ionizing radiation from
      brachytherapy and external beam therapy. Doses were determined on Computerized
      Planning System--Target 2 plus for patients with cancer of cervix.

PMID- 7789866
TI  - [Unsuccessful pregnancies in a genetic carrier of translocation
      46,XX,t(4;5)(p11;q14)].
AB  - Authors presents 36-year old female patient with three spontaneous abortions as a
      result of carrier state of balanced reciprocal translocation. This chromosome
      anomalies has been classified like the translocations with the double risk of
      unbalanced fetal karyotype++. The zygote can be normal, trisomic for part of a
      chromosome or monosomic for part of a chromosome.

PMID- 7789867
TI  - Neurophysiological evaluation of motor damage after ischaemic stroke.

PMID- 7789868
TI  - P3 components evoked by unilateral and bilateral somatosensory stimulation:
      normative data for the study of neglect syndrome.
AB  - Latency and amplitude of an "odd-ball" somatosensory P3 component evoked either
      by unilateral or bilateral somatosensory target stimulation, were measured in 15
      healthy right-handed subjects (age range 42-79 years) in order to obtain
      normative data useful for studying the neglect syndrome. The bilateral
      stimulation protocol was designed to investigate the tactile extinction
      phenomenon. P3 waves were recorded from nine electrodes. A three-way Anova showed
      that mean P3 latency on the whole scalp following unilateral stimulations,
      regardless of side (i.e. right or left stimulations), was significantly longer
      than that observed after bilateral stimulation. Both "early" and "late" peaks
      were usually observed in P3 complex. The bilateral modality stimulation showed a
      more evident "early" peak than the two unilateral stimulations. No significant
      mean P3 amplitude differences were observed on the whole scalp between bilateral
      and unilateral stimulations. No significant amplitude differences were observed
      either for the right or the left hemisphere. The reported latency decrease in the
      bilateral target stimulation may be a valuable cue for studying possible
      modifications in patients affected by neglect.

PMID- 7789869
TI  - Sensitivity and specificity of the EEG versus CT in acute cortical and
      subcortical stroke.
AB  - 122 patients with acute stroke were examined in order to demonstrate the
      sensitivity and the specificity of EEG versus CT findings, in distinguishing
      cortical from subcortical lesions. To do this the electroencephalographic
      diagnosis performed by two different electroencephalographers was compared with
      the neuroimaging diagnosis. The results showed a sensitivity of 77% and a
      specificity of 75%. Furthermore, the EEG findings can also provide
      physiopathological data, in that the cortical lesions are likely to be due to
      embolism, while the subcortical lesions are more likely to be due to the
      pathological process of the intracerebral blood-vessels and the lesions of the
      watershed territories to hemodynamic phenomena.

PMID- 7789870
TI  - Charles Edouard Brown-Sequard.

PMID- 7789871
TI  - Thalamic regulation of epileptic spike and wave discharges.
AB  - Idiopathic generalized epilepsy is characterized by the spontaneous occurrence on
      the electroencephalogram of bilateral synchronous spike and wave discharges that
      involve the entire cortical mantle from the very onset. A central role in
      cortical synchronization is played by the thalamus, and in particular by the
      reticularis thalami nucleus, which is regarded as the pacemaker structure for the
      rhythmic cortical oscillations called spindle activity. Several studies have
      suggested that the network mechanisms which underlie spindle generation can also
      account for spike and wave discharges. Experimental investigations on genetic
      animal models of generalized epilepsy, in which seizures occur spontaneously in
      the absence of any inductive agent, confirmed that the thalamo-cortical system is
      involved in spike and wave discharge generation. According to these studies a
      genetically determined dysfunction in reticularis thalami neurons may alter the
      electroresponsiveness of the developing thalamo cortical system and cause a
      persistent state of abnormal excitation.

PMID- 7789872
TI  - Adjuvant postoperative radiation: what size target?

PMID- 7789873
TI  - Comparison of a novel redox dye cell growth assay to the ATP bioluminescence
      assay.
AB  - Antisense oligodeoxynucleotides (ASOs) are being studied with increasing
      frequency to determine their potential role as anticancer drugs. The overwhelming
      majority of this research continues to be done in vitro. Reliable and accurate
      determination of cell proliferation and/or inhibition, therefore, is essential
      for the production of meaningful results. The Alamar Blue assay, a
      colorimetric/fluorometric redox dye assay, was recently marketed by Alamar
      Biosciences (Sacramento, CA). In order to determine a potential role for this
      assay in ASO research, it was extensively tested on ovarian cancer cells in
      culture under a variety of conditions including uninhibited cell growth, cell
      kill with cytotoxic chemotherapeutic agents, and growth inhibition with ASOs.
      Results were compared directly with the ATP bioluminescence assay. We conclude
      that the Alamar Blue assay correlates poorly with the ATP assay, and it should be
      used only as a rapid preliminary screening assay. The ATP bioluminescence assay
      should continue to be considered as the standard in this setting.

PMID- 7789875
TI  - Complete inhibition of human ovarian cancer xenografts in nude mice by suramin
      and cis-diamminedichloroplatinum(II).
AB  - In this study, we have determined the adjuvant effects of suramin to cis
      diamminedichloroplatinum(II) (CDDP) on human ovarian cancer (KF) cell growth in
      vitro and in vivo. Suramin inhibited the ovarian cancer cell proliferation in
      vitro in a dose-dependent manner between 10 and 80 microM, showing the IC50 of 29
      microM. From analysis of flow cytometry (FCM), suramin seemed to be a blocker of
      G2-M phase of the cell cycle. From the results of the isobologram, suramin
      appeared to have additive and somewhat synergistic effects on antitumor activity
      of CDDP. When 5 x 10(5) KF cells were inoculated sc into the right flank of nude
      mice, 8 of 10 mice formed solid tumor at 4 weeks. When 2 mg/kg CDDP was
      administered ip every week, the 80% tumor formation was prolonged to 10 weeks.
      Treatment with 5 and 10 mg/kg suramin decreased the formation rate of palpable
      tumor to 50 and 30%, respectively. When CDDP was followed by 5 or 10 mg/kg
      suramin, the tumor formation rate was 20 or 0%. On the other hand, if suramin was
      followed by CDDP, the tumor formation was not observed in any mouse during the
      experimental period. These results suggest that suramin may provide a new
      strategy for treatment of refractory ovarian carcinoma.

PMID- 7789874
TI  - A trial of lobaplatin (D-19466) in platinum-resistant ovarian cancer.
AB  - Long-term survival in epithelial ovarian cancer remains problematic despite
      multimodality therapy. A fundamental difficulty is the development of tumor
      resistance to platinum compounds. Analogs have been developed that demonstrate
      activity in platinum-resistant cell lines both in vitro and in vivo. Lobaplatin
      (D-19466), a third-generation compound, demonstrates significant activity in
      carboplatin and cisplatin-resistant cell lines. Lobaplatin was given to 17
      assessable patients with platinum-refractory ovarian cancer. The drug was
      initially administered at a dose of 50 mg/m2 but was later reduced to 40 mg/m2
      because of excessive thrombocytopenia. Nine patients required red cell
      transfusions during therapy. Cycles were repeated every 21-35 days (median cycle
      length 28 days). No objective responses were observed. Lobaplatin has no activity
      in platinum-resistant epithelial ovarian cancer.

PMID- 7789876
TI  - Evidence for tight coupling of gonadotropin-releasing hormone receptors to
      phosphatidylinositol kinase in plasma membrane from ovarian carcinomas.
AB  - Gonadotropin-releasing hormone (Gn-RH) analogs inhibit ovarian cancer cell
      proliferation in vivo and in vitro. To examine whether Gn-RH receptor (Gn-RHR)
      mediates direct antiproliferative effects, we attempted to determine inhibitory
      regulation by Gn-RH of phosphatidylinositol (PtdIns) kinase activity, known to
      stimulate mitogenic response, in plasma membranes isolated from ovarian carcinoma
      samples. Ovarian carcinomas surgically removed and cloned cell line SK-OV3 had
      been screened for Gn-RHR expression prior to plasma membrane isolation. PtdIns
      kinase activity was measured as phosphorylation of exogenous substrate PtdIns by
      the purified plasma membranes. Incubation of the plasma membranes isolated from
      Gn-RHR-positive specimens with [gamma-32P]ATP and PtdIns caused [32P]phosphate
      incorporation into PtdIns phosphate (PtdInsP) in a time-dependent manner.
      Concomitant exposure of the membrane preparations to Gn-RH analog buserelin (1
      microM) led to a 70% inhibition of the PtdInsP production, when compared to
      control. After 10 or 15 min of an initial incubation, the addition of analog
      resulted in similar suppression of PtdIns phosphorylation. This inhibition was
      dependent on the buserelin dose, and a half-maximal effect occurred at a
      concentration 0.1 to 1 nM of buserelin. Degradation of the produced PtdInsP in
      the plasma membranes was not affected by the Gn-RH analog. Similar inhibition of
      PtdIns kinase activities was observed in membranes prepared from cells that had
      been pretreated with buserelin (1 microM) for 48 hr prior to assay. These
      findings demonstrate that PtdIns kinase activity is suppressed by Gn-RH analog in
      plasma membrane isolated from GnRHR-expressing ovarian carcinomas, suggesting a
      tight coupling of Gn-RHR to PtdIns. The inhibition of membrane-associated PtdIns
      kinase by Gn-RHR occupancy may mediate the antimitogenic action of the hormone on
      human ovarian carcinomas.

PMID- 7789877
TI  - Fertility therapy in the setting of a history of invasive epithelial ovarian
      cancer.
AB  - A link between fertility drugs and epithelial ovarian cancer has been suggested
      by at least one case-control study, and by multiple case reports of such tumors
      developing following fertility drug therapy. We report the case of a woman with
      stage IC grade 1 mucinous epithelial ovarian cancer who died of recurrent disease
      shortly after receiving gonadotropin therapy for ovulation induction. The patient
      was initially treated with a staging procedure, unilateral salpingo-oophorectomy,
      and 3 courses of cytoxan and carboplatinum. Over the next 3 years she underwent 2
      cycles of ovulation induction with exogenous gonadotropins. Five months after the
      second cycle, the patient presented with a bowel obstruction and extensive
      recurrence of disease. Two months later she died despite extensive surgical
      debulking, and cis-platinum and Taxol chemotherapy. Although a causal
      relationship between fertility therapy and ovarian cancer has not been
      established, this case report suggests ovulation induction may be inadvisable in
      a woman with a prior diagnosis of invasive epithelial ovarian cancer.

PMID- 7789878
TI  - Paraneoplastic retinopathy associated with uterine sarcoma.
AB  - We present the first reported case of cancer-associated retinopathy with uterine
      sarcoma. A 65-year-old woman presented in August 1990 with loss of vision,
      photophobia, and visual field restriction. Antiretinal antibodies were elevated.
      A diagnosis of cancer-associated retinopathy was made, the patient was started on
      prednisone, and a workup for malignancy was initiated. The patient was found to
      have uterine sarcoma. She underwent an extrafascial hysterectomy with bilateral
      salpingo-oophorectomy followed by eight courses of chemotherapy (carboplatin and
      cyclophosphamide). After that, the patient's vision improved, her visual field
      stabilized. She was doing well when last seen, in July 1994. The literature
      regarding cancer-associated retinopathy and paraneoplastic syndromes associated
      with gynecologic malignancies is reviewed.

PMID- 7789879
TI  - Gonadoblastoma with dysgerminoma in one ovary and gonadoblastoma with
      dysgerminoma and yolk sac tumor in the contralateral ovary in a girl with 46XX
      karyotype.
AB  - A case of gonadoblastoma with dysgerminoma in the left ovary and gonadoblastoma
      with dysgerminoma and yolk sac tumor in the right of a 10-year-old girl is
      reported. Her karyotype was 46XX, normal female type. A case of a gonadoblastoma
      without a Y chromosome is very rare. Furthermore, the prognosis for
      gonadoblastoma accompanied by germ cell tumors other than dysgerminoma was very
      poor in the past, but the patient remains well 25 months after the first
      operation.

PMID- 7789880
TI  - Primary jejunal adenocarcinoma masquerading as a primary ovarian malignancy.
AB  - Primary adenocarcinoma of the jejunum which accounts for only approximately 3% of
      all gastrointestinal tract malignancies, is distinctly unusual. Ovarian
      metastasis from a jejunal cancer is extremely rare. It has significant
      therapeutic and prognostic implications to differentiate primary ovarian
      carcinoma from metastatic disease to the ovary. A 49-year-old Japanese woman
      presented with intermittent nausea, vomiting, and palpable abdominal mass. Pelvic
      examination and imaging studies revealed a huge ovarian tumor, suspicious for
      malignancy. Upper GI series and barium enema were unremarkable. Exploratory
      laparotomy was done for presumed primary ovarian malignancy. Mucinous
      adenocarcinoma of the right ovary, measuring 25 x 18 x 12 cm, without other
      intraabdominal dissemination was found. Exploration of the upper abdomen revealed
      an annular constriction of the jejunum 30 cm distal to the ligament of Treitz.
      Partial jejunectomy with end-to-end anastomosis was done. Metastatic ovarian
      cancer from the primary jejunal adenocarcinoma was confirmed microscopically.
      Although small bowel malignancy is uncommon, small bowel follow-through
      examination or enteroclysis may be indicated in patients with positive stool for
      occult blood who have no abnormality in the upper gastrointestinal series and
      barium enema. In addition to the imaging studies, thorough exploration of the
      entire abdominal cavity is necessary at ceiliotomy in patients with ovarian
      malignancy to distinguish primary ovarian cancer from metastatic disease to the
      ovary.

PMID- 7789881
TI  - Secretory endometrial adenocarcinoma in a patient on tamoxifen for breast cancer:
      a report of a case.
AB  - Well-differentiated endometrial adenocarcinoma of the secretory type (FIGO Grade
      1) with minimal myometrial invasion occurred in a postmenopausal patient on
      tamoxifen therapy 5 years after mastectomy for breast carcinoma. We believe that
      this is the first report of secretory carcinoma of the endometrium associated
      with tamoxifen use. This unusual pattern of low-grade endometrial carcinoma adds
      to the spectrum of uterine neoplasia associated with tamoxifen therapy.

PMID- 7789882
TI  - Minimal deviation adenocarcinoma of endometrioid type may arise in the isthmus:
      clinicopathological and immunohistochemical study of two cases.
AB  - Clinicopathological and immunohistochemical features of minimal deviation
      adenocarcinoma (MDA) of endometrioid type which may have arisen in the isthmus
      are presented. Hysterectomy specimens from two women, one 39 years of age and the
      other 64 years of age, showed the presence of endometrioid-type adenocarcinoma
      with minimal atypia and without back-to-back arrangement of the glands, which was
      consistent with a histological diagnosis of endometrioid MDA. However, the
      tumorous glands were most abundant in the isthmus, and extensively infiltrated
      into the cervical stroma, vagina, parametrium, and corpus in one case, and the
      tumor was confined to the isthmus in the other. Immunohistochemically, the
      tumorous glands were CEA-positive and vimentin-negative in both cases. p53
      protein expression was found in one case. Histogenetic origin of MDA of
      endometrioid type is discussed.

PMID- 7789883
TI  - Regarding positive smears with normal colposcopy and the frequency of CIN.

PMID- 7789884
TI  - The influence of combination chemotherapy on antigen expression in ovarian
      cancer.
AB  - The best treatment results for advanced-stage ovarian cancer patients are
      obtained with cytoreductive surgery followed by combination chemotherapy.
      However, the 5-year survival rate of only 20% clearly shows a need for new
      treatment modalities. At present several modes of immunotherapy for cancer are
      being explored such as the use of monoclonal antibodies, bispecific antibodies,
      or specific cytotoxic effector cells, all making use of the presence of tumor
      associated antigens remaining, necessary for tumor cell recognition. The
      antigenic phenotype of human epithelial ovarian cancer after chemotherapy
      treatment is an important issue in planning potential immunotherapeutic
      strategies for ovarian cancer. Therefore, we compared the antigen expression in
      tumor specimens obtained during operation for primary epithelial ovarian tumors
      and tissue biopsies taken during second-look operations after the administration
      of combination chemotherapy. A total of 60 ovarian tumors, including 44 serous, 3
      mucinous, 2 endometrioid, 1 clear cell, 6 mixed, 2 undifferentiated, and 2
      granulosa cell tumors, was studied. Frozen sections of the tumor specimens were
      stained with 15 different monoclonal antibodies by the indirect immunoperoxidase
      technique and graded semiquantitatively. The results showed only limited
      differences in antigenic expression in tumor tissue obtained before and after
      chemotherapy. Because antigen expression was not altered, immunotherapy making
      use of these antigenic determinants will not be hampered by prior chemotherapy.

PMID- 7789885
TI  - Parametrial interstitial brachytherapy for advanced or recurrent pelvic
      malignancy: the Harvard/Stanford experience.
AB  - In this study we evaluate the long-term efficacy and safety of transperineal
      interstitial implants for advanced pelvic malignancy. A total of 139 patients
      were treated at Stanford University Medical Center and the Joint Center for
      Radiation Therapy with transperineal template interstitial brachytherapy for
      locally advanced or recurrent cancers arising in the pelvic organs. Most patients
      received whole pelvis external beam irradiation to a median dose of 4200 cGy
      followed by an implant for a median duration of 48 hr to a median implant dose of
      3000 cGy (range 600-6000 cGy). Complete follow-up was obtained for 91% of the
      patients. Median follow-up for survivors is 57 months (range, 10-173 months). The
      crude disease-free survival rate was 22% at 5 years. The 5-year crude local tumor
      control rate was 25%. No dose-response relationship could be demonstrated for
      tumor control or complications. There were no acute treatment-related deaths.
      Three late deaths were seen which were directly related to treatment. Major bowel
      complications requiring surgery were seen in 17% of patients without locally
      recurrent disease, and fistulas were reported in 4% of these patients. We
      conclude that template parametrial implant brachytherapy offers a modest chance
      of cure for women with locally advanced pelvic malignancy. However, this
      treatment causes significant late morbidity.

PMID- 7789886
TI  - MIB 1 immunostaining in stage I squamous cervical carcinoma: relationship with
      natural killer cell activity.
AB  - The aim of the study was to investigate the prognostic significance of estimating
      tumor cell proliferation in stage I cervical squamous carcinoma by analyzing MIB
      1 immunostaining with respect to the lesion size, lymphatic spread, and clinical
      outcome. A possible relationship between MIB 1 index and natural killer activity
      was also discussed. The medical records of 34 patients with stage I squamous
      cervical carcinoma who had undergone primary radical surgery at the Institute of
      Gynecologic and Obstetrics, Ancona University, between 1988 and 1993, were
      recruited from our series of 57 consecutive cases and reviewed. Thirty-one
      patients were considered eligible for the study and evaluated for age,
      demographic characteristics, tumor histologic grade, tumor size, lymphatic
      spread, and adjuvant radiotherapy. The expression of primary tumor proliferation
      related to Ki67 antigen was immunohistochemically evaluated by monoclonal MIB 1
      antibody (Immunotech, Marseille Cedex, France) on microwave oven-processed
      formalin-fixed paraffin-embedded tissue. The basal natural killer cell activity
      of peripheral blood lymphocytes was evaluated against K562 cell line and
      expressed in lytic units for each patient. The MIB 1 immunostaining was
      significantly related with tumor size (P = 0.001) and lymphatic spread (P =
      0.009); in contrast, there was no relationship between grade of histologic
      differentiation and MIB 1 immunostaining. The Cox proportional hazards analysis
      showed a significant independent relationship between MIB 1 immunostaining and
      disease-free survival (P = 0.004). The analysis of natural cytotoxicity defined a
      significant inverse relationship between peripheral blood lymphocyte's natural
      killer activity and tumor MIB 1 immunostaining (r = -0.07, with P = 0.03). Our
      data defined the prognostic significance of tumor cell proliferation
      immunostaining, an interesting parameter correlated with the disease-free
      survival in locally advanced cervical carcinoma. The relationship between MIB 1
      index and natural killer activity is interesting; natural cytotoxicity seems to
      be altered in the host with respect to the cervical carcinoma characteristics.

PMID- 7789887
TI  - Phase II study to evaluate the toxicity and efficacy of concurrent cisplatin and
      radiation therapy in the treatment of patients with locally advanced squamous
      cell carcinoma of the cervix.
AB  - Sixty patients presenting with poor prognosis squamous cell cancer of the cervix
      have been studied in a phase II clinical trial. Patients were treated with
      radiotherapy and concurrent cisplatin chemotherapy every 10 days. Treatment was
      well tolerated with all patients completing radiotherapy as prescribed. There was
      one case of grade 4 acute bowel toxicity. Significant late morbidity was
      acceptable for this group of patients being restricted to two cases (3.3%) of
      grade 4 toxicity to the bowel. Pelvic control rates of 78% have been observed.
      There have been no pelvic recurrences after 26 months, although recurrences
      beyond the pelvis have occurred up to 4 years later. Actuarial 4-year survival is
      encouraging at 60%.

PMID- 7789888
TI  - Long-term observation of patients treated by postoperative extended-field
      irradiation for nodal metastases from cervical carcinoma stages IB, IIA, and IIB.
AB  - Extended-field irradiation was administered to 72 patients after radical surgery
      for nodal metastases from cervical carcinomas at Stage IB (37 patients), IIA (6
      patients), and IIB (29 patients) who were treated from 1981 to 1986. The 5-year
      disease-free survival rates (DFR) were significantly different between 61
      squamous cell carcinomas and 11 nonsquamous cell carcinomas (72 versus 27%, P =
      0.0051). In the 61 squamous patients, the DFR were 82% for 51 patients with
      resectable nodes and 20% for 10 patients with unresectable nodes (P = 0.0003). In
      the 51 patients with resectable nodes the DFR were 84% for Stage IB, 100% for
      Stage IIA, and 76% for Stage IIB. There were no significant differences among
      those categories subdivided by clinical stage, number of positive nodes, common
      iliac node metastasis, positive node laterality, depth of tumor invasion,
      parametrial extension, and menopause. These findings suggest that postoperative
      extended-field radiotherapy is effective in squamous cell carcinomas and that the
      prognostic values of these factors were decreased with high patients survival
      rates given by this combined therapy.

PMID- 7789889
TI  - Serum half-life of CA 125 during early chemotherapy as an independent prognostic
      variable for patients with advanced epithelial ovarian cancer: results of a
      multicentric Italian study.
AB  - This retrospective multicentric study assessed the prognostic value of the serum
      CA 125 assay and the common clinicopathological variables in 225 patients with
      advanced epithelial ovarian cancer. All of these patients had serum CA 125 > or =
      35 U/ml before the first cycle of chemotherapy and had had serial antigen
      determinations during early chemotherapy. By univariate analysis pathological
      complete response rate was significantly related to stage, size of residual
      disease after first surgery, serum CA 125 before the first cycle and before the
      third cycle of chemotherapy, and serum CA 125 half-life. Multiple logistic
      regression showed that residual disease (P = 0.002), serum CA 125 half-life (P =
      0.004), serum CA 125 before the third cycle (P = 0.004), and serum CA 125 before
      the first cycle (P = 0.03) retained a significant value in predicting second-look
      findings. By log-rank test survival was significantly related to stage, residual
      disease, tumor grade, serum CA 125 before the third cycle, and serum CA 125 half
      life. Cox proportional hazard model showed that residual disease (P = 0.0001),
      serum CA 125 half-life (P = 0.007), and tumor grade (P = 0.01) retained a
      significant value in predicting survival. In conclusion, serum CA 125 half-life
      during early chemotherapy was an independent prognostic factor for both the
      achievement of a pathological complete response and the survival of patients with
      advanced epithelial ovarian cancer.

PMID- 7789890
TI  - A correlation of cell cycle perturbations with chemosensitivity in human ovarian
      cancer cells exposed to cytotoxic drugs in vitro.
AB  - To test the association between cytotoxicity and in vitro cell cycle
      perturbations we systematically studied cell cycle perturbations after exposing
      human ovarian cancer cells to nine commonly used cytotoxic agents. Three
      principal patterns of cell cycle alterations were observed: a sequential S-G2/M
      block after exposure to the non-phase-specific agents cis-platinum, 4-hydroperoxy
      cyclophosphamide, and mitomycin C (Group I); an isolated G2/M block after
      exposure to the G2/M phase-specific drugs etoposide and vincristine and the non
      phase-specific agent doxorubicin (Group II); and an isolated S block following
      exposure to the S phase-specific agents 5-fluorouracil, methotrexate, and
      cytosine arabinoside (Group III). Overall, there was no direct correlation
      between the degree of cell cycle perturbations and chemosensitivity. However,
      when the three subgroups of non-phase-specific agents, S phase-specific agents,
      and G2/M-specific agents were analyzed separately, positive correlations between
      the magnitude of cell kinetic alterations and chemosensitivity were observed.
      Cell kinetic alterations appeared to precede cytotoxicity.

PMID- 7789891
TI  - Factors predicting response to chemotherapy and survival in patients with
      metastatic or recurrent squamous cell cervical carcinoma: a multivariate
      analysis.
AB  - Different regimens of chemotherapy have been proposed with contradictory results
      in patients with metastatic and recurrent cervical carcinoma: this seems mainly
      due to the lack of information about prognostic factors. This study was aimed at
      identifying significant factors predicting response to treatment and survival in
      140 patients treated with chemotherapy for advanced, recurrent, or persistent
      squamous cell cervical carcinoma. Age, performance status, histologic type and
      grade, previous irradiation, interval from start of primary treatment and from
      irradiation, site of tumor, and therapeutic regimen were considered as possible
      predictors of response and survival in multivariate analysis. By multivariate
      analysis, only performance status and interval from irradiation (> 1 year) were
      significant in predicting response to treatment, whereas interval from first
      diagnosis, site of tumor, and response to treatment were significant in
      predicting survival. None of the polychemotherapy regimens significantly improved
      survival, despite a fourfold increase in the costs when compared to the least
      expensive monochemotherapy regimen. Ethical and economical concerns should be
      considered when proposing aggressive regimens to the patients. Factors such as
      site of tumor, performance status, and interval from first treatment should be
      considered as minimal requirements for correct evaluation of newly proposed
      regimens.

PMID- 7789892
TI  - Rising ovarian cancer mortality in the elderly: a manifestation of differential
      survival.
AB  - Ovarian cancer mortality among the elderly in developed countries is increasing.
      Using published United States mortality data, annual age-specific ovarian cancer
      mortality rates from 1951 to 1989 were determined for the over-60 age groups and
      compared to corresponding annual age group population sizes. Rising ovarian
      cancer mortality rates among the elderly in the United States from 1951 to 1989
      were increasingly dependent, with increasing age, upon increasing age group
      population size. These findings suggest that differential survival, and its
      effect upon the surviving gene pool in an aging population, may account for some
      of the observed increase in ovarian cancer mortality rates among recent
      successive elderly cohorts.

PMID- 7789893
TI  - Carboplatin (CBDCA)-hexamethylmelamine (HMM)-oral etoposide (VP-16) first-line
      treatment of ovarian cancer patients with bulky disease: a phase II study.
AB  - Hexamethylmelamine (HMM) and oral etoposide (VP-16) have shown to be active
      against platinum-resistant epithelial ovarian cancer. On this basis a three-drug
      regimen including carboplatin (CBDCA) plus HMM and oral VP-16 was tested in
      previously untreated ovarian cancer patients with tumor size > 2 cm. Since
      October 1991, 29 chemotherapy-naive ovarian cancer patients with tumor larger
      than 2 cm (20 stage III and 9 stage IV) have been treated for a total of 153
      courses. CBDCA was administered i.v. on Day 1. The dose was individualized using
      the Calvert formula (the target dose was AUC = 5). VP-16 was administered orally
      at the dose of 50 mg/m2 Days 1-14, HMM at the dose of 150 mg/m2 po Days 14-28.
      Therapy was repeated every 28 days for a total of 6 courses. In order to avoid
      severe leukopenia and delays in the treatment administration, G-CSF 5
      micrograms/kg/day sc Days 8-14 (or until postnadir recovery of neutrophil count >
      10,000/mm3) and Days 22-28 was administered. All patients were evaluable for
      toxicity. No treatment-related deaths occurred. Myelotoxicity was the main side
      effect. It was grade 3-4 in a total of 13/29(45%) patients. One patient
      discontinued treatment after the first course due to HMM-related gastrointestinal
      toxicity. The actual delivered dose intensity was 89% of the planned dose. At the
      time of this analysis (April 1994) 26 patients are evaluable for response.
      Fifteen patients achieved a clinical complete remission and 9 a partial response
      for a 92% overall response rate. Fourteen patients accepted second-look
      laparotomy. We observed 11 pathological complete regressions (42%; 95% CI, 21
      63). At a median follow-up of 16 months 3 deaths have occurred. Only 2 patients
      with NED at second-look laparotomy have relapsed. We stopped the accrual since
      the 95% confidence interval of the pCR-rate observed exceeded 20%. This new first
      line regimen seems to be highly effective in patients with poor-prognosis
      advanced ovarian cancer, although the data are not yet sufficiently mature for a
      final analysis of time to progression and overall survival.

PMID- 7789894
TI  - Pelvic exenteration for adenocarcinoma of the uterine cervix.
AB  - The objective of this study was to describe and compare the outcome of patients
      with recurrent adenocarcinoma versus squamous cell carcinoma of the uterine
      cervix who have been treated with pelvic exenteration. All patients undergoing
      pelvic exenteration for cervical adenocarcinoma from 1955 to 1989 were identified
      and a retrospective review was conducted. For these 35 patients, we identified 70
      controls who had exenteration for squamous cell carcinoma and who were matched
      for node status, year of procedure, and type of procedure. No significant
      difference was noted between the control group and the adenocarcinoma group for
      size of recurrent tumor, status of margins, presence of hydronephrosis prior to
      exenteration, and the time elapsed from initial diagnosis to exenteration. The
      two groups were compared for survival and recurrence pattern. Median patient age
      was 47 years (range 22-70). All patients had prior pelvic radiotherapy. Thirty
      patients had total pelvic exenteration and 5 had anterior exenteration. There
      were 3 postoperative deaths (8.6%). Median survival was 38 months for the
      adenocarcinoma patients and 25 months for the squamous patients (P > 0.99). The
      overall survival between the two sets of patients was very similar (log rank P =
      0.86). There were 23 postexenteration recurrences among the adenocarcinomas (22
      in which the site is known) and 32 postexenteration recurrences among the
      squamous patients (30 with known site). For the adenocarcinoma patients, 14 of 22
      had a distant recurrence versus 14 of 30 for the squamous patients (P = 0.27).
      Patients with central recurrence of cervical adenocarcinoma can be successfully
      treated with pelvic exenteration and have survival rates similar to squamous
      carcinoma.

PMID- 7789895
TI  - Modulation of 5-fluorouracil with high-dose leucovorin calcium: activity in
      ovarian cancer and correlation with CA-125 levels.
AB  - The purpose of this study was to estimate the response rate, response duration,
      and survival of patients with advanced ovarian cancer treated with a 132-hr
      continuous infusion of high-dose calcium leucovorin in combination with five
      consecutive daily bolus doses of 5-fluorouracil (5-FU) and to correlate changes
      in CA-125 levels with clinical and radiologic assessment of disease progression.
      Forty-six heavily pretreated patients [median number of previous chemotherapy
      regimens, 2.5 (range 1-7)] with advanced ovarian cancer received 132-hr
      continuous infusions of calcium leucovorin (500 mg/m2/day) for 5 1/2 days, with
      daily bolus doses of 5-FU (370 mg/m2/day) for 5 days beginning 24 hr after
      initiation of the calcium leucovorin. Twenty-three patients had clinically
      measurable disease and 23 had evaluable disease; CA-125 levels were performed
      prior to each treatment course and after the final course of therapy. One of 42
      patients had a partial response to combination chemotherapy (duration, 8.9
      months); 16/42 had stable disease [median duration, 4.9 months (range, 2.4-9.0
      months)]. Toxicity of combination therapy included mild myelosuppression and
      stomatitis, similar to previously reported toxicity profiles for the 5-FU and
      calcium leucovorin combinations. Sensitivity of CA-125 levels as a single
      indicator of disease progression was 55%. The combination of infusional high-dose
      calcium leucovorin and 5-FU has little activity in refractory ovarian cancer. CA
      125 levels incorrectly predict clinical disease activity in about one-third of
      cases and should not be the sole criterion for determination of clinical response
      when evaluating chemotherapeutic efficacy in heavily pretreated patients.

PMID- 7789897
TI  - A prospective randomized comparison of an attached silver-impregnated cuff to
      prevent central venous catheter-associated infection.
AB  - The VitaCuff catheter, a specialized central venous catheter (CVC) with an
      attached silver-impregnated cuff, is designed to permit percutaneous placement
      and prolonged venous access. A prospective randomized study was undertaken
      comparing the VitaCuff with standard triple lumen catheters to determine if the
      VitaCuff reduces infection during extended use. All consenting patients underwent
      percutaneous placement of subclavian lines. By study design, control and VitaCuff
      catheters could remain in site for up to 7 and 14 days, respectively. Cultures
      were obtained from the preinsertion skin site, and upon removal, from the skin,
      hubs, infusates, CVC tip, and cuff. Statistical methods included chi 2, the
      Student t test, and the log-rank test on Kaplan-Meier estimates. Of 133 patients
      completing this study, 64 patients (48.1%) underwent VitaCuff placement and 69
      patients (51.8%) served as controls. In 124 patients (93.2%), the indication for
      catheter placement was for perioperative care. Overall, 67 patients (50.4%)
      required central venous access > 7 days, necessitating > or = 1 additional line
      in 29 patients (21.8%). The incidence of pneumothorax per patient from the
      initial central line insertion was 4/104 (3.85%), significantly lower than the
      4/29 (13.8%) incidence during secondary catheter placement (P = 0.046). Culture
      results upon catheter removal demonstrated a reduction in colonization of skin
      sites and hubs for the VitaCuff patients, but not for catheter tips or infusates.
      Regardless of the type of catheter used, colonization was dependent upon duration
      of insertion. The incidence of catheter-related sepsis was 6.8%, and did not
      differ significantly between the study groups. Multiple CVC insertions increase
      the incidence of pneumothorax. Because VitaCuff catheters permit extended access
      up to 14 days without increasing the incidence of sepsis, we recommend their use
      in patients who require prolonged CVC access.

PMID- 7789898
TI  - [Thromboembolism complications in gynecology and obstetrics. Prevention,
      diagnosis and therapy].

PMID- 7789896
TI  - Adenomyosis in postmenopausal breast cancer patients treated with tamoxifen: a
      new entity?
AB  - Between September 1, 1989 and October 31, 1994, 173 postmenopausal breast cancer
      women on tamoxifen treatment were followed up in the authors' institutions.
      During this period, 14 (8.1%) underwent total abdominal hysterectomy and
      bilateral salpingo-oophorectomy for various indications. Eight (57.1%) were found
      to have adenomyosis, of whom one had a large fundal adenomyotic lump and the
      other seven patients had two to four small microscopic foci of adenomyosis. In
      this study, the rate of adenomyosis described among those postmenopausal breast
      cancer patients treated with tamoxifen is nearly three to four times higher than
      the rate reported in the literature for pre- and postmenopausal women. There is
      no previous reported increased incidence of adenomyosis in postmenopausal breast
      cancer patients treated with tamoxifen. Thus, it is suggested that the prolonged
      and unopposed estrogen-like stimulation by tamoxifen may play a causal role
      rather than be a casual factor in the development of this pathologic entity.

PMID- 7789899
TI  - [Indications for intensive monitoring during and after extensive gynecologic
      interventions].

PMID- 7789900
TI  - [Perioperative risk factors from the forensic viewpoint and patient education].

PMID- 7789901
TI  - [Hamartoma of the breast. 2 case reports].

PMID- 7789902
TI  - [Patient education by the physician--burden or opportunity?].

PMID- 7789903
TI  - [The effect of extensive surgical interventions on cellular immune response].

PMID- 7789904
TI  - [Cardiac risk assessment in surgical medicine].

PMID- 7789906
TI  - [Postoperative psychiatric complications with special reference to gynecologic
      interventions].

PMID- 7789905
TI  - [Gastrointestinal diseases in perioperative assessment with reference to
      gynecologic interventions].

PMID- 7789907
TI  - Improved techniques for first-trimester fetal reduction using simultaneous
      abdominal and transvaginal ultrasonographic guidance. Preliminary report.
AB  - Simultaneous transabdominal injection of potassium chloride (KCl) assisted by
      transvaginal ultrasonographic guidance was evaluated in 5 patients who conceived
      due to various assisted reproductive techniques and ovarian stimulation. All 5
      underwent first-trimester fetal reduction for multiplicity of high-order
      pregnancies. Four sets of triplets were reduced to twin, and 1 twin pregnancy was
      reduced to a singleton. Less than 2 ml of 2 mEq/ml KCl per fetus was needed for
      each case. No fetal or maternal complications nor technical failure attributable
      to the procedure were recorded. All pregnancies were delivered > or = 35 weeks of
      gestation. Transabdominal fetal reduction using simultaneous transvaginal
      ultrasonographic guidance for selective feticide combines the benefits of both
      the transabdominal and transvaginal approaches, mainly in selected cases in which
      some experts prefer the abdominal route, but find it technically difficult to
      practice. Further experience is needed to confirm our encouraging preliminary
      results before drawing any definitive conclusions.

PMID- 7789908
TI  - Fetal pleural effusion: the risk of fetal trisomy.
AB  - Our objective was to review the association between fetal pleural effusion (FPE)
      and fetal aneuploidy. We conducted a retrospective survey of pregnant women who
      presented to our ultrasonographic unit between 1990 and 1991, and in whom the
      diagnosis of FPE was reached. All fetuses had karyotype investigation and a
      complete ultrasonographic search for associated anomalies. Six cases of FPE were
      identified. Trisomy 21 was found in 2 (33%). The English literature was reviewed
      and an additional 147 cases with FPE were collected, among them 6 cases of
      trisomy 21 and 1 of monosomy 45X. In this accumulated series the risk of
      aneuploidy in a fetus with an incidental finding of FPE was 5.8% (9 of 153), thus
      warranting a karyotype study.

PMID- 7789910
TI  - Relationship between granulocyte elastase levels and perinatal infections.
AB  - This study was conducted in order to investigate the usefulness of granulocyte
      elastase levels as predictive factors in the onset of perinatal infections. The
      subjects were 41 patients who delivered within 48 h after amniocentesis after
      giving their informed consent. The relationship between cervical granulocyte
      elastase (Cx-E), serum C-reactive protein (CRP) and amniotic fluid granulocyte
      elastase (Af-E), and placental infections and neonatal infections was
      comparatively investigated. In some cases, gastric juice granulocyte elastase in
      neonates (Gj-E) was measured, and the correlation by site was investigated.
      Elastase levels were not used as a management protocol. In predicting neonatal
      infections, diagnostic efficacy (sensitivity x specificity) of placental
      infections (0.97) and abnormal Af-E (0.79) were superior to those of abnormal Cx
      E (0.40) and abnormal CRP (0.49). There was no correlation between Cx-E and Af-E
      or between Cx-E and Gj-E; however, a very close correlation was noted between Af
      E and Gj-E. In predicting abnormal amniotic fluids, Cx-E (> or = 1.2
      micrograms/ml) + CRP (> or = 1.0 mg/dl) had the highest diagnostic efficacy with
      0.58. These findings demonstrate that Af-E is a good index for predicting the
      onset of neonatal infections. In predicting abnormal amniotic fluid, it might be
      advisable to consider amniocentesis in order to diagnose intrauterine infections,
      when both Cx-E and CRP show abnormal levels.

PMID- 7789909
TI  - Cyclo-oxygenase distribution in human placenta and decidua does not change with
      labour after term or preterm delivery.
AB  - Our objective was to determine, in an immunohistochemical study, the distribution
      of cyclo-oxygenase in placental and decidual tissues before and after labour at
      varying gestations. Subjects were pregnant women undergoing singleton delivery
      after idiopathic preterm labour at less than 34 weeks' gestation (n = 13);
      spontaneous term labour at 37-42 weeks' gestation (n = 11); preterm caesarean
      section at less than 34 weeks' gestation for pre-eclampsia or intrauterine growth
      retardation (n = 8); elective term caesarean section at 37-42 weeks' gestation
      for cephalopelvic disproportion (n = 7). Within the placental basal plate cyclo
      oxygenase was localised in decidual stromal cells, extravillous trophoblast, and
      the apical border of villous syncytiotrophoblast, both before and after labour,
      regardless of gestational age. Within the placental membranes, decidual stromal
      cells showed intense cytoplasmic cyclo-oxygenase labelling and the chorion laeve
      strong membrane-associated cyclo-oxygenase reactivity before and after labour,
      regardless of gestational age. The amnion showed a heterogeneous staining
      pattern. After labour at term there was either positive cytoplasmic (5/10) or
      apical staining (5/10). Cyclo-oxygenase was demonstrated in an apical
      distribution in only 50% of the other subject groups. Cyclo-oxygenase is present
      in both decidua and placental tissues prior to the onset of labour at term.
      Demonstration of decidual and trophoblastic cyclo-oxygenase in both preterm and
      term subjects suggests that differential availability of cyclo-oxygenase is
      unlikely to be important in preterm delivery. Research into the withdrawal of
      inhibition or increased substrate availability is most likely to shed light on
      the signal pathways involved in the onset of labour, regardless of gestation.

PMID- 7789911
TI  - Chronic hypertension in gestational diabetes: influence on pregnancy outcome.
AB  - Our objective was to study the influence of chronic hypertension on pregnancy
      outcome in women with gestational diabetes (GDM). 418 women with GDM (30 with
      chronic hypertension and 388 nonhypertensives) were referred to our diabetes in
      pregnancy program. All patients were followed and assessed biweekly until
      delivery. When hypertensive GDM women (n = 30) wer compared to all
      nonhypertensive GDM (n = 388), there were significant (p < 0.05) differences in
      mean maternal age (34 +/- 4.1 vs. 30 +/- 4.6 years), maternal weight (90 +/- 21.2
      vs. 70.6 +/- 14.9 kg) and gestational age at delivery (38.5 +/- 1.2 vs. 39.6 +/-
      1.2 weeks). The mean birth weight for the hypertensive GDM group was
      significantly higher than that of the nonhypertensive GDM (3,360 +/- 578 vs.
      3,293 +/- 581 g; p < 0.05). The frequencies of LGA (23.3 vs. 9.8%) and induction
      prior to onset of spontaneous labor were significantly (p < 0.05) higher in the
      hypertensive GDM group when compared to the nonhypertensive GDM. There were no
      differences with respect to the average blood glucose and frequencies of SGA
      deliveries. However, when the 30 hypertensive GDM pregnancies were compared to a
      control group of 60 nonhypertensive GDM women matched for age, weight and height,
      the only significant difference was a higher rate of inductions of labor (36.7
      vs. 6.6%, p < 0.05) in hypertensive diabetic women. There were no significant
      differences in the incidence of LGA, low Apgar scores and SGA deliveries when
      hypertensive GDM were compared to nonhypertensive GDM women.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7789912
TI  - Longitudinal Doppler ultrasonographic assessment of alterations in regional
      vascular resistance of arteries in normal and growth-retarded fetuses.
AB  - The objective of this longitudinal study was to evaluate alterations in regional
      vascular resistance of arteries with advancing gestation in normal and growth
      retarded fetuses. Color Doppler flow imaging and pulsed Doppler ultrasonographic
      assessments were performed on 13 normal and 7 growth-retarded fetuses, ranging
      from 15 to 40 weeks menstrual age. The pulsatility index was calculated for
      middle cerebral artery, descending aorta, splenic artery, renal artery, femoral
      artery and umbilical artery, respectively. Optimal models for these pulsatility
      index values were determined by regression analysis. A normal range of the
      pulsatility index for each artery generated in the normal fetuses. In the middle
      cerebral artery, the models showed a parabolic pattern during pregnancy in the
      two groups and the predicted pulsatility index values in growth-retarded fetuses
      were always lower than those in the normal fetuses, especially late in pregnancy.
      In the renal artery, the predicted pulsatility index values in growth-retarded
      fetuses were higher than those in normal fetuses near term. In other arteries,
      the predicted pulsatility index values showed their own specific patterns and
      there were no significant differences in predicted pulsatility index values in
      the two groups. In conclusion, alterations in regional vascular resistance of
      arteries with advancing menstrual age occur evidenced in both normal and growth
      retarded fetuses.

PMID- 7789913
TI  - A case-control study on post-caesarean endometritis-myometritis in Mozambique.
AB  - Post-caesarean endometritis-myometritis (PCEM) was diagnosed in 49 Mozambican
      women. They were compared with 47 control women without signs of PCEM after
      caesarean section. The patients and controls were matched for age, parity and
      days post partum. Features of the socio-economic background and of past and
      current obstetric history were registered. Endocervical, intracavitary and blood
      cultures were carried out. Screening for syphilis seropositivity and HIV-1 and
      HIV-2 antibodies was performed. Socio-economic and obstetric background factors
      were similarly distributed in cases and referents, though previous caesarean
      section was less frequent among cases than among referents (OR 0.12). Moderate
      high-risk factors in existing antenatal card tended to be more frequent among
      cases than among referents (OR 3.29). Microbiological findings indicated more
      anaerobes in the vagina, in the endocervix and in the uterine cavity, though the
      differences only approached significance. It is concluded that women with PCEM in
      the setting studied expose few characteristic background features discriminating
      them from women with uneventful post-caesarean outcome. Further research efforts
      should be directed towards case-control studies with focus upon surgical factors
      and on a more comprehensive microbiology and serology approach.

PMID- 7789914
TI  - Postoperative adhesion formation following ovarian reconstruction with fibrin
      glue in the rabbit.
AB  - To compare postoperative adhesion formation following ovarian reconstruction with
      fibrin glue or the microsurgical suturing technique, an experimental study was
      performed on sixteen adult female rabbits. While left ovaries were reapproximated
      with 6-0 coated polyglactin using a microsurgical technique, right ovaries were
      reconstructed with fibrin glue following ovarian bisection. Four weeks later,
      second-look laparotomies were performed to evaluate the adnexal adhesions. These
      were scored according to the American Fertility Society classification. Mean
      adnexal adhesion scores were 8.2 +/- 2.3 in the sutured ovary and 5.0 +/- 1.1 in
      the glued ovary (p > 0.05). Ovarian reconstruction with fibrin glue does not
      reduce postoperative adhesion when compared with the usual suturing technique.

PMID- 7789915
TI  - The reproducibility of the Doppler ultrasound measurement of uterine artery
      vascular resistance.
AB  - The intra- and interobserver variation in Doppler ultrasound measurements of
      uterine arteries (UA) and the variation of pulsatility index (PI) in UA in
      successive menstrual cycles in the same patient was studied. The intra- and
      interobserver variability of measurements was similar. In all three series the
      difference between two measurements was smaller with lower PI values. Cycle
      dependent changes, biological variation and random measurement are foremost in
      causing variability and no systematic error was evident. Doppler ultrasound
      measurements from UA can be used when patient groups are compared, but in the
      case of an individual patient, large limits of agreement must be borne in mind.

PMID- 7789916
TI  - Direct effect of danazol on the DNA synthesis and ultrastructure of human
      cultured endometrial stromal cells.
AB  - The direct effect of danazol on the DNA synthesis and ultrastructure of human
      cultured endometrial stromal cells was studied. The analysis of the [3H]thymidine
      incorporation in the endometrial stromal cells cultured for 10 days indicated
      that the DNA synthesis was inhibited in a dose-dependent manner by danazol and
      testosterone, but not by medroxyprogesterone. The effect of 10(-7) M of danazol
      was blocked by cyproterone acetate, but RU-486 did not show any influence. The
      observation of the ultrastructure of the cultured cells revealed that 10(-7) M of
      danazol increased cytoplasmic lysosomes; however, 10(-5) M of danazol destroyed
      cell organelles and cytoskeleton resulted from the cell death. These results
      indicated that the biological effects of danazol were mainly mediated by androgen
      receptors, and 10(-5) M of danazol exhibited the toxic effect on the endometrial
      stromal cells.

PMID- 7789917
TI  - Serum levels of relaxin during the menstrual cycle and oral contraceptive use.
AB  - Serum relaxin levels were analysed in 12 healthy women every other day during the
      menstrual cycle and during a second cycle on oral contraceptives. Relaxin levels
      in 7 women with posterior pelvic and lumbar pain were also measured. Relaxin was
      detected during both the follicular and luteal phases of the menstrual cycle in
      some of the healthy women. Serum levels were further increased during the use of
      oral contraceptives. Oestradiol levels in the untreated women correlated to the
      relaxin levels. Women with posterior pelvic and lumbar pain had higher relaxin
      levels than did healthy women, a finding that needs to be further explored. Our
      data indicate the existence of sources for relaxin production other than the
      corpus luteum in the non-pregnant woman. Endogenous and exogenous oestrogens may
      stimulate the production of relaxin.

PMID- 7789918
TI  - Transvaginal ultrasonographic morphology in polycystic ovarian syndrome.
AB  - To assess the morphological findings based on transvaginal ultrasound, the
      ovarian volume and the number and size of small follicles were studied in 47
      patients with polycystic ovarian syndrome (PCOS) diagnosed clinically. Thirty
      normal volunteers served as controls. The mean ovarian volume (10.3 ml) and
      number of follicles (10.6) in patients with PCOS were significantly higher than
      those of controls. An ovarian volume > 6.2 ml and follicles > 10 with a diameter
      of 2-8 mm were the most prominent features in the ovaries of patients with PCOS
      and 94% of 47 patients with PCOS had at least one of these ultrasonic findings.
      However, marked asymmetry of the two ovaries was seen in about 50% of patients
      with PCOS and a considerable overlap existed between controls and patients with
      PCOS in the ovarian volume and in the number of follicles. Three (6%) patients
      with normal ovarian volume and normal number of follicles were observed.
      Therefore, it is difficult to clearly distinguish a patient with PCOS from a
      normal woman only by transvaginal ultrasonic criteria using the ovarian volume
      and/or the number of follicles, although these criteria could be clinically
      useful for the screening of PCOS.

PMID- 7789919
TI  - Danazol suspension injected into the uterine cervix of patients with adenomyosis
      and myoma. Preliminary study.
AB  - We investigated the effect of local injections of danazol suspension (DZS) into
      the uterine cervix. In the cervix, danazol (DZ) reached high concentrations 1 and
      4-6 h after injection; then it decreased. In the endometrium, the DZ level
      reached a peak 1 h after injection, and then declined. On the other hand, the DZ
      concentration tended to increase with time after injection in ovarian tissue and
      it remained at a relatively constant level for more than 2 days. During treatment
      with DZS, various subjective symptoms and clinical findings gradually improved
      from the 4th week after the start of injection onward. Moreover, an improvement
      of subjective symptoms was observed in all the patients by the 24th week.

PMID- 7789920
TI  - Management of supraventricular tachycardia during hexoprenaline therapy for
      preterm labour: benefit of cardioselective beta blockade?
AB  - A 29-year-old woman presented with preterm labour at 32 weeks of gestation.
      Tocolytic treatment was started with intravenous hexoprenaline. Twenty-four hours
      after initiation of treatment, the patient developed supraventricular
      tachycardia, resistant to digoxin and verapamil. Medical treatment with
      metoprolol finally restored sinus rhythm. We observed no adverse effects on the
      fetal heart rate nor on the umbilical cord blood flow.

PMID- 7789921
TI  - False diagnosis of distal tubal occlusion in case of tubal diverticula.
AB  - A 28-year-old infertile patient with a diagnosis of bilateral distal tubal
      occlusion made at hysterosalpingography and laparoscopy was found at a second
      laparoscopy to have bilateral single diverticula in patient tubes. The patient
      conceived an intrauterine pregnancy 5 months after discharge. This report casts
      doubt on the suggested association between tubal diverticula and infertility.

PMID- 7789923
TI  - [A retrospective evaluation of the treatment of skeletal Class-II with removable
      appliances].
AB  - Pre- and post-treatment lateral radiographs of 120 former patients with skeletal
      class II, who had been treated with either an Andresen/Haupl type activator or
      bite jumping plates, were selected for this study. The evaluation results showed
      that bite jumping plates had a significant inhibition on the forward downward
      growth and the anterior rotation of the maxilla. The increase of the SNB-angle
      was significantly higher and there was also more posterior rotation of the
      maxilla in those patients, who had been treated with an activator. A two-way
      analysis of variance was carried out and it was possible to show that the
      independent treatment factors explained only 1/5 to 1/3 of the overall variance
      of the sample. The differences among the patients seem to depend more on
      individual growth patterns than just on the type of removable appliance.

PMID- 7789922
TI  - [Skeletal and dental changes during the use of the bite-jumping plate. A
      cephalometric comparison with an untreated Class-II group].
AB  - In this study 95 patients with a malocclusion type Angle class II were treated
      with a bite jumping appliance and the results achieved were compared with
      untreated class II patients. A clear improvement in the skeletal and dental
      relationships was observed. Significant changes were achieved yearly in the
      following: 1. the angle SNA was reduced (0.82 degrees), 2. the angle SNB was
      increased (0.57 degrees), 3. the angle ANB was reduced (1.39 degrees). All 3 of
      these variables are significant. Other skeletal variables, most notably the
      incline of the maxilla to the line NS, were not influenced nor was the relation
      of posterior facial height to anterior facial height. The mandibular incisors did
      not exhibit increased protrusion relative to the mandibular plane. Only the angle
      of the mandibular incisor to NB was changed by the total protrusion of the
      mandible. The maxillary incisors in these cases manifested obvious lingual
      tipping. For this reason the orthodontist must weigh carefully on an individual
      patient basis, whether the use of adjunctive torque springs is required and
      necessary.

PMID- 7789925
TI  - [A critical evaluation of the functional treatment of mandibular neck fractures
      in children. The results of a spiral computed tomographic follow-up].
AB  - In this retrospective follow-up study after 6 months of treatment with functional
      appliance therapy of 12 children who had suffered condylar fractures, spiral CT
      was employed for the radiological examination with 2D and 3D reconstructions.
      Although all patients exhibited restoration of normal function, only 4 showed
      favorable remodeling. The other patients had developed 5 hypoplastic, 5 moderate
      and 5 severe deformed condyles. Seven condylar fragments were resorbed; 2 were
      uprighted; 4 had developed bony spurs and 3 neoarthrosis. The results revealed a
      fracture dependent remodeling. The authors discuss the etiology of the functional
      stimulated new bone formation of the condylar process. Excessive bone apposition
      as a reaction to the anterior shift of the mandible seems to play an important
      role during the overgrowth of the head of the condyle.

PMID- 7789924
TI  - [Problems and risks in the movement of the mandibular anterior teeth].
AB  - The key role of the lower anterior incisors as well as the complicated anatomical
      relationship of this area play a significant part in orthodontic treatment
      planning. Three fundamental points of view are selected here for discussion: 1.
      the variability and clinical relevance of the initial periodontal findings, 2.
      the importance of the symphysis to sagittal and vertical tooth movement, and, 3.
      the specific problem associated with periodontal bone loss. The few clinical and
      experimental studies found in the literature indicate that every anterior tooth
      movement has to be oriented according to the structure and facio-lingual width of
      the alveolar bone and that movement should progress in a controlled fashion.
      Rapid tipping tooth movements are to be avoided so as to minimize the risk of
      bone dehiscences and root resorption. Orthodontic tooth movement should be
      avoided when the initial findings show a narrow symphysis or questionable
      labiolingual bone coverage. Pre-orthodontic thin gingiva and alveolar mucosa can
      be an indication for a mucosal graft aimed at preventing subsequent bone and
      gingival dehiscences. In the future, systematic 3-D CT analysis of pre
      orthodontic and post-orthodontic findings will contribute to a better estimation
      of the case specific potential of compensatory bone apposition.

PMID- 7789926
TI  - [Cervical headgear with angled outer arms. A biomechanically comprehensible
      system?].
AB  - When applying the angulated face bow, it doesn't seem possible to avoid vertical
      and transversal forces which occur in addition to the distalization force as
      moments. By varying the length and angulation of the outer bow, it is possible to
      influence the force components and the moments in the sagittal plane. In the
      clinical analysis of the force system it is assumed that the face bow is an ideal
      rigid system. Only under this presupposition is the assumption valid, that the
      product of the force and the perpendicular distance to the molar tube is
      responsible for the size of the moment. Under this assumption, however, all
      forces and moments created by the deflection of the headgear are not taken into
      consideration. An experimental analysis of the forces and turning moments which
      occur indicates that this simplifying geometric point of view does not always
      correspond to reality. It was evident, e.g., that there is no linear correlation
      between the force and moment in mesio-distal direction due to the deflection of
      the outer bow. This effect becomes the more obvious the longer the outer bow of
      the headgear is.

PMID- 7789927
TI  - [The development of a resorbable implant system for orthodontic anchorage. The
      BIOS implant system. Bioresorbable implant anchor for orthodontic systems].
AB  - The use of endosseous implants as temporary orthodontic anchoring elements has
      proven itself to be efficacious in many clinical applications. If, however, an
      implant is inserted into the jaw solely to correct a malocclusion without being
      used subsequently for prosthetic purposes, secondary surgery is required to
      remove the anchoring implant. The development of an orthodontic implant anchor
      system consisting of an implant made of biodegradable polylactide with a metal
      abutment may offer a solution to this problem. On the basis of its good
      mechanical properties, the BIOS implant system (bioresorbable implant anchor for
      orthodontics system) presented here is designed to assume orthodontic anchoring
      functions as long as necessary and then be resorbed by hydrolysis without foreign
      body reactions. Shear strength and maximum vertical strength were measured in
      biomechanical in vitro tests in which BIOS fixtures can be loaded with horizontal
      shear forces of 50 N with a mean deflection of 0.26 mm and mean vertical pull-off
      forces of 155 N. In a clinical case report the application of the BIOS implant
      system during orthodontic tooth movement is here illustrated. In vitro and in
      vivo results obtained to date suggest that the BIOS implant system can be used as
      an orthodontic anchoring system up to the time of degradation.

PMID- 7789929
TI  - [Anti-HIV drugs work rapidly or not at all. Virus dynamics--therapeutic
      consequences].

PMID- 7789928
TI  - [Report on the 7th Interdisciplinary Symposium. The Interdisciplinary Working
      Group on Cheilo-gnatho-uranoschisis].

PMID- 7789930
TI  - [Genetic techniques in food production--also a medical problem].

PMID- 7789931
TI  - [Polymyalgia rheumatica in patients of a rheumatologic specialty practice.
      Clinical signs and etiological events].
AB  - Manifestations of polymyalgia rheumatica in 100 ambulatory patients of an
      internistic, rheumatological specialist's practice were investigated. In this
      group of patients, both the clinical course of the disease and its prognosis were
      found to be more benign than is commonly reported in the literature. Thus, for
      example, temporal arteritis was found in only three of the one hundred patients.
      Not all of the patients were found to have the markedly elevated ESR normally
      considered to be typical. For this reason, to establish inflammatory activity, in
      addition to ESR, C-reactive protein (CRP) should also be determined in order to
      ensure that atypical forms with less marked signs of inflammation are not
      overlooked. Thirty of the 100 patients reported possible triggering life events.

PMID- 7789932
TI  - [Psychiatric consultation before liver transplantation].
AB  - BASIC REMARKS: Since the long-term results of transplantations are highly
      dependent on patient compliance, prior to the decision to undertake such an
      operation, the psychiatrist is often asked whether there are any conditions
      presenting that would militate against the necessary cooperation. METHOD: Between
      1992 and 1993, 35 patients were sent for psychiatric counselling prior to liver
      transplantation, and were evaluated using a standardised questionnaire. 23 of the
      35 patients were submitted to psychological testing. RESULTS: in 23 cases, a
      psychiatric diagnosis was established in accordance with the ICD-10 criteria. The
      largest group was formed by the addictive diseases in this study, in particular
      alcohol dependence. Eight patients proved to have organ-related mental
      disturbances, other diagnoses such as depressive disorders or personality
      disorders were less common. In four cases, the psychiatrist was unable to
      recommend the liver transplantation. In such cases as these, the tasks of the
      psychiatrist is not restricted simply to a diagnostic assessment, but must also
      include a therapeutic approach intended to enable the patient to cope with the
      coming stresses and requirements.

PMID- 7789933
TI  - [Acute poisoning. 4: Antidote therapy].

PMID- 7789934
TI  - [Externalizing and overcoming psychological crises with role playing.
      Psychotherapy, 8: Psychodrama therapy].

PMID- 7789935
TI  - [Determination of C-reactive protein--an alternative to blood sedimentation rate?
      Quantitative and semi-quantitative CRP diagnosis in the course of bacterial
      infections].

PMID- 7789936
TI  - [What is the status of vasoactive drugs? Early stages of arterial occlusive
      disease in general practice--positive series list, 3].

PMID- 7789937
TI  - SARP: a value-based approach to hospice admissions triage.
AB  - As hospices become established and case referrals increase, many programs are
      faced with the necessity of instituting waiting lists. Prioritizing cases for
      order of admission requires a triage method that is rational, fair, and
      consistent. This article describes the SARP method of hospice admissions triage,
      which evaluates prospective cases according to seniority, acuity, risk, and
      political significance. SARP's essential features, operative assumptions,
      advantages, and limitations are discussed, as well as the core hospice values
      which underlie its use. The article concludes with a call for trial and
      evaluation of SARP in other hospice settings.

PMID- 7789938
TI  - The McCanse Readiness for Death Instrument (MRDI): a reliable and valid measure
      for hospice care.
AB  - The purpose of this study was to establish whether or not readiness for death, as
      an indicator of healthy dying, is a measurable concept. Review of relevant
      literature revealed consensus regarding the universality of a human need for
      healthy dying. A theory of healthy dying was derived from the Rogerian paradigm.
      The McCanse Readiness for Death Instrument (MRDI) was constructed, which included
      indicators of physiological, psychological, sociological, and spiritual aspects
      of "healthy" field pattern as death is developmentally approached. The MRDI was a
      26-item structured interview questionnaire which generated interval-ratio data
      through a visual analog scale. A pretest was conducted with a sample of 9
      volunteer patients drawn from a small suburban outpatient hospice. The MRDI was
      concurrently administered to dying individuals, their primary caregivers, and
      their primary hospice nurses. Correlations between dying individuals' scores and
      their primary caregivers' estimates of patient death readiness as well as between
      patients and their primary hospice nurses were very encouraging. Cronbach's
      coefficient alpha for internal consistency reliability was .59. Content validity
      was supported by consensus of an expert panel of practicing hospice nurses.
      Construct validity was demonstrated through legitimate placement of the concept,
      healthy death readiness, within the theoretical web which supported it. The MRDI
      was then administered to a sample of 31 terminally-ill individuals, their primary
      caregivers, and their primary hospice nurses drawn from larger, urban hospice
      populations in three geographic areas of the United States. The MRDI was also
      administered to a contrast group of 39 cardiac-impaired individuals who were not
      terminally-ill. Overall internal consistency of the MRDI was found to be quite
      favorable (alpha = .76). Debilitating illness and actual mortality in the study
      sample precluded and/or confounded estimates of test-retest reliability.
      Convergent validity of the MRDI was indicated by significant correlations between
      patients' scores and primary caregivers' estimates (r = .35, p < .05) and between
      patients' scores and primary hospice nurses' estimates (r = .53, p < .01).
      Discriminant validity of the MRDI was demonstrated by a significant mean
      difference between the group of terminally-ill patients and the group of non
      terminal, cardiac-impaired patients (t = 1.76, p < .01).

PMID- 7789939
TI  - A family caregiving model for hospice nursing.
AB  - The literature reveals only superficial description of the clinical judgment
      needed to practice hospice nursing. Practice wisdom remains vague and taken for
      granted. To improve documentation of the nature of hospice nursing practice, 32
      expert hospice nurses were asked to tell stories of memorable practice
      experiences. Those narratives were interpreted using qualitative methodology to
      identify 10 hospice nursing practice competencies and a visual model of practice.
      This model can be used to articulate hospice nursing practice to students, fellow
      professionals, and those making decisions about health care in the future.

PMID- 7789940
TI  - The relationship between hospice length of stay and caregiver adjustment.
AB  - This study investigated the hypothesis that the greater the predeath length of
      stay in hospice the better would be the primary caregivers' bereavement
      adjustment 6 months post death. One hundred sixty caregivers from a 30% pool of
      hospice survivors who voluntarily returned 6-month, follow-up questionnaires were
      studied. Five length of stay groups were compared. There were no statistically
      significant differences in bereavement adjustment between caregivers with varying
      predeath lengths of stay. It was concluded that bereavement resolution is a
      complex process, and that cumulative medical illness burden, impairment of ADLs,
      and caregiver burden need to be considered.

PMID- 7789941
TI  - Empathic nurse-patient relationships in hospice nursing.
AB  - This naturalistic study explored the development of empathic nurse-patient
      relationships between 10 terminally ill adult hospice patients and their hospice
      nurses. The data were collected and analyzed from the hospice patient's
      perspective. Content analysis and the constant comparative method were used to
      analyze the transcripts of the audio taped interviews. The findings suggest that
      the development of empathic relationships between hospice nurses and patients was
      a process that occurred most often over time and involved a reciprocal sharing.
      Specific patient needs, nurses' functions, attributes, and the patient's
      reciprocity contributed to the development of the empathic relationship.

PMID- 7789942
TI  - Analysis of variables that impact psychological adaptation in home hospice
      patients.
AB  - In their efforts to understand the psychological impact of life-threatening
      illness upon individuals, researchers, for the most part, have focused on the
      distress associated with dying rather than the influences that promote
      adaptation. Early studies report relationships between the mental state of the
      dying and variables of age, religiosity, family relationships, and physical
      discomfort. This article analyzes and compares the influences of social support,
      pain, and age, which were confirmed in a causal model study, as direct predictors
      of an outcome of psychological adaptation. The data from a sample of 97 home
      hospice subjects is compared with other healthy, recovering ill, advanced ill,
      and psychiatric populations.

PMID- 7789943
TI  - A descriptive study of the management of pain and pain-related side effects in a
      cancer center and a hospice.
AB  - The purpose of this study was to describe the pain and pain-related symptoms
      experienced by persons receiving treatment in a cancer center or a hospice and to
      describe the nurses' responses to these problems. The sample consisted of 25
      hospice and 19 cancer center patients who were being treated for pain. Pain was
      assessed three times in a 24-hour period using a visual analogue scale (VAS).
      Constipation was assessed using the Constipation Assessment Scale. Sedation was
      assessed on a 0 (fully alert) to 4 (comatose) scale. The nurses' documentation
      was assessed using the Chart Audit for Pain. Results showed that patients in the
      cancer center and hospice continued to experience pain (VAS M = 38.6 and 29.7
      respectively) in spite of their pain management regimens. The cancer center
      patients were given an average of 38% of the maximum ordered dose of analgesic
      while the hospice patients self-administered 93% of the ordered dose. The cancer
      center nurses documented the efficacy of the analgesics in only 26% of cases
      while hospice nurses recorded this information in 96% of the charts. Sedation was
      not found to be a problem. Constipation was reported by 100% of cancer center
      patients and 84% of hospice patients but was rarely documented by nurses in
      either setting. It appears that nurses need to do more thorough assessment of
      patient symptoms and more consistent follow-up evaluation and documentation.

PMID- 7789946
TI  - Assignment of the gene responsible for cystinuria (rBAT) and of markers D2S119
      and D2S177 to 2p16 by fluorescence in situ hybridization.
AB  - We have established rBAT (named as SLC3A1 in the Genome Data Base) as a gene
      responsible for cystinuria, a heritable disorder of amino acid transport. The
      cystinuria locus has been mapped by linkage between microsatellite markers D2S119
      and D2S177. Fluorescence in situ hybridization (FISH) either with Alu-polymerase
      chain-reaction (PCR)-amplified sequences of a yeast artificial chromosome (YAC)
      containing the rBAT gene or with rBAT-specific PCR-amplified genomic fragments,
      and chromosome G-banding have cytogenetically mapped rBAT to 2p16.3. In order to
      correlate the physical and genetic information on cystinuria, we have performed
      FISH with combinations of Alu-PCR-amplified sequences from YACs containing rBAT
      or the D2S119 and D2S177 loci. In all cases, a fused signal is obtained that
      demonstrates their close physical location; this allows the assignment of rBAT,
      cystinuria and their linked markers, D2S119 and D2S177, to 2p16.

PMID- 7789945
TI  - Molecular basis of glucose-6-phosphate dehydrogenase (G6PD) deficiency in three
      Taiwan aboriginal tribes.
AB  - We have investigated glucose-6-phosphate dehydrogenase (G6PD) deficiency in 220
      unrelated aboriginal male subjects who belong to three different tribes (Saisiat,
      Ami, and Yami) in Taiwan. Our results show that the G6PD deficiency rates for
      Saisiat, Ami, and Yami people are 9.0% (6/67), 6.1% (6/99), and 0% (0/54),
      respectively. Among these deficiency cases, 4 of 6 (66.7%) Saisiat subjects have
      the 493 A-->G mutation and one carries the 1376 G-->T mutation, whereas, in Ami
      subjects, we found that four of six (66.7%) affected males have the 592 C-->T
      mutation and one carries the 493 A-->G mutation. These results contrast with our
      previous findings for Taiwan Chinese, in whom the 1376 G-->T mutation is the
      major mutant allele and accounts for 52.3% of the deficiency cases. This is the
      first report of G6PD deficiency characterized at the DNA level in Taiwan
      aboriginal populations.

PMID- 7789947
TI  - Coverage of chromosome 6 by chromosome microdissection: generation of 14
      subregion-specific probes.
AB  - Human chromosome 6 has been subdivided by chromosome microdissection into 14
      unique regions. Following microdissection, polymerase chain reaction (PCR)
      amplification of dissected DNA was performed using a universal primer to generate
      subregion-specific probes that provided complete coverage of chromosome 6. All 16
      microdissections have been regionally assigned along chromosome 6 by fluorescence
      in situ hybridization (FISH) using biotin-labeled dissected DNA hybridized to G
      banded normal metaphase chromosomes. These probes can be used as region-specific
      paints to generate unique "bar codes" and for analysis of chromosome alterations
      involving chromosome 6 that are unidentifiable by conventional banding analysis.

PMID- 7789948
TI  - Apoptosis regulatory gene NEDD2 maps to human chromosome segment 7q34-35, a
      region frequently affected in haematological neoplasms.
AB  - Developmentally regulated mouse gene Nedd2 encodes a protein similar to the
      product of the nematode Caenorhabditis elegans cell death gene ced-3 and the
      mammalian interleukin-1 beta-converting enzyme. Overexpression of Nedd2 in
      cultured mammalian cells induces apoptosis that can be blocked by proto-oncogene
      BCL2. We have isolated cDNA clones for the human homologue of the mouse gene and,
      by using these as probes, mapped the human NEDD2 gene to 7q34-35 by fluorescence
      in situ hybridisation. The potential tumour suppressor function of NEDD2 is
      discussed.

PMID- 7789949
TI  - Genetic heterogeneity of polycystic kidney disease in Bulgaria.
AB  - Linkage analysis was performed on 22 Bulgarian families with polycystic kidney
      disease (PKD) ascertained through the hemodialysis centers of two medical
      schools. A total of 128 affected and 59 unaffected individuals, and 54 spouses
      have been investigated using eight polymorphic markers linked to PKD1 and nine
      markers to PKD2. The results demonstrate locus heterogeneity with 0.67 as the
      maximum likelihood value of alpha, i.e., the proportion of families linked to
      PKD1. In five families, the results suggest linkage to PKD2 and observed
      recombinants place the gene between loci D4S1544 and D4S1542. In one family, two
      double recombinants for closely linked markers on chromosome 16 and on chromosome
      4 give evidence for the lack of linkage to either PKD1 or PKD2, thus suggesting
      the involvement of a third locus. Analysis of clinical data in the PKD1 group
      versus the unlinked group shows no significant differences in the severity of the
      disease.

PMID- 7789950
TI  - Genome-wide loss of maternal alleles in a nephrogenic rest and Wilms' tumour from
      a BWS patient.
AB  - A patient with Beckwith-Wiedemann syndrome (BWS) presented with Wilms' tumour.
      Examination of the nephrectomy specimen showed, in addition to the tumour, the
      presence of nephrogenic rests. Nephrogenic rests are thought to be precursor
      lesions from which a Wilms' tumour may develop. A molecular analysis examining
      the loss of constitutional heterozygosity (LOCH), initially for chromosome 11,
      was performed on peripheral blood, the normal kidney, nephrogenic rest and tumour
      material. The study was extended to include markers from all 23 chromosomes. At
      each informative, locus, LOCH of the maternal allele was shown in the nephrogenic
      rest and tumour material. In addition, the normal kidney displayed allele
      imbalance. It would appear from these results that either extensive LOCH across
      the genome was an early genetic event in the development of malignancy in this
      patient or that the tumour and rest developed from cells containing no maternal
      chromosomes. The apparent LOCH seen in the normal kidney sample implies that full
      reduction to homozygosity is consistent with a histologically normal appearance.
      Putative mechanisms to explain this phenomenon are discussed.

PMID- 7789951
TI  - Intricate combinatorial patterns of exon splicing generate multiple Rh-related
      isoforms in human erythroid cells.
AB  - The Rhesus (Rh) blood group system shows complex polymorphisms in the human. Some
      of the heterogeneity may be generated by alternative RNA splicing. For a
      systematic analysis of Rh-related mRNA isoforms expressed in reticulocytes, we
      isolated mRNA, which was then reverse transcribed and amplified by the polymerase
      chain reaction (PCR) to give Rh-related cDNAs of two segments of 704 bp and 975
      bp. The PCR amplification of the 5'-region yielded a single PCR product, whereas
      a complex electrophoretic pattern of PCR bands was derived from the 3'-region. A
      highly reproducible ladder of multiple additional bands migrated below the PCR
      products corresponding to the full-size cDNAs for RhPI and RhPII and encoding two
      different Rh polypeptides. Eleven and five truncated isoforms of the RhPI and
      RhPII cDNAs, respectively, were identified in the PCR products. These isoforms
      appear to be generated by combinatorial splicing of six RhPI and three RhPII
      exons. Our results suggest that the Rh-related polypeptides consist of a mixture
      of RhPI and RhPII polypeptide isoforms differing at the C terminus. Multiple RNA
      splicing pathways are thus operative in the two Rh-related genes even within a
      single cell lineage of human erythroid cells.

PMID- 7789952
TI  - Recurrence of osteogenesis imperfecta because of paternal mosaicism: Gly862-->Ser
      substitution in a type I collagen gene (COL1A1).
AB  - We determined that two siblings with type III osteogenesis imperfecta (OI) had
      the same single base substitution that converted the codon for glycine (Gly) 862
      to a codon for serine (Ser) in exon 44 of the alpha 1 chain of the type I (alpha
      1(I)) collagen gene (COL1A1). The mutation was also detected in various paternal
      tissues; the mutant allele accounted for approximately 11% of the COL1A1 alleles
      in blood, 24% of those in fibroblasts, and 43% of those in sperm determined by
      allele-specific colony hybridization using amplified genomic sequences. These
      findings demonstrate that germ-line mosaicism in the phenotypically normal father
      is responsible for the recurrence. There is a cluster of serine substitutions for
      Gly (Gly832, Gly844 and Gly901) which is associated with nonlethal phenotypes and
      which is located between two lethal clusters. In the cases studied here, a Gly862
      ->Ser mutation was identified that is located inside the nonlethal cluster.

PMID- 7789944
TI  - Turner syndrome and female sex chromosome aberrations: deduction of the principal
      factors involved in the development of clinical features.
AB  - Although clinical features in Turner syndrome have been well defined, underlying
      genetic factors have not been clarified. To deduce the factors leading to the
      development of clinical features, we took the following four steps: (1)
      assessment of clinical features in classic 45,X Turner syndrome; (2) review of
      clinical features in various female sex chromosome aberrations (karyotype
      phenotype correlations); (3) assessment of factors that could lead to Turner
      features; and (4) correlation of the clinical features with the effects of
      specific factors. The results indicate that the clinical features in 45,X and in
      other female sex chromosome aberrations may primarily be determined by: (1)
      degree of global non-specific developmental defects caused by quantitative
      alteration of a euchromatic or non-inactivated region; (2) dosage effect of a
      pseudoautosomal growth gene(s), a Y-specific growth gene(s), and an Xp-Yp
      homologous lymphogenic gene(s); and (3) degree of chromosome pairing failure in
      meiocytes that are destined to develop as oocytes in the absence of SRY. 1991;
      Grumbach and Conte 1992). However, the pertinent factors have not been determined
      to date. The method to clarify the factors responsible for the development of the
      Turner phenotype can be broken down into the following steps: (1) assessment of
      clinical features in classic 45,X Turner syndrome; (2) review of clinical
      features in various female sex chromosome aberrations (karyotype-phenotype
      correlations); (3) assessment of factors that could lead to Turner features; and
      (4) correlation of the clinical features with the effects of specific factors. If
      the clinical features in 45,X and in other female sex chromosome aberrations are
      explained by the effects of specific factors, it can be said that such factors
      contribute to the development of Turner features. In this paper, we take each of
      the above steps, and propose the principal factors involved in the development of
      clinical features in Turner syndrome.

PMID- 7789954
TI  - Linkage mapping of serotonin transporter protein gene SLC6A4 on chromosome 17.
AB  - Abnormalities in monoamine metabolism, including serotonin metabolism, have been
      implicated in the pathophysiology of affective disorders, schizophrenia, suicide,
      and other psychiatric disorders. Serotonin transporter protein (SERT) allows
      neurons to retrieve serotonin that has been released into a synapse. SERT is a
      site of action for several drugs with CNS effects, including both therapeutic
      agents (e.g., antidepressants) and drugs of abuse (e.g., cocaine). This gene had
      previously been physically mapped to chromosome 17. We used a PCR product
      corresponding to the 3' untranslated region of the gene as a probe to identify
      restriction fragment length polymorphism (RFLP), which we then used to establish
      that the SLC6A4, genetic locus for SERT, is near 17q12 and probably flanked by
      D17S58 and D17S73 (a location consistent with observed crossovers). These data
      should be useful for linkage studies of neuropsychiatric disorders.

PMID- 7789953
TI  - Screening for known mutations in the LDL receptor gene causing familial
      hypercholesterolemia.
AB  - Familial hypercholesterolemia (FH) is caused by defective low density lipoprotein
      (LDL) receptors and is characterized by hypercholesterolemia and premature
      coronary heart disease. Two strategies can be used to identify the mutation in
      the LDL receptor gene underlying FH. One strategy is to search for novel
      mutations by DNA sequencing with or without prior mutation screening. The other
      strategy is to screen for known mutations. In this study we employed the latter
      strategy to screen 75 unrelated, Norwegian FH subjects for 38 known mutations.
      Three of the 38 mutations were detected in our group of FH subjects. Two subjects
      had FH-Padova, one had FH-Cincinnati-2 and one had FH-Gujerat. When additional
      unrelated FH heterozygotes were screened for the three mutations, the gene
      frequencies were 1.3%, 1.0% and 3.0%, respectively. In addition to identifying
      known mutations we also detected a novel stop codon in codon 541 (S541X). We
      conclude that screening for known mutations in the LDL receptor gene should be
      used as a complementary strategy to screening for novel mutations in order to
      understand the molecular genetics of FH.

PMID- 7789955
TI  - Identification of a candidate missense mutation in a family with von Willebrand
      disease type IIC.
AB  - A screening project to identify candidate molecular defects causing von
      Willebrand disease type IIC (VWD IIC) in a German family was carried out using
      polymerase chain reaction (PCR) amplification of all 52 exons of the von
      Willebrand factor (VWF) gene, subsequent electrophoresis of single and double
      stranded DNA and direct sequencing of PCR products with aberrant electrophoretic
      patterns. Only one candidate mutation, G550R, caused by a G-->A transition, was
      detected in exon 14 of the pro-VWF gene sequence. This mutation was not found on
      200 chromosomes of normal individuals. The propositus was homozygous for the
      mutation and for an extended intragenic haplotype, composed of eight polymorphic
      markers. Further family members were heterozygous for the mutation and were
      phenotypically normal or only mildly affected, in accordance with the recessive
      pattern of inheritance for VWD type IIC. The mutation could influence one of the
      presumed active centers for the suspected multimerizing enzymatic activity of pro
      VWF localized in the D1 and D2 domain, which corresponds to exon 5 and exon 14 of
      the VWF gene.

PMID- 7789957
TI  - High incidence of cystic fibrosis on the Faroe Islands: a molecular and
      genealogical study.
AB  - We have studied the genetics of cystic fibrosis (CF) in The Faroe Islands. Based
      on the number of affected children born during the period 1954-1993, the
      incidence of CF at birth is 1:1775, which is more than twice the incidence in the
      rest of Denmark. We have tested all known CF patients and/or their parents for
      the presence of delta F508 and found it to be the only CF mutation in this
      population. Based on testing 881 unrelated control individuals, the carrier
      frequency was estimated to be 1:24, given a calculated incidence of 1:2300.
      Genealogical studies enabled us to trace several of the families over seven
      generations. Haplotype investigations within the families suggest that delta F508
      was introduced by two founders, probably from the Celtic population in Brittany,
      Ireland, Wales or the North West of Scotland.

PMID- 7789956
TI  - Localization of Alagille syndrome to 20p11.2-p12 by linkage analysis of a three
      generation family.
AB  - Alagille syndrome (AGS) or arteriohepatic dysplasia is a rare but well-defined
      clinical entity that is usually inherited as an autosomal dominant trait. A
      limited number of patients carry a deletion in chromosome 20p, with 20p11.23
      p12.2 as the area of minimal overlap. Recently, a family has been identified in
      which a balanced translocation with a breakpoint in 20p12 co-segregates with the
      AGS phenotype. Here, we report a three-generation family with AGS and in which
      the affected members have a normal karyotype. Linkage analysis was performed with
      markers from the 20p candidate region. A lod score of Z = 2.96 was obtained with
      D20S27 at no recombination. Combining D20S27 and D20S61 to a single highly
      informative locus resulted in a maximum lod score of Z = +3.56 at theta = 0.0.
      Haplotype analysis positioned AGS between D20S59 and D20S65, markers that define
      an interval of about 40 cM. Allelic loss was not observed for the tested markers
      and no abnormalities in the PAX1 candidate gene were detected. These findings
      demonstrate that the locus on chromosome 20p could be responsible for AGS in
      cytogenetically normal patients and argues for a general role of this locus in
      the aetiology of AGS.

PMID- 7789958
TI  - A novel splicing mutation in propionic acidemia associated with a tetranucleotide
      direct repeat in the PCCB gene.
AB  - Propionic acidemia is an inborn error of organic acid metabolism caused by a
      deficiency of propionyl Coenzyme A (CoA) carboxylase. cDNAs sequenced from a beta
      subunit deficient Japanese patient (no. 187) showed an in-frame 57-bp deletion in
      one allele. Genomic DNA analysis revealed a four-nucleotide deletion of bases 3
      to 6 in the 3' intron adjacent to the deleted exon, which disrupted the consensus
      5' splice signal and caused exon skipping. This deletion removed one-half of a
      tetranucleotide direct repeat at the splice junction and presumably resulted from
      slipped mispairing.

PMID- 7789959
TI  - Redefinition of the coding sequence of the MXI1 gene and identification of a
      polymorphic repeat in the 3' non-coding region that allows the detection of loss
      of heterozygosity of chromosome 10q25 in glioblastomas.
AB  - The MXI1 gene encodes a protein interacting with Max, a regulatory factor of the
      Myc oncogene, and is located on chromosome 10q25, a region showing frequent loss
      of heterozygosity in malignant gliomas. We have reassessed the coding sequence of
      MXI1 and found that, at the 3' end, the open reading frame is 28 codons shorter
      than previously described. We have also found an AAAAC polymorphic repeat (two
      alleles, 45% heterozygosity) in the 3' non-coding region of the gene. Six
      anaplastic astrocytomas and nine glioblastomas, the most malignant form of
      glioma, were informative for this polymorphism. Loss of heterozygosity was
      demonstrated in all glioblastomas, but not in the remaining tumors.

PMID- 7789960
TI  - Highly polymorphic dinucleotide repeat at the NF2 gene.
AB  - A highly polymorphic CA repeat was identified in a cosmid containing the 5' end
      of the NF2 tumour suppressor gene. This marker has proved useful in
      presymptomatic diagnosis in affected families.

PMID- 7789961
TI  - An intragenic deletion in the human PTPN6 gene affects transcriptional activity.
AB  - An intragenic deletion in the human PTPN6 gene is described. The PTPN6 gene maps
      to chromosome 12p12-13 and is shown to possess two alternative first exons. A 1.7
      kb deletion occurring in the intron between the two alternatively used first
      exons is the result of an illegitimate recombination between two Alu-type
      repeats. The deletion increases the transcriptional activity of the distal
      promotor.

PMID- 7789962
TI  - Frequent sequence variant in the human tyrosine hydroxylase gene.
AB  - A polymorphism of human tyrosine hydroxylase changing the amino acid 81Val to
      81Met is located in exon 2 of the human tyrosine hydroxylase gene.

PMID- 7789964
TI  - Highly polymorphic sequence at D21S1448 mapping close to D21S55, within the Down
      syndrome critical region.
AB  - We have isolated a highly polymorphic sequence from the Down syndrome critical
      region on human chromosome 21. This is a particularly useful marker because it
      lies adjacent to the locus D21S55, which is most closely associated with the
      major defects on Down syndrome. Other than this marker, few other variable
      sequences are known in this region (including other restriction fragment length
      polymorphisms or CA repeats) and therefore D21S1448 will be extremely helpful not
      only for people studying the inheritance of portions of chromosome 21 with
      respect to Down syndrome, but also for those carrying out linkage analysis of the
      chromosome.

PMID- 7789963
TI  - Characteristics of gene mutations among 32 unrelated Japanese Gaucher disease
      patients: absence of the common Jewish 84GG and 1226G mutations.
AB  - The prevalence of seven different mutations (84GG, IVS2 + 1, 754A, 1226G, 1342C,
      1448C, and 1504T) was investigated in 32 unrelated Japanese Gaucher patients of
      which 20 were type I, 6 were type II, and 6 were type III). These mutations
      constitute 95% of the mutations observed in Jewish patients with Gaucher disease
      and 75% of the mutations in non-Jews (European). The most frequent mutation,
      1448C (L444P), accounted for 26 alleles (40.6%); the second most prevalent
      mutation was 754A (F213I), accounting for 7 alleles (10.9%); 27 alleles (42.2%)
      were unidentified. To data, neither the 1226G (N370S) nor 84GG mutations have
      been identified in the Japanese population though these alleles account for
      approximately 70% and 10% of mutations in the Jewish population. These data
      suggest that mutant alleles identified from the Japanese population are distinct
      from those observed in Jewish and non-Jewish (European) patients with Gaucher
      disease.

PMID- 7789965
TI  - A trinucleotide repeat combination polymorphism in the cardiac alpha myosin heavy
      chain (MYH6) gene.
AB  - A polymorphic trinucleotide repeat combination (GAA)m(GAG)n has been demonstrated
      in the cardiac alpha myosin heavy chain gene (MYH6), which is located on
      chromosome 14q, and which is sometimes involved in familial hypertrophic
      cardiomyopathy. Based on length, at least seventeen alleles varying from 31 to 50
      repeats have been detected in a sample of 55 unrelated individuals.

PMID- 7789966
TI  - High yield of restriction fragment length polymorphisms in two-dimensional
      separations of human genomic DNA.
AB  - We have investigated the extent to which restriction fragment length polymorphism
      can be detected by two-dimensional electrophoresis of end-labeled genomic
      restriction fragments. Genomic DNA was digested with NotI and EcoRV and labeled
      at the NotI recognition site before first-dimension electrophoresis in disk gels.
      DNA in the disk gels was further digested in situ with HinfI prior to second
      dimension electrophoresis, yielding patterns in which approximately 2000 end
      labeled fragments were simultaneously visualized. On the basis of studies of 6
      mother/father/child trios, a group of 184 fragments was organized into 85
      polymorphic systems in which all allelic fragments were detectable in the 2-D
      patterns. Another 206 fragments varied as to their presence among individuals,
      but their relatedness to other fragments was not established. Our data indicate
      that a large number of DNA polymorphisms can be simultaneously scored in 2-D
      separations of genomic DNA fragments.

PMID- 7789968
TI  - Refined genetic mapping of a gene for familial juvenile nephronophthisis (NPH1)
      and physical mapping of linked markers. APN Study Group.
AB  - We have recently assigned a gene for familial juvenile nephronophthisis (NPH1) to
      chromosome 2q between microsatellite markers at loci D2S135 and D2S110. Here we
      have extended and refined our previous linkage analysis by studying five
      additional NPH families and by testing five additional markers. By haplotype
      analysis in a large family yielding proof of linkage, D2S135 and D2S283 were
      defined with certainty as flanking the NPH1 critical region within a 14-cM
      interval. These data now allow cytogenetic assignment of the NPH1 critical region
      to 2q11.1-q21.1. Furthermore, haplotype analysis in 12 small families helped to
      define as flanking markers D2S293 and D2S363, which span an 8-cM interval.
      Multipoint linkage analysis by the location score method resulted in a maximum
      multipoint lod score of 10.30. The Zmax-1 support interval spans 6.9 cM and is
      flanked by marker loci D2S293 and D2S363. Since IL1A maps to this region and has
      been cytogenetically mapped to 2q13 in the literature, NPH1 can be assigned more
      closely to 2q13 or adjacent bands. Contigs of CEPH mega-YAC clones in the region
      were established by screening the clones with microsatellite markers, adding
      marker IL1A to the physical map as a novel assignment. We conclude that the NPH1
      gene most probably localizes to an interval of 6.9 cM between marker loci D2S293
      and D2S363 in the vicinity of 2q13. This contig mapping provides the basis for
      cloning of this interval and for isolation of the NPH1 gene.

PMID- 7789967
TI  - POM-ZP3, a bipartite transcript derived from human ZP3 and a POM121 homologue.
AB  - Human POM-ZP3 is a novel bipartite RNA transcript that is derived from a gene
      homologous to rat POM121 (a nuclear pore membrane protein) and ZP3 (a sperm
      receptor ligand in the zona pellucida). The 5' region is 77% identical to the 5'
      end of the coding region of rat POM121 and appears to represent a partial
      duplication of a gene encoding a human homologue of this rodent gene. The 3' end
      of the POM-ZP3 transcript is 99% identical to ZP3 and appears to have arisen from
      a duplication of the last four exons (exons 5-8) of ZP3. Using Northern blots and
      RT-PCR, POM-ZP3 transcripts were detected in human ovaries, testes, spleen,
      thymus, lymphocytes, prostate, and intestines. The longest open reading frame
      encodes a conceptual protein of 210 amino acids, the first 76 of which are 83%
      identical to residues 241-315 of rat POM121. The next 125 amino acids are 98%
      identical to residues 239-363 of the 424-amino-acid human ZP3 protein. By
      fluorescence in situ hybridization, genomic fragments of ZP3 and a human
      homologue of POM121 were localized to chromosome 7q11.23. Taken together, these
      data suggest that partial duplications of human ZP3 and a POM121-like gene have
      resulted in a fusion transcript, POM-ZP3, that is expressed in multiple human
      tissues.

PMID- 7789969
TI  - Structure and expression of the gene (HNRPA2B1) encoding the human hnRNP protein
      A2/B1.
AB  - Heterogeneous nuclear ribonucleoprotein (hnRNP) A2 is a major nuclear protein and
      one of the major components of the hnRNP core complex in mammalian cells. We
      first determined the complete sequence of the human gene for hnRNP protein A2
      (HNRPA2B1). The human HNRPA2B1 gene exists in a single copy over 9 kb in length.
      The gene was split into 12 exons, including a 36-nucleotide mini-exon, which was
      specific to the hnRNP protein B1, providing genetic evidence that the B1 mRNA was
      generated from the primary HNRPA2B1 transcript by alternative splicing. The 5'
      region of HNRPA2B1 was GC-rich and contained several DNA motifs for the binding
      of several transcription factors, which included 2 CCAAT boxes and no TATA
      sequences. The 5' ends of the mRNA were mapped to multiple positions. These
      structural features are characteristic of promoter regions of housekeeping genes.
      Northern blot and RT-PCR analyses of the HNRPA2B1 transcripts revealed levels of
      B1 mRNA from 2 to 5% of total A2/B1 transcripts and showed that both A2 and B1
      mRNAs were transcribed in all human cell lines and mouse tissues studied. The
      structural and evolutionary characteristics of the A2 and A1 proteins as they
      relate to each other are discussed.

PMID- 7789970
TI  - The L19 ribosomal protein gene (RPL19): gene organization, chromosomal mapping,
      and novel promoter region.
AB  - The intron-containing genes encoding rat and human ribosomal protein L19 (RPL19)
      have been cloned. The DNA sequences of the entire rat RPL19 gene and the 5' end
      of the human RPL19 gene have been determined. Sequence comparison of
      corresponding regions of the two genes reveals a striking interspecies homology
      in the 5' upstream region, outside the transcribed and coding regions. The
      transcriptional start sites of the two genes have been determined and are
      identical. Both rat and human RPL19 genes have 5' ends associated with CpG
      islands. A promoter deletion analysis of the rat RPL19 gene suggests that this
      promoter may differ from those of all previously characterized ribosomal protein
      genes in requiring far upstream sequences for efficient gene expression. By
      fluorescence in situ hybridization analysis, the position of the human RPL19 gene
      has been sublocalized to 17q11 and may be coamplified with the erbB-2 gene in
      human breast cancer cells. The similarities and differences between RPL19 and
      other previously characterized ribosomal protein genes are discussed.

PMID- 7789971
TI  - Molecular cloning of a cDNA and chromosomal localization of a human theta-class
      glutathione S-transferase gene (GSTT2) to chromosome 22.
AB  - Until recently the Theta-class glutathione S-transferases (GSTs) were largely
      overlooked due to their low activity with the model substrate 1-chloro-2,4
      dinitrobenzene (CDNB) and their failure to bind to immobilized glutathione
      affinity matrices. Little is known about the number of genes in this class.
      Recently, Pemble et al. (Biochem J. 300: 271-276, 1994) reported the cDNA cloning
      of a human Theta-class GST, termed GSTT1. In this study, we describe the
      molecular cloning of a cDNA encoding a second human Theta-class GST (GSTT2) from
      a lambda gt11 human liver 5'-stretch cDNA library. The encoded protein contains
      244 amino acids and has 78.3% sequence identity with the rat subunit 12 and only
      55.0% identity with human GSTT1. GSTT2 has been mapped to chromosome 22 by
      somatic cell hybrid analysis. The precise position of the gene was localized to
      subband 22q11.2 by in situ hybridization. The absence of other regions of
      hybridization suggests that there are no closely related sequences (e.g., reverse
      transcribed pseudogenes) scattered throughout the genome and that if there are
      closely related genes, they must be clustered near GSTT2. Southern blot analysis
      of human DNA digested with BamHI shows that the size of the GSTT2 gene is
      relatively small, as the coding sequence falls within a 3.6-kb BamHI fragment.

PMID- 7789972
TI  - Murine chromosomal location of eight members of the hepatocyte nuclear factor
      3/fork head winged helix family of transcription factors.
AB  - A 100-amino-acid DNA-binding motif, known as the winged helix, was first
      identified in the mammalian hepatocyte nuclear factor-3 (HNF-3) and Drosophila
      fork head family of transcription factors. Subsequently, more than 40 different
      genes that contain the winged helix motif have been identified. In the studies
      described here, we have determined the murine chromosomal location of eight
      members of this gene family, HFH-1, HFH-3, HFH-4, HFH-5, HFH-6, HFH-8, BF-1, and
      BF-2, by interspecific backcross analysis. These genes, designated HNF-3 fork
      head homolog 1 (Hfh1), Hfh3, Hfh4, Hfh5, Hfh6, Hfh8, Hfh9, and Hfh10,
      respectively, mapped to 6 different mouse autosomes and are thus well dispersed
      throughout the mouse genome. Based on this mapping information, we predict the
      chromosomal location of these genes in humans and discuss the potential of these
      genes as candidates for uncloned mouse mutations.

PMID- 7789974
TI  - Identification of YAC clones for human chromosome 1p32 and physical mapping of
      the infantile neuronal ceroid lipofuscinosis (INCL) locus.
AB  - Infantile neuronal ceroid lipofuscinosis (INCL, CLN1) is a neurodegenerative
      disorder in which the biochemical defect is unknown. We earlier assigned the
      disease locus to chromosome 1p32 in the immediate vicinity of the highly
      informative HY-TM1 marker by linkage and linkage disequilibrium analysis. Here we
      report the construction of PFGE maps on the CLN1 region covering a total of 4 Mb
      of this relatively poorly mapped chromosomal region. We established the order of
      loci at 1p32 as tel-D1S57-L-myc-HY-TM1-rlf-COL9A2-D1S193-D1S6 2-D1S211-cen by
      combining data obtained from analysis of a chromosome 1 somatic cell hybrid
      panel, PFGE, and interphase FISH. We isolated YACs and constructed two separate
      YAC contigs, the loci L-myc, HY-TM1, rlf, and COL9A2 being present on a 1000-kb
      contig and the markers D1S193, D1S62, and D1S211 on a YAC contig spanning a
      maximum of 860 kb. Within the 1000-kb contig we were able to identify five CpG
      islands in addition to those associated with the earlier cloned genes. The YAC
      contigs as well as the physical map provide us with tools for the identification
      of the INCL gene.

PMID- 7789973
TI  - D20S16 is a complex interspersed repeated sequence: genetic and physical analysis
      of the locus.
AB  - The genomic structure of the D20S16 locus has been evaluated using genetic and
      physical methods. D20S16, originally detected with the probe CRI-L1214, is a
      highly informative, complex restriction fragment length polymorphism consisting
      of two separate allelic systems. The allelic systems have the characteristics of
      conventional VNTR polymorphisms and are separated by recombination (theta = 0.02,
      Zmax = 74.82), as demonstrated in family studies. Most of these recombination
      events are meiotic crossovers and are maternal in origin, but two, including
      deletion of the locus in a cell line from a CEPH family member, occur without
      evidence for exchange of flanking markers. DNA sequence analysis suggests that
      the basis of the polymorphism is variable numbers of a 98-bp sequence tandemly
      repeated with 87 to 90% sequence similarity between repeats. The 98-bp repeat is
      a dimer of 49 bp sequence with 45 to 98% identity between the elements. In
      addition, nonpolymorphic genomic sequences adjacent to the polymorphic 98-bp
      repeat tracts are also repeated but are not polymorphic, i.e., show no individual
      to individual variation. Restriction enzyme mapping of cosmids containing the CRI
      L1214 sequence suggests that there are multiple interspersed repeats of the CRI
      L1214 sequence on chromosome 20. The results of dual-color fluorescence in situ
      hybridization experiments with interphase nuclei are also consistent with
      multiple repeats of an interspersed sequence on chromosome 20.

PMID- 7789975
TI  - Region-specific cosmids and STRPs identified by chromosome microdissection and
      FISH.
AB  - A strategy for identifying short tandem repeat (STR)-containing cosmid clones
      from a specific chromosomal region is described. The approach is based on the use
      of uncloned, PCR-amplified DNA derived from chromosome microdissection and pooled
      groups of STR sequences as hybridization probes to screen a cosmid library.
      Cosmid clones that display a positive signal common to both hybridizations are
      then characterized for repeat length polymorphisms. This method has been applied
      to chromosome bands 17q12-q21, a region that includes a gene (BRCA1) involved in
      early onset familial breast and ovarian cancer. Of 1536 chromosome 17-specific
      cosmid clones tested, 38 were identified by the dual screening procedure.
      Fluorescence in situ hybridization revealed that 19 cosmids originated from the
      microdissected target region. Thirteen of the 19 cosmids were mapped between
      markers flanking the BRCA1 region and selected for further characterization.
      Tetranucleotide repeats were identified in 10 of these 13 cosmids. Primers
      designed for each marker were tested on a panel of 80 CEPH parents for allele
      sizes, frequencies, and observed heterozygosities. From these studies six
      polymorphic and one nonpolymorphic STRs were identified. A similar approach
      should be applicable for screening whole genomic or chromosome-specific cosmid
      libraries in efforts to isolate new polymorphic markers from any chromosomal
      region of interest.

PMID- 7789976
TI  - Genetic mapping of the spinocerebellar ataxia 2 (SCA2) locus on chromosome 12q23
      q24.1.
AB  - A refined genetic map of the spinocerebellar ataxia 2 locus was constructed
      through linkage and haplotype analysis of 11 large pedigrees from the Holguin
      SCA2 family collective. Three-point analysis makes a localization of the SCA2
      mutation in the 6-cM interval D12S84-D12S79 likely. This is consistent with
      haplotype results indicating a crossover event between two branches of the SCA2
      family Rs and placing the mutation on the telomeric side of D12S84. The
      microsatellite D12S105 within this interval shows a peak two-point lod score of Z
      = 16.14 at theta = 0.00 recombination and complete linkage disequilibrium among
      affected individuals. These data together with the observation of a common
      disease haplotype among all family ancestors support the notion of an SCA2
      founder effect in Holguin province.

PMID- 7789977
TI  - Analysis of the dopamine receptor family in the compact genome of the puffer fish
      Fugu rubripes.
AB  - The genome of the puffer fish, Fugu rubripes (Fugu), is approximately 400 Mb, 7.5
      times smaller than that of human. We have isolated four dopamine receptor-like
      genes from Fugu genomic DNA. These genes show high sequence and structural
      homology to the known dopamine receptor genes, although, in contrast to
      previously described genes from this species, the intron size is comparable to
      that in human. The 5' noncoding exons of the D2/D3 dopamine receptor-like genes
      is described and compared to that in human. The high gene density of Fugu is
      shown by the close proximity of a cystatin-like gene 1503 bp from the dopamine
      receptor gene D222. We propose that the compact genome of Fugu can serve as a
      model for identifying gene family members directly from genomic DNA.

PMID- 7789978
TI  - A high-resolution integrated physical, cytogenetic, and genetic map of human
      chromosome 11: distal p13 to proximal p15.1.
AB  - We describe a detailed physical map of human chromosome 11, extending from the
      distal part of p13 through the entirety of p14 to proximal p15.1. The primary
      level of mapping is based on chromosome breakpoints that divide the region into
      20 intervals. At higher resolution YACs cover approximately 12 Mb of the region,
      and in many places overlapping cosmids are ordered in contiguous arrays. The map
      incorporates 18 known genes, including precise localization of the GTF2H1 gene
      encoding the 62-kDa subunit of TFIIH. We have also localized four expressed
      sequences of unknown function. The physical map incorporates genetic markers that
      allow relationships between physical and genetic distance to be examined, and
      similarly includes markers from a radiation hybrid map of 11. The cytogenetic
      location of cosmids has been examined on high-resolution banded chromosomes by
      fluorescence in situ hybridization, and FLpter values have been determined. The
      map therefore fully integrates physical, genic, genetic, and cytogenetic
      information and should provide a robust framework for the rapid and accurate
      assignment of new markers at a high level of resolution in this region of 11p.

PMID- 7789979
TI  - The gene encoding the VP16-accessory protein HCF (HCFC1) resides in human Xq28
      and is highly expressed in fetal tissues and the adult kidney.
AB  - After herpes simplex virus (HSV) infection, the viral regulatory protein VP16
      activates transcription of the HSV immediate-early promoters by directing complex
      formation with two cellular proteins, the POU-homeodomain transcription factor
      Oct-1 and the host cell factor HCF. The function of HCF in uninfected cells is
      unknown. Here we show by fluorescence in situ hybridization and somatic cell
      hybrid analysis that the gene encoding human HCF, HCFC1, maps to the q28 region
      of the X chromosome. Yeast artificial chromosome and cosmid mapping localizes the
      HCFC1 gene within 100 kb distal of the renal vasopressin type-2 receptor (V2R)
      gene and adjacent to the renin-binding protein gene (RENBP). The HCFC1 gene is
      apparently unique. HCF transcripts and protein are most abundant in fetal and
      placental tissues and cell lines, suggesting a role in cell proliferation. In
      adults, HCF protein is abundant in the kidney, but not in the brain, a site of
      latent HSV infection and where HCF levels may influence progression of HSV
      infection.

PMID- 7789981
TI  - Comparative mapping of human alphoid sequences in great apes using fluorescence
      in situ hybridization.
AB  - Twenty-seven human alphoid DNA probes have been hybridized in situ to metaphase
      spreads of the common chimpanzee (PTR), the pigmy chimpanzee (PPA), and the
      gorilla (GGO) to investigate the evolutionary relationship between the
      centromeric regions of the great ape chromosomes. The surprising results showed
      that the vast majority of the probes did not recognize their corresponding
      homologous chromosomes. Alphoid sequences belonging to the suprachromosomal
      family 1 (chromosomes 1, 3, 5, 6, 7, 10, 12, 16, and 19) yielded very
      heterogeneous results: some probes gave intense signals, but always on
      nonhomologous chromosomes; others did not produce any hybridization signal.
      Almost all probes belonging to the suprachromosomal family 2 (chromosomes 2, 4,
      8, 9, 13, 14, 15, 18, 20, 21, and 22) recognized a single chromosome: chromosome
      11 (phylogenetic IX) in PTR and PPA and chromosome 19 (phylogenetic V) in GGO.
      Localization of probes of suprachromosomal family 3 (chromosomes 1, 11, 17, and
      X) was found to be substantially conserved in PTR and PPA, but not in GGO. Probe
      pDMX1, specific for the human X chromosome, was the only sequence detecting its
      corresponding chromosome in all three species. PPA chromosomes I, IIp, IIq, IV,
      V, VI, and XVIII were never labeled, even under low-stringency hybridization
      conditions, by the 27 alphoid probes used in this study. These results, with
      particular reference to differences found in the two related species PTR and PPA,
      suggest that alphoid centromeric sequences underwent a very rapid evolution.

PMID- 7789980
TI  - Molecular cloning and chromosomal localization of a pseudogene related to the
      human acyl-CoA binding protein/diazepam binding inhibitor.
AB  - The acyl-CoA binding protein (ACBP) and the diazepam binding inhibitor (DBI) or
      endozepine are independent isolates of a single 86-amino-acid, 10-kDa protein.
      ACBP/DBI is highly conserved between species and has been identified in several
      diverse organisms, including human, cow, rat, frog, duck, insects, plants, and
      yeast. Although the genomic locus has not yet been cloned in humans,
      complementary DNA clones with different 5' ends have been isolated and
      characterized. These cDNA clones appear to be encoded by a single gene. However,
      Southern blot analyses, in situ hybridizations, and somatic cell hybrid
      chromosomal mapping all suggest that there are multiple ACBP/DBI-related
      sequences in the genome. To identify potential members of this gene family,
      degenerate oligonucleotides corresponding to highly conserved regions of ACBP/DBI
      were used to screen a human genomic DNA library using the polymerase chain
      reaction. A novel gene, DBIP1, that is closely related to ACBP/DBI but is clearly
      distinct was identified. DBIP1 bears extensive sequence homology to ACBP/DBI but
      lacks the introns predicted by rat and duck genomic sequence studies. A 1-base
      deletion in the coding region results in a frameshift and, along with the absence
      of introns and the lack of a detectable transcript, suggests that DBIP1 is a
      pseudogene. ACBP/DBI has previously been mapped to chromosome 2, although this
      was recently disputed, and a chromosome 6 location was suggested. We show that
      ACBP/DBI is correctly placed on chromosome 2 and that the gene identified on
      chromosome 6 is DBIP1.

PMID- 7789982
TI  - Treatment of cells with alkaline borate buffer extends the capability of
      interphase FISH mapping.
AB  - Interphase fluorescence in situ hybridization (FISH) has been shown to be a means
      to map DNA sequences relative to each other in the 100 kb to 1-2 Mb genomic
      separation range. At distances below 0.1 Mb, probe sites are infrequently
      resolved in interphase chromatin. In the 0.1- to 1-Mb range, interphase chromatin
      can be modeled as a freely flexible chain. The mean square interphase distance
      between two probes is proportional to the genomic separation between the probes
      on the linear DNA molecule. Above 1-2 Mb, the relationship between interphase
      distance and genomic separation changes abruptly and appears to level off. We
      have used alkaline-borate treatment to expand the capability of interphase FISH
      mapping. We show here that alkaline-borate treatment increases nuclear diameter,
      the interphase distance between probes on homologous chromosomes, and the
      distance between probes on the same chromosome. We also show that the mean square
      distance between hybridization sites in borate-treated nuclei is proportional to
      genomic separation up to 4 Mb. Thus, alkaline-borate treatment enhances the
      capability of interphase FISH mapping by increasing the absolute distance between
      probes and extending the range of the simple relationship between interphase
      distance and genomic separation.

PMID- 7789983
TI  - Cloning, characterization, and chromosomal localization to 4p16 of the human gene
      (LRPAP1) coding for the alpha 2-macroglobulin receptor-associated protein and
      structural comparison with the murine gene coding for the 44-kDa heparin-binding
      protein.
AB  - We report the molecular cloning of the human gene (symbol LRPAP1) coding for the
      alpha 2-macroglobulin receptor-associated protein (A2MRAP), as well as the gene
      coding for the 44-kDa heparin-binding protein (HBP-44), its murine counterpart.
      For both, genomic cosmid clones were isolated, and for the human gene a
      bacteriophage P1 clone containing the entire A2MRAP gene was also retrieved. The
      genes were characterized after subcloning: in both species, the known coding part
      of the cDNA is encoded by eight exons, and the position of the boundaries of the
      exons was conserved. The human LRPAP1 locus was assigned to chromosome 4 by PCR
      of human-hamster hybrid cell lines and by fluorescence in situ hybridization to
      band 4p16.3. This maps closely to the variable constitutional deletions of the
      short arm of chromosome 4, observed cytogenetically in patients with the Wolf
      Hirschhorn syndrome. Metaphase spreads of two such patients were analyzed by
      fluorescence in situ hybridization with an LRPAP1 genomic probe. The first
      patient, with karyotype 46,XY,del4(p14-p16.1), had retained both copies of the
      LRPAP1 gene. In contrast, the other patient, with karyotype 46,XY,del4(p15.3
      pter), displayed no signal for LRPAP1 on the deleted chromosome.

PMID- 7789984
TI  - Genomic structure of SAS, a member of the transmembrane 4 superfamily amplified
      in human sarcomas.
AB  - SAS is a recently identified member of the transmembrane 4 superfamily (TM4SF)
      that is frequently amplified in human sarcomas. To further its characterization
      and to confirm its classification, the genomic structure of the SAS gene was
      determined. The SAS gene covers approximately 3.2 kb of DNA. It contains six
      exons within its translated region, three of which are highly conserved in the
      TM4SF. 5' to the translation start site are two putative transcription start
      sites, two CCAAT consensus sequences, and potential binding sites for both Sp1
      and ATF transcription factors. Comparison of SAS organization to human ME491,
      CD9, and CD53 and murine CD53 and TAPA-1 confirms that SAS is a member of this
      family of genes and is consistent with the theory that these genes arose through
      duplication and divergent evolution.

PMID- 7789986
TI  - Identification and characterization of a second mouse Nramp gene.
AB  - The Nramp gene was isolated as a candidate for the host resistance locus
      Bcg/Ity/Lsh, which controls natural resistance of mice to several types of
      infections. We have isolated by cross-hybridization cDNA clones corresponding to
      a second mouse Nramp gene, which we designate Nramp2. Nucleotide and predicted
      amino acid sequence analyses of full-length cDNA clones for Nramp2 indicate that
      this novel Nramp protein is closely homologous to the previously described Nramp
      and that the two genes form part of a small gene family. The two Nramp proteins
      encode integral membrane proteins that share 63% identical residues and an
      overall homology of 78%. They share very similar secondary structure, including
      identical hydropathy profiles and predicted membrane organization, with a minimum
      of 10 and most probably 12 transmembrane domains, a cluster of predicted N-linked
      glycosylation sites, and a consensus transport motif. Analysis of the
      distribution of Nramp2 mRNA transcripts in normal mouse tissues by Northern
      blotting revealed that the Nramp2 gene produces several mRNAs, including
      prominent 3.3- and 2.3-kb species generated by the use of alternative
      polyadenylation signals. In contrast to the previously described macrophage
      specific Nramp gene, Nramp2 mRNAs were found to be expressed at low levels in all
      tissues tested. Using a polymorphic (GT)26 dinucleotide repeat identified in the
      3' untranslated region of the mRNA, we have mapped the Nramp2 gene to the distal
      part of mouse chromosome 15 between markers D15Mit41 and D15Mit15, with the gene
      order and intergene distance (in cM): centromere-56.1-D15Mit41-(1 +/- 1)-Nramp2
      (5 +/- 2)-D15Mit15.

PMID- 7789985
TI  - The human osmoregulatory Na+/myo-inositol cotransporter gene (SLC5A3): molecular
      cloning and localization to chromosome 21.
AB  - A human Na+/myo-inositol cotransporter (SLC5A3) gene was cloned; sequencing
      revealed a single intron-free open reading frame of 2157 nucleotides. Containing
      718 amino acid residues, the predicted protein is highly homologous to the
      product of the canine osmoregulatory SLC5A3 gene. The SLC5A3 protein is number 3
      of the solute carrier family 5 and was previously designated SMIT. Using
      fluorescence in situ hybridization, the human SLC5A3 gene was localized to band
      q22 on chromosome 21. Many tissues including brain demonstrate gene expression.
      The inability of a trisomic 21 cell to downregulate expression of three copies of
      this osmoregulatory gene could result in increased flux of both myo-inositol and
      Na+ across the plasma membrane. The potential consequences include perturbations
      in the cell membrane potential and tissue osmolyte levels. The SLC5A3 gene may
      play a role in the pathogenesis of Down syndrome.

PMID- 7789987
TI  - Development and physical analysis of YAC contigs covering 7 Mb of Xp22.3-p22.2.
AB  - A total of 54 YAC clones have been isolated from the region of Xp22.2-p22.3
      extending from the amelogenin gene locus to DXS31. Restriction analysis of these
      clones in association with STS contenting and end clone analysis has facilitated
      the construction of 6 contigs covering a total of 7 Mb in which 20 potential CpG
      islands have been located. Thirty new STSs have been developed from probe and YAC
      end clone sequences, and these have been used in the analysis of patients
      suffering from different combinations of chondrodysplasia punctata, mental
      retardation, X-linked ichthyosis, and Kallmann syndrome. The results suggest that
      (1) the gene for chondrodysplasia punctata must lie between the X chromosome
      pseudoautosomal boundary (PABX) and DXS1145; (2) a gene for mental retardation
      lies between DXS1145 and the sequence tagged site GS1; and (3) the gene for
      ocular albinism type 1 lies proximal to the STS G13. The CpG islands within the
      YAC contigs constitute valuable markers for the potential positions of genes.
      Genes found associated with any of these potential CpG islands would be possible
      candidates for the disease genes mentioned above.

PMID- 7789988
TI  - Cloning and chromosomal localization of the human TRK-B tyrosine kinase receptor
      gene (NTRK2).
AB  - There is increasing evidence that neutrophins and their receptors play an
      important role in regulating development of both the central and the peripheral
      nervous systems. Human TRK-A (NTRK1) and TRK-C (NTRK3) have been cloned and
      sequenced, but only a truncated form of human TRK-B has been published.
      Therefore, we isolated complementary DNAs spanning the entire coding region of
      both human full-length and truncated forms of TRK-B from human brain cDNA
      libraries. Human full-length TRK-B codes for a protein of 822 amino acid
      residues. The putative mature peptide sequence is 49% homologous to human TRK-A
      and 55% to full-length human TRK-C, with 40% amino acid identify among TRK-A, -B,
      and -C. Nine of 13 cysteine residues, 4 of 12N-glycosylation sites in the
      extracellular domain, and 10 of 13 tyrosine residues in the intracellular domain
      are conserved among human TRK-A, -B, and -C. There is a cluster of 10 serine
      residues in the juxtamembrane region of TRK-B that is absent in TRK-A. Two major
      sizes of TRK-B transcripts were expressed in human brain. Northern blot analysis
      using probes specific for the extracellular or the tyrosine kinase domain
      revealed that the 9.5-kb band encodes the full-length TRK-B mRNA and the 8.0-kb
      band encodes the truncated form of TRK-B mRNA. By fluorescence in situ
      hybridization and somatic cell hybrid mapping, the human TRK-B gene was localized
      to chromosome 9q22.1.

PMID- 7789989
TI  - Genomic sequence comparison of the human and mouse XRCC1 DNA repair gene regions.
AB  - The XRCC1 (X-ray repair cross complementing) gene is involved in the efficient
      repair of DNA single-strand breaks formed by exposure to ionizing radiation and
      alkylating agents. The human gene maps to chromosome 19q13.2, and the mouse
      homologue maps to the syntenic region on chromosome 7. Two cosmids (approximately
      38 kb each) containing the human and mouse genes were sequenced to an average 8
      fold clonal redundancy. The XRCC1 gene spans a genomic distance of 26 kb in mouse
      and 31.9 kb in human. Both genes contain 17 exons, are 84% identical within the
      coding regions, and are 86% identical at the amino acid sequence level. Intron
      and exon lengths are highly conserved. For the human cosmid, a total of 43 Alu
      repetitive elements are present, a density of 1.1 Alu/kb, but due to clustering,
      the local density is as high as 1.8 Alu/kb. In addition, we observed a
      statistically significant bias for insertion of these elements in the 3'-5'
      orientation relative to the direction of XRCC1 transcription, predominantly in
      the second and third introns. This bias may indicate that XRCC1 is more
      accessible to Alu retroposition events during transcription than genes not
      expressed during spermatogenesis. The density of B1 and B2 elements in the mouse
      is 0.4/kb, integrated primarily in the 5'-3' orientation. The human chromosome 19
      specific minisatellite PE670 was present in the same orientation in 3 introns in
      the human gene, and a similar repeat was found at 3 different locations in the
      mouse cosmid.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7789990
TI  - CLONEPLACER: a software tool for simulating contig formation for ordered shotgun
      sequencing.
AB  - This communication describes a software tool that enables one to simulate large
      scale regional mapping using an ordered shotgun sequencing approach. The analysis
      routines that are provided yield an estimate of the depth of coverage of the
      physical map, the largest contig formed, and the number of gaps remaining at any
      given juncture in the project. A detailed listing describing the span of each
      contig within the physical map is also presented. This provides an a priori means
      of estimating the resources that will be required to undertake any megabase
      mapping or sequencing project. CLONEPLACER provides the much needed guide to
      deriving the optimal strategy.

PMID- 7789991
TI  - Chromosomal localization of mitochondrial transcription factor A (TCF6), single
      stranded DNA-binding protein (SSBP), and endonuclease G (ENDOG), three human
      housekeeping genes involved in mitochondrial biogenesis.
AB  - By using a PCR-based screening of a somatic cell hybrid panel and FISH, we have
      assigned the loci of mitochondrial single-stranded DNA-binding protein (SSBP),
      mitochondrial transcription factor A (TCF6), and mitochondrial endonuclease G
      (ENDOG) genes to human chromosomes 7q34, 10q21, and 9q34.1, respectively. The
      products of these three genes are involved in fundamental aspects of
      mitochondrial biogenesis, such as replication and transcription of the
      mitochondrial genome. The chromosomal localization of these genes is important to
      testing whether the corresponding proteins may play a role in the
      etiopathogenesis of human disorders associated with qualitative or quantitative
      abnormalities of mitochondrial DNA.

PMID- 7789993
TI  - Localization of the human phosphatidylinositol-specific phospholipase c beta 3
      gene (PLCB3) within chromosome band 11q13.
AB  - In course of the molecular characterization of a human extragonadal germ cell
      tumor (EGCT)-associated chromosomal translocation, we identified YACs and cosmids
      from the 11q13 region. The endclone of one of these YACs appeared to contain a
      stretch of DNA homologous to part of the human phosphatidylinositol-specific
      phospholipase C beta 3 gene (PLCB3). Since we considered PLCB3 a candidate gene
      for these EGCTs, we set out to clone the PLCB3 cDNA, from which the 5' end was
      still missing, and performed Northern and Southern blot analyses. The
      localization of PLCB3 to 11q13 was confirmed. In addition, we were able to
      exclude the gene from involvement in EGCT development.

PMID- 7789992
TI  - Homologs of Drosophila Fushi-Tarazu factor 1 map to mouse chromosome 2 and human
      chromosome 9q33.
AB  - SF-1, a nuclear receptor that regulates gene expression of the cytochrome P450
      steroid hydroxylases, and ELP, an embryonal protein that suppresses expression of
      the Moloney murine leukemia virus LTR, are isoforms transcribed from the same
      gene by alternative promoter usage and splicing. This gene is the mammalian
      homolog of the Drosophila fushi-tarazu factor 1 (FTZ-F1) gene. We have mapped the
      mouse gene Ftzf1 to the proximal quarter of Chr 2 by a linkage analysis using
      interspecific backcross mice, and its human homolog FTZ1 to Chr 9q33 by
      fluorescence in situ hybridization. The mouse and human genes are located in the
      homologous regions of mouse Chr 2 and human Chr 9, respectively.

PMID- 7789995
TI  - The beta crystallin genes on human chromosome 22 define a new region of homology
      with mouse chromosome 5.
AB  - The human beta crystallin genes CRYBB2, CRYBB2P1, CRYBB3, and CRYBA4 are located
      in 22q11.2. Using interspecific backcross analysis, we mapped the mouse
      homologues of CRYBB2, CRYBB3, and CRYBA4 (i.e., Crybb2, Crybb3, and Cryba4) to
      the central region of mouse chromosome 5. The homologue of human CRYBB2P1 is
      absent in mouse. These assignments define a new region of homology in human and
      mouse.

PMID- 7789994
TI  - Expanded CTG triplet blocks from the myotonic dystrophy gene create the strongest
      known natural nucleosome positioning elements.
AB  - Expanded blocks of repeating nucleotide triplets have been found in or near genes
      associated with several human diseases. In the case of myotonic dystrophy, a
      block of repeating CTG trinucleotides is located downstream of the gene, and
      expansions of this block to repeats of n = 100 or more are frequently found in
      afflicted individuals. Using electron microscopy, we recently demonstrated that
      these blocks form unusually stable nucleosomes. Here, competitive nucleosome
      reconstitution was employed to measure the energetics of nucleosome formation
      over CTG repeat blocks of n = 75 and n = 130. These values were compared to the
      Xenopus borealis somatic 5S RNA gene, previously one of the strongest known
      natural nucleosome positioning elements. It is shown that DNA fragments
      containing 75 and 130 CTG repeats are 6 and 9 times stronger in nucleosome
      formation, respectively, than the 5S RNA gene. These findings suggest that
      expanded CTG blocks may profoundly alter local chromatin structure.

PMID- 7789997
TI  - Chromosome mapping of human (ZNF147) and mouse genes for estrogen-responsive
      finger protein (efp), a member of the RING finger family.
AB  - We have previously identified an estrogen-responsive gene, efp (estrogen
      responsive finger protein), that encodes a putative zinc finger protein (Proc.
      Natl. Acad. Sci. USA 90: 11117-11121, 1993). The efp protein has a RING finger, a
      variant type of zinc finger motif, B1 box, and B2 box, each having a pair of zinc
      fingers, present in a family of apparent DNA-binding proteins. Some members of
      this family have transformation capabilities when found in chromosomal
      translocations. Chromosome mapping of the efp gene by fluorescence in situ
      hybridization reveals that human EFP (ZNF147) is located at 17q23.1 and that
      mouse Efp is located at 11C. These results provide additional evidence that the
      mouse 11C region displays conserved synteny with the 17q23.1 region of the human
      genome.

PMID- 7789996
TI  - Mapping of ribosomal protein S3 and internally nested snoRNA U15A gene to human
      chromosome 11q13.3-q13.5.
AB  - The mammalian ribosome is a massive structure composed of 4 RNA species and about
      80 different proteins. One of these ribosomal proteins, S3, appears to function
      not only in translation but also as an endonuclease in repair of UV-induced DNA
      damage. Moreover, the first intron of human RPS3 transcripts is processed to
      generate U15A, a small nucleolar RNA. We localized the nested RPS3/U15A genes to
      the immediate vicinity of D11S356 and D11S533 on human chromosome 11q13.3-q13.5
      using a combination of somatic cell hybrid analysis, fluorescence in situ
      hybridization, and YAC/STS content mapping. These findings add to the evidence
      that genes encoding ribosomal proteins are scattered about the human genome.

PMID- 7789998
TI  - Localization of an epithelial-specific receptor kinase (EDDR1) to chromosome
      6q16.
AB  - A protein receptor tyrosine kinase (EDDR1) has been isolated from a complementary
      DNA library of SKOV-3, an epithelial ovarian cancer cell line. The primary
      structure of the predicted amino acid sequence of the protein shows a novel N
      terminal region that has homology to a factor VIII-like domain. The C-terminal
      catalytic domain has all of the canonical sequence motifs of a receptor tyrosine
      kinase with homology to the TRK-2H protein (49%), which suggests that it is a
      type II receptor. It is expressed in epithelial cells of several tissues. To
      determine the chromosomal localization of the gene, somatic cell hybrids were
      analyzed by PCR amplification using oligonucleotide primers specific for EDDR1.
      Segregation was observed to a hybrid containing human chromosome 6. Cosmids for
      EDDR1 were isolated from a human chromosome 6 cosmid library and were shown by
      fluorescence in situ hybridization to map to 6q16.

PMID- 7789999
TI  - Localization of multiple human dihydrodiol dehydrogenase (DDH1 and DDH2) and
      chlordecone reductase (CHDR) genes in chromosome 10 by the polymerase chain
      reaction and fluorescence in situ hybridization.
AB  - Multiple human dihydrodiol dehydrogenases and human chlordecone reductase belong
      to the aldoketo reductase superfamily. These two enzymes are involved in the
      metabolism of xenobiotics, such as polycyclic aromatic hydrocarbons and
      pesticides. Recently we have isolated three closely related genes encoding two
      dihydrodiol dehydrogenases (DDH1 and DDH2) and the chlordecone reductase (CHDR).
      Mapping of the location of the genes was performed using the polymerase chain
      reaction using gene-specific primers to amplify gene sequences in human/hamster
      hybrid DNA. All three genes were found to be located on chromosome 10. In situ
      hybridization using a lambda clone as the probe further confirmed regional
      localization at 10p14-p15.

PMID- 7790000
TI  - Tandem arrangement of the closely linked desmoglein genes on human chromosome 18.
AB  - The desmogleins, together with the desmocollins, both members of the cadherin
      superfamily, are the adhesive proteins of the desmosome type of cell junction,
      characteristically found in epithelial cells. Three different human desmoglein
      isoforms are encoded by separate genes (DSG1, DSG2, and DSG3) located on
      chromosome 18q12.1. DSG2 has been shown to be the most widely expressed in all
      desmosome-containing tissues, whereas DSG1 and DSG3 are expressed only in certain
      tissues, mostly stratified squamous epithelia. The desmoglein isoforms are
      expressed in a stratification-related manner in human epidermis, DSG1 being
      suprabasally expressed and DSG3 at a lower level, while DSG2 expression is weak
      and basal. Yeast artificial chromosome clones carrying all three known human
      desmoglein genes have now been isolated. The smallest clone containing all three
      DSG genes was 275 kb, and the three desmoglein genes were clustered within a
      region of less than 150 kb. From the types of clone obtained and from restriction
      enzyme analysis the order of the DSG genes and their orientation was deduced to
      be 5'-DSG1-DSG3-DSG2-3'. There thus appears to be some correspondence between the
      order of DSG genes and their expression within tissues, raising the intriguing
      possibility that the organization of the desmoglein gene cluster is required for
      properly regulated gene expression.

PMID- 7790001
TI  - Mapping of the human protein kinase C-theta (PRKCQ) gene locus to the short arm
      of chromosome 10 (10p15) by FISH.

PMID- 7790002
TI  - Localization of the human zipper protein kinase gene (ZPK) to chromosome 12q13 by
      fluorescence in situ hybridization and somatic cell hybrid analysis.

PMID- 7790003
TI  - Dinucleotide repeat polymorphism at the human chromosome 11p telomere (D11S2071).

PMID- 7790004
TI  - Assignment of the human angiotensin II type 2 receptor gene (AGTR2) to chromosome
      Xq22-q23 by fluorescence in situ hybridization.

PMID- 7790005
TI  - Mapping of the mouse homolog of the human runt domain gene, AML2, to the distal
      region of mouse chromosome 4.

PMID- 7790006
TI  - Localization of the adenosine A2b receptor subtype gene (ADORA2B) to chromosome
      17p11.2-p12 by FISH and PCR screening of somatic cell hybrids.

PMID- 7790007
TI  - Judgments of azimuth and elevation as a function of monoscopic and binocular
      depth cues using a perspective display.
AB  - The purpose of this study was to investigate the use of three-dimensional display
      formats for judgments of spatial information using an exocentric frame of
      reference. Eight subjects judged the azimuth and elevation that separated two
      computer-generated objects using either a perspective or stereoscopic display.
      Errors, which consisted of the difference in absolute value between the estimated
      and actual azimuth or elevation, were analyzed as the response variable. The data
      indicated that the stereoscopic display resulted in more accurate estimates of
      elevation, especially for images aligned approximately orthogonally to the
      viewing vector. However, estimates of relative azimuth direction were not
      improved by use of the stereoscopic display. Furthermore, it was shown that the
      effect of compression resulting from a 45-deg computer graphics eye point
      elevation produced a response bias that was symmetrical around the horizontal
      plane of the reference cube, and that the depth cue of binocular disparity
      provided by the stereoscopic display reduced the magnitude of the compression
      errors. Implications of the results for the design of spatial displays are
      discussed.

PMID- 7790008
TI  - Situation awareness in anesthesiology.
AB  - Situation awareness has primarily been confined to the aviation field. We believe
      that situation awareness is an equally important characteristic in the complex,
      dynamic, and risky field of anesthesiology. We describe three aspects of
      situations of which the decision maker must remain aware: subtle cues, evolving
      situations, and special knowledge elements. We provide examples of real or
      simulated anesthesia situations in which situation awareness is clearly involved
      in the provision of optimal patient care, and we map the elements of situation
      awareness onto a cognitive process model of the anesthesiologist. Finally, we
      consider how situation awareness can be further investigated and taught in this
      medical domain using anesthesia simulators and analyses of real cases. The study
      of situation awareness in anesthesiology may provide a good example of the wider
      application of the concept of situation awareness to nonaerospace environments.

PMID- 7790009
TI  - Intracranial pressure dynamics in patients with acute brain damage: a critical
      analysis with the aid of a mathematical model.
AB  - The time pattern of intracranial pressure (ICP) in response to typical clinical
      tests (i.e., bolus injection and bolus withdrawal of 1 to 4 mL of saline in the
      craniospinal space) was studied in 18 patients with acute brain damage by means
      of a mathematical model. The model includes the main biomechanical factors
      assumed to affect intracranial pressure, particularly cerebrospinal fluid (CSF)
      dynamics, intracranial compliance, and cerebral hemodynamics. Best fitting
      between model simulation curves and clinical tracings was achieved using the
      Powell minimization algorithm and a least-square criterion function. The
      simulation results demonstrate that, in most patients, the ICP time pattern
      cannot be explained merely on the basis of CSF dynamics but also requires
      consideration of the contribution of cerebral hemodynamics and blood volume
      alterations. In particular, only in a few patients (about 40% of total) the ICP
      monotonically returns toward baseline following the clinical maneuver. In most of
      the examined cases (about 60%), ICP exhibits an anomalous response to the same
      maneuver, characterized by a delayed increase after bolus injection and a delayed
      decrease after withdrawal. The model is able to explain these responses, imputing
      them to active intracranial blood volume changes induced by mechanisms
      controlling cerebral blood flow. Finally, the role of the main intracranial
      biomechanical parameters in the genesis of the ICP time pattern is discussed and
      a comparison with previous theoretical studies performed.

PMID- 7790010
TI  - Machine learning in control of functional electrical stimulation systems for
      locomotion.
AB  - Two machine learning techniques were evaluated for automatic design of a rule
      based control of functional electrical stimulation (FES) for locomotion of spinal
      cord injured humans. The task was to learn the invariant characteristics of the
      relationship between sensory information and the FES-control signal by using off
      line supervised training. Sensory signals were recorded using pressure sensors
      installed in the insoles of a subject's shoes and goniometers attached across the
      joints of the affected leg. The FES-control consisted of pulses corresponding to
      time intervals when the subject pressed on the manual push-button to deliver the
      stimulation during FES-assisted ambulation. The machine learning techniques used
      were the adaptive logic network (ALN) [1] and the inductive learning algorithm
      (IL) [2]. Results to date suggest that, given the same training data, the IL
      learned faster than the ALN, while both performed the test rapidly. The
      generalization was estimated by measuring the test errors and it was better with
      an ALN, especially if past points were used to reflect the time dimension. Both
      techniques were able to predict future stimulation events. An advantage of the
      ALN over the IL was that ALN's can be retrained with new data without losing
      previously collected knowledge. The advantages of the IL over the ALN were that
      the IL produces small, explicit, comprehensible trees and that the relative
      importance of each sensory contribution can be quantified.

PMID- 7790011
TI  - Epicardial cardiac source-field behavior.
AB  - The accurate determination of the spatial distribution of cardiac
      electrophysiological state is essential for the mechanistic assessment of cardiac
      arrhythmias in both clinical and experimental cardiac electrophysiological
      laboratories. This paper describes three fundamental cardiac source-field
      relationships: 1) activation fields, 2) electrotonic fields, and 3) volume
      conductor fields. The three cases are described analytically and illustrated with
      experimentally obtained canine cardiac recordings that capitalize on a recently
      formulated technique for in vivo cardiac transmembrane current estimation.

PMID- 7790012
TI  - Predicting cardiothoracic voltages during high energy shocks: methodology and
      comparison of experimental to finite element model data.
AB  - Finite element modeling has been used as a method to investigate the voltage
      distribution within the thorax during high energy shocks. However, there have
      been few quantitative methods developed to assess how well the calculations
      derived from the models correspond to measured voltages. In this paper, we
      present a methodology for recording thoracic voltages and the results of
      comparisons of these voltages to those predicted by finite element models. We
      constructed detailed 3-D subject-specific thorax models of six pigs based on
      their individual CT images. The models were correlated with the results of
      experiments conducted on the animals to measure the voltage distribution in the
      thorax at 52 locations during synchronized high energy shocks. One transthoracic
      and two transvenous electrode configurations were used in the study. The measured
      voltage values were compared to the model predictions resulting in a correlation
      coefficient of 0.927 +/- 0.036 (average +/- standard deviation) and a relative
      rms error of 22.13 +/- 5.99%. The model predictions of voltage gradient within
      the myocardium were also examined revealing differences in the percent of the
      myocardium above a threshold value for various electrode configurations and
      variability between individual animals. This variability reinforces the potential
      benefit of patient-specific modeling.

PMID- 7790013
TI  - A three-dimensional finite element model of human transthoracic defibrillation:
      paddle placement and size.
AB  - A detailed 3-D finite element model of the conductive anatomy of the human thorax
      has been constructed to quantitatively assess the current density distribution
      produced in the heart and thorax during transthoracic defibrillation. The model
      is based on a series of cross-sectional CT scans and incorporates isotropic
      conductivities for eight tissues and an approximation of the anisotropic
      conductivity of skeletal muscle. Current density distributions were determined
      and compared for four paddle pairs and two paddle sizes. Our results show that
      the myocardial current density distributions resulting from a defibrillation
      shock were fairly uniform for the paddle pairs and sizes examined in this study.
      Specific details of the spatial distribution of the current density magnitudes in
      the heart were found to depend on paddle placement and size. When the minimum
      current necessary to defibrillate was delivered, the maximum myocardial current
      density produced with any of the paddle sizes and positions examined was less
      than four times the minimum current density necessary to render a myocyte in a
      fibrillating heart inexcitable, and less than 40% of the damage threshold. These
      results suggest that common clinically used defibrillation paddle positions have
      a safety margin as large as 2.5 for current and approximately 6 for energy.

PMID- 7790014
TI  - A technique for measurement of the extent of spatial organization of atrial
      activation during atrial fibrillation in the intact human heart.
AB  - Atrial fibrillation (AF) is a common clinical problem, associated with
      considerable morbidity and mortality, for which effective management strategies
      have yet to be devised. The absence of objective measures to guide selection of
      antiarrhythmic drug therapy for maintenance of sinus rhythm leaves only clinical
      endpoints (either beneficial or detrimental) for assessment of drug action, with
      occasional catastrophic consequences. As part of an attempt to provide an
      objective framework for the assessment of antiarrhythmic drug action on the
      electrophysiologic determinants of atrial fibrillation, we have developed a
      measure of the spatial organization of atrial activation processes during atrial
      fibrillation. By recording activation sequences at multiple equally spaced
      locations on the endocardial surface of the atria during atrial fibrillation in
      humans and determining the degree of correlation between these activation
      sequences as a function of distance, we have been able to construct spatial
      correlation functions for atrial activation. We have found that atrial activation
      remains well-correlated, independent of distance during normal sinus rhythm and
      atrial flutter. During atrial fibrillation, correlation decays monotonically with
      distance and the space-constant for this decay may be used to describe the
      relative spatial organization of atrial fibrillation. We provide examples of the
      impact of antiarrhythmic agents on the space-constant and suggest that assessment
      of the relative spatial organization of atrial activation using this methodology
      may potentially provide an objective framework to guide therapy in patients with
      AF.

PMID- 7790015
TI  - Use of sonomicrometry and multidimensional scaling to determine the three
      dimensional coordinates of multiple cardiac locations: feasibility and initial
      implementation.
AB  - We describe a new method which uses sonomicrometry and the statistical technique
      of multidimensional scaling (MDS) to measure the three-dimensional (3-D)
      coordinates of multiple cardiac locations. We refer to this new method as
      sonomicrometry array localization (SAL). The new method differs from standard
      sonomicrometry in that each piezoelectric transducer element is used as both
      transmitter and receiver and the set of intertransducer element distances is
      measured. MDS calculates the 3-D coordinates of each sonomicrometry transducer
      element from the set of intertransducer element distances. The feasibility of
      this new method was tested with mathematical simulations which demonstrated the
      ability of MDS to compensate for signal error and missing intertransducer element
      distances. We describe the design elements of a modified digitally controlled
      sonomicrometer in which a single transducer element can sequentially broadcast to
      as many as eight receiver elements. That design is used to validate SAL in a
      water bath and in ex vivo and living hearts. Correlation with caliper measurement
      in the water bath (y int. = 3.91 +/- 3.36 mm, slope = 1.04 +/- 0.05, r2 = 0.969
      +/- 0.027) and with radiography in ex vivo (y int. = -0.87 +/- 0.92 mm, slope =
      0.97 +/- 0.02, r2 = 0.960 +/- 0.023) and in vivo hearts (y int. = 2.98 +/- 2.59
      mm, slope = 1.01 +/- 0.06, r2 = 0.953 +/- 0.031) was excellent. Sonomicrometry
      array localization is able to accurately measure the 3-D coordinates of multiple
      cardiac locations. It can potentially measure myocardial deformation and
      remodeling after ischemic or valvular injury.

PMID- 7790016
TI  - Action potentials of curved nerves in finite limbs.
AB  - Previous simulations of volume-conducted nerve-fiber action-potentials have
      modeled the limb as semi-infinite or circularly cylindrical, and the fibers as
      straight lines parallel to the limb surface. The geometry of actual nerves and
      limbs, however, can be considerably more complicated. This paper presents a
      general method for computing the potentials of fibers with arbitrary paths in
      arbitrary finite limbs. It involves computing the propagating point-source
      response (PPSR), which is the potential arising from a single point source
      (dipole or tripole) travelling along the fiber. The PPSR can be applied to fibers
      of different conduction velocities by simple dilation or compression. The method
      is illustrated for oblique and spiralling nerve fibers. Potentials from oblique
      fibers are shown to be different for orthodromic and antidromic propagation. Such
      results show that the straight-line models are not always adequate for nerves
      with anatomical amounts of curvature.

PMID- 7790017
TI  - Selective minimum-norm solution of the biomagnetic inverse problem.
AB  - A new multidipole estimation method which gives a sparse solution of the
      biomagnetic inverse problem is proposed. This solution is extracted from the
      basic feasible solutions of linearly independent data equations. These feasible
      solutions are obtained by selecting exactly as many dipole-moments as the number
      of magnetic sensors. By changing the selection, we search for the minimum-norm
      vector of selected moments. As a result, a practically sparse solution is
      obtained; computer-simulated solutions for Lp-norm (p = 2, 1, 0.5, 0.2) have a
      small number of significant moments around the real source-dipoles. In
      particular, the solution for L1-norm is equivalent to the minimum-L1-norm
      solution of the original inverse problem. This solution can be uniquely computed
      by using Linear Programming.

PMID- 7790019
TI  - Performance of above elbow body-powered prostheses in visually guided
      unconstrained motion tasks.
AB  - The "classical" body-powered above elbow arm prosthesis continues to be used by a
      large majority of arm prosthesis users, even though many more modern devices are
      available. This paper presents a set of experiments designed to compare
      performance of unimpaired arms and body-powered prostheses of six unilateral
      amputees. The experiments were designed to measure quantitatively how well the
      body-powered prosthesis can be used to perform free-motion tasks, as well as to
      study the qualitative features of movement common to both the prosthesis and
      unimpaired arm. It was found that regular peaks in velocity were common to both
      the unimpaired arm and prosthesis movements, suggesting that movements were
      composed of a sequence of successive actions. In addition, it was found that the
      body-powered prosthesis generally required more movements than the unimpaired arm
      to meet an accuracy constraint and could not keep up with the unimpaired arm when
      a speed constraint was imposed, even though the body-powered prosthesis was able
      to match the unimpaired arm in a simple nondynamic task.

PMID- 7790018
TI  - Evaluation of MUAP shape irregularity--a new concept of quantification.
AB  - A coefficient for quantifying the shape irregularities of the motor unit action
      potential (MUAP) is introduced. This coefficient is defined as the "length" of
      action potential curve normalized by the signal's amplitude in such a way that it
      is independent on duration and amplitude. It characterizes only the MUAP shape.
      The irregularity coefficient may be used to measure the deviations of the
      potential from the normal MUAP. The properties of this coefficient and its
      relation to the conventional parameters describing MUAP shape, viz the number of
      phases and turns is discussed. The examples of classification of real signals
      according to this coefficient are presented.

PMID- 7790020
TI  - A 32-electrode data collection system for electrical impedance tomography.
AB  - A 32-electrode data collection system for Electrical Impedance Tomography (EIT)
      will be presented. In this system, the demodulator is a multiplexed sample and
      hold (S&H) circuit followed by a voltage difference stage. This configuration
      provides high CMRR due to the low (almost DC) operating frequency of the signals
      the difference stage is required to process.

PMID- 7790021
TI  - Human alpha beta T-cell receptor CD4-CD8 T-cell clones are predominantly Th0
      like.
AB  - The cytokine production profile, focusing on interleukin-4 (IL-4), interferon
      gamma (IFN-gamma) and interleukin-10 (IL-10) of human CD4+, CD8+ and CD4- CD8-
      alpha beta T cells cloned from the peripheral blood of healthy individuals was
      compared. Solid-phase anti-CD3 stimulation of CD4- CD8- alpha beta T cell clones
      from one individual revealed a significantly increased frequency of IL-4
      producing clones (81%), compared to CD4+ T cells (24%) or CD8+ (28%). All five
      CD4- CD8- alpha beta T-cell clones from two other individuals also produced IL-4.
      Clones that produced IFN-gamma with undetectable IL-4 production, thus being of
      the 'classical' Th1 phenotype, were infrequent in CD4- CD8- alpha beta T-cell
      clones (19%) compared to CD4+ (71%), and CD8+ clones (72%) cloned in OKT3, and
      CD4+ cells cloned in phytohaemaglutinin A (77%). Unlike previously reported
      studies with gamma delta cells, the alpha beta CD4- CD8- T cells produced IL-10
      at appreciable frequency (38%) in PHA generated clones. The supernatants from
      anti-CD3 stimulated CD4- CD8- alpha beta T-cell clones contained sufficient IL-4
      to activate B cells, enhancing CD23 and surface immunoglobulin M (IgM) expression
      and co-stimulating B-cell proliferation. These findings suggest that the function
      of CD4- CD8- alpha beta T cells is distinct from that of most CD4+ or CD8+ T
      cells.

PMID- 7790022
TI  - Antigen-presenting cells in the female reproductive tract: influence of sex
      hormones on antigen presentation in the vagina.
AB  - We report here that the stage of the reproductive cycle and the administration of
      physiological amounts of oestradiol to ovariectomized rats influences antigen
      presentation by macrophage/dendritic cells in the vagina. Antigen presentation is
      elevated when oestradiol levels in blood are low, and reduced just prior to
      ovulation. Of those hormones tested, only oestradiol lowered vaginal antigen
      presentation. When progesterone was given along with oestradiol, the inhibitory
      effect of oestradiol on vaginal antigen presentation was reversed. These studies
      demonstrate that the vagina is an inductive site and that antigen presentation is
      under hormonal control. Our results suggest that immunization studies designed to
      enhance mucosal immunity in the female reproductive tract should take into
      account the stage of the reproductive cycle when antigen is deposited.

PMID- 7790023
TI  - The survival and turnover of mature and immature CD8 T cells.
AB  - The present investigation has examined the phenotype, survival and fate of
      immature and mature CD8 T cells. CD4- CD8+ 'single positive' thymocytes (a model
      for recent thymic emigrants) were Thy-1+ CD45RC- RT6- before transfer to normal
      euthymic recipients, but changed phenotype within 7-10 days to become Thy-1-
      CD45RC+ RT6(+)--the phenotype of mature resting CD8 T cells. Following transfer
      to athymic nude recipients CD8 T cells from thoracic duct lymph of allotype
      marked rats increased 12-17-fold during the first 2 months. Proliferation
      occurred in the complete absence of CD4 T cells and the donor CD8 T cells
      persisted [at 15-18% of peripheral blood lymphocytes (PBL)] for the life of the
      recipients. When combined with equal numbers of CD4 T cells, however, CD8 T cells
      occupied only 3-4% of PBL; in these animals CD4 T cells plateaued at 15-16% of
      PBL. The results suggested that CD8 T cells competed poorly with rapidly dividing
      CD4 T cells for limited space in a recirculating pool in which total T-cell
      numbers are homeostatically regulated. Although able to proliferate and self
      renew in athymic nude recipients, when transferred to normal euthymic animals
      donor-derived mature CD8 T cells declined in number with time; their half-life
      was estimated to be 34 days. Similar studies with purified CD4- CD8+ 'single
      positive' thymocytes gave a comparable half-life of 37 days. The results
      indicated that lifespan was not due to an ageing process among CD8 T cells, but
      was rather a reflection of cell turnover dependent on thymic output.

PMID- 7790024
TI  - Predominance of MHC class II-restricted CD4+ cytotoxic T cells against mouse
      hepatitis virus A59.
AB  - Coronavirus-induced acute hepatitis is a complex event and the role of different
      components of the immune system with regard to defined viral proteins and the
      course of the infection is not yet clear. We have analysed the cytotoxic T
      lymphocyte (CTL) response in mouse hepatitis virus (MHV-A59) infection.
      Surprisingly, we detected only a very clear virus-specific major
      histocompatibility complex (MHC) class II-restricted cytotoxicity in mice
      infected with MHV-A59. We found no evidence of activation of the classical CD8+
      MHC class I-restricted CTL. The virus-specific CD4+ CTL derived from two
      different mouse strains having different MHC haplotypes recognized the same
      immunodominant epitope. This epitope, comprising the amino acid residues 329-343
      of the viral S-glycoprotein, was recognized both at the polyclonal level and by
      virus-specific CTL clones. Transfer studies using a MHV-A59-specific CD4+ CTL
      clone showed significant protection against a lethal challenge with MHV-A59,
      implicating that these CD4+ CTL play a pivotal role in the protection against MHV
      A59 infections.

PMID- 7790025
TI  - Superantigen-induced peripheral T-cell deletion: the effects of chemical
      modification of antigen-presenting cells, interleukin-4 and glucocorticoid
      hormones.
AB  - Experiments were performed to evaluate the role of antigen-presenting cells (APC)
      and the effect of interleukin-4 (IL-4) and glucocorticoid hormone (GCH) exposure
      on the in vitro deletion of CD4+ CD8- and CD8+ CD4- T cells by staphylococcal
      enterotoxin B (SEB). APC fixation with the chemical cross-linker 1-ethyl-3-(3
      dimethyl-aminopropyl) carbodiimide (ECDI) inhibited their capacity to induce SEB
      specific deletion of mature T lymphocytes. Deletion was not influenced by
      treatment with anti-CD28 antibodies, which modulate T-cell activation. However,
      it was augmented by IL-4, known to counteract anti-CD3- and GCH-induced thymocyte
      apoptosis, and was inhibited by dexamethasone (DEX). These results indicate that
      metabolically active APC are required for deletion of antigen-specific mature T
      cells and suggest that IL-4 and GCH can modulate this phenomenon in vitro.

PMID- 7790026
TI  - Comparison of the suppressive effects of interleukin-10 and interleukin-4 on
      synovial fluid macrophages and blood monocytes from patients with inflammatory
      arthritis.
AB  - This study determined the potential capacity of interleukin-10 (IL-10), compared
      with IL-4, to control the production of tumour necrosis factor-alpha (TNF-alpha),
      IL-1 beta and IL-1 receptor antagonist (IL-1ra) and the expression of major
      histocompatibility complex (MHC) class II antigens by monocytes/macrophages
      isolated from synovial fluid of patients with rheumatoid or other forms of
      chronic inflammatory arthritis. Mononuclear cells were isolated from synovial
      fluid and peripheral blood and incubated with or without lipopolysaccharide
      (LPS), and with or without IL-10 (100 U/ml, 10 ng/ml) or IL-4 (10 ng/ml) for 22
      hr. TNF-alpha, IL-1 beta and IL-1ra levels were measured by enzyme-linked
      immunosorbent assay (ELISA) in the culture supernatants, and MHC class II
      expression was examined on the monocytes/macrophages by flow cytometry. IL-10,
      unlike IL-4, decreased TNF-alpha production by LPS-stimulated synovial fluid
      cells to the same extent as by LPS-stimulated peripheral blood cells from the
      same patients. IL-10 and IL-4 suppressed equally IL-1 beta production by the same
      cells. However, only IL-4 significantly increased IL-1ra production by synovial
      fluid mononuclear cells. Synovial fluid cells expressed increased levels of MHC
      class II antigen, and these levels were not as efficiently suppressed by IL-10 as
      they were for peripheral blood cells. Because IL-10 and IL-4 differentially
      regulate TNF-alpha and IL-1ra production by synovial fluid mononuclear cells,
      selective use of either IL-10 or IL-4 in the treatment of chronic inflammatory
      conditions will depend on whether TNF-alpha or IL-1, respectively, is established
      as primarily responsible for the maintenance of the chronic inflammatory
      condition.

PMID- 7790028
TI  - Production of TNF-alpha, IL-6 and TGF-beta, and expression of receptors for TNF
      alpha and IL-6, during murine Mycobacterium avium infection.
AB  - The Mycobacterium avium complex comprises intracellular bacteria associated with
      disseminated infection in patients with acquired immune deficiency syndrome
      (AIDS). Immune defects that lead to infection are unknown but cytokines appear to
      play an important role in the immunomodulation of host defence mechanisms. We
      evaluated the cytokine profiles seen temporally after murine M. avium infection.
      Spleen cells were obtained from M. avium-infected C57BL/6 mice and uninfected
      mice at weeks 1, 2, 3, 4 and 5. Cells were cultured in vitro and subsequently
      pulsed with killed M. avium. Supernatants were collected from the cultured
      splenic cells and the concentrations of interleukin-6 (IL-6), transforming growth
      factor-beta 1 (TGF-beta 1) and tumour necrosis factor-alpha (TNF-alpha) were
      measured. TGF-beta 1 was detected at week 1, followed by IL-6 production at week
      2. Elevated TNF-alpha levels were observed at week 3. The addition of polyclonal
      anti-TGF-beta 1 antibody to M. avium-infected peritoneal macrophages in the
      presence of splenic cell supernatants from weeks 1, 3 and 5 led to decreased
      bacterial counts compared to controls. Anti-IL-6 antibody did not have any effect
      on macrophage anti-mycobacterial activity. Concurrently, we observed decreased
      expression of TNF-alpha receptors on infected macrophages. We propose that the
      early elevated levels of TGF-beta 1, a known suppressor of macrophage function,
      in conjunction with down-regulation of TNF-alpha receptors may help explain the
      suboptimal macrophage response to TNF-alpha, leading to impaired anti
      mycobacterial activity.

PMID- 7790029
TI  - Permissive recognition of a mycobacterial T-cell epitope: localization of
      overlapping epitope core sequences recognized in association with multiple major
      histocompatibility complex class II I-A molecules.
AB  - Most T-cell epitopes are recognized in the context of a single or limited number
      of major histocompatibility complex (MHC) class II molecules. We have shown
      previously, however, that the immunodominant p61-80 epitope from the
      Mycobacterium tuberculosis 19,000 MW protein is recognized in a genetically
      permissive manner. In this study, permissive recognition of p61-80 was analysed
      in three murine MHC haplotypes (H-2b,d and k) with respect to: (i) T-cell-epitope
      core structure; (ii) I-A/I-E class II MHC restriction; and (iii) the
      identification of critical amino acid residues within the core region.
      Overlapping epitope core sequences composed of 6 to 8 amino acids were identified
      for each of the three H-2 haplotypes by T-cell epitope scanning (PEPSCAN) using
      peptide-specific T-cell lines. The epitope core sequences recognized by peptide
      and 19,000 MW protein-specific T cells were similar. In all three haplotypes,
      responses to p61-80 were restricted by class II MHC I-A molecules. To identify
      residues within the epitope core critically required for recognition, single
      substitution (alanine or leucine) analogue peptides were tested for their
      capacity to stimulate p61-80-specific T-cell hybridomas. A heterogeneous pattern
      of reactivity was observed, even among individual hybridomas derived from the
      same H-2 haplotype. Although every core residue could be defined as critical for
      at least one hybridoma, only one critical substitution (74Val-->Ala) was common
      to all hybridomas. The identification and structural analysis of genetically
      permissive epitopes of mycobacteria may be a useful strategy for the rational
      design of peptide-based vaccines for tuberculosis.

PMID- 7790027
TI  - DNA damage induced by tumour necrosis factor-alpha in L929 cells is mediated by
      mitochondrial oxygen radical formation.
AB  - Treatment of L929 cells with tumour necrosis factor-alpha (TNF-alpha) plus
      actinomycin D induced DNA damage (indicated by the appearance of a sub-G1 peak
      due to extracellular leakage of low molecular weight DNA following DNA
      fragmentation) before significant cell lysis occurred. The DNA damage occurred in
      parallel with a decrease of the intracellular total glutathione content and an
      increase of intracellular reactive oxygen intermediates (ROI), as indicated by
      increased dihydrorhodamine 123 oxidation. Because the inhibition of mitochondrial
      respiration suppressed the increase of dihydrorhodamine 123 oxidation and DNA
      damage as well as the decrease in the total glutathione content, it was suggested
      that increased mitochondrial formation of ROI was responsible for DNA damage
      after TNF treatment. Deferoxamine (a ferric iron chelator) and dithiothreitol (a
      sulfhydryl reagent) both prevented DNA damage and cell killing, indicate that
      hydroxyl radicals generated from O2- and H2O2 produced by the mitochondria in a
      process catalysed by iron contributed to DNA damage and that this pathway may be
      involved in TNF-alpha-induced cytotoxicity. An inhibitor of poly(ADP)-ribose
      polymerase (3-aminobenzamide), worsened DNA damage, but was protective against
      cell lysis, suggesting that DNA repair subsequent to injury was more important
      than DNA damage per se in development of TNF-alpha cytotoxicity.

PMID- 7790030
TI  - Development of grafted gld cells in athymic and euthymic recipients.
AB  - Mice homozygous for the gld (generalized lymphoproliferative disease) and lpr
      (lymphoproliferation) mutations display similar autoimmune and
      lymphoproliferative diseases. Both result from defective apoptosis, the targets
      of the lpr and gld mutations being the genes for, respectively, an apoptosis
      signalling receptor [the Fas antigen receptor (FasR)] and its counter-receptor
      [the Fas ligand (FasL)]. Though this definitely causes the development and
      accumulation of large numbers of unusual Thy-1+ B220+ cells in peripheral
      lymphoid organs, details on how this actually occurs are still lacking. Whether
      differentiation of gld T cells into Thy-1+ B220+ cells might depend on the
      environment was analysed by phenotyping the cells which expanded in four
      different immunodeficient environments (nubg, nulpr, scid and scidbg). Though all
      four types of congenic chimeras developed hyperglobulinaemia, autoimmunity and a
      lymphoproliferative disease, substantial differences were found for the athymic
      and euthymic chimeras. In the athymic gld chimeras, the lymphoproliferation
      concerned all cell subsets, whereas in the euthymic gld chimeras it was, as in
      gld mice, due to the accumulation of cells of the Thy-1+ B220+ subset. Thus, the
      gld T cells could proliferate without differentiating into the Thy-1+ B220+
      subset, but this depended on the nature of the environment. Furthermore,
      emergence of a gld syndrome in these four environments would suggest that B cells
      and stromal cells do not express FasL, at least in levels sufficient to
      compensate for the deficiency of the grafted gld cells.

PMID- 7790032
TI  - Functional heterogeneity among CD4+ T-cell clones from blood and skin lesions of
      leprosy patients. Identification of T-cell clones distinct from Th0, Th1 and Th2.
AB  - In the present study we examined the functional properties of T-cell clones
      reactive with Mycobacterium leprae and other mycobacterial antigens. Clones
      isolated from the skin lesions and blood of leprosy patients across the spectrum
      were exclusively CD4+CD8- and expressed the alpha beta T-cell receptor.
      Substantial heterogeneity in the production of cytokines, in particular
      interleukin-4 (IL-4), was observed, although no striking correlation with
      clinical status was apparent. A variety of patterns of cytokine secretion
      distinct from those of T-helper type-1 (Th1) Th2 or Th0, as defined in murine
      studies, was evident. Most noteworthy was a large number of clones from skin
      which secreted neither IL-2 nor IL-4, but large amounts of tumour necrosis factor
      (TNF) and interferon-gamma (IFN-gamma). Clones isolated from the blood of leprosy
      patients had a more restricted cytokine secretion profile, and appeared to
      resemble more closely previously described patterns, including those of high
      level production of IL-2 and/or IL-4. Virtually all clones, from either skin or
      blood, produced high levels of IFN-gamma, and thus many clones were IL-4 and IFN
      gamma co-producers. The pattern of cytokine production by skin-derived T-cell
      clones was significantly affected by the in vitro activation status of the cells.
      Cells enriched in activated blasts tended to produce more IL-4 than small resting
      cells. In addition, the production of IFN-gamma by skin T-cell clones after < or
      = 10 weeks of culture was strikingly distinct from that of these clones after 5
      months of culture. IL-4 and IFN-gamma co-producing clones shifted to a Th2-like
      pattern with much less IFN-gamma secretion, whereas non-IL-4-producing clones
      secreted much higher levels of IFN-gamma after prolonged culture, and became much
      more Th1-like. However, there was still no correlation between clinical status
      and pattern of cytokines produced. These results imply that a high fraction of T
      cells exists in leprosy lesions that is distinct from or that has not yet fully
      matured into Th1 or Th2 cells.

PMID- 7790033
TI  - Antibody-induced modulation of CD26 surface expression.
AB  - The ability of different anti-CD26 monoclonal antibodies to modulate the
      expression of CD26 on human T lymphocytes was investigated. By means of a new non
      radioactive method using fluorescein isothiocyanate (FITC)-labelled and
      unlabelled anti-CD26 monoclonal antibodies and flow cytometry, we measured the
      internalization and re-expression of CD26 on freshly isolated resting human T
      lymphocytes. The modulation of CD26 surface expression takes place in primarily
      CD26+ as well as in CD26- T lymphocytes, indicating the presence of an
      intracellular CD26 pool. In fact, with two different anti-CD26 monoclonal
      antibodies (Ta1 and M5) intracellular CD26 was detected out of which newly
      expressed CD26 might have originated. This intracellular CD26 pool appears to be
      maintained by continuous translation of CD26 mRNA.

PMID- 7790031
TI  - Contact-dependent stimulation of monocytic cells and neutrophils by stimulated
      human T-cell clones.
AB  - By means of direct cell-cell contact, fixed, stimulated T lymphocytes trigger the
      production of interleukin-1 beta (IL-1 beta) and tumour necrosis factor by
      monocytes and prime polymorphonuclear leucocytes (PMN) for the respiratory burst
      induced by N-formyl-methionyl-leucyl-phenylalanine (FMLP). In order to assess
      whether this activity is displayed by a particular subpopulation of T
      lymphocytes, 88 T-cell clones (TCC) were generated from healthy human peripheral
      blood. The clones were stimulated by Phaseolus vulgaris agglutinin (PHA) and
      phorbol 12-myristate acetate monocytic cell line THP-1. All fixed, stimulated TCC
      induced IL-1 beta production by THP-1 cells, although to varied degrees. The
      activity of TCC on THP-1 cells correlated with their activity on PMN (r2 = 0.84,
      P < 0.001), suggesting that this pro-inflammatory activity of TCC may similarly
      affect both types of infiltrating cells. The ability of TCC to modulate target
      cells did not correlate with either their phenotype (CD4 or CD8) or their
      cytokine production profile (interferon-gamma, IL-4 and IL-6), although it tended
      to correlate inversely with their capacity to produce IL-6 (P < 0.02). These
      observations suggest that a large proportion, if not all, of human peripheral
      blood T lymphocytes may potentially affect monocytes and PMN by direct cell-cell
      contact. This activity may be relevant to the maintenance of chronic
      inflammation.

PMID- 7790034
TI  - Characterization of intermediate T-cell receptor cells expanding in the liver,
      thymus and other organs in autoimmune lpr mice: parallel analysis with their
      normal counterparts.
AB  - Autoimmune MRL-lpr/lpr (lpr) mice were previously demonstrated to have an
      abnormal proliferation of intermediate T-cell receptor (TCR) cells of extrathymic
      origin in the liver. Despite this situation, thymectomy in lpr mice resulted in
      amelioration of autoimmune disease. To understand the underlying mechanism, we
      investigated associated T-cell differentiation in the thymus and other organs of
      these mice. When the disease was evoked, T cells with extrathymic properties,
      i.e. intermediate TCR-alpha beta cells expressing double-negative (DN) CD4-8-
      phenotype and interleukin-2 (IL-2) receptor beta-chain, became prominent not only
      in the liver, but also in the thymus. Such thymic T cells mainly resided in the
      medulla. A small-scale localization of such T cells was seen in the thymic
      medulla even in normal control mice. There was a heterogeneity among intermediate
      TCR cells in terms of the composition of DN cells and the expression of CD2 and
      B220 antigens, depending on the organs and the sites in the same organ.
      Intermediate TCR cells in the liver, thymus and autoimmune target organs (e.g.
      kidney) contained a high proportion of the active form (CD2+B220-), while
      intermediate TCR cells accumulating in peripheral organs, the spleen and lymph
      nodes, were mainly of the inactive form (CD2-B220+). The active form had an
      ability to proliferate in response to IL-2 and SEB, whereas the inactive form did
      not. The present results suggest that the proliferation of intermediate TCR cells
      occur at multiple sites; this may explain the effect of thymectomy, namely, the
      retarded onset of disease, in lpr mice.

PMID- 7790035
TI  - The J alpha segment contributes to the affinity of V beta 6+ cells for vSAG-7
      (Mls-1a) presented by I-A molecules.
AB  - Recognition of superantigens (SAG) by T cells is major histocompatibility complex
      (MHC) dependent but not MHC restricted. In the case of vSAG-7 (Mls-1a), encoded
      by the Mtv-7 provirus, I-E molecules play a dominant role in the vSAG-7-MHC-T
      cell receptor (TCR) interaction, the I-A molecule being less important. vSAG-7 is
      recognized predominantly by T cells bearing the V beta 6 element, which are
      deleted in Mtv-7+ mice; this deletion is nearly complete in mice expressing I-E
      molecules, but only partial in mice expressing exclusively the I-A molecules of
      permissive haplotypes. In view of these data, we hypothesized that vSAG-7
      specific V beta 6+ T cells have a large spectrum of affinities for the MHC-vSAG-7
      complex and that all of them, even those with a relatively low affinity,
      recognize the I-E-vSAG-7 complex, while only those with high affinity can
      recognize the I-A-vSAG-7 complex. Fourteen CD4 V beta 6+ vSAG-7-specific clones
      were studied and classified into three groups of avidity, depending on their
      interactions with different I-E- I-A(+)-vSAG-7 permissive haplotypes. Sequencing
      of the alpha and beta chains of their TCR suggested that the affinity for the
      vSAG-7 is influenced by the J alpha element. Four out of six low-affinity T-cell
      clones possessed the transcript for the J alpha 34 segment. Furthermore, five out
      of six low-affinity T-cell clones had the GGSN sequence in their CDR3 alpha,
      while the sixth low affinity clone had the conservative substituted SGGN
      sequence. These results strongly suggest that the expression of the J alpha 34
      segment confers a very weak reactivity to T cells recognizing vSAG-7.

PMID- 7790037
TI  - Membrane cofactor protein (CD46) in seminal plasma is a prostasome-bound form
      with complement regulatory activity and measles virus neutralizing activity.
AB  - Human seminal plasma contains 0.55 microgram/ml of membrane cofactor protein
      (MCP; CD46) of 60,000 MW. By ultracentrifugation, gel filtration and
      immunoelectron microscope methods, we found that the MCP in seminal plasma was
      associated with prostasomes. The functional properties of the prostasome-bound
      MCP were assessed in comparison with a recombinant soluble form, gamma MCP1,
      which is composed of four short consensus repeats (SCR), type C of the
      serine/threonine-rich domain (STC), and unknown significance (UK). The MCP in
      seminal plasma, although demonstrably bound to prostasomes, behaved more like the
      soluble form of MCP. In the absence of detergent it, together with factor I,
      degraded the fluid-phase ligand, methylamine-treated C3 [C3(MA)], which is
      insensitive under no-detergent conditions to the membrane form of MCP and factor
      I. Moreover, C3dg fragment was generated as a final product instead of C3bi
      during the incubation, indicating that the prostasomal MCP and proteases may be
      responsible for the C3dg generation. The prostasomes neutralized measles virus
      (MV) infectivity, while gamma MCP1, for the most part, did not. These results,
      taken together with the CD59 concentration on the prostasomes, suggest that the
      prostasomes are potential immunomodulators for complement activation, providing
      the C3- and C9-step inhibitors. The present report also reinforces the idea that
      there are two different forms of MCP in semen. One is located in the inner
      acrosomal membrane of spermatozoa, which appears through acrosomal reaction and
      spermatoon-egg interaction. The other is a prostasome-bound form maintaining
      activities sufficient to regulate complement activation and, probably, MV
      infection.

PMID- 7790038
TI  - Requirement of CD4+ T cells and antigen-presenting cells for primary in vitro
      generation of CD8+ cytotoxic T cells against Ld-binding self-peptide p2Ca.
AB  - We investigated the cellular requirement for primary in vitro generation of
      cytotoxic T-lymphocytes (CTL) in BALB/c spleen cells against Ld-binding self
      peptide p2Ca. Depletion of CD4+ T-cells in vitro by pretreatment with anti-CD4
      monoclonal antibody (mAb) and complement or in vivo by administration of anti-CD4
      mAb abrogated generation of CTL. Depletion of adherent cells by passing spleen
      cells through a nylon wool (NW) column also abrogated generation of CTL. Addition
      of peritoneal exudate cells (PEC) to spleen cells passed through the NW column
      restored CTL generation. These findings indicate that both CD4+ T-cells and
      antigen-presenting cells (APC) were necessary for CTL generation. Treatment of
      PEC with paraformaldehyde (PFA), but not mitomycin-C (MMC) abrogated their
      ability to restore CTL generation when mixed with spleen cells from the NW
      column, suggesting that an endocytic pathway could be involved in presentation of
      p2Ca on APC.

PMID- 7790039
TI  - Modulation of mRNA expression and secretion of C1q in mouse macrophages by anti
      inflammatory drugs and cAMP: evidence for the partial involvement of a pathway
      that includes cyclooxygenase, prostaglandin E2 and adenylate cyclase.
AB  - Isolated BALB/c mouse thioglycollate-elicited (inflammatory) peritoneal
      macrophages release at least 10 times more C1q than do isolated resident
      peritoneal macrophages. Addition of non-steroidal anti-inflammatory drugs (NSAID)
      to thioglycollate-elicited macrophages in culture inhibited the release of C1q
      and reduced levels of C1q-specific mRNA. Contrastingly, the NSAID were found to
      enhance C1q-specific mRNA levels in resident macrophages, although no increase in
      C1q levels secreted was observed. This suggests that the response of macrophages
      to NSAID, with respect to C1q synthesis, reflects the developmental stage of the
      macrophage. The gold salt auranofin (AFN) was found to enhance markedly C1q
      synthesis at both transcriptional and secretory levels in thioglycollate-elicited
      macrophages whilst, conversely, AFN reduced mRNA levels in resident macrophages.
      This indicates that AFN and the NSAID may work via the same or similar
      biochemical pathway, but with opposing effects. The glucocorticoid hydrocortisone
      (HC) greatly enhanced C1q-specific mRNA levels in both thioglycollate-elicited
      and resident macrophages, although no parallel increases in C1q secreted were
      observed. The data on inhibition of C1q biosynthesis by NSAID in thioglycollate
      elicited macrophages are supported by the enhancement of C1q biosynthesis
      following addition of prostaglandin E2 (PGE2) or dibutyryl cyclic AMP (dBcAMP) to
      the cultures. From these experiments, it is concluded that C1q biosynthesis is
      controlled, at least in part, by a pathway involving cAMP.

PMID- 7790040
TI  - The anti-lipid A monoclonal antibody E5 binds to rough gram-negative bacteria,
      fixes C3, and facilitates binding of bacterial immune complexes to both
      erythrocytes and monocytes.
AB  - Treatment of patients with septic shock using monoclonal antibodies (mAbs) to
      endotoxin is still controversial. Clinical trials of E5, one of the mAbs directed
      against the lipid A moiety of lipopolysaccharide (LPS), are currently in
      progress. The mechanisms of action of this, and other antibodies under clinical
      evaluation, are, however, poorly understood. In this study we examined in vitro
      the ways in which E5 interacted with Gram-negative bacteria, complement,
      erythrocytes and monocytes. By fluorescence-activated cell sorter (FACS) analysis
      we showed direct, dose-dependent binding of E5 to Escherichia coli (E. coli) and
      Salmonella minnesota (S. minnesota). Antibody binding to S. minnesota was
      enhanced by treatment with the beta-lactam antibiotic amoxycillin, but not by
      treatment with the aminoglycoside gentamicin. Immune complexes formed between E5
      and both species of Gram-negative bacteria activated both classical and
      alternative complement pathways, but only in the case of S. minnesota did this
      facilitate binding to erythrocyte CR1 and monocyte CR3. Bacterial C3b and iC3b
      fixation by E5 was quantified using specific mAbs. These observations suggest
      that E5 may enhance bacterial clearance in several ways: (1) by facilitating
      direct complement fixation; (2) by facilitating the binding of opsonized bacteria
      to cells of the mononuclear phagocyte system; (3) by enabling bacteria to bind to
      erythrocyte CR1 (CD35), allowing safe carriage in the circulation to the fixed
      macrophages of the liver and spleen; (4) by acting synergistically with beta
      lactam antibiotics.

PMID- 7790042
TI  - Characterization of local antibody responses to the gastrointestinal parasite
      Haemonchus contortus.
AB  - The ability to identify antigens associated with an infection has generally
      relied on the use of serum antibodies produced by infected or previously exposed
      individuals. A major drawback with the use of serum is that it does not
      necessarily reflect the local antibody response at mucosal tissue sites. This
      study describes an approach that allows the use of antibodies generated close to
      the infection site to detect the transient expression of stage-specific antigens
      during infection with the gastrointestinal parasite Haemonchus contortus. This
      was achieved by infecting immune sheep with H. contortus larvae and removing the
      abomasal lymph nodes draining the infection site shortly after the challenge
      infection. Antibody-secreting cell (ASC) probes were generated from these lymph
      nodes after short-term in vitro culture of cell suspensions, which allowed the
      accumulation of antibodies secreted by in vivo-induced ASC into the culture
      supernatant. Lymph node culture supernatants (= ASC probes) from immune sheep
      challenged 5 days previously were used to probe Western blots of third and fourth
      stage larval preparations, and revealed distinct reactivity to larval antigens.
      No antibody reactivity to larval antigen preparations was detected in sheep that
      were not challenged. The number of antigens identified using ASC probes was
      significantly restricted compared to either pre- or post-challenge sera. In
      contrast to the variability of the serum response, the specificity of ASC probes
      was highly repeatable between different sheep. ASC probes were also used to
      purify a H. contortus larval antigen by affinity chromatography, which allowed
      limited biochemical studies to be undertaken. The antigen(s) recognized by the
      ASC probes were shown to be expressed on the surface of the larvae. These studies
      illustrate the use of a novel means of studying the local antibody response close
      to a mucosal infection site in order to identify and isolate stage-specific
      antigens expressed during infection.

PMID- 7790036
TI  - Blocking measles virus infection with a recombinant soluble form of, or
      monoclonal antibodies against, membrane cofactor protein of complement (CD46).
AB  - Human membrane cofactor protein (MCP, CD46) functions as an inhibitor of the
      complement (C) cascade to protect host cells from C attack, and as a receptor for
      measles virus (MV). Normal human sera contains 10-60 ng/ml of naturally produced
      soluble forms of MCP, which is also a cofactor for the factor I-mediated
      inactivation of C3b. We produced monoclonal antibodies (mAb) against MCP and a
      recombinant soluble form of MCP similar to the natural soluble forms, and tested
      their ability to block MV infection. Vero cells and CHO cells expressing human
      MCP were the targets. Of the antibodies tested, M75 and M177, which blocked the C
      regulatory activity of MCP, efficiently blocked MV infection. More than 50
      micrograms/ml of the soluble form moderately blocked MV infection of CHO cells
      expressing MCP, but barely blocked that of Vero cells. The two mAb and the
      soluble form also inhibited MV H protein-mediated green monkey erythrocyte
      rosette formation. A quantitative analysis suggested that 30 micrograms/ml of the
      soluble form functionally corresponded to 0.2 microgram/ml of M177 or M75. These
      data established that the C regulatory function and the MV receptor function of
      MCP were blocked simultaneously by the individual mAb, and that soluble forms of
      MCP could inhibit MV infection in cells expressing human MCP, although doses far
      higher than the natural concentration of soluble MCP were required.

PMID- 7790043
TI  - Decreased serum tryptophan in patients with cancer cachexia correlates with
      increased serum neopterin.
AB  - We investigated serum tryptophan (Trp), neopterin (NPT) and immunosuppressive
      acidic protein (IAP), one of tumor-associated tumor marker, concentrations in 28
      patients with gastrointestinal tumors representing cancer cachexia and 10 healthy
      controls. NPT comes from activated macrophages presumably activated by tumor
      sensitized T cells via gamma-interferon (IFN-gamma) excitation of the
      macrophages. We found that the NPT level was significantly higher than the
      control value. The negative correlation of NPT and Trp concentrations indicates
      activity of indoleamine 2,3-dioxygenase (IDO), a Trp degradating enzyme, in
      cancer-burden patients. The activity of IDO can be induced by cytokines such as
      IFN-gamma, and therefore low Trp levels may result from endogenous IFN-gamma
      production due to immune activation against tumors. We also found a positive
      correlation between NPT and IAP levels, suggesting that host immune activation
      against tumors played a role in the immunosuppression of cancer-burden states,
      followed by cancer-cachexia.

PMID- 7790041
TI  - Characterization of a progesterone-binding, three-domain antibody fragment (VH/K)
      expressed in Escherichia coli.
AB  - The heavy chain variable region (VH) and the kappa light chain of the anti
      progesterone monoclonal antibody (mAb) DB3, have been expressed as a single-chain
      three-domain polypeptide, designated VH/K, and secreted into the periplasmic
      space of Escherichia coli (E. coli). The linker sequence was derived from the VH
      CH1 elbow region. The C kappa domain provides a sensitive detection tail for
      Western blotting and enzyme-linked immunosorbent assay (ELISA). Periplasmic
      extracts of transformed E. coli contained material that bound progesterone and
      related steroids with similar specificity and affinity to DB3, and displayed the
      DB3 idiotype and kappa chain epitopes. Reference to the crystal structure of DB3
      suggests that all the characteristics of the combining site interaction with
      steroids are retained in the bacterially expressed material. Western blotting
      demonstrated material with a molecular weight equivalent to three domains after
      reduction, but six domains in the unreduced state, suggesting that the VH/K
      polypeptide is assembled in the periplasm as a disulphide-bridged dimer. The VH/K
      construct provides a novel route to expression of antibody combining sites in E.
      coli for antibody engineering.

PMID- 7790044
TI  - Plasma neopterin/C-reactive protein ratio as an adjunct to the assessment of
      infection and cancer cachexia.
AB  - Neopterin (NPT), a pteridine intermediate metabolite in the biopterine synthetic
      pathway, is synthesized and secreted by monocytes/macrophages upon stimulation,
      mainly by gamma-interferon produced by activated T cells. C-reactive protein
      (CRP) is one of the major acute-phase reactants and its release is thought to be
      mediated by interleukin-6. Plasma concentrations of NPT and CRP were
      synchronously analyzed in 25 determinations of 5 patients with severe infectious
      complications and 50 determinations of 10 cancer-burden patients representing
      cachexia. The mean value of NPT (pmol/ml) was 201.6 in the infection group and
      16.5 in the cancer cachexia group. The mean value of CRP (mg/dl) was 12.5 in the
      infection group and 3.4 in the cancer cachexia group. The number of samples in
      which NPT alone exceeded the cut-off level were 0/25 (0%) in the infection group
      and 38/50 (76.0%) in the cancer cachexia group. The number of samples in which
      both NPT and CRP exceeded the cut-off level was 25/25 (100%) in the infection
      group and 12/50 (24.0%) in the cancer cachexia group. The mean ratio of NPT to
      CRP was 11.3 in the infection group and 30.7 in the cancer cachexia group,
      respectively. These results suggest that gamma-interferon could play the
      principal role in the pathogenesis of cancer cachexia and that interleukin-6
      modified the disease status. Interleukin-6 would be the critical mediator of host
      responses in infectious complications.

PMID- 7790045
TI  - A simple method to selectively expand HIV-1 specific cytotoxic T lymphocytes in
      vitro.
AB  - Cytotoxic T lymphocytes (CTL) may play a critical role in controlling the
      progression of HIV-1 disease. Conventional assays for demonstration of CTL
      against HIV-1 have used either fresh PBMC or T cell lines and clones generated by
      non-specific stimulation. These methods are limited in their sensitivity since
      without specific secondary stimulation in vitro, epitopes recognized at low
      frequency may not be detected. Moreover, derivation of CTL clones is labor
      intensive and not practical for studying a large number of patients. We have
      developed a simple method to enrich HIV-1 specific CTL in vitro. Autologous
      antigen presenting cells (APC), either adherent macrophages or EBV transformed B
      lymphoblastoid cells, are infected with recombinant vaccinia virus encoding
      individual HIV-1 proteins and after overnight culture the vaccinia virus is
      inactivated by uv irradiation in the presence of psoralin. The infected APC are
      then cultured with patient's T cells and CTL activity determined 10-14 days
      later. We have used this method to stimulate patients' T cells obtained directly
      from PBMC and also after mitogenic stimulation. In both systems, the HIV-1
      specific response could be enhanced up to five to ten fold. This enhancement is
      comparable to CTL selection by exposure to HIV-1 immunodominant peptide incubated
      APC. In some patients, viral-specific CTL could be detected after HIV-vaccinia
      selection even though the mitogen stimulated cultures had no demonstrable
      antiviral CTL activity. Selective expansion of CTL directed against multiple HIV
      1 proteins (env, gag and RT) could be obtained from PBMC as well as from mitogen
      stimulated lines from individual patients. As these lines are predominantly CD8+
      T cells by flow cytometric analysis and are free of vaccinia virus as ascertained
      by the lack of cytopathic effect in culture, in vitro vaccinia selection might
      also be useful to generate CTL lines for adoptive immunotherapy.

PMID- 7790047
TI  - The effect of molecular weight and gel preparation on humoral adjuvancy of
      silicone oils and silicone gels.
AB  - Silicone gels from commercial breast implants have been shown previously by our
      laboratory to be potent humoral adjuvants, while the low molecular size 20
      centistoke (cs) silicone oil (M.W. 1900) possesses no measurable adjuvant
      properties. It became necessary to shear the silicone gel during our previous
      experiments in order to facilitate injection through a syringe and needle, it is
      conceivable that shearing may reduce the molecular weight of the silicone gel
      used. This investigation was undertaken to determine whether humoral adjuvancy of
      silicone oils is dependent on molecular weight and whether the method of shearing
      the silicone gel affects its adjuvancy. Four Dow Corning 360 Medical silicone
      oils (100 cs, M.W. approximately 5,000; 350 cs, M.W. approximately 10,000; 1000
      cs, M.W. approximately 16,500 and 12,500 cs, M.W. approximately 60,000) and Dow
      Corning octamethylcyclotetrasiloxane (D4, M.W. 296) were tested for their humoral
      adjuvancy by immunizing 64 Sprague Dawley rats with 50 micrograms of bovine serum
      albumin (BSA) mixed with each oil. The rats were periodically bled and the sera
      were analyzed for anti-BSA antibodies by ELISA. In a separate experiment, three
      silicone gel preparations with reproducible characteristics were prepared by
      using a tissue homogenizer and varying the applied shear force. Each of these
      preparations was tested for its humoral adjuvancy as previously described for
      silicone oils. Rats immunized with BSA mixed with the highest molecular size
      silicone oil tested (M.W. approximately 60,000) showed a significant increase in
      anti-BSA antibodies as compared to the lower molecular size oils. The three
      silicone gel preparations showed no difference in their adjuvancy effect. Thus,
      the humoral adjuvancy of silicone oil appears to be dependent on molecular
      weight. Differential shearing of the silicone gel does not alter its humoral
      adjuvancy.

PMID- 7790046
TI  - Synergistic activation of serum amyloid A (SAA) by IL-6 and IL-1 in combination
      on human Hep 3B hepatoma cell line. Role of PGE2 and IL-1 receptor antagonist.
AB  - Serum amyloid A (SAA) protein is a major acute phase reactant in human and many
      other species. Infections and traumatic inflammation are characterized by a rapid
      increase of SAA; its concentration in the plasma may augment many-fold. Cytokines
      such as IL-1 and IL-6 are considered mediators of acute phase protein synthesis.
      The most accredited mechanism of action of IL-1 in inflammatory diseases is the
      stimulation of PGE2 release, which is highly dependent on the concentration of IL
      1. In this study we found that human Hep 3B hepatoma cells treated with the
      combination of hrIL-6 (10ng/ml) plus hrIL-1 (1ng/ml) produced an augmentation in
      steady-state levels of SAA mRNA (87%) compared to hrIL-6 (10ng/ml) plus PGE2 (5
      microM), which induced an increase of only 33%, compared to IL-6 alone, while
      cells treated with hrIL-6 plus PGE2 (0.5 microM) had a similar effect as hrIL-6
      did alone. Moreover, the addition of exogenous PGE2 (5 microM) to the cell
      cultures produced no significant increase in concentration of SAA mRNA compared
      to the control. In addition, according to the data obtained by the blot analysis
      we also found, by ELISA method, that hrIL-6 acts in synergism with hrIL-1 on SAA
      protein secretion in human Hep 3B hepatoma cell cultures after 48 h incubation.
      In fact, the cell cultures treated with hrIL-6 plus hrIL-1 caused a higher
      release approximately 1.5-4-fold of SAA protein than the cells treated with IL-6
      plus PGE2 5 microM or IL-1 + PGE2 5 microM, respectively. The synergistic effect
      of hrIL-6 plus hrIL-1 beta was inhibited by hrIL-1 receptor antagonist (hrIL-1ra)
      50 micrograms/ml, a protein which specifically binds to the IL-1 receptor and is
      structurally similar to IL-1 beta but with no IL-1-like activity; while
      indomethacin (5 microM) was ineffective. These results strongly suggest that the
      synergism between hrIL-6 plus hrIL-1 on the transcription and the protein release
      of SAA release is not due to a PGE2-dependent process in human Hep 3B hepatoma
      cells. This finding highlights a specific biological effect of IL-1 not in
      relation to PGE2, suggesting a specific mechanism of action for IL-1 in
      regulating acute phase protein synthesis.

PMID- 7790048
TI  - Active immunity to Pneumocystis carinii reinfection in T-cell-depleted mice.
AB  - Immunocompetent C.B-17 mice were immunized against Pneumocystis carinii by
      several intratracheal inoculations with infective P. carinii. These mice and
      another group of C.B-17 mice naive to P. carinii were then depleted of CD4+ cells
      by treatment with both anti-CD4 and anti-Thy1 monoclonal antibodies. Both groups
      of mice were then challenged with an infective inoculum containing 10(7) P.
      carinii organisms by intratracheal instillation. The mean log10 counts of P.
      carinii nuclei in the lungs of the nonimmune mice were 4.98, 5.89, and 6.77 when
      they were killed at 4, 10, and 19 days, respectively, after challenge. The P.
      carinii counts in the lungs of the immune mice were significantly lower at each
      time point and below detectable levels at 10 and 19 days. Analysis of P. carinii
      DNA by PCR revealed no detectable P. carinii in the lungs of the immunized mice
      at either 10 or 19 days, whereas all of the nonimmunized mice contained P.
      carinii DNA at all time points. The sera of immune but not nonimmune mice
      contained P. carinii-specific immunoglobulin G. These results indicate that
      immunization of an immunocompetent host against P. carinii can protect against P.
      carinii pneumonia even after the host is depleted of CD4+ cells. In addition, the
      results are consistent with the possibility that antibodies were responsible for
      the observed protection against P. carinii.

PMID- 7790049
TI  - Intracellular processing of liposome-encapsulated antigens by macrophages depends
      upon the antigen.
AB  - Two proteins, a recombinant malaria protein (R32NS1) and conalbumin, were
      encapsulated in separate liposomes. The mechanisms of presentation of
      unencapsulated and liposome-encapsulated R32NS1 and conalbumin to antigen
      specific T-cell clones were investigated in in vitro antigen presentation assays
      using murine bone marrow-derived macrophages (BMs) as antigen-presenting cells. A
      much lower concentration of liposomal antigen than of unencapsulated antigen was
      required for T-cell proliferation. Liposome-encapsulated conalbumin required
      intracellular processing by BMs for antigen-specific T-cell proliferation, as
      determined by inhibition with chloroquine, NH4Cl, leupeptin, brefeldin A,
      monensin, antimycin A, NaF, and cycloheximide and by treatment of BMs with
      glutaraldehyde. Liposome-encapsulated conalbumin therefore follows the classical
      intracellular antigen processing pathway described for protein antigens.
      Similarly, unencapsulated conalbumin also required intracellular processing for
      presentation to antigen-specific T cells. In contrast, both unencapsulated R32NS1
      and liposome-encapsulated R32NS1 were presented to T cells by BMs without
      undergoing internalization and intracellular processing. These results suggest
      that the antigen itself is the major element that determines whether a
      requirement exists for intracellular processing of liposomal antigens by
      macrophages.

PMID- 7790050
TI  - Circulating CD4 and CD8 T cells have little impact on host defense against
      experimental vaginal candidiasis.
AB  - The etiology of recurrent vulvovaginal candidiasis in otherwise healthy women of
      child-bearing age remains an enigma. To date, results from both clinical studies
      and a murine model of vaginal candidiasis indicate that Candida vaginitis can
      occur in the presence of Candida-specific Th1-type cell-mediated immunity
      expressed in the peripheral circulation. The present study was designed to
      determine the role of circulating CD4 and CD8 cells in primary and secondary
      vaginal infections with Candida albicans. Vaginal fungal burden, Candida-specific
      delayed-type hypersensitivity (DTH), and lymph node cell Th1/Th2 cytokine
      production were monitored in CD4 and/or CD8 cell-depleted mice during persistent
      primary vaginal infections and secondary vaginal infections against which partial
      protection was observed. Treatment of mice with anti-CD4 or anti-CD8 antibodies
      resulted in 90% or greater depletion of the respective cell populations. Mice
      depleted of CD4 cells had significantly reduced Candida-specific DTH and lymph
      node cell Th1-type cytokine production during a primary vaginal infection, as
      well as reduced anamnestic DTH during a secondary vaginal infection. In contrast,
      mice depleted of CD8 cells showed only reduced gamma interferon production during
      a primary infection; no alterations in DTH were observed. Despite reductions in
      DTH and cytokine production, however, CD4 and/or CD8 cell depletion had no effect
      on vaginal C. albicans burden in mice after a primary or secondary vaginal
      inoculation. Taken together, these results suggest that while circulating CD4 and
      CD8 cells contribute to systemic Candida-specific cell-mediated immunity in
      vaginally infected mice, neither CD4 nor CD8 circulating T cells appear to
      provide significant host defenses against C. albicans at the vaginal mucosa.

PMID- 7790052
TI  - Purification and characterization of a Chinese hamster ovary cell elongation
      factor of Vibrio hollisae.
AB  - The halophilic bacterium Vibrio hollisae, isolated from patients with diarrhea,
      produces an extracellular toxin which elongates Chinese hamster ovary (CHO)
      cells. We purified this toxin to homogeneity by sequential ammonium sulfate
      precipitation, gel filtration with Sephacryl S-200, hydrophobic interaction
      chromatography with phenyl-Sepharose CL-4B, ion-exchange chromatography with DEAE
      Sephadex A-50, and affinity chromatography. The toxin is heat labile and
      sensitive to proteases, with an isoelectric point of about 6.5 and molecular
      weights of about 83,000 and 80,000, as estimated by gel filtration and sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis, respectively. The toxin did
      not react with immunoaffinity-purified antibodies to cholera toxin in a plate
      enzyme-linked immunosorbent assay and in a Western blot, and its activity could
      not be neutralized by anti-cholrea toxin serum. Mixed gangliosides and
      gangliosides GM1, GD1a, GD1b, Gq1b, GT1b, GD2, GD3, GM2, and GM3 failed to block
      its activity. Elongation of CHO cells induced by the toxin was not accompanied by
      an increase in the levels of cyclic AMP. The toxin induced intestinal fluid
      accumulation in suckling mice. These results and the lack of homology between V.
      hollisae DNA and DNA coding for cholera toxin or the heat-labile toxin of
      Escherichia coli suggest that the V. hollisae toxin is structurally and
      functionally different from other CHO cell-elongating toxins.

PMID- 7790051
TI  - Clonal relationships among bloodstream isolates of Escherichia coli.
AB  - The clonal relationships among 187 bloodstream isolates of Escherichia coli from
      179 patients at Boston, Mass., Long Beach, Calif., and Nairobi, Kenya, were
      determined by multilocus enzyme electrophoresis (MLEE), analysis of polymorphisms
      associated with the ribosomal operon (ribotyping), and serotyping. MLEE based on
      20 enzymes resolved 101 electrophoretic types (ETs), forming five clusters;
      ribotyping resolved 56 distinct patterns concordant with the analysis by MLEE.
      The isolates at each study site formed a genetically diverse group and
      demonstrated similar clonal structures, with the same small subset of lineages
      accounting for the majority of isolates at each site. Moreover, two ribotypes
      accounted for approximately 30% of the isolates at each study site. One cluster
      contained the majority (65%) of isolates and, by direct comparison of the ETs and
      ribotypes of individual isolates, was genetically indistinguishable from the
      largest cluster for each of two other collections of E. coli causing
      pyelonephritis and neonatal meningitis (R. K. Selander, T. K. Korhonen, V.
      Vaisanen-Rhen, P. H. Williams, P. E. Pattison, and D. A. Caugent, Infect. Immun.
      52:213-222, 1986; M. Arthur, C. E. Johnson, R. H. Rubin, R. D. Arbeit, C.
      Campanelli, C. Kim, S. Steinbach, M. Agarwal, R. Wilkinson, and R. Goldstein,
      Infect. Immun. 57:303-313, 1989), thus defining a virulent set of lineages. The
      isolates within these virulent lineages typically carried DNA homologous to the
      adhesin operon pap or sfa and the hemolysin operon hly and expressed O1, O2, O4,
      O6, O18, O25, or O75 antigens. DNA homologous to pap was distributed among
      isolates of each major cluster, whereas hly was restricted to isolates of two
      clusters, typically detected in pap-positive strains, and sfa was restricted to
      isolates of one cluster, typically detected in pap- and hly-positive strains. The
      occurrence of pap-positive isolates in the same geographically and genetically
      divergent lineages suggests that this operon was acquired early in the radiation
      of E. coli, while hly and sfa were acquired subsequently, most likely by pap
      positive and pap- and hly-positive precursors, respectively.

PMID- 7790054
TI  - Role of lipopolysaccharide (LPS), interleukin-1, interleukin-6, tumor necrosis
      factor, and dexamethasone in regulation of LPS-binding protein expression in
      normal hepatocytes and hepatocytes from LPS-treated rats.
AB  - Lipopolysaccharide (LPS)-binding protein (LBP) has been reported to be an acute
      phase protein. LBP binds to LPS with a high affinity; LPS-LBP complexes then
      interact with the receptor CD14, resulting in increased expression of LPS
      inducible genes. Hepatocytes represent a major source of LBP, but little is known
      about the regulation of rodent hepatocyte LBP synthesis. In these studies,
      undertaken to characterize hepatocyte LBP expression, we show that greater-than
      20-fold increases in LBP mRNA levels in hepatocytes occurred following injection
      of LPS or turpentine in rats. In primary cultures of rat hepatocytes, the
      addition of interleukin-6 (IL-6) and LPS led to 4.5- and 3.2-fold stimulation in
      LBP mRNA levels, respectively. The induction of LBP by IL-6 or LPS was attenuated
      by dexamethasone. In contrast to IL-6 and LPS, in the presence of 10(-6) M
      dexamethasone, IL-1 and tumor necrosis factor (TNF) led to maximal LBP mRNA
      induction levels, 4.7- and 3.8-fold, respectively, suggesting that IL-6 and LPS
      stimulate LBP expression by mechanisms different from those of IL-1 and TNF.
      Similar induction levels of LBP mRNA were seen in rat H35 hepatoma cells for all
      four stimuli, and dexamethasone inhibited these responses. Dexamethasone alone
      increased the spontaneous induction in primary hepatocytes at early time points
      but suppressed induction at later time points. Furthermore, hepatocytes from rats
      treated with LPS in vivo exhibited a > 10-fold increase in mRNA expression in
      response to LPS and enhanced responses to TNF and IL-1. As with the normal
      hepatocytes, dexamethasone inhibited the LPS-dependent induction in the LPS
      treated rat hepatocytes. These data suggest that LBP synthesis by hepatocytes is
      under the control of LPS, IL-1, TNF, IL-6, and glucocorticoids and that the LPS
      treatment primes hepatocytes for subsequent responses to LPS, TNF, and IL-1 for
      LBP synthesis.

PMID- 7790053
TI  - Membrane topology of Borrelia burgdorferi and Treponema pallidum lipoproteins.
AB  - A critical issue regarding the molecular architectures of Treponema pallidum and
      Borrelia burgdorferi, the agents of venereal syphilis and Lyme disease,
      respectively, concerns the membrane topologies of their major lipoprotein
      immunogens. A related question is whether these lipid-modified membrane proteins
      form intramembranous particles during freeze fracture electron microscopy. To
      address these issues, native borrelial and treponemal lipoproteins were
      reconstituted into liposomes of diverse composition. The importance of the
      covalently associated lipids for membrane association of lipoproteins was
      revealed by the observation that nonlipidated recombinant forms of both B.
      burgdorferi OspA and the T. pallidum 47-kDa immunogen (Tpp47) showed very weak or
      no binding to model bilayer vesicles. In contrast to control liposomes
      reconstituted with bacteriorhodopsin or bovine rhodopsin, two well-characterized
      transmembrane proteins, none of the lipoprotein-liposomes contained particles
      when examined by freeze fracture electron microscopy. To extend these findings to
      prokaryotic lipoproteins with relatively amphiphilic polypeptides, similar
      experiments were conducted with a recombinant nonlipidated form of Escherichia
      coli TraT, a lipoprotein which has putative transmembrane domains. The
      nonlipidated TraT oligomers bound vesicles derived from E. coli lipids but,
      surprisingly, did not form particles in the freeze-fractured liposomes. These
      findings support (i) a proposed topology of spirochetal lipoproteins in which the
      polypeptide is extrinsic to the membrane surface and (ii) the contention that
      particles visualized in freeze-fractured spirochetal membranes represent poorly
      characterized transmembrane proteins.

PMID- 7790055
TI  - Salmonella enteritidis colonization of the reproductive tract and forming and
      freshly laid eggs of chickens.
AB  - Salmonella enteritidis colonizes the tissues of the chicken ovary and oviduct,
      presumably contaminating eggs and thereby contributing to human outbreaks of
      salmonellosis. In this study, commercial adult laying hens were given an oral
      inoculation of 10(8) S. enteritidis organisms. Tissues from various organs, the
      intestines, and the reproductive tract, including freshly laid eggs, were
      collected daily for up to 40 days postinoculation (p.i.). Within 2 days p.i. S.
      enteritidis was detected by culture in pools of the spleen, liver, heart, and
      gallbladder tissues, in intestinal tissues of all infected birds, and in various
      sections of the ovary and oviduct. Detection of organisms by immunohistochemical
      staining was rare for most tissues in spite of their culture-positive status,
      suggesting a low level of tissue colonization. However, S. enteritidis could be
      detected by immunohistochemical staining in oviduct tissues associated with four
      forming eggs, indicating the possibility of a heavier colonization in the egg
      during its development. In two subsequent experiments, forming eggs taken from
      the oviduct with their associated tissue, were found to be culture positive for
      S. enteritidis at a rate of 27.1 and 31.4%, while freshly laid eggs in these
      experiments were culture positive at the rate of 0 and 0.6%. These observations
      suggest that while forming eggs are significantly colonized in the reproductive
      tract, factors within the eggs may control the pathogen before the eggs are laid.
      The data show that prior to egg deposition, forming eggs are subject to
      descending infections from colonized ovarian tissue, ascending infections from
      colonized vaginal and cloacal tissues, and lateral infections from colonized
      upper oviduct tissues. The data are consistent with an ascending infection of
      freshly laid eggs from the cloaca, as the incidence of positive eggs in
      experiments 1 and 3 coincided with heavily contaminated cloacal tissues (50.7 and
      80%, respectively), while no positive eggs were detected in experiment 2 when
      cloacal colonization was low (8.3%). The data do not support the possibility of
      egg invasion by bacterial translocation from the peritoneal cavity.

PMID- 7790056
TI  - Comparative toxicity and virulence of Escherichia coli clones expressing variant
      and chimeric Shiga-like toxin type II operons.
AB  - Shiga-like toxin (SLT)-producing strains of Escherichia coli are known to cause
      diarrhea, hemorrhagic colitis, and hemolytic-uremic syndrome in humans. The SLTs,
      particularly those related to type II (SLT-II), are a diverse family of toxins
      which may have differing in vitro or in vivo properties. To examine the impact of
      naturally occurring SLT-II sequence variation on the capacity of a given E. coli
      strain to cause disease, operons encoding four different SLT-II-related toxins,
      designated SLT-II/O111, SLT-II/OX3a, SLT-II/OX3b, and SLT-II/O48, were cloned in
      the same orientation in pBluescript. French pressure cell lysates of E. coli DH5
      alpha derivatives carrying these plasmids differed markedly in cytotoxicity for
      Vero cells, with 50% cytotoxic doses ranging from 20 to 328,000/ml. The strains
      also differed in oral virulence for streptomycin-treated mice, as judged by
      survival rate and/or median survival time, but virulence did not necessarily
      correlate with in vitro cytotoxicity. The SLT-II type associated with the lowest
      oral virulence was SLT-II/O111. Both the overall survival rate and the median
      survival time of mice challenged with clones producing this toxin were
      significantly greater than that for mice challenged with a clone producing the
      closely related SLT-II/OX3a. Experiments with clones carrying chimeric O111/OX3a
      SLT-II operons indicated that the reduced virulence was associated with an Arg
      176-->Gly substitution in the mature A subunit. Clones producing SLT-II/O48 and
      SLT-II/OX3b had similarly high cytotoxicities for Vero cells, but the latter was
      more virulent when fed to streptomycin-treated mice, as judged by median survival
      time. Experiments with clones carrying chimeric O48/OX3b SLT-II operons indicated
      that the increased virulence was a function of the A subunit of SLT-II/OX3b,
      which differs from the A subunit of SLT-II/O48 by only two amino acids (Met-4-
      >Thr and Gly-102-->Asp, respectively). These findings raise the possibility that
      naturally occurring SLT-II sequence variations may impact directly on the
      capacity of a given SLT-producing E. coli strain to cause disease.

PMID- 7790057
TI  - Characterization of a Tn4351-generated hemin uptake mutant of Porphyromonas
      gingivalis: evidence for the coordinate regulation of virulence factors by hemin.
AB  - The ability of Porphyromonas gingivalis to acquire iron in the iron-limited
      environment of the host is crucial to the colonization of this organism. We
      report here on the isolation and characterization of a transpositional insertion
      mutant of P. gingivalis A7436 (designated MSM-3) which is defective in the
      utilization and transport of hemin. P. gingivalis MSM-3 was selected on the basis
      of its nonpigmented phenotype on anaerobic blood agar following mutagenesis with
      the Bacteroides fragilis transposon Tn4351. P. gingivalis MSM-3 grew poorly when
      supplied with hemin as a sole source of iron; however, growth was observed with
      hemoglobin or inorganic iron. P. gingivalis MSM-3 grown in either hemin-replete
      or hemin-depleted conditions bound and transported less [14C]hemin or [59Fe]hemin
      than did the parent strain. At 4 h, P. gingivalis MSM-3 grown in hemin-replete
      conditions transported only 10,000 pmol of hemin per mg of protein, or 14% of the
      amount transported by P. gingivalis A7436. Unlike P. gingivalis A7436, hemin
      binding and transport by P. gingivalis MSM-3 were not tightly regulated by hemin
      or iron. Examination of P. gingivalis MSM-3 cultures by electron microscopy
      revealed an overproduction of membrane vesicles, and determination of the dry
      weight of purified vesicles indicated that P. gingivalis MSM-3 produced twice as
      much membrane vesicles as did strain A7436. Extracellular vesicles isolated from
      P. gingivalis MSM-3 also were found to express increased hemolytic and trypsin
      like protease activities compared with the parent strain. When inoculated into
      subcutaneous chambers implanted in mice, P. gingivalis MSM-3 was highly
      infectious and more invasive than the parent strain, as indicated by secondary
      lesion formation and death. Taken together, these results indicate that the
      decreased transport of hemin by P. gingivalis MSM-3 results in the increased
      expression of several virulence factors which may be coordinately regulated by
      hemin.

PMID- 7790058
TI  - Cellular immunity to the P6 outer membrane protein of nontypeable Haemophilus
      influenzae.
AB  - Cellular immunity to nontypeable Haemophilus influenzae in a population of 10
      healthy, immune adults was determined by measuring lymphocyte blast
      transformation and antibody secretion in response to the P6 outer membrane
      protein. P6 (200 microliters/ml) induced lymphocyte blast transformation that
      peaked on day 10 of incubation. The peak induction of antibody-secreting cells
      occurred on day 8 of incubation. In comparison with the response to tetanus
      toxoid stimulation, the peak lymphocyte blast transformation response to P6 was
      reduced (mean counts per minute +/- standard error of the mean [SEM], 3,457 +/-
      503 versus 9,414 +/- 1,464; P = 0.0051) and delayed (mean days +/- SEM, 10.3 +/-
      0.4 versus 8.4 +/- 0.5; P = 0.0169); however, P6 was a better stimulus of
      antibody secretion from lymphocytes, particularly antibody of the immunoglobulin
      M (IgM) class (mean peak numbers of antibody-secreting cells per 10(5) peripheral
      blood mononuclear cells +/- SEM: IgG, 85 +/- 29 versus 42 +/- 16 [P = 0.0469];
      IgM, 81 +/- 20 versus 25 +/- 7 [P = 0.0125]; IgA, 24 +/- 8 versus 16 +/- 6 [P =
      0.0526]). Thus, lymphocytes from immune individuals recognize P6 of nontypeable
      H. influenzae as an immunogen. These data provide a basis for future studies with
      otitis-prone children who fail to develop a normal antibody response to P6
      antigen (N. Yamanaka and H. Faden, J. Pediatr. 122:212-218, 1993).

PMID- 7790059
TI  - Borrelia burgdorferi binds plasminogen, resulting in enhanced penetration of
      endothelial monolayers.
AB  - Several strains of Borrelia burgdorferi and Borrelia hermsii can bind human Lys
      plasminogen specifically. Affinity blots using 125I-labeled plasminogen showed
      that numerous polypeptides of all the strains and species tested could bind via
      lysine residues to the plasminogen molecule since binding could be completely
      inhibited by the lysine analog epsilon-aminocaproic acid. Binding analysis using
      125I-labeled plasminogen on live intact organisms showed that the organisms
      possess two binding sites for plasminogen: a high-affinity site with a Kd of 24
      +/- 12 pM and 106 +/- 14 binding sites per spirochete and a low-affinity site
      with a Kd of 20 +/- 4 nM and 2,683 +/- 36 binding sites per spirochete. Indirect
      immunofluorescence and confocal microscopy showed a generalized but punctate
      pattern of plasminogen binding to the spirochete surface. Exogenously provided
      urokinase-type plasminogen activator converted B. burgdorferi surface-bound
      plasminogen to enzymatically active plasmin as demonstrated by the breakdown of
      the chromogenic plasmin substrate S2251. Plasmin-coated organisms showed an
      enhanced ability to penetrate endothelial cell monolayers grown on connective
      tissue substrates compared to untreated controls (P < 0.001). This functional
      assay demonstrated that enzymatically active plasmin on the surface of
      spirochetes can lead to greater invasion of tissues.

PMID- 7790060
TI  - Binding of Haemophilus influenzae to purified mucins from the human respiratory
      tract.
AB  - Mucins are high-molecular-weight glycoproteins and major constituents of the
      mucus layer which covers the airway surface. We have studied the interactions
      between bacteria, mucins, and epithelial cells from the human respiratory tract.
      Nontypeable strains of Haemophilus influenzae were found to bind to purified
      airway mucins in suspension and on solid phase. Mucins in suspension inhibited
      the attachment of these strains to nasopharyngeal epithelial cells, while mucin
      coating of the cells enhanced their binding. In contrast, strains of
      Streptococcus pneumoniae and encapsulated and other nontypeable H. influenzae
      strains failed to interact with mucins. These H. influenzae strains used other
      strategies for adherence to epithelial cells. The type b strain 770235 attached
      via fimbriae but also expressed a subcapsular adhesin that was detected in a
      capsule- and fimbria-defective mutant. Mucin pretreatment of these bacteria did
      not inhibit adherence, but mucin pretreatment of epithelial cells inhibited
      adherence, probably by shielding of the receptors for these adhesins. Non-mucin
      binding nontypeable and encapsulated H. influenzae strains would, therefore,
      adhere only after disruption of the mucus layer and exposure of cellular
      receptors. Differences in tissue toxicity and invasiveness among H. influenzae
      strains may also be influenced by the mucin interactions of the strains.

PMID- 7790061
TI  - Peptide permeases from Streptococcus pneumoniae affect adherence to eucaryotic
      cells.
AB  - To gain access to tissues within the human host, Streptococcus pneumoniae
      initially colonizes the nasopharynx and then interacts with glycoconjugates on
      the surfaces of target cells at various sites of infection. Although pneumococcal
      adhesins are currently unknown, exported proteins on the bacterial surface are
      potential candidates. To identify bacterial elements involved in this process,
      mutants of S. pneumoniae with defects in exported proteins were screened for the
      inability to adhere to cells representative of three in vivo niches: (i)
      agglutination of bovine erythrocytes, which reflects adherence to cells which
      reside in the nasopharynx; (ii) human type II pneumocytes (lung cells [LC]),
      representing the alveolar site of infection; and (iii) human vascular endothelial
      cells (EC), representing the endovascular site. The capacity of the mutants to
      adhere during the course of pneumococcal disease was also assessed by using
      cytokine-activated LC and EC. All of the 30 mutants analyzed produced
      hemagglutination values comparable with those of the parent strain. Four
      independent mutants demonstrated a greater than 50% decrease in adherence to both
      LC and EC. Sequence analysis of the altered alleles from these strains showed
      that mutations had occurred in two previously identified loci, plpA and ami,
      which belong to the family of genes encoding protein-dependent peptide permeases.
      Mutations in the ami locus resulted in an inability to recognize the GalNAc beta
      1-4Gal glycoconjugate receptor present on resting LC and EC, whereas mutations in
      plpA resulted in a failure to recognize a GalNAc beta 1-3Gal glycoconjugate
      receptor also present on resting cells. Mutations in neither allele affected
      recognition of GlcNAc receptors present on cytokine-activated LC and EC. These
      results suggest that peptide permeases modulate pneumococcal adherence to
      epithelial and endothelial cells either by acting directly as adhesins or by
      modulating the expression of adhesins on the pneumococcal surface during the
      initial stages of colonization of the lung or the vascular endothelium.

PMID- 7790062
TI  - Cloning and genetic characterization of the flagellum subunit gene (flaA) of
      Legionella pneumophila serogroup 1.
AB  - The gene flaA, encoding the flagellum subunit protein of Legionella pneumophila
      serogroup 1, has been isolated from an expression library of L. pneumophila
      isolate Corby in Escherichia coli K-12 by using an antiflagellin specific
      polyclonal antiserum. DNA sequence analysis of the flaA gene revealed the
      presence of a 1,428-bp open reading frame encoding a protein of 475 amino acids
      with an apparent molecular mass of 48 kDa that is expressed independently of an
      E. coli vector promoter. Peptide sequencing of the N terminus of the isolated
      flagellum subunit protein confirmed that this open reading frame encodes the
      flagellin. By comparing the FlaA amino acid sequence with those of flagellins of
      various other bacteria, high degrees of homology in the N-terminal and C-terminal
      amino acids could be observed. The flaA-specific mRNA was determined to be 1.6 kb
      in size, the expected size of a monocistronic mRNA. Temperature-dependent
      expression of flagellin was found to be regulated at the transcriptional level.
      Sequence analysis and primer extension experiments indicated that the
      transcription of the gene flaA is directed by a sigma 28-like RpoF-FliA factor.
      By using fliA and fliA+ E. coli K-12 mutants, it was shown that flaA expression
      in E. coli required the sigma 28 factor. A flaA-specific DNA probe hybridizes
      with genomic DNA isolated from L. pneumophila and with most of the genomic DNAs
      from non-L. pneumophila Legionella strains. Two L. pneumophila strains and
      isolates of Legionella bozemanii and Legionella feeleii (serogroup 1) carry flaA
      specific sequences but were not able to produce flagella.

PMID- 7790063
TI  - Microheterogeneity of Neisseria lipooligosaccharide: analysis of a UDP-glucose 4
      epimerase mutant of Neisseria meningitidis NMB.
AB  - Neisseria meningitidis is the etiologic agent of epidemic bacterial meningitis.
      Lipooligosaccharide (LOS) is a principal virulence factor associated with the
      organism, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis
      of LOS has demonstrated that there is considerable microheterogeneity in the
      molecule. To begin our understanding of the nature of this heterogeneity, we
      identified a Tn916-generated LOS mutant of N. meningitidis NMB (serotype L3,
      monoclonal antibodies 3F11+, 6B4+, and 4C4-) that was designated NMB-SS3
      (monoclonal antibodies 3F11-, 6B4-, and 4C4+). The transposon insertion was
      localized to the amino terminus of the functional copy of the UDP-Glc 4-epimerase
      gene (galE). UDP-Glc 4-epimerase (EC 5.1.3.2) activity was present in N.
      meningitidis NMB but not in NMB-SS3, indicating that the Tn916 insertion had
      abolished this activity. Mass spectrometric analysis of the LOS from strain NMB
      revealed multiple species of LOS, which is consistent with extensive
      microheterogeneity. While the most predominant structure was consistent with a
      terminal lacto-N-neotetrose structure found in other strains of N. meningitidis,
      Gal beta 1-->4GlcNAc beta 1-->3Gal beta 1-->4Glc-->(GlcNAc)-->Hep2PEA-->KDO2
      (where Hep is heptose, PEA is phosphoethanolamine, and KDO is 2-keto-3
      deoxymannooctulosonic acid), structures containing repetitive hexoses which are
      not precursors of this structure were also identified. Compositional analysis of
      LOS from strain NMB-SS3 revealed that there were no galactoses present in the
      structure. Mass spectrometric analysis of O-deacylated LOS revealed the presence
      of multiple species, with the predominant LOS species in this mutant strain
      formed by the Hex-->(HexNAc)-->Hep2PEA-->KDO2 (where Hex is hexose and HexNAc is
      N-acetylhexosamine) structure. However, LOS structures with repetitive hexoses,
      e.g., Hexn-->(HexNAc)-->Hep2PEA-->KDO2 (n = 2, 3, or 4), emanating from one or
      both heptoses were also identified. Since this mutant cannot synthesize UDP-Gal,
      these structures must repetitive glucoses. These data suggest that NMB has a
      glycosyltransferase capable of polymerizing glucose moieties as an alternative
      biosynthetic pathway to the wild-type lacto-N-neotetrose structure.

PMID- 7790064
TI  - Expression, purification, and characterization of a novel G protein, SGP, from
      Streptococcus mutans.
AB  - The sgp gene of Streptococcus mutans was recently detected immediately downstream
      from the dgk gene within the same operon. In this study, the sgp gene was
      subcloned into the pMAL-c2 vector and SGP (S. mutans G protein) was overexpressed
      in Escherichia coli as a fusion protein with the maltose-binding protein at a
      level of 40% of total cellular protein. One-step amylose affinity chromatography
      purification of this fusion protein yielded a product of approximately 95%
      purity. SGP was purified from this fusion protein following cleavage with
      protease factor Xa and DEAE-Sephacel chromatography. In nucleotide binding
      assays, recombinant SGP showed specific binding for GTP and GDP, but not ATP,
      CTP, and UTP, and also catalyzed efficient hydrolysis of GTP to GDP. Kinetic
      studies revealed that the SGP Km value for GTP in this reaction was approximately
      5.9 microM. Mg2+ also served as a cofactor of SGP in this reaction. In vivo
      subcellular localization by immunogold labelling demonstrated that SGP was
      associated with both membrane and cytoplasmic fractions. SGP not only had
      structural similarities with other G proteins but also proved to have high-level
      intrinsic GTPase activity. Therefore, SGP appears to be a new member of the G
      protein superfamily and may participate in transmembrane signaling in the
      responses of S. mutans cells to environmental stimuli.

PMID- 7790065
TI  - Clonal diversity of the taxon Porphyromonas gingivalis assessed by random
      amplified polymorphic DNA fingerprinting.
AB  - A total of 97 strains of the periopathogen Porphyromonas gingivalis were
      collected. This collection included laboratory strains and clinical isolates of
      human origin with diverse clinical and geographical origins. Biological diversity
      was further increased by including 32 strains isolated from the oral cavities of
      nine different animal species. Genomic fingerprints of the 129 strains were
      generated as random amplified polymorphic DNAs (RAPDs) by the technique of PCR
      amplification with a single primer of arbitrary sequence. Four nonameric
      oligonucleotides were used as single primers, and the banding patterns of the DNA
      products separated on agarose gels were compared after ethidium ethidium bromide
      staining. Distance coeffients based on the positions of the major DNA fragments
      were calculated, and dendrograms were generated. We identified 102 clonal types
      (CTs) that could be assembled into three main groups by cluster analysis by the
      unweighted pair group method with mathematic averages. Group I (n = 79 CTs)
      included all 97 human strains and 6 monkey isolates. The strains in group II (n =
      22 CTs) and III (n = 1 CT) were strongly differentiated from those in group I and
      included only strains of animal origin; they likely represent two cryptic species
      within the present P. gingivalis taxon. We observed that strains from Old World
      monkeys clustered together with the human genotype, whereas strains from New
      World monkeys clustered with the animal genotype. Our results with human strains
      also indicated that (i) the population structure is basically clonal, (ii) no
      dominant or widespread CT could be observed, and (iii) no relationship could be
      established between specific clusters of CTs and the periodontal status of the
      host. Our results corroborate previous findings by B. G. Loos, D. W. Dyer, T. S.
      Whittam, and R. K. Selander (Infect. Immun. 61:204-212, 1993) and suggest that P.
      gingivalis should be considered a commensal of the oral cavity acting as an
      opportunistic pathogen. Our results are not consistent with the hypothesis that
      only a few virulent clones of P. gingivalis are associated with disease.

PMID- 7790066
TI  - Suppressive effect of interleukin-4 neutralization differs for granulomas around
      Schistosoma mansoni eggs injected into mice compared with those around eggs laid
      in infected mice.
AB  - The principal pathological manifestation of murine Schistosoma mansoni infection
      is the egg-induced granuloma. Synchronous pulmonary granulomas forming around
      intravenously injected schistosome eggs are widely used to study the
      immunopathology of schistosomiasis. A number of anticytokine antibody treatments
      have a remarkable effect in modulating granulomas in this model but little effect
      on the size of hepatic granulomas around laid eggs during experimental infection.
      To examine this discrepancy, we examined the effects of anticytokine antibodies
      on liver and lung granulomas around injected eggs and around eggs laid during
      infection in both locations. Anti-interleukin-4 (IL-4) treatment greatly reduced
      the volume of granulomas around eggs injected into the liver via the portal vein
      and around eggs injected into the lung via the tail vein. On the contrary,
      granulomas around eggs laid by worms in either the liver or the lung during the
      course of infection were not significantly decreased in size by anti-IL-4
      treatment. Thus, site is not important for the disparate effects of anti-IL-4 in
      granuloma formation around injected versus laid eggs. This effect is seen in
      naive and sensitized animals and is most probably due to differences in the
      quality of injected eggs versus those laid in situ by the worms.

PMID- 7790067
TI  - In vitro and in vivo characterization of an ail mutant of Yersinia
      enterocolitica.
AB  - Ail is a 17-kDa protein of Yersinia enterocolitica previously identified on the
      basis of its ability to confer upon Escherichia coli the phenotype of attachment
      and invasion of cultured epithelial cells. Here we report an examination of the
      contribution of ail to the pathogenicity of Y. enterocolitica. A low-copy-number
      ail plasmid that promoted serum resistance in E. coli HB101 was constructed. The
      serum resistance phenotype conferred by ail to E. coli was affected by the growth
      phase of the culture as well as by the gene copy number. In contrast, the copy
      number of ail (and the relative quantity of Ail) was found to have little effect
      on the amount of Ail-promoted invasion of cultured epithelial cells. An ail
      mutant of Y. enterocolitica was constructed and characterized in vitro. This
      mutant produced no detectable Ail and had a reduced ability to invade CHO cells.
      Serum resistance of Y. enterocolitica was Ail dependent and was affected by
      growth phase and ail copy number. The phenotype of the ail mutant was examined in
      vivo by using a murine model for infection. The ail mutant phenotype was
      identical to that of the wild-type strain in oral 50% lethal dose studies and
      early colonization of Peyer's patches as well as in kinetic studies. Western blot
      (immunoblot) analysis of Ail produced by bacteria growing in vivo at 48 h
      postinfection indicated that ail was expressed at this time point. Thus, our
      findings confirm that Ail contributes to the serum resistance and invasion
      phenotypes of Y. enterocolitica in vitro and indicate that Ail is not required to
      establish an infection or to cause systemic infection of BALB/c or DBA/2 mice.

PMID- 7790068
TI  - Sex-determined resistance to Toxoplasma gondii is associated with temporal
      differences in cytokine production.
AB  - Examination of a wide range of inbred mice of diverse genetic backgrounds and
      major histocompatibility complex haplotypes revealed a dramatic difference in the
      susceptibilities of males and females to Toxoplasma gondii infection. Female mice
      were found to be more susceptible to acute infection, as determined by higher
      mortality levels, than male mice, while those female mice surviving to have
      chronic infections harbored more cysts in their brains than did surviving males.
      This phenomenon was therefore investigated in greater depth immunologically in
      the BALB/K mouse, a strain showing moderate susceptibility to infection with T.
      gondii. Plasma tumor necrosis factor alpha (TNF-alpha) levels were elevated in
      both male and female BALB/K mice on days 8 and 10 postinfection, but not
      thereafter, with males producing significantly higher levels than females.
      However, it was not until day 12 postinfection that the first deaths occurred,
      and these were among female mice, indicating that TNF-alpha production was not
      responsible for mortality. In vitro examination of T. gondii-specific T-cell
      proliferative responses from day 15 postinfection onwards revealed significantly
      higher stimulation indices in male mice than in their female counterparts. This
      difference was most apparent in splenocyte cultures initiated at day 15
      postinfection, where complete suppression of proliferation was noted in the
      splenocytes from female mice but not from male mice. Analysis of tissue culture
      supernatants from these cultures revealed distinct differences in the kinetics of
      production as well as the quantities of gamma interferon (IFN-gamma) and
      interleukin 10 (IL-10) produced. Spleen cells from male mice produced higher
      levels of IFN-gamma in the early stages of infection than those from female mice.
      IFN-gamma levels were highest in the supernatants from male splenocyte cultures
      initiated at day 15 postinfection. Similar levels of IFN-gamma were not obtained
      from the supernatants of female splenocyte cultures until day 22 postinfection.
      IL-10 production, on the other hand, peaked at maximal levels in the cell
      cultures from both sexes initiated at day 22 postinfection. These results suggest
      that, in male mice, a rapid response to infection with high levels of TNF-alpha
      and IFN-gamma helps to control parasite multiplication, after which IL-10
      production may be important in down regulating these potentially harmful
      inflammatory mediators. The failure of female mice to respond quickly in terms of
      T-cell proliferation and IFN-gamma production compared with their male
      counterparts may account for their poor survival rates and higher cyst burdens.

PMID- 7790070
TI  - Influence of preimmunization with tetanus toxoid on immune responses to tetanus
      toxin fragment C-guest antigen fusions in a Salmonella vaccine carrier.
AB  - We have previously described a new system for the delivery of recombinant
      antigens in live Salmonella vaccines as genetic fusions to the C terminus of
      fragment C of tetanus toxin (TetC) driven by the anaerobically inducible nirB
      promoter. It has been reported that preimmunization with tetanus toxoid (TT) can
      suppress the antibody response to peptides chemically coupled to TT (epitope
      specific suppression) in both animals and humans, which could interfere with
      efficacy of the Salmonella-TetC delivery system. We report that preimmunization
      of BALB/c mice with TT in alum did not suppress the response to either of two
      protective antigens of Schistosoma mansoni, the full-length S. mansoni P28
      glutathione S-transferase (P28) and a construct consisting of eight tandem copies
      of the protective peptide comprising amino acids 115 to 131 of P28. The guest
      antigens were expressed in the aroA Salmonella typhimurium SL3261 vaccine strain
      as fusions to TetC. Preimmunization with TT 10 weeks before administration of the
      recombinant salmonellae did not alter the antibody response to the full-length
      P28, whereas the response to the peptide comprising amino acids 115 to 131 was
      increased by preimmunization with TT, with the increase seen mainly in the
      immunoglobulin G1 isotype. The antitetanus response was increased by
      preimmunization with TT in all groups receiving salmonellae expressing TetC. The
      results could be important when one is considering the use of the Salmonella-TetC
      delivery system in populations preimmunized with TT.

PMID- 7790071
TI  - Role of Yops in inhibition of phagocytosis and killing of opsonized Yersinia
      enterocolitica by human granulocytes.
AB  - The virulence plasmid of Yersinia enterocolitica codes for the production of the
      outer membrane protein YadA and the secretion of several proteins, called Yops,
      which may play a role in the interaction between granulocytes and this bacterium.
      We investigated whether the expression of YadA or the secretion of Yops affected
      the phagocytosis and killing of opsonized Y. enterocolitica by human
      granulocytes. The rates of phagocytosis and killing of Y. enterocolitica by
      granulocytes in suspension in the presence of rabbit Yersinia antibodies and
      complement were determined by microbiological assays. In addition, noningested
      cell-adherent bacteria were differentiated from ingested yersiniae by
      immunofluorescence microscopy. Plasmid-bearing opsonized Y. enterocolitica was
      able to inhibit phagocytosis and killing by human granulocytes. The inhibition of
      phagocytosis was specific for the plasmid-bearing strain of Y. enterocolitica,
      since granulocytes were still able to phagocytose and kill Staphylococcus aureus
      in the presence of Y. enterocolitica. Plasmid-cured Y. enterocolitica was readily
      phagocytosed and killed by these cells. To investigate the role of YadA or Yops
      in the inhibition of phagocytosis by granulocytes, the phagocytosis of mutant
      strains unable to express YadA or to secrete Yops was studied. A Y.
      enterocolitica mutant unable to secrete Yops lost its ability to inhibit
      phagocytosis; a mutant expressing only YadA was readily ingested by granulocytes.
      These results indicate that after attachment of opsonized Y. enterocolitica to
      granulocytes, Yops play an important role in inhibiting the ingestion of Y.
      enterocolitica by human granulocytes.

PMID- 7790072
TI  - Characterization of a novel Mycobacterium bovis secreted antigen containing PGLTS
      repeats.
AB  - Serum from naturally infected cattle was used to identify a novel Mycobacterium
      bovis antigen from an expression library. The first recombinant product
      identified was a fusion protein with lacZ (55 kDa). A clone containing the whole
      gene was also obtained. This clone expressed a 38-kDa protein. A rabbit serum
      against the recombinant antigen reacts in M. bovis supernatants with two proteins
      of 36 and 34 kDa. The new protein was called P36/P34. The gene cloned has a
      deduced amino acid sequence with a predicted molecular mass of 28 kDa, showing a
      characteristic signal sequence for exportation. The protein bears partial
      homology to a 28-kDa protein from M. leprae. An interesting feature of the
      P36/P34 sequence is that it contains several PGLTS repeats, which are not present
      in the M. leprae protein. Antigenic determinants seem also to be conserved
      between the two proteins because sera from leprosy patients recognized the
      recombinant M. bovis protein. The discrepancy among the molecular mass deduced
      from the sequence (28 kDa), that of the recombinant protein in Escherichia coli
      (38 kDa), and that of the native protein in M. bovis (36 and 34 kDa) could be
      attributed to posttranslational modifications or to the high proline content that
      may alter the migration properties of the protein. This antigen seems to be
      immunodominant during bovine tuberculosis, because 8 of 9 serum specimens from
      diseased cattle are reactive. The homology among the M. leprae 28-kDa protein,
      the protein described in this article, and a recently described M. tuberculosis
      protein suggests the existence of a new protein family in mycobacteria.

PMID- 7790069
TI  - A Streptococcus mutans mutant that synthesizes elevated levels of intracellular
      polysaccharide is hypercariogenic in vivo.
AB  - We used the streptococcal transposon, Tn916 to identify and isolate mutants of
      Streptococcus mutans with altered intracellular polysaccharide (IPS)
      accumulation. We report on the isolation and characterization of S. mutans
      SMS202, a transposon mutant which accumulated the glycogen-like IPS in excess of
      wild-type levels. Southern blot analysis confirmed a single Tn916 insertion into
      the SMS202 chromosome. Moreover, quantitative ultrastructural analysis revealed
      significantly increased concentrations of IPS in SMS202 relative to those of the
      wild-type progenitor strain, UA130. The activities of ADPglucose
      pyrophosphorylase (GlgC) and glycogen synthase (GlgA), enzymes required for the
      biosynthesis of bacterial IPS, were also elevated in the IPS excess mutant.
      Furthermore, SMS202 was significantly more cariogenic on the molar surfaces of
      germ-free rats than the wild type (P < 0.01), thus confirming a central role for
      IPS in S. mutants-induced caries formation. We propose that the increased
      cariogenic potential of SMS202 is due to constitutive expression of genes which
      encode glycogen biosynthesis in this oral pathogen. The coordinate expression of
      GlgC and GlgA along with the results of ongoing nucleotide sequence analysis and
      Northern hybridization experiments support an operon-like arrangement for the glg
      genes of this oral pathogen.

PMID- 7790073
TI  - Vaccination with recombinant heat shock protein 60 from Histoplasma capsulatum
      protects mice against pulmonary histoplasmosis.
AB  - HIS-62 is a glycoprotein that has been isolated from the cell wall and cell
      membrane fraction of the pathogenic fungus Histoplasma capsulatum. It is a target
      of the cellular immune response to this fungus, and it protects mice against a
      lethal intravenous inoculum of H. capsulatum yeast cells. In this study, we
      cloned the gene encoding this antigen to reveal its biological nature and studied
      the immunological activity of recombinant antigen. The amino acid sequences of
      the NH2 terminus and internal peptides were obtained by Edman degradation.
      Degenerate oligonucleotides were used to isolate a gene fragment of HIS-62 by
      PCR. One 680-bp segment that corresponded to the known peptide sequence was
      amplified from H. capsulatum DNA. This DNA was used to screen a genomic library,
      and the full-length gene was isolated and sequenced. The deduced amino acid
      sequence of the gene demonstrated approximately 70 and approximately 50% identity
      to heat shock protein 60 (hsp 60) from Saccharomyces cerevisiae and hsp 60 from
      Escherichia coli, respectively. A cDNA was synthesized by reverse transcription
      PCR and was expressed in E. coli. Recombinant protein reacted with a monospecific
      polyclonal rabbit antiserum raised against native HIS-62, with monoclonal HIS-62
      reactive T cells, and with splenocytes from mice immunized with viable yeast
      cells. Moreover, vaccination with the recombinant protein conferred protection in
      mice against a lethal intranasal inoculation with yeast cells. Thus, HIS-62 is a
      member of the hsp 60 family, and the recombinant hsp 60 is protective against
      pulmonary histoplasmosis in mice.

PMID- 7790074
TI  - Single exposure of mice to Borrelia burgdorferi elicits immunoglobulin G
      antibodies characteristic of secondary immune response without production of
      interleukin-4 by immune T cells.
AB  - Borrelia burgdorferi antigen can elicit immunoglobulins (Igs) characteristic of
      the primary and secondary immune responses without the contribution of an
      interleukin-4-producing helper T-cell population. Single exposure of mice to
      soluble B. burgdorferi antigen elicited both Th1-type and Th2-type antispirochete
      antibodies. Production of the Ig classes showed different patterns with
      increasing time postinjection (IgM levels decreased; IgG1, IgG2a, IgG2b, and IgG3
      levels increased; IgE was not detected), and Ig patterns were similar to those
      produced in infected mice. Upon infectious challenge, immunized mice achieved
      maximal titers of all antispirochete IgG subclasses more quickly than unimmunized
      mice did. In contrast to the antibody responses which showed both Th1- and Th2
      type patterns, T-cell immune response to either immunization or infection was
      characterized by interleukin-2 and gamma interferon production; interleukin-4 and
      interleukin-5 were undetectable. Injection with whole spirochetes induced a
      pattern of antibodies and cytokine production similar to those obtained by
      injection with soluble antigen. In addition, mouse strains of different major
      histocompatibility complex backgrounds produced similar patterns of Ig in
      response to immunization. None of the various parameters of immunization tested
      resulted in detectable interleukin-4 production by primary or secondary immune T
      cells. The production of both IgM and IgG1 at early times following a single
      exposure to spirochete antigen clearly differs from immune responses to haptens
      or model protein antigens. Production of similar Ig classes in infected and
      immune mice implies that antigen-specific antibody is responsible for passive
      immunizing activity found in immune sera.

PMID- 7790075
TI  - Ingestion of acapsular Cryptococcus neoformans occurs via mannose and beta-glucan
      receptors, resulting in cytokine production and increased phagocytosis of the
      encapsulated form.
AB  - Cryptococcus neoformans is a pathogenic yeast and a major cause of opportunistic
      infection in AIDS patients. It is commonly found in an acapsular form in the
      environment, and infection is likely to occur by inhalation. The lung provides a
      suitable environment for capsule synthesis, and once encapsulated, C. neoformans
      becomes resistant to phagocytosis. A stable acapsular mutant of the organism is
      readily ingested by murine macrophages in vitro, indicating entry via
      constitutively competent receptors. We demonstrate in this report that this
      process is inhibitable by particles derived from Saccharomyces cerevisiae that
      are rich in mannan and beta-glucan, as well as more purified forms of these
      glycans. Furthermore, ingestion of the acapsular form of C. neoformans induces a
      range of proinflammatory cytokines, including tumor necrosis factor alpha and
      granulocyte-macrophage colony-stimulating factor, which, as we have previously
      shown, enhance ingestion of serum-opsonized encapsulated C. neoformans in vitro.
      We demonstrate that ingestion of the acapsular form of the organism also enhances
      ingestion of the pathogenic encapsulated form. This is dependent on the
      production of tumor necrosis factor alpha and granulocyte-macrophage colony
      stimulating factor by the macrophages, since addition of neutralizing antibodies
      to both cytokines inhibited the observed increase in ingestion. Together, these
      data demonstrate that ingestion of acapsular C. neoformans is mediated via
      mannose and beta-glucan receptors on the macrophage surface and that this process
      activates macrophages for enhanced phagocytosis of the encapsulated form via
      production of macrophage-derived cytokines.

PMID- 7790077
TI  - Rats clearing a vaginal infection by Candida albicans acquire specific, antibody
      mediated resistance to vaginal reinfection.
AB  - Oophorectomized, estrogen-treated rats were susceptible to experimental vaginal
      infection by Candida albicans. After spontaneous clearing of the primary
      infection, the animals were highly resistant to a second vaginal challenge with
      the fungus. The vaginal fluid of Candida-resistant rats contained antibodies
      directed against mannan constituents and secretory aspartyl proteinase(s) of C.
      albicans and was capable of transferring a degree of anti-Candida protection to
      naive, nonimmunized rats. This passive protection was mediated by the
      immunoglobulin fraction of the vaginal fluid and was substantially abolished by
      preabsorption of the vaginal fluid with C. albicans, but not with Saccharomyces
      cerevisiae, cells. Vaginal anti-mannan antibodies were also produced by active
      immunization with heat-killed cells of C. albicans or with a mannan extract when
      administered via the vaginal route. The protection conferred was comparable to
      that resulting from clearing of the primary infection. In summary, the data
      suggest that acquired anticandidal protection in this vaginitis model is mediated
      at least in part by antibodies, among which those directed against the mannan
      antigen(s) might play a dominant role.

PMID- 7790076
TI  - Characterization of an antiproliferative surface-associated protein from
      Actinobacillus actinomycetemcomitans which can be neutralized by sera from a
      proportion of patients with localized juvenile periodontitis.
AB  - The gentle agitation of suspensions of Actinobacillus actinomycetemcomitans
      serotype a, b, or c in saline resulted in the release of a proteinaceous surface
      associated material (SAM) which produced a dose-dependent inhibition of tritiated
      thymidine incorporation by the osteoblast-like cell line MG63 in culture. This
      cell line was sensitive to low concentrations of SAM (50% inhibitory
      concentration, 200 ng/ml for serotype c). Immunoglobulin G antibodies to
      constituents of the SAM were found in the blood of patients with localized
      juvenile periodontitis (LJP). Sera from 9 of 16 patients with LJP significantly
      neutralized the antiproliferative activity of the SAM, while sera from 15
      controls, with no evidence of periodontal disease, were unable to neutralize this
      activity. Neutralization was not directly related to the patient's antibody titer
      to the whole SAM. Characterization of the antiproliferative activity in the SAM
      demonstrated that it was not cytotoxic and was heat and trypsin sensitive. The
      active component separated in a well-defined peak in anion-exchange high
      performance liquid chromatography (HPLC) which, when further analyzed by size
      exclusion HPLC, revealed a single active peak, which had an apparent molecular
      mass of approximately 8 kDa. The lipopolysaccharide from A. actinomycetemcomitans
      was only weakly active. SAM from Porphyromonas gingivalis W50 and Eikenella
      corrodens NCTC 10596 did not exhibit any antiproliferative activity with this
      cell line, even at concentrations as high as 10 micrograms/ml. This study has
      shown that SAM from A. actinomycetemcomitans contains a potent antiproliferative
      protein whose activity can be neutralized by antibodies in the sera from some
      patients with LJP.

PMID- 7790079
TI  - Effects of the two varieties of Cryptococcus neoformans cells and culture
      filtrate antigens on neutrophil locomotion.
AB  - Cryptococcus neoformans var. gattii (serotype B and C) isolates have a relative
      predilection for immunocompetent hosts, and C. neoformans var. neoformans
      (serotype A and D) isolates have a relative predilection for immunocompromised
      hosts, suggesting that normal host resistance to the former may be relatively
      inefficient compared with that to the latter variety. In order to assess the
      possibility that normal cellular host defense is inadequate in protecting against
      C. neoformans var. gattii, we compared the two varieties of C. neoformans cells
      and their culture filtrate antigens (CneF) with respect to effects on neutrophil
      (polymorphonuclear leukocyte [PMN]) locomotion. In a 48-well modified Boyden
      chamber, the cells and CneF of C. neoformans var. neoformans (serotype A and D)
      isolates stimulated chemotaxis and chemokinesis of human PMN and activated a
      complement component(s) in pooled human serum to become a chemoattractant(s) for
      human PMN. In contrast, the cells and CneF of C. neoformans var. gattii (serotype
      B and C) isolates did not stimulate chemotaxis or chemokinesis in human PMN but
      rather inhibited chemokinesis and chemotactic responses of PMN to pooled human
      serum and formylmethionyl leucyl phenylalanine. Neither of the CneF from the C.
      neoformans var. gattii isolates was cytotoxic to PMN. Furthermore, with the mouse
      model, we found that CneF from C. neoformans var. neoformans caused migration of
      PMN into gelatin sponges implanted in naive and immunized mice, whereas CneF from
      C. neoformans var. gattii inhibited PMN migration into sponges. Our results,
      combined with findings of others showing reduced PMN infiltration in lungs of
      mice infected with C. neoformans var. gattii compared with PMN infiltration in
      lungs of mice infected with C. neoformans var. neoformans, indicate that the
      relative inadequacy of normal host resistance mechanisms to prevent infection
      with C. neoformans var. gattii results, in part, from inhibition of PMN migration
      to the site of the organism.

PMID- 7790078
TI  - Putative glycoprotein and glycolipid polymorphonuclear leukocyte receptors for
      the Actinomyces naeslundii WVU45 fimbrial lectin.
AB  - Recognition of receptors on sialidase-treated polymorphonuclear leukocytes (PMNs)
      by the Gal/GalNAc lectin associated with the type 2 fimbriae of certain strains
      of actinomyces results in activation of the PMNs, phagocytosis, and destruction
      of the bacteria. In the present study, plant lectins were utilized as probes to
      identify putative PMN receptors for the actinomyces lectin. The Gal-reactive
      lectin from Ricinus communis (RCAI), the Gal/GalNAc-reactive lectins from R.
      communis (RCAII) and Bauhinia purpurea (BPA), as well as the Gal beta 1-3GalNAc
      specific lectins from Arachis hypogaea (PNA) and Agaricus bisporus (ABA)
      inhibited killing of Actinomyces naeslundii WVU45 by sialidase-treated PMNs.
      These five lectins detected a 130-kDa surface-labeled glycoprotein on
      nitrocellulose transfers of PMN extracts separated by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis. This glycoprotein was revealed only after
      treatment of the transfers with sialidase, a condition analogous to the sialidase
      dependence of the lectin-mediated biological responses of the PMNs to the
      actinomyces. The mannose-reactive lectin concanavalin A did not inhibit killing
      of the actinomyces and failed to detect the 130-kDa glycoprotein but did block
      PMN-dependent killing of Escherichia coli B, a bacterium that possesses mannose
      sensitive fimbriae. Therefore, the PMN glycoprotein receptor for A. naeslundii is
      clearly distinct from those recognized by E. coli. Two major putative glycolipid
      receptors were also identified by actinomyces and RCAI overlays on sialidase
      treated thin-layer chromatograms of PMN gangliosides. Thus, both a 130-kDa
      glycoprotein and certain gangliosides are implicated in the attachment of the
      actinomyces to PMNs.

PMID- 7790080
TI  - Mucosal immunogenicity of polysaccharides conjugated to a peptide or multiple
      antigen peptide containing T- and B-cell epitopes.
AB  - In this study we investigated the mucosal and systemic responses to two T-cell
      independent polysaccharides, a serogroup f polysaccharide (formed of rhamnose
      glucose polymers [RGPs]) from Streptococcus mutans OMZ 175 and a mannan from
      Saccharomyces cerevisiae, covalently conjugated either to a linear peptide
      (peptide 3) or to a multiple-antigen peptide (MAP), both derived from S. mutans
      protein SR, an adhesin of the I/II protein antigen family of oral streptococci.
      Peptide 3 and MAP, which contained at least one B- and one T-cell epitope, were
      tested as carriers for the polysaccharides and as protective immunogens.
      Intragastric intubation of rats with the conjugates (RGPs-peptide 3, RGPs-MAP,
      mannan-peptide 3, and mannan-MAP) associated with liposomes produced salivary
      immunoglobulin A (IgA) antibodies which reacted with RGPs or mannan, peptide 3 or
      MAP, protein SR, and S. mutans or S. cerevisiae cells. Administration of
      conjugate boosters to the animals showed that both carriers conjugated to the
      polysaccharides were able to induce, in immunized animals, a salivary
      antipolysaccharide IgA memory. In contrast, animals primed and challenged with
      unconjugated polysaccharide showed no anamnestic response. Rats orally immunized
      with the conjugates also developed systemic primary antipolysaccharide and
      antipeptide IgM antibody responses which were characterized by a switch from IgM
      to IgG during the course of the secondary response. Data presented here
      demonstrated that both peptide 3 and the MAP construct can act as good carriers
      for orally administered polysaccharides. Unexpectedly, the use of a MAP did not
      further improve the immunogenicity of polysaccharides at the mucosal level;
      nevertheless, such a construct should be of great interest in overcoming the
      problem of genetic restriction induced by linear peptides.

PMID- 7790081
TI  - A Mycobacterium leprae gene encoding a fibronectin binding protein is used for
      efficient invasion of epithelial cells and Schwann cells.
AB  - Mycobacterium leprae, the causative agent of leprosy, is an obligate
      intracellular pathogen. M. leprae can infect a variety of cells in vivo,
      including epithelial cells, muscle cells, and Schwann cells, in addition to
      macrophages. The ligand-receptor interactions important in the attachment and
      ingestion of M. leprae by these nonmacrophage cells remains unknown. Fibronectin
      (FN) significantly enhances both attachment and ingestion of M. leprae by
      epithelial and Schwann cell lines. We cloned an M. leprae FN binding protein (FN
      attachment protein [FAP]) distinct from the 85ABC complex which has been shown
      previously to bind FN. The FAP open reading frame predicts a protein of 29.5 kDa
      with a 39-amino-acid signal peptide and was previously described as an antigen in
      leprosy patients. M. leprae FAP has homologies in M. vaccae, M. avium, and M.
      tuberculosis, as determined by Southern blotting and direct peptide analysis.
      Both anti-FAP antibodies and an Escherichia coli-expressed recombinant protein
      significantly blocked M. leprae attachment and internalization by T-24, an
      epithelial cell line, and JS1, a Schwann cell line. These data suggest that FN
      can be a bridging opsonic ligand for attachment of mycobacteria to nonphagocytes
      and that FAP plays an important role in this process. This may be an important
      step in the initiation of M. leprae infection in vivo.

PMID- 7790082
TI  - Alternate routes of invasion may affect pathogenesis of Salmonella typhimurium in
      swine.
AB  - Transmission of Salmonella typhimurium in swine is traditionally believed to
      occur by the fecal-oral route, with invasion through the intestinal wall and
      Peyer's patches. However, involvement of the upper respiratory tract may be
      equally important. An esophagotomy was performed on 6- to 8-week-old pigs.
      Esophagotomized pigs were challenged intranasally with 10(9) CFU of S.
      typhimurium cells and necropsied at 3, 6, 12, and 18 h postinoculation (p.i.). By
      3 h p.i., S. typhimurium was recovered from cecum, colon, head, and thoracic
      tissues and from the middle ileum involving a large number of Peyer's patches.
      The ileocolic lymph nodes and ileocolic junction were not positive for S.
      typhimurium until 6 and 12 h p.i., respectively. Additional pigs were inoculated
      transthoracically with 10(9) CFU of S. typhimurium and necropsied at 3 and 18 h
      p.i. By 3 h p.i., all tissues were positive for S. typhimurium. Tonsil explants
      seeded with 10(9) CFU of S. typhimurium indicated that within 6 h p.i., S.
      typhimurium was located within the tonsilar crypts. These data show that after
      intranasal inoculation, S. typhimurium rapidly appears in the gut tissues and
      suggest that the tonsils and lung may be important sites for invasion and
      dissemination of Salmonella species.

PMID- 7790083
TI  - Monoclonal antibodies against Haemophilus lipopolysaccharides: clone DP8 specific
      for Haemophilus ducreyi and clone DH24 binding to lacto-N-neotetraose.
AB  - Mouse monoclonal antibodies (MAbs) DP8 [immunoglobulin G1(kappa)] and DH24
      [immunoglobulin M(kappa)], which are specific for Haemophilus ducreyi
      lipopolysaccharide (LPS), were generated by fusing mouse myeloma NS0 cells with
      spleen cells of BALB/c mice immunized with a total membrane preparation of H.
      ducreyi. MAb DP8 reacted in whole-cell enzyme immunoassay (EIA) and colony dot
      immunoblotting with all 50 strains of H. ducreyi but not with any other bacteria
      tested, which suggests an exposed and species-specific epitope on the H. ducreyi
      cell surface. This conclusion was supported by the finding that DP8 bound to all
      six H. ducreyi LPSs tested but not to any of the Haemophilus influenzae or
      enterobacterial LPSs or synthetic glycoconjugates. The MAb DH24 bound to 43 of 50
      strains of H. ducreyi and to few strains of H. influenzae, Neisseria gonorrhoeae,
      and Neisseria meningitidis, as evaluated by whole-cell EIA and colony dot
      immunoblotting. The MAb DH24 reacted with five of the six H. ducreyi LPSs tested
      and with the lacto-N-neotetraose (Gal beta 1-->4GlcNAc beta 1-->3Gal beta 1-
      >4Glc) series of synthetic glycoconjugates, as determined by EIA. By using
      polysaccharides obtained after both mild acidic hydrolysis and strong alkali
      treatment and dephosphorylated samples as inhibitors of the MAbs binding to H.
      ducreyi LPS antigens, it could be shown that phosphate groups were essential for
      the binding of DP8 to LPS but that they did not affect antigenic recognition by
      DH24. None of the MAbs bound to isolated lipid A, but aggregation caused by the
      fatty acids of lipid A was essential for epitope recognition.

PMID- 7790084
TI  - Helicobacter pylori-induced gastritis in the domestic cat.
AB  - Helicobacter pylori has been cultured from the inflamed gastric mucosae of
      naturally infected cats; the lesions in H. pylori-infected cat stomachs mimic
      many of the features seen in H. pylori-infected human stomachs. To determine
      whether H. pylori-negative specific-pathogen-free cats with normal gastric
      mucosae were susceptible to colonization by this bacterium and whether gastritis
      developed after infections, four H. pylori-negative cats treated with cimetidine
      were orally dosed three times with 3 ml (1.5 x 10(8) CFU/ml) of H. pylori every 4
      days. All four cats became persistently colonized as determined by gastric
      cultures and PCRs from serial gastric biopsy samples and necropsy samples at 7
      months postinfection. H. pylori was not isolated from the two control cats, nor
      were their gastric tissues positive by PCR; one of the two cats had a few focal
      lymphocytic aggregates in the body submucosa, whereas the second cat had a normal
      gastric mucosa. All four H. pylori-infected cats had multifocal gastritis
      consisting of lymphoid aggregates plus multiple large lymphoid nodules, which
      were most noticeable in the antral mucosa. In addition, one H. pylori-infected
      cat had a moderate diffuse infiltration of polymorphonuclear leukocytes in the
      subglandular region of the antrum. H. pylori-like organisms were focally
      distributed in glandular crypts of the antrum. Two of the H. pylori-infected cats
      had significant (eightfold) increases over baseline in levels of immunoglobulin G
      H. pylori serum antibody. The H. pylori isolates from the four experimentally
      infected cats had restriction fragment length polymorphism patterns specific for
      the flaA gene that were identical to those of the inoculating strain. H. pylori
      readily colonizes the cat stomach and produces persistent gastritis.

PMID- 7790085
TI  - Protein Hpn: cloning and characterization of a histidine-rich metal-binding
      polypeptide in Helicobacter pylori and Helicobacter mustelae.
AB  - Helicobacter pylori is a human gastrointestinal pathogen involved in gastritis,
      duodenal ulcers, and gastric neoplasia. This microorganism produces large amounts
      of a urease which, like all known ureases, has nickel in the active site. We have
      identified a protein in clinical isolates of H. pylori and an identical protein
      in the ferret pathogen Helicobacter mustelae that strongly binds Ni2+ and Zn2+.
      This protein has been named Hpn to emphasize its origins in H. pylori and its
      affinity for nickel. The encoding hpn gene, cloned and expressed in Escherichia
      coli ER1793, has an open reading frame (180 bp) that specifies a protein with a
      calculated molecular mass of 7,077 Da and with the same amino-terminal sequence
      as that of wild-type Hpn. The deduced sequence of Hpn consists of 60 amino acids,
      of which 28 (47%) are histidines. The hpn gene does not map with the urease gene
      cluster on the H. pylori chromosome. An Hpn-negative, isogenic H. pylori strain,
      generated by hpn gene deletion and grown on blood agar, had the same urease
      activity that wild-type cells did. Thus, the role of Hpn in helicobacters is
      unknown.

PMID- 7790087
TI  - Enhancement of uptake of lipopolysaccharide in macrophages by the major outer
      membrane protein OmpA of gram-negative bacteria.
AB  - Monoclonal antibodies (MAb) to lipopolysaccharide (LPS) and to the major outer
      membrane protein OmpA from Proteus mirabilis were generated and used to monitor
      the kinetics of uptake in macrophages of LPS as well as LPS bound to OmpA. Uptake
      was measured by a modified enzyme-linked immunosorbent assay (ELISA) in a
      microtiter culture system. The MAb were of various immunoglobulin G subclasses
      and showed strong reactivities with their antigens. Four hybridoma clones
      recognizing LPS and three recognizing OmpA from P. mirabilis 19 were selected for
      the present study on the basis of reactions in ELISA and Western blot
      (immunoblot) analyses. In the uptake assay, it was possible to differentiate
      between antigen on the cell surface and antigen which had been internalized.
      Uptake of LPS by macrophages was relatively rapid during the first 4 h of culture
      and then progressed more slowly over the remaining 24-h observation period. The
      level of detection of LPS in this assay system was in the nanogram range. When
      macrophages were pulsed with LPS for 30 min and subsequently washed to remove
      antigen not bound to the cells, the amount of LPS detectable on the macrophage
      surface decreased progressively for 3 h after the pulse, which indicated
      internalization of the antigen. Thereafter, LPS rose to an increased level on the
      cell surface. The rate of uptake of LPS was more rapid when it was in complex
      with OmpA. When the fate of OmpA was monitored in the same LPS-protein complexes
      by use of MAb to OmpA in a pulse experiment, the level of protein measured on the
      cell surface decreased after an initial rise, which again indicated
      internalization, but the protein did not reappear on the cell surface in a form
      detectable with the MAb. Compared with the LPS monitoring system, detection of
      OmpA associated with macrophages was weak, although the MAb to OmpA reacted
      strongly with the protein in the ELISA and Western blot analyses.

PMID- 7790086
TI  - Heterologous antigen expression in Vibrio cholerae vector strains.
AB  - Live attenuated vector strains of Vibrio cholerae were derived from Peru-2, a
      Peruvian El Tor Inaba strain deleted for the cholera toxin genetic element and
      attRS1 sequences, which was developed as a live, oral vaccine strain. A
      promoterless gene encoding the Shiga-like toxin I B subunit (slt-IB) was inserted
      in the V. cholerae virulence gene irgA by in vivo marker exchange, such that slt
      IB was under transcriptional control of the iron-regulated irgA promoter. slt-IB
      was also placed under transcriptional control of the V. cholerae heat shock
      promoter, htpGp, and introduced into either the irgA or lacZ locus, or both loci,
      on the chromosome of Peru-2, generating JRB10, JRB11, or JRB12, respectively. A
      new technique was used to perform allelic exchange with lacZ. This method uses
      plasmid p6891MCS, a pBR327 derivative containing cloned V. cholerae lacZ, to
      insert markers of interest into the V. cholerae chromosome. Recombinants can be
      detected by simple color screening and antibiotic selection. In vitro
      measurements of Slt-IB produced by the vector strains suggested that expression
      of Slt-IB from the irgA and htpG promoters was synergistic and that two copies of
      the gene for Slt-IB increased expression over a single copy. The V. cholerae
      vectors colonized the gastrointestinal mucosa of rabbits after oral immunization,
      as demonstrated by very high serum antibody responses to V. cholerae antigens.
      Comparison of the serologic responses to the B subunit of cholera toxin (CtxB)
      following orogastric inoculation either with the wild-type C6709 or with Peru-10,
      a strain containing ctxB regulated by htpGp, suggested that both the cholera
      toxin and heat shock promoters were active in vivo, provoking comparable
      immunologic responses. Orogastric inoculation of rabbits with vector strains
      evoked serum immunoglobulin G (IgG) responses to Slt-IB in two of the four
      strains tested; all four strains produced biliary IgA responses. No correlation
      was observed between the type of promoter expressing slt-IB and the level of
      serum IgG or biliary IgA response, but the vector strain containing two copies of
      the gene for slt-IB evoked greater serum IgG responses than strains containing a
      single copy, consistent with the increased expression of Slt-IB from this strain
      observed in vitro. A comparison of the serum and biliary antibody responses to
      Slt-IB expressed from htpGp versus CtxB expressed from the same promoter
      suggested that CtxB is a more effective orally delivered immunogen.

PMID- 7790088
TI  - Characterization of a recombinant pneumolysin and its use as a protein carrier
      for pneumococcal type 18C conjugate vaccines.
AB  - Pneumolysin from Streptococcus pneumoniae was expressed in Escherichia coli as a
      glutathione S-transferase fusion protein and purified by affinity and
      hydroxylapatite chromatography. The purified recombinant pneumolysin (rPL), with
      a molecular mass of 53 kDa, had a specific activity of 3 x 10(5) hemolytic units
      per mg of protein on rabbit erythrocytes and reacted identically in
      immunodiffusion with the antisera against native pneumolysin. The rPL was used as
      a protein carrier to prepare conjugate vaccine with pneumococcal type 18C
      polysaccharide (PS18C). The PS18C was directly coupled to rPL by reductive
      animation or was indirectly coupled to rPL via a spacer molecule, adipic acid
      dihydrazide. The conjugates were nontoxic for mice and guinea pigs at 100
      micrograms per dose. The immunogenicity and protective efficacy of both
      conjugates were tested in mice. A single dose of either of the vaccines elicited
      a rise in immunoglobulin G antibody production; after two booster injections of
      the vaccines, statistically significant booster responses (P < 0.001) to both rPL
      and PS18C were produced. The sera containing the antibodies to rPL were capable
      of neutralizing the hemolytic activity of rPL to rabbit erythrocytes and the
      cytotoxicity of rPL to bovine pulmonary endothelial cells. Immunization with the
      conjugate vaccines conferred statistically significant protection in mice against
      lethal challenge with type 18C pneumococci.

PMID- 7790089
TI  - Antibody response that protects against disseminated candidiasis.
AB  - We previously showed that surface mannans of Candida albicans function as
      adhesins during yeast cell attachment to mouse splenic marginal zone macrophages.
      The mannan adhesin fraction was encapsulated into liposomes and used to vaccinate
      mice over a 5- to 6-week period. Circulating agglutinins specific for the
      fraction correlated with increased resistance to disseminated candidiasis.
      Antiserum from vaccinated animals protected naive BALB/cByJ mice against C.
      albicans serotype A and B strains and Candida tropicalis. Antiserum also
      protected SCID mice against disseminated disease. The serum protective ability
      was stable at 56 degrees C, but this ability was adsorbed by C. albicans cells.
      The antiserum was divided into three fractions after separation by high
      performance liquid chromatography. One fraction contained all of the agglutinin
      activity and transferred resistance to naive mice. A second fraction also
      transferred resistance. Two monoclonal antibodies (MAbs) specific for candidal
      surface determinants were obtained. MAb B6.1 is specific for a mannan epitope in
      the adhesin fraction, and MAb B6 is specific for a different epitope in the
      fraction. Both MAbs are immunoglobulin M, and both strongly agglutinate candidal
      cells, but only MAb B6.1 protected both normal and SCID mice against disseminated
      candidiasis. In one experiment, 10 normal mice were given MAb B6.1 and challenged
      with yeast cells. Six mice survived the 67-day observation period; 4 of the
      survivors were cured as evidenced by the lack of CFU in the kidney and spleen.
      Our studies show that antibodies against certain cell surface antigens of C.
      albicans help the host resist disseminated candidiasis.

PMID- 7790090
TI  - Human peripheral blood CD4+ and CD8+ T cells express Th1-like cytokine mRNA and
      proteins following in vitro stimulation with heat-inactivated Brucella abortus.
AB  - Defining the pattern of lymphokine production associated with Brucella abortus is
      critical for advancing the development of B. abortus as a vaccine carrier. In the
      present study we investigated the ability of heat-inactivated B. abortus or
      lipopolysaccharide from B. abortus to induce lymphokine production from purified
      human T cells in vitro. Gamma interferon (IFN-gamma), interleukin-2 (IL-2), IL-4,
      and IL-5 induction was assayed by mRNA-specific PCR and by enzyme-linked
      immunosorbent assay and bioassay for protein production. Following depletion of
      monocytes and B cells, B. abortus increased IFN-gamma and IL-2 mRNA expression in
      purified T cells compared with expression in unstimulated cells. In contrast, no
      IL-5 mRNA expression and only transient low-level IL-4 mRNA expression and no IL
      4 protein secretion were detected. Phytohemagglutinin or phorbol myristate
      acetate plus ionomycin induced mRNA and protein for all these cytokines. Similar
      results were obtained with LPS purified from B. abortus. Removal of NK cells did
      not reduce lymphokine production, and enriched NK cells did not express IFN-gamma
      mRNA or secrete IFN-gamma protein in response to B. abortus, indicating that NK
      cells were not the responding population. Both CD4+ and CD8+ populations produced
      IFN-gamma and IL-2 in response to B. abortus. Preincubation of resting T cells
      with B. abortus or LPS from B. abortus for 7 days induced their differentiation
      into Th1-like cells as judged by their subsequent lymphokine response to phorbol
      myristate acetate plus ionomycin. These results suggest that B. abortus can
      induce differentiation of Th0 into Th1-type cells.

PMID- 7790092
TI  - Protective vaccination with a recombinant fragment of Clostridium botulinum
      neurotoxin serotype A expressed from a synthetic gene in Escherichia coli.
AB  - A completely synthetic gene encoding fragment C, a approximately 50-kDa fragment,
      of botulinum neurotoxin serotype A was constructed from oligonucleotides. The
      gene was expressed in Escherichia coli, and full-sized product was produced as
      judged by Western blot (immunoblot) analysis. Crude extracts of E. coli
      expressing the gene were used to vaccinate mice and evaluate their survival
      against challenge with active toxin. Mice given three subcutaneous vaccinations
      were protected against an intraperitoneal administration of 10(6) 50% lethal
      doses (ID50) of serotype A toxin. The same mice survived when challenged with 3
      LD50 of botulinum toxin serotype E but died when challenged with 10 LD50 of
      serotype E or 3 LD50 of serotype B. Purified fragment C was compared with the
      botulinum toxoid vaccine in a vaccination and challenge study. Fragment C was as
      efficacious in protecting against challenge with active botulinum neurotoxin
      serotype A as the toxoid vaccine. This recombinant protein product has many
      properties that make it a good candidate for human use to protect against
      botulinum toxin.

PMID- 7790091
TI  - iactA of Listeria ivanovii, although distantly related to Listeria monocytogenes
      actA, restores actin tail formation in an L. monocytogenes actA mutant.
AB  - A gene homologous to the actA gene of Listeria monocytogenes was cloned from
      Listeria ivanovii (strain CLIP257) by chromosome walking starting from the ilo
      gene that encodes the pore-forming toxin ivanolysin. The nucleotide sequence
      revealed that this gene, named iactA, encodes a protein of 1,044 amino acids
      (IactA) comprising a central region with seven highly conserved tandem proline
      rich repeats of 47 amino acids. Although IactA and ActA share an overall similar
      structure, these two proteins are only distantly related. Like ActA, IactA
      migrates aberrantly on sodium dodecyl sulfate gels. When expressed in an L.
      monocytogenes actA deletion mutant strain, iactA restored actin polymerization.

PMID- 7790094
TI  - The Salmonella dublin virulence plasmid mediates systemic but not enteric phases
      of salmonellosis in cattle.
AB  - Plasmid-bearing and plasmid-free isolates and a plasmid-cured strain of
      Salmonella dublin were compared for virulence in calves. The plasmid-bearing
      strains were highly virulent, causing severe enteric and systemic disease with
      high mortality. In contrast, the plasmid-free strains caused diarrhea but only
      low mortality. The infection kinetics of a wild-type and a derivative plasmid
      cured strain were compared. Both strains were isolated in high numbers from
      intestinal sites at 3 and 6 days after oral challenge and were isolated at
      comparable frequencies from systemic sites at 3 days, but not at 6 days, when the
      wild-type strain was predominant. The strains were equally invasive in intestinal
      epithelia with and without Peyer's patch and elicited comparable secretory and
      inflammatory responses and intestinal pathology in ligated ileal loops. The
      effect of the virulence plasmid on growth kinetics and on the outer membrane
      protein profile was assessed in an in vivo growth chamber. The virulence plasmid
      did not influence either extracellular growth or the expression of major outer
      membrane proteins. These observations demonstrate that the virulence plasmid is
      not involved in either the enteric phase of infection or the systemic
      dissemination of S. dublin but probably mediates the persistence of S. dublin at
      systemic sites.

PMID- 7790093
TI  - Characterization of intestinal invasion by Salmonella typhimurium and Salmonella
      dublin and effect of a mutation in the invH gene.
AB  - The relative levels of invasiveness of two bovine isolates each of Salmonella
      typhimurium and Salmonella dublin and of invH mutants of S. typhimurium were
      determined in MDCK and Int 407 cultured-cell assays and in bovine ileal loops. S.
      dublin was found to be significantly less invasive in cultured cells than S.
      typhimurium, but this difference was not observed in bovine intestines. The invH
      mutants exhibited a significant reduction in invasion in both cultured cells and
      bovine intestines. The invasive phenotypes of the strains were confirmed by
      fluorescent microscopy and scanning and transmission electron microscopy. The
      wild-type strains were observed in the laminae propriae of the intestinal villi,
      while in contrast the invH mutants were generally associated with the enterocyte
      layer. The degree of damage in the bovine ileum was related to the magnitude of
      the invasion. There was no difference in the amount of S. typhimurium or S.
      dublin recovered from the bovine ileum either with or without Peyer's patches 3 h
      after inoculation of the loop.

PMID- 7790095
TI  - Protection against local Shigella sonnei infection in mice by parenteral
      immunization with a nucleoprotein subcellular vaccine.
AB  - Nucleoprotein subcellular (NPS) vaccine, consisting of ribosome-bound O
      polysaccharide, was prepared from avirulent Shigella sonnei. NPS vaccine was
      tested for safety and protective activity in the mouse intranasal challenge model
      of Shigella infection. The vaccine was nontoxic when injected in doses up to
      10,000 micrograms, and a single subcutaneous injection of as little as 0.1
      micrograms gave significant protection against a lethal intranasal challenge with
      S. sonnei. These data demonstrate the induction of local protective immunity by
      parenteral immunization, support the concept of the ribosome as a potent vaccine
      vector, and give additional evidence for the protective activity of the NPS
      vaccine against Shigella infection.

PMID- 7790097
TI  - Salmonella typhimurium displays normal invasion of mice with defective epidermal
      growth factor receptors.
AB  - The role of the epidermal growth factor (EGF) receptor in cell invasion by
      Salmonella typhimurium was examined in vitro and in vivo by using waved-2 mice
      which express an EGF receptor with reduced kinase activity. S. typhimurium
      invaded fibroblasts from waved-2 mice as efficiently as fibroblasts from wild
      type control animals. In vivo, S. typhimurium both invaded the gastrointestinal
      tract and penetrated through to the spleen of waved-2 mice. Our studies suggest
      that the EGF receptor has only a limited role, if any, in cell invasion by S.
      typhimurium.

PMID- 7790096
TI  - Shiga toxin-associated hemolytic uremic syndrome: effect of sodium butyrate on
      sensitivity of human umbilical vein endothelial cells to Shiga toxin.
AB  - Escherichia coli O157:H7-related vascular damage such as hemolytic uremic
      syndrome is believed to require the Shiga-like toxins. This study demonstrated
      that sodium butyrate sensitized human umbilical vein endothelial cells to Shiga
      toxin and increased the expression of Shiga toxin receptor, globotriaosylceramide
      (Gb3), on human umbilical vein endothelial cells.

PMID- 7790098
TI  - Phenotypic modulation of gonococcal lipooligosaccharide in acidic and alkaline
      culture.
AB  - Neisseria gonorrhoeae infects a diverse array of niches in its human host, which
      expose the organism to dramatic variations in pH. We examined growth and
      lipooligosaccharide expression of two gonococcal strains in liquid and solid
      cultures under acidic, neutral, and alkaline conditions. Growth rates in broth
      were similar under the three conditions, and the pH remained fairly constant
      throughout the growth cycle. Altered lipooligosaccharide expression at the
      different pHs was noted in both plate- and broth-grown organisms.

PMID- 7790099
TI  - Different forms of streptolysin O produced by Streptococcus pyogenes and by
      Escherichia coli expressing recombinant toxin: cleavage by streptococcal cysteine
      protease.
AB  - To resolve apparent discrepancies in the literature, N-terminal sequences of the
      active high- and low-molecular-weight (high- and low-M(r)) forms of native
      streptolysin O (nSLO) purified from Streptococcus pyogenes culture supernatants
      and of the similar-size high- and low-M(r) forms of recombinant SLO (rSLO) found
      in the periplasm of Escherichia coli expressing a cloned slo gene were
      determined. The high-M(r) forms of nSLO and rSLO are identical, reflecting
      removal of a 31-residue signal peptide, but the similar-size low-M(r) forms are
      very different. Removal of C-terminal sequences by proteases in the E. coli
      periplasm produces an inactive low-M(r) form of rSLO. In contrast, an active low
      M(r) form of nSLO is produced by proteolytic cleavage between the N-terminal
      residues Lys-77 and Leu-78, which was shown to correspond to an extremely
      sensitive cleavage site for the pyrogenic exotoxin B-derived streptococcal
      cysteine protease.

PMID- 7790100
TI  - Directed genomic integration in Actinobacillus actinomycetemcomitans: generation
      of defined leukotoxin-negative mutants.
AB  - To develop targeted gene integration in the periodontal pathogen Actinobacillus
      actinomycetemcomitans, a ColE1-based, spectinomycin-resistant plasmid containing
      a segment of the leukotoxin gene was electroporated into strain JP2. In all of
      the stable spectinomycin-resistant transformants that arose, the plasmid had
      recombined into the genomic leukotoxin locus since ColE1-based vectors cannot
      replicate extrachromosomally in A. actinomycetemcomitans. Directed genomic
      integration was then used to construct a leukotoxin-negative strain by
      transforming the leukotoxin-producing strain JP2 with a ColE1-based plasmid
      containing an internal fragment of the leukotoxin gene. Cytotoxicity assays
      proved that these transformants had < 0.1% of the leukotoxin activity of the
      parental strain. These results demonstrate that integration-based approaches can
      be used for generating isogenic mutants in specific virulence genes in A.
      actinomycetemcomitans.

PMID- 7790101
TI  - Characterization of the human immunoglobulin G Fc-binding activity in Prevotella
      intermedia.
AB  - Many pathogenic bacteria possess cell surface receptors which can bind
      immunoglobulins via the Fc portion. The aim of this study was to characterize the
      human immunoglobulin G (IgG) Fc-binding activity of Prevotella intermedia, a
      suspected etiologic agent of adult chronic periodontitis. The Fc-binding activity
      of P. intermedia on whole cells and on extracellular vesicles was demonstrated.
      Incubation of P. intermedia cells in the presence of Zwittergent 3-14 allowed
      complete solubilization of the Fc receptor from the cell surface. This cell
      envelope extract was thus used to characterize the Fc-binding activity. A
      microtiter plate assay using alkaline phosphatase-labeled Fc fragments showed
      that preincubation of the cell envelope extract with human IgG, human IgG Fc
      fragments, or human serum completely inhibited the Fc-binding activity. Partial
      inhibition was obtained with human IgG F(ab')2 fragments, whereas no inhibition
      occurred following preincubation with human IgA, carbohydrates, and selected
      proteins. Preincubation of the cell envelope extract with IgG from a variety of
      animals demonstrated that rabbit, mouse, rat, goat, and sheep IgG did not inhibit
      Fc-binding activity, whereas cow, pig, and dog IgG partially inhibited Fc-binding
      activity. A strong inhibition comparable to that obtained with human IgG was
      noted with monkey IgG. The Fc receptor of P. intermedia is thus different from
      the six types previously reported in other nonoral bacteria. Polyacrylamide gel
      electrophoresis and Western blotting (immunoblotting) analysis of the cell
      envelope extract revealed a major band with a molecular mass of approximately 65
      kDa which reacted with peroxidase-labeled human IgG Fe fragments. Transmission
      electron microscopy showed a uniform distribution of the Fc receptor on the
      bacterial surface, as revealed by gold labeling. The Fc-binding activity
      demonstrated in this study may act as an additional virulence factor for P.
      intermedia by reducing IgG reactions with the bacterial cell.

PMID- 7790102
TI  - Role of interleukin-6 in T-cell activation during primary and secondary infection
      with Listeria monocytogenes.
AB  - Injection of recombinant interleukin-6 (IL-6) into mice enhances recovery from
      infection with Listeria monocytogenes. In this study, the role of IL-6 during
      primary and secondary Listeria infection was further tested. Neutralization of IL
      6 by polyclonal antibody exacerbated primary infection and significantly delayed
      gamma interferon production by cultured spleen cells. In contrast, administration
      of anti-IL-6 antibody at the time of secondary infection did not affect the
      recovery of mice from infection or gamma interferon production, showing that
      activated T cells are not dependent on IL-6.

PMID- 7790103
TI  - Enhancement of macrophage microbicidal activity: supplemental arginine and
      citrulline augment nitric oxide production in murine peritoneal macrophages and
      promote intracellular killing of Trypanosoma cruzi.
AB  - The generation of nitric oxide (NO) is largely responsible for the intracellular
      killing of Trypanosoma cruzi by activated macrophages. The present study was
      carried out to determine whether the production of NO by activated murine
      macrophages cultured in physiologic levels of arginine can be augmented by
      increasing the availability of arginine, the substrate for NO biosynthesis.
      Increased exogenous arginine or citrulline resulted in a significant increase in
      NO production and complete clearance of the parasites by activated macrophages.
      As citrulline fully substituted for arginine in supporting NO production and
      trypanocidal activity, these results demonstrate the expression of a highly
      active citrulline-NO cycle in activated macrophages and that levels of arginine
      in plasma are limiting with respect to both NO production and trypanocidal
      activity in these cells. The results indicate that increasing plasma substrate
      levels for both arginine and NO biosynthesis may represent a means of enhancing
      microbicidal activity in vivo.

PMID- 7790104
TI  - Cloning and characterization of a protective outer membrane lipoprotein of
      Actinobacillus pleuropneumoniae serotype 5.
AB  - The gene encoding an outer membrane lipoprotein (omlA) of Actinobacillus
      pleuropneumoniae serotype 5 was cloned, and the protein was expressed in
      Escherichia coli. One open reading frame of 1,104 bp was detected that encoded a
      protein (OmlA) with a predicted molecular mass of 40 kDa. A comparison with the
      omlA gene and the corresponding protein of A. pleuropneumoniae serotype 1 (G.-F.
      Gerlach, C. Anderson, S. Klashinsky, A. Rossi-Kampos, A.A. Potter, and P.J.
      Wilson, Infect. Immun. 61:565-572, 1993) revealed that the nucleic acid sequences
      had an overall sequence identity of 62.9% and the deduced amino acid sequences
      showed a sequence agreement of 57.3%. Both proteins were antigenically distinct.
      In a Western blot (immunoblot) analysis using a specific antiserum against A.
      pleuropneumoniae serotype 5 OmlA, a homologous protein was detected in the
      reference strains of A. pleuropneumoniae serotypes 5A, 5B, and 10. Pigs immunized
      with this recombinant protein were protected from death in an aerosol challenge
      experiment with an A. pleuropneumoniae serotype 5 isolate.

PMID- 7790105
TI  - Inhibition of Chlamydia pneumoniae growth in HEp-2 cells pretreated with gamma
      interferon and tumor necrosis factor alpha.
AB  - An in vitro culture system was used to study the effects of increasing
      concentrations of human cytokines on the intracellular replication of Chlamydia
      pneumoniae. HEp-2 cell monolayers, pretreated for 24 h with 200 U of human
      recombinant gamma interferon (IFN-gamma) per ml restricted the intracellular
      replication of C. pneumoniae. Tumor necrosis factor alpha (TNF-alpha; 25 ng/ml)
      exhibited a synergistic effect with IFN-gamma by reducing the concentration of
      IFN-gamma necessary to restrict intracellular growth to 100 U/ml. The addition of
      200 micrograms of tryptophan per ml significantly reversed the inhibitory effects
      of IFN-gamma and TNF-alpha, suggesting involvement of the indoleamine-2,3
      dioxygenase pathway in the restriction process.

PMID- 7790106
TI  - Melanoma and use of sunscreens: an Eortc case-control study in Germany, Belgium
      and France. The EORTC Melanoma Cooperative Group.
AB  - Use of sunscreens is widely advocated as a preventive measure against sun-induced
      skin cancers. However, to date, no epidemiologic study has reported a decreased
      melanoma risk associated with sunscreen use. We have conducted a case-control
      study aimed at evaluating the influence of sunscreen use on the occurrence of
      cutaneous malignant melanoma. In 1991 and 1992, 418 melanoma cases and 438
      healthy controls were interviewed in Germany, France and Belgium. The
      questionnaire used differentiated between regular sunscreens, psoralen sunscreen
      (prepared with 5-methoxypsoralen, a tanning activator and photocarcinogen), and
      self-tanning cosmetics (which produce a tan without ultraviolet radiation). After
      adjusting for age, sex, hair colour and holiday weeks spent each year in sunny
      resorts, the melanoma risk was of 1.50 (95% Cl:1.09-2.06) for regular sunscreens,
      and of 2.28 (95% Cl: 1.28-4.04) for psoralen sunscreens. No melanoma risk was
      associated with use of self-tanning cosmetics. Among subjects with a poor ability
      to tan, psoralen sunscreen users displayed a melanoma risk of 4.45 (95% Cl: 1.25
      15.8) when compared with regular sunscreen users. There was a significant
      negative interaction between regular sunscreen use and sunburns experienced in
      adulthood. Use of sunscreens, especially psoralen sunscreen, was associated with
      higher density of pigmented lesions of the skin. Although we cannot exclude the
      presence of an unknown confounding factor, our results support the hypothesis
      that sunscreens do not protect against melanoma, probably because of their
      ability to delay or avoid sunburn episodes, which may allow prolonged exposure to
      unfiltered ultraviolet radiation. Serious doubts are raised regarding the safety
      of sunscreens containing psoralens.

PMID- 7790108
TI  - Trends in incidence of testicular cancer in boys and adolescent men.
AB  - Several epidemiological studies have described increasing trends over time in the
      incidence of testicular cancer in adult men. Less attention has been given to the
      trends in young boys, adolescents and old men. This paper describes the incidence
      of testicular cancer in young boys (0-4 years) and adolescents (15-19 years) in
      Denmark, Norway and Sweden, and compares these trends with the corresponding data
      on adults. Although only small numbers were available, the data suggest that the
      incidence of testicular cancer in young boys has been constant, at a level around
      0.5 per 100,000. This observation lends support to the idea that testicular
      cancer in young boys is aetiologically distinct from testicular cancer in adults.
      In all three populations we found a particularly high average annual increase in
      the incidence of testicular cancer in adolescents (around 6% per year). It is
      proposed that this increase is mainly caused by a secular trend towards earlier
      age at puberty.

PMID- 7790107
TI  - High incidence of BK virus large-T-antigen-coding sequences in normal human
      tissues and tumors of different histotypes.
AB  - T-antigen (TAg) coding sequences specific for BK virus (BKV) were detected, by
      PCR amplification followed by Southern-blot hybridization, in a high percentage
      of human tumors and tumor-cell lines, as well as in normal tissues, by analysis
      of 189 specimens. Specifically, the BKV early region was detected in 85% of brain
      tumors and in all normal brain tissues, in 78% of osteosarcomas, in 38% of
      Ewing's tumors, in 40% of normal bone specimens and in 71% of normal peripheral
      blood cell samples. Wilms' tumor tissues used as a control were all negative for
      BKV sequences. RT-PCR analysis indicated that TAg coding sequences were expressed
      in specimens carrying BKV early region, ranging from 64% of the osteosarcomas to
      100% of glioblastomas, Ewing's tumors, peripheral blood cells and normal bone.
      Moreover, DNA sequencing performed in 12 different positive samples revealed that
      the amplified PCR products are identical to the early-region sequence of wild
      type BKV. The role of BKV TAg and its possible mechanism of action in human
      tumorigenesis are discussed.

PMID- 7790109
TI  - Alterations in the signal-transducing molecules of T cells and NK cells in
      colorectal tumor-infiltrating, gut mucosal and peripheral lymphocytes:
      correlation with the stage of the disease.
AB  - T cells from mice bearing an experimental colon carcinoma, and from patients with
      colorectal and renal carcinomas, have atypical T-cell receptors (TCR). In the
      present study, further characterization of modulations in CD3- and CD16
      associated zeta chain in peripheral blood lymphocytes (PBL) and tumor
      infiltrating lymphocytes (TIL) from colorectal carcinomas was performed. Relative
      to PBL, the percentage of natural killer (NK) cells among fresh TIL was reduced,
      while a higher proportion of T cells expressing HLA-DR was found. As previously
      reported, we found significantly reduced levels of the CD3- and CD16-associated
      zeta chain in TIL and, to a lesser extent, also in patients' PBL. Levels of zeta
      chain in T and NK cells from non-cancerous colorectal tissue from patients were
      lower than in PBL but higher than in TIL, with a direct relationship between
      levels of this signal-transducing molecule and the distance from the tumor. In
      addition, zeta levels correlated with the Dukes' stage of the disease, since PBL
      from patients with lymph-node involvement or distant organ metastases (Dukes'
      stages C and D) had significantly less CD3 zeta than patients with localized
      disease (stages A and B). Patients' T cells also had decreased levels of cell
      surface and cytoplasmic CD3 epsilon. We also observed reduced levels of the TCR
      accessory molecules CD4 and CD8, mainly on TIL but to a lesser extent also on
      patients' PBL. Biochemical analysis of anti-CD3 epsilon-immunoprecipitated TCR
      complexes demonstrated that the CD3 complex was not associated with the zeta
      chain, either on TIL or on PBL or on lymphocytes from non-cancerous colon tissue,
      suggesting a defect in the assembly of the TCR complex. Following several days of
      in vitro culture with recombinant interleukin-2 and phytohemagglutinin, anti-CD3
      or anti-CD2 monoclonal antibodies (MAbs), levels of CD3 zeta chain as well as of
      cell surface CD3 epsilon were normalized. Our findings suggest an abnormal
      expression as well as assembly of several different signal-transducing molecules
      of T cells and NK cells, which correlate with the stage of the disease in
      patients with colorectal carcinomas.

PMID- 7790110
TI  - Risks of second primary malignancy in patients with cutaneous and ocular melanoma
      in Denmark, 1943-1989.
AB  - Risks of 2nd primary cancer were assessed in all patients with cutaneous melanoma
      (12,460) and all patients with ocular melanoma (2,018) incident in Denmark from
      1943 to 1989 and followed for totals of 88,667 person-years and 16,045 person
      years, respectively. After cutaneous melanoma, 972 2nd cancers occurred. The risk
      of non-melanoma skin cancer was significantly raised in each sex. Risk of all non
      skin cancers was not raised for all ages but was significantly increased for
      patients with the primary melanoma incident at ages under 50 years (standardised
      incidence ratio [SIR], i.e., ratio of observed to expected cancer incidence,
      multiplied by 100 = 117; 95% confidence interval [CI] 101-134). There were
      significantly increased risks of chronic lymphocytic leukaemia in males and both
      sexes combined, brain and nervous system cancers in females and both sexes
      combined and oropharyngeal cancer in both sexes combined. Risk of pancreatic
      cancer was not raised, suggesting that cutaneous melanoma patients generally do
      not share the diathesis for this malignancy which has been observed in certain
      families with atypical naevi and melanoma. There was no relation of 2nd primary
      cancer risks to duration since the first primary and no indication of any
      appreciable treatment-related risk. After ocular melanoma, 216 2nd cancers
      occurred. There was a significantly increased risk of 2nd cancer overall in males
      but not females and a significantly increased risk of liver cancer in each sex.
      Risk of non-melanoma skin cancer (NMSC) was not raised, which suggests that the
      aetiology of ocular melanoma is not mainly dependent on UV exposure, at least of
      the type causing NMSC.

PMID- 7790111
TI  - Selective cytokine gene expression in renal cell carcinoma tumor cells and tumor
      infiltrating lymphocytes.
AB  - The progression of tumors such as renal cell carcinoma (RCC), despite the
      presence of substantial lymphocytic infiltrates (TIL), suggests that the ability
      of the local immune response to control tumor growth is impaired. Cytokine gene
      expression was examined to further investigate the nature of this response.
      Initial studies were performed with frozen tumors using PCR-assisted mRNA
      amplification with cytokine-specific primers for interleukin 10 (IL-10),
      interleukin 2 (IL-2) and interferon-gamma (IFN-gamma). IL-2 mRNA was not
      detected, despite the presence of T cells as defined by the expression of CD3
      gamma mRNA. In contrast, mRNA for IFN-gamma was expressed in 4/9 and for IL-10 in
      5/9 tumors. To confirm this, 5 fresh tumor specimens were examined, and PCR
      demonstrated that IL-10 mRNA was detectable in 4/5 tumors from which RNA was
      isolated at the time of nephrectomy. In these experiments multiple cycles and
      dilutions were employed to semi-quantitate the expression of IL-10. To identify
      potential sources of this cytokine in the tumor bed, IL-10 mRNA expression in
      freshly isolated lymphocytes and tumor cells, TIL lines, cultured RCC and
      established RCC lines was examined. Our studies demonstrate that within the tumor
      TIL may be one source of IL-10. Lymphocyte-enriched populations from 4/5 tumors
      expressed IL-10 mRNA as did 4/6 freshly isolated tumor cell preparations. IL-10
      gene expression was not detected, however, in tumor cells after one passage in
      vitro in short-term cultured RCC tumor cells (passages 2-5) or in established RCC
      tumor cell lines. Finally, 4/9 CD4+ and 2/5 CD8+ TIL lines expressed IL-10 mRNA
      either constitutively or after stimulation with anti-CD3 antibody. This finding
      was associated with IL-10 production in vitro. Our studies demonstrate that IL-10
      mRNA is frequently present in RCC tumors and may originate from the tumor
      infiltrating mononuclear cell population.

PMID- 7790112
TI  - Substance-P receptors in human primary neoplasms: tumoral and vascular
      localization.
AB  - Primary human neoplasms were examined for the presence of substance-P receptors
      by receptor autoradiography with 125I-labelled Bolton-Hunter substance P.
      Substance-P receptors were localized and characterized in the neoplastic cells of
      9/12 astrocytomas, 10/10 glioblastomas, 10/12 medullary thyroid carcinomas, 8/16
      breast carcinomas and 4/5 ganglioneuroblastomas. Conversely, substance-P
      receptors were not or only rarely identified on non-small-cell carcinomas of the
      lung (1/16), neuroblastomas (0/8), adenocarcinomas of the colon (1/21) or the
      pancreas (1/9), or on malignant lymphomas (3/18). However, in the great majority
      of the investigated tumours, substance-P receptors were found on intra- and
      peritumoral blood vessels. All substance-P receptors detected had the
      pharmacological characteristics of the neurokinin-I receptor sub-type. In
      addition, the expression of somatostatin receptors was examined in all the
      neoplastic tissues mentioned above. Both substance-P and somatostatin receptors
      were present in astrocytomas and in ganglioneuroblastomas, whereas little or no
      receptor was found in pancreatic and non-small-cell lung carcinomas. The extent
      of somatostatin-receptor expression was inversely correlated to that of the
      substance-P receptors in glioblastomas, neuroblastomas and non-Hodgkin's
      lymphomas. The tumoral and vascular localization of substance-P receptors in
      tumours may have clinical implications. The use of radiolabelled substance P for
      in vivo scintigraphy may supplement the current set of diagnostic tools.
      Substance-P antagonists might be used in the treatment of tumours, as their
      binding to vascular receptors may decrease tumoral blood supply and drainage.

PMID- 7790113
TI  - Cytogenetic findings in malignant peripheral nerve sheath tumors.
AB  - Clonal chromosome aberrations were detected in 8 short-term cultured malignant
      peripheral nerve sheath tumors (MPNST). Seven had a near-triploid chromosome
      number and I was in the hyperhaploid-hypodiploid range. No recurrent structural
      rearrangements were found; the bands most frequently involved (3 tumors) were
      7p11, 12p13 and 14q11. The most common numerical changes were loss of a sex
      chromosome (all tumors) and loss of at least 1 copy of chromosomes 8, 16 and 22
      (4 tumors). Pooling our data with those on the 20 previously published MPNST with
      abnormal karyotypes, we found that the chromosome number has often been in the
      triploid range (12 tumors), with stem line variation between 34 and 270. All
      chromosome arms, except 22p and the Y chromosome, were involved in
      recombinations. The most frequently rearranged bands were 7p22 (6 tumors) and
      1p21, 7p11 and 14q11 (5 tumors each). Most numerical and unbalanced structural
      aberrations have led to loss of genetic material, in particular from Xq26-qter
      (13 tumors); 11q22-qter and 13p (12 tumors); 9p22-pter, 11p13-pter, 17p and 17q11
      21 (11 tumors); 1p22-32 and 1p34-pter (10 tumors) and 6q25-qter and chromosome 16
      (9 tumors).

PMID- 7790114
TI  - Inhibition of 3'-methyl-4-dimethylaminoazobenzene-induced hepatocarcinogenesis in
      rat by dietary beta-carotene: changes in hepatic anti-oxidant defense enzyme
      levels.
AB  - The dietary administration of beta-carotene (BC) daily has been found to be
      highly effective in reducing hepatocarcinogenesis in male Sprague-Dawley rats fed
      3'-methyl-4-dimethylaminoazobenzene (3'-Met-DAB). The anti-cancer efficacy of BC
      was evaluated by estimating some possible pre-neoplastic and neoplastic hepatic
      anti-oxidant markers such as glutathione (GSH) and related enzymes, namely
      glutathione S-transferases (GSHT, with varying substrate specificities), gamma
      glutamyl transpeptidase (GGT), glutathione peroxidase (GPX) and reductase. BC
      proved to be an effective anti-neoplastic substance in long-term treatment.
      Furthermore, BC limited the exponential increase of GSH, GGT, GSH-T and GPX both
      in the hyperplastic nodules (HNs) and surrounding liver (NNSP) areas compared
      with carcinogen control (3'-Met-DAB) rats during long-term treatment. Early
      marginal changes in GSH, GGT and GSHT (with 1-chloro-2,4-dinitrobenzene as a
      substrate) activities in BC-treated groups for 10 days compared with carcinogen
      (3'-Met-DAB once) control rats entail the participation of BC in the initial
      stages of hepatocarcinogenesis. A decrease in the number of hyperplastic nodules
      and the total liver parenchyma they occupy was observed in BC-treated groups. HNs
      and NNSP liver areas are directly correlated with hepatic BC and vitamin A
      content and with rates and patterns of hepatic anti-oxidant defense enzymes. Our
      results confirm that BC is protective in limiting the action of 3'-Met-DAB during
      the initiation phase of hepatocarcinogenesis.

PMID- 7790115
TI  - Vitamin-D3 derivatives and breast-tumor cell growth: effect on intracellular
      calcium and apoptosis.
AB  - Vitamin-D3 derivatives are now well-recognized growth inhibitors of numerous
      tumoral cells and in particular breast-cancer cells. However, the mechanisms by
      which they operate are not well established. Among the wide range of
      physiological and biological functions of vitamin-D3 derivatives, the best
      described include their action on calcium homeostasis. In this study, we sought
      to establish whether the effects of vitamin-D3 derivatives on breast-cancer cell
      growth may be in part related to intracellular calcium modulation and induction
      of apoptosis. To address these questions, we used, in addition to 1,25(OH)2D3,
      the active metabolite of vitamin D3, a non-calcemic 1,25(OH)2D3 derivative: Ro 23
      7553 [16-ene-23-yne-1,25(OH)2D3], which in our hands was more potent than the
      parent compound in inhibiting breast-cancer cell growth. We showed that the
      efficiency of both compounds in growth inhibition was higher in the estradiol
      receptor-positive-breast-tumor MCF-7 cells than in the estradiol-receptor
      negative MDA-MB 231 cells. In MCF-7 cells in particular, important modifications
      of intracellular calcium related to the emptying of intracellular pools were
      observed. The depletion of Ca++ from intracellular stores was followed by the
      induction of apoptosis. Such a phenomenon was never observed in MDA-MB 231 cells.
      Our results suggest that the action of vitamin-D3 derivatives on the depletion of
      calcium stores, which was more significant in MCF-7 than in MDA-MB 231 cells, may
      induce apoptosis in the former cells and account for the high efficiency of
      vitamin-D3 derivatives on growth inhibition of MCF-7 breast-tumor cells.

PMID- 7790116
TI  - Reduction of EGP-2-positive pulmonary metastases by bispecific-antibody
      redirected T cells in an immunocompetent rat model.
AB  - Effectiveness of bispecific-monoclonal-antibody (BsMAb)-mediated cellular anti
      tumour activity was evaluated in vitro and in vivo in relation to the additional
      need for T-cell activation in a new immunocompetent rat tumour model. L37 tumour
      cells, derived from a squamous-cell carcinoma of the lung of Wag/Rij rats, were
      transfected with the cDNA coding for the human 38-kDa transmembrane pan-carcinoma
      associated antigen EGP-2. Intravenous inoculation of EGP-2-positive L37 cells
      resulted in a rapid outgrowth of EGP-2-positive tumour nodules in the lungs. A
      BsMAb BIS-19, recognizing EGP-2 on the transfected tumour cells and the T-cell
      receptor of the rat, was made and allowed specific lysis of EGP-2-transfected L37
      tumour cells by activated rat T lymphocytes in vitro. In vivo T-cell activation,
      assessed by up-regulation of IL-2-receptor expression, could be induced by daily
      injection of rat rIL-2. Intravenous treatment of tumour-bearing EGP-2-positive
      L37 tumour with BIS-19 together with rat rIL-2 resulted in almost complete
      disappearance of established tumour. In contrast, animals treated with BIS-19
      alone, IL-2 alone or a combination of anti-EGP-2, anti-TcR and IL-2 showed much
      less or no tumour reduction. These results show effectiveness of systemic
      treatment with BsMAbs to induce anti-tumour activity in established tumours.
      Immune activation prior to or during treatment with BsMAbs, as achieved with IL
      2, appears to be a prerequisite for successful treatment.

PMID- 7790117
TI  - Integrin expression on colorectal tumor cells growing as monolayers, as
      multicellular tumor spheroids, or in nude mice.
AB  - In this study we compared the expression of integrin alpha chains 2, 3, 4, 5, 6,
      v and the beta chains 1, 3, 4 in 2 colorectal carcinoma cell lines (HRT-18 and CX
      2), growing in confluent and subconfluent monolayer cultures, as multicellular
      tumor spheroids and in nude mice, using the immunofluorescence technique
      (confocal microscopy) and flow cytometry. The fast-growing cell line HRT-18
      expressed, in confluent and subconfluent monolayer cultures, alpha 2, 3 and beta
      1 with a continuous membranous staining pattern, whereas alpha v, alpha 6, and
      beta 4 were expressed continuously membranous in the intermediate and apical part
      of the cell layer, and clustered at focal contacts at the base of the cells. In
      spheroids and tumors of nude mice the focal pattern of alpha v, 6 and beta 4 was
      changed into a diffuse one. Using flow cytometry, the expression of alpha 3 was
      found to be reduced in spheroids of HRT-18. The slowly-growing cell line CX-2
      expressed, under the same conditions in monolayer culture, alpha 6, beta 1 and
      beta 4, and very weakly alpha 2, 3, 5 and v. Alpha 3 was expressed in spheroids
      of CX-2 only at the outer rim where the cells proliferate. In contrast, alpha 2
      and 5 were expressed mainly in the quiescent, non-proliferating area. Alpha 6 was
      reduced in spheroids of CX-2. In the nude mouse tumor of CX-2, alpha 5 was
      expressed only focally and very weakly, alpha 2 was no longer detectable, but
      alpha v appeared to be enhanced in a focal pattern. These data indicate that
      integrin expression of tumor cells depends upon the culture system and that
      integrin expression in multicellular tumor spheroids is more similar to the in
      vivo situation in nude mouse tumors.

PMID- 7790118
TI  - Presence of the bcl-2 protein and apoptosis in non-Hodgkin lymphomas with diffuse
      growth pattern.
AB  - In an attempt to further clarify the role of the apoptosis-counteracting protein
      bcl-2, non-Hodgkin lymphomas (NHL, n = 170) were examined immunohistochemically,
      across the boundaries of histologic classification, for the presence of this
      oncoprotein, in comparison with apoptotic indices (AI) and percentages of Ki-67+
      cells (growth fraction). The results of this retrospective study revealed a
      highly significant inverse relationship ("mirror image") between the proportion
      of bcl-2+ cells and the AI per case. Both these parameters, although variable,
      clearly distinguished low- from high-grade-malignancy lymphomas according to the
      Kiel classification. Cluster analysis detected 2 separate groups of high-grade
      NHL, one with rather high AI and low percentages of bcl-2+ cells, comprising most
      anaplastic large-cell lymphomas, the other group with reverse characteristics. We
      found no correlation between the percentage of bcl-2+ cells per case and overall
      survival.

PMID- 7790119
TI  - Gene transfer of human TNF alpha into glioblastoma cells permits modulation of
      mdr1 expression and potentiation of chemosensitivity.
AB  - Despite substantial advances in the surgery, radiotherapy and chemotherapy of
      gliomas, the prognosis of patients with glioblastomas has still not improved.
      Disappointing results in chemotherapy of glioblastomas resulting from multi-drug
      resistance (MDR) prompted us to investigate the influence of cytokine gene
      transfer in glioblastoma cells on the expression of P-glycoprotein and on
      chemosensitivity of transduced cells. Several investigations have shown that
      malignant gliomas express P-glycoprotein at high levels. The P-glycoprotein is a
      product of the multi-drug resistance gene (mdr1) and functions as an energy
      dependent efflux pump which decreases drug accumulation and cytotoxicity. Since
      tumour necrosis factor alpha (TNF alpha) is a powerful anti-cancer agent used in
      clinical trials and gene therapy protocols, this cytokine gene was chosen for the
      present investigations. Transduction of the human TNF alpha (hTNF) gene carrying
      retroviral vector pN2tk-hTNF into U373MG human glioblastoma cells resulted in
      expression and secretion of biologically active hTNF. Release of transduced hTNF
      reduces P-glycoprotein expression and is associated with enhanced rhodamine-123
      uptake and potentiation of cytotoxicity of the MDR-relevant drugs vincristine and
      doxorubicin. Furthermore, the transfected cell clones showed a reduced growth
      rate compared to the parental cells.

PMID- 7790120
TI  - Suramin sodium: pronounced effects on methotrexate transport and anti-folate
      activity in cultured tumor cells.
AB  - Suramin is an experimental anti-neoplastic agent which has shown promising
      activity against prostatic carcinoma and lymphoma in clinical trials. To
      elucidate its mechanism of action, suramin was examined for an effect on the
      transport of folate compounds by tumor cells. Influx of the anti-folate
      methotrexate via the reduced-folate carrier system of CCRF-CEM cells was found to
      be highly sensitive to inhibition by suramin but not to various other
      arylsulfonic acids. Inhibition by suramin was competitive, and the inhibition
      constant Ki was 1.3 microM, a value 3-fold lower than the Kt for half-maximal
      influx of methotrexate. Folate binding to the membrane-associated folate-binding
      protein of KB cells was not affected by suramin. Growth studies revealed that the
      response of human CCRF-CEM, KB, PC-3 and MCF-7 cells to methotrexate was
      antagonized from 6- to 17-fold by pharmacological levels (10-200 microM) of
      suramin. Conversely, growth inhibition was additive or synergistic when suramin
      was combined with metoprine, a lipophilic anti-folate which enters cells by
      diffusion. Synergism was observed between metoprine and suramin in CCRF-CEM
      cells, which take up folate exclusively through the reduced-folate carrier
      (inhibitable by suramin), whereas additivity was observed for KB cells, which
      rely largely on the folate-binding protein (unaffected by suramin) for folate
      import. Our results indicate that inhibition of cellular transport of folate
      compounds may explain part of the anti-neoplastic effects of suramin on tumor
      cells.

PMID- 7790121
TI  - Colon goblet cells lose proliferative response to TGF alpha as they
      differentiate.
AB  - Two cell line models for colon goblet cells expressed 6- to 14-fold elevated
      levels of the EGF receptor, 3- to 5-fold levels of TGF alpha and 11- to 15-fold
      levels of amphiregulin compared with 2 cell lines which model colon enterocytic
      differentiation, suggesting a role for the EGF receptor and its ligands in goblet
      cell growth control. Two HT29 colon carcinoma sublines were used to model normal
      goblet cells at different stages of maturation. TGF alpha induced a 2-fold
      increase in growth of the HD8 subline but inhibited the growth of the more
      differentiated HD6 subline by 40%. EGF receptors were activated in each line by
      ligand, but signal transduction varied sharply. Both MAP kinase isoforms, p44 and
      p42, were markedly activated in HD8 cells for at least 20 min, while only a
      marginal activation was seen in HD6 cells. In contrast, the more differentiated
      HD6 cells showed an increase in 105 kDa MBP kinase activity with EGF treatment,
      while HD8 cells displayed constitutively elevated levels of this kinase. Thus,
      activated EGF receptors initiated different signalling pathways in model cell
      lines for colon goblet cells at different stages of maturation. TGF alpha protein
      levels have been shown by other investigators to be restricted to the top of the
      cylinder-like colonic crypt, where cells terminally differentiate and cease
      division, an unexpected location for an epithelial cell mitogen. Our data with
      model cell lines imply that normal colon goblet cells lose proliferative response
      to TGF alpha as they differentiate and the elevated levels of TGF alpha at the
      top of the colonic crypt in vivo serve to inhibit goblet cell growth.

PMID- 7790122
TI  - Susceptibility of colorectal-carcinoma cells to natural-killer-mediated lysis:
      relationship to CEA expression and degree of differentiation.
AB  - This study addresses the relevance of colorectal-carcinoma-cell (CRC) CEA
      expression and degree of differentiation in natural-killer(NK)-mediated lysis
      susceptibility. A 51Cr-release cytotoxicity assay performed with 5 human CRC
      lines demonstrated that CRC CEA expression was related to resistance to NK lysis.
      Moreover, the addition of anti-CEA Fab fragments to the assay led to a
      significant increase of lysability of high-CEA-producing and NK-resistant cells
      (LS 174-T), whereas purified CEA drastically reduced lysis of low-CEA-producing
      and NK-susceptible cells (LISP-I) in a dose-dependent manner. These results
      strongly suggest that CEA plays a causal role in CRC resistance to NK lysis.
      Nevertheless, our data did not demonstrate CEA binding to effector cell surface,
      suggesting that CEA expression can protect CRC, possibly by preventing NK-tumor
      cell adhesion to occur. Our results also show that CRC susceptibility to NK lysis
      was related to a less differentiated phenotype. HCT-8, which are poorly
      differentiated and low-CEA-producing cells, were cultured in vitro in the
      presence of the differentiation agent sodium butyrate. Treated cells became less
      susceptible to NK lysis as they progressed towards a more differentiated
      phenotype. However, CEA production was not altered upon differentiation. Our
      study thus demonstrates that both features, CEA expression and degree of cellular
      differentiation, may individually influence CRC susceptibility to NK lysis.

PMID- 7790123
TI  - Natural killer (NK) cells as effectors of antibody-dependent cytotoxicity with
      chimeric antibodies reactive with human squamous-cell carcinomas of the head and
      neck.
AB  - In patients with cancer, antibody-dependent cellular cytotoxicity (ADCC) may be
      used as a laboratory test or for enhancing immunotherapy with murine monoclonal
      or chimeric mouse/human anti-tumor antibodies (mMAbs or cMAbs, respectively). We
      have established an ADCC assay with IgG1 cMAb SF-25, using human squamous-cell
      carcinoma of the head and neck (SCCHN) cell lines as targets. By flow cytometry,
      all SCCHN cell lines tested expressed the antigen recognized by cMAb SF-25.
      Trypsinization of the cell monolayers facilitated binding of cMAb SF-25 to the
      antigen on the cell surface of SCCHN targets. Using the PCI-50 SCCHN cell line as
      a target coated with this cMAb at the optimal concentration of 1.0 micrograms/ml,
      normal human peripheral blood mononuclear cells (PBMC, n = 28) were found to
      mediate ADCC at a mean level of 283 +/- 42 (SEM) lytic units (LU20/10(7) effector
      cells). Non-adherent monocyte-depleted PBMC and natural killer (NK) cells
      purified by negative selection mediated significantly higher levels of ADCC than
      unseparated PBMC against SCCHN targets. NK cells, defined as CD3-CD56+ cells,
      could be effectively armed by cMAb SF-25, as confirmed by flow cytometry and ADCC
      assays. IL2-activated armed NK cells mediated higher levels of ADCC than non
      armed NK cells. Binding of cMAb SF-25 to NK cells and their ADCC were enhanced by
      pre-incubation with polyethylene glycol. Arming of NK cells with chimeric
      antibodies should be considered in developing novel strategies for treatment of
      human SCCHN, especially in the adjuvant setting.

PMID- 7790124
TI  - Circumvention of confluence-dependent resistance in a human multi-drug-resistant
      colon-cancer cell line.
AB  - Colorectal adenocarcinomas are inherently resistant to anthracyclines and other
      topoisomerase-II inhibitors. Resistance to doxorubicin of colon cancer cells
      (Caco2) depends on 2 main mechanisms. The first is typical multi-drug resistance,
      characterized by the mdr1 gene and its product the P170 membrane glycoprotein.
      P170 effluxes anthracyclines out of cancer cells and is antagonized in vitro by
      verapamil. The second mechanism, which develops when cell-culture density
      increases, we have designated confluence-dependent resistance. Confluence
      dependent resistance depends on the reduced topoisomerase II content of the G0/G1
      phase cells which accumulate in the confluent population. We show here that short
      treatments of confluent Caco2 cells with slightly toxic concentrations of DNA
      damaging agents (cisplatin, melphalan or mitomycin C) produced a transient
      accumulation of cells in S- and G2/M-phases of the cell cycle. Concomitantly with
      the increase in the S-phase population, the topoisomerase II cellular level and
      the sensitivity of cells to doxorubicin were greatly enhanced. Overcoming
      confluence-dependent resistance through S-phase accumulation and inhibition of
      multi-drug resistance by verapamil were fully additive, and a nearly complete
      reversal of confluent Caco2 cells' resistance to doxorubicin was obtained when
      both strategies were combined.

PMID- 7790125
TI  - Correlation between functional and molecular analysis of mdr1 P-glycoprotein in
      human solid-tumor xenografts.
AB  - The contribution of P-glycoprotein (Pgp) to multidrug resistance in human solid
      tumors is generally estimated from bulk mRNA measurements or
      immunohistochemistry, while direct measurement of the effect of Pgp on
      intracellular drug concentrations has not been pursued. We investigated the
      feasibility and sensitivity of a method for probing Pgp-mediated drug transport
      in cells isolated from solid tumors, using xenograft models. Human tumor
      xenografts (XG) were grown by s.c. injection of Pgp-expressing cell lines 2780AD,
      BRO/mdr1 and KB8-5. Tumor uptake of doxorubicin (DOX) after administration of DOX
      to the mice was determined. XG from untreated mice were enzymatically
      dissociated. The effect of the Pgp modulator bepridil on steady-state cellular
      daunorubicin (DNR) and vincristine (VCR) accumulation and chemosensitivity of
      these XG cells was compared with its effects in the cell lines (CL). mdr1 mRNA
      and Pgp (by flow cytometry) were measured. Also, the dependence on intracellular
      ATP concentration, [ATP]i, of the modulator effect was determined in intact KB8-5
      cells. The results showed that i.v. administration of DOX to the mice led to
      lower DOX levels in the Pgp-expressing XG than in the "sensitive" XG, suggesting
      the presence of an in vivo functional Pgp in these XG tumor models. Dissociated,
      viable XG cells appeared to have ATP levels sufficient to sustain Pgp-ATPase
      coupled drug transport. This was inferred from experiments using KB8-5 CL, which
      showed half-maximal inhibition of DNR transport at an [ATP]i of 1 to 2 mM. The
      effect of bepridil on DNR and VCR accumulation and chemosensitivity in the XG
      cells was in accordance with the XG expression of mdr1/Pgp. In KB8-5 XG cells,
      Pgp function was hardly detectable, in accordance with decreased mdr1/Pgp
      expression in vivo. In conclusion, Pgp activity can be determined in freshly
      dissociated XG human tumor cells. The results obtained with the more necrotic KB8
      5 XG may represent some of the interpretation problems arising when low levels of
      Pgp expression occur within a heterogeneous cell population, such as may be
      expected in clinical human tumors. Also our results indicate that Pgp activity
      may be impaired in vivo at [ATP]i below 2 mM, which are realistic values for
      human solid tumors.

PMID- 7790126
TI  - Alcohol, tobacco, illicit drugs, and sex: an analysis of risky behaviors among
      young adults.
AB  - This paper reexamines data from two previous surveys. It looks at self-reported
      alcohol, tobacco, and illicit drug use and sexual risk-taking among three
      subgroups of young adults. All subjects (N = 1,387) were aged 20-30. The samples
      consisted of nurses in the Lothian Region, and residents in Muirhouse (Edinburgh)
      and Easterhouse (Glasgow). Factor analysis revealed that risk-taking behavior was
      neither entirely general nor entirely specific. Although there was some tendency
      for a risk-taker in one area to be a risk-taker in others, five fairly distinct
      types of risk-taking could be distinguished. These included sexual risk-taking,
      illicit use of drugs, and excessive alcohol consumption. The samples differed in
      the extent to which they indulged in the different types of risk-taking, and
      various other predictors of these behaviors were found. Different patterns of
      association emerged in relation to specific subgroups of respondents.

PMID- 7790128
TI  - A comparison of pathological gamblers to alcoholics and cocaine misusers on
      impulsivity, sensation seeking, and craving.
AB  - Consecutive admissions (N = 843) to the Brecksville Veterans Addiction Recovery
      Center with a primary diagnosis of pathological gambler, alcoholic, or cocaine
      misuser were compared for differences on impulsivity, sensation seeking, and
      craving. In contrast to alcoholics and cocaine misusers, gamblers scored
      significantly higher on impulsivity and inability to resist craving; however,
      gamblers were not significantly higher than either alcoholics or cocaine misusers
      on sensation seeking. These findings suggest a need to address high impulsivity
      and inability to resist cravings in treatment and relapse prevention for
      gamblers.

PMID- 7790127
TI  - Evaluation of an AIDS education model for women drug users in jail.
AB  - This paper reports outcome evaluation results of an AIDS education program for
      drug-using women in jail, of whom the majority were current drug injectors, had
      high-risk sexual partners, and never used condoms for insertive sex. The women
      participated in four small-group health/HIV education sessions. Education
      participants and controls were followed-up 7 months after their release from
      jail; the two groups did not differ significantly on drug- or sex-related HIV
      risk behaviors at follow-up. However, being in drug dependency treatment
      (primarily methadone maintenance) at follow-up was associated with reduced heroin
      use, crack use, drug dealing, and criminal activity. Although improved HIV
      education in jail is important, better networks of community resources, including
      more accessible community drug dependency treatment, also must be developed to
      support drug-dependent women after their release from jail.

PMID- 7790130
TI  - Intentions to share injection paraphernalia: an empirical test of the AIDS Risk
      Reduction Model among injection drug users.
AB  - The AIDS Risk Reduction Model is a theory-based representation of sequential
      psychosocial processes by which people may attempt to change their HIV risk
      behavior. These processes are said to occur in three stages: 1) labeling one's
      risk behavior as problematic, 2) forming an intention to change behavior, and 3)
      taking action to accomplish change. Cognitive and perceptual factors are said to
      influence progress across stages. This study tests the degree to which
      hypothesized relationships among factors at Stages 1 and 2 are consistent with
      cross-sectional data collected from a sample of HIV-negative injection drug users
      who reported recent sharing of drug injection paraphernalia ("works"). Findings
      indicate that intentions to share works less often in the future may be
      influenced directly by drug users' perceived risk of infection, which in turn is
      influenced by their level of HIV knowledge, perceived susceptibility to HIV, and
      perceived peer norms regarding drug-related risk reduction.

PMID- 7790129
TI  - Drug use in Hungary: an overview.
AB  - Based on surveys and clinical data, it is concluded that the use of illegal drugs
      is spreading in Hungary. The social composition of drug users is changing and new
      forms of drugs and uses have appeared, such as heroin use and cocaine snorting.
      The legal regulation of access to drugs changed in 1993: stricter sentences can
      be imposed on drug traffickers, while the possibility has been created for drug
      users to undertake therapy in place of punishment. The Interministerial Committee
      on Drug Affairs and the Hungarian Association on Drug Use and Addiction have been
      set up. There are a few scientifically-based prevention programs. A number of
      clear paradigms have emerged in prevention policy and therapy, although it is not
      yet possible to see which of these will be confirmed by time and practice.

PMID- 7790132
TI  - Depression and relapses in treated chronic alcoholics.
AB  - In a sample of 99 male alcoholics at an alcoholics' rehabilitation clinic we
      recorded drinking/abstinence behavior and depression up to 1 year after
      discharge. Seventy-eight patients completed the inpatient therapy, and of these,
      39 respondents were recorded up to the final follow-up point. Generally, the
      initial, markedly elevated depression scores had declined significantly by the
      end of the inpatient treatment. In the abstainers, the depression scores
      continued to fall after release and remained low throughout the entire
      observation period. In patients who resumed alcohol use, relapses were
      accompanied by immediate, sharp increases in the scores, but declined upon a
      return to abstinence.

PMID- 7790133
TI  - Evolution of drug consumption in a sample of adolescents: the predictive capacity
      of the genesis model.
AB  - This paper analyzes the predictive capacity of the genesis model for drug
      consumption constructed by the authors in an attempt to identify the
      characteristics of a drug consumption risk population. Several years' research
      have shown the model's validity in explaining drug consumption, a behavior
      understood as one of the many for possible use by adolescents to adapt to the
      environment in which they develop. The potential for behavior which deviates from
      the norm depends on a variety of factors considered in the model (including level
      of self-control, attitudes to drugs, or the existence of peers to reinforce such
      behavior). The predictive capacity of the model is analyzed in a longitudinal
      study carried out on a sample of 476 students (238 men and 238 women).

PMID- 7790131
TI  - Tension-reduction expectancies and alcoholic beverage preferences revisited:
      associations to drinking frequency and gender.
AB  - The relationships among drinking frequency, gender, beverage preference, and
      tension-reduction outcome expectancies were examined. Subjects consisted of 503
      social-drinking college undergraduates. Results indicated that regardless of
      preferred beverage type, "high" versus "low" frequency drinkers endorsed
      significantly greater tension-reduction expectancies. Results also indicated that
      males and "frequent" drinkers preferred beer as their primary alcoholic beverage.
      Supplemental analyses suggested that drinking frequency partially confounded the
      relationship between gender and beverage preference. These results extend and
      refine previous research and have implications for alcohol misuse prevention and
      early intervention.

PMID- 7790134
TI  - Women in dermatology: gender and tropical diseases.

PMID- 7790135
TI  - Acne rosacea and Helicobacter pylori betrothed.

PMID- 7790136
TI  - The exanthem of HIV-1 seroconversion syndrome.

PMID- 7790138
TI  - Co-morbidity between dermatologic diseases and psychiatric disorders in Papua New
      Guinea.
AB  - BACKGROUND: Neurodermatitis (now subdivided into lichen simplex chronicus and
      atopic dermatitis) was included among the psychosomatic disorders. Psychologic
      causes have been suggested for many skin conditions, such as urticaria, lichen
      simplex chronicus, atopic dermatitis, psoriasis, alopecia areata, and pruritus.
      The evidence for psychologic causation is neither strong nor convincing; however,
      psychiatric disorders are common among people with established skin diseases.
      Recent investigators have published data reporting co-morbidity between certain
      psychiatric disorders and skin diseases. The objective of the research was a
      prospective clinical study of 132 consecutive patients, who attended the
      dermatologic outpatient clinic of the Port Moresby General Hospital during 1992.
      METHODS: The instrument for the study is the "Harding Self-Rating Questionnaire
      (SRQ) that has been demonstrated to work well as a gross screening instrument in
      the Urban Primary Health Care Clinic setting. The questionnaire was administered
      to 132 outpatients by one of the investigators (HM). Those patients who scored
      above the cut-off point of seven were referred to the second investigator (FYAJ)
      for examination of their mental state. RESULTS: The results of the study showed
      all 132 patients were adults, aged between 16 and 75 years. There were 67/132
      (50.75%) men and 65/132 (49.24%) women patients. The psychiatric diagnoses for
      the women patients were: normal variation 17/65, anxiety neurosis 11/65, and
      neurotic depression 37/65. For the men patients, the psychiatric diagnoses were:
      normal variation 21/67, anxiety neurosis 15/67, and neurotic depression 30/67.
      One man with psoriasis also presented with clinical features of schizophrenic
      psychosis. CONCLUSIONS: The results of the study support the hypothesis, that
      there is a co-morbidity between some psychiatric disorders and some skin
      diseases.

PMID- 7790137
TI  - Secondary syphilis: a clinicopathologic study.
AB  - BACKGROUND: With the resurgence of syphilis in the HIV era, a greater awareness
      of the clinicopathologic features of the disease is desirable. This report
      describes and correlates the clinical and histopathologic features of secondary
      syphilis seen at a teaching hospital in Delhi, India. METHODS: Forty biopsies of
      mucocutaneous lesions from 31 consecutive patients with secondary syphilis, seen
      between September 1987 and January 1991, were studied and the histopathologic
      findings correlated with the clinical findings. RESULTS: A spectrum of
      histopathologic changes ranging from a minimal infiltrate to granulomatous
      inflammation throughout the dermis was seen. The pattern of inflammation
      correlated well with the type of skin lesion, with macules showing the least and
      nodules the most prominent changes. The predominant cell type in the infiltrate
      was the mononuclear cell/lymphocyte. Plasma cells were seen infrequently except
      in condylomata lata. Endothelial proliferation, the "classical" feature of the
      histopathology of syphilis was noted infrequently. CONCLUSIONS: The histologic
      manifestations of secondary syphilis appear to be as varied as the clinical ones.
      This calls for close interaction between the clinician and the pathologist to
      correlate the clinical, serologic, and histologic findings to establish the
      diagnosis of syphilis.

PMID- 7790140
TI  - Dermatofibrosarcoma protuberans.
AB  - BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is an uncommon malignant tumor
      of the skin, the diagnosis of which can be difficult not only clinically but also
      histologically. The tumor has a low metastatic potential, but tends to recur
      locally if removal is incomplete. METHODS: We reviewed the clinical and
      histologic features of 19 cases of DFSP, seen at the Department of Dermatology
      (14 cases) and Department of Surgery (5 cases) at the Hull Royal Infirmary
      between 1975 and 1992. RESULTS: There were only 19 cases of DFSP diagnosed from a
      population of 500,000 over a period of 17 years. None of the cases were diagnosed
      clinically prior to histologic diagnosis. The highest incidence was in the 4th
      decade of age. The most frequent site was on the head and neck. None of the
      lesions metastasized but there were a total of eight incidents of local
      recurrence in five patients. Histologically all the cases showed presence of
      storiform-pattern spindle-shaped cells and new collagen formation. CONCLUSIONS:
      Dermatofibrosarcoma protuberans is a soft tissue tumor that is often not
      recognized clinically due to its rarity and variable appearance. Local recurrence
      is frequent. A wide surgical excision is the treatment of choice.

PMID- 7790139
TI  - Mucocutaneous manifestations of lymphomas and leukemias in black Kenyan children.
AB  - BACKGROUND: Childhood leukemia and lymphoma are common problems in Tropical
      Africa, including Kenya. Studies done in Western populations indicate that 25-50%
      of patients with leukemia and lymphoma have specific or nonspecific cutaneous
      signs. In dark-skinned patients, reports of such mucocutaneous manifestations are
      scarce. The lesions in these patients may easily be missed, if not specifically
      looked for. METHOD: Eighty-six indigenous Kenyan children with a confirmed
      diagnosis of leukemia or lymphoma were specifically examined for any
      mucocutaneous manifestations at presentation, during their treatment, and during
      subsequent follow-up. Whenever possible, an attempt was made to determine the
      causes of these lesions. All patients were given standard therapy for the primary
      hematologic disorder. RESULTS: Two-thirds of the patients had mucocutaneous
      symptomatology at presentation: 17.4% had skin infiltration by the malignant
      cells. During therapy an even larger number developed nonspecific skin
      manifestations. Most of these were the result of myelosuppression,
      immunosuppression, or direct cytotoxic effects on tissues. CONCLUSIONS:
      Mucocutaneous manifestations in black children with leukemia and lymphoma are
      very common.

PMID- 7790141
TI  - Cutaneous endometriosis.

PMID- 7790142
TI  - Drug-induced acute generalized exanthematous pustulosis with positive patch
      tests.

PMID- 7790143
TI  - Angiolymphoid hyperplasia with eosinophilia in a Filipino man.

PMID- 7790144
TI  - Malignant eccrine acrospiroma of the breast.

PMID- 7790145
TI  - Subcutaneous dirofilariasis caused by Dirofilaria (nochtiella) repens in a
      Belgian patient.

PMID- 7790146
TI  - Antidermatophytic activity of garlic (Allium sativum) in vitro.
AB  - BACKGROUND: Interest in herbal medicine is enjoying a renaissance at present.
      Garlic (Allium sativum) is an intriguing herb with a long history of medicinal
      use for a variety of diseases including ringworm infections. METHODS:
      Antidermatophytic activity of the aqueous extract of garlic (A. sativum) was
      investigated against 88 clinical isolates of dermatophytes by an agar dilution
      technique. The isolates included Microsporum canis (50), M. audouinii (5),
      Trichophyton rubrum (6), T. mentagrophytes (5), T. violaceum (12), T. simii (5),
      T. verrucosum (1), T. erinacei (1), and Epidermophyton floccosum (2). The results
      were compared with the minimal inhibitory concentrations of ketoconazole.
      RESULTS: The aqueous extract of garlic, diluted 1:150 and 1:100, had inhibited 50
      and 90% of the isolates tested, whereas the respective values for ketoconazole
      were 1 and 2.5 micrograms/mL. CONCLUSIONS: Garlic (A. sativum) could be used as
      an effective antidermatophytic agent. Further purification and extraction of the
      active principle of garlic would give a true antidermatophytic activity
      comparable to standard antifungal drugs.

PMID- 7790147
TI  - Effect of orally administered antithyroid thioureylenes on PCNA and P53
      expression in psoriatic lesions.
AB  - BACKGROUND: Antithyroid thioureylenes are effective agents in the oral and
      topical treatment of patients with chronic plaque psoriasis. METHOD: The effect
      of oral treatment with 6-n-propyl 2-thiouracil (propylthiouracil, PTU) and 2
      mercapto 1-methyl imidazole (methimazole, MMI) on proliferating cell nuclear
      antigen (PCNA), and p53 protein expression was studied in patients with stable
      plaque psoriasis. RESULTS: Following treatment with PTU and MMI, PCNA staining in
      psoriatic epidermis was significantly decreased. P53 was minimally expressed in
      untreated lesions, and treatment with PTU and MMI did not enhance p53 expression
      in the psoriatic lesions. CONCLUSIONS: Since PCNA is a marker of cellular
      proliferation and p53 inhibits cellular cycling, some of the beneficial effects
      of PTU and MMI in psoriasis may depend on the ability of the drugs to impair
      cellular turnover, perhaps by binding to the triiodothyronine (T3) receptor.
      These effects may be in addition to the previously described effects of PTU and
      MMI as immune modulators and free radical scavengers.

PMID- 7790148
TI  - Cutaneous fungal infections: innovative treatment schedules with systemic agents.

PMID- 7790149
TI  - Oh what a tangled web: the medicinal uses of spider silk.

PMID- 7790150
TI  - Epidermal growth factor and epidermal growth factor receptor in umbilical
      metastasis from scirrhous carcinoma of the stomach.

PMID- 7790151
TI  - Treatment of cutaneous leishmaniasis with oral itraconazole.

PMID- 7790152
TI  - Umbilicated lesions in leprosy.

PMID- 7790153
TI  - The teaching/learning preferences of student nurses in the Republic of Ireland;
      background issues and a study.
AB  - Teaching and learning in all forms of education is being increasingly reviewed in
      a climate of educational accountability. The literature generally displays a
      certain irrationality about nurse education; on the one hand teachers are
      espousing student-centred ideologies while on the other hand, students are
      expressing preferences for teacher-structured approaches. The research on nurse
      education generally concludes that the roles of teacher and student operate
      around a mechanistic view of man with the teacher being viewed as the front of
      all knowledge and the students the passive recipients of that which was given.
      This paper reports on related background issues, and a study of the
      teaching/learning preferences of student nurses from general, psychiatric, sick
      children's and mental handicap nursing. Whilst students reflected preferences for
      more teacher-structured strategies, significant differences were identified
      between the preferences of the four groups of student nurses. It is concluded
      that any insistence on a doctrinaire approach to teaching and learning would be
      unnecessarily restrictive to the whole process of nurse education. Nurse tutors
      therefore need to reflect on what they do, particularly that which influences the
      relationship between the students and what they learn. It is then the
      responsibility of nurse tutors to act on what they have learned about that
      relationship and their part in it.

PMID- 7790154
TI  - Is there a physiological basis for the couvade and onset of paternal care?
AB  - Couvade is the male experience of pregnancy and couvade syndrome incorporates a
      range of symptoms suffered by "pregnant" men. The aetiology of the couvade
      syndrome is unknown. Anthropologists, psychiatrists, nurses and sociologists have
      provided explanations for behaviour changes in "pregnant" men in terms of
      cultural pressure, intrapsychic processes and psychosocial adaptation to a new
      situation. The adoption of a biological perspective allows us to ask a new
      question: is there a physiological basis for the couvade syndrome? A fresh
      research agenda would include measurement of physiological change and a search
      for causation. Implications for nursing are outlined.

PMID- 7790155
TI  - Agency registered nurse use of medical equipment: an Australian perspective.
AB  - This cross-sectional survey explored how and what 142 registered nurses working
      for a nursing agency in a large South Australian city initially learn about the
      medical devices they use in direct patient care, as well as the consequences of
      device use both for patients and staff. The most frequently identified method of
      initial learning was reading the user/instruction manual. Furthermore, 87.1% of
      respondents indicated they had received instruction from another staff member on
      their units, typically another registered nurse. At least 90% of participants
      indicated they initially learned the purpose of the device and how to operate it.
      Medical device use caused 39.4% of registered nurses to feel stress. Only 10%
      indicated that they had used a medical device that had harmed a patient.

PMID- 7790156
TI  - Evaluating quality nursing care through peer review and reflection; the findings
      of a qualitative study.
AB  - The purpose of this study was to examine the everyday methods by which nurses
      evaluate quality care. The method was qualitative; specifically, a grounded
      theory approach was used. The sample comprised 18 registered nurses from a large
      hospital in the south of England. Data was collected through tape recorded
      interviews and the constant comparative method used to analyze the data. The
      findings revealed that although nurses used objective methods such as evaluating
      planned care as part of the nursing process, they also used more subjective
      methods such as peer review and intuition. The study seeks to explain the value
      of these less formal methods of evaluation and recognises how difficult they may
      be to substantiate in light of the recent health care reforms. It is suggested
      that the use of a more formalised process of peer review using reflection as its
      foundation would enable nurses to satisfy managerial concerns for a measurable
      outcome to quality.

PMID- 7790157
TI  - Conditions, interventions, and outcomes in nursing research: a comparative
      analysis of North American and European/International journals. (1981-1990).
AB  - This study compared the conceptual foci and methodological characteristics of
      research projects which tested the effects of nursing interventions, published in
      four general nursing research journals with predominantly North American, and two
      with predominantly European/International authorship and readership. Dimensions
      and variables of comparison included: nature of subjects, design issues,
      statistical methodology, statistical power, and types of interventions and
      outcomes. Although some differences emerged, the most striking and consistent
      finding was that there were no statistically significant differences (and thus
      similarities) in the content foci and methodological parameters of the
      intervention studies published in both groups of journals. We conclude that
      European/International and North American nursing intervention studies, as
      reported in major general nursing research journals, are highly similar in the
      parameters studied, yet in need of overall improvement. Certainly, there is no
      empirical support for the common (explicit or implicit) ethnocentric American
      bias that leadership in nursing intervention research resides with and in the
      United States of America.

PMID- 7790158
TI  - Survey and critique of studies related to shift length variations in nursing from
      1970 to 1993.
AB  - The purpose of this study was to describe the current status, stage of staffing
      change, and findings of research relating to shift length variations in nursing.
      This was accomplished through a review of the literature to (a) evaluate the
      quality of the research, (b) summarize and draw conclusions related to variations
      in nursing shift length, and (c) identify gaps in the literature for the purpose
      of making recommendations for future studies related to nursing shift length
      variations. Multiple methods were utilized for locating potential studies to
      include in this project. Smith and Stullenbarger's (1991) Quality of Study
      instrument was used to rate the studies. None of the research reviewed explicitly
      identified a conceptual or theoretical framework or model, and few studies could
      be classified as scientifically rigorous. This study illuminates the state of the
      art and findings related to length of shift variations in nursing, and as such
      has implications for practice and research in nursing service administration.

PMID- 7790159
TI  - A model for counterparts in international nursing.
AB  - The concept of counterpart is used by international health agencies to achieve
      the transfer of skills necessary for the ongoing viability of international
      nursing programs. The goal of the counterpart relationship is for the host group
      counterpart to assume responsibility for the project. The counterpart
      relationship is seen as a spectrum across which knowledge is transferred from
      counterpart to counterpart. Where each counterpart relationship falls on the
      spectrum depends on the degree of knowledge each brings to the relationship and
      changes across the life of the project. The tasks each counterpart must
      accomplish to ensure a successful relationship are illustrated by a faculty
      preparation program developed in the People's Republic of China.

PMID- 7790161
TI  - On the general concepts of action and ability. A philosophical introduction to
      the theory of handicaps.
AB  - The main task of this paper is to contribute to the theory of disabilities and
      handicaps, in particular their characterization and classification. It presents
      an analysis of the conditions for the successful performance of actions. By this
      procedure a list of reasons for failure of action, i.e., for disability and
      handicap, is obtained. This list can be used for a detailed classification of
      disabilities and handicaps. Some theories in modern philosophical action theory
      serve as platforms for the analysis.

PMID- 7790160
TI  - Technology and disability. Assessment needs and potential.
AB  - In assessing technologies for disabled people, the aims of habilitative or
      rehabilitative interventions, the concepts of disability and handicap, and the
      potential of existing and emerging technologies in various social arenas, as well
      as the structure of service delivery systems, are of importance. A discussion of
      these issues in the light of previous work on cost and effectiveness in the field
      is given.

PMID- 7790162
TI  - An elemental resource for the human-task interface.
AB  - The elemental resource model (ERM) attempts to provide a quantitative and
      straightforward framework for characterizing the human system, tasks, and their
      interface. It evolved in large part from the general systems performance theory
      (GSPT), which was developed first and independently. Resource constructs are used
      exclusively for modeling the abstract idea of system performance and for
      subsequent measurement of performance resource capacities. Resource economic
      principles provide a cause-and-effect description of the human-task interface.
      While argued to have immediate utility, it also provides the motivation to
      consider coordinated, collaborative, long-term developments that could facilitate
      effective decision making and technology utilization in rehabilitation.

PMID- 7790163
TI  - National structures in the delivery of rehabilitation technology services.
AB  - The delivery of rehabilitation services requires an infrastructure if service
      provision is to be given any priority. This article discusses some
      characteristics of handicaps, technical aids, the service delivery process, and
      habilitation/rehabilitation, and recommends developments of national structures
      for service delivery based upon the characteristics of rehabilitation technology,
      user need, and the country frameworks.

PMID- 7790164
TI  - The potential of technological innovations for the disabled.
AB  - Technical innovations have enormous potential for enhancing the lives of people
      with disabilities, often providing means for substantial independence and
      contributing to their dignity. This paper uses a framework related to the
      personal needs of individuals throughout the hours of waking and rest. Examples
      of various potentialities are provided and discussed.

PMID- 7790165
TI  - Communication aids for the speech impaired. Cost and quality-of-life outcomes of
      assessment programs provided by specialist Communication Aids Centers in the
      United Kingdom.
AB  - An evaluation was conducted of the approaches, costs, and quality-of-life
      outcomes associated with communication aid assessment programs for the speech
      impaired provided by specialist Communication Aids Centres (CACs) in the United
      Kingdom. The average costs of CAC assessment programs was 410 pounds per client,
      which is not excessive. There was evidence of moderate quality-of-life benefits
      from clients' use of the recommended aids.

PMID- 7790166
TI  - Orthoses and prostheses.
AB  - Orthoses and prostheses include a wide range of devices and strategies for
      correcting and alleviating dysfunction and disability. Features in these areas of
      technology include continuing evolution of new devices, further development of
      well-established approaches, a need for critical assessment, requirements for
      support from technical and health care workers, and the need to identify funding
      to achieve efficient programs.

PMID- 7790167
TI  - Adapting work sites for disabled persons using advanced technology.
AB  - This paper describes the technical approach in the TUFFA (Technology Procurement
      for Disabled in Working Life) project and a model for cooperating areas of
      competence based on a holistic view of the individual's abilities, the
      environmental conditions at the work site, and technical solutions.

PMID- 7790169
TI  - Outcome measurement in medical rehabilitation.
AB  - The Uniform Data System for Medical Rehabilitation (UDSmr) provides a method for
      uniform assessment of the severity of patient disability and the outcomes of
      medical rehabilitative care. The effectiveness and efficiency of medical
      rehabilitation services may be analyzed using the Functional Independence Measure
      (FIM), the functional assessment component of the UDS, and other data. Program
      evaluation models based on the UDSMR and the FIM are useful for measuring
      resource cost of disability.

PMID- 7790168
TI  - Assessment of rehabilitation technologies in stroke. Outcomes and costs.
AB  - Initial functional ability (Barthel Index, mean 57) was found to be an important
      predictor of functional ability 1 year after stroke (mean 80) and for costs
      during the period. On average the total cost for a stroke patient was about SEK
      200,000; the main expense, accommodation, averaged about SEK 140,000, while
      assistive devices amounted to SEK 2,600. Those who use assistive devices,
      although having achieved a high functional ability, perceive and rate their life
      situation (Nottingham Health Profile) considerably more impaired than those
      without assistive devices.

PMID- 7790170
TI  - The cost of the Swedish handicap service system. Implications for technology
      assessment.
AB  - The total cost of the Swedish handicap system is estimated at US $10.7 billion
      for 1989. The cost is distributed across different authorities with separate
      legal and financial responsibility. The concept of technology must be extended to
      include consideration of both the resources spent and benefits gained in the
      public sector and the magnitude and distribution of transfer payments from social
      insurance to fulfill its function in handicap policy decision making.

PMID- 7790171
TI  - Cost-utility analysis of assistive technologies in the European Commission's TIDE
      Program. Technology Initiative for Disabled and Elderly People.
AB  - Socioeconomic evaluation is an issue dealt with in the European Commission's
      research program TIDE. The principles of cost-utility analysis have been examined
      for usability in the assessment of rehabilitative technologies. A case study, the
      choice of a type of wheelchair, is described to demonstrate how estimates of
      utility can be derived and how cost-utility ratios can be used to guide decision
      making.

PMID- 7790173
TI  - Deciding to buy expensive technology. The case of biliary lithotripsy.
AB  - Acquiring expensive, new medical technology requires an evaluation of the
      efficacy and effectiveness, safety, profitability, feasibility, and risk of a
      project in the context of the hospital's social responsibility and institutional
      strategy. A case study of the decision to bring biliary lithotripsy to Strong
      Memorial Hospital illustrates how these criteria offer managers a coherent
      approach to difficult and consequential decisions about acquiring medical
      technology.

PMID- 7790172
TI  - The development of health care technology assessment. An international
      perspective.
AB  - We consider the nature of technology assessment and then briefly summarize
      technology assessment activities in five countries: Canada, France, the
      Netherlands, the United Kingdom, and the United States. Drawing from these
      examples, we then identify determinants of the emergence and impact of technology
      assessment.

PMID- 7790174
TI  - Physicians' opinions and use of controversial technologies. The case of
      mammographic screening in Norway.
AB  - In a survey of 196 Norwegian radiologists and 37 breast imaging centers,
      physicians' preferences were found to be likely to influence the use of
      mammography. In their decision making, the radiologists appear to be influenced
      by income motives and by perceptions of the risk of misdiagnosing breast cancer.
      Despite opinions favorable to mammographic screening, most radiologists would
      prefer a CT scanner or a magnetic resonance imaging unit to a mammographic unit
      if the x-ray department were in a position to acquire capital equipment.

PMID- 7790176
TI  - Declining cost-effectiveness of screening for disease. The case of gastric cancer
      in Japan.
AB  - We examined the cost-effectiveness of screening for gastric cancer in
      hypothetical cohorts of asymptomatic Japanese ages 40, 50, 60, and 70, followed
      for 10 years. Current screening recommendations in Japan are not optimal.
      Although indirect x-ray is the correct method, screening for gastric cancer may
      not be cost-effective for Japanese under the age of 50. Policymakers worldwide
      should monitor the changing incidence of disease as they consider and recommend
      screening policies.

PMID- 7790175
TI  - Hemophilia home treatment. Economic analysis and implications for health policy.
AB  - This analysis describes the development of technology for home self-infusion of
      factor VII in the treatment of hemophilia and its clinical, economic, and social
      consequences, and uses the case study of such home care treatment to illustrate
      the potentials and pitfalls of formal economic analyses of programs to treat
      chronically ill children. A comprehensive review of all original data on
      hemophilia programs, their related costs, and outcomes, conducted from 1966
      through 1993, examined the economic outcomes for two hypothetical cohorts, one
      aged 0-4 years and the other aged 30-34 years. Including the measurement of
      treatment effects on the productivity of parental caregivers substantially
      increases the benefit-cost relationship of an intervention directed at
      chronically ill children. Increased economic productivity and societal return
      resulting from such a program for young adults exceeds those for a cohort of
      children, primarily due to assumptions related to discounting. However,
      estimation of quality-adjusted life years favors the younger age cohort, since
      children survive for a longer period of time and with each year survived comes a
      higher quality of life. Unlike simpler instances in which economic benefits can
      be shown to outweigh resource costs, policy decisions concerning services for
      chronically ill children raise an additional set of complex analytic issues.
      Inclusion of the benefits in productivity experienced by family caregivers
      provides an important added dimension to such analyses. The development of cost
      benefit or cost-effectiveness analyses of these programs illustrates the
      importance of careful measurement of outcomes and explicit statements of
      underlying assumptions. Such an analysis of home care for children with
      hemophilia therefore demonstrates both the strengths and the limitations of this
      approach.

PMID- 7790177
TI  - Potential inconsistencies between cost-effectiveness and cost-utility analyses.
      An upstairs/downstairs socioeconomic distinction.
AB  - This paper indicates that certain economic evaluation methods (cost-effectiveness
      and cost-utility analyses) may yield inconsistent results. Along with the lack of
      formal grounding of these methods in economic "first principles," this finding
      suggests the possible benefit of greater reliance on the more formally developed
      method of cost-benefit analysis.

PMID- 7790178
TI  - "Continuing care': an emerging issue in European mental health policy.

PMID- 7790179
TI  - British approaches to the continuing care client.

PMID- 7790180
TI  - Psychiatric care and social support for people with long-term mental illness in
      Sweden.

PMID- 7790181
TI  - How can psychiatry survive without psychiatric hospitals? The Italian experience.

PMID- 7790182
TI  - Long-term mental illness in Germany.

PMID- 7790183
TI  - The dilemmas of chronicity: the transition of care policies from the
      authoritarian state to the welfare state in Spain.
AB  - In this article, the constitution of the population of chronic mental patients is
      examined for the period 1885 to 1975 as well as its influence on the design of
      reform programmes in the crisis of the Franco-ist state. Then follows an
      assessment of state reforms and regional policies with effect from 1980.
      Reference is made to the theoretical models utilised in this last period and to
      the tension and contradictions between professionals of bio-medical orientation
      and sectors sympathetic to community models sustained from the perspective of
      social psychiatry.

PMID- 7790184
TI  - Economic and legal aspects of mental health policies in Greece.

PMID- 7790185
TI  - Leros and the Greek mental health system.
AB  - In 1983 the Greek Ministry of Health, in presenting the new mental health law,
      described the state of the mental health system in the country as follows: "it is
      generally recognised that the psychiatric services in Greece are totally
      inadequate. The treatment inflicted on patients is often approaching the negation
      of the fundamental notions of human dignity. A radical reform is intended to
      change this intolerable situation." (EC, 1984). Eight years on, the state of the
      Greek mental health services can be defined as continuing to be 'serious' despite
      the attempts to change it and to apply the reform.

PMID- 7790186
TI  - The continuing care client.
AB  - In the present contribution, I would like to describe modes of care for people
      who, because of their mental health problems, need the continuing or occasional
      help of different institutions (Ramon, 1990). Some service structures are
      described which are the most outstanding. The history and organisation of
      relevant institutions, as well as possibilities for the improvement of their
      work, or alternatively their abolition, are also discussed.

PMID- 7790187
TI  - [Contact allergies to corticosteroids. Prevalence, cross-reactions and methods of
      detection].
AB  - Topical corticosteroids (CS) are frequently used to treat of allergic contact
      dermatitis, so that their own potential for sensitization is rarely detected.
      However, increasing numbers of hypersensitivity reactions to corticosteroids have
      been reported during the last 10 years, and allergic skin reactions to over 50
      particular compounds have been observed. CS must now be regarded as a rather
      frequent contact allergen, the prevalence being twice as high in women as in men.
      Contact allergy to CS is clinically characterized by a chronic and persistent,
      corticosteroid-resistant dermatitis. In general, hypersensitivity to CS is a type
      I and/or type IV mediated allergic reaction. Cross-sensitivity between individual
      corticosteroid preparations has been described owing to their closely related
      chemical structures (e.g. hydrocortisone and tixocortol pivalate). Contact
      allergy to CS can be confirmed by patch-tests, intradermal injection tests or
      application tests; because of the delayed appearance of positive skin reactions a
      prolonged evaluation period of up to 120 h is recommended. For routine screening
      the use of the patient's own material and of tixocortol pivalate and budesonide
      as test marker substances seems appropriate. The development of further marker
      substances is a target for ongoing research.

PMID- 7790188
TI  - [Recommendations for a photo-patch test standard series by the German speaking
      study group "Photopatch-Test"].

PMID- 7790189
TI  - [Rare keratoacanthoma variants].
AB  - Keratoacanthomas are made up of the same spinocellular differentiated cell
      material as squamous cell carcinomas, but they differ from the latter in origin
      and growth properties. The majority--in our series 98% of 741 examined cases--are
      of the "crateriform" type, which after rapid growth during the initial stage give
      way to spontaneous regression, mostly with complete restoration of the cutaneous
      structure. Less than 2% belong to the rare destructive variants with disturbed or
      absent regression and persistent invasive growth. Keratoacanthoma marginatum
      centrifugum, mutilating keratoacanthomas and aggregated keratoacanthomas can lead
      to extremely severe defects. None of the "conservative" treatment methods
      recommended in the literature up to now has proved effective, with the exception
      of surgery and radiotherapy with tumour ratio doses. Many publications are
      obviously based on uncritically interpreted individual observations.

PMID- 7790191
TI  - [Detection of nicotine in eccrine sweat after stimulation of sweat glands during
      nicotine withdrawal].
AB  - The presence of nicotine in sweat obtained from smokers and one non-smoker
      exposed to tobacco smoke after 4 h to 8 days of nicotine-free time was
      investigated. Following stimulation of the eccrine glands, sweat samples were
      taken every hour for 6 h. The total nicotine concentrations, i.e. the sum of
      nicotine and its metabolites, were determined by radioimmunoassay. The presence
      of unchanged nicotine was revealed by gas chromatography/mass spectrometry.

PMID- 7790190
TI  - [Positive tuberculin reaction in sarcoidosis].
AB  - Scar sarcoidosis is one of the rare cutaneous manifestations of sarcoidosis.
      Apart from the clinical picture, suppression of the cell-mediated immunity can
      often be determined when tuberculin tests and testing for recall antigens are
      carried out. In the present case of a 68-year-old woman patient scar sarcoidosis
      and pulmonary sarcoidosis were detected. Remarkably, a strongly positive
      tuberculin reaction was found, while acute tuberculosis and former BCG
      vaccination were excluded. Both references in the literature and the case
      presented demonstrate that a positive tuberculin test, while very unusual in
      sarcoidosis, does not however, preclude the diagnosis. On the basis of some case
      reports in the literature, our patient was treated with allopurinol; impressive
      improvement of both the skin and the pulmonary manifestations was noted. Despite
      the well-known phenomenon of spontaneous regression in sarcoidosis, we recommend
      a clinical trial with allopurinol as this substance is well tolerated.

PMID- 7790193
TI  - [Von Recklinghausen neurofibromatosis and dermal melanocytic nevi].
AB  - Neurofibromas, cafe au lait macules and freckles in the axillary or inguinal
      regions are common manifestations of von Recklinghausen's neurofibromatosis (NF
      1). Less known is the simultaneous appearance of dermal melanocytic naevi. We
      describe the case of a 21-year-old Vietnamese woman who showed generalized,
      multiple neurofibromas, a solitary plexiform neurofibroma in the left gluteal
      region and Lisch nodules. In addition, there were several large grey-blue macules
      histologically characterized by fusiform pigment-bearing cells in the dermis,
      which we diagnosed as persistent aberrant mongolian spots. In the right zygomatic
      region she presented a grey-blue, hair-bearing macule, which we saw as a variant
      of Ota's naevus. A genetic background for this coincidence of a systemic with a
      local phakomatosis can be supposed, as both Schwann's cells and melanocytes are
      derived from the neural crest. Such pathologic rearrangement in the embryogenesis
      of the cellular elements could be important for the pathogenesis of NF-1 and
      dermal melanocytic nevi.

PMID- 7790192
TI  - [Reticular elastolytic giant cell granuloma. A variant of the annular elastolytic
      giant cell granuloma].
AB  - The case report presented describes a new variant of annular elastolytic giant
      cell granuloma. Over a period of 10 years, a 40-year-old woman had developed
      reticular, brown to livid, partly atrophic skin lesions on the shoulders and
      decolletee. The patient had no subjective symptoms. Histology revealed a patchy
      lymphohistiocytic infiltrate in the dermis, with many giant cells. Elastic fibres
      were less frequently found in these infiltrates; in a few of the giant cells and
      macrophages fragments of elastic fibres were demonstrated within the cytoplasm.
      There were no deposits of mucin. For this new variant we propose the term
      "reticular elastolytic giant cell granuloma."

PMID- 7790194
TI  - [Transformation of multiple basaliomas to squamous cell carcinomas in an HIV
      patient with Gorlin-Goltz syndrome].
AB  - We report on a 32-year-old male patient with Gorlin-Goltz syndrome, who presented
      with excessive numbers of superinfected basal cell carcinoma. This led us to
      suspect an underlying HIV infection, which was confirmed by ELISA and Western
      blotting. Laboratory investigation of the immunological state revealed severe
      immunosuppression with 267 CD4+ lymphocytes and a CD4/CD8 ratio of 0.3. The
      histological picture showed multiple basal cell carcinomas, some of them
      transforming into squamous cell carcinomas. We suspect that the excessive number
      and the unusual clinical and histological picture of the basal cell carcinomas in
      this patient were probably influenced by the underlying HIV infection.

PMID- 7790196
TI  - [Green hair].

PMID- 7790195
TI  - [Verruciform palmoplantar keratoderma as a characteristic marker of hidrotic
      ectodermal dysplasia of the Clouston type].
AB  - We report on a 23-year-old man with hidrotic ectodermal dysplasia of the Clouston
      type showing a severe expression of his gene defect. As a prominent feature of
      this case, we describe the presence of verruciform keratoderma of hands and feet,
      and we visualize these skin changes by means of a new imprinting technique.

PMID- 7790197
TI  - [Significance of the serum ferritin level in porphyria cutanea tarda].

PMID- 7790198
TI  - [120 years Dresden-Friedrichstadt Dermatology Clinic].
AB  - The dermatology clinic in Dresden-Friedrichstadt this year celebrates 120 years
      of existence. It is one of the oldest dermatology clinics in Germany. The
      contribution presents an overview of the major events from the clinic's
      foundation as "External Section for Dermal and Venereal Diseases and Minor
      Surgery" in 1874 up to the present time. The clinic has played an important part
      in the development of the field of dermatology in Dresden. A brief account of the
      most important medical superintendents and of their scientific activities is
      given.

PMID- 7790199
TI  - [Idiopathic pustular and bullous variant of Sweet syndrome].

PMID- 7790200
TI  - [Necrobiology of the skin: apoptosis].

PMID- 7790201
TI  - A review of some available radioactive and non-radioactive substitutes for use in
      biomedical research.
AB  - The unavailability of disposal facilities for long-lived low-level radioactive
      waste (LLRW), expense associated with its disposal, and, for some generators,
      limitation of space to decay short half-life radioactive materials has prompted
      the search for alternatives to radiochemical techniques. Some of these
      alternatives are presented below.

PMID- 7790202
TI  - Radiocesium body burdens in immigrants to Israel from areas of the Ukraine,
      Belarus and Russia near Chernobyl.
AB  - Of the 500,000 immigrants from the former Soviet Union who came to Israel during
      1990-1993, about 100,000 are estimated to have come from radiocontaminated areas
      near Chernobyl. These people were subject to chronic uptake of environmental
      radiocesium over protracted periods. During October-November 1991, a joint
      Israeli-Canadian investigation measured radiocesium body burdens in immigrants to
      Israel from the Ukraine, Belarus, and the southern Russian republic in order to
      provide factual information on radiocesium levels to concerned immigrants and to
      relate the body burdens to the geographic area of residence before coming to
      Israel. Assessments were made of 137Cs body burdens in 1,228 volunteer men,
      women, and children. These measurements were accompanied by medical assessments
      based on clinical histories and examinations. Radiocesium levels were strongly
      dependent on the duration of residence in Israel, with the highest levels being
      found in the most recent immigrants. The maximum level, extrapolated back to the
      time of leaving the former Soviet Union, was estimated to be about 0.83 kBq (10.3
      Bq kg-1). Of the most recent immigrants from the Kiev region (< 101 days in
      Israel), only 15% had back extrapolated body burdens > 50 Bq, whereas 53% of
      those coming from Gomel and other towns in the contaminated zones (> 3.7 x 10(10)
      Bq km-2 of radiocesium) had detectable levels > 50 Bq. People coming from the
      latter region had significantly higher body burdens as compared to those from the
      former, in accordance with the higher degree of ground radiocesium contamination
      reported for the latter region. Women and children showed considerably lower
      total radiocesium content in comparison to men. All radiocesium body burdens at
      the time of measurement were too low to be of health concern.

PMID- 7790203
TI  - The regression effect as a cause of the nonlinear relationship between short- and
      long-term radon concentration measurements.
AB  - The relationship between four-day charcoal canister radon measurements and year
      long alpha-track detector measurements in 983 New Jersey homes has been recently
      examined by others. The ratio of canister measurement to long-term measurement
      for the homes in the survey, a common parameter of interest, was found to
      increase as the canister measurement increased. The examination presented
      considerable discussion of the variation of the ratios as functions of various
      parameters. Although we did not examine the raw data used in the study, it
      appears that many of the results (and perhaps those in other papers) are
      consistent with a simple model in which both the long-term and rescaled short
      term measurements provide measurements with error of the annual-average radon
      concentration in the home with no nonlinearity or other unusual functional
      dependence on radon concentration. We provide an example and discussion of this
      result, which is due to the widely known but frequently misunderstood phenomenon
      called "regression toward the mean," or simply the "regression effect." This does
      not invalidate the work of others; we merely wish to bring attention to the fact
      that the results in these papers may have a very simple explanation.

PMID- 7790204
TI  - Freeze-drying as a potential mean for waste handling of animal carcasses
      containing radioactive material.

PMID- 7790205
TI  - Pretreatment of animal wastes containing radioisotopes with dry-distillation.
AB  - Mice that had been radiolabeled with one of seven isotopes by intraperitoneal or
      subcutaneous administration were dry-distilled at 800 degrees C for 10 min, and
      the fate of the radionuclide was examined. The radionuclides administered were
      3H, 14C, 32P, 35S, 45Ca, 51Cr, and 125I, all of which are commonly used in animal
      experiments. After dry-distillation, 95% of 3H was found in the distillate
      (condensate), and 80% and 16% of 14C were recovered from exhaust gas and residual
      solids, respectively. Only between 10 and 20% of 35S was found in distillate. The
      remainder of the residual 35S was recovered from the inner wall of the exhaust
      vent of the dry-distillation equipment. About 24% of 125I was also recovered from
      the inner wall of this same exhaust vent, and the residual radioactive materials
      were recovered from the residual solids. On the other hand, 32P, 45Ca, and 51Cr
      were recovered entirely from the residual solids. The weight of the animals
      decreased to about 10%, and the volume to about 20% (mice and rats) to 40%
      (rabbits) after dry-distillation. The residual solids of animal wastes generated
      by dry-distillation were odorless and chemically and biologically stable. Dry
      distillation has many merits as a pretreatment for the disposal of animal wastes
      containing radioactive material because of the easy handling, storage, and
      transportation of the residual solids.

PMID- 7790206
TI  - An industry survey of current lower limits of detection for various
      radionuclides.
AB  - The results of a survey to assess detection limits of various radionuclides and
      their associated costs is presented herein. Included among the radionuclides of
      interest are mixed fission products, mixed activation products, actinides and
      transuranics, plus tritium (3H) and 14C. The survey encompassed commercial
      analytical radiochemistry services and nuclear instrument suppliers in the United
      States. In the study, a simple soil sample was defined as the object of
      consideration with no requirements for any special quality control/assurance.
      Standard procedures and instrumentation were requested, as were standard
      prices/costs required for the various analyses. The minimum detectable level for
      most isotopes using standard procedures was on the order of 0.0037 to 0.037 Bq g
      1 (0.1 to 1.0 pCi g-1). The analytical costs varied by factors of 2 to 4 over a
      range of 0.0037 to 0.37 Bq g-1 (0.1 to 10.0 pCi g-1). While the ability to detect
      below 0.0037 Bq g-1 (0.1 pCi g-1) is possible, the required detection times were
      considered prohibitive for a commercial laboratory.

PMID- 7790208
TI  - Clarification of whole body dose.

PMID- 7790207
TI  - Shielding and radiation safety around a superconducting cyclotron neutron therapy
      facility.
AB  - Prior to routine operation of the neutron therapy unit a radiation survey was
      performed in order to confirm the shielding design and to assure the safety of
      the personnel involved in the operation of the unit. The shielding requirements
      were calculated in accordance with NCRP Report No. 51. The contributions of the
      neutron and gamma dose equivalents have been measured separately outside the
      treatment room. The exposure outside the shield is negligible. In general, the
      measured values were lower than those derived from the shielding calculations.
      The highest total dose equivalents were registered at locations corresponding to
      the highest calculated values.

PMID- 7790209
TI  - Spatial and temporal responses of ionization chambers.

PMID- 7790210
TI  - Radiation dose to the population of Slovak Republic from diagnostic nuclear
      medicine.
AB  - This study estimated the radiation exposure attributed to nuclear medicine
      examinations during the period of 1985 through 1992 in Slovak Republic. It was
      accomplished by survey of nuclear medicine facilities from 1987 to 1992. In
      addition, a detailed analysis of nuclear medicine practice was obtained for 1992.
      The mean effective dose equivalent per capita and per exam were 0.022 mSv and 3.8
      mSv, respectively. The collective effective dose equivalent for 1992 was 110.7
      person Sv. In conclusion, the practice of nuclear medicine produces a very low
      radiation dose per examination and per capita of population. The Slovak Republic
      appeared favorable in comparison to other countries in the judicious use of
      diagnostic nuclear medicine procedures.

PMID- 7790211
TI  - Rapid monitoring of soil, water, and air dusts by direct large-area alpha
      spectrometry.
AB  - During retrieval and disposition of wastes containing transuranium elements,
      continuous monitoring of the air, water, and soil for alpha emitters was required
      to ensure that safety limits were not exceeded and that the waste itself was not
      disturbed unknowingly. Direct measurements by alpha spectrometry were
      particularly promising because of their potential speed, sensitivity, and their
      ability to identify transuranium radionuclides under field conditions. Soil
      samples or settled dusts were finely ground, suspended in 80% ethanol, sprayed
      onto circular stainless steel pans, and dried on a hotplate. Water samples were
      mounted directly by spraying. Air dusts were collected with a high-volume air
      sampler on 20- by 25-cm membrane filters. The samples were then analyzed directly
      in a large pressurized gridded ionization chamber without further sample
      preparation. The lower limits of detection for 10-min counting times were 1.5 Bq
      g-1 (40 pCi g-1) for 100-mg soil samples, and 4 x 10(-2) Bq m-3 (10(-12) microCi
      mL-1) for a 10-min air sample taken at 0.4 m3 min-1 (14 cubic feet per minute)
      and counted without waiting for decay of radon progeny.

PMID- 7790212
TI  - Variations in astronaut radiation exposure due to anisotropic shield
      distribution.
AB  - The dose incurred in an environment generated by extraterrestrial space
      radiations within an anisotropic shield distribution depends on the orientation
      of the astronaut's body relative to the shield geometry. The fluctuations in
      exposure of specific organ sites due to astronaut re-orientation are found to be
      a factor of 2 or more in a typical space habitation module and typical space
      radiations. An approximation function is found that overestimates astronaut
      exposure in most cases studied and is recommended as a shield design guide for
      future deep space missions.

PMID- 7790213
TI  - Type testing of the Siemens Plessey electronic personal dosemeter.
AB  - This paper presents the results of a laboratory assessment of the performance of
      a new type of personal dosimeter, the Electronic Personal Dosemeter made by
      Siemens Plessey Controls Limited. Twenty pre-production dosimeters and a reader
      were purchased by Ontario Hydro for the assessment. Tests were performed on
      radiological performance, including reproducibility, accuracy, linearity,
      detection threshold, energy response, angular response, neutron response, and
      response time. There were also tests on the effects of a variety of environmental
      factors, such as temperature, humidity, pulsed magnetic and electric fields, low-
      and high-frequency electromagnetic fields, light exposure, drop impact,
      vibration, and splashing. Other characteristics that were tested were alarm
      volume, clip force, and battery life. The test results were compared with the
      relevant requirements of three standards: an Ontario Hydro standard for personal
      alarming dosimeters, an International Electrotechnical Commission draft standard
      for direct reading personal dose monitors, and an International Electrotechnical
      Commission standard for thermoluminescence dosimetry systems for personal
      monitoring. In general, the performance of the Electronic Personal Dosemeter was
      found to be quite acceptable: it met most of the relevant requirements of the
      three standards. However, the following deficiencies were found: slow response
      time; sensitivity to high-frequency electromagnetic fields; poor resistance to
      dropping; and an alarm that was not loud enough. In addition, the response of the
      electronic personal dosimeter to low-energy beta rays may be too low for some
      applications. Problems were experienced with the reliability of operation of the
      pre-production dosimeters used in these tests.

PMID- 7790215
TI  - Radon entry control in new house construction.
AB  - People exposed to high concentration levels of radon face an increased risk of
      developing lung cancer. The risk is directly proportional to the length and level
      of radon exposure. Because of health reasons, it is safer to build new houses
      with radon mitigation systems installed in slab-on-grade houses. However, the
      interrelationships between parameters and factors governing radon entry and
      control are highly complex. A study performed by the University of Florida has
      examined the effectiveness of different radon entry control approaches. The
      analysis was based on 47 houses from three research projects conducted by the
      University of Florida (14 houses), Florida Solar Energy Center (13 houses), and
      GEOMET Technologies (20 houses). The evaluation of the performance and
      effectiveness of improved floor slabs, space conditioning, and ventilating
      systems were analyzed. Statistical analyses of the interrelationship between
      various parameters were also performed. Study findings such as the important
      factors in reducing radon entry and the effectiveness of passive construction
      approach and active subslab depressurization systems are presented in this paper.

PMID- 7790214
TI  - Evaluation of the 131I thyroid-monitoring measurements performed in Ukraine
      during May and June of 1986.
AB  - After the Chernobyl accident in 1986, about 150,000 monitoring measurements were
      performed in Ukraine. From this data base, 40,000 measurements were selected for
      which the results of the reference-source measurements could be analyzed by
      statistical means. The majority of these measurements are of high quality. In
      this paper, the uncertainties introduced due to the variabilities of anatomic
      parameters and the measurement geometry are quantified by measurements using a
      thyroid-neck phantom. Parameters considered are the thyroid mass, the thickness
      of the tissue overlying the thyroid as well as the detector-neck distance, the
      orientation, and the horizontal and vertical position of the detector. The
      uncertainty introduced due to the variability of these factors corresponds to a
      coefficient of variation in the range of 25-40% for the measured activity.

PMID- 7790216
TI  - 222Rn progeny surface deposition and resuspension--residential materials.
AB  - The radiological hazard of radon gas to occupants in residential environments is
      from the particulate progeny 218Po, 214Pb, 214Bi, and 214Po, rather than 222Rn
      itself. Attachment to aerosols, plateout, and resuspension impact on the progeny
      airborne concentrations. Plateout rate and resuspension factors were measured for
      air change (ventilation) rates, 0.01 to 1.0 h-1, in a 0.28 m3 test chamber for
      interior residential materials of wallboard, drapery, carpet, ceiling tile, and
      concrete, and from 0.05 to 2.5 h-i for hardwood and glass. The overall accuracy
      of the plateout rate values is estimated to be +/- 13% standard deviation. For
      the different materials, the plateout rates for 218Po progeny varied by a factor
      of nearly six. Drapery gave the largest plateout rates. Resuspension rate
      factors, R, were measured for hardwood, wallboard, drapery, carpet, and glass by
      a new time-dependent measurement method based on the difference in buildup rate
      of 214Po to equilibrium caused by resuspension. Values for R obtained for
      hardwood, wallboard, drapery, carpet and glass were 0.31, 0.29, 0.44, 0.55, and
      0.36, respectively ( +/- 30% standard deviation). All measurements were made in a
      continuous air conditioned interior environment maintaining temperature at 22.2
      +/- 1.1 degrees C and relative humidity of 30% +/- 10%. Computations were made of
      equivalent plateout rates and equilibrium fractions for a standard 5 m x 5 m x 3
      m high room to provide values to compare with other work.

PMID- 7790217
TI  - Estimates of radiogenic cancer risks.
AB  - A methodology recently developed by the U.S. EPA for estimating the carcinogenic
      risks from ionizing radiation is described. For most cancer sites, the risk model
      is one in which age-specific, relative risk coefficients are obtained by taking a
      geometric mean of the coefficients derived from the atomic bomb survivor data
      using two different methods for transporting risks from the Japanese to the U.S.
      population. The risk models are applied to estimate organ-specific risks per unit
      dose for a stationary population with mortality rates governed by 1980 U.S. vital
      statistics. With the exception of breast cancer, low-LET radiogenic cancer risk
      estimates are reduced by a factor of 2 at low doses and dose rates compared to
      acute high dose exposure conditions. For low dose (or dose rate) conditions, the
      risk of inducing a premature cancer death from uniform, whole body, low-LET
      irradiation is calculated to be 5.1 x 10(-2) Gy-1. Neglecting nonfatal skin
      cancers, the corresponding incidence risk is 7.6 x 10(-2) Gy-1. High-LET (alpha
      particle) risks are presumed to increase linearly with dose and to be independent
      of dose rate. High-LET risks are estimated to be 20 times the low-LET risks
      estimated under low dose rate conditions, except for leukemia and breast cancer
      where RBEs of 1 and 10 are adopted, respectively.

PMID- 7790219
TI  - Establishing a surveillance system for infections acquired in home healthcare.
AB  - Marin Home Care has developed a simple surveillance system that quickly produces
      monthly statistics of incidence rates of infections acquired while the patient is
      on service. Supplemental orders and culture results are reviewed, and combined
      with computer reports each month. The tables generated give the rates of
      infection for symptomatic urinary tract infections in patients with indwelling
      Foley catheters, and bloodstream infections in patients receiving intravenous
      therapy.

PMID- 7790218
TI  - Nursing research in HIV/AIDS home care, Part 1: Importance and methods.
AB  - One of the primary goals of nursing research is to develop a systematic body of
      knowledge to guide nursing practice. In the community setting, an extremely
      useful method of research is the exploratory field study, which can be used to
      discover important variables that may exist in real-life situations. This study
      reflects an analysis of the problems that were identified in persons living with
      human immunodeficiency virus/acquired immune deficiency syndrome in New York City
      who were referred for home care services. Part I presents an overview of nursing
      research methods, focusing on an actual field study in human immunodeficiency
      virus/acquired immune deficiency syndrome home care; Part II describes the
      results and implications for nursing.

PMID- 7790221
TI  - Taking the leap of faith: applying continuous quality improvement techniques to
      home care.
AB  - Methods of evaluating quality in home care are undergoing fundamental change.
      Accrediting bodies, such as JCAHO and NLN's CHAP have implemented new home care
      standards that address quality improvement rather than the familiar quality
      assurance. This article introduces the concept of continuous quality improvement
      and demonstrates its application in a home care setting.

PMID- 7790220
TI  - Lyme disease: an emerging infection with home healthcare implications.
AB  - The 11,424 cases of Lyme disease reported in 1994 represented a nearly 40%
      increase from the previous year. The dramatic increase of Lyme disease in the
      United States points to the need for home healthcare nurses to review their
      knowledge of the clinical manifestations, treatment, and prevention measures for
      this emerging infection.

PMID- 7790222
TI  - Geriatric depression.
AB  - In late life, depression is the most prevalent functional psychiatric disorder.
      Because the presentation may be multicausal and clinically complex, early
      assessment of biologic and psychosocial factors, diagnosis, and appropriate
      referral are important in ameliorating the associated morbidity and mortality.
      Nurses must have current knowledge and skills to assess mood states of elderly
      persons and to implement appropriate interventions. Successful management of
      depression in the elderly results in a reformulation of purpose and an enhanced
      quality of life.

PMID- 7790223
TI  - Assessment of depressed older persons living in a home setting.
AB  - This article discusses the complexity of assessing depression in older persons in
      a home setting. The author describes using the Older Adults Resource Survey to
      determine functional status in five domains. Other components essential to
      assessment of depression include inventory of medications, the Short Portable
      Mental Status questionnaire, the Mini-Mental Status, the Geriatric Depression
      Scale, a suicide assessment, and a drinking history.

PMID- 7790224
TI  - "Power pudding": natural laxative therapy for the elderly who are homebound.
AB  - "Power Pudding" is a natural laxative recipe for relieving and preventing
      constipation. Its ingredients are nutritious and inexpensive. A small study
      conducted at a home care agency in northern Virginia demonstrated the
      effectiveness of "Power Pudding" with several elderly clients who were homebound.
      As a nursing intervention, it has good potential for improving bowel function in
      the elderly home care population.

PMID- 7790226
TI  - Clinical indicators for the psychiatric home health nurse.

PMID- 7790225
TI  - Wound care and the human immunodeficiency virus.

PMID- 7790227
TI  - December 1994 updates to home health and hospice regulations.

PMID- 7790228
TI  - Principles of productivity.

PMID- 7790229
TI  - Looking for the good.

PMID- 7790230
TI  - Home care: a touching experience.

PMID- 7790231
TI  - [Osteosynthesis plates in the area of the facial skull--yes or no?].

PMID- 7790233
TI  - [Voice rehabilitation after laryngectomy with tracheoesophageal prosthesis.
      Analysis with special reference to psychosocial factors].
AB  - The first 2 years' experiences with Provox prostheses at the ENT Clinic of the
      University of Berne are discussed. Thirty-three prostheses were inserted after
      primary tracheoesophageal puncture and 5 after secondary puncture. Voice success
      was measured with the scale of Robillard Shultz and Harrison, which encompasses
      not only assessment of voice quality but also frequency of use and a patient's
      independence in prosthesis care. After primary puncture the percentage of
      "functional" speakers increased progressively from 26% after 2 months to 56%
      after 1 year. After secondary puncture only 2 of 5 patients became functional
      speakers after 6 months. Because only a few of the previously laryngectomized
      patients who were informed about the possibility of a secondary puncture wished
      to receive a prosthesis, the reasons for their reservation were analyzed.
      Uneasiness about an additional operation and fear of complications were the most
      frequent motives. Further psychosocial aspects--including the unwillingness of
      some patients to use their fully functioning prosthesis--are discussed.

PMID- 7790232
TI  - [Should osteosynthesis plates in the area of the facial skull be removed again?
      Results of experimental and clinical studies].
AB  - We discuss the arguments dealing with removal of fixation devices and plates
      after osteosynthesis of facial bone fractures. As an experimental model for
      examining the soft tissue reaction to implants under standard conditions, an
      inguinal flap was prepared in 24 Wistar rats. Titanium mesh implants (10 x 8 x
      0.3 mm) were then inserted into the flaps. Twelve implants were additionally bent
      to investigate histologically the influence of mechanical preparation on tissue
      reactions. Examination of all specimens was carried out with the technique of
      Donath and showed a thin capsule around the titanium implants but without any
      signs of infection. Around the bent areas of the implants there were minimal
      signs of local chronic inflammation without a capsule. Use of titanium
      microplates instead of miniplates in 89 patients with midfacial fractures
      diminished the rate of local complications. Based on our experimental and
      clinical results, indications for the different types of plates and the necessity
      for their later removal are discussed. Our present plates are only removed from
      the maxillary sinus wall and the alveolar ridge, after osteosynthesis in
      children, and in patients with local complications. If removal of the material is
      planned (because of the location), less expensive steel implants are used.

PMID- 7790234
TI  - [Modifying the stapes footplate with various laser systems. II. The pulsed
      laser].
AB  - The object of the present study was to examine the tissue ablation capacity of
      various pulsed lasers at the stapes footplate. Isolated human stapes and bovine
      compact-bone platelets (thickness 90 microns) were used to determine effective
      laser parameters for achieving a perforation measuring 500 microns to 600 microns
      in diameter. Apart from achieving the perforation diameters, particular attention
      was given to the form and quality of the perforations, reproducibility of the
      perforation effect and the thermally altered border zones occurring at the
      footplate. Four pulsed laser systems were used: excimer, Ho:YAG, Er:YSGG and CO2
      lasers. An adequately large perforation generally could only be achieved by
      several repeated shots at the same application site, since only a small amount of
      tissue was ablated per application. The mechanism of the photoablation caused the
      extent of the thermal side effects to be markedly lower than with the continuous
      wave (cw) and superpulse systems. For this reason and because of their highly
      reproducible perforation effect, they were basically better suited for
      stapedotomy than the cw systems. It was possible, however, that as a result of
      the longer application time and the need to repeatedly irradiate the same
      application site, the higher pulse counts could prove to be disadvantageous in
      clinical practice. Among the pulsed laser systems, the Er:YSGG laser had the
      highest ablation rate at the stapes and was thus the most effective laser for
      interventions at the footplate. Although somewhat less effective than the Er:YSGG
      laser in our studies, the Ho:YAG and pulsed CO2 lasers also appear to be suitable
      for stapes surgery. On the other hand, we did not consider the excimer laser (308
      nm) to be particularly effective at the footplate because of its low ablation
      rates.

PMID- 7790235
TI  - [The value of fine needle aspiration cytology in suspected neoplastic salivary
      gland enlargement].
AB  - Imaging offers little support in the management of salivary gland masses
      suggestive of a neoplastic lesion. There are also contraindications for a
      surgical biopsy in many cases. Fine-needle aspiration cytology (FNAC) is not yet
      widely recognized as a diagnostic tool. To date, 206 FNAC were carried out from
      1986 through 1993 on 181 consecutive patients and were reviewed in the present
      study. Histological confirmation was possible in 174 tests, while 32 were
      confirmed on clinical follow-up. In sum, 192 samples were sufficient for
      interpretation, 10 were questionable by our standards and 4 were non-diagnostic.
      One hundred-seventy-one samples were true-negative, 27 true-positive, 4 false
      negative and 4 false-positive. Sensitivity was 87.1% and specificity 97.7%. Out
      of 141 primary diagnostic procedures in which a final histologic diagnosis was
      available, FNAC was able to determine histogenesis in 113/124 benign lesions and
      9/17 malignant masses. These included 65/67 pleomorphic adenomas and 21/22
      adenolymphomas. In 8 cases a diagnosis of "adenoma" was made. Difficulties in
      interpretation were found in lesions that were mucoepidermoid carcinomas and, in
      part, adenoid cystic carcinomas. No complications occurred. Provided that there
      was sufficient experience in performing the aspiration technique and in cytologic
      interpretation, FNAC was found to be a quick, reliable, low-cost, easy-to-perform
      method with low risk in the management of nearly all benign and most malignant
      salivary gland lesions.

PMID- 7790237
TI  - [Rare tumor of the nose and paranasal sinuses. Leiomyosarcoma].
AB  - Leiomyosarcoma is a rare malignant tumor of the nose and paranasal sinuses.
      Including our patient, 32 cases have been reported in the literature. Radical
      surgery is currently the best therapy. In comparison with results of conventional
      irradiation, postoperative neutron treatment appears to be more effective.

PMID- 7790238
TI  - [Kikuchi lymphadenitis. A contribution to the differential diagnosis of cervical
      lymph node swelling of unknown origin].
AB  - According to its morphological appearance, Kikuchi's disease is also called
      "histiocytic necrotizing lymphadenitis". This disorder was first described in
      Japan in 1972 as a benign lymphadenopathy of the neck. In Germany only a few
      cases have been reported by pathologists, whereas most clinicians are unaware of
      the existence of this rare disease, which can easily be mistaken for malignant
      lymphoma. In 1993 three cases of Kikuchi's lymphadenitis were treated at the ENT
      Department of the University of Lubeck. Patients' ages ranged from 15 to 30 years
      old. Except for cervical adenopathy, findings in blood tests, viral serology and
      radiological imaging were unremarkable. While fine needle aspirations were
      suspicious for malignant lymphoma, a final diagnosis of self-limiting "Kikuchi's
      lymphadenitis" was established histologically from excised lymph nodes. In our
      opinion early extirpation of lymph nodes and consultation of a pathologist are
      necessary to make a correct diagnosis without delay. Thus, in patients with
      Kikuchi's lymphadenitis unnecessary staging procedures and treatment can be
      avoided.

PMID- 7790236
TI  - [Empirical studies of music listening habits of adolescents. Optimizing sound
      threshold limits for cassette players and discoteques].
AB  - The music habits of 569 pre-teens and teenagers, between 10 and 17 years of age,
      were examined and exposure to music from portable music players was compared to
      that in discotheques. Using a questionnaire we determined the length of time
      spent listening to portable music players and the frequency of disco visits. The
      individual level of the music heard through portable music players was measured
      as a free-field corrected short term mean level. The total music exposure
      (related to 40 hours per week) was calculated from the data and different assumed
      disco sound levels. We estimated the risk of ear damage according to ISO 1999
      standards on the basis of the total music exposure, whereby the mean disco level
      was varied as a parameter in the range of 95 to 110 dB(A). Taking only the
      portable music players into account, one can expect that even after 5 years of
      music, approximately 5% of the total group would have a hearing loss of 20 dB.
      This percentage clearly rises when additional exposure is given in discotheques
      having music levels above 100 dB(A). We suggest therefore that for safety reasons
      the following sound levels should be observed: 90 dB(A) for portable music
      players and 95 dB(A) for discos. Through adherence to these levels we would
      expect that 1% of the young people in our study would have a hearing loss > 10
      dB, whereas momentary exposure would result in a hearing loss > 10 dB of 10-20%.
      Therefore we believe that sound level limitations should be enacted immediately
      for portable music players and in discotheques.

PMID- 7790239
TI  - [Does summer smog damage the nasal mucosa and contribute to bacterial rhinitis?].
AB  - Smog in hot summers contains noxious agents resulting from the combustion of
      fossil fuels whose levels are highest in industrial areas. Reactions of the
      oxygen radical of ozone with sulfur dioxides, nitrous oxides, hydrocarbons and
      the water molecules of the nasal mucous membrane presumably support the formation
      of acids such as H2SO4 or HNO3 (from H2SO3 or HNO2 [3, 4]). Acid corrosion seems
      to damage the mucous membrane, leading to local erosions, bleeding, and necrotic
      changes. The collapsed local defense system and necrotic mucosa are an ideal
      culture medium for a wide spectrum of pathogenic bacteria. Main signs of tissue
      pathology are bleeding spots or pustules, nasal congestion, degenerative
      mucositis, pruritus, as well as epipharyngeal and pharyngeal irritation. Therapy
      is possible with topical or oral antibiotics. Prophylaxis includes avoiding
      touching the mucous membranes and reducing outdoor activity on hot summer days.
      Further clinical and scientific examination would be helpful in determining
      additional explanations.

PMID- 7790240
TI  - [Voice rehabilitation after laryngectomy with the Provox voice prosthesis.
      Surgical and technical aspects. II].

PMID- 7790241
TI  - Results of an RTOG phase III trial (RTOG 85-27) comparing radiotherapy plus
      etanidazole with radiotherapy alone for locally advanced head and neck
      carcinomas.
AB  - PURPOSE: The objectives of this study were to determine the efficacy and toxicity
      of Etanidazole (ETA), a hypoxic cell sensitizer, when combined with conventional
      radiotherapy (RT) in the management of advanced head and neck carcinomas. METHODS
      AND MATERIALS: From March 1988 to September 1991, 521 patients who had Stage III
      or IV head and neck carcinomas were randomized to receive conventional RT alone
      (66 Gy in 33 fractions to 74 Gy in 37 fractions, 5 fractions per week) or RT+ETA
      (2.0 g/m2 thrice weekly for 17 doses), of whom 504 were eligible and analyzable.
      Treatment assignments were stratified before randomization according to the
      primary site (oral cavity + hypopharynx vs. supraglottic larynx + oropharynx +
      nasopharynx), T-stage (T1-3 vs. T4), and N-stage (N0-2 vs. N3). Pretreatment
      characteristics were balanced. In the RT-alone arm, 39% of patients had T3 and
      34% had T4 disease, whereas in the RT+ETA arm, 42% of patients had T3 and 33% had
      T4 disease. Thirty-eight percent of the RT-alone patients and 37% of the RT+ETA
      patients had N3 disease. The median follow-up of surviving patients was 3.38
      years, with a range between 0.96 and 5.63 years. RESULTS: One hundred and ninety
      four of the 252 (77%) RT+ETA patients received at least 14 doses of the drug.
      Overall RT protocol compliance rate was 82% in the RT-alone arm and 86% in the
      RT+ETA arm. No Grade 3 or 4 central nervous system or peripheral neuropathy was
      observed in the RT+ETA arm. Eighteen percent of the patients developed Grade 1
      and 5% developed Grade 2 peripheral neuropathy. Other drug related toxicities
      included nausea/vomiting (27%), low blood counts (15%), and allergy (9%). Most of
      these toxicities were Grade 1 and 2. The incidence of severe acute and late
      radiation effects were similar between the two arms. The 2-year actuarial local
      regional control rate (LCR) was 40% for the RT-alone arm and 40% for the RT+ETA
      arm. Two-year actuarial survival was 41% for the RT-alone arm and 43% for the
      RT+ETA arm (p = 0.65). Multivariate analyses were performed to investigate the
      influence of covariates on treatment effects. A strong treatment interaction with
      N-stage was revealed: LCR (50% vs. 40% at 2 years), RT+ETA improved for patients
      with N0-2 disease but not for N3 patients (22% for RT+ETA and 40% for RT).
      Further analyses showed that RT+ETA was more advantageous in N0-1 patients, with
      a 2-year LCR of 55% for RT+ETA vs. 37% for RT only (p = 0.03). A similar
      phenomenon was observed when using survival as the end point. CONCLUSION: The
      results showed that adding Etanidazole to conventional RT produced no global
      benefit for patients who had advanced head and neck carcinomas. There was a
      suggested benefit for patients who had N0-1 disease, and that needs to be
      confirmed by another study.

PMID- 7790242
TI  - Late effects of hyperfractionated radiotherapy for advanced head and neck cancer:
      long-term follow-up results of RTOG 83-13.
AB  - PURPOSE: The objective of this study was to examine the incidence of late effects
      of hyperfractionated radiotherapy for head and neck cancer as a function of the
      dose delivered, as well as the daily interfraction interval. In addition, we
      wished to examine the influence of other prognostic factors including age,
      gender, primary site, T- and N-stage, and overall stage on the late effects of
      hyperfractionated radiotherapy. METHODS AND MATERIALS: Between 1983 and 1987, 479
      patients with advanced head and neck cancer were entered on a Phase ILE/II dose
      escalation trial of hyperfractionated radiotherapy. They were randomly assigned
      to receive a dose of 67.2, 72.0, 76.8, or 81.6 Gy, delivered at 1.2 Gy/fraction,
      twice a day (BID), 5 days/week. Of the 451 analyzable patients, 399 patients who
      received > or = 64.8 Gy and had a follow-up > 90 days were eligible for this
      study. Acute and late effects were scored with the RTOG/EORTC late radiation
      morbidity scoring scheme. For this analysis, patients were subclassified by the
      actual doses delivered and by an average daily interfraction interval of < or =
      4.5 h or > 4.5 h. The incidence of late effects was estimated using a cumulative
      incidence approach. RESULTS: Fifty-nine patients received 67.2 +/- 2.4 Gy, 119
      received 72.0 +/- 2.4 Gy, 98 received 76.8 +/- 2.4 Gy, and 123 received 81.6 +/-
      2.4 Gy. The proportion of patients treated with a daily interfraction interval of
      > 4.5 h was 32, 50, 43, and 71%, respectively. The four treatment groups were
      well balanced with respect to pretreatment characteristics. The median follow-up
      was 1.71 years (range: 0.24-9.6) for all evaluable patients and 6.12 years for 85
      alive patients. There was no significant difference in the incidence of late
      effects between the different dose levels. At 5 years, the cumulative incidence
      of late effects was 17, 14, 20, and 13% for grade 3, and 7, 3, 7, and 5% for
      grade 4. However, the incidence of late effects differed significantly with
      respect to daily interfraction interval. The cumulative incidence of grade 4 late
      effects increased from 6.3% at 2 years to 7.5% at 3 years to 8.0% at 4 years and
      8.6% at 5 years with an interval of < or = 4.5 h, while it remained at a constant
      of 2.0% with an interval of > 4.5 h during the same period (p = 0.0036).
      Multivariate analysis showed that among the prognostic factors examined, daily
      interfraction interval of < or = 4.5 h was the only significant independent
      prognostic factor for the development of grade 3+ or grade 4 late effects (p =
      0.0167 and p = 0.0013, respectively). CONCLUSION: Results of this randomized
      Phase ILE/II trial of hyperfractionated radiotherapy in head and neck cancer
      showed no apparent dose-response relationship for late effects within the range
      of 67.2-81.6 Gy. Daily interfraction interval was a significant independent
      factor for the development of late effects in a multivariate analysis.

PMID- 7790243
TI  - Randomized phase I/II trial of two variants of accelerated fractionated
      radiotherapy regimens for advanced head and neck cancer: results of RTOG 88-09.
AB  - PURPOSE: To establish the feasibility of performing split-course accelerated
      hyperfractionation (AHFX-S) and concomitant boost accelerated fractionation
      radiotherapy (AFX-C) for advanced head and neck cancer in a multi-institutional
      cooperative trial setting and to evaluate the tumor clearance rate and acute and
      late toxicity of these fractionation schedules. METHODS AND MATERIALS: Between
      February 1989 and January 1990, 75 patients with Stage III or IV squamous cell
      carcinoma of the head and neck were randomized to receive: (a) AHFX-S: 1.6
      Gy/fraction, twice daily (6-h interval), 5 days/week, to a total dose of 67.2
      Gy/42 fractions/6 weeks, with a 2-week rest after 38.4 Gy; or (b) AFX-C: 1.8
      Gy/fraction/day, 5 daily fractions/week to 54 Gy/30 fractions/6 weeks to a large
      field and 1.5 Gy/fraction/day to a boost field, 6 h after large field treatment
      during the last 11 treatment days, to a total dose of 70.5 Gy/41 fractions/6
      weeks. Acute and late toxicities were scored according to the RTOG normal tissue
      reaction scales and tumor clearance was evaluated at completion of therapy and at
      regular intervals thereafter. RESULTS: Of the 70 analyzable patients, 38 received
      AHFX-S and 32 received AFX-C. The two arms were balanced with respect to sex,
      age, T-stage, and Karnofsky Performance Status (KPS). However, the AHFX-S arm had
      a higher proportion of oropharyngeal primaries (63% vs. 44%), and Stage IV
      disease (82% vs. 50%) and lower proportion of oral cavity lesions (3% vs. 22%)
      and N0 disease (16% vs. 31%) than the AFX-C arm. The median follow-up was 2 years
      (range: 0.03-4.87 years). Tolerance of both variants of accelerated fractionated
      radiotherapy was satisfactory. There was no significant difference in local
      regional control, disease-free survival, or survival between the two arms. The 2
      year local-regional failure rate, survival, and disease-free survival was 50, 50,
      and 40%, respectively, for the entire group of patients. Acute radiation
      mucositis was increased in both arms. There was no significant difference in the
      incidence of grade 3 acute toxicities (63% vs. 56%) and grade 3 (14% vs. 14%) or
      grade 4 (6% vs. 17%) late toxicities. Permanent grade 4 late toxicity was
      observed in 6 and 7% of the patients, respectively. CONCLUSION: Results of this
      randomized Phase I/II trial showed that the two accelerated fractionated
      schedules studied can be successfully given in a multi-institutional cooperative
      trial. There was no significant difference in acute or late toxicities, local
      regional control, disease-free survival, or survival in this small scale study.
      Therefore, a Phase III trial comparing the relative efficacy of these two
      accelerated fractionation schedules against standard fractionation and
      hyperfractionation has been activated.

PMID- 7790244
TI  - Fast-neutron therapy in advanced head and neck cancer: a collaborative
      international randomized trial.
AB  - PURPOSE: To compare the efficacy of fast-neutron radiotherapy with that of
      conventionally fractionated photon therapy in the management of patients with
      locally advanced squamous cell carcinoma of the head and neck. METHODS AND
      MATERIALS: Patients with Stage III or IV disease were randomized to receive
      either 20.4 Gy/12 fractions/4 weeks of neutrons or 70 Gy/35 fractions/7 weeks of
      photons (control). Between April 1986 and March 1991, 178 patients were entered,
      169 of whom were eligible for analysis. The treatment arms were balanced for age,
      stage, and performance status, but not for primary site of origin. RESULTS:
      Complete response occurred in 70 and 52% with neutrons and photons, respectively
      (p = 0.006). Local regional failure at 3 years for all patients was 63% for
      neutrons and 68% for photons. Actuarial overall survival curves were virtually
      identical in both study arms, falling to 27% at 3 years. Acute toxicity was
      similar in the two arms, but late grade 3-5 toxicity was 40% with neutrons
      compared to 18% with photons (p = 0.008). CONCLUSION: Although the initial
      response rate was higher with neutrons, permanent local control and survival were
      not improved, and the incidence of late normal tissue toxicity was increased. As
      a result, fast-neutron therapy for advanced squamous cell carcinoma of the head
      and neck can only be recommended for patients in whom the logistic benefit of
      treatment in 12 sessions over 4 weeks outweighs the increased risk of late
      toxicity.

PMID- 7790245
TI  - Salvage surgery following radiation failure in squamous cell carcinoma of the
      supraglottic larynx.
AB  - PURPOSE: We analyzed the clinical course of patients who developed local
      (primary) recurrence following high-dose irradiation of squamous cell carcinoma
      of the supraglottic larynx. METHODS AND MATERIALS: Between October 1964 and July
      1991, 206 patients with previously untreated squamous cell carcinoma of the
      supraglottic larynx underwent radiotherapy with curative intent. Local failure
      occurred in 46 (22%) patients. Successful surgical salvage was defined as no
      evidence of recurrent cancer for at least 2 years after salvage surgery and
      continuously thereafter. RESULTS: Sixteen patients did not undergo salvage
      surgery because of refusal (7 patients), severe medical illness (2 patients),
      concurrent distant metastasis (5 patients), or unresectable neck disease (2
      patients). Twenty-six patients underwent total laryngectomy, and 4 patients had a
      voice-sparing procedure. Successful salvage was achieved in 50% of patients who
      underwent surgery. The rate of successful salvage did not correlate with
      preirradiation T-stage or time to failure after irradiation. Most of the failures
      after surgery were because of failure to control the primary cancer. The overall
      rate of postsurgical complications was 37%. No operative or perioperative deaths
      occurred. The 5-year survival rate for all 46 patients, calculated from the date
      of irradiation failure, was 20%, while the 5-year survival rate after salvage
      surgery for the 30 patients who underwent the procedure was 29%. CONCLUSION:
      There are few data in the literature regarding the clinical outcome in patients
      whose tumors are not controlled by initial radiotherapy. In the current and
      previous series, one-half to two-thirds of patients who developed primary failure
      underwent salvage surgery, which was successful in approximately half of the
      operated patients, leading to a 25-30% rate of long-term disease-free survival
      among the entire group of patients who developed failure.

PMID- 7790246
TI  - Outcome following radiotherapy in verrucous carcinoma of the larynx.
AB  - PURPOSE: To evaluate the outcome of patients with verrucous carcinoma of the
      larynx treated at the Princess Margaret Hospital with respect to control rates
      with radiotherapy, the salvage of local failure, the risk of regional lymph node
      metastasis following radiation therapy, and the risk of anaplastic transformation
      following radiotherapy. METHODS AND MATERIALS: Forty-eight patients underwent
      primary treatment for verrucous carcinoma of the larynx in the period between
      January 1961 and December 1990. This represented 1.1% of cases of laryngeal
      cancer seen in this time period. Forty-three received radiotherapy and 5 had
      surgery as the primary treatment. Several radiation dose-fractionation schedules
      were used, the most frequent being 50 Gy in 20 fractions in 4 weeks (31 cases),
      while eight patients were treated with 55 Gy over 5 weeks. RESULTS: The 5-year
      rate of local control was 59% for the 43 patients treated with radiotherapy.
      Surgical salvage was universally successful in all cases where it was attempted.
      The five cases treated with surgery alone did not experience relapse. Only one
      patient died of verrucous carcinoma. He had been medically unfit for surgical
      intervention at the time of initial treatment and at the time of relapse. He
      underwent a truncated course of radiotherapy (24 Gy in 3 fractions over three
      weeks in 1975). There was no evidence of increased neck relapse compared to other
      forms of laryngeal carcinoma following radiation treatment. No evidence to
      support anaplastic transformation of tumors treated with radiotherapy was evident
      in this series. CONCLUSIONS: Local control using radiation treatment is less
      successful than with ordinary invasive and in situ squamous carcinomas of the
      larynx. Nevertheless, the treatment is effective and provides an appropriate
      option for laryngeal conservation, especially in advanced lesions where total
      laryngectomy may be the only treatment alternative. Surgical salvage of radiation
      failures contributes to very high rates of cure for verrucous carcinoma of the
      larynx. Anaplastic transformation of cases treated with radiotherapy was not
      observed in any case in this series.

PMID- 7790247
TI  - The influence of positive margins and nerve invasion in adenoid cystic carcinoma
      of the head and neck treated with surgery and radiation.
AB  - PURPOSE: Surgery is the primary treatment for adenoid cystic carcinomas arising
      from major and minor salivary glands of the head and neck. However, local
      recurrence is frequent because of the infiltrative growth pattern and perineural
      spread associated with these tumors. At UTMDACC, we have had a longstanding
      policy of using postoperative radiotherapy to reduce the risk of local recurrence
      and to avoid the need for radical surgery; this 30-year retrospective study
      analyzes the results of this combined modality approach. METHODS AND MATERIALS:
      Between 1962 and 1991, 198 patients ages 13-82 years, with adenoid cystic
      carcinomas of the head and neck, received postoperative radiotherapy for known or
      suspected microscopic residual disease following surgery. Distribution of primary
      sites was: parotid: 30 patients; submandibular/sublingual: 41 patients; lacrimal:
      5 patients; and minor salivary glands: 122 patients. Eighty-three patients (42%)
      had microscopic positive margins and an additional 55 (28%) had close (< or = 5
      mm) or uncertain margins. One hundred thirty-six patients (69%) had perineural
      spread with invasion of a major (named) nerve in 55 patients (28%). Using
      radiation techniques appropriate to the primary site, a median dose of 60 Gy
      (range 50-69 Gy) was delivered to the tumor bed. Follow-up ranged from 5-341
      months (median, 93 months). All surviving patients had a minimum of 2 years
      follow-up. RESULTS: Twenty-three patients (12%) had local recurrences with 5-, 10
      , and 15-year actuarial local control rates of 95%, 86%, and 79%, respectively.
      Fifteen of the 83 patients (18%) with positive margins developed local
      recurrences, compared to 5 of 55 patients (9%) with close or uncertain margins,
      and 3 of 60 patients (5%) with negative margins (p = 0.02). Patients with and
      without a major (named) nerve involved had crude failure rates of 18% (10 out of
      55) and 9% (13 out of 143), respectively (p = 0.02). There was a trend toward
      better local control with increasing dose. This was significant in patients with
      positive margins, in whom crude control rates were 40 and 88% for doses of < 56
      Gy and > or = 56 Gy, respectively (p = 0.006). Actuarial 5-, 10-, and 15-year
      freedom from relapse rates were 68%, 52%, and 45%, respectively. Base of skull
      and neck failures were uncommon with or without elective treatment, developing in
      2 and 3% of patients, respectively. Distant metastases were the most common type
      of disease recurrence, developing in 74 patients (37%) of whom 62 (31%) were
      disease-free at the primary site. CONCLUSIONS: Excellent local control rates were
      obtained in this population using surgery and postoperative radiotherapy and we
      recommend this combined approach for most patients with adenoid cystic carcinomas
      of the head and neck. Perineural invasion was an adverse prognostic factor only
      when a major (named) nerve was involved. Microscopic positive margins was also an
      adverse prognostic factor, but even when present, local control was achieved in
      over 80% of our patients. We recommend a dose of 60 Gy to the tumor bed,
      supplemented to 66 Gy for patients with positive margins. Despite effective local
      therapy, one-third of patients fail systemically, and good treatment to address
      this problem is lacking.

PMID- 7790248
TI  - Mandibular reconstruction using a titanium plate: the impact of radiation therapy
      on plate preservation.
AB  - PURPOSE: To evaluate the soft tissue and bone tolerance of radiation therapy (RT)
      in patients undergoing radical composite resection and mandibular reconstruction
      using a bridging titanium plate with myocutaneous flap closure. METHODS AND
      MATERIALS: From 1990 to 1994, 47 patients with primary or recurrent oral cavity
      or oropharyngeal carcinomas were treated with radical composite resection and
      mandibular reconstruction using a bridging titanium plate with myocutaneous flap
      closure. Eleven patients received no RT (no RT), 10 patients received RT greater
      than 10 months from the time of surgery (remote RT), and 26 patients received RT
      within 12 weeks of surgery (perioperative RT). The radiation dose to the
      reconstructed mandible ranged from 45 to 75 Gy (median 63 Gy). The effect of the
      titanium plate on the radiation dose was measured using film dosimetry and soft
      tissue and bone-equivalent materials. The median follow-up was 17 months (range:
      3-50 months). RESULTS: Late complications included four patients with
      osteomyelitis or necrosis, two plate exposures requiring flap revision, one
      chronic infection, two cases of chronic pain, two fistulae, and one case of
      trismus and malocclusion. The crude incidence of late complications by treatment
      was: (a) no RT: 3 of 11 patients (27%); (b) remote RT: 2 of 10 patients (20%);
      and (c) perioperative RT: 9 of 26 patients (35%). One patient in the no-RT group
      lost the plate due to chronic pain. Five patients in the perioperative RT group
      also had plate loss, four due to osteomyelitis and/or necrosis, and one due to
      pain related to a recurrent tumor. No patients in the remote RT group had plate
      loss. The actuarial prosthesis preservation rate at 2 years was 88% for the no
      RT, 100% for the remote RT, and 57% for the perioperative RT groups (p = 0.05).
      Phantom dose measurements showed that for parallel opposed 6 MV photon beams,
      there was no significant increase in the dose proximal or distal to the plate in
      either a soft tissue- or bone-equivalent phantom. CONCLUSIONS: The impact of
      radiation therapy on plate preservation after mandibular reconstructive surgery
      using a titanium plate may be dependent on the timing of RT relative to surgery.
      Significantly more mandibular reconstruction plates were lost when the involved
      mandible received RT in the perioperative period than when RT was delivered
      beyond 10 months from surgery or when no RT was given. The use of alloplastic
      implants such as titanium plates in conjunction with myocutaneous flap coverage
      for mandibular reconstruction is attractive because it allows immediate
      reconstruction of the defect and promotes a good functional and cosmetic result;
      however, administration of perioperative RT may result in a higher plate failure
      rate.

PMID- 7790249
TI  - The influence of quantitative tumor volume measurements on local control in
      advanced head and neck cancer using concomitant boost accelerated
      superfractionated irradiation.
AB  - PURPOSE: Current methods to clinically define head and neck tumor bulk are
      qualitative and imprecise. Although the American Joint Committee on Cancer (AJCC)
      staging system is important for this purpose, limitations exist. This study will
      investigate the prognostic value of computed tomography (CT) derived tumor volume
      measurements in comparison to AJCC stage and other significant variables.
      MATERIALS AND METHODS: Seventy-six patients with advanced head and neck squamous
      cell carcinoma were treated with concomitant boost accelerated superfractionated
      irradiation. Doses ranged from 68.4-73.8 Gy (median 70.2 Gy). Good quality
      pretherapy CT scans were available in 51 patients. Total tumor volume (TTV)
      estimates were derived from these scans using digital integration of primary
      tumor and metastatic lymphadenopathy. Actuarial and multivariate statistical
      techniques were applied to analyze local control. RESULTS: Thirty-six-month local
      control was 63%. TTV ranged from 5-196 cm3 (median 35 cm3) for all cases, 5-142
      cm3 (median 17 cm3) for those controlled, and 16-196 cm3 (median 47 cm3) for
      local failures. There was a significant increase in failures above 35 cm3.
      Univariate analysis found that TTV, T-stage, N-stage, and primary site were each
      significant prognostic variables. Local control for TTV < or = 35 cm3 was 92% at
      36 months vs. 34% for TTV > 35 cm3 (p = 0.0001). Multivariate analysis, however,
      found that TTV, primary site, and sex were important as independent variables; T
      and N stage were not independently significant unless TTV was removed from the
      model. CONCLUSIONS: This study demonstrates the prognostic significance of TTV in
      advanced carcinoma of the head and neck. This variable appears to be a more
      predictive than AJCC clinical stage. Quantitative tumor volume measurements may
      prove to be a useful parameter in future analyses of head and neck cancer.

PMID- 7790250
TI  - Incidence of and factors related to late complications in conformal and
      conventional radiation treatment of cancer of the prostate.
AB  - PURPOSE: The fundament hypothesis of conformal radiation therapy is that tumor
      control can be increased by using conformal treatment techniques that allow a
      higher tumor dose while maintaining an acceptable level of complications. To test
      this hypothesis, it is necessary first to estimate the incidence of morbidity for
      both standard and conformal fields. In this study, we examine factors that
      influence the incidence of late Grade 3 and 4 morbidity in patients treated with
      conformal and standard radiation treatment for prostate cancer. METHODS AND
      MATERIALS: Six hundred sixteen consecutive patients treated with conformal or
      standard techniques between 1986 and 1994 to doses greater than 65 Gy and with
      more than 3 months follow-up were analyzed. No patients treated with
      prostatectomies were included in the analysis. The conformal technique includes
      special immobilization by a cast, careful identification of the target volume in
      three dimensions, localization of the inferior border of the prostate using a
      retrograde urethrogram, and individually shaped portals that conform to the
      Planning Target Volume (PTV). Multivariate analysis using a proportional hazards
      model compares differences in the incidence of Radiation Therapy Oncology
      Group/European Organization for Research and Center Treatment (RTOG/EORTC) Grade
      3 and 4 late gastrointestinal (GI) and genitourinary (GU) morbidity by technique,
      T-stage, grade, age, hormonal treatment, irradiated volume, dose, and comorbid
      conditions. Grade 3 rectal bleeding was defined as requiring three or more
      cautery procedures. RESULTS: The overall actuarial incidence of genitourinary
      (GU) toxicities at 5 years was 3.4%, with the crude incidence being six cases in
      616 patients satisfying the selection criteria; for gastrointestinal (GI)
      toxicities, the overall actuarial incidence was 2.7%, with the crude incidence
      being 13 cases out of 616 patients. The average time to complication for our
      patients was 12.8 months for GI toxicity and 32.9 months for GU toxicity (p <
      0.001). No factors were found that were predictive for GU morbidity. The only
      factors significantly related to incidence of late GI morbidity on multivariate
      analysis of our data were dose and age. The central axis dose was a more
      significant variable than the dose prescribed to the Treated Volume. Age was
      negatively correlated with late GI morbidity, with older patients having a
      reduced incidence of toxicity. The median tolerance dose for GI complications was
      estimated to be 92.8 Gy, and the dose for 10% incidence was estimated to be 80.2
      Gy. Treating the pelvis to 45 Gy did not increase the incidence of late
      morbidity. Late GI and GU toxicities were not correlated. CONCLUSION: The
      conformal technique has been associated with fewer acute Grade 2 toxicities (6).
      The use of conformal fields did not decrease the incidence of late GI morbidity;
      however, patients with this technique invariably had higher doses. Because of the
      dose response for this complication and the correlation between the dose and the
      use of conformal fields, one would not expect to demonstrate an advantage to
      conformal fields in this data set. On the other hand, no dose effect was observed
      for late GU morbidity. In this case, there appears to be an advantage for
      conformal treatment that has not reached statistical significance because the
      follow-up time is shorter than for the patients treated with conventional fields
      and the latency for GU morbidity is long.

PMID- 7790251
TI  - Radiotherapy and chemotherapy for invasive thymomas: a multicentric retrospective
      review of 90 cases. The FNCLCC trialists. Federation Nationale des Centres de
      Lutte Contre le Cancer.
AB  - PURPOSE: Thymoma is a rare disease. The treatment of patients with invasive
      thymoma remains controversial. The prognosis of such patients is poor, even with
      the use of postoperative radiation therapy and chemotherapy. We retrospectively
      reviewed the outcome and prognostic factors in a series of 90 patients presenting
      with an invasive thymoma treated by partial resection or biopsy and radiation
      therapy. METHODS AND MATERIALS: From 1979-1990, 163 patients with the diagnosis
      of lymphoepithelial thymoma were treated in 10 French cancer centers. Patients
      were staged using the postoperative "GETT" classification derived from that of
      Masaoka. Ninety patients who presented with an invasive thymoma, 58 Stage III (21
      IIIA: partial resection and 37 IIIB: biopsy) and 32 Stage IVA (intrathoracic
      thymoma spread), are the subject of this report. Treatment combined surgery and
      radiation therapy (+/- chemotherapy), with curative intent. Surgery consisted of
      partial resection in 31 patients (21 Stage III), and biopsy in 55 patients (37
      Stage III). The median radiation dose to the tumor was 50 Gy (30-70 Gy).
      Supraclavicular radiation was performed in 59 patients (median dose 40 Gy).
      Chemotherapy, combined with radiation in 59 patients, consisted of multidrug
      regimens, mainly platinum based. RESULTS: The median follow-up is 105 months (20
      165 months). The 5- and 10-year overall survival rates are 51 and 39%,
      respectively. There is a great impact of the extent of surgery on survival: the 5
      and 10-year survival rates were 64% and 43%, respectively, after partial
      resection, compared to 39% and 31% after biopsy (p < 0.02). Local control at 8.5
      years was obtained in 59 of 90 patients (66%): 40 Stage III, 19 Stage IVA. There
      is a significant relationship between the extent of surgery and the local control
      (16% of relapse after partial resection vs. 45% after biopsy, p < 0.05). Seven
      patients developed significant (grades 3-4 WHO grading system) treatment-induced
      side effects. Stage, histologic type, and chemotherapy were not prognostic
      factors. CONCLUSION: In this large multicentric retrospective study of invasive
      thymomas (Stage III-IVA) treated by surgery and radiation, results show the
      importance of loco-regional treatments, such as surgery and radiation therapy.
      There is also a great impact of radiation on local control. However, the rate of
      local recurrence (34%) justifies recommending a higher dose of radiation (> 50
      Gy) than doses used in this study, for incompletely resected patients. The role
      of chemotherapy needs to be further assessed.

PMID- 7790253
TI  - External irradiation of macroinvasive pituitary adenomas with telecobalt: a
      retrospective study with long-term follow-up in patients irradiated with doses
      mostly of between 40-45 Gy.
AB  - PURPOSE: Published dose recommendations for radiotherapy in patients with
      pituitary macroadenomas vary. Therefore, we retrospectively analyzed the results
      in our patients from the treatment period 1973-1992. METHODS AND MATERIALS: From
      a total of 89 patients with macroinvasive adenomas, 66 received radiation therapy
      immediately following subtotal surgical removal (combined treatment modality),
      and 22 were irradiated as primary treatment or after surgical recurrence. Only
      one patient was reirradiated. The surgical interventions have been performed by
      the same surgeon. For the majority of patients (79 out of 89) with a mean follow
      up of 8.1 years (0.5-19 years) the total tumor dose ranged between 40-45 Gy at a
      dose per fraction of 1.8-2.25 Gy. All patients had bilateral opposed fields with
      telecobalt. Eleven patients had an additional arc rotation. RESULTS: The 10-year
      progression-free survival for all 89 patients independent of treatment modality
      was 88.1%. The 10-year progression-free survival for patients treated by surgery
      and adjuvant radiation therapy (40-45 Gy at 1.8-2.25 Gy, 60 out of 79) was 90.3%,
      and for radiation therapy alone (40-45 Gy at 1.8-2.25 Gy, 19 out of 79), 100% (p
      = 0.32). The prognostic factors for progression-free survival were the subtype of
      adenoma, the presence of visual symptoms at the time of diagnosis, the
      suprasellar extension, and the initial hormone levels. The presence of
      infiltration of adenoma cells in the basal dura or in the mucosa of the sinus
      sphenoidalis do not represent prognostic factors showing the special biological
      behavior of pituitary adenomas. Signs of x-ray-induced cerebral necrosis have not
      been observed in any patient. Long-term visual complications developed in four
      patients. This could be due to scar formation in the treated region, which can
      compress the optic nerve and provoke disturbance similar to an empty-sella
      syndrome. The latter occurred prevalently years after treatment, even though
      surgical methods of sellar plugging were used. The incidence of hypopituitarism
      after combined treatment modality at time of last follow-up (irradiated between
      40-45 Gy at 1.8-2.25 Gy) was low (36%, 21 out of 60). CONCLUSION: In patients
      with pituitary macroadenomas, radiotherapy with a total dose of 40-45 Gy at 1.8
      2.25 Gy per fraction resulted in a high local tumor control without serious
      morbidity.

PMID- 7790252
TI  - Cataracts after bone marrow transplantation: long-term follow-up of adults
      treated with fractionated total body irradiation.
AB  - PURPOSE: To determine the risk of, and risk factors for, developing cataracts
      after bone marrow transplantation. METHODS AND MATERIALS: Four hundred and ninety
      two adults who underwent bone marrow transplantation in Seattle were followed for
      2 to 18 (median, 6) years. Before transplantation, patients received a
      preparative regimen of chemotherapy plus total body irradiation (TBI) (n = 407)
      or chemotherapy alone, without TBI (n = 85). TBI was administered in a single
      dose of 10 Gy (n = 74) or in fractionated doses totaling 12-15.75 Gy (n = 333).
      The risk of cataracts was determined for groups of patients with respect to the
      type of preparative regimen received and other pretransplant and posttransplant
      variables. RESULTS: One hundred and fifty-nine patients (32%) developed cataracts
      between 0.5 to 11 (median, 2.3) years after transplantation. The probability of
      cataracts at 11 years after transplantation was 85%, 50%, 34%, and 19% for
      patients receiving 10 Gy of single-dose TBI, > 12 Gy fractionated TBI, 12 Gy
      fractionated TBI, and no TBI, respectively (p < 0.0001). Among those developing
      cataracts, the severity was greater in patients after single-dose TBI (59%
      probability of surgical extraction) than after > 12 Gy fractionated TBI, 12 Gy
      fractionated TBI, or no TBI (33%, 22% and 23%, respectively). Patients given
      corticosteroids after transplant had a higher probability of cataracts (45%) than
      those without steroids (38%) (p < 0.0001). In a proportional hazards regression
      model, the variables that were correlated with an increased probability of
      cataracts were single-dose TBI (relative risk (RR) = 2.46) and steroid therapy
      (RR = 2.34), while a decreased probability of cataracts was correlated with a
      nonTBI preparative regimen (RR = 0.41). The yearly hazard of developing cataracts
      in recipients of single-dose TBI was highest during the third year after
      transplantation, while in recipients of fractionated TBI, the hazard was
      distributed among years one through seven. The probability of cataracts in all
      groups reached a plateau at 7 years after transplantation, after which the
      development of cataracts was extremely unlikely. CONCLUSION: TBI is the major
      risk factor for developing cataracts after BMT. Single-dose TBI results in the
      highest risk of cataracts. However, the risk of cataracts in recipients of
      fractionated-TBI is significantly higher than in patients who receive no TBI. In
      addition to TBI, steroid therapy is an independent risk factor for cataracts
      after BMT.

PMID- 7790254
TI  - Induction of cisplatinum sensitivity without alteration in radiation sensitivity
      by fractionated radiation treatment of a human laryngeal squamous cell carcinoma
      cell line.
AB  - PURPOSE: To determine if fractionated radiation treatment can alter cisplatinum
      sensitivity of a human laryngeal squamous carcinoma cell line. METHODS AND
      MATERIALS: Human squamous carcinoma cells, both previously untreated, as well as
      survivors of fractionated radiation therapy, were tested in vitro for their
      sensitivity to gamma radiation and cisplatinum. Fractionated gamma radiation was
      delivered in 14 or 10 daily fractions of 2 Gy. The cell line, cSCC-20, was
      derived from an untreated primary human laryngeal carcinoma. RESULTS: The human
      laryngeal squamous cell carcinoma cell line, cSCC-20, was demonstrated to have
      heterogeneous subpopulations with respect to cisplatinum sensitivity. No
      variation in radiation sensitivity was seen among subpopulations of varying
      cisplatinum sensitivity. The cells were relatively radioresistant (Do = 2.5 Gy).
      Fractionated radiation treatments of the parent cell line (14 fractions, 14 days,
      2 Gy/fraction) or a cisplatinum sensitive subline (10 fractions, 12 days, 2
      Gy/fraction) induced cisplatinum sensitivity (factor of 1.3 to 1.4) in the
      surviving cells. CONCLUSION: Fractionated radiation treatment of human squamous
      carcinoma cells in vitro induced sensitivity to cisplatinum without concomitant
      alteration in radiation sensitivity.

PMID- 7790256
TI  - PO2 in irradiated versus nonirradiated tumors of mice breathing oxygen at normal
      and elevated pressure.
AB  - PURPOSE: To determine if prior tumor irradiation influences tumor pO2 changes in
      mice breathing oxygen (100%) at normal and elevated pressure. METHODS AND
      MATERIALS: Single-point pO2 measurements were performed in nonirradiated and
      previously irradiated (72 h) isotransplanted MCaIV tumors in C3H/Sed mice.
      Continuous recordings were performed at the same tumor locus under air breathing,
      followed by 100% oxygen and oxygen at three atmospheres pressure. Following
      decompression and induction of pentobarbital anesthesia, the procedure was
      repeated at the same locus. Six nonirradiated and five irradiated tumors were
      evaluated under the three gas breathing conditions +/- anesthesia. RESULTS: The
      mean, median, and range of pO2 values did not differ under air-breathing
      conditions in the nonirradiated vs. previously irradiated tumors. However, prior
      irradiation substantially enhanced the tumor pO2 increase when the inspired gas
      phase was switched from air to 100% oxygen at 1 or 3 atmospheres pressure. In
      four of six nonirradiated tumors, 100% oxygen breathing resulted in a pO2
      increase of < 4 mmHg; in the irradiated tumors, the minimum increase was 16 mmHg.
      Pentobarbital anesthesia did not significantly influence the results obtained.
      CONCLUSION: These data indicate that the efficacy of oxygen breathing increases
      during tumor treatment, and suggests that oxygen breathing is a simple nontoxic
      method for reducing or eliminating radiobiologic hypoxia during therapy.

PMID- 7790255
TI  - Slowing proliferation in head and neck tumors: in vitro growth inhibitory effects
      of the polyamine analog BE-4-4-4-4 in human squamous cell carcinomas.
AB  - PURPOSE: These preclinical studies were carried out to examine the potential of
      the antiproliferative polyamine analog 1,19-bis-(ethylamino)-5,10,15
      triazanonadecane (BE-4-4-4-4) to serve as a therapy adjuvant to radiation for
      patients with rapidly dividing tumors of the head and neck (H&N). METHODS AND
      MATERIALS: Cytostatic and cytotoxic effects of this polyamine analog were
      investigated in three squamous cell carcinoma (SCC) cell lines derived from human
      H&N tumors. RESULTS: Growth inhibition was achieved in all cell lines within 3-4
      days of continuous 10 microM drug exposure, and inhibition of cell cycle
      proliferation kinetics was confirmed via flow cytometry. Cytotoxicity was
      pronounced (3-4 log cell kill) in the SCC-38 and SCC-4Y cell lines with
      continuous 10 microM analog exposure over 5 days, and was minimal in the SCC-13Y
      cell line. No demonstrable effect of BE-4-4-4-4 on single dose radiation survival
      was identified in any SCC cell line. Ornithine decarboxylase (ODC) activity was
      rapidly inhibited (1-2 h) following 10 microM BE-4-4-4-4 exposure in all SCC cell
      lines (approximately 90%), whereas identical exposure to 10 microM
      difluoromethylornithine (DFMO) induced animal ODC inhibition (approximately 10%).
      Dose-dependent depletion of endogenous polyamines (putrescine, spermidine,
      spermine) was achieved in all SCC cell lines following 1 microM and 10 microM BE
      4-4-4-4 exposures. Difluoromethylornithine was significantly less potent than BE
      4-4-4-4 in its capacity to deplete endogenous polyamines, with no measureable
      depletion of spermine pools even with 5 mM x 48 h DFMO exposures. CONCLUSIONS:
      These data evaluate cytostatic and cytotoxic properties of the polyamine analog
      BE-4-4-4-4 in human SCCs, and suggest a role for investigation of such agents as
      an adjuvant to radiation in the therapeutic approach to rapidly dividing human
      tumors such as those that occur in the H&N.

PMID- 7790257
TI  - Blood-spinal cord barrier function and morphometry after single doses of x-rays
      in rat spinal cord.
AB  - PURPOSE: The effects of irradiation on blood-spinal cord barrier (BSCB) function
      and ultrastructure were evaluated using a rat spinal cord model. METHODS AND
      MATERIALS: Rats received a single dose of 25 Gy to the cervical spinal cord (C2
      T2). At various times following irradiation and before the onset of paralysis,
      BSCB function was assessed using horseradish peroxidase (HRP) as a vascular
      tracer, and barrier-related structural changes in the capillaries were evaluated
      using morphometric techniques. RESULTS: Focal extravasation of HRP was seen at 93
      days after irradiation, and extensive extravasation was apparent by 114 days in
      white matter, but not in gray matter. At 93 days, pathologic changes apparent by
      light microscopy were very minor in the white matter of the irradiated segment.
      By 107 days, myelin beading, Wallerian degeneration, edema, and histiocytes were
      apparent in white matter, and these features became increasingly prominent over
      the following weeks. No noteworthy changes were seen in gray matter at these
      times. Electron microscopic examination showed that, during the first 93 days
      following irradiation, more than half of the endothelial cells in white matter
      had disappeared (p < 0.05). In terms of the putative vascular pores, no
      abnormalities in endothelial junctions (the presumed small pore) were found, but
      there was an increase in the density of endothelial vesicles (a putative form of
      the large pore) in irradiated white matter (p < 0.001), but not in gray matter.
      Pericytes, thought to act as a second line of defence in the blood-brain barrier,
      increased in size but not in number in the irradiated white matter of the spinal
      cord. CONCLUSION: We suggest that radiation damage to endothelial cells, which
      form the BSCB prior to the onset of neurological deficit, may play an important
      role in the pathogenesis of white matter necrosis.

PMID- 7790258
TI  - Optimum combination of targeted 131I and total body irradiation for treatment of
      disseminated cancer.
AB  - PURPOSE: Radiobiological modeling was used to explore optimum combination
      strategies for treatment of disseminated malignancies of differing
      radiosensitivity and differing patterns of metastatic spread. The purpose of the
      study was to derive robust conclusions about the design of combination strategies
      that incorporate a targeting component. Preliminary clinical experience of a
      neuroblastoma treatment strategy, which is based upon general principles obtained
      from modelling, is briefly described. METHODS AND MATERIALS: The radiobiological
      analysis was based on an extended (dose-rate dependent) formulation of the linear
      quadratic model. Radiation dose and dose rate for targeted irradiation of tumors
      of differing size was in part based on microdosimetric considerations. The
      analysis was applied to several tumor types with postulated differences in the
      pattern of metastatic spread, represented by the steepness of the slope of the
      relationship between numbers of tumors present and tumor diameter. The clinical
      pilot study entailed the treatment of five children with advanced neuroblastoma
      using a combination of 131I metaiodobenzylguanidine (mIBG) and total body
      irradiation followed by bone marrow rescue. RESULTS: The theoretical analysis
      shows that both intrinsic radiosensitivity and pattern of metastatic spread can
      influence the composition of the ideal optimum combination strategy. High
      intrinsic radiosensitivity generally favors a high proportion of targeting
      component in the combination treatment, while a strong tendency to
      micrometastatic spread favors a major contribution by total body irradiation. The
      neuroblastoma patients were treated using a combination regimen with an initially
      low targeting component (2 Gy whole body dose from targeting component plus 12 Gy
      from total body irradiation). The treatment was tolerable and resulted in
      remissions in excess of 9 months in each of these advanced neuroblastoma
      patients. CONCLUSIONS: Radiobiological analysis, which incorporates simple models
      of metastatic spread, emphasizes the importance of the total body irradiation
      component in a targeting/total body irradiation combination strategy. However,
      the analysis favors a larger targeting component than is used in clinical
      practice at present. A cautious escalation of the 131I mIBG component in the
      combination treatment of advanced neuroblastoma appears justified.

PMID- 7790259
TI  - Tissue compensation using dynamic collimation on a linear accelerator.
AB  - PURPOSE: The availability of computer-controlled collimators on some accelerators
      has led to techniques for dynamic beam modification, mainly to simulate beam
      wedge filters. This work addresses the practical aspects of dynamic tissue
      compensation in one dimension using available treatment-planning software.
      METHODS AND MATERIALS: Data derived from the treatment-planning program is used
      with an iterative calculational routine to determine the monitor unit settings
      needed for the collimator-controlling computer. The method was first tested by
      simulating a 60 degrees physical wedge. Further studies were carried out on a
      specially fabricated plastic phantom that modeled the sagittal contour of the
      upper torso, neck, and lower head regions. RESULTS: Dynamic wedge point doses
      generated by the planning program agreed within 1% with the values directly
      measured in a polystyrene phantom. In the patient phantom, dynamic collimation
      achieved calculated dose uniformity within 0.5% in a reference plane near the
      phantom midline. A comparison of computer-generated and measured point doses in
      this case showed agreement within 3%. CONCLUSIONS: Dynamic collimation can
      provide effective compensation for contours that vary primarily along one
      direction. A conventional treatment-planning program can be used to plan dynamic
      collimation and deliver a prescribed dose with reliable accuracy.

PMID- 7790260
TI  - Clinical experience using 8 MHz radiofrequency capacitive hyperthermia in
      combination with radiotherapy: results of a phase I/II study.
AB  - PURPOSE: Since 1985, the University of Minnesota Hospital and Clinic has
      investigated the efficacy and safety of 8 MHz radiofrequency (RF) capacitive
      hyperthermia using the Thermotron RF-8. This study reports the thermometric and
      clinical results of 119 patients treated with RF hyperthermia in combination with
      radiotherapy (RT). METHODS AND MATERIALS: Of 119 patients, 69 received high-dose
      RT and 50 patients received low-dose RT because of previous irradiation to the
      treatment site. The most common anatomic sites treated were within the pelvic
      cavity or head and neck area. Thirty-three percent and 24% of tumors treated were
      > 7 cm and > 10 cm in largest diameter, respectively. Forty percent of the
      patients had deep-seated tumors (depth > 6 cm). Hyperthermia was given as soon as
      possible after RT twice weekly, allowing at least 72 h between treatments. The
      objective was to raise intratumoral temperatures to 42-43 degrees C or above for
      30-50 min while keeping normal tissue temperatures below 40-41 degrees C.
      RESULTS: Of 119 patients, 40% achieved a Tmax tumor temperature of > 42 degrees C
      and 40% achieved 40-42 degrees C Tmax. Higher Tmax) tumor temperatures were
      observed as tumor size increased. Tumors > 10 cm in largest diameter had a Tmax
      of 42.2 degrees C. Tumor depth was not a significant factor for the tumor
      temperatures achieved. Of 119 patients, 11% achieved complete response and 38%
      achieved partial response. Of the no-response patients, 34% had symptomatic
      palliation and 15% had stable disease for at least 12 months after treatment. We
      were able to treat tumors of patients with subcutaneous fat as thick as 3 cm by
      precooling the fat for 20 min with 10-15 degrees C saline-filled boluses prior to
      the initiation of heating. During treatment, 60% of patients complained of
      varying degrees of pain and 19% had pain that was a factor in limiting treatment.
      Vital signs were relatively stable and not a factor in limiting treatment.
      CONCLUSION: The Thermotron RF-8 is a useful hyperthermia device that can raise
      tumor temperatures to a therapeutic level (i.e., 42 degrees C) in a significant
      proportion of patients with superficial, subsurface, and deep-seated tumors, with
      minimal adverse effects, complications, and systemic stress. Further clinical
      studies using improved thermometry systems are warranted.

PMID- 7790263
TI  - Split-course accelerated therapy in head and neck cancer: an analysis of
      toxicity.
AB  - PURPOSE: To retrospectively assess a protocol of split-course accelerated
      radiation therapy (SCAT) for selected head and neck cancers. METHODS AND
      MATERIALS: SCAT consisted of 1.8 Gy per fraction administered twice daily with a
      minimum gap between fractions of 6 h. The treatment protocol prescribed an
      initial 16 fractions followed by a planned 5 to 12 day break, and then a further
      20 to 22 fractions for a total dose ranging from 64.8 to 72 Gy delivered in 5 to
      6 weeks. RESULTS: Twenty-eight patients received SCAT for histologically
      confirmed head and neck cancer between January 1987 and August 1991. All patients
      were followed up until December 1, 1993. The mean potential follow-up time was
      4.2 years (range: 2.9-6.2 years). All patients completed the treatment protocol.
      Thirteen tumors were laryngeal in origin, eight hypopharyngeal, four paranasal
      sinus, and three oropharyngeal. There were no Stage I, three Stage II, nine Stage
      III, and 12 Stage IV tumors. Four tumors were not staged (two paranasal sinus
      cancers and two surgical recurrences). Early and late toxicities were moderate to
      severe. Confluent mucositis was experienced by 27 of the 28 patients (96%). One
      patient required a prolonged midtreatment break of 24 days. Nine patients (32%)
      required narcotic analgesia for pain relief. Eleven patients (39%) required
      hospitalization for nasogastric feeding or pain control. The median length of
      hospital stay was 14 days (range 7-98 days). The actuarial rate of severe late
      toxicity at 3 years was 47% (standard error (SE) = 13%). A complete tumor
      response was achieved in 86% of patients. The actuarial local control rate at 3
      years was 43% (SE = 11%) and the actuarial survival rate at 3 years was 25% (SE =
      8%). CONCLUSION: Given the encouraging complete response rate and local control
      for such advanced tumors, SCAT for locoregionally advanced tumors merits further
      investigation. However, because of the significant late toxicity observed, the
      total dose, interfraction interval, and fractionation technique used should be
      reconsidered.

PMID- 7790262
TI  - Management of adenocarcinoma of the esophagus with chemoradiation alone or
      chemoradiation followed by esophagectomy: results of sequential nonrandomized
      phase II studies.
AB  - PURPOSE: The incidence of adenocarcinoma of the esophagus is increasing, but the
      optimal treatment for this disease is unknown. We evaluated the efficacy of
      chemoradiation and chemoradiation followed by esophagectomy as treatment for
      adenocarcinoma of the esophagus in sequential prospective nonrandomized phase II
      studies. METHODS AND MATERIALS: Between May 1981 and June 1992, all previously
      untreated patients (N = 35) with potentially resectable adenocarcinoma of the
      esophagus (clinical Stage I or II) were treated with curative intent in
      sequential prospective Phase II studies. From May 1981 to August 1987, 11
      patients (median age 66) were treated with concurrent chemotherapy [mitomycin C,
      and 5-fluorouracil (5-FU)] and radiotherapy to a median dose of 60 Gy (CRT
      group). From September 1987 to June 1992, 24 patients (median age 65) were
      treated with the same regimen of chemoradiation followed by planned esophagectomy
      (CRT+PE group). Of these, 12 patients (median age 62) actually underwent
      esophagectomy (CRT+E subgroup). RESULTS: The median overall survival was 19
      months for the CRT group and 15 months for the CRT+PE group. For the CRT+E
      subgroup, the median overall survival was 33 months. The 3-year actuarial overall
      survival for the CRT and the CRT+PE groups were 36 and 28% (p = 0.949). The
      subset of patients treated with chemoradiation followed by esophagectomy had a 3
      year actuarial overall survival of 33% (p = 0.274). The 3-year actuarial freedom
      from local failure rates were similar: 62% in the CRT group vs. 58% in the CRT+PE
      group. Of the 12 patients who underwent esophagectomy (CRT+E group), 9 (75%) were
      free of local failure. Four of 12 (33%) patients had no pathologic evidence of
      malignancy in their surgical specimen. Six of 11 patients (55%) in the CRT group
      were free of local failure at the time of analysis. Two of five patients in this
      group who had local recurrence at 2 and 10 months underwent surgical salvage with
      subsequent survivals of 20 and 100 months, respectively. Treatment-related
      mortality was 0 out of 11 in the CRT group and 2 out of 24 in the CRT+PE group.
      Dysphagia relief was similar in the CRT group vs. the CRT+E subgroup; however, a
      greater percentage of patients treated with chemoradiation alone had normal long
      term swallowing function when compared to those patients also undergoing
      esophagectomy (100% vs. 73%). CONCLUSION: High-dose chemoradiation alone appears
      to provide similar survival and relief of dysphagia compared with high-dose
      chemoradiation followed by esophagectomy for patients with potentially resectable
      esophageal adenocarcinoma. Local failure may be higher in patients undergoing
      chemoradiation compared to chemoradiation followed by esophagectomy, but surgical
      salvage is possible, thus providing similar overall local control. However,
      because of the small number of patients in each group, these treatment modalities
      need to be further evaluated in a prospective randomized Phase III study.

PMID- 7790261
TI  - Very accelerated radiation therapy: preliminary results in locally unresectable
      head and neck carcinomas.
AB  - PURPOSE: To report preliminary results of a very accelerated radiation therapy
      Phase I/II trial in locally advanced head and squamous cell carcinomas (HNSCC).
      METHODS AND MATERIALS: Between 01/92 and 06/93, 35 patients with an unresectable
      HNSCC were entered in this study. Thirty-two (91%) had Stage IV, and 3 had Stage
      III disease. The mean nodal diameter, in patients with clinically involved nodes
      (83%), was 6.3 cm. The median Karnovsky performance status was 70. The treatment
      consisted of a twice daily schedule (BID) giving 62 Gy in 20 days. RESULTS: In
      all cases, confluent mucositis was observed, which started about day 15 and
      resolved within 6 to 10 weeks. Eighty percent of patients had enteral nutritional
      support. The nasogastric tube or gastrostomy was maintained in these patients for
      a mean duration of 51.8 days. Eighteen patients (53%) were hospitalized during
      the course of treatment due to a poor medical status or because they lived far
      from the center (mean 25 days). Nineteen patients (56%) (some of whom were
      initially in-patients) were hospitalized posttreatment for toxicity (mean 13
      days). Five patients (15%) were never hospitalized. During the follow-up period,
      12 local and/or regional failures were observed. The actuarial 18-month loco
      regional control rate was 59% (95% confidence interval, 45-73%). CONCLUSIONS: The
      dramatic shortening of radiation therapy compared to conventional schedules in
      our series of very advanced HNSCC resulted in: (a) severe acute mucosal toxicity,
      which was manageable but required intensive nutritional support in all cases; and
      (b) high loco-regional response rates, strongly suggesting that the time factor
      is likely to be critical for tumor control in this type of cancer.

PMID- 7790264
TI  - Outcome following radiation treatment for high-risk pigmented villonodular
      synovitis.
AB  - PURPOSE: Pigmented villonodular synovitis (PVNS) is a rare proliferative process
      involving synovial membranes. It has a variable course, and while usually benign,
      may be destructive, resulting in major symptoms and loss of function leading to
      amputation. Optimum treatment is not always clear, and little information exists
      with respect to the role of radiotherapy. The purpose was to review our
      experience with radiotherapy in cases at high risk for recurrence with functional
      loss including instances where amputation was the sole alternative for
      symptomatic disease. METHODS AND MATERIALS: The records of all patients
      registered between 1972 and 1992 with a diagnosis of PVNS were identified (21
      cases). The records of 14 cases who received radiotherapy after referral were
      reviewed retrospectively for demographic information, radiotherapy treatment
      parameters, and tumor outcome. RESULTS: All cases had confirmation of pathologic
      diagnosis. Six patients had primary and eight had recurrent disease (with a mean
      of 2.5 prior surgical procedures). All cases had both intra- and extraarticular
      disease and, without exception, the poorer prognosis diffuse subtype of the
      disease. The majority had one or more additional risk factors including skin,
      bone, tendon, neurovascular, or muscle group extension. With a mean follow-up
      time of 69 months (range 13-250 months), only one patient has shown persistence
      of disease. With the exception of that single case, all those with measurable
      disease had obvious disease until at least 12 months and, subsequently,
      manifested complete responses. The single case was lost from the clinic after 8
      months from the initiation of radiotherapy to a dose of 30 Gy in 15 fractions and
      had a palpable mass at the time. He subsequently was noted to have a persisting
      mass and an excisional biopsy 9 years later showed PVNS. He remains well 21 years
      after treatment with good function. Eleven patients enjoyed excellent or good
      function from the affected limb and three had fair function. All patients had
      greater use of limb than at the time of treatment. No patient required
      amputation, and none had evidence of serious radiotherapy complications.
      CONCLUSIONS: These results demonstrate that moderate dose radiotherapy is an
      effective modality in the treatment of a subset of cases with this rare
      condition. Its use has permitted avoidance of amputation in very advanced cases
      with acceptable function preservation. When treatment is indicated we currently
      recommend gross total removal of PVNS. This is followed by moderate dose
      radiotherapy (35 Gy in 15 fractions) for residual disease where salvage of
      subsequent recurrence may compromise function.

PMID- 7790266
TI  - Staging and follow-up of nasopharyngeal carcinoma: magnetic resonance imaging
      versus computerized tomography.
AB  - PURPOSE: To compare computerized tomography (CT) and magnetic resonance (MR) in
      relation to their accuracy in the staging of nasopharyngeal carcinoma (NPC); to
      compare CT and MR in postirradiation follow-up of NPC. METHODS AND MATERIALS:
      Staging: From 1985 to 1993, 53 patients affected with NPC were studied with MR
      and CT. All cases were biopsy-proved epithelial carcinoma. Plain and contrast
      enhanced CT scans were performed with third-generation scanners. Magnetic
      resonance were obtained with 0.5 and 1.5 Tesla units in sagittal, axial, and
      coronal planes. Computerized tomography was chosen as reference method and
      findings obtained with MR were compared to those obtained with CT. FOLLOW-UP:
      From 1985 to 1993, 53 patients irradiated with radical intent were followed up
      with both CT and MR; 71 examinations were performed in all. The baseline follow
      up scan was performed, in general, no sooner than 2 months after the end of
      radiotherapy. All patients were submitted to unlimited clinical follow-up.
      RESULTS: Staging: Magnetic resonance showed retropharyngeal adenopathies in 6 of
      14 cases in which oropharyngeal involvement had been reported after CT; in 3
      other patients, adenopathies were recognized on MR, while primary extent to
      parapharyngeal space had been diagnosed on CT initially. Infiltration of long
      muscles of the neck was revealed with MR in 14 cases. On the other hand, CT
      showed bone invasion in 12 patients vs. 8 on MR. Upstaging to T4 occurred in four
      cases on the basis of CT; no upstaging occurred after MR. FOLLOW-UP: Findings on
      CT were uncertain in 10 out of 53 patients, disease recurrence was excluded by MR
      in nine cases, whereas progressive disease was confirmed in one patient.
      CONCLUSION: Staging: Our series shows that either CT and MR can provide essential
      information in the staging of NPC. Magnetic resonance, however, seems to provide
      the most detailed imaging of soft tissue invasion outside the nasopharynx and of
      retropharyngeal node involvement. Nonetheless, its limitations in evaluating bone
      details suggest that CT should be always performed when the status of base of
      skull is uncertain on MR. General reasons and our data indicate that CT can still
      be considered a valuable tool in routine NPC staging. Follow up: Magnetic
      resonance may be the modality of choice because it seems to solve, more often
      than CT, the problems of differentiation between postradiation changes and
      recurring tumor, apart from those cases showing subtle bone erosions on initial
      CT scan.

PMID- 7790265
TI  - Evaluation of response to radiotherapy in head and neck cancer by positron
      emission tomography and [11C]methionine.
AB  - PURPOSE: To evaluate the usefulness of positron emission tomography (PET) and L
      [methyl-11C]methionine in assessing treatment response to radiotherapy in head
      and neck cancer. METHODS AND MATERIALS: Fifteen patients with head and neck
      cancer (13 with squamous cell carcinoma, 1 with adenocystic carcinoma, and 1 with
      paranasal plasmocytoma) underwent a PET study with [11C]-methionine both before
      and after preoperative radiotherapy to the total tumor dose of 61-73 Gy. Twelve
      primary and 12 metastatic tumor sites were within the field of view. Nineteen of
      the 24 tumor sites were surgically explored after radiotherapy, and the tumor
      standardized uptake values (SUVs) of [11C]methionine were compared with
      histological findings. RESULTS: All 24 malignant lesions were detectable in the
      pretreatment study. In all but one case, the tumor SUV decreased after
      radiotherapy. The median SUV of the tumor site was smaller (1.9, range, 1.3-3.1,
      n = 7) in cases with histologically verified complete response than in cases with
      persistent cancer (median 4.1, range, 2.8-7.6, n = 12, p = 0.0008). A complete
      histological response was verified in none of the 9 cases with a postirradiation
      SUV larger than the median (3.1), whereas 7 of the 10 cases with a SUV of 3.1 or
      smaller had complete response (p = 0.003). The preirradiation uptake of
      [11C]methionine in tumors did not have significant association with histological
      response (p = 0.45). The PET findings correlated well with follow-up data in five
      cases with unoperated tumor sites. The [11C]methionine uptake of the
      submandibular salivary glands decreased after radiotherapy (p = 0.04).
      CONCLUSION: PET with [11C]methionine as a tracer may be useful in assessing
      response to radiotherapy in head and neck cancer. High uptake of [11C]methionine
      in the postirradiation scan suggests the presence of persistent disease.

PMID- 7790267
TI  - Arytenoid sparing during irradiation of early stage vocal cord cancer.
AB  - PURPOSE: Optimal position of the posterior field border when irradiating early
      stage vocal cord cancer is controversial. Several experts recommend moving the
      posterior field border 5-15 mm anteriorly after 50-60 Gy to decrease the chance
      of arytenoid edema. This article will evaluate the effect of field position on
      arytenoid dose. METHODS AND MATERIALS: 5 x 5 cm opposed lateral fields centered
      on the glottis were set up on a patient with typical anatomy. Isodose profiles
      were obtained with equally weighted 6 MV photon beams attenuated with 15 degree
      wedge filters using contours from an axial CT scan. Profiles with the posterior
      field border overlaying, 5, and 10 mm posterior to the posterior edge of the
      thyroid cartilage are presented. RESULTS: With the posterior field border 10 mm
      posterior to the thyroid cartilage, the arytenoids are included in the 95%
      isodose volume. Reducing the field by 5 mm has no significant effect on the
      position of the 95 and 90% isodose lines relative to the arytenoids. A field
      reduction of 10 mm places the arytenoids in the beam penumbra and leaves
      approximately 10 mm between the 95% isodose line and the midpoint of the true
      vocal cord. CONCLUSION: To achieve a significant dose differential between the
      arytenoids and the anterior portion of the vocal cord when using opposed lateral
      6 MV photon beams the posterior field border must be at, or anterior to, the
      posterior edge of the thyroid cartilage. In view of the excellent results
      reported from institutions that include the arytenoids in the high-dose volume
      throughout treatment, it would seem appropriate to limit the use of arytenoid
      sparing techniques to patients in whom there is no ambiguity about tumor location
      and in whom the treatment setup is very reproducible.

PMID- 7790269
TI  - Simulation accuracy in radiotherapy for maxillary sinus tumors.
AB  - PURPOSE: To evaluate the accuracy and clinical importance of beam positioning
      during simulation of radiation treatment for tumors in the maxillary sinus.
      METHODS AND MATERIALS: Five patients were prepared as if they were to be treated
      for a maxillary sinus tumor. A three-beam computed tomography (CT) scan-based
      computer plan was made for each patient. The location of the central beam axis of
      each beam was measured, relative to bony anatomical structures. A simulation was
      performed using the bony references to position the radiation beams during
      simulation. After this, the simulation procedure was repeated by the use of a
      noninvasive external localization frame with a known accuracy and reproducibility
      within 2 mm margins. RESULTS: When defining the clinical target volume as the
      known tumor with a 1 cm margin, three out of five patients would suffer a partial
      geographical miss throughout the entire radiation treatment due to erroneous beam
      positioning at the simulation stage when using bony structures as a guide for
      beam positioning. The influence of these errors is analyzed as normal tissue
      complication and tumor control probabilities. CONCLUSION: When defining a
      planning target volume, one should consider a margin to correct for possible
      simulation errors. We advise the use of objective, external (and thus
      nonanatomical) landmarks as a reference during simulation to reduce this extra
      margin to a minimum. In case of simulation, using bony structures as a reference,
      an additional margin should be entered, depending on the simulation accuracy that
      can be obtained.

PMID- 7790268
TI  - A method for delivering accurate and uniform radiation dosages to the head and
      neck with asymmetric collimators and a single isocenter.
AB  - PURPOSE: To investigate the use of asymmetric collimators and a single isocenter
      for delivering a uniform, accurate dose of radiation to the head, neck, and
      supraclavicular lymph nodes. METHODS AND MATERIALS: A linear accelerator with a
      pair of asymmetric collimators is required for this technique. An isocenter was
      placed at the junction of the lateral head and neck fields and the anterior
      supraclavicular field. The asymmetric collimators were set longitudinally, by
      collimator rotation if necessary. The collimators split the radiation beam to all
      portals. Dose uniformity was measured at the junction with films in solid-water
      phantoms. RESULTS: Film dosimetry showed a uniform dose at the junction without
      hot or cold regions. A digital display tolerance of +/- 1.0 mm for a field size
      maintained an acceptable uniform dose (+/- 5% dose variation) at the junction.
      The single isocenter and asymmetric collimators reduced field setup time by half.
      No table rotation was required to match fields. CONCLUSION: The asymmetric
      collimators lead to easy and accurate patient setup. The absence of the trapezoid
      effect resulted in the complete coverage of the submandibular and cervical nodes
      without any hot spots.

PMID- 7790271
TI  - Dose-volume histogram analysis of techniques for irradiating pituitary adenomas.
AB  - PURPOSE: Three-dimensional treatment planning was performed to evaluate three
      standard coplanar irradiation techniques (two-field parallel-opposed, three
      field, and 110 degrees bilateral arcs), the 330 degrees single rotational arc,
      and a four noncoplanar arc technique for the treatment of pituitary adenomas. We
      sought to identify the optimal technique for minimizing the dose delivered to the
      normal tissues around the pituitary gland. METHODS AND MATERIALS: Contours of the
      pituitary tumor and normal tissues were traced onto computed axial tomography
      (CT) scans and reconstructed in three dimensions using a three-dimensional
      planning system. A total dose of 45 Gy was delivered to the pituitary lesion with
      the five techniques using 6 MV and 18 MV photons, and dose-volume histograms were
      generated. RESULTS: The 18 MV photons delivered a lower dose to the temporal lobe
      than did the 6 MV photons in the two-field technique, but this advantage was not
      evident for the other techniques. The three-field technique improved dose
      distribution throughout the temporal lobes with low doses being delivered to the
      frontal lobe. The bilateral arc and the 330 degrees arc techniques were superior
      to stationary two- and three-fields techniques for sparing the temporal lobes.
      The four noncoplanar arc technique delivered less doses to the temporal and
      frontal lobes than did the other techniques. However, the lens dose (3.6 Gy/25
      fractions) was higher compared to the other techniques. CONCLUSION: Analysis of
      the dose-volume histograms shows the various dosimetric advantages and
      disadvantages of the five techniques. Based upon individual considerations,
      including the patient's age and medical history, one can decide the optimal
      technique for treatment.

PMID- 7790270
TI  - Fetal dose estimates for radiotherapy of brain tumors during pregnancy.
AB  - PURPOSE: To determine clinically the fetal dose from irradiation of brain tumors
      during pregnancy and to quantitate the components of fetal dose using phantom
      measurements. METHODS AND MATERIALS: Two patients received radiotherapy during
      pregnancy for malignant brain tumors. Case 1 was treated with opposed lateral
      blocked 10 x 15 cm fields and case 2 with 6 x 6 cm bicoronal wedged arcs, using 6
      MV photons. Fetal dose was measured clinically and confirmed with phantom
      measurements using thermoluminescent dosimeters (TLDs). Further phantom
      measurements quantitated the components of scattered dose. RESULTS: For case 1,
      both clinical and phantom measurements estimated fetal dose to be 0.09% of the
      tumor dose, corresponding to a total fetal dose of 0.06 Gy for a tumor dose of
      68.0 Gy. Phantom measurements estimated that internal scatter contributed 20% of
      the fetal dose, leakage 20%, collimator scatter 33%, and block scatter 27%. For
      case 2, clinical and phantom measurements estimated fetal dose to be 0.04% of the
      tumor dose, corresponding to a total fetal dose of 0.03 Gy for a tumor dose of
      78.0 Gy. Leakage contributed 74% of the fetal dose, internal scatter 13%,
      collimator scatter 9%, and wedge scatter 4%. CONCLUSIONS: When indicated, brain
      tumors may be irradiated to high dose during pregnancy resulting in fetal
      exposure < 0.10 Gy, conferring an increased but acceptable risk of leukemia in
      the child, but no other deleterious effects to the fetus after the fourth week of
      gestation. For our particular field arrangements and linear accelerators,
      internal scatter contributed a small component of fetal dose compared to leakage
      and scatter from the collimators and blocks, and 18 MV photons resulted in a
      higher estimated fetal dose than 6 MV photons due to increased leakage and
      collimator scatter. These findings are not universal, but clinical and phantom
      TLD measurements estimate fetal dose accurately for energies < 10 MV and should
      be taken for each pregnant patient considered for treatment to confirm and
      document acceptable dose.

PMID- 7790272
TI  - Testicular doses in definitive radiation therapy for localized prostate cancer.
AB  - PURPOSE: To measure the dose received by the unshielded testes during a
      conventional course of 18 MV photon radiotherapy for localized prostate cancer
      and to identify the factors influencing it. METHODS AND MATERIALS: For each of
      four patients, a wax block containing thermoluminescent chips was attached to the
      posterior aspect of the scrotum in close proximity to the testes on each day of
      treatment during a full course of radical radiotherapy, and dose measurements
      were obtained. The distances between the thermoluminescent chips and the beam
      edge were verified by measurement from port films. The accuracy of the in vivo
      measurements and the factors influencing the testis dose were studied using a
      phantom arrangement. Six factors were considered: (a) the relative contributions
      from primary and scattered radiation, (b) the amount of buildup required for the
      thermoluminescent chips that monitored testis dose, (c) the position of the
      testes within the scrotum, (d) field size, (e) distance from the field lower
      border, and (f) the effect of port films. RESULTS: Median daily doses to the
      testes in four patients ranged from 5 to 7 cGy. Daily doses for the four patients
      ranged from 4 to 14 cGy. The total dose to the testes over the full course of
      therapy ranged from 1.8 to 2.4 Gy. The daily dose depended primarily on the
      distance from the field lower border. This was increased by approximately 2.5 cGy
      when a 6 MV port film was taken. The relative contributions from primary and
      scattered radiation were found to be similar. Dose measurements at the posterior
      aspect of the scrotum overestimated the testis dose by approximately 15%.
      CONCLUSION: The most important factors influencing the dose received by the
      testis are the distance from the testes to the field lower border and the
      occasion of a port film. A knowledge of the number of port films and the average
      distance from the field lower border to the testes allows a reasonable prediction
      of testes dose without daily measurement.

PMID- 7790273
TI  - Quality control of inhomogeneity correction algorithms used in treatment planning
      systems.
AB  - PURPOSE: This quality control program has been carried out under the auspices of
      S.F.P.H. (Societe Francaise des Physiciens d'Hopital), to evaluate the
      performances of radiotherapy treatment planning systems (RTPS) used by different
      institutions. The aim of this Quality Assurance Programme was: (a) to set up a
      methodology to assess globally the capability of a given system to perform
      inhomogeneity corrections in the irradiated medium with external photon beams;
      (b) to analyze the limitations of the algorithms presently used and especially
      the two-dimensional (2D) dose calculation possibilities; (c) to check, on a
      number of systems in clinical use, the validity of the method and the variation
      of the results as compared to measurements used as reference. METHODS AND
      MATERIALS: Phantom (lung equivalent material placed into polystyrene)
      measurements, using cobalt-60 radiation, were carried out by the authors. The
      phantoms were circulated among the participating institutes to be scanned, and
      used as input to the treatment planning computer. RESULTS: Ten systems were
      tested in this study, using seven different inhomogeneity correction algorithms
      implemented in nine different TPS; four of these algorithms are used in a pixel
      by pixel basis and five of them in a contour basis. Significant discrepancies or
      inconsistencies have been observed even for sophisticated models supposed to be
      mostly accurate. CONCLUSION: The proposed tests and the experimental data
      provided are very useful as part of a quality-control program. They should be
      included in the initial extensive validation of TPS before starting clinical use,
      and should be repeated at regular intervals and at each updating of the program.
      They have the merit of including the whole procedure, from patient data
      acquisition to dose distribution printout.

PMID- 7790274
TI  - Undifferentiated nasopharyngeal cancer (UCNT): current diagnostic and therapeutic
      aspects.
AB  - Undifferentiated carcinoma of the nasopharynx (UCNT) is a particular head and
      neck epidermoid lineage tumor related to the Epstein Barr Virus (EBV). It has
      geographically selective endemic epidemiologic features, without relation to
      external carcinogens. Its systemic agressiveness is the source of most disease
      related demises, because radiotherapy achieves excellent local control and a
      significant percentage of cure in patients with exclusive locoregional disease.
      Difference in the staying systems currently in use, the recent changes in imaging
      and radiotherapy technology, and the lack of distinction between UCNT and
      squamous cell carcinoma (SCC) of the nasopharynx in Western literature reports
      make for some difficulty in therapeutic results evaluation when analyzing
      available literature. Its chemosensitivity is a relatively recent acknowledged
      fact, and its use in metastatic patients results in a high percentage of
      objective responses, many of long duration. Neoadjuvant cisplatin-based
      chemotherapy seems to be of benefit, but outstanding controversies in this regard
      will be soon answered through ongoing phase III trials. After a review of the
      current literature of all the above-mentioned aspects of this fascinating
      nosologic entity, our own experience, both in metastatic and locoregional disease
      patients is analyzed.

PMID- 7790275
TI  - Fast neutron radiotherapy: where have we been and where are we going? The jury is
      still out--regarding Maor et al., IJROBP 32:599-604; 1995.

PMID- 7790276
TI  - Hypoxic cell radiosensitizers: the end of an era? Regarding Lee et al., IJROBP
      32:567-576; 1995.

PMID- 7790277
TI  - Interfraction interval and dose-response in RTOG trials--regarding Fu et al.,
      IJROBP 32:577-588; 1995.

PMID- 7790278
TI  - Accelerated fractionation: the do's and don'ts--regarding Fu et al., Bourhis et
      al. and Delaney et al., IJROBP 32:589-597; 1995.

PMID- 7790279
TI  - In response to Dr. Rich--IJROBP 32:547-548; 1995.

PMID- 7790281
TI  - Stage D1 prostate cancer--is radiotherapy and early hormonal therapy equivalent
      to radical prostatectomy, radiotherapy, and early hormonal therapy? regarding
      Sands et al., IJROBP 31:13-19; 1995.

PMID- 7790280
TI  - Re: "Waiting for radiotherapy in Ontario" by Mackillop et al. and "in response to
      'waiting..."' by L.W. Brady, IJROBP 30; 1994.

PMID- 7790282
TI  - The Sr-89 bracelet.

PMID- 7790283
TI  - Regarding Herman et al., IJROBP 17:1273-1278; 1989.

PMID- 7790284
TI  - Detecting simulated amnesia with event-related brain potentials.
AB  - Two experiments were done in which groups of normal college undergraduate
      subjects were instructed to simulate autobiographical amnesia related to head
      injury. The subjects were tested for autobiographical knowledge with pencil-and
      paper recall and recognition tasks, and on another day, with recognition tasks in
      which event-related potentials were recorded in response to the same
      autobiographical items, this time presented on a display screen. In the first
      study, three Event-Related Potential (ERP) block types were utilized: 1) a block
      in which the subject's birthdate was an oddball with p = 0.11 and other dates
      (not relevant to the subject) had p = 0.89, 2) a block in which phone numbers
      were used as stimuli, and 3) a block in which (mothers' maiden) names were used
      as stimuli. Only birthdate blocks were used in the second study. A P300 ERP was
      seen in response to rare, personally relevant items. In both studies, the main
      effect of stimulus type (personally relevant versus not personally relevant) on
      P300 amplitude was significant (p < 0.0001) and there was no main effect of block
      type in the first study. Under a sophisticated malingering instruction set, about
      15% of the items were correctly recalled and about 50% were correctly recognized
      by simulators in pencil-and-paper tests. Under a naive malingering instruction
      set, most simulating subjects failed to recall and recognize autobiographical
      items. In the first study, an arbitrarily but a priori derived discrimination
      criterion based on a subject's average P300 amplitude afforded 92% correct
      discrimination of simulating individual subjects for birthdates and phone
      numbers. The value was 77% for mothers' maiden names. The same criterion applied
      to the single birthdate block in the second study yielded 93% correct
      discrimination. The results suggest the P300 may be useful in detection of
      malingered amnesia.

PMID- 7790285
TI  - Baroreflex sensitivity during noxious stimulation in vasovagal reactors to blood
      donation.
AB  - Baroreflex sensitivity was assessed at rest and during constrictive pain in
      healthy males with and without a history of vasovagal reactions to blood
      donation. Continuous recordings of cardiac inter-beat interval and finger
      arterial pressure were obtained at rest and during repeated presentations of
      constrictive thigh-cuff stimulation. Baroreflex sensitivity (in msec/mm Hg) was
      computed according to the spontaneous sequence analysis method. Results indicated
      that vasovagal reactors exhibited significantly lower descending baroreflex
      sensitivity across all periods, and significantly lower ascending baroreflex
      sensitivity at rest. Baseline differences in ascending baroreflex sensitivity
      were eliminated during thigh-cuff stimulation, as vasovagal reactors exhibited
      increases in ascending baroreflex sensitivity while non-reactors exhibited
      decreases. These findings suggest that susceptibility to vasovagal reactions may
      be associated with individual differences in baroreflex sensitivity.

PMID- 7790286
TI  - Electroencephalographic coherences discriminate between children with different
      pedagogical evaluation.
AB  - The relationship of reading-writing ability and EEG coherences was studied in 84
      subjects from two age groups 7.0-8.9 and 9-11.2 years old. All children were
      divided into three groups according to their performance on a pedagogical test:
      ped1, normal children; ped2, children with mild problems; ped3, children with
      reading-writing disability. The following results were obtained: in general,
      children showed higher coherences in groups with poor performance in the delta,
      theta and beta bands. In the alpha band, higher coherence values were related to
      better performance. The exceptions to this general pattern were rare. Group ped2
      had higher coherences in delta, theta and alpha bands than ped1 and ped3, in left
      temporal leads. In older children the same tendency was observed, but group
      differences in the theta, alpha and beta bands were few. In this age range, the
      significant group differences were almost all interhemispheric coherences. The
      discriminant analysis that classified subjects by their coherence values gave
      very good results, fact that demonstrates, that EEG coherence is a highly
      sensitive measurement indicating not only the existence of a reading-writing
      problem, but also the degree of its severity.

PMID- 7790287
TI  - Changes in visual fixation and saccadic eye movements in Alzheimer's disease.
AB  - Visual fixation and saccadic eye movements were assessed in 31 mild to moderately
      demented patients with probable Alzheimer's disease (AD) and 31 age- and
      education-matched nondemented elderly control subjects. Seventeen AD and 17
      matched control subjects were reassessed after a 9-month interval. On a fixation
      task, duration of fixation and number of intrusive saccades were not different
      between groups at baseline or follow-up. Both AD patients and control subjects
      showed more intrusive saccades at follow-up than at baseline. AD patients showed
      increased latency to initiation of saccades at baseline and on follow-up.
      Amplitude and velocity of saccades were not different between groups at any
      visit. Changes in measures of fixation, but no saccade measure, correlated with
      changes in MMSE scores over testing sessions. These data suggest that fixation is
      more sensitive than are saccades to the progession of AD.

PMID- 7790288
TI  - Spontaneous conscious covert cognition states and brain electric spectral states
      in canonical correlations.
AB  - Correlations between subjective, conscious, spontaneous cognitions and EEG power
      spectral profiles were investigated in 20 normal volunteers (2 sessions each)
      during relaxation-drowsiness-sleep onset. Four-channel EEG (temporal-parietal and
      parietal-central, left and right) was continuously recorded. The subjects were
      prompted 15 times per session to give brief reports of their ongoing thoughts.
      The reports were rated on 23 scales, and the 16 seconds of EEG recording
      preceding the prompts were spectral analyzed. Canonical correlation analysis was
      applied to the data (23 cognition ratings and 124 EEG spectral values for each of
      the 538 prompts). Four of the 23 pairs of canonical EEG variables and cognition
      variables were significant (p < 0.016) with correlation coefficients ranging from
      0.78 to 0.62. The four pairs of canonical variables showed distinctive features
      in EEG spectra and cognition styles. The results demonstrate ruleful
      correspondences between EEG states and spontaneous, conscious, covert, cognitive
      emotional states in a no-input, no-task, no-response paradigm.

PMID- 7790289
TI  - Electrocortical, autonomic, and subjective responses to rhythmic audio-visual
      stimulation.
AB  - The present study was designed to test the hypothesis that varying sensory input
      can affect mood, autonomic arousal, and electrocortical activity. Twenty right
      handed males were exposed to three rhythmic audio-visual stimulation programs,
      with either a high intensity and variety of stimuli (program H), a low
      stimulation (program L) or with a transient from high to low (program HL).
      Multichannel EEG, heart rate, and skin conductance were recorded continuously,
      and after each trial mood was rated on a bipolar adjective list. EEG data were
      subjected to FFT dipole approximation procedure, and dipole locations and field
      strength (Global Field Power) were analyzed for the frequency bands theta, alpha,
      and beta 1. Mood ratings clearly differed between programs H and HL, with highest
      values of arousal after H. Programs L and HL decreased autonomic arousal, whereas
      H induced deactivating as well as activating effects. Field strength of the alpha
      band decreased similarly during all programs. Dipole sources were located more to
      the left in the alpha band and more to the right in the beta 1 band during all
      programs as compared with baseline. Therefore, programs affected mood and
      autonomic variables differently, but not electrocortical variables. The higher
      activation of the right hemisphere during all programs is interpreted as an
      indication that audio-visual stimulation does induce changes in the brain, such
      as are commonly found in altered states of consciousness.

PMID- 7790291
TI  - Random number generation and the frontal cortex.

PMID- 7790290
TI  - Baroreceptor cortical effects, emotions and pain.
AB  - The specificity of baroreceptor-dependent inhibition of pain reactions to
      electrical stimuli was investigated during induction of different emotional
      states in 27 subjects. Baroreceptors were stimulated through the PRES (Phase
      Related External Suction) technique, while emotions were induced by means of
      pleasant, neutral and unpleasant slides. The dependent variables were pain
      ratings, somatic evoked potentials (N150 and P260) recorded from Fz, Cz and Pz,
      and skin conductance response (SCR), while heart rate was recorded as a PRES
      requirement. Valence and arousal ratings were obtained in front of each slide.
      During suction (external baroreceptor activation) reduced pain ratings, cortical
      disfacilitation (from Pz, as revealed by N150) and lower SCR were found as
      compared to pressure (baroreceptor deactivation). Moreover, brain evoked
      potentials (N150 and P260) reflecting cortical inhibition were found under
      condition of baroreceptor stimulation during unpleasant slides, but not during
      pleasant or neutral ones: this result was found in the high blood pressure
      subjects only. Data showed also a valence effect on pain ratings: pain was
      evaluated to be higher during unpleasant slides, than neutral and pleasant ones.
      Results are discussed in the light of "baroreceptor reward" hypothesis, which
      proposes a learning mechanism for the development of essential hypertension.

PMID- 7790292
TI  - Migrating microchip.

PMID- 7790293
TI  - More information on San Clemente goats.

PMID- 7790295
TI  - Protecting food animal practitioners from public tirades or lawsuits.

PMID- 7790294
TI  - Comparison of surgical skills of veterinary students trained using models or live
      animals.

PMID- 7790297
TI  - Imaging techniques for facilitating diagnosis of hyperadrenocorticism in dogs and
      cats.

PMID- 7790296
TI  - The human side of veterinary medicine. Organize or agonize.

PMID- 7790298
TI  - Livestock producers' expenditures on animal health products and services in 1993.

PMID- 7790299
TI  - Animal behavior case of the month. The owners observed tail chasing and left hind
      lameness in their dog.

PMID- 7790300
TI  - What is your diagnosis? Severe osteochondritis dissecans of the lateral trochlear
      ridges in a dog.

PMID- 7790301
TI  - Compendium of chlamydiosis (psittacosis) control, 1995.

PMID- 7790303
TI  - Hepatozoon canis infection in two dogs.
AB  - Infection of 60 to 90% of neutrophils with the protozoa, Hepatozoon canis, was
      detected in 2 dogs. Clinical signs included lethargy, anorexia, and weight loss.
      Both dogs had severe anemia, leukocytosis, and thrombocytopenia as well as
      hypoalbuminemia, hyperglobulinemia, and high activities of serum alkaline
      phosphatase and creatine kinase. Both dogs were treated with imidocarb
      dipropionate and doxycycline. One dog recovered clinically, with disappearance of
      parasites from WBC. The other dog died, despite treatment. Necropsy revealed
      widespread dispersion of schizonts in the parenchymal tissues, but no involvement
      of skeletal muscle tissues. The disease syndrome that has been identified in the
      Texas Gulf region is characterized by gait abnormalities associated with
      multifocal pyogranulomatous myositis, thus, it is distinct clinicopathologically
      from the syndrome observed in these 2 dogs.

PMID- 7790302
TI  - Evaluation of three fixation techniques for repair of mandibular fractures in
      dogs.
AB  - Bilateral midbody hemimandibular osteotomies were performed between premolars 3
      and 4 in 18 adult dogs. Hemimandibles were repaired by use of monocortically
      applied bone plates (n = 6), an interdental fixator composed of an Erich arch bar
      and acrylic (n = 6), or a type I external skeletal fixator (n = 6). At the
      immediate postoperative evaluation, hemimandibles stabilized with interdental
      fixators had an osteotomy gap distance (mean +/- SEM, 1.6 +/- 0.2 mm) that was
      significantly (P < 0.05) greater than for hemimandibles stabilized with external
      skeletal fixators (1.2 +/- 0.3 mm). Osteotomy gap distance of hemimandibles
      stabilized with external skeletal fixators (1.5 +/- 0.2 mm) was significantly (P
      < 0.05) greater at weeks 4 (1.1 +/- 0.2 mm) and 8 (0.8 +/- 0.3 mm) after surgery
      than the osteotomy gap distance of hemimandibles stabilized by application of
      bone plates. By week 16, significant differences in osteotomy gap distance were
      not detected between groups. Immediately after surgery, mandibular alignment
      measurements were not significantly different for dogs with bone plates (0.3 +/-
      0.1 mm), interdental fixators (0.3 +/- 0.1 mm), and external skeletal fixators
      (0.9 +/- 0.5 mm). Mandibular alignment scores were not significantly different
      between treatment groups during the remaining postoperative period. Occlusal
      measurements were not significantly different between evaluations performed
      before surgery and 16 weeks after surgery, regardless of treatment group.
      Radiographic evidence of healing in hemimandibles stabilized with external
      skeletal fixators was significantly (P < 0.05) less at 4 and 8 weeks, compared
      with hemimandibles stabilized with bone plates and interdental fixators; however,
      radiographic evidence of bone healing was not significantly different between
      fixation groups at 16 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790304
TI  - Hemophilia B (factor IX deficiency) in a family of German shepherd dogs.
AB  - Three male German Shepherd Dog pups were treated for vaccination-induced
      hematomas. Coagulation tests in 2 of these pups revealed markedly prolonged
      activated partial thromboplastin times, whereas specific coagulation factor tests
      revealed severe deficiency of factor IX activity. Investigation of the pedigree
      supported a sex-linked pattern of inheritance and a distant relationship to a pup
      found to have hemophilia B 7 years earlier. Dogs in the pedigree had variable
      manifestations of bleeding, including hematomas, deep muscle bleeding, profuse
      bloody diarrhea, and sudden neonatal deaths. von Willebrand's disease was
      concurrently detected in several dogs in the pedigree, and may have contributed
      to the bleeding tendency in some dogs. Medical management of 2 of the 3 pups
      included transfusion of fresh whole blood, canine fresh-frozen plasma, and canine
      plasma cryosupernatant, as indicated, and cage rest. Two pups were euthanatized
      because of the severity of recurrent bleeding episodes. A third dog remains
      alive, but requires periodic infusions of blood product to maintain hemostasis.

PMID- 7790305
TI  - Use of pharmacologically induced ejaculation to obtain semen from a stallion with
      a fractured radius.
AB  - Ejaculation was pharmacologically induced in a 13-year-old Quarter Horse stallion
      with a spiral fracture of the radius. The owners desired to have semen from the
      stallion frozen prior to euthanatizing the horse, but because of the debilitating
      injury, standard methods of semen collection could not be used. With the stallion
      standing quietly in a stall, a plastic collection bag was positioned over the
      stallion's penis, and clomipramine hydrochloride (2.2 mg/kg of body weight, IV)
      was administered. Fifty-five minutes later, xylazine hydrochloride (0.5 mg/kg,
      IV) was administered. The stallion ejaculated 2 minutes after xylazine
      administration. The semen sample was of low volume and had a high concentration
      of spermatozoa; however, motility of spermatazoa was poor and the semen was
      unacceptable for freezing. The stallion was euthanatized. Semen aspirated from
      the epididymis after euthanasia was of similar quality to that of the ejaculated
      sample. Pharmacologic induction of ejaculation can be useful for obtaining semen
      from stallions when standard techniques cannot be applied.

PMID- 7790306
TI  - Sternothyrohyoideus myectomy or staphylectomy for treatment of intermittent
      dorsal displacement of the soft palate in racehorses: 209 cases (1986-1991).
AB  - The efficacy of sternothyrohyoideus myectomy (SM) and staphylectomy as treatments
      for intermittent dorsal displacement of the soft palate was evaluated in 209
      racehorses (126 Thoroughbreds, 83 Standardbreds). The 2 most common complaints
      were respiratory tract noise (75% of horses) and exercise intolerance (51% of
      horses). Stopping, defined as the inability to finish the race at racing speed,
      was reported in 40% of the horses. Endoscopy at rest revealed evidence of
      abnormal epiglottic anatomy (hypoplasia or flaccidity) in 51% of the horses and
      abnormal soft palate function in 36% of the horses. Race records were available
      for 149 (77 Thoroughbreds, 72 Standardbreds) horses. The sex distribution
      consisted of 38% sexually intact males, 20% geldings, and 42% females, with a
      mean age of 3.4 years. Sixty-nine horses underwent staphylectomy, with a mean of
      16 weeks to first stage after surgery. Eighty horses underwent SM, with a mean of
      10 weeks to first start. Sternothyrohyoideus myectomy was performed on
      significantly more (P < 0.05). Thoroughbreds than Standardbreds, and
      staphylectomy was performed on significantly (P < 0.0001; chi 2 = 39.56) more
      Standardbreds than Thoroughbreds. After surgery, most horses (74%) had no change
      in class; however, more moved up in class (17%) than down (9%). On the basis of
      comparison of earnings for 3 starts before surgery with that for 3 starts after
      surgery, successful outcome was obtained in 60% of the horses (35 Thoroughbreds,
      13 Standardbreds) that received SM and in 59% of the horses (11 Thoroughbreds, 30
      Standardbreds) that received a staphylectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790307
TI  - Alar fold resection in horses: 24 cases (1979-1992).
AB  - Between 1979 and 1992, the alar folds were resected bilaterally in 22 horses and
      unilaterally in 2 horses. Abnormal respiratory tract noise and exercise
      intolerance were the primary complaints prior to surgery. Significantly (P =
      0.01) more Standardbreds underwent resection of the alar folds, compared with the
      number of Standardbreds in the hospital population during the same period. The
      alar folds palpated abnormally thick in 13 horses and normal in 11 horses.
      Temporary dilatation of the nares with mattress sutures or clips lessened the
      respiratory tract noise and improved exercise tolerance in all 8 horses in which
      the diagnostic test was performed. Manual elevation of the alar folds reduced
      respiratory noise in the 11 horses evaluated. Long-term follow-up evaluation by
      telephone was available for 14 horses. All surgical incisions had healed
      cosmetically. Respiratory tract noise was decreased, and exercise tolerance
      improved in 10 of 14 (71%) horses. Complete charted racing information was
      obtained for 16 horses. Fourteen horses started their first race a mean of 118
      days (range, 13 to 321 days) after surgery. The mean number of starts after
      surgery was 51, with 14 of 16 (88%) horses starting more than 6 times after
      surgery. Of the 16 horses, 8 horses raced at least 3 times before and after
      surgery; 4 had improved racing performance, 2 had similar performance, and 2 had
      decreased performance. Five Standardbreds never raced, and 1 Standardbred raced
      once before surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790308
TI  - Management of a radial fracture in an adult bull.
AB  - An 823-kg 4-year-old Holstein bull was examined because of acute lameness of the
      left forelimb. Radiography revealed a closed, comminuted, spiral fracture of the
      radius that extended from the distal portion of the diaphysis to the
      antebrachiocarpal joint. The fracture was repaired with combination of internal
      fixation (2 compression plates, 1 of which incorporated a condylar screw and both
      of which were luted) and external coaptation (full-limb cast and Thomas-Schroeder
      splint). The development of larger implants and the combination of internal and
      external fixation methods provides hope that certain fractures in cattle that
      were once thought irreparable can now be treated.

PMID- 7790309
TI  - Hydrops uteri in a caprine doe pregnant with goat-sheep hybrid fetuses.
AB  - A 5-year-old caprine doe was examined for abdominal enlargement and inability to
      stand. Hydrops uteri was diagnosed via ultrasonography, and was determined to be
      the cause of hind limb paresis. The placentomes appeared to be abnormal in shape
      and number. Uterine fluid electrolyte concentrations were similar to fluid from
      cows and sheep with hydrops amnion. Two fetuses were dead at the time of induced
      parturition. Hydrops uteri is rare in goats and, in the goat of this report, was
      believed to be caused by pregnancy with an unusual goat-sheep hybrid. The
      placental abnormalities discovered by ultrasonography may have been responsible
      for the abnormal accumulation of fluid, but a fetal abnormality also was
      considered to be possible.

PMID- 7790310
TI  - Use of facilitated ankylosis in the treatment of septic arthritis of the distal
      interphalangeal joint in cattle: 12 cases (1987-1992).
AB  - Medical records were reviewed for 12 cattle with septic arthritis of the distal
      interphalangeal joint that were treated by use of facilitated ankylosis.
      Information on signalment, clinical signs, digit affected, radiographic findings,
      and type and duration of treatment were compiled. Owners were contacted for
      information about the convalescent period, reasons for culling, productivity, and
      outcome. Outcome was classified as successful or unsuccessful on the basis of
      lameness, growth pattern, and whether the cattle were subsequently productive.
      Cause of the septic arthritis was unknown in 9 of 12 (75%) cattle. Eleven of 12
      (92%) cattle represented beef breeds. Cattle were lame for a mean of 5.3 weeks
      before admission. In 8 of 12 (67%) cattle, a trephine was used in the creation of
      an arthrostomy, the middle and distal phalanges were curetted, and the joint was
      lavaged with isotonic solution. A drill bit was used in 4 of 12 (33%) cattle to
      remove articular cartilage and facilitate ankylosis. Convalescent period after
      discharge from the hospital was 1 to 7 months (mean, 4 months; median, 4 months).
      After that period, all cattle had an apparently normal gait. Eight of 12 (67%)
      cattle were maintained in their herd of origin. None of the cattle were culled
      because of lameness. Two of 12 (17%) cattle had a deformation of the affected
      digit. According to the criteria for successful outcome that were used in the
      study reported here, the success rate was 100%. Treatment of septic arthritis of
      the distal interphalangeal joint by use of facilitated ankylosis is an
      alternative to digit amputation and is recommended to promote longevity and
      productivity.

PMID- 7790311
TI  - Bartonellosis.

PMID- 7790312
TI  - Xenogenization.

PMID- 7790313
TI  - Nuclear accumulation of p53 in normal human fibroblasts is induced by various
      cellular stresses which evoke the heat shock response, independently of the cell
      cycle.
AB  - Nuclear accumulation of p53 is induced by various DNA damaging agents (the p53
      response). Induction of nuclear accumulation of p53 after various cellular
      stresses, mostly other than DNA damage, including heat shock, was examined in
      normal human fibroblasts by immunostaining and flow cytometry using a mouse anti
      p53 monoclonal antibody. Immunostaining revealed nuclear accumulation of p53
      within 6 h after various stresses [heat shock, osmotic shock, heavy metal (Cd),
      blockers of the cellular respiratory system (NaN3), amino acid analogues
      (azetidine and canavanine), an inhibitor of protein synthesis (puromycin), and
      oxygen free radicals (H2O2)]. Heat shock proved to be one of the most effective
      inducers among these stresses. FACScan analysis revealed that this induction of
      p53 occurred regardless of the stage in the cell cycle and that accumulation of
      cells in G2/M occurred. As all of these stresses are known to induce the heat
      shock response, the mechanism of p53 induction after stresses and that of heat
      shock response may share, at least partly, some common signaling pathway(s).

PMID- 7790314
TI  - A novel SCID mouse model for studying spontaneous metastasis of human lung cancer
      to human tissue.
AB  - We established a novel severe combined immunodeficient (SCID) mouse model for the
      study of human lung cancer metastasis to human lung. Implantation of both human
      fetal and adult lung tissue into mammary fat pads of SCID mice showed a 100% rate
      of engraftment, but only fetal lung implants revealed normal morphology of human
      lung tissue. Using these chimeric mice, we analyzed human lung cancer metastasis
      to both mouse and human lungs by subcutaneous inoculation of human squamous cell
      carcinoma and adenocarcinoma cell lines into the mice. In 60 to 70% of SCID mice
      injected with human-lung squamous-cell carcinoma, RERF-LC-AI, cancer cells were
      found to have metastasized to both mouse lungs and human fetal lung implants but
      not to human adult lung implants 80 days after cancer inoculation. Furthermore,
      human-lung adenocarcinoma cells, RERF-LC-KJ, metastasized to the human lung
      implants within 90 days in about 40% of SCID mice, whereas there were no
      metastases to the lungs of the mice. These results demonstrate the potential of
      this model for the in vivo study of human lung cancer metastasis.

PMID- 7790315
TI  - High-energy underwater shock wave treatment for internal iliac muscle metastasis
      of prostatic cancer: a first clinical trial.
AB  - The first clinical trial of high-energy shock wave (SW) combined with
      chemotherapy to treat metastasis of prostate cancer in the internal iliac muscle
      was conducted. The patient, a 57-year-old man, diagnosed as having mucin
      producing, poorly differentiated adenocarcinoma of the prostate invading the
      bladder wall, had been treated by total cystoprostatectomy. Five months later,
      metastatic tumors were found in the left axillar subcutaneous tissue and the
      right internal iliac muscles. For the axillar metastasis we performed radiation
      and left subclavicular arterial infusion of cisplatin 70 mg, THP-adriamycin (THP)
      50 mg and methotrexate 50 mg. For the right internal muscular metastasis, 10,000
      to 20,000 shots of SW and simultaneous intravenous injection of carboplatin 100
      mg and THP 10 mg were carried out. Neither of the tumors decreased in size, but
      on magnetic resonance images, the SW-treated tumor exhibited a central low
      intensity area. The SW-treated tumor was resected and central necrosis and a
      collection of mucin in the central area were observed. Hormone-resistant prostate
      cancer is well-known to be a multidrug-resistant tumor. It is noteworthy that SW
      and chemotherapy induced necrosis in such a refractory cancer without any
      significant side effects.

PMID- 7790317
TI  - Increased susceptibility to N-nitrosomethylurea gastric carcinogenesis in
      transforming growth factor alpha transgenic mice with gastric hyperplasia.
AB  - Glandular stomach carcinogenesis after N-nitrosomethylurea (NMU) treatment was
      examined in transgenic mice bearing a human transforming growth factor alpha (TGF
      alpha) cDNA driven by the mouse metallothionein-I promoter (mouse line MT100) in
      the inbred mouse line FVB/N. Untreated MT100 mice exhibit a severe age-related
      gastric fundic hyperplasia. Both sexes of MT100 mice were given 10 weekly
      intragastric intubations of 0.5 mg NMU per mouse from 6 weeks of age and/or zinc
      chloride in drinking water to stimulate transgene expression from 5.5 weeks of
      age to the experiment termination. Animals were killed sequentially at 10, 19 and
      29 experimental weeks. Several histochemical markers (AB-PAS, TGF-alpha,
      pepsinogen isozyme 1, proliferating cell nuclear antigen) were used. Abnormal
      histochemical patterns were found in untreated MT100 and NMU-treated MT100 mice
      for all 4 markers of differentiation and carcinogenesis. Precancerous lesions
      including atypical and/or adenomatous hyperplasia were found in the fundic region
      of 16/22 male and 8/22 female MT100 mice but not in 27 male and 24 female FVB/N
      mice treated with NMU. One of 22 MT100 males had fundic carcinoma. FVB/N mice
      treated with NMU had neither precancerous lesions nor carcinomas in the fundus.
      Well differentiated adenocarcinomas in the pyloric region were induced at
      incidences of 2/22 male and 1/22 female MT100 mice treated with NMU and 4/27 male
      and 4/24 female FVB/N mice treated with NMU. Both strains also had a high
      incidence (55 to 92%) of squamous cell carcinomas of the forestomach. In
      conclusion, TGF-alpha induced a hyperplastic lesion in the gastric fundus that
      appeared to predispose the MT100 mice to carcinogenesis by NMU.

PMID- 7790316
TI  - Intraluminal epidermal growth factor affects growth of N-methyl-N-nitrosourea
      initiated rat bladder carcinoma.
AB  - To confirm our recent finding that epidermal growth factor (EGF) appeared to
      contribute to the tumor-enhancing effect demonstrated by normal rat urine, we
      conducted 2 experiments using our heterotopically transplanted rat urinary
      bladder model. In experiment 1, after a single dose (0.25 mg) of N-methyl-N
      nitrosourea (MNU), we intravesically administered EGF (0.05 ml of 500 ng/ml
      phosphate-buffered saline) once a week for 30 weeks. Instillation of EGF induced
      a significantly larger number of tumors than did instillation of the vehicle (P =
      0.03). EGF without MNU initiation did not induce tumors. In experiment 2, 2
      groups received instillation of killed Escherichia coli (5 x 10(8) cells)/0.5 ml
      phosphate-buffered saline once a week for 4 weeks to expand the MNU-initiated
      cell population. Subsequent EGF treatment significantly increased the incidence
      of tumors (P = 0.01). In the groups which did not receive killed E. coli, EGF
      treatment induced a significantly higher number of tumors than did vehicle
      treatment (P < 0.001). All of the tumors were low-grade, superficial transitional
      cell carcinomas. These observations indicate that EGF acts as a growth
      stimulating factor on dormant neoplastic cells and thereby increases the number
      of tumors.

PMID- 7790318
TI  - Subchromosomal mapping of a putative transformation suppressor gene on human
      chromosome 1.
AB  - We previously reported that the introduction of a normal human chromosome 1 via
      microcell-mediated chromosome transfer suppressed the transformed phenotypes,
      including anchorage-independent growth, of Kirsten murine sarcoma virus
      transformed NIH3T3 (DT) cells. Soft-agar clones derived from DT-#1 cells (DT
      cells with an intact transferred human chromosome 1) exclusively failed to retain
      an intact form of this chromosome. Thus, a gene(s) with a suppressive activity on
      this chromosome had probably been lost. We therefore attempted to identify a
      commonly deleted region on human chromosome 1 in these soft-agar clones. Although
      eight of the 9 soft-agar clones examined still contained regions on this
      chromosome, to a greater or lesser degree, four loci on 1q21 and 1q23-q24 were
      commonly lost in all of them. Furthermore, the soft-agar clones had growth
      properties similar to those of DT cells. Thus, chromosome and DNA analyses
      suggested that human 1q21 and/or 1q23-q24 carries a transformation suppressor
      gene(s) which controls the transformed phenotypes of DT cells.

PMID- 7790319
TI  - Establishment and characterization of non-small cell lung cancer cell lines
      resistant to mitomycin C under aerobic conditions.
AB  - To elucidate the mechanisms of acquired resistance to mitomycin C (MMC) in non
      small cell lung cancer (NSCLC), we established two MMC-resistant NSCLC sublines
      by continuous exposure to MMC, using PC-9 as a parent cell line. The sublines, PC
      9/MC2 and PC-9/MC4, were 6.4- and 10-fold more resistant to MMC than their parent
      cell line, respectively, at the IC50 value as determined by MTT assay. They
      exhibited cross-resistance to EO9, but were not resistant to cisplatin,
      vindesine, etoposide, carboquone, or KW-2149, a novel MMC derivative. They were
      collaterally sensitive to adriamycin and menadione. Accumulation of the drug was
      decreased in the resistant sublines to about 60% of that in the parent cells.
      Cytosolic DT-diaphorase (DTD) activities were decreased to 13.5 +/- 3.2 in
      PC9/MC2 and 1.3 +/- 0.6 in PC-9/MC4 from 261.5 +/- 92.7 nmol/min/mg protein in
      the parent PC-9. NADH:cytochrome b5 reductase activities in both of the resistant
      cell lines were significantly decreased as compared to that in the parent cell
      line. Addition of dicumarol resulted in a two-fold increase in IC50 value in PC
      9, whereas the IC50 value showed no change in PC-9/MC4. Moreover, dicumarol did
      not affect the sensitivities to KW-2149 but decreased the sensitivities to EO9 in
      both the parent and the resistant cell lines. Formation of an alkylating
      metabolite was significantly decreased in the resistant cells, in parallel to the
      degree of resistance. We concluded that deficient drug activation due to
      decreased DTD activity was important as a mechanism of resistance to MMC in PC-9,
      a relatively DTD-rich NSCLC cell line.

PMID- 7790321
TI  - Synergistic effect of methionine-depleting total parenteral nutrition with 5
      fluorouracil on human gastric cancer: a randomized, prospective clinical trial.
AB  - Methionine-depleting total parenteral nutrition (Met-depleting TPN), infusing AO
      90 amino acid solution (lacking both L-methionine and L-cysteine) as a sole
      nitrogen source, showed synergistic effects with 5-fluorouracil (5-FU) in tumor
      bearing rats and in clinical trials with gastrointestinal tract cancers. In this
      study, the effect of Met-depleting TPN with 5-FU upon thymidylate synthase (TS)
      activity was examined, and the histological effect of this treatment on human
      gastric cancer was evaluated. Fourteen preoperative advanced gastric cancer
      patients were divided randomly into two groups. Seven cases were given Met
      depleting TPN for 7 days before surgery with continuous intravenous
      administration of 5-FU (500 mg/body per day; total 4.0 g/body) (AO-90 group). The
      other 7 received conventional L-methionine-containing TPN with 5-FU (control
      group). All patients underwent gastrectomy without complications due to these
      treatments. Resected materials were examined for TS kinetics, and the anti-cancer
      effect was also assessed histopathologically. The specimens in the AO-90 group
      showed marked degeneration of cancer, while almost no effect was seen in the
      control group. The free TS activity of carcinoma tissue in the AO-90 group was
      decreased and the TS inhibition rate was increased in comparison with the control
      group (P = 0.0165 and P = 0.0243, respectively). Met-depleting TPN appears to
      play a role as a biomodulator of 5-FU in human gastric cancer.

PMID- 7790322
TI  - Phase I study and clinical pharmacological evaluation of daily oral etoposide
      combined with carboplatin in patients with lung cancer.
AB  - Twenty-eight patients with inoperable or relapsed lung cancer were given a
      combination of oral etoposide, administered once a day at doses ranging from 40
      to 60 mg/m2/day (d) for 21 consecutive days, and carboplatin, administered
      intravenously over 1 h at doses ranging from 300 to 400 mg/m2 on day 1 to
      determine the appropriate doses of this combination. In addition, pharmacokinetic
      and pharmacodynamic analyses were performed. All the patients had a performance
      status of 0 to 1. Serum etoposide and free platinum (Pt) concentrations were
      measured using high-performance liquid chromatography and atomic absorption,
      respectively. Myelosuppression, nausea and vomiting were the dose-limiting
      toxicities of this schedule. The maximum tolerated dose (MTD) was 50 mg/m2/d oral
      etoposide for 21 days and 400 mg/m2 i.v. carboplatin on day 1. For heavily
      pretreated patients, the MTD was 40 mg/m2/d oral etoposide for 21 days and 350
      mg/m2 i.v. carboplatin on day 1. No cumulative increase in the area under the
      concentration-time curve (AUC) for oral etoposide over time was observed. There
      were significant correlations between the free Pt serum level (6, 8, 12, 24 h
      post-dose) and etoposide AUC level (days 1, 10 and 21) for graded hematological
      toxicity, and the percentage decreases and nadir counts of hemoglobin,
      leukocytes, neutrophils and platelets. Several pharmacodynamic models were
      developed to predict the hematological toxicity. In order to facilitate
      pharmacodynamic evaluations in future studies, a limited sampling model for oral
      etoposide was also developed and validated.

PMID- 7790320
TI  - Functional and T cell receptor gene usage analysis of cytotoxic T lymphocytes in
      fresh tumor-infiltrating lymphocytes from human head and neck cancer.
AB  - Twenty-one cytotoxic T lymphocyte (CTL) clones or lines that killed autologous
      tumor cells, but not allogeneic tumor, K562, or Daudi cells, were established
      from fresh tumor-infiltrating lymphocytes of two individuals (HP-1 and HP-2) with
      head and neck cancer by limiting dilution in the presence of recombinant
      interleukin-2. Sixteen (76%) of these 21 clones or lines comprised CD4+ CTLs and
      the other five comprised CD8+ CTLs. These observations suggest that autologous
      tumor cell-specific CD4+ CD8- and CD4- CD8+ CTLs are present in vivo at the tumor
      site in head and neck cancer. Analysis of T cell receptor (TCR) gene arrangements
      in 20 of the 21 CTL isolates with reverse transcriptase and the polymerase chain
      reaction revealed that five of 12 and five of eight isolates from HP-1 and HP-2,
      respectively, were clones, the other isolates being lines comprised of two or
      more clones. Each CTL clone showed a different combination of V alpha and V beta
      gene expression, suggesting that more than five different tumor-associated
      antigens may be expressed on head and neck cancer cells. In spite of the
      diversity of TCR alpha beta combinations, TCR V alpha 1, V alpha 3, V alpha 8, V
      alpha 10, V beta 8, V beta 9, and V beta 17 were also frequently expressed in
      both patients. These data suggest that specific CTLs proliferate oligoclonally
      and contribute to the specific immune response against head and neck cancer in
      vivo.

PMID- 7790324
TI  - A case of focal cancer of the rectum without microsatellite instability: the
      personal experience of a basic researcher.

PMID- 7790323
TI  - Comparison of false negative rates among breast cancer screening modalities with
      or without mammography: Miyagi trial.
AB  - False negative rates were compared in two screening modalities, physical
      examination with or without mammography, in an intervention study for women aged
      over 50 in Miyagi Prefecture. Thirty-five breast cancers were detected in 12,515
      subjects who participated in the trial consisting of physical examination and
      mammography, whereas 44 breast cancers were detected in 50,105 subjects who
      received physical examination alone, so that the detection rates were 0.28% and
      0.09%, respectively. Among 50,061 subjects who received physical examination
      alone, 8 women were diagnosed as having breast cancer within 12 months after the
      screening, while only one of 12,480 screenees receiving the combined modality was
      so diagnosed, implying false negative rates of 15.4% and 2.8%, respectively. When
      the screening sensitivity in the combined system was analyzed according to each
      single modality, the false negative rate provided by physical examination with
      mammography turned out to be 2.8%, significantly lower than that (33.3%) by the
      physical examination alone. Minimal breast cancers represented 25.7% of all
      screen-detected cancers in the combined modality, compared with 9.1% in the
      modality without mammography. The trial thus indicates that physical examination
      combined with mammography may be an appropriate modality for breast cancer
      screening in women aged over 50 on the basis of screening sensitivity.

PMID- 7790325
TI  - The chest x-ray in mitral stenosis.

PMID- 7790326
TI  - Radiological case of the month. Salter III fracture of distal right tibia.

PMID- 7790328
TI  - Wrapped autologous greater saphenous vein bypass for severe limb ischemia in
      patients with varicose veins. Preliminary report.
AB  - The greater saphenous veins in patients with varicose veins has been overlooked
      as a conduit for arterial bypass. Greater saphenous veins is often normal and
      when only parts of the greater saphenous veins are of normal size, a veno-venous
      or a graft composite bypass may be performed. The goal of this preliminary study
      was to asses if wrapped autologous greater saphenous veins could be suitable
      conduits for arterial bypass in patients presenting with critical ischemia. In
      three patients the greater saphenous veins had one to four dilatations which were
      wrapped with short segments of Polytetrafluoroethylene graft. In three other
      patients, the dilated area being longer, the greater saphenous veins were totally
      wrapped in a hand-made mesh of Dacron. No complications were due to the wrapping
      procedure and the unwrapped segments did not dilate during a mean three year
      follow-up. We conclude that wrapped autologous greater saphenous veins may help
      save limbs of patients with critical ischemia. As an underestimated proportion of
      patients presenting with varicose tributaries have normal or quite normal greater
      saphenous veins, the caliber of the greater saphenous veins should be carefully
      measured before treating the varicose veins. All greater saphenous veins suitable
      for an arterial bypass should be preserved remembering that one or several
      dilatations may be wrapped if the greater saphenous veins is used as an arterial
      substitute. Patients should be informed of the reasons for this choice.

PMID- 7790327
TI  - Role of A-V shunting in varicose veins: therapeutic implications.

PMID- 7790329
TI  - Physico-chemical observations on a failed Greenfield vena cava filter.
AB  - A Greenfield vena cava filter for the prevention of thromboembolism failed in
      vivo due to the displacement of 2 of the 6 legs and their subsequent break. The
      explanted stainless steel filter was analyzed with an electron microscope and
      energy dispersion system in order to assess the reason for the break. Fatigue and
      corrosion of the metal were responsible for the failure.

PMID- 7790330
TI  - In vitro testing of six inferior vena cava filters: filtering efficiency and
      pressure measurements.
AB  - The purpose of this study is to compare in standarddised ex vivo conditions the
      performances of six percutaneous vena cava filters available on the European
      Market. METHODS: We use a mock circulation with polyethylene beads simulating
      clots to objectively determine the filtering efficiency of the different devices.
      We measured pressure at contact points with the wall of the tube simulating vena
      cava, and also gradient of pressure induced by the empty and full filter.
      Statistical analysis of the data obtained (at least 100 measurements for each
      filter) showed great consistency in the response of a given filter to the
      different conditions of mock circulation. RESULTS: The Greenfield Filter, which
      served as the reference, was compared to the other models. Its filtering
      efficiency was acceptable as was that of the L.G. Filter. The Cardial Filter and
      Vascor Filter were the most efficient. The Antheor Filter and the Filcard Filter
      performed poorly. CONCLUSION: The mock circulation give reliable and reproducible
      data on the filtering efficiency for a device but ease of placement and clinical
      studies must be taken into account for the choice of the filter.

PMID- 7790333
TI  - Efficacy and limitation of a left ventricular assist system in a patient with
      dilated cardiomyopathy accompanying multi-organ dysfunction.
AB  - A left ventricular assist system (LVAS, Toyobo CO., LTD., Japan) was used to
      provide life support for 190 days in a 44-year-old male patient with end-stage
      dilated cardiomyopathy. Before LVAS implantation, heart failure and cardiogenic
      shock with multi-organ dysfunction progressed despite the use of intra-aortic
      balloon pumping (18 days), mechanical ventilatory support (15 days), continuous
      veno-venous hemofiltration (two days) and intravenous administration of
      catecholamines. Before LVAS implantation, the patient had marked hepatic and
      renal dysfunction (total bilirubin 6.1, BUN 73 and serum creatinine 3.1 mg/dl).
      Those functions returned to normal (total bilirubin 1.2, BUN 11 and serum
      creatinine 0.6 mg/dl) one month after implantation. He was complicated by
      multiple cerebral embolisms occurring on the 9th, 57th and 175th postoperative
      days and died 190 days after surgery. Autopsy showed thrombi attaching to the
      diaphragm of the blood pump and multiple embolisms in the kidney and the spleen.
      By scanning electron microscopic examination, initial thrombi with attached
      erythrocytes were seen on the diaphragm surface without intimal lining formation.
      In conclusion, LVAS support can be useful for patients with end-stage heart
      disease complicated by multi-organ dysfunction. However, the LVAS may cause
      thromboembolic complications over the prolonged use.

PMID- 7790331
TI  - A new ePTFE stretch graft for aorto-iliac reconstructions. Surgical evaluation
      and one year follow-up with magnetic resonance imaging.
AB  - Since its introduction at the beginning of the 60s Dacron has proved to be a
      reliable and durable substitute for aortic reconstructions. It is however
      susceptible to late thrombosis, infection and aneurysmal dilatation in a
      significant number of cases. ePTFE vascular prosthesis, introduced in 1972, have
      proved to perform well for peripheral reconstructions and was used in aortoiliac
      position since 1980. In 1991 a new type of ePTFE rendered longitudinally
      extensible (Gore-Tex Stretch) was introduced into clinical practice. The aim of
      this study is to evaluate surgical performance, short term patency and
      interaction with periprosthetic tissues of Gore-Tex Stretch straight and
      bifurcated prosthesis. Between October 1991 and December 1993, 59 patients
      underwent aortic reconstruction at our Institution either for infrarenal aortic
      aneurysm (19 patients, 16 males, 3 females, mean age 68.8 +/- 8.5 years) or for
      aortoiliac occlusive disease (40 patients, 36 males, 4 females, mean age 60.5 +/-
      7.2 years). Forty-eight bifurcated and eleven straight grafts were implanted
      using Gore-Tex sutures. Preoperative workup included Ultrasonography, Magnetic
      Resonance Imaging (MRI) in patients with aneurysms and Intra Arterial Digital
      Subtraction Arteriography (DSA) in patients with occlusive disease.
      Intraoperative parameters were recorded. Postoperative follow-up included
      ultrasonographic evaluation at 1st and 7th day, 15th postoperative week and at 3
      monthly intervals; Intra Venous DSA before dismission and MRI at the 1st and 15th
      postoperative week. Intraoperatively the grafts proved to be soft and flexible
      with good handling and suturing characteristics. Perioperative bleeding was 480
      +/- 299 ml for occlusive disease cases and 633 +/- 314 for aneurysm cases. No
      operative mortality was recorded.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790332
TI  - Non-infective high fever after replacement of thoracic aorta using collagen
      impregnated Dacron prosthesis.
AB  - We present three patients who were complained of a high fever without infective
      signs clinically and bacteriologically after the implantation of a woven Dacron
      prosthesis impregnated with collagen for thoracic aortic aneurysm. High fever
      appeared on the third on fourth day after surgery, and continued for three to
      seven days. The maximum fever ranged 39.1 to 39.9 degrees C. There was a close
      relationship between the value of C-reactive protein and the duration of a high
      fever. There were no differences between patients with and without a high fever
      in white blood cell counts, and other hematological and biochemical examinations.
      Non-infective high fever may be encountered in the postoperative acute phase
      following the implantation of a Hemashield prosthesis.

PMID- 7790334
TI  - Perioperative coronary artery spasm in modified Bentall's operation for annulo
      aortic ectasia in Marfan's syndrome. A case report of perioperative chordal
      rupture of the mitral valve.
AB  - We experienced a rare case of Marfan's syndrome with annulo-aortic ectasia,
      aortic regurgitation and Prinzmetal's variant angina. In a modified Bentall's
      operation (button technique), perioperative severe coronary artery spasm occurred
      in spite of the preventive use of nitroglycerin infusion, which resulted in
      profound ventricular fibrillation and subsequent chordal rupture of the mitral
      valve with Sellers IV regurgitation. Use of nicardipine contained in
      cardioplegia, continuous infusion of nicardipine and nitroglycerin after aortic
      declamping completely prevented coronary spasm throughout the course of a second
      surgery for mitral valve replacement. It is worthy to report this case because of
      rarities such as Marfan's syndrome accompanied by Prinzmetal's variant angina,
      perioperative coronary artery spasm in modified Bentall's operation, and
      perioperative chordal rupture of the mitral valve and progression of mitral valve
      regurgitation. We also stress the efficacy of a new calcium antagonist,
      nicardipine, to prevent coronary artery spasm during open heart surgery.

PMID- 7790335
TI  - Use of thoracoscopy and a minimal thoracotomy, in mammary-coronary bypass to left
      anterior descending artery, without extracorporeal circulation. Experience in 2
      cases.
AB  - A new surgical approach to mammary-coronary bypasses, to the left anterior
      descending artery, without the use of extracorporeal circulation, is described
      here. A minimal left anterior thoracotomy and the use of thoracoscopy are
      combined in this procedure performed in two patients (54-year-old male and 56
      year-old male). Results were excellent: both patients were soon discharged from
      hospital (3 days patient 1 and 36 hours patient 2). Neither blood nor inotropic
      drugs were required. New angiographies previous to discharge were done, showing
      100% patency of the mammary grafts. Both patients are angina-free. Due to its
      simplicity, and with more experience, this technique could be a good alternative
      for patients with severe lesions of the left anterior descending artery.

PMID- 7790336
TI  - Ischemic papillary muscle dysfunction in an adult with a parachute mitral valve.
AB  - A case of severe mitral regurgitation secondary to an infarct of a single
      papillary muscle in a 65-year-old female with a parachute mitral valve is
      described. To the best of our knowledge this is the oldest patient reported with
      this rare congenital anomaly. The clinical and echocardiographic features are
      discussed.

PMID- 7790337
TI  - A rare complication of mitral valve replacement: sudden cardiac death for
      immobilization of disc valve by an unraveled suture.
AB  - Disc immobilization caused by an unraveled suture in a mitral valve prosthesis
      represents a rare extrinsic complication in heart valve replacement. We report a
      case of a 54-year-old white male who underwent mitral valve replacement because
      of a severe mitral regurgitation. A Bjork-Shiley tilting disc was implanted with
      interrupted "U" shaped 3/0 silk sutures. There were no complications and the
      patient was discharged in the 10th postoperative day. Twenty days after surgery
      the patient died for acute pulmonary edema. Autopsy revealed an unraveled suture
      producing interference with the tilting disc as a cause of disc prosthesis
      immobilization in closed position. The possible explication of this rare
      complication is the combination between unraveled suture and the pleating held by
      Teflon sewing ring after restoring heart function. A flaccid heart can produce an
      overestimation of the annulus size and the valve ring can bring an anomalous
      interference with the valve mechanism. In conclusion disc immobilization by an
      unraveled suture is a complication that can occur very rarely but an accurate
      prevention must be warrant particularly with a tilting disc more than a beleaflet
      prosthesis.

PMID- 7790338
TI  - Surgical repair of a ventricular septal defect in a patient with trisomy 8
      syndrome.
AB  - We surgically repaired a ventricular septal defect (-VSD) in a patient with
      trisomy 8 syndrome. This case illustrated a number of characteristic clinical
      features associated with trisomy 8 syndrome patients which have previously been
      reported in the literature. However, our patient's VSD was not found to be
      particularly different from the VSD of patients without chromosomal abnormalities
      during either the surgery or the postoperative course.

PMID- 7790340
TI  - Paraplegia as a result of intra-aortic balloon counterpulsation.
AB  - A case of paraplegia after a perioperative intra-aortic balloon support is
      presented. This rare and devastating complication is the twelfth reported in
      international literature.

PMID- 7790341
TI  - Closure of leaks by fibrin gluing. Effects of various application techniques and
      temperatures.
AB  - This study was performed to determine the differences in covering power obtained
      with fibrin gluing using three different methods, layered, mixing, and spraying.
      The experimental system consisted of a 2 x 2 cm plastic plate with a hole 1 mm in
      diameter, a plastic syringe, and a digital manometer. The internal pressure of
      the syringe barrel was measured with the digital manometer. Five minutes after
      fibrin glue membranes (1 mm in thickness) had been prepared on the plastic plate
      with the layered, mixing, or spray method, the plunger of the syringe was pushed
      slowly, and the maximum internal pressure in the syringe barrel was measured,
      just before the breakage of the membrane. Experiments were performed five times
      at each four temperatures, 12 degrees C, 17 degrees C, 22 degrees C and 37
      degrees C. Covering power of fibrin glue membranes (units: mmHg; atmospheric
      pressure 760 mmHg) were as follows: 1) Layered method (12 degrees C: 810.0 +/-
      68.6, 17 degrees C: 769.0 +/- 10.2, 22 degrees C: 812.0 +/- 112.4, 37 degrees C:
      773.6 +/- 24.4). 2) Mixing method (12 degrees C: 956.6 +/- 219.3, 17 degrees C:
      972.4 +/- 243.5, 22 degrees C: 1045.2 +/- 233.0, 37 degrees C: 1059.0 +/- 220.2).
      3) Spray method (12 degrees C: 1010.0 +/- 231.1, 17 degrees C: 1144.4 +/- 170.6,
      22 degrees C: 1148.0 +/- 234.7, 37 degrees C: 1250.0 +/- 111.8).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7790339
TI  - Late spontaneous chylopericardium following complex cardiac surgery.
AB  - Chylopericardium as an isolated complication after open heart surgery is a rare
      event. We present here a case of late postoperative chylopericardium and comment
      on the clinical course, the aetiopathology and treatment.

PMID- 7790342
TI  - Ischemic conditioning of the rat stomach: implications for esophageal replacement
      with stomach.
AB  - BACKGROUND: Esophagectomy, with gastric pull up replacement, is not uncommonly
      complicated by leakage from the esophagogastrostomy anastomosis. Occult ischemia
      of the mobilized gastric fundus is a major etiologic factor in anastomotic
      leakage. OBJECTIVE: To test the hypothesis that tissue perfusion in a partially
      devascularized stomach will improve over time by a process of ischemic
      conditioning ("delay" phenomenon). EXPERIMENTAL DESIGN COLON: Laboratory study of
      partial gastric devascularization in rats. ANIMALS: Twenty rats. INTERVENTIONS:
      Partial gastric devascularization was achieved by ligation of the left gastric
      artery. MEASURES: Gastric perfusion was measured with a laser-Doppler flowmeter
      (in tissue perfusion units, TPU). Perfusion measurements were made at baseline,
      after vessel ligation, at 7 days, and at 14 days. RESULTS: Perfusion immediately
      after vessel ligation (23.8 +/- 6.0 TPU) was significantly lower than baseline
      gastric tissue perfusion (88.4 +/- 9.8 TPU) (p < 0.00001). After 7 days, tissue
      perfusion had increased (54.4 +/- 9.2 TPU), but it was significantly lower than
      baseline values (p < 0.00005). After 14 days, perfusion was increased (71.7 +/-
      8.6 TPU) compared to 7 day measurements (p < 0.001), but it was still
      significantly lower than baseline gastric tissue perfusion (p < 0.002).
      Nevertheless, 14 day perfusion was 81% of baseline values. CONCLUSIONS: After
      partial devascularization, gastric perfusion steadily improves by a process of
      ischemic conditioning ("delay" phenomenon). The principle of ischemic
      conditioning may be clinically applicable to the gastric pull up operation.

PMID- 7790343
TI  - The results of three cases of unilateral pulmonary embolectomy through right
      thoracotomy approach for chronic pulmonary embolism.
AB  - Three patients with chronic pulmonary embolism underwent successfully unilateral
      pulmonary arterial thromboembolectomy. In these cases, severe degree of right
      heart failure and respiratory distress were the primary indications to the
      operation. Under normothermic partial cardiopulmonary bypass, right unilateral
      pulmonary thromboembolectomy were performed with beating heart. Distal counter
      incision was found to be facilitated to remove thrombi completely from the distal
      pulmonary artery. In the results of long-term study, postoperative cardiac
      catheterization data encouraged us to use this technique in the surgical
      treatment for the selective cases of this disease. All three patients have been
      doing well without any sign of recurrence up to 17 years of the surgery.

PMID- 7790344
TI  - Long-term survival in a surgically treated non-encapsulated mediastinal primary
      liposarcoma. Diagnostic utility of core-needle biopsy for mediastinal tumors.
AB  - Primary liposarcomas of the mediastinum are uncommon tumors. Only six cases of
      mediastinal liposarcomas with survival after surgery longer than five years have
      been reported and only one of these was a non-encapsulated tumor. We report a new
      case of non-encapsulated primary liposarcoma of the mediastinum with long-term
      survival. The diagnosis was carried out using a CT-guided core-needle biopsy. We
      emphasize the utility of this technique to diagnose this kind of mediastinal
      tumors. A non-encapsulated primary liposarcoma of the mediastinum surgically
      treated with long-term survival is reported. We emphasize the diagnostic utility
      of CT-guided core-needle biopsy for the tumors.

PMID- 7790345
TI  - Adequate de-airing during cardiac surgery.

PMID- 7790346
TI  - BM28, a human member of the MCM2-3-5 family, is displaced from chromatin during
      DNA replication.
AB  - We have recently cloned and characterized a human member (BM28) of the MCM2-3-5
      family of putative relication factors (Todorov, I.T., R. Pepperkok, R.N.
      Philipova, S. Kearsey, W. Ansorge, and D. Werner. 1994. J. Cell Sci. 107:253
      265). While this protein is located in the nucleus throughout interphase, we
      report here a dramatic alteration in its nuclear binding during the cell cycle.
      BM28 is retained in the nucleus after Triton X-100 extraction in G1 and early S
      phase cells, but is progressively lost as S phase proceeds, and little BM28 is
      retained in detergent-extracted G2 nuclei. BM28 that is resistant to extraction
      in G1 nuclei is removed by DNase I digestion, suggesting that the protein is
      chromatin associated. In addition, we present evidence for variations in the
      electrophoretic mobility of BM28 that may reflect posttranslational modifications
      of BM28 during the cell cycle. During mitosis, BM28 is present as a fast
      migrating form, but on entry into G1, the protein is converted into a slow
      migrating form. With the onset of S phase, the slow-migrating form is
      progressively converted into the fast form. BM28 is phosphorylated at all stages
      of the cell cycle, but during interphase the fast form is hyperphosphorylated
      compared with the slow form. These apparent changes in modification may reflect
      or effect changes in the nuclear binding of BM28. The behavior of BM28 is not
      dissimilar to related proteins in Saccharomyces cerevisiae, such as Mcm2p, which
      are excluded from the nucleus after DNA replication. We speculate that BM28 may
      be involved in the control that limits eukaryotic DNA replication to one round
      per cell cycle.

PMID- 7790347
TI  - Nuclear envelope breakdown is under nuclear not cytoplasmic control in sea urchin
      zygotes.
AB  - Nuclear envelope breakdown (NEB) and entry into mitosis are though to be driven
      by the activation of the p34cdc2-cyclin B kinase complex or mitosis promoting
      factor (MPF). Checkpoint control mechanisms that monitor essential preparatory
      events for mitosis, such as DNA replication, are thought to prevent entry into
      mitosis by downregulating MPF activation until these events are completed. Thus,
      we were surprised to find that when pronuclear fusion in sea urchin zygotes is
      blocked with Colcemid, the female pronucleus consistently breaks down before the
      male pronucleus. This is not due to regional differences in the time of MPF
      activation, because pronuclei touching each other break down asynchronously to
      the same extent. To test whether NEB is controlled at the nuclear or cytoplasmic
      level, we activated the checkpoint for the completion of DNA synthesis separately
      in female and male pronuclei by treating either eggs or sperm before
      fertilization with psoralen to covalently cross-link base-paired strands of DNA.
      When only the maternal DNA is cross-linked, the male pronucleus breaks down
      first. When the sperm DNA is cross-linked, male pronuclear breakdown is
      substantially delayed relative to female pronuclear breakdown and sometimes does
      not occur. Inactivation of the Colcemid after female NEB in such zygotes with
      touching pronuclei yields a functional spindle composed of maternal chromosomes
      and paternal centrosomes. The intact male pronucleus remains located at one aster
      throughout mitosis. In other experiments, when psoralen-treated sperm nuclei,
      over 90% of the zygote nuclei do not break down for at least 2 h after the
      controls even though H1 histone kinase activity gradually rises close to, or
      higher than, control mitotic levels. The same is true for normal zygotes treated
      with aphidicolin to block DNA synthesis. From these results, we conclude that NEB
      in sea urchin zygotes is controlled at the nuclear, not cytoplasmic, level, and
      that mitotic levels of cytoplasmic MPF activity are not sufficient to drive NEB
      for a nucleus that is under checkpoint control. Our results also demonstrate that
      the checkpoint for the completion of DNA synthesis inhibits NEB by acting
      primarily within the nucleus, not by downregulating the activity of cytoplasmic
      MPF.

PMID- 7790348
TI  - Nuclear pore complex assembly studied with a biochemical assay for annulate
      lamellae formation.
AB  - Formation of the nuclear pore is an intricate process involving membrane fusion
      and the ordered assembly of up to 1,000 pore proteins. As such, the study of pore
      assembly is not a simple one. Interestingly, annulate lamellae, a cytoplasmic
      organelle consisting of stacks of flattened membrane cisternae perforated by
      numerous pore complexes, have been found to form spontaneously in a
      reconstitution system derived from Xenopus egg extracts, as determined by
      electron microscopy (Dabauvalle et al., 1991). In this work, a biochemical assay
      for annulate lamellae (AL) formation was developed and used to study the
      mechanism of AL assembly in general and the assembly of individual nucleoporins
      into pore complexes in particular. Upon incubation of Xenopus egg cytosol and
      membrane vesicles, the nucleoporins nup58, nup60, nup97, nup153, and nup200
      initially present in a disassembled form in the cytosol became associated with
      membranes and were pelletable. The association was time and temperature dependent
      and could be measured by immunoblotting. Thin-section electron microscopy as well
      as negative staining confirmed that annulate lamellae were forming coincident
      with the incorporation of pore proteins into membranes. Homogenization and
      subsequent flotation of the membrane fraction allowed us to separate a population
      of dense membranes, containing the integral membrane pore protein gp210 and all
      other nucleoporins tested, from the bulk of cellular membranes. Electron
      microscopy indicated that annulate lamellae were enriched in this dense, pore
      protein-containing fraction. GTP gamma S prevented incorporation of the soluble
      pore proteins into membranes. To address whether AL form in the absence of N
      acetylglucosaminylated pore proteins, AL assembly was carried out in WGA
      sepharose-depleted cytosol. Under these conditions, annulate lamellae formed but
      were altered in appearance. When the membrane fraction containing this altered AL
      was homogenized and subjected to flotation, the pore protein-containing membranes
      still sedimented in a distinct peak but were less dense than control annulate
      lamellae.

PMID- 7790349
TI  - The overgrown hematopoietic organs-31 tumor suppressor gene of Drosophila encodes
      an Importin-like protein accumulating in the nucleus at the onset of mitosis.
AB  - The tumor suppressor gene overgrown hematopoietic organs-31 (oho31) of Drosophila
      encodes a protein with extensive homology to the Importin protein of Xenopus (50%
      identity), the related yeast SRP1 protein, and the mammalian hSRP1 and RCH1
      proteins. A strong reduction in the expression of oho31 by a P element inserted
      in the 5' untranslated region of the oho31 transcript or a complete inactivation
      of oho31 by imprecise P element excision leads to malignant development of the
      hematopoietic organs and the genital disc, as shown by their growth autonomy in
      transplantation assays. We have cloned the oho31 gene of Drosophila melanogaster
      and determined its nucleotide sequence. The gene encodes a phosphoprotein of 522
      amino acids made of three domains: a central hydrophobic domain of eight repeats
      of 42-44 amino acids each, displaying similarity to the arm motif found in
      junctional and nucleopore complex proteins, and flanked by two hydrophilic NH2-
      and COOH-terminal domains. Immunostaining revealed that the OHO31 protein is
      supplied maternally and rapidly degraded during the first 13 nuclear divisions.
      Thereafter, the OHO31 protein is predominantly expressed, albeit at reduced
      levels, in proliferating tissues. During the interphase of early embryonic cell
      cycles, the OHO31 protein is present in the cytoplasm and massively accumulates
      in the nucleus at the onset of mitosis in late interphase and prophase. The
      nuclear import of OHO31 is, however, less pronounced during later developmental
      stages. These results suggest that, similar to Importin, OHO31 may act as a
      cytosolic factor in nuclear transport. Moreover, the cell cycle-dependent
      accumulation of OHO31 in the nucleus indicates that this protein may be required
      for critical nuclear reactions occurring at the onset of mitosis.

PMID- 7790351
TI  - Oligomerized transferrin receptors are selectively retained by a lumenal sorting
      signal in a long-lived endocytic recycling compartment.
AB  - Cross-linking of surface receptors results in altered receptor trafficking in the
      endocytic system. To better understand the cellular and molecular mechanisms by
      which receptor cross-linking affects the intracellular trafficking of both ligand
      and receptor, we studied the intracellular trafficking of the transferrin
      receptor (TfR) bound to multivalent-transferrin (Tf10) which was prepared by
      chemical cross-linking of transferrin (Tf). Tf10 was internalized about two times
      slower than Tf and was retained four times longer than Tf, without being degraded
      in CHO cells. The intracellular localization of Tf10 was investigated using
      fluorescence and electron microscopy. Tf10 was not delivered to the lysosomal
      pathway followed by low density lipoprotein but remained accessible to Tf in the
      pericentriolar endocytic recycling compartment for at least 60 min. The retained
      Tf10 was TfR-associated as demonstrated by a reduction in surface TfR number when
      cells were incubated with Tf10. The presence of Tf10 within the recycling
      compartment did not affect trafficking of subsequently endocytosed Tf. Retention
      of Tf10 within the recycling compartment did not require the cytoplasmic domain
      of the TfR since Tf10 exited cells with the same rate when bound to the wild-type
      TfR or a mutated receptor with only four amino acids in the cytoplasmic tail.
      Thus, cross-linking of surface receptors by a multivalent ligand acts as a
      lumenal retention signal within the recycling compartment. The data presented
      here show that the recycling compartment labeled by Tf10 is a long-lived
      organelle along the early endosome recycling pathway that remains fusion
      accessible to subsequently endocytosed Tf.

PMID- 7790350
TI  - Pendulin, a Drosophila protein with cell cycle-dependent nuclear localization, is
      required for normal cell proliferation.
AB  - We describe the dynamic intracellular localization of Drosophila Pendulin and its
      role in the control of cell proliferation. Pendulin is a new member of a
      superfamily of proteins which contains Armadillo (Arm) repeats and displays
      extensive sequence similarities with the Srp1 protein from yeast, with RAG-1
      interacting proteins from humans, and with the importin protein from Xenopus.
      Almost the entire polypeptide chain of Pendulin is composed of degenerate tandem
      repeats of approximately 42 amino acids each. A short NH2-terminal domain
      contains adjacent consensus sequences for nuclear localization and cdc2 kinase
      phosphorylation. The subcellular distribution of Pendulin is dependent on the
      phase of cell cycle. During interphase, Pendulin protein is exclusively found in
      the cytoplasm of embryonic cells. At the transition between G2 and M-phase,
      Pendulin rapidly translocates into the nuclei where it is distributed throughout
      the nucleoplasm and the areas around the chromosomes. In the larval CNS, Pendulin
      is predominantly expressed in the dividing neuroblasts, where it undergoes the
      same cell cycle-dependent redistribution as in embryos. Pendulin is encoded by
      the oho31 locus and is expressed both maternally and zygotically. We describe the
      phenotypes of recessive lethal mutations in the oho31 gene that result in a
      massive decrease or loss of zygotic Pendulin expression. Hematopoietic cells of
      mutant larvae overproliferate and form melanotic tumors, suggesting that Pendulin
      normally acts as a blood cell tumor suppressor. In contrast, growth and
      proliferation in imaginal tissues are reduced and irregular, resulting in
      abnormal development of imaginal discs and the CNS of the larvae. This phenotype
      shows that Pendulin is required for normal growth regulation. Based on the
      structure of the protein, we propose that Pendulin may serve as an adaptor
      molecule to form complexes with other proteins. The sequence similarity with
      importin indicates that Pendulin may play a role in the nuclear import of
      karyophilic proteins and some of these may be required for the normal
      transmission and function of proliferative signals in the cells.

PMID- 7790353
TI  - Oligomerization of epidermal growth factor receptors on A431 cells studied by
      time-resolved fluorescence imaging microscopy. A stereochemical model for
      tyrosine kinase receptor activation.
AB  - The aggregation states of the epidermal growth factor receptor (EGFR) on single
      A431 human epidermoid carcinoma cells were assessed with two new techniques for
      determining fluorescence resonance energy transfer: donor photobleaching
      fluorescence resonance energy transfer (pbFRET) microscopy and fluorescence
      lifetime imaging microscopy (FLIM). Fluorescein-(donor) and rhodamine-(acceptor)
      labeled EGF were bound to the cells and the extent of oligomerization was
      monitored by the spatially resolved FRET efficiency as a function of the
      donor/acceptor ratio and treatment conditions. An average FRET efficiency of 5%
      was determined after a low temperature (4 degrees C) incubation with the
      fluorescent EGF analogs for 40 min. A subsequent elevation of the temperature for
      5 min caused a substantial increase of the average FRET efficiency to 14% at 20
      degrees C and 31% at 37 degrees C. In the context of a two-state (monomer/dimer)
      model for the EGFR, these FRET efficiencies were consistent with minimal average
      receptor dimerizations of 13, 36, and 69% at 4, 20, and 37 degrees C,
      respectively. A431 cells were pretreated with the monoclonal antibody mAb 2E9
      that specifically blocks EGF binding to the predominant population of low
      affinity EGFR (15). The average FRET efficiency increased dramatically to 28% at
      4 degrees C, indicative of a minimal receptor dimerization of 65% for the
      subpopulation of high affinity receptors. These results are in accordance with
      prior studies indicating that binding of EGF leads to a fast and temperature
      dependent microclustering of EGFR, but suggest in addition that the high affinity
      functional subclass of receptors on quiescent A431 cells are present in a
      predimerized or oligomerized state. We propose that the transmission of the
      external ligand-binding signal to the cytoplasmic domain is effected by a
      concerted relative rotational rearrangement of the monomeric units comprising the
      dimeric receptor, thereby potentiating a mutual activation of the tyrosine kinase
      domains.

PMID- 7790352
TI  - Pseudomonas exotoxin-mediated selection yields cells with altered expression of
      low-density lipoprotein receptor-related protein.
AB  - The alpha 2-macroglobulin (alpha 2M) receptor/low-density lipoprotein receptor
      related protein (LRP) is important for the clearance of proteases, protease
      inhibitor complexes, and various ligands associated with lipid metabolism. While
      the regulation of receptor function is poorly understood, the addition of high
      concentrations of the 39-kD receptor-associated protein (RAP) to cells inhibits
      the binding and/or uptake of many of these ligands. Previously, we (Kounnas,
      M.Z., R.E. Morris, M.R. Thompson, D.J. FitzGerald, D.K. Strickland, and C.B.
      Saelinger. 1992. J. Biol. Chem. 267:12420-12423) [corrected] showed that
      Pseudomonas exotoxin (PE) could bind immobilized LRP. Also, the addition of RAP
      blocked toxin-mediated cell killing. These findings suggested that PE might use
      LRP to gain entry into toxin-sensitive cells. Here we report on a strategy to
      select PE-resistant lines of Chinese hamster ovary cells that express altered
      amounts of LRP. An important part of this strategy is to screen PE-resistant
      clones for those that retain sensitivity to both diphtheria toxin and to a fusion
      protein composed of lethal factor (from anthrax toxin) fused to the adenosine
      diphosphate-ribosylating domain of PE. Two lines, with obvious changes in their
      expression of LRP, were characterized in detail. The 14-2-1 line had significant
      amounts of LRP, but in contrast to wild-type cells, little or no receptor was
      displayed on the cell surface. Instead, receptor protein was found primarily
      within cells, much of it apparently in an unprocessed state. The 14-2-1 line
      showed no uptake of chymotrypsin-alpha 2M and was 10-fold resistant to PE
      compared with wild-type cells. A second line, 13-5-1, had no detectable LRP mRNA
      or protein, did not internalize alpha 2M-chymotrypsin, and exhibited a 100-fold
      resistance to PE. Resistance to PE appeared to be due to receptor-specific
      defects, since these mutant lines showed no resistance to a PE chimeric toxin
      that was internalized via the transferrin receptor. The results of this
      investigation confirm that LRP mediates the internalization of PE.

PMID- 7790354
TI  - Barriers for lateral diffusion of transferrin receptor in the plasma membrane as
      characterized by receptor dragging by laser tweezers: fence versus tether.
AB  - Our previous results indicated that the plasma membrane of cultured normal rat
      kidney fibroblastic cell is compartmentalized for diffusion of receptor
      molecules, and that long-range diffusion is the result of successive
      intercompartmental jumps (Sako, Y. and Kusumi, A. 1994. J. Cell Biol. 125:1251
      1264). In the present study, we characterized the properties of
      intercompartmental boundaries by tagging transferrin receptor (TR) with either
      210-nm-phi latex or 40-nm-phi colloidal gold particles, and by dragging the
      particle-TR complexes laterally along the plasma membrane using laser tweezers.
      Approximately 90% of the TR-particle complexes showed confined-type diffusion
      with a microscopic diffusion coefficient (Dmicro) of approximately 10(-9) cm2/s
      and could be dragged past the intercompartmental boundaries in their path by
      laser tweezers at a trapping force of 0.25 pN for gold-tagged TR and 0.8 pN for
      latex-tagged TR. At lower dragging forces between 0.05 and 0.1 pN, particle-TR
      complexes tended to escape from the laser trap at the boundaries, and such escape
      occurred in both the forward and backward directions of dragging. The average
      distance dragged was half of the confined distance of TR, which further indicates
      that particle-TR complexes escape at the compartment boundaries. Since variation
      in the particle size (40 and 210 nm, the particles are on the extracellular
      surface of the plasma membrane) hardly affects the diffusion rate and behavior of
      the particle-TR complexes at the compartment boundaries, and since treatment with
      cytochalasin D or vinblastin affects the movements of TR (Sako and Kusumi as
      cited above), argument has been advanced that the boundaries are present in the
      cytoplasmic domain. Rebound of the particle-TR complexes when they escape from
      the laser tweezers at the compartment boundaries suggests that the boundaries are
      elastic structures. These results are consistent with the proposal that the
      compartment boundaries consist of membrane skeleton or a membrane-associated part
      of the cytoskeleton (membrane skeleton fence model). Approximately 10% of TR
      exhibited slower diffusion (Dmicro approximately 10(-10)-10(-11) cm2/s) and
      binding to elastic structures.

PMID- 7790355
TI  - The 95F unconventional myosin is required for proper organization of the
      Drosophila syncytial blastoderm.
AB  - The 95F myosin, a class VI unconventional myosin, associates with particles in
      the cytoplasm of the Drosophila syncytial blastoderm and is required for the ATP-
      and F-actin-dependent translocation of these particles. The particles undergo a
      cell cycle-dependent redistribution from domains that surround each nucleus in
      interphase to transient membrane invaginations that provide a barrier between
      adjacent spindles during mitosis. When 95F myosin function is inhibited by
      antibody injection, profound defects in syncytial blastoderm organization occur.
      This disorganization is seen as aberrant nuclear morphology and position and is
      suggestive of failures in cytoskeletal function. Nuclear defects correlate with
      gross defects in the actin cytoskeleton, including indistinct actin caps and
      furrows, missing actin structures, abnormal spacing of caps, and abnormally
      spaced furrows. Three-dimensional examination of embryos injected with anti-95F
      myosin antibody reveals that actin furrows do not invaginate as deeply into the
      embryo as do normal furrows. These furrows do not separate adjacent mitoses,
      since microtubules cross over them. These inappropriate microtubule interactions
      lead to aberrant nuclear divisions and to the nuclear defects observed. We
      propose that 95F myosin function is required to generate normal actin-based
      transient membrane furrows. The motor activity of 95F myosin itself and/or
      components within the particles transported to the furrows by 95F myosin may be
      required for normal furrows to form.

PMID- 7790356
TI  - Actin polymerization and intracellular solvent flow in cell surface blebbing.
AB  - The cortical actin gel of eukaryotic cells is postulated to control cell surface
      activity. One type of protrusion that may offer clues to this regulation are the
      spherical aneurysms of the surface membrane known as blebs. Blebs occur normally
      in cells during spreading and alternate with other protrusions, such as ruffles,
      suggesting similar protrusive machinery is involved. We recently reported that
      human melanoma cell lines deficient in the actin filament cross-linking protein,
      ABP-280, show prolonged blebbing, thus allowing close study of blebs and their
      dynamics. Blebs expand at different rates of volume increase that directly
      predict the final size achieved by each bleb. These rates decrease as the F-actin
      concentration of the cells increase over time after plating on a surface, but do
      so at lower concentrations in ABP-280 expressing cells. Fluorescently labeled
      actin and phalloidin injections of blebbing cells indicate that a polymerized
      actin structure is not present initially, but appears later and is responsible
      for stopping further bleb expansion. Therefore, it is postulated that blebs occur
      when the fluid-driven expansion of the cell membrane is sufficiently rapid to
      initially outpace the local rate of actin polymerization. In this model, the rate
      of intracellular solvent flow driving this expansion decreases as cortical
      gelation is achieved, whether by factors such as ABP-280, or by concentrated
      actin polymers alone, thereby leading to decreased size and occurrence of blebs.
      Since the forces driving bleb extension would always be present in a cell, this
      process may influence other cell protrusions as well.

PMID- 7790357
TI  - Three-dimensional ultrastructural analysis of the Saccharomyces cerevisiae
      mitotic spindle.
AB  - The three dimensional organization of microtubules in mitotic spindles of the
      yeast Saccharomyces cerevisiae has been determined by computer-aided
      reconstruction from electron micrographs of serially cross-sectioned spindles.
      Fifteen spindles ranging in length from 0.6-9.4 microns have been analyzed.
      Ordered microtubule packing is absent in spindles up to 0.8 micron, but the total
      number of microtubules is sufficient to allow one microtubule per kinetochore
      with a few additional microtubules that may form an interpolar spindle. An
      obvious bundle of about eight interpolar microtubules was found in spindles 1.3
      1.6 microns long, and we suggest that the approximately 32 remaining microtubules
      act as kinetochore fibers. The relative lengths of the microtubules in these
      spindles suggest that they may be in an early stage of anaphase, even though
      these spindles are all situated in the mother cell, not in the isthmus between
      mother and bud. None of the reconstructed spindles exhibited the uniform
      populations of kinetochore microtubules characteristic of metaphase. Long
      spindles (2.7-9.4 microns), presumably in anaphase B, contained short remnants of
      a few presumed kinetochore microtubules clustered near the poles and a few long
      microtubules extending from each pole toward the spindle midplane, where they
      interdigitated with their counterparts from the other pole. Interpretation of
      these reconstructed spindles offers some insights into the mechanisms of mitosis
      in this yeast.

PMID- 7790358
TI  - Cell cycle regulation of the activity and subcellular localization of Plk1, a
      human protein kinase implicated in mitotic spindle function.
AB  - Correct assembly and function of the mitotic spindle during cell division is
      essential for the accurate partitioning of the duplicated genome to daughter
      cells. Protein phosphorylation has long been implicated in controlling spindle
      function and chromosome segregation, and genetic studies have identified several
      protein kinases and phosphatases that are likely to regulate these processes. In
      particular, mutations in the serine/threonine-specific Drosophila kinase polo,
      and the structurally related kinase Cdc5p of Saccharomyces cerevisae, result in
      abnormal mitotic and meiotic divisions. Here, we describe a detailed analysis of
      the cell cycle-dependent activity and subcellular localization of Plk1, a
      recently identified human protein kinase with extensive sequence similarity to
      both Drosophila polo and S. cerevisiae Cdc5p. With the aid of recombinant
      baculoviruses, we have established a reliable in vitro assay for Plk1 kinase
      activity. We show that the activity of human Plk1 is cell cycle regulated, Plk1
      activity being low during interphase but high during mitosis. We further show, by
      immunofluorescent confocal laser scanning microscopy, that human Plk1 binds to
      components of the mitotic spindle at all stages of mitosis, but undergoes a
      striking redistribution as cells progress from metaphase to anaphase.
      Specifically, Plk1 associates with spindle poles up to metaphase, but relocalizes
      to the equatorial plane, where spindle microtubules overlap (the midzone), as
      cells go through anaphase. These results indicate that the association of Plk1
      with the spindle is highly dynamic and that Plk1 may function at multiple stages
      of mitotic progression. Taken together, our data strengthen the notion that human
      Plk1 may represent a functional homolog of polo and Cdc5p, and they suggest that
      this kinase plays an important role in the dynamic function of the mitotic
      spindle during chromosome segregation.

PMID- 7790359
TI  - Overexpression of the human NFM subunit in transgenic mice modifies the level of
      endogenous NFL and the phosphorylation state of NFH subunits.
AB  - Neurofilaments (NFs), the major intermediate filaments of central nervous system
      (CNS) and peripheral nervous system (PNS) neurons, are heteropolymers formed from
      the high (NFH), middle (NFM), and low (NFL) molecular weight NF subunits. To gain
      insights into how the expression of NF subunit proteins is regulated in vivo, two
      transgenes harboring coding sequences for human NFM (hNFM) with or without the
      hNFM multiphosphorylation repeat domain were introduced into mice. Expression of
      both hNFM constructs was driven by the hNFM promoter and resulted in increased
      levels of hNFM subunits concomitant with an elevation in the levels of mouse NFL
      (mNFL) proteins in the CNS of both lines of transgenic mice. The increased levels
      of mNFL appear specific to NFM because previous studies of transgenic mice
      overexpressing either NFL or NFH did not result in increased expression of either
      of the other two NF subunits. Further, levels of the most heavily phosphorylated
      isoforms of mouse NFH (mNFH) were reduced in the brains of these transgenic mice,
      and electron microscopic studies showed a higher packing density of NFs in large
      diameter CNS axons of transgenic versus wild-type mice. Thus, reduced
      phosphorylation of the mNFH carboxy terminal domain may be a compensatory
      response of CNS neurons to the increase in NFs, and reduced negative charges on
      mNFH sidearms may allow axons to accommodate more NFs by increasing their packing
      density. Taken together, these studies imply that NFM may play a dominant role in
      the in vivo regulation of the levels of NFL protein, the stoichiometry of NF
      subunits, and the phosphorylation state of NFH. NFM and NFH proteins may assume
      similar functions in regulation of NF packing density in vivo.

PMID- 7790360
TI  - 7B2 facilitates the maturation of proPC2 in neuroendocrine cells and is required
      for the expression of enzymatic activity.
AB  - The prohormone convertase PC2, which is thought to mediate the proteolytic
      conversion of many peptide hormones, has recently been shown to interact with the
      neuroendocrine-specific polypeptide 7B2 in Xenopus intermediate lobe (Braks, J.
      A. M., and G. J. M. Martens. Cell. 78:263. 1994). In the present work we have
      stably transfected neuroendocrine cell lines with rat 7B2 constructs and found
      that overexpression of 27 kD 7B2 greatly facilitates the kinetics of maturation
      of proPC2, both in AtT-20/PC2 cells and in Rin5f cells. The half-life of
      conversion of proPC2 was reduced from 2.7 to 1.7 h in AtT-20/PC2 cells stably
      transfected with 27 kD 7B2 cDNA. The previously proposed "chaperone" domain was
      not sufficient for this facilitation event; however, a construct corresponding to
      the 21-kD 7B2 protein (which represents the naturally occurring maturation
      product) functioned well. A 7B2 construct in which maturation of 27 kD 7B2 to its
      21-kD form was blocked was unable to facilitate maturation of proPC2. To
      correlate effects on PC2 maturation with the actual generation of PC2 enzymatic
      activity, a similar transfection of 21 kD 7B2 was performed using CHO cells
      previously amplified for the expression of proPC2. Enzymatic activity cleaving
      the fluorogenic substrate Cbz-Arg-Ser-Lys-Arg-AMC was highly correlated with the
      expression of immunoreactive 21 kD 7B2 in the conditioned medium; medium obtained
      from the parent cell line was completely inactive. Enzymatic activity was
      identified as PC2 on the basis of inhibition by the carboxy-terminal peptide of
      7B2, which has previously been shown to represent a potent and specific PC2
      inhibitor. Taken together, our in vivo results indicate that the interesting
      secretory protein 7B2 is a bifunctional molecule with an amino-terminal domain
      involved in proPC2 transport as well as activation.

PMID- 7790361
TI  - Chemoattractant and GTP gamma S-mediated stimulation of adenylyl cyclase in
      Dictyostelium requires translocation of CRAC to membranes.
AB  - We have previously reported that activation of adenylyl cyclase by
      chemoattractant receptors in Dictyostelium requires, in addition to a
      heterotrimeric G-protein, a cytosolic protein, designated CRAC (Lilly, P., and P.
      N. Devreotes. 1994. J. Biol. Chem. 269:14123-14129; Insall, R. H., A. Kuspa, P.
      J. Lilly, G. Schaulsky, L. R. Levin, W. F. Loomis, and P. N. Devreotes. 1994. J.
      Cell Biol. 126:1537-1545). In this report, we show that in intact cells,
      chemoattractants promote translocation of CRAC from the cytosolic to the membrane
      fraction. However, CRAC is not required at the time of receptor stimulation; it
      can be added to lysates of activated cells. Treatment of membranes with guanine
      nucleotides creates binding sites for CRAC. These binding sites can be generated
      in mutants lacking each of the components of the pathway except the beta-subunit,
      suggesting that free or "activated" beta gamma-subunits may be a part of the
      binding site. This hypothesis is consistent with previous observations that CRAC
      contains a pleckstrin homology domain and that the beta gamma-subunits likely
      mediate activation of adenylyl cyclase in this system. Thus, CRAC may serve as an
      adapter, linking the G-protein beta gamma-subunits to activation of the enzyme.
      GTP gamma S cannot generate CRAC-binding sites when the adenylyl cyclase pathway
      has been adapted by prior chemoattractant stimulation, suggesting that this is a
      point of downstream adaptation.

PMID- 7790362
TI  - The G protein beta subunit is essential for multiple responses to
      chemoattractants in Dictyostelium.
AB  - Increasing evidence suggests that the beta gamma-subunit dimers of heterotrimeric
      G proteins play a pivotal role in transducing extracellular signals. The recent
      construction of G beta null mutants (g beta-) in Dictyostelium provides a unique
      opportunity to study the role of beta gamma dimers in signaling processes
      mediated by chemoattractant receptors. We have shown previously that g beta-
      cells fail to aggregate; in this study, we report the detailed characterization
      of these cells. The g beta- cells display normal motility but do not move towards
      chemattractants. The typical GTP-regulated high affinity chemoattractant-binding
      sites are lost in g beta- cells and membranes. The g beta- cells do not display
      chemoattractant-stimulated adenylyl cyclase or guanylyl cyclase activity. These
      results show that in vivo G beta links chemoattractant receptors to effectors and
      is therefore essential in many chemoattractant-mediated processes. In addition,
      we find that G beta is required for GTP gamma S stimulation of adenylyl cyclase
      activity, suggesting that the beta gamma-dimer activates the enzyme directly.
      Interestingly, the g beta- cells grow at the same rate as wild-type cells in
      axenic medium but grow more slowly on bacterial lawns and, therefore, may be
      defective in phagocytosis.

PMID- 7790363
TI  - The human E48 antigen, highly homologous to the murine Ly-6 antigen ThB, is a GPI
      anchored molecule apparently involved in keratinocyte cell-cell adhesion.
AB  - The E48 antigen, a putative human homologue of the 20-kD protein present in
      desmosomal preparations of bovine muzzle, and formerly called desmoglein III
      (dg4), is a promising target antigen for antibody-based therapy of squamous cell
      carcinoma in man. To anticipate the effect of high antibody dose treatment, and
      to evaluate the possible biological involvement of the antigen in carcinogenesis,
      we set out to molecularly characterize the antigen. A cDNA clone encoding the E48
      antigen was isolated by expression cloning in COS cells. Sequence analysis
      revealed that the clone contained an open reading frame of 128 amino acids,
      encoding a core protein of 13,286 kD. Database searching showed that the E48
      antigen has a high level of sequence similarity with the mouse ThB antigen, a
      member of the Ly-6 antigen family. Phosphatidylinositol-specific (PI-specific)
      phospholipase-C treatment indicated that the E48 antigen is
      glycosylphosphatidylinositol-anchored (GPI-anchored) to the plasma membrane. The
      gene encoding the E48 antigen is a single copy gene, located on human chromosome
      8 in the 8q24-qter region. The expression of the gene is confined to
      keratinocytes and squamous tumor cells. The putative mouse homologue, the ThB
      antigen, originally identified as an antigen on cells of the lymphocyte lineage,
      was shown to be highly expressed in squamous mouse epithelia. Moreover, the ThB
      expression level is in keratinocytes, in contrast to that in lymphocytes, not
      mouse strain related. Transfection of mouse SV40-polyoma transformed mouse
      NIH/3T3 cells with the E48 cDNA confirmed that the antigen is likely to be
      involved in cell-cell adhesion.

PMID- 7790366
TI  - Dissociation of centrosome replication events from cycles of DNA synthesis and
      mitotic division in hydroxyurea-arrested Chinese hamster ovary cells.
AB  - Relatively little is known about the mechanisms used by somatic cells to regulate
      the replication of the centrosome complex. Centrosome doubling was studied in CHO
      cells by electron microscopy and immunofluorescence microscopy using human
      autoimmune anticentrosome antiserum, and by Northern blotting using the cDNA
      encoding portion of the centrosome autoantigen pericentriolar material (PCM)-1.
      Centrosome doubling could be dissociated from cycles of DNA synthesis and mitotic
      division by arresting cells at the G1/S boundary of the cell cycle using either
      hydroxyurea or aphidicolin. Immunofluorescence micros-copy using SPJ human
      autoimmune anticentrosome antiserum demonstrated that arrested cells were able to
      undergo numerous rounds of centrosome replication in the absence of cycles of DNA
      synthesis and mitosis. Northern blot analysis demonstrated that the synthesis and
      degradation of the mRNA encoding PCM-1 occurred in a cell cycle-dependent fashion
      in CHO cells with peak levels of PCM-1 mRNA being present in G1 and S phase cells
      before mRNA amounts dropped to undetectable levels in G2 and M phases.
      Conversely, cells arrested at the G1/S boundary of the cell cycle maintained PCM
      1 mRNA at artificially elevated levels, providing a possible molecular mechanism
      for explaining the multiple rounds of centrosome replication that occurred in CHO
      cells during prolonged hydroxyurea-induced arrest. The capacity to replicate
      centrosomes could be abolished in hydroxyurea-arrested CHO cells by culturing the
      cells in dialyzed serum. However, the ability to replicate centrosomes and to
      synthesize PCM-1 mRNA could be re-initiated by adding EGF to the dialyzed serum.
      This experimental system should be useful for investigating the positive and
      negative molecular mechanisms used by somatic cells to regulate the replication
      of centrosomes and for studying and the methods used by somatic cells for
      coordinating centrosome duplication with other cell cycle progression events.

PMID- 7790364
TI  - Membrane-anchored heparin-binding EGF-like growth factor (HB-EGF) and diphtheria
      toxin receptor-associated protein (DRAP27)/CD9 form a complex with integrin alpha
      3 beta 1 at cell-cell contact sites.
AB  - Heparin-binding epidermal growth factor-like growth factor (HB-EGF) is a member
      of the EGF family of growth factors, which interact with EGF receptor to exert
      mitogenic activity. The membrane-anchored form of HB-EGF, proHB-EGF, is
      biologically active, providing mitogenic stimulation to neighboring cells in a
      juxtacrine mode. ProHB-EGF forms a complex with diphtheria toxin receptor
      associated protein (DRAP27)/CD9, a tetra membrane-spanning protein that
      upregulates the juxtacrine mitogenic activity of proHB-EGF. We explored whether
      other proteins associate with DRAP27/CD9 and proHB-EGF. Immunoprecipitation with
      anti-DRAP27/CD9 resulted in preferential coprecipitation of integrin alpha 3 beta
      1 from Vero cell, A431 cell and MG63 cell lysates. Anti-integrin alpha 3 or anti
      integrin beta 1 coprecipitated DRAP27/CD9 from the same cell lysates. Chemical
      cross-linking confirmed the physical association of DRAP27/CD9 and integrin alpha
      3 beta 1. Using Vero-H cells, which overexpress HB-EGF, we also demonstrated the
      association of proHB-EGF with DRAP27/CD9 and integrin alpha 3 beta 1. Moreover,
      colocalization of proHB-EGF, DRAP27/CD9, and integrin alpha 3 beta 1 at cell-cell
      contact sites was observed by double-immunofluorescence staining. At cell-cell
      contact sites, DRAP27/CD9 was highly coincident with alpha-catenin and vinculin,
      suggesting that DRAP27/CD9, proHB-EGF, and integrin alpha 3 beta 1 are
      colocalized with adherence junction-locating proteins. These results indicate
      that direct interaction of growth factors and cell adhesion molecules may control
      cell proliferation during the cell-cell adhesion process.

PMID- 7790365
TI  - Components of the nuclear signaling cascade that regulate collagenase gene
      expression in response to integrin-derived signals.
AB  - We have shown previously that the expression of collagenase is upregulated in
      rabbit synovial fibroblasts cultured on a substrate of antibody to the alpha 5
      chain of the alpha 5 beta 1 integrin fibronectin receptor or on the 120-kD cell
      binding chymotryptic fragment of plasma fibronectin, but remains at basal levels
      in cells plated on intact plasma fibronectin. We now have identified some of the
      components of a signaling pathway that couples the fibronectin receptor to the
      induction of collagenase transcription. We studied the control of collagenase
      gene expression in cells adhering to the 120-kD fragment of fibronectin, to
      antifibronectin receptor antibody, or to plasma fibronectin by transiently
      introducing promoter-reporter constructs into rabbit synovial fibroblasts before
      plating cells on these matrices. The constructs contained segments of the human
      collagenase promoter regulating transcription of chloramphenicol acyl
      transferase. Expression of constructs containing the -1200/-42-bp segment or the 
      139/-42-bp segment of the collagenase promoter inserted upstream from the
      reporter gene was induced to similar extents in cells plated on the 120-kD
      fragment of fibronectin or on anti-fibronectin receptor antibody, relative to
      that in fibroblasts plated on fibronectin. The expression of the construct
      containing the -66/-42-bp segment of the promoter was not regulated and was
      similar to that of the parent pBLCAT2 plasmid, suggesting that the -139/-67
      region of the collagenase promoter, which contains PEA3- and AP1-binding sites,
      regulates the transcription of collagenase caused by integrin-derived signals.
      Expression of a reporter construct containing only the PEA3 and AP1 sites in the
      collagenase promoter (-90/-67) also increased in cells plated on the 120-kD
      fragment of fibronectin or on anti-fibronectin receptor antibody, relative to
      that in cells plated on fibronectin. Mutations in either the AP1 or PEA3 site of
      this minimal promoter abrogated its activity in cells plated on these inductive
      ligands. Expression of c-fos mRNA increased within 1 h of plating cells on the
      120-kD fibronectin fragment or on anti-fibronectin receptor antibody, relative to
      that in cells plated on fibronectin. c-Fos protein accumulated in the nuclei of
      fibroblasts within 10 min of plating on the 120-kD fibronectin fragment. The
      increase in c-Fos was required for the increase in collagenase in cells plated on
      the 120-kD fibronectin fragment: incubation of cells with antisense, but not
      sense, c-fos oligonucleotides diminished both basal and induced expression of the
      -139/-42 collagenase promoter-reporter construct and decreased expression of the
      endogenous collagenase gene.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7790367
TI  - Molecular genetic studies of a human epidermal autoantigen (the 180-kD bullous
      pemphigoid antigen/BP180): identification of functionally important sequences
      within the BP180 molecule and evidence for an interaction between BP180 and alpha
      6 integrin.
AB  - The 180-kD bullous pemphigoid autoantigen (BP180) is a component of the
      hemidesmosome, a cell-matrix connector. This protein is oriented in a type II
      fashion in the membrane of the hemidesmosome and is a hybrid collagen (classified
      as type XVII). We have analyzed the fate of various mutant BP180 molecules
      transfected into several different cell types. A protein, D1, lacking the
      collagen-like extracellular domains of BP180 polarizes normally in 804G
      epithelial cells and colocalizes with other hemidesmosomal components in the
      plane of the basal cell surface. However, deletion of a stretch of 36 amino acids
      located at the NH2 terminus of D1 induces an apical polarization of the protein
      (D1-36N) in the cell surface of 804G cells. Deletion of the 27-amino acid
      noncollagenous extracellular domain that is located immediately after the
      membrane spanning domain of BP180 results in a failure of D1-27C protein to
      codistribute with other hemidesmosomal components despite its basal localization
      in transfected 804G cells. In FG cells, which lack their own BP180, transfected
      D1 protein localizes with the alpha 6 beta 4 integrin heterodimer. In HT1080
      cells, which do not possess BP180 or beta 4 integrin, D1 protein localizes with
      alpha 6 beta 1 integrin while both the D1-27C and D1-36N proteins do not.
      Moreover, D1 protein coprecipitates with alpha 6 integrin from extracts of HT1080
      transfectants. Taken together, these results suggest that the NH2-terminal domain
      of BP180 determines polarization of BP180 while the noncollagenous extracellular
      domain of BP180 stabilizes its interactions with other hemidesmosomal components,
      such as alpha 6 integrin. Perturbation of this latter domain by human bullous
      pemphigoid autoantibodies may explain the loss of epidermal cell-dermis
      attachment that characterizes the BP disease.

PMID- 7790368
TI  - Peripheral expression and biological activities of GDNF, a new neurotrophic
      factor for avian and mammalian peripheral neurons.
AB  - Glial cell line-derived neurotrophic factor (GDNF) is a neurotrophic polypeptide,
      distantly related to transforming growth factor-beta (TGF-beta), originally
      isolated by virtue of its ability to induce dopamine uptake and cell survival in
      cultures of embryonic ventral midbrain dopaminergic neurons, and more recently
      shown to be a potent neurotrophic factor for motorneurons. The biological
      activities and distribution of this molecule outside the central nervous system
      are presently unknown. We report here on the mRNA expression, biological
      activities and initial receptor binding characterization of GDNF and a shorter
      spliced variant termed GDNF beta in different organs and peripheral neurons of
      the developing rat. Both GDNF mRNA forms were found to be most highly expressed
      in developing skin, whisker pad, kidney, stomach and testis. Lower expression was
      also detected in developing skeletal muscle, ovary, lung, and adrenal gland.
      Developing spinal cord, superior cervical ganglion (SCG) and dorsal root ganglion
      (DRG) also expressed low levels of GDNF mRNA. Two days after nerve transection,
      GDNF mRNA levels increased dramatically in the sciatic nerve. Overall, GDNF mRNA
      expression was significantly higher in peripheral organs than in neuronal
      tissues. Expression of either GDNF mRNA isoform in insect cells resulted in the
      production of indistinguishable mature GDNF polypeptides. Purified recombinant
      GDNF promoted neurite outgrowth and survival of embryonic chick sympathetic
      neurons. GDNF produced robust bundle-like, fasciculated outgrowth from chick
      sympathetic ganglion explants. Although GDNF displayed only low activity on
      survival of newborn rat SCG neurons, this protein was found to increase the
      expression of vasoactive intestinal peptide and preprotachykinin-A mRNAs in
      cultured SCG neurons. GDNF also promoted survival of about half of the neurons in
      embryonic chick nodose ganglion and a small subpopulation of embryonic sensory
      neurons in chick dorsal root and rat trigeminal ganglia. Embryonic chick
      sympathetic neurons expressed receptors for GDNF with Kd 1-5 x 10(-9) M, as
      measured by saturation and displacement binding assays. Our findings indicate
      GDNF is a new neurotrophic factor for developing peripheral neurons and suggest
      possible non-neuronal roles for GDNF in the developing reproductive system.

PMID- 7790369
TI  - Signals and structural features involved in integral membrane protein targeting
      to the inner nuclear membrane.
AB  - We have examined transfected cells by immunofluorescence microscopy to determine
      the signals and structural features required for the targeting of integral
      membrane proteins to the inner nuclear membrane. Lamin B receptor (LBR) is a
      resident protein of the nuclear envelope inner membrane that has a nucleoplasmic,
      amino-terminal domain and a carboxyl-terminal domain with eight putative
      transmembrane segments. The amino-terminal domain of LBR can target both a
      cytosolic protein to the nucleus and a type II integral protein to the inner
      nuclear membrane. Neither a nuclear localization signal (NLS) of a soluble
      protein, nor full-length histone H1, can target an integral protein to the inner
      nuclear membrane although they can target cytosolic proteins to the nucleus. The
      addition of an NLS to a protein normally located in the inner nuclear membrane,
      however, does not inhibit its targeting. When the amino-terminal domain of LBR is
      increased in size from approximately 22.5 to approximately 70 kD, the chimeric
      protein cannot reach the inner nuclear membrane. The carboxyl-terminal domain of
      LBR, separated from the amino-terminal domain, also concentrates in the inner
      nuclear membrane, demonstrating two nonoverlapping targeting signals in this
      protein. Signals and structural features required for the inner nuclear membrane
      targeting of proteins are distinct from those involved in targeting soluble
      polypeptides to the nucleoplasm. The structure of the nucleocytoplasmic domain of
      an inner nuclear membrane protein also influences targeting, possibly because of
      size constraints dictated by the lateral channels of the nuclear pore complexes.

PMID- 7790370
TI  - Alterations in mitochondrial structure and function are early events of
      dexamethasone-induced thymocyte apoptosis.
AB  - In this paper we used a multiparametric approach to analyze extensively the
      events occurring during apoptotic cell death of thymocytes, and furthermore, we
      asked whether alterations in mitochondrial structure and function are occurring
      in early stages of apoptosis. A multiparametric quantitative analysis was
      performed on normal or apoptotic thymocytes emerging from a few-hour culture
      performed in culture medium or in the presence of dexamethasone. Simultaneous
      detection of light scattering properties, integrity of plasma membrane (trypan
      blue exclusion), chromatin condensation (AO/EB staining of entire cells or PI
      staining of nuclei), and DNA fragmentation (in situ nick-translation in apoptotic
      cells) allowed a precise analysis of the preapoptotic and apoptotic stages.
      Moreover a thorough study of mitochondrial transmembrane potential (delta psi m)
      assessed following in a time course study the uptake by apoptotic cells of the
      cationic lipophilic dye DiOC6(3) or the J-aggregate-forming cation JC-1,
      indicates that a drop in delta psi m occurs very early in thymocyte apoptosis,
      before DNA fragmentation. This is associated with alteration in mitochondrial
      structure assessed by cytofluorimetric study of NAO uptake in apoptotic cells.
      Finally these dramatic alterations in mitochondrial structure and function
      occurring in early stages of apoptosis were confirmed by confocal and electron
      microscopy analysis.

PMID- 7790371
TI  - Lens epithelial cell apoptosis appears to be a common cellular basis for non
      congenital cataract development in humans and animals.
AB  - Cataract is a major ocular disease that causes blindness in many developing
      countries of the world. It is well established that various factors such as
      oxidative stress, UV, and other toxic agents can induce both in vivo and in vitro
      cataract formation. However, a common cellular basis for this induction has not
      been previously recognized. The present study of lens epithelial cell viability
      suggests such a general mechanism. When lens epithelial cells from a group of 20
      cataract patients 12 to 94 years old were analyzed by terminal deoxynucleotidyl
      transferase (TdT) labeling and DNA fragmentation assays, it was found that all of
      these patients had apoptotic epithelial cells ranging from 4.4 to 41.8%. By
      contrast, in eight normal human lenses of comparable age, very few apoptotic
      epithelial cells were observed. We suggest that cataract patients may have
      deficient defense systems against factors such as oxidative stress and UV at the
      onset of the disease. Such stress can trigger lens epithelial cell apoptosis that
      then may initiate cataract development. To test this hypothesis, it is also
      demonstrated here that hydrogen peroxide at concentrations previously found in
      some cataract patients induces both lens epithelial cell apoptosis and cortical
      opacity. Moreover, the temporal and spatial distribution of induced apoptotic
      lens epithelial cells precedes development of lens opacification. These results
      suggest that lens epithelial cell apoptosis may be a common cellular basis for
      initiation of noncongenital cataract formation.

PMID- 7790372
TI  - Sphingosine-1-phosphate inhibits PDGF-induced chemotaxis of human arterial smooth
      muscle cells: spatial and temporal modulation of PDGF chemotactic signal
      transduction.
AB  - Activation of the PDGF receptor on human arterial smooth muscle cells (SMC)
      induces migration and proliferation via separable signal transduction pathways.
      Sphingosine-1-phosphate (Sph-1-P) can be formed following PDGF receptor
      activation and therefore may be implicated in PDGF-receptor signal transduction.
      Here we show that Sph-1-P does not significantly affect PDGF-induced DNA
      synthesis, proliferation, or activation of mitogenic signal transduction
      pathways, such as the mitogen-activated protein (MAP) kinase cascade and PI 3
      kinase, in human arterial SMC. On the other hand, Sph-1-P strongly mimics PDGF
      receptor-induced chemotactic signal transduction favoring actin filament
      disassembly. Although Sph-1-P mimics PDGF, exogenously added Sph-1-P induces more
      prolonged and quantitatively greater PIP2 hydrolysis compared to PDGF-BB, a
      markedly stronger calcium mobilization and a subsequent increase in cyclic AMP
      levels and activation of cAMP-dependent protein kinase. This excessive and
      prolonged signaling favors actin filament disassembly by Sph-1-P, and results in
      inhibition of actin nucleation, actin filament assembly and formation of focal
      adhesion sites. Sph-1-P-induced interference with the dynamics of PDGF-stimulated
      actin filament disassembly and assembly results in a marked inhibition of cell
      spreading, of extension of the leading lamellae toward PDGF, and of chemotaxis
      toward PDGF. The results suggest that spatial and temporal changes in
      phosphatidylinositol turnover, calcium mobilization and actin filament
      disassembly may be critical to PDGF-induced chemotaxis and suggest a possible
      role for endogenous Sph-1-P in the regulation of PDGF receptor chemotactic signal
      transduction.

PMID- 7790373
TI  - Osteogenic protein-1 binds to activin type II receptors and induces certain
      activin-like effects.
AB  - Proteins in the TGF-beta superfamily transduce their effects through binding to
      type I and type II serine/threonine kinase receptors. Osteogenic protein-1 (OP-1,
      also known as bone morphogenetic protein-7 or BMP-7), a member of the TGF-beta
      superfamily which belongs to the BMP subfamily, was found to bind activin
      receptor type I (ActR-I), and BMP receptors type IA (BMPR-IA) and type IB (BMPR
      IB) in the presence of activin receptors type II (ActR-II) and type IIB (ActR
      IIB). The binding affinity of OP-1 to ActR-II was two- to threefold lower than
      that of activin A. A transcriptional activation signal was transduced after
      binding of OP-1 to the complex of ActR-I and ActR-II, or that of BMPR-IB and ActR
      II. These results indicate that ActR-II can act as a functional type II receptor
      for OP-1, as well as for activins. Some of the known biological effects of
      activin were observed for OP-1, including growth inhibition and erythroid
      differentiation induction. Compared to activin, OP-1 was shown to be a poor
      inducer of mesoderm in Xenopus embryos. Moreover, follistatin, an inhibitor of
      activins, was found to inhibit the effects of OP-1, if added at a 10-fold excess.
      However, certain effects of activin, like induction of follicle stimulating
      hormone secretion in rat pituitary cells were not observed for OP-1. OP-1 has
      overlapping binding specificities with activins, and shares certain but not all
      of the functional effects of activins. Thus, OP-1 may have broader effects in
      vivo than hitherto recognized.

PMID- 7790374
TI  - A targeted mutation at the known collagenase cleavage site in mouse type I
      collagen impairs tissue remodeling.
AB  - Degradation of type I collagen, the most abundant collagen, is initiated by
      collagenase cleavage at a highly conserved site between Gly775 and Ile776 of the
      alpha 1 (I) chain. Mutations at or around this site render type I collagen
      resistant to collagenase digestion in vitro. We show here that mice carrying a
      collagenase-resistant mutant Col1a-1 transgene die late in embryo-genesis,
      ascribable to overexpression of the transgene, since the same mutation introduced
      into the endogenous Col1a-1 gene by gene targeting permitted normal development
      of mutant mice to young adulthood. With increasing age, animals carrying the
      targeted mutation developed marked fibrosis of the dermis similar to that in
      human scleroderma. Postpartum involution of the uterus in the mutant mice was
      also impaired, with persistence of collagenous nodules in the uterine wall.
      Although type I collagen from the homozygous mutant mice was resistant to
      cleavage by human or rat fibroblast collagenases at the helical site, only the
      rat collagenase cleaved collagen trimers at an additional, novel site in the
      nonhelical N-telopeptide domain. Our results suggest that cleavage by murine
      collagenase at the N-telopeptide site could account for resorption of type I
      collagen during embryonic and early adult life. During intense collagen
      resorption, however, such as in the immediate postpartum uterus and in the dermis
      later in life, cleavage at the helical site is essential for normal collagen
      turnover. Thus, type I collagen is degraded by at least two differentially
      controlled mechanisms involving collagenases with distinct, but overlapping,
      substrate specificities.

PMID- 7790375
TI  - Functional characterization of the 180-kD ribosome receptor in vivo.
AB  - A cDNA encoding the 180-kD canine ribosome receptor (RRp) was cloned and
      sequenced. The deduced primary structure indicates three distinct domains: an NH2
      terminal stretch of 28 uncharged amino acids representing the membrane anchor, a
      basic region (pI = 10.74) comprising the remainder of the NH2-terminal half and
      an acidic COOH-terminal half (pI = 4.99). The most striking feature of the amino
      acid sequence is a 10-amino acid consensus motif, NQGKKAEGAP, repeated 54 times
      in tandem without interruption in the NH2-terminal positively charged region. We
      postulate that this repeated sequence represents a ribosome binding domain which
      mediates the interaction between the ribosome and the ER membrane. To
      substantiate this hypothesis, recombinant full-length ribosome receptor and two
      truncated versions of this protein, one lacking the potential ribosome binding
      domain, and one lacking the COOH terminus, were expressed in Saccharomyces
      cerevisiae. Morphological and biochemical analyses showed all proteins were
      targeted to, and oriented correctly in the ER membrane. In vitro ribosome binding
      assays demonstrated that yeast microsomes containing the full-length canine
      receptor or one lacking the COOH-terminal domain were able to bind two to four
      times as many human ribosomes as control membranes lacking a recombinant protein
      or microsomes containing a receptor lacking the NH2-terminal basic domain.
      Electron micrographs of these cells revealed that the expression of all receptor
      constructs led to a proliferation of perinuclear ER membranes known as
      "karmellae." Strikingly, in those strains which expressed cDNAs encoding a
      receptor containing the putative ribosome binding domain, the induced ER
      membranes (examined in situ) were richly studded with ribosomes. In contrast,
      karmellae resulting from the expression of receptor cDNA lacking the putative
      ribosome binding domain were uniformly smooth and free of ribosomes. Cell
      fractionation and biochemical analyses corroborated the morphological
      characterization. Taken together these data provide further evidence that RRp
      functions as a ribosome receptor in vitro, provide new evidence indicating its
      functionality in vivo, and in both cases indicate that the NH2-terminal basic
      domain is essential for ribosome binding.

PMID- 7790376
TI  - BiP/Kar2p serves as a molecular chaperone during carboxypeptidase Y folding in
      yeast.
AB  - Although transiently associated with numerous newly synthesized proteins, BiP has
      not been shown to be an essential component directly linked to the folding and
      oligomerization of newly synthesized proteins in the endoplasmic reticulum. To
      determine whether it is needed as a molecular chaperone, we analyzed the
      maturation of an endogenous yeast glycoprotein, carboxypeptidase Y (CPY) in
      several yeast strains with temperature-sensitive mutations in BiP. These kar2
      mutant strains have previously been found to be defective in translocation at the
      nonpermissive temperature (Vogel, J. P., L. M. Misra, and M. D. Rose, 1990. J.
      Cell Biol, 110:1885-1895). To circumvent the translocation block, we used DTT at
      permissive temperature to delay folding and intracellular transport. We then
      followed the maturation of the ER-retained CPY after shifting to the
      nonpermissive temperature and dilution of the DTT. Without the functional
      chaperone, CPY aggregated, failed to be oxidized, and remained in the ER. In
      contrast to wild-type cells, in which BiP binding was transient with no more than
      10-15% of labeled CPY associated at any time, 30-100% of the CPY remained
      associated with BiP in the mutant strains. In a heterozygous diploid strain, CPY
      matured and exited the ER normally. Taken together, the results provide clear
      evidence that BiP plays a critical role as a molecular chaperone in CPY folding.

PMID- 7790377
TI  - Human peroxisomal targeting signal-1 receptor restores peroxisomal protein import
      in cells from patients with fatal peroxisomal disorders.
AB  - Two peroxisomal targeting signals, PTS1 and PTS2, are involved in the import of
      proteins into the peroxisome matrix. Human patients with fatal generalized
      peroxisomal deficiency disorders fall into at least nine genetic complementation
      groups. Cells from many of these patients are deficient in the import of PTS1
      containing proteins, but the causes of the protein-import defect in these
      patients are unknown. We have cloned and sequenced the human cDNA homologue
      (PTS1R) of the Pichia pastoris PAS8 gene, the PTS1 receptor (McCollum, D., E.
      Monosov, and S. Subramani. 1993. J. Cell Biol. 121:761-774). The PTS1R mRNA is
      expressed in all human tissues examined. Antibodies to the human PTS1R recognize
      this protein in human, monkey, rat, and hamster cells. The protein is localized
      mainly in the cytosol but is also found to be associated with peroxisomes. Part
      of the peroxisomal PTS1R protein is tightly bound to the peroxisomal membrane.
      Antibodies to PTS1R inhibit peroxisomal protein-import of PTS1-containing
      proteins in a permeabilized CHO cell system. In vitro-translated PTS1R protein
      specifically binds a serine-lysine-leucine-peptide. A PAS8-PTS1R fusion protein
      complements the P. pastoris pas8 mutant. The PTS1R cDNA also complements the PTS1
      protein-import defect in skin fibroblasts from patients--belonging to
      complementation group two--diagnosed as having neonatal adrenoleukodystrophy or
      Zellweger syndrome. The PTS1R gene has been localized to a chromosomal location
      where no other peroxisomal disorder genes are known to map. Our findings
      represent the only case in which the molecular basis of the protein-import
      deficiency in human peroxisomal disorders is understood.

PMID- 7790380
TI  - Transport of dendritic microtubules establishes their nonuniform polarity
      orientation.
AB  - The immature processes that give rise to both axons and dendrites contain
      microtubules (MTs) that are uniformly oriented with their plus-ends distal to the
      cell body, and this pattern is preserved in the developing axon. In contrast,
      developing dendrites gradually acquire nonuniform MT polarity orientation due to
      the addition of a subpopulation of oppositely oriented MTs (Baas, P. W., M. M.
      Black, and G. A. Banker. 1989. J. Cell Biol. 109:3085-3094). In theory, these
      minus-end-distal MTs could be locally nucleated and assembled within the dendrite
      itself, or could be transported into the dendrite after their nucleation within
      the cell body. To distinguish between these possibilities, we exposed cultured
      hippocampal neurons to nanomolar levels of vinblastine after one of the immature
      processes had developed into the axon but before the others had become dendrites.
      At these levels, vinblastine acts as a kinetic stabilizer of MTs, inhibiting
      further assembly while not substantially depolymerizing existing MTs. This
      treatment did not abolish dendritic differentiation, which occurred in timely
      fashion over the next two to three days. The resulting dendrites were flatter and
      shorter than controls, but were identifiable by their ultrastructure, chemical
      composition, and thickened tapering morphology. The growth of these dendrites was
      accompanied by a diminution of MTs from the cell body, indicating a net transfer
      of MTs from one compartment into the other. During this time, minus-end-distal
      microtubules arose in the experimental dendrites, indicating that new MT assembly
      is not required for the acquisition of nonuniform MT polarity orientation in the
      dendrite. Minus-end-distal microtubules predominated in the more proximal region
      of experimental dendrites, indicating that most of the MTs at this stage of
      development are transported into the dendrite with their minus-ends leading.
      These observations indicate that transport of MTs from the cell body is an
      essential feature of dendritic development, and that this transport establishes
      the nonuniform polarity orientation of MTs in the dendrite.

PMID- 7790378
TI  - Interaction of alpha-actinin with the cadherin/catenin cell-cell adhesion complex
      via alpha-catenin.
AB  - Cadherins are Ca(2+)-dependent, cell surface glycoproteins involved in cell-cell
      adhesion. Extracellularly, transmembrane cadherins such as E-, P-, and N-cadherin
      self-associate, while intracellularly they interact indirectly with the actin
      based cytoskeleton. Several intracellular proteins termed catenins, including
      alpha-catenin, beta-catenin, and plakoglobin, are tightly associated with these
      cadherins and serve to link them to the cytoskeleton. Here, we present evidence
      that in fibroblasts alpha-actinin, but not vinculin, colocalizes extensively with
      the N-cadherin/catenin complex. This is in contrast to epithelial cells where
      both cytoskeletal proteins colocalize extensively with E-cadherin and catenins.
      We further show that alpha-actinin, but not vinculin, coimmunoprecipitates
      specifically with alpha- and beta-catenin from N- and E-cadherin-expressing
      cells, but only if alpha-catenin is present. Moreover, we show that alpha-actinin
      coimmunoprecipitates with the N-cadherin/catenin complex in an actin-independent
      manner. We therefore propose that cadherin/catenin complexes are linked to the
      actin cytoskeleton via a direct association between alpha-actinin and alpha
      catenin.

PMID- 7790379
TI  - Non-muscle alpha-dystroglycan is involved in epithelial development.
AB  - The dystroglycan complex is a transmembrane linkage between the cytoskeleton and
      the basement membrane in muscle. One of the components of the complex, alpha
      dystroglycan binds both laminin of muscle (laminin-2) and agrin of muscle
      basement membranes. Dystroglycan has been detected in nonmuscle tissues as well,
      but the physiological role in nonmuscle tissues has remained unknown. Here we
      show that dystroglycan during mouse development in nonmuscle tissues is expressed
      in epithelium. In situ hybridization revealed strong expression of dystroglycan
      mRNA in all studied epithelial sheets, but not in endothelium or mesenchyme.
      Conversion of mesenchyme to epithelium occurs during kidney development, and the
      embryonic kidney was used to study the role of alpha-dystroglycan for epithelial
      differentiation. During in vitro culture of the metanephric mesenchyme, the first
      morphological signs of epithelial differentiation can be seen on day two.
      Northern blots revealed a clear increase in dystroglycan mRNA on day two of in
      vitro development. A similar increase of expression on day two was previously
      shown for laminin alpha 1 chain. Immunofluorescence showed that dystroglycan is
      strictly located on the basal side of developing kidney epithelial cells.
      Monoclonal antibodies known to block binding of alpha-dystroglycan to laminin-1
      perturbed development of epithelium in kidney organ culture, whereas control
      antibodies did not do so. We suggest that the dystroglycan complex acts as a
      receptor for basement membrane components during epithelial morphogenesis. It is
      likely that this involves binding of alpha-dystroglycan to E3 fragment of laminin
      1.

PMID- 7790381
TI  - Antiprogestins inhibit growth and stimulate differentiation in the normal mammary
      gland.
AB  - Antiprogestins possess a potent antitumor activity in hormone-dependent
      experimental breast cancer models. Though the underlying mechanism is not clear,
      induction of functional differentiation seems to be a major event. This study
      attempts to test directly for antiproliferative and differentiation promoting
      activities of antiprogestins on the normal mammary gland. To this end, whole
      organ cultures of mammary glands from estradiol/progesterone-primed virgin mice
      maintained in a serum-free medium with aldosteron, prolactin, insulin, and
      hydrocortisone were exposed to the antiprogestin ZK114043. A 4-day treatment of
      organ cultures led to a strong inhibition of epithelial DNA synthesis. In
      parallel, ZK114043 caused alveolar cells to acquire a more differentiated
      phenotype distinguished by secretory active alveoli composed of single cell
      layers with increased fat droplet accumulation and enhanced expression of the
      milk proteins beta-casein and whey acidic protein (WAP). Particularly strong
      effects were found on the expression of mammary-derived growth inhibitor (MDGI).
      Both half-maximal inhibition of epithelial DNA synthesis and stimulation of MDGI
      mRNA expression were found at about 5 ng/ml of ZK114043. Presence in the medium
      of 5 micrograms/ml hydrocortisone rendered antiglucocorticoid effects of ZK114043
      highly unlikely. Furthermore, prevention of action of ZK114043 by the
      progesterone agonist R5020 and ZK114043 stimulated expression of beta-casein and
      MDGI mRNA in cultured glands of 10-week-old unprimed virgin mice suggest a
      progesterone receptor-mediated mechanism of antiprogestin action. Two other
      antiprogestins, Mifepristone and Onapristone, likewise stimulated MDGI
      expression. The data provide direct evidence that antiprogestins act like a
      differentiation factor in the normal mammary gland.

PMID- 7790386
TI  - Role of protein kinase C alpha in the induction of carcinoembryonic antigen by
      transforming growth factor beta 1.
AB  - Previous studies showed that transforming growth factor beta 1 (TGF beta 1)
      regulates the expression of carcinoembryonic antigen (CEA) and CEA-cross-reactive
      glycoproteins (CEA-GLYs) in human colon carcinoma cells through a signal
      transducing pathway associated with protein kinase C (PKC) (Chakrabarty, J. Cell.
      Physiol., 1992, 152:494-499). In this study we determined the role of the PKC
      alpha isoform in the regulation of CEA and CEA-GLYs expression by TGF beta 1.
      Expression of PKC alpha antisense RNA, through transfection experiments with an
      antisense PKC alpha expression vector, resulted in down-modulation of PKC alpha
      RNA and protein expression. TGF beta 1 was unable to stimulate the expression and
      secretion of CEA in cells in which the expression of PKC alpha protein was
      substantially reduced. The ability of TGF beta 1 to stimulate the expression of
      the 95- and 55-kDa CEA-GLYs, however, was not affected. We therefore conclude
      that TGF beta 1 regulates the secretion and expression of CEA through a signal
      transducing pathway associated with PKC alpha. TGF beta 1 may also regulate the
      expression of CEA-GLYs through signal-transducing pathways associated with other
      PKC isoforms.

PMID- 7790387
TI  - Esterification of 12(S)-hydroxy-5,8,10,14-eicosatetraenoic acid into the
      phospholipids of human peripheral blood mononuclear cells: inhibition of the
      proliferative response.
AB  - 12-hydroxy-eicosatetraenoic acid (12-HETE), the lipoxygenase metabolite of
      arachidonic acid produced by activated platelets, has been shown to accumulate in
      peripheral blood mononuclear cells (PBMC) of elderly people. 12-HETE being
      antimitogenic for lymphocytes, its accumulation in blood cells might be involved
      in the well-known decline in immune function which accompanies aging. Because
      HETEs have been shown to be rapidly metabolized and/or incorporated into cellular
      lipids in a variety of cell types, we have investigated the uptake, metabolism,
      and intracellular distribution of exogenous 12-HETE by human PBMC. [3H]-12-HETE
      was dose and time dependently incorporated by PBMC and also metabolized to more
      polar products. These polar metabolites were mainly released extracellularly and
      only marginally esterfied in phospholipids. Although [3H]-12-HETE radiolabel was
      preferentially associated with phosphatidylcholine, especially after prolonged
      labeling incubations or following successive short labeling pulses, a substantial
      amount of radiolabel was also found associated with phosphatidylinositol (20-50%
      of the labeled phospholipids). The stability of 12-HETE in the phospholipid pool
      was comparable to that reported for most other cell types, with 50% of the
      initial radiolabel being still present after 18 hr. Upon exposure to mitogenic
      activation, 12-HETE-labeled PBMC released unmodified 12-HETE from
      phosphatidylinositol. In addition, 12-HETE dose dependently inhibited the
      proliferative response of PBMC to Con A stimulation. These results suggest that
      12-HETE esterification in phospholipids might lead to the generation of unusual
      lipid second messengers with impaired capacity to transduce activation signals,
      thus decreasing lymphocyte function.

PMID- 7790382
TI  - Perturbation of the platelet-derived growth factor receptor signaling by
      dibutyryl-cAMP in human astrocytoma cells.
AB  - It has been shown that cAMP may perturb the polypeptide growth factor-induced
      nuclear events. However, the possible interactions of the cAMP-protein kinase A
      (cAMP-PKA) and receptor tyrosine kinase pathways in the cytosol have not been
      fully elucidated. In this study, we use human astrocytoma cells as a model to
      investigate this issue. The results show that platelet-derived growth factor
      (PDGF)-induced receptor autophosphorylation in human astrocytoma cells is
      suppressed by dibutyryl-cAMP pretreatment and such suppression is not due to
      changes in the ligand-receptor binding properties. Further studies show that PDGF
      induced tyrosine phosphorylation of phospholipase C-gamma 1 (PLC-gamma 1) and
      phosphatidylinositol 3-kinase (PI 3-kinase) are also suppressed in dibutyryl-cAMP
      pretreated cells. The suppression of PLC-gamma 1 tyrosine phosphorylation was
      accompanied by a decreased production of water soluble inositol phosphates. In
      contrast, similar treatment with normal human astrocytes potentiates the tyrosine
      phosphorylation of PLC-gamma 1 and PI 3-kinase. The results indicate that cAMP
      can either negatively or positively modulate the PDGF receptor tyrosine kinase
      activity depending on the cell types examined.

PMID- 7790384
TI  - Regulation of multidrug resistance gene mdr1b/mdr1 expression in isolated mouse
      uterine epithelial cells.
AB  - The mammalian uterine epithelium (UE) undergoes drastic physiological and
      morphological changes during pregnancy. Steady-state levels of murine mdr1b mRNA,
      transcribed from a multidrug resistance gene encoding a membrane protein which
      functions as a transporter of lipophilic cytotoxic agents, are low in
      nonpregnant, cycling UE, but drastically increase (about 1,500- to 2,000-fold) at
      day 8 of gestation. At day 16 of gestation, levels of mdr1b mRNA are 2,500- to
      3,000-fold higher than those in the cycling UE cells. Levels of mdr1b mRNA were
      elevated to levels comparable to those observed during pregnancy, in the UE of
      ovariectomized mice following 5-8 days of estrogen and progesterone
      administration. Withdrawal of these hormones resulted in a drastic reduction of
      mdr1b mRNA within 36 hr. These results suggested that steroid hormones alone can
      account for increased mdr1b mRNA expression and do not require the presence of
      other placenta/embryo-derived factors. Moreover, the hormonal effect on uterine
      mdr1b mRNA biosynthesis during pregnancy apparently is a delayed phenomenon.
      Nuclear run-on assays demonstrated that the rate of mdr1b transcription in UE
      cells prepared from 15-day pregnant mice (d-15 UE cells) was about two- to three
      fold higher than that in nonpregnant UE cells. This increased transcription rate
      alone cannot account for mdr1b mRNA accumulation during pregnancy. mdr1b mRNA
      expression was investigated in primary cultures of d-15 UE cells. mdr1b mRNA
      levels decayed by 50% within 3-4 hr of culture and reached a steady-state 0.5-2%
      of initial levels by 24 hr. The rate of mdr1b mRNA decay in primary d-15 UE cells
      was decreased by treatment with alpha-amanitin or cycloheximide, suggesting that
      the decay pathway requires both transcription and de novo protein synthesis. Our
      results suggest that multiple mechanisms are involved in the maintenance of the
      high levels of mdr1b mRNA in pregnant UE cells. Furthermore, these data suggest
      that increased mRNA stability may contribute to the accumulation of mdr1b
      transcript during pregnancy.

PMID- 7790383
TI  - Effects of hypotonic and hypoionic media on drug pumping by P-glycoprotein
      expressed in epithelial and nonepithelial cell lines.
AB  - The effects of anisotonic and anisoionic media on the drug-pumping function of P
      glycoprotein (Pgp) were studied in epithelial and nonepithelial cells. We used HT
      29 colon cells (HT-29/Pgp-) induced to express Pgp and MDR phenotype (HT-29/Pgp+)
      and NIH3T3 (3T3/Pgp-) cells which were stably transfected with human MDR1 DNA
      (3T3/Pgp+). Intracellular concentrations of rhodamine 123 (R-123) preloaded into
      cells were monitored as a function of time by fluorescence imaging microscopy,
      while cells were superfused with media of different tonicity and/or ionic
      strength. Efflux was analyzed by a single exponential decay function. In all
      media tested efflux was considerably higher in Pgp+ than Pgp- cells. In both HT
      29 and 3T3 cells loaded with dye in isotonic conditions, dye efflux was not
      significantly different whether it was measured in isoionic-isotonic (130 mM
      NaCl, 300 mOsm), hypoionic-isotonic (87 mM NaCl), or hypoionic-hypotonic (200,
      150, or 100 mOsm) media throughout the entire experiment or whether the media
      were changed during the experiment. Similar results were obtained when cells were
      preincubated and preloaded with dye under hypotonic conditions. Under extreme
      hypotonic and hypoionic challenge (changing from 130 mM NaCl-300 mOsm to 43 mM
      NaCl-100 mOsm medium), 3T3 cells, but not HT-29 cells, underwent marked shape and
      size changes which reduced R-123 cell-associated fluorescence. The changes were
      most conspicuous in Pgp+ cells, possibly reflecting a Pgp effect on the osmotic
      or osmoregulatory properties of the cells. However, drug-pumping activity
      remained essentially unimpaired even under the most extreme hypotonic/hypoionic
      conditions.

PMID- 7790385
TI  - Evidence for a pertussis toxin sensitive calcium entry pathway in thyroid FRTL-5
      cells.
AB  - Receptor-mediated calcium entry was investigated in Fura 2 loaded FRTL-5 cells.
      The purinergic agonist ATP activated the release of sequestered calcium and the
      entry of extracellular calcium. Downregulation of protein kinase C (PKC)
      substantially enhanced the ATP-evoked calcium entry. Pretreatment of the cells
      with pertussis toxin (Ptx) decreased the ATP-evoked calcium entry by 56% and the
      release of sequestered calcium by 34%. In PKC-downregulated cells, the effect of
      Ptx treatment on the ATP-evoked increase in [Ca2+]i was 73% and 44%,
      respectively. Phorbol myristic acetate (PMA) decreased the ATP-evoked calcium
      entry to the same extent as Ptx. In Ptx-treated cells, the ATP-evoked influx of
      45Ca2+ was attenuated. Stimulation of the cells with P2p-purinergic agonist GTP
      evoked no entry of calcium, although GTP released the same amount of sequestered
      calcium as did ATP. PKC downregulation or pretreatment with Ptx had no effects on
      the GTP-evoked responses, whereas PMA decreased the GTP-evoked release of
      calcium. We conclude that the ATP-activated rapid calcium entry pathway is a
      second messenger-operated calcium channel.

PMID- 7790388
TI  - Phenotypically and karyotypically distinct Madin-Darby canine kidney cell clones
      respond differently to alkaline stress.
AB  - We isolated two cell clones from the wild-type Madin-Darby canine kidney cell
      line (MDCK) that resembles renal collecting duct epithelium. Morphology and
      karyotypes of the two cell clones were evaluated. The MDCK-C7 cell clone
      morphologically resembles principal cells (polygonal cell shape, flat), while the
      MDCK-C11 clone resembles intercalated cells (cuboidal cell shape, high). The
      diploid chromosome number of MDCK-C7 cells is 83.1 +/- 0.2 (n = 139); that for
      MDCK-C11 cells is 78.8 +/- 0.1 (n = 128). Culture of MDCK-C7 cells in alkaline
      medium (pH 7.7) induced irreversible phenotypical and genotypical alterations.
      Transformed MDCK-C7F cells are characterized by two abnormal (biarmed)
      chromosomes. In contrast, MDCK-C11 cells are not phenotypically altered by
      alkaline stress. In order to elucidate the role of intracellular pH (pHi) in the
      transformation process, we measured pHi under control conditions (pH 7.4), after
      5 min exposure to alkaline stress ("acute experiment," pH 7.7) and after
      incubation of the cells in alkaline medium for two weeks ("chronic experiment,"
      pH 7.7). Under control conditions, MDCK-C7 cells maintained pHi at 7.14 +/- 0.01
      (n = 154) and MDCK-C11 cells at 7.01 +/- 0.01 (n = 147). Acute alkaline stress
      increased pHi of both cell types to similar steady-state values. Under chronic
      alkaline stress, MDCK-C7 cells were unable to maintain intracellular pH within
      normal limits exhibiting sustained alkalinization, whereas MDCK-C11 cells could
      successfully regulate pHi. We conclude that wild-type MDCK cells consist of two
      genetically distinct subpopulations with different morphology and function. Only
      the MDCK-C7 clone that resembles the principle cell type of renal collecting duct
      can be transformed by alkaline stress while the MDCK-C11 clone resists this
      treatment, due to efficient pHi control mechanisms.

PMID- 7790389
TI  - Repression of tissue inhibitor of matrix metalloproteinase expression by all
      trans-retinoic acid in rat bone cell populations: comparison with transforming
      growth factor-beta 1.
AB  - Retinoids and transforming growth factor-beta 1 (TGF-beta 1) reduce the
      transcriptional activation of matrix metalloproteinases (MMPs) and increase the
      expression of the specific tissue inhibitor of MMPs (TIMP-1) in fibroblasts. In
      contrast, all-trans-retinoic acid (retinoic acid) increases MMP expression in
      osteoblasts. Therefore, the mechanistic aspects of TIMP-1 regulation by retinoic
      acid in primary cultures of rat calvarial bone cell populations were studied and
      compared with those of TGF-beta 1 to determine if modulation of TIMP-1 would
      augment MMP expression. Retinoic acid was found to reduce TIMP-1 mRNA levels
      after 24 and 72 hr of culture by up to 60% in a dose-dependent manner. Maximal
      inhibition occurred at 10(-6) M retinoic acid with half maximal repression at
      approximately 5 x 10(-8) M. To determine the half life of TIMP-1 mRNA, the
      specific RNA polymerase II inhibitor DRB was added to cultures and the chase RNA
      analyzed by slot blots. TIMP-1 mRNA had a half life of approximately 14 hr and
      this was unaltered by retinoic acid treatment, suggesting that retinoic acid
      exerts its effects on TIMP-1 transcriptionally. When retinoic acid was added to
      cycloheximide-treated cultures TIMP-1 mRNA levels were reduced at 5 hr compared
      with controls. This showed that ongoing protein synthesis was not required to
      mediate the retinoic acid repression of TIMP-1 mRNA levels and supports the
      evidence that retinoic acid acts at the transcriptional level to reduce TIMP-1
      expression. In contrast, TGF-beta 1 increased TIMP-1 mRNA levels by 3.5-fold at
      24 hr to > 10-fold at 72 hr without alterations in mRNA stability indicating that
      transforming growth factor (TGF)-beta 1 also acts at the transcriptional level to
      upregulate TIMP-1 expression in bone cells. Thus, these studies have revealed
      that TIMP-1 regulation by retinoic acid is different in osteoblasts from other
      cells and that retinoic acid has the property of generating resorptive and
      formative cell phenotypes in a tissue-specific manner. In bone, reduced TIMP-1
      expression would favor bone matrix degradation and bone resorption that is a
      characteristic action of retinoids.

PMID- 7790391
TI  - Hepatocyte growth factor is involved in formation of osteoclast-like cells
      mediated by clonal stromal cells (MC3T3-G2/PA6).
AB  - Osteoclast formation from hemopoietic precursors has been shown to require the
      support of stromal cells in bone tissue. In this study, we demonstrated that
      hepatocyte growth factor (HGF) is one of the stromal cell-derived molecules
      responsible for osteoclast-like cell formation. For our experiments, we used a
      coculture system for osteoclastic cell formation and activation in which
      hemopoietic blast cells are cocultured with calvaria-derived stromal MC3T3-G2/PA6
      (PA6) cells on dentine slices in the presence of 1,25-dihydroxyvitamin D3
      [1,25(OH)2D3]. Addition of anti-HGF neutralizing IgG to the cocultures inhibited
      the formation of osteoclastic cells and their dentine-resorbing activity. We
      detected a single 6.0-kb transcript for HGF in PA6 cells, and also recognized
      immunoreactive M(r) 81,000 and 88,000 forms of HGF in conditioned medium (CM)
      from PA6 cell cultures, the level of which reached 6 ng/ml. Both the CM and HGF
      stimulated the proliferation of blast cells synergistically with granulocyte
      macrophage colony-stimulating factor, resulting in an increased number of
      osteoclast precursors that respond to 1,25(OH)2D3 that are tartrate-resistant
      acid phosphatase-positive multinucleate cells in stromal cell-free blast cell
      cultures in plastic wells. The effect of the CM was diminished by the addition of
      anti-HGF IgG. However, neither the CM nor HGF stimulated the formation of
      osteoclastic cells and pits on dentine slices in the absence of PA6 cells. These
      results suggest that although HGF cannot completely replace stromal cells, it is
      one of the paracrine mediators produced by stromal cells that act on
      proliferation of osteoclastic cell precursors.

PMID- 7790390
TI  - Proteoglycan biosynthesis is required in BC3H1 myogenic cells for modulation of
      vascular smooth muscle alpha-actin gene expression in response to
      microenvironmental signals.
AB  - Induction of vascular smooth muscle (VSM) alpha-actin mRNA expression during
      cytodifferentiation of mouse BC3H1 myogenic cells coincides with the accumulation
      of cell surface- and extracellular matrix-associated sulfated proteoglycans.
      Inhibition of proteoglycan biosynthesis in myogenic cells using an artificial
      beta-D-xyloside glycosaminoglycan acceptor was accompanied by a reduction in cell
      surface/extracellular matrix proteoglycans and VSM alpha-actin mRNA expression
      while enhancing the secretion of free chondroitin sulfate/dermatan sulfate and
      heparan sulfate glycosaminoglycans into the culture medium. Maximum inhibition of
      VSM alpha-actin mRNA expression required that proteoglycan biosynthesis be
      blocked during the early phase of cytodifferentiation when myoblasts were fully
      confluent and quiescent. The inhibitory effect of beta-D-xyloside on alpha-actin
      mRNA expression resulted from attenuation at both the transcriptional and post
      transcriptional control points. Sustained proteoglycan biosynthesis was required
      for induction of VSM alpha-actin mRNA in quiescent myoblasts in response to
      cytodifferentiation-permissive, substrate-associated macromolecules (SAM) or upon
      exposure to soluble serum factors capable of transiently stimulating VSM alpha
      actin gene transcription. The results suggested that efficient myoblast
      cytodifferentiation and modulation of VSM alpha-actin mRNA levels depended on
      intact cell surface proteoglycans to convey signals generated as a consequence of
      cellular interaction with substrate components and serum factors.

PMID- 7790392
TI  - Ca(2+)-ATPase inhibitor, cyclopiazonic acid, releases Ca2+ from intracellular
      stores in RBL-2H3 mast cells and activates a Ca2+ influx pathway that is
      permeable to sodium and manganese.
AB  - Cyclopiazonic acid has been reported to inhibit the Ca(2+)-ATPase of
      intracellular calcium stores in some nonexcitable cell types, such as myeloid
      cells and lymphocytes. The present study examines the effects of cyclopiazonic
      acid on rat basophilic leukemia (RBL) cells, a mucosal mast cell line. Addition
      of cyclopiazonic acid to fura-2-loaded RBL cells evoked a biphasic increase in
      free ionized intracellular calcium. Release of stored calcium accounted for the
      first phase of this response. The second phase was determined to be calcium
      entering through an influx pathway activated by cyclopiazonic acid. The influx
      pathway was selective for calcium, but was somewhat permeable to manganese.
      However, in a Ca(2+)-free solution containing EGTA, sodium ions permeated freely.
      This influx pathway appears to be identical to that which is activated by
      antigen, the physiological stimulus to the cells. Cyclopiazonic acid also induced
      secretion when combined with the phorbol ester 12-O-tetradecanoyl phorbol 13
      acetate, which activates protein kinase C.

PMID- 7790393
TI  - Insulin-like growth factor I receptor is required for the mitogenic and
      transforming activities of the platelet-derived growth factor receptor.
AB  - R- cells are 3T3-like cells derived from mouse embryos in which the insulin-like
      growth factor I (IGF-I) receptor (IGF-IR) genes have been disrupted by targeted
      homologous recombination. These cells cannot grow in serum-free medium
      supplemented by the growth factors that sustain the growth of other 3T3 cell
      lines, and cannot be transformed by oncogenes that easily transform wild type
      mouse embryo cells. We have used these cells to study the role of the IGF-IR in
      the growth and transformation of cells overexpressing the platelet-derived growth
      factor (PDGF)-beta beta receptor. We report that an overexpressed PDGF-beta beta
      receptor fails to induce mitogenesis or transformation in cells lacking the IGF
      IR, while capable of doing so in cells expressing the IGF-IR. We conclude that
      the ability of the activated PDGF-beta beta receptor to stimulate cell
      proliferation and transformation requires a functional IGF-IR.

PMID- 7790394
TI  - Regulation of AP-3 enhancer activity during hematopoietic differentiation.
AB  - Phorbol ester treatment of the human leukemic cell line U937 induces macrophage
      differentiation over 24-48 hr. This differentiation is mediated by the activation
      and/or repression of specific gene transcription by proteins, enhancer binding
      factors, that bind to the DNA upstream of the start site of transcription. We
      find that differentiation of U937 cells induced by phorbol esters and bryostain
      1, activators of protein kinase C, and the phosphatase inhibitor, okadaic acid,
      stimulates transcription from an enhancer sequence which contains multimerized AP
      3 binding sequences but not from one that contains multimerized AP-2 binding
      motifs. Electrophoretic mobility shift assays (EMSA) demonstrate that AP-3 DNA
      binding activity peaks at 24 hr, remains elevated for 24 hr, and then decreases
      thereafter. Southwestern blotting demonstrates that the AP-3 enhancer sequence
      binds to a 48 kDa protein present in these leukemic cells. Because the AP-3
      oligomer also contains an overlapping NF-kappa B-like site, the role of NK-kappa
      B proteins in regulating transcription from this multimerized oligonucleotide was
      investigated. Transfection of U937 cells with NF-kappa B family members
      demonstrated activation of AP-3-mediated transcription by rel A but little effect
      induced by NFKB1 and c-rel. It is unlikely, however, that phorbol ester-induced
      transcription from this AP-3 sequence is solely mediated by this NF-kappa B
      family member since treatment of U937 cells with antisense rel A
      oligodeoxynucleotides did not block phorbol ester-mediated transcription from the
      AP-3 site. These data demonstrate that AP-3, but not AP-2 sequences, functions to
      activate mRNA transcription during phorbol ester-induced hematopoietic
      differentiation and suggests a complex interaction between NF-kappa B and AP-3
      proteins in the regulation of this enhancer element.

PMID- 7790395
TI  - Role of calcium in growth inhibition induced by a novel cell surface
      sialoglycopeptide.
AB  - Our laboratory has purified an 18 kDa cell surface sialoglycopeptide growth
      inhibitor (CeReS-18) from intact bovine cerebral cortex cells. Evidence presented
      here demonstrates that sensitivity to CeReS-18-induced growth inhibition in BALB
      c 3T3 cells is influenced by calcium, such that a decrease in the calcium
      concentration in the growth medium results in an increase in sensitivity to CeReS
      18. Calcium did not alter CeReS-18 binding to its cell surface receptor and CeReS
      18 does not bind calcium directly. Addition of calcium, but not magnesium, to
      CeReS-18-inhibited 3T3 cells results in reentry into the cell cycle. A greater
      than 3-hour exposure to increased calcium is required for escape from CeReS-18
      induced growth inhibition. The calcium ionophore ionomycin could partially mimic
      the effect of increasing extracellular calcium, but thapsigargin was ineffective
      in inducing escape from growth inhibition. Increasing extracellular calcium 10
      fold resulted in an approximately 7-fold increase in total cell-associated
      45Ca+2, while free intracellular calcium only increased approximately 30%.
      However, addition of CeReS-18 did not affect total cell-associated calcium or the
      increase in total cell-associated calcium observed with an increase in
      extracellular calcium. Serum addition induced mobilization of intracellular
      calcium and influx across the plasma membrane in 3T3 cells, and pretreatment of
      3T3 cells with CeReS-18 appeared to inhibit these calcium mobilization events.
      These results suggest that a calcium-sensitive step exists in the recovery from
      CeReS-18-induced growth inhibition. CeReS-18 may inhibit cell proliferation
      through a novel mechanism involving altering the intracellular calcium
      mobilization/regulation necessary for cell cycle progression.

PMID- 7790396
TI  - Effect of heparin on bovine epithelial lens cell proliferation induced by heparin
      affin regulatory peptide.
AB  - HARP (heparin affin regulatory peptide) is an 18 kDa heparin binding protein,
      also known as HB-GAM or pleiotrophin (PTN) which has been primarily isolated from
      brain and uterus, and displays neurite outgrowth, angiogenic and mitogenic
      activities. Previously, we have expressed the human cDNA encoding human HARP in
      NIH 3T3 cells. Purified recombinant HARP displayed mitogenic activity for
      endothelial cells. Its NH2-terminal sequence indicates that the HARP molecule
      possesses a three amino acid extension from the signal peptide more than the NH2
      terminal described. For HB-GAM or PTN, these three amino acids may be essential
      for the stability and the mitogenic activity of this growth factor. In an attempt
      to further study the mode of action of this growth factor, we have investigated
      the mitogenic effect of HARP on various cell types. In contrast to FGF-2, HARP
      failed to induce stimulation of DNA synthesis on a CCL39 cell line. However, we
      found that in quiescent bovine epithelial lens (BEL) cells, the stimulation of
      DNA synthesis induced by HARP is dose-dependent (EC50: 2.5 ng/ml) and maximal
      stimulation is as potent as that induced by FGF-2 (EC50: 25 pg/ml).
      Interestingly, when BEL cells were allowed to quiesce in the presence of serum,
      the stimulation induced by HARP is considerably less potent. In this highly
      responsive cell system, heparin could potentiate the mitogenic activity of HARP
      at very low doses (0.1-1 microgram/ml) and inhibit this activity at
      concentrations of 10 micrograms/ml. In contrast to its protective effect on FGF-1
      and -2, heparin was unable to preserve HARP from tryptic and chymotryptic
      degradations.

PMID- 7790397
TI  - Bone marrow stromal cells selectively stimulate the rapid expansion of lineage
      restricted myeloid progenitors.
AB  - Bone marrow stromal cells serve hematopoietic microenvironments where different
      blood cells are controlled in their growth and differentiation. To characterize
      functions of stromal cells, 33 bone marrow stromal cells including preadipocytes,
      endothelial cells, and fibroblasts were established from transgenic mice
      harboring temperature-sensitive SV40 T-antigen gene and their selective
      stimulatory abilities to support large colony formation of lineage-specific
      hematopoietic progenitor cells (erythroid, monocyte/macrophage, granulocyte, and
      monocyte-granulocyte) were examined. Among established stromal cells, 27 clones
      showed erythropoietic stimulatory activity in the presence of erythropoietin. On
      myeloid progenitors, the stromal cells showed lineage-restricted stimulatory
      activity and a reciprocal relationship was observed between granulocyte formation
      and macrophage formation, but these activities were not dependent on the amount
      of produced colony-stimulating factors (CSFs). Our present study with many
      stromal cells established from bone marrow indicated that each stromal cell in
      the bone marrow may provide the preferable microenvironment for a rapid expansion
      of the lineage-restricted progenitor cells in combination with CSFs.

PMID- 7790398
TI  - Alterations in the molecular response to DNA damage during cellular aging of
      cultured fibroblasts: reduced AP-1 activation and collagenase gene expression.
AB  - Transcriptional activation of c-fos in response to both serum stimulation and DNA
      damage requires the serum response element. The inability of in vitro aged or
      senescent fibroblasts to proliferate in response to serum has been shown to be
      associated with repressed c-fos expression and reduced AP-1 binding activity. In
      contrast, we have observed similar levels of c-fos mRNA and protein expression in
      young (early passage) and old (late passage) cells following their treatment with
      ultraviolet (UV) irradiation or methyl methanesulfonate (MMS). Thus, the early
      events in the signal transduction pathway leading to transcriptional activation
      of c-fos following DNA damage are distinct from those mediating the gene's
      expression in response to mitogenic stimulation. Despite normal levels of c-fos
      expression, we observed a reduced level of AP-1 binding activity in old cells
      relative to young cells treated with UV irradiation or MMS. Reduced AP-1 binding
      activity is associated with reduced expression of the AP-1-dependent gene,
      collagenase, in old cells treated with DNA damaging agents. Since other DNA
      damage-inducible genes also contain an AP-1 regulatory element presumed to play a
      role in their expression, reduced AP-1 binding activity is likely to have a major
      impact on the old cell's ability to respond appropriately to DNA damage.

PMID- 7790399
TI  - Apoptosis during HL-60 cell differentiation is closely related to a G0/G1 cell
      cycle arrest.
AB  - The cell cycle-associated differences in the susceptibility to apoptosis were
      examined in HL-60 cells before and after differentiation with phorbol 12, 13
      dibutyrate (PDBu). HL-60 cells in various phases of the cell cycle were separated
      by the counterflow centrifugal elutriation and the susceptibility to apoptosis
      was measured by the morphological examination and by DNA fragmentation assay.
      Undifferentiated HL-60 cells in S phase showed a significantly higher
      susceptibility to apoptosis than those in G0/G1 or G2/M phase either in the
      absence or presence of apoptosis-inducing reagents such as A23187, actinomycin D
      (Act D), and cycloheximide (CHX). In contrast, PDBu-treated HL-60 cells
      preferentially underwent apoptosis in G0/G1 phase. When untreated HL-60 cells
      enriched for G0/G1 phase were recultured in a complete medium, the percentage of
      apoptotic cells increased after 6-12 h in correlation with the increase in S
      phase cells. When the same experiment was performed with PBDu-treated cells,
      spontaneous increase of apoptotic cells was observed while almost all cells
      remained in G0/G1 phase. Northern blot analysis revealed that undifferentiated
      cells expressed the same amounts of bcl-2 mRNA in each cell cycle phase, whereas
      G0/G1-predominant reduction of bcl-2 mRNA was noted in PDBu-treated cells. There
      was no difference in the amounts of CD11b mRNA between G0/G1 fraction and S+G2/M
      fraction of differentiated HL-60 cells. BCL-2 overexpression could almost
      completely abrogate the G0/G1-predominant induction of apoptosis in
      differentiated HL-60 cells. These results suggest that G0/G1 cell cycle arrest
      and down-regulation of bcl-2 mRNA in G0/G1 phase might be associated with
      apoptosis in differentiated HL-60 cells whereas the weakness of chromatin
      structure in S phase might be related to apoptosis in undifferentiated HL-60
      cells.

PMID- 7790400
TI  - Negative regulation of a special, double AP-1 consensus element in the vimentin
      promoter: interference by the retinoic acid receptor.
AB  - The growth-regulated vimentin gene contains a functional double AP-1 binding site
      formed by two nearly perfect inverted repeats. We present evidence for down
      regulation of vimentin expression by the retinoic acid receptor (RAR) in two
      mesodermally derived cell types. By mutation analysis we prove that the double
      consensus element is responsible for this negative regulation. From in vitro
      protein-DNA interaction studies we conclude that AP-1 binding is inhibited at RAR
      amounts required for occupation of the cognate RAR binding site in nuclear
      extracts from 3T3 cells and differentiated embryonal carcinoma cells.
      Furthermore, we show that, unlike in other cases, trans-activation of the
      vimentin AP-1 enhancer element can occur in undifferentiated embryonal carcinoma
      cells, despite the low amount of Jun and Fos proteins present in these cells.
      Here, however, down-regulation by retinoic acid cannot be detected.

PMID- 7790401
TI  - Use of a new fluorescent probe, seminaphthofluorescein-calcein, for determination
      of intracellular pH by simultaneous dual-emission imaging laser scanning confocal
      microscopy.
AB  - A new pH indicator, seminaphthofluorescein (SNAFL)-calcein acetoxymethyl ester,
      was used for intracellular pH (pHi) measurement in living MDCK cells with a laser
      scanning confocal microscope (LSCM) equipped with an Argon/Krypton laser and dual
      excitation and dual-emission (FITC/Texas Red) filter set. SNAFL-calcein
      excitation maxima are approximately 492/540 nm (acid/base) and emission maxima
      are approximately 535/625 nm (acid/base) with a pKa value at approximately 7.0.
      The absorption/emission spectra of SNAFL-calcein indicate that the ratio of
      emission intensities of its basic/acidic forms is pH dependent. With an
      Argon/Krypton LSCM, we were able to monitor the acidic and basic forms of this
      dye simultaneously using dual-excitation (488/568 nm) and dual-emission (525-614
      nm/> or = 615 nm) wavelengths (lambda s). The simultaneous dual
      excitation/emission LSCM system allows for efficient recording of pHi dynamics
      (time resolution approximately 1 sec) in living cells. We have analyzed emission
      stability of the dye at different temperatures (22 degrees C and 37 degrees C)
      and constant pH, and at the same temperature (22 degrees C) but various pHs (6.6,
      7.0, and 7.4). Bleaching rate is slightly higher at 37 degree C than that at 22
      degrees C. The basic form of the dye (lambda Em approximately 625 nm) has a
      slightly higher bleaching rate than the acidic form (lambda Em approximately 535
      nm) in standard culture medium (pH 7.3) at either 22 degree C or 37 degrees C.
      The pHi in MDCK cells calculated from ratio images (535 nm/625 nm) was 7.19 +/-
      0.03 (mean +/- SEM, n = 20). Calibration experiments show that the useful pH
      range of SNAFL-calcein appears to be between 6.2 and 7.8, as the dye is difficult
      to calibrate outside this pH range.

PMID- 7790402
TI  - Specific binding of leukemia inhibitory factor to murine myoblasts in culture.
AB  - Leukemia inhibitory factor (LIF) is a member of the cytokine family of growth
      factors. It has been shown to exert a variety of actions on a diverse range of
      cell types, including neuronal, bone, and hemopoietic cells (Hilton, 1992, Trends
      Biochem. Sci., 17:72-76). In many of these cell types, studies have indicated the
      presence of specific receptors for LIF (Godard et al., 1982, J. Biol. Chem., 267:
      3214-3222; Hilton et al., Proc. Natl. Acad. Sci. USA, 85:5971-5975; Hilton and
      Nicola, 1992, J. Biol. Chem., 267:10238-10247.). The mechanism by which these
      receptors act is believed to involve tyrosine phosphorylation and the signal
      transducing receptor component gp130. We have previously shown that LIF is
      capable of inducing both human and murine myoblasts to proliferate in culture
      (Austin et al., 1992, J. Neurol. Sci., 112:185-191). We now report that LIF binds
      specifically to receptors on the surface of myoblasts, with an equilibrium
      dissociation constant of 400 pM and the number of receptors per cell varies with
      cell density. Binding competition studies showed that LIF binding to these
      receptor sites was not competed for by a number of other growth factors which
      stimulate myoblast proliferation including basic fibroblast growth factor (bFGF),
      transforming growth factor-alpha (TGF alpha), insulin-like growth factor 1 (IGF
      1), and interleukin-6 (IL-6). There was a time and concentration-dependent down
      regulation of receptor numbers following preincubation of myoblasts with LIF. The
      processing of these receptors subsequent to binding, involves as a first step,
      internalization and degradation by the myoblast. LIF appeared to stimulate
      myoblast proliferation rather than cell survival.

PMID- 7790403
TI  - Genetic factors influencing murine hematopoietic productivity in culture.
AB  - In order to study a previously described genetic difference manifested in stem
      cell kinetics of specific mouse strains, effects of this putative gene, stk, were
      measured on growth and expansion of stem and progenitor cell populations ex vivo.
      Bone marrow cells from each of two inbred mouse strains, C57BL/6J and DBA/2J,
      were placed into separate bioreactor cultures perfused continuously with growth
      medium containing erythropoietin (Epo), interleukin-3 (IL-3), granulocyte
      macrphage colony stimulating factor (GM-CSF), and Kit ligand as well as 5% CO2.
      Expansion of cell numbers reached 20-fold for DBA/2J and 10-fold for C57BL/6J
      marrow within about 1 week of culture. Significant production was also seen of
      colony-forming unit (CFU)-GM (up nine-fold from input levels) just prior to the
      cell production peak, and, importantly, moderate expansion of day 12 colony
      forming unit-spleen (CFU-S; two- to threefold) occurred as well, although CFU-S
      production peaked at a relatively short 4 days. CFU-S and CFU-GM levels declined
      rapidly in culture, either because of unfavorable growth conditions or terminal
      differentiation. Attempts to remove toxic metabolites by increasing the media
      perfusion rate resulted in a boost in cell expansion capability by DBA/2J marrow.
      In bioreactors in which stromal cells were established before marrow inoculation,
      there was greater expansion of CFU-S (especially by DBA/2J) and CFU-GM, although
      total cell yield appeared to be unaffected, perhaps because the maximum cell
      density had already been reached. The relative high potential for CFU-S expansion
      measured in DBA/2J marrow over that of C57BL/6J will be useful in following
      genetic contributions to bone marrow production capacity.

PMID- 7790404
TI  - Attenuation of stroke size in rats using an adenoviral vector to induce
      overexpression of interleukin-1 receptor antagonist in brain.
AB  - Adenoviruses have been proposed as potential vectors for gene therapy in the
      central nervous system, but there are no reports of their use in the treatment of
      a brain disease. Because central administration of interleukin-1 receptor
      antagonist protein (IL-1ra) reduces ischemic brain damage, we determined whether
      a recombinant adenovirus vector carrying the human IL-1ra cDNA (Ad.RSVIL-1ra)
      could be used to ameliorate brain injury in permanent focal ischemia. Groups of
      six rats received intraventricular injections of Ad.RSVIL-1ra or a control
      adenovirus containing the Escherichia coli beta-galactosidase gene (Ad.RSVlacZ).
      Histochemical staining for beta-galactosidase 5 days after virus injection
      indicated that transgene expression was confined primarily to the cells lining
      the ventricle. The concentrations of IL-1ra injected animals, achieving levels of
      9.1 +/- 3.3 ng/g in brain and 23.7 +/- 22.5 ng/ml in CSF. In these animals,
      cerebral infarct volume resulting from 24 h of permanent middle cerebral artery
      occlusion was reduced 64%. These studies demonstrate that adenoviral vectors can
      be used to deliver genes that attenuate brain injury.

PMID- 7790405
TI  - Three-dimensional quantitative autoradiography by disparity analysis: theory and
      application to image averaging of local cerebral glucose utilization.
AB  - Traditional autoradiographic image analysis has been restricted to the two
      dimensional assessment of local cerebral glucose utilization (LCMRglc) or blood
      flow in individual brains. It is advantageous, however, to generate an entire
      three-dimensional (3D) data set and to develop the ability to map replicate
      images derived from multiple studies into the same 3D space, so as to generate
      average and standard deviation images for the entire series. We have developed a
      novel method, termed "disparity analysis," for the alignment and mapping of
      autoradiographic images. We present the theory of this method, which is based
      upon a linear affine model, to analyze point-to-point disparities in two images.
      The method is a direct one that estimates scaling, translation, and rotation
      parameters simultaneously. Disparity analysis is general and flexible and deals
      well with damaged or asymmetric sections. We applied this method to study LCMRglc
      in nine awake male Wistar rats by the [14C]2-deoxyglucose method. Brains were
      physically aligned in the anteroposterior axis and were sectioned subserially at
      100-microns intervals. For each brain, coronal sections were aligned by disparity
      analysis. The nine brains were then registered in the z-axis with respect to a
      common coronal reference level (bregma + 0.7 mm). Eight of the nine brains were
      mapped into the remaining brain, which was designated the "template," and
      aggregate 3D data sets were generated of the mean and standard deviation for the
      entire series. The averaged images retained the major anatomic features apparent
      in individual brains but with some defocusing. Internal anatomic features of the
      averaged brain were smooth, continuous, and readily identifiable on sections
      through the 3D stack. The fidelity of the internal architecture of the averaged
      brain was compared with that of individual brains by analysis of line scans at
      four representative levels. Line scan comparisons between corresponding sections
      and their template showed a high degree of correlation, as did similar
      comparisons performed on entire sections. Fourier analysis of line scan data
      showed retention of low-frequency information with the expected attenuation of
      high-frequency components produced by averaging. Region-of-interest (ROI)
      analysis of the averaged brain yielded LCMRglc values virtually identical to
      those derived from measurements and subsequent averaging of data from individual
      brains.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7790406
TI  - Three-dimensional image analysis of brain glucose metabolism-blood flow
      uncoupling and its electrophysiological correlates in the acute ischemic penumbra
      following middle cerebral artery occlusion.
AB  - The relationship between local cerebral glucose utilization (LCMRglc) and local
      CBF (LCBF) is known to be disturbed in regions surrounding an acute focal
      ischemic lesion--areas that undergo repeated transient depolarizations. In this
      study, we evaluated the relationship between LCMRglc and LCBF in the acute focal
      ischemic penumbra to quantify metabolism-flow uncoupling, and we related these
      findings to local electrophysiological measurements. A novel strategy utilizing
      three-dimensional (3D) autoradiographic image averaging yielded group 3D
      reconstructions of LCBF, LCMRglc, and the CMR/CBF ratio. The distal right middle
      cerebral artery of Sprague-Dawley rats was occluded by laser-driven
      photothrombosis following administration of the photosensitizing dye rose bengal;
      this was coupled with permanent ipsilateral and 1-h contralateral common carotid
      artery occlusions. LCBF (n = 7) and LCMRglc (n = 7) were measured
      autoradiographically at 1.25 and 1.5-2 h postocclusion, respectively, in matched
      animal groups. Within the ischemic penumbra (defined as having LCBF of 20-40% of
      control or 0.23-0.47 ml g-1 min-1), LCMRglc showed a heterogeneous pattern with
      values ranging from near normal to markedly increased. The resulting CMRglc/CBF
      ratio in this zone was 234 +/- 100 mumol/100 ml (mean +/- SD), representing a
      severe degree of metabolism-flow dissociation when compared with the CMRglc/CBF
      ratio of 51.0 +/- 28.7 mumol/100 ml of the contralateral (normal) hemisphere.
      Metabolism-flow uncoupling was confined to the ipsilateral cortex and was most
      prominent at the anterior and posterior coronal poles of the ischemic lesion. In
      the frontoparietal penumbra, where marked uncoupling was observed, sustained
      deflections of the DC potential were recorded, which increased significantly in
      duration over the initial 65 min postocclusion. Both the heterogeneous pattern of
      LCMRglc and the widespread distribution of increased CMRglc/CBF ratio in the
      ischemic penumbra are thought to reflect the metabolic consequences of
      periinfarct depolarizations. Analysis of averaged 3D autoradiographic data sets
      provides a powerful means for assessing metabolism-flow uncoupling surrounding an
      ischemic focus.

PMID- 7790407
TI  - Identification of collaterally perfused areas following focal cerebral ischemia
      in the rat by comparison of gradient echo and diffusion-weighted MRI.
AB  - Diffusion-weighted (DW) and gradient echo (GE) magnetic resonance images were
      acquired before and after occlusion of the middle cerebral artery (MCA) in the
      rat. Upon occlusion, an increase in DW imaging signal intensity was observed in a
      core area within the MCA territory, most likely reflecting cytotoxic edema. The
      signal from GE images, which is sensitive to changes in the absolute amount of
      deoxyhemoglobin, decreased following ischemia within a region that extended
      beyond the core area observed with DW imaging. This hypointensity is attributed
      to increases in blood volume and/or oxygen extraction fraction, which result from
      a decrease in perfusion pressure in the collaterally perfused area. The evolution
      of the GE imaging signal intensity from different regions was studied for 3.5 h
      following the occlusion. In the core area, the GE imaging signal returned towards
      baseline values after approximately 1-2 h, while it remained stable in the
      surrounding area. This feature may reflect a decrease in hematocrit due to
      microcirculatory defect and/or a decrease in the oxygen extraction fraction due
      to ongoing infarction of the tissue and may indicate that tissue recovery is
      severely compromised. The combined use of DW and GE imaging offers great promise
      for the noninvasive identification of specific pathological events with high
      spatial resolution.

PMID- 7790408
TI  - The competitive NMDA antagonist CGP 40116 permanently reduces brain damage after
      middle cerebral artery occlusion in rats.
AB  - In this study we evaluated the effect of the competitive N-methyl-D-aspartate
      (NMDA) antagonist D-(E)-4-(3-phosphonoprop-2-enyl)piperazine-2-carboxylic acid
      (CGP 40116) on both early (2 days) and late (28 days) ischemic brain damage in a
      rodent model of focal cerebral ischemia by means of magnetic resonance imaging
      (MRI) and conventional histology. Immediately after occlusion of the left middle
      cerebral artery (MCA), rats received either CGP 40116 (20 mg/kg i.p.) or isotonic
      saline. Two MRI scans were performed in each animal 2 and 28 days after MCA
      occlusion. After the second scan, rats were perfusion fixed for histological
      evaluation. The volume of lesioned brain tissue as determined by MRI or histology
      was calculated from the damaged area in single sections and the distance between
      them. CGP 40116 reduced acute infarct volume as measured by MRI 2 days after MCA
      occlusion by 44% (p < 0.05, analysis of variance). After 28 days the lesion
      detected by MRI was still significantly smaller in the drug-treated animals. This
      finding was confirmed by the histological analysis showing a 64% reduction in the
      volume of brain atrophy in the CGP 40116 group (p < 0.05, analysis of variance).
      There was a good correlation between the MRI data and the results of the
      histological evaluation (r = 0.9). Our results indicate that (a) the competitive
      NMDA antagonist CGP 40116 permanently protects brain tissue from the consequences
      of cerebral ischemia in a rat model for human stroke and (b) early and late
      pathological changes can be accurately measured by MRI.

PMID- 7790409
TI  - A selective N-type calcium channel antagonist reduces extracellular glutamate
      release and infarct volume in focal cerebral ischemia.
AB  - Although a number of studies have demonstrated the neuroprotective effects of
      antagonists of postsynaptic N-methyl-D-aspartate (NMDA) and non-NMDA receptors in
      cerebral ischemia, little is known about the treatment of cerebral infarction
      through presynaptic blocking of extracellular glutamate release. We evaluated the
      effects of a presynaptic selective N-type calcium channel antagonist (SNX-111,
      given intravenously by continuous infusion at 5 mg/kg/h from 20 min prior to
      occlusion until 2 h postocclusion) on blood flow, extracellular glutamate, and
      infarct volume in rats with permanent occlusions of the right middle cerebral and
      right common carotid arteries plus 1-h transient occlusion of the left common
      carotid artery. There was no significant difference in CBF in the occluded cortex
      during the experiment between the treated and vehicle groups. SNX-111
      significantly reduced total amount of extracellular glutamate during the
      experiment and the peak value of the glutamate after occlusion from 44.2 +/- 15.8
      microM (mean +/- SD) to 21.4 +/- 11.4 microM (p < 0.01). Infusion of SNX-111 also
      significantly reduced the cortical volume of infarction from 47.2 +/- 5.8 to 19.9
      +/- 7.3% (p < 0.0001). These results suggest that SNX-111 has a protective effect
      against focal ischemia through the inhibition of glutamate release from
      presynaptic sites, although SNX-111 may also affect the release of other
      neurotransmitters.

PMID- 7790410
TI  - Basic fibroblast growth factor protects against excitotoxicity and chemical
      hypoxia in both neonatal and adult rats.
AB  - Basic fibroblast growth factor (bFGF) is a polypeptide growth factor that
      promotes neuronal survival. We recently found that systemic administration of
      bFGF protects against both excitotoxicity and hypoxia-ischemia in neonatal
      animals. In the present study, we examined whether systemically administered bFGF
      could prevent neuronal death induced by intrastriatal injection of N-methyl-D
      aspartate (NMDA) or chemical hypoxia induced by intrastriatal injection of
      malonate in adult rats and 1-methyl-4-phenylpyridinium (MPP+) in neonatal rats.
      Systemic administration of bFGF (100 micrograms/kg) for three doses both before
      and after intrastriatal injection of either NMDA or malonate in adult rats
      produced a significant neuroprotective effect. In neonatal rats, bFGF produced
      dose-dependent significant neuroprotective effects against MPP+ neurotoxicity,
      with a maximal protection of approximately 50% seen with either a single dose of
      bFGF of 300 micrograms/kg or three doses of 100 micrograms/kg. These results show
      that systemic administration of bFGF is effective in preventing neuronal injury
      under circumstances in which the blood-brain barrier may be compromised, raising
      the possibility that this strategy could be effective in stroke.

PMID- 7790411
TI  - Prolonged pretreatment with alpha-lipoic acid protects cultured neurons against
      hypoxic, glutamate-, or iron-induced injury.
AB  - The antioxidant dihydrolipoic acid has been shown to reduce hypoxic and
      excitotoxic neuronal damage in vitro. In the present study, we tested whether
      pretreatment with alpha-lipoic acid, which presumably allows endogenous formation
      of dihydrolipoic acid, can protect cultured neurons against injury caused by
      cyanide, glutamate, or iron ions, using the trypan blue exclusion method to
      determine neuronal damage. One hour of preincubation with dihydrolipoic acid (1
      microM), but not with alpha-lipoic acid, reduced damage of neurons from chick
      embryo telencephalon caused by 1 mM sodium cyanide or iron ions. alpha-Lipoic
      acid (1 microM) reduced cyanide-induced neuronal damage when added 24 h before
      hypoxia, and pretreatment with alpha-lipoic acid for > 24 h enhanced this
      neuroprotective effect. Both the R- and the S-enantiomer of alpha-lipoic acid
      exerted a similar neuroprotective effect. Pretreatment with alpha-lipoic acid (1
      microM) from the day of plating onward prevented the degeneration of chick embryo
      telencephalic neurons that had been exposed to Fe2+/Fe3+. alpha-Lipoic acid (1
      microM) added to the culture medium the day of plating also reduced neuronal
      injury induced by 1 mM L-glutamate in rat hippocampal cultures, whereas 30 min of
      preincubation with alpha-lipoic acid failed to attenuate glutamate-induced
      neuronal damage. Our results indicate that neuroprotection by prolonged
      pretreatment with alpha-lipoic acid is probably due to the radical scavenger
      properties of endogenously formed dihydrolipoic acid.

PMID- 7790413
TI  - Changes in N-acetyl-aspartate content during focal and global brain ischemia of
      the rat.
AB  - N-Acetyl-aspartate (NAA) is almost exclusively localized in neurons in the mature
      brain and might be used as a neuronal marker. It has been reported that the NAA
      content in human brain is decreased in neurodegenerative diseases and in stroke.
      Since the NAA content can be determined by nuclear magnetic resonance techniques,
      it has potential as a diagnostic and prognostic marker. The objective of this
      study was to examine the change of NAA content and related substances following
      cerebral ischemia and compare the results to the damage of the tissue. We used
      rats to study the changes of NAA, N-acetyl-aspartyl-glutamate (NAAG), glutamate,
      and aspartate contents over a time course of 24 h in brain regions affected by
      either permanent middle cerebral artery occlusion (focal ischemia) or
      decapitation (global ischemia). The decreases of NAA and NAAG contents following
      global brain ischemia were linear over time but significant only after 4 and 2 h,
      respectively. After 24 h, the levels of NAA and NAAG were 24 and 44% of control
      values, respectively. The concentration of glutamate did not change, whereas the
      aspartate content increased at a rate comparable with the rate of decrease of NAA
      content. This is consistent with NAA being preferentially degraded by the enzyme
      amidohydrolase II in global ischemia. In focal ischemia, there was a rapid
      decline of NAA within the first 8 h of ischemia followed by a slower rate of
      reduction. The reductions of NAA and NAAG contents in focal ischemia were
      significant after 4 and 24 h, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790414
TI  - Glial expression of the beta-amyloid precursor protein (APP) in global ischemia.
AB  - The beta-amyloid precursor protein (APP) bears characteristics of an acute-phase
      protein and therefore is likely to be involved in the glial response to brain
      injury. In the brain, APP is rapidly synthesized by activated glial cells in
      response to comparatively mild neuronal lesions, e.g., a remote peripheral nerve
      injury. Perfusion deficits in the brain result largely in neuronal necrosis and
      are a common condition in elderly patients. This neuronal necrosis is accompanied
      by a pronounced reaction of astrocytes and microglia, which can also be observed
      in animal models. We have therefore studied in the rat, immunocytochemically, the
      induction of APP after 30 min of global ischemia caused by four-vessel occlusion.
      The postischemic brain injuries were examined at survival times from 12 h to 7
      days. From day 3 onward, APP immunoreactivity was strongly induced in the CA1 and
      CA4 regions of the rat dorsal hippocampus as well as in the dorsolateral
      striatum. In these areas, the majority of APP-immunoreactive cells were reactive
      glial fibrillary acidic protein (GFAP)-positive astrocytes, as shown by double
      immunofluorescence labeling for GFAP and APP. Additionally, small ramified cells,
      most likely activated microglia, expressed APP immunoreactivity. In contrast, in
      the parietal cortex, APP immunoreactivity occurred focally in clusters of
      activated microglia rather than in astrocytes, as demonstrated by double
      immunofluorescence labeling for APP and the microglia-binding lectin Griffonia
      simplicifolia isolectin B4. In conclusion, following global ischemia, APP is
      induced in reactive glial cells with spatial differences in the distribution
      pattern of APP induction in astrocytes and microglia.

PMID- 7790412
TI  - Cerebrovascular responses under controlled and monitored physiological conditions
      in the anesthetized mouse.
AB  - Control of physiological parameters such as respiration, blood pressure, and
      arterial blood gases has been difficult in the mouse due to the lack of
      technology required to monitor these parameters in small animals. Here we report
      that anesthetized and artificially ventilated mice can be maintained under
      physiological control for several hours with apparently normal cerebrovascular
      reactivity to hypercapnia and mechanical vibrissal stimulation. SV-129 mice were
      anesthetized with urethane (750 mg/kg i.p.) and alpha-chloralose (50 mg/kg i.p.),
      intubated, paralyzed, and artificially ventilated. Respiratory control was
      maintained within physiological range by reducing the inspiratory phase of the
      respiratory cycle to < 0.1 s and by adjusting end-tidal CO2 to give a PCO2 of 35
      +/- 3 mm Hg. In these mice, mean arterial pressure (95 +/- 9 mm Hg), heart rate
      (545 +/- 78 beats/min), and arterial pH (7.27 +/- 0.10) could be maintained for
      several hours. Body temperature was kept at 36.5-37.5 degrees C. We observed
      stable regional CBF (rCBF) measurements (as determined by laser-Doppler
      flowmetry) when systemic arterial blood pressure was varied between 40 and 130 mm
      Hg. Hypercapnia led to a 38 +/- 15% (5% CO2) and 77 +/- 34% (10% CO2) increase in
      rCBF. Mechanical stimulation of contralateral vibrissae for 1 min increased rCBF
      by 14 +/- 4%. Changes in rCBF compare favorably with those observed previously in
      another rodent species, the Sprague-Dawley rat. After placement of a closed
      cranial window, cerebrovascular reactivity to hypercapnia and whisker stimulation
      was intact and well maintained during 2-h superfusion with artificial CSF.

PMID- 7790415
TI  - Mitochondrial hyperoxidation signals residual intracellular dysfunction after
      global ischemia in rat neocortex.
AB  - Reperfusion after global ischemia (10-60 min in duration) in rat neocortex most
      commonly provoked transient hyperoxidation of mitochondrial electron carriers,
      tissue hyperoxygenation, and CBF hyperemia. These responses were normally
      accompanied by recovery of K+ homeostasis and EEG spike activity. Goals of this
      research were to understand putative relationships among these postreperfusion
      events with special emphasis on determining whether mitochondrial hyperoxidation
      results from intracellular changes that may modulate residual damage. The
      amplitude of postischemic mitochondrial hyperoxidation (PIMHo) did not increase
      when CBF increased above an apparent threshold during reperfusion, and tissue
      hyperoxygenation was not required for PIMHo to occur or to continue. These
      findings suggest that PIMHo is not merely a response to increased CBF and tissue
      hyperoxygenation; rather, PIMHo is modulated, at least in part, by residual
      intracellular derangements that limit mitochondrial electron transport. This
      suggestion was supported by observations that NAD became hyperoxidized after
      reoxygenation in anoxic hippocampal slices. Also, PIMHo occurred and subsequently
      resolved in many animals, but K+o never was cleared fully to baseline and/or EEG
      spike activity never was evident. One suggestion is that PIMHo signals or
      initiates residual intracellular derangements that in turn impair electrical and
      metabolic recovery of cerebral neurons after ischemia; an alternative suggestion
      is that PIMHo and tissue hyperoxygenation are not the sole factors modulating the
      immediate restoration of electrical activity after ischemia. Present data also
      support the following: Decreased oxygen consumption, despite adequate oxygen
      delivery, likely contributes to tissue hyperoxygenation after ischemia; and
      mitochondrial hyperoxidation is modulated by a limitation in the supply of
      electrons to the mitochondrial respiratory chain.

PMID- 7790416
TI  - Postischemic cerebral blood flow recovery in the female: effect of 17 beta
      estradiol.
AB  - Female reproductive hormones are considered to be protective agents in
      atherosclerotic vascular disease and stroke. The present study determined if
      there are unique cerebrovascular responses in female animals to global cerebral
      ischemia and if 17 beta-estradiol is important to postischemic outcome in brain.
      Three groups of anesthetized, sexually mature rabbits were treated with
      normotensive four-vessel occlusion (6 min) and 3 h of reperfusion: females
      chronically instrumented with 17 beta-estradiol implants (EFEM; n = 8, plasma
      estradiol level = 365 +/- 48 pg/ml), untreated females (FEM; n = 8, estradiol =
      13 +/- 3 pg/ml), and untreated males (M; n = 8, estradiol < limit of
      radioimmunoassay). CBF (microspheres) and somatosensory evoked potential (SEP)
      amplitude were measured during ischemia/reperfusion. Baseline hemispheric blood
      flow and regional flow distribution were not altered by chronic estradiol
      treatment. Hemispheric blood flow was equivalently reduced during ischemia in FEM
      and M (6 +/- 1 and 9 +/- 2 ml min-1 100 g-1, respectively); however postischemic
      hyperemia was greater in FEM than M (CBF = 257 +/- 27 and 183 +/- 27 ml min-1 100
      g-1. However, EFEM experienced higher CBF during ischemia (e.g., 13 +/- 2 ml min
      1 100 g-1) and less hyperemia (134 +/- 4 ml min-1 100 g-1 in hemispheres) in
      numerous brain regions than FEM. CBF at 3 h reperfusion was not different among
      the groups. Recovery of SEPs was incomplete and similar in all groups. We
      conclude that chronic exogenous 17 beta-estradiol treatment increases CBF during
      global incomplete ischemia and ameliorates postischemic hyperemia in the female
      animal.

PMID- 7790417
TI  - Poor hemodynamic and metabolic recovery after global incomplete cerebral ischemia
      associated with short-term diabetes in dogs.
AB  - We determined the effect of 4-5 weeks of diabetes on ATP recovery following
      global incomplete cerebral ischemia. 31P magnetic resonance spectra of ATP,
      intracellular pH (pHi), and CBF (radiolabeled microspheres) were measured in
      three groups of anesthetized dogs (n = 8/group): chronic hyperglycemic diabetes
      (pancreatectomy followed by blood glucose of > 10 mM for 4-5 weeks); acute
      hyperglycemia (blood glucose of > 10 mM) during ischemia and reperfusion in
      nondiabetic dogs; and normoglycemic controls. Twenty minutes of incomplete
      ischemia was produced by ventricular fluid infusion to keep cerebral perfusion
      pressure (CPP) at 10 mm Hg during spontaneous variations in MABP. Intracranial
      pressure was increased initially to similar levels, resulting in a similar
      Cushing response among the groups. However, during the final 8 min of ischemia,
      MABP decreased to a greater extent in diabetic (86 +/- 42 mm Hg) than in
      hyperglycemic (162 +/- 30 mm Hg) and normoglycemic (135 +/- 54 mm Hg) groups and
      remained lower throughout 3 h of reperfusion. CPP was kept constant during
      ischemia, but was lower throughout reperfusion in diabetic dogs. During ischemia
      CBF was reduced similarly among groups: 5 +/- 3 ml.min-1 x 100 g-1 in
      hyperglycemic and normoglycemic and 4 +/- 3 ml.min-1 x 100 g-1 in diabetic dogs.
      During reperfusion early hyperemia was attenuated and delayed hypoperfusion was
      augmented (7 +/- 17 ml.min-1 x 100 g-1 by 180 min) as a result of low perfusion
      pressure in diabetics. However, medullary blood flow was similar among
      groups.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790418
TI  - Regional congruence and divergence of glucose transporters (GLUT1) and
      capillaries in rat brains.
AB  - The association of glucose transporters (GLUT1) and brain capillaries was tested
      in different brain structures of rats by a direct comparison of the topologies of
      capillaries and GLUT1 in identical brain sections. Antibody staining of
      capillaries (fibronectin) and GLUT1 were made visible by fluorescence microscopy.
      The results showed differences between brain structures containing a tight and a
      leaky blood-brain barrier. All capillaries of brain structures with a tight blood
      brain barrier showed congruent staining of GLUT1 and capillary morphology. The
      circumventricular organs that are known to have leaky barrier capillaries were
      stained by fibronectin antibodies but not by GLUT1 antibodies. Ependymal cells
      showed moderate staining by GLUT1 antibodies both in areas with tight and leaky
      barriers. The subcommissural organ appeared to be unique showing neither
      capillary nor GLUT1 stain. It is concluded that glucose transporters (GLUT1)
      exist in all brain capillaries of blood-brain barrier structures, whereas they
      are absent in leaky barrier structures. Moderate amounts of glucose transporter
      (GLUT1) can also be detected in ependymal cells.

PMID- 7790419
TI  - Nicotine raises the influx of permeable solutes across the rat blood-brain
      barrier with little or no capillary recruitment.
AB  - Nicotine (1.75 mg/kg s.c.) was administered to rats to raise local CBF (lCBF) in
      various parts of the brain, test the capillary recruitment hypothesis, and
      determine the effects of this increase in lCBF on local solute uptake by brain.
      lCBF as well as the local influx rate constants (K1) and permeability-surface
      area (PS) products of [14C]antipyrine and [14C]-3-O-methyl-D-glucose (3OMG) were
      estimated by quantitative autoradiography in 44 brain areas. For this testing,
      the finding of significantly increased PS products supports the capillary
      recruitment hypothesis. In 17 of 44 areas, nicotine treatment increased lCBF by
      30-150%, K1 of antipyrine by 7-40%, K1 of 3OMG by 5-27%, PS product of antipyrine
      by 0.20% (mean 7%), and PS product of 3OMG by 0-23% (mean 8%). Nicotine had no
      effect on blood flow or influx in the remaining 27 areas. The increases in lCBF
      and K1 of antipyrine were significant, whereas those in K1 of 3OMG and in PS for
      both antipyrine and 3OMG were not statistically significant. The lack of
      significant changes in PS products implies that in brain areas where nicotine
      increased blood flow: (a) essentially no additional capillaries were recruited
      and (b) blood flow within brain capillary beds rises by elevating linear
      velocity. The K1 results indicate that the flow increase generated by nicotine
      will greatly raise the influx and washout rates of highly permeable materials,
      modestly elevate those of moderately permeable substances, and negligibly change
      those of solutes with extraction fractions of < 0.2, thereby preserving the
      barrier function of the blood-brain barrier.

PMID- 7790420
TI  - Enhanced cerebrovascular responsiveness to hypercapnia following depletion of
      central serotonergic terminals.
AB  - Serotonin-containing nerve fibres innervate cerebral blood vessels, but the
      source of this innervation and the physiological effects of perivascular
      serotonin release remain controversial. The purpose of the present study was to
      examine the effects of central serotonergic depletion upon the relationship
      between CBF and glucose utilization under both normo- and hypercapnic conditions.
      To induce the loss of serotonergic terminals, rats were injected twice daily for
      4 consecutive days with 20 mg/kg of the specific serotonergic neurotoxin
      methylenedioxyamphetamine (MDA). Between 4 and 6 weeks later, local CBF and
      glucose utilization were measured using the fully quantitative
      [14C]iodoantipyrine and [14C]2-deoxyglucose autoradiographic techniques,
      respectively, and the efficacy of the lesioning protocol was assessed using
      [3H]paroxetine radioligand binding analysis. In all animals treated with MDA,
      there was a significant decrease in serotonin uptake sites throughout the brain,
      falling from 223 +/- 20 to 40 +/- 16 fmol/mg tissue in parietal cortex, for
      example, although the raphe nuclei themselves were unaffected (300 +/- 20 fmol/mg
      tissue in controls and 291 +/- 18 in MDA-treated rats). In normocapnic rats, the
      effects of MDA pretreatment upon blood flow and glucose use were slight and
      focally concentrated. However, when the animals were rendered hypercapnic, CBF
      was significantly higher in MDA-treated rats than in normal controls, for
      example, increasing from 356 +/- 22 ml 100 g-1 min-1 in frontal cortex of
      hypercapnic controls to 700 +/- 81 ml 100 g-1 min-1 in MDA-pretreated rats with
      similar levels of hypercapnia. In some brain areas of hypercapnic MDA-pretreated
      rats, blood flows were too high (> 800 ml 100 g-1 min-1) to be accurately
      quantified.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790421
TI  - Change in cerebral blood flow velocity with onset of EEG silence during
      inhalation anesthesia in humans: evidence of flow-metabolism coupling?
AB  - In eight subjects anesthetized with moderate to high doses of inhalation
      anesthetics (isoflurane or desflurane) during normocapnia, the onset of
      electrical silence in EEG was associated with a sudden reduction of blood flow
      velocity monitored from the middle cerebral artery. The magnitude of this
      reduction was 38 +/- 11% (mean +/- SD; range 24-44%). The change in EEG always
      preceded the change in flow velocity by 5-7 s. These observations suggest that
      some flow-metabolism coupling mechanism is preserved during inhalation anesthesia
      in humans.

PMID- 7790422
TI  - Possible utility of bilateral simultaneous TCD.

PMID- 7790423
TI  - Improved detection of Malassezia species in lipid-supplemented Peds Plus blood
      culture bottles.
AB  - The growth of Malassezia species in BACTEC Peds Plus blood culture bottles was
      optimized by using various lipid supplements. Palmitic acid (3%, wt/vol) was
      superior and overcame the inhibitory effect of blood in mock clinical specimens.
      Palmitic acid (3%) supplementation of Peds Plus bottles may improve recovery of
      Malassezia species in the BACTEC NR 660.

PMID- 7790424
TI  - Polyclonal Mycobacterium avium infections in patients with AIDS: variations in
      antimicrobial susceptibilities of different strains of M. avium isolated from the
      same patient.
AB  - Broth microdilution MICs were determined for pairs of strains isolated from five
      AIDS patients with polyclonal Mycobacterium avium infection. Four (80%) of the
      five patients were infected simultaneously with strains having different
      antimicrobial susceptibility patterns. These findings have implications for the
      interpretation of susceptibility data in M. avium prophylaxis and treatment
      trials.

PMID- 7790426
TI  - Evaluation of CMV-vue antigenemia assay for rapid detection of cytomegalovirus in
      mixed-leukocyte blood fractions.
AB  - The CMV-vue antigenemia assay was evaluated by using mixed-leukocyte (ML) blood
      fractions. Of 234 ML fractions studied, 32 (14%), 23 (10%), and 20 (8.5%) were
      positive in the CMV-vue assay and conventional and shell vial cultures,
      respectively. The CMV-vue assay was more sensitive than shell vial cultures for
      rapid detection of cytomegalovirus. ML fractions are appropriate specimens for
      the cytomegalovirus antigenemia assay.

PMID- 7790425
TI  - Absence of human papillomavirus sequences in ovarian pathologies.
AB  - The role of human papillomaviruses (HPVs) in ovarian epithelium (either normal or
      neoplastic) remains controversial. We have investigated by PCR the presence of
      HPV DNA in fresh tissue from ovarian neoplasms and in primary cell cultures
      established from either normal, benign or malignant ovarian surface epithelia.
      None of the fresh samples and primary ovarian cultures contained HPV DNA
      sequences.

PMID- 7790427
TI  - Evaluation of a modified nitrous acid extraction latex agglutination kit for
      grouping beta-hemolytic streptococci and enterococci.
AB  - The rapid and accurate identification of the Lancefield group of beta-hemolytic
      streptococci and enterococci is an important procedure in clinical laboratories.
      Latex agglutination techniques are more rapid and technically less demanding than
      traditional extraction-precipitation methods. Prolex (Pro-Lab Diagnostics,
      Richmond Hill, Ontario, Canada) is a latex agglutination kit which contains
      modified nitrous acid reagents to extract antigens and can be used to detect
      group D antigen in streptococci and enterococci, as well as group A, B, C, F, and
      G antigens. A total of 302 strains of streptococci and enterococci were tested
      with this kit. All streptococci of groups A (41 strains), B (39 strains), C (35
      strains), D (3 strains), F (10 strains), and G (48 strains) were correctly
      grouped, as were 125 (97%) of 129 strains of enterococci. Prolex is a reliable
      method for grouping the beta-hemolytic streptococci and enterococci most
      frequently encountered in clinical laboratories.

PMID- 7790428
TI  - Difficulties encountered in identification of a nutritionally deficient
      streptococcus on the basis of its failure to revert to streptococcal morphology.
AB  - Difficulties were encountered in the recognition of a nutritionally deficient
      streptococcus which continued to display aberrant morphologic forms (especially
      bulbous swellings and filament formation) despite provision of growth factors.
      With isolates displaying diverse morphologic entities not characteristic of a
      given species, e.g., Streptobacillus moniliformis or Erysipelothrix
      rhusiopathiae, nutritionally deficient streptococci should be considered.

PMID- 7790431
TI  - Methods for predicting susceptibility of Streptococcus pneumoniae to cefixime.
AB  - Among 698 Streptococcus pneumoniae isolates, 475 were penicillin susceptible and
      > 99% of those were susceptible to 0.5 microgram of cefixime per ml; other
      pneumococci were tentatively assumed to be resistant to cefixime. A 1-microgram
      oxacillin disk was more reliable than a 5-micrograms cefixime disk for predicting
      susceptibility to cefixime.

PMID- 7790429
TI  - Evaluation of CPS ID2 medium for detection of urinary tract bacterial isolates in
      specimens from a rehabilitation center.
AB  - CPS ID2 medium (bioMerieux) enables the presumptive identification of Escherichia
      coli and enterococci as well as the detection of indologenous or nonindologenous
      Proteeae and bacteria belonging to the Klebsiella, Enterobacter, and Serratia
      group with a specificity ranging from 98 to 100%. When the cultures were
      polymicrobial, the sensitivity varied from 70 to 97%, and the sensitivity varied
      from 97 to 100% when they were monomicrobial.

PMID- 7790430
TI  - Factors affecting growth and susceptibility testing of Helicobacter pylori in
      liquid media.
AB  - In order to increase the database for in vitro growth and/or susceptibility
      testing in liquid media, we evaluated the growth of Helicobacter pylori in broth
      media containing 5% sheep blood. We also compared the effect of bismuth on the
      growth of H. pylori in broth media containing 10% fetal calf serum with the
      effect on growth in media containing 0.5% starch. In contrast to the result seen
      with agar, we found that sheep blood, whether whole or laked, inhibited the
      growth of H. pylori in broth media. In addition, we found that bismuth inhibited
      growth in media with starch but that this inhibition was negated in media with
      serum.

PMID- 7790432
TI  - Diagnosis of American trypanosomiasis (Chagas' disease) by the new complement
      fixation test.
AB  - A new immunodiagnostic method of complement fixation was used for serodiagnosis
      of American trypanosomiasis; 92% sensitivity and 99% specificity were obtained,
      for an overall accuracy of 97%. This test can be used in field studies, obviating
      the use of most laboratory equipment and imported reagents; places where economic
      limitations hinder the use of other immunodiagnostic procedures; and in
      association with other tests for confirmation of the diagnosis.

PMID- 7790433
TI  - Alterations in sample preparation increase sensitivity of PCR assay for diagnosis
      of chancroid.
AB  - A PCR assay for the detection of Haemophilus ducreyi in clinical specimens taken
      from genital ulcers was developed. Although H. ducreyi, when present in such
      specimens, could be detected by PCR, the sensitivity of the assay was reduced by
      the presence of Taq polymerase inhibitors in the specimen. The sensitivity of the
      PCR assay was improved by the use of detergents in preparing nuclei acids from
      clinical specimens and by the inclusion of a dialysis step prior to
      amplification. In addition, sodium phosphate included in the transport medium was
      found to be an inhibitor of the Taq polymerase.

PMID- 7790435
TI  - Mycobacterium asiaticum as the probable causative agent in a case of olecranon
      bursitis.
AB  - Mycobacterium asiaticum was isolated from fluid aspirated from an olecranon bursa
      that had become inflamed following a superficial injury. Other possible causes of
      the inflammation were excluded. No specific antimycobacterial therapy was given.
      The infection responded to drainage, regular dressing, and immobilization. Our
      experience suggests that M. asiaticum is a potential cause of infection of the
      joints and surrounding tissues.

PMID- 7790434
TI  - Differentiation of Neisseria gonorrhoeae isolates requiring proline, citrulline,
      and uracil by plasmid content, serotyping, and pulsed-field gel electrophoresis.
AB  - A combination of DNA macrorestriction analysis using pulsed-field gel
      electrophoresis and a serotyping method using three panels of monoclonal antibody
      was used to discriminate 43 epidemiologically unrelated Neisseria gonorrhoeae
      isolates requiring proline, citrulline, and uracil (PCU-) into 35 groups. This
      indicates that PCU- isolates of N. gonorrhoeae are not clonal.

PMID- 7790436
TI  - More about cefuroxime screening test for pneumococci.

PMID- 7790437
TI  - Detection of Salmonella species in fecal samples by immunomagnetic separation and
      PCR.

PMID- 7790438
TI  - Detection of vancomycin resistance in enterococci by the Alamar MIC system.
AB  - The ability of the Alamar microdilution MIC system to detect vancomycin
      resistance in enterococci was evaluated by comparing the results with an agar
      dilution screen method. Of 100 strains tested, 41 were resistant and 47 were
      susceptible by both tests. Five strains were intermediate and one was resistant
      by the Alamar MIC system but susceptible by the agar screen. Three strains each
      were susceptible or intermediate by the Alamar MIC system but resistant by the
      agar screen. The predictive values for the Alamar MIC system were 94%
      (susceptible) and 88% (combined intermediate and resistant). The Alamar MIC
      system does not appear to have sufficient accuracy for the detection or
      confirmation of vancomycin resistance in enterococci.

PMID- 7790439
TI  - Stability of karyotype in serial isolates of Candida albicans from neutropenic
      patients.
AB  - Serial isolates of Candida albicans were obtained from 20 patients with leukemia
      over periods of up to 8 months. The fingerprinting of these isolates by
      interrepeat PCR and random amplified polymorphic DNA PCR has been described
      previously (A. van Belkum, W. Melchers, B. E. de Pauw, S. Scherer, W. Quint, and
      J. F. Meis, J. Infect. Dis. 169:1062-1070, 1994). Contour-clamped homogeneous
      electric field gel electrophoresis was used to examine the chromosomes of these
      isolates. When changes in the karyotype were seen in a series of isolates,
      additional interrepeat PCR and Southern blotting with a repeat DNA sequence from
      the 27A family were performed. These two genotyping tools were used to determine
      if karyotypic changes seen in a series of isolates were due to chromosome
      rearrangements in a single strain or due to colonization with more than one
      strain. It was determined that changes in karyotype in a series of strains
      indicated infection by a new strain.

PMID- 7790441
TI  - Evaluation of five new plating media for isolation of Salmonella species.
AB  - A three-phase study was conducted to compare Hektoen enteric agar (HE), Rambach
      agar (Ra), SM-ID medium (SM), xylose-lysine-Tergitol 4 agar (XLT4), novobiocin
      brilliant green-glycerol-lactose agar (NBGL), and modified semisolid Rappaport
      Vassiliadis medium (MSRV) for the recovery of nontyphoid salmonellae from stool
      specimens. After evaluation of the first two phases, which resulted in the
      elimination of Ra, SM, and NBGL, 593 consecutive stool samples were investigated
      by plating them directly and after tetrathionate enrichment at 37 degrees C on
      HE, XLT4, and MSRV. A total of 82 Salmonella-positive stool specimens were
      detected (positivity rate, 13.8%). Sensitivities for direct plating and after
      tetrathionate enrichment were 32.9 and 86.6%, respectively, for XLT4, 63.4 and
      100.0%, respectively, for MSRV, and 34.1 and 79.3%, respectively, for HE.
      Specificities (percentage of morphologically suspicious colonies that were indeed
      salmonellae) were 100.0 and 99.8%, respectively, for XLT4, 99.0 and 98.8%,
      respectively, for MSRV, and 67.9 and 75.0%, respectively, for HE. The use of MSRV
      instead of HE increased the isolation rate of salmonellae by 26.2% (65 versus 82
      strains isolated from HE and MSRV, respectively). We conclude that MSRV is the
      most sensitive medium tested and is a very specific medium for the isolation of
      nontyphoid salmonellae from stool specimens. However, its semisolid nature is a
      disadvantage and requires careful handling in the laboratory, especially when
      salmonellae are present. XLT4 had a sensitivity comparable to that of HE and a
      nearly 100% specificity and can be regarded as an alternative for the isolation
      of nontyphoid salmonellae from stool samples.

PMID- 7790442
TI  - Comparison of commercial enzyme immunoassay kits with plaque reduction
      neutralization test for detection of measles virus antibody.
AB  - Four commercially available enzyme immunoassay (EIA) kits were evaluated in
      comparison with the plaque reduction neutralization (PRN) test for detection of
      measles virus antibody. The EIA kits, Enzygnost (Behring), Diamedix, Vidas
      (bioMerieux Vitek), and Measlestat (Biowhittaker), were assessed with two PRN
      cutoff titers: a PRN titer of 8, the lowest detectable antibody level by the PRN
      test under the test conditions, and a titer of 120, which has been shown to be
      the minimum protective antibody titer. At a PRN cutoff titer of 8, the
      sensitivity was 88.2, 91.1, 74.6, and 69.8% for Behring, Diamedix, Vidas, and
      Biowhittaker EIA tests, respectively, with negative predictive values ranging
      from 22.7 to 45.5%. The specificity was 93.8% for Diamedix and 100% for the rest.
      At a PRN cutoff titer of 120, the sensitivity and specificity, respectively, were
      100 and 90.7% (Behring), 98.2 and 58.8% (Diamedix), 90.6 and 94.5% (Vidas), and
      85.7 and 96.4% (Biowhittaker). At this PRN cutoff titer, the negative predictive
      values of all EIA tests improved considerably, ranging from 70.7 to 100%. The EIA
      results showed an excellent association with PRN results when the PRN titers of
      the test samples were either < 8 or > 1,052. Discrepancies occurred especially
      when testing samples having PRN titers in the range of 8 to 120, indicating lack
      of sensitivity of the EIA tests in detecting measles virus antibody at low
      levels. Maternally derived measles virus antibody at this level has been shown to
      interfere with measles vaccine response in children and hence has implications
      from the standpoint of measles immunization. The ready availability, ease of
      operation, and rapid turnaround time are strong plus points of the EIA kits, and
      they could be useful in a clinical laboratory setting for routine application,
      but they may have limited use in vaccine-related studies and seroepidemiological
      surveys.

PMID- 7790440
TI  - Typing of human astroviruses from clinical isolates by enzyme immunoassay and
      nucleotide sequencing.
AB  - A typing enzyme immunoassay (TYPE-EIA) was used to determine the antigenic types
      of 64 astrovirus-positive specimens from nine collections from seven countries.
      Six of the seven known astrovirus types were detected in the collections, with
      HAstV-1 predominating in all collections for one from the United Kingdom.
      Selected specimens were analyzed further by reverse transcriptase PCR and
      nucleotide sequencing of 348 bp within the capsid protein precursor region of the
      genome. The phylogenetic groupings (genotypes) determined from the sequences were
      entirely consistent with the antigenic groupings (serotypes) of isolates obtained
      by using the TYPE-EIA. The genetic variation within genotypes was small compared
      with the variation between genotypes, allowing unambiguous categorization of all
      specimens. Although some strains from widely separated geographic areas had
      identical sequences, in general, within a region most strains of the same type
      were identical. The TYPE-EIA may help further our understanding of the
      epidemiology of astrovirus and the possible role of serotype-specific immunity,
      while further knowledge of sequences could facilitate the development of simpler
      molecular methods of typing astrovirus strains.

PMID- 7790443
TI  - Coagulase-negative staphylococci in multiple blood cultures: strain relatedness
      and determinants of same-strain bacteremia.
AB  - The frequency of strain relatedness was determined among randomly selected
      patients with coagulase-negative staphylococcal infections as determined in
      multiple blood cultures by plasmid typing, determination of species, and
      antibiotyping. Strain relatedness was demonstrated in 21 of 47 episodes of
      bacteremia (44.7%) among 34 patients, with a similar percentage among patients
      with two or one positive blood culture in 24 h (14 of 30 [46.7%] versus 7 of 17
      [41.2%], respectively). Same-strain bacteremia was more frequent in cases of
      infection among patients with a corresponding fever (15 of 21 [71.4%]), among
      patients infected with organisms from an identifiable source (7 of 9 [77.8%]) and
      with non-Staphylococcus epidermidis species (9 of 11 [81.8%]), and among patients
      with nosocomially acquired infections (18 of 36 [50%]). Comparing episodes with
      or without strain relatedness, no difference was noted in the time to growth (2.1
      +/- 1.4 versus 1.9 +/- 0.9 days, respectively), in bacterial growth in two
      culture bottles (5 of 14 [35.7%] versus 8 of 24 [33.3%], respectively), and in
      the presence of additional negative blood cultures (9 of 21 [42.9%] versus 11 of
      26 [42.3%], respectively). The antibiotypes of all related strains and 7 of 44
      (15.9%) unrelated pairs were identical. These findings demonstrate that coagulase
      negative staphylococci from multiple blood cultures are frequently unrelated,
      suggesting a high prevalence of contamination. In the absence of precise measures
      for demonstrating strain relatedness, the combination of a clinical assessment
      with antibiotype determination appears to be a suitable alternative.

PMID- 7790444
TI  - Detection of Borna disease virus RNA in formalin-fixed, paraffin-embedded brain
      tissues by nested PCR.
AB  - A method for detecting Borna disease virus (BDV) RNA in formalin-fixed, paraffin
      embedded brain tissue sections was established. By digestion with proteinase K
      and subsequent extraction with guanidinium thiocyanate, phenol, and chloroform,
      we were able to efficiently release RNA from the fixed tissues. By reverse
      transcription of the RNA and nested PCR a 212-bp product was generated, as
      expected.

PMID- 7790445
TI  - Detection of Rickettsia japonica in Haemaphysalis longicornis ticks by
      restriction fragment length polymorphism of PCR product.
AB  - PCR was applied to the detection of Rickettsia japonica, the causative agent of
      Oriental spotted fever (OSF), in ticks collected at two sites of the Muroto area
      on Shikoku Island, a major area in Japan where OSF is endemic. Primer pair
      Rr190.70p and Rr190.602n of the R. rickettsii 190-kDa antigen gene sequence of
      Regnery and others (R.L. Regnery, C.L. Spruill, and B.D. Plikaytis, J. Bacteriol.
      173:1576-1589, 1991) primed the DNA extracted from Haemaphysalis longicornis
      ticks but not those extracted from Haemaphysalis formosensis, Haemaphysalis
      flava, Haemaphysalis hystricis, or Amblyomma testudinarium ticks. Digestion of
      the amplification product with the restriction endonucleases PstI and AluI
      produced the restriction fragment length polymorphism pattern specific to R.
      japonica. The HindIII and MspI digests gave restriction fragment length
      polymorphism patterns identical to those of the PCR product from R. japonica DNA.
      Hemolymph preparations of H. longicornis ticks were demonstrated to contain rod
      shaped organisms that were detected by immunofluorescence with the monoclonal
      antibody specific to R. japonica species. The primer pair did not amplify the DNA
      of a laboratory colony of H. longicornis ticks originally collected at an area
      where OSF is not endemic. Our results provided evidence that H. longicornis ticks
      might be an arthropod reservoir for R. japonica and a vector of OSF.

PMID- 7790447
TI  - Detection and identification of aquatic birnaviruses by PCR assay.
AB  - A reverse transcriptase polymerase chain reaction (RT-PCR) assay was developed
      for the detection and identification of aquatic birnaviruses. The four sets of
      primers (PrA, PrB, PrC, and PrD) that we used are specific for regions of cDNA
      coded by genome segment A of aquatic birnaviruses. PrA identifies a large
      fragment (1,180 bp) within the pVP2-coding region, and PrB identifies a 524-bp
      fragment within the sequence amplified by PrA. Primer set PrC frames a genome
      fragment (339 bp) within the NS-VP3-coding region, and PrD identifies a 174-bp
      sequence within the fragment identified by PrC. PrB and PrD amplified cDNAs from
      all nine recognized serotypes of aquatic birnavirus serogroup A as well as the N1
      isolate that may represent a 10th serotype. These results indicate that these
      three primer sequences are highly conserved and can be used in PCR assays for
      group identification of these viruses. PrA routinely produced amplification
      products from eight serotypes but exhibited variable results with one serotype,
      and primer PrC identified 6 of the 11 virus isolates tested. The qualitative
      sensitivity of the RT-PCR assay was evaluated by comparison of the results with
      those of cell culture isolation assays. With the exception of one sample, the RT
      PCR assay with primer PrD was as accurate as cell culture isolation for detecting
      virus in kidney and spleen tissues from naturally infected, asymptomatic carrier
      fish. These results indicate that the RT-PCR assay can be a rapid and reliable
      substitute for cell culture methods for the detection of aquatic birnaviruses.

PMID- 7790449
TI  - Evaluation of a new identification system, Crystal Enteric/Non-Fermenter, for
      gram-negative bacilli.
AB  - A total of 505 fermentative and 201 nonfermentative gram-negative bacilli,
      identified by conventional methods, were tested by the Crystal Enteric/Non
      Fermenter ID kit and by the API 20E or API 20NE identification system. The
      overall correct results for fermenters were 92.9% by the Crystal kit and 89.1% by
      the API 20E system. The false identifications (genus and species incorrect)
      accounted for 3.1 and 7.1% for the Crystal and API systems, respectively. For
      nonfermenters, figures for correct identifications by the two systems were
      comparable (Crystal, 75.9%; API 20NE, 75.3%) while the API 20NE system gave twice
      as many incorrect results (13.8%) as Crystal (6.3%); however, Crystal failed to
      precisely identify several species included in a "miscellaneous" group. The
      Crystal Enteric/Non-Fermenter system is an easy-to-use kit which compares
      favorably with other commercial systems.

PMID- 7790446
TI  - Collagenases and the serine proteinases elastase and cathepsin G in steroid
      induced Pneumocystis carinii pneumonia.
AB  - Pneumocystis carinii pneumonia (PCP) is characterized by the formation of leaky
      alveoli and a foamy alveolar exudate. To induce PCP, male Wistar rats were
      immunosuppressed by oral dexamethasone treatment for 12 weeks, during which time
      all rats developed PCP. Bronchoalveolar lavage fluid (BALF) was analyzed at that
      time and at 1, 2, and 4 weeks after the cessation of dexamethasone treatment,
      during which time the rats were recovering from PCP and immunosuppression (and
      was compared with the BALF obtained from healthy control rats), for type IV
      collagenase, elastase, cathepsin G, and collagenase activities. Scores for 72-kDa
      (matrix metalloproteinase type [MMP-2]) and 92-kDa (MMP-9) type IV collagenase
      gelatinase activities correlated with those for BALF macrophages (r = 0.58; P <
      0.001) and neutrophils (r = 0.66; P < 0.001), respectively, suggesting that they
      may, in part, be derived from these cells. However, MMP-2 was constitutively
      expressed and may play a role in normal tissue remodeling. MMP-9 activity was
      highest in the group with PCP (1.8 +/- 0.37; P > 0.05), with a gradual decline
      (1.0 +/- 0.48 by week 4; P > 0.05) toward normal (0.67 +/- 0.42) during recovery,
      which suggests a role for it in tissue-destructive inflammatory events. In rats
      with PCP the endogenously active collagenase was present at high levels compared
      with those in healthy controls (2.6 +/- 0.69 versus 0.17 +/- 0.17, respectively;
      P < 0.01), but they returned to normal by week 4 of recovery (0.42 +/- 0.30; P >
      0.05). Collagenase activity showed a correlation with cyst number (r = 0.57; P <
      0.001). The BALF of rats with PCP also contained the serine proteinases, which
      may act as pro-MMP activators. Ultramorphology disclosed increased pinocytotic
      activities, subepithelial bleb formation, and degeneration and denudation of the
      basal lamina. These findings suggest that the increased activities of
      collagenases in BALF caused by the host response against P. carinii might
      contribute to leaky alveoli.

PMID- 7790450
TI  - Anti-idiotypic antibody as potential serodiagnostic reagent for detection of
      bluetongue virus infection.
AB  - Polyclonal anti-idiotypic antibodies (anti-Ids) were generated by the sequential
      immunization of rabbits with three mouse monoclonal antibodies (MAb1s) specific
      for a major bluetongue virus (BTV) protein, VP7. The anti-Ids, designated RAb2s,
      recognized idiotopes which were located within or near the antigen-combining
      sites of the MAb1s and were associated with both heavy and light chains of MAb1s.
      RAb2s inhibited the MAb1s from binding to BTV antigens, and their interaction
      with MAb1s was inhibited by BTV antigens. By recognizing the common idiotopes,
      RAb2s detected anti-BTV antibodies from bovine antisera; their interaction was
      also partially inhibited by BTV antigens. These results indicated that RAb2s
      recognized the common idiotopes on anti-VP7 antibodies obtained from mice and
      cattle and that at least a portion of RAb2s were internal-image anti-Ids that
      functionally mimicked VP7. RAb2s may be used to substitute for the tissue culture
      derived viral antigen in currently used serological assays for the detection of
      antibodies to BTV.

PMID- 7790451
TI  - Identification of Campylobacter jejuni on the basis of a species-specific gene
      that encodes a membrane protein.
AB  - To facilitate discrimination between the closely related enteropathogens
      Campylobacter jejuni and C. coli, unique differences in antigenic surface
      structure were examined. A genomic library of C. jejuni 81116 was constructed in
      plasmid pBluescriptIISK- and expressed in Escherichia coli K-12. Rabbit
      hyperimmune serum raised against C. jejuni ATCC 29428 recognized a clone
      expressing a C. jejuni 24-kDa membrane-associated protein. Antiserum raised
      against sonicated recombinant E. coli expressing the 24-kDa protein reacted with
      C. jejuni, whereas C. coli did not react specifically. Determination of the
      nucleotide sequence of the DNA insert of this recombinant plasmid revealed an
      open reading frame encoding 214 amino acids; the gene was designated mapA; and
      its gene product was designated MAPA. The 18 N-terminal amino acid residues
      constitute a signal sequence characteristic of prokaryotic membrane lipoproteins.
      In a dot blot hybridization assay with a mapA probe, 120 clinical isolates of C.
      jejuni were unequivocally discriminated from 126 other campylobacters, including
      34 C. coli isolates. A PCR test based on the mapA sequence was developed for
      identification of C. jejuni. A PCR product was obtained with all of the clinical
      isolates of C. jejuni tested from human, dog, cat, bovine calf, and chicken
      sources. Recombinant MAPA with an added C-terminal six-histidine tail was
      affinity purified and used to immunize rabbits. The rabbit anti-MAPA serum
      specifically recognized the protein in whole cells of C. jejuni on Western blots
      (immunoblots). The MAPA protein was present in all of the C. jejuni strains
      tested and was absent in C. coli and related campylobacters.

PMID- 7790452
TI  - Evaluation and comparison of different blood culture techniques for
      bacteriological isolation of Salmonella typhi and Brucella abortus.
AB  - An experimental study was carried out to evaluate and compare various
      noncommercial methods of blood culture for the isolation of Salmonella typhi and
      Brucella abortus from fresh human blood samples that had been artificially
      inoculated with 1 to 50 microorganisms per ml of blood. The methods compared
      included the Ruiz-Castaneda blood culture, broth blood culture, leukocyte lysis
      and direct plating on agar (WBL-P), leukocyte lysis and filtration, Ficoll
      Hypaque centrifugation and filtration, Ficoll-Hypaque centrifugation, and Ficoll
      Hypaque centrifugation and leukocyte lysis methods. Results with the WBL-P
      technique showed that S. typhi was isolated in 18 h, and its recovery rate was
      36.6% (calculated from the number of CFU recovered per milliliter versus the
      number inoculated). B. abortus was isolated in 48 h by the same technique, and
      its recovery rate was 48.8%. The isolation times for the other blood culture
      techniques were between 36 and 44 h for S. typhi and 66 h for B. abortus. The
      techniques which relied on filtering systems for the recovery of S. typhi and B.
      abortus performed poorly. The WBL-P technique for the isolation of S. typhi and
      B. abortus is faster than the other methods tested.

PMID- 7790453
TI  - Evaluation of risk and diagnostic value of quantitative assays for anti
      Toxoplasma gondii immunoglobulin A (IgA), IgE, and IgM and analytical study of
      specific IgG in immunodeficient patients.
AB  - To determine their prognostic and diagnostic values for toxoplasmosis in
      immunodepressed subjects, we assayed immunoglobulin A (IgA) and IgE antibodies by
      means of immunocapture (IC) tests, with revelation done by using a suspension of
      T. gondii (ICT). We also carried out a simultaneous analytical study of IgG
      antibodies on cellulose acetate membranes by using the comparative immunological
      profile method and an enzyme-linked immunofiltration assay (ELIFA). A total of
      1,238 samples (serum, cerebrospinal fluid, and aqueous humor from 318 patients)
      were tested. IgA and IgE antibodies were detected in all heart, kidney, and liver
      transplant recipients with clinical manifestations of toxoplasmosis; IgA was
      detected in the aqueous humor of a patient with chorioretinitis. In patients with
      AIDS-related toxoplasmosis, including the cerebral form, IgA and IgE antibodies
      or a significant modification of ELIFA IgG values were observed in 38, 19, and
      25% of patients, respectively. IgM was detected by ICT only in 12% of patients
      and aided the diagnosis in 1 of 71 patients. IC tests for specific IgA and IgE
      alone and combined with ELIFA were positive in 39 and 46% of patients who
      developed clinical toxoplasmosis, respectively. In a serial study of 16 patients
      in whom at least one of these three tests was positive, a significant
      immunological signal sometimes preceded clinical onset by 1, 6, and even 17
      months. Similarly, in a group of human immunodeficiency virus-infected patients
      with evidence of previous exposure to T. gondii but no clinical manifestations,
      IgA, IgE, and IgA and/or IgE antibodies were detected in only 11, 4, and 12% of
      patients, respectively. These two situations point to peripheral T. gondii
      reactivation. IgA and IgE emerged as interesting markers of the risk of
      toxoplasmosis in immunodepressed patients. They may also provide valuable
      assistance in the diagnosis of toxoplasmosis, especially because tests for
      specific IgM are disappointing. However, at least one in two patients with
      toxoplasmosis showed no detectable immunological reaction, suggesting that this
      polyisotypic approach should be combined with other noninvasive methods such as
      gene amplification.

PMID- 7790448
TI  - Differentiation of strains in Mycobacterium tuberculosis complex by DNA sequence
      polymorphisms, including rapid identification of M. bovis BCG.
AB  - The Mycobacterium tuberculosis complex includes M. tuberculosis, M. bovis, M.
      microti, and M. africanum. Seven strains of the M. tuberculosis complex were
      sequenced in a region of about 300 bp which contains multiple 15-bp tandem
      repeats and which is part of a 1,551-bp open reading frame. Four distinct
      sequences were obtained, each defining a sequevar. A sequevar includes the strain
      or strains with a given sequence. The type strain M. tuberculosis TMC 102 (H37Rv)
      was designated sequevar MED-G. When compared to MED-G, sequevar LONG had an
      insertion of one 15-bp tandem repeat and sequevar SHORT had a deletion of one
      tandem repeat. Sequevar MED-C had a G-->C substitution, coding for the
      conservative change Ser-->Thr. BanI cuts only sequevar MED-C at the site of the
      substitution. PCR-restriction enzyme analysis was used to determine the sequevars
      of 92 M. tuberculosis complex strains. All 23 M. bovis BCG strains belonged to
      sequevar MED-C. The M. africanum type strain was sequevar SHORT. The remaining 68
      strains of M. tuberculosis, M. bovis (not BCG), and M. microti were sequevars
      LONG (3 strains) or MED-G (65 strains). PCR-restriction enzyme analysis was
      applied to reference strains and clinical isolates with a worldwide distribution.
      This method provides rapid, sensitive, and specific identification of the
      important vaccine strain M. bovis BCG.

PMID- 7790454
TI  - Evaluation of three disk tests for identification of enterococci, leuconostocs,
      and pediococci.
AB  - Simple rapid tests for presumptive identification of catalase-negative non-beta
      hemolytic cocci (i.e., enterococci, leuconostocs, and pediococci) have not
      previously been available. Seven hundred thirty-four strains of aerobic and
      facultatively anaerobic, catalase-negative, non-beta-hemolytic gram-positive
      cocci were tested for susceptibility to vancomycin (Vans) by a screening
      procedure and production of leucine aminopeptidase (LAPase) and
      pyrrolidonylarylamidase (PYRase) in disk tests. Three unique patterns of activity
      in response to the three disks (30 micrograms of vancomycin, PYRase, and LAPase)
      can be used to presumptively identify the vancomycin-resistant (Vanr) enterococci
      (Vanr and PYRase and LAPase positive), leuconostocs (Vanr and PYRase and LAPase
      negative), and pediococci (Vanr, PYRase negative, and LAPase positive). The
      results indicate that, together with Gram stain characteristics and the catalase
      test, the vancomycin, LAPase, and PYRase disk tests can be used to presumptively
      identify Vanr strains of enterococci as well as Leuconostoc and Pediococcus
      strains from human infections.

PMID- 7790455
TI  - Identification and ribotypes of Staphylococcus caprae isolates isolated as human
      pathogens and from goat milk.
AB  - We report five cases of human infection with Staphylococcus caprae. Two were
      community acquired (one case each of endocarditis and urinary tract infection);
      the other three were acquired in a hospital (two cases of bacteremia associated
      with intravenous access and one case of urinary tract infection). Analysis of
      human isolates and goat isolates from eight herds showed that they could be
      misidentified by some commercial identification systems but were clearly
      identified as S. caprae by ribotyping, according to their species-specific
      ribotype. Phylogenetic methods applied to the ribotypes did not reveal two
      distinct lineages corresponding to the goat and human origins of the isolates,
      although human ribotypes were clearly distinguishable by the presence of a core
      of four specific bands. The latter observation may reflect some degree of
      evolutionary change within the species between human and goat isolates.

PMID- 7790456
TI  - Detection of Chlamydia trachomatis in urine specimens from women by ligase chain
      reaction.
AB  - The performance of a plasmid-based ligase chain reaction (LCR) with urine
      specimens was compared with those of cell culture of cervical swabs and enzyme
      immunoassay with urine specimens for the detection of Chlamydia trachomatis
      infection in women who had attended a family planning clinic. The prevalence of
      chlamydial infection determined by LCR was 3.1%. Discrepant results among the
      three assays were resolved by testing urine by a second LCR assay based on the C.
      trachomatis chromosomal gene encoding the major outer membrane protein.
      Sensitivity, specificity, and positive and negative predictive values for the
      cell cultures were 56.3, 100, 100, and 98.4%, respectively, whereas those for the
      enzyme immunoassay were 18.8, 100, 100, and 97.1%, respectively, and those for
      LCR were 87.5, 100, 100, and 99.5%, respectively. LCR thus provides a highly
      sensitive and specific noninvasive screening method for detecting genital
      chlamydial infections in women.

PMID- 7790457
TI  - Group-specific differentiation between high- and low-risk human papillomavirus
      genotypes by general primer-mediated PCR and two cocktails of oligonucleotide
      probes.
AB  - In recent years, general primer-mediated PCR assays have been developed to detect
      a broad spectrum of human papillomavirus (HPV) genotypes. In this study, a
      procedure enabling a simple group-specific differentiation of high-risk (HPV-16, 
      18, -31, -33, -35, -39, -45, -51, -52, -54, -56, and -58) and low risk (HPV-6, 
      11, -34, -40, -42, -43, and 44) HPVs following an HPV general primer-mediated
      (GP5+/GP6+) PCR is presented. By computer-assisted sequence analysis,
      oligonucleotides (30-mers) specific for 19 different HPV genotypes were selected
      from the internal part of the 150-bp GP5+/GP6(+)-amplified region. These oligo
      probes were tested for specificity in a Southern blot analysis of PCR products
      derived from the same panel of HPV types. No cross-hybridizations were found. The
      sensitivities of the oligo probes varied from the femtogram level for the well
      amplified HPV types like HPV-16 and -18 to the picogram level for the less-well
      amplified HPV types like HPV-39 and -51. These sensitivities were reached when
      the oligo probes were applied both individually and in a cocktail. On the basis
      of these results, two cocktail oligo probes that enabled a specific and sensitive
      differentiation between low- and high-risk HPV types were composed.

PMID- 7790458
TI  - Simple determination of human immunodeficiency virus type 1 syncytium-inducing V3
      genotype by PCR.
AB  - Human immunodeficiency virus type 1 (HIV-1) phenotype variability plays an
      important role in the pathogenesis of AIDS. The presence of syncytium-inducing
      (SI) HIV-1 isolates in infected individuals is associated with a rapid decline of
      CD4+ T cells, rapid disease progression, and reduced survival time after AIDS
      diagnosis. The strong association between the SI capacity of HIV-1 and the
      presence of positively charged amino acid residues at positions 306 and/or 320 in
      the third variable domain (V3) of gp120 could here be confirmed in 97% of 402
      primary HIV-1 isolates, indicating that the V3 genotype may be useful for
      prediction of the viral phenotype. The V3 DNA sequences revealed a remarkably
      limited codon usage for the amino acid residues that are responsible for virus
      phenotype. On the basis of this limited SI-specific DNA sequence variation, four
      SI-specific oligonucleotides were designed for selective amplification of V3 from
      SI but not non-SI HIV-1 isolates. This PCR analysis allowed the prediction of the
      biological phenotype of HIV-1 isolates on the basis of the V3 genotype and may
      prove to be useful for monitoring SI capacity of HIV-1 isolates in infected
      individuals.

PMID- 7790459
TI  - Epidemiological typing of Stenotrophomonas (Xanthomonas) maltophilia by PCR.
AB  - We used two PCR methods for epidemiological typing of Stenotrophomonas
      (Xanthomonas) maltophilia with either arbitrary primers (random amplified
      polymorphic DNA) or enterobacterial repetitive intergenic consensus sequences as
      primers (ERIC-PCR). The analysis was performed with 38 isolates of S.
      maltophilia, comprising 9 nosocomial isolates from a burn unit, 20 other clinical
      isolates epidemiologically unrelated, and 9 isolates from one cystic fibrosis
      patient. Both methods indicated that all of the nosocomial episodes were
      independent. In contrast, the nine isolates from the cystic fibrosis patient were
      assigned to very closely related profiles, especially by ERIC-PCR. We conclude
      that random amplified polymorphic DNA and ERIC-PCR have comparable reproducible
      and discriminatory powers for epidemiological typing of S. maltophilia, but ERIC
      PCR profiles can be more easily evaluated.

PMID- 7790460
TI  - Use of a colorimetric system for yeast susceptibility testing.
AB  - We examined the reliability and accuracy of a colorimetric assay using Alamar
      Blue reagent in the performance of susceptibility tests for Candida albicans. We
      compared the broth macrodilution method recommended by the National Committee for
      Clinical Laboratory Standards (NCCLS) with a macrodilution method modified with
      the Alamar reagent and a microdilution method modified with the Alamar reagent.
      The MICs of fluconazole and itraconazole for 97 isolates of C. albicans and 3
      control isolates were tested. For fluconazole, the Alamar-modified broth
      macrodilution method yielded 94% (91 of 97) concordance within 2 dilutions
      compared with the NCCLS method, while the microdilution method yielded 95% (92 of
      97) concordance. With Alamar-modified methods for itraconazole, broth
      macrodilution yielded 97% (94 of 97) concordance within 2 dilutions. MICs
      obtained by the microdilution method, although tightly nested, were shifted to a
      higher value when compared with those obtained by the NCCLS method; there was
      only 77% (75 of 97) concordance within 2 dilutions but 97% concordance (94 of 97)
      within 3 dilutions. Tests by all methods with quality control strains showed
      excellent reproducibilities. For fluconazole, the methods modified with the
      Alamar reagent yielded clear endpoints and excellent correlation for the broth
      macrodilution and microdilution methods. For itraconazole, the methods modified
      with the Alamar reagent yielded clear endpoints and were reproducible, but higher
      MICs were obtained by the microdilution methods compared with those obtained by
      the NCCLS methods.

PMID- 7790462
TI  - Production of elastase, exotoxin A, and alkaline protease in sputa during
      pulmonary exacerbation of cystic fibrosis in patients chronically infected by
      Pseudomonas aeruginosa.
AB  - Secretion of Pseudomonas aeruginosa elastase, exotoxin A, and alkaline protease
      in sputum during bronchopulmonary exacerbations was examined in 18 cystic
      fibrosis patients chronically infected with this microorganism. The patients were
      studied during one or several exacerbation periods necessitating hospitalizations
      of 12 to 20 days. In all cases, P. aeruginosa was present in bronchial secretions
      at admission and was not eradicated after treatment. The P. aeruginosa density
      decreased significantly after antibiotic therapy but remained greater than 10(6)
      CFU/g of sputum in most cases. Significant amounts of P. aeruginosa exoproteins
      were measured in total homogenized bronchial secretions by immunoenzymatic
      assays. The detection of higher levels of exoproteins at admission, the
      significant decrease after treatment, and the absence of exoproteins during
      intercrisis phases constituted arguments for a renewal of virulence of P.
      aeruginosa during exacerbations. Nevertheless, the concomitant changes in
      bacteria load and the triggering of the inflammatory process and immune complex
      formation could also contribute to pulmonary exacerbations.

PMID- 7790461
TI  - Long-term colonization with single and multiple strains of Helicobacter pylori
      assessed by DNA fingerprinting.
AB  - The gastric pathogen Helicobacter pylori establishes long-term chronic infections
      that can lead to gastritis, peptic ulcers, and cancer. The species is so diverse
      that distinctly different strains are generally recovered from each patient. To
      better understand the dynamics of long-term carriage, we characterized H. pylori
      isolates from initial and follow-up biopsy specimens from a patient population at
      high risk of H. pylori infection and gastric cancer. Eighty-five isolates were
      obtained from 23 patients and were analyzed by genomic restriction enzyme
      analysis, arbitrarily primed PCR fingerprinting, (random amplified polymorphic
      DNA analysis), and/or restriction of specific PCR-amplified genes (restriction
      fragment length polymorphism analysis). A single strain was found in sequential
      biopsy specimens from 12 of 15 patients (80%) receiving sucralfate. In the
      remaining three patients treated with sucralfate, two strains were identified in
      two patients and three strains were identified in the third patient. In contrast,
      a single strain was found in sequential biopsy specimens from only three of eight
      patients (37%) receiving bismuth, metronidazole, and nitrofurantoin. Two strains
      were identified in five other patients receiving bismuth-antibiotic (63%).
      Immunoglobulin G antibodies to H. pylori were present in the sera of all
      patients. Thus, H. pylori colonization can persist for long periods (up to at
      least 4 years), despite high titers of immunoglobulin G antibodies in serum.
      Resistance to metronidazole was noted in some strains before and/or after
      treatment, but all strains remained susceptible to amoxicillin, tetracycline, and
      nitrofurantoin. We conclude that H. pylori genotypes, as measured by several
      sensitive DNA fingerprinting methods, can remain stable for years in vivo,
      despite the acquisition or loss of drug resistance, circulating antibody, or
      exposure to antibiotics or sucralfate.

PMID- 7790464
TI  - Parasitic culture of buffy coat for diagnosis of visceral leishmaniasis in human
      immunodeficiency virus-infected patients.
AB  - Two samples of buffy coat from the peripheral blood of 25 human immunodeficiency
      virus-positive patients with proven visceral leishmaniasis, as determined with a
      bone marrow aspirate (stain and culture), were cultured onto Schneider's and Novy
      McNeal-Nicolle media. Hemoculture positivity was 67%. The average growing time
      was 10 days. This is an easy, noninvasive, and sensitive technique.

PMID- 7790463
TI  - In vitro culture and serologic and molecular identification of Septata
      intestinalis isolated from urine of a patient with AIDS.
AB  - Microsporidian spores were identified, on the basis of Weber's staining, in
      urine, stool, nasal, and saliva samples of an AIDS patient with diarrhea,
      hematuria, dysuria, and dementia. Urine and stool samples contained numerous
      spores, whereas few spores were seen in the nasal and saliva samples. Spores were
      concentrated from urine samples and inoculated into monkey kidney cell (E6)
      monolayers. After 6 to 8 weeks of culture, infected E6 cells filled with spores
      as well as spores free in the culture supernatants were seen daily. Transmission
      electron microscopy revealed that all stages of the parasite (CDC:V297) developed
      within septated, honeycomb-shaped parasitophorous vacuoles. Indirect
      immunofluorescence and immunoblotting studies using rabbit anti-Encephalitozoon
      cuniculi, anti-Encephalitozoon hellem, and anti-CDC:V297 sera revealed that
      CDC:V297 reacted intensely with the homologous serum but minimally with the
      heterologous sera. DNA isolated from CDC:V297, when PCR amplified with E. hellem
      and E. cuniculi primers, did not produce the diagnostic bands of approximately
      547 and approximately 549 bp characteristic of E. hellem and E. cuniculi,
      respectively. On the basis of these studies, we concluded that CDC:V297 fits the
      description of Septata intestinalis (A. Cali, D. P. Kotler, and J. M. Orenstein,
      J. Eukaryot, Microbiol. 40:101-112, 1993).

PMID- 7790465
TI  - Comparison of commercially available enzyme immunoassay with traditional
      serological tests for detection of antibodies to Coccidioides immitis.
AB  - A newly released commercially available enzyme-linked immunosorbent assay (ELISA)
      was evaluated for its ability to detect immunoglobulin M (IgM) and IgG antibodies
      against the tube precipitin and complement fixation (CF) antigens of Coccidioides
      immitis. The ELISA was compared with more traditional diagnostic assays, CF,
      latex agglutination (LA), and immunodiffusion (ID). When the IgM-specific portion
      of the ELISA was compared with LA, there was an agreement of 81.8%, a specificity
      of 75.0%, and a sensitivity of 84.6%. For the determination of the presence of
      IgG antibodies, the results of the IgG-specific part of the ELISA were compared
      with the combined results of ID and CF. After resolution of discrepant results,
      there was an agreement of 95.6%, a specificity of 98.3%, and a sensitivity of
      92.6%. When the results of the IgG- and IgM-specific portions of the ELISA
      combined were compared with the results of the three traditional assays (CF, LA,
      and ID) there was an agreement of 96.7%, a specificity of 98.5%, and a
      sensitivity of 94.8%. The ELISA proved to be a reliable assay for the detection
      of antibodies against the tube precipitin and CF antigens and did not suffer from
      the objectivity required to interpret the results of the traditional assays and
      anticomplement interference associated with the traditional assays.

PMID- 7790466
TI  - PCR typing of field isolates of Plasmodium falciparum.
AB  - We report on an analysis of the constraints of PCR typing of field Plasmodium
      falciparum isolates by using a few highly polymorphic markers, MSA-1, MSA-2,
      TRAP, and CS. We show that the reactions are specific for the P. falciparum
      species. The detection threshold (minimum number of parasites required to detect
      a visible band by ethidium bromide) differed from one marker to the other and,
      within one locus, from one primer combination to the other. Importantly, the
      various MSA-1 and MSA-2 reference alleles were amplified with the same
      efficiency. Amplification from reconstituted allele mixtures indicated that at
      certain allele ratios, the most abundant allele interfered with the amplification
      of the less abundant one. An analysis of nine isolates collected from patients
      with acute malaria in Dielmo, Senegal, during a transmission season when the
      inoculation rate was one infective bite every second night is presented and
      discussed. All samples contained more than one parasite type. A significant
      polymorphism was observed for the four markers. Novel TaqI restriction fragment
      length polymorphisms were found for the TRAP gene, and TRAP gene typing alone
      allowed a distinction between the various isolates. MSA-1 and MSA-2 gave multiple
      band patterns specific for each sample.

PMID- 7790467
TI  - Identification and characterization of outer membrane proteins of Pasteurella
      multocida serotype D by using monoclonal antibodies.
AB  - Monoclonal antibodies (MAbs) against Pasteurella multocida serotype D were
      obtained by fusion of spleen cells from BALB/c mice immunized with outer membrane
      proteins (OMPs) with SP2/0-Ag 14 murine myeloma cells. Desirable MAbs were
      selected by enzyme-linked immunosorbent assay (ELISA) with OMP as the antigen.
      MAbs MT1 and MT2 identified two different proteins (H [heavy] and W [weak]), each
      with a molecular mass of 32 kDa, in Western blots (immunoblots). Treatment of the
      OMPs with proteolytic enzymes and sodium periodate indicated that the binding
      sites of MAbs MT1 and MT2 are of protein and glycoprotein natures, respectively.
      The epitopes reactive with MAbs were surface exposed, as visualized by
      immunoelectron microscopy. Among field isolates of P. multocida serotype D, two
      distinct OMP patterns were recognized by sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis, and these patterns were designated types I and II. In both
      the ELISA and the Western blot, MAb MT1 recognized only type I isolates, whereas
      MAb MT2 recognized both type I and II isolates. Neither MAb MT1 nor MAb MT2
      reacted with either reference strains of capsular serotypes A, B, E, and F or
      field isolates of capsular serotype A of P. multocida. This is the first report
      of MAbs identifying the serotype D-specific OMP of P. multocida.

PMID- 7790468
TI  - Effect of ambient temperature on competence of deer ticks as hosts for Lyme
      disease spirochetes.
AB  - We determined whether the temperature of extrinsic incubation affects the
      competence of vector ticks as hosts for Lyme disease spirochetes (Borrelia
      burgdorferi). Larval Ixodes dammini ticks that had engorged on spirochete
      infected C3H mice were incubated continuously at various temperatures, and the
      gut contents of the resulting nymphs were examined for spirochetes by direct
      immunofluorescence microscopy. Spirochetes were present in virtually all nymphs
      kept at 27 degrees C or less for 6 months, in only 10% of those kept at 33
      degrees C, and in none kept at 37 degrees C. Spirochetes became undetectable
      within 8 weeks when nymphs were warmed from 27 to 33 degrees C beginning at the
      time of molting. Nymphs became virtually noninfective for mice after incubation
      at temperatures higher than 27 degrees C for 2 weeks or longer. We conclude that
      ambient temperatures in excess of 27 degrees C are not permissive for
      transmission of the agent of Lyme disease.

PMID- 7790469
TI  - Microtitration plate enzyme immunoassay to detect PCR-amplified DNA from Candida
      species in blood.
AB  - We developed a microtitration plate enzyme immunoassay to detect PCR-amplified
      DNA from Candida species. Nucleotide sequences derived from the internal
      transcribed spacer (ITS) region of fungal rDNA were used to develop species
      specific oligonucleotide probes for Candida albicans, C. tropicalis, C.
      parapsilosis, and C. krusei. No cross-hybridization was detected with any other
      fungal, bacterial, or human DNAs tested. In contrast, a C. (Torulopsis) glabrata
      probe cross-reacted with Saccharomyces cerevisiae DNA but with no other DNAs
      tested. Genomic DNA purified from C. albicans blastoconidia suspended in blood
      was amplified by PCR with fungus-specific universal primers ITS3 and ITS4. With
      the C. albicans-specific probe labeled with digoxigenin, a biotinylated capture
      probe, and streptavidin-coated microtitration plates, amplified DNA from a few as
      two C. albicans cells per 0.2 ml of blood could be detected by enzyme
      immunoassay.

PMID- 7790471
TI  - Controlled evaluation of BacT/Alert standard aerobic and FAN aerobic blood
      culture bottles for detection of bacteremia and fungemia.
AB  - A new medium, FAN, designed to enhance the recovery of microorganisms, has been
      developed for the BacT/Alert blood culture system (Organon Teknika Corp., Durham,
      N.C.). We compared the yield and speed of detection of microorganisms in 6,847
      adequately filled paired aerobic standard and FAN bottles at four university
      hospitals. Of 499 clinically significant microorganisms isolated from one or both
      bottles, significantly more Staphylococcus aureus isolates (P < 0.001), coagulase
      negative staphylococci (P < 0.001), yeasts (P < 0.01), and all microorganisms
      combined (P < 0.001) were recovered from the FAN bottles. Overall, the speeds of
      detection of positive cultures did not differ between the two medium
      formulations; mean times to detection in the standard and FAN bottles were 16.1
      and 16.0 h, respectively. When a subset of patients on antimicrobial therapy was
      evaluated, significantly enhanced yield from the FAN bottle was evident for
      staphylococci. Overall, the FAN bottle outperformed the standard aerobic
      BacT/Alert bottle.

PMID- 7790470
TI  - Controlled study of Escherichia coli diarrheal infections in Bangladeshi
      children.
AB  - Diarrheal diseases are highly prevalent in Bangladesh. However, the relative
      contribution of diarrheagenic Escherichia coli organisms--those that are
      enterotoxigenic (ETEC), enteropathogenic (EPEC), enteroinvasive,
      enterohemorrhagic, enteroaggregative, and diffuse adherent--to diarrhea in
      Bangladeshi populations is not known. With DNA probes specific for these
      diarrheagenic E. coli strains, we analyzed fecal E. coli from 451 children up to
      5 years of age with acute diarrhea seeking treatment at a Dhaka hospital and from
      602 matched control children without diarrhea from July 1991 to May 1992.
      Enteroinvasive E. coli was not isolated from any children; enterohemorrhagic E.
      coli was not isolated from any diarrheal children but was isolated from five
      control children; enteroaggregative and diffuse adherent E. coli strains were
      isolated with similar frequencies from children with and without diarrhea,
      thereby showing no association with diarrhea; ETEC was significantly associated
      with diarrhea in the diarrheal children as a whole and especially in the age
      groups of 0 to 24 months and 37 to 48 months (further analysis suggests an
      association with diarrhea for the heat-stable toxin only and for both heat-labile
      and heat-stable-toxin-producing ETEC only); and EPEC was significantly
      associated with diarrhea in the diarrhea group as a whole and particularly in
      infants up to 1 year of age. Further analysis suggested that EPEC strains of only
      the traditional serogroups were significantly associated with diarrhea. ETEC and
      EPEC infections peaked during warm months. Our data thus suggest that EPEC and
      ETEC are important causes of acute diarrhea in children in this setting.

PMID- 7790472
TI  - Specific antibody detection in invasive aspergillosis by analytical
      isoelectrofocusing and immunoblotting methods.
AB  - Aspergillus fumigatus antigens have been tested to determine their potential as
      aids in the diagnosis of invasive aspergillosis (IA). Immunoglobulin G (IgG)
      antibodies to these antigens were detected by analytical isoelectrofocusing in
      conjunction with immunoblotting. A total of 12 antigenic fractions, including
      culture filtrates and surface and mycelial extracts of A. fumigatus, were
      investigated. Eleven were reactive with serum specimens from patients with
      aspergilloma, which served as positive controls for the evaluation of a specific
      IgG response. Eight of 12 antigens showed good responses with serum specimens
      from patients with allergic bronchopulmonary aspergillosis, which were used to
      assess the sensitivity of IgG detection. No measurable reactivity was detected in
      18 negative control serum specimens, while 11 of 13 patients with proven, highly
      probable, or probable cases of IA had anti-Aspergillus IgG to multiple antigenic
      preparations. Patients with IA who were capable of mounting a substantial humoral
      response to Aspergillus antigens gave an antibody profile with five antigenic
      preparations which seemed to be characteristic of the disease. Data show that
      this method is highly sensitive and may allow the selection of fractions which
      are both highly antigenic and specific for the detection of antibodies to
      Aspergillus antigens. They also indicate that the use of a spectrum of antigenic
      molecules is advisable, given the variability observed in the immune responses of
      individual patients.

PMID- 7790473
TI  - Analysis of Salmonella enteritidis isolates by arbitrarily primed PCR.
AB  - An arbitrarily primed PCR (AP-PCR) was developed to analyze the genomic DNAs of
      Salmonella enteritidis isolates from human outbreaks and from avian sources. The
      AP-PCR generated seven distinct randomly amplified DNA patterns among the S.
      enteritidis isolates studied. Differences in the DNA patterns among isolates of
      S. enteritidis phage types 13a and 8 as well as among S. enteritidis phage type
      14b were observed. The AP-PCR analysis can be used to determine the differences
      among isolates within the same phage types and may be useful for tracing back the
      source of S. enteritidis outbreaks in humans more precisely.

PMID- 7790475
TI  - Oxygen as limiting nutrient for growth of Cryptococcus neoformans.
AB  - In microbroth cultures with RPMI 1640 medium, the growth yield of seven
      Cryptococcus neoformans isolates was unaffected by augmentation of the normal
      (0.2%) glucose concentration in the medium to 2%, and the addition of other
      potential carbon, nitrogen, and vitamin sources to the medium also failed to
      produce large changes in growth yield. However, macrobroth cultures of C.
      neoformans in RPMI 1640 that were agitated by rotation in air gave turbidities 6
      to 37 times greater than those in identical cultures incubated statically, and
      similar levels of increase were seen whether the medium contained 0.2 or 2%
      glucose. Incubation of microplates under an oxygen atmosphere or with agitation
      by rotation led to an increase of up to twofold in growth turbidity of the yeast.
      The maximum increase was achieved by incubation with rotation and was dependent
      on the brand of microplate used. The findings implicate oxygen as a growth
      limiting nutrient for C. neoformans. Incubation of microbroth cultures under
      conditions that enhance oxygen availability for antifungal susceptibility testing
      purposes may increase the speed of such tests and enhance the determination of
      MIC endpoints.

PMID- 7790476
TI  - Case report of and description of parasite in Mammomonogamus laryngeus (human
      syngamosis) infection.
AB  - About 100 cases of human infections with Mammomonogamus laryngeus (Syngamidae,
      Syngaminae) have been reported, with virtually all cases originating in the
      Caribbean Islands and Brazil. This report describes the fifth patient in North
      America infected with M. laryngeus and the first case documented to originate in
      Jamaica. The patient complained of a characteristic persistent nonproductive
      cough and a lump in her throat. M. laryngeus is a nematode in which the male and
      female are permanently joined in copula, producing a distinctive Y shape. Since
      there is scant clinical information about this parasite, this report includes a
      description of the adult worms and eggs, a summary of the epidemiology, and the
      clinical manifestations in humans. Illustrations are presented to facilitate
      future identification of this parasite and to expedite treatment.

PMID- 7790474
TI  - Characterization of the bovine group A rotavirus strain neonatal calf diarrhea
      virus-Cody (NCDV-Cody).
AB  - The neonatal calf diarrhea virus-Cody (NCDV-Cody) strain was found to contain a
      mixture of rotaviruses with G6 and G8 VP7 genes. Challenge exposure of calves
      with the mixed virus inoculum indicated that both viruses were maintained by
      passage in vivo. This is the first P1:G8 rotavirus to be characterized in cattle
      in the United States.

PMID- 7790477
TI  - Management of patellar instability.

PMID- 7790478
TI  - Operative realignment of patellar malalignment in children.
AB  - Realignment operations were performed on 57 knees to correct patellar
      malalignment in children between 1985 and 1991. Three different operative
      techniques were used: the lateral release, the lateral release and medial
      reefment, and the Roux-Goldthwait patellar tendon transposition. Roentgenographic
      values were measured before and after the operation by Laurin's method. The mean
      follow-up time was 4 years 2 months, after which 20 knees were excellent, 20
      good, 11 fair, and six poor, according to Insall's criteria. The effect of the
      operation on pathological roentgenographic values was obvious, and the
      malalignment of the patella was in most cases corrected. There are differences in
      the improvement effected by these three techniques. The lateral release and
      medial reefment correct the patellar tilt most effectively, and the Roux
      Goldthwait operation, the lateral patellar deviation. The lateral release seems
      to be the appropriate technique for mild malalignment.

PMID- 7790479
TI  - Reconstruction of mid-substance anterior cruciate rupture in adolescents with
      open physes.
AB  - Five cases of anterior cruciate ligament reconstruction, performed for
      symptomatic episodes of giving way or during surgery for associated injury, were
      carried out in preepiphyseal closure adolescents (ages 12-15 years), utilising a
      strip of iliotibial band placed over the top of the lateral femoral condyle in a
      MacIntosh type repair, and avoiding drilling through epiphyseal plates. At a mean
      follow-up of 4.4 years, all five were symptomatically satisfactory and all five
      patients had returned to their preinjury level of sports activity. Although
      objective assessment revealed that increased laxity, when compared to the normal
      leg anterior laxity measured by the KT-1000, was within normal limits in four of
      five patients. Only one patient, who had had a fracture of the contralateral
      femur, had any leg length discrepancy.

PMID- 7790480
TI  - Periarticular fractures after manipulation for knee contractures in children.
AB  - We report two cases, each of which sustained two separate periarticular fractures
      from overzealous manipulation for knee contracture. The four fractures reported
      in this study involve one normal child sustaining asynchronous ipsilateral distal
      femoral and proximal tibial fractures and a child with the diagnosis of
      amyoplasia sustaining bilateral proximal tibial fractures. The child with knee
      contracture must be treated carefully and not exposed to overzealous
      physiotherapy or manipulation. The child who has developed a joint contracture
      secondary to lengthy immobilization may be at increased risk for periarticular
      fracture secondary to disuse osteopenia. The knee joint is at particular risk
      because of the long lever arm of the leg. These concerns should be conveyed to
      anyone involved in the patient's care, including the parents, therapists, nurses,
      and physicians. Passive range of motion in the child should never be painful.
      Normal children often can obtain maximal range of motion if left alone and not
      restricted.

PMID- 7790481
TI  - Tibial tuberosity excision for symptomatic Osgood-Schlatter disease.
AB  - A modified Ferciot procedure was used to excise the tibial tubercle in patients
      with persistently symptomatic Osgood-Schlatter disease. Forty-two knees in 35
      patients were reviewed at a mean follow-up of 5 years to assess outcome. The
      results revealed relief of pain in 95% of patients and reduction of prominence in
      85.5% with minimal complication, in particular no evidence of genu recurvatum.
      The pathogenesis of the condition is outlined, and some of the theories and
      treatment modalities discussed. Tibial tubercle excision is recommended as the
      treatment of choice in those few cases that fail with conservative treatment.

PMID- 7790482
TI  - Determination of skeletal age in children with Osgood-Schlatter disease by using
      radiographs of the knee.
AB  - We determined the skeletal age in 26 children (12 girls, 14 boys) with Osgood
      Schlatter disease using knee radiographs. The average chronological age was 13.2
      +/- 2.2 years, and the average bone age was 13.1 +/- 2.3 years (p > 0.01). All
      but one of the skeletal ages fell within the normal range. Skeletal maturation in
      children with Osgood-Schlatter disease is thus normal. With normal skeletal
      maturation and normal physes histologically (previously shown), it is unlikely
      that an abnormality of physeal development or structure is the etiology of Osgood
      Schlatter disease. Rather, it is most likely a result of tensile stresses on the
      tibial tuberosity. This is in contrast to slipped capital femoral epiphysis,
      another common disorder affecting children of the same ages as those with Osgood
      Schlatter disease, in which physeal abnormalities and skeletal maturation
      anomalies do occur.

PMID- 7790483
TI  - Bipolar infrapatellar tendon rupture.
AB  - Traumatic patella alta in children occurs either distal to the patellar tendon as
      a tibial tubercle apophyseal fracture or proximally as an osteochondral sleeve
      fracture of the inferior patellar pole. Acute surgical exploration in a pediatric
      case of a knee extensor mechanism rupture revealed both proximal and distal
      (bipolar) patellar tendon pathology.

PMID- 7790484
TI  - MRI of focal fibrocartilaginous dysplasia.
AB  - Focal fibrocartilaginous dysplasia (FFCD) is an uncommon, benign condition
      associated with unilateral tibia vara in young children. The clinical,
      pathologic, plain film, and magnetic resonance imaging (MRI) findings of FFCD
      were reviewed in two children. MRI findings were virtually identical in both
      patients and correlated well with the plain film and pathologic findings. We
      believe that FFCD has a typical MRI appearance. However, FFCD also has
      characteristic plain film findings, and when these are present, MRI is indicated
      for only an atypical clinical presentation.

PMID- 7790486
TI  - Osteochondritis dissecans of the femoral head in children and adolescents: a
      report of 17 cases.
AB  - Osteochondritis dissecans of the femoral capital epiphysis is uncommon and is
      usually reported as a case report or in association with other diseases. This
      study reports 17 cases with the primary underlying diagnosis of Legg-Calve
      Perthes disease in seven, idiopathic in six, avascular necrosis following trauma
      in three, and avascular necrosis with previous infection in one. Twelve cases had
      long-term follow-up. Two cases in which no surgery was performed were followed
      for an average of 12.5 years; 10 cases in which surgery was performed were
      followed for an average of 16.1 years. Excision of the osteochondritis fragment
      was performed in six cases. It was necessary only to dislocate the hip to excise
      the lesion in five cases. No morbidity resulted from temporary surgical
      dislocation. Excision of the osteochondritis dissecans fragment allowed these six
      patients to return to fairly normal living during the time of follow-up.

PMID- 7790487
TI  - Diagnostic and therapeutic arthroscopy of the hip in children and adolescents:
      evaluation of results.
AB  - Twenty-four arthroscopies of the hip performed at the Alfred I. duPont Institute,
      Wilmington, Delaware, in 21 patients between 1981 and 1991 were retrospectively
      studied. The average age of patients at the time of arthroscopy was 16 years
      (range, 11-21 years). The arthroscopies were diagnostic if the procedure was
      performed to visualize the hip or to perform a synovial biopsy and therapeutic if
      the procedure was performed to treat a suspected intra-articular abnormality.
      There were eight diagnostic arthroscopies and 16 therapeutic arthroscopies. The
      arthroscopy correlated with the presumptive causes of symptoms in 13 hips (54%)
      and failed to correlate in 11 hips (46%). Two patients had complications of
      transient pudendal nerve dysesthesia with full recovery. There were no infections
      or residual hip stiffness. A diagnostic arthroscopy is not helpful as a
      confirming diagnostic procedure. Arthroscopy of the hip is helpful in obtaining
      synovial biopsies and allows loose body removal, thus obviating the need for open
      surgery and intraoperative dislocation of the hip.

PMID- 7790485
TI  - Complications in proximal tibial osteotomies in children with presentation of
      technique.
AB  - Proximal tibial osteotomies in children have been associated with a number of
      complications, including peroneal nerve palsies, compartment syndromes, deep and
      superficial infections, vascular injuries, iatrogenic fractures, apophyseal or
      growth plate damage, and recurrence of deformity. A retrospective review of the
      results of 22 children who had 30 primary and seven repeat proximal tibial
      osteotomies was performed to assess the frequency of complications at our
      institution. Using a specified technique that included prophylactic anterior
      compartment fasciotomy and distal fibulectomy, there were three superficial wound
      infections and one delayed union but no peroneal nerve palsies, vascular
      injuries, compartment syndromes, or fixation failures. There were no sequelae
      from the superficial infections. This is a lower rate of complications than
      previously reported in the literature and suggests a relationship to our current
      surgical technique and attention to detail. We believe that proximal tibial
      osteotomies can be performed successfully and safely in children when the surgeon
      recognizes the potential problems and takes steps to prevent them.

PMID- 7790488
TI  - Neonatal hip instability: screening with anterior-dynamic ultrasound method.
AB  - The anterior-dynamic ultrasound method was used for screening 4,430 children for
      hip dislocation. The frequency of treatment for unstable hip joints was reduced
      to 0.18%, having been 1.7% without ultrasound screening. No cases of late
      diagnosed dislocation were registered. The sensitivity of the pediatricians'
      clinical examination screening was low, only 24%. After intensive training over
      several years and improved clinical examination methods, our five technicians
      managed to increase the sensitivity to 53%. With clinical examination methods,
      cases of totally dislocated hips can be difficult to diagnose, and only two of
      four such hips were clinically diagnosed; the proportion of false-positive cases,
      0.7%, was also considerable. The anterior-dynamic ultrasound method could
      optimize the screening results of many clinics.

PMID- 7790491
TI  - Coxa magna after open reduction for developmental dislocation of the hip.
AB  - We studied coxa magna after open reduction of developmental hip dislocation,
      including the etiology, incidence, and influence on the long-term results and
      acetabular development. Forty-seven hips in 47 patients were radiographically
      examined for at least 10 years, and another 20 hips in 20 patients were examined
      arthrographically at an early stage after open reduction. At follow-up, the
      incidence of coxa magna, which was defined as a femoral head with a size > or =
      20% greater than the opposite side, was 34.0%, and that seemed to be one of
      factors that worsened the long-term results. One of the most important causes of
      coxa magna is to overwiden the acetabular capacity by excising the limbus;
      another cause is the surgical invasion and synovitis of the hip joint after
      operation.

PMID- 7790490
TI  - One-stage treatment of congenital dislocation of the hip in older children.
AB  - We reviewed the results of a primary one-stage combined operation in 47 patients
      (55 hips) who were > or = 4 years and had congenital dislocation of the hip. At a
      mean follow-up of 7.5 years (2-16 years), 67% of the whole series had good or
      excellent clinical results, and 65% were good or excellent radiologically.
      Avascular necrosis occurred in four patients, and redislocation also occurred in
      four patients. We concluded that most of the children who are > or = 4 years and
      who have congenital dislocation of the hip can successfully be treated with an
      extensive one-stage operation consisting of open reduction combined with
      innominate osteotomy and femoral varus, derotation, and shortening osteotomy.

PMID- 7790489
TI  - Ultrasonography and developmental dysplasia of the hip: a cost-benefit analysis
      of three delivery systems.
AB  - The role of ultrasound (US) in the diagnosis and management of infants with
      developmental dysplasia of the hips (DDH) is becoming widely accepted. In our
      community, there exist three delivery systems for US-DDH: the radiology based,
      the combined radiology/orthopaedic based, and the orthopaedic office based. This
      study reviewed the costs and benefits of each delivery system and found that once
      expertise had been gained and start-up costs were met, the orthopaedic office
      based system was the most convenient, efficient, and cost effective for the
      patient/family and treating physicians. This mirrors the experience of
      cardiologists, obstetricians, and family practitioners, fields in which the
      utility of office-based ultrasonography is widely recognized and has become the
      standard.

PMID- 7790492
TI  - Pelvic remodeling after Salter osteotomy.
AB  - Salter innominate osteotomy is a widely used operative procedure to redirect the
      acetabulum in cases of acetabular dysplasia. The effectiveness of this
      redirection is indicated by the change in the appearance of the obturator foramen
      after the procedure. This is usually accompanied by an increase in the center
      edge (CE) angle with an effective decrease in the forces transmitted across the
      hip joint. In a prospective study of 20 Salter innominate osteotomies performed
      on two different age groups, one mature and one immature, we studied the change
      in the deformity of the obturator foramen with time after this procedure. In the
      immature pelvis, the asymmetric appearance of the obturator foramen remodeled
      gradually during the 6 months after the procedure. However, in the mature
      patient, no such remodeling potential was demonstrable during the study period.
      This finding has clinical implications regarding the advice for performing Salter
      innominate osteotomies in mature and immature patients.

PMID- 7790493
TI  - Distal transfer of the greater trochanter revisited: long-term follow-up of nine
      hips.
AB  - Seven female patients (nine hip joints) with avascular necrosis and functional
      coxa vara secondary to developmental dysplasia of the hip joint (DDH) were
      treated by distal transfer of the greater trochanter (DTT). A 5-year follow-up
      showed good results in 89% of the hip joints. We reviewed the patients again 12
      years later using the Mayo Clinic hip score. Improvement of gait was maintained
      in the majority of the patients (71%), but the hip score was low in 67% of the
      patients because of the development of osteoarthritis. Two patients underwent a
      total hip arthroplasty, and a third is awaiting this operation. Distal transfer
      of the trochanter is beneficial in improvement of gait but may enhance the
      development of osteoarthritis.

PMID- 7790494
TI  - Slipped capital femoral epiphysis associated with endocrine disorders.
AB  - We reviewed 85 patients with endocrine disorders and slipped capital femoral
      epiphysis (SCFE). The disorders were hypothyroidism (40%), growth hormone
      deficiency (25%), and others (35%). The average age at diagnosis of the disorder
      was 13.2 +/- 6.2 years and 15.3 +/- 5.3 years at diagnosis of the first SCFE. In
      53 hips, the bone and chronologic age were both known: 11.6 +/- 3.0 years bone
      age, 16.5 +/- 6.5 years chronologic age, p < 0.01. The age at presentation of the
      first SCFE ranged from 7-35 years; only those with hypothyroidism or growth
      hormone deficiency were < 10 years of age; all patients with other
      endocrinopathies, when seen first with an SCFE at an atypical age, were > 16
      years. The hypothyroid patients usually had the endocrine diagnosis made at
      presentation of the first SCFE; the growth hormone-deficient children usually had
      the endocrine diagnosis made before that of the SCFE (p < 0.01). None of those in
      whom the diagnosis of the endocrine disorder occurred after the diagnosis of the
      SCFE was hypothyroid or growth hormone deficient. All hypothyroid patients
      developed the first SCFE before or during hormonal supplementation; 92% with
      growth hormone deficiency developed the SCFE during or after supplementation (p <
      0.01). Because the prevalence of bilaterality was 61% (p < 0.01), prophylactic
      treatment of the opposite hip should be considered.

PMID- 7790495
TI  - Epiphyseal growth after pinning of slipped capital femoral epiphysis.
AB  - Seventy-seven hips in 61 patients (mean age, 13 years) with slipped capital
      femoral epiphysis treated with in situ pinning were retrospectively evaluated to
      determine the frequency and magnitude of epiphyseal growth after pinning.
      Threaded Steinmann pins, Knowles pins, and cannulated screws were used. Evidence
      of the epiphysis "growing off" the pins was seen in 29 and 18% of the hips
      treated with Steinmann and Knowles pins, respectively. No hips with cannulated
      screws continued to grow after surgery. The use of one cannulated screw in the
      treatment of mild and moderate slipped capital femoral epiphysis is recommended.

PMID- 7790496
TI  - Legg-Calve-Perthes disease in the evolutionary period: comparison of magnetic
      resonance imaging with bone scintigraphy.
AB  - Magnetic resonance images (MRIs) and pinhole scintigraphs were obtained in 40
      patients (40 hips) with Legg-Calve-Perthes disease in the evolutionary phase, the
      mean age at onset of symptoms being 6 years 7 months. The correlation between the
      uptake of the pinhole scintigraphs and the signal intensity of MRIs was examined
      in reference to the extent of the involved femoral epiphysis. MRIs depicted the
      extent of the involved femoral epiphysis more clearly than did pinhole
      scintigraphs. The uptakes of the pinhole scintigraphs corresponded with high or
      normal intensity of T2-weighted images on MRI. The femoral epiphysis in the
      initial phase (in which the signal intensity of the lateral area of the epiphysis
      on T1-weighted coronal images was low or intermediate and high or unchanged on T2
      weighted coronal images corresponded to the lateral column [recanalization] on
      the pinhole scintigraphs) suggested a low risk of subsequent deformity. MRI is a
      powerful new technique to evaluate the femoral epiphysis in Legg-Calve-Perthes
      disease.

PMID- 7790497
TI  - Late hip subluxation in spastic diplegia associated with unrecognized
      hydrocephalus.
AB  - Problematic hip subluxation is uncommon in spastic diplegia. We have identified
      three cases of late hip subluxation in teenage children with spastic diplegia
      associated with unrecognized hydrocephalus or ventriculoperitoneal shunt
      dysfunction. Each was a community ambulator with radiologically stable hips in
      childhood, but in adolescence underwent a deterioration in ambulatory status
      associated with rapid hip subluxation. Subsequent investigation revealed
      undiagnosed hydrocephalus in one patient and shunt dysfunction requiring revision
      in the other two. Surgery was performed in all three cases to control the hip
      subluxation. The atypical presentation of a progressively unstable hip in an
      ambulatory spastic diplegic patient may indicate the presence of previously
      unrecognized raised intraventricular pressure.

PMID- 7790498
TI  - Chiari pelvic osteotomy in cerebral palsy.
AB  - Hip subluxation and dislocation in patients with cerebral palsy are challenging
      problems. The Chiari pelvic osteotomy has been commonly recommended as a
      technique for hip stabilization when acetabular dysplasia is present. We
      evaluated the results of Chiari osteotomy without concomitant femoral osteotomy
      in 24 hips in 23 patients with an average follow-up of > 7 years. Evaluation
      consisted of a pain and function questionnaire, chart review, physical
      examination, and review of serial radiographs. At final follow-up, 19 of 24 (79%)
      of the hips were painless, and 21 of 24 hips (88%) permitted unlimited sitting.
      Seven of 24 (29%) of hips, however, had a migration index of > or = 30%. Painful
      hips were associated with a greater migration index preoperatively, at 1 year
      postoperatively, and at final follow-up, and a greater height of the osteotomy
      above the edge of the acetabulum. Deterioration in the migration index
      (resubluxation) occurred largely in the first year postoperatively. Alternative
      acetabular procedures, simultaneous femoral osteotomies, or both may improve on
      these results. Long-term follow-up studies are necessary to compare the results
      of different treatments for spastic hip subluxation and dislocation to determine
      optimal treatment.

PMID- 7790499
TI  - Hip pathology in the trichorhinophalangeal syndrome.
AB  - Up to 50% of individuals with trichorhinophalangeal syndrome may have Perthes
      like hip changes. Thirteen hips in nine skeletally immature patients were
      studied. Follow-up averaged 4.7 years. The patients were categorized as juvenile
      (4-8 years) and adolescent (12-14 years) according to their age at presentation.
      The universal severity of involvement, often older age at presentation, and
      disproportionate number developing severe deformity with hinge abduction and pain
      in adolescence distinguished these patients from those with true Perthes'
      disease. Whether the process can be modified significantly to produce a better
      outcome is unclear, but management must be directed at avoiding the development
      of hinge abduction.

PMID- 7790501
TI  - 29th Annual meeting of the Scoliosis Research Society. Portland, Oregon,
      September 21-24, 1994. Abstracts.

PMID- 7790502
TI  - The role of free pericranium grafts in augmentation rhinoplasty.
AB  - Various tissues and materials have been used in augmentation rhinoplasty. This
      paper presents a retrospective analysis of 14 patients, 8 female and 6 male, in
      whom free pericranium grafts were used in order to restore postsurgery or
      posttraumatic nasal defects. There were no complications from either the donor or
      the recipient site. The early and medium term results were satisfactory. It is
      concluded that free pericranium, compared with other autografts, is a good
      alternative due to its several advantages and hardly any disadvantages. In
      selected cases it can even be the material of choice.

PMID- 7790500
TI  - The prevention of skin excoriation under children's hip spica casts using the
      goretex pantaloon.
AB  - The purpose of this study is to determine whether the use of the Goretex
      Pantaloon cast liner for children's spica casts reduces urine excoriation of the
      skin under the cast and reduces the incidence of unplanned cast changes
      necessitated by cast soilage. Between 1988 and 1993, 72 consecutive children who
      had 147 hip spica casts applied were followed. The first 36 patients had 77 spica
      casts applied without the Goretex Pantaloon, and the last 36 patients had 70
      spica casts with a Goretex liner. In the group of patients without Goretex, 22%
      of casts were associated with urine excoriation of the skin compared to 1.4% in
      the group of patients who had a Goretex liner applied. This was statistically
      significant (p = 0.0005). The incidence of unnecessary cast changes due to
      soiling of the cast was 14% in the non-Goretex group compared to 2.9% in the
      Goretex group (p = 0.05). The use of the Goretex liner in our series resulted in
      a savings of $38 per cast including the cost of the liners ($75). The Goretex
      Pantaloon cast liner used for children's spica casts prevents urine excoriation
      of the skin and is cost effective.

PMID- 7790503
TI  - Rhinoplasty with nasal bone disarticulation to deepen the nasofrontal groove.
      Experimental and clinical results.
AB  - Deepening of the nasofrontal groove is considered a fiddly task. The unwonted
      chisel ostectomy technique (Skoog, 1974; McCarthy, 1990; Aiach and Levignac,
      1991) was therefore modified and evaluated both experimentally and clinically.
      The hump is removed in one piece together with the nasal bones up to the
      horizontal part of the frontonasal suture. To accomplish this, the reduction
      osteotomy has to be performed in a wave line fashion. The depth of resection in
      the sellion area depends upon the aesthetic planning. In cases with most severe
      hypertrophy, the osteotome enters the vertical frontonasal suture behind the
      nasal bones and in front of the nasal spine of the frontal bone. The nasal bones
      are disarticulated with a levering movement. Cadaver studies demonstrate the
      safety of the technique: no fracture lines were detected in the frontal process
      of the maxilla, ethmoid, frontal or lacrimal bones, by either clinical
      inspection, or by standardised radiological examination. The clinical cases show
      a convincing outcome.

PMID- 7790504
TI  - Screening bone scintigraphy in the staging of locally advanced head and neck
      cancer.
AB  - A retrospective determination of the yield from screening bone scintigraphy in
      detecting bone metastasis when used for disease staging of 93 asymptomatic
      patients with locally extensive head and neck cancer was undertaken. The bone
      scintigraphy findings were correlated with observations from other radioimaging
      studies done within 1 month of head and neck cancer diagnosis. Bone scintigraphy
      did not reveal a single case of bone metastasis outside the head and neck region.
      On the other hand, 3 cases (8%) of resectable and 2 cases (5%) of non-resectable
      bone metastasis located within the head and neck area were observed among the 40
      patients with abnormal bone scintigraphy. Old rib fracture or degenerative
      disease was responsible for the increased radionuclide uptake in bony areas below
      the clavicle in less than half of the remaining 35 cases. We conclude that the
      routine use of bone scintigraphy for disease staging in asymptomatic patients
      with locally advanced head and neck cancer is not warranted because the positive
      yield is low.

PMID- 7790505
TI  - Submandibular swelling as the first manifestation of giant cell arteritis. Report
      of a case.
AB  - Giant cell arteritis is a systemic disease with a broad range of clinical signs
      and symptoms. Although the most frequently involved vessel is the superficial
      temporal artery, other arteries can be affected. Vasculitic changes in the facial
      artery usually present as jaw claudication. A report of a case of giant cell
      arteritis is presented in which facial artery involvement first manifested itself
      clinically as a submandibular mass. This is a very rare and atypical form of
      clinical presentation.

PMID- 7790506
TI  - Stability testing of a two miniplate fixation technique for mandibular angle
      fractures. An in vitro study.
AB  - In the case of mandibular angle fractures, a two miniplate fixation technique in
      which one plate is applied ventral to the oblique line and a second plate at the
      inferior border of the buccal cortex was used to stabilize the fracture. In this
      paper, the stability of the two miniplate fixation technique was tested in a
      three-dimensional in vitro model. The results of this study showed that in cases
      of angle fractures this fixation technique provides stable fixation under
      functional loading.

PMID- 7790507
TI  - Temporoparietal fascial flap in reconstruction of the cranio-maxillofacial area.

PMID- 7790508
TI  - Life-threatening bleeding following maxillofacial trauma.

PMID- 7790509
TI  - Anterior cranial base reconstruction using a hydroxyapatite-tricalciumphosphate
      composite (Ceratite) as a bone substitute.
AB  - The craniofacial approach to cranial base tumors has widened the operability of
      tumors with intracranial invasion. However, the resulting skull base defect must
      be reconstructed adequately to prevent postoperative morbidity and mortality. We
      use hydroxyapatite-tricalciumphosphate ceramic (Ceratite) as a bone substitute
      material to reconstruct the skull base defect in combination with the pericranial
      flap, ensuring separation between the sinonasal cavity and epidural cavity.
      Although the nasal surface of the Ceratite block is left exposed directly to the
      sinonasal cavity, it was shown to be epithelialized within 6 months
      postoperatively. Our method is less invasive than any other conventional method
      and may offer more chance of curative resection of tumors with anterior skull
      base invasion.

PMID- 7790511
TI  - Diagnostic accuracy of TMJ arthroscopy in correlation to histological findings.
AB  - From 1987-1993, 356 arthroscopic examinations of the temporomandibular joint were
      performed on 295 patients. During 69 examinations, biopsies were obtained to
      correlate arthroscopic findings with histology. In the overall group, histology
      confirmed in 78.9% the arthroscopic findings. Correlation was better in joints
      with degenerative changes (81.5%) than in those with a synovitic/hyperaemic
      appearance (61.5%). Chondroid metaplasia, detritus synovitis and synovial
      chondromatosis were additional diagnoses given by histological examination. In 11
      joints, open arthrotomy was performed after arthroscopy with biopsy was carried
      out. The excised tissue was also investigated microscopically and correlates to
      the biopsy-result. Because no different pathological changes were found, it is
      concluded that biopsies performed during arthroscopy of the temporomandibular
      joint are representative for histological investigation. An additional
      perforation for introducing the biopsy forceps is not necessary, because results
      obtained with different techniques appeared to be equally accurate.

PMID- 7790510
TI  - Lengthening of the hypoplastic mandible by gradual distraction in childhood--a
      preliminary report.
AB  - Uni- or bilateral mandibular hypoplasia can be associated with various syndromes
      or is acquired after early traumatic or inflammatory disease in the
      temporomandibular joint (TMJ). Early treatment is necessary to avoid consequent
      impairment of midfacial growth. The standard treatment of these malformations
      consists of the application of bone grafts which can lead to unpredictable
      growth. Furthermore, these procedures often require intermaxillary fixation and
      sometimes blood transfusions. Lengthening of the mandible by gradual distraction,
      according to the method of Ilizarov, opens new perspectives for interceptive
      therapy. This paper reports on this method applied in 9 cases of mandibular
      hypoplasia. Out of 3 bilateral and 6 unilateral mandibular distractions the
      average amount of bone lengthening was 21 mm, ranging from 15 to 25 mm. In order
      to facilitate ossification, the mandibles were maintained in external fixation
      for an average of 9 weeks subsequent to the period of active lengthening.
      Thereafter, immediate postoperative orthodontic treatment is necessary to avoid a
      relapse. No complications were noted during the follow-up period (max 17 months).

PMID- 7790512
TI  - Correction of post-traumatic orbital deformities: operative techniques and review
      of 26 patients.
AB  - The skeletal reconstruction of post-traumatic orbital deformities includes the
      zygomatic complex, the nasoethmoid area and the internal orbit. Repositioning of
      the malpositioned zygoma is the key element and the first step. Due to
      remodelling processes, most of the landmarks for proper positioning are lost,
      leaving the lateral orbital wall as the only reliable landmark in secondary
      revisions. The details of the skeletal reconstruction are discussed. Between
      January 1988 and December 1992, 31 patients with major post-traumatic orbital
      deformities have been operated on, of which 26 could be followed for a minimum of
      6 months. A total of 61 operative procedures using craniofacial techniques have
      been performed. Complications occurred in 5 (15%) of the 26 patients, the most
      severe being visual loss caused by a displaced bone graft. The most frequent
      deformity was enophthalmos. Most patients presented with more than one deformity.
      The aesthetic results were rated as 'good' in 12, 'satisfactory' in 8 and
      'unsatisfactory' in 6 patients. Of the patients suffering from double vision, 55%
      were improved after orbital reconstruction. Craniofacial techniques allow radical
      correction of post-traumatic skeletal deformities. The functional and aesthetic
      results, however, are limited by the soft tissues.

PMID- 7790513
TI  - Maxillofacial blast injuries.
AB  - Blast injuries cause specific lesions and occur more often than previously,
      because of the wide use of explosives. This is especially the case in wartime.
      More and more people lose their lives every day due to blast injuries. The
      mechanism of the injury and pathophysiology of this trauma are discussed. The
      clinical effects as well as management are presented. The most dramatic effects
      observed are fractures to the middle third of the face, reported here for the
      first time, with their management. New fracture lines are typically seen in
      fractures of the mandible due to the blast wave effects. This presentation should
      help in the prevention and management to save the lives of patients in future.

PMID- 7790514
TI  - Otoplasty and its origins for the correction of prominent ears.
AB  - The authors present a review of the literature concerning surgical correction of
      lop ear, re-examining the original procedures. Their own approach which combines
      the most suitable of several techniques described in the literature is presented.
      Using this approach they achieve good results stimulating them to continue
      utilizing this personal procedure.

PMID- 7790515
TI  - Back to school: training opportunities in school-based health centers.
AB  - School-based health centers are a rapidly growing model for provision of
      comprehensive, primary health care to elementary, middle, and senior high school
      students. They offer an exciting new training opportunity that is nontraditional,
      multidisciplinary, and relevant to future practice. The programs funded by the
      Robert Wood Johnson Foundation found that trainees made a significant
      contribution to their projects. The value of school-based health centers as
      training sites extends to trainees, schools, and the future growth of school
      based health centers. Integration of medical and mental health services and
      delivery of services by a multidisciplinary team are essential components of
      school-based health centers. These characteristics make school sites well suited
      to the training needs and practice opportunities sought by a number of
      disciplines, including developmental and behavioral pediatrics. A school-based
      health center rotation may be particularly important in developmental and
      behavioral pediatrics because many trainees may be called on to consult with
      schools in their future careers, and this rotation may provide their only school
      related experience.

PMID- 7790516
TI  - Massage therapy for infants and children.
AB  - Data are reviewed on the effects of massage therapy on infants and children with
      various medical conditions. The infants include: premature infants, cocaine
      exposed infants, HIV-exposed infants, infants parented by depressed mothers, and
      full-term infants without medical problems. The childhood conditions include:
      abuse (sexual and physical), asthma, autism, burns, cancer, developmental delays,
      dermatitis (psoriasis), diabetes, eating disorders (bulimia), juvenile rheumatoid
      arthritis, posttraumatic stress disorder, and psychiatric problems. Generally,
      the massage therapy has resulted in lower anxiety and stress hormones and
      improved clinical course. Having grandparent volunteers and parents give the
      therapy enhances their own wellness and provides a cost-effective treatment for
      the children.

PMID- 7790517
TI  - The accuracy of children's reports with anatomically correct dolls.
AB  - The accuracy of children's reports of alleged sexual abuse during interviews with
      anatomically correct dolls is the focus of considerable controversy. This study
      used an analog experience to measure empirically the accuracy of reports in a
      relevant, but controlled setting: the forensic medical examination for suspected
      sexual abuse. Twenty-one 3- to 7-year-old children were interviewed about what
      occurred during previous examinations with open-ended questions, open-ended
      questions with anatomically correct dolls, and direct questions with the dolls.
      Children provided significantly more accurate reports and fewer omissions with
      direct questions using the dolls compared with either of the two open-ended
      sections, but there was no significant difference in the number of false reports
      across the three sections of the interview. These results suggest that
      anatomically correct dolls may bolster the recall of children's memory in the
      setting of direct questions without prompting false reports.

PMID- 7790518
TI  - Head growth in cocaine-exposed infants: relationship to neonate hair level.
AB  - Intrauterine brain growth retardation is the most common brain abnormality in
      infants of cocaine-abusing mothers. We report a cross-sectional study of "at
      risk" pregnancies with 34 infants born to mothers urine positive for cocaine at
      delivery compared to 33 infants born to urine-negative mothers from the same
      clinic. Degree of cocaine exposure was assessed by radioimmunoassay of combined
      cocaine and benzoylecgonine (BE) levels in neonatal hair samples. Twenty-eight
      neonates were hair-positive for BE (mean 2507.40 +/- 1248.88 ng/g hair; range 716
      to 5440 ng/g) and differed significantly from the control infants (n = 33) in
      head circumference and head growth percentiles. A negative correlation
      approaching significance was found between mean BE and head circumference (r = 
      .36; p < .06) in the group of newborns with hair positive for BE (n = 28). The
      study demonstrates for the first time head growth abnormalities in association
      with levels of cocaine exposure.

PMID- 7790520
TI  - Effects of intraventricular hemorrhage and other medical and environmental risks
      on multiple outcomes at age three years.
AB  - This study examined the interrelated effects of intraventricular hemorrhage
      (IVH), neonatal medical condition, and environmental quality on development. At
      age 3 years, the functioning of 105 preterms was assessed in a variety of
      cognitive areas. Analyses revealed that IVH was related to gross motor,
      receptive, and expressive communication ability. However, it was only the
      subjects who had severe IVH who performed significantly worse than the comparison
      subjects. Subjects who had hemorrhages confined to a germinal matrix or a small
      intraventricular bleed did not differ from the comparison subjects who performed
      at expected age levels. When medical condition, socioeconomic status, and family
      risk, a composite variable including proximal environmental measures, were
      examined together with IVH as predictors, IVH remained related to motor and
      receptive communication ability after controlling for the other variables. The
      number of other medical complications and the environmental factors had more wide
      ranging effects. Each predictor was related to a unique set of outcomes.

PMID- 7790521
TI  - Follow-up studies of preterm infants.

PMID- 7790519
TI  - Self-esteem and behavior in girls with Turner syndrome.
AB  - Data on social competence, behavior, and self-esteem were gathered from a large
      sample of girls with Turner syndrome to determine whether psychological
      difficulties were associated with Turner syndrome. Subjects included 97 girls
      with Turner syndrome, 7 to 14 years of age, and 93 girls without Turner syndrome
      recruited from public schools. The two groups of girls were similar in age,
      verbal intelligence scores, and racial composition. The girls with Turner
      syndrome were found, based on both parental and self-report, to be more immature
      than the girls in the comparison group, with weaker social relationships, school
      performance, and self-esteem. A decline in self-esteem was also documented for
      the girls with Turner syndrome, but not the comparison group, as they moved into
      early adolescence. Although the findings support an increased risk for subtle
      behavioral problems among girls with Turner syndrome, in most cases the problems
      endorsed were not severe enough to suggest clinical impairment.

PMID- 7790522
TI  - Enhancing refusal skills: identifying contexts that place adolescents at risk for
      unwanted sexual activity.
AB  - Refusal skills training is one approach to reducing school-age pregnancy and
      sexually transmitted disease. The generalization of these skills is dependent, in
      part, on the relevance to participants of the training scenarios. We identified
      and cross-validated relevant contexts for inclusion in scenarios for refusal
      skills training. Fifty-six sexually active female adolescents identified 59
      contexts associated with unwanted sexual activity. Fifty-one additional subjects
      rated these on 9-point Likert scales according to how common and difficult each
      was for them. Unsupervised activity where alcohol is present or feeling an
      obligation to engage in sexual activity emerged as high risk contexts. The most
      common and difficult contexts provide points of departure for the development of
      relevant training scenarios for refusal skills training, thereby contributing to
      generalization of these skills and reducing the risk of unwanted sexual activity
      within this population.

PMID- 7790523
TI  - Elimination of Elyzol 25% Dentalgel matrix from periodontal pockets.
AB  - Elyzo 25% Dentalgel (EDG) which is developed for use in the treatment of
      periodontitis is a suspension of metronidazole benzoate (40%) in a mixture of
      glyceryl mono-oleate (GMO) and triglyceride (sesame oil). Metronidazole can be
      detected in the periodontal pockets 24-36 h after application. The aim of the
      present study was to estimate the period of time that the gel matrix persists on
      periodontal pockets after 1 application of EDG. 12 patients were included in the
      study. From each patient, 1 sample was taken before and immediately after, and 1,
      2, 3, 4, 5, 6, 8, 12 and 24 h after application. Subgingival scaling followed by
      absorption of gingival crevicular fluid with filter paper was used for sampling.
      The sampling unit was 1 tooth. Each sample was assayed for the amount of GMO and
      oleic acid (a degradation product of GMO) by means of high-performance liquid
      chromatography (HPLC) with UV detection. To allow determination of the GMO dose
      applied into the pockets and to estimate the recovery rate of the sampling
      method, 1 tooth in each patient was selected for sampling as soon as the gel had
      set, i.e., about 10 min after application. Only in 1 patient was a detectable
      amount of GMO within the pocket revealed 24 h after application. This amount was
      approximately 0.5% of the mean GMO dose applied around 1 tooth. GMO was found no
      longer than 12 h in the remaining patients.

PMID- 7790525
TI  - Periodontal disease activity: a development strategy for its investigation by
      means of accurate 3-dimensional clinical measurement.
AB  - The central problem in all previous approaches to clinical assessment of
      periodontal disease activity is the use of unidimensional measurement, which
      implies a number of unjustifiable assumptions. In addition, the use of
      unidimensional probing measurement has established that there are several
      distinct problems of validity and reliability in currently available techniques.
      The present paper begins with an analysis of these matters, leading to an
      approach to accurate clinical measurement of periodontitis in 3 dimensions, with
      the possibility of future development of a valid system for assessing the nature
      of disease activity.

PMID- 7790524
TI  - Periodontopathogens in elderly Chinese with different periodontal disease
      experience.
AB  - If an etiological relationship exists between destructive periodontal disease and
      putative periodontopathogens, they would be expected to have a very low
      prevalence in periodontally healthy elderly persons. To test this hypothesis, 2
      subgroups of elderly, rural Chinese (a periodontally "best" and a "worst" group,
      each comprising 15 persons) were identified in 1990 from a cohort aged 55-69
      years, examined in 1984. Assessment of changes in periodontal status over the 6
      year period were possible by comparing detailed clinical recordings performed by
      the same examinator. Subgingival microbial samples were taken at the mesial
      aspects of an upper central incisor and a lower canine and examined for the
      presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis,
      Prevotella intermedia group, Prevotella melaninogenica group, Capnocytophaga,
      Selenomonas, Campylobacter rectus as well as predominant Streptococcus and
      Actinomyces species. During the 6 years prior to microbiological sampling,
      persons in the "best" group had lost an average of 1.21 +/- 0.48 mm attachment,
      while persons in the "worst" group had lost an average of 1.60 +/- 0.94 mm. The
      latter group had lost 53.3 teeth, predominantly for periodontal reasons, in
      contrast to 1.8 teeth lost in the "best" group. "Best" persons did not differ
      from "worst" persons with respect to the occurrence of the putative
      periopathogens, total viable count, and total streptococcal and Actinomyces
      recovery. Similarly, sites which had experienced an attachment loss > or = 2 mm
      during the 6-year period did not differ microbiologically from sites with less
      attachment loss. It is concluded that subgingival microbial characterization does
      not allow for a distinction between elderly individuals with markedly different
      periodontal disease experiences.

PMID- 7790526
TI  - Periodontal repair in dogs: evaluation of the natural disease model.
AB  - Animal models are frequently consulted for histometric analysis of periodontal
      reconstructive therapy. Such models include surgical, periodontitis-simulating
      and natural disease defects in canines or non-human primates. Our studies suggest
      that homogeneity in defect height is critical for sensitivity of surgical and
      periodontitis-simulating supraalevolar defect models in discriminating treatment
      effects. We herein evaluate this model aspect for natural disease defects. Buccal
      lingual histologic sections from the 2nd, 3rd, and 4th mandibular premolar teeth
      (P2, P3, P4) from 6 aged beagle dogs with advanced natural periodontal disease
      were used. Defect heights from the reduced alveolar bone to the cemento-enamel
      junction were recorded in central step-serial sections at the buccal and lingual
      surfaces of the mesial and distal roots for the premolar teeth. Mean defect
      height, standard deviation and coefficient of variation were calculated for tooth
      types and jaw quadrants, separately, and for all teeth. Confidence intervals were
      calculated for teeth in left and right jaw quadrants. Mean defect height and
      standard deviation for left and right jaw quadrants was 3.6 +/- 0.9 and 3.3 +/-
      0.6 mm for P2, 3.3 +/- 0.9 and 2.3 +/- 0.9 mm for P3, and 3.3 +/- 1.0 and 4.5 +/-
      1.6 mm for P4, respectively. Coefficient of variation for defects for left and
      right jaw quadrants was 26 and 40%, respectively. Using confidence intervals for
      mean differences between jaw quadrants, it was determined that a mean treatment
      effect may be as large as 0.8, 1.1 and 1.9 mm for P2, P3 and P4, respectively,
      before being detected as statistically significant (p < or = 0.05; N =
      6).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790527
TI  - Periodontal and systemic findings in children with marginal bone loss in the
      primary dentition.
AB  - In a previous population-based study of 3896 7-9-year-old children living in
      Sweden, it was found that 32 children (0.8%) exhibited radiographic, periodontal
      bone loss at > or = 2 proximal surfaces of their deciduous teeth. In the present
      study, 26 of the 32 children were subjected to additional oral and systemic
      health examination. 20 other children without any radiographic evidence of bone
      loss in their primary dentition served as referents. None of the cases or the
      referents were detected to have any systemic disease. The frequency of bleeding
      and suppuration on probing, radiographic proximal calculus and probing attachment
      loss was higher among the cases than the referents. Actinobacillus
      actinomycetemcomitants was found subgingivally in 14 of the cases but in none of
      the referents. 11 of 22 cases analysed for presence of serum antibodies against
      A. actinomycetemcomitans leukotoxin were sero-positive compared to none of 7
      referents available for analysis. Evaluation of the data from each child revealed
      wide variations in clinical parameters among the children in the case group. In
      this group, there were children with deep probing depths, probing attachment
      loss, suppuration on probing, proximal calculus and presence of subgingival A.
      actinomycetemcomitans, indicating current periodontitis. However, in the case
      group there were also children without positive signs of inflammatory disease,
      similar to the children in the reference group. In fact, the findings suggest
      that less than half of the number of individuals with > or = 2 proximal sites
      with bone loss had current periodontitis.

PMID- 7790528
TI  - Lower protein concentration in GCF from patients with periodontitis: an indicator
      of host-specific inflammatory reaction.
AB  - To study the local inflammatory reaction associated with gingivitis and
      periodontitis, the protein concentrations were measured in gingival crevicular
      fluid (GCF) from 3 types of site: (i) inflamed sites in patients with gingivitis
      alone; (ii) inflamed sites with or (iii) without tissue destruction in patients
      with periodontitis. The GCF was sampled with paper strips and the protein
      concentration was measured with the Bradford protein assay. Higher protein
      concentrations in GCF were found at inflamed sites in patients with gingivitis
      alone than at clinically similar sites without tissue destruction in patients
      with periodontitis. In contrast, the sites with various degrees of disease in the
      same periodontitis patient showed the same protein concentrations. These
      discrepancies indicate that the local inflammatory reaction in the gingiva is
      host- and not site-specific, i.e., the tissue destruction in periodontitis
      reflects a specific host response.

PMID- 7790529
TI  - Effect of cigarette smoking on periodontal healing following GTR in infrabony
      defects. A preliminary retrospective study.
AB  - This retrospective study examined the effect of cigarette smoking on the healing
      response following guided tissue regeneration (GTR) in deep infrabony defects. 71
      defects in 51 patients underwent GTR with teflon membranes. 20 patients (32
      defects) smoked more than 10 cigarettes per day, while 31 patients (39 defects)
      did not smoke. Clinical measurements were available at baseline, at membrane
      removal and at the 1-year follow-up. The oral hygiene of both groups was good,
      but smokers had significantly higher full-mouth plaque scores. No significant
      differences were observed between smokers and non-smokers in terms of % of tissue
      gained at membrane removal. At the 1-year follow-up, however, smokers gained
      significantly less probing attachment level than non-smokers (2.1 +/- 1.2 mm
      compared with 5.2 +/- 1.9 mm). A multivariate model, correcting for the oral
      hygiene level of the patients and the depth of the infrabony component, indicated
      that smoking was in itself a significant factor in determining the clinical
      outcome. A risk-assessment analysis indicated that smokers had a significantly
      greater risk than non-smokers to display a reduced probing attachment level gain
      following GTR. It is concluded that cigarette smoking is associated with a
      reduced healing response after GTR treatment, and may be responsible, at least in
      part, for the observed results.

PMID- 7790530
TI  - Microscopic spirochete counts in untreated subjects with and without periodontal
      tissue destruction.
AB  - The purpose of the study was to determine microscopically the %s of spirochetes
      at sites without periodontal destruction in subjects with destructive periodontal
      diseases (cases) and in subjects free of it (controls), who had not received
      professional prophylaxis. From a sample of 164 individuals aged between 30-44
      years living in rural and urban areas of Tanzania, cases and controls were
      selected. Cases (n = 25) were selected who exhibited at least 3 teeth with pocket
      depth of > 5 mm. The controls (n = 28) had no pockets deeper than 3 mm. From each
      subject, 1 subgingival plaque sample was taken at the mid point of the lingual
      surface of 1 of the upper premolars which showed bleeding on probing but no
      calculus and no pockets. In addition, one subgingival sample was obtained from a
      pocket. Pockets contained the highest %s of spirochetes, which confirms earlier
      findings. A significant difference in % of spirochetes between cases and controls
      was found at non-destructive sites, indicating a host effect on the subgingival
      microflora. However, the spirochete counts at non-destructive sites did not
      provide a reliable measure to identify subjects with destructive periodontal
      disease.

PMID- 7790531
TI  - Granulocyte elastase in gingival crevicular fluid: improved monitoring of the
      site-specific response to treatment in patients with destructive periodontitis.
AB  - In 13 patients with severe destructive periodontitis, the response to periodontal
      therapy was estimated by granulocyte elastase level in gingival crevicular fluid
      (GCF). 62 sites were classified according to changes of probing depths (PD) and
      quantitative bone height (BH%) before and after 5-year regular maintenance
      treatment: (i) 17 consistently healthy sites with no changes of PD and BH%; (ii)
      6 initially healthy sites with deterioration in PD and BH%; (iii) 14 diseased
      sites with improvement in PD and BH%; (iv) 25 diseased sites with no improvement
      in PD and BH%. GCF was collected by an intracrevicular washing system. The
      released elastase in the supernatants (EA-S) and the cell-bound elastase in the
      pellets (EA-P) were determined with a low molecular weight substrate specific for
      granulocyte elastase. The ratio of EA-S and EA-P (S/P-ratio) was used as a
      relative measure of elastase released by the granulocytes present. The sites
      classified as diseased with no improvement or initially healthy but
      deteriorating, had significantly higher EA-S, EA-P and S/P-ratios than the
      consistently healthy sites or diseased but improving sites (p < 0.01). Both EA-S
      and S/P-ratio showed strongly positive correlations with the current levels of
      gingival inflammation and periodontal destruction (p < 0.001). The present study
      suggests that increased elastase level is associated with disease progression,
      and may be used to monitor the response to longitudinal maintenance therapy.

PMID- 7790533
TI  - Different types of inflammatory reactions in peri-implant soft tissues.
AB  - The aim of the present study was to analyze some features of the peri-implant
      mucosa at sites in the dog model which had been exposed to plaque accumulation
      for periods up to 9 months. The experiment was carried out in 5 labrador dogs.
      The mandibular right and left 2nd, 3rd and 4th premolars (2P2, 3P3, 4P4) and the
      1st molars (1M1) were extracted. Following a 3-month healing period, 3 titanium
      fixtures (Nobelpharma AB, Goteborg, Sweden) were installed in the edentulous
      premolar/molar regions. Abutment connection was performed 3 months later and a
      meticulous plaque control period of 3 months was initiated. A clinical
      examination was performed at the end of this preparatory period and a main study
      period of 9 months continued. During this period, the plaque control regimen was
      maintained in the mesial and central (left: L1, 2 and right: R1, 2) implant
      segments, whereas plaque was allowed to accumulate on the distal implants, i.e..
      L3 and R3. At the end of the main study period, i.e., 12 months after abutment
      connection, the clinical examination was repeated, the animals perfused and
      biopsies obtained. Semi-thin sections were produced for histometric and
      morphometric analyses. The peri-implant mucosa at implant sites exposed to daily
      and comprehensive plaque control at biopsy was clinically noninflamed and the
      connective tissue lateral to a junctional epithelium was devoid of accumulations
      of inflammatory cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790532
TI  - Role of periosteum in the formation of jaw bone. An experiment in the rat.
AB  - The aim of the present investigation was to evaluate the bone-forming capacity of
      the outer (fibrous) and inner (cambium) layer of the mandibular periosteum in
      skeletally mature rats. The experiment was carried out in 25 rats. The mandibular
      ramus was exposed on one side (experimental side) after elevation of a muscle
      periosteal flap. A teflon capsule was placed with its opening facing the
      periosteum at the subsurface of the raised muscle-periosteal flap after suturing.
      In the contralateral side serving as control, the periosteum of the lateral
      aspect of the mandibular ramus was left intact. This time the teflon capsule was
      placed with its opening facing the periosteum left behind at the ramus. The
      histological analysis demonstrated that in all experimental and control
      specimens, some bone was produced at 7 days after operation. In the experimental
      specimens, however, both the incidence and the amount of newly-formed bone in the
      teflon capsules gradually decreased from 7 to 120 days, while increasing in the
      control capsules placed over the periosteum. At 120 days, the mean amount of new
      bone produced in the experimental capsules was 3% (range 0-15%) of the total
      space created by the capsule, while it was 68% (range 41-85%) for the control
      capsules. The results demonstrated that substantial amounts of bone can be
      produced predictably by the placement of an occlusive teflon capsule facing
      mandibular covered with periosteum. Bone produced from the periosteum and without
      continuity with existing bone becomes resorbed with time.

PMID- 7790534
TI  - The effect of irrigation with chlorhexidine or saline on plaque vitality.
AB  - 24 adult patients suffering from Adult periodontitis were assigned to 4 groups:
      the 1st rinsed for 1 min with 0.2% chlorhexidine gluconate (CHX); the 2nd group
      were irrigated for 15 s with 0.2% CHX in a pulsed oral irrigator; the 3rd group
      rinsed for 1 min with saline and the 4th group were irrigated for 15 s with
      saline. Plaque vitality was measured after the 4 experimental procedures, using
      the method described by Netuschil et al. and scored using the method described by
      Rundegren et al. The results showed that a single rinse or irrigation with 0.2%
      CHX solution decreased the % of viable micro-organisms, but the vitality of the
      bacteria remained unchanged in saline groups. Statistical analysis indicated that
      irrigation with CHX was more effective at reducing plaque vitality than rinsing
      with CHX.

PMID- 7790535
TI  - Middle latency response in children with learning disabilities: preliminary
      findings.
AB  - The objective of this investigation was to determine if auditory middle latency
      responses (MLR) obtained from children with learning disabilities (LD) differ
      from those obtained from children without LD. Simultaneous recordings of auditory
      brainstem and middle latency responses were obtained in both vertex-ipsilateral
      (V-I) and vertex-contralateral derivations (V-C) in 22 children (11 LD and 11
      normal) in the age range of eight to twelve years whose peripheral hearing was
      within normal limits to bilateral. The results indicate that for specific
      recording conditions, the latencies of middle latency responses differ
      significantly between children with LD and a normal group of children.

PMID- 7790536
TI  - Speaker-listener familiarity: parents as judges of delayed speech
      intelligibility.
AB  - It has been frequently proposed that one source of bias in intelligibility
      judgments is whether the judge knows the subject personally. This study attempted
      to describe this bias using 4 speech-delayed children (aged 4 and 7 years) with
      normal hearing and no significant language delay. They were audiotaped at four
      points during therapy over a 12-18 month period using imitation of single words
      derived from the Assessment of the Intelligibility of Dysarthric Speech. Parents
      and a group of unfamiliar adult couples served as judges. Results indicated that
      mothers were significantly better than all other listeners (including fathers) at
      identifying the words being spoken. An interaction between listener type and
      subject age class was also observed with the maternal advantage being much less
      apparent with the 2 older subjects. Results are discussed relative to the
      possible source of the mothers' superior performance.

PMID- 7790537
TI  - The effects of topic and listener familiarity on discourse variables in
      procedural and narrative discourse tasks.
AB  - This study investigated the effects of listener and topic familiarity on
      procedural and narrative discourse variables. Twenty-two aphasic patients (5
      Broca's, 7 conduction, and 10 anomic aphasics) and 10 normal speakers served as
      subjects. Topic familiarity influenced discourse production in both procedural
      discourse and story retell situations. In procedural discourse, a greater number
      of optional steps were provided with familiar topics. During retelling of
      familiar topic stories, a greater proportion of action and resolution clauses
      were included. Listener familiarity affected the story retell task only. A
      greater percentage of subjects provided the setting when the listener was
      familiar.

PMID- 7790538
TI  - Error analysis of pronouns by normal and language-impaired children.
AB  - Recent research has located extraordinary weakness in specifically language
      impaired (SLI) children's development other than grammatical morphemes. A problem
      with pronoun case marking was reported to be more prevalent in SLI children than
      in normally developing children matched by mean length of utterance. However,
      results from the present study do not support that finding. Spontaneous
      utterances from 3 conversational contexts were generated by 3 groups of normal
      and SLI children and were analyzed for accuracy of pronoun usage. Third person
      singular pronouns were judged according to case, gender, number, person and
      cohesion based on their linguistic and nonlinguistic contexts. Results indicated
      that SLI children exhibited more total errors than their chronological peers, but
      not more than their language level peers. An analysis of error types indicated a
      similar pattern in pronoun case marking.

PMID- 7790539
TI  - 3D spiral CT of the tracheobronchial tree.
AB  - OBJECTIVE: Because of intrinsic limitations of transverse cross-sectional imaging
      methods, CT sometimes is insufficient for adequate evaluation of complex
      tracheobronchial anomalies. This article describes a complementary 3D procedure
      specifically dedicated to the study of the tracheobronchial tree. MATERIALS AND
      METHODS: The procedure combines a specific spiral CT acquisition with 2 or 4 mm
      collimation, 3D surface rendering of the tracheobronchial aerial content, and
      double obliquity multiplanar reformats directly planned on the 3D virtual object.
      It was performed in 11 complex cases including 3 stented benign or malignant
      stenoses and 2 single lung transplantations. RESULTS: Easier understanding of the
      tracheobronchial status was achieved in all cases. In three cases, the procedure
      yielded relevant diagnostic information that neither fiberoptic endoscopy nor
      transverse CT had provided, leading to significant modification of patient
      management. CONCLUSION: Three-dimensional spiral CT of the bronchial tree with
      secondary reformation seems suitable in clinical practice for selected cases.

PMID- 7790540
TI  - Diffuse pulmonary lymphangiomatosis: CT findings.
AB  - OBJECTIVE: Our objective was to determine and report the CT findings in patients
      with diffuse pulmonary lymphangiomatosis (DPL). MATERIALS AND METHODS: We
      retrospectively reviewed the CT findings in eight patients with pathologically
      proven DPL. The patients ranged in age from 3 to 35 years (mean 15 years) and
      included four male and four female patients. The CT scans were analyzed for type
      of pulmonary infiltrative process and its distribution, presence or absence of
      pleural fluid or thickening, and presence or absence of thoracic lymphadenopathy.
      RESULTS: The main abnormality seen on conventional and high resolution CT in all
      patients was smooth thickening of the interlobular septa and bronchovascular
      bundles. Seven of eight patients had patchy bilateral areas of ground-glass
      attenuation. All eight patients had diffuse increased attenuation of the
      mediastinal fat, approximating that of water, and mild bilateral perihilar
      infiltration. Seven of the eight had bilateral pleural effusions or smooth
      thickening of the pleura (or both), and two had regions of calcified pleural
      thickening. CONCLUSION: The constellation of CT features of DPL is distinctive
      and includes diffuse, smooth thickening of interlobular septa and bronchovascular
      bundles with extensive infiltration of the mediastinal fat and associated
      perihilar infiltration. Since the CT findings described are suggestive but not
      pathognomonic, definitive diagnosis requires lung biopsy.

PMID- 7790542
TI  - Congenital cystic adenomatoid malformation in adults: CT findings.
AB  - OBJECTIVE: Congenital cystic adenomatoid malformation (CAM) of the lung usually
      presents in children, although it has rarely been described in adults. The aim of
      this study was to review the clinical history and the CT findings in adults with
      pathologically proven CAM. MATERIALS AND METHODS: Seven patients between 21 and
      61 years of age with pathologically proved CAM were retrospectively identified at
      three institutions. Thoracic CT was reviewed in all cases. RESULTS: Six patients
      presented with recurrent pneumonia and one patient had recurrent pneumothoraces.
      Five cases were classified as a Type I CAM, and two were classified as Type II
      CAM. The CAMs were located exclusively in the lower lobes and exerted a mass
      effect on adjacent lung. They appeared as multiple thin-walled complex cystic
      masses ranging from 4 to 12 cm in diameter. No other congenital abnormality was
      identified in any patient. CONCLUSION: Cystic adenomatoid malformation in adults
      is rare. Patients usually present with recurrent pneumonia and a thin-walled
      lower lobe complex cystic mass. The diagnosis should be suggested on the basis of
      the clinical and CT findings.

PMID- 7790541
TI  - CT features of pulmonary Mycobacterium avium complex infection.
AB  - OBJECTIVE: The purposes of this study were to describe and compare the prevalence
      of disease features in subjects with Mycobacterium avium complex (MAC) disease
      with those of Mycobacterium tuberculosis infection (MTB), to compare the
      abilities of CT and chest radiography to identify the features of MAC disease,
      and to determine if sputum positivity is related to any of the CT features of MAC
      disease. METHODS: Computed tomographic scans of 15 subjects with MTB and 55
      subjects with MAC were reviewed by 2 observers. Sputum culture results (obtained
      within 1.9 +/- 2.8 days of scanning) were available in 50 of the 55 subjects with
      MAC. RESULTS: Bronchiectasis involving four or more lobes (often associated with
      centrilobular nodules) was seen only in subjects with MAC. The combination of
      right middle lobe and lingular bronchiectasis was seen only in MAC (p = 0.015).
      Thirty-one of the 34 subjects (91%) with MAC who had cavities on CT had a
      positive sputum culture within 3 weeks of CT, compared with 7 of 12 subjects
      (58%) without cavities (p = 0.001). Similarly, 36 of 42 subjects (85%) with
      airspace disease, but only 2 of 8 subjects (25%) without airspace disease grew
      mycobacteria from their sputa (p < 0.001). Sputum positivity was not associated
      with the presence of bronchiectasis (p = 0.156) or nodules (p = 0.377).
      CONCLUSION: A subgroup of patients with MAC may be distinguished from those with
      MTB by the presence of widespread bronchiectasis, particularly if it involves the
      right middle lobe and lingula. Cavities and airspace opacification on CT are
      associated with positive sputum cultures for MAC.

PMID- 7790543
TI  - Normal bronchial and pulmonary arterial diameters measured by thin section CT.
AB  - OBJECTIVE: We undertook this study to evaluate the normal values of the artery
      bronchus ratio (ABR) and the bronchial lumen ratio (BLR) at subsegmental levels
      and to determine whether these values can be used as objective parameters for
      evaluation of various diseases involving the bronchovascular trees. MATERIALS AND
      METHODS: We analyzed high-resolution CT of 30 patients without cardiopulmonary
      diseases. The CT studies were performed with 5 mm collimation at 5 mm intervals
      from the carina to the level of the inferior pulmonary vein and with 1.5 mm
      collimation at 10 mm intervals through the remainder of the lung. Both ABR,
      defined as the outer diameter of the pulmonary artery were divided by the outer
      diameter of its accompanying bronchus, and BLR, defined as the inner diameter of
      the bronchus divided by its outer diameter, were measured at the subsegmental
      level on the display console. RESULTS: The mean ABR was 0.98 +/- 0.14 (range,
      0.53-1.39), and the mean BLR was 0.66 +/- 0.06 (range, 0.51-0.86). Although BLR
      revealed no statistical differences between segments, lobes, and lungs, there
      were statistically significant differences between the ABRs of segments and
      between those of lobes. CONCLUSION: There was a wide range of normal values of
      ABR and BLR. This wide range of values would make these parameters of less value
      in the evaluation of bronchovascular bundles.

PMID- 7790545
TI  - CT evaluation of mediastinal lymphadenopathy: noncontrast 5 mm vs postcontrast 10
      mm sections.
AB  - OBJECTIVE: Two CT techniques were compared in the assessment of mediastinal lymph
      nodes: 5 mm thick sections without intravenous contrast medium and 10 mm thick
      sections with intravenous contrast medium. MATERIALS AND METHODS: Seventy-nine
      adult patients were examined by chest CT. From the level of the aortic arch
      through the level of the right middle lobe bronchus 5 mm thick sections were
      performed without intravenous contrast medium, followed by 10 mm thick sections
      of the same region with intravenous contrast medium. Two chest radiologists
      separately reviewed each CT method for each patient. Mediastinal lymph nodes were
      localized according to the American Thoracic Society scheme. Lymph node diameter
      was measured on the short axis. RESULTS: The 5 mm thick noncontrast sections
      permitted identification of more mediastinal lymph nodes than the 10 mm thick
      contrast enhanced sections (p < 0.01, signed rank test). The 5 mm thick
      unenhanced sections tended to show slightly (1-2 mm) larger nodes than the 10 mm
      thick contrast enhanced sections (stations 7, 10R, both reviewers, p < 0.05,
      signed rank test). Nodes with a short axis diameter > or = 8 mm were identified
      comparably well using either CT technique. CONCLUSION: The present study
      indicates that CT of the mediastinum using 5 mm thick sections, without
      intravenous contrast medium, is an appropriate scanning technique for evaluation
      of mediastinal lymphadenopathy.

PMID- 7790544
TI  - CT-guided pleural needle biopsy in the diagnosis of malignant mesothelioma.
AB  - OBJECTIVE: Our goal was to determine the sensitivity of CT-guided closed pleural
      needle biopsy (CPNB) for the histopathologic diagnosis of diffuse malignant
      pleural mesothelioma (DMPM). MATERIALS AND METHODS: Thirty patients with DMPM
      were studied with CT-guided CPNB. Tumor specimens were classified according to
      their cell types. RESULTS: In 25 (83.3%) patients, the diagnosis was made by CT
      guided CPNB. The remaining five patients were diagnosed by thoracoscopy,
      thoracotomy, or excisional biopsy of the chest wall mass. Pneumothorax was
      observed in 9.5% of patients and local seeding of tumor in 21.7% of patients who
      underwent CPNB. CONCLUSION: Properly performed CPNB under CT guidance may yield
      an increased sensitivity for the diagnosis of diffuse malignant pleural
      mesothelioma.

PMID- 7790546
TI  - CT and MR findings in tuberculous mediastinitis.
AB  - OBJECTIVE: Tuberculous mediastinitis, a rare complication of pulmonary
      tuberculosis, may simulate a mediastinal tumor on chest radiography. For
      evaluation and follow-up of the disease, CT and MRI are needed. MATERIALS AND
      METHODS: Two cases of tuberculous mediastinitis are presented with emphasis on
      the importance of MRI. In both cases, MRI was performed because the CT appearance
      was unusual for a mediastinal tumor. RESULTS: The areas of low signal intensity
      within the anterior mediastinal mass on both T1- and T2-weighted imaging were due
      to the reactive fibrous tissue and were suggestive of an inflammatory mass.
      CONCLUSION: When a mediastinal mass would be unusual on CT, MRI should be
      performed. If there are areas of low signal intensity within the mass on both T1-
      and T2-weighted imaging, an inflammatory mass such as tuberculous mediastinitis,
      is one of the possibilities.

PMID- 7790547
TI  - An electron-beam CT approach for transvenous coronary arteriography.
AB  - OBJECTIVE: The goal is to image the 3D anatomy of the major coronary arteries
      within a single breath-hold and using a single intravenous injection of contrast
      agent. MATERIALS AND METHODS: With use of an electron-beam CT (EBCT) scanner,
      operated in its multislice scan mode (using all four target rings, each scanning
      two nominal 8 mm thick slices in a total time interval of 224 ms), a
      radiologically realistic thorax phantom containing a heart with coronary arteries
      (opacified with 40 mg iodine/ml) was scanned six times with the patient table
      advanced by a 2 mm step into the scanner between each scan. The normalized and
      scaled sinogram data were transferred to an off-line computer and reconstructed
      using our own implementation of a 3D algebraic reconstruction technique that
      takes into account the exact 3D relationship of the X-ray source and detector
      elements of the EBCT. RESULTS: A single volume image consisting of 40 slices, at
      2 mm intervals and each uniformly 3.7 mm thick, depicted the lumina of the
      coronary arteries with greater anatomic detail than the "original" images at 8
      mm, primarily because of the reduced partial volume effect. CONCLUSION: Our
      preliminary results suggest that EBCT, operated in multislice scan mode, may be
      useful for transvenous coronary angiography performed within a single breath
      hold.

PMID- 7790548
TI  - "Acute" fat deposition in bowel wall submucosa: CT appearance.
AB  - OBJECTIVE: The deposition of submucosal fat in small and large bowel is known to
      occur in chronic processes such as inflammatory bowel disease, and has been
      assumed to reflect long disease duration. However, we have observed that
      submucosal fat deposition can occur in a short period of time. MATERIALS AND
      METHODS: Four patients were evaluated in whom serial CT examinations showed
      intramural fat deposition occurring within six months of a normal study.
      Confirmation of fatty deposition was made by Hounsfield unit measurement in all
      patients and by pathologic examination of bowel specimens in two patients.
      RESULTS: All four patients received cytoreductive chemotherapy for treatment of
      lymphoma or leukemia prior to the development of fat deposition. In all patients,
      serial CT examination documented the occurrence of fat-attenuation bowel wall
      thickening that developed in a short time period (12, 36, 67, and 186 days).
      Three of the four cases were initially misinterpreted as wall thickening from
      other causes (intussusception or colitis). Pathologic examination of bowel in the
      two patients with the shortest time intervals confirmed the presence of mature
      fat confined to the submucosa. CONCLUSION: These cases demonstrate that
      submucosal fat deposition in bowel wall is not limited to inflammatory bowel
      disease and other longstanding, chronic diseases; fatty infiltration can occur in
      a relatively short period of time, and is particularly likely to occur after
      cytoreductive therapy.

PMID- 7790549
TI  - Silicone-suppressed 3D MRI of the breast using rotating delivery of off-resonance
      excitation.
AB  - OBJECTIVE: A new silicone-suppressed MR technique was developed, and its efficacy
      in identifying free silicone and differentiating it from other breast tissues was
      investigated. MATERIALS AND METHODS: Silicone-suppressed MRI was performed using
      the RODEO (rotating delivery of excitation off-resonance) pulse sequence, which
      selectively eliminated signal from the narrow range of (CH3)4Si resonance. Ninety
      breasts in 61 patients were evaluated with both a fat-suppressed 3D MR sequence
      and a silicone-suppressed 3D MR sequence. RESULTS: Extracapsular free silicone
      and silicone injections demonstrated a unique appearance compared with normal
      breast tissue in all cases. Magnetic resonance identified free silicone in 26
      breasts, 10 of which were confirmed pathologically or from a history of previous
      silicone injections. No free silicone was present on MR in 64 breasts; 8 of these
      were confirmed by biopsy or mastectomy as showing no evidence of free silicone.
      This technique was useful in evaluation of prosthesis integrity, free silicone,
      focal palpable or mammographic lesions, and the breast with silicone injections.
      CONCLUSION: Silicone-suppressed RODEO MRI of the breast can accurately identify
      free and intracapsular silicone and can distinguish silicone from other tissues.
      This provides unique information about the breast in a number of specific
      applications.

PMID- 7790550
TI  - Helical CT of the liver: evaluation of injection flow rate, mode, and scan delay
      with a reduced-volume contrast medium bolus.
AB  - OBJECTIVE: The impact of injection flow rates, mono- or biphasic injection mode,
      and scan delay on liver and portal vein enhancement with helical CT was
      evaluated. MATERIALS AND METHODS: The liver of 75 consecutive patients was
      examined with helical CT before and after injection of 100 ml iopromide (30 g of
      iodine). Patients were randomly assigned to three protocols: (1) injection flow:
      2 ml/s; (2) injection flow; 4 ml/s (60 ml) + 2 ml/s (40 ml); and (3) injection
      flow: 4 ml/s. Scanning started 40 s after the beginning of contrast material
      injection. A second scan was performed 70 s after contrast agent injection in
      Protocol 1. RESULTS: Mean parenchymal contrast enhancement was highest with
      Protocol 3 (48.5 HU) followed by Protocols 2 (38.9 HU) and 1 (early: 21 HU; late:
      30.7 HU), with all differences being significant (p < 0.01). Enhancement of the
      portal vein was significantly higher with Protocols 3 and 2 (121 and 118 HU) than
      with Protocol 1 (early: 64 HU; late: 75 HU). CONCLUSION: Good enhancement of the
      liver parenchyma and the portal vessels can be obtained with 30 g of iodine if a
      monophasic injection with a flow rate of 4 ml/s is used.

PMID- 7790551
TI  - Benign hepatocellular tumors: MRI after superparamagnetic iron oxide
      administration.
AB  - OBJECTIVE: Our goal was to describe the features of benign hepatocellular tumors
      on superparamagnetic iron oxide (SPIO)-enhanced MR images and to evaluate the
      potential role of SPIO administration in the diagnosis of these tumors. MATERIALS
      AND METHODS: The T1- and T2-weighted SE images were performed before and after
      SPIO administration in 19 patients with focal nodular hyperplasia (FNH) or
      adenomas. The lesions were counted and qualitatively assessed. In 32 tumors with
      a diameter of > 10 mm, the contrast-to-noise ratio (CNR) and the liver and tumor
      enhancement were calculated. RESULTS: Thirty-seven tumors were detected on MR
      images: 29 before and 36 after SPIO administration (p < 0.05). The SPIO-enhanced
      T1-weighted images provided the highest detection rate and CNR. The central scar
      was most conspicuous on SPIO-enhanced T2-weighted images. Most FNHs and adenomas
      lost less signal than the liver, three tumors did not lose signal, and four FNHs
      showed a signal loss equal to or greater than that of the liver. CONCLUSION: The
      SPIO-enhanced T1-weighted images increased the CNR and the detection rate of
      benign hepatocellular tumors. On T2-weighted images, most benign hepatocellular
      tumors showed a signal decrease after SPIO administration. No significant
      difference in signal loss was observed between FNH and adenomas.

PMID- 7790552
TI  - Peribiliary cysts in liver cirrhosis: US, CT, and MR findings.
AB  - OBJECTIVE: We report the imaging features of hepatic peribiliary cysts (PC) and
      the course of their development on CT. MATERIALS AND METHODS: Both CT and US
      findings were correlated with histopathologic findings in two patients with PC at
      autopsy. Five patients with cysts around the portal vein on CT but without
      histologic correlation were also included in this study. In six patients the
      course of PC development was observed. RESULTS: In the two autopsy cases cystic
      dilatation of the peribiliary glands was confirmed. The cases showed continuous
      small cysts along the portal veins reflecting the periportal collar seen on CT
      and the abnormal MR signal intensity of the periportal area. Ultrasound (US)
      showed round or tubular anechoic lesions around the large portal tracts mimicking
      dilatation of the bile ducts. Clustered cysts and echogenic dots or bands around
      PC were also seen. In three of six cases the PCs gradually enlarged and increased
      in number. CONCLUSION: In patients with liver cirrhosis PCs can be demonstrated
      by CT, US, and MRI in the vicinity of the hepatic hilum. Peribiliary cysts
      enlarge gradually and must be differentiated from dilatation of bile ducts or
      edema of portal tracts.

PMID- 7790553
TI  - Liver perfusion studied with ultrafast CT.
AB  - OBJECTIVE: Our goal was to quantify absolute hepatic arterial and portal venous
      perfusion noninvasively in patients with and without liver disease using
      ultrafast CT. MATERIALS AND METHODS: A single slice through the porta hepatis was
      repeatedly scanned after bolus injection of 25 ml of iohexol 300 mg I/ml,
      followed by a 25 ml saline "chaser" intravenously at 10 ml/s. Thirty-nine
      controls, 7 cirrhotic patients, and 5 patients with known metastases on the slice
      plane were studied; hepatic arterial perfusion was determined in 41 patients and
      portal venous perfusion in 24. Time-attenuation curves from regions of interest
      drawn over the liver, spleen, aorta, and portal vein were analysed. Hepatic
      arterial perfusion was calculated by dividing the peak gradient of the liver time
      attenuation curve prior to the time of peak splenic attenuation by the peak
      aortic CT number increase. Splenic perfusion was calculated by dividing the peak
      gradient of the splenic time-attenuation curve by the peak aortic CT number
      increase. Portal perfusion was derived by scaling the splenic time-attenuation
      curve by the ratio of hepatic arterial/splenic perfusion. This scaled curve was
      subtracted from the liver time-attenuation curve to give a portal curve. The peak
      up-slope of this curve was divided by the peak rise in splenic or portal vein
      density. RESULTS: Hepatic arterial perfusion averaged 0.19 ml/min/ml (n = 31) in
      controls and was raised in cirrhosis to 0.25 ml/min/ml (n = 6) and metastases
      0.43 ml/min/ml (n = 4). Portal venous perfusion was 0.93 ml/min/ml (n = 19) in
      controls and 0.43 ml/min/ml (n = 4) in cirrhosis. Reproducibility has been
      confirmed. CONCLUSION: Dynamic ultrafast CT shows potential in quantifying
      arterial and portal hepatic perfusion. The technique may be adaptable to dynamic
      bolus MRI.

PMID- 7790555
TI  - Pyourachus: CT manifestations.
AB  - OBJECTIVE: To assess CT findings of pyourachus. MATERIALS AND METHODS: Computed
      tomography of two patients with surgically proven pyourachus was reviewed.
      RESULTS: The CT characteristics of pyourachus include (a) midline location deep
      to the rectus abdominis muscle; (b) conical shape extending from a tip at the
      umbilicus to a base over the bladder dome; (c) peripheral inflammatory changes in
      subcutaneous tissues, rectus abdominis muscle, and mesenteric fat; and (d)
      intraperitoneal fluid or abscess (if perforation has occurred). CONCLUSION:
      Abdominal CT demonstrates characteristic findings in pyourachus that should allow
      differentiation from other abdominal-pelvic masses.

PMID- 7790554
TI  - Percutaneous CT-guided biopsy of adrenal masses: immediate and delayed
      complications.
AB  - OBJECTIVE: To determine the immediate and delayed complications of percutaneous
      adrenal biopsy and any relationship between biopsy methods and complications.
      MATERIALS AND METHODS: Medical records and radiological examinations of 83
      percutaneous adrenal biopsy were reviewed. Indication for biopsy,
      inpatient/outpatient status, lesion size and location, imaging modality used,
      needle type, size, approach and number of passes, biopsy results, immediate
      complications, and delayed complications were recorded. RESULTS: Computed
      tomography was used in 79 cases (95%) and ultrasound in 4 (5%). The biopsy
      approach was posterior in 37 cases, transhepatic in 33, transpancreatic in 9,
      anterior in 2, transsplenic in 1, and lateral in 1. The total complication rate
      was 8.4% and was slightly higher for the transhepatic approach (12%) than the
      posterior approach (8%). Seven complications occurred: two pneumothoraces, two
      pain, one perinephric hemorrhage, one subcapsular and intrahepatic hematoma, and
      one hepatic needle-tract metastasis. The posterior approach was complicated by
      the two pneumothoraces and perinephric blood; the transhepatic was used in the
      other four. Five of the complications occurred with 22 gauge needles. CONCLUSION:
      Percutaneous adrenal biopsy is a safe procedure. Complications occurred in 7 of
      our patients (8.4%).

PMID- 7790556
TI  - MRI of placental polyps.
AB  - OBJECTIVE: Placental polyp is intrauterine polypoid placental tissue retained
      after delivery or abortion and may cause life-threatening bleeding. We studied
      the value of MRI in diagnosing placental polyps. MATERIAL AND METHODS: Two women,
      26 and 32 years old, with histologically proven placental polyp were included in
      this study. These patients were treated with local injections of methotrexate or
      transcatheter arterial embolization. The MR images before and after these
      treatments were studied retrospectively. RESULTS: High intensity pedunculated
      masses of 3-4 cm in size were observed in the expanded uterine cavity on T2
      weighted and contrast-enhanced T1-weighted SE images. Bloody contents were
      observed around the masses. Placental polyps were more intensely enhanced than
      the myometrium by the contrast media, and the enhanced T1-weighted images
      indicated the retained placental tissues with an adherent part to the myometrium.
      Magnetic resonance imaging was also useful in following up the reduction in the
      size of the lesions and in the blood flow after the treatments. CONCLUSIONS:
      Magnetic resonance imaging may be useful in diagnosing and following up placental
      polyps.

PMID- 7790557
TI  - Assessment of popliteal arterial occlusive disease with 2D time-of-flight MRA.
AB  - OBJECTIVE: The purpose of this study was to evaluate both morphology and blood
      flow in peripheral arteries with occlusive lesions using MR angiography (MRA) and
      velocity-encoded cine MRI. MATERIALS AND METHODS: Two-dimensional time-of-flight
      MRA and velocity-encoded cine MRI were performed in nine patients with peripheral
      arterial occlusive disease. Findings on MR angiograms were verified by
      conventional angiography. RESULTS: All the stenotic lesions in the popliteal
      arteries were depicted by MRA. The degree of the stenoses in the artery was
      overestimated by MRA. Major collateral circulations were demonstrated. Velocity
      encoded cine MRI provided flow velocity information on the arteries above and
      below the stenoses. The flow velocity waveform was monophasic above and below the
      stenosis. The peak systolic velocity in the artery below the stenosis was reduced
      compared with that above the stenosis (p < 0.05). CONCLUSION: The combination of
      MRA and velocity-encoded cine MRI has clinical potential for the evaluation of
      peripheral arterial occlusive disease.

PMID- 7790558
TI  - Involvement of muscle by malignant lymphoma: MR and CT appearances.
AB  - OBJECTIVE: The purpose of this study is to investigate the CT and MR findings of
      muscular involvement by malignant lymphoma and identify the CT and MR features
      that may assist in their diagnosis. MATERIALS AND METHODS: Magnetic resonance
      imaging was performed on four patients (five lesions) with pathologically proven
      non-Hodgkin lymphoma using a 1.5 T unit (Cases 1, 2, and 4) and a 0.5 T scanner
      (Case 3). Computed tomography scans were carried out on three patients (Cases 1,
      3, and 4). RESULTS: The lesions that extended along muscle fascicles with
      preserved fat planes looking like swelling of the muscle were of slightly hyper-
      to isointensity relative to uninvolved muscles on T1-weighted images, of
      hyperintensity on T2-weighted images, and of low or isodensity on CT.
      Microscopically, lymphoma cells were seen clustering among normal and atrophic
      muscle fibers in a biopsy specimen of one patient. The lesions enhanced
      relatively homogeneously after Gd-DTPA injection. In three cases, vessels were
      coursing through the lesion on MRI and in two cases on enhanced CT. CONCLUSION:
      Magnetic resonance imaging proved useful to show the extension of involvement of
      muscular lymphoma compared with CT. The diagnosis of infiltration of muscle by
      lymphoma is entertained when a lesion of relatively homogeneous intensity and
      density extends along the muscle fascisles without obliteration of the fat planes
      and especially when vessels are identified within the lesion.

PMID- 7790560
TI  - Influence of magnetic field strength on T2* decay and phase effects in gradient
      echo MRI of vertebral bone marrow.
AB  - OBJECTIVE: The goal of this study was twofold: first, to quantify the influence
      of magnetic field strength (B0) on T2* and T2susceptibility relaxation rates in
      vertebral bone marrow; and second, to determine the significance of in-phase/out
      of-phase phenomena in GE MRI as a function of TEs at different B0 values.
      MATERIALS AND METHODS: Magnetic resonance imaging of the spine was performed at
      1.5, 1.0, and 0.2 T using a GE sequence (2D-FLASH) with variable TE. Vertebral
      body signal intensities were measured and plotted against TE values. These curves
      were used to calculate T2* decay of bone marrow at different B0 values. RESULTS:
      At all field strengths, we observed exponential signal decay, modulated by a
      cosine function, the periodicity of which was proportional to B0. The T2* values
      of vertebral bodies were 9.7 +/- 1.8 ms at 1.5 T, 17.2 +/- 2.4 ms at 1.0 T, and
      53 +/- 5 ms at 0.2 T. True T2 relaxation time (independent of field strength) was
      62 +/- 4 ms. The T2susceptibility was 11.7 ms at 1.5 T, 24.8 ms at 1.0 T, and 585
      ms at 0.2 T. CONCLUSION: We conclude that at low B0, susceptibility effects
      become less important and T2* approaches true T2 relaxation.

PMID- 7790559
TI  - MR findings in peroneal tendonopathy.
AB  - OBJECTIVE: The purpose of this presentation is to familiarize the reader with the
      often subtle findings of peroneal tendon derangement on MRI examination.
      MATERIALS AND METHODS: We present four patients who were studied with MR (1.5 T)
      prior to surgical exploration of the peroneal tunnel. All patients had lateral
      ankle symptoms for > 6 months. Normal MR anatomy and an example of the peroneus
      quartus tendon are also shown. RESULTS: Surgery revealed two peroneus brevis and
      three peroneus longus lesions. A "multipartite" appearance of the peroneus tendon
      on axial MR images, especially when paired with a "flame-shaped" appearance on
      more distal axial images, indicates a longitudinal tendon split. Both patients
      with peroneus brevis tendon splits had insufficient superior peroneal retinacula.
      CONCLUSION: Partial ruptures of the peroneal tendons characteristically take the
      form of longitudinal tendon splits. Axial MR images through the ankle and
      hindfoot can help distinguish peroneal tendonitis from longitudinal tendon
      splits.

PMID- 7790561
TI  - Relationships between young modulus of elasticity, ash density, and MRI derived
      effective transverse relaxation T2* in tibial specimens.
AB  - OBJECTIVE: It has been hypothesized that the MR relaxation time T2* of bone
      marrow present in the intertrabecular spaces may be related to the density of the
      trabecular network and may be a predictor of trabecular bone properties.
      MATERIALS AND METHODS: To derive a relationship between the marrow relaxation
      time T2* and biomechanical properties of trabecular bone, we studied two sets of
      trabecular bone specimens from human tibiae. The first set consisted of 12
      specimens that were defatted and immersed in saline; the second set consisted of
      18 specimens with marrow in the trabecular spaces. The MR studies were conducted
      on a 1.5 T imaging system. In the first set of specimens, a GE sequence (TR = 70
      ms; TE = 5, 10, 15, 20, 25 ms) was used to obtain images in the axial plane. In
      the second set, a water suppression pulse was used prior to an asymmetric SE
      sequence (TR = 300 ms; TE = 4, 8, 12, 16, 20, 24 ms) to obtain images in the
      axial, coronal, and sagittal planes. The T2* of the intertrabecular saline of the
      marrow fat was calculated assuming a monoexponential decay. In both sets, the
      elastic moduli were measured in three orthogonal directions (superoinferior,
      anteroposterior, and mediolateral). The ash density was determined after the
      completion of the experiments. RESULTS: Our results indicate a moderate
      significant negative correlation between T2* and ash density or elastic modulus
      (E) in both sets of specimens. The correlation coefficients were slightly
      improved between the transverse relaxation rate 1/T2* and bone density or E. We
      found a good correlation between T2* and the reciprocal ash density (r = 0.88)
      and between T2* and the reciprocal elastic modulus 1/E (r = 0.87 to r = 0.95) in
      the first set, while in the second set the correlation remained moderate. With
      use of a multiple linear regression model (1/E = a x T2* + b x 1/T2* + n), the
      reciprocal elastic moduli 1/E were predicted to > 90% by T2* and 1/T2* in the
      first set of specimens. This finding was not replicated with the second set of
      specimens. In the second set of specimens, we found poor to moderate correlation
      coefficients between the T2* times in the three orthogonal planes (r = 0.45 to r
      = 0.71). CONCLUSION: Trabecular bone properties such as density and strength may
      potentially be assessed with quantitative MR techniques. However, especially for
      in vitro studies, specimen preparation, acquisition parameters, and specimen
      geometry may have a significant impact on the obtained results.

PMID- 7790563
TI  - MRI in acute hemiplegia of childhood.
AB  - OBJECTIVE: Acute hemiplegia in childhood is rare, the underlying etiology
      frequently obscured and the pathological site unidentified. MATERIALS AND
      METHODS: Magnetic resonance imaging (1.5 T Magnetom) was performed in two cases
      with hemiplegia followed by repeated studies at 3 and 16 months, respectively,
      after the initial examinations, including CT and angiography, were negative.
      RESULTS: MRI demonstrated otherwise occult lesions in the brain stem and showed
      the subsequent partial resolution consistent with infarction. CONCLUSION: MRI
      should be employed in those children with acute hemiplegia in whom no underlying
      cause is elicited.

PMID- 7790562
TI  - Added value of automated clinical proton MR spectroscopy of the brain.
AB  - OBJECTIVE: A trial was conducted to establish the added diagnostic value of an
      automated proton MR spectroscopy (MRS) examination (PROBE). MATERIALS AND
      METHODS: The PROBE and MRS were compared for metabolite ratios of normal controls
      and 21 patients. In addition, PROBE was performed in either the occipital cortex
      (gray matter) or the parietal cortex (white matter) or, more rarely, within the
      confines of a focal lesion identified on MRI, using a GE Signa 1.5 T whole-body
      scanner, in 112 patients undergoing routine brain MRI. The trial was conducted in
      three different MR centers to establish percentage of positive findings with MRI
      vs. MRI plus MRS. RESULTS: Cerebral metabolite ratios (N
      acetylaspartate/creatine, choline/creatine, myo-inositol/creatine) obtained by
      PROBE and MRS were similar. Metabolite profiles in dementia, head trauma, herpes
      encephalitis, hepatic and hypoxic encephalopathy, stroke, and tumor were
      identified using PROBE. The PROBE technique increased the number of positive
      findings ("added value") achieved by MRI; the added value was 28, 21, and 93% for
      the three trial sites. CONCLUSION: With only minor variations, PROBE reproduces
      the cerebral metabolite patterns obtained with MRS. It significantly increases
      the diagnostic yield of routine neuroimaging and might be incorporated as a
      standard sequence in a cost-effective manner.

PMID- 7790564
TI  - MR angiography of the persistent trigeminal artery variant.
AB  - OBJECTIVE: To evaluate the MR angiographic findings of the persistent trigeminal
      artery variant (PTAV) and to discuss its clinical implications. MATERIALS AND
      METHODS: We reviewed time-of-flight MR angiography including individual source
      imaging in three patients with PTAV, which had been recognized as an incidental
      finding on conventional arteriography. In all cases, MR angiography was performed
      at 1.5 T. RESULTS: MR angiography demonstrated the PTAVs as hyperintense
      structures originating from the precavernous portion of the internal carotid
      artery, running within or very close to the Meckel cave and near the trigeminal
      nerve root, and reaching the posterior fossa (cerebellar arteries) without
      joining the basilar artery. Spin echo imaging failed to demonstrate the PTAVs.
      CONCLUSION: Source imaging of MR angiography helped demonstrate PTAV and its
      adjacent structure. Knowledge of the presence and course of this anomalous vessel
      is useful for various treatment strategies.

PMID- 7790566
TI  - Fluid attenuated inversion recovery (FLAIR) MRI of herpes encephalitis.

PMID- 7790565
TI  - CT and MRI of hepatic focal nodular hyperplasia with peripheral steatosis.
AB  - Focal nodular hyperplasia (FNH) is a benign liver condition, which generally does
      not contain fat. In this report we describe an unusual case in which multiple
      areas of FNH were surrounded by prominent peripheral fatty infiltration.

PMID- 7790567
TI  - Oculomotor nerve invasion by lymphoma demonstrated by MRI.

PMID- 7790568
TI  - Incidental MR diagnosis of retractile testis.

PMID- 7790569
TI  - Demonstration of columella-like stapes by CT.

PMID- 7790570
TI  - Purification and characterization of angiotensin I-converting enzyme inhibitors
      from sour milk.
AB  - The inhibitory activity of angiotensin I-converting enzyme in milk increased
      during fermentation with the Calpis sour milk starter containing Lactobacillus
      helveticus and Saccharomyces cerevisiae. Two kinds of peptides inhibitory to
      angiotensin I-converting enzyme were purified from the sour milk by using four
      step HPLC. The amino acid sequences of these inhibitors were identified as Val
      Pro-Pro and Ile-Pro-Pro. The concentrations of peptides providing 50% inhibition
      of angiotensin I-converting enzyme were 9 and 5 microM, respectively. Most of the
      inhibitory activity in sour milk was attributed to these two peptides.

PMID- 7790573
TI  - Ornithine-delta-aminotransferase in lactating bovine mammary glands.
AB  - The occurrence and subcellular distribution of ornithine-delta-aminotransferase
      have been studied in lactating bovine mammary glands. The enzyme is localized in
      the mitochondria and has a unique thermal reaction profile that distinguishes it
      from putative liver and kidney isozymes. The enzyme concentration in the gland
      correlates well with a role in the conversion of ornithine into the proline
      precursor, L-delta 1-pyrroline-5-carboxylate. However, an unusually high
      Michaelis constant for the mitochondrial enzyme (8.4 mM) raises the question of
      enzyme efficiency in vivo such that this pathway needs to be considered in
      estimating barriers to protein secretion into milk.

PMID- 7790571
TI  - Alteration of plasma lipids in the rat by fractionation of modified milk fat
      (butterfat).
AB  - Our objective was to determine the nutritional effects of defined fat fractions
      of modified milk fat, or butterfat (anhydrous butter without the milk fat globule
      membrane) on lipid and lipoprotein cholesterol concentrations in plasma of rats
      fed diets containing 16% fat and two amounts of cholesterol. Five dietary fats
      were compared: 1) intact butterfat, 2) a liquid butterfat fraction enriched in
      oleic acid and unsaturated triacylglycerols with < 40 carbon atoms, 3) a solid
      butterfat fraction enriched in palmitic and stearic acids, 4) corn oil, and 5)
      palm oil. The extent of diet-induced hypercholesterolemia was the greatest with
      palm oil, followed by solid butterfat, corn oil, intact butterfat, and the lowest
      with liquid butterfat. Triacylglycerol concentrations in plasma were greater for
      rats fed palm oil than for those fed corn oil or liquid or intact butterfat.
      Among the high cholesterol dietary groups, ingestion of the liquid butterfat diet
      resulted in similar lipoprotein cholesterol and very low density lipoprotein
      concentrations relative to the corn oil diet, and ingestion of the solid
      butterfat diet resulted in similar lipoprotein cholesterol and very low density
      lipoprotein concentrations relative to the palm oil diet. These results suggest
      that changes in the triacylglycerol and fatty acid composition of butterfat by
      fractionation processes may improve its nutritional profile.

PMID- 7790572
TI  - Role of insulin in the regulation of mammary synthesis of fat and protein.
AB  - Five lactating Holstein cows were subjected to a hyperinsulinemiceuglycemic clamp
      to examine the effects of insulin on milk yield and composition. Of special
      interest was the evaluation of the glucogenic-insulin theory of milk fat
      depression. Cows were fed every other hour to minimize postprandial effects, and
      blood samples were obtained via an indwelling jugular catheter every 4 h for 2 d
      to establish baseline glucose concentrations. For the 4-d clamp, insulin was
      infused continuously (1 microgram/kg of BW per h) into the contralateral jugular
      vein, and circulating insulin was increased approximately fivefold. Blood was
      sampled frequently, and blood glucose was maintained within 10% of baseline
      concentrations by infusion of exogenous glucose at variable rates (mean = .15
      g/kg of BW per h). Dietary intake declined on the 4th d of the insulin clamp
      (23.0 vs. 16.3 kg/d). Milk yield, however, did not change (32.4 vs. 33.6 kg/d) in
      support of the lack of sensitivity of the mammary gland to insulin. Milk fat
      percentage (3.85 vs. 3.66) and yield (1.26 vs. 1.22 kg/d) did not change during
      the insulin clamp. Milk protein yield increased (.98 vs. 1.05 kg/d), and milk
      protein percentage tended to increase (3.04 vs. 3.14), during the insulin clamp.
      This modest increase in milk protein yield may have been constrained by a lack of
      available amino acids, as indicated by a decrease in circulating concentrations
      of essential amino acids, urea nitrogen, and plasma proteins. Overall, results
      offer no support for the glucogenic-insulin theory of milk fat depression but do
      indicate that the insulin infusion, either directly or indirectly, enhanced
      secretion of milk protein.

PMID- 7790574
TI  - Factors affecting variation of udder traits of dairy ewes.
AB  - Udder depth, width, and circumference; cistern height; teat position, angle,
      length, and width; and milk yield at 120 d were studied in 113 Churra sheep from
      three flocks. Means were 9.30, 12.18, and 46.55 cm, respectively, for udder
      depth, width, and circumference; 1.48 cm for cistern height; 3.64 (scored from 1
      to 5) for teat position; 50.39 degrees for teat angle; 3.83 and 1.93 cm,
      respectively, for teat length and width; and 132.39 L for milk yield. Analysis of
      variance showed significant effects for lactation month, flock, parity number,
      and milk yield. The traits related to udder size (depth, width, and
      circumference) were significantly influenced by lactation month, flock, and milk
      yield and showed low repeatability (.17 to .18). The traits related to cistern
      morphology (cistern height, teat position, and angle) were significantly
      influenced by flock and parity number. These traits, together with teat length
      and width, had high repeatabilities (.45 to .77). Cistern height, teat position
      and angle, and size of teats are related to aptitude of the udder for mechanical
      milking. This association, as with cattle, would justify focusing genetic
      improvement on these traits.

PMID- 7790575
TI  - Infection of lactating goats by mammary instillation of cell-borne caprine
      arthritis-encephalitis virus.
AB  - The possibility of transmission of caprine arthritis-encephalitis virus between
      lactating goats by the transfer of infected cells during milking has been
      examined experimentally. Four virus-free Saanen goats were infected, two in full
      lactation and two during the drying off period, by instillation of infected
      allogeneic cells into the milk canal of one-half of the udder. All four goats
      became infected, as shown by the isolation of virus from peripheral blood
      monocytes, seroconversion, and presence of typical lesions in the mammary gland.
      The virus was rapidly and constantly demonstrable in cells from the mammary
      secretions of the dry goats, but less regularly detected from milk cells from the
      lactating goats. Virus was more frequently isolated when milk SCC were elevated.
      Virus was present as often in secretions from the uninoculated half of the udder
      as the inoculated half. Dry goats seroconverted progressively, although antibody
      concentrations remained low; the lactating goats developed weak, positive Western
      blots in the late phase of lactation but only gave positive ELISA titers after
      drying off and artificial reinduction of lactation. At necropsy, lesions typical
      of the virus were observed in the mammary tissues of all four goats, and three
      had arthritis of the carpi.

PMID- 7790576
TI  - Comparison of calf housing types and tympanic temperature rhythms in Holstein
      calves.
AB  - During fall, 30 Holstein calves were randomly assigned to three housing
      treatments from birth to weaning: conventional wooden hutches, enclosed molded
      polyethylene domes, and thermomolded opaque polymer hutches with ridge-top
      ventilation systems. The wooden and polymer hutches had outdoor pens. Fifteen
      calves, 5 in each housing type, were fitted with portable data loggers to record
      ambient (calf microclimate) and tympanic temperatures. Additional data collected
      included weekly girth, BW, and feed intake; blood samples were collected within
      24 h of birth and at weaning (8 wk); and behavioral observations were made at 1,
      4, and 7 wk of age. Polyethylene domes had the warmest microclimate, followed by
      wooden and polymer hutches. Feed intake, growth measurements, blood physiology,
      and behavior were unaffected by housing type. Diurnal tympanic temperature
      rhythms of neonatal dairy calves in this study were monophasic: maximums were at
      1200 to 1700 h, and minimums were at 0600 to 0900 h. Computed fractal dimensions
      of tympanic temperature by week indicated a gradual diminishing of stress as the
      calves became older and acclimated to their environment. This objective
      characterization provides a basis for further evaluation of physiological stress
      and a means of improving environmental management.

PMID- 7790580
TI  - Addition of soybean trypsin inhibitor to bovine colostrum: effects on serum
      immunoglobulin concentrations in Jersey calves.
AB  - Secretion of trypsin by the neonate may reduce absorption of Ig from colostrum
      and increase failure of transfer of passive immunity, particularly for calves fed
      after 12 h of age. Jersey calves (n = 48) were used in a 2 x 2 factorial
      arrangement of soybean trypsin inhibitor (0 or 1 g) added to 1 L of maternal
      colostrum at the first two feedings and time of initial feeding (.65 or 12 h of
      age). A second colostrum feeding was offered 12 h after the initial feeding.
      Maternal colostrum was analyzed for Ig by radial immunodiffusion and trypsin
      inhibitor by radial protease diffusion. Jugular blood was sampled at 0, 12, 24,
      and 48 h after initial feeding, and serum was analyzed for IgG and IgM. Addition
      of trypsin inhibitor increased serum Ig and total serum protein concentrations,
      regardless of age at first feeding. Concentrations of serum IgG and IgM were
      increased 16 and 30%, respectively, when trypsin inhibitor was fed. Age of first
      feeding did not affect concentrations of IgG or IgM in serum. Supplementation of
      colostrum with trypsin inhibitor improved transfer of passive immunity to
      neonatal Jersey calves.

PMID- 7790578
TI  - Prediction of milk fatty acid profile in dairy cows fed dietary fat differing in
      fatty acid composition.
AB  - The objective of this work was to predict changes in milk fat composition caused
      by differences in dietary fat. Twenty-two references describing 35 experiments
      and 108 treatments were used in the analysis. For lauric, myristic, and palmitic
      acids in milk, proportions in the dietary fat and the total dietary fat
      concentration were important predictors for their concentrations in milk as well
      as for stearic and oleic acids in milk. Using a model that included these four
      parameters, the residual standard deviation around the observed versus predicted
      line within experiments was approximately 10% of the mean for short-chain fatty
      acids (< C12); for lauric, myristic, palmitic, and oleic acid; and for total C18
      fatty acids in milk. The model also effectively predicted milk fatty acid profile
      with respect to lauric, myristic, palmitic, and oleic acid and total C18 fatty
      acids across experiments despite differences in breed, basal diet, and milk yield
      among experiments. The content of short-chain acids, stearic acid, and poly
      unsaturated fatty acids were less effectively predicted across experiments.
      Possible explanations for the differing predictabilities for different milk fatty
      acids are discussed.

PMID- 7790579
TI  - Sucrose supplementation and feed intake of dairy cows in early lactation.
AB  - Based on results from previous 14-d sequential elimination trials, which
      indicated that cows in early lactation preferred a sucrose-sweetened diet, a 12
      wk lactation trial was conducted to evaluate further the effects of sucrose
      supplementation. Twenty-four cows (16 multiparous Jerseys and 8 primiparous
      Holsteins) were assigned at parturition to a control or sucrose-sweetened (1.5%
      of dietary DM) TMR in a randomized complete block design. The diet included 10%
      corn silage, 30% alfalfa haylage, and 60% concentrate based on corn and soybean
      meal on a DM basis and was fed to ensure 10% orts. An additional 2.3 kg of
      alfalfa hay were fed for the first 5 d postpartum. Covariant-adjusted (BW on the
      day of parturition) mean DMI, milk yields, 3.5% FCM yields, and percentages of
      milk fat, milk protein, and SNF were unaffected by treatment and averaged 19.0
      and 19.1 kg/d, 28.4 and 29.3 kg/d, 28.4 and 28.4 kg/d, and 3.40 and 3.30%, 3.51
      and 3.28%, and 8.4 and 8.3%, respectively, for cows on control and sucrose
      supplemented diets. In the absence of a choice of diets, sucrose at 1.5% of
      dietary DM did not enhance mean DMI over the first 12 wk postpartum; however, a
      transient increase in consumption of the sucrose-supplemented diet may have
      occurred over the a 2-wk period after parturition. Variation in feed consumption
      during early lactation suggests that additional data are needed to examine this
      potential effect.

PMID- 7790577
TI  - Effect of supplemental dietary fat or protein on the short-term milk production
      response to bovine somatotropin.
AB  - Effects of supplemental energy or protein on the milk production response to bST
      administration were examined in two separate trials. In trial 1, 40 cows were
      used in a 2 x 2 factorial, completely randomized design to determine the effects
      of bST and fat supplementation. The study consisted of a 7-d pretreatment period
      and a 42-d treatment period. Fat was top-dressed at 3.0 Mcal/d of NEL, and bST
      was administered. Supplemental fat had no effect on milk production, and NEL
      intakes were unaffected. Administration of bST increased milk production by 7.1
      kg/d, and the milk production response was unaffected by supplemental fat. In
      trial 2, 4 cows were used in four periods with a 2 x 2 factorial arrangement in
      which water or casein was infused into the abomasum of cows fed for ad libitum
      intake or at 80% of their requirements. Diets and infusions were initiated
      simultaneously and continued for 11 d. All cows were given bST during the last 5
      d. Infusion of water or casein did not alter the milk production response to bST,
      but restricted feeding reduced the bST response (3.2 vs. 7.2 kg/d).
      Concentrations of IGF-I in plasma were increased by bST administration, and the
      increase was greatest for cows fed for ad libitum intake. The milk production
      response to bST was not increased by additional energy or protein offered to cows
      fed well-balanced diets.

PMID- 7790581
TI  - Effects of housing and colostrum feeding on serum immunoglobulins, growth, and
      fecal scores of Jersey calves.
AB  - Ninety-six Jersey calves were used to evaluate the effects of housing and method
      of colostrum feeding on serum Ig concentrations, incidence and severity of
      scours, intake, and BW changes from birth to 35 d of age. Calves were separated
      from the dam and fed 2 L of colostrum in nipple-bottles or allowed to nurse the
      dam for 3 d. Calves were housed in individual hutches or wooden pens in a barn.
      Intake of colostrum by calves allowed to nurse the dam was not controlled. Serum
      IgG and IgM concentrations at 24 h of age were greater for calves that nursed the
      dam. Scours were less severe when calves were housed in hutches, but number of
      days scouring was unaffected by treatment. Calves fed colostrum in nipple-bottles
      and housed in the barn consumed more starter than did other calves from 3 to 5 wk
      of age. The BW were greater for calves allowed to nurse the dam and housed in
      hutches. Feed efficiency over the 35-d study was improved when calves nursed the
      dam. Optimal transfer of passive immunity and housing in hutches appeared to
      maximize health and growth in this study.

PMID- 7790582
TI  - Plasma proteins and a probiotic as ingredients in milk replacer.
AB  - Milk replacers containing all milk protein, 25% of protein from porcine plasma
      protein, 25% of protein from bovine plasma protein, or all milk protein plus
      probiotic were compared in a 6-wk experiment using 120 Holstein bull calves
      approximately 7 d of age. All replacers contained an antibiotic except the one
      that contained probiotic. Calf starter always was available, and calves were
      weaned when they consumed 680 g/d of starter. Ten calves were selected randomly
      from each group for sampling of jugular blood at d 1 and 10 of the experiment. A
      complete blood count was conducted on the samples, and protein fractionation by
      electrophoresis was performed on sera harvested from the samples. Mean BW gains
      started to differ at the end of wk 3, and by the end of wk 6 the difference of
      2.6 kg was significantly greater for those calves fed porcine or bovine plasma
      than for calves fed all milk protein (with or without probiotic). The same
      response was noted for starter consumption; the difference increased to 4.15 kg
      by the end of wk 6. Most measurements of blood did not differ by treatment; those
      that were different did not suggest an apparent difference in performance
      response. Growth performance of calves fed probiotic was not different from that
      of calves fed antibiotic when both replacers contained all milk protein. Either
      porcine or bovine plasma protein was an acceptable source of protein.

PMID- 7790584
TI  - Correlations among somatic cell scores of milk within and across lactations and
      linear type traits of Jerseys.
AB  - Genetic and phenotypic correlations were estimated for means of log2 SCC (somatic
      cell scores) from the first 305 d, the first 75 d, the first 150 d, 76 to 305 d,
      and 151 to 305 d of lactation for first and second lactations using REML. Somatic
      cell scores from the Dairy Records Processing Center in Raleigh, North Carolina
      for 31,180 Jersey cows sired by 411 bulls were used for analyses. Correlations
      between sire evaluations for somatic cell scores from this study and linear type
      traits from the American Jersey Cattle Club were also calculated. The model used
      for analyses of the somatic cell score means included herd-year of calving, age
      at first calving, sire, and residual. Heritability estimates for the means ranged
      from .05 to .15 (.12 for 305-d mean for first lactation). Genetic correlations
      among the somatic cell score means within first and within second lactation were
      > or = .79. The genetic correlation between the 305-d mean from first and second
      lactation was .90. The smallest genetic correlation across lactations was .68.
      Somatic cell scores measured at various times were under similar genetic control.
      Phenotypic correlations were usually much smaller than genetic
      correlations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790583
TI  - Association of alleles for the class I bovine lymphocyte antigens with
      conformation, semen traits, and growth rate of young bulls.
AB  - The 279 Norwegian bulls that were performance tested during 1988 and 1989 were
      typed for bovine lymphocyte antigens of class I, and relationships with
      performance test results of these bulls were investigated. A single-trait animal
      model was used to estimate the gene substitution effects of bovine lymphocyte
      antigens on conformation as well as semen volume, density, and quality; a fixed
      linear model was also applied to the breeding values of growth rate. Allelic
      frequencies ranged from .2 to 28%; alleles w16 (28%), A2 (15%), A10(w50) (12%),
      and A8 (10%) were the most frequent. Allele A12(A30) was significantly associated
      with decreased semen density and decreased growth rate, and allele A10(w50) was
      significantly associated with increased growth rate. No antigen showed a
      significant association with conformation, semen density, or semen quality.
      Heterozygosity at the locus for bovine lymphocyte antigen of class I did not show
      significant advantage in any of the traits. The bovine lymphocyte antigens
      appeared to be potential markers for quantitative trait loci controlling semen
      density and growth rate; however, further research is necessary to confirm these
      findings.

PMID- 7790586
TI  - The effect of test day models on the estimation of genetic parameters and
      breeding values for dairy yield traits.
AB  - The present study estimated genetic parameters for yields of milk, fat, and
      protein applying REML procedures under test day animal models. The data consisted
      of 155,494 test day records from 15,756 Friesian cows in first lactation from one
      region in northern Germany. The models applied included a traditional herd-year
      season model for the analysis of single test days and 305-d records and two test
      day models differing by the definition of contemporary groups, either as herd
      year-season of calving or as herd-test day. For single test days, heritabilities
      were highest for midlactation yields. For test day models, estimates of
      heritability varied with the number of test day records included for each cow.
      Estimates of .32, .19, and .20 for yields of milk, fat, and protein,
      respectively, were highest when only test d 3 to 7 were included; the
      corresponding estimates for 305-d records were .39, .32, and .30. Estimates of
      residual variances were reduced when test day records were converted to records
      of average yield in standardized intervals of 30 d. Breeding values were
      estimated for 305-d and test day models. A comparison of both sets of breeding
      values indicates only minor changes in sire rank, but more drastic reranking for
      individual cows.

PMID- 7790585
TI  - A model for reproductive efficiency of dairy bulls.
AB  - Reproductive efficiency of bulls is usually measured by nonreturn rate, which is
      commonly defined as the proportion of cows that were inseminated and did not
      return for another service within a specified number of days. The AI
      organizations use nonreturn rate to evaluate fertility of a bull or performance
      of a technician. Measures derived from nonreturn rate, such as conception rate
      and calving rate, might be more reliable for evaluation than nonreturn rate
      itself. Estimated conception rate is a better early measure of efficiency than
      nonreturn rate, because conception rate depends on the population of spermatozoa
      at insemination and not on developmental potential of the conceptus after
      insemination. A mathematical function is presented to model reproductive
      efficiency of bulls by estimation of the probability of conception at time of
      insemination (conception rate) and the probability of completing gestation after
      insemination (calving rate) through the relationship of nonreturn rate to the
      concentration of spermatozoa at insemination and the time after insemination. The
      model is illustrated with three bulls, using nonreturn rates by 28, 56, and 84 d
      after insemination.

PMID- 7790588
TI  - A diagnostic and prognostic tool for epidemiologic and economic analyses of dairy
      herd health management.
AB  - A computer program framework was established to enable a dairy herd production
      consultant to perform whole-herd analysis. The diagnostic process was an
      extensive data analysis 1) to derive key parameters related to production,
      reproduction, and health and 2) to produce input to a prognostic process. The
      prognostic process synthesized the obtained information into short- or long-term
      prognoses for the herd through a complex herd simulation model. Site specificity
      of parameter estimation and forecasting and explorability of assumptions and
      results were major characteristics of the approach. A user acceptance problem
      related to the simulation was addressed through a simultaneous process of
      development and validation during the introduction of the program framework into
      veterinary practices. The generally slow adoption of herd simulation models in
      extension work could be due to lack of credibility of the models. A major barrier
      to adoption of the current whole-herd approach may be the considerable time
      required to understand and use the tools properly. An example of a simulation
      experiment based on data from a New York dairy farm was provided, and the
      interpretation and practical applications of such simulations were discussed.

PMID- 7790587
TI  - Variance of interaction effects of sire and herd for yield traits of Holsteins in
      California, New York, and Pennsylvania with an animal model.
AB  - An animal model with a REML algorithm was used to estimate variances of additive
      genetic effects and interaction effects of sire and herd. Milk and fat yields
      were analyzed for first, second, and third lactations of Holsteins from
      California, New York, and Pennsylvania. Twenty samples of data were used in the
      study: 10 from California, 4 from New York, and 6 from Pennsylvania. Mean number
      of lactations per sample was 36,820 from 18,189 cows in 156 herds. Mean fractions
      of phenotypic variance of interaction effects of sire and herd for milk and fat
      yields were .015 and .019 for first lactation and .019 and .021 for all (up to
      three) lactations rather than the .14 used for national genetic evaluations in
      the US. Mean heritability estimates for milk and fat yields were .26 and .24 for
      first lactation and .21 and .21 for all lactations in California and .34 and .35
      for first lactations and .28 and .29 for all lactations in New York. Sums of
      variances of permanent environmental and interaction effects of sire and herd
      were similar to those used for national genetic evaluations in the US. Analysis
      of another 10 samples from California and 10 samples from New York showed only
      slightly different fractions of phenotypic variance for milk yield for
      interaction effects of sire by herd, sire by herd by year, and sire by herd by
      year by season: .023, .027, and .037 for California and .023, .017, and .023 for
      New York, respectively.

PMID- 7790589
TI  - Quantity and economic importance of nine selected by-products used in California
      dairy rations.
AB  - Food processing representatives, brokers, nutritionists, livestock producers, and
      trade associations were surveyed to quantify 9 by-products used for feeding
      livestock during 1992 in California. The commodities were almond hulls, dried
      beet pulp, wet brewers grains, wet citrus pulp, pressed citrus pulp, wet corn
      gluten feed, corn gluten meal, whole cottonseed, and rice bran. The 9 by-products
      contributed over 2.5 million tonnes and about 27% of the total feed concentrate
      moved within California during 1992. Market value of these 9 by-products was
      almost .25 billion dollars. Whole cottonseed accounted for about 31% of the total
      tonnage of these 9 by-products and provided about 66% of the total CP and 53% of
      the total NEL of these 9 by-products. The by-products were more valuable as
      energy sources than CP sources compared with NEL from corn and CP from soybean
      meal, respectively. Calculations of milk production, based on the CP content or
      NEL content of the by-products, showed that these 9 by-products could have
      contributed sufficient CP or NEL for over 31% of the milk produced in California
      during 1992. Ration formulations demonstrated that the economic value of by
      products changed with feedstuffs available and, in general, would be used in
      rations over a range of market prices.

PMID- 7790590
TI  - The mouth that roared: effective advocacy in the nineties and beyond.

PMID- 7790592
TI  - Oral Candida: clearance, colonization, or candidiasis?
AB  - Candida albicans is frequently isolated from the human mouth, yet few carriers
      develop clinical signs of candidiasis. Oral candidiasis presents clinically in
      many forms. This reflects the ability of the yeast to colonize different oral
      surfaces and the variety of factors which predispose the host to Candida
      colonization and subsequent infection. Colonization of the oral cavity appears to
      be facilitated by several specific adherence interactions between C. albicans and
      oral surfaces which enable the yeast to resist host clearance mechanisms. Thus,
      Candida has been shown to adhere to complement receptors, various extracellular
      matrix proteins, and specific sugar residues displayed on host or bacterial
      surfaces in the oral cavity. Oral candidiasis results from yeast overgrowth and
      penetration of the oral tissues when the host's physical and immunological
      defenses have been undermined. Tissue invasion may be assisted by secreted
      hydrolytic enzymes, hyphal formation, and contact sensing. While these and other
      phenotypic characteristics may endow certain Candida species or strains with a
      competitive advantage in the oral cavity, it is the host's immune competence that
      ultimately determines whether clearance, colonization, or candidiasis occurs.

PMID- 7790591
TI  - Charting our future.

PMID- 7790594
TI  - Variability in microleakage observed in a total-etch wet-bonding technique under
      different handling conditions.
AB  - Using a stereoscopic clearing protocol and scanning electron microscopy, we
      investigated the extent and nature of microleakage in a total-etch, current
      generation dentin adhesive by a wet-bonding technique under different handling
      conditions. The hypotheses were that inadequate light curing of the primer or
      incomplete drying of the primer solvent might adversely affect the sealing
      ability of an acetone-containing adhesive system. The study consisted of three
      experimental groups: (I) a control group with an adequate light source and with
      the primer solvent completely dried; (II) an "inadequate-light" group; and (III)
      an "incomplete evaporation of primer solvent" group. The extent of microleakage
      after silver staining and clearing of the specimens was scored based on a
      modified five-point scale. Nonparametric statistical analysis (Kruskal-Wallis
      ANOVA) followed by a multiple comparison test (Dunn test) indicated significant
      differences among the three groups (p < 0.05). SEM examination of the restorative
      interface revealed that microleakage appeared to be initiated from the bonding
      resin-hybrid layer interface in all three groups, representing the weak link in
      the adhesive system. In addition, microleakage was characterized by 5 zones, each
      delineating a stage in a continuous array of progressively deleterious
      microleakage patterns variously distributed among the three groups. It was
      suggested that, while the bonding resin-hybrid layer interface represented the
      intrinsic weakness in an already much improved dentin adhesive, extrinsic factors
      such as the adequacy of the curing light and, more importantly, complete removal
      of the primer solvents can and should be avoided to preserve the structural
      integrity of the marginal seal.

PMID- 7790595
TI  - Mineral distribution and dimensional changes in human dentin during
      demineralization.
AB  - Many bonding agents require the dentin surface to be acid-etched prior to being
      bonded. Understanding the stability and morphology of the etched dentin surface
      is important for improving bond strength and reliability in these systems. In
      this study, the atomic force microscope was used to quantify dimensional changes
      that occur to fully hydrated dentin during demineralization with a pH 4.0 lactic
      acid gel. A high-resolution microtomography instrument, the x-ray tomographic
      microscope, was also used to quantify the mineral density distribution in the
      dentin as a function of etching time. The intertubular dentin surface shrank by
      less than 0.5 microns during etching, while the peritubular dentin receded at an
      initially rapid linear rate. The dentin surface retained its initial morphology,
      although it was more porous with the removal of the peritubular dentin. Beneath
      the etched surface, there were three major zones characterized by mineral density
      differences. The first zone was a fully demineralized collagen layer, subjacent
      to which was a partially demineralized zone of roughly constant mineral density.
      Immediately following the partially mineralized layer was normal dentin. The
      presence of the partially mineralized layer could be explained in terms of
      different transport rates in the peritubular and intertubular dentin.

PMID- 7790593
TI  - Effects of unpolymerized resin components on the function of accessory cells
      derived from the rat incisor pulp.
AB  - Monomeric resin components from dental composites are toxic to fibroblasts in
      culture and thus may interfere with the local immune system of the pulp, reducing
      its effective defense potential, either by cytotoxicity or by a more specific
      immune mechanism. Therefore, the present study was undertaken to observe the
      cytotoxic effects elicited by certain unpolymerized components of resin
      composites upon the function of accessory pulp cells in mitogen-induced
      proliferation of T-lymphocytes. Accessory cells from the rat incisor pulp were
      released following enzymatic digestion with collagenase. The assay included
      incubation of these cells with purified T-lymphocytes from cervical lymph nodes
      for 72 h in the presence of different concentrations of the resin components. The
      proliferative T-lymphocyte response was monitored by 3H-thymidine incorporation.
      Initially, we conducted experiments on spleen cells to determine the proper
      concentration intervals for suitable testing of the resin components. To assess
      the individual susceptibility of accessory cells and T-lymphocytes, we pre
      treated each of these cells with some of the test materials prior to assay. At
      low concentrations, urethane dimethacrylate (UDMA), bisglycidyl methacrylate (bis
      GMA), triethylene glycol dimethacrylate (TEGDMA), and bis-phenol A (BPA)
      increased spleen cell proliferation to concanavalin A (con A). Purified T
      lymphocytes stimulated by pulpal cells did not show enhanced responses to UDMA,
      bis-GMA, glycidyl mehtacrylate (GMA), or N,N,-dihydroxyethyl-p-toluidine (DHEpT).
      At higher concentrations, all substances except camphoroquinone (CAMP) showed
      inhibitory effects in both test systems. The in vitro study shows that resin
      components can evoke either immunosuppression or immunostimulation on mitogen
      driven proliferation of purified T-lyumphocytes and spleen cells.

PMID- 7790596
TI  - Mercury release from dental amalgams: an in vitro study under controlled chewing
      and brushing in an artificial mouth.
AB  - The release of mercury vapor from class I amalgam restorations prepared in human
      molar teeth was studied during chewing simulations in an artificial mouth of a bi
      axial servo-hydraulic mechanical test system. So that the total mercury released
      from the restoration over a fixed time could be determined, a closed chamber
      surrounded the envelope of chewing motion. In addition, the influence of sampling
      frequency on mercury release was corrected by the use of different sampling
      frequencies over a fixed time interval of mercury release measurement and
      extrapolation to zero sampling time. Thus, a combination of a closed environment
      and an extrapolation method to determine the mercury release under continuous
      sampling was used to determine the mercury released under normal breathing
      conditions. The measured mercury release rate data were used to calculate the
      potential daily mercury dose in a patient due to a single amalgam restoration,
      following the method previously outlined by Berglund. The mercury release from
      both a conventional and a high-copper amalgam was evaluated at different age
      intervals after the restoration was placed in the teeth. The results show that
      while the age of the amalgam and the amalgam type influence the extent of mercury
      release during the initial non-steady-state conditions, the steady-state value of
      mercury daily dose due to a single amalgam filling is 0.03 micrograms/day, which
      is well below the calculated threshold-limiting value (TLV) of 82.29
      micrograms/day considered dangerous for occupational exposure in the United
      States.

PMID- 7790597
TI  - Cavity preparation with the Nd:YLF picosecond laser.
AB  - Several laser systems for the removal of hard dental substances are currently
      under investigation. However, in most cases, such systems have been demonstrated
      to be inefficient or have led to undesirable thermal side-effects. This paper
      reports, for the first time, the removal of enamel and dentin by a picosecond
      laser system, a solid-state Nd:YLF laser. Very precise cavities can be obtained
      in the enamel and dentin of extracted human molars when laser pulses are
      distributed onto well-defined areas of the teeth. Scanning electron microscopy
      shows that the quality of the cavities is superior to that achieved by other
      laser systems. The cavity walls are very steep, and their surfaces are
      characterized by a sealed structure. In contrast to laser systems with longer
      duration pulses, picosecond laser pulses ablate with less thermal damage to the
      surrounding substance. The results of dye penetration tests and polarized
      microscopy show that even mechanical shock-wave effects are negligible. When the
      Nd:YLF laser is applied to carious enamel, the ablation rate is found to be about
      ten times higher than for sound molars, thus making the Nd:YLF laser a caries
      selective laser system.

PMID- 7790598
TI  - Computer-assisted reconstruction of enamel fissures and carious lesions of human
      premolars.
AB  - The origin of cariogenesis in occlusal fissures remains elusive because of
      limited information about both the fissure structure and the morphologic details
      of carious lesions occurring there. The present study was aimed at reconstructing
      the coronal structure of human premolars with the aid of computer-assisted image
      analysis and, on the basis of the reconstructed structures, investigating the
      configuration of fissures, their proximity to the enamel-dentin junction (EDJ),
      and the occurrence and extension of carious lesions around the fissure walls. The
      coronal portions of the teeth were embedded in polyester resin and then ground
      off stepwise by hand. Serial images of the enamel contour on successive ground
      planes were recorded by objective microscopy after it was distinctly demarcated
      with either 0.5 w/v% carbol fuchsin or 1 w/v% basic fuchsin. Usually, from 150 to
      250 photoprints were collected from a single enamel crown to reproduce the
      details of the fissure structures. The enamel outline (the occlusal and lateral
      surfaces, fissure walls, and EDJ) and, if present, the outline of caries-attacked
      areas were traced accurately on those photoprints by means of a digitizing
      system. The enamel contour data in series were input into an image analyzing
      system (Nikon COSMOZONE, 2SA). Observation of the computer-drawn coronal enamel
      allowed us to view the morphologic features of the fissures (shape, divarication,
      and proximity to EDJ) and to scrutinize the pathway of enamel caries along
      fissure walls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790599
TI  - Quantifying the strength of bacterial adhesive interactions with salivary
      glycoproteins.
AB  - We adapted an assay that has been used to estimate the strength of eukaryotic
      cell-cell and cell-extracellular matrix adhesive interactions (McClay et al.,
      1981) to quantify the strength of bacterial (streptococci, fusobacteria,
      actinomyces) interactions with salivary receptors. Bacteria are centrifuged onto
      human submandibular/sublingual or parotid-saliva-coated microtiter wells. Plates
      are sealed with pressure-sensitive, double-sided tape which allows them to be
      inverted and centrifuged again. The force required to remove the bacteria from
      the coated wells is a direct measure of the adhesive strength of the
      interaction(s) being disrupted. The bacteria-saliva adhesive forces we detected
      ranged from 1.6 x 10(-8) dynes (Streptococcus sanguis 72-40) to > 1.1 x 10(-7)
      dynes (Actinomyces viscosus T14 V). These forces were in the range to withstand
      the shear stress produced by salivary flow, which we calculated as approximately
      6.1 x 10(-7) dynes.

PMID- 7790600
TI  - Formation of differentiated tissues in vivo by periodontal cell populations
      cultured in vitro.
AB  - The periodontium contains heterogeneous mesenchymal cell populations with various
      differentiation potentials. The capacity of these cells for tissue formation as
      well as the origin of their precursors are still not entirely defined. In this
      study, cells originating from different periodontal tissues were cultured in
      vitro, and tissue formation in vivo following orthotopic re-implantation was
      investigated. Cells were recovered from the alveolar bone and periodontal
      ligament tissue of six minipigs, and cultured cells were then grown on extracted
      dental roots from the homologous animals by means of co-culture in vitro. Each
      minipig received 2 roots covered with alveolar bone cells, 2 roots covered with
      periodontal ligament cells, and 2 control roots (without cells) implanted into
      palatal bone defects. Intravital fluorochrome labeling was performed, and two
      minipigs were histologically examined after 2, 4, and 12 weeks in each case.
      Controls showed widespread resorption and ankylosis, whereas roots covered with
      cultured periodontal cells exhibited tissue formation in vivo. Alveolar bone
      cells synthesized a calcified cellular tissue resembling cellular cementum,
      suggesting that cells within this population might differentiate into
      cementoblasts when reimplanted with a dental substrate in vivo. Periodontal
      ligament cells exhibited no calcified tissue formation in vivo, but cells
      synthesized a connective tissue with orientated fiber bundles attached to both
      host bone and root, resembling periodontal ligament.

PMID- 7790601
TI  - Expression of basement membrane type IV collagen and type IV collagenases (MMP-2
      and MMP-9) in human fetal teeth.
AB  - Formation and degradation of dental basement membrane (BM) are important for
      tooth development. Data on the expression of genes for type IV collagen (the
      major structural component of the BM) and type IV collagenases [MMP-2 (72 kDa)
      and MMP-9 (92 kDa)], enzymes that degrade type IV collagen during human tooth
      development, are lacking. We studied expression of type IV collagen and the MMP-2
      and MMP-9 in human fetal teeth (from the 13th to the 20th gestational weeks,
      covering cap stage through early hard tissue formation). During cap and bell
      stages, in situ hybridization located transcripts for alpha 1 type IV collagen
      chain in the fibroblasts surrounding the enamel organ. No alpha 1 type IV
      collagen chain mRNA was detected in tooth germ epithelium or dental papilla.
      However, type IV collagen immunoreactivity was observed in BM underlying the
      dental epithelium up to the appositional stage. Transcripts for MMP-2 were
      located mostly in the cells of the dental papilla and follicle. Transient
      expression of MMP-2 mRNA was observed in the inner enamel epithelium of late
      cap/early bell-stage teeth. During early apposition, a high level of MMP-2 was
      confined to secretory odontoblasts. Transcripts for MMP-9 were detected by the
      sensitive reverse-transcription polymerase chain reaction (RT-PCR) in developing
      teeth. Thus, in dental BM, alpha 1 type IV collagen chain may be of mesenchymal
      cell origin. Further, MMP-2 but not MMP-9 may participate in remodeling and
      degradation of BM during human tooth morphogenesis.

PMID- 7790602
TI  - Effect of lung inflation on levator veli palatini muscle activity.
AB  - Palatal movements play a critical role in regulating oropharyngeal airflow during
      breathing. We hypothesized that these movements are coordinated with breathing
      movements via afferent signals from the lung. However, the control of palatal
      movements in relation to the lung remains unclear. This study was designed to
      define, by electromyographic techniques, the relationship between palatal
      movement and lung action during respiration. We performed tracheotomies on 12
      mongrel dogs anesthetized with sodium pentobarbital and found that lung inflation
      augmented the activity of the levator veli palatini muscle (LVP). Two kinds of
      discharges were recognized during the expiratory pause following lung inflation.
      One was a continuous, low-amplitude discharge induced during apnea following lung
      inflation. The other was a transient, high-amplitude discharge which appeared
      immediately after lung inflation. Both of these response activities were
      eliminated by bilateral vagotomy. We thus concluded that palatal movements, which
      can regulate expiratory airflow resistance and cause switching from nasal to oral
      airflow, are under the control of vagal afferent signals from the lung.

PMID- 7790603
TI  - Is ARDS usually associated with right ventricular dysfunction or failure?

PMID- 7790604
TI  - Effects of inhaled nitric oxide on right ventricular function in severe acute
      respiratory distress syndrome.
AB  - OBJECTIVE: To compare the effects of inhaled nitric oxide (NO) and an infusion of
      prostacyclin (PGI2) on right ventricular function in patients with severe acute
      respiratory distress syndrome (ARDS). DESIGN: Randomized prospective short-term
      study. SETTING: Post-surgical ICU in an university hospital. PATIENTS: 10
      patients with severe ARDS referred to our hospital for intensive care.
      INTERVENTIONS: In random sequence the patients inhaled NO at a concentration of
      18 parts per million (ppm) followed by 36 ppm, and received an intravenous
      infusion of PGI2 (4 ng.kg-1.min-1). MEASUREMENTS AND RESULTS: Inhalation of 18
      ppm NO reduced the mean (+/- SE) pulmonary artery pressure (PAP) from 33 +/- 2 to
      28 +/- 1 mmHg (p = 0.008), increased right ventricular ejection fraction (RVEF),
      as assessed by thermodilution technique, from 28 +/- 2 to 32 +/- 2% (p = 0.005),
      decreased right ventricular end-diastolic volume index from 114 +/- 6 to 103 +/-
      8 ml.m-2 (p = 0.005) and right ventricular end-systolic volume index from 82 +/-
      4 to 70 +/- 5 ml.m-2 (p = 0.009). Mean arterial pressure (MAP) and cardiac index
      (CI) did not change significantly. The effects of 36 ppm NO were not different
      from the effects of 18 ppm NO. Infusion of PGI2 reduced PAP from 34 +/- 2 to 30
      +/- 2 mmHg (p = 0.02), increased RVEF from 29 +/- 2 to 32 +/- 2% (p = 0.02).
      Right ventricular end-diastolic and end-systolic volume indices did not change
      significantly. MAP decreased from 80 +/- 4 to 70 +/- 5 mmHg (p = 0.03), and CI
      increased from 4.0 +/- 0.5 to 4.5 +/- 0.5 l.min-1.m-2 (p = 0.02). CONCLUSIONS:
      Using a new approach to selective pulmonary vasodilation by inhalation of NO, we
      demonstrate in this group of ARDS patients that an increase in RVEF is not
      necessarily associated with a rise in CI. The increase in CI during PGI2 infusion
      is probably related to the systemic effect of this substance.

PMID- 7790605
TI  - Corticosteroid effect on early beta-adrenergic down-regulation during circulatory
      shock: hemodynamic study and beta-adrenergic receptor assay.
AB  - OBJECTIVES: The steroid effect on critically ill patients remains controversial.
      The aim of this study is to characterize the effect of methylprednisolone on the
      heart in a beta-adrenergically down-regulated condition. DESIGN: A prospective
      hemodynamic study and retrospective receptor assay. SETTING: Multidisciplinary
      ICU in a university hospital. SUBJECTS: 42 patients who required pulmonary
      arterial catheters and an additional 4 corpses who were available for study
      within 3 h of their deaths. INTERVENTION: Intravenous methylprednisolone (10
      mg/kg). MEASUREMENTS AND RESULTS: We pursued a hemodynamic study following a
      glucocorticoid administration. In patients who had undergone a long term (> 72 h)
      catecholamine treatment, the cardiac index increased. In patients who had
      undergone a short term (1-72 h) catecholamine treatment and in patients with no
      record of catecholamine administration, the cardiac index showed no remarkable
      change. Among the corpses, who died soon after their arrival, and the patients,
      who later died in the ward and were available for further study, we measured beta
      adrenergic receptor density in the left ventricular myocardium. It was found that
      receptor density was decreased after long term catecholamine treatment.
      Methylprednisolone, on the other hand increased the receptor density. CONCLUSION:
      Methylprednisolone improved the cardiac index, intriguingly, in patients with
      long term catecholamine treatment in circulatory shock. Myocardial beta
      adrenergic receptor also increased in number after the administration of
      methylprednisolone. However, the hemodynamic improvement caused by
      methylprednisolone was not observed in patients without beta-adrenergic down
      regulation.

PMID- 7790606
TI  - Oxygen cost of breathing for assisted spontaneous breathing modes: investigation
      into three states of pulmonary function.
AB  - OBJECTIVE: We investigated the effects of continuous positive airway pressure
      (CPAP) and pressure support ventilation (PSV) on the oxygen cost of breathing
      (VO2resp) for different states of pulmonary function. Additionally VO2resp was
      measured during spontaneous breathing. DESIGN: This was done in a controlled and
      prospective study. Ventilatory modes were applied randomly. SETTING: Measurements
      were performed in a quiet room on volunteers (VOL) and inpatients treated for
      chronic obstructive pulmonary disease (COPD). Post-operative patients after
      aortocoronary bypass surgery (ACB) were studied on the cardio-thoracic intensive
      care unit just before and after extubation. PATIENTS: Healthy volunteers (n =
      14), postoperative patients after aorto-coronary bypass surgery (n = 15) and
      patients with COPD (n = 9, xFEV1 47.7%) were the objects of study. INTERVENTIONS:
      Demand flow CPAP (5 mbar) and PSV (7 mbar, PEEP 5 mbar), using the Hamilton
      Veolar ventilator, were investigated in comparison to spontaneous breathing.
      MEASUREMENTS AND RESULTS: VO2 was measured by a Datex Deltatrac metabolic
      monitor. VO2resp was calculated by subtraction of total oxygen uptake (VO2tot) in
      controlled mode ventilation (CMV) from that in the respective spontaneous
      breathing mode. For VOL and COPD patients who were not intubated, a CPAP facemask
      connected to a short 7.5 mm tube was used as connection to the ventilator.
      Breathing spontaneously under a canopy system VOL showed a VO2resp of 4.5 +/-
      4.0% compared to 9.2 +/- 3.5% for ACB and 15.4 +/- 7.7% for COPD. CPAP changed
      the VO2resp to 7.8 +/- 3.9%, 12.0 +/- 4.0% and 9.1 +/- 3.6% respectively. PSV
      reduced the VO2resp to 7.9 +/- 3.8% in ACB and 7.7 +/- 5.5% in COPD. CONCLUSIONS:
      This investigation confirms findings that postoperative patients have a mild
      increase in VO2resp. COPD exhibit the highest increase in VO2resp. Tracheal
      tubes, masks and CPAP on a demand flow apparatus increases VO2resp in volunteers
      and postoperative patients after cardiac surgery. The same amount of CPAP in
      contrary reduces VO2resp in patients with COPD. Pressure support ventilation can
      offset the additional VO2resp induced by CPAP but at the same level does not
      further reduce VO2resp in COPD patients.

PMID- 7790607
TI  - Alterations in circulating vasoactive substances in the critically ill--a
      comparison between survivors and non-survivors.
AB  - OBJECTIVE: Regulation of circulatory homeostasis is based on several factors
      including various circulating vasoactive substances. Whether these regulators
      differ between survivors and non-survivors was investigated in critically ill
      patients. DESIGN: Prospective study. SETTING: Clinical investigation on a
      surgical intensive care unit of an university hospital. PATIENTS: 60 consecutive
      patients suffering from trauma (n = 21) or postoperative complications (n = 39)
      were studied prospectively. The patients were divided into survivors (n = 27) and
      non-survivors (n = 33). Therapy was adjusted to the standards of modern intensive
      care management by physicians who were not involved in the study. MEASUREMENTS
      AND RESULTS: Endothelin-1, atrial natriuretic peptide (ANP), vasopressin, renin,
      and catecholamine (epinephrine, norepinephrine) plasma levels were measured from
      arterial blood samples using radioimmunoassay (RIA) or high-pressure liquid
      chromatography (HPLC) technique on the day of admission to ICU and during the
      following 5 days. Various hemodynamic parameters were also monitored during that
      period. The non-survivors showed elevated pulmonary artery pressure (PAP: 34.1 +/
      5.4 mmHg) and pulmonary capillary wedge pressure (PCWP: 20.3 +/- 7.3 mmHg)
      already at the beginning of the study. Cardiac index (CI) did not differ among
      the groups, whereas right ventricular ejection fraction (RVEF) decreased in the
      non-survivors. PaO2/FIO2 decreased only in the non-survivors, whereas VO2
      increased in the survivors (from 246 +/- 48 to 331 +/- 43 ml/min). Plasma levels
      of renin (from 206 +/- 40 to 595 +/- 81 pg/ml) and vasopressin (from 5.78 +/-
      0.82 to 7.97 +/- 0.69 pg/ml) increased significantly in the non-survivors.
      Epinephrine and norepinephrine plasma concentrations were elevated in the non
      survivors already at baseline and tremendously increased in these patients during
      the following days. ANP plasma levels significantly increased also only in the
      non-survivors (from 188 +/- 63 to 339 +/- 55 pg/ml) (p < 0.05). Endothelin-1
      decreased in the survivors, whereas it significantly increased in the non
      survivors (from 3.62 +/- 0.68 to 9.37 +/- 0.94 pg/ml) during the study period (p
      < 0.05). Analyses of co-variance revealed overall no significant correlation
      between circulating vasoactive substances and hemodynamics. CONCLUSIONS: Systemic
      and regional regulators of the circulation were markedly changed by critical
      illness. In survivors, these regulators almost normalized within the study period
      of 5 days, whereas in non-survivors these alterations were even aggravated. It
      can only be speculated whether these regulator systems were influenced by
      activation of various mediator systems or whether they themselves influenced the
      negative outcome in the non-survivors.

PMID- 7790608
TI  - Septic shock due to Pseudomonas aeruginosa in a previously healthy woman.
AB  - Pseudomonas aeruginosa septicemia rarely occurs in non-immunocompromised adults.
      We present a case of septic shock following Pseudomonas aeruginosa pneumonia in a
      previously healthy 48-year-old woman. The onset was sudden, with back pain,
      pyrexia and shock. Chest radiographs revealed pneumonia, and Pseudomonas
      aeruginosa was identified from blood and sputum cultures. Therapy with dopamine,
      piperacillin and fluid replacement led to a prompt recovery. Laboratory tests
      failed to reveal any immunological deficits. Including this case, only five cases
      of Pseudomonas aeruginosa septicemia in patients though to be non
      immunocompromised have been reported. Two remarkable features of this type of
      Pseudomonas infection are apparent: i) it commonly develops from pneumonia and
      ii) it has a better prognosis than that in immunocompromised hosts.

PMID- 7790610
TI  - Enterococcus faecalis colonisation and endocarditis in five intensive care
      patients as late sequelae of selective decontamination.
AB  - OBJECTIVE: To describe Enterococcus faecalis colonisation and endocarditis in 5
      intensive care patients after treatment with selective decontamination (SDD).
      SETTING: Intensive care unit (ICU) in a general hospital. PATIENTS: The patients
      were admitted to the ICU because of adult respiratory distress syndrome,
      polytrauma (2 patients), abdominal aortic surgery and gastrointestinal surgery.
      Because these patients needed mechanical ventilation they received systemic
      cefotaxime and SDD (polymyxin E, amphotericin B and norfloxacin). RESULTS:
      Colonisation with E. faecalis was documented in all patients. Intravascular
      catheter-related infection with E. faecalis occurred in 4 patients. None of the
      patients received antibiotics active against, E. faecalis, because body
      temperature normalised after catheter removal. In the course of his ICU stay one
      patient died. Autopsy showed E. faecalis endocarditis. The other 4 patients
      recovered from their primary illness, but had to be readmitted after several
      months because of E. faecalis endocarditis. One of these patients died. One
      patient recovered of endocarditis, but one year later valve surgery was
      necessary. The other 2 patients needed acute valve replacement. The latter 3
      patients survived. CONCLUSION: We observed 5 patients with E. faecalis
      endocarditis as a late and severe sequela of SDD during their ICU stay.

PMID- 7790611
TI  - Excessive hypokalemia and hyperkalemia following head injury.
AB  - A sudden decrease of serum potassium below 2.5 mmol/l carries the risk of
      dangerous arrhythmias and requires immediate replacement therapy [6]. We refer to
      a patient with a brain stem compression after head injury, who developed a
      profound hypokalemia (K+ = 1.2 mmol/l) with life-threatening arrhythmias,
      probably due to a catecholamine induced intracellular potassium shift (beta-2
      stimulation). Only by aggressive potassium replacement up to 80 mmol/h (610
      mmol/16 h) could potassium levels be increased and cardiac arrhythmias
      terminated. Although replacement therapy was stopped when the serum K(+)-level
      increased to 2.4 mmol/l, 3.5 h later the patient became hyperkalemic (8.1
      mmol/l). This was probably due to a secondary shift of potassium from intra- to
      extracellular space. In patients with severe head trauma and the potential risk
      of excessive catecholamine release special attention must be paid to changes in
      potassium balance.

PMID- 7790609
TI  - Toxoplasma pericarditis in acquired immunodeficiency syndrome.
AB  - Large pericardial effusions are now a well-known complication of the acquired
      immunodeficiency syndrome, mainly caused by mycobacterial disease. However, other
      etiologies can be found. We report a case of toxoplasma pericarditis without
      other parasitic localizations. Pericarditis is a very uncommon clinical feature
      during toxoplasmosis. Its diagnosis is often difficult to establish, particularly
      in immunocompromised patients. Nevertheless, its possible evolution to
      constriction or tamponade requires its consideration. New methods of rapid tissue
      cultures may be helpful and allow early specific treatment.

PMID- 7790612
TI  - Massive vasopressin-resistant polyuria induced by dexamethasone.
AB  - A case of severe polyuria elicited by intravenous administration of a normal
      pharmacological dose of dexamethasone is reported. The polyuria did not respond
      to treatment with vasopressin. A 15-year-old girl with a brain tumour was
      referred for surgery. After induction of anaesthesia she received dexamethasone 4
      mg i.v., and developed a massive polyuria with hourly diuresis of up to 1250 ml.
      There was no response to treatment with vasopressin in doses well above those
      normally used. The patient did not fulfil any known cause of diabetes insipidus,
      and to our best knowledge, this case is the first with glucocorticoid-induced and
      vasopressin-resistant polyuria ever reported in man.

PMID- 7790613
TI  - Retinopathy of prematurity.
AB  - This review deals with retinopathy of prematurity (ROP), a disease characterized
      by retinovitreal neovascularization, eventually retinal detachment and blindness.
      Due to the increasing number of extremely premature newborns, it is becoming more
      frequent. ROP of all stages occurs in 25-35% of surviving premature newborns of
      gestational age up to approximately 35 weeks. Stages 3 or more occur in 5-10%,
      blindness in 3-5% of very immature babies. The incidence is inversely related to
      gestational age. Classification is internationally unified (ICROP) and describes
      5 stages. Its pathogenesis has not yet been clarified. More or less proven risk
      factors are retinovascular immaturity, hyperoxia and possibly circulatory and
      respiratory instability. Prophylaxis consists in avoiding hyperoxia, and probably
      also in keeping the extremely premature newborn stable. Ophthalmologic
      examinations must be performed by ophthalmologists experienced in this field or
      under their direct responsibility and must be standardized. Treatment of ROP can
      be carried out at a certain stage by coagulation therapy.

PMID- 7790614
TI  - Apnea testing in suspected brain dead children--physiological and mathematical
      modelling.
AB  - OBJECTIVE: To study the validity and safety of the traditional apnea test in
      children, and to evaluate a mathematical equation estimating the hemodynamic
      response to the apnea test. DESIGN: A prospective clinical study. SETTING:
      Pediatric ICU. PATIENTS AND PARTICIPANTS: 38 pediatric patients suffering severe
      brain injury aged 2 months to 17 years, undergoing apnea testing for brain death.
      MEASUREMENTS AND RESULTS: Apnea tests were performed 61 times (once in 19
      patients, twice in 15, and 3 times in 4 patients). Mean PaCO2 was 41.1 +/- 10.6
      mmHg before apnea and increased to 68.0 +/- 17.6 at 5 min. PaCO2 increased to
      81.8 +/- 20.1 and 86.0 +/- 25.6 at 10 and 15 min, respectively. There was a mean
      PaCO2 increase by 5.38 +/- 1.4 mmHg/min in the first 5 min, and 2.75 +/- 0.5
      mmHg/min during the next 5 min. We found a statistically significant (p < 0.05)
      linear relationship between the natural logarithm of PaCO2, time, and the
      logarithm of the initial level of PaCO2. An inverse linear relationship (p <
      0.05) was found between systemic mean arterial pressure (MAP) and initial level
      of PaCO2 presented as mathematical correlations and nomograms. CONCLUSIONS: By
      using our model for predicting MAP and PCO2 prior to apnea testing, hemodynamic
      embarrassment can be anticipated and prevented, thus allowing a safer procedure
      in the detection of brain death. Despite the fact that continuous
      cardiorespiratory monitoring is important, hemodynamic disturbances can be
      estimated before the apnea test, thus allowing a safer approach to brain death
      detection.

PMID- 7790615
TI  - Flumazenil in the treatment of hepatic encephalopathy in children with fulminant
      liver failure.
AB  - OBJECTIVE: To evaluate the effect of flumazenil on hepatic encephalopathy
      complicating fulminant liver failure in children. DESIGN: Uncontrolled
      prospective study. SETTING: Pediatric Intensive Care Unit, tertiary care center.
      PATIENTS: 9 children with fulminant liver failure and hepatic encephalopathy
      awaiting emergency liver transplantation. INTERVENTIONS: Changes in hepatic
      encephalopathy grade and in electroencephalogram were recorded during the
      injection of a bolus of flumazenil (0.01 mg/kg/i.v. bolus) followed by a
      continuous infusion of flumazenil (0.01 mg/kg/h). MEASUREMENTS AND MAIN RESULTS:
      Before flumazenil, 7 children had grade 2 and 2 had grade 3 hepatic
      encephalopathy. Flumazenile injection mediated an arousal effect in 1 child in
      whom encephalopathy improved from grade 3 to grade 2. This effect lasted 30 min.
      No clinical response was observed in other children. An improvement of EEG
      anomalies was observed lasting 3 min in one child. Despite continuous infusion of
      flumazenil, encephalopathy worsened in all children. CONCLUSION: The effect of
      intravenous administration of flumazenil on hepatic encephalopathy in children
      with fulminant liver failure is inconsistent. Its efficacy is transient. The
      therapeutic value of flumazenil in children with fulminant liver failure awaiting
      a liver graft is minimal at this dosage.

PMID- 7790616
TI  - Reliability of clinical assessments of respiratory system compliance (Crs) made
      by junior doctors.
AB  - OBJECTIVE: To assess the reliability of estimates of static respiratory system
      compliance (Crs) made by junior hospital doctors caring for ventilated newborn
      infants. DESIGN: A prospective comparison of junior doctors' estimates of Crs to
      the Crs measured immediately afterwards. SETTING: A regional neonatal intensive
      care nursery in Edinburgh, Scotland. PATIENTS: 46 ventilated newborn infants.
      MEASUREMENTS AND RESULTS: Crs was estimated by three grades of junior doctor
      (Senior House Officer, Registrar and Research Fellow) using two different
      methods, (i) based on visual assessment of tidal volume in relation to inflation
      pressure (optical Crs) and (ii) directly using a visual analogue scale (analogue
      Crs). The Crs was then measured immediately afterwards using the single breath
      passive expiratory flow technique. The differences between the estimates and the
      measurements were calculated for each grade of observer and plotted against the
      corresponding measurements. The relationship between estimates and measurements
      was also expressed in terms of the coefficients of determination r2 calculated by
      least squares regression. With both methods of estimation observers tended to
      overestimate the Crs of infants with lower measured Crs and underestimate that of
      infants with higher measured Crs with many estimates differing from the
      measurements by more than 50%. Values of r2 ranged from 0.086 to 0.481 indicating
      a weak relationship between the estimates and the measurements. CONCLUSIONS:
      Junior doctors' estimates of Crs were unreliable and did not represent a useful
      method of assessing respiratory function. The clinical use of compliance
      measurements merits wider evaluation.

PMID- 7790617
TI  - Surfactant adjunctive therapy for Pneumocystis carinii pneumonitis in an infant
      with acute lymphoblastic leukaemia.

PMID- 7790619
TI  - In vivo proton magnetic resonance spectroscopy in a case of Reye's syndrome.
AB  - A case of a 14-year-old boy with Reye's syndrome (RS) and complete neurologic
      recovery is presented. 1H magnetic resonance spectroscopy was performed on days 1
      (admission to ICU), 8 and 62: During the acute phase of RS substantial cerebral
      metabolic imbalances were observed and their normalization monitored. The spectra
      from day 1 featured extremely high glutamine content (approximately 18 mmol/kg
      excess) and low concentrations of choline compounds pounds (approximately 1
      mmol/kg deficit). Also some excess lactate was present. The subsequent spectra
      demonstrated the return to an almost normal brain metabolite profile.

PMID- 7790620
TI  - The fluidised bed.
AB  - The process of fluidisation involves blowing warm air through small solid
      microspheres thus creating a liquid, without wetness. The warmth provides some
      important properties including reducing the metabolic rate in thermal injury
      which has a beneficial effect on mortality, modifying catabolism after surgery,
      providing gradual vasodilation in shock and core temperature stability in
      illness. The fluidisation ensures prevention and successful treatment of pressure
      sores, a comfortable and less stressful environment than conventional care, a
      reduction in pain, ease of wound care, discourages a bacterial persistence and
      reduces the work of the nurse. The importance of proper fluid balance,
      bacteriological care and limitations of posture must be appreciated in using the
      bed.

PMID- 7790618
TI  - Severity scores in meningococcal septicemia and severe infectious purpura with
      shock.

PMID- 7790622
TI  - Treatment of a bronchial rupture by bronchoscopic fibrin sealant application.

PMID- 7790623
TI  - Acute stress bleeding prophylaxis with sucralfate versus ranitidine and incidence
      of secondary pneumonia in intensive care unit patients.

PMID- 7790621
TI  - Neutrophil-mediated tissue injury and its modulation.
AB  - Neutrophils play a key role in the development of the systemic inflammatory
      response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS). Since
      the lungs are the main target in these syndromes, with adult respiratory distress
      syndrome (ARDS) as the outcome, extensive research has been undertaken to prevent
      or mitigate ARDS. As evidence of the involvement of neutrophils in ARDS has
      accumulated, modulation of their function has become a major goal in terms of a
      therapeutic approach. In this short review, we sought to update our knowledge
      about neutrophils. Firstly, we summarized the various stimuli which activate
      neutrophils. Secondly, we described the different mediators, including cytokines,
      which are released by neutrophils. Lastly, we discussed the possible modulation
      of their function. Although we cannot assess the clinical usefulness of
      biochemical substances merely on the basis of their in vitro effects,
      understanding these mechanisms is fundamental to the success of the new
      therapeutic approach which is currently under way.

PMID- 7790624
TI  - Pulmonary edema after hydrogen peroxide irrigation of a war wound.

PMID- 7790626
TI  - Evolution of sigmoid intramucosal pH during orthotopic liver transplantation.

PMID- 7790625
TI  - High-dose intravenous IgG treatment and acute renal failure.

PMID- 7790627
TI  - Task difficulty and cognitive deficits in schizophrenia.
AB  - Investigators of schizophrenic cognition often produce 2 or more tasks of
      differing difficulty levels by manipulating a variable that affects the accuracy
      of both normal and schizophrenic individuals; the investigators find that the
      variable also affects the difference between the groups in accuracy and conclude
      that the variable taps a schizophrenic differential deficit. An alternative
      hypothesis is that task differences in true-score variance artifactually produce
      the finding. For free-response tasks, group differences tend to be larger when
      difficulty is near 50%. The authors illustrate a new method of controlling this
      artifact by selecting items for hard and easy tasks on opposite sides of 50%
      difficulty and equidistant from it. Using this design with an anagram task, they
      found that schizophrenic and normal individuals differ no more on hard anagrams
      than on easy ones, and they propose the design for testing hypotheses concerning
      schizophrenic deficit on tasks that differ in difficulty.

PMID- 7790629
TI  - Verbal interactions in the families of schizophrenic and bipolar affective
      patients.
AB  - Do verbal interactions between psychiatric patients and family members covary
      with the diagnosis of the patient? This study compared relatives (usually
      parents) of schizophrenic (n = 42) and bipolar (n = 22) patients on affective
      style (AS) or emotional-verbal behavior toward patients in family interaction.
      Patients were compared on coping style or verbal interactional behavior toward
      relatives. Relatives of schizophrenic patients made more negative AS
      (particularly intrusive) statements to patients than relatives of bipolar
      patients. Schizophrenic patients made fewer supportive statements and more self
      denigrating statements to relatives than bipolar patients. Among families of
      bipolar patients, negative AS in relatives was associated with oppositional,
      "refusing" styles in patients. Implications for psychosocial interventions with
      these disorders are discussed.

PMID- 7790628
TI  - Expressed emotion and subclinical psychopathology observable within the
      transactions between schizophrenic patients and their family members.
AB  - The authors examined whether young, recently discharged schizophrenic patients
      from high (n = 34) and low (n = 14) expressed emotion (EE) families differ in
      their level of subclinical symptomatology during a direct interaction task.
      Compared with patients from low-EE homes, patients from high-EE home showed
      significantly more odd and disruptive behavior with family members. High-EE
      relatives were more likely than low-EE relatives to respond with criticism to the
      first unusual thought verbalized by the patient; when this occurred, the
      probability of a second unusual thought was augmented. Results suggest that high
      EE family members may display negative attitudes toward patients in part because
      they are exposed to higher levels of unusual or disruptive behavior than low-EE
      relatives. The data also support a bidirectional, transactional model of the
      relationship between relatives' EE and patients psychopathology.

PMID- 7790630
TI  - Bodily shame as a mediator between abusive experiences and depression.
AB  - The role of bodily shame as a mediator between sexual or physical abuse and
      depression was investigated in a community sample of 101 women who had been
      followed for 8 years. In general, childhood and adult abuse were related to the
      occurrence of depression in the study period but when both were considered
      together, only adult abuse showed an independent association. However, childhood
      and adult abuse were both independently related to chronic or recurrent
      depression. Bodily shame was related to childhood abuse, and this association
      could not be accounted for by bodily dissatisfaction or low self-esteem. Bodily
      shame, but not childhood abuse, was related to chronic or recurrent depression
      when both factors were considered together and current depressive symptoms were
      controlled.

PMID- 7790631
TI  - Neuropsychological functioning among the nonpsychotic relatives of schizophrenic
      patients: a diagnostic efficiency analysis.
AB  - Numerous studies suggest that the relatives of schizophrenic patients exhibit
      neuropsychological impairments that are milder yet similar to those seen among
      schizophrenic patients. The authors assessed 35 nonpsychotic relatives of
      schizophrenic patients and 72 normal controls using a clinical and experimental
      neuropsychological test battery. Three neuropsychological functions met criteria
      for risk indicators of the schizophrenia genotype: abstraction, verbal memory,
      and auditory attention. These findings could not be attributed to parental
      socioeconomic status, education, general visual-spatial ability, or
      psychopathology. Furthermore, exploratory analyses were performed to determine
      whether the diagnostic efficiency of the indicators could be adjusted to meet the
      needs of genetic linkage analyses. These analyses suggest that psychometric
      considerations may help to create measures for genetic linkage studies.

PMID- 7790632
TI  - Depressed and normal individuals differ both in selection and in perceived tonal
      quality of positive-negative messages.
AB  - Twenty college undergraduates (10 depressed, 10 nondepressed, in terms of the
      Beck Depression Inventory and the Structured Clinical Interview for the DSM-III
      R) chose freely from a positive or negative tape-recorded message. They also
      rated the tonal quality of each tape. The nondepressed group selected the
      positive message more often than the negative message. However, the depressed
      group showed no difference in tape preference. The nondepressed individuals rated
      the negative tape as inferior in tonal quality, whereas no difference in tonal
      quality was reported by the depressed individuals. Results appear to support a
      response set not only toward positive cognitions among nondepressed individuals,
      which is absent among depressed individuals, but also toward perceived tonal
      quality differences.

PMID- 7790633
TI  - Fear-relevant illusory correlations: what types of associations promote
      judgmental bias?
AB  - A. J. Tomarken, S. Mineka, and M. Cook (1989) found that high-fear individuals
      markedly overestimated the covariation between fear-relevant stimuli and aversive
      outcomes. The authors assessed what features of stimulus-outcome associations
      promote illusory correlations. In Experiment 1, participants with high snake fear
      exhibited significant covariation bias for slides of snakes and shocks, but not
      for slides of damaged electric outlets (DEOs) and shocks. In Experiment 2,
      individuals with high and low snake fear rated DEOs and shocks as belonging
      together better than snakes and shocks. However, the shapes of high-fear
      individuals' affective response profiles to snakes and shocks were more similar
      than their profile shapes involving other pairings. In addition, their affective
      responses to snakes and snake-shock profile similarity predicted snake-shock
      belongingness ratings. These results suggest the importance of emotional
      responses and emotional profile similarity in mediating illusory correlations
      involving fear-relevant stimuli.

PMID- 7790634
TI  - Patterns of perceptual asymmetry in depression and anxiety: implications for
      neuropsychological models of emotion and psychopathology.
AB  - More than 1,000 university undergraduates were simultaneously classified as
      either high or low depressed and high or low anxious and given a face-processing
      task that typically elicits a left hemispatial bias. Depression and anxiety were
      associated with opposing biases in perceptual asymmetry scores. In particular,
      high-depressed students had smaller left hemispatial biases than low-depressed
      students, whereas high-anxious students had larger left hemispatial biases than
      low-anxious students. The results suggest that depression and anxiety may be
      associated with different patterns of asymmetric hemispheric function. Because
      the rate of comorbidity of depression and anxiety in the population is high,
      these findings confirm the importance of separating anxiety and depression when
      examining the relationship among patterns of brain activity, emotion, and
      psychopathology.

PMID- 7790635
TI  - Genetic heterogeneity in attention-deficit hyperactivity disorder (ADHD): gender,
      psychiatric comorbidity, and maternal ADHD.
AB  - The authors examined the siblings of 140 attention-deficit hyperactivity disorder
      (ADHD) and 120 control probands and classified families as antisocial if the
      proband had conduct disorder or a parent had antisocial personality. Partial
      support was found for the hypothesis that the ADHD gender effect would be limited
      to antisocial families. Boys had an increased risk for ADHD compared with girls,
      but only among siblings from antisocial families. The effect size for predicting
      ADHD in siblings of probands was greater for maternal compared with paternal
      ADHD, but only for families exhibiting antisocial disorders. Strong support was
      found for the hypothesis that, compared with siblings from nonantisocial
      families, those from antisocial families would have more psychopathology (ADHD,
      depression, substance use, and conduct disorders). The presence of antisocial
      disorders signals a distinct subtype of ADHD.

PMID- 7790636
TI  - Onset and staging of DSM-IV alcohol dependence using mean age and survival-hazard
      methods.
AB  - Orderly onset of psychiatric symptoms has implications for both case detection
      and the construct validity of the underlying illness. Mean age and survival
      hazard techniques were used to study the onset of alcohol abuse and dependence
      (as defined in the 4th edition of the Diagnostic and Statistical Manual of Mental
      Disorders; American Psychiatric Association, 1994) in 369 clinical cases drawn
      from a heterogeneous regional sample. The methods provided a similar general
      pattern of symptom sequencing, though only survival-hazard analysis described a
      punctuated onset of alcoholism in 3 discrete stages: alcohol abuse, dependence,
      and accommodation to the illness. This model survived a rigorous program of tests
      for goodness of fit and described the majority of the sample, supporting the
      construct validity of both alcohol abuse as a discrete first illness phase and of
      dependence as a set of core constructs distinct from and succeeding abuse. The
      specific strengths of survival-hazard analysis as a research tool in illness
      staging research are discussed.

PMID- 7790637
TI  - Individual differences in spatial working memory in relation to schizotypy.
AB  - With a delayed-response task, spatial working memory function was assessed in
      normal students who were selected for schizotypy. The Wisconsin Card Sorting Test
      was also administered. Twenty-eight undergraduate students who scored high on the
      Perceptual Aberration Scale (PerAb) and 23 who scored low on this scale
      participated in this study. High PerAb students performed less accurately
      compared with the low PerAb controls on the delayed-response task, and they were
      more than twice as likely as low PerAb students to be impaired. The groups did
      not differ in the number of perseverative errors or number of categories achieved
      on the Wisconsin Card Sorting Test, but, as predicted, high PerAb students were
      less able to maintain set than were the low PerAb students. Neuropsychological
      implications of these data are discussed.

PMID- 7790638
TI  - The price of soliciting and receiving negative feedback: self-verification theory
      as a vulnerability to depression theory.
AB  - The hypothesis that people who seek and receive negative feedback are vulnerable
      to increases in depressed symptoms was tested among 100 undergraduates and their
      roommates. Students and roommates completed questionnaires on their views of each
      other and on their own levels of negative feedback seeking, depressed and anxious
      symptoms, negative and positive affect, and self-esteem. Three weeks later,
      students and roommates completed the same questionnaires. Results were, in
      general, consistent with prediction. Students who reported an interest in their
      roommates' negative feedback and who lived with a roommate who viewed them
      negatively were at heightened risk for increases in depressed symptoms. These
      results could not be explained in terms of the variables' relations to trait self
      esteem. The symptom specificity of the effect was moderately supported.
      Implications for work on interpersonal vulnerability to depression are discussed.

PMID- 7790639
TI  - Fantasy proneness, DSM-III-R axis I psychopathology, and dissociation.
AB  - Two thirds of the fantasy-prone college students (16 of total N = 24) who scored
      in the upper 4% of the population on the Inventory of Childhood Memories and
      Imaginings (ICMI; S.C. Wilson & T. X. Wilson, 1981) and who were administered a
      diagnostic interview met the criteria for either a past or present Axis I
      diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders
      (3rd ed., rev.; American Psychiatric Association, 1987), compared with 31% of
      medium fantasy-prone students (8 of total N = 26) who scored within 1/2 a
      standard deviation of the mean on the ICMI. Fantasizers also reported a higher
      frequency of past diagnosis of major depression (50%) than nonfantasizers (12%)
      and more dissociative experiences and symptoms, as indexed by a structured
      interview. Contrary to certain estimates of the frequency of dissociative
      disorders in the general population, none of the participants in the study
      received an actual dissociative disorder diagnosis. For certain individuals,
      fantasy proneness can be associated with significant psychopathology.

PMID- 7790640
TI  - Subsyndromal unipolar and bipolar disorders: comparisons on positive and negative
      affect.
AB  - The authors examined the mood patterns of young adults with cyclothymia,
      intermittent depression, or no affective disorder in a nonclinical population. In
      a conceptual replication and extension of R. A. Depue et al. (1981, Study 5),
      participants completed a trait measure of mood and then completed daily mood
      ratings for 28 days. Individuals in the intermittent depression and cyclothymia
      groups were characterized by high levels of negative affect on trait and daily
      ratings. Both groups were also characterized by high variability of negative
      affect across days. Individuals with cyclothymia reported higher levels of trait
      and daily positive affect than individuals with intermittent depression and also
      exhibited high between-day variability on positive affect. Similarities and
      differences with R. A. Depue et al. (1981) are described and the results are
      discussed in terms of the common and differentiating features of the subsyndromal
      affective disorders.

PMID- 7790642
TI  - Correlates of psychosis proneness in relatives of schizophrenic patients.
AB  - The Magical Ideation Scale (MIS), Perceptual Aberration Scale (PABS), Social
      Anhedonia Scale (SAS), and Physical Anhedonia Scale (PAS) were administered to 98
      relatives of schizophrenic patients along with a measure of personality disorders
      (the Personality Diagnostic Questionnaire--Revised). Hierarchical regression
      analysis indicated that the schizotypal and borderline personality disorder (PD)
      scales explained significant variance in both the MIS and PABS; the avoidant PD
      scale also explained significant variance in the PABS. The schizoid, paranoid,
      and avoidant PD scales explained significant variance in the SAS. Sibling
      intraclass correlations indicated a significant heritability of 0.62 for the
      PABS.

PMID- 7790641
TI  - Modification of performance on the span of apprehension, a putative marker of
      vulnerability to schizophrenia.
AB  - The present study examined the effectiveness of 2 types of intervention
      (contingent monetary reinforcement and enhanced instruction) on span of
      apprehension performance. Forty chronic schizophrenia inpatients (26 men, 14
      women) received a 3- and 12-letter array version of the span of apprehension task
      4 times: baseline, intervention, immediate posttest, and 1-week follow-up. All
      patients were randomly assigned to 1 of 4 groups that differed according to
      method of intervention: repeat administration, monetary reinforcement only,
      instruction only, and monetary reinforcement plus instruction. The combination of
      monetary reinforcement plus instruction yielded significantly greater improvement
      in span accuracy than the other methods of intervention. These findings suggest
      that performance on this putative vulnerability indicator can be modified through
      certain interventions.

PMID- 7790643
TI  - On the relation between IQ, impulsivity, and delinquency: remarks on the Lynam,
      Moffitt, and Stouthamer-Loeber (1993) interpretation.
AB  - A recent report by D. Lynam, M. Moffitt, & M. Stouthamer-Loeber (1993) examined
      the inverse relation between IQ and delinquency and concluded that the observed
      relation represents "an influence of compromised intelligence on delinquent
      behavior" (p. 193). Specifically, the role of impulsivity in understanding this
      relation was discounted. The author considers the conceptual, operational, and
      analytical bases of the Lynam et al. report and argues that their neurologically
      based view of "executive dysfunction" as underlying delinquency is selectively
      portrayed. It is further contended that IQ scores, used as their index of brain
      behavior relations, are only remotely related to specifiable neurological
      functioning. The Lynam et al. conclusion that impulsivity cannot appreciably
      explain the relation between IQ and delinquency is shown to depend on the
      analytical approach used. Analyzed alternatively, impulsivity emerges as the more
      important predictor that can mediate the observed IQ and delinquency relation.
      Social policy implications of these differing interpretations are noted.

PMID- 7790644
TI  - Choice of frequency weighting for the evaluation of weapon noise.
AB  - This paper describes a laboratory study to choose an appropriate frequency
      weighting network for predicting the annoyance caused by the noise from small,
      medium, and large weapons. The results indicate that the annoyance of all three
      weapon types is the same if the blasts are heard at identical A-weighted SEL's.
      On the other hand, equal C-weighted SEL's result in large differences in
      annoyance between the weapon types. The implications of these results for outdoor
      noise criteria depend on the assumption concerning window condition. If one
      assumes that people hear the blasts predominantly through open windows, then A
      weighted criteria should be appropriate for all the weapon types without any
      correction (penalty or bonus) for weapon type. On the other hand, if the blasts
      are heard predominantly through closed windows a penalty of about 5 dB should be
      applied to the outdoor levels of the large weapons to account for the poorer low
      frequency attenuation of the windows.

PMID- 7790645
TI  - Mechanical modeling of palatal snoring.
AB  - The mechanism of human snoring caused by vibration of the soft palate and the
      characteristics of the noise are investigated. The soft palate becomes unstable
      and vibrates violently once the inspiratory flow exceeds a critical speed. The
      physiological phenomenon is modeled by studying flow over a flexible plate. In
      determining the stability of this flow, the trailing edge conditions are crucial.
      It is found that the noise generated in the simple experimental configuration has
      distinct characteristics found in human snores. For example, there is an
      antiphase relation between unsteady pressures from the oral and nasal channels
      and this provides a feature that distinguishes snoring by vibration of the soft
      palate from that caused by other parts of the human airway.

PMID- 7790646
TI  - Subjective evaluation of four low-complexity audio coding schemes.
AB  - In this study the subjective performance of four low-complexity audio data
      compression methods are compared, operating at nominal bit rates of 2, 3, 4, and
      5 bits per sample, applied to four 20-kHz bandwidth, 16-bits per sample digitized
      musical signals. The simple compression schemes compared were elementary
      differential pulse-code modulation (DPCM), noise feedback coding DPCM (NFC-DPCM),
      adaptive quantizer DPCM (DPCM-AQB), and a recently proposed method known as
      recursively indexed quantizer DPCM (RIQ-DPCM). Pairs consisting of a
      reconstructed signal and a reference signal were presented in a two-interval
      preference experiment. The reference signals were processed for specified levels
      of modulated noise reference unit (MNRU) in order to estimate the equality
      threshold rating (ETR) of the reconstructed audio stimuli. The subjective MNRU
      values were found to increase by 2-5 dB for each increment in bits per sample.
      The DPCM-AQB scores were found to be 8-10 dB higher than for DPCM and NFC-DPCM.
      RIQ-DPCM was rated highest, exceeding the DPCM-AQB results by 2-5 dB in all
      tests. Objective measurements of segmental signal-to-noise ratio (SNRSEG) for the
      reconstructed signals predicted a performance level 2-5 dB lower than was
      actually found in the subjective results, particularly for SNRSEG values below 25
      dB.

PMID- 7790647
TI  - Processing of prosthetic heart valve sounds for single leg separation
      classification.
AB  - People with serious heart conditions have had their expected life span extended
      considerably with the development of the prosthetic heart valve especially with
      the great strides made in valve design. Even though the designs are extremely
      reliable, the valves are mechanical and operating continuously over a long
      period; therefore structural failures can occur due to fatigue. In this paper
      acoustical signal processing techniques developed to process noisy heart valve
      sounds measured by a sensitive, surface contact microphone are discussed.
      Measuring heart sounds noninvasively in a noisy environment puts more demands on
      the signal processing to extract the desired signals from the noise. Heart valve
      sounds are short-duration (10-20 ms) transients and therefore nonstationary,
      requiring more sophisticated processing algorithms to achieve the desired signal
      to-noise ratios. In this paper the preclassification signal processing is
      concentrated on exclusively. That is, the signal processing operations performed
      on the heart valve sounds prior to classification are discussed--a subject that
      will be developed in a future paper. Efforts are concentrated on the sounds
      corresponding to the heart valve opening cycle. Valve opening and closing
      acoustics present additional information about the outlet strut condition--the
      structural component implicated in valve failure. The importance of the opening
      sound for single leg separation detection/classification is based on the fact
      that as the valve opens, the disk passively hits the outlet strut. The opening
      sounds thus yield direct information about outlet strut condition with minimal
      amount of disturbance caused by the energy radiated from the disk. Hence the
      opening sound is a very desirable acoustic signal to extract. Unfortunately, the
      opening sounds have much lower signal levels relative to the closing sounds and
      therefore noise plays a more significant role than during the closing event.
      Because of this it is necessary to screen the sounds for outliers in order to
      insure a high sensitivity of classification. Because of the sharp resonances
      appearing in the corresponding spectrum, a parametric processing approach is
      developed based on an autoregressive model which was selected to characterize the
      sounds emitted by the Bjork-Shiley convexo-concave (BSCC) valve during opening
      cycle. First the basic signals and the extraction process used to create an
      ensemble of heart valve sounds are briefly discussed. Next, a beat monitor
      capable of rejecting beats that fail to meet an acceptance criteria based on
      their spectral content is developed.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7790648
TI  - Classification of prosthetic heart valve sounds: a parametric approach.
AB  - People with heart problems have had their lives extended considerably with the
      development of the prosthetic heart valve. Great strides have been made in the
      development of the valves through the use of improved materials as well as
      efficient mechanical designs. However, since the valves operate continuously over
      a long period, structural failures can occur--even though they are relatively
      uncommon. Here the development of techniques to classify the valve either as
      having intact struts or as having a separated strut, commonly called single leg
      separation, is discussed. In this paper the signal processing techniques employed
      to extract the required signals/parameters are briefly reviewed and then it is
      shown how they can be used to simulate a synthetic heart valve database for
      eventual Monte Carlo testing. Next, the optimal classifier is developed under
      assumed conditions and its performance is compared to that of an adaptive-type
      classifier implemented with a probabilistic neural network. Finally, the adaptive
      classifier is applied to a data set and its performance is analyzed. Based on
      synthetic data it is shown that excellent performance of the classifiers can be
      achieved implying a potentially robust solution to this classification problem.

PMID- 7790649
TI  - Relaxation dynamics of spontaneous otoacoustic emissions perturbed by external
      tones. I. Response to pulsed single-tone suppressors.
AB  - The dynamic aspects of the suppression of spontaneous otoacoustic emissions by
      external tones are evaluated. A Van der Pol oscillator driven by an external tone
      is used as an interpretive model for data on the pulsed suppression of
      spontaneous emissions obtained from six female subjects. Typical results for both
      the onset of, and recovery from suppression yield 1/r1 (where -r1 is the negative
      linear component of the damping function) in the range of 2-25 ms. In accordance
      with the predictions of the model, (a) the relaxation time for the onset of
      suppression increases with the amount of suppression induced by the external
      tone, (b) the values of r1 and the amplitudes of the unsuppressed emissions
      exhibit an inverse correlation, (c) the values inferred for r1 are not
      significantly dependent on the frequency of the pulsed suppressor tone, and (d)
      the inferred r1 values are not significantly dependent upon the amount of
      suppression.

PMID- 7790650
TI  - Relaxation dynamics of spontaneous otoacoustic emissions perturbed by external
      tones. II. Suppression of interacting emissions.
AB  - The level of a spontaneous otoacoustic emission (SOAE) during recovery from
      suppression by an external tone sometimes exhibits a prominent overshoot before
      reaching its normal level. At the onset of suppression, a less prominent
      undershoot is sometimes observed before the emission level stabilizes. The
      overshoot and undershoot are described in terms of the variable amount
      suppression produced by a neighboring higher-frequency SOAE which is responding
      more slowly to the modulation of the external tone. The variation of the SOAE
      amplitude during pulsed suppression is modeled by a pair of Van der Pol limit
      cycle oscillators with the primary oscillator linearly coupled to the
      displacement of the secondary high-frequency one. We have found relaxation time
      constants for the onset of suppression of the order of 4.5 and 7.4 ms for the
      primary and secondary SOAEs, respectively, and for the recovery from suppression
      4.8 and 10.48 ms for the primary and secondary SOAEs, respectively. The same
      model is also successful in describing the release from suppression of the
      primary SOAE by the secondary SOAE when the latter is partially suppressed by the
      external tone. Aspirin administration reduces the magnitude of the overshoot by
      reducing the level of the higher-frequency SOAE and thereby eliminating the
      suppression of the lower-frequency one.

PMID- 7790651
TI  - Distortion product otoacoustic emission delay measurement in human ears.
AB  - The measurement of distortion product otoacoustic emission (DPOAE) delay using
      the phase gradient method is discussed. A short f2 sweep paradigm is described.
      Its merits are discussed and comparisons made with other methods. Using sweeps of
      less than 4%, consistent and reliable measurements were obtained from 12 normal
      ears, except for a few isolated measurements. Investigation of these apparent
      anomalies indicated that the short f2 sweep method was sensitive to the localized
      effects of narrow distortion product intensity notches and spontaneous emissions.
      It is possible that middle ear pressure instability or some local change in the
      cochlea sometimes compounded the situation. The intersubject range (63% of the
      mean) of DPOAE delay values was greater than the range of values observed due to
      measurement variability (5.6% of the mean) or intrasubject variability (8.5% of
      the mean) demonstrating that the method can detect real differences between ears.
      However, comparison with previous work shows that caution is needed in
      interpreting these data, as all DPOAE phase methods provide only partial latency
      values. The physical interpretation depends on both the stimulus sweep used and
      the origin of DPOAES. Our data shows that f1 sweep derived latency is lower than
      f2 sweep data by more than 20%. Caution also needs to be exercised when comparing
      cochlear traveling wave delay, as inferred from electrophysiological data, with
      that obtained from DPOAE delay measurements.

PMID- 7790653
TI  - Maximum-likelihood procedures and the inattentive observer.
AB  - In most experimental situations, it is expected that observers will achieve
      perfect detection at extremely high signal levels. Technically, it is assumed
      that the asymptote of the psychometric function is unity. In many practical
      psychophysical tests, such as those involving children, patients, or nonhuman
      animals, the observers are occasionally inattentive. Using computer simulations,
      it was assumed that inattention can be modeled as a stationary stochastic process
      whose major effect is to produce a psychometric function having an asymptote less
      than unity. A maximum-likelihood procedure was used to estimate threshold,
      because it has been shown to provide reasonably stable threshold estimates using
      very few observations. Inattention increases the variability of the threshold
      estimate, as would be expected, because inattention reduces the slope of the
      psychometric function. The simulations also show that the maximum-likelihood
      procedure poorly estimates the amount of inattention, and can, thereby, produce a
      strong bias in the threshold estimates, overestimating or underestimating the
      true values under different circumstances. Inattention appears to affect the two
      alternative forced-choice procedure more strongly than the yes-no (go/nogo)
      procedure.

PMID- 7790652
TI  - Identification of concurrent harmonic and inharmonic vowels: a test of the theory
      of harmonic cancellation and enhancement.
AB  - The improvement of identification accuracy of concurrent vowels with differences
      in fundamental frequency (delta F0) is usually attributed to mechanisms that
      exploit harmonic structure. To decide whether identification is aided primarily
      by selecting the target vowel on the basis of its harmonic structure ("harmonic
      enhancement") or removing the interfering vowel on the basis of its harmonic
      structure ("harmonic cancellation"), pairs of synthetic vowels, each of which was
      either harmonic or inharmonic, were presented to listeners for identification.
      Responses for each vowel were scored according to the vowel's harmonicity and
      that of the vowel that accompanied it. For a given target, identification was
      better by about 3% for a harmonic ground unless the target was also harmonic with
      the same F0. This supports the cancellation hypothesis. Identification was worse
      for harmonic than for inharmonic targets by 3%-8%. This does not support the
      enhancement hypothesis. When both vowels were harmonic, identification was better
      by about 6% when the F0's differed by 1/2 semitone, consistent with previous
      experiments. Results are interpreted in terms of harmonic enhancement and
      harmonic cancellation, and alternative explanations such as waveform interaction
      are considered.

PMID- 7790654
TI  - Comodulation masking release (CMR): effects of gating as a function of number of
      flanking bands and masker bandwidth.
AB  - Normal-hearing subjects participated in two CMR experiments. For experiment 1,
      two, three, five or nine 20-Hz-wide comodulated flanking bands were presented
      continuously or gated simultaneously with a 2000-Hz signal. The signal had a
      duration of 400 ms. Larger CMRs were obtained as the number of flanking bands
      increased for both the continuous and gated conditions. For fewer number of
      bands, the average CMR for continuous noise was substantially larger than for
      gated noise. As the number of bands increased, CMR increased more for gated than
      for continuous noise, and the difference between CMRs for gated and continuous
      noise decreased. Experiment 2 involved detecting a 400-ms 1000-Hz pure-tone
      signal in a seven-band comodulated noise complex. The noise bands, presented
      continuously or gated with the signal, were either 10, 20, 40, or 80 Hz wide.
      Larger CMRs were observed for continuous maskers and for smaller masker
      bandwidths; however, the effect of gating did not change significantly across
      bandwidth. The results of the first experiment indicate that the effects of
      gating on CMR are minimized when the number of auditory channels providing
      information is large. The results of the second experiment indicate that this
      effect is not simply a function of the large CMR magnitude obtained with a large
      number of flanking bands.

PMID- 7790655
TI  - The discrimination of samples of noise in monotic, diotic, and dichotic
      conditions.
AB  - Listeners' ability to discriminate between independent tokens of 800-Hz-wide
      bands of noise (centered at 1200 Hz) was measured in monaural, diotic, and
      several dichotic conditions. In a two-cue, two-alternative, temporal forced
      choice task, listeners indicated whether the second or third interval contained a
      token of noise that was different from the sample of noise that was presented in
      each of the remaining three intervals. Samples of noise were selected on a trial
      by-trial basis from a set of 50 independent noises for each hourly session. Six
      durations of noise, ranging from 10 to 328 ms, were utilized, and all were
      presented at an overall level of 79 dB. The baseline condition for comparisons of
      performance was a monaural presentation of the noises. As expected,
      discriminability improved when the baseline condition was presented diotically.
      The next best performance was obtained when the baseline stimuli was presented to
      both ears with the proviso that the noises were interaurally uncorrelated. Other
      dichotic conditions, all of which also utilized interaurally uncorrelated noises,
      produced performance that was worse than that obtained in the monaural condition.
      Large degradations in performance were observed when the left ear received a
      different sample of noise in each of the four intervals of a trial while the
      right ear continued to receive the baseline stimuli. This finding indicates that
      listeners were effectively unable to ignore the waveforms presented to one ear
      while performing a task which could be solved with the information presented to
      the other ear.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790656
TI  - Discriminating coherence in spectro-temporal patterns.
AB  - This study examined the ability of trained listeners to discriminate coherent
      components in randomly varying spectral patterns. In each observation interval,
      the listener was presented with a sequence of bursts of multitone complexes
      having a fixed number of tones (m) in each burst. In the standard interval, the
      frequency of each tone in every burst was chosen randomly between 200 and 5000
      Hz. In the signal interval, the frequencies of n tones were repeated throughout
      the burst sequence while the remaining m-n tones were chosen at random. The n
      tones were coherent in the sense that they were perceived as "sticking together"
      to form a pattern. The listener's task was to discriminate which burst sequence
      contained the n components. The results indicated that discrimination improved
      with increasing n/m, with increasing number of bursts per interval, and declined
      as the coherent components were increasingly perturbed in frequency. Further, for
      a fixed value of the ratio n/m discriminability was relatively independent of m.
      A model incorporating multichannel filtering and an optimum decision rule was
      reasonably successful in accounting for the experimental results.

PMID- 7790657
TI  - Effects of level and frequency on the detection of decrements and increments in
      sinusoids.
AB  - Thresholds for the detection of decrements in level of sinusoidal signals were
      measured as a function of decrement duration, level (25, 40, 55, and 70 dB SPL)
      and frequency (250, 1000, and 4000 Hz) in eleven normally hearing subjects.
      Thresholds for detecting a brief increment in level were also measured. The
      sinusoids were presented in a background noise intended to mask spectral splatter
      associated with the decrement or increment. Performance tended to worsen with
      decreasing frequency, for all decrement durations and for increment detection.
      Performance also worsened with decreasing level. The results were analyzed using
      a model consisting of a compressive nonlinearity, a sliding temporal integrator,
      and a decision device. The analysis indicated that the worsening in performance
      with decreasing frequency and decreasing level can be attributed partly to
      increases in the equivalent rectangular duration (ERD) of the temporal
      integrator, but mainly to changes in the efficiency of the detection process
      following the temporal integrator; at lower frequencies and levels a larger
      change is required at the output of the integrator for threshold to be reached.
      At each frequency, the ERD was relatively invariant with level for levels more
      than about 20 dB above the absolute threshold.

PMID- 7790658
TI  - A developmental study of the perception of onset spectra for stop consonants in
      different vowel environments.
AB  - The importance of different acoustic properties for the perception of place of
      articulation in prevocalic stop consonants was investigated from a developmental
      perspective. Eight adults and eight children in each of the age groups, 5, 6, 7,
      9, and 11 years, listened to synthesized syllables comprised of all combinations
      of [b d g] and [i a]. The synthesis parameters were adapted from Blumstein and
      Stevens [J. Acoust. Soc. Am. 67, 648-662 (1980)], and included manipulations of
      the following stimulus variables: formant transitions (moving or straight), noise
      burst (present or absent), and voicing duration (10 or 46 ms). Identification
      performance was high for all age groups across most stimulus types. Formant
      transition motion generally was not necessary for accurate identification, and
      there was no difference between age groups in terms of the perceptual weight
      placed on this cue. Furthermore, the results did not support the salience of
      duration as a developmental cue to place of articulation. The presence of a burst
      improved identification for the velar and alveolar places of articulation for all
      age groups, but was particularly important for the 11-year-olds and adults. These
      findings indicate that children, by age 5, do not rely on dynamic formant motion
      any more than adults do, and that the ability to integrate acoustic cues across
      regions of spectral change shows developmental patterns.

PMID- 7790659
TI  - The identification of vowel-like harmonic complexes: effects of component phase,
      level, and fundamental frequency.
AB  - These experiments investigate how the identification of vowel-like harmonic
      complexes, similar to those used by Leek et al. [J. Acoust. Soc. Am. 81, 148-154
      (1987)], is affected by spectral contrast, overall level, component phase, and
      fundamental frequency (F0). Four normally hearing subjects were required to
      identify which of six vowel-like harmonic complexes was presented on each trial.
      The test stimuli were complex tones containing the first 35 harmonics of a 100-Hz
      fundamental or the first 70 harmonics of a 50-Hz fundamental. All of the
      harmonics with frequencies below 3000 Hz were equal in amplitude except for three
      pairs of successive harmonics which were located at the first, second, and third
      formant frequency values, and incremented in level by 1, 2, 4, 8, and 16 dB
      relative to the other components. Three overall levels were used, 85, 65, and 45
      dB SPL, and harmonics were added in either cosine or random phase. The results
      indicated that identification was better for cosine phase than for random phase,
      except for the 100-Hz fundamental at 45 dB SPL. The difference between the two
      phase conditions increased with increasing presentation level and with decreasing
      fundamental frequency. The results are explained in terms of the waveforms that
      would occur at the outputs of different auditory filters. It does not appear
      necessary to invoke nonlinear enhancement mechanisms to explain the results,
      although an influence of such mechanisms cannot be ruled out.

PMID- 7790660
TI  - Frequency glide discrimination in the F2 region by normal-hearing and hearing
      impaired listeners.
AB  - The dynamic formant transitions present within consonant-vowel and vowel
      consonant utterances may be poorly processed by hearing-impaired (HI) listeners
      and may, as a result, provide reduced segmental information to these listeners.
      Both the brief durations and rapid spectral change associated with these
      transitions have been proposed as contributing to these deficits in processing.
      To investigate HI listeners' processing of transitional stimuli, six HI and six
      normal-hearing (NH) listeners were asked to discriminate between frequency glides
      patterned after second formant transitions in English CV syllables. The
      influences of glide duration, rate, and frequency extent were examined for each
      group in quiet and in broadband noise. Reductions in glide duration and the
      presence of noise each led to significant increases in frequency difference
      limens for glide onset. The magnitudes of these effects were similar across
      groups, thereby failing to show increased susceptibility to noise or greater
      deficits in dealing with brief stimuli on the part of HI listeners. Contrary to
      the expectation that HI listeners would show greatest deficits (relative to the
      NH group) for the most rapidly changing glides, the only significant group
      differences were observed for gradual glides of limited frequency extent. This
      latter finding is discussed in terms of sensitivity to "cochlear dispersion" cues
      [Porter et al., J. Acoust. Soc. Am. 90, 1298-1308 (1991)]. It is hypothesized
      that HI listeners may not process these cues as effectively as NH listeners,
      perhaps as a result of impaired frequency selectivity.

PMID- 7790661
TI  - Robust estimation of speech in noisy backgrounds based on aspects of the auditory
      process.
AB  - A new approach to speech enhancement is proposed where constraints based on
      aspects of the auditory process augment an iterative enhancement framework. The
      basic enhancement framework is based on a previously developed dual-channel
      scenario using a two-step iterative Wiener filtering algorithm. Constraints
      across broad speech sections and over iterations are then experimentally
      developed on a novel auditory representation derived by transforming the speech
      magnitude spectrum. The spectral transformations are based on modeling aspects of
      the human auditory process which include critical band filtering, intensity-to
      loudness conversion, and lateral inhibition. The auditory transformations and
      perceptual based constraints are shown to result in a new set of auditory
      constrained and enhanced linear prediction (ACE-LP) parameters. The ACE-LP based
      speech spectrum is then incorporated into the iterative Wiener filtering
      framework. The improvements due to auditory constraints are demonstrated in
      several areas. The proposed auditory representation is shown to result in
      improved spectral characterization in background noise. The auditory constrained
      iterative enhancement (ACE-II) algorithm is shown to result in improved quality
      over all sections of enhanced speech. Adaptation of auditory based constraints to
      changing spectral characteristics over broad classes of speech is another novel
      aspect of the proposed algorithm. The consistency of speech quality improvement
      for the ACE-II algorithm is illustrated over time and across all phonemes
      classified over a large set of phonetically balanced sentences from the TIMIT
      database. This study demonstrates the application of auditory based perceptual
      properties of a human listener to speech enhancement in noise, resulting in
      improved and consistent speech quality over all regions of speech.

PMID- 7790662
TI  - Acoustics, perception, and production of legato articulation on a digital piano.
AB  - This study investigated the perception and production of legato ("connected")
      articulation in repeatedly ascending and descending tone sequences on a digital
      piano (Roland RD-250s). Initial measurements of the synthetic tones revealed
      substantial decay times following key release. High tones decayed faster than low
      tones, as they did prior to key release, and long tones decayed sooner than short
      tones because of their more extensive prerelease decay. Musically trained
      subjects (including pianists) were asked to adjust the key overlap times (KOTs)
      of successive piano tones so that they sounded optimally, minimally, or maximally
      legato. The results supported two predictions based on the acoustic measurements:
      KOTs for successive tones judged to be optimally or maximally legato were greater
      for high than for low tones, and greater for long than for short tones, so that
      auditory overlap presumably remained more nearly constant. For minimal legato
      adjustments the effect of tone duration was reversed, however. Adjusted KOTs were
      also longer for relatively consonant tones (three semitones separation) than for
      dissonant tones (one semitone separation). Subsequently, KOTs were measured in
      skilled pianists' legato productions of tone sequences similar to those in the
      perceptual experiment. KOTs clearly increased with tone duration, an effect that
      was probably motoric in origin. There was no effect of tone height, suggesting
      that the pianists did not immediately adjust to differences in acoustic overlap.
      KOTs were slightly shorter for dissonant than for consonant tones. They also
      varied with position in the ascending-descending tone sequences, indicating that
      the pianists exerted strategic control over KOT as a continuous expressive
      dimension.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790663
TI  - Sonoelasticity imaging: theory and experimental verification.
AB  - Sonoelasticity is a rapidly evolving medical imaging technique for visualizing
      hard tumors in tissues. In this novel diagnostic technique, a low-frequency
      vibration is externally applied to excite internal vibrations within the tissue
      under inspection. A small stiff inhomogeneity in a surrounding tissue appears as
      a disturbance in the normal vibration eigenmode pattern. By employing a properly
      designed Doppler detection algorithm, a real-time vibration image can be made. A
      theory for vibrations, or shear wave propagation in inhomogeneous tissue has been
      developed. A tumor is modeled as an elastic inhomogeneity inside a lossy
      homogeneous elastic medium. A vibration source is applied at a boundary. The
      solutions for the shear wave equation have been found both for the cases with
      tumor (inhomogeneous case) and without tumor (homogeneous case). The solutions
      take into account varying parameters such as tumor size, tumor stiffness, shape
      of vibration source, lossy factor of the material, and vibration frequency. The
      problem of the lowest detectable change in stiffness is addressed using the
      theory, answering one of the most critical questions in this diagnostic
      technique. Some experiments were conducted to check the validity of the theory,
      and the results showed a good correspondence to the theoretical predictions.
      These studies provide basic understanding of the phenomena observed in the
      growing field of clinical Sonoelasticity imaging for tumor detection.

PMID- 7790664
TI  - Upper lip, lower lip, and jaw peak velocity sequence during bilabial closures: no
      differences between stutterers and nonstutterers.

PMID- 7790665
TI  - A definite and a semidefinite questionnaire version of the Hamilton/melancholia
      (HDS/MES) scale.
AB  - A definite (anchored) and a semidefinite (semi-anchored) questionnaire version of
      the Hamilton Depression Rating Scale (HDS) and the Bech-Rafaelsen Melancholia
      Scale (MES) were compared with the HDS/MES by observer-rating and self-rating of
      24 patients fulfilling the DSM-3R criteria for major depressive disorder. Both
      types of questionnaire showed substantial agreement with the observer scale from
      which they were derived. The sum scores were for the definite questionnaires and
      the corresponding observer scales closely similar whereas the sum scores of the
      semidefinite questionnaires were significantly higher than the sum scores of the
      corresponding observer scales. These results indicate that patients' 'halo'
      effect may be avoided by using definite scaling criteria for self-rating. Thus,
      of the two versions of questionnaires the definite versions are recommended.

PMID- 7790667
TI  - Late-life depressive disorder in the community, early onset and the decrease of
      vulnerability with increasing age.
AB  - This study examined reports of a history of psychiatric illness related to age
      and depression in 4051 community residents aged 65-84. Depression was twice as
      common among subjects with a history of psychiatric illness before age 65. 78% of
      depressed subjects reported no history. The rate of reported history was
      inversely proportionate to the subjects actual age. This did not appear to be due
      to recollection bias but it did match the proportions previously reported to
      result from excess mortality of individuals with a psychiatric history. A
      psychiatric history may be an important risk factor for late-life depression but
      in the aging process after age 65 it may become increasingly uncommon.

PMID- 7790668
TI  - The relationship between premorbid neuroticism, cognitive dysfunction and
      persistence of depression: a 1-year follow-up.
AB  - In a previous report of patients with unipolar major depressive disorder, we
      found that deficits in autobiographical memory predicted depression levels over a
      7-month interval. This follow-up examined predictors of recovery as defined by a
      period of 8 weeks with no or minimal symptoms of depression and examined the
      extra predictor variable, neuroticism. In a sample of 21 patients, episode
      duration was significantly correlated with high levels of premorbid neuroticism,
      dysfunctional attitudes and overgeneral autobiographical memories produced in
      response to emotionally negative cue words. When severity of depression was
      partialled out, high N score was significantly but independently correlated with
      each of these cognitive variables. The implication of these attitudinal and
      information processing biases were explored.

PMID- 7790666
TI  - Efficacy of the 'clonidine REM suppression test (CREST)' to separate patients
      with major depression from controls; a comparison with three currently proposed
      biological markers of depression.
AB  - We have shown that clonidine, infused i.v. during the second non-REM period, was
      significantly less REM sleep suppressant in depressed patients than in control
      subjects. We have named this procedure the 'clonidine REM suppression test
      (CREST)'. In this report, we compare in the same sample (15 patients with primary
      major affective illness, 10 normal controls, 15 patients with minor depression
      and 15 patients with generalized anxiety) the efficacy of the CREST to separate
      the major depressed patients from the control subjects with the efficacy of three
      currently proposed biological markers of depression, i.e., the latency of REM
      sleep, the dexamethasone suppression test and the clonidine growth hormone
      stimulation test. We found that the CREST had the highest efficacy and suggest
      that further studies with independent and larger samples of patients and controls
      are needed to confirm those preliminary results and establish if the CREST could
      provide a new biological marker of major affective disorders.

PMID- 7790669
TI  - Low parental care as a risk factor to lifetime depression in a community sample.
AB  - A number of studies have reported links between experiencing low parental care
      and subsequent depressive experience. As the majority have involved patient
      samples, links may reflect anomalous parenting disposing to help-seeking
      behaviour (and patient status) rather than directly to depression. We, therefore,
      report a community study, so redressing any such artefact emerging from a patient
      sample and, additionally, quantify the relevance of low parental care to
      depression in comparison to several other risk factors (i.e., age, gender,
      educational level, socioeconomic status and marital status). Subjects were drawn
      from the ECA study and comprised those assessed at the 1-year follow-up interview
      undertaken at the New Haven site, with parental care being assessed by a key item
      from the Parental Bonding Instrument (PBI). Those reaching criteria for a
      lifetime episode of major depressive disorder were significantly more likely to
      report low care from both parents as well as to be female, divorced or separated,
      and younger. Low parental care (along with age and mental status but not female
      sex) appeared pathoplastic in being linked with an increased chance of
      psychopathology in general, rather than demonstrating specificity to major
      depressive disorder.

PMID- 7790670
TI  - Social class in unipolar and bipolar probands and relatives.
AB  - 130 patients fulfilling DSM-III-R criteria for bipolar disorder (n = 62), bipolar
      disorder not otherwise specified (n = 19) and major depression (n = 49) were
      included in a comparative study on the occupational levels of uni- and bipolar
      probands and relatives. The occupational levels did not significantly differ
      between uni- and bipolar probands. An overrepresentation was found in the higher
      occupational class in bipolar probands' brothers and children. A comparison
      between the whole groups including probands and all their relatives revealed a
      social advantage both for male and female members of bipolar families. These
      results are in agreement with those of previous studies demonstrating an
      association between bipolar disorder and social achievement in relatives.

PMID- 7790671
TI  - 35% CO2 challenge in panic and mood disorders.
AB  - 20 patients with Panic Disorder (PD), 19 patients with Mood Disorder (MD) and 20
      healthy controls inhaled one vital capacity of 35% CO2-65% O2 gas mixture and of
      compressed air in a double-blind, random, cross-over design. Only PD patients
      showed a strong reaction to 35% CO2 while MD patients and controls did not react
      significantly. These results support the specificity of the 35% CO2 challenge in
      PD patients and suggest that PD and MD are separate disorders.

PMID- 7790672
TI  - Decreased temporal lobe phosphomonoesters in bipolar disorder.
AB  - In vivo [31P]magnetic resonance spectroscopic imaging ([31P]MRSI) was performed
      on 12 unmedicated, euthymic bipolar patients and 14 control subjects to determine
      if there were alterations in high-energy P metabolism in the temporal lobes of
      bipolar patients. Compared with the control group, the patients with bipolar
      disorder demonstrated significantly lower phosphomonoesters (PME) in both the
      left and right temporal lobes. No other group differences in P metabolites or
      lateralized asymmetries were noted. This preliminary study provides support for
      altered temporal lobe phospholipid metabolism in bipolar disorder.

PMID- 7790673
TI  - The likelihood of recurrence in bipolar affective disorder: the importance of
      episode recency.
AB  - These analyses used a high-intensity follow-up of of patients with bipolar
      affective disorder to describe the immediate and long-term risks for recurrence
      and the importance of sustained recovery to those risks. At the baseline
      evaluation, all patients were in episodes of Research Diagnostic Criteria major
      depressive disorder, mania or schizoaffective disorder (excluding the mainly
      schizophrenic subtype); those who were depressed at intake had a history of mania
      or schizoaffective mania. Raters re-evaluated these patients at 6-month intervals
      for 5 years and annually for the remainder of a 10-year follow-up. The following
      report describes relapse risks for the 186 patients observed to recover from
      their index episodes. Survival analyses quantified the likelihood of relapse over
      time, beginning after symptom-free periods of 4 months and 1, 2 and 3 years.
      Further survival analyses used treatment status as a censoring variable to
      estimate the eventual likelihood of recurrence among those who reported sustained
      compliance with lithium prophylaxis; the prophylaxis group remained under
      observation until they relapsed, were lost to follow-up or ceased taking lithium.
      Progressively longer symptom-free periods were clearly associated with lower
      relapse risks over the subsequent 4 years. Thereafter, however, this effect
      dissipitated. 7 years after recovery, the cumulative likelihood of recurrence was
      four in five for all bipolar patients and two in three for those whose index
      episode had been followed by at least 3 years without symptoms. Even with
      sustained lithium prophylaxis, the likelihood of at least one recurrence exceeded
      70% within 5 years of recovery.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790674
TI  - Seasonal variation in mood disorder presentation: further evidence of this
      phenomenon in a South African sample.
AB  - An earlier preliminary study conducted at Baragwanath Hospital in Soweto, South
      Africa, showed a statistically significant seasonal pattern for mood disorder
      presentation. These findings provided the basis for further exploration of the
      phenomenon. The present study replicates the earlier one in an attempt to
      establish the pervasiveness of the noted impact of season on mood disorder
      presentation.

PMID- 7790675
TI  - Induction of depressed and elated mood by music influences the perception of
      facial emotional expressions in healthy subjects.
AB  - The judgement of healthy subject rating the emotional expressions of a set of
      schematic drawn faces is validated (study 1) to examine the relationship between
      mood (depressed/elated) and judgement of emotional expressions of these faces
      (study 2). Study 1: 30 healthy subjects judged 12 faces with respect to the
      emotions they express (fear, happiness, anger, sadness, disgust, surprise,
      rejection and invitation). It was found that a particular face could reflect
      various emotions. All eight emotions were reflected in the set of faces and the
      emotions were consensually judged. Moreover, gender differences in judgement
      could be established. Study 2: In a cross-over design, 24 healthy subjects judged
      the faces after listening to depressing or elating music. The faces were
      subdivided in six 'ambiguous' faces (i.e., expressing similar amounts of positive
      and negative emotions) and six 'clear' faces (i.e., faces showing a preponderance
      of positive or negative emotions). In addition, these two types of faces were
      distinguished with respect to the intensity of emotions they express. 11 subjects
      who showed substantial differences in experienced depression after listening to
      the music were selected for further analysis. It was found that, when feeling
      more depressed, the subjects perceived more rejection/sadness in ambiguous faces
      (displaying less intensive emotions) and less invitation/happiness in clear
      faces. In addition, subjects saw more fear in clear faces that express less
      intensive emotions. Hence, results show a depression-related negative bias in the
      perception of facial displays.

PMID- 7790676
TI  - Further characterization of the inhibition of platelet aggregation by a plasma
      factor(s) in unmedicated unipolar depressed patients.
AB  - To investigate further the inhibition of platelet aggregation by a plasma
      factor(s) in unipolar depression, a series of assays were performed in which the
      platelet-rich plasma of a male volunteer was preincubated with the plasma of
      either unmedicated unipolar depressed patients or age-matched controls. Platelet
      aggregation was initiated by the following aggregating agents; ADP (10 and 2.5
      microM), ADP/5HT (0.5 microM ADP + 50 microM 5HT and 0.5 microM ADP + 25 microM
      5HT) and adrenaline (10 and 1 microM) (that act on different platelet membrane
      receptors) and by the following agents; sodium fluoride (20 mM), calcium
      ionophore A23,187 (19 microM) and phorbol-12-myristate-13-acetate (3.24 microM)
      (that act at specific intracellular sites). The plasma of depressed patients
      significantly reduced the platelet aggregatory response for each of the
      aggregating agents at each of the concentrations tested. Therefore, it is
      concluded that the inhibition of platelet aggregation by a plasma factor(s) may
      be irreversible in nature and may have an intracellular site(s) of action,
      possibly at, or beyond, the site of activated protein kinase C.

PMID- 7790677
TI  - Urinary catecholamines and plasma hormones predict mood state in rapid cycling
      bipolar affective disorder.
AB  - Over the course of 1 year, a patient with a rapid cycling bipolar affective
      disorder was followed at weekly intervals to examine whether plasma hormones and
      urinary catecholamines could predict current or future mood. Higher cortisol
      levels were found to predict depressed mood 3 days after blood sampling, higher
      urinary dopamine predicted a manic mood 3 days after blood sampling, urinary
      norepinephrine was associated with severity of current mood and prolactin was
      lower with concurrent depressed mood. In multivariate analyses of mood against
      cortisol, prolactin and three urinary catecholamines, > 50% of the variance in
      mood state in 3 days was explained by combinations of these biologic measures,
      especially cortisol and urinary dopamine, while all five biologic variables
      contributed to explaining 50% of the variance in current mood state. Based on the
      interrelationships between urinary dopamine, norepinephrine and mood, we
      postulate the existence of an overcompensating mechanism which is reflected in
      opposing correlations between urinary dopamine and norepinephrine with mood,
      despite the two urinary catecholamines being positively correlated.

PMID- 7790678
TI  - Which depressed patients respond to ECT? The Nottingham results.
AB  - The Nottingham electroconvulsive therapy (ECT) trial was designed with a
      simulated treatment group to test prospectively the power of delusions or
      agitation to predict response. The response of patients without retardation and
      without delusions was examined retrospectively as well because of doubts over the
      usefulness of ECT for this subgroup. Deluded/nondeluded and agitated/nonagitated
      subtypes responded significantly to real treatment. Neither delusions nor
      agitation predicted greater treatment response. Patients without retardation,
      with or without delusions responded to real ECT, supporting the continuing
      prescription of ECT for these patients as well.

PMID- 7790679
TI  - Do differences in sleep architecture exist between depressives with comorbid
      simple phobia as compared with pure depressives?
AB  - Sleep records from 19 subjects with major depression and comorbid simple phobia
      were compared retrospectively with 25 patients with major depression alone and 25
      normal controls. Groups were matched for age and gender; depressed subjects were
      matched for severity of depression. All subjects had been free of psychotropic
      medications at least 2 weeks when recorded. Sleep variables were analysed using
      one-way ANOVA. Both depressed groups had significantly longer sleep latency than
      normal controls. Depressed patients with and without simple phobia showed no
      differences in sleep architecture.

PMID- 7790680
TI  - Platelet peripheral-type benzodiazepine receptor in major depression.
AB  - The peripheral-type benzodiazepine receptor (PBR) plays a major role in
      steroidogenesis. This receptor is sensitive to endocrine changes and stress.
      Antidepressants have been demonstrated to modulate adrenal and hepatic PBR in
      rats. To evaluate the relationship between depression and PBR, we measured
      platelet PBR in untreated depressed patients (n = 14) in comparison to normal
      controls (n = 13). Platelet PBR density (Bmax) and the dissociation constant (kd)
      of the receptor did not differ in the patients when compared with normal
      controls. Furthermore, no correlation was found between Bmax values and the
      severity of the depression (as measured by the Hamilton Depression Rating Scale
      and Beck Depression Inventory) as well as with the severity of the anxiety (as
      measured by the Hamilton Anxiety Rating Scale). It seems that major depression,
      in contrast to stress and some anxiety disorders, is not associated with
      alteration of PBR.

PMID- 7790682
TI  - Vitamin C and disease prevention.

PMID- 7790681
TI  - Caries diagnosis and risk assessment. A review of preventive strategies and
      management.
AB  - The scientific basis for caries risk assessment, prevention and treatment on an
      individual patient basis requires further development, specification and
      continuing validation. Still, current technologies and techniques, taken
      together, can provide enhanced capabilities over those that have been employed
      traditionally. Undoubtedly, the clinical tools for carrying out these
      responsibilities will be refined and expanded in the future in response to the
      changing clinical profile of caries in the population. For example, bacteriologic
      testing methods have become easier and more reliable, and will become more widely
      used. Other effective methods to detect the early, pre-cavitation stage of caries
      also should become more available in the future. Practitioners will be
      continually challenged and responsible for evaluating the effectiveness and value
      of emerging technologies in their practices and in light of their patients'
      needs. But how can this be accomplished best? Effectiveness claims will be made
      for new drugs and devices that come onto the market. There are several sources of
      information to assist the practitioner in making such decisions. The American
      Dental Association acceptance programs (voluntary) and the U.S. Food and Drug
      Administration compliance programs (law) provide standards and guidance as to
      product safety and effectiveness. Without such determinations, the practitioner
      must judge independently product claims and clinical studies. Marketing materials
      by themselves (advertisements, videos, pamphlets) may not be sufficient evidence
      of effectiveness particularly when scientific references supporting claims either
      are not provided or are inadequate. Peer-reviewed scientific literature in
      publications of the major scientific and professional associations can be viewed
      as generally reliable. Changing the way dental caries is managed in clinical
      practice will require integrating new scientific information and technology into
      workable clinical procedures. Dental education and third-party reimbursement
      issues must be addressed also but are beyond the scope of this document. Given
      that disease patterns are always changing in the population, dentists need to
      modify practice decisions using risk assessment. Ultimately, the goal for
      dentistry is that adult patients also will enjoy the same low level of caries
      experience that many children enjoy today.

PMID- 7790683
TI  - Vitamin C supplements and disease--counterpoint.

PMID- 7790684
TI  - Drug-nutrient interactions in medical training.

PMID- 7790685
TI  - Vitamin C and the common cold: a retrospective analysis of Chalmers' review.
AB  - In 1975 Thomas Chalmers analyzed the possible effect of vitamin C on the common
      cold by calculating the average difference in the duration of cold episodes in
      vitamin C and control groups in seven placebo-controlled studies. He found that
      episodes were 0.11 +/- 0.24 (SE) days shorter in the vitamin C groups and
      concluded that there was no valid evidence to indicate that vitamin C is
      beneficial in the treatment of the common cold. Chalmers' review has been
      extensively cited in scientific articles and monographs. However, other reviewers
      have concluded that vitamin C significantly alleviates the symptoms of the common
      cold. A careful analysis of Chalmers' review reveals serious shortcomings. For
      example, Chalmers did not consider the amount of vitamin C used in the studies
      and included in his meta-analysis was a study in which only 0.025-0.05 g/day of
      vitamin C was administered to the test subjects. For some studies Chalmers used
      values that are inconsistent with the original published results. Using data from
      the same studies, we calculated that vitamin C (1-6 g/day) decreased the duration
      of the cold episodes by 0.93 +/- 0.22 (SE) days; the relative decrease in the
      episode duration was 21%. The current notion that vitamin C has no effect on the
      common cold seems to be based in large part on a faulty review written two
      decades ago.

PMID- 7790686
TI  - The health effects of vitamin C supplementation: a review.
AB  - A comprehensive review of the literature indicates that populations with long
      term consumption of higher than RDA levels of vitamin C (> or = 60 mg/day) from
      foods and/or supplements have reduced risks of cancer at several sites,
      cardiovascular disease, and cataracts. The safety of higher than RDA intakes of
      vitamin C is confirmed in eight placebo-controlled, double-blind studies and six
      non-placebo clinical trials in which up to 10,000 mg of vitamin C was consumed
      daily for up to 3 years. There are no clinical data which suggest that vitamin
      C's enhancement of non-heme iron absorption in individuals with low iron status
      could be a critical factor in the possible increased risk of heterozygous
      hemochromatosis-related cardiovascular disease. In fact, the cumulative data do
      not confirm that iron status is related to risk of cardiovascular disease.
      Moreover, higher than RDA intakes of vitamin C have been associated with several
      indices of lowered cardiovascular disease risk including increases in HDL, and
      decreases in LDL oxidation, blood pressure and cardiovascular mortality.

PMID- 7790687
TI  - Family medicine residents' knowledge and attitudes about drug-nutrient
      interactions.
AB  - OBJECTIVE: The Joint Commission on Accreditation of Healthcare Organizations
      (JCAHO) requires that health professionals recognize the importance of drug
      nutrient interactions and educate patients to prevent adverse effects. Drug
      nutrient interactions are an important issue in medical practice, but it is not
      clear how or if physicians are trained in this issue. METHODS: This investigation
      was a needs assessment that examined attitudes and knowledge about drug-nutrient
      interactions that was examined in a national sample of 834 family medicine
      residents in 56 residency programs. RESULTS: Most reported they had little or no
      formal training in drug-nutrient interactions in medical school (83%) or
      residency (80%). However, 79% believed it was the physician's responsibility to
      inform patients about drug-nutrient interactions, although many thought
      pharmacists (75%) and dietitians (66%) share this responsibility. Overall,
      residents correctly answered 61% +/- 19 of fourteen drug-nutrient interaction
      knowledge items. There was a slight increase in drug-nutrient knowledge as year
      of residency increased. CONCLUSIONS: Physicians' knowledge of drug-nutrient
      interactions may be improved by including nutrition education in the topics
      taught by physicians, nutritionists, and pharmacists using several educational
      strategies. Nutrition educators in particular can play a role in curriculum
      development about drug-nutrient interactions by developing, refining, and
      evaluating materials and educational tools. Nutrition educators need to provide
      this information in academic settings for the training of all health
      professionals as well as in patient education settings such as hospitals and
      public health clinics.

PMID- 7790688
TI  - Dietary intakes by levels of glycemic control for black and white adults with non
      insulin dependent diabetes mellitus (NIDDM).
AB  - OBJECTIVES: The relationship between diet and glycemic control was examined among
      a racially mixed population of male and female adults with non-insulin dependent
      diabetes mellitus (NIDDM). METHODS: Data from 3-day dietary records and
      glycosylated hemoglobin (HbA1c) were analyzed for two-hundred eighty two patients
      of a Family Practice Ambulatory Care Unit and a community-based health center in
      Winston-Salem, North Carolina. Correlations were calculated for individual
      nutrients to determine their strength of association with glycemic control.
      Analyses by tertiles of HbA1c were also conducted for each race/gender group.
      Regression analysis was used to determine independent dietary predictors of
      HbA1c. RESULTS: For all subjects, energy, energy per kilogram of body weight,
      fat, carbohydrates saturated fat, and cholesterol were significantly correlated
      with HbA1c. Nutritional differences across tertile levels of HbA1c for all
      subjects were not significant. For black females, consumption of energy, protein
      and fat was significantly higher among upper tertile subjects compared to the
      lowest tertile; and intake of energy, protein, fat, and saturated fat was
      significantly correlated with HbA1c in this group. For black males, energy intake
      was highest among upper tertile subjects compared to those in the middle tertile,
      while energy per kilogram of body weight, and percent of calories from protein,
      were significantly correlated with HbA1c. For white males, energy intake
      expressed as a function of body weight was highest among subjects in the upper
      tertile and a significant positive correlation with HbA1c was observed. No
      relationship between nutritional intake and HbA1c was found among white females.
      Racial differences in nutrient intake were also compared for males and females in
      the upper tertile of HbA1c. Black females in the upper tertile consumed
      significantly more energy, protein, and significantly less dietary fiber per 1000
      kilocalories. No significant differences were observed between black and white
      males in the upper tertile, although higher cholesterol consumption in black
      males compared to white males approached significance. Regression analysis
      revealed that total energy intake significantly predicted HbA1c for all subjects
      and all white subjects, while a similar observation was made for total fat intake
      among all black subjects and among black females. CONCLUSIONS: These findings
      confirm that diet, especially total energy, is an important contributor to
      glycemic control. Dietary fat is also associated with glycemic control among
      blacks, especially black females, who are especially prone to more dire health
      consequences of NIDDM. Strict monitoring of diet should lead to improved glycemic
      control and less mortality and morbidity in this population.

PMID- 7790689
TI  - Protein consumption and hepatic encephalopathy in alcoholic hepatitis. VA
      Cooperative Study Group #275.
AB  - OBJECTIVE: Patients with alcoholic hepatitis frequently have moderate or severe
      malnutrition. Dietary protein intake may be restricted in these patients because
      of concurrent hepatic encephalopathy. To further evaluate the relationship
      between dietary protein intake and hepatic encephalopathy in alcoholic hepatitis,
      we evaluated prospectively gathered data from a study of 136 placebo-treated
      patients with moderate or severe alcoholic hepatitis conducted at eight
      Department of Veterans Affairs Medical Centers. METHODS: Physical examination,
      laboratory tests, and grade of hepatic encephalopathy were recorded at entry and
      every seventh day for the first 28 days of study. Average daily protein intake
      was calculated from dietary evaluation obtained by a registered dietitian at
      entry and again three times a week. RESULTS: Sixty-three percent of patients had
      hepatic encephalopathy at entry. Hepatic encephalopathy decreased over time. Time
      dependent regression analysis found low protein intake, along with high blood
      urea nitrogen (BUN) and high serum creatinine, to be independently associated
      with worsening hepatic encephalopathy. Similar analysis found low BUN and less
      malnutrition at entry into the study to be independently associated with improved
      hepatic encephalopathy. Higher protein intake was associated with improved
      hepatic encephalopathy in univariate (p = 0.01), but not multivariate, analysis.
      CONCLUSION: In patients with alcoholic hepatitis who can be treated with standard
      anti-encephalopathy medications (e.g., lactulose and neomycin), low protein
      intake is associated with worsening hepatic encephalopathy while a higher protein
      intake correlates with improvement in hepatic encephalopathy.

PMID- 7790690
TI  - Indicators of poor dietary habits in a high risk population.
AB  - OBJECTIVE: This study was conducted to determine whether individuals attending an
      urban outpatient clinic met the National Health Promotion and Disease Prevention
      nutritional objectives and to assess factors associated with poor dietary habits.
      METHODS: Individuals who attended the general medicine outpatient clinic at the
      State University of New York Health Science Center in Syracuse were interviewed
      using an expanded version of the Health Habits and History Questionnaire. Usual
      dietary intake, medical history, occupation, stress, physical activity, tobacco
      use and other life-style factors were recorded. Of particular interest were the
      percentage of calories from fat in the diet and whether individuals consumed the
      daily requirements of the base-foods in the USDA Pyramid (grains, vegetables and
      fruits). Unconditional logistic regression was used to determine odds ratios (OR)
      and 95% confidence intervals for variables associated with high fat consumption
      and low consumption of vegetables, fruit and high-fiber grains. RESULTS: None of
      the patients met the minimal recommended daily servings for the three base-food
      categories combined (grains, vegetables and fruits) and 84% of subjects had fat
      intakes which constituted over 30% of daily energy intake. Individuals with less
      education, who were disabled or unemployed, and who participated in little
      physical activity were twice as likely to have poor dietary habits (i.e. low
      consumption of vegetables, fruit, and/or high-fiber grains) as other subjects (p
      < 0.05). Younger patients (20-49 years of age), especially those who were
      nonsmokers and who reported little physical activity were more likely to consume
      fat and less likely to consume fruit than older patients (> or = 50 years of
      age). Nonwhite subjects were less likely to consume high-fiber grains and whole
      wheat breads than white patients (p = 0.04). CONCLUSIONS: Nutritional screening
      should be considered for all patients attending similar inner-city general
      medicine clinics, regardless of the primary diagnosis in order to provide early
      dietary intervention. In particular, young adults, the unemployed, and the
      disabled should not be overlooked.

PMID- 7790691
TI  - Effect of maternal oxygen therapy on placental calcium transport in intrauterine
      growth retarded rats.
AB  - OBJECTIVE: We tested the hypothesis that continuous maternal oxygen (O2) therapy
      leads to an increase in fetal survival, improvement in fetal growth, and
      correction of decreased placental calcium (Ca) transport, in pregnant rats who
      underwent uterine artery ligation. STUDY DESIGN: We measured on Day 21 of
      pregnancy, the unidirectional maternofetal clearance of 45Ca (Kmf45Ca) and 51Cr
      EDTA (Kmf51Cr-EDTA) across in-situ perfused placentas of rats randomized on Day
      17 to a modified Wigglesworth (bilateral uterine artery ligation) procedure
      (group WW, n = 8), to modified Wigglesworth and supplemental maternal O2
      treatment (FiO2 0.40) (group WWO2, n = 8), or to a sham operation (group Sh, n =
      8). Kmf51Cr-EDTA provides a measure of placental "porosity" or passive
      permeability. RESULTS: Maternal O2 therapy did not improve fetal survival, fetal
      growth, or placental Ca transport. CONCLUSION AND SPECULATION: Bilateral uterine
      ligation in the pregnant rat leads to IUGR and decreased placental Ca transport
      which cannot be corrected by maternal O2 therapy.

PMID- 7790692
TI  - Failure of vitamin E to protect cultured human arterial smooth muscle cells
      against oxysterol-induced cytotoxicity.
AB  - OBJECTIVE: The cytotoxicity of oxysterols including 7 alpha-hydroxycholesterol (7
      alpha OHC), 7 beta-hydroxycholesterol (7 beta OHC), cholesterol 5 alpha,6 alpha
      epoxide (alpha epoxyC), cholesterol 5 beta,6 beta-epoxide (beta epoxyC), 7
      ketocholesterol (7ketoC), 26-hydroxycholesterol (26OHC), cholesterol-3 beta,5
      alpha,6 beta-triol (TriolC) and the possible protecting effect of vitamin E on
      26OHC-induced cytotoxicity were investigated in smooth muscle cells isolated from
      the arteries of human umbilical cords. METHODS: To study the cytotoxicity of
      oxysterols, the cells were incubated with each oxysterol at a level of 10
      micrograms/ml from 24 to 120 hours, then 45Ca++ uptake, cytosolic free Ca++
      level, [3H]thymidine incorporation, total DNA content and viable cell number were
      measured. Cholesterol was used as a control. For tracing the possible origin of
      cytotoxicity of 26OHC, cholesterol, phospholipid and 26OHC content in the
      membrane were investigated from 24 to 72 hours. For determining whether
      antioxidants had a protective effect against the cytotoxicity of 26OHC, vitamin E
      and butylated hydroxytoluene (BHT) were used. RESULTS: The results indicated that
      the oxysterols elevated 45Ca++ uptake and cytosolic free Ca++ level, but
      diminished [3H]thymidine incorporation, total DNA content and viable cell number.
      26OHC lowered the cholesterol content of the membrane and incorporated into the
      membrane after 24 hours of the incubation, but did not alter the total
      phospholipid content of the membrane until 72 hours. Neither vitamin E or BHT
      significantly protected the cells from the 26OHC-induced alterations. CONCLUSION:
      We suggest that the cytotoxicity of oxysterols, which might result in an
      alteration in Ca++ ion flow into the cell by decreasing cholesterol content and
      incorporating oxysterol itself into the membranes, could not be protected by
      vitamin E.

PMID- 7790695
TI  - Effects of long-term vitamin E supplementation in alcoholic cirrhotics.
AB  - OBJECTIVE: Alcohol ingestion promotes lipoperoxidation and alters cellular
      antioxidant mechanisms. Alpha-tocopherol levels decrease in alcoholics as
      severity of liver damage increases. The aim of this protocol was to study the
      effects of a long-term oral 500 mg vitamin E daily supplementation in
      decompensated ambulatory alcoholic cirrhotics. PATIENTS AND METHODS: 67 subjects
      were included in this double blind trial; 33 patients received vitamin E and 34
      patients received placebo tablets of identical appearance during 1 year. Each
      month, the patients were seen by a nurse practitioner who was in charge of
      detecting alcohol ingestion and checking adherence to treatment. Every 3 months,
      the patients underwent a medical examination, and blood samples were taken for
      clinical laboratory analysis and serum vitamin E measurement. RESULTS: Alpha
      tocopherol levels were significantly lower in patients with more severe liver
      disease. This difference was not significant when vitamin E levels were corrected
      by cholesterol. Oral supplementation significantly increased serum vitamin E
      levels in the experimental group. Alcohol ingestion and hospitalization rates
      were similar in both groups. Life table analysis did not show significant
      differences in mortality between the two groups. DISCUSSION: Vitamin E
      supplementation with adequate doses of an alpha-tocopheryl acetate formulation
      during 1 year did not influence hepatic laboratory parameters, mortality or
      hospitalization rates of decompensated alcoholic cirrhotics, although serum
      levels of the vitamin significantly increased.

PMID- 7790694
TI  - Marginal dietary protein restriction reduced nonprotein nitrogen, but not protein
      nitrogen, components of human milk.
AB  - OBJECTIVE: This study was designed to determine whether marginal dietary protein
      intakes of lactating women alter their milk production and composition. The study
      followed the observation that marginal dietary protein intakes lead to
      significantly negative nitrogen balances in these women. METHODS: Twenty-four
      healthy, mature lactating women were divided evenly into three groups on the
      basis of postpartum times; 1, 5, or 12 months. Each woman was given a controlled
      protein diet of either 1.5 (HP) or 1.0 (MP) g/kg body weight/day for 7 to 10
      days. Milk production was measured for 72 hours by test weighing the infant
      before and after feeding. Milk samples from alternate breasts were collected for
      24 hours, pooled, and analyzed for their protein nitrogen, nonprotein nitrogen,
      free and protein-bound amino acid, and lactoferrin concentrations. RESULTS:
      Reduced dietary protein intakes were associated with a decrease (p < 0.05) in the
      nonprotein nitrogen and total free amino acid fractions of milk. Although urea
      was unaffected, the concentrations of milk free leucine, phenylalanine,
      histidine, and ornithine were lower (p < 0.05) in the MP than in the HP group,
      while the output of leucine and histidine tended to be lower in the MP group. The
      amount of milk produced, as well as the amounts of protein nitrogen, protein
      bound amino acid, and lactoferrin and their concentrations were unaffected by a
      reduction of dietary protein. CONCLUSIONS: Maternal milk production and the
      protein nitrogen, but not the nonprotein nitrogen, fraction of human milk were
      relatively well-preserved in the presence of a short-term, marginal reduction of
      dietary protein.

PMID- 7790693
TI  - Dietary mustard, rape seed oils and selenium exert distinct effects on serum Se,
      lipids, peroxidation products and platelet aggregability.
AB  - OBJECTIVE: A degenerative cardiomyopathy (DCM) has been observed among mustard
      oil (MUST) users in China who eat 150 ml/week. Though the condition may be a
      selenium (Se) deficiency, MUST, rich in erucic acid (22:1), may bear a
      cardiotoxic or pro-oxidant substrate(s). The purpose of this feeding study was to
      compare the effects of feeding MUST, high erucic acid rape seed oil (HEAR), low
      erucic acid rape seed oil (LEAR) and corn oil, with or without Se addenda, on
      serum cholesterol, triglycerides, thiobarbituric acid reactive substances
      (TBARS), alpha-tocopherol, platelet aggregation and hepatic glutathione
      peroxidase (GSHPXase). Heart muscle pathology was evaluated. METHODS: Eighty
      male, weanling Wistar rats were divided into four dietary groups and fed AIN76A
      diet for 8 weeks with one of four oils: 1) MUST, 2) HEAR, 3) LEAR, or CORN oil.
      Half of each group received 0.43 mg/kg Se supplement. A purified diet was fed for
      8 weeks. RESULTS: Neither Se nor oil type affected growth, though serum Se rose
      with dietary Se addendum (p < 0.01), and hepatic GSHPXase rose for each oil (p <
      0.01). Se deprivation led to elevated serum cholesterol, except for the CORN oil
      group (p < 0.01). Only with LEAR did HDL cholesterol decrease. Serum
      triglycerides decreased with MUST and LEAR feedings (p < 0.05). In Se deficiency,
      HEAR led to elevated TBARS (p < 0.01), though not MUST, which contained twice as
      much alpha-tocopherol. Though supplementary Se protected the HEAR-fed animals
      from secondary peroxidation as TBARS (p < 0.01), the MUST group was not so
      protected. Ration Se also spared serum alpha-tocopherol for each diet group
      except the MUST/Se group (p < 0.05). MUST oil feeding resulted in increased
      platelet aggregation; MUST and HEAR resulted in increased platelet ATP release
      compared with CORN oil. CONCLUSION: Oxidative mechanisms may be involved in the
      DCM involving both Se limitation and pro-oxidant stress related to the usual
      intake of MUST. Human studies have been undertaken to test this thesis.

PMID- 7790696
TI  - Metabolic effect of parenteral nutrition in dogs with obstructive jaundice.
AB  - OBJECTIVE: To assess the effect of total parenteral nutrition (TPN) on
      macronutrient metabolism in obstructive jaundice. METHODS: Forty adult mongrel
      dogs were equally divided into four groups: group I (PO-control) received sham
      ligation of common bile duct (CBDL) and was fed dog chow and water ad libitum;
      group II (PO-CBDL) underwent CBDL and was fed dog chow; group III (TPN-control)
      received sham CBDL and TPN; and group IV (TPN-CBDL) underwent CBDL and received
      TPN. Blood chemistries, plasma amino acids and liver histologies were studied
      before (Day 1) and at the end (Day 14) of the experiment. RESULTS: A significant
      elevation of bilirubin and alkaline phosphatase was observed in dogs with CBDL.
      Blood glucose was not changed significantly in any group. Significant increases
      in triglyceride and cholesterol were present in CBDL dogs. Significant
      differences in the concentrations of a few plasma amino acids, including an
      elevation of phenylalanine, were found in TPN dogs. A significant increase in
      aromatic amino acids (AAA) and a noticeable depression of the molar ratio of
      branched-chain amino acids (BCAA) to AAA was present in TPN-CBDL dogs, as was a
      significant increase in blood ammonia. CONCLUSION: In the presence of obstructive
      jaundice, TPN does not significantly affect carbohydrate or lipid metabolism.
      However, a derangement in protein metabolism with the standard TPN solution in
      current use suggests that either a modification of amino acid composition or an
      increase in total energy to protein energy ratio in TPN solution may be necessary
      to obviate such a consequence.

PMID- 7790698
TI  - ISSFAL Board Statement: recommendations for the essential fatty acid requirement
      for infant formulas. International Society for the Study of Fatty Acids and
      Lipids.

PMID- 7790697
TI  - Effects of a ketogenic diet on tumor metabolism and nutritional status in
      pediatric oncology patients: two case reports.
AB  - OBJECTIVE: Establish dietary-induced ketosis in pediatric oncology patients to
      determine if a ketogenic state would decrease glucose availability to certain
      tumors, thereby potentially impairing tumor metabolism without adversely
      affecting the patient's overall nutritional status. DESIGN: Case report. SETTING:
      University Hospitals of Cleveland. SUBJECTS: Two female pediatric patients with
      advanced stage malignant Astrocytoma tumors. INTERVENTIONS: Patients were
      followed as outpatients for 8 weeks. Ketosis was maintained by consuming a 60%
      medium chain triglyceride oil-based diet. MAIN OUTCOME MEASURES: Tumor glucose
      metabolism was assessed by Positron Emission Tomography (PET), comparing
      [Fluorine-18] 2-deoxy-2-fluoro-D-glucose (FDG) uptake at the tumor site before
      and following the trial period. RESULTS: Within 7 days of initiating the
      ketogenic diet, blood glucose levels declined to low-normal levels and blood
      ketones were elevated twenty to thirty fold. Results of PET scans indicated a
      21.8% average decrease in glucose uptake at the tumor site in both subjects. One
      patient exhibited significant clinical improvements in mood and new skill
      development during the study. She continued the ketogenic diet for an additional
      twelve months, remaining free of disease progression. CONCLUSION: While this diet
      does not replace conventional antineoplastic treatments, these preliminary
      results suggest a potential for clinical application which merits further
      research.

PMID- 7790699
TI  - Evidence of non-A, non-B, non-C infection in chronic hepatitis by polymerase
      chain reaction testing for hepatitis B and C viruses.
AB  - BACKGROUND/AIMS: Although hepatitis C virus is clearly the major cause of non-A,
      non-B acute and chronic hepatitis, there is a group of patients with
      histologically documented chronic hepatitis with no serological marker of
      hepatitis B and C, nor any other risk factors for liver disease. METHODS: We have
      investigated 17 well-characterized patients with chronic active hepatitis. HBV
      DNA and HCV-RNA were tested by polymerase chain reaction in 17 serum samples and
      in six liver biopsies. RESULTS: Four of the 17 patients had serum HCV-RNA
      detectable by polymerase chain reaction, while none had HBV-DNA detectable by
      polymerase chain reaction. Three of the six liver samples gave a positive signal
      by cyclin A and HLA, and only these were considered for the study. One of the
      three was HCV-RNA positive, while none was HBV-DNA positive. CONCLUSIONS: Our
      results, obtained through careful elimination of all known risk factors for liver
      disease, strongly suggest that non-A, non-B, non-C hepatotropic virus(es) could
      be involved in some cases of chronic active liver disease.

PMID- 7790700
TI  - Relationship between hepatitis C virus subtypes and clinical features of liver
      disease seen in alcoholics.
AB  - The influence of hepatitis C virus and its subtypes on the clinical course of
      liver disease in alcoholics was assessed. Hepatitis C virus infection was
      confirmed by a reverse transcription and polymerase chain reaction method for the
      hepatitis C virus NS-5 region in the sera of alcoholics with various stages of
      histologically proven liver disease. The frequency of hepatitis C virus was
      significantly higher in alcoholics with chronic hepatitis (73%) than in those
      with liver fibrosis (18%), alcoholic hepatitis (17%), and fatty liver (0%).
      Hepatitis C virus subtypes, namely K1 and K2, were determined by dot-blot
      hybridization analysis of the polymerase chain reaction products with specific
      probes, and their frequencies were 68% and 32%, respectively. The proportion of
      patients whose serum transaminase levels returned to normal following 4 weeks of
      abstinence in hospital was significantly lower in alcoholics with hepatitis C
      virus viremia (glutamic oxaloacetic transaminase: 53.8%; glutamic pyruvic
      transaminase: 42.3%) than in those without viremia (glutamic oxaloacetic
      transaminase: 86.2%, p < 0.01; glutamic pyruvic transaminase: 89.7%, p < 0.01).
      When alcoholics with the K1 and K2 subtypes of hepatitis C virus were compared,
      normalization of transaminase levels was less frequent in alcoholics with K1
      (glutamic oxaloacetic transaminase: 42.8%; glutamic pyruvic transaminase: 28.6%)
      than in those with K2 (glutamic oxaloacetic transaminase: 88.9%, p < 0.05;
      glutamic pyruvic transaminase: 77.8%, P < 0.05). These data indicate that
      hepatitis C virus infection is associated with a reduced rate of recovery of
      serum transminase levels following abstinence in subjects with alcoholic liver
      disease, more so in the K1 subtype than in the K2 subtype.

PMID- 7790702
TI  - Bacterial expression and purification of hepatitis C virus capsid proteins of
      different size.
AB  - Two capsid sequences of the hepatitis C virus were cloned and expressed in an E.
      coli system. One sequence (c190) comprised the complete capsid region with 573
      nucleotides. The other sequence (c125) spanned 375 5'-nucleotides lacking the
      hydrophobic 3'-part of the hepatitis C virus capsid gene. A full-length and a
      truncated construct were chosen, since it is not known whether there is 3'
      truncation of the hepatitis C virus capsid during protein maturation similar to
      the situation in some flaviviridae. The corresponding expression clones 190/4 and
      125/4 were constructed by polymerase chain reaction cloning into pQE-vectors. The
      protein expressed, pc125, which is lacking the hydrophobic carboxyterminus of the
      full-length capsid protein pc190, showed a stronger signal in western blots using
      anti-hepatitis C virus/EIAII-positive patient's serum. This could be due to
      better expression and/or better solubilization of pc125. The truncated protein
      pc125 displayed the predicted molecular weight of 19 kD, whereas the full-length
      protein pc190 migrated faster than expected. This could be due to intracellular
      proteolytic processing, giving rise to a truncated protein or to an atypical
      mobility in SDS-PAGE gels caused by the hydrophobic nature of the full-length
      protein. Both proteins were synthesized with an aminoterminal tag of six
      histidines that could be used for purification by Nickel chelate affinity
      chromatography. The elution fractions of the two proteins showed additional bands
      in western blots. Most of these proteins had a mass between 2 and 16 kD and are
      likely to be degradation products. Protein pc125 could be purified in larger
      quantities than pc190.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790701
TI  - Improvement of liver fibrosis in chronic hepatitis C patients treated with
      natural interferon alpha.
AB  - To investigate the histological change (change of liver fibrosis) produced by the
      anti-viral effect of interferon on hepatitis C virus, 40 patients with chronic
      hepatitis C treated with natural interferon alpha were divided according to the
      existence of viremia at the end of treatment and 6 months after the end of
      treatment. The condition of liver fibrosis was scored numerically with a new
      "hepatic fibrosis score" which is sensitive to more subtle changes than Knodell's
      fibrosis score. Each portal zone was evaluated separately. End-of-treatment
      biopsy for the HCV RNA-negative group (negative for HCV RNA at the end of
      treatment) showed a significant improvement of the "hepatic fibrosis score" as
      well as the alleviation of necrosis and inflammation. At the end of treatment and
      6 months after that, serum procollagen type III peptide levels and serum type IV
      collagen-7s levels had also decreased significantly in the HCV RNA-negative
      group. The present study showed that treatment with interferon alpha could
      alleviate fibrosis in addition to necrosis and inflammation.

PMID- 7790703
TI  - Histological and biochemical effects of cyclosporine A withdrawal from a triple
      drug regimen after over 2 years of treatment in liver transplant patients.
AB  - Cyclosporine A was withdrawn from a triple drug immunosuppressive regimen in 10
      clinically and biochemically stable liver transplant patients. This study reports
      the effects of cyclosporine A withdrawal on liver tests and liver histology.
      Serum aspartate amino transferase and serum alanine amino transferase values
      increased significantly. Seven out of ten patients had histological changes after
      cyclosporine A withdrawal, but not before. These changes were compatible with
      acute rejection (consistent with rejection) in two patients and grade I also in
      two patients, including one patient with a second graft. Only two of these
      patients needed corticosteroid treatment (one consistent with rejection and one
      grade I rejection). Cyclosporine A treatment was restarted in three patients,
      because a coexisting osteoporosis prohibited prolonged corticosteroid recycling.
      Seven patients were able to maintain stable though slightly elevated
      transaminases without cyclosporine A, with a follow up of median 26 months. Our
      results suggest that in stable patients cyclosporine A withdrawal can be
      considered, for instance 2 years after liver transplantation.

PMID- 7790705
TI  - Effect of propranolol on portosystemic collateral circulation estimated by per
      rectal portal scintigraphy with technetium-99m pertechnetate.
AB  - BACKGROUND/AIMS: Propranolol is widely used in the prevention of variceal
      bleeding. However, in certain patients with cirrhosis, the portal hypotensive
      effect of propranolol cannot be obtained. An explanation for portal
      unresponsiveness to propranolol could be an increase in portocollateral vascular
      resistance mediated by this drug. METHODS: In 33 patients with cirrhosis the
      effect of chronic administration of propranolol on portocollateral blood flow
      from the inferior mesenteric vein was examined by means of per-rectal portal Tc
      99m pertechnetate scintigraphy. RESULTS: Propranolol significantly reduced the
      shunt index by 15.3 +/- 4.2%. This reduction was observed only in patients with
      cirrhosis classified as Child-Pugh A and B groups, but not group C. Differences
      between groups in portosystemic shunt index changes after propranolol were
      significant (F = 3.4, p < 0.05). CONCLUSIONS: The data presented suggest that
      propranolol changes the distribution of blood between the portal and systemic
      circulation, which is probably due to the increase in vascular resistance of
      portocollateral vessels. The magnitude of the vascular response to propranolol
      depends on the severity of liver disease.

PMID- 7790704
TI  - Endotoxemia in patients with chronic liver diseases: relationship to severity of
      liver diseases, presence of esophageal varices, and hyperdynamic circulation.
AB  - Plasma endotoxin levels were investigated using a quantitative Limulus assay in
      patients with chronic liver diseases and correlated with the severity of liver
      diseases, the presence of esophageal varices, and hemodynamic parameters. The
      plasma endotoxin levels were significantly higher in chronic hepatitis patients
      with acute exacerbation (10.1 +/- 1.3 pg/ml, n = 13, p < 0.05) and patients with
      cirrhosis (7.0 +/- 0.7 pg/ml, n = 126, p < 0.05) than in healthy subjects (2.9 +/
      0.2 pg/ml, n = 45). Chronic hepatitis patients (n = 30) had plasma endotoxin
      levels which were similar to those in healthy subjects (4.6 +/- 0.5 vs. 2.9 +/-
      0.2 pg/ml, p > 0.05) but lower than those in chronic hepatitis patients with
      acute exacerbation (4.6 +/- 0.5 vs. 10.1 +/- 1.3 pg/ml, p < 0.05). Endotoxemia
      (plasma endotoxin level > 5.7 pg/ml) was found in 27%, 85% and 41% of patients
      with chronic hepatitis, chronic hepatitis with acute exacerbation, and cirrhosis,
      respectively. In patients with cirrhosis, the plasma endotoxin levels
      progressively increased in relation to the severity of liver dysfunction (Pugh's
      class A/B/C = 4.9 +/- 0.5/7.9 +/- 1.4/10.2 +/- 2.0 pg/ml, p < 0.05). In contrast,
      plasma endotoxin levels were comparable between patients with cirrhosis with and
      without esophageal varices (p > 0.05). Chronic hepatitis patients with acute
      exacerbation (no collaterization) had much higher plasma endotoxin levels than
      those in patients with cirrhosis and large varices (p < 0.05), whereas
      compensated patients with cirrhosis and large esophageal varices had plasma
      endotoxin levels similar to those seen in chronic hepatitis patients (no
      collaterization) (p > 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790706
TI  - Aminopyrine breath test improves long-term prognostic evaluation in patients with
      alcoholic cirrhosis in Child classes A and B.
AB  - In a 4-year survival study, we evaluated the prognostic value of the aminopyrine
      breath test and the Child-Turcotte-Pugh score in 190 alcoholic patients. Using
      aminopyrine breath test results, the patients were stratified into group 1
      (aminopyrine breath test > 2%), group 2 (1% < or = aminopyrine breath test < 2%)
      and group 3 (aminopyrine breath test < 1%). Survival rates at 4 years were 68% in
      group 1, 35% in group 2 and 17% in group 3. Using the Child-Turcotte-Pugh score,
      survival rates at 4 years were 67% in Child-Turcotte-Pugh class A, 40% in class B
      and 7% in class C. To assess the value of aminopyrine breath test as an adjunct
      to Child-Turcotte-Pugh score in prognostic evaluation of patients with cirrhosis,
      two approaches have been used: a regression analysis using Cox's proportional
      hazard model by including the Child-Turcotte-Pugh score and aminopyrine breath
      test value, and the log-rank test to assess the prognostic value of aminopyrine
      breath test in each Child-Turcotte-Pugh class separately. The regression analysis
      showed that both parameters, the Child-Turcotte-Pugh score and the aminopyrine
      breath test results, were accepted in the model, suggesting that the aminopyrine
      breath test was still significantly related to survival once the Child-Turcotte
      Pugh score had been entered into the model. Analysis of the prognostic value of
      the aminopyrine breath test in each Child-Turcotte-Pugh class separately
      indicated, however, that the contribution was negligible in the Child-Turcotte
      Pugh class C.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790708
TI  - Aminoglycoside-associated nephrotoxicity in extrahepatic obstructive jaundice.
AB  - Experimental data demonstrate that biliary obstruction increases renal
      sensitivity to gentamicin. In the present study the incidence of and risk factors
      for aminoglycoside nephrotoxicity were prospectively studied in patients with
      extrahepatic obstructive jaundice. Two hundred and thirty-seven hospitalized
      adult patients were classified into three groups. Group I consisted of 84
      patients with extrahepatic obstructive jaundice, who received aminoglycoside
      (gentamicin or tobramycin). Group II consisted of 81 patients with extrahepatic
      obstructive jaundice, who received either antibiotics other than aminoglycoside
      or no antimicrobial therapy. Group III consisted of 72 noncholestatic patients
      receiving aminoglycosides for different disorders. Nephrotoxicity developed in 27
      patients (32%) in group I vs 9 patients (11%) in group II and 4 patients (5.6%)
      in group III (p < 0.00001). In group I, a comparison of patients with and without
      nephrotoxicity revealed significantly higher values in the former for mean serum
      bilirubin concentration, initial steady-state trough aminoglycoside concentration
      and estimated half-life. Stepwise multivariate analysis with nephrotoxicity
      status as the dependent variable determined that the most significant variable
      for predicting nephrotoxicity was serum total bilirubin level. In extrahepatic
      cholestasis a high serum bilirubin level is a distinct factor predisposing to
      aminoglycoside nephrotoxicity.

PMID- 7790707
TI  - Vasodilatory effects of propylthiouracil in patients with alcoholic cirrhosis.
AB  - BACKGROUND/AIMS: An experimental study has shown that propylthiouracil increases
      portal blood flow in normal rats. Whether propylthiouracil has a similar effect
      in patients with alcoholic cirrhosis remains to be demonstrated. The aim of this
      study was to evaluate the effects of oral propylthiouracil (300 mg) on systemic
      and portal hemodynamics in patients with alcoholic cirrhosis. METHODS: Plasma
      propylthiouracil levels were also measured by high performance liquid
      chromatography in five patients with alcoholic cirrhosis. In eight patients with
      cirrhosis, mean arterial pressure, cardiac output and portal blood flow were
      evaluated before and after placebo and propylthiouracil administration.
      Hemodynamic measurements were performed by the Doppler technique. The plasma peak
      level of propylthiouracil was achieved at 1.4 +/- 0.1 h in patients with
      alcoholic cirrhosis. This time was chosen to express hemodynamic changes.
      RESULTS: Propylthiouracil administration caused a significant increase in portal
      blood flow (+16.5%, p < 0.05) in patients with alcoholic cirrhosis. This effect
      was associated with a mild and significant rise in cardiac output (from 5.8 +/-
      0.2 to 6.1 +/- 0.3 l/min, p < 0.05) and a decrease in peripheral vascular
      resistance (from 1171 +/- 69 to 1070 +/- 67 dyn . s-1 . cm-5, p < 0.01). A
      significant correlation was observed between changes in portal blood flow and
      peripheral vascular resistance (r = 0.79, p < 0.05). No significant changes were
      observed after placebo. CONCLUSIONS: Our findings show that propylthiouracil has
      a vasodilatory effect in patients with alcoholic cirrhosis. We postulate that
      this effect could be the mechanism by which propylthiouracil decreases
      hypermetabolic state, and increases oxygen delivery to the liver, in patients
      with alcoholic liver diseases.

PMID- 7790709
TI  - Pattern of bile acid regurgitation and metabolism during perfusion of the bile
      duct obstructed rat liver.
AB  - Bile acid processing in the long-term, bile duct obstructed rat liver was studied
      ex vivo. Twenty four and 72 h, respectively, after bile duct obstruction the
      isolated liver was perfused with taurodeoxycholate (16 nmol/min per g liver) the
      bile duct still being closed. Uptake, metabolism and regurgitation profile were
      traced by bolus injection of tritium-labeled bile acid; in addition, concurrent
      histological changes were examined by light- and electron microscopy. Ligation
      caused dilatation of the intrahepatic ductular branches and increased the serum
      bile acid concentration to 740 +/- 75 microM (controls: 16 +/- 2.12), reaching
      its maximum within 24 h. At 16 nmol/min per g liver uptake rate was > 96% in
      controls and in bile duct obstructed rats. Maximal uptake rates (assessed
      separately) differed between controls and bile duct obstructed rats (700 nmol/min
      per g liver vs. 460). Controls excreted more than 80% of labeled bile acid in
      bile within 10 min after bolus injection. Biliary recovery of label was virtually
      completed after 30 min. In bile duct obstructed rats excretion of label back to
      the perfusate effluent (regurgitation) started quantitatively 5 min after bolus
      application and peaked between 10 and 40 min; after 80 min, effluent recovery was
      incomplete (about 60% of bolus injected). Biliary bile acids of controls
      consisted of about 20% taurodeoxycholate-metabolites; bile acids in the perfusate
      effluent of bile duct obstructed rats of about 55%. The major metabolite in all
      animal groups was taurocholate; minor metabolites were tauroursocholate, tauro-3
      alpha,7 = 0,12 alpha-cholanoic acid and 3-sulfo-taurodeoxycholate.
      Histologically, inflammation and periportal edema were present after 1 day of
      bile duct obstruction. After 3 days, marked proliferation of bile ductules was
      the dominant histological feature. It is concluded that during initial bile duct
      obstruction, bile acid processing is not altered, although ultrastructural
      alterations occur early.

PMID- 7790710
TI  - Induction of chronic cholangitis in the rat by trinitrobenzenesulfonic acid.
AB  - We investigated the effects of the hapten trinitrobenzenesulfonic acid instilled
      into the rat biliary tree. The study included three groups of animals that
      received a single intracholedochal injection of either saline, 10% ethanol or 10
      mg trinitrobenzenesulfonic acid dissolved in 10% ethanol. A fourth group of rats
      was subjected to common bile duct ligation and was used as control for biliary
      obstruction. Liver and biliary tract dysfunction was assessed 1, 10, 20 and 30
      days after treatment by serum aspartate aminotransferase, alkaline phosphatase
      and bilirubin, and by histopathological examination of liver slices. By day 10,
      saline- or ethanol-treated rats did not show changes in the biochemical
      parameters, and light microscopy revealed no alterations. In contrast, rats
      treated with trinitrobenzenesulfonic acid showed significant increases in all
      serum markers throughout the study period. Inflammatory cell infiltrates were
      seen in portal areas and around bile ducts, indicating pericholangitis. Some rats
      presented with dilatation of extrahepatic biliary ducts; ductal proliferation and
      thin porto-portal fibrotic septa were observed in these cases. Bile duct ligation
      also induced ductal proliferation and fibrosis in all cases, but pericholangitis
      was not prominent. Retrograde cholangiograms in trinitrobenzenesulfonic acid rats
      showed distortion of the intra- and extrahepatic biliary tree. In conclusion,
      chronic cholangitis may be consistently induced in rats by a single
      intracholedochal administration of trinitrobenzenesulfonic acid.

PMID- 7790712
TI  - Loss of heterozygosity in liver tumours.

PMID- 7790711
TI  - Human Kupffer cells secrete IL-10 in response to lipopolysaccharide (LPS)
      challenge.
AB  - BACKGROUND/AIMS: Kupffer cells are involved in local immunoregulation in the
      liver by secretion of cytokines and direct cellular contact. They are able to
      influence the function of other liver cells, i.e. sinusoidal endothelial cells,
      Ito cells and hepatocytes. The three known major functions of Kupffer cells are
      clearance of endotoxin from the portal circulation, release of soluble mediators
      and presentation of antigen. METHODS: Human Kupffer cells were isolated by
      collagenase perfusion followed by centrifugal elutriation and analyzed for
      cytokine secretion after 3 days in culture. RESULTS: We found that freshly
      isolated human Kupffer cells secreted the anti-inflammatory cytokine interleukin
      10 in response to stimulation with lipopolysaccharide. The release of interleukin
      10 was maximal 12-24 h after lipopolysaccharide challenge. Furthermore, we could
      show that exogenous interleukin-10 downregulated the release of the
      proinflammatory cytokines interleukin-6 and tumor necrosis factor alpha by
      Kupffer cells after lipopolysaccharide stimulation. The release of interleukin-6
      was maximal 24 h after stimulation and interleukin-10 inhibited interleukin-6
      release after 6 h. Tumor necrosis factor alpha showed maximal secretion 6 h after
      stimulation and exogenous interleukin-10 also downregulated the tumor necrosis
      factor alpha release after 6 h. CONCLUSIONS: Kupffer cells are exposed
      physiologically to lipopolysaccharide present in portal venous blood. Given the
      known anti-inflammatory effect of interleukin-10, our findings of secretion of
      interleukin-10 by Kupffer cells in response to lipopolysaccharide and suppression
      of interleukin-6 and tumor necrosis factor alpha release by Kupffer cells in
      vitro through exogenous interleukin-10 suggest an important role for interleukin
      10 in the regulation of the local immune response in the liver sinusoid.

PMID- 7790713
TI  - Biliary cholesterol transport and the nucleation defect in cholesterol gallstone
      formation.

PMID- 7790715
TI  - Correlation of HCV-RNA levels in serum and liver of patients with chronic
      hepatitis C.

PMID- 7790714
TI  - Somatostatin or octreotide versus endoscopic sclerotherapy in acute variceal
      haemorrhage: a meta-analysis study.

PMID- 7790716
TI  - Augmented endogenous nitric oxide production in partial portal vein-ligated rats.

PMID- 7790717
TI  - Cytolytic hepatitis with a venotonic drug.

PMID- 7790719
TI  - Domestic violence: a health concern.
AB  - Domestic violence may be the single most common etiology for injuries in women
      presenting to the health care system. There is a national effort to begin to ask
      all female patients about family violence. Physicians have a responsibility to
      identify, educate and appropriately manage and/or refer patients in violent
      relationships.

PMID- 7790718
TI  - State asks doctors to help test for lead. Interview by Bob Carlson.

PMID- 7790721
TI  - Trends in laparoscopic cholecystectomy in Indiana.
AB  - Laparoscopic cholecystectomy is a fairly new procedure that is quickly gaining
      widespread use among surgeons. In Indiana, 45% of cholecystectomies performed on
      Medicare beneficiaries over the age of 65 were via the laparoscopic approach,
      resulting in a shorter average length of stay, 5.9 days, compared to 12.3 days
      for those who underwent the open procedure. Among these Medicare beneficiaries,
      the complication rate for laparoscopic cholecystectomy was lower than for those
      who had the open procedure, 11.3% compared with 16.6%. The trend of the use of
      the laparoscopic approach for cholecystectomy for older patients and the
      complications arising from this procedure need further evaluation.

PMID- 7790720
TI  - Physician-assisted suicide and euthanasia: a house staff debate.

PMID- 7790722
TI  - Exhibit explores development of sports medicine.

PMID- 7790723
TI  - Secretion capture and report web: use of affinity derivatized agarose
      microdroplets for the selection of hybridoma cells.
AB  - A novel assay is described which allows the entrapment and detection of the
      immunoglobulin secreted from individual viable hybridoma cells using a secretion
      capture and reporter web (SCRW). By encapsulating the cells in agarose
      microdroplets which have been derivatized to create a fluorescent antigen
      specific sandwich assay, flow cytometry can be used to identify and sort
      productive cells from a heterogeneous population. Using agarase, the cells can be
      recovered from the microdroplets and clonally expanded after selection. The assay
      has been used to reclone rare secretors from hybridoma cultures and to enhance
      the production of cultures with poor producers. The assay is easily generalized
      for the detection of any secreted protein for which specific antibodies or other
      ligands are available.

PMID- 7790724
TI  - A novel method to purify immunotoxins from free antibodies using modified
      recombinant toxins.
AB  - Monoclonal antibodies linked to toxin polypeptides (immunotoxins) are developed
      for clinical application against cancer and graft rejection. Immunotoxins
      prepared by many conventional methods often contain a trace amount of free
      antibody. Present studies describe a method to purify immunotoxins from free
      antibody in conjugation mixtures. Recombinant ricin A chain and a truncated form
      of diphtheria toxin (385 residues) containing ten consecutive histidine residues
      at the amino terminus were prepared. The modified toxin polypeptides retaining
      full biological activity were chemically linked to monoclonal antibodies (317G5
      and 454C11) reactive to breast cancer cells. The high affinity of consecutive
      histidine residues for nickel-based resin (Ni-NTA) was exploited to purify
      immunotoxins from unreacted free antibodies. SDS-PAGE analysis of conjugates
      eluted from nickel column contained trace amounts of detectable free antibody
      whereas conjugates purified by other conventional methods using phenyl Sepharose
      or Cibacron blue Sepharose chromatography contained significant amounts of
      unconjugated antibody. Furthermore, the immunotoxin fraction containing
      predominantly two toxin molecules linked to one antibody can be separated from
      stoichiometric conjugates by Ni-NTA column. Cytotoxicity experiments showed that
      the complex of two toxin molecules linked to an antibody was more cytotoxic to
      tumor cells in vitro than the fraction enriched with immunotoxin containing
      equimolar stoichiometry.

PMID- 7790725
TI  - In vitro proliferative responses of human peripheral blood mononuclear cells to
      non-recall antigens.
AB  - Primary in vitro proliferative responses of naive T cells to antigens other than
      superantigens and alloantigens have been little studied. Two tissue culture
      techniques have been reported which support in vitro antigen priming of T cells.
      These methods require various degrees of cellular manipulation and culture
      vessels other than standard microtitre plates. We report here that primary
      proliferative responses to non-recall antigens can be readily obtained using
      unselected human PBMC prepared from either adult or cord blood. Cells proliferate
      whether cultured in 2 ml volumes, 200 microliters microcultures or 20 microliters
      hanging drops. The variation in the proliferative responses increases as the
      culture volume is decreased such that considerable errors are apparent when
      Terasaki culture plates are used. The lowest stimulation indices are also
      observed in the 20 microliters microcultures. Nevertheless, similar response
      patterns are noted for the differing culture vessels; generally, proliferative
      responses reach peak magnitude only after 7 days of culture. The initial
      concentration of PBMC in culture influences the magnitude of the reactions such
      that halving the cell numbers frequently leads to greater than 50% reduction in
      the measured responses. The results of this study indicate that neither a
      specialised culture vessel nor complex cellular manipulation are required for in
      vitro priming of T cell immunity. Consequently, this area of immunology should be
      readily amenable to further study.

PMID- 7790726
TI  - Elution of human IgG from affinity columns containing immobilised variants of
      protein A.
AB  - Immobilised analogues of protein A have been used for affinity chromatographic
      separation of human IgG. Truncation of the C-terminal region of an engineered IgG
      binding domain based upon the B domain from protein A, in combination with site
      directed mutagenesis, has led to the generation of a number of proteins with a
      decreased affinity for IgG. The elution of human IgG from these proteins when
      immobilised onto a solid support occurs over the pH range 3.2-5.0 with 0.5 M
      acetate buffer. These proteins may be effective alternatives to standard protein
      A columns when milder elution conditions are required.

PMID- 7790727
TI  - Efficient isolation of mutant antigen presenting cell lines by functional
      selection using T cell clones.
AB  - An efficient method for the isolation of mutant antigen-presenting cell (APC)
      lines is described. When mixtures of transfectant APC lines TA beta z (that
      express A beta z/A alpha d MHC class II molecules) and hypothetical variant APC
      lines TA beta d (that express A beta d/A alpha d class II molecules) were
      cultured with and selected by autoreactive A beta z/A alpha d-restricted T cell
      clones, the percentage of TA beta d APC lines increased from less than 1% of the
      original APC mixtures to almost 100% after several cycles of selection. This
      increase of hypothetical variant was shown to be due to the formation of
      aggregates of wild-type TA beta z APC lines with A beta z/A alpha d-restricted
      autoreactive T cell clones that results in the inhibition of proliferation and
      probably killing of TA beta z APC lines. Based on this, ethyl methane sulfonate
      (EMS)-treated TA beta z APC lines or B-B hybridoma APC lines MW4 (that express A
      beta z/A alpha d and A beta z/A alpha z class II molecules) were cultured with
      and selected by A beta z/A alpha d-restricted autoreactive T cell clones to
      obtain mutant APC lines that escaped the recognition by T cell clones. After
      cloning, about 43% of clones examined lost the ability to stimulate T cell clones
      with concomitant loss of class II molecule expression. Less than 1% showed loss
      of stimulatory activity against T cell clones in spite of the expression of
      normal amounts of class II molecules. Initial analysis revealed that they include
      APC mutant lines with (1) altered MHC class II sequences, (2) loss of adhesion
      molecule expression and (3) possible impairment of the peptide loading. The
      method described here may provide a variety of mutant APC lines that are useful
      for the analysis of antigen processing and presentation pathways as well as of
      class II structure for T cell stimulation.

PMID- 7790728
TI  - The derivation of binding parameters from effector and target conjugate frequency
      data using linear and non-linear data-fitting transformations. Application of
      such transformations to the NK-MOLT4 and NK-K562 effector-target systems.
AB  - Effector-target conjugation is described quantitatively by binding isotherms
      which are characterized by three parameters, the maximum effector and target
      conjugate frequencies, alpha max and beta max, and the dissociation constant of
      the conjugates formed, KD. In this paper the application of non-linear data
      fitting techniques, as well as linear transformations of the binding isotherms
      that permit us to use standard regression analysis, has been tested to calculate
      estimates of these parameters in the NK-MOLT4 and NK-K562 effector-target
      systems. Both unweighted and weighted data were used to calculate alpha max, beta
      max and KD for six different donors which were used as a source of NK cells. The
      results obtained have shown that these regression methods are useful for
      revealing potential disparities between binding efficiencies in effector-target
      systems.

PMID- 7790729
TI  - Cytokine immunotrapping: an assay to study the kinetics of production and
      consumption or degradation of human interferon-gamma.
AB  - With the aim of determining the rate of cytokine production, we have investigated
      immunoassay conditions which prevent consumption/degradation. These assays,
      termed cytokine immunotrapping assays (CITA), are based on early capturing of
      cytokines secreted during cell culture by immobilised or soluble mAbs and a
      recently described chemiluminescent immunoassay. Here we describe assay
      conditions using IFN-gamma as a prototype cytokine. For production of IFN-gamma,
      PBMC, purified CD4+ or CD8+ T cells, or diluted whole blood were cultured with
      different T cell stimulating agents. Polystyrene macrobeads precoated with an
      anti-IFN-gamma mAb were put in culture and after a defined incubation period, a
      dimethyl acridinium ester (DMAE)-labelled second anti-IFN-gamma mAb and sodium
      azide were added into the culture for additional 24 h. The beads were washed and
      chemiluminescence signals determined in a luminometer. Trapping experiments were
      also performed with the beads or the soluble mAbs alone. Irrespective of the
      configuration, IFN-gamma concentrations measured in trapping conditions were
      always higher (3-20-fold) than in conventional cultures. By using the best
      trapping combination, i.e. both bead-mAb1 and DMAE-mAb2 added at the start of
      culture (single step), it was possible to detect IFN-gamma production as early as
      2 h. Also, IFN-gamma secreted by less than 500 PBMC or whole blood cells could be
      detected within 24 h. When purified CD4+ or CD8+ cells were used instead of PBMC,
      a reduction of the trapping effect was observed. Conversely, addition of
      monocytes to purified T cells increased the trapping factor suggesting that a
      substantial amount of IFN-gamma was consumed or degraded both by CD14+ cells as
      well as T cells in culture. Preliminary results show that this assay is also
      suitable for the early detection of IL-1 and IL-4 which are known to be more
      tightly regulated. Thus, the new principle described here is expected to be
      useful in clinical settings where both the time and amounts of material are
      limited to investigate the role of cytokines in particular disease.

PMID- 7790730
TI  - Clinical implementation of electrical impedance tomography with hyperthermia.
AB  - We describe the use of electrical impedance tomography (EIT) for non-invasive
      thermal imaging in conjunction with a clinical treatment of a superficial scalp
      lesion utilizing a spiral microstrip antenna. This is our first reported use of
      EIT with a clinical hyperthermia treatment and perhaps the first world-wide. The
      thermal measurements recorded during treatment compare favourably with the images
      reconstructed from impedance data gathered during heating. A linear relation,
      measured in phantom material, between the change in temperature with the change
      in reconstructed impedance was assumed. The average discrepancy between the
      measured temperature changes with the temperatures reconstructed from the
      impedance changes was 1.4 degrees C, with the maximum being 8.9 degrees C. These
      preliminary data suggest that impedance changes can be measured during
      hyperthermia delivery and temperature estimates based on these observed changes
      are possible in the clinical setting. These findings also point to the complex,
      yet critical nature of the impedance versus temperature relationship for tissue
      in vivo. The reconstructed thermal images may provide complementary information
      about the overall thermal damage imposed during heating. Based on this initial
      clinical experience we feel that EIT has great potential as a viable clinical aid
      in imaging the temperature changes imposed during hyperthermia.

PMID- 7790731
TI  - Clinical, physiological and anatomical determinants for radiofrequency
      hyperthermia.
AB  - Temperature/time curves and corresponding CT scans of > 200 regional heat
      treatments with the hyperthermia system BSD-2000 in 43 patients have been
      analysed. In vivo variables and treatment parameters such as local specific
      absorption rate SAR, local relative SAR parallel SAR parallel, total power P,
      local cooling coefficients wb, and local steady-state temperature elevations
      delta Tss (above systemic temperature) have been determined. For determination of
      wb the well-known and accepted steady-state approach has been used, which was
      slightly modified for the purposes of this study. Specifically, comparison of
      cooling coefficients at the beginning and end of heat treatments were performed
      in tumours and normal tissues. Other variables are anatomical descriptors from CT
      scans, score of side effects plim, and various clinical factors. A variance
      analysis of the dependent variables, specifically delta Tss and parallel SAR
      parallel, is performed with respect to factors which were estimated as
      predictive. The intratumoral steady-state temperature elevations are determined
      by the perfusion-related cooling coefficients and local SAR to almost the same
      extent. Increase of cooling coefficients in tumours during the heat treatment
      characterizing the thermoregulatory potential have a slight but less important
      influence with respect to the achieved temperature elevations. SAR is influenced
      by several anatomical factors which determine the relative SAR distribution and
      clinical factors which limit the total power P. However, options for controlling
      present RHT systems in order to optimize the relative SAR distribution or to
      avoid hot spot phenomena appear limited. Three-dimensional modelling calculations
      show that the spatial arrangement of electrical interfaces emerging from bone and
      fat structures limits SAR control in available RHT technology and is mainly
      responsible for local power-dependent discomfort (Wust et al. 1994b). Some
      conclusions are drawn, about how technological development of hyperthermia
      technology can contribute towards overcoming this problem.

PMID- 7790733
TI  - Regional hyperthermia of pelvic tumours using the Utrecht 'Coaxial TEM' system: a
      feasibility study.
AB  - Between August 1989 and July 1992 a total of 22 patients (64 treatments) with
      inoperable or recurrent deep seated pelvic tumours were treated with regional
      hyperthermia and radiotherapy. The 70 Mhz Coaxial TEM applicator with its
      characteristic open waterbolus was used as heating device. The main objective of
      this pilot study was to evaluate the feasibility, toxicity and temperature data.
      The results showed that the major treatment limiting factors were insufficient
      power and systemic stress. Local pain was observed in only 10% of all treatments.
      Most of the treatments resulted in elevated systemic temperatures with the
      overall mean maximum oesophagus temperature reaching 38.9 +/- 0.7 degrees C,
      however, in only 6% of these treatments this was found to be treatment limiting.
      From the measured data the following intratumoral temperatures were calculated:
      T90 = 39.9 +/- 1.0 degrees C; T50 = 40.7 +/- 1.0 degrees C; T10 = 41.4 +/- 1.0
      degrees C. In addition, the overall mean average normal tissue temperatures were
      determined: Trectum = 40.8 +/- 0.7 degrees C; Tvagina = 41.3 +/- 0.9 degrees C;
      Turethra = 40.8 +/- 0.9 degrees C. The temperatures in normal tissue were
      frequently higher than in tumour, indicating that a large volume was heated. The
      open waterbolus allows strong cooling, but the strategy was changed during the
      study: higher systemic temperatures were allowed to improve the pelvic
      temperatures. This pilot study proved that the open waterbolus is clinically a
      success, because it offers patient comfort and SAR-steering by patient
      repositioning, and that regional hyperthermia with the Coaxial TEM is feasible.

PMID- 7790732
TI  - Efficacy of indomethacin pretreatment with regional hyperthermia for treating
      upper abdominal malignancies.
AB  - It is important to reduce a systemic stress during regional hyperthermia against
      upper abdominal malignancies. A 50 mg indomethacin suppository was administered
      to five patients with intrahepatic tumour 30 min before hyperthermia. Oral
      temperature only rose to 37.8 degrees C, heart rate increased to just 110/min,
      and systolic blood pressure only increased to 134 mmHg. Under these conditions,
      epinephrine and norepinephrine rose to only 0.09 and 0.25 ng/ml, respectively,
      which were within normal limits. In addition, prostaglandin E2 (PGE2) did not
      increase at all. However, when these same five patients were not pretreated with
      indomethacin, parameters monitoring the systemic condition rose profoundly during
      hyperthermia. Systemic stress during hyperthermia against upper abdominal
      malignancies was reduced by the indomethacin pretreatment.

PMID- 7790734
TI  - Large stationary microstrip arrays for superficial microwave hyperthermia at 433
      MHz: SAR analysis and clinical data.
AB  - Superficial hyperthermia with present day applicators provides a challenge when
      tumours exceed several cm in diameter. Unless microstrip applicators are scanned,
      the usable heat region often falls short of treating the entire region with 50%
      power or specific absorption rate (SAR). New microstrip applicator designs were
      evaluated through SAR analysis and compared to the traditional microstrip
      applicators used in the clinic at Dartmouth over the past six years. The new
      designs included fabricating thin archimedean spirals (1.0 mm strip width)
      incorporating dielectric substrate (epsilon = 5.3-10.8). The designs were
      optimized at 433 MHz for an arm length of 59 cm. Measurements in a plane 1.0 cm
      from the surface showed that thin spirals outperformed traditional designs by
      increasing the 50% SAR area by a factor of 2.5, while maintaining the same
      physical size. Arrays of four elements were fabricated from thin spirals,
      although SAR evaluation showed only 10-20% SAR between elements. Since this was
      deemed unacceptable and the design goal was to fabricate a stationary applicator
      that had at least 50% SAR between elements, dual element designs were created
      with gradually overlapped elements. It was found that overlapping three coils of
      the spiral created a large region that equalled or exceeded 50% SAR that could
      not be matched by single applicators. Coherent operation of the dual spiral array
      resulted in more central power deposition and incoherent operation resulted in
      more peripheral power deposition. SAR measurements at the fat/muscle interface
      showed an elongated heating pattern in hydroxyethylcellulose muscle equivalent
      phantom. Power deposition 1.0 cm deep in muscle retained the same basic size and
      shape with or without the fat layer. Patient treatments for chestwall tumours
      confirmed that the dual overlapping applicator heated a larger region without the
      sharp temperature peak associated with single applicators.

PMID- 7790735
TI  - Extracellular pH distribution in human tumours.
AB  - Extracellular pH (pHc) was determined by needle microelectrodes in 67 tumour
      nodules in 58 patients. The objective was to evaluate the relationship between
      pHe, tumour histology and tumour volume. The mean age of the patients was 62
      years, mean depth of the lesions was 2.7 +/- 0.2 cm, and mean tumour volume was
      187 +/- 60 cm3. Lesions were located in readily accessible areas such as on the
      limbs, neck or chest wall. Tumour histologies included: 48% adenocarcinoma; 34%
      squamous cell carcinoma; 8% soft tissue sarcoma; and 10% malignant melanoma. The
      mean tumour pHe for the entire group of tumours was 7.06 +/- 0.05 (range 5.66
      7.78). Variation in pHe measurements between tumours was greater than the
      variation in measurements within tumour (F = 7.11, p < 0.01). In adenocarcinomas
      pHe was 6.93 +/- 0.08 (range 5.66-7.78), in soft tissue sarcomas 7.01 +/- 0.21
      (6.25-7.45), in squamous cell carcinomas 7.16 +/- 0.08 (6.2-7.6), and in
      malignant melanomas 7.36 +/- 0.1 (6.98-7.77). Tumour pHe was significantly
      different between the four histological groups (p < 0.001). When adenocarcinoma
      and soft tissue sarcoma lesions were grouped together, pHe was 6.94 +/- 0.08
      compared with 7.20 +/- 0.07 in squamous cell carcinomas and malignant melanomas
      lesions (p < 0.01). Tumour pHe increased as a function of the logarithm of tumour
      volume at 0.07 +/- 0.02 pH unit/ln cm3 (p = 0.006, r = 0.34). In conclusion,
      tumour histology and tumour volume were the most important factors determining
      the range of pHe's.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790736
TI  - Response of 145 spontaneous canine head and neck tumours to radiation versus
      radiation plus microwave hyperthermia: results of a randomized phase III clinical
      study.
AB  - The results of a phase III, clinical trial of local microwave hyperthermia
      (target = 2 x 44 degrees C for 30 min) and megavoltage radiation (4 x 9 Gy
      fractions) in the treatment of 145 naturally occurring canine head and neck
      cancers are reported. Patients were re-examined at regular intervals following
      treatment until death. The median follow up time was 90 weeks. Tumour response,
      patient survival and normal tissue toxicity were analysed by treatment
      allocation. There was no significant difference in best tumour response nor
      patient survival between the two treatment groups. There was no difference in
      acute normal tissue toxicity but there was a suggestion that patients receiving
      RT and HT may suffer a higher incidence of late skin reactions. Histological type
      and tumour volume were of prognostic significance with smaller tumours and
      carcinomas showing higher response rates. There were also positive associations
      between minimum tumour dose and best tumour response and percentage of tumour
      heated and best tumour response. The results of this study must be interpreted in
      the knowledge of limitations on the dose and fractionation schedule for radiation
      therapy, the small number of hyperthermia treatments applied and the variation in
      tumour type and size that is inevitable in a clinical study. It is concluded that
      the quality of hyperthermia in terms of intra-tumour temperatures and the
      uniformity of heating is of paramount importance in governing response to
      adjuvant hyperthermia.

PMID- 7790737
TI  - Effects of step-down and step-up heating on the development of thermotolerance in
      a C3H mammary carcinoma in vivo.
AB  - The effects of step-down (SDH) and step-up heating (SUH) on the development of
      thermotolerance were investigated in a C3H mammary carcinoma in vivo. The
      endpoint was tumour growth time, i.e. the time for a tumour to reach a volume
      five times that of the first treatment day. SDH consisted of 44.5 degrees C/5 min
      followed immediately by 41.0 degrees C/120 min. SUH consisted of the same heat
      treatments but in reverse sequence. Thermotolerance was detected by subsequent
      heating at 43.5 degrees C at variable intervals following the primary SDH or SUH.
      The degree of thermotolerance was quantified by the thermotolerance ratio (TTR)
      calculated as a ratio between the slope of the dose-response curve for tumours
      heated at 43.5 degrees C and tumours preheated with either SDH or SUH followed by
      43.5 degrees C. Both SDH and SUH induced thermotolerance. However, the maximal
      degree of thermotolerance and the time interval to reach maximum thermotolerance
      were different. For SUH maximal thermotolerance was observed at 8 h with a TTR of
      3.6. For SUH, thermotolerance peaked at 24-28 h with a TTR of 7.3. In both cases
      thermotolerance had decayed with a 120 h interval. The SDH priming induced about
      2.5 times more heat damage than SUH. The results are therefore in agreement with
      previous data obtained in the same tumour model by single heating showing that
      both the degree and the time to reach maximal thermotolerance increases with
      pretreatment heat damage. In addition, the results indicate that thermotolerance
      and thermosensitization are independent phenomena.

PMID- 7790738
TI  - Changes in microregional perfusion, oxygenation, ATP and lactate distribution in
      subcutaneous rat tumours upon water-filtered IR-A hyperthermia.
AB  - The effect of hyperthermia on microcirculatory and metabolic parameters in s.c.
      DS-sarcomas of different sizes on the hind foot dorsum of SD-rats was
      investigated. Hyperthermia was carried out using a novel water-filtered, infrared
      A radiation technique. Heating was performed at a rate of 0.5 degrees C/min until
      44 degrees C was achieved in the tumour centre, which was maintained for 60 min.
      Using a multichannel laser Doppler flowmeter, red blood cell flux could be
      assessed continuously and at several sites within the tumour tissue
      simultaneously. Substantial inter-site variations in laser Doppler flux (LDF)
      were observed during hyperthermia which were independent of tumour size, site of
      measurement, and temperature at the site of measurement, indicating that single
      site measurements of tumour LDF are poor predictors of the mean response of a
      tumour to hyperthermia. When mean LDF was considered, decreases in red blood cell
      fluxes occurred that were more pronounced the greater the tumour volume. In no
      case was vascular stasis observed. Hyperthermia did not affect tumour oxygenation
      substantially. Microregional and global assessment of lactate and ATP
      concentrations demonstrated increased lactate and decreased ATP levels following
      hyperthermia. Tumour glucose levels were increased following hyperthermia,
      possibly due to an enlarged distribution space resulting from development of
      interstitial oedema. Changes in lactate and ATP levels and the lack of changes in
      tumour oxygenation suggest a modification of energy metabolism following
      hyperthermia in the form of increased ATP hydrolysis, intensified glycolysis and
      impaired oxidative phosphorylation.

PMID- 7790740
TI  - Application of the time-dependent Green's function and Fourier transforms to the
      solution of the bioheat equation.
AB  - A theory for solving the bioheat equation is developed using a time-dependent
      Green's function and Fourier transform techniques. The description of both steady
      state and time-dependent data are placed into a single framework which can also
      describe the effects of inhomogeneous blood perfusion. The theory is illustrated
      by examples including the modelling of a thermal conduction hyperthermia system
      and a new RF interstitial system. A possibility for measuring the blood perfusion
      parameter and thermal conductivity from the steady state temperature distribution
      of a point source is also proposed.

PMID- 7790739
TI  - HSP synthesis of neonatal rat heart myocytes is regulated by a collagen
      environment.
AB  - Studies on the stress response of isolated myocytes have gained great importance
      in the understanding of the response of the heart as an organ after, for
      instance, ischemia. However, the possible role of the extracellular matrix on
      these effects has thereby been neglected. The recently developed model system of
      neonatal heart cells cultured on a collagen gel, characterized by a high
      coherence of contractions, has been used to study the effects of this more in
      vivo-like collagen environment on the heat shock response of the myocytes as
      compared to 'normally used' monolayer cultures. After four days differences were
      found in the heat-induced synthesis of HSPs of cells grown by the two culturing
      procedures. The degree of induction of different HSPs appeared to be directly
      related to the basic level of synthesis of these HSPs under the used culturing
      conditions. In collagen gel-grown cultures the basic level of synthesis as well
      as the heat-induced synthesis of HSP84 and HSP100 was decreased, for HSP60 both
      were increased, and for HSP70 no differences were found compared to the monolayer
      cultures. Our results suggests that the collagen matrix has a regulatory role in
      the synthesis of HSPs.

PMID- 7790741
TI  - A new applicator utilizing distributed electrodes for hyperthermia: a theoretical
      approach.
AB  - We propose a new type of applicator for hyperthermia namely a Distributed
      Electrodes Applicator. Many electrodes are fixed on boli below which the patient
      is placed. A set of RF with optimized amplitudes and phases is supplied to the
      electrodes so as to minimize the ratio of SAR (specific absorption rate) in the
      fat layers to that in the central region of the patient. SAR patterns in a heated
      material were calculated using two-dimensional finite element method, and the
      results showed that the proposed applicator can heat the deep portions of the
      patient without excessive heating of the fat layers.

PMID- 7790744
TI  - Magnetic resonance angiography and carotid artery stenosis: state of the art.

PMID- 7790742
TI  - Noninvasive prediction of SAR distributions with an electro-optical E field
      sensor.
AB  - An integrated electro-optical (eo) E field sensor is developed on the basis of a
      Ti:LiNbO3 Mach-Zehnder interferometer. A measuring device based on the lock-in
      principle is introduced to register the E field in phase and amplitude using this
      E field probe. Segmented electrodes are used to minimize influences from the
      dielectric surroundings on the base point capacitance of the receiving dipole.
      The operating point is stabilized against drift phenomena resulting from optical
      damage and pyroelectric effect. Sensitivity, dynamic range, harmonic distortions
      and mechanical properties of a prototype of this electro-optical E field sensor
      are evaluated. A phantom setup in the SIGMA-60 applicator was developed to test
      this electro-optical sensor for hyperthermia applications. Power deposition
      patterns of various standard adjustments of the SIGMA ring are visualized in an
      elliptical lamp phantom. Simultaneously, E field in phase and amplitude is
      determined on a closed curve in 10 degrees steps around the phantom in a
      substitute bolus. The numbers are stored and utilized as boundary conditions in a
      two-dimensional finite elements code which calculates the SAR distribution on an
      appropriate triangular grid inside the closed curve. An excellent qualitative
      agreement is obtained between visualized and calculated SAR patterns. This novel
      measurement method is therefore suitable for noninvasive monitoring of SAR
      patterns during clinical application of regional radiofrequency hyperthermia.

PMID- 7790743
TI  - Oncogenic potential of hyperthermia in combination with radiation.

PMID- 7790745
TI  - Clinical significance of coronary artery calcification.
AB  - Coronary artery calcification (CAC) was easily demonstrated by plain CT-scan. The
      aim of this study was to clarify the clinical significance of CAC in
      cardiovascular diseases. The subjects were 90 patients with ischemic heart
      disease (30 myocardial infarction, 50 exertional angina pectoris and 10 variant
      form of angina pectoris; 46 males and 44 females, 68 +/- 10 y/o) and 50 patients
      without ischemic heart diseases (30 hypertension, 10 arrhythmia, 3 valvular
      disease, 2 cardiomyopathy, 2 congenital heart disease and 3 others; 25 males and
      25 females 65 +/- 9 y/o). CAC and calcification of thoracic aorta were evaluated
      by plain CT-scan (1 second scan time and 5 mm slice). The relationship between
      CAC and other clinical features (age, sex, hypertension, diabetes mellitus,
      hyperlipidemia, smoking, resting ECG, exercise stress ECG, aortic calcification
      and optic fundi) were studied. CAC were seen more frequently in patients with
      ischemic heart disease (63%), old age (67%), aortic calcification (70%) and
      positive exercise testing (64%). On the other hand, CAC were rare in variant
      angina (30%). In younger patients (under 70 y/o), CAC were seen more frequently
      in diabetic patients. But, in older patients, CAC were frequently in those with
      hyperlipidemia. These results suggested that CAC was associated with not only
      systemic arteriosclerosis, but also ischemic heart disease, except vasospastic
      angina. The prognostic value of CAC would be studied later.

PMID- 7790746
TI  - Doppler ultrasonography in giant cell arteritis.
AB  - A patient with biopsy negative giant cell arteritis was examined and treated by
      our group. Since in some cases the visual loss in this disease is due to a
      central retinal artery occlusion, a technique to evaluate the blood flow velocity
      in this artery would be useful. The Duplex scanner was utilized by us in this
      patient to study the blood flow velocity of the central retinal artery. The flow
      velocity was reduced. The patient was treated with systemic steroids which lead
      to clinical and symptomatic improvement. After the treatment with steroids the
      Duplex scanner was again used to study the flow velocity of the central retinal
      artery. The blood flow velocity improved. We think that Doppler ultrasonography
      may be useful in the diagnosis of and in monitoring the treatment of some cases
      of giant cell arteritis.

PMID- 7790747
TI  - Surgical treatment of extracranial carotid aneurysms.
AB  - During the past 23 years, 12 patients with aneurysm of the carotid bifurcation
      were treated in our department. There were 11 men and one woman between 20 and 68
      years (mean age 54.2 years). In as much as 217 patients were operated on for
      extracranial occlusive carotid disease during the same period, the incidence of
      these aneurysms in our series has been estimated to be 5%. Eleven patients
      presented with TIAs ipsilateral to the aneurysm. One patient presented with a
      painful pulsatile enlarging mass in the neck (ruptured aneurysm) without any
      neurological complications. Eleven patients underwent surgical repair. Ligation
      of the common carotid artery was done in one patient, resection of the aneurysm
      with end-to-end anastomosis was performed in 2 patients, aneurysmorraphy in 4,
      excision and reconstruction with reversed saphenous vein in one, excision and
      reconstruction with PTFE graft in one and 2 patients underwent endarterectomy and
      angioplasty of the carotid bifurcation. One patient with a high internal carotid
      artery aneurysm (base of the skull) was classified as nonoperable. There were no
      deaths or strokes postoperatively. Persistent cranial nerve injury was noted in 1
      case (8%). Follow-up at 6 months - 10 years (mean 5.5 years) yielded and
      incidence of post-op TIAs of 8% attributed to intracranial occlusive disease.
      Surgical correction is the treatment of choice for extracranial carotid aneurysm
      and can be performed with a very low morbidity and mortality and carries
      excellent long-term results.

PMID- 7790748
TI  - Early results of 132 aortic or aorto-iliac arterial reconstructions with the new
      Stretch ePTFE vascular prosthesis.
AB  - OBJECTIVE: The purpose of the present study is to document the short term
      clinical results after implantation of the new Stretch ePTFE (Gore-Tex) arterial
      prostheses in patients with aortic or aorto-iliac occlusive atherosclerotic
      disease or aneurysm. STUDY DESIGN: A descriptive, prospective and non-randomized
      clinical series with clinical follow-up at three and 12 months. SETTING: The
      study was performed at an Academic Vascular Surgery Unit. PATIENTS: Within 20
      months we consecutively implanted 379 prostheses (tubes or bifurcations): 132
      Stretch ePTFE (Gore-Tex) and 247 Dacron (Unigraft, Braun-Melsungen) grafts.
      RESULTS: There was no intraoperative deaths. Nine of 217 patients (= 4%) with
      occlusive atherosclerotic disease died < 30 days postoperatively; the mortality
      rate for asymptomatic aortic aneurysm was 8% (7/91), for symptomatic aneurysm 13%
      (4/30), and for ruptured aneurysm 22% (8/36). The primary patency of the aortic
      or aorto-iliac grafts was 99%, secondary patency at three months and one year 100
      per cent. One patient with Stretch prosthesis developed a superficial groin
      infection, and one developed infection of an aortic tube graft. In the Dacron
      series six patients developed superficial groin infection, and two deep
      infections occurred. No graft-enteric fistulas or erosions were seen, and by
      clinical examination no anastomotic aneurysm developed. Five patients had in situ
      replacement of a pan-infected Dacron bifurcation graft with a Gore-Tex Stretch
      graft. With an observation time from 50 to 400 days these five patients are well
      without clinical signs of infection. CONCLUSIONS: These short term results with
      implantation of aortic or aorto-iliac Stretch ePTFE prostheses are encouraging
      and will provide the basis for a continuing performance trial with long term
      follow-up and reporting.

PMID- 7790749
TI  - Long-term of patients receiving an aorto-bi-femoral prosthesis for
      atherosclerotic occlusive disease of the aortic bifurcation.
AB  - Over a 14-year period (1975-1989), 547 patients with a mean age of 57 years
      received an aorto-bi-femoral prosthesis for atherosclerotic occlusive disease
      (AOD) and underwent regular follow-up over a 13-year period. Immediate post
      operative mortality was 2.5% with few deaths due to cardiovascular causes (0.5%).
      The long-term mortality was significantly elevated at 5 years (10% higher than
      controls) and at 10 years (16%). These deaths were due to the AOD and its
      surgical treatment (10%), other cardiovascular disease (30%) and cancer (41%).
      Approximately 5% of patients required an immediate post-operative, or delayed
      amputation, compared to 33% which had a threatened limb before the operation.
      Thrombosis of the prosthesis was relatively rare. At 5 years, 81% of the
      survivors remained largely improved; at 10 years, 67% and at 13 years, 62%. The
      benefit of this intervention is therefore unquestionable with regards to the
      functional state and survival. Also, in avoiding immobility due to the disabling
      intermittent claudication or amputation, it considerably improves the quality of
      life which largely compensates for the low mortality rates and subsequent
      complications of the prosthesis.

PMID- 7790750
TI  - Morphological changes of dermal blood and lymphatic vessels in chronic venous
      insufficiency of the leg.
AB  - Morphological changes of dermal blood and lymphatic microcirculation in skin
      biopsies from patients affected by Chronic Venous Insufficiency (CVI) associated
      with stasis dermatitis of the lower limbs, are reported here. Blood vessels are
      characterized by an occluded lumen, thickening and reduplication of the basement
      membrane. The structural changes in dermal lymphatic vessels are: (i) collapsed
      lumen of lymphatics located in the papillar dermis; (ii) numerous and complex
      interdigitations between contiguous endothelial cells and lack of open junctions;
      (iii) derangement of the anchoring filaments that normally pull the lymphatic
      lumen open. The connective matrix is characterized by fibrosis with formation of
      dense bundles of collagen and elastic fibers. These results suggest that the
      dermal lymphatic and blood microcirculation in CVI are connected to a reduced
      fluid exchange capacity because of the structural changes occurred in the
      vascular and lymphatic wall and in the surrounding connective tissue.

PMID- 7790751
TI  - Leucocyte activity in chronic venous insufficiency.
AB  - Before and after venous stasis and upon recovery blood samples were drawn from
      the saphenous vein in 10 patients with varicose veins (Group 1), in 10 with
      venous hypertension (Group 2) and in 10 healthy controls. The total leucocyte
      count, the leucocyte filterability rate (LFR), superoxide dismutase blood
      concentrations (SOD) and the production of superoxide anions from granulocytes
      were determined. After stasis, the total leucocyte count increased significantly
      (p < 0.01) in both groups of patients and the LFR was significantly (p < 0.01)
      impaired. SOD blood concentrations fell significantly (p < 0.01) and oxygen free
      radical production dropped significantly (p < 0.01) in both groups. Upon
      recovery, all parameters returned to normal in Group 1 but significant
      differences remained in Group 2. No significant modification was observed at any
      stage of the study in the control group. These results suggest that impairments
      in leucocyte rheology and granulocyte production of oxygen free radicals cause
      capillary plugging and possibly damage to microcirculatory vessel walls in venous
      disease.

PMID- 7790752
TI  - Effects of hypertension on intimal-medial thickness, left ventricular mass and
      aortic distensibility.
AB  - The aim of the study was to evaluate arterial distensibility, intimal-medial
      thickening of the common carotid artery, left ventricular mass and the eventual
      correlations among these parameters in the hypertensive state. Our study
      population consisted of 89 hypertensive patients aged 35 to 80 years (mean age
      60.8 +/- 10.6 years), and 76 normotensive subjects aged 45 to 85 years (mean age
      61.2 +/- 11.1 years). Those patients constantly presenting systolic blood
      pressure values > or = 160 mmHg or diastolic blood pressure > 90 mmHg were
      diagnosed as hypertensive. Each patient underwent a B-mode echotomographic
      examination of the extracranial carotid tract performed with a Vingmed CFM 750
      echotomographer with a 7.5 MHz probe and M-mode echocardiography with a Vingmed
      CFM 750 device equipped with a 3.0 MHz transducer. The results show the intimal
      media thickness value in hypertensive patients (0.90 +/- 0.22 mm on the right and
      0.92 +/- 0.22 mm on the left), was significantly greater than that in
      normotensive subjects (0.64 +/- 0.13 mm on the right and 0.64 +/- 0.13 mm on the
      left, p < 0.001); in hypertensive subjects, interventricular septum thickness
      (12.1 +/- 1.25 mm) was significantly greater than that in normotensive patients
      (9.1 +/- 0.77 mm, p < 0.001). In conclusion, we can say that hypertensive
      subjects have higher values of common carotid artery intimal-medial thickness
      than normotensives and that this finding is associated with the presence of left
      ventricular hypertrophy and with a reduction in arterial compliance. Vascular
      ultrasonography, as well as echocardiography and arterial mechanography can show,
      in hypertensive subjects, cardiac and vascular abnormalities in a non invasive
      way.

PMID- 7790753
TI  - The clinical significance of carotid plaque haemorrhage.
AB  - The clinical picture with the pathology findings of 89 atheromatic plaques which
      were removed following endarterectomy of the internal carotid artery, for the
      purpose of determining the clinical significance of the haemorrhagic atheromatic
      plaque were correlated. Intraplaque haemorrhage was determined in 44 of the 57
      plaques (72.2%) of symptomatic patients while in the asymptomatic patients
      haemorrhage was noted in 12 of the 32 plaques (37.5%) p < 0.001. The extent of
      haemorrhage was > 25% of the plaque thickness in 21 of 44 symptomatic plaques
      (47.72%) and in the asymptomatic plaques in 3 out of 12 (25%) p > 0.05. The
      incidence of ulceration of the intima, with or without the presence of thrombus,
      was more frequent in the haemorrhagic plaques (68.42%) as compared with the non
      haemorrhagic (31.57%), without any significant difference between the symptomatic
      and asymptomatic plaques. Communication of haemorrhage with the lumen was
      observed in 8 of 24 plaques (33.33%), 7 of which (29.16%) were symptomatic. The
      presence of haemorrhage in the atheromatic plaque of the internal carotid artery
      does not seem to play any direct role in the pathogenesis of the symptoms but,
      nevertheless, it constitutes a significant indication of instability of the
      atheromatic plaque.

PMID- 7790754
TI  - Reconstructive vascular surgery in rotationplasty for malignant tumors of the
      femur.
AB  - The rotationplasty procedure of the femur, as first described by Borrgreve, is
      the functional improvement of an abnormally shortened lower limb. In the last 15
      years this procedure has been used in its original form and as modification for
      tumors of the femur and proximal tibia. The reconstruction of the femoral vessels
      as an important part of the operation has not enough been accentuated.
      Principally two types of reconstructions can be performed: the vessels are
      dissected in the adductor canal or a segmental resection and reanastomosis are
      performed. Between January 1990 and April 1993 classical and modified
      rotationplasties were performed for malignant tumors in 34 patients in our
      institution. In all cases a segmental femoral vessel resection with end-to-end
      anastomosis were performed. No intra- and postoperative vascular related
      complications occurred. The authors emphasize the advantage of this method:
      reanastomosing resected femoral vessels by experienced vascular surgeons is a
      save, time-saving method. In addition, the radicality of the operation increases
      in order to obtain excellent long term results.

PMID- 7790755
TI  - Intraoperative thrombolytic therapy as a treatment of small vessel thrombosis: an
      experimental study.
AB  - OBJECTIVE: This paper studies the effect of three doses of Streptokinase infused
      intra-operatively into an animal model of small vessel thrombosis. EXPERIMENTAL
      DESIGN: This is a controlled trial of intraoperative infusion of thrombolytic
      agent into a thrombosed arterial segment compared to no infusion into the
      contralateral limb. EXPERIMENTAL SUBJECTS: 19 New Zealand White rabbits were
      stratified into 3 groups. INTERVENTIONS: Thrombosis was achieved by infusing a
      mixture of topical thrombin and autologous blood into individual iliac arteries
      of the New Zealand white rabbit. A randomly selected hind limb had an infusion of
      one of three doses of streptokinase (A = 2,500u; B = 5,000u; C = 10,000u) in
      saline over 20 minute period. Preinfusion and post infusion angiography was
      performed. MEASUREMENTS: Angiograms were ranked by a radiologist blinded to the
      side of infusion and clotting parameters were assessed. RESULTS: All limbs at all
      doses of streptokinase infusion (SK) showed significant clot lysis when compared
      to the non-infused limb(C). The percentage of improved segments is as follows:
      iliac: SK = 100%, C = 79%; femoral SK = 79%, C = 32%; tibial SK = 52%, C = 5%.
      Although there was an elevation in clotting time and a reduction in fibrinogen,
      levels remained within normal limits. CONCLUSIONS: Streptokinase infused directly
      into thrombus in arteries even in low doses significantly enhances thrombolysis
      of vessels which are too small to be cleared by mechanical means. No significant
      systemic complications were encountered.

PMID- 7790756
TI  - The effect of heparin after microsurgical repair in traumatically damaged
      arteries.
AB  - A main consideration of microvascular surgery is the avoidance of thrombosis.
      This traditionally involves the avoidance of thrombogenic trauma, the
      establishment of normal blood flow and full vessel diameter, as well as the use
      of anticoagulants, such as heparin, as an antithrombotic measure. In the present
      study we assessed the effectiveness of heparin in maintaining patency in the
      femoral arteries of rats which have undergone a crush injury with damage to the
      intima and media layers of the wall. To accomplish this, the animals were treated
      with heparin 150 units or 300 units twice daily following microvascular repair
      using standard microsurgical techniques. Control animals received no treatment.
      The results of this study indicate that the number of patencies in experimentally
      injured femoral arteries did not improve significantly following heparin
      treatment, although pharmacological doses of heparin (300 units twice daily) were
      associated with a somewhat lower rate of occlusions. We conclude that heparin
      appears unable to significantly prevent clotting in vessels which have
      experienced severe trauma to the intima and media layers.

PMID- 7790757
TI  - Platelet and endothelial response with trapidil in patients with peripheral
      obliterative arteriopathy.
AB  - The activity of trapidil, an antiaggregating agent with PDGF antagonist
      properties, was investigated in order to verify its possible modulating effect in
      the endothelial and platelet activation. PDGF, t-PA, PAI-1 and ET-1 plasma levels
      were measured before and after a 2 month treatment period with trapidil 200 mg
      tablets bid or placebo in 30 patients affected by POA in Fontaine stage II. PDGF
      and PAI-1 significantly (p < 0.05) increased in the placebo group, and PDGF also
      in the comparison between treatments (p < 0.05). Aggregation data demonstrate an
      absence of Ca++ antagonist action of trapidil. The results of this study suggest
      that trapidil can interfere with the combined vascular and platelet response in
      atherogenesis.

PMID- 7790758
TI  - Obstructive uropathy, following redo aortobifemoral by-pass surgery.
AB  - A rare case of obstruction of the right ureter due to encagement between the
      right iliofemoral and right limb of an aorto-bilateral femoral Dacron graft is
      described. Patient was managed successfully by ureterolysis, removal of the
      occluded right iliofemoral graft, omentoplasty and placement of a pig tail
      catheter along the right ureter.

PMID- 7790759
TI  - Fibromuscular dysplasia. A case report with multivessel vascular involvement.
AB  - A case of multivessel fibromuscular dysplasia involving the cervico-cephalic
      arteries, the right renal artery and the iliac arteries is reported. It was
      associated with reversible bilateral internal carotid arteries and vertebral
      arteries dissection, left thalamic infarct, right hemorrhagic cerebellar infarct,
      renovascular hypertension and intermittent claudication of the right lower limb.
      This report indicates that fibromuscular dysplasia is a systemic angiopathy.
      Renovascular hypertension may foster the appearance of complication such as
      dissection of the arteries affected by fibromuscular dysplasia. In the case
      investigated the dissection of cervico-cephalic arteries was followed by
      spontaneous healing and a favourable neurological outcome whereas at the iliac
      arteries a rapid deterioration was observed.

PMID- 7790760
TI  - CAP37, a neutrophil-derived multifunctional inflammatory mediator.
AB  - Cationic antimicrobial protein of M(r) 37 kDa (CAP37) is a multifunctional
      protein isolated from the granules of human neutrophils, which has important
      implications in host defense and inflammation. CAP37 was initially recognized for
      its strong antibiotic activity against Gram-negative bacteria and was viewed as a
      component of the oxygen-independent killing mechanism of the neutrophil. However,
      we now know that CAP37 has more far reaching and important functions. It is a
      physiological protein released during inflammation with a high potential of
      regulating monocyte/macrophage functions, such as chemotaxis, increased survival,
      and differentiation. Recently, it has been demonstrated that CAP37 binds
      endotoxin. It has the structure of a serine esterase but lacks enzymatic
      activity. The bactericidal and endotoxin binding domains of the molecule have
      been delineated. The identification of functional peptides should provide new
      insight into the mechanisms of endotoxin binding, antimicrobial activity, and
      chemotaxis and in the long term provide key insights into therapies for treating
      infections and endotoxic shock.

PMID- 7790761
TI  - Interleukin-5 and its receptor: a drug target for eosinophilia associated with
      chronic allergic disease.
AB  - A characteristic feature of chronic allergic diseases such as asthma is the
      increase in eosinophil numbers in the inflamed tissue. In light of its
      specificity for the development of eosinophils, interleukin-5 (IL-5) is
      considered the most important cytokine involved in the regulation of
      eosinophilia. Hence, an antagonist for IL-5 activity is a new target for drug
      discovery programs. We have examined the opportunity for both a random and a
      rational approach for the identification of such an antagonist. The elucidation
      of the structure of IL-5 and the initial structure/function analysis of the
      ligand/receptor complex constitute a first step towards the design of
      antagonistic compounds. The identification of a small compound by random
      screening able to inhibit the IL-5/IL-5 receptor interaction indicated an
      important domain in the receptor. We examine here protein-based IL-5 antagonists,
      such as IL-5-muteins, soluble IL-5 receptor constructs, and monoclonal
      antibodies, for their potential as IL-5/IL-5 receptor antagonists, and the use of
      a murine model of eosinophil airway inflammation for their evaluation.

PMID- 7790762
TI  - Endotoxin infusion in anesthetized sheep is associated with intrapulmonary
      sequestration of leukocytes that immunohistochemically express tumor necrosis
      factor-alpha.
AB  - Plasma levels of tumor necrosis factor-alpha (TNF-alpha) peak between 2 and 4 h
      during a 12-h continuous infusion of endotoxin in awake sheep. We hypothesized
      that a source of this TNF-alpha is the pool of leukocytes that accumulate in the
      pulmonary circulation. To test this hypothesis, we physiologically monitored six
      anesthetized sheep during baseline and 4-h endotoxin infusion periods (10 ng/kg x
      min). We obtained open-lung biopsies at baseline and at 20 min and 2 and 4 h
      during the endotoxin infusion period for immunohistochemical localization of TNF
      alpha. The plasma concentration of TNF-alpha increased from an average baseline
      concentration of 0.06 +/- 0.03 ng/ml (mean +/- SD) to a peak of 1.40 +/- 0.28
      ng/ml at 2 h of the endotoxin infusion. We observed increased cytoplasmic TNF
      alpha immunoreactivity in situ among neutrophils and intravascular mononuclear
      phagocytes during the endotoxin infusion compared with baseline. Also, the number
      of immunopositive leukocytes increased in the pulmonary circulation during the
      continuous infusion of endotoxin. We conclude that TNF-alpha-producing leukocytes
      accumulate in the pulmonary circulation during endotoxemia. These cells probably
      contribute to both the rise in the circulating levels of TNF-alpha and the
      development of acute lung injury.

PMID- 7790763
TI  - Neutrophils are essential for resolution of primary and secondary infection with
      Listeria monocytogenes.
AB  - The role for neutrophils in the resolution of primary and secondary infection
      with Listeria monocytogenes was studied. The results show that although control
      mice started to clear Listeria from their spleens and livers between days 2 and 4
      of sublethal primary infection and eradicated bacteria in 2 weeks, mice given a
      specific granulocyte-depleting antibody (RB6-8C5) on days 4 or 6 of infection
      developed lethal listeriosis. Likewise, treatment of immunized mice with RB6-8C5
      monoclonal antibody abolished their acquired ability to resolve a lethal
      challenge infection. The results demonstrate that neutrophils are necessary for
      the resolution of secondary and primary Listeria infection.

PMID- 7790764
TI  - Regulatory effect of aminopeptidase inhibitor (bestatin) on the cervix during
      induction of ripening by interleukin-8.
AB  - Bestatin is an immunomodulatory peptide that stimulates the humoral and cell
      mediated immune system. It also has an inhibitory effect on multiple
      aminopeptidases. Recently we found that aminopeptidase N inactivates interleukin
      8 in vitro. Bestatin successfully suppresses the effect of aminopeptidase N on
      interleukin-8. During cervical maturation many biochemical changes occur
      including decrease in collagen concentration and increase in collagenase and
      elastase activities. Interleukin-8, which has a potent neutrophil chemotactic
      effect, was found to induce cervical ripening in rabbits. The combination of
      interleukin-8 with bestatin also induced cervical ripening by providing
      approximately regular levels of neutrophil numbers, collagenase, and elastase
      activities. We therefore suggest that this regulatory mechanism also takes place
      in vivo through the inhibitory effect of bestatin on aminopeptidase N.

PMID- 7790766
TI  - Relationship of phospholipase C- and phospholipase D-mediated phospholipid
      remodeling pathways to respiratory burst activation in human neutrophils
      stimulated by Candida albicans hyphae.
AB  - Neutrophil (PMN) oxidant release, a key component of defenses against
      disseminated candidiasis, was preceded by oxidant generation after stimulation by
      Candida albicans hyphae. Opsonized or unopsonized hyphae triggered phospholipase
      D (PLD) activation within 5 or 30 s, respectively, forming 1-O-alkyl-phosphatidic
      acid (alkyl-PA) or 1-O-alkyl-phosphatidyl-ethanol in the presence of ethanol.
      Ethanol, which competitively lowers phosphatidic acid (PA) production, caused
      dose-dependent inhibition of superoxide (O2-) generation after hyphal stimulation
      but altered neither baseline-unstimulated O2- production nor responses to phorbol
      myristate acetate. PA rises evoked by unopsonized hyphae began 2 min before
      significant O2- release, also preceding both phospholipase C activation and
      cytosolic Ca2+ rises. Diacylglycerol (DAG) rose in two distinct phases after
      stimulation by opsonized or unopsonized hyphae, peaking briefly after 60 or 120
      s, respectively, followed by prolonged secondary rises. Initial DAG rises
      preceded inositol triphosphate elevations evoked by unopsonized hyphae. Though PA
      rose before DAG, no dephosphorylation of PA to form 1-O-alkyl-DAG was noted.
      Propranalol, which increases PA accumulation by inhibiting PA phosphohydrolase,
      lowered PMN O2- responses to hyphae. Early DAG rises temporally overlapped
      respiratory burst initiation but PMN responses to hyphae were unchanged by a DAG
      kinase inhibitor, R59022, which blocks phosphorylation of DAG to PA and enhances
      DAG accumulation. Thus, neither PA nor DAG accumulation individually accounted
      for triggering PMN O2- responses to hyphae. PLD activation and PA production may
      facilitate PMN fungicidal responses to hyphae but play an indirect role in
      initiating the respiratory burst.

PMID- 7790765
TI  - Slow Ca2+ waves in large myeloid cells as a result of a diffusible cytosolic
      factor.
AB  - In the work reported here evidence is provided that shows the slow wave of Ca2+
      large neonatal myeloid cells provoked by formyl-Met-Leu-Phe was generated by
      spatially delayed Ca2+ influx. Evidence is provided that the delay in Ca2+ influx
      was the result of diffusion of a factor from the Ca2+ storage site, which is
      responsible for Ca2+ channel opening. The location of the Ca2+ release site was
      correlated with a region near the nucleus, probably a specialized region of
      endoplasmic reticulum. It is proposed that similar mechanisms of Ca2+ signaling
      occur in mature myeloid cells, such as neutrophils, but on a shorter time scale
      as a consequence of their smaller size.

PMID- 7790767
TI  - Human eosinophils in culture undergo a striking and rapid shrinkage during
      apoptosis. Role of K+ channels.
AB  - In the absence of appropriate stimulus, eosinophils in vitro rapidly exhibit the
      features of apoptotic cells (nuclear pycnosis, cell shrinkage, DNA
      fragmentation). By using electronic cell sizing, we precisely measured the volume
      distribution of human eosinophils during apoptosis. We observed that apoptosis of
      eosinophils was accompanied by a marked cell volume decrease (approximately 60%).
      Moreover, analysis of the volume distribution in different experimental
      conditions (kinetics of apoptosis, inhibition of apoptosis by cytokines) revealed
      that the cell shrinkage, once triggered, was a fast process in which the
      intermediate states between normal and shrunken volume had a short half-life. As
      a model of apoptosis, the eosinophil model allowed us to test the hypothesis that
      apoptotic cell shrinkage was linked to osmotic changes due to leakage of internal
      ions. Indeed, in the presence of K+ channel blockers, the shrinkage was inhibited
      in a dose-dependent manner. In conclusion, our results suggest that eosinophil
      shrinkage during apoptosis is a striking and rapid phenomenon and osmotic changes
      due to K+ efflux could be responsible, at least in part, of the volume decrease.

PMID- 7790768
TI  - Profile of immunoglobulin heavy chain variable gene repertoires and highly
      selective detection of malignant clonotypes in acute lymphoblastic leukemia.
AB  - The predominant B cell immunoglobulin heavy chain variable gene (IgH-V) usage and
      the uniquely rearranged, clonotype-specific variable-diversity-joining region
      gene (VDJ) sequences were identified in patients with B cell acute lymphoblastic
      leukemia (B-ALL) using a novel DNA-based gene amplification strategy. The
      approach allows a thorough and sensitive determination of the number of clonal
      leukemic IgH rearrangements and their precise V gene usage. This strategy may be
      applied in the detection of minimal residual disease, in surveillance after
      induction of disease-free states, and in analyzing the effectiveness of purging
      autologous bone marrow of malignant clones. An initial primary polymerase chain
      reaction (PCR), directed by an IgH-J generic primer and a complement of family
      specific IgH-V primers, defined the major B cell IgH-V gene usage. Use of an IgH
      J generic primer supplanted the use of a constant region primer anchor and thus
      eliminated the need to target mRNA by the traditional RNA reverse transcription
      PCR amplification method. Monoclonality of rearranged VDJ bands was further
      substantiated by high-resolution denaturant gel electrophoretic analysis. The
      predominant amplified bands were subcloned and sequenced. By sequencing through
      VDJ juxtaposed regions, that is, the third complementarity-determining region,
      clonotype-specific primers were developed and used in a secondary clonotype
      primer-directed PCR (CPD-PCR) to detect, with extreme sensitivity and
      specificity, a unique B cell clone. Analysis of the products of the CPD-PCR
      permitted the detection of a single malignant cell among 1 million polyclonal
      cells and superseded the constraints of prior studies that have provided a
      limited evaluation of family variable gene repertoire usage. Leukemic clonal
      rearrangements were detected in 100% of the eight cases of pediatric and two
      cases of adult B-ALL studied. Two or more clonal IgH-VDJ amplified sequences were
      observed in 50% of the B-ALL bone marrows analyzed. In two cases, clonotype
      specific oligodeoxynucleotide primers, derived from B-ALL VDJ sequences, directed
      the secondary CPD-PCR, and disease activity was monitored after chemotherapy and
      allogeneic bone marrow transplantation.

PMID- 7790769
TI  - Lipopolysaccharide-inactivating activity of neutrophils is due to lactoferrin.
AB  - Neutrophils can inactivate lipopolysaccharide (LPS), thereby blocking the ability
      of LPS to prime fresh neutrophils for enhanced fMLP-triggered release of
      superoxide. Here we show that inactivation of LPS by neutrophils was primarily
      due to lactoferrin. A time course for inactivating LPS showed that neutrophils (5
      million/ml) took 30 min to inactivate 10 ng/ml LPS. Mononuclear cells could not
      inactivate LPS under the same conditions. Experiments with radioactive LPS showed
      that inactivated LPS remained in the medium and was not taken up or destroyed by
      the neutrophils during inactivation. Inactivated LPS still gelled Limulus lysate
      and primed monocytes. Cell-free medium from neutrophil suspensions also
      inactivated LPS. A single LPS-inactivating factor was purified from medium by
      heparin-agarose chromatography. SDS-PAGE showed a single band at 80 kDa, which
      was identified as lactoferrin by immunoblotting. Antilactoferrin immunoglobulin G
      removed the LPS-inactivating activity from purified lactoferrin and cell-free
      medium. Surprisingly, even purified neutrophil lactoferrin required 30 min to
      inactivate LPS, indicating inherently slow binding of lactoferrin to LPS.

PMID- 7790770
TI  - Dual function of human IgA antibodies: inhibition of phagocytosis in circulating
      neutrophils and enhancement of responses in IL-8-stimulated cells.
AB  - We have sought to elucidate the responses of human peripheral blood neutrophils
      to antigenic surfaces complexed with human specific IgA antibodies obtained
      either as myeloma proteins that recognize staphylococcal alpha-toxin, or from the
      serum of patients with subacute bacterial endocarditis due to Streptococcus
      mutans, or from colostrum. In contrast to IgG, IgA antibodies bound to antigen
      coated fluorescent microspheres, and subsequently exposed to complement (or not),
      did not promote phagocytosis, as measured by flow cytometric enumeration of cell
      associated microspheres. Instead, IgA antibodies interfered with complement
      dependent phagocytosis mediated by IgG antibodies. These properties were shown by
      different forms of IgA antibodies, including serum and secretory IgA, as well as
      by monoclonal or polyclonal antibodies. Neutrophils did not respond to the
      production of superoxide to IgA antibodies complexed with antigen-coated
      microspheres or with antigen deposited on a solid surface and IgA antibodies
      suppressed IgG antibody- and complement-mediated superoxide release. However,
      neutrophils pretreated with interleukin-8 ingested IgA-opsonized microspheres and
      released superoxide when exposed to IgA antibody-antigen complexes. IgG antibody
      antigen complexes did not stimulate increased superoxide release in interleukin-8
      treated neutrophils. These findings were consistent with a selective increase in
      the surface expression of Fc alpha R by interleukin-8-treated neutrophils. We
      conclude that IgA antibodies interfere with the phagocytic activities of normal
      circulating human neutrophils and may promote these activities in inflammatory
      neutrophils activated by interleukin-8 in which Fc alpha R is up-regulated.

PMID- 7790771
TI  - Ultraviolet radiation reduces phagocytosis and intracellular killing of
      mycobacteria and inhibits nitric oxide production by macrophages in mice.
AB  - Exposure of mice to a single or multiple low doses of ultraviolet radiation (UVR)
      decreases the induction of the delayed-type hypersensitivity (DTH) response to
      Mycobacterium bovis BCG and Mycobacterium lepraemurium (MLM) and impairs the
      clearance of bacteria from the lymphoid organs. This study is an attempt to
      address the mechanism by which UV radiation impairs the clearance of bacteria
      from the lymphoid organs by determining whether alterations in macrophage
      function such as ingestion and intracellular killing of mycobacteria or
      production of reactive nitrogen intermediates might be responsible for these
      effects. BALB/c or C3H/HeN mice were exposed to a single dose of UVB (280-320 nm)
      radiation ranging from 0.35 to 45 kJ/m2, and at regular intervals after
      irradiation, the peritoneal and splenic macrophages were collected, cultured, and
      infected with live BCG or MLM. Phagocytosis was assessed at 6 h by counting the
      number of acid-fast bacteria per macrophage after Ziehl-Neelsen staining. The
      rate of intracellular killing was assessed by lysing the macrophages at 6, 12,
      24, and 48 h after BCG infection, plating the suspension on 7H11 agar, and
      counting the number of colony-forming units 21 days later. Similarly, the nitric
      oxide production, as measured by nitrite, by macrophages obtained from UVB
      irradiated and nonirradiated mice in response to BCG was assessed. There was a
      significant reduction in the uptake of organisms by both peritoneal and splenic
      macrophages collected from UV-irradiated mice. The intracellular killing of
      organisms was also significantly reduced, as was the production of nitric oxide
      by peritoneal macrophages infected with BCG in vitro. These results indicate that
      UVR affects macrophage functions and are consistent with our hypothesis that
      impaired clearance of bacteria in vivo results from an alteration in macrophage
      function.

PMID- 7790773
TI  - Characterization of a non-granule associated pore-forming protein in agranular
      lymphocytes.
AB  - Recently, two populations of small lymphocytes (SL) have exhibited non-major
      histocompatibility complex (MHC) restricted lysis. Recent studies by numerous
      laboratories have demonstrated that resting T cells triggered through CD3 and
      CD28 costimulations can result in immediate, non-MHC restricted killing. Our
      recent studies with CD3-, CD56+ SL demonstrated that although these cells
      contained no cytoplasmic granules detected with electron microscopy, they
      mediated potent NK and ADCC activity. In the present study, we have used a
      Western blotting technique that allows for the detection and quantitation of
      total cellular levels of pore-forming protein (PFP). We have found that freshly
      isolated peripheral non-granulated lymphocytes (both CD3+ and CD3-) contain PFP.
      In addition, CD3-, CD56+ SL contain levels of PFP similar to those of the highly
      granular CD3- LGL. In search of non-granule PFP, we exploited the rat NK (RNK)
      cell lines as a source of other potential cytotoxic factors. A membrane
      associated PFP, based on Western blotting, was isolated from rat RNK cells.
      Unlike PFP isolated from granules, this PFP was active after culture in Ca(2+)
      containing medium. However, the lytic activity isolated from the non-granule PFP
      of RNK cells was inhibited by monoclonal antibodies to PFP. Collectively, these
      studies indicate that PFP is present in small agranular lymphocytes (both NK and
      T cells) and that it is not stored in large cytoplasmic granules. The implication
      of our results for the acquisition and activation of lytic ability in NK and T
      cells will be discussed.

PMID- 7790774
TI  - Influence of serum on zinc, toxic shock syndrome toxin-1, and lipopolysaccharide
      induced production of IFN-gamma and IL-1 beta by human mononuclear cells.
AB  - Measurement of cytokine secretion in vitro is usually performed in culture medium
      supplemented with human serum. We compared the secretion of interferon-gamma and
      interleukin-1 beta as a parameter for lymphocyte and monocyte activation in RPMI
      1640 medium supplemented with fetal calf or autologous serum in serum-free medium
      and protein-free medium. Four different stimulatory mechanisms were tested:
      phytohemagglutinin, toxic shock syndrome toxin-1 (TSST-1), lipopolysaccharide
      (LPS), and zinc ions. We found that the optimal stimulatory zinc concentration
      depended on the total protein content of the medium, whereas the monokine levels
      were dependent on the concentration of transport proteins such as transferrin.
      Monokine induction by LPS or TSST-1 were each influenced by the protein and serum
      composition in a specific manner. Our results show that the differing mechanisms
      of cytokine induction are influenced by the medium and serum composition in a
      diverse but specific manner. Serum- or protein-free medium are especially
      suitable after superantigen challenge when LPS activity needs to be ruled out or
      after activation by agents with only a weak stimulatory capacity.

PMID- 7790772
TI  - Processing of complex antigens and simple hapten-like molecules by epidermal
      Langerhans cells.
AB  - Langerhans cells (LCs) are antigen-presenting cells of the skin that trap small
      contact-sensitizing molecules and induce cutaneous hypersensitivity. LCs can
      present larger molecules but the mechanisms of processing have required
      investigation. A system combining in vitro culture of antigen with epidermal
      cells in the presence of inhibitors, followed by fixation and transfer of these
      antigen/drug-treated epidermal cells to naive mice, was developed to investigate
      the steps of antigen processing. Langerhans cells undertake similar, but not
      identical, pathways for the processing of simple and complex molecules. Complex
      molecules such as trinitrophenyl conjugated to ovalbumin (TNP-OVA) were
      internalized and modification required a chloroquine-sensitive proteolysis step
      and a cycloheximide-sensitive protein synthesis step. This modified product was
      actively recycled to the cell membrane as presentation was inhibited by blocking
      receptor translocation with either monensin or cytochalasin B. Small contact
      sensitizers such as trinitrophenyl did not undergo modification but required
      internalization and presentation was also inhibited by blocking receptor
      translocation.

PMID- 7790775
TI  - Induction of macrophage suppressor activity by fibrosarcoma-derived transforming
      growth factor-beta 1: contrasting effects on resting and activated macrophages.
AB  - Tumor-derived transforming growth factor-beta 1 (TGF-beta 1) suppresses several
      immune responses. Because tumor growth induces macrophage (m phi) suppressor
      activity, we determined whether murine fibrosarcoma-derived TGF-beta 1
      contributed to m phi-mediated suppression of autoantigen- and alloantigen
      stimulated T cell proliferation. The murine fibrosarcoma Meth-KDE cell line
      constitutively produced TGF-beta 1. Meth-KDE tumor-bearing host (TBH) syngeneic
      splenic m phi s suppressed autoantigen- and alloantigen-stimulated normal host
      (NH) CD4+ T cell proliferation. Pretreatment with Meth-KDE supernatants induced
      NH m phi s to suppress T cell proliferation as much as TBH m phi s. Anti-TGF-beta
      1 antibody treatment reversed Meth-KDE-induced NH m phi-mediated suppression.
      Recombinant TGF-beta 1-induced m phi-mediated suppression was not blocked during
      inhibition of prostaglandin E2 (PGE2), nitric oxide (NO), or TGF-beta 1
      production. However, Meth-KDE-induced m phi-mediated suppression was partly
      reduced when PGE2 production was inhibited. Pretreatment with tumor cell-derived
      TGF-beta 1, but not recombinant TGF-beta 1, increased activated m phi PGE2
      production. These results show that additional tumor-derived molecules aid in TGF
      beta 1-enhanced PGE2 production. Also, TGF-beta 1 alone up-regulates m phi
      synthesis of suppressor molecules that are different from PGE2, NO, and TGF-beta
      1. Although TGF-beta 1 has direct suppressor activity on lymphocytes, these
      results show that release of tumor cell TGF-beta 1 also induces m phi suppressor
      activity.

PMID- 7790776
TI  - Interferon-alpha and interferon-gamma down-regulate the production of interleukin
      8 and ENA-78 in human monocytes.
AB  - The two chemotactic cytokines interleukin-8 (IL-8) and epithelial neutrophil
      activating protein 78 (ENA-78) were recently shown to be potent chemoattractants
      and activators of neutrophil function and to be present in certain inflammatory
      diseases. We have studied the effects of recombinant and natural interferon-alpha
      (IFN-alpha) and of recombinant interferon gamma (rIFN-gamma) on the production of
      IL-8 and ENA-78 in lipopolysaccharide- and interleukin-1-stimulated human
      monocytes. Both types of interferons showed a strong, concentration-dependent
      inhibition of neutrophil-stimulating bioactivity. Similarly, the secretion of IL
      8 and ENA-78 was also inhibited by up to 73%. Northern blot experiments
      demonstrated that IFN-alpha decreases the steady-state levels of IL-8 and ENA-78
      mRNA in monocytes, suggesting that IFN-alpha as well as IFN-gamma may control the
      expression of neutrophil chemotactic cytokines at the mRNA level.

PMID- 7790777
TI  - Macrophage colony stimulatory factor-activated bone marrow macrophages suppress
      lymphocytic responses through phagocytosis: a tentative in vitro model of Rosai
      Dorfman disease.
AB  - NBXFO hybridoma cells produced macrophage colony-stimulating factor (M-CSF),
      which stimulated the growth of murine bone marrow-derived macrophages with potent
      suppressor activity. These macrophages suppressed lymphocyte responses to
      mitogens and antigens in a dose-dependent manner. Using a transwell chamber, we
      demonstrated that macrophages needed physical contact with the lymphocytes to
      suppress lymphocyte proliferation on day 1 in the concanavalin A mitogen
      reaction. In addition, no soluble suppressor factor was detected at that time.
      The number of lymphocytes disappeared with time when they were cocultured with
      the macrophages. Electron microscopy revealed that the macrophage phagocytosized
      the lymphocytes after 7 1/2 h. Dextran sulfate, heparan, and fucoidan prevented
      the macrophages from suppressing the lymphocytes. This phenomenon resembles the
      human disease sinus histiocytosis, also called Rosai-Dorfman disease, in which
      macrophages (histiocytes) phagocytosize autologous lymphocytes; occasionally,
      this disease is associated with immunological abnormalities. Thus we believed
      that macrophage-activating cytokines, such as M-CSF, may stimulate macrophages to
      phagocytose lymphocytes in vivo.

PMID- 7790780
TI  - Role of YopH in the suppression of tyrosine phosphorylation and respiratory burst
      activity in murine macrophages infected with Yersinia enterocolitica.
AB  - Tyrosine phosphorylation is an important component of the signaling pathways
      responsible for the activation of the macrophage respiratory burst. Because the
      virulence plasmid of Yersinia enterocolitica encodes a phosphotyrosine
      phosphatase, YopH, it is possible that the pathogenic strategy of Y.
      enterocolitica involves the disruption of tyrosine phosphorylation in the
      macrophage leading to inhibition of respiratory burst activity. We have
      investigated the effects of Yersinia infection on tyrosine phosphorylation and
      respiratory burst activity in murine bone marrow-derived macrophages. Infection
      of macrophages with virulent [Ye(pYV+)] but not avirulent [Ye(pYV-)] strains of
      Y. enterocolitica was found to suppress both tyrosine phosphorylation and
      respiratory burst activity in response to zymosan. Mutational inactivation of
      YopH reversed the suppressive effect of Ye(pYV+) on zymosan-induced tyrosine
      phosphorylation, indicating that YopH is responsible for the dephosphorylation of
      macrophage phosphotyrosine-containing proteins observed in macrophages infected
      with the virulent strain of Y. enterocolitica. In contrast, mutational loss of
      YopH failed to reverse the inhibitory effect of Ye(pYV+) on the zymosan-triggered
      respiratory burst. We conclude that the inhibition of the macrophage respiratory
      burst by Y. enterocolitica involves a plasmid-encoded virulence protein(s) other
      than, or in addition to, YopH.

PMID- 7790778
TI  - Elevation of rainbow trout Oncorhynchus mykiss macrophage respiratory burst
      activity with macrophage-derived supernatants.
AB  - A variety of supernatants were prepared by stimulating rainbow trout Oncorhynchus
      mykiss head kidney macrophages with lipopolysaccharide (LPS), tumor necrosis
      factor alpha (TNF-alpha), or a leucocyte-derived macrophage-activating factor (I
      MAF), individually and in combination. If generated using a 12-h stimulation
      period, such supernatants were found to elevate significantly the respiratory
      burst activity of target macrophages; that is, they contained a macrophage
      derived MAF (m-MAF), but supernatants generated using a shorter incubation period
      showed no significant activity. Combinations of these treatments were
      particularly effective in generating m-MAF-containing supernatants. The elevation
      of respiratory burst activity by supernatants generated using combined treatments
      could be partially inhibited by prior treatment of the target macrophages with
      anti-TNF-alpha receptor 1 (TNFR1) monoclonal antibodies (mAbs). Similarly,
      treatment of macrophages with combinations of 1-MAF and m-MAF generated
      supernatants with potent m-MAF activity and this activity was partially inhibited
      by prior treatment of the target cells with anti-TNFR1 mAb. In addition, the
      presence of anti-transforming growth factor beta 1 (TGF-beta 1) serum while
      generating these latter supernatants resulted in significantly increased m-MAF
      activity. Such data suggest that fish leukocytes secrete a variety of potent
      macrophage-activating (TNF-alpha) and -deactivating (TGF-beta) factors.

PMID- 7790779
TI  - CD82, tetra-span-transmembrane protein, is a regulated transducing molecule on
      U937 monocytic cell line.
AB  - The mononuclear cell surface protein IA4, recently classified as CD82, was
      originally identified in our laboratory by the IA4 monoclonal antibody (mAb),
      because of its high expression on three lymphoblastoid, LAK-susceptible, variant
      cell lines. We have characterized CD82 as a new activation/differentiation marker
      of mononuclear cells. This protein belongs to the new family of TST proteins
      (tetra spans transmembrane), which includes CD9, CD37, CD53, CD63, and CD81 (TAPA
      1). Here we demonstrate that cross-linking of IA4 mAbs induces an increase of
      intracellular free calcium in U937 cells and tyrosine phosphorylation of various
      proteins. Our data indicate that the intracellular calcium increase is initiated
      by a phospholipase C (PLC)-induced PtdIns(1,4,5)P3 second messenger followed by a
      more stable change, linked to extracellular calcium entry. This transducing
      signal was dependent on dual engagement of both CD82 and Fc receptors. Surface
      cross-linking of CD82 together with Fc receptors (FcRs) induces a specific long
      lasting increase of intracellular calcium, whereas FcR cross-linking alone
      induces only a transient calcium mobilization. These results suggest that, upon
      cross-linking of CD82, a multimolecular complex including CD82 and FcR could be
      induced that is able to trigger signal transduction. We have previously shown
      that CD82 membrane expression is up-regulated during differentiation of human
      monocytes. Using U937 cells, we demonstrate here that several cytokines
      [interleukin-1 beta (IL-1 beta), IL-4, IL-6, IL-13, interferon-gamma, tumor
      necrosis factor alpha] could significantly up-regulate the surface expression of
      CD82 antigen, by contrast with FcR surface expression, which was up-regulated
      only after IFN-gamma treatments. Based on our finding of a strict dependence of
      CD82 activation on FcR stimulation, we suggest a putative role of CD82 in
      enhancing FcR-mediated activation of cells from the monocyte/macrophage lineage.

PMID- 7790781
TI  - Chiropractic treatment of frozen shoulder syndrome (adhesive capsulitis)
      utilizing mechanical force, manually assisted short lever adjusting procedures.
AB  - OBJECTIVE: To describe treatment of frozen shoulder syndrome (adhesive
      capsulitis) via conservative chiropractic treatment to the shoulder joint,
      utilizing specific contact, low force, instrumental adjusting procedures. A case
      report, providing an illustrative example of the same, is presented along with a
      review of the relevant literature. CLINICAL FEATURES: A 53-yr-old woman suffered
      severe shoulder pain of over 6 months' duration. The patient had been diagnosed
      as having adhesive capsulitis and had undergone a variety of different treatment
      regimens without obtaining relief, including various NSAIDs, analgesics and
      physical therapy. At the time of her presentation, her condition had progressed
      to the point of near total immobility of the shoulder joint, accompanied by
      severe pain with resulting marked restriction in her normal activities of daily
      living. INTERVENTION AND OUTCOME: The patient's shoulder was conservatively
      managed with chiropractic adjustments to the affected shoulder joint, as well as
      to the cervicothoracic spine. Treatment consisted of mechanical force, manually
      assisted short lever chiropractic adjustments, delivered via an Activator
      Adjusting Instrument. Successful resolution of the presenting symptomatology was
      achieved. CONCLUSION: Chiropractic care may be able to provide an effective mode
      of therapeutic treatment for certain types of these difficult cases. Low force
      instrumental adjustments, in particular, may present certain benefits in these
      cases that the more forceful manipulations and/or mobilizations cannot. As such,
      further formal investigation of this type of therapeutic intervention for
      treatment of frozen shoulder may be warranted on a larger scale.

PMID- 7790782
TI  - Chiropractic scope of practice: another perspective.

PMID- 7790783
TI  - Use of spinal manipulative therapy in the treatment of duodenal ulcer: a pilot
      study.

PMID- 7790784
TI  - A survey of 492 U.S. chiropractors on primary care and prevention-related issues.
AB  - OBJECTIVE: To gain information on the issue of scope of chiropractic practice,
      particularly in relation to primary care and prevention. DESIGN: A survey was
      administered by mail to a random sample of 753 U.S. chiropractors. SETTING: The
      sampling frame was stratified into eight geographic regions with approximately
      equal numbers of D.C.'s to ensure that all areas of the U.S. were represented.
      PARTICIPANTS: Chiropractors listed in the National Directory of Chiropractic,
      1993-4 edition, comprised the sampling frame. RESULTS: Of the 753 D.C.'s sampled,
      492 completed surveys, for a response rate of 65.3%. The majority of respondents
      (90.4%) considered themselves primary care practitioners. Over 80% were
      accessible to patients at all times. Only 4.1% accepted payment in cash only.
      Fifty-eight percent did a regional physical exam, 29.0% a complete physical, and
      71% a complete health history on every patient. Referrals to M.D.'s/D.O.'s were
      made by 78.1% and received by 46.0% within the last 3 months, although fewer than
      20% included reports with referrals. Prevention practices related directly to
      musculoskeletal problems were most often designated as important to discuss with
      patients: lifting techniques (78.0%), postural education (76.4%), fitness
      exercise (69.3%) and injury prevention (68.3%). CONCLUSIONS: In general,
      respondents demonstrated a number of practice characteristics associated with
      primary care. However, it appears that they could further strengthen their
      position by routinely accompanying referrals with reports, and by increasing
      their emphasis on prevention, especially in areas not directly related to
      musculoskeletal conditions.

PMID- 7790787
TI  - Low back pain outcome measurement assessment in chiropractic teaching clinics:
      responsiveness and applicability of two functional disability questionnaires.
AB  - OBJECTIVE: The major aims were to evaluate responsiveness and clinical/research
      applicability of the Revised Oswestry Disability Questionnaire (ODQ) and the
      Dallas Pain Questionnaire (DPQ). Construct and content validity were assessed.
      Patient characteristics and outcomes were also documented. DESIGN: Longitudinal
      observational study. SETTING: College outpatient clinics. PARTICIPANTS: Six
      hundred sixty-three consecutive new patients accepted for treatment of low back
      pain (LBP) at the clinics over a 1-yr period, age 18 or older. INTERVENTIONS:
      Treatment of low back pain by senior interns under the supervision of staff
      clinicians. MAIN OUTCOME MEASURES: ODQ and DPQ administered at baseline, 2 wk, 1
      month, and monthly up to 6 months. Responsiveness: mean standardized change score
      (delta' = mudif/sigma dif), relative efficiency ([RE = delta' ODQ/delta DPQ']2),
      and improvement rates (IR). Applicability: instrument completion rates. Construct
      validity: correlation with VAS for pain intensity. RESULTS: ODQ responsiveness
      was generally consistent over time (delta' = .70-.83) and negligibly better than
      the DPQ activities of daily living scale (RE = 1.00-1.35); most patients self
      reporting improvement showed positive outcomes (IR = 97%). For large samples (n >
      100): delta' = .47-.63 and IR = 81% for the DPQ work/leisure scale; delta' = .17
      .40 and IR = 54% for the DPQ anxiety/depression and social dimensions. Completion
      rates: 65%-78% of all instruments; 81%-100% of individual scales. Construct
      validity: r = .44-.68 for the ODQ, DPQ activities of daily living, and DPQ
      work/leisure scales; r = .20-.40 for the anxiety/depression scale. CONCLUSIONS:
      The ODQ and the activities of daily living and work/leisure scales from the DPQ
      appear appropriate for monitoring LBP patients returning for care to chiropractic
      teaching clinics. The social and anxiety/depression dimensions of the DPQ do not
      appear to be responsive in this population. The latter scale may be unsuitable on
      the grounds of misinterpretations.

PMID- 7790789
TI  - L5 vertebral compression fracture: a series of five cases.
AB  - OBJECTIVE: The purpose of this paper is to discuss five cases of L5 vertebral
      compression fracture (VCF), illustrating the epidemiology, clinical presentation
      and radiographic appearance of the fracture at this uncommon site. Additionally,
      an empirical approach to conservative management of L5 VCFs is also discussed.
      DESIGN: A series of five cases. SETTING: Private chiropractic clinic.
      CONCLUSIONS: Compression fractures at the L5 level are rare; however, this
      problem should be considered in postmenopausal women who suffer from low back
      pain and in young men with a history of trauma. Conservative treatment options,
      including both passive therapy and exercise, can be beneficial in the management
      of this condition.

PMID- 7790785
TI  - Analysis of zygapophyseal joint cracking during chiropractic manipulation.
AB  - OBJECTIVES: To determine if there is a relationship between the side of head
      rotation and the side of joint crack during "diversified" rotatory manipulation
      of the cervical spine. DESIGN: Randomized experimental study. SETTING: Macquarie
      University, Centre for Chiropractic, Summer Hill, New South Wales. SUBJECTS:
      Fifty asymptomatic subjects were recruited from the students and staff of the
      above college. INTERVENTION: Single, unilateral "diversified," high velocity, low
      amplitude, rotatory thrust technique. MAIN OUTCOME MEASURES: Joint crack sound
      wave analysis of digital audio tape (DAT) recordings, taken from two skin mounted
      microphones positioned on either side of the cervical spine. RESULTS: All 50
      subjects exhibited at least one audible joint crack sound during manipulation.
      Forty-seven subjects (94%) exhibited cracking on the ipsilateral side to head
      rotation (95% confidence interval, 83.5% to 98.7%). One subject exhibited joint
      cracking on the contralateral side only, while two subjects exhibited bilateral
      joint crack sounds. There was a statistically significant lower rate of
      exclusively ipsilateral joint cracking in subjects with a history of neck trauma
      (80% vs. 100%, p = .023). CONCLUSIONS: This research suggests that during the
      "diversified" rotatory manipulation of the cervical spine utilized in this study,
      there is a higher occurrence of the joint crack on the ipsilateral side to head
      rotation.

PMID- 7790786
TI  - The effect of exercise on the presence of leukocytes, erythrocytes and collagen
      fibers in skeletal muscle after contusion.
AB  - OBJECTIVE: To determine the comparative rate of resolution of a contusion
      resulting from mechanical trauma to skeletal muscle, as a function of one of four
      exercise regimens. DESIGN: Randomized control trial. The four exercise regimens
      were: running with its onset immediately after injury, running with a 72 hr delay
      after injury, swimming with immediate onset, or swimming with a 72 hr delay.
      Control did not exercise. SETTING: Small-animal laboratory. PARTICIPANTS: Male
      Sprague-Dawley rats. INTERVENTION: A small animal traumatizing machine applied to
      the biceps femoris. MAIN OUTCOME MEASURES: The rate of contusion resolution was
      determined by a manual count of erythrocytes, leukocytes and collagen fibers in
      the contusion, and the data were analyzed using analysis of variance. RESULTS:
      Exercise of any type produced a greater decline in erythrocyte count (28.2% after
      32 days vs. control) than no exercise. Immediate onset of any of the exercise
      regimens after injury resulted in a greater decline in erythrocyte count (32.7%
      after 32 days vs. control) and in leukocyte count (17.3% after 32 days vs.
      control) than delayed onset. Running with either immediate or delayed onset of
      exercise after injury produced a greater decline in erythrocyte count (36.2%
      after 32 days vs. control) than swimming. Running with its onset immediately
      after injury produced the greatest overall rate of decrease in erythrocyte count
      (44.8% after 32 days vs. control), and the second greatest overall rate of
      decrease in leukocyte count (15.0% after 32 days vs. control). CONCLUSIONS:
      Running with immediate onset is the regimen of choice. Any of the given exercises
      is preferable to no exercise, immediate onset of exercise is preferable to
      delayed onset, and running is preferable to swimming.

PMID- 7790790
TI  - Chiropractic manipulation of anteriorly displaced temporomandibular disc with
      adhesion.
AB  - OBJECTIVE: This AB, single-subject case study was conducted to investigate the
      capability of chiropractic manipulation of the temporomandibular joint (TMJ) in
      treating unilateral anterior displacement of the articular disc with adhesion to
      the articular eminence. A specific joint manipulation was designed to reduce the
      anteriorly displaced and adhered TMJ disc. CLINICAL FEATURES: A 21-yr-old woman
      suffered from a four year history of right-sided temporomandibular joint pain and
      clicking, with limitation of mandibular opening. The patient reported previous
      unsuccessful treatments for her condition. An exhaustive history, a complete
      review of systems and a physical examination (including, but not limited to,
      eyes, ears, nose, throat and motor, sensory and reflex neurological tests) were
      obtained. Relevant or contributory findings are extracted for this article. A
      clinical diagnosis of left-sided anteriorly displaced TMJ disc with adhesion to
      the articular eminence was made. INTERVENTION AND OUTCOME: Patient's pain level,
      presence of joint clicking upon mandibular opening and the amount of mandibular
      opening were used as outcome measures for capability of treatments. An AB, single
      subject study was used where A was the baseline period and B the therapeutic
      intervention period. The patient was treated twice a week for a total of 19
      visits. During the baseline period no treatment was given to the TMJ (3 visits)
      where the patient received cervical manipulation alone. During the experimental
      period the patient received both cervical spine manipulation and a specific
      manipulation to the left mandible. There were no physical therapeutic modalities
      applied to the jaw. The specific TMJ manipulation used requires a very low
      amplitude high velocity thrust parallel to the slope of the articular eminence.
      The results of this study show mandibular opening distance was returned to normal
      in addition to the abolition of the patient's TMJ pain and clicking. During the
      three baseline visits mandibular opening showed no significant change, with an
      average of 25.3 mm (range 25-26 mm). There was also no change in the patient's
      TMJ pain or clicking during this baseline period. The patient's TMJ clicking was
      absent following the third treatment and the patient reported significant
      subjective pain relief as well. Temporomandibular pain was again reported during
      the fifth, sixth and seventh post-treatment visits due to exacerbations caused by
      daily activities. There was no pain reported from the beginning of the eighth
      post-treatment visit to the end of the study. CONCLUSION: The findings of this
      study show this specific manipulation of the TMJ may be appropriate for the
      conservative treatment of adhered anteriorly dislocated disc.

PMID- 7790788
TI  - Measuring cervical muscle tenderness: a study of reliability.
AB  - PURPOSE: To study the inter- and intraexaminer reliability of assessing palpatory
      cervical muscle tenderness using a Total Tenderness Score System. DESIGN:
      Blinded, repeated measures of cervical muscle Total Tenderness Score. SETTING:
      Primary contact ambulatory outpatient facility in a publicly (National Health
      Service) funded chiropractic research institution. PARTICIPANTS: Fourteen
      asymptomatic volunteers, seven male and seven female, aged 23-45 yr.
      INTERVENTION: Palpatory assessment of cervical muscle tenderness by two blinded
      examiners, three times in all per subject. MAIN OUTCOME MEASURES: Total
      Tenderness Score (TTS), measured on a rank/ordinal scale. RESULTS: The inter- and
      intraexaminer reliability of TTS was evaluated using a Spearman rank correlation
      coefficient (r = .88 and r = .85, respectively), and using a Wilcoxon paired rank
      sum test (p = .85 and p = .07, respectively) and by visual inspection of a
      scatter-plot. CONCLUSION: The Total Tenderness Score system was deemed to possess
      acceptable reliability for use in the cervical muscles.

PMID- 7790791
TI  - Chiropractic in The Netherlands: a survey of Dutch chiropractors.
AB  - BACKGROUND: In the Netherlands, there is increasing public and political interest
      in chiropractic treatment. There is, however, very little descriptive information
      available in the Netherlands on the chiropractic profession. Therefore, a survey
      was conducted among all Dutch chiropractors. METHODS: A questionnaire was sent to
      all members of the Netherlands' Chiropractors Association (n = 59). It contained
      questions on (postgraduate) education, practice management, diagnostics
      (including radiology use), treatment, interprofessional cooperation and referral.
      RESULTS: The response was 88%. Chiropractic is growing rapidly: the number of
      chiropractors has doubled in five years. Chiropractors primarily treat back and
      neck pain, with an average of 8 treatments. Conventional orthopedic and
      neurological examination along with motion palpation are the cornerstones of
      physical examination. The respondents stressed the importance of direct access to
      radiography and specialized (hospital) diagnostics. Fifty-eight percent of the
      chiropractors have their own X-ray equipment. The most frequent reason for taking
      new X-rays was the absence of cooperation with radiology departments. Self
      referral is the largest source of patients. The referral rate to other health
      care professionals is low. CONCLUSIONS: The number of chiropractors is growing
      rapidly. They have an exceptional position in the Dutch health care system.
      Access to X-ray and more specialized diagnostics are presently the most important
      political issues.

PMID- 7790792
TI  - Chiropractors' attitudes toward training in prevention: results of a survey of
      492 U.S. chiropractors.
AB  - OBJECTIVE: To assist in assessing practicing DCs' attitudes toward and expressed
      needs for prevention-related training, particularly those topics most relevant to
      a primary care practice. DESIGN: Data were obtained from a mail survey of a
      random sample of 753 U.S. chiropractors. Data analysis included stratification
      and multiple logistic regression to examine the effects of gender, years of
      practice and chiropractic college attended on training, reported in 23 prevention
      topics. Responses were compared with those from a similar published survey of
      MDs. SETTING: The sampling frame was stratified into eight geographic regions
      with approximately equal numbers of DCs. PARTICIPANTS: The sampling frame
      consisted of chiropractors listed in the 1993-4 edition of the National Directory
      of Chiropractic. RESULTS: The survey response rate was 65.3%. Although 90.4% of
      respondents consider themselves primary care practitioners, a significantly fewer
      (p = .00) 78.5% reported adequate training as such in chiropractic college. Fewer
      women than men reported adequate training. Respondents with fewer years in
      practice reported more training in chiropractic college for fourteen of twenty
      three prevention topics than respondents with more years in practice. Differences
      in reported training were detected among graduates of different chiropractic
      colleges in two topics: cancer detection and immunization, con aspect. Comparing
      this survey to that of MDs, more primary care MDs than DCs reported training in
      every topic. When training in addition to that in chiropractic college was
      reported, DCs reported training that more closely approximated primary care MDs.
      CONCLUSIONS: The self-reported information in this survey may provide some
      insight into respondents' perception of their education in prevention and their
      need for additional training. These findings indicate that although prevention
      training seems to be increasing in the chiropractic colleges, an apparent need
      exists for further emphasis on preventive care, particularly in areas most
      relevant to a primary care practice.

PMID- 7790793
TI  - The efficacy of traction for lumbar back pain: design of a randomized clinical
      trial.
AB  - OBJECTIVE: To present the design of a trial on the efficacy of lumbar traction.
      DESIGN: Randomized clinical trial. PATIENTS: Patients with a minimum of 6 wk,
      nonspecific low back pain. INTERVENTION: High-dose, motorized, continuous
      traction with a force between 35% and 50% of the total body weight was compared
      with sham or low-dose traction with a force between 0 and 20% of body weight. The
      sham traction was given with a specially developed brace that becomes tighter in
      the back during traction. This is experienced by patients as if traction were
      exerted. OUTCOME MEASURES: Primary measures were the patient's global impression
      of the effect and the severity of three main complaints. Secondary effect
      measures were functional status, pain, range of motion, work absence and
      recurrences. The effect measures were rated before randomization and 4 wk, 12 wk
      and 6 months later. CONCLUSION: There have been a number of earlier trials on the
      efficacy of lumbar traction; they suffer, however, from severe methodological
      flaws. This trial aimed to avoid these shortcomings.

PMID- 7790795
TI  - The audible release associated with joint manipulation.
AB  - OBJECTIVE: The objective of this paper is to review the literature on the audible
      release associated with manipulation. DATA SOURCES: Bibliographic information in
      pertinent articles and papers located in the MEDLINE database containing the
      keywords joint, joints, cartilage, crack, cracking, cavitation, crepitus and
      noise. STUDY SELECTION: All articles relevant to the objectives were selected.
      DATA EXTRACTION: All available data was used. DATA SYNTHESIS: The audible release
      is caused by a cavitation process whereby a sudden decrease in intracapsular
      pressure causes dissolved gasses in the synovial fluid to be released into the
      joint cavity. Once a joint undergoes cavitation, the force-displacement curve
      changes and the range of motion of the joint increases. The gasses released from
      the synovial fluid make up about 15% of the joint volume and consist of
      approximately 80% carbon dioxide. Habitual joint cracking does not correlate with
      arthritic changes, but does correlate with loss of grip strength and soft-tissue
      swelling. During the "crack" associated with a joint manipulation, there is a
      sudden joint distraction that occurs in less time than that required to complete
      the stretch reflexes of periarticular muscles. Theories on the cavitation
      mechanism were reviewed and new information on the cavitation process is
      introduced. In this paper, it is proposed that the cavitation process is
      generated by an elastic recoil of the synovial capsule as it "snaps back" from
      the capsule/synovial fluid interface. CONCLUSIONS: Because the sudden joint
      distraction during a manipulation occurs in a shorter time period than that
      required to complete the stretch reflexes of the periarticular muscles, there is
      likely to be a high impulse acting on the ligaments and muscles associated with
      the joint. This is an important conclusion, because others have proposed that
      reflex actions from high threshold periarticular receptors are associated with
      the many beneficial results of manipulation. This suggests that the cavitation
      process provides a simple means for initiating the reflex actions and that
      without the cavitation process, it would be difficult to generate the forces in
      the appropriate tissue without causing muscular damage.

PMID- 7790794
TI  - Spinal manipulation vs. amitriptyline for the treatment of chronic tension-type
      headaches: a randomized clinical trial.
AB  - OBJECTIVE: To compare the effectiveness of spinal manipulation and pharmaceutical
      treatment (amitriptyline) for chronic tension-type headache. DESIGN: Randomized
      controlled trial using two parallel groups. The study consisted of a 2-wk
      baseline period, a 6-wk treatment period and a 4-wk posttreatment, follow-up
      period. SETTING: Chiropractic college outpatient clinic. PATIENTS: One hundred
      and fifty patients between the ages of 18 and 70 with a diagnosis of tension-type
      headaches of at least 3 months' duration at a frequency of at least once per wk.
      INTERVENTIONS: 6 wk of spinal manipulative therapy provided by chiropractors or 6
      wk of amitriptyline treatment managed by a medical physician. MAIN OUTCOME
      MEASURES: Change in patient-reported daily headache intensity, weekly headache
      frequency, over-the-counter medication usage and functional health status (SF
      36). RESULTS: A total of 448 people responded to the recruitment advertisements;
      298 were excluded during the screening process. Of the 150 patients who were
      enrolled in the study, 24 (16%) dropped out: 5 (6.6%) from the spinal
      manipulative therapy and 19 (27.1%) from the amitriptyline therapy group. During
      the treatment period, both groups improved at very similar rates in all primary
      outcomes. In relation to baseline values at 4 wk after cessation of treatment,
      the spinal manipulation group showed a reduction of 32% in headache intensity,
      42% in headache frequency, 30% in over-the-counter medication usage and an
      improvement of 16% in functional health status. By comparison, the amitriptyline
      therapy group showed no improvement or a slight worsening from baseline values in
      the same four major outcome measures. Controlling for baseline differences, all
      group differences at 4 wk after cessation of therapy were considered to be
      clinically important and were statistically significant. Of the patients who
      finished the study, 46 (82.1%) in the amitriptyline therapy group reported side
      effects that included drowsiness, dry mouth and weight gain. Three patients
      (4.3%) in the spinal manipulation group reported neck soreness and stiffness.
      CONCLUSIONS: The results of this study show that spinal manipulative therapy is
      an effective treatment for tension headaches. Amitriptyline therapy was slightly
      more effective in reducing pain at the end of the treatment period but was
      associated with more side effects. Four weeks after the cessation of treatment,
      however, the patients who received spinal manipulative therapy experienced a
      sustained therapeutic benefit in all major outcomes in contrast to the patients
      that received amitriptyline therapy, who reverted to baseline values. The
      sustained therapeutic benefit associated with spinal manipulation seemed to
      result in a decreased need for over-the-counter medication. There is a need to
      assess the effectiveness of spinal manipulative therapy beyond four weeks and to
      compare spinal manipulative therapy to an appropriate placebo such as sham
      manipulation in future clinical trials.

PMID- 7790796
TI  - Spondyloepiphyseal dysplasia tarda.
AB  - OBJECTIVE: To present a case of spondyloepiphyseal dysplasia (SED) tarda in a 14
      yr-old boy. CLINICAL FEATURES: The patient suffered from chronic bilateral hip
      pain and range of movement was decreased. Radiographic examination showed
      findings consistent with skeletal dysplasia tarda. INTERVENTION AND OUTCOME: The
      patient was given specific stretching exercises and encouragement to stay active.
      Physiotherapy was provided to strengthen the hip adductor muscles. CONCLUSION:
      The presence of short stature, symmetrical hip dysplasia and abnormal vertebral
      bodies should raise the suspicion of a skeletal dysplasia, specifically
      spondyloepiphyseal dysplasia.

PMID- 7790797
TI  - Charcot-Marie-Tooth disease.
AB  - OBJECTIVE: To discuss the similarities and differences in the clinical
      presentation of Charcot-Marie-Tooth Disease, an inherited peripheral neuropathy,
      and acquired lumbar spinal stenosis. CLINICAL FEATURES: Patients with lumbar
      spinal stenosis causing nerve root entrapment often have leg pain and weakness
      during such activities as walking or standing. Additional symptoms of poor
      balance, foot deformity and signs of cerebellar and sensory ataxia suggest a
      diagnosis of peripheral neuropathy rather than nerve root entrapment.
      INTERVENTION: Electrodiagnostic testing and nerve conduction studies reveal
      abnormal conduction velocities in cases of peripheral neuropathy such as Charcot
      Marie-Tooth Disease. CONCLUSION: Sciatica and leg weakness may be due to a
      variety of causes, including nerve root entrapment and peripheral neuropathy. A
      diagnosis of Charcot-Marie-Tooth Disease should be considered in a case of
      progressive lower limb weakness associated with loss of balance and sensory
      ataxia. This diagnosis can be confirmed using nerve conduction studies.

PMID- 7790798
TI  - The treatment of presumptive optic nerve ischemia by spinal manipulation.
AB  - OBJECTIVE: To discuss a case of presumptive optic nerve ischemia successfully
      treated by spinal manipulative therapy. CLINICAL FEATURES: A 62-yr-old male
      patient suffered from a 1-wk history of monocular visual defect in association
      with headaches and neck strain. Ocular examination revealed no pathology in the
      optic nerve head or retina that could explain the abnormality of vision. Based on
      physical signs, a presumptive diagnosis of optic nerve ischemia was made.
      INTERVENTION AND OUTCOME: Vision improved dramatically in the week of spinal
      manipulation therapy, as measured by serial computerized static perimetry.
      CONCLUSION: This case study records improvement in optic nerve function when
      measured before and after spinal manipulation using computerized static
      perimetry. It contends that spinal manipulation can affect the function of the
      optic nerve in some patients, presumably by increasing vascular perfusion. I
      hypothesize that derangement of the cervical spine produces microvascular spasm
      in the cerebral vasculature, including that of the eye.

PMID- 7790799
TI  - Where do we go from here?

PMID- 7790800
TI  - Some anthropometric dimensions of male adolescents with idiopathic low back pain.

PMID- 7790801
TI  - Chiropractic management of primary nocturnal enuresis.

PMID- 7790802
TI  - Telemedicine in the 90's: beyond the future.

PMID- 7790804
TI  - The role of telemedicine in disaster medicine.
AB  - Telecommunications from telephone and radio to two-way audio, video, facsimile
      (fax), and digital imaging via satellite transmission have been used in responses
      to disasters. Current and rapidly emerging communications technology offers the
      prospect of enormously expanded and more efficient application in predisaster,
      acute, and postdisaster rehabilitation activities. A survey of present and
      potential roles for telemedicine in disaster medicine will be presented with
      particular focus on initial on-going medical needs assessment, prevention
      programs, and emergency assistance for provision of emergency care of victims,
      care for other survivors, and public health and sanitation services. Attention
      will also focus on telemedicine in education and training, disaster response
      exercises, development of comprehensive plans, and research. Finally, the
      essential relationship between the routine utilization of telemedicine in
      predisaster health care and effective employment in disaster situations will be
      discussed.

PMID- 7790803
TI  - Current status of domestic telemedicine.
AB  - This manuscript addresses several aspects of the current status of telemedicine
      in the United States. Telemedicine programs have been in existence since the
      1960s, but only in the last 2 or 3 years have they begun to proliferate.
      Teleradiology has grown rapidly, both in the number of systems and the volume of
      images transmitted. Clinical telemedicine consultation, using video-conferencing,
      has seen an increase in the number of programs, but patient volumes remain low.
      In this paper, I discuss the scope and effectiveness of telemedicine, the kinds
      of applications in use at various telemedicine centers, and issues of importance
      in the development and integration of telemedicine systems into the health care
      delivery infrastructure.

PMID- 7790805
TI  - Second NASA/USUHS International Conference on Telemedicine for Remote Health Care
      and Disaster Response, held September 8-10, 1994, in Bethesda, Maryland.

PMID- 7790806
TI  - Survey of global telemedicine.
AB  - The number and scope of telemedicine projects and applications world-wide are
      growing rapidly along with exponential expansions in national and international
      information infrastructures and computer capabilities to support them. To track
      these rapid changes, the Center for Public Service Communications (CPSC) of
      Arlington, VA, developed the Telemedicine and Information Technologies in Health
      Care: Project Tracking Document for the National Aeronautics and Space
      Administration (NASA). This document is maintained by CPSC and frequently
      updated. It tracks the following areas in telemedicine and health care
      informatics: (1) major existing Federal grant and other assistance programs and
      activities; (2) legislation effecting policy in these areas; (3) projects using
      various technologies throughout the US; and (4) telemedicine projects/interests
      in other nations. This paper is a survey of international (global) telemedicine
      activities that are outlined in that document.

PMID- 7790808
TI  - Opportunities and challenges to telemedicine in rural America.
AB  - Rural communities have chronically suffered from a lack of adequate health care
      resources. Too few primary care practitioners and the need to travel long
      distances for specialty care have made it difficult for many rural residents to
      receive the care they need when they need it. Telemedicine provides one tool for
      improving this situation. As is often the case, however, telemedicine's potential
      has not been realized in rural America. Significant technical, regulatory,
      organizational, and financial barriers have prevented rural communities from
      benefiting from the technology. This paper discusses these issues and suggests a
      prescription for establishing successful rural telemedicine programs.

PMID- 7790809
TI  - Health care in remote areas.
AB  - Migration from space medicine toward telemedicine services is described by
      potential application areas in highly populated and remote areas of Europe.
      Special emphasis is laid upon links between mobile patient monitoring and health
      care in remote areas. Pilot projects are described for home (mobile) monitoring
      of newborn infants endangered by sudden infant death (SID) and adults suffering
      from sleep apnoea. Health care in remote areas is described by the "TeleClinic
      project" which will link national nodes for telemedicine services in several
      European states for the mobile European citizen. Another project describes the
      future potential of robotics for semiautonomous ultrasound diagnostics and for
      realtime interaction of remote experts with diagnostics and therapy.

PMID- 7790807
TI  - The role of medical informatics in telemedicine.
AB  - The role of medical informatics in telemedicine is dependent on using the power
      of the computerized database to not only feed patient specific information to the
      health care providers, but to use the epidemiological and statistical information
      in the data base to improve decision making and ultimately care. The computer is
      also a powerful tool to facilitate standardizing and monitoring of care and when
      applied in continuous quality improvement methodology it can enhance the
      improvement process well beyond what can be done by hand. The coupling of medical
      informatics with telemedicine allows sophisticated medical informatics systems to
      be applied in low population density and remote areas.

PMID- 7790810
TI  - Keynote address. Second NASA/Uniformed Services University of Health Science
      International Conference on Telemedicine, Bethesda, Maryland.

PMID- 7790812
TI  - T cell receptor gene recombination patterns and mechanisms: cell death, rescue,
      and T cell production.
AB  - The antigen-specific receptors of T and B lymphocytes are generated by somatic
      recombination between noncontiguous gene segments encoding the variable portions
      of these molecules. The semirandom nature of this process, while desirable for
      the generation of diversity, has been thought to exact a high price in terms of
      sterile (out-of-frame) products. Historically, the majority of T lymphocytes
      generated in mammals were thought to be useless, either because they generated
      such sterile rearrangements or because the receptors generated did not
      appropriately recognize self-molecules (i.e., positive and negative selection).
      In the studies described here, we characterize the onset of T cell receptor (TCR)
      alpha and beta chain gene rearrangements and quantitate their progression
      throughout T cell development. The results show that T cell production efficiency
      is enhanced through (a) rearrangement of TCR-beta chain genes early during T cell
      development, with selective expansion of those cells possessing in-frame
      rearrangements; (b) deletion of sterile rearrangements at the TCR-alpha chain
      locus through ordered (proximal to distal) sequential recombination; and (c)
      modification of nonselectable alpha/beta heterodimer specificities through
      generation and expression of new TCR-alpha chains. In addition, we demonstrate
      strict correlations between successful TCR-beta gene rearrangement, the onset of
      TCR-alpha gene rearrangement, rapid cell division, and programmed cell death,
      which together serve to maintain cell turnover and homeostasis during T cell
      development.

PMID- 7790811
TI  - Generation of immunoglobulin light chain gene diversity in Raja erinacea is not
      associated with somatic rearrangement, an exception to a central paradigm of B
      cell immunity.
AB  - In all vertebrate species examined to date, rearrangement and somatic
      modification of gene segmental elements that encode portions of the antigen
      combining sites of immunoglobulins are integral components of the generation of
      antibody diversity. In the phylogenetically primitive cartilaginous fishes, gene
      segments encoding immunoglobulin heavy and light chain loci are arranged in
      multiple clusters, in which segmental elements are separated by only 300-400 bp.
      In some cases, segmental elements are joined in the germline of nonlymphoid cells
      (joined genes). Both genomic library screening and direct amplification of
      genomic DNA have been used to characterize at least 89 different type I light
      chain gene clusters in the skate, Raja. Analyses of predicted nucleotide
      sequences and predicted peptide structures are consistent with the distribution
      of genes into different sequence groups. Predicted amino acid sequence
      differences are preferentially distributed in complementarity-determining versus
      framework regions, and replacement-type substitutions exceed neutral
      substitutions. When specific germline sequences are related to the sequences of
      individual cDNAs, it is apparent that the joined genes are expressed and are
      potentially somatically mutated. No evidence was found for the presence of any
      type I light chain gene in Raja that is not germline joined. The type I light
      chain gene clusters in Raja appear to represent a novel gene system in which
      combinatorial and junctional diversity are absent.

PMID- 7790813
TI  - CD43 is a murine T cell costimulatory receptor that functions independently of
      CD28.
AB  - Costimulation mediated by the CD28 receptor has been shown to play an important
      role in the development of a vigorous T cell immune response. Nevertheless, CD28
      deficient mice can mount effective T cell-dependent immune responses. These data
      suggest that other costimulatory molecules may play a role in T cell activation.
      In a search for other costimulatory receptors on T cells, we have characterized a
      monoclonal antibody (mAb) that can costimulate T cells in the absence of
      accessory cells. Similar to CD28 antibodies, this mAb, R2/60, was found to
      synergize with T cell receptor engagement in inducing proliferation. Independent
      ligation of CD3 and the ligand recognized by R2/60 results in T cell
      proliferation, suggesting that the two molecules do not have to colocalize to
      activate the R2/60 costimulatory pathway. R2/60 does not react with CD28, and
      furthermore, R2/60 costimulates in a CD28-independent fashion since the mAb
      costimulates T cells from the CD28-deficient mice as well as wild-type mice.
      Expression cloning of the R2/60 antigen identified the ligand as murine CD43.
      Together, these data demonstrate that CD43 can serve as a receptor on T cells
      that can provide CD28-independent costimulation.

PMID- 7790815
TI  - Chondroitin sulfate A is a cell surface receptor for Plasmodium falciparum
      infected erythrocytes.
AB  - Adherence of Plasmodium falciparum-infected erythrocytes to cerebral
      postcapillary venular endothelium is believed to be a critical step in the
      development of cerebral malaria. Some of the possible receptors mediating
      adherence have been identified, but the process of adherence in vivo is poorly
      understood. We investigated the role of carbohydrate ligands in adherence, and we
      identified chondroitin sulfate (CS) as a specific receptor for P. falciparum
      infected erythrocytes. Parasitized cells bound to Chinese hamster ovary (CHO)
      cells and C32 melanoma cells in a chondroitin sulfate-dependent manner, whereas
      glycosylation mutants lacking chondroitin sulfate A (CSA) supported little or no
      binding. Chondroitinase treatment of wild-type CHO cells reduced binding by up to
      90%. Soluble CSA inhibited binding to CHO cells by 99.2 +/- 0.2% at 10 mg/ml and
      by 72.5 +/- 3.8% at 1 mg/ml, whereas a range of other glycosaminoglycans such as
      heparan sulfate had no effect. Parasite lines selected for increased binding to
      CHO cells and most patient isolates bound specifically to immobilized CSA. We
      conclude that P. falciparum can express or expose proteins at the surface of the
      infected erythrocyte that mediate specific binding to CSA. This mechanism of
      adherence may contribute to the pathogenesis of P. falciparum malaria, but has
      wider implications as an example of an infectious agent with the capacity to bind
      specifically to cell-associated or immobilized CS.

PMID- 7790814
TI  - Activation of Raf-1 and mitogen-activated protein kinase in murine macrophages
      partially mimics lipopolysaccharide-induced signaling events.
AB  - Lipopolysaccharide (LPS), a highly conserved component of the outer membrane of
      gram-negative bacteria, stimulates macrophages to release various cytokine and
      eicosanoid mediators of the immune response. The mechanism by which LPS
      stimulates these cells is poorly characterized. One of the most rapid LPS
      stimulated events is the phosphorylation and activation of the p42 and p44
      isoforms of mitogen-activated protein (MAP) kinase. We wished to examine the role
      of MAP kinase in LPS-induced signaling in murine macrophages by activating MAP
      kinase independently of LPS. An expression vector encoding a Raf-1:estrogen
      receptor (ER) chimeric protein was transfected into the murine macrophage cell
      line RAW 264.7. Activation of this chimeric protein (delta Raf-1:ER) by estradiol
      resulted in rapid and prolonged activation of MAP kinase, as expected from
      previous results implicating Raf-1 as an upstream activator of this signaling
      cascade. LPS stimulation induced accumulation of MAP kinase phosphatase 1
      messenger RNA, whereas delta Raf-1:ER activation did not, perhaps accounting for
      the more prolonged activation of MAP kinase seen in response to delta Raf-1:ER
      activation. Similarly, activation of DNA binding by the transcription factor,
      nuclear factor (NF) kappa B, as assessed by electrophoretic mobility shift assay,
      occurred in response to LPS stimulation but not in response to delta Raf-1:ER
      activation or phorbol myristate acetate (PMA) stimulation. Using an enzyme-linked
      immunosorbent assay for murine tumor necrosis factor alpha (TNF-alpha), we found
      that LPS and PMA stimulation and delta Raf-1:ER activation induced secretion of
      TNF-alpha, although the amount of TNF-alpha secreted in response to delta Raf
      1:ER activation and PMA stimulation was approximately 20-fold less than that
      secreted in response to LPS. Correspondingly, accumulation of TNF-alpha messenger
      RNA was weakly induced by delta Raf-1:ER activation or PMA stimulation, whereas
      strong induction was noted in response to LPS. These results suggest that Raf-1
      or PMA activation of MAP kinase in murine macrophages is sufficient for a small
      amount of TNF-alpha production and secretion in the absence of NF-kappa B
      activation, but LPS stimulation involves additional signaling events, such as NF
      kappa B activation, that augment the response seen with activation of MAP kinase
      alone.

PMID- 7790816
TI  - Antigen capture and major histocompatibility class II compartments of freshly
      isolated and cultured human blood dendritic cells.
AB  - Dendritic cells (DC) represent potent antigen-presenting cells for the induction
      of T cell-dependent immune responses. Previous work on antigen uptake and
      presentation by human DC is based largely on studies of blood DC that have been
      cultured for various periods of time before analysis. These cultured cells may
      therefore have undergone a maturation process from precursors that have different
      capacities for antigen capture and presentation. We have now used immunoelectron
      microscopy and antigen presentation assays to compare freshly isolated DC (f-DC)
      and cultured DC (c-DC). f-DC display a round appearance, whereas c-DC display
      characteristic long processes. c-DC express much more cell surface major
      histocompatibility complex (MHC) class II than f-DC. The uptake of colloidal gold
      labeled bovine serum albumin (BSA), however, is greater in f-DC, as is the
      presentation of 65-kD heat shock protein to T cell clones. The most striking
      discovery is that the majority of MHC class II molecules in both f-DC and c-DC
      occur in intracellular vacuoles with a complex shape (multivesicular and
      multilaminar). These MHC class II enriched compartments (MIIC) represent the site
      to which BSA is transported within 30 min. Although MIIC appear as more dense
      structures with less MHC class II molecules in f-DC than c-DC, the marker
      characteristics are very similar. The MIIC in both types of DC are acidic,
      contain invariant chain, and express the recently described HLA-DM molecule that
      can contribute to antigen presentation. CD19+ peripheral blood B cells have fewer
      MIIC and surface MHC class II expression than DCs, while monocytes had low levels
      of MIIC and surface MHC class II. These results demonstrate in dendritic cells
      the elaborate development of MIIC expressing several of the components that are
      required for efficient antigen presentation.

PMID- 7790818
TI  - The IP-10 chemokine binds to a specific cell surface heparan sulfate site shared
      with platelet factor 4 and inhibits endothelial cell proliferation.
AB  - IP-10 is a member of the chemokine family of cytokines and is induced in a
      variety of cells in response to interferon gamma and lipopolysaccharide. The self
      aggregation common to many chemokines, including IP-10, has hindered the
      identification of a specific IP-10 receptor. Using an IP-10 alkaline phosphatase
      fusion protein that fortuitously blocks this self-aggregation, we have identified
      an IP-10 binding site on a variety of cells including endothelial, epithelial,
      and hematopoietic cells. This binding site has a Kd of 25 nM, is inhibited by
      recombinant murine or human IP-10, and is dependent on the presence of cell
      surface heparan sulfate proteoglycans (HSPG). This conclusion is based on the
      findings that IP-10 binding to cells is: (a) inhibited by heparin and heparan
      sulfate; (b) sensitive to a 1 M NaCl wash; (c) eliminated by treatment with
      heparinase and trypsin; and (d) absent on mutant CHO cells that do not express
      cell surface HSPG. Platelet factor 4 (PF4), but not IL-8, monocyte
      chemoattractant protein-1, RANTES, monocyte inflammatory protein (MIP)-1 alpha,
      or MIP-1 beta, can compete effectively with IP-10 for binding to the cell
      surface. Furthermore, IP-10 shares with PF4 the ability to inhibit endothelial
      cell proliferation (IC50 = 150 nM). These studies demonstrate specificity in the
      interaction of chemokines and HSPG, and they define IP-10 and PF4 as a distinct
      subset of chemokines sharing an HSPG-binding site and angiostatic properties.

PMID- 7790817
TI  - Cooperativity between the J and S elements of class II major histocompatibility
      complex genes as enhancers in normal and class II-negative patient and mutant B
      cell lines.
AB  - The class II major histocompatibility complex genes all contain in their proximal
      promoters three cis-elements called S, X, and Y that are conserved in both
      sequence and position, and a fourth element, J, conserved in sequence but not in
      position. J, X, and Y and, to some extent, S, have been shown to be functionally
      important in regulation of expression of these genes. In the present study, a
      protein factor that binds cooperatively to the S plus J elements of the promoter
      of the class II major histocompatibility complex gene DPA has been detected.
      Moreover, functional cooperativity between S and J in activation of the
      enhancerless -40 interferon-beta (-40 IFN-beta) promoter has been demonstrated.
      Finally, the latter assay appears to subdivide complementation group A of class
      II negative human B cell lines that includes both mutants generated in vitro and
      cells from patients with the bare lymphocyte syndrome (type II). In three of
      these cell lines, the enhancerless -40 IFN-beta promoter containing the S plus J
      elements was functionally active, while in the others it was inactive.

PMID- 7790819
TI  - Interleukin 6 is essential for in vivo development of B lineage neoplasms.
AB  - Interleukin (IL) 6 has been suggested to be the major cytokine responsible for
      proliferation of neoplastic plasma cells in both human myeloma and mouse
      plasmacytoma. Much of the evidence supporting this suggestion is derived from in
      vitro studies in which the survival or proliferation of some plasma cell tumors
      has been found to be IL-6 dependent. However, it remains unclear whether this
      dependency is the consequence of in vivo or in vitro selective pressures that
      preferentially expand IL-6-responsive tumor cells, or whether it reflects a
      critical in vivo role for IL-6 in plasma cell neoplasia. To address this
      question, we have attempted to induce plasma cell tumors in normal mice and in IL
      6-deficient mice generated by introduction of a germline-encoded null mutation in
      the IL-6 gene. The results demonstrate that mice homozygous (+/+) or heterozygous
      (+/-) for the wild-type IL-6 allele yield the expected incidences of plasma cell
      tumors. In contrast, mice homozygous for the IL-6-null allele (-/-) are
      completely resistant to plasma cell tumor development. These studies define the
      essential role of IL-6 in the development of B lineage tumors in vivo and provide
      experimental support for continued efforts to modulate this cytokine in the
      treatment of appropriate human B cell malignancies.

PMID- 7790820
TI  - Self tolerance to T cell receptor V beta sequences.
AB  - T cell tolerance to self is achieved by deletion or inactivation of clones
      recognizing peptides of self proteins presented by major histocompatibility
      complex molecules. A considerable fraction of self proteins accessible to the
      immune system is contributed by the system itself, for example, the receptors
      used for antigen recognition (antibodies and T cell receptors [TCRs]). Thus far,
      it has remained unclear, whether antigen receptors are subject to self tolerance,
      or on contrary, engage into network interactions implying immunity rather than
      tolerance. In this study, we demonstrate self tolerance to synthetic peptides
      corresponding to the first hypervariable region of the V beta 8.1 and V beta 8.2
      TCR proteins. We also show that the tolerogenic synthetic peptide corresponds to
      a fragment produced by processing of the V beta protein, and conversely, that a V
      beta peptide not produced by processing is also not subject to self tolerance.
      Thus, the rules of tolerance seem to apply to antigen receptors, at least to
      their germline-encoded portions, in a similar fashion as to other self proteins.
      This finding has important implications for studies of natural and artificially
      induced immune networks.

PMID- 7790821
TI  - Triglyceride-rich lipoproteins prevent septic death in rats.
AB  - Triglyceride-rich lipoproteins bind and inactive bacterial endotoxin in vitro and
      prevent death when given before a lethal dose of endotoxin in animals. However,
      lipoproteins have not yet been demonstrated to improve survival in polymicrobial
      gram-negative sepsis. We therefore tested the ability of triglyceride-rich
      lipoproteins to prevent death after cecal ligation and puncture (CLP) in rats.
      Animals were given bolus infusions of either chylomicrons (1 g triglyceride/kg
      per 4 h) or an equal volume of saline for 28 h after CLP. Chylomicron infusions
      significantly improved survival (measured at 96 h) compared with saline controls
      (80 vs 27%, P < or = 0.03). Chylomicron infusions also reduced serum levels of
      endotoxin, measured 90 min (26 +/- 3 vs 136 +/- 51 pg/ml, mean +/- SEM, P < or =
      0.03) and 6 h (121 +/- 54 vs 1,026 +/- 459 pg/ml, P < or = 0.05) after CLP. The
      reduction in serum endotoxin correlated with a reduction in serum tumor necrosis
      factor, measured 6 h after CLP (0 +/- 0 vs 58 +/- 24 pg/ml, P < or = 0.03),
      suggesting that chylomicrons improve survival in this model by limiting
      macrophage exposure to endotoxin and thereby reducing secretion of inflammatory
      cytokines. Infusions of a synthetic triglyceride-rich lipid emulsion (Intralipid;
      KabiVitrum, Inc., Alameda, CA) (1 g triglyceride/kg) also significantly improved
      survival compared with saline controls (71 vs 27%, P < or = 0.03). These data
      demonstrate that triglyceride-rich lipoproteins can protect animals from lethal
      polymicrobial gram-negative sepsis.

PMID- 7790822
TI  - Human autoantibody to defensin: disease association with hyperreactive
      onchocerciasis (sowda).
AB  - Chronic hyperreactive onchodermatitis (sowda) is a severe form of onchocerciasis
      observed in a subset of individuals infected with the filarial nematode
      Onchocerca volvulus. SDS-PAGE and immunoblot analyses of O. volvulus adult worm
      extracts were used to characterize the antigens of the marked antibody response
      of sowda patients. One 2.5-kD antigen was recognized by sera from all 35(100%)
      sowda patients that were studied. In comparison, only 7 of 44 (16%) patients with
      generalized onchocerciasis and 11 of 21 (52%) of exposed individuals with no
      microfilariae in skin snips and no signs of disease showed reactivity to this
      antigen. Microfilaricidal treatment of sowda patients with improvement of the
      clinical status was associated with a decrease or disappearance of antibodies to
      the 2.5-kD antigen. Amino acid sequencing of the antigen indicated identity to
      human defensins 1-3 of neutrophils. Defensin was demonstrated by
      immunohistochemical staining in onchocercal nodules on the surface of adult
      filariae and in the surrounding tissue. A similar staining pattern was observed
      for other proteins present in neutrophils such as myeloperoxidase, elastase, and
      the L-1 protein complex (MRP 8/MRP 14), indicating that neutrophils, macrophages,
      and their proteins predominate in the environment adjacent to the worms. These
      results demonstrate an association between the presence of autoantibodies to
      defensins and an infectious disease of known etiology. The association with a
      particular form of onchocerciasis, sowda, suggests a link between formation of
      autoantibodies to defensin and enhanced immune reactivity towards the parasite.

PMID- 7790823
TI  - Activation of CD4+ T cells in the presence of a nondepleting monoclonal antibody
      to CD4 induces a Th2-type response in vitro.
AB  - In vitro experiments using purified rat CD4+ T cells in primary and secondary
      mixed leukocyte cultures (MLC) have been carried out to explore the mechanism of
      inhibition of cell-mediated autoimmune disease in the rat by a nondepleting
      monoclonal antibody (mAb) to CD4. Previous work has shown that W3/25, a mouse
      anti-rat CD4 mAb of immunoglobulin G1 isotype, completely prevents the
      development of the paralysis associated with experimental allergic
      encephalomyelitis (EAE) in Lewis rats, but does so without eliminating the
      encephalitogenic T cells. The in vitro experiments described in this study have
      shown that when CD4+ T cells were activated in the presence of the anti-CD4 mAb
      in a primary MLC, the synthesis of interferon (IFN) gamma, but not interleukin
      (IL) 2, was completely inhibited. After secondary stimulation, now in the absence
      of the mAb, the synthesis of IL-4 and IL-13 mRNA was greatly enhanced compared
      with that observed from CD4+ T cells derived from primary cultures in which the
      mAb was omitted. As IL-4 and IL-13 are known to antagonize cell-mediated immune
      reactions, and as EAE is cell-mediated disease, the data suggest that the W3/25
      mAb controls EAE by modifying the cytokine repertoire of T cells that respond to
      the encephalitogen. The capacity for the mAb to suppress IFN-gamma synthesis
      provides, in part, an explanation for this change in cytokine production. These
      findings are discussed in terms of what is known of the factors that determine
      which cytokine genes are expressed on T cell activation. Possible implications
      for the evolution of T cell responses in human immunodeficiency virus infection
      are also discussed.

PMID- 7790825
TI  - CD4+ beta islet cell-reactive T cell clones that suppress autoimmune diabetes in
      nonobese diabetic mice.
AB  - We report the isolation of a panel of CD4+ T helper type 1 autoreactive T cell
      clones from the spleen of unprimed nonobese diabetic mice, a murine model of
      human insulin-dependent diabetes mellitus. The T cell clones express a diverse
      repertoire of T cell receptors, three of which recognize beta islet cell
      autoantigen(s). The islet cell-reactive T cell clones inhibit adoptive transfer
      of insulin-dependent diabetes mellitus and intraislet lymphocytic infiltration.
      The protective capacity of the T cell clones correlates with their ability to
      produce a novel immunoregulatory activity that potently inhibits in vitro
      allogeneic mixed lymphocyte reaction. The partially purified activity
      significantly inhibited the adoptive transfer of diabetes. Our work provides
      evidence in support of the existence of T helper type 1, CD4+ T cells reactive to
      beta islet cell autoantigens that have acquired a protective instead of a
      diabetogenic effector function. These T cells mediate their protective action in
      part by production of an immunoregulatory activity capable of down-regulating
      immune responses, and they are likely to represent a population of regulatory T
      cells that normally plays a role in maintaining peripheral tolerance.

PMID- 7790827
TI  - Perceptual load as a necessary condition for selective attention.
AB  - The early and late selection debate may be resolved if perceptual load of
      relevant information determines the selective processing of irrelevant
      information. This hypothesis was tested in 3 studies; all used a variation of the
      response competition paradigm to measure irrelevant processing when load in the
      relevant processing was varied. Perceptual load was manipulated by relevant
      display set size or by different processing requirements for identical displays.
      These included the requirement to process conjunctions versus isolated features
      and the requirement to perform simple detection of a character's presence versus
      difficult identification of its size and position. Distractors' interference was
      found only under low-load conditions. Because the distractor was usually clearly
      distinct from the target, it is concluded that physical separation is not a
      sufficient condition for selective perception; overloading perception is also
      required. This allows a compromise between early and late selection views and
      resolves apparent discrepancies in previous work.

PMID- 7790824
TI  - Molecular mimicry between the immunodominant ribosomal protein P0 of Trypanosoma
      cruzi and a functional epitope on the human beta 1-adrenergic receptor.
AB  - Sera from chagasic patients possess antibodies recognizing the carboxy-terminal
      part of the ribosomal P0 protein of Trypanosoma cruzi and the second
      extracellular loop of the human beta 1-adrenergic receptor. Comparison of both
      peptides showed that they contain a pentapeptide with very high homology (AESEE
      in P0 and AESDE in the human beta 1-adrenergic receptor). Using a competitive
      immunoenzyme assay, recognition of the peptide corresponding to the second
      extracellular loop (H26R) was inhibited by both P0-14i (AAAESEEEDDDDDF) and P0
      beta (AESEE). Concomitantly, recognition of P0-beta was inhibited with the H26R
      peptide. Recognition of P0 in Western blots was inhibited by P0-14i, P0-beta, and
      H26R, but not by a peptide corresponding to the second extracellular loop of the
      human beta 2-adrenergic receptor or by an unrelated peptide. Autoantibodies
      affinity purified with the immobilized H26R peptide were shown to exert a
      positive chronotropic effect in vitro on cardiomyocytes from neonatal rats. This
      effect was blocked by both the specific beta 1 blocker bisoprolol and the peptide
      P0-beta. These results unambiguously prove that T. cruzi is able to induce a
      functional autoimmune response against the cardiovascular human beta 1-adrenergic
      receptor through a molecular mimicry mechanism.

PMID- 7790826
TI  - Interleukin 10 but not interleukin 4 is a natural suppressant of cutaneous
      inflammatory responses.
AB  - We have examined the role of endogenously produced interleukin (IL) 4 and IL-10
      in the regulation of inflammatory and immune reactions in the skin. In these
      experiments, irritant and contact hypersensitivity (CH) responses were elicited
      in mice with targeted disruptions of the IL-4 (IL-4T) or IL-10 (IL-10T) gene. Our
      study showed that IL-4T and wild-type (wt) mice exhibited equivalent responses to
      the irritant croton oil. In contrast, the response of IL-10T mice challenged with
      croton oil was abnormally increased. When IL-10T mice were exposed to a higher
      dose of irritant, irreversible tissue damage occurred. By comparison, any
      treatment of wt mice with croton oil resulted in far less tissue damage and
      resolution of inflammation. Neutralizing antibody studies demonstrated that the
      necrosis that occurred in IL-10T mice was due to the overproduction of tumor
      necrosis factor. The anti-tumor necrosis factor antibody treatment of IL-10T mice
      did not significantly reduce the edema or the influx of inflammatory cells,
      suggesting that these changes were due to the uncontrolled production of other
      proinflammatory cytokines. T cell-dependent immune responses were also evaluated
      using the contact sensitizer oxazolone. The response of IL-4T mice did not differ
      from wt mice. In contrast, IL-10T mice mounted an exaggerated CH response,
      increased in both magnitude and duration as compared with wt mice. Based on these
      studies, we have concluded that IL-10, but not IL-4, is a natural suppressant of
      irritant responses and of CH, and it limits immunopathologic damage in the skin.

PMID- 7790828
TI  - Role of the syllable in the processing of spoken English: evidence from a nonword
      comparison task.
AB  - Previous research using monitoring tasks suggests that syllables do not play a
      role in the initial processing of speech by English listeners. The role of
      syllables in a different task, one involving the speeded comparison of 2
      nonwords, was investigated. In 2 experiments, responses to nonword pairs that
      shared a complete syllable were significantly faster than responses to pairs that
      shared part of a syllable when the shared unit was at the beginning or in the
      middle of the nonwords. Results were mixed when the shared unit was at the end of
      the nonwords, possibly reflecting a confounding effect of rhyme. Findings suggest
      that syllabified representations of the nonwords may be used in a comparison
      task, even in English. Results are interpreted relative to different demands of
      the nonword comparison and monitoring tasks.

PMID- 7790829
TI  - Calibration of human locomotion and models of perceptual-motor organization.
AB  - People coordinate the force and direction of skilled actions with target
      locations and adjust the calibrations to compensate for changing circumstances.
      Are the adjustments globally organized (adjusting a particular action to fit a
      particular circumstance would generalize to all actions in the same
      circumstance); anatomically specific (every effector is adjusted independently of
      others); of functional (adjustments would generalize to all actions serving the
      same goal and generating the same perceptible consequences)? Across 10
      experiments, changes in the calibration of walking, throwing, and turning-in
      place were induced, and generalization of changes in calibration to functionally
      related and unrelated actions were tested. The experiments demonstrate that
      humans rapidly adjust the calibration of their walking, turning, and throwing to
      changing circumstances, and a functional model of perceptual-motor organization
      is suggested.

PMID- 7790830
TI  - Strategies and mechanisms in nonselective and selective inhibitory motor control.
AB  - Motor inhibition was studied in 3 versions of the stop-signal paradigm, with the
      stop signal requiring inhibition of any response (stop-all), a fixed alternative
      response (stop-change), or selective inhibition of only 1 of the responses
      (selective-stop). The lateralized readiness potential was used in Experiment 1 to
      distinguish between a selective, central, and a global peripheral inhibition
      mechanism. Inhibition was found to be effected by the central mechanism in the
      stop-change condition and by the peripheral mechanism in the other conditions.
      Manipulation of stimulus discriminability in Experiment 2 strongly affected the
      speed of selective motor inhibition, confirming that such inhibition was achieved
      by conditionally engaging the peripheral mechanism. These results support the
      idea that functionally distinct mechanisms and strategies are involved in
      inhibitory motor control in different situations.

PMID- 7790831
TI  - Perceiving exterior letters of words: differential influences of letter-fragment
      and non-letter-fragment masks.
AB  - Previous research shows letter-fragment masks and non-letter-fragment fields have
      different effects on performance with briefly presented alphabetic targets.
      However, popular accounts of these differences ignore mask configuration. Over a
      series of experiments, configurational effects of letter-fragment (LF) and non
      letter-fragment (NLF) masks were compared. When the configuration of LF masks
      matched word boundaries, performance with exterior letter pairs from words
      improved, whereas performance with illegal exterior-letter pairs and single
      letters was unaffected. When the same changes were made to NLF masks, only an
      overall drop in performance occurred, with no selective effect on target type.
      Thus, although LF mask configuration selectively affected lexical processing, NLF
      mask configuration produced substantially different effects, indicating problems
      with contemporary accounts of masking differences that ignore influences of mask
      configuration.

PMID- 7790833
TI  - Does mental rotation require central mechanisms?
AB  - Four reaction time experiments examined the mental rotation process using a
      psychological refractory period paradigm. On each trial, participants made
      speeded responses to both a tone (S1) and a rotated letter (S2), presented with
      varying stimulus onset asynchronies (SOAs). If mental rotation of the stimulus
      letter can proceed while central mechanisms are busy with S1, then the effect of
      orientation should decrease substantially with decreasing SOA. Contrary to these
      predictions, the effect of orientation was nearly constant across SOAs,
      suggesting that mental rotation cannot effectively proceed without help from
      central mechanisms. These results support the conclusion that mental rotation
      requires access to a single-channel mechanism and must therefore be performed
      serially with other operations requiring the same mechanism.

PMID- 7790834
TI  - Competing global and local completions in visual occlusion.
AB  - In visual occlusion 2 amodal-completion tendencies occur frequently. One tendency
      leads toward the simplest completed shape (a global completion) and the other to
      a shape for which the completion itself is as simple as possible (a local
      completion). Two experimental paradigms were used to test the strengths of these
      completion tendencies: a drawing task and a simultaneous matching task. The
      experimental results support the notion that the preference for either a global
      or a local completion is the consequence of a competition between
      interpretations. Finally, the authors discuss how the preference for a completion
      can be predicted by a model that is based on a quantification of both global and
      local aspects.

PMID- 7790835
TI  - Automatic access to object identity: attention to global information, not to
      particular physical dimensions, is important.
AB  - The authors examined whether, by attending to physical properties of objects,
      participants can prevent the activation of semantic information. Participants
      received a reference object followed by a display containing both a matching
      target and a distractor. In Experiments 1 and 2, participants attended to motion
      and to surface texture, respectively. Some evidence for the processing of
      semantic information occurred. This result contrasted with a previous study in
      which no evidence for semantic information processing was apparent in a color
      matching task (M. Boucart & G.W. Humphreys, 1994). In Experiment 3, pictures were
      used with outline contours composed of randomly distributed red and green dots,
      one color being overrepresented. Participants matched pictures according to the
      dominant color. Evidence for semantic processing emerged. The authors suggest
      that these results cannot be explained in terms of attention operating
      differently on separate physiological channels. Instead it is proposed that what
      is crucial in activating stored object representations is whether the global
      configuration of the picture is processed.

PMID- 7790832
TI  - Second-order parallel processing: visual search for the odd item in a subset.
AB  - Visual search tasks in which participants searched for an odd element in a subset
      of items were investigated. Participants searched for an item of odd orientation
      in the red subset. The target was a red line of X degree, distractors were green
      lines of X degree and red lines of Y degree. The orientations, X and Y, changed
      on every trial. In this task, orientation information was useful only after color
      had been used to select the relevant subset. Results show that response time (RT)
      and error data were different from standard color X orientation conjunction
      searches (Experiment 1). RT x Set Size functions had slopes near 0 ms per item
      (Experiment 2). The selection of the subset appeared to take 200-300 ms
      (Experiments 2 and 3). Subset selection was based on properties of the relevant
      subset, not the irrelevant subset (Experiment 4). It was more difficult (perhaps
      impossible) to select a subset defined by 2 colors (Experiment 5). Random
      variation in an irrelevant dimension did not disrupt subset search (Experiment
      6).

PMID- 7790836
TI  - Temporal rescaling of sample and complex rations in rhythmic tapping.
AB  - Two well-established phenomena in temporal performance--preference for simple
      ratios over complex ratios and the ability to proportionately rescale temporal
      patterns--were examined together. Unlike the case with simple ratios,
      participants (3 trained musicians) showed only a limited ability to learn complex
      ratios and no ability to proportionately rescale them. These differences suggest
      that different mechanisms are used to produce the 2 ratio types. Systematic
      biases observed in the performances of the simple ratios (6 trained musicians)
      were modeled by assuming that an additive timing component, which is unequal for
      short and long intervals and changes with base rate, overlays a system that
      preferentially produces simple ratios. The general pattern of results was
      consistent with the view that rhythmic learning builds on or modifies a system of
      innate preferences.

PMID- 7790839
TI  - Similarity determines the attentional blink.
AB  - When participants are required to respond to a target letter imbedded in a stream
      of rapid serially presented letters, perception of a 2nd target letter is
      impaired if the interval between the 2 targets is less than about 450 ms. This
      attentionally based posttarget suppression in visual processing, referred to as
      the attentional blink (AB), is not found when there is a brief pause in the
      stream immediately after the 1st target. To investigate the importance of
      posttarget stimulation in AB production, the categorical, featural, and spatial
      similarity of the immediate posttarget item to other items in the stream was
      manipulated. Although featural and spatial dissimilarity produced significant
      attenuation of the AB effect, categorical dissimilarity did not. Significant AB
      effects were found in all conditions, suggesting that the presentation of any
      patterned stimulus in close temporal proximity to the target provokes the AB.

PMID- 7790838
TI  - Auditory coding, cues, and coherence in phonetic perception.
AB  - C. T. Best, M. Studdert-Kennedy, S. Manuel, and J. Rubin-Spitz (1989) reported
      that listeners given speech labels showed categorical-like perception of a series
      of complex tone analogs to a /la/-/ra/ speech series, whereas nonspeech listeners
      were unable to classify the stimuli consistently. In 2 experiments, a new
      training and testing procedure was used with adult listeners given nonspeech
      instructions. They classified the /la/-/ra/ tone analogs consistently, showed
      categorical-like perception, and generalized their training to a new, /li/-/ri/
      tone analog series. Two sets of auditory attributes were described for coding the
      /l/-/r/ distinction, and 1 was shown to quantitatively predict listeners'
      classification of both series. These results are consistent with models of
      perception in which a rich, abstract auditory code is computed and forms the
      basis for both speech and nonspeech auditory categories.

PMID- 7790837
TI  - What causes the face inversion effect?
AB  - What is it about the way faces are represented by the visual system that makes
      them so much harder to recognize when inverted? The authors tested the hypothesis
      that the "face inversion" effect results from the use of holistic shape
      representations. This suggests that the susceptibility of nonface patterns to
      inversion should be a function of their degree of part decomposition. In
      Experiment 1 this was tested and confirmed with dot patterns in which the degree
      of part decomposition was manipulated by grouping and segregation on the basis of
      dot color. The hypothesis also predicted that the face inversion effect can be
      eliminated with face stimuli if participants are induced to recognize the faces
      in terms of their component parts. In Experiment 2 this was tested and confirmed
      with whole, intact faces, in which the degree of part decomposition was
      manipulated by allowing participants to study them, initially, in either whole,
      intact versions or versions with parts presented separately.

PMID- 7790840
TI  - Systematic distortion of perceived three-dimensional structure from motion and
      binocular stereopsis.
AB  - The geometric relation between physical and perceived space as specified by
      binocular stereopsis and structure from motion was investigated. Four
      experimental tasks were used, each of which required a different aspect of three
      dimensional (3-D) structure to be performed accurately. To examine whether the
      transformation between physical and perceptual space preserved the 3-D structural
      properties required to perform each of our tasks, the constancy of judged shape
      over changes in a depicted object's viewing distance or orientation was examined.
      Our results reveal that observers' judgments of 3-D shape from binocular
      stereopsis and motion contained systematic distortions: Perceived 3-D shape from
      motion was not invariant over orientation change and perceived 3-D structure from
      stereo, and motion and stereo in combination was not invariant over changes in
      viewing distance.

PMID- 7790841
TI  - Comparing depth from motion with depth from binocular disparity.
AB  - The accuracy of depth judgments that are based on binocular disparity or
      structure from motion (motion parallax and object rotation) was studied in 3
      experiments. In Experiment 1, depth judgments were recorded for computer
      simulations of cones specified by binocular disparity, motion parallax, or
      stereokinesis. In Experiment 2, judgments were recorded for real cones in a
      structured environment, with depth information from binocular disparity, motion
      parallax, or object rotation about the y-axis. In both of these experiments,
      judgments from binocular disparity information were quite accurate, but judgments
      on the basis of geometrically equivalent or more robust motion information
      reflected poor recovery of quantitative depth information. A 3rd experiment
      demonstrated stereoscopic depth constancy for distances of 1 to 3 m using real
      objects in a well-illuminated, structured viewing environment in which monocular
      depth cues (e.g., shading) were minimized.

PMID- 7790842
TI  - Effects of annetocin, an oxytocin-related peptide isolated from the earthworm
      Eisenia foetida, and some putative neurotransmitters on gut motility of the
      earthworm.
AB  - Annetocin, an oxytocin-related peptide recently isolated from the lumbricid
      earthworm Eisenia foetida, and putative transmitter substances were examined for
      their effects on rhythmic, spontaneous contractions of isolated gut preparations
      of the earthworm. Significant, dose-dependent effects of the following substances
      were observed: acetylcholine (ACh), gamma-aminobutyric acid (GABA), and dopamine
      were excitatory, while serotonin (5-HT) and octopamine were inhibitory.
      Annetocin, oxytocin, and vasotocin stimulated spontaneous contraction of the
      earthworm gut, annetocin being approximately 10-fold more potent than oxytocin or
      vasotocin. However, arginine-vasopressin (Arg-vasopressin), lysine-vasopressin
      (Lys-vasopressin), tocinoic acid (N-terminal hexapeptide fragment of oxytocin),
      and MSH release-inhibiting factor (MIF; C-terminal tripeptide fragment of
      oxytocin) did not show any effect on the earthworm gut motility. On the other
      hand, oxytocin, vasotocin, Arg-vasopressin, Lys-vasopressin, and tocinoic acid
      caused spontaneous contractions of isolated rat uterine preparations, where the
      potency was in this order, while annetocin and MIF exerted no oxytocic activity
      on the uterus. Dose-response relationship of the effects of annetocin and its
      related peptides on the annelid and mammalian systems shows that amino acid
      residue at the third position of these peptides is important for exertion of
      excitatory action on the smooth muscle systems. The results in the present study
      suggest that receptors for annetocin and for GABA on the earthworm gut, unlike
      those for ACh, desensitize during continuous exposure to these substances.

PMID- 7790843
TI  - Freezing of zona-free mouse embryos: characteristics of the plasma membrane and
      subsequent development of the embryos.
AB  - Frozen-thawed mouse embryos with (+ZP) and without (-ZP) zona pellucida have been
      studied at the Scanning Electron Microscope (SEM) to determine how the process
      affects the plasma membrane and the subsequent embryo development. The main
      difference observed in -ZP embryos immediately after thawing is the abnormal
      morphology and distribution of microvilli. This could explain the spontaneous
      separation of blastomeres in -ZP embryos, and the decrease in their survival
      rate. If thawed -ZP embryos are allowed to recover in culture, their plasma
      membrane characteristics and survival rate are identical to those of control
      embryos.

PMID- 7790844
TI  - Expression of osteopontin in the head process late in gastrulation in the rat.
AB  - Osteopontin (OPN) is a secreted, glycosylated phosphoprotein. Previous studies
      have implicated OPN in calcification/decalcification and inflammation. We became
      interested in developmental expression of OPN because of our previous findings
      that suggest OPN may play a role in formation of new vascular layers after
      injury, and because of our observation of developmental regulation in vascular
      smooth muscle cells. While OPN was expressed at low levels in vessels, only late
      in development, examination of very early expression patterns revealed a
      surprising finding. OPN was expressed exclusively in the head process, on day 9.0
      late in gastrulation in the rat. In vitro studies of vascular smooth muscle cells
      have previously demonstrated that OPN promotes cell adhesion and migration. It is
      suggested that OPN may promote migration of cells, during gastrulation, via
      integrins which may be present in the head process or overlying ectoderm.

PMID- 7790845
TI  - Replicating DNA does not block germinal vesicle breakdown in mouse oocytes.
AB  - Mouse germinal vesicle GV-G2 stage oocytes were fused to very early S-phase
      blastomeres from four cell stage embryos to test whether oocytes have a mechanism
      which detects replicating DNA and thereafter arrests meiosis at the GV stage. Our
      results show that oocytes are unable to recognize replicating DNA in transplanted
      nuclei and undergo germinal vesicle breakdown (GVBD). GVBD and blastomere nucleus
      breakdown are only blocked by inhibitors of both oocyte maturation and DNA
      synthesis. These results show that mouse immature oocytes do not possess a
      feedback control capable of detecting replicating DNA.

PMID- 7790846
TI  - Effects of relative area on matching heterochromatic stimuli for saturation.
AB  - Participants adjusted the saturation of one rectangular color stimulus so that it
      appeared to match the saturation of another rectangular color stimulus for
      stimulus pairs of different relative areas. In Experiment 1, in which stimuli of
      complementary colors were used, higher saturation stimuli were consistently
      chosen for large areas to match lower saturation stimuli in smaller areas. In
      Experiment 2, better saturation matches were obtained if participants fixated and
      the stimuli were presented for very brief durations. In Experiment 3, larger
      color contrast effects were obtained with hue pairs that were nearer to
      complementary than with hue pairs that were more nearly the same. These findings
      agree with the interpretation that biases in relative saturation selected to
      match stimuli of different relative size are largely the result of negative
      afterimages of the larger stimulus having greater impact on the apparent
      saturation of the smaller stimulus.

PMID- 7790848
TI  - Increasing- and decreasing-loudness aftereffects: asymmetrical functions for
      absolute rate of sound level change in adapting stimulus.
AB  - After exposure to a tone of decreasing sound level, participants report that a
      steady tone increases in loudness; after exposure to an increasing sound level,
      they perceive a steady tone to decrease in loudness. The increasing-loudness
      aftereffect is the more sensitive to a difference between adapting and test
      frequencies, its absolute size becoming greater than that for decreasing-loudness
      aftereffect as frequencies are made to match. Although this asymmetry may reflect
      processing differences for the two directions of sound level change, a more
      parsimonious hypothesis entails perceived increasing loudness of short steady
      tones, in conjunction with differing levels of tonal adaptation across test
      frequencies. The former explanation is supported by the present report of another
      aftereffect asymmetry: With frequency the same for both adapting and test
      stimuli, so that tonal adaptation was nearly asymptotic during testing, altering
      the absolute rate of sound level change of the adapting stimulus had a greater
      effect on the magnitude of the increasing-loudness aftereffect. The first
      hypothesis is consistent with the percussive nature of natural sounds, few of
      which are steady: most of their sound levels rise almost instantaneously and
      decrease slowly.

PMID- 7790847
TI  - Feeling the parts: a developmental study of separable perception with tactile
      dimensions.
AB  - A tetrad classification task was used to determine perceptual sensitivity to the
      tactile dimensions of texture, hardness, and shape in 5- and 11-year-old children
      who classified objects by touch, unaided by vision. Both age groups reliably used
      separate dimensions to group the objects. Both age-related and individual
      differences in dimensional salience were observed. Five-year-olds predominantly
      grouped objects that were identical in hardness; 11-year-olds most often grouped
      objects identical in hardness or shape. Overall (integral) similarity was not
      used reliably by any participant. Results support the differential-sensitivity
      view of cognitive development and are consistent with Garner's (1970) distinction
      between integral and separable stimulus structure, but they do not support the
      hypothesized developmental trend from integral to separable perception.

PMID- 7790849
TI  - Retrieval of inedible objects by Norway rats after habituation of gnawing:
      resistance to satiation?
AB  - Retrieval of wooden blocks by Norway rats was tested after continuous exposure to
      these objects sufficient to reduce gnawing. In two experiments rats were first
      allowed to retrieve during restricted daily trials. Then they were exposed to
      blocks in their home cages, and at some point during exposure they were retested
      in the retrieval situation. In Experiment 1, further retrieval tests were given
      beginning the day after blocks were introduced in the cages. In Experiment 2,
      rats were exposed to blocks for 100 days before they were retested for retrieval.
      In both experiments, amount of retrieval was minimally affected by exposure,
      although gnawing was significantly depressed. This contrasts with earlier work,
      which showed that habituation of gnawing in the cage was followed by a
      significant decline in retrieval. The major qualitative difference between this
      and past work was that rats in the present experiments were allowed to retrieve
      the blocks before continuous exposure to them. The author concluded that
      retrieval experience may lead to persistence of retrieval despite a decline in
      incentive value of the objects retrieved, indicated by the decline in gnawing,
      and he discusses relations to other demonstrations of persistence in the absence
      of original motivational conditions-in particular, "resistance to satiation"
      effects.

PMID- 7790850
TI  - Visual field tunneling in aviators induced by memory demands.
AB  - Aviators are required rapidly and accurately to process enormous amounts of
      visual information located foveally and peripherally. The present study,
      expanding upon an earlier study (Williams, 1988), required young aviators to
      process within the framework of a single eye fixation a briefly displayed
      foveally presented memory load while simultaneously trying to identify common
      peripheral targets presented on the same display at locations up to 4.5 degrees
      of visual angle from the fixation point. This task, as well as a character
      classification task (Williams, 1985, 1988), has been shown to be very difficult
      for nonaviators: It results in a tendency toward tunnel vision. Limited
      preliminary measurements of peripheral accuracy suggested that aviators might be
      less susceptible than nonaviators to this visual tunneling. The present study
      demonstrated moderate susceptibility to cognitively induced tunneling in aviators
      when the foveal task was sufficiently difficult and reaction time was the
      principal dependent measure.

PMID- 7790852
TI  - Identification of new oligodendrocyte- and myelin-specific genes by a
      differential screening approach.
AB  - We have isolated several new genes that are specifically expressed by
      oligodendrocytes in the CNS. This was achieved by differential screening of a rat
      spinal cord cDNA library with probes derived from normal and from oligodendrocyte
      free spinal cord mRNAs. Four of these genes are exclusively expressed by
      oligodendrocytes: Three of these are not related to known genes, whereas one
      encodes the myelin oligodendrocyte glycoprotein (MOG). Four other genes are
      expressed by oligodendrocytes as well as by Schwann cells. One gene codes for
      apolipoprotein D, which is thought to be involved in lipid metabolism. A second
      cDNA sequence codes for the recently identified galactosylceramide-synthesizing
      enzyme UDP-galactose:ceramide galactosyltransferase. The third gene encodes a
      small protein with four putative transmembrane domains that is related to a T
      lymphocyte-specific membrane protein, MAL. The fourth gene encodes the rat
      homologue of the stearyl-CoA-desaturase 2 (SCD2) gene, which is specifically
      expressed in the nervous system and involved in the synthesis and regulation of
      long-chain unsaturated fatty acids essential for myelination. Finally, we found
      that a member of the beta-tubulin family is highly expressed in oligodendrocytes
      as well as neurons. The identification of several new proteins that may play a
      role in myelin synthesis and sheath formation will lead to new insight into this
      complex mechanism.

PMID- 7790851
TI  - Vasoactive intestinal peptide and pituitary adenylate cyclase-activating
      polypeptide potentiate c-fos expression induced by glutamate in cultured cortical
      neurons.
AB  - Previous reports have demonstrated that glutamate stimulates c-fos mRNA
      expression in primary cultures of mouse cerebral cortical neurons. We show here
      that vasoactive intestinal peptide (VIP) induces c-fos mRNA expression; however,
      this effect of VIP is completely inhibited by the noncompetitive NMDA receptor
      antagonist MK-801, therefore indicating that VIP stimulates c-fos expression in a
      glutamate-dependent manner. A similar effect was observed with pituitary
      adenylate cyclase-activating polypeptide27 (PACAP27). At the intracellular level,
      coactivation of protein kinases A and C mediates the glutamate-dependent
      stimulation of c-fos expression evoked by VIP, because either H-89 or
      staurosporin inhibits the effect of VIP as well as that of glutamate. These
      results point to a "biochemical AND gate" mechanism, which implies the obligatory
      activation of both protein kinases A and C in the transduction of c-fos
      expression. In summary, this article provides evidence that VIP and PACAP27
      potentiate the effect of glutamate, the principal effector on c-fos expression,
      suggesting that both peptides can increase the "throughput" or "strength" of
      glutamate-containing circuits in the cerebral cortex.

PMID- 7790853
TI  - Allosteric interactions among agonists and antagonists at 5-hydroxytryptamine3
      receptors.
AB  - Cooperation in the action of agonists suggests that there are multiple binding
      sites on 5-hydroxytryptamine3 (5-HT3) receptors. The purpose of this study was to
      characterize these binding sites and their interactions on both native and cloned
      5-HT3 receptors. The affinities of competitive 5-HT3 receptor antagonists were
      similar regardless of whether the receptors were labeled with [3H]RS-42358,
      [3H]granisetron, or 1-(m-[3H]chlorophenyl)biguanide ([3H]mCPG). By contrast, the
      affinities of the agonists 5-HT, mCPG, and phenylbiguanide were approximately 10
      fold higher when the receptors were labeled with [3H]mCPG. The dissociation of
      [3H]mCPG, [3H]RS-42358, and [3H]RS-25259, but not [3H]granisetron, from both
      cloned and native 5-HT3 receptors was markedly slower in the presence of 5-HT or
      2-methyl-5-HT than in the presence of antagonists such as RS-42358. This suggests
      that the binding of these agonists to unoccupied sites on the receptor can
      increase the receptor's affinity for prebound ligands and thereby slow their
      dissociation. These data support previous indications of positive cooperation
      among multiple binding sites on both native and cloned 5-HT3 receptors, and they
      extend this idea by demonstrating that agonists can modify the interaction of
      some, but not all, antagonists with the receptor.

PMID- 7790854
TI  - Local influence of endogenous norepinephrine on extracellular dopamine in rat
      medial prefrontal cortex.
AB  - Noradrenergic and dopaminergic projections converge in the medial prefrontal
      cortex and there is evidence of an interaction between dopamine (DA) and
      norepinephrine (NE) terminals in this region. We have examined the influence of
      drugs known to alter extracellular NE on extracellular NE and DA in medial
      prefrontal cortex using in vivo microdialysis. Local application of the NE uptake
      inhibitor desipramine (1.0 microM) delivered through a microdialysis probe
      increased extracellular DA (+149%) as well as NE (+201%) in medial prefrontal
      cortex. Furthermore, desipramine potentiated the tail shock-induced increase in
      both extracellular DA (stress alone, +64%; stress + desipramine, +584%) and NE
      (stress alone, +55%; stress + desipramine, +443%). In contrast, local application
      of desipramine did not affect extracellular DA in striatum, indicating that this
      drug does not influence DA efflux directly. Local application of the alpha 2
      adrenoceptor antagonist idazoxan (0.1 or 5.0 mM) increased extracellular NE and
      DA in medial prefrontal cortex. Conversely, the alpha 2-adrenoceptor agonist
      clonidine (0.2 mg/kg; i.p.) decreased extracellular NE and DA in medial
      prefrontal cortex. These results support the hypothesis that NE terminals in
      medial prefrontal cortex regulate extracellular DA in this region. This
      regulation may be achieved by mechanisms involving an action of NE on receptors
      that regulate DA release (heteroreceptor regulation) and/or transport of DA into
      noradrenergic terminals (heterotransporter regulation).

PMID- 7790856
TI  - Effects of chronic lithium treatment on agonist-enhanced extracellular
      concentrations of cyclic AMP in the dorsal hippocampus of freely moving rats.
AB  - Studies on brain slices and homogenates suggest that chronic lithium treatment
      affects the activity of adenylate cyclases in the brain. To investigate whether
      chronic lithium administration influences the cyclic AMP (cAMP) synthesis in
      vivo, we have used microdialysis to assess lithium-induced alterations in
      extracellular concentrations of cAMP in the dorsal hippocampus of freely moving
      rats. Local infusion of noradrenaline or forskolin through the microdialysis
      probes produced rapid increases in the extracellular concentrations of cAMP in
      the dorsal hippocampus. Lithium administration for 4 weeks (serum lithium
      concentration of 0.8 +/- 0.11 mmol/L) did not affect the baseline levels of cAMP.
      However, in rats fed a lithium-supplemented diet, noradrenaline- and forskolin
      induced enhancement of cAMP levels was decreased in the dorsal hippocampus. The
      rats were video-taped 18 min before and 27 min after initiating the introduction
      of noradrenaline and forskolin into the dorsal hippocampus. The infusion of
      agonists induced a moderate behavioural excitation. Rats treated with lithium
      were less active compared with the control rats. Taken together, these data
      confirm that chronic lithium administration affects the cAMP signaling system in
      the brain of living animals, presumably by interfering with a site beyond the
      receptor level.

PMID- 7790855
TI  - Differential regulation of D1 dopamine receptor- and of A2a adenosine receptor
      stimulated adenylyl cyclase by mu-, delta 1-, and delta 2-opioid agonists in rat
      caudate putamen.
AB  - Inhibition and stimulation of adenylyl cyclase by opioid and D1 dopamine or A2a
      adenosine agonists, respectively, were characterized in the caudate putamen of
      rats. D1 dopamine receptors have been reported to be localized preferentially on
      striatonigral neurons and A2a adenosine receptors on striatopallidal neurons. The
      aim of the present study was to evaluate the effects of mu-[Tyr-D-Ala-Gly-(N
      Me)Phe-Gly-ol (DAMGO)], delta 1-[Tyr-D-Pen-Gly-Phe-D-Pen (DPDPE)], and delta 2-
      ([D-Ala2]deltorphin-II [DT-II]) opioid agonists on the D1 dopamine receptor- and
      A2a adenosine receptor-stimulated adenylyl cyclase in membranes from rat caudate
      putamen. The results show that DAMGO, DPDPE, and DT-II inhibit forskolin
      stimulated adenylyl cyclase [selectively antagonized by D-Phe-Cys-Tyr-D-Trp-Orn
      Thr-Pen-Thr-NH2 (CTOP; mu antagonist), 7-benzylidenenaltrexone (BNTX; delta 1
      antagonist), and naltriben (NTB; delta 2 antagonist), respectively], but only mu-
      and delta 2-opioid agonists inhibit D1 dopamine-stimulated adenylyl cyclase
      (antagonized by CTOP and NTB, respectively). Furthermore, DT-II and DPDPE inhibit
      A2a adenosine-stimulated adenylyl cyclase (antagonized by NTB and BNTX,
      respectively), whereas DAMGO did not inhibit A2a adenosine-stimulated adenylyl
      cyclase activity. These results suggest that mu-, delta 1-, and delta 2-opioid
      receptors display differential localization and provide neurochemical evidence
      suggesting the differential location of the delta 1 and delta 2 subtypes. mu
      Opioid receptors may be preferentially expressed by striatonigral neurons, delta
      1-by striatopallidal neurons, and delta 2-by these two striatal efferent neuron
      populations.

PMID- 7790857
TI  - Receptor-mediated desensitisation of histamine H1 receptor-stimulated inositol
      phosphate production and calcium mobilisation in GT1-7 neuronal cells is
      independent of protein kinase C.
AB  - GT1-7 cells, a clonal line derived from specific tumours of gonadotropin
      releasing hormone-secreting neurons from mouse hypothalamus, were used as a model
      system to investigate the cellular mechanisms underlying the histamine H1
      receptor-mediated desensitisation. GT1-7 cells contain H1 receptors, acute
      stimulation of which leads to the desensitisation of histamine-mediated calcium
      mobilisation and is manifest as a concurrent reduction in both the magnitude of
      the calcium transient and of the sustained phase. Acute pretreatment of the cells
      with the phorbol ester, phorbol 12-myristate 13-acetate, can also ablate the
      histamine-stimulated calcium mobilisation. In addition, acute H1-receptor
      stimulation and acute phorbol ester treatment result in the attenuation of
      histamine-mediated inositol phosphate production. Receptor desensitisation
      resulting from acute stimulation with histamine is not affected by inhibiting
      protein kinase C (PKC) activity with Ro 31-7549 or staurosporine. In contrast,
      the desensitisation of H1-receptor responses induced by direct activation of
      protein kinase C is preventable by PKC inhibitors. Thus, these results imply that
      a PKC-dependent mechanism and PKC-independent mechanism are involved in the H1
      receptor desensitisation cascade in GT1-7 cells and do not support the
      involvement of PKC in the receptor-mediated desensitisation of H1 receptor
      stimulated calcium and inositol phosphate responses.

PMID- 7790858
TI  - Demonstration of kappa 3-opioid receptors in the SH-SY5Y human neuroblastoma cell
      line.
AB  - In addition to the mu- and delta-opioid receptors previously reported, the SH
      SY5Y human neuroblastoma cell line has high levels of kappa 3 receptors,
      accounting for 40% of total opioid binding, as measured with [3H]-diprenorphine
      binding. Competition studies reveal binding profiles for all three receptor
      classes that are similar to those observed in brain membranes. Differentiation
      with retinoic acid increases the levels of opioid receptor binding in the cell
      line, with the largest elevations in kappa 3 binding. Fully 75% of the increased
      binding corresponds to kappa 3 sites, which represent 50% of total opioid
      receptor binding in differentiated cells. Morphine inhibits forskolin-stimulated
      cyclic AMP accumulation, and this effect is readily blocked by the mu antagonist
      D-Phe-Cys-Tyr-D-Trp-Arg-Thr-Pen-Thr-NH2 (CTAP). Naloxone benzoylhydrazone, a
      kappa 3 agonist, inhibits forskolin-stimulated cyclic AMP accumulation more
      potently than morphine and is not reversed by CTAP. These studies indicate that
      SH-SY5Y cells contain high levels of functional kappa 3 receptors.

PMID- 7790860
TI  - Biochemistry of somatodendritic dopamine release in substantia nigra: an in vivo
      comparison with striatal dopamine release.
AB  - The somatodendritic release of dopamine in substantia nigra previously has been
      suggested to be nonvesicular in nature and thus to differ from the classical,
      exocytotic release of dopamine described for the dopaminergic nerve terminal in
      striatum. We have compared the effects of reserpine, a compound that disrupts
      vesicular sequestration of monoamines, on the storage and release of dopamine in
      substantia nigra and striatum of rats. Reserpine administration (5 mg/kg, i.p.)
      significantly decreased the tissue level of dopamine in substantia nigra pars
      reticulata, substantia nigra pars compacta, and striatum. In these brain areas,
      reserpine-induced reductions in tissue dopamine level occurred within 2 h and
      persisted at 24 h postdrug. In vivo measurements using microdialysis revealed
      that reserpine administration rapidly decreased the extracellular dopamine
      concentration to nondetectable levels in substantia nigra as well as in striatum.
      In both structures, it was observed that reserpine treatment significantly
      attenuated the release of dopamine evoked by a high dose of amphetamine (10
      mg/kg, i.p.) given 2 h later. In contrast, dopamine efflux in response to a low
      dose of amphetamine (2 mg/kg, i.p.) was not altered by reserpine pretreatment
      either in substantia nigra or in striatum. The present data suggest the
      existence, both at the somatodendritic and at the nerve terminal level, of a
      vesicular pool of dopamine that is the primary site of transmitter storage and
      that can be displaced by high but not low doses of amphetamine. The physiological
      release of dopamine in substantia nigra and in striatum is dependent on the
      integrity of this vesicular store.

PMID- 7790859
TI  - Characterization of NMDA receptor subunit-specific antibodies: distribution of
      NR2A and NR2B receptor subunits in rat brain and ontogenic profile in the
      cerebellum.
AB  - Selective antisera for NMDA receptor subunits NR2A and NR2B have been developed.
      Each antiserum identifies a single band on an immunoblot at approximately 175 kDa
      that appears to be the appropriate subunit of the NMDA receptor. Using these
      antisera the relative densities of the subunits in eight areas of adult rat brain
      have been determined. The NR2A subunit was found to be at its highest level in
      hippocampus and cerebral cortex, to be at intermediate levels in striatum,
      olfactory tubercle, mid-brain, olfactory bulb, and cerebellum, and to be at
      lowest levels in the pons-medulla. The NR2B subunit was found to be expressed at
      its highest levels in the olfactory tubercle, hippocampus, olfactory bulb, and
      cerebral cortex. Intermediate levels were expressed in striatum and mid-brain,
      and low levels were detected in the pons-medulla. No signal for NR2B was found in
      the cerebellum. These regional distributions were compared with that for [3H]MK
      801 binding sites. It was found that although the distribution of the NR2A
      subunit corresponds well with radioligand binding, the distribution of the NR2B
      subunit does not. The ontogenic profiles of NR2A and NR2B subunits in the rat
      cerebellum were also determined. Just following birth [postnatal day (P) 2] NR2A
      subunits are undetectable, whereas NR2B subunits are expressed at amounts easily
      measurable. Beginning at about P12 the levels of NR2A rise rapidly to reach adult
      levels by P22. At the same time (P12), levels of NR2B protein begin to decline
      rapidly to reach undetectable levels by 22 days after birth.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7790861
TI  - In vivo assessment of dopamine uptake in rat medial prefrontal cortex: comparison
      with dorsal striatum and nucleus accumbens.
AB  - In vivo electrochemistry was used to characterize dopamine clearance in the
      medial prefrontal cortex and to compare it with clearance in the dorsal striatum
      and nucleus accumbens. When calibrated amounts of dopamine were pressure-ejected
      into the cortex from micropipettes adjacent to the recording electrodes,
      transient and reproducible dopamine signals were detected. The local application
      of the selective uptake inhibitors GBR-12909, desipramine, and fluoxetine before
      the application of dopamine indicated that at the lower recording depths examined
      (2.5-5.0 mm below the brain surface), locally applied dopamine was cleared from
      the extracellular space primarily by the dopamine transporter. The norepinephrine
      transporter played a greater role at the more superficial recording sites (0.5
      2.25 mm below the brain surface). To compare clearance of dopamine in the medial
      prefrontal cortex (deeper sites only), striatum, and nucleus accumbens, varying
      amounts of dopamine were locally applied in all three regions of individual
      animals. The signals recorded from the cortex were of greater amplitude and
      longer time course than those recorded from the striatum or accumbens (per
      picomole of dopamine applied), indicating less efficient dopamine uptake in the
      medial prefrontal cortex. The fewer number of transporters in the medial
      prefrontal cortex may be responsible, in part, for this difference, although
      other factors may also be involved. These results are consistent with the
      hypothesis that regulation of dopaminergic function is unique in the medial
      prefrontal cortex.

PMID- 7790862
TI  - The CCK-B antagonist CI-988 increases dopamine levels in microdialysate from the
      rat nucleus accumbens via a tetrodotoxin- and calcium-independent mechanism.
AB  - CI-988, a water-soluble, selective cholecystokinin-B antagonist, was perfused
      through a microdialysis probe into the anterior nucleus accumbens, posterior
      nucleus accumbens, or caudate nucleus of anesthetized rats. High concentrations
      of CI-988 produced three- to fivefold increases in dopamine overflow, at all
      three sites, that were temporally correlated with the CI-988 perfusion and
      returned to baseline levels upon cessation of CI-988 perfusion. However, the
      cholecystokinin-A antagonist CAM-1481, and the relatively inactive enantiomer of
      CI-988, CAM-1241, also increased dopamine overflow in the nucleus accumbens.
      Furthermore, the ability of CI-988 to increase dopamine overflow persisted in the
      absence of calcium in the perfusate and was not sensitive to tetrodotoxin
      treatment. The mechanism by which locally administered CI-988 increases dopamine
      overflow appears not to be anatomically specific, not selective for one
      cholecystokinin receptor subtype, and may be nonvesicular.

PMID- 7790863
TI  - The intracellular component of cellular 3-(4,5-dimethylthiazol-2-yl)-2, 5
      diphenyltetrazolium bromide (MTT) reduction is specifically inhibited by beta
      amyloid peptides.
AB  - In vitro cell culture model systems for investigating the biochemical mechanisms
      involved in the neurodegenerative actions of beta-amyloid peptide (beta-AP) have
      been established. Using rat pheochromocytoma PC12 or human epitheloid HeLa cell
      lines, submicromolar concentrations of the beta-AP fragments beta 1-40, beta 1
      39, and beta 25-35, but not beta 1-28, were found to inhibit the reduction of the
      redox dye 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT). In
      both cell lines, the beta-AP-sensitive component represented approximately 70% of
      total cellular MTT reduction. When the reduction of a series of structurally
      related dyes was compared with that of MTT, the reduction of 3 alpha-naphthyl-2
      phenyl-5-(4-nitrophenyl)-2H-tetrazolium chloride (NTV) was also found to be
      sensitive to beta 25-35, but that of seven other redox dyes was not. A property
      common to MTT and NTV is that they are both readily taken up into PC12 and HeLa
      cells and do not require an artificial electron coupling agent to be reduced.
      Microscopic analysis of MTT-formazan product formation in PC12 and HeLa cells
      following beta 25-35 treatment revealed that it was the intracellular component
      of the reduction of this dye that was abolished. These results support the
      hypothesis that the cellular reduction of MTT represents a specific indicator of
      the initial events underlying the mechanism of beta-AP toxicity.

PMID- 7790864
TI  - Overexpression of the neurotrophic cytokine S100 beta in human temporal lobe
      epilepsy.
AB  - Neuritic sprouting and disturbances of calcium homeostasis are well described in
      epilepsy. S100 beta is an astrocyte-derived cytokine that promotes neurite growth
      and induces increases in levels of intracellular calcium in neurons. In sections
      of neocortex of surgically resected temporal lobe tissue from patients with
      intractable epilepsy, we found that the number of S100 beta-immunoreactive
      astrocytes was approximately threefold higher than that found in control patients
      (p < 0.001). These astrocytes were activated, i.e., enlarged, and had prominent
      processes. Temporal lobe tissue levels of S100 beta were shown by ELISA to be
      fivefold higher in 21 epileptics than in 12 controls (p < 0.001). The expression
      of the astrocyte intermediate filament protein, glial fibrillary acidic protein,
      was not significantly elevated in epileptics, suggesting a selective up
      regulation of S100 beta expression. Our findings, together with established
      functions of S100 beta, suggest that this neurotrophic cytokine may be involved
      in the pathophysiology of epilepsy.

PMID- 7790866
TI  - Glucose regulates glutamate-evoked arachidonic acid release from cultured
      striatal neurons.
AB  - L-Glutamate stimulates the liberation of arachidonic acid from mouse striatal
      neurons via the activation of N-methyl-D-aspartic acid (NMDA) receptors and by
      the joint stimulation of alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate
      (AMPA) and metabotropic receptors. In this study, we investigated whether
      starving cultured mouse striatal neurons of glucose would modify glutamatergic
      receptor-mediated arachidonic acid release. Glucose deprivation for 30 min led to
      enhancement of the NMDA-evoked release of arachidonic acid, compared with that
      observed in the presence of glucose. This enhanced response depended on both the
      concentration of glucose and the length of time of glucose deprivation. The
      enhanced NMDA response appeared to result from both a release of glutamate and
      the subsequent additional release of arachidonic acid due to the activation of
      AMPA and metabotropic receptors. Indeed, the increased NMDA response was
      completely reversed when extracellular glutamate was enzymatically removed.
      Moreover, glucose deprivation potentiated the combined AMPA/metabotropic receptor
      evoked release of arachidonic acid, even in the absence of extracellular
      glutamate. However, removing glucose did not improve the calcium rise induced by
      AMPA or NMDA. The ATP-evoked release of arachidonic acid from striatal astrocytes
      was not altered by glucose starvation. In summary, glucose deprivation affected
      two properties of striatal neurons: (a) it induced an NMDA-evoked release of
      glutamate from striatal neurons and (b) it selectively potentiated the
      AMPA/(1S,3R)-1-aminocyclopentane-1,3-dicarboxylic acid-evoked release of
      [3H]arachidonic acid without altering the authentic NMDA-mediated response.

PMID- 7790865
TI  - The 3' flanking region of the human tyrosine hydroxylase gene directs reporter
      gene expression in peripheral neuroendocrine tissues.
AB  - Cell type-specific expression of the catecholamine synthetic enzyme, tyrosine
      hydroxylase (TH), appears to be mediated in part by cis-acting elements located
      at the 3' end of the human gene. Further delineation of this region indicated
      sequences corresponding to a CACGTG motif significantly stimulated transcription
      of a heterologous promoter in various cell types. Mutation of this site led to a
      complete loss of activity. DNase footprinting, gel retardation, and UV cross
      linking experiments indicated that a 74-kDa cellular factor(s) bound specifically
      to the CACGTG motif in the pheochromocytoma cell line PC12. The size of this
      protein and its pattern of expression are compatible with those of the CACGTG
      binding protein TFE3. Transgenic animals were created using a 261-bp human TH 3'
      fragment encompassing the CACGTG motif in front of a thymidine kinase
      promoter/chloramphenicol acetyltransferase reporter gene. In three lines of mice
      this fragment was sufficient to direct a pattern of mRNA expression in peripheral
      neuroendocrine tissues that mimicked TH mRNA distribution. However, these
      sequences were not sufficient for CNS-specific patterns of expression. Thus,
      multiple cell type-specific enhancers may regulate TH gene expression in the CNS
      and periphery.

PMID- 7790868
TI  - Influence of perfusate glucose concentration on dialysate lactate, pyruvate,
      aspartate, and glutamate levels under basal and hypoxic conditions: a
      microdialysis study in rat brain.
AB  - The aim of this study was to evaluate the influence of perfusion media with
      different glucose concentrations on dialysate levels of lactate, pyruvate,
      aspartate (Asp), and glutamate (Glu) under basal and hypoxic conditions in rat
      brain neocortex. Intracerebral microdialysis was performed with the rat under
      general anesthesia using bilateral probes (o.d. 0.3 mm; membrane length, 2 mm)
      perfused with artificial CSF containing 0.0 and 3.0 mM glucose, respectively.
      Basal dialysate levels were obtained 2 h after probe implantation in artificially
      ventilated animals. Dialysate levels of glucose were also measured for the two
      different perfusion fluids. The mean absolute extracellular concentration of
      glucose was estimated by a modification of the no-net-flux method to be 3.3
      mmol/L, corresponding to an average in vivo recovery of 6% for glucose. Hypoxia
      was induced by lowering the inspired oxygen concentration to 3%. Hypoxia caused a
      disturbance of cortical electrical activity, evidenced by slower frequency and
      lower amplitudes on the electroencephalogram compared with prehypoxic conditions.
      This was associated with significant elevations of lactate, Asp, and Glu levels.
      There were no statistically significant difference in dialysate metabolite levels
      between the two perfusion fluids, during either normal or hypoxic conditions. We
      conclude that microdialysis with glucose-free perfusion fluid does not drain
      brain extracellular glucose in anesthetized rats to the extent that the dialysate
      lactate, pyruvate, Asp, and Glu levels during basal or hypoxic conditions are
      altered.

PMID- 7790869
TI  - Effect of development of habituation to restraint stress on hypothalamic
      noradrenaline release and adrenocorticotropin secretion.
AB  - The effect of repeated stress has been studied on noradrenaline release in the
      hypothalamic paraventricular nucleus and on adrenocorticotropin levels. Rats were
      stressed by 20-min immobilization once a day for 5 days. On day 6 they were
      exposed to the same stress or to a different one (ether vapors for 2 min).
      Immobilization and ether stress increased noradrenaline release in naive rats
      (271 +/- 43 and 197 +/- 9%, respectively) and raised adrenocorticotropin levels,
      showing activation of the hypothalamus-pituitary axis. Repeated daily restraint
      did not modify basal noradrenaline or adrenocorticotropin levels. The further
      immobilization session on day 6 did not change noradrenaline levels at any
      observation time (20-120 min). The adrenocorticotropin response was still
      present, although significantly reduced. In repeatedly restrained rats, exposure
      to ether vapors induced a maximal increase in noradrenaline level similar to that
      observed in naive rats, although prolonged. In these rats the adrenocorticotropin
      response did not differ from that in acutely stressed rats. These results suggest
      that habituation may develop to a stressful stimulus leading to suppression of
      the hypothalamic noradrenergic response and that this phenomenon is stress
      specific. Moreover, modifications of noradrenaline release in the paraventricular
      nucleus are not solely responsible for the adrenocorticotropin response during
      stress, suggesting that other pathways and/or neurotransmitters are involved too.

PMID- 7790867
TI  - Effect of acute fluoxetine treatment on the brain serotonin synthesis as measured
      by the alpha-methyl-L-tryptophan autoradiographic method.
AB  - The effect of treatment with acute fluoxetine, a serotonin reuptake inhibitor, on
      the rate of serotonin synthesis in the rat brain was studied through
      autoradiography following intravenous administration of alpha-methyl-L
      [3H]tryptophan. The rate of serotonin synthesis in fluoxetine-treated rats was
      compared with the rate measured in sham-treated rats (saline injection). Results
      showed a significant increase in the rate of synthesis in the majority of
      cerebral structures examined. The greatest increase (given as a percentage of
      rates in control animals) in the rate of serotonin synthesis was observed in the
      substantia nigra compacta (344%), hippocampus-CA3 (337%), dorsal hippocampus
      (283%), and caudate-putamen (232%). Fluoxetine had a less significant effect on
      the rate of synthesis in the pineal body (44%). Data suggest that acute
      fluoxetine treatment (30 mg/kg, i.p.) enhances the rate of serotonin synthesis in
      all the structures of rat brain examined in this work.

PMID- 7790870
TI  - Effect of acute stress on hippocampal glutamate levels and spectrin proteolysis
      in young and aged rats.
AB  - Aging in rats is associated with a loss of hippocampal neurons, which may
      contribute to age-related cognitive deficits. Several lines of evidence suggest
      that stress and glucocorticoids may contribute to age-related declines in
      hippocampal neuronal number. Excitatory amino acids (EAAs) have been implicated
      in the glucocorticoid endangerment and stress-induced morphological changes of
      hippocampal neurons of young rats. Previously, we have reported that acute
      immobilization stress can increase extracellular concentrations of the endogenous
      excitatory amino acid, glutamate, in the hippocampus. The present study examined
      the effect of an acute bout of immobilization stress on glutamate levels in the
      hippocampus and medial prefrontal cortex of young (3-4-month) and aged (22-24
      month) Fischer 344 rats. In addition, the effect of stress on spectrin
      proteolysis in these two brain regions was also examined. Spectrin is a
      cytoskeleton protein that contributes to neuronal integrity and proteolysis of
      this protein has been proposed as an important component of EAA-induced neuronal
      death. There was no difference in basal glutamate levels between young and old
      rats in the hippocampus or medial prefrontal cortex. During the period of
      restraint stress a modest increase in glutamate levels in the hippocampus of
      young and aged rats was observed. After the termination of the stress procedure,
      hippocampal glutamate concentrations continued to rise in the aged rats, reaching
      a level approximately five times higher than the young rats, and remained
      elevated for at least 2 h after termination of the stress. A similar pattern was
      also observed in the medial prefrontal cortex with an augmented post-stress
      induced glutamate response observed in the aged rats.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7790871
TI  - Investigation into the role of N-acetylaspartate in cerebral osmoregulation.
AB  - Marked abnormalities of the magnetic resonance intensity of N-acetylaspartate
      (NAA) have been reported in patients with various neurological disorders, but the
      neurochemical consequences of these alterations are difficult to assess because
      the function of NAA remains speculative. The purpose of this study was to examine
      whether NAA plays a role in protecting neurons against osmotic stress.
      Intracerebral microdialysis was used to expose a small region of the rat
      dorsolateral striatum to an increasingly hyposmotic environment and to measure
      resulting changes in NAA extracellular concentrations. NAA changes in the
      extracellular fluid (ECF) were compared with those of the amino acids, in
      particular, taurine, known to be involved in brain osmoregulation. Stepped
      increases in cellular hydration produced by hyposmotic perfusion media induced a
      marked increase in ECF NAA, reflecting a redistribution of NAA from intra-to
      extracellular space. Parallel experiments showed that, of all the extracellular
      amino acids measured, only taurine markedly increased with hyposmolar perfusion
      medium, indicating that the ECF NAA increase associated with hyposmotic stress
      was a specific response and not passive leakage out of the cells. As NAA is
      predominantly neuronal, it may contribute to the protection of neurons against
      swelling (i.e., regulatory volume decrease). In conditions with impaired blood
      brain barrier and cytotoxic oedema, efflux of intracellular NAA subsequent to
      sustained cellular swelling might lead to a reduction in total brain NAA
      detectable by magnetic resonance spectroscopy. Alternatively, redistribution of
      NAA from intra-to extracellular space implies changes in its chemical environment
      that may alter its magnetic resonance visibility.

PMID- 7790872
TI  - Direct detection of ascorbyl radical in experimental brain injury: microdialysis
      and an electron spin resonance spectroscopic study.
AB  - To examine the role played by free radicals in brain injury, we performed
      experiments to detect radicals in the frontal cortex of rats, using electron spin
      resonance (ESR) and microdialysis. A dialysis probe was inserted into the frontal
      cortex, and spin adducts in perfusates were immediately detected by ESR. We
      obtained a relatively stable doublet signal, with parameters of g = 2.0057 and aH
      = 0.17 mT. This signal corresponded with that of the ascorbyl radical. Ascorbyl
      radical in the perfusate collected from the frontal cortex was augmented by
      microinjection of H2O2 and FeCl2 adjacent to the dialysis probe. When the rats
      were challenged with cold-induced brain injury, ascorbyl radical and lactate
      dehydrogenase (LDH) level in the perfusate increased significantly. Pretreatment
      with superoxide dismutase and catalase attenuated the increase in ascorbyl
      radical and LDH level induced by the cold injury. Infusion of FeCl2 dissolved in
      perfusate caused a pronounced increase in ascorbyl radical and LDH level after
      the cold injury. We conclude that the direct detection of free radical formation
      further supports the hypothesis that free radicals play an important role in
      traumatic brain injury. Our findings also indicate that combined microdialysis
      with ESR spectroscopy is a useful in vivo method for monitoring free radical
      production in the brain.

PMID- 7790875
TI  - Resiniferatoxin-amide and analogues as ligands for protein kinase C and vanilloid
      receptors and determination of their biological activities as vanilloids.
AB  - The naturally occurring diterpene resiniferatoxin (RTX) is an ultrapotent
      analogue of capsaicin. Acting on polymodal afferent neurons, RTX induces a
      generally similar pattern of responses as does capsaicin. However, the two
      compounds, as well as other vanilloid derivatives, display different relative
      potencies for different responses. In the present study, we examined the
      vanilloid-like activities of two new derivatives, the amide analogue of RTX and
      phorbol 12,13-dibenzoate 20-homovanillylamide. Structurally, RTX-amide resembles
      capsaicin more closely than does RTX, and after cleavage of the amide bond the
      resulting amine would be predicted to not bind to protein kinase C in contrast to
      resiniferonol 9,13,14-orthophenylacetate, the parent diterpene of RTX. In
      contrast to our expectations the binding potency of the RTX-amide for the
      vanilloid receptor present in rat spinal cord was 450-fold lower than that of RTX
      (Ki values for the RTX-amide and RTX were 10.4 +/- 0.7 nM and 23.1 +/- 3.2 pM,
      respectively). In the case of phorbol 12,13-dibenzoate 20-homovanillylamide,
      there was a further loss of affinity for the vanilloid receptor compared with
      RTX; nonetheless, the Ki (8.56 +/- 0.61 microM) was comparable with that of
      capsaicin (5.31 +/- 0.37 microM). Computer fitting of the binding data yielded
      Hill coefficient values of 2.25 +/- 0.03, 2.33 +/- 0.03, and 1.84 +/- 0.05 for
      RTX, RTX-amide, and phorbol 12,13-dibenzoate 20-homovanillylamide, respectively,
      indicating that both new compounds induced apparent positive cooperativity among
      vanilloid binding sites.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790874
TI  - Apoptotic cell death induced by beta-amyloid 1-42 peptide is cell type dependent.
AB  - beta-Amyloid peptide (A beta), a proteolytic fragment of the beta-amyloid
      precursor protein, is a major component of senile plaques in the brain of
      Alzheimer's disease patients. This neuropathological feature is accompanied by
      increased neuronal cell loss in the brain and there is evidence that A beta is
      directly neurotoxic. In the present study reduced cell viability in four
      different neuroblastoma cell types was observed after treatment with human A beta
      1-42 for 1 day. Of the cell types tested rat PC12 and human IMR32 cells were most
      susceptible to A beta toxicity. Chromosomal condensation and fragmentation of
      nuclei were seen in PC12, NB2a, and B104 cells but not in IMR32 cells
      irrespective of their high sensitivity to A beta. Electrophoretic analysis of
      cellular DNA confirmed internucleosomal DNA fragmentation typical for apoptosis
      in all cell types except IMR32. These findings suggest that the form of A beta
      induced cell death (necrosis or apoptosis) may depend on the cell type.

PMID- 7790873
TI  - Antioxidant defense systems in the brains of type II diabetic mice.
AB  - The specific activities of superoxide dismutase, catalase, and glutathione S
      transferase (mu subtype) were significantly lower in the brains of mice with type
      II diabetes than in the brains of control mice. On the other hand, the specific
      activity of glutathione peroxidase was unaltered. The concentration of vitamin E,
      but not that of total glutathione and ascorbate, was increased in the brains of
      the type II diabetic mice. The relative amount of polyunsaturated fatty acids (as
      determined with soybean lipoxygenase) was increased in whole brains and crude
      synaptosomal membranes of the type II diabetic mice. Endogenous levels of
      thiobarbituric acid-positive material were decreased in both whole brain
      homogenates and crude synaptosomal membranes of the db/db mice. Susceptibility of
      lipids within whole brain homogenates and crude synaptosomal membranes of mice
      with type II diabetes to peroxidation with iron/ascorbate was also markedly
      decreased compared with that of controls. Vitamin E is known to quench lipid
      peroxidation. Therefore, decreased lipid peroxidation in the type II mouse brain
      may be due to increased vitamin E content.

PMID- 7790876
TI  - Characterization of cDNA and genomic clones encoding human myelin oligodendrocyte
      glycoprotein.
AB  - Myelin oligodendrocyte glycoprotein (MOG) is a transmembrane protein expressed
      only in the CNS and is a possible target autoantigen in multiple sclerosis (MS).
      To further study the association of MOG with MS, we have characterized cDNA and
      genomic clones encoding human MOG. The human MOG cDNA, like its rodent and bovine
      counterparts, encodes a mature protein containing an Ig-like domain, followed by
      two potential membrane-spanning regions. The intron-exon boundaries of the human
      MOG gene were mapped and revealed that the signal peptide is encoded by the first
      exon, the Ig-like domain of MOG is encoded on the second exon, whereas the
      remainder of the molecule is encoded by six shorter exons. In addition to the
      major cDNA species, a second class of MOG cDNA was isolated in which an intron
      was retained. Not only did this second cDNA species represent 30% of the clones
      analyzed (nine of 30), but RNA encoding this form was detectable by northern and
      reverse transcription-polymerase chain reaction analysis of the brain and spinal
      cord. Furthermore, we describe several restriction fragment length polymorphisms
      of the human MOG gene, one of which may be associated with MS susceptibility.

PMID- 7790877
TI  - Immunocytochemical analysis of axonal outgrowth in synaptotagmin mutations.
AB  - Synaptotagmin is a synaptic vesicle specific protein that binds calcium and
      phospholipids in vitro and is required for calcium-regulated fusion of synaptic
      vesicles with the presynaptic membrane. We have examined the possible requirement
      for synaptotagmin in axonal outgrowth by following neuronal development in
      Drosophila embryos deficient for the synaptotagmin gene. We find that
      synaptotagmin is expressed abundantly in axons and growth cones before synapse
      formation in wild-type embryos. Using antibodies to the intravesicular domain of
      synaptotagmin to label live embryos, we demonstrate that vesicle populations
      containing synaptotagmin actively undergo exocytosis during axonogenesis. We have
      used immunocytochemical techniques to examine the distribution of the axonal
      protein Fasciclin II, the presynaptic membrane protein syntaxin, and the synaptic
      vesicle protein cysteine string protein, in synaptotagmin null mutations. The
      distribution of these proteins is similar in wild-type and synaptotagmin mutant
      embryos, suggesting that synaptotagmin is not required for axonogenesis in the
      CNS or PNS. Based on these findings, we suggest that the molecular mechanisms
      underlying vesicular-mediated membrane expansion during axonal outgrowth are
      distinct from those required for synaptic vesicle fusion during neurotransmitter
      release.

PMID- 7790878
TI  - Effect of protein kinase C modulators on 14,15-epoxyeicosatrienoic acid
      incorporation into astroglial phospholipids.
AB  - Our previous studies have shown that 14,15-epoxyeicosatrienoic acid (14,15-EET)
      is a major product of arachidonic acid metabolism in astrocytes. The purpose of
      this study was to investigate cellular regulation of 14,15-EET incorporation,
      distribution, and metabolism in primary cultures of rat brain cortical
      astrocytes. Incorporation of 14,15-EET into astrocytes was lower (93,390 +/-
      11,121 dpm/5 x 10(6) cells) than incorporation of 8,9-EET (226,500 +/- 5,567
      dpm/5 x 10(6) cells) and arachidonic acid (321,600 +/- 1,200 dpm/5 x 10(6)
      cells). 14,15-EET was distributed in the order neutral lipids and free fatty
      acids (solvent front) >> phosphatidylcholine (PC) > phosphatidylinositol (PI) >
      phosphatidylethanolamine. In contrast, 8,9-EET and arachidonic acid were
      exclusively incorporated into PC. During incubation, astroglial epoxide hydrolase
      selectively metabolized 14,15-EET, but not 8,9-EET, to its vic-diol. Although 4
      phenylchalcone oxide, a potent inhibitor of epoxide hydrolase, completely
      inhibited 14,15-EET metabolism, a large amount of cell-incorporated radioactivity
      remained as free 14,15-EET. Long-term exposure of astrocytes to 4 beta-phorbol 12
      myristate 13-acetate (4 beta-PMA) resulted in a time-dependent incorporation of
      14,15-EET into PI but not in control cells exposed to 4 alpha-phorbol 12,13
      didecanoate. PKC down-regulation completely inhibited epoxide hydrolase
      metabolism of 14,15-EET. Following recovery of down-regulated PKC, 1 week after
      treatment with 4 beta-PMA, astrocytes regained their normal pattern of low
      incorporation of 14,15-EET. Protein kinase C (PKC) inhibition by staurosporine
      enhanced 14,15-EET incorporation without affecting its metabolism to 14,15
      dihydroxyeicosatrienoic acid.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790879
TI  - GM1 ganglioside activates the high-affinity nerve growth factor receptor trkA.
AB  - The monosialoganglioside GM1 has been shown to possess neurotrophic activity in
      vitro and in vivo and is now used as an experimental treatment for a variety of
      neurological disorders and trauma. Little is known about the mechanism of action
      used by GM1. Because GM1 appears to enhance nerve growth factor (NGF) activity,
      we have used C6trk+ cells, a derivative of C6-2B glioma cells that express the
      high-affinity receptor for NGF trkA, to determine whether the neurotrophic
      effects of GM1 occurs through induction of trkA activity. Exposure of C6trk+
      cells to NGF (10-50 ng/ml) resulted in a five- to 10-fold increase in trkA
      tyrosine phosphorylation within 5 min. Incubation of cells with GM1 resulted in a
      threefold increase in trkA phosphorylation beginning within 1 h and peaking
      between 3 and 6 h. Optimal responses to GM1 were obtained using 80-100 microM
      concentrations. Moreover, tyrosine phosphorylation of known trkA target proteins,
      such as extracellular signal-regulated kinases, and suc-associated neurotrophic
      factor-induced tyrosine-phosphorylated target, were activated upon stimulation of
      C6trk+ cells with GM1. In addition, GM1 potentiated the NGF-mediated activation
      of tyrosine phosphorylation of trkA. GM1 failed to induce phosphorylation of trkA
      and target proteins in mock transfected cells. Thus, our data demonstrate that
      GM1 mimics some of the effects of NGF and suggest that the neurotrophic
      properties of GM1 may be attributed to its activation of trkA signal
      transduction.

PMID- 7790880
TI  - Repeated administration of gamma-vinylGABA reduces rat brain glutamine synthetase
      activity.
AB  - The glutamine cycle has been proposed as a pathway in which glutamine synthesized
      in glia provides substrate for synthesis of the neurotransmitters glutamate and
      GABA as they are lost from neurons. To test whether GABA may regulate this
      pathway, the effect of elevated GABA on the glial enzyme glutamine synthetase was
      examined in rat brain. Repeated subcutaneous injections of the antiepileptic GABA
      transaminase inhibitor gamma-vinylGABA at a dose of 150 mg/kg per day for 21 days
      reduced glutamine synthetase activity by 36% in the cortex and 22% in the
      cerebellum. At 30 mg/kg per day, glutamine synthetase activity was reduced by
      9.5% in the cortex but unchanged in the cerebellum. The reductions were brain
      specific because the skeletal muscle and liver enzymes were unaffected by gamma
      vinylGABA administration. Amino acid analysis of the cortex from gamma-vinylGABA
      treated rats demonstrated a 270% increase in GABA levels after 150 mg/kg but no
      change after 30 mg/kg. GABA levels and glutamine synthetase activity were
      inversely correlated. The 150 mg/kg dose significantly lowered cortical glutamine
      and glutamate levels. The decline in brain glutamine synthetase activity with
      chronic gamma-vinylGABA administration developed gradually over time and may be
      due to the slow turnover of this enzyme in vivo.

PMID- 7790882
TI  - Iron regulation in the developing rat brain: effect of in utero ethanol exposure.
AB  - Fetal alcohol syndrome produces defects that parallel abnormalities associated
      with early iron deficiency. Hence, we examined the effects of prenatal exposure
      to ethanol on iron, transferrin, and ferritin concentrations. The subjects were
      the offspring of pregnant rats fed an ethanol-containing diet (Et), pair-fed an
      isocaloric control diet (Ct), or fed chow and water. The amounts of iron,
      transferrin, and ferritin were assessed in three CNS regions (cerebral cortex,
      subcortical forebrain, and brainstem). In all three segments of the control rats,
      iron, transferrin, and ferritin levels decreased during the first 2 postnatal
      weeks, reached a minimum during week 3, and then rose to adult levels. This
      pattern was delayed by ethanol treatment, e.g., the minimal concentrations in
      iron, transferrin, and ferritin in the Et-treated rats were achieved later (3
      days, 7 days, and 2 weeks, respectively) than they were in the Ct-treated rats.
      Ethanol-induced alterations in iron homeostasis persisted into adulthood; iron
      concentration was reduced, transferrin concentration was unaffected, and ferritin
      concentration was increased. The net result was that the timely delivery and
      bioavailability of iron were compromised by ethanol exposure. The defects in iron
      regulation are permanent and may underlie ethanol-induced abnormalities in iron
      dependent growth processes such as myelination.

PMID- 7790881
TI  - Stimulation of cyclic GMP production via a nitrosyl factor in sensory neuronal
      cultures by algesic or inflammatory agents.
AB  - Capsaicin stimulates cyclic GMP production via nitric oxide (NO) (or another
      nitrosyl factor) in dorsal root ganglion (DRG) neurons maintained in culture. The
      purpose of the present study was to characterize further capsaicin stimulation of
      cyclic GMP production in DRG cells maintained in culture, investigate other
      algesic and/or inflammatory agents for effects on cyclic GMP production, and
      examine cells responsible for NO production and cyclic GMP production. Capsaicin
      stimulation of cyclic GMP production in DRG cells was dose dependent, receptor
      mediated, and attenuated by hemoglobin. Prostaglandin E2, substance P, and
      calcitonin gene-related peptide did not affect basal, capsaicin-stimulated, or
      bradykinin-stimulated cyclic GMP production. Other inflammatory or algesic
      agents, including serotonin, histamine, ATP, glutamate, aspartate, and NMDA, did
      not affect cyclic GMP production. Pretreatment of DRG cells with
      lipopolysaccharide increased basal cyclic GMP production in neuronal but not in
      nonneuronal cultures and facilitated stimulation of cyclic GMP production by L
      arginine. Capsaicin pretreatment of neuronal DRG cultures, which destroys
      capsaicin-sensitive (small diameter) afferent neurons, attenuated capsaicin- and
      bradykinin-stimulated cyclic GMP production but did not affect basal or sodium
      nitroprusside-stimulated cyclic GMP production. These results indicate that
      capsaicin elicits production of a nitrosyl factor via capsaicin-sensitive (small
      diameter) neurons. Capsaicin evoked cyclic GMP production in nonneuronal DRG
      cultures in the presence but not in the absence of apposed neuronal DRG cultures.
      Overall, these findings suggest that specific exogenous (or endogenous)
      substances may stimulate production of a nitrosyl factor(s) by a subset of DRG
      neurons, and nitrosyl factors produced by these neurons may affect cyclic GMP
      production in neighboring neuronal or non-neuronal cells.

PMID- 7790883
TI  - Distribution of calretinin, calbindin D28k, and parvalbumin in subcellular
      fractions of rat cerebellum: effects of calcium.
AB  - The distribution of calretinin, calbindin D28k, and parvalbumin was examined in
      subcellular fractions prepared from rat cerebellum and analyzed by immunoblot.
      Calretinin was also quantified by radioimmunoassay. As expected, all three
      soluble, EF-hand calcium-binding proteins were predominantly localized in the
      cytosolic fraction. Calretinin and calbindin D28k were also detected in membrane
      fractions. Calretinin was more abundant in synaptic membrane than in microsomal
      fractions. The cerebellar microsomal fraction contained the greatest
      concentration of membrane-associated calbindin D28k. The association of
      calretinin and calbindin D28k with membrane fractions was decreased in samples
      prepared or incubated in low calcium. Quantification of calretinin in subcellular
      fractions of rat cerebellum revealed a greater amount of calretinin in cytosolic
      fractions prepared or incubated in low calcium and reduced amounts of calretinin
      in all membrane fractions incubated in low calcium with the exception of the
      mitochondrial fraction. These results imply that calretinin and calbindin D28k
      might have physiological target molecules that are associated with, or are
      components of, brain membranes.

PMID- 7790884
TI  - Degradation of dynorphin-related peptides by the puromycin-sensitive
      aminopeptidase and aminopeptidase M.
AB  - The degradation of dynorphin-related peptides by the puromycin-sensitive
      aminopeptidase and aminopeptidase M was examined using these peptides as
      alternate substrate inhibitors. Ki determinations showed that both
      aminopeptidases exhibit a higher affinity for longer dynorphin-related peptides,
      i.e., Ki for dynorphin A-17 = 23-30 nM with the Ki increasing to 25-50 microM for
      the enkephalin pentapeptides. Binding appears dependent not only on peptide
      length, but also on its sequence. With aminopeptidase M, as the peptide size
      increases from five to 10 amino acids, kcat remains relatively constant; however,
      as the peptide size increases beyond a decapeptide, kcat decreases significantly.
      With the puromycin-sensitive aminopeptidase, similar results were obtained except
      that kcat was greatest for the pentapeptide. Thus, if one considers kcat/Km as
      the relevant kinetic constant for estimating in vivo peptide hydrolysis, these
      results are consistent with the involvement of aminopeptidase M and the puromycin
      sensitive aminopeptidase in the degradation of extended dynorphin-related
      peptides.

PMID- 7790885
TI  - Rapid dephosphorylation of tau in heat-shocked fetal rat cerebral explants:
      prevention and hyperphosphorylation by inhibitors of protein phosphatases PP1 and
      PP2A.
AB  - We heat shocked 21- and 35-day-old fetal rat cerebral explants at 45 degrees C
      for 18 min and performed immunocytochemistry and immunoblot analysis of sodium
      dodecyl sulfate extracts using the monoclonal anti-tau antibodies Tau-1, Tau-5,
      Tau-46, and PHF-1 and the peroxidase-antiperoxidase technique or 125I-labeled
      protein A. Tau-1 and PHF-1 recognize nonphosphorylated and phosphorylated
      epitopes, respectively, and both Tau-5 and Tau-46 recognize phosphate-independent
      epitopes. tau immunoreactivity was confined to neurons and increased in heat
      shocked perikarya but not axons. At 0 h after heat shocking, there was
      dephosphorylation of tau exemplified by (1) faster migration of tau isoforms with
      resultant loss or attenuation of the 60- and 52-kDa tau isoforms recognized by
      all four anti-tau antibodies and concomitant accentuation of the fastest moving
      50-kDa tau isoform recognized by Tau-1, Tau-5, and Tau-46; and (2) significant
      increase in the nonphosphorylated Tau-1 epitope with resultant decreases in the
      ratio of total (phosphorylated plus nonphosphorylated) tau to nonphosphorylated
      tau and the difference of total tau minus nonphosphorylated tau. tau was
      phosphorylated back to the control level by 12 h and remained so at 24 and 48 h
      after heat shocking. Treatment of explants with cycloheximide, a protein
      synthesis inhibitor, did not prevent the heat shocking-induced dephosphorylation
      of tau. Treatment of explants with the inhibitors of protein phosphatases PP1 and
      PP2A, okadaic acid or calyculin A, produced hyperphosphorylated tau polypeptides,
      prevented the heat shocking-induced dephosphorylation of tau, and intensified the
      immunoreactivity of the neurofilament subunit H with the only
      antiphosphoneurofilament antibody that reacts with intraneuronal neurofibrillary
      tangles. In 35-day-old explants, in addition to the three 50-, 52-, and 60-kDa
      tau isoforms seen in 21-day-old explants, a 66-kDa tau polypeptide was also
      present.

PMID- 7790886
TI  - Internalization of voltage-dependent sodium channels in fetal rat brain neurons:
      a study of the regulation of endocytosis.
AB  - In fetal rat brain neurons, activation of voltage-dependent Na+ channels induced
      their own internalization, probably triggered by an increase in intracellular Na+
      level. To investigate the role of phosphorylation in internalization, neurons
      were exposed to either activators or inhibitors of cyclic AMP- and cyclic GMP
      dependent protein kinases, protein kinase C, and tyrosine kinase. None of the
      tested compounds mimicked or inhibited the effect of Na+ channel activation. An
      increase in intracellular Ca2+ concentration induced either by thapsigargin, a
      Ca(2+)-ATPase blocker, or by A23187, a Ca2+ ionophore, was unable to provoke Na+
      channel internalization. However, Ca2+ seems to be necessary because both
      neurotoxin- and amphotericin B-induced Na+ channel internalizations were
      partially inhibited by BAPTA-AM. The selective inhibitor of Ca2+/calmodulin
      dependent protein kinase II, KN-62, caused a dose-dependent inhibition of
      neurotoxin-induced internalization due to a blockade of channel activity but did
      not prevent amphotericin B-induced internalization. The rate of increase in Na+
      channel density at the neuronal cell surface was similar before and after channel
      internalization, suggesting that recycling of internalized Na+ channels back to
      the cell surface was almost negligible. Pretreatment of the cells with an
      acidotropic agent such as chloroquine prevented Na+ channel internalization,
      indicating that an acidic endosomal/lysosomal compartment is involved in Na+
      channel internalization in neurons.

PMID- 7790887
TI  - Ascorbate transport and intracellular concentration in cerebral astrocytes.
AB  - Regulation of the initial rate of uptake and steady-state concentration of
      ascorbate (reduced vitamin C) was investigated in rat cerebral astrocytes.
      Although these cells did not synthesize vitamin C, they accumulated millimolar
      concentrations of ascorbate when incubated with medium containing the vitamin at
      a level (200 microM) typical of brain extracellular fluid. Initial rate of [14C]
      ascorbate uptake and intracellular ascorbate concentration were dependent on
      extracellular Na+ and sensitive to the anion transport inhibitor sulfinpyrazone.
      Comparison of the efflux profiles of ascorbate and 2',7'-bis(carboxyethyl)-5 (or 
      6)-carboxyfluorescein from astrocytes permeabilized with digitonin localized most
      intracellular ascorbate to the cytosol. Pretreatment of astrocytes with dibutyryl
      cyclic AMP (dBcAMP) doubled their initial rate of sulfinpyrazone-sensitive
      [14C]ascorbate uptake compared with cells treated with either n-butyric acid or
      vehicle. dBcAMP also increased steady-state intracellular ascorbate concentration
      by 39%. The relatively small size of the change in astrocytic ascorbate
      concentration was explained by the finding that dBcAMP increased the rate of
      efflux of the vitamin from ascorbate-loaded cells. These results indicate that
      uptake and efflux pathways are stimulated by cyclic AMP-dependent mechanisms and
      that they regulate the cytosolic concentration of ascorbate in astrocytes.

PMID- 7790888
TI  - Lack of effects of inhibition of nitric oxide synthesis on local glucose
      utilization in the rat brain.
AB  - The effects of chronic treatment with NG-nitro-L-arginine methyl ester, a potent
      inhibitor of nitric oxide synthase activity, on local cerebral glucose
      utilization were examined in conscious rats. Intraperitoneal injections of 50
      mg/kg of the nitroarginine twice daily for 4 days have been found to result in
      almost complete inhibition of nitric oxide synthase activity in brain. Local
      cerebral glucose utilization was determined by means of the quantitative
      autoradiographic [14C]deoxyglucose method in an experimental group (n = 7) of
      rats that were treated with the nitroarginine according to this schedule and in a
      normal control group (n = 7) treated similarly with saline. The rats were
      conscious but partially restrained during the determinations of local cerebral
      glucose utilization. The nitroarginine treatment raised mean arterial blood
      pressure statistically significantly to 147 +/- 3 mm Hg (mean +/- SEM) from a
      level of 120 +/- 5 mm Hg in the saline controls (p < 0.001 by grouped t test),
      but there were no statistically significant effects on glucose utilization in any
      of 39 brain structures examined. It is concluded that nitric oxide normally
      exerts no significant influence on energy metabolism in the rat brain.

PMID- 7790889
TI  - Down-regulation of c-neu receptors by nerve growth factor in PC12 cells.
AB  - A small number of p185c-neu receptors have been found on PC12 cells. These
      receptors show some basal phosphorylation in quiescent cells. When the cells are
      treated with nerve growth factor (NGF) for a short time, some increase in
      phosphorylation is seen, mainly on serine and threonine residues, and this is
      accompanied by a slight shift in the apparent molecular weight. Epidermal growth
      factor (EGF) also increases the phosphorylation of p185c-neu, in this case on
      tyrosine residues. Neither heregulin-beta 1 nor gp30 stimulates the tyrosine
      phosphorylation of p185c-neu, and neither has a proliferative effect on the
      cells. Treatment of the cells with NGF for 5 days produces a 70-80% reduction in
      the number of p185c-neu receptors. This down-regulation does not occur when
      PC12nnr5 cells, which lack the high-affinity NGF receptor, p140trk, are treated
      with NGF. The level of p185c-neu mRNA is not altered by NGF treatment, suggesting
      that the down-regulation is due to either a translational or a posttranslational
      alteration.

PMID- 7790891
TI  - Functional comparison of D-serine and glycine in rodents: the effect on cloned
      NMDA receptors and the extracellular concentration.
AB  - We compared the activity of free D-Ser on the potentiation of cloned NMDA
      receptors with that of Gly by using a Xenopus oocyte expression system. The
      extracellular concentration of free D-Ser and Gly was further studied by means of
      microdialysis. The ED50 values of D-Ser were three to four times lower than those
      of Gly in any combination of epsilon 1, epsilon 2, epsilon 3, or epsilon 4 and
      zeta 1. Site-directed mutagenesis of zeta 1 subunits revealed that some aromatic
      residues necessary for the action of Gly affected the ED50 value of D-Ser. This
      result showed that the residues play crucial roles in the action of D-Ser. In
      vivo microdialysis of rodent brain revealed that the extracellular concentration
      of free D-Ser in the frontal cortex (6.5 microM) was high enough to saturate the
      Gly site on the NMDA receptor, but that in the cerebellum was not. These findings
      suggest that D-Ser is a candidate of the endogenous potentiator of the NMDA
      receptor in the rodent frontal cortex.

PMID- 7790890
TI  - Processing of procarboxypeptidase E into carboxypeptidase E occurs in secretory
      vesicles.
AB  - Carboxypeptidase E (CPE) functions in the posttranslational processing of
      bioactive peptides. Like other peptide processing enzymes, CPE is initially
      produced as a precursor ("proCPE") that undergoes posttranslational processing at
      a site containing five adjacent Arg residues near the N-terminus and at other
      sites near the C-terminus of proCPE. The time course of the N-terminal processing
      step suggests that this conversion occurs in either the Golgi apparatus or the
      secretory vesicles. To delineate further the site of proCPE processing,
      pulse/chase analysis was performed under conditions that block transit out of the
      Golgi apparatus (brefeldin A, carbonyl cyanide m-chlorophenylhydrazone, or 20
      degrees C) or that block acidification of vesicles (chloroquine, monensin, or
      ammonium chloride). The results of these analysis suggest that efficient proCPE
      processing requires an acidic post-Golgi compartment. To test whether known
      processing enzymes can perform this cleavage, purified proCPE was incubated with
      furin, prohormone convertase 1, or a dynorphin converting enzyme, and the
      products were analyzed on denaturing polyacrylamide gels. Furin cleaves proCPE
      within the N-terminal region, although the reaction is not very efficient,
      requiring relatively large amounts of furin or long incubation times. The other
      two peptide processing enzymes did not cleave proCPE, whereas a relatively small
      amount of secretory granule extract was able to convert proCPE into CPE. Taken
      together, these findings suggest that the conversion of proCPE into CPE occurs
      primarily in secretory vesicles.

PMID- 7790892
TI  - Expression of protein kinase C family members in the cerebral endothelial cells.
AB  - The protein kinase C (PKC) family is composed of at least four conventional
      (alpha, beta I, beta II, and gamma) and several related novel (delta, epsilon,
      eta, and zeta) isoforms with different distribution and sensitivity to Ca2+ and
      phorbol esters. The enzyme is known to be present in cerebral endothelial cells.
      We have investigated the occurrence of seven isoforms (alpha, beta, gamma, delta,
      epsilon, eta, and zeta) by using reverse transcriptase-polymerase chain reaction
      in rat brain, in a freshly isolated brain microvessel fraction, in primary
      cultures of rat brain endothelial cells, in an immortalized rat brain endothelial
      cell line, and in aortic endothelial cell cultures. Brain tissue contained all
      seven investigated isoforms. A similar expression pattern was seen in freshly
      purified microvessels, but the PKC-gamma isoform could not be detected. Primary
      cultures of endothelial cells expressed PKC-alpha, -beta, -delta, -eta, and 
      epsilon isoenzymes, whereas the immortalized cell line expressed PKC-alpha, 
      delta, -epsilon, and -eta. The rat aortic endothelium contained only PKC-alpha
      and -delta isoforms. The variety of expression patterns of PKC family members in
      endothelial cells of different type may reflect differences in the functional
      responsiveness to environmental stimuli. Because PKC has been shown to be
      involved in the regulation of the blood-brain barrier permeability, the presence
      of different isoforms may confer a sophisticated intracellular regulatory
      mechanism to the brain endothelial cells.

PMID- 7790893
TI  - Ceramide prevents neuronal programmed cell death induced by nerve growth factor
      deprivation.
AB  - We examined the ability of ceramide and sphingomyelinase (SMase) to prevent
      neuronal programmed cell death (PCD). We found that a cell-permeable ceramide
      analogue prevented neuronal PCD when applied to established sympathetic neuron
      primary cultures at the time of nerve growth factor (NGF) deprivation. Other
      amphiphilic lipids such as oleic acid failed to prevent cell death. Exogenous
      SMase also showed the same effect, probably by raising the intracellular ceramide
      level by sphingomyelin (SM) breakdown. Phosphocholine, another hydrolytic product
      of SM by SMase, did not prevent cell death. Other phospholipases, such as
      phospholipase C and phospholipase A2, could not prevent cell death. Given the
      recent findings that the SM cycle is activated to increase the intracellular
      ceramide level on NGF binding to the low-affinity NGF receptor (LNGFR) and that
      NGF binding to LNGFR suppresses apoptosis in neuronal cell lines, our results
      suggest the possibility of the SM cycle as a signaling mechanism transducing the
      PCD-preventing activity of NGF.

PMID- 7790894
TI  - Pentylenetetrazole-induced seizure up-regulates levels of microtubule-associated
      protein 1B mRNA and protein in the hippocampus of the rat.
AB  - Stimuli that evoke seizure are capable of inducing structural changes in the
      hippocampus. However, late-acting genes related to these changes have not been
      described. Administration of pentylenetetrazole (PTZ; 50 mg/kg) to rats of
      various ages evoked tonic-clonic seizures. Using RNA gel blot analysis we found
      that the level of the mRNA for microtubule-associated protein 1B (MAP1B) was
      robustly increased in the hippocampus of 3-month-old rats. The levels of MAP1B
      mRNA in hippocampus peaked at 40 h and began to decline by 72 h following PTZ
      treatment. Immunoblotting with anti-MAP1B antibody demonstrates the increase in
      content of immunoreactive proteins 40-72 h after seizure onset in the hippocampus
      of PTZ-treated rats. These results indicate that MAP1B is a sensitive indicator
      of hippocampal structural changes occurring in response to PTZ-induced seizure
      activity.

PMID- 7790896
TI  - Delayed excitotoxic neurodegeneration induced by excitatory amino acid agonists
      in isolated retina.
AB  - Evidence from in vitro studies suggests that excitotoxic neuronal degeneration
      can occur by either an acute or delayed mechanism. Studies of the acute mechanism
      in isolated chick embryo retina using histological methods indicate that this
      process is rapidly triggered by activation of glutamate receptors of either the N
      methyl-D-aspartate (NMDA) or non-NMDA subtypes. The delayed mechanism, studied
      primarily in cortical and hippocampal cell cultures prepared from embryonic
      rodent brain, requires activation of NMDA receptors. In these cell culture
      systems, stimulation of non-NMDA receptors does not rapidly trigger delayed
      neuronal degeneration, or does so only indirectly, via activation of NMDA
      receptors secondary to glutamate release. To provide a more valid basis for
      comparison of these two mechanisms, we have modified the isolated chick embryo
      retina model to permit studies of delayed as well as acute excitotoxic
      neurodegeneration. Retinas maintained for 24 h exhibited no morphological or
      biochemical signs of damage. Retinal damage was assessed by measuring lactate
      dehydrogenase (LDH) present in the medium at various times after exposure to
      agonists and normalized to total LDH in each retina. Glutamate exposure (1 mM, 30
      min) did not result in LDH release by the end of the exposure period, but LDH was
      released over the following 24 h. Briefer periods also led to substantial LDH
      release. Incubation in the presence of NMDA, or the non-NMDA agonists kainate
      (KA) or alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA), led
      rapidly to delayed LDH release.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790895
TI  - All-trans- and 9-cis-retinoic acid enhance the cholinergic properties of a murine
      septal cell line: evidence that the effects are mediated by activation of
      retinoic acid receptor-alpha.
AB  - We investigated the effects of retinoids on the cholinergic properties of a
      murine septal cell line, SN56. Treatment of the cells with all-trans-retinol
      (vitamin A), all-trans-retinal, all-trans-retinoic acid (t-RA), 9-cis-retinoic
      acid (9c-RA), or 13-cis-retinoic acid caused time- and concentration-dependent
      increases in choline acetyltransferase activity (up to 3.4-fold) and in
      intracellular acetylcholine levels (up to 2.5-fold, with respective EC50 values
      of 68, 50, 18, 15, and 56 nM). Furthermore, treatment with either t-RA or 9c-RA
      at 1 microM for 48 h resulted in an increase in the expression of choline
      acetyltransferase mRNA by threefold that of controls. These data and the presence
      of putative retinoic acid response elements in the 5' region of the murine
      choline acetyltransferase gene indicate that retinoids stimulate choline
      acetyltransferase transcription in murine cholinergic neurons. No additivity or
      synergism was observed between the effects of t-RA and 9c-RA on any of these
      cholinergic properties of SN56 cells, suggesting a common mechanism of action of
      the two retinoids. However, a combined treatment with t-RA and forskolin, which
      activates adenylate cyclase, resulted in an additive increase in acetylcholine
      content. Using an antagonist selective for the retinoic acid receptor-alpha
      subtype, Ro 41-5253, we found that the effects of t-RA and 9c-RA on acetylcholine
      levels were abolished. An agonist selective for retinoic acid receptor-alpha, Ro
      40-6055, increased acetylcholine levels to a similar extent as t-RA and 9c-RA,
      and this effect was blocked by the antagonist.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790897
TI  - gamma-Hydroxybutyric acid increases intracellular Ca2+ concentration and nuclear
      cyclic AMP-responsive element- and activator protein 1 DNA-binding activities
      through GABAB receptor in cultured cerebellar granule cells.
AB  - In primary cultures of mouse cerebellar granule cells, a brief stimulation by
      gamma-hydroxybutyric acid (GHB, 0.1-3 mM) significantly increased the
      intracellular Ca2+ concentration ([Ca2+]i) in a concentration-dependent manner.
      In addition, gel mobility assay showed that exposure of the cells to GHB also
      increased nuclear DNA-binding activity specific for the cyclic AMP-responsive
      element (CRE) and activator protein 1 (AP-1) transcriptional element in a
      concentration-dependent manner. The concentration range of GHB that increased the
      DNA-binding activity was essentially the same as the concentration range that
      elicited the increase in [Ca2+]i. The GHB-induced increases in [Ca2+]i and
      nuclear DNA-binding activity were antagonized by specific GABAB antagonists such
      as p-[3-aminopropyl]-p-diethoxymethylphosphinic acid (CGP 35 348) and 3-N-[1-(S)
      (3,4-dichlorobenzyl)ethanol-2-(S)-hydroxy-P-benzylphosphin ic acid (CGP 55 845).
      In addition, the GHB-induced increase in [Ca2+]i was abolished by pretreatment of
      the cells with islet-activating protein. Furthermore, treatment of the cells with
      1,2-bis(2'-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid tetraacetoxymethyl
      ester (BAPTA-AM) and thapsigargin blocked the GHB-induced increase in nuclear DNA
      binding activity. GHB inhibited [3H]baclofen binding to cultured cerebellar
      granule cells and mouse cerebellar membranes. These results suggest that
      stimulation of GABAB receptors by GHB activates intracellular Ca2+ stores and
      that the increased [Ca2+]i resulting from release of stored Ca2+ plays an
      important role in increasing the CRE- and AP-1 DNA-binding activities in cultured
      cerebellar granule cells.

PMID- 7790898
TI  - L1 and N-CAM antibodies trigger protein phosphatase activity in growth cone
      enriched membranes.
AB  - Triggering of the cell adhesion molecules L1 or N-CAM in a nerve growth cone
      membrane fraction from fetal rat brain with purified L1 or N-CAM or specific
      antibodies decreases the steady-state levels of protein tyrosine phosphorylation
      in the membranes. Here we report that triggering of L1 and N-CAM in the growth
      cone-enriched membrane fraction with a subset of antibodies directed against the
      extracellular region of L1 and N-CAM elicited dephosphorylation of endogenous
      protein substrates, indicating the presence of a cell adhesion molecule-activated
      phosphatase. The most prominent substrates were a membrane-associated 200-kDa
      protein and tubulin, both of which were dephosphorylated on tyrosine and
      serine/threonine residues in response to L1 or N-CAM triggering. The antibody
      induced phosphatase was inhibited by agents that blocked tyrosine and
      serine/threonine phosphatases, including sodium orthovanadate, vanadyl sulfate,
      zinc cations, heparin, and sodium pyrophosphate. Purified L1 and N-CAM fragments
      and other antibodies reacting with the extracellular region of these adhesion
      molecules did not activate the phosphatase but did inhibit tyrosine
      phosphorylation. These properties suggested that triggering of L1 and N-CAM can
      lead to either phosphatase activation or tyrosine kinase inhibition in growth
      cone membranes. These findings implicate protein phosphatases in addition to
      tyrosine kinases as components of L1 and N-CAM intracellular signaling pathways
      in growth cones.

PMID- 7790899
TI  - Uptake of L-glutamate into rat brain synaptic vesicles: effect of inhibitors that
      bind specifically to the glutamate transporter.
AB  - In this study we have described a series of new and potent inhibitors of the
      vesicular uptake of glutamate. The two most efficient inhibitors were the dyes
      Evans blue and Chicago Skye Blue 6B, which are structurally related to glutamate
      and were competitive inhibitors in the nanomolar range. The anion channel blocker
      4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (SITS) and the diuretics
      furosemide and bumetanide are inhibitors of chloride transport in other organs
      but were competitive inhibitors of glutamate and noncompetitive with respect to
      chloride ions. Evans blue, Chicago Skye Blue 6B, SITS, furosemide, and bumetanide
      are all large organic acids with two centers of negative charge and an electron
      donating group at close vicinity of the negative charge at physiological pH. The
      inhibition of the glutamate uptake with these inhibitors was noncompetitive with
      respect to Cl-. The inhibitors, therefore, probably interact directly with the
      glutamate carrier. Bafilomycin A1, which is a specific vacuolar ATPase inhibitor,
      was used as a control and inhibited the vesicular dopamine, glutamate, and GABA
      uptake to the same extent. None of the inhibitors had any effect on the plasma
      membrane carrier, which is therefore clearly different from the vesicular
      carrier.

PMID- 7790900
TI  - Critical role of the capsaicin-sensitive nerve fibers in the development of the
      causalgic symptoms produced by transecting some but not all of the nerves
      innervating the rat tail.
AB  - We investigated the role of capsaicin-sensitive small diameter fibers in the
      development of the thermal and mechanical allodynia in a new rat model for
      neuropathic pain, produced by transecting some but not all of the nerves
      innervating the tail. Capsaicin (50 mg/kg, s.c.) injected neonatally prior to the
      nerve injury produced thermal hypoalgesia in the tail the degree of which was
      variable across individual rats, presumably as a result of variable degeneration
      of the small diameter fibers. When subjected to the nerve injury, the animals
      with moderate thermal hypoalgesia exhibited signs of pain (e.g., tail flick) to
      normally innocuous mechanical stimuli applied to the tail with von Frey hairs
      (4.9 mN or 19.6 mN bending force), but not to thermal stimuli given by immersion
      of the tail into cold (4 degrees C) or warm (40 degrees C) water. The animals
      with marked thermal hypoalgesia, on the other hand, exhibited no signs of pain
      either to the mechanical or to the thermal stimuli. These results suggest that
      the capsaicin-sensitive fibers are critical in the development of both the
      mechanical and thermal allodynia. It is hypothesized that the destruction of A
      delta- and C-nociceptive fibers by capsaicin prevented activities induced in
      these fibers by the nerve injury from producing a central sensitization and thus
      allodynia.

PMID- 7790901
TI  - Somatodendritic internalization and perinuclear targeting of neurotensin in the
      mammalian brain.
AB  - Polypeptide hormones and growth factors have long been known to internalize into
      peripheral target cells as a result of their interaction with cell surface
      receptors. Studies in culture have suggested that certain neuropeptides might
      undergo a similar type of translocation in neurons. To investigate this
      possibility in adult mammalian brain, we have examined by confocal laser
      microscopy the events that follow the binding of fluorescein-tagged derivatives
      of the tridecapeptide neurotensin to basal forebrain cholinergic cells. Our
      results demonstrate a selective time- and temperature-dependent internalization
      of fluo-neurotensin in these cells. This internalization is receptor mediated,
      proceeds from the entire somatodendritic membrane of the cells, and utilizes
      endosome-like organelles which are mobilized from dendrites to perikarya and from
      the periphery of the cell to its perinuclear region. Parallel studies carried out
      on Sf9 insect cells expressing the rat neurotensin receptor from a recombinant
      baculovirus indicated that the internalization process involves receptor-ligand
      complexes and not merely the fluorescent peptide itself. These data suggest that
      receptor internalization plays a role in neuropeptide signaling in the brain and
      that it can be harnessed for selective identification of neuropeptide target
      cells.

PMID- 7790902
TI  - The postsynaptic localization of the glycine receptor-associated protein gephyrin
      is regulated by the cytoskeleton.
AB  - The mechanisms underlying the postsynaptic localization of neurotransmitter
      receptors are poorly understood. Recently, the peripheral membrane protein
      gephyrin has been shown to be essential for the formation of inhibitory glycine
      receptor clusters in cultured rat spinal cord neurons. In vitro gephyrin binds
      with high affinity to polymerized tubulin. Here, the interaction of gephyrin with
      different components of the cytoskeleton was investigated in primary cultures of
      rat spinal neurons. After treatment with alkaloids affecting the cytoskeleton,
      the morphology of post-synaptic gephyrin clusters was analyzed by confocal
      immunofluorescence microscopy. Depolymerization of microtubules by demecolcine
      reduced both the percentage of cells with postsynaptic gephyrin clusters and the
      number of clusters/cell. The size of the remaining gephyrin clusters was
      increased whereas their gephyrin density was significantly lower than under
      control conditions. Depolymerization of microfilaments by cytochalasin D in
      contrast generated smaller clusters of increased gephyrin density. Demecolcine
      also dispersed postsynaptic glycine receptor clusters as revealed by
      immunostaining with a specific monoclonal antibody. These findings support the
      view that in vivo gephyrin anchors receptor polypeptides to the cytoskeleton by a
      complex interaction with microtubules and microfilaments.

PMID- 7790903
TI  - Changes in expression and distribution of Aplysia cell adhesion molecules can
      influence synapse formation and elimination in vitro.
AB  - 5-HT or FMRFamide evoke long-lasting changes in the efficacy of sensorimotor (SN
      L7) synapses of Aplysia, structural alterations of the presynaptic sensory cell,
      and cell-specific downregulation in the distribution of the adhesion molecule
      apCAM. We examined how the cell-specific changes in apCAM might contribute to the
      formation of new presynaptic varicosities by 5-HT or the elimination of existing
      presynaptic varicosities by FMRFamide. We report that the formation of new
      sensory varicosities is directed by the presence of preexisting zones on the
      motor axon that are enriched for apCAM. Moreover, there was a further enrichment
      of apCAM levels at existing sensory varicosities contacting the motor axon
      beginning at 1 hr and lasting 24 hr after treatment with 5-HT. As was found for
      synapse formation during the early stages of cell-cell interaction, incubation
      with anti-apCAM mAb blocked the 5-HT-induced long-term changes in synaptic
      efficacy and the accompanying changes in sensory neuron structure. Long-term
      synaptic depression with FMRFamide was accompanied by an overall decline of apCAM
      levels. Treatment with FMRFamide evoked an even greater decline in apCAM levels
      at sites of sensory varicosities that preceded the structural changes and
      persisted especially at sites where sensory varicosities are eliminated. These
      results suggest that neurotransmitters evoke both cell- and site-specific changes
      in the levels of adhesion molecules that can influence either the formation or
      the elimination of presynaptic varicosities that accompany long-term
      heterosynaptic modulation of a behaviorally relevant synaptic connection.

PMID- 7790904
TI  - Individual variation and lateral asymmetry of the rat primary somatosensory
      cortex.
AB  - We have evaluated the interindividual variability and lateral symmetry of a major
      cortical area by comparing the primary somatosensory cortex (S1) of adult rats.
      Our choice of the rat was dictated by the accuracy with which one can measure S1
      and its component representations in the rodent brain; the importance of such
      measurements lies in understanding the rules that govern the allocation of
      cortical space and, ultimately, the consequences of differential allocation for
      behavior. With respect to interindividual differences, the major somatic
      representations in S1 are surprisingly variable in size. The area of the
      whiskerpad representation, for example, ranged from 3.72 to 6.84 mm2 in a sample
      of 53 rats; other components of S1 showed comparable differences among animals.
      With respect to lateral symmetry, the average area of each major representation
      was similar for the right and left hemispheres; thus, we found no consistent bias
      in the size of S1 or its elements in the sample as a whole. Within individual
      animals, however, the sizes of the major somatic representations were often quite
      different in the two hemispheres. The magnitude of the lateral differences
      averaged 7.9 +/- 0.8% (mean +/- SEM) for the whisker pad representation, 11.6 +/-
      1.3% for the upper lip, 15.4 +/- 1.6% for the furry buccal pad, 13.9 +/- 1.4% for
      the lower jaw, and 13.3 +/- 1.2% for the forepaw. These results show that the
      amount of cortical space allocated to corresponding functions in individual rats-
      or in the two hemispheres of a particular rat--are often different. Such
      variations are likely to be reflected in somatosensory performance.

PMID- 7790905
TI  - Cytochrome-oxidase blobs in cat primary visual cortex.
AB  - Cytochrome-oxidase blobs are central to two of the most influential ideas in
      contemporary visual neuroscience--cortical modularity and parallel processing
      pathways. In particular, the regular 2D array of cytochrome-oxidase-rich blobs in
      primate visual cortex is arguably the most compelling evidence for cortical
      modularity and has been hypothesized to mark a separate processing stream through
      the visual cortex. Although previously a variety of mammals have been studied,
      blobs have only been demonstrated in the visual cortex of primates, which has led
      to the conclusion that blobs represent a primate-specific feature of visual
      cortical organization. Here we demonstrate the presence of cytochrome-oxidase
      blobs in a nonprimate species. Throughout the full tangential extent of layers II
      III in cat visual cortex the cytochrome-oxidase staining pattern is distinctly
      patchy, with the darkly stained blobs forming a regular 2D array. In addition,
      the blobs in cat visual cortex are functionally related to the underlying ocular
      dominance columns. The presence of cytochrome-oxidase blobs in the cat clearly
      demonstrates that they no longer can be considered a primate-specific feature of
      visual cortical organization.

PMID- 7790906
TI  - Synaptic differentiation of a single motor neuron: conjoint definition of
      transmitter release, presynaptic calcium signals, and ultrastructure.
AB  - The opener muscle in the walking legs of the crayfish (Procambarus clarkii) is
      innervated by only one excitatory motor neuron, yet excitatory postsynaptic
      potentials (EPSPs) of proximal fibers are eightfold larger than those of central
      muscle fibers at low frequencies of activation, due in large measure to
      differences in presynaptic properties. We investigated quantal release
      properties, calcium signals, and ultrastructure of presynaptic terminals to
      elucidate factors that could account for the physiological differences. Focal
      macropatch electrodes were placed over individual visualized terminal
      varicosities to obtain records of quantal contributions to the excitatory
      junctional current (EJC). At low frequencies of activation, mean quantal content
      is greater for proximal than for central varicosities. This difference is due to
      a higher probability of release per synapse, and not to a larger number of active
      synapses. Recorded varicosities were labeled with fluorescent beads deposited by
      the electrode. These beads adhered to the muscle fibers, outlining the recorded
      site for subsequent serial thin sectioning and reconstruction from electron
      micrographs. Comparisons of structure and function were made for individual
      varicosities. The number of active zones per terminal surface area and the number
      of synapses with multiple active zones (complex synapses) were greater in high
      output varicosities. Calcium indicators were loaded into proximal and central
      nerve terminals by axonal injection to compare the relative differences in
      calcium buildup during stimulation. Presynaptic calcium signals were larger for
      proximal varicosities than for central varicosities.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7790907
TI  - Neurotrophins and the neuroendocrine brain: different neurotrophins sustain
      anatomically and functionally segregated subsets of hypothalamic dopaminergic
      neurons.
AB  - Hypothalamic neurons control a variety of important hormonal and behavioral
      functions. Little is known, however, about the neurotrophic factors that these
      neurons may require for survival and/or maintenance of their differentiated
      functions. We conducted experiments to examine this issue, utilizing a
      combination of immunohistochemical, in situ hybridization and cell culture
      approaches. We found that the low affinity receptor for nerve growth factor (p75
      NGFR) is present in small subsets of hypothalamic peptidergic neurons identified
      as such by their content of galanin, luteinizing hormone-releasing hormone (LHRH)
      and vasointestinal peptide (VIP). More prominently, however, examination of
      hypothalamic dopaminergic (DA) neurons for the presence of p75 NGFR-like
      immunoreactivity revealed that the receptor was present on tyrosine hydroxylase
      (TH)-positive neurons of the zona incerta and periventricular region, but not on
      neuroendocrine DA neurons of the tuberoinfundibular region. In situ hybridization
      experiments using a p75 NGFR cRNA confirmed this distribution. Regardless of the
      presence or absence of p75 NGFR, neither DA group expresses trkA mRNA, indicating
      that these two major hypothalamic subsets of DNA neurons are NGF-insensitive. A
      substantial fraction of TH mRNA-positive cells in the zona incerta expresses trkB
      mRNA, which encodes the receptor for brain derived neurotrophic factor (BDNF); in
      turn BDNF supports the in vitro survival of hypothalamic TH neurons bearing p75
      NGFR, suggesting that BDNF is trophic for DNA neurons of the zona incerta. In
      contrast, tuberoinfundibular DA neurons do not express trkB mRNA, but some have
      trkC mRNA, which encodes the receptor for neurotrophin-3 (NT-3). The in vitro
      survival of TH neurons devoid of p75-NGFR is supported by NT-3, implying that NT
      3 may be trophic for a subset of tuberoinfundibular DA neurons. These results
      suggest that, in spite of expressing an identical neurotransmitter phenotype,
      anatomically and functionally segregated DA neurons of the neurodendocrine brain
      are sustained by different neurotrophic factors.

PMID- 7790908
TI  - Kainic acid-induced neuronal death is associated with DNA damage and a unique
      immediate-early gene response in c-fos-lacZ transgenic rats.
AB  - Previously, we established that persistent upregulation of c-fos expression
      preceded kainic acid (KA)-induced neuronal death in mice. To discriminate between
      events that are products of the seizures elicited by KA and those that are
      specifically associated with its neurotoxic actions, we have examined the
      expression of cellular immediate-early genes (cIEGs) following KA or
      pentylenetetrazol (PTZ) treatment in c-fos-lacZ transgenic rats. While both
      chemoconvulsants elicit seizures, only KA causes selective neuronal death.
      Following treatment of transgenic rats with KA there was a protracted expression
      of Fos-lacZ that lasted for 2-3 d. In contrast, PTZ elicited a transient increase
      in the transgene product that lasted about 6 hr. Normally, Fos and Fos-lacZ were
      detected only in neuronal nuclei. However, 6 hr following kainic acid (but not
      PTZ) administration, beta-galactosidase activity appeared in the cytoplasm of
      neurons within vulnerable regions (as determined by the terminal transferase
      biotinylated-UTP nick end labeling (TUNEL) procedure). Like c-fos, transcripts
      for other cIEGs were elevated for longer periods in the KA-treated rat
      hippocampus. In addition, fra-1 and fra-2 were only induced in the KA-treated
      rat. These changes in mRNA levels were paralleled by a sustained increase in AP-1
      DNA binding activity. Thus, quantitative and qualitative changes in AP-1 DNA
      binding complexes accompany neurotoxic cell death that are not observed following
      seizures.

PMID- 7790909
TI  - V1 vasopressin receptor antisense oligodeoxynucleotide into septum reduces
      vasopressin binding, social discrimination abilities, and anxiety-related
      behavior in rats.
AB  - To develop and validate a vasopressin (AVP) receptor knockdown strategy, we
      infused an antisense oligodeoxynucleotide to the V1 subtype mRNA into the septum
      of male rats with osmotic minipumps and measured behavioral, cellular and
      molecular parameters. Compared to vehicle and scrambled-sequence oligo controls,
      chronic antisense administration for up to 4 d diminished the ability of the
      animals to distinguish a previously exposed juvenile from a novel one and to
      respond to exogenous AVP (1 ng/5 microliters, intracerebroventricular) with an
      improved social memory. Furthermore, anxiety-related behavior was reduced. As
      measured in the behaviorally tested rats, antisense treatment resulted in a
      reduced binding of radiolabeled AVP in the septum, but not in other limbic brain
      areas (receptor autoradiography), and an increased amount of V1 receptor mRNA
      (reverse transcriptase PCR), indicating translational arrest and ongoing
      transcriptional activity. In sense oligo-treated rats, on the other hand, both
      the social and the anxiety-related behavior scores lay between levels obtained in
      control and antisense-treated animals. These sense-treated rats showed a slightly
      reduced V1 receptor density in the septum and reduced receptor mRNA levels,
      indicating hybridization of the sense oligo to the DNA. The data show the
      potential of antisense targeting to further reveal relationships between local
      gene expression, neuropeptide-receptor interactions in distinct brain areas, and
      behavioral performance.

PMID- 7790910
TI  - Nocodazole-dependent transport, and brefeldin A--sensitive processing and
      sorting, of newly synthesized membrane proteins in cultured neurons.
AB  - The envelope glycoproteins of Semliki Forest virus (SFV), Vesicular Stomatitis
      virus (VSV), and Influenza Fowl Plague virus (FPV) are vectorially targeted in
      neurons to the plasma membrane of dendrites (SFV and VSV) and axons (FPV). To
      gain insight into the mechanisms responsible for such polarized delivery we have
      examined the effects on neurons of nocodazole and brefeldin A (BFA), which are
      known to cause microtubule depolymerization and disassembly of the Golgi
      apparatus, respectively. Nocodazole treatment blocked transport of all viral
      glycoproteins to both axons and dendrites. BFA treatment induced disruption of
      the Golgi complex, including the trans-Golgi network (TGN), and tubulation of
      endosomes. However, the delivery of the SFV and FPV glycoproteins to the cell
      surface was not affected significantly by BFA, although processing and sorting
      were altered, as revealed by surface biotinylation and immunofluorescence
      microscopy of fixed nonpermeabilized cells. These results demonstrate the
      involvement of microtubules in axonal and dendritic transport of integral
      membrane glycoproteins, and the existence of a BFA-sensitive component in the
      sorting but not in the transport machinery.

PMID- 7790911
TI  - Effects of estradiol and progesterone on voltage-gated calcium and potassium
      conductances in rat CA1 hippocampal neurons.
AB  - In this study we recorded voltage gated Ca and K conductances with patch
      electrodes in hippocampal slices from female rats, which were ovariectomized
      (OVX) 1 week before the experiment. One experimental group was primed with
      estradiol at day 3 and 4 after OVX and received progesterone 4 hr before the
      start of the experiment. The second group was treated with estradiol at day 3 and
      4, but received vehicle at the day of the experiment. The third group was not
      treated with hormones (only vehicle injections). We observed that the amplitude
      of both sustained and transient Ca currents were significantly enhanced in CA1
      pyramidal neurons recorded in tissue from estradiol primed rats receiving
      progesterone when compared to the nontreated OVX controls; without estradiol
      priming Ca current amplitudes were small. Current amplitudes in tissue from rats
      treated with estradiol only, were at intermediate values. The voltage for half
      maximal steady state inactivation of the transient Ca current was at a less
      negative value for the estradiol/progesterone treated group in comparison to the
      OVX controls. Input resistances of the cells, and voltage or kinetic properties
      of the currents as recorded under these conditions were comparable for the three
      groups. Characteristics of two voltage gated K conductances, that is, the
      transient IA and the delayed rectifier, displayed no consistent differences for
      the three experimental groups. We conclude that long-term modulation of estradiol
      and progesterone levels alters the Ca but not the K currents that were tested in
      CA1 pyramidal neurons. These alterations may be linked to steroid-induced
      morphological changes in dendrites of CA1 pyramidal cells.

PMID- 7790912
TI  - The potassium channel subunit KV3.1b is localized to somatic and axonal membranes
      of specific populations of CNS neurons.
AB  - Potassium channels play major roles in the regulation of many aspects of neuronal
      excitability. These channels are particularly well suited for such multiplicity
      of roles since there is a large diversity of channel types. This diversity
      contributes to the ability of specific neurons (and possibly different regions of
      the same neuron) to respond uniquely to a given input. Neuronal integration
      depends on the local response of spatially segregated inputs to the cell and the
      communication of these integration centers with the axon. Therefore, the
      functional implications of a given set of K+ channels varies depending on their
      precise location on the neuronal surface. Site-specific antibodies were utilized
      to characterize the distribution of KV3.1b, a subunit of voltage-gated K+
      channels in CNS neurons. KV3.1b subunits are expressed in specific neuronal
      populations of the rat brain, such as cerebellar granule cells, projecting
      neurons of deep cerebellar nuclei, the substantia nigra pars-reticulata, the
      globus pallidus, and the ventral thalamus (reticular thalamic nucleus, ventral
      lateral geniculate and zona incerta). The KV3.1b protein is also present in
      various neuronal populations involved in the processing of auditory signals,
      including the inferior colliculus, the nuclei of the lateral lemniscus, the
      superior olive, and some parts of the cochlear nuclei; as well as in several
      other neuronal groups in the brainstem (e.g., in the oculomotor nucleus, the
      pontine nuclei, the reticulotegmental nucleus of the pons, trigeminal and
      vestibular nuclei, and the reticular formation) and subsets of neurons in the
      neocortex, the hippocampus and the caudate-putamen shown by double staining to
      correspond to neurons containing parvalbumin. KV3.1b subunits are localized
      predominantly in somatic and axonal membranes (particularly in axonal terminal
      fields) but are much less prominent in dendritic arborizations. This distribution
      is different than that of other subunits of voltage gated K+ channels and is
      consistent with a role in the modulation of action potentials. KV3.1b proteins
      have a cellular and subcellular distribution different than the related KV3.2
      subunits which express in Xenopus oocytes currents similar to those expressed by
      KV3.1b.

PMID- 7790913
TI  - Bilateral control of hindlimb scratching in the spinal turtle: contralateral
      spinal circuitry contributes to the normal ipsilateral motor pattern of fictive
      rostral scratching.
AB  - In a spinal turtle, unilateral stimulation in the rostral scratch receptive field
      elicited rhythmic fictive rostral scratching in ipsilateral hindlimb motor
      neurons; contralateral hip motor activity was also rhythmic and out-of-phase with
      ipsilateral hip motor activity. When left and right rostral scratch receptive
      fields were stimulated simultaneously, bilateral rhythmic fictive rostral
      scratching was produced; left hindlimb scratching was out-of-phase with right
      hindlimb scratching. Thus, spinal circuits coordinate interlimb phase during
      bilateral fictive scratching. We examined the contributions of contralateral
      spinal circuitry to the normal pattern of right hindlimb fictive rostral
      scratching by removing the left halves of the D7 segment and the hindlimb
      enlargement (D8-S2 segments). After left-hemicord removal, stimulation in the
      right rostral scratch receptive field usually elicited a variation of rostral
      scratching with rhythmic right hip flexor activity and no right hip extensor
      activity; thus, right hip flexor rhythm generation does not require left hindlimb
      enlargement circuitry. Normal right hindlimb rostral scratching with rhythmic
      alternation between hip flexor and extensor activities was rarely observed; thus,
      contralateral spinal circuitry contributes to the production of normal
      ipsilateral fictive rostral scratching. After left-hemicord removal, stimulation
      in the left rostral scratch receptive field elicited rhythmic right hip extensor
      activity; thus, contralateral spinal circuitry can generate a hip extensor rhythm
      during ipsilateral rostral scratch receptive field stimulation. Our observations
      and those of Berkowitz and Stein (1994a,b) support the concept that an
      ipsilateral hindlimb's normal rostral scratch motor pattern is generated by a
      modular central pattern generator that is bilaterally distributed in the spinal
      cord.

PMID- 7790914
TI  - Growth cones are actively influenced by substrate-bound adhesion molecules.
AB  - As axons advance to appropriate target tissues during development, their growth
      cones encounter a variety of cell adhesion molecules (CAMs) and extracellular
      matrix molecules (ECM molecules). Purified CAMs and ECM molecules influence
      neurite outgrowth in vitro and are thought to have a similar function in vivo.
      For example, when retinal ganglion cell (RGC) neurons are grown on different CAM
      and ECM molecule substrates in vitro, their growth cones display distinctive
      morphologies (Payne et al., 1992). Similarly, RGC growth cones in vivo have
      distinctive shapes at different points in the pathway from the eye to the tectum,
      suggesting the presence of localized cues that determine growth cone behaviors
      such as pathway selection at choice points. In this report, time-lapse video
      microscopy was utilized to examine dynamic transformations of RGC growth cones as
      they progressed from L1/8D9, N-cadherin, or laminin onto a different substrate.
      Contact made by the leading edge of a growth cone with a new substrate resulted
      in a rapid and dramatic alteration in growth cone morphology. In some cases, the
      changes encompassed the entire growth cone including those regions not in direct
      contact with the new substrate. In addition, the growth cones displayed a variety
      of behavioral responses that were dependent upon the order of substrate contact.
      These studies demonstrate that growth cones are actively affected by the
      substrate, and suggest that abrupt changes in the molecular composition of the
      growth cone environment are influential during axonal pathfinding.

PMID- 7790915
TI  - Neuroblast long-term cell cultures from human fetal olfactory epithelium respond
      to odors.
AB  - Primary cell cultures from human fetal olfactory neuroepithelium have been
      isolated, cloned, and propagated in continuous in vitro culture for approximately
      1 year. The two clones we report here synthesize both neuronal proteins and
      olfactory-specific markers as well as the putative olfactory neurotransmitter,
      carnosine. In addition, patchclamp experiments reveal that these cells are
      electrically excitable. Following exposure to a panel of aromatic chemicals one
      of the cell cultures shows a specific increase in intracellular cAMP, indicating
      that some degree of functional maturity is expressed in vitro. The results
      suggest that these cells originate from the "stem cell" compartment that gives
      rise to mature olfactory receptor neurons. These long-term cell cultures
      represent models that will be useful in studying the mechanism(s) of olfaction
      and the regulation of olfactory neurogenesis and differentiation.

PMID- 7790917
TI  - Quantification of excitatory amino acid uptake at intact glutamatergic synapses
      by immunocytochemistry of exogenous D-aspartate.
AB  - To study the localization and efficiency of glutamate/aspartate membrane
      transport in the vicinity of intact glutamatergic synapses, the avascular lamprey
      spinal cord was incubated with D-aspartate, a metabolically inert transporter
      substrate. The exogenous D-aspartate was localized by immunocytochemistry after
      aldehyde fixation. Incubation at 50 or 500 microM D-aspartate for 1 hr caused a
      prominent D-aspartate labeling of glial processes at glutamatergic synapses,
      while presynaptic axons and postsynaptic dendrites remained unlabeled. The glial
      processes surrounding glutamatergic sensory axons with a predominantly tonical
      firing pattern contained significantly higher levels of D-aspartate than did
      processes surrounding glutamatergic reticulospinal axons, which fire rarely and
      in brief bursts. Preparations incubated for 10 hr with 500 microM D-aspartate
      showed D-aspartate immunolabeling in glia as well as in the two types of
      glutamatergic axon, but no evidence was obtained for uptake into synaptic
      vesicles. Nor was such evidence obtained after high-frequency electrical
      stimulation. The observations suggest that excitatory amino acids delivered
      diffusely to the extracellular space in the intact CNS are transported almost
      exclusively into glia. The avid uptake in glial processes, combined with their
      spatial arrangement around glutamatergic synapses, appears to limit the access of
      exogenous D-aspartate to the nerve terminal glutamate/aspartate transporter. In
      physiological conditions, the glial processes are likely to impede the exchange
      of glutamate between the synaptic cleft and the rest of the extracellular space.
      The transport was more efficient in glial processes located near tonically active
      synapses than in ones located near synapses releasing transmitter sporadically. D
      Aspartate is not a substrate of vesicular glutamate transport sites at these
      intact synapses.

PMID- 7790918
TI  - Expression of molecules associated with neuronal plasticity in the striatum after
      aspiration and thermocoagulatory lesions of the cerebral cortex in adult rats.
AB  - Like the hippocampus, the striatum receives excitatory afferents from the
      cerebral cortex but, in the case of the striatum, very little is known about the
      molecular events associated with plasticity after lesions of this pathway. Using
      immunohistochemical techniques, we have examined the effects of cortical lesions
      induced either by aspiration of the frontoparietal cortex or by thermocoagulation
      of pial blood vessels on axonal and glial molecules associated with neuronal
      plasticity in the striatum. The growth associated protein GAP-43, a molecule
      present in axons and growth cones, decreased in the dorsolateral striatum after
      aspiration but not after thermocoagulatory lesions. In contrast, synaptophysin, a
      marker of synaptic vesicles, remained unchanged in the denervated striatum after
      both types of lesions. Immunostaining for basic fibroblast growth factor (bFGF)
      markedly decreased in striatal astrocytes after both lesions, despite an
      increased staining for glial fibrillary acidic protein (GFAP). The adhesion
      molecules tenascin, chondroitin sulfate proteoglycans, highly polysialylated
      neural cell adhesion molecule (PSA-NCAM), and laminin did not change
      significantly in the gray matter of the dorsolateral striatum after either type
      of lesion. These effects differed from those observed after partial denervation
      of the hippocampus and spinal cord, revealing marked regional differences in the
      response of axonal and glial proteins to afferent lesions. In addition, the
      results further indicate that cortical lesions have both similar and distinct
      consequences, depending on the procedure by which the lesions are induced,
      suggesting that cortical lesions associated with different types of pathology may
      differentially affect subcortical structures.

PMID- 7790916
TI  - Activation of a nonselective cationic conductance by metabotropic glutamatergic
      and muscarinic agonists in CA3 pyramidal neurons of the rat hippocampus.
AB  - We have characterized a cationic membrane conductance activated by metabotropic
      glutamatergic and muscarinic cholinergic agonists in CA3 neurons in hippocampal
      slice cultures using the patch-clamp technique. When the potassium concentration
      in the superfusing fluid was raised above 5 mM, a biphasic current was observed
      in cells held at -60 mV in response to stimulation of postsynaptic metabotropic
      glutamate receptors (mGluRs) with 1S,3R-ACPD (50 microM) or muscarinic receptors
      with methacholine (MCh, 5 microM). The initial inward component was due to an
      increase in a cationic membrane conductance as determined by its reversal
      potential and its sensitivity to changes in extracellular K+ or Na+. The
      conductance underlying this current displayed no apparent voltage sensitivity
      over the range -120 to -50 mV. The response was reduced by extracellular
      application of Ba2+, Cd2+, Mg2+, or TEA, whereas extracellular Cs+ or loading
      cells with BAPTA or Cs+ did not affect the current. The effects of 1S,3R-ACPD
      were reversibly inhibited by bath-applied MCPG, an antagonist at mGluRs.
      Experiments with atropine and pirenzepine indicated that non-M1 muscarinic
      receptors mediated the MCh-induced current. A decrease in a resting leak
      potassium conductance (IK,leak) was responsible for the late component of the
      1S,3R-ACPD- and MCh-induced response, seen as an outward current in the bathing
      solution with high K+ concentration. Loading cells with GDP beta S, GTP gamma S,
      or GTP did not alter the cationic current, while, in the same cells, the
      reduction in IKleak was abolished or irreversibly activated. Single-channel
      recordings of cationic channel activity in the cell-attached configuration
      provided evidence for the requirement of second messengers in coupling these
      receptors to the cationic channels. The data indicate that in addition to the
      previously described reduction of IK,leak, IM, and IAHP, both 1S,3R-ACPD and MCh
      activate a nonselective cationic conductance that is clearly revealed upon
      elevating external K+ concentration. This current is mediated by activation of
      metabotropic receptors, although no evidence could be obtained to show an
      involvement of G-proteins.

PMID- 7790919
TI  - Potassium currents responsible for inward and outward rectification in rat
      neostriatal spiny projection neurons.
AB  - Many of the nonlinear membrane properties displayed by neostriatal spiny
      projection neurons are conferred by their voltage-gated potassium (K+) currents,
      including an inwardly rectifying current (IKir), fast (IAt), and slowly (IAs)
      inactivating A-currents, and a slow, noninactivating current. The relative
      contribution of these K+ currents to the pronounced inward and outward
      rectification of the current-voltage (I-V) relationship of spiny neurons was
      investigated in a neostriatal slice preparation. Manipulation of the equilibrium
      potential for K+ (EK) showed that the voltage dependence of activation of inward
      rectification was identical to that of IKir. In addition, application of barium
      (100 microM), which is known to reduce IKir in a time- and voltage-dependent
      manner, had equivalent effects on inward rectification. Subsequent application of
      cesium (3 mM) or tetraethylammonium (TEA, 25 mM) blocked inward rectification in
      a solely voltage-dependent fashion consistent with the action of these blockers
      on IKir. Administration of 4-aminopyridine (4-AP, 100 microM) at concentrations
      that selectively depress IAs, reduced outward rectification of spiny neurons at
      subthreshold membrane potentials. Higher concentrations of 4-AP (2 mM), which
      block both IAs and IAt, revealed an early transient overshoot in voltage
      deflections at potentials near spike threshold, but rectification persisted at
      the end of the responses. The transient overshoot and the residual rectification
      were eliminated by TEA (25 mM), a blocker of the slow, noninactivating K+
      current. Collectively, these results indicate that all three depolarization
      activated K+ currents contribute to outward rectification at different times and
      membrane potentials defined by their voltage dependence of activation and
      kinetics of inactivation. The spontaneous activity of neostriatal spiny neurons
      recorded in intact animals is characterized by sustained and limited shifts in
      membrane potential from relatively hyperpolarized potentials to depolarized
      potentials near spike threshold. The present data suggest that the hyperpolarized
      state is determined principally by IKir and the limits on the depolarized state
      are defined by IAf, IAs, and the noninactivating current. These outward K+
      currents also are hypothesized to govern the spike discharge characteristics once
      the depolarized state has been reached.

PMID- 7790920
TI  - Electrical activity and calcium influx regulate ion channel development in
      embryonic Xenopus skeletal muscle.
AB  - The development of electrical excitability involves complex coordinated changes
      in ion channel activity. Part of this coordination appears to be due to the fact
      that the expression of some channels is dependent on electrical activity mediated
      by other channel types. For example, we have previously shown that normal
      potassium current development in embryonic skeletal muscle cells of the frog
      Xenopus laevis is dependent on sodium channel activity. To examine the
      interrelationships between the development of different ionic currents, we have
      made a detailed study of electrical development in cultured Xenopus myocytes
      using whole-cell patch-clamp recording. The initial expression of potassium,
      sodium, and calcium currents is followed by a brief period during which the
      densities of potassium currents decrease, while at the same time sodium and
      calcium current densities continue to increase, which may increase electrical
      excitability during this time. The normal developmental increase in both
      potassium and sodium currents is inhibited by the sodium channel blocker
      tetrodotoxin, suggesting that electrical activity normally stimulates the
      expression of both these currents. These effects of electrical activity appear to
      be mediated via activation of voltage-gated calcium channels. We suggest that the
      developmental acquisition of sodium and calcium channels by these cells, possibly
      coupled with a transient decrease in potassium current density, lead to an
      increase in electrical excitability and calcium entry, and that this calcium
      entry provides a critical developmental cue controlling the subsequent
      development of mature electrical properties.

PMID- 7790921
TI  - Mechanism for modulation of nicotinic acetylcholine receptors that can influence
      synaptic transmission.
AB  - Only recently has it been appreciated that neuronal nicotinic ACh receptors
      (NnAChRs) are highly permeable to Ca2+ and are modulated by Ca2+ in a dose
      dependent manner. These findings suggest that Ca2+ could have roles in
      cholinergic synaptic plasticity. We report a possible mechanism for Ca(2+)
      initiated synaptic plasticity that differs from the intracellular Ca2+ cascade
      associated with plasticity of glutamatergic synapses. Rapid changes in external
      Ca2+ modulate cholinergic spontaneous synaptic currents in superior cervical
      ganglionic sympathetic neurons. Inhibition of cholinergic currents by
      chlorisondamine, which blocks only open channels and becomes trapped in the pore,
      showed that the modulation is not by a mechanism that activates a previously
      unresponsive population of NnAChRs. Rather, single-channel recordings with
      ganglionic NnAChRs from chromaffin cells indicated that Ca2+ directly alters the
      probability of the channels being open. We hypothesize from the results that
      activity-dependent decreases in external Ca2+, which occur throughout the nervous
      system, could directly underlie a rapid negative-feedback mechanism that
      decreases the responsiveness of NnAChRs at synapses. When external Ca2+ is
      decreased, presynaptic Ca2+ currents and transmitter release also are diminished.
      Thus, several mechanisms could combine to potently and rapidly depress synaptic
      nicotinic receptors until the external Ca2+ concentration recovers.

PMID- 7790922
TI  - Dopamine-modulated potassium channels on rat striatal neurons: specific
      activation and cellular expression.
AB  - We have used cell-attached patch-clamp electrophysiology to characterize the
      activation and distribution of an 85 pS K+ channel on freshly dissociated rat
      striatal (caudate-putamen) neurons. In recordings from 643 cells, openings of
      this channel showed an absolute dependence on the presence of dopamine or the D2
      like dopamine receptor agonist quinpirole in the cell-attached patch pipette, but
      were never seen when the D2 antagonist domperidone was applied along with
      quinpirole, or in the absence of drug. This channel displayed inward
      rectification at depolarized membrane potentials, but its activation was
      otherwise voltage insensitive. It was largely restricted to a subset of
      dissociated cells with diameters > or = 10 microns, with channel openings seen in
      about 25% of patches. When present, there were typically multiple channels per
      patch. Cells of this size were immunocytochemically stained for neuron-specific
      enolase but not glial fibrillary acidic protein; about 40% were also labeled for
      gamma-amino butyric acid (GABA) and about 60% for NADPH diaphorase, with
      GABAergic cells displaying a shape most similar to that of cells expressing the
      channel. A large number of distinct types of other channels were also present,
      comprising inwardly rectifying channels of 5-35 pS conductance and voltage
      activated channels of 100-250 pS, but the frequencies of occurrence and
      fractional open times of these channels were independent of the presence or
      absence of dopaminergic agonists. Thus, the 85 pS K+ channel uniquely requires
      activation by a D2-like dopamine receptor on rat striatal neurons, and is
      selectively expressed by a subset of these cells, which are most likely to be
      GABAergic neurons.

PMID- 7790923
TI  - Lamina-specific expression of adhesion molecules in developing chick optic
      tectum.
AB  - The optic tectum is the major synaptic target of retinal axons in birds. In the
      chick, retinal ganglion cell axons enter the optic tectum through a superficial
      lamina (the stratum opticum), extended branches into deeper laminae, and arborize
      in specific "retinorecipient" laminae, where they form synapses. Studies using an
      organotypic culture system have provided evidence that the tectum bears a series
      of distinct, lamina-specific, cell surface-associated cues that direct these
      axonal behaviors (Yamagata and Sanes, 1995). Here, we have used a panel of
      antibodies to 30 membrane and matrix components to ask whether known adhesive
      molecules are distributed in lamina-specific patterns. Among many spatiotemporal
      pattern of expression documented, three were particularly noteworthy: (1) The
      cell adhesion molecules NgCAM/L1 and TAG-1/axonin-1 were concentrated in the
      stratum opticum. (2) SC1/JC7/DM-GRASP/BEN, N-cadherin, neuropilin, polysialylated
      N-CAM, and glycoconjugates recognized by the lectin VVA-B4 were concentrated in
      retinorecipient laminae. (3) Neurofascin, tenascin-C/cytotactin, and a matrix
      molecule defined by the "Sigma" antibody were present at highest levels in areas
      that border the retinorecipient laminae. Some members of each group (NgCAM/L1,
      TAG-1/axonin, SC1/JC7, polysialic acid, VVA-B4-receptors, and neurofascin)
      appeared on schedule and in lamina-restricted patterns in tecta from embryos that
      had been enucleated before retinal axons left the eye. Thus, molecules in these
      three categories could provide signals to retinal axons that promote extension
      through the stratum opticum, induce arborization or synaptogenesis in
      retinorecipient laminae, and prevent sprouting into adjoining laminae.
      Interestingly, N-cadherin accumulated in retinorecipient laminae only following
      the onset of synapse formation, and failed to accumulate in enucleated tecta.
      Immunoelectron microscopy of normal tecta demonstrated the presence of N-cadherin
      in the synaptic cleft, suggesting a role for this molecule in synaptic
      maintenance.

PMID- 7790924
TI  - Kinase and phosphatase activities intimately associated with a reconstituted
      calcium-dependent potassium channel.
AB  - Type-2 calcium-dependent potassium (KCa) channels from mammalian brain,
      reconstituted into planar phospholipid bilayers, are modulated by ATP or ATP
      analogs via an endogenous protein kinase activity intimately associated with the
      channel (Chung et al., 1991). We show here that the endogenous protein kinase
      activity is protein kinase C (PKC)-like because (1) modulation by ATP can be
      mimicked by exogenous PKC, and (2) the effects of ATP can be blocked by PKC(19
      36), a specific peptide inhibitor of PKC. Furthermore, adding the PKC inhibitor
      peptide after the addition of ATP reverses the modulation produced by ATP,
      suggesting that there is a phosphoprotein phosphatase activity closely associated
      with type-2 KCa channels. Consistent with this idea is the finding that
      microcystin, a non-specific phosphatase inhibitor, enhances the modulation of KCa
      channel activity by ATP. Inhibitor-1, a specific protein inhibitor of
      phosphoprotein phosphatase-1, also enhances the effect of ATP, suggesting that
      the endogenous phosphatase activity is phosphatase-1-like. The results imply that
      type-2 KCa channels exist as part of a regulatory complex that includes a PKC
      like protein kinase and a phosphatase-1-like phosphoprotein phosphatase, both of
      which participate in the modulation of channel function.

PMID- 7790926
TI  - Evidence for glycine modulation of excitatory synaptic inputs to retinal ganglion
      cells.
AB  - The actions of glycine on the NMDA receptor-mediated synaptic responses of
      ganglion cells were studied in the tiger salamander retinal slice. Ganglion cell
      excitatory postsynaptic currents (EPSCs) were elicited either by exciting bipolar
      cells with potassium puffs or by light stimulation, and were measured using whole
      cell patch-clamp techniques. Increasing bath glycine concentrations to 10 microM
      had little effect on the amplitude of the puff-evoked EPSCs, indicating either
      that synaptic glycine concentrations were saturating or that the added glycine
      was buffered by uptake mechanisms. However, 5,7-dichlorokynurenic acid (5,7-DCK),
      an antagonist for the glycine site on the NMDA receptor, reduced the ganglion
      cell responses to NMDA puffs, and reduced the potassium puff- and light-elicited
      EPSCs. The IC50 values for 5,7-DCK became larger with increasing glycine
      concentrations, but not with increasing NMDA concentrations, indicating that 5,7
      DCK acted at the glycine site. The IC50 values for 5,7-DCK were increased with
      stronger potassium puffs or light stimuli, suggesting that synaptic glycine
      levels increased with the strength of the stimuli. EPSCs measured in ON-OFF
      ganglion cells at light ON and OFF were reduced by 5,7-DCK. For dim light
      stimuli, the IC50 values were lower for the OFF EPSCs compared to the ON EPSCs,
      indicating that glycine concentrations were different at the times of OFF and ON
      activity. Estimates of synaptic glycine concentrations suggest that for dim light
      stimuli, concentrations at the OFF synapses were not saturated, but
      concentrations at the ON synapses were saturated.

PMID- 7790925
TI  - Differential regulation of sympathetic neuron neuropeptide Y and catecholamine
      content and secretion.
AB  - Cultured principal neurons of the superior cervical ganglion (SCG), which
      coexpress high levels of catecholamines and neuropeptide Y (NPY), were used as a
      model to simultaneously examine whether sympathetic neuronal peptide and
      transmitter content or secretion are differentially regulated. Accumulation of
      NPY immunoreactivity and the dopamine metabolites DOPAC and HVA in SCG neuronal
      conditioned culture medium was used as an index of NPY and catecholamine
      secretion, respectively. Release of NPY and catecholamines was linear with time;
      SCG neurons exhibited a basal NPY secretory rate of approximately 0.9-3 fmol NPY
      immunoreactivity/10(4) cells/hr, and basal DOPAC plus HVA accumulation was about
      10-20 pmol total metabolites/10(4) cells/hr. While sympathetic neuronal NPY and
      total catecholamine cell content increased more than 6-10-fold by 14 d of
      culture, secretion remained constant. Depolarization stimulated the rate of NPY
      secretion 18-fold, whereas medium catecholamine metabolite levels increased 3
      fold. Activation of intracellular signaling pathways was shown to be an important
      point of regulation of sympathetic neuron peptide and transmitter content and
      secretion. Differential regulation of SCG neuron NPY and catecholamine expression
      was second messenger system specific. Activation of the protein kinase A pathway
      with the cAMP analog dibutyryl cAMP, or the adenylyl cyclase activator forskolin,
      produced a concentration-dependent, sustained stimulation of NPY secretion;
      maximal stimulation resulted in decreased cellular NPY content. Parallel
      stimulated neuronal catecholamine release was observed, but in contrast to NPY,
      total cellular catecholamine content was also increased. Regulation of the
      protein kinase C pathway with phorbol myristate acetate (PMA) stimulated SCG
      neuronal NPY secretion to a lesser degree than activation of protein kinase A,
      but did not alter cellular NPY levels. PMA minimally stimulated catecholamine
      release and content. NPY secretion induced by the calcium ionophore A23187 was
      paralleled by a concomitant decrease in cellular NPY. A23187 decreased
      catecholamine release, but did not change cellular total catecholamine levels.
      The magnitude of the secretory responses of sympathetic neurons to these
      regulators was far greater than changes in NPY or catecholamine content,
      biosynthesis or mRNA levels, suggesting that release is a primary site of
      regulation. The independent regulation of sympathetic neuronal NPY and
      catecholamine content and release is consistent with the fundamental differences
      in the biosynthetic pathways, vesicular compartmentalization, uptake and
      metabolism of neuropeptides and neurotransmitters.

PMID- 7790927
TI  - Developmental changes in presynaptic calcium channels coupled to glutamate
      release in cultured rat hippocampal neurons.
AB  - Excitatory synaptic transmission in the hippocampus involves the participation of
      at least two types of presynaptic Ca2+ channels, N-type channels sensitive to
      omega-conotoxin GVIA (omega-CTx GVIA) and Q-type channels sensitive to omega
      agatoxin IVA (omega-Aga IVA). Hippocampal pyramidal neurons in cell culture were
      used to examine the participation of these two classes of channels at different
      stages of synapse development. Specific Ca2+ channel toxins were used to block
      presynaptic Ca2+ channels while whole-cell voltage-clamp recordings were used to
      record evoked EPSCs in postsynaptic neurons. At immature synapses (cells in
      culture for 10-15 d), omega-CTx GVIA (1-5 microM) blocked transmission by more
      than 80% while omega-Aga IVA (1 microM) was less effective. In older cultures,
      however, omega-Aga IVA (1 microM) was more effective than omega-CTx GVIA (1-5
      microM) in blocking synaptic transmission. The pharmacological properties of the
      omega-Aga IVA sensitive component of synaptic transmission were examined in more
      detail using omega-Aga IVA and omega-conotoxin MVIIC (omega-CTx MVIIC). The
      properties of this component of transmitter release indicated that a Q-type Ca2+
      channel was involved in presynaptic Ca2+ entry. The results suggest that
      different classes of presynaptic Ca2+ channels begin to participate in
      transmitter release at different times during synapse development and maturation.

PMID- 7790928
TI  - Cell cycle progression in gentamicin-damaged avian cochleas.
AB  - Hair cells, the sensory receptors of the auditory, vestibular, and lateral-line
      organs, may be damaged by a number of agents including aminoglycoside antibiotics
      and severe overstimulation. In the avian cochlea, lost hair cells can be replaced
      by regeneration. These new hair cells appear to be derived from a support cell
      precursor which is stimulated to divide by events associated with hair cell loss.
      Little is known about the timing and sequencing of events leading to new hair
      cell production. In this study cell cycle-associated events in the avian cochlea
      were analyzed at early and late time intervals following a single high dose of
      gentamicin. This single dose protocol has been shown to consistently result in
      extensive morphological damage and hair cell loss in the proximal region of the
      cochlea while sparing a morphologically undamaged distal cochlear region. This
      allowed for the differential analysis of the underlying support cell populations
      with respect to local hair cell loss. Three cell cycle associated markers were
      used to evaluate which cells entered and progressed through the cell cycle:
      statin, a G0 associated nuclear marker; proliferating cell nuclear antigen
      (PCNA), a G1, S and G2 associated marker; and 5-bromodeoxyuridine (BrdU), an S
      phase associated marker. Using these markers we found evidence for reversible
      changes in cell cycle status throughout the cochlea, while progression through S
      phase and mitosis was restricted to the region of the cochlea which sustained
      hair cell loss.

PMID- 7790930
TI  - Regulation of a potassium conductance in rat midbrain dopamine neurons by
      intracellular adenosine triphosphate (ATP) and the sulfonylureas tolbutamide and
      glibenclamide.
AB  - The presence of adenosine triphosphate-regulated potassium channels (K-ATPs) in
      midbrain dopamine neurons is currently in dispute. This was investigated using
      whole-cell patch-clamp recordings from dopamine neurons in slices of midbrain
      from 9-12-d-old rats. Intracellular dialysis with Mg2+ ATP-free solutions
      resulted in a membrane hyperpolarization (14 +/- 6 mV), or outward current (102
      +/- 27 pA) in voltage clamp, which developed over 14 +/- 1.6 min. These
      hyperpolarizations and outward currents were reversed by the K-ATP-blocking
      sulfonylureas tolbutamide (100 microM) and glibenclamide (3 microM). This
      sulfonylurea-sensitive outward current was associated with an increase in a
      nonrectifying (between -50 and -130 mV) conductance of approximately 2 nS, with a
      reversal potential of -100 mV (in 2.5 mM extracellular potassium), consistent
      with a potassium conductance increase. When the dialyzate contained Mg2+ATP (2
      mM), no slowly developing hyperpolarization or outward current occurred, and
      tolbutamide (200 microM) and glibenclamide (10 microM) did not affect membrane
      potential or current. Additionally, the "potassium channel activators" (KCAs)
      lemakalim (200 microM) and pinacidil (50 microM) were also without effect on the
      membrane potential or holding current in these cells. The hyperpolarizations and
      outward currents caused by baclofen and quinpirole, agonists at GABAB and D2
      receptors, respectively, were neither blocked by sulfonylureas nor occluded by
      the current resulting from depletion of intracellular ATP. Thus, these K-ATPs
      appear independent of the potassium channels coupled to GABAB and D2 receptors in
      these cells. This ATP-regulated potassium conductance may constitute a protective
      mechanism during anoxia or hypoglycemia, by restricting membrane depolarization
      of dopamine neurons when intracellular ATP levels fall.

PMID- 7790929
TI  - Gas chromatographic-mass fragmentographic quantitation of 3 alpha-hydroxy-5 alpha
      pregnan-20-one (allopregnanolone) and its precursors in blood and brain of
      adrenalectomized and castrated rats.
AB  - Coupling high performance liquid chromatography with gas chromatography-mass
      fragmentography has made it possible to simultaneously measure subpicomolar
      concentrations of allopregnanolone and its precursors, pregnenolone, progesterone
      and 5 alpha-dihydroprogesterone (5 alpha-DHP) in various brain areas.
      Allopregnanolone was measured in the brain of adrenalectomized/castrated (ADX/CX)
      rats in nanomolar concentrations long after peripheral sources of
      allopregnanolone were removed. A partial decrease (approximately 30%) in the
      content of allopregnanolone was found in the brains of ADX/CX rats compared to
      sham-operated rats. Moreover, the content of allopregnanolone in brains of sham
      operated as well as ADX/CX rats was nonuniformly distributed (olfactory bulb >
      striatum > cortex > hippocampus) and was one to two orders of magnitude higher
      than in plasma or liver. Infusion of pregnenolone sulfate in ADX/CX rats elicited
      a fourfold increase in 5 alpha-DHP and progesterone content and a seven- to
      eightfold increase in the content of allopregnanolone in brain but not in liver
      or plasma. Furthermore, the content of allopregnanolone in brain increased to the
      same extent in both sham-operated and ADX/CX rats following pregnenolone sulfate
      infusion. The 5 alpha-reductase inhibitor, (17 beta)17[[bis(1
      methylethyl)amino]carbonyl] androstane-3,5-diene-3-carboxylic acid (SKF 105111),
      reduced the brain content of allopregnanolone and blocked the increased formation
      of allopregnanolone in brain following pregnenolone sulfate infusion. The results
      clearly demonstrate that the synthesis of allopregnanolone from 5 alpha-DHP and
      progesterone occurs in the brain and that a significant amount of
      allopregnanolone is synthesized locally in brain from its precursors. These
      experiments suggest that the brain, like adrenals and gonads, is a steroidogenic
      organ which produces allopregnanolone as one of its own most important
      physiologically relevant steroids.

PMID- 7790931
TI  - Disconnection of intracortical synaptic linkages disrupts synchronization of a
      slow oscillation.
AB  - The intracortical synaptic linkages underlying the synchronization of a recently
      described slow (< 1 Hz) oscillation (Steriade et al., 1993b,c) were investigated
      in anesthetized cats by means of multisite extra- and intracellular recordings,
      including dual impalements, from rostral and caudal sites in the association
      cortical suprasylvian and marginal gyri, before and after reversible lidocaine
      inactivation or transections in the middle suprasylvian gyrus. Stimulus-evoked
      responses revealed that the rostral and caudal suprasylvian foci are reciprocally
      connected, with a preference for posterior-to-anterior responses. Lidocaine
      infusion between the stimulating and recording sites disrupted the intracortical
      synaptic linkage, while leaving unaffected the responses at the sites close to
      the stimulating electrodes. The high coherence between slowly oscillating field
      potentials and intracellular activities recorded from anterior and posterior
      suprasylvian foci was lost after reversible inactivation or transections in the
      middle suprasylvian gyrus, whereas the synchrony between adjacent foci within the
      anterior or posterior areas was preserved. Two to four hours after inactivation
      or transection the synchrony between all channels was totally or partially
      recovered. We introduced the synchrony coefficient (SyCo) and calculated the SyCo
      for closely located and distant sites. Lidocaine infusion or transection did not
      affect the SyCo between leads placed on the same site, but significantly (60%)
      decreased the SyCo between channels separated by the functionally inactivated or
      transected sector. Our results demonstrate that pathways within or beneath the
      suprasylvian gyrus sustain the synchronization of the slow oscillation between
      cortical sites. As the loss of long-range coherence was not permanent, intergyral
      paths and/or corticothalamocortical loops may exert compensatory functions after
      the disconnection of intrasuprasylvian synaptic linkages.

PMID- 7790932
TI  - Negative feedback neuroendocrine control of the inflammatory response in rats.
AB  - We describe that an ongoing inflammatory response at one site (produced by
      complete Freund's adjuvant injection in the hindpaw) produces a negative feedback
      inhibition on plasma extravasation, produced by perfusion of the inflammatory
      mediator, bradykinin (160 nM), at a second site (the knee joint). This negative
      feedback process is abolished in rats that have been neonatally treated with
      capsaicin to deplete most of their unmyelinated primary afferent fibers, which
      suggests that this negative feedback process is mediated by activation of primary
      afferent fibers. Electrical stimulation of the hindpaw at intensities that excite
      C-fibers also inhibited bradykinin-induced plasma extravasation. Stimulation at
      intensities that only excite A-fibers had no effect on bradykinin-induced plasma
      extravasation. Platelet activating factor-induced plasma extravasation, which is
      not dependent on the innervation of the joint, was not inhibited by stimulation
      of C-fibers from the hindpaw. Acute surgical interruption of the lumbar
      sympathetic outflow to the hind limb (the paravertebral ganglia between L2 and
      L4) did not attenuate the depression of bradykinin-induced plasma extravasation
      produced by C-fiber stimulation. This indicates that the depression is not
      mediated by activity in the sympathetic outflow. Transection of the spinal cord,
      hypophysectomy, inhibition of corticosterone synthesis, and adrenalectomy (but
      not adrenal medullectomy) all prevented the inhibition of BK-induced plasma
      extravasation by electrical simulation, indicating that the negative feedback
      inhibition on plasma extravasation is dependent on an intact neuraxis and an
      intact hypothalamic-pituitary-adrenocortical axis. In summary, our data
      demonstrate a negative feedback inhibition of an inflammatory process, which is
      elicited by stimulation of C-fiber afferents.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790934
TI  - How to access images on the Internet.

PMID- 7790935
TI  - Using PET scans to probe the human mind, researchers have been uncovering new
      ways to understand intelligence as well as differences in the way men and women
      think. Are these true breakthroughs or junk science?

PMID- 7790933
TI  - Regulation of adult neurogenesis by excitatory input and NMDA receptor activation
      in the dentate gyrus.
AB  - The effects of afferent input and N-methyl-D-aspartate (NMDA) receptor activation
      on neurogenesis were examined in an intact system, the rat dentate gyrus, where
      neurons are naturally born in the adult. In the adult dentate gyrus, activation
      of NMDA receptors rapidly decreased the number of cells synthesizing DNA, whereas
      blockade of NMDA receptors rapidly increased the number of cells in the S phase
      identified with 3H-thymidine. Acute treatment with NMDA receptor antagonists
      increased the birth of neurons and increased the overall density of neurons in
      the granule cell layer. Lesion of the entorhinal cortex, the main excitatory
      afferent population to the granule neurons, also increased the birth of cells in
      the dentate gyrus. These results suggest that adult neurogenesis in the dentate
      gyrus of the rat is altered by afferent input, via NMDA receptors, and may be
      regulated naturally by endogenous excitatory amino acids.

PMID- 7790936
TI  - Regional cerebral function determined by FDG-PET in healthy volunteers: normal
      patterns and changes with age.
AB  - The main objective of this study was to determine patterns of regional brain
      metabolic activity utilizing high-resolution PET in normal healthy volunteers and
      variations in different age groups. METHODS: High-resolution [18F]FDG PET images
      of the entire brain were obtained in 120 healthy normal volunteers (64 men, 56
      women), age range from 19 to 79 yr. Each anatomic region was assessed using a
      qualitative rating scale with a score ranging from 1 to 6 (1 = definitely normal
      and 6 = definitely abnormal). Local metabolic activity was also estimated as
      showing increased (+) or decreased (-) compared to normal (0) states. RESULTS:
      The most consistent finding in normal aging was decreased cortical metabolism,
      particularly in the frontal lobes. Temporal, parietal and occipital lobe
      metabolism varied considerably among subjects within the same age group as well
      as over decades. Basal ganglia, hippocampal area, thalami, cerebellum, posterior
      cingulate gyrus and visual cortex remained metabolically unchanged with advancing
      age. CONCLUSION: These data indicate that qualitative interpretation of FDG-PET
      images allows accurate assessment of regional metabolic activity of the brain in
      normal subjects similar to those described with quantitative techniques. Adequate
      knowledge of normal variations and changes related to normal aging is necessary
      for optimal assessment of pathologic states.

PMID- 7790937
TI  - Technetium-99m-HMPAO SPECT imaging of cerebral blood flow during REM sleep in
      narcoleptics.
AB  - This study was performed to demonstrate global and regional cerebral blood flow
      (rCBF) changes during rapid eye movement (REM) sleep in six patients with
      narcolepsy using SPECT and 99mTc-HMPAO. METHODS: Global and hemispheric HMPAO
      uptake as well as regional (RI) and asymmetry indices were estimated and compared
      between polysomnographically verified sleep onset (SO)REM and wakefulness.
      RESULTS: The estimated global HMPAO uptake did not differ between the two
      conditions indicating a similar overall cortical activity. During (SO)REM sleep,
      hemispheric HMPAO uptake as well as calculated RI, especially in the
      supratemporal plane, were significantly higher on the right side than
      contralateral. This indicates an initially right-sided cerebral activation and a
      special involvement of the right, nondominant hemisphere during dreaming which is
      responsible for visual-spatial perceptions. Furthermore, increased RI in superior
      parietal regions during sleep were evident and were explained by an activation of
      associative areas. In thalamic regions, decreased RI were found during sleep,
      which may reflect thalamic dysfunction. CONCLUSION: A definite assignment of
      these CBF alterations to (SO)REM sleep might be problematic because of unstable
      boundaries between sleep stages in narcolepsy. On the other hand, specificity of
      such CBF changes for narcolepsy requires further study.

PMID- 7790938
TI  - Functional deficits in autistic disorder: characterization by technetium-99m
      HMPAO and SPECT.
AB  - Autistic disorder is an early and severe developmental disorder characterized by
      deficits in verbal and nonverbal language, social skills, cognitive functioning
      and an abnormal repertoire of behaviors. Current research, however, has failed to
      identify the neurobiological mechanisms that underlie autism or those cortical
      brain regions, if any, that are abnormal. METHODS: We examined regional cerebral
      blood flow (rCBF) in six young, severely autistic patients. High-resolution brain
      SPECT with 99mTc-HMPAO was performed while five of the six patients were under
      general anesthesia. The scans reflected the subjects' rCBF in their usual alert
      behavioral state, since the tracer was injected at least 15 min prior to
      anesthesia and is rapidly extracted and fixed in the brain. A computer-automated
      cortical region of interest (ROI) generator was used to define 12 annular
      cortical regions (region 1 = left frontal, clockwise to region 12 = right
      frontal) for count data acquisition. The ratio of average counts in each ROI to
      whole-slice counts for the autistic patients was compared to age-matched controls
      using repeated measures (splt-plot) ANOVA statistical analysis for three
      representative brain levels. RESULTS: In the autistic patients, cortical regions
      3, 4, and 10 were abnormally low at the cortical level canthomeatal (CM) + 3.5
      cm. At level CM + 5.5 cm, regions 3, 4, 5 and 10 were abnormally low, and at
      level CM + 7.5 cm, regions 7 and 9 were also abnormally low. These regions
      correspond to abnormally low rCBF values located predominately in the temporal
      and parietal lobes, with the left cerebral hemisphere showing greater rCBF
      abnormalities than the right. CONCLUSION: Our findings suggest that the temporal
      and parietal lobes have abnormal rCBF in autism. HMPAO brain SPECT in combination
      with general anesthesia is particularly useful for imaging severely noncompliant
      patients.

PMID- 7790939
TI  - High-resolution SPECT to assess hippocampal perfusion in neuropsychiatric
      diseases.
AB  - The purpose of this study is to clarify the changes of hippocampal perfusion in
      neuropsychiatric diseases, including dementia, compared with control subjects,
      and to correlate hippocampal perfusion with the dementia rating scale and the
      severity of memory disturbance in patients with these diseases. METHODS: A total
      of 45 right-handed patients were investigated (13 with dementia of Alzheimer
      type, 6 with multi-infarct dementia, 4 with progressive dementia with motor
      neuron disease (MND), 3 with transient global amnesia, 5 with other diseases and
      14 control subjects). Regional cerebral blood flow (rCBF) in the parietal cortex
      and hippocampus was evaluated by high-resolution SPECT technique with HMPAO in
      all subjects. RESULTS: The rCBF measurements in the bilateral parietal cortices
      and hippocampus were lower in dementia of Alzheimer type and multi-infarct
      dementia patients than in controls. Hypoperfusion in the hippocampus was a more
      sensitive marker than hypoperfusion in the parietal cortex in diagnosing dementia
      of Alzheimer type. Hippocampal hypoperfusion was observed in demented patients
      regardless of etiology and in patients having memory disturbance without
      dementia, such as transient global amnesia. Finally, hippocampal hypoperfusion
      reflected the severity of dementia and memory disturbance regardless of etiology.
      CONCLUSION: The rCBF image with high-resolution SPECT system may be useful in
      assessing the extent of dementia and memory disturbance in patients with
      neuropsychiatric diseases.

PMID- 7790940
TI  - Brain SPECT evaluation of the visual cortex in amblyopia.
AB  - In amblyopia, the number of visual cortical neurons are reduced and abnormal or
      absent sensitivity to retinal light stimulation of the amblyopic eye is
      demonstrated. Ten amblyopic patients were studied to evaluate the response of the
      visual cortex to visual stimulation. METHODS: All patients with unilateral
      amblyopia received 500-550 MBq 99mTc-HMPAO during visual stimulation. Strobe
      light flashing was used as the stimulus for five patients and a checkerboard
      pattern reversal was used in the other five patients, closing one eye. For both
      groups a 2-Hz frequency was used. One week later, the same procedure was repeated
      with the opposite eye closed. SPECT images were reconstructed with prefiltering
      techniques and sliced along the orbitomeatal line. RESULTS: For all patients, the
      amblyopic eye demonstrated less radioactivity in the visual cortex than in the
      normal eye. The mean cerebral-to-cerebellar ratios were 0.95 +/- 0.05 and 1.09 +/
      0.07 for amblyopic and normal eyes, respectively (p < 0.0001). CONCLUSION:
      Visual cortex response of the amblyopic eye to light stimulation was severely
      reduced when compared to the normal eye.

PMID- 7790941
TI  - Age-related decline in striatal dopamine transporter binding with iodine-123-beta
      CITSPECT.
AB  - The effect of age on human striatal dopamine (DA) transporters was investigated
      with SPECT using the ligand [123I]2 beta-carbomethoxy-3 beta-(4
      iodophenyl)tropane ([123I]beta-CIT). METHODS: Iodine-123-beta-CIT binding in the
      striatum was examined in 28 healthy human subjects (14 men, 14 women) who ranged
      in age from 18 to 83 yr. Following injection with [123I]beta-CIT (mean +/- s.d. =
      9.9 +/- 1.2 mCi), subjects were scanned with the brain-dedicated CERASPECT
      camera. A reconstructed transaxial slice 13.3-mm thick at the level of maximal
      striatal activity was used to determine tracer uptake in striatal and occipital
      regions of interest. The stability of regional uptake on Day 2 (approximately 18
      24 hr postinjection) permitted estimation of the specific-to-nondisplaceable
      equilibrium partition coefficient: V3", calculated as (striatal-
      occipital)/occipital uptake at equilibrium. RESULTS: Values of V3" ranged from
      3.6 to 11.4 for this sample (6.7 +/- 1.9). V3" showed a significant inverse
      correlation with age (r = -0.73, n = 28, p < 0.0001). Linear regression analysis
      revealed that V3" declined by 51% over the age range studied or approximately 8%
      per decade. CONCLUSION: These findings confirm postmortem reports of dopamine
      transporter loss with aging. In vivo methodologies may permit the age-related
      degeneration of dopamine nerve terminals to be studied in relation to the
      cognitive and motor deficits that occur in normal aging.

PMID- 7790942
TI  - SPECT imaging of striatal dopamine release after amphetamine challenge.
AB  - This study assesses the feasibility of using SPECT to image intrasynaptic
      dopamine release in human striatum following dextroamphetamine sulfate (d
      amphetamine) challenge testing. METHODS: A bolus plus constant infusion
      administration schedule of the D2 receptor radiotracer [123I]iodobenzamide
      ([123I]IBZM) was used to obtain a stable baseline for reliable quantitation of
      the d-amphetamine effect. Eight healthy subjects first underwent a controlled
      experiment to demonstrate that stable levels of striatal and occipital activities
      could be maintained from 150 to 420 min during programmed infusion of the tracer.
      Next, seven subjects underwent the experiment with d-amphetamine. The
      experimental conditions were identical except that 0.3 mg/kg amphetamine was
      injected intravenously at 240 min. The behavioral effects of d-amphetamine were
      measured by self-rating on the following analog scales: euphoria, alertness,
      restlessness and anxiety. RESULTS: The d-amphetamine injection induced a 15% +/-
      4% (mean +/- s.d.) decrease in D2 receptor availability, measured as the specific
      to-nonspecific equilibrium partition coefficient (V3"). The d-amphetamine
      injection induced marked increase in euphoria, alertness and restlessness scores.
      The intensity of these behavioral responses correlated with the decrease in D2
      availability measured with SPECT. In contrast, the anxiety response was milder
      and not correlated with the decrease in D2 availability. CONCLUSION: These
      studies demonstrate the feasibility of using [123I]IBZM programmed infusion and
      SPECT imaging to measure endogenous dopamine release after d-amphetamine
      challenge and to study brain neurochemical correlates of emotions.

PMID- 7790943
TI  - SPECT imaging of dopamine D2 receptors with 2'-iodospiperone.
AB  - SPECT imaging of dopamine D2 receptors was performed using 123I-labeled 2'
      iodospiperone (2'-ISP). METHODS: Iodine-123-2'-ISP was administered to 12 normal
      subjects. Serial SPECT scans were obtained in six normal subjects for kinetic
      studies and static SPECT images were obtained in four normal subjects. Two
      additional normal subjects had serial whole-body imaging to calculate radiation
      dosimetry. RESULTS: Serial SPECT scans demonstrated rapid initial brain uptake
      followed by gradual washout from the cerebral cortex and cerebellum, while the
      activity in the basal ganglia was stable for 2 hr and gradually decreased
      thereafter. There was fast clearance of blood activity with rapid conversion of
      2'-ISP to the hydrophilic metabolites. The basal ganglia-to-frontal cortex ratio
      increased with time and plateaued between 2 and 4 hr postinjection. The basal
      ganglia-to-frontal cortex ratio obtained during this period demonstrated an age
      dependent decrease similar to other D2 ligands. CONCLUSION: 2'-ISP can be used
      for mapping dopamine D2 receptors in human brain with SPECT. The relatively high
      background activity, however, suggests that further modification of the compound
      may be needed prior to widespread clinical use.

PMID- 7790944
TI  - Iodine-123-IBF SPECT evaluation of extrapyramidal diseases.
AB  - Iodine-123-IBF is a dopaminergic antagonist suitable for SPECT imaging of D2
      receptors. Initial animal studies demonstrated that its affinity for D2 receptors
      is approximately four times that of the commonly used SPECT D2 ligand [123I]IBZM.
      In this study we investigated whether this higher affinity would lead to an
      improved accuracy in differentiating between various extrapyramidal diseases.
      METHODS: SPECT imaging was performed in 17 patients with idiopathic Parkinson's
      syndrome (IPS); 4 patients with progressive supranuclear palsy (PSP), 2 patients
      with multiple system atrophy (MSA) and 7 age-matched control subjects. SPECT
      imaging was performed 5, 60, 120 and 180 min following intravenous bolus
      injection of 150-250 MBq of [123I]IBF. The ratio of ligand uptake in the basal
      ganglia and frontal cortex was determined as a measure of receptor status.
      RESULTS: In PSP and MSA patients, the basal ganglia-to-frontal cortex ratio
      reached a plateau at 2 hr; in the control subjects and the IPS patients the ratio
      was steadily increasing. At 3 hr the basal ganglia-to-frontal cortex ratio was
      2.66 +/- 0.29 (control subjects), 3.01 +/- 0.41 (IPS), 2.09 +/- 0.22 (PSP) and
      2.10 (MSA). In the IPS patients with predominantly one-sided symptoms, the
      striatum contralateral to symptoms showed a tendency towards relatively increased
      ligand uptake. Despite the higher affinity of IBF for the D2 receptor compared to
      IBZM, the separation of individual PSP and MSA patients from the control subjects
      was not as clear cut as reported for IBZM due to a relatively high variation in
      the control subjects. We hypothesize that the latter is due to imaging in
      nonequilibrium conditions. CONCLUSION: The data suggest that IBF-SPECT can help
      in discriminating extrapyramidal disease. The accuracy might be improved by an
      administration protocol that allows imaging in "true equilibrium" conditions,
      such as a bolus injection followed by a constant infusion.

PMID- 7790945
TI  - Simple quantification of benzodiazepine receptor binding and ligand transport
      using iodine-123-iomazenil and two SPECT scans.
AB  - The feasibility of simplified procedures for the quantification of benzodiazepine
      receptor binding using [123I]iomazenil and SPECT was assessed. METHODS: Six
      normal male volunteers were studied. Following intravenous injection of 111 MBq
      [123I]iomazenil, serial dynamic SPECT scanning was performed for 120 min and the
      concentration of lipophilic compounds in the arterial plasma was determined by
      chloroform extraction. Kinetic parameters were estimated by a curve-fitting
      procedure using the following four models: three-compartment, four-parameter (K1
      k4) (3C4P), three-compartment, three-parameter (fixed K1/k2) (3C3P), three
      compartment, two-parameter (fixed K1/k2 and k4) (3C2P) and two-compartment, two
      parameter (K1 and k2) (2C2P). Kinetic parameters were also calculated by a table
      look-up procedure with 3C2P using only two SPECT data acquisitions. Parametric
      images were generated based on the same procedure. RESULTS: In all models, the
      curve-fitting procedure gave similar outcomes for ligand transport (K1) and
      receptor density parameters (i.e., binding potential or distribution volume). The
      3C4P parameters showed significant correlation between k2 and k3, while 3C3P did
      not show such a correlation, suggesting the stability of 3C3P. The 3C2P provided
      parameters essentially identical to those with the 3C3P, indicating the
      suitability of this model, while 2C2P gave similar distribution volume but
      obviously low K1. CONCLUSION: Table look-up procedures based on the 3C2P model
      permit quantification of benzodiazepine receptor binding using [123I]iomazenil
      with two SPECT scans. This method may be of clinical value in the diagnosis of
      various diseases.

PMID- 7790946
TI  - Improved regional cerebral blood flow in chronic cocaine polydrug users treated
      with buprenorphine.
AB  - Chronic cocaine and polydrug abuse have been associated with regional
      abnormalities in cerebral perfusion. The authors have previously demonstrated
      that these abnormalities are partially reversible after drug addiction treatment
      with buprenorphine. This study was designed to separate the effect on cerebral
      perfusion of abstinence from drug use from that of buprenorphine directly.
      METHODS: Fifteen cocaine- and heroin-dependent men were studied with 99mTc
      hexamethylpropyleneamine oxime (HMPAO) brain SPECT. The men, all part of an
      inpatient drug abuse treatment research program, were randomly assigned after
      detoxification to receive placebo or either 6 or 12 mg daily buprenorphine
      treatment. SPECT studies were performed at baseline, after maximum dosage was
      reached and after tapering off the study drug. Studies were compared visually
      with regard to the number and location of perfusion defects by reviewers blinded
      to treatment assignment. RESULTS: Subjects receiving buprenorphine had a
      significant reduction in the number of defects per study between baseline and
      maximum buprenorphine dose as compared with those receiving placebo (decrease of
      4 +/- 5.4 versus increase of 4.8 +/- 4.7, p = 0.006). These differences were dose
      related. Improvement with buprenorphine was temporary, with return to baseline
      after tapering off. CONCLUSION: Buprenorphine treatment, and not abstinence from
      drug use alone, leads to improvement in regional cerebral perfusion abnormalities
      in chronic cocaine- and heroin-dependent men.

PMID- 7790947
TI  - Lateralized differences in iodine-123-IBZM uptake in the basal ganglia in
      asymmetric Parkinson's disease.
AB  - We used equilibrium analysis of SPECT data from patients with asymmetric
      Parkinson's disease to determine if lateralized differences in the striatal
      uptake of [123I]IBZM correlate with asymmetry in clinical findings and, by
      inference, with lateralized differences in the concentration of extracellular
      dopamine. METHODS: Twelve patients with asymmetric clinical signs of idiopathic
      Parkinson's disease were injected with a bolus of [123I]IBZM, and multiple SPECT
      scans recorded the time course of radioligand uptake. The time integral method
      was used to estimate peak specific binding, so that a ratio of specific-to
      nonspecific binding in the left and right striatum of each subject at equilibrium
      could be determined. Nine patients also had 99mTc-HMPAO SPECT scans which were
      examined for evidence of blood flow asymmetries. RESULTS: Paired t-tests
      comparing [123I]IBZM uptake revealed significantly greater (mean = 7.3%)
      availability of dopamine-D2 receptors in the basal ganglia contralateral to
      maximal clinical signs. Differences in receptor availability correlated
      significantly with differences in every measure of the clinical assessment. No
      significant differences in regional cerebral blood flow between the two sides
      were observed with 99mTc-HMPAO. CONCLUSION: These results demonstrate the ability
      of [123I]IBZM SPECT to reveal clinically meaningful variations in striatal
      dopamine receptor availability in patients with asymmetric Parkinson's disease.
      The equilibrium analysis technique used to determine these findings is a simple
      and robust method of measuring relative receptor availability and may be useful
      in studying other illnesses where dysfunction of dopaminergic neurotransmission
      is suspected.

PMID- 7790948
TI  - Regional striatal DOPA transport and decarboxylase activity in Parkinson's
      disease.
AB  - METHODS: We measured blood-brain barrier transport and decarboxylation of 6
      [18F]fluoro-L-DOPA (FDOPA) using PET in patients with Parkinson's disease (n = 7,
      57 +/- 7 yr) and age-matched control subjects (n = 7, 60 +/- 6 yr). To visually
      present regional changes of FDOPA uptake in Parkinson's disease, we introduced
      maps of FDOPA uptake relative to occipital cortex, averaged across control
      subjects and Parkinson's disease patients in an MRI-based stereotaxic coordinate
      space. RESULTS: There was no significant changes in the blood-to-brain transport
      of FDOPA (KD1) in Parkinson's disease. The KD1 values of the head of caudate were
      lower than those of putamen in both normal subjects and Parkinson's disease
      patients. In Parkinson's disease, the activity of L-DOPA decarboxylase (DDC) was
      differentially reduced in subdivisions of striatum. The residual DDC activity was
      63% of the control value in the head of caudate nucleus, 54% in the anterior
      putamen and 39% in the posterior putamen. The DDC activity in frontal and
      occipital cortices remained unchanged by the disease. Subtraction of averaged
      FDOPA uptake maps (control minus Parkinson's disease) visualized a spatial
      pattern of pathological changes in FDOPA uptake common to Parkinson's disease
      patients. CONCLUSION: The striatal blood-to-brain transport of FDOPA remained
      unchanged while the DDC activity was differentially reduced within the striatum
      in Parkinson's disease. We found the FDOPA uptake maps useful in identifying
      altered patterns of FDOPA metabolism common in Parkinson's disease.

PMID- 7790949
TI  - Aging effect on neutral amino acid transport at the blood-brain barrier measured
      with L-[2-18F]-fluorophenylalanine and PET.
AB  - Neutral amino acids (NAAs) are transported from the blood to the brain using the
      same carrier system in a competitive fashion. The purpose of this study is to
      establish a method for evaluating neutral amino acid transport at the blood-brain
      barrier (BBB) in humans and to examine the aging effect of amino acid transport.
      METHODS: A dynamic PET study with L-(2-18F)-fluorophenylalanine (18F-Phe) was
      performed in 14 normal volunteers (age 21-71 yr; mean +/- s.d., age range 48.0 +/
      17.1 yr). By using a two-compartment model analysis and a weighted integration
      technique, the influx rate constant K1, the efflux rate constant k2 and
      distribution volume Vd of 18F-Phe were estimated in various brain structures.
      RESULTS: The value of K1 was inversely correlated with plasma NAA concentration
      (r = -0.69, p < 0.01). The cerebellum showed the highest value of K1, while the
      white matter showed the lowest. There was no significant change in K1 during
      aging. The value of k2 was significantly increased with age. CONCLUSION: No
      decline of K1 during aging indicated that NAA transport from the blood to the
      brain is a limiting process of age in amino acid incorporation. Fluorine-18-Phe
      PET imaging is a feasible method to study NAA transport at the BBB in vivo in
      humans and can be applied to pathological conditions of the brain.

PMID- 7790951
TI  - FDG-PET in early infancy: simplified quantification methods to measure cerebral
      glucose utilization.
AB  - For further insight into the physiology and pathogenesis of the developing brain,
      quantification of the cerebral glucose metabolism is needed. Arterial blood
      sampling or sampling of great volumes of blood is not justified for the purpose
      of PET studies in children. Therefore, we have developed simplified PET
      approaches to analyze brain FDG examinations during infancy. METHODS: The study
      consisted of 18 FDG-PET examinations chosen from our research protocols
      concerning hypoxicischemic encephalopathy and severe neonatal hypoglycemia. The
      input function for graphical analysis according to Patlak was derived in two
      ways: (1) a combined time-activity curve derived from the left ventricular
      activity concentration (first 7-17 min of the study) and radioactivity
      concentration in venous whole-blood samples and; (2) activity concentration
      measured in whole-blood venous blood samples (arterial plasma in one case). As an
      alternative for semiquantitation, the standardized uptake values (SUV) were
      calculated and correlated to local cerebral metabolic rates for glucose
      (LCMRGlc). RESULTS: The influx rate constants (Ki) and LCMRGlc values obtained
      using the combined curve versus venous curve did not differ statistically (p >
      0.05). There was a good correlation between the SUV and LCMRGlc values (r = 0.83,
      p < 0.001). CONCLUSION: Local cerebral metabolic rates for glucose can be
      accurately calculated by using the combined curve (left ventricular activity
      concentration during first 5 min of the study and 2-3 venous whole-blood samples
      at the end of the study) for even the smallest pediatric patients. When blood
      samples cannot be obtained, SUV values provide an alternative for estimation of
      the cerebral glucose uptake and interindividual comparison of the patients.

PMID- 7790950
TI  - A diagnostic approach in Alzheimer's disease using three-dimensional stereotactic
      surface projections of fluorine-18-FDG PET.
AB  - To improve the diagnostic performance of PET as an aid in evaluating patients
      suspected of having Alzheimer's disease, we developed a fully automated method
      which generates comprehensive image presentations and objective diagnostic
      indices. METHODS: Fluorine-18-fluorodeoxyglucose PET image sets were collected
      from 37 patients with probable Alzheimer's disease (including questionable and
      mild dementia), 22 normal subjects and 5 patients with cerebrovascular disease.
      Following stereotactic anatomic standardization, metabolic activity on an
      individual's PET image set was extracted to a set of predefined surface pixels
      (three-dimensional stereotactic surface projection, 3D-SSP), which was used in
      the subsequent analysis. A normal database was created by averaging extracted
      datasets of the normal subjects. Patients' datasets were compared individually
      with the normal database by calculating a Z-score on a pixel-by-pixel basis and
      were displayed in 3D-SSP views for visual inspections. Diagnostic indices were
      then generated based on averaged Z-scores for the association cortices. RESULTS:
      Patterns and severities of metabolic reduction in patients with probable
      Alzheimer's disease were seen in the standard 3D-SSP views of extracted raw data
      and statistical Z-scores. When discriminating patients with probable Alzheimer's
      disease from normal subjects, diagnostic indices of the parietal association
      cortex and unilaterally averaged parietal-temporal-frontal cortex showed
      sensitivities of 95% and 97%, respectively, with a specificity of 100%. Neither
      index yielded false-positive results for cerebrovascular disease. CONCLUSION: 3D
      SSP enables quantitative data extraction and reliable localization of metabolic
      abnormalities by means of stereotactic coordinates. The proposed method is a
      promising approach for interpreting functional brain PET scans.

PMID- 7790952
TI  - Selective reduction of radiotracer trapping by deuterium substitution: comparison
      of carbon-11-L-deprenyl and carbon-11-deprenyl-D2 for MAO B mapping.
AB  - Recent human PET studies with the monoamine oxidase B (MAO B) tracer [11C]L
      deprenyl show that the rapid rate of radiotracer trapping relative to transport
      reduces the sensitivity of the tracer in regions of high MAO B concentration.
      This study investigates the use of deuterium substituted L-deprenyl ([11C]L
      deprenyl-D2) to reduce the rate of trapping in tissue and to improve sensitivity.
      METHODS: Five normal subjects (43-64 yr) were studied with [11C]L-deprenyl and
      [11C]L-deprenyl-D2 on the same day. Time-activity data from different brain
      regions and the arterial plasma were analyzed using a three-compartment model as
      well as graphical analysis for irreversible systems. RESULTS: For both tracers,
      maximum radioactivity accumulation occurred at about 5 min. For [11C]L-deprenyl,
      11C concentration peaked at 5 min and remained constant throughout the study.
      With [11C]L-deprenyl-D2, peak 11C concentration also occurred at about 5 min but
      was followed by an initial washout. Carbon-11 concentration generally plateaued
      from 30 to 60 min. The plateau for [11C]L-deprenyl was higher than the plateau
      for [11C]L-deprenyl-D2. Data analysis by a three-compartment model and by
      graphical analysis showed that deuterium substitution: (a) does not affect plasma
      to tissue transport (K1); (b) reduces the rate of trapping of 11C in all brain
      regions; (c) facilitates the separation of model terms related to radiotracer
      delivery from radiotracer trapping in tissue; and (d) improves tracer
      sensitivity. CONCLUSION: This study demonstrates that deuterium substitution
      causes a significant reduction in the rate of trapping of labeled deprenyl,
      providing a direct link between radiotracer uptake and MAO B in the human brain
      and enhancing tracer sensitivity to changes in MAO B concentration.

PMID- 7790954
TI  - Cerebral blood flow and perfusion reserve capacity in hemodynamic carotid
      transient ischemic attacks due to innominate artery stenosis.
AB  - Ischemia in the carotid artery territory due to atherosclerotic stenosis of the
      innominate artery is rare. We report a case in which transcranial Doppler
      ultrasonography (TCD) and SPECT with acetazolamide challenge proved the
      hemodynamic mechanism. The patient presented with three hypotensive TIAs in the
      right middle cerebral artery territory. Angiography showed a tight innominate
      artery stenosis and subclavian steal but no coexistent carotid or vertebrobasilar
      lesion. SPECT showed disturbed regional blood flow in the middle cerebral artery
      territory along with an exhausted perfusion reserve capacity. After angioplasty,
      flow velocities were normal and the perfusion reserve was restored. SPECT should
      be used to select patients at risk susceptible to benefit from angioplasty.

PMID- 7790955
TI  - Cortical blindness after correction of symptomatic hyponatremia: dynamic cerebral
      dysfunction visualized using serial SPECT scanning.
AB  - A 70-yr-old woman developed cortical blindness after correction of hyponatremia.
      Regional hyperperfusion was noted on SPECT scans obtained in the acute phase. One
      month later when symptoms had largely resolved, a repeat examination was normal.
      This regional hyperperfusion, which was not associated with any apparent
      structural damage, may have represented either luxury perfusion or a transient
      increased metabolic requirement of the dysfunctional cortical area. SPECT
      scanning may be a useful method to study cerebral dysfunction resulting from an
      osmotic disturbance.

PMID- 7790953
TI  - PET studies on brain monoamine transporters with carbon-11-beta-CIT in
      Parkinson's disease.
AB  - The cocaine analog 2 beta-carbomethoxy-3 beta-[4-iodophenyl]tropane (beta-CIT)
      labeled with 11C was used to study dopamine reuptake sites with PET. METHODS:
      Three normal subjects and nine patients with Parkinson's disease were
      investigated. Each of them underwent a dynamic PET scan (25 timeframes over 80
      min) with [11C]-beta-CIT. A dose of 102.5-211.3 MBq (2.77-5.71 mCi) of this
      ligand was administered intravenously and a PET examination with an ECAT 931/08
      PET camera was carried out. Ratios between the
      striatal/cortical/thalamic/midbrain and cerebellar uptake of this radioligand
      were calculated. RESULTS: The highest accumulation of [11C]beta-CIT was observed
      in the caudate and putamen, though there was some uptake in the thalamus and the
      midbrain. Cortical uptake was negligible. Carbon-11-beta-CIT accumulated
      significantly less in the putamen of the Parkinson's patients than in the normal
      subjects. The putamen-to-cerebellum ratio in the Parkinson's patients was 1.59 +/
      0.04 and 1.80 +/- 0.13s (p = 0.028) in the normal subjects. In the caudate,
      there was no significant difference between the Parkinson's patients and the
      normal subjects. CONCLUSION: These results imply that [11C]beta-CIT is a useful
      compound for carrying out a PET examination of the function of the presynaptic
      monoaminergic neurons both in normal and pathological brains.

PMID- 7790956
TI  - Carbon-11-FLB 457: a radioligand for extrastriatal D2 dopamine receptors.
AB  - D2 dopamine receptors in extrastriatal brain regions are of central interest for
      research in schizophrenia and antipsychotic drugs. This article reports the
      development of [11C]FLB 457 for PET examination of extrastriatal D2 dopamine
      receptors. METHODS: Carbon-11-FLB 457 was prepared by O-methylation of FLB 604 (2
      hydroxy precursor) with [11C]methyl iodide. Total radiochemical yield was 25%-35%
      within a total synthesis time of 30 min. The specific radioactivity at the end of
      synthesis was about 1300 Ci/mmole (48 GBq/mumole). RESULTS: FLB 457 bound with
      high affinity to D2 and D3 dopamine receptors, whereas binding to other putative
      central receptors was negligible. PET studies in Cynomolgus monkeys demonstrated
      15 times higher accumulation of radioactivity in the striatum than in the
      cerebellum after 60 min. Uptake in the thalamus and neocortex, extrastriatal
      regions with a low density of D2 dopamine receptors, was, respectively, 4 and 2.5
      times higher than in the cerebellum. Radioactivity was displaced by raclopride
      and haloperidol which confirms the selectivity and reversibility of [11C]FLB 457
      binding to D2 dopamine receptors in vivo in the striatum, thalamus and neocortex.
      CONCLUSION: Carbon-11-FLB 457 should be a useful PET ligand for quantitative
      examination of D2 dopamine receptors in extrastriatal regions in the human brain.

PMID- 7790957
TI  - In vitro and in vivo characterization of R(+)-FIDA2: a dopamine D2-like imaging
      agent.
AB  - R(+)-FIDA2, (R)-(+)-2,3-dimethoxy-5-iodo-N-[(1-(4'-fluorobenzyl)-2-pyrrolid iny
      l)- methyl]benzamide, is a new dopamine D2-like receptor imaging agent that can
      be labeled with either 123I or 18F for SPECT or PET imaging. The purpose of this
      study was to characterize its in vitro and in vivo binding properties. METHODS:
      In vitro binding studies using [125I]R(+)-FIDA2 were performed in Sf9 cells
      expressing dopamine D2 or D3 receptors and in rat basal forebrain homogenates,
      which contain a high density of dopamine D2-like receptors. A series of in vivo
      SPECT imaging studies in nonhuman primates (cynomologous monkeys) were performed
      by intravenously injecting 7.1 +/- 1.0 mCi of [123I]R(+)-FIDA2. At least one
      control study and one displacement experiment, in which a cold compound was
      injected intravenously 90 min after tracer injection, was performed in each
      monkey. Data were acquired in 10-min frames for 180 min, and the activity in
      regions of interest (basal ganglia and cerebellum) were plotted versus time.
      RESULTS: Iodine-125-R(+)-FIDA2 displayed Kd values for D2 and D3 receptor
      subtypes expressed in Sf9 cells of 0.11 and 0.04 nM, respectively. As expected,
      SPECT images of monkey brain (transaxial sections, 2 mm) showed that the
      radioactivity was localized in the area of the basal ganglia and reached peak
      concentrations in 11.5 +/- 5.8 min postinjection. An injection of R(+)7-OH-PIPAT,
      a new ligand that is selective for dopamine D3 receptors and the high affinity
      state of dopamine D2 receptors, did not show significant displacement of
      [123I]R(+)-FIDA2 binding in the basal ganglia. CONCLUSION: These studies indicate
      that R(+)-FIDA2 may be a useful ligand for in vitro pharmacological
      characterization and in vivo imaging of CNS dopamine D2-like receptors.

PMID- 7790958
TI  - Carbon-11-cocaine binding compared at subpharmacological and pharmacological
      doses: a PET study.
AB  - We have characterized cocaine binding in the brain to a high-affinity site on the
      dopamine transporter using PET and tracer doses of [11C]cocaine in the baboon in
      vivo. The binding pattern, however, of cocaine at tracer (subpharmacological)
      doses may differ from that observed when the drug is taken in behaviorally active
      doses particularly since in vitro studies have shown that cocaine also binds to
      low affinity binding sites. METHODS: PET was used to compare and characterize
      [11C]cocaine binding in the baboon brain at low subpharmacological (18 micrograms
      average dose) and at pharmacological (8000 micrograms) doses. Serial studies on
      the same day in the same baboon were used to assess the reproducibility of
      repeated measures and to assess the effects of drugs which inhibit the dopamine,
      norepinephrine and serotonin transporters. Time-activity curves from brain and
      the arterial plasma input function were used to calculate the steady-state
      distribution volume (DV). RESULTS: At subpharmacological doses, [11C]cocaine had
      a higher binding and slower clearance in striatum than in other brain regions. At
      pharmacological doses, [11C]cocaine had a more homogeneous distribution. Bmax/Kd
      for sub-pharmacological [11C]cocaine corresponded to 0.5-0.6 and for
      pharmacological [11C]cocaine it corresponded to 0.1-0.2. Two-point Scatchard
      analysis gave Bmax = 2300 pmole/g and Kd' = 3600 nM. Bmax/Kd for sub
      pharmacological doses of [11C]cocaine was decreased by cocaine and drugs that
      inhibit the dopamine transporter, to 0.1-0.2, but not by drugs that inhibit the
      serotonin or the norepinephrine transporter. None of these drugs changed Bmax/Kd
      for a pharmacological dose of [11C]cocaine. CONCLUSION: At subpharmacological
      doses, [11C]cocaine binds predominantly to a high-affinity site on the dopamine
      transporter.

PMID- 7790959
TI  - Functional studies in substance abuse: imaging and beyond.

PMID- 7790960
TI  - High accumulation of fluorine-18-fluorodeoxyglucose in turpentine-induced
      inflammatory tissue.
AB  - Fluorine-18-2-deoxy-2-fluoro-D-glucose ([18F]FDG) uptake and distribution in an
      experimentally induced inflammatory tissue were investigated. METHODS: Rats were
      subcutaneously inoculated with turpentine oil to induce inflammation and used for
      tissue distribution studies and autoradiography. RESULTS: Time course study of
      [18F]FDG tissue distribution showed that the uptake in inflammatory tissue
      increased gradually until 60 min and then decreased. A longitudinal study of
      [18F]FDG tissue distribution showed that the uptake increased progressively to a
      peak 4 days after inoculation and then decreased. On the fourth day
      postinoculation, a section of inflammatory tissue showed characteristic changes
      of chronic inflammation. Macro- and micro-autoradiography showed a high density
      of silver grains in the abscess wall consisting of an inflammatory cell layer and
      granulation tissue. Grain counting on micro-autoradiography of the abscess wall
      showed that the highest grain density was found in the marginal zone of young
      fibroblasts, endothelial cells of vessels and phagocytes of neutrophils and
      macrophages, followed by that in the neutrophil layer and granulation tissue.
      CONCLUSION: Our results indicate that [18F]FDG PET may be useful in detecting and
      monitoring chronic inflammatory processes.

PMID- 7790961
TI  - A method for coregistration of PET and MR brain images.
AB  - Combining MRI morphological data with functional PET data offers significant
      advantages in research as well as in many clinical situations. Automatic methods
      are needed, however, to coregister the data from the two modalities. METHODS:
      Simulated PET images were created by simple and automatic segmentation of MR
      images followed by the assignment of different uptake values to various tissue
      types. The simulated PET images were registered to actual PET images using a
      pixel-by-pixel, PET-PET registration method. The transformation matrix was then
      applied to the MR images. The method was used to register MRI data to PET
      transmission scans and emission scans obtained with FDG, nomifensine and
      raclopride. Validation was performed by comparing the results to those obtained
      by matching internal points manually defined in both volumes. RESULTS: Emission
      and transmission PET images were successfully registered to MR data. Comparison
      to the manual method indicated a registration accuracy on the order of 1-2 mm in
      each direction. No difference in accuracy between the different tracers was
      found. The error sensitivity for the method's assumptions seemed to be
      sufficiently low to allow complete automation of the method. CONCLUSION: We
      present a rapid, robust and fully automated method to register PET and MR brain
      images with sufficient accuracy for most clinical applications.

PMID- 7790962
TI  - Dosimetry of iodine-123-epidepride: a dopamine D2 receptor ligand.
AB  - Substituted benzamides have been shown to have very high affinity and specificity
      for the dopamine D2 receptor. One of these is radiolabeled epidepride, an iodine
      substituted benzamide currently under evaluation as a SPECT imaging agent.
      Detailed estimates of the radiation absorbed dose to 26 organs and the whole body
      from [123I]epidepride have been calculated. METHODS: The dosimetry calculations
      use a combination of in vivo uptake and biodistribution data from one rhesus
      monkey and seven humans to estimate residence times in eight organs. The computer
      program MIRDOSE2 was used to calculate the dosimetry. RESULTS: Results indicate
      that 75% of the radioactivity is cleared through the urinary tract while the
      remaining radioactivity clears through the gallbladder and intestinal tract. The
      radiation absorbed dose can be minimized by administering a high lipid content
      meal 1.5 hr postinjection to empty the gallbladder and by giving large volumes of
      fluids throughout the study to induce increased urinary output. CONCLUSION: By
      emptying the gallbladder and urinary bladder, the lower large intestine becomes
      the critical organ, 0.102 mGy/MBq (0.38 rad/mCi) followed by the upper large
      intestine, 0.092 mGy/MBq (0.34 rad/mCi). The effective dose equivalent is 0.025
      mSv/MBq (0.092 rem/mCi).

PMID- 7790964
TI  - Human dosimetry and biodistribution of iodine-123-iododexetimide: a SPECT imaging
      agent for cholinergic muscarinic neuroreceptors.
AB  - Iodine-123-iododexetimide (IDEX) has recently been used for SPECT imaging of
      muscarinic cholinergic neuroreceptors (mAChR) in humans. We report the human
      radiation dosimetry, whole-body and normal cerebral distribution of IDEX.
      METHODS: Serial whole-body planar and brain SPECT scans were performed over 24 hr
      in four normal subjects. Organ activity was calculated from attenuation-corrected
      geometric mean counts from ROIs drawn over visible organs. Thigh activity was
      used for background subtraction. Organ absorbed doses and effective dose were
      calculated using the MIRD schema. Brain SPECT was performed 6 hr postinjection in
      ten normal subjects. ROIs placed over cortical and subcortical structures were
      used to determine brain distribution. RESULTS: The effective dose was 24.7
      microSv/MBq. An average of 54% of IDEX remained in the body background. Decay
      corrected brain uptake was 6.9% of injected dose at 1 hr, 8.6% at 6 hr and 8.1%
      at 24 hr. Regional brain distribution showed high uptake in striatum and cortex
      with low activity in thalamus and cerebellum. At 6 hr, activity relative to
      striatum was 70% for frontal and parietal cortex, 102% for occipital cortex, 54%
      for thalamus and 11% for cerebellum. CONCLUSION: Iodine-123-IDEX produced high
      quality SPECT images with activity at 6 hr reflecting the known distribution of
      mAChR receptors. The favorable dosimetry of IDEX and high synthetic yield (50%
      70%) suggest it to be a suitable agent for clinical studies.

PMID- 7790963
TI  - Dosimetry of a D2/D3 dopamine receptor antagonist that can be used with PET or
      SPECT.
AB  - FIDA-2 (R-(+)-2,3-dimethoxy-5-iodo-N-[(1-4'-fluorobenzyl)-2-pyrrolidinyl) methyl]
      benzamide) is a simultaneously fluorinated and iodinated D2/D3 dopamine receptor
      antagonist. The purpose of this study was to measure its biodistribution and
      radiation dosimetry in humans. METHODS: Whole-body emission scans were
      sequentially acquired in eight healthy volunteers 24-43 hr after the intravenous
      administration of 101-150 MBq 123I FIDA-2. Regions of interest (ROIs) were placed
      on the initial set of conjugate emission images and transposed as a single set
      onto all the other scans without manipulating any of the regions for solid organs
      independently. The counts in each ROI were corrected for attenuation with
      transmission scans and compared to the net counts in images of the injection
      syringe containing the administered dose. The radiation doses were estimated with
      the MIRD formalism from the residence times for both the 18F- and 123I-labeled
      ligands. RESULTS: There were no subjective or objective pharmacological effects
      of the tracer on any of the subjects. The findings showed that the dose-limiting
      organ for the 123I-labeled product was the thyroid gland in this sample. If the
      18F-labeled product had been used, then the urinary bladder would have received
      0.086 mGy/MBq (0.32 rads/mCi) and become the dose-limiting organ. The effective
      dose equivalents were 0.025 mSv/MBq (0.092 rem/mCi) for both the 123I- and the
      18F-labeled versions of the tracer. CONCLUSION: The data suggest that FIDA-2 can
      be used to produce relatively high contrast images of the D2/D3 dopaminergic
      system with substantially less than the maximum allowable radiation dose for
      research volunteers.

PMID- 7790966
TI  - Ward Valley waste site poised to get green light.

PMID- 7790965
TI  - Evaluation of a double-injection method for sequential measurement of cerebral
      blood flow with iodine-123-iodoamphetamine.
AB  - To test the feasibility of applying N-isopropyl-[123I]p-iodoamphetamine (IMP) for
      sequential measurements of regional cerebral blood flow (rCBF) with injection of
      two separate doses in a single procedure, kinetic analysis based on a two
      compartment model was done using dynamic SPECT data. A microsphere model analysis
      without consideration of IMP washout from the brain was also tested for clinical
      application. METHODS: A dynamic SPECT scan consisting of fifty 1-min scans was
      obtained on 15 patients using a three-head rotating gamma camera with two
      separate doses of IMP (111 MBq each) at the beginning and 25 min after scan
      initiation. The reproducibility of two resting rCBF scans was tested in six
      patients and the cerebrovascular response shown by increased rCBF with
      acetazolamide (1 g) was assessed in nine patients. RESULTS: Two-compartment model
      analysis showed excellent reproducibility of resting rCBF scans and significantly
      different cerebrovascular reactivity to acetazolamide between areas with and
      without ischemia. Microsphere model analysis showed smaller values in the first
      rCBF image by 3% and in the second by 10%, resulting in lower values for
      cerebrovascular reactivity. The difference in cerebrovascular reactivity between
      ischemic and nonischemic areas, however, is highly significant. CONCLUSION: The
      double-injection method for IMP is feasible for two sequential rCBF measurements
      in a single procedure and is applicable for acetazolamide challenge. Simple
      microsphere model analysis, as well as a two-compartment model analysis, provide
      reliable assessment for cerebrovascular reactivity despite the complex dynamics
      of IMP and are feasible for clinical application.

PMID- 7790967
TI  - Scenes from the Oklahoma City bombing.

PMID- 7790969
TI  - Reawakening thinking: is traditional pedagogy nearing completion?

PMID- 7790968
TI  - From the past to the future: awarding nuclear medicine innovators.

PMID- 7790970
TI  - What does it mean to be well taught? A hermeneutic course evaluation.
AB  - Evaluating courses is an ongoing part of nursing education. With the adoption of
      innovative approaches to nursing curricula, there is an increasing need for
      congruent forms of evaluation. This paper explores the character of a hermeneutic
      course evaluation within a practice-driven, phenomenological approach to a 4-year
      baccalaureate curriculum. An interpretation of evaluation data from 2 years of an
      introduction to nursing course reveals a distinction between learning and being
      well taught. The article focuses on the theme "being well taught as experiencing
      structure," and the importance of teaching practices that achieve a balance
      between specificity and flexibility. It is evident that evaluations that focus on
      understanding and uncovering what is usually taken for granted have the capacity
      not only to indicate what works and does not work in a course, but also to depict
      a course's phenomenological nature and to illuminate the transformative power of
      narrative as it situates and extends learning.

PMID- 7790972
TI  - Lessons from literature: caring, interpretation, and dialogue.
AB  - There can be little doubt that nursing, like other arts and sciences, is
      experiencing an "interpretive turn" (Hiley, Bohman, & Shusterman, 1991). As part
      of this more global "turn," the curriculum revolution has spurred nurse educators
      to critically examine their schools, curricula, and everyday practices as
      teachers and propose alternative pedagogies where appropriate. I argue that what
      is now being developed as nursing humanities is a valuable approach to
      interpretive pedagogy which challenges, stimulates, integrates, and develops
      students' thinking and understanding of the lived experience of patients/clients
      in ways that more traditional scientific and behaviorist approaches to nursing
      education are unable to do. In creating courses or learning experiences using
      nursing humanities, it is essential to attend to both content and pedagogical
      approach as being inseparable. Ignoring the former will produce no more than a
      pleasant chat, while ignoring the latter will result in mere "metaphor counting"
      or rote learning of "what the book, story, or poem means." Nurse educators have
      used literature to help illuminate health and illness issues in the past, but
      unfortunately, this has been viewed as an essentially marginal approach. While
      novels, stories, poems, and other literature can certainly be used in almost any
      nursing class, I believe that nursing humanities is such a rich seam of
      pedagogical and critical possibility that it merits development of specific
      courses and options within all of our nursing courses and programs.

PMID- 7790971
TI  - Narrative pedagogy: rethinking nursing education.
AB  - Narrative pedagogy is an interpretive approach to teaching and learning that is
      being used to foster educational reform. As it pertains to nursing education,
      narrative pedagogy is an approach to thinking about teaching and learning that
      evolves from the lived experiences of teachers, clinicians, and students. In this
      article, the author reviews the philosophical underpinnings of narrative
      pedagogy, provides examples of how narrative pedagogy can be used to rethink the
      teaching of nursing knowledge and practice, and discusses the strengths and
      limitations of narrative pedagogy as an alternative approach to teaching and
      learning.

PMID- 7790974
TI  - Cooperative learning and feminist pedagogy--a model for classroom instruction in
      nursing education.
AB  - This article reports on a research study conducted as part of a doctoral
      dissertation on the development of a cooperative learning teaching model in
      nursing education. The subjects for the study were a convenience sample of
      registered nurses who were pursuing a baccalaureate degree in nursing at an urban
      university. Principles of feminist pedagogy were incorporated as part of the
      cooperative learning model. The teacher/researcher taught two sections of the
      same course and, through the use of action research, developed a model for using
      cooperative learning strategies as the primary teaching modality. End of class
      and end of semester evaluations provided feedback that suggested that this was an
      exciting and effective alternative to traditional classroom teaching.

PMID- 7790975
TI  - Fostering dialogical community through a learning experience.
AB  - Dialogue and community are two common foci of the recent nursing education
      literature. The author came to a new understanding of these concepts while
      teaching a capstone seminar course for registered nurses who were obtaining a
      baccalaureate degree. In this paper, this transformation is discussed in the
      context of one particular learning experience for the capstone course. The
      philosophical basis for fostering dialogical community through this learning
      experience is explained. The experience is described, and students' comments
      about the experience are cited. Finally, conclusions drawn as a result of the
      experience are compared to the themes of dialogue and community in the recent
      nursing education literature.

PMID- 7790973
TI  - An interpretive analysis of precepting an unsafe student.
AB  - Precepting students during their senior practicum is often viewed as an
      opportunity to nurture the next generation of nurses. However, when the student
      has only marginally passed courses or clinical experiences, precepting may become
      a difficult and challenging process. Little is known about how preceptors teach
      students and even less is known about precepting unsafe students. The purpose of
      this article is to describe a preceptor's journey through a difficult senior
      practicum experience. A hermeneutic analysis of the preceptor's journal revealed
      two themes important in precepting the unsafe student: knowing the student and
      creating possibilities for success. Two aspects of knowing the student included
      watchful listening and assessing dangerousness. These themes are described and
      the dilemma of bringing an unsafe nurse into the profession is discussed.

PMID- 7790976
TI  - Clinical learning experiences and professional nurse caring: a critical
      phenomenological study of female baccalaureate nursing students.
AB  - The purpose of this critical phenomenological study was to discover, describe,
      and analyze how nursing students learn professional nurse caring in the clinical
      context of nursing education. In this article, I report on interviews from 18
      female baccalaureate nursing students, 17 of whom are European American and one
      of whom is African American. Participants in this study narrated their stories
      about learning caring by first describing their understanding of how they created
      caring with patients. After uncovering the layers of their patient care
      interactions, they were then able to answer the research question of how they
      learned caring in clinical. Because participants' interactions with patients were
      the context for the development of their understanding of caring, I identify the
      relational theme of caring and interacting with patients as the central focal
      point for narrating stories about caring. From the data analysis, I report two
      constitutive patterns: the first, creative caring, contains seven themes, and the
      second, learning caring, contains five themes. Findings from this research are
      summarized as "embodied caring knowledge." This research has implications for
      nursing faculty, students, and practitioners who are interested in enhancing
      their understanding of living and learning caring within nursing.

PMID- 7790977
TI  - Feminist pedagogy: developing creative approaches for teaching students of
      nursing.

PMID- 7790978
TI  - Preferences for cardiopulmonary resuscitation: physician-patient agreement and
      hospital resource use. The SUPPORT Investigators.
AB  - OBJECTIVE: To describe the association between hospital resource utilization and
      physicians' knowledge of patient preferences for cardiopulmonary resuscitation
      (CPR) among seriously ill hospitalized adult patients. DESIGN: Prospective cohort
      study. SETTING: Five U.S. academic medical center, 1989-1991. PATIENTS: A sample
      of 2,636 patients with self- or surrogate interviews and matching physician
      interviews describing patient preferences for CPR, from a cohort of 4,301
      patients with life-threatening illnesses enrolled in the Study to Understand
      Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT).
      MEASURES: Patient, surrogate, and physician reports of preferences for
      resuscitation, and resource use derived from the Therapeutic Intensity Scoring
      System and hospital length of stay, converted into 1990 dollars. RESULTS: Nearly
      one-third of the patients preferred to forego resuscitation. Of the 2,636 paired
      physician-patient answers, nearly one-third did not agree about preferences for
      resuscitation. The physicians' views of the patients' preferences and those
      preferences themselves were both associated with resource use. Standardized
      adjusted hospital resource consumption, expressed as average cost in dollars
      during the enrollment hospitalization, was lowest when the physician agreed with
      the patient preference for a do-not-resuscitate order ($20,527), and highest when
      the patient did not have a preference and the physician believed the patient
      wanted resuscitation in the case of a cardiopulmonary arrest ($34,829). Hospital
      resource use was intermediate when patient-physician pairs evidenced either lack
      of agreement or communication, or awareness of options about resuscitation.
      CONCLUSIONS: Both physician and patient preferences for CPR influence total
      hospital resource consumption. Physician misunderstanding of patient preferences
      to forego CPR was associated with increased use of hospital resources, and could
      have led to a course of care at odds with patients' expressed preferences in the
      event of cardiac arrest. Increasing physicians' knowledge of patient preferences,
      and increasing communication to help patients understand that options for medical
      care that include foregoing resuscitation efforts, might reduce hospital
      expenditures for the seriously ill.

PMID- 7790979
TI  - The effect of diagnosing Alzheimer's disease on frequency of physician visits: a
      case-control study.
AB  - OBJECTIVE: Two groups of elderly subjects were studied to see whether patterns of
      visits to physicians changed after one group received the diagnosis of
      Alzheimer's disease. DESIGN: Case-control study. SETTING: Health maintenance
      organization (HMO). PATIENTS/PARTICIPANTS: Two groups of ambulatory subjects
      (mean age 77 years) were enrolled from an HMO population for this case-control
      study: 120 cases had probable Alzheimer's disease diagnosed at enrollment, and
      another 120 cognitively intact controls with similar comorbidity were enrolled
      after being frequency-matched for age and gender. Exclusion criteria were nursing
      home admission and death during the study period. INTERVENTIONS: None.
      MEASUREMENTS AND MAIN RESULTS: Medical records were examined for a four-year
      period: two years prior to and two years following enrollment and diagnosis.
      Physician visits declined slightly after enrollment for the persons receiving the
      diagnosis of Alzheimer's disease [17.5/2 years prior vs 16.5/2 years after (NS)],
      whereas visits increased over time for the controls [13.7/2 vs 16.3/2 (p <
      0.05)], hence the rates were similar after enrollment [16.5 vs 16.3 (NS)]. The
      proportion of subjects with fewer visits during the period after enrollment was
      higher among the cases than it was among the controls [54% vs 37%; odds ratio =
      2.0 (95% confidence interval = 1.6, 3.1)]. Hospitalizations and emergency
      department use did not change significantly after enrollment. CONCLUSIONS:
      Physician visit frequency was high before, then decreased after, demented
      patients received their diagnosis, approaching the frequency in a control
      population without dementia. This phenomenon cannot be accounted for by nursing
      home placement, comorbidity, or mortality. Increased hospitalization and
      emergency department use did not ensue after diagnosis.

PMID- 7790980
TI  - A comparison of self-report and chart audit in studying resident physician
      assessment of cardiac risk factors.
AB  - OBJECTIVE: To examine the relationship between resident physicians' perceptions
      of their preventive cardiology practices and a chart audit assessment of their
      documented services. DESIGN: A criterion standard comparison of two methods used
      to assess resident physicians' practices: self-report and chart audit. SETTING:
      Physician ambulatory care in a residency program. PATIENTS AND OTHER
      PARTICIPANTS: Coronary artery disease (CAD) risk factor assessment was evaluated
      by self-report for 72 resident physicians and by chart audit of randomly selected
      records of 544 of their patients who did not have CAD or a debilitating chronic
      disease during a one-year period. INTERVENTION: Measurements of the residents'
      perceived CAD risk factor assessment practice by self-report, and chart audit
      assessments of their recorded care. MAIN OUTCOME: The relationship between self
      reported and chart audit assessments of CAD risk factors. RESULTS: Chart audit
      assessment of CAD risk factor management was highly significantly (p < 0.01)
      lower than self-reported behaviors for evaluation of cigarette smoking, diet,
      physical activity, stress, plasma cholesterol, blood pressure, and body
      weight/obesity. CONCLUSIONS: Three different interpretations of these findings
      are apparent. 1) Physician self-report is a poor tool for the measurement of
      clinical behavior, and therefore research of physician behavior should not rely
      solely on self-reported data; 2) physicians' chart recording of their clinical
      practice is insufficient to reflect actual care; or 3) neither is an accurate
      measure of actual practice.

PMID- 7790981
TI  - Relationship between medication errors and adverse drug events.
AB  - OBJECTIVE: To evaluate the frequency of medication errors using a
      multidisciplinary approach, to classify these errors by type, and to determine
      how often medication errors are associated with adverse drug events (ADEs) and
      potential ADEs. DESIGN: Medication errors were detected using self-report by
      pharmacists, nurse review of all patient charts, and review of all medication
      sheets. Incidents that were thought to represent ADEs or potential ADEs were
      identified through spontaneous reporting from nursing or pharmacy personnel,
      solicited reporting from nurses, and daily chart review by the study nurse.
      Incidents were subsequently classified by two independent reviewers as ADEs or
      potential ADEs. SETTING: Three medical units at an urban tertiary care hospital.
      PATIENTS: A cohort of 379 consecutive admissions during a 51-day period (1,704
      patient-days). INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: Over the study
      period, 10,070 medication orders were written, and 530 medications errors were
      identified (5.3 errors/100 orders), for a mean of 0.3 medication errors per
      patient-day, or 1.4 per admission. Of the medication errors, 53% involved at
      least one missing dose of a medication; 15% involved other dose errors, 8%
      frequency errors, and 5% route errors. During the same period, 25 ADEs and 35
      potential ADEs were found. Of the 25 ADEs, five (20%) were associated with
      medication errors; all were judged preventable. Thus, five of 530 medication
      errors (0.9%) resulted in ADEs. Physician computer order entry could have
      prevented 84% of non-missing dose medication errors, 86% of potential ADEs, and
      60% of preventable ADEs. CONCLUSIONS: Medication errors are common, although
      relatively few result in ADEs. However, those that do are preventable, many
      through physician computer order entry.

PMID- 7790983
TI  - Medical malpractice reform: the current proposals.

PMID- 7790982
TI  - When the physician leaves the patient: predictors of satisfaction with the
      transfer of care in a primary care clinic.
AB  - OBJECTIVE: To identify independent predictors of patients' satisfaction with
      transfer of their care from a departing to a new resident physician. DESIGN: A
      self-administered questionnaire completed by consecutive patients following up
      after transfer of their care, and by a randomly selected 50% of patients not
      returning within three months after transfer. SETTING: An internal medicine
      clinic in a teaching hospital. PATIENTS: Questionnaires were completed by 376
      patients: 237 returning to clinic and 139 (91%) of 152 randomly selected patients
      who had not returned. Mean age of the patients was 65 years, 52% were men, and
      they had come to the clinic for a median of four years. RESULTS: 57% of the
      patients were satisfied with the transfer process, 25% were neutral, and 18%
      expressed frank dissatisfaction. Of nine variables significantly associated with
      satisfaction by univariate analysis, stepwise multiple regression identified five
      independent predictors. Personal notification of the patient by the departing
      physician was the most powerful determinant, explaining 41% of the variability in
      satisfaction. Other predictors were whether patients believed their physicians
      had done everything possible to facilitate transfer, whether the departing
      physician had provided opportunity for discussion of the transfer, whether this
      discussion was considered sufficient, and patients' impressions of the
      institution. CONCLUSIONS: Most of the predictors identified can be influenced by
      physician behavior, suggesting that physicians should personally notify patients
      of their departure and provide an opportunity for discussion. This could
      significantly improve patient satisfaction with the transfer process and, as
      previous studies suggest, translate into greater compliance with medications and
      follow-up.

PMID- 7790985
TI  - Confounders of auscultatory blood pressure measurement.
AB  - The appropriate use of any test requires the clinician to appreciate that test's
      limitations. By recognizing the potential confounders of the auscultatory
      assessment of blood pressure, the clinician minimizes the likelihood of enacting
      therapeutic decisions based on inaccurate data. When approaching the treatment of
      a hypertensive patient, several points should be kept in mind. First, the
      measurement of persistent and severe hypertension in a patient receiving
      treatment who describes symptoms of orthostatic hypotension with apparently
      adequate standing blood pressure or who lacks corroborating retinal,
      echocardiographic, or electrocardiographic signs of hypertension should raise the
      concern of pseudohypertension or a white-coat response. Similarly, when one finds
      a normal or near-normal systolic blood pressure in a patient with a clinical
      picture consistent with severe hypertension, one should make a directed effort to
      look for an unrecognized auscultatory gap. Second, marked discrepancies in
      measurements as obtained by different operators or in different settings should
      raise concern of the white-coat response or methodologic errors by one operator,
      such as undercuffing, excessive pressure on the head of the stethoscope, rapid
      deflation of the cuff, or use of different arms. In treating hypertension in even
      the minimally obese patient, a special point must be made that an adequate size
      cuff be used for all blood pressure determinations. Third, when blood pressure is
      determined with the patient in any but the satndardized back-and-arm-supported
      seated position described above, the clinician should acknowledge the possibility
      that the position may alter the patient's classification. Fourth, the diagnosis
      and management of hypertension requires multiple measurements of blood
      pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7790986
TI  - The search for low-cost, high-quality care: what are the assumptions and what are
      the questions now?

PMID- 7790987
TI  - Medical malpractice: the current reform proposals.

PMID- 7790988
TI  - Society of General Internal Medicine 18th annual meeting. San Diego, California,
      May 4-6, 1995. Abstracts.

PMID- 7790984
TI  - Housestaff team research in the ambulatory setting: it can be done. Internal
      Medicine Clinic Research Consortium Faculty.
AB  - Training in research has been recognized as an important component of internal
      medicine training. To provide a research experience for their residents, the
      authors established a team research project designed and implemented by
      postgraduate year-2 and -3 internal medicine trainees with guidance from general
      medicine faculty. A successful research project was conducted by trainees, which
      resulted in an award-winning poster presentation at a scientific meeting and
      publication in a peer-reviewed journal. The process of conducting a resident
      faculty team research project in the ambulatory care setting is described in this
      report. The authors encourage other internal medicine programs to consider
      resident team research efforts to expose a large number of trainees to a research
      experience.

PMID- 7790989
TI  - The trials and tribulations of interphase AgNORs.

PMID- 7790990
TI  - Morphometry in histopathology.

PMID- 7790991
TI  - Low incidence of mbr bcl-2/JH fusion genes in Hodgkin's disease.
AB  - Lymph node biopsies from 140 cases of Hodgkin's disease (HD) and from 30 non
      malignant lesions were screened for the presence of t(14;18) translocations
      involving the major breakpoint region (mbr) of the bcl-2 gene and the joining
      region (JH) of the immunoglobulin heavy chain gene, using a polymerase chain
      reaction (PCR) assay with subsequent nucleotide sequencing of amplified bcl-2/JH
      junctional regions. Expression of the bcl-2 protein within the Hodgkin and Reed
      Sternberg (HRS) cells was investigated in 86 cases of HD by immunohistochemistry
      on cryostat or paraffin sections. Although bcl-2 expression could be found in a
      proportion of neoplastic cells in up to one-third of HD cases, the frequency of
      t(14;18) gene fusions detected by PCR was low. We identified such gene fusions in
      only 3 out of 140 (2 per cent) HD cases, one biopsy of which presented with four
      clonally distinct bcl-2/JH sequences. No t(14;18) was found in any of 30 reactive
      lymph node lesions. All fusion gene sequences were unique regarding the
      localization of the chromosome 14 and 18 breakpoints and the extranucleotide N
      insertions. None of these gene fusions conformed to t(14;18) breakpoint sequences
      previously characterized in our laboratories. Our findings point to a mere
      coincidence in some cases of HD lesions and cells carrying a t(14;18) in the same
      biopsy and argue against a significant role of bcl-2 in the pathogenesis of HD.

PMID- 7790992
TI  - Interphase cytogenetic analysis of distinct X-chromosomal translocation
      breakpoints in synovial sarcoma.
AB  - Synovial sarcomas show a specific translocation involving chromosomes X and 18,
      t(X;18)(p11.2;q11.2). Two distinct X-chromosomal breakpoints occur in different
      synovial sarcoma tumour samples. These breakpoints are located within two related
      genomic regions containing ornithine aminotransferase-like sequences, termed
      OATL1 and OATL2. Preliminary observations indicated the potential correlation of
      OATL1-associated breakpoints with biphasic tumours and OATL2-associated
      breakpoints with monophasic fibrous tumours. The present study uses interphase
      cytogenetics to investigate the nature of chromosomal aberrations in frozen
      synovial sarcoma tissue samples. Two-colour fluorescence in situ hybridization
      (FISH) was performed using probes specific for the centromeres of chromosome X or
      18, along with yeast artificial chromosome probes corresponding to the distinct
      breakpoint regions on Xp. One monophasic epithelial and two monophasic fibrous
      synovial sarcomas showed an OATL2-associated breakpoint, while a biphasic tumour
      revealed a hybridization pattern indicating a breakpoint within the OATL1 region.
      These results confirm our previous suggestion of a relationship between
      alternative breakpoints in Xp11.2 and different histological phenotypes observed
      in synovial sarcomas. They also demonstrate the utility of the two-colour
      hybridization approach for the identification of chromosomal changes in
      interphase nuclei isolated from frozen tissues.

PMID- 7790993
TI  - Overexpression of the tumour suppressor gene p53 is not implicated in
      neuroendocrine tumour carcinogenesis.
AB  - The tumorigenesis of neuroendocrine tumours remains poorly understood, although a
      minority, the familial multiple endocrine neoplasia (MEN 1 and MEN 2), are known
      to be of uncommon genetic origin. Mutation of the tumour suppressor gene, p53, is
      now known to be a common genetic alteration in about half of all types of non
      endocrine cancers. In the present study, immunocytochemistry using the monoclonal
      anti-p53 antibody, DO-7, has been employed to investigate the accumulation of p53
      immunoreactivity in a wide range of primary neuroendocrine tumours. Tumours (n =
      109) were fixed and processed to paraffin wax according to a constant protocol.
      Sections were subjected to microwave antigen retrieval prior to immunostaining
      for p53. Positive nuclear immunostaining was observed in one medullary carcinoma
      of the thyroid (MCT), one lung carcinoid, and five small cell carcinomas of the
      lung (SCCL). All other tumour samples were consistently negative. As the
      neoplasia investigated in this study comprised a wide spectrum of neuroendocrine
      tumour types and ranged from minute, relatively benign lesions to malignant
      metastasizing disease and as there was no relationship between the presence of
      p53 overexpression and clinico-pathological features, the present study suggests
      that p53 gene mutation may be relatively unimportant in the genesis of
      neuroendocrine tumours.

PMID- 7790996
TI  - Immunohistochemical localization of thrombomodulin in normal human skin and skin
      tumours.
AB  - Thrombomodulin (TM) expression has been investigated in sections of normal human
      skin, in cultured normal human keratinocytes, and in a variety of skin tumours.
      TM was present in squamous epithelial cells in the spinous layer of normal
      epidermis and in the outer root sheath of hair follicles, but was absent in the
      cells of the basal layer. It appeared to be predominantly localized to the cell
      membrane and the intercellular bridges in these areas. Cultured normal human
      keratinocytes demonstrated functionally active constitutive TM expression on
      their cell surface. Immunoperoxidase staining of skin tumours using anti-human TM
      antibodies demonstrated a typical cell membrane positivity in tumours with
      squamous or hair follicle differentiation. Basal cell carcinomas showed TM
      expression only in areas where incomplete squamoid metaplasia occurred. Sweat
      gland tumours and lesions of the melanogenic system failed to express TM. The
      localization of TM by immunostaining in various benign and malignant skin tumours
      typically correlated with their normal skin element of origin. The physiological
      significance of TM expression in the epidermis is currently undefined.

PMID- 7790994
TI  - Absence of overexpression of p53 protein by intestinal carcinoid tumours.
AB  - A recessive gene on chromosome 17 encodes a protein, known as p53, which normally
      acts to regulate the cell cycle, its mutation and overexpression being amongst
      the commonest genetic abnormalities in human malignant neoplasms. As detected by
      immunolabelling using the anti-p53 protein antibody D07, overexpression was
      absent from a series of 22 intestinal carcinoid tumours (ten ileal, nine
      appendiceal, and three colorectal), nine overtly malignant, but was readily
      demonstrable in five of five colorectal adenocarcinomas, five of six cloacogenic
      carcinomas, and four of five squamous carcinomas of the anal canal used as
      controls. These observations are in keeping with previous similar studies of
      pulmonary carcinoid tumours and suggest possible differences in the pathogenesis
      of such neoplasms in comparison with non-endocrine differentiated tumours arising
      at equivalent sites.

PMID- 7790995
TI  - Experimental ulceration leads to sequential expression of spasmolytic
      polypeptide, intestinal trefoil factor, epidermal growth factor and transforming
      growth factor alpha mRNAs in rat stomach.
AB  - A model of gastric ulceration in the rat has been used to determine the
      expression of four messenger RNAs (mRNAs) encoding peptides considered to play
      active parts in the healing response. The trefoil peptides, rat spasmolytic
      polypeptide (rSP) and rat intestinal trefoil factor (rITF), along with epidermal
      growth factor (EGF) and transforming growth factor alpha (TGF alpha) were the
      molecules studied. Ulceration was caused under anaesthesia by brief application
      of a liquid nitrogen-filled cryoprobe to the gastric serosal surface and RNA
      expression was monitored over the next 10 days. Each mRNA was quantified by
      ribonuclease protection assay, and mRNAs encoding rSP and rITF were localized
      within tissue sections by hybridization in situ with 35S antisense riboprobes.
      Ulceration induced the very rapid expression of first rSP and then rITF mRNA,
      whereas the mRNAs encoding EGF and TGF alpha increased at later times, with
      maxima recorded at 3 and 6 days, respectively. Hybridization in situ detected
      extensive rSP mRNA expression in the regenerative epithelia. The pronounced, but
      temporally different patterns of mRNA induction after ulceration suggest that the
      trefoil peptides may fulfil different and more immediate roles than the more
      'traditional' healing proteins EGF and TGF alpha.

PMID- 7790997
TI  - Standardized staining and analysis of argyrophilic nucleolar organizer region
      associated proteins (AgNORs) in radically resected colorectal adenocarcinoma-
      correlation with tumour stage and long-term survival.
AB  - Quantification of silver-stained nucleolar organizer region associated proteins
      (AgNORs) was introduced in histopathology as a marker of cellular and nucleolar
      activity. However, due to the poor staining quality obtained on routinely
      processed archival material, the method yielded controversial and sometimes non
      reproducible results. The recent introduction of wet autoclave pretreatment has
      reliably improved AgNOR staining quality on routinely formalin-fixed and paraffin
      embedded tissues. In the present study, 92 routinely processed colorectal
      carcinomas were investigated, applying this novel staining technique. Subsequent
      standardized morphometric analysis revealed, irrespective of common tumour
      staging or grading classifications, a statistically highly significant
      correlation between AgNOR parameters and clinical course. The usefulness of
      standardized AgNOR parameters for the independent prediction of patient survival
      was proven by uni- and multivariate analysis.

PMID- 7790998
TI  - The autopsy.

PMID- 7790999
TI  - The method of calculating fractal dimension.

PMID- 7791000
TI  - In vivo action spectra, absorption and fluorescence excitation spectra of
      photosensitizers for photodynamic therapy.

PMID- 7791001
TI  - Photosensitization with derivatives of chlorin p6.
AB  - Biophysical and photobiological properties of three derivatives of chlorin p6
      were examined. These agents can be considered as lysyl analogs of the aspartyl
      chlorin NPe6. Lysyl chlorin p6 diester (LCP) and the triester analog (LCP2) were
      readily accumulated by murine leukemia L1210 cells, localized in lysosomes, and
      were relatively inefficient photosensitizing agents in vitro. In contrast, lysyl
      chlorin e6 imide (LCI) was poorly accumulated, concentrated in mitochondrial and
      plasma membranes, but was more efficacious. LCI was the most effective agent with
      regard to photosensitization of a murine tumor in vivo, but all three agents
      caused substantially more toxicity than was observed with NPe6.

PMID- 7791002
TI  - Fluorescence spectroscopy of pH in vivo using a dual-emission fluorophore (C
      SNAFL-1).
AB  - The aim of this study was to evaluate a dual-emission fluorophore (C-SNAFL-1:
      5'(and 6')-carboxyseminaphthofluorescein) for in vivo pH monitoring, using one
      excitation wavelength and two emissions. P388-tumour-bearing CDF mice were
      injected intravenously with C-SNAFL-1. Glucose was administered simultaneously to
      lower the tumour pH. Under our experimental conditions, tissue autofluorescence
      was found to be negligible. Two emission peaks were observed. The wavelength of
      the first one was pH insensitive (545 nm). The second one was pH sensitive: a
      shift of the emission peak as a function of pH was observed from 587 nm for pH
      7.25 to 605 nm for pH 6.3. A calibration curve linking emission intensity ratios
      (I545/I635) to in vivo pH is provided. Results clearly indicate differences
      between tumorous (ratio 0.55 +/- 0.08, pH 6.3 +/- 0.1) and normal (ratio 1.39 +/-
      0.04, pH 7.25 +/- 0.1) tissues. The concept of pH fluorescence spectroscopy in
      vivo using C-SNAFL-1 provides quantified data and accurate measurements of tissue
      pH.

PMID- 7791003
TI  - Correlation between meta(tetrahydroxyphenyl)chlorin (m-THPC) biodistribution and
      photodynamic effects in mice.
AB  - Analysis of sensitizer kinetics is essential for the performance of light
      irradiation when tumour concentration and tumour-to-normal tissue ratios are
      optimal. In this study nude mice were grafted with human adenocarcinoma 15 days
      before meta(tetrahydroxyphenyl)chlorin (m-THPC) intra-peritoneal (IP) injection.
      Fluorescence was recorded through an optic fibre spectrofluorometer at 650 (the
      most intense) and 714 nm, with intensity being proportional to injected dose. In
      tumour, skin and muscle the maximum fluorescence was obtained with 1.6 mg kg-1 72
      h after injection (44 counts per second). Tumour-to-skin and tumour-to-muscle
      ratios obtained by high performance liquid chromatography (HPLC) analysis and
      spectrofluorometric measurements decreased between 12 and 72 h (from 15 to 1.5),
      indicating that tumour selectivity decreases with time. This contrast between
      selectivity and fluorescence levels was also observed with photodynamic therapy
      (PDT) results, for which no differences were observed when 10 J cm-2 were
      delivered at 100 or 200 mW. PDT results were better 24 h after drug
      administration than at 72 h. Tumour growth decrease (-40%) was found when 1.6 mg
      kg-1 were injected 24 h before irradiation. For other groups a slower increase
      (12% vs. 23%) was noted in the first few days after PDT. The paradoxal
      correlation between fluorometric or HPLC measurements and PDT effects suggests
      that m-THPC localizes differently with time in tumour components.

PMID- 7791004
TI  - Malignancies and atherosclerotic plaque diagnosis--is laser induced fluorescence
      spectroscopy the ultimate solution?
AB  - A non-invasive diagnostic tool that can identify diseased tissue sites in situ
      and in real time could have a major impact on the detection and treatment of
      cancer and atherosclerosis. A review of the research performed on the utilization
      of laser induced fluorescence spectroscopy (LIFS) as a means of diseased tissue
      diagnosis is presented. Special emphasis is given to problems which were raised
      during clinical trials and recent experimental studies. The common origin and
      possible solution of these problems are shown to be related to, firstly, the
      identification of the fluorescent chemical species, secondly, the determination
      of the excitation/collection geometry and its effect to the method and, finally,
      the further elaboration on the laser-tissue interaction.

PMID- 7791006
TI  - Fluorescence and absorption spectroscopic properties of RNA 5'-cap analogues
      derived from 7-methyl-, N2,7-dimethyl- and N2,N2,7-trimethyl-guanosines.
AB  - Absorption and fluorescence properties of several cap analogues, namely
      nucleosides, nucleoside 5'-monophosphates and P1,P3-dinucleoside triphosphates
      derived from 7-methylguanine, N2,7-dimethylguanine and N2,N2,7-trimethylguanine,
      have been studied. The data obtained include the absorption and fluorescence
      spectra of the cationic (N1-protonated) and zwitterionic (N1-deprotonated)
      species, the pKa values of the ground and excited states of the methylated base
      moiety and the effect of temperature and solvent composition (mixtures of water
      and 1,4-dioxane) on the fluorescence intensity. Furthermore, the fluorescence
      lifetimes of N2,N2,7-trimethylguanosine 5'-triphosphate and P1-guanosine(5')-P3
      [N2,N2,7-trimethylguanosine(5')] triphosphate have been determined as a function
      of temperature. These data clearly indicate that dynamic quenching must be taken
      into account when the extent of the intramolecular stacking of the latter
      compound is estimated by fluorescence spectroscopy.

PMID- 7791005
TI  - Molecular dosimetry by flow cytometric detection of thymine dimers in mononuclear
      cells from extracorporally UV-irradiated blood.
AB  - UV-induced DNA damage in mononuclear leucocytes can be quantified by flow
      cytometry of fluorescence from a labelled monoclonal antibody that specifically
      binds to thymine dimers (T<-->T): specific fluorescence is already detectable
      after exposures of 1-2 J m-2 of 254 nm radiation and shows a linear relationship
      with dose. The distribution of UV fluences over an irradiated volume can thus be
      ascertained by measuring the UV-induced T<-->T loads of the individual cells from
      that volume. After irradiation of mononuclear cells in a phosphate buffer
      solution in a Petri dish, most cells showed a similar intensity of specific T<-
      >T fluorescence, forming a single sharp peak in the fluorescence histogram. This
      signifies an even distribution of fluences over the cells. It was noticed,
      however, that a variable minor fraction of mononuclear cells (usually less than
      10%) could be resistant to immunostaining; this fraction was rejected from the
      calculation of the specific fluorescence. The flow cytometric technique was also
      applied to blood cells exposed in an ISOLDA device, which is in use in Russian
      clinics for UV irradiation of whole blood for therapeutical purposes. Only a
      small fraction of mononuclear cells in a sample of whole blood treated in ISOLDA
      acquired a detectable T<-->T load after exposure to lamps which emit
      predominantly either UVC or UVB light ((3.6 +/- 1.0)% and (1.8 +/- 0.4)% of all
      analysed cells respectively). This small fraction had received a large variation
      in fluences, resulting in differences in nuclear T<-->T loads by a factor of
      200.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791008
TI  - Effects of vacuum UV and UVC radiation on dry E. coli plasmid pUC19. I.
      Inactivation, lacZ- mutation induction and strand breaks.
AB  - Using Escherichia coli plasmid pUC19 as a test system to study the effects of
      radiation on DNA at the molecular level, the wavelength (160-254 nm) dependence
      of inactivation (loss of the ability to transform E. coli), mutation induction in
      the target gene lacZ and induction of single-strand breaks and double-strand
      breaks was investigated. The same fluences were applied for all endpoints tested.
      In the UVC range, the cross-sections of inactivation and mutation induction match
      the DNA absorption curve, whereas the cross-section for single-strand break
      induction deviates from the DNA curve, especially at 220 nm. In the vacuum UV
      range, with increasing energy of the photons, the cross-sections of inactivation
      and single-strand breaks increase sharply (from 190 to 160 nm by more than one
      order of magnitude), which is not reflected by the DNA curve. In this UV range,
      the shape of the action spectrum is similar to that of the absorption curve of
      the sugar phosphate moiety of DNA. Only after irradiation with vacuum UV at 160
      nm are double-strand breaks detected. Their induction rate is about one order of
      magnitude lower than that of single-strand breaks at the same wavelength;
      however, their induction rate is at least twice that of single-strand breaks at
      longer wavelengths. Concerning mutation induction, the increment in the vacuum UV
      range is less well expressed. The data suggest the contribution of different
      kinds of photochemical injury to inactivation and mutation induction.

PMID- 7791009
TI  - Evidence of photoenzymatic repair due to the phrA gene in a phrB mutant of
      Escherichia coli K-12.
AB  - The role of the phrA gene in the genetic control of photoreactivation in
      Escherichia coli has been a matter of some controversy. It has been proposed that
      the gene has no significant physiological role in photoreactivation. However, we
      have previously sequenced a restriction fragment thought to contain the phrA gene
      and shown it to contain a putative gene. When this gene, termed the putative phrA
      gene, was transformed into a phrAphrB mutant, a photoreactivable response above
      that of the phrAphrB mutant was observed. It has been suggested that the
      photorepair seen in phrB mutants is due to Type III photoreactivation, which is
      independent of temperature and fluence rate effects. Here we have shown that the
      photorecovery associated with the phrA gene is dependent on both temperature and
      fluence rate. This suggests that the photorecovery is not due to Type III
      photoreactivation but to an enzymatic reaction caused by an unknown photoactive
      protein, the phrA gene product, which acts on lesions other than pyrimidine
      dimers, possibly pyrimidine (6-4) pyrimidone photoproducts. We therefore propose
      that the phrA gene be reaccepted and its role in photoreactivation in Escherichia
      coli acknowledged.

PMID- 7791007
TI  - Characterization of the reactive intermediates in laser flash photolysis of
      adenine, adenosine and dAMP using acetone as photosensitizer.
AB  - Transient absorption spectra of adenine, adenosine and 2'-deoxyadenosine 5'
      monophosphate (dAMP) arising from 248 nm laser flash photolysis using acetone as
      a photosensitizer have been observed. The intermediates recorded are assigned to
      the excited triplet states and dehydrogenated radicals of adenine and its
      nucleoside and nucleotide. The excited triplet states of adenine and its
      derivatives are produced via triplet-triplet excitation transfer and observed for
      the first time, while the dehydrogenated radicals stemming from the interaction
      of triplet acetone with adenine and its derivatives via electron transfer through
      a five-member-ring electron donor-acceptor intermediate. The site of
      dehydrogenation is suggested to be the hydrogen atom on C(8) of the adenine
      moiety. Moreover, three sets of kinetic parameters of the triplet decay have been
      determined. The rate constants of the unimolecular decay (k0), the triplet
      quenching by the ground state (ksq) and by the triplet quencher Mn2+ (kq) are 1.1
      x 10(5), 7.9 x 10(4), 3.7 x 10(4) s-1, 6.9 x 10(8), 8.3 x 10(8), 3.6 x 10(8) dm3
      mol-1 s-1 and 4.2 x 10(8), 3.5 x 10(8), 6.0 x 10(8) dm3 mol-1 s-1 respectively
      for adenine, adenosine and dAMP.

PMID- 7791010
TI  - Flow cytometric determination of absolute membrane potential of cells.
AB  - Membrane potential measurements using fluorescent membrane potential indicator
      dyes report on relative changes but usually do not result in an absolute value of
      the measured parameter. The method developed in this paper is based on the
      assumption that the negatively charged bis-oxonol distributes across the
      cytoplasmic membrane according to the Nernst equation. It is further supposed
      that the fluorescence intensity measured from a given stained cell is a single
      value function of the intracellular dye concentration. The protocol suggested
      incorporates the construction of a calibration curve (fluorescence intensity
      measured from stained cells vs. extracellular dye concentration). This allows the
      evaluation of the membrane potential in millivolts using fluorescence readings of
      the cells both in the depolarized state and in the state of interest. Good
      agreement was found between absolute membrane potential data of human peripheral
      blood lymphocytes by our method and results of parallel patch clamp measurements.

PMID- 7791011
TI  - Are antiepileptic drugs harmful when taken during pregnancy?
AB  - According to recent experiences. There are no specific teratogenic effects of
      antiepileptic drugs in humans. Polytherapy is associated with malformations more
      often than monotherapy. This does not apply to minor anomalies. Concerns
      regarding neural tube defects because of intrauterine valproate--or carbamazepine
      -exposure can be met by. Taking a careful history regarding individual or family
      predisposition to defects or anomalies. Dividing the daily dose into several
      single doses. Folate supplementation prior and during pregnancy. Antenatal
      monitoring. Those minor anomalies (hypertelorism, distal digital hypoplasies),
      which may possible be induced by antiepileptic drugs harmonize or disappear
      during further development. Most minor anomalies, small body measurements, small
      head circumferences and cognitive dysfunction are not caused by ingestion of
      antiepileptic drugs during pregnancy.

PMID- 7791012
TI  - Genetic and non genetic factors in the outcome of diabetic pregnancy.
AB  - In insulin-dependent diabetes mellitus, maternal Phosphoglucomutase genotype is a
      predictor of fetal macrosomia much more important than quality of metabolic
      control during pregnancy. In gestational diabetes and in non insulin-dependent
      diabetes, on the contrary, the most important predictor is the metabolic control
      of diabetes.

PMID- 7791013
TI  - The performance of a new valveless ventilator at rates of up to 250 bpm.
AB  - The efficacy of a new ventilator, incorporating a valveless pneumatic exhalation
      circuit, at rates of up to 250 bpm was first assessed in the laboratory. Using
      this ventilator the effect of fast rate ventilation on blood gases of infants
      with acute respiratory distress was then examined. Infants were studied at three
      rates: 60, 125 and 250 bpm. Peak inflating and positive end expiratory pressure,
      inspiratory: expiratory ratio and inspired oxygen were kept constant. The
      laboratory study demonstrated that as ventilator rate was increased the delivered
      volume fell, but even at 250 bpm the delivered volume was 7 ml. In the clinical
      study, oxygenation at 250 bpm was not significantly different from that at 60
      bpm, but significantly lower than at 125 pbm. Carbon dioxide levels were
      significantly lower at 250 bpm that at 60 bpm, but did not differ significantly
      from that at 125 bpm. We conclude increasing ventilator rate from 125 to 250 bpm
      is not advantageous for infants ventilated for acute respiratory distress.

PMID- 7791015
TI  - Efficacy and safety of a 2-tier prostaglandin labor induction schedule.
AB  - OBJECTIVES: To determine the efficacy and safety of a 2-tier, Bishop score-driven
      induction schedule using gel and tablet formulations of PGE2 to establish new
      monitoring guidelines. DESIGN: Prospective descriptive study. SETTING: eight
      Germany University obstetric departments. SUBJECTS: 467 high risk patients.
      INTERVENTIONS: Bishop score < 5: intracervical 0.5 mg PGE2 gel; Bishop score 5-7:
      intravaginal 3 mg PGE2 tablet. MAIN OUTCOME MEASURES: Uterine hyperstimulation: >
      5 contractions/min, contraction duration > 2 min and emergency tocolytic therapy;
      perinatal outcome: secondary caesarean section rate, operative vaginal delivery
      and fetal acidosis. RESULTS: PGE2 induction resulted in spontaneous delivery in
      76.9% (6.4% fetal acidosis) and 14.1% secondary c. section. The gel was
      associated with more adverse uterine effects and a poorer fetal outcome than the
      tablet. Adverse uterine events increased significantly on repeat dosing with the
      gel (39.5 vs 29.3%), but not the tablet: they also increased with a dosing
      interval < 8 h with either formulation. Overall, adverse uterine events were
      fewer and perinatal outcome better in multiparae than in nulliparae. CONCLUSIONS:
      The higher adverse uterine event rate with the gel should be viewed against the
      backdrop of the low Bishop score. The interval between repeat dosing should not
      be less than 8 h after PGE2 gel treatment. Primigravidae must be monitored with
      special care following labour induction with PGE2.

PMID- 7791016
TI  - Prenatal expectations and fears in pregnant women.
AB  - The aim of this study was to extend the medical knowledge of the prenatal
      expectations and wishes of pregnant women with respect to themselves, their
      partners and the maternity ward selected for the approaching birth, and also of
      the anxieties arising in this connection. In summary, our study shows that the
      desire to experience birth in the most natural, undisturbed and unmanipulated
      form possible is reiterated frequently, but is relativized by the intense need to
      be reassured of the safety of the unborn child. Fears experienced before the
      birth were focused accordingly on the condition of the child, although 25% of the
      women questioned acknowledged a marked fear of helplessness and failure. The
      obstetric team were expected to offer, as far as possible, the continuous
      personal supervision of a doctor and a midwife who were prepared to allow the
      patient the responsibility of being involved in obstetric decisions.

PMID- 7791014
TI  - Guillain-Barre syndrome in pregnancy--an indication for caesarian section?
AB  - Guillain-Barre syndrome (GBS) in pregnancy is a rare neurological disorder which
      confronts the obstetrician with a difficult decision regarding the management of
      pregnancy and delivery. Two case reports illustrate the problems of obstetrical
      and neurological patient management. We thereby discuss indications for
      intervention based on the reciprocal influences of GBS and pregnancy. In acute
      GBS intervention by induction of labor or caesarian section seems to provoke
      deterioration of the patient's condition and delayal of recovery.

PMID- 7791017
TI  - Repeated direct fetal intravascular high-dose immunoglobulin therapy for the
      treatment of Rh hemolytic disease.
AB  - Recently, administration of high-dose intravenous immunoglobulin (HDivIG) either
      to the mother or the neonate has been proposed in an effort to prevent
      progressive hemolysis in Rh(D) perinatal disease, but no cases have been
      published with direct fetal HDivIG administration. We report a case in which
      HDivIG was repeatedly administered by cordocentesis to a fetus affected by Rh(D)
      disease from 28 to 36 weeks gestation, at doses of approximately 450 mg/kg. The
      fetus required no transfusions, and the neonatal evolution was satisfactory. The
      treatment, performed at three weeks intervals, seemed to be useful in preventing
      fetal hemolysis. No fetal complications were present. Recurrent administration of
      HDivIG therapy to the fetus in cases of severe Rh(D) disease, appears to be
      feasible and free of serious complications to the fetus or the mother.

PMID- 7791018
TI  - Changes in apnea and autoresuscitation in piglets after intravenous and
      intrathecal interleukin-1 beta injection.
AB  - Piglets were given IL-1 beta intravenously (Index I, n = 8) or intrathecally
      (Index II, n = 9) prior to apnea to test the hypothesis that IL-1 beta may
      prolong periods of apnea during sleep and infection. Apnea variables and the
      quality of autoresuscitation were recorded and compared to an apnea control group
      (Ctr. I, n = 7, apnea without injection of IL-1 beta) and a procedure control
      group (Ctr. II, n = 6, apnea after intratecally injected sterile water).
      Hypoxanthine (Hx) and xanthine (X) were analyzed in plasma, CSF and vitreous
      humor. The duration of apnea was significantly longer in the Index I - mean: 38,
      intraquartile range: 27-52 sec and Index II-group 26 (24-36) sec than in the Ctr.
      1-12 (10-13) sec (p < 0.01) and the Ctr. II-group 14 (6-18) sec (p < 0.01). The
      number of respirations per 2 min following apnea in the Index I-group mean: 21,
      intraquartile range: 7-40 and was significantly less than in the Ctr. I-group 109
      (39-150) (p < 0.01), while a similar tendency was found in the Index II-group 42
      (27-55) (p = 0.06). IN CONCLUSION: Intravenous and intrathecal injection of IL-1
      beta prolong the duration of apnea and modifies autoresuscitation.

PMID- 7791019
TI  - Vascularization of yolk sac and vitelline duct in normal pregnancies studied by
      transvaginal color and pulsed Doppler.
AB  - The yolk sac is an organ of increasingly recognized importance in the initial
      mechanisms of pregnancy maintenance and the early growth and welfare of the
      embryo. Having a complex protein secretion and an equally intricate
      ultrastructure, it is the primary source of blood and germ cells. This small and
      to date largely ignored structure may have a vital and interesting part to play
      in human embryonic development, which may be comparable to its proven
      evolutionary importance in other animals. The aim of our study was to assess the
      vascularity of the yolk sac and vitelline duct in 105 patients between the 6th
      and 10th weeks of gestation who were scheduled for termination of pregnancy for
      psychosocial reasons. The patients were divided in five subgroups depending on
      the duration of gestation. All of them had a normal developing pregnancy with no
      clinical symptoms of pathology (e.g. bleeding in early pregnancy). Gestational
      age was calculated from the first day of the last menstrual period and
      substantiated by crown-rump (CRL) measurements. After exploration of the
      gestational sac and embryo by transvaginal sonography, color Doppler was used to
      image the yolk sac and vitelline duct vascularity. The visualized vessels were
      analyzed with pulsed Doppler using the sample volume unit set of 1 mm. The
      assessment of obtained waveform signals was made by means of peak systolic
      Doppler shift (PSV) and pulsatility index (PI). The pulsatility index was
      calculated as a difference between peak systolic and end diastolic Doppler shift
      divided by the mean maximum velocity. At least 5 separate cardiac cycles were
      measured, and the mean value was calculated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791021
TI  - Prenatal thoracocentesis may be lifesaving in congenital chylothorax.

PMID- 7791022
TI  - Surface characterization: understanding sources of variability in the production
      and use of pharmaceuticals.

PMID- 7791020
TI  - Fetal and uteroplacental flow velocity waveforms in abruptio placentae: report of
      two cases.
AB  - This paper reports two cases of abruptio placentae assessed using pulsed Doppler
      at 29 and 30 weeks of gestation. Transvaginal pulsed Doppler showed abnormal
      uterine artery FVWs in both cases. One fetus with normal umbilical and normal
      middle cerebral artery FVWs was not acidotic and only midly hypoxic, whereas the
      other fetus with normal umbilical and abnormal middle cerebral artery FVWs was
      severely acidotic and hypoxic at birth. It is suggested that Doppler assessment
      of fetal blood distribution is of great value for the rapid diagnosis of fetal
      asphyxia, and that uteroplacental FVWs provide reliable information on which to
      base the diagnosis of abruptio placentae.

PMID- 7791023
TI  - An attempt to clarify the mechanism of the penetration enhancing effects of
      lipophilic vehicles with differential scanning calorimetry (DSC).
AB  - In a previous in-vivo skin penetration study, it was observed that certain
      lipophilic liquid vehicles enhanced drug penetration, whilst others did not. To
      clarify the mechanism of skin penetration enhancement, isolated sheets of human
      stratum corneum were measured by differential scanning calorimetry (DSC), either
      untreated or after pretreatment with various lipophilic liquids (highly purified
      light mineral oil, isopropyl myristate, caprylic/capric acid triglycerides
      containing 5% phospholipids, dibutyl adipate, dimethicone 100, cetearyl iso
      octanoate, caprylic/capric acid triglycerides), commonly used in ointment bases.
      All samples were analysed over a heating range of at least--10-130 degrees C. All
      DSC curves were evaluated with regard to the phase-transition enthalpies (peak
      areas) and peak maximum temperatures of the lipid-phase transitions at ca 75 and
      85 degrees C. With the exception of dimethicone 100, cetearyl iso-octanoate and
      caprylic/capric acid triglycerides, all vehicles showed characteristic
      alterations of the phase-transition temperatures and enthalpies of the stratum
      corneum lipids. Mineral oil and isopropyl myristate caused a reduction of the
      enthalpy and a decrease of the phase-transition temperatures. These two vehicles
      are thought to fluidize the lamellar-gel phase of the stratum corneum lipids, and
      possibly partially dissolve the lipids. Dibutyl adipate and caprylic/capric acid
      triglycerides containing 5% phospholipids decreased the phase-transition enthalpy
      only, probably due to dissolution or extraction of the stratum corneum lipids.
      These DSC results provide an explanation for the in-vivo penetration-enhancing
      effects observed previously.

PMID- 7791024
TI  - Pharmacokinetic properties and interactions with blood components of N4-hexadecyl
      1-beta-D-arabinofuranosylcytosine (NHAC) incorporated into liposomes.
AB  - N4-Hexadecyl-1-beta-D-arabinofuranosylcytosine (NHAC) is a new lipophilic
      derivative of 1-beta-D-arabinofuranosylcytosine (ara-C) with strong antitumour
      activity. The interactions of NHAC incorporated into small unilamellar liposomes
      of different compositions with blood components were evaluated. In comparison
      with ara-C, NHAC is highly protected against deamination to inactive
      arabinofuranosyluracil (ara-U) in human plasma, resulting in only 2% conversion
      into ara-U after 4 h incubation at 37 degrees C, whereas from ara-C more than 80%
      was deaminated. In in-vitro incubations with human blood, it was found that NHAC
      was transferred from the liposomes at about 47% efficiency to plasma proteins,
      particularly to albumin and to the high and low density lipoproteins. The
      remaining part of NHAC was bound to erythrocytes (50%) and to leucocytes (3%).
      The addition of poly(ethylene) glycol-modified phospholipids to the liposomes
      (PEG liposomes), which were composed of soy phosphatidylcholine and cholesterol
      (plain liposomes), did not significantly prevent the fast transfer of NHAC from
      the liposomes to the blood components. Pharmacokinetic studies in mice revealed
      that NHAC had biphasic kinetics in blood with a t1/2 alpha of 16 min and a t1/2
      beta of 3.8 h when the drug was formulated in plain liposomes and a t1/2 alpha of
      15 min and a t1/2 beta of 9.67 h in PEG liposomes, respectively. NHAC was
      predominantly distributed in the liver with 29% of the injected dose found after
      30 min.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791025
TI  - Effect of policosanol on lipofundin-induced atherosclerotic lesions in rats.
AB  - Policosanol is a mixture of higher aliphatic alcohols isolated from sugar cane
      wax, showing cholesterol-lowering effects and preventing the development of
      lipofundin-induced lesions in New Zealand rabbits. This study was conducted to
      determine whether policosanol orally administered to rats also protects against
      the development of lipofundin-induced atherosclerotic lesions. Fifty four male
      Wistar rats were randomly distributed amongst a negative control group, a
      positive control group intravenously injected with lipofundin for eight days, and
      four experimental groups also injected with lipofundin, but orally receiving
      policosanol at 0.5, 2.5, 5 and 25 mg kg-1, respectively. Policosanol treatment
      was orally administered once-a-day for eight days, while control groups similarly
      received equivalent amounts of vehicle. A significant reduction of the
      atherosclerotic lesions in the treated animals was observed. It is concluded that
      policosanol has a protective effect on lipofundin-induced aortic lesions in
      Wistar rats.

PMID- 7791026
TI  - Comparative convulsant potencies of two carbapenem derivatives in C57 and DBA/2
      mice.
AB  - The behavioural and convulsant effects of imipenem and meropenem were studied
      after intraperitoneal administration in DBA/2 mice, a strain genetically
      susceptible to sound-induced seizure, and in C57 mice, a strain not prone to
      seizure. DBA/2 mice were more susceptible than C57 mice to seizures induced by
      imipenem-cilastatin or meropenem. Imipenem was also 1.9 times more potent than
      meropenem in inducing clonus in DBA/2 mice. To investigate the possibility that
      the seizure-inducing activity of imipenem might be due to a probenecid-like
      effect of cilastatin, animals were treated with imipenem alone. No significant
      differences were observed between imipenem-cilastatin and imipenem-treated
      animals. Thus, it is reasonable to exclude a probenecid-like effect of
      cilastatin. Although the main mechanism for seizure-like activity of imipenem
      cannot be easily determined, we believe that several mechanisms may be involved.
      An increased excitation of the central nervous system (CNS) by inhibition of GABA
      binding to receptors and a slow clearance of imipenem from the CNS may be
      postulated. Cilastatin did not induce seizures. In addition, meropenem, a
      compound structurally related to imipenem, showed weak or no convulsant effects.

PMID- 7791027
TI  - Properties of a resiniferatoxin-stimulated, calcium inhibited but
      phosphatidylserine-dependent kinase, which is distinct from protein kinase C
      isotypes alpha, beta 1, gamma, delta, epsilon and eta.
AB  - We have separated a resiniferatoxin-stimulated histone-kinase activity from human
      neutrophils, elicited mouse macrophages and murine alveolar macrophages by
      hydroxyapatite chromatography. The assay conditions for resiniferatoxin kinase
      were optimized as part of this study and in the presence of phosphatidylserine
      but absence of Ca2+ the Ka for histone IIIs phosphorylation by resiniferatoxin
      was calculated as 16 nM. Using a phosphate gradient of 20-500 mM, peaks of
      protein kinase C activity could be washed from the hydroxyapatite column in 300
      nM phosphate and resiniferatoxin kinase recovered in 500 mM phosphate. At the
      optimum concentration of 160 nM, the ability of resiniferatoxin to induce enzyme
      activity was compared with a range of phorbol esters all at the same
      concentration. These related compounds failed to activate resiniferatoxin kinase
      although they have previously been shown to activate protein kinase C isotypes.
      Similarly sn-1,2,-dioleoylglycerol and the potent irritant capsaicin at 30 microM
      failed to activate the kinase. A Scatchard analysis of [3H] phorbol dibutyrate
      binding produced a linear plot (Kd 41.6 nM; Bmax 11.6 fmol unit-1) and binding
      was inhibited by resiniferatoxin and 12-O-tetradecanoylphorbol-13-acetate (TPA),
      with resiniferatoxin 700 times more potent than TPA in this respect. A
      radiolabelled resiniferatoxin binding assay was also used to demonstrate specific
      binding of [3H]resiniferatoxin which could be inhibited by unlabelled compound.
      Resiniferatoxin kinase activity was shown to be distinct from the protein kinase
      C isotypes alpha, beta 1, gamma, delta and epsilon by means of immunological
      analysis and from the eta isotype, because that isotype was not stimulated by
      resiniferatoxin but was stimulated by TPA when a pseudosubstrate was used. In
      addition the resiniferatoxin-stimulated activity was inhibited in-vitro by the
      addition of Ca2+ (Ki 0.1-0.5 nM free Ca2+). Further purification of
      resiniferatoxin kinase by Superose chromatography indicated a major activity
      fraction of about 70-90 kDa. Thus resiniferatoxin kinase, isolated from human and
      mouse inflammatory cells is distinct from the known isotypes of protein kinase C
      and is a major resiniferatoxin receptor.

PMID- 7791028
TI  - The effects of racemic, (+)- and (-)-pinacidil on the membrane potential of the
      rat aorta.
AB  - The endothelium-intact and -denuded rat aorta is hyperpolarized by racemic and (
      )-pinacidil, probably by opening ATP-dependent potassium channels. (+)-Pinacidil
      caused depolarization of the endothelium-intact and -denuded rat aorta. The
      depolarization induced by 20 mAM KCl in the endothelium-intact rat aorta was
      reversed by racemic and (-)-, but not by (+)-pinacidil. On the endothelium-intact
      rat aorta, isoprenaline produced hyperpolarization and ICI 118551 (erythro-(+/-)
      1-(7-methylindan-4-yloxy)-3-isopropylamino butan-2-ol) had no effect alone but
      prevented isoprenaline from causing hyperpolarization. The hyperpolarization
      induced by isoprenaline was reversed by racemic and (+)-, but not by (-)
      pinacidil. Glibenclamide depolarized the endothelium-intact rat aorta and
      prevented the hyperpolarizing action of racemic pinacidil and (-)-pinacidil. (+)
      Pinacidil prevented the hyperpolarizing action of (-)-pinacidil. Glibenclamide is
      probably preventing the hyperpolarization associated with opening of the ATP
      dependent potassium channel by blocking this channel. Several mechanisms may
      underlie the depolarizing action of (+)-pinacidil, including blocking of ATP
      dependent potassium channels.

PMID- 7791029
TI  - In-vitro pharmacology of sarpogrelate and the enantiomers of its major
      metabolite: 5-HT2A receptor specificity, stereoselectivity and modulation of
      ritanserin-induced depression of 5-HT contractions in rat tail artery.
AB  - The new antiplatelet agent sarpogrelate (MCI-9042), its major metabolite (R,S)-1
      [2-[2-(3-methoxyphenyl)ethyl]phenoxy]-3-(dimethylamino)-2- propanol ((R,S)-M-1)
      and the enantiomers of (R,S)-M-1 were studied as antagonists at 5-HT2A receptors,
      5-HT1-like receptors, 5-HT3 receptors, alpha 1-adrenoceptors, beta-adrenoceptors,
      histamine H1 receptors, histamine H2 receptors and muscarinic M3 receptors in
      various functional in-vitro assays. Sarpogrelate, (R,S)-M-1, (R)-M-1 and (S)-M-1,
      respectively, were competitive antagonists of 5-hydroxytryptamine (5-HT) at 5
      HT2A receptors of rat tail artery with calculated pA2 values of 8.53, 9.04, 9.00
      and 8.81, respectively. Sarpogrelate lacked prominent 5-HT1-like, 5-HT3, beta,
      H1, H2 and M3 antagonist activity and weakly blocked alpha 1-adrenoceptors (pKB =
      6.30). (S)-M-1 showed weak affinity for 5-HT1-like receptors (pKB = 6.30), alpha
      1- (pKB = 6.80) and beta- (pKB = 6.54) adrenoceptors, while (R)-M-1 was a weak
      antagonist at histamine H1 receptors (pKB = 6.49). Stereoselectivity of M-1
      enantiomers was low. (R)-M-1 showed 1.6-fold, 2,3-fold and 2.5-fold higher
      antagonist activity than (S)-M-1 for 5-HT2A, H1 and M3 receptor, respectively.
      Affinity at beta-adrenoceptors and 5-HT1-like receptors was 5-fold and 3-fold
      higher for (S)-M-1 than for (R)-M-1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791030
TI  - The transhepatic response to noradrenaline in the rabbit liver: the influence of
      arterioportal pressure gradient.
AB  - The dose-related responses of the hepatic arterial and portal venous vascular
      beds to bolus administration of noradrenaline (10(-10)-10(-4) mol), injected into
      the hepatic artery and portal vein, were studied in the isolated dual-perfused
      rabbit liver at both basal and raised tone. The transhepatic ratio, defined as
      the ratio between the intra-arterial molar ED50 dose and the intraportal dose
      required to give the same arterial response, was calculated for arterial and
      venous responses to noradrenaline. At basal tone, the transhepatic ratio for
      hepatic arterial vasoconstrictive responses was 500. Portal venous
      vasoconstrictive responses were similar in potency independent of injection site
      but differed significantly in analysis of dose-response slope and maximal
      response. At raised tone, the arterio-portal pressure gradient increased by 68.5
      mmHg and there was a 10-fold increase in the transhepatic ratio for hepatic
      arterial responses, while the portal venous responses remained unchanged. These
      results demonstrate that arterio-portal pressure gradient has a powerful effect
      on transhepatic action of noradrenaline, and suggest a pre-sinusoidal site for
      the generation of both hepatic arterial and portal venous vascular resistance.

PMID- 7791031
TI  - Irreversible inhibition of rat liver mitochondrial MAO A and MAO B by enantiomers
      of deprenyl and alpha-methylpargyline.
AB  - Using rat liver mitochondrial monoamine oxidase (MAO) A and MAO B, the possible
      influence of stereochemical factors upon the irreversible inhibition by
      propargylamine derivatives has been studied using the enantiomers of deprenyl and
      of alpha-methylpargyline. Whether studying the inhibition of MAO A or MAO B,
      little difference was found among enantiomeric pairs in the first-order rate
      constant (k2) for formation of the enzyme inhibitor adduct. Similarly, and with
      the exception of (S)-D-(+)-deprenyl (k2 = 0 or an extremely low value at MAO A),
      the computed value of k2 for the individual enantiomers showed little variation
      between MAO A and MAO B. These results suggest that inhibitor selectivity towards
      a particular form of the enzyme is determined predominantly at the competitive
      phase of the inhibition.

PMID- 7791032
TI  - Antiplatelet effect of gingerol isolated from Zingiber officinale.
AB  - The purpose of this investigation was to determine the antiplatelet mechanism of
      gingerol. Gingerol concentration-dependently (0.5-20 microM) inhibited the
      aggregation and release reaction of rabbit washed platelets induced by
      arachidonic acid and collagen, but not those induced by platelet-activating
      factor (PAF), U46619 (9,11-dideoxy-9 alpha,11 alpha-methano-epoxy-PGF2 alpha) and
      thrombin. Gingerol also concentration-dependently (0.5-10 microM) inhibited
      thromboxane B2 and prostaglandin D2 formation caused by arachidonic acid, and
      completely abolished phosphoinositide breakdown induced by arachidonic acid but
      had no effect on that of collagen, PAF or thrombin even at concentrations as high
      as 300 microM. In human platelet-rich plasma, gingerol and indomethacin prevented
      the secondary aggregation and blocked ATP release from platelets induced by
      adenosine 5'-diphosphate (ADP, 5 microM) and adrenaline (5 microM) but had no
      influence on the primary aggregation. The maximal antiplatelet effect was
      obtained when platelets were incubated with gingerol for 30 min and this
      inhibition was reversible. It is concluded that the antiplatelet action of
      gingerol is mainly due to the inhibition of thromboxane formation.

PMID- 7791033
TI  - The disposition of morphine and its metabolites in the in-situ rat isolated
      perfused liver.
AB  - A specific HPLC method with UV detection was used to investigate the disposition
      of morphine and its metabolites in the in-situ rat isolated perfused liver
      preparation. Livers of male Sprague-Dawley rats (n = 4) were perfused under
      single pass conditions with protein- and erythrocyte-free perfusate, containing
      2.66 microM morphine, for up to 90 min. The concentration of morphine,
      normorphine and morphine-3-glucuronide (M3G) in outflow perfusate, and the
      biliary excretion of M3G and normorphine glucuronide, all reached steady-state
      levels within 15-20 min after commencing perfusion. At steady-state, the mean (+/
      s.d.) extraction ratio of morphine was 0.87 +/- 0.06 and clearance (26.0 +/- 1.7
      mL min-1) approached perfusate flow rate (30 mL min-1). Although M3G was the main
      metabolite, accounting for 72.8 +/- 12.7% of eliminated morphine, a significant
      proportion (21.6 +/- 13.5%) was N-demethylated to normorphine and was recovered
      as unchanged normorphine in outflow perfusate and normorphine glucuronide in
      bile. The biliary extraction ratio of hepatically-formed M3G was 0.61 +/- 0.31.
      Results from an additional six experiments, in which livers were perfused with
      1.33 and 2.66 microM of morphine for 30 min each in a balanced cross-over manner,
      indicated that the disposition of morphine and its metabolites was approximately
      linear within this concentration range.

PMID- 7791034
TI  - High-performance liquid chromatographic determination of trazodone and 1-m
      chlorophenylpiperazine with ultraviolet and electrochemical detector.
AB  - A high-performance liquid chromatographic (HPLC) assay was developed for the
      determination of trazodone and its metabolite, 1-m-chlorophenylpiperazine (m
      CPP), in plasma. The high level of trazodone in plasma was detected by
      ultraviolet absorbance at 254 nm and the low level of m-CPP in plasma was
      detected by coulometric electrochemical detection at 840 mV on the series
      arrangement of two detectors. Pilsicainide as an internal standard for both
      compounds was monitored by both detectors. Trazodone and m-CPP in plasma were
      extracted by a rapid and simple procedure based on CN bonded-phase extraction,
      and C8 reversed-phase HPLC separation. Determination was possible for trazodone
      in the concentration range 100-2000 ng mL-1 and for m-CPP in the concentration
      range 5-100 ng mL-1. The recoveries of trazodone and m-CPP added to plasma were
      81.0-84.2 and 68.0-73.2%, respectively, with coefficients of variation of less
      than 7.3 and 8.2%, respectively. The method is applicable to high level
      monitoring of trazodone and low level monitoring of m-CPP in plasma of healthy
      volunteers and patients treated with trazodone.

PMID- 7791035
TI  - Determination of octanol-water partition coefficients by an HPLC method for
      anticonvulsant structure-activity studies.
AB  - Octanol-water partition coefficients have been measured and calculated for eight
      clinically relevant anticonvulsants. For some compounds, these are the first
      experimentally available log P values. For the remainder of the molecules, new
      values have been suggested. The utility of the micro shake-flask experimental
      method and the ALOGP calculational method in determining anticonvulsant log P
      values has been demonstrated.

PMID- 7791036
TI  - Physiologically based pharmacokinetic study on a cyclosporin derivative, SDZ IMM
      125.
AB  - The immunosuppressant, SDZ IMM 125 (IMM), is a derivative of cyclosporin A (CyA).
      The disposition kinetics of IMM in plasma, blood cells, and various tissues of
      the rat was characterized by a physiologically based pharmacokinetic (PBPK)
      model; the model was then applied to predict the disposition kinetics in dog and
      human. Accumulation of IMM in blood cell is high (equilibrium blood cell/plasma
      ratio = 8), although the kinetics of drug transference between plasma and blood
      cell is moderately slow, taking approximately 10 min to reach equilibrium,
      implying a membrane-limited distribution into blood cells. A local PBPK model,
      assuming blood-flow limited distribution and tissue/blood partition coefficient
      (KP) data, failed to adequately describe the observed kinetics of distribution,
      which were slower than predicted. A membrane transport limitation is therefore
      needed to model dynamic tissue distribution data. Moreover, a slowly interacting
      intracellular pool was also necessary to adequately describe the kinetics of
      distribution in some organs. Three elimination pathways (metabolism, biliary
      secretion, and glomerular filtration) of IMM were assessed at steady state in
      vivo and characterized independently by the corresponding clearance terms. A
      whole-body PBPK model was developed according to these findings, which described
      closely the IMM concentration-time profiles in arterial blood as well as 14
      organs/tissues of the rat after intravenous administration. The model was then
      scaled up to larger mammals by modifying physiological parameters, tissue
      distribution and elimination clearances; in vivo enzymatic activity was
      considered in the scale-up of metabolic clearance. The simulations agreed well
      with the experimental measurements in dog and human, despite the large
      interspecies difference in the metabolic clearance, which does not follow the
      usual allometric relationship. In addition, the nonlinear increase in maximum
      blood concentration and AUC with increasing dose, observed in healthy volunteers
      after intravenous administration, was accommodated quantitatively by
      incorporating the known saturation of specific binding of IMM to blood cells.
      Overall, the PBPK model provides a promising tool to quantitatively link
      preclinical and clinical data.

PMID- 7791037
TI  - A non-Markovian model for calcium kinetics in the body.
AB  - We present a new generalized compartmental model for calcium kinetics as measured
      by tracer concentration in blood plasma. The parameter measuring incorporation of
      calcium in bone discriminates between different levels of physical development in
      female teenagers and between teenagers and adults.

PMID- 7791038
TI  - Comparative physiological pharmacokinetics of fentanyl and alfentanil in rats and
      humans based on parametric single-tissue models.
AB  - The objectives of this investigation were to characterize the disposition of
      fentanyl and alfentanil in 14 tissues in the rat, and to create physiological
      pharmacokinetic models for these opioids that would be scalable to man. We first
      created a parametric submodel for the disposition of either drug in each tissue
      and then assembled these submodels into whole-body models. The disposition of
      fentanyl and alfentanil in the heart and brain and of fentanyl in the lungs could
      be described by perfusion-limited 1-compartment models. The disposition of both
      opioids in all other examined tissues was characterized by 2- or 3-compartment
      models. From these models, the extraction ratios of the opioids in the various
      tissues could be calculated, confirming the generally lower extraction of
      alfentanil as compared to fentanyl. Assembly of the single-tissue models resulted
      in a wholebody model for fentanyl that accurately described its disposition in
      the rat. A similar assembly of the tissue models for alfentanil revealed non
      first-order elimination kinetics that were not apparent in the blood
      concentration data. Michaelis-Menten parameters for the hepatic metabolism of
      alfentanil were determined by iterative optimization of the entire model. The
      parametric models were finally scaled to describe the disposition of fentanyl and
      alfentanil in humans.

PMID- 7791039
TI  - Estimation of sieving coefficients of convective absorption of drugs in perfused
      rat jejunum.
AB  - Intestinal absorption of many hydrophilic drugs cannot be explained solely in
      terms of pH-partition and solvent-drag effects have been described in a number of
      cases. However, quantitative estimates of sieving coefficient (phi) for drug
      molecules have tended to be variable. In the present work an in situ perfused
      intestinal loop preparation in the rat has been used to measure the disappearance
      of five hydrophilic drugs from the intestinal lumen and a mathematical model of
      drug absorption in the presence of net and unidirectional fluid fluxes has been
      developed. The model allows separate estimation of the convective (solvent drag)
      and nonconvective (partition) components of drug absorption from the experimental
      data. The five drugs studied were found to have phi values ranging from 0.1-0.9;
      this was highly dependent on molecular size. Analysis of the data shows that
      three of the drugs are absorbed almost exclusively by the convective process
      (caffeine, cimetidine, hydrochlorthiazide) while the other two are absorbed by
      both convective and nonconvective processes (salicylate, oxprenolol). We conclude
      that the methodology is a useful and reliable means of deriving separate
      estimates of these two components of drug absorption.

PMID- 7791040
TI  - Comparison of the Akaike Information Criterion, the Schwarz criterion and the F
      test as guides to model selection.
AB  - In pharmacokinetic data analysis, it is frequently necessary to select the number
      of exponential terms in a polyexponential expression used to describe the
      concentration-time relationship. The performance characteristics of several
      selection criteria, the Akaike Information Criterion (AIC), and the Schwarz
      Criterion (SC), and the F test (alpha = 0.05), were examined using Monte Carlo
      simulations. In particular, the ability of these criteria to select the correct
      model, to select a model allowing estimation of pharmacokinetic parameters with
      small bias and good precision, and to select a model allowing precise predictions
      of concentration was evaluated. To some extent interrelationships among these
      procedures is explainable. Results indicate that the F test tends to choose the
      simpler model more often than does either the AIC or SC, even when the more
      complex model is correct. Also, the F test is more sensitive to deficient
      sampling designs. Clearance estimates are generally very robust to the choice of
      the wrong model. Other pharmacokinetic parameters are more sensitive to model
      choice, particularly the apparent elimination rate constant. Prediction of
      concentrations is generally more precise when the correct model is chosen. The
      tendency for the F test (alpha = 0.05) to choose the simpler model must be
      considered relative to the objectives of the study.

PMID- 7791041
TI  - Refining analysis of refractive surgical outcomes.

PMID- 7791042
TI  - Standing while performing phacoemulsification.

PMID- 7791043
TI  - Impact of Salzmann's lesions on corneal curvature.

PMID- 7791044
TI  - In vitro test of intraocular lens biocompatibility.

PMID- 7791045
TI  - Potential pitfall in the safe use of the DuoTrak-style diamond knife.

PMID- 7791046
TI  - Using the intraocular lens cap for intraoperative qualitative keratometry.

PMID- 7791047
TI  - Consultation section. Suture erosion of posterior chamber intraocular lenses.

PMID- 7791048
TI  - Recognition and management of internal wound gape.
AB  - We describe a method for recognizing and managing wound gape of the internal
      aspect of a scleral tunnel incision. The apposition of the cataract internal
      incision can be adequately assessed with the use of a gonioprism during and after
      surgery. With self-sealing tunnel incisions, even though the external incision
      may be well sealed either with or without the use of a suture, the internal
      incision may be inconspicuously gaping. When an internal incision gapes open, it
      takes on the appearance of an elongated oval opening by gonioscopy, a process we
      have termed fishmouthing. Often fishmouthing can be closed by rapidly deepening
      the anterior chamber with balanced salt solution through the paracentesis
      incision; if this is unsuccessful, a limbal suture may be required. Assessment of
      the internal incision with a gonioprism and management of internal incision
      fishmouthing is an important method to ensure wound stability and minimize
      surgically induced astigmatism.

PMID- 7791049
TI  - A corneal lens/shield system to promote postoperative corneal epithelial healing.
AB  - We used a disposable bandage soft contact lens piggybacked onto a medicated, 12
      hour corneal collagen shield to promote postoperative corneal epithelial healing
      and to provide sustained delivery of high levels of medications after corneal
      surgery in patients known to have poor corneal epithelial wound healing
      characteristics. Our experience with three patients indicates that the collagen
      shield dissolves completely by the first postoperative day and that the bandage
      lens remains in place with good mobility until it is removed when
      epithelialization is complete. This system eliminates the need for painful
      manipulation and placement of a bandage soft contact lens in an edematous,
      inflamed eye during the immediate postoperative period.

PMID- 7791050
TI  - Retinal detachment following intracapsular and extracapsular cataract extraction.
AB  - In 1984, our ophthalmology department switched from intracapsular cataract
      extraction (ICCE) to extracapsular cataract extraction (ECCE). We reviewed the
      postoperative incidence of retinal detachment (RD) in two consecutive series: (1)
      604 eyes operated on by ICCE from 1982 to 1983 and (2) 1726 eyes operated on by
      ECCE from 1985 to 1986. Follow-up averaged 39 months in both groups. The RD
      incidence was 1.30% after ICCE and 0.41% after ECCE, a statistically significant
      difference. In both groups, the risk of RD was high for patients less than 70
      years of age at the time of surgery but minimal for patients older than 70 years.
      The proportion of younger patients was significantly higher in the ICCE group
      (29.5%) than in the ECCE group (23.2%). When the data were stratified by age and
      the difference in age composition adjusted for statistically, the difference
      between the two groups in the incidence of postoperative RD was less pronounced.
      We conclude that although not significant at the 5% level after adjusting for age
      distribution, our results suggest a decreased risk of RD with ECCE.

PMID- 7791051
TI  - Incidence of retinal detachment after cataract surgery and neodymium: YAG laser
      capsulotomy.
AB  - The objective of this retrospective study was to determine the incidence of
      retinal detachment (RD) in patients following cataract extraction with
      intraocular lens placement and after neodymium:YAG (Nd:YAG) laser capsulotomy.
      This study comprised 1092 patients (1168 eyes) who had cataract extraction and
      related procedures between January 1986 and December 1992 identified from the
      coding and billing database. Of the 1092 patients, 215 (244 eyes) had had Nd:YAG
      laser capsulotomy. Their charts were reviewed for incidence of RD, and these data
      were correlated with age, sex, axial length, surgical complications, and other
      surgical procedures done at the time of cataract extraction. The incidence of RD
      following phacoemulsification alone was 0.75% (6/799), with a mean time between
      cataract extraction and RD of 11.6 months. The cases of RD after extracapsular
      cataract extraction, combined phacoemulsification and trabeculectomy, combined
      extracapsular cataract extraction and penetrating keratoplasty, and combined
      phacoemulsification and anterior vitrectomy were too few to draw any conclusions.
      The incidence of RD following Nd:YAG laser capsulotomy was 0.82% (2/244), with a
      mean time of 32 months between cataract surgery and capsulotomy and 13.5 months
      between capsulotomy and RD. There was a statistically significant higher
      incidence of RD after posterior capsule rupture and anterior vitrectomy than
      after uncomplicated phacoemulsification (2/12 versus 6/799). In conclusion, the
      rate of RD after uncomplicated phacoemulsification was less than or similar to
      the rate found in other recent studies. It was not statistically different from
      the rate following phacoemulsification and Nd:YAG laser capsulotomy (0.82%). This
      study confirms the increased risk of RD following posterior capsule rupture and
      anterior vitrectomy.

PMID- 7791052
TI  - Prospective study of cataract surgery, capsulotomy, and retinal detachment.
AB  - We report the incidence of retinal detachment (RD) in 1543 consecutive cases of
      cataract extraction in a prospective cohort study. Retinal detachment was
      significantly associated with intracapsular extraction, axial lengths of 24.0 mm
      or longer and an intact capsule, and capsulotomy in eyes with axial lengths of
      24.0 mm or longer. The interval between capsulotomy and RD was significantly
      shorter in eyes with axial lengths of 24.0 mm or greater. An intraocular lens
      with stiff, vaulted, poly(methyl methacrylate) optics and a biconvex PMMA optic
      was associated with significantly less capsule opacification than lenses of other
      designs.

PMID- 7791053
TI  - Clinical evaluation of hexagonal keratotomy for the treatment of primary
      hyperopia.
AB  - We evaluated the effectiveness of spiral hexagonal keratotomy in correcting
      primary hyperopia in 199 eyes. One hundred eighty-four eyes (92.5%) had a minimum
      follow-up of three months. Mean follow-up was 11.9 months and maximum, 36.2
      months. Secondary astigmatic keratotomy was performed on 54 eyes six to eight
      months after initial hexagonal surgery to correct induced astigmatism. The mean
      reduction in spherical equivalent was -1.6 +/- 0.9 diopters (D) (range -5.6 to
      +0.9 D). The mean increase in refractive cylinder was +0.5 +/- 0.9 D (range -2.3
      to +3.0 D). Uncorrected acuity improved by +3.2 lines, while best corrected
      acuity decreased slightly by -0.26 lines. Loss of two or more lines of best
      corrected acuity that was attributable to surgery was between 0.5% and 4.0%.

PMID- 7791054
TI  - Excimer laser photorefractive keratectomy for myopia: six-month follow-up.
AB  - In this study, 108 eyes of 62 patients had photorefractive keratectomy (PRK) with
      a 193 nm excimer laser to correct myopia. The eyes were assigned to one of three
      groups: low, moderate, or high myopia. Six months after PRK, 88.9% of eyes in the
      low myopia group, 90.0% in the moderate myopia group, and 23.8% in the high
      myopia group achieved an uncorrected visual acuity of 20/40 or better. In the low
      myopia group, 88.9% were within +/- 1 diopter (D) of attempted correction, as
      were 70.0% in the moderate group and 18.8% in the high myopia group. There were
      no significant complications. We conclude that excimer laser PRK appears to be a
      safe and relatively accurate procedure to correct low to moderate myopia but not
      high myopia because of regression over time.

PMID- 7791055
TI  - Relative effectiveness of topical ketorolac and topical diclofenac on discomfort
      after radial keratotomy.
AB  - Two prospective, randomized, double-masked studies were conducted evaluating the
      analgesic effect of topical eyedrops after radial keratotomy (RK). One study of
      117 consecutive initial RK procedures compared topical ketorolac (Acular) with
      topical diclofenac (Voltaren), and another study of 23 consecutive initial RK
      procedures compared topical ketorolac with a control medication (HypoTears).
      Topical ketorolac was significantly more effective than the control but not
      significantly different from topical diclofenac. The onset of analgesic effect of
      these topical nonsteroidal anti-inflammatory drugs is longer than one hour. The
      analgesic effect of oral acetaminophen #3 significantly augments that of topical
      diclofenac drops for those experiencing any discomfort by six hours after
      surgery.

PMID- 7791056
TI  - Preliminary report of sutureless phacotrabeculectomy through a modified self
      sealing scleral tunnel incision.
AB  - A method of combined cataract extraction and trabeculectomy using
      phacoemulsification through a modified 5 mm sutureless scleral tunnel incision is
      described. In eight patients who were followed for a minimum of five months in an
      initial series, the intraocular pressure (IOP) decreased to less than 19 mm Hg;
      six achieved this result at six months on no medication. The IOP decreased from a
      mean of 30.88 mm Hg preoperatively to 13.75 mm Hg at two months and 14.00 mm Hg
      at six months. The preoperative mean of 3.63 antiglaucoma medications per patient
      decreased to 0.25 postoperatively. Although all patients had advanced
      glaucomatous optic neuropathy with a preoperative mean cup/disc ratio of 0.79,
      visual acuity improved in six patients; four patients had an acuity of 20/40 or
      better at both one week and two months. Surgically induced astigmatism averaged
      0.57 diopter (D) at two months, with a mean astigmatic shift of 0.08 D with the
      rule at two months and 0.41 D with the rule at three months. No hypotonous or
      flat anterior chambers were encountered; there were visible blebs in seven
      patients at six months. The sutureless phacotrabeculectomy preserves all the
      advantages of small incision phacoemulsification and appears to be a safe and
      effective combined procedure for IOP control in glaucoma patients with cataracts.

PMID- 7791057
TI  - Atonic pupil after cataract surgery.
AB  - We report and describe the clinical findings of three patients who developed
      atonic pupil after uncomplicated extracapsular cataract extraction with posterior
      chamber intraocular lens implantation. All patients had normally reactive pupils
      one day postoperatively, but after two weeks, the pupils were dilated and
      nonreactive to light, accommodation, and miotics. To estimate the incidence of
      atonic pupil after cataract surgery, we sent a survey on the frequency, clinical
      features, and possible etiologies of this syndrome to members of the American
      Society of Cataract and Refractive Surgery. Of the 567 respondents, 60% had seen
      at least one case of atonic pupil in the past five years; they reported a total
      of 1543 cases during that time. This is probably a conservative figure since many
      cases undoubtedly go unnoticed because of a lack of visual disturbance. We
      believe this condition occurs more frequently than previously reported. The
      atonic pupil should be recognized as a possible complication of cataract surgery
      that should be included in the preoperative consent form.

PMID- 7791058
TI  - Cataract surgery outcomes: importance of co-morbidities in case mix.
AB  - Variation in patients' preoperative co-morbidities can have a significant effect
      on the outcomes of cataract surgery. To examine the effects of that variation, we
      did a retrospective study of the outcomes of extracapsular cataract surgery
      performed by seven surgeons. Medical records from 791 surgeries done from June 1,
      1986, through May 31, 1989, were retrospectively examined. Variations in
      postoperative visual acuity and intraoperative and postoperative complications
      were documented. The relationships between preoperative ocular and systemic
      medical co-morbidities and postoperative visual results and complications were
      studied. A statistical model was developed to adjust for the preoperative co
      morbidity case mix between physicians. Visual acuity rates varied by surgeon and
      surgical volume, but not significantly when adjusted for patient case mix.

PMID- 7791059
TI  - Mechanism of iris prolapse: a qualitative analysis and implications for surgical
      technique.
AB  - A theoretical explanation of the mechanism of iris prolapse is presented using
      simple flow mechanics and the Bernouille principle, which states that fluid
      pressure varies inversely to fluid velocity. Rapid aqueous escape into an
      anterior chamber perforation thus creates a relative vacuum anterior to the iris.
      Further analysis shows that the tendency of the iris to prolapse into an anterior
      chamber wound increases as an inverse function of the fourth power of the radial
      distance between the iris and the perforation. Anterior wound placement, clear of
      the iris plane, should help to prevent iris prolapse. Minimizing the irrigation
      velocity (and hence the fluid outflow velocity) should also help to prevent
      intraoperative prolapse.

PMID- 7791060
TI  - Efficacy of diclofenac sodium solution in reducing discomfort after cataract
      surgery.
AB  - Two hundred consecutive patients were enrolled in a randomized, prospective
      clinical trial evaluating the efficacy of diclofenac sodium (Voltaren Ophthalmic)
      in reducing patient discomfort after cataract surgery. Other factors evaluated
      were the effect of preoperative flurbiprofen (Ocufen) in preventing
      intraoperative miosis and on postoperative discomfort and the effect of incision
      size and intraocular carbachol (Miostat) on postoperative comfort. Diclofenac
      significantly reduced discomfort during the first 24 hours after surgery but not
      two to three days postoperatively, although there was a trend toward reduction.
      Flurbiprofen given preoperatively did not affect postoperative discomfort. It
      also did not affect pupil size at the start of surgery but did reduce
      intraoperative miosis. Incision size (5.2 mm versus 7.0 mm) had no effect on
      discomfort. Miostat did not affect discomfort, although there was a trend toward
      more discomfort. The results indicate that topical diclofenac, given immediately
      after cataract surgery, significantly reduces discomfort during the first 24
      postoperative hours.

PMID- 7791063
TI  - Contrast sensitivity, glare, and visual function: diffractive multifocal versus
      bilateral monofocal intraocular lenses.
AB  - We measured contrast sensitivity binocularly in different light conditions in
      nine patients with bilateral diffractive multifocal intraocular lenses (IOLs) and
      nine patients with bilateral monofocal IOLs. In general, the diffractive
      multifocal group had a lower mean contrast sensitivity. Patients completed a
      questionnaire that asked about their vision under daylight, twilight, and
      sunshine conditions. Monofocal patients had complete visual restitution in all
      light conditions. Multifocal patients reported several visual problems,
      especially when driving at night, but also in normal daylight and cloudy weather
      conditions.

PMID- 7791062
TI  - Comparative clinical trial of AMO Vitrax and Healon use in extracapsular cataract
      extraction.
AB  - This randomized, single-masked, multicenter clinical trial, comprising 95
      patients enrolled at five sites, evaluated the performance of AMO Vitrax and
      Healon viscoelastic materials during cataract surgery. Patients were examined
      preoperatively and at one day, four days, one month, and three months
      postoperatively. The following measurements were recorded and analyzed:
      percentage of endothelial cell loss from preoperative to three months
      postoperative; change in intraocular pressure (IOP) from preoperative to 24 hours
      postoperatively; postoperative corrected visual acuity; subjective assessment of
      ability of viscoelastic to create and maintain tissue space; intraocular
      transparency; ease of evacuation. Three months postoperatively, endothelial cell
      loss was 4.9% (+/- 8.3%) for the AMO Vitrax group and 6.3% (+/- 10.5%) for the
      Healon group. One day postoperatively, IOP decreased by 1.6 mm Hg and increased
      by +1.1 mm Hg, respectively. Postoperative visual acuities were similar between
      the two groups at three months. Subjective assessment of transparency was higher
      for Healon. Assessment of tissue space maintenance was similar between the two
      materials. Healon was rated as slightly easier to evacuate.

PMID- 7791061
TI  - Effectiveness of apraclonidine and acetazolamide in preventing postoperative
      intraocular pressure spikes after extracapsular cataract extraction.
AB  - We studied the effectiveness of two prophylactic agents in controlling early
      postoperative intraocular pressure (IOP) increases after cataract surgery. Fifty
      four nonglaucomatous patients received either topical 1% apraclonidine, one drop
      before and after surgery, or sustained-release acetazolamide, 500 mg, or no
      medication at the completion of planned extracapsular cataract extraction (ECCE).
      Mean baseline IOPs were similar among patients randomized to the apraclonidine,
      acetazolamide, and control groups: 15.29 mm Hg, 15.33 mm Hg, and 14.26 mm Hg,
      respectively. At 3 hours postoperatively, IOPs were significantly lower in the
      apraclonidine group (11.13 mm Hg, P = .035), nonsignificantly lower in the
      acetazolamide group (13.3 mm Hg, P = .17), and significantly increased in the
      control group (21.32 mm Hg, P = .003). One eye in the apraclonidine group and six
      in the control group had IOPs greater than 30 mm Hg. At 24 hours, the only
      statistically significant difference was in the control group, whose mean IOPs
      remained elevated (21.83 mm Hg, P = .0008). One eye in the apraclonidine group,
      two in the acetazolamide group, and five in the control group had IOPs greater
      than 30 mm Hg. We found a significant early IOP reduction with apraclonidine
      given topically preoperatively and at the completion of planned ECCE.

PMID- 7791065
TI  - Innovator's lecture, 1994. Limitation, logic, and language.

PMID- 7791064
TI  - Postoperative membranous proliferation from the anterior capsulotomy margin onto
      the intraocular lens optic.
AB  - We performed slitlamp microscopy and specular microscopy in 15 patients who had
      cataract surgery to determine the clinical course of postoperative membranous
      proliferation from the anterior capsulotomy margin onto the intraocular lens
      optic. Membranous proliferation observed in 11 of the 15 eyes eventually resolved
      in 10 eyes. We speculate that lens epithelial cells were the origin of the
      membrane.

PMID- 7791066
TI  - Low-dose intraocular tissue plasminogen activator treatment for traumatic total
      hyphema, postcataract, and penetrating keratoplasty fibrinous membranes.
AB  - Tissue plasminogen activator (tPA) has been used to treat severe postcataract and
      vitrectomy fibrinous membranes, but intraocular bleeding has occurred with doses
      of 25 micrograms or higher. We report three patients, one with nonclearing total
      hyphema and uncontrollable intraocular pressure and two with severe fibrinous
      membrane formation, who had treatment with low-dose (4 micrograms to 6
      micrograms) intraocular tPA. Although the fibrinous membranes or hyphema resolved
      in all three patients, they recurred and bleeding that required additional
      treatment occurred in one patient. Intraocular low-dose tPA may minimize the risk
      of corneal and retinal toxicity and may be considered an alternative treatment in
      intractable cases. However, secondary intraocular hemorrhage can occur, and the
      timing between the initial vascular injury, treatment with tPA, and subsequent
      bleeding may reduce the risk of further hemorrhaging.

PMID- 7791067
TI  - Corneal damage after glass intraocular lens implantation.
AB  - We present three cases of corneal damage in two patients after implantation of an
      anterior chamber, iris-supported, intraocular lens (IOL) with a glass optic and
      polyamide haptics. We found bullous keratopathy in all three eyes. Penetrating
      keratoplasty, IOL removal, and anterior vitrectomy were performed in all cases.
      We believe the bullous keratopathy was caused by long-term iritis and
      pseudophakodonesis.

PMID- 7791069
TI  - Different mechanisms mediated by dopamine D1 and D2 receptors are involved
      etiologically in activity-stress gastric lesion of the rat.
AB  - Rats subjected to activity-stress developed gastric lesions and showed excessive
      running activity with an increase of light/dark ratio. Daily treatment with
      centrally acting dopamine antagonists, SCH23390 [(R)-(+)-8-chloro-2,3,4,5
      tetrahydro-3-methyl-5-phenyl-1H-3- benzazepin-7-ol] (0.1-10 mg/kg), haloperidol
      (0.1-10 mg/kg), sulpiride (32-320 mg/kg), clozapine (1-100 mg/kg) and
      metoclopramide (1-100 mg/kg) suppressed the lesion formation: ID50 values were
      0.9, 0.4, 53, 8.9 and 60 mg/kg, respectively. On the other hand, domperidone (1
      100 mg/kg), a peripherally acting dopamine antagonist, failed to suppress the
      lesion formation and FR64822 [N-(4-pyridylcarbamoyl)amino 1,2,3,6
      tetrahydropyridine] (1-32 mg/kg), a central dopamine enhancer, aggravated it. The
      excessive running activity was reversed dose-dependently by treatment with
      haloperidol, a specific dopamine D2 antagonist, but not by SCH23390, a specific
      dopamine D1 antagonist. Conversely, the increased light/dark ratio was attenuated
      dose-dependently by SCH23390, but not by haloperidol. Neither antisecretory
      agents nor 5-hydroxytryptamine antagonists were effective against the lesion
      formation. These results suggest that an activation of central dopamine D1 and D2
      receptors is responsible for the increased light/dark ratio and enhanced running
      activity, respectively, and that both of the changes are involved in the etiology
      of activity-stress induced lesions.

PMID- 7791068
TI  - Relaxing the fibrosed capsulorhexis rim to correct induced hyperopia after
      phacoemulsification.
AB  - I present two cases in which hyperopia occurred after phacoemulsification through
      a capsulorhexis. In both eyes, the anterior capsule rim had become fibrosed and
      contracted. The patients were successfully treated with YAG laser relaxing
      incisions.

PMID- 7791070
TI  - Receptor subtypes involved in dual effects induced by prostaglandin E2 in
      circular smooth muscle from dog colon.
AB  - Smooth muscle strips and isolated muscle cells from the circular layer of dog
      colon, were used to study the effect of prostaglandin E2 (PGE2) and their analogs
      acting at EP receptors: Iloprost (IP/EP1), butaprost (EP2) and enprostil (EP3)
      and SC19220 (antagonist EP1) to characterize the EP-receptors involved in the
      control of muscle function. In strips treated with tetrodotoxin, only enprostil
      provoked a concentration-dependent contraction. The concentration of enprostil
      inducing a half maximal contraction (EC50) was 400 nM and the maximal effect was
      obtained at 1 microM. PGE2, butaprost and iloprost induced a dose-dependent
      relaxation, with an EC50 of 200, 80 and 200 nM, respectively. The maximal
      relaxation was obtained at 1 microM for all these agents. When the EP1
      antagonist, SC19220 (10 microM), was added 20 min before PGE2 or their analogs,
      their respective concentration-response curves were not affected. In isolated
      cells, PGE2 and enprostil induced a cell contraction in a concentration-dependent
      manner, whereas iloprost and butaprost had no effect by themselves. The maximal
      contraction was 241.1 +/- 1.7% at 10 nM PGE2 and 22.5 +/- 1.6% at 10 nM
      enprostil. EC50 of PGE2 and enprostil was 40 pM. SC 19220, at concentrations
      ranging from 1 pM to 0.1 microM, failed to inhibit the contraction induced by
      either PGE2 or enprostil. When cells were preincubated for 1 min with butaprost
      or iloprost at concentrations ranging from 1 pM to 1 microM, the contraction
      induced by CCK8 (10nM) was inhibited in a concentration-dependent
      matter.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791071
TI  - RP 73870, a gastrin/cholecystokinin-B receptor antagonist with potent anti-ulcer
      activity in the rat.
AB  - RP 73870, the racemic potassium salt of (([N-(methoxy-3-phenyl)-N-(N-methyl-N
      phenyl-carbamoylmethyl)- carbamoylmethyl]-3-ureido)-3-phenyl)-2-ethylsulfonate
      (RS) is a potent, reversible antagonist of both gastrin and cholecystokinin-B
      receptors in guinea pig and rat tissues. This compound is a potent inhibitor of
      pentagastrin-stimulated gastric acid secretion in the perfused rat stomach. RP
      73870 also inhibits basal gastric acid secretion in the rat, although at doses
      higher than that required for inhibition of pentagastrin-stimulated gastric acid
      secretion. RP 73870 is a potent inhibitor of aspirin-induced gastric damage in
      the rat. In the prevention of aspirin-induced gastric damage, RP 73870, given
      p.o., was 10-fold less potent than when given i.v. RP 73870 was as potent as a H2
      receptor antagonist or proton pump inhibitor in the prevention of cysteamine
      induced duodenal ulcers in the rat. Relative to other gastrin/cholecystokinin-B
      antagonists, RP 73870 demonstrates greater affinity to gastrin binding sites, and
      possesses a unique spectrum of in vivo biological activities appropriate for an
      anti-ulcer indication.

PMID- 7791072
TI  - Anticonvulsant efficacy/safety properties of 2-amino-N-(1,2
      diphenylethyl)acetamide hydrochloride.
AB  - 2-Amino-N-(1,2-diphenylethyl)-acetamide-hydrochloride (FPL 13950) was profiled
      preclinically in rodents for efficacy against convulsions, as well as for acute
      safety/behavioral observations. FPL 13950 exhibited good oral efficacy and
      duration of action with respect to prevention of seizures elicited by maximal
      electroshock-shock in both rats and mice. Tolerance to protection against maximal
      electroshock and hexobarbital-induced sleep-time was not evident after subchronic
      drug administration. FPL 13950 also prevented convulsions/mortality in mice after
      i.v. dosing with N-methyl-D, L-aspartate, however, it was ineffective against
      other types of chemically induced convulsions, as well as bicorneal kindling.
      High oral doses produced neural impairment in both mice and rats and
      hyperactivity in rats. Sequential administration of yet higher doses elicited
      tonic/clonic convulsions culminating in death. During i.v. infusion of metrazol
      in mice, high i.p. doses of FPL 13950 shortened the latency to first twitch and
      clonus. No increase in the startle response or phencyclidine-like behavior was
      evident after oral dosing in rats.

PMID- 7791074
TI  - Effect of intracerebroventricular beta-funaltrexamine on mu opioid receptors in
      the rat brain: consideration of binding condition.
AB  - Effects of 24 h pretreatment with intracerebroventricular (icv) beta
      funaltrexamine (beta-FNA) on brain opioid receptor binding in rats were examined
      under various conditions. Agonist binding to mu and delta opioid receptors (with
      [3H][[cap]dAla2,MePhe4,Gly-ol5]enkephalin (DAMGO)[3H][D-Pen2, D-Pen5]enkephalin
      (DPDPE), respectively) was performed under three different conditions: i)
      pretreatment of membranes with GDP and Na+ and binding in the presence of Mg++ in
      Tris-HCI buffer containing EGTA and leupeptin for 1.5 to 3 h; ii) binding in Tris
      HCI buffer containing bacitracin, leupeptin, chymostatin and bestatin for 3 to 4
      h; iii) binding in Tris-HCI buffer containing EGTA and leupeptin for 45 min.
      Condition i was shown to convert opioid receptors to a high affinity state for
      agonists. beta-FNA (2, 6 or 20 nmol) significantly reduced 1 nM [3H]DAMGO binding
      in the whole brain with i but not with ii. With iii, 20 nmol beta-FNA reduced
      [3H]DAMGO binding, but not 2 or 6 nmol. Saturation experiments with i showed that
      the reduction in [3H]DAMGO binding after 6 or 20 nmol beta-FNA was due to a
      decrease in Bmax and an increase in KD. For delta binding, there was no
      significant change in [3H]DPDPE (2 nM) binding with i after 2, 6 or 20 nmol beta
      FNA. Thus, under i, icv beta-FNA reduced [3H]DAMGO binding significantly without
      affecting [3H]DPDPE binding. In addition, mu binding was also conducted with 1 nM
      [3H]naloxone under three different conditions: iv) in the presence of Na+ and
      GDP; v), in the presence of Na+, Gpp(NH)p and Mg++; vi) in the presence of Na+.
      Both iv and v were shown to shift opioid receptors to a low affinity state for
      agonists. beta-FNA (20 nmol) significantly decreased 1 nM [3H]naloxone binding
      under each of the three conditions. Competitive inhibition of 1 nM [3H]naloxone
      binding by DAMGO in the presence of Na+ and GDP showed that receptors existed in
      a single low affinity state for DAMGO, and that icv beta-FNA caused a reduction
      in Bmax without affecting the KD of DAMGO. In summary, when all the receptors
      were converted to a high agonist affinity state i or a low agonist affinity state
      iv, the changes in mu binding induced by beta-FNA could be revealed with agonist
      binding. Additionally, changes in mu binding induced by beta-FNA could be
      detected with [3H]naloxone, which always displayed high affinity regardless of
      agonist affinity states, under each of the three conditions (iv, v and vi).

PMID- 7791073
TI  - Modulation of the activity of central serotoninergic neurons by novel serotonin1A
      receptor agonists and antagonists: a comparison to adrenergic and dopaminergic
      neurons in rats.
AB  - In this study, we used a complementary in vivo electrophysiological and (in
      individual rats) neurochemical approach to characterize the actions of chemically
      diverse serotonin (5-HT)1A receptor ligands at central 5-HT1A autoreceptors as
      compared to dopamine (DA) D2 autoreceptors and presynaptic alpha-2 adrenergic
      receptors (ARs). The novel, high efficacy, 5-HT1A agonists, WY 48,723 (an
      arylpiperazine), (+)-flesinoxan (a benzodioxane) and S 14671 and S 14506
      (methoxynaphtylpiperazines) mimicked the aminotetralin, 8-hydroxy-2-(di-n
      propylamino)tetralin hydrobromide (8-OH-DPAT), in inhibiting the firing of dorsal
      raphe nucleus (DRN) neurons. Similarly, the firing rate of DRN neurons was
      reduced by the "partial" agonists, MDL 73005EF, BMY 7378, NAN-190, tandospirone
      and the novel pyrimidinylpiperazine, zalospirone. Furthermore, S 14489, S 15535
      and S 15931, novel benzodioxopiperazines, which behave as antagonists at
      postsynaptic 5-HT1A receptors, inhibited completely DRN firing, whereas the
      methoxyphenylpiperazine, WAY 100,135, and the aryloxoarylamine, (-)-tertatolol,
      were ineffective. Indeed, in analogy to spiperone, both WAY 100,135 and (-)
      tertatolol behaved as apparently competitive antagonists in that, in their
      presence, the dose-response curves for inhibition of DRN firing by S 14671, S
      14506 or 8-OH-DPAT were shifted in parallel to the right with no loss of maximal
      effect. In distinction to WAY 100,135 and (-)-tertatolol, a further novel,
      putative "antagonist," SDZ 216-525 (a benzoisothiazolpiperazine) weakly inhibited
      the electrical activity of the DRN. With the exception of (-)-tertatolol, which
      behaved as a weak agonist, a very similar pattern of inhibition of 5-HT turnover
      was seen in the striatum (innervated by the DRN), the hippocampus and the
      hypothalamus (DRN and median raphe nucleus) and the spinal cord (nucleus raphe
      magnus), with the striatum displaying the greatest sensitivity. Drug potency for
      inhibition of firing and turnover was highly correlated (r = 0.80-0.82) and these
      actions were significantly correlated to affinity at (hippocampal) 5-HT1A
      receptors (r = 0.62-0.73). As concerns DA D2 autoreceptors, the agonist action of
      apomorphine in reducing DA turnover were mimicked only by 8-OH-DPAT, whereas the
      majority of the other 5-HT1A ligands, in analogy to raclopride, enhanced DA
      turnover. The facilitation of DA turnover appeared to reflect direct blockade of
      DA D2 autoreceptors because potency was correlated powerfully to affinity at
      these D2 sites (r = 0.89).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7791075
TI  - Spinal nonadrenergic imidazoline receptors do not mediate the antinociceptive
      action of intrathecal clonidine in the rat.
AB  - The intrathecal administration of clonidine to rats results in profound
      antinociception which is thought to be mediated through an interaction of the
      agonist with spinal alpha-2 adrenergic receptors. However, clonidine has been
      shown to also interact with nonadrenergic imidazoline receptors. Consequently,
      this study was undertaken to determine if nonadrenergic imidazoline receptors are
      present in the rat spinal cord, and the extent to which they are involved in the
      antinociceptive action of spinally administered clonidine. By using the tail
      flick test, the antinociceptive action of spinally administered clonidine was
      found to be blocked completely by the intrathecal administration of the
      imidazoline idazoxan. Similarly, yohimbine (a nonimidazoline alpha-2 adrenergic
      antagonist) also blocked completely the antinociceptive action of clonidine.
      Results of radioligand binding studies demonstrated that norepinephrine did not
      interact with approximately 20% of all specific spinal sites labeled by 4 nM
      [3H]clonidine, indicating the presence of nonadrenergic spinal sites. Affinity
      data obtained from competition binding assays demonstrated that the spinal
      nonadrenergic sites labeled by [3H]clonidine possess little affinity for
      yohimbine. Therefore, nonadrenergic imidazoline receptors are not involved in the
      antinociceptive action of spinally administered clonidine.

PMID- 7791076
TI  - Modulation of methylenedioxymethamphetamine-induced striatal dopamine release by
      the interaction between serotonin and gamma-aminobutyric acid in the substantia
      nigra.
AB  - The effects of the amphetamine analog, 3,4-methylenedioxymethamphetamine (MDMA)
      were compared to the effects of d-amphetamine on the in vivo release of dopamine
      and gamma-aminobutyric acid (GABA) in the striatum and substantia nigra. The
      brain region-dependent role of the 5-HT2 receptors in the striatum and substantia
      nigra in regulating MDMA-induced dopamine and GABA release also was studied.
      Changes in the extracellular concentration of dopamine, 5-HT and GABA were
      measured simultaneously in the awake rat by in vivo microdialysis. The increase
      in striatal dopamine produced by systemic administration of MDMA was attenuated
      by infusion of TTX into the striatum. Infusion of the 5-HT2A/2C antagonist
      ritanserin into the striatum or the ipsilateral substantia nigra also
      significantly attenuated MDMA-induced dopamine release in the striatum. At the
      doses used in this study, MDMA but not d-amphetamine increased the extracellular
      concentrations of 5-HT and decreased GABA efflux in the substantia nigra. The
      ability of MDMA to decrease nigral GABA efflux also was blocked by the local
      infusion of ritanserin into either the substantia nigra or the striatum. Overall,
      these data provide evidence that MDMA increases dopamine release partly through
      an impulse-mediated mechanism. Furthermore, this increase in striatal dopamine
      efflux produced by MDMA is regulated, in part, by 5-HT2A/2C receptors in the
      striatum and the substantia nigra and ultimately by GABAergic input into the
      substantia nigra.

PMID- 7791077
TI  - S 16118 (p-guanidobenzoyl-[Hyp3,Thi5,D-Tic7,Oic8]bradykinin) is a potent and long
      acting bradykinin B2 receptor antagonist, in vitro and in vivo.
AB  - The in vitro and in vivo effects of S 16118 [p-guanidobenzoyl-[Hyp3, Thi5,D
      Tic7,Oic8]bradykinin (BK)], a new BK receptor antagonist, were studied. S 16118
      inhibited the contraction produced by BK in the rabbit jugular vein, but was
      ineffective in the rabbit aorta, indicating the BK B2 receptor specificity of the
      compound. In isolated organs from various species including humans, S 16118 was a
      potent antagonist (Ki, pA2 or pKB value from 9.58-7.37). The effect of S 16118
      was specific as it did not show any affinity for a number of other receptors or
      channels and did not possess residual agonistic properties in most of the tissues
      studied. Furthermore, S 16118 is a poor secretagogue agent either in the rat or
      human mast cells and is resistant to degradation with an in vitro half-life in
      blood from different species, including humans, of more than 24 hr. In vivo, in
      the rabbit, i.v. injection of S 16118 inhibited the hypotension induced by BK up
      to 4 hr after administration. In the guinea pig, it was also effective in
      inhibiting the bronchoconstriction induced by BK, although when administered i.v.
      it had a shorter duration than in the rabbit. However, in the same species, when
      aerosolized, S 16118 was effective and long-acting against BK-induced
      bronchoconstriction. Changes in permeability induced by BK injection in the
      guinea pig trachea and bronchus, and by BK superfusion in the hamster cheek
      pouch, were abolished by i.v. pretreatment with S 16118.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7791078
TI  - Effects of the bradykinin B2 receptor antagonist S 16118 (p-guanidobenzoyl
      [Hyp3,Thi5,D-Tic7,Oic8]bradykinin) in different in vivo animal models of
      inflammation.
AB  - The effects of S 16118 (p-guanidobenzoyl-[Hyp3,Thi5,D-Tic7, Oic8]bradykinin
      (BK)], a new, potent and long-acting BK B2 antagonist, were tested in some in
      vivo models of inflammation. In rats, S 16118 (0.1 and 1 mg/kg) given i.v. or
      s.c. delayed the edema formation induced by intraplantar carrageenan injections
      up to 4 hr after administration, confirming the involvement of kinins in this
      inflammatory reaction. In guinea pigs treated with atropine, vagal stimulation
      induced bronchial microvascular leakage. Aerosolization of S 16118 (5 x 10(-3) M
      for 20 sec), 4 min before vagus nerve stimulation, induced a 60% decrease in the
      Evans blue extravasation, demonstrating the modulatory role of BK in neurogenic
      inflammation. In rats, caerulein infusion (4 nmol/kg/hr) induced hypotension,
      massive pancreatic edema, hypovolemia due to plasma leakage and an increase in
      serum lipase and amylase activity. S 16118 (100 nmol/kg s.c.) prevented the
      hypotension, the pancreatic edema and the hypovolemia and induced a marked
      increase in the serum lipase and amylase activity. This confirms that BK, acting
      on BK B2 receptors, is involved in this model of pancreatitis. In rabbits, the
      injection of lipopolysaccharides (LPS; 600 micrograms/kg i.v.) induced
      hypotension, metabolic acidosis and leukopenia. S 16118 (1.73 mumol/kg i.v.) did
      not influence the effects of LPS injection. In mice, i.p. LPS (25 mg/kg)
      administration induced over 90% mortality in 96 hr. S 16118 (1 mg/kg x 4), given
      30 min before LPS injection and 4, 8 and 24 hr after LPS injection, did not
      influence the mortality rate.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791079
TI  - Effects of caffeine on ventilation during acute and chronic nicotine
      administration in rhesus monkeys.
AB  - This study characterized the effects of caffeine (1.0-30.0 mg/kg) and nicotine
      (0.1-3.0 mg/kg) administered alone and in combination on ventilation in
      unanesthetized rhesus monkeys. In seated monkeys prepared with a head
      plethysmograph, ventilation was measured during exposure to air (normocapnia),
      CO2 (3%, 4% and 5%) mixed in air (hypercapnia), 10% O2 mixed in N2 (hypoxia) and
      100% O2 (hyperoxia). Caffeine produced marked, dose-dependent increases in
      ventilation during conditions of normocapnia and hypercapnia. In contrast, acute
      administration of nicotine had less pronounced respiratory-stimulant effects
      during all conditions. The joint effects of caffeine and nicotine on ventilation
      generally did not differ from those obtained with caffeine alone. Chronic
      administration of nicotine (1.0 mg/kg/day) for 4 consecutive wk via osmotic pumps
      significantly decreased the half-life of caffeine but had little effect on
      ventilation or on sensitivity to the respiratory-stimulant effects of caffeine.
      Two primary metabolites of caffeine, theophylline and paraxanthine, were active
      as respiratory stimulants and were equipotent to caffeine, and the joint effects
      of caffeine and its metabolites were additive. The results indicate that caffeine
      and nicotine stimulate respiration through different pharmacological mechanisms,
      in contrast to caffeine and its metabolites which exhibit a similar
      pharmacological profile. Moreover, significant pharmacokinetic interactions may
      be obtained when caffeine and nicotine are coadministered.

PMID- 7791081
TI  - Antiproliferative effects of delta opioids on highly purified CD4+ and CD8+
      murine T cells.
AB  - Numerous studies have shown that opioids modulate the proliferative response of
      mixed splenocytes to T cell mitogens. To identify the T cell subpopulations
      affected by opioids, splenocytes from C57BL/6 and CD1 mice were separated using a
      fluorescent activated cell sorter (FACS) to obtain 98 to 99% pure populations of
      either CD4+ or CD8+ T cells. Cells were stimulated to proliferate in serum-free
      medium by cross-linking the T cell receptor using plate-coated anti-CD3-epsilon,
      then 3H-thymidine uptake and cell number were measured at 48 and 72 hr. [D-Ala2]
      deltorphin 1 (deltorphin) dose-dependently inhibited the proliferation of C57BL/6
      CD4+ T cells by approximately 50%. This effect was maximal when cells were
      preincubated with deltorphin 60 min before activation, whereas deltorphin was
      ineffective when added at the time of activation. Similarly, [D-Ala2]-Met
      Enkephalinamide (DAME) 10(-11) to 10(-7) M inhibited CD4+ T cell proliferation.
      Naltrindole 10(-12) M abolished the antiproliferative effect of 10(-7) M
      deltorphin on CD4+ T cells. Proliferation of CD8+ T cells from C57BL/6 mice also
      was dose-dependently inhibited by deltorphin. At all concentrations to
      deltorphin, the antiproliferative effects were greater after 48 compared to 72 hr
      in culture. The effect of deltorphin and DAME on secretion of the T cell growth
      factor, IL-2, was determined by ELISA analysis of supernatants obtained from CD4+
      T cells after 48-hr culture. Deltorphin showed a biphasic effect: 10(-11) M
      enhanced IL-2 secretion, whereas higher concentrations (10(-9)-10(-7) M) were
      inhibitory.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791080
TI  - Effects on atrial repolarization of the interaction between K+ channel blockers
      and muscarinic receptor stimulation.
AB  - We have tested, in guinea pig atria, how muscarinic stimulation by oxotremorine
      (Oxo) modifies the effects on action potential duration (APD) of two iK blockers:
      d-sotalol (5 microM) and ambasilide (1 microM). APD was prolonged by d-sotalol
      (+34.8 +/- 2.9%) and ambasilide (+54.2 +/- 5.5%). Simultaneous superfusion with
      Oxo 0.5 microM markedly shortened APD; this effect was larger in the presence of
      d-sotalol than in the presence of ambasilide (-69 +/- 2% vs. -37.4 +/- 5%; P <
      .05). Moreover ambasilide, but not d-sotalol, antagonized APD shortening induced
      by Oxo. The basis for such a difference between the two drugs was studied in
      patch-clamp experiments on isolated rabbit atrial and sinoatrial myocytes.
      Besides blocking iK (half-effective concentration: EC50 = 2 microM), ambasilide
      almost completely inhibited iKACh (-86 +/- 2% at 10 microM; EC50 = 1.6 microM),
      which was minimally affected by d-sotalol. Ambasilide 2 microM increased 10-fold
      the acetylcholine (ACh) required for 50% iKACh activation, and reduced maximally
      activated iKACh by 18.8 +/- 6.3%. When iKACh was activated through a receptor
      independent mechanism, 10 microM ambasilide reduced this current by only 18.7 +/-
      1.4% of its control value. Moreover, ambasilide, although not affecting the
      current i(f), in basal conditions, reversed its inhibition by ACh. Thus, 1) the
      effect of K+ channel blockers on atrial APD may be blunted by ACh; ambasilide
      effects are less sensitive to ACh than those of d-sotalol; 2) ambasilide, but not
      d-sotalol, inhibits iKACh; this probably occurs largely, although not
      exclusively, through muscarinic receptor antagonism. Inhibition of iKACh may
      account for the persistence of the effects of this drug on atrial APD despite
      muscarinic stimulation.

PMID- 7791082
TI  - Polymeric delivery of the active isomer of misoprostol reduces systemic
      availability and uterotonic activity.
AB  - SC-30249 is the active isomer of misoprostol responsible for its mucosal
      protective effects against nonsteroidal anti-inflammatory drugs (NSAIDS). Linkage
      of SC-30249 to a polybutadiene polymer results in a delivery system (SC-55307)
      that releases the active component only under the acidic conditions of the
      stomach. This approach could be used to minimize side effects and systemic
      availability of synthetic prostaglandins. These studies were done to determine
      whether uterotonic activity could be recorded after treatment with SC-55307.
      Female beagles were implanted with uterine strain gauge force transducers,
      allowed 10 days for recovery and treated with estrogen to sensitize the uterus to
      the actions of prostaglandins. Base-line responses were determined with SC-30249,
      i.v., and then a randomized series of four treatments were given: SC-30249, IG,
      10 micrograms/kg; SC-55307, IG, equivalent to 30 and 100 micrograms/kg of SC
      30249; and a blank polymer control. HCI was given IG to provide an acid
      environment in the stomach, uterine responses were obtained for up to 4 h and
      plasma concentrations of SC-30249 free acid was determined. No uterotonic effect
      was seen after a low dose of SC-55307, whereas the high dose caused a brief but
      statistically significant increase equal to 8.8% and 17.8% of the responses to SC
      30249, i.v. and IG, respectively. Peak plasma levels of SC-30249 free acid were
      176.4 +/- 17.4 and 59.5 +/- 10.6 pg/ml after SC-30249, i.v. and IG, respectively,
      but were only 3.9 +/- 1.7 and 15.5 +/- 6.6 pg/ml after low and high doses of SC
      55307, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791083
TI  - Modulation of the 5-hydroxytryptamine4 receptor-mediated response by short-term
      and long-term administration of corticosterone in rat CA1 hippocampal pyramidal
      neurons.
AB  - Corticosterone (CT) treatment decreases the magnitude of the 5-hydroxytryptamine
      (5-HT)1A receptor-mediated hyperpolarization in rat CA1 hippocampal pyramidal
      neurons. In the present study, we examined the short- and long-term effects of CT
      on the functionally excitatory 5-HT4 receptor-mediated decrease in the amplitude
      of the slow afterhyperpolarization (sAHP) that follows a calcium spike and the
      concomitant decrease in sAHP half decay time. Rats were adrenalectomized (ADX) 2
      weeks before the experiment. Data for concentration-response curves were obtained
      with sharp electrode current clamp recordings in the CA1 pyramidal cell layer of
      hippocampal slices. Significant changes were found in the 5-HT4 receptor-mediated
      decrease in sAHP amplitude. The Emax of the 5-HT4 response was significantly
      increased in cells from ADX rats when the superfusion medium contained 1 nM CT.
      Short-term administration of 100 nM CT did not alter the 5-HT4 response. Chronic
      treatment with low concentrations of CT decreased the Emax of the 5-HT4 response.
      Treatment with CT concentrations that mimic conditions of chronic stress
      decreased the Emax of the 5-HT4 response and shifted the EC50 to the right. Based
      on these results we conclude that the magnitude and the potency of the 5-HT4
      receptor-mediated decrease in sAHP amplitude is altered by CT. Because the short-
      and long-term effects of CT treatment are not the same, the actions of CT are
      time and concentration dependent. CT modulation of the 5-HT4 response is
      different from its modulation of the 5-HT1A response.

PMID- 7791084
TI  - Serotonin potentiates ethanol-induced excitation of ventral tegmental area
      neurons in brain slices from three different rat strains.
AB  - Neurons of the ventral tegmental area of Tsai (VTA) are important in mediation of
      the rewarding effects of drugs of abuse, including ethanol. We have demonstrated
      previously that ethanol excites neurons of the VTA recorded in a brain slice
      preparation. In the present study, we tested the interaction between serotonin
      and ethanol on putative dopamine neurons of the VTA. As reported previously,
      ethanol (20-160 mM) excited VTA neurons in a concentration-dependent manner.
      Serotonin (1-50 microM) produced only minor increases or decreases of the firing
      rate. In the presence of serotonin, the potency of ethanol was increased
      significantly. This potentiation of ethanol excitation by serotonin was seen in
      VTA slices taken from Sprague-Dawley, Fischer 344 and Lewis rats. The effect of
      160 mM ethanol on VTA neurons from Fischer 344 rats, for example, was increased
      from 38.5 +/- 6.1% before serotonin to 77.4 +/- 16.7% after administration of 10
      microM serotonin. Two serotonergic agonists, (+/-)-2,5-dimethoxy-4
      iodoamphetamine hydrochloride and alpha-methylserotonin, also potentiated the
      ethanol-induced excitation. The action of serotonin to increase the potency of
      ethanol to excite VTA neurons may be an important factor in the rewarding effects
      of ethanol, and might be exploited to develop effective pharmacotherapeutic
      agents for the treatment of alcohol craving.

PMID- 7791085
TI  - Pharmacological characterization of SB 202235, a potent and selective 5
      lipoxygenase inhibitor: effects in models of allergic asthma.
AB  - The peptidoleukotrienes and leukotriene B4, formed from arachidonic acid through
      the action of 5-lipoxygenase (5-LO), exert a spectrum of biological effects. It
      has been proposed that potent and selective 5-LO inhibitors will be effective
      therapy in diseases in which the peptidoleukotrienes and leukotriene B4 have been
      implicated, such as asthma and arthritis. The novel compound (S)-N-hydroxy-N-(2,3
      dihydro-6-phenylmethoxy-3-benzyofuranyl )urea (SB 202235) was evaluated as a
      selective inhibitor of 5-LO in a cell-free system as well as in various cellular
      assays. In addition, the potential therapeutic value of SB 202235 was assessed in
      preclinical models of allergic asthma. The activity of the 5-LO enzyme isolated
      from rat basophilic leukemia-1 cells was inhibited by SB 202235 in a
      concentration-dependent manner with an IC50 value of 1.9 microM. Consistent with
      its ability to inhibit 5-LO, SB 202235 inhibited the production of leukotriene B4
      by human monocytes and in human whole blood (IC50 values of 1.5 microM and 1.1
      microM, respectively). The selectivity of SB 202235 was confirmed by its lack of
      effect against several other enzymes and receptors. SB 202235 potently and
      effectively inhibited the contraction produced by a single concentration of
      ovalbumin in guinea pig trachea (IC50 = 20 microM) and of anti-IgE in human
      bronchus (IC50 = 2 microM). SB 202235 (3-30 microM) also inhibited the
      contraction of guinea pig trachea in response to increasing concentration of
      ovalbumin. When administered orally (30 mg/kg) to conscious guinea pigs, SB
      202235 attenuated antigen-induced broncho-constriction and the subsequent
      eosinophil influx.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791086
TI  - Cytochrome P-450 2E1 is not the sole catalyst of chlorzoxazone hydroxylation in
      rat liver microsomes. off.
AB  - The contribution of individual cytochrome P-450 isozymes in the hydroxylation of
      the centrally acting skeletal muscle relaxant chlorzoxazone was determined in rat
      liver microsomes. The hydroxylation rate of chlorzoxazone was found to be 50%
      greater in male than female microsomes. Kinetic studies using control male
      microsomes showed that chlorzoxazone hydroxylation was biphasic with a calculated
      low Km (33 microM) and high Km (116 microM). Liver microsomes from isoniazid-,
      beta-naphthoflavone- or dexamethasone-treated male rats produced a Km of 93, 69
      and 26 microM, respectively. When chlorzoxazone hydroxylation activity was
      measured at a high substrate concentration (200 microM), treatment of male rats
      with isoniazid, acetone, beta-naphthoflavone and dexamethasone produced increases
      in the activity rate of 124%, 117%, 81% and 32%, respectively. However, when the
      activity was measured at a low substrate concentration (2 microM), liver
      microsomes from dexamethasone-treated male and female rats produced 5- and 10
      fold induction, respectively. In immunoinhibition studies at 200 microM of
      chlorzoxazone, antibodies specific for cytochrome P-450 2E1 inhibited the rate of
      chlorzoxazone hydroxylation in microsomes from control and isoniazid-treated male
      rats by 68% and 79%, respectively. A monoclonal antibody (C8) against P-450 1A1
      inhibited 67% of the activity in microsomes from beta-naphthoflavone-treated male
      rats but was ineffective inhibiting chlorzoxazone hydroxylation in microsomes
      from control or dexamethasone-treated male rats. In liver from control female
      rats, antibodies against cytochrome P-450 2E1 inhibited 80% of chlorzoxazone
      hydroxylation, whereas it inhibited only 47% of the activity in dexamethasone
      treated females.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791087
TI  - Role of medullary I1-imidazoline and alpha 2-adrenergic receptors in the
      antihypertensive responses evoked by central administration of clonidine analogs
      in conscious spontaneously hypertensive rats.
AB  - The antihypertensive action of clonidine analogs are generally ascribed to
      stimulation of medullary alpha 2-adrenergic receptors. Several recent studies
      have implicated the newly characterized class of imidazoline receptors as playing
      a more important role in this regard. In this study, a series of doses of four
      imidazoline and two nonimidazoline antihypertensive drugs were administered by
      intracisternal (i.c.) injection to freely moving spontaneously hypertensive rats.
      All six drugs produced a dose-dependent fall in mean arterial pressure (MAP) and
      heart rate (HR). The most potent agents in lowering MAP were the imidazoline
      agents, particularly moxonidine, a drug that has high affinity for I1-imidazoline
      receptors, but relatively low affinity for alpha 2-adrenergic receptors. There
      was a high correlation between the apparent binding affinity (Ki) for I1
      receptors on membranes derived from bovine rostral ventrolateral medulla and the
      relative potency for lowering MAP after i.c. injection in spontaneously
      hypertensive rats. In contrast, no correlation existed between binding affinity
      values for alpha 2-adrenergic receptors derived from the same source and the
      antihypertensive response. The results of these experiments are consistent with a
      role for medullary I1-imidazoline receptors in mediating the antihypertensive
      action of clonidine and related imidazoline compounds in conscious hypertensive
      animals. The nonimidazoline agent, guanfacine, although a clinically effective
      antihypertensive agent, was not efficacious after i.c. injection. This
      discrepancy may be explained by an opposing pressor action or by a depressor
      action mediated by alpha 2-adrenergic receptors at an alternate site when the
      drug is peripherally administered. In contrast, the other nonimidazoline
      antihypertensive agent azepexole was fully efficacious after i.c. injection of
      the highest doses. Further studies may be necessary to determine whether drugs
      such as azepexole have a receptor target other than I1 or alpha 2-adrenergic
      receptors. We conclude that antihypertensive efficacy within the lower brainstem
      of conscious animals is predicted by interaction with I1-imidazoline but not
      alpha 2-adrenergic receptors.

PMID- 7791089
TI  - Pharmacodynamics of 15(S)-hydroperoxyeicosatetraenoic (15-HPETE) and 15(S)
      hydroxyeicosatetraenoic acid (15-HETE) in isolated arteries from guinea pig,
      rabbit, rat and human.
AB  - The vasoactive properties of 15(S)-hydroperoxyeicosatetraenoic acid (15-HPETE)
      and 15(S)-hydroxyeicosatetraenoic acid (15-HETE) were characterized in aortic
      rings of guinea pig (GPA), rat (RA) and rabbit (RbA), as well as pulmonary
      arteries from guinea pigs (GPPA) and humans (HPA). Four distinct patterns of
      activity were identified: 1) Cyclooxygenase-dependent relaxation (in GPA, GPPA
      and HPA). This could be speculated to be due to release of prostaglandin I2 or to
      conversion of 15-H(P)ETE to another vasorelaxant eicosanoid(s). The endothelium
      was the main source of this activity in GPA but not in HPA. 2) Cyclooxygenase
      independent relaxation mediated by both endothelium and the smooth muscle proper
      (only in RA). 3) Endothelium-dependent contraction associated with the release of
      unknown factor(s) (in GPA, GPPA and HPA). 4) Endothelium-independent contraction
      (in RbA). Nitric oxide was not involved in the relaxation of GPA and RA, nor was
      endothelin in the contraction of GPA. 15-HPETE and 15-HETE always elicited
      analogous responses in the same preparations, probably because of rapid
      metabolism of 15-HPETE into 15-HETE or, even more likely, because both
      eicosanoids have identical modes of action. We concluded that depending on
      factors such as the species, the dose of the compounds and the presence of other
      vasoregulators, the overall response to 15-HPETE or 15-HETE may be vasodilation
      or vasoconstriction. In addition, the type of responses elicited with 15-HPETE
      and 15-HETE in RbA and RA differed conspicuously from those expressed in GPA,
      GPPA and HPA.

PMID- 7791088
TI  - Evaluation of cannabinoid receptor binding and in vivo activities for anandamide
      analogs.
AB  - Recent evidence implicates anandamide as the endogenous ligand for the
      cannabinoid receptor. One purpose of this study was to determine the structural
      requirements for anandamide's receptor interaction and the influence of
      phenylmethylsulfonyl fluoride (PMSF), an enzyme inhibitor, on receptor affinity.
      A second objective was evaluation of the correlation between affinities of the
      analogs and in vivo pharmacological activities. The ability of anandamide and
      analogs to displace [3H]CP-55,940 ([3](-)-3-[2-hydroxyl-4-(1,1
      dimethylheptyl)phenyl]-4-[3- hydroxylpropyl]cyclohexan-1-ol) was determined by a
      filtration assay. Displacement curves for anandamide in the presence of PMSF
      produced a Ki of 89 +/- 10 nM; without PMSF the Ki increased to 5400 +/- 1600 nM.
      Anandamide analogs were evaluated for their ability to produce antinociception
      and hypomotility. The levels of saturation of the anandamide structure were
      critical to receptor affinity and in vivo potency, with complete saturation and
      hydroxyl substitution with a fluorine moiety resulting in a compound with
      increased potency in the spontaneous activity and antinociception assays.
      Substitution of the hydroxyl with a fluorine atom increased affinity only in the
      presence of PMSF and reduced potency in the antinociception assay. Ethanolamide
      substitution with bromobenzenesulfonamide produced an inactive compound in all
      assays. Increasing the length of the N-substituent by one or two carbons
      decreased receptor binding affinity and potency in the tail-flick assay only.
      Certain structural modifications, such as methylations, allowed the analogs to
      retain affinity without the addition of PMSF. Linear correlation between the
      behavioral and binding assays were performed, and the greatest correlation was
      obtained with compounds that were either very potent or inactive.

PMID- 7791090
TI  - Effects of cicletanine on kidney function. 1. Clearance and micropuncture studies
      in anesthetized rats.
AB  - The purpose of our study was to analyze the effect of cicletanine on kidney
      function by using clearance and free flow micropuncture techniques in
      anesthetized rats. In the clearance experiments, cicletanine was tested at three
      different doses (15, 30 and 60 mg/kg i.v.). The drug dose-dependently increased
      urine flow, and urinary sodium and chloride excretion. Renal potassium excretion
      was also significantly enhanced. Cicletanine was as effective as
      hydrochlorothiazide regarding fractional renal sodium excretion. Mean arterial
      blood pressure fell after cicletanine at doses of 30 and 60 mg/kg, but at none of
      the three doses tested did cicletanine affect renal plasma flow and glomerular
      filtration rate. In this regard it differed from hydrochlorothiazide which was
      found to markedly decrease glomerular filtration rate at a dose of 10 mg/kg i.v.
      A coadministration of cicletanine (20 mg/kg i.v.) and hydrochlorothiazide, at a
      maximal effective dose (20 mg/kg i.v.), induced an additional diuretic and
      saluretic effect. By puncturing of late proximal, early and late distal nephron
      segments, an action of cicletanine (30 mg/kg i.v.) in the superficial distal
      tubule could be established. Thus, cicletanine shares with the thiazide diuretics
      its tubular site of action despite the disparity in chemical structure between
      these drugs.

PMID- 7791092
TI  - The effects of anorectic and aversive agents on deprivation-induced feeding and
      taste aversion conditioning in rats.
AB  - We compared the effects of intraperitoneally administered LiCl (0.5-2830
      mumol/kg), sulfated cholecystokinin26-33 (10-1000 nmol/kg; CCK-8), nonsulfated
      CCK-8 (500 and 1000 nmol/kg), sulfated CCK26-29 (500 and 1000 nmol/kg), CCK30-33
      (10-1000 nmol/kg) bombesin (10-1000 nmol/kg; BOM), (dl) fenfluramine HCl (0.9
      37.3 mumol/kg; fenfluramine), fluoxetine HCl (2.9-86.7 mumol/kg; fluoxetine), and
      d-amphetamine sulfate (0.27-10.9 mumol/kg; AMPH) on both 18-hr deprivation
      induced feeding and one-bottle, taste aversion conditioning in male, Long-Evans
      rats. Doses of LiCl > or = 177 mumol/kg (or 7.5 mg/kg) induced significant, dose
      related taste aversions, but only doses of LiCl > or = 2123 mumol/kg (90 and 120
      mg/kg) induced significant anorexia. CCK-8 induced marked anorexia (at doses > or
      = 25-50 nmol/kg), but only relatively mild taste aversions which were only
      statistically significant at the highest dose (1000 nmol/kg). The anorectic
      effects of CCK-8 at 500 and 1000 nmol/kg, but not at lower doses, lasted at least
      3 hr. Sulfated CCK26-29, CCK30-33 and nonsulfated CCK-8 induced neither anorexia
      nor taste aversion. BOM induced marked anorexia at all doses tested, but did not
      induce statistically significant taste aversions. The nonpeptidal anorectic
      compounds, fenfluramine, fluoxetine, and AMPH, induced both dose-related anorexia
      and taste aversion conditioning. We focus on several issues concerning the
      interpretation of taste aversion conditioning. Our results challenge any simple
      relationship between the ability of a compound to induce taste aversion and to
      decrease feeding.

PMID- 7791091
TI  - Effects of cicletanine on kidney function. 2. Role of renal prostaglandins and
      kinins, and of muscarinic receptors.
AB  - We report the effect of the prostaglandin synthesis inhibitors indomethacin and
      meclofenamate, of the ACE-inhibitor captopril and of the muscarinic receptor
      antagonist methyl-scopolamine on the renal action of cicletanine (20-30 mg/kg
      i.v.) in anesthetized rats. Methylscopolamine, at doses ranging from 60 to 600
      micrograms/kg i.v., did not at all affect cicletanine's action on the kidney's
      excretory function. Captopril (20 mg/kg i.v.) induced by its own a small rise of
      urine flow, and of urinary sodium and chloride excretion. The drug enhanced the
      effect of cicletanine on urine flow and sodium excretion by an additive effect.
      In the presence of captopril, and also of indomethacin (5 mg/kg i.v.) and
      meclofenamate (5 mg/kg i.v.), but not with control conditions, cicletanine
      significantly enhanced glomerular filtration rate and p-animohippurate clearance.
      Despite the fact that renal hemodynamics improved, the prostaglandin inhibitors
      nearly completely abolished cicletanine's effect on urinary fluid and electrolyte
      excretion. The results suggest that muscarinic receptors are not involved in the
      diuretic response to cicletanine. Cicletanine's diuretic and saluretic action may
      be related to a stimulation of renal prostaglandin synthesis. An enhanced
      prostaglandin production, and an activated reninangiotensin system, may also mask
      a direct vasodilating effect of cicletanine on the renal vasculature in the rat.

PMID- 7791093
TI  - Prenatal cocaine exposure selectively reduces mesocortical dopamine release.
AB  - The effect of prenatal exposure to cocaine on the release of [3H]dopamine and on
      presynaptic dopamine autoreceptor regulation of [3H]dopamine release in
      prelabeled frontal cortical, cingulate cortical and striatal slices was
      investigated. The release of [3H]dopamine that is evoked by high K+ was reduced
      by 20 to 28% in the cortical regions but not in striatum. This effect was
      observed at 10 days of age and persisted up to postnatal day 120 in rabbits that
      were exposed to cocaine during gestational days 8 to 29. Spontaneous [3H]dopamine
      release was increased by 18 to 22% in frontal and cingulate cortices but not in
      striatum of the 10- but not the 50- or 120-day-old rabbit that was exposed to
      cocaine during gestational days 8 to 29. Total [3H]dopamine accumulated in brain
      slices examined on postnatal days 10, 50 or 120 was not affected by prenatal
      cocaine exposure. Incubation of slices with dopamine dose-dependently inhibited
      K(+)-evoked [3H]dopamine release in both cortical and striatal slices. Prenatal
      cocaine exposure enhanced the responsiveness to in vitro dopamine in the two
      cortical regions but not in striatum. Fetal cocaine exposure did not affect the
      levels of dopamine or its metabolites, 3,4-dihydroxyphenylacetic acid and
      homovanillic acid, in frontal cortex or striatum. Similarly, no apparent
      differences in dopamine metabolism, as indicated by the ratio of 3,4
      dihydroxyphenylacetic acid + homovanillic acid/dopamine, were observed in these
      brain areas. These findings demonstrate that prenatal cocaine exposure
      selectively affects depolarization-evoked [3H]dopamine release and its regulation
      by presynaptic dopamine autoreceptor in cortical areas.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7791094
TI  - delta 9-Tetrahydrocannabinol modulates antigen processing by macrophages.
AB  - delta 9-Tetrahydrocannabinol (THC) exposure suppresses multiple immunological
      functions of macrophages. The ability of macrophages exposed to THC to process
      and present soluble protein antigens was investigated by the stimulation of
      antigen-specific helper T cell hybridomas to secrete interleukin-2. The T cell
      response to hen egg lysozyme was dramatically reduced after a 24-hr pretreatment
      of a macrophage hybridoma with THC. In contrast, THC exposure did not alter the
      capacity of the macrophage hybridoma to process chicken ovalbumin and augmented
      their presenting cell function for a pigeon cytochrome c response. These findings
      could not be attributed to differential effects of THC on either cell viability
      or expression of the antigen receptor-associated CD3 complex by the T cells. The
      level of T cell activation with peptides of lysozyme and cytochrome c, which do
      not require processing, was inhibited only at the highest concentrations of THC,
      suggesting that THC mainly affects antigen processing. Peritoneal macrophages
      exposed to THC during an antigen pulse and fixed with paraformaldehyde showed
      similar effects on the subsequent T cell responses to lysozyme and cytochrome c
      in the absence of THC, arguing against a possible influence of THC on the T
      cells. Therefore, THC differentially modulates the capacity of macrophages to
      process antigens that is necessary for the activation of CD4+ T cells.

PMID- 7791095
TI  - [3H]WIN 35,428 ([3H]CFT) binds to multiple charge-states of the solubilized
      dopamine transporter in primate striatum.
AB  - Caudate-putamen membranes of rhesus monkey were solubilized (1% digitonin; w/v)
      and [3H]WIN 35,428 ([3H]CFT: 2 beta-carbomethoxy-3- beta-(4-fluorophenyl)-N
      [3H]methyltropane) binding assayed. Saturation analysis revealed high- and low
      affinity binding components (KHIGH: 7.48 +/- 2.77 nM; KLOW: 292 +/- 788 nM; mean
      +/- SEM). Monoamine transport inhibitors and neurotransmitters had similar
      affinities for soluble and membrane [3H]CFT binding sites (r, 0.998; P < .001).
      The rank order of potency of these compounds for inhibiting [3H]CFT binding (Lu
      19-005 > mazindol > CFT > GBR 12909 > (-)-cocaine > talsupram > dopamine >
      norepinephrine > citalopram) was consistent with [3H]CFT labeling cocaine binding
      sites on the dopamine transporter. [3H]CFT binding sites were separated into
      three protein fractions by anion-exchange chromatography. Monoamine transport
      inhibitors and neurotransmitters inhibited [3H]CFT binding in each fraction with
      a rank order of potency consistent with binding to the dopamine transporter.
      Detection of multiple binding components for [3H]CFT labeled sites by these drugs
      varied in each fraction. Size-exclusion chromatography indicated [3H]CFT bound to
      a single protein in each fraction (apparent molecular weight, 170 kDa).
      Therefore, multiple binding components for cocaine reside solely on the dopamine
      transporter and exhibit different affinities for drugs depending on the charge
      state of the transporter.

PMID- 7791096
TI  - Characterization of anandamide- and fluoroanandamide-induced antinociception and
      cross-tolerance to delta 9-THC after intrathecal administration to mice: blockade
      of delta 9-THC-induced antinociception.
AB  - The antinociceptive effects of the putative endogenous cannabinoid ligand
      anandamide (ANA) and its fluorinated analog, fluoroanandamide (FA), were
      determined as measured by the tail-flick and p-phenylquinone (PPQ) stretch tests.
      The ED50 values (confidence limits) for ANA and FA were 77 (52-13) and 7 (2-21)
      micrograms/mouse, respectively, for the tail-flick test and 30 (23-41) and 0.5
      (0.1-2) micrograms/mouse, respectively, for the PPQ test after intrathecal (i.t.)
      administration. ANA was not significantly less potent than delta 9
      tetrahydrocannabinol (THC) in the tail-flick test, but it was less potent in the
      PPQ test. FA was more potent than either ANA or THC in tail-flick test. The
      antinociceptive effects of all drugs (administered i.t.) were blocked
      significantly or nearly abolished by the pretreatment of the mice with pertussis
      toxin (i.t.). Pretreatment of the mice with 5 and 25 micrograms forskolin per
      mouse or 10 micrograms 8-(4-chlorophenyl-thio)-adenosine-3',5'-monophosphate
      cyclic monosodium salt per mouse (both i.t.) significantly attenuated the
      antinociception produced by THC but not by ANA or FA. Various calcium modulators
      were tested in combination with THC, ANA, and FA, but they failed to alter the
      antinociceptive effects of the drugs. Various potassium channel blockers were
      tested in combination with the drugs. Apamin, a blocker of small (low)
      conductance calcium-gated potassium channels that attenuates THC-induced
      antinociception, failed to alter ANA- or FA-induced antinociception. In contrast
      to THC, which is blocked by the kappa antagonist nor-binaltorphimine, ANA- and FA
      induced antinociception was not altered by classic opioid antagonists. Also in
      contrast to THC, which enhances mu and delta opioid-induced antinociceptive
      effects, ANA failed to significantly alter opioid antinociception. ANA
      significantly shifted the THC dose-effect curve to the right. Thus, ED50 for
      DMSO/THC in the tail-flick test was shifted from 14 (7-29) to 54 (38-77)
      micrograms/mouse and was shifted in the hot-plate test from 22 (12-42) to 63 (43
      92) micrograms/mouse. The magnitude of the shift in the ED50 was 3.8-fold in the
      tail-flick test and 2.9-fold in the hot-plate test. The shifts were parallel and
      significant. The Ki for the displacement of 3H-CP 55,940 binding by ANA and FA
      was 214 nM (+/- 45 S.E.M.) and 72 nM (+/- 5 S.E.M.), respectively, in pure spinal
      cord synaptosomes from the rat. ANA and FA were significantly cross-tolerant to
      THC. Although similarities between ANA and cannabinoids were shown, several
      marked differences were observed between ANA and the classic cannabinoids. ANA
      appears to function as both a cannabimimetic and a blocker of cannabinoid-induced
      antinociception.

PMID- 7791097
TI  - Role of delta opioid receptors in the reinforcing and discriminative stimulus
      effects of cocaine in rhesus monkeys.
AB  - The role of delta opioid receptors in the self-administration and discrimination
      of cocaine by rhesus monkeys was evaluated using the delta opioid antagonist
      naltrindole and the delta opioid agonist BW373U86 [(+/-)-4-((alpha R*)-alpha
      ((2S*,5R*)-4-Allyl-2,5-dimethyl-1- piperazinyl)-3-hydroxybenzyl)-N,N
      diethylbenzamide dihydrochloride]. In the self-administration studies, monkeys
      were trained to respond for food (1 g banana pellets) or cocaine (0.032
      mg/kg/injection, i.v.) under a second-order FR4(VR16:S) schedule of reinforcement
      during multiple daily food and drug sessions. Substitution of saline or other
      unit doses of cocaine (0.001-0.1 mg/kg/injection) for the maintenance dose of
      cocaine yielded typical inverted-U shaped dose-effect curves relating unit dose
      of cocaine to the number of saline or drug injections per day. The unit dose of
      cocaine available during drug sessions had little effect on food-maintained
      responding. In the drug discrimination studies, monkeys were trained to
      discriminate 0.4 mg/kg cocaine (i.m.) from saline in a two-lever, food-reinforced
      drug discrimination task. Cumulative dosing with cocaine (0.004-1.3 mg/kg)
      produced a dose-dependent generalization to the training dose of cocaine without
      consistently altering response rates. Initial experiments with naltrindole (0.1
      3.2 mg/kg, i.v. or i.m.) produced effects in some monkeys suggesting that
      naltrindole may have antagonized the effects of cocaine under both procedures. In
      the drug self-administration studies, treatment with at least one dose of
      naltrindole for 10 consecutive days decreased self-administration of a unit dose
      of cocaine at the peak of the ascending limb of the cocaine dose-effect curve
      (0.01 mg/kg/injection) in three of four monkeys. In the drug discrimination
      studies, treatment with at least one dose of naltrindole shifted the cocaine dose
      effect curve 1/2 log unit to the right in two of four monkeys. However,
      naltrindole did not alter the effects of cocaine in all monkeys under either
      procedure. Furthermore, in the monkeys in which naltrindole was effective, the
      cocaine-antagonist actions of naltrindole were not replicable and were not
      monotonically related to dose. When the delta agonist BW373U86 (0.001-0.032
      mg/kg/inj, i.v.) was substituted for cocaine in one monkey in which naltrindole
      decreased cocaine self-administration, BW373186 was not self-administered. In
      addition, BW373U86 (0.0032-0.32 mg/kg, i.m.) neither generalized to cocaine nor
      potentiated the effects of cocaine in the drug discrimination procedure. These
      results suggest that delta opioid receptors play, at best, a minor and
      inconsistent role in the reinforcing and discriminative stimulus effects of
      cocaine in rhesus monkeys.

PMID- 7791098
TI  - Bradykinin receptor subtypes in rat lung: effect of interleukin-1 beta.
AB  - We have characterized bradykinin (BK) receptors in the rat lung and studied the
      effect of recombinant human interleukin-1 beta (IL-1 beta) on BK receptors in
      vitro and in vivo. In lung membranes, saturation studies with [3]BK revealed a
      single class of specific and saturable binding sites. The BK B1 antagonist des
      Arg9[Leu8]-BK was less effective in displacing [3H]BK binding sites from lung
      membranes. In contrast, the selective BK B2 antagonists, Hoe 140 (D-Arg
      [Hyp3,Thi5,D-Tic7,Oic8]-BK) and NPC 567 (D-Arg-[Hyp3,D-Phe7]-BK) fully inhibited
      the binding of [3H]BK to lung membranes with Ki values of 96.7 +/- 17.8 pM and
      9.0 +/- 2.5 nM, respectively. Intratracheal administration of 500 U of IL-1 beta
      induced airway hyper-responsiveness to inhaled BK and neutrophilia in
      bronchoalveolar lavage fluid 18 to 24 hr later. Compared to naive or saline
      treated animals, IL-1 beta had no effect on [3H]BK binding characteristics at 4,
      12 or 24 hr after IL-1 beta administration. Twenty-four hours after IL-1 beta
      instillation, there was no change in the affinity of the selective BK B1 or B2
      antagonists when compared to control animals. In vivo, the selective BK B2
      receptor antagonists, NPC 567 (3 mumol kg-1 i.v.) and Hoe 140 (100 nmol kg-1
      i.v.), inhibited BK-induced increase in lung resistance, whereas the selective BK
      B1 antagonist, des-Arg9[Leu8]-BK (10 mumol kg-1 i.v.), was without effect. These
      data suggest that the action of BK in the rat lung is dependent mainly on the
      activation of the BK B2 receptor subtype.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791099
TI  - Electrophysiological effect of BRL-32872, a novel antiarrhythmic agent with
      potassium and calcium channel blocking properties, in guinea pig cardiac isolated
      preparations.
AB  - The effects of N-(3,4-dimethoxyphenyl)-N-[3[[2-(3,4-dimethoxyphenyl) ethyl]
      propyl]-4-nitrobenzamide hydrochloride (BRL-32872), a novel antiarrhythmic agent,
      were studied in guinea pig cardiac preparations using standard microelectrode and
      patch-clamp techniques. In papillary muscle, BRL-32872 did not change resting
      membrane potential and maximum rate of depolarization but prolonged action
      potential duration (APD) by 24% +/- 2% at 1.0 microM. When the concentration was
      increased to 3.0 and 10.0 microM, the effect on APD was not further enhanced, and
      a bell-shaped dose-response curve resulted. Patch-clamp experiments in isolated
      myocytes showed that BRL-32872 inhibited the rapidly activating component of the
      delayed rectifier potassium current (EC50 = 0.028 microM) and the L-type calcium
      current (EC50 = 2.8 microM) but had a limited effect on the inward rectifier
      potassium current. In papillary muscles stimulated at 300, 500, 1000 and 2000
      msec, the effect of BRL-32872 in prolonging APD did not vary (P = .717). By
      contrast, N-(4-(1-[2-(6-methyl-2-pyridyl)ethyl]-4-piperidyl)-
      carbonyl]phenyl)methanesulfonamide dihydrochloride dihydrate (E-4031), a pure
      class III antiarrhythmic agent, increased APD more at slower than at faster
      stimulation rates (P = .001), which illustrated the reverse frequency-dependence
      of this agent. Among the 35 experiments performed with BRL-32872, only one fiber
      showed early afterdepolarizations (EADs), and these, which occurred at 1.0
      microM, were suppressed at higher concentration (3.0 microM). Moreover, EADs
      induced by E-4031 were suppressed by BRL-32872 (3.0 microM).(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7791100
TI  - Does [3H]2-methoxy-idazoxan (RX 821002) detect more alpha-2-adrenoceptor agonist
      high-affinity sites than [3H]rauwolscine? A comparison of nine tissues and cell
      lines.
AB  - The authors compared [3H]2-methoxy-idazoxan (RX 821002) and [3H]rauwolscine
      binding in rat cerebral cortex, spleen and kidney; guinea pig kidney; porcine
      kidney; human kidney and platelets and HEL and NG 108-15 cells. [3H]RX 821002 had
      less nonspecific binding and higher affinity than [3H]rauwolscine in most models.
      Although both ligands detected similar alpha-2 adrenoceptor numbers in rat,
      porcine and human kidney and in NG 108-15 cells in saturation experiments, [3H]RX
      821002 detected more alpha-2 adrenoceptors than [3H]rauwolscine in rat cerebral
      cortex and spleen, guinea pig kidney, human platelets and HEL cells. These
      differences were seen in Tris and in glycylglycine buffer regardless of whether
      EDTA, MgCl2, MgCl2 plus GTP or GTP plus NaCl was added to the former and were not
      explained by additional labeling of serotonin or dopamine receptors or
      nonadrenergic sites; in contrast, [3H]rauwolscine also labeled nonadrenergic
      sites in porcine kidney. In prazosin competition experiments, both ligands
      differentially recognized alpha-2-adrenoceptor subtypes but this could not
      account for the observed differences in detected receptor numbers. In epinephrine
      competition experiments, both ligands labeled similar numbers of agonist low
      affinity sites in all models; [3H]RX 821002, however, labeled more agonist high
      affinity sites than [3H]rauwolscine did in models in which it detected a greater
      total number of receptors. It was concluded that [3H]RX 821002 is a more suitable
      ligand for the detection of alpha-2 adrenoceptor than [3H]rauwolscine because of
      less nonspecific binding, higher affinity and greater specificity for alpha-2
      adrenoceptors; moreover, [3H]rauwolscine appears not to detect all agonist high
      affinity sites of alpha-2 adrenoceptors.

PMID- 7791101
TI  - Disposition of the bromosulfophthalein-glutathione conjugate in the isolated
      perfused rat kidney.
AB  - Renal elimination of the bromosulfophthalein-glutathione conjugate (BSP-GSH)
      after its i.v. administration in the rat in vivo is negligible. In our study we
      wanted to establish whether the high albumin-binding of BSP-GSH constitutes the
      major restrictive factor toward the urinary excretion of the compound. The renal
      disposition of BSP-GSH was studied in the isolated rat kidney during perfusions
      with or without albumin in the perfusate. The urinary clearance of BSP-GSH in the
      absence of albumin was very low (< 60 microliters/min) as compared to the inulin
      clearance (approximately 300 microliters/min). This indicates that albumin
      binding is not the major reason for the low urinary clearance of BSP-GSH.
      Addition of albumin to the perfusate further decreased the urinary excretion by
      60%. BSP-GSH is metabolized by the kidney into two major metabolites: the
      cysteinylglycine conjugate and the di-glutathione conjugate. Both metabolites
      appear in perfusate, which suggests that BSP-GSH undergoes tubular (re-)uptake.
      The di-glutathione conjugate is further metabolized to the di-cysteinylglycine
      conjugate. The di-glutathione conjugate and the di-cysteinylglycine conjugate are
      the major urinary components and the urinary elimination of BSP-GSH may depend on
      their formation. Inhibition of gamma-glutamyl transpeptidase activity with
      acivicin largely prevented the degradation to the cysteinylglycine and
      dicysteinylglycine conjugates of BSP. The total rate of urinary excretion,
      however, was only slightly lowered by acivicin. Apparently, cleavage of the gamma
      glutamyl moiety is not relevant for the total urinary elimination of BSP-GSH.

PMID- 7791102
TI  - Imidazenil, a new anxiolytic and anticonvulsant drug, attenuates a benzodiazepine
      induced cognition deficit in monkeys.
AB  - Imidazenil is a highly potent partial allosteric modulator of gamma-aminobutyric
      acid action at a great variety of gamma-aminobutyric acid(A) receptors, whereas
      alprazolam is a full allosteric modulator at these receptors. Data in rats
      indicate that imidazenil, like alprazolam, has pharmacological effects in animals
      indicative of anxiolytic, antipanic and anticonvulsant activity in humans, but
      unlike alprazolam, in animals imidazenil does not produce ataxia, sedation,
      tolerance or dependence nor does it potentiate the effects of ethanol. To extend
      the study of the imidazenil pharmacological profile, we administered this drug
      and alprazolam, alone and in combination, in monkeys working in a complex
      behavioral task. In one component of a multiple schedule (repeated acquisition or
      "learning"), patas monkeys acquired a different four-response chain each session
      by responding sequentially on three keys in the presence of four discriminative
      stimuli (geometric forms or numerals). In the other component (performance), the
      four-response chain was the same each session. The response chain in each
      component was maintained by food presentation under a fixed-ratio schedule. When
      alprazolam (0.01-0.32 mg/kg, p.o.) was administered alone, the overall response
      rate in both learning and performance decreased and the percent errors in both
      components increased with increasing doses. Learning, however, was more sensitive
      than performance; i.e., error-increasing effects were seen in learning at doses
      that had no effect on performance accuracy.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791104
TI  - The effect of carbidopa and entacapone pretreatment on the L-dopa
      pharmacokinetics and metabolism in blood plasma and skeletal muscle in beagle
      dog: an in vivo microdialysis study.
AB  - The effects of carbidopa and entacapone pretreatment on the pharmacokinetics and
      metabolism of i.v. administered L-3,4-dihydroxyphenylalanine (L-dopa) have been
      examined in vivo in blood plasma and skeletal muscle extracellular fluid (ECF),
      in beagle dog, by microdialysis. Both with or without carbidopa, blood plasma L
      dopa levels declined biexponentially after the i.v. administration of L-dopa. In
      contrast to blood plasma, a monoexponential decline was observed in muscle ECF in
      both these pharmacological conditions. Pretreatment with carbidopa had no
      significant effect on the pharmacokinetic parameters of L-dopa in blood plasma,
      but resulted in an increase in the area under the concentration versus time curve
      (AUC) and elimination half-life (t1/2) of L-dopa in muscle ECF (0.61 hr),
      compared with values achieved after L-dopa alone. Carbidopa pretreatment enhanced
      the accumulation of 3-O-methyldopa (3-OMD) and dopamine (DA) in muscle ECF but
      decreased that of L-3,4-dihydroxyphenylacetic acid (DOPAC) in both blood plasma
      and muscle ECF. Entacapone had a pronounced inhibitory effect on the formation of
      3-OMD, resulting in a reduction of the AUC for 3-OMD by 98% and 85% in blood
      plasma and muscle ECF, respectively. Pretreatment with carbidopa plus entacapone
      enhanced the Tmax of L-dopa in muscle ECF compared with the values achieved after
      pretreatment with carbidopa alone. In addition, the elimination half-life (2.66
      hr) and volume of distribution by area of L-dopa in blood plasma and its AUC and
      t1/2 in muscle ECF (1.80 hr) were enhanced substantially. No DA was detected, but
      DOPAC levels were enhanced in both blood plasma and muscle ECF. These results
      suggested that carbidopa has a L-dopa-sparing effect in skeletal muscle, which is
      further enhanced by entacapone.

PMID- 7791103
TI  - Regulation of ion transport by endothelins in rat colonic mucosa: effects of an
      ETA antagonist (FR139317) and an ETB agonist (IRL1620).
AB  - Rat colonic mucosa contains ETA and ETB receptors with Kd values for endothelin
      (ET)-1 of 32 and 11 pM and maximal binding capacities of 277 and 181 fmol/mg
      protein, respectively. In muscle-stripped rat colon without tonic nerve activity
      in Ussing chambers, the serosal addition of ET-1, ET-3 and IRL1620 inhibited
      amiloride-sensitive noncoupled Na+ entry and enhanced diphenylamine-2-carboxylate
      sensitive Cl- secretion, producing a sustained decrease and a transient increase
      in the short-circuit current (Isc) and the transepithelial conductance,
      respectively. EC50 values of ET-1, ET-3 and IRL1620 and the maximal changes in
      Isc were 2.0, 10.2 and 10.9 nM and -12.7, -7.0 and -7.1 muA/cm2, respectively for
      the Na+ entry; these values were 50, 220 and 225 nM and +57.3, +47.3 and +21.3
      muA/cm2, respectively, for the Cl- secretion. FR139317 (100 nM) inhibited ET-1
      induced Na+ and Cl- movements, shifting the concentration-response curves to the
      right (EC50 = 25 nM and 1 microM, respectively), and inhibited ET-3 (> 100 nM)
      induced Cl- movement, decreasing the maximal response to 35%, but it did not
      inhibit either ET-3-induced Na+ movement nor IRL1620-induced Na+ and Cl-
      movements. The removal of serosal Ca++ reduced 100 nM ET-1- and IRL1620-evoked
      changes in Isc by 50% and 70% for the Na+ entry and by 80% and 100% for the Cl-
      secretion, respectively. Indomethacin (1 microM) also reduced changes in Isc by
      30% and 70% for the Cl- secretion but did not affect the Na+ entry. Our results
      show that ETA and ETB receptors regulate Na+ and Cl- transport by different
      mechanisms.

PMID- 7791105
TI  - Right heart failure impairs hepatic oxygenation and theophylline clearance in
      rats.
AB  - The effect of right heart failure on theophylline clearance was investigated in
      rats in which right ventricular pressure overload was produced by pulmonary
      artery constriction (PAC). Fifteen wk after the surgery, compared to sham
      operated controls (n = 9), PAC rats (n = 9) showed markedly elevated mean central
      venous pressure (11 +/- 3 vs 1.44 +/- 0.88 mm Hg, P = .0001), and increased right
      ventricular weight (0.229 +/- 0.047 vs 0.124 +/- 0.013 g/100 g body weight, P =
      .0001). Centrilobular hepatic congestion was present in all PAC rats and total
      hepatic oxygen delivery was reduced significantly compared to controls (146 +/-
      58 mumols/min vs. 206 +/- 28 mumol/min; P = .025). In the PAC group, theophylline
      clearance was reduced (0.82 +/- 0.12 ml/min vs. 0.96 +/- 0.13 ml/min in controls;
      P = .014), and there was a nonlinear correlation between theophylline clearance
      and total hepatic oxygen delivery (r = .82). These results suggest that in
      animals with PAC, metabolism of theophylline was impaired as a result of a
      reduction in total hepatic oxygen delivery. Therefore, in addition to the known
      effect of reduced hepatic blood flow on the hepatic clearance of "flow limited"
      drugs, reduction of hepatic oxygen delivery may be another important mechanism
      that can lead to reduction in hepatic clearance of capacity-limited drugs in
      congestive heart failure.

PMID- 7791106
TI  - Effects of beta adrenoceptor agonists and antagonists on adrenal catecholamine
      release in response to splanchnic nerve stimulation in anesthetized dogs: role of
      beta-1 and beta-2 adrenoceptors.
AB  - The present study was performed to examine whether beta adrenoceptor agonists and
      antagonists modify the release of adrenal catecholamine (CA) in response to
      splanchnic nerve stimulation (SNS) in anesthetized dogs, in order to elucidate
      the beta adrenoceptor-mediated modulation of adrenal CA release. SNS at 3 Hz
      produced marked increases in both epinephrine and norepinephrine output
      determined from adrenal venous blood. Atenolol (10, 30 and 100 micrograms/kg,
      i.v.) and CGP20712A (10 and 30 micrograms/kg, i.v.), selective beta-1
      adrenoceptor antagonists, significantly enhanced the SNS-induced increases in CA
      output. Neither ICI118551 (10, 30 and 100 micrograms/kg, i.v.), a selective beta
      2 adrenoceptor antagonist, nor nadolol (10, 30 and 100 micrograms/kg, i.v.), a
      nonselective beta adrenoceptor antagonist, affected the SNS-induced increases in
      CA output. After the treatment with ICI118551 (100 micrograms/kg, i.v.), atenolol
      (10, 30 and 100 micrograms/kg, i.v.) failed to enhance the SNS-induced increases
      in CA output. On the other hand, neither isoproterenol (0.03 and 0.1
      micrograms/kg/min, i.v.) nor the selective beta-2 adrenoceptor agonist procaterol
      (0.03 and 0.1 micrograms/kg/min, i.v.) affected the SNS-induced increases in CA
      output. After the treatment with atenolol (100 micrograms/kg, i.v.), both
      isoproterenol (0.03 micrograms/kg/min, i.v.) and procaterol (0.03
      micrograms/kg/min, i.v.) enhanced the SNS-induced increases in CA output. The
      enhancing effects of isoproterenol and procaterol were abolished by ICI118551
      (100 micrograms/kg, i.v.). These results indicate that activation of beta-2
      adrenoceptors facilitates the SNS-evoked release of CA from the dog adrenal
      medulla under the condition in which beta-1 adrenoceptors are blocked, and they
      suggest that activation of beta-1 adrenoceptors inhibits the beta-2 adrenoceptor
      mediated facilitation process of adrenal CA release.

PMID- 7791107
TI  - Buprenorphine antagonism of mu opioids in the rhesus monkey tail-withdrawal
      procedure.
AB  - The apparent in vivo dissociation constant (KA) and relative efficacy values for
      alfentanil, etonitazene, morphine, and nalbuphine were determined by comparing
      the effects of these agonists in the presence of buprenorphine with the effects
      of these agonists alone in the rhesus monkey tail-withdrawal procedure. Initial
      time course studies of buprenorphine alone indicated that 3.2 and 10 mg/kg
      produced increases in tail-withdrawal latencies when studied with 48 degrees C
      water for 48 hr. No increases in tail-withdrawal latency were found with either
      dose studied with 55 degrees C water. Buprenorphine produced dose-dependent
      shifts to the right for the antinociceptive effects of alfentanil, etonitazene,
      morphine and nalbuphine 72 hr after administration and decreased the maximal
      effects of morphine in 48 degrees C water and those of alfentanil and etonitazene
      in 55 degrees C water. Buprenorphine administration decreased the receptors
      available for agonist interaction to approximately 2%. The average apparent in
      vivo dissociation constant (KA) values for alfentanil, etonitazene, morphine and
      nalbuphine were 3.3, 0.073, 60 and 31 mg/kg, respectively. High efficacy
      estimates were determined for alfentanil (149-203) and etonitazene (174-203),
      whereas lower efficacy estimates were determined for nalbuphine (57) and morphine
      (17). The apparent in vivo dissociation constant of a pseudoirreversible
      antagonist (KB) value for buprenorphine averaged 0.15 mg/kg across agonists,
      temperatures and buprenorphine doses. These data extend and emphasize the
      significance of in vivo estimates of affinity and relative efficacy for drug
      classification.

PMID- 7791108
TI  - Increased sensitivity to mu opiate antinociception in the neonatal rat despite
      weaker receptor-guanyl nucleotide binding protein coupling.
AB  - The developmental changes in mu opiate receptor-mediated antinociception and
      coupling to guanyl nucleotide binding proteins were studied in the rat. ED50
      values for morphine- and sufentanil-induced antinociception were determined in
      the paw-lift assay on days 10 and 27. The ED50 for morphine analgesia in 10-day
      old pups was 0.35 mg/kg and increased with age to 5.3 mg/kg on day 27. Similarly,
      sufentanil was more potent in pups than in weanlings, the ED50 increasing from
      1.7 to 7.6 micrograms/kg. Serum and brain morphine levels after 5 mg/kg of
      morphine were higher in neonates (day 10) than weanlings (day 27), largely due to
      a more rapid redistribution phase in weanlings (T1/2 = 26 min.) than in pups
      (T1/2 = 2.5 hr). Additionally, a substantial (70%) antinociceptive response was
      achieved in neonates at brain morphine levels that were one-half those producing
      an equal effect in weanlings. Radioligand binding studies indicated that the
      number of mu receptors increased 2-fold without change in affinity between days
      10 and 27, whereas the GTP analog guanylylimidophosphate was nearly twice as
      effective in shifting the mu receptors from high to low affinity on day 27 than
      on day 10. These data indicate that neonatal rats are more sensitive to mu opiate
      antinociception despite apparently weaker receptor-guanyl nucleotide binding
      protein coupling. This greater sensitivity is enhanced by the pharmacokinetic
      differences between neonates and weanlings which result in higher drug levels in
      pups after a similar dose.

PMID- 7791109
TI  - The ontogeny of mu opiate tolerance and dependence in the rat: antinociceptive
      and biochemical studies.
AB  - The ontogeny of tolerance to mu opiate antinociception and the behavioral and
      endocrine profiles of the opiate withdrawal syndrome were studied in rats.
      Animals were treated with saline or an increasing dose regimen of morphine for 5
      days (5-25 mg/kg b.i.d. s.c.) and were tested 36 hr later for morphine or
      sufentanil antinociception in the hot-plate paw-lift test, or withdrawal was
      precipitated with 5 mg/kg of naloxone 12 hr after the last chronic morphine dose.
      Twenty-seven-, 20- and 15-day-old rats all developed tolerance as indicated by a
      rightward shift of the dose-response curve after chronic morphine. Animals
      treated on days 4 to 8 and tested on day 10 did not develop tolerance to the same
      chronic dose regimen used in older animals. In contrast to the observed
      developmental difference in tolerance, both neonatal and weanling rats developed
      physical dependence after morphine treatment, as evidenced by the presence of
      withdrawal symptoms after naloxone administration. Withdrawal in weanling rats
      was characterized by ptosis, piloerection, abnormal posture, forepaw treading,
      vocalization on touch and mastication. In addition, both serum corticosterone and
      adrenocorticotropic hormone secretion were increased during passive withdrawal.
      The behaviors constituting the withdrawal syndrome precipitated in neonates were
      distinct from those in weanling rats. Spontaneous vocalization, wall climbing,
      tremor, mouthing and increased locomotion were all observed. As in the older
      animals, both serum corticosterone and adrenocorticotropic hormone secretion were
      elevated during passive withdrawal. Tremor also was induced in opiate naive
      neonates when naloxone (5 mg/kg) was administered 2 hr after a single 25-mg/kg
      morphine injection. Brain and serum morphine levels and the time course of
      antinociception were not altered by chronic morphine treatment at any age.
      Saturation binding assays in brain homogenates indicated that chronic morphine
      did not produce changes in receptor number or affinity for the antagonist. The
      shift induced by the guanine nucleotide Gpp(NH)p (10 microM) from high to low
      affinity on days 27 and 10, respectively, was not altered by chronic morphine
      treatment. These data indicate that 10-day-old rats are refractory to developing
      tolerance relative to older animals, and that changes in receptor number or
      coupling to guanine nucleotide proteins do not accompany tolerance to this
      regimen.

PMID- 7791110
TI  - Effects of a K+ channel blocker on glomerular filtration rate and electrolyte
      excretion in conscious rats.
AB  - Effects of a K+ channel blocker on glomerular filtration rate and electrolyte
      excretion in conscious rats were observed. Effects of K+ channel modulation on
      glomerular filtration rate and electrolyte excretion were studied using the
      adenosine-triphosphate- (ATP)-sensitive K+ channel blocker 4
      morpholinecarboximidine-N-1-adamantyl-N'-cyclohexylhydr ochloride (U-37883A) in
      conscious rats previously equipped with catheters for clearance studies. In
      saline-loaded rats, i.v. doses of U-37883A of 1.7, 5.0 and 15 mg/kg increased
      absolute and fractional Na+ excretion dose-dependently without changing K+
      excretion. The glomerular filtration rate remained constant during diuresis. In
      water-loaded (hypotonic dextrose) rats, free-water clearance studies revealed
      that the ATP-sensitive K+ channel blocker significantly decreased an index of
      solute reabsorption (free-water clearance adjusted for chloride clearance) in the
      diluting segment during peak natriuretic activity. In addition, U-37883A
      significantly decreased the osmolality of renal papillary interstitial fluid,
      indicative of an effect in the medullary portion of the diluting segment.
      Together, these findings suggest that ATP-sensitive K+ channels, possibly those
      located at the apical boarder, play a pivotal role in Na+ reabsorption in the
      thick ascending limb of the loop of Henle.

PMID- 7791112
TI  - Characterization of the facilitatory prejunctional purinoceptor on adrenergic
      nerves of the rabbit ear artery.
AB  - The effects of a number of purinoceptor agonists and antagonists on the release
      of endogenous norepinephrine (NE) from electrically field-stimulated (2 ms, 4 Hz)
      rabbit ear arteries were determined. NE was quantified by high-performance liquid
      chromatography and electrochemical detection techniques. Both P1- and P2
      purinoceptor agonists enhanced the release of NE in a concentration-dependent
      manner (0.1 microM-100 microM), the relative order of potency being beta, gamma
      methylene ATP (beta gamma-mATP) > 2-chloroadenosine (2CA) > ATP > L
      phenylisopropyl-adenosine > 2-methylthio ATP > 5'N-ethylcarboxamido-adenosine.
      Adenosine and alpha, beta-methylene ATP (alpha beta-mATP) at 100 microM did not
      significantly enhance the electrical field stimulation-evoked release of NE. None
      of drugs changed the spontaneous overflow of NE. Pretreatment with alpha beta
      mATP (1, 10 microM), a P2x-purinoceptor desensitizing agent, and 8-sulfophenyl
      theophylline (8SPT; 1 and 10 microM), a P1-purinoceptor antagonist, caused a
      shift to right of the concentration-release curve for beta gamma-mATP. alpha beta
      mATP and 8SPT did not by themselves significantly affect the spontaneous overflow
      and the electrical field stimulation-evoked release of NE. Pretreatment of alpha
      beta-mATP (30 microM) and 8SPT (30 microM) antagonized facilitation of NE release
      by 2CA (10 microM). The concentration-contraction curve for beta gamma-mATP (1
      300 microM) in the rabbit ear artery was shifted to the right by alpha beta-mATP
      (30 microM) but not by 8SPT (30 microM).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791111
TI  - Effects of a novel KATP channel blocker on renal tubule function and K channel
      activity.
AB  - ATP-sensitive potassium channels (KATP) modulate Na, K and Cl reabsorption in the
      thick ascending limb of the loop of Henle and K secretion in the cortical
      collecting tubule. Inhibition of potassium recycling in the apical membrane of
      the thick ascending limb of the loop of Henle interferes with sodium reabsorption
      and suppression of the apical potassium conductance in principal cells of the
      cortical collecting tubule and reduces potassium secretion. Both potassium
      recycling and potassium secretion depend critically on the activity of KATP, and
      recent studies indicate that the sulfonylurea compound glyburide, a known KATP
      channel blocker, is diuretic but does not produce kaliuresis.

PMID- 7791113
TI  - Inhibitors of phosphodiesterase IV (PDE IV) increase acid secretion in rabbit
      isolated gastric glands: correlation between function and interaction with a high
      affinity rolipram binding site.
AB  - In this report, we describe the ability of selective inhibitors of
      phosphodiesterase (PDE) isozymes to increase aminopyrine accumulation in rabbit
      isolated gastric glands. Aminopyrine accumulation in the presence of histamine
      was increased by the nonselective PDE inhibitor isobutylmethylxanthine (EC50 =
      4.8 microM) and by two selective PDE IV inhibitors, rolipram and Ro 20-1724 (EC50
      = 0.013 and 0.07 microM, respectively) but not by selective PDE III inhibitors
      (siguazodan and SK&F 94120) or by a selective PDE V inhibitor (zaprinast). These
      results suggest that PDE IV is an important regulator of acid secretion in
      response to histamine. One of the more fascinating properties of PDE IV is the
      expression of a high-affinity binding site for [3H]-rolipram in addition to cAMP
      catalytic activity. Although agents that inhibit PDE IV catalytic activity also
      appear to bind to the high-affinity rolipram-binding site, the rank-order
      potencies of compounds for these two effects are poorly correlated. Also, certain
      pharmacological actions of PDE IV inhibitors appear to be related to an
      interaction with this binding site. In this study, we observed that the ability
      of PDE IV inhibitors to enhance acid secretion was not associated with their
      ability to inhibit PDE IV catalytic activity but did show a strong correlation
      with their ability to compete for [3H]-rolipram binding. Furthermore, we were
      able to detect [3H]-rolipram binding sites in gastric glands that had
      characteristics similar to those of the [3H]-rolipram binding sites in rat brain
      microsomes and human recombinant PDE IV.

PMID- 7791114
TI  - A possible involvement of sodium channel blockade of class-I-type antiarrhythmic
      agents in postischemic contractile recovery of isolated, perfused hearts.
AB  - The present study was undertaken to test the hypothesis that the degree of sodium
      channel blockade by class-I-type antiarrhythmic agents accounts for enhancement
      of postischemic contractile recovery of ischemic/reperfused hearts.
      Electrophysiological studies showed that the class-I-type antiarrhythmic agents
      quinidine, disopyramide, procainamide, lidocaine, mexiletine, flecainide and
      pilsicainide suppressed the Vmax value of the rat left ventricular muscle cell, a
      marker of sodium channel blockade, in a concentration-dependent manner. Isolated
      rat hearts were subjected to 35 min of ischemia and 60 min of reperfusion.
      Postischemic contractile recovery, which was never detected in untreated hearts,
      was enhanced in hearts pretreated with these antiarrhythmic agents during the
      last 3 min before ischemia at concentrations ranging from 3 to 300 microM. Tissue
      Na, but not Ca, accumulation was also detected in the ischemic heart, and tissue
      Na and Ca accumulation was observed in the reperfused heart, which suggests that
      sodium overload occurs during ischemia, followed by sodium and calcium overload
      during reperfusion. The degree of postischemic contractile recovery seen in the
      presence of these antiarrhythmic agents was inversely related to tissue Na or Ca
      accumulation after reperfusion, which suggests that class-I-type antiarrhythmic
      agents inhibit sodium overload occurring in ischemic/reperfused myocardial cells.
      A close relationship between postischemic contractile recovery of the perfused
      heart and depression in the Vmax value of the ventricular muscle was also
      observed. These results suggest that the ability class-I-type antiarrhythmic
      agents to inhibit myocardial sodium channels plays a significant role in the
      enhancement of postischemic contractile recovery of the ischemic/reperfused
      heart.

PMID- 7791115
TI  - Pharmacological characterization of PD 156707, an orally active ETA receptor
      antagonist.
AB  - We describe the pharmacological characteristics of PD 156707 (sodium 2
      benzo[1,3]dioxol-5-yl-4-(4-methoxy-phenyl)-4-oxo-3-(3,4,5- trimethoxy-benzyl)-but
      2-enoate), a potent, orally active, nonpeptide antagonist of the endothelin A
      (ETA) receptor subtype. PD 156707 was designed on the basis of a compound
      identified by screening the Parke-Davis chemical library. PD 156707 is highly
      selective for the ETA receptor (ETAR) and inhibits the binding of [125I]-ET-1 to
      cloned human ETAR and ETBR with Ki values of 0.17 and 133.8 nM, respectively. PD
      156707 antagonizes ET-1-stimulated phosphoinositide hydrolysis in Ltk- cells
      expressing cloned human ETAR with an IC50 value of 2.4 nM. PD 156707 inhibits
      vasoconstriction in isolated blood vessels mediated by ETAR (rabbit femoral
      artery) and ETBR (rabbit pulmonary artery) with pA2 values of 7.5 and 4.7,
      respectively. PD 156707 administered orally to rats blocked subsequent ETAR
      mediated pressor responses in vivo but had no effect on ETBR-mediated dilator
      responses. As a potent and orally active ETA-selective antagonist, PD 156707 will
      be useful in defining the physiological and pathological roles of ETAR.

PMID- 7791116
TI  - Antagonist properties of LY 165,163 at pre- and postsynaptic dopamine D2, D3 and
      D1 receptors: modulation of agonist actions at 5-HT1A receptors in vivo.
AB  - In this study, we examined the influence of the actions of the halogenated
      phenylpiperazine LY 165,163 at dopamine D1, D2 and D3 receptors on its 5-HT1A
      agonist properties in vivo. LY 165,163 displayed marked affinity at striatal rat
      (r)D2 (pKi = 7.0), cloned rD2 (pKi = 7.3), cloned rD3 (pKi = 8.0), cloned human
      (h)D2 (pKi = 7.2) and cloned hD3 (pKi = 7.8) receptors, whereas its affinity at
      striatal rD1 receptors was weak (pKi = 5.7). In contrast, the prototypical 5-HT1A
      agonist 8-OH-DPAT displayed low affinity at each of these sites (pKi < 5.5). In
      vivo, LY 165,163 behaved as an antagonist at D2 autoreceptors in enhancing the
      synthesis of dopamine throughout the brain. Consistently with antagonist
      properties at postsynaptic D2 receptors, in unilateral substantia nigra-lesioned
      rats, the rotation elicited by the D2 agonist quinpirole was potently blocked by
      LY 165,163, whereas that elicited by the D1 agonist SKF 38393 was only weakly
      inhibited. In addition, LY 165,163 potently evoked prolactin secretion in rats
      and abolished apomorphine-induced climbing in mice. At native rat 5-HT1A
      receptors and cloned human 5-HT1A receptors, LY 165,163 (pKi values of 8.7 and
      8.9, respectively) mimicked the high affinity of 8-OH-DPAT (pKi values of 9.0 and
      9.2). Further, like 8-OH-DPAT, LY 165,163 acted as an agonist in inhibiting the
      firing of dorsal raphe nucleus neurons, in reducing striatal turnover of 5-HT and
      in eliciting both hypothermia and corticosterone secretion. However, in contrast
      to 8-OH-DPAT, LY 165,163 failed to evoke spontaneous tail-flicks (STFs). This
      difference probably reflects its D2 antagonist properties because the induction
      of STFs by 8-OH-DPAT was, in contrast to its induction of hypothermia and
      corticosterone secretion, blocked by the preferential D2 antagonist haloperidol.
      Moreover, in the presence of quinpirole and in the presence of a further
      dopaminergic agonist, apomorphine, LY 165,163 did elicit STFs. Further, STFs
      evoked by LY 165,163 in the presence of apomorphine were abolished by the 5-HT1A
      antagonists (-)-alprenolol, BMY 7378 and NAN-190. We conclude that LY 165,163
      exhibits marked activity at both pre- and postsynaptic dopaminergic D2 (D3 and
      D1) receptors.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7791117
TI  - mu-, delta- and kappa-opiate receptors mediate antinociception in the rat tail
      flick test following noxious thermal stimulation of one hindpaw.
AB  - Experiments were performed to investigate the possible involvement of spinal mu-,
      delta- and kappa-opiate receptors in mediating the antinociceptive effects of
      noxious thermal stimulation of one hindpaw on the tail flick reflex in the rat.
      Male Sprague-Dawley rats were implanted with chronic intrathecal catheters to the
      lumbar level of the spinal cord. After 5 to 7 days, they were lightly
      anesthetized with an i.p. injection of a mixture of Na-pentobarbital (20 mg/kg)
      and chloral hydrate (120 mg/kg). After baseline readings were taken in the tail
      flick test a conditioning noxious thermal stimulus, which consisted of immersion
      of one hindpaw in water at 55 degrees C for 90 sec, was applied and the effects
      on the latency of the tail withdrawal reflex were studied over the next 30 min.
      In animals pretreated with CSF intrathecally 10 min before the stimulus, an
      increase in tail flick reaction time was observed peaking at 30 sec after the
      stimulus. This response was attenuated in a dose-related manner by
      preadministration of the specific mu-opiate receptor antagonist, beta
      funaltrexamine, the specific delta-opiate receptor antagonist, H-Tyr-Tic
      psi[CH2NH]-Phe-Phe-OH or the specific kappa-opiate receptor antagonist, nor
      binaltorphimine. The data show that the antinociceptive effect on the tail
      withdrawal reflex from a brief noxious thermal stimulus is provoked
      heterosegmentally by the noxious conditioning stimulus to the hindpaw and is
      mediated by the endogenous release of ligands that bind to mu-, delta- and kappa
      opiate receptors in the spinal cord.

PMID- 7791118
TI  - Characterization of [3H]ABT-418: a novel cholinergic channel ligand.
AB  - ABT-418 [(S)-3-methyl-5-(1-methyl-2-pyrrolidinyl)isoxazole] is a potent and
      selective agonist at neuronal nicotinic acetylcholine receptors (nAChRs) with
      cognitive enhancing and anxiolytic activities. [3H]ABT-418 was found to bind with
      high affinity (KD = 2.85 +/- 0.14 nM) to membranes prepared from rat brain.
      Binding of [3H]ABT-418 was characterized by rapid association (T1/2 = 1.4 +/- 0.3
      min) and dissociation (T1/2 = 2.9 +/- 0.4 min) half-times. The pharmacology of
      [3H]ABT-418 binding was consistent with an interaction with the putative alpha 4
      beta 2 nAChR subtype. The nAChR agonists, (-)-nicotine, (-)-cytisine and (+/-)
      epibatidine, displayed a high affinity (Ki = 0.8 +/- 0.1, 0.2 +/- 0.1 and 0.05 +/
      0.01 nM, respectively) for [3H]ABT-418 binding sites, whereas among nAChR
      antagonists examined, only dihydro-beta-erythroidine competed with high affinity
      (Ki = 32 +/- 1.5 nM). Although autoradiography studies indicate that the binding
      distribution of [3H]ABT-418 and (-)-[3H]cytisine are largely identical, there are
      some brain regions including the striatum, olivary pretectal nucleus and the
      superior colliculus, in which [3H]ABT-418 demonstrates significantly (P < .05)
      less binding. The data in the present study demonstrate that [3H]ABT-418 binds
      with high affinity to a population of binding sites in the rat brain that have
      the pharmacological characteristics of neuronal nAChRs. [3H]ABT-418 may,
      therefore, serve as a useful radioligand to further probe the observed
      differences in pharmacological properties between ABT-418 and other nicotinic
      agonists in vivo.

PMID- 7791119
TI  - Carvedilol, a new vasodilating beta-adrenoceptor blocker, inhibits oxidation of
      low-density lipoproteins by vascular smooth muscle cells and prevents leukocyte
      adhesion to smooth muscle cells.
AB  - The present study was undertaken to assess the effect of carvedilol, a new
      vasodilating beta-adrenoceptor blocker with antioxidant activity, on the
      oxidation of low-density lipoproteins (LDL) by rat aortic smooth muscle cells
      (RASMC). LDL oxidation was assessed as thiobarbituric acid reactive substances
      (TBARS) formation and increase in electrophoretic mobility. Oxidized (ox) LDL
      induced cytotoxicity was assessed as lactate dehydrogenase release (LDH) from
      cells and ox-LDL-enhanced adhesiveness of the RASMC for leukocytes was also
      determined. Carvedilol inhibited TBARS formation and LDH release from RASMC with
      IC50 values of 1.74 and 1.62 microM, respectively. Under the same conditions, the
      IC50 values of probucol and nicardipine were 2.33 and 5.60 microM, respectively,
      for inhibition of TBARS and 5.16 and 12.10 microM, respectively, for inhibition
      of LDH release; propranolol, atenolol, pindolol and labetalol, at concentrations
      up to 100 microM, had virtually no effect on either variable. RASMC-dependent ox
      LDL stimulated the adhesive properties of RASMC for both monocytes and
      neutrophils in a concentration- and time-dependent manner, which were prevented
      when the RASMC were treated with carvedilol (IC50 2.07 microM for monocytes and
      1.12 microM for neutrophils), whereas other beta blockers, at concentrations up
      to 30 microM, had only mild effects. The monoclonal antirat intercellular
      adhesion molecule-1 antibody partially inhibited ox-LDL-induced adhesion of RASMC
      for monocytes and neutrophils. Northern analysis demonstrated that ox-LDL induced
      intracellular adhesion molecule-1 messenger RNA expression on RASMC, which was
      inhibited by carvedilol and probucol via inhibition of LDL oxidation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7791121
TI  - Ontogenically related properties of N-methyl-D-aspartate receptors in rat
      hippocampal neurons and the age-specific sensitivity of developing neurons to
      lead.
AB  - The sensitivity of N-methyl-D-aspartate- (NMDA) induced whole-cell and single
      channel currents to Pb2+ was studied in neurons acutely dissociated from the
      hippocampus of 3- to 30-day-old rats. The amplitude of NMDA-induced whole-cell
      currents in the neurons increased with age of the animals until they were 10 to
      12 days old, thereafter remaining nearly unchanged. As in cultured hippocampal
      neurons, Pb2+ at both 10 and 30 microM inhibited NMDA-induced currents, and the
      sensitivity of the currents to Pb2+ decreased with age of the rats. The
      sensitivity correlated with the age-related expression of two components of the
      NMDA-induced currents, one that was fast decaying and more prominent in younger
      neurons, and the other slowly decaying. Inhibition of the fast component by Pb2+
      was always greater than that of the slow component, which may explain the greater
      sensitivity of younger neurones to Pb2+. may explain the greater sensitivity of
      younger neurons to Pb2+. The use of trypsin during acute dissociation of the
      neurons did not qualitatively alter the findings, although in the trypsin-treated
      neurons the currents were 65% smaller, and the EC50 for NMDA and glycine for the
      slow component were both about two times greater than in the untreated neurons;
      in the case of the fast component, the EC50s for NMDA and for glycine were not
      significantly altered. In outside-out patches excised from acutely dissociated
      hippocampal neurons, Pb2+ decreased the frequency of NMDA-activated channel
      openings without altering the mean channel open time. Our results are in
      agreement with those reported for embryonic neurons that developed in culture,
      and indicate that NMDA receptors expressed in hippocampal neurons of young
      animals are key target sites for the neurotoxic actions of Pb2+.

PMID- 7791122
TI  - Nicotinic responses in acutely dissociated rat hippocampal neurons and the
      selective blockade of fast-desensitizing nicotinic currents by lead.
AB  - The patch-clamp technique was used to characterize the nicotinic currents in
      individual neurons acutely dissociated from the hippocampi of postnatal rats of
      different ages, and to investigate the effects of Pb2+ on these currents, both in
      acutely dissociated and in cultured hippocampal neurons. The effects of Pb2+ on
      nicotinic acetylcholine receptors (nAChR) expressed in frog muscle fibers were
      also investigated. Acetylcholine could activate fast- and slowly desensitizing
      whole-cell currents in neurons dissociated from the hippocampi of 4- to 20-day
      old rats. Similar to the currents elicited in cultured hippocampal neurons, the
      rapidly desensitizing currents were blocked by methyllycaconitine, and were the
      nicotinic responses that could be elicited in most of the acutely dissociated
      neurons tested, whereas the slowly desensitizing currents could be evoked only in
      a few neurons. Although the peak amplitude of nicotinic currents recorded from
      acutely dissociated neurons increased with age of the neurons as it did in
      cultured neurons, the mean amplitude of the currents was at least an order of
      magnitude smaller in acutely dissociated neurons than in cultured neurons. Pb2+
      could potently and specifically inhibit activation of fast-desensitizing
      nicotinic currents in hippocampal neurons. Pb2+ reduced the peak amplitude of
      fast-desensitizing currents with an IC50 of about 3 microM and an apparent Hill
      coefficient of 1.0, whereas only at 30 microM could Pb2+ decrease the peak
      amplitude of slowly desensitizing currents by about 50%. Inhibition of fast
      desensitizing currents by Pb2+ was voltage independent and noncompetitive.
      However, Pb2+ had no effect on acetylcholine-activated single channels in frog
      muscle fibers. Our results indicate that the hippocampus of the developing rat
      expresses functional nAChRs of diverse types, and that methyllycaconitine
      sensitive neuronal nAChRs, which are highly permeable to Ca2+, are much more
      sensitive to Pb2+ than other nAChR subtypes.

PMID- 7791120
TI  - Characterization and distribution of binding sites for a new neurotensin receptor
      antagonist ligand, [3H]SR 48692, in the guinea pig brain.
AB  - SR 48692, a selective nonpeptide antagonist of neurotensin (NT) receptors was
      developed recently. In the present work we studied the binding properties of the
      corresponding radioligand, [3H]SR 48692, in the adult guinea pig brain. The
      characterization of [3H]SR 48692 binding was carried out on brain membrane
      preparations and the distribution of [3H]SR 48692 binding sites was determined by
      receptor autoradiography and compared to that of [125I]NT binding sites. In brain
      homogenates, [3H]SR 48692 bound to a single population of sites with a Kd of 2.19
      nM and a maximal binding capacity of 1.15 pmol/mg of protein. This maximal
      binding capacity value was 20 times higher than that observed for [125I]NT. NT
      agonists were able to interact competitively with the entire population of
      binding sites labeled by [3H]SR 48692, but their affinities were much lower than
      those observed for [125I]NT. By contrast, NT antagonists exhibited similar
      abilities to inhibit the binding of both radioligands. The addition of unlabeled
      NT in saturation assays revealed a competitive inhibition of [3H]SR 48692
      binding, suggesting that agonist and antagonist ligand bind to overlapping
      domains of the NT receptor. The autoradiographic distribution of the low-affinity
      NT binding sites detected by [3H]SR 48692 (96% of the receptors) was very similar
      to the distribution of high-affinity receptors labeled with [125I]NT (4% of the
      receptors). In addition, the binding of [3H]SR 48692 was insensitive to guanyl
      nucleotides. Taken together, these findings suggest that the binding sites
      detected by [3H]SR 48692 in the guinea pig brain mainly represent the uncoupled
      form of the NT receptor.

PMID- 7791123
TI  - Rotation and striatal c-fos expression after repeated, daily treatment with
      selective dopamine receptor agonists and levodopa.
AB  - The available evidence suggests that daily injections of selective dopamine (DA)
      D2 receptor agonists to DA depleted rats typically leads to behavioral
      sensitization, but the effects of repeated treatment with selective DA D1
      receptor agonists are more equivocal. In this study we examined the effects of
      acute and repeated treatment with DA receptor agonists with various D1/D2
      receptor selectivities on rotation and striatal c-fos activation in rats with
      unilateral DA depletions. Lesioned rats were treated daily for 10 d with either
      the novel, selective DA D1 receptor agonist, A-85653, the DA D2 receptor agonist,
      quinpirole, a combination of these compounds, or the indirect D1/D2 receptor
      agonist levodopa (L-DOPA). Over days, rats given A-85653 alone showed behavioral
      tolerance, whereas those given either quinpirole or L-DOPA demonstrated
      behavioral sensitization. Repeated A-85653 + quinpirole treatment s lead to an
      increase in response magnitude early in the testing sessions and this was
      accompanied by a reduction in response duration over days. Quantitative analysis
      of striatal c-fos activation was also conducted in lesioned rats treated acutely
      or repeatedly with A-85653, A-85653 + quinpirole or L-DOPA. Numbers of Fos
      immunoreactive nuclei were sharply reduced after the agonist challenge in all
      animals given repeated, compared to acute, drug treatment, despite enhanced
      levels of rotation by rats given quinpirole + A-85653 or L-DOPA repeatedly. These
      results suggest that desensitization may develop at the DA D1 receptor as a
      consequence of repeated stimulation, and that the behavioral sensitization seen
      after repeated L-DOPA treatment may primarily involve the DA D2 receptor.

PMID- 7791124
TI  - Inhibition of interleukin-1 and tumor necrosis factor-alpha synthesis following
      treatment of macrophages with the kappa opioid agonist U50, 488H.
AB  - Previous reports from this laboratory, and others, have shown that exogenous mu
      and kappa opioids modulate both cellular and humoral immune responses. Our
      earlier work has suggested that accessory cells may serve as a target for the
      direct effects of kappa opioid compounds. In the present study, the function of
      the macrophage cell line P388D1 was modulated by the kappa-selective opioid
      agoinst U50,488H (trans-3,4-dichloro-N-methyl-N-[7-(1-
      pyrrolidinyl)cyclohexyl]benzene-acetamide methanesulfonate). Lipopolysaccharide
      induced interleukin (IL)-1 and tumor necrosis factor-alpha production were
      inhibited after the administration of nanomolar concentrations of U50,488H.
      Furthermore, inhibition of IL-1 produced by the P388D1 cell line was reversed by
      both the classical opioid antagonist naloxone and by the kappa opioid receptor
      antagonist norbinaltorphimine. Examination of IL-1 mRNA levels in P388D1 by
      northern blot analysis showed that the inhibition mediated by U50, 488H
      apparently occurred at the level of transcription. On the other hand, U50,488H
      failed to modulate the production of IL-6 by this macrophage-like cell line. In
      addition, U50,488H failed to modulate the production of either IL-1 or tumor
      necrosis factor-alpha from the macrophage-like cell line RAW 264.7, an indication
      that subpopulations of macrophages exist with different sensitivities to opioids.
      These results are consistent with a growing body of data which suggests that a
      component of the inhibition mediated by opioid compounds involves a reduction in
      the production of cytokines.

PMID- 7791126
TI  - Specific transcriptional inhibition of bone marrow-derived macrophage tumor
      necrosis factor-alpha gene expression and protein production using novel
      enantiomeric carbocyclic nucleoside analogues.
AB  - Tumor necrosis factor-alpha (TNF-alpha) is a powerful macrophage-derived
      proinflammatory cytokine, via both direct effects on host tissues as well as
      indirectly through the induction of other proinflammatory mediators, including
      interleukin- (IL) 1 beta and IL-6. Activation of murine bone marrow-derived
      macrophages (BMDM phi) with lipopolysaccharide (LPS) causes rapid expression of
      TNF-alpha, which as an autocrine factor enhances BMDM phi function through IL-1
      beta and IL-6 production. In this study, we have examined the specific
      transcriptional inhibition of BMDM phi TNF-alpha using novel enantiomeric
      carbocyclic nucleoside analogues. BMDM phi were derived in vitro from murine bone
      marrow progenitors using colony stimulating factor-1 and treated with
      combinations of LPS (1-100 nG/ml) and the enantiomeric carbocyclic nucleoside (10
      100 microM) analogues MDL 201, 112 (9-[(1S,3R)-cis-cyclopentan-3-ol]adenine); MDL
      201,451 (9-[1R,3S)-cis-cyclopentan-3-ol]adenine); MDL 201,449 (9-[(1R,3R)-trans
      cyclopentan-3-ol]adenine) and MDL 201,484 (9-[(1S,3S)-trans-cyclopentan-3
      ol]adenine). Northern blot analysis showed that MDL 201,449 was the most
      effective agent in vitro at selectively inhibiting TNF-alpha. MDL 201,449 reduced
      TNF-alpha mRNA levels by nearly 50% for up to 4 hr after the simultaneous
      addition of LPS and the synthetic agent. In contrast, mRNA and secreted protein
      levels for IL-1 beta (measured by the D10.S bioassay) and mRNA for TNF-alpha
      receptor p60 and TNF-alpha receptor p80 were not significantly affected.
      Carbocyclic nucleoside analogues were effective when added to BMDM phi up-to 2 hr
      after LPS treatment and at concentrations as low as 10 microM. Regulation of BMDM
      phi IL-6 by carbocyclic nucleoside analogues in response to LPS appears to be
      both concentration and time dependent, because IL-6 mRNA and secreted protein
      levels were inhibited at only high drug concentrations (100 microM) and effective
      only at longer exposure times (+4 hr of incubation) to LPS. These data support
      the concept that M phi-derived proinflammatory cytokine gene expression is
      differentially, rather than coordinately, regulated by selective signal
      transduction and/or molecular pathways. Enantiomeric carbocyclic nucleoside
      analogues that specifically inhibit TNF-alpha may have therapeutic potential in
      inflammatory diseases, such as systemic inflammatory response syndrome, where TNF
      alpha has been shown to have an important role in initiating the early stages of
      disease.

PMID- 7791125
TI  - Cytotoxicity of acetaminophen in human cytochrome P4502E1-transfected HepG2
      cells.
AB  - Acetaminophen (APAP) when administered in excess can cause severe hepatic
      necrosis in vivo. To study the mechanism of APAP toxicity and the role of
      cytochrome P450, a previously established human hepatoma HepG2 subline, MVh2E1-9,
      that constitutively expresses human CYP2E1 was used as a model. At high
      concentrations (above 5 mM) and when intracellular reduced glutathione (GSH) was
      depleted, APAP caused severe cytotoxicity in MVh2E1-9, but not in MV-5 cells
      which lack CYP2E1. The APAP cytotoxicity was dependent on the concentration of
      APAP and time of exposure, and could be blocked by 4-methylpyrazole, ethanol,
      diallyl sulfide, N-acetylcysteine and N-t-butyl-alpha-phenylnitrone, but not by
      propylgallate, an inhibitor of lipid peroxidation. Significantly more 14C-labeled
      APAP protein adduct was detected in MVh2E1-9 cells than MV-5 cells, especially
      after depletion of GSH. The formation of the APAP adducts could be inhibited by
      the same agents which prevent APAP cytotoxicity. At a lower concentration (1-2
      mM), APAP inhibited proliferation in both MVh2E1-9 and the control MV-5 cells to
      similar extents. This antiproliferative action of APAP did not require depletion
      of GSH as did the cytotoxic action of APAP. These data suggest that APAP has a
      dual toxic effect on MVh2E1-9 cells: a P450-independent antiproliferative effect
      and the CYP2E1-dependent cytotoxic effect. These results demonstrate the ability
      of human CYP2E1 to activate APAP to reactive metabolites which form covalent
      protein adducts and cause toxicity to a hepatoma cell line.

PMID- 7791127
TI  - Identification of a novel chemical series that blocks interleukin-1-stimulated
      metalloprotease activity in chondrocytes.
AB  - Cartilage destruction is one of the essential features of osteoarthritis and
      other degenerative disease conditions of articular disease, and it may be caused
      by metalloproteases induced by cytokines such as interleukin-1. To search for
      novel chemical entities that will block the production of metalloproteases, we
      have utilized an in vitro system in which macrophage-conditioned medium (a source
      of interleukin-1) was used to stimulate rabbit articular chondrocytes in culture.
      Upon treatment with macrophage-conditioned medium or recombinant interleukin-1,
      chondrocytes synthesize and secrete collagenase, stromelysin and other proteases
      into the surrounding medium and fail to organize an appropriate extracellular
      matrix. Using this in vitro system, we have determined that a series of
      naphthopyran derivatives were able to block the production of neutral
      metalloproteases. Structural modifications of the lead compound have revealed
      specific requirements for activity. This class of compounds represents one of
      very few that are known to block the synthesis, rather than the activity, of
      matrix-degrading metalloproteases and thus may be beneficial in preventing the
      cartilage destruction associated with several degenerative diseases of the
      articular joint.

PMID- 7791128
TI  - Increase of diazepam binding inhibitor mRNA levels in the brains of chronically
      ethanol-treated and -withdrawn mice.
AB  - Although the molecular mechanisms underlying behavioral responses observed in
      ethanol (EtOH)-dependent and -withdrawn animals are poorly understood, several
      lines of evidence have suggested that some of the pharmacological actions of EtOH
      are mediated via the potentiation of gamma-aminobutyric acid (GABA)ergic
      transmission. In the present study, the effects of acute and chronic EtOH
      treatment on the expression of diazepam binding inhibitor (DBI) mRNA in the mouse
      brain and the functional involvement of the benzodiazepine (BDZ) receptor in EtOH
      induced alteration of the DBI mRNA expression were examined. The expression of
      cerebral DBI mRNA significantly increased in EtOH-treated (130% of control) and
      EtOH-withdrawn (220% of control) mice in comparison with untreated mice, whereas
      the DBI mRNA level was not altered after a single administration of EtOH (3 g/kg
      i.p.). The increase in the DBI mRNA expression in the mouse cerebral cortex after
      EtOH withdrawal diminished over 14 days despite the disappearance of withdrawal
      signs within 2 days after the withdrawal of EtOH. Simultaneous administration of
      flunitrazepam (10 mg/kg i.p.) with EtOH completely abolished the EtOH-induced
      increase in DBI mRNA expression. On the other hand, the level of beta-actin mRNA
      was not affected by similar EtOH treatment. These results indicate that changes
      in the expression of cerebral DBI mRNA induced by long-term EtOH treatment may be
      involved in the establishment of alcohol dependence, and such changes may be also
      regulated by BDZ receptors.

PMID- 7791129
TI  - Presynaptic gamma-hydroxybutyric acid (GHB) and gamma-aminobutyric acidB (GABAB)
      receptor-mediated release of GABA and glutamate (GLU) in rat thalamic ventrobasal
      nucleus (VB): a possible mechanism for the generation of absence-like seizures
      induced by GHB.
AB  - The ventrobasal nucleus of thalamus (VB) is considered to be intimately involved
      in the genesis of experimental absence-like seizures. Bilateral microinfusion of
      gamma-hydroxybutyric acid (GHB) into VB or systemic administration of gamma
      butyrolactone, the pro-drug of GHB, induces generalized absence-like seizures in
      rats. In the present study, the basal and K(+)-evoked extracellular output of
      endogenous gamma-aminobutyric acid (GABA) and glutamate (GLU) in behaving rat VB
      nucleus was characterized 1) during unilateral GHB perfusion into VB and 2)
      during the course of generalized absence-like seizures induced by GHB. Although
      the basal extracellular release of GABA was inhibited by GHB (250-1500 microM) in
      a concentration-dependent manner, basal GLU levels remained unaltered. However,
      K(+)-evoked release of both GABA and GLU was significantly attenuated by GHB.
      During GHB-induced absence-like seizures, a similar decrease in basal GABA or
      K(+)-evoked GABA and GLU levels was observed. These effects of GHB were partially
      reversed by the specific GHB receptor antagonist NCS 382. (-)-Baclofen (10-50
      microM) also produced a concentration-dependent decrease in basal and K(+)-evoked
      levels of GABA and GLU in this thalamic nucleus. The effects of either (-)
      baclofen or GHB on the release of GABA and GLU were selectively antagonized by
      the GABAB receptor antagonists phaclofen (0.75-2 mM) and CGP 35348 (50-200
      microM), respectively. These results suggest that by selectively modulating the
      basal and K(+)-evoked release of GABA and GLU, GHB induces, in the thalamic
      ventrobasal relay nucleus, an optimal "excitatory" environment conducive to the
      generation of absence seizures. Moreover, the data raise the possibility that a
      presynaptic GHB/GABAB receptor complex occurs in VB.

PMID- 7791130
TI  - Specific inhibition of the contraction of the rat aorta by estradiol 17 beta.
AB  - Short-term exposure to estradiol 17 beta is known to inhibit the contraction of
      vascular smooth muscle preparations that is thought to be mediated by a [Ca++]
      dependent mechanism. The purpose of this investigation was to examine the effect
      of prolonged exposure of vascular preparations to estradiol 17 beta to provide
      significant time for protein synthesis. We find that treatment of rat aortic
      rings with estradiol 17 beta (0.37-37 microM) for 15 to 180 min and subsequent
      removal of the estrogen by washing, attenuated the vasoconstrictor responses to
      phenylephrine and potassium chloride in a time-dependent manner. The maximum
      inhibitory effect took 120 min to develop. The inhibitory effect was endothelium
      independent and not blocked by the cyclooxygenase inhibitor, indomethacin, or by
      the endothelium derived relaxing factor inhibitor, Nw-nitro-L-arginine methyl
      ester. This effect was highly stereo-specific in that the 17 alpha isomer was
      significantly less potent than the 17 beta isomer of estradiol. Further, compared
      to other steroids, estradiol 17 beta was the most potent. The inhibitory effect
      of estradiol was blocked completely by pretreatment with the protein synthesis
      inhibitors, cycloheximide and puromycin, but not by actinomycin D. Electron
      microscopy showed an increase in ribosomal expression at the rough endoplasmic
      reticulum after incubation of the rat aorta with estradiol for 120 min. This
      indicates increased protein synthesis after exposure to estradiol 17 beta. We
      speculate that the time dependent inhibitory effect of estradiol 17 beta on
      vascular smooth muscle is related to protein synthesis at the translational
      level.

PMID- 7791132
TI  - Opioid tolerance in human placenta due to in vitro methadone administration.
AB  - Explant culture of term placental villus trophoblast was investigated for its
      possible use as a model system for study of the effects of chronic methadone
      administration on binding and functional properties of placental kappa receptors.
      Viability parameters demonstrated that functional integrity of the tissue and its
      responsiveness to the modulation of human chorionic gonadotropin release by
      opioids are fully preserved during the 3 days of culture. Methadone
      administration for 2 days did not affect the viability of cultured explants.
      However, it resulted in the development of opioid tolerance, as demonstrated by a
      shift to the right in the concentration-response curve of U-69,593-induced
      stimulation of human chorionic gonadotropin release, and irresponsiveness to the
      inhibitory action of the antagonist nor-binaltorphimine. Kappa receptors of
      methadone-treated explants exhibited changes in their binding properties that
      preceded the shift in responsiveness. These data suggest that the development of
      tolerance to opioids in human placenta starts with an apparent down regulation
      and change in the affinity of the receptors and may involve downstream events
      that transduce receptor activation into a biological response.

PMID- 7791131
TI  - Characterization of human liver microsomal UDP-glycosyltransferases using
      photoaffinity analogs.
AB  - The photoaffinity analogs [beta-32P]5-azido-UDP-glucuronic acid ([32P]5N3UDP
      GlcUA) and [beta-32P]5-azido-UDP-glucose ([32P]5N3UDP-Glc) were used to
      characterize UDP-glycosyltransferases of microsomes prepared from human liver.
      Photoincorporation of both probes into proteins in the 50- to 56-kdalton range,
      known to contain UDP-glucuronosyl transferases (UGTs), was concentration
      dependent, and photolabeled proteins were susceptible to trypsin digestion only
      in the presence of detergent. The latter was demonstrated by the appearance on
      Western blots of the trypsin-treated, detergent-disrupted microsomes of a protein
      band of slightly lower molecular mass than, and presumably derived from, the
      UGTs. However, a labeled cleavage product was found only in samples photolabeled
      with [32P]5N3UDP-GlcUA and not in those labeled with [32P]5N3UDP-Glc. In
      detergent-treated microsomes, all of the nucleotide sugars that were tested
      protected better against photoinsertion of [32P]5N3UDP-GlcUA than of [32P]5N3UDP
      Glc, with UDP-glucose being the most effective, followed by UDP-GlcUA and UDP
      galactose. The pattern of inhibition of a series of uridinyl analogs toward
      photolabeling by the two probes was quite different: one inhibitor that was
      ineffective in blocking photoincorporation of [32P]5N3UDP-GlcUA (L-DPASiU) was
      one of the most potent inhibitors of photolabeling with [32P]5N3UDP-Glc. A
      similar dichotomy was seen with several inhibitors in enzymatic assays measuring
      hyodeoxycholic acid 6-O glucuronidation and glucosidation activities; the most
      potent inhibitors of HDCA glucosidation were not as effective against
      glucuronidation. The results indicate a lumenal orientation for human microsomal
      UGTs and provide substantial evidence that two distinct enzyme systems are
      involved in 6-O glucuronidation and 6-O glucosidation of HDCA.

PMID- 7791136
TI  - The plantar arch revisited.
AB  - In 20 random cadaveric feet, the arterial plantar arch, its anastomosis with the
      medial plantar artery, and the communication between the lateral plantar and the
      dorsal arteries of the foot were studied. The anatomic variations found in this
      material are described and illustrated. The presence of a "classic" anastomosis
      between the medial and lateral plantar arteries was observed in only 20 percent
      of cases. The "classic" conjunction of the dorsal artery with the lateral plantar
      artery was found in 95 percent of cases. The authors conclude that most
      variations in the contributions to the plantar arch have not been previously
      reported, and these may have clinical consequences.

PMID- 7791133
TI  - Benzodiazepine-withdrawal-induced gastric emptying disturbances in rats: evidence
      for serotonin receptor involvement.
AB  - This study was performed in rats to determine if serotonin and its receptors are
      involved in the increase of gastric emptying (GE) induced by benzodiazepine (BZ)
      withdrawal. GE was measured with a test meal (2 ml) containing 1 microCi/ml of
      51Cr sodium chromate administered in rats, either previously receiving injections
      with diazepam (15 mg/kg/day i.p.) or with DMSO (0.9 ml/day i.p.) during 7 days.
      On the 8th day, animals received the different serotonin (5-HT) agonists or
      antagonists, and flumazenil (BZ antagonist; 15 mg/kg i.p.) 30 and 15 min,
      respectively, before the test meal. Methiotepin (5-HT1 antagonist) either i.p.
      (0.1-1 mg/kg) or intracerebroventricularly (10 micrograms/kg) had no effect on
      the increase of GE induced by precipitated-withdrawal. 8-OH-DPAT (5-HT1A agonist)
      administered i.c.v. (1-10 micrograms/kg) dose dependently reduced GE increase.
      Administered i.p. (0.1 mg/kg), it blocked GE increase in control and diazepam
      withdrawn rats. Ritanserin (5-HT2 antagonist) antagonized GE increase only when
      administered i.p. (0.1 mg/kg). Granisetron (5-HT3 antagonist) was active both
      i.p. (0.01-0.1 mg/kg) and intracerebroventricularly (1-10 micrograms/kg).
      Administered intracerebroventricularly (1 microgram/kg) in diazepam-treated rats,
      5-HTP mimicked the effect of flumazenil. It is concluded that diazepam-withdrawal
      increases GE by stimulating central release of 5-HT and/or central activation of
      5-HT neurons. At least central 5-HT3 receptors, and in less extend, peripheral 5
      HT2 receptors are involved in this mechanism.

PMID- 7791134
TI  - Revascularization of a seven-week-old infant lower extremity: case report.
AB  - A seven-week-old infant suffered a closed segmental fracture of the left tibia
      and fibula complicated by vascular disruption and a secondary compartment
      syndrome. Initial orthopedic assessment revealed a clinically mottled, cool,
      pulseless extremity 4 hr post-injury. Radiologic investigations showed multiple
      displaced fractures of both the tibia and fibula. The infant underwent four
      compartment fasciotomies and intramedullary nailing of the tibial fractures. The
      vascularity of the limb failed to improve significantly. Angiograms done 22 hr
      post-injury revealed disruption of arterial inflow just distal to the bifurcation
      of the tibial peroneal trunk and posterior tibial artery. Urgent
      revascularization utilizing a contralateral greater saphenous vein graft was
      undertaken with a successful outcome. Despite delay in transport from the
      community hospital and lack of definitive management of the vascular injury, the
      infant has had a good-to-excellent functional outcome.

PMID- 7791135
TI  - Bone growth after replantation in children.
AB  - Bone growth and the development of epiphyseal plates are disturbed after the
      replantation of amputated extremities in children, but the potential for
      continued skeletal growth is almost always maintained in the replanted part. In
      this reported series of 12 children, all younger than 15 years old, 13 amputated
      parts of the upper limb have been successfully replanted. After long-term follow
      up (from 21 to 216 months), bone growth of the replanted parts was clinically and
      radiologically evaluated. Two different growing segments were distinguished: the
      proximal bone segment, directly injured from the initial trauma, and the distal
      replanted part. Average longitudinal growth recorded was 94.5 percent and 92.7
      percent, respectively. Two young patients demonstrated overgrowth of the proximal
      bone segment, which attained 110 percent and 118 percent of expected growth.
      Although it is difficult to determine all the parameters affecting the prognosis
      of post-traumatic reactions in growing cartilaginous plates, the level of
      amputation is considered to be a significant prognostic factor for the epiphyseal
      growth of the replanted part.

PMID- 7791137
TI  - Anterior chest-wall reconstruction with the extended TRAM double-pedicle free
      flap: case report.
AB  - A case of massive, anterior, chest-wall reconstruction is described, utilizing an
      extended TRAM flap design which was microsurgically transferred on both deep
      inferior epigastric pedicles, in order to perfuse the flap maximally. The flap is
      capable of reconstructing the largest chest-wall wounds and should be added to
      the armamentarium of those reconstructive surgeons involved in the care of these
      patients.

PMID- 7791138
TI  - Fibrin glue is a sealant and not a nerve barrier.
AB  - This experimental work on the internal popliteal nerve of the rabbit was
      undertaken to clarify whether interposition of a block of 4 mm of fibrin-sealant
      would form a barrier which stops or interferes with the passage of the axons.
      Twenty-four adult rabbit tibial nerves were placed in a microclamp, sectioned,
      and separated 4 mm. The gap between the two nerve ends was filled with fibrin
      sealant. Eight weeks after the procedure, the animals were sacrificed and the
      nerves removed. Histologic studies and morphometric longitudinal and transverse
      examination by image analysis showed that interposition of the block of fibrin
      sealant between the nerve ends was not a barrier or obstacle to the passage of
      axons. The use of fibrin sealant is a relatively good experimental model for a
      chamber of regeneration, because 70 percent of axonal regeneration was obtained.

PMID- 7791140
TI  - Comparative study between acute intraoperative arterial elongation and the use of
      the interpositional vein graft for arterial reconstruction.
AB  - This study compares the acute intraoperative arterial elongation technique with
      the interposition vein-graft method for the closure of small arterial gaps that
      cannot be repaired by undermining alone. Ten conditioned female mongrel dogs were
      divided into two groups: a vein graft interposition group and an acute expansion
      elongation group. In ten cases, a 25-mm segment of the superficial femoral artery
      was excised. The resultant defect, measuring 45 to 60 mm, was repaired by an
      interpositional graft of a comparable size segment of the superficial femoral
      vein. In ten other cases, a same-size defect was repaired by a tension-free end
      to-end anastomosis, following acute intraoperative arterial elongation. The
      animals were explored at various intervals. Overall results revealed a 100
      percent patency rate with the acute expansion-elongation group vs. 80 percent
      with the vein-graft interposition group. The versatility, time saving, and ease
      of technique, plus previous clinical experience, is encouraging enough to
      recommend this method for the sound repair of small arterial defects in clinical
      cases.

PMID- 7791139
TI  - An easy method of vascular anastomosis for replantation of fingertips.
AB  - Many cases of successful replantation of fingertips have been reported; however,
      it still remains difficult for an inexperienced surgeon to anastomose very small
      vessels (especially veins of the fingertip) because their walls and lumina cannot
      be clearly defined. The authors report a simple method which is useful for
      anastomosis of small vessels. A colored silicone background is cut into a small,
      thread-like segment, and both ends are tapered. This segment is then introduced
      into the vessel lumen to serve as a vascular stent. The silicone vascular stent
      makes it easy to identify the vessel lumen and then to suture the vessel edges.
      It also prevents a through-stitch, the most common cause of anastomosis failure
      with small vessels. The silicone vascular stent is removed before the last suture
      is tied. This technique has been used for suturing small veins in the finger pulp
      or small arteries in zone I, and it will be most helpful for the inexperienced
      microsurgeon.

PMID- 7791141
TI  - Improved efficacy of urokinase further prolongs ischemic skin-flap survival.
AB  - Salvage of a free-tissue transfer, when postoperative vascular compromise is
      detected, depends largely upon the restoration of a patent microcirculation. The
      therapeutic efficacy of thrombolytics infused directly into the failing flap has
      been clearly demonstrated. In this experiment, the authors investigated whether
      the method of selective administration of urokinase to failing skin flaps in 68
      Sprague-Dawley rats had any effect on flap survival. In one group of animals,
      postischemic flaps were perfused with 100,000 IU of urokinase given by manual
      injection, and via a pressurized delivery system (150 mmHg) in the other group.
      Flap survival was assessed at 7 days. A significantly greater survival was seen
      in flaps treated with urokinase by controlled pressure infusion (p < 0.01). This
      simple method is suggested to increase the efficacy of urokinase used in the
      context of flap salvage.

PMID- 7791142
TI  - Sensory recovery in innervated free-tissue transfers.

PMID- 7791143
TI  - A 17-year follow-up of replantation of a completely amputated leg in a child:
      case report.
AB  - With special reference to skeletal growth, a 17-year follow-up study of a lower
      leg replantation in a four-year-old boy is reported. The patient maintained good
      cosmesis and function; however, foot size on the affected side was 1.5 cm smaller
      than the contralateral side, and leg length was 1.2 cm shorter than on the normal
      side. A Cybex II study disclosed that the patient had almost half-standard
      strength of the evertors at 30 deg/sec and of the plantar flexors at 20 and 120
      deg/sec on the involved side. According to these findings on late follow-up of a
      replanted foot in a child, replantation in a growing child apparently has adverse
      influences on skeletal growth and muscle strength around the ankle joint, even
      when the original procedure has been carried out under almost ideal conditions.

PMID- 7791144
TI  - Continuous alteration of the internal milieu of a nerve-guide chamber using an
      osmotic pump and internal exhaust system.
AB  - The use of non-neural conduits to span gaps in regenerating peripheral nerves has
      been noted in the literature for many years. An intriguing addition to this so
      called entubulation repair method is the continuous instillation of
      neuronotrophic or growth factors into the lumen of the guide to bathe the
      regenerating nerve. A model is presented which uses an osmotic pump that supplies
      a constant, reproducible amount of solution into the lumen of a nerve guide
      without disrupting the regeneration process.

PMID- 7791145
TI  - Arteriole constriction following ischemia in denervated skeletal muscle.
AB  - Arteriolar diameters and flow patterns were determined in the isolated rat
      cremaster muscle following 4 hr of total ischemia. Two groups of six rats each
      were studied--an innervated group and a denervated group. The microcirculation
      was observed using intravital microscopy, and the images were recorded on
      videotape. The whole arterial tree was scanned, and the smallest vessel diameter
      for each arterial segment was measured. Preischemic mean arteriole diameters were
      significantly larger in the denervated group, compared to the innervated group.
      Following ischemia, during the 3 hr of reperfusion, the main (AI) cremaster
      arteriole from both the innervated and denervated groups constricted to 50 to 70
      percent of pre-ischemic diameters. However, the actual diameters (as distinct
      from percentage change) were not significantly different between the innervated
      and denervated groups. There were significant differences in flow patterns. Some
      A2 and A3 vessels became temporarily nonflowing vessels (either open but without
      low, or closed by severe spasm). These poorly-functioning vessels were
      significantly more common in the denervated group. Furthermore, this phenomenon
      of temporary no-flow persisted longer in the denervated group over the 3-hr
      reperfusion period. These observations suggest that the ability to recover
      quickly from an ischemic insult is less in tissues that have been denervated.

PMID- 7791146
TI  - Classification and diagnostic criteria for polymyositis and dermatomyositis.

PMID- 7791147
TI  - Is anti-U1-RNP autoantibody positive connective tissue disease genetically
      distinct?

PMID- 7791148
TI  - Fibromyalgia 20 years later: what have we really accomplished?

PMID- 7791149
TI  - Phosphodiesterase inhibitor pentoxifylline: an antiinflammatory/immunomodulatory
      drug potentially useful in some rheumatic diseases.

PMID- 7791150
TI  - Minocycline in the treatment of rheumatoid arthritis: relationship of serum
      concentrations to efficacy.
AB  - OBJECTIVE: To assess the relationships between serum concentrations of
      minocycline and clinical efficacy and toxicity during the treatment of patients
      with rheumatoid arthritis (RA) with minocycline. METHODS: Forty patients with
      active RA were administered minocycline (maximal oral dose 100 mg twice a day)
      for 26 weeks. At 3 time points during the treatment, serum samples were collected
      for measurement of minocycline activity using a microbiological assay. An
      analysis of variance was performed to estimate an extrapolated concentration at
      time = 0 (C0) for each patient separately and this value of C0 was regarded to be
      proportional to the average serum concentration in each patient. The relation
      between C0 and clinical response and between C0 and the occurrence of adverse
      effects was evaluated. RESULTS: Minocycline was detected in 96 serum samples from
      37 patients. Eighty-two percent of the variance in serum concentrations was
      accounted for by a model incorporating patient, dose, and time effects. A weak
      correlation between C0 and clinical response, as expressed by a Ritchie articular
      index and number of swollen joints, was demonstrated. No correlation was seen
      between C0 and toxicity, including gastrointestinal or vestibular adverse
      effects. CONCLUSION: Results suggest a relationship between the serum
      concentrations of minocycline and the clinical response, including Ritchie
      articular index and number of swollen joints, in the treatment of patients with
      RA. No relationship was seen between the serum concentrations of minocycline and
      its toxicity.

PMID- 7791151
TI  - Salsalate, a nonacetylated salicylate, is as efficacious as diclofenac in
      patients with rheumatoid arthritis. Salsalate-Diclofenac Study Group.
AB  - OBJECTIVE: To investigate the efficacy of salsalate, a nonacetylated salicylate,
      in the treatment of patients with rheumatoid arthritis (RA). METHODS: Three
      hundred and one patients meeting the ACR criteria for RA were drawn from 16
      centers. After withdrawal of nonsteroidal antiinflammatory drugs (NSAID) and
      subsequent flare, patients were randomized to receive either salsalate or
      diclofenac for 8 weeks, according to a double blind, double dummy protocol.
      Initial doses of salsalate 3.0 g/day and diclofenac 75 mg/day were titrated for
      the first 5 weeks. The primary outcome measure was a multivariate analysis at 8
      weeks of tender joint count, pain, visual analog scale score, and physician's
      global assessment. RESULTS: One hundred and ninety patients completed the study.
      The mean stabilized dose of salsalate was 3.55 g/day, and that of diclofenac 112
      mg/day. Discontinuations were due to lack of efficacy (17 salsalate vs 15
      diclofenac); adverse events [19 salsalate (mainly tinnitus and hearing loss; p =
      0.0001 and p = 0.04, respectively) vs 9 diclofenac]; laboratory abnormalities (3
      salsalate vs 1 diclofenac); and other reasons, including protocol violations,
      intercurrent illness, and personal factors (24 salsalate vs 23 diclofenac). Both
      treatments produced significant improvement from flare (p < 0.0001). Post hoc
      power analysis showed that the study had sufficient power (0.60 to 0.90) to
      detect clinically important differences between the 2 drugs in the primary
      outcome measures; however, no statistically significant (p = 0.29) or clinically
      important treatment differences were recorded. Other than a difference in
      erythrocyte sedimentation rate that favored salsalate, there were no significant
      differences in secondary outcome measures between the 2 groups. All outcomes
      showed a tendency for more improvement with salsalate. CONCLUSION: Salsalate is
      as efficacious as diclofenac. Salsalate may be considered an alternative to other
      NSAID in the first line treatment of patients with RA.

PMID- 7791152
TI  - An open study of pentoxifylline in the treatment of severe refractory rheumatoid
      arthritis.
AB  - OBJECTIVE: Recent data implicates the cytokine, tumor necrosis factor alpha (TNF
      alpha), in the pathophysiology of rheumatoid arthritis (RA). In vitro data
      suggest that pentoxifylline may possess anti-TNF-alpha properties. We have
      therefore carried out a prospective 3-month open evaluation of pentoxifylline in
      a group of adult patients with RA refractory to conventional disease remittive
      therapies. METHODS: Nineteen patients with RA were included and clinical
      assessments were performed according to the World Health
      Organization/International League of Associations for Rheumatology (WHO/ILAR)
      criteria at baseline, and one and 3 months after the initiation of therapy.
      Laboratory assessments included a complete blood count, erythrocyte sedimentation
      rate (ESR), and whole blood assays of TNF-alpha production. TNF-alpha was assayed
      using ELISA and semiquantitative polymerase chain reaction methodologies.
      RESULTS: A significant diminution in number of tender and swollen joints as well
      as the ESR was noted after 3 months (p < 0.05) although no consistent effects on
      TNF-alpha production were observed. Furthermore, whole blood assays of TNF-alpha
      production shortly after initiation of pentoxifylline therapy were not predictive
      of the clinical response to this agent. CONCLUSION: Although pentoxifylline may
      possess therapeutic properties in RA, any beneficial effects appear to be
      unrelated to changes in TNF-alpha generation in whole blood assays.

PMID- 7791153
TI  - The effects of food on methotrexate absorption.
AB  - OBJECTIVE: To determine the effects of food on methotrexate (MTX) absorption in
      patients receiving MTX for the treatment of rheumatoid arthritis (RA). METHODS:
      Standard pharmacokinetic variables were determined in patients with RA after
      their usual maintenance dose of MTX, under fasting conditions and after they ate
      a standard breakfast. RESULTS: No significant differences in area under the serum
      concentration versus time curve, maximal MTX concentration after dosing (Cmax),
      time to Cmax), bioavailability, urinary MTX, renal clearance of MTX, or
      creatinine clearance were observed between the 2 dosing conditions. CONCLUSION:
      We observed no significant effect of food on MTX absorption or bioavailability.
      Patients may consume MTX without regard to meals.

PMID- 7791154
TI  - Influence of low doses of methotrexate on superoxide anion production by
      polymorphonuclear leukocytes from patients with rheumatoid arthritis.
AB  - OBJECTIVE: The mechanism of methotrexate (MTX) action in rheumatoid arthritis
      (RA) is unclear. We assessed the influence of MTX on neutrophil superoxide
      production evaluated by ferricytochrome c reduction. METHODS: Neutrophils were
      collected from MTX treated patients with RA (MTX-RA), patients with RA without
      medication (RA) and healthy donors, cocultured with MTX or MTX-RA serum. RESULTS:
      Polymorphonuclear leukocytes (PMN) from MTX-RA showed decreased superoxide
      production when compared with cells collected from patients with RA and controls.
      Control PMN superoxide production was inhibited (36%) by MTX-RA serum incubation.
      This reduction was accompanied by clinical improvement. MTX had no activity in
      the in vitro assays. CONCLUSION: MTX treatment may interfere with neutrophil
      superoxide production.

PMID- 7791155
TI  - Comparison of self-reported fatigue in rheumatoid arthritis and controls.
AB  - OBJECTIVE: To compare self-reported fatigue in adults with rheumatoid arthritis
      (RA) with age and sex matched healthy controls without RA and to determine the
      relationships of fatigue to pain, sleep, functional status, depressive symptoms,
      and disease activity. METHODS: A sample of 51 patients with RA and 46 age and sex
      matched controls without RA completed self-administered questionnaires 3 times at
      6-8 week intervals. Questionnaires included the Multidimensional Assessment of
      Fatigue scale, Sleep Survey, Health Assessment Questionnaire, and the Profile of
      Mood States. Patients had blood drawn for hematocrit (Hct) and C-reactive protein
      on the same day the questionnaires were completed. RESULTS: Fatigue scores were
      significantly higher in persons with RA compared to healthy controls. Fatigue did
      not change significantly in either group over time. Fatigue was strongly
      associated with poor sleep, functional disability, greater pain, more depressive
      symptoms, and lower Hct. CONCLUSION: The importance of assessing fatigue in RA is
      confirmed. Effective management is needed to control clinical manifestations of
      RA that were found to be strongly associated with fatigue such as poor sleep,
      functional disability, pain, depressive symptoms, and lower Hct.

PMID- 7791156
TI  - Association of social support and the spouse's reaction with psychological
      distress in male and female patients with rheumatoid arthritis.
AB  - OBJECTIVE: To determine if social support and the reaction of the spouse to the
      patient's pain are contributing factors to psychological distress in male and
      female patients with rheumatoid arthritis (RA). METHODS: Physical, social, and
      psychological aspects of health were assessed in 97 male and 132 female patients
      who were living with a spouse. Differences between male and female patients were
      analyzed by means of analysis of covariance while controlling for age and
      duration of RA. In multiple regression analyses the influence of social support
      and reaction of the spouse concerning psychological distress was determined after
      age, duration of RA, and physical functioning had been controlled. RESULTS:
      Criticism of the spouse significantly contributed to anxiety in male patients and
      to depression and anxiety in female patients. In addition, male and female
      patients differed in the social support resources that contributed to
      psychological distress. A relatively low number of friends was associated with
      depression in males. A relatively low level of potential support was associated
      with more anxiety in females. CONCLUSION: High levels of criticism of the spouse
      and low levels of social support are associated with more psychological distress
      in male and female patients. The number of friends is a social support resource
      in male patients and potential emotional support a resource in female patients.

PMID- 7791157
TI  - Platelet lactate dehydrogenase activity in systemic lupus erythematosus:
      correlation with anticardiolipin antibodies.
AB  - OBJECTIVE: To evaluate lactate dehydrogenase (LDH) activity in platelet
      subpopulations in systemic lupus erythematosus (SLE) and to correlate platelet
      LDH activity with concentrations of anticardiolipin antibody (aCL). METHODS:
      Twelve female patients with SLE and 12 age matched female control subjects were
      studied. Platelets were separated on the Percoll gradient, their density values
      controlled by density marker beads. LDH activity was measured after platelet
      lysis, expressed as nU/fl. ELISA were used to measure levels of IgG and IgM aCL.
      RESULTS: A significant increase of LDH activity with a significant correlation to
      IgG and IgM aCL were found in small, light platelets with a volume < 5 mu 3
      compared to large, dense platelets and to controls. LDH activity did not
      correlate with immunoglobulin classes, anti-DNA antibodies, and complement
      fractions in small and large SLE platelets. CONCLUSION: Our data suggest a
      possible chronic activation of subpopulations of small platelets in patients with
      SLE independent of thrombotic process. Low levels of aCL can mediate small
      platelet activation. Quantitative and qualitative analysis of the small, light
      platelets can serve a clinical diagnostic purpose as an in vivo platelet
      activation index in SLE.

PMID- 7791159
TI  - Prevalence of primary Sjogren's syndrome in China.
AB  - OBJECTIVE: To determine the prevalence rate of primary Sjogren's syndrome (SS) in
      a community population of 2066 adults in a Beijing suburban village, and 100
      inpatients, who were not necessarily admitted for rheumatic diseases. METHODS:
      Questionnaire and serological studies of antinuclear antibodies, rheumatoid
      factor, and anti-SSA, anti-SSB antibodies were done. Possible positive subjects
      were given eye and oral examinations for objective evidence of xerostomia and
      keratoconjunctivitis sicca. RESULTS: According to the Copenhagen criteria, the
      prevalence rate of primary Sjogren's syndrome in China was 0.77%, and it was
      0.33% by modified San Diego criteria. In 100 inpatients, we found 4 cases of
      primary Sjogren's syndrome by Copenhagen criteria, and one case by modified San
      Diego criteria. CONCLUSION: Primary Sjogren's syndrome is not a rare disease in
      China, but most cases are overlooked or misdiagnosed.

PMID- 7791158
TI  - Circulating interleukin 1 beta and soluble interleukin 2 receptor: evaluation as
      markers of disease activity in scleroderma.
AB  - OBJECTIVES: To investigate whether circulating levels of interleukin 1 beta (IL-1
      beta) or soluble interleukin 2 receptor (sIL-2R) reflect clinical disease status
      and response to therapy in scleroderma. METHODS: Plasma IL-1 beta and serum sIL
      2R were measured by ELISA in 19 patients with limited cutaneous scleroderma (9
      with extraesophageal internal organ involvement), 5 patients with diffuse
      cutaneous scleroderma and internal organ involvement, and 11 healthy controls, as
      well as serially over 12 months in 4 patients with scleroderma treated with
      cyclosporine. RESULTS: IL-1 beta levels were similar in scleroderma and control
      subject groups. sIL-2R levels were significantly higher in subjects with
      scleroderma involving internal organs (elevated in 93%), and correlated with
      erythrocyte sedimentation rate. sIL-2R levels decreased over 12 months in 2 of 4
      patients taking cyclosporine in whom other variables remained unchanged.
      CONCLUSIONS: Elevated serum sIL-2R is a marker of internal organ involvement in
      scleroderma and warrants further investigation in assessing disease prognosis and
      response to therapy.

PMID- 7791160
TI  - Limitations of invasive modalities in the diagnosis of primary angiitis of the
      central nervous system.
AB  - OBJECTIVE: Rheumatologists are often consulted to evaluate patients suspected of
      having primary angiitis of the central nervous system (PACNS). The diagnostic
      process relies heavily on interpreting the results of cerebral angiography and
      brain biopsy. We have assessed the operating characteristics of those invasive
      modalities in the diagnosis of PACNS: METHODS: The records of 30 consecutive
      patients referred for the evaluation of possible PACNS were retrospectively
      analyzed. Patients were evaluated on clinical grounds, and the diagnostic process
      was extended accordingly until a reasonable probability of a definable disease
      was present. All patients had cerebral angiography and/or brain biopsy. The
      sensitivity, specificity, positive predictive value (PPV), and negative
      predictive value (NPV) were assessed for each of the following diagnostic tests:
      cerebral angiography, brain biopsy, cerebrospinal fluid (CSF) examination, and
      magnetic resonance imaging (MRI). RESULTS: The final diagnostic outcomes were:
      PACNS in 7, lymphoproliferative disease in 4, infection in 4, demyelinating
      disease in 2, reversible vasospastic disorder in 6, and a variety of other
      nonvasculitic conditions in 7. Cerebral angiography had less than 30% specificity
      and PPV for PACNS: Brain biopsy had limited sensitivity and NPV (53% and 70%,
      respectively). CSF examination and MRI, although sensitive, lacked specificity.
      CONCLUSION: In patients suspected of having PACNS, the results of invasive
      diagnostic modalities should be interpreted with caution. Accurate diagnosis
      should rarely rely on any single study and should only follow careful clinical,
      radiographic and pathologic correlation.

PMID- 7791162
TI  - Clinical indicators of progression in psoriatic arthritis: multivariate relative
      risk model.
AB  - OBJECTIVE: To identify markers for severe disease in psoriatic arthritis (PsA).
      METHODS: Patients with PsA followed prospectively according to a standard
      protocol over 14 years were included. Clinical and laboratory assessments of both
      active inflammation and clinical damage were performed at 6-month intervals
      according to a standard protocol. The information was entered into a computer
      database. Progression in damage was defined as transitions between damage states
      based on the number of damaged joints. Both univariate and multivariate models
      were developed to identify predictors for progression of damage. RESULTS: The
      best model available, based on patient characteristics at the time of being first
      seen in the psoriatic arthritis clinic suggests that a high number of effusions
      and of past medications predicts progression in damage, whereas a low
      sedimentation rate "protects" from such progression. CONCLUSIONS: Evidence of
      significant inflammation at first visit predicts progression of damage in the
      future, suggesting that patients with PsA should be offered more aggressive
      treatment early in the course of their disease.

PMID- 7791161
TI  - Classification criteria for polymyositis and dermatomyositis.
AB  - OBJECTIVE: The establishment of classification criteria for polymyositis (PM) and
      dermatomyositis (DM). METHODS: Questionnaires inquiring about patients with DM,
      PM, systemic lupus erythematosus, progressive systemic sclerosis and
      noninflammatory neuromuscular diseases were distributed to the main medical
      institutes in Japan. Data were collected and analyzed by computer. RESULTS: Among
      skin lesions of DM, heliotrope rash, Gottron's sign and erythema or purpura on
      the extensor surfaces of the extremity joints were shown to be distinguishing
      criteria. In both DM and PM, proximal muscle weakness, muscle grasping and
      spontaneous pain, nondestructive arthritis or arthralgia, elevated CK or aldolase
      level, presence of systemic inflammatory signs, myogenic changes on EMG, positive
      and anti Jo-1 antibody and pathologic findings compatible with inflammatory
      myositis were distinguishing criteria items. CONCLUSION: When a patient satisfies
      one of 3 skin lesion items and at least 4 other items, he or she shall be
      classified as having DM, sensitivity 94.1%. When a patient satisfies at least 4
      items other than skin lesion items, he or she shall be classified as having PM,
      sensitivity 98.9%. Specificity of DM and PM is 95.2%.

PMID- 7791163
TI  - Gut inflammation in psoriatic arthritis: a prospective ileocolonoscopic study.
AB  - OBJECTIVE: Some forms of psoriatic arthritis (PsA) are classified as
      spondylarthropathy, and subclinical gut inflammation is found in
      spondylarthropathies. Our study was designed to determine if inflammatory gut
      lesions were also present in PsA, and if the prevalence of subclinical gut
      involvement was different in the subgroups of this disease. The relationship with
      HLA subtypes was also determined. METHODS: Ileocolonoscopy was performed on 64
      patients with PsA (37 men, 27 women). RESULTS: Inflammatory gut lesions were
      found in 10 of the 64 patients (16%): in 3 of the 15 patients (20%) with
      oligoarthritis and in 7 of the 23 patients (30%) with axial involvement. None of
      the 26 patients with polyarthritis showed these lesions. The prevalence of HLA
      B27, Bw62, and B17 was significantly raised in our total group of patients with
      PsA. HLA-B27 and Bw62 were significantly more prevalent in patients with gut
      inflammation, 60 and 50%, respectively. CONCLUSION: Gut inflammation is only
      present in PsA subgroups that belong to the spondylarthropathy concept. This
      suggests that the gut plays a role in the pathogenesis of locomotor inflammation
      in these subgroups. The prevalence of gut inflammation in psoriatic
      spondylarthropathy is significantly lower than in nonpsoriatic
      spondylarthropathies. Consequently, not only the gut but also the skin may be a
      portal of entry for causative antigens in PsA.

PMID- 7791164
TI  - Comparative evaluation of adsorption with E. coli on ELISA tests for Lyme
      borreliosis.
AB  - OBJECTIVE: To evaluate prospectively in a clinical setting the use of a soluble
      fraction of E. coli to adsorb nonspecific antibodies which can cause false
      positive ELISA tests for Lyme borreliosis. METHODS: The patient population tested
      was obtained from individuals referred to or initially presenting at a pediatric
      Lyme disease clinic in Wilmington, DE. Patients were followed for a minimum of 6
      months subsequent to primary presentation at the clinic. RESULTS: A total of 209
      met criteria for study inclusion, 93 of whom were diagnosed as having Lyme
      borreliosis and 116 of whom had other diagnoses. Results of ELISA tests were
      compared with different diagnoses and, when available, ELISA results from
      commercial laboratories. Findings indicate that some commercial laboratories have
      excessively high rates of false positive results (> 90% of positives were found
      to be false positives). CONCLUSION: Adsorption with E. coli antigens effectively
      removed antibodies causing false positive results including those occurring at
      commercial laboratories and did not cause any significant reduction in assay
      sensitivity.

PMID- 7791165
TI  - Clinical and serologic features of Lyme borreliosis in Russia.
AB  - OBJECTIVE: To describe clinical and serologic features of Lyme borreliosis,
      particularly the joint abnormalities, in Russian patients. METHODS: Physicians
      were invited to refer patients with past or present erythema migrans to the
      Rheumatology Institute in Moscow; field studies were done of residents in an area
      endemic for Lyme borreliosis, and a serosurvey was conducted of patients with
      nonspecific neurologic, cardiac, or joint symptoms. Serologic testing was done by
      ELISA and Western blotting using a strain of Borrelia afzelii, a member of the B.
      burgdorferi sensu lato complex, recovered from ticks from the field study site.
      RESULTS: Of 86 patients with erythema migrans, neurologic abnormalities developed
      in 26 (30%), cardiac involvement in 5 (6%), arthritis or arthralgia in 35 (41%),
      and acrodermatitis in 2 (2%). Joint involvement was usually characterized by one
      or a few brief episodes of joint swelling or pain in one large joint at a time.
      However, 69 of the 86 patients (80%) received antibiotic therapy early in the
      infection. The majority of patients with active infection had elevated levels of
      IgM or IgG antibody to B. afzelii by ELISA, and those with late infection often
      had IgG reactivity with > or = 5 spirochetal proteins, particularly the 37, 39,
      41, 60, and 93 kDa antigens. In a serosurvey of 75 patients with facial palsy,
      atrioventricular block, or arthritis or arthralgia of uncertain cause, 6 had IgG
      reactivity with > or = 5 spirochetal proteins. CONCLUSION: Lyme borreliosis in
      Russia is similar to that in other parts of Europe. Brief episodes of arthritis
      or arthralgia were a common feature of the illness.

PMID- 7791166
TI  - Lyme arthritis--a common manifestation in a highly endemic area in Sweden.
AB  - OBJECTIVE: To study the prevalence and the clinical features of Lyme arthritis in
      a Swedish area highly endemic for Lyme borreliosis. METHODS: Sera from 480 of 540
      individuals living in a tick endemic area on an island in southern Sweden were
      tested by ELISA for IgG antibodies against Borrelia burgdorferi. A questionnaire
      was completed at the time serum was obtained. Antibody positive individuals who
      reported joint pain were examined by the authors one year later. RESULTS: Of 90
      seropositive individuals, 34 (38%) reported symptoms of chronic or recurrent
      arthralgia. Of seronegative individuals from the same area 48/390 (12%) reported
      such complaints (p < 0.001). One year later one of the 34 seropositive patients
      with arthralgia had died and, of the remaining, 32 still had arthralgia. Lyme
      arthritis was diagnosed in 11/32 (35%) of these individuals corresponding to a
      prevalence of 2.3% (95% confidence interval: 1.0-3.6) in the population. The
      prevalence of other rheumatic disorders did not differ from that found in other
      areas in South Sweden. Clinical and laboratory findings were in agreement with
      previous reports of Lyme arthritis. Other manifestations of Lyme borreliosis were
      found in 6 of the 11 patients with Lyme arthritis. After antibiotic treatment
      9/11 (82%) remain free of complaints followed for 6 months or more. CONCLUSION:
      Our results indicate that arthritis and musculoskeletal symptoms of Lyme
      borreliosis are as common in highly endemic areas for Lyme borreliosis in Sweden
      as in similar areas in North America.

PMID- 7791167
TI  - Chondroitinase ABC affects the activity of intracellular enzymes in rabbit
      articular cartilage chondrocytes.
AB  - OBJECTIVE: To determine the response of intrachondrocytic enzymes to specific
      matrix proteoglycan depletion induced by nonproteolytic enzyme, i.e.,
      chondroitinase ABC. METHODS: The activity of uridine diphosphoglucose
      dehydrogenase, glucose-6-phosphate dehydrogenase, glyceraldehyde-3-phosphate
      dehydrogenase, lactate dehydrogenase, and succinate dehydrogenase in the patellar
      cartilage chondrocytes of postpubertal rabbit was measured cytochemically
      following a single intraarticular injection of chondroitinase ABC. RESULTS: Dose
      dependent depression of dehydrogenase activity of duration up to 14 weeks was
      detected in chondrocytes of all cartilage zones. CONCLUSION: Chondroitinase ABC
      induced marked proteoglycan depletion, which was not associated with light
      microscopy structural damage. The mechanism(s) by which chondroitinase ABC
      produces intracellular effects are unknown.

PMID- 7791168
TI  - Nonsteroidal antiinflammatory drug discontinuation in patients with
      osteoarthritis.
AB  - OBJECTIVE: To determine whether discontinuation patterns differed among
      nonsteroidal antiinflammatory drugs (NSAID) prescribed to treat osteoarthritis
      (OA). METHODS: In a retrospective cohort study of Health Maintenance Organization
      enrollees, 1405 patients with OA aged 45 and older who received a new
      prescription for one of 4 NSAID were followed for 12 months. Survival analysis
      was used to evaluate time to discontinuation, used here as a relative measure of
      both drug efficacy and tolerability. RESULTS: Rates of NSAID discontinuation
      during the study period were high; only 15 to 20% of those started on a study
      NSAID were still using the same drug at the end of the 12 month followup period.
      Using a proportional hazards model to adjust for covariates, the risk of
      discontinuation did not differ when comparing the agent with the longest duration
      of use, piroxicam (the referent), to enteric coated aspirin [relative risk (RR)
      1.10, 95% confidence interval (CI) 0.93 to 1.30]. Adjusted rates of
      discontinuation were significantly higher for ibuprofen (RR 1.43, 95% CI 1.22 to
      1.69) and for naproxen (RR 1.40, 95% CI 1.19 to 1.65) when compared to piroxicam.
      CONCLUSION: NSAID discontinuation rates are high among patients with OA and risk
      of discontinuation differed between NSAID, even after controlling for the effects
      of such variables as age, disease severity, and concomitant therapy.

PMID- 7791170
TI  - Cognitive behavioral treatment of fibromyalgia syndrome: a followup assessment.
AB  - OBJECTIVE: In a previous study, we showed that cognitive behavioral therapy (CBT)
      was effective in the short term treatment of fibromyalgia (FMS). We tested the
      hypothesis that a pooled index of 10 target psychometric outcomes would show
      overall improved outcome at longterm followup versus pretreatment. METHODS: Using
      a quasiexperimental design and validated psychometric instruments, we compared
      pretreatment psychometric variables with longterm outcomes in the 25 subjects who
      had completed the earlier study. A distinction was made between target variables
      the program had specifically addressed and nontarget variables not specifically
      addressed. RESULTS: Twenty-two subjects participated at a mean of 30 months after
      discharge from the program. As at short term followup, no nontarget variable
      changed from pretreatment to longterm assessment. The short term improvement that
      had been observed in all 10 target variables was maintained in 3 variables at a
      Bonferroni corrected alpha level of 0.005: worry, p < 0.001; observed pain
      behavior, p < 0.001; and control over pain, p < 0.002. All 10 target variables
      changed in the direction of improvement. A pooled index of these 10 variables
      showed statistically significant improvement from baseline (p < 0.002).
      CONCLUSION: Our results suggest that CBT may have a role in the longterm
      treatment of FMS.

PMID- 7791171
TI  - Fibromyalgia in rheumatology practice: a survey of Canadian rheumatologists.
AB  - OBJECTIVE: To determine the perceived proportion of fibromyalgia (FMS) among new
      consultations in rheumatology practices relative to other rheumatologic
      disorders. METHODS: We conducted a cross sectional random mail survey of 100
      Canadian rheumatologists. The sampling frame was the 1991 membership directory of
      the Canadian Rheumatology Association from which 100 nonpediatric rheumatologists
      practising in Canada were selected by stratified random sampling. RESULTS:
      Results from 89 respondents indicate that FMS is perceived to be one of the 3
      most common diagnoses among new patient consultations across Canada. Perceived
      incidence was not affected by urban size or university affiliation of practice.
      FMS was the only rheumatologic disorder believed by a majority of respondents to
      have increased in proportion over the past 5 years. CONCLUSION: In Canada, FMS
      appears to contribute to a high proportion of outpatient care in rheumatology.

PMID- 7791172
TI  - Measuring shoulder function with the Shoulder Pain and Disability Index.
AB  - OBJECTIVE: To extend the validity of the Shoulder Pain and Disability Index
      (SPADI) by (1) making it suitable for telephone administration; (2) determining
      its convergent validity with other health status measures; and (3) assessing the
      responsiveness of the SPADI to clinical change. METHODS: Consecutive primary care
      patients with shoulder discomfort were followed for 3 months. At enrollment, a
      detailed shoulder specific history was obtained by a trained research assistant,
      and the Health Assessment Questionnaire (HAQ), the Medical Outcomes Study SF-20
      (SF-20), and numeric and visual analog versions of the SPADI were completed by
      the patient. At 2, 4, and 12 weeks the numeric scaled SPADI was administered by
      telephone and patients rated globally the change in shoulder discomfort. RESULTS:
      One hundred and two subjects were enrolled; 96 completed at least one followup
      assessment and 75 completed all followup assessments. Subjects were men (98%),
      predominantly white (73%), with a median age of 60 years, and the majority had
      experienced shoulder discomfort for > 3 months (66%). At baseline the visual
      analog (VAS) and numeric scaled SPADI were highly concordant (intraclass
      correlation coefficient = 0.86), and the SPADI correlated substantially with the
      HAQ (r = 0.61) and the physical functioning (r = -0.50) and pain (r = -0.43)
      domains of the SF-20. The SPADI delta (baseline-followup) discriminated
      accurately between subjects who improved versus those who stayed the same or
      worsened [receiver operating characteristic cure, (ROC) = 0.91, likelihood ratio
      for improvement = 34]. CONCLUSION: The numerically scaled SPADI is highly
      correlated with the original VAS version of the SPADI and other measures of
      health status. The SPADI is responsive to change and accurately discriminates
      among patients who are improved or worsened.

PMID- 7791169
TI  - Protective effect of misoprostol on indomethacin induced renal dysfunction in
      elderly patients.
AB  - OBJECTIVE: To evaluate the possible protective effects of misoprostol on renal
      function in hospitalized elderly patients treated with indomethacin. METHODS:
      Forty-five hospitalized elderly patients (> 65 years old) who required therapy
      with nonsteroidal antiinflammatory drugs (NSAID) were randomly assigned to
      receive either indomethacin, 150 mg/day (Group A), or indomethacin 150 mg/day
      plus misoprostol at 0.6 mg/day (Group B). Laboratory variables of renal function
      [serum creatinine, blood urea nitrogen (BUN) and electrolytes] were evaluated
      before initiation of therapy and every 2 days, until termination of the study (a
      period of at least 6 days). Response to treatment was estimated by the visual
      analog scale for severity of pain. RESULTS: Forty-two patients completed the
      study, 22 in Group A and 20 in Group B. BUN and creatinine increased by > 50% of
      baseline levels in 54 and 45% of Group A patients, respectively, compared to only
      20 and 10% of Group B patients (p < 0.05). Potassium (K) increment of 0.6 mEq/l
      or more was observed in 50% of Group A, but in only 15% of Group B patients (p <
      0.05). The mean increments in BUN, creatinine, and K were reduced by 63, 80, and
      42%, respectively, in Group B patients compared to Group A. Response to treatment
      did not differ significantly between the 2 groups. CONCLUSION: Hospitalized
      elderly patients are at risk for developing indomethacin related renal
      dysfunction. Addition of misoprostol can minimize this renal impairment without
      affecting pain control.

PMID- 7791174
TI  - The Dunlop-Dottridge Lecture. Ankylosing spondylitis: defining disease status and
      the relationship between radiology, metrology, disease activity, function, and
      outcome.

PMID- 7791173
TI  - The impact of musculoskeletal disorders in the population: are they just aches
      and pains? Findings from the 1990 Ontario Health Survey.
AB  - OBJECTIVE: In light of the high frequency of symptoms of musculoskeletal (MSK)
      disorders in the population, our objective was to establish the impact of these
      disorders on morbidity and health care utilization. METHODS: Analysis of
      interview data from the 1990 Ontario Health Survey (sample size 45,650 from the
      household population age > or = 16 years) has provided one of the first
      opportunities to relate reported MSK morbidity to disability, illness duration,
      and use of health services. RESULTS: Overall, MSK disorders were reported as a
      cause of morbidity or health care utilization by 29% of the population aged > or
      = 16 years. The prevalence of chronic MSK disorders was 22%; this includes the 5%
      of the population who reported longterm disability due to MSK disorders. Of
      reported MSK disorders, 79% had a duration of over 6 months, and the median
      duration was 5 years. MSK disorders impact in the previous 2 weeks, defined as
      reduced activity or use of health care (seeing a health professional or taking
      prescription or nonprescription medication) specifically because of MSK
      disorders, was reported by 12% of the population, of whom 72% reported chronic
      MSK disorders. A health professional had been consulted within the previous year
      for 72% of the reported MSK disorders. The proportion with consultations was over
      80% for durations of one year or less, and remained over 50% for disease
      durations > or = 10 years. CONCLUSIONS: Reported MSK disorders cannot be
      dismissed as minor problems not requiring ongoing care in view of their long
      duration, disabling impact, and continuing consumption of health care services
      and resources.

PMID- 7791175
TI  - Epidemiology of juvenile rheumatoid arthritis in Manitoba, Canada, 1975-92:
      cycles in incidence.
AB  - OBJECTIVE: To determine the yearly incidence of juvenile rheumatoid arthritis
      (JRA) and to seek correlations between this and cyclic infections occurring in
      the province of Manitoba, Canada, during the same period. METHODS: An estimate of
      the incidence of JRA in Manitoba was determined from a disease registry of the
      Pediatric Rheumatology Clinic, Children's Hospital, Winnipeg. The numbers of
      confirmed Mycoplasma pneumoniae and viral respiratory infections were determined
      from annual reports of Cadham Provincial Laboratory. Both facilities provide
      centralized services for the province. RESULTS: Between 1975 and 1992 the onset
      of JRA occurred in 261 patients (136 with pauciarticular, 91 polyarticular, and
      34 systemic onset). The average annual incidence of JRA for this period was
      5.34/100,000. However, a cyclic incidence was apparent with peaks in 1979, 1982,
      1986, and 1990-91. Increases in confirmed M. pneumoniae infections were
      concurrent with peaks in the incidence of JRA. A significant correlation was
      found between the incidence of JRA and the number of M. pneumoniae infections
      detected in the province between 1985 and 1992 (R = 0.76, p = 0.044). In
      contrast, there was no consistent variation in the incidence of seronegative
      spondyloarthropathies in children (n = 103 patients). CONCLUSION: These data
      suggest the need for further study of a possible infectious etiology for JRA.

PMID- 7791177
TI  - Interpretation of immunoblot in pediatric Lyme arthritis.
AB  - OBJECTIVE: To determine the pattern of bands present on an immunoblot (Western
      blot) in children with Lyme arthritis. METHODS: Sera from 20 children with Lyme
      arthritis from an endemic area were assayed, and the results compared with those
      obtained in 162 control sera from the same area. The study was retrospective,
      serum bank based. RESULTS: Eighty-seven percent of control sera revealed no bands
      on immunoblot, and all had < or = 4 bands. All Lyme arthritis sera revealed > or
      = 5 bands (mean 8.4, range 5-13 bands). Bands of molecular weight 25, 28, 39, 47,
      50, and 93 kDa were seen in patients and not in controls. There was no
      correlation between duration of arthritis or activity of arthritis at
      presentation and number of bands present. CONCLUSION: Criteria were derived for a
      positive immunoblot based on the number and molecular weights of bands seen in
      our laboratory. These are the presence of 5 or more bands, of which at least one
      is an apparently specific band (25, 28, 39, 47, 50, or 93 kDa). Results of
      immunoblot are useful to confirm clinically suspected Lyme arthritis.

PMID- 7791176
TI  - Musculoskeletal disorders in juvenile onset mixed connective tissue disease.
AB  - OBJECTIVE: We studied the occurrence of musculoskeletal involvement in patients
      with juvenile onset mixed connective tissue disease (MCTD) and their functional
      ability. METHODS: Thirteen patients who fulfilled the Kasukawa criteria of MCTD,
      were subjected to a general orthopedic assessment, as well as to a specific
      examination of tenderness and swelling of joints, muscle strength, joint motion
      and alignment, radiographical evaluation, and on disability and discomfort.
      RESULTS: Low indices were found on the modified Ritchie Articular Index (RI)
      (0.07) and the Fuchs Swelling Index (0.13). Mild to moderate indices were
      measured on the Joint Alignment and Motion Scale (JAM) (0.52) and on the Larsen
      Radiographic Evaluation Scales for the wrist, metacarpal, proximal and distal
      interphalangeal joints (L-RES) (1.40, 0.62, 0.31, 0.31). The mean pulp-thickness
      ratio was 22%, which is an indication for sclerodermic changes in the hands.
      Proximal muscle weakness was found in 10/13 patients (mainly in the upper
      extremity), distal muscle weakness was found in 12/13 patients. On the pediatric
      version of the Stanford Health Assessment Questionnaire (C-HAQ), pain and
      discomfort scored 0.04, disability scored 0.46; those scores were considered to
      below. Between L-RES and JAM a significant correlation was found (0.74, 0.74 and
      0.73; p < 0.01). Another significant correlation was found between the RI and the
      disability score of the HAQ (0.58; p < 0.05). CONCLUSION: Sclerodermic changes as
      well as arthritic changes are of a benign character in our population of patients
      with juvenile onset MCTD.

PMID- 7791178
TI  - Pulmonary fibrosis and myositis in a child with anti-Jo-1 antibody.
AB  - This is the first report of a child with anti-Jo-1 antibody. At 10, she had a
      chronic cough, wheezing, dyspnea on exertion, a combined obstructive and
      restrictive ventilatory defect, and a decreased diffusion capacity compatible
      with alveolar fibrosis (lung biopsy). By age 12, she developed arthralgias, malar
      rash, frontal alopecia, Raynaud's phenomenon, and was seropositive for
      antinuclear antibodies, (SSA)Ro, Jo-1 and rheumatoid factor. At 16, symptomatic
      inflammatory myositis (elevated creatinine kinase, muscle biopsy) was documented
      with persistent anti-Jo-1. Her pulmonary symptoms have progressed despite
      appropriate therapy. Although her digits have become sausage shaped with swan
      neck deformities, joint pain is not frequent.

PMID- 7791179
TI  - Parvovirus B19 associated monoarthritis in a 5-year-old boy.
AB  - We describe the case of a 5-year-old boy who presented with parvovirus B19
      associated arthritis of the left knee lasting for 6 weeks. Other features
      included flu-like symptoms, a mild "slapped cheek" sign, and a macular,
      erythematous, lace-like rash over the chest and limbs. The analysis of the
      synovial fluid showed a high white cell count with a predominance of
      polymorphonuclear cells. The characteristic features related to parvovirus B19
      associated arthropathy in children are reviewed.

PMID- 7791180
TI  - Fatal myocardial infarction in an 8-year-old girl with systemic lupus
      erythematosus, Raynaud's phenomenon, and secondary antiphospholipid antibody
      syndrome.
AB  - An 8-year-old black girl with a 5 month history of systemic lupus erythematosus
      (SLE) and secondary antiphospholipid syndrome (APS) developed Raynaud's
      phenomenon, marked hemolytic anemia, and a fatal myocardial infarction (MI).
      Pathologic evaluation of the heart demonstrated a transmural acute MI associated
      with a recent thrombus of the circumflex coronary artery, thrombosis of small
      intramural arteries, and a coronary arteriopathy resembling fibromuscular
      dysplasia. Inflammatory or atherosclerotic changes of the coronary arteries were
      distinctly absent. This case represents the youngest reported patient with SLE,
      MI, and pathologic confirmation of nonatheromatous coronary artery disease. The
      observed coronary pathological findings may have accentuated the thrombogenic
      potential of the APS, resulting in coronary thrombosis. Cardiac lesions in SLE
      and APS are reviewed, and pathogenetic considerations for the coronary
      vasculopathy are discussed.

PMID- 7791181
TI  - Bilateral juvenile temporal arteritis.
AB  - Juvenile temporal arteritis (JTA) is an uncommon nongiant cell arteritis of the
      superficial temporal artery occurring exclusively in older children and young
      adults without a history of trauma or evidence of systemic disease or localized
      symptoms. Of the 6 cases reported to date, there has been no recurrence after a
      simple surgical excision of the nodular artery for cosmetic reasons. We describe
      the first known case of bilateral JTA in a 21-year-old man and differential
      diagnoses are discussed to distinguish JTA from the classic giant cell (temporal)
      arteritis of the elderly, which requires corticosteroid drug treatment.

PMID- 7791182
TI  - Progressive multifocal leukoencephalopathy in a patient with rheumatoid arthritis
      and polymyositis.
AB  - We describe a young woman who developed postpartum rheumatoid arthritis,
      polymyositis and small vessel cerebrovascular disease. Subsequently she developed
      biopsy proven progressive multifocal leukoencephalopathy (due to JC virus
      infection) which may have been a complication of her immunosuppression. This rare
      complication of autoimmune rheumatic diseases is discussed.

PMID- 7791183
TI  - Central nervous system angiopathy associated with cocaine abuse.
AB  - Cocaine abuse has been associated with various cerebrovascular complications,
      including vasculitis. We describe a patient who presented with neurologic defects
      associated with cocaine abuse. Although angiography raised the suggestion of
      vasculitis, biopsy revealed a lack of inflammatory changes, and other aspects of
      the clinical course also militated against inflammatory vasculitis. This case was
      reminiscent of recently described patients initially suspected of having primary
      central nervous system (CNS) vasculitis but subsequently considered to have
      "benign angiopathy." We suggest that benign angiopathy of the CNS can occur as a
      result of cocaine abuse.

PMID- 7791184
TI  - Posttraumatic reflex sympathetic dystrophy anteceding inverse psoriasis and
      psoriatic arthritis.
AB  - We describe a patient wit posttraumatic reflex sympathetic dystrophy involving
      the right hand who subsequently developed inverse psoriatic skin lesions and
      psoriatic arthritis in the injured hand as well as in other joints.

PMID- 7791185
TI  - Listeria monocytogenes infection in a patient treated with methotrexate for
      rheumatoid arthritis.
AB  - We describe a patient with rheumatoid arthritis who developed bacteremia from
      Listeria monocytogenes after treatment with low dose oral pulse methotrexate. We
      discuss possible immunologic mechanisms for susceptibility to Listeria
      infections. As the elderly population increases with more frequent use of
      immunosuppressive medications, clinical suspicion must be maintained to correctly
      diagnose and treat infections such as Listeria.

PMID- 7791186
TI  - The clinical and research significance of the erythrocyte sedimentation rate.

PMID- 7791187
TI  - Extraarticular manifestations during methotrexate therapy for rheumatoid
      arthritis.

PMID- 7791188
TI  - Demography of a regional pediatric rheumatology patient population.

PMID- 7791189
TI  - Antineutrophil cytoplasmic autoantibodies in systemic sclerosis with renal
      failure.

PMID- 7791190
TI  - Myasthenia gravis and scleroderma.

PMID- 7791191
TI  - Norfloxacin induced arthralgia.

PMID- 7791192
TI  - Sex ratios and age at onset in probands and secondary cases in the
      spondyloarthropathies.

PMID- 7791193
TI  - Rheumatic diseases in China.

PMID- 7791194
TI  - Listeriosis in patients with connective tissue disease.

PMID- 7791195
TI  - Gynecomastia following low dose methotrexate therapy for rheumatoid arthritis.

PMID- 7791197
TI  - Fatal disseminated herpes simplex II infection in a patient with systemic lupus
      erythematosus.

PMID- 7791196
TI  - Evidence for bone resorption in systemic sclerosis.

PMID- 7791199
TI  - Cardiac valve replacement and antiphospholipid antibodies.

PMID- 7791198
TI  - Successful use of nitrogen mustard for cyclophosphamide resistant diffuse
      proliferative lupus glomerulonephritis: report of 2 cases.

PMID- 7791200
TI  - Propylthiouracil therapy: an unusual cause of antineutrophil cytoplasmic antibody
      associated alveolar hemorrhage.

PMID- 7791201
TI  - Bubonic plague: doubts and diagnoses.

PMID- 7791202
TI  - Evidence of Pneumocystis carinii in cell line cultures infected with peripheral
      blood mononuclear cells isolated from AIDS patients with P. carinii pneumonia.
AB  - The detection of Pneumocystis carinii was investigated in an in-vitro system
      consisting of a human lung epithelial cell line (A-549) inoculated with infected
      peripheral blood mononuclear cells (PMBC) from HIV-infected patients with proven
      or suspected P. carinii pneumonia (PCP), and from HIV-negative patients with
      other lung infections. Supernates from cultures were sampled daily and evaluated
      for the presence of P. carinii by Giemsa and immunofluorescence staining. P.
      carinii was isolated from 98 (95.1%) of 103 culture supernate samples from
      patients with proven pneumocystosis and 45 (66.1%) of 68 from patients with
      suspected PCP 40 or 72 h after PBMC inoculation. This system has been shown to
      support the growth of P. carinii but did not seem to be adequate for the
      production of large numbers of organisms, although long-term survival in vitro
      for up to 3 weeks was observed. Recovery of P. carinii from infected PBMC
      strongly supports previous observations about its ability to disseminate
      haematogenously and could represent a further advance in understanding the
      pathogenesis and diagnosis of PCP.

PMID- 7791203
TI  - Presence of lysogenic phage in the outbreak strains of Vibrio cholerae O139.
AB  - Four outbreak strains of Vibrio cholerae O139 from endemic areas of India and
      Bangladesh were found to carry lysogenic phage(s). All of these phage(s) produced
      turbid plaques characteristic of lysogeny on V. cholerae MAK 757 (El Tor, Ogawa)
      cells as well as on their VcA-1 lysogens but were unable to infect V. cholerae
      154 (classical) cells, the universal host for all classical phages. Colonies in
      the turbid plaques were O139 lysogens and these developed an auxotrophic
      requirement, mainly for purines suggesting the integration of the prophage into
      the host chromosome. The immunity profile of the O139 phage(s) was similar to
      that of phage alpha but differed in the sensitivity of the phage lysogen of V.
      cholerae MAK 757 to subsequent infection by phage beta.

PMID- 7791204
TI  - Genotyping of Shiga-like toxin genes in non-O157 Escherichia coli strains
      associated with haemolytic uraemic syndrome.
AB  - The pheno- and genotypes of Shiga-like toxins (SLTs) in non-O157 Escherichia coli
      strains from patients with haemolytic uraemic syndrome were determined. The
      clinical isolates investigated were from Italy and Germany and belonged to
      serotypes O22:H8, O26:H-, O26:H11, O91:H-, O111:H- and O128:H-; one isolate was
      non-typable. SLT genotypes were analysed by complete nucleotide sequence analysis
      of the B-subunit genes. The results showed that 14 strains possessed slt-I alone,
      two contained slt-II alone and five isolates harboured both slt-I and slt-II
      genes. In only two strains were slt-II-related genes found, together with either
      slt-I or slt-II. These findings indicate that variants of SLT-II are rarely found
      in non-O157 E. coli isolates from patients with haemolytic uraemic syndrome.
      Polymerase chain reaction (PCR) with Taq cycle sequencing was found to be a
      suitable method for classification of slt genotypes.

PMID- 7791205
TI  - Human immunodeficiency virus type-1 can be detected in monocytes by polymerase
      chain reaction.
AB  - Lymphocytes and monocytes from 25 patients infected with human immunodeficiency
      virus type-1 (HIV-1)--13 asymptomatic, seven with the AIDS-related complex (ARC)
      and five with the acquired immunodeficiency syndrome (AIDS)--were lysed and
      subjected to PCR with three primer pairs: SK38/SK39 (gag), SK68/SK69 (env) and
      SK29/SK30 (LTR). Amplified DNA was solution-hybridised with 32P-labelled probes
      (SK19, SK70 and SK31, respectively) and detected by PAGE-autoradiography. HIV-1
      DNA was detected as follows. Asymptomatic patients: monocytes--gag 61.5%, env
      100%, LTR 0%; lymphocytes--gag 100%, env 92.3%, LTR 53.84%. ARC patients:
      monocytes--gag 71.4%, env 57.1%, LTR 0%; lymphocytes--gag 100%, env 71.4%, LTR
      71.4%. AIDS patients: monocytes--gag 80.0%, env 100%, LTR 0%; lymphocytes--gag
      100%, env 60%, LTR 60%. The presence of HIV-1 DNA was confirmed in the monocyte
      fraction. In this cell subset, the env gene-directed primers were the most
      effective for amplification, whereas the LTR gene-directed primers failed to
      amplify HIV-1 DNA. The different pattern of amplification found in monocytes may
      suggest that these cells could be infected by a genetic variant of the virus.

PMID- 7791206
TI  - Electronmicroscopic investigation of the effects of biocides on Pseudomonas
      aeruginosa PAO bacteriophage F116.
AB  - Electronmicroscopy was used to observe morphological changes of the Pseudomonas
      aeruginosa PA0 bacteriophage F116 when treated with various biocides commonly
      used as antibacterial and antifungal agents. Because of its large size (145 nm)
      and its organised structure (an isometric head and a tail), it was possible to
      classify structural damage into eight categories. The morphological changes
      induced depended on the type of biocide used and its concentration.
      Glutaraldehyde increased the number of phages with empty heads. Peracetic acid
      and phenol altered the appearance of the viral genome packaged inside the head,
      produced fractured heads, and damaged the tail. Peracetic acid also induced
      folding of the phage heads. The alcohols tested also altered the head structure.
      Cetylpyridinium chloride induced mainly fractured head damage. Chlorhexidine had
      little effect on the structure of F116.

PMID- 7791207
TI  - Antibiotic susceptibility of Mycoplasma fermentans strains from various sources
      and the development of resistance to aminoglycosides in vitro.
AB  - Mycoplasma fermentans strains reputedly from human infections or tissue culture
      cells were much more susceptible to azithromycin than to clarithromycin or
      erythromycin. Lincomycin, clindamycin and several tetracyclines also exhibited
      good mycoplasmastatic activity but mycoplasmacidal concentrations were
      substantially greater than the MICs. Ciprofloxacin was the most active of three
      fluoroquinolones tested and was mycoplasmacidal at concentrations close to the
      MIC. Tiamulin and mupirocin were also very active. Synergy with specific M.
      fermentans antiserum plus guinea-pig complement was not observed with any class
      of antibiotic although the number of viable mycoplasmas was markedly reduced by
      the combined immunological components. Marked differences in susceptibility to
      various aminoglycosides were observed. Human strains isolated in cell-free media
      up to 1967 were aminoglycoside susceptible (MIC range 0.5-25 mg/L) but recent
      human isolates and strains isolated from tissue culture cells often showed either
      single or multiple aminoglycoside resistance (MIC > 500 mg/L). Two aminoglycoside
      susceptible strains developed resistance to streptomycin or neomycin (> 500 mg/L)
      within five passages in broth containing streptomycin or neomycin, respectively.
      Resistance to tobramycin, kanamycin or gentamicin emerged after seven, eight and
      14 cycles of exposure to the respective antibiotic. Streptomycin resistance was
      associated with a five-fold increase in resistance to tobramycin. Neomycin-,
      kanamycin-, gentamicin- and tobramycin-resistant variants showed mutual cross
      resistance but remained susceptible to streptomycin. Induced resistance persisted
      for at least 17 passages in aminoglycoside-free broth. The use of aminoglycosides
      in human medicine and the frequent inclusion of some of these drugs in tissue
      cell cultures to combat bacterial and mycoplasmal contamination might account for
      the aminoglycoside resistance of recent M. fermentans isolates.

PMID- 7791208
TI  - Back mutations to the TEM-1 beta-lactamase from TRC-1 lead to restored
      sensitivity to clavulanic acid.
AB  - Back mutations from the TRC-1 beta-lactamase to the TEM-1 enzyme were selected in
      vitro. The revertant beta-lactamase was obtained from Escherichia coli strain
      J62.2 carrying plasmid pUK901 which encodes the TRC-1 beta-lactamase. The
      revertant was obtained after repeated subculture of E. coli J62.2 (pUK901) in
      amoxycillin 512 mg/L for 5 days. The revertant beta-lactamase had the same pI as
      TEM-1 (5.4) and had restored inhibition by clavulanic acid (ID50 reduced from 4.2
      microM to 0.15 microM). The prevalence of these beta-lactamases in the clinical
      population may be the result of a two-way flux, with mutations in both forward
      and backward directions.

PMID- 7791209
TI  - Experimental Legionnaires' disease in SCID-Beige mice reconstituted with human
      leucocytes.
AB  - A new small animal model of experimental Legionnaires' disease is described in
      which the reconstitution of SCID-Beige mice with human peripheral blood
      leucocytes permits the in-vivo growth of Legionella pneumophila in the lungs of
      aerosol-challenged mice. Following infection, viable bacterial counts within the
      lungs of mice increased from 10(5) cfu/lung at the time of inoculation to a
      maximum of 10(10) cfu/lung by 48 h post-inoculation. Two types of disease were
      detected in the lungs of infected SCID-Beige mice. An acute exudative
      bronchiolitis and bronchopneumonia were seen in the most severely affected mice
      and, in the less severely affected mice, lesions of subacute or chronic disease
      were seen with thickening of alveolar walls and consolidation of lung tissue.
      Human cells did not appear to be involved directly in the pathology but were
      required for the establishment of infection. Immunohistological staining of lung
      tissue revealed substantial amounts of bacterial antigen distributed in a pattern
      similar to that seen in human Legionnaires' disease.

PMID- 7791210
TI  - Identification and typing of pyogenic streptococci by enzyme electrophoretic
      polymorphism.
AB  - Polyacrylamide-agarose gel electrophoresis was used to study polymorphism of
      lactate dehydrogenase (LDH), nucleoside phosphorylase (NSP), phosphoglucose
      isomerase (PGI), hydroxybutyrate dehydrogenase (HBD), adenylate kinase (ADK) and
      esterases of 44 strains of Streptococcus pyogenes, 25 group G streptococcal
      strains, 11 "S. equisimilis" strains, seven S. dysgalactiae strains, four S.
      canis strains, three S. equi strains and seven S. zooepidemicus strains. Analysis
      of LDH, NSP, PGI, HBD and ADK provided valuable interspecies differentiation, by
      showing that four groups of strains corresponded to the four known DNA homology
      groups. Esterases showed greater intraspecies variation than the other enzymes.
      The combined analysis of the six enzymes indicated 31 zymotypes among S.
      pyogenes, 14 in group G streptococci and 11 in "S. equisimilis" strains. This was
      shown to be an effective technique for typing pyogenic streptococci.

PMID- 7791211
TI  - Crystal structure of the human cell cycle protein CksHs1: single domain fold with
      similarity to kinase N-lobe domain.
AB  - The structure of the human CksHs1 homolog of the yeast cell-cycle regulatory
      proteins suc1 and CKS1, which bind to the catalytic subunit of the cyclin
      dependent kinases (Cdks) and are essential for yeast cell-cycle progression in
      vivo, has been determined at 2.9 A resolution. The CksHs1 single polypeptide
      domain fold, which consists of a four-stranded beta-sheet flanked by two alpha
      helices, is dramatically different from the subunit conformation and assembly of
      the homologous CksHs2, but strikingly similar to the Cdk N-lobe domain fold. The
      CksHs1 structure identifies sequence-conserved residues Glu61 to His65 as a novel
      beta-hinge region that folds back to form a beta-hairpin with CksHs1 subunit,
      whereas this hinge is unfolded to form an extended beta-strand exchange between
      two CksHs2 subunits. Phosphate and the phosphate analog metavanadate bind CksHs1
      in a shallow pocket and interact with five conserved residues (Lys11, Arg20,
      Ser51, Trp54 and Arg71) suggesting a specific Cks recognition site for a
      phosphorylated Cdk residue. The dramatic changes to the Cks fold, assembly and
      exposed conserved surface brought about by switching between the bent and
      extended hinge conformations are potentially important for the functions of this
      Cks homolog and could explain conflicting activities inferred from different
      types of genetic experiments.

PMID- 7791212
TI  - Phage T4-coded Stp: double-edged effector of coupled DNA and tRNA-restriction
      systems.
AB  - The optional Escherichia coli prr locus encodes two physically associated
      restriction systems: the type IC DNA restriction-modification enzyme EcoprrI and
      the tRNA(Lys)-specific anticodon nuclease, specified by the PrrC polypeptide.
      Anticodon nuclease is kept latent as a result of this interaction. The activation
      of anticodon nuclease, upon infection by phage T4, may cause depletion of
      tRNA(Lys) and, consequently, abolition of T4 protein synthesis. However, this
      effect is counteracted by the repair of tRNA(Lys) in consecutive reactions
      catalysed by the phage enzymes polynucleotide kinase and RNA ligase. Stp, a short
      polypeptide encoded by phage T4, has been implicated with activation of the
      anticodon nuclease. Here we confirm this notion and also demonstrate a second
      function of Stp: inhibition of EcoprrI restriction. Both effects depend, in
      general, on the same residues within the N-proximal 18 residue region of Stp. We
      propose that Stp alters the conformation of EcoprrI and, consequently, of PrrC,
      allowing activation of the latent anticodon nuclease. Presumably, Stp evolved to
      offset a DNA restriction system of the host cell but was turned, eventually,
      against the phage as an activator of the appended tRNA restriction enzyme.

PMID- 7791213
TI  - Immunity determinant of phage-plasmid P4 is a short processed RNA.
AB  - In the phage-plasmid P4, both lysogenic and lytic functions are coded by the same
      operon. Early after infection the whole operon is transcribed from the
      constitutive promoter PLE. In the lysogenic condition transcription from PLE
      terminates prematurely and only the immunity functions, which are proximal to the
      promoter, are thus expressed. Fragments of the P4 immunity region were cloned in
      an expression vector. A DNA fragment as short as 91 bp was sufficient, when
      transcribed, to express P4 immunity and to complement P4 immunity deficient
      mutants. This fragment, like prophage P4, produced a 69 nt long RNA (CI RNA). A
      shorter P4 fragment neither expressed immunity nor synthesized the CI RNA. Thus
      the CI RNA is the P4 trans-acting immunity factor. The 5' end of the CI RNA,
      mapped by primer extension, does not correspond to the transcription initiation
      point, thus suggesting that the CI RNA is produced by processing of the primary
      transcript. In an RNase P mutant host the processing of the 5' end and the
      production of a functional CI RNA were impaired. The requirement of RNase P for
      the correct processing of CI appears to be related to the predicted secondary
      structure of the precursor CI RNA. A region (seqB) within the CI RNA shows
      complementarity with two cis-acting sequences (seqA and seqC) required for P4
      immunity, suggesting that transcription termination may be caused by pairing of
      the CI RNA with the complementary target sequences on the nascent transcript.

PMID- 7791214
TI  - Differential regulation of Hox C6 in the appendages of adult urodeles and
      anurans.
AB  - Morphogenesis and pattern formation are biological processes that rely on the
      expression of positional determinants to divide the embryo into compartments. Hox
      genes are among the selector genes that direct the mechanism of positional
      information. Here we report the molecular structure and pattern of expression of
      a new Hox C6 transcript in the adult newt. Molecular analysis showed that the
      gene transcribes a long primary transcript in both limb and tail regeneration
      territories and subsequently uses maturation events to produce two RNAs that
      share the same DNA binding domain and differ in their 5' extremity. Both RNAs
      were found in the limb and showed a proximal-distal gradient of expression. The
      tail sample showed accumulation of only one Hox C6 transcript. These results
      suggest that both transcriptional and post-transcriptional regulations are
      involved in the appendage-specific expression of Hox C6 in the adult newt.
      Finally, the adult frog, which has lost its regeneration capacity, also post
      transcriptionally regulates the expression of Hox C6 in its appendages.

PMID- 7791215
TI  - Nag repressor-operator interactions: protein-DNA contacts cover more than two
      turns of the DNA helix.
AB  - The NagC repressor binds to two sites in the intergenic nagE-B region overlapping
      the divergently expressed nagE and nagB promoters. In addition the NagC repressor
      binds to two sites upstream of the manXYZ operon. Although basically palindromic,
      there is little sequence consensus between the four operators. To identify the
      DNA sequence important for NagC recognition, we have taken advantage of the fact
      that repression of the nagE and nagB genes requires the formation of a loop of
      DNA between molecules of the repressor bound to the nagE and nagB operators. The
      nagE operator was systematically mutagenised and the effect of the mutations
      measured on the level of expression from a nagB-lacZ fusion. These experiments
      showed that the most important positions for recognition are the two A.T base
      pairs at positions-5 and -6 from the centre of symmetry. These are the only
      absolutely conserved bases in the four operators. Certain changes of residues at
      position -3 and -4 have fairly strong effects while changes at -7 to -10 have
      only minor effects. However the presence of a G or C base at positions + 11 or 
      11 produces a NagC binding site with considerably higher affinity than the wide
      type nagE operator both in vitro and in vivo, a "super-operator". The presence of
      a super-operator considerably increased the stability of the binary looped NagC
      DNA complex in vitro. However in the presence of cAMP/CAP, NagC showed the same
      apparent binding affinity to wild-type and super-operators indicating that one
      role of cAMP/CAP in the repression complex is to reduce the need for high
      affinity sites. These super-operators allow a higher level of repression of the
      nagE promoter compared to the nagB, presumably due to the existence of linear
      complexes of NagC bound to BoxE.

PMID- 7791216
TI  - N-2-aminofluorene and N-2 acetylaminofluorene adducts: the local sequence context
      of an adduct and its chemical structure determine its replication properties.
AB  - The strong rat liver carcinogen, N-2-acetylaminofluorene, forms mainly two types
      of guanine adducts at the C-8 position, the acetylaminofluorene adduct (dGuo-C8
      AAF) and the aminofluorene adduct (dGuo-C8-AF). We have constructed different
      oligonucleotides bearing a single AF lesion at each of the guanine residues of
      the NarI mutagenesis hot spot (G1G2CG3CC) and analysed the structural distortion
      induced by this DNA adduct according to the sequence context. At position G1 and
      G2, the deformation induced by the AF adduct is smaller than the deformation
      induced by the corresponding acetylated form of this adduct (i.e. the AAF adduct
      at the G1 and G2), whereas both AF and AAF adducts induce a similar structural
      change when bound to G3. Single-stranded oligonucleotides modified with AF
      adducts were used in primer extension replication assays using purified DNA
      polymerases (PolIII holoenzyme, Klenow fragment (exo+ and exo-), Sequenase 2.0)
      and the data compared to the AAF containing substrates. Translesion synthesis
      (complete bypass) is found with all tested polymerases when AF adducts are bound
      to G1 or G2 while little or no bypass is seen when the AF adduct is bound to G3.
      On the other hand, irrespective of its position within the NarI sequence, AAF
      adducts completely block DNA synthesis. The results described in this paper show
      that the sole knowledge of the chemical structure of an adduct neither determines
      uniquely the conformational change it induces at the DNA level nor its
      replication properties. Indeed, although AF adducts are in most cases non
      distorting adducts and as a consequence non-replication blocking lesions (as
      exemplified by adducts at G1 or G2), some AF adducts (as at position G3) behave
      almost as AAF adducts in terms of the structural distortion induced and its
      replication blocking property. These findings stress the strong modulation by the
      local sequence context of the structural and biological consequences of a given
      adduct.

PMID- 7791217
TI  - The action of Escherichia coli endonuclease III on multiply damaged sites in DNA.
AB  - Energy deposition by ionizing radiation can lead to the formation of clustered
      DNA damage, i.e. more than one lesion situated within a helical turn of DNA.
      Among the postulated lesions are those characterized by damaged bases and abasic
      sites on opposite strands. Enzymatic removal of such lesions may inadvertently
      lead to the formation of double-strand breaks. To test this hypothesis, we have
      constructed model substrates containing damaged bases (5,6-dihydrothymine) or
      abasic sites set one, three, five and seven bases apart on opposite strands, and
      examined the reactivity of Escherichia coli endonuclease III towards these
      substrates. Endonuclease III demonstrates two activities; as a glycosylase that
      removes saturated pyrimidine bases, such as dihydrothymine, and as an AP lyase
      that cleaves DNA strands at abasic sites. Analysis of endonuclease III-treated
      dihydrothymidine containing plasmid DNA by agarose gel electrophoresis indicated
      that the enzyme generated only single-strand breaks when the base damage was set
      one and three base-pairs apart, and only slowly introduced double-strand breaks
      in the other substrates. Endonuclease III treatment of the abasic site-containing
      DNA, however, readily yielded double-strand breaks. Taken together, these results
      indicate that the glycosylase activity of the enzyme, but not the AP lyase
      activity, is inhibited by the presence of a closely positioned break in the
      opposite strand.

PMID- 7791218
TI  - Predicting Pol II promoter sequences using transcription factor binding sites.
AB  - A computer program, PROMOTER SCAN, has been developed to recognize a high
      percentage of Pol II promoter sequences while allowing only a small rate of false
      positives. A total of 167 primate Pol II promoter sequences, obtained from the
      Eukaryotic Promoter Database, and 999 primate non-promoter sequences, obtained
      from the GenBank sequence databank, were used in the analysis. Both promoter and
      non-promoter sequences were analyzed for the comparative density of each unique
      mammalian transcription factor binding site listed in the Ghosh Transcription
      Factor Database. The density of each of these binding sites was then used to
      derive a ratio of density of each transcriptional element in promoter compared to
      non-promoter sequences. The combined individual density ratios of all binding
      sites were then collectively used to build a scoring profile called the Promoter
      Recognition Profile. This profile, used in combination with a weighted matrix for
      scoring a TATA box, was then used by the PROMOTER SCAN program to test the
      prediction of promoter sequences and the ability of the computer program to
      discriminate them from non-promoter sequences. When the promoter cutoff score was
      set so that 70% of promoters were recognized correctly by the program, a false
      positive rate of about 1/5600 bases was observed in the non-promoter sequence
      set. PROMOTER SCAN is now being developed for public distribution.

PMID- 7791219
TI  - Crystal structure of Proteus mirabilis PR catalase with and without bound NADPH.
AB  - A catalase from a peroxide resistant mutant of Proteus mirabilis binds NADPH
      tightly. Interestingly, this enzyme can be stripped of NADPH without loss of the
      catalatic activity. It is the only known non-mammalian catalase able to bind
      NADPH. The structure without cofactor was solved by molecular replacement using
      the structure of beef liver catalase as a model. The structure was refined to an
      R-factor of 19.3% in the range 8 to 2.2 A resolution. According to the sequence,
      a methionine sulphone was positioned in the haem active site. This oxidized form
      of methionine is particular to Proteus mirabilis catalase and likely to produce
      some steric hindrance in the active site. Two important water molecules are
      positioned in the haem distal site. These two water molecules are not located in
      the structure of beef liver catalase, but are supposed to account for the
      catalytic mechanism. The liganded form was obtained by soaking crystals of the
      unliganded form into an NADPH solution. The structure was refined to an R-factor
      of 15.9% in the range of 8 to 3.1 A resolution using the unliganded structure as
      a model. The NADPH was clearly located in the electron density map with the same
      conformation as in beef liver catalase. The NADPH binding induces slight
      structural changes. However, the imidazole ring of a histidine residue (His284)
      rotates about 50 degrees to accommodate the cofactor. The electron transfer from
      NADPH to the haem molecule was examined and several pathways are proposed.

PMID- 7791220
TI  - Computer modelling of the alpha-helical coiled coil: packing of side-chains in
      the inner core.
AB  - In order to predict the structure of alpha-helical coiled-coil proteins from
      their sequences, it is necessary to know how the side-chains pack in the
      interface between the alpha-helical strands. Since in alpha-fibrous proteins
      leucine is the most common residue at both the a and d positions of the heptad
      repeat, which form the inner core of the interface, we determined the lowest
      energy conformation for a two-stranded coiled-coil with the sequence (LAALAAA)5.
      Coiled-coils were constructed using the Crick equations with a range of pitches,
      major helical radii and relative rotations of the two strands, and with different
      starting side-chain conformations. On energy minimisation, convergence occurred
      to a small number of structures. The lowest-energy coiled-coil had 2-fold
      rotational symmetry, an average pitch of 131 A and an average radius of 4.52 A;
      the leucine side-chain conformations were tt and g+t at the a and d positions.
      This coiled-coil was used as a former to determine the lowest-energy side-chain
      conformations for the 63 combinations of a and d residues that occur in the
      repeating heptad sequence of rat skeletal myosin. The leucine residues at the a
      and d positions of the central heptad were replaced by the a-d pair of interest
      and molecular dynamics simulations performed to allow the side-chains of these
      residues to explore conformational space. The lowest-energy side-chain
      conformation of a residue at an a or d position depends on the nature of the
      partnering residue, consistent with the fact that these side-chains pack against
      one another. In most cases the lowest-energy structure was symmetric but in a few
      cases the side-chains were asymmetrically disposed in the two strands. The local
      pitch is very sensitive to the nature of the residues in the inner core and
      varies over a twofold range. In contrast, the radius and relative rotation of the
      two strands were relatively insensitive to sequence.

PMID- 7791221
TI  - Cancer causes revisited: human papillomavirus and cervical neoplasia.

PMID- 7791222
TI  - Colony-stimulating factors and neutropenia: intersection of data and clinical
      relevance.

PMID- 7791223
TI  - Managed care brings major changes to cancer care.

PMID- 7791224
TI  - Getting a handle on ASCUS: a new clinical trial could show how.

PMID- 7791225
TI  - Novel technologies for cervical cancer screening seen on the horizon.

PMID- 7791227
TI  - Many Italian researchers say they can't go home again.

PMID- 7791226
TI  - Monkey diet may hold clues for finding anti-HIV drugs.

PMID- 7791228
TI  - New cancer strategies needed for changing population.

PMID- 7791229
TI  - Prevalence of human papillomavirus in cervical cancer: a worldwide perspective.
      International biological study on cervical cancer (IBSCC) Study Group.
AB  - BACKGROUND: Epidemiologic studies have shown that the association of genital
      human papillomavirus (HPV) with cervical cancer is strong, independent of other
      risk factors, and consistent in several countries. There are more than 20
      different cancer-associated HPV types, but little is known about their geographic
      variation. PURPOSE: Our aim was to determine whether the association between HPV
      infection and cervical cancer is consistent worldwide and to investigate
      geographic variation in the distribution of HPV types. METHODS: More than 1000
      specimens from sequential patients with invasive cervical cancer were collected
      and stored frozen at 32 hospitals in 22 countries. Slides from all patients were
      submitted for central histologic review to confirm the diagnosis and to assess
      histologic characteristics. We used polymerase chain reaction-based assays
      capable of detecting more than 25 different HPV types. A generalized linear
      Poisson model was fitted to the data on viral type and geographic region to
      assess geographic heterogeneity. RESULTS: HPV DNA was detected in 93% of the
      tumors, with no significant variation in HPV positivity among countries. HPV 16
      was present in 50% of the specimens, HPV 18 in 14%, HPV 45 in 8%, and HPV 31 in
      5%. HPV 16 was the predominant type in all countries except Indonesia, where HPV
      18 was more common. There was significant geographic variation in the prevalence
      of some less common virus types. A clustering of HPV 45 was apparent in western
      Africa, while HPV 39 and HPV 59 were almost entirely confined to Central and
      South America. In squamous cell tumors, HPV 16 predominated (51% of such
      specimens), but HPV 18 predominated in adenocarcinomas (56% of such tumors) and
      adenosquamous tumors (39% of such tumors). CONCLUSIONS: Our results confirm the
      role of genital HPVs, which are transmitted sexually, as the central etiologic
      factor in cervical cancer worldwide. They also suggest that most genital HPVs are
      associated with cancer, at least occasionally. IMPLICATION: The demonstration
      that more than 20 different genital HPV types are associated with cervical cancer
      has important implications for cervical cancer-prevention strategies that include
      the development of vaccines targeted to genital HPVs.

PMID- 7791230
TI  - Macrophage colony-stimulating factor complementary DNA: a candidate for gene
      therapy in metastatic melanoma.
AB  - BACKGROUND: At present, there is no highly effective treatment for metastatic
      melanoma. Innovative approaches aimed at inducing a more effective immune
      response against tumors have shown promising results in animal models. One
      approach involves the genetic modification of tumor cells so that they produce
      cytokines that stimulate an immune response. PURPOSE: The aim of this study was
      to determine the effectiveness of cytokine gene therapy for metastatic melanoma
      in a murine melanoma model. METHODS: B16F10 murine melanoma cells, which readily
      metastasize to the lungs, were transduced with a retroviral vector containing
      genes encoding neomycin resistance and human macrophage colony-stimulating factor
      (M-CSF). The presence of M-CSF messenger RNA in transduced cells was examined by
      coupled reverse transcription and polymerase chain reaction. Concentrations of
      soluble M-CSF in cell culture supernatants were determined by enzyme-linked
      immunosorbent assays (ELISAs). A clonal cell line, designated N+/CSF+, that
      expressed and secreted M-CSF was identified. Another clonal cell line, designated
      N+/CSF-, did not secrete M-CSF at levels detectable by ELISA. B16F10, N+/CSF-,
      and N+/CSF+ cells, individually or in combination, were injected intravenously or
      subcutaneously into C57BL/6 mice; we then evaluated the tumorigenicity and
      metastatic behavior of the cells, as well as the immune responses and survival of
      the mice. The immune responses assayed were the cytotoxic T lymphocyte (CTL) and
      peritoneal exudate cell (PEC) tumoricidal activities. RESULTS: Injection of
      B16F10 cells into the tail vein of C57BL/6 mice led to the establishment of lung
      metastases by week 2 and death by week 8. Injection of the N+/CSF+ or N+/CSF-
      cells led to the establishment of lung metastases that were detected at 2 and 3
      weeks, respectively; however, these metastatic lesions were eliminated, and the
      animals had survival rates similar to those of the noninjected control mice.
      Injection of mice with a mixture of B16F10 and N+/CSF- cells resulted in the
      development of metastatic disease and 0% survival at 8 weeks, whereas mice that
      had been given an injection of a mixture of B16F10 and N+/CSF+ cells had an 80%
      survival rate at 8 weeks and survived at least two times longer (P = .007). The
      CTL and PEC tumoricidal activities in animals given an injection of N+/CSF+ cells
      suggested that monocytes and lymphocytes were responsible for the observed
      antitumor response. CONCLUSION: These findings suggest that the expression of M
      CSF by genetically modified melanoma cells caused an effective antitumor immune
      response in host C57BL/6 mice and, thus, prolonged survival over that observed in
      the control mice.

PMID- 7791231
TI  - Lung cancer in radon-exposed miners and estimation of risk from indoor exposure.
AB  - BACKGROUND: Radioactive radon is an inert gas that can migrate from soils and
      rocks and accumulate in enclosed areas, such as homes and underground mines.
      Studies of miners show that exposure to radon decay products causes lung cancer.
      Consequently, it is of public health interest to estimate accurately the
      consequences of daily, low-level exposure in homes to this known carcinogen.
      Epidemiologic studies of residential radon exposure are burdened by an inability
      to estimate exposure accurately, low total exposure, and subsequent small excess
      risks. As a result, the studies have been inconclusive to date. Estimates of the
      hazard posed by residential radon have been based on analyses of data on miners,
      with recent estimates based on a pooling of four occupational cohort studies of
      miners, including 360 lung cancer deaths. PURPOSE: To more fully describe the
      lung cancer risk in radon-exposed miners, we pooled original data from 11 studies
      of radon-exposed underground miners, conducted a comprehensive analysis, and
      developed models for estimating radon-associated lung cancer risk. METHODS: We
      pooled original data from 11 cohort studies of radon-exposed underground miners,
      including 65,000 men and more than 2700 lung cancer deaths, and fit various
      relative risk (RR) regression models. RESULTS: The RR relationship for cumulative
      radon progeny exposure was consistently linear in the range of miner exposures,
      suggesting that exposures at lower levels, such as in homes, would carry some
      risk. The exposure-response trend for never-smokers was threefold the trend for
      smokers, indicating a greater RR for exposure in never-smokers. The RR from
      exposure diminished with time since the exposure occurred. For equal total
      exposure, exposures of long duration (and low rate) were more harmful than
      exposures of short duration (and high rate). CONCLUSIONS: In the miners, about
      40% of all lung cancer deaths may be due to radon progeny exposure, 70% of lung
      cancer deaths in never-smokers, and 39% of lung cancer deaths in smokers. In the
      United States, 10% of all lung cancer deaths might be due to indoor radon
      exposure, 11% of lung cancer deaths in smokers, and 30% of lung cancer deaths in
      never-smokers. This risk model estimates that reducing radon in all homes
      exceeding the U. S. Environmental Protection Agency's recommended action level
      may reduce lung cancer deaths about 2%-4%. These estimates should be interpreted
      with caution, because concomitant exposures of miners to agents such as arsenic
      or diesel exhaust may modify the radon effect and, when considered together with
      other differences between homes and mines, might reduce the generalizability of
      findings in miners.

PMID- 7791233
TI  - Mutagens from heated Chinese and U.S. cooking oils.
AB  - BACKGROUND: The lung cancer incidence in Chinese women is among the highest in
      the world, but tobacco smoking accounts for only a minority of the cancers.
      Epidemiologic investigations of lung cancer among Chinese women have implicated
      exposure to indoor air pollution from wok cooking, where the volatile emissions
      from unrefined cooking oils are mutagenic. PURPOSE: This study was conducted to
      identify and quantify the potentially mutagenic substances emitted from a variety
      of cooking oils heated to the temperatures typically used in wok cooking.
      METHODS: Several cooking oils and fatty acids were heated in a wok to boiling, at
      temperatures (for the cooking oils) that ranged from 240 degrees C to 280 degrees
      C (typical cooking temperatures in Shanghai, China). The oils tested were
      unrefined Chinese rapeseed, refined U.S. rapeseed (known as canola), Chinese
      soybean, and Chinese peanut in addition to linolenic, linoleic, and erucic fatty
      acids. Condensates of the emissions were collected and tested in the Salmonella
      mutation assay (using Salmonella typhimurium tester strains TA98 and TA104).
      Volatile decomposition products also were subjected to gas chromatography and
      mass spectroscopy. Aldehydes were detected using high-performance liquid
      chromatography and UV spectroscopy. RESULTS: 1,3-Butadiene, benzene, acrolein,
      formaldehyde, and other related compounds were qualitatively and quantitatively
      detected, with emissions tending to be highest for unrefined Chinese rapeseed oil
      and lowest for peanut oil. The emission of 1,3-butadiene and benzene was
      approximately 22-fold and 12-fold higher, respectively, from heated unrefined
      Chinese rapeseed oil than from heated peanut oil. Lowering the cooking
      temperatures or adding an antioxidant, such as butylated hydroxyanisole, before
      cooking decreased the amount of these volatile emissions. Among the individual
      fatty acids tested, heated linolenic acid produced the greatest quantities of 1,3
      butadiene, benzene, and acrolein. Separately, the mutagenicity of individual
      volatile emission condensates was correlated with linolenic acid content (r =
      .83; P = .0004). Condensates from heated linolenic acid, but not linoleic or
      erucic acid, were highly mutagenic. CONCLUSIONS: These studies, combined with
      experimental and epidemiologic findings, suggest that high-temperature wok
      cooking with unrefined Chinese rapeseed oil may increase lung cancer risk. This
      study indicates methods that may reduce that risk. IMPLICATIONS: The common use
      of wok cooking in China might be an important but controllable risk factor in the
      etiology of lung cancer. In the United States, where cooking oils are usually
      refined for purity, additional studies should be conducted to further quantify
      the potential risks of such methods of cooking.

PMID- 7791232
TI  - Oral contraceptives and breast cancer risk among younger women.
AB  - BACKGROUND: Several studies have suggested a link between oral contraceptive use
      and breast cancer in younger women, but it is possible that chance or bias,
      including selective screening of contraceptive users, contributed to the putative
      association. PURPOSE: Given that oral contraceptives were first marketed in the
      United States in the early 1960s, we conducted a population-based case-control
      study to examine the relationship between use of oral contraceptives and breast
      cancer among women in a recently assembled cohort, focusing on women younger than
      45 years of age who had the opportunity for exposure throughout their entire
      reproductive years. METHODS: Breast cancer patients and healthy control subjects
      were identified, the latter group by random-digit dialing, in Atlanta, Ga.,
      Seattle/Puget Sound, Wash., and central New Jersey. In Seattle and New Jersey,
      the study was confined to women 20 through 44 years of age; in Atlanta the age
      range was extended through 54 years. Patients included women with in situ or
      invasive breast cancer newly diagnosed during the period of May 1, 1990, through
      December 31, 1992. In-person interviews were completed by 2203 (86.4%) of 2551
      eligible patients and 2009 (78.1%) of 2571 eligible control subjects. Analyses
      focused on women younger than 45 years of age (1648 patients and 1505 control
      subjects) to maximize opportunities for extended exposure. Logistic regression
      analyses were used to obtain maximum likelihood estimates of relative risks (RRs)
      and their 95% confidence intervals (CIs). RESULTS: Among women younger than 45
      years, oral contraceptive use for 6 months or longer was associated with an RR
      for breast cancer of 1.3 (95% CI = 1.1-1.5). Risks were enhanced for breast
      cancers occurring prior to age 35 years (RR = 1.7; 95% CI = 1.2-2.6), with the RR
      rising to 2.2 (95% CI = 1.2-4.1) for users of 10 or more years. The RR for breast
      cancer for those whose oral contraceptive use began early (before age 18 years)
      and continued long-term (> 10 years) was even higher (RR = 3.1; 95% CI = 1.4
      6.7). The RRs observed for those who used oral contraceptives within 5 years of
      cancer diagnosis were higher than for those who had not, with the effect most
      marked for women younger than age 35 years (RR = 2.0; 95% CI = 1.3-3.1). Oral
      contraceptive associations were also strongest for cancers diagnosed at advanced
      stages. Evaluation of screening histories and methods of diagnosis failed to
      support the speculation that associations could be due to selective screening.
      Among women 45 years of age and older, no associations of risk with use of oral
      contraceptives were noted. CONCLUSIONS: The relationship between oral
      contraceptives and breast cancer in young women appears to have a biologic basis
      rather than to be an artifact or the result of bias.

PMID- 7791234
TI  - Chemoprevention of rat prostate carcinogenesis by use of finasteride or casodex.

PMID- 7791235
TI  - Re: Circumvention of multi-drug resistance with anti-P-glycoprotein antibodies:
      clinical potential or experimental artifact?

PMID- 7791236
TI  - Human gamma delta T lymphocytes use N-CAM to interact with the subendothelial
      matrix.

PMID- 7791237
TI  - Re: Adenocarcinoma of the esophagus: role of obesity and diet.

PMID- 7791238
TI  - First complex disasters symposium features dramatically timely topics.

PMID- 7791239
TI  - Will US polio immunization rely on IPV or OPV?

PMID- 7791240
TI  - From the Institute of Medicine.

PMID- 7791241
TI  - From the Centers for Disease Control and Prevention. Unexplained illness among
      Persian Gulf War veterans in an Air National Guard Unit: preliminary report-
      August 1990-March 1995.

PMID- 7791242
TI  - From the Centers for Disease Control and Prevention. Enhanced detection of
      sporadic Escherichia coli O157:H7 infections--New Jersey, July 1994.

PMID- 7791243
TI  - From the Centers for Disease Control and Prevention. Escherichia coli O157:H7
      outbreak at a summer camp--Virginia, 1994.

PMID- 7791244
TI  - From the Centers for Disease Control and Prevention. Deaths from melanoma--United
      States, 1973-1992.

PMID- 7791245
TI  - Malpractice, patient satisfaction, and physician-patient communication.

PMID- 7791246
TI  - Malpractice, patient satisfaction, and physician-patient communication.

PMID- 7791247
TI  - Suitability of fetal tissue for transplantation.

PMID- 7791248
TI  - Hypertension in the elderly: correction and clarification.

PMID- 7791249
TI  - Hypertension in the elderly: correction and clarification.

PMID- 7791250
TI  - Treatment of acute cystitis.

PMID- 7791251
TI  - Treatment of acute cystitis.

PMID- 7791252
TI  - Maternal growth during adolescent pregnancy.

PMID- 7791253
TI  - The cost of topical drugs for dermatophyte infections.

PMID- 7791254
TI  - The cost of topical drugs for dermatophyte infections.

PMID- 7791255
TI  - Incidence of adverse drug events and potential adverse drug events. Implications
      for prevention. ADE Prevention Study Group.
AB  - OBJECTIVES: To assess incidence and preventability of adverse drug events (ADEs)
      and potential ADEs. To analyze preventable events to develop prevention
      strategies. DESIGN: Prospective cohort study. PARTICIPANTS: All 4031 adult
      admissions to a stratified random sample of 11 medical and surgical units in two
      tertiary care hospitals over a 6-month period. Units included two medical and
      three surgical intensive care units and four medical and two surgical general
      care units. MAIN OUTCOME MEASURES: Adverse drug events and potential ADEs.
      METHODS: Incidents were detected by stimulated self-report by nurses and
      pharmacists and by daily review of all charts by nurse investigators. Incidents
      were subsequently classified by two independent reviewers as to whether they
      represented ADEs or potential ADEs and as to severity and preventability.
      RESULTS: Over 6 months, 247 ADEs and 194 potential ADEs were identified.
      Extrapolated event rates were 6.5 ADEs and 5.5 potential ADEs per 100
      nonobstetrical admissions, for mean numbers per hospital per year of
      approximately 1900 ADEs and 1600 potential ADEs. Of all ADEs, 1% were fatal (none
      preventable), 12% life-threatening, 30% serious, and 57% significant. Twenty
      eight percent were judged preventable. Of the life-threatening and serious ADEs,
      42% were preventable, compared with 18% of significant ADEs. Errors resulting in
      preventable ADEs occurred most often at the stages of ordering (56%) and
      administration (34%); transcription (6%) and dispensing errors (4%) were less
      common. Errors were much more likely to be intercepted if the error occurred
      earlier in the process: 48% at the ordering stage vs 0% at the administration
      stage. CONCLUSION: Adverse drug events were common and often preventable; serious
      ADEs were more likely to be preventable. Most resulted from errors at the
      ordering stage, but many also occurred at the administration stage. Prevention
      strategies should target both stages of the drug delivery process.

PMID- 7791256
TI  - Systems analysis of adverse drug events. ADE Prevention Study Group.
AB  - OBJECTIVE: To identify and evaluate the systems failures that underlie errors
      causing adverse drug events (ADEs) and potential ADEs. DESIGN: Systems analysis
      of events from a prospective cohort study. PARTICIPANTS: All admissions to 11
      medical and surgical units in two tertiary care hospitals over a 6-month period.
      MAIN OUTCOME MEASURES: Errors, proximal causes, and systems failures. METHODS:
      Errors were detected by interviews of those involved. Errors were classified
      according to proximal cause and underlying systems failure by multidisciplinary
      teams of physicians, nurses, pharmacists, and systems analysts. RESULTS: During
      this period, 334 errors were detected as the causes of 264 preventable ADEs and
      potential ADEs. Sixteen major systems failures were identified as the underlying
      causes of the errors. The most common systems failure was in the dissemination of
      drug knowledge, particularly to physicians, accounting for 29% of the 334 errors.
      Inadequate availability of patient information, such as the results of laboratory
      tests, was associated with 18% of errors. Seven systems failures accounted for
      78% of the errors; all could be improved by better information systems.
      CONCLUSIONS: Hospital personnel willingly participated in the detection and
      investigation of drug use errors and were able to identify underlying systems
      failures. The most common defects were in systems to disseminate knowledge about
      drugs and to make drug and patient information readily accessible at the time it
      is needed. Systems changes to improve dissemination and display of drug and
      patient data should make errors in the use of drugs less likely.

PMID- 7791258
TI  - A double-blind trial of oral progesterone, alprazolam, and placebo in treatment
      of severe premenstrual syndrome.
AB  - OBJECTIVE: To determine the effectiveness of oral micronized progesterone,
      alprazolam, and placebo in premenstrual syndrome (PMS) treatment and the effect
      of clinical contact on treatment responses. DESIGN: Randomized, double-blind,
      placebo-controlled 3-month parallel treatment arms with flexible dosage and with
      the length of clinical contact randomized within each treatment group. SETTING:
      University hospital PMS medical treatment outpatient program in
      obstetrics/gynecology department. SUBJECTS: Among volunteers for PMS treatment,
      444 were evaluated and 185 meeting defined PMS criteria were randomized to
      treatment; treatment data are available for 170. There were no medical
      withdrawals for adverse events. INTERVENTION: A double-blinded protocol in which
      300 mg of oral micronized progesterone, 0.25 mg of alprazolam, or placebo was
      administered four times a day from day 18 of the menstrual cycle through day 2 of
      the next cycle, including taper. The mean daily dose at the third treatment was
      1760 mg of progesterone or 1.5 mg of alprazolam. Subjects were randomized to
      brief (< 20 minutes) or extended (50 minutes) visits. MAIN OUTCOME MEASURES:
      Daily symptom report (DSR) scored for total DSR symptoms, four DSR factors.
      RESULTS: Alprazolam was significantly better than placebo or progesterone for
      total premenstrual symptoms and DSR factors of mental function, pain, and mood.
      Thirty-seven percent of the alprazolam group experienced a 50% reduction in total
      DSR scores. There were no clinically significant withdrawal symptoms when
      alprazolam administration was restricted to the luteal phase. Oral micronized
      progesterone therapy was no better than placebo. Brief vs extended visits had no
      effect on treatment outcome. Treatment response was associated with severity of
      premenstrual symptoms at baseline but with no other diagnostic variables.
      CONCLUSIONS: Alprazolam has a role in PMS treatment and offers a therapy limited
      to the luteal phase. Oral micronized progesterone is ineffective for PMS.

PMID- 7791257
TI  - Cognitive effects after epidural vs general anesthesia in older adults. A
      randomized trial.
AB  - OBJECTIVE: To compare the effect of epidural vs general anesthesia on the
      incidence of long-term cognitive dysfunction after total knee replacement surgery
      in older adults. DESIGN: Randomized controlled clinical trial. SETTING:
      Orthopedic specialty academic hospital. PATIENTS: A total of 262 patients
      undergoing elective primary total knee replacement with a median age of 69 years;
      70% women. INTERVENTION: Random assignment to either epidural or general
      anesthesia. MAIN OUTCOME MEASURES: A thorough neuropsychological assessment was
      performed preoperatively and repeated at 1 week and 6 months postoperatively.
      Cognitive outcome was assessed by within-patient change on 10 tests of memory,
      psychomotor, and language skills. Prospective standardized surveillance for
      cardiovascular complications was performed to allow simultaneous assessment of
      anesthetic effects on cognitive and cardiovascular outcomes. RESULTS: The two
      groups were similar at baseline in terms of age, sex, comorbidity, and cognitive
      function. There were no significant differences between the epidural and general
      anesthesia groups in within-subject change from baseline on any of the 10
      cognitive test results at either 1 week or 6 months. Overall, 5% of patients
      showed a long-term clinically significant deterioration in cognitive function.
      There was no difference between the anesthesia groups in the incidence of major
      cardiovascular complications (3% overall). CONCLUSIONS: The type of anesthesia,
      general or epidural, does not affect the magnitude or pattern of postoperative
      cognitive dysfunction or the incidence of major cardiovascular complications in
      older adults undergoing elective total knee replacement. This is the largest
      trial of the effects of general vs regional anesthesia on cerebral function
      reported to date, with more than 99% power to detect a clinically significant
      difference on any of the neuropsychological tests.

PMID- 7791259
TI  - A piece of my mind. Middle man in the prostate puzzle.

PMID- 7791260
TI  - Pitfalls in the diagnosis and treatment of Lyme disease in children.
AB  - OBJECTIVE: To define pitfalls of diagnosis and treatment of Lyme disease in
      children. DESIGN: Case series. SETTING: A university Lyme disease clinic in a
      Lyme disease endemic area. PATIENTS: A total of 146 pediatric patients (mean age,
      9.9 years) referred with possible Lyme disease. MAIN OUTCOME MEASURES: Of the 146
      patients, 56 (38%) were overdiagnosed, 12 (8%) were underdiagnosed, and 75 (51%)
      were correctly diagnosed with Lyme disease. Treatment errors were made for 19
      (25%) of these 75 patients. In addition, three patients (2%) with tick bites were
      misdiagnosed or mistreated. Frequent pitfalls included misidentifying rashes as
      erythema migrans, ascribing nonspecific symptoms to Lyme disease, failing to
      ascribe fleeting objective symptoms to Lyme disease, and inappropriate antibiotic
      therapy for patients with Lyme disease. CONCLUSIONS: Errors in the diagnosis and
      treatment of Lyme disease in children are common.

PMID- 7791261
TI  - A 72-year-old man with localized prostate cancer.

PMID- 7791262
TI  - Above all 'do no harm'. How shall we avoid errors in medicine?

PMID- 7791263
TI  - Clinical crossroads: an invitation.

PMID- 7791264
TI  - The reconfiguration of US medicine.

PMID- 7791265
TI  - [Comparison of complement activation between tuberculous and malignant
      pleuritis].
AB  - Complement activation products in pleural effusions were studied to clarify the
      causes of tuberculous and malignant pleuritis. Pleural SC5b-9, an activation
      product of complement common pathway, was significantly higher in tuberculous
      effusions than in malignant ones. In the tuberculous effusions, the levels of
      SC5b-9 and LDH (a marker of tissue damage) were significantly correlated, but in
      the malignant effusions these two values were not correlated. In the tuberculous
      effusions, SC5b-9 and Bb values were significantly correlated, but SC5b-9 and C4d
      were not, and nor were SC5b-9 and immune complex. In the malignant effusions,
      SC5b-9 and Bb values were low and were not significantly correlated. These
      results suggest that complement activation plays a significant role in
      tuberculous pleuritis, but not in malignant pleuritis.

PMID- 7791266
TI  - [Clinical study of radiation pneumonitis over 10 years].
AB  - We studied clinical aspects of radiation pneumonitis from 1983 to 1992. Fifty
      seven patients admitted to our hospital because of lung cancer were treated with
      radiotherapy, and radiation pneumonitis developed in 20 (35.1%). The incidence of
      radiation pneumonitis was closely related to male sex, chronic obstructive lung
      disease, and chemotherapy. Pneumonitis was not related to age, or to the area or
      amount of radiation. Eighteen cases (90%) of pneumonitis occurred during or
      within one month after radiotherapy. In all but five cases (25%), pneumonitis was
      limited to the area of radiation. Treatment was mainly with steroids. In 4 cases
      (20%), pneumonitis recurred when steroid therapy was reduced, and five patients
      (10%) died.

PMID- 7791267
TI  - [Effect of supplementation with eicosapentaenoic acid ethyl ester, MND-21, on
      generation of leukotrienes by calcium ionophore-activated leukocytes in bronchial
      asthma].
AB  - The effects of dietary supplementation with highly purified eicosapentaenoic acid
      ethyl ester (EPA-E) (MND-21) on asthma symptoms, fatty acids in serum, and
      generation of leukotriene (LT) C4, LTC5, LTB4 and LTB5 by leukocytes stimulated
      with calcium ionophore A23187 were studied in 10 patients with bronchial asthma.
      The patients received nine capsules of MND-21 (2.7 g EPA-E) each day for 12
      weeks. Leukocytes obtained from 39 patients with asthma who did not receive EPA-E
      were used as the control. Fatty acid composition was evaluated by gas
      chromatography and LT generation was measured by reverse-phase high performance
      liquid chromatography. EPA-E increased EPA content more than threefold, without
      changing the quantities of arachidonic acid in serum lipids. Leukocytes obtained
      from patients given EPA-E for 4 weeks generated less LTC4 (53.5 +/- 23.3 ng/10(7)
      cells) and LTB4 (24.9 +/- 12.4 ng/10(7) cells) than did those from control
      patients (142.4 +/- 91.6 ng/10(7) cells and 58.3 +/- 34.8 ng/10(7) cells,
      respectively). Although significant levels of LTC5 and LTB5 were present after 4
      weeks of EPA-E (6.5 +/- 1.9 ng/10(7) cells and 4.6 +/- 2.7 ng/10(7) cells,
      respectively), generation of total LTC (LTC4 + LTC5) and total LTB (LTB4 + LTB5)
      were substantially suppressed. Symptoms had improved after two months of EPA-E,
      but the effect was temporary. We conclude that in patients with asthma, treatment
      with EPA-E may attenuate leukocyte function without distinctly changing the
      severity of asthma.

PMID- 7791268
TI  - [Infiltration of cells in the bronchial mucosa in atopic and non-atopic patients
      with bronchial asthma].
AB  - Numbers of T lymphocytes, eosinophils, neutrophils, and mast cells in samples of
      bronchial mucosa were measured with monoclonal antibodies. Samples were obtained
      by biopsy from atopic (A) and non-atopic (NA) patients with bronchial asthma, and
      from healthy control subjects (C). The numbers of T lymphocytes, eosinophils, and
      neutrophils did not differ significantly between the A group and the NA group,
      but the A group had significantly more mast cells than the NA group (p < 0.025).
      The difference was greatest in the mucosal epithelium (p < 0.01). Electron
      microscopy revealed many degranulating mast cells in the A group. These results
      suggest that in atopic patients with bronchial asthma, mast cells infiltrate into
      bronchial mucosal epithelium and contribute to inflammation.

PMID- 7791269
TI  - [Efficacy of high-dose beclomethasone in patients with stable chronic obstructive
      pulmonary disease].
AB  - To study the role of inhaled steroids in treating patients with chronic
      obstructive pulmonary disease (COPD), 1.6 mg of beclomethasone dipropionate (BDP)
      were given for 2 weeks after 0.5 mg/kg of oral prednisolone (PSL) for 2 weeks to
      43 patients with COPD (mean age 68.7 +/- 5.2 years, mean baseline FEV1, 1.13 +/-
      0.44 L). When responders to a corticosteroid (PSL or BDP) were defined as those
      with a post-steroid EFV1/baseline FEV1 > or = 115% and a post-steroid FEV1
      baseline FEV1 > or = 0.2 L, 12 out of 43 patients responded to 30 mg of PSL for 2
      weeks and 13 responded to 1.6 mg of BDP for 2 weeks. We considered those 17
      patients who responded to 2 weeks of PSL or 2 weeks of BDP or both, to be
      possible steroid responders, and they continued inhaling BDP for 4 more weeks. In
      8 of these 17 patients (19%), FEV1 had increased by the end of the 6 weeks.
      Inhaled BDP was considered useful in treating some patients with COPD.

PMID- 7791270
TI  - [Long-term study of patients with sequelae of pulmonary tuberculosis after
      pneumonectomy--obstructive impairment and its causes].
AB  - Changes in pulmonary function, chest X-ray films, and CT were retrospectively
      studied in patients with sequeae of pulmonary tuberculosis 30 years after
      pneumonectomy (PNX). Over more than 10 years, VC and FEV1% changed at a rate of
      23.2 +/- 8.8 ml and 0.683 +/- 0.688% per year, respectively. In the patients
      studied 30 years after PNX (N = 30), VC was 900 +/- 210 ml, %VC 31.6 +/- 8.1%,
      and FEV1% was 67.2 +/- 6.8%. About half of these patients had mild airway
      obstruction. FEV1% was negatively related to the distance from the hilum to the
      diaphragm on the mid-clavicular line (on the chest films) divided by body height
      (r = -0.607). Therefore, we think that the airway obstruction may be due to
      overextension of the bronchi of middle and lower lobes. Emphysema was not found
      in 18 patients who had no sign of hyperinflation or herniation of the remaining
      lung to the PNX side on their CT, but it was found in one patient with these
      signs.

PMID- 7791271
TI  - [A case of eosinophilic pneumonia presenting as hemoptysis, with epithelioid cell
      granuloma on lung biopsy].
AB  - A 60-year-old woman was admitted because of hemoptysis and dyspnea on exertion,
      which began one month before admission and gradually increased. Chest X-ray film
      taken on admission showed an infiltrative shadow in and around the left posterior
      basal segment. Chest CT disclosed peripheral and patchy consolidation with some
      air bronchograms and interstitial thickening in the left basal segments.
      Bronchoalveolar lavage fluid contained many red blood cells and abnormally high
      numbers of eosinophils and lymphocytes. The specimen obtained by CT-guided lung
      biopsy revealed epithelioid cell granulomas, hemosiderin-laden macrophages,
      diffuse infiltration of small round cells with a few eosinophils and monocytes in
      the alveolar septa, and many eosinophils in the intraalveolar exudates. No
      pathogens of pulmonary eosinophilia were identified and there was no secondary
      pulmonary eosinophilia. Therefore, we diagnosed eosinophilic pneumonia with no
      obvious cause. Hemoptysis may have been due to alveolar hemorrhage of
      eosinophilic pneumonia. The hemoptysis and chest infiltrative shadow disappeared
      rapidly after the start of treatment with oral prednisolone.

PMID- 7791272
TI  - [A case of chronic hypersensitivity pneumonitis due to long term exposure to
      toluene diisocyanate].
AB  - A 55-year-old paint sprayer, who had been working with paint containing toluence
      diisocyanate since age 20, was admitted to our hospital with a complaint of
      exertional dyspnea. Physical examination revealed clubbed fingers, and fine
      crackles were audible in both lower lung fields. The thoracic CT film showed
      diffuse linear and ringed shadows in both lung fields. Open lung biopsy disclosed
      alveolitis and fibrosis as well as infiltration of mononuclear cells, but no
      Masson bodies or granulomas. Toluene diisocyanate-specific antibody was positive.
      Based on these results, we diagnosed chronic hypersensitivity pneumonitis due to
      the chemical. To our knowledge, there has been no previously reported case of
      chronic hypersensitivity pneumonitis due to isocyanate.

PMID- 7791273
TI  - [A case of sarcoidosis discovered by onset of pneumothorax].
AB  - A 24-year-old man was admitted to our hospital with left back and chest pain. A
      chest X-ray film showed left pneumothorax, bilateral hilar lymphadenopathy,
      mediastinal widening, and multiple nodular shadows in both lung fields. Chest CT
      showed a large nodule just under the pleura. High serum ACE and lyzozyme levels,
      and a noncaseating epithelioid granuloma (revealed by TBLB) led to the diagnosis
      of sarcoidosis. Steroid therapy was started to prevent a cardiac lesion.
      Pneumothorax secondary to sarcoidosis in its early stage is rare, and in this
      case the pneumothorax may have been caused by rupture into pleural space of the
      largest nodule in the left S9, as a result of necrosis.

PMID- 7791274
TI  - [Idiopathic interstitial pneumonia (type B) with subacute progressively enlarged
      bullae].
AB  - A 70-year-old man with a 10-year history of seal engraving presented with
      exertional dyspnea and dry coughing. Chest roentgenograms showed an interstitial
      shadow and bilateral progressively enlarging bullae. Open lung biopsy led to the
      diagnosis of idiopathic interstitial pneumonia (Type B). The size of bullae
      usually does not change, so cases such as this are rare because the bullae
      continued to expand subacutely. Persistent stimulation by the inhaled A1 and Si
      may have played a role in the pathogenesis of this condition.

PMID- 7791276
TI  - [A case of tropical eosinophilia associated with pleural effusion].
AB  - A 52-year-old man was admitted to Keio University Hospital for determination of
      the etiology of a bilateral pleural effusion associated with marked eosinophilia
      (10200 cells/mm3). He had been in Vietnam for three years and had returned to
      Japan in May 1993. He was suffering from tropical eosinophilia, as clearly
      indicated by eosinophilia, elevation of serum IgE level (708 IU/ml), the presence
      of anti-dirofilarial antibodies, and the absence of microfilaria in the blood.
      The pleural effusion was an exudate and 51% of the cells in the effusion were
      eosinophils. In the effusion, no parasites were detected but anti-dirofilarial
      antibodies were found (the titer was as high as that in the serum).
      Diethylcarbamazine was given, and a steroid had to be superimposed because of
      wheezing. These treatments successfully reduced the bronchoconstriction,
      eosinophilia and accumulation of pleural effusion. Tropical eosinophilia has
      generally been thought not to be associated with pleural effusion. This is only
      the third case report of tropical eosinophilia with authentic pleural effusion.

PMID- 7791275
TI  - [A case of extramedullary plasmacytoma of the lung associated with nodular
      deposit of amyloid].
AB  - A 63-year-old man underwent left upper lobectomy because of a 35-mm tumor in the
      lingula. Microscopic findings showed that the tumor was composed of a
      proliferation of plasma cells, and that in some areas eosinophilic amorphous
      material had been deposited between the tumor cells. By immunoperoxidase
      staining, the tumor cells were positive for IgG and kappa chain, but they were
      negative for lambda chain. In addition to the tumor in the lingula, another
      nodule was found in the left lower lobe and was resected at thoracotomy. The
      nodule was composed of diffuse eosinophilic amorphous material, which was found
      to be amyloid after Congo red staining and observation in polarized light. In and
      around the nodule, a few plasma cells were noted and these cells were also
      positive for IgG and kappa chain, but negative for lambda chain immunoperoxidase
      staining. In serum taken from the patient before surgery, M-protein was not
      detected by immuno electrophoresis but polyclonal hypergammaglobulinemia was
      noted, and it continued after the thoractomy. Bone marrow examination and a bone
      scintigram revealed no abnormality. In this case, a pulmonary plasmacytma co
      existed with nodular pulmonary amyloidosis. We could not determine which lesion
      developed first, but the results of the immunoperoxidase staining of plasma cells
      in both lesions indicate that the origin of the plasmacytoma was probably the
      same as that of the nodular amyloid.

PMID- 7791277
TI  - [A case of small cell lung cancer that developed during therapy for myasthenia
      gravis].
AB  - A 56-year-old man had been complaining of progressive proximal muscle weakness
      and bilateral ptosis before his first admission to our hospital. He received an
      injection of edrophonium chloride, which resulted in remarkable improvement of
      muscle strength. Electromyographic studies revealed a compound muscle action
      potential that decreased after repetitive stimulation at a high rate (15 Hz). He
      was regarded as having myasthenia gravis (MG) rather than Eaton-Lambert syndrome
      because of these findings. Eighteen months after successful treatment of MG with
      oral anticholinesterase medication, he complained of an abdominal mass. The mass
      was found to be a tumor that had metastasized from a primary small cell carcinoma
      of the lung. Cases of MG with small cell carcinoma of the lung seem to be very
      rare, and the details of the relationship between them remain unknown. In this
      patient, MG may have developed by paraneoplastic mechanisms. This hypothesis is
      interesting, since it has been demonstrated recently by molecular biological
      techniques that small cell carcinomas of the lung express nicotinic acetylcholine
      receptors.

PMID- 7791278
TI  - [A case of necrotizing sarcoid granulomatosis diagnosed by open lung biopsy].
AB  - A 59-year-old man had an abnormal shadow on chest X-ray film. He was admitted to
      Tohoku-chuou Hospital, and a lung lesion in the right lower lobe was diagnosed as
      a benign nodule. A new nodular lesion appeared on a chest X-ray film taken two
      months after his discharge from the hospital. Both lesions were in the same lobe;
      the older one was in segment 9 and the newer one was in segment 10. For the
      lesion in segment 10, malignancy was not ruled out, so open lung biopsy (right
      lower lobectomy) was done. With the findings of angitis and focal necrosis
      surrounded by granulomas consisting of epthelioid cells and multinuclear giant
      cells, the new lesion in segment 10 was diagnosed as necrotizing sarcoid
      granulomatosis. The older lesion in segment 9 was a tuberculoma. We conclude that
      in this case the open lung biopsy was necessary to diagnose necrotizing sarcoid
      granulomatosis in lung.

PMID- 7791280
TI  - [A case of productive aspergilloma on the inner wall of a cavity, in which
      perbronchial fiberoptic bronchoscopy within the cavity was useful for the
      diagnosis and therapeutic evaluation].
AB  - A 45-year-old man complaining of bloody sputum was admitted. He had been treated
      for pulmonary tuberculosis since October 1988. He had bloody sputum in October
      1989. His chest X-ray findings showed a cavitary lesion with a thickened and
      irregular wall in the right upper lobe. Fiberoptic bronchoscopy revealed white
      nodules on the cavity wall and the biopsy specimen from the nodule yielded a
      fungus granuloma. Aspergillus fumigatus was cultured from the sputum obtained
      after the bronchoscopy. Based on these findings, endobronchial aspergillosis and
      productive aspergilloma on the inner wall of a cavity was diagnosed. He was
      treated with oral anti-fungal drugs for 4 years. On chest X-ray films taken in
      June 1993, the cavity had enlarged, and the thickening and irregularity of the
      cavity wall had disappeared. Transbronchial fiberoptic bronchoscopy within the
      cavity showed whitish nodules and the cytology specimen obtained from the nodules
      by brushing yielded fungi, he was treated with oral itraconazol. Six months
      later, re-examination of the cavity revealed that the wall had become thinner and
      that the nodules on the inner wall had disappeared. This case illustrates the
      importance of bronchoscopy, in the diagnosis and evaluation of treatment of
      productive aspergilloma on the inner wall of a cavity.

PMID- 7791282
TI  - [Visual field compendium. Interpretation of perimetry findings. Comprehensive
      diagnostic measures].

PMID- 7791281
TI  - [A case of intra-pulmonary lymph nodes presenting as multiple small nodular
      lesions in both lungs].
AB  - A 59-year-old man came to our hospital for further examination of multiple small
      nodular lesions in both lungs. Chest CT scan revealed multiple nodular lesions in
      rt-S6, It-S5, and It-S9 (two lesions). All of these nodules measured about 10 mm
      or less and those in It-S9 had spicula. Bronchoscopic examination did not yield a
      definitive diagnosis, so open lung biopsy was done. The open lung biopsy specimen
      revealed intra-pulmonary lymph nodes with anthracosis and pulmonary emphysema.
      Intrapulmonary lymph nodes are very difficult to distinguish from small lung
      tumors by radiographic examination alone, so the possibility that small nodules
      in the lungs may be intra-pulmonary lymph nodes should be kept in mind.

PMID- 7791279
TI  - [Legionella pneumonia diagnosed by urinary antigen detection].
AB  - A 63-year-old man with dyspnea and high fever was admitted to the hospital. A
      pneumonic shadow in the right lower lung field was observed. After administration
      of rifampicin and clarithromycin, his symptoms were gradually alleviated.
      Although Legionella pneumonia was highly suspected, Legionella pneumophila was
      not isolated from his sputum specimens and the serum level of indirect
      immunofluorescent antibody titer was not significantly elevated. However, we
      believe it is very likely that he had Legionella pneumonia, because we detected a
      high density of urinary Legionella pneumophila serogroup 1 antigen by antigen
      capture EIA.

PMID- 7791283
TI  - [Vitrectomy in proliferative vitreoretinopathy. Anatomical and functional results
      in 501 patients].
AB  - BACKGROUND: Modern vitreoretinal surgery allows a successful management of most
      cases of retinal detachment (RD) due to proliferative vitreoretinopathy (PVR).
      Failure of a vitrectomy in these cases is generally caused by a recurrence of
      PVR. Little is known about the postoperative 'life cycle' of proliferative
      cellular processes within the periretinal space. An adequate retreatment of PVR
      recurrences may improve the anatomical and functional results of a vitrectomy.
      MATERIAL AND METHODS: The retrospective study comprises 501 consecutive eyes
      operated for non-diabetic traction RD. Conventional retinal surgery preceded the
      vitrectomy in 36% of the cases. PVR was staged according to the classification of
      the Retina Society (14) with supplemental stages for 'anterior loop' formation,
      epimacular and subretinal membranes. The mean follow up of 139 eyes with one
      single vitrectomy was 24.2 months. The time-course of recurrent PVR in 362 eyes
      (72%, mean follow-up 34.2 months) was analyzed. Silicone-oil tamponade was used
      in 343 (69%) eyes. RESULTS: Recurrent PVR occurred predominantly within 1 to 9
      months (median 1.8 mos) after vitrectomy. Latencies of recurrences did not differ
      significantly between PVR-C and D stages. Reattachment of the retina was achieved
      in about 85% of PVR-C and 70% of PVR-D stages. Anatomical results were better in
      non-traumatic RD cases. Final visual acuity of eyes operated since 1990 was 5/200
      or better in 78% C-stages and 65% D-stages (follow-up of > or = 12 months). The
      final visual acuity was 20/100 or better in 33% of all PVR-C cases and 9.5% of
      all PVR-D cases. Significantly improved visual results were achieved in eyes
      operated with silicone oil tamponade, and in the later series of 279 eyes
      operated since 1990. The rate of postoperative total blindness was reduced from
      16.7% before 1990 to 3.6% after 1990. CONCLUSION: Blindness due to traction RD
      can be avoided by vitreoretinal surgery in about 75% of PVR-C and over 50% of PVR
      D cases provided that PVR recurrences are detected early and treated adequately.

PMID- 7791284
TI  - [Early vitrectomy in endogenous juvenile uveitis intermedia--a long-term study].
AB  - BACKGROUND: The intermediate uveitis is one of the most common intraocular
      manifestations of inflammation during infancy and adolescence. The success of
      intensive pharmacological treatment is rather limited and often associated with
      heavy side effects. PATIENTS AND METHODS: In 25 eyes with juvenile uveitis
      intermedia (age of the patients between 5 and 18 years, mean 13.5 years) and
      visual acuities between 0.02 and 0.4 (mean 0.19) an early vitrectomy was
      performed after failure of conservative treatment and peripheral cryocoagulation.
      RESULTS: Almost all patients (22 out of 25) showed an improvement of visual
      acuity within the first 6 months of the surgery. Among the patients with a
      remarkable improvement of visual acuity 7 eyes had a chronic cystoid macular
      oedema which showed a regression postoperatively. Additionally, the number and
      the course of inflammatory periods could be reduced postoperatively. An increase
      of preexisting lens opacities, however, has not been noticed even after a follow
      up period of 10 years. CONCLUSIONS: The results show that an early vitrectomy in
      cases of juvenile uveitis intermedia often leads to a stabilization or an
      improvement of visual acuity and a regression of the inflammatory attacks
      (episodes). Therefore, in children and adolescents with endogenous uveitis
      intermedia a pars plana vitrectomy instead of a long-term systemic
      immunosuppression associated with heavy side-effects should be considered.

PMID- 7791285
TI  - [Phototherapeutic keratectomy as the primary option before perforating
      keratoplasty].
AB  - BACKGROUND: Argon fluoride excimer laser (193-nm) can perform precise corneal
      ablation with submicron accuracy and minimal reaction to the adjacent tissue. A
      possible application is anterior lamellar keratectomy to remove superficial
      corneal opacities and to smooth corneal irregularities. PATIENTS AND METHODS:
      Between August 1993 and June 1994 we performed a phototherapeutic keratectomy
      (PTK) in 35 patients with different corneal diseases by excimer laser (Aesculap
      Meditec). 3 cases (2 corneal dystrophies and 1 patient with a traumatic corneal
      opacity after chemical burn) are described more exactly with operative methods
      and postoperative results. RESULTS: By slitlamp microscopy we observed an
      improvement of the primary corneal disorder in all cases. Changing of refraction
      (hyperopic shift and newly formed astigmatism) arose in 2 out of 3 patients.
      CONCLUSIONS: Phototherapeutic keratectomy by excimer laser represents a secure,
      less invasive alternative to surgical methods promising quicker visual recovery.
      Often a penetrating keratoplasty can be avoided or delayed.

PMID- 7791286
TI  - [A new site-independent tonometer (ProTon) in comparison with the Goldmann
      applanation tonometer].
AB  - BACKGROUND: A new position-independent and portable Mackay-Marg-tonometer in
      miniature, the so-called ProTon (PT), was compared with reference to its clinical
      usefulness with the Goldmann applanation tonometer (GAT), being a commonly
      accepted reference. METHODS: The intraocular pressure (IOP) in 164 eyes of 85
      adults (patients and volunteers without ocular disease) was measured using the
      sequence GAT, PT and again GAT--each three times in a row-by three different
      investigators in a randomized scheme. In an attempt to detect any systemic
      influence, the difference obtained by subtracting the value measured using PT
      from the value attained using GAT was compared to the central corneal thickness
      and radius. Moreover, the central IOP readings were compared with the peripheral
      IOP in 60 eyes of 30 volunteers measured by PT, to detect any possible influence
      of the locality of measurement. Dependence of measurement on individual
      influences was examined by comparing PT-values obtained by each investigator.
      RESULTS: Linear regression analysis between PT (y-axis) and GAT (x-axis) for an
      IOP range of 0 to 62 mm Hg resulted in the following equation: PT = 1.036 x GAT 
      2.00 with a PT value standard deviation of 1.65 mm Hg (r = 0.988; p < 0.0001).
      Reproducibility of each of the three PT-values (mean pair difference of 1.1 mm
      Hg) corresponded to the analogous first two GAT-values (differences 1.0 up to 1.2
      mm Hg). The mean IOP-value of 1) the GAT measurements (1 to 3) was 18.35 mm Hg,
      2) of the last three GAT measurements, 17.15 mm Hg and 3) of all PT-measurements,
      16.40 mm Hg. No statistical difference was found between the IOP measured
      centrally and peripherally. A clinically nonsignificant dependency for PT
      readings on the examiner was verified. CONCLUSION: Due to the high
      reproducibility, independency on examiner and acceptable correspondence of PT
      with GAT values, the PT appears to be a promising new development for use in
      measuring intraocular pressure. It will be necessary to modify the calibration of
      PT since IOP measured systematically about 2 mm Hg too low.

PMID- 7791287
TI  - [1H-NMR spectroscopic study of cysteamine eyedrops].
AB  - BACKGROUND: The efficiency of cysteamine eye drops in the treatment of cystinosis
      has been demonstrated in several studies: Corneal cystine crystals can be removed
      by topical cysteamine. Cysteamie 0.5% eye drops were superior to a 0.1% solution.
      It is not clear how fast cysteamine is oxidized to cystamine under the influence
      of atmospheric oxygen. MATERIAL AND METHODS: Samples of a new bottled cysteamine
      0.5% solution were analysed 1H-NMR-spectroscopically over a period of several
      weeks (AM 400/WB-NMR-instrument, Bruker/Karlsruhe; 400.15 MHz). Samples bottled
      in an argon atmosphere were compared to samples bottled without inert gas.
      Definite samples were opened four times a day (A). The remainder of the samples
      was stored closed (B). RESULTS: In sample A a 1:1 weight ratio between cysteamine
      and cystamine was reached after 38 days. In samples B cysteamine was not oxidized
      to cystamine. The initial amount of cystamine was something lower in samples with
      argon, but argon could not prevent the decrease of the cysteamine concentration
      in sample A. CONCLUSIONS: The preparation of cysteamine solution in an argon
      atmosphere is useful. One bottle can be used for about one week, if less than 10%
      of the oxidation product cystamine is accepted.

PMID- 7791288
TI  - [Traumatic wound dehiscence and corneal rupture 3 1/2 years after radial
      keratotomy].
AB  - BACKGROUND: Severe complications such as a traumatic wound dehiscence have been
      described very rarely after radial keratotomy. The following case demonstrates
      for the first time that wound healing is not completed even 31/2 years
      postoperatively and that therefore an ocular blunt trauma may still cause a
      dehiscence of the radial incisions. CASE REPORT: A 22-year-old patient presented
      in July 1993 to our emergency unit because of a corneal perforation in his right
      eye after a blunt trauma. His past medical history was significant for radial
      keratotomy surgery performed in January 1990 to correct a bilateral low-degree
      myopia (OD = -3.25 D; OS = -3.75 D). At surgery a horizontal rupture running
      through the entire cornea and including the two radial keratotomies at the 3 and
      9 o'clock position was evident. The whole iris and lens were missing. The retina
      was completely detached. The corneal laceration was sutured. Twelve days later
      the retina was reattached with an encircling band, vitrectomy, endolaser and
      cryocoagulation, as well as silicone oil fill. Finally, a penetrating
      keratoplasty was performed 6 months after the accident. Thereafter, visual acuity
      improved to 0.1. The histologic examination of the corneal button showed that the
      wound healing of the incisions that had remained intact was not completed yet.
      Epithelial plugs of various size were still filling the somewhat dehiscent wound
      margins. Fibroblastic activity was detected in the surrounding stroma.
      CONCLUSION: Even several years after surgery, blunt traumas represent a definite
      risk for eyes undergoing radial keratotomy.

PMID- 7791289
TI  - [Autosomal dominant keratoconus as the chief ocular symptom in Lobstein
      osteogenesis imperfecta tarda].
AB  - BACKGROUND: Osteogenesis imperfecta is an autosomal inherited generalized disease
      of the soft tissue which can be divided into a congenital form (Vrolik) and a
      late-onset form named Lobstein. As the typical ocular symptom we find blue sclera
      whereas corneal changes as keratoconus are rarely documented. We report a family
      of 6 patients, all 5 examined being affected by keratoconus. PATIENTS AND
      METHODS: After a 14-year-period of wearing hard contact lenses due to a
      keratoconus a 26-year-old female patient developed a painful therapy-resistant
      keratitis (Acanthamoeba) which afforded a keratoplasty. A history of osteogenesis
      imperfecta tarda was known since childhood. Five further members in three
      generations of the family were certainly affected by osteogenesis imperfecta. We
      examined five patients with a computer-assisted corneal topography analysis
      system. RESULTS: Referring to localization and configuration of the keratoconus
      all of the five patients had a similar degree of affection. Only our patient
      revealed blue sclera. There was no correlation between the corneal curvature and
      the degree of affection of the bone. Both the keratoconus and the bone affections
      had shown no more progression after adolescence. CONCLUSION: With the use of
      computer-assisted corneal topography analysis we were able to show a keratoconus
      associated with osteogenesis imperfecta. The typical blue sclera was not found
      that often in this family. The shape of the keratoconus was similar in
      localization and configuration. Contrary to the normal progression of keratoconus
      in this family there was no more progression of refractive changes after
      adolescence. Association of keratoconus with osteogenesis imperfecta should be
      considered. Likewise in osteogenesis imperfecta the ophthalmologist should
      consider keratoconus beside blue sclera.

PMID- 7791290
TI  - [Clinical aspects of ataxia teleangiectatica (Louis-Bar syndrome)].
AB  - BACKGROUND: Ataxia telangiectasia is an autosomal recessive inherited multisystem
      disease of childhood characterized by progressive cerebellar ataxia, oculo
      cutaneous telangiectasia, immunological defects with increased susceptibility to
      infection and malignant neoplasms. PATIENT: A 20-year-old patient with ataxia
      telangiectasia (Louis-Bar syndrome), demonstrating the typical features of this
      hereditary disease, is described. The ophthalmological findings showed
      telangiectasia of the horizontal conjunctival vessels in the exposed bulbar
      conjunctivae and oculomotor signs with pathological pursuit and command
      movements, dissociated nystagmus, failure of gaze holding and convergence.
      RESULTS: The ataxia is the first symptom and becomes apparent when the child
      starts to walk. The pathognomonic telangiectasia at the light-exposed areas of
      the bulbar conjunctiva point the way to the diagnosis. There is no specific
      treatment for this disease. CONCLUSIONS: The ophthalmologist is able to confirm
      the clinical diagnosis by demonstrating the telangiectasia. Due to the increased
      disposition to malignant neoplasms regular check-ups should be performed.

PMID- 7791292
TI  - [Toxic pulmonary edema].

PMID- 7791293
TI  - [The selection of subjects for priority examination for the detection of ischemic
      heart disease].

PMID- 7791291
TI  - [Tarantule hairs as corneal foreign bodies].
AB  - A 22 year-old-man and owner of several tarantulas visited his ophthalmologist
      because of red itchy eyes. Additionally to kerato-conjunctivitis epidemica,
      uncommon hairs were found especially in his left cornea. Corrected visual acuity
      was 0.8. According to literature these spider hairs can induce granulomas in the
      meaning of ophthalmia nodosa, and even migrate inside the eye. Therefore we
      removed as many hairs as possible, but we left two, not to cause iatrogen
      perforation. The penetration depth was measured by laser tomography. Local
      steroids successfully prevented further granuloma formation. Regular
      ophthalmological controls are important to early detect possible changes, and if
      necessary to remove these hairs even from deeper corneal layers, in case by
      keratectomy.

PMID- 7791294
TI  - [A clinical assessment of ebrantil efficacy in arterial hypertension patients].
AB  - From before treatment throughout its course a new hypotensive drug ebrantil was
      studied for clinical efficacy in 52 patients with essential, renal and thyrogenic
      arterial hypertension. Clinical instrumental and biochemical findings support the
      drug efficacy in management of a hypertensive crisis and sudden AF rise. The
      response was registered in 83.3% of the cases. A persistent hypotensive effect of
      180 mg/day course ebrantil became obvious within the first week of the treatment,
      passing ahead of relevant changes in central hemodynamics and myocardial
      contractility. The drug acts by reducing both cardiac pre- and postload, the
      reduction being brought about due to diuretic effect. In response to AP decrease
      there was neither myocardial contractility depression nor reflex tachycardia.
      Psychoemotional testing confirmed the central effect of ebrantil promoting
      adaptation of patients to stress under long-term administration. The drug
      demonstrated good tolerance when used orally and intravenously. No bronchial
      pulmonary, carbohydrate and lipid metabolism, renal and hepatic function side
      effects were reported. 24-h AP monitoring proved ebrantil efficacy in essential
      and renal hypertension patients.

PMID- 7791295
TI  - [The effect of cardil (diltiazem) on thrombocyte aggregation in hypertension].

PMID- 7791296
TI  - [The effect of kordaron on thyroid function in patients with ischemic heart
      disease].
AB  - Thyroid function has been assessed in 56 patients with arrhythmic coronary heart
      disease (CHD) prior to and in the course of cordaron treatment. TTH level made up
      initially 1.39 +/- 0.27 IU/ml which was normal. T3 blood concentration was low-
      1.28 +/- 0.06 nmol/l; T4 was normal--128.26 +/- 4.9 nmol/l. It is stated that CHD
      patients with arrhythmia develop latent hypothyrosis of T3-low-syndrome type.
      Arrhythmia treatment with cordaron aggravates T3 deficiency as the drug inhibits
      T4 conversion into T3 in peripheral tissues. It also causes toxic damage to
      thyroid parenchyma resulting in higher TH levels in the blood. CHD patients
      receiving long-term cordaron (1 to 8 years) have clinical picture of manifest
      hypothyrosis. Cordaron molecules includes iodine macro-doses, but these fail to
      initiate autoimmune thyroid process.

PMID- 7791297
TI  - [The hemodynamic, humoral and cellular effects of plasmapheresis in a refractory
      form of hypertension].
AB  - Plasmapheresis effects on hemodynamics, neurohumoral, immunological and cell
      parameters were examined in 48 patients with refractory hypertension. Hypotensive
      effect of plasmapheresis was found to combine with positive hemodynamics and
      microcirculatory shifts, pressor factor activity inhibition, slowing of
      immunocomplex condition progress, reduced red cell deformability in refractory
      hypertension.

PMID- 7791298
TI  - [The involvement of the cardiovascular system in syphilis].
AB  - Three lethal cases of visceral (cardiovascular) syphilis are reported. A
      pathogenetic role of specific vasculitis in organic lesions, of myocarditis in a
      decline of inotropic cardiac function and endarteritis of renal vessels in
      development of organic parenchymatous insufficiency are discussed.

PMID- 7791299
TI  - [Errors and difficulties in the diagnosis of malignant neoplasms in cardiology
      patients].

PMID- 7791301
TI  - [The diagnostic significance of clinical signs of right ventricular insufficiency
      in patients with chronic obstructive bronchitis].
AB  - An echocardiographic study of right ventricular myocardial contractility in 123
      patients with chronic obstructive bronchitis (COB) confirmed the suggestion that
      in COB patients symptoms of right ventricular failure (cyanosis, acrocyanosis,
      crural edema, dilated liver) may have extracardiac origin. In echocardiographic
      diagnosis of right ventricular failure one should measure the speed of the
      anterior wall movements in the systole, diastole and ejection fraction.

PMID- 7791303
TI  - [The diagnostic significance of detecting L forms of Mycobacterium tuberculosis].

PMID- 7791304
TI  - [The differential diagnostic potentials of the determination of adenosine
      deaminase in pleural exudate].

PMID- 7791305
TI  - [The circadian phototherapy of bronchial asthma].
AB  - The authors provide validation and technique of circadian phototherapy of
      bronchial asthma. Therapeutic effect of the method occurs because of correction
      of internal asynchronism, stimulation of endogenic synthesis of corticosteroids,
      antidepressive action.

PMID- 7791302
TI  - [Bronchial reactivity characteristics in EEG variants in bronchial asthma
      patients].
AB  - The authors' investigations show that those asthmatics who have EEG-recorded
      lowered convulsion threshold of the cortical neurones exhibit higher
      hypersensitivity and hyperreactivity of the bronchi than those in patients with
      intact cortical-subcortical relationships. The interaction of the above
      parameters demonstrates stable relations between bronchial reactivity and
      bioelectrical cerebral activity.

PMID- 7791300
TI  - [The diagnosis of aspirin-induced asthma by using a functional model].
AB  - The analysis of case history, clinical, laboratory and instrumental findings,
      objectively characterizing the patient's condition in two alternative groups
      (nonaspirin and aspirin bronchial asthma) enabled the authors to create a
      functional diagnostic model for aspirin bronchial asthma. The model-based
      computer program designed by the authors can perform early diagnosis of aspirin
      asthma outpatiently without any risk for the patients.

PMID- 7791306
TI  - [The mucolytic therapy of chronic obstructive bronchitis].
AB  - The authors review the efficacy of mucolytic drugs in inhalations used alone and
      in combination with other substances (mucosolvin, ascoksal, powder soda, soda +
      ascoksal, soda + mucosolvin) against chronic obstructive bronchitis. The highest
      effect was achieved in inhalations of powder soda with ascoksal. This treatment
      is most potent in reducing the broncho-obstructive syndrome.

PMID- 7791307
TI  - [Electrostimulation of the diaphragmatic muscle in bronchial asthma patients].
AB  - A study was made of the effect of transcutaneous diaphragmatic electrostimulation
      (2 mA, 0.3 ms, 20-30 V) on the external respiratory function in 12 asthmatic
      patients with respiratory insufficiency. The course comprised 7 daily sessions
      for 20 min. The improvement in respiratory function parameters was observed in
      the majority of the patients. The effect of electrostimulation was related to the
      quantity of the procedures.

PMID- 7791309
TI  - [The clinico-pathogenetic forms of hypertension (essential hypertension) and
      their differential treatment].

PMID- 7791310
TI  - [Gastrotsepin in the therapy and prevention of peptic ulcer exacerbations
      associated with Helicobacter pylori bacteriosis].

PMID- 7791308
TI  - [The correction of the imbalance in the proteinase-inhibitor system of patients
      with protracted pneumonia with the enterosorbent polifepan].
AB  - The evidence obtained by the authors indicates that enterosorbent polyphepan
      corrects unbalance in the proteinase-inhibitory system of bronchial lavage from
      patients with lingering pneumonia and endobronchitis. Clinical symptoms improved
      also. A long-term (18 days) intermittent course (0.3 g/kg 4 days with 3-day
      intervals) is tolerated satisfactorily, produces no side effects (no colon
      dysfunction), retains normal hemoglobin values, total protein, enhances
      antiproteinase activity. As a result of the treatment hospital stay for the above
      patients reduced noticeably.

PMID- 7791311
TI  - [The rehabilitation of patients with venous diseases of the lower extremities
      under outpatient polyclinic conditions].

PMID- 7791312
TI  - [Cases of tuberculous pericarditis].

PMID- 7791313
TI  - [A rare case of alveolar echinococcosis of the lungs and liver complicated by a
      hepatopulmonary fistula].

PMID- 7791315
TI  - [The control of student knowledge of internal diseases].

PMID- 7791316
TI  - [The principles of the construction of a working classification of chronic
      pancreatitis].

PMID- 7791314
TI  - [Generalized cryptococcosis].

PMID- 7791317
TI  - [An evaluation of actovegin efficacy in bronchial asthma].

PMID- 7791318
TI  - [The efficacy of hyperbaric oxygenation in resistant heart failure in elderly
      patients with ischemic heart disease].

PMID- 7791320
TI  - [Bed bath, skin care, special genital care, dressings (invasive approaches)].

PMID- 7791321
TI  - [Hysteroscopy--possibilities and limitations in diagnosis].

PMID- 7791319
TI  - [Little-studied human viral hepatitides].

PMID- 7791323
TI  - [Determination of personnel requirements in an intensive care unit].

PMID- 7791324
TI  - [Cost reduction in the health care system. Example: wound care with hydrocolloid
      dressings].

PMID- 7791322
TI  - [Hemofiltration, hemodiafiltration, biofiltration. Methods and indications in
      continuous kidney replacement techniques in an intensive care unit. 2].

PMID- 7791325
TI  - [Truth--also at the bed side].

PMID- 7791326
TI  - Sand, sandstorms, and sandcastles.

PMID- 7791327
TI  - Pulmonary thromboxane release following intestinal reperfusion.
AB  - Microvascular dysfunction is a prominent feature of the lung injury associated
      with intestinal reperfusion (IR). This study examines the hypothesis that IR
      induces pulmonary thromboxane A2 (TxA2) release, which contributes to pulmonary
      microvascular dysfunction. Sprague-Dawley rats underwent 120 min of intestinal
      ischemia and 60 min of reperfusion (IR). Sham-operated animals served as controls
      (SHAM). Following IR or SHAM, the lungs were perfused in vitro with a modified
      Krebs buffer and ventilated with room air. Eicosanoid levels within the pulmonary
      venous effluent and bronchoalveolar lavage (BAL) fluid were determined (TxB2, 6
      keto-PGF1a, and PGE2). Pulmonary artery pressure (PAP) was measured continuously
      and expressed as change from baseline in mm Hg. The dominant eicosanoid generated
      by the lungs in response to IR was TxB2. TxB2 levels in the pulmonary venous
      effluent of IR lungs were 75% greater than controls (P = 0.005). Similarly, TxB2
      levels in the BAL were more than 2.5 times controls (P = 0.001). The change in
      PAP of lungs from IR animals was significantly greater than that of controls (4.1
      +/- 1.5 vs 0.3 +/- 0.54 mm Hg, IR vs SHAM, P = 0.01). The increased PAP
      associated with IR lungs was prevented by cyclooxygenase inhibition with
      indomethacin (-1.28 +/- 0.29 mm Hg, P < 0.05) and thromboxane synthetase
      inhibition with imidazole (-1.75 +/- 0.95 mm Hg, P < 0.05). These experiments
      support the hypothesis that IR up-regulates endogenous pulmonary TxA2 release.
      Furthermore, the local release of TxA2 by the lung may contribute to the
      microvascular dysfunction characteristic of IR-induced lung injury.

PMID- 7791328
TI  - Splanchnic PGI2 release and "no reflow" following intestinal reperfusion.
AB  - This study examines the hypothesis that reduced splanchnic blood flow during
      intestinal reperfusion (IR) is associated with impaired release of the
      vasodilatory prostanoid PGI2. Sprague-Dawley rats underwent occlusion of the
      superior mesenteric artery (SMA) for 120 min and reperfusion for up to 60 min.
      SMA blood flow was measured by transonic flow probe and radiolabeled microspheres
      (141Ce and 103Ru). Sham-operated animals served as controls (SHAM). Splanchnic
      eicosanoid release was quantitated by measuring thromboxane B2 (TxB2, stable
      metabolite of TxA2), 6-keto-PGF1a (6-keto, stable metabolite of PGI2), and PGE2
      within the portal vein (PV) and inferior vena cava (IVC) of animals sustaining IR
      and SHAM. SMA flow in IR animals was < 10% of baseline and 27% of SHAM when
      measured by transonic flow probe (8 +/- 2% and 29 +/- 3%, IR and SHAM,
      respectively, P < 0.05). Similar results were obtained when intestinal blood flow
      was measured with microspheres (0.33 +/- 0.12 vs 1.34 +/- 0.13 ml/min/g, IR vs
      SHAM, P < 0.05). The greatest change in IR-induced splanchnic eicosanoid release
      occurred with 6-keto. Following ischemia, 6-keto levels in the PV were twice
      those of SHAM (P < 0.05). Five minutes after reperfusion, PV 6-keto levels were
      22 times those of controls (P < 0.05) and 4 times greater than those of the IVC
      (P < 0.05). By 60 min of reperfusion, levels of 6-keto were reduced to those in
      the IVC. These data support the hypothesis that splanchnic blood flow is
      critically reduced by severe IR.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791329
TI  - The effect of epidermal growth factor on mucosal function after ileal resection.
AB  - Since epidermal growth factor (EGF) enhances gut mucosal regeneration, the
      present study was undertaken to evaluate the effect of EGF on brush-border
      membrane enzyme activity and glutamine uptake in the intestinal remnant following
      extensive small bowel resection. Twenty-four adult male New Zealand White rabbits
      were divided into three groups: Group 1 (n = 12) served as controls. Groups 2 and
      3 (n = 6 each) underwent a 50-60% mid-jejunoileal resection with anastomosis of
      the remaining intestine, leaving 90 cm between the pylorus and the ileocecal
      valve. Group 3 rabbits had a subcutaneous osmotic pump implanted to deliver EGF
      for 7 days at 0.3 micrograms/kg/hr. Rabbits from Groups 2 and 3 were sacrificed 3
      weeks postoperation. Mucosa from the proximal and distal segments of the
      remaining intestine was analyzed for wet/dry weight, maltase and
      aminooligopeptidase activity, and glutamine uptake. There was a twofold increase
      in mucosal dry weight/cm of intestine in rabbits without EGF at 3 weeks (Group 2)
      and a fourfold increase in those given EGF (Group 3). The maltase enzyme capacity
      (UEnzyme/rabbit) increased from 37 +/- 10 in controls (Group 1) to 167 +/- 30
      without EGF and 207 +/- 30 with EGF. The aminooligopeptidase enzyme capacity
      (UEnzyme/rabbit) increased from 55 +/- 10 to 147 +/- 20 and 226 +/- 30 in Groups
      1, 2, and 3, respectively. Glutamine uptake capacity (microM glutamine/min) also
      increased significantly, from 63 +/- 19 in Group 1 to 88 +/- 6 without EGF and
      162 +/- 18 with EGF (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791330
TI  - Nitric oxide inhibits LPS-induced IL-6 production in enterocytes.
AB  - In recent studies, production of interleukin-6 (IL-6) in cultured enterocytes was
      stimulated by lipolysaccharide (LPS). In other cell types, IL-6 production was
      inhibited by nitric oxide (NO). We tested the hypothesis that LPS-induced IL-6
      production in the enterocyte is regulated, at least in part, by NO. IEC-6 cells
      (a rat intestinal epithelial cell line) were cultured for 3 days with different
      combinations of LPS (1-10 micrograms/ml), the NO synthase inhibitor N-omega-nitro
      L-arginine (NNA, 3-300 microM), L-arginine (10 mM), the NO donor sodium
      nitroprusside (SNP, 0.5-1 microM), or medium alone as control. IL-6 levels in the
      culture medium were determined by the B9 murine hybridoma bioassay. Nitrite, a
      stable end product of NO metabolism, was measured by HPLC. PCR was performed to
      determine inducible NO synthase (iNOS) mRNA expression in the IEC-6 cells.
      Treatment of IEC-6 cells with LPS stimulated IL-6 production. LPS-induced IL-6
      production was further increased by NNA in a dose-dependent fashion. This effect
      of NNA was abolished by the addition of L-arginine. SNP caused a dose-dependent
      decrease in IL-6 production. Nitrite production was increased in a dose-dependent
      fashion after LPS treatment. PCR revealed an increase in iNOS mRNA expression in
      IEC-6 cells after administration of 1 microgram/ml LPS. The results suggest that
      NO inhibits LPS-induced IL-6 production in the enterocyte. NO may be an important
      regulator of intestinal cytokine response during sepsis and endotoxemia.

PMID- 7791331
TI  - Role of the vagal branches to the proximal stomach in mediating gastric
      distention-induced disruption of canine interdigestive upper gut motility.
AB  - Previous experiments from our laboratory have shown that the vagus nerves mediate
      proximal gastric distention-induced disruption of interdigestive motor patterns
      in the upper gut of dogs. Our aim was to determine the role of vagal innervation
      of the proximal stomach in mediating the response to nonnutrient proximal gastric
      distention. Five dogs underwent proximal gastric vagotomy (PGV) and placement of
      electrodes and manometry catheters on the antrum and the upper small intestine.
      Proximal gastric distention for 5 hr was achieved by inflating a thin, compliant
      bag in the proximal stomach. Four volumes of distention stimulus (0, 1.5, 12.5,
      and 25 ml/kg) were tested. As with total abdominal vagotomy, intragastric
      stimulus volumes of 12.5 and 25 ml/kg after PGV no longer inhibited cycling of
      the migrating motor complex in the stomach, duodenum, proximal jejunum, and
      distal jejunum. Volumes of 12.5 and 25 ml/kg did, however, on occasion, lead to
      the absence of phase III activity in the stomach or the duodenum when it would
      have been expected to precede phase III activity in the jejunum; this effect did
      not occur in the jejunum. These findings with a nonnutrient stimulus suggest that
      vagal branches to the proximal stomach might mediate, in part, the postprandial
      changes in upper gut motility in response to gastric distention by ingestion of a
      meal.

PMID- 7791332
TI  - Teleost fish islets: a potential source of endocrine tissue for the treatment of
      diabetes.
AB  - Anatomical separation of pancreatic islets in some teleost fish makes them a
      useful source of pancreatic endocrine tissue. Islets were harvested from tropical
      Tilapia fish (Oreochromis nilotica) and cultured for 24 hr at 37 degrees C. Eight
      athymic nude mice were rendered diabetic by streptozotocin (STZ) and transplanted
      under the kidney capsule with fish islets. After transplantation (Tx), nonfasting
      blood glucose (n-FBG), which was in all recipients > 450 mg/dl, decreased to <
      100 mg/dl. At 4 and 7 weeks post-Tx, the intraperitoneal (ip) glucose tolerance
      test was performed in the normoglycemic Tx mice and in six normal controls. In
      controls, K value (percentage of decline in blood glucose/min) was 1.076 +/-
      0.383 and in Tx mice it was 0.956 +/- 0.336 and 0.869 +/- 0.483 at 4 and 7 weeks,
      respectively (P = n.s.). Nephrectomy raised the n-FBG to pre-Tx levels. On
      immunohistochemistry, recipient's pancreata showed atrophic islets with no beta
      cell granules, while the islet-bearing kidneys had distinct beta-cells under
      their capsules. Alginate-embedded fish islets were encapsulated in permselective
      (25-kDa) cellulose membranes and implanted ip in six STZ-diabetic nude mice. On
      the following day, all recipients became normoglycemic and their n-FBG remained
      normal for 7 days. In one animal, the n-FBG was < 200 mg/dl for 14 days and
      subsequent removal of the capsule raised the n-FBG to the pre-Tx level. Finally,
      it was found that fish islets can be cultured at 37 degrees C for extended
      periods of time.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791333
TI  - Endotoxin tolerance alters phospholipase C-gamma 1 and phosphatidylinositol-3'
      kinase expression in peritoneal macrophages.
AB  - Although the molecular signaling mechanisms underlying macrophage endotoxin (LPS)
      responsiveness are not fully understood, alterations in intracellular
      phosphatidylinositol (PI) metabolism appear to contribute. We evaluated the
      effects of endotoxin tolerance (ET) induction upon peritoneal macrophage (PM)
      expression of the principal PI enzymes phospholipase PLC-gamma 1 (PLC-gamma 1)
      and phosphatidylinositol 3'-kinase (PI-3-K). Rats received either 5 mg/kg LPS
      (ET) or phosphate-buffered saline (nontolerant, NT) which enabled 88% of ET and
      25% of NT to survive a 25 mg/kg LPS dose 3 days later. PM were harvested by
      lavage on Day 3 from both ET and NT rats. Following overnight culture, 5 x 10(6)
      PM in serum-free media were stimulated with 5 ng/ml LPS for 0 to 30 min. Cell
      lysates fractionated by SDS-PAGE were transferred to nitro-cellulose and blotted
      with PLC-gamma 1, PI-3'-K, and phosphotyrosine (4G10) monoclonal antibodies.
      Western immunoblots were developed by enhanced chemiluminescence and quantitated
      by densitometry. Unlike NT cells in which PLC-gamma 1 was expressed
      constitutively and increased with LPS stimulation, PLC-gamma 1 expression in ET
      cells stimulated with LPS was markedly reduced in three separate experiments. In
      contrast, ET cells expressed considerably higher concentrations of PI-3'-K to NT
      cells. Patterns of protein tyrosine phosphorylation were similar in both NT and
      ET cells regardless of LPS stimulation. The development of endotoxin tolerance
      decreased PLC-gamma 1 expression and markedly amplified PI-3'-K expression in
      macrophages. PI-3'-K-generated second messengers may contribute to unique
      signaling pathways responsible for tempered cellular responses to LPS.

PMID- 7791334
TI  - PMNs primed for superoxide release and increased CD11b expression do not
      sequester in normal lung.
AB  - Our previous work has implicated platelet activating factor (PAF)-induced
      neutrophil (PMN) priming and increased CD11b/CD18 receptor expression in the
      pathogenesis of lung injury following gut ischemia/reperfusion (I/R). In this
      model CD11b blockade abrogates lung injury but does not alter PMN priming or
      pulmonary leukosequestration. We, therefore, hypothesized that PAF-stimulated PMN
      priming and CD11b expression are insufficient to promote lung PMN sequestration.
      Normal rat PMNs, labeled with 51Cr, were incubated with PAF (10 ng/ml) to induce
      priming for superoxide (O2-) generation and enhance CD11b expression. Gut I/R
      animals underwent superior mesenteric artery occlusion for 45 min. 51Cr-labeled
      PMNs (2 x 10(7)) were injected iv. Study groups, consisting of (a)
      normal/control, (b) sham/laparotomy, and (c) gut I/R, were given either normal or
      PAF-treated PMNs. PAF-primed PMNs had increased 2- release and CD11b expression,
      but did not sequester in the lungs of normal rats. However, following gut I/R PAF
      treated PMNs sequestered in the pulmonary bed. These data suggest that PAF
      priming for O2- generation and increased CD11b expression are insufficient alone
      to promote PMN sequestration in the lung. Rather, additional factors generated by
      gut I/R are necessary for this process.

PMID- 7791335
TI  - The structured clinical instruction module: a novel strategy for improving the
      instruction of clinical skills.
AB  - We have previously shown that both medical students and residents demonstrate
      numerous important deficits when evaluating patients with abdominal complaints.
      To address these deficits, we implemented a pilot instructional program derived
      from the Objective Structured Clinical Examination. Fifty third-year medical
      students were presented with a 1-hr Structured Clinical Instruction Module (SCIM)
      of five stations, each station addressing a different aspect of the surgical
      evaluation of the abdomen. Simulated patients were present at two of the
      stations. Faculty from appropriate disciplines were present at the stations to
      provide standardized instruction according to predetermined curricular
      objectives. The medical students evaluated the SCIM for its specific
      characteristics, and they evaluated each of the five stations for its efficacy in
      increasing their clinical skills. All the specific aspects of the SCIM were given
      a rating significantly higher than neutral (P < 0.0001). Students agreed most
      strongly that the faculty were well prepared for the SCIM and that the faculty
      were enthusiastic. All of the SCIM stations were given a rating significantly
      higher than average (P < 0.0001). When compared to a conventional workshop, the
      SCIM scored significantly higher on all three common evaluation items. The SCIM
      was very well received by medical students as a format for clinical instruction.
      This unique modification of the Objective Structured Clinical Examination has
      potential for teaching important clinical skills that are not consistently
      mastered within current surgical curricula.

PMID- 7791336
TI  - A comparison of spontaneous versus induced tolerance in an experimental model of
      rat hepatic allograft transplantation.
AB  - In some rodent haplotype combinations, spontaneous tolerance (ST) develops after
      orthotopic liver transplantation (OLT) without any immunosuppression [e.g., Lewis
      (Lew, RT1) into Wistar Furth (WF, RT1u)] whereas in other combinations vigorous,
      progressive rejection rapidly leads to the death of the recipients. We (and
      others) have induced tolerance (IT) in a rejecting strain combination [Dark
      Agouti (DA, RT1a) into Lew] by intrathymic inoculation of donor bone marrow cells
      and 1 cc of antilymphocyte serum (ALS) 7-14 days prior to OLT. We hypothesized
      that cellular immunity in the two groups of animals was similar. We first
      compared survival in each group of animals and found that there was no difference
      in the number of animals surviving > 100 days (8/11 vs 16/17, ST vs IT,
      respectively, P = 0.11). Liver function studies were similar in these animals at
      2 and 4 weeks after OLT and comparable to syngeneic Lew into Lew OLT animals, but
      significantly lower than in the rejecting DA into Lew combination treated with
      only ALS. Animals that were unresponsive to their allografts demonstrated donor
      specific tolerance by the acceptance of donor strain (n = 4, ST and IT) and
      rejection of third party (n = 1 and n = 2, ST and IT groups, respectively)
      heterotopic heart allografts. One-way mixed lymphocyte cultures (MLC) of
      peripheral blood lymphocytes against donor and third party antigen were
      suppressed to donor and third party stimulators versus the MLC of unmanipulated
      animals. Naive host strain responder lymph node cells and purified T cells
      demonstrated strong proliferative responses to donor strain antigen in both the
      ST and IT animals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791337
TI  - Collagen matrix cisplatin prevents local tumor growth after margin-positive
      resection.
AB  - The extent of a tumor, sometimes combined with its anatomic location, can
      compromise the surgeon's ability to obtain clear margins of resection. Regional
      recurrence of a tumor in the resection bed frequently produces significant local
      morbidity and limits patient survival time and quality of life. A positive margin
      resection model was created by induction of perinephric VX-2 tumors in New
      Zealand white rabbits followed by unilateral nephrectomy with grossly positive
      margins in the retroperitoneum. Resection bed injection of a novel collagen
      matrix with cisplatin (CDDP) and epinephrine prevented tumor recurrence in all
      treated animals. In contrast, control animals treated with CDDP alone, CDDP and
      epinephrine alone, or the collagen matrix with epinephrine had bulky tumor
      recurrence in the resection bed. Resection bed tissue levels of platinum were
      determined by flameless absorption spectrophotometry at 1, 4, and 7 days
      following nephrectomy and injection of the collagen matrix, CDDP, and epinephrine
      or CDDP and epinephrine without the collagen matrix. Significantly higher
      resection bed drug levels of platinum were achieved through the use of the novel
      collagen matrix than through the use of CDDP and epinephrine alone (P < 0.05).
      The results of this study indicate that tumor bed treatment with CDDP and a
      unique collagen matrix drug-delivery vehicle produces prolonged high resection
      bed levels of platinum and prevents local tumor recurrence.

PMID- 7791338
TI  - Prostanoids inhibit Kupffer cell nitric oxide synthesis.
AB  - Kupffer cells are the largest population of fixed tissue macrophages in the body
      and produce a number of mediators that are involved in host defense. These
      mediators include cytokines such as tumor necrosis factor-alpha and interleukin
      1, prostaglandins, oxygen radicals, and nitric oxide. Prostaglandins are produced
      by adjacent endothelial cells in addition to Kupffer cells and regulate a number
      of cellular functions in a wide array of cells, but their role in nitric oxide
      synthesis is controversial. We studied the role of prostaglandins in regulating
      lipopolysaccharide (LPS)-induced nitric oxide synthesis in cultured rat Kupffer
      cells. Prostaglandin E2 (PGE2) inhibited Kupffer cell nitric oxide synthesis in a
      dose-dependent fashion in both 24- and 48-hr cultures. The effect of PGE2
      persisted at low and high LPS concentrations. Prostaglandin analogues as well as
      other prostanoids also inhibited Kupffer cell nitric oxide synthesis. These data
      show that exogenous prostaglandins suppress Kupffer cell nitric oxide synthesis
      and may represent an important endogenous regulator of nitric oxide production.

PMID- 7791339
TI  - Protein kinase C activation inhibits glutamate transport by endothelial cells.
AB  - The role of protein kinase C (PKC) in regulating endothelial cell glutamate
      transport was investigated. Glutamate transport studies were performed in
      confluent human umbilical vein endothelial cells which were treated with the
      phorbol ester 12-myristate 13-acetate (TPA, 0-1000 nM), a compound which directly
      activates PKC. TPA inhibited Na(+)-independent System xAG- glutamate transport by
      70% but only slightly reduced Na(+)-dependent activity. The TPA-mediated
      reduction in transport activity was dose-dependent, beginning at 5 min and
      lasting for at least 24 hr. TPA inhibition of glutamate transport had two
      distinctive phases: an acute phase (< 1 hr, not affected by either cycloheximide
      or actinomycin D) in which TPA decreased System xAG- glutamate transporter
      affinity (TPA Km = 522 +/- 25 microM vs control Km = 329 +/- 85 microM, P < 0.01)
      but did not alter transporter capacity (TPA Vmax = 4426 +/- 230 pmole/mg/min vs
      control Vmax = 4535 +/- 750 pmole/mg/min, P = NS) and a chronic phase (4-24 hr)
      in which TPA inhibition of glutamate transport was due to a reduced transporter
      capacity (Vmax = 2895 +/- 570 pmole/mg/min) without altering transporter affinity
      (Km = 370 +/- 60 microM glutamate) and was abrogated by cycloheximide or
      actinomycin D. The protein kinase C inhibitor chelerythrine chloride abrogated
      TPA's inhibition effect in both the acute and chronic phases. These data indicate
      that protein kinase C activation decreases glutamate transport in human umbilical
      vein endothelial cells via protein synthesis dependent and independent
      mechanisms.

PMID- 7791340
TI  - Reperfused gut elaborates PAF that chemoattracts and primes neutrophils.
AB  - Our in vivo model of mesenteric ischemia/reperfusion (I/R) has shown that the gut
      serves as a priming bed for neutrophils (PMN). Activation of phospholipase A2
      (PLA2) during ischemia temporally precedes PMN sequestration in the gut and the
      appearance of primed PMN in the portal circulation. Therefore, we hypothesized
      that reperfused gut secretes platelet activating factor (PAF) via PLA2 activation
      that is responsible for increased PMN chemotaxis and priming for superoxide (O2-)
      generation. Sprague-Dawley rats underwent gut ischemia/reperfusion (45 min SMA
      occlusion/2 hr reperfusion) or sham laparotomy. Distal ileum was harvested,
      rinsed with bacteriostatic saline/neomycin, and incubated for 1 hr at 37 degrees
      C in RPMI 1640 and the cell-free supernatant was collected. Normal human PMNs,
      isolated by plasma-Percoll gradients, were pretreated with or without a PAF
      receptor antagonist (WEB 2170). Chemotaxis toward gut supernatant was then
      measured by the agarose method. Additionally, PMNs were preincubated with or
      without WEB 2170 and their O2- release in response to 1 microM FMLP was measured
      by the Vmax of SOD-inhibitable cytochrome c reduction. Reperfused gut produced a
      chemotactic index of 2.1 +/- 0.1 compared to 0.2 +/- 0.9 following sham
      laparotomy (P < 0.05); this was reduced to 0.4 +/- 0.9 with PAF receptor
      blockade. Similarly, gut I/R supernatant primed PMNs for O2- (P < 0.05) compared
      to laparotomy, and this effect was abrogated by a PAF antagonist. These data
      suggest that reperfused gut can elaborate PAF which chemoattracts and primes PMNs
      for O2- generation.

PMID- 7791341
TI  - Impaired release of gallbladder calcitonin gene-related peptide in human
      gallstone disease.
AB  - Calcitonin gene-related peptide (CGRP) is a neurotransmitter present in the
      peripheral ends of sensory neurons of the gut and may modulate reflexes of the
      enteric nervous system. We studied the release of CGRP in normal human
      gallbladders and in those containing gallstones to test the hypothesis that
      abnormalities of regulation of CGRP release participate in gallstone formation.
      Human gallbladder strips were obtained from histologically normal organs removed
      during liver surgery (n = 8) or from patients operated upon for symptomatic
      cholelithiasis (n = 14). After removal of the mucosa, muscle strips were
      superfused with oxygenated Kreb's buffer in an organ bath at 37 degrees C.
      Pharmacologic agents were added to the superfusate and samples were collected at
      2-min intervals for analysis. CGRP release was measured by a sensitive and
      specific radioimmunoassay and adjusted for tissue weight. In normal gallbladders,
      CGRP release was stimulated sixfold over basal by capsaicin (10(-5) M) to 363 +/-
      75 pg per gram of muscle per 2 min. This release was abolished by addition of
      somatostatin (SS) or the neural blocker tetrodotoxin (TTX). Lesser degrees of
      CGRP release were observed after nonspecific stimulation with K+ or
      phosphodiesterase inhibition with caffeine. In gallbladders with gallstones,
      capsaicin-induced CGRP release was 74 +/- 16 pg per gram of muscle per 2 min (20%
      of normal, P < 0.001). Release induced by caffeine and K+ was also inhibited
      compared to normal gallbladder strips. Release of CGRP from diseased strips was
      abolished by TTX and inhibited by SS to degrees similar to normal
      tissue.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791342
TI  - Perioperative growth hormone improves wound healing and immunologic function in
      rats receiving adriamycin.
AB  - Administration of perioperative growth hormone may reverse alterations in wound
      healing and immunologic function in animals receiving chemotherapy. F344 rats
      were randomized into three groups: Control (n = 12), Chemo (n = 13), and Chemo +
      GH (n = 12). Human growth hormone (GH) (3 mg/kg sc bid) was begun on Day 0 and
      continued for 2 weeks. On Day 7, all animals underwent a standardized midline
      laparotomy, gastrotomy, and placement of a subcutaneous wound sponge. In
      addition, a single dose of adriamycin (5 mg/kg i.v.) was administered to those
      animals receiving chemotherapy. On Day 12, right hindlimb footpads were
      challenged with 50 micrograms of dinitrochlorobenzene. On Day 14, bursting
      strengths of the laparotomy and gastrotomy were measured. The wound sponge and
      gastric anastomosis were analyzed for hydroxyproline (OH-Pro) content. Animal
      spleens were weighed and splenocytes harvested for NK cell activity. Delayed type
      hypersensitivity (DTH) is reported as percentage of hind-limb foot pad swelling
      (%FPS). Data are expressed as means +/- SD and comparisons by ANOVA. The
      laparotomy bursting strength (mm Hg) in the Chemo + GH group (81 +/- 14) was
      significantly higher than that in the Chemo group (66 +/- 15, P < 0.05). The
      anastomotic tissue OH-Pro levels (mumole/g dry tissue) in the Chemo + GH group
      (107.9 +/- 15.2) were significantly higher than those in the Chemo group (62.9 +/
      8.5, P < 0.001). GH increased splenic weights (mg) over those of Chemo (0.50 +/-
      0.13 vs 0.37 +/- 0.05, P < 0.05). NK cell activity (% killing) was significantly
      elevated in the Chemo+GH group compared to that in Chemo.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7791343
TI  - Independent signal transduction pathways for IL-1 and TNF in LPS-tolerant
      macrophages.
AB  - Macrophages rendered "tolerant" by pretreatment with low-dose endotoxin (LPSp)
      release less TNF and more IL-1 in response to a second activating endotoxin
      exposure (LPSa). We hypothesized that LPSp pretreatment alters signal
      transduction pathways for TNF and IL-1 independently. The effect of pretreatment
      with LPSp alone was compared to pretreatment with LPSp plus defined second
      messenger pathway agonists or antagonists. Murine peritoneal macrophages were
      pretreated in vitro for 4 hr with LPSp or PMA or LPSp plus protein kinase C
      inhibitor (PKCi) or 8-bromo-cAMP. Cells were then washed and cultured with medium
      alone for 20 hr. Macrophages were also pretreated with LPSp plus indomethacin for
      the total 24-hr pretreatment interval. Cells were then stimulated for 24 hr with
      LPSa, after which supernatant TNF and IL-1 were measured by bioassay. In the
      absence of LPSp, mediators were increased by LPSa in a dose-dependent manner.
      LPSp pretreatment inhibited TNF and augmented IL-1 in response to LPSa.
      Pretreatment with PMA partially reproduced LPSp pretreatment. Pretreatment with
      PKCi alone increased both TNF and IL-1 release by LPSa. The combination of LPSp
      plus PKCi pretreatment further enhanced IL-1 release without affecting TNF
      inhibition. The addition of indomethacin had a similar effect. The combination of
      LPSp plus 8-bromo-cAMP blocked the augmentation of IL-1 without changing TNF
      inhibition. Macrophage endotoxin tolerance following LPSp pretreatment alters
      LPSa-triggered TNF and IL-1 release by independent signal transduction pathways.

PMID- 7791344
TI  - Tumor necrosis factor stimulates system XAG- transport activity in human
      endothelium.
AB  - System xAG- is responsible for the carrier-mediated Na(+)-independent transport
      of anionic amino acids such as glutamate and aspartate across the plasma membrane
      of cells. In order to examine a possible role for cytokines in regulating System
      xAG- activity, the effect of TNF on [3H]glutamate transport in cultured human
      umbilical vein endothelial cells (HUVECs) was studied. Carrier-mediated glutamate
      uptake was accomplished by two high-affinity carriers, predominantly by a Na(+)
      independent carrier (System xAG-, 75% of total glutamate uptake) and, to a lesser
      extent by a Na(+)-dependent carrier (System XAG-, 24% of total uptake). TNF
      treatment (10 ng/ml for 10 hr) resulted in an 80% increase in Na(+)-independent
      glutamate transport activity with no change in System XAG- activity. The TNF
      stimulatory effect was blocked by actinomycin D and cycloheximide. TNF treatment
      increased System xAG- glutamate transporter Vmax by 51% (control Vmax = 2359 +/-
      345 pmole/mg protein/min vs TNF Vmax = 3569 +/- 436 pmole/mg protein/min, P <
      0.01) without altering transporter affinity (control Km, 229 +/- 40 microM
      glutamate vs TNF Km = 224 +/- 60 microM glutamate, P = NS). The protein kinase C
      (PKC) inhibitor chelerythrine chloride had no effect on the TNF-stimulated
      glutamate transport, indicating that the augmented glutamate transport was not
      mediated by PKC activation. These data indicate that the TNF-stimulated glutamate
      transport in HUVECs requires do novo protein synthesis, possibly of the System
      xAG- transporter protein itself. Accelerated glutamate transport provides a
      precursor for the biosynthesis of macromolecules and glutamine.

PMID- 7791345
TI  - Changes in muscle mechanics during chronic conditioning for cardiomyoplasty.
AB  - Chronic repetitive stimulation of skeletal muscle causes significant changes in
      contractile mechanics and makes the muscle fatigue resistant. The purpose of this
      study was to quantify the magnitude and time course of these changes. One
      latissimus dorsi muscle from each of 28 mongrel dogs was stimulated in situ at 1
      Hz for 0, 3, 7, 14, 21, 42, or 70 days. Changes in isometric and isotonic
      mechanical performance were measured as a function of conditioning time. Isotonic
      force and velocity data were fitted to the Hill equation to obtain Vmax. The most
      striking early change was a 30 and 26% decline in muscle mass and cross-sectional
      area, respectively. Coincident with this was an approximate 40% decline in
      tetanic and twitch tension. There was a similar decline in the rates of rise and
      fall of twitch and tetanus tensions (+dT/dt and -dT/dt). The decline in tetanus
      +dT/dt and -dT/dt followed a similar time course, suggesting that these muscle
      functions were under similar influences. Calculation of the isometric force data
      per unit of cross-sectional area minimized the effect of stimulation on
      isometrically measured muscle function but did not eliminate it. Fusion frequency
      declined 52% with conditioning. The increases in time-to-peak twitch tension and
      half-relaxation time were independent of cross-sectional area. Time-to-peak
      twitch tension and half-relaxation time increased after 7 days of stimulation and
      became maximal after 42 or 70 days, respectively. Time-to-peak tetanus tension
      was unchanged by muscle conditioning. Changes in the force-velocity relationship
      began after 3 days of stimulation, changed very little between 3 and 21 days of
      stimulation, and showed another change after 42 and 70 days of stimulation. It
      may be possible to better modify the muscle for dynamic cardiomyoplasty by
      pharmacological or stimulation regimens once the mechanism of fiber switching is
      better understood.

PMID- 7791346
TI  - Hemorrhage affects the ability of murine peritoneal macrophages to alkanize
      intracellular pH in acidic environments.
AB  - Although departures from the normal physiologic pH range, associated with states
      of shock, injury, and/or infection are thought to impair phagocytic function and
      chemotaxis, it remains unknown if the ability of the peritoneal macrophage (pMo)
      to gate H+ is affected following hemorrhagic shock. To study this, male C3H/HeN
      mice were bled to a BP of 40 mm Hg and maintained at that level for 1 hr.
      Following resuscitation with the shed blood plus 2x that volume as Ringer's
      lactate, pMo was harvested via lavage in bicarbonate-free RPMI 1640 and
      enumerated to 2 million cells/ml. PMo was then loaded with a pH-sensitive dye,
      BCECF (2 micrograms/ml), for 20 min and washed with a buffered Na+ solution
      followed by phorbol myristate acetate stimulation (0.5 micrograms/ml). The
      capacity of the pMo to gate H+ at an external pH of 7.35 or 6.7 was assessed via
      fluorescence spectrophotometry. PMo from hemorrhaged animals had a decreased
      ability to alkalinize intracellular pH compared to that of control (P < 0.05),
      indicating a decreased ability of these Mo to maintain internal pH in an acidic
      environment following hemorrhage. In additional studies, oxidative burst capacity
      was determined by employing a commercially available fluorogenic substrate, (Fc
      Oxiburst), which fluoresces during intracellular oxidation. Fluorescence (U x
      10(6)) was assessed with the ACAS 570 laser cytometer, after 0 and 200 sec
      following ingestion of substrate. The results demonstrate that pMo oxidative
      burst capacity was also decreased following hemorrhage and resuscitation.

PMID- 7791347
TI  - Endogenous nitric oxide promotes ileal absorption.
AB  - BACKGROUND/AIMS: Nitric oxide (NO) is generated in vascular endothelium and
      enteric neural plexuses from L-arginine by the action of nitric oxide synthase
      (NOS). This study tested the hypothesis that NO is a modulator of ileal water and
      ion transport. METHODS: NADPH diaphorase staining was performed on fixed frozen
      sections of canine ileum. Absorption studies (n = 80) were performed in five dogs
      with 25-cm ileal Thiry-Vella fistulas (TVF). Perfusion with [14C]PEG was used to
      calculate absorption of water, ions, and glucose from the TVF. Experiments
      comprised three 1-hr periods: basal, drug infusion, and recovery. Drugs infused
      luminally at 5 x 10(-4) mol/liter included L-ARG (NOS substrate), L-NAME (NOS
      inhibitor), L-ARG/L-NAME combination, D-ARG (inactive enantiomer of L-ARG), L-LYS
      (basic amino acid control for L-ARG), and SNAP (NO donor). RESULTS: NADPH
      diaphorase staining indicated NOS activity in the ileal mucosa and submucosa. L
      ARG and SNAP caused significant increases in water and ion absorption, whereas L
      NAME caused significant decreases. The prosecretory effect of L-NAME was
      completely reversed by synchronous L-ARG. D-ARG and L-LYS had no significant
      effects. No infused agent influenced [14C]PEG recovery. CONCLUSIONS: Inhibition
      of endogenous NO synthesis by L-NAME causes a prosecretory response for water and
      ions, which can be reversed by the administration of NOS substrate L-ARG. These
      results are consistent with the hypothesis that endogenous NO maintains a
      proabsorptive influence on water and ion transport in the ileum.

PMID- 7791348
TI  - Attenuation of the endotoxin-stimulated increase in hepatic amino acid transport
      with a glucocorticoid receptor antagonist.
AB  - The role of the glucocorticoid hormones in mediating the accelerated hepatic
      amino acid transport that is characteristic of endotoxemia was investigated. To
      determine the role of these steroid hormones, rats that received endotoxin (LPS)
      were pretreated with the glucocorticoid receptor antagonist RU38486. The
      activities of the Na(+)-dependent amino acid transport systems A, ASC, and N and
      the Na(+)-independent systems L, y+, n, b0,+, and asc in hepatic plasma membrane
      vesicles were measured 4 hr after exposure to LPS. Endotoxin treatment resulted
      in time- and dose-dependent 5-fold (System A), 2.5-fold (System N), 2.6-fold
      (System ASC), and 2-fold (System y+ and b0,+) increases in transport activity
      attributable to an increase in carrier Vmax. The activities of L, asc, and n were
      unchanged by LPS administration. Pretreatment of endotoxemic animals with RU38486
      attenuated the LPS-induced enhancement in transport activity by 20-60% by
      diminishing carrier Vmax, with no effect on transport Km. We conclude that the
      marked increase in hepatic amino acid transport activity that occurs during
      endotoxemia requires participation of the glucocorticoid hormones.

PMID- 7791350
TI  - Human pancreatic cancer growth is inhibited by peptide YY and BIM-43004-1.
AB  - Exogenous peptide YY (PYY) decreases pancreatic exocrine secretion, pancreatic
      endocrine function, and pancreatic blood flow. We hypothesized that pancreatic
      cancer cell growth may be inhibited by PYY and a new synthetic analog, BIM-43004
      1. Two human pancreatic ductal adenocarcinomas, PANC-1 and Mia PaCa-2, were
      examined in tissue cultures. Viable pancreatic cancer cells were counted with
      trypan blue on a hemocytometer slide. Cells (10K, 20K, 40K, and 80K) were
      cultured and allowed to grow for 36 hr (n = 14/cell concentration). Pancreatic
      cancer cells received either PYY or BIM-43004-1 at various concentrations.
      Control tissue cultures received an equivalent volume of saline inoculation.
      After incubation with the above peptides for 24 hr, MTT tetrazolium bromide was
      added to assay mitochondrial activity of pancreatic cancer cells in response to
      PYY and its analog. MTT assay reveals a significant decrease in pancreatic cancer
      cell growth when PYY and BIM-43004-1 are added to the cell culture. Results in
      Mia PaCa-2 reveal a 24% cell growth reduction after exposure to PYY and a 23%
      reduction in cell growth when treated with BIM-43004-1. In PANC-1 cells, a 25%
      reduction in growth of cells is noted after PYY treatment and a 24% reduction in
      growth after BIM-43004-1 treatment. (means +/- SEM, P < 0.05 by Student's t
      test). Our results reveal a significant reduction in human ductal pancreatic
      cancer growth when treated with either PYY or its analog, BIM-43004-1. These
      agents may be useful hormonal adjuncts in the chemotherapy of pancreatic
      adenocarcinoma.

PMID- 7791349
TI  - Gangliosides and spinal cord ischemia secondary to aortic cross-clamping in the
      rat model.
AB  - Gangliosides, complex glycolipids of the nervous system cell membranes, have been
      found effective both in reducing the degree of ischemic injury and in stimulating
      neuronal regeneration during the recovery period. In order to investigate their
      neuroprotective effect during spinal cord ischemia, 60 male Sprague-Dawley rats
      underwent occlusion of the thoracic aorta and both subclavian arteries for 13
      min. In the postoperative period, function of hindlimbs was appraised, daily for
      30 days, by a deficit score (0-15). The animals were then killed and spinal cord
      injury was assessed by a histologic score (0-3) based on the degree of gray and
      white matter gliosis, number of motor neurons, and white matter myelination. The
      rats received intraperitoneal injection of placebo (n = 29) or GM-1 30 mg/kg (n =
      31) daily, from 2 days prior to surgery to 15 days after. The scores of each
      group for each day were analyzed by repeated measures analysis of variance. The
      rate of recovery was better for GM-1 (P < 0.001) from the 15th to the 30th day. A
      trend was seen toward lower scores in the GM-1 group (P = 0.056). Mean histologic
      scores (placebo = 1.14 +/- 0.23 SE, GM-1 = 1.58 +/- 0.22 SE) did not differ
      (Wilcoxon, P = 0.17). The present data support the hypothesis that functional
      improvement after spinal cord ischemia due to aortic occlusion is enhanced by the
      administration of gangliosides. Optical microscopy could document only
      irreversible injury and might not be sensitive enough to detect subtle changes
      during recovery of neural elements.

PMID- 7791351
TI  - Pattern of injury and the role of neutrophils in reperfusion injury of rat lung.
AB  - Using a rat lung model, we sought to characterize the time course for ischemia
      reperfusion injury and the role of neutrophils in the development of injury.
      Adult male Long-Evans rats underwent left thoracotomy with dissection and
      clamping of the left pulmonary artery, bronchus, and vein for 90 min, resulting
      in complete left lung ischemia. The lungs were then ventilated and reperfused for
      up to 4 hr. Time-matched sham animals underwent the identical thoracotomy and
      hilar dissection, but the lungs were not rendered ischemic. Using vascular
      permeability of 125I-labeled bovine serum albumin as a measure of reperfusion
      injury, a bimodal pattern of injury was observed. Compared to sham controls,
      animals undergoing ischemia-reperfusion demonstrated a significant early phase of
      lung injury at 30 min of reperfusion (P < 0.0001), followed by partial recovery.
      A second peak of lung injury was noted after 4 hr of reperfusion (P < 0.001).
      Myeloperoxidase activity in reperfused lung tissue, a measure of neutrophil
      sequestration, increased during the reperfusion time course. To determine the
      role of neutrophils in the development of lung reperfusion injury, additional
      animals undergoing the identical ischemia-reperfusion protocol received either
      rabbit anti-rat neutrophil serum or preimmune serum the day prior to operation.
      Profound neutropenia (< 75/mm3 blood) was confirmed by differential leukocyte
      counts. Neutropenia had no protective effect against microvascular permeability
      at 30 min of reperfusion, but there was a significant reduction in lung injury at
      4 hr (P < 0.005). We conclude that, during lung ischemia-reperfusion, there is a
      bimodal pattern of injury, consisting of both neutrophil-independent and
      neutrophil-mediated events.

PMID- 7791352
TI  - A model of intestinal ischemia in the neonatal rat utilizing superior mesenteric
      artery occlusion and intraluminal platelet-activating factor.
AB  - The human premature newborn is susceptible to necrotizing enterocolitis (NEC) in
      the first 1 to 3 weeks of life, a time when the gastrointestinal tract is
      structurally and functionally premature. Studies of NEC are hampered by the lack
      of a standard, reproducible model in newborn animals. The purpose of this study
      was to produce a model for intestinal ischemic injury in newborn rats. On Days
      14, 18, 22, and 26 of life, newborn rats (10/day) were subjected to 1 hr of
      superior mesenteric artery occlusion with a microaneurysm clip. Platelet
      activating factor (PAF, 50 micrograms/kg) was injected into the lumen of the
      proximal small intestine after occlusion was initiated. Control animals (10/day)
      underwent sham laparotomy on Days 14, 18, 22, and 26. Animals were autopsied upon
      demise (7.6 +/- 0.7 hr) or at 24 hr. The intestine was inspected for gross
      ischemic changes and samples were taken for histology and myeloperoxidase (MPO,
      an index of neutrophil infiltration). Ischemic injury was graded in a blinded
      fashion, by a pathologist, using a scale from 0 to 4 (0, no injury; 4, full
      thickness necrosis). All animals in the experimental groups had evidence of
      histologic injury (mean +/- SEM) on Days 14 (1.0 +/- 0.0), 18 (2.5 +/- 0.5), 22
      (3.6 +/- 0.3), and 26 (3.1 +/- 0.5). The sham-operated control animals had no
      injury (P < 0.0001). MPO levels (U/g protein) on Days 18 (27.2 +/- 1.7 vs 13.9 +/
      2.3), 22 (40.9 +/- 5.4 vs 7.6 +/- 0.8), and 26 (29.3 +/- 4.4 vs 7.6 +/- 1.0)
      were significantly higher in experimental groups vs controls (P <
      0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791354
TI  - Lymphocyte-derived cytokines augment macrophage tumor necrosis factor-alpha and
      interleukin-6 secretion during experimental gram-negative bacterial sepsis.
AB  - Although lymphocyte-derived cytokines are known to augment macrophage cytokine
      production in vitro, their effect on macrophage tumor necrosis factor-alpha (TNF
      alpha) and interleukin-6 (IL-6) secretion during gram-negative bacterial sepsis
      has not been characterized. The purpose of this study was to examine the effect
      of lymphocyte-derived cytokines on macrophage TNF-alpha and IL-6 secretion during
      gram-negative bacterial peritonitis. To examine this problem, uninfected and
      infected mice were studied. Mice were infected with Escherichia coli O111:B4 and
      two subgroups were examined consisting of those pretreated iv 1 hr prior to
      bacterial challenge with either (1) saline or (2) anti-E. coli O111:B4 LPS mAb
      2A3, the latter administered to abrogate the effects of LPS in vivo. Thus, three
      groups of mice were studied in relation to pretreatment and infectious
      challenges: (1) saline/saline (control); (2) saline/E. coli (saline); and (3) mAb
      2A3/E. coli (mAb 2A3). Nonadherent splenocytes (> 95% lymphocytes by histologic
      staining criteria) harvested 16 hr later from mice in each group were incubated
      in culture ex vivo for 3 hr to obtain supernatants containing lymphocyte-derived
      cytokines. These supernatants containing lymphocyte-derived cytokines then were
      incubated in vitro with naive splenic macrophages with or without E. coli O111:B4
      LPS. Macrophage TNF-alpha and IL-6 levels were determined using L929 and B9
      bioassays.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791355
TI  - Efferent limb myoneural and luminal continuity and postgastrectomy gastric
      emptying.
AB  - Delayed gastric emptying and altered upper gut transit or both are common
      following Roux-en-Y gastrojejunostomy and are thought to be due to altered
      efferent limb transit secondary to isolation of the Roux limb from the duodenal
      pacemaker. We postulated that preservation of myoneural continuity of the Roux
      limb with the duodenal pacemaker would enhance solid gastric emptying, while
      division of the afferent limb of a Billroth II gastrojejunostomy (B-II),
      isolating the efferent jejunal limb from the duodenal pacemaker, would slow
      gastric emptying. Solid gastric emptying was measured in 14 dogs, who then
      underwent gastric vagotomy and antrectomy. Eight animals were reconstructed with
      a Roux-en-Y gastrojejunostomy, preserving myoneural but not luminal continuity of
      the Roux limb with the afferent limb via a muscularis bridge, while six dogs
      underwent standard B-II gastrojejunostomy. Serosal electrodes were placed on the
      afferent and efferent jejunal limbs. Gastric emptying was restudied, with fed and
      fasted myoelectric recordings. The bridge was then divided to create a standard
      Roux, while the afferent limb was transected and reanastomosed just proximal to
      the gastrojejunostomy in the B-II dogs to isolate the efferent limb from the
      duodenal pacemaker, with repeat studies. Bridge dogs had delayed solid gastric
      emptying compared to their preoperative state, despite normal efferent limb
      motility.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791353
TI  - Dibutyryl cAMP reduces nonparenchymal cell damage during cold preservation of rat
      livers.
AB  - Sinusoidal lining cells are the main target for cold preservation injury and are
      further damaged with reperfusion. Different agents known to increase
      intracellular cAMP levels have been shown beneficial. This study was designed to
      assess the possible protective effect of a cAMP analogue on nonparenchymal cells
      of rat livers, during cold storage and during reperfusion. Parameters reflecting
      the status of the liver microvasculature were analyzed. The initial effluent
      collected after preservation reflects release during the cold storage period;
      therefore we measured interleukin-1 (IL-1) and endothelin-1 (ET-1) levels in
      these samples in order to detect and quantitate the degree of activation and/or
      disruption of Kupffer and sinusoidal endothelial lining cells. Rat livers were
      harvested after in situ flush with Ringer's lactate with or without 2 mM
      dibutyryl cAMP, excised, and stored in the same solution at 4 degrees C. After 6
      hr, livers were perfused with Krebs-Henseleit buffer for 90 min. Physiological
      parameters were monitored throughout the perfusion. Perfusate samples were
      collected every 30 min for RIA measurements of IL-1 and ET-1. Treatment resulted
      in a significant decrease in release of ET-1 and IL-1 during storage. Likewise,
      livers treated with cAMP had a significantly improved bile output and decreased
      portal vein resistance during reperfusion. The beneficial effect granted by the
      analogue during cold storage and reperfusion was evident on parenchymal and
      nonparenchymal cells. Levels of ET-1 and IL-1 in the caval effluent confirm and
      quantitate preservation damage.

PMID- 7791356
TI  - GI hormonal changes in diabetes influence pancreatic cancer growth.
AB  - Streptozotocin diabetes prevents induction of pancreatic tumors in several animal
      models, suggesting a pivotal role for islet cell products in the pathogenesis of
      pancreatic cancer. To test the hypothesis that altered gastrointestinal peptide
      levels in streptozotocin diabetes influence tumor growth, human pancreatic cancer
      cells (MIA PaCa-2) were implanted subcutaneously into streptozotocin diabetic
      nude mice. After 3 weeks, tumors in the control group weighed 43 mg and tumors in
      the diabetic group weighed 12 mg (P < 0.001). Plasma insulin and IGF-1 levels
      were significantly decreased in the streptozotocin-treated animals compared to
      those of control (insulin: 23 microU/ml vs 31 microU/ml, P < 0.001; IGF-1: 254
      ng/ml vs 324 ng/ml, P < 0.001). In contrast, somatostatin and glucagon were
      significantly elevated in the streptozotocin diabetic group relative to control
      levels (somatostatin: 179 pg/ml vs 54 pg/ml, P < 0.001; glucagon: 290 pg/ml vs
      134 pg/ml, P < 0.001). Competitive binding studies revealed specific cell surface
      receptors for insulin (Kd = 15.5 nM), IGF-1 (Kd = 30.0 nM), and somatostatin (Kd
      = 2.5 nM) on the MIA PaCa-2 cells. Receptors for glucagon were absent. In an in
      vitro cell proliferation assay, cell division was promoted by insulin (P < 0.01,
      max + 11%) and IGF-1 (P < 0.01, max + 10%). Somatostatin inhibited cell division
      (P < 0.01, max - 18%). No effect was seen with glucagon. The growth of pancreatic
      cancer, particularly in diabetes, may be influenced by gut peptides in a receptor
      dependent fashion.

PMID- 7791357
TI  - Differential TNF secretion by wound fibroblasts compared to normal fibroblasts in
      response to LPS.
AB  - Fibroblasts cultured from wound sites have been shown to have an altered
      phenotype compared to normal dermal fibroblasts and are generally regarded as
      target cells of the cytokine response at sites of injury. This study was
      undertaken to determine whether wound fibroblasts can contribute to
      proinflammatory cytokine production in wounds and, in particular, whether they
      are capable of secreting TNF. Wound fibroblasts were cultured from polyvinyl
      alcohol sponges implanted subcutaneously for 2 weeks in Balb/c mice. Fibroblasts
      harvested from the skin and subcutaneous tissue of untreated mice served as a
      control population of cells. All cells were passaged at least twice and then
      stimulated with a dose range of LPS. Supernatants were harvested 8 hr following
      stimulation and TNF was assayed using a standard L929 cell-killing assay. There
      was a significant TNF response to LPS by wound fibroblasts, evident as early as 4
      hr following exposure to LPS and associated with an upregulation of TNF mRNA.
      Normal dermal fibroblasts did not secrete any measurable amounts of TNF in
      response to LPS. The results indicate that wound fibroblasts generate a brisk TNF
      response to stimulation with LPS, in contrast to normal subcutaneous fibroblasts.
      These data reveal an additional unique property of wound-harvested fibroblasts
      and suggest a possible contributing mechanism to disordered wound healing in the
      face of infection or conditions characterized by excessive fibrosis.

PMID- 7791359
TI  - A computer-based system for the measurement of membrane capacitance to monitor
      exocytosis in secretory cells.
AB  - A software-based system for real-time measurement of membrane capacitance was
      developed for monitoring exocytosis in a single cell. The IBM PC compatible
      software, linked to an interface box, provides capacitance measurement
      capabilities to a patch-clamp setup utilizing a Labmaster data acquisition board.
      In order to measure the time-dependent changes in membrane capacitance, the
      system uses a software-based phase detector which isolates capacitive membrane
      current from a cell subject to sinusoidal voltage stimulation. The sampling
      program can monitor changes in membrane capacitance in response to depolarizing
      voltage steps, intracellular calcium stimulation, or drug application. A separate
      analysis program was constructed to implement the quantitative analysis, plotting
      and exporting of the capacitance, conductance and current data acquired by the
      sampling program.

PMID- 7791358
TI  - Pulmonary hypertension in acute lung injury is due to impaired vasodilation with
      intact vascular contractility.
AB  - The major hemodynamic feature of acute lung injury (ALI) is pulmonary
      hypertension. Both endothelial-dependent and -independent pulmonary
      vasorelaxation is impaired in ALI due to endotoxemia. We hypothesized that
      endotoxemia selectively impairs relaxation of the pulmonary artery but does not
      impair contractility of pulmonary vascular smooth muscle (VSM). Our purpose was
      to determine the effect of endotoxemia (ETX) on the contractile response of
      pulmonary VSM to (1) tubular depolarization (KCl), (2) alpha 1-adrenoreceptor
      stimulation (phenylephrine, PE), (3) 5HT2 receptor stimulation (serotonin, 5HT),
      and (4) prostaglandin F2 alpha receptor stimulation. Pulmonary artery rings were
      isolated from rats 6 hr after injection of ETX, 20 mg/kg ip (n > or = 6), or
      saline (n > or = 6) and suspended on tensiometers in individual organ baths.
      Endothelial-dependent cGMP-mediated relaxation was determined using the receptor
      agonist acetylcholine (ACh) in rings preconstricted with PE. Dose-response curves
      were generated to each contractile agonist. Statistical comparison was performed
      using one-way ANOVA with post hoc Bonferonni-Dunn, P < 0.05 accepted as
      significant. Relaxation to ACh was 96.4 +/- 1.3% in controls vs 21.4 +/- 3.1% (P
      < 0.05) in endotoxin-treated rats. Endotoxin did not affect the maximal tension
      in response to the contractile agonists nor did it change the concentration
      required to produce 50% contraction (EC50). From these data we conclude that
      endotoxemia causes a decrease in vasorelaxation to the endothelial-dependent
      receptor agonist acetylcholine but does not impair agonist-induced contractility
      of pulmonary VSM. This suggests that pulmonary hypertension in ALI is mediated by
      impairment of pulmonary vasodilation with preservation of VSM contractility.

PMID- 7791360
TI  - Application of 'nose-poke habituation' validation with post-trial diazepam- and
      cholecystokinin-induced hypo- and hypermnesia.
AB  - The present study describes the use of nose-poke habituation as a memory task and
      demonstrates that it is sensitive to hypo- and hypermnestic pharmacological
      treatments administered post-trial. Habituation of nose-poke behavior of rats was
      defined as a reduction in number of nose-pokes compared to baseline. It was
      measured using a board with 16 holes, to which animals were exposed on 2
      consecutive days (baseline and test) for 10 min, respectively. After the first
      exposure, rats were injected intraperitoneally (i.p.) immediately or with a delay
      of 2.5 h with doses of diazepam (0.9-4.5 mg/kg) known to be hypomnestic, or
      cholecystokinin (CCK-8S; 0.2-25 micrograms/kg), which was reported to have memory
      facilitating effects. An enhancement of habituation in comparison with vehicle
      controls was interpreted in terms of a hypermnestic effect of the treatment.
      Conversely, hypomnestic action of the drug treatment was inferred from a reduced
      habituation. The results show that when diazepam was injected immediately post
      trial, the normal reduction in number of nose-pokes during test was prevented,
      indicative of a failure to habituate presumably due to an amnesia for the
      baseline/training trial. In contrast, enhanced habituation (facilitation of
      memory) was induced when CCK-8S was injected immediately post-trial, as reflected
      by a decrease in number of nose-pokes during test compared to control animals.
      The effects were not due to enduring proactive effects of the compounds on
      performance during test, since post-trial injections of diazepam or CCK-8S with a
      delay of 2.5 h did not have the effects that immediate post-trial injection
      had.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791361
TI  - A statistically based method to generate response maps objectively.
AB  - One scheme to classify the physiological response properties of single units in
      the cochlear nucleus is based on the average discharge rate of the unit and is
      reflected in the distribution of excitatory and inhibitory regions in a frequency
      level map (response map) that spans the unit's receptive area (e.g., Evans and
      Nelson, 1973; Young and Brownell, 1976; Young and Voigt, 1982; Shofner and Young,
      1985, Spirou and Young, 1991). Typically, discharge rate versus level curves are
      acquired at many frequencies and the investigator determines that a unit is
      excited or inhibited at a given level if the driven rate is above or below a
      spontaneous rate estimate by a specified criterion (for example, 20%). The
      investigator then encloses regions of excitation and inhibition where responses
      over adjacent frequencies and levels are consistent. In the present report, we
      describe an objective 3-step computer-based method to generate response maps: raw
      driven and spontaneous rate estimates are smoothed with a low-pass spatial
      filter; a unit is said to be excited or inhibited at a given level if the
      filtered driven rate is above or below the mean filtered spontaneous rate for
      that frequency by a specified criterion (percentage or statistical); and
      resultant response maps are median spatial filtered to eliminate spurious
      regions. The results shown here demonstrate that use of a statistical criterion
      provides a more reliable detection of excitation and inhibition than a 20%
      criterion, particularly when the variance of the rate estimates is high. Further,
      the statistically based method permits unit classification based on response map
      data that are more rapidly acquired with shorter duration stimuli (32 vs. 200
      ms). Although this method is applied to units recorded in the dorsal cochlear
      nucleus, the technique may be applicable to studies of receptive fields and their
      plasticity in other systems.

PMID- 7791362
TI  - Intracranial pressure waveform indices in transient and refractory intracranial
      hypertension.
AB  - Analysis of data obtained by continuous computerized monitoring of intracranial
      pressure (ICP) in 109 adult patients with severe head trauma was performed to
      examine the pattern of change in indices of the ICP waveform. Indices derived
      from direct measurement of the ICP wave and obtained from a Fast Fourier
      Transform (FFT) were examined. Concurrent physiologic measurements were made. Two
      types of intracranial hypertension (ICH) were defined for comparison. 'Transient
      intracranial hypertension' occurred when an abrupt rise in ICP was followed by a
      return to below 25 mm Hg (n = 63). Increases in ICP that were progressive and led
      to neurologic deterioration and death were termed 'refractory intracranial
      hypertension' (n = 18). During transient ICH heart rate, arterial pressure, end
      tidal carbon dioxide and jugular venous oxygen saturation all increased, while
      these measures either were unchanged or decreased during refractory ICH. The
      pulse amplitude of the ICP wave increased in both types of ICHtn. Other changes
      in the waveform indices were consistent with this change in pulse amplitude. HFC
      responded differently to the two types of changes, with an increase during the
      transient changes and a decrease during the refractory changes. The differences
      in changes in physiologic measurements as ICH occurred in the 2 groups suggest
      that in refractory ICH cerebral blood flow is maintained against the mounting
      ICP, while in transient ICH the hypertension is caused by an increase in cerebral
      blood flow. The waveform indices do not discriminate between the two types of
      changes.

PMID- 7791364
TI  - The analysis of excitatory, inhibitory and other amino acids in rat brain
      microdialysates using microbore liquid chromatography.
AB  - Three microbore liquid chromatography (LC) assays for determination of amino
      acids in rat brain dialysates are described: one for separation of amino acids by
      gradient elution and electrochemical detection, one for analysis of GABA by
      isocratic elution and electrochemical detection, and one for fast measurement of
      glutamate and aspartate by gradient elution and fluorescence detection. The
      assays are reliable, reproducible and sensitive. In comparison with conventional
      LC, a 5-fold increase in sensitivity was obtained for GABA. Optimization of the
      derivatization chemistry and the microbore LC system are discussed, as well as
      important practical aspects.

PMID- 7791363
TI  - A preparation of the blowfly (Calliphora erythrocephala) brain for in vitro
      electrophysiological and pharmacological studies.
AB  - We describe a method for the preparation and maintenance of the blowfly
      (Calliphora erythrocephala) brain in a recording chamber under in vitro
      conditions in a semi-slice configuration. Large identification neurones in the
      posterior part of the 3rd optic lobe (lobula plate) can be penetrated easily with
      microelectrodes. The so-called vertical system (VS) cells which respond to
      vertical image motion in vivo could be encountered best because their axons are
      escorted individually by specific tracheae. Fluorescent stained cells show their
      natural shape as being in vivo. Electrophysiological properties of the cells
      investigated so far, i.e., resting potential (about -40 mV) and firing properties
      (single rebound spikes), are comparable to recordings in intact flies. Initial
      pharmacological experiments on VS cells in this preparation reveal that
      iontophoretical application of acetylcholine and carbamylcholine results in
      depolarization. VS cells also respond to bath-applied nicotine (1 microM) with a
      slow depolarization of their membrane potential in normal fly saline as well as
      in a Ca(2+)-free saline, suggesting direct cholinergic input via nicotinic
      receptors. The suitability of the preparation for a wide range of
      electrophysiological and pharmacological studies is discussed.

PMID- 7791366
TI  - A quantitative method for morphometric analysis in neuronal cell culture:
      unbiased estimation of neuron area and number of branch points.
AB  - The morphology and fine structure of neurons in vivo as well as in vitro are
      influenced by a variety of cell-adhesion and extracellular matrix molecules and
      soluble growth factors. To examine the effects of such molecules, we have
      developed a new method for the quantitation of several parameters associated with
      the morphology of neurons in culture. Whereas methods which have been
      traditionally used to perform quantitative morphometric analysis of neurons in
      vitro are often time-consuming and subjective, the methods we describe provide a
      rapid, efficient, and unbiased approach to morphometric analysis of cultured
      neurons.

PMID- 7791365
TI  - Studies on the 3-dimensional architecture of dendritic spines and varicosities in
      human cortex by confocal laser scanning microscopy and Lucifer yellow
      microinjections.
AB  - A method for 3-dimensional (3-D) visualization of dendritic spines and
      varicosities in human cortical neurons is described. Intracellular microinjection
      of Lucifer Yellow was used to display the morphology of dendrites on pyramidal
      and non-pyramidal neurons. Confocal laser scanning microscopy was used for
      imaging, and 3-D reconstructions and analysis of spines and varicosities were
      performed. The frontal, temporal, parietal and occipital cortices, and
      hippocampus in normal and pathological human brains were studied. Using this
      technique spines can be visualized from both sides of dendrites, which are
      'hidden' in 2-D representations, and therefore not usually included in the
      extimation of dendritic spine density/total spine numbers. In patients with
      Rett's syndrome and some epilepsy patients, a regional loss of dendritic spines
      ('naked' dendrites) was found. These results will be included in the Human Brain
      Mapping Project.

PMID- 7791367
TI  - Miniature microdrive for extracellular recording of neuronal activity in freely
      moving animals.
AB  - The new design of a removable miniature microdrive for extracellular recordings
      of single-unit activity in freely moving animals with high-impedance electrodes
      is presented. The construction permits very simple installation and removal of
      the microelectrodes, rapid fixation of the microdrive on the animals skull and
      rapid removal after recording. The microdrive provides vertical positioning of
      the electrode without rotations and lateral shifts, stable recordings of single
      units for several hours and the possibility to change the penetration track 20-30
      times in the same animal. The 3.2-mm diameter of the microdrive cylinder permits
      the installation of several units simultaneously. The weight of the microdrive
      with the base is 115 mg. The microdrive permits penetrations to any desired
      depth.

PMID- 7791368
TI  - Neuron labeling by extracellular delivery of horseradish peroxidase in vivo: a
      method for studying the local circuitry of projection and interneurons at
      physiologically characterized sites.
AB  - An anatomical method is described that yields individual neurons with
      continuously labeled dendrites and axons following the extracellular deposition
      of horseradish peroxidase (HRP) at neurophysiological recording sites in vivo.
      The method is a logical evolution of previous methods for iontophoretic delivery
      of HRP: Parameters critical to the ultimate concentration of HRP at the labeling
      site are reduced by an order of magnitude relative to standard practice. In
      successful cases one neuron or two in the immediate vicinity (50 microns) of
      recording sites is/are labeled. Labeling of other processes traversing the
      injection site, if any, is subliminal at highest light microscopic magnification.
      Due to the labeling of so few cells and the absence of other labeled processes,
      dendritic trees and local axonal arbors can be reconstructed without ambiguity.
      In addition to recovering neurons at sites characterized with physiological
      (e.g., sensory) stimuli, the method offers the further advantage of being fully
      compatible with subsequent electron microscopy. Both large (> 20 microns) and
      small (approximately 8 microns) neuron types and glia have been labeled.

PMID- 7791369
TI  - Isolation of mature olfactory neurones using retrograde labelling and flow
      cytometry.
AB  - Currently we can observe an increasing interest for epithelial olfactory
      neurones. Several laboratories are involved in elucidation of the odorant
      molecule recognition process and transduction cascade which brings information to
      the olfactory bulb. Others use this model, unique in mammals, to accumulate new
      knowledge on the neurogenesis phenomenon. Here we describe a simple and efficient
      method to purify mature olfactory neurone populations extracted from the nasal
      cavity. The approach relies on retrograde axonal tracing followed by flow
      cytometry sorting. For this purpose we inject a fluorescent dye (Fast Blue or diI
      C18(3)) in the olfactory bulb of adult rats. Seven days later, we extract the
      nasal turbinates and separate the mucosa from the subjacent lamina propria. The
      tissue is enzymatically dissociated and the labelled cells are sorted with a flow
      cytometer. Purification of the mature olfactory neurones varies from 80 to 99%.

PMID- 7791370
TI  - Determination of in vivo amino acid neurotransmitters by high-performance liquid
      chromatography with o-phthalaldehyde-sulphite derivatisation.
AB  - The measurement of amino acid neurotransmitters by high-performance liquid
      chromatography (HPLC) has emerged as a reliable and sensitive method. This paper
      describes a method which employs electrochemical (EC) detection of amino acid
      derivatives formed by a reaction with o-phthalaldehyde (OPA) in the presence of
      sulphite ions. This is discussed in relation to the problems of previously
      reported methods based on OPA derivatisation. Precise separation of the following
      7 amino acid standards is achieved using isocratic elution: serine, glycine,
      taurine, glutamate, arginine, alanine and GABA, in order of increasing retention
      time. Total elution time is 25 min. Derivatisation proceeds at room temperature
      and the derivatives are stable for up to 5 h. This technique has the sensitivity
      to determine the concentrations of amino acid neurotransmitters in cerebrospinal
      fluid (CSF) and an in vivo microdialysis method is discussed for the detection of
      basal and potassium-stimulated levels of gamma-aminobutyric acid and glutamate
      from rat hippocampus.

PMID- 7791371
TI  - Massage and damage to lymphatics.

PMID- 7791372
TI  - Are peripheral lymphatics damaged by high pressure manual massage?
AB  - Massage of the foot in men and the hindpaw in dogs was performed by applying
      external pressures of 70-100 mmHg for a period of one, three, five, and ten
      minutes with a frequency of 25 strokes per minute. This protocol was performed on
      individuals without edema, on dogs with experimental lymphedema and men with post
      thrombotic venous edema. After ten minutes of forceful massage, focal damage of
      lymphatics was present. In a group of dogs with lymphedema and men with post
      thrombotic venous edema, the alteration of lymphatics was greater than in normal
      individuals and evident only after 3 to 5 minutes of massage. At first, the
      forceful massage affected the endothelial lining of the initial lymphatics.
      Alterations of lymphatic collectors were visible later. The fluid in lymphedema
      was translocated by massage using high pressure from the interstitium into the
      lumen of lymphatics by means of the open junctions and by artificial cracks that
      develop from injury to the lymphatic wall. Vigorous massage in lymphedema also
      produces loosening of subcutaneous connective tissue, formation of large tissue
      channels and release of lipid droplets that enter the lymphatics. By this
      mechanism, massage helps reduce the amount of fat cells in the lymphedematous
      leg.

PMID- 7791373
TI  - The three Williams--Hunter, Hewson and Cruikshank: their unique contributions to
      our knowledge of the lymphatics.

PMID- 7791374
TI  - The lymphatic vessels and their relationship to lymph formation in the human
      urinary bladder.
AB  - After endoscopic transurethral biopsies of normal human urinary bladder, an
      extensive network of small initial lymphatic vessels was depicted by means of
      light and electron microscopy. Using light microscopy, lymphatic vessels were
      seen in the mucosa and submucosa and formed a complex network in the detrusor
      muscular coat. These lymphatics were characterized by an irregular and attenuated
      wall and increased in number and size from the superficial to the deeper region
      of the bladder. Ultrastructurally, the lymphatic wall was characterized by
      endothelial cells joined together end-to-end or by complicated interdigitations.
      Often intercellular channels and gaps between two contiguous endothelial cells
      were present. A broad network of elastic and collagen fibers joined the lymphatic
      endothelial wall to the neighboring connective tissue. Nevertheless, as far as
      the fibrillar component was concerned, the vesical intramuscular lymphatic
      endothelial wall lacked elastic fibers. These anatomic variations were examined
      in reference to lymph formation in an organ (the urinary bladder) which undergoes
      continual changes in volume and pressure.

PMID- 7791375
TI  - Lymphatic system of the rat pancreas.
AB  - Light and electron microscopy combined with morphometric analysis were used to
      investigate the distribution, extent and structure of lymphatic vessels in the
      head, body and tail of the rat pancreas. Serial sections 3-4 microns in thickness
      were cut from tissue fixed by perfusion. Alternate sections were processed for
      light microscopy. Intervening sections were left uncovered to be re-embedded and
      sectioned for electron microscopy as needed. Vessels with valves were tentatively
      identified as lymphatics using the light microscope, with final identification
      being made on adjacent sections by electron microscopy. The ultrastructure of the
      pancreatic lymphatic vessels was typical of lymphatics generally. Interlobular
      lymphatic vessels were present throughout the pancreas and were found to be
      associated primarily with blood vessels lying in connective tissue septa.
      Intralobular lymphatics were also seen but were comparatively rare. Only about
      19% of the wall of the lymphatic system of the pancreas was in close relationship
      to acinar cells--none was closely related to the endocrine islets. The mean
      volume density of the system was 0.0012 microns3/microns3 and the profile density
      of lymphatics was 3.24/mm2. Special attention was paid to the areas of contact
      between adjacent endothelial cells. Open gaps of more than 30 nm in width were
      rare. Dilatations and associated cytoplasmic processes, suggestive of a type of
      intercellular transport, were seen in addition to the intracellular cytoplasmic
      vesicular system. The findings are consistent with the view that the lymphatic
      system of the pancreas does not have a specific role in the transport of
      pancreatic secretions other than the removal of macromolecules that may escape to
      the interstitium in small amounts under normal circumstances. The fine structure
      of the endothelial wall suggests that the mechanism of lymph formation in the
      pancreas is more comparable to that in other encapsulated organs such as the
      kidney and liver than to that in the dermis or diaphragm where fluid appears to
      enter lymphatics primarily by way of gaps between adjacent cells.

PMID- 7791377
TI  - On microwaves.

PMID- 7791378
TI  - Children's and adolescents' experiences while undergoing cardiac catheterization.
AB  - PROBLEM: To explore the experiences of children and adolescents undergoing a
      cardiac catheterization. SUBJECTS: Caucasian children and adolescents (N = 24), 9
      17 years, male and female, undergoing cardiac catheterization. METHOD:
      Exploratory design utilizing content analysis. The authors used an interview
      guide with 4 subsections to elicit self-reports of knowledge, perceptions,
      emotions, and evaluations. FINDINGS: Major themes were anticipatory anxiety,
      pain, invasion of privacy, and being comforted. Many children had misconceptions
      or lack of knowledge of the procedure. CONCLUSIONS & IMPLICATIONS FOR NURSING:
      Nurses' knowledge of the impact on children and adolescents of a cardiac
      catheterization room, high-technology equipment, and invasive procedures may
      increase their sensitivity to children's and adolescents' perceptions of the
      experiences and promote individualized nursing care.

PMID- 7791376
TI  - Measuring peripheral oedema and bioimpedance.

PMID- 7791379
TI  - Survival from a wild animal attack: a case study analysis of adolescent coping.
AB  - TOPIC: Adolescent coping strategies and long-term effects of a life-threatening
      event are examined in this retrospective case study. PURPOSE: To describe the
      hospital care and follow-up support given to an 11-year-old girl who was savagely
      mauled by a cougar. An in-depth analysis of the patient's significant memories
      six-and-a-half years after the incident is also presented. SOURCES: Two hour semi
      structured, information gathering interviews with the adolescent when she was 16
      years old. RESULTS: The outcome of this case study analysis served as a partial
      debriefing of the experience for the adolescent girl. IMPLICATIONS FOR NURSING
      PRACTICE: This case study provides a useful resource to practitioners and
      patients who may experience similar situations. Nurses have a role to play in
      anticipating and preparing children for later hospital-based, post-trauma
      interventions and assisting other adolescents who are injured and hospitalized.

PMID- 7791381
TI  - Biographical update of Dr. William Worrall Mayo.

PMID- 7791380
TI  - Mothers' moods and social support when a second child is born.
AB  - PROBLEM: The relationship between mothers' different mood states and dimensions
      of support; the influence of antepartum and postpartum support on mood states as
      a function of stress and time. SUBJECTS: Married mothers (N = 50) expecting a
      second child when their firstborn was between 28-54 months old; 90% Caucasian;
      ages 24-40 years. Average education: 13 years. METHOD: A short-term longitudinal
      correlational study to determine second-time mothers' moods relative to
      dimensions of support, stress, and timing of support. Instruments used: Profile
      of Mood States, Norbeck Social Support Questionnaire, Situation-Specific Support
      Scale, and the Crockenberg Stress Checklist. FINDINGS: Depressed, angry, and/or
      tired mothers reported inappropriate amounts of support and dissatisfaction with
      support received. CONCLUSIONS & IMPLICATIONS FOR NURSING: Different types of
      support serve different functions before and after birth. Support must "fit"
      mothers' needs and is most effective if given when needed because of the limited
      "carry over" effect. Listening carefully to mothers describe their feelings
      enables nurses to determine support wanted or needed.

PMID- 7791382
TI  - Prospective evaluation of clinical characteristics of orthostatic hypotension.
AB  - OBJECTIVE: To undertake a prospective study of the clinical characteristics of
      orthostatic intolerant patients referred to the Mayo Autonomic Reflex Laboratory
      with suspected orthostatic hypotension (OH). DESIGN: Autonomic function tests
      were performed to quantify the severity of sudomotor, adrenergic, and cardiovagal
      failure and generate a composite autonomic symptom score (CASS). CASS was related
      to a symptom score, which was derived from the frequency of orthostatic
      intolerance and syncope and the standing time until occurrence of symptoms.
      RESULTS: Three groups were defined by their response to a tilt study: group I, 90
      patients with symptomatic OH, mean age, 63.6 years; group II, 60 patients who had
      symptoms without OH, mean age, 48.9 years; and group III, 5 patients with
      asymptomatic OH, mean age, 68.0 years. Group I had a significantly higher CASS (P
      < 0.001) than did those without OH. Further analysis was done on the 90 patients
      in group I. The most common symptoms were lightheadedness, weakness, impaired
      cognition, visual blurring, tremulousness, and vertigo. The most common
      aggravating factors were prolonged standing, exercise, warming, and eating. Most
      patients (75%) could stand for less than 5 minutes before symptoms occurred.
      Symptoms regressed significantly with CASS but not with the tilt grade.
      CONCLUSION: Patients with generalized autonomic failure have a recognizable
      pattern of symptoms and aggravating factors that relate, albeit imperfectly, to
      the severity of autonomic failure.

PMID- 7791384
TI  - Incidence of alopecia areata in Olmsted County, Minnesota, 1975 through 1989.
AB  - OBJECTIVE: To assess the incidence and natural history of alopecia areata (AA)
      among unselected patients from a community. DESIGN: We conducted a retrospective
      population-based descriptive study of AA among residents of Olmsted County,
      Minnesota, for the period from 1975 through 1989. MATERIAL AND METHODS: After
      identifying 292 Olmsted County residents first diagnosed with AA during the 15
      year study period, we reviewed their complete (inpatient and outpatient) medical
      records in the community and statistically analyzed the effects of gender and age
      group. RESULTS: The overall incidence of AA was 20.2 per 100,000 person-years and
      did not change with time. Rates were similar in the two genders and over all
      ages, and lifetime risk was estimated at 1.7%. Eighty-seven percent of patients
      were examined by a dermatologist who diagnosed AA, and 29% of cases were
      confirmed by biopsy. Most patients had mild or moderate disease, but alopecia
      totalis or universalis developed at some point during the clinical course in 21
      patients. CONCLUSION: This study of the incidence and natural history of AA in a
      community shows that this disorder is fairly common and can be seen at all ages.
      Although spontaneous resolution is expected in most patients, a small but
      significant proportion of cases (probably approximately 7%) may evolve into
      severe and chronic hair loss, which may be psychosocially devastating for
      affected persons.

PMID- 7791383
TI  - Nimodipine as an add-on therapy for intractable epilepsy.
AB  - OBJECTIVE: To analyze the effect of nimodipine in patients with intractable
      epilepsy. DESIGN: We conducted a double-blind placebo-controlled crossover study
      in 95 patients. MATERIAL AND METHODS: The dihydropyridine calcium antagonist
      nimodipine was used as add-on therapy (60 mg four times a day) in a 1-year
      placebo-controlled crossover study in 71 patients with localization-related
      epilepsy and 24 with generalized seizure disorders. Of the 95 patients, 81 were
      receiving two or more antiepileptic drugs. Patients diaries were used to record
      the number of seizures and any side effects. RESULTS: Nimodipine seemed to be
      well tolerated during the study; only two patients were unable to complete the
      study because of probable adverse effects. The trial demonstrated no significant
      crossover effect and no significant effect of nimodipine on either the mean or
      the median number of seizures or seizure days. The peak median serum nimodipine
      level was less than 5 ng/mL in the 78 patients who completed the study.
      CONCLUSION: This clinical trial found no beneficial effect with use of nimodipine
      as add-on therapy for intractable epilepsy. Potential reasons for the absence of
      efficacy of nimodipine may be the inclusion of patients with very refractory
      seizure disorders or the relatively low serum nimodipine concentrations related
      to the pharmacokinetic effect of concurrent antiepileptic medication.

PMID- 7791385
TI  - Idiopathic restrictive cardiomyopathy in childhood: diagnostic features and
      clinical course.
AB  - OBJECTIVE: To describe the clinical course and outcome of children with
      idiopathic restrictive cardiomyopathy (IRCM) and to present the Doppler
      echocardiographic features of this disease in childhood. DESIGN: We reviewed the
      Mayo Clinic patient database for the period from 1975 to 1993 to identify
      children who underwent assessment for IRCM. MATERIAL AND METHODS: Clinical
      records and diagnostic studies, including two-dimensional (2-D), M-mode, and
      Doppler echocardiograms, were reviewed for each patient. Characteristics were
      analyzed statistically to determine potential predictors of outcome. RESULTS:
      Eight children (five girls and three boys) were diagnosed with IRCM between 1975
      and 1993 at our institution. The median age at diagnosis was 11 years, and the
      median duration of follow-up was 11.5 years. Of the eight patients, five died
      (the median time from initial examination to death was 1 year). All five of these
      patients had clinical and radiographic evidence of pulmonary venous congestion.
      In all patients, 2-D and M-mode echocardiography revealed atrial enlargement
      without ventricular dilatation or hypertrophy. The four patients who underwent
      detailed diastolic Doppler assessment had findings consistent with restrictive
      filling and increased left ventricular end-diastolic pressure: (1) short mitral
      deceleration time, (2) increased pulmonary vein atrial reversal velocity and
      duration, and (3) pulmonary vein atrial reversal duration greater than mitral A
      wave duration. CONCLUSION: The prognosis for children with IRCM is poor. In this
      small group of patients, absence of pulmonary venous congestion most consistently
      predicted extended survival. A combined 2-D and Doppler echocardiographic
      examination provides a reliable noninvasive means of assessing the physiologic
      and morphologic features of IRCM in children.

PMID- 7791386
TI  - Extrapulmonary lymphangioleiomyomatosis and lymphangiomatous cysts in tuberous
      sclerosis complex.
AB  - OBJECTIVE: To describe the clinical manifestations, imaging findings, and
      histologic features of extrapulmonary lymphangioleiomyomatosis (LAM) in the
      tuberous sclerosis complex (TSC). DESIGN: We retrospectively reviewed
      institutional medical records since 1940 to identify patients with TSC and
      extrapulmonary LAM. MATERIAL AND METHODS: Of 403 patients with TSC, 3 had
      pulmonary and extrapulmonary LAM and retroperitoneal lymphangiomatous cysts. The
      clinical, imaging, and histologic features of these three patients were
      summarized, including analysis of biopsy specimens by conventional histology,
      immunohistology, radiolabeled ligand-binding assays, and tissue culture. RESULTS:
      The three young women had characteristic dermatologic findings of TSC and
      pulmonary LAM. Two patients were of normal intelligence, and one had a recent
      history of contraceptive use. All three patients had intra-abdominal
      lymphangiomatous cysts, uterine LAM, and renal angiomyolipomas. Renal and uterine
      biopsy specimens demonstrated positive immunostaining for melanoma-related
      antigens and expression of estrogen and progesterone receptors by ligand-binding
      assay and immunohistology. Cells cultured from LAM tissue of one of the patients
      exhibited a mitogenic response to estradiol. CONCLUSION: Clinically significant
      extrapulmonary LAM is a rare manifestation of TSC and may occur in women with
      this disease who also have pulmonary LAM. The clinical features of these patients
      confirm the importance of sex steroids in the development of these lesions.
      Immunohistochemical findings suggest that LAM and angiomyolipomas have a
      neuroectodermal origin. The development of lymphangiomatous cysts in these
      patients is probably due to smooth muscle proliferation in lymph vessels, which
      can result in lymphatic obstruction.

PMID- 7791387
TI  - Home peak expiratory flow rate monitoring in patients with asthma.
AB  - OBJECTIVE: To describe how the peak expiratory flow rate (PEFR) is measured,
      review published studies of the accuracy in which patients and physicians can
      estimate the severity of asthma by clinical observations only, and review
      published studies of the benefits of home PEFR monitoring. DESIGN: A review of
      home PEFR monitoring and its associated benefits for both the physician and the
      patient is presented. RESULTS: An accurate assessment of the severity of asthma
      is crucial for the optimal treatment of the patient with asthma; however,
      patients and their physicians are often unable to estimate correctly the degree
      of airway obstruction. Peak flow measurement is a simple, inexpensive method of
      objectively determining airflow obstruction. Management of asthma based on home
      PEFR measurements can result in early recognition and prompt treatment of asthma
      exacerbations. Home PEFR monitoring in the setting of a comprehensive self
      management program can lead to fewer symptoms of asthma, fewer days absent from
      work or school, fewer emergency examinations, fewer hospitalizations, lower
      requirements of inhaled beta-antagonists and oral corticosteroid therapy, and
      better pulmonary function. CONCLUSION: For best results, home PEFR monitoring
      should be coupled with a thorough educational program on asthma and periodic
      office spirometry.

PMID- 7791388
TI  - Cardiac echinococcosis: case report of unusual echocardiographic appearance.
AB  - An unusual echocardiographic appearance of a cardiac echinococcal lesion
      confirmed intraoperatively is described in a patient with nonspecific cardiac
      complaints. Although previous reports have emphasized the echolucent, often
      multiseptated nature of echinococcal lesions, such characteristics were absent in
      this case. Thus, in the appropriate clinical setting, echinococcal infection
      should be included in the differential diagnosis of solid mass lesions of the
      heart because the surgical approach may need to be altered.

PMID- 7791389
TI  - Chronic cough associated with subacute bacterial endocarditis.
AB  - Although the literature on subacute bacterial endocarditis from both the
      preantibiotic and antibiotic eras mentions cough as a symptom, neither bacteremia
      nor endocarditis is listed in reviews on chronic cough. Herein we describe a 74
      year-old man who underwent an extensive workup as an outpatient because of
      chronic cough of 7 months' duration. Chest roentgenography, chest and sinus
      computed tomography, fiberoptic bronchoscopy, gallium scan, transthoracic
      echocardiography, and other studies revealed no apparent cause for his
      nonproductive cough. Because of a persistently increased erythrocyte
      sedimentation rate and associated weight loss, blood cultures were obtained, all
      of which grew Streptococcus constellatus. A transesophageal echocardiogram
      revealed mitral valve vegetation. After antibiotic therapy was administered, the
      patient's cough completely resolved. He has experienced no coughing for more than
      14 months. Bacteremia in conjunction with endocarditis should be added to the
      list of uncommon causes of chronic cough. The mechanism of cough is unknown.

PMID- 7791390
TI  - Lymphoma associated with human immunodeficiency virus infection.
AB  - OBJECTIVE: To describe lymphoma associated with human immunodeficiency virus
      (HIV) infection. DESIGN: A review of HIV-related lymphoma and its associated
      epidemiology, etiopathogenesis, and clinicopathologic characteristics is
      presented. Major studies of therapeutic regimens for HIV-related lymphoma are
      discussed. Factors that could contribute to a poor prognosis are summarized.
      RESULTS: Malignant lymphoma that develops in patients with HIV infection fulfills
      diagnostic criteria for the acquired immunodeficiency syndrome (AIDS). The
      incidence is increasing and varies by subtype of lymphoma, age, sex, race, and
      risk factors. B-cell hyperactivation is thought to contribute to the development
      of lymphoma. The mechanisms that may show transformed cell hyperproliferation and
      clonal expansion are HIV itself or other viruses (for example, Epstein-Barr
      virus), growth factors, aberrant oncogene or tumor-suppressor gene expression,
      and factors that induce genetic instability or DNA damage or alter host or viral
      genome repair. Treatment of HIV-related lymphoma is associated with toxicity,
      infectious complications, low rate of complete response, and brief median
      survival time. CONCLUSION: Persons with HIV-induced immune dysregulation have a
      high risk for the development of aggressive non-Hodgkin's lymphoma characterized
      by histologic evidence of a high-grade malignant process, B-cell phenotype, an
      unusual extranodal involvement, and a poor prognosis. The potential role of
      specific viruses, antiviral treatments, and other therapeutic strategies are
      future areas of investigation.

PMID- 7791391
TI  - Myelodysplastic (preleukemia) syndromes: the bone marrow factory failure problem.
AB  - The myelodysplastic syndromes are a group of hematologic disorders that adversely
      affect the levels of hemoglobin, platelets, erythrocytes, and leukocytes.
      Although the cause of this syndrome is unknown, new diagnostic techniques have
      facilitated identification and classification of these diseases into five
      categories: refractory anemia (refractory cytopenia), refractory anemia with
      ringed sideroblasts, refractory anemia with excess blasts, refractory anemia with
      excess blasts in transformation, and chronic myelomonocytic leukemia. Cytogenetic
      abnormalities may be present in more than 55% of the patients. Symptomatic
      patients should be assessed relative to life-threatening versus non-life
      threatening cytopenias and age. Management consists of primarily supportive
      measures, although certain approaches that are currently being used or under
      investigation, such as concomitant administration of erythropoietin and other
      growth factors, show promise for the future.

PMID- 7791393
TI  - Virginia Apgar--the Apgar score.

PMID- 7791392
TI  - Prognostic factors for patients with carcinoma of the breast.

PMID- 7791394
TI  - Symposium on geriatrics. Foreword.

PMID- 7791395
TI  - Symposium on geriatrics. Introduction.

PMID- 7791396
TI  - Symposium on geriatrics--Part I: Drug prescribing for elderly patients.
AB  - OBJECTIVE: To describe the pharmacokinetic and pharmacodynamic changes that occur
      with aging and to discuss common problems noted with the use of medications often
      prescribed for elderly patients. DESIGN: We searched the medical literature,
      reviewed pertinent articles, and summarized drug-related information applicable
      to geriatric patients. RESULTS: Use of medications is common in the elderly
      population; most elderly persons take two or more different medications each day.
      Aging is associated with anatomic and physiologic changes that can have an effect
      on how medications are handled. Such changes include alterations in various
      volumes of drug distribution and in drug absorption, metabolism, and clearance.
      Elderly patients may also have increased or decreased drug effects because of
      alteration in receptor response. These changes in pharmacokinetics and
      pharmacodynamics may result in a prolonged drug half-life, an increased potential
      for drug toxicity, and a greater likelihood for adverse drug reactions.
      CONCLUSION: Medications for elderly patients should be prescribed only after the
      anatomic and physiologic changes of aging are understood and with increased
      surveillance for potential drug toxicity or adverse drug reactions.

PMID- 7791397
TI  - Medical care of nursing home residents.
AB  - OBJECTIVE: To present an overview of the special challenges of providing medical
      care for nursing home residents. DESIGN: After researching the current medical
      literature, we summarized information on nursing home demographics, government
      regulations, and specific care issues for medical practice in nursing homes.
      RESULTS: Almost 2 million Americans currently live in more than 20,000 nursing
      homes nationwide, and these nursing home residents are increasingly older and
      more frail than in the past. Most nursing home residents receive multiple
      prescription medications, and many are cognitively and functionally impaired.
      Nursing home-acquired infections are a frequent occurrence, as are falls and fall
      related injuries. Recent federal laws have had a major effect on medical care in
      the nursing home and have made physicians more accountable for the care provided.
      The use of physical restraints and psychotropic drugs has been severely
      restricted. CONCLUSION: The medical care of nursing home residents presents many
      challenges to primary-care physicians. Nevertheless, nursing home residents are
      among those patients in greatest need of competent, compassionate care. Despite
      numerous disincentives, provision of medical care for nursing home residents can
      be gratifying.

PMID- 7791398
TI  - 64-year-old man with polyuria and polydipsia.

PMID- 7791399
TI  - Randomized clinical trails: potential cost savings due to the identification of
      ineffective medical therapies.

PMID- 7791400
TI  - Variations in the clinical manifestations of orthostatic hypotension.

PMID- 7791402
TI  - Additional causes of the blue toe syndrome.

PMID- 7791401
TI  - Calcium antagonists and epilepsy.

PMID- 7791403
TI  - Molecular and cell biological studies of ageing and their application to
      considerations of T lymphocyte immunosenescence.

PMID- 7791405
TI  - [Involvement of histocompatibility and allosensitization in recurrent abortions].
AB  - BACKGROUND: The aim of this study was to know the possible implication of human
      histocompatibility (HLA) antigens in the etiology of repeated abortions. METHODS:
      Antigen typing for the major histocompatibility system was carried out in 65
      couples with 2 or more abortions and comparative analysis was performed with 40
      fertile couples by the odds ratio. Likewise, the possible relationship between
      cytotoxic antibodies in maternal serum and reproductive prognosis was determined.
      RESULTS: The couples with abortions did not present a significantly different
      phenotypic frequency from that of the fertile couples in regard to the HLA
      antigens (loci HLA-A, HLA-B, and HLA-DR). On considering the 3 loci studied, the
      infertile couples presented significantly higher antigenic HLA identity than the
      fertile couples. This significance was demonstrable both by association and by
      odds ratio (OR: 4.9; CI 95%; 1.1-9.2). No differences were observed among women
      with primary (no full term pregnancy) or secondary abortions (some full term
      pregnancies) with regard to common HLA antigens, with both groups being
      homogeneous. CONCLUSIONS: The presence of cytotoxic antibodies against paternal
      lymphocytes in maternal serum detected by cross-match reaction was not related to
      the pertaining to an infertile (including any of the established subgroups) or
      fertile population. Neither were differences observed in the presence of these
      antibodies among women with primary or secondary abortions.

PMID- 7791404
TI  - Ultrastructural differences of hippocampal lipofuscin in human development.
AB  - The lipofuscin of pyramidal cells in each hippocampal subfield of each of seven
      human autopsy cases without brain disease at the age of 3-12 months (infants) and
      of 17-23 years (young adults) was comparatively investigated at the electron
      microscopic level. In infant pyramidal neurons of the hippocampal subfields CA 1,
      CA 2, CA 3 and CA 4 O-2, very small lipofuscin particles were observed. The
      lipofuscin composition showed a slightly larger granular component compared to
      the vacuolar component with one or two small lipid droplets. No obvious
      ultrastructural variability of lipofuscin granules was observed. The CA 1
      lipofuscin in young adults consists of larger particles than in infants, but no
      obvious difference in the composition of granular and vacuolar components from
      the infant lipofuscin was seen. The amount of lipofuscin in CA 1 strongly
      increased in young adults compared to infants and appeared in a perinuclear
      distribution. In young adults, in contrast to the infant group, the amount of
      lipofuscin in the subfields CA 2, CA 3 and CA 4 was significantly higher than in
      CA 1. In CA 2, CA 3 and CA 4 pyramidal neurons, the vacuolar component was
      significantly larger than the granular component. The similarity of infant
      hippocampal lipofuscin patterns in all subfields is discussed as a state of
      immaturity. To explain the observed differences between the CA 1 and the other
      subfields during neuronal development, as shown in the young adult group, several
      factors are discussed: the effects of cell specific metabolism, cellular
      functional activity, cytoprotective mechanisms and effects of efferent and
      afferent pathways connected with the subfields.

PMID- 7791407
TI  - [Electrocardiographic patterns in hypertensive patients without atherosclerotic
      coronary disease. Influence of the left ventricular mass].
AB  - BACKGROUND: ECG ST-T segment abnormalities in hypertensive patients are
      traditionally associated with hypertrophy or ischaemia. Hypertensive patients
      with abnormalities in ST-T segment in DI, aVL and/or V5-V6 underwent an
      echocardiographic study in order to assess left ventricular structure. All of
      them, in addition to the electric changes, showed typical or non-typical thoracic
      discomfort, showing a normal coronariographic study. METHODS: Hypertensive
      patients with ST-T segment changes were classified as follows: group A, 12
      patients (8 women, 4 men, mean age 63.6 +/- 7.2 years) with ECG image of left
      ventricular overload pattern; group B, 9 patients (3 men, 6 women, mean age 62.3
      +/- 6.3 years) with flat ST segment depression; and group C, 10 patients (3 men,
      7 women, mean age 62.4 +/- 9.7 years) without changes on the ST-T segment with
      flat or negative T wave. Control group is made up 12 hypertensive patients (7
      women, 5 men, mean age 61.6 +/- 7.6 years) with normal ECG. We assess by
      echocardiography interventricular septal thickness (IVST) and left ventricular
      posterior wall thickness (PWT) in mm, left ventricular end-diastolic diameter
      (DTD) in mm, left ventricular mass (LVM) in grs, and the mass index (MI) in g/m2.
      RESULTS: IVST, PWT, LVM and MI were significantly (p < 0.05) higher in the groups
      A, B and C than in the control group. No statistically significant differences
      were observed between the A, B and C groups. Stepwise discriminant analysis
      showed that the only parameter with independent value for discriminating between
      control, group and group ABC (the union of groups A, B and C) was IVST.
      CONCLUSION: In hypertensive patients without coronariopathy, ST-T changes
      identify a group with greater left ventricular mass. The different
      electrocardiographic patterns considered were not associated with a significantly
      different left ventricular mass.

PMID- 7791406
TI  - [IgG subclasses in patients with symptomatic IgA deficiency].
AB  - BACKGROUND: Patients with IgA deficiency may be asymptomatic or may present
      recurrent infections mainly respiratory. A possible explanation for this variety
      of symptoms may be the association with a deficiency of IgG subclasses. METHODS:
      Twenty-five patients with a symptomatic IgA deficiency with a mean age of 18 +/-
      12 years were studied. The quantification of the IgG subclasses was performed by
      ELISA test with antisubclass specific monoclonal murine antibodies. Serum from
      100 healthy adults was collected to determine normal values of the IgG
      subclasses. RESULTS: Twenty-five (48%) had a deficiency of associated IgG
      subclasses (6 IgG2 deficiency, 1 IgG3, 3 IgG4 and 2 combined deficiency). The
      patient with a deficiency of associated IgG subclasses had more recurrent
      respiratory infections (chi 2, p < 0.03) and pneumonias (chi 2, p < 0.04). This
      group also had a greater FEV1 alteration (Student-t test, p < 0.04). CONCLUSIONS:
      Patients with symptomatic IgA deficiency frequently present IgG subclass
      deficiency and are more likely to have recurrent respiratory infections and
      greater changes in pulmonary function.

PMID- 7791408
TI  - [Recurrent abortion: genetic and acquired factors].

PMID- 7791409
TI  - [Celerius, profundius, periculosius].

PMID- 7791410
TI  - [Dysbaric accident in deep sea fishing].
AB  - The case of a dysbaric accident with occurred in a professional athlete during a
      national competition is herein reported. The clinical symptoms and response to
      treatment in a depressurization chamber in addition to CT controls should alert
      physicians in coastal areas in which this sport is carried out in order to take
      into consideration neurologic disorders which may be due to dysbaric accidents
      such as those which occur in scuba divers.

PMID- 7791411
TI  - [Internet in medicine of the year 2000].

PMID- 7791412
TI  - [Formulation of a non-related anonymous screening program for HIV].

PMID- 7791413
TI  - [Clinical pharmacologists and clinical research ethics committees].

PMID- 7791415
TI  - [Professional asthenia syndrome, data relevance, and statistical totem].

PMID- 7791414
TI  - [Prenatal diagnosis of HIV infection].

PMID- 7791416
TI  - Antipseudomonal penicillins.
AB  - Antipseudomonal penicillins retain most of the antibacterial activity of
      penicillin and aminopenicillins. This group of penicillins has added activities
      against many gram-negative rods, including P. aeruginosa. Similar to the earlier
      penicillins, this group continues to be susceptible to hydrolysis by many beta
      lactamases and are, therefore, not consistently active against Staphylococcus,
      some gram-negative rods, and certain beta-lactamase-producing gram-negative
      anaerobes. The ureidopenicillins, especially piperacillin, appear to have better
      activity against Enterococcus, Klebsiella, and P. aeruginosa than ticarcillin.
      The advantages over the newer cephalosporins are (1) better activity against
      Enterococcus, (2) more consistent activity against Clostridium, and (3) more
      consistent synergy with aminoglycosides. The ureidopenicillins have certain
      advantages over carboxypenicillins, including lower sodium load, less frequent
      hypokalemia, reduced platelet dysfunction, minimal dosage adjustment in patients
      with renal failure, and a wider spectrum of antibacterial activity, especially
      against Enterococcus, Pseudomonas, and Klebsiella. The utility of the
      antipseudomonal penicillins by themselves is limited as agents for monotherapy
      when the infecting organism is not known. In addition, monotherapy is not
      recommended in certain infections to avoid the development of resistance. When
      combined with a beta-lactamase inhibitor or with an aminoglycoside, however, some
      of the weaknesses can be overcome.

PMID- 7791417
TI  - Beta-lactamase inhibitor combinations.
AB  - The beta-lactamase inhibitor combinations present a novel approach to the problem
      of beta-lactamase-induced resistance to antibiotics. These agents are derived
      from the generally safe beta-lactam class of antibiotics. They are all
      principally excreted through the kidneys and require dosage adjustment in the
      face of significant renal insufficiency. They show significantly increased
      activity against methicillin-sensitive S. aureus, H. influenzae, B. catarrhalis,
      and B. fragilis. The activity against Enterococcus, Pseudomonas, and most gram
      negative bacilli, however, remains limited to that of the respective antibiotic
      component. Although shown to be clinically useful in a variety of clinical
      situations, they appear to be most useful for skin and soft tissue infections and
      lower respiratory tract infections as well as intra-abdominal and gynecologic
      infections caused by susceptible pathogens.

PMID- 7791418
TI  - Third-generation cephalosporins.
AB  - Third-generation cephalosporins are broad-spectrum antimicrobial agents useful in
      a variety of clinical situations. No one cephalosporin is appropriate for all
      infectious disease problems. Cefotaxime and ceftizoxime have the best gram
      positive coverage of the third-generation agents. Ceftazidime and cefoperazone
      are the only third-generation drugs that provide antipseudomonal coverage.
      Ceftriaxone's long half-life allows for once-daily dosing, making ceftriaxone an
      excellent drug for outpatient antibiotic therapy of community-acquired
      infections. Ceftriaxone is also useful for the treatment of Lyme disease and
      sexually transmitted diseases. The third-generation cephalosporins except for
      cefoperazone penetrate cerebrospinal fluid and are indicated for the treatment of
      bacterial meningitis. Their proven record of clinical efficacy, favorable
      pharmacokinetics, and low frequency of adverse effects make third-generation
      cephalosporins the preferred antibiotic in many clinical situations.

PMID- 7791419
TI  - Cefepime.
AB  - Because of the popularity of some third-generation cephalosporins, emergence of
      resistant organisms (e.g., selected Enterobacteriaceae) that produce inducible
      and extended-spectrum beta-lactamases has been a problem. Cefepime's twice-a-day
      dosage schedule and enhanced activity against Enterobacteriaceae and gram
      positive organisms give it several advantages over older drugs. The clinical
      efficacy of cefepime has been demonstrated in comparative and noncomparative
      trials in the United States and Europe. Cefepime with twice-daily dosing has been
      useful in the treatment of lower respiratory tract infections, urinary tract
      infections, skin and skin structure infections, and in serious infection,
      including those with associated bacteremia. Cefepime is comparable to ceftazidime
      in clinical and bacteriologic response rates when both agents are administered
      three times a day in febrile neutropenic patients. Cefepime is also active
      against organisms that show resistance to other agents. Several studies have
      shown that cefepime retains its activity against E. cloacae and E. coli strains
      resistant to other cephalosporins and against many strains of P. aeruginosa
      resistant to ceftazidime. Cefepime exhibits a low level of cross-resistance with
      third-generation cephalosporins and a low propensity for selection of resistant
      mutants and offers a low potential for the induction of bacterial resistance,
      which complicates the course of many patients treated with single-agent third
      generation therapy. Cefepime should be used in place of ceftazidime based on
      resistance potential, activity against resistant organisms, and cost.

PMID- 7791420
TI  - Aztreonam.
AB  - Aztreonam is a monocyclic beta-lactam antibiotic that is active exclusively
      against the aerobic gram-negative bacilli. It is not ototoxic or nephrotoxic and
      so is used as an alternative to aminoglycosides in a variety of clinical
      situations. In polymicrobial infections or when used for empiric therapy,
      aztreonam must be combined with other antimicrobial agents active against gram
      positive and anaerobic species. Aztreonam is often effective against resistant
      strains of gram-negative organisms, which are often involved in nosocomial
      infections. Overuse of aztreonam should be avoided to prevent the emergence of
      resistant P. aeruginosa strains. Except in the treatment of P. aeruginosa
      infections, aztreonam should not be added to beta-lactam regimens for additional
      gram-negative coverage.

PMID- 7791421
TI  - Carbapenems.
AB  - Carbapenems are broad-spectrum beta-lactam antibiotics that cover an absolute
      majority of all bacterial pathogens that possess a cell wall. The only clinically
      important exceptions are X. maltophilia, E. faecium, and some strains of
      methicillin-resistant staphylococci and penicillin-resistant pneumococci. So far,
      after several years of clinical use of imipenemcilastatin, emergence of
      resistance has been a problem mainly restricted to P. aeruginosa. The
      pharmacokinetics of carbapenems, especially imipenem, are complicated by the
      renal metabolism, necessitating the imipenem-cilastatin combination. This is not
      required for meropenem. The safety profile of carbapenems is favorable. With
      imipenem-cilastatin, nausea constitutes a practical problem in that
      administration times may have to be prolonged. The risk for neurologic reactions
      with imipenem-cilastatin has become a factor reducing the possibilities to use
      high doses. For all indications except bacterial meningitis, the now approved
      maximal dose of 4 g per day should suffice. In this respect, meropenem has an
      advantage over imipenem-cilastatin in that it can be used in the treatment of
      bacterial meningitis without apparent increased risk of seizures. Carbapenems are
      indicated mainly as empiric monotherapy in serious infections, such as intra
      abdominal infections and infections in neutropenic patients. Combinations of
      carbapenems and other antibiotics should not be used routinely.

PMID- 7791422
TI  - Aminoglycosides.
AB  - Despite their nephrotoxic and ototoxic side effects, AG remain useful antibiotics
      because of their major, rapid, and dose-dependent bactericidal effects.
      Combination therapy with an AG appears particularly important in neutropenic and
      other high-risk patients to provide broad-spectrum bactericidal activity,
      synergism, and reduction of emergence of resistant pathogens. OD AG therapy is
      associated with high peak levels in serum that maintain efficacy and low-to
      undetectable trough levels in serum that attenuate the risk of toxicity.
      Administration of short-term OD AG therapy to patients not at risk without renal
      impairment may not absolutely require dosing monitoring. This therapeutic
      strategy has been proved useful in clinical trials, now including febrile
      episodes in neutropenic patients, but it should be avoided during infections in
      which antimicrobial synergism is required, such as enterococcal endocarditis.

PMID- 7791424
TI  - Azithromycin and clarithromycin.
AB  - Azithromycin and clarithromycin are alternatives to conventional macrolides in
      the routine treatment of many dermatologic, upper respiratory, and lower
      respiratory tract infections. In this role as alternative therapy, they are
      better tolerated, less toxic, and more convenient to take, although at a greater
      cost to the patient. This dosing convenience is an important consideration for
      the clinician; as shown by Nelson, patient compliance ranges from 95% with once
      daily dosing to 58% with four-times-a-day dosing. Thus, less frequent dosing with
      both drugs as well as the shorter course of therapy possible with azithromycin
      may be therapeutically advantageous. In addition to their role as alternatives to
      conventional macrolide therapy, azithromycin and clarithromycin extend the
      spectrum of macrolides and offer new therapeutic options for H. influenzae, MAC
      in AIDS, MOTT, and leprosy. Finally, experimental therapy may extend their use
      for additional opportunistic infections, such as toxoplasmosis and
      cryptosporidiosis.

PMID- 7791423
TI  - Tetracyclines.
AB  - Tetracyclines are relatively safe drugs with a broad antimicrobial spectrum.
      Doxycycline remains the preferred tetracycline agent for most indications.
      Doxycycline has a long half-life, which makes convenient twice-a-day dosing
      possible. It is well absorbed orally even in the presence of food, has excellent
      tissue penetration, and does not require a dose adjustment in renal
      insufficiency. Doxycycline is a useful agent for the treatment of atypical
      pneumonias, sexually transmitted diseases, traveler's diarrhea, rickettsial
      infections, and Lyme disease. Minocycline is the preferred drug for MRSA
      colonization/infection.

PMID- 7791425
TI  - Vancomycin.
AB  - Vancomycin is a nontoxic glycopeptide antibiotic most often used to treat serious
      gram-positive infections, C. difficile diarrhea/colitis, and endocarditis and
      hemodialysis shunt prophylaxis. Vancomycin should not be added to drug regimens
      for gram-positive coverage, and the empiric use of vancomycin should be
      discouraged to avoid the emergence of VRE. Vancomycin serum levels are no longer
      necessary or cost effective in most patients because vancomycin is not
      nephrotoxic.

PMID- 7791426
TI  - Teicoplanin.
AB  - Teicoplanin, a new glycopeptide antibiotic similar to vancomycin, has proved
      effective in the treatment of various gram-positive infections in both the normal
      and the immunocompromised host. In vitro activity against most gram-positive
      organisms is equal to or greater than that of vancomycin. In both open and
      comparative clinical trials, teicoplanin has been well tolerated, rarely
      prompting discontinuation of treatment. Nephrotoxicity caused by teicoplanin is
      uncommon, even when used concomitantly with aminoglycosides or cyclosporin A.
      Favorable pharmacokinetics allow for intramuscular administration as well as
      intravenous bolus dosing, and, after appropriate loading doses, maintenance
      therapy may be given on a once-daily basis. The combination of all of these
      factors makes teicoplanin an effective, safe alternative to vancomycin in the
      treatment of gram-positive infections.

PMID- 7791427
TI  - Clindamycin and metronidazole.
AB  - Metronidazole is a bactericidal antibiotic with strong activity against most
      anaerobes and certain parasites. The drug has excellent bioavailability and good
      penetration in most tissues, including the cerebrospinal fluid and brain abscess
      contents. It is usually well tolerated with few side effects. With a few
      exceptions, the percentage of anaerobes, including B. fragilis group, that are
      resistant to metronidazole remains low. Metronidazole has been used extensively
      in clinical practice for years, and its uses have expanded. Its exact role in the
      management of Crohn's disease and entities related to H. pylori is evolving.

PMID- 7791428
TI  - Quinolones.
AB  - Fluoroquinolones represent a major advance in antimicrobial chemotherapy.
      Currently, there are five fluoroquinolones approved by the FDA, and many more
      quinolones are expected to become available in years to come. Although their
      clinical utility is constantly expanding, they have been best studied in
      complicated urinary tract infections, chronic osteomyelitis caused by gram
      negative bacilli, bacterial gastrointestinal infections such as traveler's
      diarrhea and typhoid fever, and uncomplicated gonococcal infections and in the
      prophylaxis of bacterial infections in patients with neutropenia. These agents
      have the convenience of oral administration, favorable pharmacokinetic
      properties, and low toxicity profiles but should be used advisedly because
      indiscriminate use may result in the early emergence of resistance.

PMID- 7791429
TI  - Anti-infective agents and hepatic disease.
AB  - Numerous factors such as changes in plasma protein binding, tissue binding,
      hepatic blood flow, hepatic metabolism, and distribution may occur in hepatic
      disease. The impact of these physiologic changes on pharmacokinetic and
      pharmacodynamic parameters of anti-infective agents is likely to be clinically
      significant. Unfortunately, these issues have not been thoroughly investigated.
      Even within the same type of liver disease, there is considerable interpatient
      variability in pharmacokinetic variables, rendering it difficult to predict drug
      disposition accurately. Pharmacokinetics of selected anti-infective agents are
      altered in hepatic disease, necessitating careful monitoring and dosage titration
      to avoid enhanced drug concentrations and risk of toxicity.

PMID- 7791430
TI  - Antibiotic dosing in renal failure.
AB  - The Dosing in Renopathy by Easy-To-Use Multipliers (DREM) System is a simple
      method for dose adjustments of anti-infectives in renal insufficiency. The simple
      2-step method involves: (1) estimating creatinine clearance (CLcr) from age, sex,
      and serum creatinine, and (2) calculating the adjusted dose or dosing interval
      with the use of multipliers. By multiplying the normal dose or dosing interval
      with the dose (CLcr/100) or interval (100'CLcr) multiplier, the adjusted dose or
      dosing interval is obtained, respectively. Dose estimates with this method are
      reasonably accurate and compare favorably with previously published methods of
      correction.

PMID- 7791431
TI  - Antibiotic therapy in the allergic patient.
AB  - A variety of antimicrobial classes are now available. Thus, a careful history and
      skin testing for hypersensitivity reactions are often not done. It is often
      easier to give an alternative agent rather than to determine if the person does
      indeed have a hypersensitivity reaction to a particular drug. There remain
      situations (e.g., enterococcal endocarditis, neurosyphilis, syphilis in pregnant
      women), however, in which options for appropriate therapy are limited. In this
      setting, an accurate history accompanied by appropriate skin testing and
      desensitization is indicated.

PMID- 7791432
TI  - Death by denial.

PMID- 7791433
TI  - Glucose and the metabolism of ischaemic myocardium.

PMID- 7791434
TI  - New classification for lymphomas.

PMID- 7791435
TI  - Groin strain versus occult hernia: uncomfortable alternatives or incompatible
      rivals?

PMID- 7791436
TI  - Coronary artery stents.

PMID- 7791437
TI  - Long-term sequelae of Helicobacter pylori gastritis.
AB  - Chronic Helicobacter pylori gastritis has been put forward as a risk factor for
      development of gastric mucosal atrophy and gastric cancer. The purpose of our
      study was to investigate the long-term effects of H pylori gastritis on the
      gastric mucosa. We prospectively studied 49 subjects negative for H pylori and 58
      positive subjects for a mean follow-up of 11.5 years (range 10-13 years). Serum
      samples were obtained at the initial and follow-up visits for determination of H
      pylori IgG antibodies. Gastroscopies with biopsy sampling were done in all
      patients at both visits. Biopsy specimens were used for assessment of H pylori
      infection and histology. Development of atrophic gastritis and intestinal
      metaplasia occurred in 2 (4%) uninfected and 16 (28%) infected subjects.
      Regression of atrophy was noted in 4 (7%) infected subjects. Development of
      atrophic gastritis and intestinal metaplasia was significantly associated with H
      pylori infection (p = 0.0014; odds ratio 9.0, 95% CI 1.9-41.3). The proportion of
      atrophic gastritis in the study population showed an annual increase of 1.15%
      (0.5-1.8%). We conclude that H pylori infection is a significant risk factor for
      development of atrophic gastritis and intestinal metaplasia. Our findings support
      strongly the causative role of this infection in gastric carcinogenesis.

PMID- 7791438
TI  - Human papillomavirus testing in primary cervical screening.
AB  - Several studies have examined the role of tests for human papillomavirus (HPV) in
      screening for cervical cancer but as yet the relevance is unclear. We looked at
      HPV testing for types 16, 18, 31, and 33 on material taken at the time of a
      cervical smear in 2009 eligible women having routine screening. Women with any
      degree of dyskaryosis or high levels of one of these HPV types were referred for
      colposcopy. 44% of the cervical intraepithelial neoplasia (CIN) lesions of grade
      2/3 detected had negative cytology and were found only by HPV testing. A further
      22% of the CIN 2/3 lesions were positive for HPV but showed only borderline or
      mild cytological changes. The positive predictive value of HPV testing was 42%,
      which was similar to that for moderate dyskaryosis. HPV types 16 and 31 were more
      sensitive and specific for CIN 2/3 than were types 18 or 33. However, 25% of the
      CIN 2/3 lesions were not detected by these four HPV tests. We suggest that HPV
      testing could usefully augment but not replace conventional cytology. These
      results should stimulate a much larger randomised trial to assess the impact of
      these improved CIN 2/3 detection rates on the subsequent incidence of invasive
      cancer.

PMID- 7791439
TI  - Is extrinsic sugar a vehicle for dietary fat?
AB  - Although many guidelines to healthy eating recommend restriction of the intake of
      extrinsic (refined) sugar, there are concerns that such restriction might result
      in an increase in the amount and the proportion of dietary fats with a consequent
      possible increase in the risk of cardiovascular disease. We used regression
      analysis to examine the determinants of fat intake in subjects from a population
      survey who had weighed their food for 4 days. In men (n = 77) and women (n = 83),
      fat eaten was positively related to the intake of extrinsic sugar. When intakes
      were expressed as percent of calories the relation became negative. A survey in a
      semi-random sample of 739 men aged 40-69 yr and 976 women aged 25-69 yr showed
      that, in both sexes, an increase in extrinsic sugar was associated with a linear
      increase in the intake of sweetened fat and hence of fat combined with
      carbohydrate. This was due mainly to a higher intake of cakes and biscuits. Foods
      containing sugar and fat provided an extra 12.0 g per day of fat in the men and
      13.8 g per day in the women when the highest quartile of extrinsic sugar
      consumers were compared with the lowest quartile. We conclude that lowering the
      intake of extrinsic sugar is unlikely to be associated with higher fat intake.
      Instead extrinsic sugar may act as a vehicle for fat intake, encouraging
      consumption by making the fat more palatable.

PMID- 7791440
TI  - Polymorphisms in angiotensin-converting-enzyme gene and progression of IgA
      nephropathy.
AB  - We have investigated the influence of the functional insertion (I) and deletion
      (D) polymorphism in intron 16 of the gene for angiotensin-converting enzyme (ACE)
      in a retrospective study of 100 patients with IgA nephropathy. There was no
      difference in genotype frequency compared with normal subjects. However, patients
      homozygous for the D allele tended to present at an earlier age (medians: DD, 33;
      ID, 34; II, 42 years) and to require renal replacement therapy at a younger age
      (medians 37, 42, and 48 years, respectively). The rate of progression was
      significantly worse in patients homozygous for the D allele. The DD genotype is
      associated with increased severity of disease in patients with IgA nephropathy.

PMID- 7791442
TI  - Falls, a community care perspective.

PMID- 7791441
TI  - HLA-B27 binding of peptide from its own sequence and similar peptides from
      bacteria: implications for spondyloarthropathies.
AB  - The spondyloarthropathies are associated by an unknown mechanism with HLA-B27 and
      certain bacteria. HLA-B27 shares sequence with proteins from enteric bacteria.
      The B*2705 sequence contains a nonapeptide, LRRYLENGK, predicted to bind in the
      binding cleft of B27. Some nonapeptides from enteric organisms that share
      sequence with this nonapeptide of B27 also bind B27. These observations suggest
      an unappreciated mechanism for autoimmunity that may operate in the B27
      associated spondyloarthropathies involving peptides bound to and derived from
      histocompatibility alleles.

PMID- 7791444
TI  - Do we need more anti-hypertensive drugs: lessons from the new biology.

PMID- 7791443
TI  - Metabolic support for the postischaemic heart.

PMID- 7791445
TI  - Gloomy season for the social sciences.

PMID- 7791446
TI  - Swedes support UNAIDS.

PMID- 7791447
TI  - Hantaviruses: the rodents take revenge.

PMID- 7791448
TI  - Cholera treatment in Goma.

PMID- 7791449
TI  - Cholera treatment in Goma.

PMID- 7791450
TI  - Cholera treatment in Goma.

PMID- 7791451
TI  - Oral rehydration therapy.

PMID- 7791452
TI  - Formulating apomorphine for Parkinson's disease.

PMID- 7791453
TI  - Hantavirus antibodies in European mammalogists.

PMID- 7791454
TI  - Time to consider additional diagnostic criteria for HTLV-I-associated myelopathy?

PMID- 7791455
TI  - "Tumour suppressor gene" concept of carcinogenesis.

PMID- 7791456
TI  - Treatment for glioma.

PMID- 7791458
TI  - Thyrotropin-releasing hormone for prevention of neonatal respiratory disease.

PMID- 7791457
TI  - Glutathione S-transferase alpha as marker for hepatocellular damage in pre
      eclampsia and HELLP syndrome.

PMID- 7791459
TI  - Chronic arterial hypertension as unique symptom of brainstem astrocytoma.

PMID- 7791460
TI  - Manipulating medicine.

PMID- 7791461
TI  - Teaching ethics in Japan.

PMID- 7791462
TI  - Threat to German cancer-screening plan.

PMID- 7791463
TI  - Infection and hospital laundry.

PMID- 7791464
TI  - Hepatitis B vaccination follow-up.

PMID- 7791465
TI  - Hepatitis B vaccine and anti-HBs complex as approach for vaccine therapy.

PMID- 7791466
TI  - Adverse effects of acupuncture.

PMID- 7791467
TI  - Denture carriage of methicillin-resistant Staphylococcus aureus.

PMID- 7791468
TI  - Identical-twin small-bowel transplant for desmoid tumour.

PMID- 7791469
TI  - Helicobacter pylori: a human pathogen.

PMID- 7791472
TI  - String test for Helicobacter pylori.

PMID- 7791470
TI  - Helicobacter pylori: a human pathogen.

PMID- 7791471
TI  - Helicobacter pylori: a human pathogen.

PMID- 7791473
TI  - Allergic response to Brunei frog Staurois natator.

PMID- 7791475
TI  - Fluorouracil and folinic acid in colon cancer.

PMID- 7791474
TI  - Listeriosis from consumption of raw-milk cheese.

PMID- 7791476
TI  - Fluorouracil and folinic acid in colon cancer. IMPACT Investigators.

PMID- 7791477
TI  - Cutaneous T-cell lymphoma and calcitriol and isotretinoin treatment.

PMID- 7791478
TI  - Bilateral facial palsy and meningitis caused by Borrelia double infection.

PMID- 7791479
TI  - Pruritus.

PMID- 7791480
TI  - Pruritus.

PMID- 7791481
TI  - [Prognostic factors in pancreatic carcinoma].

PMID- 7791482
TI  - [Multivariate analysis of prognostic factors after resection of ductal pancreatic
      carcinomas].
AB  - At Hanover Medical School 466 patients were operated for ductal pancreatic cancer
      from 1971 to 1993. In 192 cases the pancreatic tumor could be resected, which
      amounts to a resection rate of 41%. These patients were subjected to uni- und
      multivariate factorial analysis in order to evaluate factors of significant
      prognostic value. Extended pancreatic resection because of vascular involvement
      or invasion of adjacent organs was performed in 40% (n = 77) of the cases. A
      curative R0 resection was possible in 85% of patients. The operative lethality
      dropped with time and from 1985 to 1993 was 3.5%. Patient survival at 5 years was
      13.4% with a median survival time of 10.9 months. According to the univariate
      analysis the prognosis deteriorated with increasing tumor size and lymphatic and
      hematogenic metastases. There was a significant correlation between tumor stage
      according to the UICC and prognosis. The prognosis after resection was also
      significantly influenced by the residual tumor state and tumor grading. Extended
      pancreatic resections, however, had no significant prognostic impact. The
      multivariate analysis showed that only three factors were of independent
      significant relevance: residual tumor state, tumor size and tumor grade. The
      presence or absence of lymphatic and hematogenic metastases had no independent
      prognostic significance after resection of ductal pancreatic carcinomas.

PMID- 7791484
TI  - Effects of ozone on how well split-thickness skin grafts according to Thiersch
      take in war wounds. Results of prospective study.
AB  - In a prospective study on 35 wounded persons we examined the effects of ozone on
      how well split-thickness skin grafts took in war wounds. Each of the 35 wounded
      persons hat at least two similar gunshot wounds, one on the lower leg or forearm
      and the other on the upper leg or upper arm. During the first 10 days all wounds
      were treated with 10% NaCl water solution dressings until the moment when healthy
      granulations were observed. Thereafter, the defects were covered with split
      thickness skin grafts according to Thiersch. For technical reasons we treated
      grafts on the lower leg and forearm with ozone following the usual scheme. Grafts
      on the upper leg or upper arm were treated in the conventional way and they
      served as a control group. The results obtained in the group followed up are
      presented by percentage of graft takes after 10 days and accordingly compared
      with the results obtained in the control group. There was a higher percentage of
      takes in ozone-treated split-thickness skin grafts. More than 74.3% of the split
      thickness skin grafts treated with ozone had a take of more than 75% of the
      covered surface as apposed to only 40% of the grafts treated with the
      conventional method. The results in these two groups were compared with a chi
      square matched pair test. Difference in take of the skin grafts in these two
      groups was statistically significant at P < 0.01.

PMID- 7791483
TI  - [Fournier gangrene].
AB  - Fournier's gangrene is a relatively rare, mixed aerobic and anaerobic soft tissue
      infection in the perineoscrotal area. Although it is convenient to give it a
      separate name, it is really either necrotizing fasciitis or nonclostridial
      myonecrosis of the scrotal and perineal areas. The condition frequently develops
      from perineal diseases, including perianal abscess, and fistulas, inflamed
      haemorrhoids and indwelling urethral catheter. In patients with Fournier's
      gangrene morbidity is extreme and mortality high. This article is based on a
      retrospective study of 15 cases of Fournier's gangrene, 13 in male and 2 in
      female patients. A combination of surgery and antibiotics was used to treat 9
      patients. The last 6 cases were treated with a combination of surgery,
      antibiotics and hyperbaric oxygen. In 13 cases, the diagnosis was made on the
      basis of the fulminating progression of the infection to a scrotal gangrene,
      identification of multiple underlying pathogenic organisms and toxaemia. In the 2
      female patients, a similar infection developed in the labia majora and perineum
      and extended to the buttocks and the anterior abdominal wall.

PMID- 7791485
TI  - [Primary seminoma. A rare mediastinal tumor].
AB  - This is a report on three patients with primary mediastinal seminoma. Two
      patients had no symptoms, and one had had thoracic pain for the last few years.
      The preoperative diagnosis was thymoma in all cases, and in one patient the
      radiologist had suspected a seminoma. We removed the tumor after performing
      median sternotomy (n = 2) and anterolateral left thoracotomy (n = 1). The
      presence of a primary gonadal seminoma was excluded with a urological and
      ultrasound examination. All patients are still alive following adjuvant
      chemotherapy (n = 2; 120 and 8 months) and radiotherapy (n = 1; 84 months).
      Chemotherapy consisted of four cycles of cisplatin, etoposide and ifosfamide or
      combination therapy with cisplatin, bleomycin and velbe.

PMID- 7791486
TI  - [Reconstruction of the diaphragm with various materials. An animal experiment
      study].
AB  - The relative merits of three methods of diaphragmatic hernia repair were
      evaluated in animals. Eighty Sprague-Dawley rats underwent laparotomy. The
      control group had an incision in the diaphragm with primary repair. The other
      three groups underwent partial resection of the left hemidiaphragm. The defects
      were repaired in 20 rats with lyophilized Dura, in 20 with
      polytetrafluoroethylene (PTFE) and in another 20 with absorbable serosa from a
      cow. Seventy-two animals survived the operation; they were followed up by
      electromyography (EMG) and post-mortem physical and histological examinations
      after 3 and 6 months. The EMG showed normal function for the absorbable material.
      Only scanty physiological waves were registered in the PTFE group. The
      examination for stretching and stress showed good results for all materials
      tested. The histological examinations amount to strong foreign body reactions
      with Dura and PTFE groups. The absorbable bovine serosa had vanished after 3
      months postoperatively. It is concluded that bovine serosa can be recommended for
      diaphragmatic hernia.

PMID- 7791487
TI  - [Scar carcinoma as a late complication after burns].
AB  - Carcinomas, mainly of the squamous cell type, may occur in burn scars from 3
      months to 75 years after the burn injury, and they have a poor prognosis.
      Therefore, unstable scars, chronic ulcers and tumors must be subjected to
      histological examination as soon as possible. If a malignant tumor is present,
      the therapy of choice is wide local excision, though in the event of progressive
      tumor development an ablative procedure may be necessary. Early radical surgery
      is important. Unstable scars should be investigated to allow prophylactic surgery
      to be performed if appropriate [4]. Early mobilization of the (mostly elderly)
      patients is important. Three case reports of patients with burn scar carcinoma
      are presented.

PMID- 7791488
TI  - [Hyperextension injury of the lower cervical spine and diagnosis of dorsal
      unstable motion segments].
AB  - Five patients with hyperextension injuries and dorsally instable motion segments
      are presented. In the diagnosis of posterior instabilities plain roentgenograms
      demonstrated no characteristic signs of an injured cervical spine. Flexion and
      extension views detected a mild degree (2 mm) of retrospondylolisthesis in four
      cases and a widened disc space in one case. In all five patients the MR findings
      that made use suspect a posterior unstable motion segment were disc protrusions;
      in addition, in two patients these was hemorrhage in the spinal cord and in one
      patient cord edema.

PMID- 7791489
TI  - [Resection and reconstruction of the carina in children and adolescents].
AB  - While resection of tracheobronchial segments has become a standard operation in
      adults, lesions of the carina in children are rare and their treatment is
      technically more demanding. Since 1980, 8 patients aged 8 to 19 years underwent
      surgical reconstruction of the carina. The indications were tumors in 5 and non
      neoplastic lesions in 3. In 3 patients with tumor (2) and advanced histoplasmosis
      (1), resection of the carina was combined with parenchymal resection. The
      principles of operative repair include complete resection, with frozen section
      confirmation in tumors, particular emphasis on adequate mobilization of the
      airway in children to reduce anastomotic tension, and use of anesthetic
      techniques that facilitate early extubation. One patient (12.5%) died after
      complex airway reconstruction for extensive mediastinal fibrosis. Residual
      malacia in a patient with postpneumonectomy syndrome required successful re
      resection. Seven patients remain free of anastomotic stricture and tumor
      recurrence during a mean follow-up of 62 months (range 5 to 132 months), with
      expected preservation of lung function. Late bronchoscopy in 5 patients 6 months
      to 11 years after operation demonstrated growth of the luminal diameter and
      patent anastomoses. Carinal reconstruction in children is occasionally required,
      succeeds in general, and does not result in late problems at the anastomosis.

PMID- 7791490
TI  - Mycobacterial infection after liver transplantation.
AB  - Tuberculosis occurred in 5 (1.2%) of 462 liver transplant recipients. De novo
      infection was assumed in 4 patients and a recurrent infection in 1. The clinical
      courses varied, from asymptomatic open lung tuberculosis to disseminated disease
      with cerebral tuberculoma and convulsions. Four patients survived with anti
      tuberculous triple-drug therapy. Very few cases of tuberculosis after liver
      transplantation have been reported (4 patients in the medical literature and 5
      patients in this paper). However, the incidence, course of infection, and outcome
      seem to be similar to those of tuberculosis in renal transplant recipients,
      approximately 150 cases of which are known.

PMID- 7791492
TI  - [Direct electrostimulation of sacral spinal nerves within the scope of the
      diagnosis of anorectal function].
AB  - A technique is demonstrated to evaluate the functional relevance of the sacral
      spinal nerves regarding anal sphincter function. Sacral spinal nerves S2, S3, S4
      can be reached selectively for electrical stimulation by a dorsal approach
      through the sacral foramina. Electrical stimulation of S3 and S4 results in
      visible contraction of the different striated muscular anal sphincter components
      and in an increase of anal canal closure pressure. These effects differ among
      individuals. Thus, the functional relevance of each single sacral spinal nerve on
      the striated muscular anal sphincter can be tested specifically.

PMID- 7791491
TI  - [Reactivity of cortical bone capillaries. Functional TEM analysis with
      adrenaline, ATP and insulin].
AB  - In order to study any morphological effects that vasoactive drugs might exert on
      cortical bone capillaries, Swiss mice received one intravenous bolus injection
      each of epinephrine, ATP and insulin. In one control group saline solution was
      injected and another was not treated. All animals were handled in the same way. A
      piece of the tibia diaphysis was resected and prepared for transmission electron
      microscopy (TEM). The lumina and the endothelia of capillaries were submitted to
      computerized morphometry. Some significant changes were noted: epinephrine
      increases both the width of the lumen and the endothelium. ATP decreases the
      endothelium. Insulin (hypoglycaemia?) thickens the endothelium. These finding
      suggest some physiological hypotheses: the epinephrine-induced widening of the
      lumen and the thickening of the endothelium might reflect a decreased extravasal
      space and oedema of cortical bone that might cause the diffusion of minerals to
      take longer. Intracortical perfusion pressure would then decrease and the bone
      perfusion rate increase. ATP might reduce the transcapillary diffusion time and
      increase the extravasal space in cortical bone. Apparently there are specific
      insulin receptors in cortical bone capillaries.

PMID- 7791494
TI  - Applications of lasers in gastroenterology.
AB  - In this article the clinical uses of lasers in gastroenterology are reviewed. The
      endoscopic delivery of light for therapeutic as well as diagnostic purposes is
      discussed. Current research directions in the field are also indicated where
      appropriate.

PMID- 7791493
TI  - [Follow-up of plasma endothelin and serum interleukin 2 receptor level after
      liver transplantation].
AB  - In a prospective study levels of interleukin-2 receptors (Il-2-R) in serum and of
      endothelin (ET) in plasma were sequentially determined in 97 patients (39 women,
      58 men) before and after liver transplantation (Ltx). The aim of the study was no
      evaluate the correlation and the time course of these two parameters after Ltx.
      The postoperative levels of Il-2-R and ET were higher in transplant recipients
      with no postoperative complications than in patients who had undergone operations
      to the liver. Patients suffering from acute rejection episodes after
      transplantation had more markedly increased Il-2-R and ET levels than those with
      an uneventful course, and this persisted for 3 months. A significant rise of Il-2
      R concentrations 3-6 days before a biopsy confirmed rejection proved to have a
      sensitivity of 68% and a specificity of 68% respectively. A corresponding ET
      increase preceded rejection episodes confirmed by biopsy with a sensitivity of
      62% and a specificity of 67%, respectively. These laboratory data can be obtained
      daily: they cannot undermine the "gold standard" of liver biopsy, but they are
      extremely beneficial in determining the timing and indication for the liver
      biopsy.

PMID- 7791495
TI  - Laser safety.
AB  - Safety has always been an important aspect of any laser application in surgery
      and medicine. In any review of the laser surgery literature, several issues
      continue to dominate. These issues include: wearing eye protectors, dealing with
      the plume of vaporized tissue, and controlling potential fire hazards. No one
      denies that lasers can pose a serious hazard to the eye, but the decision to wear
      eye protectors in all procedures has been frequently questioned. The degree of
      effort needed to minimize the very serious risk from chronic breathing of
      vaporized tissue also requires judgment. Aside from a few eye injuries from a
      laser beam exposure, most serious accidental injuries (and even deaths) reported
      to date from the laser beam itself can be traced to the ignition of surgical
      drapes and airway tubes.

PMID- 7791496
TI  - Evaluation of a fluorescence feedback system for guidance of laser angioplasty.
AB  - BACKGROUND AND OBJECTIVE: Laser-induced fluorescence spectroscopy (LIFS) may be
      capable of guiding laser angioplasty by discriminating normal and atherosclerotic
      artery and by determining catheter-tissue environment. Previous optical
      multichannel analyzer based LIFS systems have been expensive and cumbersome. To
      simplify LIFS, a system based on photomultiplier tubes was developed and
      evaluated. STUDY DESIGN/MATERIALS AND METHODS: Tissue fluorescence was induced by
      a helium cadmium laser (wavelength = 325 nm, power = 0.2-0.5 mW), collected by
      clinical multifiber laser angioplasty catheters and directed through one of two
      filters (10 nm bandpass, 380 nm or 440 nm peak transmission) to a photomultiplier
      tube. An LIFS ratio was defined as the relative intensity at 380:440 nm after
      calibration with an elastin fluorescence spectrum; 157 coronary artery cadaveric
      specimens were evaluated spectroscopically and histologically. To evaluate the
      utility of LIFS to optimize catheter position by determining catheter-tissue
      contact, by determining saline dilution of blood, and by orienting eccentric
      multifiber catheters a new variable, the total fluorescence intensity (TFI) was
      defined as the sum of arterial fluorescence intensities at 380 nm and 440 nm. TFI
      was recorded in vitro through multifiber catheters from 20 arterial specimens in
      vitro in blood and evaluated as a function of the catheter-to-tissue distance (d)
      over a range from 0 to 400 mu. RESULTS: Defining normal specimens as those with
      an intimal thickness < or = 200 mu, and atherosclerotic as those with an intimal
      thickness > 200 mu, 47/50 (94%) normal and 85/107 (79%) atherosclerotic specimens
      were correctly classified using a threshold LIFS ratio of 2.0. Mean (+/- SE)
      normal ratio was 1.76 +/- 0.02 and mean atherosclerotic ratio was 2.78 +/- 0.08
      (P < or = 0.01). The classification accuracy of atherosclerotic specimens
      increased with intimal thickness so that 95% of atherosclerotic specimens (69/73)
      with intimal thickness > or = 400 mu were correctly classified. TFI was capable
      of determining catheter-tissue contact as maximal TFI was recorded with the
      catheter in contact with the tissue (d = 0 mu) and decreased markedly with
      distance (to 52 +/- 6% at d = 100 mu, 19 +/- 4% at d = 200 mu, and 3 +/- 1% at d
      = 300 mu). TFI was recorded from ten arterial specimens in blood/saline mixtures
      ranging in hematocrit from 0% (saline) to 50% (whole blood). TFI was capable of
      detecting saline hemodilution of blood as TFI decreased markedly at higher
      hematocrits such that TFI could only by recorded at hematocrits < 10% for
      catheter-to-tissue distances > or = 300 mu. TFI was recorded through ecentric
      multifiber catheters from 25 arterial specimens and eval-uated as a function of
      the degree of catheter-tissue overlap. TFI was capable of detecting maximal
      catheter-tissue overlap as TFI correlated linearly with the area (A) of overlap
      (TFI = 1.12 A + .07, r = 0.92). CONCLUSIONS: By discriminating atherosclerotic
      from normal tissue and by confirming catheter-tissue contact and saline
      hemodilution, fluorescence feedback should minimize irradiation of normal tissue
      and/or blood and enhance the safety and efficacy of laser angioplasty.

PMID- 7791497
TI  - Effect of midinfrared holmium: YAG laser angioplasty with and without balloon
      angioplasty on acute outcome and restenosis in atherosclerotic femoral arteries
      in rabbits.
AB  - BACKGROUND AND OBJECTIVE: Pulsed laser may lessen vascular damage and reduce
      restenosis. This study examined the acute and chronic effects of midinfrared
      laser angioplasty with and without balloon angioplasty in atherosclerotic femoral
      arteries in rabbits. STUDY DESIGN/MATERIALS AND METHODS: Atherosclerosis was
      induced in arteries by air desiccation and cholesterol feeding. Arteries were
      assigned to one of four groups: (1) laser angioplasty with a
      Thullium/Holmium/Chromium:YAG infrared laser (Eclipse), (2) balloon angioplasty,
      (3) laser followed by balloon angioplasty, and (4) no intervention. Arteries were
      examined angiographically and histologically at 2 hours and 28 days. RESULTS:
      Intervention groups had significant initial gain, but this gain was less with
      laser alone than after balloon or after laser plus balloon. At 2 hours, laser
      alone caused greater arterial damage and thrombosis compared to controls. At 28
      days, arteries treated with laser plus balloon had greater narrowing compared
      with arteries treated with balloon angioplasty. By multivariate regression
      analysis, the severity of the pre-intervention stenosis (P = 0.001) and
      intervention with laser plus balloon (P = 0.01) correlated independently with the
      severity of luminal narrowing at 28 days. CONCLUSION: Midinfrared Ho:YAG laser
      angioplasty resulted in substantial acute damage with increased frequency of
      thrombus formation in this rabbit model. arteries treated with laser alone had
      suboptimal initial gain and more obstruction by plaque at 28 days compared to
      nonintervened arteries. The adjunctive use of balloon angioplasty improved
      initial gain, but correlated with smaller luminal diameters and more severe
      narrowing by plaque at 28 days.

PMID- 7791498
TI  - Laser-induced release of liposome-encapsulated dye to monitor tissue temperature:
      a preliminary in vivo study.
AB  - BACKGROUND AND OBJECTIVE: The objective of this in vivo study was to assess the
      possible use of temperature-sensitive liposomes as a new approach to monitor the
      temperature induced by a laser. STUDY DESIGN: An in vivo/ex vivo study was
      performed in rat liver after i.v. injection of liposomes loaded with a
      fluorescent dye. MATERIALS AND METHODS: Temperature-sensitive liposomes (DSPC: Di
      Stearoyl-Phosphatidyl-Choline) were loaded with carboxyfluorescein. These
      liposomes (1 ml solution) were injected into adult male Wistar rats. Two hours
      later, the liver was exposed and irradiated with a 100 W Nd:YAG laser using
      pulses lasting from 100 to 260 ms. Simultaneously, the surface temperature was
      recorded with a thermographic camera. The fluorescence emission was measured with
      a fluorescent imaging system. RESULTS: The results showed that the dye was
      released in response to laser energy. The amount of the drug release increased
      linearly with increasing temperature in the range 42-60 degrees C. Moreover, the
      release occurred in a short period of time upon brief exposure to its phase
      transition temperature. CONCLUSION: The feasibility of temperature monitoring by
      using laser-induced release of liposome-encapsulated dye was demonstrated. This
      procedure could conceivably prove useful for controlling the thermal coagulation
      of biological tissues such as blood vessels.

PMID- 7791500
TI  - Immediate changes in subcellular structures of transplanted tumors following
      photodynamic and laser hyperthermic therapy.
AB  - BACKGROUND AND OBJECTIVE: To further understand the precise process of the tumor
      cell degeneration after photodynamic therapy (PDT), laser hyperthermic therapy
      (LH), and combined treatments using an Nd:YAG laser. It is important to examine
      initial morphological alteration of tumor cells after these treatments. STUDY
      DESIGN/MATERIALS AND METHODS: In this study, nude mice bearing HeLa cell tumors
      were treated with PDT, LH, and combined treatments of the two. Tumor tissues
      obtained immediately after these treatments were analyzed using electron
      microscopy and morphometry. RESULTS: In the combined treatments, which produced
      more severe effects on tumor cells, morphological features of apoptosis such as
      cytoplasmic condensation, blebs, and apoptotic bodies appeared in the cells,
      although the typical alteration in the nuclear chromatin was not seen.
      CONCLUSION: Cytoplasmic alterations may proceed more rapidly than nuclear
      alterations in the cellular degeneration induced by the single or combined
      treatments of PDT and LH.

PMID- 7791499
TI  - Optical properties of human articular tissue as implication for a selective laser
      application in arthroscopic surgery.
AB  - BACKGROUND AND OBJECTIVE: Optical density of normal and pathological hyaline
      cartilage, meniscus, and synovium is determined using native and laser-irradiated
      tissue samples in order to examine potentials for a selective laser ablation.
      STUDY DESIGN/MATERIALS AND METHODS: One hundred forty-four autopsy specimens were
      irradiated in a direct contact mode using a XeCl excimer laser (lambda = 308 nm;
      20 ns; 40 Hz; 40 +/- 2.1 J/mm2; 800 microns fused silica fiber) and a continuous
      wave Nd:YAG laser (lambda = 1,064 nm; 1 s; 124 +/- 5.4 W/mm2; 600 microns fused
      silica fiber). Transmission spectra were obtained by microspectrophotometry in a
      spectral range from 250 to 770 nm. RESULTS: In the ultraviolet spectrum analyzed,
      optical density (OD) is calculated to 0.81 +/- 0.05 for native hyaline cartilage,
      to 1.0 +/- 0.07 for meniscal tissue, and to 0.68 +/- 0.04 for synovium. With
      increasing wavelength the OD steadily decreases reaching mean values of 0.06 +/-
      0.01, 0.13 +/- 0.03, and 0.15 +/- 0.04 at 750 nm. Compared to normal tissue
      degeneration of cartilage and meniscus lead to a significant increase in OD with
      a maximum relative OD of 4.39 and 1.26, respectively (P < .001 and P < .01). In
      synovitis the OD increases with a maximum ratio of 1.45:1 (P < .01). Following
      Nd:YAG laser exposition the OD of the coagulated zone exceeded the value of
      native tissue by a factor of 9.71 for cartilage, 4.71 for meniscus, and 3.04 for
      synovium (P < .001). Excimer irradiation leads to a 3.38-fold increase in OD for
      cartilage, 2.23-fold for meniscal tissue, and 1.6-fold for synovium (P < .01).
      CONCLUSION: The results presented indicate that a preferential ablation of
      pathological tissue structures in articular surgery is possible by selecting
      laser systems with an appropriate spectral emission range. However, thermal laser
      tissue interaction may lead to severe alterations in optical properties reducing
      potentials of a preferential or selective laser application.

PMID- 7791501
TI  - Lethal photosensitisation of Staphylococcus aureus in vitro: effect of growth
      phase, serum, and pre-irradiation time.
AB  - BACKGROUND AND OBJECTIVES: Staphylococcus aureus can be killed by low-power laser
      light in the presence of aluminium disulphonated phthalocyanine (AlPcS2). The
      purpose of this study was to determine the effect of pre-irradiation time (PIT),
      the presence of serum, and the physiological state of the organism on the kills
      achieved. STUDY DESIGN/MATERIALS AND METHODS: To determine the effect of PIT on
      killing, suspension of methicillin-resistant S. aureus (MRSA) were incubated in
      the dark with 12.5 micrograms/ml of AlPcS2 for 60 s or 300 s, and survivors were
      enumerated after exposure to 1.2 J of light from an 11-mW gallium aluminium
      arsenide laser. The susceptibility of MRSA in its various growth phases was
      determined in a similar manner using a PIT of 300 s. The effect of serum on
      killing was determined using stationary phase cells resuspended in horse serum.
      RESULTS: Using a PIT of either 60 s or 300 s, 10(6) cfu (99.9%) of MRSA were
      killed. There was little difference in the susceptibility of lag-, logarithmic-,
      or stationary-phase cells, the kills being 99.9%, 99.8%, and 99.9%, respectively.
      Although kills were reduced in the presence of serum, 99.6% of MRSA were killed
      using a light dose of 1.2 J. CONCLUSION: These results demonstrate that MRSA can
      be rapidly sensitised by AlPcS2 to killing by low-power laser light, that killing
      is not dependent on the organism's growth phase, and that substantial kills can
      be achieved in the presence of serum.

PMID- 7791503
TI  - Carbon dioxide laser therapy of a widespread epidermal nevus.
AB  - BACKGROUND AND OBJECTIVE: The treatment of epidermal nevi is difficult and often
      unsatisfactory. Many therapeutic approaches have been tried, of which the
      surgical methods including lasers aim to avoid recurrences and hypertrophic
      scarring. Here we report the case of a widespread, life-impairing epidermal
      nevus, summarize the available treatment modalities, and discuss CO2 laser
      therapy with respect to the clinically soft variants of these developmental
      defects. STUDY DESIGN/PATIENTS AND METHODS: A patient with a widespread,
      recurrent, biopsy-proven epidermal nevus was treated with a 10,600-nm CO2 laser.
      After test treatments in local anaesthesia, four sessions were performed under
      general anaesthesia each with a follow-up time of 4 years to date. RESULTS: CO2
      laser vaporization resulted in complete removal of the treated nevus without any
      obvious scarring. The patient is free of recurrence 4 years postoperatively.
      CONCLUSION: CO2 laser treatment of epidermal nevi is a useful modality in
      selected variants.

PMID- 7791502
TI  - Model study to investigate the contribution of spallation to pulsed laser
      ablation of tissue.
AB  - BACKGROUND AND OBJECTIVE: Absorption of a short laser pulse produces high
      thermoelastic stress in the irradiated volume. The relaxation of this stress at a
      free (tissue-air) surface leads to tensile loading, resulting in mechanical
      spallation. Using model substances, we investigated the role of this effect in
      tissue ablation. STUDY DESIGN/MATERIALS AND METHODS: Stained water and gelatine
      were irradiated with short pulses (8 ns duration) from a Nd:YAG laser at 1,064 nm
      wavelength. The dynamics of the induced effects were observed with laser-flash
      photography and stress wave detection. RESULTS: Spallation is indicated by the
      formation of cavitation bubbles below the irradiated surface and is strongly
      influenced by impurities serving as nucleation sites. Material ejection due to
      spallation was observed in the liquid sample at a fluence leading to a
      temperature below the boiling point but needed a temperature in excess of 100
      degrees C in gelatine, owing to the small mechanical energy available for this
      process, estimated to be < 1%. CONCLUSION: The mechanical action of thermoelastic
      stress waves is characterized by high stress amplitudes but low energetic
      efficiency. A model combining spallation and vaporization is therefore proposed
      for efficient tissue ablation.

PMID- 7791504
TI  - Laparoscopic surgery of chronic hyperandrogenic anovulation.
AB  - The review describes briefly the clinical and endocrinological characteristics of
      chronic hyperandrogenic anovulation (CHA), as well as ovulation induction by
      hormone therapy (therapy of first choice) and by classical wedge resection. The
      main purpose of this study, however, is to compare different laparoscopic
      treatments of CHA, with emphasis on laser treatments by argon, CO2, Nd:YAG, and
      frequency-doubled Nd:YAG laser. The overall results of laparoscopic treatments in
      hormone-therapy-resistant patients with CHA are encouraging and the results are
      comparable. In the studies considered in this review, ovulation was induced for
      longer or shorter periods in 21 out of 31 patients (68%) after ovarian biopsy, in
      57 out of 73 patients (78%) after electrosurgery, and in 82 out of 118 patients
      (70%) after laser treatment. Subsequent conception occurred in 44%, 40%, and in
      41% of the patients, respectively. Of interest is the fact that some hormone
      therapy-resistant patients become sensitive to Clomiphene after laparoscopic
      treatment, giving an overall percentage of ovulation and an overall pregnancy
      rate of 89% and 54%, respectively, for electrosurgery, and of 88% and 50%,
      respectively, for laser treatment. Unfortunately, adhesion formation, a serious
      complication of surgical treatment of the ovaries, is still a drawback using
      laparoscopic surgical techniques.

PMID- 7791506
TI  - Nonselective ETA/ETB receptor antagonist blocks proliferation of rat vascular
      smooth muscle cells after balloon angioplasty.
AB  - To elucidate the role of endothelin receptor subtypes in the abnormal
      proliferation of vascular smooth muscle cells (VSMC) associated with vascular
      injury, we have investigated the effects of a novel and potent nonselective
      ETA/ETB receptor antagonist (TAK-044) on the proliferation of rat VSMC in vitro
      and in vivo. TAK-044 dose-dependently inhibited DNA synthesis stimulated by 10(
      7) M ET-1 in cultured rat VSMC from the late passage with the approximate IC50 of
      6 x 10(-8) M. After balloon angioplasty, the neointimal lesion in the injured
      carotid arteries in the TAK-044-treated group (0.052 +/- 0.014 mm2) was
      significantly (p < 0.05) decreased compared to that in control group (0.26 +/-
      0.045 mm2), while the medial surface area was not affected. The intima/media
      ratio in the TAK-044 group (31 +/- 6%) also significantly (p < 0.05) decreased
      from that of the control group (148 +/- 25%). Our data suggest that nonselective
      ETA/ETB receptor antagonists may be therapeutic potential for prevention against
      the intimal thickening associated with vascular injury.

PMID- 7791505
TI  - Rolipram, a selective c-AMP phosphodiesterase inhibitor suppresses oro-facial
      dyskinetic movements in rats.
AB  - Since striatal dopamine D2 receptor supersensitivity in the etiology of tardive
      dyskinesia has been suggested and dopamine D2 receptors are known to inhibit
      adenylate cyclase activity resulting in a decrease of cyclic adenosine 3',5'
      monophosphate (cAMP) levels, we hypothesized that an increase in cAMP levels
      ameliorates the condition. In the present study, 21-day haloperidol treatment
      (1.5 mg/kg I.P.) in rats resulted in an increase in striatal [3H]-spiperone (D2)
      binding whereas [3H] SCH23390 (D1) binding was unaltered. This haloperidol
      treatment also induced a significantly increase in the frequency of involuntary
      chewing movements and tongue protrusions, which are considered as a model of
      tardive dyskinesia. These dyskinetic movements were suppressed by administration
      of rolipram (0.5 and 1.0 mg/kg I.P.), an inhibitor of the cAMP phosphodiesterase
      type IV. The present results suggest that selective cAMP phosphodiesterase type
      IV inhibitors could be putative therapeutic drugs for tardive dyskinesia.

PMID- 7791508
TI  - Effects of 2 alpha-DHET and its optical isomers on muscarinic and nicotinic
      receptors.
AB  - The agent 2 alpha-(2', 2'-disubstituted-2'-hydroxy-ethoxy) tropane (2 alpha
      DHET), its optical isomers and atropine were compared in their ability to inhibit
      specific [3H]QNB binding to muscarinic receptors of guinea pig ileum and to
      antagonize oxotremorine- and nicotine-induced contractions of isolated guinea pig
      ileum. A good correlation was observed between the affinities to muscarinic
      receptors and the antimuscarinic potencies in isolated guinea pig ileum. The
      binding data for 2 alpha-DHET and its isomers were also consistent with their
      central and peripheral pharmacological activity in vivo. Compounds with 2'R
      configuration are more suitable to the stereostructure of the binding sites of
      muscarinic receptors than that of 2'S configuration.

PMID- 7791507
TI  - Nitrous oxide and xenon enhance phospholipid-N-methylation in rat brain synaptic
      plasma membranes.
AB  - Halothane and isoflurane increase the rate of phospholipid methylation (PLM) in
      rat brain synaptosomal membranes, a process linked to the coupling of neuronal
      excitation to neurotransmitter release. In contrast, synaptic plasma membrane
      (SPM) Ca2+ ATPase (PMCA) pumping is reduced by exposure to halothane, isoflurane,
      xenon and nitrous oxide (N2O). To examine further the relationship between PLM,
      PMCA and anesthetic action, we investigated the effect of clinically relevant
      concentrations of two less potent anesthetic gases, N2O and xenon, on PLM in SPM.
      Biochemical assays were performed on SPM exposed to 1.3 MAC of N2O (2 atm), 1.3
      MAC of xenon (1.23 atm) or an equivalent pressure of helium for control. N2O or
      xenon exposure increased PLM to 115% or 113%, respectively, of helium control (p
      < 0.02). Similar exposures to N2O or xenon depressed PMCA activity to 78% and 85%
      of control (p < 0.05). Observations that PLM and PMCA are both altered by a wide
      variety of inhalation anesthetic agents at clinically relevant partial pressures
      lend support to a possible involvement and interaction of these processes in
      anesthetic action.

PMID- 7791509
TI  - The role of 5-HT2A receptors in antipsychotic activity.
AB  - The correlation between the clinical activity of antipsychotic agents and their
      affinity for the D2 dopamine receptor has been the mainstay of the hypothesis
      that schizophrenia is due to excessive dopaminergic function. More recently, the
      unique clinical profile of the atypical antipsychotic clozapine has been proposed
      to involve actions on additional receptor systems. In particular, the high
      affinity of clozapine for the 5HT2A receptor subtype has been suggested to
      contribute to its reduced side-effect liability, greater efficacy and its
      activity in therapy-resistant schizophrenia. We have used the highly selective 5
      HT2A antagonist MDL 100,907 to explore the contribution of 5-HT2A receptor
      blockade to antipsychotic activity. Biochemical, electrophysiological and
      behavioral studies reveal that selective 5HT2A receptor antagonists have the
      preclinical profile of an atypical antipsychotic. The limited clinical evidence
      available also suggests that compounds producing 5-HT2A receptor blockade are
      effective, in particular, against the negative symptoms of schizophrenia.

PMID- 7791510
TI  - Superoxide dismutase in the nonobese diabetic (NOD) mouse: a dynamic time-course
      study.
AB  - Superoxide dismutase (SOD) levels, thought to be the first cellular defence
      against free radicals, were studied in the nonobese diabetesprone (NOD-p) mouse,
      an animal model of type 1 diabetes in which about 100% of females and 20% of
      males become diabetic. Nonobese diabetes nonprone (NON-p) mice were used as
      controls. Animals were followed from 5th to 22nd week of life. Results show that
      SOD levels in female NOD-p mice are extremely low. In males, values are
      considerably higher than in females but still lower than values found in control
      mice. Moreover, SOD levels did not significantly change with age, degree of
      insulitis or level of diabetes. Islet beta cells in this strain, therefore, seem
      to be poorly protected against the negative effects of free radicals and this may
      predispose to diabetes. Furthermore, alterations of SOD may not be directly
      related to the development of the disease as the enzyme's activity is not further
      modified with age or the progression of diabetes.

PMID- 7791512
TI  - Physiological concentration of estradiol inhibits polymorphonuclear leukocyte
      chemotaxis via a receptor mediated system.
AB  - Estrogen exhibits a variety of actions, including immuno-modulatory effects, in
      vivo and in vitro. The mechanism by which estrogen exerts its anti-inflammatory
      effect is not yet understood. We investigated the possible mechanisms of
      estradiol acting via the polymorphonuclear leukocytes (PMNs), which are important
      in the immune response. The agent, 17 beta-estradiol, but not 17 alpha-estradiol,
      significantly reduced PMNs chemotaxis to FMLP in a dose-dependent manner (control
      vs estrogen 10(-10)-(-6) M, P < 0.05). Physiological concentrations of estradiol
      significantly reduced the chemotaxis of PMNs (10(-10) mol). Pre-incubation with
      clomiphene or tamoxifen which are estrogen receptor antagonists, eliminated the
      inhibitory effect of 17 beta-estradiol on the chemotaxis of PMNs, restoring it to
      the control level. These observations suggest that 17 beta-estradiol suppressed
      the chemotaxis of PMNs by a receptor-dependent mechanism. In addition, the level
      of estradiol in human plasma, which PMNs were drawn, showed a close, inverse
      correlation with the PMNs chemotaxis to FMLP (r = -0.821 p < 0.001). Estrogen may
      modify the activity of neutrophils during the normal menstrual cycle, not only
      during pregnancy, and influence inflammation.

PMID- 7791511
TI  - Neuroleptic effects on acquisition and performance of learned behaviors: a
      reinterpretation.
AB  - It is well-established that dopamine facilitates motor responsiveness. However,
      neuroleptics--drugs that block dopaminergic transmission--do not affect equally
      motor responses to environmental stimuli: responses to some stimuli seem
      completely preserved while responses to other stimuli are greatly disturbed. For
      example, escape responses to a noxious stimulus are typically preserved, even
      when avoidance to a cue predicting the noxious stimulus is absent. In this paper,
      we propose a connectionist account of this differential effect. We assume that
      dopamine determines the "gain" of the function relating the activation of a
      neural ensemble to its excitatory or inhibitory input. Because such a function is
      necessarily non-linear, we show that the influence of gain on whether a neural
      ensemble reaches a "threshold" of activation is critically different for low and
      high excitatory drives. This analysis makes specific predictions about the effect
      of neuroleptics on motor responses at different stages of training.

PMID- 7791513
TI  - Prejunctional muscarinic autoreceptors on horse airway cholinergic nerves.
AB  - Muscarinic autoreceptors on horse airway cholinergic nerves were studied by
      examining the effects of muscarinic receptor antagonists on electrical field
      stimulation (EFS)-induced acetylcholine (ACh) release in trachealis preparations.
      All the antagonists including atropine (non-selective), pirenzepine (M1
      selective), AF-DX 116 (M2-selective), and hexahydrosiladifenidol (M3-selective)
      augmented ACh release concentration-dependently. The augmentation was not due to
      displacement of ACh molecules from tissue receptors into the bath liquid because
      incubation with atropine after EFS had no influence on the measured amount of
      ACh. Hexahydrosiladifenidol was more potent in inhibiting ACh-induced muscle
      contraction, which is known to be mediated by M3 receptors, than in augmenting
      ACh release. The maximal ACh release rate in response to the selective
      antagonists was much less than that following atropine. Furthermore, the
      concentrations of the selective antagonists required to augment ACh release far
      exceeded their KdS for M1, M2, or M3 receptors. These observations suggest that
      the muscarinic autoreceptors on horse airway cholinergic nerves may belong to a
      novel subtype.

PMID- 7791514
TI  - A seric low molecular weight factor modulates IGFs effects on chick cartilage
      metabolism.
AB  - The effects of recombinant human insulin-like growth factors (rhIGF-I and rhIGF
      II) alone and in combination with a partially purified serum low molecular weight
      growth factor (LMW-GF) were studied by measuring proteoglycan (PG) and total
      protein synthesis by chick embryo cartilage. rhIGF-I alone did not increase the
      incorporation of L[3H]serine or [35S]Na2SO4 into whole cartilages. LMW-GF + rhIGF
      I markedly increased the incorporation of these precursors. rhIGF-I alone
      stimulated D[3H]glucosamine uptake, and LMW-GF increased the effect of rhIGF-I.
      These results for whole cartilage were reproduced with glycosaminoglycans (GAG)
      extracted from cartilage. LMW-GF acted in synergy with rhIGF-I to stimulate PG
      core protein synthesis, xylosyl transferase activity and sulfation. Total protein
      synthesis, as measured by [35S]methionine uptake, was not altered by rhIGF-I. LMW
      GF plus rhIGF-I increased the incorporation of this precursor into whole
      cartilage. The effect of rhIGF-II on PG synthesis was different from that of
      rhIGF-I. rhIGF-II alone stimulated GAG chain lengthening and sulfation. LMW-GF
      did not modify the effect of rhIGF-II on these steps. In contrast, rhIGF-II did
      not stimulate the synthesis of core protein. LMW-GF plus rhIGF-II increased the
      [3H]serine incorporation into the whole cartilage, but this combination did not
      stimulate the uptake of [3H]serine into extracted GAG. rhIGF-II plus LMW-GF were
      also without effect on xylosyl transferase activity. The combination of these
      factors increased the [35S]methionine incorporation into cartilage total
      proteins. These results suggest that rhIGF-II does not regulate the PG core
      protein synthesis, but in combination with LMW-GF, stimulates the synthesis of
      proteins other than proteoglycan core protein.

PMID- 7791515
TI  - A new extrapolation method from animals to man: application to a metabolized
      compound, mofarotene.
AB  - Allometric scaling (a technique which uses data obtained in laboratory animals to
      predict human pharmacokinetics) works well for drugs that are cleared intact, but
      is less successful with extensively metabolised compounds. This paper describes a
      new method to improve the accuracy of such projections, by integrating metabolic
      data obtained in vitro (e.g. with liver microsomes or hepatocytes) into these
      calculations. The approach was used prospectively, to predict the clearance of
      mofarotene (Ro 40-8757) in humans from in vivo kinetic data obtained in mouse,
      rat and dog. This compound was selected to illustrate this approach because it is
      exclusively eliminated through metabolism. Without the metabolic correction or
      using empirical correcting factors, the values predicted for man were 2.7 and 0.6
      ml/min/kg. This fell outside the range subsequently obtained in healthy
      volunteers dosed orally with 300 mg of mofarotene (7.5 +/- 4.0 ml/min/kg, n =
      12). However, inclusion of the microsomal or hepatocyte data gave values of 5.1
      and 4.2 ml/min/kg, respectively, illustrating that the integration of in vitro
      metabolic data improves the accuracy of kinetic extrapolations. In contrast to
      the existing empirical techniques, this approach offers a rational basis to
      predict clearance of metabolized compounds in human.

PMID- 7791516
TI  - "It's the genes, stupid". Molecular bases and clinical consequences of genetic
      cytochrome P450 2D6 polymorphism.
AB  - In this review we highlight the information available on the genetic polymorphism
      of cytochrome P4502D6 expression in man. An absent function of this enzyme is
      observed in 7-10 percent of the Caucasian population which are referred to as
      Poor metabolizers as opposed to the remainder of the population (Extensive
      Metabolizers). More than 30 widely used drugs have been identified as substrates
      for CYP2D6. Disposition and action of these compounds depend on the individual
      phenotype. Both the molecular bases of the variable enzyme activity and the
      consequences for drug therapy are outlined. While mutations on the DNA level have
      been investigated in great detail larger scale clinical trials are lacking and
      information on therapeutic consequences of CYP2D6 mediated polymorphic drug
      oxidation is restricted to case reports. Besides these implications for drug
      metabolism several lines of evidence indicate that CYP2D6 could be involved in
      biotransformation of endogenous compounds.

PMID- 7791517
TI  - Effects of monosialoganglioside on dopaminergic supersensitivity.
AB  - The effects of monosialoganglioside (GMl) treatment on dopaminergic
      supersensitivity induced by long-term haloperidol administration were studied;
      both general activity of rats observed in an open-field and apomorphine-induced
      stereotyped behavior were used as experimental parameters. GMl per se (5.0 mg/kg,
      twice daily, for 30 days) did not modify rat behavior, but when given in
      combination with haloperidol (1.0 mg/kg, twice daily, for 30 days) it increased
      neuroleptic withdrawal symptoms as detected in both models. When GMl (5.0 mg/kg,
      twice daily) was administered after abrupt withdrawal from haloperidol (1.0
      mg/kg, twice daily, for 30 days), it attenuated the increases in both general
      activity of rats observed in the open-field and apomorphine-induced stereotyped
      behavior. These results suggest that GMl may affect synaptic plasticity,
      facilitating the induction of the adaptative changes in receptor function (up and
      down-regulation), following long-term haloperidol treatment and withdrawal.

PMID- 7791518
TI  - Increased receptor-mediated phospholipase D activation and Ca2+ mobilization in
      peritoneal polymorphonuclear leukocytes from streptozotocin-induced diabetic
      rats.
AB  - Phospholipase D activation was investigated in peritoneal polymorphonuclear
      leukocytes from streptozotocin-induced diabetic rats. Stimulation of the cells
      with formyl-Met-Leu-Phe resulted in a time- and dose-dependent increase in
      phosphatidylethanol in the presence of ethanol, and this lipid formation in cells
      prepared from diabetic rats was enhanced as compared to that in the case of
      nondiabetic rats. Furthermore, the increase in the intracellular Ca2+
      concentration was also enhanced in the stimulated cells from diabetic rats. Under
      the present conditions, N-acetyl-beta-glucosaminidase release and superoxide
      generation, which are known to be dependent on phospholipase D activation, were
      higher in the cells from diabetic rats than those in the cells from control rats.
      However, there was no difference in the dissociation constant and the number of
      binding sites for formyl-Met-Leu-Phe between the cells from diabetic and control
      rats. Phosphatidylethanol formation, N-acetyl-beta-glucosaminidase release and
      superoxide generation in response to ionomycin or 4 beta-phorbol 12-myristate 13
      acetate were not enhanced in diabetic rat cells, as compared with those in
      control rat cells. These results suggest that receptor-mediated phospholipase D
      activation and Ca2+ mobilization are enhanced in diabetic rat polymorphonuclear
      leukocytes, which might be due to acceleration of receptor-mediated signaling.

PMID- 7791521
TI  - Quantitative distribution of the delta opioid receptor mRNA in the mouse and rat
      CNS.
AB  - We have used a sensitive solution hybridization assay that employs a riboprobe
      obtained from the mouse delta opioid receptor (DOR) coding sequence to quantitate
      the relative abundance of DOR mRNA in the central nervous system (CNS) of the
      adult mouse and rat. In brain Poly A+ RNA extracts this riboprobe hybridized to a
      single 10 kb transcript from mouse and two transcripts, one of 12 and the other
      of 4.5 kb in size from rat. In mouse CNS the highest levels of DOR mRNA were
      found in the caudate-putamen at 3.3 +/- 0.1 (SEM) pg/micrograms RNA. DOR mRNA
      levels in the range from 2.6 to 2.1 pg/micrograms RNA were measured in frontal
      cortex, nucleus accumbens, whole brain and olfactory tubercle. Spinal cord,
      periaqueductal gray and hippocampus had DOR mRNA levels in the range from 1.8 to
      1.5 pg/micrograms RNA, while medial thalamus and cerebellum had the lowest levels
      (0.5 pg/micrograms RNA). These results correlate with the reported relative
      distribution of DOR mRNA in mouse using an in situ hybridization technique. In
      rat CNS, the highest levels of DOR mRNA were measured in caudate-putamen at 2.3
      +/- 0.1 pg equivalents/micrograms RNA. Whole brain, cerebral cortex, olfactory
      bulb and brain stem had levels in the range from 1.5 to 0.9 pg
      equivalents/micrograms RNA while the lowest DOR mRNA levels were measured at 0.5
      pg equivalents/micrograms RNA or less in thalamus, hippocampus, substantia nigra
      and cerebellum. This study demonstrates the ability of solution hybridization
      assays to quantitate homologous (mouse) as well as similar but heterologous (rat)
      DOR mRNA levels.

PMID- 7791519
TI  - Agmatine, the bacterial amine, is widely distributed in mammalian tissues.
AB  - We sought to determine whether agmatine (decarboxylated arginine), a bacterial
      product recently discovered for the first time in mammalian brain, was contained
      in other organs. A method was developed for isolation of agmatine from tissue and
      detection by RP-HPLC following solid-liquid extraction and derivatization with o
      phthalaldehyde and mercaptoethanol. Recovery was about 80% and the limit of
      fluorometric detection was about 10 pg on column. In male Sprague-Dawley rats
      agmatine was unevenly and widely distributed in many tissues confirming its
      presence in mammals. The highest concentration (approximately 71 ng/mg net
      weight) was found in stomach, with aorta and small intestine next, followed by
      smaller levels in spleen, adrenal, aorta, and skeletal muscle and brain. Serum
      concentrations were high. Agmatine in male Long Evans rats of 3, 12, and 24
      months of age demonstrated similar but not identical tissue distribution without
      any effect of aging. Since agmatine binds to alpha 2-adrenergic and imidazoline
      receptors, is bioactive in a number of tissues, is contained in neurons and is
      found in serum and tissues, the findings are consistent with a potential role for
      agmatine as a neurotransmitter and/or hormone. It also raises the possibility
      that agmatine may, as in bacteria, serve as a polyamine precursor along metabolic
      pathways previously not detected in mammals.

PMID- 7791520
TI  - A permanent human cell line (EA.hy926) preserves the characteristics of
      endothelin converting enzyme from primary human umbilical vein endothelial cells.
AB  - Purification of endothelin converting enzyme (ECE) from endothelial cells has
      been hindered by the difficulty in obtaining primary endothelial cells in large
      quantity. We therefore tested transformed human umbilical vein endothelial cells
      (EA.hy926) for ECE activity. Our data clearly demonstrate that this transformed
      cell line preserves the ECE properties of the primary cell line. These include:
      (i) one sharp activity optimum at neutral pH; (ii) characteristics typical of a
      metalloprotease; (iii) IC50 value for phosphoramidon of 1.8 microM (2.7 microM
      for HUVEC); (iv) no inhibition by captopril and thiorphan, inhibitors of
      angiotensin converting enzyme and neutral endopeptidase 24.11. The enzyme showed
      a substrate specificity for big ET-1:big ET-2:big ET-3 in a ratio of 40:2.5:1.
      This report presents evidence that a permanent human endothelial cell line,
      EA.hy926, preserves the ECE activity of HUVEC and is useful for the study of ECE
      and its regulation of ET-1 production.

PMID- 7791523
TI  - Alterations of serum lipid levels and their biological relevances during and
      after pregnancy.
AB  - In normal pregnancy, all women displayed a significant elevation of serum
      triglyceride (TG), total cholesterol (TC), low density cholesterol (LDL-C) and
      high density cholesterol (HDL-C) during parturition. To study the quantitative
      changes in serum levels of lipids and their biological relevances during and
      after pregnancy, blood samples were collected from 62 normally pregnant women
      throughout gestation and 6 to 12 weeks postpartum. Compared with 184 nonpregnant
      control subjects, TG, TC, LDL-C and HDL-C were significantly elevated during the
      second and third trimesters of pregnancy but dropped sharply after pregnancy. To
      further understand the effect of pregnancy on other metabolic parameters, we
      compared the relative levels of apolipoproteins such as apolipoprotein A-I (apoA
      I) and apolipoprotein B (apoB), lipoprotein (a) (Lp(a)) and blood sugar during
      and after pregnancy. We found that apoB concentration progressively increased
      with advancing gestation, while the levels of apoA-I, Lp(a) and blood sugar were
      independent of gestation process. The physiological significance of
      hyperlipidemia during pregnancy is also discussed in this study.

PMID- 7791522
TI  - C-natriuretic peptide but not atrial natriuretic peptide increases cyclic GMP in
      cerebral arterial smooth muscle cells.
AB  - A-type natriuretic peptide (ANP) is found primarily in the heart and is released
      into the circulation. C-type (CNP) is found principally in the brain and has also
      been detected in the systemic circulation. When injected, both peptides produce
      vasodilatation most likely by elevation of guanosine 3'5'-cyclic monophosphate
      (cGMP) in smooth muscle cells via two distinct receptors, NPR-A and NPR-B. In
      this present study, we determined the effects of these two peptides on
      intracellular cGMP in smooth muscle cells cultured from pig cerebral and
      peripheral arteries. In smooth muscle cells cultured from the left anterior
      descending coronary artery, ANP and CNP increased cGMP with equal potency and
      efficacy (EC50 for ANP and CNP, 3.6 +/- 0.2 x 10(-8) M and 6.7 +/- 0.8 x 10(-8)
      M, respectively). In contrast, in smooth muscle cells from cerebral arteries, ANP
      was without effect while CNP increased cGMP in a concentration dependent manner
      (EC50: 9.6 +/- 1.7 x 10(-8) M). Stimulation of the soluble guanylyl cyclase with
      either nitroglycerin or nitroprusside was equivalent in the two cell types. The
      pattern of response of intracellular cGMP to CNP and ANP in isolated intact
      arteries from brain and heart was similar to that found in the cultured cells.
      These results suggest that smooth muscle cells in cerebral arteries express only
      NPR-B while cells from peripheral arteries can express both NPR-A and NPR-B.

PMID- 7791525
TI  - Sigma receptors are expressed in human non-small cell lung carcinoma.
AB  - N-(2-piperidinoethyl)4-iodobenzamide), IPAB, was used to characterize sigma
      receptors in non-small cell lung cancer (NSCLC) cell lines. 125IPAB bound with
      high affinity to large cell carcinoma (NCI-H1299), adenocarcinoma (NCI-H838), and
      lung carcinoid (NCI-H727) cell lines. Specific IPAB binding was inhibited with
      high affinity by haloperidol (Ki = 0.6 nM), IPAB (Ki = 14 nM) and 1,3-ditolyl
      guanidine (DTG) (Ki = 40 nM). Relative to other receptor ligands, IPAB was not
      readily internalized at 37 degrees C. IPAB had little effect on the growth of
      NSCLC cells. Scintigraphic imaging studies using 131IPAB in nude mice bearing NCI
      H838 xenografts visualized the tumor at 24 or 30 hours after injection. These
      results suggest that sigma receptors which are present on NSCLC cells may be used
      as external markers for imaging tumors in vivo.

PMID- 7791526
TI  - Regulation of Biosynthesis and Function of Isopentenoids. Symposium proceedings.
      Atlanta, Georgia, May 8-12, 1994.

PMID- 7791524
TI  - Inactivity of phosphoethanolamine, an endogenous GABA analog decreased in
      Alzheimer's disease, at GABA binding sites.
AB  - Phosphoethanolamine (PE) is a metabolite of the phospholipid metabolism which is
      decreased in Alzheimer's disease brain. PE shows a strong structural similarity
      to the inhibitory neurotransmitter, GABA, and the GABAB receptor partial agonist,
      3-amino-propylphosphonic acid. The ability of PE to compete for binding to GABAA
      and GABAB binding sites was investigated. GABAA sites were studied using [3H]SR
      95531 and [3H]muscimol. GABAB sites were studied using [3H]GABA in the presence
      of isoguvacine to saturate GABAA sites. Total [3H]GABA binding was also examined.
      PE showed little activity at any of the GABA binding sites investigated. PE was
      most potent at GABAB sites, but the IC50 of 7.5 +/- 0.75 mM was considerably
      higher than its maximal physiologic concentration of approximately 1.5 mM. The
      efficient exclusion of PE from GABA binding sites may be an important physiologic
      mechanism in the control of inhibitory neurotransmission. The structural basis
      for this exclusion is discussed in reference to the GABAB partial agonist 3-amino
      propylphosphonic acid.

PMID- 7791527
TI  - Some new aspects of isoprenoid biosynthesis in plants--a review.
AB  - Plants are capable of synthesizing a myriad of isoprenoids and prenyl lipids.
      Much attention has been focused on 3-hydroxy-3-methylglutaryl-CoA reductase
      (HMGR), the enzyme that synthesizes mevalonate and is generally considered
      responsible for the regulation of substrate flux to isoprenoids. In contrast to
      vertebrates, where there seems to exist only one HMGR gene, in plants a small
      family of isogenes appears differentially expressed in regard to location and
      time. Much less is known in plants about the preceding steps, viz. the conversion
      of acetyl-CoA to HMG-CoA. An enzyme system has been isolated from radish that can
      catalyze this transformation, and which shows some unusual properties in vitro.
      The intracellular localization of the early steps of isoprenoid biosynthesis in
      plant cells is still a matter of debate. The various observations and hypotheses
      derived from incorporation and inhibition studies are somewhat contradictory, and
      an attempt is being made to rationalize various findings that do not at first
      seem compatible. There are good arguments in favor of an exclusively cytoplasmic
      formation of isopentenyl pyrophosphate (IPP) via mevalonic acid, but other
      studies and observations suggest an independent formation in plastids. Other
      possibilities are being considered, such as the existence of independent
      (compartmentalized) biosynthetic pathways of IPP formation via the so-called
      Rohmer pathway. Substrate channeling through the formation of end product
      specific multienzyme complexes (metabolons) with no release of substrate
      intermediates will also be discussed.

PMID- 7791529
TI  - Cloning of the late genes in the ergosterol biosynthetic pathway of Saccharomyces
      cerevisiae--a review.
AB  - Research on the ergosterol biosynthetic pathway in fungi has focused on the
      identification of the specific sterol structure required for normal membrane
      structure and function and for completion of the cell cycle. The pathway and its
      end product are also the targets for a number of antifungal drugs. Identification
      of essential steps in ergo-sterol biosynthesis could provide new targets for the
      development of novel therapeutic agents. Nine of the eleven genes in the portion
      of the pathway committed exclusively to ergosterol biosynthesis have been cloned,
      and their essentiality for aerobic growth has been determined. The first three
      genes, ERG9 (squalene synthase), ERG1 (squalene epoxidase), and ERG7 (lanosterol
      synthase), have been cloned and found to be essential for aerobic viability since
      their absence would result in the cell being unable to synthesize a sterol
      molecule. The remaining eight genes encode enzymes which metabolize the first
      sterol, lanosterol, to ultimately form ergosterol. The two earliest genes, ERG11
      (lanosterol demethylase) and ERG24 (C-14 reductase), have been cloned and found
      to be essential for aerobic growth but are suppressed by mutations in the C-5
      desaturase (ERG3) gene and fen1 and fen2 mutations, respectively. The remaining
      cloned genes, ERG6 (C-24 methylase), ERG2 (D8AE7 isomerase), ERG3 (C-5
      desaturase), and ERG4 (C-24(28) reductase), have been found to be nonessential.
      The remaining genes not yet cloned are the C-4 demethylase and the C-22
      desaturase (ERG5).

PMID- 7791528
TI  - Developmental regulation of sterol biosynthesis in Zea mays.
AB  - Sixty-one sterols and pentacyclic triterpenes have been isolated and
      characterized by chromatographic and spectral methods from Zea mays (corn).
      Several plant parts were examined; seed, pollen, cultured hypocotyl cells, roots,
      coleoptiles (sheaths), and blades. By studying reaction pathways and mechanisms
      on plants fed radiotracers ([2-(14)C]mevalonic acid, [2-(14)C]acetate, and [2
      (3)H]acetate), and stable isotopes (D2O), we discovered that hydroxymethylgutaryl
      CoA reductase is not "the" rate-limiting enzyme of sitosterol production.
      Additionally, we observed an ontogenetic shift and kinetic isotope effect in
      sterol biosynthesis that was associated with the C-24 alkylation of the sterol
      side chain. Blades synthesized mainly 24 alpha-ethyl-sterols, sheaths synthesized
      mainly 24-methyl-sterols, pollen possessed an interrupted sterol pathway,
      accumulating 24(28)-methylene-sterols, and germinating seeds were found to lack
      an active de novo pathway. Shoots, normally synthesizing (Z)-24(28)-ethylidine
      cholesterol, after incubation with deuterated water, synthesized the rearranged
      double-bond isomer, stigmasta-5,23-dien-3 beta-ol. Examination of the mass
      spectrum and 1H nuclear magnetic resonance spectrum of the deuterated 24-ethyl
      sterol indicated the Bloch-Cornforth route originating with acetyl-CoA and
      passing through mevalonic acid to sterol was not operative at this stage of
      development. An alternate pathway giving rise to sterols is proposed.

PMID- 7791531
TI  - Identification of the active site of vertebrate oxidosqualene cyclase.
AB  - Active site mapping of rat liver oxidosqualene cyclase (OSC), a 78 kDa membrane
      bound enzyme, was carried out using the mechanism-based irreversible inhibitor,
      [3H]29-methylidene-2,3-oxidosqualene. The amino acid sequence of the radiolabeled
      CNBr peptide fragment showed unexpectedly high similarity to the yeast OSC, plant
      OSC, and bacterial squalene cyclases. Further, radio analysis established that
      the two adjacent Asp residues in the highly conserved region (Asp-Asp-Thr-Ala-Glu
      Ala, or DDTAEA) were equally labeled by the irreversible inhibitor. This result
      provided the first information on the structural details of the active site of
      OSC, and showed for the first time the ancient lineage of this vertebrate enzyme
      to ancestral eukaryotic and prokaryotic cyclases. Interestingly, the covalently
      modified DDXX(D/E) sequence of rat liver OSC showed surprising similarity to the
      putative allylic diphosphate binding site sequence of other terpene cyclases and
      prenyl transferases. The Asp-rich motif may act as a point charge to stabilize
      incipient cationic charge.

PMID- 7791530
TI  - Biochemical and physiological effects of sterol alterations in yeast--a review.
AB  - Considerable progress has been made in the selection and characterization of
      mutants that are defective in the synthesis of ergosterol in the yeast,
      Saccharomyces cerevisiae. Mutations in nearly every step of the yeast sterol
      biosynthetic pathway have been induced and selected. These mutants have been used
      to elucidate the sequential order of steps in sterol synthesis, to study the mode
      of action of antifungal agents and to determine the method of resistance of some
      pathogenic fungi, and to answer questions on the role of sterols in general cell
      biology. Physiological examination of ergosterol null mutants, lacking all
      biochemical activity attributed to the particular gene, supports a role for
      ergosterol in a number of critical functions in the organism. Among the
      physiological functions attributed to ergosterol are sparking and bulking
      requirements, involvement in amino acid and pyrimidine transport, resistance to
      antifungal agents and certain cations, and a requirement for respiratory
      activity. Those genetic null alleles discussed in this review are erg24, lacking
      the ability to reduce the delta 14 double bond; erg6, unable to methylate C-24;
      and erg3, defective in the C-5 desaturase. The different biochemical activities
      that are disrupted in the ergosterol mutants support a role for ergosterol in a
      number of critical functions in yeast.

PMID- 7791532
TI  - 2,3-Oxidosqualene cyclase: from azasqualenes to new site-directed inhibitors.
AB  - 2,3-Oxidosqualene cyclases (OSC) are enzymes which convert 2,3-oxidosqualene (OS)
      into polycyclic triterpenoids such as lanosterol, cycloartenol, and alpha- and
      beta-amyrin. Our interest in the study of OSC is the development of new OSC
      inhibitors for potential use as hypocholesterolemic, antifungal, or phytotoxic
      drugs. In particular, we describe the biological activity and the mechanism of a
      series of acyclic azasqualene derivatives mimicking the C-2, C-8, and C-20
      carbonium ions formed during OS cyclization. Some of these carbonium ion
      analogues are very promising as specific hypocholesterolemic agents. The
      toxicity, the biodistribution, and the pharmacokinetics of different azasqualene
      derivatives in mice are also presented. In order to obtain new, site-directed
      irreversible inhibitors of OSC, a series of squalene derivatives containing
      functional groups that can link covalently to an active-site thiol group was
      designed. Among these compounds, squalene maleimide was the most active toward
      mammalian OSC, whereas squalene Ellman behaved as an irreversible inhibitor of
      OSC from yeast.

PMID- 7791534
TI  - Growth of Cucurbita maxima L. plants in the presence of the cycloartenol synthase
      inhibitor U18666A.
AB  - Squash, like other Cucurbitaceae, have unique sterol profiles that offer an
      excellent opportunity to examine the relationship between sterol biosynthesis and
      plant growth. To determine the effect of sterol biosynthesis inhibition on squash
      growth, Cucurbita maxima seedlings with and without cotyledons were subjected to
      increasing concentrations of the cycloarternol synthase (EC 5.4.99.8) inhibitor 3
      beta-(2-diethylaminoethoxy)androstenone (U18666A). Inhibition of shoot growth was
      concentration-dependent (from 0, 2, 5, 10, and 20 microM); plants with intact
      cotyledons grew to 26.4, 23.7, 21.6, 20.0, and 15.6 cm, respectively, at the
      above inhibitor concentrations, compared to 25.5, 19.4, 17.0, 12.0, and 11 cm for
      plants with severed cotyledons. In plants with severed cotyledons, 10 and 20
      microM U18666A caused rapid necrosis of the first two, newly emerged, primary
      leaves, and halted new leaf formation. Secondary root formation was initially
      affected at all inhibitor concentrations regardless of whether cotyledons were
      present or not. Vegetative tissue showed a decrease in the accumulation of the
      major squash sterol, 7,22-stigmastadienol, accompanied by increased accumulation
      of minor sterol components. Sterol profiles in cotyledons were unaltered. The
      data show that sterols are crucial for maintaining plant growth and viability,
      but do not address the cotyledonary effect on growth with respect to sterol
      biosynthesis.

PMID- 7791533
TI  - Side-chain oxysterol regulation of 3-hydroxy-3-methylglutaryl coenzyme A
      reductase activity.
AB  - Side-chain oxysterols are known to be potent inhibitors of 3-hydroxy-3
      methylglutaryl CoA reductase, a key regulatory enzyme in the biosynthesis of
      sterols. Structural variations in the side-chain oxysterols influence enzyme
      inhibition. Under certain conditions, biological systems have been induced to
      produce side-chain oxysterols, adding support to the hypothesis that oxysterols
      may be natural regulators of sterol biosynthesis in the intact cell. Specific
      inhibition of sterol biosynthesis is of interest as it may prove useful in the
      prevention or reversal of various cardiovascular disease states, as well as in
      the control of normal and abnormal cell growth.

PMID- 7791535
TI  - Biosynthesis and distribution of insect-molting hormones in plants--a review.
AB  - Insect-molting hormones, phytoecdysteroids, have been reported to occur in over
      100 plant families. Plants, unlike insects, are capable of the biosynthesis of
      ecdysteroids from mevalonic acid, and in several cases the biosynthesis of
      phytoecdysteroids was also demonstrated to proceed via sterols. Spinacia oleracea
      (spinach) biosynthesizes polypodine B and 20-hydroxyecdysone, which is the
      predominant insect-molting hormone found in plant species. The onset of
      ecdysteroid production in spinach requires the appropriate ontogenetic
      development within the plant, which is related to leaf development. In spinach,
      lathosterol is the biosynthetic precursor to ecdysone and 20-hydroxyecdysone.
      Phosphorylated ecdysteroid intermediates, particularly ecdysone-3-phosphate, are
      required during biosynthesis. Polyphosphorylated forms of ecdysteroids are
      putative regulatory components of the pathway. During spinach development, the 20
      hydroxyecdysone is transported from the sites of biosynthesis to the apical
      regions. An analysis of the physiological data available suggests that different
      species may synthesize ecdysteroids in various organs and distribute these
      ecdysteroids to other sites. Annual plants appear to concentrate ecdysteroids in
      the apical regions, including flowers and seeds. Perennial plants may recycle
      their ecdysteroids between their deciduous and their perennial organs over the
      growing season. Further investigations of ecdysteroid biosynthesis and physiology
      within plants will be required before an acceptable system can be designed to
      test phytoecdysteroid effectiveness in vivo against insect herbivory.

PMID- 7791536
TI  - Sterol metabolism in the tobacco hornworm, Manduca sexta--a review.
AB  - A number of intermediates involved in the dealkylation and conversion of the
      major C28 and C29 phytosterols to cholesterol in insects were first isolated and
      identified in studies with the tobacco hornworm, Manduca sexta, carried out in
      our laboratory. We also investigated the effects of a variety of known sterol
      metabolism inhibitors in Manduca, particularly those affecting the delta 24
      sterol reductase enzyme, and synthesized and tested a number of new inhibitors as
      well. In-depth studies of ecdysteroids in Manduca during embryogenesis and during
      pupal-adult development provided new information on molting hormone content,
      biosynthesis, and metabolism. In addition, this insect has been utilized in the
      study of three specific enzyme systems of ecdysteroid metabolism, namely 20
      monooxygenase, 3-epimerase, and phosphotransferase, which are critical to
      activation and deactivation of molting hormones in insects.

PMID- 7791537
TI  - Quantitation of steryl ferulate and p-coumarate esters from corn and rice.
AB  - The principal steryl ferulate and p-coumarate esters of different fractions from
      processed corn brans and corn oils, unrefined and refined, and from rice bran and
      rice bran oil were quantified by high-performance liquid chromatography. The
      results show that hexane-extracted corn oils yield more than five times the
      amount of esters compared to expeller processed oils. The yields of esters from
      bran and related products ranged from 0.07 to 0.54 mg/g of bran. Unrefined corn
      oils had levels from 0.18 to 8.6 mg/g for oil from hexane-extracted bran. By
      comparison, rice bran had ester levels of 3.4 mg/g of bran, and rice bran oil had
      levels of 15.7 mg/g of oil. The predominant esters from corn were sitostanyl and
      campestanyl ferulate, and sitostanyl and campestanyl p-coumarate. The principal
      esters from rice bran were cycloartenyl, 24-methylenecycloartanyl, and
      campesteryl ferulate. Rice bran oils had low levels of 24-methylenecycloartanyl
      but high levels of cyclobranol esters. The data presented provide a direct
      comparison of steryl ferulate and p-coumarate levels in the two cereals, and will
      aid in selecting the most suitable sources for the isolation of these compounds
      from corn products.

PMID- 7791538
TI  - Endotoxin inactivating action of plasma in patients with liver cirrhosis.
AB  - The endotoxin inactivating action of plasma was evaluated in 62 patients with
      cirrhosis and 10 healthy subjects. Endotoxin from E. coli 0111:B4 was added to
      each plasma sample to a final concentration of 250 pg/ml and the percentage loss
      of endotoxin activity by incubation (37 degrees C for 1 h) was calculated as the
      endotoxin inactivating rate. The plasma endotoxin inactivating rate in cirrhotics
      was significantly greater than that in healthy subjects, although patients with
      Child C cirrhosis and marked hyperbilirubinemia had a significantly lower
      endotoxin inactivating rate than other cirrhotics. The plasma endotoxin
      inactivating rate was positively correlated to serum HDL-cholesterol levels. In
      patients with Child A and Child B cirrhosis, the endotoxin inactivating rate was
      positively correlated to the endotoxin binding capacity of plasma albumin. The
      present results support the assumption that the plasma of cirrhotics has a high
      endotoxin inactivating capacity. Its decrease may augment endotoxicity in
      patients with advanced liver cirrhosis.

PMID- 7791539
TI  - Testing for hepatitis C virus sequences in peripheral blood mononuclear cells of
      patients with chronic hepatitis C in the absence of serum hepatitis C virus RNA.

PMID- 7791540
TI  - Dose-related opposite effects of hydrocortisone on hepatocyte proliferation in
      the rat.
AB  - To evaluate the role of glucocorticoids in the regulation of hepatocyte
      proliferation, high doses (6.25 mg/kg or more) and low doses (1.25 mg/kg or less)
      of hydrocortisone were injected into various categories of rats which had very
      different levels of proliferation. We used: (a) suckling rats whose stable
      unsynchronized proliferation can be stimulated and synchronized by acute
      inflammation or cyproterone feeding; (b) adult rats with a low level of
      proliferation, and (c) 2/3 hepatectomized rats during the first period of
      synchronized proliferation or during the second period of lower and
      unsynchronized proliferation. The kinetics of the labelling index and mitotic
      index were observed after hydrocortisone injection. High doses inhibited
      proliferation, as already found by many investigators. This effect was observed
      in suckling and hepatectomized rats and during acute inflammation in suckling or
      adult rats. Low doses had no inhibitory activities and, on the contrary,
      stimulated proliferation in some situations. The highest stimulations were
      observed during the early period after 2/3 hepatectomy or in combination with
      acute inflammation either in suckling rats or in 2/3 hepatectomized rats during
      the late period of regeneration. In all these situations hydrocortisone was a
      cofactor active during the early G1-phase. In contrast, in normal suckling rats a
      slight stimulation was observed due to an action at the G0-G1 transition. No such
      effect was found in adult rats. Our data show that doses of hydrocortisone in the
      therapeutic range or close to physiological values do not inhibit and, on the
      contrary, can stimulate hepatocyte proliferation.

PMID- 7791541
TI  - Prediction of prognosis of primary biliary cirrhosis in Japan.
AB  - The clinical profile of primary biliary cirrhosis in Japan was clarified on the
      basis of data on 1066 patients attending 212 hospitals and institutions in this
      country. Six hundred and twelve patients (57.4%) were asymptomatic. The majority
      of the patients were middle-aged women. Pruritus was the most frequent initial
      symptom of symptomatic primary biliary cirrhosis. Antimitochondrial antibodies
      were positive in 877 patients (82.5%). Sjogren's syndrome was the most common
      associated autoimmune disease. Liver biopsy was performed in 753 patients at the
      time of diagnosis, and histological staging by Scheuer's classification indicated
      that 307 (43.7%) patients were in stage I and 222 (31.6%) were in stage II. The
      most frequent causes of death were hepatic failure and/or gastrointestinal
      bleeding, which affected 166 (78.3%) of the 212 patients who died. Statistical
      analysis using Cox's regression method revealed that the patient's age and the
      serum bilirubin, albumin, and total cholesterol concentrations were significant
      predictors of the prognosis. A prognostic index was also calculated that could be
      used to predict the duration of survival for patients with primary biliary
      cirrhosis.

PMID- 7791542
TI  - Type VI collagen gene expression in experimental liver fibrosis: quantitation and
      spatial distribution of mRNAs, and immunodetection of the protein.
AB  - Type VI collagen is a minor but essential matrix component in the liver. In this
      study, we utilized an acute and a chronic injury model to clarify the process of
      liver fibrosis in rats by administration of carbon tetrachloride. Collagen gene
      expression, with particular emphasis on type VI collagen, was studied by
      molecular hybridization techniques. The alpha 2(VI) collagen mRNA levels were
      markedly elevated on day 3 of acute injury and were approximately at the same
      high level at 7 and 14 weeks of chronic injury, as determined by Northern
      hybridizations and slot-blot analyses. Marked enhancement of type I collagen gene
      expression was similarly noted at these time points. The activation of collagen
      gene expression in acute injury, as determined by in situ hybridization, was
      particularly prominent in the vicinity of the central veins. Indirect
      immunofluorescence demonstrated marked accumulation of type VI collagen protein
      as early as day 3 of acute injury, and the reaction appeared to be initiated in
      the proximity of central veins. These results indicate that type VI collagen gene
      expression, together with other connective tissue components, including type I
      collagen, is activated in the early stages of the fibrotic process. Type VI
      collagen accumulation may contribute to the distorted architecture and functional
      impairment of the liver in hepatic fibrosis.

PMID- 7791543
TI  - Cytochemical detection of a class 3 aldehyde dehydrogenase in human
      hepatocellular carcinoma.
AB  - The development of hepatocellular carcinoma in rodents treated with different
      chemical compounds is associated with the appearance in the cytosol of neoplastic
      liver cells of an unusual aldehyde dehydrogenase isozyme of class 3 (ALDH-3)
      which is very active with aromatic aldehydes. This tumor-associated isozyme is
      readily detected by enzyme cytochemistry using the substrate benzaldehyde with
      NADP as coenzyme. To determine whether human hepatocellular carcinomas express
      ALDH-3, the activity of this isozyme was examined in frozen sections from 68 echo
      guided human liver biopsies. In 54 cases the guided biopsy was performed on one
      or more nodules suggestive for hepatocellular carcinoma found at ultrasonography
      within the liver parenchyma. The remaining 14 patients were affected by chronic
      active hepatitis or cirrhosis. An intense enzymatic activity was ascertained in 5
      out of 36 hepatocellular carcinomas. In non-neoplastic liver, in
      macroregenerative nodules and in metastatic adenocarcinomas enzymatic activity
      was not detectable. ALDH-3-positive tumors were typical hepatocellular carcinomas
      (histological grade II and III). These results suggest that ALDH-3 is a phenotype
      associated with malignancy in human liver tumors.

PMID- 7791545
TI  - MRI segmentation: methods and applications.
AB  - The current literature on MRI segmentation methods is reviewed. Particular
      emphasis is placed on the relative merits of single image versus multispectral
      segmentation, and supervised versus unsupervised segmentation methods. Image pre
      processing and registration are discussed, as well as methods of validation. The
      application of MRI segmentation for tumor volume measurements during the course
      of therapy is presented here as an example, illustrating problems associated with
      inter- and intra-observer variations inherent to supervised methods.

PMID- 7791544
TI  - Liver disease and serum hexosaminidase levels. Studies in a human hepatoma cell
      line (Hep G2 cells).
AB  - In various forms of liver disease, increased levels of the lysosomal enzyme beta
      hexosaminidase (Hex) occur in serum. This may be caused by disturbances of the
      hepatocytic function, and we therefore studied the intracellular and
      extracellular isoenzyme pattern of Hex in a human hepatoma cell-line (Hep G2),
      using an immunoassay method, which separates Hex A and Hex B isoforms. This cell
      line synthesizes and secretes Hex. The cumulative release of extracellular
      activity was about 3-10% of the intracellular activity. B-isoforms comprised one
      third of intracellular activity but only 20% of extracellular activity. The
      proportion of extracellular B-isoforms increased with time, presumably due to
      instability of A-isoforms at 37 degrees C. Cycloheximide inhibited the release of
      Hex activity, whereas NH4Cl increased the extracellular fraction of Hex, even at
      a concentration of 1 mmol/l. We speculate that the increased concentration of
      NH4+ in patients with liver disease interferes with the distribution pathway of
      the lysosomal enzymes. This might be one reason for the increased serum Hex
      activity found in patients with liver disease.

PMID- 7791546
TI  - Blue blood or black blood: R1 effects in gradient-echo echo-planar functional
      neuroimaging.
AB  - Changes in the longitudinal relaxation rate (R1) may play a role in the MRI
      signal intensity increases that have been associated with physiological brain
      activation. We used gradient-echo echo-planar MRI (GRE-EPI) to test whether
      physiological activations associated with hypercapnia in dogs were dependent on
      the delay (TR) between successive images in a time-series. Our results show that,
      in addition to activation-induced changes in the R2 (transverse relaxation
      including inhomogeneity effects), activation-induced changes in R1 are
      significant under certain pulsing conditions. In our paradigm, the R1
      contribution became significant at TR values of 1 s or less.

PMID- 7791547
TI  - Spin-lattice relaxation and magnetization transfer in intracranial tumors in
      vivo: effects of Gd-DTPA on relaxation parameters.
AB  - Spin-lattice relaxation time T1 and relaxation parameters in magnetization
      transfer (MT) imaging were measured in 11 intracranial tumors before and after
      injection of Gd-DTPA at 0.1 T by using the inversion recovery method and the
      saturation transfer technique, respectively. Preinjection T1 relaxation times of
      the tumors were longer than those of white matter, but after Gd-enhancement the
      relaxation times of most tumors were in the same range as those of white matter.
      Gd-DTPA shortened the apparent relaxation time in the presence of off-resonance
      saturation pulse (T1a) due to marked shortening of the relaxation time of mobile
      water (T1w). Gd-DTPA decreased the magnetization transfer contrast (MTC) but did
      not influence on the magnetization transfer rate (Rwm). The parameters MTC and
      Rwm differed clearly between Gd-enhanced tumors and normal brain, whereas the
      relaxation time T1a was in many Gd-enhanced tumors in the same range as in normal
      brain.

PMID- 7791548
TI  - Value of Gd-DTPA-enhanced MR imaging of the labyrinth in patients with sudden
      hearing loss.
AB  - Recent reports describe labyrinthine enhancement on MRI as a highly specific sign
      of labyrinthine disease. This paper reports 44 patients with unilateral
      sensorineural hearing loss (SNHL) and laboratory evidence of cochlear damage
      investigated with Gd-enhanced MR imaging. Enhancement of the cochlea was observed
      in only one patient with a lesion at the fundus of the internal auditory canal
      (IAC) that extended into the cochlea after Gd-DTPA administration. In one more
      patient, MR imaging demonstrated large vestibular aqueducts as underlying cause
      for his hearing loss, but no enhancement of the labyrinth was observed. No
      abnormal signal intensity on precontrast MR scans nor pathologic enhancement of
      the membranous labyrinth were identified in the other 42 patients. Gd-enhanced MR
      imaging appears to be insensitive in demonstrating labyrinthine disease and
      normal examination findings in a patient with sudden SNHL cannot exclude damage
      at the cochlear level.

PMID- 7791549
TI  - Superparamagnetically labelled neutrophils as potential abscess-specific contrast
      agent for MRI.
AB  - In order to evaluate the potential of superparamagnetically labelled neutrophils
      as inflammation-specific contrast agents for magnetic resonance imaging (MRI),
      various types of magnetite particles were associated with isolated human
      neutrophils in vitro and subsequent effects on characteristic cellular functions
      investigated. Exposure to uncoated magnetite caused strong irreversible cell
      aggregation, whereas uptake of polystyrene-embedded magnetite microcrystals
      (Estapor M1-0.70/60) occurred with only minor changes in neutrophil adhesion
      properties, cellular metabolism, and chemotactic behaviour in vitro. As revealed
      by MR phantom imaging, Estapor-labelled neutrophils generated visible contrast
      above a threshold concentration of 1-2 micrograms Fe/g in a tissue-equivalent
      environment. Intravenous administration of labelled neutrophils to rabbits
      resulted in local magnetite accumulation up to 2.4 micrograms Fe/g tissue in
      artificial inflammation sites. Subsequent T2-weighted imaging of an intramuscular
      abscess clearly demonstrated the expected hypointense area surrounding the
      typically bright core of inflammation.

PMID- 7791551
TI  - High resolution MR imaging of joint degeneration in the knee of the STR/ORT
      mouse.
AB  - MR imaging of the knee joints of the mouse at 2.35 T produces an in-plane
      resolution of 35 x 70 microns and a slice thickness of 600 microns from the
      sagittal and coronal planes, in less than 60 min. In normal, live DBA mice, which
      have no known pathology, the images clearly resolve many joint structures, such
      as the cruciate ligaments, menisci, and articulating surfaces of the femur and
      tibia. Gross pathological changes were identified first in excised knees from
      cadaver mice of the STR/ORT strain. Males of this strain spontaneously exhibit
      rapid joint degeneration with increasing age compared to females, in which much
      milder symptoms develop more slowly. Thickening of the patellar tendon,
      displacement of the patella, deformity, and sclerosis were clearly
      distinguishable in males compared with females older than 7 mo of age. The same
      degenerative features were evident in MR images of the knees of the live male but
      not female STR/ORT mice of this age, indicating that it would be possible to
      monitor longitudinally by MR imaging progressive development of joint changes in
      this osteoarthritic model.

PMID- 7791550
TI  - Preparation, physico-chemical characterization, and relaxometry studies of
      various gadolinium(III)-DTPA-bis(amide) derivatives as potential magnetic
      resonance contrast agents.
AB  - Macroscopic protonation constants were measured for a series of DTPA mono- and
      bis-amide ligands using potentiometric titrations. Proton NMR pH titrations
      yielded protonation populations of the various nitrogen and oxygen basic sites of
      the ligands for the different protonation stages. Amide formation decreased the
      basicity of the backbone nitrogens of the ligands and the thermodynamic stability
      of the corresponding Gd3+ chelates. Nuclear magnetic relaxation dispersion (NMRD)
      profiles and ESR linewidths were measured for the Gd3+ chelates. Some of these
      exhibited an elevated high field relaxivity relative to Gd(DTPA)2-, in response
      to their high molecular weight. As opposed to Gd(DTPA)2-, at 5 degrees C the
      chemical exchange process of the single inner-sphere water molecule of the bis
      amide complexes becomes so slow that it governs the paramagnetic relaxation
      process, causing the observed NMRD profiles to be close to those expected for the
      outer-sphere contribution. The chelates containing long alkyl side chains, such
      as Gd(DTPA-HPA2), showed increased relaxivity values in the presence of human
      serum albumin (HSA), indicative of noncovalent interaction with the protein.
      These chelates could be useful as nonionic hepatobiliary contrast agents.

PMID- 7791552
TI  - Temperature- and pH-dependence of proton relaxation rates in rat liver tissue.
AB  - In this study proton NMR relaxation rates R1 and R2 and pH of untreated fresh rat
      liver tissue as well as changes up to 4 h after tissue excision was investigated.
      Measurements were performed in the temperature range from 7 to 45 degrees C.
      Dynamic changes in all parameters were observed at higher temperatures (> or = 30
      degrees C). A qualitatively different time course after tissue excision of all
      three parameters was obtained for 45 degrees C. The relative alterations like the
      change of relaxation rates referred to a reference value can predict tissue
      viability. A good correlation between R2 and pH in the range of 7-37 degrees C
      was detected and is described by an improved analytical model for R2 as a
      function of temperature and pH. The observed data lead to an empirical model
      given by R2 (pH,T) = 39.8 + (10.2 * delta pH) + (0.1 * delta T) + (0.2 * delta pH
      delta T), where the reference pH value was chosen 7.4 and the reference
      temperature value 37 degrees C (310.15 K), respectively.

PMID- 7791553
TI  - Magic-echo phase-encoding solid imaging with improved time resolution.
AB  - The magic-echo phase-encoding solid imaging (MEPSI) sequence is based on the
      magic-echo pulse sequence for the refocusing of the dipolar interaction and on
      pure phase-encoding for spatial resolution in all dimensions. MEPSI has many
      advantages; however, as a consequence of pure phase-encoding, it is very time
      consuming. In the following, two strategies are proposed to decrease the time
      necessary for the acquisition of an image by a factor of 2 per dimension.

PMID- 7791554
TI  - Quantitative NMR microscopy on intact plants.
AB  - Quantitative high resolution images on intact young maize plants were acquired by
      using magnetization-prepared NMR microscopy. Although the spatial resolution is
      low compared with that of light microscopy, the calculated spin density and T1
      maps exhibit contrasts that are in excellent agreement with photomicrographic
      images. The T2 map gives image contrasts that are not visible in a usual light
      microscopic image. The diffusion images show an anisotropic behavior of the water
      self-diffusion coefficient in the vascular bundles, which can be understood by
      the cell morphology in this plant section. This work demonstrates that
      quantitative imaging on intact plant systems is possible and that long total
      acquisition times are no obstacle. Furthermore, the different single parameter
      maps give a better insight into the morphology of plants under in vivo
      conditions.

PMID- 7791555
TI  - Reduced N-acetylaspartate content in the frontal part of the brain in patients
      with probable Alzheimer's disease.
AB  - The fully relaxed water signal was used as an internal standard in a STEAM
      experiment to calculate the concentrations of the metabolites: N-acetylaspartate
      (NAA), creatine + phosphocreatine [Cr + PCr], and choline-containing metabolites
      (Cho) in the frontal part of the brain in 12 patients with probable Alzheimer's
      disease. Eight age-matched healthy volunteers served as controls. Furthermore, T1
      and T2 relaxation times of the metabolites and signal ratios: NAA/Cho, NAA/[Cr +
      PCr], and [Cr + PCr]/Cho at four different echo times (TE) and two different
      repetition times (TR) were calculated. The experiments were carried out using a
      Siemens Helicon SP 63/84 wholebody MR-scanner at 1.5 T. The concentration of NAA
      was significantly lower in the patients with probable Alzheimer's disease than in
      the healthy volunteers. No significant difference was found for any other
      metabolite concentration. For the signal ratios the only statistically
      significant difference was that the NAA/Cho ratio at TE = 92 ms and TR = 1.6 s
      was lower in the patients with probable Alzheimer's disease compared with the
      control group. A trend towards a longer T2 relaxation time for NAA in the
      patients with probable Alzheimer's disease than among the healthy volunteers was
      found, but no significant difference was found concerning the T1 and T2
      relaxation times.

PMID- 7791556
TI  - A method for in vivo assessment of reversible rat pancreatic ischemia using 31P
      NMR spectroscopy at 2.0 tesla.
AB  - A surgical method is described which allows in vivo assessment of reversible rat
      pancreatic ischemia using 31P NMR spectroscopy at 2.0 T. Phosphorous-31 NMR
      spectra acquired during the ischemic period show the expected increase in
      inorganic phosphate with a concomitant decrease in ATP levels and pH as compared
      to controls. Upon reperfusion, inorganic phosphate and ATP returned to control
      levels while pH recovered to a more alkaline value. This method provides a means
      of studying in vivo changes in high energy metabolite associated with acute
      pancreatitis (AP) and maintains the secretory ability of the gland so that
      different forms of AP, such as those arising from pancreatic juice edema, can be
      studied.

PMID- 7791557
TI  - A method to distinguish between chemical shift and susceptibility effects in NMR
      microscopy and its application to insect larvae.
AB  - We propose a simple method of distinguishing Zeeman broadening arising from
      susceptibility inhomogeneity and chemical shift variation, applicable to NMR
      microscopy. The method is based on the use of a specially built probe-head in
      which orthogonal sample alignment is possible using the same radiofrequency (RF)
      coil. This allows the investigation of alignment effects in image distortion and
      relies on the fact that the isotropic chemical shift is invariant under
      reorientation, whereas the susceptibility-related local field will depend
      strongly on relative orientation of bounding surfaces with the external
      polarizing field. We apply this approach to the study of a simple phantom, and an
      insect larva (Spodoptera litura Fabricius), demonstrating in the latter case that
      susceptibility variations are sufficiently small to allow chemical shift imaging
      on a scale greater than 1 ppm.

PMID- 7791558
TI  - Value of RARE-MRI sequences in the diagnosis of lymphangiomatosis in children.
AB  - Three patients suffering from extensive cavernous lymphangiomatosis are presented
      here. They were examined by MRI using RARE-MR hydrography (rapid acquisition with
      relaxation enhancement) as well as conventional spin-echo sequences. RARE
      sequences, which depict each fluid-filled lymphatic space, can be used for
      screening. RARE-sequences help to shorten investigation time, particularly in
      cases involving the skeleton. The imaging strategy can be changed according to
      the results of this sequence. It may be performed prior to spin-echo sequences
      and facilitates follow-up investigations. RARE sequences distinguish between
      lymphangiomatosis and hemangiomatosis, or a combination of the two.

PMID- 7791559
TI  - Proton MRS similarity between central nervous system non-Hodgkin lymphoma and
      intracranial tuberculoma.
AB  - Proton magnetic resonance spectroscopy (MRS) was carried out on a patient with
      histologically proven non-Hodgkin lymphoma (NHL) of the central nervous system
      (CNS). The observation of the presence of a huge resonance in the region between
      0.5-1.5 ppm and the absence of any other signals is not in agreement with those
      published for NHL in the literature but has a striking similarity to that
      reported for an intracranial tuberculoma.

PMID- 7791560
TI  - 31P (MRS) changes as a measure of therapy response in human osteosarcomas
      implanted into nude mice.

PMID- 7791562
TI  - [Skin impedance and analogue bridge devices for its measurement].
AB  - Principal opportunities of the impedance method in relation to studies of the
      skin electrical properties are shown. Two devices varying in functional
      capacities are proposed which are inferior to the known models in simplicity and
      range of functions. These devices are based on bridge schemes and transform
      parameters of electrical resistance of the skin into the analogue signals.

PMID- 7791564
TI  - [Automated administration system of the Samara Diagnostic Center].

PMID- 7791561
TI  - [Instruments for the development of dialogue interfaces in medical computer
      systems].

PMID- 7791565
TI  - [Structural organization of medical information as illustrated by diagnosis in
      child neurology].
AB  - Structuration of medical information is performed on three levels: structuration
      of the specialist's knowledge with resultant singling out key questions--blocks
      required for diagnosis in the given field; structuration of signs within the
      space of the blocks; identification of diagnostic syndromes basing on their signs
      analysis adjusted to resolving diagnostic tasks. The results of the method
      application in neuropathology are outlined.

PMID- 7791563
TI  - [New high-strength corrosion-resistant steel for medical instruments].
AB  - New high-strength corrosion-resistant steel based on ageing martensite,
      metastable and stable austenite intended for the production of medical
      instruments for different purposes are considered. There are data on changing
      mechanical properties of corrosion-resistant steel and their dependence on
      thermoplastic treatment condition.

PMID- 7791566
TI  - [Current methods and equipment in densitometry of the bone tissue].
AB  - In the past 15 years there has been an intensive development of methods and
      equipment for non-invasive quantitative determination of the mineral status of
      the human skeleton in the USA and some Western European countries. The
      specialized osseous densitometers which are based on photon absorptiometry and
      which use various radionuclides or an X-ray tube as a source of radiation have
      extensively spread.

PMID- 7791571
TI  - [Three models of eyeglass test frames].
AB  - The paper presents a technical, medical and economic rationales for the
      expediency of simultaneous manufacture of three models of present-day test
      spectacle frames, such as general-purpose, semiframe, and simplified semiframe
      ones, which will provide their rational, methodological and the most efficient
      use in choosing corrective spectacles in relation to the complexity of chosen
      vision correction.

PMID- 7791567
TI  - [Development of dental radiography equipment].

PMID- 7791568
TI  - [Problems of updating x-ray diagnosis departments].

PMID- 7791570
TI  - [Present-day systems of programmed bases of electrophysiological studies].

PMID- 7791572
TI  - [Image analysis of ECG rhythm].
AB  - The paper deals with ECG rhythmic structure presentation oriented on image
      thinking of the specialist making diagnostic decisions in interactive interaction
      with computer. Rhythmogram complex for personal computer is designed.

PMID- 7791569
TI  - [ELEMAGS apparatus and clinical experience in its use in the treatment of
      children with hypoacusis and otalgia].
AB  - To enhance effectiveness of magnetotherapy in the treatment of otic diseases the
      authors propose to use impulse low-frequency electromagnetic field in combination
      with constant magnetic field. ELEMAGS equipment based on the above principles is
      introduced to treat cochlear neuritis and neurosensory hypoacusis in children.

PMID- 7791573
TI  - American College of Sports Medicine position stand. Osteoporosis and exercise.
AB  - Osteoporosis is a disease characterized by low bone mass and microarchitectural
      deterioration of bone tissue leading to enhanced bone fragility and a consequent
      increase in fracture risk. Both men and women are at risk for osteoporotic
      fractures. However, as osteoporosis is more common in females and more exercise
      related research has been directed at reducing the risk of osteoporotic fractures
      in women, this Position Stand applies specifically to women. Factors that
      influence fracture risk include skeletal fragility, frequency and severity of
      falls, and tissue mass surrounding the skeleton. Prevention of osteoporotic
      fractures, therefore, is focused on the preservation or enhancement of the
      material and structural properties of bone, the prevention of falls, and the
      overall improvement of lean tissue mass. The load-bearing capacity of bone
      reflects both its material properties, such as density and modulus, and the
      spatial distribution of bone tissue. These features of bone strength are all
      developed and maintained in part by forces applied to bone during daily
      activities and exercise. Functional loading through physical activity exerts a
      positive influence on bone mass in humans. The extent of this influence and the
      types of programs that induce the most effective osteogenic stimulus are still
      uncertain. While it is well-established that a marked decrease in physical
      activity, as in bedrest for example, results in a profound decline in bone mass,
      improvements in bone mass resulting from increased physical activity are less
      conclusive. Results vary according to age, hormonal status, nutrition, and
      exercise prescription. An apparent positive effect of activity on bone is more
      marked in cross-sectional studies than in prospective studies. Whether this is an
      example of selection bias or differences in the intensity and duration of the
      training programs is uncertain at this time. It has long been recognized that
      changes in bone mass occur more rapidly with unloading than with increased
      loading. Habitual inactivity results in a downward spiral in all physiologic
      functions. As women age, the loss of strength, flexibility, and cardiovascular
      fitness leads to a further decrease in activity. Eventually older individuals may
      find it impossible to continue the types of activities that provide an adequate
      load-bearing stimulus to maintain bone mass. Fortunately, it appears that
      strength and overall fitness can be improved at any age through a carefullly
      planned exercise program. Unless the ability of the underlying physiologic
      systems essential for load-bearing activity are restored, it may be difficult for
      many older women to maintain a level of activity essential for protecting the
      skeleton from further bone loss. (ABSTRACT TRUNCATED)

PMID- 7791575
TI  - Osteomyelitis of the pubic symphysis in athletes: a case report and literature
      review.
AB  - Groin pain is a common problem in athletes. Osteitis pubis, a chronic
      inflammatory condition involving the pubic symphysis, is a rare cause, and
      pyogenic osteomyelitis of the pubis is seen even more rarely in healthy athletes.
      We report one of four cases of pyogenic osteomyelitis of the pubis seen at our
      institution, review our experience with all four cases, and present a review of
      the literature (7 cases). The diagnosis is established by the presence of extreme
      pain, point tenderness at the pubic symphysis, fever, and either a positive
      culture of blood, needle aspiration, or open biopsy of the pubis. White blood
      cell count, erythrocyte sedimentation rate, and the results of bone scan and
      computerized tomography may initially be normal and therefore cannot exclude the
      diagnosis. Prompt treatment with intravenous (i.v.) antibiotics effective against
      Staphylococcus aureus (causative organism in all documented cases-9/11) should
      initially be administered and then guided by culture and sensitivity information.
      Oral antibiotics should be given if the infection is responsive to i.v.
      antibiotic treatment. Prompt recognition and treatment with antibiotics may
      obviate the need for surgical debridement. All athletes who returned to sports
      activity did so by 6 months after diagnosis.

PMID- 7791574
TI  - Effect of a newly designed patellar realignment brace on patellofemoral
      relationships.
AB  - The effect of applying a newly developed patellar realignment brace to a patient
      with lateral subluxation of the patella was evaluated using active movement,
      loaded kinematic magnetic resonance (MR) imaging. The brace corrected the lateral
      displacement of the patella as shown on the kinematic MR imaging study. The
      patient underwent physical rehabilitation in conjunction with the use of the
      patellar realignment brace and has had resolution of her painful symptoms for the
      past 4 months.

PMID- 7791576
TI  - Lipoprotein profile changes during intense training of Israeli military recruits.
AB  - The effect of prolonged strenuous military training on serum lipoproteins was
      studied in 73 new recruits. Dietary intake, body weight, and average energy
      expenditure were recorded, and blood samples collected at three time periods
      before training began (time 0), and after 6 and 12 wk of intense physical
      activity (times I and II, respectively). There was a significant increase in high
      density lipoprotein (HDL) cholesterol and a decrease in low density lipoprotein
      (LDL) cholesterol accompanying an increase of duration and intensity of exercise.
      HDL increased from 40.5 +/- 7.7 mg.dl-1 at time 0 to 44.5 +/- 9.4 mg.dl-1 at time
      I and to 52.8 +/- 8.7 mg.dl-1 at time II, and each mean P-value for increases in
      HDL from time 0-I, I-II, and 0-II were P < 0.0001). For LDL cholesterol, the mean
      decreases were -1.1, -6.1, and -7.3 mg.dl-1, respectively (P = 0.003 from I-II,
      and 0.01 from 0-II). These changes did not correlate with weight loss, reduced
      energy, or fat intake. We conclude that intense physical activity is associated
      with beneficial changes in the lipoprotein profile in new military recruits
      during a training period extending over 12 wk.

PMID- 7791578
TI  - Lipoprotein(a) [Lp(a)] levels in middle-aged male runners and sedentary controls.
AB  - Serum Lipoprotein(a) [Lp(a)] concentration was compared between middle-aged well
      trained Caucasian male endurance runners (N = 57), (mean age +/- SEM 47.8 +/- 0.7
      yr) and age-, body mass-, and body mass index (BMI)-matched male nonathletic
      control subjects (N = 62), (mean age +/- SEM 48.7 +/- 0.8). The mean weekly
      training distance of the runners was (60.7 +/- 2.8 km.wk-1) at the time of
      testing. Median Lp(a) levels were not significantly different (P > 0.05) between
      the runners (15.0 mg.dl-1) and the control subjects (12.5 mg.dl-1). As expected,
      compared with control subjects, in runners levels of other lipoproteins and
      apoproteins were significantly more favorable for cardiovascular health (all P <
      0.01). There was no significant relationship between Lp(a) and any other measured
      variable (lipid, anthropometric, or dietary) in the runners group. In the control
      group, the significant positive correlation between Lp(a) and LDL-C was no longer
      significant after correction for the estimated contribution of Lp(a) cholesterol
      to LDL-C. These cross-sectional data suggest that a lifestyle of moderate to
      intense exercise training does not exert a significant impact on the Lp(a) level.

PMID- 7791577
TI  - A physical conditioning program does not alter fibrinogen concentration in young
      healthy subjects.
AB  - Twenty five subjects were divided into experimental (N = 13, 7 male and 6 female,
      age 32.1 +/- 6.4 yr) and control groups (N = 12, 6 male and 6 female, age 33.4 +/
      5.4 yr) in order to examine the effect of a conditioning program on fibrinogen
      concentration. Before and after conditioning, VO2max was determined in all
      subjects. The experimental group (E) exercised for 30 min, 3 d.wk-1 for 12 wk at
      70% (initial 6 wk) and 80% (latter 6 wk) of maximum heart rate. The control group
      (C) maintained normal activity pattern. After conditioning, subjects in E, but
      not in C, increased (P < 0.001) their VO2max. Resting fibrinogen concentrations
      (RFC) before conditioning were similar between the two groups, and demonstrated
      no change in the C group (242.9 +/- 40.3 mg.dl-1 vs 247.4 +/- 38.7 mg.dl-1, P >
      0.05) after conditioning. Although RFC showed a 6% decrease in the E group post
      conditioning (249.1 +/- 21.5 mg.dl-1 vs 236.4 +/- 34.6 mg.dl-1), this decrease
      was not significant (P > 0.05). A significant increase (P < 0.05) in fibrinogen
      concentrations were observed after maximal exercise in both groups pre and post
      conditioning; however, this increase disappeared (P > 0.05) when data were
      corrected for hemoconcentration. These results suggest that after conditioning
      the 6% decrease in RFC was not statistically significant, but the possibility of
      Type II error is high.

PMID- 7791579
TI  - Guidelines, standards, and perspectives in exercise immunology.
AB  - Exercise immunology is a rapidly developing subdiscipline of sports science.
      Although many interesting findings have been published, some conflicting data
      have appeared. This is not surprising given the complexity of the immune system
      and its bidirectional interactions with other physiological systems. Immune
      measurements can also be influenced by age, gender, lifestyle, and biological
      rhythms while technical factors include leukocyte purification procedures,
      reagents, equipment, and assay conditions. Exercise-induced changes in the blood
      percentages of certain cell types may explain altered functional responses that
      may not change at the single cell level. Some guidelines should be established to
      limit the influence of these extraneous factors. Investigators should agree on
      fundamental methodology if work from different laboratories is to be compared and
      replicated. Given the rapid pace of new developments in fundamental immunology
      and related fields, some views on interpreting data in a wider physiological
      context and future research directions are discussed. Finally, some
      recommendations regarding subject selection, accounting for biological rhythms,
      standardizing fundamental methodology, sampling at multiple timepoints, and data
      analysis are put forward for discussion. Although uniform consensus would be
      impossible to obtain, hopefully this commentary will stimulate debate and lead to
      the formulation of some guidelines and standards for conducting studies in
      exercise immunology.

PMID- 7791580
TI  - Training suppresses hepatic lactate dehydrogenase activity without altering the
      isoenzyme profile.
AB  - A decrease in hepatic lactate dehydrogenase (LDH) activity following endurance
      training has been a consistent observation. In the present study, we sought to
      determine whether the training-induced decrease in hepatic LDH activity (pyruvate
      = substrate) was associated with a shift in the isoenzyme profile and/or
      alteration in other kinetic parameters. Animals (rats) were randomly assigned to
      either an endurance trained group (running 90 min at 30 m.min-1, 10% grade) or
      sedentary control group. Eight weeks of endurance training resulted in a
      significant decrease in maximal hepatic LDH activity for the forward reaction
      (pyruvate-->lactate), 107.3 +/- 5.5 mumol.min-1.g-1, when compared with control
      animals, 147.3 +/- 5.6 mumol.min-1.g-1. A similar decrease was observed for
      maximal LDH activity in the reverse reaction (lactate-->pyruvate), 49.8 +/- 2.1
      vs 66.7 +/- 2.9 mumol.min-1.g-1, trained and controls, respectively. Training was
      also observed to decrease the Km for the reverse reaction, 5.18 +/- 0.78 mM vs
      6.94 +/- 0.55 mM, for trained and controls, respectively. Km for the forward
      reaction was unaffected by training. Gel electrophoresis with densitometric
      evaluation revealed no shift in the isoenzyme pattern following endurance
      training. LDH5 accounted for 89% +/- 2%, whereas 6% +/- 0.5% was observed in
      LDH4, and 4% +/- 0.3% was observed in LDH3 for both groups. The densitometric
      area was approximately 34% lower from trained liver homogenates, a fractional
      decrease similar to that observed for maximal LDH activity. The decrease in
      hepatic LDH activity with endurance training appears attributable to a down
      regulation of enzyme content, with no significant alteration in isoenzyme
      distribution.

PMID- 7791582
TI  - Effects of running on the torsional strength, morphometry, and bone mass of the
      rat skeleton.
AB  - Intensity and duration effects of weight-bearing exercise on the rat skeleton
      were investigated. Eighty-four 3-month-old female Sprague-Dawley rats were
      assigned to control and nine exercise groups. Exercised rats were run on a
      treadmill for either 30, 60, or 90 min.d-1 at low (Vo2max approximately 55%),
      medium (VO2max approximately 65%), or high (VO2max approximately 75%) intensity 4
      d.wk-1 for 10 wk. Rat femurs, tibias, and vertebrae were harvested for torsional
      mechanical tests, bone density assessment, and morphometry. Our results indicate
      exercise has a significant effect (P < 0.05) on the femoral mechanical response
      (energy absorbed and twist angle), tibial morphometry (cortical bone area and
      thickness), and tibial and vertebral bone density measurements but had no effect
      (P > 0.05) on bone strength when compared with control values. Higher intensity
      exercise decreased tibial and femoral torque (P < 0.05). Long duration exercise
      increased tibial and femoral stiffness and decreased twist angle and energy
      absorbed (P < 0.05). These results indicate bone adapts to its loading
      environment by increasing bone mineral density, increasing cortical bone area,
      increasing stiffness, decreasing energy absorbed, and decreasing twist angle.
      High-intensity exercise decreased the maximum force the bone could withstand,
      whereas long duration exercise made the bone more brittle.

PMID- 7791581
TI  - Skeletal muscle oxygenation during constant work rate exercise.
AB  - We compared the slow rise in VO2 during heavy exercise (i.e., greater than lactic
      acidosis threshold (LAT)) with changes in muscle oxyhemoglobin+oxymyoglobin
      (O2Hb/O2Mb) saturation by reflectance near infrared spectroscopy. Ten subjects
      performed four 6-min cycle ergometer tests with two constant work rates less than
      and two greater than the LAT, equivalent to 20, 40, 65 and 75% peak VO2. During
      less than LAT exercise, O2Hb/O2Mb saturation decreased to a minimum by 2 min and
      then remained constant or rose slightly. For greater than LAT work rates, the
      initial fall in O2Hb/O2Mb saturation was greater the higher the work rate and
      continued to decrease with time after 3 min. Between minutes 3 and 6, the rate of
      decrease in O2Hb/O2Mb saturation correlated with the increase in VO2 (r = -0.69,
      P < 0.0001). These studies support the hypothesis that the slow rise in VO2
      during heavy constant work rate exercise is associated with a progressive decline
      in O2Hb/O2Mb saturation in the contracting muscles themselves that may be
      facilitated by capillary oxyhemoglobin dissociation owing to tissue lactic
      acidosis (Bohr effect).

PMID- 7791583
TI  - Arm crank exercise with static leg FNS in persons with spinal cord injury.
AB  - Persons with spinal cord injury experience considerable difficulty, during
      aerobic exercise, in achieving even moderate levels of oxygen uptake. Therefore,
      the effect of static functional neuromuscular stimulation (FNS) on this parameter
      during arm crank exercise (ACE) was investigated. Eight subjects with spinal cord
      injury, lesion levels range C6-T12, performed ACE at 60% and 80% of VO2peak, both
      with and without concurrent FNS of the lower limbs. ACE was performed with no
      FNS, with FNS at 40 milliamperes (mA), and with FNS at 80 mA. Significant
      differences in oxygen uptake were found between ACE without FNS and ACE with FNS
      80 mA at 60% VO2peak (10% increase, 12.5 ml.kg-1.min-1 to 13.7 ml.kg-1.min-1, P <
      0.05), and between ACE without FNS and ACE with FNS-80 mA at 80% VO2peak (16%,
      increase, 14.8 ml.kg-1.min-1 to 17.2 ml.kg-1.min-1, P < 0.01). A 10% difference
      between ACE without FNS and ACE with FNS-40 mA, did not reach significance. These
      data indicate that, in this population of subjects with spinal cord injury, (a)
      FNS can increase submaximal ACE oxygen uptake, and (b) that such increases are
      enhanced both at higher levels of FNS and of work load. Implications for wellness
      are discussed.

PMID- 7791584
TI  - Effects of an intensive 12-wk training program by elite swimmers on neutrophil
      oxidative activity.
AB  - The effects of an intensive 12-wk training program by 12 national-level swimmers
      on neutrophil oxidative activity were studied. Eleven sedentary (untrained)
      subjects (6 males and 5 females) served as environmental controls. Blood samples
      (10 ml) were taken at rest from an antecubital vein and neutrophils isolated by
      standard separation techniques. The oxidative burst activity of isolated
      neutrophils was assessed with an in vitro flow cytometric assay that used the
      fluorescent probe dihydrorhodamine 123. Two-way ANOVA (repeated measures) showed
      that oxidative activity was lower (P < 0.05) in the elite swimmers compared with
      the sedentary control group across the 12-wk period. Analysis of cells from
      swimmers in training was made: repeated measures ANOVA provided evidence of a
      significant decline (P < 0.05) in the number of cells responding positively ito
      in vitro challenge. Despite this decline, there was no significant difference in
      self-reported upper respiratory tract infection rate between the swimmers and
      sedentary individuals. These data show that: (i) elite swimmers undertaking
      intensive training have a significantly lower neutrophil oxidative activity at
      rest than do age- and sex-matched sedentary individuals; (ii) aspects of
      oxidative activity in swimmers are further suppressed during periods of strenuous
      training, and (iii) the extent of the suppression does not appear to be of
      clinical significance.

PMID- 7791585
TI  - Bone mineral density and dietary intake of female college gymnasts.
AB  - The purposes of this study were to determine bone mineral density (BMD) of female
      college gymnasts (N = 26) and age- (+/- 1.0 yr), height- (+/- 5.1 cm), and weight
      (+/- 2.3 kg) matched controls (N = 26) using dual energy x-ray absorptiometry
      and to examine the relationship of physical activity, diet, menstrual history,
      and BMD in these athletes. Energy expenditure, dietary intake and menstruation
      were assessed using standardized questionnaires. The BMD of the gymnasts were
      significantly (all P < 0.0001) higher than controls for the lumbar spine (L1-4),
      total proximal femur, femoral neck, Ward's triangle, and whole body. Mean calcium
      and kcal intakes for both groups were lower than the Recommended Dietary
      Allowances, and gymnasts had significantly lower kcal intakes than controls (P <
      0.05). More gymnasts than controls (59% vs 24%) reported that their menstrual
      cycle had been interrupted at some point since menarche (P < 0.02). The major
      finding of this investigation is that the BMD of gymnasts were higher than
      matched controls despite the fact that gymnasts as a group had inadequate dietary
      calcium and a higher propensity to have an interruption of their menstrual cycle.

PMID- 7791586
TI  - Eating disorder symptoms in female college gymnasts.
AB  - In study 1, 21 females provided both honest and dishonest answers to the Eating
      Disorders Inventory-2 (EDI-2). It was found that the EDI-2 can be easily faked.
      The fake profile was used to screen subjects in a second study, in which 25
      gymnasts and 25 matched controls were assessed on symptoms of eating disorders,
      energy intake, menstrual history, and bone mineral density (BMD). A Hotelling's
      T2 test (Wilks' lambda = 0.70) revealed that the gymnast and control groups did
      not differ significantly (P > 0.05) on the EDI-2 subscales; however, both groups
      exhibited scores on the Drive For Thinness (DFT) subscale of the EDI-2 that were
      higher than the published average for college women. More gymnasts (61%) than
      controls (24%) reported an absence of their menstrual cycle of 3 months or more.
      A higher percentage (8/11, 73%; chi 2 = 4.7, P < 0.05) of the subgroup with
      elevated DFT scores (i.e., > 14) reported having this disruption of their
      menstrual cycle compared with those with lower DFT scores (13/33, 39%). DFT
      scores were negatively (P < 0.05) related to energy intake (r = -0.48) and whole
      body BMD (r = -0.47). It is concluded that (a) DFT scores may be useful in
      identifying gymnasts at risk for problems associated with eating disorders, and
      (b) response distortion must be considered in future research using the EDI-2.

PMID- 7791587
TI  - Effects of stimulation intensity on the physiological responses of human motor
      units.
AB  - Quadriceps femoris muscles were studied in 50 healthy subjects to determine the
      physiological responses of the motor units recruited at different force levels
      during transcutaneous electrical stimulation. During one set of experiments force
      frequency relationships were compared at stimulation intensities that produced
      tetanic contraction of 20%, 50%, or 80% of the maximum voluntary isometric
      contraction (MVC). No differences in the normalized force-frequency relationship
      were observed between the 20% and 50% of MVC conditions and only a slight shift
      to the left was observed at 80% of MVC. The other set of experiments measured the
      responses to electrically elicited fatigue tests using frequencies of 20, 40, or
      60 pps and, at each frequency, intensities that produced 20% or 50% of MVC.
      Fatigue was greater for the 50% than 20% MVC force conditions. Within each force
      level fatigue increased with increasing frequency. However, though the
      differences in the level of recruitment needed to produce the two forces varied
      for each frequency, the differences in the amount of fatigue produced at each
      force did not vary between the three stimulation frequencies. This suggests that
      the fatigue characteristics of the recruited motor units were similar at all
      intensities tested. We posit, therefore, that the physiological recruitment order
      during transcutaneous electrical stimulation is less orderly than previously
      suggested.

PMID- 7791588
TI  - Maximal voluntary quadriceps strength patterns in Olympic overtrained athletes.
AB  - Peak torques were studied in 10 elite male overtrained athletes and 10 controls
      matched for sex, age, sport, and performance level. Isokinetic concentric (CON)
      and eccentric (ECC) maximal voluntary contractions (MVC) of quadriceps muscle
      were assessed at the angular velocities of 60 degrees, 120 degrees, and 180
      degrees.s-1. Sustained isometric MVCs were also measured at knee angles of 10
      degrees, 45 degrees, and 80 degrees of flexion. Six seconds after the beginning
      of each isometric MVC, a 40-Hz electrical stimulation was superimposed on the MVC
      for a further 6 s. The overtrained subjects developed significantly smaller CON
      peak torques at 180 degrees.s-1 (P < 0.001), although ECC torques were similar at
      all three velocities. ECC/CON ratios were higher in the overtrained subjects at
      120 degrees.s-1 (P < 0.01) and 180 degrees.s-1 (P < 0.001) compared with the
      controls. Isometric MVCs at 10 degrees and 45 degrees knee flexion were lower in
      the overtrained at P < 0.01 and P < 0.05, respectively. Also in the overtrained
      subjects, at knee angle of 10 degrees, the addition of the electrical stimulation
      to the isometric MVC produced an increase (P < 0.05) in torque levels. It is
      suggested that impaired central drive may account for the present findings.

PMID- 7791589
TI  - Effects of oxygen fraction in inspired air on rowing performance.
AB  - The present study examined the effect of oxygen fraction in inspired air (FIO2)
      on exercise performance and maximum oxygen consumption (VO2max). Six national
      level male rowers exercised three 2500-m all-out tests on a Concept II rowing
      ergometer. Each subject performed one test in normoxia (FIO2 20.9%), one in
      simulated hyperoxia (FIO2 62.2%) and one in simulated hypoxia (FIO2 15.8%) in a
      randomized single-blind fashion. The mean final rowing time was 2.3 +/- 0.9% (P <
      0.01; 95% CI 1.4-3.2) shorter in hyperoxia and 5.3 +/- 1.8% (P < 0.01; 95% CI 3.1
      7.5) longer in hypoxia when compared with normoxia. The effect of FIO2 on VO2max
      exceeded its effect on exercise performance as VO2max was 11.1 +/- 5.7% greater
      (P < 0.01; 95% CI 5.1-17.1) in hyperoxia and 15.5 +/- 3.2% smaller in hypoxia (P
      < 0.01; 95% CI 12.2-19.0) than in normoxia. Blood lactate concentration and O2
      consumption per power unit (ml O2.W-1) failed to indicate statistically
      significant differences in anaerobic metabolism between normoxia and the other
      two conditions. These data suggest that there are other parameters besides those
      of energy metabolism that affect exercise performance as FIO2 is modified. These
      possible mechanisms are discussed in this paper.

PMID- 7791590
TI  - Wet suit effect: a comparison between competitive swimmers and triathletes.
AB  - The purpose of the present investigation was to examine the wet suit effect on 8
      swimmers and 8 triathletes. For swimmers, the performances of a 400-m swim with
      and without wet suit were not statistically different (4 min 12.5 +/- 8 s vs 4
      min 13.9 +/- 4 s) while for triathletes the swim times were reduced by 19 s (4
      min 45.8 +/- 34 s vs 5 min 04.7 +/- 30 s, P < 0.01). For swimmers, VO2max and
      blood lactate measured with the wet suit were lower than without (P < 0.01),
      while for triathletes stroke rate was significantly higher with the wet suit (P <
      0.01). For the whole group, the individual differences of performance were
      related to the blood lactate differences (r = -0.68; P < 0.01) and to the
      hydrostatic lift (r = 0.63; P < 0.01). For swimmers, the energy cost of swimming
      and the gliding ability were not statistically different with or without wet
      suit, while for triathletes they were significantly lower and decreased with
      velocity. It is concluded that the wet suit effect improves performance more in
      inefficient swimmers with low buoyancy, swimming at low speeds.

PMID- 7791591
TI  - Evaluation of body composition by dual energy x-ray absorptiometry and two
      different software packages.
AB  - Dual energy x-ray absorptiometry (DXA) measures body composition, tissue
      distribution, bone mineral content (BMC), and bone mineral density (BMD).
      Differences are possible due to software versions. This investigation examined
      body composition, tissue distribution, BMC, and BMD measurements using a DXA
      (Lunar Corp., Madison, WI) with different software packages (versions 3.4 and
      3.6R). Fifteen women, ages 20-40 yr, enrolled in a weight-loss study (body mass
      index = 28) and volunteered for body composition assessment by densitometry. BMC,
      BMD, and tissue distribution measurements were made using DXA. Results were
      analyzed once each with software versions 3.4 and 3.6R. BMC + total soft tissue,
      measured using DXA, was comparable to measured body weight (3.4 = 76.3 kg; 3.6R =
      76.5 kg; weight = 76.5 kg). Lower BMC and BMD (5.5% and 1.8%, P < 0.01) were
      observed with 3.6R. Arm tissue mass was lower (1,530 g; P < 0.01) and fat
      declined (1,069 g; P < 0.01) with 3.6R. Leg tissue mass decreased 487 g (P <
      0.01), but fat tissue increased (526 g, P < 0.01) with 3.6R. A larger fat mass
      (1,492 g) and lower lean mass (1,115 g) were observed with 3.6R compared with
      3.4. Percent fat values by densitometry using DXA 3.4 and 3.6R were 38.1%, 39.9,
      and 41.9%, respectively. These results demonstrated differences in total body
      composition, lean and fat tissue distribution, and bone measurements from DXA
      software versions.

PMID- 7791592
TI  - Combining event scores to estimate the ability of competitors.
AB  - Simulation was used to investigate the validities of nine measures of ability
      derived from scores of two or more competitive events. The measures were: raw
      means and least-squares means of raw scores, z scores, and normal scores; two
      measures derived from ranked scores; and the "personal-best" raw score.
      Simulations were performed for different numbers of competitors, events, and
      event entries, each for a range of validity of performance in a single event. A
      complete set of simulations was repeated for each of the following conditions:
      normal distribution of competitors' ability; skewed distribution of ability;
      event validity related to ability; validity, ability, and spread of scores
      differing between events; and events differing in difficulty. The raw mean of raw
      scores was generally the most valid measure. The personal best was comparable to
      the mean only when the number of entries approached one per competitor. The least
      squares mean of raw scores had highest validity when events differed
      substantially in difficulty; it should therefore be used when events differ in
      length, or when event scores are affected by environmental conditions, judging
      bias, or by uneven matching of competitors in match-play sports.

PMID- 7791593
TI  - Nonexercise regression models to estimate peak oxygen consumption.
AB  - The purpose of this study was to develop a VO2peak prediction model derived from
      nonexercise (N-EX) based predictors. VO2peak was measured using a walking
      treadmill protocol with 229 females and 210 males between 20 and 79 yr of age
      (mean +/- SD: 38.62 +/- 10.36 ml.kg-1.min-1). Subjects were randomly divided into
      validation (V) (85% of total; N = 374) and cross-validation (CV) (15% of total; N
      = 65) groups. The V group was used to validate generalized and gender-specific
      models using stepwise multiple regression procedures with gender, age and age2,
      percent body fat, and a physical activity code (AC). The generalized ml.kg-1.min
      1 (R2 = 0.77, SEE = 4.90 ml.kg-1.min-1, SEE% = 12.7%) and gender-specific
      (females: R2 = 0.72, SEE = 4.64 ml.kg-1.min-1; males: R2 = 0.72, SEE = 5.02 ml.kg
      1.min-1) models were highly accurate relative to N-EX and exercise based models
      in the literature. Cross-validation procedures were used to evaluate model
      stability. The generalized model was stable across the total CV group and various
      CV subsamples (by gender, decade-wide age groups, and AC groups), but not across
      groups similar in VO2peak. These results suggest that N-EX models can be valid
      predictors of VO2peak for heterogenous samples.

PMID- 7791595
TI  - PRESS-related statistics: regression tools for cross-validation and case
      diagnostics.
AB  - In the health science literature, a common approach of validating a regression
      equation is data-splitting, where a portion of the data fits the model (fitting
      sample) and the remainder (validation sample) estimates future performance. The
      R2 and SEE obtained by predicting the validation sample with the fitting sample
      equation is a proper estimate of future performance, tending to correct for the
      natural upward bias of the R2 and SEE obtained from fitting sample alone. Data
      splitting has several disadvantages, however. These include: 1) difficulty,
      arbitrariness, and inconvenience of matching samples; 2) the need to report two
      sets of statistics to determine homogeneity; and 3) the lack of equation
      stability due to diluted sample size. The PRESS statistic and associated
      residuals do not require the data to be split, yield alternative unbiased
      estimates of R2 and SEE, and provide useful case diagnostics. This procedure is
      easy to use, is widely available in modern statistical packages, but is rarely
      utilized. The two methods are contrasted here using a simulation from original
      data for predicting body density from anthropometric measurements of a group of
      117 women. The PRESS approach is particularly appropriate for smaller datasets;
      methods of reporting these statistics are recommended.

PMID- 7791594
TI  - Energy expenditure during submaximal walking with Exerstriders.
AB  - This study was designed to determine whether Exerstriding, a modified form of
      walking using walking sticks (Exerstriders), resulted in an augmented
      cardiorespiratory response and a greater energy expenditure than when walking
      without Exerstriders. Female subjects (23.6 +/- 4.0 yr; 58.5 +/- 5.5 kg)
      completed two randomly assigned trials of treadmill walking (6.7 km.h-1; 0%
      grade; 30 min.) with (Exerstrider (E)) and without Exerstriders (Control (C)).
      Mean oxygen consumption (E = 20.5 +/- 1.2 ml.min-1.kg-1; C = 18.3 +/- 2.5 ml.min
      1.kg-1), heart rate (E = 132.5 +/- 19.2 beats.min-1; C = 121.5 +/- 21.2 beats.min
      1) and respiratory exchange ratio (E = .82 +/- .03; C = .78 +/- .04) were
      significantly greater (P < or = 0.05) while walking with Exerstriders. Total
      caloric expenditure was also significantly greater during the Exerstrider
      condition (E = 173.7 +/- 20.9 kcal; C = 140.7 +/- 27.2 kcal.). In contrast, the
      rating of perceived exertion did not differ significantly between the two
      conditions. These data suggest that Exerstriding provides a means to increase
      caloric expenditure during submaximal walking, a factor that may be of critical
      importance in enhancing health benefits--such as improved body composition and
      aerobic capacity--typically associated with walking programs.

PMID- 7791596
TI  - Visual distinctiveness can enhance recency effects.
AB  - Experimental efforts to meliorate the modality effect have included attempts to
      make the visual stimulus more distinctive. McDowd and Madigan (1991) failed to
      find an enhanced recency effect in serial recall when the last item was made more
      distinct in terms of its color. In an attempt to extend this finding, three
      experiments were conducted in which visual distinctiveness was manipulated in a
      different manner, by combining the dimensions of physical size and coloration
      (i.e., whether the stimuli were solid or outlined in relief). Contrary to
      previous findings, recency was enhanced when the size and coloration of the last
      item differed from the other items in the list, regardless of whether the
      "distinctive" item was larger or smaller than the remaining items. The findings
      are considered in light of other research that has failed to obtain a similar
      enhanced recency effect, and their implications for current theories of the
      modality effect are discussed.

PMID- 7791597
TI  - Specificity of perceptual processing in rereading spatially transformed
      materials.
AB  - While most studies using the task of reading spatially transformed text do not
      reveal evidence of specific perceptual transfer, a study by Masson (1986,
      Experiment 3) provides clear evidence of such effects. Several experiments were
      designed to identify the basis for this empirical discrepancy. The only
      substantive evidence of specific perceptual transfer occurred when the words were
      presented in an unfamiliar typography, although each study suggested a trend
      toward perceptual specificity effects. The results are discussed in terms of Graf
      and Ryan's (1990) ideas about the role of distinctive memory representations.

PMID- 7791599
TI  - Decision strategies and visual-field asymmetries in same-different judgments of
      word meaning.
AB  - The accuracy with which observers judged whether two words belonged to the same
      semantic category was determined from a detection-theoretic analysis of same
      different judgments. In Experiment 1, one word was presented centrally and the
      other word in either the left visual field (LVF) or the right visual field (RVF);
      in Experiment 2, both words were presented to either the LVF or the RVF. In order
      to obtain receiver-operating characteristics (ROCs) of performance, observers
      were asked to rate their confidence that the two words belonged to the same
      semantic category. Two models of the decision strategy were fitted to the
      obtained characteristics: a differencing model, in which the decision variable
      was the difference between the two observations; and an optimal model, in which
      each observation was judged in relation to a criterion. In both experiments, the
      optimal model provided a better fit than the differencing model to the obtained
      characteristics. Maximum-likelihood estimates of both the criterion-free
      parameter, d', and the area under the operating characteristic, p(A), were
      greater for words presented in the RVF than for those presented in the LVF.

PMID- 7791598
TI  - Effects of association, frequency, and stimulus quality on naming words in the
      presence or absence of pseudowords.
AB  - According to classical dual-route theory, effects of associative priming and
      frequency on the naming of printed words arise from lexical access and should be
      weak or absent when word names are assembled prelexically. Assembled naming would
      be more likely in a shallow orthography, especially in the presence of nonwords.
      This hypothesis was examined with the shallow Serbo-Croatian orthography.
      Interactions between association, frequency, and stimulus quality were also
      examined in both Serbo-Croatian and English. Contrary to classical dual-route
      theory, both lexical effects were found for naming words in Serbo-Croatian, with
      or without nonwords. Neither interaction was significant in Serbo-Croatian and
      only association x quality was significant in English. Discussion focused on (a)
      the claim that lexical effects on naming in a shallow orthography constitute
      prima facie evidence against either prelexical phonology or the orthographic
      depth hypothesis, and (b) the possible factorization of frequency and active
      associative knowledge in naming words.

PMID- 7791601
TI  - Recollective experience in the revelation effect: separating the contributions of
      recollection and familiarity.
AB  - The revelation effect is a phenomenon of recognition memory in which words
      presented for a recognition decision are more likely to be identified as
      previously studied if they are initially disguised and are then somehow revealed
      to the subject. The goal of the present experiments was to determine whether the
      revelation effect has similar or different influences on the conscious
      recollection of a previous encounter with a test item and on the feeling of
      familiarity evoked by a test item. The process-dissociation procedure (Experiment
      1) and the remember/know procedure (Experiment 2) were used to achieve this goal.
      The main findings of these experiments were that revealing an item at test (1)
      increased the feeling of familiarity associated with that item, especially if it
      was not previously studied, and (2) decreased conscious recollection of
      previously studied items. These data narrow the range of potential explanations
      of the revelation effect.

PMID- 7791600
TI  - Pronominalization and discourse coherence, discourse structure and pronoun
      interpretation.
AB  - Two self-paced reading-time experiments are reported that examine the time course
      of pronoun interpretation processes based on local discourse structure and on
      world knowledge. The characterization of local discourse structure is based on
      recent work on centering, which provides a specific formulation of how the ways
      in which sentences make reference to common entities determines the coherence of
      discourse segments and how discourse structure influences interpretation of
      ambiguous pronouns. The results of the first experiment show that readers
      generate a default interpretation of a pronoun based on features of local
      discourse structure, and that that default interpretation is later confirmed or
      overridden by knowledge-based processes. The results of the second experiment
      show that local discourse structure continues to influence pronoun interpretation
      even when the semantic information that ultimately compels interpretation occurs
      before the pronoun. These results support the view that processes acting on local
      discourse structure play a powerful role in guiding language comprehension.

PMID- 7791603
TI  - Judging a book by its cover: interpretative effects of content on problem-solving
      transfer.
AB  - We examine how cover stories of isomorphic problems affect transfer. Existing
      models posit that people retain content in problem representations and that
      similarities and differences between the "undeleted" cover stories might
      interfere with recognition of structural similarities. We propose that cover
      stories can affect transfer in another way--by inducing semantic knowledge that
      modifies problem structures. Two experiments examined how people represent and
      solve permutation problems dealing with random assignment of elements from one
      set to elements from another set. Although the problems were structurally
      isomorphic, cover stories involving different pairs of element sets led subjects
      to abstract different "interpreted structures." Problems involving objects and
      people (e.g., prizes and students) led subjects to abstract an asymmetric
      structure ("get") and problems involving similar sets of people (e.g., doctors
      and doctors) led subjects to abstract a symmetric structure ("pair"). Transfer
      was mediated by similarities and differences between the interpreted structures
      of the learned and the novel problems.

PMID- 7791602
TI  - Essentialism and graded membership in animal and artifact categories.
AB  - A number of studies have argued that people view membership in animal and
      artifact categories as a matter of degree. These studies have generally failed to
      distinguish between the issues of typicality and category membership. Thus, data
      which have been taken to demonstrate that membership is a matter of degree may
      only demonstrate that typicality is graded. Partly on the basis of these
      findings, it has been argued that some categories are organized around an
      underlying essence. The essence determines membership absolutely. The present
      paper reports a series of studies that reexamine the question of graded
      membership. In the first study, subjects were asked to rate both typicality and
      category membership for the same stimuli as a way of distinguishing the two
      questions. A second method relied on the intuition that disagreements about
      membership in all-or-none and graded categories may have different qualities.
      Results from both studies suggest some support for claims that membership in
      animal and artifact categories is a matter of degree. A third study explored the
      possibility that graded responses were due to conflicting, or ambiguous, sets of
      criteria. A task focusing on biological features did not lead to more absolute
      categorization. These results contradict essentialist predictions.

PMID- 7791605
TI  - The diversity principle in the testing of arguments.
AB  - According to the diversity principle of scientific reasoning, hypotheses receive
      greater confirmation when they are supported by diverse rather than similar sets
      of data. This article examines whether people reason like intuitive scientists by
      conforming to the diversity principle in the testing of arguments. The results of
      two experiments demonstrate that people do indeed conform to the diversity
      principle by choosing a set of diverse rather than similar premises to test the
      conclusion of an argument. These findings are discussed in terms of the different
      reasoning processes involved in argument evaluation, argument testing, and rule
      discovery.

PMID- 7791606
TI  - Very rapid forgetting: reply to Cunningham, Healy, Till, Fendrich, and Dimitry.

PMID- 7791607
TI  - The effect of inflation on expenditures by mental health organization between
      1969 and 1990.
AB  - At first glance, the rise in current dollar expenditures for all mental health
      organizations from $3.3 billion in 1969 to $28.4 billion in 1990 seems enormous.
      However, if the annual expenditures are adjusted for inflation and expressed in
      constant dollars, the rise in expenditures is only from $3.3 billion in 1969 to
      $5.6 billion in 1990. Thus, most of the increase in expenditures by mental health
      organizations over the past two decades is due to inflation, with less than 10
      percent due to increases in real purchasing power. Since both the number of
      private psychiatric hospitals and the expenditures they incurred increased
      dramatically between 1969 and 1990, these hospitals showed gains in absolute
      dollar amounts and in dollar amounts per capita, even if the expenditures are
      expressed in constant dollars. To a lesser extent, the same was true of RTCs.
      Although both VA medical centers and State mental hospitals showed increases in
      expenditures as measured in current dollars, if expenditures are expressed in
      constant dollars, these organizations showed net decreases. Their inpatient
      populations also decreased during this period. However, if expenditures per
      inpatient under care are examined, the reverse is true. The per patient
      expenditures for State mental hospitals increased between 1969 and 1990, even if
      the results are stated in constant dollars.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791608
TI  - Data highlights on: utilization of Mental Health Organizations by elderly
      persons.

PMID- 7791604
TI  - Reasoning about curvilinear motion: using principles or analogy.
AB  - People possess implicit theories about the motion of objects, theories that are
      often incorrect. When asked to predict the path of an object emerging from a
      curved tube, for example, people often say that the object will continue to
      follow a curved path. However, when solving a problem that reminds them of a
      familiar previous instance, people often reason by analogy to the instance. In
      this study, we show that a previous instance must be very superficially similar
      to a problem in order to be used as an analogy; otherwise, people will use their
      implicit theories as the basis of their reasoning.

PMID- 7791609
TI  - Reversible enzyme inhibitors as mechanistic probes.

PMID- 7791610
TI  - Kinetics of slow and tight-binding inhibitors.

PMID- 7791612
TI  - Product inhibition applications.
AB  - A product inhibition study provides important insight into the binding mechanism
      of an enzyme, especially in the identification of abortive complexes, but seldom
      is it the only tool required to solve the mechanism completely. Always keep in
      mind that more than one mechanism may be consistent with the patterns, and
      several alternative schemes should be analyzed by including abortive complexes
      and, as a last resort, isomerization steps or slow product release steps in the
      interpretation. Support for the proposed mechanism should be garnered from other
      data, such as kinetic studies with alternative substrates and competitive
      inhibitors, positional and molecular isotope exchange studies, binding studies,
      and isotope effects. A well-characterized binding mechanism complete with the
      identification of abortive complexes is even more important as rational drug
      design becomes more prevalent. Product inhibition studies represent an important
      tool that is relatively easy to apply to gain significant information about the
      binding mechanism of most enzymes.

PMID- 7791613
TI  - Kinetics of iso mechanisms.

PMID- 7791611
TI  - Kinetic method for determination of dissociation constants of metal ion
      nucleotide complexes.

PMID- 7791614
TI  - Mechanism-based enzyme inactivators.

PMID- 7791615
TI  - Transition state and multisubstrate analog inhibitors.

PMID- 7791616
TI  - Transient kinetic approaches to enzyme mechanisms.

PMID- 7791617
TI  - Partition analysis: detecting enzyme reaction cycle intermediates.

PMID- 7791618
TI  - Isotope effects: determination of enzyme transition state structure.

PMID- 7791619
TI  - Hydrogen tunneling in enzyme catalysis.

PMID- 7791620
TI  - Rapid quench kinetic analysis of polymerases, adenosinetriphosphatases, and
      enzyme intermediates.

PMID- 7791621
TI  - Positional isotope exchange as probe of enzyme action.
AB  - The positional isotope exchange technique has been found to be quite useful for
      the identification of reaction intermediates in enzyme-catalyzed reactions. For
      reactions where intermediates are not expected the method can be used with great
      utility for the quantitative determination of the partitioning of enzyme-product
      complexes. However, it must be remembered that it has been explicitly assumed
      that the functional group undergoing positional exchange is free to rotate. This
      assumption is not always valid since examples have been discovered where the
      functional group rotation is indeed hindered. For instance, in the reaction
      catalyzed by argininosuccinate synthetase a PIX reaction was not observed on
      incubation of ATP and citrulline even though a citrulline-adenylate complex has
      been identified from rapid quench experiments.

PMID- 7791625
TI  - Expression of properly folded catalytic antibodies in Escherichia coli.

PMID- 7791624
TI  - Proton transfer in carbonic anhydrase measured by equilibrium isotope exchange.

PMID- 7791622
TI  - Manipulating phosphorus stereospecificity of adenylate kinase by site-directed
      mutagenesis.

PMID- 7791623
TI  - Equilibrium isotope exchange in enzyme catalysis.

PMID- 7791626
TI  - Cooperativity in enzyme function: equilibrium and kinetic aspects.

PMID- 7791627
TI  - Kinetic basis for interfacial catalysis by phospholipase A2.

PMID- 7791628
TI  - Analysis of enzyme progress curves by nonlinear regression.

PMID- 7791629
TI  - Site-directed mutagenesis: a tool for studying enzyme catalysis.

PMID- 7791630
TI  - Effects of atrial natriuretic peptide on the unicellular Tetrahymena pyriformis
      model.
AB  - The vertebral hormone, atrial natriuretic peptide (ANP) has characteristic
      effects in Tetrahymena cells. ANP is able to induce the release of sodium ions,
      probably via the membrane rather than the contractile vacuole. The hormone is a
      potent inhibitor of Chinese ink-phagocytosis. A 10(-12) M concentration of ANP
      has the maximum positive effect on the division of cells but long-term treatments
      indicate the presence of a down-regulation-like mechanism. ANP has a strong
      chemoattractant characteristic between 10(-13) and 10(-11) M concentrations.
      Significant concentration dependent FITC-ANP binding at pretreatments of 10(-12)
      M suggest the presence of special receptor-dependent mechanisms which are
      responsible for the development of hormonal imprinting. The similarities between
      the most effective concentrations (10(-13) - 10(-12) M) and the human serum level
      of ANP shows that the effects of ANP have a more evolutionary background than
      previously considered.

PMID- 7791631
TI  - Effects of ciprofloxacin and vancomycin on physicochemical surface properties of
      Staphylococcus epidermidis, Escherichia coli, Lactobacillus casei and
      Lactobacillus acidophilus.
AB  - Under clinical conditions, during antibiotic treatment, micro-organisms often
      grow at sub-inhibitory concentrations. This may lead to altered adhesive cell
      surface properties and to a disruption of the indigenous microflora, in addition
      to the creation of a more pathogenic biofilm. The effects of growing
      Staphylococcus epidermidis, Escherichia coli and lactobacilli in the presence of
      sub-inhibitory concentrations of ciprofloxacin and vancomycin were determined.
      Growing the cells under antibiotic burden sometimes led to altered cell surface
      hydrophobicity (by adhesion to hexadecane), changes in the pH-dependence of zeta
      potentials, and elemental surface compositions or in different SDS-PAGE protein
      profiles. For several isolates only one of the surface properties was altered by
      the presence of an antibiotic in the growth medium and no systematic effects were
      observed for all isolates representing a certain species or even strain. The
      important conclusion to be drawn from the results of this study is that the
      effects of growing cells under antibiotic burden on their adhesive cell surface
      properties can only be established when using a variety of techniques.

PMID- 7791632
TI  - Partial purification and some properties of gamma-glutamyl peptide-hydrolysing
      enzyme from Actinobacillus actinomycetemcomitans.
AB  - A gamma-glutamyl peptide-hydrolysing enzyme was partially purified from
      Actinobacillus actinomycetemcomitans. The enzyme required metal ions, and 1 to 2
      mM Mn2+ ions, especially, were essential for hydrolytic reaction. Its
      distribution by treatment of cells with lysozyme-EDTA suggested that the enzyme
      was a membrane-bound protein. The pI of the enzyme was in range of pH 5.1 to 5.6,
      and the apparent Km value for gamma-glutamyl-p-nitroanilide was 3.0 x 10(-4) M.
      The enzyme hydrolysed specifically gamma-glutamyl residues from the N-terminal of
      gamma-glutamyl compounds such as gamma-Glu-Met, gamma-Glu-Ala, gamma-Glu-Leu and
      gamma-Glu-Tyr, but did not catalyse the transpeptidation reaction. Neither free
      amino acids such as Ala-, Pro-, Gly- and Leu-p-nitroanilide nor alpha-glutamyl
      derivatives were hydrolysed. Its activity was strongly inactivated by metal
      chelators (EDTA or o-phenanthroline) and amino acids (Glu, Gln). In addition, the
      activity was specifically inactivated by gamma-glutamyl affinity-labelling
      reagents such as AT-125, 6-diazo-5-oxo-L-norleucine and azaserine, which are
      inhibitors of the gamma-glutamyl donor sites of mammalian gamma-glutamyl
      transpeptidase. Antibodies against bovine kidney gamma-glutamyl transpeptidase
      decreased the activity of the bacterial enzyme by 65%. These results suggested
      that the active sites in the bacterial enzyme were similar to those in mammalian
      gamma-glutamyl transpeptidase.

PMID- 7791633
TI  - Antitrust law applicable to managed care contracting.
AB  - Antitrust laws cannot be ignored by physicians on the basis that they are not
      fair, are too complicated or make no sense. The Justice Department and the FTC
      view independent practitioners as competitors. As such, organized actions by
      physicians relative to managed care contracting are carefully scrutinized for
      antitrust violations. A basic understanding of the antitrust laws is therefore
      essential.

PMID- 7791634
TI  - Jackson Physicians Alliance: making friends in the right places.

PMID- 7791635
TI  - Burns Clinic links up with national firm to tackle managed care.
AB  - The Burns Clinic Medical Center, PC, headquartered in Petoskey, has for many
      years been an innovator in state medical practice. Founded in 1931, the Burns
      Clinic today offers a range of medical and surgical services at eight sites in
      northern Michigan. With 120 physicians on staff and 550 support employees, the
      Burns Clinic is a major health care operation as well as a proven success.

PMID- 7791636
TI  - Corporate affiliated physicians. Who are they, and how are they likely to change
      the face of medicine in the years ahead?

PMID- 7791637
TI  - Change can be tough for physicians facing career move, retirement.

PMID- 7791638
TI  - The proper use of blood products.

PMID- 7791639
TI  - Wine, the tax man and alcohol-related disease.

PMID- 7791640
TI  - Molecular medicine makes its way to the bedside. Can medical practitioners afford
      to ignore the new DNA technology?

PMID- 7791641
TI  - Haemophilia A management in Victorian, New South Wales and South Australian
      haemophilia centres.
AB  - OBJECTIVE: To examine the management of haemophilia A in Australia and to compare
      it with international trends. METHODS: Six haemophilia centres treating most
      patients in Victoria, New South Wales and South Australia were surveyed in 1993
      by means of a written questionnaire followed by an "on site" interview. RESULTS:
      The centres were treating 739 patients; 234 (32%) had severe haemophilia. Factor
      VIII inhibitors were present in 5.9% of all patients and in 19% of those with
      severe disease. Twenty-three per cent were human immunodeficiency virus (HIV)
      antibody-positive and 74% were hepatitis C virus (HCV) antibody-positive. The
      main treatment was "on demand" therapy for acute bleeds (average use of factor
      VIII: 1350 IU/kg per year for children; and 780 IU/kg per year for adults).
      Prophylactic therapy was used in only 17 patients, with doses of 3000-4500 IU/kg
      per year. One million IU was used for three patients with high titre inhibitors
      who had "tolerising" therapy. While most developed countries have a factor VIII
      supply of 2-5 IU per capita, the total supplied to the States represented 1.46 IU
      per capita, while use at the centres represented 1.1 IU per capita. CONCLUSION:
      Because supply of factor VIII is limited, use was less than half that recommended
      internationally. Shortage of factor VIII has compromised prophylactic therapy and
      virtually prevented "tolerising" therapy.

PMID- 7791642
TI  - Appropriateness of transfusions of red cells, platelets and fresh frozen plasma.
      An audit in a tertiary care teaching hospital.
AB  - OBJECTIVE: To determine how current hospital practice for transfusions of red
      cells, platelets and fresh frozen plasma conformed with published criteria.
      DESIGN: Elaboration of criteria for transfusion from a review of the current
      literature; and analysis of the medical records of patients receiving
      transfusions of red cells (200), platelets (215), and fresh frozen plasma (260)
      during defined time periods in 1993. SETTING: A large tertiary care teaching
      hospital. OUTCOME MEASURES: Inappropriateness rates for transfusion episodes and
      numbers of individual units of blood products administered. RESULTS:
      Inappropriateness rates for transfusion episodes and numbers of individual units
      administered were 16% and 10% for red cells, 13% and 11% for platelets, and 24%
      and 16% for fresh frozen plasma (31% and 21% when transfusions for thrombotic
      thrombocytopenic purpura were excluded). Red cells and fresh frozen plasma were
      used inappropriately most frequently in association with a surgical procedure;
      for platelets, it was their use for bleeding. In many of the transfusions deemed
      inappropriate, deficiencies of red cells, platelets and/or coagulation factors
      were documented, but the degree of deficiency did not meet the stringent
      appropriateness criteria. Twenty-six transfusions were deemed inappropriate
      because the indication was not documented in the medical record. CONCLUSIONS:
      Specific problem areas in which blood product use was inappropriate were
      identified. Guidelines for transfusion appropriateness, education of hospital
      staff, and a monitoring system to ensure adherence to the guidelines, are
      required.

PMID- 7791645
TI  - Laparoscopic cholecystectomy: its impact on national health economics.
AB  - OBJECTIVE: To assess whether sound economic reasons exist for the wider
      introduction of laparoscopic cholecystectomy in Australia. DESIGN: A
      retrospective survey of patients who underwent laparoscopic cholecystectomy. We
      compared time of hospital stay and time off work after laparoscopic
      cholecystectomy with data for open cholecystectomy. PATIENTS AND SETTING:
      Seventeen participating surgeons in four Australian States allowed access to
      patients treated between May 1990 and November 1991 (1254 patients in all). MAIN
      OUTCOME MEASURES: Patient acceptability of the procedure, average length of
      postoperative in-hospital stay, and the savings associated with earlier return to
      work compared with open cholecystectomy. RESULTS: Almost 90% of patients (1127)
      replied and 1088 responses were considered appropriate for analysis. Serious
      complications were rare; 96% of patients thought the technique was successful.
      The mean length of in-hospital stay was 2.6 days (range, 1-120), compared with a
      mean of 8.7 days for open cholecystectomy. Among working patients, the mean time
      to return to work was 11.6 days (range, 10.7-13.1), an estimated 27 days sooner
      than after open cholecystectomy. Extrapolating from these results, replacing 95%
      of open cholecystectomies with laparoscopic procedures would have 133,285
      hospital bed-days and 500,000 work-days each year. CONCLUSION: Laparoscopic
      cholecystectomy is safe and effective. Its wider use in Australia would result in
      savings to both the individual and the national economy.

PMID- 7791643
TI  - Is wine the drink of moderation?
AB  - OBJECTIVE: To examine, in the light of a current national inquiry into taxation
      for wine, claims that wine drinkers rarely misuse alcohol and that cask wine is
      more likely to be misused than bottled wine. METHODS: 1272 persons aged 16 years
      and over and resident in metropolitan Perth were interviewed in their homes
      regarding their use of alcohol. RESULTS: The alcohol consumption of 524 (373
      women, 151 men) who had drunk at least one glass of wine on one or more of their
      last four drinking days was examined in relation to National Health and Medical
      Research Council guidelines. While only 2.9% of women and 2.6% of men had an
      average daily intake of wine above low risk levels, 6.9% of women and 13.2% of
      men had exceeded these levels when considering all alcoholic beverages. When wine
      intake was examined for the day of highest consumption of the last four drinking
      days recalled by each respondent, 41.1% of women and 17.0% [corrected] of men had
      exceeded low risk levels. There was no significant difference in the amounts of
      cask and bottled wine consumed in 180 wine drinkers for whom the distinction
      between cask and bottled varieties could be made and who drank wine on their last
      drinking occasion. CONCLUSIONS: Past estimates of the contribution of wine
      consumption to excessive alcohol intake are underestimates. Raising the tax on
      wine should be considered as a public health measure and taxes should be levied
      in direct relation to alcohol content to encourage the consumption of lower
      alcohol varieties.

PMID- 7791644
TI  - The impact of firearm control legislation on suicide in Queensland: preliminary
      findings.
AB  - OBJECTIVE: To examine the effect of specific firearm control legislation on
      firearm and overall suicide rates. DESIGN: Retrospective survey of data from the
      Register of the Suicide Research and Prevention Program, Queensland Department of
      Health. The hypothesis was tested that the legislation would reduce firearm and
      overall suicides more in metropolitan and provincial city areas than in rural
      areas, where firearm ownership is higher. SETTING: State of Queensland 1990-1993.
      OUTCOME MEASURES: Suicide rates by age, sex and method for metropolitan,
      provincial city and rural areas in the two years before (1990-1991) and after
      (1992-1993) legislation. RESULTS: Mean annual firearm suicide rates declined
      significantly (P < 0.05) in metropolitan and provincial city areas after
      legislation (from 3.6 to 2.3 per 100,000 and from 5.2 to 3.1 per 100,000,
      respectively), with significant declines among men and in the 15-29 years age
      group. Rates increased slightly in rural areas (from 7.2 to 8.2 per 100,000).
      Overall suicide rates declined in provincial areas only, with minimal change in
      metropolitan areas and a slight rise in rural areas. CONCLUSION: These results
      provide preliminary evidence that firearm control legislation, including a 28-day
      "cooling-off" period before firearm purchase, reduces suicide rates, especially
      among younger adult men.

PMID- 7791647
TI  - Update on scleroderma.

PMID- 7791646
TI  - Three deaths from hemlock poisoning.

PMID- 7791648
TI  - Sleep problems.
AB  - Sleep complaints are common in the elderly, and are often related to
      physiological changes with ageing, or secondary to illness and drug therapy.
      Primary sleep disorders, such as sleep apnoea and movement disorders, are also
      common. Management should be specific to the problem. Attention to underlying
      factors and sleep hygiene, as well as reassurance and education about age-related
      sleep changes, will often be sufficient. Hypnotics, which usually offer only
      temporary symptomatic relief, may be counterproductive, and should be prescribed
      only in the short term, except in limited specific cases. Short-acting
      benzodiazepines (e.g., temazepam or oxazepam), or possibly zopiclone, are
      currently the drugs of choice.

PMID- 7791649
TI  - Accident victims as patients: moral obligation or negligence.

PMID- 7791651
TI  - Subungual desmoplastic melanoma in an aboriginal woman.

PMID- 7791650
TI  - Margarine--facts and myths.

PMID- 7791652
TI  - Public attitudes to smoke-free areas in sports venues.

PMID- 7791653
TI  - Approaching the NHMRC goal for second-dose measles-mumps-rubella vaccine uptake.

PMID- 7791654
TI  - Compliance with neonatal hepatitis B vaccination.

PMID- 7791655
TI  - Localised prostate cancer: which way forward?

PMID- 7791656
TI  - Suicidal behaviour in the Solomon Islands.

PMID- 7791657
TI  - Cataract extraction and Parkinson's disease.

PMID- 7791658
TI  - Rural practice--time to teach.

PMID- 7791659
TI  - So much written, so little said.

PMID- 7791660
TI  - [Evaluation of the socioeconomic status in epidemiological surveys: hypotheses of
      research in the Brianza area MONICA project].
AB  - Socio-economic status (SES) has been reported as a causative factor of increasing
      health inequalities in industrialized countries. The phenomenon has been
      particularly investigated for job related diseases, including cardiovascular
      disease and risk. The group of occupational medicine specialists in the world
      wide MONItoring program of CARdiovascular disease (WHO-MONICA Project) is now
      producing a number of hypotheses about the application of internationally defined
      criteria and tools for SES evaluation in the Italian area of the Project, Area
      Brianza. After a short review of some main conceptual and methodological
      problems, a proposal is presented of an SES index, derived from the pooled data
      of two population surveys carried out in this area. From a randomized sample of
      3200 residents, 25-64 years old, stratified by sex and age decade, 1731 subjects,
      594 females and 1137 males, employed at the time of the screening were extracted.
      Four variables were considered: age, education, occupational level and job-strain
      (according to the Karasek-Theorell model) by which each subject was classified in
      three levels--high, medium, low--of education and occupation, whose combination
      was used to obtain as many levels of socio-economic status. This a method of
      building an SES index is based on a sequence of approximations following two
      essential criteria: limitation of the variables to be surveyed, through
      standardized procedures; ability to identify the "low" SES category, presumably
      more at risk for disease.

PMID- 7791662
TI  - [Organizational analysis of hospital work: identification of constraint elements
      and hypothesis of their relationship with nurses' wellbeing].
AB  - The paper reports the results of a research project on hospital work in which the
      analysis of organized work situations in different contexts was made using a
      method based on a valid organizational theory, with the objective of an ergonomic
      study on the relationships between organized work and well-being. From the
      analysis of these different situations, via the application of the Method of
      Organizational Congruencies, the greatest individual level of danger for well
      being was constantly observed in nurses, not only as regards the traditional
      risks of exposure to physical or biological agents, but also the psychophysical
      aspecific discomfort related, particularly, both to imposition and to uncertainty
      in the coordination and control of technical actions and in the coordination and
      control of individuals. The use of an instrument of organizational analysis and
      the contribution of specific disciplinary approaches (the theory on stress by H.
      Selye and the theory on communication by G. Bateson), satisfied the needs of
      suggesting and understanding the relationships between organization choices and
      well-being of nurses, with the aim of reducing the conditions of danger for well
      being related to organization choices.

PMID- 7791661
TI  - Neurobehavioral functions in operating theatre personnel exposed to anesthetic
      gases.
AB  - Neurobehavioral functions in paramedical operating theatre personnel were
      assessed in a cross-sectional survey. Sixty-two subjects (40 males and 22
      females) occupationally exposed to anesthetic gases were examined and compared to
      46 unexposed hospital workers (18 males and 28 females). The Simple Reaction Time
      (SRT) test was selected from the MANS battery (Milan Automated Neurobehavioural
      System). In order to evaluate acute and subacute types of effects on performance,
      the test was administered before and after the work shift, at the beginning and
      at the end of the working week. In addition, the complete battery was
      administered during one working day without exposure to anesthetic gases. On the
      last day of the working week, atmospheric nitrous oxide (N2Oa) ranged from 7 to
      553 ppm (geometric mean 62.6), atmospheric ethrane (ETHa) ranged from 0.1 to 18.8
      ppm (geometric mean 1.3), and urinary N2O (N2Ou) ranged from 4 to 297
      micrograms/l (geometric mean 26.8). An impairment of performance on the SRT test
      was observed at the end of the working week in subjects exposed to anesthetic
      gases compared to controls. This alteration was observed also considering only
      the subjects exposed to less than 55 micrograms/l (which is the Italian exposure
      limit for N2Ou, equivalent to 100 ppm for N2Oa). No significant differences were
      observed for the other psychometric tests. No dose-effect relationships where
      found between SRT test score and the indicators of exposure (N2Oa, ETHa,
      N2Ou).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791663
TI  - [Percutaneous absorption of phenanthrene: an in vitro study of the monkey skin].
AB  - It is well known that polycyclic aromatic hydrocarbons (PAHs) are absorbed
      through the skin of experimental animals and humans. However dermal uptake of
      PAHs is difficult to assess due to the lack of specific studies. The aim of this
      study was to obtain in vitro percutaneous absorption data for phenanthrene. In
      vitro penetration was measured with excised monkey (Cercopithecus Aethiops) skin
      in Franz diffusion cells, using a saline solution with 4% bovine serum albumin
      and gentamicin sulfate as receptor fluid. In two different groups of 7 and 2
      cells, 38.1 and 95.3 nmol/cm2 respectively of phenanthrene were applied in an
      acetone vehicle. The absorption rate in the first group of 7 cells was 0.025
      nmol/cm2/h (S.D. = 0.012), the lag time 11.7 (S.D. = 7.0) h and the breakthrough
      time 70 m (S.D. = 55 m). In the second group of 2 cells, the average absorption
      rate was 0.066 nmol/cm2/h and the average lag time 11.8 h. The percutaneous
      absorption at 24, 48 and 72 hours in the 7 cell group was 0.72% (S.D. = 0.52),
      2.51% (S.D. = 1.76) and 3.9% (S.D. = 2.0) of the applied dose respectively. In
      the 2-cell group 1.1%, 2.78% and 4.5% of the applied dose was absorbed at 24, 48
      and 72 hours. The results of the present study confirm the extent of percutaneous
      absorption of phenanthrene. The data can be compared with dermal absorption
      values of other PAHs obtained under the same experimental conditions.

PMID- 7791665
TI  - [Analysis of correlated data: problems and examples in industrial medicine].
AB  - In occupational health we are frequently faced with data that are not
      independent, but to recognize the lack of such an independence is not yet a
      common practice. To help researchers in the field to treat correlated data in a
      proper way this paper has two aims: to highlight practical situations in which
      the data are not independent and to show the main differences between a
      statistical analysis which does consider the correlation appropriately and one
      which doesn't. As to the first aim, four typical examples are discussed: repeated
      measurements in the same subject (e.g., cells in which the number of sister
      chromatid exchanges is counted); health effects observed in multiple organs
      (e.g., visual impairment in both eyes); evaluation of prevention programs (e.g.,
      exposure assessment to styrene before and after environment remediation);
      longitudinal studies of health effects (e.g., changes over time of pulmonary
      function parameters). With respect to the second aim a practical exercise is
      described completely. Measurements of exposure to a toxic substance in two
      different departments before and after environment remediation are evaluated with
      statistical tools which both do and do not consider the correlation between such
      measurements. Differences in the results obtained, with particular reference to
      indices of variability (e.g., standard errors), point toward the need of
      analysing correlated data with appropriate statistical tools that take
      correlation into account.

PMID- 7791666
TI  - [Carcinogenic agents and DL 626].

PMID- 7791667
TI  - [Academic medicine versus alternative medicine].

PMID- 7791664
TI  - [Determination of low levels of urinary trans,trans-muconic acid].
AB  - A method is described which allows determination of urinary t,t-muconic acid (MA)
      by means of HPLC with UV detection even at micrograms/l concentrations. The clean
      up procedure of samples involves the use of strong anionic-exchange cartridges
      (SAX) for solid phase extraction (SPE). In order to improve the reproducibility
      of the retention time of MA (CV < 1%) and to obtain an adequate separation of MA
      from interferents, a high performance reverse-phase column (250 x 4.6 [I.D.] mm,
      3 microns) is used and a careful control of the temperature (25 degrees C) is
      made. Also, a column-switching technique is applied to the chromatographic system
      in order to eliminate the highly retained peaks from the analytical column. The
      isocratic run is performed at a constant flow rate of 0.7 ml/min; the mobile
      phase consists of water: methanol: acetic acid (93.5:5.5: 1, v/v) and the UV
      detector is set at 259 nm. Under these conditions, MA elutes at 21.5 min and a
      single analysis takes 25 min; the detection limit (at a signal-to-noise ratio of
      3) is 3 micrograms/l in urine, when a 200 microliters aliquot of the extract is
      injected in the analytical apparatus. The recovery of the clean-up procedure is >
      90%; both the intra-assay and the inter-assay coefficients of variation are < 4%.
      The method has been applied to smokers and nonsmokers, subjects occupationally
      unexposed to benzene; the results showed a statistically significant difference
      between the two groups. Also, a close correlation was found between urinary
      excretion of MA measured with this method and environmental concentration of
      benzene in a population of workers occupationally exposed to low levels of this
      solvent.

PMID- 7791669
TI  - [Whooping cough. Microbiology, epidemiology, prevention].

PMID- 7791668
TI  - [Adenosine as an anti-arrhythmia agent].

PMID- 7791670
TI  - [Knowledge without information and information without knowledge].

PMID- 7791672
TI  - Organ donation for transplantation.

PMID- 7791673
TI  - [The morphologic characteristics of the vascular network of the middle and
      inferior temporal gyri and middle temporal visual area].
AB  - The vascular network of the anterior part of the middle and inferior temporal
      gyri consists of four vascular layers of which the third and fourth have the
      densest capillary network of the same density. There are all types of arteries in
      this cortex form A1 to A6 as well as all types of veins from V1 to V5. Fountain
      like arteries usually branch into five to six terminal recurrent branches; we
      have found that there are about two of them in each serial section. The middle
      temporal visual area has the same features of the vascular network as the above
      mentioned gyri with one difference only: there are at least six fountain-like
      arteries in each serial section. The increased number of these arteries might
      point to a greater sensitivity of this area to hypoxic conditions. The tangential
      sections of these areas reveal the existence of vertically-oriented vascular
      units with a centrally located venous vessel surrounded by arterial rings.

PMID- 7791671
TI  - Tramadol--a new oral analgesic.

PMID- 7791675
TI  - [Zoonoses in Vojvodina. III. Results of a seroepidemiologic study of
      leptospirosis in Vojvodina].
AB  - 2697 persons professionally exposed to leptospira working in contaminated waters
      and grounds or due to contact with infected animals or their products were
      seroepidemiologically examined. It was established that the presence of
      leptospirosis in certain categories of examined persons is three to more than ten
      times higher in relation with it's presence in the control groups. The most
      frequent serotype was Leptospira pomona. None of the seropositive persons gave
      data about having leptospirous infection which might be the consequence of
      asymptomatic infection or unidentified and not registering of the clinically
      manifested diseases.

PMID- 7791674
TI  - [Prognosis in patients with myelodysplastic syndromes based on cytomorphologic
      and clinico-biologic parameters].
AB  - Under myelodysplastic syndromes we presume a heterogeneous group of malignant
      hemopathies with clearly described characteristics of the disease given by a
      cooperative group of French, American and British authors. Myelodysplastic
      syndromes most frequently occur at older age. Survival of these patients, after
      the diagnosis is made, is mostly short because the disease evolves into acute
      leukemia. Myelodysplastic syndrome is characterized by appearance of refractive
      anemia, leukemia, thrombocytopenia with signs of expressed dishematopoiesis of
      the bone marrow. Clear criteria which could define forms with fast or slow course
      leading to acute leukemia don't exist, so there is a need to group patients into
      those with good or with bad outcome. The investigation included following
      parameters important for the outlook of the disease: 1. enlargement of lymph
      nodes, liver and spleen, 2. biochemical examination of peripheral blood, 3.
      cytomorphologic changes in the peripheral blood cells and bone marrow. By a
      follow-up of described parameters a statistically significant influence on
      survival of the sick concerning the degree of present anemia, absolute number of
      granulocytes, number of thrombocytes, dishematopoiesis of the peripheral blood
      and bone marrow, lymphadenomegaly, hepatomegaly and splenomegaly was not found.
      The percentage of blast in the peripheral blood and bone marrow has a
      statistically significant influence on patients' short survival.

PMID- 7791677
TI  - [Use of antibiotics in ambulatory pediatric care during the economic blockade].
AB  - Antibiotics are the most frequently prescribed drugs in the pediatric out-patient
      practice. The author, on the base of his personal experience, identifies and
      discusses relevant factors for the proper usage of antibiotics, through their
      behaviour under the conditions of economic blockade. These factors are:
      pharmaceutical industry, physician, patient and pharmacist. The shortage of many
      antibiotics as well as reduced communications of pharmaceutical companies with
      physicians, significantly disturb the therapeutical decision making process.
      Because of that, a physician has to confront optimal therapy, present situation
      in pharmacies, but also the economical power of patients--the availability of
      most antibiotics is possible only in the private sector. Wrong attitudes and
      habits of patients and of some physician with superficial approach to antibiotics
      irresponsible exchanges of antibiotics by some pharmacists and issuing
      antibiotics without prescription in the private sector, potentiate possibilities
      for misuse. Interaction of the mentioned factors determines present and future
      validity of antibiotics. The paper warns about the climate of their uncontrolled
      ways and suggests measurements for possible correction of present situation.

PMID- 7791678
TI  - [Backache in children].
AB  - Back ache is a rare phenomenon in children and adolescents, but it is always
      caused by serious pathologic changes. The aim of this study was to point to
      pediatricians to the importance of anamnesis and clinical examinations in making
      a diagnosis.

PMID- 7791679
TI  - [Correlation of histomorphologic changes in the blood vessels of diabetic
      patients in the aging processes].
AB  - The increase of morbidity concerning diseases of heart, CNS, kidneys and of other
      organs is primarily connected with atherosclerotic changes of blood vessels. The
      population of cardiovascular patients includes a great number of diabetics and in
      that case manifestations of illness are directly conditioned and connected with
      changes of blood vessels.

PMID- 7791682
TI  - [Echocardiographic evaluation of the effect of treatment with captopril in
      patients with essential hypertension].
AB  - Numerous antihypertensive drugs act through different mechanisms so it is natural
      to expect their various effects on consecutive myocardial changes. This study
      included 40 patients with mild or moderate hypertension: 30 patients (19 male-
      63.3% and 11 female--36.7%), their mean age 40.1 year, who were treated with
      Kaptopril (Zorkaptil), and 10 patients (6 female--60% and 4 male--40%), their
      mean age 37.7 years, who received placebo. Before the beginning of the treatment
      and three months later the following data were analyzed: blood pressure, the left
      ventricular mass, the left ventricular mass index, shortening fraction, ejection
      fraction and the endsystolic left wall stress. Three months later in the group
      treated with Kaptopril significant reduction of blood pressure, left ventricular
      mass, left ventricular mass index and endsystolic left wall stress (p < 0.05) was
      found. The changes concerning ejection fraction and shortening fraction were not
      significant. Three months later, in the group which received placebo no changes
      could be found. It can be concluded that Kaptopril is an effective
      antihypertensive drug for treating some cases of mild and moderate hypertension
      as monotherapy not only because it control the blood pressure, but also because
      it significantly reduces the wall thickness of the left ventricular mass and of
      the endsystolic left wall stress.

PMID- 7791680
TI  - [Chronic atrophic gastritis as a precursor to gastric carcinoma].
AB  - According to clinical and histological researches, a conclusion can be accepted
      that the chronic atrophic gastritis is a very serious precancerous condition of
      stomach. Biological key and connection between these two entities seemed to be
      intestinal metaplasia, but it has been suggested lately, that the dysplasia of
      gastric mucose was responsible for malignant proliferation in stomach mucose. The
      aim of this study was to determine the precancerous potential of the chronic
      atrophic gastritis, measuring the frequency of dysplasia of gastric mucose, type
      II and III, which are considered as precancerous lesions. The results (according
      to t-test) in the tested group (61 patient with histologically proved chronic
      atrophic gastritis) comparing to the control group (64 healthy persons), showed
      statistically highly significant difference in appearance of dysplasia of gastric
      mucose type II and III. It confirms high precancerous potential of the chronic
      atrophic gastritis and the need for frequent endoscopic and histologic
      examinations of these patients.

PMID- 7791676
TI  - [Treatment of retinal detachment with a giant rupture].
AB  - Results of surgical treatment in 29 cases of retinal detachment caused by giant
      tear have been reviewed. Two patients have been operated on by scleral buckling
      procedure, whereas in 27 cases vitreoretinal surgery in combination with silicone
      oil tamponade has been performed. Anatomic success was achieved in 20 of 29 eyes.
      After a follow-up period of 6 to 36 months 20 eyes (69%) had visual acuity equal
      to or better than 0.3. Silicone oil has been successfully evacuated out of 14
      eyes with retina remaining attached.

PMID- 7791681
TI  - [Types of atherosclerotic changes in relation to the type of residual lumen and
      degree of narrowing in coronary arteries in ischemic heart disease].
AB  - 510 segments of all three coronary arteries in 50 obduction cases of individuals
      suffering from ischemic (coronary) heart disease were microscopically examined.
      We examined the type of atherosclerotic change, the degree of narrowness of lumen
      artery and the type of residual lumen. In the group one of the narrowness of
      artery lumen 44 segments with fibrotic plaque were found, where concentric shape
      of lumen dominates. In the group two of the narrowness 176 segments were found.
      Most of them were with fibrotic plaque, but complicated atherosclerotic lesions
      were also present. According to the shape of residual lumen the concentric narrow
      shape dominates. In the group three of the narrowness of the lumen 191 segments
      were found; considering the type of atherosclerotic change complicated lesions
      were most common, while lipidic plaque was also present. An eccentric shape of
      residual lumen dominates this group. In the group four of the narrowness of lumen
      artery 99 segments were found; in this group we found fibrotic plaque and
      complicated atherosclerotic lesions. The most common finding of the residual
      lumen is the type of multiple lumen (channelled thrombi).

PMID- 7791685
TI  - [Surgical and prosthetic reconstruction of post-tumor defects of the face (case
      report)].
AB  - This paper shows a combination of methods in treatment of a facial post tumorous
      defect. Simultaneous surgical and prosthetic reconstruction was used when
      treating ablation of the facial basal cell carcinoma in a 70 year old female
      patient. When planning this surgery the next must be taken into consideration:
      the age of the patient, general health condition and the size and type of the
      defect, especially of the bone structures. It means that collaboration between
      the surgeon and prosthetic is of great importance. In this way a very fast facial
      rejuvenation can be achieved, even in large defects which enables not only
      healing but further social rehabilitation of such patients too.

PMID- 7791684
TI  - [Analysis of causes and sequelae of highway accidents in the region of Nis].
AB  - During the last five years there were 12,556 traffic accidents; there were
      injured persons in 2753 accidents which makes 21.9% (225 killed, 598 seriously
      and 210 lightly injured). Among the killed victims motor vehicle drivers are
      dominant, among the seriously injured are pedestrians and travellers are dominant
      in the group of lightly injured. In these accidents 404 children were injured,
      mostly 8-11 years of age. In most cases causes of death are polytrauma and
      craniocerebral injuries. The most frequent causes of traffic accidents resulting
      injured persons are: traffic regulations not being respected, bad psychophysical
      state of drivers and vehicle technical defects. The first two reasons are causes
      of serious traffic accidents. It has been established that weather conditions
      influence the occurrence and seriousness of traffic accidents, so that this area
      is characterized by a maximal number of accidents and injured persons during the
      period May--August.

PMID- 7791686
TI  - [Case report of a patient with Pott's disease].
AB  - The author presents a case of tuberculosis inflammation of thoracic vertebra with
      cold abcess along the spinal column, Pott's disease, in a woman 42 years old, a
      worker, with subjective difficulties which had lasted over a year before the
      diagnosis was made. TBC lungs and other localities was in regression in the last
      30 year, it was even thought overhauled. But in recent times because of great
      migrations of the population and the fall of personal and social standards growth
      of new cases as well as revival of the old ones has been observed. Hard cases of
      lung tuberculosis in the first place and then of other localities have been
      diagnosed sporadically since fluorography has not been done for a longer time due
      to wellknown reasons. The reasons for making diagnoses in the terminal phase of
      the shown case are the instilled manner and opinion of the physicians belonging
      to previous peaceful times that tuberculosis has been overhauled, so that now
      many of them react inertly about this disease. The author wants this review to be
      seen inside the actual conditions of life, work, nutrition, hygiene, health care
      possibilities and health care.

PMID- 7791683
TI  - [Mortality in laryngeal cancer in Belgrade 1982-1991].
AB  - The paper reviews data on mortality caused by larynx cancer in Belgrade from 1982
      to 1991. The gathered results indicate that larynx cancer was the cause of death
      in 2.01% on average of all deceased of all kinds of malignant tumors (3.17%, male
      0.67% female), while it makes 8.18% of the deceased of malignant tumors of the
      respiratory tract (9.5% male, 5.21% female). The standardized mortality rates
      during the 10 year period occurred in 1.84 to 3.05 cases per 100,000 inhabitants
      (2.60%/100000 average). In males the rates were from 3.65 to 6.01%/100000
      (4.91%/100000 average) and in females from 0.32 to 1.13%/100000 (0.69%/100000
      average). The specific mortality rates according to age were extremely low up to
      the age of 44, then an abrupt increase happens, while the occurrence of the
      highest values is present in the oldest group. The mortality trend concerning
      larynx cancer during the ten year period points to the fact that there is a
      slight decrease as well in males (y = 5.02-0.02x) as in females (y = 1.06-0.07x).

PMID- 7791687
TI  - [Dr. Ante Sokcic on the 55th anniversary of the founding of the
      otorhinolaryngology department in Subotica].

PMID- 7791689
TI  - Time-frequency spectral analysis of electric field plethysmography signals.
AB  - Cardiac activity contaminates respiratory electric field plethysmography (EFPG)
      signals, and vice versa, and is usually treated as an artefact. On the other
      hand, simultaneous information on respiration and cardiac activity is often
      required in clinical practice. Hence, we use time-frequency spectral analysis
      (TFSA) by means of the spectrogram (SG) to investigate the instantaneous cardio
      respiratory information contained in EFPG-signals and show that it is a practical
      means of extracting this information out of a single EFPG-signal. Comparisons
      with a Wigner distribution reveal sufficient time-frequency resolution of the SG
      for detection of physiological events in EFPG-signals. SG-analysis indicates
      spectral peaks related to respiration and cardiac activity (depending on the
      electrode configuration, up to the third and fifth harmonic, respectively) and
      the possibility to detect respiratory sinus arrhythmia by means of EFPG
      measurements. Intermodulation products cause overlaps of respiratory and cardiac
      spectra pointing out nonlinear relationships. Additionally, SG-analysis supplies
      essential information for the separation of EFPG-signals into respiratory and
      cardiac components, by means of filter techniques.

PMID- 7791690
TI  - Electrical impedance for estimation of irritation in oral mucosa and skin.
AB  - Our aim is to establish an objective, easy-to-use technique to evaluate tissue
      irritation in vivo using non-invasive electrical impedance measurements. Such a
      technique would facilitate testing the biocompatibility of various materials, and
      also in quantifying skin diseases and other processes involving structural
      changes. It has been found that irritation of the oral mucosa not clinically or
      histologically discernible could be detected with a simple device based on
      electrical impedance techniques. Originally, the key problem was to focus the
      probing electrical field in order to minimize artefacts emanating from tissue
      layers of no interest. The device was then refined and applied to skin testing.
      It was found that irritation effects far below the limit of the commonly used
      visual readings could be detected. In this case, it is desirable to exclude from
      the measurement tissue layers with no diagnostic information, or at least reduce
      their influence. In this paper, the essential steps of the development of a multi
      frequency depth selective device are reviewed.

PMID- 7791691
TI  - Color quantification in angioscopic video images.
AB  - Colors in video representations of angioscopic images are up until now described
      by an human observer. Differences in settings of the monitor and the inherent
      poor ability of the human eye to classify colors objectively results in a very
      poor intraobserver as well as interobserver variability. A PC-based method is
      described to measure colors in a video image and to present the results in a
      novel C-diagram. Results with this method for standard calibrated colors are
      given. Possible sources of error are discussed and methods to minimize these
      errors are presented.

PMID- 7791688
TI  - New aspects in electrostimulation of the heart.
AB  - The interaction of the autonomic nervous system (ANS) and the heart is
      characterized by a new interdisciplinary field known as neurocardiology which
      presents the newest strategy for electro-cardiostimulation. In this context, the
      reestablishment of chronotropy with physiological, closed-loop pacing, as well as
      the prevention and treatment of a malignant arrhythmia by ANS modulation, is of
      the highest priority. The main objective toward this goal consists of appropriate
      monitoring of the autonomic balance and stimulation, respectively, so that
      neuromodulation of the cardiac efferents can be established. The electrode, as a
      sensor and an actuator, with its interface on the cellular level becomes of
      essential importance. The electrode-myocardium interface is determined by the
      structure of the Helmholtz double layer with regard to its physical,
      electrochemical, and physiological behavior. The transportation of electrons
      across the boundary, as well as the electro-chemical reactions determining the
      biocompatibility of the interface, can be improved by the microstructure of the
      solid component by creating a fractal surface coating with titanium-nitride or
      iridium. Experimental and clinical results have demonstrated that the fractal
      structure ensures negligible polarization as well as improved detection
      performance, thus, detecting the evoked response of the myocardial cells makes it
      possible to monitor the neural response of the myocardium as a consequence of a
      superimposed chronotropic disturbance. The stimulation electrode also monitors
      the sympathetic activity extracted from intracardiac impedance measurements,
      thereby providing a new principle of rate adaptation in which the pacemaker is an
      integral part of the ANS, reestablishing normal chronotropy. Further advantages
      of the improved electrode interface performance open new aspects in the treatment
      and prevention of tachyarrhythmia, and in the follow-up of transplanted hearts
      for the prevention of the rejection processes.

PMID- 7791693
TI  - [Opening address by the chairman of the 101st Congress of the German Society of
      Internal Medicine, Wiesbaden, 23 April 1995. The future].

PMID- 7791692
TI  - The cochlear implant. A technology for the profoundly deaf.
AB  - The cochlear implant is a device that enables the profoundly deaf to hear. This
      article considers the nature of the technology, the need for rehabilitation
      programs for those who are implanted and the evidence of benefits from this
      approach. A preliminary economic assessment suggests that costs per QALY for this
      technology would be of the order of $ 14,000 for children and $ 22,000 for
      adults. Cochlear implantation appears to be superior to vibrotactile devices, and
      is an effective technology for appropriately selected persons.

PMID- 7791694
TI  - [Factitious disease caused by secret administration of the oral anticoagulant
      phenprocoumon: study of 16 personal cases].
AB  - BACKGROUND: It is frequently difficult to disclose covert ingestion of cumarins
      being the underlying cause of a bleeding disorder. PATIENTS AND METHODS: We
      report on 16 cases (15 patients) of phenprocoumon (Marcumar) abuse. All patients
      (9 females, 6 males) were admitted to the hospital because of bleeding and/or
      prolonged thromboplastin times. Analysis of phenprocoumon in the blood was
      performed by HPLC. RESULTS AND CONCLUSIONS: The clinical presentation of the
      bleeding was highly variable. Thromboplastin times ranged from < 5 to 58%. With
      the exception of two patients with hepatic dysfunctions factor V activity was
      normal. All but one patient denied the ingestion of Marcumar. One patient died
      from hemorrhage. Two types of patients emerge from our series: Type I is the
      young nurse (8 cases), type II the usually male patient formerly treated with
      phenprocoumon (5 cases). Type I patients had long medical histories and showed
      autoaggressive behavior including the artificial manipulation of disorders other
      than hemorrhage. Thromboplastin times however were within or close to the
      therapeutic range (10 to 25%). Type II patients did not simulate other diseases
      in addition to hemorrhage. Thromboplastin times were longer than in type I
      patients. In all instances discrimination between non suicidal and suicidal
      behaviour was difficult. Psychiatric consultance is indicated.

PMID- 7791695
TI  - [Diagnosis and therapy of Gaucher disease].
AB  - BACKGROUND: Since 3 years there is an effective enzyme replacement therapy for
      patients with Gaucher's disease which is the most prevalent sphingolipid storage
      disease. Also the diagnostic procedures have recently been improved. This study
      reports about the results of longterm enzyme replacement therapy and the
      diagnostic workup in 18 patients with Gaucher's disease. PATIENTS AND METHODS:
      Since June 1991, 18 patients with moderate to severe degree of Gaucher's disease
      were treated by administration of modified human glucocerebrosidase on regular
      bases in the University Hospital Dusseldorf. According to the severity of the
      disease, glucocerebrosidase infusion was performed every 2 weeks. The dosage was
      individually chosen according to the severity of the disease. RESULTS: Within 3
      to 4 months all patients showed an improvement of laboratory findings, of
      hepatosplenomegaly and of their general well-being. CONCLUSIONS: The advances in
      our understanding of this disease need to be publicized because an early
      diagnosis and timely enzyme replacement guarantees almost all patients with the
      adult type of Gaucher's disease to live a normal life without complaints and
      complications.

PMID- 7791696
TI  - [Patient with acute dyspnea and thoracic pain after sclerotherapy of esophageal
      varices].

PMID- 7791697
TI  - [Rheumatology update--II. Overview of the clinically important status of
      knowledge and prospects for possible relevant trends in etiopathogenetic
      research, diagnostic methods and therapeutic possibilities].

PMID- 7791698
TI  - [Drug therapy of acute hemorrhage from esophageal varices].

PMID- 7791699
TI  - [Factitious disease].

PMID- 7791700
TI  - [Delayed manifestation of post-hypoxic leukoencephalopathy].

PMID- 7791701
TI  - [Parotid swelling after DNCG aerosol].

PMID- 7791702
TI  - [Infantile seborrheic dermatitis].

PMID- 7791703
TI  - [Anemia of prematurity: risk factors influencing red cell transfusions].
AB  - To investigate the importance of transfusion practice with packed red cells
      (PRCs) in premature infants and to identify risk factors significant influencing
      transfusion practice, we analyzed 75 preterm infants (gestational age: 31 +/- 2
      weeks; birth weight: 1459 +/- 402 g) admitted to the neonatal intensive care unit
      of Catholic University of Rome. Fifty-three (70.7%) of the infants received one
      or more PRCs transfusions (in total 246 transfusions). The variables associated
      with an increase in number and frequency of PRCs transfusions were: a)
      gestational age < or = 30 weeks; b) birth weight < or = 1000 g; c) severe
      neonatal pathology (ie a respiratory disease requiring ventilatory support and/or
      a clearly documented or suspected sepsis). Repeated PRCs transfusions during the
      first week of life significantly (p < 0.01) influenced the need for late
      transfusions, after 4 weeks of age, for the treatment of the anemia of
      prematurity. These data indicate that preterm infants with a gestational age < or
      = 30 weeks, a birth weight < 1000 g and a severe respiratory or infectious
      disease represent natural candidates for administration of recombinant human
      erythropoietin to reduce the need for late PRCs transfusions.

PMID- 7791705
TI  - [Alpha-1 antitrypsin deficiency. A diagnostic approach and case report].
AB  - Subjects with alpha 1-antitrypsin deficiency, Pizz, are often subject to
      hepatopathies in infancy and pneumopathies in adulthood. The authors make a
      number of genetic and clinical observations together with a laboratory diagnosis
      of alpha 1-antitrypsin and describe an asymptomatic clinical case in which the
      diagnosis of alpha 1-antitrypsin in a PiZZ phenotype was made following the
      initial and occasional finding of altered transaminase and alpha 1-globulin
      values.

PMID- 7791704
TI  - [Celiac disease and cystic fibrosis: casual association?].
AB  - The authors describe a case of association cystic fibrosis coeliac disease, which
      they have observed. The frequency of this association in the general population
      is of 1:2,000,000. M.A. presents little growth in terms of height and weight and
      intestinal alterations (an abundance of fatty and mucous stool). The initial
      diagnosis was that of coeliac disease. After two months of diet without gluten
      one observed an increase in weight, but o result for the intestinal disturbances.
      The positive result revealed from the sweat-test and the study of genomic
      mutation (delta F508) showed the diagnosis of cystic fibrosis associated with
      coeliac disease. The specific treatment of both syndromes resolved intestinal
      alterations and caused the diminution of the acute bronchitis frequent during the
      first and the second infancy.

PMID- 7791708
TI  - [Williams-Beuren syndrome and celiac disease].
AB  - The authors describe a case of Williams syndrome-Coeliac Disease that they have
      observed at the age of three years and 10/12. There are few reports in the
      literature. We focus on the variability of clinical and biochemical aspects of
      Williams Disease and the necessity for an adequate gastroenterologic follow-up
      (anti-gliadine antibody and anti-endomisium antibody) in these patients with
      little growth in terms of weight and height and intestinal alterations present in
      superior measure in companion with the reported standards for the same syndrome.

PMID- 7791709
TI  - [Is it possible to speak about theoretical pediatrics?].

PMID- 7791707
TI  - [The clinical syndrome associated with antiphospholipid antibodies. A diagnosis
      to be confirmed after a long follow-up].
AB  - A clinical case of syndrome of antiphospholipid antibodies is reported. The
      patient is a 10-year-old girl with thrombophlebitis of the right leg associated
      with the presence of lupus-like anticoagulant antibodies. No secondary
      pathologies were found. It is not possible, anyway, to make a definitive
      differential diagnosis between primary and secondary forms of syndrome of
      antiphospholipid antibodies because of intermediate situations where
      antiphospholipid antibodies are associated with 2 or 3 ARA criteria for the
      diagnosis of lupus (lupus-like syndrome). A long term follow-up is therefore
      necessary.

PMID- 7791706
TI  - [Clinical and pathogenetic observation in a case of pulmonary hemosiderosis].
AB  - Pulmonary hemosiderosis is a rare disease of unknown aetiology, whose clinical,
      pathogenetic and prognostic aspects are still open to discussion. The authors
      report a case of pulmonary hemosiderosis in a 2 years and 3 months old girl.
      Peculiar features of this case include antibody deficiency (which may contribute
      to the pathogenesis of the disease) and severe and protracted melena. Fatal
      outcome, despite several therapeutic trials, confirms the poor prognosis of
      pulmonary hemosiderosis.

PMID- 7791710
TI  - [Nutritional prevention of allergies].

PMID- 7791711
TI  - [Follow-up study of pulmonary function in individuals subjected to lobectomy in
      infancy and childhood].
AB  - Experimental research in animals have demonstrated that pulmonary development
      continues after birth. This happens in man as well: alveolar proliferation and
      enlargement go on until the eighth year of age, furthermore complete pulmonary
      development is achieved until the 20-22 years of age. It is therefore possible to
      hypothesise that respiratory deficit following pulmonary exeresis in children
      would regress with time. In the Pediatric Surgery of IRCCS Policlinico S. Matteo
      of Pavia eight children, 4 days to 8 years of age, underwent lobectomy for
      pulmonary hypertensive emphysema (3), lung abscess (2), bronchogenic cysts (2)
      and hystiocytoma (1). One of them was lost to follow-up; the remainders were
      controlled from 3 to 25 years after surgery: all of them enjoy a normal active
      life. Respiratory function was evaluated through blood chemistry, blood gas
      analysis, basal and after strain ECG, chest X-ray, spirometry, basal and after
      strain pulmonary scintigraphy. Basal and after strain ECG, chest X-ray, and
      arterial blood gas were normal in every examined subjects; spirometry, although
      results are quite variable, did not show serious respiratory deficits; basal
      after strain pulmonary scintigraphies weren't homogeneous. These results,
      although they aren't univocally interpretable, positively confirmed that the
      residual lung after lobectomy has a satisfactory possibility of functional
      recovery.

PMID- 7791712
TI  - [Laparoscopic surgery in pediatric age].

PMID- 7791713
TI  - [Beta-cell secretion in patients with thalassemia major].
AB  - Diabetes mellitus is one of the main endocrinological disease complicating the
      course of thalassemia major. This study aimed evaluate beta-cell secretion in 24
      patients with thalassemia major attending the hematological Day Hospital at the
      Pediatric Clinic in Modena where transfusion therapy is performed in all
      thalassemic patients so as to maintain minimum hemoglobin levels above 10.5 g/dl,
      together with intensive ferrochelating therapy (desferrioxamine 50-60 mg/kg/die
      s.c. 6 days a week). A C peptide challenge with glucagon was performed in three
      patients already receiving insulin therapy for diabetes mellitus; this
      unexpectedly revealed a slight residual beta-cell secretion. An intravenous
      glucose tolerance test (IVGTT) was performed in the remaining 21 non-diabetic
      patients, with widely varying findings regarding insulin secretion: from below 50
      microUl/ml in 5 patients to above 200 microUl/ml in 5 patients, and between 50
      and 150 microUl/ml in the remaining 11 patients. This study therefore confirmed
      that insulin secretion frequently alters in thalassemic patients. Moreover,
      insulin secretion is not correlated to ferritinemia or influenced by familiar
      diabetes or patient age.

PMID- 7791715
TI  - [Description of two cases of Munchausen syndrome by proxy].
AB  - The Munchausen syndrome by proxy, or Polle syndrome can be considered as a form
      of child abuse in which parents falsify or even produce a real pathology in their
      children submitting them to frequent hospitalizations and pointless medical
      examinations. The authors discuss two cases and emphasize the importance of an
      early identification of these cases to avoid psychical impairments that
      inevitably stem from this "new" form of child abuse.

PMID- 7791714
TI  - [Primary response to tetanus toxoid stimulation in early infancy].
AB  - The authors attempt to evaluate the degree of immune response to the first dose
      of anti-tetanus vaccination in young infants and to study the correlation between
      maternal and infantile antitetanus antibody titers. The sample studied comprised
      5 males and 5 females aged between 61 and 75 days old, without acute and/or
      chronic pathologies and uncircumsized. Three samples of peripheral venous blood
      were collected for each infant: 1 at time 0, and the other two during the 15 days
      after the administration of the first dose of tetanus toxoid. The results support
      the hypothesis that vaccinal stimulation has a greater effect on cellular rather
      than humoral immunity, causing an increase in the CD4/CD8 ratio and a decrease in
      CD16. The study confirms that women with high antitetanus antibody titers during
      pregnancy have children with protective antibody titers. This underlines the
      importance of vaccinating pregnant women who, for various reasons, have not been
      immunised so as to prevent infantile tetanus and to allow the possibility of
      delaying, if necessary, the administration of the first dose of toxoid in infants
      without the risk of short-term toxoinfection.

PMID- 7791716
TI  - [Wolfram syndrome. Peculiar urologic aspects].
AB  - The 6-year follow-up of a patient affected by Wolfram's syndrome, a rare disease
      characterized by diabetes insipidus (DI), diabetes mellitus (DM), optic atrophy
      (OA), neurosensory deafness (D), atony of the urinary tract and other
      abnormalities (DIDMOAD or Wolfram's syndrome), is described. Our patient has
      diabetes insipidus, diabetes mellitus, abnormal audiograms, without subjective
      evidence of hearing loss, and dilatation of the urinary tract. Diagnosis was
      suspected at the age of 8 years. Diabetes mellitus was the first manifestation
      and treatment with insulin was necessary. Desmopressin therapy decreased
      dramatically the daily urinary output. In view of the significant morbidity and
      mortality from renal failure associated with recurrent urinary infections, we
      have drawn special attention to the urological manifestations of the syndrome.
      During the follow-up, the patients underwent some investigations, such as renal
      ultrasound and echotomography and cystourethroscopy. Outstanding results of these
      studies are severe bilateral hydronephrosis with dilatated ureters and loss of
      renal tissue. The particular finding is the presence of posterior urethral valves
      with obstructed bladder. The anatomical outlet obstruction are variable and may
      be disastrous. There may be failure to thrive, sepsis, anemia be disanal failure.
      In such instances corrective surgery could improve bladder and ureteral
      functions.

PMID- 7791717
TI  - [Cohen syndrome. A new case and review of the literature].
AB  - We report the case of a 12-year-old child suffering from mild mental retardation,
      hypotonia, long hands with tapering fingers, microcephaly, truncal obesity,
      particular facial features. The association of these abnormalities has been known
      as Cohen Syndrome since 1973. Such a dysmorphic syndrome is usually inherited as
      an autosomal recessive trait whose gene has not been yet localized. There is no
      biological marker and the diagnosis is made only on a clinical basis. The
      diagnosis is quite difficult because of the intrafamiliar variation and the lack
      of a symptom present in 100% of the cases. From the analysis of the literature it
      proves that the more frequent symptoms are: mental retardation, open mouth, short
      philtrum, high palate, hypotonia. Because of the diagnostic difficulties it is
      possible that this syndrome was underestimate. Moreover, it is usually diagnosed
      too late, (mean age: 12,9). Therefore, we think necessary to consider the
      possibility of Cohen Syndrome in the case of every mental retardation of unknown
      cause.

PMID- 7791718
TI  - [Seckel syndrome. Report of a case].
AB  - The paper report a case of Seckel's syndrome in a girl aged 7 years and 2 months
      who was referred to the authors attention due to abdominal colic. Low birth
      weight together with a significant delay in weight and stature increase,
      microcephalia with the typical bird head and considerable mental retardation were
      sufficient to diagnose the syndrome. Interesting analogies were observed with
      another case of a patient with Seckel's syndrome born to an epileptic mother
      receiving antiepileptic treatment which was suspended during the second month of
      gestation. In the case presented here, no drugs were taken during pregnancy
      although the mother had received antiepilepsy treatment for years.

PMID- 7791719
TI  - [Description of two cases of transient hyperphosphatasemia in infancy and
      childhood].
AB  - The authors describe two cases of benign transient hyperphosphatesamia of
      infancy. This form is not so frequent in childhood and the following criteria
      must be present for a correct diagnosis: 1) Patient age of less than 5 years. 2)
      Variable symptoms. 3) No bone or liver disease noted on physical examination. 4)
      No other biochemical or laboratory evidence for bone or liver disease. 5) A
      return to normal serum alkaline phosphatase levels within 4 months with no
      sequelae. We want underline the uselessness of vitamin D therapy and the
      importance of a deepened study about biochemical and laboratory parameters in all
      patients affected by alkaline hyperphosphatesamia, to exclude a possible severe
      disease.

PMID- 7791720
TI  - [Jejunal biopsy with Watson's capsule and erythromycin].

PMID- 7791721
TI  - Doling out risk. How capitation measures up in Minnesota.

PMID- 7791722
TI  - Is capitation right for your practice?

PMID- 7791723
TI  - Enough to raise one's blood pressure.

PMID- 7791724
TI  - Who bears the risk when physicians are also insurers?

PMID- 7791726
TI  - MinnesotaCare bills move forward.

PMID- 7791725
TI  - Celiac sprue in an asymptomatic elderly man.
AB  - The authors discuss the case of an asymptomatic patient with celiac sprue
      presenting with hematologic abnormalities on screening laboratory examination.
      The patient was initially treated for vitamin B-12 and folate deficiency, and
      subsequently for iron deficiency with limited success until the diagnosis was
      established. The absence of such classic features of celiac disease as
      steatorrhea and diarrhea is not an uncommon presentation. Unexplained iron
      deficiency should alert the clinician to the possibility of celiac sprue.

PMID- 7791727
TI  - Direct contracting can put doctors in the driver's seat.

PMID- 7791728
TI  - MMA strongly opposes Vulnerable Adults Act.

PMID- 7791730
TI  - Capitation without trepidation.

PMID- 7791729
TI  - Higher office to higher learning.

PMID- 7791731
TI  - Physician leadership: developing a physician-directed, community-based managed
      care network.

PMID- 7791732
TI  - Managed care plus (MC+): the wave of the future for Missouri Medicaid?

PMID- 7791733
TI  - Otolaryngology quiz #4. Metastatic carcinoma.

PMID- 7791734
TI  - Efficacy of thymectomy in myasthenia gravis.
AB  - We sought to determine the efficacy of thymectomy in patients with myasthenia
      gravis (MG). The roles of age, gender, age of onset of MG, acetylcholine receptor
      antibodies (AchR's) titers, and pathology of the thymus gland were evaluated.
      Twenty-one patients were analyzed retrospectively. Twenty patients belonged to
      Osserman Class IIA or higher; 71.42% belonged to IIB. All patients were on either
      anticholinesterase and/or immunosuppressive agents. The mean follow up was three
      years. Seventy-six percent of the patients showed improvement by Osserman and by
      "results of treatment" classification, 14.28% were in complete remission, on no
      medications. The age, gender, age of onset, thymic pathology and AchR titers had
      no correlation with post-operative improvement. With longer follow up the
      beneficial effect is more apparent.

PMID- 7791735
TI  - Farm-tractor-related fatalities--Kentucky, 1994.
AB  - Fatalities associated with farm tractors are the most common cause of work
      related death in the U.S. agricultural industry (1). To characterize farm-tractor
      related fatalities in Kentucky, the Kentucky Fatality Assessment and Control
      Evaluation (KY FACE) Project studied all fatal farm injuries occurring among
      persons in that state during 1994, the initial year of operation for FACE in
      Kentucky. This report summarizes the results of that study.

PMID- 7791736
TI  - Mass treatment of humans exposed to rabies--New Hampshire, 1994.
AB  - On October 22, 1994, the laboratory of the New Hampshire Division of Public
      Health Services (NHDPHS) diagnosed rabies in a kitten that had been purchased
      from a pet store in Concord, New Hampshire. On October 19, the animal had
      developed seizures, then died of unknown causes during the night of October 20
      21. Approximately 665 persons received rabies postexposure prophylaxis because of
      exposure to this kitten and other cats from the same pet store. This report
      summarizes the epidemiologic investigation of the source of the infection and
      follow-up care of humans and animals potentially exposed to rabies.

PMID- 7791737
TI  - Measles--United States, 1994.
AB  - As of June 13, 1995, local and state health departments in 39 states had reported
      958 measles cases to CDC for 1994. This represents the second lowest number of
      cases ever reported, after the historic low of 312 cases in 1993 (1). In
      addition, 303 cases were reported for the U.S. territory of Guam (228) and the
      commonwealths of the Northern Mariana Islands (29) and Puerto Rico (46). This
      report summarizes the epidemiologic characteristics of measles cases and
      outbreaks reported in the United States during 1994.

PMID- 7791738
TI  - Prevalence of smoking by area of residence--Missouri, 1989-1991.
AB  - Variation in smoking prevalence by area of residence may be an important
      consideration in the development, implementation, and management of programs that
      promote nonsmoking. In general, the prevalence of cigarette smoking is highest
      among persons at economic, educational, and social disadvantage (1,2), and the
      proportion of persons who are disadvantaged is greater in urban and
      nonmetropolitan areas. Because smoking prevalence varies by area of residence and
      characterization of these differences can assist in directing efforts to promote
      nonsmoking, the Missouri Department of Health compared urban, suburban, and
      nonmetropolitan areas using data from two sources: the Behavioral Risk Factor
      Surveillance System (BRFSS) for Missouri from 1989 through 1991 (suburban and
      nonmetropolitan areas) and a survey specially commissioned in 1990 (Smoking
      Cessation in Black Americans [SCBA]) of persons living in low-income census
      tracts in north St. Louis and central Kansas City (urban areas). This report
      summarizes the results of this analysis.

PMID- 7791739
TI  - Increase of (Ca(2+)-Mg2+)-ATPase activity in hepatic plasma membranes of rats
      administered orally calcium: the endogenous role of regucalcin.
AB  - The alteration of the plasma membrane (Ca(2+)-Mg2+)-ATPase activity in the liver
      of rats administered orally calcium chloride solution was investigated. The
      plasma membrane (Ca(2+)-Mg2+)-ATPase activity was significantly increased by a
      single oral administration of calcium (10, 25 and 50 mg/100 g body weight) in
      rats. This increase was seen between 10 and 60 min after the administration. The
      presence of anti-regucalcin IgG (1.0-5.0 micrograms/ml) in the enzyme reaction
      mixture caused a complete inhibition for the elevation of the plasma membrane
      (Ca(2+)-Mg2+)-ATPase activity by the addition of regucalcin (0.25 microM). Also,
      the calcium administration-induced increase in hepatic plasma membrane (Ca(2+)
      Mg2+)-ATPase activity was completely abolished by the presence of anti-regucalcin
      IgG (1.0 and 2.5 micrograms/ml). Moreover, the calcium administration-induced
      increase in hepatic plasma membrane (Ca(2+)-Mg2+)-ATPase activity was not
      inhibited by vanadate (0.1 and 0.2 mM) addition into the enzyme reaction mixture,
      although the inhibitory effect of vanadate was seen in the plasma membranes from
      normal rat liver. Now, the activating effect of regucalcin (0.25 microM) on
      hepatic plasma membrane (Ca(2+)-Mg2+)-ATPase was not inhibited by vanadate
      addition. The endogenous regucalcin may play a role in the calcium administration
      induced increase of (Ca(2+)-Mg2+)-ATPase activity in the liver plasma membranes
      of rats.

PMID- 7791740
TI  - In vivo effect of vitamin E on serum and tissue glycoprotein levels in
      perchloroethylene induced cytotoxicity.
AB  - The antioxidant efficacy of vitamin E on Perchloroethylene (PER) induced
      cytotoxicity has been studied in rats. Feeding PER to rats for 42 days using
      sesame oil as vehicle alters total protein and protein bound carbohydrate
      components in liver and kidney of experimental animals. Supplementation of
      vitamin E prevented the changes observed in total protein and protein bound
      carbohydrate components of PER administered rats. Histopathological studies also
      show the effectiveness of vitamin E on PER administered rats in protecting the
      cellular architecture of liver and kidney from PER induced cytotoxicity.

PMID- 7791741
TI  - Effect of ischemia-reperfusion injury on the morphology of peroxisomes.
AB  - We have previously demonstrated that ischemic injury changed the density of
      peroxisomes into two distinct peaks, one with a normal density (1.21 g/cm3; Peak
      I) and a second peak with a lighter density (1.14 g/cm3; Peak II). We studied the
      peroxisomes from both peaks under the Electron microscope. Examination of peak I
      following ischemia showed loss of matrix proteins and damaged limiting membranes
      with leakage of DAB positive material in direct proportion to the duration of
      ischemia. Upon reperfusion of the ischemic liver Peak I showed more severe damage
      to the organelle. These observations clearly demonstrated that ischemia
      reperfusion injury causes structural damage to peroxisomes. Interestingly
      ultrastructural examination of Peak II following ischemia showed evidence of
      perisomal proliferation with budding of existing peroxisomes and the presence of
      micro peroxisomes (changes similar to those noted under conditions leading to
      perisomal proliferation). However, peak II following reperfusion showed only
      damaged organelle. These observations underline the importance of peroxisomes in
      the response of the cell to ischemia-reperfusion injury.

PMID- 7791742
TI  - Potential involvement of a constitutive heat shock element binding factor in the
      regulation of chemical stress-induced hsp70 gene expression.
AB  - It was reported that chemical stresses such as arsenite, cadmium or salicylate
      fail to induce synthesis of the inducible form of HSP70 (HSP70i). We report here
      that exposure of cells to higher doses of these chemical treatments induced
      significant synthesis of HSP70i in CHO cells as well as other cell lines. The
      synthesis of HSP70i is primarily regulated at the transcriptional level. Although
      all tested chemical treatments induced heat shock factor (HSF) binding to the
      heat shock element (HSE), HSP70i synthesis appears to be regulated by an
      alternative factor (CHBF) which constitutively binds to the HSE at 37 degrees C.
      The treatments, which dissociate the HSE-CHBF complex, induced significant HSP70i
      synthesis. The treatments, which failed to induce HSP70i synthesis, still
      activated HSF binding to HSE but the HSE-CHBF complex remained as that of
      untreated control cells.

PMID- 7791743
TI  - Extracellular matrix components and proteolytic enzymes in uterine cervical
      carcinoma.
AB  - The important components of mucopolysaccharides and collagen have been analyzed
      in tissues of control and carcinoma of uterine cervix. Among these components
      hyaluronic acid and chondroitin sulphate levels were found to be increased,
      whereas decreased level of collagen was observed in uterine cervical carcinoma.
      Serum cathepsin B, D and acid and alkaline phosphatases have also been analyzed
      in controls and carcinoma patients before and after treatments. The activities of
      these enzymes have been found to increase prominently in advanced stages. Among
      these enzymes cathepsin B and alkaline phosphatase have exhibited remarkable
      increase in activity in uterine cervical carcinoma. Different modes of treatment
      exerted reversion of the elevated activities of these enzymes. However, combined
      therapy type II (radiation combined with cisplatin and cyclophosphomide) seems to
      be more effective in reverting the activities of these enzymes to normal levels.

PMID- 7791744
TI  - Expression of GTP-binding protein alpha subunits in human thymocytes.
AB  - In this report, we investigate G protein alpha subunit diversity in human
      thymocytes, utilizing common properties shared by these genes and reverse
      transcription-polymerase chain reaction (RT-PCR). Sequence analysis of PCR
      amplified gene portions, indicate the presence of members from all four G-protein
      families that have been described thus far. The alpha subunit genes identified
      are: G alpha i1-3 and G alpha z but not G alpha o from the Gi family, G alpha s
      from the Gs family, G alpha 11, G alpha q, and G alpha 16 from the Gq family, and
      G alpha 12 and G alpha 13 from the G12 family. Also in this report we present the
      nucleotide and predicted amino acid sequences of the human G alpha 13 cloned from
      a thymocyte cDNA library. The sequence of the human G alpha 13 has not been
      previously reported. Comparison of this sequence with the reported murine G alpha
      13 shows > 90% identity at the deduced amino acid sequence level. We conclude
      that thymocytes represent a useful experimental system for the study of G protein
      involvement in immune responses and lymphocyte development.

PMID- 7791745
TI  - Modulated red blood cell survival by membrane protein clustering.
AB  - Human and murine blood cells treated with ZnCl2 and
      bis(sulfosuccinimidyl)suberate (BS3) (a cross linking agent) undergo band 3
      clustering and binding of hemoglobin to red blood cell membrane proteins. These
      clusters induce autologous IgG binding and complement fixation, thus favouring
      the phagocytosis of ZnCl2/BS3 treated cells by macrophages. The extension of red
      blood cell opsonization can be easily modulated by changing the ZnCl2
      concentration in the 0.1-1.0 mM range thus providing an effective way to affect
      blood cell recognition by macrophages. In fact, murine erythrocytes treated with
      increasing ZnCl2 concentrations have proportionally reduced survivals when
      reinjected into the animal. Furthermore, the organ sequestration of ZnCl2/BS3
      treated cells strongly resembles the typical distribution of the senescent cells.
      Since the ZnCl2/BS3 treatment can also be performed on red blood cells loaded
      with drugs or other substances, this procedure is an effective drug-targeting
      system to be used for the delivery of molecules to peritoneal, liver and spleen
      macrophages.

PMID- 7791746
TI  - Na(+)-Ca2+ exchange and Ca2+ channel characteristics in bovine aorta and coronary
      artery smooth muscle sarcolemmal membranes.
AB  - Tension generation and Ca2+ flux in smooth muscle varies depending upon the
      diameter of a vessel and its location. The purpose of the present investigation
      was to determine if the biochemical characteristics of the Na(+)-Ca2+ exchanger
      and the Ca2+ channel differ in sarcolemmal membrane preparations isolated from a
      large conduit vessel (thoracic aorta) or from large and small coronary arteries.
      We also investigated the possibility of differences between sarcolemmal membranes
      isolated from coronary arteries dissected from the right and left ventricles. The
      purification of the sarcolemmal membranes was of a similar magnitude amongst the
      different groups. Contamination of the sarcolemmal membranes with other
      membranous organelles was negligible and similar amongst the groups. The Km and
      Vmax of Na(+)-dependent Ca2+ uptake in sarcolemmal vesicles was similar amongst
      the groups. Calcium channel characteristics were examined by measuring [3H] PN200
      110 binding to sarcolemmal vesicles. The right coronary artery membranes from
      both large and small caliber vessels exhibited a higher Kd and the small right
      coronary artery sarcolemmal preparation had a lower maximal binding density for
      [3H] PN200-110. The results suggest that the right coronary artery, and in
      particular the small diameter right coronary artery, possesses altered Ca2+
      channel characteristics in isolated sarcolemmal membranes.

PMID- 7791747
TI  - Oxidative stress adaptation improves postischemic ventricular recovery.
AB  - Adaptation to various forms of stress has been found to be associated with
      increased cellular tolerance to myocardial ischemia. In this study, the effects
      of myocardial adaptation to oxidative stress was examined by injecting rats with
      endotoxin (0.5 mg/kg) and its non-toxic derivative, lipid A (0.5 mg/kg). Both
      compounds exerted oxidative stress within 1 h of treatment as evidenced by
      enhanced malonaldehyde formation. The oxidative stress disappeared steadily and
      progressively with time in concert with the appearance of the induction of
      glutathione and antioxidative enzymes that included superoxide dismutase,
      catalase, glutathione peroxidase and glutathione reductase. After 24 h of
      endotoxin or lipid A treatment, the amount of oxidative stress and antioxidant
      enzyme levels were significantly lower and higher, respectively, compared to
      those at the baseline levels. Corroborating these results, both endotoxin and
      lipid A provided protection against myocardial ischemia and reperfusion injury as
      evidenced by a significantly improved postischemic recovery of left ventricular
      functions. The data presented here demonstrates that a controlled amount of
      oxidative stress induces the expression of intracellular antioxidants that can
      result in enhanced myocardial tolerance to ischemia. This suggests that
      myocardial adaptation to oxidative stress may be a potential tool for reduction
      of ischemic/reperfusion injury.

PMID- 7791748
TI  - Cisplatin induced nephrotoxicity and the modulating effect of glutathione ester.
AB  - The objective of this study was to assess the therapeutic advantage of
      glutathione ester along with cisplatin. Comparisons were made with renal reduced
      glutathione, enzymatic antioxidants, and lipid peroxidation levels. Cisplatin
      caused differential toxic effects on renal antioxidants and lipid peroxidation.
      However administration of glutathione ester modulates the toxic effects of
      cisplatin observed in renal antioxidants and lipid peroxidation. The finding that
      glutathione ester co-administration along with cisplatin is more effective and
      advantageous in protecting against the nephrotoxicity of cisplatin when it was
      given alone.

PMID- 7791749
TI  - Pathological changes of myocardial cytoskeleton in cardiomyopathic hamster.
AB  - Immunocytochemical investigation was performed on the cytoskeletal proteins in
      cardiac tissue of the cardiomyopathic hamster. Male cardiomyopathic UM-X7.1
      hamsters at 180 days of age (n = 8) and age- and sex-matched normal BIO-RB
      hamsters (n = 8) were used in this study. Immunofluorescence microscopy using
      monoclonal antibodies against desmin, alpha-actinin, titin, and vincullin was
      employed. The heart weight to body weight ratio was significantly increased in
      the heart of cardiomyopathic hamster compared with that of normal hamster. In
      cardiomyopathic hamster, the left ventricular cavity was markedly dilated. Light
      microscopically, hypertrophy and atrophy of myocytes and myocardial fibrosis were
      prominently observed in cardiomyopathic myocardium. Immunocytochemically, desmin,
      alpha-actinin and titin showed the cross striations along the myofibers in normal
      myocardium. In contrast, in cardiomyopathic myocardium, desmin was irregularly
      distributed in myocytes and the amount of desmin was increased. Loss of cross
      striations of alpha-actinin and titin were frequently observed.
      Immunofluorescence against vinculin was not significantly altered. We conclude
      that the alterations of cytoskeletal proteins in myocardial cells may relate to
      decreased myocardial function in cardiomyopathic hamster failing heart.

PMID- 7791750
TI  - Renal dopamine receptors are involved in the development of cardiac hypertrophy.
AB  - The present study examined the effect of fenoldopam, a known dopamine-1 receptor
      (DA1) agonist in order to understand its involvement in the cardiac hypertrophic
      process. Male Sprague-Dawley rats underwent abdominal aortic constriction (AB)
      with placement of a suprarenal ligature while sham operated animals served as
      controls. The AB groups showed an increase in their heart wt, left ventricular
      (LV) wt, heart wt/body wt and LV wt/body ratio. Furthermore, the length of these
      hearts, as measured from the auriculoventricular border to the apex, LV wall and
      interventricular (IV) septal thickness were increased from control levels.
      Treatment with SCH 23390, a DA1 antagonist, on the other hand, was able to
      partially regress the cardiac hypertrophic changes. All these parameters were
      also increased in control animals treated with fenoldopam (F). Such changes were
      more striking in the F+AB group which showed a significant acceleration of the
      cardiac hypertrophic process on superimposing the two  treatments. Plasma
      dopamine and renin activity were increased in all the groups as compared to
      control. These results indicate that dopamine receptors are implicated in the
      development of cardiac hypertrophy.

PMID- 7791751
TI  - Glutathione disulfide as an index of oxidative stress during postischemic
      reperfusion in isolated rat hearts.
AB  - The objectives of this study were to determine 1) whether reactive oxygen species
      generated upon postischemic reperfusion lead to oxidative stress in rat hearts,
      and 2) whether an exogenous prooxidant present in the early phase of reperfusion
      causes additional injury. Isolated buffer-perfused rat hearts were subjected to
      30 min of hypothermic no-flow ischemia followed by 30 min of reperfusion.
      Increased myocardial content of glutathione disulfide (GSSG) and increased active
      transport of GSSG were used as indices of oxidative stress. To impose a
      prooxidant load, cumene hydroperoxide (20 microM) was administered during the
      first 10 min of reperfusion to a separate group of postischemic hearts.
      Reperfusion after 30 min of hypothermic ischemia resulted in a recovery of
      myocardial ATP from 28% at end-ischemia to 50-60%, a release of 5% of total
      myocardial LDH, and an almost complete recovery of both coronary flow rate and
      left ventricular developed pressure. After 5 and 30 min of reperfusion, neither
      myocardial content of GSSG nor active transport of GSSG were increased. These
      indices were increased, however, if cumene hydroperoxide was administered during
      early reperfusion. After stopping the administration of cumene hydroperoxide,
      myocardial GSSG content returned to control values and GSH content increased,
      indicating an unimpaired glutathione reductase reaction. Despite the induction of
      oxidative stress, reperfusion with cumene hydroperoxide did not cause additional
      metabolic, structural, or functional injury when compared to reperfusion without
      cumene hydroperoxide. We conclude that reactive oxygen species generated upon
      postischemic reperfusion did not lead to oxidative stress in isolated rat hearts.
      Moreover, even a superimposed prooxidant load during early reperfusion did not
      cause additional injury.

PMID- 7791754
TI  - Human type II receptor for bone morphogenic proteins (BMPs): extension of the two
      kinase receptor model to the BMPs.
AB  - Bone morphogenic proteins (BMPs) are universal regulators of animal development.
      We report the identification and cloning of the BMP type II receptor (BMPR-II), a
      missing component of this receptor system in vertebrates. BMPR-II is a
      transmembrane serine/threonine kinase that binds BMP-2 and BMP-7 in association
      with multiple type I receptors, including BMPR-IA/Brk1, BMPR-IB, and ActR-I,
      which is also an activin type I receptor. Cloning of BMPR-II resulted from a
      strong interaction of its cytoplasmic domain with diverse transforming growth
      factor beta family type I receptor cytoplasmic domains in a yeast two-hybrid
      system. In mammalian cells, however, the interaction of BMPR-II is restricted to
      BMP type I receptors and is ligand dependent. BMPR-II binds BMP-2 and -7 on its
      own, but binding is enhanced by coexpression of type I BMP receptors. BMP-2 and
      BMP-7 can induce a transcriptional response when added to cells coexpressing ActR
      I and BMPR-II but not to cells expressing either receptor alone. The kinase
      activity of both receptors is essential for signaling. Thus, despite their
      ability to bind to type I and II receptors receptors separately, BMPs appear to
      require the cooperation of these two receptors for optimal binding and for signal
      transduction. The combinatorial nature of these receptors and their capacity to
      crosstalk with the activin receptor system may underlie the multifunctional
      nature of their ligands.

PMID- 7791753
TI  - The nerve growth factor-responsive PC12 cell line does not express the Myc
      dimerization partner Max.
AB  - Heterodimerization of Max with the nuclear oncoprotein Myc and the
      differentiation-associated proteins Mad and Mxi1 enables these factors to bind E
      box sites in DNA and control genes implicated in cell proliferation and
      differentiation. We show that in the PC12 pheochromocytoma tumor cell line,
      functional Max protein is not expressed because of the synthesis of a mutant max
      transcript. This transcript encodes a protein incapable of homo- or
      heterodimerization. Furthermore, the mutant Max protein, unlike wild-type Max, is
      incapable of repressing transcription from an E-box element. Synthesis of mutant
      max transcripts appears to be due to a homozygous chromosomal alteration within
      the max gene. Reintroduction of max into PC12 cells results in repression of E
      box-dependent transcription and a reduction in growth rate, which may explain the
      loss of Max expression either during the growth of the pheochromocytoma or in
      subsequent passage of the PC12 cell line in vitro. Finally, the ability of these
      cells to divide, differentiate, and apoptose in the absence of Max demonstrates
      for the first time that these processes can occur via Max- and possibly Myc
      independent mechanisms.

PMID- 7791752
TI  - Different roles for cyclins D1 and E in regulation of the G1-to-S transition.
AB  - Ectopic expression of cyclins D1 and E was previously shown to accelerate the
      G1/S-phase transition, indicating that both classes of G1 cyclin control an
      event(s) that is rate limiting for entry into S phase. In order to determine
      whether cyclins D1 and E control the same or two different rate-limiting events,
      we have created cell lines that express both cyclins in an inducible manner. We
      show here that ectopic expression of both cyclins E and D1 in the same cell has
      an additive effect on shortening of the G1 interval relative to expression of any
      single cyclin. In order to further explore the molecular basis for G1 cyclin
      action, we used cell lines capable of expressing cyclin D1, E, or both
      prematurely and measured the effect of cyclin expression in early G1 on
      phosphorylation of the retinoblastoma susceptibility gene product (pRb). We show
      here that while premature expression of either cyclin alone advances the G1/S
      phase transition to the same extent, premature expression of cyclin D1 leads to
      immediate appearance of hyperphosphorylated pRb, while premature expression of
      cyclin E does not. Ectopic expression of both cyclins E and D1 in the same cell
      has an additive effect on shortening of the G1 interval, while the effect on pRb
      phosphorylation is similar to the effect of cyclin D1 alone. These results
      suggest that cyclins E and D1 control two different events, both rate limiting
      for the G1/S-phase transition, and that pRb phosphorylation might be the rate
      limiting event controlled by cyclin D1.

PMID- 7791756
TI  - Yeast silencers can act as orientation-dependent gene inactivation centers that
      respond to environmental signals.
AB  - The mating-type loci located at the ends of chromosome III in Saccharomyces
      cerevisiae are transcriptionally repressed by a region-specific but sequence
      nonspecific silencing apparatus, mediated by cis-acting silencer sequences.
      Previous deletion analyses have defined the locations and organizations of the
      silencers in their normal context and have shown that they are composed of
      various combinations of replication origins and binding sites for specific DNA
      binding proteins. We have evaluated what organization of silencer sequences is
      sufficient for establishing silencing at a novel location, by inserting
      individual silencers next to the MAT locus and then assessing expression of MAT.
      The results of this analysis indicate that efficient silencing can be achieved by
      inserting either a single copy of the E silencer from HMR or multiple, tandem
      copies of either the E or I silencer from HML. These results indicate that while
      all silencers are functionally equivalent, they have different efficiencies; HMR
      E is more active than HML E, which itself is more active than HML I. Both HMR E
      and HML E exhibit orientation-dependent silencing, and the particular
      organization of binding elements within the silencer domain is critical for
      function. In some situations, silencing of MAT is conditional: complete silencing
      is obtained when cells are grown on glucose, and complete derepression occurs
      when cells are shifted to a nonfermentable carbon source, a process mediated in
      part by the RAS/cyclic AMP signaling pathway. Finally, the E silencer from HMR is
      able to reestablish repression immediately upon a shift back to glucose, while
      the silencers from HML exhibit a long lag in reestablishing repression, thus
      indicating distinctions between the two silencers in their reestablishment
      capacities. These results demonstrate that silencers can serve as nonspecific
      gene inactivation centers and that the attendant silencing can be rendered
      responsive to potential developmental cues.

PMID- 7791755
TI  - Identification of a mouse protein whose homolog in Saccharomyces cerevisiae is a
      component of the CCR4 transcriptional regulatory complex.
AB  - The CCR4 protein from Saccharomyces cerevisiae is a component of a multisubunit
      complex that is required for the regulation of a number of genes in yeast cells.
      We report here the identification of a mouse protein (mCAF1 [mouse CCR4
      associated factor 1]) which is capable of interacting with and binding to the
      yeast CCR4 protein. The mCAF1 protein was shown to have significant similarity to
      proteins from humans, Caenorhabditis elegans, Arabidopsis thaliana, and S.
      cerevisiae. The yeast gene (yCAF1) had been previously cloned as the POP2 gene,
      which is required for expression of several genes. Both yCAF1 (POP2) and the C.
      elegans homolog of CAF1 were shown to genetically interact with CCR4 in vivo, and
      yCAF1 (POP2) physically associated with CCR4. Disruption of the CAF1 (POP2) gene
      in yeast cells gave phenotypes and defects in transcription similar to those
      observed with disruptions of CCR4, including the ability to suppress spt10
      enhanced ADH2 expression. In addition, yCAF1 (POP2) when fused to LexA was
      capable of activating transcription. mCAF1 could also activate transcription when
      fused to LexA and could functionally substitute for yCAF1 in allowing ADH2
      expression in an spt10 mutant background. These data imply that CAF1 is a
      component of the CCR4 protein complex and that this complex has retained
      evolutionarily conserved functions important to eukaryotic transcription.

PMID- 7791758
TI  - Inhibition of cellular proliferation by the Wilms' tumor suppressor WT1 is
      associated with suppression of insulin-like growth factor I receptor gene
      expression.
AB  - We have investigated the regulation of the insulin-like growth factor I receptor
      (IGF-I-R) gene promoter by the Wilms' tumor suppressor WT1 in intact cells. The
      levels of endogenous IGF-I-R mRNA and the activity of IGF-I-R gene promoter
      fragments in luciferase reporter constructs were found to be significantly higher
      in G401 cells (a Wilms' tumor-derived cell line lacking detectable WT1 mRNA) than
      in 293 cells (a human embryonic kidney cell line which expresses significant
      levels of WT1 mRNA). To study whether WT1 could suppress the expression of the
      endogenous IGF-I-R gene, WT1-negative G401 cells were stably transfected with a
      WT1 expression vector. Expression of WT1 mRNA in G401 cells resulted in a
      significant decrease in the rate of cellular proliferation, which was associated
      with a reduction in the levels of IGF-I-R mRNA, promoter activity, and ligand
      binding and with a reduction in IGF-I-stimulated cellular proliferation,
      thymidine incorporation, and anchorage-independent growth. These data suggest
      that a major aspect of the action of the WT1 tumor suppressor is the repression
      of IGF-I-R gene expression.

PMID- 7791757
TI  - Myristoylation and differential palmitoylation of the HCK protein-tyrosine
      kinases govern their attachment to membranes and association with caveolae.
AB  - The human proto-oncogene HCK encodes two versions of a protein-tyrosine kinase,
      with molecular weights of 59,000 (p59hck) and 61,000 (p61hck). The two proteins
      arise from a single mRNA by alternative initiations of translation. In this
      study, we explored the functions of these proteins by determining their locations
      within cells and by characterizing lipid modifications required for the proteins
      to reach those locations. We found that p59hck is entirely associated with
      cellular membranes, including the organelles known as caveolae; in contrast, only
      a portion of p61hck is situated on membranes, and none is detectable in
      preparations of caveolae. These distinctions can be attributed to differential
      modification of the two HCK proteins with fatty acids. Both proteins are at least
      in part myristoylated, p59hck more so than p61hck. In addition, however, p59hck
      is palmitoylated on cysteine 3 in the protein. Palmitoylation of the protein
      requires prior myristoylation and, in turn, is required for targeting to
      caveolae. These findings are in accord with recent reports for other members of
      the SRC family of protein-tyrosine kinases. Taken together, the results suggest
      that HCK and several of its relatives may participate in the functions of
      caveolae, which apparently include the transduction of signals across the plasma
      membrane to the interior of the cell.

PMID- 7791760
TI  - A role for mitogen-activated protein kinase in mediating activation of the
      glycoprotein hormone alpha-subunit promoter by gonadotropin-releasing hormone.
AB  - Gonadotropin-releasing hormone (GnRH) interacts with a G protein-coupled receptor
      and increases the transcription of the glycoprotein hormone alpha-subunit gene.
      We have explored the possibility that mitogen-activated protein kinase (MAPK)
      plays a role in mediating GnRH effects on transcription. Activation of the MAPK
      cascade by an expression vector for a constitutively active form of the Raf-1
      kinase led to stimulation of the alpha-subunit promoter in a concentration
      dependent manner. GnRH treatment was found to increase the phosphorylation of
      tyrosine residues of MAPK and to increase MAPK activity, as determined by an
      immune complex kinase assay. A reporter gene assay using the MAPK-responsive,
      carboxy-terminal domain of the Elk1 transcription factor was also consistent with
      GnRH-induced activation of MAPK. Interference with the MAPK pathway by expression
      vectors for kinase-defective MAPKs or vectors encoding MAPK phosphatases reduced
      the transcription-stimulating effects of GnRH. The DNA sequences which are
      required for responses to GnRH include an Ets factor-binding site. An expression
      vector for a dominant negative form of Ets-2 was able to reduce GnRH effects on
      expression of the alpha-subunit gene. These findings provide evidence that GnRH
      treatment leads to activation of the MAPK cascade in gonadotropes and that
      activation of MAPK contributes to stimulation of the alpha-subunit promoter. It
      is likely that an Ets factor serves as a downstream transcriptional effector of
      MAPK in this system.

PMID- 7791759
TI  - Overexpression of RelA in transgenic mouse thymocytes: specific increase in
      levels of the inhibitor protein I kappa B alpha.
AB  - RelA (p65) is one of the strongest activators of the Rel/NF-kappa B family. As a
      first step to elucidate the mechanisms that regulate its activity in vivo, we
      have generated transgenic mice overexpressing RelA in the thymus. Although the
      levels of RelA were significantly increased in thymocytes of transgenic mice, the
      overall NF-kappa B-binding activity in unstimulated cells was not augmented
      compared with that in control thymocytes. This could be explained by the dramatic
      increase of endogenous I kappa B alpha levels observed in RelA-overexpressing
      cells in both cytoplasmic and nuclear compartments. The ikba mRNA levels were not
      augmented by overexpressed RelA, but I kappa B alpha inhibitor was found to be
      stabilized through association with RelA. Although a fraction of RelA was
      associated with cytoplasmic p105, no changes in the precursor levels were
      observed. Upon stimulation of RelA-overexpressing thymocytes with phorbol 12
      myristate 13-acetate and lectin (phytohemaglutinin), different kappa B-binding
      complexes, including RelA homodimers, were partially released from I kappa B
      alpha. Association of RelA with I kappa B alpha prevented complete degradation of
      the inhibitor. No effect of phorbol 12-myristate 13-acetate-lectin treatment was
      detected on RelA associated with p105. Our data indicate that cytoplasmic
      retention of overexpressed RelA by I kappa B alpha is the major in vivo mechanism
      controlling the potential excess of NF-kappa B activity in long-term RelA
      overexpressing thymocytes.

PMID- 7791761
TI  - Activation of retinoid X receptors induces apoptosis in HL-60 cell lines.
AB  - Retinoids induce myeloblastic leukemia (HL-60) cells to differentiate into
      granulocytes, which subsequently die by apoptosis. Retinoid action is mediated
      through at least two classes of nuclear receptors: retinoic acid receptors, which
      bind both all-trans retinoic acid and 9-cis retinoic acid, and retinoid X
      receptors, which bind only 9-cis retinoic acid. Using receptor-selective
      synthetic retinoids and HL-60 cell sublines with different retinoid
      responsiveness, we have investigated the contribution that each class of
      receptors makes to the processes of cellular differentiation and death. Our
      results demonstrate that ligand activation of retinoic acid receptors is
      sufficient to induce differentiation, whereas ligand activation of retinoid X
      receptors is essential for the induction of apoptosis in HL-60 cell lines.

PMID- 7791763
TI  - Molecular cloning of an amphibian insulin receptor substrate 1-like cDNA and
      involvement of phosphatidylinositol 3-kinase in insulin-induced Xenopus oocyte
      maturation.
AB  - An insulin receptor substrate 1 (IRS-1)-like cDNA was isolated from a Xenopus
      ovary cDNA library by low-stringency hybridization using rat IRS-1 cDNA as a
      probe. The deduced amino acid sequence encoded by this cDNA (termed XIRS-L) is
      67% identical (77% similar) to that of rat IRS-1. Significantly, all the insulin
      induced tyrosine phosphorylation sites identified in rat IRS-1, including those
      responsible for binding to the Src homology domains of phosphatidylinositol (PI)
      3-kinase, Syp and Grb2, are conserved in XIRS-L. Both mRNA and protein
      corresponding to the cloned XIRS-L can be detected in immature Xenopus oocytes.
      Recombinant XIRS-L protein produced in insect cells or a bacterial glutathione S
      transferase fusion protein containing the putative PI 3-kinase binding site can
      be phosphorylated in vitro by purified insulin receptor kinase (IRK) domain, and
      the IRK-catalyzed phosphorylation renders both proteins capable of binding PI 3
      kinase in Xenopus oocyte lysates. Another glutathione S-transferase fusion
      protein containing the C terminus of XIRS-L and including several putative
      tyrosine phosphorylation sites is also phosphorylated by IRK in vitro, but it
      failed to bind PI 3-kinase. Insulin stimulation of immature Xenopus oocytes
      activates PI 3-kinase in vivo [as indicated by an elevation of PI(3,4)P2 and
      PI(3,4,5)P3] as well as oocyte maturation (as indicated by germinal vesicle
      breakdown). Pretreatment of these oocytes with wortmannin inhibited insulin
      induced activation of PI 3-kinase in vivo. The same treatment also abolished
      insulin-induced, but not progesterone-induced, germinal vesicle breakdown. These
      results (i) identify an IRS-1-like molecule in immature Xenopus oocytes,
      suggesting that the use of IRS-1-like Scr homology 2 domain-docking proteins in
      signal transduction is conserved in vertebrates, and (ii) strongly implicate PI 3
      kinase as an essential effector of insulin-induced oocyte maturation.

PMID- 7791764
TI  - Interactions of Cbl with Grb2 and phosphatidylinositol 3'-kinase in activated
      Jurkat cells.
AB  - T-cell receptor (TCR) cross-linking increases tyrosine phosphorylation of
      multiple proteins, only a few of which have been identified. One of the most
      rapidly tyrosine-phosphorylated polypeptides is the 120-kDa product of the proto
      oncogene c-cbl, a cytosolic and cytoskeletal protein containing multiple proline
      rich motifs that are potential binding sites for proteins containing Src homology
      3 (SH3) domains. We report here that in cultured Jurkat T cells, Cbl is
      coprecipitated with antibody against the adapter protein Grb2. Upon activation of
      Jurkat T cells via the TCR-CD3 complex, we find that high-affinity binding of Cbl
      requires the N-terminal SH3 domain of GST-Grb2 fusion protein but after cross
      linking of the TCR-CD3 and CD4 receptors, Cbl binds equally to its SH2 domain.
      Grb2 antisera also precipitated p85 from serum-starved cells, while TCR
      activation increased p85 and tyrosine-phosphorylated Cbl but not Cbl protein in
      Grb2 immunocomplexes. Phosphatidylinositol (PI) 3-kinase activity was
      immunoprecipitated from serum-starved cells with Cbl and to a lesser extent with
      Grb2 antisera, and TCR cross-linking increased this activity severalfold. The PI
      3-kinase activity associated with Cbl amounted to 5 to 10% of the total cellular
      activity that could be precipitated by p85 antisera. The Ras exchange factor Son
      of-sevenless 1 (Sos-1) was not found in anti-Cbl immunoprecipitates from
      activated cells, and Cbl was not detectable in anti-Sos-1 precipitates,
      supporting the likelihood that Sos-Grb2 and Cbl-Grb2 are present as distinct
      complexes. Taken together, these data suggest that Cbl function in Jurkat T cells
      involves its constitutive association with Grb2 and its recruitment of PI 3
      kinase in response to TCR activation.

PMID- 7791765
TI  - Differentiation-regulated serine phosphorylation of STAT1 promotes GAF activation
      in macrophages.
AB  - Gamma interferon (IFN-gamma), a macrophage-activating cytokine, modulates gene
      expression through the activity of a transcription factor designated IFN-gamma
      activation factor (GAF). GAF is formed after phosphorylation on tyrosine and
      dimerization of the 91-kDa protein STAT1. We have recently reported that
      differentiation of the promonocytic cell line U937 into monocytes increases the
      amount of cellular GAF after IFN-gamma treatment and at the same time increases
      the phosphorylation of STAT1. Here we show that activation of the JAK family
      kinases, which are instrumental in mediating STAT1 phosphorylation on tyrosine,
      did not increase upon monocytic U937 differentiation. Consistent with this
      finding, levels of STAT1 tyrosine phosphorylation were virtually identical in
      promonocytic and monocytic U937 cells. Analysis of STAT1 phosphoamino acids and
      mapping of phosphopeptides showed an IFN-gamma-dependent increase in Ser
      phosphorylation in differentiated cells. Analyses of STAT1 isoforms by two
      dimensional gel electrophoresis demonstrated a differentiation-induced shift
      toward more acidic isoforms. All isoforms were equally sensitive to subsequent
      tyrosine phosphorylation, as indicated by a sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis mobility shift typical for tyrosine-phosphorylated STAT1.
      Consistent with the importance of Ser phosphorylation for high-affinity binding
      to the IFN-gamma activation site sequence, phosphatase 2A treatment strongly
      reduced the formation of IFN-gamma activation site-GAF complexes in an
      electrophoretic mobility shift assay. Our data indicate that the activity of GAF
      is modulated by STAT1 serine kinases/phosphatases and suggest that this mechanism
      is employed in the developmental control of macrophage responsiveness to IFN
      gamma.

PMID- 7791762
TI  - Differential roles of two tandem E2F sites in repression of the human p107
      promoter by retinoblastoma and p107 proteins.
AB  - Although many lines of evidence indicate that the cellular protein p107 is
      closely related to the retinoblastoma protein, the exact function of the p107
      gene and its regulation are presently not known. To investigate the molecular
      mechanism controlling expression of the human p107 gene, a 5' flanking sequence
      of this gene was isolated and shown to promote high-level expression of a
      luciferase reporter gene in cycling human 293 and Saos-2 cells. Sequencing and
      transcription mapping analyses showed that the human p107 promoter is TATA-less
      and contains a tandem, direct repeat of E2F-binding sites, with the 3' copy
      overlapping the major transcription initiation site. Deletion analysis of the
      p107 promoter showed that a promoter DNA fragment containing only the two E2F
      sites together with the leader sequence could direct relatively efficient
      expression in 293 cells. Site-directed mutagenesis of these E2F sites revealed
      that although both sites were important for p107 promoter activity, mutation on
      the proximal, initiation site copy of the E2F site showed a stronger effect. The
      human p107 promoter could be repressed by the retinoblastoma protein and its own
      gene product. Interestingly, the repression was found to be mediated through the
      5' copy of the E2F site. These studies demonstrate for the first time
      differential roles of two tandem E2F sites in promoter regulation.

PMID- 7791766
TI  - Interaction of the CCAAT displacement protein with shared regulatory elements
      required for transcription of paired histone genes.
AB  - The H2A and H2B genes of the Xenopus xlh3 histone gene cluster are transcribed in
      opposite directions from initiation points located approximately 235 bp apart.
      The close proximity of these genes to one another suggests that their expression
      may be controlled by either a single bidirectional promoter or by separate
      promoters. Our analysis of the transcription of histone gene pairs containing
      deletions and site-specific mutations of intergenic DNA revealed that both
      promoters are distinct but that they overlap physically and share multiple
      regulatory elements, providing a possible basis for the coordinate regulation of
      their in vivo activities. Using the intergenic DNA fragment as a probe and
      extracts from mammalian and amphibian cells, we observed the formation of a
      specific complex containing the CCAAT displacement protein (CDP). The formation
      of the CDP-containing complex was not strictly dependent on any single element in
      the intergenic region but instead required the presence of at least two of the
      three CCAAT motifs. Interestingly, similar CDP-containing complexes were formed
      on the promoters from the three other histone genes. The binding of CDP to
      histone gene promoters may contribute to the coordination of their activities
      during the cell cycle and early development.

PMID- 7791769
TI  - Repression of activator-mediated transcription by herpes simplex virus ICP4 via a
      mechanism involving interactions with the basal transcription factors TATA
      binding protein and TFIIB.
AB  - Infected-cell polypeptide 4 (ICP4) of herpes simplex virus is both a
      transcriptional activator and a repressor. It has been previously demonstrated
      that both SP1-activated transcription and USF-activated transcription are
      repressed by ICP4 without affecting basal transcription (B. Gu, R. Rivera
      Gonzalez, C. A. Smith, and N. A. DeLuca, Proc. Natl. Acad. Sci. USA 90:9528-9532,
      1993; R. Rivera-Gonzalez, A. N. Imbalzano, B. Gu, and N.A. DeLuca, Virology
      202:550-564, 1994). In this study, it was found that ICP4 repressed the
      activation function of two other activators, VP16 and ICP4 itself, in vitro. ICP4
      inhibited transcription by interfering with the formation of transcription
      initiation complexes without affecting transcription elongation. Repression of
      activator function required that an ICP4 DNA binding site was present in one
      orientation within approximately 45 bp 3' to the TATA box. DNA binding by ICP4
      was necessary but not sufficient for repression. ICP4 has been shown to form
      tripartite complexes cooperatively with the TATA box-binding protein and TFIIB on
      DNA containing an ICP4 binding site and a TATA box (C. A. Smith, P. Bates, R.
      Rivera-Gonzalez, B. Gu, and N. DeLuca, J. Virol. 67:4676-4687, 1993). A region of
      ICP4 that enables the molecule to form tripartite complexes was also required in
      addition to the DNA binding domain for efficient repression. Moreover, repression
      was observed only when the ICP4 binding site was in a position that resulted in
      the formation of tripartite complexes. Together, the data suggest that ICP4
      represses transcription by binding to DNA in a precise way so that it may
      interact with the basal transcription complex and inhibit some general step
      involved in the function of activators. The steps or interactions involved in
      transcriptional activation that are inhibited by ICP4 are discussed.

PMID- 7791768
TI  - Disturbance of normal cell cycle progression enhances the establishment of
      transcriptional silencing in Saccharomyces cerevisiae.
AB  - Previous studies have indicated that mutation of RAP1 (rap1s) or of the HMR-E
      silencer ARS consensus element leads to metastable repression of HMR. A number of
      extragenic suppressor mutations (sds, suppressors of defective silencing) that
      increase the fraction of repressed cells in rap1s hmr delta A strains have been
      identified. Here we report the cloning of three SDS genes. SDS11 is identical to
      SWI6, a transcriptional regulator of genes required for DNA replication and of
      cyclin genes. SDS12 is identical to RNR1, which encodes a subunit of
      ribonucleotide reductase. SDS15 is identical to CIN8, whose product is required
      for spindle formation. We propose that mutations in these genes improve the
      establishment of silencing by interfering with normal cell cycle progression. In
      support of this idea, we show that exposure to hydroxyurea, which increases the
      length of S phase, also restores silencing in rap1s hmr delta A strains.
      Mutations in different cyclin genes (CLN3, CLB5, and CLB2) and two cell cycle
      transcriptional regulators (SWI4 and MBP1) also suppress the silencing defect at
      HMR. The effect of these cell cycle regulators is not specific to the rap1s or
      hmr delta A mutation, since swi6, swi4, and clb5 mutations also suppress
      mutations in SIR1, another gene implicated in the establishment of silencing.
      Several mutations also improve the efficiency of telomeric silencing in wild-type
      strains, further demonstrating that disturbance of the cell cycle has a general
      effect on position effect repression in Saccharomyces cerevisiae. We suggest
      several possible models to explain this phenomenon.

PMID- 7791767
TI  - Functional mRNA can be generated by RNA polymerase III.
AB  - Eukaryotic cellular mRNA is believed to be synthesized exclusively by RNA
      polymerase II (pol II), whereas pol I produces long rRNAs and pol III produces 5S
      rRNA, tRNA, and other small RNAs. To determine whether this functional
      differentiation is obligatory, we examined the translational potential of an
      artificial pol III transcript. The coding region of the human immunodeficiency
      virus type 1 tat gene was placed under the control of a strong pol III promoter
      from the adenovirus type 2 VA RNAI gene. The resultant chimera, pVA-Tat, was
      transcribed accurately in vivo and in vitro and gave rise to Tat protein, which
      transactivated a human immunodeficiency virus-driven chloramphenicol
      acetyltransferase reporter construct in transfected HeLa cells. pol III-specific
      mutations down-regulated VA-Tat RNA production in vivo and in vitro and
      dramatically reduced chloramphenicol acetyltransferase transactivation. As
      expected for a pol III transcript, VA-Tat RNA was not detectably capped at its 5'
      end or polyadenylated at its 3' end, but, like mRNA, it was associated with
      polysomes in a salt-stable manner. Mutational analysis of a short open reading
      frame upstream of the Tat-coding sequence implicates scanning in the initiation
      of VA-Tat RNA translation despite the absence of a cap. In comparison with tat
      mRNA generated by pol II, VA-Tat RNA was present on smaller polysomes and was
      apparently translated less efficiently, which is consistent with a relatively low
      initiation rate. Evidently, human cells are capable of utilizing pol III
      transcripts as functional mRNAs, and neither a cap nor a poly(A) tail is
      essential for translation, although they may be stimulatory. These findings raise
      the possibility that some cellular mRNAs are made by pol I or pol III.

PMID- 7791770
TI  - Specificity of Rel-inhibitor interactions in Drosophila embryos.
AB  - The Rel family of transcription factors participate in a diverse array of
      processes, including acute responses to injury and infection, lymphocyte
      differentiation, and embryonic patterning. These proteins show homology in an
      extended region spanning about 300 amino acids (the Rel homology domain [RHD]).
      The RHD mediates both DNA binding and interactions with a family of inhibitor
      proteins, including I kappa B alpha and cactus. Previous studies have shown that
      an N-terminal region of the RHD (containing the sequence motif RXXRXRXXC) is
      important for DNA binding, while the C-terminal nuclear localization sequence is
      important for inhibitor interactions. Here we present a structure-function
      analysis of the Drosophila dorsal RHD. These studies identify another sequence
      within the RHD (region I) that is essential for inhibitor interactions. There is
      a tight correlation between the conservation of region I sequences and the
      specificity of Rel-inhibitor interactions in both flies and mammals. Point
      mutations in the region I sequence can uncouple DNA binding and inhibitor
      interactions in vitro. The phenotypes associated with the expression of a
      modified dorsal protein in transgenic Drosophila embryos suggest a similar
      uncoupling in vivo. Recent crystallographic studies suggest that the region I
      sequence and the nuclear localization sequence might form a composite surface
      which interacts with inhibitor proteins.

PMID- 7791771
TI  - Inhibition of G-protein signaling by dominant gain-of-function mutations in
      Sst2p, a pheromone desensitization factor in Saccharomyces cerevisiae.
AB  - Genetic analysis of cell-cell signaling in Saccharomyces cerevisiae has led to
      the identification of a novel factor, known as Sst2p, that promotes recovery
      after pheromone-induced growth arrest (R. K. Chan and C. A. Otte, Mol. Cell.
      Biol. 2:11-20, 1982). Loss-of-function mutations lead to increased pheromone
      sensitivity, but this phenotype is partially suppressed by overexpression of the
      G protein alpha subunit gene (GPA1). Suppression is allele specific, however,
      suggesting that there is direct interaction between the two gene products. To
      test this model directly, we isolated and characterized several dominant gain-of
      function mutants of SST2. These mutations block the normal pheromone response,
      including a loss of pheromone-stimulated gene transcription, cell cycle growth
      arrest, and G protein myristoylation. Although the SST2 mutations confer a
      pheromone-resistant phenotype, they do not prevent downstream activation by
      overexpression of G beta (STE4), a constitutively active G beta mutation
      (STE4Hpl), or a disruption of GPA1. None of the SST2 alleles affects the
      expression or stability of G alpha. These results point to the G protein alpha
      subunit as being the direct target of Sst2p action and underscore the importance
      of this novel desensitization factor in G-protein-mediated signaling.

PMID- 7791774
TI  - Calcium activates serum response factor-dependent transcription by a Ras- and Elk
      1-independent mechanism that involves a Ca2+/calmodulin-dependent kinase.
AB  - Enhanced levels of cytoplasmic Ca2+ due to membrane depolarization with elevated
      levels of KCl or exposure to the Ca2+ ionophore ionomycin stimulate serum
      response element (SRE)-dependent transcription in the pheochromocytoma cell line
      PC12. By using altered binding specificity mutants of transcription factors that
      bind to the SRE, it was demonstrated that in contrast to treatment with purified
      growth factors, such as nerve growth factor, the serum response factor (SRF), but
      not Elk-1, mediates Ca(2+)-regulated SRE-dependent transcription. Enhanced levels
      of cytoplasmic Ca2+ were found to trigger SRE-dependent transcription via a Ras
      independent signaling pathway that appears to involve a Ca2+/calmodulin-dependent
      kinase (CaMK). Overexpression of a constitutively active form of CaMKIV
      stimulated SRF-dependent transcription. Taken together, these findings indicate
      that SRF is a versatile transcription factor that, when bound to the SRE, can
      function by distinct mechanisms and can mediate transcriptional responses to both
      CaMK- and Ras-dependent signaling pathways.

PMID- 7791773
TI  - A truncated K-sam product lacking the distal carboxyl-terminal portion provides a
      reduced level of autophosphorylation and greater resistance against induction of
      differentiation.
AB  - The K-sam gene was originally cloned from KATO-III human gastric cancer cells and
      is identical to the bek or keratinocyte growth factor (KGF) receptor (KGFR) or
      fibroblast growth factor receptor 2 gene. K-sam generates several variant
      transcripts by alternative splicing, and the most abundant K-sam transcript in
      KATO-III cells was cloned as the K-sam-IIC3 cDNA, which has the KGF-binding motif
      and a short carboxyl terminus lacking a putative phospholipase C-gamma 1
      association site, Tyr-769. The K-sam-IIC3 cDNA was distinct from the K-sam-IIC1
      cDNA, which was the same as the previously reported KGFR cDNA. The K-sam-IIC1
      product contains a long carboxyl terminus with Tyr-769. K-sam-IIC3 showed greater
      transforming activity in NIH 3T3 cells than did K-sam-IIC1, and in gastric cancer
      cell lines in general, the level of K-sam-IIC3 mRNA was greater than that of K
      sam-IIC1 mRNA. Here we report that the K-sam-IIC3 product was less
      autophosphorylated than the K-sam-IIC1 product in NIH 3T3 transfectants. K-sam
      IIC3-transfected keratinocytes showed a stronger mitogenic response to KGF than
      did K-sam-IIC1 transfectants. Moreover, K-sam-IIC3-transfected L6 myoblast cells
      hardly differentiated when cultured in differentiation-inducing medium and growth
      was not significantly affected, while K-sam-IIC1 transfectants showed a
      differentiated phenotype with a reduced growth rate. These data indicate the
      difference in the signal transduction mediated by two KGFR-type K-sam variants
      generated by alternative splicing which might be involved in certain
      differentiation and carcinogenesis scenarios.

PMID- 7791772
TI  - Ras transformation results in an elevated level of cyclin D1 and acceleration of
      G1 progression in NIH 3T3 cells.
AB  - Ectopic overexpression of v-H-Ras protein in NIH 3T3 cells resulted in cellular
      transformation and an acceleration of G1 progression of these cells. A shortened
      G1 phase was found to be associated with an increased level of cyclin D1 but not
      cyclin E protein. Using an antisense blocking method, reduced synthesis of cyclin
      D1 in v-H-Ras transformants resulted in a slower G1 progression rate of these
      cells. Although constitutive overexpression of cyclin D1 in NIH 3T3 cells
      accelerated G1 progression, cells remained untransformed. Furthermore, inhibition
      of cyclin D1 synthesis greatly impaired the soft-agar cloning efficiency of v-H
      Ras transformants. These results suggest that increased expression of cyclin D1
      is necessary but not sufficient for the transforming activity of v-H-Ras. Similar
      effect on cell cycle progression was also observed in Raf-transformed cells. In
      addition to cyclin D1, cyclin E protein was found to be elevated in Src
      transformants. This may account for the further shortening of the G1 phase of
      these cells. Activation of an additional Ras-independent pathway was suggested to
      be responsible for the further acceleration of the G1 phase in Src transformants.

PMID- 7791775
TI  - Bdf1, a yeast chromosomal protein required for sporulation.
AB  - The BDF1 gene of Saccharomyces cerevisiae is required for sporulation. Under
      starvation conditions, most cells from the bdf1 null mutant fail to undergo one
      or both meiotic divisions, and there is an absolute defect in spore formation.
      The Bdf1 protein localizes to the nucleus throughout all stages of the mitotic
      and meiotic cell cycles. Analysis of spread meiotic nuclei reveals that the Bdf1
      protein is localized fairly uniformly along chromosomes, except that it is
      excluded specifically from the nucleolus. A bdf1 null mutant displays a reduced
      rate of vegetative growth and sensitivity to a DNA-damaging agent. The BDF1 gene
      encodes a 77-kDa protein that contains two bromodomains, sequence motifs of
      unknown function. Separation-of-function alleles suggest that only one of the two
      bromodomains is required for sporulation, whereas both are required for Bdf1
      function in vegetative cells. We propose that the Bdf1 protein is a component of
      chromatin and that the mitotic and meiotic defects of the bdf1 null mutant result
      from alterations in chromatin structure.

PMID- 7791777
TI  - Role of heat shock cognate 70 protein in import of ornithine transcarbamylase
      precursor into mammalian mitochondria.
AB  - The roles of the 70-kDa cytosolic heat shock protein (hsp70) in import of
      precursor proteins into the mitochondria were postulated to be related to (i)
      unfolding of precursor proteins in the cytosol, (ii) maintenance of the import
      competent state, and (iii) unfolding and transport of precursor proteins through
      contact sites, in cooperation with matrix hsp70. We examined roles of cytosolic
      hsp70 family members in import of ornithine transcarbamylase precursor (pOTC)
      into rat liver mitochondria, using an in vitro import system and antibodies
      against hsp70. Immunoblot analysis using an hsc70 (70-kDa heat shock cognate
      protein)-specific monoclonal antibody and a polyclonal antibody that reacts with
      both hsc70 and hsp70 showed that hsc70 is the only or major form of hsp70 family
      members in the rabbit reticulocyte lysate. The hsc70 antibody did not inhibit
      pOTC import when added prior to import assay. However, when pOTC was synthesized
      in the presence of the antibody and then subjected to import assay, pOTC import
      was markedly decreased. pOTC import was also decreased when the precursor was
      synthesized in the lysate depleted for hsc70 by treatment with hsc70 antibody
      conjugated Sepharose. This reduction was almost completely restored by readdition
      of purified mouse hsc70 during pOTC synthesis. The readdition of hsc70 after pOTC
      synthesis and only during the import assay was not effective. Thus, once import
      competence of pOTC was lost, hsc70 was ineffective for restoration. Newly
      synthesized pOTC lost import competence in the absence of hsc70 somewhat more
      rapidly than in its presence. These results indicate that hsc70 is required
      during pOTC synthesis and not during import into the mitochondria. hsc70
      presumably binds to pOTC polypeptide and maintains it in an import-competent
      form.

PMID- 7791776
TI  - Characterization of fus1 of Schizosaccharomyces pombe: a developmentally
      controlled function needed for conjugation.
AB  - In Schizosaccharomyces pombe, the fus1 mutation blocks conjugation at a point
      after cell contact and agglutination. The cell walls separating the mating
      partners are not degraded, which prevents cytoplasmic fusion. In order to
      investigate the molecular mechanism of conjugation, we cloned the fus1 gene and
      found that it is capable of encoding a 1,372-amino-acid protein with no
      significant similarities to other known proteins. Expression of the fus1 gene is
      regulated by the developmental state of the cells. Transcription is induced by
      nitrogen starvation and requires a pheromone signal in both P and M cell types.
      Consequently, mutants defective in the pheromone response pathway fail to induce
      fus1 expression. The ste11 gene, which encodes a transcription factor controlling
      expression of many genes involved in sexual differentiation, is also required for
      transcription of fus1. Furthermore, deletion of two potential Ste11 recognition
      sites in the fus1 promoter region abolished transcription, and expression could
      be restored when we inserted a different Ste11 site from the mat1-P promoter.
      Since this element was inverted relative to the fus1 element, we conclude that
      activation of transcription by Ste11 is independent of orientation. Although the
      fus1 mutant has a phenotype very similar to that of Saccharomyces cerevisiae fus1
      mutants, the two proteins appear to have different roles in the process of cell
      fusion. Budding yeast Fus1 is a typical membrane protein and contains an SH3
      domain. Fission yeast Fus1 has no features of a membrane protein, yet it appears
      to localize to the projection tip. A characteristic proline-rich potential SH3
      binding site may mediate interaction with other proteins.

PMID- 7791779
TI  - A UV-responsive G2 checkpoint in rodent cells.
AB  - We have studied the effect of UV irradiation on the cell cycle progression of
      synchronized Chinese hamster ovary cells. Synchronization of cells in S or G2
      phase was accomplished by the development of a novel protocol using mimosine,
      which blocks cell cycle progression at the G1/S boundary. After removal of
      mimosine, cells proceed synchronously through the S and G2 phases, allowing
      manipulation of cells at specific points in either phase. Synchronization of
      cells in G1 was achieved by release of cells after a period of serum starvation.
      Cells synchronized by these methods were UV irradiated at defined points in G1,
      S, and G2, and their subsequent progression through the cell cycle was monitored.
      UV irradiation of G1-synchronized cells caused a dose-dependent delay in entry
      into S phase. Irradiation of S-phase-synchronized cells inhibited progression
      through S phase and then resulted in accumulation of cells for a prolonged
      interval in G2. Apoptosis of a subpopulation of cells during this extended period
      was noted. UV irradiation of G2-synchronized cells caused a shorter G2 arrest.
      The arrest itself and its duration were dependent upon the timing (within G2
      phase) of the irradiation and the UV dose, respectively. We have thus defined a
      previously undescribed (in mammalian cells) UV-responsive checkpoint in G2 phase.
      The implications of these findings with respect to DNA metabolism are discussed.

PMID- 7791778
TI  - Dioxin induces localized, graded changes in chromatin structure: implications for
      Cyp1A1 gene transcription.
AB  - In mouse hepatoma cells, the environmental contaminant 2,3,7,8-tetrachlorodibenzo
      p-dioxin (TCDD, or dioxin) induces Cyp1A1 gene transcription, a process that
      requires two basic helix-loop-helix regulatory proteins, the aromatic hydrocarbon
      receptor (AhR) and the aromatic hydrocarbon receptor nuclear translocator (Arnt).
      We have used a ligation-mediated PCR technique to analyze dioxin-induced changes
      in protein-DNA interactions and chromatin structure of the Cyp1A1 enhancer
      promoter in its native chromosomal setting. Dioxin-induced binding of the
      AhR/Arnt heteromer to enhancer chromatin is associated with a localized (about
      200 bp) alteration in chromatin structure that is manifested by increased
      accessibility of the DNA; these changes probably reflect direct disruption of a
      nucleosome by AhR/Arnt. Dioxin induces analogous AhR/Arnt-dependent changes in
      chromatin structure and accessibility at the Cyp1A1 promoter. However, the
      changes at the promoter must occur by a different, more indirect mechanism,
      because they are induced from a distance and do not reflect a local effect of
      AhR/Arnt binding. Dose-response experiments indicate that the changes in
      chromatin structure at the enhancer and promoter are graded and mirror the graded
      induction of Cyp1A1 transcription by dioxin. We discuss these results in terms of
      a TCDD-induced shift in an equilibrium between nucleosomal and nonnucleosomal
      chromatin configurations.

PMID- 7791780
TI  - Gene-specific and strand-specific DNA repair in the G1 and G2 phases of the cell
      cycle.
AB  - We have analyzed the fine structure of DNA repair in Chinese hamster ovary (CHO)
      cells within the G1 and G2 phases of the cell cycle. Repair of inactive regions
      of the genome has been suggested to increase in the G2 phase of the cell cycle
      compared with other phases. However, detailed studies of DNA repair in the G2
      phase of the cell cycle have been hampered by technical limitations. We have used
      a novel synchronization protocol (D. K. Orren, L. N. Petersen, and V. A. Bohr,
      Mol. Cell. Biol. 15:3722-3730, 1995) which permitted detailed studies of the fine
      structure of DNA repair in G2. CHO cells were synchronized and UV irradiated in
      G1 or early G2. The rate and extent of removal of cyclobutane pyrimidine dimers
      from an inactive region of the genome and from both strands of the actively
      transcribed dihydrofolate reductase (DHFR) gene were examined within each phase.
      The repair of the transcribed strand of the DHFR gene was efficient in both G1
      and G2, with no major differences between the two cell cycle phases. Neither the
      nontranscribed strand of the DHFR gene nor an inactive region of the genome was
      repaired in G1 or G2. CHO cells irradiated early in G2 were more resistant to UV
      irradiation than cells irradiated in late G1. Since we found no major difference
      in repair rates in G1 and G2, we suggest that G2 resistance can be attributed to
      the increased time (G2 and G1) available for repair before cells commit to DNA
      synthesis.

PMID- 7791782
TI  - Transcriptional activation of the fra-1 gene by AP-1 is mediated by regulatory
      sequences in the first intron.
AB  - Constitutive expression of c-Fos, FosB, Fra-1, or c-Jun in rat fibroblasts leads
      to up-regulation of the immediate-early gene fra-1. Using the posttranslational
      FosER induction system, we demonstrate that this AP-1-dependent stimulation of
      fra-1 expression is rapid, depends on a functional DNA-binding domain of FosER,
      and is a general phenomenon observed in different cell types. In vitro
      mutagenesis and functional analysis of the rat fra-1 gene in stably transfected
      Rat-1A-FosER fibroblasts indicated that basal and AP-1-regulated expression of
      the fra-1 gene depends on regulatory sequences in the first intron which comprise
      a consensus AP-1 site and two AP-1-like elements. We have also investigated the
      transactivating and transforming properties of the Fra-1 protein to address the
      significance of fra-1 up-regulation. The entire Fra-1 protein fused to the DNA
      binding domain of Ga14 is shown to lack any transactivation function, and yet it
      possesses oncogenic potential, as overexpression of Fra-1 in established rat
      fibroblasts results in anchorage-independent growth in vitro and tumor
      development in athymic mice, fra-1 is therefore not only induced by members of
      the Fos family, but its gene product may also contribute to cellular
      transformation by these proteins. Together, these data identify fra-1 as a unique
      member of the fos gene family which is under positive control by AP-1 activity.

PMID- 7791781
TI  - Functional interaction between the POU domain protein Tst-1/Oct-6 and the high
      mobility-group protein HMG-I/Y.
AB  - The POU domain protein Tst-1/Oct-6 is a transcriptional activator of human
      papovavirus JC virus in transient transfections. Because of its endogenous
      expression in myelinating glia, Tst-1/Oct-6 might also be an important
      determinant for the glia specificity of JC virus in vivo. Activation of viral
      early and late genes depends on the ability of Tst-1/Oct-6 to interact with an AT
      rich element within the viral regulatory region. Here, we show that this element
      not only is bound by Tst-1/Oct-6 but, in addition, serves as a binding site for
      the high-mobility-group protein HMG-I/Y. In the presence of HMG-I/Y, Tst-1/Oct-6
      exhibited an increased affinity for this AT-rich element. The specificity of this
      effect was evident from the fact that no stimulation of Tst-1/Oct-6 binding was
      observed on a site that did not allow binding of HMG-I/Y. In addition, both
      proteins interacted with each other in solution. Direct contacts were identified
      between the POU domain of Tst-1/Oct-6 and a short stretch of 10 amino acids in
      the central portion of HMG-I/Y. These results point to an accessory role for HMG
      I/Y in the activation of JC viral gene expression by the POU domain protein Tst
      1/Oct-6. In agreement with such a role, HMG-Y synergistically supported the
      function of Tst-1/Oct-6 in transient transfections, measured on the early
      promoter of JC virus or on an artificial promoter consisting of only a TATA box
      and the common binding element for Tst-1 and HMG-I/Y.

PMID- 7791784
TI  - The EGP1 gene may be a positive regulator of protein phosphatase type 1 in the
      growth control of Saccharomyces cerevisiae.
AB  - The Saccharomyces cerevisiae GLC7 gene encodes the catalytic subunit of type 1
      protein phosphatase (PP1) and is required for cell growth. A cold-sensitive glc7
      mutant (glc7Y170) arrests in G2/M but remains viable at the restrictive
      temperature. In an effort to identify additional gene products that function in
      concert with PP1 to regulate growth, we isolated a mutation (gpp1) that
      exacerbated the growth phenotype of the glc7Y170 mutation, resulting in rapid
      death of the double mutant at the nonpermissive temperature. We identified an
      additional gene, EGP1, as an extra-copy suppressor of the glc7Y170 gpp1-1 double
      mutant. The nucleotide sequence of EGP1 predicts a leucine-rich repeat protein
      that is similar to Sds22, a protein from the fission yeast Schizosaccharomyces
      pombe that positively modulates PP1. EGP1 is essential for cell growth but
      becomes dispensable upon overexpression of the GLC7 gene. Egp1 and PP1 directly
      interact, as assayed by coimmunoprecipitation. These results suggest that Egp1
      functions as a positive modulator of PP1 in the growth control of S. cerevisiae.

PMID- 7791783
TI  - A gene that is related to SRY and is expressed in the testes encodes a leucine
      zipper-containing protein.
AB  - SRY-related cDNA encoding a protein with a high-mobility-group (HMG) box and a
      leucine zipper motif, which was designated SOX-LZ, was isolated from a rainbow
      trout testis cDNA library. Comparison of this cDNA with the mouse homologous cDNA
      isolated from a testis cDNA library exhibits an overall amino acid sequence
      identity of 77%, which is in striking contrast to the abrupt loss of amino acid
      sequence homology outside the HMG box found among mammalian SRY genes. In both
      rainbow trout and mice, Northern (RNA) blot analyses have revealed the presence
      of a testis-specific 3-kb-long SOX-LZ mRNA, and this transcript appeared
      coincidentally with the protamine mRNA, suggesting its expression in the germ
      line. A recombinant HMG box region protein encoded by SOX-LZ could bind strongly
      with an oligonucleotide containing an AACAAT sequence, which is also recognized
      by mouse Sry and Sox-5. Upon cotransfection into CHO cells, SOX-LZ transactivated
      transcription through its binding motif when the region including the leucine
      zipper motif was deleted [SOX-LZ (D105-356)]; however, the intact SOX-LZ failed
      to transactivate. The intact SOX-LZ could form homodimers through the leucine
      zipper, which resulted in inhibition of DNA binding by the HMG box, while SOX-LZ
      (D105-356), which was incapable of dimerization, showed specific binding with the
      AACAAT sequence. Thus, the repressed transactivation of the intact SOX-LZ in CHO
      cells was primarily attributable to the low level of DNA binding of SOX-LZ
      homodimers.

PMID- 7791785
TI  - The Saccharomyces cerevisiae gene SDS22 encodes a potential regulator of the
      mitotic function of yeast type 1 protein phosphatase.
AB  - In higher eukaryotes, the activity and specificity of the type 1 protein serine
      threonine phosphatase (PP1) catalytic subunit is thought to be controlled by its
      association with a number of regulatory or targeting subunits. Here we describe
      the characterization of a gene encoding one such potential polypeptide in the
      yeast Saccharomyces cerevisiae. The gene which we have isolated (termed SDS22)
      encodes a product with a high degree of sequence identity to the fission yeast
      sds22 protein, a known regulator of the mitotic function of PP1 in
      Schizosaccharomyces pombe. Using two different criteria, we have demonstrated
      that Sds22p and the catalytic subunit of PP1 (Glc7p) interact in yeast cells. We
      have also generated a temperature-sensitive allele of GLC7 (glc7-12) which causes
      a block to the completion of mitosis at the restrictive temperature. Additional
      copies of SDS22 lead to allele-specific suppression of the glc7-12 mutant,
      strongly suggesting that the interaction between the two proteins is of
      functional significance. Sds22p is therefore likely to be the second example of a
      PP1 regulatory subunit identified in S. cerevisiae.

PMID- 7791786
TI  - Both Pbx1 and E2A-Pbx1 bind the DNA motif ATCAATCAA cooperatively with the
      products of multiple murine Hox genes, some of which are themselves oncogenes.
AB  - E2A-PBX1 is the oncogene produced at the t(1;19) chromosomal breakpoint of
      pediatric pre-B-cell leukemia. Expression of E2A-Pbx1 induces fibroblast
      transformation and myeloid and T-cell leukemia in mice and arrests
      differentiation of granulocyte macrophage colony-stimulating factor-dependent
      myeloblasts in cultured marrow. Recently, the Drosophila melanogaster protein
      Exd, which is highly related to Pbx1, was shown to bind DNA cooperatively with
      the Drosophila homeodomain proteins Ubx and Abd-A. Here, we demonstrate that the
      normal Pbx1 homeodomain protein, as well as its oncogenic derivative, E2A-Pbx1,
      binds the DNA sequence ATCAATCAA cooperatively with the murine Hox-A5, Hox-B7,
      Hox-B8, and Hox-C8 homeodomain proteins, which are themselves known oncoproteins,
      as well as with the Hox-D4 homeodomain protein. Cooperative binding to ATCAATCAA
      required the homeodomain-dependent DNA-binding activities of both Pbx1 and the
      Hox partner. In cotransfection assays, Hox-B8 suppressed transactivation by E2A
      Pbx1. These results suggest that (i) Pbx1 may participate in the normal
      regulation of Hox target gene transcription in vivo and therein contribute to
      aspects of anterior-posterior patterning and structural development in
      vertebrates, (ii) that E2A-Pbx1 could abrogate normal differentiation by altering
      the transcriptional regulation of Hox target genes in conjunction with Hox
      proteins, and (iii) that the oncogenic mechanism of certain Hox proteins may
      require their physical interaction with Pbx1 as a cooperating, DNA-binding
      partner.

PMID- 7791787
TI  - Constitutive phosphorylation of eps8 in tumor cell lines: relevance to malignant
      transformation.
AB  - eps8, a recently identified tyrosine kinase substrate, has been shown to augment
      epidermal growth factor (EGF) responsiveness, implicating it in EGF receptor
      (EGFR)-mediated mitogenic signaling. We investigated the status of eps8
      phosphorylation in normal and transformed cells and the role of eps8 in
      transformation. In NIH 3T3 cells overexpressing EGFR (NIH-EGFR), eps8 becomes
      rapidly phosphorylated upon EGF stimulation. At receptor-saturating doses of EGF,
      approximately 30% of the eps8 pool is tyrosine phosphorylated. Under
      physiological conditions of activation (i.e., at low receptor occupancy),
      corresponding to the 50% effective dose of EGF for mitogenesis, approximately 3
      to 4% of the eps8 contains phosphotyrosine. In human tumor cell lines, we
      detected constitutive tyrosine phosphorylation of eps8, with a stoichiometry
      (approximately 5%) similar to that associated with potent mitogenic response in
      NIH-EGFR cells. Overexpression of eps8 was able to transform NIH 3T3 cells under
      limiting conditions of activation of the EGFR pathway. Concomitant tyrosine
      phosphorylation of eps8 and shc, but not of rasGAP, phospholipase C-gamma, and
      eps15, was frequently detected in tumor cells. This suggested that eps8 and shc
      might be part of a pathway which is preferentially selected in some tumors.
      Cooperation between these two transducers was further indicated by the finding of
      their in vivo association. This association was, at least in part, dependent on
      recognition of shc by the SH3 domain of eps8. Our results indicate that eps8 is
      physiologically part of the EGFR-activated signaling and that its alterations can
      contribute to the malignant phenotype.

PMID- 7791789
TI  - MyoD-induced expression of p21 inhibits cyclin-dependent kinase activity upon
      myocyte terminal differentiation.
AB  - The terminal differentiation of C2C12 skeletal muscle cells involves the
      activation of unique sets of genes and an irreversible withdrawal from the cell
      cycle. This process is associated with a decrease in cdk2 activity in cell
      extracts. The decrease in cdk2 activity correlates with diminished levels of cdk2
      and cyclin A and with a marked induction of the p21 cyclin-dependent kinase (cdk)
      inhibitor. The upregulation of p21 occurred at the levels of mRNA and protein,
      and p21 formed a complex with the cyclin kinases in myotubes. Further, the
      immunodepletion of p21 from myotube extracts neutralized the heat-stable cdk2
      inhibitory activity that was induced upon myogenic differentiation. The levels of
      p21 mRNA, protein, and activity remained constant in myotubes when they were
      reexposed to mitogen-rich growth medium, indicating that permanent changes in the
      cell's genetic program contribute to its sustained expression following terminal
      differentiation. Indeed, 10T1/2 fibroblasts transformed with the myogenic factor
      MyoD, but not the parental multipotent cells, upregulated p21 transcript levels
      when induced to differentiate by serum withdrawal, demonstrating that the
      upregulation is an integral feature of myogenic commitment and differentiation.
      The functional consequences of this upregulation were indicated by ectopically
      expressing p21 in myoblasts; this was sufficient for cell cycle arrest in mitogen
      rich growth medium. The induction and sustained expression of p21 appears to be a
      contributory mechanism by which myocytes irreversibly exit the cell cycle upon
      terminal differentiation.

PMID- 7791788
TI  - Identification of a new family of tissue-specific basic helix-loop-helix proteins
      with a two-hybrid system.
AB  - With modified two-hybrid technology, we have isolated a member of a new family of
      basic helix-loop-helix (bHLH) transcription factors. Thing1 (Th1) was identified
      in a screen of a mouse embryo cDNA library as a partner for the Drosophila E
      protein daughterless. RNA in situ hybridization and reverse transcriptase-PCR
      demonstrate a stage- and tissue-specific distribution for the expression of Th1.
      Although tissue specific, the expression pattern of Th1 is fairly complex. During
      development, Th1 mRNA is widely expressed in extraembryonic tissues, portions of
      the heart, autonomic ganglia, the gut, and pharyngeal arches. At embryonic day
      7.5 (E7.5), extraembryonic derivatives show robust Th1 expression. By E8.5,
      expression in the embryonic heart becomes detectable. During the next 2 days of
      development, the signal also includes gut and pharyngeal arches. Predominant
      expression at E13.5 is in neural crest derivatives, especially the autonomic
      nervous system and adrenal medulla. Expression of Th1 persists in the adult, in
      which it is localized to the smooth muscle cells of the gut. In vitro, Th1
      protein recognizes a set of DNA sites that are more degenerate than has been
      determined for other bHLH factors, indicating a reduced binding specificity.
      Transient transfection of NIH 3T3 cells with GAL4-Th1 fusions reveals a
      repression activity mediated by the Th1 bHLH domain. In combination, these
      properties define Th1 as a new bHLH protein with a unique set of properties.

PMID- 7791791
TI  - Pi 1 binding sites are negative regulators of bcl-2 expression in pre-B cells.
AB  - The bcl-2 gene is differentially regulated during B-cell development, with low
      level expression in pre-B cells and higher-level expression in mature B cells.
      These changes correlate with susceptibility to cell death by apoptosis and
      suggest that the Bcl-2 protein may play a role in the control of cell death
      during B-cell development. We have identified two negative regulatory regions in
      the human bcl-2 5' flanking and 5' untranslated regions in pre-B cells; these
      regions have no significant function in mature B cells. Further investigation of
      these regions revealed two pre-B-cell-specific enhancer elements (pi 1 sites) in
      the 5' negative regulatory region and one in the 3' negative regulatory region.
      Mutational analysis confirmed that these three sites functioned as negative
      regulators of the bcl-2 promoter in the pre-B-cell line Nalm-6. Electrophoretic
      mobility shift assays with each of the three sites demonstrated a complex of
      identical mobility to that formed with the immunoglobulin heavy-chain enhancer pi
      1 site. UV cross-linking experiments revealed that a protein with a molecular
      mass of 58 kDa bound to the three bcl-2 sites and to the immunoglobulin enhancer
      site. This protein reacted with an antibody against Ets family proteins.
      Constructs with the isolated pi 1 sites linked to the simian virus 40 promoter
      were used in transient transfection experiments in the pre-B-cell line. The bcl-2
      sites decreased expression of the simian virus 40 promoter, while the
      immunoglobulin enhancer site increased its expression. The pi 1 sites in the bcl
      2 gene may play a role in the developmental regulation of bcl-2 expression during
      B-cell differentiation.

PMID- 7791790
TI  - Of the GATA-binding proteins, only GATA-4 selectively regulates the human
      interleukin-5 gene promoter in interleukin-5-producing cells which express
      multiple GATA-binding proteins.
AB  - Interleukin-5 (IL-5) is produced by T lymphocytes and known to support B-cell
      growth and eosinophilic differentiation of the progenitor cells. Using ATL-16T
      cells which express IL-5 mRNA, we have identified a region within the human IL-5
      gene promoter that regulates IL-5 gene transcription. This cis-acting sequence
      contains the core binding motif, (A/T)GATA(A/G), for GATA-binding family proteins
      and thus suggests the involvement of this family members. In this report, we
      describe the cloning of human GATA-4 (hGATA-4) and show that hGATA-4 selectively
      interacts with the -70 GATA site within the IL-5 proximal promoter region. By
      promoter deletion and mutation analyses, we established this region as a positive
      regulatory element. Cotransfection experiments revealed that both hGATA-4 and
      phorbol-12-myristate-13-acetate (PMA)-A23187 stimulation are necessary for IL-5
      promoter activation. The requirement for another regulatory element called CLE0,
      which lies downstream of the -70 GATA site, was also demonstrated. ATL-16T cells
      express mRNAs of three GATA-binding proteins, hGATA-2, hGATA-3, and hGATA-4, and
      each of them has a potential to bind to the consensus (A/T)GATA(G/A) motif.
      However, using ATL-16T nuclear extract, we demonstrated that GATA-4 is the only
      GATA-binding protein that forms a specific DNA-protein complex with the -70 GATA
      site. An electrophoretic mobility shift assay with extracts of COS cells
      expressing GATA-binding proteins showed that GATA-4 has the highest binding
      affinity for the -70 GATA site among the three GATA-binding proteins. When the
      transactivation abilities were compared among the three, GATA-4 showed the
      highest activity. These results demonstrate the selective role of GATA-4 in the
      transcriptional regulation of the IL-5 gene in a circumstance where multiple
      members of the GATA-binding proteins are expressed.

PMID- 7791792
TI  - Characterization of a mutant calcineurin A alpha gene expressed by EL4 lymphoma
      cells.
AB  - The calmodulin-stimulated phosphatase calcineurin plays a critical role in
      calcium-dependent T-lymphocyte activation pathways. Here, we report the
      identification of a missense mutation in the calcineurin A alpha gene expressed
      by EL4 T-lymphoma cells. This mutation changes an evolutionarily conserved
      aspartic acid to asparagine within the autoinhibitory domain of the calcineurin A
      alpha protein. A comparison of wild-type and mutant autoinhibitory peptides
      indicates that this amino acid substitution greatly reduces inhibition of
      calcineurin phosphatase activity. Additional peptide inhibition studies support a
      pseudosubstrate model of autoinhibitory function, in which the conserved aspartic
      acid residue may serve as a molecular mimic of either phosphoserine or
      phosphothreonine. Expression of the mutant calcineurin appears to affect cellular
      signal transduction pathways, as EL4 cells can be activated by suboptimal
      concentrations of calcium ionophore in the presence of phorbol esters. Moreover,
      this phenotype can be transferred to Jurkat T cells by transfection of the
      mutated calcineurin gene. These findings implicate a conserved aspartic acid in
      the mechanism of calcineurin autoinhibition and suggest that mutation of this
      residue is associated with aberrant calcium-dependent signaling in vivo.

PMID- 7791793
TI  - Role of the hepatitis B virus posttranscriptional regulatory element in export of
      intronless transcripts.
AB  - Hepatitis B virus S transcripts contain a region, known as the
      posttranscriptional regulatory element (PRE), that activates their transport from
      the nucleus to the cytoplasm. J. Huang and T. J. Liang (Mol. Cell. Biol. 13:7476
      7486, 1993) have shown that this element can partially substitute for the human
      immunodeficiency virus Rev-response element (RRE) in a reporter plasmid that is
      dependent on the RRE and Rev protein for expression and concluded that PRE
      exhibits Rev-RRE-like functions by inhibiting splicing. However, we have obtained
      additional data which indicate that the PRE functions in a novel manner that is
      not dependent on inhibition of splicing. Unlike Rev-RRE, the PRE functions
      independently of splice donor and acceptor sites and can activate cytoplasmic
      expression of an intronless (so-called prespliced) beta-globin transcript.
      Conversely, a heterologous intron can substitute for the PRE in increasing
      cytoplasmic expression of hepatitis B virus S transcripts. In addition, the host
      nuclear factor, YL2 (p32), which enhances Rev-RRE function has no effect on PRE
      dependent gene expression. Since S transcripts are not normally known to be
      spliced and since RNA splicing and cytoplasmic transport are tightly linked
      processes in higher eucaryotic cells, we conclude that the PRE functions in cis
      to allow the export of nuclear transcripts that do not interact efficiently with
      the splicing pathway and hence are normally not exported well from the nucleus.
      Such elements are critical for the life cycle of viruses, such as hepatitis B
      virus, which undergo reverse transcription during replication.

PMID- 7791795
TI  - Role of cysteine residues in regulation of p53 function.
AB  - Previous studies of p53 have implicated cysteine residues in site-specific DNA
      binding via zinc coordination and redox regulation (P. Hainaut and J. Milner,
      Cancer Res. 53:4469-4473, 1993; T. R. Hupp, D. W. Meek, C. A. Midgley, and D. P.
      Lane, Nucleic Acids Res. 21:3167-3174, 1993). We show here that zinc binding and
      redox regulation are, at least in part, distinct determinants of the binding of
      p53 to DNA. Moreover, by substituting serine for each cysteine in murine p53, we
      have investigated the roles of individual cysteines in the regulation of p53
      function. Substitution of serine for cysteine at position 40, 179, 274, 293, or
      308 had little or no effect on p53 function. In contrast, replacement of cysteine
      at position 173, 235, or 239 markedly reduced in vitro DNA binding, completely
      blocked transcriptional activation, and led to a striking enhancement rather than
      a suppression of transformation by p53. These three cysteines have been
      implicated in zinc binding by X-ray diffraction studies (Y. Cho, S. Gorina, P.D.
      Jeffrey, and N.P. Pavletich, Science 265:346-355, 1994); our studies demonstrate
      the functional consequences of the inability of the central DNA-binding domain of
      p53 to studies demonstrate the functional consequences of the inability of the
      central DNA-binding domain of p53 to bind zinc. Lastly, substitutions for
      cysteines at position 121, 132, 138, or 272 partially blocked both
      transactivation and the suppression of transformation by p53. These four
      cysteines are located in the loop-sheet-helix region of the site-specific DNA
      binding domain of p53. Like the cysteines in the zinc-binding region, therefore,
      these cysteines may cooperate to modulate the structure of the DNA-binding
      domain. Our findings argue that p53 is subject to more than one level of
      conformational modulation through oxidation-reduction of cysteines at or near the
      p53-DNA interface.

PMID- 7791796
TI  - Homologous DNA sequences and cellular factors are implicated in the control of
      glucagon and insulin gene expression.
AB  - The glucagon gene is specifically expressed in the alpha cells of pancreatic
      islets. The promoter of the glucagon gene is responsible for this specificity.
      Within the promoter, the upstream promoter element G1 is critical to restrict
      expression to the alpha cells. We define here a composite DNA control element,
      G4, localized upstream of G1 between nucleotides -100 and -140 which functions as
      an islet-specific activator in both glucagon- and insulin-producing cells but not
      in nonislet cells. G4 contains at least three protein binding sites. The most
      proximal site, E2, is highly homologous to the E1, SMS-UE, and B elements of the
      rat insulin I, somastatin, and elastase I genes, respectively, and interacts with
      a pancreas-specific complex; the distal site, E3, represents an E box which is
      identical to the E boxes of the rat insulin I and II genes and binds to a complex
      similar or identical to IEF1 which has been implicated in the tissue-specific
      control of insulin gene expression. These two sites necessitate a third element,
      the intervening sequence, to activate transcription. We conclude that the first
      140 bp of the glucagon gene promoter contains at least two DNA control elements
      responsible for pancreatic alpha-cell-specific expression: G4, an islet cell
      specific element sharing common binding sites with the insulin gene, and G1,
      which restricts glucagon gene expression to the alpha cells. This double control
      of specificity might have relevance during islet cell differentiation.

PMID- 7791794
TI  - Characterization of promoter elements required for cell-specific expression of
      the neurotensin/neuromedin N gene in a human endocrine cell line.
AB  - Expression of the gene encoding neurotensin/neuromedin N (NT/N) is mostly limited
      to the brain and specialized enteroendocrine cells (N cells) of the distal small
      intestine. We have analyzed the NT/N DNA sequences upstream of the RNA start site
      that direct cell-specific expression using a novel human endocrine cell line,
      BON, that resembles intestinal N cells in several important aspects, including
      NT/N precursor protein processing, ratios of different NT/N mRNA forms, and high
      levels of constitutive expression of the NT/N gene. Transient transfection assays
      with plasmids with progressive 5' deletions of the rat NT/N promoter identified
      the proximal 216 bp of 5' flanking sequences as essential for high-level
      constitutive NT/N expression in BON cells. In addition, a detailed mutational
      analysis defined multiple regions within the proximal 216 bp that contribute to
      cell-specific NT/N expression. These elements include a proximal cyclic AMP
      response element (CRE)/AP-1-like motif (TGACATCA) that binds c-Jun, JunD, CRE
      binding (CREB), and ATF proteins, a near-consensus glucocorticoid response
      element, and a distal consensus AP-1 site that binds c-Fos, Fra-1, and JunD. In
      addition, elements contained within two 21-bp imperfect direct repeats play an
      important role in NT/N expression in BON cells and may bind novel factors that
      act as positive regulators of NT/N expression. DNase I footprinting and gel shift
      analyses demonstrate that the sites identified by mutational analysis, and at
      least one additional site, specifically bind BON cell nuclear proteins in vitro.
      We speculate that a complex pattern of regulation requiring interaction between a
      proximal CRE/AP-1-like motif and other upstream control elements play an
      important role in the high-level constitutive expression of NT/N in the human
      endocrine cell line BON. In addition, the BON cell line provides a unique model
      to further characterize the factors regulating cell-specific NT/N expression and
      to better understand the mechanisms responsible for the terminal differentiation
      of the N-cell lineage in the gut.

PMID- 7791797
TI  - Mutational analysis of Hsp90 function: interactions with a steroid receptor and a
      protein kinase.
AB  - Hsp90 is a protein chaperone whose functions are focused on a specific set of
      target proteins. The nature of Hsp90's interactions with these proteins is poorly
      understood. To provide tools for examining these interactions, we have isolated
      eight broadly distributed temperature-sensitive (ts) point mutations in the Hsp90
      gene (HSP82) of Saccharomyces cerevisiae. The mutants fall into two distinct
      classes. One has a classic ts phenotype, with nearly wild-type activity at 25
      degrees C and a precipitous loss of function at 34 degrees C. The remaining seven
      mutants, in contrast, cause a general reduction in Hsp90 function and are ts
      because they do not provide the high level of function required for growth at
      high temperatures. The effects of these mutants on two target proteins, a
      transcription factor (glucocorticoid receptor) and a tyrosine kinase (pp60v-src),
      provided several insights on Hsp90 function. First, Hsp90 is not only required to
      help the glucocorticoid receptor achieve a hormone-activable state, it is
      continuously required to maintain that state. Second, Hsp90's function in the
      maturation of pp60v-src involves separable roles in protein accumulation and
      kinase activation. Thus, Hsp90 is an integral component of both the steroid
      receptor and kinase signaling pathways. Finally, all eight point mutants affect
      the activation of both the glucocorticoid receptor and pp60v-src, indicating that
      Hsp90 promotes the activity of these very different target proteins through
      common mechanisms.

PMID- 7791798
TI  - Cyclin E restores p53 activity in contact-inhibited cells.
AB  - The wild-type p53 protein is a potent growth suppressor when overexpressed in
      vitro. It functions as a transcriptional activator and causes growth arrest at
      the G1/S stage of the cell cycle. We monitored p53 transactivation as an
      indicator of p53 function throughout the cell cycle. We first demonstrate that
      cells which exhibited contact inhibition of growth lacked p53 transactivation
      function at high cell density. Since these cells were noncycling, we examined
      whether the ectopic expression of any cyclin could override contact inhibition of
      growth and restore p53 transactivation function. The transfection of cyclin E at
      high cell density stimulated the progression of cells through the cell cycle and
      restored p53 transactivation function. The transcriptional activity of p53
      induced by cyclin E was regulated at the level of DNA binding. Cells that did not
      show contact inhibition of growth had a functional p53 regardless of cell
      density. Thus, contact inhibition of cell growth corresponded to a lack of p53
      transactivation function and the overexpression of cyclin E in these contact
      inhibited cells stimulated cell cycle progression and resulted in p53
      transcriptional activity.

PMID- 7791799
TI  - A 15-base-pair element activates the SPS4 gene midway through sporulation in
      Saccharomyces cerevisiae.
AB  - Sporulation of the yeast Saccharomyces cerevisiae represents a simple
      developmental process in which the events of meiosis and spore wall formation are
      accompanied by the sequential activation of temporally distinct classes of genes.
      In this study, we have examined expression of the SPS4 gene, which belongs to a
      group of genes that is activated midway through sporulation. We mapped the
      upstream boundary of the regulatory region of SPS4 by monitoring the effect of
      sequential deletions of 5'-flanking sequence on expression of plasmid-borne
      versions of SPS4 introduced into a MATa/MAT alpha delta sps4/delta sps4 strain.
      This analysis indicated that the 5' boundary of the regulatory region was within
      50 bp of the putative TATA box of the gene. By testing various oligonucleotides
      that spanned this boundary and the downstream sequence for their ability to
      activate expression of a heterologous promoter, we found that a 15-bp sequence
      sufficed to act as a sporulation-specific upstream activation sequence. This 15
      bp fragment, designated UASSPS4, activated expression of a CYC1-lacZ reporter
      gene midway through sporulation and was equally active in both orientations.
      Extending the UAS fragment to include the adjacent 14-bp enhanced its activity 10
      fold. We show that expression of SPS4 is regulated in a manner distinct from that
      of early meiotic genes: mutation of UME6 did not lead to vegetative expression of
      SPS4, and sporulation-specific expression was delayed by mutation of IME2. In
      vivo and in vitro assays suggested that a factor present in vegetative cells bind
      to the UASSPS4 element. We speculate that during sporulation this factor is
      modified to serve as an activator of the SPS4 gene or, alternatively, that it
      recruits an activator to the promoter.

PMID- 7791801
TI  - The decapentaplegic core promoter region plays an integral role in the spatial
      control of transcription.
AB  - The Drosophila melanogaster decapentaplegic (dpp) gene encodes a transforming
      growth factor beta-related cell signaling molecule that plays a critical role in
      dorsal/ventral pattern formation. The dpp expression pattern in the Drosophila
      embryo is dynamic, consisting of three phases. Phase I, in which dpp is expressed
      in a broad dorsal domain, depends on elements in the dpp second intron that
      interact with the Dorsal transcription factor to repress transcription ventrally.
      In contrast, phases II and III, in which dpp is expressed first in broad
      longitudinal stripes (phase II) and subsequently in narrow longitudinal stripes
      (phase III), depend on multiple independent elements in the dpp 5'-flanking
      region. Several aspects of the normal dpp expression pattern appear to depend on
      the unique properties of the dpp core promoter. For example, this core promoter
      (extending from -22 to +6) is able to direct a phase II expression pattern in the
      absence of additional upstream or downstream regulatory elements. In addition, a
      ventral-specific enhancer in the dpp 5'-flanking region that binds the Dorsal
      factor activates the heterologous hsp70 core promoter but not the dpp core
      promoter. Thus, the dpp core promoter region may contribute to spatially
      regulated transcription both by interacting directly with spatially restricted
      activators and by modifying the activity of proteins bound to enhancer elements.

PMID- 7791802
TI  - Molecular and genetic toxicology of 1,3-butadiene.
AB  - During the last 9 years, there have been many studies published concerning the
      mutagenic potential of butadiene in mammalian systems, including alterations at
      the molecular level. Butadiene has tested positive in several mouse in vivo and
      in vitro assays, but has generally tested negative in rat studies. Most of these
      studies are cytogenetic and include positive data in mice for chromosomal
      aberrations, micronucleus formation, and sister chromatid exchanges. Butadiene
      also induces mutations in lung, spleen, and bone marrow of transgenic mice. The
      positive bone marrow cytogenetic and transgenic data may be significant in view
      of the increased lymphohematopoietic malignancies observed in mice and probably
      in humans. In addition, butadiene causes mutations in the K-ras protooncogene and
      in the p53 tumor suppressor gene in mouse studies. Mutations in these genes are
      associated with oncogenesis in humans as well as in rodents. Also, positive
      mutagenicity data have been obtained in a pilot study of workers exposed to
      butadiene. Positive dominant lethal studies in rodents suggest that exposure to
      butadiene can result in germ cell mutation and heritable risk. These mutagenicity
      and molecular data suggest that butadiene is both a somatic and germ cell mutagen
      in mammals, possibly including humans.

PMID- 7791800
TI  - Evidence for impaired retinoic acid receptor-thyroid hormone receptor AF-2
      cofactor activity in human lung cancer.
AB  - Retinoic acid (RA) is required for normal airway epithelial cell growth and
      differentiation both in vivo and in vitro. One of the earliest events following
      the exposure of bronchial epithelial cells to RA is the strong induction of RA
      receptor beta (RAR beta) mRNA. Previous work established that many lung cancer
      cell lines and primary tumors display abnormal RAR beta mRNA expression, most
      often absence or weak expression of the RAR beta 2 isoform, even after RA
      treatment. Restoration of RAR beta 2 into RAR beta-negative lung cancer cell
      lines has been reported to inhibit tumorigenicity. Since RAR beta 2 inactivation
      may contribute to lung cancer, we have investigated the molecular mechanism of
      defective RAR beta 2 expression. Nuclear run-on assays and transient
      transfections with RAR beta 2 promoter constructs indicate the presence of trans
      acting transcriptional defects in most lung cancer cell lines, which map to the
      RA response element (RARE). These defects cannot be complemented by RAR-retinoid
      X receptor cotransfection and can be separated into two types: (i) one affecting
      transcription from direct repeat RAREs, but not palindromic RAREs, and (ii)
      another affecting transcription from both types of RARE. Studies using chimeras
      between RAR alpha, TR alpha, and other transcription factors suggest the
      existence of novel RAR-thyroid hormone receptor AF-2-specific cofactors, which
      are necessary for high levels of transcription. Furthermore, these factors may be
      frequently inactivated in human lung cancer.

PMID- 7791804
TI  - Genotoxicity of 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU).

PMID- 7791805
TI  - Stability of 1-nitropyrene and 1,6-dinitropyrene in environmental water samples
      and soil suspensions.
AB  - This study examined the stability of mutagenic 1-nitropyrene (1-NP) and (1,6
      dinitropyrene (1,6-diNP) in environmental water samples and various soil
      suspensions containing 0.1% peptone and in water samples containing no peptone.
      The water samples or the soil suspensions were mixed with NPs and incubated at 30
      degrees C. The stability of NPs was expressed as mutagenic activity remaining in
      the test solutions. The mutagenicity decreased rapidly when 1-NP or 1,6-diNP was
      incubated in unautoclaved test solutions containing 0.1% peptone but not when
      incubated in autoclaved test solutions. The mutagenicity in the soil suspensions,
      especially in the sludge, decreased faster than in the water samples. This was
      due to the large number of colony-forming units (CFU) in the soil suspensions. In
      the water samples containing 0.1% peptone, the mutagenicity of NPs in the
      polluted Tamiya River water decreased faster than in the unpolluted Yoshino River
      water. The rate of decrease was dependent on the number of CFU in the water
      samples. A large number of CFU decreased the mutagenicity more rapidly than did a
      small number of CFU in samples. The disappearance of mutagenicity was dependent
      on the initial concentrations of NPs. The periods required for a 50% decrease in
      the mutagenicity of 1-NP at the low concentration (0.2 microgram/ml) was shorter
      than that at the high concentration (3 micrograms/ml). 1-Aminopyrene was detected
      in the 1-NP test solution after incubation when it was analyzed by high-pressure
      liquid chromatography. In the water samples containing no peptone, the
      mutagenicity of 1-NP (0.2 microgram/ml) decreased gradually during 30 days of
      incubation. After incubation for 1540 days, the remaining mutagenicity of 1-NP in
      the water samples was almost the same as that in autoclaved water samples. On the
      other hand, the mutagenicity of 1,6-diNP (10 ng/ml) decreased and the remaining
      mutagenicity, except in the Yoshino River water, was less than 20% after 30 days
      of incubation and was completely lost during the 1540-day incubation. However,
      the mutagenicity of 1,6-diNP in autoclaved water samples was very stable and
      almost all mutagenicity, except in sea water, remained after 1540 days of
      incubation at 30 degrees C. These results suggest that the microflora in the
      environment plays an important role in the primary degradation and
      decontamination of relatively low concentrations of NPs.

PMID- 7791803
TI  - Potential genotoxicity of chronically elevated nitric oxide: a review.
AB  - Several human cancers are associated with chronic bacterial, viral and parasitic
      infections. Nitric oxide, which is a short-lived free radical produced by many
      types of cells for a number of important physiological functions, is elevated in
      these infections. Long-term exposure to elevated NO. in cells could have
      potential genotoxic effects on hosts. There are at least three mechanisms by
      which intracellular elevated NO. could exert genotoxic affects after reacting
      with O2. These include formation of carcinogenic N-nitroso compounds, direct
      deamination of DNA bases, and oxidation of DNA after formation of peroxynitrite
      and/or hydroxyl radicals. One or more of these mechanisms could, theoretically,
      explain why chronic infection increases the risk of certain cancers.

PMID- 7791806
TI  - Fish micronuclei for assessing genotoxicity in water.
AB  - Micronucleus assays with fish have been shown to be useful in vivo techniques for
      genotoxicity testing, and show potential for in situ monitoring of water quality.
      In this paper, we review the literature on the clastogenic effects of chemical
      and physical agents on fish cells, with emphasis on the induction of micronuclei
      in teleosts. Included in the review is a description of the mechanisms for
      formation of micronuclei in cells, and a summary of the various techniques that
      have been used for micronucleus analysis in fish. This review is directed to
      assisting laboratories in the development of fish genotoxicity assays for water
      quality monitoring.

PMID- 7791808
TI  - Mutagenicity and contents of polycyclic aromatic hydrocarbons in new high
      viscosity naphthenic oils and used and recycled mineral oils.
AB  - Mutagenic activity on the Ames test was evaluated in 15 samples of naphthenic
      high-viscosity mineral oils and 12 samples of used lubricants (recovered and
      pooled) and their recycled products. Bacterial mutagenesis was assayed using both
      the standard technique and Blackburn's modification. The contents of polycyclic
      aromatic hydrocarbons (PAH) was also evaluated, as polynuclear aromatic fraction
      (PAF) and total PAH, determined respectively with the semi-quantitative
      dimethylsulphoxide-refractive index method and the Grimmer method. Only four
      samples (three acid-treated naphthenic oils and one recycled fraction of a used
      oil) showed mutagenic activity higher than 6 revertants/mg of oil, considered by
      Blackburn and coworkers as indicating a potential carcinogenic risk for these
      compounds. Limited mutagenicity was found in all used and recycled oils, but also
      in samples of acid- or solvent-treated oils. No hydrogen-treated naphthenic oils
      turned out to have any mutagenic activity. PAF contents of oils were closely
      correlated with those of total PAH (n = 15, r = 0.83; n = 12, r = 0.91; p < 0.01
      for both naphthenic and used/recycled oils respectively). No recycled oil had
      high PAF contents. Eleven samples had PAF contents higher than 3%, the arbitrary
      danger threshold suggested by the CONCAWE (1988). Of these 11 samples, the
      majority were acid-treated products, although there was one hydrogen-treated oil
      and one used and recycled oil. No mutagenic activity could be demonstrated in
      almost half the oils with PAF > 3%. In this study, the presence of mutagens was
      not correlated wither with PAF or with total or mutagenic PAH. The difficulty of
      predicting the mutagenicity of mineral oils is stressed. Most naphthenic and some
      recycled oils clearly have components which inhibit the metabolizing system in
      the bacterial mutagenesis test, with consequent possible false negative results.

PMID- 7791807
TI  - Mutagenic activity of the Ganges water with special reference to the pesticide
      pollution in the river between Kachla to Kannauj (U.P.), India.
AB  - Water samples from Ganga river were collected from 3 different locations viz.
      Kachla, Fatehgarh and Kannauj (U.P.). High performance liquid chromatography
      analysis of samples by liquid-liquid extraction procedure showed the presence of
      some pesticides like DDT, alpha-BHC, aldrin, dieldrin etc. DDT, alpha-BHC, DDD,
      aldrin and dieldrin were present at concentration ranges of 3.33-5.33 ppb, 1.73
      3.01 ppb, 0.88-2.41 ppb, 1.17-2.81 ppb and 0.49-4.11 ppb, respectively. The
      organophosphorus pesticides like dimethoate and methyl parathion were also
      detected at the concentration levels of 0.41-0.56 ppb and 0.16-0.50 ppb,
      respectively. The organic substances in the test samples were extracted by XAD
      resin and liquid-liquid extraction procedures, and the extracts were assayed for
      mutagenic potential by the Ames Salmonella/microsome test. The test samples
      exhibited a remarkable degree of mutagenicity with TA98, TA100 and TA97a strains
      with the probable role of contaminating pesticides in the river water.

PMID- 7791809
TI  - Cytogenetic effects in the peripheral lymphocytes and kidney cells of rats
      exposed to 3-chloro-4-(dichloromethyl)-5-hydroxy-2(5H)-furanone (MX) orally on
      three consecutive days.
AB  - We reported previously that 3-chloro-4-(dichloromethyl)-5-hydroxy-2(5H)- furanone
      (MX), a chlorine disinfection by-product in drinking water, induces sister
      chromatid exchanges (SCEs) in the peripheral lymphocytes of male and female rats
      after subchronic exposure. In the present study, we found that the peripheral
      lymphocytes of male rats exposed to MX (25-150 mg/kg) by gavage on three
      consecutive days showed a significant dose-related increase in chromosomal damage
      measured as micronuclei, in addition to SCEs. Moreover, MX produced a significant
      dose-related increase in SCEs in the kidney cells of the exposed rats. The
      magnitude of the genotoxic responses observed was relatively weak. The finding
      is, however, consistent with the known pharmacokinetic distribution of MX in the
      rat after oral dosing.

PMID- 7791810
TI  - The in vivo-in vitro replicative DNA synthesis (RDS) test with hepatocytes
      prepared from male B6C3F1 mice as an early prediction assay for putative
      nongenotoxic (Ames-negative) mouse hepatocarcinogens.
AB  - To assess the efficacy of the in vivo-in vitro hepatocyte replicative DNA
      synthesis (RDS) test as a short-term assay, 41 putative nongenotoxic (Ames
      negative) mouse hepatocarcinogens, as well as 31 noncarcinogens, were examined
      using male 8-week-old B6C3F1 mice and an in vitro [methyl-3]thymidine
      incorporation technique. Animals were exposed to the maximum tolerated dose (MTD)
      and 1/2 MTD of each chemical by gavage and after 24, 39 or 48 h, hepatocytes were
      prepared with a collagenase-perfusion technique. Assessment of the distribution
      of spontaneous RDS in a total of 337 control mice gave an average incidence of
      0.15 +/- 0.08% within the range of 0 to 0.39% (mean +/- 3 x SE) with a 99.7%
      probability. Values of 0.4% or more for RDS incidences induced by test samples
      were therefore judged as indicating a positive response in our RDS test. Under
      the experimental conditions applied, 32 of 41 putative nongenotoxic
      hepatocarcinogens gave clear positive responses (positive sensitivity: 78%), and
      of 31 noncarcinogens 25 samples gave negative responses (negative specificity:
      81%), thus giving an overall concordance for the RDS test with long-term findings
      of 79%.

PMID- 7791811
TI  - Prophylaxis of antioxidants against the genotoxicity of methyl mercuric chloride
      and maleic hydrazide in Allium micronucleus assay.
AB  - Antioxidants, namely cysteine, 2.46 x 10(-5) M; glutathione 9.75 x 10(-6), 9.75 x
      10(-4) M; vitamin C, 10(-2) M; mannitol, 5 x 10(-2) M; potassium iodide, 5 x 10(
      2) M and sodium selenite, 1.73 x 10(-6) M; were tested for their prophylactic
      activity against the genotoxicity of methylmercuric chloride, 1.26 x 10(-6) M and
      maleic hydrazide, 3 x 10(-4) M in Allium micronucleus assay. Antioxidants doses
      were administered simultaneously or prior to the genotoxic exposures. The results
      from the present experiments indicated that antioxidants conferred protection
      against the genotoxicity of both methyl mercuric chloride and maleic hydrazide.
      Furthermore, the protection of GSH against methyl mercuric chloride depending on
      the concentration persisted for 12 h.

PMID- 7791812
TI  - Genotoxicity of quercetin in the micronucleus assay in mouse bone marrow
      erythrocytes, human lymphocytes, V79 cell line and identification of kinetochore
      containing (CREST staining) micronuclei in human lymphocytes.
AB  - Quercetin, a mutagenic flavonoid widely distributed in edible plants, was studied
      for the induction of micronuclei (MN). We have carried out the MN assay in bone
      marrow polychromatic erythrocytes in mice, in cytokinesis-blocked human
      lymphocytes and in cytokinesis-blocked V79 cells. MN assay in vitro was performed
      in the presence and in the absence of S9. To further extend the study, an
      antikinetochore antibody (CREST staining) was used to distinguish MN containing
      whole chromosomes (kinetochore positive) from those containing acentric fragments
      (kinetochore negative). When tested in vivo quercetin failed to induce
      micronuclei, a result which is in agreement with other published reports. When
      tested in vitro in V79 cells quercetin clearly induces micronuclei in the absence
      of S9 and also in the presence of S9 for the highest dose used. When tested in
      vitro in human lymphocytes quercetin shows a significant induction of micronuclei
      in the absence and in the presence of S9. The presence of S9 compared to its
      absence is not significant for any of the systems used. Both in the presence and
      absence of S9, quercetin appears to behave as a clastogenic agent in human
      lymphocytes inducing a significant majority of kinetochore-negative MN.

PMID- 7791813
TI  - The genotoxicity profile of atorvastatin, a new drug in the treatment of
      hypercholesterolemia.
AB  - While HMG-CoA reductase inhibitors such as fluvastatin, lovastatin, pravastatin
      and simvastatin demonstrate lack of in vitro and in vivo mutagenicity and
      clastogenicity in bacterial and mammalian cells, long term rodent carcinogenicity
      studies resulted in an increased incidence in neoplasms at high doses. These
      effects may be attributable to an exaggeration of the desired biochemical effect
      of the drug and/or a tumor promoting effect. The genotoxicity of atorvastatin, a
      newly developed HMG-CoA reductase inhibitor, was evaluated in a variety of test
      systems. In bacterial mutagenicity tests, the E. coli tester strain WP2(uvrA) and
      S. typhimurium strains TA98, TA100, TA1535, TA1537, and TA1538 were exposed to
      concentrations of atorvastatin as high as 5000 micrograms/plate both in the
      absence (S9-) and presence (S9+) of metabolic activation. Atorvastatin was not
      mutagenic in either E. coli or S. typhimurium. Chinese hamster lung V79 cell
      cultures were exposed to atorvastatin at concentrations of 50-300 micrograms/ml
      (S9-) and 100-300 micrograms/ml (S9+) and structural chromosome aberrations were
      assessed. Mutation at the hgprt locus was assessed at concentrations of 100-300
      micrograms/ml (S9-) and 150-275 micrograms/ml (S9+). Atorvastatin was neither
      mutagenic nor clastogenic in the absence or presence of S9. The lack of in vitro
      genotoxicity was corroborated in vivo in a mouse micronucleus study in which
      single oral doses of atorvastatin were administered to male and female CD-1 mice
      at 1, 2500, or 5000 mg/kg. No biologically significant increases in the frequency
      of micronucleated polychromatic erythrocytes in bone marrow at 24, 48, or 72 h
      postdosing were observed. Thus, atorvastatin, as with the other tested HMG-CoA
      reductase inhibitors, is not genotoxic.

PMID- 7791814
TI  - Combination therapy with cyclosporine and methotrexate in severe rheumatoid
      arthritis. The Methotrexate-Cyclosporine Combination Study Group.
AB  - BACKGROUND: Patients with severe rheumatoid arthritis who are treated with
      methotrexate frequently have only partial improvement. METHODS: In a six-month
      randomized, double-blind trial, we compared combination therapy with cyclosporine
      (2.5 to 5 mg per kilogram of body weight per day in two divided doses at 12-hour
      intervals) and methotrexate (at the maximal tolerated dose) with methotrexate and
      placebo in 148 patients with rheumatoid arthritis who had residual inflammation
      and disability despite partial but substantial responses to prior methotrexate
      treatment. The primary outcome measure was the change in the number of tender
      joints. RESULTS: The mean (+/- SD) dose of cyclosporine at the final treatment
      was 2.97 +/- 1.02 mg per kilogram per day. As compared with the placebo group,
      the patients in the treatment group had a net improvement in the tender-joint
      count of 25 percent, or 4.8 joints (95 percent confidence interval, 0.7 to 8.9; P
      = 0.02), and in the swollen-joint count of 25 percent, or 3.8 joints (95 percent
      confidence interval, 1.3 to 6.3; P = 0.005); improvement in overall disease
      activity as assessed by the physician (19 percent, P < 0.001) and the patient (21
      percent, P < 0.001); and improvement in joint pain (23 percent, P = 0.04) and in
      the degree of disability (26 percent, P < 0.001). The mean erythrocyte
      sedimentation rate increased by 4.2 mm per hour in the cyclosporine group and
      decreased by 4.8 mm per hour in the placebo group (P = 0.006). Thirty-six
      patients (48 percent) in the cyclosporine group and 12 patients (16 percent) in
      the placebo group (P < 0.001) met the 1993 criteria for improvement of the
      American College of Rheumatology (more than 20 percent improvement in the numbers
      of both swollen and tender joints and improvement in three of five other
      variables). Seventeen patients in the cyclosporine group and 12 patients in the
      placebo group were withdrawn from the study; 2 patients in the cyclosporine group
      died, 1 from viral pneumonia and the other in a motor vehicle accident. Serum
      creatinine concentrations increased by a mean of 0.14 +/- 0.27 mg per deciliter
      (12 +/- 24 mmol per liter) in the cyclosporine group and by 0.05 +/- 0.19 mg per
      deciliter (4 +/- 17 mmol per liter) in the placebo group (P = 0.02). CONCLUSIONS:
      In a six-month study, patients with severe rheumatoid arthritis and only partial
      responses to methotrexate had clinically important improvement after combination
      therapy with cyclosporine and methotrexate. Side effects were not substantially
      increased. Long-term follow-up of patients treated with this combination is
      needed.

PMID- 7791815
TI  - The effect of glucocorticoids on joint destruction in rheumatoid arthritis. The
      Arthritis and Rheumatism Council Low-Dose Glucocorticoid Study Group.
AB  - BACKGROUND: Oral glucocorticoids are widely used to treat patients with
      rheumatoid arthritis, but their effect on joint destruction, as assessed
      radiologically, is uncertain. METHODS: We conducted a randomized, double-blind
      trial comparing oral prednisolone (7.5 mg daily for two years) with placebo in
      128 adults with active rheumatoid arthritis of less than two years' duration.
      Except for systemic corticosteroids, other treatments could be prescribed. The
      primary outcome variables were the progression of damage as seen on radiographs
      of the hand after one and two years, as measured by the Larsen index, and the
      appearance of erosions in hands that had no erosions at base line. The
      radiographs were viewed jointly by a radiologist and a rheumatologist who were
      unaware of the treatment assignment and the time point at which the films were
      obtained. RESULTS: The statistical analysis of radiologically detected changes
      was based on 106 patients for whom there were films obtained at base line and two
      years later. After two years, the Larsen scores increased by a mean of 0.72 unit
      in the prednisolone group, indicating very little change, and by 5.37 units in
      the placebo group, indicating substantial joint destruction (P = 0.004). Of the
      212 hands of these patients, 147 (69.3 percent) had no erosions at the start of
      the study. At two years, 15 of the 68 such hands in the prednisolone group (22.1
      percent) and 36 of the 79 such hands in the placebo group (45.6 percent) had
      acquired erosions (difference, 23.5 percentage points; 95 percent confidence
      interval, 5.9 to 40.7; P = 0.007). The patients in the prednisolone group had
      greater reductions than the patients in the placebo group in scores on an
      articular index and for pain and disability at 3 months; for pain at 6 months;
      and for disability at 6, 12, and 15 months (all P < 0.05). There was no
      difference between groups in standardized scores for the acute-phase response.
      The adverse events were typical of those encountered with antirheumatoid drugs.
      CONCLUSIONS: In patients with early, active rheumatoid arthritis, prednisolone
      (7.5 mg daily) given for two years in addition to other treatments substantially
      reduced the rate of radiologically detected progression of disease.

PMID- 7791816
TI  - Postoperative infections traced to contamination of an intravenous anesthetic,
      propofol.
AB  - BACKGROUND: Between June 1990 and February 1993, the Centers for Disease Control
      and Prevention conducted investigations at seven hospitals because of unusual
      outbreaks of bloodstream infections, surgical-site infections, and acute febrile
      episodes after surgical procedures. METHODS: We conducted case-control or cohort
      studies, or both, to identify risk factors. A case patient was defined as any
      patient who had an organism-specific infection or acute febrile episode after a
      surgical procedure during the study period in that hospital. The investigations
      also included reviews of procedures, cultures, and microbiologic studies of
      infecting, contaminating, and colonizing strains. RESULTS: Sixty-two case
      patients were identified, 49 (79 percent) of whom underwent surgery during an
      epidemic period. Postoperative complications were more frequent during the
      epidemic period than before it. Only exposure to propofol, a lipid-based
      anesthetic agent, was significantly associated with the postoperative
      complications at all seven hospitals. In six of the outbreaks, an etiologic agent
      (Staphylococcus aureus, Candida albicans, Moraxella osloensis, Enterobacter
      agglomerans, or Serratia marcescens) was identified, and the same strains were
      isolated from the case patients. Although cultures of unopened containers of
      propofol were negative, at two hospitals cultures of propofol from syringes
      currently in use were positive. At one hospital, the recovered organism was
      identical to the organism isolated from the case patients. Interviews with and
      observation of anesthesiology personnel documented a wide variety of lapses in
      aseptic techniques. CONCLUSIONS: With the increasing use of lipid-based
      medications, which support rapid bacterial growth at room temperature, strict
      aseptic techniques are essential during the handling of these agents to prevent
      extrinsic contamination and dangerous infectious complications.

PMID- 7791817
TI  - Attenuation of isoproterenol-mediated vasodilatation in blacks.
AB  - BACKGROUND: The mechanism of enhanced vascular reactivity in young blacks, which
      may play a part in the development of hypertension, has not been defined. To
      determine the contribution of blunted vasodilatation mediated by beta 2
      adrenergic receptors to this phenomenon, we compared forearm blood-flow responses
      to isoproterenol in young black and white normotensive men. METHODS: We used
      venous-occlusion plethysmography to measure the responses of blood flow in the
      forearm to the intraarterial administration of isoproterenol (10 to 400 ng per
      minute) in 9 normotensive black men (mean [+/- SD] age, 31.3 +/- 8.0 years) and
      13 normotensive white men (mean age, 32.9 +/- 5.6 years). Sympathetic activity in
      the forearm was measured simultaneously by isotope-dilution techniques. RESULTS:
      Base-line blood flow in the forearm was similar in blacks and whites, but the
      degree of vasodilatation in response to isoproterenol was markedly lower in
      blacks. Isoproterenol at an infusion rate of 400 ng per minute produced a 9-fold
      increase in blood flow in whites but only a 3.5-fold increase in blacks (P <
      0.001). The base-line rate of norepinephrine spillover in the forearm was higher
      in blacks (2.0 +/- 1.3 ng per minute [11.8 +/- 7.7 nmol per minute]) than in
      whites (0.6 +/- 0.5 ng per minute [3.5 +/- 3.0 nmol per minute], P = 0.002), but
      there was no difference between the groups after isoproterenol stimulation.
      CONCLUSIONS: Forearm blood-flow responses to isoproterenol were markedly
      attenuated in normotensive blacks, indicating a blunting of vasodilatation
      mediated by beta 2-adrenergic receptors. Sympathetic activity in the forearm was
      greater in blacks than in whites, but isoproterenol-stimulated presynaptic beta 2
      adrenergic responses (which facilitated norepinephrine release) did not differ
      significantly between blacks and whites. Our findings suggest that the mechanisms
      responsible for blunted vasodilatation in response to the administration of
      isoproterenol may contribute to enhanced vascular reactivity in blacks and may
      play a part in the pathogenesis of hypertension in blacks.

PMID- 7791818
TI  - Absence of an environmental effect on the recurrence of facial-cleft defects.
AB  - BACKGROUND: The rate of recurrence of a broad range of birth defects may decrease
      among women who change residence after the birth of their first infant. The aim
      of the present study was to determine the effect of changing residence on the
      recurrence of congenital facial-cleft defects. METHODS: We identified 4189 women
      who had infants with facial-cleft defects by linking a data base comprising the
      records of children with facial clefts born between 1952 and 1987 with the
      Central Person Registry in Denmark. Among the 4189 mothers, 1902 each had
      additional children after the first child with a facial-cleft defect. A total of
      2692 younger siblings were identified. We compared the proportion of infants with
      facial-cleft defects among the younger siblings between mothers who had changed
      municipalities or sexual partners and those who had not. RESULTS: Changing the
      municipality of residence did not decrease the frequency with which facial-cleft
      defects recurred in younger siblings. Among the 907 infants of mothers who
      changed municipalities but not partners, 29 (3.2 percent) had facial-cleft
      defects, as compared with 48 (3.4 percent) of 1425 infants of mothers who changed
      neither municipality nor partner (relative risk, 0.9; 95 percent confidence
      interval, 0.6 to 1.5). However, a change of partner reduced the recurrence risk
      significantly. Among 236 infants of mothers who changed partners, 1 (0.4 percent)
      had a facial-cleft defect, as compared with 77 (3.3 percent) of 2350 infants of
      mothers who did not change partners (relative risk, 0.1; 95 percent confidence
      interval, 0.02 to 0.9). CONCLUSIONS: Recurrence of facial-cleft defects is not
      linked to the residence of the mother, but having a different partner reduced a
      woman's risk of having a second child with this defect.

PMID- 7791819
TI  - Images in clinical medicine. Echinococcal cyst of the pericardium.

PMID- 7791820
TI  - Renal osteodystrophy.

PMID- 7791821
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 22-1995. An 82-year-old woman with odynophagia and a large
      mediastinal mass.

PMID- 7791822
TI  - New perspectives on treating rheumatoid arthritis.

PMID- 7791823
TI  - Bacterial contamination of an anesthetic agent.

PMID- 7791824
TI  - Nicotine addiction in young people.

PMID- 7791825
TI  - Antibacterial treatment of gastric ulcers.

PMID- 7791826
TI  - Antibacterial treatment of gastric ulcers.

PMID- 7791827
TI  - Antibacterial treatment of gastric ulcers.

PMID- 7791828
TI  - Antibacterial treatment of gastric ulcers.

PMID- 7791830
TI  - Interleukin-2 as therapy for HIV disease. Dinitrochlorobenzene Study Group.

PMID- 7791829
TI  - Antibacterial treatment of gastric ulcers.

PMID- 7791831
TI  - Interleukin-2 as therapy for HIV disease.

PMID- 7791832
TI  - Molecular diagnosis of neoplasms.

PMID- 7791833
TI  - Molecular diagnosis of neoplasms.

PMID- 7791834
TI  - Relapsing lymphoma.

PMID- 7791835
TI  - Overdose of extended-release acetaminophen.

PMID- 7791836
TI  - A comparison of magnesium sulfate with phenytoin for the prevention of eclampsia.
AB  - BACKGROUND: Magnesium sulfate is used widely to prevent eclamptic seizures in
      pregnant women with hypertension, but few studies have compared the efficacy of
      magnesium sulfate with that of other drugs. Anticonvulsant prophylaxis with
      phenytoin for eclampsia has been recommended, but there are virtually no data to
      support its efficacy. Our objective was to compare magnesium sulfate with
      phenytoin in preventing seizures in hypertensive women during labor. METHODS: We
      randomly assigned women with hypertension who were admitted for delivery to
      receive either magnesium sulfate or phenytoin. The magnesium sulfate regimen
      consisted of a 10-g intramuscular loading dose followed by a maintenance dose of
      5 g given intramuscularly every four hours. For women with severe preeclampsia,
      an additional 4-g loading dose was given intravenously. The phenytoin regimen
      included a 1000-mg loading dose infused over a period of 1 hour, followed by a
      500-mg oral dose 10 hours later. With either regimen, anticonvulsant therapy was
      continued for 24 hours post partum. RESULTS: Ten of 1089 women randomly assigned
      to the phenytoin regimen had eclamptic convulsions, as compared with none of 1049
      women randomly assigned to magnesium sulfate (P = 0.004). There were no
      significant differences in any risk factors for eclampsia between the two study
      groups. Maternal and infant outcomes were also similar in the two study groups.
      CONCLUSIONS: Magnesium sulfate is superior to phenytoin for the prevention of
      eclampsia in hypertensive pregnant women. These results validate the long
      practiced use of magnesium sulfate in the prevention of eclampsia.

PMID- 7791838
TI  - Outbreak of tuberculosis among regular patrons of a neighborhood bar.
AB  - BACKGROUND: Outbreaks of tuberculosis have been reported in prisons, nursing
      homes, urban homeless shelters, and other crowded settings. We report a
      nonresidential outbreak of tuberculosis that originated in a neighborhood bar.
      METHODS: A homeless patient with highly infectious pulmonary tuberculosis was a
      regular patron of a neighborhood bar during a long symptomatic interval before
      diagnosis. We investigated 97 other regular customers and employees of the bar
      through interviews, tuberculin skin testing, and chest roentgenography. We
      performed DNA fingerprinting on isolates from the index patient and 11 other
      patients. RESULTS: The index patient apparently infected 41 of 97 contacts (42
      percent), resulting in 14 cases of active tuberculosis and 27 cases of infection
      but no disease (indicated by positive tuberculin skin tests). Four other cases of
      active tuberculosis occurred among regular customers of the bar who were missed
      by the contact investigation. There were also two secondary cases. Radiographic
      findings in active cases included upper-lobe disease in seven cases (three
      cavitary) and negative chest films at the time of diagnosis in four cases. All 12
      culture isolates we tested had the same chromosomal-DNA restriction pattern.
      CONCLUSIONS: The spread of tuberculosis in a neighborhood bar can be a major
      public health problem. The high rate of infection and disease among the contacts
      was unexpected and was not due to coinfection with the human immunodeficiency
      virus. Possible explanations include heavy alcohol use among the contacts, high
      infectivity of the index case, or both. Sputum cultures must be performed in
      tuberculin-positive contacts who have symptoms, even if the chest films are
      normal.

PMID- 7791839
TI  - Images in clinical medicine. Giant colonic diverticulum.

PMID- 7791840
TI  - Tuberculosis in New York City--turning the tide.
AB  - BACKGROUND: From 1978 through 1992, the number of patients with tuberculosis in
      New York City nearly tripled, and the proportion of such patients who had drug
      resistant isolates of Mycobacterium tuberculosis more than doubled. METHODS: We
      reviewed, confirmed, and analyzed data obtained during the surveillance of
      patients with tuberculosis. RESULTS: From 1992 through 1994, there was a 21
      percent decrease in reported cases of tuberculosis in New York City. An
      evaluation of the surveillance system revealed very few unreported cases. The
      number of cases decreased by more than 20 percent among blacks and Hispanics,
      persons with documented human immunodeficiency virus infection, homeless persons,
      and patients with multidrug-resistant tuberculosis; in all these groups,
      tuberculosis is likely to result from recent transmission. In contrast, the
      number of cases of tuberculosis increased among elderly and foreign-born persons,
      in whom the disease is likely to result from the reactivation of an infection
      acquired many years earlier. Enrollment in a program of directly observed
      therapy, in which health workers watch patients take their medications, increased
      from fewer than 100 patients to nearly 1300, with more than 32,000 patient-months
      of observation from 1992 through 1994. CONCLUSIONS: Epidemiologic patterns
      strongly suggest that the decrease in cases resulted from an interruption in the
      ongoing spread of M. tuberculosis infection, primarily because of better rates of
      completion of treatment and expanded use of directly observed therapy. Another
      contributing factor may have been efforts to reduce the spread of tuberculosis in
      institutional settings, such as hospitals, shelters, and jails. Expansion of
      measures to prevent and control tuberculosis and support of international control
      efforts are needed to ensure continued progress.

PMID- 7791837
TI  - A comparison of conservative and aggressive transfusion regimens in the
      perioperative management of sickle cell disease. The Preoperative Transfusion in
      Sickle Cell Disease Study Group.
AB  - BACKGROUND: Preoperative transfusions are frequently given to prevent
      perioperative morbidity in patients with sickle cell anemia. There is no
      consensus, however, on the best regimen of transfusions for this purpose.
      METHODS: We conducted a multicenter study to compare the rates of perioperative
      complications among patients randomly assigned to receive either an aggressive
      transfusion regimen designed to decrease the hemoglobin S level to less than 30
      percent (group 1) or a conservative regimen designed to increase the hemoglobin
      level to 10 g per deciliter (group 2). RESULTS: Patients undergoing a total of
      604 operations were randomly assigned to group 1 or group 2. The severity of the
      disease, compliance with the protocol, and the types of operations were similar
      in the two groups. The preoperative hemoglobin level was 11 g per deciliter in
      group 1 and 10.6 g per deciliter in group 2. The preoperative value for
      hemoglobin S was 31 percent in group 1 and 59 percent in group 2. The most
      frequent operations were cholecystectomies (232), head and neck surgery (156),
      and orthopedic surgery (72). With the exception of transfusion-related
      complications, which occurred in 14 percent of the operations in group 1 and in 7
      percent of those in group 2, the frequency of serious complications was similar
      in the two groups (31 percent in group 1 and 35 percent in group 2). The acute
      chest syndrome developed in 10 percent of both groups and resulted in two deaths
      in group 1. A history of pulmonary disease and a higher risk associated with
      surgery were significant predictors of the acute chest syndrome. CONCLUSIONS: A
      conservative transfusion regimen was as effective as an aggressive regimen in
      preventing perioperative complications in patients with sickle cell anemia, and
      the conservative approach resulted in only half as many transfusion-associated
      complications.

PMID- 7791841
TI  - Calcium-ion-sensing cell-surface receptors.

PMID- 7791842
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises. Case 23-1995. A 44-year-old woman with pulmonary infiltrates,
      respiratory failure, and pancytopenia.

PMID- 7791843
TI  - Magnesium for preeclampsia and eclampsia.

PMID- 7791844
TI  - Interval cytoreduction in ovarian cancer.

PMID- 7791845
TI  - Interval cytoreduction in ovarian cancer.

PMID- 7791846
TI  - Melanoma in children.

PMID- 7791847
TI  - Melanoma in children.

PMID- 7791848
TI  - More on skin cancer after the extravasation of doxorubicin.

PMID- 7791849
TI  - Patients with chronic diarrhea.

PMID- 7791850
TI  - Patients with chronic diarrhea.

PMID- 7791852
TI  - Treatment of psoriasis.

PMID- 7791851
TI  - Treatment of psoriasis.

PMID- 7791853
TI  - Recombinant tissue plasminogen activator for prosthetic mitral-valve thrombosis.

PMID- 7791854
TI  - Metaphors and health care reform.

PMID- 7791855
TI  - Metaphors and health care reform.

PMID- 7791856
TI  - Another truly presidential checkup.

PMID- 7791857
TI  - Honorary authorship.

PMID- 7791858
TI  - Masculinity at risk.

PMID- 7791859
TI  - Germany minister backs genome research.

PMID- 7791861
TI  - As US reviewer resigns over slur.

PMID- 7791860
TI  - Uproar greets new blood scandal indictment.

PMID- 7791862
TI  - UK fraud verdict prompts moves on ethics...

PMID- 7791863
TI  - Paradox of placebo effect.

PMID- 7791864
TI  - Applying a genetic cantilever.

PMID- 7791865
TI  - Drug design. Rules for the manipulation of polyketides.

PMID- 7791866
TI  - Planetary science. Sublime Solar System ices.

PMID- 7791868
TI  - Molecular pharmacology. Endothelin versatility.

PMID- 7791867
TI  - Reproductive biology. Another DDT connection.

PMID- 7791869
TI  - A human BRCA1 gene knockout.

PMID- 7791870
TI  - Mouse knockouts rule OK.

PMID- 7791871
TI  - Rational design of aromatic polyketide natural products by recombinant assembly
      of enzymatic subunits.
AB  - Recent advances in understanding of bacterial aromatic polyketide biosynthesis
      allow the development of a set of design rules for the rational manipulation of
      chain synthesis, reduction of keto groups and early cyclization steps by genetic
      engineering. The concept of rational design is illustrated by the preparation of
      Streptomyces strains that produce two new polyketides by expression of
      combinations of appropriate enzymatic subunits from naturally occurring
      polyketide synthases. The potential for generating molecular diversity within
      this class of molecules by genetic engineering is enormous.

PMID- 7791873
TI  - Persistent DDT metabolite p,p'-DDE is a potent androgen receptor antagonist.
AB  - The increase in the number of reports of abnormalities in male sex development in
      wildlife and humans coincided with the introduction of 'oestrogenic' chemicals
      such as DDT (1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane) into the environment.
      Although these phenotypic alterations are thought to be mediated by the oestrogen
      receptor, they are also consistent with inhibition of androgen receptor-mediated
      events. Here we report that the major and persistent DDT metabolite, p,p'-DDE
      (1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene), has little ability to bind the
      oestrogen receptor, but inhibits androgen binding to the androgen receptor,
      androgen-induced transcriptional activity, and androgen action in developing,
      pubertal and adult male rats. The results suggest that abnormalities in male sex
      development induced by p,p'-DDE and related environmental chemicals may be
      mediated at the level of the androgen receptor.

PMID- 7791872
TI  - The 2.2 A crystal structure of the Ras-binding domain of the serine/threonine
      kinase c-Raf1 in complex with Rap1A and a GTP analogue.
AB  - The X-ray crystal structure of the complex between the Ras-related protein Rap1A
      in the GTP-analogue (GppNHp) form and the Ras-binding domain (RBD) of the Ras
      effector molecule c-Raf1, a Ser/Thr-specific protein kinase, has been solved to a
      resolution of 2.2 A. It shows that RBD has the ubiquitin superfold and that the
      structure of Rap1A is very similar to that of Ras. The interaction between the
      two proteins is mediated by an apparent central antiparallel beta-sheet formed by
      strands B1-B2 from RBD and strands beta 2-beta 3 from Rap1A. Complex formation is
      mediated by main-chain and side-chain interactions of the so-called effector
      residues in the switch I region of Rap1A.

PMID- 7791874
TI  - Elevation of auditory thresholds by spontaneous cochlear oscillations.
AB  - The inner ear sometimes acts as a robust sound generator, continuously
      broadcasting sounds (spontaneous otoacoustic emissions) which can be intense
      enough to be heard by other individuals standing nearby. Paradoxically, most
      individuals are unaware of the sounds generated within their ears. Two hypotheses
      could explain this paradox: (1) the spontaneous emissions may not be transmitted
      to the central nervous system; or (2) the spontaneous emission produces a
      continuous, high rate of neural activity, which, like the natural pattern of
      spontaneous activity, is ignored by the central nervous system. Here we
      demonstrate that high-intensity spontaneous otoacoustic emission can vigorously
      activate auditory nerve fibres in mammals (Chinchilla laniger). This 'internal
      biological noise' creates a 'line busy' signal that significantly degrades a
      neuron's ability to respond to sound and results in a hearing loss completely
      different from that caused by damage to sensory cells.

PMID- 7791875
TI  - Mediation of PACAP-like neuropeptide transmission by coactivation of Ras/Raf and
      cAMP signal transduction pathways in Drosophila.
AB  - Much work on the signal transduction mechanisms underlying neurotransmission has
      been directed towards studying the roles of the cyclic AMP and phosphoinositide
      pathways. Upon ligand binding, the transmitter receptors interact with
      heterotrimeric G proteins, allowing G alpha and G beta gamma subunits to
      disengage. The free G alpha then modulates the activity of adenylyl cyclase and
      phospholipase C. It has been suggested that the G beta gamma complex which is
      activated through muscarinic or neuropeptide receptors can stimulate mitogen
      activated protein kinase (MAPK) via activation of the small guanine-nucleotide
      binding protein Ras. Sequential activation of the intermediates in the Ras/Raf
      serine-threonine protein kinase/MAPK kinase/MAPK/transcription factor pathway has
      emerged as a central mechanism for controlling cell proliferation and
      differentiation in yeast, worms, fruitflies and mammals. Here we show, by
      analysis of Drosophila mutants, that synaptic current and modulation of K+
      current, triggered by a pituitary adenylyl cyclase-activating polypeptide-like
      neuropeptide, are mediated by coactivation of the Ras/Raf and Rutabaga-adenylyl
      cyclase pathways. Thus the Ras/Raf pathway also appears to be essential for G
      protein-coupled neurotransmission.

PMID- 7791876
TI  - Preferential addition of newly synthesized membrane protein at axonal growth
      cones.
AB  - The addition of plasma membrane proteins to a growing axon could occur by
      preferential insertion at the tip (the growth cone), by uniform insertion along
      the axon, or by insertion at the cell body and bulk flow along the axon. To
      differentiate between these possibilities we used a defective herpesvirus vector
      to express an exogenous protein, the lymphocyte transmembrane protein CD8 alpha,
      in cultured rat hippocampal neurons. The newly synthesized protein first appeared
      on the axonal surface almost exclusively at the growth cone. Preferential
      addition at the growth cone was also observed in minor processes (immature
      dendrites), but not in mature dendrites. Over several hours, CD8 alpha reached a
      uniform distribution over the entire neuronal surface, presumably by diffusion
      within the membrane and possibly endocytic recycling. As well as providing
      materials for axonal growth, the selective addition of membrane vesicles at the
      growth cone may contribute to the polarized distribution of axonal surface
      molecules.

PMID- 7791877
TI  - Ca(2+)-dependent and -independent activities of neural and non-neural
      synaptotagmins.
AB  - Synaptotagmins (Syts) are brain-specific Ca2+/phospholipid-binding proteins. In
      hippocampal synapses, Syt I is essential for fast Ca(2+)-dependent synaptic
      vesicle exocytosis but not for Ca(2+)-independent exocytosis. In vertebrates and
      invertebrates, Syt may therefore participate in Ca(2+)-dependent synaptic
      membrane fusion, either by serving as the Ca2+ sensor in the last step of fast
      Ca(2+)-triggered neurotransmitter release, or by collaborating with an additional
      Ca2+ sensor. While Syt I binds Ca2+ (refs 10, 11), its phospholipid binding is
      triggered at lower calcium concentrations (EC50 = 3-6 microM) than those required
      for exocytosis. Furthermore, Syts bind clathrin-AP2 with high affinity,
      indicating that they may play a general role in endocytosis rather than being
      confined to a specialized function in regulated exocytosis. Here we resolve this
      apparent contradiction by describing four Syts, three of which (Syt VI, VII and
      VIII) are widely expressed in non-neural tissues. All Syts tested share a common
      domain structure, with a cytoplasmic region composed of two C2 domains that
      interacts with clathrin-AP2 (Kd = 0.1-1.0 nM) and with neural and non-neural
      syntaxins. The first C2 domains of Syt I, II, III, V and VII, but not of IV, VI
      or VIII, bind phospholipids with a similar Ca(2+)-concentration dependence (EC50
      = 3-6 microM). The same C2 domains also bind syntaxin as a function of Ca2+ but
      the Ca(2+)-concentration dependence of Syt I, II and V (> 200 microM) differs
      from that of Syt III and VII (< 10 microM).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791878
TI  - An excitatory amino-acid transporter with properties of a ligand-gated chloride
      channel.
AB  - Excitatory amino-acid transporters (EAATs) in the central nervous system maintain
      extracellular glutamate concentrations below excitotoxic levels and may limit the
      activation of glutamate receptors. Here we report the cloning of a novel human
      aspartate/glutamate transporter, EAAT4, which is expressed predominantly in the
      cerebellum. The transport activity encoded by EAAT4 has high apparent affinity
      for L-aspartate and L-glutamate, and has a pharmacological profile consistent
      with previously described cerebellar transport activities. In Xenopus oocytes
      expressing EAAT4, L-aspartate and L-glutamate elicited a current predominantly
      carried by chloride ions. This chloride conductance was not blocked by components
      that block endogenous oocyte chloride channels. Thus EAAT4 combines the re-uptake
      of neurotransmitter with a mechanism for increasing chloride permeability, both
      of which could regulate excitatory neurotransmission.

PMID- 7791879
TI  - Antigenic oscillations and shifting immunodominance in HIV-1 infections.
AB  - A typical protein antigen contains several epitopes that can be recognized by
      cytotoxic T lymphocytes (CTL), but in a characteristic antiviral immune response
      in vivo, CTL recognize only a small number of these potential epitopes, sometimes
      only one, this phenomenon is known as immunodominance. Antigenic variation within
      CTL epitopes has been demonstrated for the human immunodeficiency virus HIV-1
      (ref. 11) and other viruses and such 'antigenic escape' may be responsible for
      viral persistence. Here we develop a new mathematical model that deals with the
      interaction between CTL and multiple epitopes of a genetically variable pathogen,
      and show that the nonlinear competition among CTL responses against different
      epitopes can explain immunodominance. This model suggests that an antigenically
      homogeneous pathogen population tends to induce a dominant response against a
      single epitope, whereas a heterogeneous pathogen population can stimulate
      complicated fluctuating responses against multiple epitopes. Antigenic variation
      in the immunodominant epitope can shift responses to weaker epitopes and thereby
      reduce immunological control of the pathogen population. These ideas are
      consistent with detailed longitudinal studies of CTL responses in HIV-1 infected
      patients. For vaccine design, the model suggests that the major response should
      be directed against conserved epitopes even if they are subdominant.

PMID- 7791880
TI  - A DNA metalloenzyme with DNA ligase activity.
AB  - Single-stranded DNA can fold into well-defined sequence-dependent tertiary
      structures that specifically bind a variety of target molecules, raising the
      possibility that some folded single-stranded DNAs might exhibit catalytic
      activities similar to those of ribozymes and protein enzymes. Derivatives of the
      hammerhead ribozyme that contain a majority of deoxyribonucleotides retain the
      ability to cleave RNA, and a 'deoxyribozyme' was generated by leaving all
      essential ribonucleotides of the hammerhead on the RNA 'substrate'. Recently in
      vitro selection has been used to isolate a DNA sequence that shows Pb(2+)
      dependent RNA-cleaving activity. Here we report the isolation by in vitro
      selection of a small single-stranded DNA that is a Zn2+/Cu(2+)-dependent
      metalloenzyme. The enzyme catalyses the formation of a new phosphodiester bond by
      the condensation of the 5'-hydroxyl of one oligodeoxynucleotide and a 3'
      phosphorimidazolide on another oligodeoxynucleotide, and shows multiple turnover
      ligation.

PMID- 7791882
TI  - Life sciences gain favour in patents.

PMID- 7791881
TI  - How to police fraud.

PMID- 7791883
TI  - UK panel warns of crisis in clinical research careers.

PMID- 7791886
TI  - Citation analysis.

PMID- 7791885
TI  - ET search project in struggle for survival.

PMID- 7791884
TI  - NASA scientists rapped over experiments with animals.

PMID- 7791887
TI  - Mannerly research.

PMID- 7791888
TI  - Preserving embryos.

PMID- 7791889
TI  - Elastic properties of DNA revealed.

PMID- 7791890
TI  - Prion diseases. Yielding under the strain.

PMID- 7791891
TI  - Footnote on limb evolution.

PMID- 7791892
TI  - Muscle contraction. Crossbridge tilting confirmed.

PMID- 7791893
TI  - Intracellular calcium. Replenishing the stores.

PMID- 7791894
TI  - Neurobiology. New visions of the cortex.

PMID- 7791895
TI  - HIV clearance in an infant?

PMID- 7791896
TI  - Advantage of diabetes?

PMID- 7791897
TI  - The synaptic vesicle cycle: a cascade of protein-protein interactions.
AB  - The synaptic vesicle cycle at the nerve terminal consists of vesicle exocytosis
      with neurotransmitter release, endocytosis of empty vesicles, and regeneration of
      fresh vesicles. Of all cellular transport pathways, the synaptic vesicle cycle is
      the fastest and the most tightly regulated. A convergence of results now allows
      formulation of molecular models for key steps of the cycle. These developments
      may form the basis for a mechanistic understanding of higher neural function.

PMID- 7791898
TI  - Polarization of both major body axes in Drosophila by gurken-torpedo signalling.
AB  - Anterior-posterior polarity in Drosophila arises from the movement of the oocyte
      to the posterior of the egg chamber, and the subsequent acquisition of posterior
      fate by the adjacent somatic follicle cells. We demonstrate that gurken is
      necessary in the oocyte and torpedo/DER in the follicle cells for the induction
      of posterior fate. As the gurken-torpedo/DER pathway also establishes
      dorsoventral polarity later in oogenesis, Drosophila uses the same germline to
      soma signalling pathway to determine both embryonic axes.

PMID- 7791899
TI  - Speciation driven by natural selection in Drosophila.
AB  - Reinforcement is the process by which natural selection strengthens sexual
      isolation between incipient species, reducing the frequency of maladaptive
      hybridization and hence completing reproductive isolation. Although this model of
      speciation was once widely accepted, its plausibility and experimental support
      have been recently attacked. Here we provide an example of speciation by
      reinforcement, in the North American fruitfly Drosophila pseudoobscura. The
      results suggest that females of D. pseudoobscura evolved increased sexual
      isolation from their sibling species, D. persimilis, by natural selection against
      maladaptive hybridization.

PMID- 7791900
TI  - Hox gene expression in teleost fins and the origin of vertebrate digits.
AB  - Hox genes are essential for growth and patterning of the tetrapod limb skeleton.
      Mice mutant for the Hoxd-13 gene have an important delay in morphogenesis owing
      to reduced proliferation. Based on the appearance of atavisms in such mice, we
      suggested that modifications of Hox gene regulation may have been a source of
      morphological variation during the evolution of tetrapod limbs. Pectoral and
      pelvic fins are homologous to fore- and hindlimbs, respectively. To compare the
      relative importance of Hox genes during fin versus limb morphogenesis, we cloned
      zebrafish (Danio rerio) HoxD and HoxA complex genes and analysed their expression
      during fin development. The results suggest a scheme for the fin-limb transition
      in which the distal autopods (digits) are neomorphic structures produced by
      unequal proliferation of the posterior part of an ancestral appendix.

PMID- 7791901
TI  - Dendritic spines as basic functional units of neuronal integration.
AB  - Most excitatory synaptic connections occur on dendritic spines. Calcium imaging
      experiments have suggested that spines constitute individual calcium
      compartments, but recent results have challenged this idea. Using two-photon
      microscopy to image fluorescence with high resolution in strongly scattering
      tissue, we measured calcium dynamics in spines from CA1 pyramidal neurons in
      slices of rat hippocampus. Subthreshold synaptic stimulation and spontaneous
      synaptic events produced calcium accumulations that were localized to isolated
      spines, showed stochastic failure, and were abolished by postsynaptic blockers.
      Single somatic spikes induced fast-peaking calcium accumulation in spines
      throughout the cell. Pairing of spikes with synaptic stimulation was frequently
      cooperative, that is, it resulted in supralinear calcium accumulations. We
      conclude: (1) calcium channels exist in spine heads; (2) action potentials invade
      the spines; (3) spines are individual calcium compartments; and (4) spines can
      individually detect the temporal coincidence of pre- and postsynaptic activity,
      and thus serve as basic functional units of neuronal integration.

PMID- 7791902
TI  - Tilting of the light-chain region of myosin during step length changes and active
      force generation in skeletal muscle.
AB  - Force generation and relative sliding between the myosin and actin filaments in
      muscle are thought to be caused by tilting of the head region of the myosin
      crossbridges between the filaments. Structural and spectroscopic experiments have
      demonstrated segmental flexibility of myosin in muscle, but have not shown a
      direct linkage between tilting of the myosin heads and either force generation or
      filament sliding. Here we use fluorescence polarization to detect changes in the
      orientation of the light-chain region of the head, the part most likely to tilt,
      and synchronized head movements by imposing rapid length steps. We found that the
      light-chain region of the myosin head tilts both during the imposed filament
      sliding and during the subsequent quick force recovery that is thought to signal
      the elementary force-generating event.

PMID- 7791903
TI  - Stimulation of E2F1/DP1 transcriptional activity by MDM2 oncoprotein.
AB  - The MDM2 proto-oncogene is found amplified in a variety of tumours. The oncogenic
      capacity of the MDM2 protein is attributed to its ability to bind the p53 tumour
      suppressor protein and mask its transcriptional activation potential. Here we
      show that MDM2 makes a functional contact with two cooperating transcription
      factors, E2F1 and DP1 (refs 4,5), which are involved in S-phase progression. MDM2
      contacts the activation domain of E2F1 using residues conserved in the activation
      domain of p53. However, in contrast to its repression of p53 activity, MDM2
      stimulates the activation capacity of E2F1/DP1. These results indicate that MDM2
      not only releases a proliferative block by silencing the tumour suppressor p53,
      it also positively augments proliferation by stimulating the S-phase inducing
      transcription factors E2F1/DP1.

PMID- 7791904
TI  - Interaction between the retinoblastoma protein and the oncoprotein MDM2.
AB  - Inactivation of tumour-suppressor genes leads to deregulated cell proliferation
      and is a key factor in human tumorigenesis. Both p53 and retinoblastoma genes are
      frequently mutated in human cancers, and the simultaneous inactivation of RB and
      p53 is frequently observed in a variety of naturally occurring human tumours.
      Furthermore, three distinct DNA tumour virus groups--papovaviruses, adenoviruses
      and human papillomaviruses--transform cells by targeting and inactivating certain
      functions of both the p53 and retinoblastoma proteins. The cellular oncoprotein,
      Mdm2, binds to and downmodulates p53 function; its human homologue, MDM2, is
      amplified in certain human tumours, including sarcomas and gliomas.
      Overproduction of Mdm2 is both tumorigenic and capable of immortalizing primary
      rat embryo fibroblasts. Here we show that MDM2 interacts physically and
      functionally with pRB and, as with p53, inhibits pRB growth regulatory function.
      Therefore, both pRB and p53 can be subjected to negative regulation by the
      product of a single cellular protooncogene.

PMID- 7791905
TI  - Non-genetic propagation of strain-specific properties of scrapie prion protein.
AB  - The infectious agents causing scrapie and other transmissible spongiform
      encephalopathies have been postulated to consist solely of the protease-resistant
      form of prion protein (PrPSc). One unprecedented requirement of the protein-only
      model is that the 'inheritance' of pathogen strain differences must be mediated
      by stable variations in PrPSc structure, rather than mutations in an agent
      specific nucleic acid. Strain differences in PrPSc structure have been described
      for the hyper (HY) and drowsy (DY) strains of hamster transmissible mink
      encephalopathy (TME), a scrapie-like disease originating in mink. Although HY and
      DY PrPSc are both post-translationally derived from the precursor prion protein
      (PrPC) they are cleaved at different amino-terminal sites by proteinase K (ref.
      8). Here we investigate whether this strain-specific property of PrPSc is
      transmitted to PrPC during formation of new PrPSc. PrPSc from the HY and DY TME
      strains converted the protease-sensitive PrPC into two distinct sets of protease
      resistant PrP products in a cell-free system. These data provide evidence that
      self-propagation of PrPSc polymers with distinct three-dimensional structures
      could be the molecular basis of scrapie strains.

PMID- 7791906
TI  - Crystal structure of isopenicillin N synthase is the first from a new structural
      family of enzymes.
AB  - Penicillin antibiotics are all produced from fermentation-derived penicillins
      because their chemical synthesis is not commercially viable. The key step in
      penicillin biosynthesis, in which both the beta-lactam and thiazolidine rings of
      the nucleus are created, is mediated by isopenicillin N synthase (IPNS), which
      binds ferrous iron and uses dioxygen as a cosubstrate. In a unique enzymatic
      step, with no chemical precedent, IPNS catalyses the transfer of four hydrogen
      atoms from its tripeptide substrate to dioxygen forming, in a single reaction,
      the complete bicyclic nucleus of the penicillins. We now report the structure of
      IPNS complexed with manganese, which reveals the active site is unusually buried
      within a 'jelly-roll' motif and lined by hydrophobic residues, and suggest how
      this structure permits the process of penicillin formation. Sequence analyses
      indicate IPNS, 1-aminocyclopropane-1-carboxylic acid oxidase and many of the 2
      oxo-acid-dependent oxygenases contain a conserved jelly-roll motif, forming a new
      structural family of enzymes.

PMID- 7791907
TI  - [Stereotactic radiosurgery].

PMID- 7791908
TI  - [Application of leukocyte-poor blood products. Work Group Blood Group Serology
      from the Medical Advisory Commission of the College for Blood Transfusion].

PMID- 7791909
TI  - [5 patients with Takayasu's disease in The Netherlands].
AB  - OBJECTIVE: To describe the patients with Takayasu's disease in the University
      Hospital Nijmegen, and to compare these patients with literature. DESIGN:
      Retrospective, descriptive. SETTING: University Hospital Nijmegen. METHODS: All
      patients with Takayasu's disease in the period of 1980-1993 were traced via
      medical registration codes. These patients are described and compared with the
      literature. RESULTS: Five patients with Takayasu's disease were found, 3 women
      and 2 men, 4 Dutch and I Turkish female. The diagnosis in all patients was made
      before the age of 21 and confirmed by angiography. Four of the 5 patients
      presented initially with general complaints, and, except for patient A, all had a
      pulse or blood pressure difference (left-right) to the disadvantage of the left
      arm. Occlusion of the left subclavian artery occurred finally in all cases. Four
      patients had associated diseases as described in the literature. Four of the 5
      showed no progression on prednisone therapy. Until now no patient has died, with
      a mean follow-up of 10 years. CONCLUSIONS: Takayasu's disease is rare in the
      Netherlands. First symptoms are general fatigue and a pulse/blood pressure
      difference. Early detection by medical history, physical examination and
      angiography appears beneficial, because early treatment may have a favourable
      effect on prognosis.

PMID- 7791910
TI  - [Consensus noninvasive diagnosis of peripheral arterial vascular diseases.
      Central Guidance Organization for Peer Review].
AB  - The outcome is described of a 1993 consensus meeting regarding the role and value
      of functional non-invasive vascular investigations in the assessment of severity
      and localization of arterial obstructions and in the selection of a therapeutic
      strategy in patients with arterial obstructive disease of the lower extremities.
      Since symptoms and clinical investigation alone are unreliable in assessing the
      severity of peripheral arterial disease, complementary functional vascular
      examinations are needed. Measurement of the systolic blood pressures at ankle
      level by means of a sphygmomanometric method and a Doppler flowmeter allows
      reliable determination of the presence or absence of haemodynamically significant
      arterial obstructions. In the case of minor obstructions the sensitivity of ankle
      pressure measurements can be increased by examination during a period of
      hyperaemia, preferably induced by a treadmill walking test. In the case of
      unreliable ankle pressure measurements due to non-compressible arteries
      determination of the toe blood pressure is indicated. Segmental blood pressure
      measurements as well as Doppler analysis of the blood flow at various levels of
      the leg were not considered reliable enough for the localization of arterial
      obstructions, unless the obstructive disease is restricted to one single arterial
      segment. Accurate non-invasive localization of arterial obstructions and the
      determination of their haemodynamic severity are only possible by means of a
      combined echo-Doppler (duplex) examination of the arteries. Duplex examination
      can also be helpful in choosing between surgery and percutaneous transluminal
      angioplasty of localised stenoses and short occlusions.

PMID- 7791911
TI  - [How sick is the neonatal intensive care patient? Limited prognostic significance
      of the Neonatal Therapeutic Intervention Scoring System for mortality and for
      psychomotor development in the first year of life].
AB  - OBJECTIVE: To study the Neonatal therapeutic intervention scoring system (NTISS
      score) as a prognostic indicator for mortality and psychomotor development in
      newborns admitted to an intensive care unit. DESIGN: Retrospective. SETTING:
      Neonatal intensive care unit, Sophia Hospital, Zwolle, the Netherlands. METHOD:
      The medical files of all neonates (n = 152) admitted for intensive care in 1991
      were studied. The NTISS scores at admission were compared of infants with
      birthweights < 1500 g and > or = 1500 g and in these groups of infants who died
      and infants who survived and of infants with normal and with abnormal psychomotor
      development in the first year of life regardless of their birthweight (data of
      110 children were available from outpatient clinic control or reports from
      paediatricians). RESULTS: 22 infants died. There was no significant correlation
      between NTISS score and birthweight or gestational age (r = -0.07 and -0.03
      respectively). In the group of very low birthweight infants, the NTISS score was
      significantly higher of the infants who died (25.9; SD: 4.3) than of those who
      survived (15.9; 5.0). The NTISS score did not differ between infants with normal
      and with abnormal psychomotor development. CONCLUSION: The NTISS score at
      admission only correlates with mortality in infants with birthweights < 1500 g.
      There is no correlation with mortality in infants with birthweights > or = 1500
      g, with gestational age or with psychomotor development in the first year of
      life.

PMID- 7791912
TI  - [Femoral neck fractures in bicyclists due to clipless pedals].
AB  - Femoral neck fractures in healthy young adults caused by a relatively low-energy
      trauma are uncommon. The cases are presented of four cyclists, men of 37, 42 (n =
      2) and 43 years old, with a femoral neck fracture, in which so called clipless
      pedals played an important part. The shoes of the cyclist are affixed to these
      pedals, and the patients had been unable to remove their feet quickly when they
      fell. They were treated by osteosynthesis using screws, but one of them developed
      intra-articular infection which eventually necessitated implantation of a total
      hip prosthesis.

PMID- 7791913
TI  - [Unrecognized neurological symptoms following a visit to the Caribbean Region:
      ciguatoxin poisoning].

PMID- 7791914
TI  - [Variation in management and quality of medical decision making; discussion of a
      conference of the National Forum Medical Decision Making].

PMID- 7791915
TI  - [Belt and suspenders. Medical jargon in The Netherlands and Flanders].

PMID- 7791916
TI  - [Anal blood loss during pregnancy, a symptom which should be taken seriously].

PMID- 7791917
TI  - [Anal blood loss during pregnancy, a symptom which should be taken seriously].

PMID- 7791918
TI  - [Antifibrinolytic therapy].

PMID- 7791919
TI  - [The dilemma of 'the final laparotomy'].

PMID- 7791920
TI  - [Promotion of rapid and oriented referral of patients with possible heart infarct
      by ECG at home].

PMID- 7791922
TI  - [Local treatment of dermatoses in pregnancy].

PMID- 7791921
TI  - [Immunopathology of Sjogren syndrome].

PMID- 7791923
TI  - [The quality of referral letters to the gynecologist compared with the standard
      of the Dutch Family Physicians Society].
AB  - The quality of referral letters to the gynaecologist compared with the standard
      of the Dutch Association of General Practitioners. OBJECTIVE. To assess the
      quality of referral letters of general practitioners (GP) used to refer new
      patients to a gynaecologic outpatient clinic. DESIGN. Prospective study. SETTING.
      Gynaecologic outpatients' clinic, Medical Centre Alkmaar, the Netherlands.
      METHOD. The actual quality of referral letters was compared with ideal quality,
      as defined by the Dutch Association of General Practitioners (NHG) in 1989.
      RESULTS. Fifty-three (14%) of the 373 new patients did not have a referral
      letter: 23 women (6%) consulted the gynaecologist without having consulted their
      GP first. Of the 320 referral letters 63% conformed to the NHG criteria and 27%
      contained a specific question to the specialist. One hundred and fifty-two
      letters (47%) were handwritten, of which 32 (10% of the total) were hardly
      legible. A good to excellent letter had a length of slightly more than 6 to 8
      lines (A4 size). CONCLUSION. Of all 320 letters analysed 15% was qualified as
      'excellent', 48% as 'reasonable/good', 25% as 'brief/just adequate' and 12% as
      'inadequate/insufficient'.

PMID- 7791924
TI  - [The ideal physician: medical students' image of the profession].
AB  - OBJECTIVE: To investigate the view medical students have of the medical
      profession. DESIGN: Cross sectional study of year cohorts, Utrecht. METHOD: The
      attitudes of 445 medical students towards the 'ideal physician' were studied. It
      is often assumed that medical students' attitudes change to a less care-oriented
      direction as they proceed in their education. It is also assumed that female
      students' attitudes are more care-oriented than male students' attitudes. Traits
      of the ideal physician were described in a scale of 18 care-versus cure oriented
      items. Validity and reliability of the measuring instrument were sufficient. The
      scores of pre-clinical and clinical, male and female students were obtained.
      RESULTS: Contrary to expectation, ideals of clinical students. In were more care
      oriented than ideals of beginning students. In general, students' ideals were
      neutral to slightly care-oriented. As was expected, female students' ideals were
      more care-oriented than male students' ideals. CONCLUSION: Medical students did
      not lose their slightly care-oriented ideals as they progressed. Female students
      held more care-oriented attitudes than their male colleagues.

PMID- 7791925
TI  - [Endovascular stent in the treatment of residual pulmonary stenosis in patients
      operated on for congenital heart defects; initial results].
AB  - OBJECTIVE: Evaluation of the preliminary results of stent implantation as a new
      technique of intervention cardiology to treat (residual) stenosis of pulmonary
      arteries in congenital heart disease. DESIGN: Descriptive. SETTING: Children's
      Heart Centre, University Hospital Nijmegen, the Netherlands. METHODS: Data about
      physical condition, heart catheterization/angiography and lung perfusion scan
      were collected. Special attention was paid to the lung perfusion scan as a
      potential parameter of evaluation. RESULTS: The physical condition was not a
      useful parameter to judge the result of the pulmonary intravascular stenting, due
      to a simultaneously present important pulmonary valve insufficiency in most
      cases. Angiography showed a good result immediately after the procedure in all
      cases, except in one with kinking of the stent. The increase of lung perfusion
      could be confirmed by lung scintigraphy in most cases. The relative perfusion of
      the affected lung increased from 22.7% (SD: 10.8) to 38.6% (12.3) (p < or =
      0.001). CONCLUSION: Percutaneous implantation of endovascular stents in pulmonary
      artery branch stenosis is a welcome alternative to (reconstructive) cardiac
      surgery. Objective quantification of this stenting by lung perfusion
      scintigraphy, a technique without patient discomfort, is possible.

PMID- 7791927
TI  - [Coalition agreement 1994: policy breach or continuity in the field of health
      care?].

PMID- 7791926
TI  - [The legacy of Rudolph Hendrik Saltet].

PMID- 7791928
TI  - [Travel experiences in Central and Eastern Europe: Hungary, Poland and former
      Czechoslovakia].

PMID- 7791930
TI  - [Liver transplantation; indications, contraindications and the right time for
      referral].

PMID- 7791931
TI  - [Heart surgery and interventional cardiology for adults; Health Council
      recommendations].
AB  - In the scientifically solidly based report 'Heart surgery and intervention
      cardiology for adults' the Dutch Health Council presents its advice relating to
      the expected developments in the area of invasive treatment of coronary diseases,
      mainly coronary artery bypass grafting (CABG) and percutaneous transluminal
      coronary angioplasty (PTCA). The Council advocates combined cardiological
      surgical discussions about indications for CABG and PTCA and central registration
      of data. Minimum requirements to guarantee quality of a treatment centre are the
      presence of 5 heart surgeons and 5 intervention cardiologists each performing 150
      and 100 interventions a year, respectively. It is, according to the Council, not
      possible to determine the maximum size of a treatment centre scientifically.
      Concerning the waiting lists, the Council recommends a maximal waiting time of 2
      3 months. It is interesting to follow the developments as on the one hand the
      Government wants to deregulate, whereas on the other it advocates a centralized
      approach.

PMID- 7791929
TI  - [Small bowel transplantation and short bowel syndrome].

PMID- 7791932
TI  - [Pain and pain measurement in children].

PMID- 7791933
TI  - [Duplex ultrasonography study in the diagnosis of cerebral, abdominal and
      peripheral artery stenoses].

PMID- 7791934
TI  - [Indications for an increase in lung disease caused by Mycobacterium kansasii in
      the former Limburg mining area?].
AB  - OBJECTIVE: To establish the occurrence of lung disease caused by Mycobacterium
      kansasii in order to determine whether the incidence has increased since 1991.
      DESIGN: Descriptive and retrospective. SETTING: The former coal-mining region
      (Limburg) of the Netherlands. METHOD: The occurrence of lung disease caused by M.
      kansasii and other non tuberculous mycobacteria (NTM) in the Netherlands and in
      the former coal-mining region in particular, was inferred from reports of
      tuberculosis of the national and local Public Health Authorities and of the
      Regional Public Health Laboratory. RESULTS: Between 1991 and 1993 in the former
      coal-mining region of the Netherlands 43 cases of tuberculosis were reported, of
      which 12 afterwards proved to be caused by M. kansasii, i.e. more than were
      diagnosed in the ten preceding years. An epidemiological relationship between
      these patients could be neither established nor disproved. CONCLUSION: The
      incidence of NTM diseases may be increasing with falling prevalence rates of
      tuberculosis infection. As lung disease caused by M. kansasii is not
      transmissible from man to man and its treatment is different from that of lung
      tuberculosis, it is essential to be able to differentiate between these diagnoses
      quickly by using rapid modern microbiological identification methods, and to
      determine the epidemiological links.

PMID- 7791935
TI  - [Consensus depression in adults. Dutch Association for Psychiatry].
AB  - Depression is a frequent and treatable disorder, but it is insufficiently
      recognized. A generally used classification system is lacking. In a consensus
      meeting the following terms were defined: a normal feeling of depression,
      depression as a symptom and depression as an illness. The use of the term 'masked
      depression' was advised against. The undertreatment mentioned is caused by the
      following factors: presentation of physical symptoms by depressive patients,
      unfamiliarity of patients with depressive disorders and difficulties of patients
      and GPs in labelling depression as mental. Depressive disorders have various
      causes. For scoring the severity of depression the Bech version of the Hamilton
      Depression Rating Scale is preferred. There is no valid laboratory test for
      diagnosing depression. Laboratory tests are recommended to exclude physical
      disorders, for choosing an antidepressant and for the follow-up of drug
      treatment. Cognitive Behavioural Therapy and Interpersonal Therapy are preferred
      psychotherapeutic methods because of their scientifically proved efficacy. Women
      suffer from depression twice as frequently as men, which is due to social factors
      rather than to genetic or hormonal factors. Therefore hormonal therapy is not
      indicated, a more equal doctor-patient relationship is. Patients with a
      depressive disorder may consider suicide; this should regularly be discussed with
      them.

PMID- 7791936
TI  - [Improved diabetes control through strict observance of the standard 'Type II
      Diabetes Mellitus' from the Dutch College of Family Physicians].
AB  - OBJECTIVE: Comparison of diabetes regulation by strict or less strict observance
      of the relevant standard protocol of the Netherlands College of General
      Practitioners (NHG standard). SETTING: Two general practices in the region
      'Nieuwe Waterweg Noord', near Rotterdam, the Netherlands. DESIGN: Cross-sectional
      comparative descriptive study. METHOD: Type II diabetic patients from two general
      practices were investigated for diabetic symptoms, type of medication, metabolic
      abnormalities and (risk factors for) complications in relation to their HbA1c as
      a measure of mean blood glucose regulation. One GP strictly observed the NHG
      standard as a protocol, the other GP used it as a guideline. RESULTS: Metabolic
      control was significantly better in the 'strictly observing' general practice
      than in the 'guideline' practice: HbA1c 7.3% (SD: 1.7) versus 8.1% (1.5) (p <
      0.01). Systolic blood pressure was also significantly lower in the 'strict'
      practice: 141 mmHg (23) versus 155 mmHg (21) (p < 0.01), but mean age was lower
      and mean duration of diabetes was significantly shorter. The prevalence of
      macrovascular complications, diabetic retinopathy and nephropathy did not differ
      significantly in these practices; symptoms of polyneuropathy, however, were found
      more often in the patients of the 'strict' practice (41% versus 20%; p < 0.05).
      CONCLUSION: Good metabolic control in patients with type II diabetes mellitus is
      made possible by strict application of the NHG standard for general
      practitioners.

PMID- 7791937
TI  - [Medical program Memisa in Mugunga Camp, Goma, Zaire, August-October 1994].

PMID- 7791938
TI  - [Treatment of hyperthyroidism and indications for radioactive iodine].

PMID- 7791939
TI  - [Prion diseases: a new class of neurodegenerative disorders].

PMID- 7791940
TI  - [A pre-auricular swelling: not always parotitis!].

PMID- 7791941
TI  - Thoughts and observations regarding dementia evaluation.

PMID- 7791943
TI  - Cocaine: how dangerous is it during pregnancy?
AB  - The risk of prematurity, stillbirth, small for gestational age, and central
      nervous system damage are clearly a consequence of maternal cocaine use during
      pregnancy. There is also the risk of concommitent use of alcohol which may cause
      long term developmental problems. Therefore cocaine should be avoided in
      pregnancy, but the good news is that if the child survives, the longterm outcome
      may be very favorable. The cocaine exposed child given proper parenting and
      educational support may well develop normally with a bright future. It is
      important not to be too pessimistic about the term infant exposed to cocaine
      since it may lead to a "self-fulfilling prophecy". Supporting the cocaine exposed
      child and their family is an important task for all health professionals who deal
      with children.

PMID- 7791944
TI  - Acetabular fractures.
AB  - Acetabular fractures are not uncommon injuries of the pelvis. They are most
      frequently associated with high energy trauma such as that seen in a motor
      vehicle accident. Management of patients with acetabular fractures includes
      careful attention to ATLS (advanced Trauma Life Support) protocols and delayed
      operative treatment of the acetabular fractures. Diagnostic evaluation with plain
      radiography and CT is used to plan the treatment approach. Treatment includes not
      only the recognition of the fracture but avoidance of early and late
      complications. Emergent treatment includes closed reduction of associated hip
      dislocations followed by skeletal traction. Delayed reconstruction at four days
      after the injury decreases intraoperative blood loss by allowing retroperitoneal
      hemorrhage to subside. Final outcome after acetabular trauma depends not only on
      the reconstruction of the fracture, but the avoidance of complications.
      Acetabular fractures are becoming an increasingly common orthopedic injury.
      Fractures of the acetabulum (or hip socket) are most commonly seen after motor
      vehicle accidents. Young patients (18 to 30 years old) are typically affected. A
      frequent mechanism of injury is a direct blow to the anterior aspect of the knee
      with the hip flexed such as a dashboard injury in an automobile accident. Other
      mechanisms of injury include direct blows to the lateral aspect of the hip as in
      a fall from a height or a side impact automobile collision.

PMID- 7791942
TI  - Cervical dystonia: a review the role of botulinum toxin.
AB  - Cervical dystonia, although rare in the general population, can severely affect
      the lives of those afflicted with the disease. Throughout history several
      theories have been proposed regarding its etiology and pathophysiology, from
      underlying mental disorders to post-infectious to altered basal ganglia and
      brainstem function. However, CD remains poorly understood. Because of its
      similarity to Idiopathic Torsion Dystonia a genetic basic is suspected, but is
      not proven. Without a true understanding of the disease treatment remains
      symptomatic, and begins with physical therapy and medications and progresses to
      consideration of surgery. These treatment strategies have provided some relief,
      which is usually less than satisfactory within a short period of time. Recently,
      the use of botulinum toxin has provided significant symptomatic relief of pain in
      CD and has been associated with subjective and objective improvement in head
      posture. This newest therapy, although symptomatic, restores a more normal head
      posture and pain relief enabling the individuals with CD to continue to be active
      and productive participants in life, providing a ray of hope to these people as
      we continue to search for a better understanding of the disease process and the
      development of more effective treatment strategies.

PMID- 7791946
TI  - Sensory nerve conduction studies in children. Age-related changes of conduction
      velocities.
AB  - Normal values of sensory conduction velocities (CV) in four routinely examinated
      peripheral nerves are presented median, ulnar, radial and sural were gathered
      from the intact side of children with unilateral brachial plexus or different
      peripheral nerve lesions aged from two weeks to 15.5 years. The data were
      computer treated using an exponential function as the one which best reflects the
      dynamics of CV age-related changes i.e. its neurophysiological maturation.
      Approximated exponential curves and standard error, 95 per cent of confidence
      limits were computer-fitted to CV values and computer-plotted for each nerve. The
      values of sensory CV were computed for each month of age. The minimum and maximum
      values of CV (CVo, CVmax), the age when CV reaches 95% of its maximum maturity
      (age 95%), and maturation rate constant-k were computed for each nerve and used
      for comparative assessment of their neurophysiological maturation. In addition
      the increase of CV per month during the period equal to age 95% was calculated.
      The results have shown: 1. Values of CV along the segment wrist to elbow in
      newborns (CVo) and after maturation (CVmax) were found to be significantly higher
      than those along the distal fingers to wrist segment of both median and ulnar
      nerves (p < 0.001). The main reason for this is probably temperature difference
      between these two segments. 2. Smaller variations of CV values found in different
      nerves along the same nerve segment can be caused by measurement or other
      technical error. Besides, in case of infants it is also very important that age
      groups are identical.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791945
TI  - Linguistic development in a patient with Landau-Kleffner syndrome: a nine-year
      follow-up.
AB  - A longitudinal linguistic analysis of aphasic disorder in a 15-year-old boy
      affected by Landau-Kleffner syndrome followed since the age of 6 is reported. The
      phonological, morphosyntactic and lexical levels of verbal deficits have been
      evaluated by means of collected samples of spontaneous language and a battery of
      linguistic tests. The clinical course has fluctuated with improvement and
      worsening of aphasia and epilepsy; at the end of the follow-up the boy was
      seizure-free and a medium-degree disturbance in language production and
      comprehension was present. The results of the linguistic evaluation suggest that
      the aphasic disturbance was related to a deficiency in phonological decoding
      which leads to phonological, morphosyntactic and lexical disturbances. A temporal
      relationship between the electroclinical picture and the aphasia has been
      observed: the persistent improvement in linguistic performances took place only
      after the disappearance of the seizures and of the EEG epileptic anomalies during
      sleep.

PMID- 7791947
TI  - Somatosensory and visual evoked potentials in congenital muscular dystrophy:
      correlation with MRI changes and muscle merosin status.
AB  - Congenital muscular dystrophy comprises a heterogeneous group of disorders, that
      have in common an early onset and a dystrophic picture on the muscle biopsy. The
      "pure" form of congenital muscular dystrophy is not associated with severe mental
      retardation or structural changes in the brain, though white matter changes on
      brain imaging have been detected in a significant proportion of cases. In this
      study we evaluated the incidence of sensory abnormalities (somatosensory and
      visual evoked responses) in a group of 17 patients with "pure" congenital
      muscular dystrophy and correlated the results of the evoked responses with the
      presence or absence of white matter changes on brain magnetic resonance imaging.
      Our results show close correlation between the presence of MRI white matter
      changes and abnormalities in the sensory evoked potentials. Conversely, all
      patients with normal brain MRI had normal somatosensory evoked potentials (SEP).
      Visual evoked potentials were less sensitive than somatosensory evoked potentials
      in detecting abnormalities in children with white matter changes on MRI. With the
      recent discovery of deficiency in merosin expression in the skeletal muscle of a
      subgroup of patients with CMD, we also correlated the presence or absence of
      white matter changes and the SEP responses with the merosin status. The results
      indicate that all merosin-negative patients had abnormal SEP as well as abnormal
      MRI, whilst no patient with normal merosin expression had an abnormal scan or
      abnormal SEP.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791948
TI  - Moyamoya disease in three siblings--follow-up study with magnetic resonance
      angiography (MRA).
AB  - Three siblings with moyamoya disease including identical twins are reported.
      Although the younger of identical twins had no neurological problems, CT and MRI
      detected cerebral infarctions and cerebral angiography showed the typical
      features of moyamoya disease. All three cases underwent encephalo-duro-arterio
      synangiosis (EDAS), and serial magnetic resonance angiography (MRA) showed that
      the distal portions of the middle cerebral artery (MCA) were well perfused
      through surgically created anastomoses. There were no findings of disease
      progression. MRA might play an important role in follow-up studies of moyamoya
      disease.

PMID- 7791949
TI  - Band brain heterotopia. Case report and literature review.
AB  - The authors describe the case of an 11-year-old boy with a neuroradiologic
      pattern of band gray matter heterotopia, clinically characterized by epileptic
      seizures as well as normal psychomotor development. The clinical history and
      neurophysiological and neuroradiological investigations are reported. The
      diagnosis is based on brain magnetic resonance (MR) imaging, which has proved to
      be the most specific and sensitive test to describe neuronal migration disorders.
      Possible treatments are discussed.

PMID- 7791950
TI  - Cerebellar and brainstem hypoplasia in a child with a partial monosomy for the
      short arm of chromosome 5 and partial trisomy for the short arm of chromosome 10.
AB  - A child with hypoplasia of the cerebellum and brainstem in association with an
      unbalanced translocation, resulting in a partial deletion of the short arm of
      chromosome 5 and a partial trisomy of the short arm of chromosome 10, is
      described. A balanced translocation was present in his mother and maternal
      grandmother. A maternal uncle had died at the age of 4 years with the same
      clinical picture. After reviewing the literature, we conclude that the monosomy
      5p is the most likely cause for this malformation. We suggest that the possible
      existence of chromosomal anomalies should always be considered in the
      differential diagnosis of hypoplasia of the cerebellum and/or brainstem.

PMID- 7791952
TI  - Molybdenum-cofactor deficiency: CT and MR findings.
AB  - We describe the CT and MR findings in molybdenum-cofactor deficiency, a rare
      metabolic disorder which is caused by the defect of a molybdenum-containing
      enzyme cofactor. The CT (3 patients) and/or MR studies (3 patients) of 4
      children, which became symptomatic with intractable seizures within the first
      days after birth and finally turned out to have molybdenum cofactor deficiency,
      were reviewed. All patients showed multicystic leukencephalopathy and a normal
      newborn pattern of myelination of the brainstem. A striking finding in some
      studies was an abnormal shape of the frontal horns of the dilated ventricles
      caused by severe volume loss of the basal ganglia, especially of the caudate
      nucleus, and of the corpus callosum. MRI was superior to CT in the demonstration
      of these lesions. In molybdenum-cofactor deficiency, which can be diagnosed by a
      typical laboratory pattern, CT and MR show the findings of severe perinatal brain
      damage. The abnormal shape of the frontal horns, although possibly not specific,
      may even suggest molybdenum-cofactor deficiency in newborns with intractable
      seizures.

PMID- 7791951
TI  - Treatment of "benign" partial epilepsies of childhood, including atypical forms.
AB  - In a retrospective study the results of therapy in 60 children with so-called
      benign partial epilepsies are reported. It has been shown that the assessment of
      the therapeutic effect has to include the EEG, especially in epilepsies with
      atypical course. Carbamazepine has no effect on the EEG, in epilepsies with
      atypical course (atypical benign partial epilepsy, Landau-Kleffner syndrome,
      epilepsy with continuous spikes and waves during slow sleep [CSWS]) carbamazepine
      usually has no effect either on the seizures or on the EEG, on the contrary, in
      some cases both may even get worse. In our experience, the drug of choice in all
      types of benign childhood epilepsy is sulthiame, if necessary in combination with
      clobazam. Other drugs previously administered, including carbamazepine, should be
      dropped quickly. If the treatment with sulthiame or sulthiame/clobazam in
      children with atypical course is not effective, ACTH-therapy should be considered
      as soon as possible. These results should be confirmed in a prospective
      randomized study.

PMID- 7791953
TI  - Metachromatic leukodystrophy and coincidental finding of papillomatosis of the
      gallbladder. A case report.
AB  - In this case report we describe the coincidental finding of polyps in the
      gallbladder by ultrasound investigation in a six-year-old girl, known to have
      metachromatic leukodystrophy. The investigation was carried out because of
      suspicion of abdominal trauma after falling down the stairs and finding elevated
      serum amylase.

PMID- 7791954
TI  - Modulation of motor activity patterns and sleep states in low-risk prematurely
      born infants reaching normal term: a comparison with full-term newborns.
AB  - To evaluate the influence of prematurity and postnatal age on the relationship
      between motor activity (MA) and sleep states, forty clinically and neurologically
      normal infants were recorded polygraphically and grouped according to their
      gestational (GA, prematures: < 36 weeks, full-term: 37-41 weeks) and conceptional
      (CA, 37-38 and 39-41 weeks) ages. Sleep states (active: AS, and quiet: QS) were
      defined by the concordance of EEG and rapid eye movement criteria. Movements of
      both upper (UL) and lower (LL) limbs were independently recorded. In all groups
      the amount of MA in both UL and LL clearly predominated in AS compared with QS (p
      < 0.02). Contrariwise, both the longest period without movement and the no
      movement 20-sec epochs were significantly higher in QS than in AS (p < 0.005). In
      AS, age-related modifications and modulation of MA amount throughout the state
      were similar for PRT and FT groups: a) in both groups a significant decrease of
      MA with advancing CA was observed (p < 0.05); b) MA throughout the state was
      randomly distributed regardless of CA. In QS, however, PRT were distinguishable
      from FT by the absence of: a) a significant decrease of MA amount with advancing
      CA, together with a reduced increase of both the longest period without movements
      and the no-movement 20-sec epochs; b) prevalence of MA in LL compared with UL; c)
      modulation of the distribution of MA throughout the state.

PMID- 7791955
TI  - Current bibliographies of neuropeptides prepared by the University of Sheffield
      Biomedical Information Service.

PMID- 7791956
TI  - An immunoelectron microscopic study of methionine-enkephalin structures in cat
      prevertebral ganglia.
AB  - Methionine-enkephalin-like immunoreactivity was detected in presynaptic nerve
      fibers and SIF cells in cat prevertebral ganglia. The immunoreactive nerve fibers
      contained a mixture of numerous small clear vesicles and a few large vesicles;
      the immunoreactivity was only confined to the large vesicles. Most of the
      immunoreactive fibers were in apposition with non-immunoreactive neuronal
      profiles, without any detectable synaptic membrane specializations. The other
      immunoreactive fibers formed synaptic contacts mainly with non-immunostained
      dendrites and to a lesser extent with axons and neuronal soma. The
      characterization at the ultrastructural level of the enkephalin-like
      immunoreactive structures is discussed as regards the modalities whereby opiates
      may be involved in sympathetic ganglionic transmission.

PMID- 7791957
TI  - Substrate- and inhibitor-specificity of a non-endothelial enzyme which forms
      [Met5]-enkephalin from [Met5]-enkephalin-Arg6,Phe7 in isolated rabbit ear artery:
      pharmacological characterization.
AB  - The captopril-inhibited enzyme which forms [Met5]-enkephalin from [Met5]
      enkephalin-Arg6,Phe7 in isolated rabbit ear artery was characterized further by
      using various natural substrate candidates/analogues ([Met5]-enkephalin-Arg6,Phe7
      and its amide, [Met5]-enkephalin, angiotensin I and bradykinin), peptidase
      inhibitors such as captopril, enalaprilate and thiorphan and by endothelial
      removal. 10(-5) and 10(-4) M but not 10(-6) M captopril reduced the effectiveness
      of [Met5]-enkephalin-Arg6,Phe7 and potentiated the effect of bradykinin but did
      not affect markedly the action of the other peptides. Of the inhibitors,
      enalaprilate was less effective than captopril, and thiorphan had no effect. The
      [Met5]-enkephalin-Arg6,Phe7-->[Met5]-enkephalin conversion was not affected by
      endothelial removal. The substrate and inhibitor spectrum of this non-endothelial
      enzyme activity bears no relationship in other, hitherto characterized
      dipeptidylcarboxypeptidases/endopeptidases known to be involved in the metabolism
      of the tested peptides.

PMID- 7791958
TI  - Mode of action of an inhibitory neuropeptide SchistoFLRFamide on the locust
      oviduct visceral muscle.
AB  - The possible mode of action of an inhibitory neuropeptide SchistoFLRFamide
      (PDVDHVFLRFamide) on locust oviduct visceral muscle was studied by examining its
      ability to inhibit calcium ionophore A23187-, caffeine- or phorbol ester-induced
      oviduct contractions. A23187-induced muscle contractions included two components:
      one which required the influx of extracellular Ca2+ through Ca2+ channels
      (blocked by cobalt ions), the other not blocked by cobalt ions. SchistoFLRFamide
      inhibited the cobalt-sensitive components, but not the latter. Caffeine induced
      two phases of contractions, a phasic contraction which was probably due to the
      release of intracellular Ca2+ and a tonic contraction which required the influx
      of extracellular Ca2+. SchistoFLRFamide inhibited the tonic contraction in a dose
      dependent manner but did not influence the phasic contraction. The phorbol 12
      myristate 13-acetate-induced muscle contraction required the presence of
      extracellular Ca2+, with Ca2+ probably entering through ligand-gated channels,
      but the contraction was not inhibited by SchistoFLRFamide. Based upon these
      results, it appears that SchistoFLRFamide inhibits muscle contraction by
      preventing the accumulation of free intracellular Ca2+ from extracellular stores.
      SchistoFLRFamide is incapable of inhibiting contraction induced by the release of
      intracellular stores of Ca2+. It is possible that SchistoFLRFamide closes or
      blocks voltage-gated and some ligand-gated Ca2+ channels in the plasma membrane.

PMID- 7791959
TI  - Characterization of a serine peptidase responsible for the inactivation of
      endogenous cholecystokinin in human brain.
AB  - Depolarization of slices of human cerebral cortex releases cholecystokinin-8
      immunoreactivity, only a fraction of which is recovered in intact immunoreactive
      form in the medium. This suggests that extensive hydrolysis takes place during
      short incubations. In the presence of diisopropylfluorophosphate, a serine
      reagent, the recovery is nearly doubled, however, consistent with the involvement
      of a serine peptidase activity. The latter was characterized by assessing the
      protective effects of a series of serine protease inhibitors belonging to the
      families of peptide chloromethylketones or boronic acids. The relative potency of
      these inhibitors was similar to corresponding values previously found with rat
      brain slices indicating that a similar serine peptidase activity is responsible
      for endogenous cholecystokinin inactivation in the two species.

PMID- 7791960
TI  - Involvement of vasopressin and corticotropin-releasing hormone in VIP- and PHI
      induced secretion of ACTH and corticosterone.
AB  - The relative roles of hypothalamic corticotropin-releasing-hormone (CRH) and
      vasopressin (AVP) as mediators of the stimulant effect of vasoactive intestinal
      peptide (VIP) and peptide histidine isoleucine (PHI) on ACTH and corticosterone
      (CORT) secretion, were examined using receptor blockade of endogenous CRH and
      AVP. ACTH and CORT secretion were stimulated 6- and 7-fold, respectively, by PVN
      infusion of VIP (3.0 nmol) and 6- and 9-fold, respectively, by PHI (3.0 nmol).
      ACTH and CORT stimulation by VIP were inhibited 78 and 72%, respectively, by
      pretreatment with the CRF antagonist, 59 and 57%, respectively, by pretreatment
      with the AVP antagonist and about 78% by combined pretreatment with the CRF and
      AVP antagonists. PHI-induced stimulation of ACTH and CORT was inhibited 89 and
      81%, 73 and 59% and 93% by pretreatment with the CRF- or AVP-antagonist or
      combined administration, respectively. These results support the hypothesis that
      the activation of the hypothalamic-pituitary-adrenal (HPA) axis by VIP and PHI is
      mediated through the release of endogenous CRH. AVP also plays a role in this
      response, possibly by enhancing the activity of CRH in a synergistic manner.

PMID- 7791961
TI  - Role of endogenous opioid peptides in central glucocorticoid receptor (GR)
      induced decreases in circulating LH in the male rat.
AB  - While it has been shown that intracerebral administration of exogenous
      glucocorticoids diminishes pituitary luteinizing hormone (LH) release, it is not
      known if these hormones act directly on gonadotropin-releasing hormone (GnRH)
      synthesizing neurons, or if their central inhibitory effects are mediated by
      specific neural substrates. In the present study, we examined whether the opioid
      receptor antagonist, naltrexone (NALT), alters patterns of LH release elicited by
      either systemic or intracerebroventricular (i.c.v.) delivery of GR agonists.
      Subcutaneous (s.c.) injection of the GR agonist, RU362 (2.5 mg/kg), promoted a
      significant reduction in circulating LH levels; pretreatment by i.c.v. injection
      of 1.0 microgram NALT, however, attenuated this inhibitory hormonal response. It
      was also found that rats treated sequentially with NALT and RU362 exhibited
      significantly lower plasma LH levels compared to rats injected with NALT alone.
      In other experiments, intracranial delivery of the synthetic glucocorticoid,
      dexamethasone (DEX), into either the ventricular system or the hypothalamic ARC
      resulted in significantly decreased plasma LH concentrations; the central
      inhibitory effects of DEX on peripheral LH release were reversed, however, by
      i.c.v. pretreatment with NALT. In summary, the present studies show that opioid
      receptor blockade attenuates systemic, as well as intracerebral inhibitory
      effects of GR agonists on the GnRH-pituitary LH axis, suggesting that circulating
      glucocorticoids inhibit LH, in part, through central actions involving endogenous
      opioid receptors. The observed decline in peripheral plasma LH following intra
      ARC injection of DEX suggests that local GR may be functional target sites for
      glucocorticoid effects on LH.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791962
TI  - [125I]-BQ3020, a potent ETB-selective agonist, displays species differences in
      its binding characteristics.
AB  - Binding of [125I]-BQ3020 to membranes prepared from rat cerebellum, dog lung and
      CHO cells stably transfected with the human endothelin ETB receptor clone was
      specific, saturable and of high affinity. The apparent dissociation constants
      (KdS) were 63, 53 and 112 pM for rat cerebellum, dog lung and human ETB,
      respectively. The maximum bindings (Bmax) were 3.8, 0.430 and 20 pmol/mg protein
      for rat cerebellum, dog lung and human clone, respectively. Competition binding
      experiments using [125I]-BQ3020 and unlabelled ET-1, ET-3, S6c and BQ123
      indicated that ET-1, ET-3 and S6c competed for [125I]-BQ3020 binding with similar
      high affinity (IC50 approximately 0.3 nM), whereas BQ123 was ineffective in
      competing for [125I]-BQ3020 binding. Time course experiments suggested that the
      binding of [125I]-BQ3020 to all three preparations was rapid, and reached steady
      state by approximately 40 min at 30 degrees C. Addition of excess unlabelled ET-1
      resulted in partial dissociation (25-40%) from human ETB and dog lung receptors,
      whereas from rat cerebellum it was essentially irreversible. These data suggest
      that [125I]-BQ3020 is a potent and selective ETB agonist and its reversible
      binding property is species-dependent.

PMID- 7791964
TI  - Candidal pituitary abscess: case report.
AB  - We report a case of a culture-proven intrasellar Candida albicans abscess. A 36
      year-old woman presented with a history of headaches, menstrual irregularities,
      and mild symptoms of diabetes insipidus. She was neurologically intact at the
      time of a transsphenoidal surgery for a presumed pituitary adenoma. An extensive
      work-up revealed that although the patient was seronegative for human
      immunodeficiency virus, she was immunocompromised with a T-cell dysfunction.
      Fungal abscesses of the pituitary gland have rarely been reported. This is the
      first documented case of a patient who is seronegative for human immunodeficiency
      virus who becomes infected by an ordinarily innocuous fungus, Candida albicans.

PMID- 7791963
TI  - Attenuation of traumatic cell death by an adenosine A1 agonist in rat hippocampal
      cells.
AB  - In a rat hippocampal cell culture, we studied the mechanism of adenosine-mediated
      neuroprotection in traumatic injury to neurons. When the processes and bodies of
      cells in culture were mechanically disrupted, neurons that were located at a
      distance from the damage site died. This secondary neuronal death is at least
      partially mediated by glutamate, because MK801, a specific N-methyl-D-aspartate
      glutamate channel blocker, diminished the toxic effect. Furthermore, cyclopentyl
      adenosine, a specific A1 adenosine receptor agonist that specifically attenuates
      synaptic release at the excitatory terminal, also blocked this trauma-mediated
      cell death. The dissemination of neurotoxicity from cell injury implies a release
      of a toxin by the dying cells. Consistent with this hypothesis, we found that
      neurotoxicity could be transferred to an uninjured neuronal culture by applying
      extracellular solution of the damaged culture to the healthy undamaged culture,
      as long as the fluid was transferred within 5 minutes. However, the glutamate
      concentrations in this medium were never higher than 20 nmol/L, suggesting that
      glutamate is not mediating the soluble and transferable toxicity. Consistent with
      this observation, the transferable neurotoxicity was not blocked by MK801 but was
      effectively blocked by cyclopentyl adenosine. Our observations suggest that
      traumatic cell death in culture is mediated by multiple mechanisms, including
      glutamate excitotoxicity.

PMID- 7791965
TI  - Thickening of the pituitary stalk: a finding suggestive of intrasellar
      tuberculoma? Case report.
AB  - We describe the case of a patient with an exclusively intrasellar mass, disclosed
      because of a left sixth nerve palsy and headaches. No other manifestation of
      disease, namely, endocrinological, was present. The lesion was approached
      transsphenoidally, and the pathological examination revealed a tuberculoma.
      Complete removal was achieved, and the patient started postoperative
      antituberculous therapy. In some circumstances, thickening of the infundibulum
      and the pituitary stalk could preoperatively suggest the diagnosis of hypophysial
      tuberculoma.

PMID- 7791967
TI  - Teratoma of the cavernous sinus: case report.
AB  - We report the case of an infant with a mature teratoma of the lateral wall of the
      cavernous sinus. A complete excision of the tumor was achieved. There was no
      evidence of recurrence at 1-year follow-up examination. Intracranial teratomas
      and the anatomy of the lateral wall of the cavernous sinus are briefly reviewed.
      To our knowledge, this is the first case of a teratoma confined to the cavernous
      sinus.

PMID- 7791966
TI  - Lymphocytic hypophysitis: case report.
AB  - We report a rare case of lymphocytic hypophysitis in a 52-year-old man who
      presented with a combination of hypopituitarism and diabetes insipidus. Magnetic
      resonance imaging with a contrast medium revealed an expanding sellar mass and
      thickening of the pituitary stalk with homogeneous enhancement. These findings
      may be useful in differentiating lymphocytic hypophysitis from pituitary adenoma.
      The unique clinical and radiological features of this case are discussed.

PMID- 7791968
TI  - Total resection of torcular herophili hemangiopericytoma with radial artery
      graft: case report.
AB  - A case of recurrent hemangiopericytoma involving the torcular herophili is
      reported, with special reference to the reconstruction of the straight sinus with
      a radial artery graft. In preoperative investigations, the tumor was found
      invading the straight and transverse sinuses. The involved occipital superior
      sagittal sinus had been removed in the previous surgery. A collateral bypass was
      observed from the superior sagittal sinus to the straight sinus, and the veins of
      Rosenthal were not opacified, suggesting poor venous drainage from the deep
      venous system to the cavernous sinus. We considered it necessary to reconstruct
      the straight and right transverse sinuses to achieve total removal of the tumor.
      The affected sinuses were removed and were successfully reconstructed with a
      radial artery interposition graft between the straight and right transverse
      sinus. The postoperative course was good, and the bypass was patent on the
      postoperative angiogram. The details of the operative technique are described.

PMID- 7791970
TI  - Regional cerebral oxygen saturation during intra-arterial papaverine therapy for
      vasospasm: case report.
AB  - Cerebral arterial vasospasm continues to be a major secondary medical
      complication of aneurysmal subarachnoid hemorrhage. Despite hypervolemic
      hemodilution, arterial hypertension, and pharmacological therapy, morbidity and
      mortality due to vasospasm remain high. The authors discuss a patient with
      vasospasm who did not respond to traditional medical therapy and who underwent
      intra-arterial papaverine infusions while being monitored with transcranial
      cerebral oximetry. Oximetry during the procedure revealed significant
      improvements in brain regional saturation of oxygen, with the relief of vasospasm
      that correlated with clinical improvements in the patient's neurological status.
      Transcranial cerebral oximetry was used to monitor regional oxygen saturation
      throughout the angiographic and interventional procedures, providing continuous,
      real-time, clinically relevant information about the effects of vasospasm and its
      treatment.

PMID- 7791971
TI  - An endoscopic approach to cysticercosis cysts of the posterior third ventricle.
AB  - An attempted removal of a third ventricular cysticercosis cyst by an endoscopic
      approach was aborted before surgery when a preoperative scan demonstrated
      migration of the cyst into the fourth ventricle. In a second case, successful
      endoscopic removal of a cysticercosis cyst of the posterior third ventricle by a
      precoronal, transforaminal approach is described. Transforaminal endoscopic
      removal of third ventricular cysticercosis lesions is feasible, and immediate
      preoperative imaging should be performed to rule out migration of the lesion
      before surgery.

PMID- 7791969
TI  - Idiopathic spinal cord herniation: a treatable cause of the Brown-Sequard
      syndrome--case report.
AB  - Symptomatic herniation of the spinal cord through the dura is an uncommon
      clinical problem. Since 1989, we have encountered three patients who each
      presented with an unexplained, longstanding Brown-Sequard syndrome and were found
      to have idiopathic herniation of the thoracic spinal cord. This report describes
      the clinical, radiographic, and surgical findings in these three patients and
      reviews the five previously reported patients with this syndrome. Idiopathic
      herniation of the spinal cord is a treatable cause of the Brown-Sequard syndrome
      that may be more common than is currently recognized and should be known to all
      surgeons managing spinal disorders.

PMID- 7791972
TI  - Implantation of fetal tissue for the management of Parkinson's disease: a
      technical note.
AB  - A relatively simple method for implanting fetal tissue within the human basal
      ganglia is described. Stereotactic techniques are used to deposit 14 to 16
      strands of fetal mesencephalic tissue in a linear array within the putamen
      bilaterally. To eliminate the need for targeting each needle pass independently,
      we have devised a novel rotating template/micromanipulator apparatus that can be
      mounted on a Cosman-Roberts-Wells stereotactic frame. The template contains two
      parallel columns of nine holes, all spaced at 4-mm intervals. It can be aligned
      to the longitudinal axis of the putamen and targeted with coordinates for the
      center point of the putamen. Surgery is performed on an awake patient. Short-term
      morbidity (4-6 wk) in the form of variability of Parkinsonian signs, particularly
      "off" symptoms and mild confusion, appears to be the rule with simultaneous
      bilateral implants.

PMID- 7791974
TI  - Library: historical perspective.

PMID- 7791973
TI  - Illumination of mastoid air cell for suboccipital craniotomy: technical note.
AB  - The mastoid air cell was illuminated to estimate the location of the sigmoid
      sinus in 12 cases of a retrosigmoid suboccipital craniotomy for cerebellopontine
      angle tumors. A special illuminator system was designed, and the tip of the
      illuminator was placed inside the external auditory canal. The posterior margin
      of the illuminated air cell was delineated on the outer surface of the skull
      after the skin flap was turned and the position of the sigmoid sinus was
      estimated with reference to the preoperative computed tomographic scan. The
      posterior margin of the mastoid air cell in an axial slice, including the
      internal auditory canal, usually exists within the breadth of the sigmoid sinus.
      A gap between the posterior margin of the mastoid air cell and the position of
      the sigmoid sinus was easily corrected by the computed tomographic finding. This
      method was found to be simple and reliable in performing the suboccipital
      craniotomy with safety and exactness.

PMID- 7791975
TI  - Meta-analysis of antibiotic prophylaxis.

PMID- 7791976
TI  - Surgical management of orbital cavernous angiomas: prognosis for visual function
      after removal.

PMID- 7791977
TI  - Vascular considerations and complications in cranial base surgery.

PMID- 7791978
TI  - Chordomas and chondrosarcomas of the cranial base: results and follow-up of 60
      patients.
AB  - The management of chordomas and chondrosarcomas involving the cranial base
      remains controversial. The options for therapy include biopsy, partial resection,
      radical resection, and various forms of radiotherapy. In this article, we analyze
      the outcome of 60 patients with cranial base chordoma or chondrosarcoma treated
      with extensive surgical resection between 1984 and 1993. Forty-six patients had
      chordomas, and 14 had low-grade chondrosarcomas; 50% of these patients had been
      treated previously. Preoperative studies included computed tomography, magnetic
      resonance imaging, cerebral angiography, and balloon occlusion test of the
      internal carotid artery, as indicated. Magnetic resonance imaging was performed
      on all patients during follow-up. The surgical approaches used for tumor
      resection were predominantly the following: subtemporal, transzygomatic,
      transcavernous, and transpetrous apex; subtemporal and infratemporal; extended
      frontal; and extreme lateral transcondylar. Staged operations with a combination
      of approaches were used when necessary (52% of cases) to remove a tumor more
      completely. Statistical analysis was done by the chi 2 test and correlation
      matrix. Sixty-seven percent of the patients had total or near-total resection.
      Twenty percent of the patients received postoperative radiotherapy. Eleven
      patients died during the postoperative follow-up period, nine with chordomas and
      two with chondrosarcomas. Three patients died because of systemic complications
      within 3 months after surgery, five died because of tumor recurrence, one died
      from unrelated causes, and two died from late complications of radiotherapy. The
      recurrence-free survival rate for all tumors was 80% at 3 years and 76% at 5
      years. Chondrosarcomas had a better prognosis than chordomas (recurrence-free
      survival rates, 90% at 5 years and 65% at 5 years, respectively; P = 0.09).
      Patients who had undergone previous surgery had a greater risk of recurrence (5
      year recurrence-free survival rate, 64%) than did patients who had not undergone
      previous surgery (5-year recurrence-free survival rate, 93%; P < 0.05). Patients
      with total or near-total resection had a better 5-year recurrence-free survival
      rate (84%) than did patients with partial or subtotal resection (64%) (P < 0.05).
      Postoperative leakage of cerebrospinal fluid was the most frequent complication
      (30% of patients) and was found to increase the risk of permanent disability.
      Patients who had undergone previous radiotherapy had a greater risk of death in
      the postoperative period (within 3 months of their operations) and during follow
      up. However, total or near-total resection did not increase the rate of
      postoperative disability.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7791980
TI  - Recurrent subarachnoid hemorrhage from untreated ruptured vertebrobasilar
      dissecting aneurysms.
AB  - The clinical characteristics of vertebrobasilar dissecting aneurysms occurring
      with subarachnoid hemorrhage (SAH) were reviewed in 42 patients, with particular
      focus on the time, incidence, and outcome in association with subsequent rupture.
      Twenty-nine patients underwent 31 surgical procedures, and the remaining 13
      patients were managed without surgery. Surgical details included 19 proximal
      vertebral artery obliterations (including 1 case of endovascular surgery using
      balloon occlusion), 9 trappings, 1 wrapping, 1 bleb clipping, and 1 bleb clipping
      combined with wrapping. Surprisingly, subsequent rupture occurred in 30 (71.4%)
      of the 42 patients. Excluding one patient with postoperative rupture, 29 patients
      suffered a subsequent rupture in the unsecured stage. Of these 29 patients, 19
      were operated on after the subsequent rupture and 10 were not operated on because
      of deteriorated clinical condition (9 patients) or anatomic considerations (1
      patient). Of the 30 patients that suffered a subsequent rupture, 14 died. Twelve
      of the deaths were directly related to the second episode of rupture. Of the 12
      patients who did not suffer a subsequent rupture, 10 underwent operations and
      there were no operative deaths. Only one patient died as the result of the
      initial critical SAH. The mortality (46.7%) of the patients with subsequent
      rupture was significantly higher (P < 0.05) than that (8.3%) of the patients
      without subsequent rupture. Seventeen (56.7%) of the 30 subsequent ruptures
      occurred within 24 hours after the first SAH, and 24 (80%) occurred within the
      first week. Six (66.7%) of the 9 patients operated on within 24 hours after the
      first SAH and 11 (68.8%) of the 16 patients operated on within a week suffered
      preoperative subsequent ruptures.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791979
TI  - Large effect of age on the survival of patients with glioblastoma treated with
      radiotherapy and brachytherapy boost.
AB  - A retrospective review was undertaken to study the influence of age on the
      survival of patients undergoing brachytherapy boost for glioblastoma multiforme.
      From February 1981 through December 1992, 159 adults with primary glioblastoma
      multiforme underwent high-activity iodine-125 brain implant boost after external
      beam radiotherapy. There were 98 men and 61 women, ranging in age from 18 to 73
      years (median, 52 yr). Karnofsky performance scores ranged from 70 to 100
      (median, 90). Surgery before radiotherapy consisted of biopsy in 7% of patients,
      subtotal resection in 66%, and gross total resection in 27%. External beam
      radiotherapy doses ranged from 39.6 to 76.8 Gy, with 91% of patients receiving
      59.4 to 61.2 Gy. Brachytherapy doses ranged from 35.7 to 66.5 Gy (median, 55.0
      Gy) at 0.30 to 0.70 Gy per hour (median, 0.43 Gy/h). Reoperations were performed
      in 81 patients (51%). Information on quality of life was available for 13 of the
      14 living 3-year survivors; 10 patients were steroid independent, and mean
      Karnofsky performance scores had decreased from 92 at the time of brachytherapy
      to 75 at the last follow-up. Univariate and multivariate analyses showed that age
      was the most important parameter influencing survival (P < 0.0005). The nine
      patients 18 to 29.9 years old had a 3-year survival probability of 78 +/- 14%
      (median survival was not yet reached at the time of this report), with a follow
      up of 145 to 511 weeks in living patients (median, 322 wk).(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7791981
TI  - Proximal balloon occlusion for dissecting vertebral aneurysms accompanied by
      subarachnoid hemorrhage.
AB  - Five patients with spontaneous dissecting vertebral aneurysms presenting with
      subarachnoid hemorrhage were treated with endovascular proximal balloon occlusion
      after a successful balloon Matas' test. Occlusion was performed in the
      extracranial portion of the vertebral artery after the potentially dangerous
      period of cerebral vasospasm. Two patients rebled preoperatively during the
      waiting period. Although angiograms demonstrated residual aneurysmal dilatation
      for four of the five patients, postoperative hemorrhages or progression of the
      dissection were not observed during the 19- to 48-month follow-up period. Only
      one patient experienced transient postoperative ischemic complication. Although
      the timing of the procedure and the site of occlusion remain controversial,
      proximal balloon occlusion of the vertebral artery appears to be a safe and
      effective therapy for patients with dissecting vertebral aneurysms presenting
      with subarachnoid hemorrhages. This method provides an important, less invasive
      alternative for this condition.

PMID- 7791983
TI  - Long-term results of surgical treatment of idiopathic neuralgias of the
      glossopharyngeal and vagal nerves.
AB  - Physicians disagree about the best surgical treatment for patients with
      idiopathic neuralgias of the glossopharyngeal and vagal nerves after medical
      treatment has failed. Some favor percutaneous thermal rhizotomy, and other prefer
      extracranial section of the glossopharyngeal or branches of the vagal nerve,
      intracranial section of the glossopharyngeal and upper vagal rootlets, or
      microvascular decompression. However, the results of these procedures are limited
      to series with follow-up periods of less than 5 years or to series with longer
      follow-ups that were performed before the microneurosurgical era. We reviewed the
      long-term results of 14 patients with vagoglossopharyngeal neuralgia treated
      surgically at our center between 1976 and 1987 to determine the best treatment.
      Sixteen procedures were performed: 2 percutaneous thermal rhizotomies; 2
      extracranial sections of the superior laryngeal nerve; and 12 intracranial
      glossopharyngeal and upper vagal rhizotomies, 4 with and 8 without microvascular
      decompression. The follow-ups ranged from 4 to 17 years (mean, 10 yr). All 14
      patients who underwent percutaneous or intracranial rhizotomies were pain free.
      Two patients who underwent percutaneous rhizotomies developed persistent
      dysphagia and hoarseness. Both patients who underwent extracranial nerve section
      experienced pain recurrence 2 and 4 years later. Of 12 patients who underwent
      intracranial section of the glossopharyngeal and upper vagal rootlets, 2
      developed dysphagia, which resolved completely in 1 patient and persisted mildly
      in the other; 1 had transient hoarseness; and 2 developed frequent coughing
      episodes, which persisted in 1 patient and resolved completely in the other. Side
      effects due to motor vagal deficits may be eliminated by intraoperative
      monitoring.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791982
TI  - Functional magnetic resonance imaging mapping of the sensorimotor cortex with
      tactile stimulation.
AB  - The purpose of this study is to compare tactile stimulation of the palm with
      voluntary movement of the fingers as paradigms for mapping the sensorimotor
      cortex in functional magnetic resonance imaging. In 22 subjects, 24 sets of
      functional magnetic resonance images were obtained with echoplanar acquisitions
      and cross-correlation image processing techniques. Two tasks were employed: a
      motor task in which subjects moved the thumb and index finger of one hand and a
      sensory task in which the palm was scratched by another person. The activation
      from the two tasks coincided entirely in 20 sets and partially in 3 sets. In one
      case, no activation was seen with the motor task. The study suggests that tactile
      stimulation of the palm is useful and reliable for mapping the sensorimotor
      cortex.

PMID- 7791984
TI  - Early postoperative appearance of radiofrequency lesions on magnetic resonance
      imaging.
AB  - Eleven patients who underwent stereotactic radiofrequency lesions in the central
      nervous system had magnetic resonance imaging follow-up within 72 hours of
      surgery to determine the early appearance of their lesions. Eight patients with
      severe tremor, one with chronic pain, and two with dystonia were analyzed. There
      were six female patients and five male patients, age 7 to 75 years (mean +/-
      standard deviation = 42 +/- 21). Magnetic resonance imaging was performed
      postoperatively at 32 +/- 25 hours (range, 3-72). Postoperative T1-weighted spin
      echo images demonstrated foci of iso- to hyperintensity surrounded by an edge of
      hypointensity, and corresponding T2-weighted images showed a lesion with three
      concentric zones consisting of inner hypointense, middle hyperintense, and outer
      hypointense zones. Gadolinium increased T1-weighted image lesion visibility, and
      a ring of enhancement around the zone of hypointensity was observed. Lesions
      could be seen as early as 3 hours after surgery. The lesions were best shown on
      gadolinium-enhanced T1-weighted images and on T2-weighted images. The edema
      surrounding the lesion increased over time, up to the 72 hours studied. These
      data provide important information on the development of lesion appearance, which
      may be applied in the development of real-time magnetic resonance imaging
      monitoring of radiofrequency lesion formation. This technique associated with
      electrophysiological response and the real-time visualization of the anatomic
      correlation of the probe may allow for a very precise and selected lesion in the
      central nervous system for the treatment of functional disorders and brain
      tumors.

PMID- 7791985
TI  - Disappearance of arachnoid cysts after head injury.
AB  - The mechanism of the disappearance of arachnoid cysts is not fully understood.
      This article discusses the spontaneous disappearance of these cysts after head
      injury. Five patients underwent computed tomography and were diagnosed as having
      a subdural hematoma or effusion associated with arachnoid cysts. In four of the
      five patients, the cyst decreased in size or disappeared. These cases suggest a
      possible mechanism by which this type of cyst associated with subdural hematoma
      or effusion might disappear. For the arachnoid cyst to disappear, the rupture of
      the cyst wall appears to be essential, and after rupture, subdural effusion must
      develop around the cyst. As this effusion is absorbed, the fluid in the cyst
      drains away, after which the cyst becomes smaller and gradually disappears. This
      hypothesis supports the possibility of a "natural cure" for arachnoid cysts
      without surgical intervention.

PMID- 7791986
TI  - Continuous regional cerebral cortical blood flow monitoring in head-injured
      patients.
AB  - Continuous regional cerebral cortical blood flow (rCoBF) was monitored with
      thermal diffusion flowmetry in 56 severely head-injured patients. Adequate,
      reliable data were accumulated from 37 patients (21 acute subdural hematomas, 10
      cerebral contusions, 4 epidural hematomas, and 2 intracerebral hematomas). The
      thermal sensor was placed at the time of either craniotomy or burr hole
      placement. In 15 patients, monitoring was initiated within 8 hours of injury. One
      third of the comatose patients monitored within 8 hours had rCoBF measurements of
      18 ml per 100 g per minute or less, consistent with previous reports of
      significant ischemia in the early postinjury period. Initial rCoBF measurements
      were similar in the patients with Glasgow Coma Scale scores of 3 to 7 and in
      those with scores of 8 or greater. In patients with poor outcomes, rCoBF
      measurements did not change significantly from initial measurements; however, in
      those patients who had better outcomes, final rCoBF measurements were higher than
      initial rCoBF measurements. The patients who had better outcomes experienced
      normalization of rCoBF during the period of monitoring, and patients with poor
      outcomes had markedly reduced final rCoBF. These changes were statistically
      significant. When management was based strictly upon the intracranial pressure,
      examples of inappropriate treatment were found. For example, hyperemia and
      increased intracranial pressure treated with mannitol caused further rCoBF
      increase, and elevated intracranial pressure with low cerebral blood flow treated
      with hyperventilation increased the severity of ischemia. In 3 (5%) of 56
      patients, wound infections developed. Continuous rCoBF monitoring in head-injured
      patients offers new therapeutic and prognostic insights into their management.

PMID- 7791987
TI  - Magnetic resonance imaging of titanium anterior cervical spine plating systems.
AB  - Magnetic resonance imaging (MRI) of titanium anterior cervical plating systems
      and their effect on postoperative images were evaluated ex vivo and in vivo. The
      Synthes and Caspar plating systems were examined by 0.5- or 1.5-T MRI scanners. A
      phantom study of these implants showed that in spin-echo modes, the plates and
      screws were seen as areas of signal loss accompanying a marginal hyperintense
      band, which was more obvious in higher tesla magnetic fields. Distortion of the
      magnetic field was more prominent in T2-weighted images. In gradient echo mode,
      the plate and screws were seen as areas of signal loss larger than the size of
      the metal because of the magnetic susceptibility effect. Postoperative MRI
      produced images of the implants similar to those observed ex vivo. The Synthes
      plating system did not interfere with the evaluation of the spinal cord, and the
      Caspar screw (which penetrated the posterior cortex of the vertebral body) caused
      a small artifact to be present at the anterior aspect of the spinal cord. In
      addition to being able to provide fixation of the cervical spine, titanium
      anterior cervical plates allow superior MRI of the postoperative spine.

PMID- 7791989
TI  - Gene expression from recombinant viral vectors in the central nervous system
      after blood-brain barrier disruption.
AB  - Direct intracerebral injection of recombinant adenoviral vectors within the brain
      parenchyma or the ventricular system results in a limited volume of distribution
      of virus, as demonstrated by transgene expression. Global delivery to the central
      nervous system may increase the use of these vectors but only if the viral
      vectors can cross the blood-brain barrier and result in transduction of the
      underlying cells. This short-term study examines whether osmotic disruption with
      mannitol can result in sufficient opening of the vascular endothelium to allow
      for passage of replication-defective adenovirus containing the Escherichia coli
      beta-galactosidase gene (lacZ). Virus was injected into the carotid artery of
      rats after blood-brain barrier disruption with intracarotid hypertonic mannitol,
      and the animals were killed and analyzed after 4 days. Histochemical analysis and
      electron microscopy confirmed expression of the E. coli lacZ gene in the
      pericapillary astrocytes of the ipsilateral cerebral cortex and deep grey matter.
      Furthermore, the extent of gene transfer and expression correlated with the
      degree of barrier opening, as measured by Evans blue staining. Transgene
      expression was not seen in control animals that received intracarotid saline
      before recombinant virus injection. These data demonstrate, for the first time,
      that blood-brain barrier disruption can allow for the delivery of functional
      viral vectors to the central nervous system.

PMID- 7791988
TI  - An experimental technique to induce and quantify complex cyclic forces to the
      lumbar spine.
AB  - The human spine is a complex, heterogeneous nonlinear and viscoelastic structure.
      In addition, in vivo loading is not uniaxial. Although many studies on the
      mechanical behavior of the spine under "pure" forces and single cycle load
      applications exist, little research is conducted with complex cyclic loads. In
      this study, we developed a technique to induce and quantify controlled complex
      physiological loads to the lumbar spinal column under cyclic (chronic)
      conditions. The methods described include specimen preparation and mounting to
      induce controlled complex loading (cyclic compression-flexion vector was chosen
      as an example), instrumentation, and biomechanical data to achieve the
      objectives. The results indicated that the specimen sustained the external load
      in a combined compression-flexion mechanism without considerable off-axis forces
      (lateral shears) and moments (lateral bending and torsion). By mounting the
      anchoring bolt in appropriate places (such as an anterolateral placement to
      induce compression-flexion-lateral bending), this technique can be used to apply
      and continuously quantify complex physiological acute or cyclic loads to describe
      the biomechanics of the spine. This procedure of inducing complex loads
      eliminates the difficulty in applying the principles of superposition, using the
      response from individual "pure" forces to account for the nonlinearity and
      viscoelasticity of the human lumbar spinal column.

PMID- 7791990
TI  - The multiple tumor suppressor 1/cyclin-dependent kinase inhibitor 2 gene in human
      central nervous system primitive neuroectodermal tumor.
AB  - The recently described multiple tumor suppressor 1/cyclin-dependent kinase
      inhibitor 2 (MTS1/CDKN2) gene, encoding the cyclin-dependent kinase 4 inhibitor
      p16, is mutated in a wide variety of tumor cell lines, including gliomas. To
      investigate the possible role of this gene in the genesis of the central nervous
      system primitive neuroectodermal tumor (PNET), four established PNET cell lines
      and 18 PNET surgical specimens were studied for deletions and mutations of the
      MTS1/CDKN2 gene. One of the four cell lines had homozygous deletion of the gene.
      No mutation in any of the three MTS1/CDKN2 exons was detected in the other three
      cell lines by single strand conformational polymorphism analysis. Eighteen
      surgical PNET specimens were studied for allelic and homozygous deletion at
      chromosome 9p21, the location of the MTS1/CDKN2 gene. No loss of heterozygosity
      was noted in 11 of the tumors, and no homozygous loss was noted in any tumor.
      Single strand conformational polymorphism analysis of the entire coding region of
      the MTS1/CDKN2 gene revealed no mutation within MTS1/CDKN2 in any tumor. Although
      deletion of MTS1/CDKN2 may occur in some PNET cell lines, neither deletion nor
      mutation of the gene is found in tumors before culture. The genesis of the human
      central nervous system PNET does not involve deletion or mutation of the
      MTS1/CDKN2 gene.

PMID- 7791991
TI  - A pial window model for the intracranial study of human glioma microvascular
      function.
AB  - A new model for human brain tumor uses the intracranial placement of tumor
      xenografts under transparent glass cranial windows in nude rats, which require no
      immunosuppression for tumor engraftment. Adult male nude rats underwent
      implantation of human anaplastic astrocytomas (D-54 MG in 10 rats, D-317 MG in 11
      rats). The tumors were placed on the pial surface of the left cerebral hemisphere
      under a glass cranial window overlying the cranium. Six control animals underwent
      cranial window placement alone. Tumor volumes were estimated from direct
      measurements of tumor dimensions, revealing a mean doubling time of 1.58 days for
      the D-54 MG tumors and 2.62 days for the D-317 MG tumors. When tumor volume
      estimates reached 35 mm3, photomicrographs revealed tumor vasculature in each
      tumor cell line that was distinct from both the other xenograft and the normal
      brain parenchyma. Qualitative differences in vascular appearance were supported
      by length/density coefficient calculations in each study group, with D-317 MG
      demonstrating the highest vascular density. Vessel caliber tended to be smaller
      in D-54 MG tumors than in D-317 MG tumors. Laser-Doppler measurements of local
      blood flow in tumors and normal parenchyma revealed significantly lower blood
      flow in both tumor cell lines than in control brain. Evaluation of
      leukocyte/endothelial cell interactions indicated more leukocyte rolling in D-54
      MG tumors than in D-317 MG tumors; no evidence of this cell interaction was found
      in normal pial vasculature. This model allows direct serial inspection of human
      brain tumor growth and vascular function in an experimental animal and could be
      used to study tumor vascular and inflammatory responses to a variety of
      therapeutic manipulations.

PMID- 7791992
TI  - A canine model of acute hindbrain ischemia and reperfusion.
AB  - Animal models of brain stem ischemia are needed for pathophysiological study and
      evaluation of treatment; few such models are available currently. A new canine
      model of hindbrain ischemia and reperfusion is introduced in this article.
      Through an anterior cervical approach, the basilar artery was surgically exposed
      in 18 dogs. The posterior communicating and superior cerebellar arteries were
      embolized with cyanoacrylate glue to isolate the posterior circulation from the
      anterior circulation. Reversible hindbrain ischemia was induced in 14 dogs by the
      temporary clipping of the vertebral and ventral spinal arteries for various
      periods (10-30 min), then the clips were removed and reperfusion was achieved for
      5 hours. In all 14 dogs, the hindbrain ischemia was confirmed by the decreased
      perfusion pressure in the basilar artery (< 10 mm Hg), the diminished regional
      cerebral blood flow as measured with a laser Doppler flowmeter at the medulla
      oblongata (< 10 ml/100 g/min), the flattened brain stem auditory evoked
      potentials, and the increased leakage of Evans blue dye from tissue. These
      parameters did not change in the four control dogs. The changes in brain stem
      auditory evoked potentials were closely related to the length of ischemic
      interval; after 10 minutes of ischemia, reperfusion fully reversed the changes in
      brain stem auditory evoked potentials, but 20-minute and 30-minute ischemic
      intervals partially or totally depleted the brain stem auditory evoked
      potentials. Delayed postischemic hypoperfusion occurred in all five dogs that
      underwent the 30-minute ischemic interval. The early physiological changes in
      this model allowed us to estimate the severity of brain stem ischemia and the
      resulting damage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7791993
TI  - Intraischemic hypothermia decreases the release of glutamate in the cores of
      permanent focal cerebral infarcts.
AB  - The cerebroprotective effects of hypothermia in focal models of ischemia are well
      established, but little is known about the underlying mechanisms of this form of
      brain protection. Cortical cooling in global transient ischemic models suggests
      that hypothermia limits glutamate excitotoxicity by decreasing the release of
      glutamate during ischemia. Few studies have examined glutamate release in the
      more physiological model of permanent focal ischemia. In this study, we used a
      rat model of middle cerebral artery occlusion (MCAO) of permanent focal ischemia.
      Extracellular glutamate concentration was analyzed bilaterally by microdialysis
      for 30 minutes before MCAO to 120 minutes after MCAO. Normothermic animals (n =
      13) had a baseline glutamate concentration of 9.23 +/- 2.5 mumol/ml (mean +/-
      standard error of the mean) before MCAO. Extracellular glutamate rose quickly
      after vessel occlusion and peaked at 33.95 +/- 6.3 mumol/ml 30 minutes after
      MCAO. By 60 minutes after MCAO, this level had decreased to 25.14 +/- 6.3
      mumol/ml; glutamate levels decreased slightly to 21.35 +/- 6.8 mumol/ml by 120
      minutes. Hypothermic animals (n = 11) had an initial extracellular glutamate
      concentration of 5.22 +/- 1.3 mumol/ml before MCAO. This value rose gradually to
      a maximum of 10.69 +/- 3.3 microns/ml at 50 minutes after MCAO and then returned
      to a baseline value of 2.58 +/- 1.2 mumol/ml by 120 minutes. Contralateral
      control glutamate dialysates in the normothermic and hypothermic groups remained
      near baseline throughout the experimental period. The mean percentages of right
      hemispheric volumes occupied by infarcts were 11.96 +/- 1.68% in the hypothermic
      group and 19.77 +/- 2.03% in the normothermic animals.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7791994
TI  - Fluid intelligence after frontal lobe lesions.
AB  - Generally positive correlations between different ability tests provide the
      evidence for a factor of "general intelligence" or Spearman's g. Though a
      possible neural substrate for g is suggested by executive impairments following
      frontal lobe lesions, preserved IQs in some frontal patients have been taken as
      strong evidence against this interpretation. We show that such results depend on
      how g is measured. Patients with superior IQs on the most clinically popular test
      -the Wechsler Adult Intelligence Scale--show impairments of 20-60 points on
      conventionally measured fluid intelligence or novel problem solving. On
      psychometric grounds, it is fluid intelligence that is most closely related to
      Spearman's g. The data suggest that g may in large part be a reflection of
      frontal functions.

PMID- 7791995
TI  - Functional separation of global and local stereopsis investigated by cross
      adaptation.
AB  - Reports that brain lesions may differentially affect global and local stereopsis
      suggest that anatomically separate mechanisms underlie these two functions. We
      demonstrate here that adaptation to global stereograms induces an after-effect on
      local stereopsis as well as on global stereopsis, showing that the two mechanisms
      cannot be entirely separate. We suggest that global stereopsis depends upon an
      interaction between primary visual area V1 and higher brain areas such as
      inferotemporal cortex.

PMID- 7791996
TI  - The effects of frontal- or temporal-lobe lesions on susceptibility to
      interference in spatial memory.
AB  - Patients with unilateral frontal- or temporal-lobe lesions and normal control
      subjects studied multiple arrays of pictures and were tested for recall of the
      locations of the pictures. One condition consisted of three trials of the same
      pictures in different spatial arrangements, recall being tested immediately after
      each presentation. In a second condition (using different stimuli), the subject
      was given two trials with one set of pictures, but a new set of pictures was
      viewed on the third trial. All groups showed a build-up of proactive interference
      across trials using the same pictures, and a release of proactive interference
      when they studied new pictures. Patients with frontal-lobe lesions were more
      susceptible to proactive interference than were the other groups.

PMID- 7791997
TI  - Visual scanning behavior in patients with homonymous hemianopia.
AB  - This study examined oculomotor scanning behavior in 60 patients suffering from
      homonymous hemianopia due to postgeniculate damage. Eye movements were recorded
      using an infra-red recording technique during performance of a visual searching
      task. In 24 patients (40%) scanning behavior was found to be normal; the
      remaining 60% showed significantly increased search times. Detailed analysis of
      patients' eye movements revealed that the pronounced slowing of visual scanning
      was mainly due to the disordered spatial organization of scanning not only in the
      affected, but also, to a lesser degree, in the intact hemifield. CT and NMR
      examination revealed that additional damage to the ipsilateral posterior thalamus
      or the parieto-occipital cortex results in impaired spatial organization of
      visual scanning. A smaller group of patients (n = 14) with impaired visual
      scanning was treated to improve the spatial organization of visual exploration.
      After training, all patients showed a significant improvement in visual
      searching, indicating that successful oculomotor adaptation can substitute the
      lost visual hemifield. It is argued that impaired visual scanning in hemianopic
      patients is mainly caused by visual spatial disorientation which also affects
      spatial integration of visual information processing.

PMID- 7791998
TI  - Perceptual completion in patients with drawing neglect: eye-movement and
      tachistoscopic investigations.
AB  - A group of neglect patients was compared with control patients in the perception
      of complete and incomplete figures, including the patients' own incomplete
      drawings. Eye movements were recorded throughout. Under both tachistoscopic and
      free-vision conditions, the neglect patients failed to report the absence of the
      left side of figures only when this missing side lay in the left visual field;
      they always reported the absence of the left side when the right half-stimulus
      lay entirely within the right visual field. Thus, the position of a stimulus in
      the visual field is an important factor in explaining neglect.

PMID- 7791999
TI  - Mutism and auditory agnosia due to bilateral insular damage--role of the insula
      in human communication.
AB  - We report a case of transient mutism and persistent auditory agnosia due to two
      successive ischemic infarcts mainly involving the insular cortex on both
      hemispheres. During the 'mutic' period, which lasted about 1 month, the patient
      did not respond to any auditory stimuli and made no effort to communicate. On
      follow-up examinations, language competences had re-appeared almost intact, but a
      massive auditory agnosia for non-verbal sounds was observed. From close
      inspection of lesion site, as determined with brain resonance imaging, and from a
      study of auditory evoked potentials, it is concluded that bilateral insular
      damage was crucial to both expressive and receptive components of the syndrome.
      The role of the insula in verbal and non-verbal communication is discussed in the
      light of anatomical descriptions of the pattern of connectivity of the insular
      cortex.

PMID- 7792000
TI  - The role of prefrontal regions in the Stroop task.
AB  - The Stroop is a classical paradigm that presumably involves the inhibition of
      automatic responses and is frequently used to assess the frontal lobe functions.
      We investigated the effect of discrete prefrontal lesions in a Stroop task. A
      sample of 32 patients with frontal lesions were matched with normal controls by
      sex, age and years of education. Significant differences between patients and
      controls were found for errors but not for reaction time. Regression analysis
      showed that the region most related to errors was the right prefrontal lateral
      cortex. Left lobectomies did not impair the Stroop performance. Our results
      favour the role of the right prefrontal cortex in sustained attention, and
      disagree with the conception of the left prefrontal cortex having a role in the
      inhibition of verbal automatic responses.

PMID- 7792001
TI  - Clock-drawing in a case of left visuo-spatial neglect: a deficit of
      disengagement?
AB  - A patient (C.B.) with severe left visuo-spatial neglect and hemianopia after
      right hemisphere stroke was tested on three conditions of a clock-drawing task.
      Either on spontaneous drawing or when the number sequence was provided by the
      experimenter, C.B. drew a clockface with left-sided numbers transposed to the
      right side of the dial. By contrast, when each number was drawn on a separate
      dial, its location was correct and there was no transposition. Directional
      hypokinesia or a representational deficit cannot explain these effects. It is
      proposed that a deficit in disengaging attention from right-sided visual stimuli
      plays a critical role in some forms of number transpositions.

PMID- 7792003
TI  - Impaired movement sequencing in patients with Huntington's disease: a kinematic
      analysis.
AB  - This experiment asked whether Huntington's disease, like Parkinson's disease,
      another disorder of the basal ganglia, causes a specific progressive deficit in
      the performance of sequential movement. Ten patients with Huntington's disease
      and their age-matched controls wrote the lower-case letter "l" four times in a
      linked cursive script, upon a graphics tablet which sampled pen position at 200
      Hz. Kinematic features of sequential movement (stroke length, stroke duration,
      peak velocity, time to peak velocity and time from peak to zero velocity) were
      examined in a Group by Stroke Position (2 x 8) design, to identify which aspects
      of movement might show progressive disturbances. Unlike Agostino et al. [Brain
      115, 1481-1495, 1992], this experiment did in fact find progressive changes in
      the performance of sequential movements. Kinematic analysis indicated a
      progressive increase in movement duration during sequential movement, that was
      associated with the accelerative phase of movement.

PMID- 7792002
TI  - Performance on motor tasks as an indication of increased behavioral asymmetry
      with advancing age.
AB  - Age-related asymmetrical functional decline was tested on a sample of 64 right
      handed volunteers between 60 and 64 years of age who were free from neurological
      illnesses and physical handicaps. Increase in functional asymmetry was explored
      by examining performance indexes for each hand and superiority of the dominant
      hand on motor tasks of different complexities: the Finger Tapping Test, the
      Grooved Pegboard Test, and the Pin Test. Our study revealed an increase in
      superiority of the right hand with age on a highly demanding task (Pin Test).
      This finding is discussed in light of the hypothesis of a decline in callosal
      functioning with age and the alternative hypothesis of a greater vulnerability of
      the right hemisphere in the elderly.

PMID- 7792005
TI  - Release from proactive interference in early Alzheimer's disease.
AB  - The study analyses the performance of 22 mild Alzheimer's disease (AD) patients
      on the Release from Proactive Interference (RPI) paradigm with the aim to
      investigate the relationship of RPI with frontal function. Twenty-one normal
      elderly subjects, age and education matched, constituted the control group.
      Patients with AD were found to recall less words on each trial of the RPI than
      did the controls. The analysis of Proactive Interference (PI) and Release from
      PI, in AD patients, by using Anova (trial x group), showed a significant effect
      of trial and group but not a group by trial interaction. These results indicate a
      similarity between the performance of AD patients and normal controls on the
      Release from Proactive Interference paradigm. Despite the similar pattern of
      performance, AD patients were significantly inferior to normal controls with
      regard to global performance level. The AD patients' scores on "frontal lobe"
      tests were correlated with an index of RPI (shift condition index). The only
      significant result was with the number of categories on the Wisconsin Card
      Sorting Test, suggesting a weak correlation between RPI and "frontal lobe"
      function.

PMID- 7792004
TI  - Ocular space exploration in the dark and its relation to subjective and objective
      body orientation in neglect patients with parietal lesions.
AB  - Eye movements of neglect patients with right parietal lesions were recorded
      during ocular searching for a (non-existent) target in complete darkness. With
      respect to the objective orientation of the sagittal midplane, ocular exploration
      was biased toward the ipsilesional side. However, in relation to the patients'
      subjective localization of the sagittal midplane in space, exploratory eye
      movements were symmetrically distributed to the subjective "left" and "right" as
      observed in non-brain-damaged controls. The present results further support the
      hypothesis that the essential aspect leading to spatial neglect is a disturbance
      of those cortical structures that are crucial for computing egocentric, body
      centred coordinates that allow use to determine our body position in space and
      that are necessary for visuomotor coordination and exploration of space. In
      neglect patients the central coordinate transformation seems to work with a
      systematic error resulting in a deviation of the spatial reference frame to the
      ipsilesional side. Consequences of this deviation are a displacement of
      subjective localization of body orientation and--to the same degree--of the
      spatial area in which motor behavior (here exploratory eye movements) is
      executed.

PMID- 7792006
TI  - Increased activation as a limiting factor of performance in sharp shooters.
AB  - The measurement of autonomic nervous system (ANS) activity was performed on 10
      male and five female sharp shooters (rifle) during competitions. Electrodermal,
      thermovascular, cardiorespiratory variables and two indices of performance were
      recorded simultaneously. When the subjects fired shots that hit the target, they
      had a higher number of negative skin potential responses than when they missed.
      The responses had lower amplitude but lasted longer than when the shots missed
      the target. Good performance seemed to depend on high levels of motivation
      (increase in negative potential response), better mastery of the emotional
      reactivity (low amplitude response), and greater concentration time (increased
      duration of response).

PMID- 7792007
TI  - Disturbances of cortical development.
AB  - The development processes coinciding in formation of cerebral cortex were
      presented. On this background may arise the cortical developmental abnormalities.
      The review of principal cortical malformations include the 1) agyria-pachygyria -
      lissencephaly type I, 2) polymicrogyria, 3) disorganized cortical structure -
      lissencephaly type II, 4) minor cortical developmental anomalies and 5) other
      cortical dysplasia syndromes. It will help to reconstruct the pathomechanism of
      cortical abnormal development from early occurring primary errors to late changes
      in which coincide necrotic lesions. The presented material illustrate the role of
      time of occurrence and intensity of damage in final result of pathologic
      developmental processes.

PMID- 7792008
TI  - Ammon's horn changes in focal brain ischemia in humans.
AB  - Neuronal changes in Ammon's horn were examined immunocytochemically in 20
      patients aged from 51 to 101 years, deceased in the course of ischemic lesions
      localized within the area supplied by vessels derived from other then Ammon's
      horn vascularization (middle cerebral artery). Numerous neurons within various
      sector of the pyramidal layer, in the dentate gyrus, subiculum and entorhinal
      cortex were immunopositive in reaction with antibodies to serum proteins
      (albumin, IgG, alpha-1-antitrypsin), indicating their damage. The distribution of
      damaged Ammon's horn pyramidal cells differed from the location of injured
      Ammon's horn neurons in experimental investigations of brain ischemia and did not
      indicate a selective vulnerability of pyramidal cells in the human h1 area,
      corresponding to the CA1 sector in animals. Contrary to experimental material,
      changes in the human Ammon's horn are caused by numerous overlapping factors.

PMID- 7792009
TI  - Cyclic GMP levels in the rat brain and plasma during clinical death and after
      resuscitation.
AB  - Changes of cGMP content in the rat brain and plasma have been evaluated by means
      of the radioimmunologic method after 5-min clinical death and up to 2 hours after
      resuscitation. Ischemia produced a decrease of cGMP in the brain, however, at the
      15th min after resuscitation a reversible significant rise of nucleotide
      concentration was noted. In plasma at the end of ischemia and in the postischemic
      period a significant decrease of cGMP level was observed. The mechanisms of cGMP
      regulation in the central nervous system and the significance of the obtained
      results are discussed.

PMID- 7792010
TI  - Ultrastructural evaluation of neuronal damages induced by low doses of quinolinic
      acid in dissociated hippocampal culture.
AB  - The effect of a subtoxic level of quinolinic acid (QUIN) on the morphological
      picture of the rat hippocampus in dissociated cultures was investigated. Addition
      of 50 microM of QUIN to the culture medium induced only slight advanced and
      reversible changes of the postsynaptic elements, whereas the majority of
      pyramidal neurons were undamaged. The results suggest that subtoxic concentration
      of QUIN is insufficient to produce stable depolarization of cell membranes and
      severe neuronal damage.

PMID- 7792011
TI  - Hemiballismus in patient with blastic phase of chronic myelogenous leukemia.
AB  - The authors report the clinical course and neuropathological findings in the case
      of hemiballismus due to leukemic infiltration of the subthalamic nucleus. The
      symptoms were observed in a 19-year-old patient with blastic phase of chronic
      myelogenous leukemia, two weeks before death, when what is called the "critical
      point" developed (white cell count beyond 100 G/l and thrombocytopenia less than
      50 G/l). The investigation are considered to confirm the role of the "critical
      point" in the development of central nervous system leukemic complications.

PMID- 7792012
TI  - Effect of chronic administration of sodium valproate on the morphology of the rat
      brain hemispheres.
AB  - Effective doses of sodium valproate (200 mg/kg) applied in rats chronically (1,
      3, 6, 9 and 12 months) evoked the first morphological changes in the brain
      hemispheres after 9 months of drug administration. Structural abnormalities of
      the brain tissue consisted in disseminated nonspecific neuronal lesions and
      patchy nerve cell loss, more pronounced in the final phase of the experiment. The
      neuronal lesions were localized predominantly in the 3rd and 5th layers of the
      neocortex and in the pyramidal cell layer of the hippocampus. They were
      accompanied by vascular wall alterations, perivascular tissue damage, as well as
      by microvacuolar changes and spongy degeneration of the subpial and
      periventricular regions. Vasogenic character of parenchymal changes is stressed
      by the authors. The possible influence of liver damage on the development of
      brain pathology is discussed.

PMID- 7792013
TI  - [The "natural" history of ischemic cardiopathy, Incidence of coronary events in
      the follow-up of 114 ambulatory patients].
AB  - In the last decade advances in cardiovascular research improved remarkably our
      understanding of coronary heart disease. However many important problems are so
      far unresolved. In the present study we focused on the "natural" history of
      ischemic heart disease in a group of 114 patients. One hundred-seven patients had
      recent myocardial infarction, and seven suffered from angina. They were observed
      for a mean period of five years (one to 168 months). Forty-nine patients (42.9%)
      had no coronary events; sixty-five had angina, myocardial infarction or both. The
      myocardial infarction was however rare (five cases). The most frequent
      presentation of angina was stable and effort angina, which sometimes subsided
      after a period of presence. The classification of angina was often very difficult
      in cases of effort angina with very low threshold. No relevant differences were
      found between patients with and without coronary events according to age, sex,
      duration of follow-up, location of previous myocardial infarction. A significant
      difference was found in the prevalence of risk factors only for hypertension,
      which was more frequent in patients with coronary events. Smokers were more
      frequent in group without coronary events. In our opinion, the most interesting
      conclusion is that, almost half of these patients remained completely
      asymptomatic for a very long period.

PMID- 7792014
TI  - [Complementary echo flow imaging and digital angiography in the supra-aortic area
      for indication and intervention of carotid revascularization in 1587 subjects in
      the OPI (Stroke Prevention) program].
AB  - The availability of non invasive carotid ultrasound imaging techniques actually
      allows planning and carrying on of large screening programs for detection of
      atherosclerotic carotid occlusive disease. The aim of non invasive ultrasound
      patient selection is to limit the practice of invasive carotid angiography only
      to patients for whom carotid endarterectomy is likely to be a therapeutic choice.
      PURPOSE. Testing the efficacy of sequential use of color coded echo flow imaging
      (echo color Doppler: ECD) and arterial digital angiography (ADA) respectively in
      the second and third phases of a screening program for detection and treatment of
      carotid occlusive disease in a resident population (OPI program). METHODS. From
      January 29th 1990 through March 31st 1992, 1,587 subjects underwent ECD out of
      16,379 subjects that participated in the first level investigations. 404 of these
      (25.5%) were affected with carotid occlusive disease, 271 (17%) had inframural
      non stenosing carotid lesions and 228 (14.3%) carotid kinkings. At ECD, 71 showed
      lesions as severe as to be susceptible of surgical operation and underwent ADA.
      The percentage of carotid stenosis was calculated on the ADA imagins, applying
      the method suggested by the North American Symptomatic Carotid Endarterectomy
      Trial. RESULTS. Overall sensitivity and specificity of ECD versus ADA were 94%
      and 95.2% respectively. Cases in which ECD overestimated the lesion as compared
      to ADA results were recorded as false positive, while cases in which ECD
      underestimated the lesion were recorded as false negative. CONCLUSIONS. Both
      ultrasound imaging and ADA are useful in screening programs for carotid occlusive
      disease: informations different and complementary to the definition of the
      lesions can be obtained from each procedures in subsequent phases. Morphologic
      findings of carotid ECD are essentially consistent with ADA, thus allowing to
      carry on safely non invasive long-term follow-up programs for operated subjects
      as well as for people bearing carotid lesions originally not susceptible of
      surgical treatment.

PMID- 7792016
TI  - [Hyperuricemia and cardiac risK factors: epidemiologic study in the aged].
AB  - The aim of our study is to evaluate whether hyperuricemia may be considered a
      cardiovascular risk factor also in the elderly. 370 subjects over 60-years-old of
      both sexes were examined of which 148 presented an ischemic heart disease and
      222, age and sex homogeneous, were considered as control group. Serum uric acid
      was determined. A strong difference among the two groups (p < 0.001) was
      statistically demonstrated. Such modifications were sex independent. A strict
      correlation of hyperuricemia and hyper trygliceridemia was present; in fact high
      uric acid levels were mostly found in the group with triglycerides > 200 mg/dl (p
      < 0.02). In the whole group and in males a stability of uric acid was noted. In
      females a significant increase among the first (60-69 years) and the second (70
      79 years) age class was present. In conclusion, a positive role of hyperuricemia
      in the ischemic heart disease pathogenesis is possible.

PMID- 7792015
TI  - [Structural and morphometric analysis of the internal mammary artery used in
      coronary bypass surgery].
AB  - The internal mammary artery is currently regarded as the optimal canal in
      coronary bypass surgery. Even if the motives for the excellent behaviour of this
      artery are still not fully clarified, the morphological and morphofunctional
      study of its wall can contribute to explain the clinical results obtained using
      this canal. In order to complete existing studies on this topic and to increase
      our knowledge of the structure of this artery, segments of internal mammary
      artery taken from patients undergoing coronary bypass surgery were analysed.
      Histological, immunohistochemical, histochemical and morphometrical tests were
      performed in these samples. The results of the tests underline the considerable
      complexity of the internal mammary artery whose walls appear to be rich in
      elastic fibres, divided into numerous lamellar structures concentric to the vasal
      lumen and without vasa vasorum in the tunica media given that this is adjacent to
      the tunica adventitia. Moreover, the marked presence of the NO-synthase enzyme,
      responsible for nitrogen monoxide synthesis, was observed in the endothelial
      layer and tunica media, as suggested by histochemical analysis. These data argue
      in favour of a structure able to resist the considerable hemodynamic stress to
      which the artery is subjected after bypass, a structure which is functionally
      well adapted to receive the majority of nutrition through its own lumen, and,
      lastly, a structure capable of self-regulation in response to the requirements
      made from time to time. These findings may further our understanding of the
      morphofunctional aspects of the internal mammary artery and may contribute to
      explaining the latter's relative immunity to atherosclerosis and, thus, its
      success in coronary bypass.

PMID- 7792017
TI  - [Comparative characteristics of electrocardiographic tracing in young subjects of
      various ethnic groups].
AB  - In this study we evaluated the potential differences in normal
      electrocardiographic parameters between two groups of young patients belonging to
      different races (Caucasians and Blacks). For this purpose 100 electrocardiograms
      had been taken, coded and compared in 50 Italian males and 50 north-Africans who
      came to an Emergency Department because of minor condition. On the whole we could
      not find significant differences between the two groups, except for a small
      increase in P-wave duration in black people. We conclude that the same parameters
      used to evaluate normal electrocardiograms in white people, may be satisfactory
      applied also for black individuals. This fact is worthy of attention since more
      and more extracomunitarian patients are addressing the Italian Health Service.

PMID- 7792018
TI  - [CoQ10 blood levels and erythrocyte concentration of GSH in ischemic heart
      patients during exercise test (effects of vitamin E)].
AB  - During exercise there is an increase of oxygen consumption with production of
      superoxide anion. Tocopherols and ubiquinones are intrinsic lipid components
      involved in antioxidant protection and also glutathione reduced is an important
      water soluble antioxidant. The authors take into consideration 28 patients with
      ischemic heart disease coming in a rehabilitation center. In a group of 14 of
      them we studied the effects on the exercise ergonometer test of administration of
      1200 mg of tocopherol on the behaviour of ubiquinone plasmatic levels and GSH. In
      this group CoQ10 after exercise increase significantly (0.762 SD 0.134 g/ml
      before vs 0.827 SD 0.89 after). GSH doesn't increase after (2.5 SD 0.459 mM/l vs
      2.492 SD 0.457). In the group of patients without tocopherol after exercise CoQ10
      decrease significantly (-39%) and also GSH has the same behaviour (-15%). Our
      study shows that the administration of tocopherol prevents lipoperoxidation
      occurring during exercise test.

PMID- 7792019
TI  - [Atrial fibrillation induced by massage of the carotid sinus in patients with
      orthodromic reciprocal supraventricular tachycardia and Wolff-Parkinson-White
      syndrome].
AB  - A 46 years old man with WPW syndrome, due to a posteroseptal accessory pathway,
      was admitted because of orthodromic reciprocating tachycardia, 210/m'in
      frequency. At the end of the carotid sinus massage, for accomplish the conversion
      of tachycardia to sinus rhythm, the orthodromic reciprocating supraventricular
      tachycardia degenerated into atrial fibrillation associated with high ventricular
      rate and the presence of hemodynamic instability, reverted to sinus rhythm by
      intravenous propafenone. Vagal stimulation, induced by carotid sinus massage,
      probably caused dispersion of atrial refractorines and intraatrial reentry,
      converting the orthodromic tachycardia into atrial fibrillation. The
      transesophageal electrophysiologic study, executed in treatment with propafenone,
      not documented the accessory connection and atrial fibrillation or reciprocating
      tachycardia were not inducible.

PMID- 7792022
TI  - Is there a role for specific anti-TNF strategies in glomerular diseases?

PMID- 7792020
TI  - [Myocardial infarct without Q wave in the elderly: diagnostic evaluation using
      vectorcardiography].
AB  - The diagnosis of previous non-Q wave myocardial infarction by standard
      electrocardiographic investigation is uncertain, particularly in elderly patients
      because of concomitant disease. We have studied 31 elderly patients (aged 63-72
      years) with a diagnosis of non-Q wave myocardial infarction between 1-6 months
      after this acute event. The patients underwent clinical-anamnestic examination,
      standard electrocardiography, vectorcardiography according to the Frank system
      and M-mode and 2-D echo-cardiography with continuous and pulsated Doppler. The
      ECG showed ST-T anomalies in 12 patients (38.7%) whereas the VCG showed anomalies
      of QRS-loop normal convexity in 27 patients (87%) and 16 of these (51.6%) showed
      bites criteria (duration > or = 10 msec, voltage > or = 0.1 mV, present at least
      on two planes). By echocardiography, regional hypo-akinesia was observed in 19
      patients (61.3%). Although bites are not only present in myocardial infarction,
      they indicate an interruption of myocardial gradual electric activation,
      compatible with fibrous areas, and should be evaluated as a part of the clinical
      anamnestic, laboratory and instrumental data.

PMID- 7792021
TI  - Chemoattractive cytokines (chemokines) and immune renal injury.

PMID- 7792023
TI  - Are continuous therapies superior to intermittent haemodialysis for acute renal
      failure on the intensive care unit?

PMID- 7792024
TI  - Hyperlipidaemia of the nephrotic syndrome--the search for a nephrotic factor.

PMID- 7792025
TI  - Resistance of parathyroid cell to calcitriol as a cause of parathyroid
      hyperfunction in chronic renal failure.

PMID- 7792026
TI  - Subtotal nephrectomy: a mosaic of growth factors.
AB  - We have studied the distribution of immunoreactive growth factors, by an avidin
      biotin-peroxidase technique, throughout the course of progressive renal scarring
      in rats submitted to extensive renal ablation. Groups of rats (n = 6) were
      sacrificed at Days 7, 15, 21, 30, 90 and 150 following subtotal nephrectomy (SNx)
      by ligation and resection of the renal poles. During the early stages, when
      compensatory renal growth took place, increased renal immunostaining for insulin
      like growth factor-I (IGF-I) and epidermal growth factor (EGF) was detected
      within the collecting ducts and distal tubules, respectively. As renal scarring
      became established by Days 90 and 150, these two growth factors were detected
      within the cells of damaged and vacuolated distal tubules. By contrast, a
      progressive increase immunostain for platelet-derived growth factor (PDGF)-AB was
      apparent within the glomeruli from Day 15 onward preceding the onset of
      glomerulosclerosis. A third staining pattern was apparent by Day 15 for
      transforming growth factor-beta (TGF-beta) and by Day 30 for IGF-I consisting of
      a perivascular and interstitial distribution coinciding with adventitial
      expansion and tubulo-interstitial fibrosis, respectively. A mosaic of growth
      factors is expressed within the kidneys of rats submitted to extensive renal
      ablation.

PMID- 7792027
TI  - Endotoxins modulate chronically tumour necrosis factor alpha and interleukin 6
      release by uraemic monocytes.
AB  - We examined in vivo the release of tumour necrosis factor alpha (TNF alpha) and
      interleukin 6 (IL-6) by uraemic monocytes upon stimulation with endotoxin
      contaminated bicarbonate concentrate. Twelve uraemic patients underwent 1-month
      subsequent periods of standard haemodialysis (SHD) with cuprophane (CU), a high
      complement-activating membrane (6 patients), or haemodiafiltration (HDF) with
      polyacrylonitrile (PAN), a low-complement-activating membrane (6 patients), by
      using a dialysate prepared with either non-sterile bicarbonate concentrate tanks
      (phase 1) or sterile bicarbonate concentrate bags (phase 2). TNF alpha and IL-6
      concentrations were determined in monocyte supernatants by ELISA; endotoxin
      levels in bicarbonate concentrates were measured by a chromogenic limulus
      amoebocyte lysate (LAL) assay. A significant increase in LAL reactivity was found
      in bicarbonate concentrate tanks compared to sterile bags (P < 0.001). Non
      sterile dialysate caused a significant (P < 0.001) predialytic increase in
      monocyte TNF alpha release as compared to controls and non-dialysed uraemic
      patients. One month treatment with sterile bicarbonate significantly decreased
      TNF alpha predialytic activity in monocyte supernatants (P < 0.001) to levels
      closer to those of non-dialysed uraemic patients. A similar decrease was observed
      for IL-6 production. Dialytic treatment induced a further increase in both TNF
      alpha and IL-6 production, particularly in phase 1.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7792028
TI  - Interactions between sodium balance, intrarenal dopamine synthesis, and
      sympathetic activity in HLA-identical kidney donors and recipients.
AB  - Intrarenal dopamine (DA) synthesis, sympathetic activity and sodium homeostasis
      were studied in eight HLA-identical kidney recipient and donor pairs at 50, 150,
      and 300 mmol sodium intake. Trimethaphan was given intravenously (i.v.), to mimic
      acute denervation, tyramine i.v. to induce noradrenaline (NE) release, and the DA
      precursor DOPA i.v. to study DOPA to DA conversion. Blood pressure was higher in
      the recipients (P < 0.05) and was not influenced by sodium intake. Cumulative
      sodium balances were not different between the groups. Sodium intake did not
      affect DA excretion in either group. The recipients had higher DA (P < 0.05) and
      DOPA (P < 0.01) excretions and lower urinary DA over DOPA ratio (UDA/DOPA, P <
      0.01) and lower NE excretion (P < 0.05) during the whole study. High sodium
      intake suppressed the UDA/DOPA in both groups (P < 0.05). Trimetaphan decreased
      renal vascular resistance (RVR) and increased sodium excretion only in the donors
      (P < 0.05), while GFR increased in both groups. During HiSo tyramine increased
      RVR in the recipients (P < 0.01) and UDA/DOPA in the donors (P < 0.05). DOPA
      infusion increased DA excretion four to fivefold but did not change sodium
      excretion in either group. It is concluded that the recipients maintained sodium
      homeostasis well but seem to have an impaired functional innervation of the
      transplanted kidney. NE release seem to stimulate intrarenal DOPA to DA
      conversion. In both groups a direct relation between DA and sodium excretion was
      lacking.

PMID- 7792029
TI  - Tuberous sclerosis complex with end-stage renal failure.
AB  - Renal angiomyolipoma is common in the tuberous sclerosis complex (TSC), the
      classic features of which are facial angiofibroma, seizures, and mental
      retardation. We report a family with three affected members demonstrating the
      wide spectrum of TSC-associated lesions ranging from asymptomatic findings to
      life-threatening complications. The predominant symptoms of the index patient
      were hypertension and mild renal insufficiency at age 48, resulting in end-stage
      renal failure at age 63 due to giant bilateral angiomyolipoma of the kidneys. The
      two TSC-affected siblings had died years previously, one from pulmonary
      lymphangioleiomyomatosis and the other during an epileptic state; the latter had
      situs inversus totalis as another remarkable finding. The diagnosis of TSC may be
      overlooked if CNS symptoms are absent and if cutaneous lesions are masked by
      cosmetic procedures, as occurred in the index case. Chronic renal failure due to
      angiomyolipoma is not widely known to clinical nephrologists, but develops in
      approximately 15% of TSC patients. Displacement of functional renal parenchyma by
      abnormal tissue appears to be the major pathogenetic mechanism leading to end
      stage renal failure. Angiomyolipomas can be diagnosed from this characteristic
      sonographic pattern and the demonstration of fatty tissue in CT or MRI. Multiple
      renal cysts are also common in TSC. Therefore TSC should be considered in the
      differential diagnosis of polycystic kidney disease.

PMID- 7792030
TI  - Lipids and lipoprotein(a) as risk factors for vascular disease in patients on
      renal replacement therapy.
AB  - A large cohort of patients on renal replacement therapy were screened for the
      presence of symptomatic arterial disease affecting the coronary, cerebral or
      peripheral circulations. Ninety-two of 325 patients were found to have vascular
      disease. Those with vascular disease had significantly higher median
      lipoprotein(a) [Lp(a)] levels than those without (38.4 vs 14.2 mg/dl, P < 0.001),
      with a preponderance of Lp(a) levels greater than 30 mg/dl (58% vs 25% P <
      0.001). Apolipoprotein(a) [apo(a)] isoform distribution was similar between the
      groups, but those with vascular disease had higher Lp(a) levels in the S2, S3/S4
      and S4 isoform types. Comparison of 76 matched pairs of patients confirmed
      elevated Lp(a) levels in those with vascular disease. These patients also had
      significantly higher total cholesterol (6.66 vs 6.02 mmol/l) and low-density
      lipoprotein cholesterol (4.49 vs 3.86 mmol/l). Only Lp(a) was independently
      associated with vascular disease (P = 0.02). Elevated Lp(a) levels are
      significantly associated with the presence of vascular disease in patients on
      renal replacement therapy and may constitute another risk factor for the
      development of such disease in these patients.

PMID- 7792031
TI  - Cell cholesterol transport to plasma in blood from patients with renal failure or
      a kidney transplant.
AB  - Accumulation and distribution of cell cholesterol in plasma lipoproteins of
      incubated blood was examined in 36 patients with chronic renal failure including
      13 who were dialysis-independent, 12 on haemodialysis, and 11 on continuous
      ambulatory peritoneal dialysis (CAPD), 17 renal transplant recipients, and 8
      healthy controls. In addition, transport of cholesterol between red blood cells
      and high-density lipoprotein subfraction 3 (HDL3) isolated from a subgroup of
      patients with chronic renal failure was determined. Significantly less cell
      cholesterol appeared in plasma (P < 0.002) and HDL (P = 0.03), the main recipient
      of cell cholesterol, in patients with chronic renal failure compared with healthy
      subjects. Corresponding values in blood from renal transplant recipients were
      similar to controls. In patients with chronic renal failure, plasma HDL3
      cholesterol levels (P < 0.02), HDL3 phospholipid content (P < 0.001) and net
      transport of red cell cholesterol to isolated HDL3 (P < 0.001) were significantly
      lower compared with controls. The data suggest that in patients with chronic
      renal failure, low levels of plasma HDL3 of abnormal composition may restrict the
      incorporation of cell cholesterol into the antiatherogenic HDL fraction
      potentially leading to inefficient transport of cholesterol from peripheral
      tissues and the development of atherosclerosis. These abnormalities appear to be
      reversed by renal transplantation.

PMID- 7792032
TI  - Parathyroid hormone and platelet cytosolic calcium concentration in essential
      hypertension.
AB  - To investigate the possible relationships between blood pressure, parathyroid
      hormone (PTH) and platelet cytosolic Ca2+ concentration ([Ca2+]i) in patients
      with essential hypertension, we studied 17 patients with this disease aged 48 +/-
      2 years and 17 normotensive controls aged 44 +/- 3 years. Platelet [Ca2+]i was
      measured by spectrofluorimetry using the dye Fura-2 acetoxymethylester. Patients
      with essential hypertension displayed lower levels of serum ionized Ca2+ (0.99 +/
      0.03 versus 1.1 +/- 0.01 mmol/l, P < 0.05) and higher serum intact PTH levels
      (37 +/- 3 versus 26 +/- pg/ml, (P < 0.01) than the normotensive controls.
      Although serum levels of intact PTH were significantly correlated with mean
      arterial pressure (MAP) in the combined group of subjects (r = 0.42, P < 0.05),
      there was no correlation when each group was considered separately. Resting
      platelet [Ca2+]i was also higher in patients than in controls (57 +/- 3 versus 48
      +/- 2 nmol/l, P < 0.005). When platelets were stimulated in vitro with thrombin,
      the increment in [Ca2+]i was also greater in patients than in controls in the
      presence of extracellular Ca2+ (264 +/- 24 versus 194 +/- 19 nmol/l, P < 0.05)
      but not in its absence (123 +/- 12 versus 112 +/- 10 nmol/l). The thrombin
      induced increment in [Ca2+]i was correlated with MAP in the hypertensive patients
      (r = 0.64, P < 0.01) and in the combined group of subjects (r = 0.42, P < 0.05).
      There was no relationship between resting or thrombin-induced [Ca2+]i and serum
      PTH in either group of patients or in the combined group of subjects.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7792033
TI  - Role of protein adsorption on haemodialysis-induced complement activation and
      neutrophil defects.
AB  - The present clinical study investigated the role of protein adsorption on
      complement activation and neutrophil functions during in vivo haemodialysis. The
      parameters were measured simultaneously at the arterial and venous sites of a
      cuprophan (CU) dialyser with or without pretreatment with human albumin, human
      immunoglobulins or human total plasma proteins (PLP). Leukocyte count, complement
      activation (C3a des arg), oxygen radical production and chemotaxis were measured
      at time zero and 15 min at the arterial and venous sites of the dialyser.
      Leukopenia observed at both sites was prevented only with PLP treatment.
      Complement activation was maximal at the venous site, but was not prevented by
      any of the treatments. Neutrophil oxygen radical production and chemotaxis were
      significantly decreased only at the venous site and restored to normal with any
      of the three treatments. Complement activation was maximal at the venous site,
      but was not prevented by any of the treatments. Protein adsorption on the
      dialyser membrane seems to modulate the bioincompatibility parameters in a
      different way. Depending on the functions tested, the protein fractions have
      different protecting effects, indicating the multifactorial mechanism implicated
      in the CU haemodialysis-induced leukopenia, complement activation and neutrophil
      defect.

PMID- 7792035
TI  - Determination of the relation between alterations of total body water and
      thoracic fluid content during ultrafiltration by bioelectrical impedance
      analysis.
AB  - Total body impedance (TBI) is used to monitor alterations in total body water
      (TBW), e.g. during haemodialysis. However, 80% of the TBI signal is due to the
      resistance in extremities. Therefore TBI measurements give little information
      about alterations in thoracic fluid content (TF). Measuring both total body
      impedance and thoracic impedance (THI) can be a useful method to monitor TBW and
      TF changes during haemodialysis. In this study TBI and THI measurements were
      performed during 30 dialysis sessions and also in one group of 24 control
      subjects with normal tissue hydration. During haemodialysis TBI and THI
      significantly increased, demonstrating a decrease of TBW and TF. The ratio
      THI/TBI did not differ significantly during haemodialysis, indicating a similar
      effect of ultrafiltration on TBW and TF. The finding that TF decreased during
      haemodialysis was rather surprising, whereas pulmonary oedema is not an evident
      clinical problem in patients on maintenance haemodialysis treatment. THI
      measurements after dialysis proved to be significantly higher in comparison to
      the control subjects. This finding supports the hypothesis that the decrease in
      TF during dialysis is partly due to the sudden ultrafiltration-induced
      hypovolaemia leading to a fall in thoracic blood volume. ABBREVIATIONS: UF
      volume, ultrafiltration volume; TBI, total body impedance; THI, thorax impedance;
      TBW, total body water; TF, thoracic fluid.

PMID- 7792034
TI  - Risk factors for bacterial infections in chronic haemodialysis adult patients: a
      multicentre prospective survey.
AB  - All adult patients from 13 dialysis centres were prospectively followed up for 6
      months in an attempt to appraise the current risk factors for bacterial
      infections in stable chronically haemodialysed patients. Parameters recorded as
      potential risk factors for BI were age, gender, cause of renal failure, time
      elapsed since the start of dialysis, history of transplantation, recent surgical
      procedure, previous bacterial infection, current immunosuppressive or
      erythropoietin therapy, type of angioaccess device, and serum ferritin level. Six
      hundred and seven patients (mean age 56.5 years, range 18-85) were enrolled in
      the study. Mean time elapsed since the start of dialysis was 4.7 years. One
      hundred and eighteen patients had developed at least one bacterial infection
      during the study period whereas 489 had remained free of bacterial infection at
      the end of the follow-up. In multivariate analysis three parameters were found to
      be significant and independent risk factors for bacterial infection: previous
      history of bacterial infection (at least one versus no previous episode), type of
      angioaccess device (catheter versus native fistula), and elevated serum ferritin
      level (greater versus lower than 500 micrograms/l). These results support the
      evidence that impaired host defences in chronic haemodialysis patients may be
      secondary to the dialysis procedure and suggest that the incidence of bacterial
      infection in these patients may be further reduced by appropriate supportive
      therapy.

PMID- 7792036
TI  - Surgical implantation of CAPD catheters: presentation of midline incision-lateral
      placement method and a review of 110 procedures.
AB  - One hundred-and-ten consecutive surgically implanted one-cuff straight peritoneal
      dialysis catheters in 103 adult patients over a 7 year period have been reviewed.
      All catheters were placed for chronic dialysis (CAPD). There were no early
      failures. Early complications consisted of one leak, 14 migrations, and two wound
      infections. In the long term 15 patients required transfer to haemodialysis (5
      recurrent peritonitis, 7 unable to cope, 3 inadequacy of dialysis). Overall
      probability of catheter survival was 92.4% at 1 year and 82.4% at 2 years. The
      surgical implantation technique described provides a safe, reliable access for
      peritoneal dialysis with a low complication rate.

PMID- 7792037
TI  - Pyruvate anions neutralize peritoneal dialysate cytotoxicity.
AB  - A new peritoneal dialysate containing pyruvate anions was developed in order to
      avoid cytotoxic effect of conventional lactate-based dialysate. The dialysate has
      a final pH of 5.4 to 5.6 and is composed of 1.36-3.86% glucose-monohydrate; 132
      mmol/l sodium; 1.75 mmol/l calcium; 0.75 mmol/l magnesium; 102 mmol/l chloride
      and 35 mmol/l pyruvate. For cytotoxicity testing peritoneal macrophages, and
      mesothelial cells (MC) were exposed to conventional lactate dialysate, and
      pyruvate dialysate. We investigated the O2- generation and cytokine synthesis
      after endotoxin stimulation in peritoneal macrophages and the proliferation of
      mesothelial cells of cultured human MC. After exposure to lactate dialysate O2-
      generation and cytokine synthesis in peritoneal macrophages and proliferation of
      mesothelial cells were inhibited when compared to solution containing pyruvate
      and the control solution. After preincubation with 3.86% glucose containing
      solutions, all negative effects became even more pronounced in the lactate group
      whereas after pre-exposure to pyruvate containing solution the toxic effects were
      absent. These results suggest that the acute toxic effects of commercially
      available peritoneal dialysates can be avoided by the use of sodium pyruvate
      instead of sodium lactate.

PMID- 7792038
TI  - Changes in bone mineral content during long-term CAPD. Indication of a sex
      dependent bone mineral loss.
AB  - Change in bone mineral content (BMC) was evaluated in a longitudinal trial
      comprising 12 women and 11 men with chronic renal disease treated with CAPD and 1
      alpha-OH-D3 for 2 years. The patients served as their own controls. No patients
      were treated with steroids. Median age was 54 and 60 years for women and men
      respectively. No significant difference in 1-alpha-OH-D3 dosage or serum
      1,25(OH)2D3 was found between the genders in the study period. Bone mineral
      content at the distal radius deteriorated significantly in the females with a
      median decrease of 12% over 2 years, i.e. approximately 6% per year (P < 0.001
      and 95% confidence limits 8-20%). No significant change was noted in the males.
      There was no correlation between age and BMC change. Serum total alkaline
      phosphatase decreased nonsignificantly in both sexes. Total serum calcium
      increased significantly (P < 0.05) and serum phosphate decreased significantly (P
      < 0.05) in the women. Serum albumin and body weight decreased significantly in
      the males (P < 0.01 and P < 0.05) while no change was seen in the females. The
      demonstrated decrease in BMC in the female patients of approximately 6% per year
      exceeds the commonly observed loss of 1-2% per year in healthy women when
      measured with the same technique. Tentatively, the severe mineral loss in the
      women could indicate a sex-hormone-related disturbance in bone metabolism of
      uraemic females.

PMID- 7792040
TI  - Renal involvement in the hypereosinophilic syndrome.

PMID- 7792039
TI  - Acute renal failure due to accelerated hypertension following ingestion of 3,4
      methylenedioxymethamphetamine ('ecstasy').

PMID- 7792041
TI  - Alloimmune haemolytic anaemia after renal transplantation.

PMID- 7792042
TI  - Sterile peritonitis in a CAPD patient caused by a juxtaperitoneal abscess.

PMID- 7792044
TI  - The introduction of urine microscopy into clinical practice.

PMID- 7792045
TI  - Second symposium on uraemic toxicity. Summary of a symposium held in Gent,
      Belgium, 22-24 September 1994.

PMID- 7792047
TI  - The uraemic patient with multiple small sugillations on the forehead.

PMID- 7792046
TI  - Magnetic resonance image documentation of quadriceps tendon rupture.

PMID- 7792048
TI  - Seizures in dialysis patients treated with recombinant erythropoietin.

PMID- 7792043
TI  - Nephrology across the Atlantic: American election results indicate lurch to the
      right.

PMID- 7792050
TI  - Metformin-associated lactic acidosis in diabetic patients with acute renal
      failure.

PMID- 7792049
TI  - Treatment of Wegener's granulomatosis. A nephrologist's view.

PMID- 7792051
TI  - Prostaglandin E2 facilitates excitatory synaptic transmission in the nucleus
      tractus solitarii of rats.
AB  - Prostaglandin E2 (PGE2) binding sites are rich in the nucleus tractus solitarii
      (NTS). We studied the effects of PGE2 on evoked excitatory postsynaptic currents
      (eEPSCs) and miniature EPSCs (mEPSCs) in voltage-clamped neurons in rat NTS
      slices. eEPSCs and mEPSCs, mediated by non-NMDA glutamate receptors, fluctuated
      in size from event to event. In 37.5% of neurons, PGE2 increased the mean size of
      eEPSCs and changed the size distribution non-proportionally. In 42.9% of neurons,
      PGE2 increased the frequency of mEPSCs keeping the skewed size distribution
      unchanged. However, PGE2 did not modulate postsynaptic non-NMDA receptor
      sensitivity. We propose that size distributions of eEPSCs before and after PGE2
      application are predictable from those of mEPSCs by quantal analysis with
      multinomial distribution. Our results suggest that PGE2 facilitates evoked and
      spontaneous release of glutamate vesicles.

PMID- 7792052
TI  - Expression of insulin receptor-related receptor mRNA in the rat brain is highly
      restricted to forebrain cholinergic neurons.
AB  - Insulin receptor-related receptor (IRR) is a member of the insulin receptor
      family. However, its endogenous ligand and the physiological roles of IRR are
      unknown. To elucidate the physiological roles of IRR in the brain, we examined
      the expression of its mRNA in the rat brain by in situ hybridization. In contrast
      to the widespread expression of insulin receptor and insulin-like growth factor-1
      receptor mRNAs in the brain, the expression of IRR mRNA was highly restricted to
      the forebrain cholinergic neurons. All the forebrain cholinergic neurons
      expressed IRR mRNA. The present findings indicate that IRR has a selective role
      in the brain for forebrain cholinergic function.

PMID- 7792053
TI  - Adenosine triphosphate and arachidonic acid stimulate glycogenolysis in primary
      cultures of mouse cerebral cortical astrocytes.
AB  - Adenosine triphosphate (ATP) promotes glycogenolysis in primary cultures of mouse
      cerebral cortical astrocytes with an EC50 of 1.5 microM. A pharmacological
      analysis indicates an involvement of purinergic P2Y receptors in this action of
      ATP. Application of either arachidonic acid (AA), or certain unsaturated fatty
      acids, also results in glycogen breakdown. The EC50 of AA is approximately 50
      microM. Thus ATP and AA can be added to the list of neuroactive agents that
      control glycogen levels in astrocytes, which includes noradrenaline, vasoactive
      intestinal peptide (VIP), adenosine and histamine.

PMID- 7792054
TI  - Vulnerability of the hippocampus to kainate excitotoxicity in the aged, mature
      and young adult rat.
AB  - Sensitivity to excitotoxic damage was assessed in young adult, mature and aged
      male Sprague-Dawley rats. Kainic acid was injected into the hippocampus and the
      size of the hippocampal lesion rated. Intrahippocampal injection of kainic acid
      produced lesions in aged animals that were significantly smaller than lesions in
      the young rats (P < 0.05), while lesion size in mature rats was intermediate.
      Excitotoxic damage was localized primarily to the CA3 region of the hippocampus
      in the aged rats. Young adult rats had more damage to the hippocampus with
      involvement of CA1 pyramidal and dentate granule cells. These results suggest
      that increased age may reduce susceptibility to excitotoxic damage.

PMID- 7792056
TI  - Dopamine favours the emergence of long-term depression versus long-term
      potentiation in slices of rat prefrontal cortex.
AB  - In the present study, we have investigated possible interactions between dopamine
      and long-term changes in synaptic efficacy induced in layer V pyramidal cells by
      tetanization of afferents from layer I-II. In the absence of dopamine, we
      confirmed that high frequency stimulation of excitatory afferents induced long
      term potentiation, long-term depression or no change. Inversely, in the presence
      of dopamine, we have found that the same tetanus led to long-term depression in
      synaptic transmission in a majority of cells, but no more long-term potentiation.
      These results suggest that in rat prefrontal cortex, dopamine may determine the
      direction of activity dependent changes in synaptic efficacy and therefore, plays
      a functional role in the physiology of this structure.

PMID- 7792055
TI  - No evidence for contribution of nitric oxide to spinal reflex activity in the rat
      spinal cord in vitro.
AB  - The effects of nitric oxide (NO) synthase inhibition, NO generation and an N
      methyl-D-aspartic acid (NMDA) receptor antagonist upon spinal reflex responses
      evoked by electrical activation of high threshold afferent fibres and brief
      application of NMDA have been compared in an in vitro preparation of the neonatal
      rat spinal cord. Reflex responses of spinal cords prepared from naive animals and
      those exhibiting a behavioural hyperreflexia following UV irradiation of the left
      hindpaw have been compared. C-fibre evoked and NMDA induced ventral root
      potential responses were significantly reduced by the selective NMDA receptor
      antagonist D-AP5 (40 microM) but completely unaffected by application of 7
      nitroindazole (30 microM), NG-nitro-L-arginine methyl ester (L-NAME; 100 microM)
      or sodium nitroprusside (50 microM) either in hyperalgesic or naive animals. In
      vivo behavioural experiments performed upon age-matched rat pups showed that
      reflex sensitivity was significantly reduced following administration of L-NAME
      (30 mg kg-1). The present study has failed to provide evidence that NO is
      involved in nociceptive spinal reflex activity measured in vitro. In contrast, an
      NO synthase inhibitor was shown to influence nociceptive reflex responses
      observed in vivo. We suggest it is possible that NO participates in post-injury
      induced hyperreflexia at sites other than directly upon spinal neurones.

PMID- 7792058
TI  - Alpha 2-adrenoceptor-mediated inhibition of capsaicin-evoked release of glutamate
      from rat spinal dorsal horn slices.
AB  - It is known that the descending noradrenergic system suppresses nociceptive
      transmission in the spinal dorsal horn. To determine whether noradrenaline-alpha
      adrenoceptor systems exert inhibitory influence on the release of glutamate from
      the nociceptive primary afferents, the effects of alpha-adrenoceptor agonists on
      the capsaicin (3 microM)-evoked release of glutamate from rat spinal dorsal horn
      slices were examined using an on-line continuous monitoring system for glutamate.
      The application of alpha 2-agonists clonidine (0.1-10 microM) and ST-91 (1 and 10
      microM), respectively, decreased the capsaicin-evoked release of glutamate in a
      concentration-dependent manner. The partial alpha 2-agonist oxymetazoline (1 and
      10 microM) produced a slight inhibition in the evoked release of glutamate. In
      contrast, the alpha 1-agonist phenylephrine (1 and 10 microM) did not show any
      significant effects on the evoked release of glutamate. The inhibitory action of
      10 microM clonidine on the evoked glutamate release was antagonized by the alpha
      2-antagonist yohimbine (1 microM) but not by the opioid antagonist naloxone (10
      microM). These findings suggest that noradrenaline, probably released from the
      descending inhibitory system, reduces the release of glutamate from the capsaicin
      sensitive primary afferent terminals through alpha 2-adrenoceptors.

PMID- 7792057
TI  - Prenatal ethanol exposure alters neurotrophic activity in the developing rat
      hippocampus.
AB  - Extract made from hippocampus of rat pups exposed prenatally to an ethanol
      supplemented diet was found to contain more neurotrophic activity at postnatal
      day 21 than that from animals exposed to control diets, when quantified in a
      dorsal root ganglion bioassay. This apparent upregulation was specific to
      hippocampal extract (cerebellar and forebrain/midbrain extracts were also
      assessed), and to this age (P1, P7, P14 and P60 extracts were also tested). It
      was suggested that this upregulation may be indicative of, or secondary to,
      trauma resulting from fetal ethanol exposure. It is speculated that such
      departures from the normal developmental timetable could contribute to anomalies
      seen in the fetal alcohol syndrome.

PMID- 7792059
TI  - Expression of glutamate transporters in cultured glial cells.
AB  - Expression of mRNAs for glutamate transporter (GLT-1) and glutamate aspartate
      transporter (GLAST) was investigated in three different types of purified glial
      cells by the reverse transcriptase-polymerase chain reaction (RT-PCR). Cultured
      astrocytes, oligodendrocytes, and microglia expressed mRNAs for GLAST and GLT-1;
      mRNA for GLAST was expressed more prominently than that for GLT-1 in astrocytes.
      Oligodendrocytes and microglia expressed mRNAs for both GLT-1 and GLAST equally,
      but the expression in microglia was not prominent, suggesting glutamate uptake is
      not essential in microglia. In astrocytes cultured from different brain regions,
      GLAST mRNA was equally expressed. GLT-1 mRNA was also detected in these
      astrocytes, but the expression level was lower than that of GLAST.

PMID- 7792060
TI  - Bird viruses in multiple sclerosis: combination of viruses or Marek's alone?
AB  - This is a short report confirming recent articles that birds are very likely
      involved as vectors of the exogenous causative agent of multiple sclerosis (MS).
      It also critically reviews the most recent article (MacGregor, H. and Latiwonk,
      Q., Neurol. Res., 15 (1993) 391-394.) in which a high percentage of serums from
      MS patients reacted positively with Marek's antigen and it was accidentally
      discovered that Epstein-Barr virus antibodies also cross-react positively with
      Marek's antigen. This discovery might help explain the complex epidemiology of MS
      (an infectious mononucleosis infection would immunize a person against future
      mononucleosis and a Marek's infection). A table comparing the similarities
      between MS and Marek's is included. Other possible avian viral candidates are
      entertained plus the possibility of various viral combinations within a
      protective chlamydial plasmid including Marek's and avian retroviruses.

PMID- 7792061
TI  - The effect of cholinoceptor agonists and neurotoxins on the release of
      vasopressin in the rat in relation to the subunit composition of the
      cholinoceptor.
AB  - The effects of cholinoceptor agonists and neurotoxins on the release of
      vasopressin and oxytocin have been investigated in water-loaded rats under
      ethanol anaesthesia. Release of vasopressin was monitored by antidiuretic
      responses accompanied by increased urinary excretion of vasopressin. The rate of
      excretion of oxytocin-like radioimmunoreactivity was measured as an indicator of
      oxytocin release. Both nicotine and cytisine caused a preferential release of
      vasopressin. The release by nicotine was not inhibited by alpha- or neuronal
      bungarotoxin. Neosurugatoxin blocked the release by cytisine. Comparison with the
      effects of these agents on combinations of alpha and beta subunits expressed in
      oocytes suggests that the central cholinoceptors mediating release of vasopressin
      are similar to those at autonomic ganglia and may contain a beta 4 subunit.

PMID- 7792062
TI  - Motor cortex activity and predicting side of movement: neural network and dipole
      analysis of pre-movement magnetic fields.
AB  - Neuromagnetic fields were recorded from human subjects during the performance of
      left and right voluntary finger movements. Modeling of current dipole sources
      indicated symmetric activation of both motor cortices beginning 600 ms prior to
      movement onset. This activity became lateralized to the contralateral hemisphere
      200-300 ms prior to movement onset, the period during which an artificial neural
      network showed increased ability to predict side of movement within single
      trials. The results describe the mechanism of lateralization of cortical brain
      activity preceding voluntary movement and provide further evidence of the
      involvement of ipsilateral motor cortex in unilateral movements.

PMID- 7792064
TI  - Light- and electron-microscopic localization of the glutamate receptor channel
      delta 2 subunit in the mouse Purkinje cell.
AB  - The localization of the glutamate receptor channel delta 2 subunit was
      investigated by immunohistochemistry. The delta 2-immunoreactivity was observed
      exclusively in the molecular layer of the cerebellar cortex. The electron
      microscopic analysis showed that the delta 2 subunit was localized in the
      dendritic spines of the Purkinje cells. The immunopositive spines often formed
      synaptic contacts with parallel fiber varicosities. As for the Purkinje cells
      ectopically localized in the cerebellar nuclei and brain stem, the dendritic
      shafts and cell bodies were strongly labeled. These ectopic Purkinje cells also
      formed asymmetrical synapses at the delta 2-immunopositive dendritic spines.
      Considering the specific localization of the delta 2 subunit in the postsynaptic
      site of the Purkinje cells, the subunit is suggested to be involved in the
      excitatory synaptic transmission in the cells, as a component of the glutamate
      receptor channel.

PMID- 7792065
TI  - Pancreatic polypeptide stimulates gastric motility through a vagal-dependent
      mechanism in rats.
AB  - The present study examined the influence of peripherally administered pancreatic
      polypeptide (PP) on vagal control of gastric motility. The jugular vein was
      cannulated in urethane-anesthetized rats and a strain gauge was sewn onto the
      antrum to monitor motility. Intravenous infusion of rat PP (2-200 pmol over 45
      min) resulted in a dose-dependent increase in antral contraction amplitude. The
      motility response to i.v. PP was eliminated by pretreatment with atropine or
      bilateral vagotomy. In contrast to i.v. infusion, close intra-arterial infusion
      of PP into the gastric circulation had no effect on motility suggesting that PP
      does not act upon peripheral afferent terminals or directly within the stomach.
      These results support the hypothesis that circulating PP indirectly enhances
      gastric motility through a vagal cholinergic mechanism.

PMID- 7792068
TI  - Physician control of health care delivery in the managed care environment.
AB  - Managed care is a part of nearly every physician's practice. Physicians need not,
      however, lose control of their practices. By taking predetermined risks,
      physicians can maintain control over the quality of medical care, the manner in
      which that care is provided, their incomes, and their futures.

PMID- 7792067
TI  - Health care system reform and the changing physician-patient relationship.
AB  - The increasing management of medicine has meant an increasing intrusion into the
      physician-patient relationship. This has caused a shift in the balance of the
      basic principles of medical ethics and of the major aspects of the physician
      patient relationship.

PMID- 7792063
TI  - Spatial and temporal distribution of 7B2 in the pulmonary diffuse neuroendocrine
      system of the cat.
AB  - The postnatal developmental profile of the presence of 7B2 was studied
      immunocytochemically in the pulmonary diffuse neuroendocrine system of the cat.
      Labelling was found in neuroepithelial bodies (NEB) but not in solitary
      neuroendocrine cells. The identity of NEB was confirmed on adjacent serial
      sections by the immunostaining for protein gene product 9.5, a pan-neuroendocrine
      marker. The first 3 weeks after birth 7B2 stained NEB were most abundant with a
      subsequent decline thereafter. The positive correlation between the variation of
      7B2 immunoreactivity and number of NEB suggests an important role for 7B2 in NEB.

PMID- 7792066
TI  - Efferent responses to twitch tests used in identifying human muscle afferents.
AB  - The response of a muscle afferent to the mechanical stimulus produced by a twitch
      contraction of the receptor-bearing muscle is an important test for
      differentiating between muscle spindle endings and Golgi tendon organs. The
      present study demonstrates that active alpha-motor axons can behave in a similar
      manner to spindle afferents, presumably responding not to the mechanical event
      per se, but reflexly to the change in afferent discharge created by the
      mechanical event. alpha-Motor axons were unequivocally identified during
      microneurography using spike-triggered averages of EMG. Caution is required when
      the twitch test is utilized to assist in the classification of muscle afferents
      during an intentional or unintentional voluntary contraction.

PMID- 7792069
TI  - The purposes, formation, and legal implications of PHOs.
AB  - In response to rapid changes in the health care delivery system, hospitals and
      physicians are exploring collaborative efforts. One of these efforts is the
      physician hospital organization (PHO). This article explores the purposes for
      forming PHOs, their actual formation, and related legal issues.

PMID- 7792071
TI  - Health care reformation and the need for tort reform.
AB  - Health care reform is changing the medical profession and the way physicians
      manage their patients, including reducing the incentive to practice defensive
      medicine. Conflicting pressures on physicians make this an ideal time for medical
      malpractice tort reform.

PMID- 7792072
TI  - Managed care and powerful networks result in state public utility commission.
AB  - This article focuses on why managed care, capitated payment, and the health
      alliances could lead to the formation of 15 major networks in New Jersey and
      require a Trenton-based health services commission. As a result, how physician
      services are organized in the state could undergo significant change.

PMID- 7792070
TI  - Regulation of medical practice in New Jersey.
AB  - The New Jersey state Board of Medical Examiners (BME) is responsible for
      protecting the public from impaired, unethical, or incompetent practitioners.
      This article discusses the structure and function of BME as well as several new
      BME initiatives.

PMID- 7792073
TI  - Feverfew: chemistry and biological activity.

PMID- 7792074
TI  - A morphological study of the retinal ganglion cells of the Afghan pika (Ochotona
      rufescens).
AB  - The distribution and morphology of the retinal ganglion cells was studied in a
      relative of the rabbit, the Afghan pika. The total number of retinal ganglion
      cells was approximately 170,000. The total number of optic nerve fibers was
      between 160,000 and 190,000, corresponding to the total number of retinal
      ganglion cells. Retinal ganglion cells were found to have a horizontal region of
      high-density. The maximum density was 5250 cells/mm2. This region was located in
      the central retina below the optic disc. This area contained numerous closely
      packed small ganglion cells, while the peripheral retina (especially in the
      dorsal periphery) contained large ganglion cells more loosely dispersed. The
      retinal ganglion cells labeled by horseradish peroxidase (HRP) were
      morphologically classified into three types based on dendritic length and
      ramification pattern.

PMID- 7792075
TI  - Straying phenomenon of migrating LHRH neurons and highly polysialylated NCAM in
      the chick embryo.
AB  - The present study on unilaterally incompletely placodectomized chick embryos
      revealed that arrival of migrating LHRH neurons into the forebrain area is
      dependent on the presence of a central projection of the olfactory nerve. When a
      fragment of the lateral and medial olfactory epithelium was spared the damage, a
      small number of LHRH-ir cells were found to migrate into the forebrain along a
      thin NCAM-H-expressing fiber bundle of the olfactory nerve. In embryos with large
      lesions which destroyed the lateral olfactory epithelium, the poorly developed
      NCAM-H-positive olfactory nerve fibers were arrested where they meet the NCAM
      positive medial nasal branch of the ophthalmic nerve and frequently fused with
      this branch fiber bundle. In these embryos, no LHRH-ir cells were detected in the
      forebrain area. They were deviated from their regular migratory course to the
      NCAM-H-positive medial nasal branch fiber bundle. This straying phenomenon
      indicates that some structural support is apparently needed for the migration of
      LHRH-ir cells, but their migratory route is not completely programmed in their
      precursor cells in the olfactory placode. In cultures of placodal tissues, the
      coexistence of migrating LHRH-ir cells with NCAM-H-expressing neural elements was
      always confirmed. It is suggested therefore that not only the structural support
      for the migration but also the interaction between LHRH-ir cells and NCAM-H
      expressing neural elements is a prerequisite for successful LHRH neuronal
      migration.

PMID- 7792076
TI  - Rapid eye movement sleep deprivation decreases membrane fluidity in the rat
      brain.
AB  - In this study we examined the effects of rapid eye movement sleep (REMS)
      deprivation on synaptosomal and microsomal membrane fluidity by studying 1,6
      diphenyl-1,3,5-hexatriene (DPH) fluorescence polarization in control as well as
      REMS-deprived rats. The flower pot technique was used to perform 24, 48 and 96 h
      REMS deprivation. Suitable control experiments were carried out to rule out the
      nonspecific effects. The results showed that DPH fluorescence polarization
      increased both in the microsome as well as in the synaptosome in REMS-deprived
      animals, except in the cerebellum, indicating that there was a generalized
      decrease in membrane fluidity in the rat brain. The alterations in membrane
      fluidity returned to baseline upon recovery from REMS deprivation. Control
      experiments suggested that the alterations were primarily caused by REMS
      deprivation and not due to nonspecific effects. This finding supports REMS
      deprivation induced other changes reported earlier. This increase in membrane
      rigidity could be at least one of the possibilities for REMS loss induced
      alterations in physiological phenomena including membrane bound enzyme activities
      and receptor densities.

PMID- 7792077
TI  - Cyclosporin A prevents ischemia-induced reduction of muscarinic acetylcholine
      receptors with suppression of microglial activation in gerbil hippocampus.
AB  - We previously reported the late onset reduction of muscarinic acetylcholine
      receptors (LORMAR) which begins 7 days after a 5-min period of experimentally
      induced forebrain ischemia in the gerbil hippocampus. This study demonstrated
      that post-ischemic administration of cyclosporin A (CsA) reduced LORMAR 10 days
      after 5 min of forebrain ischemia in the gerbil hippocampus, suggesting that
      immunosuppression by CsA may reduce damage to the cholinergic system after
      ischemia. Microglia positive for HLA-DR class II antigen which presented in the
      hippocampal CA1 area, the region most vulnerable to ischemia, were also reduced
      by CsA. CsA may suppress microglial activation especially with regard to the
      antigen-presenting function, and LORMAR may be attenuated by this modulation of
      microglial function.

PMID- 7792078
TI  - A sodium- and energy-dependent glucose transporter with similarities to SGLT1-2
      is expressed in bovine cortical vessels.
AB  - In order to investigate glucose transport at the blood-brain barrier (BBB),
      glucose transport properties were studied pharmacologically with a novel model
      system of inverted bovine brain cortical arteries. These vessels displayed
      glucose transport characteristics of facilitative glucose transporters (GLUT1-5)
      and of sodium- and energy-dependent glucose transporters (SGLT1-2). So far,
      glucose transport in the central nervous system (CNS) has only been shown to be
      achieved by facilitative transporters, in particular by GLUT1 at the blood-brain
      barrier and in glial cells and by GLUT3 in a subset of neurons. We report here
      that a SGLT-like transporter might partake in glucose transport at the bovine
      BBB, as indicated by immunocytochemical analysis and by Western immunoblot
      analysis of cultured bovine brain endothelial cells. A RNA protection assay
      revealed the presence of a SGLT-like gene fragment in rabbit cortex.

PMID- 7792080
TI  - Functional roles of the superior laryngeal nerve afferents in electrically
      induced vocalization in anesthetized cats.
AB  - Our purpose was to elucidate the functional roles of the laryngeal afferents in
      controlling vocalization. We investigated the effects of laryngeal
      deafferentation (sectioning the internal branch of the superior laryngeal nerve
      (ISLN)) on respiration and voice quality during electrically-induced vocalization
      in twelve ketamine anesthetized cats. Co-ordinated vocal activity was obtained by
      electrical stimulation to the pontine call site. After the bilateral ISLN
      section, the respiratory, expiratory and inspiratory durations during induced
      vocalization became 0.56 +/- 0.15, 0.44 +/- 0.12 and 0.67 +/- 0.19 (mean +/-
      S.D., n = 9) times, respectively, compared with those before the ISLN section. A
      decrease in respiratory duration was also observed when local anesthetics were
      applied to the laryngeal mucosa. The laryngeal deafferentation increased the
      degree of hoarseness with a decrease in the fundamental frequency. Since the
      laryngeal deafferentation caused a decrease in the intralaryngeal adductor
      activities, it was suspected that the voice quality change was partly caused by
      the reduction in adductor activities. It was thus concluded that feedback via
      laryngeal afferents plays an important role in controlling vocalization.

PMID- 7792079
TI  - Immunohistochemical localization of protein phosphatase isoforms in the rat
      cerebellum.
AB  - Protein phosphatase isoforms, PP1 gamma 1, PP1 delta, PP1 alpha and PP2A (alpha
      and/or beta), were immunohistochemically localized in the rat cerebellum.
      Purkinje cell perikarya, dendrites and spines were very PP1 gamma 1
      immunoreactive. PP1 delta and PP1 alpha were perinuclear in all neurons, PP1
      alpha also revealed a new cell type and PP2A was homogeneous in Purkinje cell
      soma and large dendrites. PP1 gamma 1 seems to be dominant for dephosphorylation
      at the dendritic synapses of Purkinje cells.

PMID- 7792082
TI  - Conductivity ratios of the scalp-skull-brain head model in estimating equivalent
      dipole sources in human brain.
AB  - The dipole tracing (DT) method estimates the position and vector dipole moment of
      an equivalent current dipole by minimizing the mean squared error of the dipole
      potentials at the surface electrode positions. In the scalp-skull-brain/DT
      (SSB/DT) method, which we have developed, the head model consists of three
      compartments of uniform conductors corresponding to the scalp, skull and brain.
      The accuracy of the calculations are mainly dependent on the ratios of the
      conductivities of the three compartments. The best result was obtained with the
      conductivity ratios of 1:1/80:1 for the scalp, skull and brain compartments,
      respectively.

PMID- 7792081
TI  - Conditioned taste aversion in rats with excitotoxic brain lesions.
AB  - Conditioned taste aversion (CTA) is well known to be a robust and long-lasting
      learning after a single conditioned stimulus (CS) (taste)--unconditioned stimulus
      (US) (malaise) pairing. The neural mechanisms of this taste aversion learning
      still remain to be resolved. To elucidate the basic brain mechanisms of the taste
      aversion learning, we examined the effects of lesions of various sites of the rat
      brain on the acquisition and retention of CTAs. Confined brain lesions were made
      by injections of a small amount of excitotoxic drug, ibotenic acid. CTAs were
      established to saccharin (CS) by pairing its ingestion with an i.p. injection of
      LiCl (US). Rats lacking the parabrachial nucleus (PBN) almost completely failed
      to acquire CTAs. The second most effective lesion was in the medial thalamus
      including the parvocellular part of the ventral posteromedial nucleus of the
      thalamus (VPMpc) and the midline part, followed by the damage of the lateral
      nuclear group of the amygdala including the basolateral amygdaloid nucleus.
      Lesions of the gustatory cortex (GC) and hippocampus induced moderate effects,
      but lesions in the other subnuclei of the amygdala, such as the medial and
      central amygdaloid nuclei, entorhinal cortex, lateral hypothalamic area, and
      ventromedial hypothalamic nucleus induced slight or no effects. On the other
      hand, paired lesions among the amygdala, medial thalamus and GC caused severe
      impairment of CTAs; in particular, lesions of amygdala and VPMpc completely
      disrupted acquisition of CTAs. These results suggest that the PBN, medial
      thalamus and the lateral nuclear group of the amygdala play an essential role in
      the formation of taste aversion learning.

PMID- 7792083
TI  - Diametrically opposite effects of estrogen on the excitability of female rat
      medial and lateral preoptic neurons with axons to the midbrain locomotor region.
AB  - Electrical stimulation of the midbrain locomotor region (MLR) in 76
      ovariectomized, urethan-anesthetized female rats elicited antidromic action
      potentials in 252 preoptic neurons. Thresholds and refractory periods for the
      activation ranged from 60 to 1550 microA and 1.3 to 5.0 ms, respectively. The
      probability distribution for the peak-to-peak amplitude (2-14 mV) or the overall
      duration (0.7-4.4 ms) was bell-shaped, whereas that for the latency (1.8-33.5 ms)
      was distinctively bimodal with a division at 12.0 ms. Two groups of preoptic
      neurons of a similar soma size therefore project to the MLR presumably via
      different routes. In 121 neurons with latencies < or = 12.0 ms, estrogen lowered
      the antidromic activation thresholds (nested analysis of variance, P < 0.02), but
      131 neurons with latencies > 12.0 ms had their thresholds increased (P < 0.005)
      and refractory periods prolonged (P < 0.02) by estrogen. Even though both
      overlapped in part, many potentials with the shorter latencies were recorded from
      the medial part of the lateral preoptic area (mLPO), lateral to the recording
      sites of the longer-latency potentials in the medial preoptic area (MPO). The
      observed antagonistic effects of estrogen on the two groups of preoptic neurons
      with axons to the MLR may contribute to increased locomotor activity in female
      rats in estrus.

PMID- 7792084
TI  - Discrete acetylcholine release from neuroblastoma or hybrid cells overexpressing
      choline acetyltransferase into the neuromuscular synaptic cleft.
AB  - Neuroblastoma (clones NS-20Y, N1E-115, and Neuro2A) and neuroblastoma x glioma
      hybrid (NG108-15) cells were transfected with mouse choline acetyltransferase
      (ChAT) complementary DNA (cDNA) or vector DNA alone and stably transformed cell
      lines were established to examine their ability to secrete acetylcholine (ACh).
      Membrane potentials were recorded from either presynaptic neuroblastoma and
      hybrid cells or postsynaptic myotubes in co-culture. After transformation with
      ChAT, synapses were formed and miniature end-plate potentials (MEPPs) were
      recorded in myotubes co-cultured with Neuro2A and N1E-115 cells, while parental
      and mock-transfected control cells totally lacked this ability. The rate of
      synapse formation and/or MEPP frequency was higher in transformed NG108-15 hybrid
      and NS-20Y cells than that in the control cells. Action potentials of NS-20Y,
      Neuro2A or NG108-15 cells overexpressing ChAT were able to evoke end-plate
      potentials in myotubes, though the average quantum content of these cells was
      0.04-0.14, which is as low as the control value. The results show that increased
      concentrations of ACh by ChAT cDNA transfection reveal a masked property in
      vesicular ACh release from Neuro2A and N1E-115 cells with no endogenous ChAT
      activity, or modify their secretory capacity upwardly from NG108-15 and NS-20Y
      cells with endogenous activity.

PMID- 7792086
TI  - Liability reform: organized medicine scores big!

PMID- 7792087
TI  - PPHP founder talks of medicine's future. Interview by Elaine S. Herrmann and
      Maria T. Montesano.
AB  - The Pennsylvania Medical Society's Board of Trustees in March approved a
      recommendation to fully support and endorse the goals of the Pennsylvania
      Physician Healthcare Plan, Inc. Also known as PPHP, the plan aims to be the
      commonwealth's first statewide, physician-owned managed care organization. Gary
      C. Brown, MD, a Wyndmoor ophthalmologist, is the founder and driving force of
      PPHP. Shortly after the board action, Dr. Brown spoke with us about the concept
      of physician control, his involvement with PPHP, and the organization's chances
      of success.

PMID- 7792085
TI  - Distribution of the calcium binding proteins, calbindin D-28K and parvalbumin, in
      the subicular complex of the adult mouse.
AB  - The immunohistochemical localizations of two specific calcium binding proteins,
      calbindin D-28K (calbindin) and parvalbumin (PV) were examined in the subicular
      complex, that is, the subiculum, presubiculum, and parasubiculum, of the adult
      mouse and were compared in detail with staining pattern of the
      acetylcholinesterase (AChE) histochemistry. The calbindin immunoreactivity
      exhibited a conspicuous regional and laminar pattern of distribution, which
      somewhat resembled the AChE staining pattern but was apparently different from
      the latter in various points. The PV immunoreactivity also exhibited a
      characteristic regional difference, although less prominent. The subiculum could
      be divided into two subregions, intensely calbindin-immunoreactive (calbindin-IR)
      and AChE stained proximal subiculum and only faintly calbindin-IR and AChE
      stained distal subiculum. In the subiculum most of calbindin-IR neurons were
      pyramidal cells which were clustered in the superficial half of the cell layer in
      the proximal subiculum and appeared to be segregated from calbindin negative
      pyramidal cells located in the distal subiculum and in the basal part of the
      proximal subiculum. In the presubiculum calbindin-IR neurons were clustered in
      layer 2, most of which were supposed to be presubicular pyramidal cells. In the
      parasubiculum, the overall immunostaining pattern of PV and calbindin were
      somewhat complementary. In the transition area calbindin-IR neurons were
      clustered but few PV-IR neurons were located, and thus the distribution of
      immunoreactive neuronal somata was apparently different from the adjacent parts
      of the parasubiculum, indicating that the transition area might be a separate
      entity. In addition to calbindin-IR presumable principal neurons, calbindin-IR
      and PV-IR nonpyramidal cells were scattered throughout the subicular complex.
      Furthermore, these two calcium binding proteins were colocalized in some
      nonpyramidal cells in the subicular complex. The present study revealed some new
      aspects of the areal and laminar organization of the subicular complex, which had
      not been shown by previous classical purely morphological approaches.

PMID- 7792088
TI  - Physician leverage: your strength is in your unity.

PMID- 7792089
TI  - Patients' medical records: whose business is it anyway?
AB  - Physicians receive many requests for medical records information: Attorneys
      request medical records information for court cases; colleagues request
      information which may assist with consultations or in the medical care of
      individual patients; insurers request information with respect to necessity or
      appropriateness of care. However, none of these scenarios prompt as many
      telephone calls for advice to the Office of General Counsel at State Society
      headquarters as does the call or letter from a patient requesting a copy of his
      or her medical record.

PMID- 7792090
TI  - Veterans' health care: lessons for care planners.
AB  - Integrated care is a popular trend in today's health care marketplace. In this
      article, the former Pennsylvania secretary of health, now chief of staff at the
      Lebanon VA Medical Center, H. Arnold Muller, MD, describes a model integrated
      health care system which has been operating for almost 50 years--the medical
      centers run by the U.S. Department of Veterans Affairs.

PMID- 7792091
TI  - Ignore mergermania; find your niche. Downsizing: an alternate solution to managed
      care woes.

PMID- 7792092
TI  - New therapeutic agents marketed in 1994.
AB  - A total of 21 therapeutic agents reached the U.S. market for the first time in
      1994, representing a continuation of the decline from the record number of 31 new
      therapeutic agents which were marketed in 1991. This review of the therapeutic
      agents first marketed in 1994 considers their most important properties. When
      additional information is needed, more comprehensive references and the product
      literature should be consulted.

PMID- 7792094
TI  - Good communication: the best defense against litigation.

PMID- 7792095
TI  - Is emergency medicine emergency medicine?

PMID- 7792093
TI  - KePRO south: a source of pride.

PMID- 7792096
TI  - Influence of humoral immunity on leukotriene B4 production by neutrophils in
      response to Trichomonas vaginalis stimulation.
AB  - Neutrophils are the predominant inflammatory cells found in vaginal discharges
      from patients with Trichomonas vaginalis infection. In this study, we
      investigated the effect of humoral immunity on leukotriene B4 (LTB4) generation
      by neutrophils in the inflammatory response of vaginal trichomoniasis. As
      quantitated by a radioimmunoassay, no release of LTB4 was detected from
      neutrophils (5 x 10(6)/ml) interacted with trichomonads (1 x 10(6)/ml). However,
      specific immunoglobulin G(IgG) but not F(ab')2, at a titre of 1:256 directed
      against T. vaginalis, augmented LTB4 production (1.4 +/- 0.4 ng/ml, n = 5) by
      neutrophils, suggesting that this enhancement is Fc gamma receptor-mediated.
      Moreover, addition of the specific IgG (1 mg/ml) to C2-deficient serum or Factor
      B-deficient serum, but not C5-deficient serum, significantly increased LTB4
      production by neutrophils in response to trichomonad stimulation. This indicates
      that the complement common pathway activation is crucial for the amplification of
      host defence mechanisms against T. vaginalis. An LTB4 receptor antagonist, SC
      41930, completely abolished neutrophil chemotactic activity induced by LTB4.
      Taken together, these results indicate that humoral immunity could promote the
      interaction of neutrophils with T. vaginalis and augment the inflammatory
      response through the amplification of LTB4 production.

PMID- 7792097
TI  - Relationship between granulocyte macrophage-colony stimulating factor, tumour
      necrosis factor-alpha and Trypanosoma cruzi infection of murine macrophages.
AB  - Gamma interferon (IFN-gamma)-activated macrophages control Trypanosoma cruzi
      infection via nitric oxide (NO), recently recognized as a major effector
      molecule. Granulocyte macrophage-colony stimulating factor (GM-CSF) is a
      multipotent cytokine secreted by macrophages and many other cells. It induces the
      production of tumour necrosis factor alpha (TNF-alpha), another cytokine also
      secreted by macrophages and involved in the control of T. cruzi infection.
      However, no data are available on the relationship between GM-CSF, TNF-alpha and
      NO produced by macrophages activated by IFN-gamma and infected with T. cruzi. To
      highlight this relationship, mouse peritoneal macrophages (MPM) and two c-myc
      retrovirus-induced macrophage cell lines (9.1.1 and BMM8), respectively
      characterized by a constitutive and an inducible production of GM-CSF, were
      activated with IFN-gamma and/or GM-CSF and infected with T. cruzi. Our results
      indicate that T. cruzi upregulates GM-CSF release from MPM and from the two
      macrophage cell lines, activated (or not) by IFN-gamma. A high autocrine
      production of GM-CSF or an exogenous supply of GM-CSF is correlated with an
      enhanced release of TNF-alpha and NO, inducing an improved control of T. cruzi
      infection by IFN-gamma-activated MPM.

PMID- 7792098
TI  - Suppressor macrophages in Trypanosoma brucei infection: nitric oxide is related
      to both suppressive activity and lifespan in vivo.
AB  - African trypanosome infections cause immunosuppression in both experimental
      rodent and natural hosts. One characteristic of this is an eliciting of
      suppressor macrophages which results in an unresponsiveness in lymphocytes.
      Macrophages from Trypanosoma brucei-infected mice have previously been shown to
      produce high levels of nitric oxide (NO). Using model systems based on in vivo
      macrophage transfer and drug cure, we have sought to determine the relationship
      between NO and suppressed lymphocyte responses. Peritoneal macrophages from T.
      brucei-infected mice inhibited the Concanavalin A (Con-A) response of spleen
      cells from syngeneic recipients 3-4 days after transfer in vivo due to the
      activity of suppressor macrophages. When macrophage NO synthesis was inhibited
      either in vitro or in vivo the suppressive effects were partially abrogated.
      These data provide evidence of a role for NO in mediating immunosuppression
      during murine T. brucei infection. Suppression in spleens of mice receiving
      suppressor macrophages was transient, with total recovery of spleen cell mitogen
      responses six days after transfer. Suppression and recovery was found to coincide
      with the presence or absence (respectively) of donor macrophages in recipient
      spleens. When T. brucei-infected mice were treated with a curative dose of a
      trypanocide there followed a recovery of lymphocyte responsiveness after a period
      of 4-5 days, and this directly correlated with a reduction of macrophage NO
      synthesis to control levels both in vivo and in vitro. The apparent loss of
      suppressor macrophage activity after 4-6 days in both drug cured animals and
      recipients of macrophage transfer was shown to be due to NO-mediated apoptosis of
      these cells.

PMID- 7792099
TI  - Induction of CD4+ and CD8+ T cell responses in efferent lymph responding to
      Toxoplasma gondii infection: analysis of phenotype and function.
AB  - The kinetics of induction of T cell responses were examined in efferent lymph
      from a node draining the site of a primary inoculation of Toxoplasma gondii. The
      numbers of T cells increased after infection, due initially to an expansion of
      the CD4+ T cell population followed by an increase in the number of CD8+ T cells
      which coincided with the peak lymphoblast response. Proliferative responses of
      CD4+ T cells to T. gondii antigen were detectable from day six after infection
      and immune efferent lymph cells inhibited the intracellular multiplication of T.
      gondii in vitro. Optimum inhibition was achieved using CD8+ T cells restimulated
      in vitro, and the effector function appeared to be directed preferentially
      against the autologous rather than the allogeneic infected target cell. The
      results provide unique information on the induction of immune responses to T.
      gondii in vivo and provide evidence that both CD4+ and CD8+ T cells are necessary
      for the development of protective immunity induced by the S48 strain of T. gondii
      which is used as a live vaccine in sheep.

PMID- 7792101
TI  - From a child's fable to a moral for nursing.

PMID- 7792100
TI  - The role of CD4+ and CD8+ T cells in protective immunity to the murine nematode
      parasite Trichuris muris.
AB  - The role of CD4+ and CD8+ T cells in protective immunity to Trichuris muris was
      studied in CD4+ or CD8+ or both CD4+ and CD8+ T cell-depleted BALB/c mice. To
      assess in vivo depletion of T-cell subsets, CD4+ and CD8+ T cells in the Peyer's
      patches, the mesenteric lymph nodes (MLN), and the spleens of mice treated with T
      cell-specific monoclonal antibodies (MoAbs) were analysed by FACS. CD4+ T cells
      were selectively depleted in mice injected with anti-CD4 MoAb i.p. and injection
      of anti-CD8 MoAb resulted in selective depletion of CD8+ T cells. The expulsion
      of T. muris was inhibited in CD4+ T cell-depleted mice and numerous worms were
      detected in the large intestine on days 14 and 21 after infection, although no
      suppression of protective immunity to T. muris was observed in CD8+ T cell
      depleted mice. Moreover, there was no difference in suppression of protective
      immunity to T. muris between CD4+ T cell-depleted and both CD4+ and CD8+ T cells
      play a central role in protective immunity to T. muris infection.

PMID- 7792102
TI  - Assessing acute abdominal pain in adolescent females.
AB  - The possible causes of acute abdominal pain in the adolescent female are varied
      and numerous. Some problems are self-limiting, while others can be life
      threatening. Etiologies include, but are not limited to, gastrointestinal,
      urinary, gynecologic, and psychosocial problems. Assessment requires taking an
      accurate history quickly, and includes assessing the characteristics of the pain,
      any associated symptoms, and the overall physical and psychosocial health status
      of the adolescent. Physical assessment begins with observing how the adolescent
      presents herself. Although the abdomen is the focus of the examination, the
      general examination should not be ignored. Laboratory and radiologic testing
      logically follow, yet in the case of acute abdominal pain, greater reliance is
      placed in the symptoms and signs.

PMID- 7792103
TI  - Female adolescent contraception.
AB  - Numerous clinical challenges confront care providers in caring for adolescents
      regarding contraception and sexual health issues. Strong communication skills are
      an integral factor in dealing with the sexually active teen. The most common
      contraceptive options for adolescents include Norplant, Depo-Provera, oral
      contraception, and condoms. Providing contraceptive care for adolescents requires
      knowledge of these methods, including the new FDA guidelines that standardize
      instructions for oral contraceptive use. Nursing responsibilities include
      counseling the adolescent regarding the risks of sexual activity with multiple
      partners, exposure to HIV, STDS, and the correct use of condoms. Educational
      efforts should focus on improving adolescent communication skills and encouraging
      discussion by sexual partners about the issue of condom use.

PMID- 7792104
TI  - Menstrual dysfunction in athletes: assessment and treatment.
AB  - The reported incidence of exercise induced menstrual dysfunction varies among
      adolescent athletes from 12% to 66%. Women who experience amenorrhea associated
      with exercise are at risk for irretrievable bone mineral density loss and
      increased rate of stress fractures. Nurses should provide information to parents,
      coaches, and athletes about changes in exercise intensity and frequency, dietary
      modifications, and estrogen and progesterone replacement therapy to minimize the
      sequelae of exercise induced menstrual dysfunction.

PMID- 7792106
TI  - Parental perspectives related to decision-making and neonatal death.
AB  - With the advent of many new technologies, decision-making about the care of
      critically ill neonates represents one of the primary ethical arenas in health
      care today. Professionals and parents are forced to make decisions about when,
      how, and if critically ill neonates die. This qualitative study, based on
      interviews with a very small, convenience sample of parents, begins to explore
      the parental perspective about ethical decision-making regarding critically ill
      neonates by describing their personal experiences as they faced the reality or
      possibility of their babies' deaths.

PMID- 7792105
TI  - Social support and coping in young adolescents with cancer.
AB  - The social support networks and coping mechanisms of adolescents with cancer were
      assessed in this study. Twenty 10 to 16-year-olds completed the Norbeck Social
      Support Questionnaire (NSSQ) and the Adolescent Coping Orientation for Problem
      Experience (A-COPE). Social support networks of youths with cancer were found to
      include the following: parents, siblings, other relatives, friends, other
      nonprofessionals, and professionals. Males and females listed a similar number of
      persons in their personal network (6.5 and 7.0 respectively). Overall,
      adolescents reported a high amount of perceived functional support (affect,
      affirmation, aid). They also reported being very satisfied with the general
      support and support specific for their cancer from different groups of people.
      Although the sample was limited in size, adolescents in this study reported using
      a number of coping behaviors that are similar to those reported in the normative
      data. Moderate positive correlations were found between functional support and
      specific coping patterns. Significant moderate negative correlations were found
      between the length of illness and specific coping patterns. Results of the study
      are discussed and recommendations for future research are made. Nursing
      implications are discussed as they pertain to clinical practice.

PMID- 7792109
TI  - New books related to the care of children.

PMID- 7792107
TI  - Family experiences when a child is HIV-positive: reports of natural and foster
      parents.
AB  - The purpose of this exploratory study was to examine issues reported by natural
      and foster parents when caring for a child 3 years of age or younger with
      vertically transmitted HIV-disease. Issues common to both groups, and specific to
      the natural and foster parents were explored. The issues discussed by the natural
      mothers included guilt, their relationship with their infected child, and the
      effects of their HIV infection on their family. Issues discussed by foster
      mothers included their decision to foster a HIV-positive child, characteristics
      of their HIV- positive foster children, fears of transmission, and the effect of
      the HIV-positive foster child(ren) on their natural family. Issues common to both
      sets of mothers include disclosure, support, preparation for the HIV-positive
      child's death, and life in general. The experiences of these families are
      important to describe in order for pediatric nurses to give accurate, sensitive,
      and culturally appropriate care.

PMID- 7792108
TI  - When values conflict with obligations: safeguards for nurses.
AB  - Increasingly, nurses are being confronted with clinical situations that challenge
      their personal and professional integrity. For integrity to be preserved,
      safeguards must be developed and an environment that supports ethical practice
      fostered. Standards such as those promulgated by the JCAHO provide an important
      opportunity for nurses to create mechanisms to assure that diverse religious,
      cultural, and ethical beliefs of nurses are respected and upheld.

PMID- 7792110
TI  - Incubator noise: a method to decrease decibels.
AB  - PURPOSE: To examine the effect of covering the incubator on environmental noise
      levels inside the incubator. METHOD: Noise level measurements were taken to
      measure noise outside the incubators, inside the uncovered incubators, and inside
      covered incubators of 24 premature infants. The sound levels and differences in
      patient care equipment were analyzed by means, t-tests, and ANOVA. FINDINGS:
      Significant differences were found between the covered and uncovered incubators'
      sound level readings. Covered incubators had lower noise level readings.
      CONCLUSION: Covering incubators is one method to decrease environmental noise in
      the NICU.

PMID- 7792112
TI  - Antiretroviral therapy in infants and children with HIV.

PMID- 7792111
TI  - Child health issues in the 104th Congress.

PMID- 7792113
TI  - Teasing: who says names can never hurt you?
AB  - Although teasing is a common behavior of children, it does not occur without
      consequences in children. Children at particular risk are those with differing
      beliefs and feelings, distinctive personality traits, or obvious physical
      differences from that of the group norm. In these children, teasing can have
      deleterious effects on their psychological well-being. Strategies to use for
      assessment of and intervention with high-risk children are presented.

PMID- 7792114
TI  - Resources for family-centered care: an annotated bibliography.
AB  - Understanding and implementing family-centered care becomes easier as nurses are
      exposed to both the concept and examples of the concept in practice. An annotated
      bibliography of articles, books, films, training materials, and newsletters will
      be useful to individual nurses, nurse-educators, and nurse administrators.

PMID- 7792115
TI  - What is your assessment? Otitis media with effusion.

PMID- 7792116
TI  - Gender differences in asthma.

PMID- 7792117
TI  - The Yentl syndrome in childhood asthma: risk factors for undertreatment in Swiss
      children.
AB  - Recent prevalence data for childhood asthma in Switzerland suggest a substantial
      underdiagnosis which seems to be more pronounced in girls. We further analysed
      our data trying to specify risk factors for underdiagnosis and undertreatment.
      Our special interest was focused on female sex as there is evidence for a sex
      dependent diagnosis and treatment of chronic disease in adults, called the Yentl
      syndrome. The data are derived from a parent completed questionnaire survey of a
      stratified cluster sample of schoolchildren aged 7, 12, and 15 years. Besides the
      12 months prevalence of asthma symptoms and bronchodilator treatment, the
      lifetime prevalence of an asthma diagnosis was noted. With a response rate of
      97%, a total of 4353 completed questionnaires were analysed. While age was not
      associated with undertreatment (except for exercise-induced symptoms in
      adolescents), the lack of a formal diagnosis of asthma and atypical asthma
      symptoms other than wheeze such as chronic night cough were confirmed as
      significant risk factors for undertreatment. Of all boys reporting asthma
      symptoms 31% received bronchodilator treatment compared with only 15% of the
      symptom-reporting girls (P < 0.001). For all particular asthma-related symptoms
      (except wheeze), significantly more boys than girls (approximately double)
      received treatment. The physiological and psychological bases for these findings
      are discussed and suggest that gender is an important risk factor for
      underdiagnosis and undertreatment of asthma. Our research indicates that the
      Yentl syndrome may exist for childhood asthma.

PMID- 7792118
TI  - Prevalence of respiratory symptoms in Swiss children: is bronchial asthma really
      more prevalent in boys?
AB  - Precise epidemiological data for the prevalence of childhood asthma were lacking
      for Switzerland until recently. In 1990 we performed a stratified cluster
      sampling of schoolchildren (aged 7, 12, and 15 years), using a parent completed
      questionnaire to obtain data for the 12 months prevalence of asthma symptoms and
      the lifetime prevalence of asthma diagnosis. A response rate of 97.5% enabled us
      to analyse 4,353 completed questionnaires. The prevalence of any asthma symptom
      during the last 12 months was 17.5% while only 4.8% of the children reported the
      diagnostic label "asthma". The 12 months prevalence of chronic night cough was
      12% and is comparable to other European data. Wheeze (5.9%) was reported less
      often in Switzerland than in England. At the age of 7 years asthma symptoms such
      as wheeze, morning tightness, and allergen-induced symptoms were reported more
      often in boys than in girls; at the age of 12 and 15 the male preponderance was
      no more evident. For all asthma symptoms the male-female ratio decreased with
      increasing age of the children, while independently of age twice as many boys
      than girls reported the diagnostic label "asthma." We conclude that asthma
      symptom prevalence in Swiss schoolchildren is within the lower range of European
      data. Chronic night cough might be a more appropriate variable to compare
      prevalence rates between regions with different cultural and linguistic
      backgrounds that the symptom of wheeze. Evidence exists for a substantial
      underdiagnosis of bronchial asthma in Swiss children, especially in girls.
      Further evaluation is needed to define risk factors for underdiagnosis and the
      associated risk for undertreatment.

PMID- 7792120
TI  - Preservation of pulmonary function in the ventilated neonatal piglet with normal
      lungs.
AB  - Little attention has been focused on the progressive pulmonary deterioration
      which occurs in mechanically ventilated infants with normal or mildly abnormal
      lungs. We hypothesized that lung function would deteriorate over a 24-hr period
      in anesthetized neonatal piglets with normal lungs mechanically ventilated at 2
      cm H2O PEEP (2PEEP group). We further hypothesized that an intermittent lung
      inflation procedure consisting of 15 out of 60 min of increasing lung distention
      (4, 8, 12 cm H2O PEEP), with the remaining 45 min at 2 cm H2O PEEP (Inflation
      group) would prevent this deterioration in lung function, similar to piglets
      mechanically ventilated continuously at 6 cm H2O PEEP (6PEEP). Results indicate
      that 2PEEP piglets experienced progressive deterioration in lung function,
      including dynamic lung compliance (-42%) and lung resistance (+55%). In contrast,
      inflation piglets and 6PEEP piglets had no deterioration in lung function.
      Hemodynamics were similar between groups, although they were the most stable in
      the 6PEEP group. Histopathological changes were not significantly different. We
      conclude that (1) prolonged mechanical ventilation at 2 cm H2O PEEP in neonatal
      piglets resulted in progressive deterioration in pulmonary function, (2)
      intermittent lung inflation or continuous 6 cm H2O PEEP prevented deterioration,
      and (3) functional changes occurred without changes in histopathology. Lung
      inflation strategies other than PEEP can be used to prevent deterioration in lung
      function which accompanies prolonged mechanical ventilation in anesthetized
      nonspontaneously breathing piglets with normal lungs.

PMID- 7792121
TI  - Spontaneous pneumothorax as the first manifestation of Ewing's sarcoma.

PMID- 7792122
TI  - Cystoplasty for treatment of a congenital lung cyst.

PMID- 7792119
TI  - Validation of the phase angle technique as an objective measure of upper airway
      obstruction.
AB  - Thoraco-abdominal asynchrony (TAA) during upper airway obstruction (UAO) in small
      children can be documented by phase angle analysis of the Lissajous figure from
      the output of a noncalibrated respiratory inductance plethysmograph. Phase angle
      measurements have not been related to levels of inspiratory resistance, nor to
      the effect of breathing a 79% helium-21% oxygen mixture (heliox) during
      inspiratory resistance. We examined the effects of graded inspiratory loading (5
      1000 cm H2O/L/sec) on TAA as measured by phase angle in 10 male, anesthetized,
      and intubated Rhesus monkeys, breathing room air and heliox. Phase angles
      increased with inspiratory loading from a baseline value of 22 +/- 3 degrees to
      165 +/- 8 degrees at 1,000 cm H2O/L/sec resistance and correlated significantly
      with the level of inspiratory loading (r = 0.82). End-tidal carbon dioxide PETCO2
      increased from 39 +/- 1 to 49 +/- 3 mm Hg at the highest load, but correlated
      only weakly with phase angle measurements (r = 0.60) and the level of inspiratory
      loading (r = 0.56). By changing to heliox breathing at the highest tolerated
      resistance, PETCO2 dropped significantly from 49 +/- 3 to 40.5 +/- 4 mmHg (P <
      0.001) with no significant change in phase angles: 169 +/- 13 degrees and 165 +/-
      8 degrees, respectively (P > 0.05). We conclude that heliox therapy for acute
      alveolar hypoventilation during UAO improves ventilation, but does not decrease
      TAA at high inspiratory resistance. Continuous monitoring of the relative changes
      in phase angles is useful to observe the severity of UAO in the early
      stages.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792123
TI  - Primary lung abscess in infancy.

PMID- 7792124
TI  - The surface monolayer theory does not explain surfactant function in vivo.

PMID- 7792125
TI  - Clinical experience with cefpodoxime proxetil in acute otitis media.
AB  - Although it varies from country to country, there is a worrying worldwide
      increase in antibiotic resistance among pathogens causing otitis. This has led to
      a search for therapeutic alternatives to the reference treatment, which is still
      amoxicillin in many countries. Cefpodoxime proxetil is one such alternative. Six
      comparative randomized trials of cefpodoxime proxetil in childhood acute otitis
      media have been published or presented at international conferences. They
      involved a total of 1188 patients, 658 of whom received cefpodoxime proxetil and
      530 of whom received the comparator drug (amoxicillin/clavulanic acid in 3
      trials, cefaclor in 1, and cefixime in 2); duration of treatment varied from 5
      days for cefpodoxime proxetil to 10 days for amoxicillin/clavulanic acid, and the
      age of the children included ranged from 2 months to 12 years. The clinical
      efficacy of cefpodoxime proxetil was at least equivalent to that of the
      comparators in 4 trials and significantly better in 2 trials. Firstly, in one
      study vs. amoxicillin/clavulanic acid, the superiority of cefpodoxime proxetil (8
      mg/kg/day twice daily) in terms of healing at the end of treatment and in terms
      of the number of normal tympanograms at the follow-up visit was shown. Secondly,
      in a study performed by our group, vs. cefixime, cefpodoxime proxetil (8
      mg/kg/day twice daily) showed a better healing rate at the end of treatment in
      febrile and painful acute otitis media. The microbiologic and pharmacokinetic
      data show that cefpodoxime proxetil is one of the most active compounds against
      Haemophilus influenzae and Streptococcus pneumoniae.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7792126
TI  - Multicenter trial of cefpodoxime proxetil vs. amoxicillin-clavulanate in acute
      lower respiratory tract infections in childhood. International Study Group.
AB  - Acute lower respiratory tract infections in children are a worldwide public
      health problem, with an estimated 4 million potentially preventable deaths every
      year. Until recently, penicillin and related drugs were the treatment of choice
      for empiric therapy of paediatric lower respiratory tract infections. However,
      concerns over the emergence of penicillin-resistant strains of Streptococcus
      pneumoniae and beta-lactamase-producing strains of Haemophilus influenzae and
      Moraxella catarrhalis have led physicians to turn increasingly towards
      alternatives, such as the third generation cephalosporins. The oral extended
      spectrum cephalosporin cefpodoxime proxetil is highly active against the
      bacterial pathogens commonly associated with childhood lower respiratory tract
      infections. In order to evaluate its clinical efficacy in children with acute
      febrile lower respiratory tract infections, an international, multicenter,
      comparative, randomized open study was conducted in children ages 3 months to
      11.5 years. Of 348 cases enrolled, 234 were randomized to cefpodoxime proxetil (8
      mg/kg/day twice daily) and 114 to amoxicilin/clavanulate (amoxicillin 40
      mg/kg/day 3 times a day). The duration of treatment was 10 days. Pretreatment
      diagnosis was pneumonia in 292 patients, bronchiolitis in 19 patients and acute
      bronchitis in 37 patients. Pathogens isolated from 59 cases included H.
      influenzae (47.5%), S. pneumoniae (23.7%), M. catarrhalis (11.9%) and Haemophilus
      parainfluenzae (6.8%). Clinical efficacy was evaluable in 278 children at the end
      of treatment when 95.2% of patients in the cefpodoxime proxetil group and 96.7%
      of patients in the amoxicillin/clavanulate group showed a satisfactory clinical
      response (cured or improved). The improvement was sustained at the follow-up
      visit, 10 to 20 days after completion of treatment.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7792128
TI  - Do we still need new oral antibiotics for community-acquired infections in
      pediatrics? Introduction.

PMID- 7792127
TI  - Otitis media complications and treatment failures: implications of pneumococcal
      resistance.
AB  - Classic complications of untreated otitis media include meningitis, lateral sinus
      thrombosis and chronic suppurative otitis media. In the past, in countries where
      otitis media is usually treated, complications have been rare, because of the
      good activity of almost all orally administered antibiotics against the most
      common cause of complications, Streptococcus pneumoniae. Treatment failures were
      usually caused by beta-lactamase-producing nontypable Haemophilus influenzae or
      by Moraxella (Branhamella) catarrhalis and were rarely associated with serious
      systemic infections. With the advent of multidrug-resistant pneumococci, however,
      serious and fatal infections can occur in the face of our most potent
      antimicrobial agents. The consequences of the emergence of multidrug-resistant
      pneumococci are likely to include more persistent purulent otitis media,
      increased usage of broad-spectrum antibiotics, an increase in surgical treatment
      rates for otitis media and, eventually, an increase in suppurative complications
      of otitis media. Medical treatment failures probably already surpass eustachian
      tube dysfunction as the most common reason for tympanostomy tube insertion.
      Multidrug-resistant pneumococci may be expected to change the way in which
      primary and secondary care is currently administered.

PMID- 7792129
TI  - Pharyngitis/tonsillitis: European and United States experience with cefpodoxime
      proxetil.
AB  - Most authorities continue to recommend penicillin as the treatment of choice for
      group A streptococcal pharyngitis. If penicillin is used, 10 days of treatment
      are necessary to achieve a clinical and bacteriologic cure. The usually
      recommended penicillin V dose is 250 mg (400,000 IU) three times daily. Twice
      daily dosing is acceptable to some authorities if compliance is good. However,
      oral penicillin fails to eradicate group A streptococci from the pharynx in up to
      17% of cases; in some studies 30% failure rates have been reported. Several
      European and United States studies indicate that a variety of oral
      cephalosporins, when used for 10 days, are significantly superior to penicillin V
      in eradicating group A streptococci from the pharynx. For example cefpodoxime
      proxetil given twice daily for 10 days is comparable to penicillin V given three
      times daily for 10 days in achieving a clinical cure and appears to be
      significantly superior to penicillin in eradicating group A streptococci from the
      pharynx. Preliminary studies from Europe and the United States strongly suggest
      that 5-day therapy with cefpodoxime (or other selected oral cephalosporins) is at
      least as effective, clinically and microbiologically, as 10-day therapy with
      penicillin V. Further clinical trials are warranted to confirm the adequacy of 5
      day treatment and to assess the efficacy of cefpodoxime and other agents in
      preventing rheumatic fever.

PMID- 7792130
TI  - Temporal properties of colour and shape priming: evidence of multiple components
      of attention.
AB  - It has been shown in several studies that the selection of letters or numerals
      from an array can occur efficiently if criteria such as location, colour, shape,
      or size are used. It is also known that there are at least two components of
      spatial attention, the transient exogenous and the sustained endogenous. An
      interesting question is whether it is possible to elicit similar components when
      colour or shape information is used as a selection criterion. Experiments are
      reported the aim of which was to try to produce colour or shape precue effects on
      location and colour/shape discrimination accuracy, and to determine the minimum
      latency of these effects by sampling numerous cue lead times from 0 ms to 1000
      ms. The results showed that, although accuracy did not increase monotonically
      with increased cue lead time, there were two transient peaks of performance at
      cue lead times of 0-200 ms, culminating at 30-50 ms and at 160-200 ms. It is
      suggested that the first component reflects nonspecific exogenous activation,
      triggered by the onset of a cue; the second component, in turn, may reflect
      feature-specific endogenous activation related to selection by colour or shape.

PMID- 7792131
TI  - The dependence of two-dimensional shape perception on orientation.
AB  - While it is true that in daily life we generally recognize objects regardless of
      their orientation, previous experiments involving novel shapes indicate a decline
      in recognition when these are tested in altered orientation. Here the question is
      raised of whether there is a component of shape perception based purely on the
      geometry of an object, independent of orientation. By means of two tests designed
      to eliminate awareness of change of orientation, one more stringent than used
      heretofore, it was found that shape perception is dependent on orientation. The
      apparent contradiction between these findings and the apparent orientation-free
      character of recognition in daily life is discussed.

PMID- 7792132
TI  - Infants perceive spatial structure specified by line junctions.
AB  - Lines in drawings can be perceived as the corners where surfaces intersect, outer
      boundaries of surfaces, or as markings on a surface. In this study infants'
      ability to distinguish between lines that indicate corners and edges and lines
      that indicate markings was investigated. Infants aged 7.5 months were habituated
      to line displays in which the lines specified a three-dimensional cube or two
      overlapping rectangles. Both displays contained lines indicating corners, edges,
      and surface markings. After habituation, infants viewed two test displays, one in
      which the corners or edges were deleted and one in which the surface markings
      were deleted. Infants looked significantly longer at the displays that lacked the
      corners or edges. The results suggest that infants attend to lines that depict
      corners and edges to a greater degree than they attend to lines that depict
      markings. Infants may do so because corners and edges specify the shapes of
      objects whereas markings do not.

PMID- 7792133
TI  - Stereokinetic effects with sharp and fuzzy illusory contours.
AB  - A black, 8-shaped pattern, whose centre of gravity is in the centre of a rotating
      disc, appears to split into two black discs rotating with phenomenal independent
      motion, orientation stability, and sliding of one on the other. The type of
      observed movement, the order of overlapping, and the extent of the stereokinetic
      depth in relation to the contour type and different dimensions of the pattern
      were investigated. The experimental data show that a fuzzy contour facilitates
      the stereokinetic effect. Furthermore, the extent of the stereokinetic depth has
      been found to be greater in case of fuzzy contour and vertical orientation of the
      pattern. These results are in contrast with the models in which this effect is
      considered as a problem of minimisation of distances or velocities. A vector
      model of the observed movement and an interpretation of the overlapping based on
      an energy approach are proposed. A tentative explanation of the stereokinetic
      depth for our patterns is put forward.

PMID- 7792134
TI  - Updating after rotational and translational body movements: coordinate structure
      of perspective space.
AB  - As people move through an environment, they typically change both their heading
      and their location relative to the surrounds. During such changes, people update
      their changing orientations with respect to surrounding objects. People can also
      update after only imagining such typical movements, but not as quickly or
      accurately as after actual movement. In the present study, blindfolded subjects
      pointed to objects after real and imagined walks. The role of rotational and
      translational components of movement were contrasted. The difficulty of imagined
      updating was found to be due to imagined rotation and not to imagined
      translation; updating after the latter was just as quick and accurate as updating
      after actual rotations and translations. Implications for understanding primary
      spatial orientation, the organization of spatial knowledge, and spatial
      imagination processes are discussed.

PMID- 7792136
TI  - Haptic discrimination of doubly curved surfaces.
AB  - Active haptic discrimination of mathematically well-defined surfaces was
      investigated. The quadric surfaces were defined in terms of 'shape index'--a
      quantity describing shape--and 'curvedness'--a quantity describing overall
      curvature. In these experiments shape index was varied and curvedness kept
      constant. The influence of laterality (unilateral versus bilateral
      discrimination) was tested in separate sessions. No influence of shape on the
      discrimination of solid objects was found. From the results an estimate can be
      made of the just-noticeable difference in terms of shape-index units. There was a
      significant effect of laterality on discrimination: performance with unilateral
      (successive) examination (both with left and with right hand) was better than
      with bilateral (simultaneous) examination.

PMID- 7792135
TI  - The role of surface information in object recognition: studies of a visual form
      agnosic and normal subjects.
AB  - Three experiments were conducted to explore the role of colour and other surface
      properties in object recognition. The effects of manipulating the availability of
      surface-based information on object naming in a patient with visual form agnosia
      and in two age-matched control subjects were examined in experiment 1. The
      objects were presented under seven different viewing conditions ranging from a
      full view of the actual objects to line drawings of those same objects. The
      presence of colour and other surface properties aided the recognition of natural
      objects such as fruits and vegetables in both the patient and the control
      subjects. Experiment 2 was focused on four of the critical viewing conditions
      used in experiment 1 but with a large sample of normal subjects. As in experiment
      1, it was found that surface properties, particularly colour, aided the naming of
      natural objects. The presence of colour did not facilitate the naming of
      manufactured objects. Experiment 3 was focused on possible ways by which colour
      could assist in the recognition of natural objects and it was found that object
      naming was facilitated only if the objects were presented in their usual colour.
      The results of the experiments show that colour does improve recognition for some
      types of objects and that the improvement occurs at a high level of visual
      analysis.

PMID- 7792137
TI  - Effects of hypobaric hypoxia on histochemical fibre-type composition and myosin
      heavy chain isoform component in the rat soleus muscle.
AB  - Histochemical fibre-type composition and myosin heavy chain isoform component in
      the soleus muscle were studied in normoxic rats at postnatal ages of 5, 10, 15,
      and 20 weeks and in rats exposed to hypobaric hypoxia (460 torr) for 5 weeks from
      postnatal ages of 5, 10, and 15 weeks. The increase in the percentage of type I
      fibres and the concomitant decrease in that of type IIa fibres in the soleus
      muscle of normoxic rats were observed until 15 weeks of age. On the other hand,
      no change in the fibre-type composition of the muscle during postnatal
      development was observed in hypoxic rats, irrespective of the age at which they
      were exposed to hypoxia. The changes in the myosin heavy chain isoform component
      (MHC I and MHC IIa) of the muscle during postnatal development and by hypoxia
      corresponded well with those in the muscle fibre-type composition. It is
      concluded that hypobaric hypoxia inhibits the growth-related shift of muscle
      fibre-types from type IIa to type I and of myosin heavy chain isoforms from MHC
      IIa to MHC I in the rat soleus muscle, and that there are no changes in the
      muscle fibre-type composition or the myosin heavy chain isoform component caused
      by hypoxia after the shifts in these parameters which occur during postnatal
      development are completed.

PMID- 7792138
TI  - Biophysical, pharmacological and developmental properties of ATP-sensitive K+
      channels in cultured myotomal muscle cells from Xenopus embryos.
AB  - Unlike mammalian muscle cells in culture, cultured myotomal muscle cells of
      Xenopus embryos express ATP-sensitive K+ (KATP) channels. The KATP channels are
      blocked by internal ATP (half-maximal inhibition K0.5 = 16 microM) and to a
      lesser extent by internal ADP, are voltage independent, have an inward
      rectification at positive potentials and are inhibited by glibenclamide (K0.5 = 2
      microM). Surprisingly, these KATP channels are not sensitive to K+ channel
      openers such as cromakalim. Opening of these KATP channels does not occur under
      normal physiological conditions. It is elicited by metabolic exhaustion of the
      muscle cell and it precedes the development of an irreversible rigor state.
      Neither intracellular acidosis nor an increase of intracellular Ca2+ are involved
      in KATP channel opening. Different types of K+ channels are successively
      expressed after plating of myotomal muscle cells: (1) sustained delayed-rectifier
      K+ channels; (2) KATP channels; (3) inward-rectifier K+ channels; (4) transient
      delayed-rectifier K+ channels. The current density associated with KATP channels
      far exceeds that of voltage-dependent K+ channels. Innervation controls the
      expression of these KATP channels. Co-culture of muscle cells with neurons from
      the neural tube decreases the number of active KATP channels per patch.
      Similarly, in situ innervated submaxillaris muscle of tadpoles at stage 50-55 has
      a very low density of KATP channels.

PMID- 7792140
TI  - Adenosine triphosphate-dependent K currents activated by metabolic inhibition in
      rat ventricular myocytes differ from those elicited by the channel opener
      rilmakalim.
AB  - Adenosine triphosphate (ATP) dependent potassium channels (KATP channels) in
      heart ventricular muscle cells can be activated by depletion of intracellular ATP
      stores as well as by channel openers. In the present study we examined whether
      properties of KATP channels are dependent on the mode of activation. Whole-cell
      and single-channel currents were investigated by use of the patch-clamp technique
      in isolated ventricular rat myocytes. The channel opener rilmakalim dose
      dependently activated whole-cell currents [concentration for half-maximal
      activation (EC50) = 1.1 microM, Hill coefficient = 3.1, saturation concentration
      10 microM]. Metabolic inhibition with 2-deoxy-D-glucose (10 mmol/l) also
      activated KATP currents after a time lag of several minutes. These currents were
      about two-fold higher than the rilmakalim-activated currents (rilmakalim
      activated current 3.9 +/- 0.2 nA, 2-deoxy-D-glucose-activated current 8.1 +/- 0.9
      nA; both recorded at 0 mV clamp potential). While the rilmakalim-activated
      current could be blocked completely and with high affinity by the sulphonylurea
      glibenclamide [concentration for half-maximal inhibition (IC50) = 8 nM, Hill
      coefficient = 0.7] the 2-deoxy-D-glucose-activated current could only be blocked
      partially (by maximally 46%) and higher glibenclamide concentrations were needed
      (IC50 = 480 nM, Hill coefficient = 0.8). The partial loss of blocking efficiency
      after metabolic inhibition was not restricted to glibenclamide but was also
      observed with the sulfonylureas glimepiride and HB 985, as well as with the non
      sulfonylureas HOE 511 and 5-hydroxy-decanoate. Single-channel studies were in
      accordance with these whole-cell experiments. Both rilmakalim and metabolic
      inhibition with the uncoupler carbonyl cyanide p-(trifluoromethoxy)
      phenylhydrazone (FCCP) activated single channels in the attached mode, where the
      number of current levels was significantly higher in the case of FCCP. Rilmakalim
      activated channels were completely blocked by 10 microM glibenclamide, whereas
      several single-channel levels appeared in the presence of 100 microM
      glibenclamide after metabolic inhibition. In conclusion, after metabolic
      inhibition the amplitude of the activated KATP current is about twice as high as
      under saturating concentrations of the opener rilmakalim. Moreover, channels
      activated by metabolic inhibition lost part of their sensitivity to known channel
      blockers.

PMID- 7792139
TI  - Control of pulmonary vascular smooth muscle tone by sarcoplasmic reticulum Ca2+
      pump blockers: thapsigargin and cyclopiazonic acid.
AB  - The effect of thapsigargin (TG) and cyclopiazonic acid (CPA) on the mechanical
      activity of the rat pulmonary artery were investigated. In chemically (beta
      escin)-skinned arterial strips, application of TG (0.1-1 microM) or CPA (0.5-10
      microM) prior and throughout the loading procedure of the internal Ca2+ stores
      (0.3 microM free Ca2+ ions for 8-10 min) concentration dependently inhibited the
      subsequent contractile response induced by noradrenaline (NA, 10 microM) or
      caffeine (25 mM). In intact strips repeatedly incubated in a Ca(2+)-containing
      solution (2.5 mM for 10 min), followed by incubation in a Ca(2+)-free solution 12
      min before NA-stimulation, TG and CPA not only inhibited the NA-induced
      contraction but also increased the tension which appeared during the exposure
      time to Ca2+. The two phenomena developed with similar time courses. The increase
      in tension during the readmission of Ca2+ ions was not antagonized by verapamil
      (10 microM) or nifedipine (1 microM) but was blocked by La3+ (50 microM) and Co2+
      (1 mM) ions. The amplitude of the verapamil-insensitive TG (or CPA)-induced
      contraction was dependent on the external [Ca2+] [0.1-10 mM, concentration for
      half maximal effect (EC50) = 0.85 mM], not modified by the reduction of the
      external [Na+] (from 130 to 10 mM) and decreased by depolarization of the strip
      using K(+)-rich (30-120 mM) solutions. Under the latter condition, 38 +/- 9 and
      83 +/- 4% reduction (n = 5) was observed in the presence of 60 and 120 mM K+
      respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792142
TI  - Calcium is not involved in the cAMP-mediated stimulation of Cl- conductance in
      the apical membrane of Necturus gallbladder epithelium.
AB  - The permeability properties of the forskolin-stimulated Cl- conductance in the
      apical membrane of Necturus gallbladder epithelium and the possible participation
      of intracellular Ca2+ in its stimulation have been investigated. The anion
      selectivity sequence as derived from biionic potential measurements (SCN- > I-
      approximately NO3- > Br- > Cl- >> ISE-) differed from the sequence derived from
      measurements of apical membrane resistance (NO3- approximately Br- approximately
      Cl- > SCN- > I- approximately ISE-). Accordingly, the conductance was inhibited
      by SCN- and I- which, from the potential measurements, appeared to be more
      permeable than Cl-. This finding agrees with observations of the cystic fibrosis
      transmembrane conductance regulator (CFTR) Cl- channel reported recently.
      However, none of the commonly used Cl- channel blockers, such as 5-nitro-2-(3
      phenylpropylamino)-benzoic acid (NPPB), 4,4'-diisothiocyanatostilbene-2,2'
      disulphonic acid (DIDS), anthracene-9-carboxylic acid (9-AC) and glibenclamide
      reduced this conductance in Necturus gallbladder. In contrast to the situation in
      most other epithelia, elevation of intracellular Ca2+ concentration ([Ca2+]i) by
      ionomycin stimulated only K+ conductance and not that of Cl- in the apical cell
      membrane. Chelation of intracellular Ca2+ did not prevent the stimulation of Cl-
      conductance by forskolin. This indicates that [Ca2+]i does not have even a
      permissive role in the cyclic adenosine monophosphate-(cAMP)-mediated stimulation
      process, as would have been expected if exocytosis was involved. Further evidence
      against the involvement of exocytosis in the stimulation process came from the
      observation that the stimulation was not associated with an increase in apical
      membrane capacitance and was not suppressed by disruption of the cytoskeleton by
      preincubation of the tissue with cytochalasin D. The data indicate that Necturus
      gallbladder epithelium contains homologues of the CFTR Cl- channel which reside
      permanently in the apical cell membrane and which can be stimulated by a cAMP
      dependent phosphorylation process without involvement of cell Ca2+ or exocytosis.

PMID- 7792141
TI  - Arachidonic acid inhibits hormone-stimulated cAMP accumulation in the medullary
      thick ascending limb of the rat kidney by a mechanism sensitive to pertussis
      toxin.
AB  - The possible regulation of adenosine 3',5'-cyclic monophosphate (cAMP)
      accumulation by arachidonic acid (AA) was studied in segments, microdissected
      from the rat kidney, which are sensitive to arginine vasopressin (AVP). In the
      presence of 5 microM indomethacin, the addition of 5 microM AA did not impair AVP
      dependent cAMP accumulation (measured during 4 min at 35 degrees C) in the
      cortical or outer medullary collecting tubule, but decreased this response in the
      thick ascending limb with an inhibition much more pronounced in the medullary
      portion (MTAL) than in the cortical portion. In MTAL, the response to 10 nM AVP
      was inhibited by 34.4 +/- 9.6% (SEM) and 65.8 +/- 5.4% with 1 microM and 5 microM
      AA, respectively, N = 5 experiments. AVP-, glucagon- and calcitonin-sensitive
      cAMP levels in MTAL were inhibited by 5 microM AA to a similar extent. AA-induced
      inhibition was unaffected by the presence of inhibitors of AA metabolism: (1)
      either 10 microM indomethacin or 50 microM ibuprofen added to all media; (2) a 10
      min pre-incubation and a 4-min incubation of MTAL samples with 10 microM eicosa
      5,8,11,14-tetrayonic acid, (3) a 1-h preincubation with either 30 microM SKF
      525A, 20 microM ketoconazole, or 20 microM nordihydroguariaretic acid. In
      contrast to AA, 11 other saturated or unsaturated fatty acids had no inhibitory
      effect on the AVP-dependent cAMP level. In fura-2-loaded MTAL samples, AA induced
      a slow increase of the intracellular calcium concentration ([Ca2+]i) which
      reached 21.0 +/- 3.8 nM and 92.9 +/- 21.4 nM over basal values (n = 11) at 2 min
      and 4 min, respectively, after the beginning of the superfusion of 5 microM AA.
      AA-induced inhibition of AVP-dependent cAMP accumulation was due neither to the
      increase in [Ca2+]i elicited by AA, nor to an activation of protein kinase C
      because this inhibition: (1) was not blocked when MTAL samples were incubated
      either in zero Ca2+ medium, or in the presence of 1,2-bis(2-aminophenoxy)ethane
      N, N, N', N'-tetraacetic acid (BAPTA) to chelate [Ca2+]i, and (2) it was not
      reproduced by a pre-treatment of MTAL segments with a phorbol ester. Pre
      incubation of MTAL (6 h at 35 degrees C) with 500 ng/ml pertussis toxin (PTX)
      prevented AA-induced inhibition: in the presence of PTX inhibition was 24.7 +/-
      6.6% vs 10 nM AVP, as compared to 81.6 +/- 4.0% in control groups, i.e in the
      absence of PTX, N = 6.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7792143
TI  - Cell membrane stretch in osteoclasts triggers a self-reinforcing Ca2+ entry
      pathway.
AB  - Many cell types respond to mechanical membrane perturbation with intracellular
      Ca2+ responses. Stretch-activated (SA) ion channels may be involved in such
      responses. We studied the occurrence as well as the underlying mechanisms of cell
      membrane stretch-evoked responses in fetal chicken osteoclasts using separate and
      simultaneous patch-clamp and Ca2+ imaging measurements. In the present paper,
      evidence is presented showing that such responses involve a self-reinforcing
      mechanism including SA channel activity, Ca(2+)-activated K+ (KCa) channel
      activity, membrane potential changes and local and general intracellular Ca2+
      ([Ca2+]i) increases. The model we propose is that during membrane stretch, both
      SA channels and KCa channels open at membrane potential values near the resting
      membrane potential. SA channel characterization showed that these SA channels are
      permeable to Ca2+. During membrane stretch, Ca2+ influx through SA channels and
      hyperpolarization due to KCa channel activity serve as positive feedback, leading
      ultimately to a Ca2+ wave and cell membrane hyperpolarization. This self
      reinforcing mechanism is turned off upon SA channel closure after cessation of
      membrane stretch. We suggest that this Ca2+ entry mechanism plays a role in
      regulation of osteoclast activity.

PMID- 7792144
TI  - A confocal scanning laser microscope for quantitative ratiometric 3D measurements
      of [Ca2+] and Ca2+ diffusions in living cells stained with Fura-2.
AB  - A confocal scanning laser microscope (CSLM) for observation and quantitative
      ratiometric measurements of the intracellular dynamics of Ca2+ ions in living
      neurons has been developed. The instrument consists of a UV-enhanced CSLM, an
      optical arrangement providing simultaneous excitation at two wavelengths, an
      electronic arrangement for processing the simultaneous fluorescence response, and
      software for computing the absolute Ca2+ concentrations, ([Ca2+]). The instrument
      can be used for any excitation ratiometric measurements, provided that the dye
      substance used is excitable by wavelengths between 334 nm and 750 nm (such as,
      e.g. Fura-2). The spatial resolution of the CSLM, as well as a temporal
      resolution of 20 ms per line (maximum sampling rate) for dynamic measurements are
      provided by the instrument. Using Fura-2 in calibrated Ca2+ buffer solutions, the
      instrument measures [Ca2+] between 0 and 1.35 mumol.l-1 with an error of less
      than 1%. The capability of the instrument to measure absolute [Ca2+] was verified
      by recording fluorescence images of test solutions with well defined [Ca2+]
      values (Molecular Probes, Eugene, Ore., USA, C-3009 calibration solutions). In
      order to verify the dynamic capability of the instrument in real biological
      specimens, fluorescence changes of Fura-2 that were due to an intracellular flux
      of Ca2+ ions, and to an increase of [Ca2+]i (the intracellular Ca2+
      concentration) have been recorded in Fura-2-loaded cultured cells of the line TE
      671.

PMID- 7792145
TI  - Enhancement of an L-type calcium current in AtT-20 cells; a novel effect of the
      m4 muscarinic receptor.
AB  - Activation of muscarinic receptors has been shown to inhibit L-type calcium
      conductances by mechanisms sensitive to pertussis toxin (PTX). In this study we
      show that agonist stimulation of the m4 muscarinic receptor leads to an increase
      in an L-type calcium conductance in the AtT-20 pituitary cell line, by a PTX
      sensitive mechanism. The amplitude of the dihydropyridine (DHP)-sensitive or L
      type calcium current was increased by acetylcholine (ACh), with no shift in the
      voltage dependence. This action of ACh was completely inhibited by PTX pre
      treatment. Forskolin, cAMP and phorbol 12,13-dibutyrate reduced, while RpcAMPs,
      an inhibitor of cAMP-dependent protein kinase (PKA), increased the L-type calcium
      conductance. We propose that the m4 muscarinic receptor activates the L-type
      calcium channel by inhibition of adenylyl cyclase resulting in reduced cAMP
      levels and, hence, reduced PKA activity. This novel increase in calcium current
      via the m4 muscarinic receptor appears to reflect the coupling with an L-type
      channel of the D class, due to the sensitivity of the L-type calcium conductance
      to both DHPs and omega-conotoxin, and, thus, is distinct from the skeletal muscle
      and cardiac L-type channels of the C class previously studied.

PMID- 7792146
TI  - The variable coupling between force and myosin light chain phosphorylation in
      Triton-skinned chicken gizzard fibre bundles: role of myosin light chain
      phosphatase.
AB  - The mechanism responsible for the regulation of smooth muscle tone at low levels
      of myosin light chain (MLC) phosphorylation is still poorly understood. According
      to one model, so-called latchbridges, which contribute to force maintenance at
      low levels of MLC phosphorylation, are generated by dephosphorylation of attached
      and phosphorylated crossbridges. The model predicts that the force generated for
      a given level of MLC phosphorylation depends on the activity of the MLC
      phosphatase. We tested this hypothesis by reducing the activity of the
      phosphatase by at least 80% in two ways: inhibition with okadaic acid and
      extraction. Under both conditions, higher levels of MLC phosphorylation were
      required to support a given level of force, suggesting a decreased flux of
      attached phosphorylated to attached dephosphorylated crossbridges, as predicted
      by this model. Although, under both conditions, the relationship between force
      and MLC phosphorylation was shifted to the right, the curves did not superimpose
      as would have been expected if the phosphatase activity were the only determinant
      of the coupling between force and phosphorylation. In the extracted fibres, two
      more proteins, calponin and SM22, were significantly reduced in addition.
      Therefore, these proteins might be involved in modulating the relationship
      between force and MLC phosphorylation.

PMID- 7792147
TI  - The effects of calcium and calcium channel blockers on sodium pump.
AB  - The effects of 10 mM Ca2+ and Ca2+ channel blockers verapamil, diltiazem and
      flunarizine on the ouabain-sensitive electrogenic Na+, K+ pump activity of mouse
      diaphragm muscle fibres enriched with Na+ were compared with the changes in
      cytosolic [Ca2+]. The electrogenic Na+ pump activity produced by adding K+ to
      muscles previously bathed for 4 h in a K(+)-free, 2-mM [Ca2+] solution increased
      the resting membrane potential by about 18 mV. This hyperpolarization was
      completely inhibited after 10 min incubation in 10 mM Ca2+. Verapamil 10(-5) M,
      10(-5) M diltiazem and 10(-7) M flunarizine effectively prevented the effect of
      elevated [Ca2+]. At these concentrations, these drugs did not affect the K(+)
      induced hyperpolarization. In mouse diaphragm, the basal cytosolic [Ca2+]
      measured by the fluorescent indicator 1-[2-(5-carboxyoxazol-2-yl)-6-
      aminobenzofuran-5-oxy]2-(2'-amino-5'-methylphenoxy)ethane-N,N,N',N '- tetraacetic
      acid acetoxymethyl ester (fura-2/AM) was 261 +/- 6 nM. After 4 h in a Liley K(+)
      free, 2 mM [Ca2+] solution, the cytosolic [Ca2+] increased to 314 +/- 28 nM.
      Increase in [Ca2+] from 2 to 10 mM caused a twofold increase of cytosolic [Ca2+]
      to 637 +/- 26 nM. This rise was, like the Ca(2+)-induced inhibition of
      electrogenic pump, prevented by 10(-5) M verapamil, 10(-5) M diltiazem and 10(-7)
      M flunarizine. The results suggest that substances which block Ca2+ entry into
      the cell prevent the Ca(2+)-induced inhibition of the Na+ pump.

PMID- 7792148
TI  - Cellular acidification occurs during anoxia in cultured, but not in freshly
      isolated, rabbit proximal tubular cells.
AB  - In a variety of cells it has been shown that acidosis is protective against
      anoxic injury. We have demonstrated previously that proximal tubule (PT) cells in
      primary culture were more resistant to anoxia-induced cell injury than were
      freshly isolated cells. Therefore, we asked the question of whether a difference
      in cellular acidification during anoxia could explain this difference in
      susceptibility to anoxia. To answer this question, intracellular pH (pHi) was
      measured during anoxic incubation of PT cells in culture and those that were
      freshly isolated. PT cells were incubated in an anoxic chamber at 37 degrees C
      after loading with 2',7'-bis-(2-carboxyethyl)-5,6-carboxyfluorescein
      acetoxymethyl ester (BCECF-AM) or fura-2 acetoxymethyl ester (fura-2-AM). pHi and
      cytosolic free Ca2+ ([Ca2+]i) were measured by digital imaging fluorescence
      microscopy. During anoxia, pHi in cultured PT cells decreased from 7.3 +/- 0.1 to
      6.8 +/- 0.1, whereas pHi in freshly isolated cells did not decrease
      significantly. In addition, the intrinsic buffering capacities (beta i) in
      cultured and freshly isolated PT cells were determined and turned out to be the
      same at a pHi greater than or equal to 7.3. Below pHi 7.3, beta i increased
      several fold in freshly isolated PT cells, and rose to significantly higher
      levels than in cultured PT cells. During 1 h of anoxia, cell viability of freshly
      isolated PT cells decreased significantly to 54% +/- 2% (P < 0.05), while no loss
      in viability was observed in cultured PT cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792149
TI  - Characterization of the high-conductance Ca(2+)-activated K+ channel in adult
      human skeletal muscle.
AB  - Ca(2+)-activated K+ channels of a large conductance (BKCa) in human skeletal
      muscle were studied by patch clamping membrane blebs and by using the three
      microelectrode voltage-clamp recording technique on resealed fibre segments.
      Single-channel recordings in bleb-attached and inside-out modes revealed BKCa
      conductances of 230 pS for symmetrical and 130 pS for physiological K+
      distributions. Open probability increased with membrane depolarization and
      increasing internal [Ca2+]. The Hill coefficient was 2.0, indicating that at
      least two Ca2+ ions are required for full activation. Kinetic analysis revealed
      at least two open and three closed states. An additional long-lived inactivated
      state, lasting about 0.5-20 s, was observed following large depolarizations, when
      extracellular K+ was lowered to physiological values. BKCa were blocked by three
      means: (1) externally by tetraethylammonium which reduced single-channel
      amplitude (IC50 approx. 0.3 mM); (2) internally by polymyxin B which decreased
      the open probability (IC50 approx. 5 micrograms/ml); and (3) externally by
      charybdotoxin which caused long-lasting periods of inactivation (IC50 < 10 nM).
      Measurements on resealed fibre segments at physiological [K+] were in accordance
      with the single-channel data: only when intracellular [Ca2+] was elevated did
      charybdotoxin (50 nM) reduce the macroscopic membrane K+ conductance with
      depolarizing voltage steps.

PMID- 7792150
TI  - Tetraethylammonium-insensitive, Ca(2+)-activated whole-cell K+ currents in rat
      submandibular acinar cells.
AB  - Using whole-cell patch-clamp techniques, we demonstrate, for the first time, that
      rat submandibular acinar cells contain a tetraethylammonium (TEA)-insensitive,
      Ca(2+)-activated K+ conductance which is not attributable to large conductance,
      voltage-sensitive, Ca(2+)-dependent K+ channels (maxi-K+ channels). Taken
      together with our recent K+ efflux and fluid secretion studies in intact rat
      submandibular gland, we postulate that the K+ conductance reported here may be
      involved in the basolateral K+ efflux pathway activated by cytosolic Ca2+
      concentration during secretion by this gland.

PMID- 7792151
TI  - The emotional environment of older adults: a holistic nursing perspective.

PMID- 7792152
TI  - Encountering environment through interiority.

PMID- 7792153
TI  - A collage of awareness for a sustainable future.

PMID- 7792154
TI  - Family life after Hurricane Andrew: personal and phenomenological reflections.

PMID- 7792156
TI  - Environments experienced by hospital nurses during Hurricane Andrew.

PMID- 7792155
TI  - Emotional and environmental connections: impact of the Armenian earthquake.

PMID- 7792157
TI  - Voluntary simplicity: nurses creating a healing environment.

PMID- 7792159
TI  - Environmentally responsible clinical practice.

PMID- 7792158
TI  - In the gloom of the environmental crisis, can nurses afford to dwell in hope and
      be defined by the past?

PMID- 7792160
TI  - Environmental messages: experiencing the wisdom of the natural world.

PMID- 7792161
TI  - Environmental connections and reawakened spirit.

PMID- 7792163
TI  - An ecofeminist look at animal research.

PMID- 7792162
TI  - The environment: alive, whole, and interacting.

PMID- 7792164
TI  - The environment as a curricular concept in professional nursing programs: a case
      study.

PMID- 7792165
TI  - Practicing environmental accountability: a mosaic of meanings for nursing.

PMID- 7792166
TI  - Endings and new beginnings.

PMID- 7792167
TI  - Nightingale, nursing, and the ecofeminists.

PMID- 7792168
TI  - Nurses as fairies in gumboots.

PMID- 7792169
TI  - Exploring ethical ways of being with another and earth, including life-style
      changes to promote a culture of simplicity.

PMID- 7792170
TI  - The Bright Alps Project: creating caring environments for people with
      disabilities.

PMID- 7792171
TI  - Toward a more friendly social environment for the patient: the role of the
      resident hospital relative.

PMID- 7792174
TI  - Divided we fall.

PMID- 7792173
TI  - Managing success.

PMID- 7792172
TI  - Professional development. Managing diabetes: revision notes (continuing education
      credit).

PMID- 7792175
TI  - Indecent exposure.

PMID- 7792176
TI  - The case for and against the practice of euthanasia.

PMID- 7792177
TI  - Euthanasia. Definitions and debate.
AB  - This paper looks at the origins and history of euthanasia and describes active
      and passive intervention. The author also describes the development of the
      various organisations advocating euthanasia or supporting those who wish to use
      it. Public opinion on the subject is explored, as well as the rights of patients
      and practitioners.

PMID- 7792178
TI  - Euthanasia and the legal situation in The Netherlands.
AB  - In The Netherlands a doctor may, under certain circumstances, avoid prosecution
      if he or she helps a patient to die who has persistently requested euthanasia.
      This paper describes the current legal situation.

PMID- 7792179
TI  - Euthanasia. The issue of resuscitation.
AB  - Euthanasia in this country is illegal, but issues surrounding 'do not
      resuscitate' guidelines raise the questions on the right to a death with dignity
      for many nurses. In this paper the author discusses the statement by the British
      Medical Association and the Royal College of Nursing on cardiopulmonary
      resuscitation and advises health practitioners to use this statement as a
      guideline for their own policy and framework in hospitals and not to accept this
      framework as implicit.

PMID- 7792180
TI  - Sociology in nurse education: help or hindrance?
AB  - Recent years have seen a dramatic increase in the role of the social and
      behavioural sciences in nurse education. In part this follows the UKCC's
      recommendations for Project 2000 curricula, but it can also be seen as a wider
      reaction to the domination of nursing knowledge by the so-called 'biomedical'
      model. Indeed, not only do pre-registration courses in nursing and midwifery now
      incorporate significant elements of sociology and psychology, but so, especially,
      do post-registration diploma and degree courses. Although this development is
      often regarded by nurse educators (many of whom either possess, or are in the
      process of acquiring degrees or post-graduate qualifications in the social
      sciences) as a positive step towards greater professionalism and autonomy within
      the nursing profession, there are a number of reasons why such assumptions should
      be regarded with caution. This paper explores some of the most important of
      these, and argues that the keenness with which nurse educators have embraced the
      discipline of sociology into the nursing curriculum, could in fact be seriously
      misplaced.

PMID- 7792181
TI  - Social Marxism, class conflict and health care.
AB  - In the first of a six-part series the sociological theories of Karl Marx are
      examined and related to the purported neutrality of medicine. The role of nursing
      within a Marxist analysis of the world is considered, and the value of such
      analysis is described.

PMID- 7792183
TI  - Complementary medicine. Nature cures.

PMID- 7792182
TI  - Scandinavian style of care.

PMID- 7792184
TI  - Older people: individual practices.

PMID- 7792185
TI  - HIV/AIDS. The family way.

PMID- 7792186
TI  - Unhealthy attitudes.

PMID- 7792187
TI  - Infection control. Knowledge of disinfection.

PMID- 7792188
TI  - Infection control. Motivation: the key factor.

PMID- 7792189
TI  - Seeing the light.

PMID- 7792190
TI  - Taken to task.

PMID- 7792191
TI  - Island reforms.

PMID- 7792192
TI  - Challenging ageism through our speech.
AB  - Aspects of ageism that are directed towards older people can sometimes be
      reflected in speech. This study puts some of the relevant literature to the test
      by finding out the opinions of some older people about the way they are spoken to
      and communicated with. The research suggests that ageism through speech is very
      real, but the reinforcements of these attitudes are perhaps also to do with the
      behaviour of older people themselves.

PMID- 7792194
TI  - A new approach to practice development in mental health.
AB  - This paper describes the structure and implementation of a training strategy in a
      mental health service. An approach was adopted which sought to combine the needs
      of staff, quality patient care and national agendas.

PMID- 7792193
TI  - Power of language in a ward for the care of older people.
AB  - This study examines nurse-patient interaction in a ward caring for older
      patients. The role of language in exerting control over patients is explored and
      the research confirms previous work which revealed that most of the observed
      interactions were brief, superficial and related to tasks. An inherent tension in
      the quality of communication expected from nurses and that which actually occurs
      is identified. It is recommended that attention to language, as a specific
      component of communication, is vital if nurses are to develop the skills
      necessary to interact with patients in a manner consistent with the demands of
      contemporary thinking in nursing.

PMID- 7792195
TI  - Managing occupational health services in NHS trusts.
AB  - This paper, the last in a series of six, reviews the areas to consider when
      managing occupational health provision in NHS settings. It covers the operational
      policy, which explains the functions of the occupational health service. It then
      discusses the staffing and structure of the service and how it fits into the rest
      of the organisation. The concluding section is perhaps the most important of all;
      without financial awareness, understanding and maintaining a budget, the manager
      of the occupational health service will not be successful. Previous papers in the
      series appeared on December 14, January 11, February 8, March 1 and April 12.

PMID- 7792196
TI  - The effects of psoriasis and its treatment: Part 1.
AB  - The first of a series of two papers on the subject describes a range of
      treatments for psoriasis. The pharmaceutical treatment of the condition is
      described together with consideration of the general support of the person
      affected. Treatment may be topical or systemic depending on the severity of the
      condition.

PMID- 7792197
TI  - Prejudice in practice.

PMID- 7792198
TI  - A disaffected profession.

PMID- 7792199
TI  - Fear busters.

PMID- 7792200
TI  - Midwives' journal. Implementing good practice.

PMID- 7792201
TI  - Midwives' journal. Feeding after mammoplasty.

PMID- 7792202
TI  - The pathologist's approach to the diagnosis of metabolic disease.
AB  - Many inborn errors of metabolism have tissue changes that suggest or indicate a
      diagnosis on morphologic bases. This emphasizes the involvement of the
      pathologist in the study of tissues obtained by biopsy as part of the diagnostic
      workup of cases with clinical evidence suggesting a metabolic disorder. Some of
      these diseases involve proteins with enzymatic activity with a consequent backlog
      of precursor metabolites. If these metabolites are insoluble or compartmentalized
      in cells, they accumulate in tissues. The diagnosis in those cases rests on
      establishing the nature of the accumulated materials and their topographic
      distribution. In some storage diseases, the abnormal substance can be identified
      in the affected tissues by histochemistry or ultrastructure. Another group of
      inborn disorders of metabolism produce changes in subcellular organelles such as
      peroxisomes and mitochondria. A third group is expressed by rather unique tissue
      changes which strongly suggest the diagnosis of metabolic disease.

PMID- 7792204
TI  - Prognostic significance of T-cell infiltrates, expression of beta 2-microglobulin
      and HLA-DR antigens in breast carcinoma.
AB  - In this study immunohistological staining was used to assess the presence of T
      cell infiltrates and the expression of beta 2-microglobulin (beta 2-m) and HLA-DR
      antigens on tumor cells of 75 ductal invasive carcinomas. The results were
      compared with the morphometric prognostic index (MPI) that seems to be the most
      accurate prognostic predictor. The extent of T-cell infiltrates differed widely
      between tumors, but statistically significant correlation was found only with the
      lymph node status, namely, tumors with a high degree of infiltration had
      predominantly negative lymph nodes and vice versa (p < 0.05). Only 19 (25.3%) out
      of 75 carcinomas were beta 2-m+, 34 cases (45.3%) showed heterogeneous staining
      pattern and 22 tumors (29.3%) were completely negative. We could not find any
      significant correlation between beta 2-m expression and MPI or T-cell content.
      While normal breast epithelium was always HLA-DR negative, tumor cells displayed
      positivity in 25 cases (33.3%), 5 tumors (6.7%) were completely positive and 20
      tumors (26.7%) displayed only focal expression of class II antigens. This
      expression did not correlate with any single prognostic parameter, nor with MPI.
      The results suggest that T-cell infiltrates and the expression of
      histocompatibility antigens can not be accepted as prognostic indicators in
      breast carcinoma.

PMID- 7792203
TI  - The localization of lipopolysaccharide in an endotoxemic rat liver and its
      relation to sinusoidal thrombogenesis: light and electron microscopic studies.
AB  - The distribution of lipopolysaccharide (LPS) and sequential thrombus formation in
      the liver was investigated by immunohistochemical and cytochemical techniques in
      endotoxemic rats, using horseshoe crab factor C, a specific ligand for
      biologically active LPS, a monoclonal antibody against it, and rabbit anti-rat
      fibrinogen IgG. One hour after the intravenous administration of LPS (5 mg/kg),
      LPS was localized in the secondary lysosomes of Kupffer cells and in the vesicles
      of endothelial cells, mainly at the peripheries of the hepatic lobules. Small
      necrotic foci of hepatic tissue were scattered close to the LPS-containing
      Kupffer cells, and were frequently associated with infiltration of neutrophils
      and deposition of fibrin. Three hours after the administration of LPS, the
      immunohistochemical reaction of LPS became stronger and was mostly confined to
      Kupffer cells. Strands of polymerized fibrin were frequently observed on both the
      surface of the LPS-containing Kupffer cells and on endothelial cells. These
      findings suggest that the activation of the coagulation cascade in plasma is
      first initiated, even though only transiently, by hepatic necrosis which is
      probably caused by LPS-activated leukocytes, and then by the procoagulant
      activity expressed on the surface of both Kupffer cells and endothelial cells.
      Fibrinogen-related antigens were also immuno-ultrastructurally detected in the
      lysosomes of Kupffer cells three hours after the injection of LPS, which
      suggested that the Kupffer cells phagocytozed and degraded fibrin. Therefore
      Kupffer cells in endotoxemia may closely participate in both the sinusoidal
      thrombogenesis and degradation of fibrin.

PMID- 7792205
TI  - Stereologic parameters of nuclear ultrastructure as markers of the steroid
      receptor status in breast cancer epithelium.
AB  - The nuclear specific surface density (Sv/Vv), mean nuclear area (A) and numerical
      density (Nv) of tumor cell nuclei from 30 primary invasive female breast
      carcinomas with known concentrations of estrogen and progesterone receptors (ER
      and PR), were morphometrically analyzed at the ultrastructural level. It was
      found that carcinomas with concordant positive ER and PR status contained
      significantly higher number of smaller nuclei per volume unit of epithelium (mean
      Nv = 1.5 x 10(6) mm-3, mean A = 27 microns 2), than carcinomas of negative
      concordant receptor status (mean Nv = 0.8 x 10(6) mm-3, mean = 37 microns 2).
      Tumor cell nuclei of the former frequently displayed an elliptic shape (mean
      Sv/Vv = 1.16 microns-1), and had deeply invaginated surfaces, whereas nuclei of
      the latter were more frequently ball-shaped and exhibited a smooth-surface (mean
      Sv/Vv = 0.88 microns-1). The numerical density Nv (NUC/EPI) of tumor cell nuclei
      turned out to be a most reliable morphological marker of the concordant ER and PR
      status (overall efficiency = 84%, p < 0.01). The nuclear surface and volume ratio
      and mean nuclear area also appear to be reliable markers for terminal stages of
      the biochemical differentiation of breast carcinoma (overall efficiency = 79%, p
      < 0.05).

PMID- 7792207
TI  - Carcinoid tumour complicating inflammatory bowel disease. A study of two cases
      with review of the literature.
AB  - Two cases of carcinoid tumour complicating inflammatory bowel disease (IBD) are
      presented. Both tumours were located in the appendiceal tip. The first case
      occurred in a man with Crohn's disease (CD), and the second one in a woman
      suffering from ulcerative colitis (UC). Histochemical and immunohistochemical
      studies were not allowed on case 1 because the tumour was not still present on
      serial sections of the appendix. On case 2, tumour cells were not reactive with
      Grimelius and Masson-Fontana stainings, but were strongly stained with anti
      keratin and anti-chromogranin monoclonal antibodies (MAb), and faintly expressed
      neuron specific enolase (NSE), and Leu-7. Both cases occurred in inflammatory or
      damaged mucosa which exhibited Paneth cell metaplasia and hyperplasia and areas
      indefinite for dysplasia. Along with these lesions, hyperplasia of
      enteroendocrine cells was pointed out in the neighbouring appendiceal and colonic
      mucosa by means of anti-chromogranin MAb. These data suggest that the association
      of carcinoid tumour with IBD, albeit rare, is not coincidental and is the result
      of hyperplastic and dysplastic troubles that may involve enteroendocrine cells as
      well as such other derivatives of digestive stem cells as columnar cells, goblet
      cells and Paneth cells.

PMID- 7792206
TI  - Creatine kinase isoenzymes as markers of differentiation in rhabdomyosarcoma
      cells in culture.
AB  - Rhabdomyosarcomas have been classified on the basis of their degree of
      differentiation, a feature closely related with their response to chemotherapy.
      We recently reported the role of creatine kinase isoenzymes as tumoral markers in
      the diagnosis of rhabdomyosarcoma. The present study was designed to determine
      whether these isoenzymes are also good markers of the degree of differentiation
      of these neoplasm. Dimethyl sulfoxide, a well-known differentiating agent, was
      used to induce myogenic differentiation. This agent increased CK-MM and/or CK-MB
      fractions, and decreased CK-BB isoenzyme in rhabdomyosarcoma cell lines. The
      variable behavior of MCK-1 macromolecule was unrelated to the degree of
      differentiation. Our findings suggest that CK-MM, CK-MB and CK-BB isoenzymes are
      good markers of the degree of differentiation in rhabdomyosarcomas and could be
      used as specific markers of prognostic and diagnostic value.

PMID- 7792208
TI  - Sarcoidosis of the thyroid gland manifested initially as thyroid tumor.
AB  - A rare case of a patients with sarcoidosis of the thyroid gland, who was
      preoperatively diagnosed as having thyroid carcinoma and who had no other
      clinical features of sarcoidosis, is reported. Thyroidectomy specimen revealed
      numerous noncaseating, epithelioid granulomas in the thyroid tissue.
      Mycobacteria, fungi and foreign body material were not identified. Similar
      granulomas were also found in the lymph nodes and muscular tissue adjacent to the
      thyroid gland and parathyroid gland After the diagnosis of sarcoidosis of the
      thyroid, systemic examination failed to reveal any involvement in other sites,
      including lung, eye and skin. This case demonstrated that sarcoidosis can
      manifest initially as a thyroid tumor with no other evidence of disease.

PMID- 7792209
TI  - Renal and hepatic angiomyolipomas in a child without evidence of tuberous
      sclerosis.
AB  - A renal neoplasia, displaying the typical features of angiomyolipoma (an
      admixture of smooth muscle cells, mature adipocytes and tangles of thick-walled
      blood vessels) was found in a nine-year-old boy. In addition, cytoplasmic
      crystalloid structures and HMB 45 positivity were found in smooth muscle cells.
      Similar findings were also observed in a small nodule of the liver. According to
      literature data, angiomyolipoma is very rare in children and almost exclusively
      associated with tuberous sclerosis. Our case suggest that the diagnostic
      hypothesis of angiomyolipoma can not be disregarded when a renal mass is
      identified in a young patient even in a clinical setting other than tuberous
      sclerosis.

PMID- 7792210
TI  - What's new in managing health hazards in pathology departments.
AB  - Health hazards related to activities performed in pathology departments have
      represented, in recent years, an increasing concern among pathologists and
      pathology technicians. The major occupational health problems encountered in
      pathology departments are reviewed. They include biological hazards
      (tuberculosis, hepatitis, HIV, other infectious diseases), chemical hazards
      (formaldehyde, xylene(s), aromatic amines, methacrylates, glutaraldehyde, latex)
      and physical hazards (cut injuries, accidental fires, radiation). Current data
      suggest that infections (particularly, tuberculosis and hepatitis) still
      represent the more relevant risk. Exposure to HIV and Creutzfeldt-Jakob agent may
      be highly harmful but containment measures have been proven to be effective. The
      actual adverse effects due to chemicals seem to be less alarming than was
      previously believed. Attaining a safe work environment is an inherent element of
      good quality assurance management. This task is largely a matter of information,
      education, organization and common sense. Well-designed premises, efficient
      equipment and well-trained personnel are the keys to preventing and minimizing
      hazardous exposures. In order to provide current information that may be used by
      pathology staff to implement the functional quality of the workplace,
      organizational and preventive measures are described.

PMID- 7792211
TI  - Not all hemangiomas look like strawberries: uncommon presentations of the most
      common tumor of infancy.
AB  - The typical appearance of cutaneous hemangiomas of infancy is well known. We
      studied unusual manifestations of this common tumor. We reviewed over 500
      hemangiomas in the registry of the Vascular Anomalies Program at Boston
      Children's Hospital. We found four uncommon morphologic variations: deep
      hemangiomas with normal overlying skin (n = 12); macular hemangiomas with a port
      wine stainlike appearance (n = 6); bossed hemangiomas with telangiectasia and
      peripheral pallor (n = 5); and hemangiomas with persistent fast flow (n = 3).
      Deep and superficial (macular) varieties regressed at a normal rate.
      Telangiectatic (bossed) hemangiomas, however, involuted rapidly, usually before 1
      year of age. Hemangiomas with persistent fast flow required either resection or
      sclerotherapy for complications in early childhood.

PMID- 7792212
TI  - The frequency of erythromycin-resistant Staphylococcus aureus in impetiginized
      dermatoses.
AB  - A trend toward increasing resistance of Staphylococcus aureus to standard
      antibiotic therapy has been reported. Specimens were taken from 98 patients in
      our outpatient staff clinic who had clinical signs of superficial skin
      infections. Patients with erythromycin-resistant S. aureus were contacted by
      telephone or seen in clinic. The organism was found in 87% of patients. Twenty
      two (26%) of the 85 cultures that grew S. aureus were resistant to erythromycin.
      Treatment failure occurred in one of these patients. We conclude that S. aureus
      is the most common causative organism in secondary skin infections and impetigo
      in our patient population. Despite significant erythromycin resistance, there was
      a low frequency of treatment failure in this group. Erythromycin may still be a
      reasonable agent in the treatment of uncomplicated superficial skin infections in
      our community at this time.

PMID- 7792213
TI  - Childhood acquired epidermolysis bullosa.
AB  - We present the ninth case of epidermolysis bullosa acquisita (EBA) reported in
      children. As in most of the other childhood cases, the 7-year-old boy described
      herein had an acute, widespread, inflammatory vesiculobullous eruption with oral
      involvement. Indirect immunofluorescence on salt-split skin as well as Western
      immunoblot confirmed the diagnosis of EBA. The patient responded to combined
      prednisone and dapsone, and was maintained with dapsone alone.

PMID- 7792214
TI  - Erythrokeratoderma variabilis: case report and review of the literature.
AB  - A 5-month-old boy with erythrokeratoderma variabilis is presented. The parents
      noted that the asymptomatic erythematous plaques changed over the course of hours
      to days. Topical therapy with retinoic acid proved ineffective. A brief review of
      the literature is presented.

PMID- 7792215
TI  - Branchio-oculo-facial syndrome and dermal thymus: case report and review of the
      literature.
AB  - We report a patient affected by the rare branchio-oculo-facial syndrome.
      Histologic study of the branchial clefts showed thymic remnants. A scanning
      electron microscopic study of the hair was also performed. The clinical features
      of the patient were compared with those of other patients reported in the
      literature.

PMID- 7792217
TI  - Eosinophilic panniculitis.
AB  - Eosinophillic panniculitis is a poorly defined entity with variable clinical
      features. We report a case of rapidly enlarging, asymptomatic subcutaneous scalp
      nodules in a 6-year-old black boy with atopic dermatitis. The nodules resolved
      spontaneously over two to three days. Biopsy specimens were remarkable for
      eosinophilic panniculitis without evidence of epidermal change or vasculitis. We
      believe that this is the youngest reported patient with this disorder.

PMID- 7792216
TI  - A case of infantile febrile psoriasiform dermatitis.
AB  - An infant suffered from psoriasiform dermatitis complicated by severe
      constitutional symptoms. During his 12 months of hospitalization, the symptoms
      exacerbated periodically despite numerous therapeutic trials. Histologic findings
      revealed lichenoid psoriasiform dermatitis with striking eosinophilic necrosis of
      epidermal cells and satellite cell necrosis. Immunohistochemically, CD1+
      Langerhans cells had almost disappeared, and CD8+ cytotoxic-suppressor T cells
      were predominant over CD4+ helper-inducer T cells in the epidermis. These
      findings in the skin biopsy specimens suggested some similarity to graft-versus
      host disease but no known cause of that disorder was proved. Finally,
      methotrexate was effective. The patient became afebrile, and his skin lesions
      improved, leaving almost no scarring. This patient seems to have had specific
      clinical features that do not correspond with any of the known dermatitis.
      Clinical, histologic, and laboratory findings did not uncover any etiologic
      factors.

PMID- 7792218
TI  - Pyoderma gangrenosum and sterile multifocal osteomyelitis preceding the
      appearance of Takayasu arteritis.
AB  - A 9-month-old infant had pyoderma gangrenosum (PG) and sterile osteomyelitis.
      Three years later the patient developed Takayasu arteritis (TA). Sterile
      osteomyelitis was reported in approximately 30 patients with different skin
      lesions, but never together with pyoderma gangrenosum. The association of PG and
      TA has been reported rarely, and then mainly in adults or in children over age 9
      years. This rare association should alert physicians with a case of infantile PG
      of unknown etiology to consider the possible diagnosis of TA.

PMID- 7792219
TI  - Subcutaneous fat necrosis, hypercalcemia, and prostaglandin E.
AB  - We present two patients with subcutaneous fat necroses (SCFN) in whom
      endocrinologic studies revealed an association with elevated prostaglandin E
      (PGE) levels. A boy born after prolonged labor complicated by meconium aspiration
      developed erythematous, indurated plaques over the back, arms, buttocks, and
      cheeks at 4 days of age. A biopsy specimen of involved skin showed panniculitis
      with foci of necrotic adipocytes containing radially arranged, needle-shaped
      clefts and a granulomatous infiltrate in the septae. Laboratory studies revealed
      hypercalcemia of 13.6 mg/dl (normal 8.8-10.1 mg/dl), elevated 1.25-1.25(OH)2D3,
      and increased urinary excretion of PGE2. The child was hospitalized and treated
      with systemic steroids and diuretics, with resolution of SCFN and hypercalcemia.
      The second patient was a girl born with cyanotic heart disease. A diagnosis of
      Ebstein anomaly was made, and intravenous PGE1 was started to keep patent the
      ductus arteriosus. Four days later erythematous, indurated plaques were noted on
      the knee, back, and anterior chest. A skin biopsy specimen revealed SCFN. There
      was no associated laboratory abnormality. On discontinuing PGE1, no new lesions
      formed and the existing panniculitis resolved. These two cases demonstrate the
      association between SCFN and elevated PGE levels (endogenous in patient 1,
      exogenous in patient 2). No previous reports of SCFN after the administration of
      PGE1 have appeared in the literature.

PMID- 7792220
TI  - Apocrine chromhidrosis involving the areolae in a 15-year-old amateur figure
      skater.
AB  - Apocrine chromhidrosis is a rare disease frequently localized to the face or
      axillae, and rarely has been reported to occur around the breasts. We report a 15
      year-old amateur figure skater who displayed localized chromhidrosis around her
      areolae. The most common precipitating event was exercise. She was treated
      topically with capsaicin cream 0.025% with a subsequent decrease in
      symptomatology.

PMID- 7792221
TI  - Fixed drug eruption on the tongue of a 4-year-old boy.
AB  - A 4-year-old boy had a rare fixed drug eruption due to amoxicillin and confined
      to the tongue. Avoidance of the drug resulted in complete clearance within three
      months.

PMID- 7792222
TI  - Treatment of childhood dermatophyte infections with oral terbinafine.
AB  - Over the past four years terbinafine has become established as an effective
      systemic antimycotic agent with an excellent safety profile. However, experience
      with its use in children is very limited. We report the effective treatment of
      five children with oral terbinafine.

PMID- 7792223
TI  - What syndrome is this? Ollier disease + vascular lesions: Maffucci syndrome.

PMID- 7792224
TI  - Multiple cutaneous nodules in a newborn.

PMID- 7792225
TI  - Atypical pityriasis rosea in a 2-year-old.

PMID- 7792227
TI  - UVB phototherapy in childhood psoriasis.

PMID- 7792226
TI  - Treatment of chronic bullous dermatosis of childhood with oral dicloxacillin.

PMID- 7792228
TI  - Golf tee hairs in Netherton disease.
AB  - We present a case of Netherton disease, where the hairs lacked the characteristic
      microscopic feature of trichorrhexis invaginata. In its place were certain hairs
      with a golf tee morphology. These represent the proximal half of the invaginate
      node seen in typical Netherton disease. Scanning electron microscopy demonstrated
      the three-dimensional quality of this abnormality, which is subtle when assessed
      by light microscopy alone. We describe this sign so that it might be recognized
      when seen in isolation, as here, and allow the diagnosis of Netherton disease to
      be confirmed.

PMID- 7792229
TI  - Selection for high eight-week body weight in normal and dwarf chickens under high
      protein and high-energy diets.
AB  - A study was conducted to examine genetic parameters associated with selection for
      high 8-wk BW in normal and dwarf Athens Canadian randombreds under two
      nutritional environments (high protein and high energy) and to determine the
      influence of the selection diet on subsequent water to feed ratios and abdominal
      fat levels. High-protein lines (HP) received a diet containing 25% CP and 3,100
      kcal ME/kg, whereas high-energy lines (HE) received a 22% CP diet containing
      3,200 kcal ME/kg. Body weights, selection gains, selection differentials, and
      heritabilities were similar for normal HP and HE lines. There was evidence,
      however, that the realized heritability was greater in the HE than the HP dwarf
      line. Similar selection differentials indicate that this difference was
      apparently due to the expression of greater genetic variation in the HE dwarf
      line. Water intake, feed intake, water to feed ratio, and abdominal fat data for
      the four lines under "selection" and "reciprocal" environments differed between
      experiments. In Experiment 1, when fed the HE diet, normal birds selected under
      the HP environment had higher (P < .05) water to feed ratios and lower abdominal
      fat levels than contemporaries selected under the HE diet. However, these
      differences were not significant in Experiment 2.

PMID- 7792230
TI  - The influence of genetic changes in body weight, egg production, and body
      conformation on organ growth of turkeys.
AB  - Measurements were made on the breast with bone (BWB), a demand organ, and various
      supply organs in mature turkeys (approximately 40 wk of age) from various lines
      of turkeys to determine the influence of selection for increased egg production,
      BW, and body conformation on resource allocation. Comparisons made were: 1) a
      line (E) selected long-term for increased egg production and its randombred
      control (RBC1); 2) a line (F) selected long-term for increased 16-wk BW and its
      control (RBC2); 3) the F line with a commercial sire line (C); and 4) the RBC1
      line and a randombred control (RBC3) that was formed from the F and C lines. Data
      were analyzed on an absolute basis and after adjustment to a common BW by
      covariance analysis. The only major change in organ sizes that occurred that
      could not be accounted for by differences in BW was in the E line. The actual and
      relative weights of total supply organs decreased and the relative weight of the
      BWB increased in the E line when compared with its randombred control. Selection
      for increased BW in the F line did not result in a relative change in BWB. The
      BWB weight was relatively heavier in the C line than in the F line. The relative
      amount of BWB was slightly but significantly different in the two randombreds
      (RBC1 and RBC3) formed 29 yr apart. Weight of the gizzard did not increase at the
      same rate as BW in two large-bodied lines (F and RBC3).

PMID- 7792231
TI  - Influences of age at final beak trim on the productive performance of commercial
      layers.
AB  - Two commercial egg-type strains were beak-trimmed at 10, 10 and 63, or 10 and 84
      d. There were no interactions between strain and beak trimming treatment. Pullet
      feed consumption was significantly reduced within the 14-d period following beak
      trimming at 63 or 84 d. Total pullet feed consumption (1 to 126 d) was
      significantly lower among birds trimmed twice than among those trimmed only at 10
      d. At 126 d, body weight of pullets trimmed at 10 and 84 d or 10 and 63 d was
      significantly less than that of those trimmed only at 10 d. Pullet mortality was
      not significantly influenced by beak trimming treatments. No significant effects
      of beak trimming treatments on layer mortality, egg production, egg weight, egg
      mass, feed conversion, or egg quality were detected. Layer feed consumption was
      significantly greater among birds beak trimmed at 10 d than among those trimmed
      at 10 and 84 d. Most of the effects associated with beak trimming treatments can
      be attributed to the influence that beak trimming had on feed consumption.

PMID- 7792232
TI  - Effects of feeding nivalenol-contaminated diets to male broiler chickens.
AB  - In two feeding trials the effect of nivalenol (NIV) on male broiler chickens was
      studied. A commercial starter diet was provided for ad libitum consumption
      throughout the whole experiment. The NIV was added to the feed when the birds
      were 7 d old. Growth and feed consumption were thereafter registered every 5th d
      during 20 d. In the first trial birds were offered feed containing 0, .5, 2.5, or
      5 ppm NIV. The only variable that significantly differed from the control was the
      concentration of uric acid in plasma, which was increased by 94 and 66%,
      respectively, in treatment groups 2.5 and 5 ppm. In the second trial, NIV
      concentrations of 0, 3, 6, and 12 ppm were used. The weight gain for the 20-d
      period was decreased by 11% with 6 and 12 ppm. During this period these birds
      showed a decrease of about 6% in feed consumption and feed conversion efficiency.
      Gizzard erosions were found in 33% of the birds fed 12 ppm NIV and in 8% of those
      fed 3 or 6 ppm. No such erosions were found in the control birds. Relatively, the
      liver weights in the 12 ppm group were reduced more than total body weights. No
      effects on relative organ weights were found when bursa, spleen, and gizzard were
      compared to control. In the blood, no change compared to control was found in
      hematocrit or in the plasma concentration of glucose, calcium, cholesterol,
      triglycerides, and uric acid, or in the plasma activity of aspartate amino
      transferase, alanine amino transferase, or gamma glutamyl transpeptidase.

PMID- 7792233
TI  - Influence of a hydrated sodium calcium aluminosilicate and virginiamycin on
      aflatoxicosis in broiler chicks.
AB  - Male broiler chicks were fed diets containing 0 or 3.5 mg aflatoxin (AF)/kg from
      1 to 28 d of age. The diets were amended with either .5% hydrated sodium calcium
      aluminosilicate (HSCAS), 16.5 mg virginiamycin (VM)/kg of diet, or .5% HSCAS +
      16.5 mg VM/kg of diet to determine the effects of these compounds during
      aflatoxicosis. When compared with controls (814 g), BW gains were significantly
      lower for broilers fed the AF (731 g) or AF+VM (716 g) diets. No differences were
      found between the BW gains of chicks fed diets without aflatoxin (814 g) and
      those of chicks fed AF+HSCAS (793 g) or AF+HSCAS+VM (803 g), indicating
      approximately 75% protection against decreased BW gain by HSCAS and 87%
      protection by the HSCAS+VM combination. Relative weights of the liver and kidney
      and creatine kinase activity were significantly increased and albumin, total
      protein, cholesterol, uric acid, and inorganic phosphorus concentrations were
      decreased in chicks fed the diet containing AF alone. With the exception of
      albumin, HSCAS was effective in restoring these values to control values. The
      findings of this research suggest that HSCAS and HSCAS+VM can counteract some of
      the toxic effects of AF in growing broiler chicks.

PMID- 7792235
TI  - Observations on disinfection regimens used on Salmonella enteritidis infected
      poultry units.
AB  - Studies carried out at the laboratory and in the field identified many potential
      problems during disinfection of poultry units naturally contaminated with
      Salmonella enteritidis. There appeared to be variations in the efficiency of
      commonly used disinfectants within a disinfectant group when used in a
      contaminated house. It was possible for Salmonella and other coliforms to be
      amplified during the pressure washing or steam cleaning process. If an effective
      terminal disinfectant was not used after this, then high levels of Salmonella
      were likely to persist. The efficiency of the disinfection regimen was not
      directly dependent on the standard of physical cleaning if this was carried out
      to a reasonable standard, as a high level of elimination of Salmonella could be
      achieved even in the presence of substantial quantities of residual organic
      matter. Disinfection regimens involving formaldehyde, either as part of a
      terminal compound disinfectant spray or as a final fogging agent, were found to
      be the most effective in the field.

PMID- 7792234
TI  - Effects of cage population on the productive performance of layers.
AB  - Two commercial layer strains (3,456 hens total) were used to examine the effects
      of bird population on productive performance. Four cage population sizes (6, 8,
      12, and 24 birds per cage) were compared. All cages were 35.7 cm deep and varied
      in width (61.2, 81.6, 122.4, and 244.8 cm). Floor space per bird was 364.1 cm2
      and feeder space per bird was 10.2 cm in each cage configuration. Egg production
      and egg quality were measured from 20 to 72 wk of age. Strain differences were
      detected in hen-day egg production, egg mass, feed consumption, cracked egg
      percentage, Grade A eggs, Grade B eggs, peewee eggs, and large egg yield. There
      were no interactions between strain and cage population size. Cage population had
      no influence on hen-day egg production, mortality, feed conversion, egg size
      (peewee, small, medium, large, extra large), egg mass, lost eggs (by meat or
      blood spots), and percentage Grade B eggs. Percentage Grade A eggs, cracked egg
      percentage, and feed consumption were significantly influenced by cage population
      size. Hens housed at eight birds per cage had a greater percentage of Grade A
      eggs and a lower percentage of cracked eggs than those at other populations. Feed
      consumption was significantly greater for hens housed at 12 and 24 birds per cage
      compared with those at 6 and 8 birds per cage, respectively.

PMID- 7792236
TI  - Polyacrylamide gel electrophoretic patterns of chicken serum in acute
      inflammation induced by intramuscular injection of turpentine.
AB  - To develop a method to detect hidden inflammation using serum protein in
      chickens, changes in serum proteins with acute inflammation were analyzed using a
      turpentine-induced inflammation model. Inflammation in the pectoral muscle of a
      14-wk-old White Leghorn became apparent 3 h after the injection of turpentine and
      became more severe thereafter. Coincident with the development of inflammation,
      changes in serum proteins were analyzed by electrophoresis on polyacrylamide
      gradient gels. The electrophoretic patterns were divided into 21 segments. Two of
      these segments increased remarkably. These were located near the center of the
      electrophoretic pattern and were identified as transferrin due to iron staining,
      correlation of movement against a commercial transferrin sample in SDS-PAGE, and
      immunoblotting. These results suggest that transferrin may serve as a marker for
      inflammation in chicken.

PMID- 7792237
TI  - Response to Salmonella enteritidis infection by the immunocompromised avian host.
AB  - To develop knowledge of the avian immune response and improve the ability of
      chickens to resist infection by Salmonella enteritidis (SE), the role of the
      different components of the immune response against SE infection was examined.
      Birds were given treatments with cyclophosphamide, cyclosporine A, or
      testosterone propionate to induce immunological deficiency, and experiments were
      performed to determine the effects of each on the immune response. Each treatment
      reduced hatch rate, survival rate, and rate of weight gain. As measured by flow
      cytometry, treatments with cyclophosphamide and testosterone propionate decreased
      the percentages of B cells to background levels and increased the percentages of
      CT8 cells significantly above controls. The intestinal shed rate of SE increased
      after treatment with testosterone propionate and cyclophosphamide, but
      dissemination to the spleen of infected birds was not different from controls for
      any treatment. The SE infection was also immunosuppressive as measured by the
      proliferative response to mitogenic stimulation. Maximum lymphocyte proliferation
      occurred 1 wk after infection in response to .5 micrograms concanavalin A per
      10(6) cells. By the 2nd wk, proliferation dropped 10-fold to almost no response.
      Results showed that immunocompetence relied on interdependent functions of
      multiple components of the immune response, i.e., aspects of both humoral and
      cell-mediated immunity.

PMID- 7792238
TI  - Vitamin E in viral inactivated vaccines.
AB  - This research aimed at verifying whether vitamin E added to inactivated and
      emulsified vaccines enhances the immune response to viral antigens in chicken.
      Three hundred and twenty broilers (males and females) and 16 types of vaccines,
      varying in viral antigen [Newcastle disease virus, egg drop syndrome 1976 virus
      (EDS76V), and infectious bursal disease virus] and vitamin E amount (replacing
      10, 20, and 30% of mineral oil) were used. Results show that vaccines with
      vitamin E, especially when it replaces 20 or 30% of mineral oil, induces a more
      rapid and higher antibody response than control vaccines. An adjuvant effect of
      vitamin E was also present in viral vaccine lacking bacterial antigens. Apart
      from vitamin E content, the Newcastle disease virus and infectious bursal disease
      virus monovalent vaccines induced higher titers of specific circulating
      antibodies in birds than did trivalent vaccines.

PMID- 7792239
TI  - Effect of substituting sesame meal for soybean meal on layer and broiler
      performance.
AB  - Sesame meal (SM, 47.1% CP) has an amino acid composition similar to that of
      soybean meal (SBM, 47.7% CP) with the exception of lower lysine and higher
      methionine, but has been relatively underutilized in poultry feeds. Two
      experiments (1 and 2) were conducted to measure laying performance and
      hatchability of White Leghorn hens fed practical diets (17% CP), and two
      additional experiments (3 and 4) examined the performance of broiler chicks fed
      practical diets (22% CP) with varying substitution levels of screw-pressed SM for
      solvent-extracted SBM. In Experiment 1, SM contributed 0, 12.6, 25.3, 38, or
      50.6% of dietary CP, and each diet was fed to hens for 6 wk. In Experiment 2, SM
      contributed 0, 4.7, 9.4, 14.1, 18.8, or 23.6% of dietary CP, and each diet was
      fed for 4 wk. In Experiment 3, SM contributed 0, 15, 30, 45, or 60% of dietary
      CP, and in Experiment 4, SM contributed 0, 38, or 76% of dietary CP; in these
      experiments, diets were fed to broiler chicks for 3 wk. There were no differences
      in egg production, egg weight, egg mass, daily feed intake, or body weight
      measurements among control hens fed SBM and hens fed SM at 12.6% (Experiment 1)
      or 4.7 to 18.8% of dietary CP (Experiment 2). Hens consuming these diets were
      able to satisfy their daily requirements for essential amino acids. Egg quality
      measurements were similar among hens fed the control SBM diet and those fed SM at
      12.6 or 25.3% of dietary CP in Experiment 1, and at 4.7 to 23.6% of dietary CP in
      Experiment 2. All production variables were significantly depressed in hens that
      were fed SM at 38 or 50.6% of dietary CP, but Haugh units increased. In
      Experiment 3, the performance of broiler chicks fed the diet containing SM at 15%
      of dietary CP was not different from that of the control chicks fed the SBM diet,
      and both diets contained essential amino acids at required levels. Feed intake,
      body weight gain, and feed conversion were consistently depressed with increased
      SM substitution at 30, 45, or 60% of dietary CP. In Experiment 4, feed intake was
      not different between the control chicks fed the SBM diet and those fed the diet
      containing SM at 38% of dietary CP. However, body weight gain and feed conversion
      of chicks fed diets containing SM at 38 or 76% of dietary CP were significantly
      lower than those of the control chicks fed the SBM diet.

PMID- 7792240
TI  - Response of broiler breeders to low-protein diets. 1. Adult breeder performance.
AB  - Four hundred female and 50 male commercial strain breeders were reared separately
      from 1 d to 18 wk of age, with all birds receiving the same diet. At 18 wk, all
      pullets were weighed and the extreme weights removed from the group. The
      remaining hens were then randomly sorted into four treatment groups each
      represented by four replicate groups. Treatment involved feeding different levels
      of CP (16, 14, 12, and 10%), supplemented with synthetic lysine and methionine in
      order to maintain constant lysine and TSAA levels, respectively. Diets were
      isoenergetic and all birds received the same quantity of feed daily. Dietary
      protein had no effect on egg production (P > .05). However, breeders fed 10% CP
      were lighter (P < .01) in weight than birds fed 16% CP. Eggs from birds fed 10
      and 12% CP were consistently smaller (P < .01), and this resulted in reduced
      chick weight at hatching. Low-protein diets also resulted in less nitrogen
      excretion. These data suggest that it is possible to reduce the CP intake of
      broiler breeders while maintaining intake of critical amino acids without
      affecting performance.

PMID- 7792241
TI  - Response of broiler breeders to low-protein diets. 2. Offspring performance.
AB  - Broiler breeders were allocated at random to one of four experimental diets
      containing various levels of CP (16, 14, 12, or 10%), at constant
      methionine+cystine and lysine levels of .59 and .82%, respectively. Diets were
      isoenergetic and all birds received the same quantity of feed daily to 64 wk of
      age. Eggs from birds fed 10 and 12% CP were consistently smaller (P < .01) and in
      two trials involving breeders at 30 and 52 wk of age this resulted in reduced
      chick weight at hatching, although no lasting effect was observed on weight of
      offspring at 48 d. Better feed efficiency (P < .05) was observed from broilers
      hatched from hens fed lower CP diets. These data suggest that it is possible to
      reduce the CP intake of broiler breeders while maintaining intake of critical
      amino acids without adversely affecting offspring performance.

PMID- 7792242
TI  - Relative biological availability of manganese from manganese proteinate,
      manganese sulfate, and manganese monoxide in broilers reared at elevated
      temperatures.
AB  - The relative biological availabilities of Mn from Mn proteinate, MnSO4, and MnO
      were compared under two different environmental conditions. Commercial broilers
      were reared in brooder batteries between Days 1 and 21 and fed diets containing
      0, 1,000, 2,000, or 3,000 mg supplemental Mn/kg diet. On Day 22, birds were
      transferred to individual cages in two environmental chambers maintaining the
      same dietary Mn sources and supplemental levels. The temperature in one chamber
      cycled between 18 and 23.9 C (thermoneutral, TN), and in the other chamber cycled
      between 23.9 and 35 C (heat distress, HD). Birds in the HD environment were
      exposed to 8 h of 23.9 C, 4 h of 23.9 to 35 C, 4 h of 35 C, and 8 h of 35 to 23.9
      C. Tibia Mn increased linearly (P < .05) with level of supplementation when
      measured on Days 22 and 47. Based on ratios of slopes from multiple linear
      regression analysis of bone Mn on Mn intake from various sources, the biological
      availabilities of Mn proteinate and MnO relative to MnSO4 (100%) were 120 and
      91%, respectively, in 21-d-old chicks. In 49-d-old birds, corresponding relative
      biological availabilities of Mn from proteinate and oxide were 125 and 83%,
      respectively, in birds reared under TN, and 145 and 82%, respectively, for HD
      birds.

PMID- 7792243
TI  - Changes in pulmonary arterial and femoral arterial blood pressure upon acute
      exposure to hypobaric hypoxia in broiler chickens.
AB  - An experiment was conducted to investigate the pulmonary arterial and femoral
      arterial pressure responses to acute hypobaric hypoxia. Twenty-four, 7-wk-old
      Hubbard x Hubbard male chickens were lightly anesthetized and catheters were
      introduced into the right femoral artery and the pulmonary artery. The birds were
      then placed in a hypobaric chamber, and blood pressure responses were monitored
      during acute (15 min) exposures to simulated altitudes of 2,000 and 4,000 m. The
      pulmonary artery pressure increased .7 and 4% during the first and second
      exposures to a simulated altitude of 2,000 m, whereas the femoral artery pressure
      decreased 6 and 8% during exposures to this altitude. The pulmonary artery
      pressure increased 7% on the first exposure and 23% (P < .05) on the second
      exposure to a simulated altitude of 4,000 m. The femoral arterial pressure
      decreased (P < .05) on both exposures to this altitude (29 and 24%,
      respectively). The initial femoral and pulmonary artery pressures and changes in
      these pressures upon exposure to hypobaric hypoxia were not consistently
      correlated with the characteristics of the electrocardiogram, packed cell volume,
      body weight, or the right:total ventricular weight ratio. These results indicate
      that acute hypobaric hypoxia elicits a hypotensive response in the systemic
      arterial circulation and a hypertensive response in the pulmonary arterial
      circulation of broiler chickens.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792244
TI  - An opiate receptor in the neurohypophysis of laying hens.
AB  - An opiate binding component in the membrane fraction of the neurohypophysis of
      the laying hen showed a high affinity, limited capacity, reversible binding, and
      binding specificity to [3H]diprenorphine. The binding sites were of a single
      class. The equilibrium dissociation constant was .30 +/- .03 nM (mean +/- SEM; n
      = 5) in Scatchard analysis and .31 +/- .02 nM (n = 5) in kinetic analysis. The
      maximum binding capacity determined by Scatchard analysis was 619 +/- 34 fmol/mg
      protein (n = 5). The association and dissociation rate constants determined by
      kinetic analysis were .088 +/- .002 nM-1 min-1 (n = 5) and .027 +/- .001 min-1 (n
      = 5), respectively. The results suggest that the binding component is regarded as
      being an opiate receptor.

PMID- 7792245
TI  - The role of defeathering in the contamination of turkey skin by Salmonella
      species and Listeria monocytogenes.
AB  - This study was undertaken to determine whether the incidence of either Salmonella
      spp. or Listeria monocytogenes on turkeys at three commercial processors could be
      related to the type of defeathering system: 1) conventional, 58 C common bath
      scald; 2) kosher, 7 C common bath scald; or 3) steam-spray, 62 C nonimmersion
      scald. Flocks were sampled before defeathering, after defeathering, and after
      chill at each facility. The incidence of Salmonella-positive turkeys
      significantly increased subsequent to conventional defeathering (10 positive out
      of 14) as compared with before defeathering (3/14). The number of Salmonella
      positive carcasses following kosher (0/14) and steam-spray (2/14) defeathering
      were similar to the number of Salmonella-positive carcasses found prior to
      defeathering (1/14 and 3/14, respectively). The incidence of Salmonella-positive
      carcasses following chill was slightly lower, but not significantly different
      than the number of Salmonella-positive carcasses found immediately following
      defeathering at all processors (8/14, 0/14, 1/14 for conventional, kosher, and
      steam-spray processors, respectively). Although L. monocytogenes was detected on
      turkeys sampled before chilling (2/10, kosher) and after chilling (8/14, kosher;
      1/14, conventional), no L. monocytogenes was detected on turkeys at any of the
      processors prior to the evisceration process. Flocks with high aerobic plate
      counts prior to processing were more likely to contain Salmonella-positive birds
      throughout processing. Aerobic plate counts of all flocks were similar after
      chill whether or not Salmonella spp. and L. monocytogenes were detected.

PMID- 7792246
TI  - Effect of type of defeathering system on Salmonella cross-contamination during
      commercial processing.
AB  - The cross-contamination effects of three commercial defeathering systems were
      compared using turkeys from a single Salmonella-positive flock (< or = 15%
      cloacal-positive). Single or "common" flocks were used to control flock-to-flock
      variability. Thirty birds were mechanically defeathered in each system as the
      first flock of the day and compared with 30 hand-defeathered (control) birds.
      Three trials, each using a different common flock, were completed. In Trial 1,
      the incidence of Salmonella-positive birds decreased following mechanical
      defeathering at all three processors. The incidence of Salmonella-positive
      carcasses in test flocks increased following steam-spray (approximately 100%) and
      kosher (approximately 50%) defeathering in Trials 2 and 3, whereas no increase in
      Salmonella-positive carcasses resulted from conventional defeathering. The
      decrease in the number of Salmonella-positive birds as a result of defeathering
      observed in Trial 1, as compared to increases observed in Trials 2 and 3, may be
      related to the selection of feather-contaminated (Trial 1) vs intestinal
      colonized (Trials 2 and 3) turkeys. Surface temperature of the carcasses and
      length of time required to defeather were monitored within each system. It is
      hypothesized that the increases in the number of Salmonella-positive birds
      following steam-spray and kosher defeathering in Trials 2 and 3 were a result of
      skin surface changes occurring during the defeathering process, which allowed
      increased adherence or entrapment of Salmonella spp. on or within remaining skin
      layers.

PMID- 7792248
TI  - Salmonella contamination in commercial eggs and an egg production facility.
AB  - Egg samples were collected from various stages of an egg processing operation and
      from the attached production facility. Salmonella was isolated from 72.0% of all
      samples collected from the laying house environment. Recovery of Salmonella from
      flush water, ventilation fan, egg belt, and egg collector samples were (positive
      samples/total samples collected): 2/2, 4/4, 16/22, and 14/22, respectively.
      Salmonella was found on 7 of the 90 eggshells sampled before processing and 1 of
      90 eggshells sampled after processing, but Salmonella was not found in the 180
      eggs analyzed for internal contamination following processing. The one eggshell
      found positive for Salmonella following processing was detected when the pH of
      wash water samples was lowest (10.19). The 60 isolates from production facilities
      included the following Salmonella serotypes: S. agona, S. typhimurium, S.
      infantis, S. derby, S. heidelberg, S. california, S. montevideo, S. mbandaka, and
      untypable. The 22 isolates obtained from eggshells prior to processing were
      serotyped as S. heidelberg and S. montevideo. All five isolates obtained from
      eggshells after processing were serotyped as S. heidelberg. These data suggest
      that although the shells of about 1% of commercial eggs are contaminated with
      Salmonella, contamination of the internal contents of eggs with Salmonella is a
      rare event.

PMID- 7792247
TI  - The effects of ultrapasteurization with and without homogenization on the
      chemical, physical, and functional properties of aseptically packaged liquid
      whole egg.
AB  - The effects of ultrapasteurization with and without homogenization on some
      chemical, physical, and functional properties of liquid whole egg were observed.
      Heat treatments of 64, 68, and 72 C each at 30, 60, and 95 s were conducted on
      liquid whole egg, unhomogenized and homogenized [10.34 mPa (1,500 psi)]. The
      viscosity of the egg increased with increased processing temperature, and
      unhomogenized egg was more viscous than homogenized egg. alpha-Amylase was
      inactivated at 68 C for 30 s. Although cake height was highly correlated to
      soluble protein content, this relationship did not hold for all time-temperature
      combinations. Due to homogenization effects on soluble protein results, soluble
      protein is not a reliable predictor of egg functionality when homogenization is
      used in the process. Homogenization had no effect on the population reduction of
      aerobic bacteria in all but three of the nine time-temperature combinations.

PMID- 7792249
TI  - Rudolf Buchheim Conference. Focus on Neuropharmacology. In commemoration of the
      175th birthday of Rudolf Buchheim. Tartu, Estonia, May 21-23, 1995. Abstracts.

PMID- 7792250
TI  - N-CAM and N-cadherin are specifically expressed in xanthophores, but not in the
      other types of pigment cells, melanophores, and iridiphores.
AB  - Little is known about cell-cell communication in pigment cells, whereas a number
      of signalling molecules have been implicated to control their migration,
      differentiation, and proliferation. We set out to investigate the expression of
      cell adhesion molecules (CAMs) in the three different types of pigment cells in
      poikilotherms, Oryzias latipes and Xenopus laevis. In the present experiments,
      the expression of N-CAM and N-cadherin in the pigment cells in vitro was examined
      by immunocytochemistry. Melanophores and xanthophores were isolated and cultured
      from scales or skins, while iridophores were harvested from skins or peritoneum.
      The results showed that N-CAM and N-cadherin were specifically expressed in
      xanthophores, but not in melanophores or iridophores in both O. latipes and X.
      laevis. N-CAM and N-cadherin basically colocalized in the restricted regions of
      xanthophores, although the N-caderin-expressed region was broader than the N-CAM
      expressed region in the same cell. The incidence of N-cadherin expression was
      higher than that of N-CAM expression. N-CAM and N-cadherin were expressed at the
      tip or the base of dendrites, or at the edge between dendrites in dendritic
      xanthophores. N-CAM and N-cadherin usually localized in small and narrow regions
      of xanthophores. This distribution pattern was essentially similar in
      xanthophores with round morphology, which exhibited spot, band, or semicircular
      immunoreactive regions on the peripheral edge of the cells. The difference in the
      distribution of pigment granules within the cells, culture period, fixatives, or
      immunofluorescent markers used in the experiments did not alter the
      immunostaining pattern.

PMID- 7792252
TI  - A transmission electron microscopic (TEM) method for determining structural
      colors reflected by lizard iridophores.
AB  - Iridescent tissue colors are thought to be produced by iridophores through the
      optical phenomenon of thin-layer interference. Land and others have shown that
      structural features, predominantly reflecting platelet width and the cytoplasmic
      spacing between layers of platelets, determine the wavelength of light maximally
      reflected by this mechanism in iridophores. Some researchers have used
      interference microscopy to estimate these structural parameters, but the most
      direct measurement technique should be transmission electron microscopy (TEM).
      Transmission electron microscopy (TEM) has associated processing artifacts
      (particularly cytoplasmic shrinkage) that preclude direct measurement of
      ultrastructure, but if a number of assumptions are made, reflected wavelengths
      can be predicted. A thin-layer interference model and its associated assumptions
      were tested using TEM measurements of iridophores from several brightly colored
      tissues of each of three lizards (Sceloporus jarrovi, S. undulatus
      erythrocheilus, and S. magister). In all the instances examined when the
      contribution of the pigments present were accounted for, tissue color
      corresponded with predicted iridophore reflectances from the model. Finally, if
      the model and its assumptions are assumed to be correct, the amount of iridophore
      cytoplasmic shrinkage as a result of TEM processing can be calculated.

PMID- 7792251
TI  - Keratinocyte extracellular matrix-mediated regulation of normal human melanocyte
      functions.
AB  - Active roles of cell-cell interaction between melanocytes and neighboring
      keratinocytes for the regulation of melanocyte functions in the skin have been
      suggested. We examined substantial regulatory mechanisms of keratinocyte
      extracellular matrix (kECMs) for normal human melanocyte functions without direct
      cell-cell contact. We specially devised kECMs from proliferating or
      differentiating keratinocytes and further treated them with environmental
      stimulus ultraviolet B (UVB) for skin pigmentary system. Normal human melanocytes
      (NHM) were cultured on the various keratinocyte ECMs and initially the effects of
      the kECMs upon melanocyte morphology (dendrite formation and extension), growth,
      melanin production and expressions of pigmentation-associated protein (MEL-5) and
      proliferation-associated protein (proliferating cell nuclear antigen;
      PCNA/cyclin) were studied. Then we compared the effects of these cell-matrix
      interactions with those of direct melanocyte-keratinocyte, cell-cell contact in
      co-culture on melanocyte functions. Melanocytes cultured on any types of the
      kECMs that were tested significantly extended dendrites more than that on plastic
      cell culture dish without kECM (control). Melanocytes cultured on any types of
      the kECMs that were tested significantly extended dendrites more than that on
      plastic cell culture dish without kECM (control). Melanocytes cultured on the
      kECM prepared from UVB irradiated differentiating keratinocytes resulted in 219%
      increase in the number of dendrites. The growth of melanocytes on kECMs was also
      stimulated up to 280% of control. The kECM produced by proliferating
      keratinocytes had a more significant effect on the growth than kECM from
      differentiating keratinocytes. This melanocyte growth stimulating effect was
      decreased with kECM from UVB treated differentiating keratinocytes. The melanin
      content per melanocyte was constant on any of the kECMs.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7792253
TI  - Changes in adrenergic innervation to chromatophores during prolonged background
      adaptation in the medaka, Oryzias latipes.
AB  - The pattern of adrenergic innervation to scale chromatophores of the wild-type
      medaka, Oryzias latipes, was examined by autoradiography with 3H-norepinephrine
      and found for the first time to be changed reversibly during prolonged background
      adaptation. In scales of the medaka, which was adapted to a black background for
      10-15 days, a great number of melanophores and dense networks of varicose fibers
      were observed: many fibers built up a radial plexus around each melanophore.
      However, the dense distribution of varicose fibers disappeared with a decrease in
      the number of melanophores during long-term adaptation to a white background. As
      to the changes in the innervation pattern to amelanotic melanophores of the
      medaka, orange-red variety, a similar result was obtained. Although the increase
      in the number of leucophores was observed in the medaka adapted to a white
      background, no exact plexuses of labeled fibers were confirmed around
      leucophores. From these results, it is concluded that the density of chromatic
      nerve fibers changes in parallel with the variation of the number of melanophores
      during prolonged background adaptation.

PMID- 7792254
TI  - The identification and partial cloning by PCR of the gene for tyrosinase-related
      protein-1 in the Mexican axolotl.
AB  - The tyrosinase gene family is currently composed of three members, tyrosinase and
      two tyrosinase-related proteins, TRP-1 and TRP-2. These three gene products have
      all been found to act in the synthesis of melanin pigments with the enzyme
      tyrosinase catalyzing the initial rate-limiting steps. Thus far these genes have
      primarily been analyzed in higher vertebrates. We have used degenerate PCR
      primers to isolate a large fragment of an axolotl tyrosinase-related protein.
      Sequence analysis of the entire 1,057-bp fragment isolated indicates a high
      degree of similarity to the mouse TRP-1, the product of the brown locus.
      Phylogenetic analysis supports the conclusion that the fragment isolated
      corresponds to the axolotl TRP-1 homolog. This is the first TRP-1 gene to be
      identified in an amphibian species.

PMID- 7792255
TI  - Characterization of vitiligo antigens.
AB  - Patients with vitiligo have circulating antibodies directed in part to pigment
      cell antigens with MWs of approximately 90, 75, and 40-45 kDs. These antigens are
      denominated VIT 90, VIT 75, and VIT 40, respectively. To further characterize
      these "vitiligo" antigens, we examined their relation to antigens defined by a
      panel of 25 monoclonal antibodies (moab) to pigment cell antigens. We found by
      immunoprecipitation and SDS-PAGE analysis of 125I labelled, detergent soluble,
      human melanocyte macromolecules, that 24 (83%) of 29 patients with vitiligo had
      antibodies to one or more vitiligo antigens vs. 2 (7%) of 28 control individuals.
      Seventeen of the 25 moabs did not react with any labelled antigen in the same
      lysate. Of the remaining eight moabs, only four precipitated an antigen that co
      migrated with one of the vitiligo antigens. Moab TA99, HMSA-5, and TMH-1 (all
      directed to the 75 kD tyrosinase-related protein [TRP1]) co-migrated with VIT 75.
      Moab W6/32 (directed to class I HLA antigen) co-migrated with VIT 40.
      Immunodepletion studies with vitiligo antibodies selectively depleted the antigen
      defined by W6/32 but not the antigen defined by TA99 and HMSA-5, indicating that
      VIT 75 was not the 75 kD tyrosinase-related protein. The vitiligo antigens were
      easily labelled by the lactoperoxidase technique but poorly labelled with 35S
      methionine, suggesting they are expressed on the cell surface. These studies
      indicate that VIT 90 and VIT 75 differ from antigens defined by currently
      available moabs to pigment cell antigens. VIT 40 appears to share a cross
      reactive epitope, or be tightly bound to, class I HLA antigen.

PMID- 7792257
TI  - Protein, calcium, and iron content of wild and cultivated species of Echinochloa.
AB  - Two species of Echinochloa millets and their direct wild ancestor species were
      analyzed for proximate composition, and amino acid, calcium, and iron content.
      Additionally, lactate polyacrylamide gel electrophoresis (PAGE) was performed to
      separate and resolve prolamin polypeptide present in the wild and domesticated
      species. The protein, calcium, and iron content of the four species were
      comparable to or greater than in other major cereals. Calcium was higher in each
      of the wild species than their domesticated counterpart. Essential amino acid
      values for the three species analyzed were generally higher than the FAO/WHO
      standards, except for lysine. Densitometric analysis of lactate PAGE gels
      revealed that the domesticated species contained prolamin, polypeptides that were
      either absent or present in smaller amounts in the wild species. The results
      indicate a wide variation in the content of examined nutrients and suggest that
      there is opportunity for improvement in the nutritional value of the Echinochloa
      millets via selective crossbreeding of wild and domesticated species.

PMID- 7792256
TI  - Antimelanoma antibodies in swine with spontaneously regressing melanoma.
AB  - Sinclair swine provide a unique model for studying mechanisms of tumor regression
      because they are born with melanomas that spontaneously regress approximately 10
      weeks after birth. To examine whether an antitumor immune response is present in
      these animals, and, if so, to study its relation to tumor regression, 38 sera
      specimens collected at different times from 13 swine born with melanomas were
      tested for melanoma antibodies by immunoprecipitation and SDS-PAGE analysis of
      125I labelled swine melanoma macromolecules. Antibodies to melanoma were present
      in 13 (100%) of the swine versus 1 of 3 control swine. The antibodies were
      directed to antigens of approximately 45, 68-75, or 100 kDa. These antigens were
      also expressed on human melanomas and normal melanocytes but on only one of five
      unrelated tumors. The incidence and level of these antibodies increased with
      time. Antibodies to the 45, 68-75, and 100 kDa antigens were present in 36%, 55%,
      and 9%, respectively, of sera collected prior to 7 weeks of age, but in 80%,
      100%, and 37% of sera collected between 7 and 20 weeks (P < 0.05). The rise in
      melanoma antibodies usually preceded or appeared together with tumor regression
      and loss of pigmentation. These findings indicate that Sinclair swine with
      melanomas have antibodies to antigens preferentially expressed on pigment cells,
      and support the hypothesis that the regression phenomenon and the vitiligo-like
      skin depigmentation result from immune responses to common antigens shared by
      normal and malignant swine pigment cells.

PMID- 7792258
TI  - Effect of Japanese mint (Mentha arvensis) oil as fumigant on nutritional quality
      of stored sorghum.
AB  - Japanese mint (Mentha arvensis) oil (JMO) can be used effectively as fumigant
      against Sitophilus oryzae in stored sorghum. The effect of JMO at a dose of 166
      microliter/l of space on nutrient composition and protein quality was studied in
      infested and uninfested sorghum grains stored for 3 months. The results revealed
      non significant effect of JMO on gran moisture, total ash, crude fibre, crude
      fat, crude protein and fat acidity in infested and uninfested grains at the end
      of 3 months storage. The JMO treatment had small but significant effect on
      reducing and non-reducing sugars. The values of Protein Efficiency Ratio (PER)
      for uninfested JMO treated grains, infested JMO treated grains and for untreated
      control stored for 3 months were 1.11, 1.07 and 1.09, respectively against
      control casein diet for which it was 2.15.

PMID- 7792259
TI  - Nutritional value and content of antinutritional compounds and toxics in ten wild
      legumes of Yucatan Peninsula.
AB  - The chemical and toxicological composition of ten wild legumes collected in
      Yucatan, Mexico was determined. For each species the whole fruit, (seed and pod),
      were studied as well as the seed and pod separately. A higher protein content was
      found in the seeds of A. lebbeck and P. saman (37.07 and 37.60% respectively). In
      the seeds of L. longystilus, C. yucatanensis and P. keyense a high concentration
      of fat was found, especially in the first with 31.34%. A high quantity of fiber
      was found in the pods. In general, the samples were rich in lysine (especially
      seeds) and scant in sulfur amino acids and tryptophan. All the samples showed
      high concentration of potassium and calcium. Some of them exhibited significant
      concentrations of iron. The pods of P. saman and P. keyense showed a high content
      of lectins. In the seeds of C. yucatanensis and in the pod of P. keyense high
      concentrations of trypsin inhibitors were found 60 and 406.7 TUI/mg sample
      respectively. The presence of saponins, was detected in seven samples, of which
      the seed of P. keyense had the highest concentration. Alkaloids were found only
      in the whole fruit and pod of P. saman and cyanogenic glucosides were present in
      A. pennatula. In general terms, the whole legume showed better digestibility than
      the pods alone.

PMID- 7792260
TI  - Effect of home processing on ascorbic acid and beta-carotene content of spinach
      (Spinacia oleracia) and amaranth (Amaranthus tricolor) leaves.
AB  - The present investigation was conducted to study the concentration of ascorbic
      acid and beta-carotene in spinach and amaranth leaves as affected by various
      domestic processing and cooking methods which included storage of leaves in
      polythene bags or without packing for 24 and 48 hours in refrigerator at 5
      degrees C; at 30 degrees C in polythene bags; drying (sun and oven); blanching
      (5, 10, 15 min); open pan and pressure cooking. Ascorbic acid content of fresh
      leaves was 624.1 to 629.0 mg and beta-carotene content was 35.3 to 53.1 mg/100 g
      dry weight. The percent loss of ascorbic acid ranged from 1.1 to 6.3 and 55.3 to
      65.9 while lower losses (0.0 to 1.3 and 1.5 to 2.1) of beta-carotene were
      observed in leaves stored in refrigerator and at 30 degrees C, respectively. A
      markedly greater reduction in ascorbic acid and beta-carotene was observed in
      dried, blanched and cooked leaves. The study recommended the storage of leaves in
      refrigerator, drying in oven, blanching for shorter time and cooking in pressure
      cooker for better retention of these two vitamins.

PMID- 7792261
TI  - Composition of sulfited potatoes: comparison with fresh and frozen potatoes.
AB  - The content in moisture, fat, protein, carbohydrate, fibre and vitamin C was
      analyzed in three commercial types of potatoes: sulfited (treated with E223),
      frozen potatoes (pre-fried) and fresh potatoes (not processed). The composition
      of sulfited potatoes does not usually appear in food composition tables. Our
      results showed significant differences in the content of carbohydrates and fibre
      between sulfited and fresh potatoes. The content of vitamin C in sulfited
      potatoes, which is similar to that of frozen potatoes, was shown to be
      approximately half of that found in fresh potatoes.

PMID- 7792262
TI  - Nutritional evaluation of the soy-whey milk analog La colina.
AB  - The milk analog La colina is a product which contains mainly whey, soy protein
      isolate and vegetable oil, designed for infants since one year, children,
      adolescents and adults of all ages. The concept behind this product is to offer
      an alternative to milk consumption which during the last decade has decreased
      dramatically in Venezuela mainly due to its high price and low availability.
      Accordingly, the purpose of this study was to evaluate nutritionally this new
      product in order to determine if from a nutritional stand point it could
      represent a valid alternative to milk consumption. The results showed that La
      Colina offers the same amount of protein, energy, vitamin A, calcium, phosphorus
      and potassium as whole milk powder and more sodium, iron and zinc. In addition, a
      rat assay showed that the energy in these two products is equally available and
      even though the proteins in La colina are 3.9% less digestible, their quality
      determined by growth, PER or the nitrogen retained are excellent and identical to
      the quality of the proteins in milk. These results agreed with the theoretical
      chemical score of the proteins of this new product, which indicated that the
      amino acid profile of the mixture can fulfill the amino acid requirements of
      children, adolescents an adults. Both milk and La colina are products with a high
      fat content. The fat in this new product however, is vegetable oil and therefore
      it has a more convenient fatty acid profile than whole milk and about one third
      of its cholesterol. In short, these results showed that La Colina from a
      nutritional point of view is an excellent alternative to milk consumption.

PMID- 7792263
TI  - The effect of Cd2+ on lipid components of sunflower (Helianthus annuus L.) seeds.
AB  - The effect of seven levels of Cd2+ viz. 0, 10, 20, 30, 40, 60 and 80 ppm
      (micrograms/g soil) supplied as cadmium chloride, on lipid components of
      sunflower seeds was studied in a pot experiment. The total and neutral lipids
      decreased while polar lipids (phospho and glycolipids) increased with the
      increasing levels of Cd2+. Oleic acid and linoleic acids were the major fatty
      acids in the total, polar and neutral lipid fractions. Oleic acid generally
      increased while linoleic acid decreased in all the lipid fractions with Cd2+
      levels. The neutral lipid fraction had higher levels of palmitic, palmitoleic,
      stearic and oleic acid as compared to the total and polar lipid fractions. The
      plant dry weight and seed yield decreased whereas cadmium concentration in seeds
      increased consistently with increasing Cd2+ levels.

PMID- 7792264
TI  - Influence of growth conditions on the value of crisphead lettuce. 4. Quality
      changes during storage.
AB  - Crisphead lettuce (Lactuca sativa L. var capitata cvs. Marius and Saladin) were
      grown with a nitrogen supply from 50 to 200 kg N/hectare. Heads were stored for
      one or two weeks at 1 degree C in cold storage or ice bank cooling. Samples were
      taken for measurement of dry matter, sugars, vitamin C and nitrate. The content
      of dry matter, sugars (glucose, fructose) and vitamin C decreased with increasing
      level of nitrogen, and the content of nitrate increased. Except for nitrate the
      contents of the other quality attributes decreased at all nitrogen supply levels
      during storage. No differences were found between the storage systems, and beside
      fructose no significant differences were found between the two cultivars. The
      content of dry matter, vitamin C, and nitrate decreased from the outer to the
      inner head fraction, while the content of sugars increased. Trimming decreased
      the content of dry matter, vitamin C and nitrate and increased the content of
      sugars. To obtain heads from storage with a relatively high content of dry
      matter, sugars and vitamin C, and a relatively low content of nitrate the
      nitrogen supply must be as low as possible. Except for nitrate where no distinct
      results were found in this experiment it must also be recommended to store the
      heads as short time as possible. Possibly the cv. Saladin has some advantage
      quality attributes after storage compared with the cv. Marius.

PMID- 7792265
TI  - Variability in phytic acid content and protein digestibility of grain legumes.
AB  - Several genotypes, number given within parenthesis, of chickpea, pigeonpea, urd
      bean, mung bean and soybean, differing in seed characteristics were analyzed for
      phytic acid, in vitro protein digestibility (IVPD), protein, total phosphorus,
      and seed size. Phytic acid contents and IVPD values differed significantly among
      and within these species. Phytic acid content (mg/g) was the highest in soybean
      (36.4) followed by urd bean (13.7), pigeonpea (12.7), mung bean (12.0) and
      chickpea (9.6). On an average, phytic acid constituted 78.2 percent of the total
      phosphorus content and this percentage figure was the highest in soybean and the
      lowest in mung bean. In vitro protein digestibility (IVPD) of pigeonpea and
      chickpea genotypes varied from 60.4 to 74.4 percent and 65.3 to 79.4 percent,
      respectively. The IVPD values of genotypes of mung bean, urd bean and soybean
      ranged from 67.2 to 72.2 percent, 55.7 to 63.3 percent and 62.7 to 71.6 percent,
      respectively. There was a significant negative correlation between phytic acid
      and IVPD of these genotypes. Phytic acid was significantly and positively
      correlated with protein but the magnitude of correlation was very low in chickpea
      and pigeonpea. Results indicate that the genotypes of pulses with low phytic acid
      content could be identified and used in breeding program to improve their
      nutritive value and utilization.

PMID- 7792266
TI  - Improvement in HC1-extractability of minerals in home made weaning foods.
AB  - Three weaning foods were formulated from locally available cereals and pulses
      such as rice (Oryza sativa), kangini (Setaria italica), sanwak (Echinochloa
      frumentacea), green gram (Vigna radiata) and jaggery. Cereals and pulses were
      mixed in the proportion of 7:3. Nutrient composition of developed weaning foods
      was within range prescribed by Indian Standard Institute and was found to be
      acceptable. Roasting was the processing technique employed in developing weaning
      foods which resulted in significant increase in HC1-extractable minerals, an
      index of their bioavailability to humans. The higher HC1-extractability of the
      minerals may be ascribed to the decreased phytic acid in the processed home made
      weaning foods.

PMID- 7792268
TI  - [Macroscopic and microscopic heart preparation in ischemic heart diseases].
AB  - The quality of the morphological analysis of myocardial and coronary alterations
      depends essentially on the method chosen for the heart dissection. Even if
      previous postmortem coronary angioplasty is not feasible, the best results are
      obtained by transverse sectioning of the ventricles in a bread-loaf fashion
      subsequent to formalin-fixation and serial cross-sectioning of the coronary
      arteries, with decalcification in addition if necessary. The distribution pattern
      of disseminated myocardial necrosis, the longitudinal, circumferential and
      transmural extent of infarction, its age and sequelae and its correlation to the
      coronary supplying areas can be evaluated with better accuracy than by dissecting
      the heart chambers according to the flow of blood. Cross-sectioning of coronary
      arteries with preservation of their luminal shape allows proper examination of
      the degree and extent of luminal narrowing, plaque hemorrhage, parietal and
      occluding thrombi and the effects and complications of angioplastic procedures or
      bypass surgery. Transverse sectioning of the heart is a prerequisite for adequate
      examination following sudden cardiac death and short-term territorial ischemia.
      Full-thickness samples of the ventricular walls, taken systematically with
      respect to coronary narrowing and coronary supplying areas, enable identification
      of early myocardial damage.

PMID- 7792267
TI  - Comparative study of the chemical composition of wild and cultivated beans
      (Phaseolus vulgaris).
AB  - Five wild Phaseolus vulgaris beans were compared with five cultivated Phaseolus
      vulgaris beans in proximate composition, total (true) protein, amino acid
      composition, and toxic and antinutritional factors. The wild beans contained more
      protein (25.5% vs. 21.7%), ash (5.15 vs. 4.15%), crude fiber (7.08% vs. 5.04%)
      compared to cultivated beans while the former contained less fat (0.56 vs. 0.89%)
      and carbohydrates (61.64 vs. 68.05%). Sulfur amino acids were found to be
      limiting in both groups of bean as expected; however, the cultivated beans had a
      higher content of the limiting amino acids. Therefore, the cultivated beans
      showed a better amino acid profile than the wild beans. Toxic factors were not
      found in either type of bean; the determinations included saponins, alkaloids,
      and cyanogenic glycosides. The antinutritional factors investigated were
      hemagglutinins (lectins) and trypsin inhibitors. The wild beans presented a
      higher content of trypsin inhibitors (28 TUI per mg) and lectins (9.6) than the
      cultivated beans did (21 TUI per mg and 7 respectively). From the chemical point
      of view, domestication seems to be positive; however, the better protein
      nutritive quality of the cultivated beans should be further confirmed by
      biological assays.

PMID- 7792269
TI  - [Cytokines and hematopoiesis].
AB  - In hematopoiesis, regulation and differentiation present a very complex
      functional network in which multiple factors of the microenvironment are
      involved. In addition to direct cell-to-cell contacts and the modifying
      influences of the intercellular matrix, soluble mediators play an important role
      in intercellular communication. Cytokines exert their effects by binding with
      specific receptors that transfer their signals to individual cells. A common
      structure shared by subunits of these receptors leads to competitive inhibition
      in binding the cytokines with different affinity. By this mechanism specificity
      is reduced, on the one hand; however, on the other the complexity of interactions
      in the bone marrow is enhanced. A flood of in vitro and in vivo studies have
      established the impact of various cytokines on single hematopoietic cell lineages
      and their application for clinical use. However, there is a lack of knowledge
      concerning the cellular origin of the cytokines. According to the results of our
      studies elements of the erythro- and megakaryopoiesis are the source of cytokines
      like IL-1 alpha, IL-3, IL-6, and GM-CSF.

PMID- 7792270
TI  - [Analysis of inflammatory reaction and epithelial proliferation in corpus mucosa
      of the stomach. A contribution to carcinogenesis].
AB  - To elucidate conflicting evidence concerning the role of Helicobacter pylori (HP)
      in the evolution of gastric carcinoma, a retrospective analysis was performed on
      the corpus mucosa of gastric surgical specimens removed from patients with
      gastric carcinoma (n = 53) and pancreatic carcinoma (n = 45). Prevalence,
      activity and degree of chronic active gastritis (CAG) were investigated.
      Furthermore, proliferative activity was determined by the expression of the Ki67
      antigen in epithelial cells of the neck region and the foveolae using
      immunohistochemistry. CAG and intestinal metaplasia were significantly more
      prevalent in patients with gastric than with pancreatic neoplasms. Degree and
      activity of CAG were higher in the group of patients with gastric carcinomas.
      Numbers of Ki67-positive nuclei were significantly higher in pronounced than in
      mild CAG. Our data are in keeping with the assumption that HP-associated CAG
      contributes to the development of gastric adenocarcinoma. As possible
      pathomechanism, it may be assumed that a conspicuously expressed inflammatory
      reaction triggers epithelial proliferation, with resulting higher vulnerability
      to mutagenic effects.

PMID- 7792271
TI  - [Value of monoclonal antibodies (PC 10, MIB1, p53 and LeuM 1) for assessing the
      prognosis of patients with squamous epithelial carcinoma of the larynx after
      partial laser resection].
AB  - An immunohistochemical analysis with monoclonal antibodies against Ki-67 (MIB 1),
      PCNA (PC10), p53 and Lewis X antigen was performed on 47 squamous carcinomas of
      the larynx after partial laser resection. Ki-67 index and expression of Lewis X
      antigen correlated significantly with both tumor recurrence rate and tumor-free
      interval. A much weaker relationship was found for the expression of
      proliferating cell nuclear antigen (PCNA), and no correlation existed with p53
      expression. In conclusion, examination of Ki-67 and Lewis X antigen is thought to
      provide useful prognostic information concerning laser-resectable squamous
      carcinomas of the larynx.

PMID- 7792272
TI  - [Initial studies of the prevalence of human Herpesvirus 7 (HHV-7) in Mexican
      blood donors].
AB  - Human herpesvirus 7 (HHV-7) has been recently isolated from CD4-positive
      peripheral blood lymphocytes of a healthy person. The present study was performed
      to find the antibody prevalence of this virus in the healthy Mexican population.
      Two hundred blood samples from candidates for blood donation at the General
      Hospital of Mexico were studied with the indirect immunofluorescence test (IFA)
      in HHV-7 infected SupT1 cells. 83.5% were male persons and 16.5% female, the mean
      age for the male group was 28.8 years and for the female group 31.5. The donors
      came from 12 different states in Mexico, predominantly from the city (60.8%), and
      had different occupations. Almost all samples (98.5%) were positive to HHV-7.
      Other studies done revealed 1% positive to brucella, 1% positive to Hepatitis B,
      2% positive to syphilis, hepatitis C and HIV test were negative in the whole
      group studied. There was a high incidence of HHV-7 in the group studied: more
      than 50% of the subject had high titers. This results should be further studied
      determine titers indicative of an active infection and to search for any
      association with illnesses.

PMID- 7792273
TI  - [Apoptosis in Hodgkin's disease].
AB  - Previous studies have concentrated on the proliferative behaviour of the
      neoplastic cell compartment in Hodgkin's disease (HD). The aim of the current
      investigation was to analyse the frequency of programmed cell deaths in Hodgkin
      and Reed-Sternberg (HRS) cells in the different subtypes of HD and to correlate
      this phenomenon with the expression of the bcl-2 oncogene. For this purpose, we
      investigated paraffin-embedded material from 63 cases of HD. Oncogene expression
      was determined by immunohistochemistry with the monoclonal antibody bcl-2-124.
      The detection of apoptotic cells was facilitated by application of the in situ
      end-labelling (ISEL) technique. Our results confirmed that bcl-2 expression is
      low in the lymphocyte-predominant subtype of HD. Apoptotic cells were found in
      all subtypes to a variable extent and were not significantly associated with any
      particular subtype. Interestingly, there was no correlation of bcl-2 expression
      and the presence or absence of apoptotic HRS cells. Hence, other factors must be
      operative in the regulation of programmed cell death in HD. Such mechanisms have
      been described for lymphocytes under various conditions, such as negative
      selection in germinal centres and within the thymus, DNA damage due to
      irradiation, and cellular cytotoxicity.

PMID- 7792274
TI  - [Small cell bronchial carcinoma following chemotherapy. Morphological findings].
AB  - Resection specimens of 14 patients with small cell bronchial carcinoma after
      neoadjuvant chemotherapy were processed histologically and graded according to a
      three-step regression grading system: grade I, no or only slight tumor
      regression; grade II, incomplete tumor regression; grade III, complete tumor
      regression without vital tumor tissue. In five patients with either no vital
      tumor tissue or only small tumor remnants in the resection samples, a typical
      sequence of central fresh tumor necrosis, foam cell rim, vascular granulation
      tissue and peripheral scar formation was seen. This morphological finding may be
      interpreted as a characteristic, but unspecific parameter of good response to
      preoperative chemotherapy. The presence of vital tumor rims surrounding the
      capillary bed with intermingled necrotic foci, however, argues in favor of
      spontaneous tumor regression, which is commonly observed in small cell lung
      cancer.

PMID- 7792275
TI  - [Extraneural metastasis of brain and spinal cord tumors. Report of 2 cases].
AB  - This case report refers to two patients with the rare entity of an extraneural
      metastasizing central nervous system tumor. The first patient presented with
      ipsilateral cervical lymph node metastases 4 years after a diagnostic biopsy and
      2 years after removal of an anaplastic oligodendroglioma, respectively. The
      origin of the metastases was confirmed by immunohistochemistry. The second case
      described was found in a 26-year-old female who had suffered from a spinal cord
      pilocytic astrocytoma in infancy and been treated by surgery and radiotherapy. On
      postmortem examination, transformation to a primitive neuroectodermal tumor was
      found. Morphological and immunohistochemical features of the metastases were
      exactly identical with those of the primary tumors in both cases. The
      pathomechanisms of metastasizing CNS tumors are discussed with reference to the
      reasons why such cases are so rarely observed. The incidence of remote metastases
      and differences depending on tumor type are estimated. No relation to malignancy
      grade can be detected.

PMID- 7792276
TI  - [Bilateral breast carcinoma after recurrent myxoid liposarcoma of the breast].
AB  - The case is presented of a 26-year-old woman with myxoid liposarcoma of the right
      breast who developed a relapse with anaplastic spindle-cell mesenchymal tumor 7
      months after primary therapy. Additionally, 13 months later a bilateral adeno
      carcinoma of differing histological grade occurred in the breasts. To the best of
      our knowledge, no comparable sarcoma-carcinoma sequence in the mammary gland has
      been reported. For this reason this case is discussed, with special emphasis on
      possible causative factors and the relationship to the Li-Fraumeni syndrome.

PMID- 7792277
TI  - Mechanisms of the fetomaternal transfer of Na+ across the dually perfused
      placenta of the rat.
AB  - In order to investigate mechanisms of fetal-maternal (F-M) transfer of Na+,
      clearance of 22Na+ and 51Cr-EDTA was measured simultaneously across the dually
      perfused placenta of the rat. In eight experiments clearance was measured
      successively in the F-M (Kfm) and in the maternal-fetal (M-F; Kmf) directions.
      Clearance of 22Na+ in the two directions was approximately equal (Kmf = 11.6 +/-
      2.0 microliters/min; Kfm = 11.1 +/- 1.7 microliters/min: mean +/- s.d.) while Kfm
      of 51Cr-EDTA (4.4 +/- 0.7 microliters/min) was nearly double Kmf (2.4 +/- 0.8
      microliters/min) for this tracer. Even greater asymmetry in the transfer of 51Cr
      EDTA was found when measured across intact (non-perfused) placenta. It is
      suggested that this asymmetry is caused by volume flow in the F-M direction. In
      other experiments transfer was measured in the F-M direction only. Ouabain (0.1
      mM) on the maternal side and reduced concentration of Na+ (25 mM) on the fetal
      side had no effect on the F-M transfer of the tracers. Reducing the temperature
      of the preparation by 5 degrees C significantly decreased transfer of 22Na+. The
      transfer of 22Na was inversely related to the concentration of K+ on the fetal
      side. These observations suggest that the F-M transfer of Na+ has three
      components: diffusion through paracellular routes; convective flow by filtration
      through wide placental pores, and transcellular transport by a mechanism which is
      uncertain at present.

PMID- 7792278
TI  - Cellular localization of corticotrophin releasing hormone in the human placenta,
      fetal membranes and decidua.
AB  - Corticotrophin releasing hormone (CRH), is produced by the human placenta, fetal
      membranes and decidua and has been detected in maternal and fetal plasma and
      amniotic fluid during human pregnancy. Previous studies of the cellular
      localization of CRH in the placenta and fetal membranes have yielded conflicting
      results. In this study, placentae were obtained from uncomplicated pregnancies
      immediately after elective termination or after normal delivery at term.
      Zamboni's fixed sections of villi and membrane-decidua, were cut at 10 microns by
      cryostat and immunocytochemistry was performed using an anti-rat/human CRH
      antiserum. In first and second trimester placentae, the amount of CRH reaction
      product present was variable. CRH was localized in both the syncytiotrophoblast
      and cytotrophoblast in first and second trimester tissue. In term placentae, CRH
      was identified consistently in the syncytiotrophoblast. In addition, strong CRH
      reaction was localized to the amnion epithelium of the fetal membranes. Positive
      immunoreactivity was also detected in the chorion and decidua although at a lower
      level of intensity. In trophoblast cells and in the amnion epithelium, CRH
      reaction product was contained in distinct granules. The regulation of CRH and
      its physiological role may differ in these diverse cell types. Possible effects
      of CRH include autocrine or paracrine actions within the amnion, chorion and
      decidua while CRH derived from syncytiotrophoblast may have endocrine effects
      through access to the maternal and fetal circulations.

PMID- 7792279
TI  - Maternal plasma and placental immunoreactive corticotrophin-releasing factor
      concentrations in infection-associated term and pre-term delivery.
AB  - The present study aimed to investigate whether microbial invasion of the amniotic
      cavity affects maternal plasma or placental immunoreactive corticotrophin
      releasing factor (ir-CRF) concentrations in pregnant women with pre-term or term
      labour. A cross-sectional study was conducted collecting blood samples in: (1)
      women with pre-term labour and intact membranes (25-36 weeks), with or without
      microbial invasion of the amniotic cavity (subdivided into three groups: 1A, no
      microbial invasion of the amniotic cavity, delivery at term, n = 54; group 1B,
      delivery < 48 h, no microbial invasion of the amniotic cavity, n = 10; group 1C,
      delivery < 48 h, microbial invasion of the amniotic cavity, n = 8); (2) women at
      term, not in labour and without microbial invasion of the amniotic cavity (n =
      15); (3) women in spontaneous active labour at term without (A) (n = 55) or with
      (B) (n = 16) microbial invasion of the amniotic cavity; and (4) healthy women not
      in labour at 25-36 weeks of gestation (n = 25). Specimens of trophoblast tissue
      were collected from pregnant women with pre-term labour (no microbial invasion of
      the amniotic cavity, n = 6; microbial invasion of the amniotic cavity, n = 4) or
      delivering at term (no microbial invasion of the amniotic cavity, n = 8;
      microbial invasion of the amniotic cavity, n = 4). A specific radioimmunoassay on
      acidic extracts of plasma or placental specimens was used.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7792280
TI  - Chronic reduction in fetal blood flow is associated with placental infarction.
AB  - The placenta receives two arterial blood supplies, i.e. one maternal and one
      fetal. It has been suggested that placental infarction should occur only if both
      blood supplies are compromised (Wigglesworth, 1984). This hypothesis has not been
      tested. Haemosiderosis of the trophoblast basement membrane (TBMH) has recently
      been identified as a feature of fetal artery thrombosis and suggested as a marker
      of impaired fetal blood flow which is identifiable in both viable and necrotic
      tissue. We examined 50 placental infarcts for evidence of TBMH, both grossly and
      microscopically. These were compared with four types of control tissue. Eleven
      placentae from cases of prolonged intrauterine death, in which this feature was
      first described, and 35 fetal artery thromboses were used as positive controls
      and 20 placentae from uncomplicated pregnancies were available as negative
      controls. Non-infarcted tissue adjacent to infarcts served as an internal
      negative control. Non-infarcted tissue adjacent to infarcts served as an internal
      negative control. Microscopically, 36 per cent of infarcts showed TBMH in at
      least 5 per cent of villi within the lesion and 60 per cent of infarcts showed at
      least one cluster of villi with the feature. These findings point to a
      disturbance in fetal blood flow intimately associated with but pre-dating the
      placental infarction. These findings represent the first experimental evidence to
      support Wigglesworth's theory and suggest that reduction in fetal blood flow
      prior to thrombosis of maternal vessels contributes to the pathophysiology of
      placental infarction.

PMID- 7792281
TI  - The effects of maternal aerobic exercise on human placental development:
      placental volumetric composition and surface areas.
AB  - The histomorphometry of term placentae from women who exercised regularly
      throughout either the first half or all of pregnancy was compared to that of
      placentae from matched controls to determine if regular exercise during pregnancy
      produced histomorphometric evidence of altered development and transport
      capacity. Conventional stereological techniques were used to estimate placental
      volumetric composition, surface areas, and villous and vascular configurations in
      the three groups. Exercise confined to early pregnancy increased the parenchymal
      component of the placenta, total vascular volume and site-specific capillary
      volume and surface area. Exercise throughout pregnancy increased these and
      multiple other histomorphometric parameters associated with the rate of placental
      perfusion and transfer function. However, significant changes were confined to
      villi > 80 microns in diameter. The localization of both the timing of the
      stimulus and the anatomical sites affected indicates that regular, sustained
      exercise modifies placental development primarily in early and mid-pregnancy. We
      speculate that the lack of significant changes in the structure and configuration
      of the smaller villi indicates that other adaptive mechanisms, such as increased
      rates of placental blood flow, must be well developed by the latter portion of
      the mid-trimester and adequately maintain fetal oxygenation and substrate
      delivery throughout the third trimester.

PMID- 7792282
TI  - Cytokines in the viviparous reproduction of squamate reptiles: interleukin-1
      alpha (IL-1 alpha) and IL-1 beta in placental structures of a skink.
AB  - Placental viviparity is known in many species of squamate reptiles. Among these,
      some scincids have developed an epithelio-chorial chorio-allantoic placenta which
      in the structure of its central ridged zone is similar to those of certain
      therian mammalian species. A broad range of immunoregulatory peptides, cytokines,
      has been identified at the maternofetal interface of several species of mammals,
      either with invasive or non-invasive types of placenta. Thus we began to study
      whether interleukin-1, which is considered to play a crucial role in mammalian
      pregnancy, might also be involved in the viviparity of reptilian species.
      Placentae of Chalcides chalcides L. were processed by immunohistochemistry and
      incubated in a culture medium for different times. A very strong immunoreactivity
      for interleukin-1 alpha (IL-1 alpha) and for interleukin-1 beta (IL-1 beta) was
      present in the chorial epiblast and in uterine epithelial cells, with varying
      degree and localization in different periods of pregnancy. IL-1 beta was also
      released into the medium at different amounts during incubation. In light of the
      mammalian data, our results suggest that the role of cytokines in pregnancy may
      represent a significant event in the evolution of placental viviparity.

PMID- 7792283
TI  - Characterization of the placental barrier to murine enterovirus infection.
AB  - We performed studies to characterize the mechanisms responsible for development
      during gestation of a placental barrier to Theiler's murine encephalomyelitis
      virus (TMEV) in a murine model of gestational enterovirus infection. Electron
      microscopy of placentae infected in early gestation revealed TMEV-induced changes
      in the decidua, giant cell, spongiotrophoblast, and labyrinth layers; in
      contrast, placentae infected in middle and late pregnancy demonstrated
      degenerative changes in the decidua, giant cell, and spongiotrophoblast layers
      but not in the labyrinth. Immunohistochemistry and in situ hybridization of
      placentae infected in early or late gestation demonstrated accumulation of
      monocytes/macrophages in infected, histologically damaged labyrinths, but no
      infiltration of immune cells into infected but histologically normal placental
      regions. Silver staining of placentae from dams inoculated in late gestation with
      inert gold beads the size of TMEV virions revealed beads within the decidua,
      giant cell, and spongiotrophoblast layers, but restriction of beads from
      labyrinths, similar to the usual distribution of TMEV in placentae infected in
      late pregnancy. These experiments suggest that anatomical relationships, and not
      systemic immune response, appear to be a major contributor to the murine
      placental barrier to TMEV.

PMID- 7792284
TI  - [Pilot project for evaluation of lung function reference values].
AB  - Lung function tests were performed in this study on 139 adults (mean age 36
      years), as well as on 91 female persons between 16 and 18 years of age (the
      latter just starting on their professional careers), the lungs being healthy in
      each case in both groups. The findings were compared with the currently accepted
      reference value formulae after Quanjer et al., and Zapletal as well as further
      developed reference value formulae after Brandli et al., Most of the measurement
      data obtained by spirometry for the BGFA group of probands are between the two
      recommended reference values for adults with better coincidence with Brandli's
      predictions (exceptions being MMEF25-75 MEF 50 and MEF 25). In our studies we
      obtained higher values than the reference median values after Quanjer and
      Zapletal for IVC, FVC, FEV1 and PEF by 6-8% and 5-15%, respectively, whereas the
      values for adults differ from the predictions made by Brandli et al. by -4% to
      +5%. The flow data MMEF 75-25, MEF 50 and especially MEF 25 are set at too low
      levels (by 5-23%) by Zapletal's and Brandli's values. Comparatively, the values
      predicted by Quanjer et al. for the above mentioned flow-volume parameters (with
      the exception of MEF 75) are too high by 4% to 12%. There are also considerable
      differences in respect of the reference values for IGV to the tune of +15% in the
      BGFA group compared to Quanjer et al.; in the BAFAM group the values differ from
      those of Zapletal et al. by +17%. RV yields results in the BGFA group which are
      higher by 11% than according to Quanjer's formulae, whereas in the BAFAM group
      they are higher by 15% compared to Zapletal's predictions. In respect of Rt there
      are differences to the predictions by Ruhle and Matthys by +16% (BGFA group) and
      +13% (BAFAM group), respectively. The BAFAM group differs from Zapletal's
      predictions by +11%. Looking at the reference limit values the overall impression
      is confirmed that the predictions after Quanjer et al. and mostly also those by
      Zapletal are too low in respect of the abovementioned lung function parameters
      (in the majority of cases not 5% of the examined probands, as expected, are below
      those levels, but only about 2%). Females, who had been underrepresented in the
      previous healthy proband groups, show larger deviations than males in respect of
      most of the parameters.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7792285
TI  - [Pulmonary manifestations of systemic scleroderma: pathophysiologic and clinical
      significance of the activation of lung fibroblasts].
AB  - Fibrosing alveolitis (FA) is a common and often fatal complication of systemic
      sclerosis (SSC). The purpose of this study was to characterize the fibrotic
      process within the lungs using bronchoalveolar lavage fluid (BALF). We
      investigated 25 healthy controls (CON) and 85 SSC patients. In 61 patients (72%)
      lung function tests, clinical, and radiological findings indicated manifest FA,
      whereas 24 patients (28%) where free of significant lung disease. Of the latter,
      12 had pathologic BAL differential cell counts (= subclinical alveolitis; SUB),
      12 had normal BAL cytology (NOR). BAL samples were analysed for chemoattractant
      activity (CAA) for fibroblasts using Boyden chambers. Procollagen-III-Peptide (P
      III-P) and Laminin fragment P1 (Lam-P1) were measured radioimmunologically. CAA
      (expressed as % of the effect of conditioned medium) was increased in FA and SUB
      (CON: 17.3 +/- 3.2; FA: 40.8 +/- 5.8, p < 0.01 vs. CON; SUB: 58.6 +/- 11.8, p <
      0.01 vs. CON; NOR: 23.7 +/- 6.3; n.s.). Lam-P1 [U/ml ELF] was also elevated in FA
      and SUB patients (CON: 0.90 +/- 0.17; FA: 2.07 +/- 0.48, p < 0.05 vs. CON; SUB:
      2.61 +/- 1.14, p < 0.05 vs. CON; NOR: 1.05 +/- 0.35, n.s. vs. CON). P-III-P [U/ml
      ELF] was elevated in FA patients (CON: 8.3 +/- 1.1; FA: 26.9 +/- 5.5, p < 0.001
      vs. CON) but not in SUB or NOR (SUB: 10.2 +/- 0.7, NOR: 7.9 +/- 2.9; n.s.). There
      was no significant relationship between P-III-P and LAM-P1 values in ELF and
      serum, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792286
TI  - [Lung function in chronic persistent pulmonary embolism].
AB  - Chronic thromboembolic pulmonary hypertension is characterized by widespread
      obstruction of the pulmonary arteries with organized thrombus. Typically, the
      afflicted patients present with complaints of progressive dyspnea and exercise
      intolerance. The typical functional picture of the 22 patients in this series
      revealed normal lung volumes. Only about 10% of the subjects had mild restrictive
      defects. The universal findings were mild to moderate hypoxemia, chronic
      respiratory alkalosis, high pulmonary vascular resistance and low cardiac output.
      Pathophysiological mechanisms responsible for dyspnea in chronic thromboembolic
      pulmonary hypertension are discussed.

PMID- 7792287
TI  - [Primary amyloidosis of the lung].
AB  - We report on a female patient of 66 years of age in whom primary nodular
      amyloidosis of the lung was diagnosed on the basis of a chance radiological
      finding. Based on this case report we discuss the pathophysiology, diagnosis and
      clinical findings of pulmonary amyloidosis.

PMID- 7792288
TI  - Are traditional prognostic criteria useful in pancreatic abscess?
AB  - Pancreatic abscess remains a potentially lethal disease. Efforts to relate
      outcome to the severity of associated pancreatitis or the type of surgical
      drainage employed have yielded conflicting results. This study was designed to
      test the validity of traditional prognostic criteria in the clinical setting of
      pancreatic abscess and to determine whether the technique of surgical drainage
      employed correlated with survival. The records of 40 consecutive patients with
      pancreatic abscess were reviewed. In each case the diagnosis was confirmed by
      operation. Prognostic factors analyzed included number of Ranson criteria,
      etiology, type, and number of microorganisms isolated, extent of abscess, time to
      diagnosis and operation, and technique of surgical drainage. Of the 11 Ranson
      criteria evaluated, only an elevation in blood urea nitrogen > 5 mg/dl correlated
      with decreased survival (p < 0.001). Polymicrobial abscesses (three or more
      organisms) resulted in a higher mortality than abscesses where fewer than three
      organisms were isolated (45.4 vs 13.8%; p < 0.05). Intraperitoneal extension of
      the abscess was associated with an increased mortality rate compared to those
      confined to the retroperitoneum (57.1 vs 15.2%; p < 0.01). In patients requiring
      unplanned reexploration, mortality was significantly increased (42.9 vs 11.5%; p
      < 0.05). The technique of surgical drainage employed (open versus closed) did not
      influence overall mortality (23.5 vs 21.7%; p = NS). Extent of disease at
      operation, polymicrobial abscess, reexploration for persistent or recurrent
      disease, and deterioration in renal function were all predictive of increased
      mortality in cases of pancreatic abscess.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792289
TI  - The course of pain is the same in alcohol- and nonalcohol-induced chronic
      pancreatitis.
AB  - The natural course of pain in chronic pancreatitis was followed up in 318
      patients over 10.6 +/- 8.0 years (median, 9.0 years). By the end of our follow
      up, a significant decline in pain in alcoholics (n = 228) and nonalcoholics (n =
      90) (p < 0.001 and p < 0.03) was marred by the fact that, even after more than 10
      years, 50% of alcoholics and 62% of nonalcoholics still reported pain attacks
      (difference insignificant). Only alcoholics had pain relief with increasing
      exocrine pancreatic insufficiency (p < 0.02), but 54% of alcoholics and 73% of
      nonalcoholics still had pain attacks despite severe, enzyme substitution
      requiring exocrine pancreatic insufficiency. The development of severe endocrine
      pancreatic insufficiency did not significantly influence the course of pain. It
      is concluded that no clinically relevant differences exist in the course of pain
      in alcoholic and nonalcoholic chronic pancreatitis.

PMID- 7792290
TI  - Cyst fluid NB/70K concentration and leukocyte esterase: two new markers for
      differentiating pancreatic serous tumors from pseudocysts.
AB  - Cystic lesions of the pancreas include inflammatory pseudocysts, serous
      cystadenomas, and mucinous tumors, some of which are malignant. Preoperative
      clinical and radiological parameters are unreliable and may result in incorrect
      diagnosis and inappropriate treatment. Cyst fluid analysis for cytology,
      viscosity, carcino-embryonic antigen, CA 72-4, and CA 15-3 will distinguish
      mucinous from nonmucinous lesions and usually help in determining malignancy.
      Currently, there is no reliable method to differentiate inflammatory pseudocysts
      from serous cystadenomas. This distinction is important because the treatment of
      these two lesions is different; pseudocysts are either observed or drained,
      whereas serous tumors are usually resected. The tumor marker NB/70K was measured
      in aspirated cyst fluid from 13 inflammatory pseudocysts and 11 serous
      cystadenomas by a commercial immunoassay. Leukocyte esterase was measured using
      Chemstrip SG urine test strips and amylase and lipase on a routine chemistry
      analyzer. The cyst fluid NB/70K concentration was significantly higher in
      pseudocysts (mean, 555 U/ml; range, 42-1,926 U/ml) than in serous cystadenomas
      (mean, 12 U/ml; range 0-130 U/ml) and this difference was significant (p <
      0.0002). Leukocyte esterase was detected in 7 of 11 pseudocysts but was absent in
      10 of 10 serous tumors (p = 0.002). Amylase and lipase values were generally
      higher in pseudocysts but these markers were unreliable due to marked outliers.
      Cyst fluid NB/70K and leukocyte esterase are promising markers to help
      differentiate pseudocysts from serous tumors on percutaneous aspirates. When
      combined with previously reported cyst fluid parameters (amylase, lipase,
      cytology, and amylase isoenzymes), these two cystic lesions can be reliably
      distinguished.

PMID- 7792291
TI  - Detection of beta cell-specific DNA damage in streptozotocin-treated rats by in
      situ nick translation with immunostaining of alpha cells.
AB  - In situ nick translation with immunostaining of alpha cells could demonstrate the
      specific localization of streptozotocin- (STZ) induced DNA damage in beta cells
      using in vivo materials. The extent of DNA damage was determined through
      autoradiography by counting the number of grains in the nucleus of the alpha,
      beta, and exocrine cells of the rat pancreas. Subsequently, in situ nick
      translation with immunostaining of alpha cells was carried out in a pancreas
      pretreated with STZ. The number of grains observed in the beta cells of the STZ
      treated groups was significantly higher than that in the control group. DNA
      damage of pancreatic beta cells due to STZ could be detected visually using in
      situ nick translation with immunostaining of alpha cells. Moreover, it was also
      possible to compare the DNA damage in the individual cells of the pancreas.

PMID- 7792292
TI  - Supramaximal secretagogue stimulation enhances heat shock protein expression in
      the rat pancreas.
AB  - Heat shock or stress proteins (HSPs) are synthesized by various cell types in
      response to different metabolic insults (e.g., hyperthermia). Although the
      function of HSPs is not fully understood, they are believed to be an evolutionary
      conserved intracellular defense mechanism. In an attempt to characterize the
      autoprotective potential of pancreatic acinar cells, we investigated the
      regulation of HSPs of the 70-kD family and the small HSP ubiquitin in vitro and
      in vivo during supramaximal cerulein stimulation. Infusion of the secretagogue
      cerulein induces a mild edematous form of pancreatitis in vivo and is
      characterized by a marked disturbance of the intracellular transport and
      segregation of enzymes. Synthesis of HSP70 mRNA is upregulated in isolated
      pancreatic lobules by either cerulein (100 nM) or hyperthermia (42 degrees C for
      60 min). In contrast, expression of ubiquitin mRNA was not altered by either
      secretagogue treatment or hyperthermia. This heat shock-like response of
      pancreatic acinar cells could be reproduced in vivo: Pancreatitis was induced in
      male Wistar rats by intravenous infusion of supramaximal doses of cerulein (10
      micrograms/kg/h). Analysis of mRNA expression revealed a significant upregulation
      of HSP70 RNA during supramaximal secretagogue stimulation. mRNA levels encoding
      for ubiquitin remained unchanged. Western blot analysis demonstrated that the
      transcriptional upregulation of HSP70 in vivo was reflected on the protein level.
      This study demonstrates that the marked intracellular disturbance observed in
      secretagogue-induced pancreatitis is associated with enhanced expression and
      synthesis of a major stress protein. Given the autoprotective potential of HSPs,
      this upregulation may indicate a self-defense mechanism of pancreatic acinar
      cells in experimental pancreatitis.

PMID- 7792293
TI  - Comparison of two dose-response techniques to study the pancreatic secretory
      response to intraduodenal tryptophan in the absence and presence of the M1
      receptor antagonist telenzepine.
AB  - To answer the questions if the type of continuous dose-response technique
      influences the pancreatic secretory response to intraduodenal tryptophan and if
      the M1-receptor antagonist telenzepine influences the intestinal absorption of
      tryptophan, we determined, in 12 conscious dogs with chronic gastric and duodenal
      fistulas, pancreatic bicarbonate and protein secretion and tryptophan plasma
      concentrations following intraduodenal tryptophan perfusion using two dose
      response techniques. With an ascending continuous dose-response technique (aDRT),
      tryptophan was perfused in loads ranging from 0.12 to 10.0 mmol h-1, starting
      with the lowest load and tripling it every 45 min. With the descending continuous
      dose-response technique (dDRT), the order of tryptophan loads was reversed, with
      the highest load being given first. All studies were done on a fixed background
      of intravenous secretin (20.5 pmol kg-1 h-1) and repeated in the presence of the
      anticholinergic M1-receptor antagonist telenzepine (243 nmol kg-1 h-1). The
      bicarbonate and protein response as well as tryptophan plasma concentrations to
      the same loads of tryptophan did not differ significantly between the two
      techniques. Using both techniques, telenzepine significantly (p < 0.05) inhibited
      the overall pancreatic protein response by 65% (dDRT) to 81% (aDRT). The overall
      bicarbonate response was only numerically, and not statistically significantly,
      inhibited by telezepine. Tryptophan plasma concentrations after duodenal
      perfusion with tryptophan were neither influenced by the order of tryptophan
      loads nor altered by telenzepine.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792294
TI  - Evidence of heterotrimeric G-protein involvement in regulated exocytosis from
      permeabilized pancreatic acini.
AB  - Constitutive membrane trafficking events are regulated by heterotrimeric G
      proteins (G-proteins) in addition to their regulation by small GTP-binding
      proteins (smgs). Here, we used streptolysin O-permeabilized mouse pancreatic
      acini and compounds that interact with G-proteins, but not smgs, to examine
      whether G-proteins are also involved in regulated pancreatic exocytosis. The wasp
      venom mastoparan (10 microM) inhibited by 25-50% amylase release from
      permeabilized acini stimulated by various combinations of Ca2+, cyclic AMP
      (cAMP), 12-O-tetradecanoylphorbol 13-acetate, and guanosine (5'-[gamma
      thio]triphosphate (GTP gamma S), while the inactive analogue Mas17 was without
      effect. Pretreatment of intact acini with pertussis toxin resulted in an
      approximately 30% reduction of amylase secretion from cells subsequently
      permeabilized and stimulated with calcium and GTP gamma S. Pretreatment of intact
      acini with cholera toxin increased stimulated amylase release by 30% from
      subsequently permeabilized cells, and this effect was mimicked by 8-Br-cAMP. The
      cAMP-dependent protein kinase inhibitor H-89 (3 microM) largely reversed the
      effect of cholera toxin, indicating that cholera toxin's effect is due to
      increased cellular cAMP levels. The inhibitory effects of mastoparan and
      pertussis toxin suggest that a Gi/Go-type G-protein(s) is (are) involved in the
      regulation of exocytosis. Since mastoparan inhibited exocytosis stimulated by all
      intracellular mediators tested, it indicates that the G-protein acts at a distal
      step in the exocytic process.

PMID- 7792296
TI  - Evidence for the role of pancreatic acinar cells in the production of ornithine
      and guanidinoacetic acid by L-arginine:glycine amidinotransferase.
AB  - L-Arginine:glycine amidinotransferase (transamidinase) occurs at high
      concentrations in the kidney and the pancreas of rats. The cellular localization
      of transamidinase was investigated in fetal, neonatal, and adult rat pancreatic
      tissue using three indicators of the presence of transamidinase: (1)
      immunofluorescence microscopy, (2) in vitro enzymatic activity measurements on
      homogenates of whole pancreas and on isolated acinar and islet tissue from adult
      rats, and (3) ornithine production from perfused adult rat pancreas. The cellular
      localization of transamidinase was determined in fetal, neonatal, and adult rat
      pancreas, using a polyclonal guinea pig antibody made against a highly purified
      preparation of kidney transamidinase. Immunoreactive transamidinase was detected
      only in the pancreatic acinar cells. The cellular distribution of the
      immunostaining was compatible with the presence of transamidinase in
      mitochondria. The transamidinase enzymatic activity of whole pancreatic
      homogenates was 13.4 +/- 0.7 U/g wet weight (n = 11). In pancreata where islets
      had been isolated away from the acinar tissue, the transamidinase activity was
      similar to that of the whole pancreatic homogenates (16.8 +/- 2 U/g wet weight).
      Any transamidinase activity present in isolated islets was below the sensitivity
      of the assay. Transamidinase activity in the isolated perfused pancreas was
      determined by measuring the amount of ornithine released into the perfusate. The
      transamidinase activity of the perfused pancreas was 16.4 +/- 1.8 U/g pancreas
      and is an estimate of the physiological production capacity of the enzyme (270 +/
      29 nmol ornithine/min/g pancreas). These results indicate that transamidinase is
      present at high concentrations in the pancreas.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792297
TI  - Somatostatin inhibits cholecystokinin-induced pancreatic protein secretion via
      cholinergic pathways.
AB  - Although somatostatin is a potent inhibitor of pancreatic exocrine secretion in
      vivo, its mechanism of action remains unclear. The influence of extrapancreatic
      nerves and intrapancreatic cholinergic activity on somatostatin-induced
      inhibition of pancreatic exocrine secretion was studied in conscious dogs.
      Chronic pancreatic fistulae were created in six mongrel dogs, and a second group
      of six dogs also underwent complete pancreatic denervation. The pancreatic
      responses to graded doses of cholecystokinin (12.5-200 ng/kg/h) and bethanechol
      (57-916 micrograms/kg/h), both alone and during background infusion of
      somatostatin-14 (800 pm/kg/h), were determined in all dogs. The cholecystokinin
      dose-response with a somatostatin-14 background was then repeated with the
      addition of atropine (10 micrograms/kg/h). In both groups of animals,
      cholecystokinin elicited a dose-dependent increase in pancreatic protein
      secretion that was inhibited significantly by somatostatin-14. Regardless of the
      status of extrapancreatic nerves, atropine further inhibited cholecystokinin
      induced protein secretion beyond that evoked by somatostatin-14. In both
      innervated and denervated animals, cholinergic stimulation with bethanechol
      elicited a dose-dependent increase in pancreatic protein secretion that was
      unaffected by somatostatin-14. We conclude that extrapancreatic nerves do not
      mediate the inhibitory effects of somatostatin-14. Somatostatin-14 appears to
      inhibit cholecystokinin-induced pancreatic secretion by an intrapancreatic
      cholinergic mechanism.

PMID- 7792295
TI  - Dynamics of pancreatic tyrosine kinase and phospholipase D activities in the
      course of cerulein-induced acute pancreatitis and during regeneration.
AB  - Acute pancreatitis can be induced in the rat by high doses of cerulein, a
      cholecystokinin analogue. Regeneration of the pancreatic gland after this
      aggression can be accelerated by endogenous or exogenous cholecystokinin.
      However, the biochemical and molecular events associated with the cholecystokinin
      induced regeneration process have not yet been identified. This study was
      therefore undertaken to determine the potential involvement of particulate and
      crude cytosolic tyrosine kinases as well as phospholipase D (PLD) in the course
      of pancreatitis induction and during regeneration. Acute pancreatitis was induced
      by cerulein, 12 micrograms kg-1, every 8 h for 2 days; this treatment was
      followed by 3 days of rest, and the regeneration treatment was started on the
      morning of the sixth day, with cerulein given at 1 microgram kg-1 every 8 h for 1
      4 days. Animals were sacrificed 1, 3, 6, 12, 24, and 48 h after the first
      cerulein injection (high dose), on the morning of the sixth day (end of the rest
      period), and on the morning of the seventh and tenth days (low dose, regeneration
      period). After sacrifice, pancreata were excised and prepared for tyrosine kinase
      and PLD assays. Parallel increases in tyrosine kinase and PLD activities were
      observed from 6 to 48 h during pancreatitis induction and at the end of the
      resting period. Activities returned to control values during the regeneration
      period in the untreated cerulein-pancreatitis groups.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7792298
TI  - Pancreatic exocrine secretion in response to median raphe stimulation in
      anesthetized rats.
AB  - To investigate a possible role of the central serotonergic system in the central
      control of pancreatic exocrine secretion, the median raphe nucleus of the
      anesthetized rat was electrically stimulated. The parameters of the biphasic
      square wave stimulus were 2 V, 2 ms, and 40 Hz. Electrical stimulation of the
      median raphe nucleus for 10 min resulted in large increases in pancreatic volume
      flow and protein output. The pancreatic responses were completely abolished by
      spinal cord transection at the level between C4 and C5. Cervical vagotomy or
      adrenalectomy failed to attenuate the pancreatic responses. The median raphe
      stimulation evoked a remarkable elevation of the blood pressure of the carotid
      artery as well as the plasma concentrations of noradrenaline and adrenaline. The
      responses were also completely inhibited by spinal cord transection but
      unaffected by cervical vagotomy. Adrenalectomy blocked the elevation of the
      plasma concentration of adrenaline only. Noradrenaline, given intravenously,
      stimulated the pancreatic volume flow and protein output. The actions of
      noradrenaline were antagonized by propranolol but not by phentolamine. It is,
      therefore, concluded from the present study that the median raphe nucleus may
      play a stimulatory role in pancreatic exocrine secretion of anesthetized rats and
      that the stimulatory role is mediated via the sympathetic nervous system acting
      on beta-adrenoceptors.

PMID- 7792299
TI  - Painless acute pancreatitis mimicking pancreatic carcinoma.
AB  - Painful acute pancreatitis masking pancreatic carcinoma and painless acute
      pancreatitis with shock or coma as leading symptoms have been described before.
      We report a first case of almost-painless pancreatitis mimicking pancreatic
      carcinoma with spontaneous normalization of symptoms and biochemical as well as
      imaging procedure findings.

PMID- 7792300
TI  - Very late recurrence of a somatostatin cell tumor of the head of the pancreas.

PMID- 7792301
TI  - Chronic sclerosing pancreatitis in Sjogren's syndrome: a case report.

PMID- 7792303
TI  - Pharmacokinetic drug interactions. Part 2: Drugs D-O.

PMID- 7792304
TI  - Chitosan microspheres of diclofenac sodium, II: In vitro and in vivo evaluation.
AB  - A biodegradable diclofenac sodium (DS) microsphere system using chitosan has been
      characterized and evaluated in vitro and in vivo. The particle size distribution
      and drug content was determined. The release rate data were investigated by using
      zero-order, first-order, Hixson-Crowel and Higuchi kinetics. The optimum DS
      Chitosan microsphere formulation, empty chitosan microspheres, sustained release
      commercial product and plain drug were evaluated for pharmacological activity.
      The ulcerogenic index in rabbits was also determined.

PMID- 7792305
TI  - Abietane diterpenes from Lepechinia urbaniana.
AB  - Lepechinia urbaniana was investigated with respect to abietane diterpenes. In
      addition to four widespread diterpenes, two rare compounds were isolated and
      characterized.

PMID- 7792306
TI  - [One hundred years of biotechnology in the chemical industry in the example of E.
      Merck, Darmstadt].
AB  - The purposeful use of microorganisms as producers of pure substances began about
      one hundred years ago with the production of lactic acid, followed by citric acid
      and by sorbose for the synthesis of vitamin C. The growth of pure cultures of
      microorganisms in a technical scale became available nearly fifty years ago by
      the development of the fermenter. By this it became possible to produce
      penicillin and other antibiotics, to transform substances in steroid syntheses
      and to get many enzymes, alkaloids, and other substances from microorganisms. The
      development of some of the older processes as basis of actual use of
      biotechnology at E. Merck is described, followed by some facts of the early
      situation in Germany and some remarks on the inclusions of biotechnology within
      the chemical industry.

PMID- 7792302
TI  - Response to Kloppel and Maillet.

PMID- 7792307
TI  - Synthesis of 1-[2-(4-phenylpiperazinyl-1)ethyl]imidazolidine derivatives and
      their pharmacological activity.

PMID- 7792308
TI  - Determination of heavy metals in samples of plant drugs by differential pulse
      polarography.

PMID- 7792309
TI  - Antiestrogenic properties of raloxifene.
AB  - This 21-day, open-label study evaluated the effects of raloxifene and tamoxifen
      on estrogen-induced changes in serum levels of anterior pituitary hormones
      (prolactin, luteinizing hormone, and follicle-stimulating hormone), sex steroids
      (testosterone, estradiol), and binding globulins [thyroid binding globulin (T3
      resin uptake), transcortin, sex steroid binding globulin]. Seventeen healthy male
      volunteers completed the study after being randomized to one of three treatments:
      raloxifene, tamoxifen, or placebo. Six subjects received raloxifene (200 mg
      daily) for 10 days, 6 subjects received tamoxifen [20 mg twice a day (b.i.d.)]
      for 10 days, and 5 subjects received placebo for 10 days. All subjects received
      ethinyl estradiol (20 micrograms b.i.d.) for 7 days starting 3 days after
      initiation of study drug or placebo treatment. Results of the primary analysis of
      this study indicate that for six of the seven analyzable parameters of estrogen
      action (excluding luteinizing hormone) raloxifene blunted the estrogen response;
      this effect was significant only for T3 resin uptake. Tamoxifen administration
      significantly blunted or reversed the estrogen effect in all six of these
      parameters. Raloxifene, an effective antiestrogen in animal models, is also
      antiestrogenic in humans.

PMID- 7792310
TI  - Quantitative analysis of the electrocorticogram after forebrain ischemia in the
      rat.
AB  - The purpose of the study was to test the hypothesis that the postischemic
      neuronal damage is accompanied by changes of the electrocorticogram (ECoG) of
      freely moving rats during long-term recovery after forebrain ischemia. Ten
      minutes forebrain ischemia was induced in male Wistar rats. ECoG was recorded 1
      day before as well as 1 h, 1 day and 7 days after ischemia. The ECoG power was
      calculated and for characterizing postischemic ECoG development the percentage of
      preischemic ECoG power was evaluated. The awake state of the rats was considered
      for analysis only. Furthermore, the neuroprotective effect of phencyclidine (PCP,
      5 mg/kg i.v., 15 min prior to ischemia) was demonstrated in the ECoG changes. One
      hour after ischemia the ECoG power of the theta (4.75-6.75 Hz), alpha (7.00-12.50
      Hz) and beta (12.75-18.50 Hz) band was decreased compared with sham-operated
      controls and PCP did not influence these changes. However, 1 day after ischemia
      ECoG power of the saline-treated ischemic rats was completely restored and no
      longer different from that of the sham-operated group. PCP-treated ischemic
      animals showed significantly elevated ECoG power in comparison with saline
      treated animals. Seven days after ischemia ECoG power of the saline-treated
      ischemic rats again decreased. In comparison with the ischemic controls, the ECoG
      activity of the PCP-treated ischemic rats was significantly higher. PCP
      maintained postischemic ECoG power at the non-ischemic control level. It is
      suggested that the decrease in the ECoG activity several days after ischemia is
      related to the delayed neuronal damage.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792311
TI  - Age-related changes in vascular reactivity in genetically diabetic rats.
AB  - A long-term study to identify age-dependent alterations in vascular reactivity in
      obese Zucker rats, a model for non-insulin-dependent diabetes mellitus, was
      carried out. On aortic rings of 12-week-old obese Zucker rats, but not in older
      animals (36 and 52 weeks), the following different effects in comparison to the
      lean rat control group were observed: (i) a significantly enhanced maximal
      relaxation to acetylcholine and A23187, which was abolished by the nitric oxide
      synthase inhibitor L-nitro-arginine methyl ester (L-NAME); relaxation of aortic
      rings to the endothelium-independent vasodilator nitroglycerin was similar; (ii)
      more pronounced maximal 5-hydroxytryptamine-induced-contractions in the presence
      of L-NAME, and (iii) a more pronounced reduction in phenylephrine-induced
      contractions by verapamil. These results are suggestive of an altered calcium
      metabolism in the first weeks of development in the obese rat strain, which is
      probably responsible for the hypotension seen in this early time period.

PMID- 7792313
TI  - Different pharmacological actions of adenosine on gastric function and mucosal
      damage in normotensive and spontaneously hypertensive rats.
AB  - It has been reported that there are functional defects in the purinergic system
      in spontaneously hypertensive rats (SHR). The following experiments examined the
      gastric effects of adenosine in these animals. SHR had a significantly higher
      gastric mucosal blood flow (GMBF), but the secretion of acid and pepsin was not
      different from that of normotensive counterparts. In SHR, adenosine (s.c. 3.75 or
      7.5 mg/kg) time- and dose-dependently decreased gastric acid secretion and GMBF.
      The nucleoside, however, did not affect the pepsin secretion. In normotensive
      rats, gastric acid secretion was also reduced, but not to the extent of SHR. The
      GMBF was increased instead. Adenosine potentiated ethanol-induced mucosal damage
      in SHR, which was likely caused by GMBF reduction. It is concluded that adenosine
      produces a greater depressive action on the stomach in SHR. These differential
      actions are probably due to the genetic difference between the two types of
      animals.

PMID- 7792312
TI  - Activation of protein kinase C inhibits potassium currents in cultured
      endothelial cells.
AB  - The effect of protein kinase C on potassium channels in cultured endothelial
      cells was investigated by using whole-cell patch-clamp techniques. Activation of
      protein kinase C by phorbol 12-myristate 13-acetate (PMA) and phorbol 12,13
      dibutyrate (PDBu), but not phorbol 12-monomyristate (PMM), an inactive analogue
      of phorbol esters, depressed an outward calcium-dependent potassium current. The
      inhibitory actions of PMA and PDBu could be reversed by the kinase inhibitor H-7.
      Cyclopiazonic acid, an inhibitor of the sarcoplasmic reticulum calcium pump, and
      LP-805, a novel vasodilator which also releases endothelium-derived relaxing
      factors, activated the outward calcium-dependent potassium conductance. PMA and
      PDBu, but not PMM, reduced the outward conductance induced by cyclopiazonic acid
      and LP-805. These effects of PMA and PDBu on potassium currents may be mediated
      either by phosphorylation of ion channels, or by decreasing intracellular calcium
      concentration.

PMID- 7792314
TI  - Effect of zinc on the anti-inflammatory and ulcerogenic activities of indometacin
      and diclofenac.
AB  - In the present study, the potential anti-inflammatory activity of zinc sulfate
      (zinc) has been examined in rats with acute and chronic inflammation.
      Additionally, we studied the effect of the concurrent administration of zinc on
      the anti-inflammatory activity of indometacin and diclofenac and their gastric
      side effects. Oral or subcutaneous administration of zinc (25 and 15 mg/kg,
      respectively) significantly reduced carrageenan-induced paw edema. Subcutaneous
      co-administration of zinc (15 mg/kg) and indometacin (5 mg/kg) or diclofenac (10
      mg/kg) resulted in a further reduction in paw edema which was more than either
      that produced by either agent alone. However, after oral co-administration of
      zinc and diclofenac the reduction in paw edema was not significantly different
      from that produced by either zinc or diclofenac alone. In rats with chronic
      inflammation, the administration of zinc (5 mg/kg s.c. for 7 days) proved as
      effective as either indometacin (3 mg/kg) or diclofenac (5 mg/kg). Co
      administration of zinc with indometacin or diclofenac did not affect the level of
      activity of either drug. Co-administration of zinc did not affect the ulcerogenic
      effect of indometacin expressed as the ulcer index. In contrast to indometacin,
      administration of zinc markedly reduced the ulcerative action of diclofenac. In
      conclusion, zinc supplementation may contribute significantly to the treatment of
      inflammation. The combination of zinc with other anti-inflammatory drugs may
      provide beneficial additive effects and reduce their gastric hazards,
      particularly with diclofenac.

PMID- 7792315
TI  - Tissue angiotensin generation and regulation of vascular tone.
AB  - The renin-angiotensin system is intimately involved in the control of sodium and
      water balance, the activity of the sympathetic nervous system, mitogenesis and
      the regulation of vascular tone. There is evidence that many of these effects may
      be controlled at a local level by independent tissue renin-angiotensin systems.
      Drugs that are specific inhibitors of the cascade have proved powerful tools for
      dissecting the physiology of the renin-angiotensin system, and are of major
      benefit in the treatment of hypertension and chronic heart failure. Recent
      evidence suggests that variations in the genes coding for components of the
      system may affect the risk of developing hypertension and ischaemic heart
      disease.

PMID- 7792316
TI  - Control of vascular resistance in the maternal and feto-placental arterial beds.
AB  - This review aims to provide a comprehensive summary of the mechanisms involved in
      the physiological adaptation of the vasculature to pregnancy. Profound changes
      occur both systemically and in discrete circulations in the mother, but it is
      debatable which factors are responsible. Similarly, whilst the feto-placental
      circulation must be substantially controlled by humoral mechanisms, the exact
      role of each potential contributor is not known. In view of the hitherto
      unappreciated and very important role of the endothelium-derived vasodilator,
      nitric oxide, in the control of peripheral vascular resistance, considerable
      emphasis will be placed on the many recent investigations in this area.

PMID- 7792317
TI  - The circadian system and the therapeutics of the affective disorders.
AB  - Establishing that a circadian rhythm is abnormal tells us little about the cause,
      which can arise from changes in the patient's lifestyle, irregularities of the
      body clock or a malfunction in the process of entrainment of the clock. In a
      clinical context, such a range of possible explanations implies differences in
      the most appropriate mode of treatment. Against this background, the conventional
      view that the underlying abnormality in endogenous depression is due to a
      disorder of the body clock is challenged. The challenge is based on difficulties
      of interpretation of the clinical data and the results of studies on circadian
      rhythms in patients. It is suggested that the state of the circadian system in
      depression resembles its state in healthy individuals after time-zone transitions
      or in shift work maladaptation syndrome and that this disturbance should be seen
      as resulting from changes in the phasing of external zeitgebers rather than from
      an abnormality in the clock itself.

PMID- 7792318
TI  - Interferons alpha, beta and gamma therapy of anogenital human papillomavirus
      infections.
AB  - Anogenital condyloma acuminatum (genital warts) is the most commonly diagnosed
      sexually transmitted viral disease in the United States. At least 14 of the more
      than 60 types of human papillomaviruses (HPVs) are responsible for condyloma
      acuminatum. Anogenital condyloma acuminatum has a broad spectrum of
      manifestations in men and women, including subclinical latent infection,
      clinically apparent warts, abnormal genital cytology and squamous carcinoma.
      Traditional therapeutic modalities include cytolytic chemical agents and ablative
      techniques. These anti-wart methods are used in an attempt to eliminate
      clinically apparent disease. However, they are associated with high rates of
      recurrence because they do not eradicate the subclinical or latent reservoir of
      HPV remaining in adjacent epithelial cells and mucous membranes. Immunologic
      therapy with interferons (IFNs) represents a promising new antiviral modality
      that can be directed against all sites of infection, including clinical,
      subclinical and latent disease. IFN-alpha, IFN-beta and IFN-gamma are the three
      major groups of IFNs. These three groups of IFNs have been used successfully as
      monotherapy or in combination with traditional modalities to treat anogenital
      condyloma acuminatum. This review focuses on IFN-alpha, IFN-beta and IFN-gamma
      therapy of anogenital HPV infections.

PMID- 7792319
TI  - Families and schizophrenia redux.

PMID- 7792320
TI  - Linguistic reference performance in parents of schizophrenic patients.
AB  - Clinicians have often reported observing subtle signs of thought disorder or
      communication difficulties in parents of schizophrenic patients. Ascertaining
      empirically whether these impressions are valid and, if so, clarifying the nature
      of such disturbances is important for at least two reasons. First, it could
      assist in elucidating the etiologies of the illness. If distinguishing parental
      characteristics could be clearly defined, then further research could be
      undertaken to determine to what extent they represent genetic vulnerability
      markers, pathogenic environmental influences, or behavioral responses to having a
      disordered offspring. Secondly, it could facilitate our understanding of the
      cognitive processes involved in schizophrenia or in the constitutional
      vulnerability to schizophrenia.

PMID- 7792321
TI  - Fusion in the parent relationship of schizophrenics.
AB  - Parents of schizophrenics have increasingly been included in the treatment of
      their offspring, either in psychoeducational oriented approaches (Anderson et al.
      1980) or in regular family therapy (Hoffman 1981). However, the success of such
      interventions may depend on the nature of the parental relationship. Furthermore,
      in designing treatment programs for schizophrenics that include their parents,
      the particularities of the parental relationship need to be taken into account.
      Hence, descriptions of the relationship between parents of schizophrenics should
      be valuable for the clinician. Providing such descriptions is the general aim of
      the present study.

PMID- 7792322
TI  - Beyond the biopsychosocial model: integrating disorder, health, and recovery.

PMID- 7792323
TI  - DSM-III-R Axis IV: clinician reliability and comparability to patients' reports
      of stressor severity.
AB  - Stress has long been considered an important precipitant to the development or
      exacerbation of psychopathology (Selye 1980). However, it has been difficult to
      reach agreement on how to measure stressors reliably, and whether stressors
      should be assessed using an objective clinical rating or a subjective appraisal
      (Mazure and Druss 1995). When the DSM-III multiaxial diagnostic system was
      derived, Axis IV was designed to provide a mechanism for objectively rating the
      severity of psychosocial stressors that contributed to the development or
      exacerbation of psychiatric disorders (Williams 1985). With the continued use of
      this nosological system, DSM-III-R Axis IV has become the most commonly used
      assessment of stressors in clinical settings today. The current work focuses on
      whether DSM-III-R Axis IV can be used reliably by clinicians generating objective
      ratings, and on whether these objective ratings reflect patients' appraisals of
      the severity of their psychosocial stressors. Based on this work, options for
      future use of Axis IV are discussed.

PMID- 7792324
TI  - Longitudinal analysis of communication deviance in the families of schizophrenic
      patients.
AB  - Considerable research on the family's contribution to the psychopathology and
      coping of mentally ill offspring has focused on disturbed parental communication
      patterns, in which parents are unable to share a common focus of attention and
      meaning with their children. This style of communication has been referred to as
      communication deviance (CD - Wynne and Singer 1963). Specifically, CD refers to
      instances in which speakers leave ideas incomplete, use language in an odd
      manner, use unclear referents, contradict previously made statements with little
      explanation, or make unintelligible or tangential statements.

PMID- 7792325
TI  - Nonverbal perceptual organization output disability and schizophrenia spectrum
      symptomatology.
AB  - Patients with neurodevelopmental syndromes often receive numerous psychiatric
      diagnoses before the true nature of their disorder becomes apparent. We present a
      case in which the neuropsychological evaluation played a significant role in
      reconceptualizing a patient who had received, at various times, diagnoses of
      schizotypal personality disorder, schizoaffective disorder, and schizophrenia.
      The identification of specific cognitive deficits in executive functioning,
      perceptual organization, visual-spatial problem solving, and abstraction led to:
      1) a diagnosis of nonverbal perceptual-organization-output disabled; 2) the
      adoption of a rehabilitative treatment model; and 3) a greater understanding of
      the way in which the patient's social deficits represented adaptations to her
      cognitive impairments. Research data and theoretical models relating cognitive
      deficits to psychiatric symptoms are discussed, and evidence is presented that
      schizophrenia and certain neurodevelopmental syndromes may share commonalities of
      pathophysiology. Diagnostic issues arising from similarities between these
      disorders are discussed. It is suggested that direct comparisons between these
      groups can aid in clarifying the specific nature of cognitive deficit-symptom
      relationships, as well as leading to improvements in the understanding, diagnosis
      and treatment of schizophrenic and neurodevelopmental syndromes.

PMID- 7792326
TI  - Implications of mind-body theory for integration in psychiatry.
AB  - Recently, several authors have called for an integration of philosophy,
      psychology, and neuroscience regarding the mind-brain problem (Brothers 1989;
      Cooper 1985; Hundert 1989). In this essay I review two philosophical theories of
      mind that lead to very different conclusions regarding integration. Reductionist
      materialism is the theory that currently has the widest acceptance. Unity theory,
      a less familiar theory, may present the most plausible alternative to
      reductionism currently available. Numerous examples from the psychiatric
      literature are used to illustrate the challenge that faces each of these
      theories. Critical evaluation of how they meet the challenge, particularly in
      accounting for apparent psychosomatic causation, shows the strengths and
      weaknesses of each theory, particularly regarding their clinical utility in
      psychiatry.

PMID- 7792327
TI  - Decreased cingulate and precuneate glucose utilization in alcoholic Korsakoff's
      syndrome.
AB  - Localized cerebral glucose utilization was determined for nine abstinent
      alcoholic men with Korsakoff's syndrome and 10 age-matched normal men who
      underwent positron emission tomography with [18F]2-fluoro-2-deoxyglucose (FDG).
      Patients with Korsakoff's syndrome showed relatively decreased glucose
      utilization in cingulate and precuneate areas. These decreases persisted even
      after correction for group differences in ventricular and sulcal cerebrospinal
      fluid measured on computed tomography. Electroencephalographic recordings at the
      time of FDG uptake showed no group differences, a finding that demonstrates that
      the metabolic differences could not be explained by differences in physiological
      arousal at the time of scanning. It is concluded that the decreased glucose
      utilization in the patients reflects a disruption of memory circuitry, the Papez
      circuit, caused by diencephalic lesions induced by thiamine deficiency.

PMID- 7792328
TI  - Serum cortisol levels are related to moods of elation and dysphoria in new
      mothers.
AB  - Serum cortisol levels were measured in 163 women on the third day after
      childbirth. Significantly elevated levels of cortisol were found to be associated
      with the "blues," and significantly lower levels characterized women who
      exhibited mild hypomania (the "highs"). Low levels of cortisol were independently
      associated with epidural anesthesia, while elevated levels were related to
      assisted delivery. There was no significant association with breast or bottle
      feeding. Changes in serum cortisol were thus found to parallel the mild
      bidirectional changes in affect that frequently follow childbirth.

PMID- 7792329
TI  - A prospective follow-along study of the course of social phobia.
AB  - The goals of this study were to delineate the courses of social phobia and to
      determine whether the course of generalized and specific social phobia differed.
      In the Harvard/Brown Longitudinal Study of Anxiety Research Project, 66 specific
      and 74 generalized social phobic subjects were identified for whom adequate
      course data were available. These subjects had been followed prospectively with a
      standardized follow-along measure of psychopathology. The probability of
      remission was calculated for each individual group and both groups combined.
      Demographics were the same for both groups except that the specific social phobia
      group had a marginally higher mean score on the Global Assessment Scale. Complete
      remission for the combined group was not different from that for either subgroup
      and was 0.11 at 65 weeks. Social phobia appears to be a disorder with
      considerable long-term morbidity. Surprisingly, both subtypes took a comparably
      long time to remit and were similar in their high level of psychosocial
      dysfunction.

PMID- 7792330
TI  - Attentional abilities and measures of schizotypy: their variation and covariation
      in schizophrenic patients, their siblings, and normal control subjects.
AB  - Thirty-five schizophrenic patients in the early stages of illness, 26 of their
      healthy siblings, and 35 normal control subjects performed the Continuous
      Performance Test, Identical Pairs version (CPT-IP). Both schizophrenic patients
      and their siblings were significantly impaired in their attentional performance
      compared with normal subjects. These results support impaired attention as a
      vulnerability marker of schizophrenia and indicate that at-risk siblings of
      schizophrenic patients display attentional deficits comparable to those found for
      the offspring of schizophrenic parents. By contrast, a decline in performance
      with the onset of a distraction condition (auditory and visual stimuli) was seen
      only in schizophrenic patients; siblings and normal control subjects did not
      differ from one another in response to experimental distraction. Therefore, it
      was concluded that differential distractibility is likely to be a state marker of
      schizophrenia. In clinical assessments, healthy siblings rated themselves as
      experiencing significantly more physical anhedonia than did normal control
      subjects, but the siblings did not differ from normal control subjects in self
      rated perceptual aberrations. Contrary to expectation, performance on the CPT-IP
      did not correlate significantly with either anhedonia or perceptual aberration in
      high-risk siblings. These results suggest that psychometrically measured
      "psychosis proneness" and neuropsychologically detected deficits may tap two
      nonoverlapping sources of vulnerability to schizophrenia.

PMID- 7792331
TI  - Relapse criteria in schizophrenic disorders: different perspectives.
AB  - Relapse and exacerbation of psychotic symptoms were investigated in a prospective
      study of 88 patients with recent-onset schizophrenia and related disorders.
      Relapse definitions were derived from expressed emotion and family intervention
      studies and based on the Brief Psychiatric Rating Scale (BPRS), the Present State
      Examination, and clinical judgment. Results indicate that research and clinical
      criteria represent different perspectives on relapse. Clinical criteria provide a
      validity check that can verify BPRS-rated changes in partially remitted patients.

PMID- 7792332
TI  - Geniculocalcarine hyperintensities on brain magnetic resonance imaging associated
      with visual hallucinations in the elderly.
AB  - Magnetic resonance scans of five geriatric patients presenting with formed visual
      hallucinations in the absence of other psychopathology were compared with those
      of 12 healthy elderly subjects for the presence and extent of subcortical and
      periventricular signal hyperintensity. While the number of discrete brain lesions
      did not differ between groups, scans from the patient group contained a higher
      incidence (100% vs. 50%) and greater mean size (11.1 vs. 2.9 mm) of
      periventricular signal hyperintensity in the posterior region. Peripheral visual
      acuity was impaired in all of the patients, but cerebrovascular risk factors were
      not elevated in this group. The authors suggest that structural abnormalities in
      the area of the primary visual pathway may predispose some older individuals,
      particularly those with poor peripheral visual acuity, to develop the symptom of
      visual hallucination.

PMID- 7792333
TI  - Ipsilateral subcortical atrophy associated with temporal lobectomy.
AB  - Stereologic methods for determining the volume of cerebral structures in vivo via
      magnetic resonance imaging have identified unilateral hippocampal atrophy among
      patients with complex partial epilepsy of temporal lobe origin. Metabolic imaging
      has also identified altered metabolism in temporal as well as extratemporal
      regions among these patients. As the temporal cortex and subcortical nuclei of
      the limbic system are reciprocally connected with striatal projection fields, we
      examined the putamen nuclei for evidence of associated extratemporal volume
      asymmetry in patients before and after temporal lobectomy. There was no evidence
      of preoperative putamen volume asymmetry, but a significant postoperative
      decrement in ipsilateral putamen volume was observed. The magnitude of
      postsurgical putamen volume asymmetry was correlated with the duration of time
      since resection. Progressive degeneration of extratemporal projections of the
      temporal lobe may occur in association with temporal lobectomy.

PMID- 7792334
TI  - Comparing means based on generalized matched sampling.

PMID- 7792335
TI  - Trial of interferon in chronic alcoholism.

PMID- 7792336
TI  - DSM-III-R Axis I and II disorders in agoraphobic inpatients with and without
      panic disorder before and after psychosocial treatment.
AB  - Panic disorder patients with agoraphobia (n = 32) and agoraphobic patients
      without panic disorder (n = 18) who were participants in an inpatient behavioral
      psychodynamic treatment program were assessed repeatedly from pretreatment to 2
      year posttreatment follow-up. At pretreatment, there were statistical trends for
      more of the panic with agoraphobia patients to have obsessive-compulsive disorder
      and alcohol abuse/dependence, and for more of the agoraphobia without panic
      patients to have generalized anxiety disorder and avoidant personality disorder.
      There was also a trend for more of the panic with agoraphobia patients to have
      met criteria for major depression during the 2-year follow-up period.

PMID- 7792337
TI  - Seasonal affective disorder in a tropical country: a case report.
AB  - Seasonality and affective disorders in the Southern Hemisphere were investigated
      in populations living in latitudes (40 degrees S) equivalent to those of the
      studies conducted in the Northern Hemisphere. The authors describe a patient with
      bipolar II affective disorder who was living in a low-latitude area (Sao Paulo,
      latitude: 23 degrees 39' S). The patient experienced five episodes of affective
      disorder that began in the summer and were characterized by symptoms typical of
      an autumn-winter depression. During the last two depressive episodes, the
      symptoms remitted after a 4-week course of evening light therapy. The case calls
      attention to the possibility that seasonality may influence the natural history
      of affective disorders even in lower latitude regions.

PMID- 7792338
TI  - Does recruitment method make a difference? Effects on protocol retention and
      treatment outcome in elderly depressed patients.
AB  - The specific aim of this study was to contrast effects of recruitment method
      (solicited, referred) on demographic, psychosocial, medical, and treatment
      outcome measures in an ongoing clinical trial of maintenance therapies in late
      life depression. Data from 125 elderly patients (56 solicited via media campaign,
      69 clinically referred) with recurrent, unipolar major depression were available
      for analysis. Several statistical contrast procedures, including group t tests,
      chi 2 tests, survival analysis, and logistic regression, were used to assess
      differences in patient profiles related to method of recruitment. Referred
      patients included a higher proportion of African Americans and had a lower level
      of education, fewer economic resources, and higher chronic medical burden.
      Solicited patients had been in the index episode longer than the referred
      patients at the time of protocol entry and were 3.4 times more likely to have
      experienced a "provoking agent" (severe life event or chronic difficulty) during
      the 6 months that preceded the onset of depressive symptoms. In contrast to these
      demographic and illness history differences, there were no differences in
      treatment response rates or time to response related to recruitment method.
      Solicited patients had an overall treatment response rate of 71% versus 62% in
      the referred group. Median time to response was 14.3 weeks in the solicited group
      and 13.6 weeks in the referred group. These results suggest that the inclusion of
      solicited patients in geriatric depression clinical trials does not bias short
      term treatment outcome.

PMID- 7792339
TI  - Platelet monoamine oxidase activity and deficit syndrome schizophrenia.
AB  - Measures of affective flattening that combine self-reported emotional experience
      with observed affect may identify deficit syndrome patients better than ratings
      based on observed affect alone. In this study, we examined 23 clinically stable
      but chronically ill schizophrenic patients, 15 of whom were found to have a
      deficit syndrome. After exclusion of patients with self-reported depressed mood
      from the deficit syndrome group, the remaining patients with a deficit syndrome
      not accompanied by self-reported depressed mood showed a strikingly homogeneous
      distribution of platelet monoamine oxidase activity. Results suggest that
      inclusion of self-reported emotional experience in clinical definitions of the
      deficit syndrome will increase the specificity of diagnosis.

PMID- 7792341
TI  - Wisconsin card sorting test and work performance in schizophrenia.
AB  - Patients with schizophrenia have long been observed to perform poorly on the
      Wisconsin Card Sorting Test (WCST). Although numerous studies have established
      links between WCST performance and specific and diffuse structural brain
      abnormalities, little is known about its relationship to occupational
      functioning. The present study has investigated the relationship between behavior
      at a vocational work placement and performance on the WCST test for 89 subjects
      with schizophrenia or schizoaffective disorder. Multiple regression analyses that
      examined select WCST raw scores and that covaried out IQ and Digit Symbol Subtest
      scores found that Task Orientation at work was significantly related to WCST
      Trials to the First Category and Total Number Correct. Multiple regression
      analyses that examined standard scores, corrected for age and education, revealed
      that Task Orientation was related to Percent Conceptual Level and that Social
      Skills were related to Total Errors and Percent Conceptual Level. Results support
      the criterion-related validity of the WCST and have implications for
      understanding impairments in work function.

PMID- 7792340
TI  - Borna disease virus and schizophrenia.
AB  - The development of a new serological assay method to detect antibodies in human
      sera recognizing Borna disease virus (BDV) proteins and a clinical pilot study
      are presented. Psychiatric patients from a schizophrenia research clinic in
      Baltimore, Maryland, were examined for antibodies to BDV antigen with traditional
      indirect immunofluorescence assays (IFA) that used both single and double
      labeling techniques and also with a Western blot assay capable of detecting
      antibodies to the three BDV proteins from a human neuroblastoma cell line.
      Thirteen of 90 (14.4%) patients and 0/20 control subjects had antibodies that
      recognized more than one BDV protein on the Western blot. Three patients had
      antibodies that recognized all three BDV proteins. Magnetic resonance imaging
      assessments of the volume of the putamen (with controls for total cranial volume)
      differentiated BDV+ from BDV- patients, and there were trend differences for
      bilateral amygdalae and the left amygdala-hippocampal process. We conclude that:
      (1) the Western blot assay is superior to IFA assays in BDV serology studies, (2)
      detection of antibodies to more than one BDV protein is a useful working
      criterion for seropositivity, (3) the 14.5 kDa BDV protein is 10 times more
      predictive of seropositivity than either the 38/40 kDa or the 24 kDa protein, (4)
      there is tentative evidence for a schizophrenia-control difference in the
      prevalence of anti-BDV antibodies, and (5) it is likely that there are
      neuroanatomical/behavioral features that differentiate seropositive from
      seronegative schizophrenic patients.

PMID- 7792342
TI  - Diurnal variation in tardive dyskinesia.
AB  - Tardive dyskinesia (TD) is a common movement disorder that is associated with
      chronic neuroleptic exposure. To better characterize the clinical aspects of TD,
      we investigated the diurnal pattern of involuntary movements by blindly rating
      videotaped examinations of patients from the morning shortly after awakening and
      later in the same afternoon. In 10 patients, average TD ratings were worse in the
      afternoon than in the morning, especially in the case of limb-trunk dyskinesias.
      These findings suggest that it is important to rate patients at the same time of
      day in TD studies. Moreover, patients should be evaluated at least several hours
      after awakening.

PMID- 7792343
TI  - Abnormal processing of irrelevant information in attention deficit hyperactivity
      disorder.
AB  - The presence of a selective attention deficit in children with attention deficit
      hyperactivity disorder (ADHD) was investigated by administering a trial-by-trial
      version of the Stroop Color-Naming Task to children, aged 9-12, with ADHD (n =
      19) and age-matched normal control children (n = 19). Performance was evaluated
      on both interference and facilitation components of the task. On the standard
      version of the task, with equal numbers of color words and neutral words,
      children with ADHD showed increased Stroop interference (prolongation of color
      naming times by color-incongruent stimuli) but normal amounts of facilitation
      (speeding of color naming by color-congruent stimuli). This finding suggests that
      children with ADHD show increased disruption of color-naming performance by task
      irrelevant information, probably secondary to decreased attentional control over
      the interference process. In contrast to findings of studies in adults, both
      groups of children failed to use an attentional strategy to reduce interference
      when they were administered blocks of trials that varied their expectancy for
      color word trials. This precluded a direct test of the diminished control
      hypothesis. There were no significant correlations between abnormal Stroop
      performance and impairment on the Continuous Performance Test or the Wisconsin
      Card Sorting Test or measures of IQ or reading performance. The implications of
      these findings for our understanding of information-processing deficits in
      children with ADHD and of the neurobiological underpinnings of these deficits are
      discussed.

PMID- 7792344
TI  - Patterns of cognitive asymmetry and syndromes of schizotypal personality.
AB  - The Schizotypal Personality Questionnaire, modeled on the nine components of DSM
      III-R schizotypy, was administered to 122 medical students along with the Thayer
      Activation-Deactivation Adjective Checklist and the Warrington Recognition Memory
      Test for words and faces. Close affinities were found between a three-factor
      schizotypal personality structure and a three-syndrome model of schizophrenia.
      Different patterns of cognitive asymmetry (word-face discrepancy scores) were
      related to Active and Withdrawn syndromes as in schizophrenia, and were related
      to high activation and general deactivation differences as predicted. A
      prospective single case study showed that a face-word discrepancy before a first
      episode of schizophrenia accurately predicted a Withdrawn presenting syndrome.
      The consistency between syndromes of schizophrenia and schizotypal personality in
      a normal population suggests possible etiological links between the two, and it
      supports a dimensional view of psychosis and subclinical predispositions.

PMID- 7792345
TI  - Hypothalamic-pituitary-gonadal axis, prolactin, and cortisol in alcoholics during
      withdrawal and after three weeks of abstinence: comparison with healthy control
      subjects.
AB  - Serum concentrations of luteinizing hormone, follicle-stimulating hormone,
      testosterone, androstenedione, estradiol, sex hormone-binding globulin, cortisol,
      and prolactin were measured in 12 male chronic alcoholics once during withdrawal
      and once after 21 days of abstinence. The results were compared with those of 14
      healthy volunteers. During withdrawal, luteinizing hormone, estradiol, and
      cortisol levels were significantly enhanced. Estradiol and cortisol
      concentrations fell significantly during abstinence, whereas luteinizing hormone
      concentrations remained elevated. The results may be interpreted as follows: the
      well-known inhibitory effect of alcohol on the biosynthesis of testosterone may
      have led to a compensatory increase in luteinizing hormone secretion, so that
      normal serum concentrations of testosterone were maintained. On the other hand,
      peripheral conversion from androstenedione to estradiol via aromatase pathways
      seemed to be enhanced in chronic alcoholics, at least during withdrawal. Whether
      this marked increase in estradiol concentrations is implicated in different
      clinical and psychological symptoms seen in chronic alcoholics remains to be
      investigated.

PMID- 7792346
TI  - ICD-10 mild cognitive disorder: epidemiological evidence on its validity.
AB  - Criteria for the diagnosis of ICD-10 Mild Cognitive Disorder (MCD) were applied
      to a sample of 897 community dwelling elderly participants. Criterion A (the
      presence of a physical disorder) was met by 44%, Criterion B (report of a
      cognitive disorder) by 17%, Criterion C (an abnormality in quantified cognitive
      assessments) by 60%, and Criterion D (exclusion on basis of dementia and other
      conditions) by 74%. A total of 36 cases (4%) met all four criteria. Correlations
      between Criteria A and B, and B and C were weak (r = 0.18), and the correlation
      between Criteria A and C was almost zero (r = 0.02). This suggests that no
      syndrome exists. Membership of MCD was predicted by a report that memory or
      intelligence interfered with daily life but not by performance on cognitive tests
      or by a report of physical illness. Cases of MCD had higher anxiety, depression
      and neuroticism scores than normal elderly, but did not differ substantially on
      tests of cognitive functioning. These findings call into question the validity of
      the ICD-10 diagnosis of MCD.

PMID- 7792347
TI  - Can memories of childhood sexual abuse be repressed?
AB  - We sought studies which have attempted to test whether memories of childhood
      sexual abuse can be repressed. Despite our broad search criteria, which excluded
      only unsystematic anecdotal reports, we found only four applicable studies. We
      then examined these studies to assess whether the investigators: (1) presented
      confirmatory evidence that abuse had actually occurred; and (2) demonstrated that
      their subjects had actually developed amnesia for the abuse. None of the four
      studies provided both clear confirmation of trauma and adequate documentation of
      amnesia in their subjects. Thus, present clinical evidence is insufficient to
      permit the conclusion that individuals can repress memories of childhood sexual
      abuse. This finding is surprising, since many writers have implied that hundreds
      of thousands, or even millions of persons harbour such repressed memories. In
      view of the widespread recent public and scientific interest in the areas of
      trauma and memory, it is important to investigate further whether memories of
      sexual abuse can be repressed.

PMID- 7792348
TI  - Factors that mediate between child sexual abuse and adult psychological outcome.
AB  - The psychological outcome for a random community sample of women who had
      experienced significant childhood sexual abuse was assessed, using two outcome
      measures: (i) psychiatric morbidity (measured with the short PSE); (ii) self
      esteem. Sexual abused women with a good outcome, i.e. who were not a PSE 'case'
      or who had high self-esteem were compared with abused women with a poor outcome.
      This paper describes the post-abuse factors that modified the two outcomes. In
      general, a range of variables, all correlated with each other in a complex
      manner, distinguished good outcome subjects from poor outcome subjects. Post
      abuse adolescent variables included family factors (poor mother-father and parent
      child relationships), high school factors (poor academic, sporting and social
      performance) and early pregnancy. Women who had a good adolescent relationship
      with their father did better than expected statistically. Sport emerged as an
      alternative at secondary school to academic achievement in catalysing a good
      psychological outcome. Adult factors included the quality of relationship with
      partner, which was associated with a good outcome on both measures. Current paid
      employment was linked to high self-esteem but not to lowered psychiatric
      morbidity, while the converse applied for high socio-economic status. These
      findings imply that different processes operate for each outcome measure. A clear
      recognition by the school of childhood sexual abuse may help to provide the
      opportunity for the girl to experience success in some arena; this in turn may
      protect her against the likely adult consequences of low self-esteem and
      increased psychiatric morbidity.

PMID- 7792349
TI  - Ten-year follow-up of anorexia nervosa: clinical course and outcome.
AB  - The clinical course and outcome of anorexia nervosa are presented in a 10-year
      follow-up study of 76 severely ill females with anorexia nervosa who met specific
      diagnostic criteria and had participated in a well-documented hospital treatment
      study. Information was obtained on 100% of the subjects. A comprehensive
      assessment was made in 93% of the living subjects in specific categories of
      weight, eating and weight control behaviours, menstrual function, anorexic
      attitudes, and psychological, sexual, social and vocational adjustment. Five
      subjects had died, which gives a crude mortality rate of 6.6%. Standardized
      mortality rates demonstrated an almost 13-fold increase in mortality in the
      anorexia nervosa subjects. Only eighteen (23.7%) were fully recovered. Sixty-four
      per cent developed binge-eating at some time during their illness, 57% at least
      weekly. Twenty-nine (41%) were still bulimic at follow-up. The high frequency and
      chronicity of the bulimic symptoms plus the high rate of weight relapse (42%
      during the first year after hospital treatment) suggest that intensive
      intervention is needed to help anorexics restore and maintain their weight within
      a normal range and to decrease abnormal eating and weight control behaviours.

PMID- 7792351
TI  - Detecting psychiatric disorders in medical practice using the General Health
      Questionnaire. Why do cut-off scores vary?
AB  - In this study we assessed the accuracy of the General Health Questionnaire in
      detecting psychiatric disorders in general medical out-patients. A total of 290
      newly referred patients were interviewed with the Present State Examination.
      Prior to the interview, 112 patients completed the full GHQ-60, 100 completed the
      GHQ-30 and 78 completed the GHQ-12. Data from the first group were used to study
      the full GHQ-60, together with the GHQ-30 and and GHQ-12, when disembedded from
      the full questionnaire. In a comparison between the disembedded and the separate
      versions of the GHQ-30 and GHQ-12 we observed considerable variation in the cut
      off scores where a certain sensitivity and specificity was attained. In ROC
      analysis, the versions were not materially different in their discriminatory
      capacity (area under the curve). The use of different criteria to define a 'case'
      demonstrated that case severity was another source of increasing cut-off scores.
      Our data demonstrate that the use of disembedded or separate versions of the
      questionnaire, together with variation in the case criteria can be a major
      explanation for variation in cut-off scores that was observed in previous
      studies.

PMID- 7792353
TI  - Attempted suicide in Oxford University students, 1976-1990.
AB  - During the 14 years between the beginning of academic year 1976-7 and the end of
      academic year 1989-90, 216 Oxford University students (119 females and 97 males)
      were referred to the general hospital in Oxford because of suicide attempts (254
      in all). The rate of attempted suicide during university term-time (106/100,000)
      was lower than in other young people of similar age in Oxford City (164/100,000).
      The difference was particularly marked in females (178/100,000 v. 269/100,000).
      The lower rate in the students may in part reflect their generally higher socio
      economic status. Very few of the attempts by the students appeared to be failed
      suicides. The most frequent problems faced by the students at the time of their
      attempts were interpersonal, especially difficulties regarding partners, followed
      by academic problems. The latter were usually problems with ongoing course work
      rather than with the Finals examinations. Approximately a quarter of the students
      had psychiatric problems, with personality disorders and depression being most
      common. At least 30% had a history of previous attempts. Suggestions are made
      concerning measures for improving the management and prevention of attempted
      suicide by students.

PMID- 7792355
TI  - Obese binge eaters: metabolic characteristics, energy expenditure and dieting.
AB  - The study was carried out in two groups of massively obese women with BMI values
      who were to undergo bariatric surgery. The patients were evaluated for weight
      variability and for the presence and the frequency of binge eating. Body
      composition, resting energy expenditure (REE) and metabolic parameters were also
      measured. When non-bingeing individuals were compared with patients who met Binge
      Eating Disorder criteria, no differences in body composition, fat distribution,
      REE values and concentrations of serum lipids, insulin and thyroid hormones were
      found. On the other hand, weight variability due to reduced diet in the subjects'
      lifetime was significantly higher. This study does not support the hypothesis
      that in massively obese women binge eating is somehow induced by a reduced energy
      expenditure.

PMID- 7792350
TI  - The capacity of a measure of disability (the LSP) to predict hospital readmission
      in those with schizophrenia.
AB  - One hundred and eighteen subjects with an admission diagnosis of schizophrenia
      were reassessed after 12 months to establish whether hospital readmission had
      occurred. All subjects were rated at baseline and after 12 months on the Life
      Skills Profile (LSP), a 39-item measure of disability, with scores demonstrating
      moderate stability. The baseline LSP score was a significant predictor of
      readmission, both in univariate and multivariate analyses. By contrast, several
      univariate variables (e.g. unemployment and non-compliance with medication over
      the review period) did not maintain their predictive capacity in multivariate
      analyses, suggesting that they were manifestations or consequences of significant
      disability, rather than independent contributors to poor outcome.

PMID- 7792352
TI  - Predictors of survival with Alzheimer's disease: a community-based study.
AB  - Factors associated with reduced survival were investigated in elderly people
      diagnosed as having Alzheimer's disease (AD) and in those free of dementia at
      diagnosis. The study population comprised 155 people free of dementia and 222
      with AD; all were aged 75 years and over and were part of a two-stage prevalence
      study of dementia during 1988 in Melton Mowbray, Leicestershire. An increased
      risk of death was found for those with a history of heavy alcohol use, lower
      cognitive function, a history of heart failure and those in institutional care,
      these factors acting in the same manner for persons free of dementia and those
      with AD. For the non-demented group a greater risk of death was found with
      increasing age and for those with a history of cancer. A greater risk of death
      was found for males with AD compared to females with the risk increasing over
      time. The longer survival of women over men may explain the sex differences found
      in the prevalence of AD without accompanying differences in incidence.

PMID- 7792354
TI  - Measuring disease severity in patients with end-stage renal disease: validity of
      the Craven et al. ESRD Severity Index.
AB  - The validity of a recently developed measure of disease severity, the End-stage
      Renal Disease Severity Index (Craven et al. 1991) was examined in haemodialysis
      (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients (total N =
      82). Scores on the ESRD Severity Index were compared with three commonly
      identified components of disease severity: physiological indices of severity,
      functional status, and psychological burden of illness. For the entire group of
      subjects, scores on the ESRD Severity Index were negatively associated with
      functional ability and positively related to physiological severity. ESRD
      Severity Index scores showed a weaker relationship with psychological burden of
      illness which depended in part on treatment mode. Disease severity scores were
      positively related to depression in CAPD patients but not in HD patients. These
      findings suggest that the ESRD Severity Index is a valuable research tool with
      construct validity.

PMID- 7792356
TI  - Suicide among psychiatric hospital in-patients.
AB  - We examined for risk factors for suicide among psychiatric in-patients by
      comparing 37 in-patients from an Ontario Provincial Psychiatric Hospital who had
      committed suicide with 37 age and sex matched in-patient controls. Significantly
      more of the suicide victims had made a previous suicide attempt (62.2 v. 35.1%),
      suffered from schizophrenia (75.7 v. 35.1%), were involuntary at their last
      admission (70.3 v. 43.2%) and lived alone (70.3 v. 43.2%). Only six patients
      committed suicide on the ward. Almost a third of the patients, the majority
      schizophrenic, committed suicide after having been in the hospital for more than
      a year. These results suggest that in the psychiatric hospital setting the in
      patient at risk for suicide has previously exhibited suicidal behaviour, suffers
      from schizophrenia, was admitted involuntarily, lives alone and that the risk of
      suicide may remain high among long-stay schizophrenics.

PMID- 7792357
TI  - Isolated retrograde amnesia for autobiographical material associated with acute
      left temporal lobe encephalitis.
AB  - Retrograde amnesia for autobiographical material in the absence of anterograde
      amnesia or other memory disturbances was found in a patient with acute viral
      encephalitis. Memory loss showed a temporal gradient, but new learning was
      spared. Both brain perfusion imaging with 99mTc-HMPAO SPECT, and EEG localized
      the lesion in the left temporal lobe while CT and MRI were normal. This
      observation supports the anatomical differentiation between the different memory
      functions. The uncommon combination of isolated retrograde amnesia without other
      neuropsychological findings may raise the doubt of psychogenic aetiology, which
      in this case was refuted.

PMID- 7792358
TI  - Stability and change in low self-esteem: the role of psychosocial factors.
AB  - Low self-esteem, defined as negative evaluation of self (NES), has been shown to
      play a significant role in the development of depression at a case level (Brown
      et al. 1986). This study investigated the stability of this risk factor in 102
      women over a 7-year period and examined psychosocial factors that might influence
      change. At the end of the 7 years about half of those originally identified as
      having NES no longer had it, but very few moved in the reverse direction to NES.
      Level of depressive symptomatology also decreased but this was not a sufficient
      explanation for the substantial improvement in self-esteem. Life changes that
      involved an improvement in the quality of close relationships or an increase in
      work status appeared to be the most important factors in positive NES change.
      Ratings made at the time of first contact of environmental difficulties and
      positive evaluation of self (measured independently of NES) were related to
      positive NES change, but only via their link with positive life changes occurring
      in the 7-year follow-up period.

PMID- 7792359
TI  - Depression undertreatment: lost cohorts, lost opportunities?

PMID- 7792360
TI  - Social problems as factors affecting medical consultation: a comparison between
      general practice attenders and community probands with emotional distress.
AB  - Comparison between general practice attenders and community subjects with
      emotional distress (as measured by GHQ-12) showed that women from a general
      practice sample reported more social problems than those from the community. In
      both men and women, problems with their spouse or partner were far more likely
      among general practice attenders than among community probands. Furthermore,
      women who consulted the general practitioners could count less often on the
      availability of friend confidants and had more well-defined physical disorder
      than their community counterparts. Results from a logistic regression analysis
      showed that in women (but not in men) problems in the relationship with spouse or
      partner increased the probability of being a general practice attender more than
      twofold. Physical health status did not exert a significant effect either in men
      or in women.

PMID- 7792361
TI  - Positive and negative symptoms/syndromes in schizophrenia: reliability and
      validity of different diagnostic systems.
AB  - The paper explores the reliability, concurrent validity and overlap of some
      positive/negative symptom rating scales and typological criteria in 100
      schizophrenic patients. Rating scales include Andreasen's Scales for the
      Assessment of Positive and Negative Symptoms, Abrams and Taylor's Scale for
      Emotional Blunting, and Kay's Positive and Negative Syndrome Scale. Criteria for
      categorizing individual patients include Andreasen's and Kay's criteria for
      positive and negative types of schizophrenia as well as Carpenter's criteria for
      the deficit syndrome. The correlations among positive as well as among negative
      scales were high. The agreement among criteria tended to be lower. Both positive
      scales showed low internal consistency. Kay's negative scale had the greatest
      internal consistency, which suggests that it is measuring a homogeneous syndrome.
      All negative symptom scales and categorical syndromes identified a group of
      patients who were single and exhibited schizoid or schizotypal pre-morbid
      personality disorders, poor premorbid sexual/social adjustment, poor response to
      neuroleptics and poor prognosis.

PMID- 7792362
TI  - Differing patterns of electrodermal and finger pulse responsivity in
      schizophrenia and depression.
AB  - Non-response of the autonomic orienting response (OR), as indexed jointly by
      deficient skin conductance (SCR) and finger pulse amplitude responding (FPAR),
      has been shown to occur with excessive frequency in the schizophrenic population.
      The present study is an attempt to replicate earlier evidence that SCR-OR and
      FPAR-OR, when measured in concert, could distinguish schizophrenic from depressed
      patients (Bernstein et al. 1988). This issue is critical of the question of
      diagnostic specificity of OR non-responding, since reduced SCR has been found
      repeatedly in depression as well as in schizophrenia. We examined SCR and FPAR
      concurrently in 69 schizophrenic, 45 depressed, and 67 normal subjects. SCR non
      responding was more frequent in both schizophrenics and depressives than in
      normal controls, while only the schizophrenics displayed excessive FPAR non
      responding. Moreover, among SCR non-responders, concordant OR non-responding-
      defined as non-responding indexed simultaneously in both the SCR and FPAR
      components--was most common in the schizophrenic sample. These findings support
      our previous conclusion that OR non-responding in depression, may have distinct
      peripheral origins. Our results also suggest that measuring multiple
      biochemically distinct components of the OR may be more sound methodologically
      than obtaining a single channel recording.

PMID- 7792363
TI  - Autism as a strongly genetic disorder: evidence from a British twin study.
AB  - Two previous epidemiological studies of autistic twins suggested that autism was
      predominantly genetically determined, although the findings with regard to a
      broader phenotype of cognitive, and possibly social, abnormalities were
      contradictory. Obstetric and perinatal hazards were also invoked as
      environmentally determined aetiological factors. The first British twin sample
      has been re-examined and a second total population sample of autistic twins
      recruited. In the combined sample 60% of monozygotic (MZ) pairs were concordant
      for autism versus no dizygotic (DZ) pairs; 92% of MZ pairs were concordant for a
      broader spectrum of related cognitive or social abnormalities versus 10% of DZ
      pairs. The findings indicate that autism is under a high degree of genetic
      control and suggest the involvement of multiple genetic loci. Obstetric hazards
      usually appear to be consequences of genetically influenced abnormal development,
      rather than independent aetiological factors. Few new cases had possible medical
      aetiologies, refuting claims that recognized disorders are common aetiological
      influences.

PMID- 7792364
TI  - Loss, humiliation and entrapment among women developing depression: a patient and
      non-patient comparison.
AB  - This paper is part of a series dealing with the role of life events in the onset
      of depressive disorders. Women who developed depression in a general population
      sample in Islington in North London are contrasted with a National Health Service
      treated series of depressed patients in the same area. Findings among the latter
      confirm the importance of a severely threatening provoking event for onset among
      the majority of depressed women patients. The results for the two series are
      similar except for a small subgroup of patients characterized by a
      melancholic/psychotic condition with a prior episode. The severe events of
      importance have been recognized for some time by the traditional ratings of the
      Life Events and Difficulty Schedule (LEDS). However, the full descriptive
      material collected by the LEDS has been used to develop a new refined measure
      reflecting the likelihood of feelings of humiliation and being trapped following
      a severely threatening event, in addition to existing measures of loss or danger.
      The experience of humiliation and entrapment was important in provoking
      depression in both the patient and non-patient series. It proved to be associated
      with a far greater risk of depression than the experience of loss or danger
      without humiliation or entrapment.

PMID- 7792365
TI  - Time course of prefrontal lobe dysfunction in severely depressed in-patients: a
      longitudinal neuropsychological study.
AB  - The Stroop Colour-Word Test (SCWT) and the Verbal Fluency Test (VFT), two tests
      that have been suggested to be particularly sensitive to prefrontal dysfunction,
      were administered to 23 severely depressed in-patients. Both tests were impaired
      in patients at inclusion, but only verbal fluency normalized with successful
      treatment of depression. VFT impairment is consistent with the hypothesis of a
      left prefrontal cortex dysfunction in depression. Moreover, the persistence of an
      impaired performance on SCWT in patients at discharge suggests that a selective
      attention deficit may persist in patients beyond a clear clinical improvement.

PMID- 7792366
TI  - Dysfunctional attitudes in depressed and recovered depressed patients and their
      first-degree relatives.
AB  - A series of depressed probands and their first-degree relatives were categorized
      as follows: (a) currently depressed; (b) recovered depressed; and (c) never-ill
      relatives. Their scores on a subscaled version of the Dysfunctional Attitude
      Scale (the DAS-24) were compared. The DAS total scores mirrored previous findings
      in that the total scores for recovered individuals returned to normal or near
      normal levels. However, the dependency subscale scores remained elevated for the
      recovered depressed group. It is proposed that these results support the
      conclusion that self-report measures of cognitive vulnerability should focus on
      specific rather than global effects, if progress is to be made in the search for
      true vulnerability factors.

PMID- 7792367
TI  - Determinants of the help-seeking process: Goldberg and Huxley's first level and
      first filter.
AB  - This paper discusses minor psychiatric morbidity in the community and its
      relation to help-seeking. The research is aimed at identifying the demographic
      and social characteristics that enhance the likelihood of minor psychiatric
      morbidity, as measured by the General Health Questionnaire, and to reveal how
      these determinants relate to health status. In the second stage of the study, the
      same characteristics are related to their effect on the decision to decision to
      consult a general practitioner and, specifically, on presenting psycho-social
      problems to the GP. At the population level, the likelihood of a high GHQ score
      was greater for women, divorced persons and the unemployed, other variables
      remaining equal. However, GHQ score was contaminated by poor subjective health
      perception, especially for unemployed persons. Chronic physical illness did not
      have an independent effect on the GHQ score. Chronic physical illness did
      influence help-seeking. In addition, several socio-demographic characteristics
      showed an independent effect on consulting behaviour for both GHQ-positive and
      GHQ-negative patients. Women, unemployed persons and publicly insured patients
      with a minor psychiatric disturbance were more apt to visit their GP, regardless
      of their physical health status. However, no socio-demographic characteristics
      increased the likelihood that a GHQ-positive patient would present unambiguous
      psycho-social complaints as a reason to see their doctor.

PMID- 7792368
TI  - Abuse-related posttraumatic stress disorder: evidence for chronic neuroendocrine
      activation in women.
AB  - The following study tested the hypothesis that women with post-traumatic stress
      disorder (PTSD) related to childhood sexual abuse would display elevated
      norepinephrine-to-cortisol ratios similar to that found in male combat veterans
      diagnosed with PTSD. Twenty-four-hour urine samples were collected from 28 women:
      11 women with PTSD who experienced childhood sexual abuse (PTSD+), 8 women who
      experienced childhood sexual abuse without PTSD (PTSD-), and 9 nonabused
      controls. All urine samples were tested for creatinine, total catecholamines,
      free-cortisol, and 17-ketosteroid levels. Psychological testing validated that
      the PTSD+ group was significantly elevated on all three subscales of the Impact
      of Events Scale. Both abused groups (PTSD+ and PTSD-) showed a tendency for
      polyuria, and the PTSD+ group showed a tendency towards obesity. Thus,
      neuroendocrine values (micrograms/day) were adjusted by creatinine clearance
      rates (creatinine mg/day/kg body weight). The corrected values indicated that the
      PTSD+ group had significantly elevated daily levels of norepinephrine,
      epinephrine, dopamine, and cortisol. However, because of the parallel elevation
      in cortisol, the norepinephrine-to-cortisol ratio was not significantly elevated
      in the PTSD+ diagnosed women in contrast to the findings reported for male PTSD
      patients. This discrepancy may reflect an important gender difference, an
      interaction between gender and age at onset of the traumatic experience
      (childhood abuse in females vs. combat experience in young adult males), or
      physiological variation related to phase of the disorder.

PMID- 7792370
TI  - Longitudinal follow-up of amenorrhea in eating disorders.
AB  - The authors recruited 229 treatment-seeking anorexic and bulimic women for a
      prospective, longitudinal study. Telephone interviews were arranged every 3
      months for at least 1 year for 225 patients. At intake, 132 subjects were
      menstruating, 34 subjects were taking oral contraceptives, 5 subjects had an
      organic cause for amenorrhea (e.g., hysterectomy), and 58 subjects were
      amenorrheic. Each patient met Diagnostic and Statistical Manual of Mental
      Disorders, third edition, revised (DSM-III-R) criteria for anorexia nervosa (AN,
      N = 41), bulimia nervosa (BN, N = 98), or AN/BN (N = 90). All subjects were
      interviewed with the Schedule for Affective Disorders and Schizophrenia-Lifetime
      Version, which was modified to include a section for DSM-III-R eating disorders,
      the Longitudinal Interval Follow-Up Evaluation, and the Structured Interview for
      DSM-III Personality Disorders. It was found that body weight was associated with
      menstrual status: those with amenorrhea had a mean percent ideal body weight
      (IBW, Metropolitan Life criteria) of 74 +/- 1% compared with 102 +/- 19% for
      menstruating patients (p < .01). Affective illness was more prevalent among
      patients with amenorrhea than among menstruating patients (75% vs. 56%, p < .05).
      Menses were regained within 1 year by 33% of amenorrheic patients. These patients
      gained an average of 7.3% of their IBW. Longer duration of eating disorder (p <
      .03) and the presence of an anxiety disorder (p < .05) were associated with
      persistent amenorrhea. Menses were lost within 1 year by 8% of menstruating
      patients. These patients lost an average of 5.0% of their IBW.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7792369
TI  - Blood lipids and lipoproteins in married and formerly married women.
AB  - As part of the Cardiovascular Occupational Risk Factors Determination in Israel
      (CORDIS) study, the association between marriage termination (divorce/separation
      or widowhood) and blood lipids and lipoproteins was examined in a sample of 351
      healthy women employed in industry. Eighty-seven former spouses were each matched
      with three married women (N = 264) for age, number of children, smoking status,
      and type of job (blue/white collar). After controlling for age, number of
      cigarettes per day, leisure sport participation, and daily coffee consumption,
      former spouses in the younger women group (younger than 45 years) had
      significantly higher total cholesterol, total cholesterol ratio, and LDL levels
      than married women. Among older women (> or = 45 years), there were no
      significant differences. Significantly more younger former spouses had abnormally
      high cholesterol and LDL levels. In both age groups, former spouses smoked more
      cigarettes daily. These differences between the marital status groups may be
      explained by stress effects and changes in primary prevention practices. If
      replicated, such findings would delineate a population in need of intervention to
      reduce disease risk.

PMID- 7792371
TI  - Herpes simplex and mood: a prospective study.
AB  - The effect of mood, the common cold, amount of sleep, and sunshine on recurring
      herpes simplex virus (HSV) infection was investigated using daily self-reports
      over a 3-month period from 23 female and 15 male patients with genital herpes and
      26 female and two male patients with oral herpes. Results showed recurring
      genital HSV infection to be preceded by reduced and decreasing overall emotional
      well being over a period of 10 days, with a temporary improvement in the middle
      of the period. This pattern was significantly represented by rated nervousness
      and rated alertness. Females showed more marked trends for reported mood than did
      the males, which could not be attributed to the menstrual cycle. Conversely,
      males showed a more marked, strongly significant fourth-order trend for reported
      amount of sleep, with nadirs on the 8th and the 3rd day before the recurrence.
      Neither exposure to sunshine nor the common cold showed any relation to
      recurrence of genital HSV infection. The common cold appeared as the major
      precipitating factor in oral herpes. Except for a significant fourth-order trend
      for rated alertness, no relationship between mood and subsequent onset was found.
      This negative finding was interpreted as a masking effect of the common cold. Two
      alternative physiological theories, the ganglion trigger theory and the skin
      trigger theory, were discussed in relation to present findings. It was suggested
      that various possible mediators between mood states and recurring herpes should
      be investigated using the present approach, with structured diaries as complement
      to the rating scales.

PMID- 7792373
TI  - Classical conditioning of total respiratory resistance in humans.
AB  - A differential classical conditioning paradigm was used to investigate changes in
      total respiratory resistance in healthy adult female subjects. The conditioned
      stimuli were red and blue colors projected on a screen, and the unconditioned
      stimulus was an arithmetic task in which the subject mentally subtracted serial
      17s from a number displayed on the screen. One of the two colors was paired with
      the arithmetic problem, and the other color was presented alone. Participants
      completed seven paired and seven unpaired trials. Both total respiratory
      resistance and functional residual capacity changes were measured before and
      during each conditioned stimulus. Total respiratory resistance was higher during
      the paired conditioned stimuli than it was during the unpaired conditioned
      stimuli. This result was not related to variations in functional residual
      capacity. It was concluded that elevated total respiratory resistance during the
      paired stimuli was a result of conditioning. The elevations were probably due to
      increases in bronchomotor tone. Conditioned changes in total respiratory
      resistance may be related to some respiratory behaviors both in healthy
      individuals and in patients with asthma.

PMID- 7792372
TI  - Validity of the Quality of Well-Being Scale for persons with human
      immunodeficiency virus infection. HNRC Group. HIV Neurobehavioral Research
      Center.
AB  - To evaluate the validity of the Quality of Well-Being Scale (QWB) for studies of
      patients with human immunodeficiency virus (HIV) disease, 514 men were studied
      who were divided among four categories: Centers for Disease Control and
      Prevention (CDC) Group A (N = 272), CDC-B (N = 81), CDC-C (N = 47), and
      uninfected male controls (N = 114). The QWB and a variety of medical,
      neuropsychological, and biochemical measures were administered to all
      participants. When QWB scores were broken down by HIV group, the CDC-C group was
      significantly lower (.614) than the CDC-B (.679), CDC-A (.754), or control group
      (.801). The difference between Groups CDC-C and CDC-A was about .14 units of well
      being, which suggests that individuals lose 1/7 equivalents of 1 well year of
      life for each year they are in Group CDC-C in comparison to the asymptomatic
      group (Group CDC-A). In comparison to the controls, this would equal a 1-year of
      life loss for each seven infected individuals. The QWB was shown to be
      significantly associated with CD4+ lymphocytes (p < .001), clinician ratings of
      neuropsychological impairment (p < .04), neurologists ratings of dysfunction (p <
      .001), and all subscales of the Profile of Mood States. Baseline QWB scores were
      significant prospective predictors of death over a median follow-up time of 30
      months. Multivariate models demonstrated high covariation between predictors of
      QWB. It was concluded that the QWB is a significant correlate of biological,
      neuropsychological, neurological, psychiatric, and mortality outcomes for male
      HIV-infected patients.

PMID- 7792374
TI  - Heterogeneity in neuroendocrine and immune responses to brief psychological
      stressors as a function of autonomic cardiac activation.
AB  - Human responses to brief psychological stressors are characterized by changes and
      large individual differences in autonomic, neuroendocrine, and immune function.
      The authors examined the effects of brief psychological stressors on
      cardiovascular, neuroendocrine, and cellular immune response in 22 older women to
      investigate the common effects of stress across systems. They also used
      interindividual variation in heart rate reactivity, cardiac sympathetic
      reactivity (as indexed by preejection period reactivity in their reactivity
      paradigm), and cardiac vagal reactivity (as indexed by respiratory sinus
      arrhythmia reactivity) to explore the heterogeneity in human responses to brief
      psychological stressors. The results revealed that brief psychological stressors
      heightened cardiac activation, elevated plasma catecholamine concentrations, and
      affected the cellular immune response. It was also found that individuals
      characterized by high, relative to low, cardiac sympathetic reactivity showed
      higher stress-related changes in adrenocorticotropic hormone and cortisol plasma
      levels but comparable changes in epinephrine and norepinephrine concentrations.
      These data suggest that the effects of psychological stressors on cardiovascular
      and cellular immune response are governed by coordinated regulatory mechanism(s)
      and that going beyond the simple notion of heart rate reactivity to examine
      neural substrates may shed light on the interrelationships among and the
      regulatory mechanisms for the autonomic, endocrine, and immune responses to
      stressors.

PMID- 7792376
TI  - Preoperative rehearsal of active coping imagery influences subjective and
      hormonal responses to abdominal surgery.
AB  - Existing evidence suggests that preoperative psychological preparation that is
      designed to reduce anxiety may sensitize cortisol and adrenaline responses to
      surgery. In a controlled trial of abdominal surgery patients, we therefore tested
      the effects of a preoperative preparation that used guided imagery, not to reduce
      anxiety, but to increase patients' feelings of being able to cope with surgical
      stress; 26 imagery patients were compared with 25 controls who received, instead,
      background information about the hospital. State-anxiety was similar in each
      group, but imagery patients experienced less postoperative pain than did the
      controls, were less distressed by it, felt that they coped with it better, and
      requested less analgesia. Hormone levels measured in peripheral venous blood did
      not differ on the afternoon of admission, before preparation. Cortisol levels
      were, however, lower in imagery patients than in controls immediately before and
      after surgery. Noradrenaline levels were greater on these occasions in imagery
      patients than controls. The results are interpreted in relation to two theories.
      One states that preoperative "worry" reduces surgical stress. The other concerns
      the influence of active and passive coping on endocrine responses to stress.

PMID- 7792377
TI  - Affiliation moderates the effects of social threat on stress-related
      cardiovascular responses: boundary conditions for a laboratory model of social
      support.
AB  - The authors tested the hypothesis that the response-attenuating effects of
      affiliation under stress are limited to conditions that involve high social
      threat. Ninety-six young adult women were exposed to standardized psychological
      challenges in one of four conditions that involved two levels of social
      affiliation (alone or accompanied by a close friend) and two levels of social
      threat (variations in the social behavior and perceived status of the
      experimenter). Social affiliation was associated with attenuated blood pressure
      responses to the challenges but only under conditions of high social threat.
      Affiliation was not associated with differences in self-reported emotional
      response to the challenges nor with alterations in cognitive task appraisal.
      Exploratory analyses suggested that some of these effects were stronger in
      hostile or socially avoidant individuals. Implications of these findings for
      interpreting the literature on social support and cardiovascular reactivity, and
      for understanding the potential role of social support in reducing stress-related
      disease pathogenesis, are discussed.

PMID- 7792375
TI  - Acute psychological stress and epinephrine infusion in normolipidemic and
      hyperlipidemic men: effects on plasma lipid and apoprotein concentrations.
AB  - This study examined whether psychological stress and the infusion of epinephrine
      increase plasma lipid and apoprotein concentrations in normolipidemic and
      hyperlipidemic men. Subjects were studied during three separate 6-hour laboratory
      sessions: a control session, during which subjects rested quietly while blood
      samples and hemodynamic measurements were obtained; a stress session, during
      which subjects were presented with two challenging mental tasks, followed by
      quiet rest; and an epinephrine infusion session, during which subjects received a
      low-dose infusion of epinephrine followed by quiet rest. The stress and
      epinephrine infusion manipulations produced the expected changes in plasma
      epinephrine and norepinephrine levels, blood pressure, and heart rate. Free fatty
      acid concentration increased markedly during epinephrine infusion and less
      dramatically but consistently during mental stress. Both stress and epinephrine
      infusion produced acute increases in plasma total, low-density lipoprotein, very
      low-density lipoprotein, and high-density lipoprotein cholesterol and apoprotein
      B concentrations, but comparable increases during the control session were not
      observed. Changes in albumin concentration (an index of plasma volume) were
      associated with changes in lipid concentrations during psychological stress.
      Epinephrine increases during psychological stress were correlated with increases
      in free fatty acid and triglyceride levels both during and after task
      administration. It was concluded that psychological or pharmacological stress
      induced in the laboratory produces changes in lipid concentrations, which at
      least during psychological stress, may be attributed to concomitant changes in
      plasma volume. The association between task-induced changes in epinephrine and
      changes in free fatty acid and triglyceride levels, also supports the hypothesis
      that psychological stress increases lipolysis.

PMID- 7792378
TI  - Clinical speculation: is specificity back? This time thromboangiitis obliterans.
AB  - Do men with thrombangiitis obliterans (TO) show conspicuous personality features
      and behavior? Twenty-one men with TO were compared with 20 men with coronary
      artery disease (CAD). All diagnoses were angiographically confirmed. Mean ages
      were 40.1 (TO) and 43.4 years (CAD). Semistructured, open-ended interviews were
      conducted. Interview-behavior: TOs were more hostile, minimizing, evasive, and
      complicated than CADs (p < .001). The interviewer reacted with more anger,
      impatience, boredom, astonishment, and less empathy towards TOs (p < .001). Adult
      behavior: TOs had changed their place of work more often (p < .001), had more
      absentism from work (p < .001), and had more debts (p = .01) unrelated to the
      present illness. They smoked more before the illness (p = .01) and continued to
      smoke more frequently during their illness than CADs (p < .003). They were more
      often single or divorced (p < .05) and had more conflicts in their relationships
      (p < .001) than CADs. During conflicts, TOs more often shouted or withdrew and
      less frequently tried to resolve conflicts with humor and discussions (p < .001)
      than CADs. TOs were more frequently dissatisfied with their life situation than
      CADs (p < .001). TOs more often passively submitted to their illness than CADs,
      who tried to cope by giving up smoking and by exercising (p < .001). Childhood:
      TOs more often mentioned a bad relationship with their father than CADS (p = .01)
      and had more disciplinary problems at home and in school (p = .002). TOs show
      remarkable personality features.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792379
TI  - Psychosis in an adolescent patient with Wilson's disease: effects of chelation
      therapy.
AB  - Wilson's disease is a rare genetic disorder involving the liver and brain, with
      onset frequently in adolescence. Psychiatric symptoms are often the first
      manifestation of the disease and can obscure the diagnosis. Chelation therapy can
      reverse the fatal outcome of untreated patients, so early detection is critically
      important. This paper describes an adolescent with Wilson's disease who, after
      initiation of penicillamine therapy, developed florid psychosis that improved as
      copper levels were decreased and that did not require use of neuroleptic
      medication.

PMID- 7792380
TI  - Aerobic exercise and the placebo effect: a controlled study.

PMID- 7792382
TI  - [Behavioral markers of premature infants--a study of "temperament in early
      childhood"].
AB  - In a two-point longitudinal study we compared preterm and fullterm infants with
      respect to certain behaviour patterns known as "infant temperament".
      Interdependencies between depression and childrearing attitudes of the mothers
      and temperamental characteristics of infants are analysed. Investigations took
      place after birth and four months (corrected age) later and comprised, among
      other questionnaires, a new German temperament assessment scale as well as
      clinical data. Our results show that, independent of their depression and
      childrearing attitudes, mothers of preterm infants describe their babies as
      showing much less positive emotions and having far more problems in being
      soothed. In both groups the baby's positive reactions and soothability was
      related to the extent of its mother's motivation to stimulate the baby and care
      for it. However, showing many negative emotions cannot sufficiently be explained
      by prematurity and certain mother characteristics at time of birth.

PMID- 7792383
TI  - [Patients in (post)modern society--does psychosomatic medicine still have
      concrete foundations?].
AB  - The paper describes the scientific development psychosomatic medicine has
      undergone in the last decades, as well as the politically induced changes in the
      German Health Care system. In three future scenarios the dangers of a) biological
      and b) voluntaristic schools of thought are presented along with the c)
      consequences of ecological destruction and economic power. The increasing trend
      for psychosomatic medicine to use salutogenetic models is discussed as a feasible
      approach for the prevention of fear-provoking perspectives.

PMID- 7792381
TI  - Effects of sleep on the production of cytokines in humans.
AB  - The restorative functions of sleep may affect immunologic functioning. The
      present study examined the effects of sleep on stimulated cytokine release in 13
      healthy men. The subjects spent 2 experimental nights in the sleep laboratory. In
      one condition, lights were turned off at 11:00 PM to enable sleep for 3.5 hours.
      Thereafter, they stayed awake till 7:00 AM. In the other condition, conversely,
      subjects stayed awake between 11:00 PM and 3:00 AM. Then, lights were turned off
      for a 3.5-hour phase of sleep. Blood was sampled every 30 minutes between 11:00
      PM and 7:00 AM. Sleep was monitored by polysomnographic recordings. Release of
      tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 beta (IL-1 beta) was
      determined after stimulation of mononuclear cells with lipopolysaccharide from
      Escherichia coli. The release of IL-2 was stimulated with phytohemagglutinin.
      Compared with wakefulness, after 3 hours of sleep, production of TNF-alpha and IL
      1 beta was substantially diminished (p < .01). Production of IL-2 was enhanced
      during sleep (p < .05), with this effect being limited to the second nocturnal
      sleep phase after 3:00 AM. Sleep-dependent changes in stimulated cytokine release
      were independent of changes in plasma cortisol concentrations. These results
      indicate a specific reducing effect of sleep (vs. wakefulness) on cytokine
      production by monocytes (TNF-alpha and IL-1 beta). The rather slow development of
      the effects calls for further studies to establish the exact time course of the
      influence of sleep on cytokine production.

PMID- 7792384
TI  - [Which factors modify the duration of inpatient psychotherapy?].
AB  - The indication for differential duration of inpatient psychotherapy is a
      difficult question to answer, especially when the possible outcome-success of
      more severely disturbed patients (e.g. with borderline-personality disorder) is
      considered. Our own results showed no relevant correlation between the degree of
      patients' disturbance and treatment duration, neither any relevant correlation
      between treatment duration and therapists' evaluation of symptomatic or ego
      structural improvement. The only marked effect on treatment duration was found
      for the patients' evaluation of their therapeutic relationship: the better they
      judged this relationship, the more their therapists tended to elongate inpatient
      psychotherapy. This finding supports a paradigm, which has been already well
      confirmed for outpatient psychotherapy: the specific importance of the
      therapeutic relationship for the therapeutic process even within the scope of
      inpatient psychotherapy. Another finding of our study indicates that more
      severely disturbed patients probably need a modified setting of inpatient
      psychotherapy: favorably a focus oriented interval treatment with short duration
      periods and alternating focus if necessary.

PMID- 7792385
TI  - [Alexithymic verbal behavior in patients with Crohn disease].
AB  - This study investigates the language of Morbus Crohn patients using a
      quantitative, objective linguistic method which was developed by M. v. Rad
      (1983). Significant results were: The language of Morbus Crohn patients is more
      generalized and includes not only fewer emotional terms but also fewer
      differential emotional terms than the language of neurotic patients. This result
      supports the hypotheses that the language of Morbus Crohn patients is alexithyme
      and that the Morbus Crohn disease belongs to psychosomatic disorders.

PMID- 7792386
TI  - [Clinical and psychometric findings in spasmodic torticollis].
AB  - In a previous study screening for psychopathological symptoms in a sample of 256
      patients with spasmodic torticollis had resulted in 27% of patients, whose mean
      score of the GSI of the SCL-90-R was above the double standard deviation of the
      control group of normals (Scheidt et al. 1994). In this study the self-reported
      psychopathology of a subsample of 19 TS patients was controlled for its agreement
      with a clinical assessment in a psychiatric interview. The results of the study
      confirm the validity of the SCL-90-R as a screening instrument for psychological
      distress and psychopathology. However a tendency for social desirability in a
      subgroup of patients might lead to underestimate the degree of psychological
      distress in this patient group and might als account for some of the discrepant
      findings concerning psychological distress and psychopathology in TS in former
      studies. Furthermore the clinical assessment revealed a high psychiatric and
      psychosomatic morbidity prior to the onset of the spasmodic torticollis as well
      as a high frequency of traumatic life events (e.g. bereavement) in the patients
      premorbid history. In addition to coping with a crippling neurological condition
      concurrent psychopathology in TS therefore should be considered also in terms of
      the individuals premorbid psychological vulnerability.

PMID- 7792388
TI  - Interleukin-1 beta-stimulated PGE2 production from early first trimester human
      decidual cells is inhibited by dexamethasone and progesterone.
AB  - Cytokines are known to increase the production of prostaglandins by human
      decidual cells, but negative regulators have not been identified. We have
      examined the effects of dexamethasone and progesterone on prostaglandin (PG) E2
      synthesis by cultured human first trimester decidual cells. The numbers of
      cyclooxygenase (COX) enzyme positive cells were visualised by
      immunocytochemistry, using antibodies specific for COX-1 and COX-2. Interleukin-1
      beta stimulated the production of prostaglandins E2 and F2 alpha dose
      dependently, and this was associated with increased numbers of COX-2 positive
      cells. Progesterone (10(-7)-10(-6) M) and dexamethasone (10(-7)-10(-6) M)
      inhibited basal and interleukin-1 beta-stimulated prostaglandin production, and
      decreased the numbers of COX-2 positive cells. Neither interleukin-1 beta nor the
      steroids affected numbers of COX-1 positive cells. COX-2 seems to be the main
      enzyme controlling the synthesis of PGE2 by human decidual cells, and may be
      negatively regulated by progesterone.

PMID- 7792387
TI  - Dose-related effect of IGF-I on placental prostanoid release.
AB  - Prostanoids play an important role throughout all of pregnancy and during the
      initiation and progress of labor. The human placenta at term produces large
      quantities of prostanoids, yet little is known of the factors regulating their
      biosynthesis. In a previous study we observed that insulin-like growth factor I
      (IGF-I) specifically inhibits thromboxane B2 (TxB2) and prostaglandin F2 alpha
      (PGF2 alpha) from human term placental explants. In these studies we have defined
      the dose-related action of IGF-I on the release of placental prostanoids. With
      use of a perifusion system, the basal release of prostaglandin E2 (PGE2), PGF2
      alpha, TxB2 and 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) from human term
      placental explants increased from the fifth hour in culture, while the release of
      13,14-dihydro-15-keto-PGF2 alpha (PGFM) remained constant. The addition of IGF-I
      (5.2-83.3 ng/mL) to the perifusing medium effected an inhibition of TxB2 and PGF2
      alpha. The release of TxB2 was inhibited in a dose-related fashion from the
      initiation of IGF-I treatment and throughout the five hours of treatment, whereas
      the inhibition of PGF2 alpha was significant only at a dose of 83.3 ng/mL of IGF
      I. Yet, the release of 6-keto-PGF1 alpha, PGE2, or PGFM was not altered by any
      dose of IGF-I studied. Because both TxB2 and PGF2 alpha are vasoconstrictors, we
      have proposed that IGF-I may enhance vasodilation in the placenta. Therefore, IGF
      I may allow for increased blood flow, thus affecting the maintenance of pregnancy
      and the supply of nutrients available for the growth of the fetus.

PMID- 7792390
TI  - Cervical mucus concentration of prostaglandins E2 and F2 alpha after pretreatment
      with mifepristone in the first trimester of pregnancy.
AB  - Cervical dilatation and softening after pretreatment with mifepristone are well
      documented. As this effect is similar to that observed after local application of
      prostaglandin E2 (PGE2) it is tempting to speculate that the effect of
      mifepristone is mediated via an increase of the endogenous secretion of
      prostaglandins from the cervical mucosa. Eighteen healthy women in the first
      trimester of pregnancy were treated with oral mifepristone (200 mg) 48 and 24
      hours before legal abortion by vacuum aspiration and 18 women in the same age of
      gestation without any pretreatment served as controls. Cervical mucus was
      collected for measurement of prostaglandins by radioimmunoassay before
      administration of the drug and in connection with vacuum aspiration. The cervical
      dilatation at the time of surgery was significantly increased in women given
      mifepristone as compared with untreated women (7.6 versus 5.8 mm). The wet weight
      of collected cervical mucus was significantly increased in mifepristone treated
      women. The amount of PGE2 and prostaglandin F2 alpha per sample was unchanged in
      mifepristone-treated women, whereas the concentration was lower as an effect of
      dilution due to an increased yield in cervical secretion observed after
      mifepristone treatment. The present observation does not give any support to the
      hypothesis that mifepristone-induced cervical maturation is mediated via an
      increase in cervical prostaglandin production.

PMID- 7792389
TI  - Effects of a single drip infusion of lipo-prostaglandin E1 on vibratory threshold
      in patients with diabetic neuropathy.
AB  - We evaluated acute effects of prostaglandin E1 encapsulated in lipid microspheres
      (lipo-PGE1), in 14 type 2 diabetic patients with neuropathy. Nerve conduction
      velocity (NCV), vibratory threshold (VT), skin temperature and subjective
      symptoms were evaluated for 24 hours after a single drip infusion of lipo-PGE1.
      In 6 of the 14 patients, the decrease in VT (P < 0.05) more than 50% measured by
      an SMV-5 vibrometer was observed at 6 hours after the infusion (responders).
      Subjective symptoms were improved (P < 0.05) in 5 of the 6 responders, whereas it
      improved in only 1 of the 8 patients who had no change in VT (nonresponders). NCV
      did not change (P > 0.05) either in the responders or in the nonresponders by the
      infusion. The responders had less impairment in VT and milder retinopathy and
      nephropathy than the nonresponders (P < 0.05). Our results demonstrate that
      vibratory sensation and subjective symptoms can be improved by a single infusion
      of lipo-PGE1 in type 2 diabetic patients with mild neuropathy.

PMID- 7792391
TI  - 12-Lipoxygenase in Lewis lung carcinoma cells: molecular identity, intracellular
      distribution of activity and protein, and Ca(2+)-dependent translocation from
      cytosol to membranes.
AB  - Recently we demonstrated that Lewis lung (3LL) tumor cells express 12
      lipoxygenase (12-LOX) mRNA and protein, respectively. In this study we partially
      sequenced the 12-LOX cDNA after reverse-transcription polymerase chain reaction
      amplification of 12-LOX mRNA from cultured 3LL cells. Comparison with platelet
      and leukocyte 12-LOX indicates that 3LL 12-LOX is identical with the platelet
      type enzyme at least within the sequenced region. Further, we investigated the
      intracellular distribution of both 12-LOX enzyme protein and its activity which
      are prerequisites for understanding 12-LOX regulation. 12-LOX activity was
      monitored via the production of 12-hyroxyeicosatetraenoic acid from 3LL cells and
      their subcellular fractions using reverse-phase high performance liquid
      chromatography. 12-LOX protein was measured by direct slot blot and by Western
      Blotting. In 3LL cells, both 12-LOX activity and 12-LOX protein were
      predominantly localized in the cytosol. This 12-LOX activity was optimal at 37
      degrees C. However at 24 degrees C and 10 degrees C, it showed 87% and 61% of
      this activity, respectively, thus differing distinctly from 12-LOX in platelets
      or rat basophilic leukemia cells. Incubation of 3LL cell homogenates with 0-100
      microM free Ca2+ and subsequent separate analyses of cytosol and membrane
      fractions indicated that, as in platelets, an increase in intracellular free Ca2+
      caused a loss of cytosolic 12-LOX activity. However, no significant Ca(2+)
      induced increase in membrane-associated 12-LOX activity was observed under these
      conditions in 3LL cells. In contrast, at the 12-LOX protein level we observed a
      Ca(2+)-dependent loss in the cytosol and a concomitant increase in the membrane
      fraction. Thus, we suggest that 12-LOX in 3LL cells undergoes rapid translocation
      from cytosol to membrane in a Ca(2+)-dependent manner, but is no longer active or
      becomes inactivated at the membrane site.

PMID- 7792392
TI  - Sensitivity of ovine myometrial tissue to various eicosanoids in vitro.
AB  - The sensitivity of sheep myometrial tissue to prostaglandin F2 alpha (PGE2
      alpha), PGE2, the thromboxane analog U-44069, and leukotrienes C4 (LTC4) and LTD4
      was investigated in a superfusion system. Tissues were obtained from eight
      oophorectomized ewes, with or without pretreatment with estradiol-17 beta. After
      equilibration, spontaneous activity was abolished by adding indomethacin to the
      superfusion fluid. The dose needed to induce a contraction with a peak level of
      50% of the median peak level of spontaneous contractions increased from PGE2 to
      PGF2 alpha, U-44069, LTC4, and LTD4. The differences between the doses required
      were significant for all compounds, except between LTC4 and LTD4. Estradiol-17
      beta pretreatment caused an increase in the required dose of PGF2 alpha. The
      results of this study do not support the hypothesis that leukotrienes are
      involved in the regulation of myometrial activity.

PMID- 7792393
TI  - Leydig cell function and radiation: a review of the literature.

PMID- 7792394
TI  - Aggressive fibromatosis: optimisation of local management with a retrospective
      failure analysis.
AB  - The records of 40 consecutive patients treated at the Princess Margaret Hospital
      (PMH) between 1979 and 1988 for aggressive fibromatosis were reviewed. The median
      follow-up was 86 months (range 21-167 months). All surgery was performed at the
      referring hospitals. Thirty-six underwent an attempt at excision, four were
      biopsied. Thirty-one had no overt disease after surgery and 26 of these received
      adjuvant irradiation. Eight were treated with radiotherapy alone, and another was
      treated with azathioprine and prednisone. Twenty-four (60%) presented with
      recurrent disease. The overall relapse free rate was 63% at 5 and 10 years.
      Combined surgery and irradiation had a higher relapse rate than irradiation alone
      (46% vs. 25%), and a high proportion of failures in the combined group were
      marginal failures (36%). Relapses following surgery alone were 1/5 (20%), and
      chemotherapy 0/1. Tumour size greater than 8 cm predicted for relapse (p =
      0.002), but tumour site, status of surgical margins, and presence or absence of a
      history of relapse were not statistically significant. Twelve with subsequent
      treatment failure underwent successful salvage surgery, and 37/40 (92%) were
      disease free at last follow-up. A functional assessment (modified Johnstone
      scale) revealed 11/24 patients (46%) with poor functional outcomes (grade 2 or
      less) after all treatment compared with 6/24 (25%) at referral. Ten of 11 (91%)
      with grade of 2 or less had a history of recurrence, and 4/5 amputations were for
      treatment of a painful recurrence. Treatment planning in this study was hampered
      by inadequate information on tumour location since few patients had clinically
      apparent disease when seen by the radiation oncologist (only 35% of cases) and
      fewer had preoperative cross-sectional imaging available (12% of cases).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7792395
TI  - Involved field radiation therapy for Hodgkin's disease autologous bone marrow
      transplantation regimens.
AB  - From 1986 through 1992, involved-field radiation therapy (IF-RT) was administered
      to 29 of 86 patients with recurrent Hodgkin's disease (HD) who received a high
      dose cyclophosphamide/etoposide regimen with autologous bone marrow
      transplantation (A-BMT). Patients without a significant history of prior RT
      received total body irradiation (TBI), initially as a single dose 5-7.5 Gy, and
      subsequently with fractionated TBI (F-TBI) delivering 12 Gy. Previously
      irradiated patients received a high-dose BCNU regimen instead of TBI. IF-RT was
      employed selectively, usually for sites of bulky disease (> 5 cm). IF-RT doses
      were typically 20 Gy at 2 Gy per fraction for TBI patients and 30-40 Gy at 1.8
      2.0 Gy per fraction for non-TBI Patients. Fatal complications developed in four
      patients while second malignancies have developed in two. The region which
      received IF-RT was the site of first recurrence in only two cases (7%). With a
      median follow-up of 28 months, the two-year disease-free survival rate was 44%.
      For the 22 patients treated by either F-TBI or high-dose BCNU, the 2-year disease
      free survival rate was 50% with a median follow up of 29 months. Selective use of
      IF-RT may increase the chances of complete remission and disease free survival in
      HD patients with a history of bulky disease.

PMID- 7792396
TI  - Radiation tolerance of normal mouse bladders after intravesical chemotherapy.
AB  - The aim of this study was to compare functional damage in normal mouse bladder
      after various initial intravesical therapies and to investigate tolerance to
      subsequent irradiation. Six consecutive weekly intravesical instillations of
      Mitomycin C (MMC) or doxorubicin (DOX) were used as the initial therapy.
      Irradiation with single doses of 10-25 Gy (X-rays) was given at 4 or 12 weeks
      after intravesical treatment. Functional bladder damage was assessed from changes
      in the micturition frequency, expressed as frequency index (FI, number of
      urination events/ml urine in a 24-h test period) and from cystometry measurements
      of bladder volume at 52-56 weeks. Irradiation alone caused a temporary acute
      response (increased FI) within the first 4 weeks and a progressive late response
      starting from 15 to 37 weeks, depending on the radiation dose. A reduced bladder
      capacity was also evident at 52-56 weeks after 25 Gy. Intravesical MMC or DOX
      caused a 3-fold increase in FI during intravesical therapy with recovery to
      control levels within 2-3 weeks after cessation of treatment. Irradiation 4 weeks
      after MMC, or 4 or 12 weeks after DOX resulted in acute responses very similar to
      irradiation alone. There was no difference in time of onset or extent of late
      bladder damage when irradiation was given after DOX, compared with irradiation
      alone as assessed from repeated measurements of FI or cystometry at 52-56 weeks.
      In contrast, irradiation 12 weeks after MMC led to a decrease in acute radiation
      response compared with X-rays alone.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792397
TI  - Effects of continuous hyperfractionated accelerated and conventionally
      fractionated radiotherapy on the parotid and submandibular salivary glands of
      rhesus monkeys.
AB  - Radiotherapy is a major treatment modality for head and neck cancer. It is often
      not possible to exclude the salivary glands from the treatment fields. The unique
      susceptibility of the serous cells of the salivary glands to irradiation often
      results in xerostomia with ensuing secondary complications and discomfort to the
      patients. Recent reports have suggested that continuous hyperfractionated
      accelerated radiotherapy (CHART) can lead to considerably less reduction in the
      parotid salivary gland than conventional radiotherapy. This study was undertaken
      to assess histologic changes of salivary glands induced by CHART and conventional
      radiation fractionation schedules. The parotid and submandibular salivary glands
      of adult rhesus monkeys were irradiated with cobalt-60 gamma radiation at 50
      Gy/20 fractions/4 weeks, 55 Gy/25 fractions/5 weeks, or 54 Gy/36 fractions/12
      days (CHART). Salivary tissues were harvested at 16 weeks following irradiation
      and evaluated histopathologically. Microscopically, the glands receiving 50 Gy,
      55 Gy, or CHART were virtually indistinguishable. There was severe atrophy and
      fibrosis of all glands. Quantitative analysis revealed that 50 Gy, 55 Gy, and
      CHART induced a reduction of serous acini in parotid glands by 86.4%, 84.8%, and
      88.8%, respectively. In submandibular glands, serous acini were reduced by 99.4%,
      99.0%, and 100%, respectively. The corresponding reduction in mucous acini were
      98.4%, 98.4%, and 99.2%, respectively. These histopathologic and quantitative
      morphologic studies show that the magnitude of serous gland atrophy in the
      parotid and submandibular salivary glands of rhesus monkeys was similar at 16
      weeks after receiving 50 Gy in 20 fractions, 55 Gy in 25 fractions, or CHART.

PMID- 7792398
TI  - Chemosensitization of CCNU in KHT murine tumor cells in vivo and in vitro by the
      agent RB 6145 and its isomer PD 144872.
AB  - The cytotoxicity and chemosensitizing potential of the nitrohetercyclic agent RB
      6145 and its R enantiomer PD 144872 were determined in rodent tumor cells grown
      in tissue culture or as solid tumors. Using a clonogenic cell survival assay the
      degree of selective cytotoxicity of these bioreductive drugs was first determined
      in KHT/iv cells. Cells treated under hypoxic conditions were observed to be
      approximately 50-80-fold more susceptible to the action of RB 6145 or PD 144872
      than were cells exposed under air. To assess the in vitro chemosensitizing
      potential of RB 6145 and PD 144872, doses of these agents which led to survival
      values between 0.5 and 1.0 under hypoxic conditions were administered, and were
      then combined concomitantly with variable doses of the nitrosourea CCNU. Exposure
      to the nitrosourea was for 1 h. The results showed that inclusion of either
      sensitizer enhanced the cell killing of the chemotherapeutic agent 2.4-2.6-fold.
      Subsequent experiments evaluated the therapeutic benefit of combining these
      bioreductive agents with CCNU in KHT sarcoma-bearing C3H/HeJ mice. When given at
      times ranging from 90 min before to 60 min after CCNU exposure, these
      bioreductive drugs increased the tumoricidal activity of the chemotherapeutic
      agent. Complete dose response curves combining RB 6145 and PD 144872 and a range
      of CCNU doses also were evaluated. The sensitizers (0.75 mmol/kg) were
      administered 30 min prior to the chemotherapeutic agent and survival of
      clonogenic tumor cells 22-24 h after treatment was used to assay tumor
      response.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792399
TI  - Picture archiving and communications systems in radiation oncology (PACSRO):
      tools for a physician-based digital image review system.
AB  - Digital imaging is becoming more and more important in the diagnosis, staging,
      and treatment of patients in radiation oncology. In order to facilitate the most
      efficient interface of this technology to physicians and other users of this
      information, a medical image display system (MID) has been developed at the Fox
      Chase Cancer Center (FCCC). The system runs on 20 personal computers situated in
      physicians offices as well as a modified system located in the radiation oncology
      conference room. Access to CT, MRI, and EPID information is achieved through an
      Ethernet connection to the hospital picture archiving and communications system
      (PACS). Over a 1-year period a total of 503 patients and 3845 images have been
      stored on the system. Physician approval using the MID system (without
      conventional films) was performed on 106 patients. Of these, 22%, 16%, 11%, 10%,
      and 9% consisted of breast, prostate, pelvic, lung, and head and neck patients,
      respectively. Digital images sent from a variety of image sources to the MID
      system take up to 15 s to process and format while image access and display can
      take 2-5 s, dependent upon image size and speed of the host computer.

PMID- 7792400
TI  - Calculation of the dose in the build-up region for high energy photon beam.
      Treatment planning when beam spoilers are employed.
AB  - Recoil electrons from a polystyrene sheet (beam spoiler) placed in a photon beam
      were used to modulate the dose in the build-up region. The effects of the beam
      spoiler on the dosimetry in simple phantoms were studied for both 6 MV and 15 MV
      photon beams at 100 cm source-to-surface distance (SSD) as a function of (1) the
      thickness of the spoiler, (2) the spoiler-to-surface distance (SD) and (3) the
      field size. A radiotherapy treatment planning (RTP) algorithm was used that
      employs pencil beam dose deposition kernels to evaluate the three-dimensional
      (3D) dose distribution due to photons and electrons in the build-up region. To
      determine the energy deposition kernels for the recoil electrons emanating from
      the spoiler, their energy spectrum needs to be known. Monte Carlo simulations
      were performed to derive the spectrum of electrons from the beam spoiler. The
      recoil electron spectrum was found to be nearly independent of field size, SD,
      and spoiler thickness. The pencil beam energy deposition kernel was calculated
      for the recoil electrons from the spoiler and inserted in the treatment planning
      algorithm. The dose calculation algorithm permits merging the photon and recoil
      electron dose components. In all cases the calculation agrees to within 3% of the
      measured results.

PMID- 7792401
TI  - Accuracy of field alignment in radiotherapy of head and neck cancer utilizing
      individualized face mask immobilization: a retrospective analysis of clinical
      practice.
AB  - Deviations between simulation and first check films were quantitatively assessed
      for 95 unselected head and neck cancer patients. All measured deviations-
      calculated on the basis of a total of 190 simulation and 380 verification films-
      were normally distributed, with mean values of 0-3 mm and standard deviations of
      3-5 mm. Of the absolute deviations, 50% and 95% were within 3 mm and 9 mm,
      respectively. These results should be considered in clinical practice when
      prescribing safety margins and adequate cut off doses for sparing critical organs
      in head and neck cancer.

PMID- 7792402
TI  - Verification of an on line in vivo semiconductor dosimetry system for TBI with
      two TLD procedures.
AB  - This work presents the verification of an on line in vivo dosimetry system based
      on semiconductors. Software and hardware has been designed to convert the diode
      signal into absorbed dose. Final verification was made in the form of an
      intercomparison with two independent thermoluminiscent (TLD) dosimetry systems,
      under TBI conditions.

PMID- 7792403
TI  - Granulate of stainless steel as compensator material.
AB  - Compensators produced with computer controlled milling devices usually consist of
      a styrofoam mould, filled with an appropriate material. We investigated granulate
      of stainless steel as filling material. This cheap, easy to use, clean and re
      usable material can be obtained with an average granule diameter of 0.3 mm,
      enabling an accurate and reproducible filling. No wax or other sealing material
      is added. The density of the granulate is approximately 4.5 g/cm3, which allows
      an accurate production of compensators in a sufficiently wide transmission range
      without the compensators becoming too thick. Transmission and surface dose
      measurements show that the dosimetric properties of stainless steel granulate are
      suitable for use as compensator material.

PMID- 7792404
TI  - Re: SF2: clothes for the emperor?

PMID- 7792405
TI  - Dose escalation, treatment protraction, and the steepness of the dose-response
      curve for squamous cell carcinoma of the head and neck.

PMID- 7792407
TI  - Annual Brachytherapy Meeting. GEC-ESTRO. York, United Kingdom, 10-12 May, 1995.
      Abstracts.

PMID- 7792406
TI  - Thymoma: results of a multicentric retrospective series of 149 non-metastatic
      irradiated patients and review of the literature. FNCLCC trialists. Federation
      Nationale des Centres de Lutte Contre le Cancer.
AB  - Between 1979 and 1990, 149 patients with non-metastatic thymomas were treated in
      ten French cancer centers. Patients were staged according to the 'GETT'
      classification, derived from that of Masaoka. There were 13 stage I patients, 46
      stage II, 58 stage III and 32 stage IVA. Gross total resections were performed in
      63 cases, subtotal resections in 31 cases and in 55 cases a biopsy alone was
      performed. All patients received radiotherapy and 74 were given post-operative
      chemotherapy. Median follow-up was 7.7 years. Local control was achieved in 117
      cases (78.5%) and was influenced by the stage of the disease (p < 0.01) and the
      extent of surgery (p < 0.01). Twenty-six patients developed metastatis after a
      median period of 9 months. Five- and ten-year disease-free survival rates were
      59.5% (51-67%) and 49.5% (39-60%), respectively, and were influenced by the stage
      of the disease (p < 0.01), the extent of surgery (p < 0.001) and a mediastinal
      compression on presentation (p = 5 x 10(-6)). Four factors could predict a worse
      overall survival in the multivariate analysis: mediastinal compression on
      presentation (p < 0.001), absence of chemotherapy (p < 0.001), biopsy alone (p =
      0.003), and young age (p = 0.013). A worse DFS was predicted by mediastinal
      compression on presentation (p < 0.001), absence of chemotherapy (p < 0.001),
      young age (p = 0.006), and stages III-IVA (p = 0.04). Future therapeutic
      strategies are discussed and the literature is reviewed.

PMID- 7792409
TI  - Analysis of an escalating sequence of problem behaviors: a case study.
AB  - This case study focused on a student with severe disabilities who displayed
      multiple problem behaviors that fit a pattern of behavioral escalation. Analysis
      of the pattern in which problem behaviors occurred within instructional sessions,
      and comparisons of conditional rates of occurrence for specific behaviors to
      overall base rates of occurrence, indicated that the student's problem behaviors
      did represent a behavioral sequence. Functional assessment led to the hypothesis
      that the use of rule statements by the teacher was related to the occurrence and
      escalation of the problem behaviors. An ABAB reversal design showed that
      eliminating the use of rule statements was an effective instructional
      intervention for decreasing the rate of the student's problem behaviors.
      Independent ratings of the physical effort required for specific problem
      behaviors in the sequence suggested that response effort may be one variable
      underlying the pattern of responding within a behavioral sequence. Implications
      are offered for our theoretical understanding of complex patterns of problem
      behaviors and for future research and clinical intervention.

PMID- 7792408
TI  - Measuring stress in the mildly intellectually handicapped: the factorial
      structure of the Subjective Stress Scale.
AB  - The Subjective Stress Scale (SSS) was developed by Bramston and Bostock (1994) to
      provide a sensitive measure of stress for people with intellectual disabilities.
      This study examined the underlying structure of the SSS by analysing responses of
      221 intellectually disabled people to the questionnaire. Exploratory factor
      analysis of the interitem correlation matrix yielded at least three solutions
      that were quite interpretable: a one-factor, a two-factor, and a four-factor
      solution. Factors in all three solutions bore a strong resemblance to stress
      dimensions reported for the general population using other stress measures. The
      results suggest that although the actual stressors vary, persons with mild
      intellectual disability are affected by the same major stress dimensions as the
      general population. The results also suggest that the SSS can be used as a much
      needed measure of subjective stress levels in people with mild intellectual
      disabilities.

PMID- 7792411
TI  - Effects of task size on work-related and aberrant behaviors of youths with autism
      and mental retardation.
AB  - The effects of task size on rate of responding and on-task behavior as well as on
      nontask-related behaviors of students with autism and mental retardation on a
      repetitive task under conditions of no reinforcement for responding was analyzed.
      Task size, defined as the presence of either 36 or 250 beads in a container at
      the onset of the session, was compared in an alternating treatment design. The
      small-task condition resulted in higher on-task behavior for all participants and
      in higher work rate for four of the five participants. For the four participants
      who engaged in inappropriate use of task materials, higher levels of this
      behavior occurred in the large-task conditions. Other nontask-related behaviors
      were higher in the large-task condition for all participants with the exception
      of stereotypy, which was higher in the small-task condition for one participant.
      Better work-related behavior occurred for these participants in small- than in
      large-task conditions even though no tangible reinforcement was provided for task
      responding. Implications of these results are discussed in the context of
      arranging workplace environments to maximize productivity of persons with
      developmental disabilities.

PMID- 7792410
TI  - Suicidal behavior in children and adolescents with mental retardation.
AB  - Despite increasing attention to psychiatric disorders in the mentally retarded,
      suicidal behavior remains an underreported phenomenon in this population,
      particularly in children and adolescents. This study was aimed at documenting the
      existence of suicidal behavior among 90 consecutive admissions to a specialty
      unit for dually diagnosed children and adolescents in a medical school-affiliated
      children's psychiatric hospital. Archival chart review yielded a total of 19
      patients, or 21%, for whom suicidal behavior was a presenting complaint upon
      admission or during hospitalization. Suicidality was distributed across gender,
      level of mental retardation, and psychiatric diagnosis. Additional findings of
      note with regard to family dysfunction and/or abuse history are summarized.
      Clearly, in this sample, children and adolescents with mental retardation were
      capable of formulating and engaging in potentially fatal acts. Results of this
      study suggest that suicidal behavior is an underrecognized, yet significant
      phenomenon in children and adolescents with mental retardation and psychiatric
      disorder.

PMID- 7792412
TI  - [Latex allergy. New risks in anesthesiologic practice].

PMID- 7792413
TI  - [Hepato-pulmonary syndrome: meta-analysis].
AB  - INTRODUCTION AND OBJECTIVES: The clinical introduction of multiple elimination of
      inert gases (MEIG) has meant a qualitative advance in our understanding of the
      physiopathology of a wide range of pulmonary diseases. This meta-analysis aims to
      bring together data on patients with cirrhosis of the liver from 3 similar
      studies in which MEIG was used. PATIENTS AND METHODS: The results from 30
      patients in 3 studies, divided into 2 groups based on baseline partial arterial
      O2 pressure (hypoxemic: PaO2 < 80 mmHg, n = 17; normal: PaO2 > or = 80 mmHg, n =
      13) were subjected to statistical analysis. RESULTS: The hypoxemic group
      experienced an increase in the percentage of cardiac output perfusing regions of
      shunting (10.1 +/- 10 vs. 1.08 +/- 1.6%; p < 0.01) and low ventilation/perfusion
      relationships (16.3 +/- 10.3 vs. 3.5 +/- 5.8%; p < 0.01). We also observed
      greater dispersion in the distribution of perfusion (1.09 +/- 0.43 vs. 0.67 +/-
      0.34; p < 0.01) and ventilation (0.62 +/- 0.14 vs. 0.49 +/- 0.13; p < 0.05), with
      the ventilation mean located in regions with higher ventilation/perfusion
      relationships (1.3 +/- 0.5 vs. 0.85 +/- 0.15; p < 0.01). The difference between
      observed and calculated PaO2 was significant in the hypoxemic group (7.3 +/- 5.5
      vs. 1.2 +/- 1.3 mmHg; p < 0.01). CONCLUSIONS: Hypoxemia in patients with
      cirrhosis of the liver is mainly due to changes in ventilation/perfusion
      relationships and shunting. In the most hypoxemic patients, however, we cannot
      rule out a role for the causes of hypoxemia, such as diffusion changes.

PMID- 7792414
TI  - [Intravenous anesthesia using propofol during lengthy neurosurgical
      interventions].
AB  - OBJECTIVE: To compare the hemodynamic stability and time to recovery of
      consciousness after long-duration (> 3 h) neurosurgery with 2 anesthetic
      protocols: total intravenous anesthesia with propofol as the single hypnotic
      agent and inhalational anesthesia with isoflurane. PATIENTS AND METHOD: We
      studied 58 middle-aged patients (range 40-50 years) scheduled for intracranial
      surgery. The patients, who all scored over 13 on the Glasgow coma scale before
      surgery, were randomly divided into two groups: 27 in group I received isoflurane
      and 31 in group II received propofol. Anesthetic induction was with sodium
      thiopental 4 mg/kg i.v. in group I and with propofol 2.5 mg/kg i.v. in group II.
      Both groups then received fentanyl 2 micrograms/kg i.v., lidocaine 1.5 mg/kg i.v.
      and vecuronium 0.2 mg/kg i.v. Before placement of the Mayfield head grip, with
      clamps, or before start of surgery in those cases in which the head grip was not
      used, all patients were given a 3 micrograms/kg i.v. dose of fentanyl. Hypnosis
      was maintained in group I with concentrations of isoflurane that were adequate
      for keeping minimum alveolar concentration (MAC) between 0.6 and 1. In group II
      maintenance was by continuous i.v. perfusion of propofol 10 mg/kg/h for 30 min.,
      followed by 8 mg/kg/h for 30 min. and 6 mg/kg/h until the end of surgery. N2O was
      never used. RESULTS: After induction systolic and mean arterial pressures (SAP
      and MAP) decreased significantly in both groups in comparison with baseline
      values (SAP: 113.1 +/- 30.0 vs. 140.9 +/- 27.08 mmHg in group I and 109.6 +/-
      22.1 vs. 135.0 +/- 19.7 mmHg in group II; MAP: 76.8 +/- 18.7 vs. 95.6 +/- 17.0
      mmHg in group I and 74.9 +/- 13.2 vs. 93.4 +/- 13.7 mmHg in group II). The
      patients in group II showed less tendency to develop arterial hypertension in
      response to orotracheal intubation (SAP and MAP at the moment of intubation:
      156.4 +/- 33.7 and 104.6 +/- 18.1 mmHg, respectively, in group I as compared to
      135.1 +/- 31.2 and 93.5 +/- 22.4 mmHg in group II; p < 0.05 between the 2 groups
      and p < 0.05 for the baseline and intubation pressures in group I). Time to
      recovery of effective, spontaneous breathing was shorter in group I (5.9 +/- 4.9
      and 8.9 +/- 5.7 min.) than in group II (10.9 +/- 9.6 and 13.0 +/- 7.4 min.) and
      tubes could be extracted earlier from patients in the isoflurane group (10.4 +/-
      6.1 min. vs. 17.6 +/- 12.8 min.; p < 0.01). We found no differences between the 2
      groups for time until eye opening, response to verbal orders or time until start
      of spontaneous movement. CONCLUSIONS: Propofol can be considered an alternative
      to the traditional thiopental-isoflurane sequence in neurosurgery lasting more
      than 3 h. In our study the hypertensive response to the stimulus of orotracheal
      intubation was lower in the propofol group than in the thiopental-isoflurane
      group.

PMID- 7792415
TI  - [Latex allergy in anesthesiology].
AB  - Allergy to latex, described 15 years ago, is increasing. It affects mainly
      certain risk groups, such as health-care workers and patients with spina bifida
      or genitourinary malformations. Symptoms vary in intensity from mild to life
      threatening and can present during any medical procedure involving skin or
      mucosal contact, or inhalation, of the allergen in a previously sensitized
      patient. The most serious cases reported have generally involved patients
      undergoing surgery. Prevention is based mainly on tentative diagnosis made when
      the patient's history is taken, followed by laboratory tests and consultation
      with an allergist. Because prophylactic drug protocols have proven ineffective,
      the patient must be offered a latex-free environment in keeping with standard
      recommendations.

PMID- 7792416
TI  - [Anesthesia in a patient with latex allergy].
AB  - Anaphylactic reactions triggered by latex-based products are increasingly
      frequent, particularly in the hospital environment. We describe a patient with a
      prior history of atopic allergy and documented allergy to latex who was scheduled
      for abdominal surgery. A great deal of anesthetic and surgical equipment contains
      latex and substitutes for such material must be used in order to prevent severe
      hypersensitivity reactions.

PMID- 7792417
TI  - [Postoperative cortical blindness after resection of a retroperitoneal teratoma].
AB  - We present a rare case of cerebrovascular accident involving non-cardiac, non
      neurological, non-carotid surgery in a 44-year-old man with no cardiovascular
      risk factors who underwent retroperitoneal resection of a teratocarcinoma,
      immediately after which he showed signs of confusion accompanied by cortical
      blindness. Neurological signs and symptoms remitted completely 5 days after
      surgery. Complementary tests and the patient's evolution confirmed a diagnosis of
      reversible ischemic neurological deficit.

PMID- 7792419
TI  - [Anesthetic management of the achondroplastic patient].

PMID- 7792418
TI  - [Anesthetic implications in antiphospholipid syndrome. 2 clinical cases].
AB  - Anti-phospholipid syndrome, originally called anticardiolipin syndrome, is
      characterized by the presence of anti-phospholipid antibodies and a marked
      tendency to both arterial and venous thrombosis. The little information available
      on the implications of this syndrome for anesthesia derive from the recent
      description of the disease. We describe 2 patients, each with 1 of the 2 forms of
      antiphospholipid syndrome that have been described to date, and each needing
      surgery for a different reason. The first was a 24-year-old woman who was
      admitted to the hospital with diarrhea, fever and metrorrhagia in her fifth month
      of pregnancy. Blood tests revealed a weakly positive title of anti-cardiolipin
      antibodies. Steroid and antiplatelet therapy was begun. Delivery was at 35 weeks
      by elective cesarean with epidural anesthesia due to oligoamnios. The second
      patient was 52-year-old woman with a history of 13 miscarriages, cerebrovascular
      accident and deep venous thrombosis. She had been diagnosed as having systemic
      lupus erythematosus with anti-phospholipid syndrome and was receiving corticoid
      and antiplatelet therapy. She had been admitted on 2 occasions for epistaxis,
      purpura in the lower extremities and severe thrombocytopenia. The last condition
      did not respond well to immunosuppressant therapy and a splenectomy was therefore
      performed with the patient under general anesthesia. In both cases recovery was
      good in spite of the serious complications of anesthetic management.

PMID- 7792420
TI  - [Anesthesia device compatibile with magnetic resonance].

PMID- 7792421
TI  - [2 cases of anesthesia in long-QT syndrome].

PMID- 7792423
TI  - [Heart transplantation as an alternative to conventional surgical
      revascularization in extensive coronary disease with severe ventricular
      dysfunction. Arguments against it].

PMID- 7792422
TI  - [Cardiac herniation after bilobectomy with partial pericardectomy].

PMID- 7792424
TI  - [Heart transplantation as an alternative to conventional surgical
      revascularization in extensive coronary disease with severe ventricular
      dysfunction. Arguments in its favor].

PMID- 7792425
TI  - [Quality of life in patients with pacemakers].
AB  - INTRODUCTION AND OBJECTIVES: On the occasion of the doctoral thesis
      "Epidemiologic study in pacemaker patients", the social and some health factors
      around the pacemaker patient has been studied. METHODS: Data were obtained by a
      patient verbal questionnaire and the pacemaker follow-up form. The social
      parameters studied are: employment aspects, change life feeling, health feeling,
      sporting activity and change of intensity of pharmacologic treatment. Just to get
      alone a quantitative social parameter, a social resulting punctuation or "social
      balance" has been designed. It has been used in bi-variable relation against the
      symptoms, electrocardiogram, complications, time from the pacemaker implantation,
      pacemaker type, dependence of the pacemaker and social variables between himself.
      Among the 108 variables considered, it has been studied which of them had more
      weight in the "pacemaker profitability". Greatest profitability (and vice versa):
      greatest profit in symptoms and in social conditions, smallest number of
      complications; greater time passed and worst evolution of electrocardiogram. The
      numerical value of the "profitability" is set up by assigning 20 points to each
      foregoing concepts, obtaining a greatest theoretical punctuation of 100 points
      and a smallest of 0 points. RESULTS: We obtained values of arithmetical mean, a
      frequency profile of quality life parameters, a profile of the better and worst
      situation in the bi-variable relation and the definition of those social factors
      who contributed to the segmentation of the "pacemaker profitability".
      CONCLUSIONS: The kind of job and the time of going out of it after the pacemaker
      implantation, the changing life feeling, the health feeling after the pacemaker
      and the transport means to the hospital are the variables which contributed to
      discriminate the major and the minor profitability.

PMID- 7792426
TI  - [Univentricular heart with left morphology with permeable atrio-ventricular
      valves. Study of the bulbo-ventricular foramen with color echo-Doppler.
      Importance for the surgical repair].
AB  - INTRODUCTION AND OBJECTIVES: Bidimensional and color-coded Doppler
      echocardiography were used to study 19 patients with univentricular heart,
      permeable atrioventricular valves, muscular bulbo-ventricular foramen and an
      anterior rudimentary chamber. We evaluated the influence of the foramen upon the
      size of the great vessels, and in consequence the most appropriated surgical
      techniques. MATERIAL AND METHODS: The foramen was measured in two projections at
      the end of the systolic period, and its area was calculated, according to the
      body surface, with the formula S = pi (D1/2 x D2/2). Indexes lower than 2 cm2/m2
      were considered as restrictive. We studied 19 patients that presented a mean age
      of 11 +/- 12 years (range 1 day-39 years). The patients were classified in two
      groups. Group A: patients who had transposition of the great vessels (13 cases).
      Group B: patients who had normal connection of the great vessels (6 cases). Each
      group was classified in two subgroups: subgroup 1, patients who presented a
      restrictive foramen, and subgroup 2, patients who presented a normal foramen. In
      this study, we evaluated the associated cardiac anomalies. RESULTS: Group A.
      Thirteen cases. The index value for the whole group was 2.47 +/- 1.18 cm2/m2. The
      first subgroup included 6 cases with a restrictive foramen, 2 patients presented
      pathology of the arch. Four patients had a pressure gradient between the
      ventricle and the rudimentary chamber beyond 20 mmHg. The index of this subgroup
      was 1.68 +/- 0.39 cm2/m2, the median was 1.7. Seven cases, with a normal foramen,
      were included in the second subgroup, six of them had pulmonary valve stenosis,
      and the other one had undergone a pulmonary artery bandage 2 months before. Only
      one patient had a gradient pressure at the foramen beyond 20 mmHg. The index for
      this second subgroup was 3.34 +/- 0.83 cm2/m2. GROUP B: Six patients with normal
      connection of the great vessels were included. The index was 1.56 +/- 1.17
      cm2/m2. The first subgroup included 3 cases with a restrictive foramen. The index
      was 0.72 +/- 0.29 cm2/m2 (range 0.41-1) and the median was 0.75. Pressure
      gradient between the ventricle and the rudimentary chamber was greater than 20
      mmHg. Three patients with a normal foramen were in the second subgroup and here,
      the index was under normal limits 2.4 +/- 0.52 cm2/m2 (range 2.1-3), the median
      was 2.1. One patient underwent a pulmonary artery bandage two months before.
      CONCLUSIONS: Bulbo-ventricular foramen size/body surface index may exert an
      influence on the size of the vessel connected to the rudimentary chamber. The
      index vary in a negative way with the evolution time, or in those cases with
      transposition of the great vessels after a pulmonary artery bandage. Whenever the
      foramen is restrictive, the pulmonary artery or the aorta have a smaller diameter
      and the pressure gradient between the ventricle and the rudimentary chamber
      rises.

PMID- 7792427
TI  - [Non-surgical extraction of intravascular foreign bodies in children. Experience
      with 8 cases].
AB  - BACKGROUND AND OBJECTIVES: Foreign body retrieval in the catheter room is a
      useful procedure at any age, but, although its interest, few reports of such
      technique have been reported in children. METHODS: We review and present our
      experience in 8 children, aged 5 days to 11 years, five of them having congenital
      hearts defects. RESULTS: We retrieved 4 catheter fragments, 2 endocardial
      electrode catheter tips, 1 Rashkind 12 mm. PDA umbrella, and 1 detachable Jackson
      coil. All of them were placed in systemic veins, right heart chambers or
      pulmonary arteries. We used biplane fluoroscopy and percutaneous right femoral
      vein puncture in all cases. Goose-Neck (Microvena Corporation) snares were used
      in 5 patients, hand made snares in 2 and a Swan-Ganz catheter in one. In 4 cases,
      the snare was introduced trough a Mullins long sheath and the foreign body pulled
      into its distal end, in order to bring it out of the femoral vein. Six foreign
      bodies came off the femoral vein: 4 trough the puncture site and 2 needing a
      venous cut-down. The two remaining foreign bodies, stopped while pulling at the
      common iliac vein and a minor surgical procedure was needed for final extraction.
      CONCLUSIONS: Therapeutic catheterization is the technique of choice for
      intravascular foreign body retrieval in children.

PMID- 7792428
TI  - [Anatomic correction of transposition of great vessels with entire
      interventricular septum. Initial results].
AB  - INTRODUCTION: Optimal management for patients with simple transposition of great
      arteries is currently the arterial switch operation. We review our initial
      experience to evaluate the results. METHOD: From 1988 to 1993, 21 children with
      simple transposition of the great arteries underwent arterial switch operation.
      Mean age at surgery was 10.5 +/- 5.6 days, excluding two cases with two-stage
      arterial switch and one with late diagnosis. Patent ductus arteriosus was present
      in 12 cases, and a small ventricular septal defect in two. The coronary artery
      pattern was unusual in 9 cases. Balloon atrial septostomy was performed in 19
      cases, seven of them using two-dimensional echocardiography. It was considered no
      necessary in the remaining two, with a large ductus arteriosus. RESULTS: Total
      circulatory arrest was used in 13 patients (mean time 29.7 +/- 22.6 min). Three
      patients died in the early postoperative period (14.3%) in a refractory cardiac
      failure, one of them secondary to myocardial necrosis. The coronary artery
      pattern was unusual in two of died patients. All patients but three were in sinus
      rythm. Mean age at follow-up was 21 months (follow-up range 2 months to 5 years).
      Seventeen of surviving patients are in a functional state grade I and one in
      grade II of NYHA. There haven't been late deaths. CONCLUSION: These results
      compared with the ones of atrial switch operation, have encouraged to us to use
      the arterial switch operation in all children with simple transposition of the
      great arteries. Increasing experience will likely lead to improve our results.

PMID- 7792429
TI  - [Cardiovascular pharmacology (XII). Pharmacologic interventions in the
      progression of coronary atherosclerosis].

PMID- 7792430
TI  - [Anomalous origin of the circumflex artery from the pulmonary artery in a patient
      with rheumatic mitral stenosis].
AB  - Left circumflex coronary artery arising from the pulmonary artery is an
      infrequent congenital anomaly, only described once in an adult patient. We
      present one patient with rheumatic mitral stenosis in whom this anomaly was
      noticed when an angiography was performed prior to a percutaneous mitral
      valvuloplasty.

PMID- 7792431
TI  - [Orthotopic heart transplantation in a patient with previously undiagnosed
      persistence of the left superior vena cava].
AB  - The amount of transplants has gone through a remarkable increase during the last
      years. As a result, congenital anomalies of little prevalence appear more and
      more often while performing the transplants. The persistence of upper cava vein
      is one of them and, if not linked to other anomalies, it usually remains
      unnoticed. This article presents a case of an orthotopic cardiac transplant in a
      patient with an upper cava vein duplication not diagnosed before undergoing
      surgery, and it compares the way it was handled to diverse techniques previously
      described.

PMID- 7792432
TI  - [Left aorto-ventricular tunnel. Diagnosis with transthoracic and transesophageal
      echo-Doppler].
AB  - Aortic-left ventricular tunnel is an infrequent congenital heart lesion
      consisting of an abnormal tubular-shaped communication between the aortic root
      and the left ventricle that bypasses the aortic valve. It is clinically
      undistinguishable from aortic insufficiency. Its prompt and precise diagnosis is
      crucial since early surgical treatment is definitely indicated, in contrast to
      aortic insufficiency. In our case, two-dimensional and pulsed color-flow Doppler
      imaging established the diagnosis, and the transesophageal approach was a great
      aid in detecting the aortic opening with its turbulent diastolic flow, and in
      tracing its intramyocardial course. This paper may be of interest not just as a
      new case-report but insofar as it stresses how importantly the transthoracic and
      transesophageal echocardiographic and Doppler scanning contributes to its
      diagnosis and therapeutic indication.

PMID- 7792433
TI  - [Utilization of angiotensin-converting enzyme inhibitors in anterior infarction
      without congestive semiology].

PMID- 7792434
TI  - Nebulizer performance: AFLM study. Association Francaise de Lutte contre la
      Mucoviscidose.
AB  - This study was conducted by the AFLM order to determine the performance
      characteristics of 12 commercially available nebulizers (6 ultrasonic and 6 jet)
      used in the treatment of cystic fibrosis (CF). The nebulizers were connected to a
      circuit which simulated the ventilation of a CF child and CF adult, and were
      tested using three drug solutions: tobramycin (T), colistin (C), and amiloride
      (A). Nebulizer performance was evaluated according to the volume of drug solution
      delivered in 10 min during the simulated inspiratory phase (VI), drug
      granulometry (G%), drug concentration modification in the nebulizer reservoir
      (delta C), and percentage of efficiently aerosolized drug EA%). The ultrasonic
      devices delivered a significantly higher VI than the jet nebulizers (p < 0.0001)
      for all three study drug. Ventilation rate did not influence VI. Regarding
      granulometry, higher percentages of T and A were found to be contained in
      droplets ranging from 0.5 to 5.0 micron following ultrasonic nebulization. Drug
      concentration modifications were independent of the nebulizer used but were
      influenced by drug type; overconcentrations of T and A were observed (delta C =
      +10.5 +/- 18.6 and +13.4 +/- 8.9%, respectively). On average, the ultrasonic
      devices achieved a higher EA% than the jet nebulizers (17.3 +/- 6.7 and 9.7 +/-
      9.6%, respectively). This study highlights the significant variability in
      performance of different nebulizer types and empahsizes the importance of
      accurately testing nebulizers prior to clinical use so that the most efficacious
      nebulizer/drug combinations may be prescribed.

PMID- 7792435
TI  - Aerosol administration of antibiotics.
AB  - Aerosol administration of antibiotics is an attractive approach to the treatment
      of the recurrent respiratory infections experienced by patients suffering from
      cystic fibrosis (CF). Through aerosol administration, drugs can, theoretically,
      be delivered directly to the target site of infection, i.e. the lumen of the
      lower respiratory tract, thus enabling smaller doses to be given. This, in turn,
      should result in reduced costs and decreased potential for systemic toxicity. The
      efficacy of aerosol antibiotic therapy is, however, influenced by numerous
      variables, including the type of nebulizer device used to deliver the aerosol,
      the drug's physical properties, its concentration in the aerosol and particle
      size, carrier gas and patient factors. The efficacy of aerosol antibiotics in the
      treatment of CF is controversial. This appears to be due mainly of problems and
      inconsistencies with clinical trials. However, various antibiotics, including
      beta-lactams, polymyxins and aminoglycosides, have demonstrated clinical benefits
      when administered by inhalation to CF patients.

PMID- 7792436
TI  - Physical and functional properties of airway secretions in cystic fibrosis-
      therapeutic approaches.
AB  - The airway secretions which line the respiratory tract form a biphasic layer
      composed of an aqueous 'sol' layer and a more superficial 'gel' layer. In the sol
      layer, also described as the 'periciliary' layer or 'airway surface fluid', the
      cilia beat and relax. The lubricant sol layer enables the gel mucus present at
      the tips of the cilia to be transported by the ciliary beating of the ciliated
      cells. Due to difficulties with sampling, little is known about the physical and
      biochemical properties of the sol layer. The gel layer is composed of high
      molecular weight glycoproteins (mucins) linked with proteins and lipids. They
      form a gel network with a high water content (95%) and rheologic and physical
      properties (viscoelasticity, adhesivity) adapted in normal conditions to protect
      the airway mucosa, particularly through mucociliary transport. The adhesive
      properties of mucus, which are influenced by its lipid composition and degree of
      hydration, are very important in controlling the efficacy of mucus transport
      through ciliary activity and coughing. An intermediate viscosity and elasticity
      is required for optimal mucociliary transport. In obstructive airway diseases,
      either of genetic origin, such as cystic fibrosis (CF), or acquired (acute or
      chronic bronchitis), and particularly during inflammatory and infectious
      episodes, mucus dehydration is associated with an increase in secreted or
      transudated molecules and with marked augmentation of DNA content. These
      abnormalities contribute to the increased viscosity and adhesivity of the airway
      secretions and are responsible for their abnormally low transport rate by ciliary
      activity and for inefficient cough clearance. In view of these alterations in the
      physical and functional properties of CF airway secretions, pharmacologic
      approaches should aim to rehydrate the mucus and to restore normal mucociliary or
      cough transport by stimulating chloride ion secretion (i.e. using UTP or ATP
      associated with amiloride in order to block sodium ion and water reabsorption).
      During acute episodes of infection, recombinant human DNase (rhDNase) may rapidly
      prevent mucus stasis by improving its rheologic properties. Lubrication of the
      mucus at the sol phase interface by 'surfactant' therapy may also represent a
      very promising therapeutic perspective to reduce the hyperviscosity and
      hyperadhesivity of airway secretions.

PMID- 7792437
TI  - Proteases and antiproteases in cystic fibrosis: pathogenetic considerations and
      therapeutic strategies.
AB  - The association between abnormal chloride transport, resulting from mutations in
      the cystic fibrosis transmembrane regulator (CFTR) gene, and the immunologic
      processes involved in the development of CF lung disease is poorly understood.
      However, neutrophil-dominated inflammation on the respiratory epithelial surface
      is a common finding in CF patients and suggests a mechanism for the immunologic
      abnormalities described in CF. Of particular importance for the pathophysiology
      of CF are proteases such as neutrophil elastase (NE) which are released from
      neutrophils in CF airways and cause direct structural damage to respiratory
      tissue. In healthy individuals, the deleterious effects of excess protease
      activity in the respiratory system are inhibited by antiproteases such as alpha 1
      antitrypsin (alpha 1AT) and secretory leukoprotease inhibitor (SLPI). However, in
      CF, antiproteases are outnumbered by proteases and this protective mechanism is
      rendered ineffective. Restoration of this protease/antiprotease balance through
      antiprotease replacement therapy is currently under clinical investigation and
      preliminary results are promising.

PMID- 7792439
TI  - Quantitative methods for utilization of multi-source data in public health.
      Proceedings of a symposium.

PMID- 7792438
TI  - Clinical studies of rhDNase in moderately and severely affected patients with
      cystic fibrosis--an overview.
AB  - Clinical data are now available on the use of recombinant human DNase (rhDNase)
      in the treatment of CF patients with mild, moderate and severe pulmonary disease.
      Phase I studies were conducted and indicated the initial safety of rhDNase in
      humans. In the US phase II study, 181 patients with FVC > or = 40% were randomly
      allocated to receive rhDNase 0.6, 2.5, 10 mg, or placebo twice daily for 10 days.
      All three doses of rhDNase significantly improved FEV1 10-14% and FVC 10-12%
      compared to placebo. There was no significant increase in serious intercurrent
      events but a slight increase in pharyngitis and voice alteration. A phase II
      study including 71 patients was carried out in the UK. FEV1 improved by 13% from
      baseline compared to placebo. There was an improvement in CF-related symptoms and
      no increase in serious adverse events. The phase III double-blind placebo
      controlled study included 968 patients with FVC > or = 40% predicted. These
      patients were randomized to 2.5 mg rhDNase, once or twice daily, or placebo for
      24 weeks. Compared to placebo, rhDNase-treated patients had a relative risk of
      protocol-defined respiratory tract infection reduced by 22 and 34% and improved
      FEV1 compared to baseline by 5.8% (p < 0.001) and 5.6% (p < 0.001), respectively,
      compared to placebo. A double-blind, short-term, placebo-controlled study in
      severely ill patients, FVC < 40% predicted, showed the drug to be safe but there
      was no significant improvement in lung function. After a further 6-month open
      label treatment, patients showed improvement in FEV1 and FVC.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7792440
TI  - Meta-analysis: reconciling the results of independent studies.

PMID- 7792441
TI  - The development of the series of U.S. cancer atlases: implications for future
      epidemiologic research.
AB  - An historic perspective on the development of the National Cancer Institute's
      series of cancer atlases is provided. Emphasis is placed on the role which
      emergent questions concerning environmental determinants of cancer played in the
      acquisition and utilization of data resources. Studies which were fielded as a
      consequence of the atlases are highlighted. The legacy of the collective effort
      of many persons who worked on the development of the cancer atlases-the
      facilitation of many current epidemiologic investigations-is discussed.

PMID- 7792442
TI  - Linking public health data using geographic information system techniques:
      Alaskan community characteristics and infant mortality.
AB  - This article identifies geographical contexts important in differentiating infant
      mortality in Alaska and uses spatial processing models to link and analyse multi
      source data. Information characterizing geographical locations are collected from
      Alaska's vital statistics for the years 1982-91 and the 1990 Census. Geographic
      information system (GIS) techniques are applied to identify spatially homogeneous
      regions, assess spatial compatibility across databases, and allocate geographical
      units across boundaries. A primary goal of this paper is to encourage spatial
      linkage and analysis techniques for vital statistics and census data. By
      demonstrating the interplay of tabular, graphical, and mapping techniques on
      Alaskan infant mortality, this analysis describes procedures for conducting
      epidemiological research with data spatially defined at distinct geographical
      levels.

PMID- 7792443
TI  - Probabilistic linkage of large public health data files.
AB  - Probabilistic linkage technology makes it feasible and efficient to link large
      public health databases in a statistically justifiable manner. The problem
      addressed by the methodology is that of matching two files of individual data
      under conditions of uncertainty. Each field is subject to error which is measured
      by the probability that the field agrees given a record pair matches (called the
      m probability) and probabilities of chance agreement of its value states (called
      the u probability). Fellegi and Sunter pioneered record linkage theory. Advances
      in methodology include use of an EM algorithm for parameter estimation,
      optimization of matches by means of a linear sum assignment program, and more
      recently, a probability model that addresses both m and u probabilities for all
      value states of a field. This provides a means for obtaining greater precision
      from non-uniformly distributed fields, without the theoretical complications
      arising from frequency-based matching alone. The model includes an iterative
      parameter estimation procedure that is more robust than pre-match estimation
      techniques. The methodology was originally developed and tested by the author at
      the U.S. Census Bureau for census undercount estimation. The more recent advances
      and a new generalized software system were tested and validated by linking
      highway crashes to Emergency Medical Service (EMS) reports and to hospital
      admission records for the National Highway Traffic Safety Administration (NHTSA).

PMID- 7792444
TI  - Evaluating the quality of anonymous record linkage using deterministic procedures
      with the New York State AIDS registry and a hospital discharge file.
AB  - Linkage of same-person records across multiple databases relies on high-quality,
      uniformly available identifying information. These data quality issues become
      increasingly important when personal names are not available for record linkage.
      Using deterministic decision criteria, we linked records from two population
      based files in the absence of personal names. The sensitivity of anonymous record
      linkage procedures ranged from 32 to 85 per cent for the two years studied, and
      the positive predictive value (PPV) ranged from 14 to 99 per cent. Decreasing
      sensitivity and PPV were primarily attributed to (1) errors in computerized
      identifying information and (2) the deterministic decision criteria specified for
      record linkage. An evaluation of the contribution of personal names to the
      quality of record linkage found no measurable impact.

PMID- 7792446
TI  - On combining dose-response data from epidemiological studies by meta-analysis.
AB  - Using data from a meta-analysis of the effects of oestrogen replacement therapy
      on the development of breast cancer, we compared alternative methods for
      combining dose-response slopes from epidemiological studies. We evaluated issues
      related both to summarizing data from single studies and to combining results
      from multiple studies. Findings related to the analysis of individual dose
      response studies include: (1) a method of weighing studies that gives greater
      influence to dose-response slopes that conform to the linear relation of relative
      risk to duration can lead to large differences in calculated weights as a
      function of non-linearity; (2) a regression model using a variable-intercept
      resulted in a mean dose-response slope that increased as much as threefold when
      compared with the values obtained with a zero-intercept model. When combining
      results from multiple studies, we found: (1) calculating standard errors of mean
      dose-response slopes by methods that allow for both among-study and within-study
      variability (a random-effects type model) gave values different from a method
      that assumes homogeneity and equal within-study precision (a fixed-effects
      model); (2) the random-effects model gives mean and standard error results most
      similar to a bootstrap resampling method as increasing heterogeneity is observed
      (however, this model could give biased mean estimates compared with the bootstrap
      method); (3) a components-of-variance model compares favourably with the
      bootstrap and is easier to apply than the random-effects model. Based on these
      findings, we recommend the use of methods which incorporate heterogeneity to
      guard against underestimating the standard error. However, caution is urged
      because bias in point estimates can occur if extreme heterogeneity is present.
      Two other observations affect the interpretation of data combined from multiple
      studies. First, inclusion into a model of quality scores assigned by blinded
      reviewers had little effect on the mean dose-response slope and its standard
      error. Second, the number of studies required to achieve desired statistical
      power, varies with effect size.

PMID- 7792445
TI  - Verification of information in a large medical database using linkages with
      external databases.
AB  - Efforts to utilize Uniform Hospital Discharge Data Sets (UHDDS) for
      epidemiological studies have been hampered by the limitations of those databases.
      The purpose of this paper is to illustrate that linking to external databases can
      provide the verification necessary to overcome many of those limitations. This
      method has dramatically altered study design at the Connecticut Hospital Research
      and Education Foundation and has provided an efficient method for specifying data
      collection weaknesses within the resident databases.

PMID- 7792447
TI  - Meta-analytic approaches to dose-response relationships, with application in
      studies of lung cancer and exposure to environmental tobacco smoke.
AB  - This paper outlines several meta-analytic approaches to the assessment of quantal
      dose-response relationships; that is, to the evaluation of an increase in the
      level of exposure to an agent and the associated relative risk of a disease when
      this is investigated over a number of different studies. Analysis is developed at
      two levels: first, a consistent method of evaluating the dose-response
      relationship is applied to each study, and second, an overall picture is obtained
      by comparing and combining these relationships. At the first stage, for an
      individual study, dose-response assessment involves choices of model and
      appropriate tests for trend, which are influenced by such issues as dose
      measurement and use of the unexposed group. At the second stage, different
      methods for pooling results across studies must be considered. These depend on
      the choices made in the first stage of analysis, with additional attention paid
      to heterogeneity, and possible bias due to studies included in meta-analysis. We
      describe these meta-analytic approaches for three methods of evaluating dose
      response. The approaches are illustrated by evaluating the relationship between
      lung cancer and levels of exposure to environmental tobacco smoke (ETS). The
      strength of this relationship has been a point of debate in recent assessment of
      evidence for an overall carcinogenic effect of ETS exposure. We find little
      indication of a consistent dose response, a result explained in terms of recent
      models for cancer and passive smoking developed by Darby and Pike, the current
      meta-analysis results of overall risk-ratios of current studies in Tweedie and
      Mengersen, and misclassification models developed by the United States
      Environmental Protection Agency (EPA).

PMID- 7792448
TI  - A dual frame design for sampling elderly minorities and persons with
      disabilities.
AB  - Multiple data sources are sometimes available as potential sampling frames for
      population surveys, and in some situations the use of a multiple frame sample
      design is more advantageous than using a single sampling frame. The use of
      multiple sampling frames, however, has variance and bias implications, as well as
      sampling, data collection, and logistical considerations. These issues are
      addressed for a proposed dual frame sampling approach in the National Health
      Interview Survey (NHIS). The results of an investigation of the sampling
      efficiencies and operational issues in supplementing the NHIS area frame sample
      with a sample of elderly African and Hispanic Americans and persons with
      disabilities selected from Social Security Administration files are presented.

PMID- 7792450
TI  - Development and applications of a city-level alcohol availability and alcohol
      problems database.
AB  - Data on alcohol availability and problems in all cities in Los Angeles County
      were collected from several different sources and linked together to form a Local
      Alcohol Availability Database (LAAD). The two major purposes of the project are
      to provide a city-level alcohol availability and alcohol-related problems
      database needed by local community alcohol policy planners and to collect the
      data necessary for research on the relationship between these measures. The
      prevalence of drunk driving arrests is displayed on a map. We describe how the
      LAAD has been used to guide alcohol policy decisions. A fixed year and city
      effects regression model suggests that outlet density is positively related to
      several alcohol-related problems.

PMID- 7792451
TI  - Feasibility of contour mapping epidemiological data with missing values.
AB  - Data of epidemiologic interest often occur as spatial information during each of
      several time periods. In most cases data are available from a set of regions or
      localities which can be viewed as points in a plane. Although contour mapping is
      useful for displaying these data, the lack of data for all data points in a
      region may lead to erroneous interpretation. In this paper we use stimulation to
      investigate the impact of missing data points for contour mapping using two
      distinct simulated spatial-time distributions for epidemiologic variables. A
      model for the occurrence of malaria in localities randomly distributed in one
      region is chosen as the prototype for data generation.

PMID- 7792449
TI  - Multiple hypothesis tests in multiple investigations.
AB  - Inferential statistical methods have traditionally been based on the assumption
      that one experiment is performed and that interest centres on one or more
      predetermined hypothesis tests. Exploratory research, on the other hand, often
      involves multiple hypotheses or repeated investigations under similar or
      different conditions or both. Several techniques have been proposed to deal with
      multiple or simultaneous hypothesis testing in single investigations, and
      procedures to combine observed significance levels for an individual hypothesis
      test from two or more investigations have been suggested. In this paper we
      propose a method for identifying important results from multiple statistical
      tests in multiple investigations. The method is illustrated by using high
      performance liquid chromatography to identify potential aetiologic contaminants
      in L-tryptophan samples.

PMID- 7792452
TI  - Effects of the choice of age-adjustment method on maps of death rates.
AB  - Maps of morbidity or mortality rates, whether considered individually or as a
      layer in a geographic information system application, invite multiple comparisons
      of area rates. However, comparisons of rates across different populations require
      standardization of the age-specific rates to account for differences in
      population age structures. The indirect standardization method, or equivalently
      the standardized mortality ratio (SMR), has been recommended for small areas
      where age-specific rates can be quite variable. Although theoretically equivalent
      to directly adjusted rates under the assumption of independent age and area
      effects, indirect summary measures are not comparable across areas when this
      assumption is violated. We tested the validity of this assumption for the 10 most
      common causes of death in the United States during 1980-84 and examined the
      geographic clustering apparent when categorized death rates, adjusted by
      different methods, are presented as thematic maps. Although overall agreement
      between the methods was good (rank correlation coefficient > 82 per cent for each
      cause), when the adjusted rates were classified into quintiles 18 per cent of the
      states fell into different categories depending on the method of adjustment.
      Using an internal standard for the indirect method reduced this discrepancy to
      4.9 per cent. However, both traditional chi-square tests and a generalized
      logistic spline model identified significant interactions between age and area
      for each cause of death, a violation of the assumption required for equivalence
      of the methods. Potential variation in geographic inferences is illustrated by
      maps of direct and indirect rates and an empirical Bayes posterior mean, which is
      a function of these traditionally adjusted rates. Based on these results, we
      recommend the direct age-adjustment method for rate maps.

PMID- 7792454
TI  - Differences in morbidity measures and risk factor identification using multiple
      data sources: the case of coronary heart disease.
AB  - The NHANES I Epidemiologic Followup Study contains several sources of information
      that can be used to define case status. Incidence rates and relative risks
      associated with selected, documented risk factors for heart disease were
      estimated using nine different case definitions. Despite wide variation in the
      estimates of incidence, the characteristics of the cases were remarkably similar
      as were the risks associated with heart disease incidence. The main difference
      occurred when cases were defined on the basis of death certificate information.
      Cases defined this way are more severe and models based on this definition result
      in relative risks of greater magnitude.

PMID- 7792455
TI  - The price and purity of cocaine: the relationship to emergency room visits and
      death, and to drug use among arrestees.
AB  - This paper examines the relationship of the price and purity of cocaine to
      emergency room visits and deaths associated with cocaine use and to cocaine use
      among arrestees. A model is developed for the trend in cocaine prices at the
      retail level during the period January 1986 to December 1991. This trend is then
      compared to information on emergency room visits, medical examiner reports, and
      the percentage of arrestees testing positive for cocaine use over the same
      period. The principal conclusion is that there is a significant negative
      relationship between the estimated street price of cocaine and the level of
      related medical emergencies and deaths and the number of arrestees who test
      positive for cocaine.

PMID- 7792453
TI  - Public health surveillance for chronic conditions: a scientific basis for
      decisions.
AB  - In this paper we investigate the important contribution of multiple public health
      surveillance systems to policy in chronic disease control and prevention. We show
      that, typically, surveillance for chronic diseases relies on multiple data
      sources, often created for another purpose. We also define the concept of burden
      for chronic conditions based on data from multiple sources. An example from a
      state illustrates a model for combining data for use in policy development. These
      applications illustrate the central role of statistical methods in ensuring the
      appropriate use of data from multiple surveillance systems.

PMID- 7792456
TI  - Combining National Health Interview Survey Datasets: issues and approaches.
AB  - This paper identifies issues, special problems, and approaches in preparing
      estimates when combining National Health Interview Survey (NHIS) datasets. Such
      datasets can be used to produce estimates jointly based on individual NHIS survey
      components. This paper illustrates several issues associated with the analysis of
      multiple related datasets.

PMID- 7792457
TI  - Meta-analysis for dose-response models.

PMID- 7792458
TI  - Data linkage.

PMID- 7792459
TI  - Utilization. 1: special datasets.

PMID- 7792460
TI  - Utilization. 2: special datasets.

PMID- 7792461
TI  - Study design and public health planning.

PMID- 7792462
TI  - Methodologic issues.

PMID- 7792463
TI  - [Progress in hepatitis diagnosis].
AB  - Until today only five pathogens of viral hepatitis have been discovered:
      hepatitis virus A (HAV), B (HBV), C (HCV), D (HDV) and E (HEV). An update on the
      state of the art of actually established diagnostic procedures is briefly
      summarized. Some recent topics and problems are covered more extensively; in the
      case of HBV the value of HBsAG concentration as a prognostic marker, the finding
      'anti-HBc only' the role of HBV mutants, the determination of circulating HBV
      genomic material, and modalities for HBV vaccination control; in the case of HCV
      the indications for study of its viral genomic material and the role of HCV
      subspecies are explained. Finally, first results on HEV prevalence in Switzerland
      are introduced.

PMID- 7792464
TI  - [Portal hypertension].
AB  - Portal hypertension is a frequent and dangerous consequence of chronic liver
      diseases. The most important complications are ascites and variceal bleeding. In
      this article new pathophysiological theories of portal hypertension are reviewed.
      In addition, the prophylactic and therapeutic management of variceal bleeding are
      discussed.

PMID- 7792465
TI  - [Therapy in hepatic ascites].
AB  - This is a review on the pathogenesis, precipitating causes, analyses,
      complications, prognosis and therapeutic possibilities of hepatic ascites for
      practical purposes. Among the possible analyses, granulocyte count, difference
      between serum albumin and ascitic albumin, cytologic evaluation and bacterial
      culture in blood-culture media are the most promising. Spontaneous bacterial
      peritonitis often shows no local clinical signs and carries a bad prognosis,
      unless looked for and treated. The hallmark of treatment of hepatic ascites
      consists of reduced sodium intake, diuretics and total paracentesis.
      Peritoneovenous shunt, TIPPS and hepatic transplantation are options in
      refractory cases.

PMID- 7792466
TI  - [Dyspepsia: work-up or provisional treatment?].
AB  - Dyspepsia is defined as symptoms that are considered by a physician to originate
      from the upper gastrointestinal tract. The term 'functional dyspepsia' designates
      dyspepsia after exclusion of organic causes. Dyspepsia is a frequent problem in
      general practice. Mainly for economical reasons, it is impossible to perform
      every available diagnostic test in every patient to exclude all possible organic
      causes. The initial work-up is directed at identifying alarm symptoms and alarm
      signs from history, physical examination, and simple laboratory tests. The
      presence of any alarm symptoms or alarm sign requires prompt investigation. If
      none can be found, empirical drug treatment may be performed according to the
      leading symptom. Treatment failure or rapid recurrence require additional
      investigations, in particular by gastroscopy.

PMID- 7792467
TI  - [Gastroduodenal ulcer disease: update on pathogenesis].
AB  - Gastroduodenal ulcer disease comprises a heterogeneous group of different
      diseases resulting uniformly in a mucosal defect reaching beyond the muscularis
      mucosae. Consequently, a single unifying pathogenesis of ulcer disease does not
      exist but only a rather general concept that ulcers develop when mucosa-injuring
      factors outweigh the mucosa-protecting factors. According to this concept, ulcers
      develop within a broad range of different possibilities in the relation of mucosa
      injuring factors to impaired mucosal protection. The main histological and
      physiological elements for the understanding of peptic ulcer disease are briefly
      summarized, followed by a short survey of the important known 'traditional'
      abnormalities of possible pathogenetic importance in duodenal and gastric ulcer
      patients. Gastroduodenal ulcer disease represents a typical example of a
      multifactorial disease, where different combinations of both hereditary and
      environmental factors produce the same morphological lesion. By far the most
      exciting data of the last ten years originate from the still increasing
      understanding of the role of Helicobacter pylori in gastroduodenal ulcer disease.
      The most important evidence and hypotheses are presented of how and where
      Helicobacter pylori is or could be involved in the complicated pathogenetic
      network of ulcer disease. The infection of gastric epithelium by Helicobacter
      pylori has become the second main factor besides acid/pepsin in the pathogenesis
      of ulcer disease. Beside the improved insights in ulcer pathogenesis, the
      translation of the new data into clinical medicine has led and will lead to
      remarkable progress. Most important: a causal therapy of ulcer disease has become
      available in contrast to the so far practiced sole symptomatic treatment of
      single ulcer episodes. What has treatment of single ulcer episodes. What has been
      a domain of ulcer surgery has come into reach of drug therapy.

PMID- 7792468
TI  - [Psychosocial aspects of the climacteric].
AB  - Medicine has till now payed less attention to psychosocial aspects of the
      menopause than to the hormonal changes of woman in this period of life. The
      climacteric woman is characterized in the language of the organ-medicine by
      faulty terms. The lack of hormones is considered to be a disease which has to be
      treated. The tendency to medicalize the menopause is in contradiction to the
      results of recent prospective studies. These studies show that pre- and
      postmenopausal complaints are less severe than they are often described.
      Psychosocial risk factors before and during the climacteric phase favour the
      development of psychic and psychosomatic symptoms. The climacteric period of life
      has to be seen as a vulnerable time of life which should be considered in the
      treatment of menopausal women.

PMID- 7792469
TI  - [Pharmacotherapy of sleep disorders using benzodiazepine hypnotics and their
      analogs].
AB  - Benzodiazepine hypnotics and analogs promote the inhibitory neurotransmitter GABA
      in the brain. The individual substances of this class differ mainly with respect
      to their elimination half-life. They are all effective hypnotics, but exhibit a
      number of undesired effects. Hypnotics should be administered generally for the
      short-term treatment of insomnia, and they should be prescribed for a prolonged
      time period only exceptionally.

PMID- 7792470
TI  - [Female incontinence: work-up and therapy].
AB  - Female incontinence is a more frequent disorder than sometimes realized. The
      patient should be asked about urinary incontinence symptoms. Depending on her
      degree of suffering, the appropriate diagnostic examinations and therapy can be
      chosen. With simple procedures, such as anamnesis, gynecological examination with
      testing, Valsalva maneuver with a full bladder, and a review of miction diaries,
      the kind of incontinence can be reliably determined, and first therapeutic steps
      can be initiated. For stress incontinence this would be pelvic floor reeducation
      or physical therapy with electric stimulation and bio-feed-back; only if these
      conservative measures fail, one should operate. For urge incontinence, it is
      important to strive for a change in drinking and miction habits (bladder
      training), i.e., to increase the amount of liquid intake and the miction volume
      (checked by miction diaries). This therapy can be further supported by
      medication. Urodynamic diagnostic examinations are indicated when primary therapy
      (pelvic floor reeducation, bladder training) fails, before any incontinence
      operation and when the type of incontinence is not clear.

PMID- 7792471
TI  - [Sleep apnea syndrome and morbid snoring].
AB  - Regular, continuous snoring usually does not have any sleep disturbing effects;
      however, discontinuous snoring may be associated with increased upper airway
      resistance and leads to recurrent arousals, sleep fragmentation and excessive
      daytime sleepiness. Loud snoring, recurrent obstructive apneas and oxygen
      desaturation during sleep with excessive daytime sleepiness are the hallmarks of
      the obstructive sleep apnea syndrome (OSAS). A tentative diagnosis of disturbed
      breathing during sleep can be made from a careful history and confirmed by a
      sleep study. Continuous positive airway pressure (CPAP) applied by a nasal mask
      is the primary treatment for OSAS and for snoring associated with increased upper
      airway resistance and symptoms of sleep disruption. CPAP may improve sleep
      quality, excessive daytime sleepiness, and potentially vascular morbidity and
      mortality among patients with severe OSAS.

PMID- 7792472
TI  - [Cerebellar ataxia with autosomal dominant transmission].

PMID- 7792473
TI  - [Radiation-induced neuropathies. Experimental and clinical data].
AB  - In contrast with the central nervous system, the peripheral nerves are usually
      considered radioresistant. However, experimental and clinical data show evidence
      of peripheral nerve injury after radiation therapy. The physiopathology remains
      unclear. Vascular alterations appear to play an important role. Direct damage to
      axon or Schwann cell and nervous compression in areas of radiation fibrosis could
      also be involved. Clinically, brachial plexopathy is a well-recognized
      complication but all the structures of the peripheral nervous system can be
      involved: cranial nerves, roots, plexus and nerve trunks. A syndrome of early and
      reversible plexopathy differs from the classical progressive form with pejorative
      outcome. Radiation-induced peripheral nerve tumors are infrequent.

PMID- 7792474
TI  - [Cerebral localizations before Charcot].

PMID- 7792475
TI  - [A study network of human spongiform encephalopathies: 1st results].
AB  - Several French teams including clinicians and researchers have created a group
      within the European network for the study of Creutzfeldt-Jakob disease and other
      human spongiform encephalopathies. The main objectives are to monitor the
      incidence of the disease and to search for possible risk factors with a case
      control study. The diagnosis is based on neuropathological studies or the
      identification of an abnormal protein prion in cerebral fragments. The sequence
      of the gene encoding for the prion protein has was studied from blood or cerebral
      samples. The early results indicate that the incidence, mortality and clinical
      presentation remain relatively constant compared with earlier studies. Studying
      the expression of the 129 codon of the prion protein gene has led to the
      verification that homozygous methionine/methionine forms predominate in sporadic
      forms.

PMID- 7792476
TI  - [Mitochondrial encephalopathies with late disclosure and predominant involvement
      of central nervous system].
AB  - We report three cases of mitochondrial encephalomyopathy affecting predominantly
      the central nervous system; two patients had the MELAS syndrome and one had
      "ophthalmoplegia plus". Histoenzymatic analysis of muscle biopsy and biochemical
      studies of muscle mitochondria demonstrated myopathy associated with partial
      deficiency of complex I of the electron transfer chain in three cases, complex IV
      in two cases and complex III in one case. Molecular analysis of mtDNA in the
      first case did not revealed any abnormality. Coenzyme Q10 therapy improved
      exercise tolerance but not the central nervous signs.

PMID- 7792477
TI  - [Leptomeningeal gliomatosis. 2 clinicopathological cases].
AB  - Leptomeningeal gliomatosis is a diffuse glial infiltration of the subarachnoid
      space. It is primary and very rare when primary astrocytoma arises in the
      leptomeninges from heterotopic neuroglial tissue; it is secondary and more
      frequently reported when associated with a medullar or cerebral intraparenchymal
      astrocytoma and secondary involvement of the leptomeninges. Primary and secondary
      forms are difficult to differentiate before neuropathological examination. The
      authors report 2 anatomo-clinical cases of leptomeningeal gliomatosis in adults,
      with clinical courses of 6 months and 40 days respectively. The initial clinical
      picture was aseptic chronic or subacute meningitis. Cytologic examinations of the
      cerebrospinal fluid (CSF) showed moderate lymphocytosis, with elevated protein
      and low glucose levels, without abnormal cells. On case 2 CT scan and in case 1
      spinal MRI isolated diffuse meningeal contrast enhancement was present, without
      intraparenchymal lesion. The neuropathological study revealed a diffuse
      astrocytoma glial leptomeningeal tumour with a focal involvement of the central
      nervous system (spinal cord in one case, temporal lobe in the other). In
      conclusion, an isolated aseptic lymphocytosis meningitis with meningeal abnormal
      signal may reveal leptomeningeal gliomatosis. Neuropathological examination can
      distinguish primary from secondary forms.

PMID- 7792478
TI  - [Subacute leukoencephalopathy of the rhombencephalon after pituitary
      radiotherapy].
AB  - Two patients had early delayed leucoencephalopathy mainly confined to the
      brainstem after radiotherapy for pituitary tumours. To our knowledge, we report
      the first MRI description. The patients had somatotroph cell adenomas (associated
      with prolactin secretion, patient 2). Surgical removal of the adenomas were
      complete (patient 1) and partial (patient 2). Both underwent pituitary
      irradiation: patient 1, 55.8 Gy (31 x 1.8 Gy); patient 2, 54 Gy (27 x 2 Gy). Six
      weeks after completion of radiation, the patients had low vigilance, sleepiness,
      cerebellar symptoms, optic neuropathy (patient 1), CSF inflammatory reaction. T2
      weighted MRI scans showed hypersignal in brainstem, cerebellar peduncles (both
      patients), temporal lobe white matter (patient 2). T1-weighted images showed
      hyposignals, pseudonecrotic and contrast-enhanced images in brainstem (patient
      1). Both patients responded to intravenous then oral steroid treatment with a
      progressive and complete clinical recovery. Radiological abnormalities improved
      with clinical statement. Present characteristics support a demyelinating
      mechanism of early delayed cerebral radiation injuries.

PMID- 7792479
TI  - [Cerebral cysticercosis treated by albendazole: development of cerebral magnetic
      resonance imaging].
AB  - A 36-year-old Indian man presented with a generalized tonic-clonic seizure. The
      diagnosis of neurocysticercosis was suspected by the presence of multiple cystic
      and nodular cerebral lesions on MRI, and was confirmed by serological studies
      (ELISA). He was treated with albendazole during one week at the daily dose of 15
      mg/kg. This case illustrates the advantage of MRI over CT for the detection and
      the therapeutical follow-up of neurocysticercosis. Moreover, the MRI findings can
      be correlated to the anatomical stage of neurocysticercosis, proposed by Escobar
      (1983); four stages are described: I = vesicular stage (living larvae), II =
      vesicular colloidal stage (degenerating larvae), III and IV, granular nodular and
      nodular calcified inactive stages respectively.

PMID- 7792480
TI  - [Spinal dural fistula with peri-medullar venous drainage].
AB  - Clinical and neuroradiological findings of 8 patients with a spinal dural
      arteriovenous fistula are reviewed. Disturbance of micturition or defecation and
      weakness of the legs were always present and the most frequent initial symptom
      was a progressive spastic paraparesis. Duration of symptoms before diagnosis was
      2 years. Lumbar puncture showed elevation of proteins and myelography
      demonstrated dilated perimedullar posterior veins. In every case, magnetic
      resonance imaging of the spinal cord (T2- weighted images) revealed
      intramedullary high signal intensity of the conus medullaris and selective
      angiography confirmed the site of the dural fistula. Each patient was treated
      with endovascular method consisting in liquid adhesive embolization (0.2 cc of N
      butyl cyanoacrylate) with hyperselective catheterism of the dorsospinal artery.
      Embolization procedure was successful in 6 cases with large improvement of leg
      weakness and partial regression of disturbed micturition and defecation. The
      pathophysiological mechanisms explaining the clinical signs are discussed.

PMID- 7792481
TI  - [Nocturnal orthosis: a new treatment of compression of the ulnar nerve at the
      elbow. 30 cases].
AB  - Compression of the ulnar nerve at the elbow was confirmed by electromyography in
      30 patients including 29 cases of idiopathic aetiology and 1 case of late onset
      ulnar palsy. Six cases occurred after general anaesthesia and 3 had undergone an
      unsuccessful operation. All patients were managed solely with an orthesis worn at
      night. The orthesis held the elbow in 60 degrees flexion. Clinical improvement
      was noted in all cases (including the 3 cases of unsuccessful surgery) evaluated
      by the patient and the physician at 88% on the average. Improvement occurred
      rapidly and was evaluated at 50% on day 15 in 9 out of 10 patients seen on this
      day. The level of improvement was directly related to regular use of the
      orthesis. Seven electromyographic criteria were measured and nerve conduction
      speed was 33.0 m/sec (motor and sensory) and improved significantly by 7.3 m/sec
      (motor) and 9.5 m/sec (sensory) in all cases but one (p < 10(-8)). In conclusion,
      this simple non-invasive management protocol is not a simple symptomatic
      treatment but helps restore nerve function. The effectiveness of this method
      suggests that nocturnal position plays a major role in impairment due to
      compression of the ulnar nerve.

PMID- 7792482
TI  - [Multiple and recurrent paralysis of cranial nerves: primary Gougerot-Sjogren
      syndrome].
AB  - Over a period of 10 years, a 49-year-old man had 3 episodes of recurrent cranial
      nerve palsy regressing within a few weeks. Each episode was accompanied with
      acute inaugural headache and diplopia and once with sensory impairment of the
      trigeminal nerf and once with tinnitus. The diagnosis of Goujerot-Sjogren's
      syndrome was retained after demonstration of hypergammaglobulinaemia, a positive
      Rose Bengale test and histological examination of biopsy specimens from the
      accessory salivary glands which revealed advanced typical lesions. Clinically,
      impaired secretion was not obvious.

PMID- 7792483
TI  - [Acute motor axonal neuropathy with favourable outcome after Salmonella Ohio
      infection].
AB  - We report one patient presenting an acute weakness following an infection with
      Salmonella Ohio. Diagnosis was Guillain-Barre syndrome (GBS). However,
      preservation of reflexes and electrophysiological study showing purely axonal
      pattern make this case different from typical GBS. Outcome was favourable. There
      are probably various forms of GBS and the axonal form do not always carry a bad
      prognosis as previously reported.

PMID- 7792484
TI  - [Case presentation at Salpetriere Hospital, March 1993. Bucco-facial dyskinesis,
      memory disorder and psychomotor inertia in a 52-year-old man].

PMID- 7792485
TI  - [Charcot-Marie-Tooth disease type II and dopa-sensitive Parkinson syndrome].

PMID- 7792486
TI  - [Study of 82 cases of infarction in the posterior cerebral arteries].

PMID- 7792487
TI  - [Post-traumatic inter-hemispheric disconnection syndrome].

PMID- 7792489
TI  - Dreams and rapid eye movement sleep in the multiple sleep latency test.
AB  - Dreams are closely associated with rapid eye movement (REM) sleep. The purpose of
      this study was to evaluate the reliability of dreams in predicting the presence
      of REM sleep during naps of the multiple sleep latency test (MSLT). We
      prospectively analyzed MSLTs performed in the evaluation of 44 patients with
      excessive daytime sleepiness. A total of 167 naps were studied. The patients'
      ages ranged from 11 to 69 years (mean 45 years). There were 26 males and 18
      females. The relationship between the presence of reported dreams and the
      presence of REM sleep was as follows: sensitivity (percentage of naps with REM in
      which dreams were reported), 59%; specificity (percentage of naps without REM in
      which no dreams were reported), 63%; positive predictive value (probability that
      REM occurred if dreaming is present), 29%; and negative predictive value
      (probability that REM did not occur when no dreaming is present), 85%. In the
      daytime naps of the MSLT, the presence of reported dreaming did not appear to be
      a reliable indicator of the presence of REM sleep in the preceding nap.

PMID- 7792488
TI  - [Sclerosis with benign plaques with childhood onset].

PMID- 7792490
TI  - Sleep disturbance in elderly patients with cognitive impairment, decreased daily
      activity and periventricular white matter lesions.
AB  - We investigated how sleep disturbance is correlated with brain lesions, cognitive
      impairment and decreased daily activity (ADL). Two hundred and four chronically
      ill patients including patients with vascular dementia were classified into eight
      groups based on cognitive function, ADL and grades of PVL (periventricular
      lucency) as shown by computerized tomography. Visual monitoring of the sleep/wake
      state was performed hourly for 14 consecutive days and the daytime sleep hours
      and the nighttime sleep hours were determined based on detected disturbances in
      the sleep/wake pattern. Whether any specific infarcted regions were correlated
      with sleep disturbance was also evaluated. We found that daytime sleep hours were
      increased and nighttime sleep hours were decreased by three single factors:
      cognitive impairment, decreased ADL and the severe grade of PVL. As for an
      interactive effect of the two factors, daytime sleep hours were increased by
      dementia with decreased ADL (independent of PVL) and increased by decreased ADL
      with the severe grade of PVL (independent of dementia). Although three factors
      affected sleep independently, ADL has an interactive effect on sleep with
      dementia and with PVL. No specific cortical regions related to sleep disturbance
      were found.

PMID- 7792491
TI  - Assessment of accuracy and analysis time of a novel device to monitor sleep and
      breathing in the home.
AB  - Obstructive sleep apnea is increasingly recognized as a common and debilitating
      disorder. As a result, a variety of diagnostic technologies have evolved to
      potentially decrease cost and improve access and ease of assessment. In this
      study we compared the Healthdyne NightWatch (NW) System (a home sleep diagnostic
      methodology) to standard polysomnography (PSG) in two sleep centers. Two separate
      studies were completed. NW was compared to a simultaneously obtained PSG in 30
      patients (IN-LAB study). Seventy additional patients were studied in both the
      home with NW and in the laboratory with PSG (HOME-LAB study). The NW system
      records eye movement, leg movement, SaO2, nasal-oral airflow, chest and abdominal
      wall motion, body position and heart rate on a solid state recorder, which
      permits sleep staging based on body and eye movement and standard respiratory
      assessment. For the PSG, standard paper recording techniques were used. The IN
      LAB study revealed a correlation between NW and PSG for total sleep time of r =
      0.72, with NW tending to score some awake time as nonrapid eye movement sleep.
      The correlation for apnea-hypopnea index (AHI) was r = 0.94 between systems, with
      a sensitivity of 100% and specificity of 63.6% at an AHI threshold of 10. The
      HOME-LAB study demonstrated understandably poor correlations between NW and PSG
      for most measures of sleep, which is likely a product of night-to-night
      variability in sleep, home versus laboratory effects and the differences in sleep
      staging methodology. However, the correlation for AHI was r = 0.92, with a
      sensitivity of 90.7% and a specificity of 70.4% at an AHI threshold of 10. Using
      a new methodology to assess agreement between diagnostic systems, we observed
      78.6% diagnostic agreement between NW and PSG in the HOME-LAB study, with NW
      underestimating AHI 4.3% of the time and overestimating it in 17.1% of cases.
      This may relate to night-to-night variability in AHI or greater NW computer
      sensitivity to subtle hypopneas. We conclude that NW provides an accurate
      determination of AHI in both the home and laboratory, using limited
      instrumentation. The analysis time for NW is also reduced compared to PSG, and
      patients generally prefer the NW evaluation.

PMID- 7792492
TI  - Gender- and age-related differences in sleep determined by home-recorded sleep
      logs and actimetry from 400 adults.
AB  - Home-based sleep was monitored by morning logs and wrist actimetry for 15 nights
      in a sample of 400 adults (20-70 years old; 211 female, 189 male; one per
      household). Subjects on sleep-enhancing medications and/or whose sleep was
      severely disturbed by illness were excluded. Subjects were grouped into age
      bands: ("young" = 20-34 years, "mid-aged" = 35-49 years and "older" = 50-70
      years). Women retired to bed and fell asleep earlier than men. Men and women woke
      up earlier with increasing age. Sleep period time was markedly longer for women.
      Most reported awakenings were < 5 minutes. Women reported more awakenings, more
      total time spent awake during the night and poorer sleep quality; all these
      findings were most evident in the older women, who also took longer to fall
      asleep than any other group. Although these age effects are consistent with those
      reported elsewhere, the gender effects, some of which are much stronger than the
      age effects, have not been so evident before.

PMID- 7792493
TI  - Portable recording to assess the severity of obstructive sleep apnea: a European
      perspective.

PMID- 7792494
TI  - Guidelines for in-home testing: a need for reassessment.

PMID- 7792495
TI  - Behavioral state organization in normal human term fetuses: the relationship
      between periods of undefined state and other characteristics of state control.
AB  - Repeated alteration in episodes of quiet sleep and active sleep is a basic
      feature of behavioral state organization in human fetuses. When compared to
      normal fetuses, at-risk fetuses generally exhibit extended periods of no
      coincidence (PsNC), that is, associations between state variables that cannot be
      classified as a sleep state. The purpose of this study was to determine if
      fetuses with extended PsNC differ in other state measures from fetuses with short
      PsNC. Fetal heart rate and fetal eye and gross body movements were collected
      simultaneously on 85 normal human fetuses between 37 and 41 weeks gestation for a
      total of 9,135 minutes (mean 108.8 +/- 12.7 minutes, range 85-130 minutes). We
      found that as percent PsNC increased, the frequency (r = 0.464, p < 0.0001) of
      state changes increased and the time spent in active sleep (r = -0.456, p <
      0.0001) and the number of fetuses entering an awake state (chi 2 = 4.26, p <
      0.039) decreased. In contrast, percent PsNC was independent of the length of time
      spent in quiet sleep (r = 0.070, p > 0.05). We interpret these findings as an
      indication that extended PsNC may be the result of disruption of homeostatic
      control mechanisms during active sleep.

PMID- 7792496
TI  - Naps in children: 6 months-7 years.
AB  - A cohort of 172 children was followed from 6 months to 7 years of age to
      determine how nap patterns change with age and whether there was individual
      stability of nap patterns. Results showed that there were no differences in nap
      patterns based on gender, ordinal position, whether naps spontaneously
      disappeared or were stopped by the parents, and the number of naps at 6 months of
      age. Total daytime sleep remained a stable individual characteristic between 6
      and 18 months of age. Age was associated with hours napping (r = -0.73, p <
      0.001) and number of naps (r = -0.52, p < 0.001). A pattern of two naps per day
      was well established by 9-12 months of age and one afternoon nap by 15-24 months.
      The modal duration of naps from 2 to 6 years was 2 hours. During the 3rd and 4th
      year, napping occurred in the majority of children, but at decreasing rates. A
      minority of children were napping at 5 and 6 years and naps usually disappeared
      by age 7.

PMID- 7792497
TI  - Effects of flurazepam and zolpidem on the perception of sleep in normal
      volunteers.
AB  - In previous studies we have reported that the benzodiazepine hypnotic triazolam
      and the nonbenzodiazepine zolpidem increase the likelihood that insomniacs will
      report having been asleep when awakened by an electronic tone of progressive
      intensity. It has not been known, however, whether this occurs with normal
      sleepers. In the present study we have administered placebo, flurazepam 30 mg and
      zolpidem 10 mg to 15 normal sleepers and awakened them with an electronic tone at
      five points across the night. In contrast to previous reports with insomniacs,
      both compounds made only modest improvements in sleep. When all time points were
      combined, subjects reported having been asleep in 40.3, 42.9 and 47.9% of the
      trials on placebo, flurazepam and zolpidem, respectively (ns). Subjects were
      accurate in their estimate of total time asleep, and this accuracy was not
      influenced by the drugs. Similarly, there were no effects on a variety of
      questions related to dreaming and other cognitive activity during sleep. These
      results suggest that the effects of these hypnotics, which have been described
      previously in insomniacs, are not found in normals. Further studies will be
      necessary to clarify whether such effects in insomniacs are related to the
      clinical efficacy of hypnotics.

PMID- 7792498
TI  - Effects of flurazepam and zolpidem on the perception of sleep in insomniacs.
AB  - We have shown previously that the benzodiazepine hypnotic triazolam alters the
      perception of being awake or asleep in insomniacs, making it more likely that
      they will report having been asleep when awakened by an electronic tone at
      various times of the night. In the present study, we examined the question as to
      whether this is also true for other benzodiazepines as well as for
      nonbenzodiazepine hypnotics. Ten insomniacs were given placebo, flurazepam 30 mg
      and zolpidem 10 mg and were awakened at five times during subsequent sleep in a
      random-sequence repeated-measures study. Across all five awakenings following
      placebo, insomniacs reported being asleep with a frequency of 30.9%. This rose to
      40.4% (ns) and 54.7% (p < 0.03) on flurazepam and zolpidem, respectively.
      Subjects were also more likely to report having been dreaming during the
      awakening 5 minutes after "lights out" after receiving zolpidem. A number of
      polygraphic measures of sleep, including sleep latency, total sleep and sleep
      efficiency, improved significantly on both drugs, and there was similar
      improvement in some global measures of quality of sleep. Neither drug altered the
      subjective sense of duration of time. These findings suggest that drug-induced
      alterations in the perception of being awake or asleep are not unique to
      benzodiazepines, but occur with the nonbenzodiazepine zolpidem as well.

PMID- 7792500
TI  - [Professional development in participating health organizations].

PMID- 7792499
TI  - The use of caffeine versus prophylactic naps in sustained performance.
AB  - Previous studies have shown that performance during sleep loss is improved by
      prophylactic naps as a function of varying nap length. Based on single-dose
      caffeine studies, a similar dose-response effect has been hypothesized on
      performance, alertness and mood during sleep loss. The present study compared the
      effects of repeated versus single-dose administration of caffeine and varying
      amounts of sleep taken prior to sleep loss on performance, mood and physiological
      measures during 2 nights and days of sleep loss. A total of 140 normal, young
      adult males participated at one of two study sites. Ninety-eight subjects at one
      site were randomly assigned to one of four nap conditions (0, 2, 4 or 8 hours)
      and 42 subjects at the second site were assigned to one of four caffeine
      conditions. After a normal baseline night of sleep and morning baseline tests of
      performance, mood and nap latency, subjects in the nap groups returned to bed at
      noon, 1600 hours, 1800 hours or not at all. Bedtimes were varied so that all naps
      ended at 2000 hours. Subjects in the caffeine groups received either a single 400
      mg dose of caffeine at 0130 hours each night or repeated doses of 150 or 300 mg
      every 6 hours starting at 0130 hours on the 1st night of sleep loss. A placebo
      control group (no nap and placebo administered every 6 hours on the repeated
      caffeine schedule) was run at both sites.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792501
TI  - [Back pain].

PMID- 7792502
TI  - [History of nursing. "Rules from 1417". Hospital of Santa Creu of Barcelona].

PMID- 7792503
TI  - [Meningomyelocele and surgery of scoliosis].

PMID- 7792504
TI  - [Continuous hemofiltration. A technique on the rise].

PMID- 7792505
TI  - [Continuing education. What to do about a rise in intracranial pressure].

PMID- 7792507
TI  - Prostate cancer: the pros and cons of treatment.

PMID- 7792506
TI  - Take the pain out of CPR training.

PMID- 7792508
TI  - When pain cuts to the bone.

PMID- 7792509
TI  - Insulin therapy.

PMID- 7792510
TI  - Working with a new staff mix.

PMID- 7792511
TI  - Neuromuscular blockade: when paralysis is intentional.

PMID- 7792512
TI  - The basics of therapeutic touch.

PMID- 7792513
TI  - When language is an obstacle.

PMID- 7792514
TI  - Write it down.

PMID- 7792515
TI  - UAPs or not ...

PMID- 7792516
TI  - [Accumulation of heavy metals (Pb, Cd) in selected varieties of vegetables].
AB  - Vegetables have a great share in supplying of lead and cadmium with food into the
      human organism. For this reason an attempt was undertaken for quantitative
      evaluation of accumulation of those metals in three varieties of the following
      vegetables: carrots, parsley, garden beet, cabbage and potato grown at identical
      fertilization, weather conditions and pollution. Cadmium and lead were complexed
      with diethyldithiocarbamate, extracted into organic phase, and determined using
      atomic absorption spectrometry method. Cadmium content in tested vegetables was
      close to allowed values, established by Polish Legislation for these foods
      stuffs, and even exceeded limits in many specimens. Lead content is lower than
      allowed values with exception of one variety of carrot and all parsley specimens
      (leaf). Statistically significant differences (t-Student test) in the content of
      lead and cadmium in different varieties of the same vegetable were not observed.
      However, the minimum content of both metals in cultivated vegetables was observed
      in the following vegetables: parsley, carrot (three varieties), red beet (two
      varieties), potato, cabbage (two varieties).

PMID- 7792517
TI  - [Simultaneous determination of metals in milk by the ICP-AES technique].
AB  - The method of the emission atomic spectrometry with an excitation in the
      inductively coupled plasma (ICP-AES) has wide range of applications due to the
      possibility of the simultaneous determination of several elements in various
      materials. This technique allows to carry out a multi-element analysis at
      relatively low consumption of the sample which is an additional advantage of the
      method. In this paper we report an application of the ICP-AES method for a direct
      determination of the element Al, Cu, Fe, Mn, Sn and Zn in the samples of milk.
      Several types of pressure mineralization (teflon bomb, sealed quartz tubes) as
      well as the pressureless technique with the use of the H2SO4, HNO3 and H2O2
      agents have been studied. The determinations have been carried out with the use
      of the Spectroflame M sequential spectrometer with the excitation in ICP plasma
      made by Spectro Analytical Instruments at the Frequency of 27.12 MHz. The milk
      samples after mineralization have been diluted to the same volume and directly
      introduced into the ICP plasma with the help of the pneumatic nebulizer of
      Meinhard type. On the basis of the obtained results it has been concluded that
      with an application of the aforementioned mineralization method the average
      values for the determination of the particular elements are comparable. Generally
      the most "repeatable" results have been obtained for the sample mineralized in
      the quartz tubes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792518
TI  - [Content of micro- and macro-elements, lead and cadmium in albumins and globulins
      of fresh and stored, dried seeds of the Faba bean].
AB  - The content of micro/macroelements, lead and cadmium in Faba bean proteins from
      the seeds after their harvest and from the seeds stored (2 months, 6-8 degrees C)
      and dried (6h at 35 degrees C up to 15-15% moisture) was determined. Proteins
      were extracted with water (pH 8.0). Globulins were precipitated from water
      protein extract at pH 4.2. The microelements (Cu, Mn, Fe and Zn) content in
      albumins and globulins from the seeds after their harvest and from stored and
      dried seeds were as follows: 37.4 and 27.1; 46.7 and 35.8; 15.4 and 18.9; 179.2
      and 229.7 micrograms/g (albumins) and 24.9 and 31.9; 20.0 and 28.1; 92.1 and
      205.4; 68.7 and 102.9 micrograms/g (globulins). These findings indicate that Faba
      bean albumins and globulins form the labile and neutral nucleo-glycoprotein
      complexes with Cu, Mn, Fe and Zn. The process of storage and drying caused the
      migration of the micro and macroelements between albumins and globulins.
      Generally, one may say that Faba bean albumins and globulins are the source of
      the biologically active micro- and macroelements.

PMID- 7792519
TI  - [The influence of potassium sorbate addition on the quality of pickled zucchini
      fruit].
AB  - The investigation included zucchini cultivars of Polish (Astra) and foreign
      (Storr's Green F1) breeding. The analysed material was harvested in the
      investigator's experimental field. Lactic fermentation at controlled temperature
      of fruits 100-130 mm in length was carried out in early September, the variants
      consisting of souring at the concentration of 0.05% and 0.10% in the brine which
      filled 35% of the volume of pickling containers. The evaluation of pickles was
      carried out after 6 month of souring. The raw material for pickling contained
      8.67-9.66% of dry matter, 2.47-2.60% of sugars, 1.84-18.9% protein (N x 6.25),
      0.42-0.50% of pectic compounds, and 46.9 mg/100 g of vitamin C. The pickles were
      characterized by a good organoleptic quality expressed by scores from 4.39-4.96
      and by the following physico-chemical composition: dry matter 8.11-8.86%, sugars
      0.9-0.11%, N x 6.25 1.54-1.56%, total acidity 0.82-1.01%, sodium chloride 2.15
      2.26%, pectic compounds 0.20-0.25%, volatile acidity 43-64 mg/100, ethyl alcohol
      30-35 mg/100 g, and vitamin C 10.9-14.9 mg/100 g. The addition of potassium
      sorbinate to the brine favourably affected the chemical composition and
      organoleptic quality of the final product. With the level of sorbic acid in
      pickles rising from 0 to 26 mg/100 g (the 0.10% addition of potassium sorbinate
      to the brine) the total content of acids increased by 18% and the content of
      preserved vitamin C by 32%, while the amount of volatile acids was reduced by 25%
      and that of ethyl alcohol by 38%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792520
TI  - [The value of Polish field grown sweet pepper cultivars for freezing and
      pickling].
AB  - Raw and blanched sweet pepper and frozen goods and pickles produced of blanched
      and non-blanched vegetable were evaluated after 6-month storage, the following
      cultivars of Polish origin being used in the screening: Bryza, Ino, Jantar, Kano,
      Kujawianka, Passat, Sono, and Zefir. The compared cultivars differed by the level
      of analysed indices. The variability range of dry matter content was 25%, of
      sugars 23%, of starch 97%, of protein 25%, of mineral constituents 24%, and of
      vitamin C 40%. The blanching of the raw material reduced the content of sugar by
      11%, raw protein by 8%, mineral constituents by 14%, and vitamin C by 18%. The
      freezing and 6-month storage of frozen sweet pepper did not significantly affect
      its chemical composition, except vitamin C whose level was decreased by 17% on
      the average in the case of freezing non-blanched raw material, and by 22% when
      blanched sweet pepper was used. The pickling and storage of pickles significantly
      reduced the content of vitamin C, the losses amounting to 58% in products of non
      blanched and to 67% in these of blanched fruit. The lossesin protein content were
      relatively small while and increase in the content of dry matter, sugars, and
      ashy constituents was due to additives in the marinade. The process of blanching
      sweet pepper before freezing ensure the preservation of proper smell and taste.
      Hence, this treatment has to be regarded as indispensable prior to the longterm
      storage of frozen vegetables. In the case of pickling the blanching has no
      favourable effect on the organoleptic qualities. The highest organoleptic values
      was in pickles and frozen goods of Kujawianka, the scores being 4.5 each, however
      no statistical differences were found for products of Kano, Sono, Bryza, and
      Zefir.

PMID- 7792522
TI  - [Bacterial pollution with Campylobacter in surface waters of water-plants after
      different steps of water processing].
AB  - The presence of bacteria of Campylobacter genus was investigated in 55 samples of
      surface water taken from Vistula river nearby Warsaw, and from different stages
      of water processing plants in Central and Northern water plants. For this purpose
      the membrane filters technique in microaerophilic conditions and differential
      medium with the antibiotics addition were used. Bacteria of Campylobacter genus
      were detected in 36% samples of surface waters and positive correlation with the
      contamination with coli of fecal type bacteria was found. The presence of
      Campylobacter was also found in water intakes in Central and Northern water
      plants and in water samples taken from sediment trap after fast filters and
      coagulation in Central water plants. No Campylobacter type bacteria were found in
      chlorinated water containing of free chlorine in concentration of 0.66 mg Cl2/l.

PMID- 7792521
TI  - [Evaluation of the current state of pollution of selected natural water resources
      with cadmium and lead].
AB  - Concentrations of lead and cadmium in water of lakes located on agricultural and
      recreation areas have been analysed. Surveys were performed in summer and autumn
      1988 and once more in 1993. Concentrations of both metals were analysed by atomic
      absorption spectrophotometry after chelation and extraction. Obtained results
      suggest that present concentrations of lead and cadmium are not very dangerous
      for analysed waters.

PMID- 7792524
TI  - [A comparative study of determining fluoride ions with spectrophotometric and ion
      selective methods].
AB  - The usefulness of two methods for fluorine determination in different mineral
      waters was compared: a spectrophotometric method using of a zirconium-xylene
      reagent and electrochemical using of fluoride ion-sensitive microcapillary inset
      electrode. The influence of the presence of chlorine, sulphate or iron ions on
      the fluorine determination has been evaluated in solutions containing 0.5; 1.5;
      5.0 and 10.0 mg F-/1 and increasing concentration of Cl-, SO4(2-), Fe3+ ions in
      the range they can occur in natural mineral waters. The ion-selective method has
      been found more advantageous for analysis of solutions and waters of
      mineralization of 5 g/l and concentrations of sulphates below 1,000 mg/l in which
      fluorides concentrations ranges from 0 to 1.5 mg/l. For solution of higher
      mineralization degree containing more than 1.5 mg F-/1 and less than 1000 mg/l of
      sulphates, the spectrophotometric method seems to be more advantageous.

PMID- 7792523
TI  - [The occurrence of keratinolytic fungi in the polluted environment of the Labedy
      District in Gliwice].
AB  - This study was undertaken to find relationships between the degree of
      bacteriological contamination with qualitative composition of potentially
      pathogenic keratinolytic fungal population in soil, sediment and air samples from
      the Labedy district in Gliwice (Poland). The examined soil samples were
      characterized by the predominance of Botryotrichum piluliferum, Chrysosporium
      anamorph of Arthroderma curreyi, Myceliophthora anamorph of Ctenomyces serratus,
      Chrysosporium pannicola and Trichphyton ajelloi. These species are typical for
      keratinolytic mycoflora in moderate climate soils, and their abundance was
      certainly resulted from the assembly of keratin remains in the soil environment.
      In the light of the weak bacteriological and mycological differentiation of the
      examined soil samples, however, it is difficult to determine categorically the
      extent to which the remains were originated from sewage via soil flooding by
      sewage or air transportation, or from the local human and animal population.
      Subsequently, the population of keratinolytic fungi in sediments was found to be
      clearly dependent of the degree of water contamination with sewage. In badly
      polluted sediments, Chrysosporium pannicola, Chrysosporium anamorph of
      Aphanoascus fulvescens, Chrysosporium keratinophilum, Trichophyton ajelloi and
      Microsporum cookei were prevalent species. Keratinolytic fungi were only a small
      part of airborne fungal population in sewage bioaerosoles. Geomyces pannorum, a
      soil species better known by its celullotytic than keratinolytic properties,
      predominated in air samples. Some pathogenic species, such as Aspergillus flavus,
      Aureobasidium pullulans, Chrysporium anamorph of Aphanoascus fulvescens, Candida
      spp., Geotrichum candidum, Microsporum canis, Sporothrix schenckii and
      Trichosporon beigelii, were recovered in the present study. This confirms that
      the sewage-contaminated environments in an important storage place of pathogenic
      fungi, mostly from the opportunistic subgroup.

PMID- 7792525
TI  - [The influence of natural peat and isolated humic acid solution on certain
      indices of metabolism and of acid-base equilibrium in experimental animals].
AB  - The biological effect in rats treated with natural peat homogenate and isolated
      humic acids has been shown in pharmacodynamic studies. After 24 days of this
      treatment decrease of total cholesterol, total lipids, an increase of HDL
      fraction of cholesterol, decrease in glucose level and increase of protein
      fraction of globulin, hemoglobin, hematocrit and total number of erythrocytes
      were observed. The treatment did not influence the electrolyte equilibrium.
      However, after the treatment with humic cides the respiratory acidosis not
      compensated with the metabolic component was observed. The activity of the
      natural peat was more favorable as compared to the activity of humic acids
      solution.

PMID- 7792526
TI  - [House fly development after chitin biosynthesis inhibitor application to eggs].
AB  - Nine asymmetrically substituted ureas were bioassayed against house-fly (Musca
      domestica L.) eggs. The compounds included benzoylaryl urea derivatives, shown in
      Table I, (compounds 1 and 3-8) and benzoylheteroaryl ureas (2 and 9) which
      previously revealed effective inhibition of metamorphosis and reproduction when
      applied in food to the larvae and adults. The benzoyl moiety of the compounds
      comprise 2,6-disubstituted benzene ring with fluorine atoms (6-9), chlorine atoms
      (1-2) or fluorine and chlorine atoms (3-5), respectively. The majority of the
      compounds include aniline derivatives (1, 3-8), except the two containing
      pyridine ring (2) or pyridone-2 system (9). The eggs of house fly Musca domestica
      L. (some hours after they were laid) were put on a piece of cloth impregnated
      with acetone solution of tested compounds in concentrations 0.1 and 0.01%. The
      hatching of larvae and the later phases of development were observed. From the
      tested compounds one (no 8 in tab. II) decreased and delayed the hatching, two
      compounds (no 1 and 4 in tab. II) affected the later stages of development: the
      number of pupae and adults were decreased.

PMID- 7792527
TI  - [Evaluation of water sanitation and hygiene in swimming pools in the town of
      Biala Podlaska].
AB  - The purpose of the study was the characteristic of physico-chemical and
      bacteriological features of water quality in three swimming pools of standard
      type accepted for most pools in the country, and it was tried to assess their
      sanitary-hygienic state in relation to the accepted sanitary standards. The study
      was carried out in the years 1991-1992 taking water samples from each pool twice
      in a month during water removal, and once in the whole study during pool filling.
      The physico-chemical and bacteriological studies were carried out by the methods
      evolved at the National Institute of Hygiene, and the results were compared with
      the obligatory standards. It was found that physico-chemical parameters of water
      quality different only slightly between the tested pools. Most evident
      differences were observed in chloride concentrations. It was noted that falling
      free chlorine concentration in a pool was associated with increasing bacterial
      contamination of water. The degree of bacterial contamination of water in that
      pool was above the permissible value in 18% of the studied samples. The obtained
      results point out water quality depends, in the first place, on correct
      performing of disinfection, which was not always adequate in these pools.

PMID- 7792528
TI  - [Coexistence of low-molecular component combustion gas formed during the burning
      of gaseous fuels].
AB  - The equations of nitric and formaldehyde concentrations in combustion gas against
      carbon monoxide in combustion gas were shown in this study. Measures for various
      conditions of burners operating are down. It was shown that nitric oxides
      concentration in combustion gas is proportional to carbon monoxide concentration
      and universally proportional to fuel consumption velocity and dry product volume
      of combustion gas formed from fuel elementary volume. In case of formaldehyde all
      three partial relationships were inversely proportional.

PMID- 7792529
TI  - [Mechanisms of bone loss in osteoporosis].
AB  - Aging and menopause are the two main determinants of osteoporosis, a rarifying
      osteopathy due to bone loss. Type I osteoporosis observed in post-menopausal
      women is characterized mainly by trabecular bone loss results from an unbalanced
      coupling between resorption and formation inducing a thinning of trabeculae and
      from an increased osteoclast activation resulting in irreversible trabecular
      perforation. Anti-osteoclastic drugs prevent trabecular and cortical bone loss.
      Drugs that stimulate osteoblastic proliferation thicken trabecular plates but do
      not restore the normal trabecular microarchitecture after complete destruction of
      a large number of trabeculae. In type II osteoporosis, cortical bone loss is
      favoured by secondary hyperparathyroidism and is responsible for hip fracture.
      Calcium and vitamin D supplementations decrease the risk of hip fractures by
      reducing the secondary hyperparathyroidism.

PMID- 7792530
TI  - [Present and future epidemiology of osteoporosis].
AB  - Osteoporotic patients are exposed to fractures at all bones sites, mainly the
      upper extremity of the femur, the vertebral bodies, and the distal forearm.
      According to an overview of 6 French surveys, it is estimated that there has
      been, in 1990, 45,000 to 50,000 new fractures of the upper extremity of the
      femur, in patients aged 20 years and above. Owing population aging, more than
      145,000 fractures are expected to occur in 2050. The frequency of osteoporosis,
      its spontaneous tendency to increasing prevalence, its functional consequences
      and its cost make it a major public health issue with a requirement for a
      specific preventive strategy.

PMID- 7792532
TI  - [Clinical usefulness of biochemical markers of bone remodeling in osteoporosis].
AB  - Osteoporosis with its various clinical expressions is characterized by
      abnormalities of bone remodeling that can be assessed by biochemical markers of
      formation and resorption. Measurements of the serum concentration of osteocalcin
      and bone alkaline phosphatase (formation) and of the urinary excretion of
      pyridinoline and its peptides (resorption) are the most efficient markers in the
      investigation of osteoporosis. Recent studies, some of them still in progress,
      allow to define the clinical use of these markers: firstly to improve the
      evaluation of the fracture risk, and secondly to monitor the efficacy of
      antiresorptive drugs.

PMID- 7792533
TI  - [Risk factors and prevention of postmenopausal osteoporosis].
AB  - Preventing postmenopausal bone loss and osteoporotic fractures (vertebral crush
      fractures and femoral neck fractures) is an important challenge for the next
      decades. This goal should be achieved by developing screening strategies and
      deploying established preventive measures. The risk assessment is currently based
      on densitometric measurements of bone mass and knowledge of risk factors for low
      bone mass and/or exaggerated bone loss. Hormone replacement therapy is the only
      well established treatment for preventing osteoporotic fractures. Therefore, it
      should be recommended to many women. It is important to associate a progesterone
      derivative with the oestrogen, to exclude patients with breast cancer history and
      to ensure a follow up by a gynaecologist. Alternative regimens could be useful in
      patients with low acceptance or contraindication to oestrogens. The long term
      antifracture efficacy of these molecules remains to be determined, and they have
      yet, at least in France, no marketing authorization for this purpose.

PMID- 7792531
TI  - [Contribution of osteo-densitometry in the definition and diagnosis of
      osteoporosis].
AB  - Since its first characterisation, osteoporosis has always been defined on an
      anatomical basis. The term osteoporosis refers to a reduction (or atrophy) in the
      amount of bone tissue and to microarchitectural deterioration without any
      mineralisation defect. Its clinical significance lies in the fractures (vertebral
      fracture, Colles' fracture and hip fracture) that occur spontaneously or after a
      minimal trauma. During the past 15 years, developments in technology of bone mass
      measurement (osteodensitometry) currently allow a diagnosis of osteoporosis at
      its anatomical stage characterised by a reduction in bone mass (osteopenia)
      without any symptom. A definition based on densitometry offers the major
      advantage of an early diagnosis, well before the development of fractures. It has
      been validated recently by several prospective studies which have confirmed the
      close relationship between the decrease in bone mass and the fracture risk. This
      modern densitometric approach of osteoporosis has major therapeutic implications.
      Indications of curative treatments of osteoporosis has major therapeutic
      implications. Indications of curative treatments of osteoporosis should be
      reconsidered according to the contribution of bone densitometry.

PMID- 7792534
TI  - [Diagnosis and treatment of osteoporotic vertebral collapses].
AB  - Vertebral fracture is a typical and frequent complication of trabecular
      osteoporosis. It is responsible for pain and disability. Diagnosis is supported
      by X-rays and some pitfalls must be known and avoided. Physical treatment is
      important in order to prevent recurrence. Among different treatments available in
      osteoporosis, ostrogenotherapy must be discussed, even after fractures have
      occurred.

PMID- 7792535
TI  - [Physiopathology and prevention of fractures of the proximal end of the femur].
AB  - Hip fracture is the most important skeletal problem in elderly people. Its two
      main determinants are falls and bone loss leading to an intrinsic bone fragility.
      Bone fragility results from postmenopausal and senile bone loss. The latter is
      increased by the secondary hyperparathyroidism of elderly persons which is
      induced by a combination of vitamin D deficiency and calcium intake, both very
      common in old age, particularly in Europe. Prophylactic strategies should be
      based on prevention of falls and of bone fragility. The latter includes the
      optimization of peak bone mass during childhood, postmenopausal oestrogen
      replacement therapy and a late prevention of senile secondary hyperparathyroidism
      by vitamin D and calcium supplements which have recently been shown to reduce by
      25% the number of hip fractures in a prospective study performed in a large
      population of institutionalized women. Therefore, it is never too early to pay
      attention to the risk of osteoporosis, and never too late to prevent hip
      fractures.

PMID- 7792536
TI  - [Secondary osteoporosis].
AB  - Although primary osteoporosis is much more frequent than other diseases
      associated with osteopenia, the diagnosis of idiopathic osteoporosis should be
      made only after the causes of secondary osteoporosis have been excluded. Indeed,
      therapeutic efficiency in secondary osteoporosis depends mainly on the
      concomitant treatment of the actual cause of osteopenia. Glucocorticoid-induced
      osteoporosis is the commonest form of secondary osteoporosis, mainly for doses of
      prednisone of 0.1 mg/kg/day or greater. Hypogonadism in men and women, idiopathic
      hypercalciuria and chronic alcoholism in men are other frequent causes of
      osteopenia. The diagnosis of secondary osteoporosis is based on careful
      examination as well as biochemical and hormonal investigations. Together with the
      treatment of the associated disease, correction of other risk factors, calcium
      supplementation, and a regular program of weight-bearing physical activity may be
      of benefit to reduce bone loss. As fluoride is able to stimulate bone formation,
      it is an effective agent in the treatment of glucocorticoid or alcohol-induced
      osteoporosis.

PMID- 7792537
TI  - [Infant mortality and morbidity. Definitions, main causes related to age.
      Obligatory health examinations].

PMID- 7792538
TI  - [Drug accidents of immunological origin. Physiopathology].

PMID- 7792539
TI  - [Salivary lithiasis. Diagnosis, principles of treatment].

PMID- 7792540
TI  - [Methods of evaluating nutritional status].

PMID- 7792541
TI  - [Chronic kidney failure. Etiology, physiopathology, diagnosis, treatment].

PMID- 7792542
TI  - [Mitral valve stenosis].

PMID- 7792543
TI  - [Burns. Etiology, physiopathology, diagnosis, early treatment].

PMID- 7792544
TI  - [Cutaneous ectoparasitosis: pediculosis. Epidemiology, diagnosis, treatment].

PMID- 7792545
TI  - Physical and psychological workload in men with and without low back pain.
AB  - Current and retrospective physical and psychological workload was studied in 148
      mean, 45-55 years old. The men represented three groups with respect to low back
      health status: Healthy low back (Group 1, n = 36), intermittent low back pain
      (LBP) (Group 2, n = 91) and chronic LBP (Group 3, n = 21). The methods used were
      a self administered questionnaire, a rating scale of perceived exertion, and
      blind expert assessment built on a classification of job titles. Group 1, the
      back-healthy subjects, had been less exposed to heavy physical work than subjects
      with intermittent LBP (Group 2) and chronic LBP subjects (Group 3) through their
      whole working-career and in their present work (p < or = 0.05, p < or = 0.01).
      Group 2 tended to be significantly less exposed in their present work than Group
      3 (p < or = 0.06). Non-neutral working postures were reported more often in
      Groups 2 and 3 than in Group 1 (p < or = 0.05, p < or = 0.001). Both groups 2 and
      3 perceived present and earlier work to be more strenuous than Group 1, with
      respect to the low back (p < or = 0.000). Subjects in the healthy low-back group
      had lower values in the qualitative demand index ("too difficult working tasks"
      and "too great responsibility") than subjects in Groups 2 and 3 (p < or = 0.01).
      This study indicates that more attention should be given to the individual's
      perception of physical workload.

PMID- 7792547
TI  - The Balance Scale: reliability assessment with elderly residents and patients
      with an acute stroke.
AB  - The objective of this study was to assess the reliability of the Balance Scale.
      Subjects were chosen from a larger group of 113 elderly residents and 70 stroke
      patients participating in a psychometric study. Elderly residents were examined
      at baseline, and at 3, 6 and 9 months, and the stroke patients were evaluated at
      2, 4, 6 and 12 weeks post onset. The Cronbach's alphas at each evaluation were
      greater than 0.83 and 0.97 for the elderly residents and stroke patients
      respectively, showing strong internal consistency. To assess inter-rater
      reliability, therapists treating 35 stroke patients were asked to administer the
      Balance Scale within 24 hours of the independent evaluator. Similarly, caregivers
      at the Residence were asked to test the elderly residents within one week of the
      independent evaluator. To assess intra-rater reliability, 18 residents and 6
      stroke patients were assessed one week apart by the same rater. The agreement
      between raters was excellent (ICC = 0.98) as was the consistency within the same
      rater at two points in time (ICC = 0.97). The results support the use of the
      Balance Scale in these groups.

PMID- 7792548
TI  - Gait analysis of hemiplegic patients by measurement of ground reaction force.
AB  - Ground reaction force during walking was measured and analyzed in 58 patients who
      had been hemiplegic for more than 6 months. Utilizing the impulse (area between a
      component curve and the baseline) as an assessment value, several parameters were
      selected to represent the characteristics of each component curve (vertical, fore
      aft and lateral) of the ground reaction force, and correlated with the degree of
      motor recovery in the patients. As a result, a high correlation was found between
      these parameters and the degree of motor recovery, indicating that ground
      reaction force well reflects the degree of motor recovery, which is highly
      correlated with the gait ability of hemiplegic patients. This evaluation method
      would also be very helpful for objective and quantitative estimation of the gait
      of hemiplegic patients.

PMID- 7792546
TI  - The role of the psychologist in multidisciplinary treatments for chronic neck and
      shoulder pain: a controlled cost-effectiveness study.
AB  - This study was designed to determine a cost-effective use of psychologist
      resources in multimodal cognitive-behavioural treatments (MMCBT) for chronic
      neck/shoulder pain. A randomised controlled trial was conducted with 66 patients
      divided in two groups. The first group (A) was treated following the approach of
      MMCBT with the clinical psychologist only functioning as a "coach" to the other
      health professionals. In this group, the psychologist had on average 5 hours of
      input per patients. The second group (B) was treated with the same inpatient
      MMCBT but with the behavioural component administered by the clinical
      psychologist directly to the patients. In this second group the psychologist had
      on average 17 hours of input per patient in the entire intervention. The outcome
      variables included physical, emotional and social factors, and sick-leave. Both
      groups showed significant improvements over time. The improvements were evident
      only in sub-groups, specifically in women. The only significant difference
      between the groups was in "perceived helplessness" favouring the "psychologist
      contact" setting. It is concluded that in terms of input of clinical psychology,
      the treatment setting with the "coaching" technique proved to be the most cost
      effective use of the psychologist in the two treatment settings investigated.

PMID- 7792550
TI  - Does hyperextension have an unloading effect on the intervertebral disc?
AB  - A stadiometer (a device to measure the overall height of a subject) was used to
      determine the effect of hyperextension in rehydration of the intervertebral disc.
      Hyperextension for 20 minutes in a prone posture was compared with the prone
      posture alone for 20 minutes. The stadiometer measurement was made after the
      subject was exposed to 10 kg of loading applied to the shoulders for five minutes
      and after each of the recovery postures. It was found that hyperextension gave a
      significantly increased height recovery compared with the prone posture.

PMID- 7792549
TI  - Intervention design for rehabilitation at home after stroke. A pilot feasibility
      study.
AB  - This study aimed at identifying the characteristics and feasibility of
      rehabilitation at home for acute stroke patients in south-west Stockholm. A
      population-based systematic sample of 16 patients, fulfilling defined criteria,
      was selected from approximately 1/3 of the stroke patients having been in
      hospital for one week or more at a neurology department, and offered early
      discharge in combination with home-based rehabilitation as an alternative to
      sustained rehabilitation in hospital. Fifteen patients, mean age 68.2 years,
      male/female ratio 9/6, independent in feeding and continent one week after acute
      stroke, participated in the study. The most important components of the home
      based rehabilitation programme were that: 1) one therapist was selected as case
      manager using the other therapists on a consultant basis; 2) the training
      sessions consisted of different task-specific activities, based on the patients'
      personal interest; 3) education and individual counselling were offered to all
      spouses; and 4) adherence to structured training between therapy sessions was
      promoted. The length of such programmes varied from 4 to 19 weeks after discharge
      and the mean number of home visits was 11. Reported time for training between
      therapy sessions for 14 patients was mean 1.2 hours per day. The patients'
      lifestyle activities, personal and instrumental ADL, and motor capacity at 3, 6
      and 12 months after stroke, assessed by validated and reliable methods, followed
      patterns similar to those reported for other stroke patients. The mean time in
      hospital for patients in the study was 14 days; for patients with similar ADL
      capacity but not included in the study it was 27 days.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7792551
TI  - Metabolic response and muscle glycogen depletion pattern during prolonged
      electrically induced dynamic exercise in man.
AB  - Muscle glycogen depletion pattern and metabolic responses during voluntary (VOL)
      and functional electrical stimulated (FES) dynamic knee-extensor exercise with
      one leg were evaluated. Seven healthy men exercised for 60 minutes at 30 W with
      an pulmonary oxygen uptake of 0.8 and 1.01 min-1, and respiratory exchange ratios
      of 0.90 and 0.95 in VOL and FES, respectively. Heart rate reached a level around
      90 beats min-1 (VOL) and up to 110 beats min-1 (FES). Muscle glycogen decreased
      in FES with 260 and 290 mmol kg-1 d.w. in vastus lateralis and m. rectus femoris,
      respectively, compared with 45 and 160 mmol kg-1 d.w. in VOL (p < 0.05). In FES
      the percentage of empty and almost empty fibres determined by periodic acid
      Schiff staining in vastus lateralis and rectus femoris was 50 and 77% of type I,
      63 and 90% of type IIa, and 59 and 84% of type IIb fibres, respectively, whereas
      in VOL it was 24 and 26% of type I, 7 and 19% of type IIa, and 2 and 3% of type
      IIb fibres. Muscle lactate reached 30 mmol kg-1 d.w. in FES and was 9 mmol kg-1
      d.w. lower in VOL. The changes in blood lactate and NH3 during the exercise were
      slightly higher in FES than in VOL, whereas the alterations in glucose, FFA, and
      K+ were small in both exercise modes. The pressure in the two muscle portions at
      different locations (proximal-distal) and depths was always higher (approximately
      50%) in FES than in VOL, reaching levels around 55 mmHg.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7792552
TI  - Deterioration of motor function in myotonic dystrophy and hereditary motor and
      sensory neuropathy.
AB  - In order to obtain more information about the deterioration of motor function in
      patients with myotonic dystrophy and in patients with hereditary motor and
      sensory neuropathy, changes in strength and functionality were determined at one
      year intervals, over a follow-up period of 1 to 5 years. Twenty-five myotonic
      dystrophy patients and 16 hereditary motor and sensory neuropathy patients
      participated. Strength measurements were restricted to knee extension and flexion
      torques measured isokinetically on a dynamometer at two velocities (120 and 60
      degrees/s). Functionality was measured as scaled time scores for rising from
      sitting, rising from supine, walking and stair climbing. Myotonic dystrophy
      patients showed a reduction of knee extension torques at 60 degrees/sec (mean
      decrease per year 5.7 Nm, or 9%) as well as a decrease in functionality.
      Hereditary motor and sensory neuropathy patients showed no statistically
      significant changes in torques or functionality. The correlation between
      isokinetically measured knee extension torques and functional scores was
      statistically significant in myotonic dystrophy but not in hereditary motor and
      sensory neuropathy. No correlation was found between changes in torques and
      changes in functional scores.

PMID- 7792554
TI  - Conjoined double internal mammary artery grafting.
AB  - Double internal mammary artery (IMA) grafting to the coronary arteries was
      performed on 82 patients. In ten of them one IMA was used as a free graft, and
      was proximally connected to the other ("conjoined" double IMA), the indications
      being insufficient supply of adequate veins, diseased aortic wall, availability
      of only a short right IMA segment for free grafting, occluded left subclavian
      artery, and when distal and scattered lesions of relatively important vessels had
      to be bypassed. Additional sequential IMA anastomoses were performed in four
      patients and an additional sequential vein graft in a fifth. All patients became
      angina-free postoperatively and have remained so during observation up to 16
      months. Recatheterization studies were performed in six patients and in all of
      them the IMA-to-IMA (n = 6) and distal anastomoses (n = 26) were patent.
      Conjoined double IMA grafting is an important option available to the cardiac
      surgeon for management of selected patients with coronary artery disease.

PMID- 7792553
TI  - Traumatic inferior vena caval injuries.
AB  - Twenty-three cases of inferior vena caval injury (1.4% of all operatively managed
      abdominal injuries) are reviewed. The caval injury presented as free haemorrhage
      in 15 cases and as a retroperitoneal haematoma in eight. The site of vena caval
      injury was at or above the level of the renal veins in 14 cases (61%). Successful
      lateral suture repair was achieved in 18 cases (78%). The overall mortality rate
      was 39%. Factors positively associated with survival were stab wound,
      presentation as retroperitoneal haematoma, infrarenal injury, low Abdominal
      Trauma Index score and small peroperative blood loss. Concomitant injury to the
      abdominal aorta, liver or kidney worsened the prognosis. The crucial factor in
      management of inferior vena caval injuries is rapid and effective control of
      bleeding, whether from the caval or associated injuries.

PMID- 7792555
TI  - Mitral valve prosthetic implantation with preservation of native mitral valve
      apparatus.
AB  - To avoid postoperative morbidity and mortality often associated with left
      ventricular dysfunction after mitral valve replacement (MVR) for chronic mitral
      insufficiency, reconstruction or preservation of the native mitral valve
      apparatus may be attempted during mitral prosthetic implantation (MPI). The
      effects of mitral surgery on heart function, studied with echocardiography and
      radionuclide angiography, were compared in seven patients with MPI (study group)
      and five with MVR (control group) who underwent complete preoperative, early
      postoperative and 3-6 months follow-up examinations. Preoperatively there was
      significant intergroup difference only in right ventricular ejection fraction
      measured at radionuclide angiography, which was lower in the MPI group (p <
      0.05). At follow-up the MPI group had improved as regards this fraction (p <
      0.005) and stroke volume index (p < 0.05). The number of patients with improved
      NYHA class at follow-up was significantly greater in the MPI group. Our
      preliminary experience with preservation of the native mitral valve apparatus
      thus suggests that the method offers haemodynamic advantages for postoperative
      right ventricular function.

PMID- 7792556
TI  - CarboMedics valve in congenital heart disease. Midterm follow-up study of 14
      patients.
AB  - In 14 patients aged 5-329 (mean 131) months a CarboMedics valve was implanted
      because of congenital heart disease. The preoperative NYHA function class was III
      IV in ten cases. Seven aortic and seven atrioventricular valves were replaced
      without early mortality. All patients were followed up, with mean observation
      time 27 months (total 384 months). One of the 14 patients died of heart failure
      10 months postoperatively. Thrombosis occurred in four valves, three in tricuspid
      and one in mitral position. In all patients who received only warfarin,
      anticoagulation was demonstrably inadequate. Consequently we now recommend
      antiplatelet medication in addition to warfarin for children with
      atrioventricular mechanical valve replacement. In our experience the complication
      rate with CarboMedics prosthesis is acceptable, provided that anticoagulant
      therapy is adequate.

PMID- 7792557
TI  - Microvascular injury induced by intravascular platelet aggregation. An
      experimental study.
AB  - Microvascular injury due to platelet aggregation was studied in cats for an hour
      after 1-hour intraaortic infusion of a suspension of collagen fibrils.
      Haematocrit and numbers of circulating platelets and leukocytes were repeatedly
      measured in arterial blood and a major cutaneous lymph vessel in the thigh was
      cannulated for measurement of lymph flow and erythrocyte counts in peripheral
      lymph. There were seven groups, each of eight cats, viz. normal cats infused with
      collagen (I) or vehicle (II) and collagen-infused cats which were platelet
      depleted--by antiserum (III), or neutrophil-depleted--by anti-serum (IV), or
      decomplemented--by cobra venom (V), or pretreated with indomethacin--10 mg/kg
      (VI), or treated with nonimmunized serum (VII). Induced intravascular platelet
      aggregation reduced the numbers of circulating platelets and leukocytes, and
      increased haematocrit, lymph flow and numbers of red cells in peripheral lymph.
      These effects were inhibited by platelet depletion and indomethacin and
      attenuated by decomplementation and neutrophil depletion. Platelet aggregation
      was thus shown to induce microvascular injury and increase microvascular
      permeability, which is partly dependent on complement and neutrophils.

PMID- 7792558
TI  - Myocardial metabolism 8 hours after coronary surgery: effects of dopamine.
AB  - Myocardial substrate metabolism is abnormal in the early period after cardiac
      surgery. Myocardial uptake of substrates remains restricted 6 hours
      postoperatively and cannot match the demand during periods of increased energy
      requirements. We investigated the relationship between myocardial oxidative rate
      and substrate uptake in 22 men c. 8 hours after coronary surgery. Myocardial
      energy demand was raised experimentally by infusing dopamine. The influence of
      selective beta 1-blockade was analyzed. The uptake of free fatty acids dominated
      (34.74 +/- 8.83 mmol/min*10(-3) and sufficed to explain the oxygen consumption in
      basal postoperative conditions (0.468 +/- 0.051 mumol/min) and during amplified
      energy requirements (0.881 +/- 0.117, r = 0.71). Although the capacity to adjust
      substrate uptake to energy requirements thus was regained, the uptake of glucose
      and of lactate (6.14 +/- 13.13 and 2.29 +/- 20.31 mmol/min*10(3) respectively)
      was marginal, which may be important for ischaemic tolerance. Metoprolol
      influenced oxygen consumption during amplified adrenergic activity, but did not
      markedly affect substrates.

PMID- 7792559
TI  - Ceftriaxone vs cefuroxime for infection prophylaxis in coronary bypass surgery.
AB  - The most serious infection after coronary artery bypass grafting (CABG) is
      mediastinitis following deep sternal wound infection. Antibiotic prophylaxis for
      at least 48 hours has been recommended. In this trial 551 consecutive patients
      were randomized to receive ceftriaxone in a single dose or cefuroxime thrice
      daily until the end of the second postoperative day. The overall infection rate
      was 7.7% in the ceftriaxone and 8.3% in the cefuroxime group, and the incidence
      of deep sternal infection was 2.9% in both groups. Significant risk factors for
      such infection were chronic respiratory disease (p < 0.001) and diabetes (p <
      0.01). The antibiotic prophylaxis had no harmful effects on the colonic flora in
      either group. Acquisition and delivery costs for the prophylactic agents were
      three times higher in the cefuroxime than in the ceftriaxone group. Both
      antibiotics are concluded to be equally safe and effective. Single-dose
      ceftriaxone prophylaxis is as effective as cefuroxime given for 48 hours
      postoperatively. Single-dose ceftriaxone is also simple to use.

PMID- 7792560
TI  - Lung cancer containing growth hormone-releasing hormone associated with
      hypertrophic osteoarthropathy. Case report.
AB  - In a 49-year-old man, large-cell carcinoma of the lung was accompanied by raised
      serum levels of growth hormone (GH) and growth hormone-releasing hormone (GHRH)
      and hypertrophic osteoarthropathy. Immunohistochemically the tumour contained
      GHRH but not GH. The osteoarthropathy disappeared after resection of the primary
      tumour and did not reappear after its recurrence. The high serum GH level
      presumably was due to ectopic GHRH production in the tumour. The hypertrophic
      osteoarthropathy was not clearly attributable to these hormones.

PMID- 7792561
TI  - Tracheobronchomegaly accompanied by bilateral giant pulmonary bullae and left
      spontaneous pneumothorax. Case report.
AB  - A 58-year-old man with tracheobronchomegaly underwent simultaneous bilateral
      pulmonary surgery via median sternotomy for left spontaneous pneumothorax with
      bilateral giant bullae. Postoperative hypoxaemia and pneumonia necessitated
      ventilator and antibiotic treatment. Simultaneous bilateral pulmonary operations
      in patients with tracheobronchomegaly carry a risk of respiratory complications.

PMID- 7792562
TI  - Clinical significance of intranodal and extranodal growth in lymph node
      metastases of non-small cell lung cancer.
AB  - In non-small cell lung cancer with mediastinal lymph node metastasis, intranodal
      growth is regarded as prognostically more favourable than extranodal growth. We
      evaluated the clinical implications. Mediastinal lymph node metastases removed at
      mediastinoscopy and/or surgery were classified as intranodal, extranodal or
      indefinite. "Minimal N2 disease" denoted a solitary, intranodal metastasis,
      "extranodal" at least one extranodal lymph node metastasis, and "indefinite" more
      than one intranodal or at least one indefinite metastasis. Although in patients
      with resected N2 disease, c. 21% of the nodal metastases were "indefinite",
      survival was significantly better in minimal N2 disease than in the combined
      groups with extranodal and indefinite lymph node metastases. Of the metastatic
      nodes removed at mediastinoscopy, 75% were unsuitable for definite classification
      as only intranodal or extranodal. Only 1 of 49 patients had purely intranodal N2
      disease. Thus, it was seldom feasible to classify mediastinoscopic lymph node
      involvement as intranodal or extranodal, and this classification is unhelpful as
      regards decisions on thoracotomy. However, when nodal involvement in resected N2
      disease was limited to a single node with intranodal growth, the prognosis was
      better than in patients with extranodal disease or more than one intranodal
      metastasis or indefinite nodes.

PMID- 7792564
TI  - Swiss Society of Internal Medicine, Hematology, Hypertension, Clinical Chemistry,
      Endocrinology, Nephrology, Clinical Pharmacology. Montreux, 18-20 May, 1995.
      Abstracts.

PMID- 7792563
TI  - Fifty years of cardiac and pulmonary surgery 1942-1993. The beginning of open
      heart surgery of postoperative intensive care. The first complete left heart
      catheterization. Mechanical heart valves.

PMID- 7792565
TI  - Outcome of a clinical cohort of unipolar, bipolar and schizoaffective patients.
      Results of a prospective study from 1959 to 1985.
AB  - In a prospective study, 186 unipolar depressives and 220 cases of bipolar
      disorder meeting DSM-III criteria for major depression or mania were followed up.
      Subjects were classified according to polarity and the presence or absence of
      schizophrenic symptoms, into four diagnostic subgroups: unipolar depression,
      bipolar disorder, unipolar schizoaffective disorder and bipolar schizoaffective
      disorder. At the last follow-up in 1985, 53% of the patients had deceased. Eleven
      percent of the sample (17% of all deaths) had committed suicide. The risk of
      suicide was associated with clinical severity and onset prior to the age of 60.
      However, there was no difference in suicide rates according to sex or diagnostic
      subgroup. Late onset of affective illness was associated with chronicity, which
      occurred in 10 to 19% of cases. Recovery was more frequent among unipolar than
      among bipolar patients. The 5-year remission rates (i.e. 26% in unipolars, 16% in
      bipolars) were independent of the number of episodes.

PMID- 7792566
TI  - [Status of the discussion regarding cost-effectiveness of community psychiatry
      and inpatient psychiatry].
AB  - In the current climate of escalating health care costs and shrinking resources,
      higher priority is also being given to the relation between costs and benefits of
      reform efforts and further developments of existing service delivery systems in
      the field of mental health. Some proponents of community psychiatry have
      predicted in a pointed manner that a change in the allocation of resources in
      favor of community-based care would dramatically decrease the need for hospital
      beds, cost half as much and be clinically at least as efficacious as inpatient
      treatment. The author gives careful consideration to these postulates based on
      today's available literature and on his own experiences in Mannheim and in Bern.
      He presents an array of newer findings which places them in perspective and to
      some extent contradicts them as well. Recent studies on the effects of an
      expansion of outpatient treatment programs on the overall mental health delivery
      system suggest that in areas with already reasonably developed community services
      its further enhancement rarely has an effect on the number of admissions to and
      length of hospital stays. In addition, the postulate that community care is
      considerably less costly only holds if in- and outpatient facilities are not
      considered to be integral parts of a comprehensive system of mental health care
      which both serve different purposes. Accordingly, the question of the
      effectiveness of treatment must also be discussed very distinctively. Although a
      network of well-functioning community-based services is (not yet) a veritable
      alternative, it can by all means, however, serve as a useful counterpart to the
      intensive treatment offered in modern mental institutions.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7792567
TI  - [Effectiveness of psychiatric day clinic treatment. An empirical study from the
      psychiatric service of the Thun regional hospital].
AB  - As a part of a new community mental health service in a non-university region
      this intermediary institution questioned its effectiveness. We wanted to know
      whether rehabilitative goals were attained at all and whether achieved changes
      would persist a certain time beyond discharge. With the use of goal attainment
      scaling changes in relation to goals defined in the beginning of the treatment
      were rated at the end of it and again one year after discharge. The psychologist
      who took care of these 46 catamnestic interviews had not been personally involved
      in the treatment. The positive results regarding "job situation" and "social
      contacts" as well as the immutability of "lodging situation" and the incapacity
      to keep up with the realization of "spare time interests" after discharge are
      discussed. The reflections are made within the frame of different levels of
      evaluation.

PMID- 7792569
TI  - President's message: creating your own challenges.

PMID- 7792570
TI  - The pharmacotherapy of spinal spasticity: a decade of progress I. Theoretical
      aspects.

PMID- 7792568
TI  - Course of a clinical cohort of unipolar, bipolar and schizoaffective patients.
      Results of a prospective study from 1959 to 1985.
AB  - This paper reports the results of a 27 year prospective study of 186 unipolar
      depressives and 220 bipolar disorders meeting DSM-III criteria for major
      depression or mania. Subjects were classified into four diagnostic subgroups,
      according to polarity and presence or absence of schizophrenic symptoms: unipolar
      depression, bipolar disorder, unipolar schizoaffective disorder and bipolar
      schizoaffective disorder. Course parameters were assessed for all samples. As the
      sequence of subtypes of affective and schizoaffective disorders progresses from
      unipolar depression, schizodepression, pure affective bipolar disorder to
      schizobipolar disorder, a systematic decrease in age of onset and length of
      episode can be observed. When compared to unipolar disorders (unipolar depression
      and schizodepressive disorder), bipolar (bipolar and schizobipolar) disorders
      showed more periodicity, characterized by greater number of total episodes, more
      episodes per year, but with shorter episodes and cycles. Despite the lower age of
      onset among schizoaffective subjects compared to pure affective disorders, the
      only difference in course between the two groups was a greater frequency in
      episodes requiring hospitalization among schizoaffectives.

PMID- 7792571
TI  - Nursing case management: enhancing interdisciplinary care of the spinal cord
      injured patient.
AB  - Comprehensive care of the person with a spinal cord injury (SCI) requires
      collaborative, coordinated, interdisciplinary care. It is imperative that the
      care provided by nurses, therapists, physicians, and ancillary personnel is
      organized and integrated in a holistic manner if optimal outcomes of
      rehabilitation are to be achieved. Nursing case management has been identified as
      an approach to health care delivery that provides quality, patient-centered care.
      The potential impact of this care delivery model on the health care system for
      persons with SCI includes quality rehabilitation outcomes, increased patient
      satisfaction, enhanced interdisciplinary relationships, and improved continuity
      of care from intensive care to community settings.

PMID- 7792572
TI  - Development and testing of computer software for nursing assessment and care
      planning at a spinal cord injury center.
AB  - This paper describes a pilot project using a Macintosh personal computer and
      customized software to computerize nursing admission assessment and care planning
      data. The project setting is a 47-bed Spinal Cord Injury Center with two
      inpatient units and an outpatient department serving approximately 1,000 patients
      with spinal cord injury at a Department of Veterans Affairs Medical Center in
      northern California. The computer software development, implementation, and
      evaluation are described. This software (MacNursing) was found to be a low cost,
      customized approach to computerizing spinal cord injury admission assessment data
      and care planning which reduces repetitive writing and facilitates continuity of
      care. Personal computers and this software have provided the mechanism for
      establishing a spinal cord injury patient database.

PMID- 7792573
TI  - Reliability, validity and data collection.

PMID- 7792574
TI  - How do you define "nurse"?

PMID- 7792575
TI  - President's message: national networking.

PMID- 7792576
TI  - Catheter cleaning for re-use in intermittent catheterization: new light on an old
      problem.
AB  - Clean intermittent catheterization is a common method of urinary elimination for
      people with Spinal Cord Injuries. The methods of catheter cleaning for re-use,
      however, have not been validated with research studies. This study compared the
      effectiveness of Hydrogen Peroxide, vinegar, dishwashing detergent, and tap water
      alone to clean catheters contaminated with Pseudomonas aeruginosa and Escherichia
      coli. The effect of rinsing and drying before cleaning was also examined, as well
      as the effect of storage in paper or plastic bags after cleaning. Results
      indicated that rinsing and drying catheters immediately after use was the most
      effective at reducing bacteria to very near zero. Elements of a procedure are
      outlined, as well as plans for further development and testing of a rinse & dry
      procedure for catheter cleaning and re-use.

PMID- 7792577
TI  - Finding success in research? The first step: literature search!

PMID- 7792579
TI  - What is non-compliance and how do I handle it?

PMID- 7792578
TI  - The pharmacotherapy of spinal spasticity: a decade of progress. II. Therapeutics.
AB  - Spinal spasticity is the term used to describe the increase in muscle tone which
      often develops following spinal cord injury (SCI). A review of spasticity and
      approaches to its treatment has been presented in a previous article. The purpose
      of this paper is to discuss the pharmacologic agents that are currently used to
      treat spinal spasticity. These medications can be classified as centrally and
      peripherally acting agents. The following review is therefore organized into two
      sections, according to the site of drug action.

PMID- 7792580
TI  - Bowel care: implementing changes toward quality improvement.
AB  - This article describes the challenges accepted by two healthcare teams at the
      Hampton Veterans Affairs Medical Center, which impacted significantly upon the
      practice of nursing. The first healthcare team developed a medium size glycerine
      suppository ("glycerine bomb"), which was determined to be more effective than
      the bisacodyl in oil base suppository. The second team evaluated the
      effectiveness of a suppository of choice ("Magic Bullet") which was approved for
      use and replaced the "glycerine bomb." The need for a formalized protocol for a
      bowel care program was identified, developed and implemented. A bowel care
      program quality improvement monitor was developed to evaluate the effectiveness
      of the protocol. With continuous monitoring, we are challenged to evaluate our
      findings and restructure our interventions.

PMID- 7792581
TI  - Scientific conduct: contrasts on a gray scale.

PMID- 7792582
TI  - An active National Institute of Mental Health.

PMID- 7792585
TI  - Play ball!

PMID- 7792584
TI  - Play ball!

PMID- 7792586
TI  - Key NASA lab under fire for animal care practices.

PMID- 7792583
TI  - Play ball!

PMID- 7792587
TI  - U.K. Health Care. Will research be priced out of the market?

PMID- 7792588
TI  - Remapping the motor cortex.

PMID- 7792589
TI  - Discovery of AT gene sparks biomedical research bonanza.

PMID- 7792590
TI  - Indiana: wrong answers--but no right ones.

PMID- 7792591
TI  - Pittsburgh: interwoven with the fabric of learning.

PMID- 7792592
TI  - Stanford: bringing in the big guns.

PMID- 7792593
TI  - Dispute slows paper on "remarkable" vaccine.

PMID- 7792594
TI  - Share and share alike isn't always the rule in science.

PMID- 7792595
TI  - IIT: serving up ethics for lunch.

PMID- 7792596
TI  - How the brain creates imagery: projection to primary visual cortex.

PMID- 7792597
TI  - Crystal structure of lac repressor core tetramer and its implications for DNA
      looping.
AB  - The crystal structure of the tryptic core fragment of the lac repressor of
      Escherichia coli (LacR) complexed with the inducer isopropyl-beta-D
      thiogalactoside was determined at 2.6 A resolution. The quaternary structure
      consists of two dyad-symmetric dimers that are nearly parallel to each other.
      This structure places all four DNA binding domains of intact LacR on the same
      side of the tetramer, and results in a deep, V-shaped cleft between the two
      dimers. Each monomer contributes a carboxyl-terminal helix to an antiparallel
      four-helix bundle that functions as a tetramerization domain. Some of the side
      chains whose mutation reduce DNA binding form clusters on a surface near the
      amino terminus. Placing the structure of the DNA binding domain complexed with
      operator previously determined by nuclear magnetic resonance onto this surface
      results in two operators being adjacent and nearly parallel to each other.
      Structural considerations suggest that the two dimers of LacR may flexibly alter
      their relative orientation in order to bind to the known varied spacings between
      two operators.

PMID- 7792598
TI  - Electron tunneling in proteins: coupling through a beta strand.
AB  - Electron coupling through a beta strand has been investigated by measurement of
      the intramolecular electron-transfer (ET) rates in ruthenium-modified derivatives
      of the beta barrel blue copper protein Pseudomonas aeruginosa azurin. Surface
      histidines, introduced on the methionine-121 beta strand by mutagenesis, were
      modified with a Ru(2,2'-bipyridine)2(imidazole)2+ complex. The Cu+ to Ru3+ rate
      constants yielded a distance-decay constant of 1.1 per angstrom, a value close to
      the distance-decay constant of 1.0 per angstrom predicted for electron tunneling
      through an idealized beta strand. Activationless ET rate constants in combination
      with a tunneling-pathway analysis of the structures of azurin and cytochrome c
      confirm that there is a generally efficient network for coupling the internal
      (native) redox center to the surface of both proteins.

PMID- 7792599
TI  - ILR1, an amidohydrolase that releases active indole-3-acetic acid from
      conjugates.
AB  - In plants, the growth regulator indole-3-acetic acid (IAA) is found both free and
      conjugated to a variety of amino acids, peptides, and carbohydrates. IAA
      conjugated to leucine has effects in Arabidopsis thaliana similar to those of
      free IAA. The ilr1 mutant is insensitive to exogenous IAA-Leu and was used to
      positionally clone the Arabidopsis ILR1 gene. ILR1 encodes a 48-kilodalton
      protein that cleaves IAA-amino acid conjugates in vitro and is homologous to
      bacterial amidohydrolase enzymes. DNA sequences similar to that of ILR1 are found
      in other plant species.

PMID- 7792600
TI  - A single ataxia telangiectasia gene with a product similar to PI-3 kinase.
AB  - A gene, ATM, that is mutated in the autosomal recessive disorder ataxia
      telangiectasia (AT) was identified by positional cloning on chromosome 11q22-23.
      AT is characterized by cerebellar degeneration, immunodeficiency, chromosomal
      instability, cancer predisposition, radiation sensitivity, and cell cycle
      abnormalities. The disease is genetically heterogeneous, with four
      complementation groups that have been suspected to represent different genes.
      ATM, which has a transcript of 12 kilobases, was found to be mutated in AT
      patients from all complementation groups, indicating that it is probably the sole
      gene responsible for this disorder. A partial ATM complementary DNA clone of 5.9
      kilobases encoded a putative protein that is similar to several yeast and
      mammalian phosphatidylinositol-3' kinases that are involved in mitogenic signal
      transduction, meiotic recombination, and cell cycle control. The discovery of ATM
      should enhance understanding of AT and related syndromes and may allow the
      identification of AT heterozygotes, who are at increased risk of cancer.

PMID- 7792601
TI  - Crystal structure of Pseudomonas mevalonii HMG-CoA reductase at 3.0 angstrom
      resolution.
AB  - The rate-limiting step in cholesterol biosynthesis in mammals is catalyzed by 3
      hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, a four-electron
      oxidoreductase that converts HMG-CoA to mevalonate. The crystal structure of HMG
      CoA reductase from Pseudomonas mevalonii was determined at 3.0 angstrom
      resolution by multiple isomorphous replacement. The structure reveals a tightly
      bound dimer that brings together at the subunit interface the conserved residues
      implicated in substrate binding and catalysis. These dimers are packed about a
      threefold crystallographic axis, forming a hexamer with 23 point group symmetry.
      Difference Fourier studies reveal the binding sites for the substrates HMG-CoA
      and reduced or oxidized nicotinamide adenine dinucleotide [NAD(H)] and
      demonstrate that the active sites are at the dimer interfaces. The HMG-CoA is
      bound by a domain with an unusual fold, consisting of a central alpha helix
      surrounded by a triangular set of walls of beta sheets and alpha helices. The
      NAD(H) is bound by a domain characterized by an antiparallel beta structure that
      defines a class of dinucleotide-binding domains.

PMID- 7792603
TI  - Transcriptional activation by tetracyclines in mammalian cells.
AB  - A transcriptional transactivator was developed that fuses the VP16 activation
      domain with a mutant Tet repressor from Escherichia coli. This transactivator
      requires certain tetracycline (Tc) derivatives for specific DNA binding. Thus,
      addition of doxycycline to HeLa cells that constitutively synthesized the
      transactivator and that contained an appropriate, stably integrated reporter unit
      rapidly induced gene expression more than a thousandfold. The specificity of the
      Tet repressor-operator-effector interaction and the pharmacological
      characteristics of Tc's make this regulatory system well suited for the control
      of gene activities in vivo, such as in transgenic animals and possibly in gene
      therapy.

PMID- 7792602
TI  - Aggressive behavior and altered amounts of brain serotonin and norepinephrine in
      mice lacking MAOA.
AB  - Deficiency in monoamine oxidase A (MAOA), an enzyme that degrades serotonin and
      norepinephrine, has recently been shown to be associated with aggressive behavior
      in men of a Dutch family. A line of transgenic mice was isolated in which
      transgene integration caused a deletion in the gene encoding MAOA, providing an
      animal model of MAOA deficiency. In pup brains, serotonin concentrations were
      increased up to ninefold, and serotonin-like immunoreactivity was present in
      catecholaminergic neurons. In pup and adult brains, norepinephrine concentrations
      were increased up to twofold, and cytoarchitectural changes were observed in the
      somatosensory cortex. Pup behavioral alterations, including trembling, difficulty
      in righting, and fearfulness were reversed by the serotonin synthesis inhibitor
      parachlorophenylalanine. Adults manifested a distinct behavioral syndrome,
      including enhanced aggression in males.

PMID- 7792604
TI  - Construction of a soluble adenylyl cyclase activated by Gs alpha and forskolin.
AB  - A soluble adenylyl cyclase was constructed by linkage of portions of the
      cytosolic domains of the mammalian type I and type II enzymes. The soluble enzyme
      was stimulated by both forskolin and the alpha subunit of the heterotrimeric
      guanine nucleotide-binding protein (G protein) Gs (Gs alpha). Expression of the
      construct complemented the catabolic defect in a strain of Escherichia coli that
      is deficient in adenylyl cyclase activity. The active, approximately 60
      kilodalton enzyme accumulated in the cytoplasmic fraction of E. coli to yield
      activities in excess of 1 nanomole per minute per milligram of protein. The two
      sets of transmembrane helices of mammalian adenylyl cyclases are thus not
      necessary for the catalytic or the most characteristic regulatory activities of
      the enzyme. This system may be useful for both genetic and biochemical analysis
      of G protein-regulated adenylyl cyclases.

PMID- 7792605
TI  - Common mechanisms of visual imagery and perception.
AB  - Detection of a visual target can be facilitated by flanking visual masks. A
      similar enhancement in detection thresholds was obtained when observers imagined
      the previously perceived masks. Imagery-induced facilitation was detected for as
      long as 5 minutes after observation of the masks by the targeted eye. These
      results indicated the existence of a low-level (monocular) memory that stores the
      sensory trace for several minutes and enables reactivation of early
      representations by higher processes. This memory, with its iconic nature, may
      subserve the interface between mental images and percepts.

PMID- 7792606
TI  - Shared neural substrates controlling hand movements in human motor cortex.
AB  - Voluntary hand movements in humans involve the primary motor cortex (M1). A
      functional magnetic resonance imaging method that measures relative cerebral
      blood flow was used to identify a distributed, overlapping pattern of hand
      movement representation within the posterior precentral gyrus, which contains M1.
      The observed pattern resembles those reported in nonhuman primates and differs
      from a somatotopically organized plan typically used to portray human motor
      cortex organization. Finger and wrist movements activated a wide expanse of the
      posterior precentral gyrus, and representations for different finger movements
      overlapped each other and the wrist representation. Multiple sites of activation
      occurred in the precentral gyrus for all movements. The overlapping
      representations may mediate motor and cognitive functions requiring coordinated
      neural processing for finger and wrist actions rather than discrete control
      implied by somatotopic maps.

PMID- 7792607
TI  - [Transient ischemic accidents. Results of studies on secondary prevention].

PMID- 7792608
TI  - [Health promotion].

PMID- 7792609
TI  - [Conference "Human beings in nursing"; Caring as a human characteristic].

PMID- 7792610
TI  - [Factors creating preoperative stress].

PMID- 7792612
TI  - [Smoking by the fathers and pathology in the children].

PMID- 7792611
TI  - [Evaluation of the quality of care. An outline for practical application].

PMID- 7792613
TI  - [Outline of osteoporosis].

PMID- 7792615
TI  - [The extent of bioethics].

PMID- 7792614
TI  - [Knowing how to listen. In a helping relationship].

PMID- 7792616
TI  - Urology nurses of Canada: partners in education and care.

PMID- 7792617
TI  - Pharmacologic erection program: an alternative solution for the man with erectile
      dysfunction.

PMID- 7792618
TI  - Use and effectiveness of sexual self-care strategies for interstitial cystitis.

PMID- 7792619
TI  - Pediatric bladder stimulation therapy.

PMID- 7792620
TI  - Listening as an art.

PMID- 7792621
TI  - Helping external catheter wearers to prevent skin breakdown.

PMID- 7792622
TI  - President's message: preparing urologic nurses to meet the challenges of health
      care in the next century.

PMID- 7792623
TI  - Treating stress incontinence with the bladder neck support prosthesis.
AB  - OBJECTIVE: To evaluate a vaginal device designed to support the bladder neck in
      women with urinary stress incontinence. STUDY DESIGN: Thirty physically active
      women completed the study. All underwent urodynamic evaluation at baseline and
      with the best fitting Bladder Neck Support Prosthesis (Johnson and Johnson
      Medical Inc., Arlington, Texas) in place. A bladder diary was maintained before
      enrollment and during 4 weeks of device use. Outcome measures included changes in
      the number of reported incontinence episodes, urine loss on stress testing, and
      changes in urodynamic parameters with the device in place. Patient comfort,
      convenience, and satisfaction were also evaluated. RESULTS: Thirty women
      completed the study. Twenty-five (84%) were dry with the device in place. Weekly
      incontinence episodes decreased from ten to three (p < 0.05). Significant changes
      in functional urethral length, pressure transmission ratio, and Q-tip angle were
      noted. No evidence of urethral obstruction was noted. The subjects found the
      device comfortable, easy to use, and convenient. CONCLUSIONS: The bladder neck
      support prosthesis reduces stress incontinence symptoms significantly and
      normalizes urodynamic parameters like a colposuspension.

PMID- 7792624
TI  - Under-users of antenatal care: a comparison of non-attenders and late attenders
      for antenatal care, with early attenders.
AB  - Demographic, behavioural, environmental, economic and obstetric history data from
      the Jamaican Perinatal Morbidity and Mortality Survey were examined to identify
      characteristics of women who do not attend for antenatal care, or present late
      instead of early for care, using multiple logistic regression. Non-attenders were
      more likely to be teenagers, unmarried, in unions of very short duration, smokers
      and women who felt that friends and relatives were not supportive. Multigravid
      non-attenders often had short inter-pregnancy intervals and included women who
      had experienced a post neonatal death. They were often drawn from deprived
      environments (lack of sanitation, water supplies). Late attenders shared features
      common to non-attenders (teenagers, unmarried, multigravid). Many however were
      self employed and did not fit the depressed profile of the non-attender. Most
      multigravidae who attended late had had previously uneventful pregnancies,
      including this one. Early attenders had little in common with non-attenders or
      late attenders. They were older, many had a secondary or tertiary education, were
      married and were generally middle class women. The group however included high
      risk multigravidae who had previous pregnancy complications or bad outcomes.
      Programmes aimed at reaching non-attenders must focus on the wider social and
      economic needs of these women and must give them a sense of their own power to
      effect change in their lives. Reaching the late attender will be more difficult
      and may be unnecessary with the possible exception of the teenager. She needs to
      be treated in a more sympathetic and non-judgmental way as this is often a high
      risk pregnancy. More fundamental changes require improved educational and
      employment opportunities for women as the best consumer is an educated consumer.

PMID- 7792625
TI  - Why worry about embryos?

PMID- 7792626
TI  - Overcoming ethnocentrism: how social science and medicine relate and should
      relate to one another.

PMID- 7792627
TI  - The effect of third-party payers on the clinical decision making of physical
      therapists.
AB  - According to Freidson, third-party payers have eroded the political and economic
      authority of medicine. To what extent is this also true for alternative
      practitioners such as physical therapists? The effect of Medicare's restrictive
      guidelines on physical therapy practice in skilled nursing facilities (SNFs) is
      examined. SNF physical therapists in Connecticut were surveyed (response rate
      99%) using a mixture of open-ended and fixed-alternative responses. Results
      indicate that SNF physical therapists recognize Medicare criteria and view them
      as important. Twenty-five to 33% of SNF therapists recommend care based on the
      guidelines. Younger therapists, therapists with fewer years in the field, and
      contract therapists are more greatly influenced by the guidelines than older,
      more experienced, staff therapists (P < 0.08). Those who recommend care based on
      the guidelines may do so because of possible nonpayment for services already
      rendered, or because they fear loss of their positions. The majority of
      Connecticut SNF patients who qualify do receive therapy and Medicare coverage.
      Therapists may use their knowledge of the guidelines to secure services for their
      patients, or SNFs may be selecting patients that have the best chances for
      recovery. Like physicians, SNF physical therapists are under pressure from third
      party payers to economize and rationalize, but most continue to secure services
      for their patients.

PMID- 7792628
TI  - Adolescent psychiatry as a product of contemporary Anglo-American society.
AB  - Societies differ with respect to medical traditions. The kinds of healers and
      their emphases vary as a function of culture and social structure. In Western
      nations, a number of specialty disciplines have evolved. Psychiatry is a creation
      of the nineteenth century and linked to demographic and social changes of the
      period. Comparatively little attention has been given to the growth of Adolescent
      Psychiatry, a sub-discipline that has achieved definition in the last two
      decades. Its dependence on cultural and political economic transformations is
      unique insofar as it first required construction of its clientele, namely
      adolescence itself. The 'disorders' that are the focus of Adolescent Psychiatry
      appear to be very much linked symbolically and structurally to the unique social
      pressures impacting on this newly constructed group. The historical and cultural
      determinants of the developments that have culminated in the evolution of
      Adolescent Psychiatry are reviewed and discussed.

PMID- 7792629
TI  - An economic analysis of the resettlement of people with mild learning
      disabilities and challenging behaviour.
AB  - New models of care are needed following the closure of long-stay mental handicap
      hospitals. Based on an evaluation of a recently established assessment and
      treatment service in south-east England, this paper is concerned with the costs
      and likely benefits of different patterns of services for people with mild
      learning disabilities and severely challenging behaviour. Different models of
      provision are compared in terms of their costs and quality of life opportunities
      for clients. The assessment and treatment services provided a better
      understanding of the care needs, and achieved a reduction in challenging
      behaviours. It was therefore possible to give access to care settings closer to a
      normal life. For approximately 25% additional expenditure, 20 out of 34 clients
      who received the service moved to community placements, including three who had
      been referred following a breakdown in the community. If community care is to be
      implemented as a policy for clients with learning disabilities and serious
      challenging behaviours, it is necessary to recognise the financial implications.
      Better quality of life opportunities for this client group are associated with
      higher costs. When seen in the dynamic context of the costs and quality of life
      opportunities of the subsequent care, a high cost assessment and treatment
      service may be a good investment. On current evidence, the additional benefits of
      community homes, with a closer association with the local community, and greater
      freedom for clients is bought only at quite a high cost.

PMID- 7792630
TI  - Doctor-patient communication: a review of the literature.
AB  - Communication can be seen as the main ingredient in medical care. In reviewing
      doctor-patient communication, the following topics are addressed: (1) different
      purposes of medical communication; (2) analysis of doctor-patient communication;
      (3) specific communicative behaviors; (4) the influence of communicative
      behaviors on patient outcomes; and (5) concluding remarks. Three different
      purposes of communication are identified, namely: (a) creating a good inter
      personal relationship; (b) exchanging information; and (c) making treatment
      related decisions. Communication during medical encounters can be analyzed by
      using different interaction analysis systems (IAS). These systems differ with
      regard to their clinical relevance, observational strategy, reliability/validity
      and channels of communicative behavior. Several communicative behaviors that
      occur in consultations are discussed: instrumental (cure oriented) vs affective
      (care oriented) behavior, verbal vs non-verbal behavior, privacy behavior, high
      vs low controlling behavior, and medical vs everyday language vocabularies.
      Consequences of specific physician behaviors on certain patient outcomes, namely:
      satisfaction, compliance/adherence to treatment, recall and understanding of
      information, and health status/psychiatric morbidity are described. Finally, a
      framework relating background, process and outcome variables is presented.

PMID- 7792631
TI  - A prepayment scheme for hospital care in the Masisi district in Zaire: a critical
      evaluation.
AB  - In most developing countries, government funding allocated to the health services
      is not sufficient to allow these services to provide appropriate health care
      accessible to all. Consequently, community financing has received much more
      attention in recent years and innovative schemes are being explored throughout
      the developing world. Risk-sharing schemes, like prepayment, are interesting
      because of their potential redistributive effects. At the end of the eighties, a
      prepayment scheme for hospital care was experimented with in the Masisi health
      district in Eastern Zaire. In the present paper, the experiment is described in a
      chronological way and the results are analyzed and discussed in detail. Although
      this particular case-study was not successful, it yields important lessons
      concerning the design, implementation and evaluation of prepayment schemes for
      hospital health care in developing countries. More specifically, phenomena like
      adverse selection and moral hazard are discussed. Finally, conditions for success
      of similar experiments are discussed. These conditions relate mainly to the
      organization pattern of the district health services system. The Masisi
      experiment is a nice illustration of the fact that prepayment is not a 'magic
      bullet': the lessons drawn from it may be of relevancy to health planners
      intending to implement hospital prepayment schemes in similar settings.

PMID- 7792632
TI  - Transforming aids prevention to meet women's needs: a focus on developing
      countries.
AB  - As currently conceived, the global AIDS prevention strategy consists primarily of
      three interrelated tactics: (1) encouraging people to reduce their number of
      sexual partners; (2) promoting the widespread use of condoms; and (3) treating
      concurrent STDs in populations at risk of HIV. This three-pronged attack,
      however, is inadequate for meeting the protection needs of many of the world's
      women. Disproportionately poor and with little power to negotiate the terms of
      sexual encounters, women often cannot avail themselves of these life-saving
      strategies. Women need both a new commitment to addressing the underlying
      inequities that heighten their risk, and new technologies that provide them with
      a means of HIV protection within their personal control. This article makes the
      case for restructuring AIDS prevention by describing the growing risk of HIV
      infection faced by women throughout the world, examining the serious limitations
      of the contemporary AIDS prevention strategy in meeting women's needs, and
      exploring how new approaches--including a shift toward a more 'community
      organizing' approach to AIDS prevention--could help women exert more control over
      their sexual and reproductive lives.

PMID- 7792633
TI  - 'A bothersome death'--narrative accounts of infant mortality in Cape Town, South
      Africa.
AB  - Traditional measures of health status such as mortality rates and cause-of-death
      information give limited insight into the role of caregivers and health care
      providers in infant illness and death. To the extent that the behaviours of these
      parties can be accurately mapped, they may reveal important sites for effective
      community interventions and the improvement of medical care. This possibility is
      explored in relation to infant mortality in Cape Town, South Africa, by analysing
      verbal histories provided by the caregivers of 70 infants in the course of
      obtaining police death certification. From these verbal histories it appears that
      acute respiratory infection and diarrhoeal disease caused the majority of deaths.
      Infants with a respiratory condition were likely to have been taken for medical
      attention prior to death. By contrast, the parents of infants with diarrhoeal
      disease, while more active towards these infants, were less likely to seek
      medical care--these infants typically being found dead in bed or dying en route
      to the hospital or clinic. A story of infant death at home following recent
      medical care was obtained in over half the cases. This study demonstrates a
      simple method for the examination of the content and structure of lay accounts of
      illness and death. The implications for health care of such accounts are
      discussed in terms of the behavioural antecedents of infant mortality due to
      acute respiratory infections and diarrhoeal disease.

PMID- 7792634
TI  - The psychosocial problems of sickle cell disease sufferers and their methods of
      coping.
AB  - We interviewed 170 sickle cell disease (SCD) patients (mean age 25 years) with a
      modified version of the Frankfurter Befindlichkeitskala (FBS, 33-item) and the 12
      item General Health Questionnaire (GHQ-12), with a view to highlighting the
      psychosocial issues which worry them, the way they cope with these problems, and
      the factors associated with these issues. The mean FBS score of SCD patients was
      comparable with those of insulin dependent diabetics, but significantly higher
      than that of non-insulin dependent diabetics. The FBS scores were significantly
      correlated with GHQ-12 scores. Feelings of inadequacy of social contact were
      significantly associated with high FBS and GHQ scores. Some common complaints
      were: the limitations illness placed on social life; depressive feelings;
      abnormal habitus; suicidal ideation during crises; and the burden of illness on
      the family. They frequently resorted to prayers as a method of coping, as most
      had no clear ideas on how to deal with these issues. Worries over psychosocial
      consequences of SCD, seem to add considerably to the burden of illness, and
      clinicians will offer better care to patients if they routinely enquire into some
      of these issues and offer health education and counselling in a group setting.

PMID- 7792635
TI  - Occupational life course and lung cancer risk in men. Findings from a socio
      epidemiological analysis of job-changing histories in a case-control study.
AB  - Psychosocial factors in general, and the social and psychological conditions of
      work and occupation in particular, have attracted little attention to the
      epidemiological investigation into the occupational-related causes of lung
      cancer. There is some evidence available concerning the impact of loss events-
      including job losses--on cancer development. During our research presented in
      this article, we examined job changes and job transitions in the occupational
      biography of men with regard to their circumstances in terms of (in
      )voluntariness both as individual events and the job-changing histories of
      individuals. We expected the job-changing histories of lung cancer cases to be
      more involuntary than those of population controls, and vice versa. Our sample
      contains 391 male case-control pairs. Cases are defined as newly-diagnosed men of
      German nationality with a histologically- or cytologically-confirmed diagnosis of
      primary lung cancer. Population controls were drawn randomly from the
      municipality records of residents and individuals matched to cases 1:1 by age and
      region. Occupational histories were reconstructed, and information about other
      classical and suspected risk factors was collected during standardized interviews
      by trained interviewers. We categorized the reported reasons for job changes, and
      classified them with respect to voluntariness on a seven-stepped rating scale
      from -3 'very involuntary' to +3 'very voluntary', defining relations within the
      empirically established categories. The job-changing histories of individuals are
      described by using the average score of voluntariness. We measured the degree of
      voluntariness for the occupational history: (1) by the rounded average score; and
      (2) by the quintiles of the average score. On the basis of individuals matched
      odds ratios (OR) estimates are derived for the score of voluntariness unadjusted
      and adjusted for smoking, asbestos exposure and socio-economic group by
      conditional logistic regression. The investigation into job-changing histories
      using the average score of voluntariness lead to similar results for both
      measuring methods for the total study group. When the rounded score was used, job
      changing histories which were assessed as 'very involuntary' and 'involuntary'
      (score -3 and -2) showed an elevated odds ratio of adjusted 1.41 (95%-CI: 0.57;
      3.48), and when they were assessed as 'moderately involuntary' (score -1) the
      adjusted odds ratio was 1.59 (95%-CI: 1.02; 2.48), as compared with job-changing
      histories assessed as neutral (score 0). When the degree of voluntariness was
      measured by quintiles, the first quintile (score -3- < -0.6) showed an elevated
      risk of adjusted OR 1.36 (95%-CI: 0.79; 2.36) as compared to the third quintile
      (score -0.2- < -0.1).(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7792636
TI  - Talking about the pain: a patient-centered study of low back pain in primary
      care.
AB  - Despite considerable research, low back pain (LBP) often proves resistant to
      treatment. This study was designed to increase the understanding of low back pain
      through access to patients' perceptions, beliefs, illness behaviors and lived
      experiences. The findings are based on focus groups, individual interviews and
      participant observation conducted in primary care practices and community
      settings in three regions in Israel. Inclusion criteria for the interviews and
      groups include age greater than 18 years and a history of at least one episode of
      LBP. Seventy-six LBP subjects between the ages of 18 and 67 (mean 39.5)
      participated, 65% male and 35% female. The analytic method is content analysis,
      consisting of a formal, multi-step process designed to elucidate inherent
      patterns and meanings. This research finds that LBP subjects articulate a rich
      world of pain sensation, awareness and meanings. From subjects' own words and
      experiences we present a patient-centered classification system of backache
      symptoms based on typical pain intensity, dysfunction, duration and treatment. An
      elaborate system of explanatory models of LBP and a typology of dominant coping
      styles designed to either minimize pain or maximize function are also derived.
      Subjects choose multiple conventional and alternative treatments based on 'what
      works', and articulate ample criticisms of and suggestions for the medical
      system. In addition, we find that variations in the social construction of the
      back pain experience vary sharply, even between similar neighboring communities.
      Given the difficult state of diagnosis and treatment and the frustration of
      practitioners, attempts at greater understanding of patients' health beliefs,
      experiences, and behaviors are warranted.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792637
TI  - Treatment of childhood diarrhea in rural Egypt.
AB  - The Egypt National Control of Diarrheal Diseases Project, implemented between
      1983 and 1991, is widely regarded as one of the most successful national oral
      rehydration programs. Data from a longitudinal household survey conducted in 1990
      91 in rural Egypt indicate substantial increases in both knowledge and use of
      oral rehydration salts during the 1980s. However, the same data show that
      treatment of acute diarrheal episodes is still far from optimal. In particular,
      the use of oral rehydration during diarrheal episodes is far from universal, the
      prescription of antibiotics is still too frequent, and antidiarrheal drugs of no
      therapeutic value are still widely used. Analysis of the factors associated with
      different treatment patterns shows that children with severe diarrhea, those aged
      6-23 months and those from poor households were more likely to be given ORS; boys
      were somewhat less likely to receive ORS than girls, but mother's education
      showed no consistent effects. The type of treatment received is strongly
      influenced by the source of care. Government clinics are more likely than private
      physicians or pharmacies to prescribe ORS, whereas children taken to the latter
      two sources of care are more likely to be given antibiotics and antidiarrheals.
      To improve diarrhea treatment patterns in Egypt, not only must the public service
      educational campaign be reinstated and strengthened, but training programs must
      also be targeted at the treatment practices of private physicians.

PMID- 7792638
TI  - Habitat destruction syndrome.

PMID- 7792639
TI  - [Principal complications in the hemodialyzed patient].

PMID- 7792640
TI  - [Nutritional hygiene for the dialyzed patient].

PMID- 7792641
TI  - [Course of a hemodialysis session. The nurse's role].

PMID- 7792642
TI  - [Middle and long-term follow-up of dialyzed patients].

PMID- 7792643
TI  - [Education in home dialysis and autodialysis. The nurse's role].

PMID- 7792644
TI  - [Psychological effects of hemodialysis].

PMID- 7792645
TI  - [The quality of care in a hemodialysis unit].

PMID- 7792648
TI  - [The nurse and the dialyzed patient].

PMID- 7792647
TI  - [The future of the dialyzed patient].

PMID- 7792646
TI  - [Kidney transplantation. Indications and preparation of the graft].

PMID- 7792649
TI  - [Practical application of nursing ethics].

PMID- 7792650
TI  - [The nurses' responsibility. Professional responsibility and the proper role of
      the autonomous nurse].

PMID- 7792651
TI  - [Chronic kidney failure].

PMID- 7792652
TI  - [The unbearable gap in nursing education and practice].

PMID- 7792654
TI  - [Extrarenal purification by hemodialysis].

PMID- 7792653
TI  - [Lithium salts].

PMID- 7792656
TI  - [Practice of home hospitalization].

PMID- 7792655
TI  - [Clinical significance of home hospitalization].

PMID- 7792657
TI  - [The institutional coffee habit. An aspect of wearing-out].

PMID- 7792658
TI  - [Therapeutic placement in families. Dun-sur-Auron specialized hospital center].

PMID- 7792660
TI  - [Group therapy in psychiatric medical centers].

PMID- 7792659
TI  - [Activities of a department. Parameters and indices].

PMID- 7792662
TI  - [Black nights].

PMID- 7792661
TI  - [Psychiatric home hospitalization. Preface].

PMID- 7792663
TI  - [Psychiatric home hospitalization].

PMID- 7792664
TI  - [Breast carcinoma: successful early diagnosis, increased mortality].

PMID- 7792665
TI  - [Side effects and complications of intra-arterial tumor therapy--experiences with
      577 interventions].

PMID- 7792666
TI  - [Parametric images of cerebral blood volume with T1 FLASH sequences].

PMID- 7792667
TI  - [Cystic lymphangioma of the mesentery--a rare space-occupying lesion of the
      abdomen].

PMID- 7792670
TI  - Human susceptibility to indoor contaminants.
AB  - Indoor environmental pollutants can act as irritants, allergens, carcinogens, or
      infectious agents. This chapter focuses on human susceptibility to indoor
      environmental pollutants, here defined as inherent factors that alter exposure
      response relationships. The host defense system is an important determinant of
      human susceptibility and is composed of two portions: nonspecific immunity and
      specific immunity. Pollutants elicit responses from many components of the human
      host defense system, and human susceptibility results from biologic variability
      in these components. Nonspecific immunity responds to stressors based on
      physicochemical properties. Components include mucociliary clearance, the
      epithelial barrier, airway surface fluid, and neural reflexes. Specific immunity
      recognizes and responds to unique peptide or carbohydrate sequences present on
      the foreign agent, and components of the response may include lymphocytes,
      basophils, mast cells, and immunoglobulins. Irritants typically stimulate
      nonspecific immunity, allergens stimulate specific immunity, and infecting
      organisms and carcinogens interact with both. Additional inherent factors that
      may alter the toxicity of an agent include genetic background, the presence of
      disease or specific organ pathology, age, gender, body weight, nutritional,
      hormonal, and central nervous system status. Understanding the basis for human
      susceptibility to indoor environmental pollutants can assist in implementing
      practical strategies for managing indoor air quality.

PMID- 7792669
TI  - Biologic contaminants.
AB  - Dr. Seltzer lays the groundwork for a discussion of the importance of a healthy
      environment by pointing out that most Americans spend at least 90% of their time
      indoors. He describes conditions that promote biologic contamination, ways that
      these contaminants induce illness, the key components of any evaluation of an
      indoor environment, and methods of decontamination and prevention.

PMID- 7792668
TI  - [Detection of a hepatic artery aneurysm with color-coded duplex ultrasound].

PMID- 7792672
TI  - The behavioral effects of indoor air pollutants.

PMID- 7792671
TI  - Irritation and odor as indicators of indoor pollution.
AB  - Both irritation and odor figure prominently in complaints about indoor air.
      Irritation poses the greater problem since it arguably represents an adverse
      health effect per se and since its sources are often difficult to locate. There
      exist various potential assays for irritation, some better for validation of
      symptoms and some better for research on structure-activity relations. One animal
      assay, the respiratory depression technique, has produced measures of irritant
      potency in good accord with sensory psychophysical measurements in humans. Both
      the animal and human data point toward common physicochemical determinants of
      potency, especially for the weak irritants that often exist in indoor
      environments. For the foreseeable future, the assessment of odors in indoor
      environments will need to proceed as in the past, as a psychophysical measurement
      rather than as a chemical measurement. Methodologies for odor measurement
      continue to evolve. The evaluation of their usefulness in field settings must
      ultimately stand against a criterion of validity that has to date proved elusive
      to establish.

PMID- 7792674
TI  - The medical evaluation.

PMID- 7792673
TI  - The sick-building syndrome.
AB  - The sick-building syndrome is a poorly defined term whose use should be
      discontinued. In the majority of cases, engineering problems and pollutant
      sources can be identified that contribute to the generation of complaints.
      Although psychosocial factors are likely to exacerbate underlying complaints,
      they should not distract from identifying solutions.

PMID- 7792675
TI  - A systematic approach to indoor air quality for the building manager.

PMID- 7792677
TI  - Indoor air quality: research needs.
AB  - Areas of research for which the author finds a need include source
      characterization, exposure assessment, health effects, risk assessment, and
      solutions that will prevent or mitigate pollution. Policies regarding radon are
      cited to provide examples of directions that other IAQ policies can follow.

PMID- 7792678
TI  - Creating healthy indoor environments. A road map for the future.
AB  - This road map for the future describes 12 steps toward the creation of healthy
      indoor environments. Pointing out that funding for indoor air issues pales in
      comparison to that spent on outdoor pollution, the author argues that a
      multidisciplinary approach is necessary to improve the existing knowledge base
      concerning IAQ.

PMID- 7792676
TI  - The legal aspects of indoor air and health.

PMID- 7792680
TI  - Ventilation.
AB  - This chapter begins with an overview of the history of ventilation guidelines,
      which has led to the guidelines that are in effect today. Of particular interest
      is the most recent return in the past 5 years to ventilation rates that more
      closely reflect a mean or average of the range of guidelines that have existed
      over the past century. OSHA's and the EPA's recognition of the need to operate
      ventilation systems in buildings in an accountable manner is also of note. Of
      even more interest is the resurgence of the concept of minimum mixing and once
      through ventilation air that has been pursued in parts of Northern Europe for the
      past 10 years, and in a school that is being designed with this concept in New
      Hampshire. In addition, the design concept of equipping office buildings with low
      pressure drop high efficiency particle filtration to remove fine particles from
      all of the air that is supplied to the occupants is being used increasingly in
      the U.S. This chapter also presents an overview of the various types of
      ventilation systems found in homes and commercial office buildings and the common
      indoor air quality problems that may be associated with them. It also offers an
      overview of common HVAC evaluation techniques that can be used to determine if a
      ventilation system is performing in a manner that makes sense for the use of the
      space and the needs of the occupants. Are the occupants receiving a reasonable
      supply of outdoor air? Is the air that they receive of reasonable quality? Are
      obvious pollutants being exhausted? Ventilation systems have become extremely
      complex and more difficult to run and maintain over the past 40 years. This trend
      will continue to drive the need for professionally maintained HVAC equipment that
      is serviced and run by individuals who are accountable for the quality of the air
      that the system delivers.

PMID- 7792679
TI  - Aerobiology of the indoor environment.
AB  - This review of aerobiology focuses on the principles of aerobiology, the effect
      of airborne agents on human health, and the characteristics of indoor aerosols
      and outdoor aerosols that enter the indoor environment. A discussion of
      representative monitoring describes observational, bulk, and air sampling.

PMID- 7792681
TI  - Physical factors in the indoor environment.
AB  - This comprehensive chapter presents a discussion of physical factors in the
      nonindustrial indoor environment that affect human health, comfort, productivity,
      and well-being. Areas stressed include the thermal environment, light, noise, and
      other mechanical energy.

PMID- 7792682
TI  - The environmental evaluation: commercial and home.

PMID- 7792683
TI  - Why, how, and when? Why did this happen? How should it be treated? When will
      there be a cure?

PMID- 7792684
TI  - Estrogen and progesterone receptors in human meningiomas: biochemical and
      immunocytochemical evaluation.
AB  - BACKGROUND: The observation that human meningiomas are rich in steroid hormone
      receptors has led to the hypothesis that their growth may be hormonally
      dependent. This study aims to correlate the biochemical expression of estrogen
      (ER) and progesterone receptors (PgR) with their nuclear immunoreactivity in a
      large series of meningiomas. METHODS: The occurrence of ER and PgR in patients
      with primary untreated meningiomas was studied with a dextrancoated charcoal
      method (DCC) and the results were compared with those of an immunocytochemical
      assay (ICA). Progesterone and estrogen receptor determinations were performed on
      103 and 99 meningiomas respectively using the DCC assay. Forty-six and 44 of
      these samples were immunocytochemically evaluated for the presence of PgR and ER
      respectively. RESULTS: Of the 46 samples evaluated by both the methods, 89% were
      found PgR positive by DCC and 70% by ICA. The overall concordance between PgR-DCC
      and PgR-ICA was 80%. Whereas low concentrations of ER were found in 8/44 samples
      (18%) assayed by DCC, specific staining was never observed in any of the samples
      tested by ICA. CONCLUSIONS: Our findings confirm that the majority of meningiomas
      are devoid of ER and that the biochemical evidence of PgR correlates well with
      the nuclear localization of progesterone receptors determined by
      immunocytochemistry.

PMID- 7792685
TI  - Cystic meningiomas.
AB  - BACKGROUND: Meningiomas are generally solid tumors and are easily diagnosed by CT
      scans and MRI scans. Rarely are these tumors associated with cysts that can cause
      a confusion in the pre- and intraoperative diagnosis. Cysts associated with
      meningiomas may be intratumoral or peritumoral. METHODS: The authors conducted a
      retrospective study of the seventeen meningiomas, out of a total number of 232,
      which were associated with cysts. The cysts were classified based on their
      relationship to the tumor. The patients' sex, age group, location of the tumor,
      and pathological type of tumor were also analyzed. RESULTS: The 17 cases of
      cystic meningioma formed 7.3% of the meningiomas seen between 1984 and 1993.
      Eleven of these were intratumoral and 6 peritumoral. One case had both intra- and
      peritumoral cysts. The tumors were found mostly in the fourth and fifth decades
      of life. Histologically, all the peritumoral cysts except one were associated
      with meningotheliomatous meningiomas. Tumors with peritumoral cysts were more
      common in males. Intratumoral cysts, more common in females, were angioblastic or
      meningotheliomatous on histopathology. Only one case was an anaplastic
      meningioma. CONCLUSION: Cysts associated with meningiomas, although uncommon, are
      certainly not rare. The peritumoral and the intratumoral cysts form distinct
      subtypes needing separate consideration. Cystic meningiomas are only rarely
      malignant.

PMID- 7792686
TI  - Dysembryoplastic neuroepithelial tumor: report of three cases.
AB  - BACKGROUND: Dysembryoplastic neuroepithelial tumor (DNT) is one of the mixed
      neuronal-glial tumors that should be differentiated from low-grade gliomas. The
      recognition and correct diagnosis of DNT is important because this tumor is
      curable by excision. METHODS: We report three cases of histologically proven DNTs
      with various image studies performed preoperatively and describe characteristic
      findings of them, as well as those of previous reports. RESULTS: In our three
      cases, computed tomography (CT) showed a well-defined, nonenhancing hypodense
      area. Magnetic resonance imaging (MRI) demonstrated a cortical mass of
      hypointensity on T1- and of marked hyperintensity on T2-weighted images. I-123
      IMP or Tc-99m-HMPAO single-photon emission computed tomography (SPECT) images
      showed marked hypoperfusion of the lesion. Thallium-SPECT showed no uptake.
      CONCLUSIONS: I-123-IMP, Tc-99m-HMPAO, and Thallium-SPECT images, as well as CT
      and MRI, may be helpful in distinguishing DNT from low-grade gliomas.

PMID- 7792687
TI  - Epidermoid tumors of the fourth ventricle.
AB  - BACKGROUND: Epidermoids of the brain are rare tumors. Their fourth ventricle
      localization is about the rarest localization. No series of such tumors has been
      reported. Their manifestations and management are therefore not well understood.
      METHODS: Four epidermoid tumors of the fourth ventricle were collected over a
      period of 39 years from the neurosurgical units of the American University of
      Beirut Medical Center and the Orient Hospital. These were retrospectively studied
      and the medical literature reviewed. RESULTS: Epidermoids of the brain form 1% of
      all brain tumors, and those located in the fourth ventricle are 16.7% of the
      epidermoids. They rarely present symptoms of increased intracranial pressure.
      They commonly present in adults with only cerebellar signs. The duration of
      symptoms may be short, medium, or long. The diagnosis, when clinically suspected,
      should be confirmed by magnetic resonance imaging. An early diagnosis is the key
      for a good outcome. CONCLUSION: Although a rare condition, these tumors can be
      lethal if not treated. Total excision should be attempted. Because this tumor is
      very slow-growing, a near-total excision is acceptable in cases where complete
      removal may endanger function or life.

PMID- 7792688
TI  - Central neurocytoma with hemorrhagic onset.
AB  - A case of central neurocytoma with spontaneous intraventricular hemorrhage is
      reported. A 23-year-old man, 2 years after experiencing intraventricular
      hemorrhage, developed severe headaches. The magnetic resonance image showed a
      mixed intense mass in the lateral ventricle with associated hydrocephalus. The
      tumor mass was totally removed. The tumor was histologically diagnosed as central
      neurocytoma. Review of the computed tomography taken 2 years ago showed not only
      the hemorrhage but also a mass in the left lateral ventricle. This emphasizes
      that central neurocytoma should be considered in the differential diagnosis of
      patients with either intraventricular hemorrhage or hemorrhagic tumor.

PMID- 7792689
TI  - Extradural tumor causing spinal cord compression in Klippel-Trenaunay-Weber
      syndrome.
AB  - BACKGROUND: Myelopathy in Klippel-Trenaunay-Weber syndrome is uncommon but has
      been reported secondary to spinal vascular malformations. REPORT: A patient with
      Klippel-Trenaunay-Weber syndrome who presented with spinal cord compression from
      a spinal extradural mass lesion (angiomyolipoma) is described. DISCUSSION: This
      association has not been reported previously but is consistent with the segmental
      vascular abnormalities observed in Klippel-Trenaunay-Weber syndrome.

PMID- 7792690
TI  - A case of spinal low-grade astrocytoma with exophytic and intracranial extension.
AB  - BACKGROUND: Ventral exophytic growth of a spinal intramedullary glioma into the
      cranial cavity is an unusual condition. CASE DESCRIPTION: A 16-year-old boy was
      admitted because of lower cranial nerve dysfunction and acute hydrocephalus.
      Magnetic resonance images showed an intramedullary mass lesion in the upper
      cervical spinal cord with exophytic extension into the medullary and prepontine
      cisterns. The patient underwent suboccipital craniectomy and C1-2 laminectomy for
      decompression and histologic evaluation. The histopathologic findings were
      characteristic of astrocytoma grade II. Although radiotherapy was performed, the
      patient died 7 months later. CONCLUSIONS: This is considered to be a rare case of
      spinal low-grade astrocytoma with ventral exophytic intracranial extension.

PMID- 7792691
TI  - Cryoprobe-assisted removal of spinal cord tumors: technical note.
AB  - The application of a cryosurgical contact probe to assist in the removal of
      intraspinal neoplasms is described. Most often used by ophthalmic surgeons for
      intraocular extraction purposes, these .89-3 mm cryoprobes provide an ideal safe
      "handle" when attached to intramedullary or extramedullary spinal cord tumors and
      facilitate dissection and removal with standard microsurgical techniques.

PMID- 7792692
TI  - Intracerebral hematoma in patients with ruptured cerebral aneurysms.
AB  - BACKGROUND: Intracerebral hematoma from ruptured aneurysms is one of the
      unfavorable factors for outcome in patients with subarachnoid hemorrhage. In this
      study, the clinical characteristics of intracerebral hematoma in patients with
      ruptured aneurysms were examined. METHODS: The subjects were 512 patients who had
      been admitted by day 3 after aneurysmal rupture without episodes of rebleeding
      before the initial computed tomography (CT) scan. They were divided into two
      groups according to the findings of initial CT; groups 1 and 2 comprised patients
      with and without intracerebral hematoma, respectively. RESULTS: Of the 512
      patients, intracerebral hematoma was observed in 98 (19%). The incidence of
      intracerebral hematoma was higher in patients with distal anterior cerebral and
      middle cerebral artery aneurysms, compared with those at other sites (both, p <
      0.01). Interhemispheric, callosal, and temporal lobe/sylvian hematomas were
      observed more frequently in patients with anterior communicating, distal anterior
      cerebral, and middle cerebral artery aneurysms, respectively, than in those with
      aneurysms at other sites. The incidence of rebleeding was 22% in group 1 and 14%
      in group 2 (p < 0.05). Clinical grades on admission were higher and outcome at 6
      months after onset was less favorable in group 1 than in group 2 (both, p <
      0.01). The larger the intracerebral hematoma, the higher was the clinical grade
      and the less favorable the outcome. However, when comparing management and
      surgical outcome under the same clinical grades, there was no significant
      difference between the two groups. CONCLUSIONS: There was a close correlation
      between the site of hematoma and that of the ruptured aneurysm. Poor outcome in
      patients with intracerebral hematoma seems to be related to severity of clinical
      grade on admission.

PMID- 7792694
TI  - The different classification systems for astrocytomas.

PMID- 7792695
TI  - Glia: the brain's other cells.

PMID- 7792693
TI  - Factors leading to early recurrence of carotid plaque after carotid
      endarterectomy.
AB  - BACKGROUND: Carotid endarterectomy to remove atherosclerotic plaque restores
      blood flow and reduces the risk of cerebral ischemia. In some patients, however,
      postoperative plaque recurrence reduces the clinical benefit of carotid
      endarterectomy. METHODS: Using duplex ultrasound scanning, we evaluated carotid
      artery restenosis in 63 endarterectomy patients followed for an average of 26.6
      months after surgery. RESULTS: During follow-up, two-thirds of the patients
      showed some observable vessel wall thickening. A negative correlation was found
      between years since smoking cessation and recurrence of carotid plaque. Maximum
      benefit was seen when smoking cessation occurred at least 1 year before
      endarterectomy. The least benefit was seen when smoking continued or when
      cessation occurred within 1 year of endarterectomy. CONCLUSIONS: Smoking status
      was the only cardiovascular risk factor independently and significantly
      associated with recurrent plaque thickness.

PMID- 7792697
TI  - The 47th annual meeting of the Neurosurgical Society of America, May 22-25, 1994.

PMID- 7792696
TI  - The erythrocyte sedimentation rate: an interface between science and the law.
AB  - Excerpts from the deposition of a medical expert appearing for a female plaintiff
      in a malpractice action dealing with a postoperative disk space infection are
      presented. Much of the issue centered about the erythrocyte sedimentation (ESR)
      rate 4 months postdisk surgery (ESR = 23 mm/hr). The expert testified that the
      ESR will, after an initial rise, return to normal levels in the face of
      progressive symptomatology and inflammatory bone change. The pertinent literature
      cited indicates that the elevated sedimentation rate in infection not only
      persists, but escalates and remains in an elevated state until appropriate
      therapy is instituted.

PMID- 7792699
TI  - The treatment of hydrocephalus: a brief guide to shunt selection.
AB  - The placement of a cerebrospinal fluid shunt system is a procedure that most
      neurosurgeons feel comfortable performing. The procedure is fraught with many
      pitfalls and the choices of equipment are staggering. We review the recent
      literature on shunt systems. We describe the newer shunt systems and procedures
      and identify possible roles for them in shunt procedures by the neurosurgeon in
      practice.

PMID- 7792698
TI  - Whose life is it anyway?

PMID- 7792700
TI  - A new shunt for hydrocephalus that relies on CSF production rather than on
      ventricular pressure: initial clinical experiences.
AB  - BACKGROUND: Ventricular shunting for hydrocephalus is one of the surgical
      procedures most frequently associated with complications. When the hydrocephalus
      is secondary to arachnoiditis the prognosis is usually poor. METHODS: Twenty-six
      patients with hydrocephalus secondary to chronic arachnoiditis due to meningeal
      cysticercosis were treated with a new ventriculoperitoneal shunt whose design is
      based on the rate of cerebrospinal fluid (CSF) production and shunt resistance
      rather than on ventricular pressure, which has been the principal parameter for
      most other shunting devices. RESULTS: The shunt has remained functional in 25
      patients (96%). A peculiar response was documented in all cases by sequential CT
      scans; i.e.; the size of the ventricular cavities showed gradual reduction and
      about 1 month postsurgery the ventricles had returned to normal size. In all
      cases, fast clinical improvement was documented within the first 2 days after
      surgery with remission of all symptoms of intracranial hypertension. Improvement
      has continued for a mean follow-up of 9 +/- 2 months. In one case, the shunt was
      occluded a month after surgery, was withdrawn, and was replaced by a conventional
      shunt. CONCLUSIONS: Our initial results contrast with the experience with other
      shunts, which in these patients have a rate of 50% occlusion within the first 4
      months after surgery. Although a long-term follow-up is mandatory, it seems that
      the treatment of hydrocephalus by a shunt devoid of valve mechanisms, with
      drainage capacity limited to physiological parameters of CSF production, could
      avoid the unacceptable high frequency of overdrainage and occlusion that are the
      main complications of shunting devices that operate in relation to ventricular
      pressure.

PMID- 7792701
TI  - Shunt failure in adult hydrocephalus: flow-controlled shunt versus differential
      pressure shunts--a cooperative study in 289 patients.
AB  - BACKGROUND: In order to assess the efficiency of flow-controlled shunts in
      reducing shunt failure in the treatment of adult hydrocephalus (with a special
      focus on overdrainage complications), a series of 289 patients was analyzed
      through a retrospective and comparative study performed in three neurosurgical
      departments. METHODS: A group of 142 adult patients suffering from hydrocephalus
      were operated on using a conventional differential pressure (DP) shunt and
      compared with a group of 147 adult patients operated on using flow-controlled
      (FC) system (Orbis-Sigma, Cordis). Only the first complication, which required a
      surgical revision within the first 2 years after shunt implantation, was taken
      into account for each patient and analyzed using life-table methods. RESULTS: The
      actuarial risk of shunt infection in the two groups is respectively 8.3% and
      10.9% at 1 year (nonsignificant difference). The actuarial risk of mechanical
      complications at 1 year is 38% for the DP patients and 10% for the FC patients (p
      = 0.0001); this difference is largely due to a decrease of complications related
      to overdrainage phenomenon (14/142 subdural collections were observed in the DP
      group versus 1/147 in the FC group) (p = 0.0001). CONCLUSION: The conclusion of
      this cooperative and retrospective study is that the use of a flow-controlled
      system decreases the risk of mechanical complications related to the hydrodynamic
      properties of the shunts used in the treatment of adult hydrocephalus, especially
      those related to overdrainage.

PMID- 7792703
TI  - A no-touch technique protocol to diminish cerebrospinal fluid shunt infection.
AB  - BACKGROUND: Cerebrospinal fluid (CSF) shunts become infected primarily by
      bacterial organisms indigenous to the patient's skin flora, but bacteria from the
      operating room environment, hospital, or no obvious source may also infect a
      shunt. To decrease the incidence of shunt infection, a no-touch technique
      protocol was developed and utilized in a prospective manner. METHODS: A before
      after trial analysis was performed to compare the infection rates between
      patients who had CSF shunts placed using the no-touch technique protocol versus
      patients who had surgery without the protocol. Patients were stratified by age,
      etiology of hydrocephalus, type of shunt surgery, and presence of a contaminated
      skin wound, namely, tracheostomy, gastrostomy-jejunostomy, colostomy, or halo.
      The differences in infection rates were analyzed with the Fisher exact test with
      midpoint value correction, and standard statistical methods were used to
      calculate the 90% confidence interval odds ratio and number to treat. RESULTS:
      The no-touch technique protocol resulted in a clinically significant threefold
      decrease in shunt infection rate from 9.1% to 2.9% (p = 0.058 at 0.10 level, odds
      ratio 0.305, confidence interval 0.084-1.11), and a near threefold decrease in
      the infection rate per patient from 11.3% to 3.9% (p = 0.032 at 0.10 level, odds
      ratio 0.243, confidence interval 0.065-0.906). CONCLUSIONS: The no-touch
      technique protocol as described herein is a useful method to decrease shunt
      infection. A larger prospective, randomized, multicenter clinical trial is
      encouraged to stringently assess the efficacy of the protocol.

PMID- 7792702
TI  - Hydrothorax from intrathoracic migration of a ventriculoperitoneal shunt
      catheter.
AB  - BACKGROUND: The intrathoracic complications of the ventriculoperitoneal (VP)
      shunt are very rare. We report an unusual case of VP shunt complication with
      intrathoracic migration, associated with pleural effusion in a 55-year-old man.
      METHODS: We reviewed the seven cases reported in the literature and the mechanism
      of shunt-tip migration and preventive measures are presented. RESULTS: The
      patient was successfully managed with revision. The catheter was retrieved and
      replaced in the peritoneal cavity. CONCLUSIONS: With VP shunting, it is important
      to keep in mind the possibility of peritoneal shunt-tip migration into the chest.
      To prevent this kind of complication, we stressed precise location of a
      subcutaneous tunneling device above the ribs during subcutaneous passage.

PMID- 7792704
TI  - Ruptured aneurysm associated with arachnoid cyst: intracystic hematoma without
      subarachnoid hemorrhage.
AB  - BACKGROUND: It is well-known that arachnoid cysts of the middle fossa are
      associated often with chronic subdural hematomas and/or intracystic hemorrhages.
      However, reports of an arachnoid cyst associated with an aneurysm are rare. CASE
      DESCRIPTION: A 45-year-old man was admitted with headache due to intracystic
      hemorrhage in the sylvian fissure, associated with a saccular aneurysm at the
      bifurcation of the internal carotid artery. The aneurysm ruptured into the
      arachnoid cyst, without causing a subarachnoid hemorrhage. Subsequently, the neck
      of the aneurysm was clipped successfully. The patient's postoperative course was
      uneventful, and there was no vasospasm. CONCLUSIONS: This is the first reported
      case of an intracystic hematoma due to a ruptured aneurysm. We discuss the
      possible etiology of the association between the aneurysm and the arachnoid cyst,
      and the formation mechanism for the intracystic hematoma that did not result in a
      subarachnoid hemorrhage.

PMID- 7792705
TI  - Endovascular management of biopsy-related posterior inferior cerebellar artery
      pseudoaneurysm.
AB  - We present a case of a posterior inferior cerebellar artery pseudoaneurysm with
      subarachnoid hemorrhage resulting from a transoral head and neck tumor biopsy.
      The pseudoaneurysm was managed using transcatheter coil embolization.

PMID- 7792707
TI  - Giant cephalhematoma in a 15-year-old boy. Unilateral amaurosis as the main
      complication.
AB  - BACKGROUND: The term "cephalhematoma" is applied to a collection of blood under
      the periosteum of a skull bone. It most frequently occurs in the neonatal period
      and is rare at other times of life. METHODS AND RESULTS: We report on a 15-year
      old boy with a subperiosteal hematoma involving the whole cranial surface.
      Surgical drainage was performed. In the immediate postoperative course, the
      patient developed a progressive decrease in the right eye visual acuity. An
      orbital computed tomographic scan revealed the retro-orbital subperiosteal
      extension of the hematoma. A second surgical procedure was necessary to obtain
      visual recovery. CONCLUSIONS: The occurrence of cephalhematoma in adults is
      exceptional. However, it may lead to serious complications. Surgical treatment
      should be aimed to avoid retro-orbital extension of the hematoma.

PMID- 7792706
TI  - Superficial temporal artery to superior cerebellar artery anastomosis via the
      presigmoid retrolabyrinthine transtentorial approach.
AB  - BACKGROUND: The conventional method for performing superficial temporal artery to
      superior cerebellar artery (STA-SCA) anastomosis is applied to ischemic lesions
      in the posterior circulation via the temporobasal approach. However, this
      approach can be difficult and presents limitations due to the deep and narrow
      surgical field. METHODS AND RESULTS: STA-SCA anastomosis using the presigmoid
      retrolabyrinthine transtentorial approach was performed, in which a large skin
      incision was required for the isolation of the STA, compared to that associated
      with the petrosal approach as described in previous reports. The superior
      petrosal sinus was sacrificed, and the tentorium cerebelli was cut up to the
      level of the incisula. Being very close to the surface opening, the SCA was
      approached easily at the ambient portion without any danger to the vein of Labbe.
      The SCA ran perpendicularly upward in the surgical field, which was advantageous
      in performing the anastomosis. CONCLUSION: The presigmoid retrolabyrinthine
      transtentorial approach may provide a better surgical strategy than the
      temporobasal approach in performing STA-SCA anastomosis.

PMID- 7792708
TI  - Pathogenesis and treatment of growing skull fractures.
AB  - BACKGROUND: Growing skull fractures are poorly understood complications of
      pediatric skull fractures. METHODS: A retrospective review of skull fractures at
      our institution from 1980-1993 revealed 10 patients with growing skull fractures.
      The age at injury ranged from 1-144 months, with 9 of 10 patients being under one
      year of age. The etiology of these fractures included falls, motor vehicle
      accidents, and child abuse. On average, growth of the fracture was diagnosed 14
      months after the initial injury. RESULTS: Six patients have had magnetic
      resonance imaging (MRI) with one demonstrating leptomeningeal cyst herniation,
      two having brain herniation, and three having both brain parenchyma and
      leptomeningeal cyst herniation. All patients had malacic cortex underlying the
      fracture, but there was no evidence of intracranial hypertension. Nine patients
      have undergone craniotomy with excision of granulation tissue and gliotic brain,
      dural repair, and cranioplasty using surrounding normal skull. There were no
      surgical complications or recurrences. CONCLUSIONS: Brain/leptomeningeal cyst
      herniation through a dural rent, without MRI evidence of increased intracranial
      pressure, implicates physiologic growth and brain cerebrospinal fluid (CSF)
      pulsations as the cause of fracture enlargement.

PMID- 7792709
TI  - Primary intracranial plasma-cell granuloma: a case report and review of the
      literature.
AB  - BACKGROUND: Plasma-cell granulomas, which are characterized by the non-neoplastic
      proliferation of plasma cells, are primarily found in the lungs and upper
      respiratory tracts, and are extremely rare in the central nervous system.
      METHODS: An intracranial tumor of an 11-year-old boy was evaluated by histologic
      and radiologic examination. RESULTS: An 11-year-old boy had a 2-month history of
      mild headache and nausea. A computed tomography scan showed a round, slightly
      high-density mass surrounded by marked edema in the left frontal lobe. On
      magnetic resonance imaging (MRI), the mass had a slightly high signal intensity
      on the T1-weighted image and marked low signal intensity on the T2-weighted
      image. It was heterogenously enhanced with gadolinium-DTPA. Microscopic
      examination demonstrated a non-neoplastic mixed cell population with a
      predominance of plasma cells. Immunohistochemical staining revealed that it was
      characterized by a polyclonal plasma cell population. CONCLUSION: Our extensive
      search of the literature indicated this to be the ninth reported case of
      intracranial plasma cell granulation. The MRI was very useful for evaluating the
      extent of the intracranial lesions. The tumor was removed surgically and did not
      recur during a 2-year follow-up with no radiation therapy.

PMID- 7792711
TI  - Mycosis fungoides with central nervous system involvement--a case report: T-cell
      lymphoma of the brain.
AB  - Mycosis fungoides is a rare malignant T-cell lymphoma, involving mainly the skin.
      It can, in 50%-75% of cases, involve visceral organs and, in 11%-14% of cases,
      metastasize to the central nervous system. The prognosis is poor. A case with
      cerebral involvement is presented and the relevant literature reviewed.

PMID- 7792710
TI  - Indications for the surgical management of central nervous system blastomycosis.
AB  - BACKGROUND: Blastomycotic infections of the central nervous system (CNS) occur
      infrequently. The medical literature concerning blastomycosis of the CNS contains
      little information regarding indications for surgery. METHODS: We report five
      cases of CNS blastomycosis that required surgery: four intracranial and one
      intraspinal. One patient had a prior diagnosis of sarcoidosis, whereas none of
      the others had been diagnosed with any other systemic illness. The patients were
      evaluated with plain x rays as well as with computed tomography or magnetic
      resonance imaging. RESULTS: Four of these patients had extradural abscesses that
      required surgical drainage as well as debridement of granulomatous tissue and
      infected bone. The remaining patient had an intracerebellar abscess.
      Postoperatively, three patients were treated with amphotericin B, one with
      amphotericin B and ketoconazole, and one with an experimental protocol of
      fluconazole alone. All of the patients recovered without sequelae of seizures,
      recurrence of disease, or reaction to pharmacotherapy, although one patient had
      transient renal insufficiency due to amphotericin B. CONCLUSIONS: Our experience
      with CNS blastomycosis managed surgically is reported. We propose three general
      surgical indications for these patients: mass lesions, diagnostic biopsy, and
      osteomyelitis refractory to pharmacotherapy.

PMID- 7792712
TI  - Control of tumor cell proliferation and radiation therapy.

PMID- 7792713
TI  - Lighted mirror for microneurosurgery.
AB  - We describe a newly developed, lighted mirror that provides enough luminous
      intensity to obtain a clear image in deep operative fields under high
      magnification. Through the initial neurosurgical procedures in which it was
      tested, the mirror proved particularly useful for inspecting the ventral aspect
      of the fifth nerve in a microvascular decompression for trigeminal neuralgia, and
      for observing the fundus of the internal auditory meatus after removal of an
      acoustic neuroma to ensure no residual tumor.

PMID- 7792715
TI  - Retirement: what to do?

PMID- 7792714
TI  - Pneumocephalus after thoracotomy.
AB  - BACKGROUND: Pneumocephalus is a well-known phenomenon in which a fistula between
      the thoracic cavity and the subarachnoid space is one of its rare etiologies.
      METHODS: We report a new case of pneumocephalus after thoracotomy and review
      eight similar cases in the literature. RESULTS: In all cases, an operation was
      carried out for an intrathoracic neoplasm located at the apex with chest wall
      invasion. In the presence of symptoms, the diagnosis of pneumocephalus and
      identification of the subarachnoid pleural fistula were differently supplied by
      radiographic and isotopic exams. In the follow-up, one patient was affected by
      meningitis and two patients died. CONCLUSIONS: The occurrence of pneumocephalus
      must be considered when neurologic problems emerge after thoracotomy. It appears
      that if conservative treatment fails, surgical closure of the fistula via
      thoracic or neurosurgical approach is indicated.

PMID- 7792716
TI  - What is a Torkildsen shunt?

PMID- 7792717
TI  - The future of neurosurgery: a perspective on the next 30 years.

PMID- 7792718
TI  - Modulation of dopamine D1-mediated turning behavior and striatal c-fos expression
      by the substantia nigra.
AB  - In order to study the possible contribution of the substantia nigra (SN) in the
      positive interaction between dopamine D1 receptor agonists and glutamate
      antagonists in unilaterally 6-hydroxydopamine (6-OHDA) lesioned rats, the effect
      of the D1 agonist, SKF 38393, was studied in combination with intranigral
      infusions of glutamate antagonists of the NMDA (MK 801, CPP) or AMPA (NBQX) type
      of receptor. Local infusion into the SN of the 6-OHDA lesioned side of MK 801,
      CPP or NBQX at doses inducing no or minimal behavioral effects significantly
      increased the turning behavior and the expression of c-fos induced, in the
      lesioned caudate-putamen (CPu), by a parenteral administration of SKF 38393. The
      same result was obtained after intra-SN infusion of the GABA agonist, muscimol.
      High doses of MK 801, CPP or muscimol infused into the SN produced intense
      contralateral turning per se and induced a sparse c-fos expression in the
      lesioned CPu which was antagonized by parenteral administration of MK 801. The
      results indicate that a depression of SN pars reticulata efferent neurons
      potentiates D1-mediated responses and suggest that this area may play a role in
      the positive interaction between glutamate antagonists and D1 receptor agonists.

PMID- 7792719
TI  - Effects of the sigma receptor ligand SR 31742A on neurotensin biosynthesis in rat
      basal ganglia.
AB  - The effects of SR 31742A, a specific sigma ligand, were investigated on
      neurotensin (NT) biosynthesis in the basal ganglia of the rat. Both single and
      repeated treatments with either SR 31742A (20 mg/kg i.p.) or haloperidol (1 mg/kg
      i.p.) increased the concentration of NT-like immunoreactivity (NT-li) in the
      nucleus accumbens. In contrast to haloperidol, the administration of SR 31742A
      failed to increase the concentration of NT-li in the caudate-putamen. We have
      further investigated drug-induced variations in NT biosynthesis by studying
      NT/neuromedin N (NT/NN) mRNA levels in the nucleus accumbens and the ventral
      tegmental area of the rat following SR 31742A administration. The NT/NN mRNA
      levels in the ventral tegmental area were increased by a maximum of fifteen fold
      (7 h at 20 mg/kg i.p.). A lower increase in NT/NN mRNA levels was elicited in the
      nucleus accumbens. These results suggest that the increase in NT-li observed
      after SR 31742A treatment, like that produced by haloperidol, may result from an
      increase of NT biosynthesis. Furthermore, the effects of SR 31742A on NT
      metabolism are similar to those of atypical antipsychotics, since they appear to
      be selective for the limbic system.

PMID- 7792720
TI  - Synaptic reorganisation in the rat striatum after dopaminergic deafferentation:
      an ultrastructural study using glutamate decarboxylase immunocytochemistry.
AB  - The ultrastructure of GABAergic and non-GABAergic synapses in the adult rat
      neostriatum was examined 6-8 months after unilateral removal of the nigrostriatal
      dopaminergic pathway by 6-hydroxydopamine injection into the medial forebrain
      bundle. GABAergic profiles were identified by preembedding glutamate
      decarboxylase (GAD) immunocytochemistry performed on parasagittal vibratome
      sections. In three representative fields of the striatum, the nature and number
      of boutons and their postsynaptic partners were determined and the differences
      between the striata ipsi- and contralateral to the lesion analyzed. The
      percentage of GAD-immunoreactive boutons was increased from 23% on the intact
      side to 28% on the lesioned side. In addition, the GABAergic boutons underwent
      significantly more multiple contacts with several independent postsynaptic
      profiles, preferentially with dendritic spines. This could reflect a lesion
      induced sprouting of local GABAergic axon terminals. On the other hand, although
      the vast majority of GABAergic boutons underwent synaptic contacts with dendrites
      (77% vs. 80%), the number of boutons per dendrite or per dendritic circumference
      remained unchanged. Thus, the higher frequency of GABAergic boutons may simply
      reflect the loss of the dopaminergic nerve endings, without a heterosynaptic
      replacement by GABAergic boutons. The deafferentation also induced structural
      changes of the postsynaptic profiles. Some dendritic spines had a shortened neck;
      others were completely integrated in the dendrite which now contained a spine
      apparatus and was contacted by boutons with the features of axospinous synapses.
      The spine retraction resulted in a quantitative decrease in the number of spines.
      Analysis of the synaptic curvature revealed that only spines with a flat contact
      zone were lost. Concurrently, the number of dendrites was increased, of the GAD
      containing in particular, suggesting that the denrites of GABAergic interneurons
      tend to elongate and/or arborize. Taken together, the results of the present
      study show that the dopaminergic denervation caused a remodeling of the
      postsynaptic neurons. The relative increase of the number of GABAergic boutons
      and their synaptic contacts suggests that an altered wiring of the intrinsic
      GABAergic system contributes to the changes in the striatal output activity.

PMID- 7792721
TI  - Glutamate/dopamine D1/D2 balance in the basal ganglia and its relevance to
      Parkinson's disease.
AB  - The recent availability of selective ligands for NMDA and AMPA receptors has
      enabled neuroscientists to test the hypothesis that Parkinson's disease is a
      glutamate hyperactivity disorder and hence treatable with glutamate antagonists.
      This review takes a critical look at the motor characteristics of this new class
      of drugs in rodent and primate models of parkinsonism and assesses the clinical
      potential and pitfalls of this radical new approach. Monotherapy of Parkinson's
      disease with glutamate antagonists appears impractical at the present time, due
      to their low efficacy and unacceptable side effects, but polypharmacy with L-DOPA
      and a glutamate antagonist as adjuvant is a more realistic prospect. This review
      will focus on the ways in which glutamate receptor blockade facilitates motor
      recovery with L-DOPA and will examine whether the basis for this beneficial
      effect can be traced to a specific interaction with dopamine at D1 or D2
      receptors, and therefore to discrete motor pathways within the basal ganglia.

PMID- 7792722
TI  - A new morphological feature associated with perforated synapses: vesicular
      lateralization.

PMID- 7792724
TI  - Trends in the health of older Americans: United States, 1994. Analytic and
      epidemiologic studies no. 3.

PMID- 7792723
TI  - Lipophilic metabolite of [123I]beta-CIT in human plasma may obstruct quantitation
      of the dopamine transporter.
AB  - I-123 or C-11 labelled 2 beta-carbomethoxy-3 beta-(4-iodophenyl)tropane (beta
      CIT) is a recently developed radioligand for the study of dopamine and serotonin
      reuptake sites in humans with single photon emission tomography (SPET) or
      positron emission tomography (PET). Determination of the radioligand metabolite
      pattern is fundamental for a quantitative analysis of radioligand binding. The
      metabolism of [123I]beta-CIT was determined by a gradient HPLC method in plasma
      samples of six human subjects. Two metabolites of [123I]beta-CIT were found, a
      polar and a lipophilic. At 4 h after [123I]beta-CIT injection the percentages of
      parent compound and polar and lipophilic metabolites were 23 +/- 3% (mean +/-
      SD), 33 +/- 11%, and 44 +/- 8%, respectively. The lipophilic metabolite might
      pass the blood-brain barrier and account for a fraction of free and
      nonspecifically bound radioactivity in brain. The existence of a lipophilic
      metabolite of [123I]beta-CIT may obstruct the use of simple ratio methods for
      quantitation of the dopamine transporter in brain.

PMID- 7792725
TI  - Systematic underestimation of treatment effects as a result of diagnostic test
      inaccuracy: implications for the interpretation and design of thromboprophylaxis
      trials.
AB  - Many clinical trials that have assessed strategies for the prevention of deep
      vein thrombosis have employed diagnostic tests that are less accurate than
      venography. The correct interpretation of these trials has been the subject of
      considerable debate. This paper attempts to quantify the likely effects of the
      use of inaccurate diagnostic tests (in particular fibrinogen scanning) on the
      validity and precision of estimates of treatment effects. It is shown that, if
      there is no difference in the rate of misclassification of deep vein thrombosis
      between study and control groups, then treatment effects will tend to be
      systematically underestimated in trials that only use inaccurate diagnostic
      tests. However, for trials in which there are no false positive diagnoses, such
      as those employing venography, the estimate of relative treatment effects will be
      unbiased. This phenomenon is demonstrated empirically by data from randomised
      trials of antiplatelet therapy. The implications of these findings are two-fold.
      First, so long as the accuracy of the test is the same in study and control
      groups, positive trial results cannot be ascribed to diagnostic test inaccuracy.
      Second, unbiased estimates of relative treatment effects can be obtained by using
      cheap, practicable and non-invasive screening tests that are supplemented by
      venographic assessment of positive test results. This would facilitate the
      conduct of much larger randomised trials than has generally been possible when
      mandatory venography was used; if future trials randomised some thousands of
      patients and employed confirmatory venography then they would provide both
      unbiased and precise estimates of relative treatment effects.

PMID- 7792726
TI  - The complexity of the phospholipid binding protein Annexin V.

PMID- 7792727
TI  - Urokinase therapy in neonates with catheter related central venous thrombosis.
AB  - The results of fibrinolytic therapy with urokinase were evaluated in 26 neonates
      with catheter related central venous thrombosis. Complete thrombolysis could be
      achieved in 13 patients (50%), partial thrombolysis in 3 patients (12%). No
      effect was seen in 10 patients (38%). Therapy success was influenced by age, size
      and location of the thrombus. Coincidence of infection occurred in 16 patients
      (62%). Mild hemorrhagic complications were seen in 2 patients (8%), no other
      significant side effects were observed. Nine patients with residual thrombosis
      were treated with oral anticoagulants following urokinase resulting in resolution
      of the thrombus in 6 patients within 3 months (67%). The incidence of
      asymptomatic recurrent thrombosis was high (28%). Urokinase might be an effective
      and safe treatment for central venous thrombosis in neonates. Prophylactic
      antibiotic therapy during the infusion of urokinase and long-term treatment with
      oral anticoagulants after thrombosis are advisable. Early detection of thrombosis
      might enhance the success rate of fibrinolytic therapy. Therefore, we strongly
      recommend routine echocardiographic screening of central venous catheters.

PMID- 7792728
TI  - Six different point mutations in seven Danish families with symptomatic protein C
      deficiency.
AB  - Six different point mutations of the protein C gene are described in seven Danish
      families with protein C deficiency associated with an increased risk of venous
      thromboembolism. All affected family members are heterozygotes for the mutated
      protein C genotype. One mutation is a G2992-->A transition at position +5 in the
      5' splice site of intron D. The other five mutations affect the protein coding
      region. One is a C1432-->T transition in exon III converting the highly conserved
      Arg15 to Trp in the Gla-domain. Another mutation is a G3157-->C transversion in
      exon V converting the non-conserved Gly72 to Arg in the epidermal growth factor
      domain. The remaining three mutations are located in non-conserved amino acid
      positions in exon IX and affect the serine proteinase domain. The first is a
      G8559-->C transversion converting Gly282 to Arg. The second is a C8571-->T
      transition (present in two families) converting Arg286 to Cys. The third is a
      C8695-->T transition converting Pro327 to Leu. In each family the protein C
      deficiency cosegregates or probably cosegregates (one family, G8559-->C) with the
      mutation. All affected family members exhibit a reduction of both the antigen and
      the functional plasma concentration of protein C to approximately 50% of normal
      indicating that the mutated protein C is not present (type 1 deficiency) or only
      present in low amounts in plasma. Agarose gel electrophoresis followed by Western
      blotting shows that the Arg15-->Trp substitution is associated with a normal as
      well as an abnormal migrating plasma protein C band.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7792729
TI  - Definition of the bleeding tendency in factor XI-deficient kindreds--a clinical
      and laboratory study.
AB  - Individuals with severe factor XI deficiency are prone to excessive bleeding
      after injury or surgery, but the existence of a haemorrhagic tendency in partial
      factor XI deficiency is controversial. In this study, 172 members of 30 kindreds
      (20 non-Jewish) transmitting factor XI deficiency in North West England were
      interviewed and a bleeding history questionnaire completed. Blood was taken for
      coagulation assays. The questionnaires were categorised independently by two
      assessors to determine presence or absence of a bleeding tendency, in the absence
      of information about the factor XI level or family history. Analysis shows that
      48% of heterozygotes have a bleeding tendency. Eighteen (60%) families came to
      attention because of bleeding problems in heterozygotes. Comparison of histories
      between partially deficient and non-deficient individuals demonstrated a higher
      incidence of menstrual problems, an increase in significant bruising, and an
      increased likelihood of excessive bleeding after tonsillectomy and dental
      extractions. The incidence of von Willebrand's disease was not increased, but
      individuals with heterozygous factor XI deficiency who were bleeders tended to
      have lower levels of factor VIIIc and von Willebrand factor, and were more
      commonly of blood group 0. These features may contribute to the bleeding
      tendency. There was no evidence of alteration in factor VII activity (as defined
      by the ratio of activity to antigen) between the bleeders and non-bleeders. This
      is convincing evidence for abnormal bleeding in factor XI deficiency which is not
      confined to severely deficient patients.

PMID- 7792730
TI  - Prothrombin Frankfurt: a dysfunctional prothrombin characterized by substitution
      of Glu-466 by Ala.
AB  - We have identified a patient with a dysfunctional prothrombin that we have
      designated Prothrombin Frankfurt. The proband was characterized by a prothrombin
      activity level of 13% and 20% compared to normal controls using two different
      assays with a normal prothrombin antigen level of 91% of normal controls. The
      genetic defect responsible for the abnormal prothrombin activity was determined
      by the polymerase chain reaction followed by single-strand conformation
      polymorphism (PCR-SSCP) analysis and by DNA sequence analysis of the human
      prothrombin gene. Substitution of a C for an A at nucleotide 10177 in the human
      prothrombin gene of the proband was identified, which results in the replacement
      of Glu-466 by Ala. The proband and one sister were homozygous for this mutation.
      Both parents, as well as one brother, were found to be heterozygous for this
      mutation. The same amino acid substitution was previously identified to be
      responsible for the dysfunctional protein Prothrombin Salakta and was
      hypothesized to result in altered substrate specificity. Four polymorphisms were
      also identified in the prothrombin gene from the proband when compared to the
      published sequence at nucleotides 554, 4048, 4272 and 10253.

PMID- 7792731
TI  - Platelet consumption in thrombocythemia complicated by erythromelalgia: reversal
      by aspirin.
AB  - The involvement of platelets in the pathogenesis of erythromelalgia, a frequent
      and characteristic microvascular thrombotic manifestation in patients with
      primary thrombocythemia and polycythemia rubra vera, was investigated by
      measuring the survival and turnover of 51Cr labeled autologous platelets in 10
      patients with thrombocythemia complicated by erythromelalgia, in 10 asymptomatic
      thrombocythemia patients and in 6 subjects with reactive thrombocytosis. The mean
      platelet survival time of the erythromelalgia patients was 4.2 +/- 0.2 days,
      which is significantly decreased as compared with asymptomatic thrombocythemia
      patients (6.6 +/- 0.3 days, p < 0.001) and patients with reactive thrombocytosis
      (8.0 +/- 0.4 days, p < 0.001). The mean platelet survival time of asymptomatic
      thrombocythemia patients was significantly decreased (p < 0.01) as compared with
      reactive thrombocytosis patients. Treatment of erythromelalgia with aspirin
      increased the mean platelet survival time from 4.0 +/- 0.3 days to 6.9 +/- 0.4
      days (p < 0.001) and was associated with an elevation of the platelet count of
      216 +/- 30 x 10(9) platelets per liter (p < 0.001). Coumadin failed to improve
      platelet survival or symptoms caused by erythromelalgia. The increased platelet
      consumption in erythromelalgia is attributed to the formation of platelet thrombi
      in the arterial microvasculature. This conclusion is supported by the ability of
      aspirin to interrupt platelet consumption and clinical features of
      erythromelalgia.

PMID- 7792732
TI  - Incidence of factor VIII inhibitor development in severe hemophilia A patients
      treated only with one brand of highly purified plasma-derived concentrate.
AB  - The incidence of factor VIII inhibitor was studied in a cohort of 56 previously
      untreated patients with severe hemophilia A (factor VIII below 1 U/dl). They
      received only one brand of highly purified factor VIII concentrate (HPSD-VIII)
      prepared by conventional chromatography with a solvent-detergent step for viral
      inactivation. Follow-up since the first infusion of HPSD-VIII was from 1 to 76
      months (mean = 29) and cumulative exposure days (CED) from 1 to over 100 (median
      = 26). Five patients (9%) developed an inhibitor after 6 to 19 CED, only one
      being a high responder (2%), showing a low incidence of inhibitor compared with
      previous studies using high purity plasma-derived or recombinant products.

PMID- 7792733
TI  - Effects of two different doses of hirudin on APTT, determined with eight
      different reagents.
AB  - The APTT has been considered the most suitable candidate to monitor the
      anticoagulant activity of hirudin. However, its use is hampered by problems of
      standardization, which make the results heavily dependent on the responsiveness
      of the reagent used. Our aim was to investigate if this different responsiveness
      of different reagents when added in vitro is to be confirmed in an ex vivo study.
      Two different doses of r-hirudin (CGP 39393), 0.3 mg/kg and 1 mg/kg, were
      administered subcutaneously to 20 New Zealand male rabbits, and the differences
      in prolongation of APTT 2 and 12 h later were compared, using 8 widely used
      commercial reagents. All groups exhibited a significant prolongation of APTT 2 h
      after sc administration of hirudin, both at low and high doses. But this
      prolongation persisted 12 h later only when the PTTa reagent (Boehringer
      Mannheim) was used. In general, hirudin prolonged the APTT most with the silica
      based reagents. In a further study, we compared the same APTT reagents in an in
      vitro study in which normal pooled plasma was mixed with increasing amount of
      hirudin. We failed to confirm a higher sensitivity for silica-containing
      reagents. Thus, we conclude that subcutaneous administration of hirudin prolongs
      the APTT most with the silica-based reagents, but this effect is exclusive for
      the ex vivo model.

PMID- 7792734
TI  - Complete inhibition of endotoxin-induced coagulation activation in chimpanzees
      with a monoclonal Fab fragment against factor VII/VIIa.
AB  - Gram-negative sepsis is oftentimes complicated by activation of coagulation with
      disseminated intravascular coagulation and microthrombosis. This may contribute
      to the associated morbidity, multiple organ failure and death. Recent studies
      have established that the tissue factor-dependent pathway of blood coagulation
      has a significant participatory role in the initial endotoxin-induced activation
      of coagulation. Tissue factor (TF), expressed on the surface of activated
      monocytes and endothelial cells forms cell surface complexes with free
      circulating factors VII and VIIa. The latter complex proteolytically activates
      factors X and IX. Recent in vivo experiments have shown that a rapidly
      neutralizing TF monoclonal antibody prevents and arrests the endotoxin-induced
      activation of coagulation and similar studies have shown to reduce mortality in
      baboons. In this study we describe the preparation of a factor VII/VIIa
      neutralizing monoclonal Fab fragment and characterize its effect on in vivo
      activation of coagulation during experimental endotoxemia in chimpanzees. Four
      chimpanzees received a bolus intravenous injection of 4 ng/kg endotoxin in
      combination with Fab fragments of a factor VII/VIIa neutralizing murine
      monoclonal antibody (12D10) at a dose of either 50 micrograms/kg (n = 2) or 100
      micrograms/kg (n = 2). Four control animals received a bolus injection of
      endotoxin alone. Administration of the 12D10 Fab fragments, immediately preceding
      the endotoxin bolus injection, effectively blocked the endotoxin-induced
      activation of coagulation. Plasma levels of products of in vivo activation,
      namely F1 + 2, TAT complexes and FpA remained at baseline values. The
      administration of 12D10 resulted in a rapid decline in factor VII/VIIa antigen
      levels which remained below 5 ng/ml for 180-240 min, followed by a rapid return
      to baseline levels.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792735
TI  - Internalization and degradation of recombinant human coagulation factor VIIa by
      the human hepatoma cell line HuH7.
AB  - Previous studies demonstrated that several normal and transformed cultured human
      cell lines specifically bind human coagulation factors VII and VIIa via tissue
      factor. In the present study, we show that 125I-radiolabeled recombinant human
      factor VIIa (125I-rFVIIa) binds to a human hepatoma cell line (HuH7). In the
      presence of rabbit polyclonal anti-human tissue factor apoprotein IgG, binding of
      125I-rFVIIa to the HuH7 cells was decreased approximately 60%, suggesting of
      tissue factor-independent binding sites for 125I-rFVIIa on these cells. The
      binding isotherm of 125I-rFVIIa for the HuH7 cells in the presence of anti-tissue
      factor IgG exhibited a hyperbolic profile and was time-, temperature- and calcium
      dependent. Furthermore, binding at 4 degrees C was specific, dose-dependent and
      saturable. Scatchard analysis of the binding data demonstrated a single class of
      binding sites with a dissociation constant (Kd) of 3.2 nM and 27,000 binding
      sites per cell. At 4 degrees C, 125I-rFVIIa bound to, and eluted from, the cell
      was indistinguishable from offered 125I-rFVIIa as judged by sodium dodecyl
      sulfate-polyacrylamide gel electrophoresis followed by autoradiography. The
      molecular properties of the tissue factor-independent binding protein were
      studied by using the cleavable cross-linking agent 3,3'
      dithiobis(sulfosuccinimidylpropionate). A cross-linking product of 125I-rFVIIa
      and a cell surface protein with an apparent M(r) approximately 100,000 was
      observed. The cross-linking reaction was strongly inhibited by a 100-fold molar
      excess of unlabeled rFVIIa, but not by rabbit polyclonal anti-human tissue factor
      apoprotein IgG, indicating that cross-linking does not involve the extracellular
      domain of tissue factor.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792736
TI  - Dietary changes in fasting levels of factor VII coagulant activity (FVII:C) are
      accompanied by changes in factor VII protein and other vitamin K-dependent
      proteins.
AB  - The mechanisms behind dietary effects on fasting coagulant activity of factor VII
      (FVII:C) are not clarified. In the present study of 15 young volunteers, two
      experimental diets differing in composition of saturated fatty acids (C18:0 [diet
      S] or C12:0 + C14:0 [diet ML]) were served for 3 weeks each. Fasting blood
      samples were collected before and after the dietary regimen and analysed for
      triglycerides, FVII:C, and protein concentrations of FVII, FII, FX, protein C,
      CRP, albumin, fibrinogen, and F1 + 2. FVII:C was significantly reduced on diet S
      compared with diet ML. This was accompanied by a decrease in FVII protein, F1 + 2
      and the vitamin K-dependent proteins FII, FX, and protein C. In contrast, no
      changes were observed in triglycerides, FVII:C/FVII:Ag, albumin and CRP.
      Fibrinogen was increased on diet S compared with diet ML. Our findings suggest
      that the change in fasting FVII:C was part of a general change in concentrations
      of vitamin K-dependent proteins.

PMID- 7792737
TI  - The effect of insulin-induced hypoglycaemia on factor VIII:C concentrations and
      thrombin activity in subjects with type 1 (insulin-dependent) diabetes.
AB  - The effect of insulin-induced hypoglycaemia on plasma coagulant activity was
      studied in 11 subjects with well-controlled, uncomplicated type 1 diabetes.
      Thrombin generation was determined in plasma by a computer ex-vivo assisted
      chromogenic method and by the activated partial thromboplastin time (APTT). In
      addition, factor VIII:C, thrombin-antithrombin III (TAT) complex and
      fibrinopeptide A (FPA) levels were measured. Hypoglycaemia induced a rise in mean
      (SD) factor VIII:C concentrations from a baseline level of 1.13 (0.32) IU/ml to a
      peak 15 min after onset of symptoms and they remained increased at 90 min [1.54
      (0.57) and 1.5 (0.54) IU/ml, p < 0.001 respectively]. A corresponding reduction
      in time to generate 50% maximal thrombin activity occurred from a pre-insulin
      value of 56 (6) s to a minimum reading of 46 (7) s at 15 min (p < 0.001) and
      remained low at 90 min [48 (6) s, p < 0.001]. APTT shortened from 43.3 (4.8) s to
      40.1 (4.6) s at 30 min (p < 0.001) but did not fall below the normal range (37.6
      42.7 s) and no significant changes in TAT or FPA levels were noted. Factor VIII:C
      correlated inversely with time to generate 50% maximal thrombin activity and APTT
      (r = -0.580, p < 0.001; r = -0.673, p < 0.001, n = 66, respectively). The results
      show that the rise in plasma factor VIII:C levels induced by hypoglycaemia is
      accompanied by accelerated rates of generation of thrombin in contact-activated
      plasma, though concentrations of FPA and TAT remain unchanged, although TAT
      complexes are not a sensitive marker of in vivo thrombin generation.

PMID- 7792738
TI  - The Nijmegen modification of the Bethesda assay for factor VIII:C inhibitors:
      improved specificity and reliability.
AB  - Antibodies against factor VIII coagulant activity can appear in haemophiliacs who
      are treated with factor VIII preparations but also spontaneously in non
      haemophiliacs. The Bethesda assay is the most commonly used method to detect
      these antibodies, but it lacks specificity especially in the lower range
      resulting in unreliable data. Two modifications are proposed and tested to
      resolve the imperfections: 1. Buffering the normal plasma used in the assay- and
      control mixture with 0.1 M imidazole to pH 7.4. 2. Replacing the imidazole buffer
      in the control mixture by immunodepleted factor VIII deficient plasma. These
      modifications allow better discrimination between positive and negative samples
      and improve reliability.

PMID- 7792739
TI  - Antinociceptive properties of protein C in a model of inflammatory hyperalgesia
      in rats.
AB  - We investigated the role of human protein C in an animal model of inflammatory
      hyperalgesia. Pain was induced by intraplantar injection of carrageenan (3 mg)
      into the hind paw of rats. The pain threshold was measured by exerting increasing
      amounts of pressure (in mmHg) on the paw until a struggle reaction was observed.
      Protein C (8-800 IU/kg) was administered intravenously immediately after
      carrageenan. Controls received either intraplantar injections of saline (100
      microliters) instead of carrageenan or carrageenan alone. Effects on pain
      threshold were expressed in percent of the pretreatment value. Carrageenan alone
      lowered the mean pain threshold after 3 h to 33.2 +/- 2.2% of the pretreatment
      level. Addition of protein C resulted in a dose-dependent rise in pain threshold
      towards the level observed in control animals treated with saline instead of
      carrageenan (pain threshold after 800 IU/kg protein C = 62.9 +/- 2.3% of
      pretreatment level), demonstrating an antinociceptive effect. Protein C had no
      effect in animals not preconditioned with intraplantar carrageenan. Thus protein
      C clearly antagonized the inflammatory pain induced by carrageenan. The
      antinociceptive action of protein C was antagonized by injection of a monoclonal
      antibody against protein C, providing additional evidence that the effect was
      protein C-mediated.

PMID- 7792740
TI  - ARIC hemostasis study--IV. Intraindividual variability and reliability of
      hemostatic factors. The Atherosclerosis Risk in Communities (ARIC).
AB  - We have recently reported the short-term intraindividual variability of several
      coagulation factors and inhibitors included in the ARIC study (Chambless et al.
      Ann Epidemiol 1992; 2:723). In this paper, we reported the intraindividual
      variability results of additional hemostatic factors. Blood samples were
      collected for hemostatic assays three times at 1-2-week intervals from 39
      subjects recruited from 4 ARIC field centers. The contributions of within-person,
      processing and assay (designated "method") and between-person variances to the
      total variance were estimated and from them the reliability coefficient, R, was
      computed as the proportion of total variance in the between-person component. The
      R value was high for beta-thromboglobulin and tissue-plasminogen activator: 0.83
      and 0.81, respectively; and intermediate for D-dimer and plasminogen activator
      inhibitor-1: 0.73 and 0.72, respectively. Protein S (total and free) and platelet
      factor 4 had low repeatability (R < 0.50) derived mostly from "method"
      variability while low R value (0.03) for fibrinopeptide A was attributed to high
      "method" and "within-person" variability. Gender, age and the level of hemostatic
      factors did not influence the intraindividual variability.

PMID- 7792741
TI  - Determinants of plasminogen activator inhibitor-1 activity in survivors of
      myocardial infarction.
AB  - A significant relationship has been described between plasminogen activator
      inhibitor-1 (PAI-1) and plasma insulin concentrations. However, most
      radioimmunoassays (RIA) substantially overestimate plasma insulin concentrations
      because of cross reaction with proinsulin-like molecules and it has been proposed
      that proinsulin-like molecules may be important determinants of PAI-1 activity.
      We measured fasting plasma immunoreactive insulin by conventional RIA, fasting
      plasma insulin (EIMA) by specific two site immunoenzymometric assay, and intact
      proinsulin and des-31,32-proinsulin by two site immunoradiometric assay (IRMA) in
      74 (50 nondiabetic and 24 diabetic) subjects who had survived a myocardial
      infarction between 6 and 24 months previously. In univariate analysis, PAI-1
      activity correlated with serum triglycerides (rs = 0.43; p < 0.0001), insulin
      sensitivity (rs = -0.30; p = 0.004), and immunoreactive insulin (rs = 0.45; p <
      0.0001). However, the relationship between PAI-1 activity and plasma specific
      insulin (IEMA) was weaker (rs = 0.24; p = 0.019) than those with intact
      proinsulin (rs = 0.53; p < 0.0001) and des-31,32-proinsulin (rs = 0.54; p <
      0.0001) despite the low concentrations of these proinsulin-like molecules. In
      multiple regression analysis, only des-31,32-proinsulin (p = 0.001) and serum
      triglycerides (p = 0.013) were significant determinants of PAI-1 activity. In
      conclusion, these results suggest that proinsulin-like molecules and serum
      triglycerides are important determinants of PAI-1 activity in survivors of
      myocardial infarction.

PMID- 7792742
TI  - Up-regulated expression of plasminogen activator inhibitor-1 in Hep G2 cells:
      interrelationship between insulin and insulin-like growth factor 1.
AB  - Insulin resistance represents a situation with a high risk of atherothrombosis
      and is accompanied by increased plasma plasminogen activator inhibitor-1 (PAI-1)
      levels. Fasting insulin level is highly correlated with PAI-1 levels in plasma.
      It has been shown that insulin increases PAI-1 synthesis by the human hepatoma
      cell line Hep G2. Moreover when Hep G2 cells expressing a down-regulation of
      insulin receptors by incubation with 10(-7) M insulin, were stimulated by 10(-9)
      M insulin, an overexpression of PAI-1 synthesis was observed despite a reduced
      number of insulin receptors. Insulin-like growth factor 1 (IGF-1) shares many
      properties with insulin. The aim of the present study was to evaluate the effect
      of IGF-1 on PAI-1 synthesis by Hep G2 cells down-regulated either by insulin or
      IGF-1. Incubation of Hep G2 cells with increasing doses from 10(-9) to 10(-7) M
      IGF-1 induced a dose-dependent stimulation of PAI-1 synthesis up to 4.5-fold the
      control level. When cells were first pre-incubated with 10(-7) M IGF-1 for 18 h,
      acid washed, and then stimulated with 10(-9) M IGF-1, the expression of IGF-1
      receptors was greatly reduced (up to 70%). In contrast PAI-1 secretion was
      increased 3.4-fold the level of control cells and by 1.9-fold the level of cells
      first stimulated with 10(-9) M IGF-1. Both transcripts of PAI-1 mRNA were also
      increased.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792744
TI  - Acute dynamic exercise increases fibrinolytic activity.
AB  - The influence of acute bouts of dynamic exercise on plasma tissue plasminogen
      activator (tPA), plasminogen activator inhibitor (PAI) and fibrinogen was
      investigated on nine healthy non-smoking men aged 23 to 37 years. Subjects
      performed maximal and two submaximal (duration 30 min, intensity 50% [aerobic
      threshold] and 78% [anaerobic threshold]VO2max) bicycle ergospirometry tests
      separated by seven days. The order of the submaximal tests was randomized. Blood
      samples were drawn before, immediately after and 24 h after each test. Plasma tPA
      and PAI activities were measured amidolytically, and fibrinogen concentration by
      thrombin method. All postexercise values were corrected for the change in plasma
      volume. The pre-exercise tPA and PAI activities and fibrinogen concentration were
      similar in each tests. tPA activity increased during each test (from 2.0 [SEM
      0.24] IU/ml to 20.3 [3.14] during maximal, 2.0 [0.22] to 19.0 [2.59] during
      anaerobic threshold test, 1.8 [0.22] to 5.5 [0.82] during aerobic threshold; p <
      0.001 during all tests, p = 0.01 aerobic threshold vs maximal and anaerobic
      threshold). PAI activity decreased during maximal (from 6.6 [2.51] AU/ml to 2.0
      [2.00], p < 0.05) and anaerobic threshold (5.0 [2.07] to 0.2 [0.22], p < 0.01)
      tests but not during aerobic threshold test (7.0 [3.69] to 4.5 [2.93], p =
      0.123). One subject had clearly higher pre-exercise PAI activity and smaller tPA
      response to exercise as compared to other subjects. All 24 h post-exercise
      activities were similar to pre-exercise values. Plasma fibrinogen concentration
      did not change during any tests.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792743
TI  - Limited proteolysis of human alpha-thrombin by urokinase yields a non-clotting
      enzyme.
AB  - Limited proteolysis of human alpha-thrombin by various proteases has been
      efficiently used to demonstrate the importance of two insertion loops located on
      the surface of this molecule. In the present study, we demonstrate that two-chain
      urokinase (tcu-PA) specifically cleaves the B chain of alpha-thrombin giving rise
      to a transient derivative, consisting of two non-covalently linked subunits.
      Although the thrombin derivative conserves its activity towards the synthetic
      substrate S-2238 (Km = 8.4 microM and kcat = 145 s-1 versus respectively 4.5
      microM and 149 s-1 for alpha-thrombin), most of its coagulant activity is lost
      (140 NIH u/mg versus 3000 NIH u/mg) and its ability to activate platelets is
      considerably reduced (threshold for full platelet aggregation 2.5 nM versus 0.25
      nM). The thrombin fragments were separated by HPLC and after reduction and S
      carboxyamidemethylation were digested with a lysylendopeptidase; the resulting
      peptides were separated by HPLC and sequenced. One fragment corresponded to B
      chain fragment 1-73 and the second to B chain fragment 74-259 covalently linked
      to the A chain, indicating that tcu-PA cleaves selectively the peptide bond Arg
      73-Asn 74 in the B chain. The proteolytic derivative obtained, designated beta u
      thrombin, is therefore identical to the transient proteolytic derivative, beta 1
      thrombin, produced by trypsin. Prolonged incubation with tcu-PA resulted in
      further conversion in a derivative analogous to gamma t-thrombin.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7792746
TI  - Internalization of an anti-glycoprotein IIb/IIIa antibody by HEL cells.
AB  - Platelets are known to internalize monoclonal antibodies directed against the
      glycoprotein (GP) IIb/IIIa complex. We investigated whether an antibody directed
      against this complex (NNKY 2-11) was transported from the surface membrane to the
      intracellular pool in HEL cells. Flow cytometry showed that the percent binding
      of NNKY 2-11 to the surface membrane of HEL cells was decreased after incubation
      for 24 h compared with 1 h, while the binding of an anti-GPIb antibody (NNKY 5-5)
      did not change. It did not seem likely that the GP IIb/IIIa complex antibody was
      shed from the surface membrane of the HEL cells during incubation, because the
      medium conditioned by incubation with these cells for 24 h showed almost no
      binding to washed platelets. In addition, immunoelectron microscopy demonstrated
      that GP IIb/IIIa complex antibodies were incorporated into the intracellular pool
      of HEL cells and were associated with alpha granules. These findings indicated
      that an anti-GP IIb/IIIa antibody could be internalized by megakaryocytes, as has
      been previously shown with platelets, suggesting that megakaryocyte GP IIb/IIIa
      may act as a carrier for various adhesion proteins.

PMID- 7792745
TI  - Desmin 370, a low molecular weight dermatan sulfate, reduces the weight of
      preformed thrombi in rats made afibrinogenemic by ancrod.
AB  - Desmin 370 (D370), a low molecular weight dermatan sulfate, has been shown to
      induce a marked reduction of the weight of preformed venous thrombi in rats and
      rabbits by mechanisms that appeared largely independent of inhibition of thrombus
      accretion. In order to provide further support for such a mechanism, we exploited
      the defibrinating capacity of ancrod to obtain a thrombosis model characterized
      by the lack of thrombus growth and thus sensitive only to agents promoting
      thrombus lysis. Thrombus formation in anesthetized rats was induced by vena cava
      ligature. Injection of ancrod (5 U/kg) 5 h after induction of venous stasis
      caused a more than 95% reduction in plasma fibrinogen and prevented thrombus
      accretion as indicated by the lack of thrombus weight increase during the 3 h
      experimental period (12.2 +/- 0.6 vs 14.5 +/- 1 as compared to 12.6 +/- 0.6 vs
      19.6 +/- 0.8, p < 0.01, in control rats) and by the almost complete (> 90%)
      inhibition of 125I-fibrin(ogen) binding to thrombi. Moreover, when ancrod was
      given 1 h before vena cava ligature, no thrombi were formed within 2 h whereas at
      the same time interval visible thrombi were present in all control rats.
      Administration of D370 (10 mg/kg) to thrombus bearing rats, 1 h after induction
      of afibrinogenemia, resulted in a significant reduction in thrombus weight (43%
      after 2 h, p < 0.01) which was only slightly lower than that recorded in
      normofibrinogenemic rats (54%). Enhancement of plasma fibrinolytic activity by
      ancrod had no influence on thrombus lysis and was not all affected by
      administration of D370.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792747
TI  - Fibrinogen binding is independent of an increase in intracellular calcium
      concentration in thrombin degranulated platelets.
AB  - In a suspension of thrombin degranulated platelets (TDP), ADP and epinephrine can
      induce platelet aggregation, whereas the synthetic agonist of the
      thromboxane/endoperoxide receptor U46619 causes only shape change. However,
      U46619 can enhance platelet aggregation induced by ADP and epinephrine. In this
      paper, we have measured fibrinogen binding in relation to phospholipase C (PLC)
      activation and calcium mobilization in TDP activates by ADP, epinephrine and
      U46619. ADP caused fibrinogen binding in TDP but neither activated PLC nor caused
      a calcium mobilization. The requirement for ADP in inducing exposure of
      fibrinogen binding sites was not absolute since the combination of epinephrine
      and U46619 produced an increase in fibrinogen binding. U46619 caused significant
      PLC activation and cytosolic calcium release but not fibrinogen binding. These
      results suggest that in TDP the exposure of fibrinogen binding sites, after
      agonist activation, is independent of both PLC activation and calcium
      mobilization.

PMID- 7792749
TI  - Antithrombotic effect of a recombinant von Willebrand factor, VCL, on nitrogen
      laser-induced thrombus formation in guinea pig mesenteric arteries.
AB  - To assess the antithrombotic effectiveness of blocking the platelet glycoprotein
      (GP) Ib/IX receptor for von Willebrand factor (vWF), the antiaggregating and
      antithrombotic effects were studied in guinea pigs using a recombinant fragment
      of vWF, Leu 504-Lys 728 with a single intrachain disulfide bond linking residues
      Cys 509-Cys 695. The inhibitory effect of this peptide, named VCL, was tested in
      vitro on ristocetin- and botrocetin-induced platelet aggregation and compared to
      the ADP-induced platelet aggregation. In vivo, the antithrombotic effect of VCL
      was tested in a model of laser-injured mesentery small arteries and correlated to
      the ex vivo ristocetin-induced platelet aggregation. In this model of laser
      induced thrombus formation, five mesenteric arteries were studied in each animal,
      and the number of recurrent thrombi during 15 min, the time to visualization and
      time to formation of first thrombus were recorded. In vitro, VCL totally
      abolished ristocetin- and botrocetin-induced platelet aggregation, but had no
      effect on ADP-induced platelet aggregation. Ex vivo, VCL (0.5 to 2 mg/kg)
      administered as a bolus i.v. injection inhibits risocetin-induced platelet
      aggregation with a duration of action exceeding 1 h. The maximum inhibition was
      observed 5 min after injection of VCL and was dose related. The same doses of VCL
      had no significant effect on platelet count and bleeding time.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7792750
TI  - Very low frequency of "normandy type" mutations among type 1 von Willebrand
      disease families.

PMID- 7792748
TI  - Glycoprotein Ib can mediate endothelial cell attachment to a von Willebrand
      factor substratum.
AB  - Introduction of single amino acid substitutions into the C-terminal Arg-Gly-Asp
      Ser (RGDS) site of von Willebrand Factor, referred to as RGD mutant vWF,
      selectively abrogated vWF binding to platelet glycoprotein IIb/IIIa (GpIIb/IIIa
      alpha IIb beta 3) and abolished human umbilical vein endothelial cell (HUVEC)
      spreading, but not attachment, to RGD mutant vWF (Beacham, D.A., Wise, R.J.,
      Turci, S.M. and Handin, R. I. 1992. J. Biol. Chem. 167, 3409-3415). These results
      suggested that in addition to the vitronectin receptor (VNR, alpha V beta 3), a
      second endothelial membrane glycoprotein can mediate HUVEC adhesion to vWF. HUVEC
      attachment to wild-type (WT) and RGD-mutant vWF was reduced by two proteins known
      to block the vWF-platelet glycoprotein Ib/IX (GpIb/IX) interaction, the
      monoclonal antibody AS-7 and the recombinant polypeptide, vWF-A1. The addition of
      cytochalasin B or DNase I to disrupt potential GPIb alpha-cytoskeletal
      interactions enhanced the immunoprecipitation of endothelial GPIB alpha, caused
      HUVEC to round up, and increased HUVEC adhesion to RGD mutant vWF. These results
      indicate that while the VNR is the primary adhesion receptor for vWF, endothelial
      GPIb alpha can mediate HUVEC attachment to vWF. GpIb-dependent attachment could
      contribute to HUVEC adhesion under conditions when cell surface expression of the
      VNR is downregulated, and VNR-dependent adhesion is reduced.

PMID- 7792751
TI  - Effect of factor VII genotype on response to warfarin treatment.

PMID- 7792752
TI  - Plasma thrombomodulin is increased in cord blood of healthy newborns.

PMID- 7792753
TI  - Acquired factor VIII inhibitor associated with a prostatic cancer: simultaneous
      occurrence and healing.

PMID- 7792754
TI  - Loss of heparin-releasable tissue factor pathway inhibitor in patients undergoing
      PTCA.

PMID- 7792755
TI  - Comparison of HLA-DRB1 typing by DNA-RFLP, PCR-SSO and PCR-SSP methods and their
      application in providing matched unrelated donors for bone marrow
      transplantation.
AB  - The aim of the study was to devise a strategy for large batch analysis to
      determine HLA Class II alleles exhibited by candidate bone marrow transplant
      donors and prospective recipients using previously published DNA-based typing
      techniques. Special attention was directed towards the technical aspects of
      procedures, the level of typing resolution and the speed of data analysis. 200
      blood samples from volunteer bone marrow transplant donors typed serologically
      for HLA-DR and DQ were further investigated using three DNA-based typing methods:
      (i) restriction fragment length polymorphism (RFLP) analysis, (ii) polymerase
      chain reaction (PCR) amplification and subsequent hybridisation with sequence
      specific oligonucleotide probes (PCR-SSO), and (iii) PCR amplification with
      sequence specific primers (PCR-SSP) to resolve the DRB1* specificity of each
      individual. In general, the HLA-DR results obtained using PCR-SSO and PCR-SSP
      correlated well with each other. However, discordant results were obtained
      between PCR and RFLP based typing in 21 cases, especially in relation to DRB3*
      alleles associated with the DRB1 gene. These differences were due to three
      problems pertaining to RFLP analysis: i) alleles with identical DRB, DQA and DQB
      fragment sizes, ii) reliance on DQA and DQB results to assign the DRB genotype,
      and iii) a "new polymorphism" of DR7, in a DR7 homozygous, exhibiting a fragment
      similar in size to DR8. Our findings suggested a strategy requiring PCR-SSO
      analysis for initial low resolution class II typing involving large numbers of
      samples, while the use of PCR-SSP is reserved for small numbers of samples, for
      urgent samples or for situations where higher resolution is required.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7792756
TI  - Distribution of HLA and haplotypes of Colombian and Jamaican black populations.
AB  - To investigate the genetic background of the black populations of Colombia and
      Jamaica, we determined HLA types of 78 Colombian and 98 Jamaican blacks from 2
      different socioeconomic groups (Jamaican #1 and Jamaican #2) and estimated the
      frequencies of HLA genes and haplotypes. A phylogenetic tree based on the HLA
      gene frequencies revealed that Jamaican #1 and Jamaican #2 were distinct from
      each other, Jamaican #1 being closely related to the Colombian blacks and the
      Jamaican #2 being closely related to Senegalese and Zairean populations. Three
      locus HLA haplotypes of Colombian and Jamaican #1 blacks were an admixture
      between Africans and Caucasians or South American Indians, while Jamaican #2
      blacks were relatively homogeneous and appeared to conserve African lineages. The
      major five-locus HLA haplotypes were not shared among Colombian, Jamaican #1 and
      Jamaican #2 blacks. These results indicated that the black populations of
      Colombia and Jamaican were originated from African blacks and admixed variably
      with Caucasians and South American Indians to make genetic subpopulations in
      Colombia and Jamaica.

PMID- 7792758
TI  - HLA-DRB1*01 subtyping by heteroduplex analysis.
AB  - In this report we describe an alternative method for the identification of the
      four known HLA-DRB1*01 alleles, which is based on the generation of unique
      heteroduplex patterns between the different DRB*01 alleles and a synthetic DNA
      heteroduplex generator (DHG) molecule. The method is technically simple, rapid
      and cost-effective, as it essentially involves only a single polymerase chain
      reaction (PCR) followed by polyacrylamide gel electrophoresis. This technique
      allows the rapid discrimination of the various known HLA-DRB1*01 subtypes, both
      in homozygous and heterozygous situations. We propose that this technology can
      potentially be applied to most HLA class I and class II subtyping.

PMID- 7792757
TI  - HLA in familial and nonfamilial Mediterranean Kaposi's sarcoma in Greece.
AB  - Fifty-four (54) unrelated patients with Mediterranean Kaposi's sarcoma (MKS) and
      8 patients members of 4 unrelated families with familial MKS were serotyped for
      HLA-A,B and DR antigens. The diagnosis was histologically confirmed and all
      patients were negative for anti-HIV antibodies. An increased frequency of HLA-B18
      (44.4% vs 14.2% in the controls, p < 0.001, RR = 4.8) and HLA-DR5 (57.6% vs 37.2%
      in the controls, p < 0.025, RR = 2.29) was observed in the group of patients with
      MKS. Seven (7) of the 8 family members with FMKS possessed HLA-DR5, and the
      affected members in the 3 families shared a common haplotype which included HLA
      DR5. These findings support the hypothesis that genetic factors linked to HLA-DR5
      antigen may contribute to the pathogenesis of MKS.

PMID- 7792759
TI  - A description of a new DR allele, DRB1*1113.
AB  - We have discovered a previously unpublished HLA-DRB1 allele, observed in a
      patient (SB), his mother, and one sibling. The undefined allele gave sporadic
      positive reactions with sera in the DR52-associated group. SSOPH analysis
      utilizing both generic and group specific primers and probes also gave ambiguous
      results. SB typed clearly as a DRB1*0301 (paternal allele) but the DNA from SB
      also bound probes specific for DRB1*14 and DRB1*11. Sequencing revealed that the
      undefined allele was similar to a DRB1*14 allele with a segment of sequence found
      in DRB1*11 alleles. The patient was MLC reactive with donors who express
      DRB1*0301, *1401 and *0301, *11 and was nonreactive solely to DRB1*0301 (Dw3)
      homozygous typing cells.

PMID- 7792761
TI  - Novel human TAP2*103 allele shows further polymorphism in the ATP-binding domain.

PMID- 7792760
TI  - Comparison of two HLA-DRB high resolution microtiter plate reverse hybridization
      typing methods: advantage of a codon-86 valine or glycine PCR segregation.
AB  - Two rapid, nonisotopic, high-resolution HLA-DRB typing methods have been
      developed for DRB1, DRB3, DRB4 and DRB5 alleles. These methods are based on a
      single procedure consisting of the reverse hybridization of biotinylated
      amplicons to oligonucleotide probes that are covalently attached to a microtiter
      plate. Detection is by an enzymatic reaction with a fluorescent substrate. The 1
      Generic Amplification (1GA) method amplifies all HLA-DRB alleles in the same
      reaction mix. The 2 Allelic Subset Amplification (2SA) method uses two distinct
      amplification reactions that distributes all DRB alleles into two equal-size
      subsets, according to the codon 86 Gly or Val polymorphism; this adds an extra
      discrimination level to the typing. 108 samples were typed using the 1GA and the
      2SA methods and no discrepancies were found. Typing indeterminations due to
      overlapping probe combinations were compared; it was found that the 2SA method,
      with the extra discrimination level at the PCR step, greatly improved resolution.

PMID- 7792762
TI  - An HLA-DR11 variant (HLA-DRB1*1115) segregating in a family of Turkish origin.

PMID- 7792763
TI  - HLA-DQ alleles and susceptibility to celiac disease in Spanish children.

PMID- 7792765
TI  - Comprehensive, serologically equivalent DNA typing for HLA-B by PCR using
      sequence-specific primers (PCR-SSP).
AB  - Polymorphic products of HLA class I genes from the human major histocompatibility
      complex (MHC) are traditionally assigned by serology with additional
      heterogeneity detectable using one-dimensional isoelectric focusing (1D-IEF).
      With the increased availability of HLA class I DNA sequence information it has
      become feasible to genotype for class I by polymerase chain reaction utilising
      sequence-specific primers (PCR-SSP). We describe here a comprehensive HLA-B PCR
      SSP typing system based on available HLA nucleotide sequences which can detect
      all serologically defined antigens in most heterozygous combination in 48 one
      step PCR reactions. In addition, four new unsequenced variants have been
      identified. DNA samples from 57 International Histocompatibility Workshop
      reference cell lines and 160 control individuals have been typed by the HLA-B PCR
      SSP technique. 3/57 cell line types and 12/160 normal control individuals types
      were discrepant with the reported serological types. The SSP system has been
      designed to be higher resolution than serology but is not a complete allele
      specific PCR although many single alleles can be identified. The system is
      entirely complementary to previous published PCR-SSP systems for HLA-Class II and
      HLA-Class I in that the same PCR conditions and controls are used which allows us
      to do one step PCR-SSP for all relevant HLA loci in under 3 hours in a system
      suitable for the typing of cadaver donors.

PMID- 7792764
TI  - Effects of the second HLA-DQ haplotype on the association with childhood insulin
      dependent diabetes mellitus.
AB  - Analysis of HLA-DQ molecules in a large study comprising 425 consecutively
      diagnosed Swedish Caucasians with IDDM and 367 age, sex and geographically
      matched controls confirms previous observations that: (a) DQB1*0302-DQA1*0301
      confer susceptibility in a dominant manner, except when they are associated with
      DQB1*0602-DQA1*0102; (b) DQB1*0501-DQA1*0201 does not confer susceptibility to
      IDDM in either homozygous or heterozygous combinations with any other DQ
      molecules except when it is in association with DQB1*0302-DQA1*0301; (c)
      heterozygous combinations of DQB1*0302-DQA1*0301 and DQB1*0501-DQA1*0201 confer
      the highest risk to IDDM; (d) in DQ2 positive patients being negative for DQ8 in
      second haplotype (n = 58) the susceptibility may be explained by DR, since all
      these patients were DR3 positive, or by unknown factors between DQ and DR and (e)
      DQB1*0602-DQA1*0102 confers protection in a dominant manner. This large study
      does not confirm the positive association previously observed in Norwegians
      between the DQ8/DQ4 genotype and IDDM, as this genotype was not significantly
      associated with IDDM in Swedish patients. The new findings in this study include
      (a) that DQ8/DQ6 (DQB1*0604-DQA1*0102) was associated with IDDM in Swedish
      patients and (b) analysis of individual amino acids in DQB1 chain does not fully
      explain susceptibility to IDDM.

PMID- 7792767
TI  - Distribution of HLA antigens and haplotypes in the Buryat population of Siberia.
AB  - Polymorphisms of HLA-A, B, C, DR, and DQ antigens were investigated in a
      Mongoloid population named Buryat living in Siberia. HLA gene and haplotype
      frequencies were calculated from the population data obtained from 141 unrelated
      healthy Buryat adults. Gene frequencies of class I antigens A2, A24, A1, B61,
      Cw10, and Cw6 were estimated to be more than 10%. For class II, DR4, DR7, DR13,
      DQ7, and DQ1 antigens were predominant. A phylogenetic tree was constructed based
      on HLA gene frequencies, and the Buryat population was clustered with the
      Mongoloid groups in Northeast Asia. In the analysis of HLA-A, C, B, DR, and DQ
      five-locus haplotype frequencies, seven kinds of haplotypes were calculated to
      occur at frequencies of more than 2%. Five of the seven common haplotypes have
      also been described in the other human populations thus far. Some of the
      haplotypes have been described in European populations, while the others were
      shared with Northeast Asian Mongoloids as well as Amerindians. Similar situation
      was also found in the analysis of class I (HLA-A, C, B) three locus haplotypes.
      These observations suggest the unique genetic background of this Buryat
      population.

PMID- 7792766
TI  - Major histocompatibility complex class II and C4 alleles in Mexican Americans
      with systemic lupus erythematosus.
AB  - Few data exist on associations of class II and class III alleles of the major
      histocompatibility complex (MHC) and susceptibility to systemic lupus
      erythematosus (SLE) in Mexican Americans, a group of predominantly mixed Spanish
      and Native American ancestry. Therefore, MHC class II alleles (HLA-DRB1, DQA1,
      DQB1, DPA1 and DPB1 alleles) and C4 allotypes were determined in 52 Mexican
      American SLE patients and 105 ethnic-matched controls. HLA-DRB1*0301 and C4A*Q0
      were each increased in the SLE patients, especially HLA-DRB1*0301 in those with
      anti-Ro/SSA autoantibodies. C4A*Q0 was associated with HLA-DRB1*0301 only in a
      minority of patients and controls. Anti-U1RNP antibodies were significantly
      associated with the presence of HLA-DQB1*0302, and the risk for the production of
      anti-Ro antibodies was heightened by the presence of at least three (out of four
      possible) DQA1 chains possessing a glutamine at position 34 and/or DQB1 chains a
      leucine at position 26 of their outermost domains. Thus the HLA class II and C4
      null allele associations that have been noted in other ethnic groups are also
      found in Mexican Americans, suggesting shared susceptibility factors across
      ethnic lines in predisposition to SLE.

PMID- 7792768
TI  - [Non-invasive patient monitoring in veterinary medicine: pulse oximetry and
      capnography. II. Capnography].
AB  - Capnography measures carbon dioxide concentration or partial pressure of the
      respiratory gas continuously and non-invasively. The endtidal value is of great
      diagnostic value, it corresponds approximately to the arterial value, except for
      ventilation-perfusion-mismatching (horse), shunting (horse), or increased dead
      space-ventilation (panting in the dog). Capnography primarily serves for
      monitoring of spontaneous and artificial ventilation, it is a reliable method for
      detecting hypo- and hyperventilation. Because metabolism and circulation
      influence the amount of carbon dioxide eliminated in the lung, capnography
      monitors these functions too. The plotting of the carbon dioxide concentration as
      a carbon dioxide-time-diagram draws attention to malfunctions of the equipment.
      Technical problems of capnography depend on the design of the capnograph (main-
      or side-stream) used as well as on the weight of the patient. In the discussion
      the value of pulse oximetry and capnography in detection of critical events
      during anaesthesia is compared. Capnography is superior to pulse oximetry in the
      capability to detect critical events. But pulse oximetry complements capnography
      perfectly, both methods together give a good impression of the patient's state of
      health.

PMID- 7792769
TI  - [The clinical situation. Tumor in the sublingual region associated with high
      grade osteolysis in the masticatory surface of the mandible].

PMID- 7792770
TI  - [The hemorrhagic form of acute bovine virus diarrhea: literature review and case
      report].
AB  - Infection of cattle with certain strains of BVD-virus causes a severe
      thrombocytopenia. The most obvious clinical and pathological lesions are multiple
      hemorrhages. Until now, problems with the Hemorrhagic syndrome have been reported
      predominantly from veal calf operations in the U.S.A. This publication presents
      first a literature review about the Hemorrhagic syndrome. The current data are
      based upon retrospective studies of field cases and experimental infections.
      Afterwards clinical, pathological and virological findings from three herds of
      veal calves in Germany are reported in which hemorrhagic diathesis was observed
      in calves and BVD-virus was isolated from tissues of diseased calves. The
      findings in these herds closely resemble the ones described in the literature for
      the Hemorrhagic syndrome. Therefore, infection with BVD-virus should be
      considered as differential diagnoses in Germany too, when hemorrhagic diathesis
      is observed in cattle.

PMID- 7792771
TI  - [Gynecological laparoscopy in sheep. 1. Foundations].
AB  - Laparoscopy is a gentle and safe method for diagnosis and manipulation of the
      genital tract in female sheep. After a short history outline the equipment and
      the fundamental principles of the laparoscopy in sheep are described. Possible
      laparoscopic incidents and their treatment are explained.

PMID- 7792772
TI  - [Accuracy of current rapid milk progesterone assays in comparison with a routine
      laboratory method].
AB  - Four current commercially available rapid milk progesterone assays (Cowside rapid
      tube kit [test No. 1], Hormonost-Schnelltest Milch [test No. 2], Hygia Diagnostic
      RPT Progesterone Test [test No. 3] and Target-Milch-Progesterone-Schnelltest
      [test No. 4]) for dairy cows were tested for their accuracy in comparison with
      the gynecological status on the one hand and by using an approved quantitative
      laboratory-bound assay on the other hand. Milk samples were taken from 23 dairy
      cows with behavioural oestrus. From 18 species with expected intermediate levels
      of progesterone milk probes were taken between day 3 and day 6 post insemination
      and also from 26 gravid cows. The clinically established gynecological status of
      the dairy cows correlated completely with their milk progesterone values
      investigated with the laboratory-bound EIA. In contrast the accuracy levels of
      the rapid progesterone kits differed. The accuracy of test No. 1 was 81%
      regarding all milk probes, whereas test No. 2 achieved 91%, test No. 3 73.5% and
      test No. 4 only 69.5%. Milk samples yielding low progesterone levels partly
      showed big differences. The highest rates of false semiquantitative
      classifications were recorded in milk samples with intermediate progesterone
      values. Test No. 2 was the only one with satisfactory results in this range. Milk
      samples yielding high progesterone values proved to be the best in all four
      assays.

PMID- 7792774
TI  - [Publication of a valid determination--cauterization in horses].
AB  - Cauterization in horses is a painful method to enable the identification of
      horses. This method is not allowed (section 17 Nr. 2b Tierschutzgesetz, FRG),
      because recent findings have found a painless method to identify horses.

PMID- 7792773
TI  - [Pathological changes in the urogenital tract and mammae of culled sows from an
      industrial pig production unit].
AB  - In an industrial pig production unit 101 sows were culled because of reproduction
      failure. All the sows had a previous history of MMA, PHS, SUGD. All the sows were
      crosses of the two breeds Large White and Landrace. 101 sows were examined
      postmortem for pathologic changes. Changes were found in the kidney (38.6%),
      pyelum (49.5%), ureter (52.5%), bladder (100%), urethra (100%), uterus (50.5%),
      cervix (31.7%), vagina (28.7%), ovaries (51.5%), mammary gland (100%). Since 100%
      of the pathologic findings happened simultaneously in the urinary tract as well
      as in the mammary gland and just over 50% of the investigated cases had
      pathologic changes in the genital organs as well, the results suggest that MMA,
      PHS, and SUGD must be regarded as different manifestations of the same
      pathological entity of the urogenital organs of the sow. The authors introduce
      the term SUGD to denominate the conflicting terminology around the periparturient
      reproductive failure syndrome complex.

PMID- 7792775
TI  - [Radiologic follow-up examination of podotrochlosis].
AB  - X-rays of 205 horses having navicular disease and having been reexamined up to
      six times are evaluated. For this, the x-rays of each foreleg are evaluated in
      the dorsopalmar (Oxspring) and lateromedial view. Additionally to changes of the
      navicular bone, changes of the distal part of the toe are also assessed.
      Differences can be found in the radiographic process in view of the limitation of
      vascular foramina and cyst-like lesions. Vascular foramina with sclerotic rim
      grow less frequent than poorly defined ones and therefore allow for easier
      prognostication. Cyst-like lesions with sclerotic rim often stay unchanged or
      decrease separately, whereas poorly defined areas of rarefication show a stronger
      tendency to expand into the surrounding spongiosa. Changes of vascular and bone
      structure occur already within a few months, whereas most of the margination
      changes are already formed in the early stages of disease and proceed slowly.
      Finally the effects of the therapy are being examined for the radiographic course
      of disease. Following a neurectomy, a more intensive development of the changes
      can be observed. The rate of only minimally altered navicular bones as well as
      the often simultaneous occurrence of changes in the joints of the toe do not
      allow for a diagnosis only on the basis of radiographic findings. The often slow
      development of the pathological radiographic changes requires intervals of
      examination of at least one year and shows that prognostic statements can only be
      made with caution even after follow-up examinations.

PMID- 7792777
TI  - [Demonstration of two trimethoprim/sulfonamide combinations in bronchoalveolar
      lavage fluid of horses and determination of blood levels].
AB  - Five healthy horses were given a sulfadoxine/trimethoprim combination (Borgal,
      Hoechst AG) i.v. on day 1. The next ten days the horses got once a day a
      sulfadimethoxine/trimethoprim combination orally (Trafigal, Hoechst AG). The
      doses were given as recommended. One horse received no medicaments for control.
      On each horse six bronchoalveolar lavages were performed. Blood samples were
      taken to calculate blood levels and elimination half lives. To determine the
      amount of substances in lavage fluid and plasma the high performance liquid
      chromatography (HPLC) was used. Regularly low quantities of sulfonamides and
      trimethoprim were detected in lavage-samples. The mean plasma concentration (n =
      4) of sulfadoxine and trimethoprim 30 min after i.v. administration was 71.6 and
      1.13 micrograms/g respectively. 24 h after injection the sulfadoxine blood level
      was 3.0 micrograms/g, while trimethoprim was no longer detectable. The average
      elimination half lives of sulfadoxine and trimethoprim were 7.94 h and 1.35 h
      respectively. 8 h after oral application (n = 5) the highest mean
      sulfadimethoxine blood levels of 53.8 micrograms/g were measured. The elimination
      half life of sulfadimethoxine was 9.77 h. Two hours after feeding the drug the
      first blood samples were taken. They already contained the highest mean
      trimethoprim concentration of 0.32 microgram/g plasma.

PMID- 7792776
TI  - [Incidence of Parascaris equorum in foals and their mares after strategic use of
      wide-spectrum anthelmintics for several years].
AB  - In this epidemiological survey 30 foals and their mares from seven breeding farms
      were investigated. Six farms used wide spectrum anthelmintics strategically at
      least for three years, on one farm no anthelmintic prophylaxis was practiced.
      Excretion of P.-equorum-eggs occurred in all breeding farms and in 80% of the
      foals, but in only one mare. In foals infection with roundworms was detected at
      the earliest 85 days post partum. Before first shedding of P.-equorum-eggs wide
      spectrum anthelmintics had been administered to two and to one foal(s) one and
      two times, respectively, to four animals three times and to one foal each four,
      five, six and seven times. After metaphylactic use of wide spectrum anthelmintics
      in the control of an infection with roundworms or other helminths, eggs of P.
      equorum were found in one foal already 12, 17, 54, 55, 70 and 71 days after
      treatment with Ivomec-P each and 65 days after use of Panacur in one foal. After
      application of Banminth roundworm eggs were detected 12, 27, 45, 47, 49 and 62
      days in one foal each and 19 and 56 days in two foals each. In eight foals each
      P.-equorum-eggs were noticed 72 and 196 days after anthelmintic treatment.

PMID- 7792778
TI  - [Electron microscopic demonstration of viruses in feces of dogs with diarrhea].
AB  - 4044 stool samples of dogs with diarrhoea were examined by electron microscopy.
      The samples were sent for routine diagnostics in the years 1988-1993. Over the
      examination period virus was detected in 32% of the samples. Parvovirus was
      diagnosed in 17.2% and coronavirus in 12.4% of the cases. The number of
      parvovirus-positive samples was lower than in former years, whereas the number of
      coronavirus-positive samples was higher. Other virus particles (paramyxo-,
      picorna-, calici- and astrovirus or morphologically similar particles as well as
      rota- and adenovirus) were altogether detected in 2.5% of the samples. This
      detection rate corresponded to the results of former years. The majority of
      parvovirus-positive samples (80.7%) was found in animals aged between six weeks
      and six months. Of the coronavirus-positive samples 56.5% were detected in dogs
      older than six months of age and 42.5% in animals between six weeks and six
      months. In puppies up to six weeks viruses were only detected infrequently
      (parvovirus 4.7%, coronavirus 0.9%).

PMID- 7792779
TI  - [Neoplasms originating from large granular lymphocytes in a dog and cats].
AB  - Clinical, cytological and pathological findings in three cases of large granular
      lymphoma in a dog and two cats are presented. These tumors consist of large
      granular lymphocytes, which have been in part classified as natural killer cells,
      based on their phenotype and functional aspects. It is likely that such tumors
      are more frequent than commonly appreciated, because they are only recognized as
      such in cytological preparations or in electron microscopy.

PMID- 7792780
TI  - [Morphology of the ligamentum glenohumerale mediale in shoulder joints of dogs].
AB  - This study was performed on the shoulder joints of 23 dogs of different age and
      sex. The purpose was to examine the medial wall of the articulatio humeri as well
      as the intraarticular position of the ligamentum glenohumerale mediale. The
      examinations showed an attachment of the ligamentum glenohumerale mediale at the
      articular capsule by crossing the capsule and forming an intraarticular
      structure. Section of frozen shoulders showed that the ligamentum glenohumerale
      mediale separated the cavitas glenoidalis of the scapula and the caput humeri of
      the humerus from medial like a meniscus. Histological sections were remarkable
      because of the fibrocartilaginous structure. The attachment of the ligament
      arised from the tendon of the musculus subscapularis and divided the recessus m.
      subscapularis into two subpouches. The lateral one was more capacious and more
      extended under the tendon of m. subscapularis.

PMID- 7792781
TI  - [Treatment of chronic diarrhea in dogs and cats under field conditions using oral
      E. coli vaccines].
AB  - An autogenous oral E. coli vaccine was tested for efficacy in the treatment of
      chronic diarrhoea in dogs (n = 82) and cats (n = 50) under field conditions. The
      data were collected through evaluation of questionnaires completed and returned
      by veterinarians. After oral application of the E. coli vaccine the symptoms of
      diarrhoea were stopped in 71% of the treated animals within two to five days. In
      further 15% of the cases the enteric symptoms continued but were not so severe as
      in the beginning of the treatment. There was no therapeutic success with the oral
      E. coli vaccine in further 14% of the animals in cause of food allergy,
      ascariasis, volvulus or pancreatic insufficiency.

PMID- 7792782
TI  - [Domestic animals as patients in a small animal practice. 2. Handling, sex
      determination, blood collection, drug application].
AB  - The importance of small pets as domestic animals and patients in veterinary
      practice increased in the last years. Differences in physiology and behaviour
      require exact knowledge of appropriate handling and sex determination, techniques
      of blood collection as well as drug application methods. Therefore, a survey of
      rabbit, guinea-pig, chinchilla, hamster, gerbil, mouse, and rat as patients in
      veterinary practice is given.

PMID- 7792783
TI  - [Clinical symptoms and diagnosis of feline infectious peritonitis].
AB  - Body effusions from 197 cats and blood serum samples from 252 cats, where Feline
      Infectious Peritonitis (FIP) was part of the differential diagnosis, were
      analysed. The diagnoses were confirmed by clinical follow up or histopathology.
      The final diagnosis FIP was always confirmed by histopathology. The median age of
      cats with FIP was 1.6 years. FIP was responsible for 41% of the body effusions,
      whereas malignomas caused 24%, cardial insufficiencies 14% and purulent serositis
      12% of the body effusions. The rivalta test was highly sensitive for FIP.
      Predictive value of a negative result was 100%, predictive value of a positive
      result was 84%. In half of the cases with purulent serositis and in 20% of
      malignomas rivalta reacted positive. The cardial insufficiencies were negative
      for rivalta. Coronavirus antigen could be demonstrated by immunofluorescence in
      34 of 49 body effusions caused by FIP, whereas in the 50 body effusions caused by
      other diseases no coronavirus antigen was detected. An albumin globulin ratio of
      < 0.6 was highly diagnostic for an inflammatory process, nearly exclusively for
      FIP. An albumin globulin ratio of > or = 0.8 almost excluded FIP. Only a negative
      or very high (1:1600) FIP titer could contribute to confirm diagnosis. Low and
      medium titers, however, should not be interpreted.

PMID- 7792784
TI  - Bronchial hyperreactivity in the peripheral airways.

PMID- 7792785
TI  - Eosinophils infiltration in the rat seminal vesicle associated with estradiol-17
      beta-related stromal proliferation.
AB  - We performed a histological quantitative analysis of collagen and smooth muscle
      in seminal vesicle (SV) stroma after Estradiol-17 beta (E2) administration to the
      immature castrated rat. On day 14 after E2 administration, collagen and smooth
      muscle had increased approximately five and fifteen times, respectively, over the
      baseline of day 0. On day 28 (14 days after the cessation of E2 administration),
      smooth muscle decreased to the same level as that on day 7, but collagen did not
      decrease during the 14 days after the cessation of E2 administration. As the
      proliferation of stroma, the infiltration of eosinophils was seen in the
      perigrandular stroma that consisted of rich collagen. The number of infiltrated
      eosinophils increased exponentially in the period in which collagen proliferated.
      But in the peripheral stroma which consists of rich smooth muscle, no eosinophil
      infiltration was seen. These results suggest that eosinophil infiltration into SV
      is related to E2 administration and to stromal proliferation, especially to
      collagen proliferation in this condition.

PMID- 7792786
TI  - Evaluation of the effectiveness of cervical cancer screening: a case-control
      study in Miyagi, Japan.
AB  - To estimate the effectiveness of screening for invasive cervical cancer, a case
      control study was performed in Miyagi, Japan. A total of 198 cases (129 mass
      screen-detected and 69 outpatient-detected) of invasive cervical cancer were
      identified between 1984 and 1990. The results of the Papanicolaou smear of these
      cases were compared to those of 396 age- (+/- 5 years) and area-matched controls.
      Compared with women who had no prior screening (cases 51.6%, controls 16.2%),
      women who were screened had an odds ratio (OR) for invasive cervical cancer of
      0.14 (95% confidence interval [CI] 0.088-0.230). The OR for the 175 cases of
      squamous cell carcinoma was 0.13 (95% CI 0.077-0.215), while the OR for the 23
      cases of screened women with adenocarcinoma was 0.40 (95% CI 0.091-1.753). The
      time intervals following the last negative smear were assessed and we found an OR
      for a one-year interval and a two-year interval of 0.09 (95% CI 0.055-0.163) and
      0.17 (95% CI 0.083-0.335), respectively. In conclusion, screening for invasive
      cervical cancer is not only effective but also the degree of protection is high
      for one to two years.

PMID- 7792787
TI  - Viability of partial liver graft from living donor in pigs.
AB  - For evaluation of the viability of partial liver graft from a living donor, we
      investigated energy production of mitochondria and radical scavenging enzyme
      activities in partial and whole liver transplantation in pigs. The values of
      adenosine triphosphate (ATP) and total adenine nucleotide (TAN) of the partial
      liver graft were higher than those of the whole liver graft, whereas the
      hypoxanthine of the partial liver graft was lower than that of the whole liver
      graft. There was no statistical difference in the radical scavenging enzyme
      activities between the two groups. The values of respiratory control ratio (RCR)
      in both groups were above 3.0 and there was no statistical difference. The
      survival rates of pigs received partial liver and whole liver graft with 2 to 3
      hr cold preservation was 71% and 91%, respectively and there was no statistical
      difference between two groups. These results suggest that viabilities of the
      partial liver graft from the living donor are satisfactory enough, compared with
      those of whole liver graft from a cadaver.

PMID- 7792788
TI  - Longitudinal investigation of epidemiologic feature of adenovirus infections in
      acute respiratory illnesses among children in Yamagata, Japan (1986-1991).
AB  - Using human embryonic fibroblast (HEF) and HEp-2 cell cultures, adenoviruses were
      isolated from 989 (3.7%) out of 26,793 pediatric patients with ARI in Yamagata,
      Japan from January, 1986 to December, 1991. All isolates were identified as types
      1 (Ad1)-6 and no other serotypes were identified. Epidemiologic feature was
      different depending on the subgenus group. Ad1, 2, 5 and 6 (group C) were endemic
      and the infections occurred frequently in the summer season. Ad3 (group B) was
      epidemic in the autumn to winter season, although the virus was isolated every
      month in non-epidemic season. No seasonal distribution of Ad4 (group E) could be
      determined because the number of patients was limited. Neutralizing antibody
      positive ratio for group C were more than 40% at 1-2 years of age and almost 100%
      by 10 years of age but those for Ad3 (group B) were 40% by 10 years of age. The
      neutralizing antibodies for Ad4 (group E) or Ad7 (group B) became negative by 10
      years of age. With group C infections, most cases were infants and young children
      less than 2 years of age, but Ad3 infections were older children with the peak at
      4 and 5 years of age.

PMID- 7792789
TI  - Vascularization and innervation of the canine wrist joint synovial membrane.
AB  - The correlation between vascular distribution and synovial structures was
      investigated using corrosion cast of the synovial fold of the dog
      antebrachiocarpal joint (wrist joint) under scanning electron microscopy.
      Arterial branches arose from a main artery deep in the subsynovial layer,
      ascended toward the free margin of the fold, dividing into several branches, and
      finally formed a dense capillary network beneath the lining layer.
      Immunohistochemical study and a retrograde axonal tracing experiment revealed
      that almost all nerve fibers were associated with the arterial tree and that: (1)
      proximal parts of the arterial tree were innervated with neuropeptide Y (NPY)
      containing noradrenergic sympathetic fibers, vasoactive intestinal peptide
      containing non-catecholaminergic sympathetic fibers from the stellate ganglion
      and substance P (SP)- and calcitonin gene-related peptide (CGRP)-containing
      sensory fibers from the C7-T1 segments of the dorsal root ganglia; (2) more
      distal parts of the arterial branches were associated with NPY-immunoreactive
      sympathetic fibers and SP- and CGRP-immunoreactive sensory fibers; and (3) the
      most peripheral precapillary arterioles were accompanied by only SP- and CGRP
      containing sensory fibers. These results indicate that synovial blood flow is
      regulated by at least three different nerve systems which possess regional
      differences.

PMID- 7792790
TI  - Ganglioglioma in the basal ganglia totally resected by a trans-distal Sylvian
      approach.
AB  - A patient with a ganglioglioma in the basal ganglia is presented. An 18-year-old
      man presented with involuntary movement in his right hand and right homonymous
      hemianopsia. Computed tomography and magnetic resonance imaging revealed a cystic
      tumor with an enhancing nodule in the basal ganglia extending into the thalamus.
      The mass was totally resected by a trans-distal Sylvian approach and was
      histologically proven to be a ganglioglioma. This is a rare case of midline
      ganglioglioma in a patient who underwent gross total resection.

PMID- 7792792
TI  - A cell-specific nuclear receptor regulates the steroid hydroxylases.
AB  - Recent studies of the gene regulation of the cytochrome P450 steroid hydroxylases
      have established a key role for an orphan nuclear receptor, designated
      steroidogenic factor 1 (SF-1). SF-1 binds to shared promoter elements upstream of
      the steroid hydroxylases to mediate their coordinate expression in steroidogenic
      cells. Analyses of SF-1 expression during mouse embryonic development showed that
      SF-1 is expressed from the earliest stages of organogenesis of the steroidogenic
      tissues, suggesting an intimate link between SF-1 and steroidogenic cell
      differentiation. Finally, in gene disruption experiments, the gene encoding SF-1
      was shown to be essential for development of the adrenal glands and gonads. These
      results establish the essential role of this orphan nuclear receptor in the
      development and function of the primary steroidogenic tissues.

PMID- 7792791
TI  - Aldosterone and Hypertension. Proceedings of a satellite symposium to the 15th
      International Society of Hypertension Congress. Lorne, Victoria, Australia, March
      17-19, 1994.

PMID- 7792793
TI  - Recognition of markers of response to potassium-canrenoate in essential
      hypertension.
AB  - Potassium canrenoate (K-Can) prevents hypertension in Milan hypertensive strain
      (MHS) but not in spontaneously hypertensive rats (SHR). Essential hypertensive
      patients (HT) may have differential sensitivity to diuretics, since a subgroup of
      HT insensitive to hydrochlorothiazide (HCTZ) but sensitive to K-Can has
      previously been found. The aims of this study were: 1) to seek markers of
      response in essential hypertensive patients selectively sensitive to K-Can: and
      2) to test whether selective sensitivity to furosemide may also be demonstrated.
      After 2 weeks of placebo (P) 50 uncomplicated, mild to moderate HT (46 +/- 9 yrs,
      mean +/- SD) received K-Can (50 mg/day) for 4 weeks. After 2 more weeks of P,
      patients received HCTZ (25 mg) and furosemide (25 mg) for 4 weeks each in a
      single blind crossover design, with 2 weeks P between each treatment. Dosages
      were doubled after 2 weeks if diastolic blood pressure (DBP) was > 90 mmHg.
      Responders (R) were those HT whose DBP was < or = 90 mmHg and/or at least 10 mmHg
      lower than before treatment. Systolic blood pressure (SBP)/DBP was measured every
      2 weeks with plasma renin activity (PRA), red blood cell Na(+)-K(+)-Cl-
      cotransport (COT) and Na(+)-K+ ATPase pump activity measured at the end of the
      first P period, and serum electrolytes at the end of each period. Four HT dropped
      out because of low compliance, 6 because of reversible side effects, and 1
      because blood pressure was not back to pre-treatment value after the second
      placebo period.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792795
TI  - Aldosterone (ALDO) increases transmembrane influx of Na+ in vascular smooth
      muscle (VSM) cells through increased synthesis of Na+ channels.
AB  - We have previously reported our studies on glucocorticoid (GC) effects on Na+
      influx in vascular smooth muscle (VSM) cells. We now report a parallel study on
      the effect of mineralocorticoid (MC) on Na+ influx in VSM cells. Unidirectional
      influx of Na+ was measured in cultured cells of rabbit aortic media with 22Na as
      tracer. Cells were treated with near physiologic (5 nM) or supraphysiologic (50
      nM) aldosterone (ALDO) for 24 or 48 hours, or for 7 to 10 days, in the presence
      of competitive inhibitors of MC-receptor binding, K-prorenoate (PRN), or GC
      receptor binding, RU 486. ALDO at 5 nM increased Na+ influx by 98% +/- 12%, but
      only after 7-10 days of treatment. This effect was inhibited by PRN, but not by
      RU 486, and blocked by amiloride but not by ethylisopropyl-amiloride or by
      dichlorobenzamil (DCB). In VSM cell membranes from aortae of rabbits treated in
      vivo with ALDO (2 mg/day) for 4 weeks. Na+ channels were quantified by
      determination of specific [3H]amiloride binding in the presence of excess of DCB
      and EIPA to exclude tracer binding from the Na+/Ca2+ exchanger and the Na+/H+
      antiporter. ALDO doubled the number of of Na+ channels in such isolated cell
      membranes, as determined by Bmax per mg membrane protein. We propose that this
      vascular effect of ALDO may constitute an important pathogenetic mechanism of
      hypertension induced by chronic excess of MC, in addition to the well known renal
      mechanism.

PMID- 7792794
TI  - Ouabain-inhibiting activity of aldosterone antagonists.
AB  - It has been suggested that endogenous substances (known as ouabain-like factors,
      OLF), secreted from the central nervous system in response to salt and water
      retention, inhibit the cell membrane Na+/K+ pump in the renal tubules and reduce
      sodium reabsorption. However, by also acting upon vascular smooth muscle cells,
      they may induce cell Na+ and Ca++ accumulation, vasoconstriction and systemic
      hypertension. Recently, an endogenous Na+/K+ pump inhibitor was isolated from
      human plasma; this inhibitor is indistinguishable from the cardiac glycoside
      ouabain based on biochemical and immunological criteria. Its plasma concentration
      is close to the therapeutic range for ouabain (around 0.4 nmol/L). Since plant
      ouabain promotes natriuresis, vasoconstriction, and hypertension; endogenous
      ouabain may therefore control extracellular fluid volume and blood pressure. The
      highest plasma concentrations of endogenous ouabain and OLF were found in
      congestive heart failure, aldosterone producing adenoma, human and animal models
      of volume expanded hypertension (reduced renal mass and DOCA-salt hypertension),
      and in Milan hypertensive rats (MHS). Aldosterone antagonists (canrenone and
      canrenoate) exert both agonist and antagonist effects on the digitalis receptor
      site of the Na+/K+ pump. They are effective antihypertensive agents in animal
      models of hypertension sustained by OLF (reduced renal mass-Na+ and DOCA-salt
      hypertension in rats). Moreover, in a subgroup of essential hypertensives, 4
      weeks of canrenoate administration reduced blood pressure, heightened red blood
      cell Na+/K+ pump activity, and antagonized ouabain-induced vasoconstriction. None
      of these effects was seen in the other hypertensives. These data suggest that
      aldosterone antagonists stimulate the Na+/K+ pump inhibited by endogenous ouabain
      and exert their antihypertensive action at least in part through this mechanism.

PMID- 7792796
TI  - Aldosterone biosynthesis and action in vascular cells.
AB  - In view of the hypothetical possibility that the vascular renin-angiotensin
      system (RAS) might include aldosterone biosynthesis and action in the
      vasculature, we have undertaken a study to identify aldosterone released into the
      perfusion circuit from the rat mesenteric artery, and to investigate the effects
      of an angiotensin converting enzyme inhibition (ACEI) on aldosterone production
      from the vasculature. After 30 min equilibration, 240 mL of perfusate was
      collected and subjected to reverse-phase HPLC and subsequent mass spectrometry.
      Mass spectra corresponding to authentic corticosterone and aldosterone were
      obtained from the samples of mesenteric artery perfusate. Production of
      aldosterone in the mesenteric artery was not changed by adrenalectomy, although
      it was reduced in the arterial perfusate from rats pretreated with ACEI. By RT
      PCR the expression of CYP 11B2 and mineralocorticoid receptor genes were
      demonstrated in both vascular endothelial and smooth muscle cells. These studies
      constitute indirect evidence supporting our hypothesis that locally produced
      aldosterone in the vascular tissue acts on vascular tone and remodeling via a
      paracrine or autocrine manner.

PMID- 7792798
TI  - Adrenal steroids and cardiac fibrosis.
AB  - Uninephrectomized rats maintained on 0.9% NaCl as drinking fluid and infused for
      8 weeks with aldosterone 0.75 micrograms/h via subcutaneous osmotic minipumps
      respond with hypertension, cardiac hypertrophy, and both interstitial and
      perivascular cardiac fibrosis. Similar animals injected with desoxycorticosterone
      (20 mg/week), or the glucocorticoid antagonist RU 486 (2 mg/day) show
      interstitial cardiac fibrosis to a lesser degree than animals injected with
      aldosterone, and show perivascular fibrosis to a greater degree. These findings
      suggest that glucocorticoid antagonist activity may play a role in exacerbating
      perivascular collagen deposition in response to chronic mineralocorticoid and
      salt imbalance.

PMID- 7792797
TI  - Chronic mineralocorticoid excess and cardiovascular remodeling.
AB  - Chronic mineralocorticoid (MC) excess, whether due to elevated plasma aldosterone
      (ALDO) or deoxycorticosterone (DOC), is associated with a perivascular fibrosis
      of systemic and coronary arterioles. This remodeling of resistance vessels
      contributes to the appearance of hypertension. Chronic MC excess is also
      accompanied by cardiac myocyte necrosis, secondary to myocardial potassium
      depletion, and a subsequent reparative fibrosis that appears in the normotensive,
      nonhypertrophied right and hypertensive, hypertrophied left ventricles. Fibrosis
      contributes to the appearance of ventricular arrhythmias and dysfunction. Herein,
      clinical and experimental evidence linking chronic, inappropriate (relative to
      dietary sodium) elevations in circulating ALDO and DOC with these reactive and
      reparative forms of fibrous tissue formation in the heart and other tissues is
      presented.

PMID- 7792799
TI  - Significance of 19-noraldosterone, a new mineralocorticoid, in clinical and
      experimental hypertension.
AB  - 19-Noraldosterone, which was recently shown to be synthesized and produced in the
      human adrenal gland, possesses potent mineralocorticoid and hypertensinogenic
      activities. 18,19-Dihydroxycorticosterone (18,19-(OH)2-B) and 18-hydroxy-19
      norcorticosterone (18-OH-19-nor-B), a possible precursor of 19-noraldosterone,
      have been identified in human urine. These mineralocorticoid hormones are
      regulated by the renin-angiotensin system and synthesized in adrenal glomerulosa
      cells. Urinary 19-noraldosterone correlated with urinary 18,19-(OH)2-B, 18-OH-19
      nor-B, 18-hydroxycorticosterone (18-OH-B), and aldosterone. Urinary excretion of
      19-noraldosterone, 18,19-(OH)2-B, and 18-OH-19-nor-B were increased in patients
      with aldosterone-producing adenoma (APA) and in those with idiopathic
      hyperaldosteronism (IHA), but the two did not differ significantly. Urinary 18-OH
      B and 18-hydroxycortisol (18-OH-F) were significantly higher in APA compared with
      IHA. Though urinary 18-OH-F and 18-OH-B concentrations were useful markers,
      urinary 19-noraldosterone, 18,19-(OH)2-B, and 18-OH-19-nor-B could not be used to
      distinguish the two subsets of primary aldosteronism. Urinary 19-noraldosterone
      did not differ in hypertensive and normotensive patients. However, urinary 19
      noraldosterone was increased in some hypertensive patients. In spontaneously
      hypertensive rats (SHR) and stroke-prone SHR (SHRSP), urinary 19-noraldosterone
      was increased at the prehypertensive stage compared with Wistar-Kyoto (WKY) rats.
      Urinary 19-noraldosterone was decreased in 9-week-old SHR and SHRSP compared with
      WKY rats. However urinary 19-noraldosterone was higher in SHRSP than in SHR.
      These elevated levels of 19-noraldosterone may contribute to hypertension in some
      individuals and in experimental hypertensive rats.

PMID- 7792800
TI  - Cortisol to cortisone: glucocorticoid to mineralocorticoid.
AB  - 11 beta-hydroxysteroid dehydrogenase (11 beta-HSD), by converting cortisol and
      corticosterone to hormonally inactive cortisone and 11-dehydrocorticosterone,
      respectively, is an important pre-receptor signaling pathway for the renal
      mineralocorticoid receptor (MR). This receptor has an equal affinity for the
      glucocorticoids, cortisol and corticosterone, and for the mineralocorticoid,
      aldosterone. In states of 11 beta-HSD deficiency such as the syndrome of apparent
      mineralocorticoid excess (AME) and licorice ingestion, cortisol acts as a potent
      mineralocorticoid. In addition to the established and cloned type I 11 beta-HSD,
      a second 11 beta-HSD isoform has been reported in rabbit kidney and human
      placenta. We have analyzed the kinetics of 11 beta-HSD activity in human kidney
      and compared it with the expressed human type I 11 beta-HSD cDNA. Microsomes were
      prepared from mid-gestational human fetal kidneys and incubated with various
      concentrations of cortisol (0.0125-10 microM) and NAD or NADP. Kinetic analysis
      revealed a high affinity (apparent Km 60 nM) isoform, the activity of which was
      exclusively NAD-dependent. No convincing NADP-dependent activity was seen.
      Similarly with cortisone as a substrate no 11-oxoreductase activity was evident.
      In contrast, when type I human 11 beta-HSD was ligated into the expression vector
      pcDNAI and transiently transfected into COS-I cells, low affinity (apparent Km
      2.1 microM) NADP-dependent activity was seen. 11-Oxoreductase activity was also
      observed. The cloned type I human 11 beta-HSD encodes an enzyme with both low
      affinity, NADP-dependent, dehydrogenase and 11-oxoreductase activities, but this
      activity is absent in human fetal kidney (and probably adult kidney).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7792801
TI  - Evidence for the regulation of Na+, K(+)-ATPase alpha 1 gene expression through
      the interaction of aldosterone and cAMP-inducible transcriptional factors.
AB  - Mineralocorticoid hormones such as aldosterone modulate cellular ion homeostasis
      at least in part through the regulation of Na+, K(+)-ATPase (NAKA) gene
      expression. While aldosterone acts at the transcriptional level through its
      ligand-inducible mineralocorticoid receptor (MR), tissue specific and other
      transcriptional factors may interact with the MR to modulate this regulatory
      response. cAMP also regulates NAKA alpha 1 gene expression which at the
      transcriptional level is mediated, in part, through a cAMP response element (CRE)
      present on a highly conserved, 48 base pair enhancer region, the PUC-1 core, of
      the rat NAKA alpha 1 subunit gene promoter. We have tested the hypothesis that
      the MR interacts with cAMP induced transcriptional factors to modulate the NAKA
      alpha 1 gene expression. In transient transfection studies a PUC-1 core attached
      to an enhancerless SV40 promoter driven reporter gene (pB1CAT) was induced by 8
      bromo-cAMP in HeLa cells. Co-transfected MR expression vector inhibited the 8
      bromo-cAMP inducible activity of pB1CAT. DNA binding studies suggested that the
      PUC-1 core binds both CREB/ATF proteins as well as the glucocorticoid hormone
      class of steroid receptors. These results suggest that the MR suppresses cAMP
      mediated activation of PUC-1 core driven CAT activity possibly through a direct
      interaction with CREB/ATF transcriptional factors. This in turn suggests that the
      interaction of two distinct signal transduction systems, aldosterone and cAMP,
      may define the mineralocorticoid responsiveness of the Na+, K(+)-ATPase alpha 1
      gene.

PMID- 7792802
TI  - Inborn errors of aldosterone biosynthesis in humans.
AB  - Corticosterone methyl oxidase (CMO) type I and type II deficiencies are inborn
      errors at the penultimate and ultimate steps in the biosynthesis of aldosterone
      in humans. Recently, steroid 18-hydroxylase (P450C18), or aldosterone synthase
      (P450aldo), was shown to be a multifunctional enzyme catalyzing these two steps
      of aldosterone biosynthesis, i.e., the conversion of corticosterone to 18
      hydroxycorticosterone and the subsequent conversion of 18-hydroxycorticosterone
      to aldosterone. This observation suggests that CMO I and CMO II deficiencies are
      derived from two different mutations in the P450C18 gene (CYP11B2). To elucidate
      whether or not this is the case, we performed molecular genetic studies on
      CYP11B2 of both types of patients. Nucleotide sequence analysis has indicated
      that the gene of CMO I deficient patients is completely inactivated by a
      frameshift to form a stop codon due to a 5-bp nucleotide deletion in exon 1.
      Sequence analysis of CYP11B2 of CMO II deficient patients has revealed two point
      mutations, CGG-->TGG (Arg181-->Trp) in exon 3 and GTG-->GCG (Val386-->Ala) in
      exon 7. CYP11B1, the gene for steroid 11 beta-hydroxylase (P45011 beta) which was
      previously postulated to be the target for CMO II deficiency, is not impaired in
      these two types of patients. Expression studies using the corresponding mutant
      cDNAs have shown that CMO I deficient patients are null mutants with a complete
      lack of P450C18 whereas CMO II deficient patients are leaky mutants with an
      altered P450C18 activity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792803
TI  - Nongenomic aldosterone effects: the cell membrane as a specific target of
      mineralocorticoid action.
AB  - Studies in extrarenal, nonepithelial cells such as human lymphocytes and smooth
      muscle cells indicate that aldosterone produces not only delayed genomic effects,
      but also rapid, non-genomic effects on transmembrane electrolyte movements. These
      non-genomic events involve the immediate activation of the sodium/proton
      exchanger of the cell membrane at very low, physiological concentrations of
      aldosterone in both lymphocytes and cultured rat vascular smooth muscle cells.
      This new pathway for mineralocorticoid action is further characterized by a
      10,000-fold selectivity for aldosterone over cortisol and the ineffectiveness of
      spironolactones, classical mineralocorticoid antagonists, as antagonists of the
      response. Aldosterone-specific binding sites have been demonstrated in the plasma
      membrane of human lymphocytes, with features identical to those seen for the
      rapid aldosterone effects in the same cells. As second messenger the inositol
      1,4,5-trisphosphate pathway has been identified both in human lymphocytes and
      vascular smooth muscle cells, which respond over the same rapid time course. In
      addition, the aldosterone effect on inositol-1,4,5-trisphosphate production in
      vascular smooth muscle cells is sensitive to pertussis toxin, but not to cholera
      toxin, pointing to a possible involvement of G-proteins in the cellular
      signalling. This article reviews the data supporting a new, two-step model for
      successive non-genomic and genomic mineralocorticoid effects.

PMID- 7792804
TI  - Familial pseudohypoaldosteronism: a review on the heterogeneity of the syndrome.
AB  - Pseudohypoaldosteronism is thought to be a rare salt-losing disorder, caused by
      resistance to the action of aldosterone. Defective aldosterone receptor binding
      is present in familial as well as sporadic cases and it has been suggested that
      the pathogenesis is due to a defect in the aldosterone receptor system. To date,
      however, molecular genetic analysis has been unable to identify a mutation in the
      aldosterone receptor gene itself. We have reviewed the findings in patients with
      pseudohypoaldosteronism, for clues which might enable us to identify the
      underlying pathogenesis. Although aldosterone receptor binding is regularly
      decreased or absent in monocytes of patients with pseudohypoaldosteronism, in
      some patients receptor protein can be detected with a fluorescence-labeled
      antibody. Receptor protein was detected in patients from familial autosomal
      dominant families and in sporadic cases, but was undetectable in two patients
      with the familial recessive form. To further elucidate the pattern of inheritance
      we studied the response of the renin-angiotensin-aldosterone system to the
      stimulation by sodium depletion in the familial autosomal dominant form and in
      two families with sporadic cases. In both "sporadic" families investigated, one
      parent and one sibling had an exaggerated response of renin and aldosterone to
      sodium depletion indicating a defect of sodium conservation apparent only during
      stress, leading to reclassification as familial cases. No additional family
      member in the "classical" autosomal dominant families responded abnormally to
      sodium depletion. These findings indicate that pseudohypoaldosteronism is
      unusually heterogeneous in its clinical, biochemical, and genetic presentations
      and findings and suggest that its pathogenesis is heterogeneous as well.

PMID- 7792805
TI  - Pseudohypoaldosteronism: evaluation of type I receptors by radioreceptor assay
      and by antireceptor antibodies.
AB  - We have previously demonstrated a deficiency of mineralocorticoid receptors in
      pseudohypoaldosteronism, by radioreceptorassay. We now report findings with an
      antireceptor antibody derived from the immunogenic region of the receptor.
      Lymphocytes from normal controls and from two cases of pseudohypoaldosteronism
      previously shown to lack receptor binding were tested. After the plasma membrane
      of lymphocytes was permeabilized with methanol the cells were incubated with a
      1:200 dilution of antibody followed by fluorescent antirabbit immunoglobulin
      mouse serum. After washing fluorescence was detected by microscopy and
      cytofluorimetry in both controls and patients with pseudohypoaldosteronism.
      Recent studies on mineralocorticoid receptor cDNA in pseudohypoaldosteronism have
      not established a mutation in the sequence. We thus suggest that the pathogenesis
      of pseudohypoaldosteronism is not related to an abnormality of the receptor but
      rather due to intracellular factor(s) which can block the binding of aldosterone
      to its receptor.

PMID- 7792806
TI  - Molecular characterization of the mineralocorticoid receptor in
      pseudohypoaldosteronism.
AB  - Pseudohypoaldosteronism (PHA) is characterized by salt-wasting and failure to
      thrive in the newborn, accompanied by high urinary levels of sodium despite
      hyponatremia, hyperkalemia and metabolic acidosis, elevation of plasma renin
      activity, and high plasma aldosterone levels. PHA patients are resistant to
      mineralocorticoid administration, but their symptoms ameliorate after a period of
      sodium supplementation, which can be discontinued in older subjects. Binding
      studies performed on mononuclear leukocytes of the family members affected by the
      disease have shown the absence of binding of [3H]aldosterone to the
      mineralocorticoid receptor (MR) in mononuclear leukocytes in two siblings and a
      marked reduction in another sibling and the father, suggesting either the absence
      of MR or a defect in the ligand binding domain of the MR in these patients.
      Molecular analysis of the MR in the members of this family did not reveal any
      major rearrangement or deletion of the MR gene. In addition, no mutation was
      found in the entire MR coding sequence by RT-PCR and direct sequencing of MR
      mRNA, and the semiquantitative RT-PCR analysis of the MR mRNA of one affected
      patient failed to show any quantitative abnormality in MR expression. These
      results do not exclude a molecular abnormality present in the MR gene being
      responsible for PHA. However, they indicate that in this family PHA is not
      related to a modification of the MR primary structure or to a major abnormality
      in MR expression.

PMID- 7792807
TI  - Pseudohypoaldosteronism: options for consideration.
AB  - Pseudohypoaldosteronism (PHA), or mineralocorticoid resistance, displays several
      features which distinguish it from other steroid resistance syndromes: while at
      presentation the clinical manifestations may be severe, patients almost
      invariably survive into adulthood without ill effects in the absence of ongoing
      treatment; patterns of inheritance are very variable; and, in addition to the
      more common primary form, it may develop secondary to a variety of conditions.
      Although the clinical presentation and the finding of absent or greatly
      diminished binding of aldosterone by peripheral blood leukocytes strongly suggest
      an underlying abnormality involving the mineralocorticoid receptor (MR), no
      abnormality in the MR has been identified, unlike other forms of resistance to
      hormones in the steroid superfamily, in which the underlying abnormality has been
      traced to a defect in the gene encoding the receptor protein. Molecular studies
      of the index case have excluded a major cytogenetic abnormality and major
      deletions or rearrangements of the MR gene. They have also shown that the cDNA
      sequence corresponding to the open reading frame of the mineralocorticoid
      receptor molecule is normal, compared with the published human MR cDNA sequence,
      and that MR mRNA is expressed in apparently normal quantities in peripheral blood
      mononuclear leukocytes. These findings raise a number of questions about the
      underlying mechanism for PHA and the mechanisms by which homeostasis is achieved
      in the absence of effective aldosterone action. With respect to the mechanism(s)
      of PHA, several possibilities can be envisaged. It is possible, albeit unlikely,
      that by unfortunate chance small mutations have been missed as a result of
      cloning only normal alleles in heterozygous patients.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7792808
TI  - Syndromes of glucocorticoid and mineralocorticoid resistance.
AB  - Glucocorticoid resistance results from incomplete but apparently generalized
      inability of glucocorticoids to exert their effects on their target tissues. The
      condition is associated with compensatory elevation of circulating ACTH and
      cortisol, with the former causing excess secretion of both adrenal androgens and
      adrenal steroid biosynthesis intermediates with salt-retaining activity. The
      manifestations of glucocorticoid resistance vary from asymptomatic to different
      degrees of hypertension and/or hypokalemic alkalosis and/or hyperandrogenism,
      caused by elevation cortisol and other salt-retaining steroids, and of adrenal
      androgens, respectively. In women, hyperandrogenism can result in acne,
      hirsutism, male type baldness, menstrual irregularities, oligoanovulation, and
      infertility; in men, it may lead to infertility; and in children to precocious
      puberty. Different molecular defects, such as point mutations or microdeletions
      of the highly conserved glucocorticoid receptor gene, alter the functional
      characteristics or concentrations of the intracellular receptor and cause
      glucocorticoid resistance. The extreme variability in the clinical manifestations
      of glucocorticoid resistance and its mimicry of many common diseases can be
      explained by different degrees of glucocorticoid resistance, differing
      sensitivity of target tissues to mineralocorticoids and/or androgens or both, and
      perhaps different biochemical defects of the glucocorticoid receptor.
      Mineralocorticoid resistance results from the inability of aldosterone to exert
      its effect on target tissues. The syndrome is associated with salt loss,
      hypotension, and hyperkalemic acidosis. We have cloned and sequenced the cDNA of
      five unrelated patients with this syndrome and have not found any mutations of
      pathophysiological significance that would explain the resistance of these
      patients to aldosterone.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792809
TI  - Evidence for a novel mechanism of androgen resistance in the human prostate
      cancer cell line, PC-3.
AB  - Progression to hormone-refractory disease is a common outcome of human prostate
      cancer. In this study, we have investigated the basis of androgen insensitivity
      in the human prostate cancer cell line, PC-3, which was derived from a bone
      metastasis of a hormone-refractory prostate cancer. PC-3 cells with virtually
      undetectable (PC-3AR-) or low (PC-3AR+) levels of androgen receptor (AR) RNA
      expression were examined. RNase protection assays demonstrated that the level of
      AR RNA in PC-3AR+ cells was similar to that in a normal androgen-responsive
      genital skin fibroblast cell strain. Quantitative immunocytochemical staining of
      AR in PC-3AR+ cells using antibodies directed against the amino and carboxyl
      termini of the receptor revealed staining in 30% of cells with either antibody.
      Furthermore, the level of AR staining in PC-3AR+ cells was higher than in the
      androgen-responsive breast cancer cell lines ZR-75-1, T47-D, and MCF-7. Despite
      the expression of AR RNA and protein, PC-3AR+ cell proliferation was unaffected
      by the presence of 0.1-10 nM mibolerone. Scatchard analysis demonstrated a
      complete absence of specific [3H]dihydrotestosterone ([3H]DHT) binding to PC-3AR+
      cytosolic extracts, which could not be explained by structural alterations in the
      AR gene. The sizes of individual AR exons amplified from genomic DNA derived from
      PC-3AR+ cells were identical to those amplified from normal human cells.
      Furthermore, sequence analysis did not reveal a mutation in the DNA- or hormone
      binding domains of the AR gene in PC-3AR+ cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792810
TI  - Aldosterone: the minority hormone of the adrenal cortex.
AB  - In comparison with the glucocorticoids cortisol and corticosterone, the
      mineralocorticoid aldosterone is a minority hormone of the mammalian adrenal
      cortex, and its proper function is dependent upon protective physiological
      mechanisms. These include a particular site of aldosterone synthesis in zona
      glomerulosa cells as well as a complex multifactorial control system, which
      adapts aldosterone production to acute and chronic changes in body sodium and
      potassium contents, irrespective of pituitary ACTH secretion. In the course of
      the last few years, an important element of these mechanisms has been identified
      in the form of the enzyme involved in the final steps of aldosterone
      biosynthesis. In species such as the human, rat, and mouse, the conversion of
      deoxycorticosterone to aldosterone is catalyzed by an isozyme (CYP11B2) of
      cytochrome P450(11 beta) (CYB11B1). The gene encoding this enzyme is expressed
      only in the zona glomerulosa. Its transcription is enhanced by sodium deficiency
      and potassium intake, but is suppressed by long-term administration of high doses
      of ACTH. In contrast, the gene encoding CYP11B1, i.e., the major (non-aldosterone
      producing) type of the enzyme, is expressed mainly in the zona fasciculata, and
      its expression depends on physiological concentrations of ACTH. In other animal
      species (cattle, pig), the major forms of cytochrome P450(11) beta have an
      inherent aldosterone-synthesizing activity, which is, however, selectively
      suppressed in mitochondria of zona fasciculata cells by yet unknown mechanisms.

PMID- 7792811
TI  - Genetic recombination as a cause of inherited disorders of aldosterone and
      cortisol biosynthesis and a contributor to genetic variation in blood pressure.
AB  - CYP11B1 (11 beta-hydroxylase) and CYP11B2 (aldosterone synthase) are
      steroidogenic enzymes which mediate the final step (11 beta-hydroxylation) in
      cortisol synthesis and the final three steps (11 beta-hydroxylation, 18
      hydroxylation, and 18-oxidation) in aldosterone synthesis, respectively. The
      enzymes share 93% identity in amino acid sequence and are encoded by two
      structurally similar genes which are located in tandem on chromosome 8q22,
      approximately 40 kb apart. Expression of the aldosterone synthase gene (CYP11B2)
      is limited to the zona glomerulosa of the adrenal cortex, thereby limiting the
      synthesis of aldosterone to that zone, where it is principally regulated by
      plasma levels of angiotensin II and potassium. The 11 beta-hydroxylase gene
      (CYP11B1) is expressed in the zona fasciculata, the zone which also expresses a
      17-hydroxylase activity, where it mediates cortisol synthesis under the control
      of ACTH. Genetic recombination involving a mispairing of the two CYP11B genes can
      lead to duplications and deletions of the genes, creation of hybrid genes of
      several forms, or transfer of coding and regulatory sequences from one gene to
      the other. Since the two genes have related but different activities, are
      normally expressed in different zones, and respond to different physiological
      signals, such recombination has the potential to generate a variety of inherited
      disorders of steroid production. In this paper we review the range of mutations
      which can occur and the resulting disorders of steroid biosynthesis, and suggest
      some novel mutations which might be sought in variants of these endocrinological
      syndromes.

PMID- 7792812
TI  - Type 1 angiotensin II receptors of adrenal tumors.
AB  - The present study was designed to clarify the transcriptional regulation of the
      human type 1 angiotensin II receptor (AT1) gene and its pathophysiological roles
      in steroidogenesis by adrenal tumors. A cDNA encoding type 1 angiotensin II
      receptor (AT1) was isolated from a human liver cDNA library encoding a protein of
      359 amino acids with seven transmembrane segments. It is very likely that human
      has only one type of AT1 receptor, in contrast with rodents. A genomic clone
      containing 217 bp of exon 1 and 2558 bp of the 5'-flanking region of human AT1
      receptor gene was isolated. Its proximal promoter region contained putative TATA
      and GC boxes, CRE and AP1 sites. Aldosterone-producing adenoma (APA) contained
      significantly higher levels of mRNA for AT1 and ACTH receptors than normal
      tissues adjacent to APA. There were no mutations within the cytoplasmic third
      loops of AT1 and ACTH receptors in APAs examined. APA showed increased expression
      of the mRNA for P450c11 and decreased expression of the mRNA for P450c17. These
      results suggest that renin-independent overproduction and clinically observed
      ACTH-dependent production of aldosterone in APAs may results from the enhanced
      transcription of P450c11 and ACTH receptor genes. The mechanism of the
      discordantly increased expression of AT1 receptor in APA remains to be clarified.

PMID- 7792813
TI  - Primary aldosteronism--some genetic, morphological, and biochemical aspects of
      subtypes.
AB  - Primary aldosteronism is the commonest cause of potentially curable hypertension
      when diagnosed in both florid and less florid forms. Genetic screening, so far
      available only for glucocorticoid-suppressible hyperaldosteronism, permits
      diagnosis from birth, before any biochemical or clinical abnormalities appear.
      Biochemical screening using the aldosterone-to-renin ratio permits diagnosis in
      the absence of raised aldosterone or of hypokalemia. Primary aldosteronism occurs
      in several familial forms. As well as the variety described in 1966 which is ACTH
      dependent and glucocorticoid-suppressible, and not so far associated with tumors,
      another variety described in 1991 is not glucocorticoid-suppressible and is
      frequently associated with aldosterone-producing adenomas (APAs). Primary
      aldosteronism due to adrenocortical hyperplasia, adenoma, or carcinoma can also
      occur as part of the multiple endocrine neoplasia syndromes, where normoplasia,
      hyperplasia, benign neoplasia, and malignant neoplasia can exist in the same
      patient in the same endocrine gland(s) at the same time. The morphology of
      adrenocortical hyperplasia causing primary aldosteronism ranges from glomerulosa
      like (idiopathic hyperplasia of the adrenals) to fasciculata-like (glucocorticoid
      suppressible hyperaldosteronism). The morphology of adrenocortical neoplasia
      causing primary aldosteronism can also be either predominantly glomerulosa-like
      or fasciculata-like, in our experience equally often. Varying morphology of APAs
      is associated with varying responses of aldosterone to angiotensin II. Tumors
      predominantly fasciculata-like are unresponsive to angiotensin II, whereas those
      predominantly glomerulosa-like are responsive to angiotensin II. Both subtypes
      can be seen in a single family. Primary aldosteronism represents a spectrum of
      genetic disorders resulting in hyperplasia or neoplasia, but all are associated
      with some degree of autonomy of aldosterone production, independent of the renin
      angiotensin system.

PMID- 7792814
TI  - Significance of steroidogenic enzymes in the pathogenesis of hyperfunctioning and
      non-hyperfunctioning adrenal tumor.
AB  - To elucidate the mechanisms of abnormal steroid production in hyperfunctioning
      and non-hyperfunctioning adrenal tumors, we examined both the activities and
      amounts of steroidogenic cytochromes P450 in the tumor and non-tumor portions of
      these adrenals at the posttranslational (protein) level. Adrenals from 5 patients
      with primary aldosteronism, 5 with Cushing's syndrome, 1 with deoxycorticosterone
      (DOC)-producing adenoma, 10 with non-hyperfunctioning adrenal adenoma, and 5
      subjects with normal control adrenals (obtained from patients with renal cell
      carcinoma) were used in our studies. Activities of P450scc, P45011 beta and
      P450aldo, and P450C21 and P-45017 alpha were assayed in a reconstituted enzyme
      system using 20 alpha-hydroxycholesterol, DOC, and progesterone, respectively,
      and the substrate and the extracted products were analyzed by HPLC. Enzyme
      amounts were determined by immunoblot analysis with anti-bovine P450scc, P45011
      beta, and P450C21 IgG, and anti-porcine P45017 alpha IgG. Human P450aldo was only
      detected in the tumor portion of primary aldosteronism adrenals, with both
      activities and amounts of other P-450s similar to those in the non-tumor portion
      of primary aldosteronism and normal controls. In Cushing's syndrome, both
      activities and amounts of P45017 alpha and P450C21 were significantly increased
      in the tumor compared with those in the non-tumor portion of Cushing's syndrome
      and normal controls. In DOC-producing adenoma, both activities and amounts of
      P45017 alpha and P45011 beta in the tumor portion of the adenoma decreased
      compared with normal control, while those of other P450s were similar to normal
      controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792815
TI  - Glucocorticoid-remediable aldosteronism (GRA): diagnosis, variability of
      phenotype and regulation of potassium homeostasis.
AB  - Glucocorticoid-remediable aldosteronism (GRA) is a hereditary cause of human
      hypertension in which aldosterone secretion is regulated by adrenocorticotropin
      (ACTH). A genetic mutation which causes GRA has recently been identified in our
      laboratory, a hybrid or chimeric gene fusing nucleotide sequences of the 11 beta
      hydroxylase and aldosterone synthase genes. The finding that these chimeric gene
      duplications are sensitive and specific markers for GRA allows for a simple,
      direct genetic test for this disorder. In preliminary studies, we found a wide
      range of blood pressure levels (including normotension) in affected GRA subjects.
      Studies to data indicate that this is not related to environmental factors such
      as sodium intake. Another possibility is that chimeric gene expression is
      variable, with low blood pressure subjects having reduced gene expression.
      However, the data have not demonstrated differences in steroid levels in subjects
      with severe versus mild hypertension. In fact, it is likely that the wide range
      in blood pressure levels in affected subjects involves interaction of other
      systems which control blood pressure. Preliminary data in two kindreds suggest
      that blood pressure levels are reciprocally related to levels of urinary
      kallikrein excretion, supporting the notion that GRA is a hypertension
      predisposing syndrome, with the resultant blood pressure the interaction of the
      gene mutation with other blood pressure regulatory systems. Although GRA is a
      mineralocorticoid excess state, as evidenced by profoundly suppressed levels of
      plasma renin activity, we have observed (contrary to the reported literature)
      that normokalemia is a typical finding. In one large normokalemic pedigree,
      preliminary findings indicate that these subjects have a normal capacity to
      excrete potassium.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792816
TI  - My engagement with steroids: a review.
AB  - In the course of my studies of patients with mineralocorticoid hypertensive
      disorders, unusual presentations led to unexpected findings, both clinically and
      in steroid etiologies and regulation. Unique circumstances permitted early
      studies in defining the autonomy of the aldosterone-producing adenoma. A chance
      referral brought the index case of 17 alpha-hydroxylase deficiency to the
      research center. New techniques were developed in unusual ways to measure the
      metabolites of deoxycorticosterone (DOC) using an anesthetic agent. Procedural
      delays were followed by the surreptitious transfer of a patient from one hospital
      to the research center after a benign DOC-secreting tumor had been removed. The
      delay of DOC and all 17-deoxysteroids to respond normally to ACTH stimulation
      suggested a possible second regulator of DOC. This observation led to studies
      that demonstrated divergent responses between DOC and cortisol in diverse
      conditions. An unexplained mineralocorticoid form of hypertension with
      suppression of renin and aldosterone, but normal DOC production, is seen in
      licorice intoxication. After licorice was discontinued we documented the delay in
      the recovery of the inhibited cortisol metabolism (14 days) and renin-angiotensin
      system (4 months). Licorice extract given to normal subjects on low sodium diets
      with and without ACTH suppression showed similar results. Other factors in
      licorice may thus be operative in terms of renin and aldosterone suppression.

PMID- 7792817
TI  - Rodent models for studying steroids and hypertension: from fetal development to
      cells in culture.
AB  - We have used several different approaches to study the role of steroids in
      hypertension, including rodent in vivo models, transgenic animals, and cell
      culture systems. Using the developing rodent fetus as a model for the ontogeny of
      regulation of glucocorticoid and mineralocorticoid synthesis, we found that in
      the developing rodent fetus, expression of both P450scc (cholesterol side chain
      cleavage) and P450c11 beta (11 beta-hydroxylase) mRNAs occur early, before there
      is complete organization of the fetal adrenal. Even after the zones of the
      adrenal are evident, the fetal adrenal still does not express the glomerulosa
      specific P450c11AS (aldosterone synthase) mRNA. Stimulating maternal adrenal
      mineralocorticoid or glucocorticoid synthesis does not affect accumulation of
      fetal adrenal steroidogenic mRNAs, suggesting that the rodent fetal adrenal may
      be somewhat transcriptionally quiescent in vivo. We also used two different
      transgenic rodent systems to study the roles of steroids in hypertension. Using
      promoter-directed tumorigenesis in transgenic mice, we created transgenic mice
      that expressed SV40 T antigen under control of the P450scc promoter. Massive
      adrenal tumors, but not gonadal tumors, developed in all transgenic mice, and
      cells from these tumors were easily cultured. Using a novel selection tactic, we
      obtained several adrenocortical cell lines which have distinct characteristics,
      suggesting they were locked into various stages of differentiation; both
      expression of steroidogenic mRNAs and the steroids synthesized differ among the
      lines. Regulation of steroid synthesis and mRNA abundance also varies among cell
      lines. Several cell lines also express mouse renin, and its synthesis, secretion,
      and mRNA abundance is also hormonally regulated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792818
TI  - Functional studies of 11 beta-hydroxysteroid dehydrogenase.
AB  - 11 beta-Hydroxysteroid dehydrogenase (11-HSD) catalyzes the interconversion of
      cortisol and cortisone. This activity is postulated to protect the type I
      (mineralocorticoid) receptor from excessive concentrations of cortisol, allowing
      aldosterone to function as a mineralocorticoid. An enzyme with 11-HSD activity
      was isolated from rat liver and the corresponding rat and human cDNA and genomic
      clones isolated. This enzyme is a member of the "short chain dehydrogenase"
      family. Using site-directed mutagenesis, it was demonstrated that two highly
      conserved residues, Tyr-179 and Lys-183, are required for enzymatic function.
      Elimination of the amino terminus or the two glycosylation sites also destroys
      enzymatic activity. This may be due to actual disruption of enzymatic function or
      to effects on intracellular localization or stability of the enzyme. Examination
      of patients with apparent mineralocorticoid excess, a syndrome of juvenile
      hypertension thought to represent 11-HSD deficiency, did not reveal any mutations
      in the gene for this enzyme. There is substantial evidence for a second 11-HSD
      isozyme with distinct kinetic properties that is expressed in the renal distal
      tubule and possibly other sites of mineralocorticoid action. Apparent
      mineralocorticoid excess may involve this enzyme.

PMID- 7792819
TI  - Mineralocorticoid modulation of central control of blood pressure.
AB  - An association between mineralocorticoids and hypertension has been recognized
      for over 50 years, although the mechanisms involved are not entirely clear. In
      addition to the hypertension seen in cases of frank mineralocorticoid excess,
      such as in an aldosterone-producing adenoma, many essential hypertensive patients
      respond to treatments mitigating mineralocorticoid action, even though
      circulating levels of these steroids are within normal ranges. It has been a
      decade since David Bohr hypothesized that a center within the brain, probably in
      the AV3V area, was responsible for the orchestration of the multiple homeostatic
      mechanisms controlling blood pressure. It was proposed that the "set point" for
      such a center was dependent upon intracellular Ca + + and/or another ion content
      or transport across cell membranes, and was altered by mineralocorticoids and in
      some forms of genetic hypertension. The focus of this paper is the role of the
      central nervous system in mineralocorticoid hypertension. The importance of these
      data resides in the possibility that the central mechanisms involved in
      mineralocorticoid hypertension may also be operant in the pathogenesis of other
      forms of hypertension, as well as in the normal control of blood pressure.

PMID- 7792820
TI  - Differences in temperature-sensitive receptor binding of glucocorticoids in
      spontaneously hypertensive and normotensive Wistar-Kyoto rats.
AB  - Glucocorticoid receptor binding was compared in liver cytosol preparations from
      spontaneously hypertensive rats (SHR) and Wistar-Kyoto (WKY) rats using
      homologous displacement of [3H]dexamethasone. At 5 degrees C, there was no
      difference in receptor binding affinity or concentration between strains for
      dexamethasone, corticosterone or aldosterone. At 37 degrees C, affinity for
      dexamethasone was lower than at 5 degrees C for both rat strains and decreased
      with time. However, at this higher temperature, binding affinity in the SHR
      preparation was consistently higher than in the WKY preparation. The WKY
      preparation had a higher receptor concentration. The rate of dissociation of the
      [3H]dexamethasone-receptor complex prepared at 5 degrees C and then incubated at
      37 degrees C was rapid but not different between strains. A possible explanation
      of these results is that the relationship of the heat shock proteins to the
      receptor heterocomplex is different between strains. Evidence exists of a genetic
      difference in Hsp 70 between SHR and WKY rats, although its cosegregation with
      blood pressure has not been established.

PMID- 7792821
TI  - Mechanisms of cortisol-induced hypertension in humans.
AB  - There is emerging evidence that cortisol plays a significantly greater role in
      human hypertension than previously thought. Apart from the well recognized role
      of cortisol in the hypertension of Cushing's syndrome, local cortisol excess has
      been recognized as responsible for rare forms of hypertension such as apparent
      mineralocorticoid excess and licorice abuse and more recently implicated in the
      hypertension of chronic renal failure, hypertension related to low birth weight
      and essential hypertension. Although cortisol-induced hypertension is
      characterized by sodium retention and volume expansion, studies with synthetic
      glucocorticoids or sodium restriction suggest that the hypertension is, to a
      substantial degree, independent of sodium and volume. Increase in cardiac output
      is not essential for cortisol-induced blood pressure rise but the precise role of
      increases in total or regional peripheral resistance as a primary mechanism has
      nto been determined. Increased pressor responsiveness, particularly to catechols,
      is a prominent feature but whether these changes are sufficient to account for
      the hypertension remains unclear. There is no evidence for increased sympathetic
      nervous activity as judged by measurements of plasma catcholamines, neuropeptide
      Y, or resting noradrenaline spillover rate. Responses to mental stress or maximal
      hand-grip are unchanged and baroreflex sensitivity is increased. Octreotide
      profoundly reduced the elevated plasma insulin concentrations seen with cortisol
      administration but had no effect on the rise in blood pressure.

PMID- 7792822
TI  - Long-term treatment of mineralocorticoid excess syndromes.
AB  - Recognition of the pathogenesis of secondary forms of hypertension is often
      considered the key to appropriate choice of treatment. We here present the
      results of a prolonged clinical follow-up (from 1 to 20 years) of a large number
      of patients with mineralocorticoid excess syndromes (MES), including over 100
      patients with primary aldosteronism (PA), 3 cases with dexamethasone-suppressible
      aldosteronism (DSA), 3 cases of apparent mineralocorticoid excess (AME) Type II,
      and 4 patients with 17-hydroxylase deficiency (17OHDS). The patients with PA have
      been divided in two subgroups, one of 69 cases followed between 1973 and 1982,
      and the second of 37 patients studied between 1983 and 1992; 33 further cases
      were not evaluated due to poor compliance. In group I, 26 patients underwent
      surgery (23 unilateral adenoma, 1 primary hyperplasia, 2 bilateral nodular
      hyperplasia); at 5 years 50% had normal blood pressure, 25% had mild hypertension
      and 25% had moderate to severe hypertension. Forty-three patients with either
      adenoma (APA) or idiopathic aldosteronism (IHA) received long-term spironolactone
      treatment. Among them, 13 required the addition of thiazide and/or beta-blockers,
      while 13 were switched to an amiloride/thiazide combination (+/- beta blockers)
      due to side-effects to spironolactone (gynecomastia 6/20 males, menstrual upset
      or breast pain in 7/23 females). In group II, 12 patients underwent surgery (11
      adenoma, 1 primary hyperplasia) with a similar outcome at 3 years as in group I;
      25 patients were put on either K canrenoate (11) or Ca++ channel blockers (14)
      with or without KCl supplementation; in 8 cases these two drugs were combined
      according to blood pressure levels achieved during the follow-up.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7792823
TI  - Cortisol resistance and the guinea pig glucocorticoid receptor.
AB  - The guinea pig has been employed as a model to study the structure/function
      relationships of the glucocorticoid receptor (GR), and to determine the regions
      of the receptor important for binding hormone and antihormone. Guinea pigs have
      high levels of circulating cortisol and GR with a approximately 20-fold lower
      affinity for dexamethasone than mouse GR. Cloning and sequencing of guinea pig GR
      has identified 24 amino acid changes in the ligand-binding domain (LBD) compared
      to the human GR. By substituting the guinea pig GR LBD for the human LBD in a
      human GR expression vector we have shown in cotransfection studies that guinea
      pig GR LBD confers glucocorticoid resistance as observed in vivo. In initial
      studies guinea pig GR LBD appeared constitutively active; in subsequent studies
      to determine which of the 24 amino acid changes present in the guinea pig GR LBD
      conferred resistance, it became apparent that the guinea pig LBD (LBD delta),
      amplified by PCR for subcloning into the human GR expression vector, contained a
      single adenine deletion in the hinge region within ten bases of the PCR primer.
      This single base deletion resulted in a frameshift bringing a stop codon into
      frame one codon after the deletion. While this now clearly accounts for the
      observed constitutive activity, since it is known that C-terminally truncated
      steroid receptors exhibit constitutive activation such a truncation is more
      difficult to reconcile with the repeatedly demonstrable hormone dose-response
      curves obtained with this guinea pig GR LBD delta.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7792824
TI  - Molecular genetic analysis of glucocorticoid signaling during mouse development.
AB  - Glucocorticoids are important in a number of developmental processes in mammals
      around birth. The pathway of gluconeogenesis is activated in liver shortly after
      birth due to the combined effects of glucocorticoids and glucagon. We have
      defined the essential cis-regulatory elements directing hormone-dependent liver
      specific expression of the gene for tyrosine aminotransferase, a key
      gluconeogenic enzyme. The hormone response elements synergize with cell-type
      specific elements. In the case of glucocorticoids, the glucocorticoid-dependent
      enhancer is composed of the glucocorticoid response element and binding sites for
      liver cell-enriched transcription factors, in particular hepatocyte nuclear
      factor-3. The dependence of the respective enhancer motifs on each other
      restricts the hormonal activation of the tyrosine aminotransferase gene in liver
      in response to a hormonal signal. To further understand the role of
      glucocorticoid signaling via the type II glucocorticoid receptor (GR) in the
      perinatal period and earlier during development, we have studied the expression
      of the mouse GR gene. Expression of the gene is controlled by at least three
      promoters, one of which is only active in T-lymphocytes. Expression of GR mRNA
      has been detected as early as day 9.5 of mouse development. To specifically
      address the role of glucocorticoid signaling via the GR during development, we
      have disrupted the GR gene by homologous recombination in mouse embryonic stem
      cells. The majority of GR mutants die shortly after birth and analysis so far has
      revealed defects in lung, liver, and adrenal function.

PMID- 7792825
TI  - The two faces of a steroid antagonist: when an antagonist isn't.
AB  - Activation of protein kinase A potentiates the transcriptional response mediated
      by the glucocorticoid receptor in responsive fibroblasts and in mammary carcinoma
      cells. This potentiation is ligand-dependent and occurs in responsive fibroblasts
      and in mammary carcinoma cells. This potentiation is ligand-dependent and occurs
      without detectable change in the phosphorylation of receptor. The transcriptional
      response to glucocorticoid or progestin agonists can be blocked by potent
      antagonists like RU 486. However, upon activation of protein kinase A, the
      antagonist action of RU 486 on both receptors is blunted. Indeed, RU 486 can
      itself activate transcription of a hormone-responsive promoter. The conditional
      agonist activity is observed with type II antagonists, those which recapitulate
      many of the early steps of ligand-dependent receptor activation, but not type I
      antagonists, which do not. These studies have now been extended to
      antimineralocorticoids. In COS-1 cells transfected with a mineralocorticoid
      receptor expression vector, treatment with 8-BromocAMP potentiates the response
      to the agonist aldosterone and elicits additional agonist activity in
      mineralocorticoid antagonists. A model is proposed wherein type II antagonist
      receptor complexes occupy receptor binding sites on the genome. The antagonist,
      however, fails to promote a receptor conformation that can interact productively
      with a coactivator mediating the communication between receptor and the basal
      transcription apparatus. Activation of protein kinase A results in the
      recruitment or activation of a coactivator that permits recovery of receptor
      mediated activation function.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7792827
TI  - Active-site-directed photoaffinity radioiodination of androgen-binding proteins.
AB  - Androgen-binding protein (ABP) in rat epididymal cytosol and sex hormone-binding
      globulin (SHBG) in rabbit serum and SHBG purified from human serum were active
      site-directed photoaffinity radiolabeled with 17 alpha-[(E)-2
      [125I]iodoethenyl]androstan-4,6-dien-17 beta-ol-3-one ([125I]1). The interaction
      of this compound with binding components in epididymal cytosol was dependent on
      exposure of the mixture to ultraviolet light and on the duration of exposure.
      Photolysis in the presence of [125I]1 and 5 alpha-dihydrotestosterone (5 alpha
      DHT) resulted in a 40% inhibition of binding of [125I]1 to cytosolic components.
      These result indicate that, while [125I]1 interacted with 5 alpha-DHT binding
      sites, it also formed adducts with other sites. To characterize the labeled
      species, the photolysis mixture was subjected to electrophoresis under denaturing
      and reducing conditions. Autoradiography of the gel revealed that ABP and SHBG
      were labeled with [125I]1, but in cytosol and serum, higher and lower molecular
      weight components were also labeled. Purified SHBG was labeled, but no labeled
      contaminating protein was detected. The presence of 5 alpha-DHT completely
      inhibited [125I]1 photolabeling of human and rabbit SHBG and of ABP. However, in
      cytosol, the presence of 5 alpha-DHT also eliminated photolabeling to a component
      that may be albumin, but 5 alpha-DHT did not affect [125I]1 photolabeling of
      other contaminating proteins in cytosol. Thus, while [125I]1 is an effective
      photoaffinity radiolabel for ABP and SHBG, the observation that it also
      photolabels other proteins limits its practical use to the radiolabeling of
      purified ABP and SHBG preparations.

PMID- 7792826
TI  - Synthesis of (17R)- and (17S)-17-hydroxy-14, 15-secoandrost-4-en-15-yn-3-one and
      the X-ray crystal structure of the (17S)-diastereomer.
AB  - (17R,S)-17-Hydroxy-14,15-secoandrost-4-en-15-yn-3-one has been shown previously
      to be a mechanism-based inactivator of rat liver 3 alpha-hydroxysteroid
      dehydrogenase. This manuscript describes the synthesis of this diastereomeric
      14,15-secosteroid from [2S-2 alpha,4a alpha,4b beta,10a beta)]-
      1,2,3,4a,4b,7,9,10,10a-decahydro-2,4b-dimethyl-7-oxo-2-phenanth renecarboxylic
      acid methyl ester. The separation of this diastereomeric 14,15-secosteroid into
      (17R)- and (17S)-17-hydroxy-14,15-secoandrost-4-en-15-yn-3-one was accomplished
      by HPLC separation of the (S)-1-[(4-methylphenyl)sulphonyl]-2
      pyrrolidinecarboxylate derivatives on a silica column. The crystal structure of
      (17S)-17-hydroxy-14,15-secoandrost-4-en-15-yn-3-one was then solved by X-ray
      diffraction analysis to establish unambiguously the absolute configuration of the
      diastereomeric 14,15-secosteroid.

PMID- 7792828
TI  - Crystal structure of doisynolic acid and the structure of other products formed
      during its synthesis.
AB  - The crystal structure of the D-seco-estrogen doisynolic acid shows it to have the
      natural S configuration at the position derived from C-14 in estrone. Two major
      by-products during the synthesis of doisynolic acid from estrone are shown to be
      dimeric steroids. One is an aldol condensation product, and the other appears to
      arise from an alkaline cleavage of the aldol product.

PMID- 7792829
TI  - 19-Acetylenic-deoxycorticosterone inhibits 19-hydroxylase and 11 beta-hydroxylase
      activities in dispersed bovine zona fasciculata cells.
AB  - 19-Acetylenic-deoxycorticosterone (19-A-DOC) is believed to be a competitive
      irreversible inhibitor of the synthesis of 19-nor-deoxycorticosterone (19-nor
      DOC), a potent mineralocorticoid implicated in some forms of human and animal
      hypertension. It has been shown to inactivate 11 beta/19-hydroxylase in hamster
      adrenal mitochondria. Dispersed bovine zona fasciculata cells were incubated for
      one hour with 1.5 x 10(-8) M ACTH and 0, 1, 10, or 100 microM 19-A-DOC and
      tritiated deoxycorticosterone (DOC) substrate. Steroids were separated using two
      sequential thin-layer chromatography systems and their tritium content was
      counted and corrected for recovery. The 19-A-DOC decreased synthesis of 19
      hydroxydeoxycorticosterone, the precursor of 19-nor-DOC. The inhibitor also
      impaired 11-hydroxylation of DOC to form corticosterone. The data suggest that 19
      A-DOC is an effective inhibitor of 11 beta/19-hydroxylase activity in dispersed
      bovine adrenal cells.

PMID- 7792830
TI  - Synthesis of 21-hydroxy-11,19-oxidopregn-4-ene-3,20-dione and 21-hydroxy-6,19
      oxidopregn-4-ene-3,20-dione.
AB  - The 21-hydroxy analogues of 11,19-oxidoprogesterone and 6,19-oxidoprogesterone
      have been synthesized from readily available materials. Hydroxylation at C-21 was
      effected with iodosobenzene (from phenyliodosodiacetate and methanolic potassium
      hydroxide) on a 20-ketopregnane. For the 11,19-oxido derivative, the
      hydroxylation was carried out on a precursor containing the oxido-bridge. This
      approach was not adequate for the 6,19-oxido steroid due to the very low yields
      encountered; hence in the latter case the order of introduction of the C-21
      functionality and the oxido-bridge was reversed.

PMID- 7792831
TI  - Stimulation of progesterone secretion in dispersed cells of rat corpora lutea by
      antioxidants.
AB  - Antioxidants were used to investigate the role of free radicals in control of
      luteal steroidogenesis. Corpora lutea from pseudopregnant rats were enzymatically
      dispersed, the cells were incubated with antioxidants, and progesterone
      production was measured. Addition of the antioxidants nordihydroguaiaretic acid
      (NDGA), butylated hydroxytoluene (BHT), and the gonadotropin luteinizing hormone
      (LH) resulted in a dose-dependent increase in progesterone secretion. However,
      the response pattern to these treatments differed with the age of the corpora
      lutea, and unlike LH neither NDGA nor BHT treatment resulted in an increase in
      the intracellular second messenger cAMP. Nevertheless, LH and antioxidant-induced
      progesterone stimulation could be blocked by the addition of either
      aminoglutethimide or ketoconazole, cytochrome P450 side-chain cleavage
      (cytochrome P450 SCC) enzyme inhibitors, which prevent the conversion of
      cholesterol to pregnenolone and thus block steroid hormone synthesis. Also,
      unlike exposure to LH, exposure to antioxidants resulted in an additional
      increase in progesterone production in luteal tissue saturated with 25
      hydroxycholesterol, a soluble cholesterol analog which serves as a substrate for
      cytochrome P450 SCC. This study suggests that the site of antioxidant action in
      affecting progesterone secretion may be at the cytochrome P450 SCC enzyme. Based
      on these results and on studies in other steroid hormone-producing cells, it
      appears that free radicals may be involved in regulating synthesis by modulating
      activity of cytochrome P450 SCC enzyme in rat luteal tissue.

PMID- 7792833
TI  - A method for measurement of free testosterone in premenopausal women involving
      equilibrium dialysis, chromatography, and radioimmunoassay.
AB  - A three-step procedure to evaluate the quantity of true free testosterone in
      female serum was established. Unbound and bound testosterone were first separated
      by equilibrium dialysis using undiluted serum. Testosterone in dialysate was
      extracted and separated from cross-reactive steroids by column chromatography and
      finally quantified with a sensitive radioimmunoassay. The detection limit of the
      radioimmunoassay was 2.7 pmol/L and the detection limit of the whole method was 6
      pmol/L. The intra-assay coefficients of variation of the method were 20.6%,
      16.8%, and 9.5% for free testosterone concentrations 12.0 pmol/L, 21.4 pmol/L,
      and 31.4 pmol/L, respectively. The interassay coefficients of variation were
      26.3% and 14.8% for free testosterone concentrations 10.4 pmol/L and 21.3 pmol/L,
      respectively. Serum free testosterone concentrations were determined in 27
      regularly menstruating control women. The mean concentration of actual free
      testosterone was 10.0 +/- 4.9 pmol/L (mean +/- SD, range from below 6 to 19
      pmol/L, n = 27).

PMID- 7792832
TI  - Synthesis of 15 alpha-hydroxyestrogen 15-N-acetylglucosaminides.
AB  - The synthesis of 15-N-acetylglucosaminides of 15 alpha-hydroxyesterone, 15 alpha
      hydroxyestradiol, and 15 alpha-hydroxyestriol (estetrol) is described. The latter
      two were prepared by condensation of 2-acetamido-1 alpha-chloro-1,2-dideoxy-3,4,6
      trio-O-acetyl-D-glucopyranose with appropriately protected 15 alpha
      hydroxyestrogens by the Koenigs-Knorr reaction employing cadmium carbonate as a
      catalyst. Subsequent removal of protecting groups with methanolic potassium
      hydroxide provided the desired conjugates. 15 alpha-Hydroxyestrone 15-N
      acetylglucosaminide was synthesized from the corresponding 15 alpha
      hydroxyestradiol derivative by Jones oxidation followed by brief alkaline
      hydrolysis. These conjugates underwent enzymatic hydrolysis with beta-N
      acetylglucosaminidase from Jack beans to produce 15 alpha-hydroxyestrogens.

PMID- 7792834
TI  - A convenient synthesis of 7 alpha-hydroxycholest-4-en-3-one by the hydroxypropyl
      beta-cyclodextrin-facilitated cholesterol oxidase oxidation of 3 beta,7 alpha
      cholest-5-ene-3,7-diol.
AB  - The initial biosynthetic conversions of cholesterol to the bile acids involve
      sequential 7 alpha-hydroxylation (catalyzed by cholesterol 7 alpha-hydroxylase)
      followed by C-3 oxidation and concomitant double bond migration (to a delta 4
      configuration, catalyzed by 3 beta-delta 5-C27-steroid oxidoreductase) to provide
      7 alpha-hydroxycholest-4-en-3-one. A straightforward, and economical, preparation
      (on a 0.1 g scale) of this pivotal biosynthetic intermediate has been devised.
      Reduction of 3 beta-(benzoyloxy)-cholest-5-en-7-one with LiB(sec-butyl)3H
      provided a 4:1 mixture, respectively, of the 7 alpha- and 7 beta-hydroxy
      diastereomers, which were separated chromatographically. Solvolytic removal of
      the C-3 benzoyl group gave 3 beta,7 alpha-cholest-5-ene-3,7-diol. A suspension of
      the 1:1 (v/v) complex (formed by mutual dissolution in MeOH, followed by
      evaporation of the solvent) of this diol with hydroxypropyl-beta-cyclodextrin, at
      a concentration of 1 mg mL-1 (in neutral phosphate buffer), was converted by
      Brevibacterium sp cholesterol oxidase (0.25 U mg-1 of substrate) and catalase (70
      U mg-1 of substrate, to recover O2 from the H2O2 produced by the enzymatic
      oxidation) to a suspension of 7 alpha-hydroxycholest-4-en-3-one and the
      hydroxypropyl-beta-cyclodextrin. The yield for the enzymatic conversion was in
      excess of 90%. A much poorer and less reproducible yield (< 20%) was seen in the
      absence of the hydroxypropyl-beta-cyclodextrin. Routine extraction of this
      aqueous suspension, and chromatographic purification (85:15 CHCl3/acetone v/v on
      silica) of the residue, gave pure 7 alpha-hydroxycholest-4-en-3-one in 68%
      isolated yield. This route is a significant improvement, in terms of reaction
      scale and convenience, over the previous procedures for the preparation of this
      steroid.

PMID- 7792836
TI  - Estrone sulfate analogs as estrone sulfatase inhibitors.
AB  - The high serum concentration of estrone sulfate and the presence of estrone
      sulfatase in breast tumors constitute an important mechanism of local synthesis
      of estrogens in the tissue. Thus, inhibitors of estrone sulfatase may be
      effective in the treatment of estrogen-dependent breast cancer. In this study, we
      synthesized several isostructural analogs of estrone sulfate (estrone-3
      methylsulfonate, estrone phosphate, 3-desoxyestradiol-3-methylenesulfonate, and 3
      desoxyestrone-3-methylenesulfonate) and tested them on human placental
      sterylsulfatase. The results were (i) The Ki of 3-desoxyestrone-3
      methylenesulfonate 12 and 3-desoxyestradiol-3-methylenesulfonate 7 are more than
      100-fold higher than the Ki or KM values for estrone sulfate, (ii) As compared to
      estrone sulfate, the Ki value for estrone-3-methylsulfonate 2 is about 30-fold
      higher, while estrone phosphate 3 is bound by the sulfatase with roughly the same
      affinity as estrone sulfate. The results shed some light on the electronical and
      sterical requirements for high affinity binding to the enzyme.

PMID- 7792835
TI  - Direct determination of human urinary cortisol metabolites by HPLC/CRIMS.
AB  - Feasibility of using high performance liquid chromatographic input to the
      chemical reaction interface mass spectrometry system was assessed by measuring
      the profile of hydrolyzed urinary metabolites of [9,12,12-2H3] cortisol in six
      human subjects with no preparation other than hydrolysis and solid phase
      extraction. Relative amounts of tetrahydrocortisol, tetrahydrocortisone, and
      cortolones (as the sum of alpha- and beta-) were 0.417 +/- 0.047, 0.523 +/- 0.036
      and 0.059 +/- 0.019, respectively. The constant reproducibility of the
      measurements coupled with a profile consistent with that observed by other
      workers shows that the technique represents an important tool in the
      determination of metabolites of endogenous molecules.

PMID- 7792837
TI  - Proceedings of the Vth International Alexis Carrel Conference. Genesis,
      prevention, diagnosis and treatment of chronic rejection, obliterative
      bronchiolitis and graft vessel disease after organ transplantation. Munich,
      Germany, June 22-24, 1994.

PMID- 7792838
TI  - Graft vasculopathy among recipients of heart transplantation during the first 12
      years of life. The Pediatric Heart Transplant Group.

PMID- 7792840
TI  - Cardiac allograft vasculopathy.

PMID- 7792839
TI  - Does donor and recipient sex influence the development of cardiac allograft
      vasculopathy?

PMID- 7792842
TI  - The role of PTCA in the management of focal critical lesions in transplant
      coronary artery disease.

PMID- 7792841
TI  - Prevention and treatment of graft vessel disease after heart transplantation.

PMID- 7792844
TI  - Coronary artery disease in cardiac allografts: association with depleted
      arteriolar tissue plasminogen activator.

PMID- 7792843
TI  - Coronary artery disease in cardiac allografts: association with arteriolar
      endothelial HLA-DR and ICAM-1 antigens.

PMID- 7792846
TI  - The histological grade of rejection does not relate to intracardiac pressures.

PMID- 7792845
TI  - Coronary artery disease in cardiac allografts: association with arterial
      antithrombin.

PMID- 7792847
TI  - Heparin-induced extracorporeal low-density-lipoprotein plasmapheresis (HELP) and
      its use in heart transplant patients with severe hypercholesterolemia.

PMID- 7792848
TI  - Is a reduction of graft vessel disease by maximal treatment of
      hypercholesterolemia after heart transplantation possible?

PMID- 7792850
TI  - Enhanced monocyte transendothelial migration into graft-specific vessel wall
      cocultures after cardiac transplantation.

PMID- 7792853
TI  - Cyclophosphamide as an adjunct to maintenance immunosuppression in cardiac
      transplantation.

PMID- 7792849
TI  - Impaired renal function but not high cyclosporine levels determines increased
      endothelin plasma levels after heart transplantation.

PMID- 7792851
TI  - Acute rejection and cytomegalovirus infection: correlation with cardiac allograft
      vasculopathy.

PMID- 7792852
TI  - Evaluation of cytomegalovirus-polymerase chain reaction in graft dysfunction
      after heart transplantation.

PMID- 7792854
TI  - Measurement of microalbumin and retinol binding protein in cardiac and lung
      transplant recipients.

PMID- 7792855
TI  - Dobutamine stress echocardiography for detection of transplant coronary
      vasculopathy: comparison with angiography and intracoronary ultrasound.

PMID- 7792856
TI  - Qualitative and quantitative assessment of cardiac allograft vasculopathy by
      intravascular ultrasound.

PMID- 7792858
TI  - Influence of acute cellular rejection on long-term left ventricular systolic
      function after orthotopic heart transplantation.

PMID- 7792857
TI  - Influence of HLA compatibility on the incidence of cardiac allograft vasculopathy
      after heart transplantation.

PMID- 7792859
TI  - Cardiac changes during acute allograft rejection: evaluation by serial
      echocardiographic measurements over a 5-year follow-up period.

PMID- 7792860
TI  - Intramyocardial electrograms for monitoring of allograft rejection after heart
      transplantation.

PMID- 7792861
TI  - Role of intracoronary ultrasound for the diagnosis of cardiac allograft
      vasculopathy.

PMID- 7792862
TI  - Prophylactic photopheresis and effect on graft atherosclerosis in cardiac
      transplantation.

PMID- 7792863
TI  - Living-related lobar transplantation: recipient outcome and early rejection
      patterns.

PMID- 7792864
TI  - Human lung preservation with Euro-Collins solution: early postoperative
      transplant function correlates with ultrastructural alterations of the
      contralateral donor lung.

PMID- 7792866
TI  - Videothoracoscopic wedge resection of the lung for the diagnosis of acute
      rejection in lung transplant recipients.

PMID- 7792865
TI  - Monitoring of lung rejection with home spirometry.

PMID- 7792867
TI  - Rejection and nonrejection related forms of bronchiolitis obliterans: morphologic
      terms or clinico-pathological entities?

PMID- 7792868
TI  - Gastro-esophageal reflux as cause of obliterative bronchiolitis: a case report.

PMID- 7792869
TI  - Evaluation of the development of bronchiolitis obliterans syndrome in single lung
      recipients by assessment of transplant FEV1 with 133-XE radiospirometry.

PMID- 7792870
TI  - Pathology of graft vascular disease after heart and heart-lung transplantation
      and its relationship to obliterative bronchiolitis.

PMID- 7792871
TI  - Graft vessel disease and obliterative bronchiolitis after heart/lung
      transplantation in children.

PMID- 7792872
TI  - Significance of graft coronary artery disease in heart-lung transplant
      recipients.

PMID- 7792873
TI  - Behavior of serum cytokine levels and peripheral lymphocyte subsets after H-LTx.

PMID- 7792874
TI  - Cytokine and cytokine-receptor profiles after liver and heart transplantation.

PMID- 7792875
TI  - Risk factors for chronic transplant failure after kidney transplantation.

PMID- 7792876
TI  - Evaluation of chronic allograft reaction in kidneys by interphase cytogenetics
      with centromere-specific DNA probes and immunocytochemistry with regard to
      distribution of donor and recipient cells.

PMID- 7792877
TI  - The role of lipoprotein abnormalities in chronic vascular rejection after kidney
      transplantation.

PMID- 7792879
TI  - Haemodynamic changes in kidney graft chronic rejection evaluated by echo-colour
      Doppler flowmetry.

PMID- 7792878
TI  - Chronic rejection in kidney transplant patients receiving cytomegalovirus
      prophylaxis with acyclovir.

PMID- 7792880
TI  - Tc-DTPA scintigraphy in renal allograft rejection.

PMID- 7792882
TI  - Manifestation of metabolic risk factors after renal transplantation: I:
      Association with long-term allograft function.

PMID- 7792881
TI  - Cell surface phenotype and in vitro donor antigen-specific hyporesponsiveness in
      recipients of living donor kidney transplants.

PMID- 7792883
TI  - Manifestation of metabolic risk factors after renal transplantation: II. Impact
      of maintenance therapy.

PMID- 7792885
TI  - Impact of lipids on progression and regression of atherosclerosis.

PMID- 7792884
TI  - Manifestation of metabolic risk factors after renal transplantation: III. Impact
      on cerebrocardiovascular complications.

PMID- 7792886
TI  - Early proliferation of medial smooth muscle cells in coronary arteries of rabbit
      cardiac allografts during immunosuppression with cyclosporine A.

PMID- 7792887
TI  - Role of growth factors in graft vessel disease.

PMID- 7792889
TI  - Gender effects on graft myointimal hyperplasia.

PMID- 7792888
TI  - Studies in experimental models of chronic rejection: use of rapamycin (sirolimus)
      and isoxazole derivatives (leflunomide and its analogue) for the suppression of
      graft vascular disease and obliterative bronchiolitis.

PMID- 7792890
TI  - Nitric oxide and its role in transplantation.

PMID- 7792892
TI  - Pathogenetic studies in a rat cardiac model of chronic vascular rejection.

PMID- 7792891
TI  - Transplant vasculopathy in rat heart transplantation: a morphologic chameleon
      determined by antigen-dependent and -independent factors.

PMID- 7792893
TI  - Pathological alterations in graft vessels after major histocompatibility complex
      incompatible heterotopic heart transplantation: a rat model.

PMID- 7792894
TI  - Assessment of troponin-T for detection of cardiac rejection in a rat model.

PMID- 7792895
TI  - Assessment of cardiac rejection and immunosuppression by magnetic resonance
      imaging and spectroscopy.

PMID- 7792896
TI  - Neurohumoral regulation of endothelin release by opioid and natriuretic peptides.

PMID- 7792897
TI  - Enhanced endothelin-1 urine excretion in patients with graft arteriosclerosis
      after heart transplantation.

PMID- 7792899
TI  - Chronic rejection in cryopreserved aortic allografts.

PMID- 7792900
TI  - Evidence that the degeneration of heart valve grafts is immunologic.

PMID- 7792898
TI  - Modulation of inflammatory activation pathways in the Lewis-to-F-344 rat chronic
      cardiac rejection model.

PMID- 7792901
TI  - Preformed natural antibodies: their impact on contractile activity of
      cardiomyocytes.

PMID- 7792902
TI  - Intrathymic injection of donor splenocytes plus systemic antilymphocyte serum or
      antilymphocyte serum alone prolongs cardiac allograft survival and inhibits graft
      arteriosclerosis in the Lewis-to-F344 chronic rejection model.

PMID- 7792903
TI  - Chronic vascular changes and obliterative bronchiolitis in an experimental
      porcine lung transplantation model.

PMID- 7792904
TI  - Graft-infiltrating cells in rat lung allograft with late airway damage.

PMID- 7792906
TI  - Experimental models of chronic renal allograft rejection.

PMID- 7792905
TI  - Thoughts on the immunobiology of chronic allograft rejection.

PMID- 7792907
TI  - Experimental studies of the pathogenesis of chronic allograft rejection.

PMID- 7792908
TI  - Characteristic signs of chronic allograft rejection can be observed in
      mechanically manipulated naive rat kidneys over the long-term.

PMID- 7792910
TI  - Graft survival after corneal transplantation: role of factors with the potential
      for recipient presensitisation. The Australian Corneal Graft Registry (ACGR).

PMID- 7792911
TI  - The 12th scientific meeting of the Transplantation Society of Australia and New
      Zealand. 20-22 April 1994.

PMID- 7792912
TI  - Covert presensitization to HLA antigens in parous heart and lung transplant
      recipients may predispose to early allograft rejection.

PMID- 7792909
TI  - Growth hormone and insulin-like growth factor-I: a suggested role in renal
      transplantation and graft vessel disease.

PMID- 7792913
TI  - Renal transplantation in infants and very small children: 3-year experience in
      patients treated with triple immunosuppression including cyclosporine.

PMID- 7792914
TI  - Liver transplantation for alcoholic cirrhosis: outcomes and difficulties in
      patient selection.

PMID- 7792915
TI  - Cardiac transplantation in patients over 60 years.

PMID- 7792916
TI  - Hyperlipidemia in renal transplant recipients: does it matter and can we treat
      it?

PMID- 7792917
TI  - Twenty and 25 years survival after cadaveric renal transplantation.

PMID- 7792918
TI  - Systemic immune response in rejection and tolerance of rat liver allografts.

PMID- 7792920
TI  - Infiltrating cells in mouse cardiac allografts after anti-CD4 monoclonal antibody
      treatment.

PMID- 7792919
TI  - Comparison of immune changes in rejecting rat cardiac allografts with tolerant
      cardiac allografts secondary to liver grafts.

PMID- 7792921
TI  - Endothelial cell activation and cytokine expression during acute human cardiac
      allograft rejection.

PMID- 7792923
TI  - Neonatal transfer of allogeneic thymic macrophages prevents autoimmunity in
      nonobese diabetic mice.

PMID- 7792922
TI  - Prevention of both rejection and recurrence of autoimmune disease in the NOD/Lt
      mouse following segmental pancreas transplantation.
AB  - In the NOD/Lt recipient mice, disease recurrence in untreated isografts was
      extremely rapid (median less than 10 days) compared to the rejection of an
      untreated BALB/c pancreas graft in a CBA mouse (median 26 days). This would be
      expected since disease recurrence is a secondary response in diabetic mice with
      lymphocytes primed to respond to the beta-cell autoantigen. The median survival
      time for the untreated CBA to NOD/Lt pancreas graft falls, as expected, between
      these two survival times (median 20 days). Although anti-CD4 and/or anti-CD8 were
      effective in delaying or stopping autoimmune disease recurrence and rejection in
      the separate models, they were unsuccessful in significantly altering survival
      times in the combined model, despite using 2-mg doses and dual therapy. Similar
      doses of anti-CD4 have failed to prevent islet allograft rejection in NOD/Lt
      mice. Long-term dual treatment may be required to inactivate CD4+ and CD8+ T
      cells in the NOD/Lt mouse to prevent both autoimmune disease recurrence and
      rejection. NOD/Lt recipients will require greater immunosuppression to prevent
      rejection-autoimmune disease recurrence will be easier to prevent. This study
      shows the value of using NOD/Lt mice, with naturally occurring type 1 diabetes,
      for assessment of immunosuppressive therapy to prevent failure of pancreas
      transplants.

PMID- 7792924
TI  - Construction of CD46 minigenes for the production of transgenic mice.

PMID- 7792925
TI  - Xenotransplantation of fetal pig pancreas and reversal of diabetes in
      spontaneously diabetic NOD mice.

PMID- 7792926
TI  - Effect of anti-CD4 monoclonal antibody on survival of xenografted human fetal
      pancreas.

PMID- 7792927
TI  - Effect of anti-CD4, anti-NC, and anti-NK monoclonal antibody on the survival of
      cardiac xenografts and allografts in mice.

PMID- 7792928
TI  - Serum uric acid and liver transplantation.

PMID- 7792929
TI  - Subjective assessment of donor liver quality.

PMID- 7792930
TI  - 5-HT2 receptor subtypes: a family re-united?
AB  - The current classification for 5-HT2 receptors accommodates three subtypes. In
      addition to the originally defined 5-HT2 receptor, sanctuary is now provided for
      the structurally related 5-HT1c receptor (now 5-HT2c) and at least one atypical 5
      HT receptor subtype. The strong functional union of this family is reflected in
      the paucity of ligands that will discriminate between its subtypes and prompts
      some re-evaluation of the activities of compounds which may now be regarded as
      nonselective for the receptor subtypes in this class. In this article, Gordon
      Baxter and colleagues examine the pharmacology of both officially recognized and
      atypical 5-HT2 receptor subtypes. A number of novel selective agents are
      highlighted, some of which may prove useful for 5-HT2 receptor classification
      and, ultimately, clarify the mechanistic basis for current and future therapeutic
      strategies which target this receptor family.

PMID- 7792931
TI  - Multiple actions of somatostatin in neoplastic disease.
AB  - The role played by the neuropeptide somatostatin, also known as somatotropin
      release inhibitory factor (SRIF), in human cancer is not well understood. Recent
      investigations involving somatostatin receptors in normal and neoplastic human
      tissues suggest that the action is complex and involves both direct and indirect
      mechanisms. In this article, Jean-Claude Reubi and Jean Laissue describe the
      variety of biological mechanisms involved in neoplasia that are associated with
      somatostatin, and illustrate the therapeutic potential and present limitations of
      somatostatin analogues.

PMID- 7792932
TI  - Melatonin comes of age?

PMID- 7792933
TI  - Receptor state and ligand efficacy.

PMID- 7792935
TI  - Superficial buffer barrier function of smooth muscle sarcoplasmic reticulum.
AB  - In smooth muscle the superficial sarcoplasmic reticulum accumulates a portion of
      the Ca2+ that enters cells through the plasmalemma and thus functions as a buffer
      barrier to Ca2+ entry into the myoplasm (superficial buffer barrier or SBB). In
      this review Cornelis van Breemen, Qian Chen and Ismail Laher summarize
      experimental support for the SBB, and discuss data indicating that: (1)
      contraction is related more to the rate than extent of Ca2+ entry; (2) refilling
      of sarcoplasmic reticulum from the extracellular space is mediated by Ca2+ influx
      and Ca2+ pumping by the sarcoplasmic reticulum Ca2+ pump; (3) the superficial
      sarcoplasmic reticulum unloads Ca2+ to the extracellular space by a multi step
      process that involves sequentially the opening of Ca2+ and inositol 1,4,5
      trisphosphate [Ins(1,4,5,)P3] sensitive channels and Ca2+ extrusion by Na(+)-Ca2+
      exchange; (4) the SBB generates a peripheral Ca2+ gradient; (5) Ca(2+)-mobilizing
      receptor agonists generate Ins(1,4,5)P3 which short circuits the SBB to increase
      the effectiveness of Ca2+ influx in raising [Ca2+]i and consequently increase
      smooth muscle contraction. A physiologically regulated SBB is thought to enhance
      the informational content of Ca2+ signalling and support variable reduction of
      smooth muscle tone. Pharmacological modulation of Ca2+ transport in the
      superficial sarcoplasmic reticulum therefore presents an alternative means of
      controlling smooth muscle tone dependent on Ca2+ entry.

PMID- 7792934
TI  - Classification and nomenclature of somatostatin receptors.
AB  - There is considerable controversy about the classification and nomenclature of
      somatostatin receptors. To date, five distinct receptor genes have been cloned
      and named chronologically according to their respective publication dates, but
      two were unfortunately given the same appellation (SSTR4). Consensually, a
      nomenclature for the recombinant receptors has been agreed according to IUPHAR
      guidelines (sst1, sst2, sst3, sst4, and sst5). However, a more informative
      classification is to be preferred for the future, employing all classification
      criteria in an integrated scheme. It is already apparent that the five
      recombinant receptors fall into two classes or groups, on the basis of not only
      structure but also pharmacological characteristics. One class (already referred
      to by some as SRIF1) appears to comprise sst2, sst3 and sst5 receptor subtypes.
      The other class (SRIF2) appears to comprise the other two recombinant receptor
      subtypes (sst1 and sst4). This promising approach is discussed but it is
      acknowledged that much more data from endogenous receptors in whole tissues are
      needed before further recommendations on somatostatin receptor nomenclature can
      be made.

PMID- 7792936
TI  - [A comparison of the differentiation of tumor cells and of the epithelium of the
      gastric mucosa in cancer].
AB  - The correlation between differentiation of tumor cells in different directions
      (toward the foveolate epithelium or glandular epithelium in stomach, or small and
      large intestine epithelium, or endocrine cells) and the state of gastric mucosa
      (differentiation of its cells in direction of foveolate epithelium or glandular
      epithelium (hypoplasia of corresponding epithelium), or appearance of focals of
      metaplasia in small or large intestines, or pronounced hyperplasia of endocrine
      cells) was revealed in most cases of gastric cancer. The other of the disease did
      not reveal such correlation.

PMID- 7792937
TI  - [The effect of thyroid and gonadal hormones on the chromosomal integrity of liver
      cells].
AB  - The materials presented as well as the data of the author's previous
      investigations indicate different cytogenetic importance of the basic hormones of
      the thyroid and sexual glands (thyroxine, testosterone, and estradiol) when they
      are used in physiologic doses. Thyroxine possesses mutagenic and antimutagenic
      properties, testosterone possesses only mutagenic ones, while estradiol has no
      effect on chromosome integrity.

PMID- 7792938
TI  - [The polymorphic BsuRI restriction site of the swine growth hormone gene].
AB  - Restriction fragment length polymorphism of the gene of the growth hormone was
      investigated in Big White and Mirgorod pigs. A polymorphous BsuRI restriction
      site was found within an amplified gene-region near 5-end. It was localized
      within the first intron, 1.6 b.p. higher than exon 2 was. Homozygous as well as
      heterozygous animals according to variants of the gene were found.

PMID- 7792940
TI  - [The intrabreed genotypic variability of Ukrainian beef cattle].
AB  - The intrabreed genotype heterogeneity in Ukrainian beef cattle was studied for 13
      genetic-biochemical systems in relation to the differentiation of animals by sex,
      age color, birth weight and the weight increase during the first 6 months of
      life. The greatest value of genetic distance was revealed between animal groups,
      distinguished by the weight increase. The locus of purine nucleoside
      phosphorylase greatly contribute to this genetic differentiation.

PMID- 7792939
TI  - [Protein polymorphism in the crossbred progeny of Simmental and Red-and-White
      Holsteins].
AB  - The analysis of the genetic structure at 12 genetic-biochemical systems of pure
      parental breeds and their mixed offspring was carried out. The genetic structure
      of the mixed offspring was also investigated in relation with their differences
      in milk productivity. Locus-specific peculiarities of reorganization of the gene
      pool in the process of obtaining mixed offspring were described. Some genetic
      biochemical systems involved in differentiation of groups of animals with respect
      to characteristics of milk production were revealed.

PMID- 7792941
TI  - [The detection and study of mitomycin C-induced mutational changes in stable
      lines of Drosophila melanogaster].
AB  - The influence of mitomycin C on the genetic stability of Drosophila laboratory
      lines was investigated. This mutagen caused one-locus and multi-loci mutations
      with high frequencies (approximately 10(-2), 10(-3)) in the first and the second
      generations. It is locus-specific mutagenesis. In situ hybridization experiments
      indicated the existence of primary and new sites of location of mobile genetic
      elements mdg 1, mdg 2, mdg 4. This instability was caused by activation of
      transposition and recombination.

PMID- 7792942
TI  - [The morphofunctional heterogeneity between peritoneal and alveolar macrophages
      in their biogenic amine content: the effect of their presence or absence in the
      microenvironment of mast cells].
AB  - Peritoneal macrophages differ from alveolar ones in biogenic amine content:
      peritoneal macrophages contain smaller amounts of histamine and serotonin. When
      activated, alveolar macrophages release biogenic amines, whereas in peritoneal
      macrophages stimulators of macrophage activity induce the increase in amine
      content. This may be due to the presence of mast cells in their microenvironment
      macrophage activity.

PMID- 7792943
TI  - [The markers of cells and other structures in the mammalian epiphysis cerebri].
AB  - The information about pineal markers obtained mainly by the light and electron
      microscopic immunocytochemical and cytochemical methods is reviewed. The main
      attention is focused on the distribution of neuroglial and photoreceptor markers
      in different pineal cells and other pineal structures. Besides, the data on
      ultrastructural location of calcium and calcium-bound proteins (calbindins) in
      pineal tissues are presented. The main current trends of the development of this
      kind of research and possibilities to apply the results obtained for diagnostic
      purposes (oncomorphology etc.) are briefly discussed.

PMID- 7792944
TI  - [The mononuclear and multinuclear cells of tissue resorption and their functional
      characteristics].
AB  - Mononuclear and multinuclear chondroclasts as well as osteoclasts and their
      involvement into the processes of replacement of provisional cartilaginous
      skeleton by definitive bony one were cytogenetically studied during ontogenesis
      of terrestrial vertebrates (amphibians, reptiles, birds, and mammals). It was
      detected that mononuclear and multinuclear clastic cells were distinctive morpho
      functional forms. The former are capable to resorb only non-calcified hyaline
      cartilage, the latter are capable to resorb only calcified tissues (cartilage,
      bone). The mechanisms of tissue resorption performed by these cells are
      discussed.

PMID- 7792945
TI  - Society for ultrastructural pathology 1994 pathologist-in-training award.

PMID- 7792946
TI  - Proliferative activity of synovial sarcoma: an immunohistochemical evaluation of
      Ki-67 labeling indices of 52 primary and recurrent tumors.
AB  - The relationship between cell differentiation and proliferation in biphasic
      synovial sarcoma (BSS) and the connection between the two components of these
      tumors and monophasic synovial sarcoma (MSS) are still unknown. In this study we
      specifically compared the Ki-67 labeling indices (Ki-67-LI) in the
      solid/glandular and spindle cell components of primary BSS (n = 8) as well as the
      values thus obtained in primary BSS both outside clear-cut biphasic areas (n = 7)
      and in primary MSS (n = 23). We also compare the Ki-67-LI of primary tumors
      (seven BSS, seven MSS) and their respective first recurrences. We observed that
      the cells of the solid/glandular component of BSS proliferate significantly
      faster (p = 0.007) than those of spindle cell areas. No significantly different
      Ki-67-LI were observed in the comparison of the solid/glandular areas of BSS with
      the spindle/epithelioid component of BSS without clear-cut biphasia and MSS. No
      significant differences of Ki-67-LI were observed in the comparison of primary
      tumors of both subtypes with their respective first recurrences. The implications
      of the low proliferative activity of the spindle cell component of BSS exhibiting
      clear-cut biphasia, which was also confirmed in a concurrent study using anti
      proliferating cell nuclear antigen/Cyclin PC10, remains to be clarified.

PMID- 7792948
TI  - Abnormal melanosomes: ultrastructural markers of melanocytic atypia.
AB  - To identify possible ultrastructural markers of melanocytic atypia, a
      quantitative ultrastructural study was made of melanocytes found at the dermal
      epidermal boundary of normal skin and in benign, premalignant, and malignant
      melanocytic lesions. There was a significant increase (p < 0.05) in the number of
      melanosomes per melanocyte in the premalignant and malignant lesions compared
      with the number observed in the benign lesions. There was a significantly higher
      number (p < 0.05) of abnormal melanosomes (with irregularities in the laminar
      matrix or with a granular or clumpy matrix) in the premalignant and malignant
      lesions, which suggests that the presence of a high percentage of abnormal
      melanosomes might act as a useful ultrastructural marker in the diagnosis of
      melanocytic atypia.

PMID- 7792947
TI  - Ultrastructure of epidermis of mice with chronic proliferative dermatitis.
AB  - C57BL/Ka mice with chronic proliferative dermatitis (cpdm/cpdm) develop chronic
      persistent skin lesions characterized by epidermal hyperplasia, infiltration by
      granulocytes and macrophages, and vascular dilatation. Similar lesions are
      present in other orthokeratotic epithelia in affected mice, in particular the
      esophagus and forestomach. Here, we report on further characterization of
      epidermal hyperplasia and the granulocytes. Keratinocytes of lesional skin, but
      not of normal skin, show round and electron-dense mitochondrial inclusions that
      are present in all layers of the epidermis. Similar inclusions are also present
      in the esophagus and forestomach of affected mice. There appears to be a direct
      relation between the presence of intramitochondrial inclusions and epidermal
      hyperplasia in the mouse. Furthermore, the presence of keratinocyte-derived
      apoptotic bodies in the epidermis, esophagus, and forestomach was frequently
      observed in the lesions, which is consistent with previous light microscopic
      observations of single cell death of keratinocytes. The granulocytes present in
      the skin, esophagus, and forestomach were mainly eosinophils. There were
      widespread gaps observed in the lamina densa in the epidermis that were mostly
      directly associated with dermal or epidermal eosinophils. This type of gap is
      also observed in psoriasiform diseases in humans. This electron microscopic study
      demonstrated that this mouse model should be useful to screen potential
      therapeutic strategies for psoriasiform and other inflammatory skin disorders.

PMID- 7792949
TI  - Colorized digital transmission electron microscopic images for teaching
      pathology.
AB  - We describe how electron microscopic images can be selectively colorized to
      accentuate ultrastructural detail for teaching purposes. Images are either
      captured by a CCD camera attached to the electron microscope or are scanned into
      a computer as electron micrographs. The computer's digital images are then
      manipulated using image-editing and colorizing software to highlight specific
      ultrastructural details, and subsequently printed or converted into 35-mm slides
      to be used for teaching.

PMID- 7792950
TI  - Case for the panel. "Raspberry" particles in optic nerves from an AIDS patient.

PMID- 7792951
TI  - Case for the panel. Weibel-Palade body-like lamellar structure in angiosarcoma.

PMID- 7792952
TI  - Vascular rejection or cyclosporine toxicity?

PMID- 7792954
TI  - Disseminated toxoplasmosis and acquired immunodeficiency syndrome: diagnosis by
      transmission electron microscopy.
AB  - A 43-year-old, bisexual, black man with acquired immunodeficiency syndrome
      (AIDS), detected by CD4 lymphocyte criteria alone, presented with low-grade
      fever, chills, malaise, and watery diarrhea of 2 days' duration. Over the next 5
      days, he developed a fulminant septicemia-like illness with progressive
      hypotension, disseminated intravascular coagulation, and very high serum lactic
      acid dehydrogenase (2,150 U/L) and serum creatine phosphokinase (5,395 U/L)
      levels, and died. The cause of this illness was not clinically apparent. A bone
      marrow biopsy performed on the day of his death revealed intracytoplasmic
      clusters of 3 microns long, oval, basophilic organisms, the exact nature of which
      was not evident by light microscopy. The diagnosis of disseminated toxoplasmosis
      (DT) was made only after electron microscopic study of the bone marrow revealed
      organisms with features typical of Toxoplasma gondii tachyzoites. These features
      included a multilayered pellicle, a pointed anterior end containing a conoid, up
      to nine rhoptries, sparse micronemes, and a posterior end containing a nucleus.
      Some of the organisms had divided by internal budding or endodyogeny. This case
      illustrates the value of transmission electron microscopy in making the diagnosis
      of DT.

PMID- 7792953
TI  - True synovial metaplasia of breast implant capsules: a light and electron
      microscopic study.
AB  - The formation of true synovial-lined membranes at tissue sites not intimately
      related to an articulation or a tendon sheath has been described in a variety of
      pathologic and postsurgical conditions, but until recently has not been well
      recognized to occur in association with tissue surrounding silicone breast
      implants. Of 15 cases with resected periprosthetic breast capsules, 7 (47%)
      demonstrated true synovial metaplasia with capsule-implant interfaces lined by
      typical synovial cells. Histochemical and immunohistochemical staining reactions
      were essentially identical to those observed in synovial control cases and
      featured positive reactions to Alcian blue-periodic acid-Schiff, reticulin, and
      vimentin. Focal positive immunoreactivity was observed with alpha 1-antitrypsin,
      alpha 1-antichromotrypsin, lysozyme, and CD68. No immunoreactivity was observed
      with cytokeratin AE1/AE3, S-100 protein, carcinoembryonic antigen, or basement
      membrane antigens. Transmission electron microscopy of the lining cells confirmed
      their true synovial nature with the type A (macrophage-like) cells, type B
      (fibroblast-like) cells, and intermediate forms or type AB cells identified. We
      conclude that the cellular lining surrounding silicone breast implants is a true
      synovial membrane, that synovial metaplasia may occur in nearly one half of all
      resected periprosthetic capsules, and that awareness of this entity will enable
      the surgical pathologist to render an accurate histopathologic diagnosis.

PMID- 7792955
TI  - [Examination in chronic splanchnic ischemia--arteriography or flow measurement?].

PMID- 7792956
TI  - [Intestinal ischemia. Clinical picture and examination methods].
AB  - A review of chronic intestinal ischaemia with special emphasis on symptoms,
      clinical findings, diagnostic procedures and treatment is given. Chronic
      intestinal ischaemia is not a frequent disease and is often caused by
      arteriosclerosis. The symptoms are postprandial abdominal pain accompanied by
      weight loss. The weight loss is mainly caused by reduced food consumption. The
      diagnosis is traditionally based on angiography and it is recognised that two of
      the three arteries to the intestines must be affected before the symptoms are
      experienced. Recently, more functional tests have become available. Especially
      the measurements of splanchnic blood flow before and after a test meal are used.
      The lack of a postprandial rise in blood flow is taken as evidence for intestinal
      ischaemia. Noninvasive methods such as duplex scanning with measurement of portal
      flow and tonometry seem promising. The treatment is surgical reconstruction of
      the blood flow or, more recently, percutaneous transluminal angioplasty. The
      results are generally excellent, although percutaneous transluminal angioplasty
      in some cases needs to be repeated. The diagnosis and treatment are for a
      specialist with a special interest. The patients should be concentrated in just a
      few centres.

PMID- 7792958
TI  - [Health profile of farmers--a study from Djursland].
AB  - The aim of the study was to describe the pattern of illness and the incidence of
      diseases in a population of Danish full-time farmers. All members of the Farmers
      Association in Djursland, Jutland, Denmark, (n = 1309), were asked to complete a
      questionnaire. Of these, 896 (68.4%) accepted, of whom 610 were full-time
      farmers. The pattern of illness is described by the incidence of chronic disease,
      the incidence of specific disease, and the incidence of typical symptoms within
      the last 14 days. Furthermore, the incidence of work-related accidents and the
      use of medicine were registered. The data were compared with results from a
      similar investigation in the general Danish population. The incidence of disease
      in the locomotive and the respiratory system is higher among farmers. In
      contrast, the incidence of psychiatric and cardiovascular disease as well as
      insomnia appeared lower. In conclusion full-time farmers have an increased risk
      of suffering from certain diseases.

PMID- 7792959
TI  - [The adolescent psychiatric clientele in a district psychiatric center].
AB  - This study is retrospective and based on the charts of 44 adolescents (age 17-22)
      admitted to a Danish community psychiatric centre during the first 32 months
      after the opening of the centre. The social status of the adolescents, reasons
      for admission, previous treatment and need for psychiatric treatment are
      presented. The adolescents were generally a little older than a typical
      adolescent psychiatric clientele, and comparatively many of them had rather mild
      psychiatric conditions. A characteristic feature of these patients was a certain
      instability in their contact to the centre. Although many of them had long
      lasting basic disabilities (e.g. personality disorders), only a few of them
      achieved a stable treatment alliance with the ward. This indicates difficulties
      of integrating an adolescent clientele in a community psychiatric centre that
      primarily takes care of adult patients.

PMID- 7792957
TI  - [Percutaneous transluminal angioplasty of iliac occlusions].
AB  - Percutaneous transluminal angioplasty (PTA) has become an established treatment
      modality for iliac artery stenosis. PTA of iliac artery occlusions, however,
      remains a topic of controversy due to difficulties with mechanical
      recanalization, a lower patency rate and a higher complication rate than obtained
      after PTA of iliac artery stenosis. During a three year period, we performed 31
      PTA's of iliac artery occlusions. The primary recanalization rate was 71% (22
      occlusions). Stents were applied in 16 patients. The cumulated patency rates were
      95% and 85% after one and six months respectively. There was one late reocclusion
      after two years. We found a tendency towards inferior patency in the longer
      occlusions (> or = 5cm). The complication rate was 10% due to three episodes of
      distal embolisation, all of which were successfully treated immediately with
      additional PTA and stenting. These results are in accordance with the results of
      international studies, and suggest that PTA is a useful alternative to surgical
      treatment of iliac artery occlusions, albeit long occlusions involving both the
      common and the external iliac artery should be excluded.

PMID- 7792961
TI  - [Pressure and flow-profile of different spinal needles].
AB  - The flow characteristics of four different types of spinal needles were
      investigated by measuring the infusion pressure during steady state infusion of
      either saline or an X-ray contrast agent. Two pencilpoint needles, a Whitacre
      22Gauge and a Sprotte 24Gauge, possessed flow characteristics similar to a
      22Gauge Quincke point needle. Use of pencilpoint needles for spinal anaesthesia
      results in a lower incidence of postdural puncture headache compared to the
      Quincke point needle. We therefore recommended the use of pencilpoint needles for
      myelography.

PMID- 7792960
TI  - [Survey of clinical diagnoses and autopsy findings. Autopsy findings and
      sensitivity, specificity and predictive values for clinical diagnosis during the
      periods 1 July 1980-30 June 1081 and 1 July 1990-30 June 1993].
AB  - The sensitivity, specificity and clinical accuracy of clinical diagnoses were
      determined and compared for two periods of time: 1.7.1980-30.6.1981 and 1.7.1990
      30.6.1993 based on the analysis of 286 and 138 autopsies respectively. The
      autopsy rate decreased from 82.7% in the first period to 11.2% in the second. The
      first period shows a generally higher sensitivity and accuracy for positive
      diagnosis. Both periods reveal the lowest sensitivity for pulmonary embolism and
      the lowest accuracy for positive clinical diagnosis of
      pneumonia/bronchopneumonia. For malignancies and arteriosclerotic heart diseases
      significant discrepancy between the periods was demonstrated using the chi 2
      test. The results are influenced by low autopsy rates causing fewer true-positive
      diagnoses and a declining sensitivity. This type of study is a useful tool for
      demonstrating changes in the diagnostic procedure. The present investigation
      demonstrates a need for further analysis of malignancies to explain the
      simultaneous decrease in sensitivity, specificity and accuracy in spite of an
      increasing number of malignancies in autopsy findings.

PMID- 7792962
TI  - [Spontaneous avulsion of the tibial tuberosity following Osgood-Schlatter
      disease].
AB  - Two cases of spontaneous fracture and dislocation of the tibial tuberosity in
      boys (15 and 19 years of age), who had both suffered from Osgood-Schlatter
      disease are described. The treatment and prognosis are discussed.

PMID- 7792963
TI  - [Testicular cancer presenting as acute scrotum].
AB  - Acute scrotum is a condition which often causes diagnostic difficulties despite
      all the available investigation methods. Ruling out or confirming torsion of the
      testis is the main problem in most cases. Other more rare conditions, however,
      need acute exploration such as illustrated in this case report, where the sudden
      bleeding in a testicular neoplasm caused severe acute symptoms. The tumor may not
      necessarily be clearly apparent during surgery. Peroperative analysis of a
      specimen of testis tissue is therefore recommended in such cases.

PMID- 7792965
TI  - [Gynecologic examination--up to date?].

PMID- 7792964
TI  - [Ethylene glycol poisoning].
AB  - Ethylene glycol poisoning is a rare event in Denmark. The diagnosis can only be
      made as one of exclusion, since serum ethylene glycol measurements are not made
      in Danish laboratories. A case report of ethylene glycol poisoning is presented
      here. Diagnostic problems and treatment are described.

PMID- 7792966
TI  - [Drug consumption among nursing home residents].

PMID- 7792968
TI  - [New puritanism or professional controversy?].

PMID- 7792967
TI  - [Is the respiratory syncytial virus underestimated as an etiological factor of
      severe respiratory tract diseases among the elderly?].

PMID- 7792969
TI  - [Smoking habits of Danes].

PMID- 7792970
TI  - [Smoking habits of Danes 1988-1993. A follow-up of earlier population studies].
AB  - The present study is a six year follow-up of earlier published population
      studies, where about 18,000 subjects in the normal population over fifteen years
      of age are interviewed annually in omnibus surveys. The study shows a further
      continuous fall in the percentage of smokers among males (45% in 1993) and during
      the last years also a smaller decrease among females (39% in 1993). Smokers of
      tobacco other than cigarettes have stopped smoking to a greater extent than have
      cigarette smokers. The most pronounced decrease in percentage of smokers has been
      observed in the youngest age-group (15-19 years), where smoking prevalence has
      fallen to about 20%, now with a little higher percentage among females than
      males. The percentage of heavy cigarette-smokers (15 cigarettes or more daily) is
      still increasing (now 22% in the male population and 16% in the female
      population, corresponding to about 800,000 in the total population in Denmark).
      The increase is especially seen in groups with the lowest educational level. The
      annual surveys are used as guidelines for directing anti-smoking campaigns in the
      general population. Future campaigns should in Denmark be concentrated on school
      children and young people, women between 20 and 40 years, and the increasing
      group of heavy cigarette smokers. Specific smoking cessation programmes will be
      run in 1995 (STOP '95).

PMID- 7792971
TI  - [Changes in smoking habits in a Danish population from 1983 to 1988].
AB  - Changes in smoking habits are described for 2,986 danes aged 30, 40, 50 and 60
      examined in 1983 as part of the MONICA survey and reexamined five years later. In
      this period the prevalence declined by 8.1% for men and 5.9% for women. Smoking
      was related to social class, with an increasing proportion of smokers with
      decreasing social class. In 1988 the social differences had increased for
      females. The prevalence of cessation was 17.6% for males and 17.2% for females.
      The highest proportion of cessation was found among 60 year-old males. The
      average consumption of tobacco in the group of smokers increased over the period,
      the increment was higher the younger the person. The prevalence of heavy smokers
      (20 grams or more daily) increased especially in younger persons. The proportion
      of young heavy smokers was highest in the lowest social class. By logistic
      regression a low tobacco consumption was the most important factor associated
      with cessation. In addition, high social class was associated with cessation for
      women.

PMID- 7792972
TI  - [Identification of cancer genes. The need for diagnosis and counseling of
      families with cancer].

PMID- 7792973
TI  - [Pulmonary edema after upper airway obstruction].
AB  - Post obstructive pulmonary edema (POPE) is a rare, but potentially dangerous
      condition. We present two patients with post-anaesthetic POPE. The literature is
      reviewed and aetiology, risk factors, pathogenesis, symptoms, prophylaxis and
      management are discussed. The condition is often associated with upper airway
      obstruction related to anaesthesia, but is also related to other causes of upper
      airway obstruction. Development of pulmonary edema can be delayed for up to 90
      minutes. The treatment consists of oxygen therapy by nasal catheter or by mask
      with continuous positive airway pressure. In severe cases, intubation and
      mechanical ventilation by respirator with positive end-expiratory pressure is
      necessary. Further therapy is controversial and without significant effect. With
      sufficient therapy, almost all patients regain their habitual condition within 24
      48 hours and present a normal chest X-ray.

PMID- 7792974
TI  - [Occurrence of bulimic behavior among a group of Danish medical students].
AB  - As part of a prospective survey of Danish medical student's conditions we looked
      into the question of the frequency of bulimic behaviour in this group of
      students. One hundred and ninety-one (75.2%) of 254 students matriculated during
      1992-1993 answered a minor structured questionnaire in 1994 about their eating
      habits, weight and weight control and perception of their bodies. Body mass index
      was calculated. Forty-five percent of the women and 15.2% of the men admitted to
      binge-eating, 28.0% of the women and 9.1% of the men admitted to binge-eating
      together with some kind of weight regulation. Fifty-six percent of the women and
      25.8% of the men used some weight regulating procedures, most often exercising
      and eating less of sweet and fattening foods. Only a very few admitted to self
      induced vomiting. Binge eating was clearly related to suppressing depressive and
      negative feelings. Almost 30% of the women were underweight (BMI < 20) but felt
      themselves to be a normal weight. The male students seemed to be more satisfied
      with their body and psyche than the women who more often felt overweight and were
      prone to binge-eating when they felt depressed, and consequently had to regulate
      their weight in order to live up to their ideals. In order to elucidate the
      magnitude of the problem of bulimic behaviour and the consequences, we need
      further surveys of other groups in the Danish population.

PMID- 7792975
TI  - [Surgical versus non-surgical treatment of unilateral dislocated fractures of the
      lower mandibular condyle].
AB  - To compare open versus closed reduction of unilaterally dislocated low
      subcondylar fractures in adults, 101 consecutive patients were treated either by
      closed reduction with a median of four weeks of maxillomandibular fixation or by
      a median of six weeks of maxillomandibular fixation after surgical repositioning
      and transosseous wiring of the dislocated condylar fragment. No selection of
      patients was done for either treatment. Fifty-two patients were observed for a
      median of two years after treatment. Complications such as malocclusion,
      mandibular asymmetry, impaired masticatory function, and pain located to the
      affected joint or masticatory muscles were significantly more frequent in
      patients treated with closed reduction (39%) compared with those treated
      surgically (4%)(p = 0.005). Neither the degree of dislocation of the proximal
      fragment, concomitant mandibular fractures, nor the absence of posterior occlusal
      support seemed to influence the results.

PMID- 7792977
TI  - [Ketamine in the management of intractable phantom pain].
AB  - A case of phantom limb pain, which had not successfully responded to a long list
      of medical therapy or neurosurgery, is presented. After oral ketamine treatment
      was instituted the patient became free of pain. A possible mode of action is
      described.

PMID- 7792976
TI  - [Irritable colon among 30-60-year old subjects. A cohort study of 4581 Danes].
AB  - With the aim to assess prevalence, incidence, recovery and risk factors of
      irritable bowel syndrome a follow-up study of 4581 Danes was carried out. The
      cohort was obtained by a sex- and age-stratified random sample of Danes living in
      the Western part of Copenhagen County. Participants were interviewed about
      abdominal symptoms. According to various definitions, the prevalence of irritable
      bowel syndrome varied from 5 to 65% and the incidence varied from 1 to 36%. At
      the five year follow-up only 5% of subjects with irritable bowel syndrome were
      free of all symptoms. Psychic vulnerability, female sex, younger age and having
      problems were strongly associated to irritable bowel syndrome, while lifestyle
      factor were not important risk factors. Populations defined as suffering from
      irritable bowel syndrome according to various definitions had less than 50% of
      subjects in common. It is concluded that irritable bowel symptoms are frequent,
      fluctuating phenomena in the general population. Women, the young, the psychic
      vulnerable, and people having problems are at greater risk of having irritable
      bowel syndrome. Different studies applying different definitions of irritable
      bowel syndrome can not be considered to be comparable.

PMID- 7792978
TI  - [Hemorrhage in cerebral cavernous hemangioma as a cause of hemiballismus].
AB  - A 19 year old righthanded woman, without previous neurological symptoms, was
      examined in April 1993, because of involuntary movements affecting especially the
      right hand, but also her right leg and the right side of her face. Magnetic
      Resonance Imagning (MRI), showed a process located in the area of the left
      subthalamic nucleus, which was recognized as a cavernous haemangioma. A left
      carotic arteriography in August was normal. The patient had a complete regression
      of her symptoms, wherefore there was no indication for neurosurgical
      intervention. The patient is still being followed without treatment.

PMID- 7792979
TI  - [Hypoxemia and arrhythmia in acute myocardial infarction].

PMID- 7792980
TI  - [Anaerobic infection].

PMID- 7792981
TI  - [Blood fibronectin and liver phagocytic function in peritonitis patients].
AB  - The concentration of blood fibronectin and the state of the phagocytic function
      in the liver was studied in 19 patients with an emergency pathology of the
      abdominal cavity complicated by the infective-toxin shock and polyorganic
      insufficiency. Patients with severe abdominal pathology had a considerably
      decreased level of circulating fibronectin, disturbed phagocytic function of the
      liver and development of the hypercatabolic state. Hypofibronectinemia was
      accompanied by polyorganic disorders, systemic bacteriotoxemia and disseminated
      intravascular coagulation. Causes of hypofibronectinemia and its role in
      pathogenesis of systemic complications in patients with emergency abdominal
      pathology are discussed.

PMID- 7792982
TI  - [The efficacy of subtotal distal gastric resection in a modified Billroth-I in
      cancer].
AB  - For the period from 1982 to 1994 subtotal resection of the stomach (96) or
      gastrectomy (10) was performed on 106 patients by the Bilroth-I method.
      Efficiency of this method is confirmed by the 5 year survival data, which was
      determined by dynamic method in 42 patients and was 69.8%. Total postoperative
      lethality was 6.7%, and gastrectomy-4.2%.

PMID- 7792983
TI  - [The treatment of combined burn lesions of the esophagus and stomach].
AB  - In patients with an associated burn injury of the esophagus and the stomach, of
      determining significance is stenosis of the latter. Resection of the stomach is
      indicated in cases of subcompensated stenosis of the stomach with distinct
      boundaries of the scary damage. In parallel with the operation on the stomach for
      its stenosis, the formation of a gastrostoma of the proximal part of the organ
      should be also planned for the following bougienage of the esophagus by the
      directing thread.

PMID- 7792984
TI  - [Single-stage esophagoplasty for combined chemical burn of the esophagus and
      stomach and a giant stomach ulcer].

PMID- 7792985
TI  - [Malignant villous neoplasms of the large intestine].
AB  - An investigation of 532 villous tumors of the colon resected in 490 patients has
      shown that malignant tumors take place more often in patients with an increased
      volume of the villous component and the size of the tumor, in patients with more
      distal localization of adenoma in the colon and in adult people. In 38% of the
      patients the villous formation was removed through the endoscope, 12% of the
      patients were subjected to transanal dissection of the rectum tumor and 47.8%--to
      different operations with resection of the intestine.

PMID- 7792986
TI  - [Control over the function of the anastomosed segments of the digestive tract].
AB  - One of the most effective methods of prophylactics of incompetence of anastomoses
      sutures is the intraoperative registration of bioelectrical activity of the
      connected segments of the digestive tract when performing operations on the
      stomach and esophagus. The implanted electrodes allow analysis of the action
      potential fluctuation during the postoperative period followed by the
      corresponding conclusions about the state of blood circulation in hollow organs.
      The effectiveness and adequacy of management of the patients after the
      interventions is estimated by means of rheography of the intestine wall. The
      proposed program of controlling the state of proximal segments of the digestive
      tract gave good results in 42 patients after total and partial gastrectomies.

PMID- 7792987
TI  - [Combined strangulated hernia and rectosigmoid phlegmon].

PMID- 7792988
TI  - [The pathogenesis of suppurative complications in acute pancreatitis].

PMID- 7792989
TI  - [The differential diagnostic difficulties in acute stomach dilatation combined
      with acute destructive pancreatitis in a patient with a left-sided pneumonectomy
      in his anamnesis].

PMID- 7792990
TI  - [Liver hemangiomas].

PMID- 7792991
TI  - [The surgical treatment of lung cancer patients with an exacerbated hereditary
      factor].
AB  - Surgical treatment of 258 patients (1st group) with carcinoma of the lung whose
      hereditary case history was aggravated by the presence of malignant tumors in
      blood relatives was compared with treatment of 861 patients of the control group
      (2nd group). Lung cancer patients of the 1st group were less operable than those
      of the 2nd group, 60.0% and 71.2% (p < 0.001) correspondingly. Resectability was
      84.1% and 93.7% (p < 0.001) correspondingly. Totally in early stages (I-II
      stages) operations were performed only on 118 patients (45.7%) with the
      aggravated heredity and 536 (62.2%) of patients of the control group (p < 0.001).
      The symptoms which characterize surgical treatment of lung cancer in patients
      with the aggravated heredity are much worse as compared with the control group of
      patients because of the biological features of the tumors characterized by
      extremely high potential of the regional and remote metastases.

PMID- 7792992
TI  - [The therapeutic procedure in different degrees of leakage in the injured lung].
AB  - Based of an experience with treatment of 118 patients with spontaneous and
      posttraumatic pneumothorax, pyopneumothorax and state after resection of the
      lung, the authors have developed a method of determination of the degree of
      nonhermeticity of the lung in different regimens of respiration and of the
      selection of treatment depending on the nonhermeticity of the lung.

PMID- 7792993
TI  - [Neurological complications after surgical interventions on the branches of the
      aortic arch].

PMID- 7792994
TI  - [Ways to enhance the efficacy of treating patients with the terminal stage of
      arterial ischemia of the lower extremities].
AB  - Experience with treatment of 410 patients with obliterating diseases of lower
      extremities arteries with the terminal stage of ischemia and occlusions of the
      femoro-popliteal segment have shown that successful results of small amputations
      can be obtained but against the background of complex treatment based on a
      thorough and comprehensive examination of the patient, and aimed at the recovery
      of adequate blood supply of distal parts of the extremity by operations of direct
      and indirect revascularization, normalization of microcirculation and struggle
      against infection. It allows performing amputation distal to the knee joint in
      79.5% of cases, and to reduce the amount of postoperative complications in 38.8%
      of cases.

PMID- 7792995
TI  - [The immunogenetic status of patients with infectious endocarditis].
AB  - On the basis of a deep clinico-immunological examination of 23 patients with
      septic endocarditis it was established that HLA B35 antigen and haplotype A2-B35
      are the most probable markers of the genetic predisposition to the development of
      infective endocarditis. Immune deficiency is accompanied by a decreased content
      of T-helpers, decreased activity of natural killers and phagocytic activity of
      granulocytes. A combination of a genetically determined defect of the immune
      response with a modification of histocompatibility antigens by infective agents,
      drugs (narcotics, antigens etc.) and other factors are thought to be of
      pathogenetic significance in the development of infective endocarditis.

PMID- 7792996
TI  - [Cellular immune reactions in the victims of explosive injuries to the skull and
      brain].
AB  - Specific features in the immunological status of 49 wounded with explosion
      injuries of neurosurgical profile are as follows: in light injuries--it is
      hyperergic character of the immune system and its inadequacy to the injuries of a
      middle degree it is a distinct parallelism between the dynamics of the immune
      status indices and the functional state of the CNS depending on the severity of
      the injury-an extremely flabby with the inhibiting of main immunological indices
      at a low but permanent level.

PMID- 7792997
TI  - [Gunshot trauma].

PMID- 7792998
TI  - [The clinical aspects of toxic-septic shock in peritonitis].
AB  - An analysis of observations of 747 patients with peritonitis is presented, 94 of
      them had toxico-septic shock. A classification of severity of the shock is
      proposed in the article as well as principles of making diagnosis and treatment
      at different steps of management of such patients.

PMID- 7792999
TI  - [The diagnosis and surgical procedure in wounds of the heart and pericardium].

PMID- 7793001
TI  - [The computerized functional monitoring of victims with severe mechanical
      trauma].

PMID- 7793002
TI  - [Birth trauma to the central nervous system in premature infants, its incidence
      and structure].
AB  - The analysis of 1097 newborns case reports is carried out, the high frequency
      (86.4%) of congenital CNS disorders and high diagnostic possibilities of lumbar
      puncture are showed as well as REG and roentgenography of the vertebral column
      cervical portion in CNS birth injury diagnostics, which has been revealed in
      71.9% of patients (60.8%--trauma of the cervical portion of the vertebral column
      with haematoma in CNS and 4.8%--haematoma in CNS). Decreasing of vertebral column
      birth injury frequency and increasing of haematoma cases frequency with enhancing
      of immature newborns rate are revealed, which ratio in mature and immature of the
      I, II, III and the IV degrees is as 9.4; 10.6; 5.2; 2.1; 0.6.

PMID- 7793000
TI  - [Surgical treatment in stab and cut wounds of the neck with esophageal injury].
AB  - The author describes methods of surgical treatment of people wounded in the neck
      area with injuries of the esophagus. Clinical observations are presented which
      show that breach of the rules of revision of the wound canal and organs of the
      neck will inevitably lead to a diagnostic error. The method and volume of the
      surgical intervention for wounds of the esophagus depend on the kind of the
      injury and time from the moment of trauma.

PMID- 7793003
TI  - [The experience of 15 years of development in the rehabilitative trend in the
      surgery of heart defects].

PMID- 7793004
TI  - [The use of the hemostatic preparation Kaprofer in emergency surgery].

PMID- 7793005
TI  - [A method for closure of the duodenal stump in reconstructive gastric resection
      after prior vagotomy with a drainage operation].
AB  - A new method of duodenal closure in stomach reconstructive resection in patients
      with pathologic disturbances after vagotomy with drainage operation is worked up.
      6 patients have been operated. No postoperative complications were observed. All
      the method advantages are evident.

PMID- 7793006
TI  - [The use of the Cell-Saver method of blood preservation in reconstructions of
      aortic aneurysms].

PMID- 7793007
TI  - The effects of feeding emissions from a metal-producing plant upon the immune
      system of sheep.
AB  - The aim of our study was to asses the effects of feeding emissions of a plant
      producing metals from heavy metal-containing ore upon the humoral immunity in
      sheep. Three-year-old sheep of the Wallachian breed were included in an
      experiment and they were divided into two groups. The experimental group (5
      animals) was administered emission-containing (prevailingly Cu and Zn) capsules
      for 3 weeks at a dose amounting to the twofold and during week four the threefold
      of the daily intake of sheep bred in the exposed area. The animals were
      subcutaneously immunized with ovalbumin (OVA, SIGMA A 5503) in 10% alhydrogel at
      a dose of 2 mg/100 kg l.w. In weekly intervals, blood samples were analyzed for
      specific antibody and total immunoglobulin levels. In both groups, OVA antibody
      formation was most pronounced in the 3rd and 5th weeks of observation. It was
      significantly (P < 0.01) higher in the experimental animals than in the controls
      (1.021, 0.641 and 1.138 vs. 0.435, 0.265 and 0.673 in the 3rd, 4th and 5th weeks,
      respectively). In the experimental group, total immunoglobulin concentrations
      slightly increased from 33.5 U ZST (starting value) to 38.72 U ZST (final value).
      As to the total immunoglobulin levels, no significant differences were determined
      between the two groups. It can be seen from the results that short-term
      administration of emissions promotes increased specific OVA antibody formation
      and a slight increase in total immunoglobulin levels. At the same time the ELISA
      method was proved to be suitable for specific antibody detection as a part of
      humoral immunity assessment.

PMID- 7793008
TI  - [Morphologic characteristics of the testes in breeding rams after experimental
      loading with industrial emissions containing copper].
AB  - The aim of this work was to experimentally evaluate the effect of feeding
      industrial emissions from a copper-producing plant upon Cu accumulation in the
      testes of six Merino breeding rams. In the experimental animals (4) the daily
      copper intake from the exhalations was 15 mg/kg l.w. Administration was continued
      until the haemolytic crisis appeared (on day 42 in one animal and on day 50 of
      the experiment in the other animals). The tissue of the testes was examined by
      both optic and electron microscopy. The patho-anatomical picture of the organs
      was characterized by general icterus which was also evident on the sectional
      surfaces of the testes. In the right and left testis of the experimental animals
      Cu levels were found that were twice higher than those of the controls (Tab. IV).
      The toxic effect of copper became evident by the destruction of all developmental
      stages of germinative cells mainly by that the integrity of the cell membranes
      was damaged thus resulting in a gradual release of the germinative cells, into
      the tubular lumen. In extreme cases the tubules were lined with nuclei only and
      the residual cytoplasm of Sertoli cells (Sertoli cells--only syndrome). Ruptures
      of the cytoplasmic membranes were also observed on the Leydig cells. Thickening
      of the tubular lamina propria was caused by homogenization and enormous
      invagination of the lamellar layer, which was rather predominant on the periphery
      of the organ (Fig. 2). In the deeper layers of the testes reduction of the
      cellular and non-cellular layers of the tubular walls occurred which frequently
      resulted in the rupture of the basement membrane.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7793009
TI  - [Pathogenesis of avian mycobacteriosis in the domestic goose (Anser anser f.
      domestica) and duck (Anas platyrhynchos f. domestica)].
AB  - Experimental infections enabled to test susceptibility of the goose and duck to
      M. avium. After intramuscular implantation of M. avium suspension, local lesions
      were observed at the spot of puncture in the geese, and miliary tuberculosis of
      spleen in 35 days, as well as miliary tuberculosis of liver after 69 days. In the
      ducks, local lesions were found at the spot of puncture in 35 days and miliary
      tuberculosis of liver and spleen in 69 days. Cultivation demonstrated
      mycobacteria in various tissues and organs since day 12 after infection. Peroral
      infection with contaminated feed caused lesions in spleen and intestine in the
      geese in 106 days, and then in liver and lungs in 133 days. The ducks had lesions
      in the intestine in 106 days, and in liver and spleen in 133 and 136 days, resp.
      Cultivation proved sporadic mycobacteria in liver, spleen, lungs and/or bone
      marrow and brain in both species. No tuberculous lesions were observed in the
      geese or ducks within 253 days of the experiment after infections by contacts
      with the TBC fowl. Cultivation demonstrated sporadic mycobacteria in liver,
      spleen, kidneys, lungs and bone marrow. The goose and the duck are very resistant
      to M. avium infection. The duck seems to be less susceptible than the duck.

PMID- 7793010
TI  - [Pathogenesis of avian mycobacteriosis in the domestic turkey (Meleagris
      gallopavo f. domestica) and guinea fowl (Numida meleagris f. domestica)].
AB  - Experimental infections enabled to study susceptibility to M. avium and disease
      pathogenesis in the turkey and guinea fowl. After intramuscular implantation of
      M. avium suspension macroscopic tuberculous lesions were observed at the spot of
      puncture in turkeys in 35 days, and miliary tuberculosis of liver and spleen in
      55 days. Cultivation demonstrated mycobacteria in various organs and tissues
      since day 12 after infection. The guinea fowl showed macroscopic lesions at the
      spot of puncture in 28 days, and miliary tuberculosis of liver and spleen in 42
      days. Cultivation of most tissues gave positive results since day 14 with
      prevailing massive growth of mycobacteria. After infection with feed contaminated
      with the liver of the tuberculous fowl isolated tuberculous lesions in liver,
      spleen and lungs were observed in the turkey in 133 days, and in the intestine in
      163 days. Cultivation was successful enough to demonstrate sporadic mycobacteria
      in spleen and lungs in 106 days. The guinea fowl showed isolated tuberculous
      lesions in liver, spleen and intestines in 160 days. Cultivation after 160 days
      also gave positive results, particularly the presence of mycobacteria in liver,
      spleen and lungs was proved to be massive. After contacts with the tuberculous
      fowl, the turkeys showed isolated tuberculous lesions in the liver, spleen and
      lungs since day 218. Cultivation gave positive results since day 218. Isolated
      tuberculous lesions in liver were observed in the guinea fowl in 180 days, as
      well as in spleen, lungs and intestines in 270 days. Cultivation demonstrated
      smaller numbers of mycobacteria in the infected tissues.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7793011
TI  - [Detection of sarcocystosis in slaughterhouse animals during a veterinary
      inspection].
AB  - The objective of our study was to acquire objective data on the finds of
      sarcocystiosis incidence in particular species of farm animals during veterinary
      inspection and to compare the efficiency of different direct diagnostic methods:
      compression and digestion methods. The examined and observed animals involved
      sheep, cattle, pigs and goats slaughtered in the packing plants at Ruzomberok,
      Rimavska Sobota, Trstena, Sabinov and Kosice. The animals were subjected to
      regular veterinary inspection including aspection focused on predilection spots
      of sarcocyst incidence. Sarcocysts were investigated in detail in 353 head of
      sheep, 27 goats, 350 head of cattle and 1,409 pigs. The examination consisted in
      inspection of the whole body, of cross-sections of muscles and organs. The rate
      of sarcocyst invasion in meat as well as the size of cysts were largely variable.
      The highest incidence in sheep was observed on the inner surface of ventral
      muscles in the region of diaphragmatic ribs (21.4%) and in the region of
      intercostal muscles (39.6%). The rate of sarcocyst invasion in the organs was
      highest in the gullet with cysts of various forms and size (in 47% of sheep).
      Veterinary inspection of the total number of 27 goats revealed at aspection the
      presence of macrocysts in eight goats, which makes 29.62%, and in six head of
      cattle (1.7%) and in 13 pigs (0.9%). Regular finds of sarcocysts on a slaughter
      line were confronted with direct diagnostic methods: compression and digestion
      methods (Fig. 1, Tabs. I, II and III). Direct diagnostic method confirmed
      different results, while only the digestion method--trypsin digestion of muscle-
      can be considered as diagnostically reliable.

PMID- 7793014
TI  - Prevalence of antibodies to Toxoplasma gondii in army dogs in the Czech Republic
      and Slovak Republic.
AB  - Army dogs, mostly German Sheep-dogs, were tested for antibodies to T. gondii
      using Sabin-Feldman dye test (DT) and complement fixation test (CFT). Titers
      greater than or equal to 4 and 10 were considered as positive in DT and CFT,
      respectively. Seroprevalences in the group of 720 dogs from the civil sector of
      different areas in the former Czechoslovakia were 39.3% and 15.4% in DT and CFT,
      respectively. During dogs' stay in army seroprevalences decreased only slowly.
      The decrease was probably due to less possibility to contact sources of infection
      -dogs were fed with cooked food, kept in pens with a high level of hygiene, and
      cats were very rare there. Nevertheless, some dogs in the army training centre
      were infected by T. gondii in that way of dog rearing.

PMID- 7793013
TI  - [Antibodies to certain infections on large goat farms in the Czech Republic].
AB  - On five newly established large goat farms the incidence of antibodies to some
      chronic and latent infections (arthritis and encephalitis, Q-fever, caseous
      lymphadenitis and toxoplazmosis) was investigated in the first six months of the
      year 1994. Agar-gel immunodiffusion did not reveal any antibodies to arthritis
      and encephalitis of goats (CAE). Complement fixation test did not demonstrate any
      antibodies to Q-fever. Neither agar-gel immunodiffusion nor neutralization test
      confirmed any antibodies to caseous lymphadentitis. Complement fixation test
      (titer 1:8 and more) revealed antibodies to toxoplazmosis at 20.2% of the cases.
      No clinical symptoms of toxoplazmosis were observed on the investigated goat
      farms. It was recommended to take a preventive serological examination of goats
      against CAE, Q-fever and caseous lymphadenitis before they were housed on the
      given farms. By maintaining high zoohygienic parameters on the large goat farms
      it is possible to except a decrease in prevalence of antibodies to toxoplazmosis.

PMID- 7793012
TI  - [The effect of virginiamycin on rumen fermentation in vitro after adaptation of
      donors to the inoculum].
AB  - Virginiamycin is an antibiotic active against grampositive bacteria in the
      alimentary tract, which is also suitable for supplementation of diets of growing
      and finishing ruminants. The aim of this work was to specify the effect of
      virginiamycin on some parameters of rumen fermentation in vitro with inoculi
      taken from wethers adapted or non-adapted to the virginiamycin intake.
      Incubations were performed anaerobically at 39 degrees C in serum bottles closed
      with Bunsen valves. Virginiamycin was added at 0 or 10 mg/l to the rumen fluid
      diluted with McDougall buffer. Virginiamycin significantly decreased production
      and utilization of lactic acid, production of methane and decomposition of casein
      when rumen fluid was taken from non-adapted wethers. Most of its effects
      disappeared when rumen fluid was sampled from wethers adapted to the
      virginiamycin intake (100 mg per head daily for 2 months). Adaptation of wethers
      to virginiamycin was further confirmed by analyses of the rumen fluid which was
      used for inoculation of in vitro cultures. Molar percentages of acetate,
      propionate, butyrate and valerate were the same before and after the adaptation.
      Therefore it can be concluded that the effects of virginiamycin on rumen
      parameters are not stable and its addition to ruminant diets cannot be
      recommended, with exception of the milk nutrition period. In the last experiment
      the stability of virginiamycin in the rumen fluid of adapted wethers was
      investigated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793015
TI  - [Comparison of the detection of Giardia intestinalis cysts with the presence of
      specific antibodies in dogs and cats].
AB  - We investigated giardiosis of dogs and cats with a view to cysts in fecal samples
      and antibodies in the blood serum. Cysts were found in 25 fecal samples (5.5%)
      out of 458. Cysts were excreted frequently in puppies and adolescent dogs. In 15
      cases giardiosis was diagnosed together with canine distemper or parvovirosis as
      an opportunic infection. Indirect immunofluorescence was used for detection of
      specific antibodies. We tested sera of 588 dogs and specific antibodies were
      detected in 156 cases (36.5%) in titres 10-160. In basic dilution 1:10 antibodies
      were detected in 61% positive samples. Titres 20-160 were found in 39% of the
      positive sera. In cats cysts were found only in 1 fecal sample out of 135 due to
      the difficulties in obtaining fecal samples for repeated examinations. Specific
      antibodies were detected in 107 cats (56.9%) out of 188 at titres 10-320. In
      basic dilution 1-10 antibodies were detected only in 30% of the positive sera but
      on the other hand in 70% we detected higher titres, i.e. 20-320. We did not
      consider titre 10 as significantly positive in both dogs and cats because cross
      parasitic infections frequently occur. The number of serological positive dogs
      and cats grew with their age because they acquired giardiosis in the course of
      their life mostly as asymptomatic infection. The detection of specific antibodies
      cannot be used for the diagnosis because their level in blood serum persists for
      months. We must tread every dog and cat excreting cysts in fecal samples to stop
      transmission to other animals and humans-zoonosis.

PMID- 7793016
TI  - [The effect of high gravity on embryonic development in birds].
AB  - An experiment was conducted on Japanese quail and hen hatching eggs that had been
      incubated, and the embryos were subjected to hypergravitation of 10 G for 10 min
      on days 1 to 9 of embryonic development. Both the experimental group and the
      control contained each 20 hatching eggs every day of the experiment (360 eggs in
      total). A centrifuge of the diameter 1,300 mm was used to create overload
      (hypergravitation) at the speed of 118 rotations per min. Tab. I shows the layout
      of the experiment. Embryonic mortality in Japanese quail was investigated during
      incubation by egg candling on days 1 to 8 and 9 to 14 while suffocated embryos
      were investigated on days 15 to 17. As for chicks, embryonic mortality was
      determined by egg candling on days 1 to 8 and 9 to 18, suffocated embryos were
      determined on days 19 to 21. After incubation was terminated, hatchability in per
      cent of the fertilized eggs was determined. The results were processed in two
      stages of development: the first stage days 1 to 5, the second stage days 6 to 9.
      As can be seen in Fig. 1, hypergravitation did not influence the hatchability of
      quail eggs in the first stage. But this experimental treatment resulted in a
      steep fall of hatchability in the second stage of observation in comparison with
      the control group (the difference is significant P < 0.01). Fig. 2 shows
      hatchability.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793017
TI  - [The NEFERM-Test for identification of psychrotrophic bacteria in food].
AB  - Identification of gramnegative nonfermentative bacteria by traditional methods
      requires much labor and time consumption. Therefore in this study we tested the
      use of an available commercial diagnostic kit and processing of its results by
      computerized numerical identification systems. Identification involved 83
      gramnegative, psychotrophic, nonfermentative, oxidase-positive bacteria isolated
      from just slaughtered and deep-frozen chickens. The strains were isolated from
      primary cultures in Psedomonas F and Endo agar, Violet Red Bile agar (IMUNA,
      OXOID) and King B agar (King et al., 1954), under two cultivation regimes (room
      temperature for three days and 7 degrees C for 10 days). A commercial kit for
      diagnostics of nonfermentative bacteria in clinical microbiology under the name
      NEFERM-test (Lachema a.s., Brno) containing 12 biochemical assays was used for
      strain identification: GLU, AGR, IND, ESL, SCI, PHS, URE, MAN, XYL, MLT, LAC,
      NIT. All these assays were conducted parallelly by traditional methods.
      Additional tests involved the use of OXI and ONPG commercial strips (Lachema
      a.s., Brno), gelatin and Tween 80 hydrolysis (Pacova and Kocur, 1984) and
      fluorescein production (King et al., 1954). These identification systems were
      used to process the results of tests; index and differentiation table (Lachema
      a.s., Brno) and numerical computerized systems TNW (Czech Collection (Z. Svoboda,
      Jihlava). Various shortened procedures, identification keys and systems are used
      to speed up identification of gramnegative nonfermentative bacteria. Available
      commercial identification kits (API NE20) in form of microassay have been
      developed particularly for diagnostics of bacteria from clinica materials, which
      applies to NEFERM-test of the Czech make.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793018
TI  - Devitalization of bacterial and parasitic germs in sewage sludge during aerobic
      digestion under laboratory conditions.
AB  - The survival of 8 bacterial species (Pseudomonas sp., Salmonella sp.,
      Enterobacteriae, Streptococcus sp., Escherichia coli) was detected in municipal
      sewage sludge up to 37 hours of mesophilic aerobic digestion under laboratory
      conditions. The model strain Enterococcus faecium CCM 4231 survived almost twice
      as long as the above-mentioned isolates. Similar findings, regarding the
      viability of the microorganisms studied, were also determined during thermophilic
      aerobic digestion of municipal sewage sludges. The final reduction in the total
      count of bacteria was not directly dependent on the temperature during aerobic
      digestion. It may be supposed that E. faecium CCM 4231 strain as a bacteriocin
      producing strain with a broad antimicrobial spectrum, inoculated into the
      sludges, could inhibit the growth of microorganisms in the sludges by the way of
      its bacteriocin activity. Studying the effect of aerobic digestion on the
      viability of helminth eggs, the observed negative effect of higher temperatures
      was more expressive in comparison with bacterial strains. During thermophilic
      digestion process all helminth eggs (Ascaris suum, Toxocara canis) were
      devitalized. All eggs of T. canis were killed in experiments under mesophilic
      temperature. However, 32% of nonembryonated A. suum eggs remained viable.

PMID- 7793020
TI  - An experimental investigation of the costs and benefits of beak trimming in
      turkeys.
AB  - An investigation was carried out on 504 BUT 8 female poults to identify the
      optimum technique and age for beak trimming breeding turkeys, which have to be
      kept at relatively high light intensities and are thus at serious risk of
      cannibalism. Different groups of birds were subjected to electronic trimming (Bio
      beaking) at one day old, cold cutting (with secateurs) at six days or at 21 days,
      or hot cutting (with a cautery iron) at six days or 21 days old. The behaviour,
      production traits, feather damage, injuries and mortality of the birds were
      measured up to 12 weeks old. None of the methods had much effect on the behaviour
      or production traits, other than relatively minor reductions in beak-related
      activities such as pecking other birds and preening, and short term depressions
      of food intake and bodyweight gain, and improvements in food conversion ratio.
      All the beak-trimming techniques resulted in marked reductions in mortality
      (controls 8.7 per cent, trimmed 1.6 per cent), in injuries due to cannibalism
      (controls 68.1/100 birds, trimmed 9.8/100 birds) and in the scores of feather
      damage caused by pecking (controls 1.05, trimmed 0.29). The adverse effects of
      beak trimming were minor and short-lived, and were clearly outweighed by the
      benefits in reducing cannibalism. Of the different methods, trimming with a hot
      blade is not recommended. Electronic trimming appeared to offer the most benefits
      and caused little apparent distress, but can be hazardous in unskilled
      hands.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793019
TI  - SEAC reports on transmissible spongiform encephalopathies.

PMID- 7793021
TI  - Surgical correction of left displaced abomasum in cattle.
AB  - A left displaced abomasum was corrected surgically in 200 adult cattle by a
      modification of the method described by Dirksen. Manual repositioning of the
      displaced organ, localisation of the pylorus and fixation of the greater omentum
      are described in detail.

PMID- 7793022
TI  - Prevalence of Actinobacillus seminis in the semen of rams in the United Kingdom.
AB  - A survey was conducted to establish the prevalence of Actinobacillus seminis in
      ovine semen and the possible importance of the organism as a cause of ram
      infertility. A seminis was isolated from three of 16 infertile rams and the
      infected animals had lesions of the genital tract and produced poor quality
      semen. A seminis was also isolated from two of 96 fertile rams used as donors of
      semen for artificial insemination programmes. The strains of A seminis could be
      identified on the basis of their API ZYM profiles. The results suggest that in
      the United Kingdom A seminis should be considered as a common cause of
      infertility in rams.

PMID- 7793024
TI  - Possible effect of microbial infection on yolk utilisation in ostrich chicks.

PMID- 7793023
TI  - Dual infection with bovine immunodeficiency virus and bovine leukaemia virus in
      Mississippi dairy cattle.

PMID- 7793025
TI  - Docking of puppies' tails.

PMID- 7793026
TI  - New rules on medicines.

PMID- 7793028
TI  - 'Normal' blood copper levels in horses.

PMID- 7793027
TI  - Diagnosis of BSE.

PMID- 7793029
TI  - Dangerous Dogs Act.

PMID- 7793030
TI  - Suspected carbon, monoxide poisoning in a dog.

PMID- 7793031
TI  - Severe post-dipping dermatitis.

PMID- 7793032
TI  - Spontaneous cataract resorption in an ostrich.

PMID- 7793033
TI  - Parameters of forelimb ground reaction force in 48 normal ponies.
AB  - Recordings of forelimb ground reaction forces were made from 48 normal ponies
      moving at the trot, to evaluate the relationships between bodyweight, vertical
      ground reaction forces, the timing of individual events within the stance phase
      and the total contact time. There were highly significant correlations between
      the mean vertical ground reaction forces and bodyweight. The mean vertical ground
      reaction forces, corrected for bodyweight, were inversely correlated with the
      total contact time suggesting that higher trotting speeds may be associated with
      greater vertical ground reaction forces. The ponies' bodyweights were positively
      correlated with the contact time, implying a reduced stride frequency with
      increasing size. The ground reaction force events in the mid and late stance
      phases occurred at consistent fractions of the total stance time. The ground
      reaction forces and time parameters were highly symmetrical.

PMID- 7793035
TI  - Suitability of the intact acrosome method for the prediction of fertility in
      bovine artificial insemination.
AB  - The average percentages of sperm with intact acrosomes in eight batches of frozen
      thawed semen from each of 17 bulls were compared with the non-return rates to
      artificial insemination by these bulls achieved over a period of three years.
      Despite the fact that the bulls could be categorised into three statistically
      significantly different groups according to their non-return rates, there was no
      significant correlation between the percentage of intact acrosomes and the non
      return rates of the 17 bulls.

PMID- 7793036
TI  - Euthanasia of day-old chicks with carbon dioxide and argon.
AB  - The efficacy for the euthanasia of day-old chicks of mixtures of carbon dioxide
      and air, or carbon dioxide and argon containing 1, 2 or 5 per cent residual
      oxygen, or argon containing 1 or 2 per cent residual oxygen was tested in three
      experiments. The time to the onset of unconsciousness of individual chicks,
      determined from the time to loss of posture, was similar during their exposure to
      2 per cent oxygen in argon, 20, 30 or 40 per cent carbon dioxide in argon with 2
      per cent residual oxygen, or 90 per cent carbon dioxide in air. The exposure of
      chicks in batches of 20 to a mixture of 20, 30 or 40 per cent carbon dioxide in
      argon resulted in the death of all the chicks within two minutes. However, a
      residual oxygen level of 5 per cent in these mixtures resulted in the survival of
      some chicks for longer than two minutes. With argon alone the level of residual
      oxygen was critical; less than 2 per cent was essential to achieve 100 per cent
      mortality within three minutes, and a rise from 2 to about 3 per cent resulted in
      up to 20 per cent of the chicks surviving for seven minutes.

PMID- 7793034
TI  - Effect of an outbreak of sheep scab (Psoroptes ovis infestation) during mid
      pregnancy on ewe body condition and lamb birthweight.
AB  - A naturally occurring outbreak of sheep scab in a flock of 202 ewes during mid
      pregnancy resulted in exudation from the scab lesions and hypoalbuminaemia
      lasting for two to 10 weeks in the severely affected ewes. The serum albumin
      concentration at the time of diagnosis and two weeks after treatment with
      ivermectin was inversely correlated with the severity of the scab lesions (P <
      0.001). The loss of body condition score over a period of 48 days after treatment
      was significantly correlated with the initial severity of the scab lesions (P <
      0.001). Despite adequate energy nutrition of the ewes during late pregnancy, the
      birthweights of lambs born to ewes with severe sheep scab were 10 per cent less
      than those of lambs born to ewes with mild sheep scab.

PMID- 7793037
TI  - Immunohistochemical test for rabies: identification of a diagnostically superior
      monoclonal antibody.

PMID- 7793038
TI  - Hydropericardium syndrome outbreak in a pigeon flock.

PMID- 7793039
TI  - Serological monitoring of PRRS transmission: a case study.

PMID- 7793041
TI  - Docking of puppies' tails.

PMID- 7793040
TI  - Docking of puppies' tails.

PMID- 7793043
TI  - New rules on medicines.

PMID- 7793045
TI  - Ileocaecal anastomosis in a dairy cow.

PMID- 7793044
TI  - New rules on medicines.

PMID- 7793042
TI  - Docking of puppies' tails.

PMID- 7793046
TI  - Hepatic abscess due to fascioliasis.

PMID- 7793047
TI  - L-forms of staphylococci and streptococci.

PMID- 7793048
TI  - [Computed tomography in the diagnosis of gastric cancer].
AB  - The potentialities of x-ray computer-aided tomography (CAT) in the studies of
      intraparietal blastomatous infiltration are analyzed as shown by examinations of
      134 patients with gastric cancer. The diagnostic efficacies of various
      modifications of CAT (filling of the stomach with liquid, pneumoscanning of the
      stomach with or without tubes) are assessed. Good diagnostic potentialities of
      tubal scanning of the stomach in the assessment of intraparietal tumor
      infiltration are demonstrated. CAT semeiotics of gastric cancer is presented,
      characterizing the tumors with predominantly intraparietal dissemination of
      blastomatous infiltration. The existent projection limitations of axial CAT of
      individual portions of the stomach and high price of the examination imply that
      the indications to the use of this method in gastrooncology should be clearly
      defined. At the same time, scrupulous adherance to methodologic requirements
      aimed at imaging of intraparietal changes in gastric cancer may help to solve a
      number of differential diagnostic difficulties, primarily those connected with
      predominantly submucously growing carcinomas.

PMID- 7793050
TI  - [Chronic catheterization of the thoracic lymphatic duct in the treatment of liver
      cirrhosis].
AB  - The suggested method of chronic catheterization of the thoracic lymph duct is
      based on preservation of lymphaticostoma after a course of lymphosorption. The
      catheter is removed and a repeated course of lymph perfusion carried out, if
      necessary. It is particularly important for patients with neglected liver
      cirrhosis.

PMID- 7793051
TI  - [Radiodiagnosis of intestinal endometriosis].
AB  - Twenty-five women aged 24 to 52, suffering from endometriosis of the large and
      small intestine were examined. The rectum and the rectosigmoid portion were the
      most frequent sites of involvement. The endoscopic information is absolutely
      insufficient. The authors distinguish 4 endometriosis forms with different growth
      forms and degree of the intestinal wall involvement. Each of these forms has a
      specific x-ray pattern. The condition is to be differentiated from cancer,
      regional colitis, strictures and pericolitis by x-ray diagnostic methods.

PMID- 7793049
TI  - [Effect of radiologic contrast chemoembolization on ultrastructural changes of
      malignant liver neoplasms].
AB  - The authors confirm the efficacy of treating primary and metastatic cancer of the
      liver by selective blocking of vessels in the involved liver part with an oily x
      ray contrast agent with a citostatic dioxadet. Profound irreversible injury to
      tumor tissue was observed. Only solitary tumor cells were left slightly injured.
      Excepting a narrow adjacent area, lesser amount of lipid tissue accumulated in
      the tumor; hepatocytes were sufficiently well preserved, showing signs of
      reparation and increased functional activity 1-2 weeks after chemoembolization.

PMID- 7793053
TI  - [Contemporary methods of the target puncture of the mammary gland].
AB  - New accurate methods of puncture of the mammary gland, making use of preliminary
      layout using roentgenograms, coordination nets, Cytoguide comprter device, and
      ultrasound-monitored spot biopsy replaced the traditional poorly informative
      methods. Sonography-monitored puncture is the most informative in cases with both
      palpated and unpalpated formations shaped as nodules: it permits imaging in 85%
      of cases. However, in 25-30% of cases unpalpated cancer presents as
      microcalcinates and cord-like restructuring which cannot be imaged on sonograms.
      Moreover, unpalpated cancer presenting as a nodule against the background of
      fatty involution also may be undiscernible on sonograms. In such cases puncture
      controlled by roentgenography with a computer device and a relevant kit of
      disposable instruments is advisable, giving accurate information in 61.1% of
      cases.

PMID- 7793052
TI  - [Clinical efficacy of abdominal ultrasonography].
AB  - Ultrasonic examinations of the abdomen is suspected visceral diseases may result
      in the detection of the pathology processes that were not suspected before. To
      determine the frequency of these unexpected findings, the authors have examined
      3000 patients for 2 years. A total of 792 pathology processes were detected that
      were quite unexpected for the physicians who sent the patients for the
      examination. Liver tumor were detected in 36 cases, 25 of these metastatic ones,
      gallbladder stones were detected in 82 cases, tumors and cysts of the kidney and
      other conditions were detected. The authors come to a conclusion, that no matter
      what the suspected condition is, the specialist in radiodiagnosis should carry
      out an ultrasonic examination of the total abdomen.

PMID- 7793054
TI  - [Current achievements and trends in the development of radiodiagnosis of
      abdominal and retroperitoneal diseases].

PMID- 7793055
TI  - [Radiologic assessment of heart transplantation].
AB  - Twenty patients were examined before and after orthotopic transplantation of the
      heart. The significance of x-ray examination of donors to ascertain brain death
      was demonstrated. The possibility of x-ray examination of recipients is analyzed.
      X-Ray criteria of prognostically unfavorable signs for cardiologis patients are
      defined. The x-ray picture before and after transplantation of the heart was
      studied. Possible complications in the immediate posttransplantation period are
      analyzed, as are the potentialities of x-ray detection of chronic crisis of
      transplanted heart rejection.

PMID- 7793056
TI  - [Evaluation of imaging validity in mammary-coronary shunts].

PMID- 7793058
TI  - [Diagnosis of cancer of solitary kidney].

PMID- 7793057
TI  - [Gastric pneumatosis caused by aerophagia].

PMID- 7793059
TI  - [Academical science in roentgenoradiology].

PMID- 7793060
TI  - [On the history of roentgenology at the Moscow District Research and Clinical
      Institute and in the Moscow District].

PMID- 7793061
TI  - The remarkable coding strategy of borna disease virus: a new member of the
      nonsegmented negative strand RNA viruses.
AB  - BDV uses a remarkably broad range of mechanisms to direct expression of its 8.9
      kb genome. Although much remains to be elucidated, it is clear that BDV genome
      expression is modulated by the use of multiple strategies, including differential
      gene transcription, post-transcriptional modification, and translational
      efficiency. Further insights into the details of this multilevel system will be
      essential to understanding BDV biology, pathogenesis, and neurotropism.

PMID- 7793062
TI  - Nucleotide sequence analysis of a 30-kb region of the bovine herpesvirus 1 genome
      which exhibits a colinear gene arrangement with the UL21 to UL4 genes of herpes
      simplex virus.
AB  - We report the nucleotide sequence of the 19-kb HindIII fragment B of bovine
      herpesvirus 1 (BHV-1) DNA and adjacent parts of the HindIII A and L fragments,
      which together span a still completely uncharted 30-kb region located between the
      glycoprotein H gene and the right end of the unique long segment. The analysis
      revealed 17 complete open reading frames (ORFs) and 2 ORFs that were interrupted
      by potential splice donor and acceptor sites. All of these ORFs exhibited strong
      amino acid sequence homology to the gene products of other alphaherpesviruses.
      The BHV-1 ORFs were arranged colinearly with the prototype sequence of herpes
      simplex virus 1 in the range of the UL21 to UL4 genes. Colinearity was also
      observed with the genes of betaherpesviruses and gamma herpesviruses, although
      not all ORFs exhibited clear sequence homology. The possible functions of the
      proteins encoded within the sequenced region are assessed and features found are
      discussed. Unexpected findings include the following: high amino acid sequence
      conservation among alphaherpesviruses despite large differences in G + C content,
      ranging from 45% for varicella zoster virus to 72% for BHV-1; high similarity
      with other UL20 proteins at the predicted structural level in spite of relatively
      low amino acid homology; and a 2-kb open reading frame overlapping UL19 in the
      opposite sense and exhibiting high amino acid similarity to the same area of
      pseudorabies virus.

PMID- 7793063
TI  - The genome segments of DpRV, a commensal reovirus of the wasp Diadromus
      pulchellus (Hymenoptera).
AB  - The complete nucleotide sequences of the five double-stranded RNA genome segments
      of the Diadromus pulchellus reovirus (DpRV) have been determined. They consist of
      985, 1240, 1318, 1652, and 4230 bp. Each segment contains at least one putative
      open reading frame encoding 33-, 40-, 45-, 49-, and 148-kDa proteins,
      respectively. The proteins have no significant similarities with sequences in
      data banks. Analysis of these segments and of two other previously published
      segments revealed the presence of degenerate consensus inverted repeats at both
      ends (5'-rCAAUUUUnnACU...AGUAAAAAAAUnrG-3'). The biological, structural, and
      genomic features of DpRV suggest that this virus is related to members of the
      Orthoreovirus genus.

PMID- 7793064
TI  - Antibodies raised in a natural host and monoclonal antibodies recognize similar
      antigenic features of foot-and-mouth disease virus.
AB  - Swine polyclonal antibodies directed against a major antigenic site (site A) of
      foot-and-mouth disease virus (FMDV) of serotype C, and monoclonal antibodies
      (MAbs) which recognize different epitopes within this site, have been compared
      with regard to reactivity with a panel of synthetic peptides. The peptides used
      represent different segments or variant sequences of site A, and their
      reactivities reflect differences in antigenic specificity. The results indicate a
      remarkable immunochemical similarity between the site A epitopes defined by
      murine MAbs and those recognized by antibodies elicited in a natural host of
      FMDV. This similarity further validates previous conclusions, based on analyses
      with MAbs, on the relevance of amino acid substitutions at a few critical
      positions on the intratypic antigenic variation of FMDV in the field. They also
      give further support to a dual function of the Arg-Gly-Asp motif of the G-H loop
      in cell attachment and in the recognition by host antibodies, as recently
      documented with the elucidation of the three-dimensional structure of an antigen
      antibody complex of FMDV. In addition, the results encourage the use of extended
      panels of well-characterized MAbs for a precise molecular analysis of the
      antigenic variation of FMDV, and of other viruses, in the field.

PMID- 7793065
TI  - Inhibition of pseudorabies virus replication by a chimeric trans-gene product
      repressing transcription of the immediate-early gene.
AB  - A chimeric gene encoding a fusion protein consisting of the DNA-binding domain of
      the immediate-early (IE) protein of pseudorabies virus (PRV) and a tail-truncated
      Vmw65 of herpes simplex virus 1, lacking the transcription activation domain, was
      constructed. The chimeric gene product inhibited transcription from the PRV IE
      promoter in a transient expression assay. A HeLa cell line stably transformed
      with the chimeric gene showed remarkable resistance to PRV infection. In the
      transformed cells infected with PRV, transcription of the PRV IE gene was
      repressed, indicating that the resistance of the cells to PRV infection was due
      to interference with IE gene transcription by the fusion protein.

PMID- 7793068
TI  - Studies on neurovirulence in poliovirus-sensitive transgenic mice and cynomolgus
      monkeys for the different temperature-sensitive viruses derived from the Sabin
      type 3 virus.
AB  - We have studied methods for testing the neurovirulence of live poliovaccine
      viruses by intraspinal inoculation into mice carrying the human poliovirus
      receptor gene (Tg mice). A comparison of the neurovirulence of Sabin type 3
      vaccine virus and related viruses using the 50% paralysis dose determined after
      intraspinal inoculation into the Tg mice as an index revealed a close correlation
      between the results of the paralysis dose in Tg mice, the neurovirulence
      expressed by the histopathological lesions core in monkeys, and the temperature
      sensitivity of the viruses. The results of experiments in the Tg mice also showed
      a good correlation with the number of mutations at position 472 from U to C in
      the 5' noncoding region in the genomes of the viruses tested. These results
      strongly suggest that the neurovirulence test for oral poliomyelitis vaccine
      using the Tg mice is an excellent method and may be used in place of the test
      using monkeys.

PMID- 7793067
TI  - An arbovirus cline across the northern hemisphere.
AB  - The mode and tempo of arbovirus evolution and dispersal can help to explain the
      dynamics of pandemics, viral outbreaks, and emerging viruses. By comparing
      nucleotide and deduced amino acid sequences of their envelope proteins, we
      describe the continuous distribution of the tick-borne encephalitis (TBE) complex
      viruses, the most important flaviviruses in Europe, across major geographical
      areas and the conditions under which mutations occur. The analyses reveal a
      correlation between the geographical and genetic distances of these viruses. The
      arthropod host appears to be a key factor for the formation and maintenance of
      this cline by constraining TBE dispersal and evolution. This is also illustrated
      by comparisons with mosquito-borne flaviviruses.

PMID- 7793066
TI  - The roles of the cAMP-response element and TATA box in expression of the herpes
      simplex virus type 1 latency-associated transcripts.
AB  - A quantitative ribonuclease protection assay (RPA) was developed in order to
      rapidly and accurately measure the levels and timing of latency-associated
      transcript (LAT) expression in ganglia latently infected with wild-type and
      mutant herpes simplex virus (HSV). Use of this assay in parallel with measurement
      of viral titers in murine trigeminal ganglia demonstrated that the peak of viral
      replication precedes the peak and subsequent plateau of LAT expression. This
      plateau of LAT expression was unaltered from Day 7 through the end of the
      experimental period on Day 28, suggesting that LAT does not further accumulate
      during latency of wild-type virus. RPA analyses of trigeminal ganglia latently
      infected with HSV-1 mutants containing specific alterations in the LAT TATA box,
      cyclic AMP-response element (CRE), and both TATA and CRE were performed. Mutation
      of the upstream TATA box reduced LAT expression to 25% of wild-type or marker
      rescued virus levels, whereas mutation of the CRE did not significantly affect
      LAT expression in vivo whether in the presence or absence of the TATA box. These
      experiments demonstrate a specific requirement for the upstream promoter TATA box
      for wild-type LAT expression. Further examination of the role of the CRE and the
      TATA box by transient expression assays suggests that the CRE is important for
      inducible activity and that its interaction with the TATA box requires
      stereospecific alignment.

PMID- 7793069
TI  - Replicating foamy virus-based vectors directing high level expression of foreign
      genes.
AB  - Replication-competent retroviral vectors (pFOV-1 to -3 and -7) were constructed
      on the basis of an infectious human foamy virus molecular clone which has
      deletions in the U3 region of the long terminal repeat and in the 3' region of
      the genome, previously identified to be nonessential for virus replication in
      vitro. The CAT and luciferase indicator genes were expressed as C-terminal fusion
      proteins to 215 amino acids of the viral Bet protein in the pFOV-1 vector.
      Introduction of the foot-and-mouth disease 2A protease sequence between the
      truncated bet coding sequence and the cloning site for the insertion of foreign
      genes in the pFOV-7 vector resulted in self-cleaving of the recombinant fusion
      protein. Alternatively, an internal ribosomal binding site was introduced,
      allowing expression of authentic foreign protein (pFOV-2 and -3 vectors). DNA
      fragments derived from the mouse hepatitis virus surface gene up to the length of
      1.3 kb were inserted into pFOV-1. The vector constructs gave rise to viruses
      which were fully infectious in diploid human fibroblasts and recombinant viruses
      stably expressed high levels of foreign protein indicating that the pFOV vectors
      may be useful tools to study the effects of proteins of interest at least in
      tissue culture cells.

PMID- 7793070
TI  - Expression and purification of a recombinant tobacco etch virus NIa proteinase:
      biochemical analyses of the full-length and a naturally occurring truncated
      proteinase form.
AB  - The tobacco etch virus 27-kDa nuclear inclusion a (NIa) proteinase was expressed
      in Escherichia coli as a recombinant fusion protein containing a seven-histidine
      tag at the amino-terminus. Catalytically active and inactive (by virtue of a
      single amino acid change) forms of the proteinase were purified to homogeneity in
      a two-column chromatographic procedure. The active form of the proteinase was
      slowly converted to a lower molecular weight form, while the inactive form was
      not. This conversion was dilution independent and thought to be intramolecular.
      Isolation of the approximately 2-kDa peptide cleavage product and determination
      of its N-terminal amino acid sequence positioned the cleavage site 24 amino acids
      from the carboxy-terminus of the proteinase. A recombinant NIa proteinase lacking
      the C-terminal 24 amino acids was shown to possess limited activity. Kinetic
      analyses of cleavage of a synthetic peptide by the full-length or truncated
      proteinase were conducted and indicated that the Km of the truncated proteinase
      was approximately fourfold higher than that of the full-length form. The
      truncated proteinase was approximately one-twentieth as efficient in proteolysis
      of the test peptide substrate as the full-length form.

PMID- 7793071
TI  - Assessment of fusogenic properties of influenza virus hemagglutinin deacylated by
      site-directed mutagenesis and hydroxylamine treatment.
AB  - Influenza virus hemagglutinin (HA) subtype H7 expressed from a baculovirus vector
      in insect cells requires cysteine residues for palmitoylation. Mutant HA devoid
      of fatty acids shows hemagglutinating and hemolytic activities almost identical
      to those of the acylated wild-type HA (wt). Using a membrane mixing assay (R18),
      neither the kinetics nor the pH dependence of fusion induced by wt or mutant HA
      was significantly different from virus-induced fusion. HA-induced fusion of
      insect cells with human erythrocyte ghosts could also be demonstrated by a
      cytoplasmic content mixing assay. Both species of recombinant HA induced the flow
      of lucifer yellow from preloaded ghosts into the cytoplasm of HA-bearing cells.
      This indicates that membrane fusion mediated by wild-type and fatty-acid-free HA
      includes both leaflets of the lipid bilayers. Hydroxylamine treatment of wt HA
      (H7) and fatty-acid-free mutant HA present in lysates of insect cells led to the
      complete inhibition of hemolytic activity. Deacylation of spike proteins by NH2OH
      treatment of virus particles resulted in a block of hemolytic activity in
      influenza virus subtypes H7 and H10 as well as of that in the togaviruses Semliki
      Forest and Sindbis virus. However, the same treatment did not affect subtypes H2
      and H3 or two vesicular stomatitis virus serotypes. With such a differential
      effect whether or not fatty acids are present in the spike proteins of the
      different virus particles, hydroxylamine must have other effects than just
      deacylation, and therefore seems unsuitable for the study of the biological
      functions of acylproteins.

PMID- 7793072
TI  - Replication-deficient vaccinia virus encoding bacteriophage T7 RNA polymerase for
      transient gene expression in mammalian cells.
AB  - The vaccinia virus/bacteriophage T7 hybrid transient expression system employs a
      recombinant vaccinia virus that encodes the T7 RNA polymerase gene, a plasmid
      vector with a gene of interest regulated by a T7 promoter, and any cell line
      suitable for infection and transfection. Although high expression in a majority
      of cells is achieved, the severe cytopathic effects of vaccinia virus and the
      safety precautions required for use of infectious agents are undesirable features
      of the system. Here, we report the construction of a highly attenuated and avian
      host-restricted vaccinia virus recombinant that encodes the T7 RNA polymerase
      gene (MVA/T7 pol) and demonstrate the use of the virus for transient expression
      in mammalian cells. MVA/T7 pol has reduced cytopathic effects compared to the
      previously used replication-competent vaccinia virus, while providing a high
      level of gene expression in multiple mammalian cell lines.

PMID- 7793074
TI  - Crystallization and preliminary X-ray analysis of the core particle of bluetongue
      virus.
AB  - Core particles of bluetongue virus serotype 1 (South Africa) have been
      crystallized. The crystals, which grow up to 0.8 mm in diameter, belong to a
      primitive orthorhombic space group and have point group symmetry 222. The unit
      cell dimensions are 754 x 796 x 823 A3 and the crystallographic asymmetric unit
      contains one-half of a core particle. The best crystals diffract strongly to 4.8
      A Bragg spacings, which is the maximum resolution to which we can measure data
      with the detectors available, suggesting that useful diffraction extends well
      beyond this. Core particles of serotype 10 have also been crystallized but the
      crystals have yet to be analyzed by X-ray diffraction.

PMID- 7793073
TI  - Impaired infectivity of HIV-1 after a single point mutation in the POL gene to
      escape the effect of a protease inhibitor in vitro.
AB  - To examine whether the mutation of protease in an HIV-1 resistant to a protease
      inhibitor affects the virus phenotype in vitro, the infectivity of the protease
      inhibitor-escape-virus was compared to that of the parent virus. In different T
      cell lines, the infectivity of the escape virus was impaired by 10-fold compared
      to the parent virus. MT-4 cell killing by the escape virus, measured using the
      MTT assay, was much weaker than that by the parent virus. The escape virus
      contained more unprocessed Pr55gag than the parent virus. A delayed appearance of
      mature p24 in cells chronically infected with the escape virus was also noticed
      by the pulse-chase method. The same findings were obtained using pNL432 (HIV-1
      DNA molecular clone) with the same mutation in the protease gene. Despite the
      lack of a significant difference in virus binding, less unintegrated and
      integrated DNA was detected in MT-4 cells infected with the escape virus compared
      to the parent virus. The impaired infectivity of the escape virus may be
      explained by the inefficient maturation of Gag proteins, due to the mutated
      protease, which may affect an early step in the virus life cycle.

PMID- 7793075
TI  - HIV-1 infection of primary human neuroblasts.
AB  - Central nervous system (CNS) disorders are frequent in HIV-1-infected
      individuals, particularly in newborns and children, and are accompanied by
      histological alterations resulting in neuronal loss. Although several tumor
      derived neuroectodermal cell lines can be infected by HIV-1, it has been reported
      that primary neural cells cannot be infected after they differentiate. However,
      pediatric AIDS is often the result of HIV-1 infection occurring during fetal
      development and early postnatal life, when neural cells are not yet
      differentiated. Here we show that primary cell cultures derived from the human
      fetal olfactory system which are representative of the developing CNS can be
      infected by both HIV-1 strains, the monocyte-macrophagotropic BaL and the
      lymphotropic HTLV-IIIB, although they do not express the CD4 molecule. In
      addition, the levels of viral replication are higher with the HIV-1 BaL than with
      the IIIB isolate. These results suggest that (1) during development immature
      neurons are susceptible to HIV-1 infection; (2) monocyte-macrophagotropic HIV-1
      strains may preferentially be involved in the productive infection of the nervous
      system; and (3) a mechanism(s) other than the CD4-mediated viral entry is
      responsible for HIV-1 infection of immature neurons.

PMID- 7793076
TI  - Foreign gene expression by human adenovirus type 5-based vectors studied using
      firefly luciferase and bacterial beta-galactosidase genes as reporters.
AB  - Adenovirus (Ad) vectors have been used extensively to obtain high-level
      expression of foreign genes in mammalian cells and are currently being studied
      for use as live viral-vectored vaccines and as gene transfer vectors for gene
      therapy. Many Ad recombinants have been generated that express foreign genes
      inserted in early region 3 (E3); however, little has been done to study the
      importance for gene expression of regulatory sequences flanking the gene. We have
      generated a series of Ad5 helper-independent vectors that contain the firefly
      luciferase gene or the bacterial beta-galactosidase gene (LacZ) with or without
      simian virus 40 (SV40) regulatory sequences, combined with E3 deletions of 1.88
      or 2.69 kb. The greatest levels of luciferase expression were obtained with a
      vector containing the luciferase gene under the control of the SV40 promoter and
      polyadenylation signal inserted in a 1.88-kb E3 deletion. In contrast, LacZ
      expression was highest with a vector containing the LacZ gene with just the SV40
      polyadenylation sequence combined with a 1.88-kb E3 deletion. It was also
      observed that regardless of the SV40 sequences flanking the reporter gene or the
      E3 deletion used, expression from the luciferase recombinants was dependent on
      viral DNA replication, whereas expression from the LacZ recombinants was only
      partially reduced when DNA replication was blocked. Analyses of RNA by dot blot
      hybridizations revealed that the levels of reporter gene-specific mRNA for
      various vectors in each series did not vary significantly. These results indicate
      that the kinetics and efficiency of expression of genes inserted into the E3
      region, in nonconditional helper-independent vectors, may be more strongly
      dependent on the sequences in the foreign gene insert itself than on flanking
      regulatory sequences such as those used here, derived from SV40.

PMID- 7793077
TI  - Sequence analysis of pigeon, turkey, and chicken rotavirus VP8* identifies
      rotavirus 993/83, isolated from calf feces, as a pigeon rotavirus.
AB  - Partial-length gene 4 cDNA encompassing the VP8* portion of VP4 from chicken
      rotavirus (RV) Ch-1, turkey RV Ty-1 and Ty-3, and pigeon RV PO-13 was sequenced
      and compared to RV 993/83 isolated from a calf with diarrhea. Ninety-six percent
      amino acid sequence identity was seen between VP8* from calf RV 993/83 and pigeon
      RV PO-13, while only 77 to 83% identity was seen in comparison with turkey and
      chicken RV VP8* sequences. Phylogenetic tree analysis places all avian RV
      (including calf isolate 993/83) on a branch at the bottom of the VP8* tree. When
      tested with three neutralizing monoclonal antibodies raised against pigeon RV PO
      13, RV 993/83 and Ty-1 share three, Ch-1 shares two, and Ty-3 shares one
      neutralizing epitope(s) on VP4 with pigeon RV PO-13.

PMID- 7793078
TI  - CTL escape viral variants. I. Generation and molecular characterization.
AB  - Cytotoxic T lymphocytes (CTL) play a pivotal role in preventing persistent viral
      infections and aborting acute infections. H-2Db-restricted CTL optimally
      recognize a specific peptide of 9 to 11 amino acids (aa) derived from a viral
      protein and held in place (restricted) by a MHC class I glycoprotein on the
      surfaces of infected cells. Only three peptide sequences with the appropriate Db
      motif from lymphocytic choriomeningitis virus Armstrong strain (LCMV) are known
      to be presented to CTL by H-2Db molecules; they are from the glycoproteins (GP),
      residues 33-41 KAVYNFATC (GP1) and 276-286 SGVENPGGYCL (GP2), and the
      nucleoprotein (NP), 396-404 FQPQNGQFI. Incubation of virally infected H-2b cells
      with CTL clones that recognize only GP1, GP2, or NP leads to the selection of
      viral variants which upon infecting cells bearing H-2b molecules, escape
      recognition by CTL of the appropriate specificity. Nucleic acid sequencing showed
      a single mutation in GP1 (aa 38 F-->L), GP2 (aa 282 G-->D), or NP (aa 403 F-->L)
      in the variant viruses. When wild-type (wt) LCMV peptides and the three variant
      peptides (GP1, GP2, NP) were synthesized and subjected to a competitive
      inhibition binding assay, no differences in binding affinity for H-2Db were found
      between the wt and variant peptides. Uninfected cells coated with the wt peptide
      were recognized and lysed by the appropriate CTL clone or by in vivo-primed bulk
      CTL, but similar targets coated with the GP1, GP2, or NP variant peptides were
      not. This result, coupled with computer graphic analysis of these variant
      peptides with the recently solved three-dimensional structure for the Db MHC
      class I molecule, placed the side chain of the mutated residues on the outer
      surface of the MHC-peptide complex and accessible to the T cell receptor. Ala
      substitution at GP residue 38 or 282 or at NP 403 also abrogated CTL recognition
      and lysis. Inoculation of any one of the mutated viral variants into mice
      produced an effective CTL response to the other two nonmutated GP or NP peptides,
      suggesting that production of biologically relevant CTL escape virus variants in
      vivo requires selection of mutations in more than one and likely all the CTL
      epitopes, a low probability event.

PMID- 7793079
TI  - Host effects and sequences essential for accumulation of defective interfering
      RNAs of cucumber necrosis and tomato bushy stunt tombusviruses.
AB  - Passage of cucumber necrosis virus (CNV) containing defective interfering (DI)
      RNAs through cucumber plants decreased the accumulation of DI RNAs to
      undetectable levels. Subsequent passages in two Nicotiana species (Nicotiana
      benthamiana or N. clevelandii) resulted in the appearance of DI RNA species that
      were larger than the DI RNAs observed during exclusive serial passages of CNV
      through the Nicotiana species. Sequence analysis of cloned cDNAs corresponding to
      the two DI RNA populations indicated that the smaller CNV-DI RNAs contained the
      four conserved regions (I through IV) of the genome typical of tombusvirus DI
      RNAs, whereas the larger DI RNAs were of similar organization but had a direct
      repeat of the middle portion of the molecule. This result suggests that the host
      has an influence on the type of DI RNA that accumulates during consecutive high
      multiplicity of infection passages. A comparative analysis of deletions targeting
      the individual conserved regions in both CNV and tomato bushy stunt virus (TBSV)
      DI RNAs revealed that only region III was completely dispensable for accumulation
      of either DI RNA species. More refined deletion analyses in regions I and II
      indicated that smaller segments of 75 and 35 nucleotides (nt), respectively,
      could be deleted without abolishing infectivity. The dispensable sequences in
      region II of both TBSV and CNV DI RNAs mapped to the top portion of a putative
      stem-loop structure. These studies indicate that both essential and nonessential
      sequences are conserved in DI RNAs. The essential sequences in regions I, II, and
      IV likely contain important cis-acting elements, whereas nonessential regions
      such as region III may play secondary roles such as optimally spacing cis-acting
      elements or maintaining the DI RNA at an overall size that is stable.

PMID- 7793080
TI  - MHV-A59 enters polarized murine epithelial cells through the apical surface but
      is released basolaterally.
AB  - Coronaviruses have a marked tropism for epithelial cells. Entry and release of
      the porcine transmissible gastroenteritis virus (TGEV) is restricted to apical
      surfaces of polarized epithelial cells, as we have recently shown (J. W. A.
      Rossen, C. P. J. Bekker, W. F. Voorhout, G. J. A. M. Strous, A. van der Ende, and
      P. J. M. Rottier, 1994, J. Virol. 68, 7966-7973). In this paper we analyze the
      interactions of mouse hepatitis coronavirus A59 (MHV-A59) with polarized murine
      kidney cells (mTAL) grown on permeable supports. After inoculation from the
      apical or basolateral side, virus entry was found to take place only through the
      apical membrane. The virus utilized a protein of the carcinoembryonic antigen
      family as its receptor. In contrast to TGEV, MHV-A59 was released preferentially
      from the basolateral plasma membrane domain, as evidenced by the accumulation of
      viral proteins and infectivity in the basolateral culture fluid as well as by
      electron microscopical observations. In the mouse, MHV initially replicates in
      the nasal epithelium before being disseminated throughout the body; the
      basolateral release of MHV from epithelial cells into the animal's circulation
      may be the first step in the establishment of a systemic infection.

PMID- 7793081
TI  - Unclassified poxvirus: characterization and physical mapping of Cotia virus DNA
      and location of a sequence capable of encoding a thymidine kinase.
AB  - DNA from Cotia virus, an unclassified poxvirus, was mapped by overlapping
      fragment analysis using the restriction endonucleases HindIII, PstI, BamHI, XhoI,
      SalI, and SmaI. The linear genome was 177 kbp in length and possessed inverted
      terminal repeats and cross-links. A Cotia virus thymidine kinase (TK) gene was
      detected and mapped to about 74 kbp from the left end of the genome using
      degenerate oligonucleotide probes. Nucleotide sequencing of the TK gene revealed
      an open reading frame (ORF) that encoded a peptide of 178 amino acids. An A/T
      rich sequence, TAA AAA TGA ATA AATA, and a transcription termination signal,
      TTTTTGT, were revealed upstream and just downstream of the ORF, respectively,
      consistent with the characteristic features of an early poxvirus gene. Cotia
      virus resembles swinepox virus based on the restriction profiles generated by
      endonucleases and shares amino acid sequence similarity with orthopox, leporipox,
      Yaba, and fowlpox viruses.

PMID- 7793083
TI  - Quantitative analysis of the binding of turnip crinkle virus coat protein to RNA
      fails to demonstrate binding specificity but reveals a highly cooperative
      assembly interaction.
AB  - An element(s) within a 386-nucleotide segment (TCV-386 RNA) of the turnip crinkle
      virus (TCV) genome was previously implicated in virus assembly nucleation. To
      localize the proposed high-affinity binding determinants, we analyzed the ability
      of the coat protein to bind the full-length and truncated derivatives of the TCV
      386 RNA using gel retardation and nitrocellulose filter retention assays.
      Quantitation of the binding data indicated that the coat protein did not
      preferentially recognize a particular region of the RNA. Moreover, the affinity
      of the coat protein for the TCV-386 RNA [apparent dissociation constant (Kd)
      approximately 0.5 microM) did not appreciably differ from its affinity for other
      comparably sized RNAs tested, including nonviral RNAs. However, the quantitative
      studies also suggested that the coat protein binds RNA in a cooperative manner
      and this was supported by evidence that all of the RNAs examined were bound by
      multiple copies of the coat protein. Based on the number of binding intermediates
      which could be detected in titrations involving RNAs of different chain length,
      it appeared that each coat protein binding unit occupies 35-40 nucleotides. Our
      results demonstrate that encapsidation of TCV RNA results from highly cooperative
      binding of the coat protein on the large viral genome. However, we were not able
      to confirm that assembly is mediated by initiation at a high-affinity binding
      site on the viral RNA.

PMID- 7793082
TI  - The small cysteine-rich protein P14 of beet necrotic yellow vein virus regulates
      accumulation of RNA 2 in cis and coat protein in trans.
AB  - The effect of null mutations of the small cysteine-rich protein P14 encoded by
      RNA 2 of beet necrotic yellow vein virus has been investigated using in vitro
      transcripts of viral RNA to infect Chenopodium quinoa protoplasts. The P14
      mutations down-regulated RNA 2 accumulation by approximately 10- to 50-fold.
      Accumulation of minus-strand RNA 2 was also diminished but RNA 1 accumulation was
      much less affected. The inhibition of RNA 2 accumulation could not be
      complemented in trans by providing P14 from another source (either a second
      molecule of RNA 2 or an RNA 3-based replicon) containing and expressing the P14
      gene. The P14 null mutations dramatically inhibited accumulation of viral coat
      protein, which is encoded by the 5'-proximal gene on RNA 2, but this effect could
      be complemented in trans, indicating that it occurs by a mechanism distinct from
      that affecting RNA 2 accumulation. Transient expression experiments were also
      carried out in which a plasmid expressing P14 and plasmids expressing a reporter
      gene placed downstream of potential translational control sequences (the 5'
      noncoding sequences of RNAs 2, 3, or 4) were introduced into C. quinoa or
      Nicotiana tabacum leaves by microprojectile bombardment. Coexpression of P14
      produced a 3- to 4-fold stimulation of reporter gene expression levels for all
      the constructs. The lack of sequence specificity suggests that this phenomenon is
      not directly related to the RNA 2-specific stimulation of coat protein
      accumulation observed in a viral infection.

PMID- 7793084
TI  - Characterization of putative defective interfering (DI) A/WSN RNAs isolated from
      the lungs of mice protected from an otherwise lethal respiratory infection with
      influenza virus A/WSN (H1N1): a subset of the inoculum DI RNAs.
AB  - Defective interfering (DI) influenza virus A/WSN (H1N1) grown in embryonated eggs
      protected adult mice from a lethal respiratory infection with A/WSN virus.
      Eighteen bands of putative DI RNA, ranging in size from about 230 to 1020 nt,
      were identified in this preparation by reverse transcription and polymerase chain
      reaction using a segment-specific 3' primer and a segment-universal 5' primer.
      Every virion RNA segment was represented by one to four bands of putative DI RNA.
      However, only five bands of putative DI RNA could be isolated, using the same
      conditions, from lungs of WSN-infected mice protected from death by co
      inoculation with egg-grown DI WSN. These five bands originated from PB1, PB2, PA,
      and M virion RNAs and were all about 350-450 nt in length. Four putative DI RNAs
      originating from PB1, PB2, and PA virion RNAs were sequenced, and three were
      identical (including deletion junctions and base substitutions) to putative DI
      RNAs from the inoculum. These data suggest that the mouse lung was highly
      selective for a subset of inoculum DI RNAs and that one or more of these DI RNAs
      was responsible for protection in vivo. All putative DI RNAs had a single
      internal deletion.

PMID- 7793085
TI  - Entry and release of measles virus are polarized in epithelial cells.
AB  - The initial site of virus replication during measles infection is in the
      epithelial cells of the respiratory tract. We have investigated measles virus
      infection of two types of polarized epithelial cells to determine if entry and/or
      release of the virus is confined to either the apical or the basolateral plasma
      membrane. The Caco-2 line of human intestinal epithelial cells and the polarized
      Vero C1008 monkey kidney cell line were grown on permeable supports and
      inoculated either through the apical or basolateral surfaces. Cells exposed to
      virus in the apical medium showed high levels of synthesis of virus-specific
      proteins, whereas no synthesis of viral proteins was detected in cells inoculated
      at the basolateral surface. Virus titers derived from apically infected cells
      were found to be about 1000-fold greater than titers derived from cells infected
      at the basolateral surface. Indirect immunofluorescence results also demonstrated
      that expression of measles viral antigens occurs at high levels only when input
      virions are inoculated at the apical surface. To investigate the localization of
      CD46 and moesin, which are receptors for measles virus, Caco-2 cells were
      incubated with monoclonal antibodies against CD46 or moesin followed by 125I
      labeled anti-mouse Ig. The results indicate that CD46 is expressed preferentially
      on the apical membranes while moesin appears to be present at similar levels on
      both surfaces. Release of the virus was also examined and found to be polarized
      as well. Virus was released into the apical medium at up to 1000-fold higher
      titers than virus released into the basolateral medium. These results demonstrate
      that in two epithelial cell types measles virus preferentially enters and is
      released from epithelial cells in a polarized fashion through the apical plasma
      membrane.

PMID- 7793086
TI  - [Mechanisms of inhibiting production of tumor necrosis factor alpha by the
      synthetic hexapeptide--immunophane].
AB  - The authors examined the human blood mononuclear-induced tumor necrosis factor
      production using the new drug--the synthetic hexapeptide Immunophan. The levels
      of tumor necrosis factor in the supernatant liquid were measured by the enzyme
      immunoassay and the cytotoxic test using L-929 fibroblastoid cells. Following 2-8
      hours of short-term incubation of mononuclear cells with Immunophan, there was a
      reduction in spontaneous or lipopolysaccharide - or ionophore A23187-induced
      production of tumor necrosis factor. As high as 5-20% of plastic-nonadherent
      cells treated with Immunophan in a concentration of 0.25 mu/ml were found to
      produce the same effect. Two-four hours after Immunophan activation, the cells
      produced into the supernatant liquid soluble factors with a molecular weight of
      70-85 kD that suppressed the production and activity of tumor necrosis factor.
      Thus, the modulating effect of Immunophan against tumor necrosis factor
      production is associated with the induction of regulatory cells producing the
      soluble receptors of tumor necrosis factor. It is suggested that extrabody
      pharmacological induction of the cells that regulate the production of tumor
      necrosis factor, followed by their subsequent administration into the autologic
      organism might be used while developing new variants of extracorporeal treatments
      of the diseases which are characterized by the pathogenetically significant
      hyperproduction of the inflammatory cytokins,--tumor necrosis factor, interleukin
      1, interleukin-6.

PMID- 7793088
TI  - [Tissue hypoxia: clinical-biochemical aspects].

PMID- 7793087
TI  - [The effect of application-sorption therapy on dynamics of activity of molecular
      carriers of electrons of the energetic and detoxifying systems of cells in
      experimental burn disease].
AB  - Integral free radical state, paramagnetic enzyme complexes of nonheme iron with
      sulfur- and nitrogen-containing ligands in mitochondria and heme iron in
      microsomes as well as metalloenzymes of blood plasma ceruloplasmin and
      transferrin were studied in dynamics of burn disease in rats. Significant
      decrease in content of reduced ferrosulfur proteins in mitochondrial energy
      system was observed in kidneys within the second day after the burns and in liver
      tissue within the 14-21 days after the failure which correlated with reduction of
      cytochrome P-450 oxidized form. Development of paramagnetic nitrosyl complexes of
      heme and nonheme iron, specific for hypoxia, were detected in the impaired muscle
      tissue. Increase in tissue hypoxia was accompanied by decrease in content of
      transferrin and by elevation in the antioxidant activity of blood plasma.
      Application of local adsorption after early excision of burns crust contributed
      to normalization of both metabolism in the impaired tissues and in activity of
      the electron transport chain in liver and kidney tissues. Therefore, local
      adsorption therapy may be considered as an alternative procedure in sorptional
      detoxication of burns.

PMID- 7793089
TI  - [Effect of natural complexes of biologically active substances on liver
      regeneration in alcohol poisoning].
AB  - Hepatoprotective effect of natural substances obtained from extracts of grape
      combs, leaves of green and black tea were studied in liver tissue of ethanol
      consuming rats by means of evaluation of the neutral lipid fractions and
      phospholipids as well as by measurement of glucose and nicotinamide coenzymes
      NAD+ and NADP in blood. In all the animal groups treated with these vegetable
      extracts content of total phospholipids, decreased after the ethanol treatment,
      was increased, while fraction composition of phospholipids and of neutral lipids
      was normalized; in blood content of glucose, NAD+ and NADP approached to control
      values. These results suggest that the vegetable extracts studied exhibited the
      hepatoprotective effect in alcohol intoxication.

PMID- 7793090
TI  - [Erythrocyte lipids and the gas transport function of blood in acute hemorrhage].
AB  - Alterations of erythrocyte lipid composition were studied during oxygenation of
      the cells in rabbit lesser circulation in simultaneous single massive hemorrhage.
      The state of blood respiratory function was studied in order to evaluate an
      importance of the erythrocyte membranes transformation occurred in lungs during
      gas exchange; for this purpose arteriovenous difference in oxygen and coefficient
      of erythrocyte deoxygenation were evaluated. Increase in content of phosphatidyl
      serine in erythrocytes during blood arterial transformation was shown to
      correlate highly with arteriovenous difference in oxygen. Pathophysiological
      importance of the alterations observed is discussed.

PMID- 7793091
TI  - [Effectiveness of lignin as a protective factor in exposure to polychlorinated
      biphenyls].
AB  - The effect of lignin on some biochemical and morphological parameters was studied
      in rats after short-term treatment with the industrial mixture of polychlorinated
      biphenyls (PCB) sovol at a daily dose of 5 mg/kg, 5 times a week for a fortnight.
      Dietary supplementation of 5% lignin as the drug polyphenane did not protect the
      induction of the rat hepatic P-450 cytochrome monooxygenase system, which is
      typical of the action of PCB, but slightly modified the inducing effect of sovol.
      In the polyphepane-fed animals, there was a decrease in impairments of the liver
      structure and its more rapid normalization than in control rats. The lower
      hepatotoxic effect of the PCB mixture when lignin was added to the ration was
      likely to be associated with the action of lignin as a nonspecific polyvalent
      enterosorbent. It is concluded that polyphepane is a promising protective agent
      on exposure to PCB.

PMID- 7793093
TI  - [The effect of methyluracil polymorphism on lipid and antioxidant composition of
      rat tissues].
AB  - The effect of two methyluracil forms on the composition of lipids, the content of
      peroxidation products and the amount of lipid-soluble scavengers of free radicals
      was studied in rat liver and heart tissues. Both these forms caused an increase
      in content of total lipids in the animal liver tissue 2 hrs after injection,
      whereas beta-form increased 1.6-fold the content of cholesterol esters and 1.9
      fold that of triglycerides in liver tissue, unlike the alpha-form which affected
      these parameters slightly. The effect of methyluracil polymorphic derivatives on
      lipid peroxidation (TBA-positive products) was not detected. The methyluracil
      beta-form, not affecting the total pool of hydrophobic antioxidants, was found to
      decrease the content of active scavengers of free radicals in rat liver and heart
      tissues, as well as beta-form decreased the content of vitamin E in these
      tissues. At the same time, the methyluracil alpha-form did not affect the
      composition of tissue hydrophobic antioxidants. These differences found in the
      effect of two methyluracil forms on lipid composition and lipid-soluble
      scavengers of free radicals may be responsible for biological nonequivalence of
      the drug polymorphic forms.

PMID- 7793092
TI  - [Adaptation of renewal of rat liver proteins to dietary protein with low
      biological value].
AB  - The study of the dynamics of adaptation to the rations containing casein and
      wheat protein showed some accumulation of hepatic protein on days 4-9. Evaluation
      of 14C-Leucine and protein turnover from the kinetics of precursor elimination
      from the pool and that of incorporation into proteins, demonstrated that there
      were no significant differences in the rate of endogenous protein synthesis, and
      the higher protein levels are associated with the lower secretion of these export
      proteins from the liver. In another experiment after adaptation to the casein
      feed, the animals were fed a wheat protein-containing feed, there were no changes
      in protein levels, yet the rate of total liver protein turnover was significantly
      increased on day 5, as shown by massive label estimation and calculation using
      the modified equation. Adaptation to new rations is accompanied by the initial
      accumulation of protein in the liver tissue and the subsequent adaptation to
      proteins of low biological value may be related to increases in the turnover of
      blood proteins exported from liver tissue.

PMID- 7793095
TI  - [The effect of Staphylococcus aureus toxic shock exotoxin on whole blood cell
      chemiluminescence in vitro and in vivo].
AB  - Stimulated and nonstimulated blood chemiluminescence were studied in presence of
      the toxic shock syndrome toxin I (TSST-I) in vivo and in vitro. In vivo
      experiments involved evaluation of rabbit whole blood chemiluminescence developed
      within various periods after the TSST-I intraperitoneal administration. Effect of
      various TSST-I concentrations on blood chemiluminescence was studied in vitro.
      TSST-I was shown to inhibit the nonstimulated chemiluminescence in blood within
      45 min after administration of LD50 of both opsonized zymosan and calcium
      ionophore A 23187 in vivo. Similar effects the toxin exhibited at concentrations
      20 microM and more in vitro. The maximum effect TSST-I demonstrated within the
      first 5 min of incubation and this effect was distinctly dose-dependent.

PMID- 7793094
TI  - [Some biochemical indicators of the cytotoxic response of human fibroblasts
      cultured with natural and synthetic polycations].
AB  - Cationic antiseptics--catamine AB, polysept (polymeric derivative of
      chlorhexidine) as well as cationic protein protamine exhibited a pronounced
      cytotoxic effect on human skin and lung fibroblasts in cell culture. Their effect
      was accompanied by augmentation of lipid peroxidation products and by inhibition
      of DT-diaphorase, LDH, ATPase and glutathione reductase. Introduction of alpha
      tocopherol into the cultural medium normalized the rate of lipid peroxidation but
      did not remove the inhibitory effect on activity of oxidoreductase studied. Blood
      serum proteins immunoglobulins and albumin diminished significantly the cytotoxic
      effect of cationic preparations contributing to restoration of all the parameters
      studied to control values; this phenomenon appears to occur due to nonspecific
      membrane protective and antioxidation effects of the blood serum proteins.

PMID- 7793096
TI  - [Immunoenzyme analysis of ferritin in diagnosing brain tumors].
AB  - A procedure was developed to purify ferritin from the human brain tissue. The
      preparation is a heavy chain of ferritin. The level of ferritin in biological
      fluids was evaluated using the sandwich solid-phase immunoassay. This fraction of
      ferritin was found in the cerebrospinal fluid of patients with brain tumors.
      Content of the ferritin heavy chain in cerebrospinal fluid correlated with the
      rate of brain tissue malignancy.

PMID- 7793098
TI  - [Features of tissue oxygenation in patients with alimentary-constitutional and
      hypothalamic obesity].
AB  - Tissue oxygen consumption was studied in 111 patients with alimentary
      constitutional and hypothalamic obesities. Polarography was used to study oxygen
      tension by means of oxygen and ischemic tests. Great impairments of oxygen
      consumption were found in the tissue of patients with hypothalamic obesity at the
      initial state, while in alimentary-constitutional obesity they increased during
      the oxygen test as the obesity progressed and was characterized by impairments of
      both oxygen supply and consumption, depending on the type of obesity. It is
      recommended to examine initial pO2 in the patients' skin as one of objective
      criteria for differential diagnosis of obesity.

PMID- 7793097
TI  - [Postoperative hypermyoglobinemia. Mechanism of occurrence. Predictive value].
AB  - The time course of free myoglobin content and the rate of lipid peroxidation were
      simultaneously studied in cancer patients. The initial concentrations of
      myoglobin, hydroperoxides and malonic dialdehyde (MDA) were found to be higher
      than the control values, thus suggesting the increased rate of lipid peroxidation
      in these patients, which was responsible for destruction of cell membranes.
      Within the first 24 hours after surgery, there was a drastic release of
      myoglobin, its levels being sometimes higher in case of a complicated
      postoperative period than those in its smooth course. The increase in content of
      MDA was less marked, by reaching its maximum on days 1-2. The postoperative
      levels of hydroperoxides was considerably decreased, yet it began gradually
      increasing on day 2. The rather high correlation coefficients between the content
      of myoglobin and MDA suggest that there is a relationship between
      hypermyoglobinemia and the state of cell membranes. However, surgical
      intervention, enhancing lipid peroxidation, concurrently activates the mechanisms
      aimed at maintaining cell homeostasis.

PMID- 7793099
TI  - [Change in phospholipid composition of synovial fluid in children with various
      types of arthritis].
AB  - Phospholipid composition of synovial fluid was studied in patients with reactive,
      rheumatoid and juvenile chronic forms of arthritis as compared with that of
      normal synovial fluid. The most pronounced alterations of the synovial fluid
      phospholipid composition (additional phospholipid fractions, increase in content
      of lyso-derivatives) were found in the patients with rheumatoid and juvenile
      chronic arthritis, which appear to occur due to activation of endogenous
      phospholipases A2, C and lysophospholipase A1.

PMID- 7793100
TI  - [Study of heat-protective effects of bromantane at various levels of
      overheating].
AB  - The thermoprotective properties of bromantane were studied during overheating.
      Simultaneously with the known effects on heat exchange and sensitivity to high
      temperatures bromantane caused a decrease in ranges of heat tolerance, increased
      the rate of SVTK growth as well as altered protein metabolism and antioxidant
      protection and also affected the autonomic regulation of heat exchange which were
      essential in adaptation. At the same time, during ergothermal loading accompanied
      by any troubles in evaporation and heat exchange, marked thermoprotective
      efficiency of bromantane was compared for its ability to improve muscle
      dynamometry and hemodynamics as compared with control values.

PMID- 7793102
TI  - [Polarized immunofluorescent analysis of the herbicide isoproturon].
AB  - Polarographic fluoroimmunoassay was developed for estimation of residual amounts
      of the herbicide isoproturon . The procedure is simple, accurate, highly
      sensitive and allows 10 preparations to be tested within approximately 7 min; the
      sample volume was 50 microliters and the low limit of the procedure sensitivity
      was about 0.2 micrograms/ml. The polarographic immunoassay may be used in
      screening express controls of isoproturon concentration in the sewage or in
      various extracts from various sources to control the herbicide contamination.

PMID- 7793101
TI  - [Change in the level of prostaglandins E and glutathione-S-transferase in
      leukocytes and plasma of hashish addicts].
AB  - Content of prostaglandins E (PGE) as well as activity of glutathione-S
      transferase (GST) were studied in T lymphocytes, neutrophils and blood plasma of
      patients with hashishism as compared with healthy volunteers. Decrease in content
      of PGE was found in the blood cells studied but not in blood plasma of these
      patients, while distinct decrease of PGE by 40% occurred only in neutrophils.
      However, activity of GST was considerably decreased both in the cell fractions
      and blood plasma by 79-81%. The narcotic appears to affect the immunity system by
      means of the prostaglandin E metabolism impairment, thus suggesting the
      prostaglandin study in various immunity-related cells of the patients with
      narcomania. Besides, glutathione-S-transferase activity proved not to be a
      deciding factor affecting the prostaglandin content in leukocytes and blood
      plasma.

PMID- 7793104
TI  - KOBE declaration--the health paradigm for diabetes mellitus in the 21st century.

PMID- 7793103
TI  - [Production and some properties of covalent conjugates of total histone and
      kanamycin].
AB  - A complex containing total histone and antibiotic kanamycin was produced under
      optimal conditions using glutaric aldehyde. The obtained water-soluble covalently
      bound conjugates of these substances were identified by means of enzyme labelled
      immunoassay and their molecular mass estimated. The validity of new class of
      highly effective drugs, which may be produced basing on the principles studied,
      was substantiated considering that histones exhibit the transport properties and
      are able to augment hematoencephalic barrier permeability.

PMID- 7793105
TI  - Systemic lupus erythematosus, rheumatoid arthritis and HLA phenotypes in
      Jamaicans.
AB  - The HLA phenotypes were investigated in 30 Jamaican patients with Systemic Lupus
      Erythematosus (SLE), 30 with Rheumatoid Arthritis (RA) and 40 healthy controls.
      HLA phenotypes were determined by the microcytoxicity technique, using
      commercially prepared typing trays. In this study, the HLA phenotypic
      associations with SLE (HLA-B14, RR 4.3: HLA-A28, RR 4.3) were not statistically
      significant. However, a statistically significant lack of HLA-A9 (p < 0.01; CP <
      0.1) was observed in SLE patients compared to healthy controls. In RA patients, a
      statistically significant association was noted with HLA-A2 (RR 5.1; CP < 0.01).
      No HLA class II associations were noted with SLE. Class II associations with RA
      did not achieve statistical significance but included those previously
      established in other populations. The preliminary data obtained from this study
      indicate differences in the patterns of HLA phenotypes in Jamaican patients with
      SLE and RA compared to those observed in such patients elsewhere. Further studies
      involving larger groups of patients and typing at the serological, cellular and
      molecular levels are clearly warranted.

PMID- 7793106
TI  - Asymptomatic cardiac involvement in systemic lupus erythematosus.
AB  - Cardiologic and laboratory parameters were studied in 21 patients with systemic
      lupus erythematosus (SLE) with cardiopulmonary symptoms (CPS), 20 SLE patients
      without CPS and 45 age- and sex-matched healthy controls. The most frequent
      cardiac abnormalities in patients with CPS included pericardial effusion (24%),
      ventricular enlargement (20%), mitral regurgitation (19%) and tricuspid
      regurgitation (14%). No structural abnormalities were observed in SLE patients
      without CPS. Mean calculated and derived echocardiographic values in both groups
      of SLE patients differed significantly from those observed in normal controls (p
      < 0.004). Patients with CPS had significantly lower mean values of ejection
      fraction (p < 0.05) and fractional shortening (p < 0.03). However, the
      frequencies of functional abnormalities in patients with CPS did not differ
      significantly from those observed in patients without CPS. There were no
      remarkable laboratory findings in SLE patients with CPS compared to those
      without. The finding that some SLE patients may have functional cardiac
      abnormalities in the absence of CPS is an important one. It raises the question
      as to whether asymptomatic cardiac involvement in SLE is a separate entity or
      whether it heralds symptomatic cardiopulmonary involvement.

PMID- 7793107
TI  - Prevalence of exercise-induced asthma in schoolchildren in Kingston, St. Andrew
      and St. Catherine, Jamaica.
AB  - A cross-sectional study was done, focusing on the prevalence of exercise-induced
      asthma in Jamaica and variables that may account for this rate. No previous study
      of this nature had been undertaken, and the investigators contend that there is a
      need to identify children who suffer from this condition but are unaware of it. A
      sample of 214 students from primary and secondary schools in the Corporate Area
      were chosen and given questionnaires to complete. Eighty-four of the children
      reported a history consistent with that of exercise-induced asthma and were
      further subjected to stress testing for a definitive diagnosis of this condition.
      A prevalence of 20.8% [C.I. +/- 5.35] was identified which reflected a rate
      comparable to that recorded in North America. There was a significantly higher
      prevalence in children of primary school ages, but all other variables considered
      for significance testing to determine associations between these and the
      prevalence of EIA proved not significant. A recommendation has been made for
      opportunity screening by medical practitioners.

PMID- 7793108
TI  - Testosterone deficiency and extreme retardation of puberty in homozygous sickle
      cell disease.
AB  - Homozygous sickle-cell (SS) disease is associated with retardation of physical
      and sexual development but most Jamaican SS children commence their adolescent
      growth spurt before 16 years of age. Analysis of growth data from children in the
      Jamaican Cohort Study noted extreme growth retardation, defined as absence of the
      adolescent growth spurt and pre-pubertal sexual development (Tanner stage 1 or 2)
      at age 16 years, in 8/52 (15%) SS boys. These and two boys from the general
      sickle-cell clinic with a similar growth pattern provided a study group of 10
      boys who were investigated for a possible endocrine explanation for their extreme
      retardation of physical maturation. A sub-optimal testosterone response (< 10
      nmol/l) to human chorionic gonadotrophin and an exaggerated gonadotrophin
      response to gonadotrophin hormone releasing hormone was consistent with poor
      testicular function in 5 boys. Retardation of adolescent growth and development
      is common in boys with SS disease but, when extreme, requires early investigation
      to identify potentially correctable mechanisms.

PMID- 7793110
TI  - Socio-biological associations of bacteriuria in pregnancy.
AB  - The prevalence and socio-biological relations of bacteriuria in Trinidadian
      pregnant women were investigated. The prevalence of bacteriuria was found to be
      16.7% and it was more common in the 30-39 year age group, among parous women,
      among Negroes, and in patients with a low family income and overcrowded living
      conditions. Symptoms were present in 19% of bacteriuric patients and almost one
      third gave a past history of urinary tract infection. Only 10% had been
      previously exposed to sexually transmitted diseases such as syphilis, gonorrhea
      and herpetic genital infections. Because of the serious consequences to mother
      and foetus, we advocate quantitative urine cultures for all antenatal patients,
      especially those coming from disadvantaged socio-economic conditions.

PMID- 7793109
TI  - Glyoxalase I activity in erythrocytes from severely malnourished children.
AB  - The enzyme glyoxalase I (Glyox I) is involved in metabolic detoxification, and
      requires glutathione (GSH) as a cofactor. Given the low concentration of whole
      blood GSH in children with oedematous malnutrition, it is possible that the
      function of this pathway may be compromised in these children. Glyox I activity
      was therefore assayed in erythrocytes taken from 133 severely malnourished
      children and 21 age-matched controls. The mean values (+/- SEM) for the marasmic
      group (Marasmus: 105 +/- 4/u/gm Hb) and the group with kwashiorkor (Kwash: 103 +/
      4/u/gm Hb) were not significantly different from controls (Cont: 104 +/- 2 u/gm
      Hb). In the group with marasmic-kwashiorkor (M-K: 88 +/- 4 u/g Hb) Glyox I
      activity was significantly lower than in controls (p < 0.005), as well as in
      children with Marasmus (p < 0.005), and kwashiorkor (p < 0.05). Enzyme activity
      was lower than normal in 45% of the MK group. Seven children died subsequent to
      admission; in five cases Glyox I activities were exceedingly low. There was a
      weak positive correlation between Glyox I activity and whole blood levels of GSH
      (r = 0.215). We conclude that Glyox I activity is relatively unaffected in
      malnutrition, except in those with M-K and especially those who do not survive
      the acutely malnourished state.

PMID- 7793111
TI  - "Religio Medici" 1994.

PMID- 7793112
TI  - Acute carpal tunnel syndrome secondary to thrombosis of a persistent median
      artery.
AB  - An unusual case of thrombosis of a persistent median artery as a cause of acute
      carpal tunnel syndrome is reported. The sudden onset of numbness in the median
      nerve distribution and pain in the fingers were the main symptoms. The embryonic
      development of the median nerve vascular supply and the reported incidence of
      persistent median artery are reviewed.

PMID- 7793116
TI  - The influence of arginine-vasopressin on stool output and gastrointestinal
      transit time in healthy volunteers.
AB  - OBJECTIVE: It was asked whether continuous infusion of arginine-vasopressin (AVP)
      could decrease stool output and gastrointestinal transit time in healthy
      volunteers. DESIGN: Randomised single blind cross-over-design. SUBJECTS: 5
      healthy male volunteers. INTERVENTIONS: Continuous s.c. infusion of AVP (7.5
      micrograms/d) for one week vs. 0.9% NaCl-solution (placebo). Some days before the
      experiment started, the volunteers underwent a two-day-thirsting-period (< 500
      ml/day). MEASUREMENTS: AVP-levels in serum, urine output, AVP-urine-excretion,
      stool frequency, stool weight, colonic transit time. RESULTS: As compared to
      saline infusion both serum-levels of AVP and AVP-excretion in urine were about
      four times higher during AVP-infusion whereas they were doubled during thirsting.
      Accordingly urine output was lower when AVP-levels were high. Parameters of
      colonic motility did not differ significantly (stool frequency 6.8 +/- 0.8/week
      for placebo vs. 6.8 +/- 0.5/week during AVP, stool weight 200.3 +/- 25.0 g/d vs.
      210.6 +/- 21.1 gld, total colonic transit 22.9 +/- 7.0 hours vs. 25.7 +/- 5.8
      hours). CONCLUSION: 1. AVP is well absorbed when applied subcutaneously. 2. AVP
      in the dosage given has no major influence on stool output and gastrointestinal
      transit time in healthy volunteers.

PMID- 7793114
TI  - Congenital solitary non-parasitic cyst of the liver.
AB  - Although non-parasitic cysts of the liver have often been described in adults,
      solitary non-parasitic cysts are rare in infants. We report a 17-month-old child
      with a large hepatic cyst.

PMID- 7793113
TI  - Tropical spastic paraparesis occurring in HTLV-1 associated infective dermatitis.
      Report of two cases.
AB  - An association between HTLV-1 infection and infective dermatitis (ID) a relapsing
      eczematous condition of Jamaican children, was reported in 1990. These patients
      are at risk of developing other known HTLV-1 related diseases. We have observed
      the development of HTLV-1 associated myelopathy/tropical spastic paraparesis in
      two patients, ages 14 and 35 years, who were diagnosed with ID at ages 2 and 10
      years, respectively. Infective dermatitis of children serves as an early marker
      of HTLV-I infection and may predict later development of either the malignant
      outcome, adult T-cell leukaemia/lymphoma or the neurologic manifestation HAM/TSP
      among adult carriers of HTLV-1 infection.

PMID- 7793115
TI  - Attitudes of medical students toward the acquired immune deficiency syndrome
      (AIDS).
AB  - Several studies have reported negative attitudes toward AIDS patients,
      homosexuals and drug abusers among physicians, nurses, and health workers in
      training. To examine attitudes towards AIDS of a group who in the near future
      would be practising physicians in the Caribbean, medical students at the Cave
      Hill Campus of the University of the West Indies were surveyed regarding their
      attitudes toward AIDS. This paper analyses responses to 21 Attitude Items with
      reference to five primary areas related to AIDS: Testing for HIV, Homosexuality,
      Fear of Contagion, Comfort in Interacting with AIDS Patients, and Intention to
      care for Persons with AIDS. The analysis indicates that these students were all
      not comfortable with issues related to homosexuality, and there was wide
      variation and some inconsistency in opinions regarding controversial and
      contentious issues. Most of these students, regardless of their choice of
      specialty after graduating, will eventually come into contact with an HIV
      positive individual or an AIDS patient. There is a distinct possibility that
      biases and misperceptions held during the period of training are at risk of being
      carried over into clinical practice, resulting in unwillingness, or even refusal,
      to treat certain types of patients. What has also become evident is that emphasis
      should be placed on ethical and attitudinal training within the Faculty of
      Medical Sciences. Our future doctors have to be trained to effectively manage the
      many psycho-social, ethical, and legal problems that will be generated by the
      AIDS epidemic. What is urgently needed, therefore, is relevant curriculum design
      and development in the area of AIDS Education directed at the region's future
      physicians.

PMID- 7793118
TI  - Helicobacter pylori eradication in the treatment and differential diagnosis of
      giant folds in the corpus and fundus of the stomach.
AB  - In an earlier study, we were able to show that giant fold gastritis is probably a
      special form of Helicobacter pylori-associated gastritis. Proof of this
      contention, however--namely regression of the giant folds following eradication
      of the organism--in a large number of patients was not then possible. To rectify
      this, Helicobacter pylori (HP) eradication treatment with omeprazole and
      amoxicillin was applied to 47 patients with HP gastritis and giant folds (5
      patients with giant folds localized in the anterior or posterior wall, 42
      patients with generalised giant folds within the corpus and fundus). The results
      of treatment were investigated by endoscopy and histology at the earliest 4 weeks
      after termination of treatment. In 40 of the 47 patients (85.1%), HP eradication
      treatment was successful. In 7 patients in whom treatment was unsuccessful,
      follow-up examinations revealed no changes in the endoscopic or histological
      findings. In 2 out of 3 patients in whom the endoscopic findings were unchanged
      despite successful HP eradication, biopsy material revealed the cause of the
      giant folds to be a signet ring cell carcinoma; in the remaining patient the
      cause of giant fold persistence was unclear. In 36 patients, the endoscopic-
      findings normalised completely, while in one patient there was obvious regression
      of the giant folds. We conclude from this study that giant fold gastritis is
      indeed a special form of HP gastritis, and that eradicating the organism in
      patients with gastric giant folds may help to distinguish between inflammatory,
      hyperplastic and tumorous giant folds.

PMID- 7793117
TI  - Relative risks of age, gender, nationality, smoking, and Helicobacter-pylori
      infection in duodenal and gastric ulcer and interactions.
AB  - A logistic regression model was applied to assess risk factors and diagnostic
      predictors in duodenal and gastric ulcer, as well as in unspecific changes of
      gastric mucosa. In the latter group smoking, epigastric distress, and pain were
      associated with elevated relative risks. In the gastric ulcer model, increased
      odds were found for age, German nationality, smoking, and low and high urease
      activity of antral mucosa. This holds for duodenal ulcer, too; however
      interactions between complaints, urease activity, and nationality must be
      considered. In each case odds depend from the composition of the control group.
      Therapeutic implications have been considered.

PMID- 7793119
TI  - [Laser lithotripsy of refractory bile duct calculi after failure of
      extracorporeal shock wave treatment].
AB  - After failure of extracorporeal shockwave lithotripsy (ESWL) the benefit of
      further nonsurgical methods for treatment of difficult bile duct stones is
      undetermined. Endoscopic laserlithotripsy is a promising procedure providing
      target application of high energy levels. METHOD: Twenty patients (median age: 81
      [67-91] years) were referred for laserlithotripsy of 1-8 (median, 2) difficult
      bile duct stones after failure of 1-4 (median, 3) ESWL sessions. The median
      diameter of each of the largest stone was 22 (10-48) mm. The laser used was a
      pulsed rhodamine laser (wavelength: 594 nm) with an automatic cut-out system upon
      no stone contact. The laser fiber was positioned by means of ERCP under
      fluoroscopic control or by use of mini-cholangio-scopes. Laserlithotripsy was
      cholangioscopically performed via the percutaneous transhepatic route in 8
      patients because of retrogradely inaccessible bile ducts (n = 5) or because
      further ERCP was refused (n = 3). All procedures were carried out under
      intravenous sedation and/or analgesia. RESULTS: Laser lithotripsy and complete
      removal of fragments was achieved in 19 of the 20 patients after application of
      70-25700 (median, 3310) pulses in 1.2 sessions per patient. Median duration of a
      single session was 70 (15-140) minutes. The procedure failed in one patient with
      an impacted stone at the cystic duct confluence. Cholangitis could be
      conservatively managed in 2 cases. No further complication was observed. The 30
      day mortality rate was 0 %. CONCLUSION: Endoscopic laserlithotripsy is an
      effective, a rapid and safe procedure for bile duct stones even after failure of
      ESWL. The results compare favorably with open surgery, particularly in view of an
      increased risk in a group of elderly patients.

PMID- 7793120
TI  - Malabsorption associated with a high-grade-malignant non-Hodgkin's lymphoma,
      alpha-heavy-chain disease and immunoproliferative small intestinal disease.
AB  - We report on a 28 year old Turkish woman, who was admitted to our hospital with
      the symptoms of malabsorption and protein-loosing enteropathy. Histologically, on
      duodenal biopsy, a lymphoplasmacellular infiltration of the submucosa with
      partial to subtotal atrophy of the villi was found. An immunoproliferative small
      intestinal disease (IPSID) was diagnosed. A short remission whilst on a
      glutenfree diet and tetracycline therapy, was followed by a laparatomy because of
      ileus in the small intestine. A high-grade-malignant Non-Hodgkin's Lymphome of B
      cell type with intracellular production of alpha-Heavy-Chains (AHCD) was
      diagnosed histologically. Following chemotherapy with CEOP-IMVP-Dexa
      (Cyclophosphamide, Epidoxorubicin, Vincristine, Prednisolone, Ifosfamide, VP-16,
      Dexamethason, Methotrexat) the patient is still in complete remission three years
      after starting the therapy. We discuss here a case of AHCD in IPSID, the
      differential diagnosis of protein losing enteropathy and malabsorption, and we
      also present conservative (diet, medical treatment) and operative therapies.

PMID- 7793122
TI  - [Neuroimmune interactions in the gastrointestinal tract].
AB  - The enteric nervous system and immune system are integrated systems that play an
      important role in the regulation of gastrointestinal functions. Recent studies
      suggest a bidirectional interaction between both systems. The relationship is
      based on the synthesis and release of neuropeptides from immune cells and the
      receptor-mediated alteration of nervous and immune functions by neurotransmitters
      and inflammatory mediators. The activity of the enteric nervous and immune system
      can be modulated by the central nervous system. These psycho-neuro-immuno
      interactions are involved in gut inflammation, in functional bowel diseases and
      in the physiological control of gastrointestinal functions.

PMID- 7793123
TI  - [Insulin promotor factor I (IPF-I) is an essential factor during development of
      the pancreas].

PMID- 7793124
TI  - [Gene transfer in the gallbladder].

PMID- 7793121
TI  - [Nonobstructive mesenteric ischemia--a diagnostic problem in internal intensive
      care].
AB  - Four cases of acute gut ischemia in elderly patients due to non-occlusive disease
      (NOD) are presented. Bowel necrosis occurred after episodes of hypotension in the
      course of myocardial infarction, arrhythmias and sepsis. Symptoms and clinical
      findings were blurred by the underlying extraintestinal disease. Angiography
      showed coexistent atherosclerosis but no occlusion of the major celiac and
      mesenteric vessels. At laparotomy (three cases) or autopsy (one case) extensive
      small and large bowel necroses were detected. Early laparotomy (possibly preceded
      by laparoscopy) is recommended for patients with suspected acute gut ischemia
      even if angiography fails to reveal occlusion of the large splanchnic arteries.

PMID- 7793125
TI  - 6th Workshop for experimental and clinical liver transplantation and hepatoloy.
      Wilsede, 18-20 May 1995. Abstracts.

PMID- 7793126
TI  - Priming and induction of anti-rotavirus antibody response by synthetic peptides
      derived from VP7 and VP4.
AB  - Synthetic peptides derived from bovine rotavirus C-486 (BRV) outer capsid (VP7
      and VP4) and inner capsid (VP6) proteins were tested to evaluate their ability to
      prime and induce an anti-rotavirus antibody response. Peptides corresponding to
      the amino acid residues 232-255 of VP4 (VP4-peptide), 275-295 of VP7 (VP7
      peptide) and 40-60 of VP6 (VP6-peptide) of BRV were chemically synthesized. These
      peptides were coupled to carrier proteins (either keyhole limpet haemocyanin
      (KLH) or recombinant rotavirus inner capsid protein-VP6 assembled into virus-like
      particles (VP6-carrier) were used as carrier to link the synthetic peptides under
      study), and the resulting conjugates were used to immunize rotavirus seronegative
      mice. An enzyme-linked immunosorbent assay (ELISA) was used to determine anti
      peptide and anti-rotavirus antibody titres in serum samples collected after
      immunization. All peptides were immunogenic in mice and induced the production of
      anti-peptide antibodies, but with the exception of VP6-peptide they were not able
      to induce anti-rotavirus antibodies as measured by ELISA. Western blot analysis
      indicated that antibodies against each peptide were able to react with the
      respective authentic viral proteins of various rotavirus serotypes. To determine
      if a peptide-primed animal would respond to native viral proteins, animals were
      subsequently injected with purified BRV. A rapid and high anti-rotavirus antibody
      titre, in addition to a rise in anti-peptide antibody titre, was observed in
      peptide-primed mice. Furthermore, the sera obtained from these mice neutralized
      the virus under in vitro conditions. The significance of these results in
      relation to a potential rotavirus synthetic peptide-based vaccine is discussed.

PMID- 7793127
TI  - Mechanism of enhancement of the immune responses to influenza vaccine with
      cholera toxin B subunit and a trace amount of holotoxin.
AB  - Cholera toxin B subunit (CTB) (1 microgram) and a trace amount of cholera toxin
      (CT) (0.1-10 ng), when inoculated intranasally into Balb/c mice together with
      influenza vaccine, induced synergistically a greater delayed-type
      hypersensitivity (DTH) response to the vaccine than did a trace amount of CT
      alone. In parallel with the in vivo response, normal peritoneal macrophages that
      were incubated in vitro with the vaccine and the CT-containing CTB, induced a
      higher adenylate cyclase activity and a greater ability to transfer DTH response
      into naive recipient mice than did the macrophages incubated with the vaccine and
      CT. The treatment of macrophages with the vaccine and CTB failed to induce either
      adenylate cyclase or DTH response. From these results, the mechanism by which CTB
      and a trace amount of CT enhance immune responses synergistically could be
      explained by the enhancement of the CT action on macrophages or by the efficient
      binding of a trace amount of CT to antigen-presenting cells in the presence of a
      relatively large amount of CTB, resulting in enhanced cyclic AMP formation
      followed by enhanced antigen presentation.

PMID- 7793128
TI  - An inactivated vaccine based on a glycoprotein E-negative strain of bovine
      herpesvirus 1 induces protective immunity and allows serological differentiation.
AB  - The bovine herpesvirus 1 (BHV1) strain Za is a conventionally attenuated strain
      with a 2.7 kb deletion that encompasses the complete coding region for
      glycoprotein E (gE). This gE-negative strain was used as whole-virus antigen in
      an inactivated virus vaccine. Three different antigen concentrations of this
      vaccine were evaluated for safety and efficacy in a vaccination-challenge
      experiment in calves. No adverse effects were observed in any of the calves
      vaccinated with the gE-negative vaccines. Calves given the vaccine with the
      highest antigen concentration were adequately protected against challenge;
      clinical symptoms were virtually absent and challenge virus shedding was
      significantly reduced as compared with unvaccinated calves. We developed a
      sensitive blocking enzyme-linked immunosorbent assay (ELISA) to detect antibodies
      against gE. After vaccination, calves did not produce antibodies against gE, but
      these antibodies were detectable within 2 weeks after challenge both in
      vaccinated and in unvaccinated calves. These results demonstrate the efficacy of
      a gE-negative inactivated BHV1 vaccine and the detectability of antibodies
      against gE after infection. The combined use of the marker vaccine and the gE
      blocking ELISA makes it possible to differentiate between vaccinated animals and
      infected animals. This possibility may be very useful in BHV1 control programmes.

PMID- 7793129
TI  - Eimeria maxima gametocyte antigens: potential use in a subunit maternal vaccine
      against coccidiosis in chickens.
AB  - Affinity-purified gametocyte antigens (APGA) from Eimeria maxima, emulsified in
      Freund's adjuvant, were injected intramuscularly into breeding hens on two or
      three occasions. As a result, progeny of the immunized hens were partially immune
      to infection with E. maxima, Eimeria tenella and Eimeria acervulina (with a
      reduction in total oocyst output of 45-63% as compared with progeny of untreated
      hens). Thus, APGA in Freund's adjuvant appears to have great potential as part of
      a maternally applied vaccine against coccidiosis. The ability of APGA to induce
      partial cross-species protection is most probably due to the existence of
      conserved epitopes in the different species as indicated by comparative Western
      blots of E. maxima and E. tenella. Surprisingly, Freund's adjuvant by itself also
      induced significant levels of maternal immunity to coccidiosis (with a 12-35%
      reduction in oocyst output in the progeny). In contrast to the purified antigens
      or Freund's alone, crude extracts from gametocytes as well as other developmental
      stages, induced little if any significant maternal immunity despite provoking the
      production of large amounts of parasite-specific IgG, including antibodies to
      APGA. This result indicates that a successful maternal vaccine against
      coccidiosis requires, in addition to good recognition of protective antigens, the
      exclusion of irrelevant antigens from the vaccine preparation.

PMID- 7793130
TI  - Does the HIV-1 manipulate immune network via gp120 immunoglobulin-like domain
      involving V3 loop?
AB  - According to the multiple criteria used, the consensus sequences of HIV-1 gp120
      and immunoglobulin heavy chain variable segment, which is more than 40 amino
      acids long, show structural similarities. We assume that this gp120 sequence
      might encode idiotopes. If this is the case then the particular idiotope-bearing
      gp120, either soluble or expressed in multiple form on the surface of the
      infected cell, can influence the immune response in idiotype(Id)-anti-Id fashion.
      This might be the mechanism by which HIV induces immunological abnormalities and
      it should be taken into consideration in vaccine production as suggested by the
      authors previously.

PMID- 7793131
TI  - Detection of Newcastle disease virus in poultry vaccines using the polymerase
      chain reaction and direct sequencing of amplified cDNA.
AB  - In order to develop an in vitro method for the control of poultry vaccines for
      identity and the absence of extraneous agents, reverse transcription-polymerase
      chain reaction (RT-PCR) was applied for the detection of Newcastle disease virus
      (NDV). NDV vaccines were employed for the establishment of the method, using two
      primer pairs spanning the cleavage site of the F0 fusion protein coding sequence.
      Amplification of a specific cDNA segment was possible from live and inactivated,
      oil-adjuvanted NDV vaccines without prior treatment. The cDNA was characterized
      by restriction endonuclease digestion as well as by direct nucleotide sequencing.
      The RT-PCR was able to detect between 5 x 10(2) EID50 (in live vaccine
      preparations) and 10(5) EID50 or 0.056 haemagglutinating units of NDV (in
      inactivated vaccine preparations). In addition, live vaccine preparations were
      inactivated with beta-propiolactone (beta-PL). Amplified cDNA was obtained after
      treatment with 0.1% beta-PL, whereas at a concentration of 1% or 10% no specific
      bands were visible in the agarose gel. These results demonstrate the
      applicability of the method for the control of poultry vaccines for identity and
      for the absence of extraneous agents, and additionally allow a rapid
      characterization of the respective NDV strain.

PMID- 7793132
TI  - Influenza immunization policies in Europe and the United States.
AB  - Influenza vaccination policies of 28 European countries were compared with those
      of the US Immunization Practices Advisory Committee. Twenty-four of 28 (86%)
      European countries had immunization policies for influenza. European and US
      recommendations were in complete agreement concerning immunization of those with
      heart and lung disease. Within Europe there was 81-86% agreement concerning
      immunization of the elderly, irrespective of their health status, and patients
      with diabetes, renal dysfunction and immunosuppression, and 71% agreement
      concerning those in residential care and occupational groups that can transmit
      influenza to high-risk patients. Unlike the US, 62-71% of European countries did
      not target those with haemoglobinopathies, children and teenagers taking
      salicylates or household members of  those at high risk. Few recommendations were
      endorsed by relevant medical or patient organizations. The observed variation in
      vaccination policies in Europe and North America possibly reflect uncertainties
      concerning risks from influenza and benefits from vaccination, and differences in
      public health systems and attitudes towards preventive medicine.

PMID- 7793133
TI  - Characterization of measles viruses isolated after measles vaccination.
AB  - Seven measles virus (MV) strains were isolated from children who developed
      clinical signs of fever and rash 3-9 days after measles vaccination. The
      nucleotide sequence of the H gene, the molecular size of the H protein, the
      haemadsorption activity on African green monkey red blood cells, and antigenicity
      as determined by virus neutralization revealed that one strain was of the vaccine
      type and the remaining six were the wild virus type. Isolation of the virus
      directly from patients suspected of a vaccine-induced side-reaction and
      subsequent characterization of such isolated virus may be useful in
      differentiation between vaccine-induced side-reactions and natural measles.

PMID- 7793134
TI  - A reduced dose approach to hepatitis B vaccination for low-risk newborns and
      preschool children.
AB  - The effectiveness of a 2.5 micrograms dose of the hepatitis B vaccine (B-Hepavac
      II) was compared with that of 5 micrograms in 587 low-risk neonates and 777
      preschool children of age 3-8 years. The vaccines were administered at months 0,
      1 and 3, with postvaccination serology tested at months 4 and 12. The
      seroconversion rates of the 2.5 microgram recipients (newborn: 93.5%; preschool
      children: 97.4%) are comparable with the 5 micrograms group (newborn: 95.7%;
      preschool children: 98.7%). The seroconversion rates of the newborns are,
      however, significantly lower in the 2.5 micrograms group if positive response is
      taken as a titre > 10 IU l-1, instead of > 0 IU l-1. The older children, on the
      other hand, achieved a higher seroconversion rate and geometric mean titre (GMT)
      when compared with the newborns. irrespective of the dose received.

PMID- 7793135
TI  - Influenza immunization for HIV-infected persons in Los Angeles.
AB  - We assessed the use of influenza vaccine in a cohort of HIV-infected patients
      during 1991 and 1992 in Los Angeles County. Influenza vaccination status and
      clinical and demographic data were obtained from medical records in three
      different outpatient clinics: a health maintenance organization (HMO), a public
      clinic and a private medical group. The overall proportion of patients immunized
      with influenza vaccine was 28%. Patients receiving medical care at the HMO were
      more likely to receive influenza vaccine (45%) than were patients at the public
      clinic (25%) or the private facility (13%). Higher immunization levels were also
      observed among patients with greater numbers of clinic visits for both years
      studied (p < 0.001). After we controlled for the number of outpatient visits,
      patients at the HMO and the public clinic were still more likely to receive
      influenza vaccine in both 1991 (adjusted relative risks 3.2 and 2.1,
      respectively) and 1992 (adjusted relative risks 1.7 and 1.8) compared with
      private clinic patients. Health-care providers should increase efforts to provide
      influenza vaccine to HIV-infected patients.

PMID- 7793136
TI  - The effect of Escherichia coli J5 and modified live Salmonella dublin vaccines in
      artificially reared neonatal calves.
AB  - One thousand neonatal calves, allocated in a factorial design into four groups,
      were vaccinated subcutaneously with two doses each of either killed Escherichia
      coli (0111:B4) J5 bacterin or a UC Davis modified live, genetically altered (aro
      ) Salmonella dublin vaccine, or both, or with a placebo. In this prospective
      double-blind study to determine the immunogenicity and protective effects of both
      vaccines on bovine neonates in field conditions, calves were observed daily until
      2 months of age, and serum samples from selected study calves were obtained at
      five different time points. No clinical adverse vaccine reactions were observed.
      Overall mortality was 7.5% (75 of 1000), E. coli and S. dublin infection being
      the most commonly associated aetiological agents of deaths. Both J5 (p < 0.01)
      and Salmonella (p = 0.05) vaccines were significantly effective in reducing the
      mortality rate but without an additive effect. The role of passive transfer was
      important in calf survival. The E. coli J5 and (aro-) S. dublin vaccination
      schedule employed significantly (p < 0.001) elevated J5 and Salmonella-specific
      serum ELISA antibody titres, respectively, by the sixth week of age.

PMID- 7793137
TI  - Formulation of the purified fusion protein of respiratory syncytial virus with
      the saponin QS-21 induces protective immune responses in Balb/c mice that are
      similar to those generated by experimental infection.
AB  - The feasibility of employing a vaccine composed of the purified fraction 21 of
      Quillaja saponaria (QS-21) and the fusion (F) protein of respiratory syncytial
      virus (RSV) to induce protective immune responses in the lower respiratory tract
      of Balb/c mice was examined. Our goal was to compare local and systemic immune
      responses with those induced following immunization with the protein adsorbed to
      aluminium hydroxide (F/ALOH) adjuvant or by experimental infection. Sera from
      mice vaccinated with the QS-21 formulation (F/QS-21) contained elevated anti-F
      protein IgG antibody titres that were dependent on the dose of QS-21 employed.
      Similar to the immune responses generated by experimental infection, the sera
      from mice vaccinated with F/QS-21 possessed greater capacity to neutralize virus
      infectivity that was associated with the generation of heightened complement
      fixing IgG2a antibody titres. In contrast, vaccination with F/ALOH elicited
      systemic immune responses that were characterized by a predominance of protein
      specific antibodies of the IgG1 subclass and lower neutralizing antibody titres.
      The capacity of F/QS-21 to facilitate local pulmonary immune responses was also
      examined and found to be similar to those induced by experimental infection.
      After virus challenge, a 90-fold increase in the number of F protein-specific
      antibody-secreting cells was observed and associated with the clearance of virus
      from the infected lungs. Moreover, elevated levels of antigen-dependent killer
      cell activity were detected and appeared to be mediated by class I major
      histocompatibility complex restricted CD8+ T cells. Additional characterization
      of the pulmonary immune response was performed on the cellular infiltrates
      obtained after bronchoalveolar lavage and on formalin-fixed lung tissue. The
      local protective immune responses induced after challenge of the groups immunized
      with F/QS-21 or infectious virus were significantly different from those elicited
      in naive control mice injected with adjuvant alone, or in mice immunized with
      F/ALOH. The cellularity of the lavage fluids from the former groups was
      characterized by a significantly greater percentage of lymphocytes and less
      neutrophils. In similar fashion histological evaluation of the lungs from mice
      immunized with F/QS-21 or infectious virus revealed significantly elevated local
      immune responses after challenge. In conclusion, the results suggest that
      formulation with F/QS-21 alters the qualitative and quantitative nature of the
      immune response to the F glycoprotein when compared with the traditional
      aluminium-based adjuvants.

PMID- 7793139
TI  - Stimulation of rotavirus IgA, IgG and neutralising antibodies in baboon milk by
      parenteral vaccination.
AB  - A rhesus rotavirus vaccine adjuvanted with ISCOMs was injected intramuscularly to
      5 pregnant baboons, with repeated doses 1-2 and 14 weeks after delivery. Maternal
      blood and milk samples and blood samples from their babies were collected at 2
      weekly intervals until 26 weeks after parturition. Samples were assayed for
      rotavirus antibodies by ELISAs and neutralisation tests. Vaccination produced
      statistically significant increases in maternal serum IgG and neutralising
      antibodies, and in milk IgA, IgG, and neutralising antibodies. Control baboon
      mothers sampled from 12 weeks after delivery had lower serum and milk antibody
      titres, but responded to vaccination at 16 weeks by producing a similar antibody
      profile in serum and milk to those previously vaccinated. Because of the endemic
      nature of human rotaviral infections, similar maternal vaccinations have
      potential as a means of increasing milk antibodies to a level at which they may
      be protective to infants.

PMID- 7793138
TI  - Construction of Neisseria meningitidis strains carrying multiple chromosomal
      copies of the porA gene for use in the production of a multivalent outer membrane
      vesicle vaccine.
AB  - Starting with Neisseria meningitidis strain H44/76, a set of strains was
      constructed for use in production of a multivalent outer membrane vesicle
      vaccine. The aim was to remove unwanted outer membrane components and at the same
      time to improve the range of protection. This was accomplished through
      transformation with plasmid constructs made in Escherichia coli and their
      homologous recombination into the meningococcal chromosome. Deletion of the cps
      locus resulted in loss of expression of the group B capsular polysaccharide as
      well as the lacto-N-neotetraose structure in lipopolysaccharide. Deletion of the
      porB gene abolished expression of the class 3 outer membrane protein. Additional
      copies of the porA gene, encoding the immunodominant class 1 outer membrane
      protein, were inserted into one of the opa genes and into the rmpM gene encoding
      the class 4 outer membrane protein. This construction was done with three sets of
      porA alleles, resulting in three trivalent strains, each of which expressed a
      different combination of class 1 epitopes.

PMID- 7793140
TI  - Current approaches to the development of vaccines against disease caused by
      respiratory syncytial virus (RSV) and parainfluenza virus (PIV). A meeting report
      of the WHO Programme for Vaccine Development.
AB  - The paramyxoviruses respiratory syncytial virus (RSV) and parainfluenza virus
      type 3 (PIV3) are the two most common agents of severe lower respiratory tract
      disease in infants and children throughout the world. RSV causes yearly epidemics
      of bronchiolitis and pneumonia in infants and young children, while PIV3 is a
      common cause of bronchiolitis, pneumonia and croup. Together these two agents
      account for up to 30% of all hospitalizations of infants and young children for
      respiratory tract disease. A licensed vaccine is not currently available for
      either of these viruses. Development of vaccines against diseases caused by RSV
      and PIV3 is one of the priorities of the Global Programme for Vaccines (GPV). On
      27 March 1994, GPV sponsored a workshop in Nyon, Switzerland, to review the
      status of vaccine development for these pathogens and to explore new methods of
      immunization that might be applied to the prevention of diseases caused by RSV
      and PIV. Furthermore, the World Health Organization (WHO) wished to assess
      progress in the development of methodologies to rescue infectious virus from cDNA
      clones of RSV and PIV3. This technology, when developed, will be extremely
      valuable in developing new vaccine candidates and in unravelling the genetic
      basis of attenuation of existing vaccines. This paper summarizes the findings
      presented at this one-day meeting.

PMID- 7793142
TI  - [Subclavian vein thrombosis: epidemiologic data of the PHLEKO (phlebothrombosis
      conservative treatment) Study].
AB  - This is a report of 91 cases of subclavian vein thrombosis. The data are derived
      from the PHLECO-study (Phlebothrombosis-Conservative treatment) which is a
      multicenter investigation on the fate of 2088 deep vein thromboses as diagnosed
      by phlebography. In this cohort the subclavian vein thrombosis incidence was
      recorded at 4.36%. The interval between first symptoms and hospital admission
      lasted 3.90 days. The average patient's age was 46.3 years. The genders were
      evenly distributed. The causes of subclavian vein thromboses were in 29.7%
      traumatic (effort thrombosis, catheter manipulation), in 31.9% symptomatic
      (accompanying other diseases), and in 38.4% idiopathic (cause unknown).
      Fibrinolytic therapy was carried out in 49.4% of the cases, the remainder
      received anticoagulants. Patients with acute subclavian vein thrombosis and
      conservative treatment (no fibrinolytic therapy) stayed for 18.8 days in the
      hospital. No instances of pulmonary embolism, either fatal or non-fatal, were
      recorded.

PMID- 7793144
TI  - Vascular injuries in Sweden 1986-1990: the result of an enquiry.
AB  - In order to review the management of vascular trauma in Sweden all surgical and
      orthopedic departments were asked to report retrospectively vascular injuries
      occurring between 1986 and 1990. There were 294 injuries reported from 55
      departments. The majority (approximately 80%) of the injuries were confined to
      the extremities. In the arms the injuries of the vessels were mostly simple,
      whereas in the legs they were more complex and correct treatment demanded
      extensive experience in vascular surgery. No less than 20% of the injuries were
      iatrogenic and half of them required reconstructive surgery. 55% of the
      iatrogenic injuries occurred during angiological examinations and treatments.
      Complex vascular injuries are often combined with fractures and soft tissue
      damage and required close cooperation between vascular and orthopedic surgeons.
      Advanced angiological examinations and treatments should only be performed in
      hospitals with vascular surgery facilities.

PMID- 7793141
TI  - Guidelines for therapeutic studies in Fontaine's stages II-IV peripheral arterial
      occlusive disease. German Society of Angiology.

PMID- 7793143
TI  - The incidence of postoperative deep vein thrombosis in vascular procedures.
      FINNVASC Study Group.
AB  - This survey aimed to estimate the rate of deep venous thrombosis (DVT) in an
      unselected population treated for peripheral vascular diseases. The study
      comprised 7533 patients on the nationwide Finnish vascular registry (FINNVASC)
      during two-years study period. Thirty-four (0.45%) patients were reported to have
      a postoperative thrombosis. Thirty-two (94%) of these had undergone vascular
      procedures involving the infrarenal aorta or arteries in the lower extremities.
      There was no difference in the occurrence of determinants (diabetes, hypertension
      etc.) when the group with postoperative DVT was compared to the rest of the
      patients on the registry. The procedures involving the lower extremity seem to
      carry a higher risk of postoperative DVT. In this type of surgery special
      attention should be focused on DVT prophylaxis.

PMID- 7793145
TI  - [The diagnostic value of angioscopy in venous thrombectomy].
AB  - Since 1983 angioscopy was applied as a control method in 187 venous
      thrombectomies to improve the treatment of acute iliofemoral thrombosis. In a
      retrospective study we tried to show the impact of angioscopy intraoperatively
      and the influence on long-term results. Thrombectomy was performed in 97 patients
      affected at three levels, in 50 cases with pelvic-femoral, in 35 with pelvic and
      in 43 with femoro-tibial thrombosis. The average clinical age of the thrombosis
      was 5 days, 66% of the patients (age 39 years) were female. The endoscopic
      findings were compared with phlebological results after one year using a
      phleboscore between 0 points (occlusion) and 5 points (normal). The
      phlebographies were analyzed so that the functional status of the vein was
      represented. After venous thrombectomy 42.8% of the cases were endoscopically
      classified complete but in 57.2% residual clots were observed. It was possible to
      completely (24.6%) or partly (18.7%) remove these clots by further thrombectomy
      maneuvers, non removable remnants were found in 7.5% and a venous spur in 6.4%.
      The statistical analysis with Kruskal-Wallace test showed significant differences
      in venous morphology between the endoscopically complete thrombectomies and those
      with residual clots. After a follow-up period of 30 months (12-64) the clinical
      results were very good. In 58% we observed normal findings, a cvi grade I in 35%,
      grade II in 4%. Crural ulcers had developed in only 3%. From our data we conclude
      that endoscopy is an excellent method for intraoperative quality-control in
      venous thrombectomy.

PMID- 7793146
TI  - [Metabolic effects of intermittent exercise by patients with stage II arterial
      occlusive disease].
AB  - During intermittent exercise lasting six minutes with two minutes' rest the
      fluctuations in arterial and venous blood of lactate, pyruvate and blood gases as
      well as changes in the lactate pyruvate ratio were studied in eleven patients
      with intermittent claudication. There were significant differences of O2
      extraction during intermittent exercise. The level of arterial lactate did not
      vary significantly. The highest venous lactate was found during the rest period.
      Significant differences in venous lactate, pyruvate and lactate pyruvate ratio
      were found between the first and second exercise periods. It is assumed that the
      rate of glycolysis is reduced during intermittent exercise.

PMID- 7793147
TI  - [Reactive hyperemia after arterial occlusion: comparison of infrared
      telethermography and laser Doppler flowmetry].
AB  - Before, during and after arterial occlusion we measured Laser-Doppler Flux (LDF)
      and skin temperature using Infrared-Thermographie (IRT) in 40 healthy adults (20
      female, 20 male). In the region of the hypothenar eminence of the left hand LDF
      and skin temperature showed significantly higher values in male compared with
      female subjects prior to occlusion (p < 0.01 resp. p < 0.05). After arterial
      occlusion for 120 seconds LDF showed a significant overshoot of 71.3% (+/- 39.5%)
      above baseline. During this phase of hyperemia skin temperature rose from 33.5 to
      34.8 degrees C (p < 0.0001). This reaction was similar in men and in women.
      Changes in skin temperature were slower and more prolonged compared with the
      rapid changes of LDF. The absolute temperatures were significantly higher when we
      used IRT compared with temperatures measured by resistance thermometry. Both
      methods showed a close correlation (p < 0.0001, r = 0.891). Using the IRT
      technique a large number of skin temperatures can be measured simultaneously and
      temperature changes can be detected and visualized by colour thermograms.
      Postocclusive cutaneous hyperemia induces similar responses in LDF parameters and
      in skin temperatures. IRT therefore could be used as an additional tool for the
      assessment of physiological and pathological functions of the cutaneous
      microcirculation.

PMID- 7793148
TI  - Neutrophil-derived adhesion molecules in human digital ischaemia and reperfusion.
AB  - In order to see whether leucocyte-derived adhesion molecules are involved in
      ischaemia and reperfusion, the total and differential leucocyte counts and
      expression of the LFA complex i.e. CD11a/CD18 (LFA-1), CD11b/CD18 (Mac-1) and
      CD11c/CD18 (p 150,95) were monitored before and after standard cold and heat
      tests in 8 females with Raynaud's Disease and 8 matched controls. All patients
      suffered from vasoconstriction during the cold test which, compared with
      controls, was associated with fewer granulocytes expressing significantly more
      CD11b/CD18 (Mac-1) integrin and a significant degree of neutropenia persisting
      during reperfusion. Leucocyte-endothelial adhesive interactions may therefore
      occur during ischaemia and reperfusion.

PMID- 7793149
TI  - [Reconstruction of brain-supplying arteries with bilateral monitoring by
      transcranial Doppler ultrasound--new aspects for technical surgical procedures].
AB  - From January to June 1994 reconstruction of 61 internal carotid arteries (ICA)
      with cerebral monitoring using bilateral transcranial Doppler sonography in the
      Clinic of Vascular Surgery Charite was performed. Recording of the maximal mean
      blood flow velocity in both middle cerebral arteries (MCA) was performed
      intraoperatively. After clamping of ICA flow velocity in the ipsilateral MCA
      decreased immediately but recovered within short time in 60% of our patients
      (Vmean > 25 cm/s). Based on the reaction of the contralateral MCA 3 types were
      differentiated: 1) Vmean of the contralateral side changed contrary to the
      ipsilateral side (compensation, "scissors type"). 2) The contralateral side did
      not react ("indifferent type"). 3) The contralateral side changed parallel to the
      ipsilateral side ("parallel type"). In 62% of our patients the operative strategy
      was influenced by transcranial Doppler monitoring: in 35% of cases the operative
      reconstruction was performed without intraluminal shunting, in 19% of cases the
      position of the intraluminal shunt was corrected, in 8% of cases the blood
      pressure was increased. Doppler signals due to emboli were registered in 43% of
      our patients. These patients did not show any new neurologic signs and symptoms.
      In one patient who developed a neurological deficit during the postoperative
      phase, emboli signals were recorded during a period of 30 minutes. Bilateral
      transcranial Doppler monitoring, especially in patients with contralateral high
      grade stenoses or occlusions of the ICA, is a useful method for intraoperative
      cerebral monitoring. We recommend its application on a wide scale.

PMID- 7793150
TI  - [Cerebral oximetry by infrared spectroscopy in comparison with continuous
      measurement of oxygen saturation of the jugular vein bulb in interventions of the
      internal carotid artery].
AB  - OBJECTIVE: Monitoring the central nervous system during carotid endarterectomy
      plays an important role in detection of cerebral ischemia. With optical
      spectroscopy in the near-infrared light range it is now possible to measure
      regional cerebral oxygen saturation (rSO2) noninvasively. Numerous studies
      emphasize the importance of cerebral oxygen balance rather than absolute values
      of cerebral blood flow or metabolic rate. In this study data from oxygen
      saturation measured in the jugular bulb (SJO2) were compared to rSO2. METHODS: 10
      patients undergoing elective carotid end-arterectomy were enrolled after written
      informed consent and approval by the local ethics committee. rSO2 data were
      measured by cerebral spectroscopy (INVOS 3100, Somanetics, Michigan/USA). To
      avoid lesions of the internal carotid artery, a 4-F oxymetry catheter (OPTICATH,
      Abbot GmbH, Wiesbaden) was placed in the jugular bulb by retrograde approach
      after preparation by the surgeon. Anaesthesia and mechanical ventilation were
      standardised. RESULTS: After cross-clamping of the internal carotid artery rSO2
      significantly decreased (60.5 +/- 3.5%) compared to baseline (66.0 +/- 1.4%).
      After declamping rSO2 increased significantly (63.0 +/- 4.2%) and was close to
      baseline at the end of operation (65.0 +/- 2.8%). The SJO2 time course showed
      good correlation compared to rSO2 data (r = 0.85). After cross-clamping SJO2
      decreased significantly (51.5 +/- 6.3%) in comparison to baseline (59.5 +/-
      4.9%). Declamping increased SJO2 to 59.5 +/- 6.3%. No changes in latencies or
      amplitudes of SEP were observed throughout the operation. CONCLUSIONS:
      Noninvasive cerebral optical spectroscopy is a useful tool to determine the brain
      tissue oxygenation. The positive correlation to jugular bulb oxygen saturation is
      somewhat unexpected as rSO2 evaluates regional while SJO2 measures global oxygen
      content. However our results suggests that both methods are able to detect
      episodes of cerebral ischemia during carotid endarterectomy. The interpretation
      of the changes of cerebral oxygen saturation with respect to neurological outcome
      warrants further studies.

PMID- 7793151
TI  - [Determination of the degree of stenosis of the internal carotid artery in the
      surgical specimen after eversion TEA: comparison with angiography and c-w-Doppler
      ultrasound].
AB  - 22 carotid specimens following eversion-endarterectomy were compared with
      preoperative assessment of carotid stenosis obtained angiographically and by c-w
      Doppler-sonography. The intact, unsplit specimens were perfused with a liquid
      plastic material (Palavit M). After hardening of the plastic material the
      specimens were removed. The local degree of carotid stenosis with respect to
      diameter reduction was assessed by direct measurement of the plastic specimens at
      the narrowest site compared with the diameter of the carotid eversion specimens
      at the place of the maximum stenosis. The distal degree of carotid stenosis was
      assessed by comparison of the diameter of the distal internal carotid artery
      obtained intraoperatively with the measurements of the plastic specimens (1 mm
      vascular wall thickness of distal internal carotid artery was taken into
      account). RESULTS: Both the local and the distal degree of carotid stenosis
      diameter (mean 84.7% +/- 8.4% and 82.1% +/- 9.1% respectively) were
      underestimated in the preoperative angiogram (79.8 +/- 9% by ECST-criteria and 69
      +/- 10.3% by NASCET-criteria) in most of the cases. The difference of the
      diameter reduction was statistically significant (p < 0.05 and p < 0.01
      respectively, Wilcoxon signed rank test). The c-w-Doppler assessments were 82.6
      +/- 8.2% (n.s.). CONCLUSION: Our results suggest that the preoperative assessment
      of internal carotid stenosis obtained angiographically or by c-w-Doppler
      sonography easily underestimate the true degree of carotid stenosis.

PMID- 7793152
TI  - [Experimental aortic aneurysm with endovascular technique].
AB  - We created a simple experimental aneurysm by a minimal operative trauma
      performing the balloon-dilatation and the rupture of the abdominal aorta of
      animals. The aorta of minipigs was dilated under angiographic control until the
      rupture became visible. The abdominal aorta and its branches were mapped out and
      measured. The angiographics were calculated using a planimetric device. The
      dilatation of the aorta was increased up to 3.5 times the initial diameter when
      rupture occurred. The microscopical examination showed lesions in all three
      layers of the vessel only at the rupture site and some focal lesions of the
      tunica intima. This one-step procedure of producing an experimental aneurysm is
      done using a low operative trauma and allows testing of endovascular systems
      using only one anaesthetic.

PMID- 7793154
TI  - Fibromuscular dysplasia causing atypical coarctation of the thoracic aorta:
      histological presentation of a case.
AB  - The authors report a case of atypical coarctation of the thoracic aorta
      discovered by chance in a 37-year-old man, victim of a car accident. The
      angiogram revealed a "string-of-beads" contour in the coarctate area while the
      left subclavian artery presented a severe stenosis at its origin. Vascular
      checkup examination failed to identify any additional vascular anomaly. The
      patient underwent surgical resection, with a Dacron prosthetic bypass.
      Histological study of the specimen removed, showed a typical perimedial and
      extensive medial types of fibromuscular dysplasia (FMD) of the aorta.
      Pathogenesis of this disease is discussed.

PMID- 7793153
TI  - [Media sclerosis: a case of pseudohypertension].
AB  - A 51-year-old diabetic showed symptoms of a hypertensive crisis with a systolic
      blood pressure above 300 mmHg. The antihypertensive therapy failed and the
      Doppler-pressure values were also too high for all limb arteries. Duplex
      sonography and soft-x-ray examination showed a mediasclerosis of arms and legs.
      The true pressure, measured at the still compressable arteries of the fingers was
      relatively low. There was symptomatic improvement after completion of the
      antihypertensive therapy.

PMID- 7793155
TI  - Diagnosis of acute aortic occlusion by computer tomography.
AB  - We present a case of acute aortic occlusion, which was diagnosed immediately with
      CT. Since a prompt diagnosis is essential we recommend contrast enhanced CT as a
      quick procedure to confirm diagnosis and to exclude dissecting thoracic aneurysm
      and genuine abdominal aneurysm.

PMID- 7793157
TI  - [Combination therapy in chronic polyarthritis].
AB  - Long-term effects of disease-modifying antirheumatic drugs are not at all
      satisfactory. Therefore combinations of different substances have long been
      studied. But no convincing recommendations could be derived from those results.
      Some combinations seem to be more effective than the single substances, but often
      have more side-effects. First of all, those types of rheumatoid arthritis must be
      defined which require an aggressive therapy. These may profit from combinations
      with sulfasalazine, methotrexate or azathioprine. But such questions may only be
      answered by long-term studies which can be statistically evaluated.

PMID- 7793158
TI  - [Innervation of the sacroiliac joint of the human].
AB  - The innervation of the human sacroiliacal joint was investigated on adult
      cadaveric specimens devoted for routine dissection courses, and on fetuses
      obtained from therapeutic abortions. Gross anatomical and microscopic dissection,
      histology of dissected nerves, and histological and immunocytochemical approaches
      were used. Innervation of the iliosacral joint is provided by fine nerve branches
      derived exclusively from dorsal rami of spinal nerves S1-S4. No branches could be
      detected from the plexus sacralis and obturator nerve coursing over the ventral
      aspect of the joint. Nerves were distributed to superficial and deep dorsal
      sacroiliac ligaments, and to the sacrotuberous and sacrospinous ligaments. Dorsal
      spinal rami continued their course laterally, sandwiched between superficial and
      deep portions of sacroiliac ligaments, piercing the origin of the glutaeus
      maximus muscle. Histological examination of dissected nerves demonstrated
      numerous thick myelinated, besides thin myelinated and unmyelinated nerve fibers
      compatible with a broad repertoire of sensory receptors including encapsulated
      mechanoreceptors. Histological and immunocytochemical studies on fetal iliosacral
      joints showed neurofilament positive nerve fibers only in dorsal portions. This
      innervation pattern may provide explanations for various patterns of
      pseudoradicular and referred pain in affections of the sacroiliac joint.

PMID- 7793156
TI  - [Experimental therapy of rheumatoid arthritis with cytokine antagonists].
AB  - Although the etiology of rheumatoid arthritis is still unknown, our knowledge of
      pathophysiologic mechanisms in this disease has markedly increased. Especially
      the immunological characterization of cells involved in the inflammatory process
      and their secretory products (cytokines) allowed new experimental therapeutic
      approaches. Apparently, the cytokines TNF alpha, IL-1, and IL-6, predominantly
      produced by accessory cells, play an important role in the actual articular and
      extraarticular inflammation. Therefore, several pilot studies employed various
      methods to inhibit the effects of these proinflammatory cytokines. This paper
      provides an overview about initial results of these studies and an outlook with
      regard to future developments.

PMID- 7793159
TI  - [Osteopoikilosis--skin and joint manifestations].
AB  - Osteopoikilosis (Osteopathia condensans disseminata) is a rare and usually
      asymptomatic sclerosing bone dysplasia of unknown origin. Familial clustering
      suggests a dominant inheritance. The observation of a 47-year-old woman lead to
      differential diagnostic considerations in view of the literature on about 350
      cases. For 2 years the patient has been complaining about pain and stiffness of
      both hands with swelling of the fingers. Additionally, she remarked about
      bilateral paresthesias corresponding to the sensory innervation of the median
      nerve. Clinical examination revealed a sensory carpal tunnel syndrome and mild
      synovitis of the proximal interphalangeal joints with skin induration and limited
      flexion of the fingers. In addition, some finger and toe nails showed pitting and
      most fingers had scar-like linear skin alterations. Radiologic findings showed
      symmetric, well-defined, homogeneous sclerosing areas in spongy bone. The
      combination of symmetrical sclerosing bone densities, hereditary character, and
      associated skin and joint manifestations suggests the existence of a general
      connective tissue disease.

PMID- 7793160
TI  - [Modern pathogenetically-oriented therapeutic methods for chronic polyarthritis-
      New World symphony or only an intermezzo?].

PMID- 7793162
TI  - [Women live longer].

PMID- 7793161
TI  - [Use of cyclosporin A in chronic polyarthritis and other rheumatic diseases].
AB  - Cyclosporin A (CyA), a well-established drug in human transplantation for more
      than 10 years, has been used as an experimental treatment in autoimmune diseases
      increasingly since 1985. Its efficacy in rheumatoid arthritis (RA) and
      psoriasis/psoriatic arthritis has been demonstrated in numerous placebo
      controlled studies. In RA is seems to be equal to azathioprine and D
      penicillamine. CyA may also be of considerable benefit in other systemic diseases
      like polymyositis and primary biliary cirrhosis. The risk of side-effects, mainly
      nephrotoxicity has led to dosage guidelines, including a starting dose between
      2.5 and 3.5 mg/kg/day and an upper dose limit of 5 mg/kg as well as dose
      reduction if serum creatinine is persistently raised by more than 30% of pre
      treatment values. In the future, CyA may be an ideal partner for drug
      combinations because of its well-defined mechanism of action (inhibition of
      lymphokine-, especially interleukin-2-production) and possibly the low-dose
      sufficient for efficacy in combination. Studies relating to this are on-going.

PMID- 7793163
TI  - [Hormone substitution in climacteric. Position of the German Menopause Society].

PMID- 7793164
TI  - [The age limit in surgical geriatric gynecology].
AB  - From 1970 to 1989, 2880 gynecologic surgeries were performed on women aged 80
      years and over in Berlin (West). During the period of observation, the operations
      increased continuously in number. There were 418 in 1970 to 1974; 542 in 1975 to
      1979; 777 in 1980 to 1984, and 1143 procedures in 1985 to 1989. This rise can be
      seen in all groups of diseases. 151 postoperative deaths were reported (5.2%).
      However, this figure represents an incorrect "hospital-mortality". The number of
      postoperative deaths decreased despite the increase in surgical procedures: 44
      women in 1970 to 1974 (10.5%); 36 women in 1975 to 1979 (6.6%); 44 women in 1980
      to 1984 (5.7%); 27 women in 1985 to 1989 (2.4%). This demonstrates that advanced
      age is no contraindication to an otherwise indicated gynecologic surgery. Our
      findings support the clinical use of an age limit of 80 years for the examination
      of problems of "gynecologic surgery in the geriatric patient". This age limit
      serves for the general work-up of a quantitatively representative material.

PMID- 7793165
TI  - [Biochemical prognostic factors of ovarian carcinoma].
AB  - In therapy decision and monitoring of ovarian cancer clinicians use clinical and
      histomorphological criteria. Thus, intensive research in tumor biology of ovarian
      cancer leads to the development of biochemical parameters and a deeper
      understanding of proliferation and metastasis in-vitro testing of anticancer
      drugs is one way to achieve a dynamic model to tumor growth. The expression of
      the erb B oncogene family, especially erb-B-2, is an important finding for the
      estimation of the potential of an ovary tumor to grow at metastatic sites. The
      erb B oncogenes encode membrane-growth-factor-receptors functioning in signal
      transduction for cell growth stimulation. In several studies disease-free
      survival of advanced ovarian carcinoma was significantly related to the extent of
      erb-B-2 amplification and/or over-expression. High erb-B-2 expression in the
      tumor at time of primary treatment indicated a positive second-look-laparotomy.
      New experimental approaches for alternative therapies use erb-B-2 as the target
      for interference of tumor cell proliferation.

PMID- 7793166
TI  - [Lymphohistiocytic infiltration of endometrial adenocarcinoma].
AB  - Mononuclear cells adjacent to endometrial adenocarcinoma were evaluated in 8
      biopsies by the immunoperoxidase technique. Between benign and malignant tissue a
      remarkable infiltration of CD45+, CD3+, CD4+, CD8+, and CD14+ cells could be
      observed. B cells (CD19) and NK cells (CD57) were rare. Tumor-infiltrating
      lymphocytes were only sparsely distributed. The findings suggest a cellular, yet
      ineffective, immune reaction of the host against the tumor at the borderline
      between benign and malignant tissue.

PMID- 7793167
TI  - [The prognostic value of cathepsin D concentration in cytosol of primary breast
      carcinoma].
AB  - The concentration of total cathepsin D in tumor cytosol was measured in 300
      patients with primary breast cancer treated at the Women's University Hospital in
      Wurzburg between 10/86 and 9/92. Patients were followed for a median of 28
      months. The level of cathepsin D was correlated with estrogen receptor status and
      tumor size but seemed to be independent of progesterone receptor status,
      histological grading, patient's age, axillary lymph node involvement and primary
      distant metastases. Overall survival, disease-free survival and metastases-free
      survival did not differ between patients with cathepsin D-levels above the median
      value of 47 pmol/mg of protein and patients with cathepsin D-concentration below
      47 pmol/mg. Patients with node-negative disease and low cathepsin D-levels (< or
      = 47 pmol/mg) had a longer disease-free survival than those with cathepsin D
      concentration > 47 pmol/mg (p < 0.05). Our findings could not confirm cathepsin D
      as a useful additional prognostic marker in all breast cancer patients. In the
      low-risk collective the measurement of total cathepsin D may be significant by
      isolating subgroups with a poorer prognosis who might benefit from adjuvant
      therapy.

PMID- 7793168
TI  - [Norplant and its side effects].
AB  - Norplant is a subcutaneous contraceptive with levonorgestrel. From March to
      October 1993. Norplant was implanted in 58 women and its side effects were
      observed for a period of six months. No pregnancy occurred during the study
      period. Almost all the women experienced irregular menstruations or amenorrhea.
      The most frequent side effect was weight gain in 21 women (36.2%) followed by
      headache (13.7%), hair loss (8.6%) and emotional changes (8.6%). However, they
      were usually mild and 86.2% of the women showed complete satisfaction at the end
      of study. Norplant was removed in 6 women for its side effects. Younger women
      appeared to tolerated better than older women. There was a significant
      relationship between the frequency of side effects with Norplant and those with
      previous use of birth control pills.

PMID- 7793169
TI  - [Comparison of dinoprostone gel and gemeprost suppositories for induction of
      abortion in the second and third trimester].
AB  - The results of the cervical priming with a Dinoprost-containing gel and a
      Gemeprost-containing vaginal suppository were compared in 68 patients, who
      required termination of pregnancy beyond 14 weeks because of a severe maternal
      disease or a fetal abnormality. The priming consisted of either an intracervical
      application of Dinoprost (500 micrograms) in a tylose-gel in 6-8 hour intervals
      or a retrocervical application of Gemeprost (1 mg) as a vaginal suppository in 12
      hour intervals. Although no significant parameter variances were found in the
      selected patient groups, abortion was induced in 75% of cases within 24 hours, in
      89% within 36 hours using Gemeprost. Mean induction time for Gemeprost was 19.5
      hours. Using Dinoprost only 19% of patients had an abortion within 24 hours (44%
      within 36 hours, respectively), mean induction time was significantly longer
      (38.8 hours, p < 0.005). These differences remained unchanged, when patients who
      had a prior caesarean section were not evaluated. Using Gemeprost the additional
      systemic administration of Sulprost was necessary in 21% of cases, using
      Dinoprost, in 50% of cases. Severe complications did not occur and minor side
      effects such as nausea or vomiting were observed in single cases. These results
      demonstrate that Gemeprost can be used in cervical priming even after 14 weeks of
      pregnancy and that the longer application interval of 12 hours results in a
      reduction of side effects without a decrease in efficacy.

PMID- 7793170
TI  - [Determination of postpartum fructosamine for assessment of gestational diabetes-
      a suitable method?].
AB  - Postpartal screening of undetected gestational diabetes has proven to be
      difficult. Rapid decrease in diabetogenic hormones and normalisation of the
      former delayed insulin-response make it difficult to detect disturbed glucose
      tolerance in the puerperium. Therefore, glycolysated serum proteins offer the
      opportunity for retrospective diagnosis. They allow an evaluation of the
      patient's carbohydrate metabolism, retrospectively over several weeks. In this
      context, we were most interested in the significance of fructosamine. In a
      prospective study covering 12 months, 123 patients with several risk factors for
      gestational diabetes underwent a 100 g glucose tolerance test in the puerperium.
      Furthermore, we measured fructosamine and glycolysated hemoglobin. A carbohydrate
      intolerance could be detected by the oral glucose tolerance test in 22.7%. In
      12.2% of the cases, glycolysated hemoglobin was found to be higher than 5.5%.
      Fructosamine levels were normal for all patients, with a mean value of 1.84
      mmol/l. Even though fructosamine concentration was significantly higher (p <
      0.05) in patients with a pathologic glucose tolerance, our study showed the oral
      glucose tolerance test to be better to detect unknown gestational diabetes than
      measurement of serum fructosamine.

PMID- 7793171
TI  - [Sactosalpinx after previous hysterectomy--removal using surgical laparoscopy].
AB  - Six consecutive patients with sactosalpinx after preceding hysterectomy were
      treated by laparoscopic surgery and the outcome was analysed. Irrespective of
      extensive intraabdominal adhesions the operation could be completed by
      laparoscopy and the sactosalpinx was successfully removed in all cases. No
      complications were observed. Operative laparoscopy may be an adequate procedure
      to remove a sactosalpinx after antecedent hysterectomy.

PMID- 7793172
TI  - [Hematometra after hysteroscopic endometrium ablation--a case report].
AB  - 13 months after a hysteroscopic endometrial ablation a haematometra was diagnosed
      in a 44 year-old women as a source of recurrent pelvic pain. The cause of the
      haematometra was a complete obliteration of the ostium cervicae internum. This
      long-term complication of the endometrial ablation shows that all patients should
      have a regular clinical and sonographical follow up after endometrial ablation.

PMID- 7793173
TI  - Evaluation of a companion animal program on a continuing care psychiatric unit.

PMID- 7793174
TI  - The golden years? Myths and realities.

PMID- 7793175
TI  - Sexuality in the elderly: what is the health professional's role?

PMID- 7793176
TI  - Is hearing screening needed for all admissions to a stroke rehabilitation unit?

PMID- 7793177
TI  - Butyrylcholinesterase variants and the new methods of molecular biology.

PMID- 7793178
TI  - Identification of human plasma cholinesterase variants using molecular biological
      techniques.
AB  - Genetic variation is one of several factors determining the level and quality of
      plasma cholinesterase activity (butyrylcholinesterase, BChE). The many genetic
      variants known today, and the resulting large number of genotypes and phenotypes,
      have complicated the problem of identifying individual BChE genotypes and
      phenotypes on the basis of enzymatic analyses alone. Modern molecular biological
      techniques have, however, permitted the development of diagnostic tests which
      allow BChE variants to be identified at the DNA level. Today, at least 20 genetic
      variants have been identified in this way. This review is an introduction to the
      principles of molecular biology used to identify the variants forms of the BCHE
      gene.

PMID- 7793179
TI  - Plasma cholinesterase and abnormal reaction to succinylcholine: twenty years'
      experience with the Danish Cholinesterase Research Unit.
AB  - For more than 20 years, the Danish Cholinesterase Research Unit (DCRU) has
      collected information about patients showing an abnormal response to
      succinylcholine. The purpose of this study was, on the basis of the 20 years'
      experiences with the Unit, to evaluate our clinical findings in patients referred
      because of prolonged response following succinylcholine. Also, we wanted to
      evaluate the results of our prospective controlled studies of the effect of
      succinylcholine in patients with normal and abnormal plasma cholinesterase
      genotypes. An explanation for the apparent abnormal response to succinylcholine
      was found in 61.1% of the 1,247 patients referred to the Unit. Of the 1,247
      patients, 28.5% were genotypically normal and 46.5% had an abnormal genotype. In
      the remaining 24.9% of the patients, the genotype could not be established. The
      time to sufficient recovery of neuromuscular function following succinylcholine
      1.0-1.5 mg kg-1 was 15-30 min in patients heterozygous for one abnormal gene, 35
      45 min in patients heterozygous for two abnormal genes and 90-180 min in patients
      homozygous for the atypical gene. Patients with two newly discovered genotypes
      (AK (5 patients) and AH (1 patient) showed slightly prolonged (20 min) and
      markedly prolonged (90 min) duration of action of succinylcholine, respectively.
      Our results indicate that it is a problem for many anaesthetists to correctly
      diagnose a prolonged response to succinylcholine. We therefore urge the
      anaesthetist always to use a peripheral nerve stimulator when faced with a case
      of apparent abnormal response to succinylcholine.

PMID- 7793180
TI  - Identification of human plasma cholinesterase variants in 6,688 individuals using
      biochemical analysis.
AB  - In 1973, a Cholinesterase Research Unit was established in Denmark (DCRU). The
      primary aim was to provide a central service for determining genotypes and
      activity of plasma cholinesterase (BChE) in patients showing abnormal response
      after succinylcholine. The purpose of the present study was, on the basis of 20
      years experience with this Unit, to establish accurate reference intervals for
      BChE activity and inhibition values for the different genotypes of BChE. Also we
      wanted to evaluate the influence of age and sex on the BChE activity in
      genotypically normal patients. Plasma cholinesterase activity was measured using
      benzoylcholine as substrate. The genetic variations of the enzyme were identified
      using differential inhibitors, i.e.: Dibucaine, Sodium Fluoride, Succinylcholine,
      Urea and Ro-2-0683. We investigated 6,688 patients. The reference values for the
      13 genotypes represented agree with previous findings. In genotypically normal
      patients, no age or sex differences were found in BChE activity in children below
      the age of 10 years. From the age of 10 years the activity decreased
      significantly in both males and females, the activity in females being
      significantly lower than in males. In females the activity was lowest in the age
      group 30-40 years, returning to prepuberty level at about 60 years of age. In
      males the activity decreased slightly up to 50-60 years of age. Hereafter the
      activity was stable or tended to increase slightly. Most genotypes could be
      recognized using the results of the different inhibition studies. We found the
      inhibitors Dibucaine, Sodium fluoride, Urea and Ro-2-0683 most helpful, whereas
      succinylcholine was of less value.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793182
TI  - Topical ketamine inhibits albumin extravasation in chemical peritonitis in rats.
AB  - BACKGROUND: As ketamine has local anaesthetic actions and local anaesthetics are
      known to have anti-inflammatory effects, ketamine could be expected to be an anti
      inflammatory agent. Here we sought to determine whether ketamine is indeed anti
      inflammatory in chemical peritonitis induced by HCl in rats. METHODS: Peritonitis
      was elicited by applying 0.02 M HCl on the surface of the cecum or appendix and
      quantified by measuring the extravasation of intravenously injected Evan's Blue
      bound to albumin extracted from those tissues. Three experimental sets were
      performed. In the first set, four groups of 10 rats each received: 1%, 2%, and 4%
      ketamine and 1% lidocaine. In the same animal, before induction of peritonitis
      one area was topically pre-treated with 0.9% saline (control site) and another
      area was topically pre-treated with 1%, 2% or 4% ketamine or 1% lidocaine
      (experimental site). In the second set, two groups of 10 rats each received: 2%
      ketamine or 1% lidocaine. Ten min after the induction of peritonitis, the control
      site was topically treated with 0.9% saline, while the experimental site was
      treated with 2% ketamine or 1% lidocaine. In the third set 20 rats, divided into
      two groups, were pre-treated either with 2% S(+)ketamine or 2% R(-)ketamine
      before the induction of peritonitis instead of the previously employed racemic
      version of the drug. RESULTS: Treatment of the cecum or appendix areas with
      ketamine or lidocaine before the induction of peritonitis decreased the
      extravasation of Evan's Blue-albumin from 5.7 +/- 0.7 micrograms/100 mg tissue to
      4.5 +/- 0.8, N.S. with 1% ketamine; from 5.9 +/- 0.8 to 4.1 +/- 0.7, P < 0.01
      with 2% ketamine; from 4.8 +/- 0.7 to 3.5 +/- 0.6, P < 0.05 with 4% ketamine and
      from 5.9 +/- 0.6 to 3.6 +/- 0.8, P < 0.01 with 1% lidocaine. Treatment of the
      areas of peritonitis with 2% ketamine or 1% lidocaine decreased the extravasation
      of Evan's Blue-albumin from 5.6 +/- 0.5 micrograms/100 mg tissue to 4.4 +/- 0.6,
      P < 0.05 and from 6.0 +/- 0.8 to 5.0 +/- 0.7, P < 0.01. Administration of the
      isomer S(+)ketamine to colonic areas before the induction of peritonitis reduced
      the extravasation of Evan's Blue-albumin from 6.5 +/- 0.7 micrograms/100 mg
      tissue to 4.1 +/- 0.6, P < 0.01; while the isomer R(-)ketamine was inactive.
      CONCLUSIONS: These results indicate that topically applied ketamine inhibited the
      development of chemical peritonitis. This action of racemic ketamine was due to
      the isomer S(+)ketamine.

PMID- 7793184
TI  - Comparison of the recovery characteristics of midazolam, alone or antagonised
      with flumazenil, and thiopental in ASA III-IV patients.
AB  - Sixty non-premedicated male patients, physically ASA III-IV, 50-80 years of age,
      undergoing translumbar aorthography, were randomly allocated into three groups.
      Group A received midazolam (0.13 mg.kg-1), group B received thiopental (4 mg.kg
      1), and group C midazolam (0.13 mg.kg-1) combined with flumazenil (6
      micrograms.kg-1) at the end of the operation. Three minutes before the
      anaesthesia began, fentanyl (1.5 micrograms.kg-1) was administered to all the
      patients. An evaluation was made of the time they took to open their eyes
      spontaneously, of time-space orientation, comprehension-collaboration,
      hypnosedation, psychomotor performance and memory. In groups "C" and "B"
      spontaneous opening of the eyes took place before that of group "A". The recovery
      of orientation, comprehension and hypnosedation was fastest with thiopental, next
      with midazolam combined with flumazenil, and later with midazolam. Psychomotor
      performance in Trieger test was impaired for a shorter period with thiopental
      than in the other two groups. Recovery in group "C" was incomplete within the
      time, with the result that resedation was detected in 20% of the subjects.

PMID- 7793183
TI  - How are haemodynamic and metabolic responses to haemorrhage influenced by
      segmental thoracic and thoracolumbar epidural analgesia? An experimental study in
      dogs.
AB  - To determine the effects of the spread of sympathetic blockade administered prior
      to haemorrhage on haemodynamic and metabolic responses to haemorrhage, we
      compared these responses among dogs treated by segmental thoracic epidural
      analgesia, thoracolumbar epidural analgesia and general anaesthesia. Group 1 of
      six dogs received 0.2% halothane plus epidural analgesia ranging from C4 to T5,
      group 2 of seven 0.2% halothane plus epidural analgesia ranging from C5 to L7,
      and group 3 of eight 0.9% (1 MAC) halothane anaesthesia. A volume of 35 ml.kg-1
      was bled over 30 min. The haemodynamic, metabolic and catecholamine variables
      were measured repeatedly at 30-min intervals for 2.5 h. The mean arterial
      pressure decreased significantly in all groups immediately after haemorrhage. It
      recovered to 80-90 mmHg at 2-2.5 h in groups 1 and 3 but remained at 20-30 mmHg
      in group 2. The cardiac output decreased significantly in all groups. The
      systemic vascular resistance increased significantly in group 1 but decreased
      significantly in group 2. In group 3 it decreased significantly but soon
      recovered. Arterial pH and base excess decreased significantly in all groups
      immediately after haemorrhage. After that, base excess recovered slowly in groups
      1 and 3 but decreased further in group 2. The plasma epinephrine concentration
      increased immediately after haemorrhage and then decreased slowly in groups 1 and
      3. In group 2 it remained unchanged at the lower level. The decreases in mean
      arterial pressure, systemic vascular resistance and base excess were
      significantly larger in group 2 than in groups 1 and 3.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7793181
TI  - Interstitial fluid accumulation does not influence oxygen uptake in the rabbit
      small intestine.
AB  - Crystalloid resuscitation increases interstitial fluid volume. Intestinal
      ischemia and impaired barrier function may contribute to the precipitation of
      multiple organ failure. Accordingly, the intestine was chosen as target organ to
      test whether interstitial oedema impairs oxygen extraction by the tissue. The
      portal vein in anaesthetized rabbits was partially obstructed for 30 min along
      with an intravenous infusion of 0.9% saline 60-90 ml kg-1 (oedema group, n = 7).
      Total water content of the small intestine increased from 3.4 ml g-1 dry weight
      in control (n = 8) to 3.9 ml g-1 in the oedema group (P = 0.049). Small
      intestinal O2 uptake was calculated from the arteriovenous O2 content and
      electromagnetic flow measurements in the superior mesenteric artery. Mesenteric
      flow was reduced stepwise by a snare occluder around the artery. Intestinal
      oxygenation was monitored indirectly as well, by means of mesenteric venous
      lactate, arterial base excess and by mucosal pH (pHi) assessed tonometrically.
      The oxygen extraction ratios were similar in the oedema and control group at
      similar oxygen supplies. After a 45 min flow reduction to 15% of baseline
      mesenteric venous lactate and pHi did not differ between the groups. pHi averaged
      7.31 and fell to 6.74. Below an intestinal O2 uptake of 2.5 ml min-1, pHi
      correlated somewhat better with O2 uptake (r = 0.66) than did arterial base
      excess (r = 0.50). The results indicate that acute elevation of extracellular
      volume to the extent in the present study, does not impede oxygen uptake in the
      gut.

PMID- 7793185
TI  - Intramuscular ketorolac following total hip replacement with spinal anaesthesia
      and intrathecal morphine.
AB  - We have studied the analgesic and morphine sparing effect of ketorolac
      tromethamine in 60 patients after total hip replacement under spinal anesthesia.
      In this double blind study 30 patients received ketorolac 30 mg IM 6 hourly
      postoperatively and the control group received saline. Analgesia was assessed by
      visual analogue pain scores (VAS) and morphine consumption by patient controlled
      analgesia (PCA). There was a significantly (P < 0.02) lower morphine consumption
      in the ketorolac group (7.1 +/- 8.6 mg; Mean +/- s.d.) when compared to the
      saline group (14.2 +/- 13.6 mg). Although there was a trend for lower VAS on the
      first postoperative night this was only significant at 10 hours postoperatively
      and the next morning at 08:00 hr. The incidence of side effects (emetic sequelae,
      pruritus and headache) were similar in both groups. It is concluded that
      ketorolac reduces the consumption of additional morphine in conjunction with
      intrathecal morphine but had no effects on the side effects.

PMID- 7793187
TI  - Effects of hypothermia on the elimination of ethanol, diazepam and oxazepam in
      rat liver slice incubations.
AB  - The elimination of ethanol, diazepam and oxazepam which are metabolised by
      different enzymes, has been studied for 30, 60, 90 and 120 min at 37, 27, 17 and
      7 degrees C in rat liver slice incubations. Ethanol elimination followed zero
      order kinetics at all temperatures, while the benzodiazepines consistently
      displayed first-order kinetics. No sign of phase transition was observed in the
      respective Arrhenius-plots. Ethanol elimination was more temperature dependent
      than the elimination of diazepam, while the elimination of oxazepam was little
      influenced by temperature. This is shown by the temperature ratios (Q10) and
      energies of activation (Ea) of 1.76, 1.56, 1.24 and 40.5, 31.9, 15.2 for ethanol,
      diazepam and oxazepam, respectively. This means that ethanol, diazepam and
      oxazepam elimination was reduced by 25, 22 and 14%, respectively, for each 10
      degrees C of temperature reduction, which is considerably lower than the commonly
      observed 50% reduction of enzyme activity. We conclude that observations made for
      one drug on temperature dependent elimination may not apply to other drugs.

PMID- 7793186
TI  - Effect of intraperitoneal bupivacaine on pain after laparoscopic cholecystectomy.
AB  - The effect of intraperitoneal bupivacaine on postoperative pain was studied in 60
      ASA 1-2 patients undergoing elective laparoscopic cholecystectomy. The patients
      were randomly selected (20 patients in each group) to receive in double-blind
      fashion 100 mo of either plain 0.15% bupivacaine (150 mg.100 ml-1) or the same
      solution with adrenaline (1.5 micrograms ml-1), or the same volume of saline into
      the right subdiaphragmatic space at the end of surgery. The patients were kept in
      the Trendelenburg's position for 20 min after the instillation. Venous blood
      samples for the determination of bupivacaine plasma concentrations were drawn up
      to 180 min. Plasma bupivacaine concentrations peaked at 30 min (highest
      individual value 2.6 micrograms ml-1) after instillation. Bupivacaine
      concentrations were significantly lower in the bupivacaine-adrenaline group.
      During the follow-up no difference between the groups occurred as to the time to
      first demand of analgesia, severity of postoperative pain, amount of consumed
      analgesics during 7 days, and length of hospitalization. In all groups, 30-45% of
      the patients complained of right shoulder pain. After the first 24 hours, pain at
      rest and during moving was reported as mild and was managed with oral ketoprofen.
      It is concluded that postsurgical intraperitoneal instillation of 150 mg
      bupivacaine in 100 ml of saline had no effect on pain after laparoscopic
      cholecystectomy.

PMID- 7793188
TI  - Intravenous propofol vs thiamylal-isoflurane for caesarean section, comparative
      maternal and neonatal effects.
AB  - Several studies on propofol (Diprivan) for induction of anaesthesia during
      caesarean section have demonstrated its safety, however, it safety during
      maintenance of anaesthesia is not yet fully evaluated. The present study was
      undertaken to compare the maternal and neonatal effects of propofol or isoflurane
      in 74 term parturients undergoing primary or repeat caesarean section. Patients
      were randomly assigned to two groups, propofol group (n = 37) received propofol
      1.5-2.5 mg.kg-1 for induction followed by a continuous infusion of propofol of
      0.05-0.2 mg.kg-1.min-1. The isoflurane group (n = 37) received thiamylal 3-4mg.kg
      1 for induction followed by isoflurane 0.25-0.75% for maintenance. All patients
      had rapid sequence induction using succinylcholine and endotracheal intubation,
      50% N2O and O2 were used in all patients until delivery. After delivery N2O
      concentration was increased to 67% and intravenous butorphanol (Stadol) was given
      as needed. Patients in the propofol group had less hypertension after intubation
      (P < 0.05) and this was also of shorter duration compared to patients in the
      isoflurane group (5 min vs 10 min respectively). Maternal blood loss as well as
      intraoperative awareness and recovery time did not differ significantly between
      the two groups. Neonatal status as ascertained by Apgar scores, cord acid base
      status and the neurological and adaptive capacity scores (NACS) was equally good
      in both groups. It is concluded that propofol used for induction and maintenance
      of anaesthesia is a safe alternative to thiamylal/isoflurane for patients
      undergoing caesarean section and is associated with less hypertensive response
      during laryngoscopy and intubation.

PMID- 7793189
TI  - Prilocaine reduces injection pain caused by propofol.
AB  - Propofol, which is commonly used for outpatient anaesthesia, may evoke pain
      during infusion. Forty-eight patients (ASA-I-II) undergoing elective uterine
      dilatation and curettage received randomly in a standardised fashion: A: Propofol
      mixed with prilocaine; B: Propofol and lidocaine; C: Propofol with
      prilocaine+lidocaine (equal amounts) or D: Propofol and saline. The final ratio
      of propofol:local anaesthetic/saline was 9:1 in all mixtures. Pain on injection
      was significantly decreased in the three groups receiving propofol and local
      anaesthetic(s) compared to the one given propofol and saline. Propofol is
      required in greater amounts when mixed with lidocaine than when mixed with
      saline. A binding between the algesic part of the propofol molecule and the local
      anaesthetic agent may explain these findings. Another twenty-two comparable
      patients were given 30 mg of ketorolac or an equal volume of saline
      intramuscularly 45-60 minutes prior to propofol. Ketorolac given before propofol
      did not reduce pain on injection. This indicates that inhibition of the
      cyclooxygenase pathway of arachidonic acid metabolism does not play a major role
      in the reduction of this pain.

PMID- 7793190
TI  - Eye symptoms, visual evoked potentials and EEG during intravenous infusion of
      glycine.
AB  - Disturbance of vision is a complication that may occur from absorption of the
      glycine solution used to irrigate the bladder during transurethral operations. We
      examined for a possible dose-response relationship between glycine dose, eye
      symptoms and neurophysiological changes after repeated intermittent intravenous
      infusions of 4.4 g of glycine for up to 22 g over 1 h in 10 male volunteers. The
      serum glycine concentration increased from 230 +/- 75 to 5,232 +/- 1,088 mumol/l
      (mean +/- s.d.) during the infusions. We found an increase in diastolic arterial
      pressure but no significant changes in systolic pressure, heart rate or mental
      status. Five of the volunteers developed blurring of vision which lasted for 10
      30 min. The visual evoked potentials (VEP) of these subjects showed an increase
      of the P100 and N70 latencies which started after no more than 4.4 g of glycine
      had been administered. The amplitude of the VEP was preserved and the main
      frequency of the EEG did not change, indicating that VEP changes were not due to
      cortical dysfunction. There was no dose-response relationship between glycine
      infusion and eye symptoms but a sub-group of volunteers responded with both
      visual disturbances and VEP changes.

PMID- 7793191
TI  - Potency and maintenance requirement of atracurium and vecuronium given alone or
      together.
AB  - A synergism exists between some competitive muscle relaxants. However,
      maintenance requirement of a combination of muscle relaxants has been evaluated
      only in paediatric patients. We studied 45 elective adult surgical patients (ASA
      I-II) during propofol-alfentanyl-N2O-O2-anaesthesia. The first 30 patients were
      randomized to receive either atracurium or vecuronium to create individual dose
      response curves for these muscle relaxants. ED95-values for atracurium and
      vecuronium were 260 +/- 9 and 59 +/- 3 micrograms.kg-1, respectively (mean +/-
      s.e. mean). Requirements of atracurium and vecuronium to maintain an 85-95%
      neuromuscular blockade were 301 and 83 micrograms kg-1 h-1, respectively. An
      additional 15 patients received a combination of atracurium and vecuronium (cAV)
      in an equipotent dose ratio. An ED95 of a cAV was 94 +/- 7 micrograms.kg-1 of
      atracurium together with 21 +/- 2 micrograms.kg-1 of vecuronium, or 72 +/- 6% of
      one ED95 dose of a parent agent. Potentiation was significant (P = 0.0001). A
      maintenance requirement of a cAV was 120 micrograms kg-1 h-1 of atracurium
      together with 27 micrograms kg-1 h-1 of vecuronium. Thus, a significant
      potentiation was maintained also during the course of anaesthesia. A cAV had an
      effect like one intermediate-acting agent. If a cAV is used instead of using
      atracurium or vecuronium alone, the maximal reduction of drug consumption would
      be approximately 30%.

PMID- 7793192
TI  - Rectal versus intramuscular morphine-scopolamine as premedication in children.
AB  - Intramuscular morphine-scopolamine for premedication was compared with a hydrogel
      of the same drugs for rectal administration in 205 healthy children scheduled for
      minor ENT surgery. The intramuscular dose was 0.15 +/- 0.006 mg x kg-1 compared
      to 0.25 +/- 0.015 mg x kg-1 rectally. Reaction at administration and anaesthetic
      induction, incidence of intraoperative airway difficulties, Spo2, ECG changes,
      postoperative pain and incidence of nausea were recorded. The administration for
      the rectal hydrogel group worked better and resulted in less postoperative nausea
      and slightly more postoperative pain. The children's behaviour at anaesthesia
      induction and the frequency of perioperative complications were similar in both
      groups. We conclude that for minor ENT surgery on children, premedication with
      rectal hydrogel of morphine-scopolamine is a good alternative to intramuscular
      morphine-scopolamine.

PMID- 7793193
TI  - Comparison of cardiac output measurement techniques: thermodilution, Doppler, CO2
      rebreathing and the direct Fick method.
AB  - Simultaneously measured cardiac output obtained by thermodilution (TD),
      transcutaneous suprasternal ultrasonic Doppler (DOP), CO2-rebreathing (CR) and
      the direct Fick method (FI) were compared in eleven healthy subjects in a supine
      position (SU), a sitting position (SI), and during sitting exercise at a workload
      of 50 W (EX). The agreements between the techniques, two by two, were expressed
      as the bias calculated as the averaged differences between the techniques.
      Precision was expressed as the standard deviation of the bias. The overall
      agreement (bias +/- precision) between TD, DOP and CR respectively and FI were
      2.3 +/- 1.6, -0.1 +/- 1.4, and -0.2 +/- 1.1 l/min. TD overestimated cardiac
      output consistently in SU, SI and EX. DOP was in-accurate during EX and agreed
      well with FI in SU and SI. CR agreed closely with FI in SI and EX, but values
      were underestimated in SU. The overall agreement between DOP and CR,
      respectively, and TD were 2.5 +/- 2.2 and 2.6 +/- 1.6 l/min. The overall
      agreement between DOP and CR was 0.1 +/- 1.6 l/min. In conclusion, TD
      overestimated cardiac output compared to the other techniques and the poor
      agreement has to be taken into consideration especially in measures of low
      values. The precision of DOP and CR against FI seems to be within clinically
      acceptable limits, and these methods may provide interchangeable alternatives to
      the invasive Fick method.

PMID- 7793194
TI  - Ethanol monitoring of irrigating fluid absorption in transcervical resection of
      the endometrium.
AB  - BACKGROUND: We evaluated the precision in using ethanol to indicate and quantify
      absorption of irrigating fluid during transcervical resection of the endometrium.
      METHODS: The ethanol concentration in the expired breath, the serum sodium level,
      the blood loss and the volumetric fluid balance were measured over 10-min periods
      during 62 operations. A solution containing glycine 1.5% and ethanol 1% was used
      to irrigate the uterus. RESULTS: Most principles previously outlined for ethanol
      monitoring in transurethral prostatic surgery could also be applied in
      endometrial resection. In the 21 patients who showed the intravascular pattern of
      ethanol changes, the breath alcohol measurement corrected for absorption time
      predicted the volume of irrigant absorbed (up to 2,531 ml) with a standard error
      of 230 ml at the end of any 10-min period of absorption. Repeated measurement of
      serum sodium indicated intravascular fluid absorption with practically the same
      precision as the breath test. Extravascular absorption was found in 14 patients.
      In these operations, the volume of irrigant absorbed (up to 1,767 ml) could be
      predicted with a standard error of 92 ml from the ethanol concentration at the
      plateau level attained after absorption had occurred. CONCLUSION: Ethanol
      monitoring is precise enough to allow monitoring of irrigating fluid absorption
      in endometrial resection.

PMID- 7793195
TI  - Desflurane analgesia for vaginal delivery.
AB  - The use of subanaesthetic concentration of inhalational anaesthetic for vaginal
      delivery offers many advantages to the mother and newborn. Desflurane, with the
      characteristics of rapid onset and minimal metabolism, may provide better
      analgesia and safety for labour pain control. Eighty healthy parturients were
      randomly assigned to receive either desflurane 1.0-4.5% and oxygen (n = 40) or
      nitrous oxide 30-60% in oxygen (n = 40). Analgesia was assessed using a score
      from 0 (no relief) to 4+ (excellent analgesia), amnesia for the delivery, blood
      loss were recorded. Neonates were evaluated by Apgar scores and neurologic and
      adaptive capacity scores (NACS). Data were analyzed for statistical significance
      using Student's t-test or Chi-square when appropriate. Analgesia scores were
      similar for both groups with more amnesia in desflurane group (23% vs 0% P <
      0.05). Blood loss did not differ significantly, 364 ml for the desflurane group
      and 335 ml for the nitrous oxide group. There were no significant differences for
      neonatal Apgar score at 1 min or at 5 min or the NACS at 2 hr or 24 hr between
      the two groups. We conclude that desflurane in subanaesthetic doses is safe and
      effective inhalation agent for normal delivery but might be associated with
      amnesia.

PMID- 7793197
TI  - Prolonged interference of blue dye "patent blue" with pulse oximetry readings.
AB  - Several blue dyes were reported to interfere with the accurate determination of
      oxygen saturation by pulse oximetry. However, in previous reports the
      interferences were observed only for a short duration. We have experienced a case
      in which the interference by a blue dye, "patent blue" continued for a long time.
      It was suggested that the blue dye, when it was injected intra-arterially and in
      an anaemic patient, interfered with the pulse oximetry measurement to a greater
      extent.

PMID- 7793196
TI  - Death associated with anaesthesia and surgery in Finland in 1986 compared to
      1975.
AB  - Mortality associated with anaesthesia and surgery in Finland in 1986 was studied
      using a retrospective method and was compared with the results of a similar study
      performed in 1975. The total number of procedures was 325,585. 570 patients
      fulfilled one of the three criteria: 1. The patient died within three days of a
      procedure needing anaesthesia. 2. The patient died more than three days after a
      procedure needing anesthesia, but had suffered a cardiac arrest or been
      resuscitated, or there was a surgical or an anaesthesiological complication
      contributing to the death. 3. The patient suffered a major handicapping
      neurological (or other) deficit, which was associated with anaesthesia, or there
      was a surgical or an anaesthesiological complication possibly contributing to the
      death or handicap (no patients). The number of consultant anaesthesiologists had
      more than doubled since 1975. At the same time there was also a significant
      increase in recovery room and intensive care facilities. Surgery was the main
      contributing factor in the death of 22 (frequency 0.68/10,000 procedures), and
      anaesthesia in the death of five (frequency 0.15/10,000 procedures) patients. The
      role of surgery had decreased to about one third and the role of anaesthesia to
      less than one tenth as the main cause of death associated with anaesthesia and
      surgery compared to the year 1975. 95.3% of all the patients died mainly because
      of co-existing medical or surgical disease.

PMID- 7793198
TI  - Blood-stained pleural effusion complicating interpleural analgesia.
AB  - A case of blood-stained pleural effusion complicating interpleural analgesia for
      a difficult nephrectomy is reported. We describe our technique of placement of
      the interpleural catheter. Interpleural infusion of 0.25% bupivacaine at 7 mls/h
      provided excellent postoperative analgesia. However, a left pleural effusion was
      demonstrated from chest X-ray films taken from the third day post-operatively.
      Persistent low grade fever and a large pleural effusion necessitated drainage
      which resulted in improvement in symptoms. Possible aetiologies of the effusion
      are discussed, although the exact cause was uncertain. Observation for a
      developing pleural effusion and other complications should form part of the
      postoperative observation and if one does develop, the necessary measures can be
      taken.

PMID- 7793199
TI  - Intraoperative anaphylaxis caused by a hydatid cyst.
AB  - The incidence of the hydatid disease is still high in some regions of the
      Mediterranean. A serious, but rare, peroperative complication is IgE-mediated
      anaphylaxis, as a result of passing of the highly antigenic hydatid cyst content
      into the bloodstream. We present here a case of anaphylactic reaction in a
      patient who underwent surgical treatment of hydatid cyst.

PMID- 7793200
TI  - Needle fixation with combined spinal-epidural anaesthesia.

PMID- 7793201
TI  - Pulse oximetry--clinical implications and recent technical developments.
AB  - The pulse oximeter has been shown to be a reliable monitor of arterial oxygen
      saturation and has therefore been recommended as mandatory monitoring for
      patients during anaesthesia and intensive care. In 1989 two review articles on
      pulse oximetry were published (1, 2) and two years ago Severinghaus and Kelleher
      summarized the literature between 1989 and October 1991 (3). Our aim is to focus
      the discussion on technical aspects and applications of pulse oximetry with
      special attention centered on recent developments. This review is consequently an
      update on pulse oximetry since the end of 1991, and the first on technically
      based publications in the two last decades.

PMID- 7793202
TI  - Recovery from neuromuscular blockade: residual curarisation following atracurium
      or vecuronium by bolus dosing or infusions.
AB  - We conducted a survey of the incidence of Postoperative Residual Curarisation
      (PORC) in two groups of patients following the use of atracurium or vecuronium.
      In the first group (B) the neuromuscular blocking drugs were administered by
      bolus dosing, and in the second group (I) by continuous fusion. On arrival in the
      recovery room, neuromuscular function was assessed both by compound evoked
      electromyogram (EMG) in a train of four pattern and also clinically, by the
      ability to sustain a headlift for > 5 seconds, and to cough. Results were
      obtained from 150 patients (100 in group B and 50 in group I). The incidence of
      PORC, as defined by a train of four ratio of < 0.7, on arrival in the recovery
      room was 12% in group B, and 24% in group I. Clinical criteria of adequate
      neuromuscular reversal revealed different results, with the majority of patients
      being unable to perform either clinical test on arrival in recovery. Those
      patients in whom a peripheral nerve stimulator was used intra-operatively did not
      have a reduced incidence of PORC. We have demonstrated that PORC is still a
      common occurrence even with intermediate duration of action neuromuscular
      blocking drugs.

PMID- 7793203
TI  - Epidural anaesthesia blocks changes in peripheral lymphocytes subpopulation
      during gastrectomy for stomach cancer.
AB  - To examine the effects of surgery and anaesthesia on cell-mediated and humoral
      immunity, we investigated changes in subpopulations of peripheral T cells and B
      cells during gastrectomy. Twenty-one patients with gastric cancers who underwent
      total or subtotal gastrectomy were randomly assigned to receive thiopental/N2O
      general anaesthesia supplemented with either epidural (epidural group, n = 12) or
      enflurane(enflurane group, n = 9). The changes in peripheral lymphocyte
      subpopulations were detected and quantified using single and double label
      analysis of monoclonal antibodies against lymphocyte membrane surface markers
      (Leu series). Subpopulations were measured before induction, and 1 and 2 hours
      after skin incision. In the enflurane group, B cells (Leu12+), total T cells
      (Leu4+), inducer T cells (CD4+, Leu8+) and the CD4/CD8 ratio decreased and
      suppressor T cells (CD8+, Leu15+) increased significantly after skin incision.
      Whereas, the epidural group showed no change in the number of B cells and each T
      cell subpopulation during the study. These data suggest that epidural anaesthesia
      blocks the effect of stress induced by major surgery on fluctuation of peripheral
      lymphocyte subpopulations which may be associated with suppression of immunity.

PMID- 7793204
TI  - Lack of effect of flumazenil on the reversal of propofol anaesthesia.
AB  - Propofol, like the benzodiazepines, activates the GABAA receptor-chloride
      ionophore complex; they potentiate one another. Since neither pharmacodynamic nor
      pharmacokinetic data concerning drug interaction between flumazenil and propofol
      is available, and especially considering the relationship of binding sites,
      flumazenil, the antagonist of benzodiazepines, was investigated to determine its
      effect upon recovery from propofol anaesthesia. Forty women receiving dilatation
      and curettage procedures were included in this double-blind test. After 50
      micrograms fentanyl, propofol 2 mg.kg-1 was injected for induction and followed
      by infusion at the rate of 15 mg.kg-1.hr-1. After the operation, patients were
      given normal saline (Group A) or flumazenil 10 micrograms.kg-1 (Group B)
      randomly. Recovery time in Group A was 15.2 +/- 5.1 min and Group B 15.8 +/- 4.8
      min. Propofol concentrations at the end of infusion were 4.17 +/- 1.33
      micrograms.ml-1 (Group A) and 4.03 +/- 1.45 micrograms.ml-1 (Group B); these then
      declined to 1.22 +/- 0.17 micrograms.ml-1 (Group A) and 1.18 +/- 0.15
      micrograms.ml-1 (Group B) when patients were able to open their eyes on command.
      No significant differences were found between the groups based on propofol
      concentrations and recovery time, nor did haemodynamic changes differ between
      them after administration of reversal agents. It was concluded that flumazenil 10
      micrograms.kg-1 does not influence recovery from propofol anaesthesia.

PMID- 7793205
TI  - Lung function after open versus laparoscopic cholecystectomy.
AB  - Postoperative lung function and gas exchange were studied in 36 patients after
      cholecystectomy. Twenty-four of the patients underwent laparoscopic
      cholecystectomy while the remaining twelve were operated with open technique.
      Before surgery all patients had normal ventilatory volumes (forced vital
      capacity, FVC and forced expired volume in 1 s, FEV1) and normal gas exchange.
      Two hours postoperatively FVC was reduced to 64 +/- 16% (P < 0.05) of the
      preoperative level in the laparoscopic group and to 45 +/- 23% (P < 0.05) after
      open cholecystectomy. On the first postoperative day FVC was virtually normal in
      the laparoscopic patients (77 +/- 17% of preoperative level, NS), whereas the
      open surgery patients still had a decreased FVC (56 +/- 13% of preoperative, P <
      0.05). FEV1 in the postoperative period followed the same course as FVC. Gas
      exchange was significantly impaired in the early postoperative period in all
      patients but no difference between the two groups was found. Two hours
      postoperatively PaO2 was reduced to 85% (P < 0.05) of preoperative value and
      PaCO2 had increased by 0.5 kPa (P < 0.05). The alveolo-arterial oxygen tension
      difference (PA-aO2) had increased by approximately 45% to a mean of 3.7 kPa (P <
      0.05). On the first postoperative day gas exchange was still significantly
      impaired in the open surgery patients. Atelectasis detected by computed X-ray
      tomography of the lungs were found in both groups. However, the amount of
      atelectasis tended to be smaller in the laparoscopic group than in the open
      surgery patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793206
TI  - Clinical application of differential ventilation with selective positive end
      expiratory pressure in adult respiratory distress syndrome.
AB  - Differential ventilation in the lateral position with positive end-expiratory
      pressure (PEEP) selectively applied to the dependent lung (DVSP) has been shown
      to reduce venous admixture and improve oxygenation without compromising cardiac
      output in short term studies of patients with acute respiratory failure. We have
      applied this ventilation technique as a long-term treatment in severe adult
      respiratory distress syndrome (ARDS) in an open clinical trial. Eleven patients
      with ARDS of varying aetiology were treated with DVSP for a total of 34 days.
      Median duration of conventional ventilatory therapy before start of DVSP was 5
      days (1 to 18 days), inspiratory oxygen fraction (FIO2) was 0.61 +/- 0.16 (mean
      +/- s.d.), resulting in a mean arterial oxygen tension (PaO2) of 7.1 +/- 2.1 kPa
      (PaO2/FIO2 = 11 +/- 4 kPa). A gradual improvement in gas exchange was seen during
      the first 24 h of DVSP such that PaO2 increased to 8.4 +/- 1.4 with a decreased
      FIO2 (0.52 +/- 0.14) resulting in an increased PaO2/FIO2 (16 +/- 5 kPa). Five out
      of the eleven patients survived. No major complication was noted using DVSP as a
      method. We found a steady improvement in gas exchange over the first 24 hours in
      most patients. However, mortality rate was no lower than expected. Drawbacks with
      DVSP were increased demand on staff and difficulties with adequate endo-bronchial
      suctioning.

PMID- 7793207
TI  - Protective effects of halothane but not isoflurane against global ischaemic
      injury in the isolated working rat heart.
AB  - The effects of equi-anaesthetic concentrations of halothane (HAL) and isoflurane
      (ISO) on myocardial performance, perfusion, oxygenation and lactate release were
      studied before, during and after a low-flow, global ischaemic insult in isolated,
      paced rat left heart preparations. An antegrade perfusion technique was used,
      where left atrial pressure (LAP) and mean aortic pressure (MAP) could be altered
      independently of each other. Aortic flow, coronary flow (CF) and PO2 in venous
      coronary effluent were continuously recorded and stroke volume, myocardial oxygen
      consumption (MVO2) and myocardial oxygen extraction as well as lactate release
      were calculated. The hearts were exposed for at least ten minutes to the
      perfusate without (control, n = 10) or with HAL (n = 10) or ISO (n = 10) at a MAP
      of 80 mmHg (10.4 kPa) and a LAP of 7.5 mmHg (1.0 kPa). After baseline
      measurements, MAP was reduced to 25 mmHg (3,2 kPa) for a total of nine minutes.
      Thereafter MAP was increased to 80 mmHg (10.4 kPa) for another nine minute
      period. During the whole experimental procedure, LAP was maintained at 7.5 mmHg
      (1.0 kPa) and heart rate at 325 beats per minute. In the pre-ischaemic control
      period, MVO2 was lower with HAL compared to ISO (P < 0.05) and control (P <
      0.05). Stroke volume was also lower with HAL compared to control (P < 0.05).
      During hypoperfusion, lactate release was twice as high in the control group (P <
      0.01) and with ISO (P < 0.01) compared to HAL.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793208
TI  - Attenuation of hyperoxic lung injury in rabbits with superoxide dismutase:
      effects on inflammatory mediators.
AB  - BACKGROUND: Superoxide dismutase (SOD) has been shown to attenuate hyperoxic lung
      injury. This effect is thought to be exhibited by scavenging superoxide released
      from neutrophils and other aerobic cells. The aim of the current study was to
      investigate the effect of pre-treatment with SOD on the chemical mediators in
      hyperoxic lung injury. METHODS: Thirty male anesthetized rabbits were allocated
      to receive one of three treatments (n = 10 for each group): ventilated with 100%
      oxygen for 36 h with or without recombinant human SOD (rhSOD) treatment, and
      ventilated with air for 36 h without rhSOD. In the rhSOD-treated group, a single
      intravenous dose of rhSOD 10,000 U kg BW-1 was administered immediately after the
      start of exposure to 100% oxygen and thereafter infused at a rate of 340,000 U kg
      BW-1 day-1 for 36 h until the animals were sacrificed. The lungs of all rabbits
      were ventilated with 100% oxygen or air. Haemodynamics, PaO2, and lung mechanics
      were recorded during the ventilation period. After exposure to 100% oxygen, lung
      mechanics, cell fraction of bronchoalveolar lavage fluid (BALF), activated
      complements, cytokines, and arachidonic acid metabolite concentrations in BALF
      were measured and analyzed. The lung wet-to-dry (W/D) weight ratio and albumin
      concentrations in BALF were determined as indices of pulmonary oedema. RESULTS:
      Exposure to the high concentration of oxygen for 36 h caused no significant
      changes in haemodynamics but decreased compliance and increased A-aDo2. In the
      rhSOD-treated group, the decrease in compliance was not observed. At the end of
      the 36 hr-exposure period, however, hyperoxia significantly increased the lung
      W/D weight ratio, influx of neutrophils into the lung, BALF concentrations of
      C3a, C5a, tumor necrosis factor-alpha, interleukin (IL)-1 beta, IL-6, IL-8,
      thromboxane B2, and albumin. Pre-treatment with rhSOD attenuated these increases.
      Exposure to 100% oxygen caused extensive morphologic lung damage (alveolar
      haemorrhage and hyaline membrane formation), which was lessened by rhSOD.
      CONCLUSION: These results indicate that intravenous rhSOD prevented hyperoxic
      lung injury (decreases in PaO2 and compliance, increased pulmonary vascular
      permeability, histopathological damage) in rabbits. This prophylactic effect of
      rhSOD amy be due, in part, to decreased chemical mediators such as activated
      complements, cytokines, and arachidonic acid metabolites.

PMID- 7793209
TI  - Prophylactic oral ibuprofen or ibuprofen-codeine versus placebo for postoperative
      pain after primary hip arthroplasty.
AB  - The postoperative analgesic effect of ibuprofen was compared with a combination
      of ibuprofen and codeine versus placebo. The study was prospective, randomized,
      double blind with 123 consecutive hip arthroplasty operations. All the patients
      received oral diazepam as premedication and spinal anaesthesia with bupivacaine 5
      mg/ml 3-4 ml. Postoperatively, when the spinal anaesthesia started to wear off,
      the patients were randomly assigned to one of three groups; the ibuprofen group
      (n = 48) received 800 mg of ibuprofen orally. The ibuprofen/codeine group (IC, n
      = 48) received 800 mg of ibuprofen combined with 60 mg of codeine. The placebo
      group (P, n = 25), received oral placebo medication. The patients were observed
      for the need of additional opioid (e.g. ketobemidone), pain score (verbal and
      VAS), bleeding and side effects for five hours. The patients in the placebo group
      (P) had significantly higher pain scores (P < 0.05) compared with the two other
      groups after 2 and 4 hours, with no significant differences after 1, 3 and 5
      hours. The P group also received 45% more opioids (P < 0.001) compared with the
      two other groups during the same period. No significant differences in bleeding
      or side-effects were observed between the groups. There were no significant
      differences between the ibuprofen group and the ibuprofen/codeine group. We
      conclude that a prophylactic dose of 800 mg ibuprofen orally has an opioid
      sparing effect with a tendency of less pain experience during the first hours
      after hip arthroplasty.

PMID- 7793210
TI  - Contribution from upper and lower airways to exhaled endogenous nitric oxide in
      humans.
AB  - Endogenous nitric oxide (NO) is thought to regulate many biological functions,
      including pulmonary circulation and bronchomotion, and it has been found in
      exhaled air. Our aim was to study the excretion of NO in different parts of the
      respiratory system. Exhaled concentrations of NO were measured by
      chemiluminescence in chronic tracheostomy outpatients (group 1), in patients
      admitted for minor abdominal surgery (group 2), and in patients with acute
      respiratory failure (ARF) during mechanical ventilation (group 3). In awake
      volunteers (group 4), 0.57 L/min gas was aspirated through the nasal cavity into
      the chemiluminescence device. In group 1 (tracheostomy, n = 5) we detected 16 +/-
      2 (mean +/- s.e. mean) parts per billion (ppb) NO when exhaling through the
      mouth, and a lower (P < 0.05) value of 4.6 +/- 0.8 ppb NO when exhaling through
      the tracheostomy. Before anaesthesia, group 2 (n = 11) exhibited 18 +/- 2.4 ppb
      NO in orally exhaled gas, increasing considerably during exhalation through the
      nose. Upon endotracheal intubation exhaled NO concentration dropped to 1.3 +/-
      0.2 ppb (P < 0.05). In group 3 (ARF, n = 7) tracheal NO concentrations were 0.8
      +/- 0.2 ppb. In group 4 (volunteers, n = 6) 394 +/- 23 ppb NO was recorded in air
      from the nasal cavity. In both healthy subjects and patients with respiratory
      failure a significant NO excretion occurs in the lower airways and lungs. The
      upper airways, especially the nose, contribute the largest amount of NO (> 90%)
      to exhaled air. The physiological implications of an upper airway source of NO
      remain to be defined.

PMID- 7793211
TI  - Implicit processing and therapeutic suggestion during balanced anaesthesia.
AB  - The effect of therapeutic suggestion--implicit processing during balanced
      anaesthesia was studied in 70 female patients scheduled for elective breast
      surgery. The patients were randomly allocated to listen to a message with
      reassuring information focused on minimising postoperative nausea and vomiting,
      or just a blank tape during surgery. Occurrence of nausea and vomiting was
      studied during the postoperative period. No patient recalled any explicit
      memories during the peroperative period. No major differences were observed in
      the number of patients who experienced nausea or vomiting during the 24 hour
      observation period. The patients exposed to positive suggestion did, however,
      have a lower frequency of recall for nausea and vomiting compared to those just
      listening to the blank tape. We did not observe any major effect of peroperative
      suggestion for postoperative nausea and vomiting. However, we cannot rule out
      some implicit processing during balanced anaesthesia.

PMID- 7793212
TI  - Autogenous production of hydroxyl radicals from thiopental.
AB  - It is generally believed that barbiturates can protect neural tissues from the
      damage induced by cerebral hypoxia. One of the mechanisms for protecting neurons
      is through the inhibition of lipid peroxidation (LPO). We therefore examined LPO
      in rat brain, liver and kidney by measuring the accumulation of thiobarbituric
      acid-reactive substances (TBAR) after thiopental administration under 21% O2. We
      also designed an in vitro study to gain insight into free radical generation
      leading to the formation of LPO from thiopental by electron spin resonance (ESR).
      An accumulation of TBAR in the rat liver was observed after the administration of
      a large dose of thiopental (70 mg/kg intraperitoneally). However, no change in
      LPO in the brain and kidney was observed. In the in vitro study, thiopental could
      scavenge superoxide (O2-.) radicals, while it spontaneously generated hydroxyl
      radicals (.OH) in solution. We conclude that thiopental can scavenge O2-., while
      producing .OH, subsequently resulting in membrane lipid peroxidation under
      physiologic O2 conditions. This formation of .OH may damage cell membrane lipids.

PMID- 7793213
TI  - Modulation of ryanodine-induced contractures in human skeletal muscle pretreated
      with dantrolene.
AB  - Dantrolene seems to be the causal therapy in malignant hyperthermia (MH) crisis
      but the complex mechanisms of MH and dantrolene therapy are still not fully
      understood. The influence of dantrolene on ryanodine-induced contractures has
      been reported in animal studies only. In the present study 20 patients from 17
      families were tested for MH using the protocol of the European Malignant
      Hyperthermia Group. In addition ryanodine-induced contractures were evaluated
      following bolus application of 10.0 mumol.l-1 ryanodine. After pretreatment with
      1 mumol.l-1 dantrolene ryanodine-provoked contractures developed significantly
      later in MHS (15.8 +/- 1.8 min) and MHN (46.0 +/- 4.2 min) muscle specimens than
      after ryanodine alone (MHS 4.8 +/- 0.7 min. (MHN 13.7 +/- 0.9 min). They were no
      longer observed in either group after pretreatment with 5 mumol.l-1 dantrolene.
      We conclude that dantrolene is able to attenuate ryanodine-induced contractures
      dose-dependently, and therefore it is speculated that dantrolene could
      specifically act at the ryanodine receptor binding site.

PMID- 7793214
TI  - Effects of hypotensive treatment with alpha 2-agonist and beta 1-antagonist on
      cerebral haemodynamics in severely head injured patients.
AB  - Therapy of post-traumatic brain oedema often includes preservation of high
      arterial blood pressure to avoid secondary ischaemic injuries to the brain. This
      practice can be questioned since high arterial blood pressure may aggravate brain
      oedema through raised hydrostatic capillary pressure, causing fluid filtration
      across the damaged blood-brain barrier. This latter view is in agreement with our
      clinical experience and therefore hypotensive therapy with an alpha 2-adrenergic
      agonist (clonidine) and a beta 1-adrenergic antagonist (metoprolol) has become
      part of our treatment protocol for severely head injured patients to decrease the
      post-traumatic brain oedema. The present study is an attempt to analyse whether
      there are any direct local cerebrovascular effects of the hypotensive agents
      used, which also might influence intracranial pressure. Severely head injured
      patients were investigated. Heart rate, mean arterial blood pressure,
      intracranial pressure, cerebral blood flow and arteriovenous difference in oxygen
      content were measured before and after a bolus dose of clonidine (six patients)
      and metoprolol (nine patients). Clonidine decreased mean arterial blood pressure
      and cerebrovascular resistance without affecting other parameters measured.
      Metoprolol decreased heart rate and mean arterial pressure, but had no effect on
      the cerebrovascular parameters. The results show that clonidine and metoprolol
      have no, or only minor, direct influence on local cerebral haemodynamics in
      severely brain injured patients. This implies that if there is an intracranial
      pressure reducing effect of these drugs, as suggested, this must be due to other
      mechanisms, namely a reduction in capillary hydrostatic pressure secondary to
      decreased arterial blood pressure and heart rate.

PMID- 7793215
TI  - Diabetic autonomic neuropathy and the haemodynamic actions of vecuronium and
      pancuronium during vitrectomy.
AB  - In order to clarify whether autonomic neuropathy modifies the haemodynamic
      effects of alfentanil, vecuronium and pancuronium, twenty-seven patients with
      diabetes mellitus were studied at thiopentone induction, and during nitrous oxide
      anaesthesia for ophthalmic vitreous surgery. Heart rate was lower in the diabetic
      patients receiving vecuronium compared with those receiving pancuronium, but no
      difference was seen in arterial pressure. During and after anaesthesia induction,
      the profiles of heart rate and arterial pressure resembled those found in healthy
      controls. Even in patients with advanced autonomic neuropathy, anaesthetics may
      exert their inherent vagotonic or sympathicotonic actions.

PMID- 7793216
TI  - Comparison of induction time and characteristics between sevoflurane and
      sevoflurane/nitrous oxide.
AB  - A previous investigation using nitrous oxide with 5% enflurane (3.8 MAC) for
      single breath induction produced a stage of excitement which may be related to
      the difference in blood/gas coefficient solubility of these agents. The closer
      blood/gas solubility coefficient of sevoflurane and nitrous oxide may eliminate
      this phenomenon. We therefore evaluated 40 volunteers in a randomized study using
      7.5% sevoflurane (3.7 MAC) in oxygen (n = 21) or sevoflurane with nitrous oxide
      (n = 19) using a single breath induction technique. Sevoflurane in nitrous oxide
      and oxygen reduced induction time by 15% compared to sevoflurane in oxygen alone
      (41 +/- 16 and 48 +/- 16 sec (s.d.), respectively). This was, however, not
      statistically significant. There were scarcely induction-related complications,
      such as coughing, laryngospasm, breath-holding, movements of a limb and excessive
      salivation, in either group. Thus, the addition of nitrous oxide neither
      increased the number of complications, nor the speed of induction.

PMID- 7793218
TI  - Long-term local corticosteroid application does not influence nerve transmission
      or structure.
AB  - The long-term effects of a locally applied depot form of a corticosteroid on the
      electrical properties and structure of nerves were investigated in an animal
      experimental model. The conduction in electrically stimulated A-fibres of the
      plantar nerve was monitored by a bipolar volley recording of the sciatic nerve
      whereas the conduction in C-fibres of the plantar nerve was measured through a C
      fibre evoked segmental flexion reflex in the anaesthetized rat. Droplets of
      either methylprednisolone acetate or vehicle were placed under direct observation
      on the plantar nerve. Saline was used as a control on the contralateral side. One
      to two weeks after the application both the A-fibre volley of the sciatic nerve
      and the C-fibre evoked reflex discharge of flexor motoneurons were recorded. No
      difference was found between the nerves treated with corticosteroid, constituent
      vehicle or saline. Light and electron microscopic analysis of the nerves showed
      no changes in the nerve fibres or in the intraneural connective tissue in either
      the corticosteroid treated or the control nerves. It is concluded that locally
      applied corticosteroids in limited amounts have no long-term effects on the
      electrical and structural properties of peripheral nerves.

PMID- 7793217
TI  - Oral premedication one hour before minor gynaecological surgery--does it have any
      effect? A comparison between ketobemidone, lorazepam, propranolol and placebo.
AB  - The purpose of the present study was to compare the effects of oral premedication
      with ketobemidone 5 mg, lorazepam 1 mg, propranolol 40 mg or placebo, given about
      an hour prior to anaesthesia, in a prospective randomized double-blind fashion.
      One hundred and twenty ASA I female patients scheduled for elective laparoscopy
      were randomly prescribed one of the study drugs. Patient evaluation of anxiety,
      nurse evaluation of premedication, induction and postoperative course were
      studied. Ninety-three of the 120 patients (78%) experienced no change or a
      decrease in anxiety, regardless of type of active drug or placebo administered.
      Eighty-eight of the patients (73%) were considered adequately premedicated by the
      nurse observer, with no differences between the groups. Pre induction pulse rate,
      blood pressure and amount of induction agent needed was also similar between the
      four groups of patients. No major differences could be seen during the
      postoperative course. We found no major effects of any of the active drugs
      studied compared to placebo. Routine use of small doses of oral premedication one
      hour before elective surgery among low anxiety patients could probably be
      omitted.

PMID- 7793219
TI  - Healthy lungs tolerate repetitive collapse and reopening during short periods of
      mechanical ventilation.
AB  - The possible occurrence of lung damage if alveolar units are allowed to collapse
      and reopen breath by breath during mechanical ventilation with normal tidal
      volumes was investigated. Anaesthetised, paralysed, open chest rabbits were
      subjected to either intrathoracic negative (NEEP; n = 6) or positive (PEEP; n =
      6) end-expiratory pressure during volume controlled mechanical ventilation. Both
      experimental settings were preceded by a 30 min control period and followed by a
      30 min recovery period during which a PEEP of 0.2 kPa was maintained. Pao2 and
      pulmonary compliance deteriorated significantly in the NEEP group during the
      experimental period and compared to ventilation with PEEP. Partial restoration of
      lung mechanics and blood gases was achieved during the recovery period. After an
      alveolar recruitment manoeuvre, this recovery was complete. Lung clearance
      studied by depositing an aerosol of technetium-99m-labelled diethylenetriamine
      pentaacetate (99mTc-DTPA) in the alveoli, was significantly faster during
      ventilation with NEEP compared to the PEEP group (P = 0.0002) as well as the
      control period (P = 0.0029). It did not recover completely during the recovery
      period but remained significantly faster. Light microscopic histology was normal
      in both groups with no evidence of inflammation or epithelial disruption. We
      conclude that previously healthy rabbit lungs show only a transient disturbance
      of lung mechanics and blood gases with repetitive collapse and re-expansion. The
      integrity of the alveolar microstructure is preserved. The disturbance in the
      alveolo-capillary permeability persists and may indicate surfactant related
      alveolo-capillary barrier dysfunction.

PMID- 7793220
TI  - Recovery from sevoflurane and isoflurane anaesthesia after outpatient
      gynaecological laparoscopy.
AB  - As the low blood solubility (blood gas partition coefficient 0.69) of sevoflurane
      suggests a rapid emergence from anaesthesia, recovery from sevoflurane
      anaesthesia was compared to isoflurane in outpatient gynaecological laparoscopy.
      Fifty ASA I or II, consenting women participated in a randomised, controlled and
      single blind study. The patients received, after induction of anaesthesia with
      propofol, either sevoflurane or isoflurane, both with 67% nitrous oxide in
      oxygen, for maintenance of anaesthesia. The study drug was administered at 1 MAC
      (end tidal concentration 0.6% for sevoflurane and 0.5% for isoflurane) but
      adjusted in 0.5 MAC steps, if clinically indicated. Before the end of surgery the
      end tidal concentration of the study drug was reduced to 0.5 MAC. Recovery
      assessments were made from the time anaesthetic gases were discontinued. The
      subjects were able to open eyes in 2.3 (0.8-7.0) min and 4.1 (2.0-6.8) min,
      orientate in 2.8 (1.0-6.8) min and 4.7 (2.2-8.3) min and follow orders in 2.6
      (0.7-6.8) min and 4.3 (1.2-7.3) min, in the sevoflurane and isoflurane groups,
      respectively (P < 0.05) [median (range)]. Walking was achieved in 72 (24-464) min
      and 66 (35-134) min, tolerance of oral fluids in 37 (15-88) min and 35 (45-161)
      min and voiding in 262 (96-459) min and 217 (52-591) min in the sevoflurane and
      isoflurane groups, respectively (NS). Overall home readiness was achieved in 281
      (96-708) min after sevoflurane group and 242 (96-591) min after isoflurane
      (NS).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793221
TI  - Anesthetic modulation of the cardiovascular response to microlaryngoscopy. A
      comparison of propofol and methohexital with special reference to leg blood flow,
      catecholamines and recovery.
AB  - The modulating effects of propofol versus methohexital on the cardiovascular
      response to microlaryngoscopy were studied in 35 patients divided into four equal
      groups (one patient participated twice). Heart rate (HR), mean arterial blood
      pressure (MAP, cardiac output (CO; impedance cardiography), leg blood flow (LBF;
      occlusion plethysmography) and concentrations of arterial catecholamines were
      measured. After administration of atropine and fentanyl (2 micrograms.kg-1),
      anesthesia was induced by either an injection of propofol (2.0 mg.kg-1) followed
      by a low (6 mg.kg-1.h-1; n = 9) or a high (12 mg.kg-1.h-1; n = 9) dose propofol
      infusion or an injection of methohexital (1.5 mg.kg-1) followed by a low (5 mg.kg
      1.h-1; n = 9) or a high (10 mg.kg-1.h-1; n = 9) dose methohexital infusion. The
      low methohexital infusion dose was insufficient to control MAP, which increased
      41% during microlaryngoscopy compared to the awake state. The HR increased in all
      groups but the increase was most prominent in the low dose methohexital group.
      There were no statistically significant changes in CO in any group, whereas LBF
      increased consistently in all groups except in patients anesthetized with the low
      dose of methohexital. The increases of LBF in the propofol groups were
      intermediate and not dose dependent. The methohexital low dose group showed
      increases in norepinephrine levels compared to awake values and in epinephrine
      levels compared to the other groups. Propofol seems to differ from methohexital
      in modulation of peripheral vascular tone.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793222
TI  - Perioperative autotransfusion and functional coagulation analysis in total hip
      replacement.
AB  - Functional coagulation analyses like Sonoclot and thromboelastography have not
      been evaluated during perioperative autotransfusion. We have prospectively
      studied three different transfusion regimes in 45 patients undergoing total hip
      arthroplasty. Blood losses were replaced either with heterologous erythrocyte
      concentrate (group I), intra- and postoperative autotransfusion of blood salvaged
      with cellsaver technique (group II) or predonated autologous erythrocyte
      concentrates together with salvaged blood (group III). Routine and functional
      coagulation analyses with a Sonoclot were performed preoperatively, 6 hours
      postoperatively (6 h), day 1-5 and 10. An early postoperative hypo- and late
      postoperative hypercoagulative phase could be detected with Sonoclot signs of
      platelet function and fibrin deposition in all groups. Sonoclot coagulation
      analyses better correlated to both blood loss and dextran dosage than APTT and
      platelet count in the routine coagulation analyses. Functional coagulation
      analysis has a potential use in individualizing plasmasubstitution and
      thromboprophylaxis regimes during autotransfusion in THR.

PMID- 7793224
TI  - ECG T-wave amplitude changes during thiopentone induction with or without
      alfentanil.
AB  - The T-wave amplitude of ECG is thought to reflect the sympathetic tone of the
      heart but anaesthesia studies on this topic are rare. Haemodynamic and ECG T-wave
      amplitude changes were studied during induction of anaesthesia in 24 ASA I-II
      patients. Twelve patients were given alfentanil 30 micrograms kg-1 at induction
      while physiologic saline was given to the rest (control). Thiopentone was then
      administered at the rate of 5 mg s-1 until eyelash reflex disappeared. Vecuronium
      0.1 mg kg-1 was given thereafter. No anticholinergics were used. The lungs were
      ventilated with 40% oxygen in air. Haemodynamic parameters and T-wave amplitude
      were measured before induction, before intubation, 30 s, 3 min and 5 min after
      intubation. A significantly higher amount of thiopentone was needed to abolish
      the eyelash reflex in the control group than in the alfentanil group (P < 0.001).
      There were no changes in heart rate (HR) in the alfentanil group during the
      trial. Systolic and diastolic arterial pressures (SAP and DAP) were continuously
      below the preinduction levels in the alfentanil group. After baseline HR, SAP and
      DAP were significantly higher in the control group than in the alfentanil group
      at each data point. T-wave amplitude flattened significantly (P < 0.001) after
      intubation in the control group while no significant changes were seen in the
      alfentanil group. T-wave flattening correlated to the increases in HR (P < 0.01)
      and SAP (P < 0.01). Three control patients with flattened T-wave had a transient
      bigeminia period after intubation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793223
TI  - Erythrocyte counts in the cerebrospinal fluid associated with continuous spinal
      anaesthesia.
AB  - Continuous spinal anaesthesia technique can be associated with peridural
      haemorrhage due to blood vessel damage caused by the needle or the catheter. We
      studied whether thrombosis prophylaxis or anticoagulation medications increase
      the risk of subarachnoid haemorrhage when continuous spinal anaesthesia is used.
      Twenty arthroplasty patients received low-molecular-weight heparin preoperatively
      and twenty-two vascular surgery patients received heparin (100 IU kg-1)
      peroperatively; eight of the latter patients were on regular preoperative
      antiplatelet medication. Twenty-four prostate surgery patients, not exposed to
      heparin or other drugs affecting coagulation, served as controls. A 22-gauge
      spinal catheter was used and bupivacaine was injected through the catheter.
      Within the following 24 hours, 4-5 cerebrospinal fluid samples were collected for
      erythrocyte counts. In the arthroplasty and the vascular group there were five
      patients each and in the control group seven patients with more than 100 x 10(6)
      l-1 erythrocytes in at least one of the samples. The highest erythrocyte count
      was 23900 x 10(6) l-1 in a control patient. The 24-hour sample was blood-tinged
      (erythrocytes > 1000 x 10(6) l-1) in two patients in the arthroplasty group, in
      one patient in the vascular group and in four patients in the control group. In
      spite of the haemorrhages detected in this study, no related neurological
      symptoms or other serious consequences were observed. The risk of subarachnoid
      haemorrhage was not increased by drugs affecting coagulation.

PMID- 7793226
TI  - Early detection of CO2 pneumothorax with continuous spirometry during
      laparoscopic fundoplication.
AB  - In two patients, operated on because of gastroesophageal reflux, carbon dioxide
      pneumothorax developed during laparoscopic Nissen fundoplication. In both
      instances, decrease of lung compliance and a change of pressure-volume loop
      configuration, computed and illustrated with on-line spirometry, led quickly to
      diagnosis of this complication. We conclude that continuous spirometry is
      valuable as an early indicator of intraoperative pneumothorax.

PMID- 7793225
TI  - Train-of-four recovery after pharmacologic antagonism of pancuronium-,
      pipecuronium-, and doxacurium-induced neuromuscular block in anaesthetized
      humans.
AB  - Previous studies have suggested that the increased duration of action of long
      acting neuromuscular relaxants may make their pharmacologic antagonism more
      difficult and, thus, increase the likelihood of residual block. This hypothesis
      was tested in healthy, adult humans who received a background of
      isoflurane/N2O/fentanyl anaesthesia. Study subjects were paralyzed with either
      pancuronium (N = 8), pipecuronium (N = 8), or the longer-acting relaxant,
      doxacurium (N = 8). Neuromuscular function was monitored, and, using a blinded,
      randomized study design, the relaxants were titrated to identify the ED95 dose in
      each patient. Thereafter, spontaneous recovery was observed until there was 25%
      of baseline response to the first supramaximal twitch (T1) in a train-of-four
      (TOF). At this time, the block was antagonized with neostigmine 0.07 mg/kg and
      glycopyrrolate 0.014 mg/kg i.v., and recovery of TOF was recorded. Spontaneous
      recovery to 25% of the baseline T1 response occurred at 52 +/- 14 min (mean +/-
      SD) following administration of either pancuronium and pipecuronium, and 85 +/-
      33 min following doxacurium (P < 0.05 for doxacurium versus pancuronium and
      pipecuronium). In doxacurium-treated patients, reversal of block with neostigmine
      was less predictable and less complete than with the other two relaxants. For
      example, the ratio of the fourth to first twitch (T4/T1) of the TOF at 10 and 15
      min after reversal was significantly less with doxacurium (59 +/- 14% and 61 +/-
      16%, respectively) than with either pancuronium (75 +/- 6% and 75 +/- 10%) or
      pipecuronium (76 +/- 9% for both).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793227
TI  - The laryngeal mask simplifies airway management during percutaneous dilational
      tracheostomy.
AB  - The Laryngeal Mask Airway (LMA) is used for many procedures which previously
      required endotracheal intubation. Percutaneous Dilational Tracheostomy (PCT)
      facilitates the bedside insertion of a tracheostomy tube in the Intensive Care
      Unit. Most patients requiring this procedure are intubated with a conventional
      endotracheal tube. Insertion of a LMA has advantages over tracheal intubation for
      PCT mainly because the artificial airway lies remote from the operating field.
      Three cases are reported to illustrate these advantages.

PMID- 7793228
TI  - Long-term survival and predictors of mortality in Alzheimer's disease and multi
      infarct dementia.
AB  - Long-term survival was examined for 218 patients with Alzheimer's disease (AD)
      and 115 patients with multi-infarct dementia (MID). The 14-year survival rate for
      AD was 2.4% versus an expected rate of 16.6%, and for MID 1.7% versus 13.3%
      expected. MID showed a more malignant natural course than AD. Men carried a less
      favourable survival prognosis than women, both in AD and MID: the relative risk
      of dying for women was half that for men in both diseases. In MID, advanced
      disability indicated a relative risk of dying over twice as high. In both
      diseases the risk of death was substantially higher in the event of occurrence of
      primitive reflexes.

PMID- 7793229
TI  - Cu, Zn superoxide dismutase in patients with dementia of the Alzheimer type.
AB  - Cu, Zn superoxide dismutase (SOD) levels in the serum, cerebrospinal fluid (CSF)
      and skin fibroblasts of patients with dementia of the Alzheimer type (DAT) were
      estimated using enzyme immunoassay. The SOD mRNA level in the skin fibroblasts
      was also determined by the Northern blot analysis. As compared with the age
      matched control groups of neurological patients without dementia, the AD group
      consisting of patients with DAT at ages under 65 years of age as well as the SDAT
      group of patients with DAT at ages over 65 years of age showed no significant
      changes in serum or CSF SOD levels. However, the skin fibroblast SOD- and SOD
      mRNA levels, which were correlate each other, were significantly higher in the AD
      group (p < 0.05), while lower in the SDAT group (p < 0.05). These results suggest
      that the determination of the SOD level of skin fibroblast may be useful for
      diagnosis of DAT and that the abnormality of SOD may play an important role in
      developing DAT.

PMID- 7793230
TI  - Rising mortality from Parkinson's disease in Japan, 1950-1992.
AB  - The death rate from Parkinson's disease (PD) were analyzed using Japanese vital
      statistics for 1950-1992. The age-adjusted PD death rate increased statistically
      significantly with the years between 1950 and 1992 for both sexes. However,
      decline in the PD death rate were observed among the population under 65 years
      old, while striking increases were seen among those over 70 years old. The
      changing patterns in the PD death rate might be explicable by a constantly
      improving ascertainment of PD, a true rise in the incidence of PD, particularly
      among the elderly, and a constantly increasing number of elderly people. There
      were remarkable differences in the PD death rates among the four marital
      categories in each sex. The mean age at death in PD increased from about 60 years
      in 1950 to 77 years in 1992 for both sexes.

PMID- 7793231
TI  - Early selegiline therapy reduces levodopa dose requirement in Parkinson's
      disease.
AB  - In an earlier report of our placebo-controlled selegiline trial on de novo
      parkinsonian patients, we have shown that the need to start additional levodopa
      therapy is significantly postponed by using selegiline monotherapy. Now we report
      the two-year interim results of the double-blind continuation of the trial in 44
      patients after the introduction of levodopa to the earlier therapy with placebo
      or selegiline (21 and 23 patients, respectively). The clinical disability was
      assessed by three rating scales. The daily dose of levodopa needed to maintain an
      optimal condition had to be increased progressively up to a 52% higher level in
      the placebo group than in the selegiline group (543 +/- 150 and 358 +/- 117 mg,
      respectively, p < 0.001). The number of daily doses of levodopa was also
      statistically significantly higher in the placebo group during the 24 months'
      observation period (p < 0.01). The ratio of levodopa doses that was expected to
      stay the same contrarily significantly increased suggesting that selegiline
      would, besides having the levodopa potentiating effect, also have a beneficial
      influence on the progression of the basic cerebral dopamine deficiency. The
      combination of selegiline and levodopa was well tolerated, and the adverse event
      profiles did not differ from each other. In conclusion, early selegiline therapy
      allows a significant saving in the subsequent levodopa dosage. This saving seems
      to become even stronger along with the treatment time.

PMID- 7793232
TI  - Hereditary ataxias and paraplegias in Valle d'Aosta, Italy: a study of prevalence
      and disability.
AB  - INTRODUCTION: a study was conducted in the Valle d'Aosta Region, Italy, (115270
      inhabitants) to determine the prevalence of hereditary ataxias (HA) and
      hereditary spastic paraplegias (HSP), and the degree of disability they cause.
      METHODS: we identified all patients with suspected HA or HSP referred from 1981
      to 1991 to in- and out-patient departments, EEG, EMG, and CT-scan services, and
      centres for the handicapped. Harding's criteria were followed for diagnosis and
      classification. RESULTS: at the prevalence day, 17 patients were alive, with a
      prevalence ratio of 14.8/100,000 population. There were 2 cases of Friedreich's
      ataxia (FA), 1 of early onset cerebellar ataxia with retained tendon reflexes
      (EOCA), 1 of autosomal dominant cerebellar ataxia (ADCA), 8 of sporadic
      idiopathic late onset cerebellar ataxias, and 5 of HSP. CONCLUSIONS:
      epidemiological studies on HA and HSP show highly variable prevalence ratios,
      which could be due in part to the inclusion of sporadic cases. FA, EOCA and ADCA
      have similar prevalence ratios in most studies.

PMID- 7793233
TI  - Correlation between magnetic resonance imaging and clinical parameters in
      multiple sclerosis.
AB  - In this study, the course of 60 consecutive multiple sclerosis patients
      (relapsing-remitting (RR), relapsing-progressive (RP), primary-progressive (PP))
      was compared with the number and mean size of the lesions as well as the total
      load of the lesions as shown on magnetic resonance imaging (MRI). Significant
      differences were found between RR and RP patients in total load and number of
      lesions. Between RR and PP patients statistical significant differences were
      found in total load, number and size of the lesions when correlated with EDSS.
      Between RP and PP patients statistical differences were found in total load and
      size of the lesions on MRI. Patients with a relapsing course of the MS (RR or RP)
      had a higher total load and size of the lesions than PP patients. The total load,
      number and size of the lesions corrected for EDSS were also lower compared to
      relapsing patients. Factor analysis showed a correlation between clinical
      progression rate and progression rate of MRI abnormalities. No correlation
      between EDSS and total load of MRI lesions could be found. In conclusion, this
      study confirms the results of previous studies of differences between MRI scans
      of patients with a different course of MS.

PMID- 7793234
TI  - Associated autoimmune diseases in myasthenia gravis. A population-based study.
AB  - During a comprehensive epidemiological study of myasthenia gravis (MG) in Western
      Denmark 1975-1989, we analyzed the occurrence, clinical characteristics and
      prognosis of associated autoimmune diseases (AAD) in MG patients. AAD were found
      in 20 of 212 incident cases (9%) and in 30 of 220 prevalent cases (14%). The most
      common diseases were: thyroid disorders and rheumatic arthritis. Clinically, it
      was not possible to identify a subgroup of MG patients with a higher risk of AAD.
      In most MG patients the AAD occurred before thymectomy. The severity of the AAD
      was not influenced by thymectomy. The remission rate was lower in MG patients
      with AAD than in MG patients without AAD suggesting that the autoimmune response
      in MG patients with AAD is more severe.

PMID- 7793235
TI  - Familial spasmodic dysphonia with low arylsulphatase A (ASA) level.
AB  - Two familial cases of late onset spasmodic dysphonia and low Arylsulphatase A
      (ASA) are reported. In one case spasmodic dysphonia was associated with negative
      head tremor and orthostatic tremor, both displayed postural tremor of the upper
      extremities. A familial predisposition for both focal dystonia and metabolic
      lysosomal impairment is suggested by similar observations.

PMID- 7793236
TI  - Lamotrigine as an add-on drug in typical absence seizures.
AB  - INTRODUCTION: Lamotrigine is licensed in many countries for use in patients with
      partial seizures. Evidence suggests that it may also be effective in generalised
      epilepsies. MATERIAL & METHODS: We analysed retrospectively our patients with
      idiopathic generalised epilepsy with refractory absences. RESULTS: Fifteen
      patients with idiopathic generalised epilepsies were identified who had been
      treated with lamotrigine for 3 months or more. All patients were also treated
      with sodium valproate. Fourteen patients had active absences. Nine (64%) had a
      total or virtual cessation of absences and in a further patient they became
      milder and less frequent. One patient reported an increase in seizures. The
      effective dose of lamotrigine was 1.6-3.0 mg/kg/day in children and 25-50 mg/day
      in adults. Patients who responded did so after the first or second dose.
      Lamotrigine was well tolerated. CONCLUSION: Low-dose lamotrigine added to sodium
      valproate appears to be effective in typical absence seizures. A therapeutic
      interaction of the two drugs seems likely.

PMID- 7793237
TI  - The prognostic value of the EEG in asphyxiated newborns.
AB  - Peripartal asphyxia is still one of the most important factors of neonatal
      morbidity and mortality and accounts for the majority of non-progressive
      neurological deficits seen in children. A set of evaluations that may
      consistently predict outcome in this patient population would be valuable. The
      purpose of the present retrospective study was to investigate the prognostic
      value of the early neonatal EEG and Sarnat scoring obtained in 23 asphyxiated
      term newborns. All infants met strict entrance criteria, regarding asphyxia, and
      received standard treatment. The relationship between the Sarnat scoring, the
      early EEG findings, and the clinical follow up examination (at 1,5-7 years) were
      studied using the Pearson Correlation test and multiple regression. Our study
      clearly demonstrates a strong correlation between the early neonatal EEG and
      outcome, even regarding the prediction of minor sequelae (r = 0.79, p < 0.0001).
      The early neonatal EEG is more accurate in predicting the ultimate clinical
      outcome than the Sarnat scoring.

PMID- 7793238
TI  - Intracranial traumatic and non-traumatic haemorrhagic complications of warfarin
      treatment.
AB  - An increased referral of patients with anticoagulation related haemorrhages
      necessitated an analysis of causes and outcome of these complications in a
      patient group that reflected Swedish therapeutic traditions of anticoagulation
      treatment. Prospectively, all patients from Stockholm evaluated for warfarin
      related intracranial haemorrhage occurring during 1987 were analysed and their 6
      month outcome recorded. Sixty-eight patients were included. The results of
      intracranial haemorrhagic complications were catastrophic with a 77% mortality
      rate. Their incidence was much higher than expected. Forty-one patients had non
      traumatic intracerebral haematomas, 1 had a non-traumatic subarachnoid
      haemorrhage and 26 had traumatic injuries. In the 42 patients with non-traumatic
      haemorrhages, the indications for anticoagulation were cerebral ischaemic events
      in a majority (27/42). The remaining 15 patients had different indications for
      anticoagulation. They also had an increased frequency of hypertension (p < 0.05).
      In the 26 patients with traumatic haematomas, only 6/26 patients had previous
      cerebral ischaemic injuries (p < 0.01). Valvular heart prosthesis was their most
      common indication (11/26) for anticoagulation. Caution in instituting
      anticoagulation therapy in patients with hypertension or cerebrovascular disease,
      which is an important indication for anticoagulation in Sweden, is mandatory.
      Adherence to strict treatment regimens and their continuous reevaluation may help
      to avoid complications. The finding of more patients than expected with
      haemorrhagic complications is not compatible with the risk evaluations used to
      justify anticoagulation therapy in the patient groups studied. Clinical practice
      must have changed with time, showing that risk evaluations from controlled trials
      or retrospectively collected clinical data from selected patients are not
      necessarily applicable for long-term clinical practice.

PMID- 7793240
TI  - Decreased plasma alanine and isoleucine in Huntington's disease.
AB  - Amino acid concentrations in plasma of patients with Huntington's disease (HD)
      were determined in 16 patients and 21 age- and sex-matched healthy controls.
      Alanine and isoleucine were significantly decreased in HD plasma whereas
      arginine, histidine, leucine, lysine, ornithine, proline, serine, threonine,
      tyrosine, and valine showed no significant changes. Our findings confirm the
      decreases of alanine and isoleucine that were described in plasma and
      cerebrospinal fluid by other investigators. A possible defect in cellular uptake
      or metabolism of neutral amino acids seems to be a consistent feature of HD.

PMID- 7793241
TI  - Abnormal penetration of haptoglobin through the blood-brain-barrier (BBB) into
      the cerebro-spinal fluid (CSF) in Alzheimer's disease patients.

PMID- 7793239
TI  - A follow-up study of neuropsychological functioning in AIDS-patients. Prognostic
      significance and effect of zidovudine therapy.
AB  - Thirty-three patients with AIDS were subjected to neuropsychological and
      immunological testing with semi-annual examinations over a two year period. No
      patient had signs of opportunistic infections or neoplasms in the CNS. Patients
      who were neuropsychologically impaired at the time of AIDS diagnosis (n = 12)
      survived for a significantly shorter period than did the non-impaired subjects (n
      = 21), and neuropsychological function at first test had a significant predictive
      value concerning survival time. The poor prognosis associated with impaired
      neuropsychological status was seen also in patients treated with zidovudine
      (ZDV). Of the 21 patients who started ZDV treatment shortly after the first
      neuropsychological examination, 12 were retested. Follow-up data showed that this
      group of patients had a significant improvement in neuropsychological functioning
      during the first 6 months. However, a decrease in performance was observed at
      second follow-up. In the group not treated with ZDV (n = 7), two initially normal
      patients developed signs of HIV-encephalopathy, while none of the initially
      normal ZDV-treated patients did so. This might suggest a prophylactic effect of
      ZDV on development of neuropsychological dysfunction. Changes in
      neuropsychological test results were correlated with changes in serum
      concentration of neopterin irrespective of ZDV treatment, suggesting that
      monocyte/macrophage activation may be involved in the pathogenesis of HIV
      encephalopathy.

PMID- 7793242
TI  - Clozapine in the treatment of tremor in Parkinson's disease.

PMID- 7793243
TI  - [Oncogenes and cancer of the larynx. EGFR, p21 ras and HPV-DNA infections].
AB  - The modern concept of oncogenesis is based upon the interaction between factors
      which modulate cellular growth and differentiation, in particular oncogenes and
      tumor suppressor genes. The molecular events which induce laryngeal
      carcinogenesis are not yet known. Protoncogenes seem to be the target of the risk
      factors (cigarette smoking, alcohol abuse, ionizing radiations and, not least HPV
      DNA) that are commonly considered related to laryngeal squamous cell carcinoma.
      New information on the role of alterations of oncogenes and/or their proteic
      products in laryngeal cancer will be useful in identifying new diagnostic and
      clinical therapeutical applications. The Authors investigated Epidermal Growth
      Factor Receptor (EGFR) expression in 103 primary laryngeal squamous cell
      carcinoma and 42 normal laryngeal tissue specimens in order to assess its
      clinical significance in primary laryngeal cancer. Significantly higher EGFR
      levels were found in cancer specimens compared with normal mucosa (p < 0.001).
      EGFR expression did not correlate with age, tumor localization, T classification,
      cervicallymphonode involvement or surgery, whereas in G3 tumors it was
      significantly higher than in G1-G2 (p < 0.05). Follow-up data were available for
      74 cases: EGFR levels resulted significantly higher in patients who had a
      recurrence of the disease than those in recurrence-free patients (p < 0.05). The
      24-month disease-free survival (DFS) was 58% for EGFR+ patients and 82% for EGFR
      subjects. Multivariate analysis permitted identification of EGFR status and tumor
      localization as significant independent prognostic factors. Data reported here
      suggest that EGFR expression probably plays a role not only by regulating the
      growth of laryngeal cancer, but also by identifying a sub-set of laryngeal cancer
      patients at a higher degree of relapse risk and with an unfavorable prognosis.
      Furthermore, in this study p21-ras expression in 43 primary laryngeal cancers and
      in 7 normal laryngeal mucosa specimens was evaluated. Scattered p21 levels,
      expressed as optical density (O.D), were found in normal mucosa (median = 1.94)
      and in primary laryngeal tumours (median = 1.74). Higher p21 levels were found in
      neoplastic tissue than in normal laryngeal tissue (median = 2.54 vs median =
      1.94; p = 0.023). The correlation between p21 ras protein and EGFR levels was
      also investigated. EGFR+ cases do not show any difference in p21 expression with
      respect to EGFR- cases (median = 1.52 O.D. vs median = 1.84). Our findings
      suggest that overexpression of p21 is associated with malignant phenotype in
      laryngeal cancer.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7793244
TI  - Analysis of seven pedigrees of childhood Wilson's disease characterized by
      abdominal symptoms.
AB  - In a survey of childhood Wilson's disease (WD) characterized by abdominal
      symptoms, three patients with high levels of immunologically detectable
      ceruloplasmin (CP) in serum were found. These three cases were compared with
      typical cases of WD in which serum CP level was low. In order to clarify the
      cause of WD, serum CP levels were quantified by two methods, an immunological
      protein assay and an oxidase activity assay. Using the results of these two
      assays, WD cases were classified into three groups on the basis of CP content;
      the first group consisted of patients with low enzyme activity and low CP protein
      content, the second group consisted of patients with low enzyme activity and
      normal CP protein content, and the third group, those patients with normal enzyme
      activity and normal CP protein content. No significant difference in symptoms was
      observed between these three groups. Since relatively high levels of CP were
      detected in some WD patients, genetic variation in CP in WD patients was examined
      by restriction enzyme fragment length polymorphism analysis using CP cDNA.
      However, no large deletion in the CP gene was detected. Using four types of gene
      probes for chromosome 13 known to be related to WD, the DNA of WD patients was
      examined in a similar fashion, but no significant difference was observed between
      the groups.

PMID- 7793245
TI  - Growth and development of 280 hypothyroidic patients at diagnosis.
AB  - The growth and development of 280 hypothyroidic patients who were diagnosed from
      1979 to 1991, has been evaluated by standardized anthropometric criteria.
      According to the chronologic age during the diagnosis, the patients were divided
      into five groups of 0-6, 7-12, 13-24, 25-60 and 61-144 months. In these groups,
      the rates of the patients' weights and heights which were found below the 5th
      percentile, were as follows; for height 44%, 69%, 71%, 85%, 80% and for weight
      38%, 68%, 70%, 55%, 60% respectively. Height age, weight age, head circumference
      age, and bone age were found to be significantly lower than chronologic age in
      all the groups, with the exception of the head circumference age in the 0-6
      months group. The bone age was found to be significantly retarded compared to the
      height age in all the groups.

PMID- 7793246
TI  - Influence of parental obesity on the physical constitution of preschool children
      in Japan.
AB  - The objective of this study was to assess the influence of parental obesity on
      the physical constitution of preschool children. A total of 3187 children aged
      between 1-6 years and their parents were studied. A child whose per cent obesity
      (%OB; per cent overweight for age, height and sex) was greater than 15%, and a
      parent whose body mass index (BMI; kg/m2) was greater than the 95th percentile
      were defined to be obese (27.40 and 25.97 for a father and a mother,
      respectively). We found that the incidence of obesity in children with obese
      fathers (11.5%) was significantly higher than in those with non-obese fathers
      (6.2%), and a similar difference was obtained between children with obese mothers
      (14.5%) and with non-obese mothers (6.2%), respectively. The incidence of obesity
      in children was 6.0% if both parents were non-obese; this incidence rose to 22.7%
      if one parent was obese, and to 30.8% if both were obese. The %OB of children was
      more markedly correlated with the mothers' BMI (r = 0.219) than the fathers' BMI
      (r = 0.165). The %OB of children correlated significantly with fathers' BMI, but
      only from the age of 3-6 years, whereas mothers' BMI correlated from the age of 1
      6 years. We conclude that parental obesity was of significance in determining the
      development of juvenile obesity even in the preschool period.

PMID- 7793247
TI  - Age-related profile of neuroblastoma: a comparison of tumors detected by mass
      screening with those detected clinically.
AB  - Infants with neuroblastoma are known to have a favorable prognosis compared to
      those over 1 year of age. However, there is little biological information about
      the age-related heterogeneity of neuroblastoma. We evaluated the biological
      profile comparing cases detected by mass screening with those detected
      clinically. A total of 238 patients with neuroblastoma were classified into four
      groups according to their age at diagnosis. Patients in group A were 0-5 months
      of age (n = 31). Patients in group B were detected clinically and were 6-11
      months of age (n = 25). Patients in group C were 6-11 months of age and were
      detected by mass-screening (n = 97). Patients in group D were more than 12 months
      of age (n = 85). The age-related heterogeneity was evaluated by Kaplan-Meier
      survival analysis, several clinical markers (neuron specific enolase, ferritin,
      vanillylmandelic acid and homovanillic acid) at diagnosis, tumor Ha-ras p21
      expression and tumor N-myc amplification. Infant neuroblastoma had unique
      features in comparison to neuroblastoma diagnosed over 12 months of age. Clinical
      outcome of the patients in groups A and C was quite favorable. Even patients with
      stage III or IV disease in group A had a favorable prognosis. However, stage IVs
      disease in group A was not necessarily associated with a good prognosis and the
      early death after diagnosis was also characteristic. The biological profile of
      tumors in group C was similar to that in group A but different from the profile
      in groups B and D. Tumors in group B had a biological profile intermediate
      between groups A and D.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793248
TI  - Opsonic activity in cord blood: comparison between normal and elevated
      immunoglobulin M infants.
AB  - In order to clarify the relation between opsonic activity (OA) in newborn infants
      and their gestational age, we determined OA by Cypiridina luciferin analog
      dependent chemiluminescence (MCLA-CL). In addition, complement C3 which plays the
      major role in OA, was determined by the two-dimensional immunodiffusion method.
      Although OA and C3 in newborn infants increased in proportion to their
      gestational age, the levels were significantly lower in full-term infants than in
      adults. In neonates with IgM levels of more than 30 mg/dL at birth, both OA and
      C3 levels were significantly higher than in normal neonates, yet these levels
      were significantly lower than in adults. These findings suggest that low opsonin
      activity is an important factor in neonatal susceptibility to infection. When OA
      is measured by chemiluminescence, MCLA-CL is the preferred technique to luminol
      dependent chemiluminescence.

PMID- 7793249
TI  - Inhaled nitric oxide and extracorporeal membrane oxygenation in persistent
      pulmonary hypertension of the newborn.
AB  - Persistent pulmonary hypertension of the newborn (PPHN) may occasionally require
      an invasive treatment with extracorporeal membrane oxygenation (ECMO). Inhaled
      nitric oxide (NO) has recently been introduced as a selective pulmonary
      vasodilator for treatment of PPHN. We describe a case of PPHN in which neither
      inhaled NO nor ECMO was effective in reversing pulmonary hypertension. The
      clinical course of the patient suggested a potential role of NO inhalation in
      predicting the outcome of ECMO treatment for PPHN.

PMID- 7793250
TI  - Nephrocalcinosis in newborn.
AB  - Nephrocalcinosis is uncommon in childhood, and almost always develops outside the
      newborn period. Over the last decade, nephrocalcinosis due to multifactorial
      pathogenesis has increased in very low birthweight infants. In this report a 23
      day old full-term baby with nephrocalcinosis secondary to distal renal tubular
      acidosis is described.

PMID- 7793251
TI  - Persistent vacuoles in leukocytes: familial Jordans anomaly.
AB  - Multiple persistent vacuoles were seen in the neutrophils, monocytes and
      eosinophils of a 9 year old boy and his 10 year old sister. The siblings were
      both asymptomatic. In the bone marrow, the cytoplasmic vacuoles were also present
      in the promyelocytes, myelocytes and metamyelocytes, but not in the myeloblasts
      and they tended to be single and large in immature cells. The cytoplasmic
      vacuoles did not stain with PAS, Sudan Black or Oil Red O; Sudan III positivity
      of the vacuoles was found only in a very small number of granulocytes. The
      vacuoles appeared as round and bright bodies with phase contrast microscopy. By
      electron microscopy, the vacuoles contained material of low electron density and
      had no surrounding membrane. Granulocyte functions were unimpaired. Muscle biopsy
      showed normal morphology. This anomalous vacuolization of the leukocytes is
      consistent with familial Jordans anomaly.

PMID- 7793252
TI  - Unique form of rickets with low serum 25-hydroxyvitamin D in two normally
      nourished children.
AB  - We present an unusual type of rickets involving two children: a 2 year old boy
      and a 15 month old boy, who presented with marked bowing of the lower extremities
      and bulging of costochondral junctions. Both children had normal growth, with
      their height and body weight greater than the 50th and 97th percentile for age.
      Roentgenograms of their extremities showed the typical changes of vitamin D
      refractory rickets. Serum alkaline phosphatase levels were elevated and serum
      levels of calcium and phosphate were both within the normal range. No primary
      cause for the rickets, including nutritional deficiencies, was found in the two
      patients. Characteristic findings were persistently low serum 25-hydroxyvitamin D
      (25-OH-D) and normal 1,25-dihydroxyvitamin D (1,25-(OH)2-D). Improvements in
      clinical and X-ray findings were observed after either oral administration of 1
      alpha-(OH)-D3 (9-15 micrograms per day) or massive vitamin D2 therapy (600,000 IU
      single injection). The low serum levels of 25-OH-D did not increase unless
      massive vitamin D2 therapy was also given. These two cases represent a unique
      form of rickets that does not meet the criteria for any type of previously known
      rickets.

PMID- 7793254
TI  - Hypercalcemia associated with Aeromonas hydrophila gastro-enteritis.
AB  - We describe a 4 year old girl with acute Aeromonas hydrophila gastro-enteritis
      who presented with a combination of hypercalcemia, metabolic alkalosis, and renal
      impairment. Serum parathyroid hormone was not elevated. Both milk-alkali syndrome
      and intoxication of vitamins A and D were ruled out. The hypercalcemia, metabolic
      alkalosis, and renal impairment were improved by fluid infusion and intravenous
      administration of furosemide. Gastro-enteritis also improved with oral
      administration of the antibiotic norfloxacin. The association of A. hydrophila
      gastro-enteritis with hypercalcemia has not been described previously.

PMID- 7793255
TI  - Recurrent pneumococcal meningitis in a patient with transient IgG subclass
      deficiency.
AB  - We report the case of a 3 year old boy who exhibited recurrent serious infections
      with a transient imbalance of IgG subclass in the second year of life. He
      suffered from pneumococcal meningitis at 3 months, hepatitis at 9 months, and
      purulent arthritis at 11 months of age. The second episode of pneumococcal
      meningitis occurred at 14 months. Serum IgG level was normal for age. Low level
      of IgG2, undetectable level of IgG4 and negligible level of pneumococcus-specific
      IgG1-G2 antibodies were found. No other primary immunodeficiency was apparent.
      Serum IgG2-G4 levels but not pneumococcus-specific IgG1-G2 titers increased by
      the age of 30 months. At that time, he was inoculated with a polyvalent
      pneumococcal vaccine along with acellular diphtheria-pertussis-tetanus vaccine.
      He acquired the immunity against these agents, and had no episodic infections in
      the following 2 years. This observation stresses the existence of transient IgG
      subclass deficiency associated with delayed development of the anti
      polysaccharide antibody response.

PMID- 7793256
TI  - Transient low level of IgG3 induced by sepsis.
AB  - Staphylococcus aureus sepsis developed in a 14 year old girl. Immunological
      evaluation revealed low level of IgG3, although total IgG level was normal. The
      level of IgG3 increased gradually along with the recovery from sepsis.
      Immunoglobulin replacement therapy might have been useful in this patient, even
      though the total immunoglobulin level was within normal limits.

PMID- 7793253
TI  - A case of distal 9q trisomy syndrome associated with an unusual inheritance of
      ABO blood type.
AB  - A male infant with distal 9q trisomy syndrome associated with an unusual
      inheritance of ABO blood type is reported. His clinical features were concordant
      with those of distal 9q trisomy syndrome. His karyotype was 46,XY, -10, +der (10)
      t(9;10) (q22.3;q24.3) confirmed by G-banding and high resolution methods. His
      father had the balanced translocation t(9;10) (q22.3;924.3). He had a blood type
      of AB, despite his father's blood type of AB and his mother's blood type of O.
      The gene of ABO blood type is located at 9q34.1-q34.2. Therefore, he would have
      received A and B type alleles from his father. 9q trisomy syndrome should be
      carefully investigated with ABO blood type.

PMID- 7793257
TI  - Beta-thalassemia with the IVS-I-1 (G-->T) mutation in a Japanese girl.
AB  - We analyzed the hemoglobins of a Japanese girl with beta-thalassemia and those of
      her immediate family. DNA sequencing of the cloned beta-globin gene from this
      patient revealed a point mutation at the IVS-I position 1 (G-->T). This rare
      point mutation has been found in Asian Indians, but this is the first reported
      Japanese case.

PMID- 7793258
TI  - A female infant successfully treated by ganciclovir for congenital
      cytomegalovirus infection.
AB  - An 11 month old female infant, diagnosed as having congenital cytomegalovirus
      (CMV) infection and suffering from pneumonia and intractable diarrhea, was
      treated with 9-(1,3-dihydroxy-2-propoxymethyl) guanine (DHPG), intravenously for
      8 weeks. Watery diarrhea ceased and pneumonia associated with massive
      endotracheal aspirates was reduced. No leukopenia, thrombocytopenia or other side
      effects were observed during the therapy. The clinical findings suggest that DHPG
      might be an effective and safe agent for the treatment of both intestinal and
      lower respiratory CMV infection in young infants.

PMID- 7793259
TI  - Fatal cytomegalovirus myocarditis in a seronegative ALL patient.
AB  - Fatal cytomegalovirus (CMV) myocarditis occurred in a 2 year old boy with acute
      lymphoblastic leukemia (ALL) in remission. The patient showed mild hepatic
      dysfunction and a rapid progress of pancytopenia after complete remission had
      been achieved. At the fifth week of complete remission, he presented signs of
      heart failure such as tachycardia, S4 gallop on auscultation and decreased
      ejection fraction on echocardiography. However, no significant
      electrocardiographic changes were recognized. In addition to the cardiac
      dysfunction, the patient presented a marked tachypnea and dyspnea associated with
      hypoxemia. These were dramatically improved by methylprednisolone pulse therapy
      (30 mg/kg per day, for 3 days) and CMV high titer immunoglobulin (400 mg/kg per
      day, for 3 days). On the sixth day after signs of respiratory failure were
      improved, the patient suddenly presented a paroxysmal atrial tachycardia followed
      by a fatal ventricular fibrillation. Although we could detect neither a specific
      IgM antibody, a significant increase of IgG antibody, nor CMV genome by DNA
      hybridization techniques during the course of the illness, microscopic
      examination of necropsy specimens of the heart showed a marked disruption and
      disintegration of muscle bands associated with cytomegalic inclusion bodies.
      Polymerase chain reaction (PCR) yielded a 305 bp amplification product in the
      heart and lung tissues, supporting the view that myocarditis was caused by CMV.

PMID- 7793260
TI  - Interferon-alpha potentiates priming-dependent FMLP-induced neutrophil superoxide
      generation in a patient with chronic myeloid leukemia.
AB  - A 13 year old girl diagnosed as having chronic myeloid leukemia (CML) was treated
      with interferon-alpha (IFN-alpha) alone and 4 months later hematological
      remission was obtained. In the course of the IFN-alpha treatment there was
      neither infectious sign nor side effects. In this study we have examined the
      effect of IFN-alpha on superoxide O2- generation by polymorphonuclear neutrophils
      (PMN). The PMN of the patient generated less O2- than PMN from normal controls.
      When patient PMN were cultured in the presence of 1000 U/mL IFN-alpha,
      enhancement of the formyl-methionyl-leucyl-phenylalanine induced O2- generation
      following priming with tissue necrosis factor-alpha was observed. Over the course
      of the IFN-alpha therapy, such O2- generation was gradually restored. It is
      suggested that CML PMN are in the resting condition in terms of their ability to
      generate O2- and that IFN-alpha is effective in inducing O2- generation by CML
      PMN.

PMID- 7793261
TI  - Occurrence of acute megakaryoblastic leukemia in a patient with idiopathic growth
      hormone deficiency.
AB  - We describe a case of a 15 year old boy who developed acute megakaryoblastic
      leukemia (AMKL) while receiving treatment with human growth hormone (hGH) for
      idiopathic growth hormone deficiency (GHD). He was diagnosed as having idiopathic
      GHD and given hGH from December 1991. The examination of his peripheral blood
      showed mild pancytopenia 2 months before the start of the hGH therapy. Since
      January 1992, paleness of the skin, general fatigue and fervescence progressed
      gradually. In February 1992, because of the occurrence of acute leukemia,
      administration of hGH was discontinued. Judging from the results of surface
      marker analysis of the blast cells, the patient was diagnosed as having AMKL. He
      was treated with chemotherapy for acute non-lymphoblastic leukemia from March
      1992. A complete remission was obtained after 4 weeks of treatment. The
      chemotherapy was completed in July 1993. He remains in complete remission 26
      months after diagnosis. This case suggests the importance of hematological
      examination and, when there is any abnormality which is not caused by GHD, such
      as pancytopenia, more detailed medical examinations (for example bone marrow
      examination) are necessary.

PMID- 7793262
TI  - Mononucleosis-like illness in an infant associated with human herpesvirus 6
      infection.
AB  - Illnesses resembling mononucleosis, hematologically characterized by atypical
      lymphocytosis in the peripheral blood, are caused by other viral infections as
      well as by a primary Epstein-Barr virus infection. Human herpesvirus 6, a newly
      isolated member of the herpesvirus group, can also cause a mononucleosis-like
      illness. Illness associated with human herpesvirus 6 infection mostly occurs in
      immunocompetent adults. We observed a 3 month old infant who presented with
      marked atypical lymphocytosis and liver dysfunction. We examined serum samples to
      detect viral antibodies related to mononucleosis-like illness. Only the titers of
      antibody against human herpesvirus 6 were elevated. Primary human herpesvirus 6
      infection cannot only cause exanthem subitum or present in an inapparent form but
      can also cause an illness like mononucleosis, even in an infant.

PMID- 7793263
TI  - Alpha-mannosidosis: the first Turkish case.
AB  - We describe a 10 month old boy with alpha-mannosidosis who presented with
      recurrent bronchopneumonia and diarrhea. Facial coarsening, deafness,
      hepatosplenomegaly, umbilical hernia, pectus carinatum and widespread Mongolian
      spots were distinguishing features. He also had mild skeletal deformities grouped
      together as 'dysostosis multiplex', and vacuolated lymphocytes on peripheral
      blood smear. These findings coupled with an abnormal urinary oligosaccharide
      pattern led to the suspicion of a lysosomal storage disease in the patient which
      proved to be alpha-mannosidosis. An exceptionally low level of alpha-mannosidase
      activity was subsequently found in serum and cultured skin fibroblasts. The
      patient's brother, who had died at the age of 10 months, had similar features. To
      the best of our knowledge, this is the first case reported from Turkey.

PMID- 7793264
TI  - Clinical features of Bardet-Biedl syndrome.
AB  - Six patients with Bardet-Biedl syndrome who have been followed in our clinics for
      the last 5 years are reported in this study. Of the five classic features of this
      syndrome; obesity and mental retardation were present in all cases, retinal
      disturbances were present in five, polydactyly in three and hypogenitalism was
      observed in all four male patients. Renal involvement, often suggested as a
      cardinal feature of this syndrome, was described in two patients. Iron deficiency
      anemia occurred in three patients, two patients were of short stature, one
      patient presented with an empty sella, and in two patients clinodactyly was
      detected. The results are compared to previously published literature and
      discussed.

PMID- 7793265
TI  - Child abuse and child abuse studies in Japan.
AB  - Medical research on child abuse has a short history of only 20 years. However,
      the social and familial changes that have occurred since the Second World War
      have resulted in an increasing number of abused children throughout Japan.
      Reported cases represent only the tip of the iceberg, with many cases being
      ignored. This article discusses the history, definition, incidence, and social,
      familial, and psychopathology factors in the etiology of child abuse based on
      clinical experience and research surveys undertaken during the past 20 years.
      Suggestions for improving child abuse preventive and reactive services are also
      made.

PMID- 7793267
TI  - Analysis of child abuse cases admitted in pediatric service in Japan. II.
      Backgrounds of child abuse in non-low birth-weight infants.
AB  - Child abuse of 126 non-low birth-weight (non-LBW) cases reported from pediatric
      clinics of major hospitals in Japan in 1986 were examined. Compared to LBW
      infants abused children's medical problems were few (25.4%) but the presence of
      step-parents and a history of rearing outside the home were evident (41.3%). The
      abuse of a child with medical problems by real parents showed similar
      characteristics to abuse of LBW, occurring at 0-1 and 4 years and two types of
      abuser's problems were apparent; one problem was the lack of child rearing
      ability and the other was the inability to cope with the stress involved in child
      rearing. In abuse of a child by step-parents, most abusers expressed emotional
      problems with their abused children. Child abuse by a real parent following a
      period of non-home care occurred soon after the child returned home, and abusers
      complained that the abused child did not take to its real parents. Abuse of a
      child without medical problems by real parents occurred at or around birth and
      indicated a poor ability to rear a child due to parental problems or low
      tolerance to cope with child rearing. Abuse both of a child and siblings by real
      parents implied a deficiency of understanding and inability in child rearing due
      to parental problems that may have resulted in abuse of the children at 0-1 year.
      It seems that two processes are critical in non-LBW child abuse as well as LBW
      child abuse.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793268
TI  - Early intervention in case of child abuse: co-operation between the hot-line and
      local facilities.
AB  - The Center for Child Abuse Prevention (CCAP), a citizens' organization, was
      started in May 1991 with such members as pediatricians, psychiatrists, lawyers
      and people working at child welfare offices. A hot-line dealing with child abuse
      was set up immediately after the establishment of CCAP on 20 May 1991, and in the
      2 years it has been in operation this hot-line has received 3189 calls out of
      which we picked 30 cases that CCAP was consulted about by helping persons or
      therapists affiliated with such facilities as hospitals, public health centers,
      etc. in order to evaluate how CCAP co-operates with these organizations. We
      reviewed the CCAP records of these 30 cases, comparing them with the materials
      concerning other hot-line calls, while at the same time interviewing the helping
      persons and therapists who had called in those cases, ascertaining their motives
      and the later course of the cases. This follow-up study was begun in June 1992 so
      that the longest follow-up period from the first call was 2 years and 7 months
      and the shortest 7 months. A total of 73.3% of these 30 cases required emergency
      intervention, and 53.4% were extremely severe, life-threatening cases of child
      abuse. The age distribution of these 30 victimized children peaked between 4 and
      6, and 13 and 15 years. The perpetrator was the biological mother in 55.9% of the
      cases, the biological father in 29.4% and the stepfather in 8.9%. The abuse was
      physical in 58.3% of the cases, sexual in 8.9%, emotional in 5.6%, and involved
      neglect in 22.2%. These percentages differ from the general trend seen in the
      total hot-line cases, but were very similar to those reported by the Child
      Guidance Center. In the majority (56.7%) of the cases CCAP was consulted about,
      CCAP went beyond its hot-line service and co-operated to intervene, organizing
      network sessions in which the helping persons and therapists involved could
      discuss how best to deal with the problem at hand in five of these cases. In 22
      of these 30 cases, the persons involved are still co-operating with CCAP after
      successful intervention through which the victimized children were rescued from
      critical situations. It is vitally important to set up networks between the
      professionals of the various support agencies involved if we are to intervene
      successfully in cases of child abuse.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7793266
TI  - Analysis of child abuse cases admitted in pediatric service in Japan. I. Two
      types of abusive process in low birth-weight infants.
AB  - A very high rate (43.0%) of low birth-weight (LBW) was shown in 331
      abused/neglected cases reported from pediatric clinics of major hospitals in
      Japan. Of 87 LBW cases, 82.8% had medical problems and/or unsatisfactory reunion
      after non-home care and were abused at a particular age when each of the problems
      may have caused difficulties in caring. Two types of processes to abuse these
      intractable LBW were estimated: (i) abusers with psychiatric, mental problems or
      poor knowledge abused their children during the first 2 years, presumably because
      of an inability in child rearing; and (ii) abusers with neurosis or abnormal
      personality abused at ages over 2 years, complained of difficulties with rearing
      their children, and were suspected to be unable to cope with the difficulties. In
      both types, a combination of child and parental problems increased at risk.
      Obstetricians and neonatologists, who first encounter both high-risk mothers
      while pregnant and LBW, should give due care to the prevention of child abuse.

PMID- 7793270
TI  - Interpretation of child sexual abuse from the viewpoint of women's studies.
AB  - Child sexual abuse is interpreted as a triple infringement upon personal rights,
      and the nature of the problem of child sexual abuse is considered with regard to
      each of these three aspects, namely violence against women, child abuse and
      sexual assault.

PMID- 7793271
TI  - A boy with psychosocial short stature followed up from infancy to adulthood.
AB  - A boy with psychosocial short stature who has been followed up from the age of 11
      months to adulthood is described. The boy was the product of an unwanted
      pregnancy. The emaciated short boy gained weight and height markedly during a
      short-term stay at hospital, but lost weight and experienced minimal height gain
      at home. On the fourth hospital admission at the age of 6 years 3 months the boy
      weighed 10 kg and measured 85.7 cm, he was malnourished and exhibited strange
      behavior and had a voracious appetite. He was examined endocrinologically and
      provocative tests performed early after admission showed insufficient growth
      hormone secretion, although this recovered later at a time of catch-up growth.
      The boy was reared in an orphanage from the age of 6 years 5 months until the age
      of 15 years 3 months. His growth rapidly caught up to a normal rate, his abnormal
      behavior disappeared, and he demonstrated an increased IQ. He attained 169.5 cm
      at the age of 17.5 years and possessed normal secondary sexual characteristics.
      After graduating from senior high school the patient has been living happily by
      himself without intervention from his mother, and is working in a Chinese
      restaurant. The impaired relationship between the boy and mother has never been
      restored. The record of growth and development described in this case is the
      longest ever reported.

PMID- 7793269
TI  - Child abuse viewed through the hot-line in Osaka, Japan.
AB  - Cases of child abuse identified by a hot-line telephone service and by a survey
      of health and welfare agencies are reported. Many consultations to the telephone
      hot-line were from mothers concerned about maltreating their own children. In
      such cases, the extent of abuse was often mild to moderate, and many of those
      mothers were troubled about child care in the relatively segregated context of
      the nuclear family. In only a few cases did the callers indicate that the
      children's life was in danger. In the administrative survey, however, deaths
      occurred in 5% of the cases, and the abused children frequently had physical and
      psychological symptoms. There were also more frequent and more serious family
      problems in the administrative survey compared to the telephone consultation
      cases. The findings of these surveys suggest that many children and parents are
      suffering from child abuse in Japan, that many cases are currently not being
      identified by health and welfare agencies, and that a wide range of measures,
      from protection of severely abused children to prevention of abuse, are
      necessary.

PMID- 7793272
TI  - Child ecology and child abuse as one of the new morbidities and new mortalities.

PMID- 7793273
TI  - Stable microbubble test for predicting the occurrence of respiratory distress
      syndrome.
AB  - To predict the development of respiratory distress syndrome (RDS) in premature
      neonates who might benefit from early administration of surfactant, the clinical
      applicability of stable microbubble (SM) test was prospectively evaluated. Fifty
      nine preterm neonates with the gestational ages of less than 37 weeks were
      studied. SM test was performed on gastric aspirates obtained within 30 minutes
      after birth. The number of microbubbles was correlated with later development of
      RDS. With a cut-off value of less than 10 microbubbles/mm2, the SM test showed a
      positive predictive value of 76.0% (19/25) and a negative predictive value of
      97.1% (33/34), while sensitivity and specificity were 95.0% (19/20) and 84.6%
      (33/39), respectively. The overall accuracy was 88.1% (52/59). It was concluded
      that use of the SM test on gastric aspirates immediately after birth is a rapid,
      simple and reliable procedure for identifying those neonates with surfactant
      deficiency who may benefit from prophylactic surfactant therapy.

PMID- 7793274
TI  - Renal effects and urinary excretion of prostaglandin following indomethacin
      therapy in premature infants with patent ductus arteriosus.
AB  - Renal side effects and urinary prostaglandin were evaluated in 10 premature
      infants (Mean +/- SD: BW 1245 +/- 290 gm, GA 32 +/- 2.2 wks, Postnatal age 7.7 +/
      3.8 days) with significant PDA who were given one dose of indomethacin (0.3
      mg/kg intravenously). There was a significant decrease in urinary output, osmolal
      and free water clearance after therapy. The fractional excretion of sodium,
      chloride, potassium, glomerular filtration rate and urinary prostaglandin E2 also
      decreased but were not statistically different from the baseline values. In
      infants who responded to indomethacin with ductus closure, their renal functions
      appeared to be preserved even though they had higher plasma indomethacin levels
      than the non-responders in whom significant changes in renal function were
      observed following indomethacin therapy. This observation suggested that the
      improved renal hemodynamics following the closure of the ductus may minimize or
      attenuate the renal side effects of indomethacin.

PMID- 7793275
TI  - Normal oscillometric blood pressure values in Chinese children during their first
      six years.
AB  - To establish normal blood pressure values, values of the upper arm blood
      pressure, heart rate, body weight, body length and thickness of skin fold over
      the deltoid area were measured in 3937 healthy children aged 1 day to 6 years.
      The cuff to measure the blood pressure was selected to cover a two-thirds length
      of the upper arm. Triple measurements of blood pressure and heart rate were
      obtained from infants younger than one year of age by an oscillometric device at
      supine position and in a quiet situation and at a sitting position from children
      older than one year. The average of blood pressure values
      (systolic/diastolic/mean) increased rapidly from 62.1/39.7/47.2 mmHg at age day
      one up to 72.7/46.9/56.6 mmHg at one week of life and up to 85.0/47.4/56.0 mmHg
      at age two months. After that, the blood pressure value (systolic/diastolic/mean)
      increased gradually with age. Blood pressure values (systolic/diastolic/mean)
      increased rapidly from 68.0/43.7/53.1 mmHg in children weighing less than 5 kg up
      to 87.6/41.8/59.8 mmHg in those weighing 5 to 10 kg; then values increased
      gradually with body weight. There were no significant differences in blood
      pressure and heart rate between boys and girls with different ages, different
      body lengths or different body weights.

PMID- 7793276
TI  - Radiofrequency catheter ablation of supraventricular tachycardias in pediatric
      patients.
AB  - Supraventricular tachycardia (SVT) is the most common cardiac arrhythmia in
      children. Atrioventricular (AV) reciprocating tachycardia utilizing an accessory
      pathway and AV nodal reentrant tachycardia (AVNRT) constitute a majority of SVTs.
      Radiofrequency energy ablation has recently become the treatment of choice in
      adults. Initial experience in pediatric patients in this Institute is reported in
      this study. Six consecutive patients (aged 5-22 years, mean age 13 years; 3 boys,
      3 girls) with narrow-QRS SVT were studied from July to October in 1993. They had
      experienced symptomatic SVT for a mean period of five years (ranged from 1 to 15
      years). Anti-arrhythmic agents, including beta-antagonists and calcium channel
      blockers, were unable to satisfactorily suppress these SVTs. Four of the six
      patients were shown to have a left-sided concealed accessory connection as the
      retrograde limb of the reentrant circuit. After identification of the earliest
      retrograde activation site, a steerable 7F catheter with a 4-mm-long electrode at
      the distal tip was placed within the left ventricle and positioned against the
      atrio-ventricular annulus. Another two patients were proved to have AVNRT. The
      ablation catheter was placed at the posterior/inferior aspect of the tricuspid
      annulus and guided by putative slow potential. Radiofrequency current was
      delivered at a power from 15 to 25W for four to six times with a mean duration of
      40 seconds in patients with AV reciprocating tachycardia, and a single time in
      those with AVNRT. All six SVTs were successfully ablated. No complication was
      noted in any patient. Follow-up for three to seven months has indicated no
      recurrence of SVT.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793278
TI  - Ascariasis associated with acute pancreatitis in a child.
AB  - A six-year-old aboriginal girl living in northeast Taiwan, was admitted via
      Emergency Service with the chief complaint of epigastralgia for one day. Fever,
      leucocytosis, hyponatremia, acidosis and unilateral pleural effusion were noted.
      The serum amylase was 2976 U/L. Image studies including abdominal sonography and
      computerized tomography revealed a swollen and edematous pancreas. There was no
      evidence of previous trauma, drug using, hereditary problems, nor biliary tract
      stone; the patient was noted to have adult worms and eggs of Ascaris lumbricoides
      in stool and vomitus. Ascariasis associated with pancreatitis was suspected. She
      recovered completely after antihelmintic therapy (mebendazole) and supportive
      treatment. Fourteen ascarides and 20 trichurides were expelled during nine days
      of admission.

PMID- 7793277
TI  - The effect of recombinant human erythropoietin in treating the anemia of
      prematurity.
AB  - Anemia of prematurity (AOP) has been conventionally treated with erythrocyte
      transfusions. Recent investigations have reported the use of recombinant human
      erythropoietin (rHuEPO) as an alternative for treating AOP. The potential of
      rHuEPO in increasing erythropoiesis implies its clinical usefulness. The effect
      of rHuEPO on reticulocyte count as well as other parameters of blood cells was
      examined in 14 premature babies with AOP. The average birth body weight and
      gestational age of these premature babies were 1533.71 +/- 61.66 g (Mean +/- SEM)
      and 31.36 +/- 0.49 weeks respectively. They received the first dose of rHuEPO at
      age 26.14 +/- 2.03 days with a hemoglobin level by 9.40 +/- 0.27 g/dL and
      hematocrit level of 28.20 +/- 0.81%. They were given rHuEPO 200 U/kg
      subcutaneously every other day for 10 doses, and iron 3 mg/kg and vitamin E 25
      IU/kg per os every day. Average erythropoietin level of the patients on entry
      into this study was low (7.66 +/- 1.10 mu/mL). After treatment with rHuEPO for 20
      days, the corrected reticulocyte count increased from 0.64 +/- 0.10% to 1.68 +/-
      0.42% on Day 5 (P < 0.05), 1.96 +/- 0.41% on Day 12 (P < 0.05), 1.77 +/- 0.43% on
      Day 20 (P < 0.05), and hematocrit increased from 28.2 +/- 0.81% to 29.58 +/-
      1.02% (p < 0.05) on Day 20. Bone marrow aspirates on Day 10 for 9 infants
      revealed moderate to high cellularity, mostly with erythroblasts (47.89 +/-
      1.78%); the M/E ratio was low (0.57 +/- 0.05). The granulocyte series and
      megakaryocyte could be well visualised.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793279
TI  - Cerebral cryptococcosis in a child.
AB  - Reported is one case of cerebral cryptococcosis in a 12-year-old girl. The
      diagnosis was confirmed by the detection of Cryptococcus neoformans with both
      India ink preparation of the cerebrospinal fluid and Sabouraud's media culture.
      Clinical presentation included progressive severe headache, vomiting, left eye
      pain, diplopia, dizziness and unstable gait. Fever was absent as a symptom.
      Initial brain magnetic resonance imaging revealed a focal lesion over the right
      cerebellar hemisphere with better demonstration than contrast-enhanced computed
      tomography. The patient was treated with amphotericin B and 5-flucytosine with
      good final outcome. Early diagnosis and proper therapy are necessary in order to
      decrease the motality of cerebral cryptococcosis.

PMID- 7793281
TI  - Gianotti-Crosti syndrome associated with cytomegalovirus infection: report of one
      case.
AB  - A one and half a month-old infant, a female, was brought to this hospital with
      the chief problem of diarrhea lasting for more than one week. Four days after
      admission, symmetric and nonpruritic lichenoid papules developed over her face
      and limbs. Physical examination showed several small palpable lymph nodes over
      the bilateral inguinal areas, but without hepatosplenomegaly. Gianotti-Crosti
      syndrome was diagnosed. Latter on, cytomegalovirus (CMV) was isolated from urine
      and throat swab. It seemed that this case of Gianotti-Crosti syndrome was
      associated with CMV infection.

PMID- 7793282
TI  - Epilepsy as the sole manifestation of brain tumor--report of two cases.
AB  - Epilepsy may be the earliest and the sole clinical manifestation of a brain
      tumor. The existence and the character of the brain tumor cannot be predicted
      based solely on the severity and pattern of seizure. Epilepsy is common in
      patients with brain tumors, however, it is less common to find brain tumors in
      patients with epilepsy. Due to the slow progression of brain tumors and
      limitations in the use of brain computed tomography (CT), it often takes a long
      time to diagnose brain tumors in an epileptic child. Relief of epilepsy by
      surgical removal of the etiologic brain tumor appears to be promising. We report
      two cases of brain tumors presenting as intractable epilepsy with a discordant
      neuroimage. Therefore for those children taking long-term anticonvulsants with
      frequent recurrence, it appears reasonable to perform magnetic resonance imaging
      (MRI) to enable discovering of any organic lesions.

PMID- 7793283
TI  - Critical care medicine in pediatric.

PMID- 7793280
TI  - Serial ultrasonic changes of the bladder diverticulum during urination: report of
      one case.
AB  - A seven-year-old boy with a retrovesical diverticulum and ipsilateral renal
      dysplasia is reported. He had had a history of frequent urination and dysuria for
      four years. According to sonography, the volume of bladder diverticulum obviously
      changed during urination. The diverticulum presented as a temporary large
      reservoir of the bladder. In this case, serial ultrasonic changes assisted
      understanding of the role of the diverticulum during urination.

PMID- 7793284
TI  - Respiratory syncytial virus and bronchiolitis.
AB  - Viral bronchiolitis is a common world-wide disease of infants and children
      resulting in respiratory failure and occasionally death. The major underlying
      pathophysiology is airway inflammation of peripheral airways and airway
      hyperresponsiveness to bronchoprovocation. Management is primarily prevention
      through strict hand washing and avoidance of exposures during respiratory
      seasons, especially in small infants who have underlying heart or lung disease.
      Careful supportive therapy, including fluid hydration, good nutrition, and
      aerosolized bronchodilators, steroids or ribavirin may be helpful. Long term
      follow-up for these children is important because a significant number will have
      recurrent episodes of bronchiolitis and wheezing, and many will develop clinical
      asthma. There's some evidence that long term abnormalities of airway function,
      perhaps secondary to airway fibrosis, may result from bronchiolitis infections.
      Avoidance of exposure to passive smoking, cold air and air pollutants is also
      beneficial to long term recovery from RSV bronchiolitis.

PMID- 7793286
TI  - Multiple sclerosis in children: clinical, neuroimaging, and neurophysiological
      correlations.
AB  - Four female children with clinically-definite diagnoses of multiple sclerosis
      (MS) were studied with multimodal evoked potentials (EPs), electroencephalogram
      (EEG), cerebrospinal fluid (CSF) analysis, computed tomography (CT) and magnetic
      resonance imaging (MRI). Correlations among the clinical features, neuroimaging
      and neurophysiological studies were also evaluated. Their ages of the onset
      ranged from 5 to 11 years. The clinical evolution in the all four MS cases was
      relapsing-remitting form. MRI studies in three cases showed abnormal
      demyelinating plaques in the brainstem, cerebellum and white matter of the
      cerebrum. CT examination, performed in the other MS case, did not reveal
      hypodensic lesion. Despite that MRI failed to document optical nerve lesions,
      three cases had abnormal visual evoked potentials (VEPs). Somatosensory evoked
      potentials (SSEPs) were abnormal in three cases. Brainstem auditory evoked
      potentials (BAEPs) were abnormal in two cases presenting with signs of brainstem
      dysfunction. The conclusion was that paraclinical evidences obtained from MRI and
      multimodal evoked potential studies are of value as an aid in localizing involved
      areas and detecting silent lesions in children with MS.

PMID- 7793285
TI  - Relationship between hemodynamics and plasma atrial natriuretic peptide in
      children with ventricular septal defect or patent ductus arteriosus.
AB  - To evaluate the relationship between concentrations of ANP in plasma of the right
      sided central circulation and hemodynamic parameters in congenital heart disease
      with left-to-right shunt. We enrolled 20 children aged from 1 month to 4.8 years
      with ventricular septal defect (VSD) or patent ductus arteriosus (PDA). The
      concentrations of ANP in plasma were extracted through a cartridge (Sep-Pak C18)
      before being measured by radioimmunoassay. Significant increased concentrations
      of ANP in plasma from inferior vena cava (117.6 +/- 18.1 pg/mL), right atrium
      (160.6 +/- 21.6 pg/mL) to pulmonary artery (PA) (253.4 +/- 38.8 pg/mL) were
      recognized. In VSD (n = 10) and PDA (n = 10), the concentrations of ANP in plasma
      from the inferior vena cava correlated significantly with the ratio of pulmonary
      to systemic blood flow (Qp/Qs) (r = 0.69, p < 0.05; r = 0.94, p < 0.01
      respectively), the systolic pulmonary artery pressure (r = 0.90, p < 0.01; r =
      0.93, p < 0.01 respectively), the diastolic pulmonary artery pressure (r = 0.76,
      p < 0.02; r = 0.68, p < 0.05 respectively), and the mean pulmonary artery
      pressure (r = 0.88, p < 0.01; r = 0.87, p < 0.01 respectively). The
      concentrations of ANP in plasma from the pulmonary artery also correlated
      significantly with the Qp/Qs (r = 0.81, p < 0.01; r = 0.87, p < 0.01
      respectively). The results indicated that left atrial volume loading may have an
      important influence on secretion of ANP in some congenital heart disease with
      left to right shunt.

PMID- 7793287
TI  - [Water uptake of tablets, their disintegration and dissolution are in close
      relation].
AB  - Authors investigated the factors influencing this connection on phenylbutazone
      tablets. Tablets were prepared by wet granulation using three binders (gelatine,
      hydroxypropyl-cellulose, hydroxyethylcellulose) in different concentrations.
      Three disintegrants were compared (polyvinylpolypyrrolidon, formalin-casein and
      cyclodextrin polymer) on the basis of their disintegrating and dissolution
      enhancing properties. It was found, that the binder having surface activity
      improves the wetting of phenylbutazone tablets. Increasing the concentration of
      gelatine solution, tablets became harder, disintegrated very slowly and the
      active agent hardly dissolved. Among disintegrants the polyvinyl polypyrrolidon
      was found to be the best. This material increases the hardness and the drug
      release as well. The use of cyclodextrin polymer is limited because of the slow
      water uptake of its tablets. The water uptake of nondisintegrating tablets was
      described with the Washburn equation. Water penetrates into disintegrating
      tablets according to the Weibull distribution. The penetration rate can be
      characterized with the "characteristic water penetration time (t63.2%), obtained
      from the Weibull equation. The difference between nondisintegrating and
      disintegrating tablets can be observed in the dissolution kinetic, too. The drug
      dissolves from the nondisintegrating tablets according to Noyes-Whitney equation
      (Eq. 1.), from disintegrating tablets according to the modified Noyes-Whitney
      equation (Eq. 2.) or Weibull equation (Eq. 3.). The dissolution rate constant (K)
      obtained from the modified Noyes-Whitney equation is proportional with water
      uptake and in inverse.

PMID- 7793288
TI  - [Polymer-containing eyedrops. III. Surface tension of polymer solutions].
AB  - Therapeutical effect of ophthalmological solutions is markedly influenced by
      their surface tension which is also responsible for the irritating effect of the
      eye drop. Authors studied the effect of different polymers on surface tension.
      They found that each of the water soluble polymers studied decreased the surface
      tension of solutions against air. This surface tension decreasing effect is
      independent from the concentration of the solution. Its value is slightly
      influenced by the pH of the solution, while it is increased by its electrolyte
      content.

PMID- 7793289
TI  - [Production technology and in vitro study of rectal suppositories containing
      chloroquine phosphate].
AB  - Chloroquine-phosphate was suspended in various lipophilic and hydrophilic
      suppository bases in an amount of 250 mg/2.0 g. The authors studied the solidity
      and the disintegration time of the suppositories as well as the in vitro drug
      liberation with a membrane diffusion method. The effect of the storage time and
      the storage circumstances on the stability of the suppositories was observed.
      Tropics-resistance studies were also carried out at a temperature of 45 degrees C
      and at a relative humidity content of 75%, thus these suppositories may be used
      for the treatment of malaria. The Witepsol H 15 base was found to be the best in
      all respect for use in countries with a continental climate. Finally a function
      relationship was found between the concentration of the pharmacon and the
      diffusion time with linear regression analysis.

PMID- 7793290
TI  - [Thermostability of the structure of creams and gels. I. Investigation of
      hydrophilic creams containing Hostaphat emulsions].
AB  - The effect of temperature on the change of structure of creams containing
      Hostaphat emulsifiers has been investigated. The micelles consisting of
      hydrophilic and liphophilic surfactants are disintegrated and desolvatated on the
      effect of heat, therefore the evaporation of water can be resulted. This theory
      was verified by the correlation between rheological data and the results of
      derivatographic measurements. It has been established that the hydrophilic
      emulsifier plays an important role in thermostability.

PMID- 7793292
TI  - VI Congress of the Bulgarian Physiological Society. Basic Mechanisms of
      Regulation in the Organism under Normal and Pathologic Conditions. Sofia, June 8
      9, 1995. Abstracts.

PMID- 7793291
TI  - [Preparation and investigation of liposomes].
AB  - Vesicles dispersed in an aqueous milieu and containing a phospholipid double
      layer are used primarily in cosmetic and dermatological preparations, though
      experiments are under way to use them as carriers of diagnostics and medicines.
      Different parenteral and dermatological drug preparations are already in
      circulation worldwide. Researchers have hopes of using them for the
      lyophilization of lipophobic pharmacons, to prolong medicinal effects, for the
      active and passive targeting of drugs etc. The first steps of liposome research
      started in 1965 and we now know much about liposome technology and their use in
      therapy, but various questions remain to be answered. On the level of basic
      research, this paper investigates the preparation of liposomes and
      characteristics influencing their stability.

PMID- 7793293
TI  - The Comprehensive Assessment List for Affective Disorders (COALA): a
      polydiagnostic, comprehensive, and serial semistructured interview system for
      affective and related disorders.
AB  - This supplement describes the development and structure of the Comprehensive
      Assessment List of Affective Disorders (COALA) system, which was recently
      developed for a collaborative follow-up study of a broad spectrum of affective
      disorders in Japan and which consists of a series of semistructured interviews
      for affective and related disorders. The COALA distinguishes itself from the
      extant semistructured interviews by being able to provide polydiagnostic,
      comprehensive and serial assessments. It is polydiagnostic because it derives
      diagnoses according to 29 historical and modern diagnostic systems through
      computer algorithms. It is comprehensive because it not only depicts the symptoms
      profile and rates their severity according to various endogenicity indices and
      severity rating scales but also measures, in the psychosocial domain, the life
      events and their characteristics. In addition, it has sections for past illnesses
      and family history. It is serial because the system includes follow-up
      semistructured interviews that can be administered monthly and that monitor
      changes in the psychopathological and psychosocial features. The theoretical
      underpinnings of the COALA system, especially its polydiagnostic approach to a
      broad spectrum of affective disorders and its treatment of psychosocial factors,
      are discussed in view of recent proposals for the future nosological research.
      The findings of the interrater reliability study (n = 107) are also presented,
      with satisfactory to excellent results for almost all of the psychopathological
      and psychosocial variables, all of the composite severity ratings and most of the
      polydiagnostic evaluations.

PMID- 7793295
TI  - Impaired luteinizing hormone responsiveness to gonadotropin-releasing hormone in
      the inferior petrosal sinuses of hyperprolactinemic patients.
AB  - The aim of this study was to evaluate serum baseline and gonadotropin-releasing
      hormone (GnRH)-stimulated follicle-stimulating hormone (FSH) and luteinizing
      hormone (LH) concentrations in the inferior petrosal sinuses and in peripheral
      blood in nine normoprolactinemic and eight hyperprolactinemic patients who were
      being subjected to perihypophyseal phlebography for diagnostic purposes or
      neurosurgical indications. Serum FSH and LH concentrations were significantly
      higher in both inferior petrosal sinuses than in peripheral blood (p < 0.001 and
      p < 0.05, respectively) in normoprolactinemic but not in hyperprolactinemic
      patients. Additionally, in normoprolactinemic patients, the LH response to
      intravenous bolus GnRH in the inferior petrosal sinuses (evaluated as peak/basal)
      was significantly greater than in hyperprolactinemic patients (p < 0.01). No
      difference was found as far as FSH response to GnRH was concerned. In conclusion,
      these findings suggest that the hypogonadism of hyperprolactinemic patients may
      depend on the impaired release of LH at the pituitary level.

PMID- 7793294
TI  - Evidence for a role of neurosteroids in modulation of diurnal changes and acute
      stress-induced corticosterone secretion in rats.
AB  - The neurosteroid allopregnanolone has been shown to be a potent ligand of gamma
      aminobutyric acid (GABA)-A receptors and enhances its receptor-mediated
      inhibitory events. Since central GABA plays a major inhibitory role, via GABA-A
      receptors, in hypothalamic-pituitary-adrenal (HPA) function in rats, the present
      study has evaluated the effect of passive immunoneutralization of
      allopregnanolone on diurnal changes in corticosterone secretion and acute stress
      induced corticosterone secretion in rats. In the first protocol, four groups of
      male rats (prepubertal, fertile, castrated adult and aged) and three groups of
      female rats (prepubertal, fertile at different phases of the estrous cycle and
      aged) were studied. Rats were injected intracerebroventricularly (i.c.v.) with 10
      microliters anti-allopregnanolone serum or 10 microliters normal rabbit serum
      (control) 24 h before exposure to an acute cold swimming stress, and sacrificed
      either before stress or after 5 min stress. In the second protocol, fertile male
      or female rats at diestrus II were injected i.c.v. with anti-allopregnanolone
      serum or normal rabbit serum and sacrificed on the following day at 10.00 or
      18.00. Truncal blood samples were collected for measuring plasma corticosterone.
      Our results showed that there was no significant difference in basal plasma
      corticosterone levels between antiserum-treated and control rats of both sexes.
      However, in male rats, central injection of antiserum to allopregnanolone
      significantly potentiated plasma corticosterone response to stress in prepubertal
      and adult fertile rats as well as in castrated rats. Likewise, in female rats,
      the stress response of plasma corticosterone was enhanced by passive
      immunoneutralization of allopregnanolone in prepubertal and fertile rats
      throughout the estrous cycle.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793296
TI  - The influence of DHEA on serum lipids, insulin and sex hormone levels in rabbits
      with induced hypercholesterolemia.
AB  - The authors estimated the influence of dehydroepiandrosterone (DHEA)
      administration, a potential antiatherogenic agent, on serum lipids, sex hormones
      and insulin levels in male rabbits fed on an atherogenic diet. They concluded
      that (1) DHEA administration has an unfavorable impact on the serum lipid
      profile; (2) an atherogenic diet causes insulin resistance; (3) the glucose and
      insulin levels are not related to DHEA in normally fed rabbits and in rabbits
      with hyperlipoproteinemia; (4) an atherogenic diet causes a slight increase of
      estradiol concentration; (5) DHEA treatment has no significant effect on
      testosterone and estradiol concentrations in both normally fed rabbits and those
      on an atherogenic diet; (6) DHEA administration has an anti-obesity effect.

PMID- 7793297
TI  - Effects of danazol and medroxyprogesterone acetate on estrogen-(estradiol and
      estriol) specific binding sites in rabbit uterus.
AB  - In rabbit uterus, the presence of separate specific binding sites for not only
      estradiol but also estriol has been proposed. These sites may be correlated with
      an antiestradiol effect. Therefore, this study was designed to investigate the
      effect of antiestrogenic agents such as danazol and medroxyprogesterone acetate
      (MPA), especially on the estriol binding sites. Danazol and MPA in combination
      with estradiol were administered subcutaneously to immature female rabbits daily
      for 10 days, and resulted in a significant (p < 0.05) decrease in uterine weight
      and estradiol binding sites in the uterus. Treatment with MPA significantly (p <
      0.05) decreased the level of estriol binding sites, but treatment with danazol
      resulted in this to a minimal extent in the uterus primed by estradiol. MPA did
      not bind to estradiol and estriol binding sites, while danazol at a high
      concentration bound to estriol binding sites with some affinity, but not to
      estradiol binding sites in the uterine cytosol of estrogen-primed rabbits. These
      results suggest that within the antiproliferative effect of danazol and MPA (an
      antiestrogenic action on estrogen-stimulated uterine growth) there are likely to
      be specific differences between some of the possible mechanisms of danazol and
      MPA in their action at the estriol binding site.

PMID- 7793298
TI  - Sensitivity of plasma insulin levels in obese and non-obese women with functional
      hyperandrogenism.
AB  - Hyperinsulinemia has been implicated in the etiology of functional
      hyperandrogenism (FH). In a prospective controlled trial, we determined the
      sensitivity and diagnostic accuracy of fasting plasma insulin levels in 37
      females of reproductive age with FH, who were further subdivided into obese (body
      mass index (BMI) > 25 kg/m2, n = 22) and non-obese (n = 15) groups, in women with
      (n = 30) and without (n = 7) polycystic ovaries on vaginal endosonography and in
      controls of similar age (n = 29) who were body mass-matched to the non-obese FH
      subgroup. Insulin, testosterone, androstenedione, luteinizing hormone (LH),
      LH/follicle-stimulating hormone (FSH) ratio and dehydroepiandrosterone sulfate
      (DHEA-S) levels were measured by conventional radio-immunoassay. All hormonal
      parameters, including insulin (p , 0.0001), were significantly increased in the
      FH group vs. controls. Mean BMI and insulin did not differ between the subgroups
      with and without polycystic ovaries. Only insulin was increased (p = 0.0012) in
      the obese FH vs. non-obese FH subgroup. In the FH group, insulin showed the
      highest coefficient of variation (0.76) but also the best sensitivity (0.57) and
      diagnostic accuracy (0.73), equal that of testosterone (0.54 and 0.73,
      respectively). Insulin was more sensitive (0.72) than testosterone (0.59) in the
      obese FH subgroup, but less sensitive (0.27) than testosterone (0.47) in the non
      obese FH subgroup. Multiple correlation analysis showed a significant linear
      relationship (p < 0.0001) between insulin and BMI but no correlation between
      insulin and the other parameters.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793299
TI  - Insulin secretion in obese and non-obese women with polycystic ovary syndrome and
      its relationship with hyperandrogenism.
AB  - Insulin resistance has been reported to be associated with hyperandrogenism and
      polycystic ovaries. To study the prevalence of insulin resistance in patients
      with polycystic ovary syndrome (PCO) and the correlation between hyperinsulinemia
      and hyperandrogenism, 48 patients were divided into four groups: group 1, non
      obese ovulatory women (n = 10); group 2, obese ovulatory women (n = 9); group 3,
      non-obese women with PCO (n = 14); group 4, obese women with PCO (n = 15). Each
      patient was submitted to an oral glucose tolerance test (OGTT). Glucose, insulin,
      androstenedione and testosterone levels were determined and the blood glucose and
      insulin response of women with PCO and normal women were compared. Glucose
      intolerance was observed in group 3 (28.6%) and group 4 (40%) but not in groups 1
      or 2, and hyperinsulinemia was observed in group 2 (66.7%), group 3 (64.3%) and
      group 4 (86.6%). There was a correlation between androstenedione and testosterone
      levels and insulinemia in group 4. There was also a high prevalence of insulin
      resistance in patients with PCO regardless of obesity, and hyperandrogenism
      aggravated insulin resistance.

PMID- 7793300
TI  - Hormonal profiles in successful and unsuccessful implantation in IVF-ET after
      combined GnRH agonist/gonadotropin treatment for superovulation and hCG luteal
      support.
AB  - The luteal phase of in vitro fertilization-embryo transfer (IVF-ET) cycles has
      come under great scrutiny as the cause for the discrepancy between fertilization
      rates (> 70%) and pregnancy rates (around 20%) in most IVF programs is sought.
      The effects of the various stimulation protocols on the subsequent hormonal
      events of the luteal phase are both important and controversial but information
      regarding cycles where ovarian stimulation has been carried out with
      gonadotropins under pituitary suppression is scanty. The effect of high levels of
      estrogen in the late follicular phase and around the time of implantation is a
      matter of concern. As combined gonadotropin-releasing hormone analog (GnRH-a)
      gonadotropin treatment for superovulation is associated with supraphysiological
      ovarian steroid levels, both in the follicular and luteal phase of IVF cycles, we
      compared preovulatory (estradiol), midluteal (estradiol, progesterone and
      prolactin) and late luteal (estradiol and progesterone) hormone levels in on
      going pregnancies, abortions and non-conception cycles in 222 patients
      accomplishing their first IVF-ET attempt who received such ovarian stimulation
      therapy. For both successful and unsuccessful implantation cycles, estradiol on
      the day of human chorionic gonadotropin (hCG) administration correlated
      positively with progesterone and estradiol levels and negatively with the
      progesterone/estradiol ratio in the midluteal phase. Mean peak follicular
      estradiol, midluteal estradiol and progesterone levels, mean mid- and late luteal
      progesterone/estradiol ratio, and mean midluteal prolactin concentration, were
      similar in the three groups studied. The mean late luteal estradiol and
      progesterone in the on-going pregnancy group were significantly higher than in
      non-conception cycles (p < 0.005 and p < 0.001, respectively) as a reflection of
      trophoblastic hCG production. Forty-eight patients (21.6%) had
      hyperprolactinemia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793301
TI  - The results of an in vitro fertilization program: two regimens of superovulation.
AB  - Gonadotropin-releasing hormone (GnRH) agonists are increasingly used in ovarian
      hyperstimulation protocols in in vitro fertilization (IVF) programs. From March
      1992 to June 1993, 565 patients attending our Institute underwent superovulation
      in 1104 IVF program cycles. Of these cycles, 650 were stimulated with clomiphene
      citrate and gonadotropins (human menopausal gonadotropin/hMG), and 454 with the
      GnRH agonist buserelin and hMG in a group of patients who had earlier failed to
      respond or did not conceive after clomiphene citrate/hMG stimulation. The ovarian
      response was similar in both groups, however, with the use of buserelin more
      oocytes were recovered -4.9 +/- 3.2 and 3.5 +/- 2.3 oocytes, respectively. The
      clinical pregnancy rate per transfer in the group of patients superovulated with
      buserelin/hMG was twice that of the clomiphene citrate/hMG group (21.0% vs.
      10.4%). The relatively high pregnancy rate with the buserelin/hMG regimen in the
      group of 'poor responders' may be connected with GnRH agonist-induced
      pharmacological hypophysectomy and the sequelae thereof: normalization of some
      endocrinopathies, absence of an endogenous luteinizing hormone (LH) surge and
      better endometrium receptivity, oocytes and embryo quality.

PMID- 7793302
TI  - Ethinylestradiol from contraceptive formulations and the ovarian response: an
      estrogen dose-dependency on natural estradiol concentrations.
AB  - To evaluate the competitive molecular phenomenon of ethinylestradiol from
      contraceptive formulations vs. endogenous 17 beta-estradiol in the intra- and
      extracellular compartments, a descriptive analysis was performed. Plasma and
      endometrial samples were simultaneously obtained on different days of the
      pseudomenstrual cycle from oral contraceptive users taking
      ethinylestradiol/norgestrel (30 micrograms/500 micrograms; n = 13) and
      ethinylestradiol/norethindrone (50 micrograms/1.0 mg; n = 14) in order to
      quantify the 17 beta-estradiol concentrations. From our results the chronic
      administration of these combined oral contraceptives demonstrated that the lower
      component ethinyl-estradiol (30 micrograms) does not compete substantially at the
      circulating level, permitting concentrations of natural estradiol such as those
      seen during follicular maturation in the ovulatory cycle. However, in the
      endometrium such a cyclicity is not seen, thus the possibility of a local
      infertility effect should be reconsidered to enable the investigation of a
      different approach in future methods of contraception.

PMID- 7793303
TI  - Potential impact on breast cancer risk of circulating insulin-like growth factor
      I modifications induced by oral HRT in menopause.
AB  - Unlike parenteral estrogens, oral estrogen administration in menopause causes,
      through its hepatocellular action, a significant decrease of circulating insulin
      like growth factor I (IGF-I) levels; this effect is opposed by the addition of an
      androgenic progestogen. In vitro studies show that IGF-I is a potent mitogen for
      'estrogen responsive' breast cancer cells. Moreover, some findings in breast
      cancer patients and in women treated with tamoxifen suggest that reduction of
      circulating IGF-I could be protective to the breast. However, by also considering
      (1) the potential action on breast cancer cells of IGF-II, (2) the possible
      consequences of the growth hormone (GH) increase caused by the IGF-I reduction
      and (3) the fact that in vitro results are not simply transferable to the in vivo
      condition, other 'scenarios' can be envisaged, besides the favorable one. In
      support of the latter, there are epidemiologic data which suggest that oral
      estrogen use could have some favorable peculiarities with regards to breast
      cancer risk. The associated decrease in circulating IGF-I level could well be one
      of these peculiarities.

PMID- 7793306
TI  - Acetyl-L-carnitine restores choline acetyltransferase activity in the hippocampus
      of rats with partial unilateral fimbria-fornix transection.
AB  - Transection of the fimbria-fornix bundle in adult rats results in degeneration of
      the septohippocampal cholinergic pathway, reminiscent of that occurring in aging
      as well as Alzheimer disease. We report here a study of the effect of a treatment
      with acetyl-L-carnitine (ALCAR) in three-month-old Fischer 344 rats bearing a
      partial unilateral fimbria-fornix transection. ALCAR is known to ameliorate some
      morphological and functional disturbances in the aged central nervous system
      (CNS). We used choline acetyltransferase (ChAT) and acetyl cholinesterase (AChE)
      as markers of central cholinergic function, and nerve growth factor (NGF) levels
      as indicative of the trophic regulation of the medio-septal cholinergic system.
      ChAT and AChE activities were significantly reduced in the hippocampus (HIPP)
      ipsilateral to the lesion as compared to the contralateral one, while no changes
      were observed in the septum (SPT), nucleus basalis magnocellularis (NBM) or
      frontal cortex (FCX). ALCAR treatment restored ChAT activity in the ipsilateral
      HIPP, while AChE levels were not different from those of untreated animals, and
      did not affect NGF content in either SPT or HIPP.

PMID- 7793305
TI  - Cortisol levels alter the response to metoclopramide in patients with
      hypothalamic amenorrhea.
AB  - The reduction in frequency and/or amplitude of gonadotropin-releasing hormone
      (GnRH) pulses in patients with amenorrhea of hypothalamic origin has been
      attributed to increased dopamine activity. The objective of the present study was
      to determine the role of dopamine in the pathogenesis of hypothalamic amenorrhea.
      Fourteen patients with hypothalamic amenorrhea, nine of whom had psychogenic
      amenorrhea and five anorexia nervosa, were studied and compared with nine normal
      women during the early follicular phase. Metoclopramide (10 mg), a dopamine
      antagonist, was infused intravenously and blood samples were collected at 15-min
      intervals for 2 h for follicle-stimulating hormone (FSH) and luteinizing hormone
      (LH) measurement by radioimmunoassay. Both the hypothalamic amenorrhea
      (psychogenic amenorrhea and anorexia nervosa) and control groups were
      unresponsive to FSH, suggesting that dopamine may have little or no effect on FSH
      secretion. Five patients of the psychogenic amenorrhea group responded to LH
      (responsive psychogenic amenorrhea) and four did not (non-responsive psychogenic
      amenorrhea). No anorexia nervosa or control patient responded to the stimulus.
      Responsive psychogenic amenorrhea patients showed decreased basal cortisol levels
      compared to the non-responsive psychogenic amenorrhea and anorexia nervosa
      groups. It is possible that patients with exclusive alterations in the
      dopaminergic system are those who respond to metoclopramide (responsive
      psychogenic amenorrhea group), whereas patients who also have involvement of the
      hypothalamic-adrenal axis like the women with anorexia nervosa, are not
      responsive to metoclopramide and tend to have elevated cortisol levels. The non
      responsive psychogenic amenorrhea group, with elevated cortisol levels, probably
      represents an intermediate step between the responsive psychogenic amenorrhea and
      anorexia nervosa patients.

PMID- 7793304
TI  - Sex hormones, the menopause and urinary problems.
AB  - To date, there have been few appropriate placebo-controlled studies using both
      subjective and objective parameters to assess the efficacy of estrogen therapy
      for the treatment of urinary incontinence. Further confusion arises from the
      heterogeneity of different study protocols. Consequently, the best treatment in
      terms of type and dose of estrogen and route of administration is unknown. From
      these studies, however, there is clear evidence to suggest that recurrent urinary
      tract infection can be prevented or even treated by the use of estrogen therapy.
      Furthermore, systemic estrogen replacement appears to alleviate the symptoms of
      urgency, urge incontinence, frequency, nocturia and dysuria, and low-dose topical
      estrogen is effective in the management of atrophic vaginitis. Although the
      latter example appears to be free from side-effects, even following prolonged
      administration, it is unclear whether low-dose therapy has a sufficient effect on
      the lower urinary tract to treat urinary incontinence. There is no conclusive
      evidence that estrogen replacement alone is sufficient to cure stress
      incontinence, but in combination with an alpha-adrenergic agonist there may be a
      role for estrogen therapy in the conservative management of genuine stress
      incontinence. On the other hand, estrogen supplementation definitely improves the
      quality of life of many postmenopausal women and, therefore, makes them better
      able to cope with other disabilities. Perhaps the role of estrogen in the
      management of postmenopausal urinary disorders is as an adjunct to other methods
      of treatment such as surgery, physiotherapy and drugs. This is certainly a
      hypothesis which should be tested.

PMID- 7793307
TI  - Evidence of internucleosomal DNA fragmentation and identification of dying cells
      in X-ray-induced cell death in the developing brain.
AB  - Newborn Sprague-Dawley rats received a single dose of 2 Gy X-rays and were killed
      6 hr later. Dying cells were characterized by extreme chromatin condensation and
      nuclear fragmentation. Dying cells were distributed in the primary and secondary
      germinal zones and in other brain regions. Among these latter, dying cells
      occurred in the cortical layers of the olfactory bulb, layers II-III and VIb of
      the neocortex, piriform and entorhinal cortex, stratum oriens and pyramidale of
      the hippocampus, striatum, thalamus, amygdala, brainstem, internal granular layer
      of the cerebellum, and cerebral and cerebellar white matter. Dying cells were
      immature cells, neurons and glial cells (including radial glia). In-situ labeling
      of nuclear DNA fragmentation identified individual cells bearing fragmented DNA.
      Since the number of cells stained with this method was larger than the number of
      dying cells, as revealed with current histological techniques, it is suggested
      that nuclear DNA fragmentation precedes chromatin condensation and nuclear
      fragmentation in X-ray-induced apoptosis. Furthermore, agarose gel
      electrophoresis of extracted DNA from irradiated brains showed a "ladder" pattern
      which is typical of internucleosomal DNA fragmentation and endonuclease
      activation.

PMID- 7793308
TI  - Expression of basic fibroblast growth factor and its receptors in human fetal
      microglia cells.
AB  - The presence of basic fibroblast growth factor (bFGF) and FGF receptors was
      investigated in microglia cells derived from human fetal brain long-term
      cultures. Production of bFGF was suggested through the capability of microglial
      extracts to stimulate plasminogen activator (PA) synthesis in endothelial cells.
      The identity of PA-stimulating activity with bFGF was confirmed by its high
      affinity for heparin and its cross-reactivity with polyclonal antibodies to human
      recombinant bFGF. These antibodies recognized a cell-associated M(r) 18,000
      protein as well as trace amounts of the M(r) 24,000 bFGF isoform in Western blot.
      All microglial cells showed bFGF immunoreactivity in the cytoplasm and,
      sometimes, in the nucleus. Scatchard plot analysis of 125I-bFGF binding data
      revealed the presence of low affinity heparansulphate proteoglycans (380,000 +/-
      60,000 sites/cell; Kd = 730 +/- 200 nM) and of high affinity tyrosine-kinase
      receptors (10,300 + 2500 sites/cell; Kd = 30 +/- 9 pM). Immunocytochemistry
      confirmed the presence of FGF receptor (1/flg) on the cell surface of some, but
      not all microglial cells, with prevalent association to ameboid microglia.
      Transcripts for FGF receptors 1, 2, 3 and 4 were found in microglia by Northern
      blot analysis. Co-expression of bFGF and its receptors in human fetal microglia
      suggests an autocrine role of bFGF in these cells.

PMID- 7793309
TI  - Neural activity and the levels of high energy phosphates during deprivation of
      oxygen and/or glucose in hippocampal slices of immature and adult rats.
AB  - To investigate the relationship between neural activity and cerebral energy
      metabolism during anoxia or ischemia in neural tissue of different ages,
      hippocampal slices were prepared from four-, seven- and 10-day-old and adult
      rats. For the index of the neural activity, the population spikes were recorded
      in the pyramidal cell layer of the CA3 area. ATP and phosphocreatine levels in
      the slices were measured during oxygen and/or glucose deprivation. After
      deprivation of both oxygen and glucose, population spikes of the slices from
      four, seven- and 10-day-old and adult rats ceased completely in 14.2, 11.8, 9.4
      and 5.3 min, respectively. The level of ATP at the time of cessation of
      population spike in four-, seven- and 10-day-old and adult rats was 37.4, 30.2,
      28.5 and 56.4% of the original concentrations. After deprivation of glucose only,
      the decay time of the population spikes of the slices from four-, seven- and 10
      day-old and adult rats was 17.8, 14.5, 9.0 and 10.0 min and at the time of
      population spikes cessation the level of ATP was 99.8, 84.2, 79.3 and 49%,
      respectively. After deprivation of oxygen only, population spikes of the slices
      from four, seven- and 10-day old and adult rats ceased completely in 257, 283,
      109 and 8.5 min, respectively. The level of ATP at the time of population spikes
      cessation was 50, 40, 36.6 and 94.4% of the initial values, respectively. These
      results indicate that the immature rat is extremely resistant to oxygen
      deprivation from a functional and a metabolic view, whereas in the adult rat,
      preservation of neural activity depends much on both oxygen and glucose. During
      glucose deprivation, population spikes of the slices of immature and mature rats
      ceased rapidly although the level of ATP is preserved at high levels. This
      suggests that glucose plays an important role in the preservation of neural
      activity in addition to its major function as an energy substrate especially in
      immature animals.

PMID- 7793310
TI  - Enhanced survival and differentiation in vitro of different neuronal populations
      by some interleukins.
AB  - Data from the literature demonstrate the existence of a growing family of
      neuropoietic cytokines; members of this group have structural motifs in common
      with other members and with neurotrophic factors. In this research we studied the
      responses elicited in vitro by some of these molecules in two different neuronal
      populations: murine neuroblastoma N18TG2 and neurons from chicken dorsal root
      ganglia. Both IL-2 and IL-6 improve the survival of murine neuroblastoma cells in
      clonal density plating experiments; in addition IL-2 significantly inhibits
      thymidine incorporation by single cell suspension. The survival of sensory
      neurons, on the other hand, non-responsive to IL-2 and IL-6, was significantly
      supported by IL-3, which also stimulates their morphological differentiation,
      inducing the formation of a well-developed neural net. In conclusion, results
      reported here confirm the neurotrophic activity of some ILs and provide
      additional neuronal models for future investigations.

PMID- 7793311
TI  - Basic fibroblast growth factor (bFGF) increases the survival of embryonic and
      postnatal basal forebrain cholinergic neurons in primary culture.
AB  - Basic fibroblast growth factor (bFGF) is found in high concentrations in the
      mammalian central nervous system. It is a mitogen for glia and it influences the
      development and survival of specific populations of neurons. In this study, we
      investigated the effect of various concentrations of bFGF on the survival of
      embryonic and postnatal cholinergic basal forebrain neurons plated at low and
      high density in the presence and absence of glia. We observed that 50 and 100
      ng/ml of bFGF increased the survival of embryonic cholinergic neurons plated at
      high density. This effect was observed only in the presence of glia. Lower
      concentrations of 10 and 20 ng/ml had no effect on cholinergic neuronal survival.
      The number of GFAP (glial fibrillary acidic protein)-positive cells in high
      density embryonic cultures was increased by all concentrations of bFGF. In low
      density embryonic cultures, an increase in cholinergic neuron survival was
      observed at concentrations ranging from 20 to 100 ng/ml. The number of GFAP
      positive cells in low-density cultures was also increased by all concentrations
      of bFGF. Similar to low-density embryonic cultures, the survival of cholinergic
      neurons from postnatal day 2 cultures was significantly increased in the presence
      of glia at concentrations of 20, 50 and 100 ng/ml of bFGF. Postnatal glia was
      affected by all concentrations of bFGF, as was observed in embryonic cultures.
      This study indicates that high concentrations of bFGF can influence cholinergic
      neuronal survival by stimulating and increasing glia, which may produce factor(s)
      that are necessary for cholinergic neuron survival.

PMID- 7793312
TI  - The adventures of a biologist: prenatal diagnosis, hematopoiesis, leukemia,
      carcinogenesis, and tumor suppression.

PMID- 7793314
TI  - Cyclins and cyclin-dependent kinases: theme and variations.

PMID- 7793315
TI  - Molecular genetics of 11q23 chromosome translocations.

PMID- 7793316
TI  - Role of scatter factor and the c-met protooncogene in the pathogenesis of AIDS
      associated Kaposi's sarcoma.
AB  - Kaposi's sarcoma is a highly lethal tumor in patients with sexually acquired
      AIDS. A number of etiologic agents have been implicated in the development of
      this disease in this patient population and there is ample evidence that aberrant
      production of and responsiveness to KS tumor and host cell-derived cytokines
      plays a central role in the pathogenesis of AIDS-KS. In this review we propose
      that aberrant expression SF and c-met is central to the pathogenesis of KS. KS is
      a serious and life-threatening consequence for many patients with AIDS.
      Unfortunately, current therapeutic strategies for the treatment of this complex
      neoplasm have met with only limited success. In view of the poor survival rates
      for AIDS-KS patients which continue to decline at an alarming rate, it is
      eminently clear that a better understanding of the etiology and pathogenesis of
      this form of KS is needed if novel therapeutic strategies designed to
      successfully combat this disease are to be developed. If our hypothesis is
      validated, one could envision several approaches whereby the modulation of SF/c
      met function or production might lead to a reduction in the incidence and
      severity of KS lesions. Antibody therapy directed against either SF-producing
      tumor cells or against the c-met receptor might decrease the incidence of new
      tumors by limiting their clonal expansion and lead to regression of established
      tumors by blocking SF-mediated tumor cell proliferation and neovascularization.
      It might also be possible to suppress production of SF or accessory cytokines
      involved in the induction SF production and thus short circuit SF/c-met growth
      promoting effects. We have outlined a novel hypothesis for understanding the
      mechanism underlying the development of AIDS-associated KS. This is most
      certainly not the whole story, however. Clearly, other cytokines and alterations
      in natural host defenses and the immune system contribute significantly to the
      development of AIDS-associated KS. We believe, however, that recognition of SF/c
      met as a participant in this disease is necessary if we are to more fully
      understand the pathogenesis of AIDS-associated KS.

PMID- 7793313
TI  - p53: a cell cycle regulator activated by DNA damage.

PMID- 7793317
TI  - Rel/NF-kappa B/I kappa B story.

PMID- 7793318
TI  - Radiation leukemia virus-induced leukemogenesis: a paradigm of preleukemia and
      its control by preventive therapy.

PMID- 7793319
TI  - The insertion of foreign DNA into mammalian genomes and its consequences: a
      concept in oncogenesis.

PMID- 7793320
TI  - From Aristotle, through Spemann, to tumor immunology: a personal experience.

PMID- 7793321
TI  - Tumor suppressor p53 mutations and breast cancer: a critical analysis.
AB  - Alterations in the tumor suppressor gene p53 are the most commonly identified
      changes in cancer, including neoplasia of the breast. The activity of p53 is
      regulated post-translationally. Phosphorylation state, subcellular localization,
      and interaction with any of a number of cellular proteins are likely to influence
      the function of p53. The exact effect of p53-mediated growth suppression seems to
      be cell-type specific but appears to be directly related to the ability of p53 to
      act as a specific transcriptional activator. The role that transcriptional
      repression plays in the function of WT p53 is less clear. It is also possible
      that p53 has a more direct activity in DNA replication and repair. Most
      documented p53 mutations result in single amino acid substitutions which may
      confer one or more of a spectrum of transforming abilities on the protein.
      Mutation may lead to nuclear accumulation of p53 protein; however, inactivation
      of p53 by nuclear exclusion and interaction with the mdm2 protein also appear to
      be important in tumorigenesis. Used in conjunction with other established
      factors, accumulation of cellular p53 may be a useful prognostic indicator in
      breast cancer. A syngeneic mouse model system yielded evidence that p53 mutations
      are important in the early, preneoplastic stages of mammary tumorigenesis. This
      murine system may provide the ability to investigate the functions of p53 in the
      early stages of breast cancer which are technically difficult to examine in the
      human system.

PMID- 7793322
TI  - Apoptosis in viral infections.

PMID- 7793323
TI  - Membrane fusion and the alphavirus life cycle.

PMID- 7793324
TI  - Equine herpesviruses 4 (equine rhinopneumonitis virus) and 1 (equine abortion
      virus).

PMID- 7793327
TI  - Characterization of genome structure and establishment of vector cell lines for
      plant reoviruses.

PMID- 7793326
TI  - Feline immunodeficiency virus as a model for development of molecular approaches
      to intervention strategies against lentivirus infections.

PMID- 7793325
TI  - Bovine herpesvirus 1 (BHV-1): biology, pathogenesis, and control.

PMID- 7793328
TI  - Bacteriophage PRD1: a broad host range DSDNA tectivirus with an internal
      membrane.

PMID- 7793329
TI  - Modification of membrane permeability by animal viruses.

PMID- 7793330
TI  - Are elderly Asians in Britain at a high risk of vitamin D deficiency and
      osteomalacia?
AB  - Many studies have shown the indigenous elderly population and Asian immigrants to
      be groups at particular risk of vitamin D deficiency and osteomalacia, but there
      are no data on the risks in elderly Asians. In this community-based study a group
      of elderly Asians was compared with control groups of elderly and young whites
      and young Asians. Levels of 25-hydroxyvitamin D3 (25-OHD3) were significantly
      lower (p < 0.0001) in elderly Asians (21/37) and young Asians (7/17) compared
      with white controls. The difference in parathyroid hormone (PTH) between Asians
      and whites was also significant (p < 0.0007) as was that between young and old (p
      < 0.0002). Abnormal PTH and 25-OHD3 (high PTH and low 25-OHD3), indicative of a
      high risk of osteomalacia, occurred in 22% of elderly Asians compared with 6% of
      elderly whites. The calcium, phosphate and alkaline phosphatase were normal in
      all individuals. Among the Asians, vegetarianism was not related to lower 25-OHD3
      levels. Symptoms suggestive of osteomalacia were more common (p < 0.05) in
      elderly Asians than in their white counterparts. This first study of 25-OHD3
      levels in community-resident elderly Asians suggests that more than half were
      low, placing them at a significantly higher risk of osteomalacia.

PMID- 7793331
TI  - Upper-extremity motor co-ordination of healthy elderly people.
AB  - Motor co-ordination is an important prerequisite to adequate upper-extremity
      performance. With the ageing of the population, more and more elderly people are
      at risk of acquiring upper-extremity motor inco-ordination following sensorimotor
      deficit. The main objective of the study was to develop normative data on upper
      extremity motor co-ordination for elderly people. Three hundred and sixty
      subjects aged 60 and over were randomly selected and evaluated with the Finger
      Nose Test. The results revealed a linear decline in the performance of this test
      with age. Younger, more active and subjectively healthier subjects presented
      better motor co-ordination. Some differences were found between sexes and sides.
      The normative data will help clinicians to identify pathological reduction in
      motor co-ordination in an elderly population.

PMID- 7793332
TI  - Relationship of health behaviours to five-year mortality in an elderly cohort.
AB  - To assess the risk of mortality associated with different health behaviours in a
      Mediterranean elderly population, we have analysed the mortality experience of a
      cohort of 1219 non-institutionalized men and women aged 65 years or over, who had
      participated in the 1986 Health Interview Survey of Barcelona. At baseline, self
      reported information on smoking, alcohol consumption, physical activity, and
      hours of daily sleep was collected through face-to-face home interviews. After 5
      years of follow-up, a total of 224 (18.4%) participants had died. After adjusting
      for age, level of education and perceived health status, current smokers at
      baseline had a relative risk of dying during the follow-up of 3.0 [95% confidence
      interval (CI) 1.78, 5.04] compared with non-smokers. Those reporting moderate
      alcohol consumption had a relative risk of dying of 0.38 (95% CI 0.17, 0.86)
      compared with abstainers. Finally, individuals who reported a sedentary life
      style had a risk of dying of 1.53 (95% CI 1.08, 2.15) compared with the more
      active. Although limited for interpreting associations as causal relationships,
      our results add to the evidence that the adverse effects on survival of smoking
      and of being sedentary extend later into life. Because of the high prevalence of
      a sedentary life-style among elderly people, results suggest that promoting
      physical activity may have an important role in enhancing survival in this age
      group.

PMID- 7793333
TI  - The SF-36 health survey questionnaire: is it suitable for use with older adults?
AB  - An Anglicized version of the SF-36, a recently developed generic health status
      measure, was tested among people aged 65 years and over in hospital outpatient
      and general practice settings as both a self-completed and interview-administered
      instrument. The SF-36 was quick to complete, with 84% completed in 10 minutes or
      less (median time 8 minutes), while the distribution of scores provided further
      evidence of its sensitivity and validity. As an interview-administered instrument
      the SF-36 was acceptable among all age groups, although 32% of outpatients and
      10% of general-practice patients, consisting predominantly of people aged 75
      years and over with poor physical or mental health scores, felt unable to self
      complete the questionnaire. In addition, 26% of respondents missed out at least
      one of the 36 statements, with missing items being significantly related to older
      age and self-completion. Missing responses were mainly concentrated on a small
      number of questions whose emphasis on work or vigorous activities meant that they
      were frequently regarded as not applicable by elderly people. Suggested
      modifications to these questions for elderly respondents are given. With these
      changes the SF-36 is regarded as suitable for use as a self-completed
      questionnaire among the younger age group of elderly people, although some
      assistance may often be required by people aged 75 years and over and especially
      those with poor physical or mental health.

PMID- 7793334
TI  - A Hierarchical Assessment of Balance and Mobility.
AB  - The Hierarchical Assessment of Balance and Mobility (HABAM) is a new instrument
      which displays changes in balance and mobility graphically. To assess the
      validity, reliability, and responsiveness to change of the HABAM it was compared
      with the Barthel Index, the Spitzer Quality of Life Index, the Folstein Mini
      Mental Status Examination, and the Lawton-Brody Instrumental Activities of Daily
      Living Scale. A consecutive sample (n = 28) of patients aged 65 and older
      admitted to a tertiary-care teaching hospital was studied. Convergent construct
      validity was assessed by correlation with the Barthel Index (r = 0.76) and its
      mobility subscale (r = 0.74), and discriminant validity by correlation with the
      Folstein Mini Mental Status Exam (r = 0.15), Lawton-Brody Instrumental Activities
      of Daily Living (r = 0.30), and Spitzer Quality of Life Index (r = 0.39).
      Reliability was demonstrated by an intra-class correlation coefficient of R1 =
      0.94. Responsiveness was demonstrated by a relative efficiency of 3.13 and an
      effect size of 0.59. The HABAM, a new instrument to assess balance and mobility
      in the hospitalized elderly, is valid, reliable, and responsive to change.

PMID- 7793336
TI  - How useful are non-random comparisons of outcomes and quality of care in
      purchasing hospital stroke services?
AB  - We performed a prospective observational study using a stroke register, case-note
      review and survey of carers with 6 months of follow-up in two adjacent health
      districts in East London. District 1 was a teaching district and had no special
      stroke service; District 2 had a comprehensive stroke service comprising stroke
      unit, review of all stroke admissions and community follow-up. Three hundred and
      sixty-one consecutive patients with stroke admitted to hospital and 103 carers
      were surveyed at 6 months from admission using the Royal College of Physicians
      (London) Stroke Audit standards. We also assessed mortality, disability,
      perceived health, mood, and satisfaction with services 6 months after stroke,
      carer mood, perceived health and satisfaction with services. The standard of care
      was below that set by the Royal College of Physicians of London in both districts
      and there were no significant differences between the districts in age
      standardized mortality at 1 and 6 months, Barthel score, extended ADL score,
      Geriatric Depression score, Nottingham Health Profile score and patient
      satisfaction with services at 6 months. Carer outcomes did not differ between
      districts. Service costs, particularly costs of rehabilitation services, were
      much lower in District 2. A comprehensive district stroke service was not
      associated with major differences in patient outcomes or standards of care. This
      may have been because the non-random nature of the comparison meant that the
      patients differed in other ways than in the nature of treatment. Caution is
      needed when using these techniques in making purchasing decisions.

PMID- 7793335
TI  - The nutritional status and clinical course of acute admissions to a geriatric
      unit.
AB  - Undernutrition of long-stay hospital patients and those in surgical units is well
      documented. This study was designed to determine the extent of the problem in
      elderly people admitted to hospital with acute medical problems and to assess the
      relationship between nutritional status and course of hospital stay. Sixty-nine
      patients underwent a nutritional assessment on admission and at intervals
      throughout their hospital stay and episodes of sepsis were documented. Severely
      malnourished patients were identified using body mass index, BMI (22%) and
      corrected arm muscle area, CAMA (26%). Episodes of sepsis occurred significantly
      more often in the severely undernourished group (p < 0.04). The median length of
      stay of the group was 16 days (range 2-113): during this time there was no
      significant change in markers of nutritional status apart from actual muscle
      circumference (AMC), which showed a reduction in measurement between admission
      and discharge which was statistically significant (p < 0.0003). This study
      indicated that severe malnutrition is common in elderly medical admissions, and
      that it is associated with an increased risk of sepsis. Additional nutritional
      depletion may occur during hospital stay, and is not easily recognized unless
      anthropometry is undertaken.

PMID- 7793337
TI  - Serum creatinine levels in older adults: relationship with health status and
      medications.
AB  - We aimed to examine the association of serum creatinine with health status and
      current medications in the population of older adults. We employed a cross
      sectional study within an ongoing cohort of 3999 residents of three communities
      of the Established Populations for Epidemiologic Studies of the Elderly who had
      venepuncture at the 6-year follow-up when they were aged 71 years and older.
      Serum creatinine levels, history of diabetes and heart attack, current
      medications, and blood pressure were measured. Creatinine levels were higher in
      men than in women, and in blacks than in whites. Higher creatinine levels were
      observed in persons with a history of diabetes or heart attack, and in those
      reporting use of cimetidine and diuretic medications. Persons taking frusemide
      and the potassium-sparing diuretics had higher creatinine levels than those
      taking thiazides. This study confirms associations of higher creatinine with male
      sex, older age, black race, history of diabetes and cimetidine use reported from
      cross-sectional research in younger populations and in smaller, more selected
      groups of older adults. Longitudinal studies will be necessary to strengthen our
      understanding of the causes of changes in kidney function in the older
      population.

PMID- 7793339
TI  - The use of deaf-aid communicators in a Salford Hospital: a failure of
      communication?
AB  - It is estimated that 7.5 million adults in the UK have varying degrees of hearing
      loss. People with hearing deficits often feel isolated, neglected and can be
      mistakenly labelled as confused. Responding to this need, ten deaf-aid
      communicators were purchased for our elderly-care wards. It however became
      apparent that the aids were being under-used, and to test this observation a
      survey of ten elderly-care wards was undertaken. Fifty-six nurses were questioned
      about their knowledge and use of the communicators. Only 32% knew the
      communicators were on their ward. Of these 32%, only 61% knew where the aids were
      kept and only five nurses had ever used the communicators. Only one original,
      functioning communicator was found and over 50% of the machines could not be
      recovered. The possible reasons for the failure of this initiative are discussed
      and lessons drawn. Similar surveys in other hospitals and general practice would
      be useful to determine the level of service offered to patients with hearing
      impairments and to provide a basis for future audit.

PMID- 7793338
TI  - Age-associated alterations in thirst and arginine vasopressin in response to a
      water or sodium load.
AB  - We have examined simultaneous changes in thirst, plasma osmolality and arginine
      vasopressin, after oral water loading or hypertonic saline infusion. The studies
      were carried out in the same subjects, comprising young controls aged 26.8 years
      (SD 4.8, n = 10) and health status-defined elderly people aged 72.1 years (SD
      3.1, n = 10). Water loading caused significant falls in plasma osmolality (p <
      0.001) and thirst (p < 0.001), but there was no variation with age. Infusion with
      462 mmol/l of sodium chloride increased plasma osmolality significantly (p <
      0.001), but there was no variation with age (p = 0.12). The perception of thirst
      during the osmotic loading experiment was recorded differently by the two age
      groups (p < 0.0001). However, linear regression analysis showed no age difference
      in the relationship between thirst and plasma osmolality during osmotic loading.
      During osmotic loading the relationship between the plasma concentration of
      arginine vasopressin in response to increasing plasma osmolality varied
      significantly (slope: p = 0.02; intercept: p = 0.02). Plasma arginine vasopressin
      rose more rapidly with increasing plasma osmolality in old subjects.

PMID- 7793340
TI  - Review: readmission of elderly patients to hospital.

PMID- 7793341
TI  - Geriatric day hospitals.

PMID- 7793342
TI  - Twenty-four-hour ambulatory blood pressure monitoring in healthy elderly people:
      reference values.
AB  - One hundred and two healthy elderly volunteers (aged 65-83 years) underwent 24
      hour ambulatory blood pressure monitoring. Mean day- and night-time pressures
      were higher than reported for younger subjects. Removing outlying BP measurements
      from individual 24-hour recordings only minimally affected mean figures of the
      group but in some individuals mean day diastolic BP may be up to 5 mmHg lower on
      editing. Using unedited data, mean day and night pressures were 134/81 mmHg and
      119/67 mmHg respectively (corresponding 95th centiles 160/96 mmHg and 146/84
      mmHg) and systolic and diastolic BP loads were 36% and 21%. These values may be
      used as temporary reference values for elderly subjects pending the results of
      longitudinal studies. Studies quoting ABPM data should specify whether data
      editing has been employed and, if so, the editing thresholds should be stated.

PMID- 7793343
TI  - Prediction of rehabilitation after hip fracture.
AB  - Six hundred and forty-three consecutive patients admitted from their own home
      with a hip fracture were studied to determine which factors would predict
      patients' abilities to continue living at home. At 1 year from injury 22% of
      patients had died, 14% were in long-term residential care and the remaining 65%
      were living at home. The pre-fracture mobility of the patients was the most
      significant factor in predicting ability to continue to live at home, but also
      significant were mental state, physical health, age and type of fracture.

PMID- 7793345
TI  - Urologic complications of renal transplantation.

PMID- 7793346
TI  - The experience of the CHU Liege with conservative surgery in the management of
      upper urinary tract tumors.
AB  - A review of 20 cases of conservative surgery for urothelial tumors of the upper
      tract is presented. The morbidity is limited; the recurrence rate is around 15%
      in the ipsilateral urinary tract with a mean follow up of 41 months. Conservative
      surgery does not seem to carry a higher fatal risk as compared to more radical
      surgery. It has indications in some cases which are defined.

PMID- 7793344
TI  - Tetanus immunity in elderly people.
AB  - The aims of this study were to document the level of tetanus immunity in elderly
      people; to assess the value of immunization history in predicting tetanus immune
      status and to determine the response to tetanus immunization in elderly people
      compared with younger subjects. One-hundred day-hospital attenders (group 1), 100
      long-term-care residents (group 2) and 50 young subjects (group 3) were
      recruited. Protective titres of tetanus antitoxin antibodies were detected in 20%
      of group 1, 45% of group 2 and 80% of group 3. Tetanus immunization history was a
      poor predictor of immune status in older people with a positive predictive value
      of 50% and a negative predictive value of 76%. The response to tetanus
      immunization was slower and of lower magnitude in older people. However, 36 of 37
      older subjects developed protective levels of tetanus antitoxin antibodies on
      completion of a primary immunization programme.

PMID- 7793347
TI  - [Synchronous bladder metastasis of a clear-cell adenocarcinoma of the kidney].
AB  - Urinary bladder synchronous metastases from renal cell carcinoma are rare, three
      cases were reported in the literature and we present the fourth. In these four
      published cases, the bladder metastases followed a left kidney tumor and in
      three, a brain metastases was also found. A possible retrograde metastatic
      dissemination through the left genital and vertebral veins has to be taken in
      consideration. The short survival after the extirpation of the tumor and the
      bladder metastases implies a less aggressive approach in the presence of a
      bladder metastases.

PMID- 7793348
TI  - Fluorescence imaging of bladder cancer.
AB  - Fluorescence tagging of tumors by sensitizing agents such as hematoporphyrin
      derivatives is an efficient method for diagnosing tumors but presents, even at
      low doses, a number of serious drawbacks for the patients. We demonstrate a
      fiberoptic instrument for the diagnosis of bladder cancer, based on a tripled
      frequency Nd YAG laser, without need for sensitizing agents, based on the
      autofluorescence of tissues. The contrast demarcation obtained for CIS and TCC
      respectively is 2.2 and 2.7, which is about 30% higher than what can be obtained
      after photosensitizing. The integration of the diagnostic method with a reliable
      therapeutic technique for tumor cell destruction, opens the way for cost
      effective preventive care of high risk patients.

PMID- 7793349
TI  - [Electrophysiological study of the distal motor branch of the internal pudendal
      nerve].
AB  - The authors describe their experience with the Swash technique. It consists of
      the measurement of the latency over the distal segment of the motor branch of the
      pudendal nerve following a transrectal stimulation of the pudendal nerve during a
      rectal examination. The response is picked up from the anal sphincter by the use
      of a surface electrode and from the bulbocavernosus muscle with a needle
      electrode.

PMID- 7793350
TI  - Nocturnal penile tumescence evaluation before and after corporeal plication for
      Peyronie's disease.
AB  - A prospective study was done on 76 patients who underwent surgical correction by
      corporeal plication of the penile deformity secondary to Peyronie's disease.
      Nocturnal penile tumescence and rigidity were recorded by RigiScan during three
      consecutive nights, before and after the operation. A significant number of
      patients developed erections of better quality especially at the tip, after this
      corporeal plication procedure. These data indicate that corporeal plication does
      significantly enhance the quality of erectile episodes, by increasing penile
      rigidity.

PMID- 7793352
TI  - Complications of xanthogranulomatous pyelonephritis (XGP).

PMID- 7793351
TI  - A histopathological study of deep dorsal penile vein in venogenic impotence.
AB  - We have studied the histopathology of 87 dorsal penile veins, obtained from
      patients who underwent a resection of the deep dorsal penile vein because of
      proven venous leakage. The amount of muscle tissue and of collagenous connective
      tissue has been numerically quantified. Special attention has been focused on the
      muscular/collagenization ratio. We show that this ratio is not correlated to age
      neither with the outcome of the operation and that no differences exist between
      veins in venous leakage patients and in potent patients. This study confirms that
      the reduction of venous outflow-the so called corporeal veno-occlusive mechanism
      is probably a secondary passive phenomenon, due to smooth muscular relaxation,
      and mainly located within the corpora cavernosa, between the expanding sinusoidal
      wall and the noncompliant tunica albuginea. Our findings also strongly refute the
      hypothesis that polsters or other venous wall characteristics contribute to the
      normal physiology of the deep dorsal penile vein.

PMID- 7793353
TI  - Eosinophilic cystitis: a rare case which presented as an invasive bladder tumor.
AB  - Eosinophilic cystitis is a rare inflammatory lesion of the bladder of unknown
      etiology. It can be confused clinically and cytoscopically with invasive bladder
      cancer. We report a case in which the lesion presented as an invasive bladder
      tumor and we discuss the literature in brief.

PMID- 7793354
TI  - Recombination between genetically modified and unmodified Autographa californica
      nuclear polyhedrosis virus in Trichoplusia ni larvae.
AB  - Trichoplusia ni larvae have been injected with a mixture of wild-type Autographa
      californica multiple nuclear polyhedrosis virus (AcMNPV) and a mutant derivative,
      AcRP8.UW1.lacZ, which lacks the polyhedrin gene, and has the p10 gene replaced by
      the Escherichia coli beta-galactosidase gene. Following plaque assay of the
      haemolymph and subsequent staining for beta-galactosidase activity and scoring
      for polyhedra, recombinant plaques were identified and the recombination
      frequency estimated as 6.6%.

PMID- 7793355
TI  - Genomic identification of Rickettsia slovaca among spotted fever group rickettsia
      isolates from Dermacentor marginatus in Armenia.
AB  - Restriction fragment length polymorphism (RFLP) analysis of polymerase chain
      reaction (PCR) amplified genes was used for genomic identification of Armenian
      isolates of the Spotted fever group (SFG) rickettsiae with unclear taxonomic
      position. Analysis was performed by using one genus-specific primer pair derived
      from R. prowazekii citrate synthase gene and two species-specific primer pairs
      derived from R. rickettsii genes for 190 K and 120 K antigens following AluI,
      PstI and RsaI digestion of amplicons. All tested rickettsial SFG Armenian
      isolates from Dermacentor marginatus were identified as R. slovaca. The
      geographic distribution and genetic homogeneity of R. slovaca strains are
      discussed.

PMID- 7793356
TI  - Protective immunity induced by 67 K outer membrane protein of phase I Coxiella
      burnetii in mice and guinea pigs.
AB  - A 67 K outer membrane protein (OMP) isolated from phase I Coxiella burnetii QiYi
      strain was purified with monoclonal antibodies (MoAb) coupled to CNBr-Sepharose
      4B. Chemical analyses of the 67 K protein showed that it contained seventeen
      kinds of amino acids and no LPS. The immunogenicity and protectivity of the 67 K
      protein against C. burnetii was evaluated in mice and guinea pigs by in vitro
      lymphocyte proliferation assay, delayed-type skin test, antibody conversion rate,
      and immunization and challenge tests. Intraperitoneal injection of the 67 K
      protein resulted in antibody production against phase I and II whole cell
      antigens. The anti-67 K antibody conversion rate was found to be 100% in mice and
      guinea pigs as well. Lymphocytes were responses in vitro to specific antigen. In
      addition, delayed-type hypersensitivity appeared two weeks after immunization
      with the 67 K protein. Moreover, 100% of mice and guinea pigs inoculated with the
      67 K protein were protected against a challenge with 10(3) ID50 virulent C.
      burnetii. In conclusion, these results demonstrate that the 67 K OMP elicits in
      vivo and in vitro both B cell-mediated and T cell-mediated immunity in mice and
      guinea pigs. Thus the 67 K protein is a candidate for an effective subunit
      vaccine against Q fever.

PMID- 7793357
TI  - Increased yields of Japanese encephalitis virus in heat shocked cell cultures.
AB  - Monolayers of porcine stable kidney (PS) and baby hamster kidney (BHK-21) cell
      lines were exposed to 43 degrees C and 41 degrees C, respectively, for 4 hrs and
      infected with Japanese encephalitis virus (JEV) Nakayama strain at low and high
      multiplicity of infection. Virus yields were increased by 0.2-2.5 log PFU/ml in
      heat shocked cultures compared to control cultures at 37 degrees C. This
      phenomenon was detected in the late phase of replication after 16 hrs post
      infection. The progeny virus obtained from heat shocked cultures was more
      thermostable.

PMID- 7793358
TI  - Immunogenicity of Coxiella burnetii whole cells and their outer membrane
      components.
AB  - The immunogenicity and protective efficacy of the phase I and phase II Coxiella
      burnetii whole cells (Cb I and Cb II) and their outer membrane components (OMC),
      i.e. phase I trichloroacetic acid extract (TCAE), phase I 29 K protein (PRO),
      phase I and II lipopolysaccharides (LPS I, LPS II), polysaccharides (PS I, PS
      II), and lipid A (LA I, LA II), were compared. The highest immune response was
      observed in BALB/c mice by Cb I in both humoral immunity and lymphocyte
      transformation assays, and in the protective effect as well. The immune response
      was also significant by Cb II, but their protective capacity was low. The OMC
      reacted variously. Only TCAE and PRO gave a high value of humoral immunity
      evaluated by the serological methods. All OMC reacted in the haemolytic plaque
      assay giving different responses. Lymphoproliferation of splenocytes was positive
      with all OMC using both Cb I and Cb II antigens with the exception of PS I and PS
      II in the case of Cb II antigen. The induction of protection against infectious
      Cb I was demonstrated after immunization with TCAE, PRO, and LPS I. Other OMC did
      not induce protection against this agent.

PMID- 7793359
TI  - Human type I interferons: structure and function.
AB  - Human type I interferons (IFNs) comprise a family of 13 IFN-alpha subtypes and
      single species of IFN-beta and IFN-omega. Their 20% overall sequence homology
      determines identical secondary and tertiary folding of polypeptides. Three
      dimensional models suggest that the globular structure of type I IFNs consists of
      a bundle of 5 alpha-helices, which might form two polypeptide domains. Disulfide
      bond Cys 29-Cys 139 stabilizes both domains in a bioactive configuration. The IFN
      molecule exerts its functional entity only as an organic polypeptide complex and
      therefore molecular fragments apparently lack biological activity. IFN-beta, IFN
      omega and some IFN-alpha subtypes are glycoproteins, but the sugar moiety was
      found to be neither structurally nor functionally relevant. Type I IFNs share a
      common cellular receptor, a fact that implies a high structural conservativity of
      their receptor-binding areas. Two conservative hydrophilic regions associated
      with the amino acids (aa) 30-41 and 120-145 appear to constitute the basic
      framework of receptor recognition site in type I IFNs. However, the individual
      IFN-(sub)types induce different spectra of biological effects which reflect some
      specificity in modelling of binding sites. Besides a subtle sequential
      heterogeneity in the segments aa 30-41 and 120-145, also the variable hydrophilic
      aa regions 23-26, 68-85 and 112-121 are responsible for structural and functional
      individuality among human type I IFNs. The interaction between IFN and its
      receptor seems to be a complex event which triggers simultaneously antiviral,
      antiproliferative and immunomodulating actions, although different parts of IFN
      molecule are not involved equally in eliciting of respective basal activities.

PMID- 7793360
TI  - Perinatal asphyxia: MR findings in the first 10 days.
AB  - PURPOSE: To determine whether one can detect hypoxic-ischemic brain injury by MR
      in the first 10 days of life and to identify patterns of injury in affected
      neonates. METHODS: Standard T1- and T2-weighted MR sequences that were performed
      in the first 10 days of life in 20 patients who suffered hypoxia/ischemia in the
      intrapartum or neonatal periods were reviewed retrospectively. Images were
      evaluated for patterns of signal changes. RESULTS: Four patients had normal
      findings and were clinically healthy. The remaining 16 patients were divided into
      four groups based on pattern of injury: (a) primarily deep gray matter
      involvement; (b) primarily cortical involvement; (c) primarily periventricular
      white matter injury; and (d) mixed injury pattern. Two patients had appearances
      that suggested prepartum injury. T1 shortening was seen in injured tissue as
      early as 3 days after injury. T2 shortening did not appear until 6 or 7 days
      after injury. CONCLUSION: MR can show brain damage in asphyxiated neonates during
      the first 10 days of life and shows early appearances of several patterns of
      brain injury.

PMID- 7793361
TI  - Acute encephalopathy with bilateral thalamotegmental involvement in infants and
      children: imaging and pathology findings.
AB  - PURPOSE: To investigate the imaging and pathologic characteristics of acute
      encephalopathy with bilateral thalamotegmental involvement in infants and
      children. METHODS: Five Japanese children ranging in age from 11 to 29 months
      were studied. We performed CT imaging in all patients, 10 MR examinations in four
      patients, and an autopsy in one patient. RESULTS: The encephalopathy affected the
      thalami, brain stem tegmenta, and cerebral and cerebellar white matter. The brain
      of the autopsied case showed fresh necrosis and brain edema without inflammatory
      cell infiltration. Petechiae and congestion were demonstrated mainly in the
      thalamus. CT and MR images showed symmetric focal lesions in the same areas in
      the early phase. These lesions became more demarcated and smaller in the
      intermediate phase. The ventricles and cortical sulci enlarged. MR images
      demonstrated T1 shortening in the thalami. The prognosis was generally poor; one
      patient died, three patients were left with severe sequelae, and only one patient
      improved. CONCLUSIONS: The encephalopathy might be a postviral or postinfectious
      brain disorder. T1 shortening in the thalami indicated the presence of petechiae.

PMID- 7793363
TI  - Holoprosencephaly: an analysis of callosal formation and its relation to
      development of the interhemispheric fissure.
AB  - PURPOSE: To correlate the degree of hemispheric fusion in holoprosencephaly with
      degree of callosal formation, with degree of thalamic and basal ganglia fusion,
      and with presence or absence of dorsal cyst. METHODS: MR, CT, and ultrasonography
      from 19 patients with holoprosencephaly was retrospectively reviewed. The imaging
      studies were graded according to extent of the hemispheric fusion, thalamic
      fusion, corpus striatum fusion, callosal formation, and the presence or absence
      of a dorsal cyst. These factors were statistically correlated with each other
      using Kendall rank correlation coefficient. RESULTS: There were significant
      correlations between hemispheric fusion and failure of corpus callosum formation,
      presence of dorsal cyst and failure of corpus callosum formation, and hemispheric
      fusion and presence of dorsal cyst. Additional correlations were noted between
      thalamic fusion and corpus striatum fusion. CONCLUSIONS: Our results suggest that
      the presence of an interhemispheric fissure is necessary for callosal formation,
      and the presence of a dorsal cyst may interfere with callosal formation in
      holoprosencephaly.

PMID- 7793362
TI  - Postvaricella basal ganglia infarction in children.
AB  - Two patients presented with acute neurologic deficits attributable to
      contralateral basal ganglia infarction 1 to 3 months after episodes of
      chickenpox. Both presented with hemiparesis with one patient also demonstrating
      ipsilateral choreoathetosis. In both patients MR revealed unilateral basal
      ganglia infarction. Cerebral angiography findings in one patient were normal; in
      the second, there was unilateral narrowing of the common carotid artery and of
      proximal branches of the anterior and middle cerebral artery.

PMID- 7793364
TI  - Hematopoietic marrow regeneration in pediatric patients undergoing spinal
      irradiation: MR depiction.
AB  - PURPOSE: To evaluate changes in vertebral marrow signal intensity that occur over
      time in children undergoing craniospinal radiation therapy, specifically
      evaluating for the occurrence and timing of marrow regeneration. METHODS: MR
      images of nine pediatric patients (ages 4 to 12 years) with posterior fossa
      medulloblastoma who received total spinal irradiation (24 to 40 Gy) and had at
      least three MR examinations were reviewed. Signal intensity to vertebral body
      marrow was graded by two pediatric neuroradiologists who were blinded to patient
      identity and to the timing of the studies. RESULTS: Eight of nine patients
      demonstrated increasing signal intensity of the vertebral marrow after
      irradiation, consistent with conversion of hematopoietic to fatty marrow. In each
      of these patients, this was followed by subsequent decreasing signal intensity in
      a mottled or peripheral band pattern indicating recovery of hematopoietic marrow.
      CONCLUSION: Changes in vertebral body signal intensity consistent with marrow
      reconversion commonly are seen in pediatric patients 11 to 30 months after they
      undergo total spinal irradiation.

PMID- 7793365
TI  - Ultrasound determination of the normal location of the conus medullaris in
      neonates.
AB  - PURPOSE: To establish the normal range of the position of the conus medullaris in
      neonates and determine whether it differs from that in adults. METHODS: One
      hundred five healthy neonates born over an 18-day period in a single obstetric
      unit had ultrasound examinations of their lower spines to relate the conus
      medullaris to the nearest intervertebral disk or midvertebral level. RESULTS: The
      mean position of the conus was midway between the L1-2 disk and mid-L-2 body,
      ranging from T-12/L-1 to L-3, with the modal position being L1-2 (47.6%). A small
      but significant rise in position from 33 to 42 weeks postconceptual age was
      identified. Comparison with data previously reported from adults showed a small
      but highly significant difference in conus position of approximately 0.25
      vertebral levels. DISCUSSION: Our data confirm studies suggesting that ascent of
      the cord after birth is minor.

PMID- 7793366
TI  - Ethmoid mucocele in an infant with a benign fibroosseous lesion.
AB  - We present a case of ethmoid mucocele occurring in a two-month-old child, and
      associated (presumably causally) with a benign fibroosseous lesion of the ethmoid
      bone. These two conditions may be more frequently associated than previously
      recognized; MR greatly facilitates their evaluation.

PMID- 7793367
TI  - Solitary infantile myofibromatosis of the skull.
AB  - We describe the CT and plain-film appearance of solitary infantile
      myofibromatosis of the skull in a 5-year-old boy. This benign lesion closely
      resembles histiocytosis X on imaging studies.

PMID- 7793368
TI  - Occlusion of cerebral arteriovenous malformations with N-butyl cyano-acrylate is
      permanent.
AB  - PURPOSE: To verify the permanence of total occlusion of cerebral arteriovenous
      malformations after embolization with N-butyl cyano-acrylate and to evaluate the
      occlusion rate. METHODS: One hundred thirty-four patients were treated for
      cerebral arteriovenous malformations with N-butyl cyano-acrylate embolization
      after superselective catheterization. Those initially totally occluded have been
      followed with angiography. RESULTS: In 15 instances (11.2%) the arteriovenous
      malformations were totally occluded by embolization alone. Follow-up angiograms
      have been performed in 12 cases (80%) after 4 to 78 (mean, 27) months after
      embolization. In all instances the arteriovenous malformations have remained
      occluded, and there have been no clinical signs of activity. CONCLUSION: After
      total occlusion of a cerebral arteriovenous malformation with N-butyl cyano
      acrylate, the lesion stays occluded, and the clinical course seems stable.

PMID- 7793369
TI  - Iatrogenic carotid-cavernous fistula occurring after embolization of a cavernous
      sinus meningioma.
AB  - A carotid-cavernous fistula developed in a 62-year-old woman during an attempt at
      embolization of a skull base meningioma. The cause is thought to be perforation
      by the guide wire during catheterization of the meningohypophyseal trunk at the
      sharp bend at its origin.

PMID- 7793370
TI  - Adolf Bingel, the second inventor of lumbar pneumencephalography.

PMID- 7793371
TI  - Clinically unsuspected venous malformations limited to the submandibular
      triangle: CT findings.
AB  - PURPOSE: To present the CT characteristics of histologically confirmed venous
      vascular malformations limited to the submandibular triangle in patients without
      clinical stigmata of venous vascular malformations. METHODS: The clinical records
      and CT scans of five women with venous vascular malformations limited to the
      submandibular triangle were reviewed. Patients ranged from 39 to 70 years of age.
      None of the patients had a history of malignant tumors. All patients presented
      with a solitary suprahyoid neck mass. None of the patients demonstrated cutaneous
      manifestations of venous vascular malformation. RESULTS: Contrast-enhanced CT
      scans in all five patients demonstrated a lobulated, heterogeneously enhancing,
      well-circumscribed solid mass, separable from the submandibular gland. Areas of
      contrast enhancement within each mass were isodense to the internal jugular vein
      in four of five cases. Only two of five lesions demonstrated focal
      calcifications. Excisional biopsy (two patients) demonstrated pathologic features
      compatible with venous vascular malformation. Fine needle aspirations (three
      patients) yielded venous blood or blood-tinged fluid. CONCLUSIONS: Venous
      vascular malformations may present as isolated neck masses in adults without
      typical clinical stigmata. Clues to the CT diagnosis include a lobulated
      appearance to the mass with intense but heterogeneous contrast enhancement. This
      appearance, in combination with results of fine needle aspiration, may be
      sufficiently diagnostic to preclude excisional biopsy.

PMID- 7793372
TI  - A reappraisal of the radiologic findings of acute inflammation of the epiglottis
      and supraglottic structures in adults.
AB  - PURPOSE: To evaluate the radiologic characteristic of acute inflammation of the
      epiglottis and supraglottic structures in adults. METHODS: The clinical and
      radiographic findings in 27 adult patients with epiglottitis (average age, 43
      years; range, 28 to 81 years) were compared with those of a control group of
      asymptomatic subjects (n = 15; average age, 48 years; range, 24 to 79 years).
      Unusual clinical aspects in the current series included two patients who were
      positive for human immunodeficiency virus, 1 with acquired immunodeficiency
      syndrome and Kaposi sarcoma, 3 with emphysematous epiglottitis, 1 with abscess
      formation, and 1 with laryngeal carcinoma. One patient required emergency
      tracheostomy. One patient died of pneumonia. RESULTS: The ratio of the soft
      tissue parameters to the anteroposterior width of the C-4 vertebral body yielded
      three key parameters of high statistical significance in adult epiglottitis. The
      ratio of the width of the epiglottis to the anteroposterior width of C-4 should
      not be greater than 0.33 (sensitivity, 96%; specificity, 100%). The ratio of the
      prevertebral soft tissue to C-4 should not exceed 0.5 (sensitivity, 37%;
      specificity, 100%) and the ratio of the width of the hypopharyngeal airway to the
      width of C-4 should be less than 1.5 (sensitivity, 44%; specificity, 87%). The
      aryepiglottic folds were enlarged in 85%, and the arytenoids were swollen in 70%
      of the patient population (specificity, 100%). CONCLUSION: These defined
      radiologic parameters should aid in the diagnosis of acute epiglottitis in
      adults.

PMID- 7793373
TI  - MR in neurofibromatosis of the larynx.
AB  - We report the MR results of four patients with plexiform neurofibromas of the
      larynx. Three had irregular margins and were circumferential around the airway.
      The distinction between regularly and irregularly shaped neurofibromas may have
      implications for symptom onset.

PMID- 7793374
TI  - MR findings of sclerosing cervicitis.
AB  - The MR appearance of sclerosing cervicitis in the case presented is that of a
      fusiform mass arising in the lateral neck with vascular encasement. The mass is
      mildly hyperintense to skeletal muscle on the T1- and T2-weighted images.

PMID- 7793375
TI  - Clinical significance of asymmetry of the fornix and mamillary body on MR in
      hippocampal sclerosis.
AB  - PURPOSE: To investigate the clinical significance of MR-defined asymmetry of the
      fornix and mamillary body for presurgical determination of the side of
      hippocampal sclerosis in patients with temporal lobe epilepsy. METHODS: Fast spin
      echo MR images were evaluated for evidence of an asymmetrically small fornix and
      mamillary body in 33 patients with pathologically proved hippocampal sclerosis
      (presurgical hippocampal sclerosis group), 7 patients who had undergone anterior
      temporal lobectomy (mean, 3 years from surgery) because of hippocampal sclerosis
      (postsurgical hippocampal sclerosis group), and 34 healthy subjects (control
      group). Fast spin-echo hippocampal volumetry was performed in each patient.
      RESULTS: In the control group, 6% (2 of 34) of subjects had MR evidence of
      asymmetrically small fornix and none (0 of 34) of the subjects had asymmetrically
      small mamillary body. In the patient population, an asymmetrically small fornix
      was seen in 42% of presurgical hippocampal sclerosis group, 39% (13 of 33)
      ipsilateral, and 3% (1 of 33) contralateral, and in 71% of the postsurgical
      hippocampal sclerosis group (5 of 7), all ipsilateral. In the presurgical
      hippocampal sclerosis group, hippocampal atrophy measured with MR was more severe
      in patients with an ipsilaterally small fornix than in patients without. An
      asymmetrically small mamillary body was found ipsilaterally in 3% (1 of 33) of
      the presurgical hippocampal sclerosis group and in 57% (4 of 7) of the
      postsurgical hippocampal sclerosis group; all patients with an asymmetrically
      small mamillary body in the postsurgical hippocampal sclerosis group also had an
      asymmetrically small fornix on the same side. CONCLUSION: In presurgical
      hippocampal sclerosis patients, an asymmetrically small fornix can be seen
      ipsilaterally on the side of the hippocampal sclerosis; however, its low
      frequency, its association with severe hippocampal atrophy only, and the
      possibility of false-positive results limit its clinical usefulness in
      determining the side of the seizure focus. An asymmetrically small mamillary body
      is too rare to be used for presurgical location of hippocampal sclerosis.
      However, an asymmetrically small fornix and mamillary body are frequently seen on
      MR images after temporal lobectomy.

PMID- 7793376
TI  - The asymmetric mamillary body: association with medial temporal lobe disease
      demonstrated with MR.
AB  - PURPOSE: To determine whether mamillary body atrophy is caused by deafferentation
      of the mamillary body in patients with mesial temporal sclerosis. METHODS: We
      studied 36 patients with thin-section MR to assess mamillary body symmetry. These
      patients included 10 control subjects without seizures and 26 patients with a
      history of seizures. Thin-section T1 scans were available for all cases. The
      patients with epilepsy underwent axial and coronal T2 scans as well. RESULTS: In
      five of eight cases with prior medial temporal lobe resection for intractable
      epilepsy, there was evidence of unilateral mamillary body atrophy ipsilateral to
      the resection. Similar findings were evident in three of six patients with MR
      findings of mesial temporal sclerosis without surgery. Two patients with medial
      temporal stroke or tumor also had ipsilateral mamillary body atrophy. CONCLUSION:
      These findings provide support for the proposed mechanism of mamillary body
      atrophy caused by prior medial temporal lobe injury.

PMID- 7793377
TI  - MR in temporal lobe epilepsy: early childhood onset versus later onset.
AB  - PURPOSE: To study the relationship between the MR findings and the clinical
      features in temporal lobe epilepsy in childhood (less than 10 years of age).
      METHODS: MR studies were performed with a 1.5-T imager on 38 temporal lobe
      epilepsy patients receiving drug therapy at the psychiatric department. These
      patients were divided into two groups according to their age at onset (10 years
      or less, 11 years or more). The two groups were compared in terms of the MR
      findings and clinical features. RESULTS: The 11 younger-onset patients included 5
      with a high-signal area attributed to mesial temporal sclerosis. Clinically, all
      of these 5 patients had a history of "complex" febrile convulsions, which sharply
      distinguished them from the older-onset group. CONCLUSION: The analysis suggests
      that complex febrile convulsions in infancy can be associated with high-signal
      areas on MR attributed to mesial temporal sclerosis.

PMID- 7793378
TI  - Size estimation and magnification error in radiographic imaging: implications for
      classification of arteriovenous malformations.
AB  - PURPOSE: To assess magnification error in digital subtraction angiography as it
      pertains to arteriovenous malformation (AVM) size. METHODS: A rectangular grid
      phantom with equally spaced markers mounted in a stereotactic frame was imaged
      with digital angiographic equipment. The location and orientation of the grid was
      altered relative to the central plane of the phantom. Both linear and area
      measurements were made according to the perceived location of phantom markers
      using a standard catheter calibration technique and compared with
      stereotactically derived estimates. Finally, a single case example of an
      angiographically imaged rolandic AVM was used to compare linear dimensions
      obtained with both described techniques. RESULTS: The determination of location
      and size with standard angiographic imaging is subject to error because of the
      divergent geometry of the incident x-ray beam. The resulting nonconstant
      geometric magnification causes errors in linear measurements of 10% to 13% at
      depths of 7 cm from the calibration plane. Errors in area measurements at the
      same position increase by 20% to 25%. Measurements of maximum diameter or cross
      sectional area may have an additional error when nonspherical objects are
      inclined to the viewing direction (40% at 45 degrees inclination). These errors
      are reduced to less than 1 mm using the stereotactic technique. Some commercial
      angiographic systems have internal software to enable a spatial calibration based
      on known distances in the image or on the diameter of a catheter. The catheter
      technique was accurate in the calibration direction (perpendicular to the
      catheter axis) but had a 12% error in the direction parallel to the catheter
      because of a nonunity aspect ratio in the video system. Measurement of the
      dimensions of a rolandic AVM using the catheter calibration technique had an
      error that ranged from -3% to +26% (standard error, 20%) with respect to the
      stereotactic technique. CONCLUSIONS: Numerous nonstereotactic referential systems
      for determining linear distances are inherently erroneous by varying degrees
      compared with the stereotactic technique. Area and volume determinations
      naturally increase this error further. To the extent that no standardized method
      for determining linear distances exists, significant variations in estimation of
      AVM size result. Classification schemes for AVMs have been hampered by this
      technical error.

PMID- 7793379
TI  - Rerupture of cerebral aneurysms during angiography.
AB  - PURPOSE: To assess the incidence of angiography-related rerupture of intracranial
      aneurysms and to analyze other risk factors of this complication. METHODS:
      Clinical data from 144 patients with acute subarachnoid hemorrhage from ruptured
      intracranial aneurysm were reviewed retrospectively. In all patients, angiography
      was done by the transaortic approach. RESULTS: The incidence of rerupture caused
      by angiography was 2 (1.4%) of 144 and that of spontaneous rerupture was 14
      (9.7%) of 144. Angiography within 6 hours after the initial subarachnoid
      hemorrhage attack was associated with a significantly higher incidence of
      rerupture (4.8%) than that after a longer interval (0%). In cases of spontaneous
      rerupture, patients with worse levels of consciousness showed a higher incidence
      of rerupture, and this tendency also was evident in cases of induced rerupture.
      There was no significant correlation between the rerupture rate and the injection
      volume of contrast medium, aneurysm location, or patient age or sex. CONCLUSION:
      Although angiography within 6 hours after initial intracranial aneurysm rupture
      was associated with a higher rate of rerupture, the incidence of rerupture in
      this study (4.8%) was much lower than those reported previously (20% to 38.5%).
      The present findings suggest that emergency angiography within 6 hours after
      aneurysm rupture, which enables neurosurgeons to carry out early surgery, should
      not be discouraged.

PMID- 7793380
TI  - MR and cognitive testing of patients undergoing osmotic blood-brain barrier
      disruption with intraarterial chemotherapy.
AB  - PURPOSE: To determine whether osmotic blood-brain barrier disruption is
      associated with MR abnormalities or cognitive deterioration and, if so, whether
      the MR findings correlate with cognitive test results. METHODS: Fifteen brain
      tumor patients who had a complete tumor response (nine central nervous system
      lymphoma, three germ cell and two astrocytoma, and one primitive neuroectodermal
      tumor) treated with blood-brain barrier disruption procedures (318 total
      procedures) with intraarterial chemotherapy were included. MR images were
      evaluated for the development of white matter hyperintensity, vascular lesions,
      or atrophy. Cognitive testing was performed to assess deterioration caused by
      this therapy. RESULTS: In two patients white matter hyperintensity developed, in
      two small vascular lesions developed, and in one mild atrophy developed. One
      infarct was asymptomatic and the second one resulted in mild dysesthesia in one
      upper extremity. No patient showed diminished cognitive function on the
      posttherapy evaluation. CONCLUSION: In patients undergoing blood-brain barrier
      disruption with intraarterial chemotherapy, new abnormalities on MR imaging may
      develop. These patients maintain the same level of cognitive and neurologic
      function and MR findings do not correlate with the results of cognitive testing.

PMID- 7793381
TI  - MR of cerebral aspergillosis in patients who have had bone marrow
      transplantation.
AB  - PURPOSE: To assess the CT and MR appearance of cerebral aspergillosis in patients
      who have undergone bone marrow transplantation. METHODS: The imaging and clinical
      data of five patients with cerebral aspergillosis were reviewed retrospectively
      and compared with autopsy findings. RESULTS: Lesions are often located in the
      basal ganglia and demonstrate an intermediate signal intensity within surrounding
      high-signal areas on long-repetition-time MR scans. The lesions were multiple in
      four of the five patients and more numerous on MR images than on CT scans. The
      lesions (which demonstrate no parenchymal enhancement) are consistent with acute
      infarcts as confirmed at autopsy. In the large lesions, there is early
      intravascular and meningeal enhancement, as expected in acute infarcts involving
      an appreciable portion of the territory of a cerebral artery. CONCLUSION: The
      diagnosis of early cerebral infarction in a patient considered at risk for
      invasive aspergillosis, even without overt pulmonary disease, is an indication to
      institute aggressive antifungal therapy.

PMID- 7793382
TI  - Vascular reserve in chronic cerebral ischemia measured by the acetazolamide
      challenge test: comparison with positron emission tomography.
AB  - PURPOSE: To determine the value of the acetazolamide challenge test with stable
      xenon-enhanced CT (Xe CT) for making therapeutic decisions in patients with
      chronic cerebrovascular disease. METHODS: We compared the Xe CT-measured
      acetazolamide response with various measures obtained by positron emission
      tomography. We performed both a positron emission tomographic scan and a Xe CT
      study in 11 patients with chronic cerebral ischemic diseases within a 1-week
      interval. An increase of cerebral blood flow after injection of acetazolamide was
      expressed as delta AT. Regional cerebral blood flow, cerebral oxygen metabolism,
      oxygen extraction fraction, and cerebral blood volume were measured with oxygen
      15-labeled gases by positron emission tomography. RESULTS: In low-cerebral blood
      flow regions, decreased delta AT was accompanied by a significant elevation of
      oxygen extraction fraction and cerebral blood volume, compared with oxygen
      extraction fraction and cerebral blood volume in regions of normal delta AT.
      Plotting of regional data indicated that delta was significantly dependent on
      oxygen extraction fraction and cerebral blood volume. The area of decreased
      vascular reserve determined by the Xe CT image corresponded to the area of
      "misery perfusion" determined by positron emission tomography. CONCLUSION: The
      acetazolamide challenge test with Xe CT may offer an alternative to positron
      emission tomography in detecting lesions with elevated oxygen extraction fraction
      and cerebral blood volume (misery perfusion) that result from chronic hemodynamic
      stress.

PMID- 7793383
TI  - The value of MR in differentiating subligamentous from supraligamentous lumbar
      disk herniations.
AB  - PURPOSE: To determine the value of MR criteria in differentiating subligamentous
      from supraligamentous lumbar disk herniations. METHODS: A retrospective review of
      surgical reports and MR images of 50 patients undergoing first-time lumbar
      surgery was performed. Three MR imaging criteria were assessed: the presence and
      integrity of a low-signal-intensity line posterior to the disk herniation, the
      size of the disk herniation in comparison with the size of the spinal canal, and
      the presence of disk fragments. Correlation was made with surgical findings to
      determine the value of these MR criteria in differentiating subligamentous from
      supraligamentous disk herniations. RESULTS: For determining subligamentous disk
      herniations: the presence of a continuous low-signal-intensity line posterior to
      the disk herniation was 29% sensitive, 65% specific, and 42% accurate; disk
      herniation size less than 50% of the size of the spinal canal was 64% sensitive,
      47% specific, and 58% accurate; and the absence of disk fragments was 88%
      sensitive, 12% specific, and 62% accurate. Combinations of individual MR criteria
      did not improve diagnostic accuracy. CONCLUSIONS: For differentiating
      subligamentous from supraligamentous lumbar disk herniations, none of the MR
      imaging criteria assessed was reliable.

PMID- 7793384
TI  - MR imaging in a case of postvaccination myelitis.
AB  - We describe a case of acute transverse myelitis after the administration of the
      recombinant form of hepatitis B vaccine. Abnormal enhancement of MR imaging
      accompanied residual neurologic deficit.

PMID- 7793385
TI  - Posterior fossa glioblastoma multiforme: MR findings.
AB  - PURPOSE: To characterize the MR findings of glioblastoma multiforme in the
      posterior fossa. METHODS: MR studies of nine patients with surgically proved
      posterior fossa glioblastoma multiforme were retrospectively evaluated. MR
      characteristics studied included tumor location, signal intensity, enhancement
      pattern, and presence of intratumoral hemorrhage, as well as presence of
      secondary hydrocephalus or metastatic spread. RESULTS: The tumors were located in
      the median portion of the cerebellum or brain stem in eight cases. Six extended
      into the fourth ventricle. Hydrocephalus was seen in four cases. Six cases
      demonstrated decreased T1- and increased T2-weighted signal intensities. Three
      cases demonstrated mixed signal intensities suggesting intratumoral hemorrhage.
      All of the eight patients who received contrast showed moderate to marked
      heterogeneous ringlike enhancement suggesting intratumoral necrosis.
      Multicentric/multifocal lesions or extraaxial metastases were identified in three
      of the nine cases, and there was extracranial extension into the cervical region
      in one case. CONCLUSION: Glioblastoma multiforme is a rare tumor in the posterior
      fossa. Differentiating it from metastatic tumor or malignant astrocytoma was
      difficult. However, combination of heterogeneous and ringlike enhancement,
      midline location, poorly defined margin, tumoral hemorrhage, concomitant
      multicentric/multifocal lesions, and extraaxial or extracranial metastasis may be
      clues for the prospective diagnosis of glioblastoma multiforme.

PMID- 7793386
TI  - Transorbital color Doppler flow imaging of the carotid siphon and major arteries
      at the base of the brain.
AB  - PURPOSE: To describe and evaluate an application of sonography, transorbital
      color Doppler flow imaging of the carotid siphon and major intracranial arteries,
      and to compare it with transtemporal color Doppler flow imaging. METHODS: The
      carotid siphon and major arteries at the base of the brain of 50 healthy
      volunteers were screened using the transorbital color Doppler flow sonography.
      These arteries were also studied by a transtemporal approach for comparison. In 5
      volunteers, MR images in special inclination planes were obtained and compared
      with the transorbital color-coded Doppler flow images. RESULTS: The B-mode image
      of the orbit and intracranial anatomic structures, in addition to the color-coded
      flow images, provided an unambiguous identification of the carotid siphon and
      major intracranial arteries. The failure rate was lower when using the
      transorbital approach than when using the transtemporal approach in identifying
      the anterior cerebral artery (17% versus 32%). Color Doppler flow imaging using
      the transtemporal approach was better for the middle cerebral artery, whereas
      color Doppler flow imaging using the transorbital approach was better for the
      anterior cerebral artery (contralateral). The Doppler incident angles using the
      transorbital approach were better for the carotid siphon and anterior cerebral
      artery (contralateral). CONCLUSION: Transorbital color Doppler flow imaging, when
      used in conjunction with the transtemporal examination, can add information
      concerning the major arteries at the base of the brain.

PMID- 7793387
TI  - A simple CT method for location of auditory brain stem implant electrodes.
AB  - A method for locating auditory brain stem implant electrodes that have been
      placed in the lateral recess of the fourth ventricle is described. CT bone window
      images are "inverted" to black on white, then manually superimposed onto soft
      tissue window images to enable identification of electrodes in relation to soft
      tissue structures.

PMID- 7793388
TI  - MR of parenchymal neurocutaneous melanosis.
AB  - Two cases of neurocutaneous melanosis are presented. MR showed hyperintense areas
      in the brain on short-repetition-time/short-echo-time sequences, compatible with
      intraparenchymal melanin deposits. No leptomeningeal abnormality was seen.

PMID- 7793389
TI  - MR lesion enhancement: spin-echo versus gradient-echo.

PMID- 7793390
TI  - Guglielmi coils in ruptured aneurysms.

PMID- 7793391
TI  - Subthalamus versus substantia nigra.

PMID- 7793392
TI  - Annotated bibliography.

PMID- 7793393
TI  - Clinical characteristics and mortality of patients screened for entry into the
      Trandolapril Cardiac Evaluation (TRACE) study.
AB  - In mortality studies of patients after acute myocardial infarction (AMI),
      exclusion of patients during selection from the screened population may be
      important for evaluating the impact of trials, but data on patients excluded from
      studies are rarely presented. In the Trandolapril Cardiac Evaluation (TRACE)
      trial of the angiotensin-converting enzyme inhibitor trandolapril versus placebo
      in patients with left ventricular (LV) systolic dysfunction shortly after AMI,
      medical history, infarct complication, and survival were accounted for in all
      patients screened for entry. A total of 7,001 consecutive enzyme-confirmed AMIs
      were screened for entry in 27 Danish coronary care units. The 1-year mortality of
      all screened AMI cases was 23% (95% confidence interval 22% to 24%). The target
      population of the TRACE trial were patients with LV systolic dysfunction
      (echocardiographically determined wall motion index < or = 1.2, n = 2,606 within
      6 days of AMI. The 1-year mortality of this group was 34 +/- 2%. Patients with
      wall motion index > 1.2 (n = 3,920) had a 1-year mortality of 12 +/- 1%. were
      excluded. A total of 1,749 were included in the study. The excluded and included
      groups had a 1-year mortality of 54 +/- 3% and 24 +/- 2%, respectively. The
      result of the TRACE study will be applicable to two thirds of the patients with
      LV systolic dysfunction; however, even with this high figure, care should be
      taken in extrapolating the result to the general population with reduced LV
      function after AMI since the group excluded from the study had a higher mortality
      than those who were included.

PMID- 7793394
TI  - Doppler-derived gradients in normally functioning Monostrut Bjork-Shiley
      prostheses.
AB  - In summary, reference values of Doppler gradients obtained in a large number of
      patients with normal-functioning mitral and aortic Monostrut Bjork-Shiley
      prostheses are reported. It is shown that the value of the transprosthetic
      gradient increases with decreasing valve size in patients with aortic prostheses.
      No individual significant variations of the transprothetic Doppler gradient
      during a 3-year follow-up were observed.

PMID- 7793395
TI  - Recurrence of a discrete subaortic membrane 27 years after operative resection.

PMID- 7793396
TI  - Q-wave regression unrelated to patency of infarct-related artery or left
      ventricular ejection fraction or volume after anterior wall acute myocardial
      infarction treated with or without reperfusion therapy.
AB  - We examined the relation of Q-wave regression to left ventricular (LV) indexes in
      acute anterior wall myocardial infarction (AMI) in relation to reperfusion
      therapy. A total of 94 patients with their first anterior wall AMI (segment 6 or
      7 occlusion according to the American Heart Association classification) were
      examined. The follow-up period with 12-lead electrocardiograms ranged from 6 to
      60 months (mean 24 +/- 18). An abnormal Q wave was defined as > 40 ms and > 25%
      of the R-wave amplitude. Q-wave regression was defined as Q-wave disappearance
      and r-wave regression > 0.1 mV in > or = 1 lead. Contingency tables with the chi
      square test and analysis of variance were used for assessment of the relation
      between Q-wave regression and angiographic and clinical indexes. Q-wave
      regression in > or = 1 lead was found in 77% of the patients. The incidence of Q
      wave regression in patients with patent infarct-related artery (81%) was not
      significantly different from that in those with an occluded lesion (67%). Q-wave
      regression appeared within 1 month in 60% of patients with a patent infarct
      related artery but in 25% of those with an occluded lesion. No difference in the
      incidence of Q-wave regression was seen between patients with lesions at segments
      6 (81%) and 7 (70%), or between those with (75%) and without (77%) collateral
      circulation. Q-wave regression did not correlate with LV ejection fraction, LV
      end-diastolic or end-systolic volumes, or regional wall motion.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7793397
TI  - Can atherosclerotic coronary arteries vasodilate? An intraoperative high
      frequency epicardial echocardiographic study.
AB  - Our purpose was to evaluate the vasodilating responses of atherosclerotic
      coronary arteries using intraoperative high-frequency (12 MHz) epicardial
      echocardiography. We obtained continuous high-frequency epicardial
      echocardiographic recordings during surgery, and determined cross-sectional lumen
      area from 17 coronary arterial segments (12 patients). Nitroglycerin (100 to 400
      micrograms/min) was administered intravenously to reduce mean (+/- SEM) arterial
      pressure 14 +/- 1.8 mm Hg. The cross-sectional arterial images were classified
      using 3 different parameters: arterial lumen area, percentage of the arterial
      wall circumference that was atherosclerotic (wall thickness > 0.7 mm), and
      presence of an eccentrically shaped arterial lumen (maximal/minimal luminal
      diameter > 1.5). Nine arterial segments had small (< 5.0 mm2) arterial lumens
      (1.7 +/- 0.40 mm2 [+/- SEM; range 0.6 to 3.9]). With nitroglycerin, the luminal
      area increased 0.8 +/- 0.28 mm2 (range 0 to 2.5), and 39 +/- 12.1% (range 0 to
      117). The remaining 8 segments had larger (> 5.0 mm2) lumens (8.7 +/- 0.91 mm2
      [range 5.0 to 11.9]). With nitroglycerin the luminal area increased 4.3 +/- 1.11
      mm2 (range 1.4 to 11.4), and 51 +/- 10.2% (range 16 to 96). Seven arterial
      segments had eccentric lumens; mean maximal/minimal ratio was 1.8 +/- 0.08 (range
      1.6 to 2.0). The area increased 39 +/- 7.3% (range 16 to 71) with nitroglycerin.
      In the 10 concentrically shaped lumens (maximal/minimal lumen diameters 1.3 +/-
      0.04 [range 1.1 to 1.5]), nitroglycerin increased luminal area by 48 +/- 12.6%
      (range 0 to 117) (p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793398
TI  - Mechanisms of hypotension during dobutamine stress echocardiography in patients
      with coronary artery disease.
AB  - Fifty-nine consecutive patients with angiographically documented coronary artery
      disease were prospectively studied during dobutamine stress echocardiography.
      Twelve patients (20%) developed hypotension, defined as a decrease in systolic
      blood pressure of > or = 20 mm Hg compared with baseline. The transmitral flow
      velocities, isovolumic relaxation time (IVRT), and flow in the left ventricular
      (LV) outflow tract were measured at baseline, at maximal dobutamine dose, or
      during a hypotensive episode; stroke volume, cardiac output, and systemic
      vascular resistance (SVR) were computed. Correlates of hypotensive response to
      dobutamine stress echocardiography included therapy with angiotensin-converting
      enzyme inhibitors (p = 0.032), a longer IVRT at baseline (121 +/- 25 vs 103 +/-
      28 ms, p = 0.047), a greater decrease in LV end-diastolic (-6.0 +/- 3.1 vs -2.2
      +/- 2.1 mm, p < 0.0001) and end-systolic (-8.3 +/- 7.0 vs -5.1 +/- 3.7 mm, p =
      0.037) dimensions, and a greater decrease in stroke volume (-10 +/- 10 vs -2 +/-
      11 ml, p = 0.023) compared with those with a normal response. The groups did not
      differ significantly with regard to baseline stroke volume, cardiac output, SVR,
      and LV ejection fraction or LV mass.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793399
TI  - Prognostic implications of mental stress-induced silent left ventricular
      dysfunction in patients with stable angina pectoris.
AB  - Thirty patients with stable angina pectoris and ischemia on stress perfusion
      imaging underwent continuous ambulatory left ventricular (LV) function
      monitoring. Mental stress was induced by mental arithmetic. Fifteen patients
      developed transient LV dysfunction during mental arithmetic. Patients were
      followed for 2 years for adverse cardiac events. Twelve patients had cardiac
      events over 1 year (myocardial infarction in 4, and unstable angina in 8). Nine
      of 15 patients (60%) with and only 3 of 15 (20%) without mental stress-induced LV
      dysfunction developed cardiac events (p = 0.025). A higher proportion of patients
      with cardiac events were taking beta blockers (p = 0.01) and had lower resting
      heart rates (p = 0.002) than those without cardiac events. There was no
      difference in the baseline characteristics between the groups of patients with
      and without cardiac events. At 2-year follow-up, 10 of 15 patients (67%) with
      mental stress-induced LV dysfunction had adverse events compared with only 4 of
      15 (27%) with no mental stress-induced LV dysfunction (p = 0.025). Thus, in this
      cohort of patients with stable angina pectoris, mental stress-induced LV
      dysfunction was associated with higher cardiac events on follow-up. The exact
      mechanism of this association is not clear. Mental stress may be a trigger for
      adverse cardiac events in these patients. Transient LV dysfunction in response to
      mental stress may be a marker of abnormal cardiovascular reactivity to emotional
      and psychological stimuli in patients with coronary artery disease and may be
      useful for risk stratification.

PMID- 7793400
TI  - Importance of baseline functional and socioeconomic factors for participation in
      cardiac rehabilitation.
AB  - Enrollment in cardiac rehabilitation has been reported to improve exercise
      capacity, psychological well-being, and survival. However, participation rates
      are low and the reasons for nonparticipation have not been adequately defined.
      The purpose of this study was to evaluate the major correlates of
      nonparticipation and to examine the level of participation of patients who stand
      to benefit most on the basis of preenrollment functional status and health
      behaviors. Three hundred ninety-three patients undergoing coronary artery bypass
      surgery (1) had baseline functional status and quality-of-life data collected,
      and (2) were recruited for participation in the Duke Center for Living
      comprehensive 3-week post-coronary bypass surgery rehabilitation program.
      Baseline demographic, clinical, catheterization, functional status, psychological
      status, and health behavior descriptors were analyzed to identify univariate and
      multivariable correlates of a patient's decision to participate in the program.
      At baseline, most clinical factors were similar in participants (n = 52) and
      nonparticipants (n = 341), but the nonparticipants were more often women (26% vs
      12%, p = 0.02). Participants were also more likely to be employed (63% vs 45%, p
      = 0.02) and had a higher education and income distribution than nonparticipants
      (both p = 0.001). On 2 separate scales, nonparticipants had significantly more
      baseline functional impairment than participants (both p = 0.001). In
      multivariable analysis, the independent correlates of higher participation rates
      were: higher education (college graduates 71% more likely to participate than
      high school graduates) and better baseline Duke Activity Status Index (patients
      with mild functional impairment were at least 42% more likely to participate than
      patients with moderate impairment).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793401
TI  - An accurate stepwise electrocardiographic algorithm for localization of accessory
      pathways in patients with Wolff-Parkinson-White syndrome from a comprehensive
      analysis of delta waves and R/S ratio during sinus rhythm.
AB  - Prediction of accessory pathway location before radio-frequency ablation has
      become increasingly important for patients with Wolff-Parkinson-White syndrome.
      However, existing electrocardiographic (ECG) criteria for localization of
      accessory pathways have several limitations, and the polarity of delta waves has
      not been well defined. In the present study, 369 patients with a single
      anterogradely conducting accessory pathway who underwent successful
      radiofrequency ablation were included. The polarity of delta waves was defined
      and categorized in detail, and various ECG characteristics of the most preexcited
      QRS complexes were examined and compared with QRS complexes after successful
      ablation in the initial 182 patients, which included morphology and polarity of
      delta waves, initial 20, 40, and 60 ms segments of the preexcited QRS complex,
      R/S ratio in the precordial leads, R/S ratio in the frontal leads, delta wave
      axis in the frontal plane, polarity of delta waves in the frontal leads, and
      polarity of delta waves in the precordial leads. The polarity of the initial 40
      ms segment of the most preexcited QRS complexes in each of the frontal leads, and
      the polarity of the initial 60 ms segment of the most preexcited QRS complex in
      each of the precordial leads proved to be the best representatives of delta wave
      polarity in the respective leads.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793403
TI  - Examination of mechano-electrical feedback in the transplanted human heart.
AB  - Several investigators have demonstrated that changes in atrial or ventricular
      pressure and size may modulate changes in electrophysiologic properties. The
      coupling of mechanical and electrical changes in the heart has been termed
      mechano-electrical feedback and is believed to play a role in arrhythmias
      observed with mitral valve disease, congestive heart failure, and left
      ventricular hypertrophy. To avoid confounding influences of the autonomic nervous
      system on electrophysiologic measurements, we measured right atrial and
      ventricular pacing thresholds with temporary epicardial pacing wires, right
      ventricular monophasic action potential duration at 90% repolarization during
      right ventricular pacing at 600 and 400 ms, donor heart rate, systolic,
      diastolic, and mean arterial and central venous pressures in 22 patients after
      orthotopic heart transplantation. Each variable was measured at baseline, in the
      resting supine state, and during graded lower body negative pressure of -10, -20,
      and -30 mm Hg. All levels of lower body negative pressure resulted in a
      significant decrease in mean right atrial pressure up to 5 +/- 6 mm Hg at maximal
      lower body negative pressure, and a significant decrease in mean arterial
      pressure occurred only at -20 and -30 mm Hg. Lower body negative pressure did not
      result in a significant change in any electrophysiologic variable despite
      significant changes in right atrial pressure. Thus, in the denervated
      transplanted human heart, unloading of the right heart results in no or small
      changes in atrial or ventricular pacing thresholds and ventricular monophasic
      action potential duration.

PMID- 7793402
TI  - Long-term efficacy of amiodarone for the maintenance of normal sinus rhythm in
      patients with refractory atrial fibrillation or flutter.
AB  - The purpose of this study was to examine the efficacy and safety of amiodarone to
      maintain sinus rhythm in patients with refractory atrial fibrillation or flutter.
      One hundred ten patients with atrial fibrillation or flutter, refractory to > or
      = 1 class I antiarrhythmic agents (mean +/- SD 2.5 +/- 1.5, median 2), were given
      low-dose amiodarone (mean maintenance dose 268 +/- 100 mg/day) to determine its
      efficacy to maintain normal sinus rhythm after chemical or electrical
      cardioversion. Fifty-three patients had chronic and 57 patients had paroxysmal
      atrial fibrillation or flutter. Mean age of the study population was 60 +/- 13
      years, and the mean follow-up was 36 +/- 38 months (range 31 days to 137 months).
      Actuarial rates for maintenance of sinus rhythm were 0.87, 0.70, and 0.55 at 1,
      3, and 5 years, respectively. Twenty-one patients (19%) with arrhythmia
      recurrence had an increase in amiodarone dose, and after a mean additional follow
      up of 2.5 years, 86% remained in normal sinus rhythm. The only observed predictor
      of atrial fibrillation or flutter recurrence was paroxysmal arrhythmia (40%
      recurrence vs 9% in patients with chronic atrial fibrillation or flutter; p <
      0.001). Actuarial rates for withdrawal because of adverse effects were 0.08,
      0.22, and 0.30 at 1, 3, and 5 years, respectively. The most frequent adverse
      effects necessitating withdrawal were skin discoloration (4.5%), pulmonary
      fibrosis (3.6%; none fatal), and thyroid toxicity (2.7%). No deaths occurred
      during the study period. In conclusion, amiodarone sinus rhythm in patients with
      atrial fibrillation or flutter, with a relatively low incidence of adverse
      effects necessitating withdrawal.

PMID- 7793404
TI  - Impaired low-frequency oscillations of heart rate in patients with prior acute
      myocardial infarction and life-threatening arrhythmias.
AB  - Myocardial infarction results in abnormal cardiac autonomic function, which
      carries an increased risk of cardiac mortality, but it is not well known whether
      autonomic dysfunction itself predisposes patients to life-threatening arrhythmias
      or whether it merely reflects the severity of underlying ischemic heart disease.
      To determine the significance of abnormalities of cardiovascular neural
      regulation on the risk for ventricular tachycardia (VT), heart rate (HR)
      variability in the time and frequency domain were compared in a case-control
      study between 30 patients with a prior myocardial infarction and a history of
      sustained VT (n = 18) or cardiac arrest (n = 12) (VT group) and 30 patients with
      a prior myocardial infarction but no arrhythmic events (control group). The
      patient groups were carefully matched with respect to age, sex, location,
      ejection fraction, number of prior infarctions, number of diseased coronary
      arteries, and beta-blocking medication. In all patients in the VT group,
      inducibility into sustained VT was achieved, but none of the control patients had
      inducible nonsustained or sustained VT during programmed electrical stimulation.
      Patients in the VT group had a significantly lower SD of the RR intervals (p <
      0.01), and reduced ultra low-, very low-, and low-frequency power spectral
      components of HR variability (p < 0.001 for all) than controls, but the high
      frequency component of HR variability did not differ significantly between
      groups. In multiple regression analysis, reduced very low-frequency power of HR
      variability was the strongest independent predictor of VT
      susceptibility.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793405
TI  - Assessment and significance of ST-segment changes detected by ambulatory
      electrocardiography after acute myocardial infarction.
AB  - This study assessed the prognostic value of ST-segment changes detected by
      ambulatory electrocardiographic monitoring during the early in-hospital period
      after acute myocardial infarction. New methods for defining the ST-segment
      reference level and for measuring ST-segment elevation were used. ST-segment
      depression was defined as a change in ST level by > or = 0.1 mV 80 ms after the J
      point, elapsing > or = 1 minute. ST-segment elevation was defined as a deviation
      by > or = 0.15 mV, elapsing > or = 1 minute, and measured at the J point. An
      interval of > or = 2 minutes was required before another discrete episode was
      counted. Four ST-segment reference levels were automatically calculated: (1)
      "isoelectric," (2) "nearest to normal," (3) "24-hour median," and (4) "first-hour
      median." During a mean follow-up period of 3 years (mean 36 +/- 15 months), 47
      cardiac events occurred in 38 patients: 18 deaths, 9 nonfatal reinfarctions, and
      20 revascularization procedures. More deaths occurred in patients with than
      without ST elevation-24-hour median (22% vs 5%, p = 0.03), and in patients with
      than without ST depression-isoelectric (61% vs 32%, p = 0.02), and in patients
      with than without ST-depression-24-hour median (61% vs 23%, p = 0.003). "All
      cardiac events" (deaths, infarctions, or revascularization procedures) occurred
      more often in patients with than without ST depression-isoelectric (55% vs 22%, p
      = 0.003), and in patients with than without ST-depression-24-hour median (47% vs
      17%, p = 0.004). Sensitivity, specificity, and accuracy of ST
      depression/elevation-24-hour median to assess mortality were 78%, 71%, and 73%,
      respectively.

PMID- 7793407
TI  - Deletion within chromosome 22 is common in patients with absent pulmonary valve
      syndrome.
AB  - Interstitial deletions in chromosome 22 and features associated with CATCH-22
      syndrome have been reported in patients with conotruncal congenital heart
      anomalies. Absent pulmonary valve syndrome is characterized by absent or
      rudimentary pulmonary valve cusps, absent ductus arteriosus, conoventricular
      septal defect, and massive dilation of the pulmonary arteries. Because absence of
      the ductus arteriosus is a key element in the pathogenesis of this syndrome and
      aortic arch malformations are frequently seen in patients with CATCH-22 syndrome,
      we hypothesized that patients with absent pulmonary valve syndrome would have a
      high incidence of deletions in the critical region of chromosome 22. Eight
      patients with absent pulmonary valve syndrome were studied. Metaphase
      preparations were examined with fluorescent in situ hybridization of the N25
      (D22S75) probe to the critical region of chromosome 22q11.2. Deletions were
      detected in 6 of 8 patients. The presence of deletions in chromosome 22 in most
      of the patients we have examined with a diagnosis of absent pulmonary valve
      syndrome supports a specific genetic and embryologic mechanism involving the
      interaction of the neural crest and the primitive aortic arches as one cause of
      congenital absence of the pulmonary valve.

PMID- 7793406
TI  - Left ventricular ejection fraction during supine and upright exercise in patients
      with systemic hypertension and its relation to peak filling rate.
AB  - In hypertensive patients with hypertrophy, abnormal peak filling rate (PFR) is
      related to a decline in left ventricular (LV) ejection fraction (EF) during
      supine exercise. Because an increased LV preload is more common during upright
      exercise, we determined this relation during upright and supine exercise. In 20
      hypertensive patients, rest and exercise radionuclide angiography in the supine
      and upright positions, as well as echocardiography, were performed and compared
      with 20 age-matched controls. At rest in the supine and upright positions, blood
      pressure, LVEF, and PFR were 164 +/- 20/94 +/- 10 and 164 +/- 24/94 +/- 10 mm Hg,
      65 +/- 8% and 65 +/- 6%, and 2.77 +/- 0.59 and 2.70 +/- 0.52 end-diastolic
      volumes/s, respectively. PFR was reduced compared with controls (3.29 +/- 0.3 and
      3.27 +/- 0.27 end-diastolic volumes/s, supine and upright). LV mass index was
      normal (94 +/- 19 g/m2). LVEF increased during upright but not during supine
      exercise in the hypertensives. Four patients had a decline in each position
      versus none of the controls. There was no relation between the change in LVEF and
      rest PFR. In patients with mild to moderate hypertension without extensive
      hypertrophy, abnormal filling rates were present but did not correlate with the
      change in LVEF with exercise.

PMID- 7793408
TI  - Time course of "warm-up" in stable angina.
AB  - Warm-up exercise can significantly reduce the severity of myocardial ischemia on
      exercise after a 10-minute rest, but this benefit is significantly less after a
      30-minute rest. Further study is needed to clarify the mechanisms responsible for
      warm-up. The results of this study are consistent with a change in myocardial
      metabolism similar to ischemic preconditioning or a delayed increase in
      myocardial perfusion to the ischemic territory, which has returned toward
      baseline after 30 minutes.

PMID- 7793409
TI  - Intraaortic balloon pumping as adjunctive therapy to rescue coronary angioplasty
      after failed thrombolysis in anterior wall acute myocardial infarction.

PMID- 7793410
TI  - Late angiographic follow-up after Palmaz-Schatz stent implantation.

PMID- 7793411
TI  - Coronary stenting for acute myocardial infarction.
AB  - In summary, our experience suggests that coronary stents may play a useful role
      in carefully selected patients undergoing angioplasty for myocardial infarction.
      The potential may exist to increase rates of successful infarct artery
      reperfusion and increase long-term patency. The use of stents in myocardial
      infarction should probably be reserved for situations in which balloon
      angioplasty fails. Newer stent designs and anticoagulant regimens may alleviate
      some of the current concerns with regard to stenting at the time of acute
      myocardial infarction.

PMID- 7793412
TI  - Exercise training and blood viscosity in patients with ischemic heart disease.

PMID- 7793414
TI  - Usefulness of endothelin-1 as a predictor of response to head-up tilt-table
      testing in children with syncope.

PMID- 7793413
TI  - Prior restraint: a Bayesian perspective on the optimization of technology
      utilization for diagnosis of coronary artery disease.
AB  - In conclusion, at least 1/3 of patients with suspected coronary artery disease
      are inappropriately referred for scintigraphic diagnostic testing from a Bayesian
      such as those described in this report, may be a powerful mechanism for
      encouraging more appropriate technology utilization while simultaneously
      controlling costs, and are thereby deserving of a formal prospective
      demonstration trial. However, since only half the patients currently being tested
      are referred for diagnostic purposes, analogous strategies must be developed with
      respect to prognostic and therapeutic evaluation.

PMID- 7793415
TI  - Developmental changes of alpha 1-adrenergic chronotropic action on human sinus
      node.
AB  - The important role of alpha 1-adrenoceptors in reperfusion ventricular arrhythmia
      is mentioned in the introduction. However, the present report is concerned with
      the sinus node. It is speculated that the decreased positive chronotropic action
      of alpha 1-adrenergic stimulation due to aging may contribute to the development
      of sick sinus syndrome.

PMID- 7793416
TI  - Inadvertent malposition of a transvenous-inserted pacing lead in the left
      ventricular chamber.
AB  - In conclusion, we propose the following approach to prevent and manage lead
      malposition in the left ventricle: A 12-lead electrocardiogram in the paced mode
      and an anterior and lateral chest view should be thoroughly inspected shortly
      after pacemaker implantation. A definitive diagnosis of malposition can be
      established with these tests. Development of any neurologic symptoms should be
      attributed to the malpositioned lead until proved otherwise. In such patients,
      serious consideration should be given to transcatheter or surgical lead
      extraction after a period of anticoagulation. If this is not possible, chronic
      anticoagulation with warfarin must be initiated, achieving an international
      normalized ratio of > or = 2.5. Antiplatelet therapy alone may not confer
      adequate protection against future cerebral events. Furthermore, most patients
      with neurologic manifestations do not have echocardiographic evidence of thrombus
      on the lead. Conversely, presence of thrombus is highly associated with
      neurologic symptoms. Any intraarterial lead must be removed due to inevitable
      complications. Patients who have remained completely asymptomatic for > or = 3
      years may be followed carefully with no therapy. For asymptomatic patients
      diagnosed before this time period, we recommend empiric therapy with antiplatelet
      agents or low-dose warfarin (international normalized ratio 1.5-2) with careful
      observation for symptoms.

PMID- 7793417
TI  - Relation between saliva cotinine concentration, cigarette consumption, and blood
      pressure among smokers.
AB  - In conclusion, we found no evidence of any reduction in blood pressure with
      greater smoking exposure. For smokers allowed to smoke in a natural manner before
      blood pressure assessment, greater smoking exposure indexed by saliva cotinine
      concentration is associated with higher systolic blood pressure levels.

PMID- 7793418
TI  - A prospective study of the seroprevalence of Borrelia burgdorferi infection in
      patients with severe heart failure.
AB  - We conclude that Lyme disease is not a common cause of idiopathic heart failure
      in the Midwestern United States and that false-positive Lyme disease serologic
      results are not rare among patients with severe heart failure. Patients with
      significant cardiac disease who are found to be EIA seropositive should have
      confirmatory Western blots performed before consideration of treatment. Based on
      our findings, we cannot recommend either the routine serologic screening of
      patients with idiopathic cardiomyopathy or aggressive (e.g., parenteral)
      antibiotic treatment of seropositive patients unless the specific clinical
      history suggests antecedent Lyme disease.

PMID- 7793419
TI  - Prevalence and work-relatedness of self-reported carpal tunnel syndrome among
      U.S. workers: analysis of the Occupational Health Supplement data of 1988
      National Health Interview Survey.
AB  - To estimate the prevalence and work-relatedness of self-reported carpal tunnel
      syndrome (CTS) among U.S. workers, data from the Occupational Health Supplement
      of 1988 National Health Interview Survey (NHIS) were analyzed. Among 127 million
      "recent" workers" who worked during the 12 months prior to the survey, 1.47% (95%
      CI: 1.30; 1.65), or 1.87 million self-reported CTS, and 0.53% (95% CI: 0.42;
      0.65), or 675,000, stated that their prolonged hand discomfort was called CTS by
      a medical person. Occupations with the highest prevalence of self-reported CTS
      were mail service, health care, construction, and assembly and fabrication.
      Industries with the highest prevalence were food products, repair services,
      transportation, and construction. The risk factor most strongly associated with
      medically called CTS was exposure to repetitive bending/twisting of the
      hands/wrists at work (OR = 5.2), followed by race (OR = 4.2; whites higher than
      nonwhites), gender (OR = 2.2; females higher than males), use of vibrating hand
      tools (OR = 1.8), and age (OR = 1.03; risk increasing per year). This result is
      consistent with previous reports in that repeated bending/twisting of the hands
      and wrists during manual work is etiologically related to occupational carpal
      tunnel syndrome.

PMID- 7793420
TI  - Workers' response to risk notification.
AB  - Since 1988, the National Institute for Occupational Safety and Health (NIOSH) has
      notified workers who were subjects in occupational epidemiology studies of the
      study findings ("worker notification"). This paper describes seven notifications
      and the worker's reactions to them. The chemicals of interest in the studies
      were: carbon monoxide, o-toluidine, bis-chloromethyl ether, polychlorinated
      biphenyls, cadmium, acid mist, and dioxin. Materials describing the study results
      were sent to 15,958 subjects who were notified of their increased risk of
      arteriosclerotic heart disease, bladder cancer, lung cancer, melanoma, kidney
      dysfunction, laryngeal cancer, all cancers combined, or soft tissue sarcoma.
      Workers provided feedback via telephone calls, and for three notifications, by
      postcards containing workers' comments and ratings of the notification materials.
      The percentage of telephone calls received from notified workers ranged from 0.3%
      to 3.8%, and the percentage returning postcards ranged from 8.8% to 17.6%. The
      two largest categories of callers were those with questions about their disease
      risk (30%) or who reported on their health status (25%). Most of the comments on
      postcards (26%) were complimentary or expressed appreciation for receiving the
      letters; reports of ill health were second (20%). A majority (66%) rated the
      notification materials well done. Few of the callers (5%) requested information
      on legal issues. Most (85%) did not find the materials, which ranged in reading
      level from sixth to ninth grade, too hard to read, although 15% reported
      difficulty reading them. Although this response system was effective in producing
      some input from workers, its limitation is that respondents may not be
      representative of all notified workers. However, such information is useful
      because there are few data on the effects of notifications on workers.

PMID- 7793421
TI  - Proportionate mortality among construction laborers.
AB  - This report presents the results of proportionate mortality ratio (PMR) analyses
      and proportionate cancer mortality ratio (PCMR) analyses among the 11,685 members
      of the Laborers' International Union of North America (LIUNA), who died between
      1985-1988, using U.S. proportionate mortality rates as the comparison population.
      Statistically significant elevated mortality risks were observed for all
      malignant neoplasms (N = 3285, PMR = 1.13, CI = 1.09-1.17), as well as for site
      specific neoplasms of the lung (N = 1208, PCMR = 1.06, CI = 1.00-1.12), stomach
      (N = 170, PCMR = 1.44, CI = 1.23-1.68), and thyroid gland (N = 10, PCMR = 2.24,
      CI = 1.07-4.12). The PCMRs for these malignant neoplasms were elevated among both
      white and non-white males, regardless of length of union membership, in most 10
      year categories of age at death above 40 and for the three largest LIUNA regions
      examined. The study also observed 20 mesothelioma deaths, which indicated that
      some LIUNA members had been previously exposed to asbestos. Statistically
      significant elevated risks were also observed for deaths from transportation
      injuries (N = 448, PMR = 1.37, CI = 1.25-1.51), falls (N = 85, PMR = 1.34, CI =
      1.07-1.66), and other types of injuries (N = 245, PMR = 1.61, CI = 1.42-1.83).
      The deaths due to injuries were most often observed among those members who had
      the shortest amount of time within the union, were younger, and first entered the
      union after 1955. This is the first study that has examined the general mortality
      experience limited to construction laborers only (Bureau of Census code 869).

PMID- 7793422
TI  - Perimenstrual symptoms and working conditions among hospital workers in Quebec.
AB  - Perimenstrual symptoms are among the most common disorders of women. Seven
      perimenstrual symptoms were related to working conditions among 539 hospital
      workers in a retrospective cohort questionnaire study, as part of a larger
      examination of health problems and working conditions of Quebec hospital workers.
      Only 8% of women had experienced no symptoms of discomfort associated with their
      last menstrual period. Lower abdominal pain, the most common symptom (58%
      prevalence), was associated with lifting weights (usually patients) in a logistic
      regression adjusted for parity and contraceptive use. Back pain, leg pain,
      swelling, and headache were associated with indicators of time pressure and fast
      work speed. Back pain during menstruation was experienced by 44% of workers.
      Studies of the prevalence and etiology of back pain, a common occupational health
      problem among hospital workers, may be confused if perimenstrual back pain is not
      taken into account. Similar reservations hold for the results on other
      perimenstrual symptoms that are also likely to occur outside the perimenstrual
      period, such as leg pain, irritability, and headache.

PMID- 7793423
TI  - Tumor markers in serum, polyamines and modified nucleosides in urine, and
      cytogenetic aberrations in lymphocytes of workers exposed to polycyclic aromatic
      hydrocarbons.
AB  - Some polycyclic aromatic hydrocarbons (PAHs) such as benzo(a)pyrene and
      benzo(a)anthracene are well-established genotoxic agents. Long-term exposure to
      PAHs may lead to proliferative cell disorders in humans, predominantly in the
      skin, lung, and bladder. The concentration of several tumor markers in serum, of
      polyamines and modified nucleosides in urine, and of cytogenetic endpoints in
      peripheral lymphocytes (sister-chromatid exchanges, high frequency cells [HFC],
      and micronuclei) were measured in 149 male workers exposed to PAHs in two coke
      oven and one graphite electrode plants, and in 137 controls. We have assessed
      whether these biomarkers were related to several parameters reflecting exposure
      to PAHs, i.e., the sum of the airborne concentration of 13 PAHs, 1-hydroxypyrene
      (1-OHP) concentration in postshift urine, benzo(a)pyrene-diolepoxide adducts to
      hemoglobin (BPDE-Hb adducts), and duration of exposure, taking also into account
      several possible confounding factors. HFC was the biomarker most consistently
      associated with the intensity of current exposure to PAHs. Smoking exerts an
      independent effect on the same parameter. On the basis of the logistic regression
      between the prevalence of abnormal HFC values and PAHs in air and 1-OHP in
      postshift urine found in nonsmokers, it is suggested that the latter should be
      kept below 6.4 micrograms/m3 and 2.7 micrograms/g creatinine, respectively. No
      relationship was found between the cytogenetic effects and BPDE-Hb adducts
      although both parameters are statistically correlated with the airborne PAH
      level. Some tumor markers in serum (carcinoembryonic antigen, tissue polypeptide
      antigen, sialic acid) and the urinary concentration of some polyamines were
      correlated with either PAHs in air or 1-OHP in urine. The associations, however,
      were very weak which suggests that these biomarkers have limited practical value
      for the health surveillance of groups of workers exposed to genotoxic PAHs.

PMID- 7793425
TI  - Occupational exposure of deck crews to carcinogenic agents on crude oil tankers.
AB  - Occupational exposure to carcinogenic agents on the decks on six Norwegian crude
      oil tankers was examined in five harbors. The purpose of the study was to
      evaluate the need for improving the working environment on deck on these tankers.
      Technical arrangements and the work itself on the deck were observed during
      loading or unloading. Occupational monitoring was performed by active sampling of
      benzene, polyaromatic hydrocarbons, and some aldehydes. The crew answered a
      questionnaire concerning their work, use of protective equipment, and occurrence
      of acute symptoms. The levels of air-borne carcinogenic agents were low, probably
      due to closed loading systems on all tankers. However, the seamen reported
      discomfort during the work that may be related to other chemical agents in the
      cargo. The seamen were frequently painting with lead chromate paint without using
      personal protective equipment. This type of chemical exposure should be
      evaluated.

PMID- 7793424
TI  - Irritant dermatitis among workers cleaning up a pesticide spill: California 1991.
AB  - An outbreak of dermatitis occurred among county jail inmates who removed dead
      fish from the Sacramento River in California after a spill of metam sodium. The
      spilled chemical decomposes to methylisothiocyanate (MITC), a known skin
      irritant. A retrospective cohort study was conducted among the inmates and their
      crew leaders. Among 42 jail group members, 27 had dermatitis involving the feet
      and ankles; dermatitis was associated with lower extremity water contact (RR =
      3.4, 95% CI 1.0-11.8); the attack rate increased with length of time spent in the
      water. For comparison, other state and federal employees who worked in the river
      at the same time were also interviewed. None reported dermatitis. Over three
      quarters (24/31) of these other clean-up workers whose feet became wet changed to
      dry clothing immediately; none of the jail group changed immediately. The river
      concentration of MITC measured 20-40 ppb at the time of exposure. We speculate
      that prolonged wetness, occlusive boots, friction, and heat contributed to
      chemical irritation at this low concentration; the experience of the other clean
      up workers suggests that this outbreak could have been prevented.

PMID- 7793426
TI  - Relationship between locations of chromosome breaks induced by vinyl chloride
      monomer and lymphocytosis.
AB  - The distribution of vinyl chloride monomer (VCM)-induced chromosome breaks was
      studied in cultured lymphocytes of subjects occupationally exposed to this gas.
      In the examined subjects, the mean group value of chromosome aberrations is 6.5%
      and for sister chromatid exchange (SCE) frequencies, the mean value per cell is
      7.9. These values are significantly higher than in the control population.
      Occupational exposure to VCM caused lymphocytosis together with disturbances of
      mitogenic activity in lymphocytes stimulated by phytohaemagglutinin. The results
      of G-banding showed that sites of chromosome breakpoints caused by VCM can be
      related to the lymphatic tissue disorders.

PMID- 7793427
TI  - Malignant mesothelioma in thermoelectric power plant workers in Italy.
AB  - Asbestos has been widely used in Italian thermoelectric power plants and
      instances of exposure to workers have been documented in a variety of jobs.
      Preventive measures were put into effect only in the late 1970s. We report here
      on four mesothelioma cases among workers of three Italian power plants where
      cohort studies were carried out, and on three additional cases recorded by a
      systematic survey carried out on this neoplasm in Tuscany. When the data of the
      cohorts sources are merged, a significant excess of lung cancer is also evident.
      Even without a quantitative assessment of exposure, this report shows the
      importance of asbestos risk in thermal power plants. The risk appears not to be
      restricted to any particular category of workers.

PMID- 7793429
TI  - Fibers in lung tissues of mesothelioma cases among miners and millers of the
      township of Asbestos, Quebec.
AB  - Twenty cases of mesothelioma among miners of the township of Asbestos, Quebec,
      Canada, have been reported. To further explore the mineral characteristics of
      various fibrous material, we studied the fibrous inorganic content of postmortem
      lung tissues of 12 of 20 available cases. In each case, we measured
      concentrations of chrysotile, amosite, crocidolite, tremolite, talc
      anthophyllite, and other fibrous minerals. The average diameter, length, and
      length-to-diameter ratio of each type of fiber were also calculated. For total
      fibers > 5 microns, we found > 1,000 asbestos fibers per mg tissue (f/mg) in all
      cases; tremolite was above 1,000 f/mg in 8 cases, chrysotile in 6 cases,
      crocidolite in 4 cases, and talc anthophyllite in 5 cases. Among cases with
      asbestos fibers, the tremolite count was highest in 7 cases, chrysotile in 3
      cases, and crocidolite in 2 cases. The geometric mean concentrations of fibers >
      or = 5 microns were in the following decreasing order: tremolite > crocidolite >
      chrysotile > other fibers > talc-anthophyllite > amosite. For total fibers < 5
      microns, we found > 1,000 fibers per mg tissue (f/mg) in all cases; tremolite was
      above 1,000 f/mg in 12 cases, chrysotile in 8 cases, crocidolite in 7 cases, and
      talc-anthophyllite in 6 cases. Tremolite was highest in 8 cases, chrysotile in 2
      cases, and crocidolite and amosite in 2 cases. The geometric mean concentrations
      of fibers < 5 microns were in the following decreasing order: tremolite > other
      fibers > chrysotile > crocidolite > talc-anthophyllite > amosite. We conclude, on
      the basis of the lung burden analyses of 12 mesothelioma cases from the Asbestos
      township of Quebec, that the imported amphibole (crocidolite and amosite) were
      the dominant fibers retained in the lung tissue in 2/12 cases. In 10/12 cases,
      fibers from the mine site (chrysotile and tremolite) were found at highest
      counts; tremolite was clearly the highest in 6, chrysotile in 2, and 2 cases had
      about the same counts for tremolite and chrysotile. If a relation of fiber burden
      causality of mesothelioma is accepted, mesothelioma would be likely caused by
      amphibole contamination of the plant in 2/12 cases and by the mineral fibers
      (tremolite and chrysotile) from the mine site in the 10 other cases.

PMID- 7793430
TI  - Chronology of asbestos cancer discoveries: experimental studies of the Saranac
      Laboratory.
AB  - This commentary challenges a recently published perception that Dr. Le Roy Upson
      Gardner had not actually discovered in 1942 that inhaled chrysotile fibers could
      induce malignant neoplasia in mice. The handwritten laboratory notes and some of
      Dr. Gardner's slides have recently been found. They verify that the tumors he saw
      in the mice included truly malignant neoplasms. Gardner had by then also
      accumulated 11 cases of human lung cancer (two mesotheliomas) derived from Quebec
      asbestos miners and millers. An inhalation study designed by Dr. Gardner and
      conducted between 1951 and 1954, using cancer-insusceptible mice, yielded
      neoplasia risk ratio of 5.7 compared with control animals. The studies also
      showed that the primary effect of chrysotile is to cause epithelial proliferation
      in alveoli adjacent to bronchioles. Chrysotile type asbestos bodies were shown to
      remain only transiently ferruginous, but even though invisible in direct light
      they can be visualized at high magnification through use of phase contrast and
      polarized light micrography.

PMID- 7793431
TI  - Re: Epidemiological studies of paternal exposure and spontaneous abortion.

PMID- 7793428
TI  - Pleural mesotheliomas are underreported as occupational cancer in Sweden.
AB  - The aim of this study was to estimate to what degree malignant pleural
      mesotheliomas were reported as occupational cancers. The study included all
      malignant pleural mesotheliomas (n = 210) found in the Cancer Registry 1980-1989
      from four Swedish counties. Whether or not a case was reported as occupational
      cancer was found in the Swedish Register of Reported Occupational Diseases. To
      evaluate the presence of exposure histories, the chest department files for 58
      mesotheliomas from one county were reviewed. The reporting was low, with only 75
      mesotheliomas (36%) reported. All the cases were men, and for the men, the
      reporting frequency was 42%. The reporting was significantly lower for the last
      part of the decade than for the first part. The reporting frequency decreased
      with age. In the review of the chest department files, an exposure history was
      found in 93% of the reported cases and in 47% of the unreported cases. It is
      concluded that physicians must give more priority to exposure histories in
      patients with pleural mesotheliomas.

PMID- 7793432
TI  - Paternal occupational exposure and spontaneous abortions: a closer look at
      paternal recall and vinyl chloride.

PMID- 7793433
TI  - Silicosis risk: Canadian and South African miners.

PMID- 7793434
TI  - Role of the family in recovery and major depression.
AB  - OBJECTIVE: Major depression is significantly influenced by the family environment
      of the depressed patient. In order to explore how family functioning relates to
      this illness, the authors examined changes in family functioning over a 1-year
      course of major depression. METHOD: Subjective (Family Assessment Device) and
      objective (McMaster Clinical Rating Scale) assessments of family functioning were
      collected at hospitalization and 6 and 12 months after discharge for 45
      inpatients diagnosed with major depression and their family members. Patterns of
      family functioning were examined by subjective and objective perspectives,
      initial levels of functioning, and reports of patients and other family members.
      RESULTS: Approximately 50% of families with a depressed member perceived their
      own family functioning as unhealthy; clinicians rated 70% of the families as
      unhealthy. While family functioning improved significantly from hospitalization
      through 12 months after discharge, the improvement was not uniform across all
      areas of functioning. Further, patients with good family functioning at
      hospitalization generally maintained their healthy functioning and were more
      likely to recover by 12 months than patients with poor family functioning.
      Although steady improvement in family functioning characterized the subjective
      ratings, objective assessments of family functioning suggested initial
      improvement followed by a decline from month 6 to month 12. CONCLUSIONS: Results
      show a clear association between family functioning and recovery from major
      depression. Different aspects of family life respond differently to the
      depressive illness; no one family dimension was uniquely related to outcome.

PMID- 7793435
TI  - Vulnerability to psychosis in unipolar major depression: is premorbid functioning
      involved?
AB  - OBJECTIVE: This research examined whether deficits in premorbid functioning are
      associated with a vulnerability to psychosis in unipolar major depressive
      disorder. METHOD: A group of 92 inpatients with unipolar major depression were
      assessed for premorbid functioning and psychotic symptoms during an index
      hospitalization. They were prospectively assessed for psychotic symptoms 2.0 and
      4.5 years after hospital discharge. RESULTS: The psychotic depressed patients had
      significantly poorer premorbid functioning--particularly, adolescent social
      functioning--than the nonpsychotic depressed patients. Longitudinal analyses
      indicated that poor premorbid social adaptation was significantly associated with
      the emergence of psychosis during the follow-up period in depressed patients who
      had not been psychotic as inpatients. CONCLUSIONS: Factors related to a
      vulnerability to psychosis among patients with major depression are present even
      years before the onset of overt psychotic symptoms. The data could support the
      view that impaired premorbid functioning is one manifestation of prepsychotic
      processes that constitute an underlying diathesis for psychotic episodes during
      the longitudinal course of unipolar major depression. These findings are
      consistent with other emerging findings pointing to early developmental deficits
      in patients who subsequently develop psychotic disorders.

PMID- 7793436
TI  - Rates of seasonal affective disorder in children and adolescents.
AB  - OBJECTIVE: The authors estimated the frequency of seasonal affective disorder in
      children and adolescents and examined the relationship of this rate to age and
      pubertal status. METHOD: A modified version of the Seasonal Pattern Assessment
      Questionnaire was distributed to 2,267 students at a middle school and a high
      school in a suburb of Washington, D.C. A case diagnosis was made if the
      respondent scored over 18 and also indicated that the change of seasons was at
      least a "pretty bad" problem. RESULTS: A total of 1,871 questionnaires (82.5%)
      were returned. Sixty probable cases of seasonal affective disorder (3.3%) were
      identified among the 1,835 surveys analyzed. Age was directly correlated with the
      frequency of seasonal affective disorder, and the rate was higher in postpubertal
      girls. Differences between the subjects with and without identified cases of
      seasonal affective disorder were seen in the symptom endorsement patterns,
      particularly for "feel worst," "least energy," "most irritable," and "socialize
      least." CONCLUSIONS: These pilot data suggest that between 1.7% and 5.5% of 9-19
      year-old children may have seasonal affective disorder. Further research is
      warranted, particularly that which examines the relationship between seasonal
      affective disorder and puberty.

PMID- 7793437
TI  - Mental health and choice between managed care and indemnity health insurance.
AB  - OBJECTIVE: Populations enrolled in various health insurance plans may differ in
      their health care needs. Whether mental health affects choice among competing
      health plans is not clear. This study examined self-selection by participants in
      a Swiss indemnity insurance plan that was transformed into a managed care
      organization that controlled access to specialists through gatekeeping and
      restricted coverage for psychiatric treatments. METHOD: Information regarding
      past use of health services and health status was provided by 421 persons who
      joined the new managed care organization and 222 nonjoiners. The mental health
      and somatic health characteristics of these two groups were compared. RESULTS: In
      the year preceding the creation of the managed care organization, the nonjoiners
      had made on average 2.3 more visits to psychiatrists than the joiners but 0.0 to
      0.6 more visits to other physicians. The nonjoiners were more likely to have used
      psychoactive medications but not other medications. The rates of treatment for
      depression were similar in the two groups. The joiners reported significantly
      lower mental health status, but not somatic health status, than the nonjoiners.
      CONCLUSIONS: Both mental health status and past use of mental health services
      strongly affected choice of health insurance plan. The effects of somatic health
      and use of somatic health services on selection were consistently weaker. People
      who join managed care organizations may have substantial uncovered needs for
      psychiatric care. Minimum mandatory benefits for mental health care may be an
      effective countermeasure to unequitable self-selection.

PMID- 7793438
TI  - Social consequences of psychiatric disorders, I: Educational attainment.
AB  - OBJECTIVE: This is the first in a series of investigations of the social
      consequences of psychiatric disorders based on the National Comorbidity Survey.
      Data on the relationship between preexisting psychiatric disorders and subsequent
      educational attainment are presented. METHOD: The National Comorbidity Survey is
      a nationally representative survey of 8,098 respondents in the age range 15-54
      years. A subsample of 5,877 respondents completed a structured psychiatric
      interview and a detailed risk factor battery. Diagnoses of DSM-III-R anxiety
      disorders, mood disorders, substance use disorders, and conduct disorder were
      generated, and survival analyses were used to project data on school terminations
      to the total U.S. population. RESULTS: Early-onset psychiatric disorders are
      present in more than 3.5 million people in the age range of the National
      Comorbidity Survey who did not complete high school and close to 4.3 million who
      did not complete college. The most important disorders are conduct disorder among
      men and anxiety disorders among women. The proportion of school dropouts with
      psychiatric disorders has increased dramatically in recent cohorts, and persons
      with psychiatric disorders currently account for 14.2% of high school dropouts
      and 4.7% of college dropouts. CONCLUSIONS: Early-onset psychiatric disorders
      probably have a variety of adverse consequences. The results presented here show
      that truncated educational attainment is one of them. Debate concerning whether
      society can afford universal insurance coverage for the treatment of mental
      disorders needs to take these consequences into consideration.

PMID- 7793439
TI  - Comparison of standards for assessing patients' capacities to make treatment
      decisions.
AB  - OBJECTIVE: This study investigated the proportion of psychiatric and medical
      patients who are impaired in their decision-making abilities in relation to each
      of several major legal standards for determining competence to consent to
      treatment. METHOD: The subjects were hospitalized patients with diagnoses of
      schizophrenia (N = 75), major depression (N = 92), and ischemic heart disease (N
      = 82) and equal numbers of community comparison subjects matched on age, race,
      gender, education, and occupation. Three instruments measuring abilities related
      to the legal standards for competence were administered to each group. Impaired
      functioning was defined as scores two standard deviations below the means for all
      subjects combined or lower. RESULTS: Although similar percentages of subjects
      with impaired performance were found for each of the measures, different groups
      of patients were identified as impaired depending on the measure used. The
      proportion of patients identified as impaired increased when compound standards
      were used, i.e., when impairment was defined as poor performance on any of two or
      three measures. Despite previous suggestions that the legal standards might form
      a hierarchy of rigorousness, the data did not support this hypothesis.
      CONCLUSIONS: Choice of standards for determining competence, including compound
      standards, will affect the identity and proportion of patients classified as
      impaired. Clinicians should be aware of applicable standards in their
      jurisdictions. Use of compound standards requires independent evaluation of
      performance on abilities related to each relevant standard, because standards do
      not appear to be hierarchical. Policies relating to the characterization of
      persons as incompetent must be fashioned with caution.

PMID- 7793440
TI  - Hospital use of antipsychotic agents in 1989 and 1993: stable dosing with
      decreased length of stay.
AB  - OBJECTIVE: This study evaluated recent and current use of antipsychotics by
      psychiatric inpatients. METHOD: Computer-based hospital pharmacy records
      identified prescriptions for antipsychotics in 1993. Medical records were
      reviewed to verify prescription and clinical data, and these were compared with
      similar data from 1989. RESULTS: In 1993, antipsychotics were prescribed for 299
      (42%) of 709 hospitalized patients. Treatment usually started within 24 hours of
      admissions averaging 18 days. High-potency agents were used 2.4 times more
      frequently than low-potency drugs; 13% received clozapine. The mean
      chlorpromazine-equivalent daily dose, corrected for as-needed supplements, was
      305 mg; peak doses were 32% higher. Doses of the most potent agents (fluphenazine
      and haloperidol) were only 22%-33% above the overall mean. Rarely were two
      neuroleptics given simultaneously, but cotreatment with an anticonvulsant (84% of
      patients, 92% of whom received valproate), a potent benzodiazepine (81%), lithium
      (70%), one CNS depressant (84%), or more (45%) was common. Doses averaged 20%
      higher for men, 42% lower at age > 50 years versus 20-30 years, and 53% greater
      for schizophrenia or schizoaffective disorder versus other conditions. Comparison
      with 1989 admissions (N = 50) averaging 73 days indicated few differences in use
      of neuroleptics or benzodiazepines but less frequent use of anticonvulsants and
      lithium. CONCLUSIONS: High-potency antipsychotic agents and clozapine were used
      most often in 1993; doses of high-potency agents were only slightly higher than
      doses of low-potency agents, but combinations with mood stabilizers were more
      common in 1993, when length of stay was one-fourth that in 1989.

PMID- 7793441
TI  - Chronic alcoholism and male sexual function.
AB  - OBJECTIVE: The relation between chronic alcohol abuse and male sexuality remains
      uncertain. This study assessed the effect of chronic alcoholism on sexual
      function, marital adjustment, sleep-related erections, sleep disorders, and
      hormone levels during abstinence from alcohol. METHOD: Twenty chronically
      alcoholic men, aged 28-59 years, without evidence of severe hepatic disease and
      free from unrelated medical illnesses, were assessed 2-36 months after achieving
      sobriety and compared to a group of 20 nonalcoholic volunteers. Each subject and
      his sexual partner underwent semistructured interviews and completed several
      questionnaires; the men had medical and psychiatric evaluations and polygraphic
      assessment of sleep parameters and nocturnal penile tumescence during 4 nights,
      with the last night devoted to sequential blood sampling for evaluation of
      hormone levels. RESULTS: The alcoholic men did not differ from the comparison
      group in any sexual dimension or in the prevalence of sexual problems despite the
      significant marital dissatisfaction reported by their sexual partners. In
      addition, there were no differences between groups in sleep and nocturnal penile
      tumescence measures. The alcoholic group had a greater prevalence of periodic leg
      movement disorders but no respiratory abnormalities during sleep. Except for a
      significant overnight increase in plasma luteinizing hormone in the alcoholic
      men, there were no differences between groups in total and bioavailable
      testosterone, dihydrotestosterone, and prolactin or in the nocturnal circadian
      changes in testosterone and prolactin levels. CONCLUSIONS: These findings suggest
      that prolonged and severe alcohol abuse in men is compatible with normal sexual
      function during sobriety in the absence of substantial hepatic or gonadal
      failure.

PMID- 7793442
TI  - Bulimia nervosa in a Canadian community sample: prevalence and comparison of
      subgroups.
AB  - OBJECTIVE: Previous epidemiological studies of bulimia nervosa have generated
      differing estimates of the incidence and prevalence of the disorder. These
      differences are attributable, in part, to varying definitions of the illness and
      a range of methodologies. The authors sought to define the prevalence of bulimia
      nervosa in a nonclinical community sample, examine the clinical significance of
      DSM-III-R threshold criteria, and examine comorbidity. METHOD: Subjects across
      Ontario (N = 8,116) were assessed with a structured interview, the World Health
      Organization Composite International Diagnostic Interview, with specific
      questions added for bulimia nervosa. Subjects who met DSM-III-R criteria for
      bulimia nervosa were compared with those who were missing only the frequency
      criterion (two or more binge-eating episodes per week for 3 months). RESULTS: In
      this sample, the lifetime prevalence of bulimia nervosa was 1.1% for female
      subjects and 0.1% for male subjects. The subjects with full- and partial-syndrome
      bulimia nervosa showed significant vulnerability for mood and anxiety disorders.
      Lifetime rates of alcohol dependence were high in the full-syndrome group. Rates
      of parental psychopathologies were high in both bulimic groups but tended to be
      higher in the subjects with full-syndrome bulimia nervosa. Both bulimic groups
      were significantly more likely to experience childhood sexual abuse than a normal
      female comparison group. CONCLUSIONS: This study confirms other prevalence
      estimates of bulimia nervosa and its comorbid diagnoses from studies that were
      based on sound methodologies. It also points to the arbitrary aspects of the
      frequency of binge eating as a diagnostic threshold criterion for the disorder.

PMID- 7793444
TI  - Pilot study of current factors influencing the choice of psychiatry as a
      specialty.
AB  - OBJECTIVE: This is a time of major shifts in the perception of medical
      specialties. The authors have attempted to assess current attitudes of potential
      applicants for a residency in psychiatry. METHOD: Pilot interviews with fourth
      year medical students at the University of California, San Francisco, led to the
      development of a questionnaire on factors influencing the choice of psychiatry as
      a specialty. The questionnaire was then sent to 113 fourth-year students with an
      identified psychiatric interest at nine schools. RESULTS: There was a response
      rate of 50.4%. The 54 students with a clear career decision had 22 of 38 item
      responses that significantly distinguished between those who matched in
      psychiatry and those who chose other specialties. CONCLUSIONS: Focused
      recruitment strategies are suggested based on answers to the questionnaire items.

PMID- 7793443
TI  - Borderline personality disorder symptoms and severity of sexual abuse.
AB  - OBJECTIVE: This study explored the relationship of specific symptoms of
      borderline personality disorder to dimensions of severity of sexual abuse
      experiences in childhood. METHOD: A group of 41 patients with borderline
      personality disorder who retrospectively reported a childhood history of sexual
      abuse on the Familial Experiences Interview were studied. Six items from the
      Diagnostic Interview for Borderline Patients (DIB) were chosen on the basis of
      their univariate (chi-square) association with a sexual abuse severity scale that
      was developed by the authors and their research team. These six DIB items were
      each modeled in a logistic regression. Predictor variables were the most severe
      experience within each of three dimensions of sexual abuse: 1) perpetrator
      (sexual abuse by a parent), 2) duration (sexual abuse that was ongoing), and 3)
      type (sexual abuse that involved penetration). RESULTS: The severity dimension
      that was most frequently found to be a significant predictor of the sum of the
      six DIB items as well as the total scaled DIB score was the duration dimension.
      Ongoing sexual abuse predicted parasuicidal behavior as well. CONCLUSIONS:
      Ongoing sexual abuse may be a strong determinant of specific aspects of the
      disordered interpersonal behavior and functioning found in patients with
      borderline personality disorder. The expectation that the world is an empty,
      malevolent place may have some of its roots in the repetition of sexual abuse
      experiences in childhood. This expectation of malevolence among patients with
      borderline personality disorder may manifest itself in psychotherapy through
      regressive and distancing behavior.

PMID- 7793445
TI  - Low discharge weight and outcome in anorexia nervosa.
AB  - OBJECTIVE: Because recent limitations in health care coverage have resulted in
      shorter lengths of inpatient stay, many patients with anorexia nervosa are
      discharged while still underweight. The authors' goal was to determine whether
      anorectic patients who were underweight when they were discharged had a worse
      outcome and a higher rate of rehospitalization than those who had achieved normal
      weight at discharge. METHOD: They assessed weight and height, eating disorder
      symptoms, and severity of depressive and anxiety symptoms in 22 women with
      anorexia nervosa at hospital admission and at follow-up a mean of 29 months after
      discharge. RESULTS: Anorectic patients who were discharged while severely
      underweight reported significantly higher rates of rehospitalization and endorsed
      more symptoms than those who had achieved normal weight before discharge.
      CONCLUSIONS: These data suggest that brief hospitalization for severely
      underweight women with anorexia may not be cost effective because the majority
      are rehospitalized.

PMID- 7793446
TI  - Mortality in anorexia nervosa.
AB  - OBJECTIVE: The author's goal was to shed light on the debate regarding the
      mortality rate over time associated with anorexia nervosa. METHOD: He conducted a
      meta-analytic study using weighted linear regression to combine crude mortality
      proportions from 42 published studies to estimate the mortality associated with
      anorexia nervosa over time. RESULTS: The crude rate of mortality due to all
      causes of death for subjects with anorexia nervosa in these studies was 5.9% (178
      deaths in 3,006 subjects). The aggregate mortality rate was estimated to be 0.56%
      per year, or approximately 5.6% per decade. CONCLUSIONS: The aggregate estimated
      mortality rate for subjects with anorexia nervosa is substantially greater than
      that reported for female psychiatric inpatients and for the general population.

PMID- 7793447
TI  - Attempted suicide among living co-twins of twin suicide victims.
AB  - OBJECTIVE: The authors hypothesized that significantly more living monozygotic
      than dizygotic co-twins of twin suicide victims would themselves have attempted
      suicide. METHOD: They determined the absence or presence of an attempt at suicide
      at any time among 26 living monozygotic co-twins and nine living dizygotic co
      twins of twins who had committed suicide. RESULTS: They found that 10 of the 26
      surviving monozygotic co-twins but none of the nine surviving dizygotic co-twins
      had themselves attempted suicide. CONCLUSIONS: Although monozygotic and dizygotic
      twins may have some differing developmental experiences, these results contribute
      to findings of previous studies of suicide in twins in suggesting that genetic
      factors may play a role in suicidal behavior.

PMID- 7793448
TI  - A quarter century of suicide in a major urban jail: implications for community
      psychiatry.
AB  - OBJECTIVE: The authors' goal was to identify factors that increase the risk of
      suicide in urban jails. METHOD: They examined and verified all suicides as of
      1992 in a representative large jail in Detroit since the beginning of record
      keeping in 1967 to 1992. RESULTS: There were 37 suicides over this time period.
      Inmates charged with murder or manslaughter were 19 times more likely to commit
      suicide than were inmates with other charges. Thirty-nine percent of the suicides
      were committed by individuals charged with murder. All 37 suicides were by
      hanging, and most occurred at night within 31 days of admission. Many of the
      inmates who committed suicide had made previous attempts while incarcerated.
      Thirty-nine percent of the suicides were committed by individuals charged with
      murder, constituting 2% of the admissions (two per day). CONCLUSIONS: An
      important risk factor in jail suicide not previously identified is the charge of
      murder or manslaughter. Treatment and prevention programs should recognize these
      inmates as belonging in a very high-risk category.

PMID- 7793450
TI  - Double-blind, placebo-controlled, crossover trial of inositol treatment for panic
      disorder.
AB  - OBJECTIVE: Because they found in an earlier study that inositol, an important
      intracellular second-messenger precursor, was effective against depression in
      open and double-blind trials, the authors studied its effectiveness against panic
      disorder. METHOD: Twenty-one patients with panic disorder with or without
      agoraphobia completed a double-blind, placebo-controlled, 4-week, random
      assignment crossover treatment trial of 12 g/day of inositol. RESULTS: The
      frequency and severity of panic attacks and the severity of agoraphobia declined
      significantly more after inositol than after placebo administration. Side effects
      were minimal. CONCLUSIONS: The authors conclude that inositol's efficacy, the
      absence of significant side effects, and the fact that inositol is a natural
      component of the human diet make it a potentially attractive therapeutic for
      panic disorder.

PMID- 7793449
TI  - Discrimination between panic disorder and generalized anxiety disorder by 35%
      carbon dioxide challenge.
AB  - OBJECTIVE: The authors' goal was to determine whether 35% carbon dioxide (CO2)
      challenge would discriminate between patients with panic disorder and patients
      with other anxiety disorders. METHOD: Nine patients with panic disorder and nine
      with generalized anxiety disorder underwent the 35% CO2 challenge. RESULTS:
      Patients with panic disorder experienced a significantly stronger increase in
      subjective anxiety than patients with generalized anxiety disorder. However,
      increases in panic symptom scores were high in both groups. CONCLUSIONS: These
      results suggest that a large increase in subjective anxiety due to the CO2
      challenge is specific for patients with panic disorder but that an increase in
      panic symptoms is not.

PMID- 7793451
TI  - Lack of effect of clonidine on stuttering in children.
AB  - OBJECTIVE: The authors studied the effects of the alpha 2-receptor agonist
      clonidine on stuttering in children. METHOD: Using a double-blind crossover
      study, they gave placebo or 4 micrograms/kg body weight per day to 25 stuttering
      children who were 6-13 years old. Stuttering was measured by counting the
      occurrences of four elementary speech difficulties and by asking parents and
      teachers to give an overall impression of the amount of stuttering, as well as
      their impression of how troublesome the stuttering was to the children. RESULTS:
      Clonidine did not improve stuttering. CONCLUSIONS: Clonidine cannot be
      recommended as a useful drug for treating children who stutter.

PMID- 7793452
TI  - Fluvoxamine augmentation for clozapine-resistant schizophrenia.

PMID- 7793454
TI  - Venlafaxine for adult ADHD.

PMID- 7793455
TI  - Adult ADHD and AIDS.

PMID- 7793453
TI  - Effects of venlafaxine treatment for ADHD in a child.

PMID- 7793456
TI  - Dysphoria after treatment with ondansetron.

PMID- 7793457
TI  - Sinus arrest in a catatonic patient.

PMID- 7793458
TI  - Fever associated with clozapine administration.

PMID- 7793459
TI  - Complete anticoagulation for treatment of neuroleptic malignant syndrome?

PMID- 7793460
TI  - Renaming multiple personality disorder.

PMID- 7793461
TI  - Treatment of dysthymia with antidepressants.

PMID- 7793462
TI  - Effect of gun control legislation on suicide.

PMID- 7793463
TI  - Corpus callosum morphology in ADHD.

PMID- 7793464
TI  - Posttraumatic stress disorder: psychology, biology, and the manichaean warfare
      between false dichotomies.

PMID- 7793465
TI  - Cortex, IX. Heschl's gyrus and the planum temporale.

PMID- 7793466
TI  - Prodromes and precursors: epidemiologic data for primary prevention of disorders
      with slow onset.
AB  - OBJECTIVE: The concepts of prodrome and precursor are used to show how
      epidemiologic data on age at onset can be used in timing preventive interventions
      and selecting target populations. METHODS: Data concerning onset of DSM-III major
      depression and panic disorder were taken from the Epidemiologic Catchment Area
      Program. Cumulative distributions of ages at onset of diagnosis and onset of
      precursors are presented, and the concept of attributable risk is introduced.
      Attributable risk is the maximum proportion of cases that would be prevented if
      an intervention were 100% effective in eliminating a specific precursor. RESULTS:
      Illustrative results for depression and panic are presented. Precursors vary in
      the degree to which they predict onset of the full disorder; 2 or more weeks of
      sad mood in the year before full-blown depression is a better predictor (relative
      odds, 7.0) than weight loss or gain (relative odds, 3.0). The formula for
      population attributable risk was applied to the precursor relative risks and
      prevalences to estimate the potential success of interventions for specific
      precursors in preventing the disorder. The precursor attributable risks indicate
      that sleep problems would identify 47% of the new cases of major depression
      occurring in the following year, and the question "Are you a nervous person?"
      would identify 60% of persons with onset of panic disorder in the following year.
      CONCLUSIONS: This conceptual framework links the early natural history of
      disorders with the search for syndromes. Knowledge of precursor prevalence and
      attributable risk, combined with other host characteristics and environmental
      risk factors, can be used in screening and prevention.

PMID- 7793467
TI  - MRI-based measurement of hippocampal volume in patients with combat-related
      posttraumatic stress disorder.
AB  - OBJECTIVE: Studies in nonhuman primates suggest that high levels of cortisol
      associated with stress have neurotoxic effects on the hippocampus, a brain
      structure involved in memory. The authors previously showed that patients with
      combat-related posttraumatic stress disorder (PTSD) had deficits in short-term
      memory. The purpose of this study was to compare the hippocampal volume of
      patients with PTSD to that of subjects without psychiatric disorder. METHOD:
      Magnetic resonance imaging was used to measure the volume of the hippocampus in
      26 Vietnam combat veterans with PTSD and 22 comparison subjects selected to be
      similar to the patients in age, sex, race, years of education, socioeconomic
      status, body size, and years of alcohol abuse. RESULTS: The PTSD patients had a
      statistically significant 8% smaller right hippocampal volume relative to that of
      the comparison subjects, but there was no difference in the volume of other brain
      regions (caudate and temporal lobe). Deficits in short-term verbal memory as
      measured with the Wechsler Memory Scale were associated with smaller right
      hippocampal volume in the PTSD patients only. CONCLUSIONS: These findings are
      consistent with a smaller right hippocampal volume in PTSD that is associated
      with functional deficits in verbal memory.

PMID- 7793468
TI  - Low urinary cortisol excretion in Holocaust survivors with posttraumatic stress
      disorder.
AB  - OBJECTIVE: The authors' objective was to compare the urinary cortisol excretion
      of Holocaust survivors with posttraumatic stress disorder (PTSD) (N = 22) to that
      of Holocaust survivors without PTSD (N = 25) and comparison subjects not exposed
      to the Holocaust (N = 15). METHOD: Twenty-four-hour urine samples were collected,
      and the following day, subjects were evaluated for the presence and severity of
      past and current PTSD and other psychiatric conditions. RESULTS: Holocaust
      survivors with PTSD showed significantly lower mean 24-hour urinary cortisol
      excretion than the two groups of subjects without PTSD. Multiple correlation
      analysis revealed a significant relationship between cortisol levels and severity
      of PTSD that was due to a substantial association with scores on the avoidance
      subscale. CONCLUSIONS: The present findings replicate the authors' previous
      observation of low urinary cortisol excretion in combat veterans with PTSD and
      extend these findings to a non-treatment-seeking civilian group. The results also
      demonstrate that low cortisol levels are associated with PTSD symptoms of a
      clinically significant nature, rather than occurring as a result of exposure to
      trauma per se, and that low cortisol levels may persist for decades following
      exposure to trauma among individuals with chronic PTSD.

PMID- 7793469
TI  - Magnetic resonance imaging measurement of gray matter volume reductions in HIV
      dementia.
AB  - OBJECTIVE: The authors recently reported smaller basal ganglia volumes for
      patients with HIV-associated dementia than for HIV-infected patients without
      dementia and a seronegative comparison group. The purpose of the current study
      was to determine whether HIV dementia is associated with volume reductions in
      other brain regions. METHOD: The authors measured volumes of CSF and gray and
      white tissue on cranial magnetic resonance images from homosexual men who were 1)
      infected with HIV with HIV-associated dementia complex, 2) infected with HIV
      without dementia, and 3) HIV seronegative. RESULTS: Results suggest that loss of
      white matter occurs with HIV infection and is more severe in HIV-positive
      patients with dementia than in those without dementia. There was some generalized
      volume reduction in gray matter in HIV-positive demented patients, although group
      differences did not reach significance when adjusted for age. Volume of posterior
      cortex, however, was significantly smaller among HIV-positive patients with
      dementia than in either remaining group. There were no significant differences
      between HIV-positive nondemented patients and HIV-negative subjects in these
      regions. CONCLUSIONS: In conjunction with findings from previous research, the
      authors conclude that HIV dementia is associated with specific gray matter volume
      reduction in basal ganglia and posterior cortex, as well as with generalized
      volume reduction of white matter.

PMID- 7793470
TI  - Predictors of retrograde amnesia following ECT.
AB  - OBJECTIVE: Substantial progress has been made in identifying how the treatment
      parameters used in ECT impact on cognitive side effects. However, there is
      limited information regarding individual differences in vulnerability to these
      side effects. The authors examined patients' pretreatment global cognitive status
      and postictal orientation recovery time as potential predictors of the magnitude
      of retrograde amnesia for autobiographical memories after ECT. METHOD: Seventy
      one inpatients with major depressive disorder were randomly assigned to four ECT
      conditions that varied in electrode placement (right unilateral versus bilateral)
      and stimulus dosage (low versus high intensity). Orientation recovery time was
      assessed at virtually every session during the course of ECT. Global cognitive
      status was assessed with the modified Mini-Mental State examination before
      treatment, during the week after termination of treatment, and 2 months after
      treatment ended. Retrograde amnesia was assessed at these same time points with
      the Autobiographical Memory Interview. RESULTS: Pre-ECT global cognitive status
      and the duration of postictal disorientation were strong predictors of the
      magnitude of retrograde amnesia in the week after the course of ECT and at 2
      month follow-up. In general, these relationships were maintained regardless of
      technical parameters in the administration of the ECT. CONCLUSIONS: Patients who
      manifest global cognitive impairment before treatment and patients who experience
      prolonged disorientation in the acute postictal period may be the most vulnerable
      to persistent retrograde amnesia for autobiographical information.

PMID- 7793473
TI  - Cellular benign mesenchymal tumors of the uterus. A comparative morphologic and
      immunohistochemical analysis of 33 highly cellular leiomyomas and six endometrial
      stromal nodules, two frequently confused tumors.
AB  - Thirty-three highly cellular leiomyomas of the uterus from patients 29 to 65
      (mean, 46) years of age and six endometrial stromal nodules from patients 41 to
      53 (mean, 46) years of age are described. The patients usually presented with
      irregular uterine bleeding. Twenty-eight of the leiomyomas were intramural and
      five, submucosal. Eleven of 18 whose consistency is known were soft, fish-flesh,
      or rubbery, 10 were yellow or yellow-tan; one had a prominent cystic component.
      The tumors ranged from 0.5 to 15 cm (mean, 4.6 cm) in maximum dimension. On
      microscopic examination, they were densely cellular and composed of cells that
      ranged from round to spindle-shaped and had scanty cytoplasm. A focal fascicular
      pattern was present in all of the cases. Blood vessels were typically large;
      thick muscular walls and focally dilated lumens were a conspicuous feature of the
      majority of the neoplasms. Arterioles were evident focally in most of the tumors
      but were prominent in only one of them. Cleft-like spaces, some representing
      compressed vessels, others due to internodular edema, were present in 24 of the
      tumors and were conspicuous in 15 of them. The neoplasms typically exhibited
      focal irregular extension into the adjacent myometrium, and this feature was
      conspicuous in 18 of them. They often merged almost imperceptibly with the
      adjacent myometrium. All tumors were immunoreactive for desmin and 32 of 32 for
      alpha-smooth muscle actin. Two of the stromal nodules were polypoid intracavitary
      masses, three were submucosal, and one intramural. Five were completely or
      predominantly solid with cysts present focally in three of them; one tumor was
      predominantly cystic. The solid tissue was frequently yellow. Microscopic
      examination disclosed a diffuse growth of closely packed small cells with scanty
      cytoplasm and nuclei that lacked atypia. Three neoplasms contained cells with
      abundant foamy cytoplasm that were immunoreactive for CD68, indicating that they
      were histiocytes and not neoplastic cells. All the neoplasms had a prominent
      component of arterioles, which in one tumor had hyalinized walls. Five tumors
      were entirely well circumscribed and one predominantly well circumscribed with
      limited extension into the adjacent myometrium. The tumors were
      immunohistochemically negative for desmin.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7793472
TI  - Lipomatous hemangiopericytoma. A histologic, ultrastructural and
      immunohistochemical study of a unique variant of hemangiopericytoma.
AB  - We report three cases of a unique, previously undescribed soft tissue tumor
      composed of mature adipocytes and hemangiopericytomatous areas, for which we
      propose the term lipomatous hemangiopericytoma. The tumors occurred in adults and
      were located in the sinonasal area, the soft tissue of the shoulder, and the
      retroperitoneum. The tumors ranged in size from 4 to 10 cm in greatest diameter
      and grossly were solid and ranged from tan to yellow. Histologically, they were
      composed of a variable admixture of benign lipomatous and hemangiopericytomatous
      components. Immunohistochemically, they stained with antibodies to vimentin and
      not to alpha-smooth-muscle actin, muscle-specific actin, desmin, S-100 protein,
      glial fibrillary acidic protein, epithelial membrane antigen, or keratin.
      Ultrastructurally, the cells constituting the hemangiopericytomatous areas had
      the features of pericytes, and no lipoblasts or transitional forms between
      lipocytes and pericytes were found. The histologic differential diagnosis of this
      neoplasm includes spindle-cell lipoma, angiolipoma, liposarcomas, tumors showing
      smooth muscle and adipocytic differentiation, and hemangiopericytoma infiltrating
      fat. Because of the small number of cases and the limited follow-up, we cannot be
      certain of their biologic behavior, although we expect that they are benign.
      Lipomatous hemangiopericytoma represents a distinctive pathologic entity that
      should be recognized and studied further.

PMID- 7793471
TI  - Adenosis of the prostate. Histologic features in needle biopsy specimens.
AB  - Classically, adenosis has been described as occurring in the transition zone of
      the prostate, a region not routinely sampled with needle biopsies. However, with
      urologists performing more needle biopsies, we have seen an increasing number of
      cases of adenosis in needle biopsies of the prostate. To better characterize the
      histologic features of adenosis present in needle biopsy specimens, we reviewed
      63 needle biopsies of the prostate containing a total of 75 foci of adenosis. Of
      the 63 cases, 51 (81%) were seen in consultation by one of the authors, and in
      approximately 80% of these cases, the differential diagnosis included low-grade
      adenocarcinoma. Crystalloids were present in 18 foci (24%), a minimally
      infiltrative growth pattern in 10 foci (13%), prominent nucleoli in 10 foci
      (13%), scattered single cells in eight foci (11%), mitoses in two foci (3%), and
      blue-tinged muci-nous secretions in two foci (3%). Immunohistochemistry was
      performed on 29 (39%) foci to rule out adenocarcinoma. Intraluminal crystalloids,
      a minimally invasive growth pattern, and single cells occur with sufficient
      frequency in adenosis, such that their presence is not useful in distinguishing
      low-grade adenocarcinoma from adenosis; 62 (83%) of the foci of adenosis were
      found to contain none of the remaining histologic features (mitoses, blue-tinged
      luminal secretions, prominent nucleoli), whereas 12 foci (16%) had one of the
      features and one focus (1%) had two features. Adenosis should always be in the
      differential diagnosis when one is considering low-grade carcinoma on needle
      biopsy. The key feature of adenosis is the merging of small crowded glands with
      surrounding benign glands; in contrast, the small glands of adenocarcinoma differ
      in their cytoplasm, nuclei, or luminal contents from adjacent benign glands.

PMID- 7793474
TI  - Low-stage clear-cell carcinoma of the endometrium.
AB  - Clear-cell carcinoma (CCC) of the endometrium is a relatively rare malignancy
      that is considered to be one of the most aggressive types of endometrial
      carcinoma. To evaluate the behavior of low-stage (stages I and II) CCC of the
      endometrium, we retrospectively reviewed 17 such cases seen at The University of
      Texas M.D. Anderson Cancer Center from 1963 to 1990. Patients' ages ranged from
      52 to 81 years. Fifteen cases were pure CCC, and two cases were predominantly CCC
      with a focus of endometrioid adenocarcinoma FIGO grade I. All patients have been
      followed-up for at least 3 years. At the time of the study, six patients were
      alive without disease, one patient was alive with disease, five had died of other
      causes, and five had died of disease. The estimated survival rate was 71%.
      Estimated 5-year survival rates for endometrioid adenocarcinoma FIGO grade III
      and uterine papillary serous carcinoma are 73 and 39%, respectively. We conclude
      that patients with low-stage CCC of the endometrium have a survival rate similar
      to that of patients with endometrioid adenocarcinoma FIGO grade III and better
      than that of patients with uterine papillary serous carcinoma of similar stages.

PMID- 7793475
TI  - Fibrous dysplasia and cemento-ossifying fibroma. A histologic spectrum.
AB  - Fibrous dysplasia (FD) and cemento-ossifying fibroma (COF) are benign fibro
      osseous lesions that are generally considered to be separate entities,
      distinguished by histologic and radiographic features. In our experience, some
      lesions lack the classic clinical, radiographic, or pathologic features of FD or
      COF and rather have overlapping features of both entities. Consequently, these
      cases are frequently diagnosed nonspecifically as fibro-osseous lesions. We
      examined 56 gnathic and extragnathic fibro-osseous lesions of bone
      morphologically, clinically, and radiographically to determine whether they can
      be reliably distinguished and whether their distinction has any clinical or
      prognostic significance. The lesions exhibited a broad morphologic spectrum of
      patterns ranging from pure FD (24 cases) to pure COF (10 cases). Twenty-two
      lesions contained a mixture of both patterns; 11 lesions with a predominant FD
      pattern contained calcified spherules histologically indistinguishable from those
      characteristically seen in COF. The remaining 11 lesions contained areas of
      typical FD adjacent to areas of COF. The lesions examined also demonstrated
      considerable radiographic overlap, and FD could not be reliably distinguished
      from COF. The recurrence rate was low for all lesions regardless of the
      histologic pattern. Because of histologic and radiographic overlap and similar
      low recurrence rate of FD and COF, we consider them to be related lesions, and
      COF is probably an opposing end of a morphologic spectrum of FD.

PMID- 7793476
TI  - Liposarcoma of the anterior mediastinum and thymus. A clinicopathologic study of
      28 cases.
AB  - We studied 28 cases of anterior mediastinal liposarcoma occurring in 16 males and
      12 females with a mean age of 43 years (range, 14-72). Presenting symptoms
      included dyspnea (four cases) and chest pain (four cases), although 11 tumors
      were detected incidentally by routine chest radiography. Seven cases were
      believed to be located within the thymus. Most (i.e., 25) of the cases were of
      low grade, with the well-differentiated lipoma-like or sclerosing subtypes
      constituting 60% and the myxoid subtype constituting 28%; the remaining 12%
      exhibited mixed features. Three cases were pleomorphic type. Several low-grade
      tumors exhibited widespread, dense aggregates of mature-appearing lymphocytes and
      plasma cells, which occasionally obscured the mesenchymal nature of the neoplasm,
      suggesting instead a lymphoid neoplasm or a reactive fibroinflammatory condition.
      The three high-grade tumors showed combinations of pleomorphic and round cell
      patterns, with focal myxoid areas. Of the cases grossly arising within the
      thymus, only one showed extensive thymic tissue within the lesion
      ("thymoliposarcoma"); six others exhibited residual thymus peripheral to the
      tumor. Clinical follow-up in 23 cases revealed recurrence in seven patients
      (31.8%), with a mean interval to recurrence of 3 years. Eight patients died (mean
      survival, 2.6 years), one postoperatively and three following a recurrence.
      Fifteen patients were alive (mean survival, 2 years), four with recurrent tumor.
      The myxoid tumors had a somewhat more aggressive course than the well
      differentiated tumors. Metastases were not observed in any of the patients.

PMID- 7793477
TI  - Pagetoid melanocytosis. Histologic features in benign and malignant lesions.
AB  - Pagetoid melanocytosis (PM), the upward discontinuous extension of melanocytes
      into the superficial epidermis, although generally considered a histologic
      feature of malignancy, may be seen in certain benign melanocytic lesions. To
      formulate the histologic criteria for distinction between benign and malignant
      PM, we examined 218 melanocytic tumors, including melanomas, Spitz nevi, nevi of
      palms and soles, pigmented spindle cell nevi, recurrent nevi, vulvar nevi, nevi
      of infancy and early childhood, and ordinary acquired nevi. We found PM to be
      present in 96% of melanomas, 38% of Spitz nevi, 61% of nevi of palms and soles,
      20% of pigmented spindle cell nevi, 60% of recurrent nevi, 80% of vulvar nevi,
      and none of the ordinary acquired nevi. All the nevi of infancy and early
      childhood showed PM, but they had been selected for that feature. In melanomas,
      PM showed significant cellular atypia (81%), which was extensive and diffuse, and
      in 13% it extended laterally beyond the underlying junctional component. In the
      benign lesions, cellular atypia was generally absent, nor was lateral extension
      present, and PM was usually focal or multifocal rather than diffuse and not
      extensive. Although PM should be considered a tocsin for malignant melanoma, it
      may also occur in certain benign melanocytic lesions. Accurate interpretation
      depends on evaluation of all of the pertinent histologic and clinical findings.

PMID- 7793478
TI  - Kikuchi's disease (histiocytic necrotizing lymphadenitis). A clinicopathologic
      study of 79 cases with an analysis of histologic subtypes, immunohistology, and
      DNA ploidy.
AB  - We conducted a clinicopathologic study of 79 cases of Kikuchi's disease. Our
      results confirmed that Kikuchi's disease is a distinctive type of necrotizing
      lymphadenitis that affects primarily the cervical lymph nodes of young adults and
      has a self-limited clinical course. However, female predominance was not as
      striking as heretofore reported. A low, but possible, recurrence rate of 3.3% was
      documented. Extranodal cutaneous involvement occurred in one patient who had a
      more severe and protracted clinical course. Classification of the histopathologic
      changes into three histologic types was proposed: proliferative, necrotizing, and
      xanthomatous types. These three types differed in certain aspects of their
      clinical features. Immunohistologic analysis revealed that the predominant cells
      of the lesions were various types of histiocytes, including the enigmatic
      plasmacytoid monocytes. A variable number of CD8(+) T cells correlating with the
      duration of the disease was detected. B cells were nearly absent, and only an
      insignificant number of OPD4(+) T cells was present. Eight cases studied by the
      flow cytometric DNA analysis all showed a diploid DNA content. Although the
      histologic changes of Kikuchi's disease were variable, the findings were
      sufficiently distinctive to permit accurate diagnosis. Malignant lymphoma and
      especially lupus lymphadenitis can be mistaken for Kikuchi's disease; thus
      differentiation is crucial.

PMID- 7793479
TI  - Papillary Hurthle cell carcinoma with lymphocytic stroma. "Warthin-like tumor" of
      the thyroid.
AB  - We report 13 cases of a peculiar thyroid tumor of follicular epithelial
      differentiation with distinctly papillary architecture, oxyphilic cytology, and
      lymphocytic infiltrates in papillary stalks. The majority of these tumors arose
      in glands with chronic lymphocytic thyroiditis. The combination of oxyphilic
      cells and lymphocytic stroma gives these tumors a startling resemblance to
      papillary cystadenoma lymphomatosum, or "Warthin's tumor" of the salivary gland.
      Twelve tumors occurred in women (age range: 26-66 years, mean 44 years). Two
      tumors were in the isthmus, six in the right lobe, and four in the left lobe. The
      only man, 34 years old, had multiple bilateral tumor nodules. The lesions ranged
      from 0.3 cm to 3.5 cm in maximum dimension. The largest lesion, in a 58-year-old
      woman, infiltrated skeletal muscle. Three other patients had lymph node
      metastases, while the nine remaining tumors were confined to the thyroid. Follow
      up in these cases suggests that although the histological appearance of these
      neoplasms is unusual, they behave as typical papillary carcinomas. The striking
      lymphocytic infiltration and oxyphilic metaplasia in these tumors as well as the
      association with chronic lymphocytic thyroiditis suggest that as yet undefined
      immunological mechanisms may play a role in the pathogenesis of this disorder.

PMID- 7793480
TI  - Malignant mesothelioma of the tunica vaginalis. A clinicopathologic analysis of
      11 cases with review of the literature.
AB  - Eleven malignant mesotheliomas of the testicular tunica vaginalis occurred in
      patients aged 12 to 76 (mean, 54.1) years. Hydrocele, with or without an
      associated mass, or appreciation of a paratesticular mass accounted for the
      clinical presentation. One patient had a history of asbestos exposure. Grossly,
      the tumors typically presented as multiple nodules studding a hydrocele sac,
      frequently associated with a mass infiltrating the spermatic cord or adjacent
      testis. Microscopically, five tumors were epithelial and six biphasic, with the
      typical architectural and cytologic features of mesothelioma. Mixtures of
      papillary, tubular, and solid patterns predominated in the epithelial areas;
      interlacing fascicles of spindle cells with scanty stroma characterized the
      sarcomatous components. All eight of the tumors that were stained for keratin
      (AE1/AE3) were positive, four of five for epithelial membrane antigen, and four
      of five for vimentin. Seven of seven tumors were carcinoembryonic antigen
      negative and five of five B72.3, Leu-M1, and Ber-Ep4 negative. Follow-up ranging
      from 1 to 15 (mean, 4.3) years was available for seven patients. Three died of
      disease after 4, 4, and 3 years, and three are alive with disease 2, 2, and 15
      years after diagnosis. Two of the latter three patients had extensive local
      recurrences, one 15 years after the diagnosis of a well-differentiated papillary
      mesothelioma, the other 2 years following treatment with hydrocelectomy only. One
      patient who has been followed for only 1 year has no evidence of disease. This
      series emphasizes a number of important features of testicular mesothelioma; (a)
      a wide age range with occasional occurrence at a young age, (b) a wide
      morphologic spectrum with regard to degree of differentiation, and (c) an
      aggressive natural history with a potential for late recurrence or metastasis of
      even well-differentiated tumors, suggesting the need for initial aggressive
      surgical treatment.

PMID- 7793481
TI  - Mucoepidermoid carcinomas of the thymus. A clinicopathologic study of six cases.
AB  - Six cases of mucoepidermoid carcinoma of the thymus are presented. The patients
      were two men and four women aged 17 to 66 years (median age, 34.5). Clinically,
      three patients had symptoms of chest discomfort and three were asymptomatic.
      Grossly, the tumors in three patients were described as cystic structures varying
      in size from 7 to 8 cm in greatest dimension, with focal areas of induration
      within the walls of the cyst that averaged from 1.5 to 3 cm. The other three
      cases had grossly and radiographically well-circumscribed, homogeneous tumor
      masses. Histologically, the lesions showed a spectrum of features that ranged
      from those of well-differentiated, to moderately well-differentiated, to poorly
      differentiated mucoepidermoid carcinoma, with sheets and solid islands of
      squamoid cells admixed with mucin-secreting epithelium lining gland-like spaces.
      In four cases, the tumor was histologically seen in continuity with the
      epithelial lining of multilocular cystic structures; the nonneoplastic components
      of the cysts contained abundant inflammation and showed the features of otherwise
      conventional acquired multilocular thymic cysts. Clinical follow-up showed that
      the two patients with intermediate and high-grade tumors died within 2 and 7
      months after initial diagnosis. One of these patients showed at autopsy residual
      tumor limited to the mediastinum, whereas the other patient died with metastases
      to pericardium and myocardium despite postoperative radiation therapy. Two
      patients with low-grade tumors were alive and well with no residual disease 2 and
      3 years after surgery, and the other two were lost to follow-up. Mucoepidermoid
      carcinoma of the thymus should be included in the differential diagnosis of
      cystic neoplasms of the thymus. As with their counterparts at other sites, the
      biologic behavior of these tumors closely correlates with their degree of
      differentiation and amount of cytologic atypia.

PMID- 7793482
TI  - Carcinoma of the thymus with clear-cell features. Report of eight cases and
      review of the literature.
AB  - We report eight cases of thymic carcinoma with clear-cell features and review the
      five previously reported cases. The tumor was composed of cells with clear
      cytoplasm and rather bland nuclear features, and showed a lobular or occasionally
      sheet-like growth pattern. Cytoplasmic glycogen was demonstrable in 92% of cases,
      whereas mucin was absent in all cases tested. The tumor cells were uniformly
      immunoreactive for low- and high-molecular-weight keratins and were reactive for
      epithelial membrane antigen in 22% of cases. The differential diagnosis includes
      mediastinal seminoma, parathyroid carcinoma, and metastatic clear-cell carcinoma.
      The diagnosis of primary thymic carcinoma depends on the exclusion of other
      primary sites clinically, particularly lung and kidney, and the demonstration of
      postivity for keratins and negativity for placental alkaline phosphatase. Thymic
      carcinoma with clear-cell features behaves as a high-grade thymic carcinoma:
      including our cases and the previously reported cases, nine of 13 patients (69%)
      are either dead of disease or have persistent disease at the latest follow-up.
      The importance of this entity is recognition of its aggressive clinical behavior
      and its distinction from other primary and metastatic clear-cell neoplasms of the
      mediastinum.

PMID- 7793483
TI  - Clarifying statements on T-cell-rich B-cell lymphomas.

PMID- 7793484
TI  - MAb O13.

PMID- 7793485
TI  - A critical appraisal of the small-diameter portacaval H-graft.
AB  - BACKGROUND: The ideal portasystemic shunt should prevent variceal hemorrhage and
      preserve portal flow to reduce hepatic encephalopathy. The partial shunting
      proposed by Sarfeh effectively controls variceal bleeding while preserving
      prograde hepatic portal flow. PATIENTS AND METHODS: We analyzed results of the
      partial portacaval shunt prospectively in 43 patients undergoing small-diameter
      (8-mm or 10-mm) portacaval H-graft. Patients entered into the study had Child
      Pugh class A and class B cirrhosis, and all had documented previous variceal
      hemorrhages. We used the Sarfeh technique without performing portal collateral
      ligation. RESULTS: Operative mortality was 5%. Acute graft thrombosis occurred in
      3 patients, 2 of whom were successfully lysed by urokinase infusion
      angiographically, while later graft occlusion occurred in 1 case. Only 1 patient
      rebled from varices in our late follow-up (14 to 65 months). Prograde portal flow
      was maintained in 90% of patients undergoing repeat angiography 27 +/- 13 months
      postoperatively. The incidence of all encephalopathy episodes was 16%, with only
      1 patient having this complication chronically. CONCLUSIONS: The small-diameter
      portacaval H-graft of Sarfeh is an effective operation for controlling variceal
      hemorrhage. It preserves hepatic portal perfusion over time in the majority of
      patients, reducing the risk of encephalopathy. The procedure may be particularly
      suited for alcoholic cirrhotic patients with less advanced liver disease.

PMID- 7793486
TI  - Polypropylene mesh closure of the complicated abdominal wound.
AB  - BACKGROUND: Closure of the abdominal wall in the face of fascial necrosis or
      massive intestinal edema remains a difficult problem with frequent complications.
      Prior studies have addressed both the utility and the pitfalls of placing
      polypropylene mesh in this setting. METHODS: We performed a retrospective
      evaluation of our experience with polypropylene mesh in traumatic and
      nontraumatic difficult abdominal closures. Timing of mesh placement and removal
      relative to the initial operation were recorded, as were abdominal complications,
      number of operative procedures, and type of ultimate abdominal closure. RESULTS:
      Between 1988 and 1993, polypropylene mesh was placed in 26 critically ill or
      injured patients requiring celiotomy, of whom 23 survived more than 3 weeks.
      Ultimate wound management was delayed mesh removal and primary closure (17%),
      myocutaneous flap coverage over mesh (4%), split-thickness skin grafting to the
      granulating wound (35%), or closure by secondary intention over mesh (43%). Split
      thickness skin grafting and closure by secondary intention resulted in
      enterocutaneous fistulas in 50% and 40% of cases, respectively. Full-thickness
      closure with or without mesh removal resulted in no fistulas. CONCLUSION: Mesh
      provided adequate fascial closure, even with gross wound contamination. Coverage
      of polypropylene mesh by secondary intention or split-thickness skin grafting
      resulted in unacceptably high rates of fistulous complications, and this
      procedure should be replaced by either mesh removal or full-thickness coverage.

PMID- 7793488
TI  - Psychoneuroimmunology: a new fad or the fifth cancer treatment modality?

PMID- 7793487
TI  - A prospective multicenter evaluation of preoperative hemostatic screening tests.
      The French Associations for Surgical Research.
AB  - BACKGROUND: Several retrospective and four prospective reports have questioned
      the need for routine preoperative hemostatic screening tests (PHST) in general
      surgery. PATIENTS AND METHODS: The results of four standard tests (prothrombin
      time, activated partial thromboplastin time, platelet count, and bleeding time)
      were prospectively compared with patient history and clinical data in a
      multicenter study of 3,242 consecutive patients. The patients were divided into
      four groups: group A (n = 1,951) had no clinical or PHST abnormalities; group B
      (n = 340) had no clinical and one or more PHST abnormalities; group C (n = 779)
      had one or more clinical and no PHST abnormalities; group D (n = 172) had both
      clinical and PHST abnormalities. RESULTS: Preoperative modifications of
      guidelines (postponed operations and ordering of additional hemostatic tests)
      were significantly more frequent in both groups of patients with PHST
      abnormalities (groups B and D), but specific treatment to correct hemostatic
      disorders was prescribed only when clinical abnormalities were also present
      (group D). Intraoperatively, modifications of anesthetic and surgical vigilance
      (planning of increased number of blood units, vascular catheter placement, and
      number of patients requiring transfusion) were significantly more frequent in
      group D. Postoperatively, all groups had similar incidences of hematoma or
      bruises, volumes of blood loss per drainage, reoperations to control hemorrhage,
      and mortality due to bleeding (n = 5). CONCLUSIONS: Our results suggest that PHST
      should not be performed routinely, but only in patients with abnormal clinical
      data. Such a policy necessitates a thorough history--including answers to a
      specific questionnaire like those used in prospective studies--and a rigorous,
      well-conducted physical examination.

PMID- 7793489
TI  - Unilateral breast masses in men over 40: a diagnostic dilemma.
AB  - BACKGROUND: Breast enlargement in men is a common condition with advancing age.
      The main problem in this age group is to differentiate gynecomastia or benign
      enlargement from carcinoma. PATIENTS AND METHODS: Over a 14-year period, 60
      patients > or = 40 years old were operated on four unilateral breast masses (11
      carcinoma, 49 gynecomastia) at the University College Hospital, Galway, Ireland.
      The medical records of these patients were reviewed and data were collected from
      patients' charts and histopathology records. RESULTS: Patients with carcinoma
      delayed significantly longer before presentation than patients with gynecomastia,
      a median of 33 versus 3.4 months, respectively. A lump was the presenting
      complaint in patients with carcinoma unless the disease was advanced. Patients
      with gynecomastia were more likely to present with pain; and the majority of
      these patients described tenderness on clinical examination. A history of
      carcinoma (18% and 0%) or a family history of breast carcinoma (36% and 14%) was
      more common in the patients with carcinoma than in those with gynecomastia,
      respectively (P < 0.05; P = NS, respectively). Histories of consuming alcohol and
      smoking cigarettes were more common in those with gynecomastia (67% and 43%) than
      in those with carcinoma (55% and 18%). A similar proportion of patients in both
      groups were taking drugs known or suspected to cause gynecomastia (29% and 27%).
      CONCLUSIONS: Carcinoma must be excluded in patients presenting with unilateral
      breast masses, particularly in those patients who present with painless masses.
      Clues to the diagnosis are provided by a history of carcinoma or a family history
      of breast carcinoma. A history of consumption of drugs known to cause
      gynecomastia should not influence the decision to perform a biopsy on unilateral
      breast masses in older men.

PMID- 7793490
TI  - A comprehensive characterization of lymphoepithelial cyst associated with the
      pancreas.
AB  - BACKGROUND: Lymphoepithelial cyst of the pancreas is a rare but distinctive
      cystic lesion lined by a mature, keratinizing squamous epithelium and surrounded
      by lymphoid tissue. METHODS: To gain more insights into this entity, we describe
      5 examples of lymphoepithelial cyst of the pancreas (2 of which were briefly
      described before) and compare them with similar cases in the literature for a
      total of 19 cases. RESULTS: The male:female ratio was 16:3; patients' ages ranged
      from 32 to 73 years (mean and median 51). The lymphoepithelial cyst was
      incidentally found at autopsy in 4 patients (21%) or during evaluation for
      unrelated diseases in another 4 patients (21%). In the remaining 11 patients, the
      cyst was associated with abdominal pain in 9 (47% of all patients),
      nausea/vomiting in 3 (16%), diarrhea in 1 (5%), and nonspecific systemic symptoms
      in 6 (32%) (some patients had more than 1 associated symptom). Computed axial
      tomography scan, with or without ultrasonographic study, was done in 16 cases and
      uniformly displayed a single, well-circumscribed, cystic mass protruding beyond
      the surface of the pancreas; the rest of the pancreas was normal.
      Intraoperatively, the cyst was readily apparent once the lesser sac was entered
      and the surface of the pancreas exposed; the cyst was located at the head (3
      cases), neck (1 case), body (6 cases), and tail (9 cases). Surgery was done for
      all 15 clinical cases and included local excision of the cyst with a thin rim of
      attached, underlying pancreas (6 cases), or distal pancreatectomy with (4 cases)
      or without (3 cases) splenectomy. Follow-up information, available in 7 cases,
      showed that all symptoms disappeared and the patients were alive and well up to 6
      years after surgery. CONCLUSIONS: This rare cyst of the pancreas has a uniform
      and characteristic clinicopathologic profile, enabling easy and accurate
      diagnosis. Although the histogenesis of lymphoepithelial cysts is not known, they
      are benign and can be cured by local excision.

PMID- 7793492
TI  - Predicting common bile duct lithiasis: determination and prospective validation
      of a model predicting low risk.
AB  - BACKGROUND: The aim of this two-part prospective study was: (1) to identify
      simple, noninvasive, preoperative factors associated with low or very low risk of
      common bile duct lithiasis (CBDL); and (2) to test the validity of the
      statistical model obtained during Part One by the postcholecystectomy follow-up
      of patients classified into a low-risk group. PATIENTS AND METHODS: In Part One
      of the study, preoperative clinical, biologic, and ultrasonographic data, and
      intraoperative cholangiographic findings were collected from 503 consecutive
      patients undergoing cholecystectomy for symptomatic lithiasis from 1985 to 1989.
      Using the data obtained in Part One, a linear logistic model was used
      prospectively in Part Two to determine the prediction of absence of CBDL in 279
      consecutive patients. No jaundice, normal transaminase levels, common bile duct
      (CBD) diameter < 8 mm, and no intrahepatic duct enlargement defined the low-risk
      group of CBDL. RESULTS: In Part One, CBDL was present in 84 (17%) of all
      patients. Five parameters were used to classify 73% of all patients as low risk
      of CBDL and 27% as high risk. In the low-risk groups, CBDL was present in 1% of
      116 cases with acute gallbladder complications, and 5% of 250 cases with no acute
      gallbladder complications. In Part Two, 171 (61%) patients were classified in the
      low-risk group (Group 1), and CBD stones were not sought by any additional
      preoperative investigations or intraoperative cholangiography (IOC). One hundred
      eight patients (39%) were considered at risk of CBDL (Group 2). Mean follow-up
      was 20.6 months (median 19); 2 patients (1%) in the low-risk group presented a
      symptomatic retained stone. CONCLUSIONS: This study validated this simple model
      for predicting risk of CBDL and avoiding invasive preoperative investigations--as
      well as IOC--in more than 60% of symptomatic cholelithiases. In addition, this
      model seemed useful for defining patients in whom further exploration for CBDL
      was justified, since 42 (39%) of the 108 Group 2 patients were proved to have
      CBDL.

PMID- 7793491
TI  - Anomalies at the thoracic outlet are frequent in the general population.
AB  - BACKGROUND: Abnormal anatomy at the thoracic outlet is frequent in patients
      operated on for thoracic outlet syndrome (TOS). The present study was designed to
      find out the rate of thoracic outlet anomalies in the general population.
      METHODS: Fifty cadavers representing a general population were subjected to a
      total of 98 meticulously performed cervical dissections to ascertain the
      frequency of congenital anomalies in the thoracocervicoaxillary region. RESULTS:
      During the 98 cervical dissections, 62 instances of abnormal anatomy of the
      thoracic outlet were found, and fully normal anatomy was found in 36 cases. Of
      the total 69 abnormalies, 66 could be classified according to Roos: 37 were type
      3 abnormalities, 15 were type 5, 9 were type 11, and there was 1 each of type 4,
      type 6, type 7, type 9, and type 10 abnormalities. The remaining 3 abnormalities
      did not fit into Roos' classification. Only 10% (5/50) of the cadavers had a
      bilaterally normal anatomy. CONCLUSIONS: The results demonstrate that abnormal
      structures, such as congenital bands in the thoracic outlet, are more common in
      the general population than had previously been described. We suggest that
      fibrous bands confer a predisposition for TOS following a certain degree of
      stress or injury.

PMID- 7793493
TI  - Classification and treatment of local septic complications in acute pancreatitis.
AB  - BACKGROUND: An international symposium on acute pancreatitis recently developed a
      clinical classification system for severe acute pancreatitis that classifies all
      local septic complications into three groups: infected necrosis (IN), sterile
      necrosis (SN), and pancreatic abscess (PA). Despite the appeal of having three
      distinct, well-defined labels for this complex process, the clinical utility of
      this schema has yet to be determined. The purpose of this study was to
      investigate the prognostic and therapeutic utility of applying this clinical
      classification system to a large group of surgical patients with local septic
      complication from acute pancreatitis. PATIENTS AND METHODS: We reviewed the cases
      of 62 patients with complicated pancreatitis, classifying them into IN (n = 20),
      SN (n = 14), or PA (n = 28) groups. Ranson's score, APACHE II score, and computed
      tomography grading were calculated within the first 48 hours of admission.
      Information on patient demographics, etiology of pancreatitis, operative
      procedures, timing of intervention, bacteriology, blood loss, intensive care unit
      days, ventilator days, and morbidity and mortality were also accrued and
      analyzed. RESULTS: Despite similar demographics and etiology of pancreatitis,
      patients with necrosis, both IN and SN, were more critically ill than were
      patients with PA (APACHE II score > 15, 21% versus 0%, respectively), required
      earlier operative intervention (mean 14 days versus 29 days, P = 0.02), required
      necrosectomy with drainage (65% versus 4%, P < 0.001) rather than simple drainage
      (3% versus 86%, P < 0.001), more reoperations (2.3 versus 1.1, P < 0.05), and had
      a significantly higher mortality rate (35% versus 4%, P < 0.05). In addition,
      patients with IN required significantly more hospital days, ventilator days, and
      blood transfusions than either patients with SN or PA (P < 0.05). CONCLUSIONS: We
      conclude that this classification system allows for the stratification of
      patients into three distinct groups--infected necrosis, sterile necrosis, and
      pancreatic abscess--and has both therapeutic and prognostic usefulness.

PMID- 7793494
TI  - Pitfalls in the diagnosis of blunt diaphragmatic injury.
AB  - BACKGROUND: Severe blunt trauma to the torso can result in diaphragmatic
      disruption. Prompt recognition of this potentially life-threatening injury is
      difficult when the initial chest roentgenogram is unrevealing and immediate
      thoracotomy or celiotomy is not performed. This retrospective study was
      undertaken to: (1) determine the incidence of missed diaphragmatic injuries on
      initial evaluation; (2) identify factors contributing to diagnostic delays; and
      (3) formulate a diagnostic approach that reliably detects diaphragmatic rupture
      following blunt trauma. METHODS: Retrospective review of hospital records and
      radiographs from our 18-year experience with blunt diaphragmatic injuries.
      RESULTS: Seven of 57 (12%) blunt diaphragmatic injuries were missed on initial
      evaluation. Recognition followed 2 days to 3 months later. Two (4%) isolated left
      sided injuries initially presented with normal chest roentgenograms. Five
      patients (9%) (4 with right-sided ruptures) had abnormalities on chest
      roentgenogram or computed tomography (CT) initially attributed to chest trauma.
      They were diagnosed by radionuclide, ultrasound, or CT investigations of
      hemothorax, pulmonary sepsis, and right upper quadrant pain; and, in 1 case, at
      thoracotomy for a persistent right hemothorax. In the remaining 50 patients
      (88%), the diagnosis was established within 24 hours. In 21 (42%) of these, the
      problem was initially recognized at the time of celiotomy for accompanying
      injuries. CONCLUSIONS: Blunt diaphragmatic injuries are easily missed in the
      absence of other indications for immediate surgery, since radiologic
      abnormalities of the diaphragm--particularly those involving the right
      hemidiaphragm--are often interpreted as thoracic trauma. In this setting, a high
      index of suspicion coupled with selective use of radionuclide scanning,
      ultrasound, and CT or magnetic resonance imaging is necessary for early detection
      of this uncommon injury.

PMID- 7793496
TI  - The learning curve for laparoscopic cholecystectomy. The Southern Surgeons Club.
AB  - BACKGROUND: The use of laparoscopic surgical procedures without previous training
      has grown rapidly. At the same time, there have been allegations of increased
      complications among less experienced surgeons. METHODS: Using multivariate
      regression analyses, we evaluated the relationship between bile duct injury rate
      and experience with laparoscopic cholecystectomy for surgeons in the Southern
      Surgeons Club. RESULTS: Fifty-five surgeons performed 8,839 procedures. Fifteen
      bile duct injuries (by 13 surgeons) resulted with 90% of the injuries occurring
      within the first 30 cases performed by an individual surgeon. Multivariate
      analyses indicated that the only significant factor associated with an adverse
      outcome was the surgeon's experience with the procedure. A regression model
      predicted that a surgeon had a 1.7% chance of a bile duct injury occurring in the
      first case and a 0.17% chance of a bile duct injury at the 50th case.
      CONCLUSIONS: While surgeons appear to learn this procedure rapidly, institutions
      might consider requiring surgeons to move beyond the initial learning curve
      before awarding privileges.

PMID- 7793497
TI  - A salvage technique for continuous ambulatory peritoneal dialysis catheters with
      exit-site infections.
AB  - Catheter infection is a major complication of continuous ambulatory peritoneal
      dialysis (CAPD) therapy for end-stage renal disease. Catheter exist-site
      infections were treated with a new surgical technique consisting of dissection
      and removal of the existing catheter in the subcutaneous layer, insertion of a
      catheter connector and new catheter piece, and creation of a new subcutaneous
      tunnel. The new surgery can be performed on an outpatient basis and allows for
      the continuation of CAPD, thereby avoiding the cost associated with inpatient
      admission and interim hemodialysis.

PMID- 7793495
TI  - Reappraisal of safety of endoscopic sphincterotomy for common bile duct stones in
      the elderly.
AB  - BACKGROUND: Endoscopic sphincterotomy is the method of choice for elderly
      patients with common bile duct stones, even though these patients are poor
      operative risks. We undertook this study to analyze the operative risk factors
      for this age group. METHODS: We compared specific problems of 182 patients aged
      80 years or older and 921 younger patients who underwent endoscopic
      sphincterotomy for common bile duct stones. RESULTS: Despite a higher frequency
      of periampullary diverticula in the elderly than in the younger patients (54%
      versus 36%, P < 0.001), the success rates of sphincterotomy were not different.
      The elderly patients required lithotripsy more often than did the younger ones
      (15% versus 4%, P < 0.001), and the necessity of stenting or nasobiliary drainage
      was greater in this group (9%) than in the younger group (5%, P < 0.05). This
      difference in the tactics between the older and younger groups was due to the
      greater number and size of stones, longer period of time for complete clearance
      of the common bile duct (13.5 versus 6.0 days, P < 0.01), and a greater
      percentage of patients with operative risks (55% versus 36%, P < 0.001). The
      elderly also had significantly greater overall morbidity compared with the
      younger patients (13% versus 7%, P < 0.005), frequency of acute cholangitis (8%
      versus 2%, P < 0.001), and mortality (1% versus 0%). CONCLUSION: These results
      suggest that frequent stenting or nasobiliary drainage to prevent cholangitis or
      prompt stone removal by lithotripsy would be necessary in this group of patients.

PMID- 7793498
TI  - A technique for laparoscopic repair of herniation of the anterior abdominal wall
      using a composite mesh prosthesis.
AB  - Improved laparoscopic techniques have engendered many new gastrointestinal and
      other intracavity abdominal procedures. Groin hernias have also been repaired
      with the assistance of the laparoscope via both transperitoneal and properitoneal
      approaches, but less emphasis has been placed upon repair of hernias of the
      anterior abdominal wall. A technique for the transperitoneal, laparoscopic repair
      of anterior abdominal wall hernias using a composite mesh prosthesis is
      presented. The technique is applicable to hernias in many locations.

PMID- 7793500
TI  - Obturator hernia needs a laparotomy, not a diagnosis.
AB  - The obturator hernia is rare, accounting for only 0.05% of all hernias and 0.2%
      of all small-bowel obstructions requiring laparotomy at our institution.
      Typically, there is a delay in diagnosis and surgical intervention, despite the
      presence of a bowel obstruction. A laparotomy is needed, not a preoperative
      diagnosis.

PMID- 7793499
TI  - Efficacy of intraportal injection of anti-ICAM-1 monoclonal antibody against
      liver cell injury following warm ischemia in the rat.
AB  - BACKGROUND: Increased expression of intercellular adhesion molecule-1 (ICAM-1)
      and lymphocyte-function-associated antigen-1 (LFA-1) has been reported to play a
      major role in reperfusion injury after ischemia. In the present study we tested
      the effects of anti-rat-ICAM-1 monoclonal antibody (1A29) on partial-liver warm
      ischemia in rats. METHODS: Histological changes and expression of ICAM-1 and LFA
      1 were investigated in rat partial-liver warm ischemia, performed by clamping
      hepatic hilar vessels distributing to the right lateral lobe for 30, 45, and 60
      minutes. In a second study, the effects of intraportal 1A29 injection after 60
      minutes of warm ischemia in the rat were examined histologically. In both
      studies, the liver tissue was removed for analysis 48 hours after clamping.
      RESULTS: Reperfusion after 60 minutes of warm ischemia induced histological liver
      injury and strong expression of ICAM-1 and LFA-1, although 30 and 45 minutes of
      ischemia did not provoke either histological damages or the expression of ICAM-1
      and LFA-1. Intraportal injection of 1A29 after 60 minutes of warm ischemia
      clearly suppressed liver cell injury histologically. CONCLUSION: Intraportal
      injection of 1A29 prevented the histological inflammation of an ischemic liver
      and may be useful in liver surgery or liver transplantation, because high
      concentrations can reach the target organ and nonspecific immunosuppression in
      other tissues and organs can be decreased.

PMID- 7793501
TI  - Diagnosis and management of malignant pleural effusions.
AB  - Approximately half of all patients with metastatic cancer develop malignant
      pleural effusions. Because the patients are already terminally ill, these
      effusions can present significant diagnostic and therapeutic challenges. Symptoms
      are either present at the time of diagnosis or develop subsequently in virtually
      all cases. The diagnosis is based on chest radiography followed by thoracentesis
      or thoracoscopy. Most malignant effusions are exudative and about one third are
      bloody. Cytology is positive for cancer cells in the initial pleural fluid
      specimens from 60% of patients who are ultimately shown to have malignant
      effusions. The remaining 40% require a repeat thoracentesis, pleural biopsy,
      thoracoscopy, or multiple procedures to prove the presence of cancer. Because the
      average life expectancy of a patient with a malignant pleural effusion is about 6
      months, it is important to obtain a diagnosis expeditiously and formulate a
      treatment plan that optimizes quality of life. Tube thoracostomy with chemical
      pleurodesis using doxycycline or bleomycin is the mainstay of current treatment
      and is about 85% effective.

PMID- 7793503
TI  - Alternate hemihepatic vascular control for hepatic resection.

PMID- 7793502
TI  - Transplantation of keratinocytes in the treatment of wounds.
AB  - BACKGROUND: Keratinocyte grafting can be used to treat acute traumatic and
      chronic non-healing wounds. The keratinocyte sheets are fragile and clinical
      "take" is difficult to assess, especially as activated keratinocytes secrete many
      growth factors, which have effects on wound healing apart from take. We have
      developed animal models of grafting that allow us to examine factors influencing
      autologous keratinocyte graft take. Results show clearly that pretreatment of the
      wound bed with viable dermis greatly increases the take of keratinocyte grafts.
      DATA SOURCES: International literature. CONCLUSIONS: As a greater understanding
      of the complex interactions of cell and matrix evolve, so will potential
      therapeutic maneuvers, not just in the field of cultured keratinocyte grafts, but
      clearly in that of benign tumors, for example, keloids, and that of oncology.
      There is now overwhelming evidence of the requirement for a dermal substitute for
      cultured keratinocyte autografts, and the sheet complexity of the situation
      demands that this should approximate live human dermis as closely as possible.
      The stumbling blocks relate to avoiding the risks of viral transmission, tissue
      matching of host and donor, providing early epithelial cover, and improving
      delivery systems for fragile keratinocyte grafts.

PMID- 7793504
TI  - Prognostic factors in paranasal sinus cancer.
AB  - PURPOSE: This study was designed to evaluate the influence of several different
      prognostic factors in determining both local recurrence rates and survival in
      patients treated for carcinoma of the paranasal sinuses. MATERIALS AND METHODS: A
      retrospective study of patients treated between January, 1975 and December, 1991
      was undertaken. Hospital charts were reviewed collecting demographic, clinical,
      and radiographic findings, which were correlated with treatment and subsequent
      follow-up. RESULTS: Carcinoma of the paranasal sinuses was identified in 129
      patients. This included 95 men and 34 women with an average of 59 years. The
      ethmoid sinus was primarily involved in 50 patients, the maxillary sinus and 49,
      the nasal sinus and 25, sphenoid sinus in three in the frontal sinus and two
      patients. Advanced stage (T3/T4) was diagnosed in 60% of patients at
      presentation. The most commonly encountered histologies were squamous-cell
      carcinoma and adenocarcinoma. The most accurate predictors of poor prognosis were
      advanced T stage and involvement of the anterior skill base. Involvement of the
      posterior wall of the maxillary sinus, infratemporal fossa, and erosion of the
      orbital wall was not associated with the worst prognosis. CONCLUSION: In spite of
      advances in imaging technique and surgical therapy, the primary cause of death is
      inability to control local disease. Diagnosis at an earlier stage is associated
      with improved outcome.

PMID- 7793506
TI  - Wegener's granulomatosis of the orbit: lacrimal gland involvement as a major
      sign.

PMID- 7793505
TI  - Adenosquamous carcinoma of the larynx.

PMID- 7793507
TI  - Hydatic cyst in the head and neck area.

PMID- 7793508
TI  - Laryngeal chondrosarcoma: two unusual cases.
AB  - Although CS is the most common mesenchymal tumor of the larynx, there have only
      been approximately 200 cases reported to date. The nature, diagnosis, and
      management of these tumors are discussed. Although conservative therapy is
      acceptable in most instances, total laryngectomy may be opted for in cases of
      extensive tumor, high-grade lesions, and recurrences. CO2 laser excision for
      palliation has been shown to be a viable alternative in patients with high
      operative risk. It is also shown that the behavior of these tumors is
      predictable, though not without some variation. Although these tumors are rare,
      CS must be considered when presented with a solid subglottic or neck mass.

PMID- 7793509
TI  - Imaging facial pain of trigeminal origin.

PMID- 7793510
TI  - Therapeutic embolization for control of epistaxis in a patient with hereditary
      hemorrhagic telangiectasia.
AB  - This article describes a woman with hemorrhagic telangiectasia, or Osler-Weber
      Rendu disease, with recurrent nosebleeds despite prior septal dermoplasty and
      laser treatments. Telangiectasias were clearly shown at the time of angiography.
      Embolization of abnormal vessels on both sides resulted in cessation of epistaxis
      for many months. Bilateral studies are important, even when the epistaxis seems
      to be unilateral.

PMID- 7793511
TI  - Medicine and art: facial palsy depicted in archaic Greek art on Crete.
AB  - A small earthenware statuette was evacuated from the votive-depot of acropolis of
      Gortys, an ancient town in South-Crete/Greece. This ex-voto is dated
      approximately 7th to 6th century BC and very probably represents some symptoms of
      a stroke, especially the left facial palsy and the contracture of the left arm.
      Since the Minoan time until today, people of Crete have been offering ex-votos to
      gods or saints to ask for help in specific diseases.

PMID- 7793512
TI  - The management of the lower eyelid in facial paralysis.

PMID- 7793514
TI  - [A parallel comparison between cytological and cervicographic screening in early
      pregnancy].
AB  - The aim of this study is to compare the diagnostic possibilities of cytologic and
      cervicographic screening of the cervix uterus in patients with early pregnancy.
      Fifty-four patients between the ages of 20 and 37 were examined cytologically and
      cervicographically in a prospective screening study. The dependability of each of
      the diagnostic tests was measured histologically (with the patient's approval)
      using punch biopsy under colposcopic control. The histologic results showed the
      presence of CIN in 9 women (16.7%), 8 of them with CIN I and one with CIN III.
      The rest of examined patients (45) had normal of various inflammatory findings.
      The analysis of the obtained results confirm a statistically significant
      difference between the two diagnostic, screening methods. The cervicographic
      examination is considerably more sensitive in finding CIN-44.4% compared to 22.2%
      of the cytology. Whereas the cytological method has a higher specificity as a
      test in determining the healthy patients-91.1% versus 51.2% of the cervicography.
      12 or 22.2% of the cervicograms were technically defective.

PMID- 7793513
TI  - Interleukin-8 gene expression in chronic sinusitis.
AB  - PURPOSE: Interleukin-8 (IL-8), a monocyte-derived and macrophage-derived
      cytokine, displays potent chemotactic activating properties toward neutrophils
      and thus may contribute to the pathogenesis of chronic sinusitis. The object of
      this investigation was to show the expression of the IL-8 gene in chronic
      sinusitis by Northern blot analysis and a reverse transcription-polymerase chain
      reaction (RT-PCR). MATERIALS AND METHODS: For Northern blot analysis, RNAs were
      extracted from maxillary mucosa and nasal polyps from two patients with chronic
      sinusitis, respectively, and from the inferior turbinate of a nasal allergy
      patient. For RT-PCR, RNAs were extracted from 11 patients with chronic sinusitis,
      8 patients with allergic rhinitis, and 4 patients with hypertrophic rhinitis.
      RESULTS: Whereas IL-8 mRNA was expressed in the maxillary mucosa, IL-8 transcript
      was not detected in the inferior turbinate by Northern blot analysis. IL-8
      transcripts were detected in 45% of chronic sinusitis RNAs (5/11) and in 50% of
      allergic rhinitis RNAs (5/10) by RT-PCR. CONCLUSION: These data suggest IL-8 may
      contribute to neutrophil involvement in chronic sinusitis.

PMID- 7793515
TI  - [An epidemic outbreak among newborn infants caused by rotaviruses].
AB  - The authors describe a nosocomial infection of rotavirus gastroenteritis in a
      Neonatal Intensive Care Unit, which affect ten, mainly premature infants. A
      positive coproculture of rotavirus is isolated from 4 symptomatic and 4
      asymptomatic infants. The leading syndrome is that of dehydration in 80% of the
      cases, attended by moderately expressed diarrhoea and vomitus. The main
      laboratory sign is marked metabolic acidosis in 80% of the patients. An effective
      pathogenetic therapy is implemented which eliminates the infection in 2 months
      without lethal exitus.

PMID- 7793516
TI  - [The current aspects of hospital infections in maternity and neonatal wards].
AB  - The epidemiologic, etiologic and clinical structure of HAI in the maternity and
      neonatal wards in the country for the 1982-1992 period has been specified. 934
      women in child-birth and 2357 neonates acquire nosocomial infections at an
      average annually. A comparatively constant level in HAI epidemic process
      intensity is observed with inconsiderable diversions in the beginning and by the
      end of the studied period. Staphylococci like causative agents of HAI take up a
      leading place in both types of wards with especially marked incidence rate among
      the newborn children. The predominant clinical forms in the women in child-birth
      are the surgical wound infections, skin and genital infections and in the
      neonates--the staphylodermatites, upper respiratory airway infections, pulmonary
      and enteric infections.

PMID- 7793517
TI  - [Genital chlamydial infection in women studied with the new Clearview Chlamydia
      diagnostic test].
AB  - For the first time in Bulgaria a clinical investigation was carried out using the
      direct antigen test Clearview Chlamydia for the diagnosis of Chlamydia infection
      in gynaecologic patients 130 women were examined in whom chlamydial infection was
      suspected. 43 patients (out of 130) were positive. The conclusion of the study is
      that the clinical signs of female genital chlamydial infection are not specific
      and for the exact diagnosis a laboratory test for detecting Chlamydia trachomatis
      must be carried out. The new diagnostic test Clearview Chlamydia is easy and
      rapid to perform and could be very useful for the office practice.

PMID- 7793518
TI  - [The static and dynamic profiles of urethral pressure in women with stress
      incontinence and in healthy controls].
AB  - The study presents the results of urethral pressure profile measurements in 3
      groups of women: continent nulliparous, continent parous and stress incontinent
      women. The maximum urethral closure pressure, the functional urethral length and
      the length of continence zone are compared. The healthy control groups (both
      parous and nulliparous) show much higher maximum urethral closure pressures than
      those mentioned in literature. No difference is evident between continent parous
      and continent nulliparous which suggests that vaginal delivery at term does not
      necessarily impair urethral sphincteric function. On the other hand women with
      similar age and parity with stress incontinence have a marked decrease of maximum
      urethral closure pressure at rest and demonstrate inability to increase it by
      volitional contraction of the pelvic floor. These findings support the idea of
      the leading role of sphincteric incompetence in stress incontinence. The
      functional urethral length and the length of continence zone show no significant
      differences among the investigated groups which implies that they are of no
      importance for the occurrence of stress incontinence.

PMID- 7793520
TI  - [The potentials of computed axial tomography (CAT) in the diagnosis of carcinoma
      of the cervix uteri].
AB  - 14 women with diagnosis Ca colli uteri Ib stage were investigated. CAT (computer
      axial tomography) was carried out before and after surgery (Wertheim). CAT gave a
      picture of the tumor lesion as well as of the regional lymph nodes. This method
      proved fast, efficient and non invasive for the correct diagnosis of Ca colli
      uteri and surgery effect.

PMID- 7793519
TI  - [Uterine sonography as a method for the early detection and screening of
      endometrial carcinoma in women in the postmenopause with and without diabetes
      mellitus].
AB  - An attempt was made to examine the efficiency of the uterus sonography as a
      method for screening of endometrial cancer in postmenopausal women with or
      without diabetes mellitus for ten years period. 150 patients with diabetes
      mellitus and 150 patients from control group without diabetes mellitus were
      subjected to progesterone ampule 250 mg im. After bleeding occurred there were
      performed uterus sonographies before the abrasion probatoria, after the abrasion
      probatoria and on the 6th and 12th months. The performed abrasion probatoria
      showed full correspondence with exception of 3 cases. In 3 patients was found
      polipus endometrill, in one--atypical glandular hyperplasia, one case with
      carcinoma in situ and two cases with endometrial cancer.

PMID- 7793521
TI  - [The use of the Bethesda-terminology cytological system in clinical practice. A
      pilot study].
AB  - The aim of the present study is to summarize the one-year experience in applying
      the Bethesda terminological system (BTS) for assessment of cervical cytology. The
      study was based on 164 women, aged from 18 to 45, of which 98 with early
      pregnancy and 66 not pregnant. The materials for cytological examination were
      prepared by classical techniques and then coloured with hemalaun-eosin.
      Cytological findings were interpreted according to the revised BTS (1991), and an
      assessment of the adequacy of smears, possible infectious and reactive changes
      was made. Intraepithelial lesions were classified in two categories--low and high
      grade lesions. The advantages and shortcomings of the proposed new
      terminological, cytological classification system for assessment of the uterine
      cervix are discussed.

PMID- 7793523
TI  - [Premature rupture of the amniotic sac with a term fetus and low pelvic score-
      its management].
AB  - The author gives to us the results of the labour the rupture volamentorum ovi
      precocs to term--baby & low pelvic score about the period of 4 years (1987-1990).
      The analysis of results of two labours gives an opportunity to make the
      conclusions, which give a method of labour in clinic of Obstetrics & Gynaecology
      St. Zagora, giving a good results.

PMID- 7793522
TI  - [Contraception among adolescents].
AB  - Adolescence is a period of which the contraception is difficult, because of lower
      compliance of the teenagers to this methods. The authors were observed the
      contraceptive uses in 792 pregnant adolescent girls, 264 of which with abortions
      (group A) and 528 teen-age mothers (group B). Only 12.88% of all patients have
      used birth control methods, usually with low and middle effects. We founded only
      15 patients (1.89%) practiced hormonal contraception and 1 case (0.13%) with
      Intrauterine devise. The condoms for men was the most popular and useful in
      teenagers (4.23%), and Natural family planning methods were practiced from 52
      (6.57%) patients. There was the statistically differences between adolescent
      girls included in group A and B about their contraceptive behaviors and live
      standards (p < 0.01). By the kind of contraceptive methods, there was a high
      differences in the teenagers with a hormonal uses (p < 0.05).

PMID- 7793524
TI  - [Myxoid myomas of the uterus].
AB  - Two cases of myxoid smooth muscle tumours of the uterus have been reported.
      Clinical and morphological characteristics are briefly described. Inspite of the
      lack of cellular and nuclear atypia and mitotic figures below 2 in 10 high power
      fields, the clinical course was very malignant. A review of the literature on
      this new entity from the last 10-12 years has been made.

PMID- 7793525
TI  - [Puerperal involution of the uterus--its ultrasonic follow-up].

PMID- 7793526
TI  - [Septic (endotoxic) shock in parturients--its management during labor and in the
      puerperium].
AB  - Author provides a description of septic shock in a parturient. He analyses the
      clinical cause and proposes a therapeutic behaviour during labour and puerperium.

PMID- 7793528
TI  - [Myoma combined with a giant degenerating myomatous nodule].

PMID- 7793527
TI  - [Neonatal infections caused by Streptococcus group B--their epidemiology,
      clinical picture, diagnosis, treatment and prevention].

PMID- 7793529
TI  - [The diagnostic and surgical difficulties in abortion on demand in a woman with a
      bicornate uterus and an ovarian cyst].

PMID- 7793530
TI  - [A clinical trial with the monophasic contraceptive Marvelon].
AB  - The authors present their clinical experience with a monophasic preparation
      consisting of 30 mcg ethynyl estradiol and 150 mcg desogestrel (Marvelon,
      Organon). 121 cycles of 24 fertile women were followed. The results show a full
      contraceptive success, a stable cycle control as well as a low incidence of the
      side effects.

PMID- 7793531
TI  - [Transdermal estradiol--the possibility for replacement therapy in the
      postmenopause].
AB  - The author presents his experience in the treatment of 21 early postmenopausal
      women (mean age of 49.2 yrs) with transdermal delivery of 17 beta-oestradiol
      (Estraderm TTS, Ciba). During the treatment Kuppermann index falls from 28.5 to
      10.9. Karyopyknotic index increases from 6.8 to 23.4 and maturation index moves
      from 39:52:9 to 0:71:29. Genital bleeding occurs in 52% of the patients. The
      author concludes that the treatment with transdermal delivery of oestradiol could
      be used more widely for replacement therapy in the postmenopause.

PMID- 7793532
TI  - [Pregnancy and labor in young girls].
AB  - The premature sexual contacts in adolescence are the most important factor for
      the high rate of teenage pregnancies. The authors were observed 528 pregnancies
      in adolescent girls (aged 13-17 years) and 100 mothers at their 20-24 years, as a
      control group. There were significant differences between the education level,
      ethnic origin and professional status in our populations. We founded in
      adolescent group anaemia in 13.64%, an overweight in 6.44% and preeclampsia
      eclampsia in 3.22%. The rate of premature delivery was higher (17.99%), caesarean
      section were performed in 5.44% and instrumental extraction was practiced in
      1.70% of adolescent girls. Despite an pregnancy and delivery with a normal
      evolution, the mother-fetal prognoses were complicated from the hard
      psychoemotional, social and economical problems about these young mothers.

PMID- 7793535
TI  - Clinical studies with agents active on the 5-lipoxygenase pathway.
AB  - Leukotrienes may be considered asthmatic mediators. Compounds inhibiting their
      production and activity show promise in the treatment of asthma. Further clinical
      studies will determine the clinical usefulness of such agents.

PMID- 7793536
TI  - Future of anti-inflammatory therapy in asthma.

PMID- 7793534
TI  - The airway inflammatory response in allergic asthma and its relationship to
      clinical disease.
AB  - Endobronchial biopsy and lavage studies have revealed the presence of mast cell,
      eosinophil, T-lymphocyte and epithelial cell activation in asthma, along with the
      structural changes of tissue eosinophil infiltration, loss of superficial
      columnar ciliated epithelial cells and enhanced collagen deposition in the
      laminar reticularis. As these cellular and structural changes underlie the
      clinical features of asthma, i.e., symptom expression, variable airflow
      obstruction and bronchial hyperresponsiveness, and understanding of their
      induction and regulation is essential to the understanding of the asthmatic
      process. The acute airway response to allergen has been studied by the technique
      of local endobronchial allergen challenge with direct airway sampling in asthma.
      These studies identify allergen-mast cell interaction as the initial airway
      event, with mediator release inducing bronchoconstriction and enhancing vascular
      permeability. As preformed cytokines are present in mast cells, cytokine release
      from this cell population is likely to initiate the process of endothelial cell
      activation, with upregulation of cell adhesion molecules, and tissue cell
      recruitment. Subsequent cytokine elaboration from airway macrophages and T
      lymphocytes will perpetuate this response while in chronic clinical disease T
      lymphocytes, mast cells, matrix tissue, epithelial cells and eosinophils
      themselves are all likely to contribute to the cytokine pool within the airways
      and thus to the regulation of inflammatory cell migration and activation.

PMID- 7793533
TI  - [Prolonged pregnancy and trace elements: iron].
AB  - Iron is an essential trace element and it is well known that the iron requirement
      steadily increase during pregnancy. The aim of this investigation was to compare
      the serum iron levels in normal and serotine pregnancy. Twenty-six women with
      serotine pregnancy (19 in 42 and 7 in 43 gestation week (g.w.)) were included in
      the study. The control group is consisted from 74 women with normal pregnancy.
      The serum iron concentration is elevated in the women with serotine pregnancy
      (24.59 +/- 11.60 mmol/(l), but the difference was not significant. The group with
      serotine pregnancy in 42 g.w. has even lower serum iron concentration than the
      women with normal pregnancy (19.44 +/- 6.52 mmol(l). The serum iron concentration
      was significantly elevated (p < 0.001) in serotine pregnancy in 43 g.w. compared
      with normal pregnancy as well as with serotine pregnancy in 43 g.w. The possible
      pathogenetic mechanisms of the observed changes are discussed.

PMID- 7793537
TI  - The role of indoor allergens in asthma.

PMID- 7793538
TI  - Recognition of the anaesthetist.

PMID- 7793540
TI  - Cardiovascular and catecholamine response to surgery in brain-dead organ donors.
AB  - Eleven brain-dead organ donors were studied during surgery. Plasma levels of
      adrenaline and noradrenaline were measured before and after skin incision, upon
      sternotomy and 15, 30 and 45 min thereafter. Haemodynamic changes were measured
      continuously throughout the observation period. Blood pressure and heart rate
      increased after skin incision, remained high at sternotomy then decreased towards
      the end of the observation period in six of the 11 patients. Plasma
      catecholamines increased promptly with the onset of surgical stimuli. We conclude
      that surgical stress can evoke an excessive rise of plasma adrenaline and
      noradrenaline and thus could impair allograft function.

PMID- 7793539
TI  - A prospective study to assess the demand for a high dependency unit.
AB  - We performed a prospective study in our teaching hospital to determine the demand
      for a High Dependency Unit where none had existed before. An admission criteria
      protocol was designed for medical and surgical patients and this was used in an
      intense surveillance of 22 acute wards over 2 weeks. It was predicted that a high
      dependency unit of eight beds would operate to capacity 50% of the time. An
      analysis of this type over a short period of time using similar admission
      criteria could be used to assist in the prediction of the necessary size of a
      High Dependency Unit facility in any hospital.

PMID- 7793541
TI  - Time course of action and intubating conditions following vecuronium, rocuronium
      and mivacurium.
AB  - The purpose of this study was to compare the time course of action and tracheal
      intubating conditions of vecuronium, rocuronium and mivacurium in anaesthetised
      patients. Anaesthesia consisted of thiopentone, fentanyl, N2O/O2 and isoflurane.
      After a 2 x ED90 dose the first attempt at tracheal intubation was made at 90 s.
      If required, maintenance doses of 0.5 x ED90 were administered. The intubating
      conditions after rocuronium were significantly better than those after vecuronium
      and mivacurium. The average onset times of rocuronium (172 s) and vecuronium (192
      s) were significantly shorter than that of mivacurium (229 s). The clinical
      duration and recovery time were significantly shorter after mivacurium (13 and 6
      min, respectively) than with vecuronium (33 and 14 min, respectively) and
      rocuronium (28 and 11 min, respectively). We conclude that rocuronium might be of
      advantage whenever the interval between the administration of the muscle relaxant
      and tracheal intubation must be short, whereas mivacurium may be of benefit if
      fast spontaneous recovery is required.

PMID- 7793542
TI  - The influence of nitrous oxide on propofol dosage and recovery after total
      intravenous anaesthesia for day-case surgery.
AB  - We studied the influence of nitrous oxide on the maintenance dose of propofol and
      recovery characteristics in 42 patients, aged 18-62 years, ASA 1 or 2, scheduled
      for day case inguinal herniotomy. Using a double-blind, randomised design,
      patients received anaesthesia with propofol-alfentanil-vecuronium-oxygen and
      either nitrous oxide or room air (FIO2 = 0.30). The rate of propofol infusion was
      adjusted depending on anaesthetic depth as judged using standard clinical
      criteria; alfentanil was administered on a weight basis. Patients' lungs were
      manually ventilated after tracheal intubation and muscle relaxation was reversed
      at the end of surgery with neostigmine and atropine. A series of psychomotor
      tests was performed pre-operatively and 30 and 120 min postoperatively. The mean
      maintenance doses of propofol were 0.084 mg.kg-1.min-1 in the N2O group and 0.088
      mg.kg-1.min-1 in the air group (p = 0.97). In the nitrous oxide group the mean
      (SD) interval to spontaneous eye opening was 13.1 (7.3) min compared to 8.1 (4.9)
      min in the air group (p = 0.01). Similarly, the interval until obtaining a
      standardised response was 13.5 (5.3) min and 9.8 min (5.4) in the nitrous oxide
      and air groups, respectively (p = 0.04). The addition of nitrous oxide to
      propofol-alfentanil-vecuronium anaesthesia does not reduce propofol requirements
      and prolongs early recovery compared to air.

PMID- 7793543
TI  - Local anaesthesia for cannulation. Has practice changed?
AB  - A questionnaire study was undertaken to assess the influence of recently
      published, simple and conclusive research on the practice of anaesthetists in
      four centres. The research had clearly demonstrated the benefit of subcutaneous
      infiltration of local anaesthetic in reducing the pain of intravenous
      cannulation. Of the 81% who responded, 71% were aware of the research; 43% of
      these anaesthetists had altered their clinical practice as a result of the
      research and 73% used local anaesthesia for cannulae of 18 gauge or less,
      compared with only 46% of those who were unaware of the research. Practice
      comparisons were made between centres and grades of anaesthetist. Senior house
      officers were significantly less likely to be aware of the research than other
      grades. Anomalies were identified between the apparent awareness of the research
      and routine practice agreeing with the study findings. The value of research and
      the incorporation of clinical findings into everyday practice is discussed.

PMID- 7793544
TI  - Prevention of nausea and vomiting after day case gynaecological laparoscopy. A
      comparison of ondansetron, droperidol, metoclopramide and placebo.
AB  - We have compared the efficacy of ondansetron, metoclopramide, droperidol and
      placebo in the prevention of postoperative nausea and vomiting in 118 day stay
      patients undergoing laparoscopic gynaecological procedures. All received a
      standardised general anaesthetic of fentanyl, propofol, nitrous oxide in oxygen
      and isoflurane. Three to five min before induction of anaesthesia, patients were
      allocated to receive ondansetron 4 mg, metoclopramide 10 mg, droperidol 1 mg or
      placebo in a randomised, double-blind manner. Visual analogue scores for nausea,
      the incidence of emetic episodes, and analgesic and antiemetic consumption were
      recorded for 48 h postoperatively. The scores for nausea were significantly lower
      in the ondansetron group (p < 0.01) compared with the other three groups at 1, 2
      and 4 h after operation; thereafter there was no difference. The incidence of
      emesis was lower (p = 0.063) and time to first oral fluids was shorter (p < 0.05)
      in the ondansetron group. Oral analgesic requirements were significantly greater
      in the ondansetron group over the 48 h study period. Two patients, one each in
      the placebo and metoclopramide groups, had to remain in hospital overnight
      because of persistent emetic symptoms.

PMID- 7793545
TI  - Comparison of central venous pressure measurements in the intrathoracic and the
      intra-abdominal vena cava in critically ill children.
AB  - A prospective study was conducted to compare simultaneous intrathoracic and intra
      abdominal central venous pressures in 10 critically ill, ventilated paediatric
      intensive care patients. Central venous pressures were measured using the water
      column technique over a 6 h study period. There was excellent correlation between
      intrathoracic and intra-abdominal vena caval pressure measurements (r = 0.974, p
      < 0.001). The difference between paired measurements did not exceed the limits of
      agreement (+/- 2SD, -2.36 to 4.42 cm H2O). The mean (SD) difference between
      readings was small (1.03 +/- 1.69 cmH2O) and was within clinically tolerable
      limits. These data suggest a clinically useful, close relationship between intra
      abdominal and conventional intrathoracic central venous pressure measurement in
      this group of patients.

PMID- 7793546
TI  - Somatosensory evoked potential changes following electro-acupuncture therapy in
      chronic pain patients.
AB  - Somatosensory evoked potentials were recorded in 20 healthy volunteers and 20
      patients with chronic pain undergoing electro-acupuncture therapy. The values of
      absolute peak latency and amplitudes of N19 and P22 in the control group were
      compared with the corresponding baseline values in the study group and after
      electro-acupuncture therapy at three stages during a 10-treatment cycle. On these
      occasions the intensity of pain was recorded using a 100 mm visual analogue scale
      score. Each patient in the study group had 10 treatments given on alternate days.
      The absolute peak latency of N19 was significantly delayed (p < 0.05) in chronic
      pain patients when compared to the control group. This increase in latency of N19
      persisted after the first electro-acupuncture treatment (p < 0.05), tended to
      revert to normal after the fifth treatment (p > 0.05) and reverted completely to
      control values after the 10th treatment (p > 0.05). Visual analogue scores also
      decreased significantly (p < 0.05) after the fifth and 10th electro-acupuncture
      sessions. These observations suggest that there is an interaction of the neural
      mechanisms of electro-acupuncture with the thalamic generator of somatosensory
      evoked potentials i.e. N19.

PMID- 7793547
TI  - Epidural infusion of alfentanil or diamorphine with bupivacaine in labour--a dose
      finding study.
AB  - Following induction of epidural analgesia with 0.375% bupivacaine, 120 healthy
      parturients were randomly assigned in a double blind fashion to one of eight
      infusion groups. All received 8 ml.h-1 of 0.125% bupivacaine either alone
      (control group), or with alfentanil at 133, 266 or 400 micrograms.h-1 (groups A1
      A3) or with diamorphine at 133, 266, 400 or 533 micrograms.h-1 (groups D1-D4).
      Significantly longer top-up intervals were achieved with the two highest doses of
      both alfentanil and diamorphine when compared with bupivacaine alone (p < 0.01),
      making the minimum effective doses 266 micrograms.h-1 of alfentanil and 400
      micrograms.h-1 of diamorphine. Perineal analgesia was better in all the opioid
      groups compared with the control group (p < 0.05). The intensity of motor block
      was greater in the control group (p < 0.05). The incidence of pruritus did not
      differ between groups. The highest dose of diamorphine caused significantly more
      nausea. No significant neonatal side-effects were demonstrated.

PMID- 7793548
TI  - Epidural infusions of bupivacaine and diamorphine in labour.
AB  - Three different concentrations of bupivacaine, 0.125%, 0.062% and 0.031%, all
      with diamorphine 0.0025%, were given as an epidural infusion at 10 ml.h-1 to 63
      mothers in labour. When the three infusions were compared, significant
      differences were found in maternal requirements for top-ups and the degree of
      motor block, but there were no differences in the pain scores. The reduced motor
      block was not associated with a reduction in the instrumental delivery rate.

PMID- 7793550
TI  - Measurement of tidal flow using a transit-time ultrasonic breath analyser.
AB  - The ability of the Transit-time Ultrasonic Breath Analyser (TUBA, GHG Medical
      Electronics GMBH, Zurich, Switzerland) to measure peak flow and tidal volume in
      the laboratory was tested using a variety of flow and pressure conditions, chosen
      to simulate the respiratory patterns of patients receiving mechanical ventilatory
      support. A stable zero baseline was achieved by acoustic damping of the TUBA flow
      sensor head. A piston pump was used to generate sinusoidal flow pattern, with a
      peak flow range from 0.1 to 1.51.s-1. The calculated peak flow matched the peak
      flow measured by the TUBA. The TUBA accurately measured tidal volumes (+/- 10%)
      delivered using three different flow patterns over a range of volumes from 0.25
      to 11. We conclude, that once modified, the TUBA can provide an accurate
      measurement of peak flow and tidal volume over a range of values likely to be
      encountered during mechanical ventilation of the lungs.

PMID- 7793549
TI  - Evaluation of the influence of movement on saturation readings from pulse
      oximeters.
AB  - This study aimed to develop a protocol for assessing the influence of movement on
      oxyhaemoglobin saturation readings from pulse oximeters. Thirty-six volunteers
      took part in the study. In each volunteer, each hand was monitored by both a
      Nellcor N200 oximeter using a disposable probe and by a Datex Satlite DS103
      oximeter using a clip-on finger probe. Volunteers made five standardised
      movements during which output was recorded from all four oximeters. All movements
      were associated with apparent decreases in oxyhaemoglobin saturation which were
      statistically significant for two movements with the Nellcor equipment and for
      four movements with the Datex equipment. Movement was associated with increases
      in the magnitude of pulse amplitude, but this was not quantitatively associated
      with magnitude of artefactual changes in saturation. Use of this standardised
      movement protocol allows quantification of movement artefact from pulse oximeters
      and should facilitate the development of equipment less affected by movement.

PMID- 7793552
TI  - Anaesthetic and postoperative recovery rooms. Some notes on their early history.
AB  - From time to time questions are asked about the origins and history of
      anaesthetic and postoperative recovery rooms. Early accounts of the use of these
      facilities, and their introduction into hospital planning, are reviewed.

PMID- 7793551
TI  - The output of an 'empty' Tec 3 vaporizer.
AB  - The output of 30 Tec 3 vaporizers (halothane, enflurane and isoflurane) was
      studied, starting at the point where no liquid was visible in the content window.
      At 6 l.min-1 and 1% v/v initial output, consistent delivery was on average
      maintained for in excess of 90 (range 55-120) min. Thereafter, output declined
      rapidly. At the flows and concentrations studied there is a significant reserve
      in the vaporizing chamber, but it is likely that when higher flows and
      concentrations are used this reserve may be substantially reduced.

PMID- 7793553
TI  - Deaths associated with anaesthesia. A report on 1,000 cases. 1956.

PMID- 7793554
TI  - An asthmatic weaned from a ventilator using a laryngeal mask.
AB  - A case is described in which a patient was unable to be weaned from ventilatory
      support whilst the trachea remained intubated. She was successfully weaned using
      a laryngeal mask.

PMID- 7793555
TI  - Physostigmine in recovery from anaesthesia.
AB  - Intravenous ketamine anaesthesia has been used by the British army in the field
      for many years. A recognised problem has been the unpredictable recovery profile
      this produces. We anaesthetised 28 ASA 1 patients using a standard British
      military technique. At termination of the anaesthetic, half of the patients were
      given a physostigmine/glycopyrronium mixture and half were given the equivalent
      volume of saline 0.9%. There was a significant difference between the two groups
      with regard to recovery times (p < 0.001). There was no significant difference
      with regard to other variables. In trauma anaesthesia the improved recovery
      profile from the use of physostigmine following ketamine anaesthesia may lead to
      earlier evacuation of the patient.

PMID- 7793556
TI  - Prolonged starvation in paediatric surgery.
AB  - An evaluation of the pre-operative preparation of 285 children attending
      Sheffield Children's Hospital for elective surgery showed that prolonged and
      unnecessary starvation takes place, particularly in children over 1 year of age
      who have their operation in the morning. Excessive starvation of children is
      unkind and unnecessary. In order to prevent it a revision of current starvation
      guidelines is required.

PMID- 7793557
TI  - Analgesia following day-case knee arthroscopy--the effect of piroxicam with or
      without bupivacaine infiltration.
AB  - Sixty patients presenting for day-case arthroscopy of the knee under general
      anaesthesia were studied. Patients were randomly allocated to receive, in
      addition to intramuscular piroxicam 20 mg, either bupivacaine 0.25% 20 ml applied
      locally to the knee at the end of the procedure (n = 30) or no further intra
      operative analgesia (n = 30). Visual analogue pain scores were significantly
      lower at 1, 2 and 4 h postoperatively in the bupivacaine group (p < 0.05). A
      higher proportion of patients in the piroxicam-only group required supplemental
      analgesia before discharge from hospital. The combination of piroxicam and
      bupivacaine provided superior analgesia to piroxicam alone.

PMID- 7793558
TI  - Facilitation of laryngeal mask insertion. Effects of lignocaine given
      intravenously before induction with propofol.
AB  - The effects of pretreatment with lignocaine administered intravenously on the
      insertion of the laryngeal mask airway were investigated in 80 unpremedicated,
      ASA 1 or 2, adult day-case patients in a randomised, double-blind, placebo
      controlled trial. Patients received either intravenous lignocaine 1.5 mg.kg-1 or
      an equivalent volume of sodium chloride 0.9%. Induction of anaesthesia was
      achieved with propofol given via a syringe driver at a fixed rate of 600 ml.h-1
      until the patient dropped a weighted syringe. No opioid or sedative drugs were
      given prior to induction. Pain on injection of propofol was recorded. Jaw
      opening, ease of insertion of the laryngeal mask, coughing, gagging and airway
      patency were all scored on three-point scales immediately after mask insertion re
      attempted. This cycle was continued until success was achieved and the number of
      such cycles recorded. There were no differences between the lignocaine and
      control groups with respect to induction dose of propofol, degree of jaw opening,
      or amount of gagging. Laryngeal mask insertion was facilitated by pretreatment
      with lignocaine administered intravenously, without an alteration in induction
      dose of propofol (p < 0.05). Coughing and airway obstruction were both
      significantly reduced by pretreatment with lignocaine, as was the incidence of
      failure of insertion requiring deepening of anaesthesia (p < 0.05).

PMID- 7793559
TI  - Postoperative shivering.

PMID- 7793560
TI  - Difficulty in inserting a laryngeal mask airway.

PMID- 7793561
TI  - An unusual complication of percutaneous tracheostomy.

PMID- 7793562
TI  - Pretracheal abscess following retrograde tracheal intubation.

PMID- 7793563
TI  - Fentanyl versus morphine for patient-controlled analgesia.

PMID- 7793564
TI  - An unusual complication of intra-osseous infusion during paediatric
      resuscitation.

PMID- 7793566
TI  - Early venous catheter blockade: a cause for immediate concern.

PMID- 7793565
TI  - Visceral vapours.

PMID- 7793567
TI  - Is smoking good for you?

PMID- 7793568
TI  - Continuous spinal anaesthesia and cauda equina syndrome.

PMID- 7793569
TI  - Pain during injection of rocuronium bromide.

PMID- 7793570
TI  - The place of 0.375% bupivacaine in obstetric anaesthesia.

PMID- 7793571
TI  - Another subdural block, or was it?

PMID- 7793572
TI  - Nebulised adrenaline in adults with upper airway obstruction.

PMID- 7793573
TI  - Insertion of the Montgomery T-tube.

PMID- 7793575
TI  - Caution in the use of disposable tubing.

PMID- 7793574
TI  - Age-related haematological disturbances.

PMID- 7793576
TI  - Evaluation of the SMART needle.

PMID- 7793577
TI  - A defective connector.

PMID- 7793579
TI  - Single medial injection pf peribulbar anaesthesia.

PMID- 7793578
TI  - A hazardous modification of a heat and moisture exchanger.

PMID- 7793580
TI  - Murray's chloroform mask.

PMID- 7793582
TI  - Anaesthesia for laser pharyngoplasty--a comparison of the tracheal tube with the
      reinforced laryngeal mask airway.
AB  - A common cause of snoring is palatal flutter which occurs when turbulent air flow
      causes the flexible soft palate to flutter. Surgical correction involves either
      removal of the soft palate or a reduction in its flexibility. Laser
      pharyngoplasty is a new surgical procedure designed to stiffen the soft palate.
      It presents a unique combination of problems for the anaesthetist. In this paper
      we describe the evolution of the anaesthetic technique for laser pharyngoplasty
      and analyse the results of the first 165 cases. Points of particular interest
      include the use of the reinforced laryngeal mask airway compared with the
      tracheal tube and late onset pain.

PMID- 7793581
TI  - Inguinal field block for adult inguinal hernia repair using a short-bevel needle.
      Description and clinical experience in Solomon Islands and an Australian teaching
      hospital.
AB  - One of the limitations of an inguinal field block is that it does not reliably
      produce complete anaesthesia. The purpose of this study was to describe a
      modified short-bevel needle technique, facilitating correct needle placement, for
      inguinal hernia repair. Anaesthetists from two different institutions performed
      the described infiltration blocks. Prospective data were collected from these
      groups, each having 30 patients. We evaluated the safety and reliability of the
      described block. Of the 60 patients, two were "failed" blocks, requiring
      conversion to general anaesthesia. There were no other major intraoperative or
      recovery room complications. Results of the modified inguinal field block showed
      a 97% ability to achieve a "fair" block or better. Intraoperative and
      postoperative data showed high surgeon and patient satisfaction for the block.
      The described block using a short-bevel needle is recommended as a suitable
      method for adult patients undergoing inguinal hernia repair.

PMID- 7793583
TI  - Modulating effects of lignocaine on propofol.
AB  - Pain is a well known complication of propofol injection. Premixing with
      lignocaine 0.1 mg.kg-1 and injection into a large forearm vein has been
      recommended. The amount of lignocaine to be added is often empirical when the
      vein on the dorsum of the hand is used. In this study we attempt to determine the
      optimal amount of lignocaine necessary to reduce pain when propofol is injected
      into a hand vein. Our study shows that a propofol emulsion containing 0.05%
      lignocaine is effective in reducing the incidence of propofol injection pain. The
      addition of lignocaine also reduces the incidence of excitatory effects.
      Increasing the dosage of lignocaine above 0.05% does not improve the results.

PMID- 7793584
TI  - Ketorolac or pethidine for analgesia after elective laparoscopic sterilization.
AB  - Laparoscopic sterilization is commonly performed as a day surgery procedure
      despite difficulties in providing adequate postoperative analgesia for all
      patients. We have examined the analgesic utility of intramuscular ketorolac in
      this setting by comparing it with intramuscular pethidine, both given after
      induction in a randomized, double-blind study in sixty such patients. Although
      the analgesic effects of the two drugs were comparable in the immediate
      postoperative period, ketorolac provided significantly better analgesia four
      hours after surgery (pain score of 2.7 v. 4.2, P = 0.006). The recovery times
      taken to awake, to ambulate and for discharge were all significantly shorter
      after ketorolac (4.6 v. 8.8 min, P = 0.01; 178 v. 260 min, P = 0.0005; 242 v. 320
      min, P = 0.02), and the unplanned admission rate was also significantly less
      after ketorolac (7% v. 33%, P = 0.01). Ketorolac appears to be a useful
      supplement for analgesia after laparoscopic sterilization, providing improved
      analgesia as well as decreased recovery time and fewer unplanned admissions.

PMID- 7793585
TI  - Comparison of halothane, enflurane and isoflurane kidney effects through alanine
      aminopeptidase/urine creatinine values.
AB  - The kidney effects of halothane, enflurane and isoflurane were evaluated by using
      the ratio of urinary excretion of alanine aminopeptidase (AAP) to urine
      creatinine. Thirty patients in ASA class 1 or 2 were studied. None had renal
      disease nor received nephrotoxic drugs. Groups 1, 2 and 3 received halothane,
      enflurane and isoflurane respectively. Creatinine and AAP activities in urine
      spot tests, serum creatinine and BUN levels were determined preoperatively and on
      the first and second postoperative days. Urine AAP activity and AAP/urine
      creatinine values increased significantly on the first and second postoperative
      days compared with the preoperative values in all groups (P < 0.05). The present
      study did not reveal any significant difference in the kidney effects of
      halothane, enflurane and isoflurane through AAP/creatinine in spot urine values.

PMID- 7793586
TI  - Rationalizing venepuncture pain: comparison of lignocaine injection, Butterfly
      (21 gauge and 23 gauge) and Venflon (20 gauge).
AB  - Two hundred and seventy-eight patients scheduled for all types of surgery and
      premedicated with diazepam and metoclopramide were randomly allocated to one of
      four groups to compare the relative pain of an injection of 0.25 ml of lignocaine
      1% via a 25 gauge needle with the pain of the siting of a 21 gauge Butterfly
      (Abbott), 23 gauge Butterfly or a 20 gauge Venflon (Vigo Spectramed). The
      injection of lignocaine and insertion of the 23 gauge Butterfly were associated
      with the least complaints of pain and least observed responses to pain. The 21
      gauge Butterfly and 20 gauge Venflon were associated with complaints of greater
      pain and more pain responses. We conclude that a pre-cannulation injection of
      lignocaine causes minimal discomfort and is the most appropriate means of
      reducing the discomfort of venous cannulation when not using skin penetrating
      analgesic creams.

PMID- 7793587
TI  - Is there a role for selective decontamination of the digestive tract in primarily
      infected patients in the ICU?
AB  - The role of selective decontamination of the digestive tract (SDD) for the
      prevention of nosocomial infection in critically ill patients remains
      controversial, and the efficacy of this technique in patients who are already
      infected on presentation to the intensive care unit has not previously been
      assessed. We performed a double-blind randomized placebo controlled trial of SDD
      (parenteral cefotaxime, six-hourly oral and enteral polymyxin E, tobramycin, and
      amphotericin B vs placebo) for all infected patients presenting to the ICU
      requiring mechanical ventilation for more than 48 hours and ICU stay of more than
      5 days. Daily clinical and microbiological monitoring for secondary infection was
      undertaken until hospital discharge. In all, 59 selective decontamination and 76
      placebo fully comparable patients fulfilled criteria for enrollment and analysis
      (APACHE II 15.2 vs 15.1). The number of patients receiving SDD who developed
      nosocomial infections was significantly reduced (P = 0.048), and there were no
      infections caused by the enterobacteriaceae or Candida spp in this group. No
      difference in ICU (17.5 vs 18.8 days) or hospital stay (32.7 vs 34.2 days) or
      mortality (17% vs 22.3%) was shown. Critically ill, primarily infected patients
      are protected from nosocomial infection by the use of SDD.

PMID- 7793589
TI  - Correction of splanchnic oxygen deficit in the intensive care unit: dopexamine
      and colloid versus placebo.
AB  - Correction of the splanchnic oxygen deficit indicated by low gastric intramucosal
      pH (pHi < 7.35) appears to reduce ICU mortality. Dopexamine hydrochloride is in
      clinical use for this purpose but its efficacy has not been fully investigated.
      We report the results of a prospective, randomized, placebo-controlled study with
      a crossover design to assess the efficacy of dopexamine in correcting low pHi.
      Twelve patients in whom pHi < 7.32 was detected during eight-hourly monitoring
      were randomized to receive either incremental dopexamine (4-6 micrograms/kg/min)
      with colloid or 5% dextrose for three hours prior to crossover. There was no
      difference in pHi between treatments despite cardiovascular effects during
      dopexamine infusion. There was, however, a time-related increase in pHi
      suggesting a beneficial effect of conventional therapy. Dopexamine hydrochloride
      at 4-6 micrograms/kg/min in conjunction with colloid is not a clinically useful
      therapy to correct the splanchnic oxygen deficit indicated by low pHi.

PMID- 7793588
TI  - Bronchoscopic insufflation of room air for the treatment of lobar atelectasis in
      mechanically ventilated patients.
AB  - Segmental and lobar pulmonary atelectasis is a common occurrence in mechanically
      ventilated patients. Standard therapy for atelectasis relies on positive pressure
      ventilation, positive and expiratory pressure (PEEP), tracheobronchial toilet and
      regular chest physiotherapy. Various adjuncts to physiotherapy such as
      bronchoscopic clearance of secretions have not proved to be of additional
      benefit. Bronchoscopic clearance of secretions followed by insufflation of room
      air at 30 cm H2O into the atelectatic segment was employed on ten occasions in
      mechanically ventilated patients. Rapid re-expansion of the collapsed segment or
      lobe occurred in seven out of the ten treatments.

PMID- 7793591
TI  - Problems in the modelling of inert gas kinetics.
AB  - The models used to describe the kinetics of inert gases during underwater diving
      are inadequate. Medical practitioners and scientists interested in such diving
      have attempted to quantitatively describe the behaviour of nitrogen in compressed
      air diving since 1908, with little success. The problems encountered during this
      diving research are relevant to anaesthesia theory and practice.

PMID- 7793590
TI  - The Medical Emergency Team.
AB  - The concept of a Medical Emergency Team was developed in order to rapidly
      identify and manage seriously ill patients at risk of cardiopulmonary arrest and
      other high-risk conditions. The aim of this study was to describe the utilization
      and outcome of Medical Emergency Team interventions over a one-year period at a
      teaching hospital in South Western Sydney. Data was collected prospectively using
      a standardized form. Cardiopulmonary resuscitation occurred in 148/522 (28%)
      calls. Alerting the team using the specific condition criteria occurred in
      253/522 (48%) calls and on physiological/pathological abnormality criteria in
      121/522 (23%) calls. Survival rate to hospital discharge following
      cardiopulmonary arrest was low (29%), compared with other medical emergencies
      (76%).

PMID- 7793592
TI  - Parental presence at induction of anaesthesia: a survey of N.S.W. hospitals and
      tertiary paediatric hospitals in Australia.
AB  - We undertook a survey of N.S.W. hospitals and tertiary paediatric hospitals in
      other States to determine their practice in relation to parental presence at
      induction of anaesthesia of children. There were 135 responses to 174
      questionnaires. Twenty-one indicated that no children were anaesthetized at their
      institution and one was inadequately filled out. One hundred and thirteen
      questionnaires were assessed. Only 44% of departments had an official policy on
      parental attendance. A quarter of all hospitals described their facilities as
      entirely suitable, and a half compromised to allow parents to be present. The
      remaining quarter described their facilities as unsuitable. Overall, two-thirds
      of hospitals never or only sometimes had parents present at induction, and this
      applied equally to day stay patients and inpatients. Tertiary hospitals were more
      likely to have parents present, however they were more likely to have suitable
      facilities. The most common reason cited for parental attendance was parental
      expectation of being present, closely followed by the individual anaesthetist's
      philosophy. The most common reason for parents not attending was the individual
      anaesthetist's philosophy, followed by inadequate staffing.

PMID- 7793593
TI  - Postoperative vomiting in children.
AB  - A survey of the incidence of postoperative vomiting in 1476 children was
      conducted over a two-month period as part of our quality assurance programme. The
      incidence of vomiting was 24%, and was highest in children over three years of
      age and in those receiving opioids. The incidence is lower than that recorded in
      an earlier (1981) survey in our hospital. Changes in anaesthetic practices may
      have contributed to this decrease.

PMID- 7793594
TI  - Continuous intravascular blood gas analysis during aortic aneurysm repair: the
      Paratrend 7.

PMID- 7793595
TI  - Measurement of neuromuscular blockade--a comparison between a new "homemade"
      force displacement transducer and the accelerometer.
AB  - Train-of-four (TOF) ratios are compared between a new homemade force pressure
      transducer and a commercially available accelerometer. Twenty adult patients were
      studied and 600 simultaneous TOF ratio pairs were recorded during anaesthesia
      with varying degrees of muscle relaxation. Laboratory testing revealed that the
      output from the homemade device was linear up to 900 g and that there was a
      linear relationship between the output from the new device and the accelerometer
      (y = 0.802x + 5.167, R = 0.943, t = 69, P < 0.0001). Although the homemade device
      underestimates the accelerometer TOF ratio by 20%, it is a reliable and economic
      alternative to commercially available products for measuring TOF ratios.

PMID- 7793596
TI  - Traumatic tracheal disruption--diagnostic difficulties.

PMID- 7793597
TI  - Diagnosis of cryptantigen exposure and polyagglutinability: management of
      transfusion therapy in a patient with sepsis and colitis.

PMID- 7793598
TI  - Cardiovascular collapse after combined spinal anaesthesia and interscalene
      brachial plexus block.

PMID- 7793599
TI  - Anaesthesia for caesarean section in a patient with acute fatty liver of
      pregnancy.

PMID- 7793600
TI  - Brainstem anaesthesia following a peribulbar block for eye surgery.

PMID- 7793601
TI  - Myocardial dysfunction in a 23-month child with acute poststreptococcal
      glomerulonephritis.

PMID- 7793602
TI  - Fatal hepatic necrosis following cardiac surgery and enflurane anaesthesia.

PMID- 7793603
TI  - Midazolam and parenteral nutrition in the management of life-threatening
      hyperemesis gravidarum in a diabetic patient.

PMID- 7793607
TI  - Bilateral vocal cord paralysis.

PMID- 7793605
TI  - Fatal foetal outcome from diabetic ketoacidosis in pregnancy.

PMID- 7793604
TI  - Envenomation by Ingram's Brown snake (Pseudonaja ingrami).

PMID- 7793606
TI  - Anaesthesia in a patient with agoraphobia.

PMID- 7793608
TI  - Clinical indicators: what does a stay in the recovery room for longer than two
      hours indicate?

PMID- 7793609
TI  - Cancer of the trachea, an unusual presentation.

PMID- 7793610
TI  - Fibreoptic guided intubation: setting up a teaching programme.

PMID- 7793611
TI  - Anaesthesia mortality.

PMID- 7793612
TI  - A non-muscle-relaxant technique for video-assisted thoracoscopic thymectomy in
      myasthenia gravis.

PMID- 7793614
TI  - Anaesthetic alerts.

PMID- 7793613
TI  - Anaesthesia for stenting tracheal stenosis.

PMID- 7793615
TI  - Pacemaker inhibition by calf stimulator.

PMID- 7793616
TI  - The Sprotte spinal needle: spot the introducer!

PMID- 7793617
TI  - Blind nasal intubation is not performed blindly.

PMID- 7793618
TI  - Separation and size determination of circular and linear single-stranded DNAs by
      alkaline agarose gel electrophoresis.
AB  - The electrophoretic mobility of single-stranded DNA (ssDNA) through agarose gels
      depends on size (number of bases; molecular weight), topology (linear or
      circular), and conformation (secondary and tertiary folding through base pairing
      and stacking), as well as on gel concentration and field strength. Under alkaline
      conditions that disrupt secondary and tertiary structures, the linear and
      circular forms of a given single-stranded DNA can be easily resolved. The
      mobility ratios, mulinear/mucircular, depend strongly on gel concentration and
      less strongly on DNA size. Protocols have been developed to determine
      conveniently the size within 2% and the fractions of circular and linear forms
      for ssDNA sizes on the order of 10 kb.

PMID- 7793619
TI  - Assay of pancreatic lipase with the surface acoustic wave sensor system.
AB  - A new type of surface acoustic wave sensor system for assaying the activity of
      pancreatic lipase has been proposed. The assay of this enzyme is based on the
      change in conductance of the solution caused by the release of a fatty acid,
      using triolein as a substrate. A linear relationship between frequency response
      and enzyme concentration is obtained. Kinetic parameters of pancreatic lipase,
      i.e., the Michaelis constant for triolein and the corresponding maximum initial
      rate, are estimated to be 5.46 mM and 7551.6 Hz/min, respectively. The effects of
      temperature and pH value are also investigated.

PMID- 7793620
TI  - Optimization of calcium phosphate transfection for bovine chromaffin cells:
      relationship to calcium phosphate precipitate formation.
AB  - Optimal conditions for formation of calcium phosphate-DNA precipitates and for
      chromaffin cell transfection by the calcium phosphate method were examined. A
      relationship was observed between turbidity of calcium phosphate solutions and
      the ability of calcium phosphate-DNA mixtures to give efficient transfection of
      bovine chromaffin cells. Under optimal conditions up to 35% of chromaffin cells
      in cultures transfected with plasmid DNA encoding human proenkephalin or
      Escherichia coli beta-galactosidase expressed the respective proteins. Important
      factors for transfection were the pH (6.95) and buffer employed for calcium
      phosphate-DNA precipitate formation, the amount and type of DNA, and the absence
      of serum in the cultures. Additionally, phosphate and calcium concentrations in
      the culture medium during incubation of cells with DNA are critical. Optimal
      conditions for transfection of chromaffin cells were also useful for transfection
      of clonal BSC-40 cells, an African green monkey kidney cell line. These results
      suggest that the optimal conditions described here for chromaffin cells may have
      broad applicability to other cell types. In addition, the results suggest that it
      is possible to optimize the solutions used for transfection conditions by
      monitoring calcium phosphate formation.

PMID- 7793621
TI  - A continuous spectrophotometric assay for 5-aminolevulinate synthase that
      utilizes substrate cycling.
AB  - A continuous spectrophotometric assay for determining 5-aminolevulinic acid
      synthase activity is described. The assay is based upon coupling the production
      of coenzyme A by 5-aminolevulinic acid synthase to the reduction of NAD+ by alpha
      ketoglutarate dehydrogenase and monitoring the increase in absorbance at 340 nm.
      Reduction of NAD+ is stoichoimetric with formation of 5-aminolevulinic acid.
      Kinetic parameters for glycine and succinyl-CoA are similar to those reported for
      other assays which measure the formation of 5-aminolevulinic acid. Regeneration
      of succinyl-CoA in the alpha-ketoglutarate dehydrogenase reaction facilitates
      determination of initial rates at subsaturating concentrations of this substrate.
      This assay will permit the rapid accumulation of kinetic data and aid in
      mechanistic analyses of both 5-aminolevulinic acid synthase and its recombinant
      mutants.

PMID- 7793622
TI  - A spectrophotometric assay for the determination of the catalytic efficiency of
      plasminogen activators using a slowly hydrolyzed plasmin substrate.
AB  - A simple spectrophotometric assay for the determination of the catalytic
      efficiency and activity of plasminogen activators is presented. The assay system
      contains activator, plasminogen, and the chromogenic substrate N-benzoyl-L
      arginine-p-nitroanilide (BAPA). Plasmin production is monitored continuously by
      the hydrolysis of BAPA under non-steady-state, first-order conditions with
      respect to plasminogen. Apparent catalytic efficiency constants are calculated
      from the values obtained for the apparent first-order rate constant of
      activation. The results obtained with the present method were compared with the
      catalytic efficiency determined through the measurement of kcat and Km, using a
      different system, under steady-state conditions. Tissue plasminogen activator in
      the absence and presence of fibrinogen and high-molecular-weight urokinase were
      used as model activators. Potential applications are discussed.

PMID- 7793624
TI  - A general method for detecting and sizing large plasmids.
AB  - We have devised a method for detecting and estimating the sizes of large
      bacterial plasmids in the presence of genomic DNA by pulsed-field gel
      electrophoresis (PFGE). Bacteria harboring plasmids were embedded in agarose and
      lysed using a rapid protocol. Plugs were incubated with S1 nuclease and subjected
      to PFGE in agarose gels. S1 nuclease converted supercoiled plasmids into full
      length linear molecules. Large plasmids migrated as discrete bands that were
      readily observed after ethidium staining. Their sizes were reliably estimated by
      comparison with linear DNA markers. Without S1 digestion, supercoiled plasmids
      migrated at rates that were not a simple function of their molecular weights,
      making size determinations problematic. S1-PFGE detected megaplasmids up to 609
      kilobases (kb) in six genera of bacteria (Agrobacterium, Escherichia, Klebsiella,
      Pseudomonas, Salmonella, and Staphylococcus). The procedure gave size values
      consistent with previous estimates for characterized megaplasmids. Eight new
      plasmids between 102 and 316 kb were discovered in Klebsiella and Staphylococcus.
      S1-PFGE avoids the difficulties of plasmid isolation, eliminates the preparation
      of probes, and does not require knowledge of restriction enzyme cleavage sites.
      It detects multiple large plasmids up to the limits of PFGE and can be used to
      screen for megaplasmids in many strains simultaneously.

PMID- 7793623
TI  - Utilization of patterns of biotinyl-polypeptides as a promising analytical target
      for bacterial identification.
AB  - The family of biotin enzymes, which are involved in carboxylation,
      transcarboxylation, and decarboxylation reactions in cells, is essential and
      conserved for bacteria. The prosthetic group biotin is stably linked to the
      biotinyl-polypeptide by an amide bond. Since avidin interacts with biotin in an
      irreversible manner, the patterns of biotinyl-polypeptides for bacterial cells
      could be revealed by probing them with an avidin-enzyme complex in Western blots
      of total cellular proteins. In this way, the family of commonly existing gene
      products of bacteria could be monitored and compared without the use of specific
      DNA probes, oligonucleotide primers, or antibodies. In this study, this approach
      was tested and it was found that different species of bacteria showed different
      patterns of biotinyl-polypeptides. Our results indicate that patterns of biotinyl
      polypeptides can be a promising analytical target for bacterial identification.

PMID- 7793625
TI  - Analysis of leukotrienes, lipoxins, and monooxygenated metabolites of arachidonic
      acid by reversed-phase high-pressure liquid chromatography.
AB  - Arachidonic acid can be converted to a large number of metabolites by various
      lipoxygenases, cyclooxygenase, and other enzymes. Because of the complex profiles
      of products formed by many types of cells, high-pressure liquid chromatography
      (HPLC) has proved to be an invaluable technique for their purification and
      analysis. In the present study we have developed improved methods for the
      analysis of complex mixtures of eicosanoids by HPLC using binary gradients
      containing trifluoroacetic acid (TFA), which allows considerable manipulation of
      the retention times of the cysteine-containing leukotrienes (LTs) LTC4, LTD4, and
      LTE4 relative to those of other eicosanoids. With a gradient between 0.003 and
      0.005% TFA and a 4.6-mm-i.d. column of Spherisorb ODS-2, cysteinyl-LTs are very
      well resolved from one another and are separated as a group with retention times
      longer than those of all other major eicosanoids. These conditions can be used
      for the analysis of prostaglandin B2 (PGB2), LTB4, monohydroxyeicosatetraenoic
      acids (HETEs), and cysteinyl-LTs in only 30 min. Slightly longer analysis times
      must be used for the separation of more polar eicosanoids such as hydroxy
      metabolites of LTB4 and lipoxins. We have also developed methods for the analysis
      of eicosanoids using a midbore (3.2 mm i.d.) column containing Spherisorb ODS-2,
      which improves sensitivity and reduces solvent consumption. In this case higher
      concentrations (0.04 to 0.05%) of TFA have been used, resulting in retention
      times for cysteinyl-LTs between those of the cyclooxygenase product 12-hydroxy
      5,8,10-heptadecatrienoic acid and the HETEs. This approach permits analysis of
      PGB2, LTB4, HETEs, and cysteinyl-LTs in only 20 min. Samples which also contain
      hydroxy-LTB4 and lipoxins can be analyzed in 40 min. The above techniques are
      highly reproducible and give baselines which are free of interfering peaks.

PMID- 7793627
TI  - Atomic absorption spectrometric determination of cadmium and lead in human and
      artificial teeth by direct atomization technique.
AB  - A method of graphite furnace atomic absorption spectrometry (GFAAS) with a direct
      atomization technique has been developed for the determination of trace amounts
      of Cd and Pb in human teeth and artificial teeth. The samples were ground to a
      particle size of less than 10 microns and mixed with the same amount of graphite
      powder. One-half to 2 mg of mixed sample was weighed in a tared graphite cup and
      atomized in a cup-type graphite furnace according to the heating program that was
      established. Absorbances were determined by integration of the spectral lines in
      the absorbance vs time spectrum. Calibration was affected using aqueous standard
      solutions. The results for six human tooth samples and two artificial tooth
      samples were in good agreement with the values obtained by GFAAS for dissolved
      samples. The relative standard deviations were 3.1-12% (n = 10) for Cd (19-95 ng
      g-3) and 0.9-8.1% (n = 10) for Pb (1.43-6.32 micrograms g-3). The determination
      limits corresponding to twice the standard deviation (sigma, n = 10) for blank
      measurements were 13 pg for Cd and 53 pg for Pb.

PMID- 7793626
TI  - Extractive derivatization of the 12-lipoxygenase products, hepoxilins, and
      related compounds into fluorescent anthryl esters for their complete high
      performance liquid chromatography profiling in biological systems.
AB  - Facile methods for the detection of intact hepoxilins, monohydroxy-epoxide
      derivatives of arachidonic acid formed through the 12-lipoxygenase pathway, are
      unavailable because (i) an absence in these compounds of an appropriate
      chromophore for sensitive detection by uv exists, (ii) these compounds are
      sensitive to the acidic workup leading to varying degrees of decomposition, and
      (iii) they decompose to the derivatization procedures required for their analysis
      by gas chromatography mass spectrometry. Herein we apply a method which
      introduces a fluorescent ester chromophore to the carboxylic group of the
      hepoxilins under conditions which do not require acidification leading to
      stabilization of the derivative which is extracted into an organic solvent in
      situ. This procedure quantitatively derivatizes hepoxilins in a biological
      sample, permitting the detection of hepoxilins after a TLC purification with a
      limit of 50 pg/sample. This method permits the profiling of 12-HETE, hepoxilins
      A3 and B3, as well as the corresponding epoxide hydrolase products, trioxilins A3
      and B3, in a biological sample by reverse-phase HPLC with fluorescent detection.
      We also report on the fluorescent and mass spectral properties of these
      derivatives using a liquid chromatography mass spectrometry LCMS interface with
      thermospray ionization.

PMID- 7793628
TI  - Protein farnesyltransferase: measurement of enzymatic activity in 96-well format
      using TopCount microplate scintillation counting technology.
AB  - Protein farnesyltransferase (PFT) catalyzes the transfer of the farnesyl group of
      farnesyl pyrophosphate (FPP) to proteins ending with a carboxy-terminal CAAX
      motif, forming a thioether linkage to the cysteine residue of the protein. A
      method is described herein for measurement of PFT activity in 96-well format
      using TopCount microplate scintillation counting technology. This method has the
      advantages of requiring only a single transfer from reaction vessels or wells of
      a 96-well reaction plate to the filtration wells of a 96-well Packard UniFilter
      GF/B filtration plate following acid precipitation and of allowing liquid
      scintillation counting to be conducted directly in the filtration plate without
      the need for either removal of the filter from the plate or transfer of the
      filter to liquid scintillation vials prior to radioactivity assessment. Using rat
      brain cytosol as the source of PFT, H-ras as the source of farnesyl acceptor
      protein, and [1-3H]FPP as the farnesyl donor, the incorporation of radiolabeled
      farnesyl residues into H-ras was found to be a linear function of both the time
      of incubation at 37 degrees C (up to 75 min) and the concentration of rat brain
      cytosolic protein present during incubation (up to 40 micrograms protein), and to
      be dependent on the concentration of H-ras (Km = 1.1 microM) and FPP (Km = 0.6
      microM) present in the incubation reaction. In the presence of 4 microM H-ras,
      0.5 microM FPP, 4 mM MgCl2, and 20 microM ZnCl2, the specific activity of rat
      brain cytosolic PFT measured using this methodology was 0.253 +/- 0.036 (SD; n =
      30) pmol H-ras farnesylated per minute of incubation at 37 degrees C per
      milligram cytosolic protein. The signal-to-noise ratio for H-ras farnesylation
      using this methodology averaged 25 relative to incubation in the absence of H-ras
      (background farnesylation of cytosolic proteins) and 50 relative to incubation in
      the absence of both H-ras and rat brain cytosol (background filter associated
      radioactivity). Intraassay variability averaged 4% and interassay variability
      averaged 9%. FPP mimetics from a variety of distinct structural classes,
      previously shown to act as competitive inhibitors of the FPP-utilizing enzyme,
      squalene synthetase (SQS), also inhibited PFT activity measured using this
      methodology, but exhibited approximately 300- to 500-fold specificity for
      inhibition of SQS relative to inhibition of PFT, when both enzymes were measured
      at their respective Km FPP concentrations, suggesting structural differences
      between the FPP binding sites of the two enzymes.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 7793630
TI  - Enzymatic synthesis of ATP analogs and their purification by reverse-phase high
      performance liquid chromatography.
AB  - The enzymatic syntheses of ATP analogs, such as tubercidin 5'-triphosphate,
      formycin A 5'-triphosphate, and etheno-ATP, from their respective mono- and
      diphosphate are described. The reaction products were purified by reverse-phase
      HPLC using a C-18 matrix and a volatile mobile phase at pH 7, with tributylamine
      as the ion-pairing agent. Each of the analogs required a buffer of somewhat
      different composition for the baseline separation of reaction product and
      reactants. The elutions were isocratic and allowed several successive runs
      without any intermediate equilibration of the column. After freeze-drying of the
      pooled fractions, the yield of the synthesized nucleoside triphosphate was
      approximately 70%. The described procedures are applicable either for analytical
      investigations or for semi-preparative purposes.

PMID- 7793631
TI  - Development of the on-line high-performance liquid chromatography/thermospray
      mass spectrometry method for the analysis of phospholipid molecular species in
      rat brain.
AB  - An on-line thermospray liquid chromatography/mass spectrometry method was
      developed to rapidly analyze phosphoglyceride molecular species in biological
      fluid. After total lipid extraction, the extract was subjected to the analysis
      using on-line reversed-phase high-performance liquid chromatography (HPLC) and
      filament-on thermospray mass spectrometry. Using nonconventional HPLC conditions,
      partial separation of individual phospholipid class (phosphatidylserine,
      phosphatidylinositol, phosphatidylethanolamine, and phosphatidylcholine) and
      partial separation of molecular species within each class were achieved. In
      addition, good peak shape was maintained throughout the analysis. By monitoring
      characteristic fragment ions (diacylglycerol ions) formed in the filament-on
      thermospray process and according to the retention time, individual molecular
      species in each phospholipid class can be identified. Using this method, we
      observed significant differences in the molecular species composition of each
      phospholipid class in rat whole-brain lipid. Although nonlinear calibration
      curves were observed for all the diacylglycerol ions monitored, even in the
      presence of internal standard, semiquantitative and quantitative results still
      could be obtained for a mixture of phospholipids.

PMID- 7793629
TI  - The functional effects of biotinylation of anti-angiotensin-converting enzyme
      monoclonal antibody in terms of targeting in vivo.
AB  - The effect of modification with biotin N-hydroxysuccinimide ester of mouse
      monoclonal antibody to angiotensin-converting enzyme, anti-ACE Mab 9B9, on its
      targeting to endothelial cells has been studied in vitro and in vivo. By in vitro
      assay, Mab 9B9 biotinylated at a biotin/IgG molar ratio in reaction mixture
      (B/IgG ratio) of 0.7-2.2 bound streptavidin monovalently and retained antigen
      binding capacity. Mab 9B9 biotinylated at a B/IgG ratio of 20 and higher bound
      streptavidin polyvalently. Extensive biotinylation (B/IgG ratio of 60 and higher)
      led to dramatic reduction of Mab 9B9 Ag-binding capacity and to reduction of Mab
      9B9 recognition by goat polyclonal antibody to mouse IgG. Radiolabeled Mab 9B9
      biotinylated at a B/IgG ratio of 6 (b6-Mab 9B9) bound effectively to cultured
      vascular endothelium, with affinity characteristics similar to nonbiotinylated
      Mab 9B9. Endothelial cells internalized both Mab 9B9 and b6-Mab 9B9 to the same
      extent (60% internalization at 3 h incubation at 37 degrees C). Degradation of
      cell surface-associated Mab 9B9 or b6-Mab 9B9 was very low (< 1% as measured by
      TCA solubility of radiolabel). In contrast, degradation of internalized b6-Mab
      9B9 was more profound than that of Mab 9B9 (20 +/- 3% vs 6 +/- 1%, P < 0.01).
      After injection in rats, radiolabeled b6-Mab 9B9 had a biodistribution pattern
      similar to that of radiolabeled Mab 9B9. Both preparations effectively
      accumulated in the lung (15-20% of injected dose/g of tissue vs 2% of injected
      dose/g of blood).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793632
TI  - Luminescent visualization of low amounts of cytochrome P450 and hemoproteins by
      luminol in acrylamide gels.
AB  - In this paper we apply luminol (5-amino-2,3-dihydro-1,4-phthalazinedione), a
      light-emitting substrate, in conjunction with H2O2 to the luminescence labeling
      of hemoproteins. We describe in detail a photodetection device which permits an
      efficient recording of the light emitted by heme-containing proteins resolved in
      acrylamide gels. The sensitivity of this procedure, when compared to the
      classical 3,3'-5,5'-tetramethylbenzidine staining method, results in a 5- to 20
      fold enhancement with standard hemoproteins (lactoperoxidase, catalase,
      cytochrome P450 2B4, horseradish peroxidase, hemoglobin, myoglobin, and
      cytochrome b5). The potential applications of this technique are illustrated by
      the detection of cytochrome P450 in microsomes from plant as well as from animal
      extrahepatic tissues which possess low amounts of this cytochrome.

PMID- 7793633
TI  - Analysis of 8-hydroxy-2'-deoxyguanosine in rat urine and liver DNA by stable
      isotope dilution gas chromatography/mass spectrometry.
AB  - A previously developed gas chromatographic/mass spectrometric method was applied
      to the measurement of 8-hydroxy-2'-deoxyguanosine (8-OHdG) in rat liver DNA and
      in rat urine. For DNA samples, the method included: (i) fortification of samples
      with [15N]DNA (internal standard), (ii) enzymatic hydrolysis of DNA to
      deoxynucleosides, (iii) degradation of native nucleosides by treatment with
      trifluoroacetic acid and hydrazine, (iv) purification by C18 solid-phase
      extraction (SPE), (v) derivatization (acetylation followed by
      pentafluorobenzylation, Ac-PFB), and (vi) GC/MS analysis of the derivatives. For
      urine, the following methodology was used: (i) fortification of the samples with
      8-18OHdG, (ii) prepurification by C18/OH SPE, (iii) derivatization, (iv) high
      performance liquid chromatography purification of the Ac-PFB derivatives, and (v)
      GC/MS analysis. The precision of the method was demonstrated by carrying out
      replicate analysis of several urine and DNA samples: within-run and between-run
      variability was less than 5 and 8%, respectively. The analytical approaches were
      sufficiently sensitive to quantitate the urinary excretion of 8-OHdG (490 +/- 70
      pmol/kg/24 h; sample size, 600 microliters urine) and to measure the level of 8
      OHdG in liver DNA (20 8-OHdG/10(6) deoxynucleosides; sample size, 30 micrograms
      DNA) of rats not deliberately exposed to oxidative stress. Major advantages over
      previous methods are increased precision due to the use of proper isotopically
      labeled internal standards, and increased sensitivity due to the optimization of
      cleanup procedures. The simultaneous analysis of standards of three different
      oxidized nucleosides, namely 8-OHdG, thymidine glycol, and 5-hydroxy-methyl-2'
      deoxyuridine, is shown.

PMID- 7793634
TI  - A long-lived batch reaction system of cell-free protein synthesis.
AB  - Several reaction conditions of cell-free protein synthesis such as temperatures,
      buffers, tRNAs, and creatine phosphate were intensively investigated and
      optimized to prolong protein synthesis and make it more efficiently in a batch
      system. As a result of these modifications, the protein synthesis reaction
      continued for 10 h so that about 30 micrograms of dihydrofolate reductase (DHFR)
      protein derived from Escherichia coli was synthesized in 1 ml of reaction
      mixture. In this improved system, translational reactions of other mRNAs such as
      rabbit beta-globin, Xenopus beta-globin, and tobacco mosaic virus RNA also
      continued for about 10 h. In addition, protein synthesis directed by uncapped
      dhfr mRNA containing a viral cap-independent translation initiation-mediating
      sequence continued for 10 h, resulting in the synthesis of 18 micrograms of DHFR
      protein per milliliter of reaction mixture.

PMID- 7793635
TI  - Solid-phase hybridization capture of low-abundance target DNA sequences:
      application to the polymerase chain reaction detection of Mycobacterium
      paratuberculosis and Mycobacterium avium subsp. silvaticum.
AB  - Polymerase chain reaction (PCR) has been widely applied to the detection of
      microorganisms. Overall sensitivity of PCR tests may be substantially reduced due
      to a large excess of nontarget DNA and inhibitory substances in the sample. We
      used a 5'-biotinylated 513-bp probe from the 3' region of the IS 900 element
      specific for Mycobacterium paratuberculosis (Mptb) to capture target Mptb DNA
      from crude sample DNA extracts. Captured target DNA was separated using
      streptavidin-coated magnetic particles (Dynal). Since the IS 900 element shares
      homology over this region with IS 902 in Mycobacterium avium subsp. silvaticum
      (Mavs), target DNA from this other pathogen was also retained. Highly specific
      PCR for the detection of either organism directed to the 5' regions of IS 900 or
      IS 902 was then performed directly on the solid phase. Hybridization capture of
      target DNA using sequence adjacent to the desired specific PCR site applied to
      Mptb increased overall sensitivity of detection in tissue and fecal extracts 10-
      to 100-fold. False positives due to contamination artifact were substantially
      excluded since the capture probe did not retain amplicons from the detection PCR.
      Development of the method to involve covalent 5' immobilization of capture probes
      on heat-resistant polymers should, in the future, provide a simple system with
      broad potential applications.

PMID- 7793636
TI  - Phospholipid/alkanethiol bilayers for cell-surface receptor studies by surface
      plasmon resonance.
AB  - Supported hybrid bilayer membranes (HBM) composed of a monolayer of phospholipid
      and a monolayer of alkanethiol associated with a thin gold film on glass are
      useful as model lipid bilayer membranes for studying membrane receptor-ligand and
      cell-cell binding events by surface plasmon resonance (SPR). Measurements of
      specific binding of proteins and lipid vesicles to well-defined HBMs have been
      performed under conditions of continuous flow using a commercial SPR instrument
      (BIAcore). HBMs are shown to be stable in flow and to block nonspecific
      adsorption of proteins to the alkanethiol/gold surface. The use of such supported
      lipid bilayers in flow provides a means of conducting equilibrium and kinetic
      studies of models of ligand-cell and cell-cell interactions with receptors or
      ligands in a membrane environment. Compared to the extended dextran polymer layer
      that is currently used for surface modification of BIAcore "sensor chips," the
      described HBMs provide a well-defined surface that will permit less ambiguous
      modeling of these important biological interactions.

PMID- 7793637
TI  - A colorimetric assay for measuring activation of Gs- and Gq-coupled signaling
      pathways.
AB  - Current assays for functional activation of Gs-coupled receptors usually involve
      quantitation of adenylyl cyclase or measurement of cAMP concentration by
      radioimmunoassay. The activation of Gq-coupled receptors is commonly assayed by
      measurement of the production of inositol triphosphate or diacylglycerol from
      phosphatidylinositol 4,5-bisphosphate or of changes in intracellular calcium.
      These assays generally require large numbers of cells (10(5)-10(6)) and/or the
      use of radioactive materials. We have developed a rapid nonradioactive
      colorimetric assay that utilizes a beta-galactosidase (lacZ) gene fused to five
      copies of the cyclic AMP response element (CRE) to detect the activation of CRE
      binding protein that results from an increase in intracellular cAMP or calcium.
      This assay can be performed using as few as 30,000 cells in a 96-well format with
      the end products measured simultaneously in a microplate reader. Consequently, a
      single individual can readily assay 1000 samples a day. Using this assay, the
      fold increase in beta-galactosidase activity was similar in magnitude to
      increases in cAMP or adenylyl cyclase activity and was approximately linear from
      0.01 to 0.27 fmol/cell of intracellular cAMP. Furthermore, pharmacological
      characterization of one of the melanocortin receptors, mMC5-R, using this assay
      resulted in a similar order of potency for several melanocortin peptides to that
      obtained with a commonly used adenylyl cyclase enzyme assay. This assay is also
      useful for the characterization of Gq-coupled receptors as is demonstrated here
      using cells transfected with the mouse bombesin receptor. The large-scale
      capacity of this assay makes it an excellent method for screening molecules of
      interest acting on Gs- and Gq-coupled receptors.

PMID- 7793638
TI  - Facile, in situ matrix-assisted laser desorption ionization-mass spectrometry
      analysis and assignment of disulfide pairings in heteropeptide molecules.
AB  - During a routine analysis of disulfide-linked synthetic heterodipeptides by
      matrix-assisted laser desorption ionization (MALDI) mass spectrometry with linear
      detection we observed not only the expected mass of the dipeptide, but also the
      mass of the individual constituent monomer peptides. This was surprising because
      the peptide was purified as an intact dipeptide and no overt attempt was made to
      reduce the disulfide linkage before mass analysis. In contrast, analysis of the
      same sample by electrospray ionization mass spectrometry gave the mass of the
      dipeptide only. To investigate this further, two additional model
      heterodipeptides were prepared and all three were used to systematically study
      several matrix-assisted laser desorption ionization mass spectrometry parameters.
      These parameters were three different matrices (alpha-cyano-4-hydroxycinnamic
      acid, 2,5-dihydroxybenzoic acid, and sinapinic acid), both positive and negative
      modes of detection, and varying the acceleration voltage from 5 to 20 kV. Except
      for the sinapinic acid matrix where poor-quality spectra were obtained, all three
      model heterodipeptides fragmented under the tested conditions in a manner
      consistent with the cleavage of disulfide bonds, although the absolute level was
      sample dependent. The precise mechanism of disulfide cleavage during analysis is
      unknown, but the cleavage we observed appears to originate during the initial
      ionization event. Because the MALDI process involves irradiating samples with a
      laser, the fragmentation of disulfide-linked peptides that we observe bears some
      resemblance to light-induced homolytic cleavage of aqueous solutions of the amino
      acid cystine, although other mechanisms for fragmentation are also
      possible.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793640
TI  - Improved method for silver staining of glycoproteins in thin sodium dodecyl
      sulfate polyacrylamide gels.
AB  - A method for detection of glycoproteins in thin sodium dodecyl sulfate
      polyacrylamide gels was developed by a combination of (i) initial periodic acid
      oxidation/Alcian blue staining and (ii) subsequent staining with silver nitrate.
      The procedure allowed detection of as little as 1.6 ng of alpha 1-acid
      glycoprotein and 8-40 ng of a polydisperse mucin sample, which is at least 10
      times more sensitive than previously published methods. The method should be very
      useful for assessment of sample purity and detection of glycoproteins in dilute
      mixed samples.

PMID- 7793639
TI  - Efficient analysis of cytochrome P4501A catalytic activity, porphyrins, and total
      proteins in chicken embryo hepatocyte cultures with a fluorescence plate reader.
AB  - An efficient method for measuring polychlorinated biphenyl-mediated induction of
      cytochrome P4501A, using the ethoxyresorufin-O-deethylase (EROD) assay, and total
      porphyrins in chicken embryo hepatocyte cultures is described. Hepatocytes were
      cultured in 48-well plates, assays were carried out within the wells, and
      concentrations of the product of the EROD reaction (resorufin), porphyrins, and
      total proteins were measured in the same wells with a fluorescence plate reader.
      The method differs from previous methods developed in this laboratory in that
      three fluorophors were measured in the same well rather than two.

PMID- 7793641
TI  - Ferrireductase activity in Saccharomyces cerevisiae and other fungi: colorimetric
      assays on agar plates.

PMID- 7793642
TI  - Microassay of adenylosuccinase by capillary electrophoresis.

PMID- 7793643
TI  - Concentration of dilute protein for gel electrophoresis.

PMID- 7793644
TI  - Aerosolized prostacyclin. In search of the ideal pulmonary vasodilator.

PMID- 7793646
TI  - Pharmacokinetic model selection for target controlled infusions of propofol.
      Assessment of three parameter sets.
AB  - BACKGROUND: Computer-assisted target controlled infusions (TCI) result in
      prediction errors that are influenced by pharmacokinetic variability among and
      within patients. It is uncertain whether the selection of a propofol
      pharmacokinetic parameter set significantly influences drug concentrations and
      clinical acceptability. METHODS: Thirty patients received similar propofol TCI
      regimens after being randomly allocated to one of three parameter sets. Arterial
      and venous concentrations were measured and prediction errors calculated from
      pooled and intrasubject data. RESULTS: Arterial propofol concentrations in the
      Dyck group revealed greater bias (mean 43%) than did those in the Marsh (-1%) and
      Tackley (-3%) groups. The Dyck group also showed greater inaccuracy (mean:47%)
      than the Marsh (29%) and Tackley (24%) groups. There was little tendency for
      measured concentrations to vary from targeted values over time (divergence).
      Variability about an observed mean in individual patients (wobble) was low.
      Venous propofol concentrations were initially much less than arterial
      concentrations, but this difference decreased over time. CONCLUSIONS: Although it
      may be preferable to administer propofol TCI by using a locally derived parameter
      set, it is acceptable to use a model from elsewhere. The Marsh and Tackley models
      produced equally good performance and are appropriate for propofol TCI within the
      range of 3-6 micrograms/ml. The Dyck model was less accurate at maintaining
      anesthetic concentrations, possibly because it was derived from low
      concentrations. Concentrations in blood, the most sensitive indicators of
      performance, demonstrated differences among the parameter sets. Clinically, TCI
      worked well, and by clinical criteria, the choice of pharmacokinetic model did
      not appear to make a difference.

PMID- 7793645
TI  - Inferences about respiratory muscle use after cardiac surgery from compartmental
      volume and pressure measurements.
AB  - BACKGROUND: After upper abdominal surgery, patients have been observed to have
      alterations in respiratory movements of the rib cage and abdomen and respiratory
      shifts in pleural and abdominal pressure that suggest dysfunction of the
      diaphragm. The validity of making such deductions about diaphragm function from
      these observations is open to discussion. METHODS: In eight adult patients,
      American Society of Anesthesiologists physical status 2, scheduled for elective
      cardiac surgery, we measured respiratory rate, tidal volume, rib cage and
      abdominal cross-section changes, and esophageal (Pes) and gastric (Pga) pressures
      preoperatively, 1 day postoperatively, and 5 days postoperatively. These data
      were analyzed in detail by following the variables through each respiratory
      cycle. RESULTS: Mean delta Pga/delta Pes decreased from 0.73 preoperatively to 
      0.56 1 day postoperatively and recovered to 0.47 5 days postoperatively. Plots of
      Pes against Pga and rib cage against abdominal expansion (Konno-Mead diagrams)
      were constructed. Six patients showed a postoperative pattern of breathing
      similar to that seen in patients who have undergone abdominal surgery: a decrease
      in the ratio of delta Pga/delta Pes and a shift toward rib cage expansion, with
      an increase in breathing rate and a decrease in tidal volume. This change was
      accomplished in most cases by the use of abdominal muscles in expiration with an
      increase in inspiratory intercostal muscle action without an increase in
      diaphragm activation, that is, a shift in the normal balance of respiratory
      muscle use in favor of muscles other than the diaphragm. A different ventilatory
      pattern was observed in the other two patients, consisting of minimal rib cage
      excursion and a large abdominal excursion. In these cases tidal volume was
      generated largely by contraction and relaxation of abdominal muscles with
      probable reduction in diaphragm activity. In addition, five patients exhibited
      positive changes in Pes at the end of inspiration that corresponded to closure of
      the upper airway, relaxation of inspiratory muscles, and subsequent opening of
      the airway with sudden exhalation, producing a grunt. CONCLUSIONS: Indirect
      measurements of respiratory muscle action based on pressure and chest wall motion
      are easier than are assessments based on implanted electromyogram electrodes and
      sonomicrometers that measure electric activity and muscle length, respectively,
      directly. Interpretation requires numerous assumptions and detailed analysis of
      phase relations among the variables. In patients after thoracic surgery, however,
      these measurements strongly point to a shift in the distribution of motor output
      toward muscles other than the diaphragm.

PMID- 7793647
TI  - Clinical effects and maternal and fetal plasma concentrations of epidural
      ropivacaine versus bupivacaine for cesarean section.
AB  - BACKGROUND: Ropivacaine is a new amide local anesthetic structurally similar to
      bupivacaine and mepivacaine. Previous studies showed that ropivacaine has a
      similar clinical effect as bupivacaine with regard to sensory anesthesia and
      slightly less motor blockade than bupivacaine. Ropivacaine appears to be less
      cardiotoxic and arrhythmogenic than bupivacaine. The clinical and pharmacokinetic
      effects of 0.5% ropivacaine (5 mg/ml) versus 0.5% bupivacaine (5 mg/ml) when used
      epidurally for elective cesarean section were investigated. METHODS: Using a
      randomized, double-blind study design, 60 ASA physical status 1 or 2 term
      parturients presenting for elective cesarean section received either 0.5%
      bupivacaine (150 mg) or 0.5% ropivacaine (150 mg) epidurally in appropriate
      fractionated doses over a 10-min period. Onset, duration, and regression of
      sensory and motor blockade were noted until complete resolution was observed.
      Quality of intraoperative anesthesia and abdominal wall muscle relaxation were
      noted. Maternal plasma concentrations of local anesthetic were determined before
      anesthetic administration and 5, 10, 20, 30, and 60 min and 2, 3, 6, 8, 12, and
      24 h after drug injection in 20 subjects. Umbilical cord blood was obtained at
      time of delivery for acid-base values and determination of the free and total
      plasma concentration of local anesthetic. Neonates also were examined for
      neurobehavioral assessments by Scanlon's and Neurologic and Adaptive Capacity
      Scores at 2 and 24 h after delivery. RESULTS: All patients received satisfactory
      anesthesia for operation. The onset, duration, and regression of sensory blockade
      were similar for both groups. Onset of degree 1 and 2 motor blockade was faster,
      and duration of degree 1 motor block was longer in the group receiving
      bupivacaine. Hemodynamic sequelae were similar between groups. All neonates had 5
      min Apgar scores of 7 or greater and normal acid-base values and neurobehavioral
      assessments. Pharmacokinetic analysis showed that the Cmax was similar for both
      drugs (1.3 +/- 0.09 for ropivacaine and 1.1 +/- 0.09 micrograms/ml for
      bupivacaine). The T1/2 of the terminal decline in plasma concentration was
      shorter for ropivacaine versus bupivacaine (5.2 +/- 0.60 versus 10.9 +/- 1.08 h,
      respectively; P < 0.01). The free (i.e., unbound) concentrations of ropivacaine
      were approximately twice those of bupivacaine in both maternal and neonatal blood
      at the time of delivery. The ratio of umbilical vein to maternal vein
      concentration of unbound drug was 0.72 for ropivacaine and 0.69 for bupivacaine.
      CONCLUSIONS: Ropivacaine, 0.5%, epidurally provided satisfactory and similar
      sensory anesthesia compared to 0.5% bupivacaine for elective cesarean section.
      The Cmax was similar for both drugs, although the terminal half-life of
      ropivacaine was significantly shorter, and the blood concentrations of free
      ropivacaine were significantly greater than that for bupivacaine. These values
      were less than concentrations shown to be toxic in animals.

PMID- 7793648
TI  - Oral clonidine prolongs lidocaine spinal anesthesia in human volunteers.
AB  - BACKGROUND: Premedication with oral clonidine may improve the quality and
      duration of lidocaine spinal anesthesia, but this effect has not been examined in
      a quantitative fashion. METHODS: Eight volunteers received 50 mg lidocaine (1.5%
      dextrose free) both with and without 0.2 mg oral clonidine 1.5 h before spinal
      anesthesia in a randomized, double-blind, placebo-controlled, crossover fashion.
      Sensory block was assessed by pinprick, transcutaneous electric stimulation
      equivalent to surgical incision, and duration of tolerance to pneumatic thigh
      tourniquet. Motor block at the quadriceps and gastrocnemius muscles was assessed
      by isometric force dynamometry. Episodes of bradycardia, hypotension, and
      sedation were recorded. RESULTS: Regression of pinprick was unchanged with
      clonidine. However, duration of tolerance to electric stimulation was increased
      at the knee (28 +/- 24 min) and ankle (31 +/- 28 min) with clonidine (P < 0.05).
      The duration of tolerance to tourniquet-induced pain was increased with clonidine
      (14 +/- 12 min; P < 0.05). The duration of motor block was increased at the
      quadriceps (20 +/- 13 min) and gastrocnemius (33 +/- 24 min) muscle groups with
      clonidine (P < 0.05). Although clonidine decreased systolic blood pressure (13 +/
      4 mmHg, P < 0.003) and heart rate (13 +/- 5 beats/min; P = 0.02), no subjects
      had hypotension or bradycardia. The incidence of sedation was greater with
      clonidine than with plain lidocaine (50% vs. 0%, P < 0.04). DISCUSSION:
      Premedication with oral clonidine prolonged sensory and motor block from
      lidocaine spinal anesthesia. The exact mechanism whereby oral clonidine prolongs
      spinal anesthesia remains to be determined.

PMID- 7793649
TI  - Postpartum changes in the minimum alveolar concentration of isoflurane.
AB  - BACKGROUND: Minimum alveolar concentration (MAC) is decreased in pregnancy, but
      it is not known how quickly after delivery MAC returns to normal. We measured the
      MAC of isoflurane in a group of women undergoing elective tubal ligation after
      delivery. METHODS: After delivery, 20 patients underwent inhalational induction
      of anesthesia with isoflurane and tracheal intubation. MAC was determined in each
      patient by observing the response to a 10-s, 50-Hz, 80-mA transcutaneous tetanic
      electric stimulus to the ulnar nerve at various concentrations of isoflurane. The
      end-tidal concentration of isoflurane was kept constant for at least 10 min
      before each stimulus, and the concentration of isoflurane was ultimately varied
      in steps of 0.05 vol% until we obtained a sequence of three alternate responses:
      move-not move-move or not move-move-not move. The MAC for each subject was taken
      as the mean of the two concentrations just permitting and just preventing
      movement. A venous blood sample was taken immediately before induction of
      anesthesia for measurement of progesterone concentration. MAC was compared with
      time after delivery and plasma progesterone concentrations by Kendall's rank
      correlation. RESULTS: There was a positive correlation between MAC and the time
      after delivery (P < 0.001). The median MAC of isoflurane was 0.775 vol% (range
      0.675-0.775 vol%) in five women 24-36 h postpartum. MAC was more variable, 0.825
      vol% (0.675-0.975 vol%) in nine women 36-72 h postpartum, whereas six patients
      more than 72 h postpartum had a MAC of 1.125 vol% (1.025-1.175 vol%). The
      correlation between MAC and plasma progesterone concentration was almost
      statistically significant (P = 0.060). CONCLUSIONS: The MAC of isoflurane was
      reduced in women 24-36 h postpartum and gradually increased to normal values by
      72 h postpartum.

PMID- 7793650
TI  - The minimum alveolar concentration of isoflurane in patients undergoing bilateral
      tubal ligation in the postpartum period.
AB  - BACKGROUND: The minimum alveolar concentration (MAC) of volatile anesthetics is
      decreased during pregnancy, but MAC in the early postpartum period has not been
      reported. The aim of this study was to determine the MAC of isoflurane and to
      evaluate the relation between MAC and serum progesterone and beta-endorphin in
      patients after delivery. METHODS: Eight patients undergoing elective bilateral
      tubal ligation during general anesthesia in the early postpartum period (< 12 h
      postpartum) and eight patients undergoing this procedure in the late postpartum
      period (12-25 h postpartum) were studied. Eight patients undergoing bilateral
      tubal ligation more than 6 weeks after delivery served as control subjects.
      Anesthesia was induced with propofol and maintained with isoflurane in oxygen to
      a steady end-tidal concentration of 0.8-1.0 vol% for 10 min. Reaction to a
      standardized electric stimulation applied to the forearm was graded as positive
      (gross or delayed movement) or negative. By using the bracketing technique, the
      concentration of isoflurane was increased or decreased by 0.1 vol%, depending on
      the positive or negative responses. RESULTS: The MAC (mean +/- SD) in patients in
      the early postpartum period was significantly less (0.75 +/- 0.17 vol%) than that
      in control subjects (1.04 +/- 0.12 vol%; P < 0.01) and that in patients in the
      late postpartum period (0.95 +/- 0.2 vol%; P < 0.05). The difference in MAC
      values between late postpartum and control was not significant (P > 0.05). There
      was an inverse correlation between progesterone concentration postpartum and time
      after delivery (r = -0.527; P = 0.036), but P = 0.744). There was no correlation
      between plasma progesterone or beta-endorphin and MAC by multiple regression (r =
      0.166; P = 0.950). CONCLUSIONS: Isoflurane MAC remains 28% less than normal
      within the 1st 12 h postpartum and then returns to normal 12-25 h after delivery.

PMID- 7793653
TI  - Methohexital impairs osmoregulation. Studies in conscious and anesthetized volume
      expanded dogs.
AB  - BACKGROUND: Anesthetic agents influence central regulations. This study
      investigated the effects of methohexital anesthesia on renal and hormonal
      responses to acute sodium and water loading in dogs in the absence of surgical
      stress. METHODS: Fourteen experiments (two in each dog) were performed in seven
      well-trained, chronically tracheotomized beagle dogs kept in highly standardized
      environmental and dietary conditions (2.5 mmol sodium and 91 ml water/kg body
      weight daily). Experiments lasted 3 h, while the dogs were conscious (7
      experiments) or, after 1 h control, while they were anesthetized (7 experiments)
      with methohexital (initial dose 6.6 mg/kg body weight and maintenance infusion
      0.34 mg.min-1.kg-1 body weight) over a period of 2 h. In both experiments,
      extracellular volume expansion was performed by intravenous infusion of a
      balanced isoosmolar electrolyte solution (0.5 ml.min-1.kg-1 body weight). Normal
      arterial blood gases were maintained by controlled mechanical ventilation. In
      another five dogs the same protocol was used, and vasopressin (0.05 mU.min-1.kg-1
      body weight) was infused intravenously during methohexital anesthesia. RESULTS:
      Values are given as means. During methohexital anesthesia, mean arterial pressure
      decreased from 108 to 101 mmHg, and heart rate increased from 95 to 146
      beats/min. Renal sodium excretion decreased; urine volume increased; and urine
      osmolarity decreased from 233 to 155 mosm/l, whereas plasma osmolarity increased
      from 301 to 312 mosm/l because of an increase in plasma sodium concentration from
      148 to 154 mmol/l. Plasma renin activity, plasma aldosterone concentration,
      plasma atrial natriuretic peptide, and plasma antidiuretic hormone concentrations
      (range 1.8-2.8 pg/ml) did not change in either protocol. In the presence of
      exogenous vasopressin (antidiuretic hormone 3.3 pg/ml), water diuresis did not
      occur, and neither plasma osmolarity nor the plasma concentration of sodium
      changed. CONCLUSIONS: Methohexital may impair osmoregulation by inhibiting
      adequate pituitary antidiuretic hormone release in response to an osmotic
      challenge.

PMID- 7793651
TI  - Clinical sevoflurane metabolism and disposition. I. Sevoflurane and metabolite
      pharmacokinetics.
AB  - BACKGROUND: Sevoflurane has low blood and tissue solubility and is metabolized to
      free fluoride and hexafluoroisopropanol (HFIP). Although sevoflurane uptake and
      distribution and fluoride formation have been described, the pharmacokinetics of
      HFIP formation and elimination are incompletely understood. This investigation
      comprehensively characterized the simultaneous disposition of sevoflurane,
      fluoride, and HFIP. METHODS: Ten patients within 30% of ideal body weight who
      provided institutional review board-approved informed consent received
      sevoflurane (2.7% end-tidal, 1.3 MAC) in oxygen for 3 h after propofol induction,
      after which anesthesia was maintained with propofol, fentanyl, and nitrous oxide.
      Sevoflurane and unconjugated and total HFIP concentrations in blood were
      determined during anesthesia and for 8 h thereafter. Plasma and urine fluoride
      and total HFIP concentrations were measured during and through 96 h after
      anesthetic administration. Fluoride and HFIP were quantitated using an ion
      selective electrode and by gas chromatography, respectively. RESULTS: The total
      sevoflurane dose, calculated from the pulmonary uptake rate, was 88.8 +/- 9.1
      mmol. Sevoflurane was rapidly metabolized to the primary metabolites fluoride and
      HFIP, which were eliminated in urine. HFIP circulated in blood primarily as a
      glucuronide conjugate, with unconjugated HFIP < or = 15% of total HFIP
      concentrations. In blood, peak unconjugated HFIP concentrations were less than 1%
      of peak sevoflurane concentrations. Apparent renal fluoride and HFIP clearances
      (mean +/- SE) were 51.8 +/- 4.5 and 52.6 +/- 6.1 ml/min, and apparent elimination
      half-lives were 21.4 +/- 2.8 and 20.1 +/- 2.6 h, respectively. Renal HFIP and net
      fluoride excretion were 4,300 +/- 540 and 3,300 +/- 540 mumol. Compared with the
      estimated sevoflurane uptake, 4.9 +/- 0.5% of the dose taken up was eliminated in
      the urine as HFIP. For fluoride, 3.7 +/- 0.4% of the sevoflurane dose taken up
      was eliminated in the urine, which, because a portion of fluoride is sequestered
      in bone, corresponded to approximately 5.6% of the sevoflurane dose metabolized
      to fluoride. CONCLUSIONS: Sevoflurane was rapidly metabolized to fluoride and
      HFIP, which was rapidly glucuronidated and eliminated in the urine. The overall
      extent of sevoflurane metabolism was approximately 5%.

PMID- 7793652
TI  - Clinical sevoflurane metabolism and disposition. II. The role of cytochrome P450
      2E1 in fluoride and hexafluoroisopropanol formation.
AB  - BACKGROUND: Sevoflurane is metabolized to free fluoride and hexafluoroisopropanol
      (HFIP). Cytochrome P450 2E1 is the major isoform responsible for sevoflurane
      metabolism by human liver microsomes in vitro. This investigation tested the
      hypothesis that P450 2E1 is predominantly responsible for sevoflurane metabolism
      in vivo. Disulfiram, which is converted in vivo to a selective inhibitor of P450
      2E1, was used as a metabolic probe for P450 2E1. METHODS: Twenty-one patients
      within 30% of ideal body weight, who provided institutional review board-approved
      informed consent and were randomized to receive disulfiram (500 mg oral, n = 11)
      or nothing (control, n = 10) the night before surgery, were evaluated. All
      patients received sevoflurane (2.7% end-tidal, 1.3 MAC) in oxygen for 3 h after
      propofol induction. Thereafter, sevoflurane was discontinued, and anesthesia was
      maintained with propofol, fentanyl, and nitrous oxide. Blood sevoflurane
      concentrations during anesthesia and for 8 h thereafter were measured by gas
      chromatography. Plasma and urine fluoride and total (unconjugated plus
      glucuronidated) HFIP concentrations were measured by an ion-selective electrode
      and by gas chromatography, respectively, during anesthesia and for 96 h
      postoperatively. RESULTS: Patient groups were similar with respect to age,
      weight, sex, case duration, and intraoperative blood loss. The total sevoflurane
      dose, measured by cumulative end-tidal sevoflurane concentrations (3.7 +/- 0.1
      MAC-h; mean +/- SE), total pulmonary uptake, and blood sevoflurane
      concentrations, was similar in both groups. In control patients, plasma fluoride
      and HFIP concentrations were increased compared to baseline values
      intraoperatively and postoperatively for the first 48 and 60 h, respectively.
      Disulfiram treatment significantly diminished this increase. Plasma fluoride
      concentrations increased from 2.1 +/- 0.3 microM (baseline) to 36.2 +/- 3.9
      microM (peak) in control patients, but only from 1.7 +/- 0.2 to 17.0 +/- 1.6
      microM in disulfiram-treated patients (P < 0.05 compared with control patients).
      Peak plasma HFIP concentrations were 39.8 +/- 2.6 and 14.4 +/- 1.1 microM in
      control and disulfiram-treated patients (P < 0.05), respectively. Areas under the
      plasma fluoride- and HFIP-time curves also were diminished significantly to 22%
      and 20% of control patients, respectively, by disulfiram treatment. Urinary
      excretion of fluoride and HFIP was similarly significantly diminished in
      disulfiram-treated patients. Cumulative 96-h fluoride and HFIP excretion in
      disulfiram-treated patient was 1,080 +/- 210 and 960 +/- 240 mumol, respectively,
      compared to 3,950 +/- 560 and 4,300 +/- 540 mumol in control patients (P < 0.05).
      CONCLUSIONS: Disulfiram, an effective P450 2E1 inhibitor, substantially decreased
      fluoride ion and HFIP production during and after sevoflurane anesthesia. These
      results suggest that P450 2E1 is a predominant P450 isoform responsible for human
      sevoflurane metabolism in vivo.

PMID- 7793654
TI  - Inhibition by volatile anesthetics of endogenous glutamate release from
      synaptosomes by a presynaptic mechanism.
AB  - BACKGROUND: Synaptic transmission is more sensitive than axonal conduction to the
      effects of general anesthetics. Previous studies of the synaptic effects of
      general anesthetics have focused on postsynaptic sites of action. We now provide
      direct biochemical evidence for a presynaptic effect of volatile anesthetics on
      neurotransmitter release. METHODS: Rat cerebrocortical synaptosomes (isolated
      presynaptic nerve terminals) were used to determine the effects of general
      anesthetics on the release of endogenous L-glutamate, the major fast excitatory
      neurotransmitter. Basal and evoked (by 4-aminopyridine, veratridine, increased
      KCl, or ionomycin) glutamate release were measured by continuous enzyme-coupled
      fluorometry. RESULTS: Clinical concentrations of volatile halogenated
      anesthetics, but not of pentobarbital, inhibited 4-aminopyridine-evoked Ca(2+)
      dependent glutamate release. Halothane also inhibited veratridine-evoked
      glutamate release but not basal, KCl-evoked, or ionomycin-evoked glutamate
      release. Halothane inhibited both the 4-aminopyridine-evoked and the KCl-evoked
      increase in free intrasynaptosomal [Ca2+]. CONCLUSIONS: Inhibition of glutamate
      release from presynaptic nerve terminals is a potential mechanism of volatile
      anesthetic action. Comparison of the sensitivity of glutamate release evoked by
      secretogogues that act at various steps in the neurotransmitter release process
      suggests that halothane does not affect Ca(2+)-secretion coupling or vesicle
      exocytosis but inhibits glutamate release at a step proximal to Ca2+ influx,
      perhaps by blocking presynaptic Na+ channels. Synaptosomal glutamate release
      evoked by 4-aminopyridine should provide a useful system for further
      characterization of the presynaptic effects of anesthetics.

PMID- 7793655
TI  - Regulation of norepinephrine release by beta 2-adrenergic receptors during
      halothane anesthesia.
AB  - BACKGROUND: Presynaptic receptors control norepinephrine (NE) release. It has
      been hypothesized that epinephrine stimulates prejunctional beta 2-adrenergic
      receptors to facilitate NE release from sympathetic nerve endings, and therefore,
      presynaptic receptors controlling NE release are potential therapeutic targets to
      limit the adverse effects of excess sympathetic stimulation during anesthesia. We
      have previously demonstrated beta 2-adrenergic receptor-augmented release of NE
      in the human forearm and have shown that halothane inhibits sympathetic activity
      in vivo by decreasing the NE spillover rate into plasma. The goal of the current
      study was to determine the effect of halothane on beta 2-adrenergic receptor
      augmented NE release in a canine hind-limb experimental model. METHODS: Seven
      female dogs were studied awake and during halothane anesthesia (1.0 minimum
      alveolar concentration). A trace dosage of [3H]NE (15 microCi over a 1-min period
      and 0.6 microCi/min thereafter) was infused into the femoral vein. Before and
      during femoral arterial administration of isoproterenol at two dosages (30 and 80
      mg/min), hind-limb blood flow was measured by an ultrasonic flow probe and hind
      limb NE spillover by an isotope dilutional technique. RESULTS: In awake dogs,
      isoproterenol significantly increased hind-limb blood flow and NE spillover into
      the hind limb. Halothane had no effect on baseline or isoproterenol-stimulated
      hind-limb blood flow (a postjunctional beta 2 effect) but significantly inhibited
      the isoproterenol-induced increase in hind-limb NE spillover (a prejunctional
      beta 2 effect). CONCLUSIONS: The isoproterenol-mediated increase in NE release is
      inhibited by halothane anesthesia, indicating that halothane inhibits
      prejunctional beta 2-adrenergic receptor regulation of NE release.

PMID- 7793656
TI  - Ketamine has stereospecific effects in the isolated perfused guinea pig heart.
AB  - BACKGROUND: S(+)-Ketamine is judged to produce more potent anesthesia than either
      the racemate or the R(-) ketamine isomer because of differential activation of
      specific cerebral receptors. Other than central nervous system effects, the most
      important side effects of ketamine occur in the cardiovascular system. We
      examined the direct cardiac effects of the isomers and the racemate of ketamine
      in the isolated perfused guinea pig heart. METHODS: Twenty-three guinea pig
      hearts were perfused by the Langendorff technique with modified 37 degrees C
      Krebs-Ringer's solution (97% oxygen and 3% carbon dioxide) at a constant
      perfusion pressure. Eight animals were pretreated with reserpine to deplete
      hearts of catecholamines. These pretreated hearts were also perfused with Krebs
      Ringer's solution containing propranolol, phenoxybenzamine, and atropine to block
      any remaining effects of catecholamines and of acetylcholine. Five additional
      hearts were perfused with naloxone to block cardiac opioid receptors. Ten hearts
      were not treated. All 23 hearts were then exposed to four increasing equimolar
      concentrations of each isomer and the racemate of ketamine for 10 min. Heart
      rate, atrioventricular conduction time (AVCT), left ventricular pressure,
      coronary flow, and inflow and outflow oxygen tensions were measured. Percentage
      oxygen extraction, oxygen delivery, and oxygen consumption were calculated.
      RESULTS: Both isomers and the racemate caused a concentration-dependent
      depression of systolic left ventricular pressure and an increase in AVCT. In the
      untreated hearts, S(+)-ketamine decreased heart rate and left ventricular
      pressure and, at higher concentrations, oxygen consumption and percentage oxygen
      extraction significantly less than R(-)-ketamine independent of blocked or
      unblocked opioid receptors. Racemic ketamine depressed cardiac function to a
      degree intermediate to that produced by the isomers. Coronary flow and AVCT were
      equally affected by the isomers and by the racemic mixture. In the catecholamine
      depleted hearts both isomers and the racemate caused equipotent depression of all
      variables. In these hearts cardiac depression was greater, and AVCT, coronary
      flow, and oxygen delivery were significantly greater than in untreated and opioid
      receptor-blocked hearts. CONCLUSIONS: Lesser cardiac depression by the S(+)
      isomer is attributable to an increased availability of catecholamines, because
      previous depletion of catecholamine stores and autonomic blockade completely
      inhibited these differences. The inability of cardiac tissue to reuptake released
      catecholamines into neuronal or extraneuronal sites during exposure to ketamine
      is stereoselective and caused predominantly by the S(+) isomer. Cardiac opioid
      receptors are apparently not involved in this phenomenon.

PMID- 7793658
TI  - Anesthetics and automaticity of dominant and latent pacemakers in chronically
      instrumented dogs. IV. Dysrhythmias after sinoatrial node excision.
AB  - BACKGROUND: Subsidiary atrial pacemakers assume control after sinoatrial (SA)
      node excision, and anesthetic-catecholamine interactions can produce severe
      bradycardia during isoflurane anesthesia. We hypothesized that epinephrine
      enhances atrial, atrioventricular junctional, and ventricular dysrhythmias after
      SA node excisions in dogs and that inhalation anesthetics would facilitate such
      dysrhythmias. METHODS: In eight dogs, SA nodes were excised and epicardial
      electrodes implanted at the atrial appendages, at the His bundle, and along the
      sulcus terminalis. Site of the earliest atrial activation and incidences of
      nonatrial beats were determined in the conscious state, with methylatropine, with
      epinephrine, and during halothane, isoflurane, or enflurane anesthesia. RESULTS:
      After SA node excision, a stable, regular subsidiary atrial pacemaker rhythm
      resulted. Epinephrine and halothane shifted the site of earliest activation to
      more remote atrial sites. Epinephrine-induced ventricular escape was increased by
      all anesthetics tested, but atropine prevented ventricular escape. Epinephrine
      induced His bundle (atrioventricular junctional) and premature ventricular beats
      were increased by halothane and enflurane. After SA node excision, ventricular
      escape occurred as a result of epinephrine-anesthetic interactions, especially
      during anesthesia with isoflurane. CONCLUSIONS: In dogs with excised SA nodes,
      anesthetic-catecholamine interaction facilitates ventricular escape, His bundle
      dysrhythmias, and premature ventricular beats. In addition, halothane and
      enflurane, more than isoflurane, facilitate ectopic ventricular tachydysrhythmias
      with epinephrine. Compared to intact dogs, dogs with excised SA nodes may be more
      susceptible to epinephrine anesthetic dysrhythmias. If findings can be
      extrapolated to humans, intrinsic SA node dysfunction may facilitate severe
      cardiac dysrhythmias with inhalation anesthetics and catecholamines.

PMID- 7793657
TI  - A subtype of alpha 1 adrenoceptor mediates depression of conduction in Purkinje
      fibers exposed to halothane.
AB  - BACKGROUND: An action of epinephrine at alpha adrenoceptors has been reported to
      slow conduction in Purkinje fibers exposed to halothane. In Purkinje fibers one
      pharmacologically distinguishable alpha 1-adrenoceptor subtype (alpha 1B)
      sensitive to the noncompetitive antagonist chloroethylcholinidine mediates
      decreases in automaticity. Another alpha 1 subtype (alpha 1A), sensitive to the
      competitive antagonist WB4101, increases spontaneous rate and action potential
      duration by a mechanism thought to involve hydrolysis of membrane
      phosphoinositides by phospholipase C. This study examined the dose-response
      relation and receptor-effector mechanisms underlying depression of conduction in
      canine Purkinje fibers by epinephrine with halothane. METHODS: Conduction
      velocity was determined in vitro by measuring the conduction time between action
      potentials recorded from two Purkinje fibers located about 6 mm apart along the
      length of free running portions of the ventricular conduction system, the false
      tendons. Velocity was evaluated at 1-min intervals during trials of rapid
      exposure to different agonists in groups of 6-12 preparations. RESULTS:
      Epinephrine (0.2-5.0 microM) transiently decreased Purkinje conduction velocity
      in a dose-related manner by as much as 33% (at 5 microM epinephrine with 0.86 mM
      (2.8%) halothane). Velocity decreased by 5% (P < or = 0.01) at an epinephrine
      concentration similar to "just-threshold" dysrhythmogenic plasma epinephrine
      concentrations (0.2 microM epinephrine with 0.46 mM halothane) reported in
      halothane-anesthetized dogs. The decreases of conduction velocity were blocked by
      prazosin but not by metoprolol, were produced by phenylephrine but not by
      clonidine, and were antagonized by equimolar (0.5 microM) concentrations of
      WB4101 more so (P < or = 0.01) than by chloroethylclonidine. WB4101 (0.1 microM)
      produced 87% inhibition of the response to 0.2 microM epinephrine after
      chloroethylclonidine pretreatment, indicating mediation by the alpha 1A subtype.
      Other agonists linked to cardiac phospholipase C activation, including endothelin
      1 (40 nM) and the muscarinic agonist carbamylcholine (1 mM), also decreased
      conduction velocity in fibers exposed to halothane. CONCLUSIONS: Clinically
      relevant concentrations of epinephrine transiently depress conduction in Purkinje
      fibers exposed to halothane by activating cardiac alpha 1 adrenoceptors, largely
      but not exclusively the WB4101-sensitive alpha 1A subtype, reportedly coupled to
      stimulation of phospholipase C and generation of the second messengers
      diacylglycerol and inositol trisphosphate. Anesthetic potentiation of cardiac
      alpha 1-adrenoceptor effects may contribute to the generation of halothane
      epinephrine dysrhythmias by abnormally slowing conduction and facilitating
      reentry.

PMID- 7793659
TI  - Halothane restores the altered force-frequency relationship in failing human
      myocardium.
AB  - BACKGROUND: The terminally failing human myocardium exerts a negative force
      frequency relationship (FFR), whereas a positive FFR occurs in nonfailing
      myocardium. To study the possibility of pharmacologically influencing this defect
      of the failing human heart, the effect of halothane on the basal FFR and the FFR
      in the presence of isoproterenol and ouabain was investigated. METHODS:
      Experiments were performed on isolated, electrically driven (0.5-2 Hz, 37 degrees
      C, Ca2+ 1.8 mmol/l) ventricular preparations. Myocardium from human failing and
      nonfailing hearts was obtained at cardiac surgery. To further characterize the
      studied myocardium, the positive inotropic effect of isoproterenol and the
      density of beta-adrenoceptors were measured using the radioligand 125I-CYP.
      RESULTS: Halothane produced a negative inotropic effect. The anesthetic (0.38
      mmol/l) reversed the negative FFR in failing myocardium, antagonized the effect
      of isoproterenol (0.1 mumol/l) on FFR, and restored the FFR in the presence of
      ouabain. CONCLUSIONS: Halothane restores the FFR in human failing myocardium
      possibly by influencing the intracellular Ca2+ homeostasis. These findings
      provide evidence that pharmacologic interventions, e.g., during anesthesia, may
      influence contractility also as a result of a depressed or enhanced FFR.

PMID- 7793660
TI  - The local anesthetic n-butyl-p-aminobenzoate selectively affects inactivation of
      fast sodium currents in cultured rat sensory neurons.
AB  - BACKGROUND: Aqueous suspensions of the local anesthetic n-butyl-p-aminobenzoate
      (BAB), epidurally applied in terminal cancer patients, resulted in a sensory
      blockade, lasting up to several months. To investigate the mechanism of action on
      the cellular level, the effect of 100 microM BAB on Na+ action potentials and on
      Na+ currents in dorsal root ganglion neurons from neonatal rats was studied.
      METHODS: Small neurons grown in cell culture were selected for patch-clamp
      measurements. Both Na+ action potentials, evoked by current pulses of increasing
      amplitude (current clamp) and Na+ currents, activated at different membrane
      potentials (voltage clamp), were investigated in the absence and presence of 100
      microM BAB. The local anesthetic was applied by external perfusion for 2 or 10
      min. RESULTS: In the presence of 100 microM BAB, either the firing threshold was
      raised or the action potential was abolished. The maximal peak conductances,
      underlying the fast sodium current INa,F and the slow sodium current INa,5, were
      not changed. However, the inactivation of INa,F was increased by BAB. The sigmoid
      inactivation curve shifted 12 mV toward hyperpolarizing membrane voltages,
      whereas no changes were found for the inactivation of the slow Na+ current. Only
      at short exposure times of 2 min, the effects of BAB could be reversed during a
      10-min wash-out. CONCLUSIONS: BAB dramatically increased the firing threshold,
      and in part of the sensory neurons, it blocked the action potential. The
      inactivation of the fast Na+ channels, but not of the slow Na+ channels, was
      increased by BAB. Thus, the block of fast Na+ channels by BAB may contribute to
      epidural analgesia. At exposure times of 10 min, the effect of BAB was not
      reversible. This probably originates from its high lipid-solubility, which may be
      an important factor in determining the duration of the block in vivo.

PMID- 7793661
TI  - Epidural anesthesia and analgesia. Their role in postoperative outcome.

PMID- 7793662
TI  - Aerosolized prostacyclin versus inhaled nitric oxide in children with severe
      acute respiratory distress syndrome.

PMID- 7793663
TI  - Selective pulmonary vasodilation by inhaled prostacyclin in a newborn with
      congenital heart disease and cardiopulmonary bypass.

PMID- 7793665
TI  - Intraoperative hyperkalemia as a triggering mechanism or presenting sign of
      malignant hyperthermia in two patients with chronic renal failure.

PMID- 7793666
TI  - Epidural abscess after obstetric epidural analgesia.

PMID- 7793667
TI  - Unintended transthoracic pulmonary artery cannulation: a complication of central
      line insertion.

PMID- 7793664
TI  - Dissection of the posterior pharynx resulting in acute airway obstruction.

PMID- 7793668
TI  - Intentional occlusion of the right upper lobe bronchial orifice to tamponade life
      threatening hemoptysis.

PMID- 7793670
TI  - Negative pressure ventilation during tracheal tube exchange.

PMID- 7793669
TI  - Postoperative analgesia.

PMID- 7793673
TI  - Intraoperative transcranial Doppler monitoring.

PMID- 7793671
TI  - Postanesthesia care unit costs.

PMID- 7793672
TI  - Nasal midazolam in children.

PMID- 7793674
TI  - Syringe cap prevents leaks during one-lung ventilation.

PMID- 7793675
TI  - Peri- or postoperative ulnar neuropathy?

PMID- 7793676
TI  - Should the government continue to fund basic biomedical research?

PMID- 7793677
TI  - Central cholinergic stimulation causes miosis.

PMID- 7793678
TI  - Timing of elective surgery after coronary angioplasty.

PMID- 7793679
TI  - Relations between genetic distance of parental pig breeds and heterozygosity of
      their F1 crosses measured by genetic markers.
AB  - The aim of this paper is to examine the extent to which increment of
      heterozygosity in F1 crosses can be predicted from genetic distance of parental
      breeds. For this purpose, 38 polymorphic marker loci (blood groups, allotypes,
      polymorphic proteins and enzymes) were tested in 1115 purebred animals (Duroc,
      Hampshire and Czech Meat Pig as sire breeds; Landrace, Large White and Black Pied
      Prestice as dam breeds) and in 1428 crossbred animals of the resulting nine
      crossbred groups. The number of animals in each genetic group ranged from 75 to
      230. On the basis of the allele frequencies of the scored loci, three measures of
      genetic diversity (heterozygosity, standardized heterozygosity, effective number
      of alleles) were calculated in all 15 genetic groups. Furthermore, two measures
      of genetic distance (Nei's standard genetic distance and Gregorius' absolute
      genetic distance) were calculated between the parental populations. High
      correlations (Pearson product-moment correlation 0.62 to 0.73; Spearman rank
      correlation 0.58 to 0.85) were found between the increment of heterozygosity in
      the crosses (in relation to the mean of the heterozygosities of parental
      populations) and the genetic distance between the parental populations.

PMID- 7793680
TI  - Organization of the sex-linked late-feathering haplotype in chickens.
AB  - Nucleotide sequence analysis of polymerase chain reaction products confirmed that
      ev21 integrated into one of two large homologous elements on the Z chromosome of
      late-feathering (LF) White Leghorn chickens. Southern blots of NotI-, NaeI-, KspI
      and BamHI-digested DNA from early-feathering (EF) and LF White Leghorns, that
      had been hybridized with a probe that flanks ev21, indicated a 180 kb duplication
      of an unoccupied repeat in the LF genotype of White Leghorns. A KspI fragment
      that carries ev21 was about 32 kb smaller than the KspI fragment found in EF DNA.
      In the evolution of LF, retroviral insertion into one of two large repeats and a
      32 kb deletion may have generated LF.

PMID- 7793681
TI  - Sequence and PCR-RFLP analysis of 14 novel BoLA-DRB3 alleles.
AB  - The genetic diversity of the bovine class II DRB3 locus was investigated by
      polymerase chain reaction (PCR) amplification and DNA sequencing of the first
      domain exon. Studying 34 animals of various cattle breeds, 14 previously
      unrecognized DRB3 alleles were identified. In three alleles, amino acid
      substitutions were observed that had not been previously found in bovine DRB3,
      but occurred at the same position in bovine DQB and in the DRB alleles of other
      mammals. For all newly identified alleles, the restriction fragment length
      polymorphism (RFLP) patterns of PCR products obtained with the enzymes RsaI,
      BstYI, and HaeIII were compared with patterns of 38 previously described alleles.
      Altogether, eleven novel PCR-RFLP types were defined. Twelve out of the 42 PCR
      RFLP types identified so far were not found to be fully informative because they
      corresponded to more than one allelic sequence. PCR-RFLP may therefore be a rapid
      and useful method for DRB3 typing in cattle families, but for studies on outbred
      populations, sequencing and hybridization techniques are required.

PMID- 7793682
TI  - Probability of random sire exclusion using microsatellite markers for parentage
      verification.
AB  - Many microsatellite sequences have been described in the bovine genome. Being
      highly polymorphic these have been suggested as markers for parentage
      verification and individual identification in cattle. We have evaluated the use
      of five highly polymorphic microsatellite markers for parentage verification in
      14 breeds of cattle in the UK. Three of the microsatellite loci occur within
      introns in genes: BoLA DRB3, steroid 21-hydroxylase, and the beta subunit of the
      follicle-stimulating hormone. The other two are anonymous sites ETH131 and HEL6.
      Results were analysed by a statistical approach that takes in to account
      deviations from Hardy-Wienberg equilibrium and linkage disequilibrium for
      multiple loci. The method of determining the probability of random sire exclusion
      uses observed genotype frequencies instead of allele frequencies. Independently,
      the markers used have a probability of between 0.72 and 0.62 of identifying a
      parentage error, while used together the five markers give, on average across
      breeds, a probability of 0.99 of excluding an incorrect sire.

PMID- 7793684
TI  - Five regional localizations to the sheep genome: first assignments to chromosomes
      5 and 12.
AB  - The regional localization of five reference loci to sheep chromosomes is
      reported. The newly mapped loci are the T-cell receptor, beta (TCRB), coagulation
      factor X (F10), laminin gamma 1 (LAMC1), cyclic GMP rod phosphodiesterase, alpha
      (PDEA) and fibroblast growth factor 2 (FGF2). The assignments of PDEA and LAMC1
      to chromosomes 5q23-q31 and 12q22-q24 respectively provide the first markers
      physically assigned to these chromosomes. They also allow the provisional
      assignment of sheep syntenic group U19 to chromosome 5 and U1 to chromosome 12.
      The mapping of FGF2 to chromosome 17q23-q25 anchors the unassigned linkage group
      'A' to chromosome 17, and the assignment of TCRB to chromosome 4q32-qter
      facilitates the orientation of a linkage group on sheep chromosome 4. The mapping
      of F10 to sheep chromosome 10q23-qter supports the recent assignment of bovine
      syntenic group U27 to cattle chromosome 12, as sheep chromosome 10 and cattle
      chromosome 12 are banded homologues.

PMID- 7793683
TI  - Genetic characterization of highly inbred chicken lines by two DNA methods: DNA
      fingerprinting and polymerase chain reaction using arbitrary primers.
AB  - Thirteen highly inbred chicken lines were analysed at the DNA level by DNA
      fingerprinting (DEP) and by polymerase chain reaction (PCR) using random primers.
      In general, the DFP patterns of individuals within a line were identical. The DFP
      band-sharing (BS) values among lines from different breeds (Leghorn, Fayoumi,
      Spanish) ranged from 0.10 to 0.20. The DFP BS values among Leghorn lines from
      different genetic backgrounds ranged from 0.42 to 0.79. The DFP BS values among
      lines selected for different major histocompatibility complex serotypes from a
      common genetic background ranged from 0.70 to 0.95. Some randomly amplified
      polymorphic DNA (RAPD) PCR products were specific to a single line, some to all
      lines from the same genetic base, and some to all lines from the same breed. The
      RAPD-PCR band-sharing values ranged from 0.66 to 0.99 for all between-line
      comparisons. Thus, the ability to detect biodiversity at the DNA level was
      greater in this study for DFP than for RAPD-PCR. The possible origin of line
      specific bands, relative advantages of detecting biodiversity by using different
      molecular screening techniques and uses of highly inbred chicken lines in
      molecular analysis are discussed.

PMID- 7793685
TI  - Synteny-mapping horse microsatellite markers using a heterohybridoma panel.
AB  - A panel of horse-mouse heterohybridoma cells was tested for genetic markers using
      biochemical and polymerase chain reaction-(PCR-) based tests. Biochemical markers
      included phosphoglucomutase (PGM), glucose phosphate isomerase (GPI) and 6
      phosphogluconate dehydrogenase (PGD). Markers detected using PCR-based tests
      included microsatellite markers HTG2-15, HMS 1-3, 5-8, VHL20, ECA2 and genes for
      equine major histocompatibility gene ELA-DRA, tumour necrosis factor alpha (TNFA)
      and transferrin. The results were analysed for correlation and concordance. Based
      on the results, five synteny groups were identified, specifically between ELA
      DRA, TNFA, HMS5 and HTG5; between HTG3 and HTG13; between HTG4, HTG8 and HMS3;
      between HTG6 and HMS1; and between HTG7, HTG9 and HMS6. Evidence was also found
      for synteny between HTG12, HMS7 and ECA2, however, confirmation requires further
      testing. Cytogenetic evaluation of the cell lines making up the panel indicated
      that large metacentric chromosomes were preferentially lost or tended to break at
      the centromere. Consequently, the results from this analysis can be used to
      identify synteny, but not to exclude synteny.

PMID- 7793686
TI  - Long-range mapping of the calcium release channel and glucosephosphate isomerase
      loci using pulsed-field gel electrophoresis.
AB  - Long range restriction maps of the calcium release channel (CRC) and
      glucosephosphate isomerase (GPI) loci have been constructed using pulsed field
      electrophoresis, Southern blotting and CRC- and GPI-specific probes. The maps,
      deduced from the restriction fragments detected by the probes, covered 1.1 and
      0.3 Mb respectively and no overlap between the maps of these closely linked loci
      was detected. The minimal distance between the GPI and CRC loci was estimated to
      be at least 500 kb.

PMID- 7793687
TI  - Genetic analysis of three loci homologous to human G9a: evidence for linkage of a
      class III gene with the chicken MHC.
AB  - The cDNA clones of two newly discovered genes in the class III region of the
      human major histocompatibility complex (MHC) were hybridized to chicken DNA. One
      of these cDNA clones (pG9a-4C7), which detects the single-copy human G9a (BAT8)
      gene, gave a repeatable restriction pattern. This heterologous cDNA clone was
      used to detect and map three different PstI restriction fragment length
      polymorphisms among the two internationally recognized chicken reference
      populations. Two of the loci were unlinked to previously mapped markers, but one
      polymorphism cosegregated with the EaB locus in the Compton mapping population.
      These results provide evidence that some genes of the mammalian class III region,
      such as G9a, may be linked to the MHC in chickens.

PMID- 7793688
TI  - A rapid PCR-based test for the endogenous viral element ev3 of chickens.
AB  - A short fragment of chicken genomic DNA encompassing the insertion site of the
      endogenous avian leucosis viral element ev3 was isolated using the inverse
      polymerase chain reaction (inverse PCR) technique. The nucleotide sequence of the
      unoccupied site was used to design PCR primers that can be used to unambiguously
      determine the genetic status of any chicken, with respect to ev3. Screening of a
      small number of individuals from exotic breeds of chickens suggested that the
      frequency of ev3 is highly variable. The ev3 integration site shows a high degree
      of sequence homology with the macrophage-specific tyrosine kinase gene, bmk, in
      mice.

PMID- 7793689
TI  - Extensive mtDNA diversity in horses revealed by PCR-SSCP analysis.
AB  - The hypervariable D-loop region of mitochondrial DNA (mtDNA) was amplified with
      the polymerase chain reaction using total horse DNA samples. Analysis of single
      strand conformation polymorphism (SSCP) of denatured amplification products was
      carried out by native polyacrylamide (8%) gel electrophoresis followed by silver
      staining. As many as 15 distinct SSCP variants were revealed when screening a
      total of 78 maternally unrelated horses representing five different breeds. All
      breeds showed a high degree of polymorphism and the estimated probability (PImt)
      that two maternally unrelated individuals have, by chance, identical SSCP
      variants varied between 0.14 and 0.30. We detected no heteroplasmy or deviations
      from strict and stable maternal inheritance when examining four maternal
      lineages, each represented by six to eight horses, separated by up to five
      generations from a common ancestral mare. The study establishes a simple
      screening method for detecting equine mtDNA types, which can be applied for
      tracing maternal genealogies and for association studies.

PMID- 7793690
TI  - Two new variants of the bovine PAS-1 glycoprotein.
AB  - Two new alleles (A and E) of the bovine MUC locus which encodes PAS-1 protein, a
      glycoprotein of the milk fat globule membrane, are reported. The A allele was
      found in Italian Brown while E was present in the Jersey and the Piedmont breeds.

PMID- 7793691
TI  - Comparative mapping of sheep inhibin subunit beta b to chromosome 2 in sheep and
      cattle by fluorescence in situ hybridization.
AB  - A cosmid clone containing the complete sheep inhibin subunit beta B gene (INHBB)
      was assigned to sheep and cattle homologous chromosome bands 2q31-q33 by
      fluorescence in situ hybridization. The assignment of INHBB in sheep excludes
      another candidate gene as the site of the FecB mutation.

PMID- 7793692
TI  - Bovine microsatellite dinucleotide repeat polymorphisms at the TEXAN11, TEXAN12,
      TEXAN13, TEXAN14 and TEXAN15 loci.

PMID- 7793693
TI  - Dinucleotide repeat polymorphisms at the bovine HUJ673, HUJ121, HUJ174, HUJ225,
      HUJI13 and HUJI29 loci.

PMID- 7793696
TI  - HincII and HaeIII RFLPs in the porcine mtDNA D-loop region.

PMID- 7793694
TI  - TXQG1: a polymorphic microsatellite on bovine chromosome 10.

PMID- 7793695
TI  - DNA polymorphisms in two transcription control elements (SP1- and TATA-box) of
      porcine HSP70.2 gene detected by allele-specific PCR.

PMID- 7793697
TI  - Four SINE-associated polymorphic bovine microsatellites (HEL23-HEL26).

PMID- 7793698
TI  - A PCR-RFLP marker for the erythroid aminolevulinate synthase gene (ALAS2) on
      canine chromosome X.

PMID- 7793699
TI  - BglII and HincII detect polymorphisms at porcine GPI locus.

PMID- 7793700
TI  - Bovine microsatellite dinucleotide repeat polymorphisms at the TEXAN16, TEXAN17,
      TEXAN18, TEXAN19 and TEXAN20 loci.

PMID- 7793701
TI  - Polymorphic bovine microsatellites INRAMTT178, INRAMTT180 and INRAMTT183.

PMID- 7793702
TI  - A SstI RFLP at the chicken transforming growth factor-beta 2 locus (TGFB2).

PMID- 7793703
TI  - Mapping the CdxA gene to a new linkage group in chicken.

PMID- 7793705
TI  - A BglII polymorphism at the porcine INHBB locus.

PMID- 7793704
TI  - A BglII polymorphism at the porcine transferrin (TF) locus.

PMID- 7793706
TI  - A MnlI polymorphism at the bovine alpha s2-casein gene.

PMID- 7793708
TI  - Rollerblades.

PMID- 7793707
TI  - Sensitivity of the Ottawa rules.
AB  - STUDY OBJECTIVE: To validate criteria predicting ankle and mid-foot fractures
      with 100% sensitivity. DESIGN: Prospective validation study SETTING: A 929-bed
      community teaching hospital with an annual census of 76,488 ED visits.
      PARTICIPANTS: Convenience sample of patients older than 18 years with acute ankle
      or midfoot injury. INTERVENTIONS: Radiography was performed in each patient
      received after pertinent history and physical examination findings were recorded.
      RESULTS: Five hundred seventy radiographs were obtained in 484 patients. Four
      hundred twenty-one were of the ankle, and 149 were of the foot. There were 93
      ankle fractures and 29 midfoot fractures, giving a fracture yield of 22.1% for
      ankle films and 19.5% for foot films. Decision rules had sensitivity of 94.6% and
      specificity of 15.5% for ankle fractures and sensitivity of 93.1% and specificity
      of 11.5% for midfoot fractures. Prospective criteria failed to predict fracture
      in five of the ankle group and two of the midfoot group. Physicians predicting
      fracture solely on the basis of clinical suspicion had a sensitivity of 69% in
      ankle injuries and 76% in midfoot injuries. CONCLUSION: We were unable to
      validate with 100% sensitivity the Ottawa rules predicting ankle and midfoot
      fractures. However, the Ottawa rules were more sensitive than clinical suspicion
      alone.

PMID- 7793709
TI  - Chest pain treatment center.

PMID- 7793711
TI  - Terbutaline sulfate overdose.

PMID- 7793710
TI  - Practice of procedures on the newly dead.

PMID- 7793712
TI  - Fatal serotonin syndrome with trismus.

PMID- 7793713
TI  - Endotracheal tube placement.

PMID- 7793714
TI  - Recognition and evaluation of oncology-related symptoms in the emergency
      department.
AB  - STUDY OBJECTIVE: To identify the oncology patient population presenting to the
      emergency department and examine the causes and clinical management of oncology
      symptoms in the ED. DESIGN: Retrospective review of 5,640 adult patients, with
      the following variables identified for oncology patients presenting to the ED:
      age, sex, cancer type, cancer stage, previous cancer treatment, previous
      hospitalization, presenting symptoms, treatment provided in the ED, admission and
      discharge data, and day, time, and length of ED visit. SETTING: Community
      teaching hospital with annual ED census of 31,000. PARTICIPANTS: All adult
      oncology patients who presented to the ED during the study period. We identified
      these patients by cross-referencing ED logs and tumor registry records. RESULTS:
      Cancer history was identified for 284 of the 5,640 adult ED admissions (5%).
      Forty-three percent (n = 122) of the 284 patients with cancer history had an
      oncology-related ED visit. The most common symptoms of these patients were
      gastrointestinal (48%), pain (40%), neurologic (38%), cardiac (25%), and
      pulmonary (23%). Ten percent of patients with oncology-related ED visits died
      during the admission, and 48% died within 1 year of the ED visit. CONCLUSION:
      Oncology patients present to the ED with symptoms of undiagnosed malignancy,
      complications of cancer treatment, and acute disease-related symptoms. Knowledge
      of an individual's cancer history and ability to recognize oncologic symptoms are
      important to the management of oncology patients.

PMID- 7793715
TI  - Fever in geriatric emergency patients: clinical features associated with serious
      illness.
AB  - STUDY OBJECTIVE: To determine the clinical significance of fever in geriatric
      emergency department patients. DESIGN: Case series with follow-up. SETTING:
      Urban, university-affiliated community hospital. PARTICIPANTS: Consecutive
      patients over the age of 65 years who presented to the ED during a 12-month
      period with an oral temperature of 100.0 degrees F (37.8 degrees C) or higher.
      RESULTS: We considered the following features indicators of serious illness:
      positive blood culture(s), related death within 1 month of ED visit, need for
      surgery or other invasive procedure, hospitalization for 4 or more days, IV
      antibiotics for 3 or more days, and repeat ED visit within 72 hours for related
      condition. Four hundred eighty-nine patients were eligible for study. Of the 470
      patients with complete follow-up data, 357 (76.0%) had indicators of serious
      illness. Clinical features found to be independently associated with serious
      illness included oral temperature of 103 degrees F (39.4 degrees C) or more,
      respiration rate of 30 or more, leukocytosis of 11.0 x 10(9)/L or more, presence
      of an infiltrate, and pulse of 120 or more. At least one indicator of serious
      illness was present in 63 of 128 patients (49.6%) with none of these
      independently predictive clinical features. The most common final diagnoses were
      pneumonia (24.0%), urinary-tract infection (21.7%), and sepsis (12.8%).
      CONCLUSION: Fever among geriatric ED patients frequently marks the presence of
      serious illness. All such patients should be strongly considered for hospital
      admission, particularly when certain clinical features are present. The absence
      of abnormal findings does not reliably rule out the possibility of serious
      illness.

PMID- 7793717
TI  - Pain and tissue-interface pressures during spine-board immobilization.
AB  - STUDY OBJECTIVES: Although spine boards are one of the main EMS means of
      immobilization and transportation, few studies have addressed the discomfort and
      potential harmful consequences of using this common EMS tool. We compared the
      levels of pain and tissue-interface (contact) pressures in volunteers immobilized
      on spine boards with and without interposed air mattresses. DESIGN: Prospective
      crossover study. SETTING: Emergency department of Methodist Hospital of Indiana,
      Indianapolis, Indiana. PARTICIPANTS: Twenty healthy volunteers who had not taken
      any analgesic drugs in the preceding 24 hours, were not experiencing any pain at
      the time of the study, and did not have history of chronic back pain.
      INTERVENTIONS: To simulate prehospital transport conditions, we immobilized
      volunteers with hard cervical collars and single-buckle chest straps on wooden
      spine boards with or without commercially available medical air mattresses. The
      crossover order was randomized. After 80 minutes, immobilization measures were
      discontinued and the subjects were allowed to get off the boards for a recovery
      period of 60 minutes. Subjects were then studied for a second 80-minute period
      with the opposite intervention. At baseline and at 20-minute intervals, the level
      of pain was rated with a 100-mm visual analog scale. Tissue-interface pressures
      were measured at the occiput, sacrum, and left heel. RESULTS: Mean pain on the
      visual analog scale was 9.7 mm at the end of the mattress period and 37.5 mm at
      the end of the no-mattress period (P = .0001). Although there were no significant
      differences in pain between the two groups at time 0, volunteers reported
      significantly more pain during the no-mattress period at 20 (P = .003), 40 (P =
      .0001), and 60 minutes (P = .0001). All 20 subjects reported that immobilization
      on the spine board with the mattress was "much better" (five-point scale) than
      that without the mattress. Interface pressure levels were significantly less in
      the mattress period than in the no-mattress period measured at occiput (P =
      .0001), sacrum (P = .0001), and heel (P = .0001). CONCLUSION: In a simulated
      immobilization experiment, healthy volunteers reported significantly less pain
      during immobilization on a spine board with an interposed air mattress than
      during that on a spine board without a mattress. Tissue-interface pressures were
      significantly higher on spine boards without air mattresses. This and previous
      studies suggest that immobilization on rigid spine boards is painful and may
      produce tissue-interface pressure high enough to result in the development of
      pressure necrosis ("bedsores"). Emergency care providers should consider the use
      of interposed air mattresses to reduce the pain and potential tissue injury
      associated with immobilization on rigid spine boards.

PMID- 7793716
TI  - Three-rescuer CPR: the method of choice for firefighter CPR?
AB  - STUDY OBJECTIVE: To compare the quality of CPR provided by firefighters
      performing three-rescuer CPR with that achieved by firefighters trained to
      provide standard two-rescuer CPR. DESIGN: Eight months after training a large
      number of firefighters to perform three-rescuer CPR, we used a quasi-experimental
      design to compare the performance of a randomly selected subset of these
      companies to that achieved by a control group of engine companies that received
      refresher training in standard two-rescuer CPR. Both groups used bag-valve masks
      to provide rescue ventilations. Testing was conducted on a no-notice basis with a
      recording mannequin. Key actions were scored by an experienced observer using
      explicit pass-fail criteria. Mannequin-generated strip charts were used to
      calculate the rate and depth of chest compressions and the ventilatory rate,
      volume, and minute ventilation in a blinded manner. SETTING: Fire stations of the
      Memphis Fire Department. The department is the sole provider of first-responder
      emergency care to the citizens of Memphis, Tennessee (population, 610,000).
      RESULTS: Three-rescuer teams delivered a mean minute ventilation substantially
      greater than that produced by two-rescuer teams (7.7 +/- 5.3 L versus 4.9 +/- 4.2
      L, P < .001). Intergroup differences in the mean depth of chest compressions were
      less marked, but they were still significant (17.2 +/- 8.3 mm of recorder-needle
      deflection versus 13.7 +/- 7.0 mm, P < .001). CONCLUSION: Three rescuers can
      produce better CPR than two when a bag-valve-mask device is used. The technique
      is easily learned and readily retained.

PMID- 7793719
TI  - Hyponatremia as the cause of seizures in infants: a retrospective analysis of
      incidence, severity, and clinical predictors.
AB  - STUDY OBJECTIVES: (1) To determine the incidence of hyponatremic seizures in
      infants, (2) to compare the severity and outcome of seizures in hyponatremic and
      normonatremic patients, and (3) to evaluate the utility of clinical predictors of
      hyponatremia. DESIGN: Retrospective chart review of infants who presented to an
      urban pediatric emergency department from 1988 through 1993. PARTICIPANTS:
      Patients who experienced seizures while in the ED. These patients were divided
      into hyponatremic and normonatremic groups. RESULTS: Hyponatremia was the cause
      of seizures in 70% of 47 infants younger than 6 months who lacked other findings
      suggesting a cause. Median seizure duration was longer in hyponatremic patients
      (30 versus 17 minutes; P = .007), with a greater incidence of status epilepticus
      (73% versus 36%; P = .02) and fewer patients with seizures lasting less than 10
      minutes (9% versus 36%; P = .04). Emergency intubation was performed more often
      in hyponatremic patients (12% versus 0%; P = .009). The median temperature was
      lower in hyponatremic infants than in normonatremic patients (35.5 degrees C
      versus 37.2 degrees C; P = .0001). Exact logistic-regression methods identified
      temperature of 36.5 degrees C or less as the best predictor of hyponatremic
      seizures, with an OR of 64 (95% CI, 8 to 1,026). CONCLUSION: Hyponatremia should
      be strongly suspected in an infant less than 6 months old with seizures and a
      temperature of 36.5 degrees C or less.

PMID- 7793718
TI  - Pediatric basilar skull fracture: do children with normal neurologic findings and
      no intracranial injury require hospitalization?
AB  - STUDY OBJECTIVE: To delineate complications in patients with basilar skull
      fractures (BSFs) and normal neurologic findings, including computed tomography
      (CT) scans without intracranial injury, and to assess the need for
      hospitalization. DESIGN: Retrospective chart review. PARTICIPANTS: All emergency
      department patients with the ED diagnosis or hospital discharge diagnosis of BSF.
      Patients were included if they had a clinical or radiographic diagnosis of BSF. A
      subgroup of patients ("simple BSF") with normal neurologic examination findings
      in the ED, Glasgow Coma Scale scores of 15, and cranial CT scans without
      intracranial pathology was specifically analyzed. RESULTS: We included 239
      patients in the study. One hundred fourteen patients (48%) were included in the
      "simple BSF" subgroup. In this subgroup, vomiting (6%) was the most common
      complication, meningitis (1%) the most serious. There were no cases of delayed
      intracranial hemorrhage, and no patient with "simple BSF" required surgery.
      CONCLUSION: Given the relatively low frequency of serious complications, our
      study suggests that some patients with BSFs may not require hospital admission.

PMID- 7793720
TI  - The temporal profile of increased transaminase levels in patients with
      acetaminophen-induced liver dysfunction.
AB  - STUDY OBJECTIVE: It is often taught that acetaminophen-induced liver dysfunction
      occurs only after a latent period of 24 to 48 hours. This study was designed to
      evaluate the temporal profile of transaminase levels in patients with
      acetaminophen-induced hepatotoxicity. DESIGN: Prospective data collection using
      standard poison control center data sheets. PARTICIPANTS: Hospitalized patients
      with acetaminophen exposure who were reported to the Long Island Poison Control
      Center between January 1993 and June 1994. Patients who presented within 24 hours
      of ingestion and in whom increased aspartate aminotransferase (AST) levels
      developed during hospitalization were included in the data analysis. Patients who
      presented more than 24 hours after ingestion, who had ingested another
      potentially hepatotoxic agent, or who had ingested acetaminophen over a period of
      more than 2 hours were excluded. RESULTS: Of 1,825 patients with reported
      acetaminophen exposure, 779 had potentially toxic ingestions and were examined in
      an emergency department. Of 291 patients with toxic acetaminophen levels who were
      admitted, 36 (12%) had increased levels of AST at some point during
      hospitalization. All received oral N-acetylcysteine within 2.5 hours of
      presentation. In 11 of 19 patients who met all inclusion criteria (58%), AST
      levels were noted to be increased in the 24 hours after ingestion. The median
      peak AST level was 422 IU/L (range, 74 to 8,538 IU/L). AST levels peaked within
      48 hours in 4 patients (21%) and within 72 hours in 18 patients (95%). Six of
      eight patients with peak AST levels greater than 1,000 IU/L had increased
      transaminase levels during the 24 hours after acetaminophen ingestion.
      CONCLUSION: Acetaminophen poisoning may cause the serum transaminase level to
      increase during the 24 hours after ingestion.

PMID- 7793721
TI  - Iron overdose and detection of gastrointestinal bleeding with the hemoccult and
      gastroccult assays.
AB  - STUDY OBJECTIVE: To determine the ability of the Hemoccult and Gastroccult tests
      (SmithKline Diagnostics) to detect blood in vitro in whole-bowel irrigation (WBI)
      solution. INTERVENTIONS: One tablet of ferrous gluconate 324 mg, ferrous sulfate
      325 mg, or ascorbic acid 500 mg; or one Materna prenatal vitamin tablet (Lederle
      Laboratories) was dissolved in 30 mL of Colyte. Colyte alone and each test
      solution were tested with Hemoccult and Gastroccult slides, then retested at pH
      values of 3 and 8. Fresh solutions were then spiked with blood and tested with
      Gastroccult slides. Materna and ascorbic acid solutions were spiked with blood,
      then tested with Hemoccult slides. RESULTS: Positive results were difficult to
      detect on Gastroccult slides. Hemoccult slides were falsely positive for
      solutions containing only iron and falsely negative for blood-spiked samples
      containing ascorbic acid. CONCLUSION: Both the Hemoccult and Gastroccult tests
      may be unreliable in detecting GI bleeding in cases of iron overdose treated with
      WBI.

PMID- 7793722
TI  - Does a sodium-free buffer affect QRS width in experimental amitriptyline
      overdose?
AB  - STUDY OBJECTIVES: We carried out this study to determine the effects of pH
      alteration on QRS width with administration of tromethamine, a non-sodium
      containing buffering agent, in experimental amitriptyline overdose. DESIGN:
      Prospective, nonblinded trial. PARTICIPANTS: Adult mongrel dogs. INTERVENTIONS:
      Pentobarbital-anesthetized dogs were overdosed with amitriptyline 5 mg/kg
      followed by infusion at 1.0 mg/kg/minute until the QRS width doubled, then
      decreased to .5 mg/kg/minute until the end of the experiment. At two defined
      points of toxicity, the dose of tromethamine required to raise the pH to 7.50 +/-
      4 was given. pH and QRS width at a speed of 100 mm/second were measured over a 30
      minute period after each tromethamine dose. Data were analyzed with non-linear
      regression analysis. RESULTS: At toxicity 1 the mean pH was 7.32, with a QRS
      width of 11.6 mm. Two minutes after the tromethamine dose the pH rose to 7.51,
      with narrowing of the QRS width to 8.4 mm. At toxicity 2 the pH was 7.40, with
      QRS width of 10.6 mm. Two minutes after tromethamine, the pH rose to 7.49 and the
      QRS width decreased to 9.7 mm. Regression analysis showed a correlation between
      pH and QRS width; as pH increased, QRS width decreased (P = .0001). CONCLUSION:
      Cardiac toxicity of amitriptyline overdose, as manifested by QRS widening, is
      reversible by pH changes alone.

PMID- 7793723
TI  - Factors associated with relapse after emergency department treatment for acute
      asthma.
AB  - STUDY OBJECTIVE: The rate of relapse after emergency department treatment for
      acute asthma is high. Most studies on this subject were performed before the
      recent recommendations for routine use of corticosteroids and followed the
      patients for 10 or fewer days. We sought to evaluate relapse following ED
      treatment for acute asthma over a longer period, focusing particularly on the
      relationship between steroid use and outpatient follow-up visits. DESIGN: A
      prospective study in which we followed patients for 21 days after discharge to
      determine their relapse rate (unscheduled return for asthma treatment) and
      compliance with scheduled outpatient appointments. SETTING: University-affiliated
      county hospital ED. PARTICIPANTS: One hundred four adult asthmatic patients
      discharged from our ED after treatment under a standardized protocol. RESULTS:
      Follow-up was performed for 91 patients (88%). There was no difference in the
      posttreatment forced expiratory volume at 1 second between those who relapsed
      (55.2%) and those who did not (57.8%; NS). Twenty-three patients (25.3%) relapsed
      within 3 weeks of discharge. Ninety-one percent of relapses occurred before the
      patients saw their primary care physician. Those who relapsed had a history of
      previous ED visits and hospitalizations. There was no difference in theophylline
      levels or history of cigarette use. Patients who relapsed within 3 days had
      higher eosinophil counts. CONCLUSION: Even with routine use of oral
      corticosteroids, a high percentage of patients relapse after ED treatment for
      acute asthma. Patients who relapse have a greater number of recent ED visits and
      so should be targeted for more aggressive management of their asthma.

PMID- 7793725
TI  - ECG diagnosis of acute myocardial infarction in the presence of left bundle
      branch block in patients undergoing continuous ECG monitoring.
AB  - It is common knowledge that the ECG diagnosis of completed myocardial infarction
      in the presence of left bundle-branch block (LBBB) is extremely difficult and
      often impossible. More than 50 rules have been proposed as criteria for
      interpreting Q-wave equivalents superimposed on the QRS complex in the presence
      of LBBB. However, because of misinterpretation of the available literature,
      physicians frequently recommend that patients with chest pain in the presence of
      LBBB receive thrombolytic therapy or urgent coronary arteriography on the basis
      of the assumption that acute injury and ischemia cannot be interpreted in the
      presence of LBBB. Unfortunately, many physicians fail to realize that although
      completed infarction is difficult to confirm in the presence of LBBB, ongoing
      ischemia and injury can be detected in the presence of LBBB and may be seen as
      often as they are in the presence of normal cardiac conduction. A deflection of
      the J point (and ST segment) in the direction of the major QRS complex or an
      elevation of the ST segment of more than 7 to 8 mm opposite the direction of the
      major QRS complex has been demonstrated to have a sensitivity of more than 50% in
      detecting acute injury, with a specificity of more than 90%. During the first
      half of an ongoing prospective study of the use of continuous 12-lead ECG
      monitoring in the emergency department, we encountered five patients with final
      diagnoses of acute myocardial infarction in the presence of LBBB who demonstrated
      significant ECG changes while undergoing continuous ST-segment monitoring with
      frequent serial ECGs. The five different locations of the infarcts in these five
      patients were posterior, posterolateral, inferior, anterior, and anterolateral.
      We present these patients' cases to demonstrate the ECG characteristics of acute
      injury in the presence of LBBB.

PMID- 7793724
TI  - Anticonvulsant effects of intracerebroventricular adenocard in theophylline
      induced seizures.
AB  - STUDY OBJECTIVE: To evaluate the potential anticonvulsant effects of Adenocard in
      theophylline-induced seizures, we developed a rodent model of theophylline
      neurotoxicity with resultant convulsions. We used this model to investigate the
      actions of intracerebroventricular (ICV) Adenocard on seizure onset.
      PARTICIPANTS: Male Sprague-Dawley rats. INTERVENTIONS: Surgical cannulation of
      the jugular veins of the rats was followed by stereotaxic placement of a catheter
      in the right lateral ventricle. The rats then received 15 micrograms (5 microL)
      ICV Adenocard or an equivalent. Ten seconds later, continuous infusion of IV
      aminophylline was begun at a rate of 75 mg/minute until the appearance of
      generalized convulsions with maximal hindlimb extension. RESULTS: Compared with
      vehicle-injected controls, rats that received ICV Adenocard had a significant
      delay in mean time to seizure (162.1 seconds versus 107.4 seconds; P < .001).
      There was a corresponding increase in the weight-adjusted convulsant dose of
      aminophylline after the ICV administration of Adenocard (311.4 mg/kg versus 470.4
      mg/kg; P < .003). CONCLUSION: Our data indicate that ICV Adenocard ameliorates
      theophylline-induced seizures. Potential anticonvulsant benefits of Adenocard and
      other adenosinergic compounds for victims of severe theophylline poisoning should
      be investigated further.

PMID- 7793727
TI  - Subarachnoid hemorrhage: an unusual presentation of shock.
AB  - A 42-year-old woman became profoundly hypotensive shortly after arriving at our
      emergency medical center after a seizure. The patient's blood pressure did not
      respond to aggressive fluid resuscitation, administration of inotropic agents,
      vasopressors, or corticosteroids. After a thorough search for the cause of shock,
      she was found to have a subarachnoid hemorrhage (SAH). Hypotension is a rare
      occurrence in SAH. Several mechanisms of SAH are reviewed in this report and are
      invoked to explain this patient's lack of response to the standard therapies for
      hypotension. Emergency physicians should consider SAH in the differential
      diagnosis of refractory shock in patients who present with neurologic
      abnormalities.

PMID- 7793726
TI  - Moonlighting.

PMID- 7793729
TI  - Warfarin sodium-induced skin necrosis.
AB  - Skin necrosis is a rare complication of treatment with coumarin derivatives.
      Since it was first identified by Verhagen in 1952, approximately 200 cases of
      skin necrosis have been reported worldwide, but only 73 have been reported in the
      English language literature. A telltale clinical scenario of pain and petechiae
      progressing to sharply demarcated ecchymosis, bullae formation, and gangrenous
      necrosis manifests most often in the adipose tissues of middle-aged women.
      Necrosis usually appears within 3 to 6 days of the initiation of warfarin sodium
      therapy. We report a case of cutaneous necrosis that began 46 days after warfarin
      sodium therapy was begun.

PMID- 7793728
TI  - Anterior spinal artery infarction.
AB  - Spinal cord ischemia, as represented by acute paraplegia, is rare in the absence
      of trauma. It is even more uncommon that an infarction of the spinal cord occurs
      in a patient with no predisposition to vascular disease. We report a case of
      anterior spinal artery syndrome resulting from an infarction of the anterior
      aspect of the spinal cord in an otherwise healthy 45-year-old woman.

PMID- 7793731
TI  - Fertilizing the spirit of Hippocrates.

PMID- 7793730
TI  - Ventricular tachycardia may masquerade as supraventricular tachycardia in
      patients with preexisting bundle-branch block.
AB  - We present the cases of three patients with preexisting bundle-branch block in
      whom wide-complex tachycardias were considered to be of supraventricular origin
      because QRS morphologies were essentially unchanged from those during normal
      sinus rhythm. The patients experienced adverse effects from medications for
      supraventricular tachycardia. Ventricular tachycardia eventually was diagnosed in
      all three by means of invasive electrophysiologic studies. Ventricular
      tachycardia may masquerade as supraventricular tachycardia in patients with fixed
      intraventricular conduction disturbance. Emergency therapy based solely on the
      QRS identity criteria may result in poor clinical outcome.

PMID- 7793732
TI  - Carotid endarterectomy based on preoperative duplex ultrasound.
AB  - Recent studies have suggested that carotid endarterectomy can be performed safely
      based solely on the noninvasive duplex ultrasound evaluation in selected
      patients. We have prospectively evaluated 60 consecutive patients who underwent
      65 carotid endarterectomies, 48 patients without preoperative angiography and 12
      with angiography. Forty-two patients were operated on for symptomatic disease,
      and 23 procedures were done for critical, asymptomatic stenoses. Long term
      followup consisted of physical examination and serial duplex scans every 3-6
      months postoperatively over a mean followup period of 2.4 years. Clinical
      management indicated by duplex ultrasound was altered in only one of the 12
      patients who had preoperative angiography, a change in the timing of the
      endarterectomy in a symptomatic patient with an ulcerated lesion seen at
      angiography. At operation the severity of disease predicted by duplex ultrasound
      was confirmed in all cases (100 per cent sensitivity), including one > 80%
      diameter stenosis interpreted by angiography as occluded; no unsuspected anatomic
      anomalies were found at surgery. The duplex scan also correlated well with
      intraoperative findings of surface ulceration and gross intraplaque hemorrhage.
      There was one intraoperative stroke with good recovery in a patient with
      preoperative angiography; and there were no deaths, for a combined morbidity and
      mortality of 1.6 per cent. During long term followup, 97 per cent of patients
      have remained symptom-free. We conclude that clinical assessment with a
      preoperative duplex ultrasound scan of good technical quality and interpreted in
      collaboration with the vascular surgeon provides appropriate information on which
      to base carotid endarterectomy and allows a safe alternative to the routine use
      of preoperative angiography.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793733
TI  - Rupture of known abdominal aortic aneurysms: an ethical dilemma.
AB  - Elderly patients with abdominal aortic aneurysms (AAA) may be deemed inoperable
      due to the presence of comorbid conditions. Presentation of these patients with
      acute rupture can then result in difficult ethical decisions regarding surgical
      treatment. Over six years, 80 patients were treated emergently for ruptured AAA.
      Of these patients, 26 (32.5%) had known aneurysms. This study was performed to
      determine outcome and factors affecting mortality in patients with known AAAs.
      There were no significant differences between known and unknown AAA groups with
      regard to operative risk. In the overall group (n = 80), patient delay in seeking
      treatment averaged 20.4 hours with a trend towards shorter times in those with
      known AAAs (13.8 hours) compared with the unknown group (23.6 hours; p = 0.09).
      Medical transport delay, however, was significantly shorter for patients with
      known AAA (124 minutes versus 230 minutes; p = 0.04). Overall mortality was 56
      per cent (n = 45). Those patients with known AAAs had a higher mortality (69%; n
      = 18) than those with unknown AAAs (50%, n = 27) but this was not statistically
      significant (P = 0.10). In patients with known AAAs, operative death was related
      to patient delay, with an average delay in seeking medical advice of 21.3 hours
      in nonsurvivors compared with 8.6 hours in survivors (P = 0.04). No other risk or
      demographic factors correlated with mortality. Despite a known AAA, significant
      delay in seeking medical advice occurred, and this delay resulted in decreased
      survival. Patient education is imperative if nonoperative treatment is
      chosen.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793734
TI  - Is CT portography (CTAP) really useful in patients with liver tumors who undergo
      intraoperative ultrasonography (IOUS)?
AB  - The objectives were to compare the role of CT during arterial portography (CTAP)
      and intraoperative ultrasound (IOUS) in the management of patients with primary
      or metastatic liver tumors; to study the ability of CTAP to define resectability
      before laparotomy in these patients; and to study whether the omission of CTAP in
      the imaging algorithm resulted in a diminished resectability rate. Eighty-eight
      consecutive patients with primary or metastatic liver cancer who underwent CTAP
      and/or IOUS between January 1990 and December 1993 were reviewed. Thirty patients
      had both CTAP and IOUS and underwent 31 laparotomies (Group I). The sensitivity
      of these two tests to detect liver tumors was compared. Twenty-eight explorations
      were performed for hepatic metastases and three for hepatocellular carcinoma.
      Fifty-three patients, including those in group I, underwent CTAP before
      laparotomy and were studied to assess the sensitivity of CTAP in determining
      unresectability (Group II). Thirty-five patients (Group III) had IOUS only and
      were studied to determine whether the omission of CTAP decreased the
      resectability rate. In Group I, 52 hepatic lesions were found by a combination of
      imaging studies, operative exploration, and pathologic examination. The
      sensitivity of CT, CTAP, IOUS, and exploration were 67 per cent, 65 per cent, 100
      per cent, and 75 per cent, respectively. IOUS was more sensitive than any other
      modality in detecting liver tumors (P < 0.001). It added new information in 7/31
      cases (23%). The false positive rate of CTAP was 4/31 (13%). In one case (3%), a
      false positive result would have precluded a curative resection. CTAP changed
      management of 4/53 patients (7.5%) by showing unresectable disease.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7793735
TI  - The use of tranexamic acid to reduce postoperative bleeding following cardiac
      surgery: a double-blind randomized trial.
AB  - Bleeding during the first 24 hours following cardiac surgery using cardio
      pulmonary bypass (CPB) is a serious complication. Attempts to modify the degree
      of postoperative bleeding with pharmacologic therapy have met with limited
      success. Tranexamic acid, a potent inhibitor of plasminogen, may decrease the
      amount of mediastinal bleeding following surgery utilizing CPB. We assigned 30
      patients who were about to undergo cardiac surgery to a double-blind randomized
      trial. The treatment group received tranexamic acid, given intravenously as 10
      mg/kg over 30 minutes, at the time of skin incision, followed by a 1 mg/kg/hr
      infusion for 12 hours. The control group received a placebo (saline) of equal
      volume. Measurements of shed mediastinal blood and transfused homologous blood
      were made at 6, 12, and 24 hours postoperatively. Mediastinal blood loss in the
      treatment and control groups was 382 mL versus 594 mL at 6 hours (P = 0.08), 502
      mL versus 848 mL at 12 hours (P = 0.04), and 711 mL versus 1160 mL at 24 hours (P
      = 0.02). The mean transfusion volumes after 24 hours were 356 mL in the treatment
      group and 528 mL in the placebo group (P = NS). Prophylactic tranexamic acid
      infusion decreases mediastinal blood loss following cardiopulmonary assisted
      cardiac surgery.

PMID- 7793737
TI  - Marked asymmetry of LES: important element of LES barrier in subsets of patients
      with reflux symptoms.
AB  - Computerized axial manometry (CAM) of the lower esophagus measures squeeze
      pressure at multiple points in each segment of the lower esophageal sphincter
      (LES), calculates several unique parameters of LES function, and constructs a 3-D
      display of the LES. Whether parameters derived from CAM, such as the radial mean
      pressure (LESrmp), Asymmetry (Asym), and Vector Volume (VV), have relevance to
      function of the LES remains undefined. This study compares the results of CAM in
      patients with gastroesophageal reflux disease (GERD) and controls. There were 54
      patients with GERD and 21 volunteers; all underwent CAM as part of their
      evaluation; GERD was defined by clinical and endoscopic examinations, and all
      patients had abnormal 24-hour pH tests. Statistical evaluation was performed. The
      LESrmp and the Vector Volume were significantly correlated in both groups of
      patients and differed significantly in both. Asymmetry of the LES was a
      significant negative factor in LES strength as shown by VV and LESrmp. Asymmetry
      alone, however, did not show a strong correlation with reflux. Asymmetry is
      indirectly correlated with the major determinants of LES strength; in patients
      with low VV, asymmetry might be a critical factor. When a high VV is present,
      asymmetry has no particular relevance. CAM provides invaluable measurements of
      the LES.

PMID- 7793736
TI  - Preoperative administration of antibodies against tumor necrosis factor-alpha
      (TNF-alpha) and interleukin-1 (IL-1) and their impact on peritoneal adhesion
      formation.
AB  - This study investigates the effects of preoperative intravenous administration of
      antibodies against TNF-alpha and IL-1 on peritoneal adhesion formation. Fifty-six
      Sprague-Dawley rats (350-400 gm) were used in this study. Eight rats were used to
      empirically determine the amount of anti TNF-alpha and anti IL-1 needed for
      complete in vivo neutralization. This amount was used for preoperative treatment
      of selected groups. Forty-eight rats were divided into four equal groups (n =
      12). All rats underwent a midline laparotomy. Ten cm square of cecal serosa was
      abraded, the peritoneal cavity was irrigated with normal saline, and the incision
      was closed in layers. Cultures were obtained intraoperatively and rats with
      positive cultures were excluded. Rats in Group 1 were not treated (control),
      while rats in Groups 2, 3, and 4 were treated with anti TNF-alpha, anti IL-1, and
      a combination of anti TNF-alpha and IL-1 respectively. All rats were killed at 3
      weeks, and peritoneal adhesions were graded using a scale of 0 (none) to 3
      (extensive, dense). Rats treated with anti IL-1 (Group 3) and those treated with
      a combination of anti TNF-alpha and anti IL-1 (Group 4) had significantly fewer
      adhesions when compared with Group 1 (control) (P < 0.01 and < 0.005,
      respectively). Least adhesion formation was associated with Group 4 rats. In
      conclusion, selective immunosuppression, at a molecular level, appears to have a
      significant impact on rates of postoperative peritoneal adhesion formation.

PMID- 7793739
TI  - Ileoproctostomy is preferred over ileoanal pull-through in patients with
      indeterminate colitis.
AB  - A 15-year retrospective review was undertaken to evaluate the operative outcomes
      of patients with indeterminate colitis who were referred for rectal-sparing
      operations. Review of 95 consecutive patients operated for ulcerative colitis
      (UC) or indeterminate colitis (IC) revealed characteristics of IC in 13 patients.
      In the group as a whole, there were 45 females and 50 males; the average age was
      33. A total of 64 patients had ileoanal pull-through (IAA). Analysis revealed
      that four of these patients had IC revealed by findings before operation in three
      patients and following the first stage of operation in one patient. Three of
      these four patients have subsequently required permanent ileostomy. Six patients
      who underwent IAA have subsequently demonstrated signs and symptoms of Crohn's
      disease (CD). All six have subsequently required ileostomy. Overall 10 patients
      with CD underwent IAA, and nine have required permanent ileostomy. Fourteen
      patients had ileorectal anastomosis (IRA) for UC or IC. IRA was performed for
      patients with IC in nine cases, and five patients with UC elected this operative
      option. Indications for IRA in patients with UC included obesity, 2; mental
      retardation, 1; advanced age, 1; and patient preference, 1. Of the patients with
      IC who underwent IRA, two have subsequently shown signs and symptoms of Crohn's
      disease. Overall, 14 of 14 patients who had IRA still have functioning IRA. None
      has required ileostomy. The poor results in patients with UC or IC subsequently
      shown to have CD have caused us to change our operative approach in patients with
      any question in the diagnosis of UC.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793740
TI  - Experience with surgical resident training in a combined program in plastic
      surgery.
AB  - Healthcare reform may impact graduate medical education (GME) to reduce both
      specialty training positions and the length of training in these programs.
      General Surgery residencies often provide prerequisite training for surgery
      specialty training and will be affected by these changes. The purpose of this
      study is to identify the quality, outcome, and differences between PGYI-PGYIII
      categorical general surgery residents (GS) and matched prerequisite plastic
      surgery residents (PS). Concurrent comparisons analyzed American Board of Surgery
      Inservice Training Examinations (ABSITE) data from 1980-1992 as well as the
      surgery operative logs (SOL) and the curriculum of matched residents from 1989
      1992. Outcome was assessed by board performance and from a piloted questionnaire
      to all PS graduates of the combined (3-year GS and 2-year PS) program. ABSITE
      analysis demonstrated satisfactory performance for both PS and GS at each PGY
      level, with significant increases each year for GS, but only between PGYI and
      PGYII for PS; there was a significant difference between PS and GS at all PGY
      levels. SOL analysis paralleled the curriculum and demonstrated more plastic
      surgery for PS compared to GS, with no difference in general surgery or hand
      surgery. PS program graduate respondents (32/44-72.7%) identified that the GS
      training/PS training was appropriate (71.9%/93.8%), effective (90.7%/93.8%) and
      of appropriate duration (87.5%/75.1%). 87.5 per cent of PS graduates completed
      ABPS certification. Combined PS training in all PS programs would reduce GME
      payments by over $20 million. Combined PS training is effective, appropriate,
      resource-efficient, and has an excellent outcome, but it requires a specific
      curriculum and close coordination between General Surgery and Plastic Surgery
      programs.

PMID- 7793738
TI  - Reconstruction with myocutaneous flaps following resection of locally recurrent
      rectal cancer.
AB  - Local or regional recurrence is frequent in patients treated for rectal cancer.
      Many will die with regional disease in the absence of distant metastases. To
      achieve cure or palliation, radical surgery resulting in large pelvic defects may
      be warranted. Myocutaneous flap reconstruction may be used to achieve
      satisfactory closure. From 1988 to 1993, nine patients (5 female, 4 male)
      underwent 10 myocutaneous flap reconstructions for large perineal or pelvic
      defects following surgical extirpation of recurrent rectal cancer at Fox Chase
      Cancer Center. All nine patients had been previously treated with radiation
      therapy. Their clinical course was reviewed and quality of life assessed. The
      mean age at diagnosis of recurrence was 56 years. In six, this was a first, and
      in three patients a second recurrence. Clinical presentation was most often
      bleeding, abscess, or perineal pain. Resection was determined by extent of
      recurrence and included perineal resection, pelvic exenteration, cystectomy,
      sacrectomy, or coccygectomy. Extent of disease necessitated intraoperative
      radiation therapy in one case and placement of brachytherapy catheters in four.
      Bilateral gracilis flaps were used in four, unilateral in three, gluteus maximus
      in two, and combined gluteal and gracilis flaps in one patient. Six perineal and
      four combined perineal and vaginal defects were reconstructed. The mean length of
      surgery was 9.1 hours, and the length of hospitalization averaged 17.5 days. In
      nine of 10 cases, patients had prehospital level of function at discharge. Acute
      surgical flap-related complications included three cases of minor wound infection
      or separation, two of minimal but persistent drainage, and one of vaginal
      colonization.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793741
TI  - Laparoscopic liver biopsy in patients with coagulopathy, portal hypertension, and
      ascites.
AB  - The safety, reliability, and technique of laparoscopic liver biopsy were
      evaluated in 22 consecutive patients with coagulation abnormalities who were
      considered high risk for standard percutaneous liver biopsy. Fifty-eight biopsies
      were performed in 15 men and seven women. All patients had a prolonged
      prothrombin time (> 13.5 seconds), bleeding time (> 9 minutes), or
      thrombocytopenia (< 100,000 TH/UL). Ten patients (45%) had more pronounced
      coagulation abnormalities defined as a prolonged PT > 2.5 seconds or < or = 30%
      control, platelet count < 50,000 TH/UL, or bleeding time twice normal. Thirteen
      patients (59%) had both thrombocytopenia and a prolonged PT. Ascites was present
      in 19 patients (86%) and portal hypertension in 16 (73%). Laparoscopic liver
      biopsy was performed under general anesthesia, most commonly using two trocar
      sites and an open laparoscopic technique. Hemostasis was most effectively
      obtained by application of direct pressure and topical gelfoam and thrombin. A
      postoperative drop in hemoglobin of > or = 1 gm per cent occurred in four
      patients. One patient required laparotomy for postoperative bleeding and was the
      only patient requiring transfusion of red blood cells. Other complications
      included two minor ascitic leaks, one small subcapsular hematoma, and one wound
      infection. In conclusion, laparoscopic liver biopsy can be performed safely and
      reliably in patients with conditions contraindicating percutaneous biopsy.

PMID- 7793742
TI  - Recent experience with cancer of the ampulla of Vater in a national hospital
      group.
AB  - A total of 64 resections, 24 operative bypasses and 35 nonoperative biliary
      intubations, were performed for ampullary carcinoma in U.S. Dept. of Veterans
      Affairs hospitals from 1987 to 1991. Mean survival after resection was 702 days,
      significantly higher (ANOVA, P < or = 0.005) than that after bypass (345 days) or
      intubation (385 days). Operative mortality rates were similar: resection or
      intubation = 14%, bypass = 12%. Operative (30-day) mortality was zero in four
      local resections, 10% in 51 Whipples and 44% in nine total pancreatectomies. TNM
      staging was available for 74 patients, and mean survival after resection exceeded
      2 years in 34 patients with Stage I-II (localized) cancers, was 532 days in 10
      patients with Stage III (regional nodes +) and 77 days in two patients with Stage
      IV (metastatic) disease. However, mean survival without resection was 498 days in
      14 patients with localized cancer, 634 days in two patients with regional and 215
      days in 11 patients with distant metastases. Resection clearly increased survival
      only for Stage I cancers (P < or = 0.02). Predicted 5-year survival rates by
      stage after resection were: I-II = 21%, III < 10%, IV = 0%. Complications were
      recorded in 29 per cent of resected patients, with sepsis the most common (21% of
      resections). Both sepsis and GI bleeding significantly decreased mean survival (P
      < or = 0.05, ANOVA), but pneumonia, pancreatic fistula, or wound problems did
      not. Ampullary cancer is a favorable subtype of peri-ampullary cancers, but
      prolonged survival is also seen without resection and may be largely limited to
      tumors that do not involve regional nodes.

PMID- 7793744
TI  - Surgical office-based ultrasound of the breast.
AB  - How surgical office-based ultrasound (US) influences the management of
      nonpalpable, new or increasing size, mammogram-detected breast masses was
      evaluated. Ninety-seven patients had diagnostic US only; of these, 67 had their
      mass diagnosed as a simple cyst, and 30 had a negative US. Fifty-three additional
      patients underwent US-guided aspiration and/or biopsy (US-GAB) of their breast
      mass after diagnostic US. Of 12 patients with diagnostic US of "simple cyst," US
      GAB confirmed each to be cysts. Of five patients with diagnostic US of
      "fibroadenoma," four had fibroadenomas and one had insufficient tissue on US-GAB.
      In all five cases a fibroadenoma was diagnosed at open biopsy. Of 27 patients
      with diagnostic US of "indeterminate" (cyst versus solid/complex cyst), 15 had
      cysts, one had a fibroadenoma, and one had a papilloma on US-GAB; the latter two
      were confirmed on open biopsy. Ten of these 27 patients had fibrocystic change
      identified on US-GAB; six were benign on open biopsy, and four had no change on
      follow-up mammogram. Of nine patients with diagnostic US of "suspicious," three
      had carcinomas, five had fibrocystic change, and one had insufficient tissue on
      US-GAB; three cancers were confirmed, and the remaining six were benign on open
      biopsy. There were no false positives and no false negatives among those patients
      undergoing US-GAB. In conclusion, office-based ultrasound of the breast performed
      by surgeons can accurately diagnose nonpalpable simple cysts and can accurately
      guide needle aspiration and/or biopsy of probable fibroadenomas, indeterminate,
      or suspicious masses for diagnosis of cystic, benign solid, or malignant lesions.

PMID- 7793743
TI  - Closed drainage versus open packing of infected pancreatic necrosis.
AB  - Infected pancreatic necrosis is the most lethal form of pancreatic infections. We
      have compared our results of open packing and closed catheter drainage after
      surgical debridement in 20 patients between 1978 and 1993. There were 18 men and
      2 women, ages 18 to 72 (mean 54 years). Pancreatitis was attributed to alcohol in
      eight patients, gallstones in four, surgery in four, hyperlipidemia in one, and
      was unknown in one. The most common infectious organisms were Strep. viridans, E.
      coli, Staph aureus, and Candida albicans. Surgical debridement and closed
      catheter drainage without lavage was the initial treatment in nine patients.
      Seven of 9 (78%) required reoperation for recurrent abscess and necrosis.
      Procedure related morbidity was 70 per cent and overall mortality was 44 per
      cent. Sepsis was the cause of death in three patients and multi-system organ
      failure in one patient. Surgical debridement and open packing was performed in 11
      patients. Each patient had scheduled reoperations for repeat debridement and
      packing an average of 10 times over 21 days. Procedure-related morbidity was 73
      per cent and overall mortality was 18 per cent. One patient died of cardiac
      failure and one of multisystem organ failure. Retroperitoneal hemorrhage and
      recurrent abscesses were more frequent after closed drainage, whereas gastric
      fistula and incisional hernia were more frequent after open packing. Ventilator
      dependence, pancreatic and intestinal fistula, and organ failure occurred at the
      same rate. In conclusion, surgical debridement and open packing, with planned
      redebridement and packing, is more effective in controlling the septic process
      than is closed catheter drainage of infected pancreatic necrosis.

PMID- 7793746
TI  - Congenital thyroid hemiagenesis.
AB  - Failure of embryologic development of a lobe of the thyroid gland is a rare
      anomaly. In order to characterize this unusual entity, we report our experience
      in seven patients with thyroid hemiagenesis involving the left lobe in five and
      the right lobe in two patients. The diagnosis was made as a result of evaluation
      and treatment of a thyroid nodule (4), diffuse thyroid enlargement with
      thyrotoxicosis (2), and a simple goiter in a patient with a prior history of
      radiation treatment for facial acne. In five patients thyroid scintigraphy
      demonstrated unilateral absence of function, four of whom had an ultrasound exam
      of the neck that revealed a corresponding absence of thyroid tissue. In one
      patient the diagnosis was made incidentally on a screening ultrasound exam of the
      neck. Thyroid hemiagenesis was unsuspected preoperatively in one patient with
      Graves' disease because of marked hyperplasia of a single thyroid lobe and
      isthmus. Thyroid hemiagenesis was confirmed in four patients who underwent
      thyroidectomy. The presence of a thyroid isthmus was established in six patients.
      Postoperatively, all patients were treated with thyroid hormone. Associated
      thyroid pathology included adenoma (1), follicular carcinoma (1), colloid nodule
      (2), Graves' disease (2), and a simple goiter (1). In conclusion, the diagnosis
      of thyroid hemiagenesis should be considered in any patient with unilateral
      absence of function on thyroid scintigraphy and confirmed by ultrasonography.
      Recognition of this rare congenital anomaly is important to avoid unnecessary
      contralateral neck exploration with its potential morbidity and to insure that
      all patients receive careful follow-up and appropriate thyroid hormone therapy
      when necessary.

PMID- 7793747
TI  - Computational simulation of worker exposure using a particle trajectory method.
AB  - The velocity field downstream of a worker is approximated with a discrete vortex
      algorithm. This information is used to calculate trajectories of massless tracer
      'particles' released from a point-source of contaminant. Concentrations in the
      plane of this source are estimated by averaging over a number of such
      trajectories. Approximations include: (1) representing the worker by a two
      dimensional elliptical cylinder; and (2) representing tracer gas contaminant by
      massless particles generated without momentum. These particles are transported by
      both vortex shedding and turbulent diffusion. Computer-predicted mean
      concentrations in the near-wake region downstream of the worker compare well with
      results from wind-tunnel tracer gas experiments employing a mannequin.
      Subsequently, the concept of a computational breathing zone is introduced, and
      predictions of worker exposure are made. These simulations of time-integrated
      breathing zone concentration also compare well with measured values.

PMID- 7793745
TI  - Simultaneous fine-needle aspiration and core-needle biopsy of thyroid nodules.
AB  - To evaluate the efficacy of simultaneous fine-needle aspiration (FNA) and core
      needle (CN) biopsies of thyroid nodules, the clinical course and operative
      findings in 100 patients having both tests were reviewed. Each patient had a
      diagnosis made with this approach. Both specimens were adequate for diagnosis in
      95 patients. In the remaining 5 patients, a diagnosis was provided by FNA in four
      and CN biopsy in one. FNA and CN biopsies gave the same diagnosis of either a
      benign nodule in 53 patients or neoplasia in 30 patients. When both FNA and CN
      biopsies showed a benign nodule, a nonoperative approach was taken in 43 of the
      53 patients. Forty-two patients were operated on either because of biopsy
      findings (32) or clinical indications (10). The surgical specimens were used to
      determine the false positive and false negative rates, the sensitivity,
      specificity, and accuracy for the diagnosis of neoplasia. The false (+) and false
      (-) rates in diagnosing neoplasia were 33 per cent and 7 per cent for FNA, 20 per
      cent and 4 per cent for CN biopsy, and 20 per cent and 0 per cent for both. The
      sensitivity, specificity, and accuracy for FNA were 93 per cent, 67 per cent, and
      83 per cent, for CN biopsy 96 per cent, 80 per cent, and 90 per cent, and 100 per
      cent, 80 per cent, and 93 per cent for both FNA and CN. All neoplasms were
      detected, and no thyroid carcinomas were missed by this combination. There was
      only one complication: bleeding after a CN biopsy. Combined FNA and CN biopsies
      allow most patients with thyroid nodules to avoid an unnecessary operation and
      accurately diagnose those with thyroid carcinoma. These two procedures are safe
      and complementary.

PMID- 7793748
TI  - Correlation between different measures of exposure in a cohort of bakery workers
      and flour millers.
AB  - This paper describes the relationship between continuous and 'grouped' variables
      for several measures of exposure in a longitudinal study of bakery workers and
      flour millers. Average shift and peak levels, both for dust and for flour
      aeroallergen were measured, duration of exposure obtained from questionnaire and
      cumulative exposure both for dust and for flour aeroallergen calculated. Neither
      for dust nor for flour aeroallergen was there a correlation between duration of
      exposure and intensity measures of exposure (peak and average). Moderate to good
      correlation existed between the various intensity measures of exposures both for
      dust and for flour aeroallergen. Good correlations existed between measures of
      exposure of dust and measures of exposure for flour aeroallergen. The degree of
      correlation was reflected by the fact that the number of workers changing
      categories depended on which measure of exposure was considered. The higher the
      correlation coefficient between various measures of exposure the fewer workers
      changed category. This information provides important information for a better
      understanding of the exposure-response relationship amongst bakery workers and
      flour millers.

PMID- 7793749
TI  - Flour dust exposure variability in flour mills and bakeries.
AB  - As part of a longitudinal study to explore the exposure-response relationship
      between flour dust exposure and work-related symptoms and skin sensitivity the
      authors formed exposure groups and estimated various components of variability.
      This paper describes the between-exposure group, the between-worker and the
      within-worker variation of personal flour dust exposure in bakeries, flour mills
      and packing stations. In total 346 samples were collected in 13 exposure groups.
      The geometric means of the exposure groups ranged from 0.3 up to 9.0 mg m-3.
      Between-worker variances within exposure groupings were less than the overall
      between-worker component although substantial differences in exposure between
      workers remained in some exposure groups. Overall the largest variance component
      was the between-exposure group component followed by the considerably smaller
      between-worker and within-worker components.

PMID- 7793750
TI  - Epidemiological study of eye irritation by hydrogen sulphide and/or carbon
      disulphide exposure in viscose rayon workers.
AB  - In the framework of an extensive health survey 123 male viscose rayon workers
      exposed to hydrogen sulphide (H2S) and/or carbon disulphide (CS2) and 67
      referents not exposed to either of these chemicals answered questions on eye
      irritation complaints in a self-administered questionnaire. Personal exposure
      varied from 4 to 112 mg m-3 for CS2 and from 0.2 to 8.9 mg m-3 for H2S. A
      combined exposure measure was calculated using principal component analysis. The
      exposed subjects had a significantly higher prevalence of eye pain, burning and
      photophobia. Adjustment for age and smoking in logistic regression revealed
      significantly more eye complaints for all workers that were highly exposed. In a
      postal survey one-third of the ex-workers of the same viscose rayon factory
      reported having left the factory because of eye complaints, indicating that their
      occurrence may be underestimated in the cross-sectional study.

PMID- 7793751
TI  - Particle inhalability curves for humans and small laboratory animals.
AB  - Several inhalability curves for nose breathing in humans have been developed. No
      studies have been designed specifically to develop inhalability functions for
      animals, although it has been shown that pulmonary deposition of large particles
      (> 4-5 microns) via inhalation is minimal in laboratory animals [Raabe et al.,
      Inhaled Particles VI, pp. 53-63. Pergamon Press, Oxford (1988)]. The logistic
      function was fitted to these animal deposition data of Raabe et al. (1988) to
      estimate an inhalability curve for laboratory animals. The logistic function was
      also fitted to the human data of Breysse and Swift [Aerosol Sci. Technol. 13, 459
      464 (1990)] for comparison. The results suggest that ambient concentration is a
      good predictor (inhalability > 95%) of inhaled concentration for humans for
      particles < 11 microns dae. In small laboratory animals, however, the inhalable
      portion of the ambient concentration is predicted to be 95% for 0.7 microns dae
      particles but declines to 45% for 10 microns dae particles. It is, therefore,
      important to consider the effects of inhalability when estimating dose delivered
      to the target tissue in animals. In comparing delivered doses between animals and
      humans, adjusting for inhalability may change not only the magnitude of the
      difference but also which species is predicted to receive a greater delivered
      dose.

PMID- 7793752
TI  - Polycyclic aromatic hydrocarbon exposure in coal liquefaction workers: the value
      of urinary 1-hydroxypyrene excretion in the development of occupational hygiene
      control strategies.
AB  - Studies in coal liquefaction workers were conducted to examine relationships
      between work activities, exposure to polycyclic aromatic hydrocarbons (PAHs) and
      excretion of urinary 1-hydroxypyrene (1-OHP). In a single-week study in
      operators, the end of work period 1-OHP excretion was an order of magnitude
      higher than in a shadow control subject, who experienced exposure by inhalation
      only (shadowed operator = 15.8 mumol mol-1 creatinine; shadow control = 1.07
      mumol mol-1 creatinine). Dermal exposure was estimated to account for over 70% of
      excreted 1-OHP in exposed workers. A second study over 4 consecutive weeks (multi
      week study) showed consistency in 1-OHP excretion from week to week both in
      operators and laboratory technicians, indicating little variation in weekly
      exposures for these workers. Excretion levels in maintenance workers however,
      showed some week to week variation, consistent with the variable nature of
      exposures associated with this type of work. A further study involving an end of
      work period spot assessment for all personnel showed a clear distinction between
      exposed workers (operators and maintenance staff) and other workers not thought
      to be exposed (laboratory technicians and office staff). Findings in the course
      of these studies indicated that there is no loss of 1-OHP at 4 degrees C,
      compared with -20 degrees C. On the basis of work to date at the coal
      liquefaction facility, hygiene control strategies have been proposed involving
      periodic urinary 1-OHP monitoring.

PMID- 7793753
TI  - Exposure of the deck crew to carcinogenic agents on oil product tankers.
AB  - Work on deck on eight oil product tankers was examined. The purpose was to
      evaluate the need for improvement of the working environment to reduce the risk
      of occupational cancer. Benzene, polyaromatic hydrocarbons (PAHs) and organic
      lead compounds were sampled, and the crew answered a questionnaire on acute
      health effects. By area monitoring, benzene was generally found to be in the
      range from the detection limit, of 0.01 ppm, up to 1.15 ppm, but one tanker which
      loaded gasoline with the hatches open had levels up to 55 ppm. Personal
      monitoring showed exposure levels in the range 0.01-1.15 ppm. The PAH-levels and
      the levels of organic lead were low. No seamen were observed using respiratory
      protective equipment. Central nervous system symptoms were reported by the crew
      with the highest exposures to benzene although benzene may not be the only cause.
      The exposure to benzene and other hydrocarbons on the deck of oil product tankers
      ought to be reduced.

PMID- 7793754
TI  - Malignant mesothelioma and duration of asbestos exposure: correlation with tissue
      mineral fibre content.
AB  - Among 441 cases of malignant mesothelioma in the author's files, there were 324
      for whom reliable information was available regarding the duration of exposure to
      asbestos. Included were 298 pleural and 26 peritoneal mesotheliomas. The mean
      duration of exposure to asbestos was 23 +/- 14 years for all cases, and was not
      different for the pleural and peritoneal groups. Lung tissue was available for
      analysis of mineral fibre content in 94 cases. Linear regression analysis showed
      a significant correlation between duration of exposure and asbestos bodies per
      gramme of wet lung as determined by light microscopy, and between duration of
      exposure and total uncoated fibres (5 microns or greater in length) as well as
      commercial amphibole fibres per gramme as determined by scanning electron
      microscopy (P < 0.05). Individuals with direct exposures had on average higher
      asbestos contents than patients with indirect exposures. Furthermore, for each
      duration of exposure, shipyard workers had on average higher asbestos contents
      than non-shipyard workers (P < 0.05). Mesotheliomas are associated with a wide
      range of durations of exposure to asbestos and pulmonary asbestos burdens, and
      there is a rough correlation between duration of exposure and pulmonary
      commercial amphibole content.

PMID- 7793755
TI  - Biologically relevant assessment of dermal exposure.
AB  - Dermal uptake of hazardous substances is dependent on the concentration of the
      material on the surface of the skin rather than its mass. It is suggested that it
      would be appropriate to consider the integral of concentration, over the skin
      surface and throughout the exposure duration, as an appropriate index of dermal
      exposure. For a low volatility substance this exposure index would correspond to
      the product of concentration, area of skin exposed and the duration of exposure.
      For volatile materials the magnitude of the exposure index would additionally
      depend on the loss of the substance by evaporation. This dermal exposure index is
      more likely to reflect the contribution to the overall dose received from the
      skin than the previously used determinations of mass of hazardous substance on
      the skin. Suggestions are made for possible methods of making measurements using
      this index.

PMID- 7793756
TI  - [Towards a 1st French consensus development conference on a dermatologic topic].

PMID- 7793757
TI  - [Hair dysplasia in oculo-dento-digital syndrome. Apropos of a mother-daughter
      case].
AB  - Oculo-dento-digital syndrome (SODD) as defined by Meyer-Schwickerath in 1957 is a
      rare entity (84 cases) which belongs to ectodermal dysplasias. It consists of:
      the characteristic features (long face, pinched nose); syndactyly; ocular, dental
      and bone abnormalities. This entity is usually transmitted on the autosomal
      dominant mode. We report two cases (a mother and daughter) with polymalformations
      which we classed as SODD. Furthermore, agenesis of lacrimal duct and
      genitourinary abnormalities were noted. The mother had a very particular complex
      hair shaft dysplasia (incomplete pili torti, "tiger tail" aspect, fractures) with
      alopecia since she was fifteen years old. The daughter's hair was normal at
      birth. In SODD, fine and sparse hair is often observed (44 p. 100). Only one
      patient had hair shaft investigation under polarized light: pili annulati and
      monilethrix were described but not found in our cases. These two reports incite
      to the systematic hair shaft study in SODD as other ectodermal dysplasia
      syndromes.

PMID- 7793758
TI  - [Focusing on a test to evaluate the efficacy of skin barrier creams].
AB  - INTRODUCTION: The aim of this study was to adjust an experimental protocol with
      the rabbit to control the skin barrier creams efficacy. ELABORATE TECHNIQUE:
      Therefore, we applied irritant aqueous solutions and solvents on the shaved skin
      of the rabbit flank protected with one of these creams. We noticed inflammatory
      reactions of erythema and oedema but we also conducted an histological
      examination of the treated skin. DISCUSSION: This protocol is simple, there is no
      investment with equipment and only a few number of rabbits are required. There is
      only a difficulty with applying the same volume of cream since cream consistency
      is variable and makes the comparison between the different creams quite delicate.
      This method should be supported by well-controlled studies between several
      laboratories.

PMID- 7793760
TI  - [Parry-Romberg syndrome associated with homolateral segmental vitiligo].
AB  - We report the case of a 11 year-old girl with segmentary vitiligo in the left
      side of the neck and superior part of the hemithorax, associated to an
      homolateral Parry-Romberg syndrome. This association had never been reported. The
      pathogenic hypothesis are discussed. We think that this association can be
      explained by the autoimmune origin of these diseases.

PMID- 7793759
TI  - [Adult T-cell leukemia associated with HTLV-1 in a HIV-2 seropositive African].
AB  - INTRODUCTION: The aim of this report is to describe an HIV-2 seropositive patient
      from Mali who had adult-T cell Leukaemia/Lymphoma associated with HTLV-I
      infection. CASE REPORT: The patient presented with erythroderma and foliate
      lymphocyte leukaemia. Skin biopsy showed an epidermotropic lymphoma. Tumoural
      cells expressed a mature T-cell phenotype CD4+/CD25+. High anti-HTLV-I titers and
      the evidence of monoclonal integration of HTLV-I provirus within circulating
      lymphoid cells led to the confirmation of HTLV-I as the causal agent in tumour
      cell transformation. HIV-2 serology was positive. DISCUSSION: Sub-Saharan Africa
      is a vast reservoir of HTLV-I virus with at least 5 million infected persons.
      Cases of adult-T cell Leukaemia/Lymphoma in Africans are exceptional. Lack of
      sufficient knowledge of the disease could partially explain this discrepancy. The
      main differential diagnosis in dermatology is primary T-cell lymphomas of the
      skin, particularly mycosis fungoides and Sezary syndrome.

PMID- 7793761
TI  - [Unilateral isolated purpura disclosing scurvy].
AB  - We report a case of scurvy. This case is interesting by the unilateral character
      of the ecchymotic leg's purpura. Ascorbic acid assays do not yet enable
      subclinical vitamin C deficiency to be reliably detected. Hence the importance of
      knowing the situation which expose to this deficiency.

PMID- 7793764
TI  - [Vulvar involvement in Crohn disease].
AB  - INTRODUCTION: There are many skin manifestations of Crohn's disease including
      specific lesions occurring late after digestive signs. These manifestations are
      also termed metastatic and are rarely located on the vulva. CASE REPORT: We
      observed a metastatic localization in the vulva of Crohn's disease in a 34-year
      old woman with predominantly rectosigmoid disease. The right labia major was
      greatly enlarged with oedema involving the inguinal cural area. Pustulization and
      erosive lesions were seen. The course of these lesions was independent of the
      colonic disease and responded temporarily only to a triple drug combination of
      metronidazol, prednisolone and minocyclin. CONCLUSION: This case emphasizes the
      frequency of colonic or rectal manifestations associated with vulval involvement
      in Crohn's disease. The metastatic lesions follow a course independent of the
      digestive disease raising therapeutic problems in this localization.

PMID- 7793762
TI  - [Buschke-Ollendorff syndrome].
AB  - The Buschke-Ollendorff syndrome (BOS) is a rare connective tissue disorder
      inherited in an autosomal dominant pattern characterized by cutaneous lesions,
      dermatofibrosis lenticularis disseminata, and osteopoikilosis. We report a new
      case of this syndrome in a 66 year old man, interesting by its association with a
      protein C deficiency, another rare genetically transmitted disease. Diagnosis of
      the BOS is difficult on the mere cutaneous lesions; it is therefore important to
      systematically practice bone X-rays in the presence of atypical pseudoxanthoma
      elasticum, disseminated collagenoma or disseminated connective tissue or elastic
      nevi. The radiologically detectable osteopoikilotic bone lesions, evoking Paget's
      disease, easily sign the diagnosis. In our case, the association of a protein C
      deficiency with the BOS may not be fortuitous because both the elastin and
      protein C genes are localized on chromosome 2q.

PMID- 7793766
TI  - [Keratoacanthoma centrifugum marginatum].
AB  - INTRODUCTION: Keratoacanthoma centrifugum marginatum (KCM) is a rare
      keratoacanthoma. Treatment relies essentially on exeresis which is however
      difficult due to the widespread nature of the lesions. CASE REPORT: A patient
      with a 1 year history of KCM associated with psoriasis vulgaris was successfully
      treated with etretinate (1 mg/kg/day) for 5 months. This medical therapy made it
      possible to avoid the classical surgery and to blanch the associated psoriasis.
      COMMENTS: Several authors have shown the favourable effect of etretinate on
      multiple or large single-site keratoacanthomas. To our knowledge, this is the
      first case reported of successful treatment with etretinate in a case of
      keratoacanthoma associated with psoriasis. We suggest that this drug could be an
      effective alternative to mutilating surgery for this specific variety of
      keratoacanthoma.

PMID- 7793765
TI  - [Lymphomatoid papulosis and anaplastic giant-cell lymphoma].
AB  - INTRODUCTION: The association between lymphomatoid papulosis and malignant
      Hodgkin or non-Hodgkin lymphoma is well known but still raises the problem of
      nosology between these two pathologies. Is lymphomatoid papulosis a
      pseudolymphoma, a prelymphomatous state or a true skin lymphoma? CASE REPORT: We
      observed a patient who had lymphomatoid papulosis and anaplastic large-cell
      lymphoma within an interval of 8 years between. This case was particularly
      interesting because identical immunophenotypes were observed in the atypical
      large-cells of the skin and the lymphomatous cells of the lymph nodes (positive
      for CD43, CD45, CD25, CD30, CD15, EMA). DISCUSSION: This case points out that
      atypical large-cells of lymphomatoid papulosis express the CD15 antigen which is
      only expressed by atypical large-cells in half of the cases of lymphomatoid
      papulosis. In addition, EMA is classically expressed in primary lymph node
      lymphomas rather than in primary cutaneous anaplastic large cell lymphomas which
      could predict extracutaneous dissemination of lymphomatoid papulosis.
      Furthermore, the demonstration that the skin lesions and the lymph nodes
      responded differently to the same treatment would suggest that there are other
      unrecognized biological differences. Lymphomatoid papulosis appears to be a range
      of disorders of the lymphoproliferation of activated T-cells and could include
      varioliform parapsoriasis and cutaneous lymphoma.

PMID- 7793763
TI  - [A case of unilateral elastosis with cysts and comedones. Favre-Racouchot
      syndrome].
AB  - INTRODUCTION: Cutaneous elastosis with cysts and comedones (Favre-Racouchot) is
      one of the oldest known manifestations of helioderma. Both sides of the face are
      usually involved symmetrically. CASE REPORT: We observed a 65-year-old woman with
      extremely severe Favre-Racouchot disease localized exclusively on the left side
      of the face. The diagnosis of elastosis with cysts and comedones was confirmed
      histologically. This elastosis with cysts and comedones was associated with
      spasms of the hemiface treated with injections of botulinic toxin. This
      association was fortuitous and we retained actinic irradiation as the causal
      agent in this woman who had worked for 15 years in the same room. The elastosis
      occurred on the side of the face which had been continuously exposed at the same
      orientation to the window. COMMENTS: This original observation is similar to
      cases where facial exposure to artificial light or sunlight is asymmetrical,
      leading to a higher incidence of lesions on one side of the face: colloid milium,
      actinic keratosis, Dubreuilh melanoma (malignant lentigo) or simple helioderma.
      The asymmetrical nature of the actinic lesions is often related to automobile
      driving. This case was particular since it demonstrated that Favre-Racouchot
      elastosis with cysts and comedones is due to actinic irradiation and not to skin
      aging.

PMID- 7793768
TI  - [Is ischemic ulcer of the leg a good model for pharmacoclinical experiments?].

PMID- 7793767
TI  - [Treatment of Langerhans-cell histiocytosis by oral cyclosporin A and topical
      nitrogen mustard].

PMID- 7793770
TI  - [Grover disease and gastric adenocarcinoma].

PMID- 7793769
TI  - [Hirsutism treated by estrogens and anti-estrogens: disclosure of porphyria
      cutanea tarda. Association with chronic hepatitis C].

PMID- 7793771
TI  - [A case for diagnosis: Osler's nodes and Janeway lesions].

PMID- 7793773
TI  - [Superficial thrombophlebitis].

PMID- 7793774
TI  - [Management of deep venous thrombosis of the lower limbs].

PMID- 7793775
TI  - [Surgery of arterial ulcers].

PMID- 7793776
TI  - [Monthly question: antihistaminics and pregnancy].

PMID- 7793772
TI  - [A case for diagnosis: phlegmasia cerulea dolens].

PMID- 7793778
TI  - Measurement of breast implant volume with magnetic resonance imaging.
AB  - In principle, tomographic imaging of breast implants provides the information
      needed to compute implant volume. We have investigated the reliability of this
      measurement as a means of diagnosing the loss of gel from the implant. We find
      that measurement errors, postimplantation changes of the implant, uncertainties
      in the patients' records, and lack of knowledge of the implant temperature in the
      body can lead to significant discrepancies, making this measurement unreliable as
      a diagnostic tool.

PMID- 7793777
TI  - Do patients with silicone-gel breast implants have elevated levels of blood
      silicon compared with control patients?
AB  - Whole blood silicon levels in 30 patients with silicon-gel implants (inserted
      between 1973 and 1991) were compared with those of 24 healthy, age-matched,
      female patients without breast implants using atomic absorption spectrometry with
      a graphite furnace. The blood silicon levels in the implant patients were
      significantly higher than those of controls (medians 33.45 vs 17.05 ng/ml; p =
      0.005). Of the 30 patients with implants, 15 had received their implants between
      1973 and 1985, and 15 had received implants between 1986 and 1991. Implants made
      between 1973 and 1985 have been shown to be weaker and to have higher silicone
      "bleed" levels than those made from 1986 onward. However, there were no
      significant differences in the blood silicone levels between these two groups of
      patients.

PMID- 7793779
TI  - Utility of magnetic resonance imaging and ultrasonography in diagnosing breast
      implant rupture.
AB  - We prospectively evaluated 81 patients (with 160 implants) who subsequently had
      implants removed to determine sensitivity and specificity of both magnetic
      resonance imaging and ultrasonography. Positive and negative predictive values
      were also calculated to determine whether a statistically beneficial interaction
      existed when ultrasonography and magnetic resonance imaging were used in
      combination to examine an implant. Finally, the misdiagnoses were retrospectively
      evaluated to identify the pitfalls of the investigations. Positive diagnostic
      criteria were described. The sensitivity and specificity of ultrasonography were
      47% and 83%, respectively, and of MRI, 46% and 88%, respectively. On
      retrospective review by the radiologist, the sensitivity and specificity of
      ultrasonography were 70% and 90%, respectively, and of magnetic resonance
      imaging, 75.6% and 94%, respectively. Although definite conclusions could not be
      obtained, there did not seem to be an additive benefit from using both
      ultrasonography and magnetic resonance imaging.

PMID- 7793780
TI  - Anthropometric optical surface imaging system repeatability, precision, and
      validation.
AB  - Disciplines using human body surface dimensions require accurate, repeatable
      measurements. This study presents a design for the analysis of repeatability,
      precision, and validation of a new anthropometric device. This model enables
      estimation of the proportion of the total variation attributable to each level of
      data collection. This model is applied to an analysis of repeatability,
      precision, and validation of the Cencit Imaging System, a new optical surface
      scanner. Twenty-seven facial landmarks were marked on 10 men and 10 women at two
      measurement sessions. Two images were scanned during each session, and each image
      was digitized twice. The Cencit Imaging System results were compared with a
      previously validated digitizer. The Cencit Imaging System was found to produce
      accurate, highly repeatable images. Much of the error in this study is
      attributable to human error in marking landmarks on the subjects. The new imaging
      system will prove useful in a variety of anthropometric applications.

PMID- 7793781
TI  - Functional and social long-term results after free tissue transfer to the lower
      extremity.
AB  - We report the long-term social and functional results in 53 patients receiving
      free tissue transfer after trauma to the lower extremity. The results are
      compared with those of a matched group of patients receiving primary amputation.
      The microsurgically treated patients had significantly more complaints over pain
      during walk (p = 0.02) and edema (p < 0.00005). Regarding social results, no
      significant differences between the two groups were found. Time until surgery,
      infection, or bone defect before free flap surgery did not alter the overall
      results significantly. It is concluded that the long-term functional and social
      results after free tissue transfer are almost the same as those achieved after
      simple amputation. Because the median time until free flap surgery in this series
      was 158 days, early limb-saving procedures could possibly improve the long-term
      results.

PMID- 7793782
TI  - Using the split Latram for better breast projection in breast reconstruction.
AB  - Over the years, although methods of breast reconstruction have improved, the
      ability to build a symmetrical projecting breast has not. When stacked Meme
      implants were used, better projection was obtained. Folding the transverse rectus
      abdominis musculocutaneous flaps allows for good projection; however, the breast
      is then quite wide and large. For smaller breast women with projection and some
      larger breasted women as well, splitting and stacked flaps give a much better
      result. We now do this procedure with simultaneous Latram and mastectomy surgery
      in fewer than 3 hours.

PMID- 7793783
TI  - Minimal expansion for correction of male pattern baldness.
AB  - Tissue expansion for correction of male pattern baldness has not gained wide
      acceptance by patients or surgeons because of the substantial albeit temporary
      deformity of the expansion. Minimal expansion is an alternative. Scalp flaps can
      be expanded just to the point of becoming noticeable over 4 to 6 weeks followed
      by scalp flap transposition and easy closure of the donor site. The
      temporoparietal (Juri) or superiorly based (Dardour) flaps have been used
      unilaterally or bilaterally. The entire restoration is completed in approximately
      8 weeks, is minimally deforming during the expansion phase, and does not require
      the patient to alter his lifestyle significantly or to go into hiding. Hair
      grafts, in contrast, do not begin to grow hair until 12 weeks after
      transplantation, and the process usually requires four sessions over an 8- to 12
      month period with the patient looking temporarily variably absurd. Tissue
      expansion increases scalp available for flap restorations, which appear more
      natural than even the most well-executed hair transplants. Minimal expansion
      makes the process more palatable to the patient and surgeon.

PMID- 7793784
TI  - The Mercedes incision in hair restoration.
AB  - Standard technique for hair transplantation includes plug composite grafts placed
      in circular recipient defects of smaller diameter. The plugs can also be placed
      in slit incisions that are temporarily dilated to accommodate grafts. Two
      drawbacks of these techniques are the appearance of row cropping resulting from
      the regular pattern and compression of individual grafts caused by scar
      contracture. These drawbacks result in tufting and a "doll's head" appearance.
      The expansile Mercedes incision as described here camouflages these failings.
      Donor minigrafts are taken with a biopsy punch knife or as strips in a standard
      fashion. A Mercedes logo-shaped defect is then made at the recipient site using a
      no. 11 scalpel to create a three-armed stellate incision. The incisions are
      rapidly made with the axis oriented parallel to the direction of the native hair
      shafts. The graft is then pushed in flush with the skin. The triangulation
      eliminates compression of grafts because they are spread in three directions
      rather than squeezing in a tight circular or slit configuration. The use of the
      stellate incision along with altering its rotational orientation in a haphazard
      pattern also prevents row cropping. Thus, the Mercedes incision is quicker and
      yields an overall improved result.

PMID- 7793786
TI  - Cutaneous foot malignancies: outcome and options for reconstruction.
AB  - We retrospectively reviewed 26 cases of primary or recurrent cutaneous foot
      malignancies for which patients underwent tumor extirpation and reconstructive
      surgery between 1990 and 1994. The most common disease was malignant melanoma (24
      cases), and most tumors were located on the heel and midplantar area. Free tissue
      transfer was used for nine reconstructions, and various types of plantar,
      rotation flaps, or split-thickness skin grafts were also used. Twenty-five
      patients were ambulatory postoperatively without the use of corrective shoes or
      supportive devices. Sensation was noted to be normal in 20 patients, decreased in
      4, and increased in 1. Two free tissue transfers were lost in the same patient
      because of venous thrombosis. Other complications included partial flap loss,
      skin graft loss, and flap dehiscence. Several patients have resumed pretreatment
      running regimens. Cutaneous tumor extirpation followed by reconstructive surgery
      of the foot does not inhibit the cancer patient's ability to function normally.

PMID- 7793785
TI  - Free radical damage in acute nerve compression.
AB  - Nerve compression causes injury by local ischemia and direct mechanical
      distortion. Peripheral nerves in diabetes mellitus are more prone to injury than
      those of nondiabetics. We sought to determine whether reperfusion-induced, oxygen
      derived free radical injury occurs in peripheral nerves subjected to acute
      compression in normal and chronically diabetic rats. Female Sprague-Dawley rats
      weighing 250 to 275 g (N = 347) were divided into two groups: normal and
      streptozocin-induced diabetics. A total of 187 normal and 160 diabetic nerves
      were analyzed. After 8 weeks of untreated hyperglycemia, the sciatic nerves of
      normal and diabetes mellitus rats were subjected to one of three operations: a
      sham operation, 24-hour compression alone, and 24-hour compression followed by 1
      hour reperfusion (CR). Nerve compression was established by banding the right
      sciatic nerve with a Silastic tubing, 1 cm long and 0.62 mm internal diameter,
      which was secured with 6-0 nylon suture. In the CR group, after 24 hours of
      compression, the tubings were released for 1 hour to permit reperfusion. Nerve
      tissue within the zone of compression underwent biopsy examination and was frozen
      for subsequent analysis. Blood flow to the nerve was quantified by injecting
      fluorescein (10 mg/kg intravenously) 10 minutes before harvest and measuring
      tissue levels fluorometrically. Compression with the Silastic tubing
      significantly reduced neural blood flow by 75%. Blood flow improved but failed to
      return to baseline levels after tubing release in diabetes mellitus nerves while
      perfusion returned to baseline in non-diabetes mellitus nerves. Nerve homogenate
      was assayed for malonyldialdehyde, an indicator of lipoperoxidation, as well as
      enzymes of cellular defense and glucose metabolism.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7793787
TI  - Triangular flap repair of the congenital earlobe cleft.
AB  - Repair of a congenital earlobe cleft was performed on 16 patients using a new
      surgical technique derived from the Tennison-Randall triangular flap operation
      for cheiloplasty. There were no complications. This method was applied because
      the deformities and desired outcomes in the congenital earlobe cleft are similar
      to those of the cleft lip. Many papers have described surgery for congenital and
      acquired clefts; the former differs from the latter in some respects. The
      techniques described for the repair of acquired clefts are not always appropriate
      for congenital clefts. In addition, some operations specifically designed for
      congenital clefts require more complicated techniques. Using our technique to
      correct lobule deformities with a triangular flap in proportion to the angle and
      extent of the cleft, a superior cosmetic result was obtained in the repair of
      longitudinal earlobe clefts.

PMID- 7793788
TI  - Transverse rectus abdominis musculocutaneous (TRAM) flap from TRAM flap for
      sequential bilateral breast reconstruction.
AB  - Sequential as opposed to synchronous autogenous tissue bilateral breast
      reconstruction imposes a dilemma because of the increasing complexity of the
      usually few remaining options. This fact became evident 4 years after an
      ipsilateral superior-pedicled lower transverse rectus abdominis musculocutaneous
      (TRAM) flap for left-breast reconstruction was successful in a patient who only
      then desired a prophylactic contralateral mastectomy but also demanded breast
      symmetry without implants. Without resorting to microsurgical transfers and
      foregoing local delay tactics, a right-breast facsimile was formed via an
      adaptation of breast-sharing principles. Transverse splitting of the original
      TRAM flap with re-elevation of the inframammary half of the reconstructed breast
      still maintained viability through the retained medial left rectus abdominis
      muscle pedicle. This second TRAM flap was immediately transposed to the opposite
      side without incident. Although only a fair overall aesthetic result was
      possible, the patient's expectation for having two "breasts" was met.

PMID- 7793790
TI  - Gastrocnemius muscle transposition to the femur: how high can you go?
AB  - The gastrocnemius muscle flap has gained wide acceptance as a reconstructive
      technique for management of wounds of the knee and proximal tibia. The use of the
      muscle as a pedicle flap to the distal and middle femur has not been well
      quantified, and the proximal rotation arc has been underestimated. We report the
      use of the island gastrocnemius pedicle flap to reach two femur defects 21 and 26
      cm above the joint line, achieved by taking advantage of the favorable location
      of the vascular pedicle above the joint line and the individual length of the
      medial gastrocnemius muscle belly. Evaluation of standard arteriograms suggests
      the location of the medial sural artery pedicle is an average of 32 +/- 14.5 (SD)
      mm above the inferior border of the femur. All vessel origins were found above
      the joint line by radiograph. A common sural artery origin was noted in 32% of
      patients at a mean distance of 35 mm proximal to the joint line. Despite a wide
      range, 62% of sural artery origins were within 1 cm of an axis drawn through the
      widest point of the femoral condyles.

PMID- 7793789
TI  - Closure of massive chest wall defects after full-thickness chest wall resection.
AB  - We report an unusual repair of a massive chest wall defect resulting from
      resection of a chronic ulcer after radiation therapy for stage IV breast
      carcinoma. The defect was 690 cm2 and included the body of the sternum, 10 ribs,
      and the anterior portion of the diaphragm. Chest wall reconstruction was
      accomplished with multiple flaps: a pectoralis major advancement flap, a reversed
      abdominoplasty, an omental flap, and a latissimus dorsiscapular-parascapular
      musculofasciocutaneous (hemiback) flap. Skeletal reconstruction with prosthetic
      material or bone grafts was not performed in this patient. The problems
      associated with complex chest wall reconstructions are discussed.

PMID- 7793791
TI  - Internal brain herniation in a patient with Apert's syndrome.
AB  - Patients with Apert's syndrome typically exhibit craniosynostosis, exorbitism,
      midface hypoplasia, and symmetric syndactyly. There have also been occasional
      descriptions of the variable dysmorphology of the inner surface of the calvarium.
      We present a patient with Apert's syndrome who had an intracranial herniation of
      a portion of the frontal lobe through a ridge of ossified dura. The ridge and the
      gliotic cortical tissue were removed when the patient underwent repair of the
      hypertelorism at age six. Bone grafts for this repair were fashioned in part from
      the resected ridge. We believe this finding may be the result of a small dural
      tear that occurred during prior surgery.

PMID- 7793792
TI  - Cleft palate and congenital lateral alveolar synechia syndrome: case presentation
      and literature review.
AB  - Cleft palate and congenital lateral alveolar synechia syndrome remains a rare
      occurrence. Our patient represents only the fourth case of bilateral alveolar
      synechia with isolated cleft palate in the world literature and, as such, is only
      the second patient from the United States. More commonly, additional anomalies
      are associated. Just more than 50 cases involving intraoral synechiae have been
      reported. This group of cases has implications on fetal facial growth and cleft
      palate development because there are no documented cases of lateral interalveolar
      synechiae without cleft palate. Earlier reports can be grouped as variants along
      the spectrum. Theories of etiology are discussed.

PMID- 7793793
TI  - Cortical blindness after a failed free tissue transfer: a case report and review
      of the literature.
AB  - Cortical blindness is an uncommon but well-documented entity that results from
      occipital ischemia or insult. We present a case of blindness following a failed
      free tissue transfer and review the pertinent literature. Careful history and
      physical examination can usually distinguish cortical blindness from other
      organic or psychogenic causes. The workup centers on the exclusion of treatable
      concurrent pathology. Despite the dramatic presentation of cortical blindness,
      its treatment is generally supportive and the prognosis for full recovery is
      excellent.

PMID- 7793794
TI  - Familial Saethre-Chotzen syndrome with or without polydactyly of the toe.
AB  - A family with Saethre-Chotzen syndrome with or without polydactyly of the great
      toes is presented. Saethre-Chotzen syndrome with polydactyly of the great toes
      has been reported as Robinow-Sorauf syndrome. Both syndromes were observed in
      this family. This suggests that Saethre-Chotzen syndrome and Robinow-Sorauf
      syndrome fall within the same clinical spectrum, and the cause is a pleiotropic
      effect, which is variously expressed.

PMID- 7793796
TI  - Baron Larrey and cold injury during the campaigns of Napoleon.

PMID- 7793797
TI  - Malpractice--2015: a future fable.

PMID- 7793795
TI  - Pigmented basal cell carcinoma: an unusual case.
AB  - The case of a 66-year-old man who presented with an extensive pigmented basal
      cell carcinoma of the left cheek is reported. Treatment consisted of irradiation
      and staged surgical resections. The cosmetic result was excellent, and the
      patient has been free of the cheek tumor for 2 1/2 years. The numerous problems
      inherent in the treatment of patients with disfiguring facial skin malignancies
      were surmounted by a multidisciplinary team in which radiotherapy, plastic
      surgery, and dental services participated.

PMID- 7793798
TI  - Re: Secondary reconstruction of abdominal wall defects associated with exstrophy
      of the bladder.

PMID- 7793799
TI  - The silver nail.

PMID- 7793800
TI  - Early mortality in 100 consecutive liver resections in 96 patients with benign
      and malignant liver tumours.
AB  - This report describes the mortality in 100 liver resections performed in 96
      patients for seven benign and 93 malignant liver tumours. Repeat hepatectomy was
      performed in four patients who developed recurrences after the first liver
      resection. Two patients died within 30 days. The first was a 67-year-old man who
      died on the 2nd postoperative day from cardiac failure. The second was a 69-year
      old man who died on the 4th postoperative day with liver failure caused by
      hepatic vascular ischaemia. There were four other hospital deaths at days 33, 40,
      45 and 50. A 65-year-old lady died on day 40 from sepsis caused by small bowel
      infarction. A 30-year-old man died on the 33rd postoperative day owing to liver
      failure from accelerated hepatic lymphoma spread. A 71-year-old diabetic lady
      died on the 45th postoperative day from sepsis caused by an untreated subphrenic
      abscess. A 65-year-old lady died on day 50 from systemic candidiasis after adult
      respiratory distress syndrome (ARDS). Further reduction in operative mortality
      could be achieved by better patient selection. Liver resection still remains a
      major operation, but has become a safe surgical procedure.

PMID- 7793801
TI  - Cystic carcinoma of the breast: a trap for the unwary.
AB  - Cystic breast masses are a common presentation to breast clinics. While the
      majority of cysts can be managed by simple aspiration, a small proportion are
      malignant. Histology records for a 10-year period have been examined to identify
      patients with cystic breast carcinomas. In all, 31 patients were identified. Of
      these, 18 had cystic degeneration of high-grade tumours, while 13 had intracystic
      papillary carcinoma. Both of these tumour types were diagnosed by a combination
      of cyst fluid cytology and breast imaging. The prognosis of high-grade tumours
      was poor, while that of intracystic papillary carcinomas was excellent. After
      cyst aspiration, bloodstained fluid should be sent for cytology and breast
      imaging arranged in all patients. Patients in whom a cyst refills within 2 week
      of aspiration require a careful re-evaluation. Cysts in postmenopausal women
      should be viewed with suspicion. Excision should be performed in patients with
      positive cytology or imaging.

PMID- 7793803
TI  - The 'nodding' sign.

PMID- 7793802
TI  - Management of fibroadenoma of the breast.
AB  - Fibroadenoma is a common cause of discrete breast lumps in young women. There is
      agreement that fibroadenomas can be diagnosed preoperatively with a high degree
      of confidence and that some of the lesions thus diagnosed will resolve, possibly
      obviating the need for excision. There is, however, wide disagreement over the
      proportion of fibroadenomas that resolve spontaneously and therefore the benefit
      that accrues from an expectant policy. The aim of this study was to audit the
      management of fibroadenomas on one unit and clarify their natural history over a
      5-year period. A cohort of 70 women with 87 fibroadenomas diagnosed using a
      triple assessment of clinical examination, cytology and imaging (sonomammography)
      have been followed for a minimum of 5 years. In all, 53 of the 'fibroadenomas'
      have been excised. In four cases the histology revealed benign disease other than
      fibroadenoma; there were no neoplasms. The sensitivity of cytology and
      sonomammography for the diagnosis of fibroadenoma were 84% and 98% respectively.
      Thirty-four fibroadenomas have not been excised. Of 25 fibroadenomas that have
      been reassessed after at least 5 years of follow-up, 13 (52%) have reduced in
      size, 4 (16%) are unchanged in size and 8 (32%) have grown. No patient has
      developed a carcinoma at the site of the presumed fibroadenoma. This study
      confirms that an expectant management policy of fibroadenomas has not resulted in
      misdiagnosis of carcinomas. Further, since a significant proportion of
      fibroadenomas remain static or reduce in size over a 5-year period many women can
      avoid excision.

PMID- 7793804
TI  - Management of small fragment wounds in war: current research.
AB  - The majority of war wounds are caused by antipersonnel fragments from munitions
      such as mortars and bomblets. Modern munitions aim to incapacitate soldiers with
      multiple wounds from very small fragments of low available kinetic energy. Many
      of these fragments may be stopped by helmets and body armour and this has led to
      a predominance of multiple wounds to limbs in those casualties requiring surgery.
      The development of an appropriate management strategy for these multiple wounds
      requires knowledge of the contamination and extent of soft tissue injury;
      conservative management may be appropriate. The extent of skin and muscle damage
      associated with a small fragment wound, the way in which these wounds may
      progress without intervention and their colonisation by bacteria has been
      determined in an experimental animal model. Results from 12 animals are
      presented. There was a very small (approximately 1 mm) margin of nonviable skin
      around the entrance wound. The amount of devitalised muscle in the wound tract
      was a few hundred milligrams. Some muscles peripheral to the wound track also
      showed signs of damage 1 h after wounding, but this improved over 24 h; the
      proportion of fragmented muscle fibres in the tissue around the track decreased
      as time went on. There was no clinical sign or bacteriological evidence of the
      track becoming infected up to 24 h after wounding. This preliminary work suggests
      that, in the absence of infection, the amount of muscle damage caused by small
      fragment wounds begins to resolve in the first 24 h after injury, even without
      surgical intervention.

PMID- 7793806
TI  - Digital flexor sheath injury: a new diagnostic test.
AB  - The diagnostic value of the transthecal digital nerve block is proposed for
      identifying flexor sheath injuries associated with seemingly trivial finger
      lacerations. Its use is described in five cases which were referred to our hand
      service for further exploration, with subsequent confirmation of flexor sheath
      and tendon injury.

PMID- 7793805
TI  - Flexor pollicis longus tendon injuries in children.
AB  - Tendon injuries to the thumb are uncommon in children. Nine children (mean age
      6.1 years) with isolated complete injuries to the flexor pollicis longus (FPL)
      were treated with primary suture and controlled mobilisation at a major referral
      centre between 1985 and 1992. Five injuries occurred in zone II, two in zone III
      and two in zone V. One child developed sepsis and there were no cases of tendon
      rupture. Good or excellent results (Buck-Gramcko criteria) were achieved in seven
      of the nine children. Pinch grip after repair was similar to the non-injured
      hand. Primary repair and early controlled mobilisation of FPL leads to
      satisfactory results in children.

PMID- 7793807
TI  - Improving exposure and safety at the saphenofemoral junction.

PMID- 7793809
TI  - The surgery of mitral stenosis 1898-1948: why did it take 50 years to establish
      mitral valvotomy?

PMID- 7793808
TI  - Long posteromedial myocutaneous flap below-knee amputation.

PMID- 7793810
TI  - Clinical guidelines on the management of groin hernia in adults.

PMID- 7793811
TI  - Laparoscopic cholecystectomy: potential for missed pathology.

PMID- 7793812
TI  - An audit of the early complications of turbinectomy.

PMID- 7793813
TI  - Direct puncture technique for laparoscopy.

PMID- 7793814
TI  - Use of hand-held Doppler to avoid abdominal wall vessels in laparoscopic surgery.

PMID- 7793815
TI  - Traumatic rupture of the thoracic aorta: computed tomography may be a dangerous
      waste of time.

PMID- 7793816
TI  - Current attitudes to cementing techniques in British hip surgery.

PMID- 7793817
TI  - Experience with a knot-free absorbable subcuticular suture.

PMID- 7793818
TI  - War injuries during the Gulf War: experience of a teaching hospital in Kuwait.

PMID- 7793819
TI  - Lower limb amputation: striking the balance.

PMID- 7793820
TI  - Adjuvant chemotherapy for colorectal cancer.
AB  - Colorectal cancer is the second most common cancer in the Western world, and yet
      the survival after potentially curative excisional surgery has improved little
      over the last half century. Newer tumour prognostic markers are not superior to
      conventional Dukes' staging and there are currently no markers which predict
      response to chemotherapy. Adjuvant chemotherapy has had a chequered past, but
      recently a number of important prospective studies have demonstrated its proven
      benefit in patients with Dukes' stage C colorectal cancer. However, several
      issues still require clarification. (1) Do immunomodulators such as levamisole
      have a significant role in adjuvant chemotherapy? (2) Which patients derive most
      benefit from adjuvant chemotherapy? (3) Do prognostic markers have a role in
      predicting these patients? Approximately 30% of patients with Dukes' stage B
      cancers die of metastatic disease and the role of adjuvant chemotherapy in
      patients with these tumours seems worth exploring. Only a large randomised trial
      can give answers to these important questions. Such a trial would also encourage
      the widespread introduction of standard methods of surgical and pathological
      assessment.

PMID- 7793822
TI  - Transduodenal sphincterotomy for stenosing papillitis and massive
      choledocholithiasis after Billroth II gastrectomy.
AB  - Management of stenosing papillitis with massive cholecystodocholithiasis in
      patients previously operated upon with a Billroth II (B-II) type gastrectomy, is
      a challenging clinical problem. Endoscopic papillotomy in these patients has been
      described, but the success rate is low especially in the presence of a long
      afferent loop of the gastrojejunostomy and/or extensive adhesions. Long-standing
      common bile duct (CBD) stones lead to varying degrees of papillary stenosis. The
      latter could predispose to new stone formation because of the damaged CBD mucosa
      and varying degrees of stasis. In this paper we describe a simple method for
      intraoperative assessment of the papillary calibre and distensibility by
      correlation to the diameter of an inflated balloon catheter. This method has been
      used successfully in the management of five patients with no stone recurrence in
      the dilated CBD at follow-up.

PMID- 7793821
TI  - Luminal and humoral influences on human rectal epithelial cytokinetics.
AB  - Multiple genetic and environmental steps may underpin the development of human
      colorectal neoplasia, and experimental evidence suggests that promoters of
      colorectal cancer also induce colorectal epithelial cell hyperplasia. In vitro
      crypt cell production rate (CCPR) was measured to determine the effect of
      calcium, epidermal growth factor (EGF), vitamin D3 metabolites and synthetic
      analogues on human rectal epithelial cell proliferation. In a double-blind trial
      of oral calcium supplementation, CCPR was reduced by 49% in patients with
      familial adenomatous polyposis (FAP), but there was no effect on established
      neoplasia. In control tissue, the active form of vitamin D3 (1,25(OH)2D3) reduced
      rectal CCPR by 57% at 1 microM, 55% at 10 nM and 45% at 100 pM. Likewise, in
      tissue taken from patients with FAP, 1,25(OH)2D3 reduced CCPR by 52%. Vitamin D3
      has profound effects on calcium metabolism, but synthetic analogues can avoid
      these. The effects of a synthetic analogue (MC-903) on human rectal CCPR were
      therefore studied. MC-903 (10(-7) M) reduced CCPR in control tissue by 51%, and
      in FAP tissue by 52% at 10(-6) M and 51% at 10(-7) M. In addition, MC-903 and a
      related analogue, EB 1089, produced a clear-cut dose-dependent inhibition of both
      HT-29 and Caco2 colorectal cancer cells maintained in culture. Hence, vitamin D3
      and its analogues can reduce the rate of cell proliferation in normal,
      premalignant and malignant colorectal epithelial cells and might therefore have
      future therapeutic uses as chemoprotective or chemotherapeutic agents. Lastly,
      EGF increases CCPR by 102% in FAP tissue that expresses the EGF receptor. Thus,
      human colorectal cell proliferation is influenced by a variety of luminal and
      humoral agents and a greater understanding of these actions should help plan
      future treatments.

PMID- 7793823
TI  - Direct access surgery.
AB  - Evolving surgical practice in the UK is imposing increasing pressures on surgical
      outpatient clinics. A Direct Access Surgery (DAS) programme was evaluated in
      which otherwise healthy patients with simple surgical conditions presenting
      little diagnostic difficulty were referred directly to hospital for surgical
      operation without attending the outpatient department. Specific referral criteria
      for DAS were devised. Appropriate surgical conditions or procedures included
      hernias, vasectomies, cystic scrotal swellings, subcutaneous lumps and skin
      lesions, symptomatic gallstones, varicose veins and ingrowing toenails. Over a 12
      month period, 105 patients were referred for DAS and 102 underwent operation.
      There was a low incidence of inaccurate diagnosis (< 2%) and inappropriate
      referral (< 1%). DAS was well received by both General Practitioners (GPs) and
      patients. Implementation of such programmes may result in considerable savings of
      outpatient time and resources.

PMID- 7793825
TI  - [Cancer of the rectum in the elderly].

PMID- 7793826
TI  - [Place of surgery in the treatment of lung metastases from colorectal cancers].
AB  - The authors analysed the five main series reported in the literature exclusively
      devoted to surgical treatment of lung metastases of colon and rectum cancers and
      their own experience. The classical indications, limited to solitary lesions,
      have been extensively modified, and resection of bilateral lesions, recurrent
      lesions and pulmonary lesions in patients previously operated for other
      extrathoracic metastases is now possible. The 5-year survival rates vary between
      20 and 44% in the various series. The complete nature of the resection is an
      essential prerequisite to prolonged survival. The other prognostic factors are
      discussed: presence of lymph node invasion or raised CEA appear to carry a poor
      prognosis. On the other hand, the type of resection performed, the disease-free
      interval, the repeated nature of the pulmonary resection and the presence of
      previously operated extrathoracic metastases do not appear to influence survival.
      Opinions differ concerning the prognostic significance of disseminated pulmonary
      lesions, particularly when complete resection is possible. These results confirm
      the special place of surgery in the treatment of lung metastases of colon and
      rectum cancers. The operative indications are still difficult to define, but the
      relatively benign nature of this surgery justifies an extension of the
      indications.

PMID- 7793824
TI  - Parathyroidectomy for hyperparathyroidism associated with renal disease.
AB  - Between 1969 and 1993, 123 patients were accepted in this unit for surgery for
      refractory hyperparathyroidism associated with chronic renal failure. Subtotal
      parathyroidectomy was the procedure of choice. At operation, four or more
      parathyroids were identified in 75% of patients. Methylene blue localised
      additional parathyroids in 32% of initial explorations in which it was used.
      Coincidental thyroid pathology was found in 8.3%, including papillary carcinoma
      in 2.4%. No further parathyroid surgery was required in 90% of patients at a mean
      of 6.6 years after operation. Reoperation (10%) was more likely to be required
      (14.3%) when less than four glands were found than when four or more were found
      (8.5%). Patients continuing on dialysis were more likely to need reoperation than
      those with functioning renal transplants.

PMID- 7793827
TI  - [Colonic esophagoplasty for benign lesions].
AB  - 68 patients underwent oesophageal replacement for benign disease: atresia (12),
      reflux oesophagitis (16), caustic stenosis (37), internal fistula (3). The
      transplant was the ileocolon (27), the transverse (5) or left colon (36). It was
      substernal (55) or posterior mediastinal (13). A by-pass was performed without
      oesophagectomy (51) or an interposition accompanied oesophagectomy (17). The
      superior anastomosis was cervical (52) or thoracic (16). The inferior anastomosis
      was on the stomach (46), duodenum (10) or jejunum (12). Hospital mortality was
      8.8%, morbidity was 57.3%. Among the 62 survivors, 18 had another operation. At
      the end of the survey, 68% had near normal function.

PMID- 7793829
TI  - [Evolution of indications for Hartmann's operation. Reflexions on a series of 160
      cases].
AB  - The authors report the results and indications of 160 Hartmann's procedures
      performed over a period of 15 years. Between 1978 and 1992, 160 patients (90
      males, 70 females), with a mean age of 72, underwent Hartmann's procedure for
      rectosigmoid carcinoma in 55% of cases, for complications of sigmoid
      diverticulitis in 36% and for other lesions in 14%. Hartmann's procedure was
      performed either electively (42%) or as an emergency (58%) with a mortality of 6%
      and 32% respectively. The majority of complications included wound infections or
      intraperitoneal abscess, and the overall morbidity was 30%. Re-establishment of
      bowel continuity was performed in 30.7% of patients, most of whom had been
      initially operated as an emergency for a benign lesion. These 160 cases of
      Hartmann's procedure represent 27% of the 590 operations performed during the
      same period as an emergency or electively for rectosigmoid lesion. Hartmann's
      procedure remains a most effective technique for emergency surgery for benign or
      malignant lesions with colonic septic complications, and is also indicated
      electively for palliative treatment of rectosigmoid carcinoma.

PMID- 7793830
TI  - [Pedicular traumas during laparoscopic cholecystectomy. Apropos of 5 cases].
AB  - Laparoscopic cholecystectomy is now the procedure of choice for surgical removal
      of the gallbladder. Injury to the hepatic pedicle is the most significant
      complication of this procedure. Four cases of bile duct injury and one case of
      right hepatic artery injury were reviewed. Two complications arose from excessive
      use of cautery in the area of bile common duct and right hepatic artery,
      resulting in one case of biliary necrosis and one case of right hepatic artery
      pseudoaneurysm. Two injuries were due to classical confusion between the common
      bile duct and the cystic duct. Another injury was due to partial ligation of the
      common by a clip on the cystic duct. Two patients required a Roux en Y
      hepaticojejunostomy, two patients had a common duct repair on a T tube and one
      patient required emergency ligation of the right hepatic artery and suture of the
      duodenum. We did not observe any mortality. Morbidity consisted of one case of
      spontaneously resolving duodenum leakage. In the light of these cases, after
      having discussed the therapeutic attitudes toward these lesions. The authors
      suggest practical tips to prevent hepatic pedicle injuries during laparoscopic
      cholecystectomy.

PMID- 7793831
TI  - [Primary cancer of the gastric stump. Apropos of 8 cases].
AB  - The authors review their experience of 8 cases of primary carcinoma of the
      gastric stump during the period 1989-1992. During the same period, 164 gastric
      cancers were treated in the same department. Mean duration between primary
      gastric resection and diagnosis of gastric stump carcinoma was 30 years (6 to 42
      years). All patients underwent a Billroth II primary gastric resection. Only 4
      patients underwent radical surgical resection of their gastric stump carcinoma; 2
      patients underwent only explorative laparotomy for very advanced and unresectable
      gastric stump carcinoma; 2 patients were inoperable because of their general
      status. This series of 8 cases of gastric stump carcinoma emphases the importance
      of endoscopic investigations during follow-up of patients with gastric resection,
      in order to diagnose and treat resectable gastric stump carcinoma.

PMID- 7793828
TI  - [Management of primary hyperparathyroidism in case of negative cervicotomy].
AB  - Negative initial cervicotomy for primary hyperparathyroidism can be due to one of
      two reasons: first, one gland has not been found: it was an missing adenoma on an
      ectopic gland. Secondly, four normal glands were found: a missing adenoma arising
      in a supernumerary and ectopic gland. Successful parathyroid surgery depends the
      on surgeon's experience, his knowledge of parathyroid gland embryology, and his
      perseverance to find the pathologic gland. After an unsuccessful cervicotomy, the
      necessity for reoperation must be discussed. Before reexploration, diagnosis of
      hyperparathyroidism must be reviewed, the operative notes and pathologic report
      of the previous operation must be studied, and localization studies must be
      performed in order to define the cervical or mediastinal surgical approach.

PMID- 7793833
TI  - [Rules of decontamination and disinfection of medicosurgical instruments in the
      operating room].
AB  - Nosocomial infections may result from the reuse of surgical devices if adequate
      disinfection or sterilization measures are not employed. The first step of
      reprocessing occurs immediately after use in the operating room. This consists of
      cleaning and decontamination to eliminate organic material and to reduce the
      number of microorganisms, in order to protect personnel who subsequently
      manipulate these instruments and to facilitate the ultimate process of
      sterilization or disinfection. Instruments that cannot be sterilized must be
      submitted to "high level disinfection" to remove undesirable microorganisms. In
      order to guarantee the desired results of disinfection, it is very important to
      adopt reliable and effective protocols, chemical products with good germicidal
      properties and with minimal adverse effects on the personnel and the environment.
      The personnel involved in this delicate and important task must be thoroughly
      trained. If the above conditions are met, the infectious risk associated with
      reuse of surgical devices can be controlled.

PMID- 7793832
TI  - [Non-surgical treatments of hepatocellular carcinoma].
AB  - Hepatocellular carcinoma has as poor prognosis. Curative surgical treatment
      remains the first-line treatment. However, because of the limited indications and
      the high recurrence rate of this cancer, nonsurgical treatments have been
      developed. Intraarterial chemotherapy (with or without embolization or lipiodol),
      although effective on tumour bulk, has not yet been demonstrated to be effective
      on survival in the controlled studies published to date. Ultrasound-guided
      percutaneous alcohol injection, which is a more recent method, is simple,
      inexpensive and well tolerated. The inclusion of patients into controlled
      therapeutic protocols remains essential for both of these methods. Outside of the
      context of these studies, inoperable hepatocellular carcinoma without
      extrahepatic metastases can be treated by chemo-embolization in the case of
      unilobar tumours, without portal thrombosis, or major hepatocellular
      insufficiency or renal failure, and by alcohol injection in the case of small
      tumours, limited in number, without any serious clotting disorders or abundant
      ascites. When these two methods are contraindicated, endocrine therapy by
      tamoxifen remains an alternative to symptomatic treatment. In contrast, external
      beam radiotherapy, systemic chemotherapy and intraarterial chemotherapy without
      Lipiodol or embolization are no longer indicated. Finally, internal radiotherapy
      by intraarterial injection of lipiodol radioactive iodine is currently under
      evaluation.

PMID- 7793834
TI  - [The intestinal capsule: a new way of investigating the small intestine].
AB  - The small bowel is difficult to explore because of its location far away from the
      natural orifices. The aim of this study is to describe a telemetric, autonomous
      and multifunctional capsule (39 mm in length and 11 mm in diameter) designed
      according to a modular system to explore the small bowel. It consists of a
      central cylinder containing a location detector which allows permanent data
      collection concerning its position in the small bowel, the length of the small
      bowel and the transit velocity; secondly, several interchangeable tips allow
      either aspiration of a sample of intestinal juice, or release of a substance
      previously placed in the capsule, or to perform a mucosal biopsy. After having
      been swallowed by the patient, the capsule passes through the whole gut and is
      then recovered in the stools between 24 and 48 hours later. The preliminary study
      consisted of comparing, in patients undergoing a surgical procedure, the small
      bowel length measured by telemetry (542.3 +/- 113.8 cm) to that measured
      intraoperatively by the arithmetical mean of the mesenteric and antimesenteric
      edges (515 +/- 112.7 cm), p = 0.28. These different interchangeable working tips
      have already been used to determine the level of absorption of various
      substances, the discovery of absorption sites and the performance of mucosal
      biopsies without any material link between patient and the measuring or recording
      equipment. The main advantages of this intestinal capsule are the possibility to
      continuously transmit its location, its total autonomy and remote control of the
      desired action.

PMID- 7793835
TI  - [Gallbladder pneumatosis. An ultrasonic pitfall].

PMID- 7793836
TI  - [Appendectomies in Bamako].

PMID- 7793837
TI  - [Neonatal gastric perforation after assisted ventilation in the presence of
      duodenal atresia].

PMID- 7793838
TI  - [Reflex ileus after placement of percutaneous gastrostomy by endoscopic approach:
      value of erythromycin].

PMID- 7793839
TI  - [Administration of erythrocytes for the compensation of surgical blood loss in
      adults].

PMID- 7793840
TI  - [The treatment of acute dissections of the aorta by circulatory arrest under deep
      hypothermia and retrograde cerebral perfusion].
AB  - The use of profound hypothermia with retrograde cerebral perfusion was described
      by Ueda in 1988. The innovation of this technique was the retrograde perfusion of
      oxygenated blood at a temperature of 15 degrees C and a pressure of 25 mmHg via
      the superior vena cava during the circulatory arrest period. Between february
      1993 and march 1994, this technique was used in 12 patients in our department,
      with acute dissection of the aorta present in 8 cases. In this series of 8
      patients, 3 females and 5 males aged 47 to 73 (mean age 60 years)--there were 7
      type I acute dissections, one of which occurred on an annulo-aortic ectasia, and
      1 type III retrograde dissection with hemopericardium. Treatment consisted of 7
      supracoronary tubes one of which extended as a tongue along the inner curvature
      of the aortic arch, and 1 Cabrol's procedure. Mean times were: extracorporeal
      circulation: 148 +/- 50 minutes, core cooling: 60 +/- 20 min., circulatory
      arrest: 34 +/- 9 min., core rewarming: 69 +/- 27 min. Average flow of retrograde
      perfusion was 440 +/- 350 ml/minute. Mean post operative bleeding was 650 +/- 150
      ml for the first 48 hours. No patient awoke with signs of neurological
      deficiency. Seven patients were weaned from mechanical ventilation either on day
      1 or day 2. They presented normal neurological examination. One patient in whom
      minor post operative disturbance postponed mechanical ventilation weaning to day
      4, was neurologically intact upon examination prior to hospital discharge. One
      patient with no initial post operative complication, died of thrombosis of the
      Cabrol prosthesis at day 8.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793842
TI  - [Mitral surgery by superior biatrial septotomy].
AB  - The superior biatrial septotomy approach consists of two semicircular right
      atrial and septal incisions joined at the superior end of the interatrial septum
      and extended across the dome of the left atrium, allowing exposure of the mitral
      valve by reflecting the ventricular side using stay sutures. From 1991 to 1993,
      81 patients underwent mitral valve surgery by this technic. Mitral valve
      operation was combined with other cardiac procedures in 30 patients (37%) and was
      performed as a second operation in 21 patients (25.9%). Duration of
      cardiopulmonary bypass and aortic occlusion was not significantly different from
      that of patients operated via a conventional left atrial approach. The five
      hospital deaths (6.2%) were not related to this operative approach. Only 2
      patients (3.3%) with preoperative in sinus rythm were discharged in atrial
      fibrillation after operation. In one patient (1.6%), atrioventricular block
      appeared at late follow-up. There were no cases of bleeding, atrioventricular
      nodal dysfunction or intra-atrial shunting related to the approach. This approach
      provides excellent exposure of the mitral valve even in unfavorable situations
      such as a small left atrium, dense adhesions from previous procedures or a
      previously implanted aortic prosthesis, without damage to various cardiac
      structures due to excessive traction. No retractor or vena cava repair are
      required. These data support a wide application of the superior biatrial
      septotomy approach in mitral valve surgery.

PMID- 7793841
TI  - [Prognostic effect of diverse surgical parameters in significant stenoses of the
      left coronary trunk. Retrospective study of 185 cases].
AB  - A retrospective study of 185 cases of left main coronary artery stenosis operated
      between 1980-01-01 and 1991-06-15 at the Limoges University Hospital Center was
      performed. The influence of operative procedures: cardiopulmonary bypass and
      aortic cross clamping times, type and number of coronary grafts, time between
      coronary surgery and coronary angiography, on early (before the 30th days after
      surgery) and late postoperative vital prognosis was studied. This study confirms
      in our study the poor early postoperative prognosis of: 1) cardiopulmonary bypass
      time over 140 min; 2) coronary bypasses in an emergency context (surgery less
      than 24 h after coronary angiography); 3) incomplete coronary revascularization.
      The nature of grafts and the aortic cross clamping time have no influence. The
      actuarial survival studies confirm the poor long-term postoperative prognosis of
      incomplete coronary revascularization; the other surgical procedures have no
      influence.

PMID- 7793843
TI  - [Thoracic tumors after treatment for Hodgkin disease].
AB  - Twenty-one patients were admitted to the surgical unit for management of an intra
      thoracic mass following treatment of Hodgkin's disease (HD). They consisted of 14
      males and 7 females, with a mean age of 34 years (range: 17-62). Seven had
      recurrent HD, 14 had a non-Hodgkin solid tumour. HD recurrences were treated with
      repeated chemotherapy with 4 prolonged survivals including 1 relapse (40 to 84
      months follow-up). Non-Hodgkin tumours were 13 lung carcinomas, which were
      resected in 4 cases, with only 1 prolonged survival (54 months) and malignant
      schwannoma. HD recurrences are observed equally in both young males and females
      and are subsequent to a mediastinal location of the disease, after an average 3.2
      years. They are located on the borders or irradiation fields. Repeated
      chemotherapy is effective. Carcinomas more often appear in males, at an older
      age, in a favorable clinical context, after an average 10.2 years. Their
      prognosis is very poor. Irradiation and chemotherapy contribute to their
      development. Long-term risks of HD treatment must be considered.

PMID- 7793844
TI  - [Is endoscopy of the respiratory-digestive tract under general anesthesia useful
      in the screening for cancer of the superior respiratory-digestive tract
      synchronous with lung cancer?].
AB  - The frequency of lung cancers associated with synchronous head and neck
      malignancies can be evaluated between 1.5 to 2%. The purpose of our work was to
      determine if complete endoscopic head and neck examination performed under
      general anesthesia was superior than clinical head and neck examination for the
      diagnosis of these synchronous additional tumors. From july 1991 to august 1992,
      we realised a prospective study on 58 consecutive patients suffering from
      pulmonary removable lung cancers. All the patients had a clinical head and neck
      examination during the preoperative period. Immediately before thoracotomy a
      complete endoscopy of head and neck aerian and digestive tract was performed.
      During this last examination 18 new macroscopical lesions were discovered in 13
      patients: benign lesions (n = 17), oral cavity and laryngeal dysplasia (n = 1).
      The one gingivolingual sulcus carcinoma, already discovered by the clinical
      examination, was confirmed. This study suggests that complete head and neck
      endoscopy is not superior than clinical examination for the diagnosis of
      synchronous malignancies before lung cancers removal.

PMID- 7793845
TI  - [Surgical treatment of pneumothorax. Study of a series of 400 cases].
AB  - Surgical management is indicated for recurrent forms of pneumothorax as well as
      for failures of tube drainage. We report a series of 400 patients treated
      surgically mainly by pleural abrasion over the past 17 years. Statistical
      analysis of the results identifies two groups: 308 patients under the age of 45
      years had surgery mainly for spontaneous idiopathic pneumothorax, where as 92
      patients over the age of 45 years had surgery mainly for emphysema. In young
      patients, the axillary incision was preferred due to the lack of muscular
      sequelae and to avoid unpleasant aesthetic sequelae. Postoperative complications
      occurred in 60 patients (15%). The main complication was a residual pneumothorax
      after drain removal requiring further drainage (10%). A single recurrence
      occurred (0.25%). Pleural abrasion is a very effective way to treat recurrent
      forms of pneumothorax.

PMID- 7793847
TI  - [Left single-lung allotransplantation with or without bronchial artery
      revascularization in pigs. Development of a model with a five-week survival].
AB  - After lung transplantation, immunological mechanisms are easier to understand if
      the pathologist can examine larger pieces of tissues than those obtained by
      endoscopic biopsies. The purpose of this study was to test the experimental left
      lung transplantation in the pig, performed with or without bronchial arterial
      revascularization and with a survival of 5 weeks. Three animals were only
      thoracotomised (sham-operated), ten were allotransplanted without and nine with-
      bronchial arterial revascularization. To optimize survival several clinical and
      paraclinical parameters were used: laboratory, immunological, endoscopic and
      flowmetric examinations. Seven of the nineteen transplanted animals survived
      until the fifth week. Long-term survival is possible and depends mainly on the
      development of pulmonary sepsis. We observed an increase of the pulmonary
      vascular resistances and pressures in the allo-transplanted animals. In these
      animals, histologic examination showed lymphoplasmocytic infiltration in the
      interalveolar walls and the number of ciliated epithelial cells decreased on the
      main and lobar bronchi. Our observations suggest that CD8 lymphocytic
      infiltration is predominant on the bronchi after transplantation and that
      rejection may occur in the pig. Class 2 DR Swine Leukocyte Antigen does not seem
      to be expressed on the bronchi in the allo-transplanted pig after 5 weeks.
      Finally, it is very difficult to demonstrate the patency of bronchial arterial
      grafts after 5 weeks and therefore to prove the influence of revascularization.

PMID- 7793848
TI  - [Experimental models of arterial thrombosis].
AB  - Arterial thrombosis is clearly responsible for a very wide range of
      cardiovascular diseases, which is why many models of arterial thrombosis have
      been developed. These models are based on various techniques such as electrical,
      mechanical, biochemical, photochemical induction. They are an essential
      prerequisite to the understanding of molecular and cellular phenomena and are
      also essential to test the antithrombotic activity of new molecules before the
      first clinical trials in man. The large range of models means that the most
      appropriate model can be selected for the study of the test substance. However,
      the antithrombotic activity of a substance needs to be studied by several models.
      Most of these models induce total occlusion in which the number of parameters
      studied is limited. As a result of technological progress and the development of
      techniques such as laser and image analysers, new perspectives are now available
      for both basic and pharmacological research. Consequently, the already major
      value for these models should continue to grow over the years to come.

PMID- 7793846
TI  - [Closed traumas of the thorax. Assessment of two years activity at the Dakar
      Trauma Center].
AB  - Two years after opening the Dakar Trauma Center has received 179 cases of blunt
      chest trauma without prehospital treatment. Road accidents were the leading
      cause. The initial mortality was 29 patients (16.20%) and 150 patients arrived
      alive and were treated. The initial mortality was primarily due to the associated
      extrathoracic injuries mainly hemorrhagic with hemoperitoneum in 44.82% and brain
      hemorrhage in 24.14% of cases. Secondly, it was due to the thoracic injuries with
      41.37% of anterior flail chest and massive hemothorax in 65.51% of cases. Among
      the 150 patients treated, 42% had extrathoracic injuries, mainly head trauma. 56%
      were admitted to intensive care units with 39 chest drainages and 6 thoracotomies
      were performed. The mortality in this group was about 11.33%. The very high
      initial mortality could be reduced by the organisation of prehospital treatment
      to take better care of patients involved in road accidents.

PMID- 7793849
TI  - [Cardiac manifestations of diffuse systemic scleroderma. Apropos of 4 cases].
AB  - Based on a series of four cases and a review of the literature, the authors
      describe the lesions of the various cardiac tissues in the course of systemic
      scleroderma. Pericardial involvement presents in the form of either acute
      pericarditis or chronic pericarditis. Pericardial tamponade is exceptional.
      Sclerodermal cardiomyopathy is frequent and serious and can be responsible for
      heart failure. Arrhythmias are frequent and may be either ventricular or
      supraventricular. Involvement of the conduction tissue often requires
      implantation of a pacemaker. Endocardial and valvular involvement is very rare.
      Lastly, coronary involvement appears to be fairly rare and responsible for
      vasospastic episodes in the coronary artery territory.

PMID- 7793851
TI  - [Hemangioma of the interventricular septum simulating right obstructive
      cardiomyopathy. Apropos of a case and review of the literature].
AB  - The authors report a case of haemangioma of the interventricular septum, a rare
      cardiac tumour (2.8% of all primary cardiac tumours) simulating right obstructive
      cardiomyopathy. Based on a review of the literature, they emphasize the diversity
      of the clinical expression of this disease and the uncertain medium and long-term
      outcome of operated and nonoperated tumours.

PMID- 7793850
TI  - [Myxoma of atypical manifestation and morphology].
AB  - The authors report a case of myxoma of the left atrium unusual by its clinical
      presentation, very calcified radiological appearance and histological findings.
      The topographic description, facilitated by transoesophageal echocardiography, is
      also emphasized.

PMID- 7793852
TI  - [Total permanent auricular paralysis. Review of the literature apropos of 109
      cases].
AB  - Analysis of 109 well documented cases of permanent total atrial paralysis
      reported in the literature illustrated the features of this arrhythmia which is a
      well defined entity consisting of suppression of all electrical and mechanical
      activity of both atria lasting for more than 6 months. Standard electrocardiogram
      reveals junctional bradycardia of about 40 bpm without any visible P waves and
      narrow supraventricular QRS complexes in 80% of cases. This diagnosis can only be
      confirmed by meticulous bipolar endocavitary recordings exploring all atrial
      walls without recording an auriculogram and by right intra-atrial and coronary
      sinus stimulation which proves to be ineffective. This disease has a male
      predominance in two-thirds of cases and a familial nature in 18% of cases.
      Seventy one per cent of affected subjects are under the age of 50 years. In 33%
      of cases, it is associated with Emery-Dreifuss muscular dystrophy, in which it
      constitutes a specific sign allowing this dystrophy to be differentiated from all
      other forms, especially facio-scapulo-humeral myopathy, and in 30% of cases, it
      is associated with a degenerative disease such as diabetes, amyloidosis or
      primary cardiomyopathy. Idiopathic dilatation of the right atrium is revealed in
      15% of cases. The arrhythmia is responsible for syncope or faintness in 31% of
      cases, cerebral vascular accidents in 21% of cases and heart failure in 35% of
      cases. Cardiac activation is dependent on a junctional escape rhythm. The
      mechanism of the lesion responsible is atrial fibrosis which may extend to the
      sinoatrial node. The treatment of choice consists of implantation of a VVI or
      VVIR mode cardiac pacemaker in combination with anticoagulant therapy.

PMID- 7793853
TI  - [What attitude should be adopted in congenital heart disease in adults?].
AB  - Two types of congenital heart disease are observed in adults: those discovered
      during childhood which may or may not have been operated, depending on their
      degree of severity and the surgical possibilities; those discovered during
      adulthood, which represent approximately 500 new cases per year and which raise
      particular problems: the extensive assessment which must be performed, the
      therapeutic solution adapted to particular situations, contraception, pregnancy,
      prophylaxis of endocarditis, sports or work. It is often difficult to decide to
      operate. Interventional catheterization represents an elegant solution in
      congenital heart disease in adults.

PMID- 7793854
TI  - [Monitoring of heparin in the treatment of deep venous thrombosis. An obsolete
      question?].
AB  - For over 25 years, it has been the rule to monitor heparin in this indication,
      mostly using the TCA (or APTT) test. The goal to be reached (APTT ratio), not yet
      definitely defined, results from multiplying an uncertain baseline value (control
      APTT) by a variable factor (> or = 1.5 control value), these values being, in
      turn, determined using different reagents not providing uniform responses. With
      time, it has become clear that it was difficult to maintain the successive APTTs'
      within the therapeutic range and moreover, that a biologically satisfying
      monitoring could not, by itself, prevents from complications or clinical
      failures. Other classical methods experienced the same shortcomings. Low
      molecular weight heparin fractions have been proved to be easier to administer,
      since there is no need for biological monitoring. Although persisting a still
      unresolved problem, heparin monitoring in this indication appears to be, to date,
      an obsolete situation and in the process of being circumvented.

PMID- 7793857
TI  - Quinolone antibiotics in therapy of experimental pneumococcal meningitis in
      rabbits.
AB  - Using a rabbit model of pneumococcal meningitis, we compared the pharmacokinetics
      and bactericidal activities in cerebrospinal fluid (CSF) of older (ciprofloxacin,
      ofloxacin) and newer (levofloxacin, temafloxacin, CP-116,517, and Win 57273)
      quinolones with those of the beta-lactam ceftriaxone. All quinolones penetrated
      into the inflamed CSF better than ceftriaxone, and the speed of entry into CSF
      was closely related to their degrees of lipophilicity. At a dose of 10 mg/kg.h,
      which in the case of the quinolones already in use in clinical practice produced
      concentrations attainable in the sera and CSF of humans, ciprofloxacin had no
      antipneumococcal activity (delta log10 CFU/ml.h, +0.20 +/- 0.14). Ofloxacin
      (delta log10 CFU/ml.h, -0.13 +/- 0.12), temafloxacin (delta log10 CFU/ml.h, -0.19
      +/- 0.18), and levofloxacin (delta log10 CFU/ml.h, -0.24 +/- 0.16) showed slow
      bactericidal activity (not significantly different from each other), while CP
      116,517 (delta log10 CFU/ml.h, -0.59 +/- 0.21) and Win 57273 (delta log10
      CFU/ml.h, -0.72 +/- 0.20) showed increased bactericidal activities in CSF that
      was comparable to that of ceftriaxone at 10 mg/kg.h (delta log10 CFU/ml.h, -0.80
      +/- 0.17). These improved in vivo activities of the newer quinolones reflected
      their increased in vitro activities. All quinolones and ceftriaxone showed
      positive correlations between bactericidal rates in CSF and concentrations in CSF
      relative to their MBCs. Only when this ratio exceeded 10 did the antibiotics
      exhibit rapid bactericidal activities in CSF. In conclusion, in experimental
      pneumococcal meningitis the activities of new quinolones with improved
      antipneumococcal activities were comparable to that of ceftriaxone.

PMID- 7793856
TI  - Identification of the aminocatechol A-3253 as an in vitro poison of DNA
      topoisomerase I from Candida albicans.
AB  - The aminocatechol A-3253 is active against several pathogenic fungi, including
      Candida albicans, Cryptococcus albidus, and Aspergillus niger. A-3253 interferes
      with both the in vitro biosynthesis of (1,3)-beta-glucan and the activity of
      topoisomerases I isolated from Candida spp. It is likely that one or more of the
      enzymes involved in glucan biosynthesis rather than topoisomerase I is the
      primary intracellular target of A-3253, since a strain of Saccharomyces
      cerevisiae lacking topoisomerase I is as susceptible to A-3253 as cells
      containing wild-type levels of topoisomerase I. However, the interaction of A
      3253 with topoisomerase I in vitro is of interest since the Candida topoisomerase
      is more susceptible to A-3253 than is the topoisomerase I isolated from human
      HeLa cells. A-3253 is both a reversible inhibitor of topoisomerase I catalysis
      and a reversible poison of topoisomerase I, and in both reactions the fungal
      topoisomerase I is more susceptible than the human topoisomerase I to A-3253. In
      contrast, an earlier study found that the human topoisomerase I is more
      susceptible than the fungal topoisomerase to camptothecin (J. M. Fostel, D. A.
      Montgomery, and L. L. Shen, Antimicrob. Agents Chemother. 36:2131-2138, 1992).
      Taken together with the response to camptothecin, the greater susceptibility of
      the Candida topoisomerase I to A-3253 suggests that there are structural
      differences between the human and fungal type I topoisomerases which can likely
      be exploited to allow for the development of antifungal agents which act against
      the fungal topoisomerase and which have minimal activity against the human
      enzyme.

PMID- 7793855
TI  - Erythromycin resistance by ribosome modification.

PMID- 7793859
TI  - Safety, tolerance, and pharmacokinetics of atevirdine mesylate (U-87201E) in
      asymptomatic human immunodeficiency virus-infected patients.
AB  - Atevirdine mesylate (U-87201E) is a new nonnucleoside (bisheteroarylpiperazine)
      inhibitor of human immunodeficiency virus type 1 reverse transcriptase. In a
      double-blind, escalating single-dose study the safety, tolerance, and
      pharmacokinetics of atevirdine mesylate were investigated in 24 asymptomatic
      human immunodeficiency virus-seropositive male patients. Each patient received
      one single oral dose of atevirdine mesylate and placebo separated by an interval
      of 1 to 3 weeks. For each dose level (400, 800, 1,200, and 1,600 mg) six patients
      received drug and placebo on separate occasions. Blood samples were collected
      before dosing and at intervals afterward for safety evaluation and estimation of
      atevirdine and metabolite levels. The concentrations of atevirdine and its
      principal metabolite (U-89255) in serum were determined by high-performance
      liquid chromatography. The results of the study showed that atevirdine mesylate
      is well tolerated at all dose levels. No clinically significant effects on vital
      signs, electrocardiograms, or laboratory tests were observed. Occasional headache
      and nausea were reported both in the drug group and in the placebo group. The
      times to peak values were relatively short (0.5 to 1.0 h), suggesting a rapid
      absorption. The maximum concentrations of drug in serum were 1.4 microM (400 mg),
      4.2 microM (800 mg), 7.3 microM (1,200 mg), and 5.8 microM (1,600 mg). The values
      of the pharmacokinetic parameters for atevirdine were found to have relatively
      large intersubject variabilities, and consequently, the study had little power to
      detect dose-dependent changes in the values of the pharmacokinetic parameters.
      The oral clearance of atevirdine tended to increase by 90% as the atevirdine
      mesylate doses increased from 400 to 1,600 mg, but this change in oral clearance
      was not statistically significant. The values of the pharmacokinetic parameters
      determined in the study were similar to those found in a previous single-dose
      study in healthy volunteers.

PMID- 7793860
TI  - Selection of clarithromycin-resistant Mycobacterium avium complex during combined
      therapy using the beige mouse model.
AB  - Sixteen weeks of treatment with clarithromycin (CLARI) alone displayed
      significant bactericidal activity against Mycobacterium avium complex infection
      in beige mice. Only two combined regimens, CLARI combined with an initial 4 or 8
      weeks of amikacin (AMIKA), displayed activity greater than that displayed by
      CLARI alone. Four other combined regimens, CLARI combined with ethambutol (EMB),
      rifabutin (RBT), or both EMB and RBT during the entire 16 weeks of treatment or
      with AMIKA administered in an initial 2-week course showed bactericidal activity
      not significantly greater than that of CLARI alone. After 16 weeks of treatment,
      CLARI-resistant mutants were isolated from the majority of mice that had been
      treated with CLARI alone, CLARI-RBT, CLARI-EMB, or CLARI-EMB-RBT, as was the case
      for untreated controls, but the frequencies of occurrence of mutants were
      significantly greater in the groups treated with these combinations or CLARI
      alone. On the other hand, no CLARI-resistant mutants were isolated from the mice
      that had been treated with the combination of CLARI plus an initial 4 or 8 weeks
      of AMIKA and were isolated from only a tiny proportion of mice that had been
      treated with CLARI plus an initial 2 weeks of AMIKA. Therefore, only treatment
      with CLARI combined with an initial 4 or 8 weeks of AMIKA but not combined with
      RBT or EMB or both, could enhance the activity of the drug treatment and prevent
      the selection of CLARI-resistant mutants.

PMID- 7793858
TI  - Combination therapy of murine invasive candidiasis with fluconazole and
      amphotericin B.
AB  - A study was performed to assess the in vivo relevance of the in vitro antagonism
      between fluconazole and amphotericin B against Candida albicans. Combinations of
      fluconazole and amphotericin B were explored for their efficacies against acute
      (100% mortality in 2 to 5 days) or less acute (100% mortality in 30 days)
      invasive candidiasis infections in mice with healthy immune systems and
      immunocompromised mice. Treatment efficacy was assessed by protection from
      mortality and/or a reduction in the fungal burden in tissue. In models of acute
      infection in mice with healthy immune systems or less acute infection in
      immunocompromised mice, combinations of fluconazole and amphotericin B were
      superior to fluconazole alone, and the effects were at least additive.
      Combination therapy was at least as efficacious as amphotericin B alone. In a
      different model of less acute infection in mice with healthy immune systems,
      combinations of fluconazole and amphotericin B showed no interactions and were no
      better than either drug alone. We conclude that combination therapy with
      fluconazole and amphotericin B is not antagonistic in vivo, in contrast to
      published in vitro studies, and, consequently, suggest that combination therapy
      should be considered in the management of clinical candidiasis.

PMID- 7793862
TI  - Comparative complement selection in bacteria enables screening for lead compounds
      targeted to a purine salvage enzyme of parasites.
AB  - Expression plasmids encoding the hypoxanthine phosphoribosyltransferases (HPRTs)
      of Plasmodium falciparum, Schistosoma mansoni, Tritrichomonas foetus, and Homo
      sapiens were subcloned into genetically deficient Escherichia coli that requires
      complementation by the activity of a recombinant HPRT for growth on semidefined
      medium. Fifty-nine purine analogs were screened for their abilities to inhibit
      the growth of these bacteria. Several compounds that selectively altered the
      growth of the bacteria complemented by the malarial, schistosomal, or
      tritrichomonal HPRT compared with the growth of bacteria expressing the human
      enzyme were identified. These results demonstrate that the recombinant approach
      to screening compounds by complement selection in a comparative manner provides a
      rapid and efficient method for the identification of new lead compounds
      selectively targeted to the purine salvage enzymes of parasites.

PMID- 7793863
TI  - Quantitative assessment of antimalarial activities from Malaysian Plasmodium
      falciparum isolates by modified in vitro microtechnique.
AB  - Malaysian, TGR (Thailand), and Gambian (West African) Plasmodium falciparum
      isolates were cultured in vitro by the candle jar method and were characterized
      for their susceptibilities to present antimalarial drugs by the modified in vitro
      microtechnique. Results showed that 93 and 47% of the Malaysian isolates were
      resistant at 50% inhibitory concentrations of 0.1415 to 0.7737 and 0.1025 to
      0.1975 microM, respectively, while the rest were susceptible to choloroquine and
      cycloguanil at 0.0376 and 0.0306 to 0.0954 microM, respectively. All isolates
      were susceptible to mefloquine, quinine, and pyrimethamine at 0.0026 to 0.0172,
      0.0062 to 0.0854, and 0.0149 to 0.0663 microM, respectively. In contrast, the
      Gambian isolate was susceptible to multiple drugs at 0.0024 to 0.0282 microM; TGR
      was resistant to chloroquine at 0.8147 microM but was susceptible to mefloquine,
      quinine, cycloguanil, and pyrimethamine at 0.0024, 0.0096, 0.0143, and 0.0495
      microM, respectively.

PMID- 7793861
TI  - Mechanism of tonB-dependent transport of KP-736, a 1,5-dihydroxy-4-pyridone
      substituted cephalosporin, into Escherichia coli K-12 cells.
AB  - The mechanism of transport of KP-736, a novel cephalosporin with a 1,5-dihydroxy
      4-pyridone moiety at the C-7 position, into the Escherichia coli K-12 cell was
      investigated by determining the susceptibilities of iron transport mutants to KP
      736. The tonB mutant showed a higher degree of resistance to KP-736, indicating
      that KP-736 was incorporated into E. coli cells via the tonB-dependent iron
      transport system. The product of the exbB gene was also necessary for the maximal
      antibacterial potency of KP-736. Cir-lacking and Fiu-lacking mutants showed a
      moderate level of resistance to KP-736. However, mutants lacking any one of the
      proteins FepA, FecA, FhuA, and FhuE did not show any increased resistance to KP
      736. Two types of spontaneous mutants (e.g., KT1004 and KT1011) could be isolated
      from cir and fiu mutants by selection for KP-736 resistance and showed the same
      level of resistance to KP-736 as a tonB mutant. KT1004 showed tonB phenotypes,
      resistance to phage phi 80, and loss of FecA, whereas KT1011 did not. KT1011 lost
      the ability to express both Cir and Fiu proteins. These results indicate that the
      Cir and Fiu outer membrane proteins are involved specifically in the tonB
      dependent transport process of KP-736. Against OmpF- and OmpC-deficient
      transformants producing various groups of beta-lactamases, KP-736 was more
      effective than the other cephalosporins tested.

PMID- 7793864
TI  - Characterization of an LysR family protein, SmeR from Serratia marcescens S6, its
      effect on expression of the carbapenem-hydrolyzing beta-lactamase Sme-1, and
      comparison of this regulator with other beta-lactamase regulators.
AB  - Serratia marcescens S6 produces a chromosomally encoded carbapenem-hydrolyzing
      class A beta-lactamase, Sme-1 (T. Naas, L. Vandel, W. Sougakoff, D. M. Livermore,
      and P. Nordmann, Antimicrob. Agents Chemother. 38:1262-1270, 1994). Upstream from
      smeA we identified a second open reading frame (EMBL accession number Z30237).
      This encodes a 33.1-kDa protein, SmeR, which has a high degree of homology with
      NmcR, the LysR regulatory protein of the only other sequenced carbapenem
      hydrolyzing class A beta-lactamase, NmcA from Enterobacter cloacae NOR-1. It is
      weakly related to AmpR of the chromosomal cephalosporinase regulatory systems
      described in E. cloacae, Yersinia enterocolitica, Citrobacter freundii, and
      Pseudomonas aeruginosa and is very weakly related to other LysR-type regulators
      of class A beta-lactamases. SmeR is a weakly positive regulator for Sme-1
      expression in the absence of or in the presence of beta-lactam inducers. The -35
      and -10 regions of smeR are in the opposite orientations and are face-to-face
      relative to the smeA promoter. SmeR acts similarly to NmcR and not as the AmpR
      regulators described for class C beta-lactamase systems. SmeR is a weak inducer
      in the absence or presence of beta-lactams. As was found for the AmpC-AmpR and
      NmcA-NmcR systems, a putative SmeR-binding site was present upstream from the
      beta-lactamase gene promoter regions. beta-Galactosidase activity from a smeR
      lacZ translational fusion was expressed constitutively and decreased in the
      presence of SmeR from a coresident plasmid, suggesting that SmeR is autogeneously
      controlled. Finally, beta-lactams did not affect the expression of SmeR, which is
      the second regulator of a class A carbapenem-hydrolyzing beta-lactamase to be
      identified.

PMID- 7793865
TI  - French multicenter study involving eight test sites for radiometric determination
      of activities of 10 antimicrobial agents against Mycobacterium avium complex.
AB  - The radiometric BACTEC 460-TB methodology has filled an increased need in the
      screening of a wide range of antimicrobial agents against Mycobacterium avium
      (MAC) isolates on a patient-to-patient basis. In this context, a multicenter
      study involving eight test sites across France was performed to determine the
      MICs of 10 antimicrobial agents for MAC organisms. The aim of the investigation
      was to compare the in vitro activities of D-cycloserine, ethambutol, ethionamide,
      rifampin, amikacin, streptomycin, ciprofloxacin, sparfloxacin, clofazimine, and
      clarithromycin against MAC isolates. All of the test sites received the same
      clinical isolates of MAC, and the MICs were determined by a common protocol. The
      overall interlaboratory reproducibility of the MICs within +/- 1 dilution of the
      modal MICs varied from 79.70 to 100% (mean, 95.2% +/- 2.1%), whereas overall
      agreement of the MICs among the test sites varied from a mean of 91% +/- 4.1% to
      a mean of 98 +/- 1.3%. We confirmed that the proposed methodology is easy,
      accurate, and sufficiently reproducible to be used routinely in a clinical
      laboratory. Despite variations in the MICs of the same drug among strains, no
      link between the origin of MAC isolates (from human immunodeficiency virus
      positive or -negative patients) and their drug susceptibilities was established.
      On the basis of the MICs that inhibited 50 and 90% of isolates tested for the
      drugs used, clarithromycin, clofazimine, ethambutol, and streptomycin were the
      most uniformly active against MAC; this was followed by amikacin, rifampin, and
      sparfloxacin. On the other hand, ciprofloxacin, D-cycloserine, and ethionamide
      showed only marginal in vitro activities.

PMID- 7793866
TI  - Outer membrane proteins responsible for multiple drug resistance in Pseudomonas
      aeruginosa.
AB  - Three types of multiple-drug-resistant mutants which were phenotypically similar
      to previously described nalB, nfxB, and nfxC mutants were isolated from
      Pseudomonas aeruginosa PAO1 and two clinical isolates. Type 1 (nalB-type) mutants
      showed cross-resistance to meropenem, cephems, and quinolones. They overproduced
      an outer membrane protein with an apparent molecular mass of 50 kDa (OprM). Type
      2 (nfxB-type) mutants showed cross-resistance to quinolones and new cephems,
      i.e., cefpirome and cefozopran, concomitant with overproduction of an outer
      membrane protein with an apparent molecular mass of 54 kDa (OprJ). Type 3 (nfxC
      type) mutants showed cross-resistance to carbapenems and quinolones. They
      produced decreased amounts of OprD and increased amounts of a 50-kDa protein
      (OprN), which was almost the same molecular weight as that of OprM, but it was
      distinguishable from OprM by its heat modifiability on sodium dodecyl sulfate
      polyacrylamide gel electrophoresis. In the presence of salicylate, the parent
      strains showed an increased level of resistance to carbapenems and quinolones and
      produced decreased amounts of OprD and increased amounts of OprN. Salicylate
      caused the repression of OprJ production and the loss of resistance to cefpirome
      and cefozopran in two of the three OprJ-overproducing mutants, although
      salicylate slightly increased the level of resistance in the parent strains. The
      changes in susceptibilities were transient in the presence of salicylate. These
      data suggest that at least three different outer membrane proteins, OprM, OprJ,
      and OprN, are associated with multiple drug resistance in P. aeruginosa.

PMID- 7793867
TI  - Experience with a once-daily aminoglycoside program administered to 2,184 adult
      patients.
AB  - Once-daily aminoglycoside (ODA) regimens have been instituted to maximize
      bacterial killing by optimizing the peak concentration/MIC ratio and to reduce
      the potential for toxicity. We initiated an ODA program at our institution that
      utilizes a fixed 7-mg/kg intravenous dose with a drug administration interval
      based on estimated creatinine clearance: > or = 60 ml/min every 24 h (q24h), 59
      to 40 ml/min q36h, and 39 to 20 ml/min q48h. Subsequent interval adjustments are
      made by using a single concentration in serum and a nomogram designed for
      monitoring of ODA therapy. Since initiation of the program, 2,184 patients have
      received this ODA regimen. The median dose was 450 (range, 200 to 925) mg, while
      the median length of therapy was 3 (range, 1 to 26) days. The median age of the
      population was 46 (range, 13 to 97) years. Gentamicin accounted for 94% of the
      aminoglycoside use, and the majority (77%) of patients received the drug q24h.
      The 36-, 48-, and > 48-h intervals were used for 15, 6, and 2% of this
      population, respectively. Three patients exhibited clinically apparent
      ototoxicity. Twenty-seven patients (1.2%) developed nephrotoxicity (the Hartford
      Hospital historical rate is approximately 3 to 5%) after a median of 7 (range, 3
      to 19) days of therapy. On the basis of a prospective evaluation of 58 patients
      and follow-up of additional patients via clinician reports, we have noted no
      apparent alterations in clinical response with our ODA program. This ODA program
      appears to be clinically effective, reduces the incidence of nephrotoxicity, and
      provides a cost-effective method for administration of aminoglycosides by
      reducing ancillary service time and serum aminoglycoside determinations.

PMID- 7793868
TI  - Fluconazole concentrations in saliva from AIDS patients with oropharyngeal
      candidosis refractory to treatment with fluconazole.
AB  - Fluconazole (FCZ) has been extensively used as a primary therapy for
      oropharyngeal candidosis in AIDS patients. Clinical resistance to FCZ is now
      encountered, often related to decreased susceptibility of the isolate in vitro.
      We wondered if low levels in saliva play a role in the therapeutic failure,
      especially in patients complaining of dry mouth. Sixteen AIDS patients treated
      for oropharyngeal candidosis with FCZ were studied. MICs for the isolates were
      determined. Serum and saliva samples were collected to measure FCZ levels with a
      bioassay using paper disks loaded with the clinical specimens. We showed that (i)
      paper disks were convenient for collecting saliva in patients with dry mouth;
      (ii) levels in saliva depended on the FCZ dosage regimen but did not correlate
      with the response to therapy; (iii) correlation between concentrations in saliva
      and serum was poor and independent of clinical response to treatment, other
      therapies, or decreased salivation; and (iv) levels in saliva were always lower
      than MICs in patients who failed to respond to treatment. In conclusion,
      therapeutic failures are more likely to be related to in vitro resistance of the
      isolate to FCZ or insufficient dosage regimen than to decreased salivary
      secretion.

PMID- 7793869
TI  - Comparison of cefuroxime axetil and doxycycline in treatment of patients with
      early Lyme disease associated with erythema migrans.
AB  - A randomized, multicenter, investigator-blinded clinical trial was undertaken in
      order to compare the efficacies of cefuroxime axetil and doxycycline in the
      treatment of patients with Lyme disease associated with erythema migrans. A total
      of 232 patients with physician-documented erythema migrans were treated orally
      for 20 days with either cefuroxime axetil, 500 mg twice daily (119 patients), or
      doxycycline, 100 mg three times daily (113 patients), and clinical evaluations
      were conducted during treatment (8 to 12 days) and at 1 to 5 days and 1, 3, 6, 9,
      and 12 months posttreatment. Patients were assessed as to the resolution of
      erythema migrans and of the signs and symptoms related to early Lyme disease as
      well as to the prevention of late Lyme disease. A satisfactory clinical outcome
      (success or improvement) was achieved in 90 of 100 (90%) evaluable patients
      treated with cefuroxime axetil and in 89 of 94 (95%) patients treated with
      doxycycline (difference, -5%; 95% confidence interval, -12 to 3%). Patients with
      paresthesia, arthralgia, or irritability at enrollment were at higher risk for an
      unsatisfactory clinical outcome at 1 month posttreatment. Of the patients with
      satisfactory outcomes at 1 month posttreatment who were evaluable at 1 year
      posttreatment, a satisfactory outcome was achieved in 62 of 65 (95%) and in 53 of
      53 (100%) patients treated with cefuroxime axetil and doxycycline, respectively
      (difference, -5%; 95% confidence interval, -10 to 4%). Twenty-eight percent of
      patients treated with doxycycline and 17% of those treated with cefuroxime axetil
      had one or more drug-related adverse events (P = 0.041). Doxycycline was
      associated with more photosensitivity reactions (6% compared with 0% for patients
      treated with cefuroxime axetil; P=0.006), and cefuroxime axetil was associated
      with more cases of diarrhea (5% compared with 0% for patients treated with
      doxycycline; P=0.030). Jarisch-Herxheimer reactions occurred in 12% of the
      patients in each treatment group. In summary, cefuroxime axetil is well tolerated
      and appears to be equally as effective as doxycycline in the treatment of early
      Lyme disease and in preventing the subsequent development of late Lyme disease.

PMID- 7793870
TI  - Safety and bioequivalency of three formulations of respiratory syncytial virus
      enriched immunoglobulin.
AB  - Respiratory syncytial virus (RSV) causes serious illness (lower respiratory
      illness) in preterm infants. RSV antibody-enriched immunoglobulin (RSVIG) that
      was lyophilized (LYO) protected against RSV lower respiratory illness. The Food
      and Drug Administration now requires an additional viral inactivation step (VI).
      We compared LYO, LYO-VI, and a more convenient liquid RSVIG (LIQ-VI) in 30
      preterm infants (median age, 7 months; median weight, 5.4 kg). Infants were
      randomized to receive LYO (n = 10), LYO-VI (n = 10), or LIQ-VI (n = 10) in
      monthly infusions of 750 mg/kg of body weight per dose (December to March).
      Children were monitored closely for adverse reactions to RSVIG and for RSV
      illness.

PMID- 7793872
TI  - Should Pseudomonas aeruginosa isolates resistant to one of the fluorinated
      quinolones be tested for the others? Studies with an experimental model of
      pneumonia.
AB  - A clinical isolate of Pseudomonas aeruginosa resistant to pefloxacin (Pef) but
      susceptible to ciprofloxacin (Cip) was studied to compare the in vitro and in
      vivo activities of Pef, ofloxacin (Ofl), and Cip. The time-kill curve method
      showed no bactericidal activity for Pef and Ofl, but a reduction of 4 log10
      CFU/ml was achieved with Cip at 1 h. A model of experimental P. aeruginosa
      pneumonia was used to evaluate in vivo the relevance of the difference in
      susceptibility observed in vitro. At 36 h, a 100% cumulative survival rate was
      observed in Cip-treated rats, which was far higher than the survival rate
      obtained with Pef (53%) or Ofl (46%) (P < 0.001). At 4 h, no bacteremia was
      observed in Cip-treated rats, whereas 93% of the Pef-treated rats and 80% of the
      Ofl-treated rats were bacteremic (P < 0.001). The best pulmonary bacterial
      clearance was observed with Cip. Interestingly, Pef and Ofl, to which the strain
      was resistant in vitro, showed a fairly good in vivo activity despite sub-MIC
      concentrations. Cip was more effective than Pef and Ofl in terms of pulmonary and
      systemic bactericidal activity and provided the best survival rate in animals. We
      conclude that differences between the different quinolones in terms of the
      organism's sensitivity assessed in vitro may be relevant and that it might be
      useful to reconsider the use of a quinolone to which P. aeruginosa shows
      resistance if the organism shows sensitivity to no other agent.

PMID- 7793871
TI  - Effect of cefodizime and ceftriaxone on phagocytic function in patients with
      severe infections.
AB  - Thirty patients with severe bacterial infections were treated with 50 mg of
      cefodizime per kg of body weight once daily or 50 mg of ceftriaxone per kg once
      daily for 10 +/- 3 days. The effect of cefodizime and ceftriaxone on the
      phagocytic capacity and generation of reactive oxygen intermediates after
      phagocytosis by granulocytes was assessed prior to, during, and after therapy.
      Flow cytometry was used to study phagocytic capacity by measuring the uptake of
      fluorescein-labeled bacteria. The generation of reactive oxygen intermediates
      after phagocytosis was estimated by the quantification of the intracellular
      conversion of dihydrorhodamine 123 to rhodamine 123. Prior to therapy, patients
      in both groups exhibited a decreased capacity to phagocytize Escherichia coli and
      subsequently to generate reactive oxygen intermediates. Granulocyte function
      increased after the initiation of therapy and normalized within 7 days for the
      ceftriaxone-treated patients and within 3 days for the cefodizime group (P <
      0.05). In the cefodizime group, an enhancement of phagocytic capacity was
      observed 14 days after the initiation of therapy (P < 0.05). Prior to therapy,
      phagocytic capacity was significantly correlated with the generation of reactive
      oxygen products (r = 0.674 and P < 0.005).

PMID- 7793873
TI  - In vitro and ex vivo activities of antimicrobial agents used in combination with
      clarithromycin, with or without amikacin, against Mycobacterium avium.
AB  - MICs of clarithromycin, amikacin, isoniazid, rifabutin, ciprofloxacin,
      sparfloxacin, ethambutol, and clofazimine were determined for six isolates of
      Mycobacterium avium complex (MAC) from AIDS patients both by the radiometric
      method and by an ex vivo model of infection in human macrophages. The median MICs
      in macrophages were similar or slightly lower than values found in broth, except
      for amikacin, which had slightly higher MICs inside the cells. Combinations of
      clarithromycin with other antimicrobial agents showed that clarithromycin
      clofazimine and clarithromycin-rifabutin were synergistic on five of six strains
      while clarithromycin-amikacin and clarithromycin-isoniazid were antagonistic on
      one and two strains, respectively. The addition of amikacin made the combinations
      of clarithromycin-clofazimine and clarithromycin-ethambutol synergistic against
      all the MAC strains. In the macrophage model, the combination of clarithromycin
      clofazimine (mean survival, 21%) and clarithromycin-rifabutin (mean survival,
      29%) showed a strong reduction in viable counts compared with single drugs, while
      clarithromycin-amikacin was less active than single drugs alone. In general, the
      addition of amikacin did not improve the activity of the combinations, except for
      clarithromycin-isoniazid-amikacin (mean survival, 19%), which was significantly
      more active than either clarithromycin-isoniazid or clarithromycin-amikacin. The
      use of the macrophage model can suggest new combinations of antimicrobial agents
      with anti-MAC activity which, on the basis of their in vitro effectiveness, would
      probably be disregarded for assay in animal models.

PMID- 7793874
TI  - New mobile gene cassettes containing an aminoglycoside resistance gene, aacA7,
      and a chloramphenicol resistance gene, catB3, in an integron in pBWH301.
AB  - The multidrug resistance plasmid pBWH301 was shown to contain a sull-associated
      integron with five inserted gene cassettes, aacA7-catB3-aadB-oxa2-orfD, all of
      which can be mobilized by the integron-encoded DNA integrase. The aadB, oxa2, and
      orfD cassettes are identical to known cassettes. The aacA7 gene encodes a protein
      that is a member of one of the three known families of aminoglycoside
      acetyltransferases classified as AAC(6')-I. The chloramphenicol acetyltransferase
      encoded by the catB3 gene is closely related to members of a recently identified
      family of chloramphenicol acetyltransferases. The catB3 gene displays a
      relatively high degree of sequence identity to a chromosomally located open
      reading frame in Pseudomonas aeruginosa, and this may represent evidence for the
      acquisition by a cassette of a chromosomal gene.

PMID- 7793875
TI  - Recognition of multiple effects of ethambutol on metabolism of mycobacterial cell
      envelope.
AB  - Ethambutol is known to rapidly inhibit biosynthesis of the arabinan component of
      the mycobacterial cell wall core polymer, arabinogalactan (K. Takayama and J. O.
      Kilburn, Antimicrob. Agents Chemother. 33:1493-1499, 1989). This effect was
      confirmed, and it was also shown that ethambutol inhibits biosynthesis of the
      arabinan of lipoarabinomannan, a lipopolysaccharide noncovalently associated with
      the cell wall core. In contrast to cell wall core arabinan, which is completely
      inhibited by ethambutol, synthesis of the arabinan of lipoarabinomannan was only
      partially affected, demonstrating a differential effect on arabinan synthesis in
      the two locales. Further studies of the effect of ethambutol on cell wall
      biosynthesis revealed that the synthesis of galactan in the cell wall core is
      strongly inhibited by the drug. In addition, ethambutol treatment resulted in the
      cleavage of arabinosyl residues present in the mycobacterial cell wall; more than
      50% of the arabinan in the cell wall core was removed from the wall 1 h after
      addition of the drug to growing mycobacterial cultures. In contrast, galactan was
      not released from the cell wall during ethambutol treatment. The natural function
      of the arabinosyl-releasing enzyme remains unknown, but its action in combination
      with inhibition of synthesis during ethambutol treatment results in severe
      disruption of the mycobacterial cell wall. Accordingly, ethambutol-induced damage
      to the cell wall provides a ready molecular explanation for the known synergetic
      effects of ethambutol with other chemotherapeutic agents. Nevertheless, the
      initial direct effect of ethambutol remains to be elucidated.

PMID- 7793876
TI  - Mechanism of enhanced antipseudomonal activity of BO-2727, a new injectable 1
      beta-methyl carbapenem.
AB  - The mechanism of the enhanced activity of BO-2727 against imipenem-resistant
      Pseudomonas aeruginosa was studied by using a set of four isogenic strains
      derived from beta-lactamase-deficient P. aeruginosa PAO4089 (blaJ blaP).
      Complementation of the blaJ and blaP mutations conferred greater resistance to
      biapenem, panipenem, and imipenem than to BO-2727 and meropenem, most notably in
      the outer membrane protein D2-deficient strain. The higher levels of resistance
      to biapenem, panipenem, and imipenem can be explained by the slow but significant
      hydrolysis by beta-lactamase, whereas the reduced levels of resistance to BO-2727
      and meropenem would be attributable to their stability in the presence of high
      levels of beta-lactamase and the fact that they cause only low induction of beta
      lactamase. It is also noted that the activity of BO-2727 against the beta
      lactamase-deficient strain was less affected by the loss of the D2 porin than was
      that of meropenem, indicating that BO-2727 in comparison with meropenem can
      overcome an intrinsic resistance caused by the loss of D2. Moreover, comparative
      in vitro resistance studies have shown that BO-2727 and meropenem selected fewer
      resistant cells than other carbapenems. In conclusion, BO-2727 exhibited improved
      activity against imipenem-resistant P. aeruginosa, probably because of its
      ability to overcome loss of the D2 porin and beta-lactamase hydrolysis.

PMID- 7793878
TI  - Mode of action of the lantibiotic mersacidin: inhibition of peptidoglycan
      biosynthesis via a novel mechanism?
AB  - Mersacidin is an antibiotic peptide produced by Bacillus sp. strain HIL Y
      85,54728 that belongs to the group of lantibiotics. Its activity in vivo against
      methicillin-resistant Staphylococcus aureus strains compares with that of the
      glycopeptide antibiotic vancomycin (S. Chatterjee, D. K. Chatterjee, R. H. Jani,
      J. Blumbach, B. N. Ganguli, N. Klesel, M. Limbert, and G. Seibert, J. Antibiot.
      45:839-845, 1992). Incubation of Staphylococcus simulans 22 with mersacidin
      resulted in the cessation of growth and slow lysis. Biosyntheses of DNA, RNA, and
      protein were not affected, whereas incorporation of glucose and D-alanine was
      inhibited and a regular reduction in the level of cell wall thickness was
      observed. Thus, unlike type A lantibiotics, mersacidin does not form pores in the
      cytoplasmic membrane but rather inhibits cell wall biosynthesis. Comparison with
      tunicamycin-treated cells indicated that peptidoglycan rather than teichoic acid
      metabolism is primarily affected. Mersacidin caused the excretion of a putative
      cell wall precursor into the culture supernatant. The formation of polymeric
      peptidoglycan was effectively inhibited in an in vitro assay, probably on the
      level of transglycosylation. In contrast to vancomycin, the activity of
      mersacidin was not antagonized by the tripeptide diacetyl-L-Lys-D-Ala-D-Ala,
      indicating that on the molecular level its mode of action differs from those of
      glycopeptide antibiotics. These data together with electron microscopy suggest
      that mersacidin acts on a novel target, which opens new perspectives for the
      treatment of methicillin-resistant S. aureus.

PMID- 7793877
TI  - Roles of divalent cations and pH in mechanism of action of nitroxoline against
      Escherichia coli strains.
AB  - The antibacterial activity of nitroxoline (NIT), an antibiotic used in the
      treatment of acute or recurrent urinary tract infections caused by Escherichia
      coli, is decreased in the presence of Mg2+ and Mn2+ but not Ca2+. In order to
      elucidate the interaction between this drug and the divalent cations,
      spectrophotometric studies based on the natural absorption of the nitroxoline
      moiety were conducted. In the presence of the divalent metal ions, a shift in the
      NIT A448 suggested the formation of drug-ion complexes, for which the stability
      followed the order Mn2+ > Mg2+ > Ca2+. A clear correlation was found between the
      chelating property and antibacterial activity of NIT; both were pH dependent. A
      convenient colorimetric method for the determination of NIT uptake by bacterial
      cells was also developed. Uptake was energy independent and showed biphasic
      kinetics: a rapid association with cells and then a slower increase in cell
      associated NIT which reached a plateau. NIT uptake was reduced in the presence of
      magnesium. The implications of metal ion complexation and pH on the clinical
      efficacy of NIT are discussed.

PMID- 7793879
TI  - Successful treatment of Pneumocystis carinii Pneumonia in mice with benanomicin A
      (ME1451).
AB  - Benanomicin A (BNM-A) has antimycotic activities via binding to mannan in the
      cell walls of fungi. Anti-Pneumocystis carinii activity of the agent was examined
      in the P. carinii-infected BALB/c nu/nu female mouse model because P. carinii
      also possesses mannan in the membranes. The infected mice were treated with
      intraperitoneal injections of six doses of BNM-A (1, 2.5, 5, 10, 30, and 100
      mg/kg of body weight), 4 mg of pentamidine isethionate per kg, 100 mg of
      sulfamethoxazole per kg combined with 20 mg of trimethoprim per kg (co
      trimoxazole), or saline for 21 days. Each dosage group consisted of 10 mice.
      During treatment, five mice in the control group (saline) died, whereas 8 to 10
      mice in all treatment groups survived. Almost the same efficacies were obtained
      for the groups treated with 5 mg or more and 10 mg or more of BNM-A per kg
      regarding the weight and number, respectively, of cysts found in the lungs as
      were obtained for the groups treated with pentamidine isethionate and co
      trimoxazole. Overall, a dose of 10 mg of BNM-A per kg was effective against P.
      carinii pneumonia infection in the mice. Thus, BNM-A is a good candidate for a
      novel treatment for P. carinii pneumonia as a compound with a new mechanism of
      action against P. carinii.

PMID- 7793881
TI  - In vitro activity and killing effect of DX-8739, a new carbapenem, compared with
      those of meropenem and imipenem against multiresistant Pseudomonas aeruginosa.
AB  - DX-8739 is a new dehydropeptidase I-stable carbapenem. In order to evaluate its
      activity in comparison with those of meropenem and imipenem, 147 multiresistant
      Pseudomonas aeruginosa isolates acquired nosocomially were simultaneously exposed
      to the actions of the three carbapenems in vitro, whereas to compare their
      killing effects on 14 strains, 56 killing curve studies were performed. Overall
      DX-8739 was found to possess inhibitory activity as well as bactericidal activity
      statistically superior to those of meropenem and imipenem. At a concentration of
      4 micrograms/ml, 106 strains (72.1%) were found to be imipenem resistant; 33 and
      27.4% of these strains were inhibited by DX-8739 and meropenem, respectively, a
      statistically significant difference (P < 0.05). DX-8739 was also shown to
      possess intrinsic activity in vitro superior to those of meropenem and imipenem
      against the imipenem-susceptible population of strains. However, no statistically
      significant difference regarding the comparative killing activities of the three
      studied carbapenems was observed. Following exposure to carbapenem for 24 h,
      33.3, 44.4, and 70% of the strains which survived became resistant to DX-8739,
      meropenem, and imipenem, respectively. The reported results demonstrate the
      significant activity of DX-8739 against multiresistant P. aeruginosa strains
      acquired nosocomially. The mechanism of action of DX-8739 on P. aeruginosa is
      unknown, and various hypotheses that might explain its in vitro superiority over
      meropenem and imipenem are proposed.

PMID- 7793880
TI  - Therapy of Mycobacterium avium complex infections in beige mice with streptomycin
      encapsulated in sterically stabilized liposomes.
AB  - Mycobacterium avium complex (MAC) causes serious opportunistic infections in AIDS
      patients. Previous studies with MAC-infected beige mice have indicated that
      weekly administration of liposome-encapsulated streptomycin can reduce
      significantly the CFU in the liver and spleen. We examined whether streptomycin
      encapsulated in recently developed sterically stabilized liposomes with prolonged
      circulation times would have a therapeutic effect in this animal model. Two
      liposome types with prolonged circulation (polyethyleneglycol
      distearoylphosphatidylethanolamine [PEG-DSPE]-distearoylphosphatidylcholine
      [DSPC]-cholesterol [chol] or phosphatidylinositol [PI]-DSPC-chol) and
      conventional liposomes (phosphatidylglycerol [PG]-phosphatidylcholine [PC]-chol)
      encapsulating streptomycin and administered twice weekly were bactericidal to MAC
      strain 101 in the spleen when the level of infection after treatment was compared
      with the level of infection before treatment. PI-DSPC-chol and PG-PC-chol
      liposomes encapsulating streptomycin were bactericidal in the liver. Although PG
      PC-chol or PEG-DSPE-DSPE-chol liposomes encapsulating streptomycin were not
      bactericidal in the lungs, they reduced the level of MAC infection by more than 3
      orders of magnitude compared with the level of MAC infection in untreated
      controls.

PMID- 7793882
TI  - Use of normal C57BL/6 mice with established Mycobacterium avium infections as an
      alternative model for evaluation of antibiotic activity.
AB  - Several murine models have been used to evaluate the activities of antimicrobial
      agents against Mycobacterium avium infection. The main model used is the beige
      mouse model, but beige mice are expensive and not easily available. Thus, we
      developed a model of infection in wild C57BL/6 mice. The drugs that exhibited
      some activity in a previous model of early infection were evaluated in a new
      model of established infection. Sparfloxacin (50 mg/kg of body weight),
      ethambutol (50 mg/kg), minocycline (25 mg/kg), and the inhibitor of the cortisol
      receptors RU-40555 (100 mg/kg) were compared with clarithromycin (50 mg/kg).
      Treatments were started 5 weeks after the inoculation and were continued for 21
      days. Sparfloxacin and RU-40555, which exhibited a moderate activity in the model
      of early infection, were not effective in this model of established infection.
      Clarithromycin and combinations with clarithromycin kept their activities against
      M. avium infection, both in the spleen and in lungs. The present model of
      established infection of normal C57BL/6 mice is more relevant than the model of
      early infection for a stringent evaluation of drugs.

PMID- 7793883
TI  - Antigenic properties and immunoelectron microscopic localization of Mycobacterium
      fortuitum beta-lactamase.
AB  - Mycobacterium fortuitum is a fast-growing Mycobacterium species which produces a
      beta-lactamase involved in the intrinsic resistance of the microorganism to beta
      lactam antibiotics. An anti-beta-lactamase serum against the purified enzyme was
      raised in rabbits. Antibody binding was specific for native beta-lactamase, and
      enzyme activity was partially inhibited by the serum; furthermore, cross
      reactions with denatured class A beta-lactamases were observed. This serum was
      used as a probe in immunogold labeling for the localization of the cell-bound
      beta-lactamase in both the low-level producer ATCC 19542 (parental strain) and
      the overproducer mutant D316. By the combination of preembedding immunogold
      labeling and replica technique, it was shown that the beta-lactamase was
      uniformly distributed on the whole external cell surface, where it appeared to be
      associated with a Tween 80-removable capsule-like material. Compared with the
      parental strain, a much higher level of expression of surface enzyme was observed
      in strain D316. Surface labeling was more intense in the stationary phase of
      growth than in exponentially growing cells. The data obtained are interpreted in
      the context of the intrinsic resistance of M. fortuitum to beta-lactam
      antibiotics.

PMID- 7793884
TI  - (R)-9-(2-phosphonylmethoxypropyl)-2,6-diaminopurine is a potent inhibitor of
      feline immunodeficiency virus infection.
AB  - The antiviral efficacy of acyclic nucleoside phosphonates, including 9-(2
      phosphonylmethoxyethyl)adenine (PMEA) and (R)-9-(2-phosphonylmethoxypropyl)-2,6
      diaminopurine [(R)-PMPDAP] against feline immunodeficiency virus (FIV) infection
      was determined. (R)-PMPDAP showed the highest selectivity index (> 2,000) in
      vitro. Treatment of experimentally FIV-infected asymptomatic cats with PMEA or
      (R)-PMPDAP had no effect on the CD4+/CD8+ ratio. However, mean plasma viral RNA
      concentrations decreased significantly in the (R)-PMPDAP-treated cats. Our data
      show that, in comparison to PMEA, (R)-PMPDAP is a more potent and less toxic
      inhibitor of FIV replication both in vitro and in vivo.

PMID- 7793886
TI  - Bioluminescence method to evaluate antimicrobial agents against Mycobacterium
      avium.
AB  - Plasmid pLUC10, carrying the firefly luciferase gene, was transformed by
      electroporation into Mycobacterium avium A5. Bioluminescence production by strain
      A5(pLUC10), as measured in a microdilution plate luminometer, was approximately 1
      relative light unit per 2 x 10(6) viable bacilli, whereas it was 0.0005 relative
      light unit for an equal number of parental cells. The susceptibility of strain
      A5(pLUC10) to eight concentrations of each of eight antimicrobial agents was
      evaluated by the luciferase microplate assay in parallel with a conventional
      broth macrodilution method with antimicrobial agents. Decreases in
      bioluminescence to levels that were < or = 10% of those of drug-free controls
      were observed in microplate wells containing inhibitory concentrations of drugs
      in as few as 3 days. The close correlation of these inhibitory concentrations
      with the MICs determined by a conventional broth macrodilution method suggests
      that the luciferase microplate method may offer a convenient and reliable means
      of evaluating the in vitro activities of antimicrobial agents against the M.
      avium complex.

PMID- 7793885
TI  - Comparison of activities of fluoroquinolones in murine macrophages infected with
      Mycobacterium tuberculosis.
AB  - In this study the compounds levofloxacin and sparfloxacin, as well as three
      experimental compounds (AMQ2, AMQ4, and AMQ5), were compared with isoniazid and
      rifabutin in terms of their capacity to inhibit the intracellular growth of the
      drug-susceptible Mycobacterium tuberculosis strain Erdman and the isoniazid
      resistant katG gene-negative strain 24 within monolayers of mouse bone marrow
      derived macrophages. Both levofloxacin and sparfloxacin, as well as compound
      AMQ4, had substantial activity in this physiologically relevant model, further
      confirming the potential usefulness of this class of compounds in the therapy of
      tuberculosis.

PMID- 7793887
TI  - Potential use of a simplified method for determination of itraconazole levels in
      plasma and esophageal tissue by using high-performance liquid chromatography.
AB  - A simplified high-performance liquid chromatography assay was developed for
      determination of itraconazole levels in plasma and esophageal tissue in four
      patients with AIDS who had been receiving daily oral doses of 100 mg of
      itraconazole in solution for at least 3 weeks for therapy of esophageal
      candidiasis. Itraconazole levels were about three times higher in esophageal
      tissue than in plasma (means +/- standard errors of 0.69 +/- 0.50 micrograms/g
      and 0.24 +/- 0.16 micrograms/ml, respectively; P = 0.04). This method is quick
      (it requires only 1 h for completion) and sensitive (the limits of detectability
      for itraconazole in plasma and esophageal tissue are 0.005 micrograms/ml and 0.01
      micrograms/g, respectively), and it can be reliably used in clinical and research
      settings (accuracy, > 95%; absolute recovery from biological samples, 80 to 90%;
      coefficient of variation, 3.3 to 6.6%).

PMID- 7793888
TI  - Susceptibilities of Chlamydia trachomatis isolates causing uncomplicated female
      genital tract infections and pelvic inflammatory disease.
AB  - The in vitro susceptibilities of 45 recent clinical isolates of Chlamydia
      trachomatis obtained from women with asymptomatic genital tract infection,
      mucopurulent cervicitis, or pelvic inflammatory disease to doxycycline,
      azithromycin, ofloxacin, and clindamycin were determined. In addition,
      susceptibilities of 12 isolates to amoxicillin and trimethoprim-sulfamethoxazole
      were also determined. Isolates also were serotyped with a panel of monoclonal
      antibodies specific for chlamydial major outer membrane protein; 24 of 45 (53%)
      belonged to serovars Ia and E. For all isolates, the MIC range of doxycycline was
      0.008 to 0.06 micrograms/ml, for trimethoprim-sulfamethoxazole it was 0.03 to
      0.25 micrograms/ml, for azithromycin it was 0.125 to 2.0 micrograms/ml, for
      ofloxacin it was 0.5 to 1.0 micrograms/ml, for clindamycin it was 0.25 to 2.0
      micrograms/ml, and for amoxicillin it was 0.25 to 4.0 microgram/ml. The ranges of
      minimum chlamydiacidal concentrations were generally 1 to 4 dilutions above the
      MICs of most agents, with a rank order similar to those of the MICs. Comparing
      the minimum chlamydiacidal concentrations for 90% of isolates tested, isolates
      causing asymptomatic infection belonged to a greater variety of serovars and were
      relatively more susceptible to doxycycline and azithromycin than isolates causing
      mucopurulent cervicitis or pelvic inflammatory disease; these differences in
      susceptibility were not detected among the other study agents. These data
      indicate that additional studies are needed to better define the apparent
      association of certain chlamydial serovars with the clinical severity of disease
      and the in vitro susceptibilities to certain antimicrobial agents.

PMID- 7793890
TI  - Use of cryomicrotomy to study gastric diffusion of amoxicillin in guinea pigs.
AB  - Cryomicrotomy has been used as a new technique for removing gastric mucosae from
      adult guinea pigs for the study of amoxicillin secretion across gastric mucosae.
      This method allowed a very regular thickness of the removed surface layer of
      mucosa to be obtained with good reproducibility. Gastric superficial mucosa
      concentrations and gastric juice concentrations of amoxicillin were determined 1,
      2, and 4 h after intramuscular administration (50 mg/kg) in 21 guinea pigs by a
      microbiological method. No antibiotic was detected in gastric samples at 4 h,
      except for a low-level mucosal concentration in one animal, thus indicating the
      short time that amoxicillin is present in gastric samples.

PMID- 7793889
TI  - In vitro effects of sulfadiazine and its metabolites alone and in combination
      with pyrimethamine on Toxoplasma gondii.
AB  - Sulfadiazine and the metabolites N4-acetyl-sulfadiazine, 4-OH-sulfadiazine, 5-OH
      sulfadiazine, 5-OH-glucuronide-sulfadiazine, and 5-OH-sulfate-sulfadiazine were
      tested separately and in combination with pyrimethamine for the inhibitory
      activity on Toxoplasma gondii growth in vitro. Except for N4-acetyl-sulfadiazine,
      all sulfa compounds possessed anti-Toxoplasma activity. The addition of 0.05
      micrograms of pyrimethamine per ml, a concentration which in itself is not
      inhibitory, potentiated the microbial activity of sulfadiazine and its
      metabolites 100 fold.

PMID- 7793891
TI  - Identification of a carbenicillin-hydrolyzing beta-lactamase in Alcaligenes
      denitrificans subsp. xylosoxydans.
AB  - Eleven strains of Alcaligenes denitrificans subsp. xylosoxydans produced a beta
      lactamase with a pI of 5.7 with kinetic data characteristic of a PSE-1-type
      enzyme. A CARB-type enzyme was identified by using an intragenic DNA probe of
      blaCARB. Hybridization of genomic DNA after XbaI restriction and pulsed-field
      electrophoresis suggested a chromosomal location for the gene.

PMID- 7793893
TI  - Efficacy of the triazole D0870 in a murine model of systemic histoplasmosis.
AB  - The efficacy of D0870 was studied in a murine model of systemic histoplasmosis
      and was compared with that of fluconazole. All regimens of D0870 (1 or 10 mg/kg
      of body weight given daily or 1, 10, or 100 mg/kg given every other day) and 100
      mg of fluconazole per kg given daily provided complete protection from lethality.
      Comparison of the number of viable Histoplasma capsulatum yeasts remaining in the
      spleen or liver indicated that D0870 was superior to fluconazole in clearing and
      curing infection. D0870 was 10- to 100-fold more efficacious than fluconazole in
      the treatment of experimental histoplasmosis.

PMID- 7793892
TI  - SCH 51048, a new antifungal triazole active against hematogenous Candida krusei
      infections in neutropenic mice.
AB  - Candida krusei is increasingly recognized as an opportunistic pathogen in
      immunocompromised patients and is inherently resistant to fluconazole. We tested
      the in vivo efficacy of SCH 51048, an investigational antifungal triazole, in
      experimental hematogenous murine infection caused by two C. krusei isolates and
      compared its activity with those of amphotericin B and fluconazole. CF1 mice were
      immunosuppressed with cyclophosphamide and cortisone acetate and were challenged
      intravenously with infecting inocula of each C. krusei isolate. Treatment with
      SCH 51048 (50 or 100 mg/kg of body weight per day orally) or amphotericin B (2
      mg/kg/day intraperitoneally) significantly prolonged the survival of infected
      mice and significantly reduced fungal titers in the kidneys (P < or = 0.05).
      Treatment with fluconazole (100 mg/kg/day orally) had no effect. Both dosages of
      SCH 51048 were as effective as amphotericin B in improving survival, but the
      higher dosage was significantly (P < or = 0.05) better in reducing the fungal
      burden in the kidneys of infected animals. A dose-dependent response was observed
      with SCH 51048 treatment, especially in organ clearance. Our results indicate
      that SCH 51048 is the first triazole that has in vivo activity against
      experimental infection with C. krusei and deserves further evaluation.

PMID- 7793894
TI  - Dimerization and membrane anchors in extracellular targeting of vancomycin group
      antibiotics.
AB  - Antibiotics of the vancomycin group are shown to enhance their affinities for the
      bacterial cell wall by the devices of either dimerization (vancomycin and other
      glycopeptides which dimerize even more strongly) or use of a membrane anchor
      (teicoplanin); a chelate mechanism is suggested in both cases, as supported by
      antagonism experiments with the cell wall analog di-N-acetyl-L-Lys-D-Ala-D-Ala.
      These results may have implications for other binding processes which occur near
      membrane surfaces.

PMID- 7793897
TI  - Photosensitivity associated with ciprofloxacin use in adult patients with cystic
      fibrosis.

PMID- 7793895
TI  - Activities of rifabutin, clarithromycin, and ethambutol against two virulent
      strains of Mycobacterium avium in a mouse model.
AB  - Rifabutin, clarithromycin, and ethambutol, which were administered at
      concentrations similar to those used in clinical trials that are now under way,
      were tested for their capacities to inhibit the growth of two highly virulent
      isolates of Mycobacterium avium in inbred C57BL/6 mice and in vitro in a bone
      marrow-derived murine macrophage model. In the latter model rifabutin and
      clarithromycin had modest activities against strain 101 and somewhat better
      activities against strain 2-151. When they were tested in vivo, however, the best
      results, against strain 101 were seen when the three drugs were given in
      combination, whereas against strain 2-151 the combination therapy showed no
      significant improvement over that of clarithromycin given alone. It will be of
      interest to note to what degree the eventual outcomes of the current trials
      correlate with the predictions of these animal model systems.

PMID- 7793896
TI  - nfxC-type quinolone resistance in a clinical isolate of Pseudomonas aeruginosa.
AB  - Quinolone resistance gene nqr-T91 in a clinical isolate of Pseudomonas aeruginosa
      P1481 was cotransducible with catA1 in P. aeruginosa PAO. The nqr-T91
      transductant, PKH-T91, was resistant to norfloxacin, imipenem, and
      chloramphenicol and showed less norfloxacin accumulation than the parent strain
      did. Loss of the 46-kDa outer membrane protein (D2) and an increase in the 50-kDa
      outer membrane protein in PKH-T91 were observed by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis. Lipopolysaccharides in the transductant were
      also changed. These alterations were considered to be related to lower levels of
      norfloxacin accumulation in PKH-T91. These genetic and biochemical properties
      suggested that an nfxC type of quinolone-resistant mutation occurred in a
      clinical isolate of P. aeruginosa P1481.

PMID- 7793898
TI  - Effect of novobiocin-containing antimicrobial regimens on infection and
      colonization with vancomycin-resistant Enterococcus faecium.

PMID- 7793899
TI  - You, too, can publish an article in the AORN Journal.

PMID- 7793900
TI  - Angioplasty with stent placement in peripheral arterial occlusive disease.
AB  - Percutaneous transluminal balloon angioplasty (PTBA) is a minimally invasive and
      effective adjunct treatment for patients with atherosclerotic peripheral vascular
      disease. This surgical technique involves placing an intraarterial balloon within
      an obstructing arterial lesion and forcibly dilating the balloon under
      fluoroscopy. The PTBA technique has become an accepted interventional therapy for
      iliac artery stenoses. In selected patients with stenotic lesions of the iliac
      artery, percutaneous transluminal angioplasty (PTA) with the use of an
      intravascular stent may be an alternative to traditional aortofemoral bypass
      surgery. The PTA procedure involves only a needle entry site in one or both
      groins as opposed to an incision exposing the entire abdomen. The hospital stay
      for the average patient undergoing PTA of the iliac artery is three days as
      opposed to seven days for the patient undergoing aortofemoral bypass, and the
      patient may return to normal activity in a much shorter period of time after a
      PTA procedure.

PMID- 7793901
TI  - Perioperative nursing interventions for intravascular stent placements.
AB  - Keeping abreast of changing surgical technologies is among the more challenging
      aspects of perioperative nursing. Because peripheral vascular disease is a
      leading cause of lower extremity disabilities that require surgical
      interventions, new procedures and techniques are being developed continually.
      These procedures involve the insertion of intraluminal structural supports into
      patients who have had mixed or unsuccessful results from angioplasty.
      Perioperative nurses are an integral part of vascular surgery teams performing
      the insertion of intravascular stents. To function effectively, perioperative
      nurses must understand the concepts of intravascular stent procedures, nursing
      diagnoses, and nursing interventions that promote optimal patient outcomes.

PMID- 7793902
TI  - The challenge of performing three heart transplantations in one day.
AB  - Heart transplantation procedures, which present a number of challenges not
      generally seen in perioperative nursing practice, provide important knowledge for
      perioperative nurses because they demonstrate the importance of organization,
      communication, collaboration, and resourcefulness among surgical team members. On
      Friday, Aug 13, 1993, the Virginia Heart Center at Fairfax Hospital, Falls
      Church, implanted donor hearts in three adult recipients in a single day. The day
      was even more challenging because of elective coronary artery bypass graft
      procedures performed on three other patients. Successful response to the demands
      of Aug 13 was facilitated by the presence of skilled, versatile, cardiovascular
      OR staff members.

PMID- 7793904
TI  - Minimizing patients' hypothermia and bleeding after cardiac surgery.

PMID- 7793905
TI  - Developing an instrument for measuring patient satisfaction.
AB  - We developed a 21-item questionnaire to evaluate the effectiveness of nursing
      care provided in an outpatient surgery center. The four constructs of the
      instrument for measuring patient satisfaction are caring, continuity of care,
      competence of nurses, and education of patients and family members. Content
      validity and test-retest reliability have been established. Using this tool to
      analyze patients' responses to nursing care can help perioperative nurses improve
      patient care and patient satisfaction.

PMID- 7793903
TI  - Competency-based orientation for perioperative cardiovascular nurses.
AB  - Nurses working in cardiovascular surgery must be responsible and highly competent
      to meet the demands of their profession. Hospitals that hire nurses for
      cardiovascular surgery also must assume responsibility for the competency of
      nurses hired. The Virginia Heart Center at Fairfax Hospital, Falls Church, uses a
      competency-based orientation plan to train newly hired cardiovascular surgery
      nurses in providing quality care. Competency-based orientation is an effective
      approach to incorporating new members of the team into the work environment. The
      benefits of this appraoch include the development of teamwork and esprit de
      corps, skill and knowledge enhancement, and possible increased staff retention.

PMID- 7793906
TI  - State health care reform blocked by federal legislation.

PMID- 7793907
TI  - Biocontrol of mold growth in high-moisture wheat stored under airtight conditions
      by Pichia anomala, Pichia guilliermondii, and Saccharomyces cerevisiae.
AB  - Pichia anomala inhibits the growth of Penicillium roqueforti and Aspergillus
      candidus on agar. In this investigation, antagonistic activity on agar against 17
      mold species was determined. The abilities of Pichia anomala, Pichia
      guilliermondii, and Saccharomyces cerevisiae to inhibit the growth of the mold
      Penicillium roqueforti in nonsterile high-moisture wheat were compared by adding
      10(3) Penicillium roqueforti spores and different amounts of yeast cells per gram
      of wheat. Inoculated grain was packed in glass tubes, incubated at 25 degrees C
      with a restricted air supply, and the numbers of yeast and mold CFU were
      determined on selective media after 7 and 14 days. Pichia anomala reduced growth
      on agar plates for all of the mold species tested in a dose-dependent manner.
      Aspergillus fumigatus and Eurotium amstelodami were the most sensitive, while
      Penicillium italicum and Penicillium digitatum were the most resistant. Pichia
      anomala had the strongest antagonistic activity in wheat, with 10(5) and 10(6)
      CFU/g completely inhibiting the growth of Penicillium roqueforti. Inhibition was
      least pronounced at the optimum temperature (21 degrees C) and water activity
      (0.95) for the growth of Penicillium roqueforti. Pichia guilliermondii slightly
      reduced the growth of Penicillium roqueforti in wheat inoculated with 10(5) and
      10(6) yeast CFU/g. S. cerevisiae inhibited mold growth only weakly at the highest
      inoculum level. Pichia anomala grew from 10(3) to 10(7) CFU/g of wheat in 1 week.
      To reach the same level, Pichia guilliermondii had to be inoculated at 10(4) CFU
      while S. cerevisiae required an inoculum of 10(5) CFU to reach 10(7) CFU/g of
      wheat.

PMID- 7793909
TI  - Construction and characterization of a DNA probe for distinguishing strains of
      Aspergillus flavus.
AB  - Repetitive DNA sequences have proven useful and reliable characters in evaluating
      genetic relatedness of strains at different levels of taxonomic classification. A
      DNA probe was constructed to distinguish among strains of Aspergillus flavus by
      DNA fingerprinting techniques. Chromosomal DNA of A. flavus var. flavus NRRL 6541
      was partially digested with EcoRI and ligated to a Lambda Dash bacteriophage
      vector. Four lambda clones were identified which displayed multiple and distinct
      bands when hybridized with chromosomal DNA from seven strains of A. flavus var.
      flavus digested with either EcoRI or PstI. One of these clones was chosen for
      further analysis and was subcloned into pUC19. The subclone, pAF28, contained a
      6.2-kb chromosomal DNA insert and was able to distinguish among strains
      characterized by K. E. Papa (Mycologia 78:98-101, 1986) as belonging to 22
      different vegetative compatibility groups. The subclone identified unique banding
      patterns when hybridized to genomic DNA digested with PstI. The cloned probe may
      be species specific as it hybridized with the DNA of all isolates of A. flavus
      tested in addition to strains recognized as varieties of A. flavus (e.g., A.
      flavus var. oryzae, A. flavus var. parasiticus, and A. flavus var. sojae). pAF28
      hybridized to a single band on a Southern blot with Aspergillus nomius DNA but
      did not hybridize with the DNA of other fungal species tested including
      Aspergillus ochraceus, Aspergillus auricomus, Aspergillus alliaceus, Fusarium
      moniliforme, and Penicillium thomii.

PMID- 7793908
TI  - Isolation and characterization of acidocin A and cloning of the bacteriocin gene
      from Lactobacillus acidophilus.
AB  - Acidocin A, a bacteriocin produced by Lactobacillus acidophilus TK9201, is active
      against closely related lactic acid bacteria and food-borne pathogens including
      Listeria monocytogenes. The bacteriocin was purified to homogeneity by ammonium
      sulfate precipitation and sequential ion-exchange and reversed-phase
      chromatographies. The molecular mass was determined by high-performance liquid
      chromatography gel filtration to be 6,500 Da. The sequence of the first 16 amino
      acids of the N terminus was determined, and oligonucleotide probes based on this
      sequence were constructed to detect the acidocin A structural gene acdA. The
      probes hybridized to the 4.5-kb EcoRI fragment of a 45-kb plasmid, pLA9201,
      present in L. acidophilus TK9201, and the hybridizing region was further
      localized to the 0.9-kb KpnI-XbaI fragment. Analysis of the nucleotide sequence
      of this fragment revealed that acidocin A was synthesized as an 81-amino-acid
      precursor including a 23-amino-acid N-terminal extension. An additional open
      reading frame (ORF2) encoding a 55-amino-acid polypeptide was found downstream of
      and in the same operon as acdA. Transformants containing this ORF2 became
      resistant to acidocin A, suggesting that ORF2 encodes an immunity function for
      acidocin A. The 7.2-kb SacI-XbaI fragment containing the upstream region of acdA
      of pLA9201 was necessary for acidocin A expression in the acidocin A-deficient
      mutant, L. acidophilus TK9201-1, and other Lactobacillus strains.

PMID- 7793910
TI  - Genes involved in immunity to the lantibiotic nisin produced by Lactococcus
      lactis 6F3.
AB  - The lantibiotic nisin is produced by several strains of Lactococcus lactis. The
      complete gene cluster for nisin biosynthesis in L. lactis 6F3 comprises 15 kb of
      DNA. As described previously, the structural gene nisA is followed by the genes
      nisB, nisT, nisC, nisI, nisP, nisR, and nisK. Further analysis revealed three
      additional open reading frames, nisF, nisE, and nisG, adjacent to nisK.
      Approximately 1 kb downstream of the nisG gene, three open reading frames in the
      opposite orientation have been identified. One of the reading frames, sacR,
      belongs to the sucrose operon, indicating that all genes belonging to the nisin
      gene cluster of L. lactis 6F3 have now been identified. Proteins NisF and NisE
      show strong homology to members of the family of ATP-binding cassette (ABC)
      transporters, and nisG encodes a hydrophobic protein which might act similarly to
      the immunity proteins described for several colicins. Gene disruption mutants
      carrying mutations in the genes nisF, nisE, and nisG were still able to produce
      nisin. However, in comparison with the wild-type strain, these mutants were more
      sensitive to nisin. This indicates that besides nisI the newly identified genes
      are also involved in immunity to nisin. The NisF-NisE ABC transporter is
      homologous to an ABC transporter of Bacillus subtilis and the MbcF-MbcE
      transporter of Escherichia coli, which are involved in immunity to subtilin and
      microcin B17, respectively.

PMID- 7793911
TI  - Cloning and expression in Saccharomyces cerevisiae of a Trichoderma reesei beta
      mannanase gene containing a cellulose binding domain.
AB  - beta-Mannanase (endo-1,4-beta-mannanase; mannan endo-1,4-beta-mannosidase; EC
      3.2.1.78) catalyzes endo-wise hydrolysis of the backbone of mannan and
      heteromannans, including hemicellulose polysaccharides, which are among the major
      components of plant cell walls. The gene man1, which encodes beta-mannanase, of
      the filamentous fungus Trichoderma reesei was isolated from an expression library
      by using antiserum raised towards the earlier-purified beta-mannanase protein.
      The deduced beta-mannanase consists of 410 amino acids. On the basis of
      hydrophobic cluster analysis, the beta-mannanase was assigned to family 5 of
      glycosyl hydrolases (cellulase family A). The C terminus of the beta-mannanase
      has strong amino acid sequence similarity to the cellulose binding domains of
      fungal cellulases and is preceded by a serine-, threonine-, and proline-rich
      region. Consequently, the beta-mannanase is probably organized similarly to the
      T. reesei cellulases, having a catalytic core domain separated from the substrate
      binding domain by an O-glycosylated linker. Active beta-mannanase was expressed
      and secreted by using the yeast Saccharomyces cerevisiae as the host. The results
      indicate that the man1 gene encodes the two beta-mannanases with different
      isoelectric points (pIs 4.6 and 5.4) purified earlier from T. reesei.

PMID- 7793912
TI  - PCR amplification and direct sequencing of gyrB genes with universal primers and
      their application to the detection and taxonomic analysis of Pseudomonas putida
      strains.
AB  - Degenerate PCR primers, UP-1 and UP-2r, for the amplification of DNA gyrase
      subunit B genes (gyrB) were designed by using consensus amino acid sequences of
      gyrases from Escherichia coli, Pseudomonas putida, and Bacillus subtilis. In
      addition to the degenerate sequences, these primers have sequences at the 5' end
      which allow direct sequencing of amplified PCR products. With these primers, DNA
      segments of the predicted size were amplified from a variety of gram-negative and
      gram-positive genera. The nucleotide sequences of the amplified gyrB DNA from
      three P. putida strains were determined directly from the amplified fragments.
      The base substitution frequency of gyrB between the strains of P. putida was much
      higher than that of the 16S rRNA gene. With a specific set of PCR primers, it was
      possible to amplify gyrB fragments selectively from P. putida or its subgroups.
      The direct sequencing method of gyrB developed in this study provides a rapid and
      convenient system for bacterial identification, taxonomic analysis, and
      monitoring of bacteria in the natural environment.

PMID- 7793913
TI  - Addition of cellulolytic clostridia to the bovine rumen and pig intestinal tract.
AB  - Studies were conducted to determine whether intestinal cellulolytic bacteria
      could be introduced into the bovine rumen or pig large intestine. In the first
      study, the ruminal fluid of three cows was evacuated and replaced with 20 liters
      of buffer and 6 liters of the ruminal or swine cellulolytic organism Clostridium
      longisporum or Clostridium herbivorans, respectively. The introduced organisms
      were the predominant cellulolytic bacterium in the fluid (> 10(7) cells ml-1) at
      0 h. C. longisporum was still the predominant cellulolytic organism after 5 h, at
      0.55 x 10(7) cells ml-1; however, after 24 h the count of C. longisporum
      decreased to 0.05 x 10(7) cells ml-1 compared with 2.8 x 10(7) cells ml-1 for the
      total cellulolytic organisms. After 48 h, C. longisporum was no longer
      detectable. C. herbivorans was identified in only one of the three cows after 24
      h and was not detected at 72 h. In a second study, when C. longisporum (50 ml;
      10(7) cells ml-1) was infused into the terminal ileum of seven pigs, it was not
      recovered when fecal samples were evaluated at 24, 48, or 72 h after infusion.
      These studies emphasize the competition that must be overcome to successfully
      introduce organisms into an intestinal ecosystem. Furthermore, these studies
      suggest that C. longisporum is a transient organism in the bovine rumen; however,
      C. herbivorans is part of the normal intestinal flora of some pigs, although the
      role that it plays in fiber degradation in these pigs is unclear.

PMID- 7793914
TI  - Evidence that water transmits Vibrio vulnificus biotype 2 infections to eels.
AB  - Vibrio vulnificus biotype 2 is classically considered an obligate eel pathogen.
      However, it has recently been associated with one human septicemic case. In this
      paper, the opportunistic behavior of this pathogen is discussed. The bacterium
      can survive alone in brackish water or attached to eel surfaces for at least 14
      days. It is able to spread through water and infect healthy eels by using skin as
      a portal of entry. These results suggest that water and infected eels may act as
      reservoirs of infection. A capsule seems to be essential for waterborne
      infectivity, which would explain why cells recovered from naturally diseased eels
      give rise to pure cultures of opaque colonies. The spread of the disease is
      dependent on temperature and water salinity, thus suggesting a method to reduce
      the risk of epizootics and that of infection for humans.

PMID- 7793915
TI  - Comparison of methods of DNA extraction from stream sediments.
AB  - In Upper Three Runs Creek (Aiken, S.C.) and many other environments, less than 1%
      of bacteria visible microscopically can be cultured. Exploitation of molecular
      biology techniques has led to development of new methods, such as extraction of
      nucleic acids from soils or sediments, to study the dominant, nonculturable
      bacteria. The purpose of this study was to compare three published methods of DNA
      extraction that fall into two general categories: those in which cells are lysed
      in sediments (the Ogram and Tsai and methods [A. Ogram, G. S. Sayler, and T.
      Barkay, J. Microbiol. Methods 7:57-66, 1987; Y. L. Tsai and B. H. Olson, Appl.
      Environ. Microbiol. 57:1070-1074, 1991]) and those in which cells are removed
      from sediments prior to lysis (the Jacobsen method [C. S. Jacobsen and O. S.
      Rasmussen; Appl. Environ. Microbiol. 58:2458-2462, 1992]). DNA yield varied with
      extraction method; the Ogram method had a significantly higher yield than the
      other methods. However, DNA extracted via the Ogram method was badly sheared and
      contained a smaller proportion of eubacterial DNA. The Tsai method was less time
      consuming than the other methods, but DNA samples were of lower purity. If DNA
      purity is of paramount concern (as would be the case if PCR was to be performed)
      and quantity is not important, the Jacobsen method is recommended because of the
      low concentration of contaminants. If DNA is to be used directly in DNA-DNA
      hybridizations, the Ogram method is recommended since it gives maximal
      yields.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793916
TI  - Comparison of Lactobacillus strains with respect to bile salt hydrolase activity,
      colonization of the gastrointestinal tract, and growth rate of the murine host.
AB  - The significance of bile salt hydrolase production by lactobacilli in the
      microecology of the murine intestinal tract has not been extensively studied
      previously. Assays of bile salt hydrolase (sodium taurocholate as substrate)
      associated with cell extracts of five Lactobacillus strains of murine origin gave
      a range of activities (from 915 nmol of cholate released per mg of protein per 30
      min to none detected). All of the strains tested colonized the murine
      gastrointestinal tract equally well. The growth rates of mice were not affected
      by colonization of their intestinal tracts by lactobacilli whether or not the
      bacteria produced bile salt hydrolase.

PMID- 7793917
TI  - Thermostability of Ochratoxin A in wheat under two moisture conditions.
AB  - The decomposition of ochratoxin A (OTA) was examined, under different temperature
      and moisture conditions. The calculated half-lives, corresponding to 50% values,
      were 707, 201, 12, and 6 min, respectively, at 100, 150, 200, and 250 degrees C
      for dry wheat and 145, 60, and 19 min, respectively, at 100, 150, and 200 degrees
      C for wheat heated under wet conditions. The presence of water (50%) increased
      the decomposition of OTA at 100 and 150 degrees C; the opposite was observed at
      200 degrees C. Complete destruction of OTA within the limits of this study (100
      to 250 degrees C) was not obtained.

PMID- 7793919
TI  - Stabilization of microbial cytochrome P-450 activity by creation of station-phase
      conditions in a continuously operated immobilized-cell reactor.
AB  - Bacillus megaterium (ATCC 13368) exhibits cytochrome P-450 monooxygenase activity
      (referred to herein as Cyt P-450 meg) catalyzing 15 beta-steroid hydroxylation.
      This activity belongs to the widespread ferredoxin reductase-ferredoxin-Cyt P-450
      type of monooxygenases, providing a representative model system for this type of
      activity. The level of Cyt P-450 meg activity reaches its maximum in the cells
      during the stationary phase of the growth curve and is not affected by Cyt P-450
      inducers. Here we present the development of an approach for stabilizing the Cyt
      P-450 meg system so that it performs continuous steroid hydroxylation and will be
      a model system for Cyt P-450-based detoxification. It is based on cell
      immobilization and simulation of stationary-phase conditions in a continuously
      operated fluidized-bed bioreactor. The combination of an appropriate
      immobilization technique, operational conditions, and medium composition provided
      a stabilized cell environment resulting in "freezing" of a physiological steady
      state analog under stationary phase conditions, allowing stable performance of
      continuous hydroxylation for several weeks. It is suggested that this approach
      may be extended for use with other environmentally induced enzymatic activities.

PMID- 7793918
TI  - Multiple Vibrio vulnificus strains in oysters as demonstrated by clamped
      homogeneous electric field gel electrophoresis.
AB  - Clamped homogeneous electric field gel electrophoresis and a computer program for
      managing electrophoresis banding patterns (ELBAMAP) were used to analyze genomic
      DNA of 118 Vibrio vulnificus strains, isolated from three oysters by direct
      plating. Analysis with SfiI resulted in 60 restriction endonuclease digestion
      profiles (REDP), while analysis with SrfI produced 53 different REDP.
      Similarities between REDP ranged from 7 to 93%. Principal-component analysis
      showed that the strains were heterogeneous.

PMID- 7793920
TI  - Regulation of the alginate biosynthesis gene algC in Pseudomonas aeruginosa
      during biofilm development in continuous culture.
AB  - Reporter gene technology was used to observe the regulation of the alginate
      biosynthesis gene, algC in a mucoid strain of Pseudomonas aeruginosa in
      developing and mature biofilms in continuous culture on Teflon and glass
      substrata. The plasmid pNZ63, carrying an algC-lacZ transcriptional fusion, was
      shown to not be diluted in continuous culture over a period of 25 days in the
      absence of selection pressure. Biofilm cells under bulk phase steady-state
      conditions demonstrated fluctuations in algC expression over a 16-day period, but
      no trend of increased or decreased expression over the time interval was
      indicated. In vivo detection of algC up-expression in developing biofilms was
      performed with a fluorogenic substrate for the plasmid-borne lacZ gene product
      (beta-galactosidase) by using microscopy coupled with image analysis. By this
      technique, cells were tracked over time and analyzed for algC activity. During
      the initial stages of biofilm development, cells already attached to a glass
      surface for at least 15 min exhibited up-expression of algC, detectable as the
      development of whole-cell fluorescence. However, initial cell attachment to the
      substratum appeared to be independent of algC promoter activity. Furthermore,
      cells not exhibiting algC up-expression were shown to be less capable of
      remaining at a glass surface under flowing conditions than were cells in which
      algC up-expression was detected.

PMID- 7793921
TI  - Laccase component of the Ceriporiopsis subvermispora lignin-degrading system.
AB  - Laccase activity in the lignin-degrading fungus Ceriporiopsis subvermispora was
      associated with several proteins in the broth of cultures grown in a defined
      medium. Activity was not increased significantly by adding 2,5-xylidine or
      supplemental copper to the medium. Higher activity, associated with two major
      isoenzymes, developed in cultures grown on a wheat bran medium. These two
      isoenzymes were purified to homogeneity. L1 and L2 had isoelectric points of 3.4
      and 4.8, molecular masses of 71 and 68 kDa, and approximate carbohydrate contents
      of 15 and 10%, respectively. Data indicated 4 copper atoms per mol. L1 and L2 had
      overlapping pH optima in the range of 3 to 5, depending on the substrate, and
      exhibited half-lives of 120 and 50 min at 60 degrees C. They were strongly
      inhibited by sodium azide and thioglycolic acid but not by hydroxylamine or EDTA.
      The isoenzymes oxidized 1,2,4,5-tetramethoxybenzene but not other methoxybenzene
      congeners. A variety of usual laccase substrates, including lignin-related
      phenols and ABTS [2,2'-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid)], were
      also oxidized. Kinetic parameters were similar to those of the laccases of
      Coriolus versicolor. The N-terminal amino acid sequence (20 residues for L1)
      showed significant homology to those of laccases of other white rot
      basidiomycetes but not to those of the laccases of Agaricus bisporus or
      Neurospora crassa.

PMID- 7793922
TI  - Denitrification by the fungus Cylindrocarpon tonkinense: anaerobic cell growth
      and two isozyme forms of cytochrome P-450nor.
AB  - We examined the denitrification system of the fungus Cylindrocapon tonkinense and
      found several properties distinct from those of the denitrification system of
      Fusarium oxysporum. C. tonkinense could form N2O from nitrite under restricted
      aeration but could not reduce nitrate by dissimilatory metabolism. Nitrite
      dependent N2O formation and/or cell growth during the anaerobic culture was not
      affected by further addition of ammonium ions but was suppressed by respiration
      inhibitors such as rotenone or antimycin, suggesting that denitrification plays a
      physiological role in respiration. Dissimilatory nitrite reductase and nitric
      oxide reductase (Nor) activities could not be detected in cell extracts of the
      denitrifying cells. The Nor activity was purified and found to depend upon two
      isoenzymes of Cytochrome P-450nor (P-450nor), which were designated P-450nor1 and
      P-450nor2. These isozymes differed in the N-terminal amino acid sequence,
      isoelectric point, specificity to the reduced pyridine nucleotide (NADH or
      NADPH), and the reactivity to the antibody to P-450nor of F. oxysporum. the
      difference between the specificities to NADH and NADPH suggests that P-450nor1
      and P-450nor2 play different roles in anaerobic energy acquisition.

PMID- 7793923
TI  - Activity of synchronized cells of a steady-state biofilm recirculated reactor
      during xenobiotic biodegradation.
AB  - The maintenance of a steady-state biofilm in a continuous-flow fixed-bed reactor,
      as a consequence of the reproduction-detachment of cells (an interfacial cell
      physiology phenomenon of steady-state biofilm) during the biodegradation of 2,4,6
      trichlorophenol by Pseudomonas cells, was determined. After cell adhesion on an
      open-pore glass support, the biofilm was formed in a packed-bed recirculated
      reactor. After the steady-state biofilm was reached, the mechanisms of the
      interfacial cell detachment (at the biofilm-liquid interface) were determined. It
      was established that (i) the hydrophobicity of immobilized sessile cells (parent
      cells) increased (from 50 to 80%) as the dilution rate increased, while the
      hydrophobicity of detached suspended cells (daughter cells) remained constant
      (about 45%); and (ii) the immediately detached suspended cells showed a
      synchronized growth in about three generations. These results indicate that (i)
      the immobilized sessile and suspended detached cells grew synchronically at the
      end and at the beginning of the cell cycle, respectively; and (ii) the
      hydrophobicity difference of immobilized sessile and suspended detached cells
      permitted the cells detachment. Therefore, it is probable that independent of
      shear stress (due to recirculated flow), the synchronized growth and
      hydrophobicity of cells (which vary during the cell cycle) are the main factors
      permitting the maintenance of a steady-state xenobiotic-degrading biofilm reactor
      (in which the overall accumulation of biofilm is determined by the average growth
      rate of the biofilm cells minus the rate of detachment of cells from the
      biofilm).

PMID- 7793924
TI  - Isolation and characterization of a cytotoxic metabolite of Talaromyces
      bacillosporus.
AB  - A cytotoxic metabolite, talarotoxin, was isolated from a fungus, Talaromyces
      bacillosporus IFO 8397, cultured on rice. The structure of the toxin was
      elucidated and found to contain a pyrrolizidinedione connected with a trans delta
      1-octalin through a conjugated triene.

PMID- 7793925
TI  - Characterization and substrate specificity of an endo-beta-1,4-D-glucanase I
      (Avicelase I) from an extracellular multienzyme complex of Bacillus circulans.
AB  - An endo-1,4-beta-D-glucanase I (Avicelase I; EC 3.2.1.4) was purified to
      homogeneity from an extracellular celluloxylanosome of Bacillus circulans F-2.
      The purification in the presence of 6 M urea yielded homogeneous enzyme. The
      enzyme had a monomeric structure, its relative molecular mass being 75 kDa as
      determined by gel filtration and 82 kDa as determined by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis. The pI was 5.4, and the N-terminal amino acid
      sequence was ASNIGGWVGGNESGFEFG. The optimal pH was 4.5, and the enzyme was
      stable at pH 4 to 10. The enzyme has a temperature optimum of 50 degrees C, it
      was stable at 55 degrees C for 46 h, and it retains approximately 20% of its
      activity after 30 min at 80 degrees C. It showed high-level activity towards
      carboxymethyl cellulose (CMC) as well as p-nitrophenyl-beta-D-cellobioside, 4
      methylumbelliferyl cellobioside, xylan, Avicel, filter paper, and some cello
      oligosaccharides. Km values for birch xylan, CMC, and Avicel were 4.8, 7.2, and
      87.0 mg/ml, respectively, while Vmax values were 256, 210, and 8.6 mumol x min-1
      x mg-1, respectively. Cellotetraose was preferentially cleaved into cellobiose
      (G2) plus G2, and cellopentaose was cleaved into G2 plus cellotriose (G3), while
      cellohexaose was cleaved into cellotetraose plus G2 and to a lesser extent G3
      plus G3. G3 was not cleaved at all. G2 was the main product of Avicel hydrolysis.
      Xylotetraose (X4) and xylobiose (X2) were mainly produced by the enzyme
      hydrolysis of xylan. G2 inhibited the activity of carboxymethyl cellulase and
      Avicelase, whereas Mg2+ stimulated it. The enzyme was completely inactivated by
      Hg2+, and it was inhibited by a thiol-blocking reagent. Hydrolysis of CMC took
      place, with a rapid decrease in viscosity but a slow liberation of reducing
      sugars. On the basis of these results, it appeared that the cellulase should be
      regarded as endo-type cellulase, although it hydrolyzed Avicel.

PMID- 7793926
TI  - Development and testing of improved suicide functions for biological containment
      of bacteria.
AB  - We have developed very efficient suicide functions for biological containment
      based on the lethal Escherichia coli relF gene. The suicide functions are placed
      in duplicate within a plasmid and arranged to prevent inactivation by deletion,
      recombination, and insertional inactivation. The efficiency of this concept was
      tested in a plasmid containment system that prevents transfer of plasmids to wild
      type bacteria. Protection against plasmid transfer was assayed in test tubes and
      in rat intestine. Protection was efficient and refractory to inactivation by
      mutation and transposons. The efficiency of the suicide system was also tested in
      soil and seawater. We show that unprecedented suicide efficiency can be achieved
      in soil and seawater after suicide induction by IPTG (isopropyl-beta-D
      thiogalactopyranoside). More than 7 orders of magnitude reduction in suicide
      bacteria was achieved.

PMID- 7793927
TI  - Suppression of Listeria monocytogenes colonization following adsorption of nisin
      onto silica surfaces.
AB  - Nisin is an antimicrobial peptide proven to be an effective inhibitor of gram
      positive bacteria. It is known that nisin can adsorb to various surfaces and
      still retain much of its original activity (M. A. Daeschel, J. McGuire, and H. Al
      Makhlafi, J. Food Prot. 55:731-735, 1992). In this study, nisin films were
      allowed to form on silanized silica surfaces and then exposed to medium
      containing Listeria monocytogenes. Representative areas were selected from each
      surface, and images of resident listeriae were obtained at 4-h intervals for 12
      h. During this time, cells on surfaces that had been in contact with a high
      concentration of nisin (1.0 mg/ml) exhibited no signs of growth and many
      displayed evidence of cellular deterioration. Surfaces treated with a lower
      concentration of nisin (0.1 mg/ml) had a smaller degree of inhibition. In
      contrast, both protein-free surfaces and those with films of heat-inactivated
      nisin allowed attached L. monocytogenes cells to grow and reproduce. These
      studies, when repeated with a nisin-resistant strain of L. monocytogenes,
      resulted in no inhibition of growth on surfaces with adsorbed nisin. The
      bactericidal effect of adsorbed nisin was also studied with iodonitrotetrazolium
      violet, a tetrazolium salt, which is reduced to a red formazan crystal by viable
      bacteria. Crystals were visible in 95% of the cells adhered to control surfaces
      but were present in less than 20% of the cells on surfaces with adsorbed nisin.
      These data indicate that adsorbed nisin may have potential for use as a food
      grade antimicrobial agent on food contact surfaces.

PMID- 7793929
TI  - Characterization of biphenyl catabolic genes of gram-positive polychlorinated
      biphenyl degrader Rhodococcus sp. strain RHA1.
AB  - Rhodococcus sp. strain RHA1 is a gram-positive polychlorinated biphenyl (PCB)
      degrader which can degrade 10 ppm of PCB48 (equivalent to Aroclor1248), including
      tri-, tetra-, and pentachlorobiphenyls, in a few days. We isolated the 7.6-kb
      EcoRI-BamHI fragment carrying the biphenyl catabolic genes of RHA1 and determined
      their nucleotide sequence. On the basis of deduced amino acid sequence homology,
      we identified six bph genes, bphA1A2A3A4, bphB, and bphC, that are responsible
      for the initial three steps of biphenyl degradation. The order of bph genes in
      RHA1 is bphA1A2A3A4-bphC-bphB. This gene order differs from that of other PCB
      degraders reported previously. The amino acid sequences deduced from the RHA1 bph
      genes have a higher degree of homology with the tod genes from Pseudomonas putida
      F1 (49 to 79%) than with the bph genes of Pseudomonas sp. strains KF707 and
      KKS102 (30 to 65%). In Escherichia coli, bphA gene activity was not observed even
      when expression vectors were used. The activities of bphB and bphC, however, were
      confirmed by observing the transformation of biphenyl to a meta-cleavage compound
      with the aid of benzene dioxygenase activity that complemented the bphA gene
      activity (S. Irie, S. Doi, T. Yorifuji, M. Takagi, and K. Yano, J. Bacteriol.
      169:5174-5179, 1987). The expected products of the cloned bph genes, except
      bphA3, were observed in E. coli in an in vitro transcription-translation system.
      Insertion mutations of bphA1 and bphC of Rhodococcus sp. strain RHA1 were
      constructed by gene replacement with cloned gene fragments.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7793930
TI  - Detection and counting of Nitrobacter populations in soil by PCR.
AB  - Although the biological conversion of nitrite to nitrate is a well-known process,
      studies of Nitrobacter populations are hindered by their physiological
      characteristics. This report describes a new method for detecting and counting
      Nitrobacter populations in situ with the PCR. Two primers from the 16S rRNA gene
      were used to generate a 397-bp fragment by amplification of Nitrobacter species
      DNA. No signal was detected from their phylogenetic neighbors or the common soil
      bacteria tested. Extraction and purification steps were optimized for minimal
      loss and maximal purity of soil DNA. The detection threshold and accuracy of the
      molecular method were determined from soil inoculated with 10, 10(2), or 10(3)
      Nitrobacter hamburgensis cells per g of soil. Counts were also done by the most
      probable-number (MPN)-Griess and fluorescent antibody methods. PCR had a lower
      detection threshold (10(2) Nitrobacter cells per g of soil) than did the MPN
      Griess or fluorescent antibody method. When PCR amplification was coupled with
      the MPN method, the counting rate reached 65 to 72% of inoculated Nitrobacter
      cells. Tested on nonsterile soil, this rapid procedure was proved efficient.

PMID- 7793928
TI  - Identification and epidemiological typing of Naegleria fowleri with DNA probes.
AB  - Naegleria fowleri is a small free-living amoeboflagellate found in warm water
      habitats worldwide. The organism is pathogenic to humans, causing fatal primary
      amoebic meningoencephalitis. When monitoring the environment for the presence of
      N. fowleri, it is important to reliably differentiate the organism from other
      closely related but nonpathogenic species. To this end, we have developed species
      specific DNA probes for use in the rapid identification of N. fowleri from the
      environment. Samples were taken from the thermal springs in Bath, England, and
      cultured for amoebae. Of 84 isolates of thermophilic Naegleria spp., 10 were
      identified as N. fowleri by probe hybridization. The identity of these isolates
      was subsequently confirmed by their specific whole-cell DNA restriction fragment
      length polymorphisms (RFLPs). One DNA clone was found to contain a repeated
      element that detected chromosomal RFLPs that were not directly visible on agarose
      gels. This enabled the further differentiation of strains within geographically
      defined whole-cell DNA RFLP groups. N. fowleri DNA probes represent a specific
      and potentially rapid method for the identification of the organism soon after
      primary isolation from the environment.

PMID- 7793931
TI  - Phenotypic and genetic diversity of chlorine-resistant Methylobacterium strains
      isolated from various environments.
AB  - Strains of pink-pigmented facultative methylotrophs which were isolated
      previously from various environments and assigned tentatively to the genus
      Methylobacterium were characterized in comparison with authentic strains of
      previously known species of this genus. Most of the isolates derived from
      chlorinated water supplies exhibited resistance to chlorine, whereas 29 to 40% of
      the isolates from air, natural aquatic environments, and clinical materials were
      chlorine resistant. None of the tested authentic strains of Methylobacterium
      species obtained from culture collections exhibited chlorine resistance.
      Numerical analysis of phenotypic profiles showed that the test organisms tested
      were separated from each other except M. organophilum and M. rhodesianum. The
      chlorine-resistant isolates were randomly distributed among all clusters. The 16S
      ribosomal DNA (rDNA) sequence-based phylogenetic analyses showed that
      representatives of the isolates together with known Methylobacterium species
      formed a line of descent distinct from that of members of related genera in the
      alpha-2 subclass of the Proteobacteria and were divided into three subclusters
      within the Methylobacterium group. These results demonstrate that there is
      phenotypic and genetic diversity among chlorine-resistant Methylobacterium
      strains within the genus.

PMID- 7793932
TI  - Characterization of genetically transformed Saccharomyces cerevisiae baker's
      yeasts able to metabolize melibiose.
AB  - Three transformant (Mel+) Saccharomyces cerevisiae baker's yeast strains, CT-Mel,
      VS-Mel, and DADI-Mel, have been characterized. The strains, which originally
      lacked alpha-galactosidase activity (Mel-), had been transformed with a DNA
      fragment which possessed an ILV1-SMR1 allele of the ILV2 gene and a MEL1 gene.
      The three transformed strains showed growth rates similar to those of the
      untransformed controls in both minimal and semi-industrial (molasses) media. The
      alpha-galactosidase specific activity of strain CT-Mel was twice that of VS-Mel
      and DADI-Mel. The yield, YX/S (milligrams of protein per milligram of substrate),
      in minimal medium with raffinose as the carbon source was 2.5 times higher in the
      transformed strains than in the controls and was 1.5 times higher in CT-Mel than
      in VS-Mel and DADI-Mel. When molasses was used, YX/S (milligrams of protein per
      milliliter of culture) increased 8% when the transformed strains CT-Mel and DADI
      Mel were used instead of the controls. Whereas no viable spores were recovered
      from either DADI-Mel or VS-Mel tetrads, genetic analysis carried out with CT-Mel
      indicated that the MEL1 gene has been integrated in two of three homologous loci.
      Analysis of the DNA content by flow cytometry indicated that strain CT-Mel was
      3n, whereas VS-Mel was 2n and DADI-Mel was 1.5n. Electrophoretic karyotype and
      Southern blot analyses of the transformed strains showed that the MEL1 gene has
      been integrated in the same chromosomic band, probably chromosome XIII, in the
      three strains.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793934
TI  - Fate of Salmonella montevideo on and in raw tomatoes as affected by temperature
      and treatment with chlorine.
AB  - A study was undertaken to determine the survival patterns of Salmonella
      montevideo G4639 on and in tomatoes during storage and the efficacy of chlorine
      treatment on inactivation of the pathogen. The population of S. montevideo on the
      surfaces of inoculated tomatoes stored at 10 degrees C did not change
      significantly (P < 0.05) throughout an 18-day storage period. Significant
      increases in population occurred within 7 days and within 1 day when tomatoes
      were stored at 20 and 30 degrees C, respectively. A significantly higher number
      of cells was taken up by the core tissue of tomatoes tempered at 25 degrees C
      when the tomatoes were dipped in a suspension at 10 degrees C compared with the
      number taken up when the tomatoes were dipped in cell suspensions tempered at 25
      or 37 degrees C. Populations remained constant throughout subsequent storage for
      8 days at 10 degrees C, regardless of the temperature differential between
      tomatoes and the dip suspension. Storage of tomatoes at 20 degrees C, however,
      resulted in significant increases in populations of S. montevideo. Populations of
      the pathogen on the surfaces and in the core tissues of tomatoes were
      significantly reduced by dipping for 2 min in a solution containing 60 or 110 ppm
      (60 or 110 micrograms/ml) chlorine, respectively; however, treatment in solution
      containing 320 ppm chlorine did not result in complete inactivation. Populations
      of S. montevideo remained unchanged in chopped tomatoes stored at 5 degrees C for
      216 h (9 days) but increased significantly after storage for 96 or 22 h at 20 or
      30 degrees C, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793933
TI  - Quantitation of fungal mRNAs in complex substrates by reverse transcription PCR
      and its application to Phanerochaete chrysosporium-colonized soil.
AB  - Thorough analysis of fungi in complex substrates has been hampered by inadequate
      experimental tools for assessing physiological activity and estimating biomass.
      We report a method for the quantitative assessment of specific fungal mRNAs in
      soil. The method was applied to complex gene families of Phanerochaete
      chrysosporium, a white-rot fungus widely used in studies of organopollutant
      degradation. Among the genes implicated in pollutant degradation, two closely
      related lignin peroxidase transcripts were detected in soil. The pattern of
      lignin peroxidase gene expression was unexpected; certain transcripts abundant in
      defined cultures were not detected in soil cultures. Transcripts encoding
      cellobiohydrolases and beta-tubulin were also detected. The method will aid in
      defining the roles of specific genes in complex biological processes such as
      organopollutant degradation, developing strategies for strain improvement, and
      identifying specific fungi in environmental samples.

PMID- 7793936
TI  - Characterization of Listeria monocytogenes isolated from poultry products and
      from the poultry-processing environment by random amplification of polymorphic
      DNA and multilocus enzyme electrophoresis.
AB  - A total of 289 Listeria monocytogenes strains isolated from a poultry-processing
      environment and poultry products over a 6-month period were characterized by
      random amplification of polymorphic DNA, (RAPD) to pinpoint sources of
      contamination within the plant and gain some measure of the persistence of
      individual genotypes within this environment. Eighteen RAPD profiles (A through
      R) were identified within this group, with 64% (184 of 289) of all strains
      displaying a single RAPD profile, RAPD type A. This genotype was more prevalent
      in the raw-poultry-processing environment, where, although its origin within this
      environment appeared to be the incoming birds, it was also widespread on food
      contact surfaces, floors, and drains. This was the only genotype which persisted
      throughout the entire 6-month period, and it and RAPD type B were the only two
      genotypes found in both the raw- and cooked-poultry-processing environments. L.
      monocytogenes strains isolated from cooked poultry products and the cooked
      poultry-processing environment up to 1 year later (17 strains) contained only
      RAPD types A and B, highlighting the potential which exists for persistent
      strains to cross-contaminate foods processed in that environment. The other
      genotypes (C through R) occurred more sporadically, suggesting varied sources of
      contamination. These were confined to either the raw- or the cooked-poultry
      processing environment and were relatively short-lived. Further characterization
      of a selection of RAPD type A strains, together with strains of RAPD types B
      through R, was carried out by multilocus enzyme electrophoresis. Strains of RAPD
      type A contained two electrophoretic types, one of which was serotype 1/2a and
      the other was 1/2c.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793935
TI  - Fe(III) and S0 reduction by Pelobacter carbinolicus.
AB  - There is a close phylogenetic relationship between Pelobacter species and members
      of the genera Desulfuromonas and Geobacter, and yet there has been a perplexing
      lack of physiological similarities. Pelobacter species have been considered to
      have a fermentative metabolism. In contrast, Desulfuromonas and Geobacter species
      have a respiratory metabolism with Fe(III) serving as the common terminal
      electron acceptor in all species. However, the ability of Pelobacter species to
      reduce Fe(III) had not been previously evaluated. When a culture of Pelobacter
      carbinolicus that had grown by fermentation of 2,3-butanediol was inoculated into
      the same medium supplemented with Fe(III), the Fe(III) was reduced. There was
      less accumulation of ethanol and more production of acetate in the presence of
      Fe(III). P. carbinolicus grew with ethanol as the sole electron donor and Fe(III)
      as the sole electron acceptor. Ethanol was metabolized to acetate. Growth was
      also possible on Fe(III) with the oxidation of propanol to propionate or butanol
      to butyrate if acetate was provided as a carbon source. P. carbinolicus appears
      capable of conserving energy to support growth from Fe(III) respiration as it
      also grew with H2 or formate as the electron donor and Fe(III) as the electron
      acceptor. Once adapted to Fe(III) reduction, P. carbinolicus could also grow on
      ethanol or H2 with S0 as the electron acceptor. P. carbinolicus did not contain
      detectable concentrations of the c-type cytochromes that previous studies have
      suggested are involved in electron transport to Fe(III) in other organisms that
      conserve energy to support growth from Fe(III) reduction.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7793938
TI  - Copper as a signal for alginate synthesis in Pseudomonas syringae pv. syringae.
AB  - Plant-associated pseudomonads are commonly exposed to copper bactericides, which
      are applied to reduce the disease incidence caused by these bacteria.
      Consequently, many of these bacteria have acquired resistance or tolerance to
      copper salts. We recently conducted a survey of 37 copper-resistant (Cur)
      Pseudomonas spp., including P. cepacia, P. fluorescens, P. syringae, and P.
      viridiflava, and found that a subset of the P. syringae strains showed a dramatic
      increase in exopolysaccharide (EPS) production on mannitol-glutamate medium
      containing CuSO4 at 250 micrograms/ml. A modified carbazole assay indicated that
      the EPS produced on copper-amended media contained high levels of uronic acids,
      suggesting that the EPS was primarily alginic acid. Uronic acids extracted from
      selected strains were further confirmed to be alginate by demonstrating their
      sensitivity to alginate lyase and by descending paper chromatography following
      acid hydrolysis. Subinhibitory levels of arsenate, cobalt, lithium, rubidium,
      molybdenum, and mercury did not induce EPS production, indicating that alginate
      biosynthesis is not induced in P. syringae cells exposed to these heavy metals. A
      200-kb plasmid designated pPSR12 conferred a stably mucoid phenotype to several
      P. syringae recipients and also increased their resistance to cobalt and
      arsenate. A cosmid clone constructed from pPSR12 which conferred a stably mucoid
      phenotype to several P. syringae strains but not to Pseudomonas aeruginosa was
      obtained. Results obtained in this study indicate that some of the signals and
      regulatory genes for alginate production in P. syringae differ from those
      described for alginate production in P. aeruginosa.

PMID- 7793939
TI  - Cloning and sequencing of LlaDCHI [corrected] restriction/modification genes from
      Lactococcus lactis and relatedness of this system to the Streptococcus pneumoniae
      DpnII system.
AB  - The natural 7.8-kb plasmid pSRQ700 was isolated from Lactococcus lactis subsp.
      cremoris DCH-4. It encodes a restriction/modification system named LlaDCHI
      [corrected]. When introduced into a phage-sensitive L. lactis strain, pSRQ700
      confers strong phage resistance against the three most common lactococcal phage
      species, namely, 936, c2, and P335. The LlaDCHI [corrected] endonuclease was
      purified and found to cleave the palindromic sequence 5'-GATC-3'. It is an
      isoschizomer of Streptococcus pneumoniae DpnII. The plasmid pSRQ700 was mapped,
      and the genetic organization of LlaDCHI [corrected] was localized. Cloning and
      sequencing of the entire LlaDCHI [corrected] system allowed the identification of
      three open reading frames. The three genes (llaIIA, llaIIB, and llaIIC)
      overlapped and are under one putative promoter. A putative terminator was found
      at the end of llaIIC. The genes llaIIA and llaIIB coded for m6A
      methyltransferases, and llaIIC coded for an endonuclease. The LlaDCHI [corrected]
      system shares strong genetic similarities with the DpnII system. The deduced
      amino acid sequence of M.LlaIIA was 75% identical with that of M.DpnII, whereas
      M.LlaIIB was 88% identical with M.DpnA. However, R.LlalII shared only 31%
      identity with R.DpnII.

PMID- 7793937
TI  - Bacteria obtained from a sequencing batch reactor that are capable of growth on
      dehydroabietic acid.
AB  - Eleven isolates capable of growth on the resin acid dehydroabietic acid (DhA)
      were obtained from a sequencing batch reactor designed to treat a high-strength
      process stream from a paper mill. The isolates belonged to two groups,
      represented by strains DhA-33 and DhA-35, which were characterized. In the
      bioreactor, bacteria like DhA-35 were more abundant than those like DhA-33. The
      population in the bioreactor of organisms capable of growth on DhA was estimated
      to be 1.1 x 10(6) propagules per ml, based on a most-probable-number
      determination. Analysis of small-subunit rRNA partial sequences indicated that
      DhA-33 was most closely related to Sphingomonas yanoikuyae (Sab = 0.875) and that
      DhA-35 was most closely related to Zoogloea ramigera (Sab = 0.849). Both isolates
      additionally grew on other abietanes, i.e., abietic and palustric acids, but not
      on the pimaranes, pimaric and isopimaric acids. For DhA-33 and DhA-35 with DhA as
      the sole organic substrate, doubling times were 2.7 and 2.2 h, respectively, and
      growth yields were 0.30 and 0.25 g of protein per g of DhA, respectively. Glucose
      as a cosubstrate stimulated growth of DhA-33 on DhA and stimulated DhA
      degradation by the culture. Pyruvate as a cosubstrate did not stimulate growth of
      DhA-35 on DhA and reduced the specific rate of DhA degradation of the culture.
      DhA induced DhA and abietic acid degradation activities in both strains, and
      these activities were heat labile. Cell suspensions of both strains consumed DhA
      at a rate of 6 mumol mg of protein-1 h-1.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793940
TI  - Genetic diversity of Desulfovibrio spp. in environmental samples analyzed by
      denaturing gradient gel electrophoresis of [NiFe] hydrogenase gene fragments.
AB  - The genetic diversity of Desulfovibrio species in environmental samples was
      determined by denaturing gradient gel electrophoresis (DGGE) of PCR-amplified
      [NiFe] hydrogenase gene fragments. Five different PCR primers were designed after
      comparative analysis of [NiFe] hydrogenase gene sequences from three
      Desulfovibrio species. These primers were tested in different combinations on the
      genomic DNAs of a variety of hydrogenase-containing and hydrogenase-lacking
      bacteria. One primer pair was found to be specific for Desulfovibrio species
      only, while the others gave positive results with other bacteria also. By using
      this specific primer pair, we were able to amplify the [NiFe] hydrogenase genes
      of DNAs isolated from environmental samples and to detect the presence of
      Desulfovibrio species in these samples. However, only after DGGE analysis of
      these PCR products could the number of different Desulfovibrio species within the
      samples be determined. DGGE analysis of PCR products from different bioreactors
      demonstrated up to two bands, while at least five distinguishable bands were
      detected in a microbial mat sample. Because these bands most likely represent as
      many Desulfovibrio species present in these samples, we conclude that the genetic
      diversity of Desulfovibrio species in the natural microbial mat is far greater
      than that in the experimental bioreactors.

PMID- 7793943
TI  - Occurrence of fecal indicator bacteria in surface waters and the subsurface
      aquifer in Key Largo, Florida.
AB  - Sewage waste disposal facilities in the Florida Keys include septic tanks and
      individual package plants in place of municipal collection facilities in most
      locations. In Key Largo, both facilities discharge into the extremely porous Key
      Largo limestone. To determine whether there was potential contamination of the
      subsurface aquifer and nearby coastal surface waters by such waste disposal
      practices, we examined the presence of microbial indicators commonly found in
      sewage (fecal coliforms, Clostridium perfringens, and enterococci) and aquatic
      microbial parameters (viral direct counts, bacterial direct counts, chlorophyll
      a, and marine vibriophage) in injection well effluent, monitoring wells that
      followed a transect from onshore to offshore, and surface waters above these
      wells in two separate locations in Key Largo in August 1993 and March 1994.
      Effluent and waters from onshore shallow monitoring wells (1.8- to 3.7-m depth)
      contained two or all three of the fecal indicators in all three samples taken,
      whereas deeper wells (10.7- to 12.2-m depth) at these same sites contained few or
      none. The presence of fecal indicators was found in two of five nearshore wells
      (i.e., those that were < or = 1.8 miles [< or = 2.9 km] from shore), whereas
      offshore wells (> or = 2.1 to 5.7 miles [< or = 3.4 to 9.2 km] from shore) showed
      little sign of contamination. Indicators were also found in surface waters in a
      canal in Key Largo and in offshore surface waters in March but not in August.
      Collectively, these results suggest that fecal contamination of the shallow
      onshore aquifer, parts of the nearshore aquifer, and certain surface waters has
      occurred.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793942
TI  - Gene cloning, nucleotide sequence, and expression of a cephalosporin-C
      deacetylase from Bacillus subtilis.
AB  - The gene encoding a cephalosporin-C deacetylase (CAH) from Bacillus subtilis SHS
      0133 was cloned and sequenced. The nucleotide sequence contained an open reading
      frame encoding a polypeptide consisting of 318 amino acids, the molecular weight
      of which was in good agreement with the value obtained by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis. The deduced amino acid sequence contained the
      common sequence Gly-X-Ser-X-Gly found in many esterases, lipases, and serine
      proteases. This indicates that CAH is a serine enzyme. A possible promoter
      sequence which is very similar to the consensus sequences of -35 and -10 regions
      recognized by B. subtilis RNA polymerase utilizing sigma factor H was found in
      the 5'-flanking region of the CAH structural gene. Two repeated A+T-rich blocks
      consisting of 24 bp were also found in the upstream region of the initiation
      codon. We constructed a series of expression plasmids by inserting the CAH gene
      into Escherichia coli ATG vectors. The degree of CAH gene expression depended on
      promoters and vector plasmids, which have different replication origins. The
      expressed CAH protein was an active form in the soluble fraction obtained after
      cell disruption. The highest expression level was accomplished with an expression
      plasmid, pCAH400, which has the trp promoter and the replication origin derived
      from pAT153. In the fermentation using a 30-liter jar fermentor, the transformant
      E. coli JM103(pCAH400) produced 440 U of CAH per ml of culture during a 24-h
      incubation. This value corresponded to 2.1 g of CAH protein in 1 liter of culture
      broth.

PMID- 7793941
TI  - Combination of the tod and the tol pathways in redesigning a metabolic route of
      Pseudomonas putida for the mineralization of a benzene, toluene, and p-xylene
      mixture.
AB  - Construction of a hybrid strain which is capable of mineralizing components of a
      benzene, toluene, and p-xylene mixture simultaneously was attempted by
      redesigning the metabolic pathway of Pseudomonas putida. Genetic and biochemical
      analyses of the tod and the tol pathways revealed that dihydrodiols formed from
      benzene, toluene, and p-xylene by toluene dioxygenase in the tod pathway could be
      channeled into the tol pathway by the action of cis-p-toluate-dihydrodiol
      dehydrogenase, leading to complete mineralization of a benzene, toluene, and p
      xylene mixture. Consequently, a hybrid strain was constructed by cloning
      todC1C2BA genes encoding toluene dioxygenase on RSF1010 and introducing the
      resulting plasmid into P. putida mt-2. The hybrid strain of P. putida TB105 was
      found to mineralize a benzene, toluene, and p-xylene mixture without accumulation
      of any metabolic intermediate.

PMID- 7793944
TI  - Investigations related to the epidemic strain involved in the French listeriosis
      outbreak in 1992.
AB  - Two hundred seventy-nine cases of human listeriosis (92 pregnancy-related cases
      and 187 non-pregnancy-related cases) caused by a serovar 4b and phagovar
      2389:2425:3274:2671:47:108:340 strain were identified in France between March and
      December 1992. Epidemiological investigations included a case-control study (not
      described here) and microbiological analyses of foods. Results of the case
      control study and characterization of food isolates identified pork tongue in
      jelly, a ready-to-eat meat product, as the major vehicle of this outbreak, and to
      a lesser extent, delicatessen products contaminated secondarily during handling
      in food stores. As far as serotyping, phage typing, DNA macrorestriction pattern
      analysis (obtained by pulsed-field gel electrophoresis [PFGE]), and ribotyping
      are concerned, this epidemic strain is phenotypically and genomically closely
      related to strains responsible for major outbreaks of listeriosis previously
      observed in Europe and North America. The epidemic strain sensu stricto as
      defined by PFGE (2/1/3) displayed the same serovar, phagovar, ribovar, and ApaI
      and NotI PFGE patterns as the epidemic strains from outbreaks in Switzerland,
      California, and Denmark, but it consistently showed differences in the SmaI PFGE
      profile. This information greatly contributed to the identification of the major
      food vehicle (pork tongue in jelly) and further allowed exclusion of other foods
      (cheese) as possible sources of this major listeriosis epidemic.

PMID- 7793945
TI  - Nonuniform spatial patterns of respiratory activity within biofilms during
      disinfection.
AB  - Fluorescent stains in conjunction with cryoembedding and image analysis were
      applied to demonstrate spatial gradients in respiratory activity within bacterial
      biofilms during disinfection with monochloramine. Biofilms of Klebsiella
      pneumoniae and Pseudomonas aeruginosa grown together on stainless steel surfaces
      in continuous-flow annular reactors were treated with 2 mg of monochloramine per
      liter (influent concentration) for 2 h. Relatively little biofilm removal
      occurred as evidenced by total cell direct counts. Plate counts (of both species
      summed) indicated an average 1.3-log decrease after exposure to 2 mg of
      monochloramine per liter. The fluorogenic redox indicator 5-cyano-2,3-ditolyl
      tetrazolium chloride (CTC) and the DNA stain 4',6-diamidino-2-phenylindole (DAPI)
      were used to differentiate respiring and nonrespiring cells in biofilms.
      Epifluorescence micrographs of frozen biofilm cross sections clearly revealed
      gradients of respiratory activity within biofilms in response to monochloramine
      treatment. These gradients in specific respiratory activity were quantified by
      calculating the ratio of CTC and DAPI intensities measured by image analysis.
      Cells near the biofilm-bulk fluid interface lost respiratory activity first.
      After 2 h of biocide treatment, greater respiratory activity persisted deep in
      the biofilm than near the biofilm-bulk fluid interface.

PMID- 7793946
TI  - Identification of grass-associated and toluene-degrading diazotrophs, Azoarcus
      spp., by analyses of partial 16S ribosomal DNA sequences.
AB  - The genus Azoarcus includes nitrogen-fixing, grass-associated strains as well as
      denitrying toluene degraders. In order to identify and group members of the genus
      Azoarcus, phylogenetic analysis based on partial sequences of 16S rRNA genes (16S
      rDNAs) is proposed. 16S rRNA-targeted PCR using specific primers to exclude
      amplification in the majority of other members of the beta subclass of the class
      Proteobacteria was combined with direct sequencing of the PCR products. Tree
      inference from comparisons of 446-bp rDNA fragments yielded similar results for
      the three known Azoarcus spp. sequences and for analysis of the complete 16S rDNA
      sequence. These three species formed a phylogenetically coherent group with
      representatives of two other Azoarcus species which were subjected to 16S rRNA
      sequencing in this study. This group was related to Rhodocyclus purpureus and
      Thauera selenatis. New isolates and also sequences of so far uncultured bacteria
      from roots of Kallar grass were assigned to the genus Azoarcus as well. Also,
      strains degrading monoaromatic hydrocarbons anaerobically in the presence of
      nitrate clustered within this genus, albeit not with grass-associated isolates.
      All representative members of the five species harboring rhizospheric bacteria
      were able to form N2O from nitrate and showed anaerobic growth on malic acid with
      nitrate but not on toluene. In order to visualize different Azoarcus spp. by
      whole-cell in situ hybridizations, we generated 16S rRNA-targeted, fluorescent
      probes by in vitro transcription directly from PCR products which spanned the
      variable region V2. Hybridization was species specific for Azoarcus communis and
      Azoarcus indigens.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7793947
TI  - Correction of the beta-mannanase domain of the celC pseudogene from
      Caldocellulosiruptor saccharolyticus and activity of the gene product on kraft
      pulp.
AB  - The celA, manA, and celB genes from Caldocellulosiruptor saccharolyticus compose
      a cellulase-hemicellulase gene cluster and are arranged on a 12-kb C.
      saccharolyticus genomic fragment of the recombinant lambda bacteriophage NZP
      lambda 2. The beginning of a fourth open reading frame (celC) which was
      homologous to the C. saccharolyticus manA and celA genes was located at the 3'
      end of the 12-kb NZP lambda 2 genomic fragment. Genome-walking PCR was used to
      isolate DNA fragments downstream of the C. saccharolyticus celB gene, and the
      entire nucleotide sequence of celC was obtained. From the preliminary nucleotide
      sequence, celC appeared to encode yet another multidomain bifunctional enzyme
      (CelC) consisting of an N-terminal endo-1,4-beta-D-glucanase domain (75% similar
      to CelA domain 1), two central cellulose-binding domains, and a C-terminal endo
      1,4-beta-D-mannanase domain (98% similar to ManA domain 1). However, upon
      completion of the celC sequencing, two -1 frameshifts were identified in the
      region encoding the putative CelC mannanase domain. The isolated CelC mannanase
      domain exhibited no beta-mannanase activity, which supported this observation.
      Recombinant PCR was used to correct the celC frameshifts by inserting the
      appropriate nucleotides into the gene. The repaired celC fragment containing the
      base insertions (manB) expressed strong beta-mannanase activity on soluble mannan
      substrates and showed significant activity on kraft pulp as judged by the release
      of reducing sugars.

PMID- 7793948
TI  - Unraveling the extent of diversity within the order Planctomycetales.
AB  - The phylogenetic positions of 22 isolates that morphologically resemble members
      of the family Planctomycetaceae were determined by sequence analysis of genes
      coding for 16S rRNA. While nine and eight isolates could be assigned to the
      genera Planctomyces and Pirellula, respectively, three strains grouped near
      Isosphaera pallida and one strain was closely related to Gemmata obscuriglobus.
      No isolate was found to be related to a previously described species of any of
      the four genera at the species level. Morphological characters and sequence
      idiosyncrasies of genes coding for 16S rRNA of the isolates generally correlated
      with features described for the four genera to which the isolates could be
      assigned. One strain stands phylogenetically isolated and may be representative
      of a novel genus of the family. Comparison with environmental clone sequences
      representing planctomycetes in soil and water revealed that three of the novel
      isolates were related to one clone of soil origin, but no close relationships
      between clones and the other new strains were found. The study reveals that the
      biodiversity of planctomycetes is significantly greater than was previously
      determined.

PMID- 7793949
TI  - Evidence for the existence of distinct populations of Vibrio anguillarum
      serogroup O1 based on plasmid contents and ribotypes.
AB  - A total of 103 Vibrio anguillarum serogroup O1 strains displaying 15 different
      plasmid profiles were characterized with respect to biochemical properties and
      ribotypes. The results confirmed that V. anguillarum O1 is a biochemically
      homogeneous group. The 103 strains could be allocated to three main clusters with
      high similarity coefficients. None of the biochemical properties were connected
      with the presence of plasmids. In total, 12 different ribotypes were
      demonstrated, with HindIII being used as the restriction enzyme. Forty of the
      strains were isolated from the same Danish fish farm, some from the kidneys of
      diseased fish and some from the environment, and some strains were isolated from
      the mucus, gills, and feces of healthy fish. Nineteen of these isolates possessed
      the 67-kb virulence plasmid alone or in combination with other plasmids, while 21
      had no plasmids. All strains isolated from the kidneys of diseased fish on this
      farm had plasmids. Irrespective of their origin (kidneys, gills, or mucus), all
      19 strains carrying the 67-kb virulence plasmid had the same ribotype, profile 1,
      while isolates without plasmids belonged to five different profiles, all
      different from profile 1. These results suggest that pathogenic V. anguillarum O1
      strains possessing a virulence plasmid and nonpathogenic strains without plasmids
      from a small geographical area and even from the same fish may constitute two
      essentially distinct populations. Thus, it may be suggested that an exchange of
      virulence plasmids among strains is unlikely to occur in vivo.

PMID- 7793950
TI  - Massive fungal contamination in animal care facilities traced to bedding supply.
AB  - During the course of immunologic studies involving the gastrointestinal
      colonization of mice with Candida albicans, it became apparent that the animals
      were being exposed to large numbers of Aspergillus fumigatus spores which
      interfered with the C. albicans colonization. To determine the source of the A.
      fumigatus exposure and the extent of fungal contamination of the medical school
      vivarium and four satellite facilities, fungal analyses of feed, bedding, and air
      were undertaken. Initial samples from the air were collected with 3-h settle
      plates; air sampling following cleanup was done with an Anderson air sampler. The
      source of contamination in the mouse rooms was determined to be Beta Chip
      bedding, which came from the manufacturer highly contaminated. Beta Chip bedding
      (1 g) obtained from the manufacturer just prior to testing contained 10(4) CFU of
      A. fumigatus, 20 CFU of a zygomycete, and 10 CFU of a Penicillium sp. Coarse
      grade Beta Chip had approximately one-half those levels of contamination. Pure
      Cob bedding was highly contaminated also, but with a Fusarium sp. and a
      Cladosporium sp. Untreated and heat-treated Sani-Chip as well as all other heat
      treated preparations obtained from the manufacturer contained no detectable
      spores. Rodent chow direct from the manufacturer had no A. fumigatus, although it
      did contain 150 CFU of fungus per g, including 80 CFU of a Rhodotorula sp., 60
      CFU of Cryptococcus uniguttulatus, and 1 CFU of a Penicillium sp.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7793951
TI  - Overexpression of the robA gene increases organic solvent tolerance and multiple
      antibiotic and heavy metal ion resistance in Escherichia coli.
AB  - Escherichia coli K-12 OST3410 was isolated previously as a stable cyclohexane
      tolerant mutant derived from cyclohexane-sensitive strain JA300. A plasmid which
      provides cyclohexane tolerance to strain JA300 was isolated from the OST3410
      genomic library. Subcloning and sequence analysis showed that the plasmid
      contained the robA gene, whose gene product was reported to bind specifically to
      the right border of oriC. We observed that the robA gene on the multicopy plasmid
      generally increased the organic solvent tolerance of several E. coli strains. We
      also observed an increase in the organic solvent tolerance of JA300 carrying the
      lac-robA fusion gene on a low-copy plasmid by isopropyl-beta-D
      thiogalactopyranoside induction. Strain JA300 carrying the multicopy robA plasmid
      also showed an increase in resistance to a number of unrelated antibiotics and
      heavy metal ions, and the spectrum of resistance was significantly similar to
      that of the soxS-overexpressing strain.

PMID- 7793952
TI  - PCR analysis of the viral complex associated with La France disease of Agaricus
      bisporus.
AB  - Reverse transcription PCR analysis was used to investigate the involvement of two
      RNA-genome viruses, La France isometric virus (LIV) and mushroom bacilliform
      virus (MBV), in the etiology of La France disease of the cultivated mushroom
      Agaricus bisporus. Reverse transcription PCR amplification of sequences targeted
      to the genomes of LIV and MBV, with a sensitivity of detection of < 10 fg of
      viral RNA, showed diseased mushrooms to be either singly infected by LIV or
      doubly infected by LIV and MBV. Of 70 geographically diverse diseased mushroom
      isolates, 100% were infected by LIV, whereas almost 60% of these isolates were
      coinfected by MBV. Of 58 mushroom isolates determined to be free of infection by
      LIV, 3 were found to be infected by MBV. This represents the first documented
      report of the independent replication of these two viruses. Our data support the
      hypothesis that La France disease is associated with infection by two
      autonomously replicating viruses in which LIV is the primary causal agent and
      MBV, although possibly pathogenic and capable of modulating symptoms, is not
      required for pathogenesis.

PMID- 7793953
TI  - Effect of oxytetracycline-medicated feed on antibiotic resistance of gram
      negative bacteria in catfish ponds.
AB  - The effect of oxytetracycline-medicated feeds on antibiotic resistance in gram
      negative bacteria from fish intestines and water in catfish ponds was
      investigated. In experiments in the fall and spring, using ponds with no previous
      history of antibiotic usage, percentages of tetracycline-resistant bacteria in
      catfish intestines obtained from medicated ponds increased significantly after 10
      days of treatment. In the fall, resistance of the intestinal and aquatic bacteria
      returned to pretreatment levels within 21 days after treatment. In the spring,
      resistance declined after treatment but remained higher than pretreatment levels
      for at least 21 days in intestinal bacteria and for 5 months in aquatic bacteria.
      Plesiomonas shigelloides, Aeromonas hydrophila, and Citrobacter freundii were
      isolated frequently in both spring and fall; Escherichia coli, Klebsiella
      pneumoniae, Edwardsiella tarda, and Enterobacter spp. were isolated primarily in
      the spring. Oxytetracycline treatment did not affect the distribution of
      bacterial species in the fall but may have accelerated a shift toward greater
      prevalence of members of the family Enterobacteriaceae in the spring. Multiple
      antibiotic resistance did not appear to be elicited by oxytetracycline treatment.

PMID- 7793954
TI  - A serine (threonine) protein kinase confers fungicide resistance in the
      phytopathogenic fungus Ustilago maydis.
AB  - A mutant of Ustilago maydis (VR43) with single-gene resistance to the
      dicarboximide fungicide vinclozolin was previously isolated and characterized. A
      genomic library was constructed, and an 8.7-kb resistance-conferring fragment was
      isolated by sib selection. Sequencing this fragment, we identified an 1,218-bp
      open reading frame, which, if disrupted by deletion, no longer confers
      resistance. Analyses of the data in GenBank demonstrated a high degree of
      homology between the product of the 1,218-bp open reading frame, referred to as
      the adr-1 gene, and Ser (Thr) protein kinases.

PMID- 7793955
TI  - Characterization of chemoautotrophic bacterial symbionts in a gutless marine worm
      Oligochaeta, Annelida) by phylogenetic 16S rRNA sequence analysis and in situ
      hybridization.
AB  - The phylogenetic relationships of chemoautotrophic endosymbionts in the gutless
      marine oligochaete Inanidrilus leukodermatus to chemoautotrophic ecto- and
      endosymbionts from other host phyla and to free-living bacteria were determined
      by comparative 16S rRNA sequence analysis. Fluorescent in situ hybridization
      confirmed that the 16S rRNA sequence obtained from these worms originated from
      the symbionts. The symbiont sequence is unique to I. leukodermatus. In
      phylogenetic trees inferred by both distance and parsimony methods, the
      oligochaete symbiont is peripherally associated with one of two clusters of
      chemoautotrophic symbionts that belong to the gamma subdivision of the
      Proteobacteria. The endosymbionts of this oligochaete form a monophyletic group
      with chemoautotrophic ectosymbionts of a marine nematode. The oligochaete and
      nematode symbionts are very closely related, although their hosts belong to
      separate, unrelated animal phyla. Thus, cospeciation between the nematode and
      oligochaete hosts and their symbionts could not have occurred. Instead, the
      similar geographic locations and habitats of the hosts may have influenced the
      establishment of these symbioses.

PMID- 7793956
TI  - PCR-mediated analysis of lignocellulolytic gene transcription by Phanerochaete
      chrysosporium: substrate-dependent differential expression within gene families.
AB  - We compare the kinetics of appearance of supernatant enzyme activities (lignin
      peroxidase, manganese peroxidase, and cellulase) and gene expression (LIG, mnp,
      and cbhI gene families and the unique cbhII gene) in Phanerochaete chrysosporium
      ME446 when grown on four different carbon sources: ball-milled straw,
      representing the natural substrate lignocellulose; Avicel as a crystalline
      cellulose; and high and low concentrations of glucose, in all cases with limiting
      nitrogen. PCR-based technology utilizing pairs of primers specific for particular
      genes showed that there is differential expression between and within the
      families. There were a number of instances of mRNA species being present only on
      a single day, implying tight regulation of lignocellulose degradation at the mRNA
      level. The patterns of extracellular enzyme activities and mnp and cbh gene
      expression are similar whereas LIG gene expression can be detected when no
      corresponding enzyme activity is observed in the extracellular supernatant. The
      enzyme produced under these conditions is presumably sequestered by the mycelium
      and is likely to be functionally significant. Another striking result is that
      cellulose, in the form of Avicel, elicits the expression of three LIG gene for
      which there is no expression under the same conditions with the other carbon
      sources.

PMID- 7793959
TI  - Differentiation of Aspergillus parasiticus from Aspergillus sojae by random
      amplification of polymorphic DNA.
AB  - Aspergillus parasiticus and Aspergillus sojae are two morphologically similar
      species belonging to the Aspergillus section flavi. A new method to distinguish
      the two species, the aflatoxin producer A. parasiticus and the koji mold A.
      sojae, was developed. Single primers with arbitrary sequences were used to
      generate random amplified polymorphic DNA (RAPD) markers from strains of these
      two species. Three decamers, OPA-04, OPB-10, and OPR-01, allowed adequate
      discrimination between strains of A. parasiticus and A. sojae in RAPD analyses.
      A. sojae was further separated into group I and group II with the three primers.
      On the other hand, A. parasiticus was divided into group A and group B when
      amplified with OPA-04 and OPR-10 primers. The previously misidentified stain CCRC
      32423 and the misclassified strain CCRC 30227 were identified as Aspergillus
      flavus and A. sojae, respectively, on the basis of RAPD patterns and
      morphological characteristics. We suggest that the RAPD technique is a rapid and
      reliable tool to distinguish A. parasiticus from A. sojae.

PMID- 7793957
TI  - Comparative mapping of aflatoxin pathway gene clusters in Aspergillus parasiticus
      and Aspergillus flavus.
AB  - Aflatoxins are toxic and carcinogenic secondary metabolites produced by the fungi
      Aspergillus flavus and A. parasiticus. Aflatoxins are synthesized by condensation
      of acetate units; their synthesis is estimated to involve at least 16 different
      enzymes. In this study we have shown that at least nine genes involved in the
      aflatoxin biosynthetic pathway are located within a 60-kb DNA fragment. Four of
      these genes, nor-1, aflR, ver-1, and omtA (previously named omt-1), have been
      cloned in A. flavus and A. parasiticus. In addition, five other genes, pksA,
      uvm8, aad, ord-1, and ord-2 have been recently cloned in A. parasiticus. The
      pksA, aad, and uvm8 genes exhibit sequence homologies to polyketide synthase,
      aryl-alcohol dehydrogenase, and fatty acid synthase genes, respectively. The cDNA
      sequences of ord-1 and ord-2 genes, which may be involved in later steps of
      aflatoxin biosynthesis, have been determined; the ord-1 gene product exhibits
      homology to cytochrome P-450-type enzymes. By characterizing the overlapping
      regions of the DNA inserts in different cosmid and lambda DNA clones, we have
      determined the order of these aflatoxin pathway genes within this 60-kb DNA
      region to be pksA, nor-1, uvm8, aflR, aad, ver-1, ord-1, ord-2, and omtA in A.
      parasiticus and nor-1, aflR, ver-1, ord-1, ord-2, and omtA in A. flavus. The
      order is related to the order in enzymatic steps required for aflatoxin
      biosynthesis. The physical distances (in kilobase pairs) and the directions of
      transcription of these genes have been determined for both aflatoxigenic species.

PMID- 7793958
TI  - Increased expression of Aspergillus parasiticus aflR, encoding a sequence
      specific DNA-binding protein, relieves nitrate inhibition of aflatoxin
      biosynthesis.
AB  - The aflR gene from Aspergillus parasiticus and Aspergillus flavus may be involved
      in the regulation of aflatoxin biosynthesis. The aflR gene product, AFLR,
      possesses a GAL4-type binuclear zinc finger DNA-binding domain. A transformant,
      SU1-N3 (pHSP), containing an additional copy of aflR, showed increased
      transcription of aflR and the aflatoxin pathway structural genes, nor-1, ver-1,
      and omt-1, when cells were grown in nitrate medium, which normally suppresses
      aflatoxin production. Electrophoretic mobility shift assays showed that the
      recombinant protein containing the DNA-binding domain, AFLR1, bound specifically
      to the palindromic sequence, TTAGGCCTAA, 120 bp upstream of the AFLR translation
      start site. Expression of aflR thus appears to be autoregulated. Increased
      expression of aflatoxin biosynthetic genes in the transformant might result from
      an elevated basal level of AFLR, allowing it to overcome nitrate inhibition and
      to bind to the aflR promotor region, thereby initiating aflatoxin biosynthesis.
      Results further suggest that aflR is involved in the regulation of multiple parts
      of the aflatoxin biosynthetic pathway.

PMID- 7793960
TI  - Distribution of cryV-type insecticidal protein genes in Bacillus thuringiensis
      and cloning of cryV-type genes from Bacillus thuringiensis subsp. kurstaki and
      Bacillus thuringiensis subsp. entomocidus.
AB  - DNA dot blot hybridizations with a cryV-specific probe and a cryI-specific probe
      were performed to screen 24 Bacillus thuringiensis strains for their cryV-type
      (lepidopteran- and coleopteran-specific) and cryI-type (lepidopteran-specific)
      insecticidal crystal protein gene contents, respectively. The cryV-specific probe
      hybridized to 12 of the B. thuringiensis strains examined. Most of the cryV
      positive strains also hybridized to the cryI-specific probe, indicating that the
      cryV genes are closely related to cryI genes. Two cryV-type genes, cryV1 and
      cryV465, were cloned from B. thuringiensis subsp. kurstaki HD-1 and B.
      thuringiensis subsp. entomocidus BP465, respectively, and their nucleotide
      sequences were determined. The CryV1 protein was toxic to Plutella xylostella and
      Bombyx mori, whereas the CryV465 protein was toxic only to Plutella xylostella.

PMID- 7793961
TI  - Cloning and sequencing of a laccase gene from the lignin-degrading basidiomycete
      Pleurotus ostreatus.
AB  - The gene (pox1) encoding a phenol oxidase from Pleurotus ostreatus, a lignin
      degrading basidiomycete, was cloned and sequenced, and the corresponding pox1
      cDNA was also synthesized and sequenced. The isolated gene consists of 2,592 bp,
      with the coding sequence being interrupted by 19 introns and flanked by an
      upstream region in which putative CAAT and TATA consensus sequences could be
      identified at positions -174 and -84, respectively. The isolation of a second
      cDNA (pox2 cDNA), showing 84% similarity, and of the corresponding truncated
      genomic clones demonstrated the existence of a multigene family coding for
      isoforms of laccase in P. ostreatus. PCR amplifications of specific regions on
      the DNA of isolated monokaryons proved that the two genes are not allelic forms.
      The POX1 amino acid sequence deduced was compared with those of other known
      laccases from different fungi.

PMID- 7793962
TI  - Overproduction, purification, and biochemical characterization of a xylanase
      (Xys1) from Streptomyces halstedii JM8.
AB  - Streptomyces halstedii JM8, isolated from straw, produces and secretes into the
      culture supernatant at least two proteins with hydrolytic activity towards xylan.
      The cloning of a DNA fragment of this microorganism in several Streptomyces
      strains permitted us to overproduce both proteins. N-terminal sequence analyses,
      immunoblot assays, and time course overproduction experiments allowed us to
      ensure that both xylanases were encoded by the same gene and that the smallest
      form (35 kDa) originated from the large one (45 kDa) by proteolytic cleavage on
      the C terminus. The production of both forms was studied in different strains
      carrying the gene in a multicopy plasmid. The best production was obtained with
      Streptomyces parvulus transformed with the plasmid pJM9, a pIJ702 derivative,
      which yielded 144 U/ml. Both forms of the xylanase were purified with a fast
      performance liquid chromatography system and characterized biochemically. The
      optimal pH and temperature, for both, were 6.3 and 60 degrees C, respectively, in
      7.5-min assays. Both proteins were highly stable in a wide range of pHs (4 to 10)
      and temperatures (4 to 50 degrees C); nevertheless, after 1-h incubations, both
      enzymes lost most of their activity at temperatures over 55 to 60 degrees C.
      Endoxylanolytic activity was demonstrated in both enzymes, but no beta-xylosidase
      activity was detected.

PMID- 7793963
TI  - Cloning and DNA sequencing of xyaA, a gene encoding an endo-beta-1,4-xylanase
      from an alkalophilic Bacillus strain (N137).
AB  - The gene xyaA encoding an alkaline endo-beta 1,4-xylanase from an alkalophilic
      Bacillus sp. strain (N137) isolated in our laboratory was cloned and expressed in
      Escherichia coli. The nucleotide sequence of a 1,656-bp DNA fragment containing
      xyaA was determined, revealing one open reading frame of 993 bp that encodes a
      xylanase (XyaA) of 39 kDa. This xylanase lacks a typical putative signal peptide,
      yet the protein is found in the Bacillus culture supernatant. In Escherichia
      coli, the active protein is located mainly in the periplasmic space. The xylanase
      activity of the cloned XyaA is an endo-acting enzyme that shows optimal activity
      at pH 8 and 40 degrees C. This activity is stable at a pH between 6 and 11.
      Incubations of XyaA at 40 degrees C for 1 h destroyed 45% of the activity.

PMID- 7793964
TI  - Enhanced fermentation of mannitol and release of cytotoxin by Clostridium
      difficile in alkaline culture media.
AB  - Clostridium difficile ATCC 43255 fermented less than 10% of the mannitol in a
      medium at pH 7; however, when the initial pH of the medium was adjusted to 8.5 or
      9, about 80% of the mannitol was fermented. Cell extracts of C. difficile
      phosphorylated mannitol with phosphoenolpyruvate, not ATP, indicating a
      phosphoenolpyruvate phosphotransferase system transport phosphorylation of
      mannitol. The phosphorylation product was dehydrogenated by D-mannitol-1
      phosphate:NAD oxidoreductase. Growth at an initial pH of 8.5 yielded cytotoxin
      titers of 10(7) to 10(8) in Trypticase-yeast extract-mannitol medium, wit a titer
      of 10(8) as early as 13 h.

PMID- 7793965
TI  - The Lly protein protects Legionella pneumophila from light but does not directly
      influence its intracellular survival in Hartmannella vermiformis.
AB  - The lly locus (legiolysin) mediates the browning of the culture medium of
      Legionella pneumophila in the late stationary growth phase, presumably as a
      result of synthesis of homogentisic acid. Mutagenesis of the lly gene of the L.
      pneumophila Philadelphia I derivative JR32 did not affect intracellular
      replication in the natural host Hartmannella vermiformis. The Lly-negative
      mutant, however, showed a markedly decreased resistance to ordinary light. The
      cloned lly gene conferred an increased resistance to light in recombinant L.
      pneumophila and Escherichia coli K-12, indicating a contribution of the Lly
      protein to ecological adaptation of Legionella species.

PMID- 7793966
TI  - Rapid large-scale growth of Helicobacter pylori in flasks and fermentors.
AB  - We developed procedures for large-scale cultivation of Helicobacter pylori in
      flasks and fermentors. Flasks incubated closed under a microaerophilic gas phase
      with a cotton plug covered by a plastic bag, followed by removal of the bag after
      8 h, gave excellent growth. Growth in a 10-liter fermentor led to excessive
      foaming if the medium was sparged with gas; silicone- or polyglycol-based
      antifoaming agents were severely inhibitory. Use of fermentor surface gassing,
      first with a microaerophilic 6% oxygen gas mixture, then with air, and then with
      95% oxygen, allowed the culture to grow to an A600 of 2.5 in < 24 h. This method
      was modified for scale-up to a 100-liter fermentor.

PMID- 7793967
TI  - Complexation of nicotinamide adenine dinucleotide with ferric and ferrous ions.
AB  - Motivated by the observed influence of stainless steel and ferric and ferrous
      ions on the behavior of the peroxidase/oxidase oscillator, the mechanism and
      kinetics of interaction of 1,4-dihydronicotinamide adenine dinucleotide (NADH)
      with iron ions in 0.1 M acetic acid/sodium acetate buffer with pH 5.1 and with
      the solution/stainless steel interface were extensively studied. The character of
      a possible mutual influence of NADH/acetate buffer solution and Type 316
      stainless steel has been investigated. We also suggest the mechanism of stainless
      steel corrosion inhibition by NADH. It was determined that fast complexation of
      ferric and ferrous ions with NADH occurred with rate constant kcompl = 4.0 x
      10(9) +/- 0.2 x 10(9) M-1 s-1. The composition of the product complex is [Fe
      (NADH)2] for both Fe2+ and Fe3+. A previously unreported complex of ferrous ion
      and NADH was discovered, determined, and separately investigated. Kinetic and
      equilibrium constants for reactions of iron ions-NADH complexation and following
      redox processes of the complex decomposition were determined from
      spectrophotometric and electrochemical experiments.

PMID- 7793968
TI  - Protein oxidation and aging. I. Difficulties in measuring reactive protein
      carbonyls in tissues using 2,4-dinitrophenylhydrazine.
AB  - A current hypothesis explaining the aging process implicates the accumulation of
      oxidized protein in animal tissues. This hypothesis is based on a series of
      reports showing an age-dependent increase in protein carbonyl content and an age
      dependent loss of enzyme function. This hypothesis is also supported by the
      report of a novel effect of N-tert-butyl-alpha-phenylnitrone (PBN) in reversing
      these age-dependent changes. Here we specifically study the method that was used
      to measure reactive protein carbonyls in tissues. This method uses 2,4
      dinitrophenylhydrazine (DNPH) and includes a washing procedure. Our results
      indicate that reactive protein carbonyls in normal crude tissue extracts cannot
      be reliably measured by this method, although it does reliably measure reactive
      carbonyls in purified proteins which have been oxidatively modified in vitro. The
      nucleic acids in tissues could be a major problem encountered in the assay. Using
      the streptomycin sulfate treatment combined with a dialysis step, we were
      successful in removing most nucleic acids from a crude tissue extract, but then
      the reactive carbonyl level in the crude tissue extract was too low to be
      reliably measured. This streptomycin sulfate treatment procedure, however, had no
      effect on the reactive carbonyl measurement of an oxidized protein sample. The
      unwashed free DNPH was another major problem in the assay because of its very
      strong absorption around 370 nm, where reactive carbonyls were quantitated.
      Nevertheless, on using the procedure described in the literature to measure total
      "reactive carbonyls" in rat liver and gerbil brain cortex, no change with age or
      PBN treatment was found. Then, we investigated a HPLC procedure which uses sodium
      dodecyl sulfate in the mobile phase but this was also found to be unsuitable for
      the reactive protein carbonyl assay in tissues.

PMID- 7793970
TI  - Cloning, sequencing, and expression of the dipeptidyl peptidase IV gene from
      Flavobacterium meningosepticum in Escherichia coli.
AB  - The dipeptidyl peptidase IV (DP IV, EC 3.4.14.5) gene from Flavobacterium
      meningosepticum was cloned by Southern and colony hybridizations using probes
      amplified by PCR, and expressed in Escherichia coli DH1. E. coli DH1 harboring
      pFDP-H1, which was a subclone derived from the positive clone pFDP-1, showed 3.5
      fold higher activity than F. meningosepticum. Nucleotide sequencing analysis
      revealed an open reading frame of 2133 bp, coding for a protein of 711 amino
      acids with a predicted molecular weight of 80,626. The expressed enzyme in E.
      coli DH1/pFDP-H1 was purified about 345-fold with an activity recovery of 12.3%.
      The molecular weight of the purified enzyme was estimated to be 75,000 by sodium
      dodecyl sulfate-polyacrylamide gel electrophoresis and 160,000 by gel filtration,
      respectively, suggesting a dimeric form of the native enzyme. The deduced amino
      acid sequence of DP IV was homologous to those of the serine proteases of the
      "prolyl endopeptidase family." A sequence near the C-terminal region and the
      putative catalytic triad residues were well conserved among these enzymes.

PMID- 7793969
TI  - Acid-base chemical mechanism of aspartase from Hafnia alvei.
AB  - An acid-base chemical mechanism is proposed for Hafnia alvei aspartase in which a
      proton is abstracted from C-3 of the monoanionic form of L-aspartate by an enzyme
      general base with a pK of 6.3-6.6 in the absence and presence of Mg2+. The
      resulting carbanion is presumably stabilized by delocalization of electrons into
      the beta-carboxyl with the assistance of a protonated enzyme group in the
      vicinity of the beta-carboxyl. Ammonia is then expelled with the assistance of a
      general acid group that traps an initially expelled NH3 as the final NH4+
      product. In agreement with the function of the general acid group, potassium, an
      analog of NH4+, binds optimally when the group is unprotonated. The pK for the
      general acid is about 7 in the absence of Mg2+, but is increased by about a pH
      unit in the presence of Mg2+. Since the same pK values are observed in the
      pKi(succinate) and V/K pH profile, both enzyme groups must be in their optimum
      protonation state for efficient binding of reactant in the presence of Mg2+. At
      the end of a catalytic cycle, both the general base and general acid groups are
      in a protonation state opposite that in which they started when aspartate was
      bound. The presence of Mg2+ causes a pH-dependent activation of aspartase
      exhibited as a partial change in the V and V/Kasp pH profiles. When the aspartase
      reaction is run in D2O to greater than 50% completion no deuterium is found in
      the remaining aspartate, indicating that the site is inaccessible to solvent
      during the catalytic cycle.

PMID- 7793971
TI  - Inactivation of an animal and a fungal catalase by hydrogen peroxide.
AB  - We have quantitatively compared the rates of peroxide-dependent inactivation of
      bovine liver catalase and Aspergillus niger catalase as class representatives of
      catalases that contain tightly bound NADPH and those that do not. Inactivation of
      these catalases in the presence of ethanol has also been quantitated in an effort
      to assess the importance of compound II, an inactive form of bovine liver
      catalase, in the inactivation reaction. The values of k2, the second-order rate
      constant for inactivation calculated for the bovine enzyme, in the absence and
      presence of ethanol, respectively, were 8.9 +/- 0.26 and 8.5 +/- 0.27 M-1 min-1.
      In contrast, the values for the A. niger enzyme were 0.51 +/- 0.069 and 10.5 +/-
      0.32 M-1 min-1. The A. niger enzyme is more stable toward hydrogen peroxide
      induced inactivation than the liver enzyme. The A. niger enzyme is markedly
      destabilized by 20 mM ethanol, whereas the inactivation of the liver enzyme is
      unaffected by ethanol. Reaction of bovine liver catalase with ethyl hydroperoxide
      produced the characteristic absorption spectrum of compound I and in the absence
      of ethanol the spectrum associated with compound II. In contrast, the fungal
      enzyme developed compound I spectrum but spectral changes that might be ascribed
      to compound II were barely detected in the Soret region. Spectral changes for A.
      niger catalase in the visible region were modified by the presence of ethanol but
      could not be clearly correlated with the bovine catalase compound II spectra
      either in the presence or absence of ethanol. The stability of the fungal and
      bovine catalases in the presence of hydrogen peroxide is quantitatively
      documented. The enzymes are also shown to be different in their response to
      ethanol and in the formation of compound II-like species with ethyl
      hydroperoxide. It appears unlikely that compound II is an intermediate in the
      hydrogen peroxide-mediated inactivation reaction of either catalase under
      catalatic assay conditions.

PMID- 7793972
TI  - Inhibition of alpha-chymotrypsin with an enzyme-activated n-nitrosoamide: active
      site labeling by the naphthylmethyl cation.
AB  - alpha-Chymotrypsin was irreversibly inhibited with an enzyme-activated N
      nitrosamide inhibitor, N-nitroso-N-(1-naphthylmethyl)-N'-isobutyrylalanine;
      alkylation of the active-site residues by the naphthylmethyl cation produced in
      the enzymatic reaction occurred. The inhibited enzyme was reduced and
      aminoethylated and then subjected to tryptic and chymotryptic digestion.
      Separation of the digest by reversed-phase HPLC revealed one major new peak
      relative to that of a control run from the native enzyme. Subsequent amino acid
      analysis and sequencing along with fast atom bombardment-mass spectrometry
      measurements indicated that this new peak stemmed from an active-site peptide,
      Met-192-Leu-199, and that the naphthylmethyl label was attached to the side-chain
      oxygen of Ser-195. The general approach employed can be applied to labeling
      active sites of a variety of hydrolytic enzymes.

PMID- 7793975
TI  - Magnetic resonance of Fe-S clusters: isolation and characterization of a 7Fe
      ferredoxin from Rhodopseudomonas palustris.
AB  - A novel iron-sulfur protein from the photosynthetic purple bacterium
      Rhodopseudomonas palustris was purified to homogeneity and identified as a
      ferredoxin on the basis of its physicochemical properties. Based on the uv/vis
      spectrum, iron quantitation, cyclic voltammetry, EPR, and 1H NMR data, the
      ferredoxin is found to contain two iron-sulfur clusters, one [3Fe-4S] and one
      [4Fe-4S], which places this protein in the class of 7Fe ferredoxins. The
      voltammetric peak potentials of the two clusters are -0.260 and -0.560 V at pH
      8.0. The molecular mass around 19 kDa makes this protein the heaviest known in
      this class. This paper further demonstrates the diagnostic power of magnetic
      resonance spectroscopies in recognition of the two types of clusters in iron
      sulfur proteins.

PMID- 7793973
TI  - Reexamination of properties of prophenoloxidase isolated from larval hemolymph of
      the silkworm Bombyx mori.
AB  - Prophenoloxidase in hemolymph of the silkworm (Bombyx mori) was purified by the
      method of Ashida (Ashida, M. (1971) Arch. Biochem. Biophys. 144, 749-762) with
      slight modifications to further increase the purity, and its properties were
      reinvestigated. The purified prophenoloxidase gave two discrete bands in
      isoelectric focusing-polyacrylamide gel electrophoresis (IEF-PAGE) (pI 4.95 and
      4.98) and in native-polyacrylamide gel electrophoresis with 4.5% separating gel.
      Each band in IEF-PAGE was separated into two bands in sodium dodecyl sulfate
      polyacrylamide gel electrophoresis (SDS-PAGE) with mobilities corresponding to
      71.5- and 71-kDa polypeptides. In HPLC on octadecyl column the prophenoloxidase
      preparation gave two well-separated symmetrical peaks (proPO polypeptide I and
      proPO polypeptide II). The molecular masses of the proPO polypeptides I and II
      were determined to be 71.5 and 71 kDa in SDS-PAGE and 78,880 and 81,105 Da by
      matrix-assisted laser desorption ionization mass spectrometry, respectively.
      Native prophenoloxidase was eluted at a position corresponding to 126-kDa protein
      in gel permeation chromatography. Amino acid compositions and peptide mappings of
      proPO polypeptides indicated that both polypeptides differ in their primary
      structures. These results are discussed in relation to the subunit structure, the
      presence of bicopper cluster, and the polymorphism of prophenoloxidase in
      silkworm hemolymph.

PMID- 7793974
TI  - Molecular cloning and sequence analysis of cDNAs for metalloproteinases from
      broad-banded copperhead Agkistrodon contortrix laticinctus.
AB  - The cDNA sequences of two related genes coding for metalloproteinases from a
      venom gland library of Agkistrodon contortrix laticinctus have been determined.
      The ACLPREH cDNA codes for a 220-amino acid zinc-dependent hemorrhagic
      metalloproteinase, and the predicted sequence is in agreement with the N-terminal
      sequence of the previously purified protein. ACLPREF cDNA sequence predicts a 222
      amino acid molecule having strong similarity to fibrolase, a fibrinolytic enzyme
      isolated from A. contortrix contortrix venom that is reported to be devoid of
      hemorrhagic activity. Both cDNAs present the same pattern of domain organization
      as other members of the metalloproteinase/disintegrin gene family. They code for
      short toxins which do not have the disintegrin domain and have three-disulfide
      bonds in the metalloproteinase domain. Both cDNA sequences have the highly
      conserved 5' and 3' untranslated regions that have been described for the
      metalloproteinase and phospholiphase A2 snake venom gene families. ACLPREH and
      ACLPREF cDNAs share a higher degree of homology in the untranslated regions and
      proenzyme domain than in the mature protein domain. The amino acid sequences of
      hemorrhagic and/or fibrinolytic metalloproteinases demonstrate that a few
      substitutions may result in different enzymatic activities. Also, some of these
      toxins have valine instead of isoleucine in the CIM Met-turn consensus sequence.
      From our data, we can suggest that snake venom fibrinolytic metalloproteinase
      genes belong to the metalloproteinase/disintegrin gene family. This is the first
      report of cDNA sequences of small snake venom metalloproteinases having three
      disulfide bonds in the metalloproteinase domain.

PMID- 7793976
TI  - Spin-labeling study of the oxidative damage to low-density lipoprotein.
AB  - In this study, we have spin-labeled the lysine and cysteine residues of low
      density lipoprotein (LDL) using N-4-(2,2,6,6-tetramethylpiperidinyl-1-oxyl-4-yl)
      maleimide (MAL-6) and succinimidyl-2,2,5,5-tetramethyl-3-pyrroline-1-oxyl-3
      carboxylate (SSL), respectively. The electron spin resonance (ESR) spectrum of
      SSL bound to LDL indicated that the nitroxide moiety was relatively mobile. In
      contrast, the ESR spectrum of MAL-6 bound to LDL showed that the nitroxide moiety
      was rotationally restricted. Using the continuous-wave power saturation technique
      in the presence of hydrophobic and hydrophilic paramagnetic relaxing agents, we
      have determined that (i) approximately 60-70% of lysine-bound SSL is exposed to
      the aqueous phase, (ii) approximately 30-40% of SSL-LDL is buried in a
      hydrophobic region, and (iii) MAL-6 bound to LDL is localized predominantly in
      the hydrophobic region. During Cu(2+)-initiated oxidation of spin-labeled LDL,
      nitroxide labels located in a hydrophobic environment were predominantly
      degraded. Nitroxide destruction was inhibited by butylated hydroxytoluene,
      indicating the role of lipid peroxidation in this process. ESR data also showed
      that Cu2+ binding to lysine is essential for LDL oxidation. The spin label
      methodology may be useful for the investigation of site-specific radical
      reactions in LDL.

PMID- 7793977
TI  - Functional assessment of specific amino acid residues of cytochrome P4501A1 using
      anti-peptide antibodies.
AB  - Several positively charged amino acid residues in cytochrome P450 have been shown
      to be involved in the electrostatic association with NADPH-cytochrome P450
      reductase. For cytochrome P4501A1, five regions were proposed as the putative
      binding sites for the reductase (Shen, S., and Strobel, H. W. (1993) Arch.
      Biochem. Biophys. 304, 257-265). To elucidate the specific roles of each of these
      amino acid residues, five anti-peptide antibodies defined as 1A, 4A, 5A, 6A, and
      7A were generated against these regions containing 8-13 amino acids and were
      affinity-purified using a peptide-Sepharose 4B column. Analysis by enzyme-linked
      immunosorbent assay and protein immunoblot techniques demonstrated that three of
      five anti-peptide antibodies have specific binding to the peptides as well as to
      cytochrome P4501A1. Incubation of the various anti-peptide antibodies with
      cytochrome P450 followed by reconstitution with reductase, lipid, and NADPH
      resulted in significant inhibition of P450 activity for antibodies 5A and 6A, but
      not for 1A, 4A, or 7A. Antibody 5A also exhibited inhibition of P450 activity
      supported by cumene hydroperoxide, though the inhibition was 45 to 30% less than
      the inhibition of reductase-supported activity at each of the increasing
      concentrations of antibody. Kinetic studies with antibody 5A revealed no change
      in the Km for the substrate ethoxycoumarin, but rather a dramatic effect on the
      Vmax of the cytochrome P4501A1 system whether reconstituted with reductase or
      supported by cumene hydroperoxide. Characterization of the effects of antibody 5A
      on cytochrome P4501A1 suggested that the binding of antibody 5A to P4501A1 may
      change the binding of P4501A1 with reductase. Furthermore, the binding of 5A to
      cytochrome P4501A1 also lowered the Vmax of the P450. These results are
      consistent with the roles for the regions of cytochrome P4501A1 from amino acid
      residues 269 to 281 (peptide 5) and 454 to 463 (peptide 6) in cytochrome P4501A1
      hydroxylation activity.

PMID- 7793978
TI  - The influence of antibiotics and antitumor agents on the relaxation activity of
      Pisum sativum leaf chloroplast topoisomerase I.
AB  - DNA topoisomerase was isolated from pea leaf chloroplasts. The relaxation
      activity of this topoisomerase was Mg2+ dependent and sensitive to ethidium
      bromide and novobiocin, a gyrase inhibitor. Chloroplast topoisomerase (Topo I)
      was ATP independent, as shown by the characteristic gel distribution of
      topoisomers. Topoisomerase, compared with the known eucaryotic topoisomerase I,
      was not stimulated by polyamines as are spermidine, spermine, and cadaverine.
      Ethidium bromide, DAPI, heparin, nalidixic acid, and m-AMSA (but not
      camptothecin) were able to inhibit the relaxation activity of chloroplast topo I.
      Nalidixic acid, novobiocin, m-AMSA, camptothecin, and amiloride were tested for
      their effects on the topoisomerase-catalyzed "cleavage complex" between DNA and
      chloroplast DNA topoisomerase I.

PMID- 7793979
TI  - Phycobilin biosynthesis: reductant requirements and product identification for
      heme oxygenase from Cyanidium caldarium.
AB  - Algal heme oxygenase is a soluble enzyme from Cyanidium caldarium that catalyzes
      the first committed step of phycobilin biosynthesis by converting protoheme to
      biliverdin IX alpha. Although the physiological substrate (protoheme) of algal
      heme oxygenase is identical to that of microsomal heme oxygenase, which catalyzes
      heme catabolism in animals, the two enzyme systems differ in several respects
      including the nature of the required reductants and solubility of the enzymes.
      Addition of the strong Fe3+ ion chelators, desferrioxamine and Tiron (4,5
      dihydroxy-1,3-benzenedisulfonic acid), greatly increased the yield of solvent
      extracted bilin product. The effect of the Fe3+ chelators was approximately equal
      whether they were added during or after the enzyme incubation. Postincubation
      treatment of the enzyme reaction mixture with strong acid also greatly increased
      the product yield. Addition of desferrioxamine to the reaction mixture after the
      incubation was terminated caused the appearance of an absorption spectrum,
      indicating an increase in the concentration of free bilin product. Acid and Fe3+
      chelators are known to cause dissociation of Fe(III)-bilin complexes. These
      results indicate that the in vitro enzymic reaction product of algal heme
      oxygenase is a nonenzyme-bound Fe(III)-biliverdin IX alpha complex that is poorly
      extracted and/or quantitated unless it is first dissociated. Algal heme oxygenase
      required the simultaneous presence of both reduced ferredoxin and a second
      reductant such as ascorbate for activity. The requirement for L-ascorbate could
      be substituted by Trolox (6-hydroxy-2,5,7,8-tetramethylchroman-2-carboxylic acid)
      or D-ascorbate, but not by dehydroascorbate or dithiothreitol. Heme oxygenase was
      purified over 200-fold from C. caldarium by differential (NH4)2SO4 precipitation
      and serial column chromatography over reactive blue 2-Sepharose, DEAE-cellulose,
      Sephadex G-75, and ferredoxin-Sepharose.

PMID- 7793981
TI  - Purification of human hepatic arginase and its manganese (II)-dependent and pH
      dependent interconversion between active and inactive forms: a possible pH
      sensing function of the enzyme on the ornithine cycle.
AB  - Purification of human liver arginase by chromatography on DEAE-Sepharose, CM
      Sepharose, hydroxylapatite, and MonoS yielded protein of greater than 95% purity
      by sodium dodecyl sulfate-gel electrophoresis. Detailed kinetic studies of the
      interconversion of active and inactive forms of arginase showed the effects of
      metal ion addition and withdrawal, metal ion type, time, temperature, and pH. At
      pH 7 and 37 degrees C, removal of Mn2+ caused a first-order deactivation with
      half-life of 1 h. Reactivation was completed within 0.5 min (1 mM Mn2+) or 90 min
      (ca. 6 nM Mn2+). Activation by Mn2+ showed a hyperbolic response, with Kd for
      Mn2+ of about 36 nM. Mn2+ apparently displaced about 2 H+, resulting in sigmoid
      dependence upon concentration of OH-. Both the maximal velocity of catalysis and
      the Km toward arginine were markedly pH-dependent in the physiological range. The
      findings lead to a model where Mn2+ allosterically activates arginase by a
      sequential, and pH-sensitive, mechanism. The combined pH sensitivities of
      activation, Vmax, and Km are likely to give arginase a role in mediating the
      demonstrated pH control of the ornithine cycle and hence in the regulation of
      body pH.

PMID- 7793980
TI  - Protein oxidation and aging. II. Difficulties in measuring alkaline protease
      activity in tissues using the fluorescamine procedure.
AB  - A current hypothesis explaining the aging process implicates the accumulation of
      oxidized protein in animal tissues. This is primarily based on a series of
      reports showing an age-dependent increase in protein carbonyl content and an age
      dependent decrease in the activities of enzymes, especially of alkaline
      proteases, which preferentially degrade oxidatively modified protein. Recently,
      this hypothesis was strongly supported by the report of a novel effect of the
      spin-trapping compound N-tert-butyl-alpha-phenylnitrone (PBN) in reversing these
      age-dependent changes. However, we found that the reactive protein carbonyls
      could not be reliably measured in tissues by using the 2,4-dinitrophenylhydrazine
      procedure described in the PBN study. We now focus on the alkaline protease
      activity assay and show that alkaline protease activity cannot be reliably
      measured in crude tissue extracts by using the fluorescamine procedure also
      described in the PBN study. We were, however, able to reliably measure a protease
      activity in crude tissue extracts at alkaline pH by using a synthetic fluorogenic
      peptide substrate, but no effect of aging or PBN treatment was found on the
      protease activity in rat brain cortexes. Thus, the reported age-dependent changes
      in protein carbonyl formation and alkaline protease activity remain to be
      confirmed.

PMID- 7793983
TI  - Stimulation of glycolysis by histidine buffers in mammalian liver during cold
      hypoxia.
AB  - This study was designed to address the reasons why glycolysis in mammalian liver
      is unable to function more efficiently during periods of cold hypoxia. Our
      hypothesis was that control of intracellular pH, by use of amino acid buffers
      with high pKa values, would allow prolonged flux through glycolysis and better
      maintenance of liver high-energy adenine nucleotide pool. The effects of two
      concentrations of histidine (90 and 180 mM) and one of carnosine (90 mM), a
      histidyl dipeptide, on energy metabolism and levels of glycolytic substrate
      (glucose) and anaerobic endproduct (lactate) were investigated during cold
      hypoxia using rat livers to model the mammalian system. The transition to
      anaerobic metabolism was apparent by an immediate rise in lactate levels upon
      entry into cold hypoxia. By 10-14 h hypoxia, contents of the endproduct had
      increased by 10, 13.5, and 14.5 mumol/g in buffers containing 90 and 180 mM
      histidine and 90 mM carnosine, respectively. As well, ATP, total adenylate
      contents, and "energy charge" ratios exhibited a rapid decline from initial
      values of 2.3-3.3 mumol/g, 4.3-5.5 mumol/g, and 0.64-0.75, respectively, over the
      first 2-4 h of cold hypoxia. With respect to efficacy, the 180 mM histidine
      buffer exhibited the most positive maintenance of adenylate levels, followed
      closely by 90 mM carnosine, and finally 90 mM histidine as the least effective of
      the three buffers. Nevertheless, all three buffers examined in this study showed
      positive effects compared to similarly treated livers stored in a solution of
      minor buffering capacity (a citrate-based solution) over the same time period.
      The data support the hypothesis that glycolytic flux and cellular energetics can
      be maintained by the inclusion of efficient buffering agents during periods of
      cold hypoxia.

PMID- 7793982
TI  - Cooperative manganese (II) activation of 3-phosphoglycerate mutase of Bacillus
      megaterium: a biological pH-sensing mechanism in bacterial spore formation and
      germination.
AB  - The conversion of 3-P-glycerate mutase of Bacillus megaterium from a
      catalytically inactive to an active form was markedly more effective with
      buffered Mn2+ than with just added Mn2+. The previously reported stimulation by
      threonine disappeared when buffered Mn2+ was used. Activation of mutase showed a
      sigmoid dependence on Mn2+ concentration when buffered with tetramethylenediamine
      tetraacetate. The curve obeyed Hill kinetics with a coefficient of 2.1 +/- 0.1.
      At 0.5 microM free Mn2+, buffered with trimethylenediamine tetraacetate,
      activation of mutase increased about 73-fold over the pH range 6.6 to 7.4.
      Plotted against [OH-], the activation showed a strongly sigmoid response with
      Hill coefficient of 3.5 +/- 0.1. When mutase activated at pH 6.4 and 0.5 microM
      free Mn2+ in the presence of substrate was transferred to a similar medium at pH
      7.4, the rate of product accumulation increased 360-fold within a few minutes.
      The pH sensitivity conferred upon mutase by low [Mn2+] may account for its large
      activity decrease during sporulation, and later increase during spore
      germination, when spore pH, respectively, declines and rises by about 1 unit.
      These changes result in the accumulation, and later reutilization, of 3-P
      glycerate reserves in the spore. Such a pH-sensing function of Mn2+ may have
      wider biological uses.

PMID- 7793985
TI  - Redox-dependent changes in beta-sheet and loop structures of Cu,Zn superoxide
      dismutase in solution observed by infrared spectroscopy.
AB  - Redox-dependent conformational changes of bovine Cu,Zn superoxide dismutase in 20
      mM phosphate buffer (pH 7.4) were studied at 20 degrees C using Fourier transform
      infrared spectroscopy. Amide I spectra provide evidence that conformational
      changes in the protein accompany a change in the oxidation state of copper at the
      active site. Quantitative analysis of these spectra indicates that both reduced
      (CuI,ZnII) and oxidized (CuII,ZnII) enzymes are composed of about 35%
      antiparallel beta-sheet, 45% unordered/loop, and 20% beta-turn structures.
      Significant redox-dependent changes occur in regions ascribed to beta-sheet and
      unordered/loop structures that are consistent with an active channel structure
      wherein the copper ion bonds to imidazolate side chains of His 44, 46, and 118
      within the beta-sheet structure and also to the imidazolate side chain of His 61
      associated with unordered/loop structure. This study provides the first
      experimental evidence that an unordered structure can exhibit bands in more than
      one region, one near 1658 cm-1 and another near 1648 cm-1 in both H2O and D2O
      solutions. The detected changes in protein conformation are expected to be
      critical to the catalytic function of this enzyme.

PMID- 7793984
TI  - Reactive oxygen species and DNA damage in 2-bromo-(glutathion-S-yl) hydroquinone
      mediated cytotoxicity.
AB  - Exposure of renal proximal tubular epithelial cells (LLC-PK1) to the
      nephrotoxicants 2-bromo-6-(glutathion-S-yl)hydroquinone, 2-bromo-3-(glutathion-S
      yl)-hydroquinone, and 2-bromo-(diglutathion-S-yl)hydroquinone caused DNA
      fragmentation and cytotoxicity. Viability measured by lysosomal neutral red
      accumulation was the most sensitive parameter of cytotoxicity, and preceded
      toxicity determined by either the mitochondrial MTT assay or by measuring
      intracellular lactate dehydrogenase activity. DNA fragmentation was detected as
      early as 15 min after exposure to 2-bromo-6-(glutathion-S-yl)hydroquinone (100
      microM), 2-bromo-3-(glutathion-S-yl)hydroquinone (200 microM), and 2-bromo
      (diglutathion-S-yl)hydroquinone (400 microM) and prior to other indices of
      toxicity. The ability of the cells to repair DNA damage was evident by the
      decrease in the extent of single strand breaks following removal of 2-bromo-3
      (glutathion-S-yl)hydroquinone from the incubation medium. Moreover, inhibition of
      poly(ADP-ribose)polymerase with 3-amino-benzamide (10 mM), following exposure of
      LLC-PK1 cells to 0.5 mM 2-bromo-6-(glutathion-S-yl)hydroquinone or 2-bromo
      (diglutathion-S-yl)hydroquinone, decreased cytotoxicity, indicating that DNA
      repair processes, activated in response to DNA damage, exacerbate toxicity.
      Treatment with the endonuclease inhibitor, aurintricarboxylic acid did not
      decrease cytotoxicity. A decrease in the cytotoxicity caused by 2-bromo-6
      (glutathion-S-yl)hydroquinone and 2-bromo-(diglutathion-S-yl)hydroquinone was
      observed when cells were incubated with catalase or pretreated with deferoxamine
      (10 mM). The data suggest a mechanism whereby the conjugates generate hydrogen
      peroxide, and the subsequent iron-catalyzed generation of hydroxyl radicals
      causes DNA fragmentation and cytotoxicity.

PMID- 7793986
TI  - Purification and characterization of an NADH-hexacyanoferrate(III) reductase from
      spinach leaf plasma membrane.
AB  - Plasma membranes were purified from spinach (Spinacea oleracea L.) leaves by
      aqueous two-phase partitioning. The NADH-hexacyanoferrate(III) reductase was
      released from the membrane by Chaps solubilization and purified 360-fold by ion
      exchange chromatography followed by affinity chromatography and size-exclusion
      chromatography on FPLC. A major band of 45 kDa and a minor contaminant of 66 kDa
      were detected by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS
      PAGE). The band at 45 kDa cross-reacted with antibodies raised against an NADH
      hexacyanoferrate(III) reductase from potato tuber microsomes. The native size of
      the enzyme was 160 kDa as determined by size-exclusion chromatography indicating
      that it is a tetramer. Two-dimensional gel electrophoresis, isoelectric focusing,
      followed by SDS-PAGE revealed three main bands of identical molecular weight with
      pI of 5.3-5.6. The enzyme contained about one flavin adenine dinucleotide (FAD)
      per 45-kDa subunit as determined by fluorescence spectroscopy, was specific for
      the beta-hydrogen of NADH, preferred NADH over NADPH as electron donor, and
      preferred hexacyanoferrate(III) as electron acceptor, e.g., it reduced Fe3+-EDTA,
      cytochrome c, oxygen, and duroquinone at < 10% of the rate with
      hexacyanoferrate(III). p-Chloromercurobenzoate, mersalyl, and dicumarol inhibited
      the activity by > 70% whereas FAD, flavin mononucleotide, duroquinone, and
      ubiquinone0 did not affect the activity.

PMID- 7793987
TI  - Brain mitochondrial cytochromes P450: xenobiotic metabolism, presence of multiple
      forms and their selective inducibility.
AB  - The capability of rat brain mitochondria to metabolize a variety of xenobiotics
      was examined. The presence of cytochrome P450 (P450) and associated monooxygenase
      activities were estimated in isolated rat brain mitochondria and compared with
      the corresponding activities in microsomes. Total P450 content in brain
      mitochondria from naive rats was twice that of the corresponding microsomal
      level. The ability of brain mitochondria to metabolize the potent carcinogen N
      nitrosodimethylamine was more than twofold that of the corresponding microsomal
      activity, while the 7-ethoxycoumarin-O-deethylase activity was significantly
      lower in mitochondria. Immunoblot experiments using antisera to purified rat
      liver microsomal P450s, namely P450 (2B1/2B2), P4501A1, and P4502E1, and purified
      phenobarbital-inducible rat brain P450, revealed the presence of immunoreactive
      bands in isolated brain mitochondria. These various antibodies to P450 inhibited
      the brain mitochondrial monooxygenase activities to significant, though varying
      extent. The addition of antiserum to microsomal NADPH cytochrome P450 reductase
      did not affect the mitochondrial P450 associated monooxygenase activities,
      although it completely inhibited the corresponding microsomal activities. Chronic
      ethanol administration resulted in twofold induction of total P450 content and
      the monooxygenase activities known to be mediated by P4502E1, such as N
      nitrosodimethylamine-N-demethylase and p-nitrophenol hydroxylase in brain
      mitochondria. Pretreatment of animals with phenobarbital resulted in the
      induction of aminopyrine N-demethylase activity in brain mitochondria. The study
      demonstrates the presence of multiple forms of P450 in the rat brain
      mitochondria, their inducibility, and their capability to metabolize xenobiotics.

PMID- 7793988
TI  - Differential binding of vascular cell-derived proteoglycans (perlecan, biglycan,
      decorin, and versican) to the beta-amyloid protein of Alzheimer's disease.
AB  - Previous studies have demonstrated the immunolocalization of perlecan, a specific
      heparan sulfate proteoglycan, to the beta-amyloid protein (A beta)-containing
      amyloid deposits within the walls of blood vessels (i.e., congophilic angiopathy)
      in Alzheimer's disease (AD) brain. In the present investigation, the differential
      binding of previously characterized endothelial cell (EC)- and smooth muscle cell
      (SMC)-derived PGs to A beta was examined to determine whether the accumulation of
      A beta in cerebrovascular amyloid deposits may be due to its interactions with
      perlecan. Pretreatment of AA amyloidotic splenic and liver tissue sections with
      synthetic A beta (1-28) produced strong immunoreactivity with A beta antibodies
      at tissue sites enriched in perlecan which was partially removed by pretreatment
      with heparitinase, but not by chondroitin ABC lyase. [35S]-Sulfate labeled
      proteoglycans (PGs) derived from cultured ECs and SMCs bound to affinity columns
      containing A beta (1-28) or (1-40), with virtually no binding to A beta (40-1)
      (reverse peptide), beta-amyloid precursor protein (410-429), or bovine serum
      albumin. Characterization of EC and SMC PGs bound to A beta (1-28) revealed
      strong binding by perlecan, weak binding by decorin and biglycan, two dermatan
      sulfate proteoglycans, and lack of binding by versican/PG-M, a large chondroitin
      sulfate proteoglycan. Binding of 125I-labeled perlecan to A beta (1-28) was
      strongly inhibited by isolated perlecan and to a lesser extent by heparin, but
      not by chondroitin-6-sulfate or unsulfated dextran sulfate. Heparitinase
      treatment decreased, but did not eliminate the binding of 125I-labeled perlecan
      to A beta (1-28). Scatchard analysis of the interaction of A beta (1-28)- and EC
      derived perlecan in solid-phase assays indicated high-affinity (Kd = 8.3 x 10(
      11) M) and lower-affinity (Kd = 4.2 x 10(-8) M) binding sites, with approximately
      1 mol of perlecan binding 1.8 mol of A beta. A significant decrease in binding of
      EC-derived perlecan to A beta (1-28) was observed when a sequence within the
      putative heparin-binding motif of A beta (His13His14Gln15Lys16) was replaced by
      the uncharged peptide sequence, Gly13Gly14Gln15Gly16, indicating a perlecan
      binding site on A beta near the postulated alpha-secretase site (at Lys-16).
      Overall, the results indicate that specific vascular cell-derived PGs
      differentially interact with A beta, and that the interactions of highest
      affinity occur between A beta and binding sites on both the core protein and
      glycosaminoglycan chains of perlecan.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7793989
TI  - Characterization of hormonogenic sites in an N-terminal, cyanogen bromide
      fragment of human thyroglobulin.
AB  - We have confirmed the observation of Marriq et al. (FEBS Lett. 207, 302-306,
      1986) that substantial thyroxine formation occurs on enzymatic iodination of a
      171-residue, N-terminal cyanogen bromide (CNBr) fragment of human goiter
      thyroglobulin. Marriq et al. concluded from their studies that Tyr130 is the
      donor for the preferential hormonogenic acceptor site Tyr5. However, in the
      present study we observed that thyroxine formation in the CNBr fragment occurred
      not at Tyr5, but rather at Tyr130. Moreover, we did not confirm the report of
      Marriq et al. that formation of thyroxine in the iodinated CNBr fragment involves
      cleavage of the Val129-Tyr130 bond. Our finding of thyroid hormone at Tyr130 was
      unexpected, as Tyr5 is known to be the major site of hormone formation in
      thyroglobulin isolated from the thyroids of humans and other mammals. In the CNBr
      fragment, however, Tyr5 appeared to act as a donor rather than an acceptor. Thus,
      while we have confirmed the finding that the N-terminal CNBr fragment of human
      goiter thyroglobulin is by itself capable of efficient thyroxine formation when
      enzymatically iodinated in vitro, we observed that the role of specific tyrosines
      in the hormone-forming process was different from that in intact thyroglobulin.
      We question, therefore, whether the CNBr fragment is a valid model for defining
      the role and location of hormonogenic sites in intact thyroglobulin.

PMID- 7793990
TI  - [Gene diagnosis of cancer].
AB  - Recently, many DNA alterations have been reported in most of cancers. Now, gene
      diagnosis of cancers becomes a hot topic. There are at least three kinds of
      cancer-related genes, oncogenes, tumor suppressor genes and DNA mismatch repair
      genes. In hereditary tumors, gene diagnosis is particularly important, because it
      is possible to find predisposing individuals even before the appearance of
      cancers. Of course, gene diagnosis is also very useful for nonhereditary tumors.
      A very small numbers of cancer cells in blood, sputum, urine and stool can be
      detected by the highly sensitive PCR (polymerase chain reaction) technique.
      Prognosis may also be predicted from specific gene alterations in cancers.

PMID- 7793991
TI  - [Endoscopic mucosal resection for radical treatment of esophageal cancer].
AB  - Clinico-pathological results of patients with superficial esophageal cancer was
      reviewed to determine the indications of endoscopic mucosal resection (EMR) for
      esophageal cancer as a radical treatment and to evaluate clinical results of EMR.
      The analysis on eighty-seven cases with superficial esophageal cancer who
      underwent esophagectomy revealed no lymph node metastasis in any 0% of case with
      cancer confined to the lamina propria mucosae, 10% of cancer reaching the
      muscularis mucosae and 43% of cancer infiltrating the submucosa. These results
      suggested that the endoscopic mucosal resection should be indicated for patients
      with esophageal cancer confined to the lamina propria mucosae. The accuracy rate
      for estimating depth of invasion of mucosal cancer of the esophagus was 96%. We
      early established "the double channel technique" for resection of mucosal lesion
      of the esophagus with a major part of the submucosa, we used it for sixty-nine
      cases, and all were eventually discharged. Immediate complications of EMR were
      noted in 12.9% of all cases (mediastinal emphysema: 2.9%, ulcer bleeding: 10%)
      and the late complication in 7.2% (esophageal stricture due to scar formation:
      5.8% and ulcer bleeding 5 days after EMR: 1.4%). All cases who developed
      stricture had mucosal defect over 3/4 the circumference. The cumulative 5-year
      survival rate of patients with esophageal mucosal cancer treated by EMR (86%)
      showed no significant difference from those treated by esophagectomy (83.2%). We
      to conclude that endoscopic mucosal resection is indicated for the patient with
      mucosal cancer confined to the lamina propria mucosae. One can expect an
      excellent prognosis by less invasive treatment than esophagectomy.

PMID- 7793992
TI  - [Progress in surgical treatment of carcinoma of the intrathoracic esophagus].
AB  - In the past 20 years, 403 patients with thoracic esophageal carcinoma underwent
      radical surgery. The aim of this study was to determine whether extended lymph
      node dissection improved the prognosis of these patients. All of the patients
      were divided into 4 groups every 5 years from group A to group D. Group A (n =
      39) underwent radical esophagectomy with lower mediastinal and abdominal
      lymphadenectomy by the left thoracoabdominal approach. Majority cases in Group B
      (n = 94) also underwent radical esophagectomy with right upper, lower mediastinal
      and abdominal lymphadenectomy (incomplete 2-field dissection) by the right
      thoraco-abdominal approach. About 40% cases in Group C underwent radical
      esophagectomy with extended cervicothoraco-abdominal lymph node dissection (3
      field dissection) and almost all of the others had radical esophagectomy with 2
      field dissection. About 60% of the cases in group D underwent radical
      esophagectomy with 3-field dissection and the majority of the others had complete
      2-field dissection (i.e.) radical lymphadenectomy around bilateral upper, lower
      mediastinal and abdominal lymph nodes. The five-year survival rate was 21% in
      group A, 23% in group B, 37% in group C and 55% in group D. The survival curve
      was improved according to the extent of lymph node dissection. Especially
      significant improvements of survival rate were found in group C and D compared
      with those in group A and B. Furthermore, group D showed significantly better
      survival than that of group C. Complete 2-field and 3-field dissection resulted
      in a better prognosis than incomplete 2-field dissection, while no significant
      difference in prognosis was found between complete 2-field and 3-field
      dissection. However, neither 2-field nor 3-field dissection resulted in improved
      prognosis in cases involving 7 or more positive lymph node metastases. These
      results suggest that radical esophagectomy and lymph node dissection involving
      bilateral upper mediastinal area are important factors to improve postoperative
      prognosis in patients with thoracic esophageal carcinoma. However, more effective
      adjuvant therapy is needed for the patients with many positive node metastases.

PMID- 7793993
TI  - [Current status of radiotherapy for esophageal carcinoma].
AB  - Preoperative radiotherapy for esophageal carcinoma had no improvement on survival
      or locoregional control. The role of postoperative radiotherapy is limited to
      patients with residual tumor. According to the nationwide statistics of the
      results of radiotherapy alone, 5-year survival rate of superficial or Ep-Sm type
      was 26% and 32.5%, respectively. Intracavitary irradiation will improve not only
      survival but provide palliation of dysphagea. Now, it must be discussed the
      usefulness of radiotherapy from the viewpoint of cost-benefit ratio.

PMID- 7793994
TI  - [Local chemotherapy by a sustained-release preparation with fibrin seal against
      the operative wound in head and neck cancer].
AB  - Fibrin seal has been used for hemostasis and sealing in operative field of tumors
      in the head and neck. The authors applied it for drug preparation and tried a
      local chemotherapy to treat residual and disseminated tumors of cellular level in
      the operative wound using 5-FU. The drug release rate in this therapy in vitro
      study was 50% after 24 hrs. When injected to rats bearing Yoshida sarcoma, it
      exhibited a marked antitumor effect compared to the control group given 5-FU
      alone. This therapy is easy to make the dosage adjustment and can apply drugs
      directly to the tumor residue at the high concentration. It will be clinically a
      useful adjuvant therapy for radiotherapy, surgery or chemotherapy.

PMID- 7793996
TI  - [A cooperative late phase II trial of l-leucovorin and 5-fluorouracil in the
      treatment of advanced gastric cancer. l-Leucovorin and 5-FU Study Group (Japan
      Western Group)].
AB  - A multicenter cooperative study was conducted to evaluate the clinical efficacy
      of l-leucovorin (l-LV) and 5-fluorouracil (5-FU) treatment in 69 cases of
      advanced gastric cancer. l-LV was administered intravenously by a 2-hour infusion
      at a dosage of 250 mg/m2 and 5-FU at a dosage of 600 mg/m2, intravenously via
      bolus one hour after administration of l-LV had been started. The combination was
      given weekly for 6 weeks followed by a 2-week rest period. Patients were
      evaluated for response after the sixth dose. Nineteen PRs were noted in the 55
      patients for an overall response rate of 34.5%. Median survival time was 190 days
      for eligible cases, and 448 days for PR cases. Age and performance status (PS)
      appeared to influence clinical response. Patients aged 49 years or younger showed
      a significantly higher PR rate than those aged 50 years or older. The PR rate was
      significantly higher in the patients of PS 0-1 than those of PS 2. Diarrhea and
      leukopenia were experienced in 46.7% and 65% of patients, respectively. Patients
      who had severe toxicities required discontinuity of treatment. After recovery,
      treatment was repeated. The clinical results are promising for patients with
      advanced gastric cancer, particularly middle-aged patients. However, whether the
      l-leucovorin and 5-FU combination therapy will ultimately produce superior
      results in middle-aged patients awaits the results of Phase III trials.

PMID- 7793995
TI  - [Pilot study of irinotecan in refractory small cell lung cancer].
AB  - Sixteen patients with refractory small cell lung cancer (SCLC) were treated with
      an irinotecan starting dose of 100 mg/m2 given as a 90-minute iv infusion every
      week with subsequent doses based on toxicity. Mean age was 64 years; 14 male and
      2 female; 4 with limited disease and 12 with extensive disease; all patients
      pretreated with combination chemotherapy containing etoposide. The overall
      response rate was 50% (95% CI 25-75%) with no CR and 8 PR. The median duration of
      response was 46 days. Major toxicities were leukopenia, diarrhea and pulmonary
      toxicity. Irinotecan was thus an effective agent in refractory SCLC.

PMID- 7793997
TI  - [Quality of life in patients with advanced gastric cancer receiving AO-90, a
      methionine-free intravenous amino acid solution, with 5-fluorouracil and
      mitomycin C].
AB  - We conducted a randomized, multicenter, controlled trial of AO-90, a methionine
      free 7.43% intravenous amino acid solution, in patients with advanced recurrent
      gastric cancer. The regimen used in the study was comprised of two-week treatment
      cycles, with a withdrawal period between cycles. During treatment, patients were
      given either AO-90 (500-750 ml/day; AO/MF group) or a commercial amino acid
      solution (600-800 ml/day; C/MF group) by total parenteral nutrition (TPN) for 14
      days concomitantly with MF therapy (5-fluorouracil 350 mg/m2/day, iv continuously
      for 14 days and mitomycin C 7 mg/m2, iv push on days 7 and 14). We interviewed
      118 eligible and evaluable patients (72 men and 46 women; 59 cases in the AO/MF
      group and 59 in the C/MF group) about their quality of life immediately before
      the start of treatment, one week and two weeks after the start of treatment, and
      one week and two weeks after treatment. A 11-item questionnaire was used to
      interview the subjects: nine questions using a five-point scale, one question
      using a 100-mm linear visual analog scale, and one question using a five-grade
      face scale. Changes in the grades compared with baseline data were scored as 1
      point (improvement of one grade or more, or 20 mm or more), 0 points (no
      changes), and-1 point (decline of one grade or more, or 20 mm or more). Before
      analyzing the significance, quality of life score data were adjusted by the
      Mantel-Haenszel method due to uneven distribution of subjects concerning baseline
      performance status and complications. Among the items questioned, subjects
      receiving AO-90 showed significantly higher scores in appetite, nausea, and
      ambulation at some evaluation time points than those receiving a methionine
      containing TPN. The results show that AO-90 improved the quality of life of
      patients with advanced recurrent gastric cancer.

PMID- 7793998
TI  - [A late phase II trial of l-leucovorin and 5-fluorouracil in advanced colorectal
      cancer. l-Leucovorin and 5-FU Study Group (Japan Western Group)].
AB  - A multicentral cooperative study was conducted to evaluate the clinical efficacy
      and toxicity of l-Leucovorin (l-LV) and 5-fluorouracil (5-FU) in advanced
      colorectal cancer. The administration schedule was a two-hour intravenous
      infusion of l-LV (250 mg/m2) and an intravenous bolus injection of 5-FU (600
      mg/m2), given one hour after the beginning of the l-LV infusion. Sixty-four
      patients were treated weekly for six weeks followed by two-weeks rest, and then
      evaluated for response. Complete response and partial response were obtained in
      21 patients (32.8%). The median survival time was 12.8 months. The most prominent
      side effects were anorexia (57.8%), nausea and vomiting (56.3%), diarrhea (48.4%)
      and myelosuppression such as leucopenia (54.7%), thrombocytopenia (18.8%) and
      decreased hemoglobin (40.6%). These side effects, however, were within
      permissible levels. Severe toxicity was prevented by discontinuance of the
      treatment. From the present study, l-LV and 5-FU combination therapy seems to be
      a very promising and useful treatment for patients with advanced colorectal
      carcinoma.

PMID- 7793999
TI  - [Retrospective analysis of postoperative chemotherapy with UFT against pancreatic
      cancer].
AB  - The retrospective study was carried out to evaluate the effect of UFT given
      orally in patients with histologically proven pancreatic cancer in our
      institutions for 6 years. The study regimen was designed as follows: 400 or 600
      mg/body UFT per day after the patients having something solid evidences of tumor.
      For 6 years, 78 patients were entered in this protocol. Further details of the
      patients characteristics were as follows: head 47 (60.3%) cases, tail & body 31;
      resection cases 26 (33.3%), palliative 52; Stage IV 62 (79.5%) cases. Resection,
      P (peritoneal dissemination). H (liver metastasis) and T (tumor size) were
      statistically proven to be significant prognostic factors. The median survival
      time of UFT group was 204 days and that of non UFT group was 123 days. According
      to the retrospective analysis, there was a significant difference in the
      cumulative survival rate between UFT group and non UFT group with 1.98 of
      Hazard's proportional ratio (p = 0.009). However, further clinical investigations
      prospective study are necessary to confirm these data.

PMID- 7794000
TI  - [Essential thrombocythemia transformed to minimally differentiated acute myeloid
      leukemia].
AB  - A 64-year-old female diagnosed for essential thrombocythemia was treated with
      MCNU 50 mg four times in the course of the disease. Six months after the last
      administration, in May 1991, she was admitted because of decreasing thrombocyte
      count and appearance of blasts in the peripheral blood. On admission, laboratory
      findings were as follows: WBC 700/microliters with 5% of blasts, RBC 331 x
      10(4)/microliters, and PLT 17.9 x 10(4)/microliters. Bone marrow aspiration
      revealed hypocellular marrow with 39% blasts. About 5% of the blasts were
      positive for myeloperoxidase by electron microscopy analysis. Leukemic cells were
      positive for CD 7, 13, 33 and 34, negative for other lymphoid lineage markers,
      and demonstrated no rearrangement of TCR-beta, gamma and IgH genes. Although she
      was treated with low-dose cytosine arabinoside, no response was observed.
      Subdural hematoma and sequential pneumonia developed and the patient died eight
      months after leukemic transformation. In conclusion, we think that the leukemic
      transformation might have been developed in the natural course of essential
      thrombocythemia in the present case. However, we cannot exclude the influence of
      MCNU.

PMID- 7794001
TI  - [Refractory anemia with excess myeloblast in transformation induced remission by
      combined oral administration of cytarabine ocfosfate and 6-mercaptopurine].
AB  - A 55-year-old female presented with sore throat and slight fever. The patient was
      admitted to our hospital on December 13, 1993. Full blood count showed hemoglobin
      10.7 g/dl, white cell count 960/microliters (neutrophils 14%, lymphocytes 82%,
      blasts 2%) and platelets 13,000/microliters. Bone marrow examination showed
      hypocellularity with 4.5% of myeloblast positive for peroxidase. The bone marrow
      specimens on Dec. 20 showed 15.5% of myeloblasts, some of which had Auer rods.
      These findings led to the diagnosis of refractory anemia with excess myeloblast
      in transformation (RAEB-T) of French-American-British Cooperative Group. The
      patient was transfused and treated with cytarabine ocfosfate (SP-AC) (100 mg tid)
      and 6-mercaptopurine (50 mg tid) for 14 days. During chemotherapy she complained
      of nausea and anorexia, but they were managed easily with medication. On Feb. 7,
      1994, forty-two days after the start of administration, peripheral blood and bone
      marrow aspirate were compatible with a complete remission. Although complete
      remission was sustained with courses of chemotherapy for 4 months, relapse
      occurred and the patient died of septicemia on August 29, 1994 after induction
      failure. Observation suggested that oral SPAC in combination with 6
      mercaptopurine had a good antileukemic effect on the myelodysplastic syndrome.
      However, the duration response was short, and further improvement of the therapy
      is needed.

PMID- 7794002
TI  - [Neoadjuvant chemotherapy of liver tumors metastasized by sigmoid colon cancer: a
      case report of CDDP/5-FU intraarterial infusion therapy followed by hepatectomy].
AB  - A case of liver tumors metastasized by Sigmoid colon cancer was treated with
      intrahepatic arterial infusion of CDDP (10 mg) and 5-FU (250 mg) via
      subcutaneously implanted reservoir. After 20 administrations of CDDP and 5-FU,
      the tumors in the right lobe of the liver disappeared, but those in the left lobe
      remained. Therefore left hepatectomy was carried out. Six months after the
      hepatectomy, a nodule recurrence was disclosed in the right lobe of the liver.
      With re-elevated serum CEA level, subsequent intrahepatic arterial infusion of
      CDDP and 5-FU the nodule size reduced with normalization of the serum CEA level.

PMID- 7794003
TI  - [Effects of 5-fluorouracil in shrinking residual gastric cancer: a case report].
AB  - The patient was a 79-year-old man who underwent extensive gastrectomy and
      Billroth-II reconstruction for gastric ulcer in 1974. He complained of heartburn
      in November, 1992, and endoscopy for the residual stomach revealed IIb + IIa-like
      lesion mainly in the posterior wall of the anastomosed site, which was diagnosed
      as well differentiated adenocarcinoma. As the patient refused to be operated, 150
      mg/day of 5-FU was administered. For 4 months before he decided to undergo
      operation, 12.9 g of 5-FU was administered in total. After rehospitalization,
      endoscopy of the residual stomach showed shrinkage of the lesion, and biopsy
      revealed no malignant findings. The pathological examination after total
      resection of the residual stomach showed atypism, but no evidence to support
      malignancy. He has continued to be well without sign of recurrence for 1 year
      since the operation. The administration of 5-FU is widely used as preoperative
      adjuvant chemotherapy. This case it is rare for 5-FU to cause the disappearance
      or falling off of malignant cells.

PMID- 7794004
TI  - [Pilot study of sequential chemotherapy and radiation therapy using of liniac and
      fast neutron for limited small cell lung cancer].

PMID- 7794005
TI  - [Biochemically modulated chemotherapy with high-dose L-leucovorin and 5
      fluorouracil for multiple liver metastasis from colorectal cancer].

PMID- 7794006
TI  - [Ifosfamide-induced hemorrhagic cystitis and its prevention by mesna].

PMID- 7794007
TI  - [Liver tumor targeting of drugs: Spherex, a vascular occlusive agent].
AB  - Embolizing chemotherapeutic methods are presently used primarily for
      nonresectable metastatic hepatic carcinoma. Because this kind of carcinoma is
      generally ischemic, little is expected from embolizing chemotherapeutic methods
      aimed at tumor necrosis by blood flow obstruction using gelatin sponges. On the
      other hand, since the arrival rate of Lipiodol is not very good, embolizing
      chemotherapeutic therapy employing Lipiodol is not expected to be very effective.
      Consequently, therapies against metastatic hepatic carcinoma have mainly been
      intraarterial chemotherapies without embolization. Spherex is a transient
      embolization agent prepared by suspending 60 mg/ml of degradable starch
      microspheres (hereinafter, DSM) in physiological saline. It was developed by
      Pharmacia AB, Sweden, as an arterial embolizing agent for embolizing
      chemotherapy, and it was the first agent approved for use in Japan as an
      embolization material. DSM is composed of spherical particles approx. 45 microns
      in diameter prepared by crosslinking partially hydrolyzed potato starch using
      epichlorohydrin as a crosslinking agent, and it is characterized by gradual
      decomposition by blood amylase, having a half-life of 20-35 minutes in vitro.
      Clinically, when Spherex is administered via the arteries, embolization has been
      found to occur in the arterioles. Furthermore, administration of Spherex via the
      hepatic artery in combination with an anticancer drug results in the formation of
      transient reduction of bloodflow, thus making it possible to extend the period of
      retention of the anticancer drug at a high concentration in the tumorous region.
      As a result, the local antitumor effect of the anticancer drug may be reinforced,
      with alleviation of systemic side effects. In clinical tests involving its
      administration to metastatic hepatic tumors in combination with mitomycin C
      (hereinafter, MMC), the efficacy is 54.5% with arterial injection therapy with
      Spherex, which is significantly superior to the 20.0% obtained with arterial
      injection of MMC alone. Although the rate of side effects exhibited, including
      pain, digestive symptoms and fever, has been significantly higher in combination
      with Spherex, myelosuppression indicated by abnormal fluctuations in leukocyte
      and platelet counts was found to be greater with administration of MMC alone,
      suggesting its value as an effective future therapy for metastatic hepatic
      carcinoma. These data indicate that Spherex is not expected to yield an antitumor
      effect due to long-term blood flow obstruction in the hepatic artery, an effect
      associated with gelatin sponges heretofore used for embolizing chemotherapy.
      Instead, it causes a transient occlusion upon one-shot intraarterial injection
      therapy with MMC, thus extending the retention time of MMC at high concentration
      in tumorous sections, thereby yielding a high local antitumor effect with
      MMC.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7794008
TI  - [Prognostic factors of hepatocellular carcinomas after non-surgical treatment].
AB  - We studied 710 patients with hepatocellular carcinoma(HCC) who underwent non
      surgical treatment. Multivariate analysis demonstrated that four factors, the
      number of tumors, tumor size, portal vein tumor thrombus and the severity of
      liver dysfunction (Child's classification) before treatment were found to be
      significant for the prognosis of patients and that severity of liver dysfunction
      was the most significant factor. of 179 patients with small HCC who underwent
      percutaneous ethanol injection (PEI), the severity of liver dysfunction was the
      most significant factor contributing to the prognosis. The prognosis of HCC is
      influenced by many factors. We conclude that early detection of tumors followed
      by early therapy is the most important.

PMID- 7794009
TI  - Modelling and monitoring organochlorine and heavy metal accumulation in soils,
      earthworms, and shrews in Rhine-delta floodplains.
AB  - In the Rhine-delta, accumulation of microcontaminants in floodplain foodwebs has
      received little attention in comparison with aquatic communities. To investigate
      organochlorine and metal concentrations in a terrestrial foodchain, samples of
      soil, earthworms (Lumbricus rubellus), and shrew (Crocidura russula, Sorex
      araneus) livers and kidneys were taken from two moderately to heavily polluted
      floodplains. Chlorobiphenyl residues in earthworm fat were 0.10 to 3.5 times the
      concentrations in soil organic matter, whereas ratios for other organochlorines
      varied between 0.87 and 8.8. These ratios are one order of magnitude lower than
      expected from laboratory experiments with earthworms, and laboratory and field
      studies on aquatic invertebrates. Bioconcentration ratios for heavy metals are in
      accordance with literature values for other locations, confirming the high
      potential for cadmium accumulation in Lumbricidae. Concentrations of
      organochlorines in shrew liver lipids were 1.0 to 13 times the residues in
      earthworm fat. These values are higher than lipid-corrected biomagnification
      ratios for laboratory rodents, but equal to those measured for benthivorous birds
      in the Rhine-delta. On a dry weight basis, kidney-earthworm ratios for cadmium
      were about one order of magnitude lower than previously reported values for
      insectivores. Soil concentrations of many compounds in both floodplains did not
      meet Dutch quality standards. Yet, hexachlorobenzene, chlorobiphenyl 153
      (PCB153), gamma-hexachlorocyclohexane, sigma DDT, and dieldrin residues in
      earthworms and shrews did not exceed diet levels expected to be safe for
      endothermic species. An exception was noted for cadmium in worms and shrew
      kidneys. Heavy metal pollution in soil was close to levels that are critical to
      earthworms in laboratory studies. Cadmium concentrations in shrew kidneys were
      below levels suggested to be safe for Sorex araneus, but above those that were
      critical to the rat.

PMID- 7794010
TI  - Contaminant levels in harbor seals from the northeastern United States.
AB  - The concentrations of polychlorinated biphenyls (PCBs), organochlorine
      pesticides, polycyclic aromatic hydrocarbons (PAHs), polychlorinated
      dibenzofurans (PCDF), polychlorinated dibenzo-p-dioxins (PCDD), and mercury (Hg)
      were determined in blubber and liver tissues of harbor seals (Phoca vitulina)
      collected along the northeast coast of the U.S. Average PCB concentrations in
      seal blubber (sum of congeners) were 12.0 micrograms/g (wet weight) with a range
      of 7.30 to 24.3 micrograms/g in 1980 and 6.66 micrograms/g (wet weight) with a
      range of 2.61 to 11.3 micrograms/g in 1990-1992. Comparisons between blubber data
      from this study and previous work indicated that the concentration of PCBs along
      the northeast coast of the U.S. may have decreased over the past twenty years.
      The average p,p'-DDE concentrations in seal blubber were 10.9 micrograms/g (wet
      weight) in 1980 with a range of 6.95 to 21.9 micrograms/g and 4.12 micrograms/g
      (wet weight) with a range of 1.83 to 7.84 micrograms/g in 1990-1992. Only trace
      amounts of PCDFs and PCDDs were found in a few blubber samples; levels in most
      tissues were below detection (3-5 pg/g) (wet weight). Trace amounts (< 30 ng/g)
      of phenanthracene, anthracene, and alkylated MW-178 compounds were found in some
      seal samples; all other PAH compounds were below the detection level (5-15 ng/g).
      Toxic equivalents (TEQ) of selected coplanar and mono-ortho PCB congeners and
      relative toxic equivalents (RTE) (pg total TEQ/microgram total PCB) were
      calculated, using recently proposed dioxin toxic equivalent factors (Ahlborg et
      al. 1994). The TEQs ranged from 41 to 315, and the RTEs ranged from 2.25 to
      16.3.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794011
TI  - Biological monitoring of occupational exposure to methyl ethyl ketone in Japanese
      workers.
AB  - The relationship between occupational exposure to methyl ethyl ketone (MEK) and
      its concentration in urine and blood was studied in a group of 72 workers in a
      printing factory. Personal exposure monitoring was carried out with passive
      samplers during the workshifts. The time weighted average (TWA) concentration of
      MEK ranged from 1.3 to 223.7 ppm, with a mean concentration of 47.6 ppm. In
      addition to MEK, toluene, xylene, isopropyl alcohol, and ethyl acetate were
      detected as the main contaminants in all samples. At the end of the workshift,
      urine samples were collected to determine the urinary MEK, hippuric acid (HA),
      and creatinine, and blood samples were also collected at the same time for
      determination of MEK. The concentrations of urinary MEK ranged from 0.20 to 8.08
      mg/L with a mean of 1.19 mg/L and significantly correlated with TWA
      concentrations of MEK in the air with a correlation coefficient of 0.889 for
      uncorrected urine samples. The concentration of MEK in the blood was also
      significantly correlated with the TWA concentration of MEK with a correlation
      coefficient of 0.820. From these relationships, MEK concentrations in urine and
      blood corresponding to the threshold limit value-TWA (200 ppm; ACGIH 1992) were
      calculated to be 5.1 mg/L and 3.8 mg/L as a biological exposure index (BEI),
      respectively. Although the BEI for urinary MEK obtained from the present study
      was higher than that of previous reports and ACGIH's recommendation (2.0 mg/L),
      the BEI agreed well with a previous study in Japan.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7794012
TI  - Modulation of the adherence of human polymorphonuclear leukocytes by cadmium and
      nickel: sexual differences.
AB  - The effect of cadmium (xenobiotic element) and nickel (ultra-trace bioelement) on
      the adherence to plastic of peripheral polymorphonuclear leukocytes (PMNs) from
      male (M-PMNs) and female (F-PMNs) donors was analyzed. Exposure of PMNs to either
      metal stimulated adherence, mainly the early adherence (8 min). A sex influence
      on the adherence was observed. Up to 45 min of incubation, M-PMNs adhered more
      than F-PMNs. This sexual dimorphism also took place in the case of metal
      stimulation. Cadmium and nickel enhanced early spontaneous adherence of cells
      from either sex, but only the late adherence (25 min) of F-PMNs. The adherence
      stimulation was generally greater in F-PMNs, but M-PMNs achieved higher adherence
      levels. Nickel was more effective than cadmium in enhancing the adherence,
      especially the early adherence of F-PMNs.

PMID- 7794013
TI  - Isomer-specific analysis of polychlorinated biphenyls and 2,3,7,8
      tetrachlorodibenzo-p-dioxin equivalents (TEQs) in red fox and human adipose
      tissue from central Italy.
AB  - The general exposure of humans and foxes to polychlorinated biphenyls (PCBs) and
      DDT in Italy was determined by analysis of adipose tissue samples collected from
      1991-1992. sigma PCB concentrations varied between 1.0 and 2.6 micrograms/g (wet
      wt.). sigma DDT concentrations ranged from 1.6 to 5.0 micrograms/g (wet wt.).
      About thirty-five PCB congeners were identified in most samples. PCB congeners of
      IUPAC Nos. 138, 153, and 180 were the most abundant compounds, accounting for an
      average of 50% of the sigma PCBs in humans and 64% in foxes. Generally, higher
      chlorinated biphenyls and those with a 2,4,5-chlorine substitution in one ring
      and at least one substitution in the 4-position of the other ring were
      preferentially accumulated. Coplanar PCB congeners were detected at considerable
      concentrations and there is no sign of decline in their concentrations with
      respect to previously reported data. IUPAC Nos. 118, 156 and 126 were the main
      contributors to toxicity in humans and foxes. The significant contribution of
      mono-ortho congeners in humans and non-ortho congeners in foxes suggests that
      differences in metabolic potential may affect the PCB toxicity pattern.

PMID- 7794014
TI  - Postmortem tissue levels of polychlorinated biphenyls in female rhesus monkeys
      after more than six years of daily dosing with Aroclor 1254 and in their non
      dosed offspring.
AB  - Polychlorinated biphenyl (PCBs) analyses were made on prenecropsy blood samples
      and postmortem adipose, liver, kidney, and brain tissues from female rhesus
      monkeys fed a daily dose of 0, 5, 20, 40, or 80 micrograms Aroclor 1254/kg body
      weight for approximately 6 years. During this time, the females were bred with
      non-dosed males. All resulting offspring were nursed for 22 weeks and fed no
      additional PCBs until they were necropsied at approximately 120 weeks after
      birth. PCBs were also measured in necropsied infant tissues to determine PCB
      levels due to intake of PCB-contaminated milk from the dosed dams, in addition to
      in utero exposure. Polychlorinated biphenyl levels in all tissues of the adult
      monkeys increased with their dosage. The highest PCB levels were found in adipose
      tissue and the lowest levels were found in the brain. Polychlorinated biphenyl
      residues in the cortex of the kidney were lower than in the medulla, while in the
      brain no appreciable differences were observed between the occipital and frontal
      lobes. Necropsy tissues of infants from dosed dams contained more PCBs than those
      nursed by controls, but less than tissues from stillborn infants. Although no
      differences were observed between PCB tissue levels from monkeys having offspring
      and those having no offspring, those having a stillborn infant had higher PCB
      levels in their tissues than those with a viable infant. Similarly, monkeys that
      were euthanized because of poor health had higher PCB levels in their tissues
      than those necropsied at the conclusion of the study and showed a dramatic shift
      from tetra- and hexachlorobiphenyls to penta- and heptachlorobiphenyls in their
      tissues. The PCB distribution pattern in tissues from a dosed mother/infant pair
      differed considerably. A larger percentage of heptachlorobiphenyls was found in
      the infant than in its dam. The adipose/blood PCB ratio in the adult monkeys
      remained remarkably constant.

PMID- 7794015
TI  - Toxicological potency of 2,3,7,8-tetrachlorodibenzo-p-dioxin relative to 100
      other compounds: a relative potency analysis of in vitro and in vivo test data.
AB  - A common definition of relative potency is the dose of a reference compound
      required to cause a particular incidence of a specific toxic response divided by
      the dose of a test compound needed to cause an equal incidence of that same
      effect. In this simple manner, toxicological assessments for a chemical of
      concern can be made in terms of another compound about which much is known from a
      human health perspective. Relative potency factors were used to compare 2,3,7,8
      tetrachlorodibenzo-p-dioxin CAS # 1746-01-6 (TCDD) with 100 other compounds both
      individually and collectively. All results were standardized to a common scale
      that spanned many orders of magnitude and was indexed to an arbitrary potency of
      unity for benzo(a)pyrene [B(a)P]. From comparisons between 2,771 pairs of
      bioassay results (i.e., matched experimental design conditions) for TCDD compared
      with the 100 other compounds, it was found that TCDD is about 600 times as toxic
      as B(a)P (interquartile range of 130 to 1,900). The distribution of relative
      potency values is fitted accurately with a log-normal distribution function
      having an untransformed mean of 550 and an untransformed slope (i.e., the inverse
      of the standard deviation of the distribution) of 140. These factors combined
      with (a) a reference lifetime carcinogenic risk level of 1/100,000 and (b) a
      universal, potency-dependent risk coefficient (estimated from the collection of
      epidemiologically-based carcinogens) yielded estimates that equally toxic
      concentrations for TCDD should be in the range of 13 pg/m3 and 7 pg/L in air and
      water, respectively.

PMID- 7794016
TI  - Chronic accumulation of cadmium in the edible tissues of Oreochromis aureus
      (Steindachner): modification by mercury and lead.
AB  - The influence of mercury and lead on cadmium accumulation was investigated by
      exposing the fish Oreochromis aureus, or Blue Tilapia, to two heavy metals
      simultaneously. The chronic accumulation profile of cadmium in the liver, brain,
      gill filaments, intestine, caudal muscle, spleen, trunk kidney, and gonads was
      determined for exposure to cadmium alone and with lead or mercury. O. aureus was
      exposed to cadmium alone at 0.05 and 0.10 mg/L, and mixtures of 0.05 mg/L cadmium
      with 0.05 mg/L mercury or lead (0.05 and 0.50 mg/L). Little research has
      previously been carried out on the long-term interaction between these heavy
      metals and their effects on tissue accumulation of heavy metals. In a food fish
      such as O. aureus, a knowledge of toxic metal accumulation patterns is of great
      importance. The highest levels of cadmium were consistently accumulated by the
      kidney, and the presence of other mercury or lead did not change this trend. The
      spleen, intestine, and liver also accumulated high levels of cadmium, while the
      caudal muscle and brain accumulated the lowest levels of cadmium. Separating the
      viscera from the muscle would therefore reduce the cadmium burden of fishmeal.

PMID- 7794017
TI  - Quantitative structure-toxicity relationships and volume fraction analyses for
      selected esters.
AB  - The acute toxicity of aliphatic and aromatic mono and diesters in two eucaryotic
      organisms was compared. The test systems were the static 2-d Tetrahymena
      pyriformis 50% population growth impairment (IGC50(-1)) assay, and the flow
      through 4-d Pimephales promelas 50% mortality (LC50(-1)) assay. In ciliates,
      esters act via the nonpolar narcosis mechanism of toxic action. This was
      indicated by: the high quality 1-octanol/water partition coefficient (log Kow)
      dependent quantitative structure-activity relationship (QSAR), log IGC50(-1) =
      0.79 (log Kow) - 1.93, n = 15, r2 = 0.945, s = 0.22, f = 222.37 Pr > f = 0.001);
      volume fraction (Vf) (0.8e-02); and "a" coefficient (0.3) which are not different
      from other nonpolar narcotics. In vivo hydrolysis in Tetrahymena appears to be
      insignificant. However, in fish, presumably because of more active esterases, in
      vivo hydrolysis is significant and leads to greater toxicity of esters than
      observed for nonpolar narcotics. Moreover, it leads to a unique high quality
      QSAR, log LC50(-1) = 0.64 (log Kow) - 0.64, n = 14, r2 = 0.945, s = 0.22, f =
      207.08, Pr > f = 0.0001). Due to in vivo hydrolysis, a nonreducing concentration
      gradient is formed between water and fish. Therefore, the fish take up more
      toxicant as compared to a situation that leads to thermodynamic equilibrium.
      Additional information about the mechanism of ester toxicity in fish was gained
      by applying corrections for hydrolysis in volume fraction analyses. The corrected
      Vf (0.6e-02) is very close to the one found for nonpolar narcotics (0.7e
      02).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794020
TI  - [Needle biopsy of the breast: cytopuncture with fine needle and microbiopsy of
      non palpable breast lesions detected by mammography].

PMID- 7794018
TI  - [Quality control in anatomo-cytopathology. Breast cancer].

PMID- 7794021
TI  - [Non palpable cancers of the breast. The point of view of the pathologist].

PMID- 7794019
TI  - [Recommendations for the anatomopathological study of non palpable breast lesions
      detected by mammography].

PMID- 7794022
TI  - [Breast cancer, model in biological and clinical oncology. Role of hormones and
      growth factors].
AB  - It is shown that breast cancer can be considered as a paradigm of comprehensive
      cancer biology and treatment based on analysis of each individual tumor.
      Historically, it was first observed in breast cancer that tumor progression could
      be dependent on factors regulating physiological activities (i.e. hormones). It
      was also observed that tumor growth progressively becomes autonomous, through
      successive degradation of the multiple steps involved in the control of cell
      proliferation and differentiated activities. Hormonal treatment of breast cancer
      provided the first example of targetted biotherapy. The discovery of the
      mechanism of action of hormones via specific receptors opened the field of tumor
      tissue analysis to determine the main biological factors involved in tumor
      progression. In the near future, such data should be the best guide for selection
      of the most appropriate treatment in each individual case.

PMID- 7794023
TI  - [Predictive value of cytology for the efficacy of chemotherapy in breast
      cancers].
AB  - For the past decade, primary chemotherapy has been extensively used in breast
      cancer treatment. However, valuable indicators of tumor response are needed. Fine
      needle cytopuncture allows the study of malignant cells by cytologic examination,
      image analysis and flow cytometry. Some parameters evaluated before treatment
      (cytologic grade, nuclear area and S phase) or at the beginning of treatment
      (cytomorphologic and cell kinetic changes) have been shown to be correlated with
      tumor response. The methods, their value and limitations, and results of the
      literature are discussed.

PMID- 7794024
TI  - [Effects of progesterone and progestational hormones on the mammary gland].
AB  - The growth of the mammary gland during the active genital period depends on a
      delicate balance between the action of the two major female sex steroid hormones,
      estradiol and progesterone. The regulation of growth and maturation of the gland
      primarily depends on the combined action of estradiol and progesterone. Breast
      epithelial proliferation is maximal during the luteal phase of the menstrual
      cycle. While estrogen appears to be the major impetus to the proliferation of
      mammary cells, the effect of progestin is subject to debate. Progestins have
      either a positive, modest or no growth effect or may even inhibit growth.
      Progestins could stimulate the development of malignant cells in contrast to
      normal or non-malignant cells. It is difficult to extrapolate in vitro results to
      the human breast. There is presently no direct evidence that progestins regulate
      the concentration of estrogen receptors (ER) in normal breasts. Furthermore, it
      is possible that each type of progestin may have different effects. Most studies
      suggest that progestins are effective in the treatment of premenstrual syndrome
      and benign breast disease. The therapeutic basis for the use of progestins is the
      suppression of pituitary-ovarian function the reduction of the effect of estrogen
      on breast tissues. Whether progestins give protection against breast cancer is
      less clear. If they do, the mechanism is not the same as that of the endometrium
      [down-regulation of ER, increase of 17 beta-hydroxysteroid dehydrogenase activity
      (E2DH)]. High doses of oral synthetic progestins are effective in the treatment
      of breast cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794025
TI  - [Inflammatory cancer of the breast: review and experience at Saint-Louis
      hospital].
AB  - Inflammatory breast cancer represents about 1 to 6% of all breast cancers. It has
      a sudden onset and affects women of the same age as other breast cancers. Its
      particular feature is the almost constant development of metastases. The 5-year
      survival after surgery or surgery and radiotherapy varies between 0 and 28% with
      a median survival of 18 months. The use of anthracycline-based chemotherapy has
      doubled the median survival, but has not achieved cure. Clinical research is
      directed towards therapeutic intensification with or without autologous bone
      marrow transplantation. The authors report their experience at Hopital Saint
      Louis.

PMID- 7794026
TI  - [Medullary carcinoma of the breast. What remains of this entity today?].
AB  - Identified half a century ago as a favorable prognostic form, medullary breast
      cancer was classified by Ridolfi in 1977 as necessarily combining 5 features:
      seemingly wall-circumscribed histological limits, a syncytial architecture in at
      least 75% of the areas examined, inflammation of the stroma containing diffuse
      lymphocytes and plasma cells, moderate or marked anisonucleosis and absence of
      tubular differentiation and/or an intraductal component. Defined is this way, it
      only accounts for one third of breast cancers with stromal invasion and its
      outcome is significantly more favorable. Although the reproducibility of this
      classification is not perfect, only the combination of morphological features
      prevail over the "new" biological characteristics.

PMID- 7794027
TI  - [Genetics and cancer: application to the breast].
AB  - Various gene systems are involved in events occurring during transformation of a
      normal cell into a cancer cell. By order of intervention, genes responsible for
      an increased individual susceptibility to cancer can be distinguished from actual
      cancer genes, followed by genes involved at other levels of carcinogenesis. 15 to
      20% of patients with breast cancer have a first-degree relative affected by the
      same cancer, although an inherited predisposition to cancer is only established
      in 4 to 10% of cases. The genetic heterogeneity of familial forms of breast
      cancer make it difficult to identify susceptibility genes. At the present time, 3
      regions of the genome have been implicated in the predisposition to breast cancer
      in women: the BRCA1 gene, the BRCA2 gene and the TP53 gene. All predisposition
      genes are able to transmit susceptibility due to a mutation or inherited
      microdeletion.

PMID- 7794028
TI  - [Sarcomatoid carcinoma of the breast].

PMID- 7794029
TI  - [Phyllodes tumors].
AB  - A review of mammary phyllodes tumors is presented. Clinical, radiological and
      cytological features are treated, with special emphasis on the histopathological
      grading system and prognostic indicators. Other analytical methods are described:
      immunohistochemistry, hormonal receptors study, flow cytometry and electron
      microscopy. A large place is also given to differential diagnosis, clinical
      course, histogenesis and originality of some phyllodes tumors. The authors stress
      the importance of wide excision and the contribution of frozen sections in
      surgical treatment.

PMID- 7794030
TI  - [Mesenchymal breast sarcomas: general review].
AB  - Breast sarcomas are rare, representing 1% of all malignant breast tumors. A
      variety of histologies are found, the main ones being fibrosarcomas and malignant
      fibrohistiocytomas. Nodal involvement is rare and, as in other sarcomas,
      hematogenous spread of metastases is more usual. Major prognostic factors are
      histological grade and mitotic activity; the three-year disease-free survival
      ranges between 40% and 60%. Surgery remains the treatment of choice of these
      tumors; for some authors adjuvant irradiation could improve local control,
      especially for patients treated with conservative surgery. The role of adjuvant
      chemotherapy remains undefined.

PMID- 7794031
TI  - [Primary non-Hodgkin lymphomas of the breast. Focus].
AB  - Although very rare (0.12 to 1.1% of all breast tumours), primary non-Hodgkin's
      lymphomas of the breast need to be distinguished from the group of malignant
      epithelial tumours, as the staging and therapeutic modalities are different,
      corresponding to those applied to lymphomas in general. In the majority of cases,
      the current techniques of aspiration cytology, needle or surgical biopsy,
      immunohistochemistry allow the diagnosis and typing according to the usual
      histological classifications.

PMID- 7794032
TI  - [Dermatoses of the nipple and the areola].
AB  - Dermatoses of the nipple and areola are rare. The commonest dermatosis is Paget's
      disease, which presents in the form of a well demarcated erythematous area,
      sometimes erosive, oozing or hyperkeratotic. Histological examination reveals an
      intraepidermal proliferation of large clear cells, either isolated or grouped in
      clumps, predominantly in the suprabasal layers. Immunohistochemistry shows that
      these cells express low molecular weight cytokeratins and the epithelial membrane
      antigen, fairly frequently carcinoembryonic antigen. In 96% of cases, Paget's
      disease is associated with underlying breast carcinoma, either in situ or
      invasive. Erosive adenomatosis presents in the form of an erosion of the nipple,
      which is sometimes increased in size. Histologically, it consists of a benign
      tumour which may ulcerate the epidermis, composed of tubes and papillae lined by
      a double layer of epithelial and myoepithelial cells. The syringomatous tumour is
      exceptional. In places, it forms rudimentary sweat ducts and is considered to
      have an intermediate malignancy; its resection must be complete. Other tumours
      may also be observed in this site: leiomyoma, leiomyosarcoma, benign cutaneous
      lymphocytoma, basal cell carcinoma, naevoid areolar hyperkeratosis. They are
      exceptional except areolar neurofibromas in case of neurofibromatosis. Infectious
      dermatoses (viral warts, molluscum contagiosum, scabies) are accompanied by
      lesions in other sites. They same applied to the majority of inflammatory
      dermatoses such as eczema or Fox-Fordyce disease. Supernumerary nipples are
      situated on a line extending from the anterior part of the axillary crease to the
      medial part of the inguinal crease.

PMID- 7794033
TI  - [Lymphocytic plasma cell mastitis].
AB  - Plasma cell mastitis is a rare form of inflammatory, non-infectious, non
      neoplastic, mastitis, not occurring during the post-partum and breastfeeding
      period. The pathogenesis of this lesion is not yet fully elucidated and an auto
      immune origin is currently proposed. The common feature of this form of mastitis
      is the possibility of evolving towards recurrent aseptic abscesses. Treatment
      remains difficult and relapses are frequent with fistula formation to the skin,
      either spontaneously, or after surgery, even involving wide excision.

PMID- 7794034
TI  - [Immunohistochemical evaluation of estrogen and progesterone receptors on
      paraffin sections of breast carcinomas. Practical thoughts based on the study of
      368 cases].
AB  - 368 formalin-fixed and paraffin-embedded carcinomas of the breast were studied by
      immunohistochemistry using antibodies to estrogen and progesterone receptors. The
      results, which are comparable to the results published in the literature, are
      discussed with particular emphasis on quality assurance parameters.

PMID- 7794035
TI  - Different concepts of chronic musculoskeletal pain.

PMID- 7794036
TI  - Imaging the swollen joint in the young patient.

PMID- 7794037
TI  - Magnesium whitlockite deposition in articular cartilage: a study of 80 specimens
      from 70 patients.
AB  - OBJECTIVE: To examine articular cartilage from a number of joint sites, using a
      large sample group, for the presence of magnesium whitlockite crystal deposition.
      METHODS: Articular cartilage specimens were taken from a total of 70 patients.
      The majority of specimens were taken from femoral heads, with smaller numbers
      from femoral condyle, tibial plateau, radius, ulna, and several small peripheral
      joints. Normal and osteoarthritic articular cartilage specimens were obtained
      from patients undergoing prosthesis replacement or amputation. Specimens were
      resin embedded and examined using transmission electron microscopy and x ray
      microanalysis. RESULTS: Magnesium whitlockite crystals were identified, on the
      basis of morphology, size and elemental composition, in articular cartilage from
      all sites sampled. The distribution of crystals was similar in all samples
      (restricted to the superficial zone), although the density of deposition was
      extremely variable, with the greatest density observed in femoral head specimens.
      No magnesium whitlockite crystals were observed in osteophytic or epiphysial
      cartilage. CONCLUSIONS: This study demonstrated the widespread extent of
      magnesium whitlockite deposition in human articular cartilage, albeit at much
      lower density than previously reported in femoral head articular cartilage. In
      consideration of possible roles for these crystals in articular cartilage, it is
      concluded that an opportunistic mode of formation, possibly influenced by
      mechanical stresses, would be most plausible.

PMID- 7794038
TI  - Identification and functional importance of plasma kallikrein in the synovial
      fluids of patients with rheumatoid, psoriatic, and osteoarthritis.
AB  - OBJECTIVES: To determine and identify, unequivocally, if plasma kallikrein (PK)
      is present in the synovial fluid of patients with rheumatoid (RA), psoriatic (PA)
      and osteo (OA) arthritis, and to consider its functional importance in the
      inflamed joint. METHODS: Therapeutically aspirated synovial fluids (pooled and
      individual samples, n = 66) were obtained from patients with arthritis. In
      addition, serum (n = 14) was collected from RA patients, and saliva (n = 10) and
      urine (n = 10) from normal individuals. Enzymic (amidase) and immunoreactive
      activities of PK and its precursor, prokallikrein (PPK), were determined. The
      presence of PK was assessed by incubation with soya bean trypsin inhibitor
      (SBTI), and by adsorption with anti-PK antibody linked to Sepharose. An enzyme
      linked immunosorbant assay (ELISA) for PK was developed for quantitative
      measurement of total PK in biological fluids. Enhancement of the PK dose-response
      by RA synovial fluid made it necessary to remove RF from synovial fluids before
      determination of PK by ELISA. RESULTS: Amidase activity was demonstrated in
      synovial fluid pools and shown to be inhibited completely by SBTI, and removed by
      prior treatment with anti-PK Sepharose. Total PK activity (PK + PPK) from
      individual synovial fluid specimens did not differ significantly between patients
      with RA (median activity 76 mU/g protein), PA (80 mU/g protein) or OA (60 mU/g
      protein). Similar results were obtained when active PK alone was measured. No
      correlation was found between active PK or total PK values and the severity score
      for individual joints. Most of the measured immunoreactivity was removed by
      adsorption with anti-PK antibody linked to Sepharose. CONCLUSION: The results
      support the hypothesis that plasma kallikrein is present in synovial fluid. The
      enzyme may be important in the pathogenesis of inflamed joints.

PMID- 7794041
TI  - Endothelin-1 release from cultured endothelial cells induced by sera from
      patients with systemic lupus erythematosus.
AB  - OBJECTIVES: To clarify the pathophysiological role of endothelin-1 (ET-1) in the
      vascular injury associated with systemic lupus erythematosus (SLE) by
      investigating the effect of sera from patients with SLE on ET-1 release from
      cultured human umbilical vein endothelial cells. METHODS: Confluent monolayers of
      cultured human umbilical vein endothelial cells were incubated with serum samples
      (diluted 1:10) from 25 patients with SLE and 16 normal controls for two hours at
      37 degrees C and ET-1 concentration in the culture supernatant was measured by
      enzyme immunoassay. RESULTS: The mean release of ET-1 from endothelial cells in
      the presence of serum from SLE patients was greater than in the presence of serum
      from normal controls (p < 0.005). ET-1 release from endothelial cells
      significantly correlated with the titre of IgM anti-endothelial cell antibodies
      (IgM-AECA) and immune complex concentration in sera from SLE patients (p < 0.05
      and p < 0.01, respectively). After gel chromatography of the serum from an SLE
      patient, those fractions containing IgM-AECA or immune complex were shown to
      stimulate ET-1 release from endothelial cells. Heat aggregated IgG also
      stimulated ET-1 release from endothelial cells in a concentration dependent
      manner. CONCLUSIONS: IgM-AECA and immune complexes may stimulate ET-1 release
      from endothelial cells and ET-1 may play an important role in the initiation and
      development of vascular injury, such as pulmonary hypertension and lupus
      nephritis, in SLE.

PMID- 7794042
TI  - Role of TNF alpha in the induction of antigen induced arthritis in the rabbit and
      the anti-arthritic effect of species specific TNF alpha neutralising monoclonal
      antibodies.
AB  - OBJECTIVE: To investigate the role of tumour necrosis factor alpha (TNF alpha) in
      the development of antigen induced arthritis (AIA) in rabbits. METHODS:
      Monoclonal antibodies to rabbit TNF alpha were developed in rats and were used to
      detect TNF alpha in synovial fluid by enzyme linked immunosorbent assay and to
      localise it in tissue sections of synovium and cartilage from rabbits up to 21
      days after induction of AIA. An antibody which neutralised TNF alpha activity in
      vitro was injected into rabbits to block TNF alpha action in vivo in AIA. Joint
      swelling, leucocyte infiltration into synovium and proteoglycan loss from
      cartilage were measured and compared with a control group, which were injected
      with sterile saline. RESULTS: Monoclonal antibodies to purified rabbit TNF alpha
      were prepared in rats and two were selected which were able to neutralise rabbit
      TNF alpha in a cytotoxicity bioassay. TNF alpha was detected in significant
      concentrations (21.7 (SE 0.5) pg/ml) in the arthritic joint fluid of rabbits with
      AIA only at one day after induction and it was then also sparsely localised in
      cells of the synovium, but from day 3 onwards it was localised more strongly in
      the deep zone of articular cartilage. Injection of anti-TNF monoclonal antibody
      R6 over three days into rabbits with AIA reduced joint swelling and leucocyte
      infiltration into joint fluid and decreased the expression of CD11b and CD18 on
      cells in the joint fluid. However, there was no significant reduction in the loss
      of proteoglycan from articular cartilage, although the joint fluid at three days
      contained a lower glycosaminoglycan content. The antibody R6 gave most effect at
      a dose of 0.6 mg/kg and there was no increase in its effectiveness at a fivefold
      greater dose (3.0 mg/kg). Treatment over 10 days gave a more complete suppression
      of joint swelling, but did not result in any less proteoglycan loss from
      cartilage. Treatment for five days with a 16 day follow up gave a significant
      reduction in swelling for several days beyond the treatment, but the swelling
      then slowly returned, until by day 21 there was no significant difference in
      joint swelling and there was also no recovery of cartilage proteoglycan content.
      A rabbit anti-rat immunoglobulin response was detected at 21 days, which may have
      limited the long term effectiveness of the antibody. CONCLUSIONS: In AIA in
      rabbits, TNF alpha was only detected in synovial fluid at one day after induction
      and there was only limited cellular localisation of TNF alpha in synovium and
      cartilage from three days. However, neutralising TNF alpha with a monoclonal
      antibody was effective in suppressing inflammatory changes in the joint during
      the acute onset of AIA, but it had little effect on the loss of proteoglycan from
      cartilage. The results suggest that blocking inflammation and synovitis with anti
      TNF alpha may be more easily achieved than preventing damage to articular
      cartilage.

PMID- 7794039
TI  - Apolipoprotein E phenotypes in patients with gout: relation with
      hypertriglyceridaemia.
AB  - OBJECTIVE: To elucidate the relationship, if any, between lipid abnormalities and
      apolipoprotein E (apo E) polymorphism, by investigating apo E phenotype and
      allele frequency. METHODS: Fasting blood samples were taken for determination of
      apo E phenotype and serum lipids in 221 male patients with gout and 141 control
      male subjects. Apo E phenotype was determined by one dimensional flat gel
      isoelectric focusing. RESULTS: Frequencies of apo E phenotypes in gout were apo
      E3/3 67.9%, E4/3 18.1%, E4/4 2.3%, E4/2 1.8%, E3/2 9.5%, and E2/2 0.5%; those in
      control male subjects were 74.5%, 15.6%, 0%, 1.4%, 7.1%, and 1.4%, respectively.
      Frequencies of the e2, e3, and e4 alleles in gout were 0.061, 0.817 and 0.122,
      compared with the corresponding control frequencies of 0.057, 0.858 and 0.085.
      These differences in apo E phenotype and allele frequencies between gout and
      control subjects were not significant. The frequency of apo e4 allele in
      hyperlipidaemic gout subjects was significantly greater than that in
      normolipidaemic gout subjects; in contrast, its frequency was not different
      between hyperlipidaemic and normolipidaemic control subjects. Serum triglyceride,
      total cholesterol, apo B and E concentrations were significantly greater in gouty
      patients with the apo E4/3 phenotype than in those with gout having the apo E3/3
      phenotype. CONCLUSIONS: These data suggest that gout subjects with
      hyperlipidaemia (hypertriglyceridaemia, hypercholesterolaemia or both) possess
      the apo e4 allele with higher frequency than those with normolipidaemia. They
      also suggest that apo e4 may induce some susceptibility to the development of
      hyperlipidaemia in gout in addition to that induced by obesity or excessive
      alcohol consumption, and may contribute to the high prevalence of atherosclerotic
      diseases in gout patients.

PMID- 7794040
TI  - Novel 68 kDa autoantigen detected by rheumatoid arthritis specific antibodies.
AB  - OBJECTIVE: To improve the understanding of the pathogenesis of rheumatoid
      arthritis (RA) by identifying novel, disease specific autoantibodies. METHODS:
      Total protein preparations from synovial membranes were separated
      electrophoretically and immunoblotted. Sera from RA patients were screened for
      predominant immunoreactions by blotting. A 68 kDa antigen target of the most
      predominant reaction was detected and further characterised. RESULTS: The
      dominant immunoreaction in most of the RA sera tested was with a 68 kDa antigen.
      The antigen is probably ubiquitously expressed. It has an isoelectric point of
      5.1, is O-glycosylated, and is located in the endoplasmic reticulum, the
      cytoplasm, or both. Antibodies to the 68 kDa autoantigen were present in 64% of
      167 RA patients tested, and could also be detected in seronegative RA patients,
      but were present in only 1% of 98 patients with other rheumatic diseases. They
      could not be detected in 55 healthy controls. CONCLUSIONS: Because of its high
      sensitivity (64%) and specificity (99%), the anti-68 kDa autoantibody not only
      provides another valuable parameter for diagnosis, but also represents an
      antibody that may be involved in the pathological mechanisms leading to RA. This
      hypothesis can be tested by investigating if 68 kDa specific T cells are present
      in RA patients.

PMID- 7794043
TI  - Vertebral hyperostosis and diabetes mellitus: a case-control study.
AB  - OBJECTIVE: To compare glucose metabolism in patients with vertebral hyperostosis
      (VH), with that in control patients. METHODS: We studied 50 patients aged 60
      years or more who had VH according to Resnick's criteria, and 50 control patients
      without VH, matched for sex, age, weight and height. Plasma glucose was evaluated
      before and 120 minutes after ingestion of 75 g glucose. World Health Organisation
      criteria for diabetes mellitus (DM) were used. Radiographs of the pelvis and
      thoracic and lumbar spine were performed and read blind by two physicians.
      RESULTS: Statistical analysis showed no difference between cases and control
      patients for prevalence of DM, and plasma glucose at 0 and 120 minutes.
      CONCLUSION: These data suggest that glucoregulation in patients with VH does not
      differ from that in matched controls.

PMID- 7794045
TI  - Long term treatment of rheumatoid arthritis with high doses of intravenous
      immunoglobulins: effects on disease activity and serum cytokines.
AB  - OBJECTIVE: To evaluate the effects of long term treatment of rheumatoid arthritis
      (RA) with high doses of intravenous immunoglobulins (IVIg). METHODS: Ten patients
      with active RA and prior unsuccessful treatment with at least one slow acting
      antirheumatic drug were treated with 400 mg/kg of IVIg for the first three days
      and then once a month for 12 months. Clinical evaluation and laboratory analysis
      were performed every month. Serum levels of tumour necrosis factor alpha (TNF
      alpha), soluble interleukin-2 receptor (sIL-2R), IL-1 alpha, IL-1 beta, IL-6 and
      interferon gamma (IFN gamma) were measured at baseline and at three monthly
      intervals for 15 months. RESULTS: Although laboratory parameters were not
      influenced by the treatment, a late but significant clinical improvement was
      observed after six months. Serial measurement of cytokines revealed a rapid and
      persistent decrease in serum TNF alpha and a late and significant reduction in
      sIL-2R concentrations. CONCLUSION: This study suggests that IVIg can ameliorate
      the symptoms and improve the functional capability of RA patients. This effect is
      associated with a partial modulation of serum concentrations of inflammatory
      cytokines and, more interestingly, with a late decrease in sIL-2R which
      correlated with the late reduction in disease activity.

PMID- 7794044
TI  - Intra-articular triamcinolone hexacetonide in knee osteoarthritis: factors
      influencing the clinical response.
AB  - OBJECTIVE: To assess the efficacy of a single intra-articular injection of
      triamcinolone hexacetonide (THA) in knee osteoarthritis (OA) and examine factors
      which may relate to treatment efficacy. METHODS: Eighty four patients with
      clinical and radiographic evidence of knee OA were recruited and randomly
      allocated to receive either THA (20 mg in 1 ml) or placebo (0.9% normal saline, 1
      ml). Follow up assessments evaluated the following outcome variables: patient
      opinion of overall change in the treated knee, visual analogue pain score (VAS),
      distance walked in one minute (WD), and Health Assessment Questionnaire modified
      for lower limb function (HAQ). RESULTS: Seventy eight percent of THA and 49% of
      placebo treated patients reported overall improvement at week 1 (p < 0.05). At
      week 6, improvement was reported in 57% and 55% of patient groups, respectively.
      VAS improved in both groups at week 1 (THA, p < 0.001; placebo, p < 0.05) and
      week 6 (both p < 0.01). Improvement in VAS was significantly greater among THA
      treated patients at week 1 only (p < 0.01). Subgroup analysis of THA treated
      patients revealed greater improvement in VAS among patients with clinical
      evidence of an effusion (p < 0.05), and those who had synovial fluid successfully
      aspirated at the time of injection (p < 0.01). WD improved in THA treated
      patients at week 1 (p < 0.001), and in both groups at week 6 (THA, p < 0.001;
      placebo, p < 0.01). Improvements in HAQ were seen in THA patients only at weeks 1
      and 6 (p < 0.05). Regression analysis did not identify any additional clinical,
      radiographic, or synovial fluid characteristics which influenced the response.
      CONCLUSIONS: THA provided short term pain relief in knee OA. Increased benefit
      was associated with both clinical evidence of joint effusion and successful
      aspiration of synovial fluid at the time of injection.

PMID- 7794046
TI  - TAP polymorphism in patients with Behcet's disease.
AB  - OBJECTIVE: To determine if susceptibility to Behcet's disease (BD) is associated
      with polymorphism of HLA-DRB1, HLA-DQB1, DQB1, and TAP1 and TAP2 genes. METHODS:
      Fifty eight Spanish BD patients and 116 ethnically matched unrelated healthy
      subjects were typed at the HLA-DRB1 and HLA-DQB1 loci using polymerase chain
      reaction/sequence specific oligotyping (PCR/SSO). TAP1 and TAP2 alleles were
      assigned using amplification refractory mutation system-PCR. RESULTS: TAP1C was
      absent in BD patients, but was found in 12.1% of control subjects (pcorr < 0.05;
      relative risk = 0.06). Additionally, a linkage disequilibrium between HLA
      DQB1*0501 and TAP2B was observed in BD patients (delta = 0.095, pcorr < 0.02),
      but not in the control group (delta = -0.0031, p > 0.05). CONCLUSIONS: The
      complete absence of TAP1C alleles in BD patients may indicate that TAP1
      polymorphism is not without some significance in the development of BD.
      Furthermore, the existence of a linkage disequilibrium between HLA-DQB1*0501 and
      TAP2B in our patients suggests that the gene conferring susceptibility for BD is
      inherited as an extended haplotype in the population studied.

PMID- 7794047
TI  - Second international meeting on synovium. Cell biology, physiology and pathology.
      21-23 September, Canterbury, United Kingdom.

PMID- 7794048
TI  - Synovial macrophages.

PMID- 7794049
TI  - Synovial intimal fibroblasts.

PMID- 7794050
TI  - Extracellular matrix of the synovial intimal cell layer.

PMID- 7794051
TI  - Synovial hyaluronate in rheumatoid arthritis binds C1q and is covalently bound to
      antibodies: a model for chronicity.

PMID- 7794052
TI  - Interaction between synoviocytes and extracellular matrix in vitro.

PMID- 7794054
TI  - Synovial perfusion and synovial fluid solutes.

PMID- 7794055
TI  - Functions of hyaluronan.

PMID- 7794053
TI  - Fluid movement across synovium in healthy joints: role of synovial fluid
      macromolecules.

PMID- 7794056
TI  - Effect of synovial fluid hyaluronan on the clearance of albumin from the canine
      knee.

PMID- 7794057
TI  - Effect of long term intramuscular gold therapy on the seroprevalence of
      Helicobacter pylori in patients with early rheumatoid arthritis.

PMID- 7794058
TI  - Vertebral fracture induced by chronic contained rupture of aortic aneurysm.

PMID- 7794059
TI  - [Eugene Jamot and Emile Lejeune. Historical pages].

PMID- 7794060
TI  - Malaria vector control: a critical review on chemical methods and insecticides.

PMID- 7794061
TI  - [Plasmodium falciparum index and level of parasitemia: diagnostic and prognostic
      value in the Congo].
AB  - Parasitological data of various malarial studies performed in the Congo where
      Plasmodium falciparum malaria is holo-endemic in rural and suburban zones,
      between 1988 and 1991, were analyzed with the intention of establishing diagnosis
      and prognosis value of Plasmodium falciparum parasitaemia in areas with high
      perennial transmission. In such an area congolese school-children (6-10 years
      old) had 88% P. falciparum index, this is the same percentage as that for
      children hospitalized with a pernicious attack. However, the parasite load is
      distributed differently; parasitaemia is greater than 6,000 asexual form of P.
      falciparum/microliters (afPf/microL) in only 4.6% of cases in the former group
      versus 67% in the second group. A threshold of 10,000 afPf/microliters, above
      which the Plasmodium infection triggers a febrile attack in semi-immune children,
      is confirmed in school children in a rural context where the factor of taking
      antimalarial drugs within the preceding days is negligible; three out of four
      children with levels above this threshold are febrile versus 4.1% (7 out of 170)
      with lower blood parasite levels. Some adults were also asymptomatic carriers but
      much less frequently and with lower mean parasitaemia levels. The parasite load
      mirrors the clinical severity although this concept can be misleading as an
      individual prognostic criterion and for hospital studies carried out in areas
      where multiple drug administration before hospitalisation is common. For the
      studies recently performed in Brazzaville, the 5% threshold level of parasitized
      red cells, the WHO severity criterion, was never reached in asymptomatic subject
      or in cases of simple attack; it was reached in one out of two cases of
      pernicious attack.

PMID- 7794062
TI  - Malaria vectors and transmission in an area deforested for a new international
      airport in southern Cameroon.
AB  - Nsimalen, a village in Southern Cameroon, has been deforested over a surface of
      370 hectares for the construction of the new Yaounde international airport
      (Cameroon). Mosquitoes night catches on human bait were performed over a year in
      two hamlets of this village, one adjoining the airport and the other situated 3
      kilometers off the deforested area. The aim of the survey was to observe malaria
      vectors and transmission around the airport and to record malaria epidemiological
      changes resulting from deforestation. The findings showed that the main malaria
      vector was Anopheles moucheti (95% of the vector population). Anopheles gambiae
      was also present but in very small quantities. The increased density of the
      latter near the airport combined with the low parity rates, indicated that
      deforestation favoured the breeding of this species. Malaria transmission was
      estimated at 106 and 68 infective bites per man per year in hamlets close to and
      far away from the airport zone respectively. An. gambiae accounted for 13% of the
      transmission in the hamlet adjoining the airport and 0% three kilometers off the
      airport.

PMID- 7794063
TI  - An etiologic study of hemoglobinuria and blackwater fever in the Kivu Mountains,
      Zaire.
AB  - Between January 1985 and March 1986, in the high altitude area of Kivu, Eastern
      Zaire, 38 patients presenting with hemoglobinuria as main manifestation were
      investigated. Profound glucose-6-phosphate dehydrogenase deficiency was detected
      in 4 patients, leptospirosis in 2 and Hantaan virus infection in 2. Hemolysis was
      doubtful (haptoglobin > 40 mg/dl, Hemoglobin > 12 g/dl) in 2 patients. Other
      potential causes of hemoglobinuria such as hemoglobinopathy, toxic agents,
      infectious diseases or blood transfusion incompatibility were carefully screened
      and excluded. The syndrome observed in the remaining 28 cases was strongly
      suggestive of blackwater fever (BWF) as described in malaria patients by several
      authors under the french name "fievre bilieuse hemoglobinurique". Quinine was
      used as curative treatment of malaria before admission in a significant greater
      proportion (p < 0.01) of patients with BWF compared to patients with
      uncomplicated malaria, suggesting that this drug might have played a triggering
      role in the genesis of BWF. However, quinine was usually administered at
      inadequate doses to malaria patients non responding to chloroquine and belonging
      to a population of whom 50% are non immune. It may thus also be hypothesized that
      BWF in our patients could result from a hyperparasitemic state that remained
      undetected because of an unusual synchronous lysis of infected erythrocytes. In
      the latter case BWF would correspond to a major complication of falciparum
      malaria only coincidentally related to the use of quinine.

PMID- 7794064
TI  - Alternative application of melarsoprol for treatment of T. B. gambiense sleeping
      sickness. Preliminary results.
AB  - The protocols for treatment of human African trypanosomiasis (sleeping sickness)
      with the organoarsenical drug melarsoprol are based on empirical observations.
      Therapy is often accompanied by serious side effects and relapses. Additionally,
      the duration of treatment, which is up to forty days, is a major drawback in
      African countries. Based on pharmacokinetic investigations an alternative therapy
      protocol for T. gambiense sleeping sickness has recently been proposed which
      consists of ten consecutive injections of 2.2 mg/kg melarsoprol given at
      intervals of 24 hours. In a preliminary study, eleven patients were treated in
      Vanga, Zaire following this alternative protocol which reduces the duration of
      the treatment to ten days. The results indicate that the alternative schedule was
      as effective as the traditional protocol, showed similar adverse reactions but
      required a much shorter treatment period.

PMID- 7794065
TI  - Combined chloroquine and primaquine resistant Plasmodium vivax malaria in a
      patient returning from India.

PMID- 7794066
TI  - Results of pancreas transplantation with portal venous and enteric drainage.
AB  - PURPOSE: The standard method for pancreatic transplantation involves drainage of
      exocrine secretions into the urinary bladder with venous outflow into the
      systemic circulation. Despite the high success rate associated with this
      approach, it often leads to complications, including chemical cystitis, reflux
      pancreatitis, metabolic acidosis, and hyperinsulinemia. The authors developed a
      new technique of pancreatic transplantation with portal drainage of endocrine
      secretions and enteric drainage of exocrine secretions (PE), which theoretically
      should be more physiologic. PROCEDURES: All patients were insulin-dependent
      diabetics with end-stage renal disease who underwent combined kidney-pancreas
      transplantation. Between 1990 and 1994, 19 patients have been transplanted using
      intraperitoneal placement of the pancreas allograft with exocrine drainage into a
      Roux-en Y loop and venous drainage into the portal circulations (PE). A
      comparison group of all patients undergoing standard systemic-bladder (SB)
      transplantation between April 1989 and March 1993 (n = 28) also was studied.
      Patient follow-up ranges from 6 months to 5 years for the SB patients (mean = 2.5
      years) and 6 months to 4 years for the PE patients (mean = 1.6 years). Routine
      follow-up includes documentation of the clinical course and detailed endocrine
      studies. FINDINGS: Patient and graft actuarial survival at 1 and 3 years is no
      different for SB and PE patients. Urinary tract infections occurred in 89.3% of
      the SB patients (2.8/patient) versus 26.3% of the PE patients (0.25/patient, p <
      or = 0.0001). None of the PE patients experienced hematuria compared with 53.6%
      of the SB patients (p < or = 0.0001); however, two PE patients had melanotic
      episodes. The incidence of urinary retention and reflux pancreatitis was 32.1%
      versus 5.3% (p < or = 0.028) for SB and PE groups, respectively. Patients in the
      SB group required sodium bicarbonate therapy (mean = 55 mEq/day) although no PE
      patient required routine therapy; despite this, SB patients experienced more
      episodes of acidosis (44 vs. 5). Endocrine studies indicate no difference in
      glycosylated hemoglobin or fasting and stimulated glucose values throughout the
      follow-up period. In contrast, hyperinsulinemia was evident in both fasting and
      stimulated tests for the SB patients, with values consistently two- to fivefold
      higher than those of the PE group. CONCLUSIONS: These results indicate that PE
      and SB pancreas transplantation are equivalent in terms of patient and graft
      survival and suggest that the PE approach is associated with a decreased
      incidence of metabolic and bladder-related complications. In addition, the PE
      approach eliminates the state of peripheral hyperinsulinemia that characterizes
      the SB procedure. Continued follow-up will be necessary to determine if long-term
      outcomes will differ for patients with PE and SB grafts.

PMID- 7794067
TI  - Decreased mortality of severe acute pancreatitis after proximal cytokine
      blockade.
AB  - OBJECTIVE: This study determined the ability of interleukin-1 receptor antagonist
      (IL-1ra) to decrease the mortality of experimental acute pancreatitis. The
      response of the inflammatory cytokine cascade and its subsequent effects on
      pancreatic morphology were measured to determine the role of these peptides in
      mediating pancreatic injury. SUMMARY BACKGROUND DATA: Previous studies have shown
      that proinflammatory cytokines are produced in large amounts during acute
      pancreatitis and that blockade at the level of the IL-1 receptor significantly
      decreases intrinsic pancreatic damage. The subsequent effect on survival is not
      known. METHODS: A lethal form of acute hemorrhagic necrotizing pancreatitis was
      induced in young female mice by feeding a choline-deficient, ethionine
      supplemented (CDE) diet for 72 hours. For determination of mortality, the animals
      were divided into 3 groups of 45 animals each: control subjects received
      100/microL normal saline intraperitoneally every 6 hours for 5 days; IL-1ra early
      mice received recombinant interleukin-1 receptor antagonist 15 mg/kg
      intraperitoneally every 6 hours for 5 days beginning at time 0; IL-1ra late mice
      received IL-1ra 15 mg/kg intraperitoneally every 6 hours for 3.5 days beginning
      1.5 days after introduction of the CDE diet. A parallel experiment was conducted
      simultaneously with a minimum of 29 animals per group, which were sacrificed
      daily for comparisons of serum amylase, lipase, IL-1, IL-6, tumor necrosis factor
      alpha, IL-1ra, pancreatic wet weight, and blind histopathologic grading. RESULTS:
      The 10-day mortality in the untreated control group was 73%. Early and late IL
      1ra administration resulted in decreases of mortality to 44% and 51%,
      respectively (both p < 0.001). Interleukin-1 antagonism also was associated with
      a significant attenuation in the rise in pancreatic wet weight and serum amylase
      and lipase in both early and late IL-1ra groups (all p < 0.05). All control
      animals developed a rapid elevation of the inflammatory cytokines, with maximal
      levels reached on day 3. The IL-1ra-treated animals, however, demonstrated a
      blunted rise of these mediators (all p < 0.05). Blind histologic grading revealed
      an overall decrease in the severity of pancreatitis in those animals receiving
      the antagonist. CONCLUSIONS: Early or late blockade of the cytokine cascade at
      the level of the IL-1 receptor significantly decreases the mortality of severe
      acute pancreatitis. The mechanism by which this is accomplished appears to
      include attenuation of systemic inflammatory cytokines and decreased pancreatic
      destruction.

PMID- 7794068
TI  - Optimal management of the pancreatic remnant after pancreaticoduodenectomy.
AB  - OBJECTIVE: The authors evaluated methods of operative management of the
      pancreatic remnant after pancreaticoduodenectomy. SUMMARY BACKGROUND DATA:
      Despite reductions in mortality after pancreaticoduodenectomy, leakage from the
      pancreatic remnant still may cause significant morbidity. Patients with small,
      unobstructed pancreatic ducts or soft, friable pancreata are at particularly high
      risk. Although numerous surgical techniques have been described to avoid such
      complications, no single method is suitable for all patients. METHODS: The
      authors retrospectively reviewed the medical records of 114 consecutive patients
      who underwent pancreaticoduodenectomy. Sixty-nine patients were men (61%) and 45
      were women (39%), with median age 66 years. Underlying disease was malignant in
      87 (76%) and benign in 27 (24%). Patients were divided into groups based on risk
      for postoperative pancreatic fistula and on the operative management of the
      pancreatic remnant. Sixty-eight patients underwent end-to-side
      pancreaticojejunostomy, 13 of whom were high risk (group 1A) and 55 of whom were
      low risk (group 1B). Thirty-seven patients, all high risk, had either pancreatic
      duct closure by oversewing (N = 19, group 2) or end-to-end pancreaticojejunal
      invagination (N = 18, group 3). Nine patients underwent total pancreatectomy
      (group 4). Morbidity related to prolonged pancreatic drainage (PPD) of greater
      than 20 days was determined. RESULTS: Overall incidence of PPD was 17% and caused
      the only death. Patients considered high risk for postoperative pancreatic
      fistula had a 36% incidence of PPD compared with 2% in patients considered low
      risk (p < 0.0001). Prolonged pancreatic drainage frequency related to the method
      of pancreatic remnant management was as follows: group 1A, 15%; group 1B, 2%;
      group 2, 79%; and group 3, 6% (p < 0.001 for group 2 vs. other groups). No
      serious sequelae followed PPD in 15 patients (79%); however, 4 patients required
      reoperation for pseudocyst or abscess drainage; one in group 1A (who died) and
      three in group 2. Multivariate analysis revealed that operative technique
      (oversewing of the pancreatic duct) and male sex were significant factors
      predisposing a patient to the development of PPD. CONCLUSION: After
      pancreaticoduodenectomy, pancreatic remnant management by end-to-side
      pancreaticojejunostomy appeared safe in low-risk patients. In high-risk patients,
      end-to-end pancreaticojejunal invagination was the safest option. Morbidity was
      greatest after pancreatic duct closure without anastomosis.

PMID- 7794070
TI  - Treatment of hyperesthetic neuropathic pain in diabetics. Decompression of the
      tarsal tunnel.
AB  - OBJECTIVE: The authors evaluated the causal relationship between entrapment of
      the posterior tibial nerve and neuropathic pain and describe the results of nerve
      decompression in a selected group of patients with intractable pain. SUMMARY
      BACKGROUND DATA: Painful metabolic neuropathy has, until recently, been thought
      to be an irreversible and essentially untreatable complication of diabetes.
      Recent studies have shown that metabolic deterioration is only one component of
      the disease process. METHODS: A group of patients with intractable painful
      neuropathy and a positive percussion sign underwent posterior tibial nerve
      decompression. RESULTS: Nerve decompression relieved the pain in the majority of
      treated patients. Return of other sensory function also was noted. CONCLUSIONS:
      Painful diabetic neuropathy of the lower extremities is potentially reversible.
      It appears to be caused partially by nerve entrapment and can be reversed by
      decompression.

PMID- 7794069
TI  - Characterization of growth hormone enhanced donor site healing in patients with
      large cutaneous burns.
AB  - BACKGROUND: Human growth hormone is an anabolic agent that attenuates injury
      induced catabolism and stimulates protein synthesis. Recombinant human growth
      hormone (rhGH) administered therapeutically to patients with massive burns has
      been shown to increase the rate of skin graft donor site healing. It has been
      postulated that growth hormone affects wound healing and tissue repair by
      stimulating the production of insulin-like growth factor-1 (IGF-1) by the liver
      to increase circulating IGF-1 concentrations. The mechanism by which it improves
      wound healing, however, remains in question. The authors hypothesize that rhGH up
      regulates IGF-1 receptors and IGF-1 levels both systemically and locally in the
      wound site to stimulate cell mitosis and increase synthesis of laminin, collagen
      types IV and VII, and cytokeratin. This hypothesis was tested in nine patients
      with burns covering > 40% of total body surface area. OBJECTIVE: The authors
      assessed the efficacy of rhGH in promoting several major building materials in
      the donor site of patients with massive burns. METHODS: Ten massively burned
      patients with full-thickness burns covering more than 40% of total body surface
      area were participants in a placebo-controlled prospective study to determine the
      efficacy of 0.2 mg/kg/day rhGH on donor site wound healing and to identify some
      of the major components involved in wound healing and its integrity. RESULTS:
      Donor sites in burn patients receiving rhGH showed an increased coverage by the
      basal lamina of 26% for placebo to 68% coverage of the dermal-epidermal junction.
      Insulin-like growth factor-1 receptors and laminin, types IV and VII collagen,
      and cytokeratin-14 all increased significantly. Healing times of the donor sites
      were significantly decreased compared with patients receiving placebo.
      CONCLUSION: Results indicate that growth hormone or its secondary mediators may
      directly stimulate the cells of the epidermis and dermis during wound healing to
      produce the structural proteins and other components needed to rebuild the
      junctional structures.

PMID- 7794071
TI  - Mechanisms of transplant right ventricular dysfunction.
AB  - OBJECTIVE: Right ventricular (RV) dysfunction remains the leading cause of early
      mortality after cardiac transplantation. The effect of brain death and subsequent
      hypothermic cardioplegic arrest and storage on subsequent post-transplant right
      ventricular function was examined. SUMMARY BACKGROUND DATA: Right ventricular
      dysfunction in the donor heart usually is attributed to failure of the donor
      right ventricle to adapt to the sudden increase in afterload (pulmonary vascular
      resistance) in the recipient. Strategies to improve ventricular mechanics in the
      postoperative period are aimed at reducing pulmonary vascular resistance with
      vasodilators or augmenting right ventricular contractility with inotropic agents.
      Events occurring in the donor heart (brain death, hypothermic cardioplegic
      arrest, and storage) also may be directly related to post-transplant RV
      dysfunction. METHODS: A canine model of brain death and orthotopic cardiac
      transplantation was used. A dynamic pressure-volume analysis of RV mechanics was
      performed using micromanometers and sonomicrometric dimension transducers.
      Systolic function was assessed by measurement of preload recruitable stroke work
      (PRSW). Brain death was induced in 17 dogs by inflation of an intracranial
      balloon. Right ventricular function then was assessed serially to 6 hours (PRSW).
      Right ventricular adrenergic beta receptor density and function was sampled at
      control and after 6 hours of brain death. The effect of cardioplegic arrest and
      hypothermic storage was assessed in a second group of 17 dogs, using the same
      instrumentation and method of RV analysis. RESULTS: A significant decrease in
      right ventricular PRSW occurred after brain death, with the average decrease
      being 37% +/- 10.4% from the control. The RV myocardial beta adrenergic receptor
      density did not significantly change (253 +/- 34 fmol/ng control vs. 336 +/- 54
      fmol/ng after brain death). The adenylyl cyclase activity of the RV beta receptor
      was assessed and was not altered by brain death. Orthotopic transplantation after
      cardioplegic arrest and hypothermic storage significantly decreased RV PRSW from
      23.6 +/- 2.0 x 10(3) erg to 13.5 +/- 1.4 x 10(3) erg. CONCLUSIONS: These data
      indicate that the donor right ventricle is exposed to factors significantly
      detrimental to its mechanical performance well before facing an increased
      afterload in the recipient. Strategies to reduce RV dysfunction associated with
      brain death and hypothermic storage could positively impact post-transplant
      survival.

PMID- 7794072
TI  - The significance of c-erb B-2 and p53 immunoreactivity in patients with
      adenocarcinoma of the esophagus.
AB  - OBJECTIVE: Studies in breast cancer suggest that p53 and c-erb B2 protein
      overexpression are predictive of outcome. The authors determined whether these
      molecular markers correlated with treatment response and survival in patients
      with adenocarcinoma of the esophagus and esophagogastric junction. METHOD:
      Immunostaining for p53 and c-erb B2 was performed on paraffin-embedded specimens
      from 42 patients with esophageal adenocarcinoma. All patients received
      neoadjuvant chemotherapy (cisplatin and fluorouracil [5-FU] x 3 cycles) and
      irradiation (4500 rads) followed by resection. RESULTS: In this cohort of
      patients, 79% (33/42) were positive for p53, and 43% (18/42) were positive for c
      erb B2. p53 positivity correlated with residual disease in the resection specimen
      but not with disease-free survival. Although c-erb B2 negatively correlated with
      residual disease after resection and a 5-year survival of 10%, c-erb B2
      positivity was associated with a 5-year actuarial survival of 60%. CONCLUSIONS:
      Although p53 protein overexpression is commonly observed in adenocarcinoma of the
      esophagus, its prognostic value appears limited. In contrast, c-erb B2 protein
      expression predicts a favorable response to therapy and improved survival.

PMID- 7794073
TI  - Downstaging of esophageal cancer after preoperative radiation and chemotherapy.
AB  - OBJECTIVE: This retrospective, nonrandomized review evaluates 125 patients with
      esophageal carcinoma (adenocarcinoma and squamous cell) who underwent either
      surgery only or preoperative chemotherapy and/or radiation therapy followed by
      surgery. Major end points were survival and postchemoradiation downstaging.
      METHODS: Forty-four patients underwent radiation therapy of 4500 cGy over 5
      weeks. Fluorouracil and cisplatin were administered on the first and fifth week
      of radiotherapy. Ninety-eight patients underwent "potentially curative"
      resections-transhiatal esophagectomy (70), Lewis esophagogastrectomy (25), and
      left esophagogastrectomy (3). All patients with preoperative adjuvant therapy
      underwent endoscopy and biopsy before surgery. RESULTS: There were no differences
      in overall mortality (5%) or surgical complications in either group. Fourteen of
      44 patients (32%) downstaged to complete pathologic response, with 5-year
      survival of 57%. Fifteen of 44 patients (34%) downstaged to microscopic residual
      tumor, with 1- and 3-year survival of 77% and 31%, respectively. Twenty-eight of
      29 patients in the two downstaged groups were lymph node negative. Overall, 5
      year survival in the adjuvant therapy plus surgery group versus surgery only was
      36% and 11% (p = 0.04). Five-year survival in lymph node-negative adjuvant
      therapy and surgery patients was 49% (p = 0.005). Positive nodes in the surgery
      only group was 48% versus 23% in the adjuvant therapy and surgery group (p =
      0.02). CONCLUSION: Although retrospective and nonrandomized, these results
      suggest that preoperative chemoradiation results in significant clinical and
      pathologic downstaging, increases survival, and may sterilize local and regional
      lymph nodes, accounting for both downstaging and survival statistics.

PMID- 7794074
TI  - Noninvasive diagnosis of mesenteric ischemia using a SQUID magnetometer.
AB  - OBJECTIVE: The authors assessed the ability of a Superconducting Quantum
      Interference Device (SQUID) magnetometer to noninvasively detect mesenteric
      ischemia in a rabbit model. SUMMARY BACKGROUND DATA: Superconducting Quantum
      Interference Device magnetometers have been used to detect magnetic fields
      created by the basic electrical rhythm (BER) and to detect changes in BER of
      exteriorized bowel of anesthetized rabbits during mesenteric ischemia. METHODS:
      The BER of rabbit ileum was noninvasively measured transabdominally using a SQUID
      magnetometer and compared with the electrical activity recorded with surgically
      implanted serosal electrodes before, during, and after snare occlusion of the
      superior mesenteric artery. RESULTS: Transabdominal SQUID recording of BER
      frequency was highly correlated to the measurements obtained with electrodes (R =
      0.91). Basic electrical rhythm frequency decreased from 16.4 +/- 0.8 to 8.3 +/-
      0.3 cpm (p < 0.001) after 25 minutes of ischemia. Reperfusion of ischemic bowel
      resulted in recovery of BER frequency to 14.3 +/- 0.4 cpm 10 minutes after blood
      flow was restored. CONCLUSIONS: A SQUID magnetometer is capable of noninvasively
      detecting mesenteric ischemia reliably and at an early stage by detecting a
      significant drop in BER frequency. These positive findings have encouraged the
      authors to continue development of clinically useful, noninvasive, detection of
      intestinal magnetic fields using SQUID magnetometers.

PMID- 7794075
TI  - Oncogene protein co-expression. Value of Ha-ras, c-myc, c-fos, and p53 as
      prognostic discriminants for breast carcinoma.
AB  - OBJECTIVE: A refinement of prognostic variables using traditional pathologic
      markers integrated with oncogene proteins, enzymes, and hormonal factors may
      enhance the ability to predict for recurrence or survival in patients with
      mammary carcinoma. Although various oncogenes and oncogene products have been
      identified in human breast carcinoma, their relationship to disease outcome
      remains controversial. METHODS: Using the monoclonal antibodies cS93.1, 9E1.0,
      F235-1.7.1, and PAb 1801 against each oncogene protein studied, the avidin-biotin
      complex immunoperoxidase method provided immunohistochemical staining of bound
      oncogene protein for c-fos, c-myc, Ha-ras, and p53, respectively. Analyses were
      made on archival pathology tissues of 85 breast cancer patients (stages I, IIA,
      and IIB). Forty patients (47%) had recurrence of disease; 45 remained free of
      local-regional or distant disease at mean follow-up of 48 months (range 6-180
      months). Molecular biological data were merged with clinicopathologic
      demographics 1) to determine the frequency of single or co-expression of
      oncogenes in this patient population; 2) to evaluate the value of these molecular
      protein markers to predict probability of recurrence; and 3) to determine worth
      of the studied oncogenes to correlate with traditional clinical pathologic
      parameters and overall survival. RESULTS: In this study, oncogene expression had
      statistical correlation for recurrence with increasing co-expression: one
      oncogene 17.2%, two oncogenes 56.3%, three or four oncogenes, 100% (p = 0.001).
      Increasing oncogene or co-oncogene expression correlated with statistically
      significant reduction in disease-free and overall survival; with no expression of
      oncogenes, disease-free survival was 30 (SE +/- 5.7) months and overall survival
      was 56.4 (SE +/- 4.57) months. With expression of three oncogenes, disease-free
      survival was 12 (SE +/- 1.23) months (p = 0.0018) and overall survival was 23.4
      (SE +/- 3.38) months (p = 0.0025). In univariate Wilcoxon analysis, oncogene
      expression was the most significant variable to determine survival (p = 0.035);
      in multivariate analysis, age and oncogene co-expression each emerged as the most
      significant variables for overall survival. For the proportional hazards
      regression model, oncogene co-expression was significant (p = 0.0104, risk-ratio
      1.914) and correlated with age and tumor size as significant variables. Ha-ras
      and c-fos both emerged as important individual oncogene proteins to affect
      survival (p = 0.0925, risk-ratio 3.517 and p = 0.025, risk-ratio 4.214,
      respectively). The proto-oncogene c-myc and the antitumor suppressor gene p53 did
      not have significant effects as individual oncogenes to influence survival.
      CONCLUSIONS: Approximately one fifth of the breast cancer patients in this
      analysis (disease-free and recurrent) expressed only a single oncogene marker (c
      fos, c-myc, Ha-ras, or p53); one quarter of patients with recurrent disease
      expressed only one oncogene protein. Single oncogene expression did not possess
      independent prognostic significance for prediction of recurrence. Further, p53
      mutations did not function as independent correlates for prognosis. The co
      expression of the studied proto-oncogenes (c-myc, Ha-ras) and the nuclear
      transcriptional protein (c-fos) functioned as a strong prognostic correlate for
      recurrence and survival; the effect of individual oncogenes to predict survival
      was greatest for Ha-ras and c-fos. Immediate or early co-expression of three
      oncogene proteins in neoplastic transformation endowed cells of invasive
      carcinoma with an aggressive phenotype. This aggressive phenotype was evident in
      a small percentage of the studied population (11%) and predicted adverse disease
      free and overall survival. These findings suggest that oncogene co-expression
      possesses significant prognostic and potential therapeutic value; incorporation
      of this molecular technology into future prospective randomized trials is
      advisable.

PMID- 7794077
TI  - Adjuvant chemotherapy improves survival after liver transplantation for
      hepatocellular carcinoma.
AB  - OBJECTIVE: The aim of this study was to evaluate the effect of postoperative
      adjuvant chemotherapy on the recurrence rate and survival of patients after
      orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC).
      SUMMARY BACKGROUND DATA: Historically, liver transplantation for HCC has yielded
      poor long-term survival. Multimodality therapy has been initiated in an effort to
      improve survival statistics. METHODS: Twenty-five patients were placed on 6
      months of intravenous fluorouracil, doxorubicin, and cisplatin after OLT. Risk
      factors, recurrence rates, and survival rates were analyzed and compared with
      historic controls. RESULTS: Overall long-term survival in the protocol patients
      was 46% at 3 years, improved over our historic controls of 5.8% at 3 years (p =
      0.0001). Overall recurrence rate was 20% (n = 4). Possible risk factors, such as
      tumor size, vascular invasion, multifocality, capsular invasion, and tumor
      differentiation, were not found to be significantly predictive of survival. Three
      patients with long-term, disease-free survival had tumors > 5 cm. Side effects
      from chemotherapy were common, but rarely severe. CONCLUSIONS: This study
      suggests that adjuvant chemotherapy after transplantation for HCC can provide
      long-term cure and may improve survival, even in patients with stage III and IV
      disease.

PMID- 7794076
TI  - Pancreaticoduodenectomy for cancer of the head of the pancreas. 201 patients.
AB  - OBJECTIVE: This single-institution study examined the outcome after
      pancreaticoduodenectomy in patients with adenocarcinoma of the head of the
      pancreas. SUMMARY OF BACKGROUND DATA: In recent years, pancreaticoduodenectomy
      for adenocarcinoma of the head of the pancreas has been associated with decreased
      morbidity and mortality and, in some centers, 5-year survival rates in excess of
      20%. METHODS: Two hundred one patients with pathologically verified
      adenocarcinoma of the head of the pancreas undergoing pancreaticoduodenectomy at
      The Johns Hopkins Hospital between 1970 and 1994 were analyzed (the last 100
      resections were performed between March 1991 and April 1994). This is the largest
      single-institution experience reported to date. RESULTS: The overall
      postoperative in-hospital mortality rate was 5%, but has been 0.7% for the last
      149 patients. The actuarial 5-year survival for all 201 patients was 21%, with a
      median survival of 15.5 months. There were 11 5-year survivors. Patients resected
      with negative margins (curative resections: n = 143) had an actuarial 5-year
      survival rate of 26%, with a median survival of 18 months, whereas those with
      positive margins (palliative resections; n = 58) fared significantly worse, with
      an actuarial 5-year survival rate of 8% and a median survival of 10 months (p <
      0.0001). Survival has improved significantly from decade to decade (p < 0.002),
      with the 3-year actuarial survival of 14% in the 1970s, 21% in the 1980s, and 36%
      in the 1990s. Factors significantly favoring long-term survival by univariate
      analyses included tumor diameter < 3 cm, negative nodal status, diploid tumor DNA
      content, tumor S phase fraction < 18%, pylorus-preserving resection, < 800 mL
      intraoperative blood loss, < 2 units of blood transfused, negative resection
      margins, and use of postoperative adjuvant chemotherapy and radiation therapy.
      Multivariate analyses indicated the strongest predictors of long-term survival
      were diploid tumor DNA content, tumor diameter < 3 cm, negative nodal status,
      negative resection margins, and decade of resection. CONCLUSIONS: The survival of
      patients with pancreatic adenocarcinoma treated by pancreaticoduodenectomy is
      improving. Aspects of tumor biology, such as DNA content, tumor diameter, nodal
      status and margin status, are the strongest predictors of outcome.

PMID- 7794078
TI  - Nonoperative management of blunt hepatic trauma is the treatment of choice for
      hemodynamically stable patients. Results of a prospective trial.
AB  - BACKGROUND: A number of retrospective studies recently have been published
      concerning nonoperative management of minor liver injuries, with cumulative
      success rates greater than 95%. However, no prospective analysis that involves a
      large number of higher grade injuries has been reported. The current study was
      conducted to evaluate the safety of nonoperative management of blunt hepatic
      trauma in hemodynamically stable patients regardless of injury severity. METHODS:
      Over a 22-month period, patients with blunt hepatic injury were evaluated
      prospectively. Unstable patients underwent laparotomies, and stable patients had
      abdominal computed tomography (CT) scans. Those with nonhepatic operative
      indications underwent exploration, and the remainder were managed nonoperatively
      in the trauma intensive care unit. This group was compared with a hemodynamically
      matched operated cohort of blunt hepatic trauma patients (control subjects) who
      had been prospectively analyzed. RESULTS: One hundred thirty-six patients had
      blunt hepatic trauma. Twenty-four (18%) underwent emergent exploration. Of the
      remaining 112 patients, 12 (11%) failed observation and underwent celiotomy--5
      were liver-related failures (5%) and 7 were nonliver related (6%). Liver related
      failure rates for CT grades I through V were 20%, 3%, 3%, 0%, and 12%,
      respectively, and rates according to hemoperitoneum were 2% for minimal, 6% for
      moderate, and 7% for large. The remaining 100 patients were successfully treated
      without operation--30% had minor injuries (grades I-II) and 70% had major (grades
      III-V) injuries. There were no differences in admission characteristics between
      nonoperative success or failures, except admission systolic blood pressure (127
      vs. 104; p < 0.04). Comparing the nonoperative group to the control group, there
      were no differences in admission hemodynamics or hospital length of stay, but
      nonoperative patients had significantly fewer blood transfusions (1.9 vs. 4.0
      units; p < 0.02) and fewer abdominal complications (3% vs. 11%; p < 0.04).
      CONCLUSIONS: Nonoperative management is safe for hemodynamically stable patients
      with blunt hepatic injury, regardless of injury severity. There are fewer
      abdominal complications and less transfusions when compared with a matched cohort
      of operated patients. Based on admission characteristics or CT scan, it is not
      possible to predict failures; therefore, intensive care unit monitoring is
      necessary.

PMID- 7794080
TI  - Colon cancer cells that are not growth inhibited by TGF-beta lack functional type
      I and type II TGF-beta receptors.
AB  - OBJECTIVE: The authors determined the molecular mechanisms for the failure of
      transforming growth factor-beta (TGF-beta) to inhibit the growth of SW1116 and
      SW48 colon cancer cell lines. BACKGROUND: Transforming growth factor-beta is a
      bifunctional regulator of cell growth that typically stimulates proliferation of
      mesenchymal cells, but inhibits proliferation of normal epithelial cells. In the
      colon, TGF-beta appears to arrest proliferation of enterocytes as they leave the
      intestinal crypt and move to the villus tip. Transforming growth factor-beta
      actions are mediated by binding to heteromeric complexes of type I and type II
      TGF-beta receptors. Loss of TGF-beta responsiveness may contribute to
      uncontrolled cell growth and cancer. METHODS: The effects of TGF-beta 1 on DNA
      synthesis were measured by incorporation of tritiated thymidine into DNA of
      cultures of moderately differentiated adenocarcinoma (SW48) and poorly
      differentiated adenocarcinoma (SW1116) colon cell lines and a mink lung
      epithelial cell line (CCL-64). The effects of TGF-beta on the expression of c
      myc, TGF-alpha, and TGF-beta in SW48 cells, SW1116 cells, and CCL-64 cells (c-myc
      only) were measured by Northern blot analysis. Expression of TGF-beta receptors
      in the cell lines was measured using competitive binding assays, receptor
      affinity labelling techniques, and reverse transcriptase-polymerase chain
      reaction. RESULTS: Incubation with TGF-beta 1 (50 ng/mL) did not decrease serum
      stimulated uptake of [3H]-thymidine into actively growing cultures of SW48 or
      SW1116 cells, but suppressed DNA synthesis of actively growing CCL-64 cells by
      90%. Similarly, incubation with TGF-beta 1 (12 ng/mL) for 4 hours did not
      substantially alter the mRNA levels of c-myc, TGF-alpha, and TGF-beta 1 in either
      colon tumor cell line, although levels of c-myc mRNA in CCL-64 cells were reduced
      by TGF-beta 1 treatment. Competitive displacement of [125I]-TGF-beta 1 binding
      detected high levels (16,500 TGF-beta receptors per cell) of specific, high
      affinity (200 pmol/L half-displacement) TGF-beta receptors on CCL-64 cells. In
      marked contrast, very low levels of TGF-beta 1 binding to SW1116 cells (250
      receptors per cell) and SW48 cells (260 receptors per cell) were detected.
      Autoradiograms of CCL-64 cells affinity labelled with [125I]TGF-beta 1 revealed
      the presence of type I, type II, and type III TGF-beta receptors. No TGF-beta
      receptors were identified on SW1116 cells, and only very low levels of the
      nonsignaling type III TGF-beta receptors were detected on SW48 cells. Reverse
      transcriptase-polymerase chain reaction amplification detected mRNAs for type I,
      type II, and type III TGF-beta receptors in CCL-64 cells. SW48 cells, and SW1116
      cells. CONCLUSIONS: These results suggest that the lack of growth inhibition by
      TGF-beta in SW48 and SW1116 colon cancer cells may be caused by a lack of
      expression of functional TGF-beta receptors.

PMID- 7794079
TI  - TRAM flap breast reconstruction after radiation treatment.
AB  - OBJECTIVE: Patients with and without radiation treatment before their breast
      reconstruction were compared to study the relationship of radiation to flap
      related complications. SUMMARY BACKGROUND DATA: The transverse rectus abdominis
      muscle (TRAM) flap for breast reconstruction involves a a vascular pedicle and
      recipient bed, both included in the radiated field of patients undergoing
      adjunctive therapy. Detailed reviews of flap-related complications in this
      subgroup of patients have been limited. METHODS: One hundred eight patients with
      radiation treatment who subsequently underwent a TRAM flap breast reconstruction
      were compared with 572 patients with no radiation treatment before similar
      reconstruction. Flap-related complications, radiation dosage, time, fields,
      relationships between risk factors, and complications were studied. RESULTS:
      Overall complication rates were comparable between the two groups. Only fat
      necrosis (> 10% of total reconstruction) was found to be statistically
      significant (17.6% vs. 10.1%, p = 0.03228). No difference was found for fat
      necrosis in unipedicled vs. bipedicled flaps controlled for radiation (17.7% vs.
      17.4%). Obesity and radiation therapy were associated with fat necrosis and major
      infection in a logistic regression. Significant abdominal scarring was also
      associated with major infection (p = 0.0044). CONCLUSIONS: In this, the largest
      reported series, radiation therapy was associated with increased fat necrosis and
      major infection. The use of the TRAM flap was not found to be prohibitive in
      radiated patients and should still be the first choice in this subgroup of
      patients.

PMID- 7794081
TI  - Preoperative radiation and chemotherapy in the treatment of adenocarcinoma of the
      rectum.
AB  - OBJECTIVE: In this study, the impact of preoperative chemotherapy and radiation
      on the histopathology of a subgroup of patients with rectal adenocarcinoma was
      examined. As well, survival, disease-free survival and pelvic recurrence rates
      were examined, and compared with a concurrent control group. SUMMARY BACKGROUND
      DATA: The optimal treatment of large rectal carcinomas remains controversial;
      current therapy usually involves abdominoperineal resection plus postoperative
      chemoradiation; the combination can be associated with significant postoperative
      morbidity. In spite of these measures, local recurrences and distant metastases
      continue as serious problems. METHODS: Fluorouracil, cisplatin, and 4500 cGy were
      administered preoperatively over a 5-week period, before definitive surgical
      resection in 43 patients. In this group of patients, all 43 had biopsy-proven
      lesions > 3 cm (median diameter), involving the entire rectal wall (as determined
      by sigmoidoscopy and computed tomography scan), with no evidence of extrapelvic
      disease. The patients ranged from 31 to 81 years of age (median 61 years), with a
      male:female ratio of 3:1. A concurrent control group consisting of 56 patients
      (median: 62 years, male:female ration of 3:2) with T2 and T3 lesions was used to
      compare survival, disease-free survival, and pelvic recurrence rates. RESULTS:
      The preoperative chemoradiation therapy was well tolerated, with no major
      complications. All patients underwent repeat sigmoidoscopy before surgery; none
      of the lesions progressed while patients underwent therapy, and 22 (51%) were
      determined to have complete clinical response. At the time of resection, 21
      patients (49%) had gross disease, 9 (22%) patients had only residual microscopic
      disease, and 11 (27%) had sterile specimens. Of the 30 patients with evidence of
      residual disease, 4 had positive lymph nodes. In follow-up, 39 of the 43 remain
      alive (median follow-up = 25 months), and only 1 of the 11 patients with complete
      histologic response developed recurrent disease. Six of the 32 patients with
      residual disease (2 with positive nodes) have developed metastatic disease in
      follow-up (median time to diagnosis 10 months, range 3-15 months). Three of these
      patients with metastases have died (median survival after diagnosis of metastases
      = 36 months). Local recurrence was seen in only 2 of 43 patients (< 5%). Cox
      Mantel analysis of Kaplan-Meier distributions demonstrated increased survival (p
      = 0.017), increased disease-free survival (p = 0.046), and decreased pelvic
      recurrence (p = 0.031) for protocol versus control patients. CONCLUSIONS: This
      therapeutic regimen has provided enhanced local control and decreased metastases.
      Furthermore, the marked degree of tumor downstaging, as seen by a 27% incidence
      of sterile pathologic specimens and a low rate of positive lymph nodes in this
      group with initially advanced lesions, strongly suggest that less radical surgery
      and sphincter preservation may be used with increasing frequency.

PMID- 7794082
TI  - Perihilar cholangiocarcinoma. Postoperative radiotherapy does not improve
      survival.
AB  - OBJECTIVE: The aims of this analysis were to determine prospectively the effects
      of surgical resection and radiation therapy on the length and quality of survival
      as well as late toxicity in patients with perihilar cholangiocarcinoma.
      BACKGROUND: Retrospective analyses have suggested that adjuvant radiation therapy
      improves survival in patients with perihilar cholangiocarcinoma. However, in
      these reports, patients receiving radiotherapy tended to have smaller, often
      resectable tumors, and were relatively fit. In comparison, patients who have not
      received radiotherapy often had unresectable tumors, metastatic disease, or poor
      performance status. METHODS: From 1988 through 1993, surgically staged patients
      with perihilar cholangiocarcinoma and 1) no evidence of metastatic disease, 2)
      Karnofsky score > 60, 3) no prior malignancy or radiotherapy, and 4) a patent
      main portal vein were analyzed. Fifty patients were stratified by resection (n =
      31) versus operative palliation (n = 19) and by radiation (n = 23) versus no
      radiotherapy (n = 27). RESULTS: Patients undergoing resection had smaller tumors
      (1.9 +/- 2.8 vs. 2.4 +/- 2.1 cm, p < 0.01) that were less likely to invade the
      hepatic artery (3% vs. 42%, p < 0.05) or portal vein (6% vs. 53%, p < 0.05).
      Multiple parameters that might have affected outcome were similar between
      patients who did and did not receive radiation therapy. Resection improved the
      length (24.2 +/- 2.5 vs. 11.3 +/- 1.0 months, p < 0.05) and quality of survival.
      Radiation had no effect on the length (18.4 +/- 2.9 vs. 20.1 +/- 2.4 months) or
      quality of survival or on late toxicity. CONCLUSIONS: This analysis suggests that
      in patients with localized perihilar cholangiocarcinoma, resection prolongs
      survival whereas radiation has no effect on either survival or late toxicity.
      Thus, new agents or strategies to deliver adjuvant therapy are needed to improve
      survival in these patients.

PMID- 7794083
TI  - Prevention of embolic events after cardioversion of atrial fibrillation. Current
      and evolving strategies.
AB  - We review the incidence of embolic events following cardioversion of atrial
      fibrillation, as well as the literature that forms the basis for the current
      strategy of anticoagulation before, and following, cardioversion to reduce the
      risk of post-cardioversion embolism. We evaluate a new strategy that uses
      transesophageal echocardiography to identify patients in atrial fibrillation
      without atrial thrombi who may be safely cardioverted without preceding
      anticoagulation and we also address the embolic event and anticoagulation issues
      in patients with atrial flutter. Cardioversion of atrial fibrillation to sinus
      rhythm is associated with a small but significant risk of thromboembolic events
      (average incidence, 1.5%; range, 0% to 7%). Anticoagulating these patients before
      cardioversion appears to significantly reduce this risk, and because of the delay
      in return of atrial contraction, anticoagulation should be continued for several
      weeks following cardioversion. The current guidelines for anticoagulating
      patients in atrial fibrillation who are to be cardioverted is based primarily on
      clinical observations, numerous uncontrolled case series, two retrospective
      trials, and one prospective nonrandomized controlled trial. Anticoagulation for 3
      weeks before cardioversion followed by 4 weeks of anticoagulation after
      cardioversion is a theoretically sound and effective approach to reduce the risk
      of thromboembolic events. The use of transesophageal echocardiography to rule out
      thrombus and thus identify low-risk patients who may undergo cardioversion
      without preceding anticoagulation has been supported by several small studies
      that successfully used this strategy. However, the demonstration of a
      postcardioversion atrial and atrial appendage "stunning" suggests that
      anticoagulation needs to be given at the time of, and following, cardioversion.
      While promising, this transesophageal echocardiography--guided strategy for
      cardioversion of patients in atrial fibrillation requires more rigorous study
      before its routine use can be recommended. The current management of pure atrial
      flutter requires no anticoagulation before cardioversion; however, several
      clinical observation suggest theoretical risks for embolic events in these
      patients, thus further investigation of this strategy may be warranted.

PMID- 7794084
TI  - The angiotensin II type 1 receptor antagonists. A new class of antihypertensive
      drugs.
AB  - The angiotensin II (AII) type 1 receptor antagonists represent a new
      pharmacologic class of drugs that are specifically designed to displace AII from
      its type 1 receptor subtype. These drugs antagonize AII-induced biologic actions,
      including smooth-muscle contraction, sympathetic pressor mechanisms, and
      aldosterone release. Initial clinical trials suggest that these drugs are
      effective in the treatment of essential hypertension and hypertensive patients
      with intrinsic renal disease. Thus, they are the newest addition to the
      therapeutic armamentarium for the treatment of hypertensive diseases. We review
      the developmental history and pharmacology of the AII type 1 receptor
      antagonists. We specifically discuss the following factors: mechanism(s) of
      action; members under clinical investigation; effects on renal function, salt and
      water excretion, and plasma renin activity, plasma AII type 1, and plasma
      aldosterone concentrations; and efficacy and safety. Given the demonstrable
      benefits of AII type 1 receptor blockade, these drugs should achieve broad
      utility in the treatment of hypertensive diseases.

PMID- 7794085
TI  - Peptic ulcer and gastrointestinal hemorrhage associated with nonsteroidal anti
      inflammatory drug use in patients younger than 65 years. A large health
      maintenance organization cohort study.
AB  - BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with an
      elevated risk of peptic ulcer and upper gastrointestinal hemorrhage, but
      published reports have lacked information on rates of outpatient disease, have
      concentrated on the elderly, and have not provided comparisons of rates for
      specific types of NSAIDs. METHODS: We compared incidence rates of peptic ulcer
      and upper gastrointestinal hemorrhage in 68 028 people younger than 65 years who
      used diclofenac sodium, naproxen, piroxicam, or sulindac, and who were members of
      a network of health maintenance organizations. We reviewed automated insurance
      claims data and medical records to ascertain cases and included conditions
      treated on an outpatient basis. RESULTS: Medical claims data were adequate for
      crude identification of potential cases, but review of medical records led to
      rejection of 63% of these, representing either no abnormality or diseases other
      than peptic ulcer or upper gastrointestinal hemorrhage. Of the total 112 cases,
      64 (57%) were treated as outpatients. The crude incidence rate per 1000 person
      years in users of any current, recent, or past NSAID was 2.2 and in distant-past
      users of NSAIDs was 0.75. For diclofenac, naproxen, piroxicam, and sulindac, we
      found a consistent pattern of decreasing NSAID effects from current to recent to
      past exposure. The risk of peptic ulcer or upper gastrointestinal hemorrhage was
      1.6 cases per 1000 people using NSAIDs. CONCLUSIONS: Combining use of automated
      claims records with review of medical records promotes efficiency while
      maintaining specificity of case ascertainment. This study, with 57% of cases
      treated as outpatients, had results consistent with other published reports that
      were based on hospitalized patients. Within the limits of statistical error, the
      incidence rates of peptic ulcer and upper gastrointestinal hemorrhage appeared to
      be similar for the various NSAIDs studied.

PMID- 7794086
TI  - Low complication rate of corticosteroid-treated asthmatics undergoing surgical
      procedures.
AB  - OBJECTIVE: To determine the incidence of perioperative complications in asthmatic
      patients who received preoperative treatment with corticosteroids and whether
      these could be predicted using any study variables such as age, sex, severity of
      asthma, or surgery type. METHODS: Using a retrospective cohort design, we studied
      71 asthmatic patients who underwent 89 surgical procedures; 86 of 89 patients
      received preoperative treatment with systemic corticosteroids. The main outcome
      measures evaluated were incidence of postoperative bronchospasm, infection,
      clinical evidence of adrenocortical insufficiency, and death. RESULTS: Three
      patients (4.5%) developed mild postoperative bronchospasm; five (5.6%) developed
      postoperative infections, two of which were wound infections (2.2%); there were
      no patients with evidence of adrenocortical insufficiency; there was one death
      related to a neurosurgical intraoperative complication. Incidence of infection
      was not statistically different from two comparison surgical groups. None of the
      complications was predicted using any of the study variables. CONCLUSION:
      Asthmatic patients who are treated preoperatively with corticosteroids can
      undergo surgical procedures with a low incidence of complications.

PMID- 7794087
TI  - Does aspirin consumption affect the presentation or severity of acute myocardial
      infarction?
AB  - BACKGROUND: While consumption of aspirin has been shown to decrease the
      occurrence of nonfatal cardiac events, the majority of studies have not
      demonstrated any impact of aspirin intake on cardiovascular mortality. The
      present population-based study explores the possibility that aspirin consumption
      affects the presentation and severity of acute myocardial infarction (AMI), and
      hence the likelihood of clinical detection. METHODS: We monitored the use of
      aspirin before admission for 2114 patients with a validated diagnosis of AMI in
      16 hospitals in the Worcester, Mass, metropolitan area during 1986, 1988, and
      1990. The AMIs were characterized as Q wave vs non-Q wave and large (peak
      creatine kinase levels more than five times normal) vs small (peak creatine
      kinase levels less than two times normal). RESULTS: A total of 332 patients (16%)
      with validated AMI took aspirin before hospital admission. Nearly 65% of aspirin
      users had non-Q wave AMIs, compared with 49% of nonaspirin users. Thirty percent
      of aspirin users sustained small AMIs, compared with 22% of nonaspirin users.
      These findings persisted after stratifying for previous AMI, history of coronary
      disease, receipt of thrombolytic therapy, and exclusion of early hospital deaths.
      Using multivariable regression models to control for age, gender, previous
      evidence of coronary disease, and use of other medications, prior aspirin
      consumption remained independently associated with AMI type (non-Q-wave AMI) and
      smaller infarct size. CONCLUSION: Aspirin consumption appears to modify the
      presentation of AMI, increasing the likelihood that the infarct will be of the
      small, non-Q-wave variety.

PMID- 7794088
TI  - Persistence and new onset of asthma and chronic bronchitis evaluated
      longitudinally in a community population sample of adults.
AB  - BACKGROUND: Some patients with chronic obstructive pulmonary disease may share
      the clinical characteristics of those with asthma; their disease is sometimes
      called "asthmatic bronchitis." Whether there is a difference between asthmatics
      who do and do not develop chronic bronchitis is not yet clear. We investigated
      whether asthma and chronic bronchitis may share some "allergic" phenotypes and
      whether asthmatic individuals who develop chronic bronchitis subsequently have
      steeper declines in lung function. METHODS: Known risk factors for decline in
      lung function were analyzed in a representative community population of adults
      followed up longitudinally since 1972 in Tucson, Ariz, in groups with persistent,
      newly developed, and past diagnoses of asthma and chronic bronchitis. We
      evaluated contributions of initial level of forced expiratory volume in 1 second
      (FEV1), reversibility with isoproterenol hydrochloride nebulized aerosol
      bronchodilator treatment, percentage of blood eosinophils to determine
      eosinophilia, and IgE level. RESULTS: The concurrence of chronic bronchitis and
      asthma is associated with a steeper decline in FEV1 than is asthma as the sole
      diagnosis. Asthmatics (those with persistent asthma with and without chronic
      bronchitis) had the greatest prevalence of increased reversibility with
      isoproterenol therapy and with eosinophilia. The prevalence of eosinophilia was
      also high in those with newly diagnosed chronic bronchitis without asthma;
      however, this was not the case in those with persistent chronic bronchitis
      without asthma. Larger bronchodilator responses were related to steeper declines
      in FEV1, both in persistent asthma and in chronic bronchitis. CONCLUSIONS:
      Bronchodilator response and eosinophilia are generally believed to be hallmarks
      of asthma. We show that these characteristics may be present in chronic
      bronchitis as well. The presence of a large (> 25%) bronchodilator response is
      associated with a steeper decline in FEV1.

PMID- 7794089
TI  - Outcome of hypothyroidism caused by Hashimoto's thyroiditis.
AB  - BACKGROUND: Hypothyroidism is a common condition that is frequently irreversible
      and requires lifelong thyroid replacement therapy. OBJECTIVE: To assess the
      incidence and factors that can predict reversibility of hypothyroidism caused by
      Hashimoto's thyroiditis. METHODS: We studied 79 patients in whom Hashimoto's
      thyroiditis was diagnosed according to suggestive cytologic features and/or the
      presence of thyroid antibodies (antimicrosomal antibody titer, > or = 1:1600;
      antiglobulin antibody titer, > or = 1:400). All patients were initially
      hypothyroid (serum total thyroxine level, 83.5 +/- 28.6 nmol/L [6 +/- 2
      micrograms/dL]; thyrotropin level, 24.7 +/- 28.3 mU/L). Levothyroxine sodium was
      then administered for 1 year to normalize results of thyroid blood tests.
      Thereafter, the treatment was stopped for 3 weeks and serum thyrotropin and total
      thyroxine concentrations were determined. RESULTS: After withdrawal of
      levothyroxine treatment, thyroid blood tests showed that the degree of
      hypothyroidism worsened in 20 patients, remained unchanged in 40, and improved in
      19. Nine patients (11.4%) did show normalization of the thyroid blood tests.
      Before treatment, the presence of the following in a patient--of a goiter that is
      35 g or larger, thyrotropin levels greater than 10 mU/L, and an anamnestic
      familial incidence of thyroid disease--was clearly associated with an increased
      incidence of recovery of normal thyroid function (relative risk, 5.4; 95%
      confidence interval, 2.8 to 10.7; P < .0002). CONCLUSIONS: Our results confirm
      that hypothyroidism caused by Hashimoto's thyroiditis is not always permanent.
      The presence of a larger goiter and high thyrotropin levels at the time of
      diagnosis, associated with a familial incidence of thyroid disease, may be
      related to an increased incidence of hypothyroidism remission.

PMID- 7794090
TI  - Usefulness of patient interview in bleeding disorders.
AB  - BACKGROUND: It is not known which questions in a medical interview are most
      informative for diagnosing mild bleeding disorders, and what the value is of the
      entire interview in screening for hemostatic disorders. METHODS: A questionnaire
      was sent to 222 patients with a proven bleeding disorder, to 134 patients
      suspected of a bleeding disorder but whose hemostasis proved normal, and to 341
      healthy volunteers. A first comparison, between patients with a bleeding disorder
      and patients with bleeding complaints whose hemostasis proved normal, mimics the
      situation in a department of hematology where patients are referred because of
      complaints. The second comparison, between patients with a proven bleeding
      disorder and healthy volunteers, may serve as a model for the situation where the
      interview is used as a screening tool to detect patients with a bleeding disorder
      in a population where there is no prior suspicion, eg, before surgical
      intervention. For each question we calculated a univariate odds ratio,
      multivariate odds ratios, and a positive and negative likelihood ratio. With a
      receiver operating characteristic curve analysis we evaluated the value of a
      simple vs an elaborate interview. RESULTS: Ninety-two percent of the
      questionnaires were returned. For both comparisons the most informative questions
      were questions about bleeding disorders in the family and traumatic events, with
      the exception of delivery. Noninformative questions were frequent gumbleeds and
      blood in the urine. A receiver operating characteristic curve analysis revealed
      that a simple interview has a high discriminating power in a screening situation,
      whereas in a referred situation even an elaborate interview has a low
      performance. CONCLUSIONS: A simple interview is useful as a screening tool for
      the dentist or surgeon. In a specialized hematology center with referred
      patients, however, the interview is of little value in identifying patients with
      a bleeding disorder.

PMID- 7794091
TI  - A prospective study of effects of weight cycling on cardiovascular risk factors.
AB  - BACKGROUND: The possible adverse health effects of weight cycling (weight loss
      followed by weight regain) have been the subject of recent concern. To determine
      whether such weight cycling negatively influences cardiovascular risk factors,
      153 overweight individuals were followed up prospectively through a 30-month
      weight loss and maintenance program. METHODS: Subjects were divided into seven
      groups according to their weight-change patterns during this 30-month study
      (steady weight loss of different magnitudes, weight gain, no change in weight,
      and different weight-cycling patterns). These weight-change groups were compared
      with regard to lipid levels, blood pressure measurements, waist-to-hip ratio, and
      percent body fat at 0, 6, 12, 18, and 30 months. RESULTS: No adverse effects of
      weight cycling on any of the cardiovascular risk factors were observed. Subjects
      who initially lost 9.0 kg or more and then regained it did not differ from those
      who had no change in weight with regard to any cardiovascular risk factor at
      month 30. Subjects who gained weight during the 30-month interval increased their
      risk factors, those who lost weight decreased their risk factors in proportion to
      the magnitude of weight loss, and, in general, cardiovascular risk factors at
      month 30 were related to the net weight loss achieved and not the route taken to
      achieve the weight loss. CONCLUSIONS: This study showed no negative effects of
      weight cycling on cardiovascular risk factors and confirmed previous findings of
      positive effects of weight loss on risk factors. Therefore, overweight
      individuals should be encouraged to lose weight and then maintain their weight
      loss.

PMID- 7794092
TI  - Overuse of the indwelling urinary tract catheter in hospitalized medical
      patients.
AB  - BACKGROUND: The indwelling urinary tract catheter (IUTC) is an important aspect
      of medical care. We studied the prevalence of the unjustified use of the IUTC in
      hospitalized medical patients and identified situations associated with its
      unjustified use. METHODS: This prospective study involved 202 patients admitted
      to either the medical intensive care unit (n = 135) or the medical floors (n =
      67) of a tertiary care university hospital who were catheterized during the
      hospital admission. An independent observer assessed the indication of initial
      catheterization by chart review and interview with the patient and the nurse. The
      need for continued catheterization was assessed daily by the same observer. The
      proportion of unjustified IUTC placement was determined using the study
      guidelines. Complications as a direct consequence of catheter use were recorded.
      RESULTS: Of the 202 patients who were studied, the initial indication for the
      placement of an IUTC was found to be unjustified in 21% (95% confidence interval
      [CI], 15% to 27%). Continued catheterization was unjustified in 47% (95% CI, 42%
      to 57%) of 912 patient-days with IUTC studied. In the medical intensive care
      unit, 64% (95% CI, 58% to 70%) of the total unjustified patient-days with IUTC
      resulted from its excessively prolonged use for monitoring urine output. Urinary
      incontinence was found to be the major cause of unjustified initial ([52%] 95%
      CI, 32% to 74%) and continued ([56%] 95% CI, 50% to 62%) use of IUTC in the
      noncritical care areas. Catheter-related urinary tract infection requiring
      intravenous antibiotics or continuous bladder irrigation with amphotericin B was
      observed in 5% of the patients. CONCLUSIONS: The IUTCs are significantly overused
      in hospitalized medical patients and careful attention to this aspect of medical
      care may reduce catheter-related complications by primary prevention.

PMID- 7794093
TI  - Morning report. A survey of resident attitudes.
AB  - BACKGROUND: Morning report is a time-honored tradition of most internal medicine
      residency programs. Despite its ubiquity, residents' attitudes regarding morning
      report have not been investigated. METHODS: Using a 44-item questionnaire, we
      surveyed residents in an academic internal medicine training program working in
      five teaching hospitals on the processes of teaching and learning during morning
      report. RESULTS: Among 74 residents completing the survey (100%), morning report
      was ranked as the most valuable of six educational activities. Residents
      preferred discussing new cases, with time equally divided between "great" cases
      and common problems, an interactive discussion with open-ended questions, and a
      Socratic teaching style. Seventy-two percent stated that attending physicians
      should be chosen from among the best teachers. General medical knowledge (90%),
      an ability to ask effective questions (86%), and good interpersonal skills (84%)
      were identified as the most important attending physicians' attributes.
      Discussions of basic science, use of anecdotes, and subspecialty knowledge were
      not considered highly desirable characteristics. Attending physicians with
      limited knowledge (41%) were viewed as the major obstacle to effective teaching
      while provocative attending physicians (52%) were considered as being most
      valuable to the learning experience. CONCLUSIONS: Residents believed that the
      morning report was a valuable educational experience. They preferred clinically
      based, open-ended interactive discussions led by attending physicians with a
      broad knowledge base. These findings underscore the importance of morning report
      in general, and the role of attending physicians in particular, in medical
      education.

PMID- 7794094
TI  - Hypoalbuminemia in hospitalized patients with community-acquired pneumonia.
AB  - BACKGROUND: Hypoalbuminemic patients admitted to the hospital for community
      acquired pneumonia have increased mortality and morbidity. The aim of this study
      was to investigate the reasons for hypoalbuminemia in these patients. METHODS:
      During a 12-month period, all patients aged 50 to 85 years (with the exception of
      immunocompromised patients) with community-acquired pneumonia who were admitted
      to the Department of Infectious Diseases at Danderyd Hospital, Stockholm, Sweden,
      were included in a prospective study. The population studied consisted of 97
      patients with a mean age of 69.6 years. The patients' nutritional status,
      including weight, history of weight loss, body mass index, and triceps skinfold
      thickness, was assessed on admission, as well as at two follow-up visits 8 weeks
      and 6 months after discharge from the hospital. Blood samples were drawn on
      admission, during the time in the hospital, and at the follow-up visits.
      Laboratory tests performed included the following: plasma proteins, albumin,
      transthyretin and transferrin, alpha 1-antitrypsin, orosomucoid, haptoglobin, C
      reactive protein, and interleukin-6. RESULTS: No correlation was found between
      the serum albumin levels and the nutritional measurements. The serum albumin
      levels correlated positively with the transthyretin and transferrin levels, and
      inversely with the acute-phase proteins. CONCLUSIONS: The inflammatory reaction
      is the main reason for depressed serum albumin levels in elderly patients with
      pneumonia. The study results do not support the use of nutritional
      supplementation to alter the clinical outcome in these patients.

PMID- 7794095
TI  - Vancomycin-resistant Enterococcus faecium sepsis following persistent
      colonization.
AB  - Vancomycin-resistant enterococci have emerged as important nosocomial pathogens
      and represent a serious threat to patients with impaired host defenses. We
      describe a patient with leukemia who developed prolonged colonization with
      vancomycin-resistant Enterococcus faecium and ultimately died of sepsis due to
      this multidrug-resistant organism. This case report confirms that colonization
      with vancomycin-resistant enterococci may last indefinitely and that asymptomatic
      carriage can lead to invasive infection.

PMID- 7794096
TI  - Cost-effectiveness and misoprostol.

PMID- 7794097
TI  - Multidrug-resistant tuberculosis in patients with AIDS.

PMID- 7794098
TI  - Interobserver variability in interpreting chest radiographs.

PMID- 7794099
TI  - The control of asymmetric gene expression during Caulobacter cell
      differentiation.
AB  - The dimorphic bacterium Caulobacter crescentus provides a simple model for
      cellular differentiation. Each cell division produces two distinct cell types: a
      swarmer cell and a stalked cell. These cells possess distinct functional
      morphologies and differential programs of transcription and DNA replication. The
      synthesis of a single polar flagellum is restricted to the swarmer pole of the
      predivisional cell by a genetic hierarchy comprising at least 50 genes whose
      transcription is regulated by novel and ubiquitous promoters, cognate sigma
      factors, and auxiliary transcriptional regulators. Chromosome replication is
      restricted to the stalked cell by a unique chromosome origin of replication that
      may be regulated by a novel cell-specific transcriptional control system.
      Phosphorylation signals, DNA methylation, differential chromosome structures,
      protein targeting, and selective protein degradation are also involved in
      establishing and maintaining cellular asymmetry. The molecular details of these
      universal cellular processes in C. crescentus will provide paradigms applicable
      to many general aspects of cellular differentiation.

PMID- 7794101
TI  - Purification and characterization of a Synechococcus sp. strain PCC 7942
      polypeptide structurally similar to the stress-induced Dps/PexB protein of
      Escherichia coli.
AB  - A stable DNA/protein complex having an apparent molecular mass of approximately
      150 kDa was purified from nitrate-limited cultures of the cyanobacterium
      Synechococcus sp. strain PCC 7942. Amino-terminal peptide sequencing indicated
      that the polypeptide was structurally similar to the Dps protein of Escherichia
      coli; Dps is also known as the product of the starvation- and stationary-phase
      inducible gene, pexB. The 150-kDa complex dissociated into a 22-kDa protein
      monomer after boiling in 2% SDS. The 150-kDa complex preparation had
      approximately a 10% nucleic acid content and upon dissociation released DNA
      fragments that were sensitive to S1 nuclease digestion. Immunoblot data indicated
      that the complex accumulates during stationary phase and during nitrogen, sulfur,
      and phosphorus limitation. DNA-binding assays indicated that the protein
      nonspecifically binds both linear and supercoiled DNA. Circular dichroism
      spectroscopy revealed that the Synechococcus sp. Dps-like protein contains
      extensive regions of alpha-helical secondary structure. We propose that the 150
      kDa complex represents a hexameric aggregate of the Dps-like protein complexed
      with single-stranded DNA and serves to bind a portion of the chromosomal DNA
      under nutrient-limited conditions.

PMID- 7794100
TI  - The upstream region of the isocitrate lyase gene (UPR-ICL) of Candida tropicalis
      induces gene expression in both Saccharomyces cerevisiae and Escherichia coli by
      acetate via two distinct promoters.
AB  - The upstream region of the isocitrate lyase gene (UPR-ICL, 1530bp) of an n-alkane
      utilizable yeast, Candida tropicalis, induced gene expression in another yeast,
      Saccharomyces cerevisiae, when the yeasts were grown on acetate. Surprisingly,
      UPR-ICL displayed the same regulatory function in the bacterium Escherichia coli
      when grown on acetate. We determined the interesting nucleotide sequence of UPR
      ICL. The deletion analysis of UPR-ICL in both cells revealed the presence of two
      distinct promoters: one was localized at -394 to -379 and regulated gene
      expression in S. cerevisiae; the other was located near the initiation codon and
      regulated gene expression in E. coli. The two promoter sequences were similar,
      but not identical to regulatory elements that have been previously reported in S.
      cerevisiae and E. coli, respectively. Accordingly, the possibility of novel
      regulatory mechanisms could not be excluded. This is an interesting example of
      the presence of distinct cis-acting regulatory elements responsible for the
      induction of gene expression in one gene by acetate in both S. cerevisiae and E.
      coli. Preservation of such promoters through evolution is also discussed.

PMID- 7794102
TI  - Chemical characterization of two lipopolysaccharide species isolated from
      Rhizobium loti NZP2213.
AB  - Phenol-water extraction of Rhizobium loti NZP2213 cells allowed a simultaneous
      isolation of two structurally different lipopolysaccharides from the aqueous (LPS
      W) and phenol (LPS-P) phase that differed in their sodium deoxycholate-PAGE
      pattern and composition. LPS-W showed a profile indicating an R-type LPS; LPS-P
      had a cluster of poorly resolved bands in the high-molecular-weight region. LPS-P
      contained large amounts of 6-deoxy-L-talose (6dTal), and a small amount of 2-O
      methyl-6-deoxy-talose (molar ratio approximately 30:1), both of which were
      completely absent in LPS-W. Methylation analysis gave only one major product, 2,4
      di-O-methyl-6dTal, indicating that the O-chain is composed of a homopolymer of
      1,3-linked 6dTal, having the methylated 6dTal (2-O-Me-6dTal) probably localized
      at the non-reducing end of the O-chain. This homopolymeric O-chain was
      additionally O-acetylated, as evidenced by GC-MS and by 13C NMR analysis. The
      lipid A moieties of both LPS-W and LPS-P showed almost identical composition,
      with six different 3-OH fatty acids and with two, so far not described, long
      chain 4-oxo-fatty acids, all being amide-linked, and with 27-OH-28:0 as the main
      ester-linked fatty acid. Lipid A was of the lipid ADAG-type, i.e., having a
      (phosphorylated) 2,3-diamino-2,3-dideoxy-D-glucose-containing lipid A backbone.
      Lipid ADAG is widespread among species of the alpha-2 group of Proteobacteria,
      but has so far not been encountered in any other rhizobial or agrobacterial
      species.

PMID- 7794104
TI  - Homosexuality, type 1: an Xq28 phenomenon.
AB  - Despite the absence of phenotypic manifestations in alternating generations
      characteristic of X-linked disorders, a thesis is presented that a major type of
      Kinsey grades 5 and 6 male homosexuality is determined by a gene in the Xq28
      region. A total of 133 families in 78 kinshps of male and female homosexual
      probands, in addition to 116 families (including those of 40 famous homosexuals)
      from the literature, revealed an unbalanced secondary sex ratio in the maternal
      generation of male, but not of female, homosexuals. On the maternal side, in this
      study, the ratio of all uncles to all aunts of 90 males homosexuals was 132/209,
      chi 2 = 8.52, p = 0.004. On the maternal side for the total of all sources, the
      ratio of uncles to aunts of male homosexuals was 241/367, chi 2 = 13.20; p <
      0.0001. The male/female ratio of the total number of maternal sibships bearing
      homosexuals (310/628: 0.491) was a measure of fetal wastage of the mothers' male
      sibs; 49%. This ratio was very close to that of the total number of children born
      to fathers affected with any one of nine Xq28-linked male semilethal conditions
      (255/508: ratio 0.556); for the difference between the two populations chi 2 =
      0.859, p = 0.354. The male/female ratio of the total number of children born to
      female carriers of any one of these same conditions (1,232/1,062: ratio 1.16),
      chi 2 = 13.8 p < or = 0.0001, is close to that of the total number of children in
      homosexual sibships: 511/413, chi 2 = 10.4, p = 0.005. Between the number of
      children born to Xq28 mothers and to those born of mothers of homosexuals chi 2 =
      0.581, p = 0.446. One may readily surmise that the maternal influence so often
      related to homosexuality may lie in the mother being a genetic carrier, with
      traits thereto associated. In this study, 65% of the mothers of homosexuals had
      no or only one live-born brother. Additional support for a genetic hypothesis is
      found in the occurrence of multiple instances--almost exclusively among maternal
      relatives--of infertility, spontaneous abortions, miscarriages, stillbirths,
      remaining single past age 30, and suicide. Of 109 male and 43 female homosexual
      index cases in the present series there were 6 instances of brother/sister
      homosexual sibships.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7794105
TI  - Surgical sex reassignment: a comparative survey of international centers.
AB  - The Harry Benjamin International Gender Dysphoria Association's Standards of Care
      (Walker et al., 1985) set out minimum standards for the selection of patients for
      sex reassignment surgery. This survey reports on the standard and policies
      actually used by clinics in Europe and North America, including their areas of
      agreement and disagreement with the Standards. To our knowledge, there has been
      only one prior survey of gender clinic policies, and that was restricted to
      European treatment facilities. The present survey is aimed at primary caregivers
      in the medical community; however, it may also be of use to administrators in
      responding to increasing demands for accountability from special interest groups
      and from government, with their often divergent agendas. It is our hope that this
      survey will begin the process of developing more uniform standards of care.

PMID- 7794103
TI  - Cell-surface properties of the food- and water-borne pathogen Aeromonas
      hydrophila when stored in buffered saline solutions.
AB  - Aeromonas hydrophila, a ubiquitous inhabitant of aquatic environments, commonly
      expresses several cell-surface properties that may contribute to virulence. Since
      many aquatic microorganisms in hostile environments can withstand starvation
      conditions for long periods, we examined the effect of storage under nutrient
      poor conditions on the expression of cell-surface properties of this pathogen.
      Phenotypes studied were: (1) cell-surface hydrophobicity and charge, and (2) the
      ability to bind connective-tissue proteins and lactoferrin. Our results suggest
      that the response of A. hydrophila to nutrient-poor conditions is regimen
      specific. Generally, A. hydrophila cells became more hydrophobic and
      significantly increased their ability to bind the iron-binding glycoprotein
      lactoferrin when the bacterium was stored under nutrient-poor conditions;
      however, under these conditions, the cells seemed to lose their ability to bind
      connective-tissue proteins.

PMID- 7794106
TI  - Psychosexual functioning of partners of men with presumed non-organic erectile
      dysfunction: cause or consequence of the disorder?
AB  - In the treatment of couples where the male partners have erectile dysfunction
      (ED) it often becomes apparent that characteristics of the female partners and of
      the relationship in general have contributed to the problem. However, this has
      received little research attention. We investigated female partners of men with
      ED where no organic cause could be found (n = 34) and partners of men with
      organically based ED (n = 71) to compare their views on their relationships,
      sexual function, sexual attitudes, and psychological adjustment. Relationship
      problems and the psychosexual dysfunctions of vaginismus and dyspareunia were
      more common in the partners of men with nonorganic ED; they also reported higher
      levels of sexual interest. Female sexual dysfunctions in the nonorganic ED group
      had usually preceded the onset of the erectile difficulties. While belief in male
      sexual myths was substantial in both groups of patients, neither the presence of
      traditional views on sexuality nor psychological complaints distinguished
      partners of men experiencing nonorganic ED from those with organic ED.
      Relationship problems, female psychosexual dysfunction, and the possible effect
      of relatively high levels of female sexual interest may contribute to the onset,
      exacerbation, and maintenance of ED. These should be addressed during assessment
      and treatment of couples in which the male partners have erectile difficulties.

PMID- 7794107
TI  - Sex without emotional involvement: an evolutionary interpretation of sex
      differences.
AB  - Two samples of male (n = 243) and female (n = 298) college students completed
      sexual surveys, and in-depth, oral interviews were conducted with 28 highly
      sexually active female college students. Findings supported five predictions
      derived from evolutionary (parental-investment) theory. Even when females
      voluntarily engaged in low-investment copulation, coitus typically caused them to
      feel emotionally vulnerable, and to have thoughts expressing anxiety about
      partners' willingness to invest. For females, increasing numbers of partners
      correlated positively with the incidence of these feelings and thoughts; for
      males, these correlations were negative. Females' attempts to continue regular
      coitus when they desired more investment than partners were willing to give
      produced feelings of distress, degradation, and exploitation despite acceptance
      of liberal sexual morality. Increasing numbers of partners did not mitigate these
      reactions in females and may exacerbate them. Multiple-partner females developed
      techniques for dealing with their emotional reactions to low-investment
      copulation: They frequently tested their partners for signs of ability and
      willingness to invest (e.g., dominance, prowess, jealousy, nurturance), and they
      limited or terminated sexual relations when they perceived partners' investment
      as inadequate. Results were consistent with the view that the emotional
      motivational mechanisms that mediate sexual arousal and attraction are sexually
      dimorphic.

PMID- 7794108
TI  - Maternal sexuality during pregnancy and after childbirth in Muslim Kuwaiti women.
AB  - The sexuality of Kuwaiti Muslim women before pregnancy, during pregnancy, and 6
      months after childbirth was studied. A group of 220 women attending the prenatal
      clinic of the Maternity Hospital Kuwait were randomly selected; 40 (18.2%)
      declined at the outset, 10 (4.6%) withdrew due to miscarriage and 10 (4.6%) due
      to failure to attend interviews. The semistructured interview was conducted by a
      female obstetrician at 4-week intervals starting from 12 weeks pregnancy to 6
      months after childbirth. The study led to the following observations: (i) All the
      women were religious and abided by the Islamic rules and way of life. (ii) The
      diagnosis of pregnancy led to a decline in sexuality that continued throughout
      the pregnancy, with a second and early third trimester increase in sexuality but
      still below the prepregnancy baseline. (iii) Each woman had a consistent pattern
      of sexuality during pregnancy reflecting her prepregnancy level of sexuality.
      (iv) Younger age group, multiparity, low-level of education, lesser duration of
      marriage, and intention of breast-feeding characterized the sexuality pattern
      positively, as did attitudes towards sexuality during pregnancy and after
      childbirth. Breast-feeding mothers exceeded their prepregnancy level of sexuality
      earlier than bottle-feeding mothers.

PMID- 7794109
TI  - ICP27 immediate early gene, glycoprotein K (gK) and DNA helicase homologues of
      infectious laryngotracheitis virus (gallid herpesvirus 1) SA-2 strain.
AB  - A 4.8 kilobase segment located at the left-terminal in the unique long (UL)
      region of infectious laryngotracheitis virus (ILTV) SA-2 strain contained three
      open reading frames (ORFs). The first of 421 amino acids (aa) was located at map
      units 0.065 to 0.07, and its predicted 48 kiloDaltons (kDa) protein product has
      significant homology to the immediate early regulatory protein ICP27 (UL54) of
      herpes simplex virus type-1 (HSV-1), to varicella-zoster virus (VZV) ORF4 and to
      equine herpesvirus 1 (EHV-1) ORF5. The zinc finger conserved in the C-terminal of
      the proteins from HSV-1, VZV and EHV-1, is poorly conserved in ILTV homologue.
      The second ORF of 336 aa, located at map units 0.075 to 0.08, has a predicted
      molecular weight (MW) of 38 kDa with significant homology to glycoprotein K (gK)
      of HSV-1 (UL53), ORF5 of VZV and ORF6 of EHV-1. ILTV gK has features
      characteristic of a membrane-bound glycoprotein. The 3' region of a third ORF was
      located at map units 0.08 to 0.095. Translation of the sequence revealed
      significant homology to the 3'-region of the DNA helicase-primase complex protein
      (UL52) of HSV-1, ORF6 of VZV and ORF 7 of EHV-1. Northern blot analyses were used
      to characterize the ILTV ICP27, gK and DNA helicase mRNAs. The data revealed that
      ILTV ICP27 is an immediate early gene that encodes a 1.6 kb mRNA, ILTV gK encodes
      a late transcript of 1.8 kb, while ILTV DNA helicase encodes a late transcript of
      3.7 kb.

PMID- 7794110
TI  - The HIV-1 V3 domain on field isolates: participation in generation of escape
      virus in vivo and accessibility to neutralizing antibodies.
AB  - The V3 domain is highly variable and induces HIV neutralizing antibodies (NA).
      Here we addressed the issues of 1) the participation of mutations in V3 in
      generation of neutralization resistant escape virus in vivo and 2) the
      applicability of synthetic V3 peptides corresponding to field isolates to induce
      neutralizing immune sera. Seven peptides corresponding to the V3 region of
      primary and escape virus from 3 HIV-1 infected patients were synthesized and used
      for antibody (Abs) studies and immunizations. The anti-V3 Abs titre in patient
      serum was generally low against peptides corresponding to autologous virus
      isolated later than the serum sample in contrast to the titre against peptides
      corresponding to virus isolated earlier than the serum sample. Furthermore,
      neutralizing anti-V3 monoclonal antibodies (MAbs) raised against V3 peptides from
      laboratory strains of HIV-1 showed distinct binding patterns against V3 peptides
      corresponding to sequential primary and escape field isolates, with the strongest
      reactivity against late isolated escape virus. These observations suggest that
      the neutralization epitope was influenced by the appearance of mutations. When
      used as immunogen in rabbits, V3 peptides corresponding to field isolates were
      highly immunogenic but failed to induce neutralizing or gp120-precipitating Abs.
      On the contrary, V3 peptide corresponding to the laboratory strain HXB2 induced
      HIV neutralizing, gp120-precipitating immune serum. In conclusion, these data
      suggest a participation of the V3 domain in the immunoselection of escape virus,
      and that V3 on early field virus is less accessible to NA than that on laboratory
      strains.

PMID- 7794112
TI  - Serological recognition of feline infectious peritonitis virus spike gene regions
      expressed as synthetic peptides and E. coli fusion protein.
AB  - Cats exposed to feline infectious peritonitis virus (FIPV) or feline enteric
      coronavirus (FECV) cannot be differentiated by serological analysis. Three
      synthetic peptides and an E. coli recombinant fusion protein generated from FIPV
      79-1146 spike gene sequence were produced. Coronavirus positive cat sera reacted
      to peptide aa 950-990 but were non-reactive to aa137-151 and aa 150-180 peptides
      as demonstrated by ELISA. Amino acid sequence 97-222 expressed as a galk fusion
      protein in E. coli was tested against coronavirus positive cat sera by western
      blot analysis. Only sera from cats exposed to the FIPV type-II strains DF-2 or 79
      1146 that were exhibiting signs of FIP recognized the fusion protein. Sera from
      FECV exposed cats did not recognize the 97-222 fusion protein in western blot
      analysis.

PMID- 7794111
TI  - Genetic recombination of pseudorabies virus: evidence that homologous
      recombination between insert sequences is less frequent than between autologous
      sequences.
AB  - We studied in vivo recombination between a thymidine kinase (TK) negative,
      glycoprotein E (gE) negative, attenuated strain and a virulent strain of
      pseudorabies virus (PRV) in pigs. To simplify the detection of recombination we
      inserted different but overlapping (375 bp) parts of the E1 gene of classical
      swine fever virus into the gG locus of both virus strains. Recombination between
      the E1 sequences of these viruses results in reconstitution of the complete E1
      coding sequence and expression of the E1 protein. Since E1 is highly immunogenic,
      we expected to detect in vivo recombination in co-inoculated pigs by the presence
      of serum antibodies against E1. However, after co-inoculation of pigs with high
      doses of both virus strains, we were unable to detect antibodies against E1,
      suggesting that in vivo recombination did not occur or remained below the
      detection limit. Analysis of individual progeny viruses showed that 13 out of 995
      (1.3%) possessed a recombinant TK-negative gE-positive phenotype. In contrast, no
      E1-positive viruses were detected among 5000 analyzed. This result showed that in
      vivo recombination between the two virus strains did occur, but was much more
      frequent between the TK and gE loci than between the E1 sequences. Similar
      results were obtained in in vitro recombination experiments in which possible
      growth differences between the various virus strains were excluded. The different
      recombination frequencies could not be attributed to the difference in distance
      of the genetic loci since recombination between mutations at a distance of 266 bp
      in the TK gene occurred as frequent as recombination between the TK and gE genes
      which are separated by approximately 60 kilobasepairs. These results indicate
      that some property of the E1 sequence and/or the location of the E1 sequence
      within the PRV genome affects the frequency of recombination.

PMID- 7794114
TI  - Distribution of antibodies to porcine circovirus in swine populations of
      different breeding farms.
AB  - An enzyme linked immunosorbent assay (ELISA) was developed for mass antibody
      screening to porcine circovirus (PCV) in pig herds of different age groups and of
      different husbandries. Infection with PCV was found to be common in all swine
      herds tested, with only one exception, a herd at a small farm. Statistically, the
      percentage of PCV negative sera decreased and titer levels increased with
      increasing age of the pigs. Within individual age groups, differences were found
      to exist between different husbandries. No correlation was detected between
      antibody levels and reproductive disorders in the herds.

PMID- 7794113
TI  - The antiviral activity of tumour necrosis factor on herpes simplex virus type 1:
      role for a butylated hydroxyanisole sensitive factor.
AB  - We have previously shown that specific antibodies (Mab 32/Ab 301) against tumour
      necrosis factor (TNF) enhance its antiviral activity in vaccinia virus-infected
      mice. In the present study, TNF alone was found to have antiviral activity
      against herpes simplex virus-1 (HSV-1). Antibody enhancement was found, both in
      vivo and in vitro, at lower TNF doses. The magnitude of the TNF-induced antiviral
      response was dependent upon the genetic background of the mouse. C57BL/6 mice
      were very sensitive to the antiviral activity of TNF, which was inhibited by the
      free radical scavenger butylated hydroxyanisole (BHA). TNF plus Mab 32 induced a
      significant antiviral effect in L929 cells which was associated with pronounced
      CPE. The CPE was largely reversed in the presence of BHA, and furthermore, TNF
      antiviral activity was significantly reversed in the presence of BHA. Specific
      inhibitors of nitric oxide synthetase, lipoxygenase or cyclo-oxygenase did not
      influence either the CPE or growth kinetics of HSV-1, suggesting that neither
      reactive nitrogen intermediates nor arachidonic acid metabolites were involved in
      the antiviral mechanism of TNF. This, together with observed increases in Cu/Zn
      SOD levels in virus infected cells, suggests that reactive oxygen intermediates
      may have a role in the direct control of HSV-1 growth and that free radicals may
      play a part in the antiviral activity induced by TNF.

PMID- 7794116
TI  - Large scale purification of rubella virus and the isolation of native viral core
      protein.
AB  - A number of structural analyses of viruses are dependent on the availability of
      purified virus and of pure viral components in milligram amounts. In order to
      allow such analyses of the Rubella togavirus we have identified a virus-cell
      system which produces large amounts of Rubella virus in tissue culture and we
      have developed a rapid and efficient procedure of Rubella virus purification
      which involves adsorption and elution of virus to fixed erythrocytes.
      Furthermore, we describe a procedure which allows the extraction of native core
      protein from viral cores and its chromatographic purification.

PMID- 7794115
TI  - Phylogenetic analyses of the putative M (ORF 6) and N (ORF 7) genes of porcine
      reproductive and respiratory syndrome virus (PRRSV): implication for the
      existence of two genotypes of PRRSV in the U.S.A. and Europe.
AB  - The putative membrane (M) protein (ORF 6) and nucleocapsid (N) protein (ORF 7)
      genes of five U.S. isolates of porcine reproductive and respiratory syndrome
      virus (PRRSV) with differing virulence were cloned and sequenced. To determine
      the genetic variation and the phylogenetic relationship of PRRSV, the deduced
      amino acid sequences of the putative M and N proteins from these isolates were
      aligned, to the extent known, with other PRRSV isolates, and also other members
      of the proposed arterivirus group including lactate dehydrogenase-elevating virus
      (LDV) and equine arteritis virus (EAV). There was 96-100% amino acid sequence
      identity in the putative M and N genes among U.S. and Canadian PRRSV isolates
      with differing virulence. However, their amino acid sequences varied extensively
      from those of European PRRSV isolates, and displayed only 57-59% and 78-81%
      identity, respectively. The phylogenetic trees constructed on the basis of the
      putative M and N genes of the proposed arterivirus group were similar and
      indicated that both U.S. and European PRRSV isolates were related to LDV and were
      distantly related to EAV. The U.S. and European PRRSV isolates fell into two
      distinct groups, suggesting that U.S. and European PRRSV isolates represent two
      distinct genotypes.

PMID- 7794117
TI  - Preferential selection of VP7 gene from a parent rotavirus strain (SA11) in
      sequential passages after mixed infection with SA11 and SA11-human rotavirus
      single-VP7 gene-substitution reassortants.
AB  - We studied the competitive growth among SA11-L2(G3) and its single-human VP7 gene
      substitution reassortants SA11-L2/KU-R1(G1) and SA11-L2/DS1-R1(G2), which have
      the genetic background of SA11-L2, during sequential passages after mixed
      infection. When the same infectious units (m.o.i. of 5 p.f.u./cell) of SA11-L2
      and a reassortant SA11-L2/KU-R1 were inoculated onto and passaged in MA104 cells,
      88% of the virus clones isolated from the culture fluid at the 3rd passage
      belonged to G3, and all the clones from the 10th passage had G3 specificity. Even
      when SA11-L2/KU-R1 with titer 10 times higher than that of SA11-L2 was used in
      the coinfection, the predominance of clones with G3-VP7 was observed. Although G2
      clones slightly surpassed G1 clones in number in the mixed culture of SA11-L2/KU
      R1 and SA11-L2/DS1-R1, G3 clones predominated in the virus progeny from a mixed
      culture infected with the same titers of SA11-L2, SA11-L2/KU-R1, and SA11-L2/DS1
      R1. However, no significant difference in viral growth was detected among SA11-L2
      and the two reassortants.

PMID- 7794118
TI  - Serial passage in tissue culture of mixed foot-and-mouth disease virus serotypes.
AB  - The foot-and-mouth disease (FMD) virus field specimen SAU/8/88 was previously
      shown to consist of a mixture of O and Asia 1 serotypes [15]. In this study,
      plaques representing the O and Asia 1 components isolated from the original
      epithelial virus suspension were used to construct mixtures of known ratios, and
      these were serially passaged in tissue culture. After each passage, the ratio of
      O to Asia 1 virus was calculated. The two virus populations were shown to be
      cycling through time. This cycling phenomenon has not been described before for
      FMD virus in tissue culture, but is consistent with current population theory.

PMID- 7794119
TI  - Immunization with glycoprotein C of equine herpesvirus-1 is associated with
      accelerated virus clearance in a murine model.
AB  - The glycoprotein C (gC) gene of equine herpesvirus-1 (EHV-1) was expressed in
      insect cells by a recombinant baculovirus as several products with apparent
      molecular weights of 66 kDa-80 kDa. The baculovirus EHV-1 gC products were
      recognised by monoclonal antibody and by EHV-1 convalescent equine sera,
      indicating conservation of antigenic determinants and confirming this
      glycoprotein as a target for the equine immune system. Mice immunized with
      recombinant EHV-1 gC showed accelerated clearance of EHV-1 from respiratory
      tissues following intranasal challenge. Virus clearance was accompanied by virus
      specific antibodies and by cell mediated immune responses measured by a delayed
      type hypersensitivity reaction and lymphocyte stimulation by killed EHV-1 as
      antigen.

PMID- 7794120
TI  - A model for the membrane topology of the NS3 protein as predicted from the
      sequence of segment 10 of epizootic haemorrhagic disease virus serotype 1.
AB  - Segment 10, encoding nonstructural proteins 3 (NS3) and 3a (NS3a) of epizootic
      haemorrhagic disease virus serotype 1 (EHDV-1) was sequenced. Computer motif
      recognition programs were used for interpretation of the sequence data to predict
      a structure for NS3. Integral membrane protein theories were then applied to
      produce a general topological model for the EHDV-1 NS3 protein. Homology was
      observed between EHDV-1 NS3 integral membrane motifs and those similarly observed
      in the cognate proteins of other orbiviruses.

PMID- 7794121
TI  - Fructose-induced hypertension, hypertriglyceridemia and elevated cytosolic
      calcium in rats: prevention by deuterium oxide.
AB  - We examined the effect of 5% deuterium oxide (D20) in drinking water on systolic
      blood pressure, platelet cytosolic free calcium, aortic calcium uptake and plasma
      insulin, glucose and triglycerides in rats with fructose-induced hypertension.
      Eighteen male Wistar-Kyoto (WKY) rats, age 8 weeks, were divided into 3 groups of
      6 animals each. Animals in group I were given water; group II, 8% fructose and
      group III, 8% fructose + 5% D20 as their drinking water for the next 15 weeks.
      Systolic blood pressure in the fructose treated rats was significantly higher (p
      < 0.01) than in animals on water after 2 weeks and remained higher throughout the
      study. At 15 weeks, systolic blood pressure, platelet cytosolic calcium, aortic
      calcium uptake and plasma glucose, insulin and triglycerides were significantly
      higher (p < 0.01) in the fructose treated rats compared with rats from other
      groups. Deuterium oxide given together with fructose prevented development of
      high blood pressure and the associated increase in platelet cytosolic calcium,
      aortic calcium uptake and plasma triglycerides. D20 treatment did not prevent
      fructose induced increases in plasma insulin and glucose. The parallel increase
      in systolic blood pressure, cytosolic free calcium, and in vascular calcium
      uptake suggests that an increased cytosolic free calcium is involved in the
      pathophysiology of hypertension. D20 prevents this hypertension by normalizing
      cytosolic free calcium.

PMID- 7794122
TI  - Anticoagulant effects of warfarin and kinetics of K vitamins in blood and feces.
AB  - Patients (40 cases) were treated with daily dosage of warfarin of 2-7 mg after
      being undergone artificial valve replacements. Twenty one days after
      administration of warfarin, we examined the patients for kinetics of K vitamins
      and vitamin K-dependent coagulation factors in blood, and intestinal flora in
      feces, as well as the relationship between K vitamins and coagulation activity.
      The following results were obtained. (1) In warfarin-administered patients (Group
      B), blood levels of vitamin K1 and menaquinone-7, a vitamin K2 homologue, were
      similar to those in non-warfarin-administered patients. Therefore, administration
      of warfarin did not significantly decreased the levels. (2) In patients selected
      randomly from Group B (Group C), the vitamin K1 level in feces was higher than
      that in non-warfarin-administered patients. The menaquinone-7 level in feces was
      similar to that in non-warfarin-administered patients. For the total counts of
      bacteria and the detection rate of vitamin K2-producing bacteria, there was no
      significant difference between Group C and non-warfarin-administered patients.
      (3) The above mentioned results of (1) and (2) suggest that it is important for
      development of anticoagulant effects by warfarin to inhibit conversion from
      vitamin K1 to reduced vitamin K1, as well as to inhibit the reducing process from
      vitamin K1-epoxide to vitamin K1. (4) Vitamin K1-epoxide, a metabolite of vitamin
      K1, appeared in blood after administration of warfarin; there was a lower
      correlation between the blood level of vitamin K1-epoxide and the warfarin
      dosage. Further, PIVKA-II appeared in blood after administration of warfarin;
      there was a inverse lower correlation between the level of PIVKA-II and HPT, and
      between PIVIKA-II and TT. In conclusion, it has been clarified that vitamin K1
      epoxide and PIVKA-II are useful parameters to evaluate anticoagulant effect of
      warfarin.

PMID- 7794123
TI  - Interleukin-4 inhibits human smooth muscle cell proliferation.
AB  - Although proliferation of smooth muscle cells is a key event in the pathogenesis
      of atherosclerosis, the signals which regulate this proliferation are not fully
      understood. It is likely that proliferation is regulated by cytokines released by
      cells found in the plaque, such as T cells. In this study we report that the T
      cell-derived cytokine, interleukin-4 (IL-4), can inhibit proliferation of
      cultured human umbilical artery smooth muscle cells. Maximum inhibitory effect
      was achieved at IL-4 concentrations of 20 U/ml or greater. In addition, the data
      showed that IL-4 acted early in the G1 phase of the cell cycle, thereby
      preventing cells from entering S phase. The mechanism of IL-4 inhibition did not
      appear to involve stimulation of prostanoid synthesis since similar data were
      obtained when experiments were performed in the presence of a cyclooxygenase
      inhibitor. We propose that IL-4 may act as a protective factor released by T
      cells in an atherosclerotic lesion in order to minimise the size of the plaque.

PMID- 7794124
TI  - The influence of rate of cell entry to S phase on the labelling index of human
      buccal epithelium.
AB  - The physiological basis of the circadian rhythm in cell kinetics in human
      epithelia remains unclear. A 24-h periodicity in the labelling index (LI) of
      human buccal epithelium has been demonstrated previously. A double-labelling
      technique in vitro using tritiated deoxythymidine was used here to examine
      fluctuations in the time spent in S phase (Ts) and the rate of cell entry to S
      phase (S influx). While the range in Ts values was limited (5.1-6.9 h), influx to
      S phase ranged from 0 to 1.26% per hour at six different time periods. An
      increase in the S influx was apparent around 18:00 h leading to a peak LI 4 h
      later. These preliminary data indicate that the most likely kinetic mechanism
      related to circadian variations in LI is a variable G1-S influx at this site.

PMID- 7794125
TI  - Inhibition by thiocyanate of muscarinic-induced cytosolic acidification and Ca2+
      entry in rat sublingual acini.
AB  - Thiocyanate (SCN-) plays a critical part in an oral antimicrobial system by
      acting as a substrate for peroxidases. Salivary glands concentrate SCN- from
      blood up to 5 mM in saliva; however, the influence of SCN- on salivary acinar
      cell function is unknown. The present study examined the effects of SCN- on the
      regulation of cytosolic pH (pHi) and free Ca2+ concentration ([Ca2+]i) in rat
      sublingual mucous acini using the pH- and Ca(2+)-sensitive fluorescent
      indicators, 2',7'-bis-(2-carboxyethyl)-5,6-carboxyfluorescein and fura-2,
      respectively. SCN- induced a concentration-dependent inhibition of the carbachol
      stimulated cytosolic acidification (K1/2, approx. 1.4 mM SCN-). Cytosolic pH
      recovery from an acid load was not changed by substitution of Cl- by SCN-,
      suggesting that Na+/H+ exchange activity was not affected by SCN-. SCN- did not
      alter the initial carbachol-stimulated increase in [Ca2+]i; however, the
      sustained [Ca2+]i increase was inhibited by > 65% (K1/2, approx. 1.0 mM SCN-).
      Furthermore, SCN- prevented the carbachol-stimulated Mn2+ influx, indicating that
      it inhibits the divalent-cation entry pathway. Consistent with decreased Ca2+
      mobilization being involved in the blockade of the agonist-induced acidification
      by SCN-, only total replacement of Cl- with SCN- significantly inhibited the
      acidification induced by the Ca2+ ionophore ionomycin. The permeability to SCN-
      through the Ca(2+)-dependent Cl- channels was 5.2-fold higher than the
      permeability to Cl-. These results suggest that inhibition of the agonist-induced
      cytosolic acidification by high-concentration SCN- may be mediated by both
      competitive inhibition of HCO3- efflux and by blockade of Ca2+ influx.

PMID- 7794126
TI  - Mandibular growth rates in human fetal development.
AB  - A morphometric analysis of changing proportions in the developing mandible was
      undertaken in 18 human embryos and fetuses of both sexes (developmental age from
      8 to 14 weeks, crown-rump length, CRL, from 34 to 110 mm), previously cleared and
      stained with a specific method for bone (alizarin red S). Reference points were
      located on the mandible, i.e. condylar process (Pcl), coronoid process (Pco),
      gnathion (GN), gonion (GO), superior symphyseal point (SSP), for measuring linear
      dimensions, i.e. Pcl-GN, Pcl-Pco, Pco-GN, GO-GN, SSP-GN. The gonial (Pcl-GO-GN)
      and the (Pcl-GN-Pcl) angles were also measured. All linear dimensions were
      correlated with the CRL by bivariate allometry (1n y = 1n a+b 1n x): they all
      grew with positive allometry, except GO-GN with isometry. The mandibular ramus
      grew relatively faster than the body, both in length and height, and the greatest
      growth rate was found for ramus height. The relation between mandibular shape and
      the craniofacial structures was investigated using scale drawings obtained from
      photographs of fetal skulls in lateral view. In the youngest fetuses the mandible
      was prognathic, then became retrognathic. During the period investigated the
      zygomatic process and squama of the temporal bone were in a lower and more
      inclined position in relation to the transverse plane passing through the
      zygomatic arch than in the newborn and adult. This study identifies parameters
      fitting changing trends in height, length and shape of the human mandible during
      the prenatal period (8-14 weeks); moreover, it emphasizes that the mandibular
      growth patterns differ significantly from those of successive development
      periods.

PMID- 7794127
TI  - Spatial distribution of epidermal growth-factor transcripts and effects of
      exogenous epidermal growth factor on the pattern of the mouse dental lamina.
AB  - The initiation of odontogenesis is characterized by the site-specific
      proliferation of mandibular epithelium in the formation of the dental lamina. The
      epidermal growth factor (EGF) gene is expressed in the developing mandible
      immediately before the appearance of the dental lamina. This expression is
      necessary for the formation of the dental lamina and subsequent development of
      teeth. Previous work has demonstrated that retinoids and EGF may interact in the
      establishment of the pattern of the dentition. In the present study explanted
      mandibles that were treated with exogenous EGF (40 ng/ml of medium) contained
      supernumerary buds of mandibular epithelium in the diastema region. These pattern
      changes were the same as in previous retinoid-treated explants. These results, in
      addition to the previously reported effects of retinoids on the expression of the
      EGF gene, support the hypothesis that retinoids and EGF interact in controlling,
      at least in part, the pattern of the dentition by affecting the pattern of the
      dental lamina. The spatial distribution of EGF transcripts was also
      characterized. The location of EGF transcripts in the mesenchyme adjacent to the
      mandibular epithelium suggests a paracrine mechanism in the stimulation of
      epithelial proliferation in the formation of the dental lamina.

PMID- 7794128
TI  - Bone matrix proteins in osteogenesis and remodelling in the neonatal rat mandible
      as studied by immunolocalization of osteopontin, bone sialoprotein, alpha 2HS
      glycoprotein and alkaline phosphatase.
AB  - The neonatal rat mandible was used as a model to study bone formation,
      mineralization, quiescence, and resorption, using immunolocalization and a
      variety of tissue-processing techniques. Monospecific antibodies for osteopontin
      (OPN), bone sialoprotein (BSP), alkaline phosphatase (AP) and alpha 2HS
      glycoprotein (alpha 2HS-GP) were used on fixed paraffin-embedded tissue, fixed
      frozen tissue and unfixed frozen tissue. Immunostaining was correlated with
      mineral content by two procedures, the von Kossa and the morin techniques. Morin
      fluorescence was used with secondary immunostaining to provide a way of closely
      correlating bone matrix proteins and matrix mineralization. Co-immunolocalization
      procedures were used to compare the sites of bone proteins in the matrix. AP was
      found earliest during osteogenic cell differentiation, appearing in the
      preosteoblasts, followed by OPN and BSP, which first appeared in osteoblasts.
      alpha 2HS-GP expression was not observed in cells. The results provide clear
      evidence for the presence of OPN in osteoid, while BSP and alpha 2HS-GP were
      confined to the mineralized matrix. Immunostaining of bone proteins is highly
      technique-dependent: immunolocalization investigations required several methods
      of approach to ensure adequate demonstration of these proteins in cells and
      matrix. The results support the contention that osteopontin is multifunctional in
      bone metabolism, and that alpha 2HS-GP, though produced in the liver, is abundant
      in bone matrix and may also have a function in bone metabolism.

PMID- 7794129
TI  - Gene expression of epimorphin in rat incisor ameloblasts.
AB  - Epimorphin has been recently identified as an important factor in the
      morphogenesis of epithelial cells. A cDNA encoding epimorphin from skin of
      newborn mice was cloned by the polymerase chain-reaction technique before the
      preparation of digoxigenin-labelled cRNA probes. In situ hybridization of
      longitudinal sections of rat incisors revealed a distinct pattern of expression
      of epimorphin mRNA in the ameloblast layer. Epimorphin mRNA was detected from the
      presecretory stage up to the beginning of the maturation stage of amelogenesis.
      With the identification of this expression by epithelial-derived cells, i.e.
      ameloblasts, it is thought likely that epimorphin is one of the factors that
      modulate the differentiation cascade of ameloblasts in the course of
      amelogenesis.

PMID- 7794130
TI  - Characterization of cyclic AMP phosphodiesterase isozymes in rat parotid gland.
AB  - Cyclic AMP phosphodiesterase (PDE) isozymes were isolated and characterized from
      the soluble fraction of rat parotid gland. Four main peaks containing PDE
      activity were obtained by Q-Sepharose Fast Flow column chromatography. The four
      peaks were identified as PDEs I-IV by kinetic properties, molecular-weight
      analysis and their responses to effectors and inhibitors.

PMID- 7794133
TI  - Expectations of medical education.

PMID- 7794131
TI  - Immunoelectron-microscopic study of the localization of fibronectin in the
      odontoblast layer of human teeth.
AB  - Indirect immunofluorescence-based studies have shown similarities in the
      distribution patterns of fibronectin-positive fibrous structures and so-called
      von Korff fibres. The aim of the present study was to analyse the reactivity of
      fibronectin in the odontoblast layer of fully developed human teeth by means of
      immunoelectron microscopy. Between the odontoblasts, discrete and undulatory
      fibrillar fascicles with peroxidase labelling were observed. They seemed to be in
      contact with odontoblasts in some areas, while in others they appeared to be
      intervening between two neighbouring odontoblasts. Higher magnifications of the
      fibrillar material demonstrated axial periodic staining of about 70 nm.
      Peroxidase reaction of fibronectin was also recognized along the cell membrane of
      odontoblasts facing predentine. The fibronectin in fibrillar fascicles observed
      between odontoblasts would be held in place by the direct molecular interaction
      with collagen fibrils and contribute to the pulpward migration of these cells and
      maintenance of their specific morphology. At the distal end of odontoblasts, a
      tight seal would be maintained by means of odontoblast-fibronectin adhesion.

PMID- 7794132
TI  - Racemization of aspartic acid in human cementum with age.
AB  - This study explored the application of the racemization reaction to forensic
      dental medicine in relation to estimation of age from tooth cementum. Cementum
      from the cervical two-thirds and the apical one-third of 16 upper incisor teeth
      gave ratios of D-/L-aspartic acid that correlated highly with actual age, the
      correlation coefficients being r = 0.993-0.996. For whole cementum from lower
      central and lateral incisors, first and second premolars (n = 8) the correlation
      coefficients were r = 0.984-0.997. Incisors gave more reliable results than
      premolars. The study was extended to compare cementum, enamel and dentine from
      first premolar teeth of the same individuals. The correlation of the ratio of D
      /L-aspartic acids with actual age was highest for dentine (r = 0.992), followed
      by cementum (r = 0.988) and enamel (r = 0.961). These results indicate that the
      racemization reaction in cementum proceeds in a constant manner, and confirm that
      cementum remains stable throughout the individual's life. Accurate estimation of
      age is thus possible when cementum is subjected to the amino-acid racemization
      method.

PMID- 7794134
TI  - General practice: a philosophical tour.

PMID- 7794135
TI  - General practice and the new renaissance.
AB  - Traditional medical education has tended to emphasise the acquisition of
      knowledge and analytical skills. But it is the author's belief that this system
      has some limitations when applied in the general practice situation. Dr Edward
      DeBono has described an alternative style of thinking that relies fundamentally
      on perceptive and creative skills; ideas that have great relevance in learning
      how to apply our acquired knowledge in a meaningful way to the health care of our
      patients. This paper describes the personal odyssey that led to this realisation.

PMID- 7794136
TI  - Frank.
AB  - In medical school we are taught that the 'proper' relationship between doctor and
      patient is one where the doctor remains aloof and objective. Because of the
      nature of general practice we often form friendships with our patients. These
      friendships enrich our professional lives without detracting from the doctor
      patient relationship.

PMID- 7794137
TI  - Holistic medicine.
AB  - When the author completed medical school in 1981, the importance of
      psychoneuroimmunology, treating patients as a 'whole person', and experiencing
      meditation as a form of stress management, were not covered in the medical
      curriculum as they are now. This article gives a brief overview of these topics
      and presents several case histories and studies to illustrate the benefits of a
      holistic approach.

PMID- 7794140
TI  - Sexuality and the psyche.
AB  - A lack of knowledge of human sexuality, on completing medical school, was the
      prompt to explore this area more fully. However, as more experience is gained in
      an area, more questions are raised, emphasising that the black and white approach
      taken in medical school is often inappropriate in human health.

PMID- 7794139
TI  - Clinical hypnosis.
AB  - Clinical hypnosis is now an available tool for general practitioners. Hypnotists
      do not possess any magical powers. It is the patient who possess the magic; the
      hypnotist merely unlocks this power.

PMID- 7794138
TI  - Munchausen syndrome by proxy: a profile for medical child abuse.
AB  - The term Munchausen Syndrome by Proxy describes a pattern of physical abuse in
      which a perpetrator produces or fabricates illness in a victim. Victims are
      almost always children. We alternatively call this behaviour medical child abuse.
      Our report describes five recent cases. Two presented with infantile apnoea, one
      with alleged hypoventilation, one with recurrent vomiting and one with recurrent
      infections. Three of the perpetrators were mothers, two were fathers. In three
      cases diagnoses were confirmed by covert video surveillance. Contrary to popular
      beliefs, this behaviour is not rare and is not a syndrome of any known
      psychopathology. It is simply another, very dangerous, form of child abuse.
      Reported victim mortalities range from 9% to 31%. To ensure child safety we
      suggest the medical, legal and law enforcement communities begin to view this
      entity more as a profile of criminal abusive behaviour and less as a medical
      syndrome.

PMID- 7794141
TI  - Is that absolutely true? Reflections on reality in general practice.
AB  - Biomedical scientific knowledge appeared to me, as a medical student, to be
      carved in stone. After many years in general practice it seemed more like it was
      carved in the shifting sands of time. A feeling of insecurity in diagnosis and
      treatment followed. There was also a perceived superiority of scientific
      knowledge over knowledge gained by other means. This did not sit well with my
      experience in everyday general practice. This article explores a rational
      framework for change in medical science and a justification for giving equal
      importance to other forms of knowledge in general practice.

PMID- 7794142
TI  - Hospital in the home units. Early issues for GP involvement.
AB  - This paper reviews the early challenges for Hospital in the Home units which
      choose to utilise general practitioner skills. A model is described. Issues
      surrounding GP selection, remuneration, responsibility, leadership, and other
      hurdles are described. Since alternatives to GP involvement exist, GPs should be
      prepared to seize this important opportunity.

PMID- 7794143
TI  - The star of general practice.
AB  - These dimensions are not mutually exclusive. They all inter-relate. Their purpose
      is to provide a series of focal points to group the various knowledge, attitudes
      and skills required of a general practitioner, which can be diagrammatically
      represented by a five pointed star (Figure 1). The description of the domains in
      Table 2, is not exhaustive. It is intended to demonstrate how the knowledge,
      attitudes and skills of a general practitioner can be concisely described by a
      small number of categories. This framework is offered as a means of organising
      the long and detailed lists that describe what GPs do. These domains can be a
      vehicle for examining a GP curriculum or be used for program evaluation. They
      provide a description of the skills of a competent GP that can be used in many
      situations but also could be used to describe the skills of other professional
      groups, for example, teaching. This paper has presented a description of the six
      domains or skills required by a general practitioner. The purpose is to provide a
      description that is both easy to remember and yet sufficiently comprehensive to
      cover all the key competencies, and objective to encourage debate in this area.

PMID- 7794145
TI  - Treatment of menorrhagia.
AB  - The treatment of menorrhagia has changed significantly in two ways. Between 20%
      to 40% of women complaining of menorrhagia have normal to below normal blood loss
      and may avoid medical and surgical treatment by learning how to cope with
      menstrual loss. Ninety per cent of women with menorrhagia not responding to drug
      therapy can be treated by a wide variety of endoscopic procedures and
      hysterectomy is required for only a few of these patients. This article reviews
      the subject with emphasis on current practice and new endoscopic procedures.

PMID- 7794144
TI  - Review of mammography.

PMID- 7794146
TI  - Evaluation of an educational program in rational prescribing for GP trainees.
AB  - Education on rational prescribing is receiving increased emphasis but the
      effectiveness of this education is not well researched. This study used a
      randomised trial to evaluate a seminar for general practice trainees on rational
      prescribing of antibiotics and benzodiazepines, two important areas of general
      practice prescribing. Results show a decrease in prescribing of antibiotics by
      the group of trainees attending the seminar but no effect on an already low level
      of benzodiazepine prescribing. The study provides evidence that group educational
      approaches to influencing prescribing behaviour can be effective.

PMID- 7794147
TI  - Can GPs co-operate after hours in a competitive urban environment?
AB  - Before designing an intervention aimed at improving the quality of after-hour
      general practice services to the residents of a relatively isolated outer suburb
      of Brisbane, a survey of 247 residents was conducted to assess the provisions of
      after-hours care. The results of the survey were presented to the suburb's
      general practitioners (GPs). Meetings with the GPs led to attempts at improved
      communication, using patient-held Health Summary Cards and doctor-to-doctor
      clinical feedback forms. Forty-four per cent of the 27 GPs participated in the co
      operative scheme. One year later the community was resurveyed to assess the
      impact of the changes in medical services. There was a small but insignificant
      increase in satisfaction with the provision of after-hours care from 45% to 48%.

PMID- 7794149
TI  - Common chronic skin disorder.

PMID- 7794150
TI  - Andrea Mant. General practitioner researcher.

PMID- 7794148
TI  - Gout: 'a disease of plenty'.
AB  - Gout is a syndrome caused by an inflammatory response to the formation of
      monosodium urate monohydrate crystals which develop secondary to hyperuricaemia.
      Acute and chronic forms occur. Hyperuricaemia may be due to environmental and/or
      genetic factors. It most commonly affects middle-aged males. This article
      discusses the management of both acute and chronic gout.

PMID- 7794152
TI  - Rural general practice: is it a distinct discipline?
AB  - This article, an edited version of a paper presented to the RNZGP/RACGP Combined
      Conference, Wellington, New Zealand, 1994 explores the nature of rural practice
      so as to determine whether it qualifies as a distinct discipline. Certainly rural
      doctors live and work in a different world from their urban counterparts. The
      psychology and sociology of rural communities are markedly different from the
      cities. Also, the spectrum of illness and injuries with which rural doctors have
      to cope is specific to rural areas, and the structure and process of health
      services in the country are quite different. Rural doctors carry a higher level
      of clinical responsibility and provide a wider range of services in relative
      professional isolation.

PMID- 7794153
TI  - Patient education. Dry skin.

PMID- 7794151
TI  - Epilepsy or pseudo-epilepsy?
AB  - The practitioner must be sensitive to the possibility of patients' hidden agendas
      in presentation, particularly in cases with associated inconsistencies. Issues
      can be clarified by comprehensive clinical assessment and communication with
      other health professionals and significant others. This case illustrates some of
      these issues.

PMID- 7794154
TI  - Clinical decision making. Are computers really helpful?
AB  - The introduction of computers to Australian general practice will require changes
      beyond those of simply changing from pen to keyboard. The form in which
      information is stored has a major impact on how it can be used. General
      practitioners should be informed about this potential and take part in decision
      making about the use of computers.

PMID- 7794156
TI  - Musculoskeletal medicine tip. Slipping rib syndrome.

PMID- 7794155
TI  - Eye and penile problems in a young man.

PMID- 7794157
TI  - Practice tip. Simple removal of xanthoma.

PMID- 7794158
TI  - Acromioclavicular joint.

PMID- 7794159
TI  - Facet joint pain.

PMID- 7794160
TI  - Paediatric burns.

PMID- 7794161
TI  - Pap smear technique.

PMID- 7794162
TI  - Pap smear technique.

PMID- 7794163
TI  - Use of antibiotics when taking the oral contraceptive pill.

PMID- 7794164
TI  - Euthanasia and ethics.

PMID- 7794166
TI  - Chronic pain and 'faith healing'.

PMID- 7794167
TI  - Mitogenic responses of the head-associated lymphoid tissues of the chicken.
AB  - A blastogenesis microassay employing 3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyl
      tetrazolium bromide (MTT) was adapted to measure blastogenic responses of
      lymphocytes from the chicken's head-associated lymphoid tissues (i.e., the
      harderian gland and conjunctiva-associated lymphoid tissue) to T- and B-cell
      mitogens. Lymphocytes isolated from peripheral blood, spleen, and the harderian
      gland had highly significant (P < 0.01) responses to T- and B-cell mitogens
      compared with control lymphocytes cultured without mitogens. Cultured lymphocytes
      obtained from the harderian gland had highly significant mitogenic responses to
      the T-cell mitogen concanavalin A (25 to 100 micrograms/ml) and to the B-cell
      mitogen Salmonella typhimurium lipopolysaccharide (1.25 to 5.0 micrograms/ml)
      compared with the control lymphocytes. Mitogenic responses of cultured
      lymphocytes obtained from the conjunctiva-associated lymphoid tissue could not be
      measured within the given parameters of the blastogenesis microassay. This was
      primarily due to the low yield of lymphocytes, which proved to be a limiting
      factor. The ability of the MTT blastogenesis microassay to detect blastogenic
      responses of the harderian gland to mitogens may be indicative of its usefulness
      for measuring cell-mediated immunity responses to other antigens.

PMID- 7794165
TI  - Supraventricular tachycardia and eczema due to milk allergy.

PMID- 7794168
TI  - Induction of tibial dyschondroplasia and suppression of cell-mediated immunity in
      chickens by Fusarium oxysporum grown on sterile corn.
AB  - An isolate of Fusarium oxysporum from corn associated with Kaschin-Beck disease
      in humans was tested for its ability to induce tibial dyschondroplasia (TD) and
      toxicity in chicks. Both leghorn and broiler chicks were fed diets in which corn
      was replaced with varied amounts (0% to 50%) of the F. oxysporum culture grown on
      sterile corn, or with known TD-inducing agents. F. oxysporum did not affect body
      weight in either type of chicks. In leghorn chicks, neither F. oxysporum nor the
      known TD-inducing agents (F. equiseti, 4%; tetramethylthiuram disulfide [Thiram],
      35 ppm) caused TD. However, F. oxysporum at high levels (50%) and the two known
      TD-inducing agents reduced interdigital cutaneous response to phytohemagglutinin
      P challenge. In addition, Thiram also reduced body-weight gain by more than 17%.
      In female broiler chicks (Cornish Rock), F. oxysporum not only decreased cell
      mediated cutaneous response to phytohemagglutinin-P but also increased TD
      incidence; these same effects were observed with F. equiseti and Thiram.
      Histological examinations revealed similar pathological changes among
      dyschondroplastic lesions induced by F. oxysporum, F. equiseti, and Thiram.
      Results of this experiment indicate that the isolate of F. oxysporum from the
      region in which Kaschin-Beck disease is endemic can induce TD in broiler chicks
      and that it is immunosuppressive.

PMID- 7794169
TI  - Physiologic and electrocardiographic changes occurring in broilers reared at
      simulated high altitude.
AB  - An experiment was conducted to determine whether differences in the
      electrocardiograms (EKGs) of broilers reared at simulated high altitude from the
      day of hatch can be used to predict which birds are developing ascites. In three
      replicate experiments, conducted with 100 broilers per replicate, birds were
      reared at a simulated altitude of 3000 meters or at ambient atmospheric pressure.
      Lead I, II, and III EKGs were obtained from all birds on days 0, 14, 28, and 42.
      No consistent significant differences were seen on day 0 in the amplitude of the
      R or S wave or total amplitude of the QRS complex when broilers that developed
      ascites while being reared at simulated high altitude were compared with
      unaffected birds reared at simulated high altitude and with birds reared at
      ambient atmospheric pressure. On days 14 and 28, the average amplitude of the S
      wave and the total amplitude of the QRS complex were significantly higher in the
      ascites group than in the two other groups. Packed cell volumes were
      significantly higher in birds reared at simulated high altitude at all sampling
      days (days 14, 28, and 42) than in those reared at ambient atmospheric pressure,
      and they were significantly higher in the ascites group on day 28 than in the two
      other groups. Birds in the ascites group weighed significantly less than the two
      other groups by day 14, and this trend persisted.

PMID- 7794171
TI  - Escherichia coli cellulitis: experimental infections in broiler chickens.
AB  - The objectives of this study were to evaluate the role of trauma to the skin in
      development of Escherichia coli cellulitis and to compare the abilities of three
      cellulitis isolates (O78, O115, O21,83), one airsacculitis isolate (untypable)
      and one fecal isolate (O86) of E. coli to induce cellulitis in broiler chickens.
      Forty-eight 4-week-old commercial broiler chickens were housed in groups of six
      in eight battery cages. For five groups, the skin on the left side of the
      abdominal region of chickens was traumatized by scratching with a 22-gauge
      needle, then contaminated with a swab dipped in a broth culture of one of the
      five E. coli isolates. For chickens in the remaining three groups, an avian
      cellulitis culture (O115, O21,83) or sterile broth was applied to intact skin.
      The experiment was duplicated. All birds were euthanatized 10-13 days
      postinoculation. No lesion developed in chickens in which the skin had not been
      traumatized. Among the traumatized birds, cellulitis isolates induced
      characteristic lesions of cellulitis in 86% of the birds, whereas airsacculitis
      and fecal isolates induced lesions in 42% and 8% of birds, respectively. Severe
      or moderate gross pathologic changes were found in 86% and microscopic pathologic
      changes were found in 88% of birds inoculated with cellulitis isolates; the
      corresponding percentages for the airsacculitis isolate were 25% and 17%. This
      study demonstrated that trauma to the skin is necessary for initiating disease
      and that strains of E. coli of serotypes epidemiologically associated with
      cellulitis are highly virulent in experimental infection.

PMID- 7794170
TI  - Characteristics of Escherichia coli isolates from avian cellulitis.
AB  - The purpose of this study was to characterize Escherichia coli isolates from
      avian cellulitis, particularly with respect to the occurrence of potential
      virulence factors. At slaughter, five broilers with lesions of cellulitis were
      selected from each of 20 farms from among the broilers processed. One hundred E.
      coli isolates from the lesions were characterized with respect to serotype;
      biotype; drug susceptibility; plasmid profile; ability to produce aerobactin,
      colicin, colicin V, and hemolysin; and cytotoxicity for Vero cells and chicken
      fibroblasts. The same properties were determined from a collection of 25 E. coli
      from the feces of chickens. Serotyping showed that, among the cellulitis
      isolates, 23 belonged to O group 78, 14 belonged to O2, eight belonged to O115,
      and seven belonged to O(21.83); 25 were untypable. Isolates from a single farm
      typically belonged to three to five O groups. More than half of the fecal
      isolates were untypable, and the rest were distributed among seven O groups.
      Biotype, drug-resistance pattern, and plasmid profile could not be used as
      markers of avian cellulitis E. coli. No plasmid was detected in 12% of cellulitis
      isolates and 48% of fecal isolates. No isolate was hemolytic or showed cytotoxic
      effects. Aerobactin was produced by 90% of cellulitis isolates, and colicin was
      produced by 85% of these isolates; the corresponding percentages for the fecal
      isolates were 16% and 40%. Production of colicin V was detected in 21% of
      cellulitis isolates and 24% of fecal isolates.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794173
TI  - Consumptive coagulopathy in turkeys exposed to Pasteurella multocida.
AB  - When turkeys were inoculated intramuscularly with live Pasteurella multocida,
      three of the four inoculated turkeys developed an increase in modified Russell's
      viper venom time (mRVVT) 24 hours after inoculation. This increase was followed
      by irregular decreases and increases in mRVVT at subsequent bleedings. When
      turkeys were inoculated intravenously with P. multocida, the mRVVT increased
      markedly after inoculation in all eight inoculated turkeys: 9 hours later, the
      average mRVVT was significantly (P < 0.05) higher than that of the uninoculated
      turkeys. No microthrombi were observed in the blood vessels of the liver, spleen,
      kidneys, or lungs. An increase in mRVVT was interpreted as an excessive
      consumption of one or more of clotting factors X, V, II, and I. These results
      indicate that consumptive coagulopathy could be a factor in the pathogenesis of
      fowl cholera in turkeys.

PMID- 7794174
TI  - Incidence of Pasteurella multocida in poultry house cats used for rodent control
      programs.
AB  - Cats used as mousers in commercial poultry breeder farms were tested for the
      presence of Pasteurella multocida. Of the cats tested, 72.7% were positive for P.
      multocida serotypes common to both farm cats and commercial broiler breeders.
      Thirty-one percent were type 1, 19% were type 4, and 6% were type 3.4.

PMID- 7794172
TI  - Immunosuppression and intracellular calcium signaling in splenocytes from chicks
      infected with chicken anemia virus, CL-1 isolate.
AB  - Hematocrits, histopathology, concanavalin A-induced lymphocyte proliferation,
      intracellular calcium signaling, and lymphocyte subpopulations were analyzed over
      a 6-week period in individual chicks inoculated with the CL-1 isolate of chicken
      anemia virus. Lymphoid depletion/atrophy was present in the thymus and bone
      marrow by 11 days post-infection (PI). Anemia was present at 14 days PI. The mean
      lymphocyte proliferation stimulation index (SI) of the inoculated group was
      significantly lower than that of the control group at 11 days PI. This response
      was reversed at 18 days PI, when the SI of the inoculated group was significantly
      higher than that of the controls; values subsequently returned to baseline. The
      increase in intracellular calcium levels in CAV-infected chicks and controls
      paralleled the proliferative response. Percentages of CD3-, CD4-, CD8-, and
      natural-killer-positive-staining cells decreased significantly at 18 and 25 days
      PI. The most dramatic decrease occurred in the CD8-positive-staining cell
      population at 18 and 25 days PI.

PMID- 7794175
TI  - Incidence of campylobacters in the intestine of avian species in Alabama.
AB  - Avian species necropsied at the C. S. Roberts Veterinary Diagnostic Laboratory,
      Auburn, Alabama, from December 1993 until May 1994 were examined for the
      incidence of intestinal campylobacters. Ninety-one intestinal swabs, representing
      66 separate cases and 17 different avian species, were collected and placed into
      Cary-Blair transport medium. Selective enrichment and culture media were used for
      initial isolation of Campylobacter spp. Presumptive colonies were identified as
      Campylobacter spp. by phase-contrast microscopy and Gram stain, and they were
      confirmed by serological latex agglutination. Campylobacter spp. were isolated in
      18 (19.7%) of the 66 cases. From the remainder of the cases, 13 (15%) yielded
      presumptive colonies on Campy-Cefex agar; however, they were not confirmed
      serologically as Campylobacter spp. Use of Cary-Blair transport medium held in
      refrigeration for up to 24 days did not hinder the determination of
      campylobacters in intestinal samples. A variety of avian species, including
      chicken, emu, hawk, ostrich, and parrot, harbored commensal campylobacters and
      therefore should be considered potential reservoirs.

PMID- 7794176
TI  - Formaldehyde vaporization in the hatcher and the effect on tracheal epithelium of
      the chick.
AB  - Chicken embryos were exposed to formaldehyde vapors in the hatcher during the
      final 3 days of incubation. Measured formaldehyde levels approached 130 ppm.
      Tracheas collected at hatch and 5 days post-hatch were evaluated for functional
      and morphologic changes. Tracheal cilia motility was reduced in formaldehyde
      exposed chicks. Scanning electron microscopy revealed blunted cilia and blebs
      occurring in the cilia surfaces. At 5 days of age, excessive tracheal mucus was
      present. Sloughing of the tracheal epithelium was visible by light microscopy.

PMID- 7794177
TI  - Salt toxicosis in commercial turkeys.
AB  - Salt toxicosis was confirmed in a flock of 20,000 thirteen-week-old tom turkeys
      experiencing an increase in mortality. Clinical signs included polydipsia,
      diarrhea, ataxia, incoordination, tremors that progressed to depression, sternal
      and lateral recumbency accompanied by torticollis, and death. Mortality over a 5
      day period was 6.7%. Necropsy lesions included pallor and dehydration of pectoral
      muscles, hepatic congestion, and fluid-filled small and large intestines.
      Microscopic lesions consisted of bilaterally symmetrical areas of necrosis within
      the cerebral hemispheres accompanied by vascular congestion and edema, as well as
      hyalinization of the glomerular capillary walls of the kidney and eosinophilic
      granular casts in the renal tubules. Average salt concentration in the feed from
      affected houses with 8.04%.

PMID- 7794178
TI  - Hypoglycemia, enteritis, and spiking mortality in Georgia broiler chickens:
      experimental reproduction in broiler breeder chicks.
AB  - The clinical signs, hypoglycemia, and mortality of "spiking mortality syndrome"
      were experimentally reproduced. Seven groups of day-old male primary broiler
      breeder chicks were orally inoculated with tissue and/or fecal-urate homogenates
      taken from field broilers with spiking mortality syndrome and from field broilers
      with enteritis and/or runting-stunting syndrome. All homogenates used as inocula
      were shown by transmission electron microscopy and negative staining to contain
      arenavirus-like particles. Inocula produced from field broilers with spiking
      mortality syndrome contained the highest numbers of the arena-virus-like
      particles and produced the highest percentage of hypoglycemic chicks 13-15 days
      postinoculation after a 5-to-9-hour fast. These homogenates also produced the
      most significant differences in mean plasma growth hormone and insulin-like
      growth factor-1 levels. The significance of the arenavirus-like particles is
      unknown but is currently being investigated.

PMID- 7794179
TI  - Intralesional herpesvirus, reovirus-like particles, and bacteria in a flock of
      broiler chicks with spiking mortality, diarrhea, and enterotyphlitis.
AB  - The search for a solitary cause of spiking mortality (so-called spiking mortality
      syndrome) among broiler chicks has been thwarted by the fact that multiple agents
      cause similar mortality histograms. In the present case report, we describe
      intralesional herpesvirus, reovirus-like virus particles, and bacteria in small
      and large intestines from chicks with a spiking mortality histogram, diarrhea,
      and enterotyphlitis. We attributed the spiking mortality histogram to starvation
      coupled with diarrhea.

PMID- 7794180
TI  - Effect of calcium/phosphorus imbalance in the ration on flock performance in two
      broiler flocks in north Georgia.
AB  - Five- and six-day-old broilers from two flocks experiencing excessive mortality
      were submitted for necropsy. Rickets was diagnosed based on clinical signs of
      lameness and on gross and histopathologic lesions. Because of a confirmed feed
      mill error, these flocks had been fed a starter ration with a high
      calcium/phosphorus ratio (either 7.7:1 or 3.5:1). After debate concerning the
      profitability of salvaging the remaining birds in the affected flocks, the
      starter feed was replaced at 7 days of age. At processing, the affected flocks
      had weighted averages of body weight and feed conversion of 1.71 kg and 1.88,
      respectively; these averages compared favorably with the company averages of 1.72
      kg and 1.87. The majority of the mortality in the affected flocks occurred during
      the first week. This case report demonstrates that it may be advantageous for a
      producer to salvage chicks that have been affected severely with rickets at less
      than 1 week of age.

PMID- 7794181
TI  - Enteritis in turkeys associated with an unusual flagellated protozoan (Cochlosoma
      anatis).
AB  - Outbreaks of enteritis associated with an unusual flagellated protozoan occurred
      in six California turkey flocks during the summer of 1992. Certain morphological
      and ultrastructural details of the parasite, which resembles Cochlosoma anatis,
      are illustrated with scanning and transmission electron micrographs. The
      flagellate attached to the intestinal mucosa by means of a sucker-like apparatus,
      and circular impressions of the sucker were created on the surface epithelium.
      Histological lesions were characterized by blunting and fusion of villi; cellular
      infiltration of the lamina propria with lymphocytes, plasma cells, histiocytes,
      and heterophils; and increased numbers of mitotic figures in crypt epithelium.

PMID- 7794182
TI  - Erysipelas in quail and suspected erysipeloid in processing plant employees.
AB  - Erysipelas was diagnosed in two commercial breeder flocks of Coturnix quail and
      was characterized clinically by sudden mortality. At necropsy, lesions comprised
      generalized congestion, hemorrhages in the thigh and breast muscles, swelling of
      liver, spleen, and kidney, and dark red edematous lungs. Erysipelothrix
      rhusiopathiae was cultured from visceral organs of affected birds. Medication
      with penicillin in the drinking water controlled the mortality. A possible source
      of infection was fish raised on the premises. Seven people at the quail
      processing plant developed localized inflammation of the fingers, which responded
      when antibiotic therapy for erysipeloid was initiated.

PMID- 7794183
TI  - Mycotic rhinitis in an ostrich.
AB  - A 2-year-old female ostrich had become gradually emaciated over a 4-month period
      and subsequently died. Gross necropsy revealed a granulomatous mass filling the
      right nasal passageways. Microscopically, the mass contained numerous thin,
      regular-diameter, septate, branching fungal hyphae consistent with Aspergillus
      sp. and foreign plant material. This appears to be the first report of a mycotic
      granuloma limited to the nasal cavities of an ostrich or any other ratite
      species.

PMID- 7794184
TI  - Intestinal smooth muscle hyperplasia in a rhea (Rhea americana).
AB  - Smooth muscle hyperplasia of the small intestine occurred in an 18-month-old rhea
      (Rhea americana). The mucosal thickening was 2-3 mm, and the enlarged muscle
      layers averaged 5 mm thick. The intestinal villi were lengthened, pleated, and
      expanded by smooth muscle hyperplasia within the lamina propria. The prominent
      muscularis mucosa averaged 20 smooth muscle cells thick. The tunica muscularis
      had symmetrical hyperplasia of both the inner circular muscle layer, which had an
      excess of 220 cells, and the outer longitudinal muscle layer, which consisted of
      five to six large fascicles, each approximately 75 cells thick. The smooth muscle
      hyperplasia, without hypertrophy, in all intestinal muscle layers differs greatly
      from mammalian cases of smooth muscle hypertrophy, in which the increase in
      intestinal size results from smooth muscle hypertrophy of the tunica muscularis.

PMID- 7794186
TI  - Comparison of prophylactic and therapeutic efficacy of Salmonella enteritidis
      immune lymphokines against Salmonella enteritidis organ invasion in neonatal
      Leghorn chicks.
AB  - Investigations in our laboratories have indicated that when Salmonella
      enteritidis (SE)-immune lymphokines--supernatants from concanavalin-A-stimulated
      T cells derived from SE-immune adult chickens--were administered
      intraperitoneally to 1-day-old chicks before SE challenge, they conferred
      protection against SE organ invasion within 24 hr. This resistance mediated by SE
      immune lymphokines was associated with a concomitant increase in peripheral blood
      polymorphonuclear leukocytes that peaked 4 hr after SE challenge. In the present
      study, we evaluated efficacy of SE-immune lymphokines in protecting chicks
      against SE organ invasion and alterations in peripheral blood polymorphonuclear
      leukocyte counts. Administration of SE-immune lymphokines to chicks either 30 min
      or 6 days before SE challenge caused a significant reduction in SE organ
      invasion. However, when SE-immune lymphokines were administered 2 days after SE
      challenge, there was no reduction in SE organ invasion. Both prophylactic (before
      SE challenge) and therapeutic (after SE challenge) administration of SE-immune
      lymphokines caused a significant increase in numbers of peripheral blood
      polymorphonuclear leukocytes. Results from these studies suggest that SE-immune
      lymphokines have potential value as an effective prophylactic but not as a
      therapeutic modulator of early resistance to SE organ invasion in neonatal
      leghorn chicks.

PMID- 7794187
TI  - Detection of specific antibodies directed against a consistently expressed
      surface antigen of Mycoplasma gallisepticum using a monoclonal blocking enzyme
      linked immunosorbent assay.
AB  - Sera from 14 groups of chickens inoculated with different laboratory and field
      strains of Mycoplasma gallisepticum (MG) were used to compare the diagnostic
      potential of the hemagglutination-inhibition (HI) test and a recently developed
      monoclonal blocking enzyme-linked immunosorbent assay (ELISA). HI was performed
      with strain A5969, commonly used as hemagglutinating antigen, and it could detect
      62.7% of the inoculated chickens as positive. Of all sera, 83% proved to be
      positive when examined with the blocking ELISA. The difference between the
      sensitivities of the two methods was due to group-specific insensitivity of the
      HI test. None of the sera from groups inoculated with strains K 1501, K 1503, K
      503, or K 703 and only half of the sera from groups inoculated with K 1453 or
      236C could inhibit the activity of the A5969 hemagglutinating antigen, indicating
      antigenic differences between these challenge strains and the diagnostic strain.
      ELISA detected MG-specific antibodies in every group of sera, although
      inoculation with variant strains K 503 or K 703 resulted in lower level of
      antibody production than inoculation with other strains. The monoclonal blocking
      ELISA can be useful in the serological diagnosis of MG infections, because it is
      based on a consistently expressed, specific region of MG.

PMID- 7794185
TI  - Central nervous system toxoplasmosis in Roller canaries.
AB  - Several birds in a flock of 40 Roller canaries (Serinus canaria) from an outdoor
      aviary in Victoria, Australia, developed central nervous system signs that
      included blindness, nystagmus, ataxia, and head rotation. Four died, and four
      were euthanatized. Two euthanatized birds were submitted for microscopic
      examination of tissues. Brain lesions in both birds consisted of scattered foci
      of nonsuppurative meningoencephalitis with gliosis, mild to moderately extensive
      lymphocytic/plasmacytic perivascular cuffs, and a patchy increased prominence of
      cerebral blood vessels associated with hypertrophy of the vascular endothelium
      and/or thickening of their connective tissue walls. These lesions were associated
      with the presence of Toxoplasma gondii tissue cysts. Lesions in the eyes of both
      birds were bilateral and consisted of severe plasmacytic/granulomatous
      ophthalmitis. Surviving birds were treated with trimethoprim and sulfadiazine, no
      subsequent deaths occurred, and no new cases developed over an 8-month period.

PMID- 7794190
TI  - Isolation of Salmonella from poultry tissue and environmental samples: a
      nationwide survey.
AB  - A nationwide survey of veterinary laboratories culturing poultry tissue and
      environmental samples for Salmonella found a large variation in isolation
      procedures. There were 17 different selective enrichment media or combinations of
      enrichment media being used for poultry tissue samples. Variations were found in
      how long the selective enrichments were incubated and in the temperature of
      incubation. There were 14 different plating media being used. Many laboratories
      screen and identify only one colony from the plating media. For the protection of
      poultry breeding and hatchery organizations and with the formation of official
      poultry monitoring programs, with their legal and public health implications, it
      becomes increasingly important that diagnostic laboratories adopt minimal
      standardized protocols for isolating Salmonella.

PMID- 7794189
TI  - Prevalence of Salmonella in broiler flocks: effect of litter water activity,
      house construction, and watering devices.
AB  - Litter samples from 24 flocks of broilers and four flocks of broiler breeders
      were evaluated for Salmonella contamination, water activity (Aw), and total
      moisture content (MC). The drag swab (DS) monitoring system was used to collect
      samples to detect Salmonella contamination. Simultaneously, representative
      samples of the uppermost surfaces of dry (loose) litter and wet (caked) litter
      were collected for Aw and MC analyses. On dry litter surfaces, high Aw values
      (0.90-0.95) were associated with flocks Salmonella-positive using DS; low Aw
      values (0.79-0.84) were associated with flocks Salmonella-negative by DS; and
      transition Aw values (0.85-0.89) were associated with flocks having an increased
      risk for the presence of Salmonella. The association of high Aw values with
      Salmonella risk was not observed for wet (caked) litter surfaces. Observations
      suggest that limiting Aw in the litter base of broiler houses may create a less
      favorable environment for the multiplication of Salmonella and thus a more
      hygienic environment for broiler production.

PMID- 7794188
TI  - Effects on turkey poults of feeding Fusarium moniliforme M-1325 culture material
      grown under different environmental conditions.
AB  - The effects of feeding Fusarium moniliforme M-1325 culture material (CM), grown
      under different environmental conditions, were studied in turkey poults. Poults
      were fed a control diet or diets containing four levels of FB1 (75, 150, 225, or
      300 mg/kg) prepared from F. moniliforme M-1325 cultures that produced 7800 (CM1)
      or 4000 mg FB1/kg (CM2). F. moniliforme M-1325 CM that produced a low
      concentration of FB1 (350 mg FB1/kg) was also used to prepare an additional diet
      containing 75 mg FB1/kg (CM3). Dose-dependent decreases in feed intake and body
      weight gains and dose-dependent increases in liver weights and serum sphinganine
      (SA) to sphingosine (SO) ratios were observed in poults fed CM1 or CM2. Poults
      fed CM3 consumed more feed and had lower body-weight gains than controls or
      poults fed CM1 or CM2 (at 75 mg FB1/kg). Poults fed CM3 also had increased liver
      weights and SA:SO ratios compared with control poults. Generalized hepatocellular
      hyperplasia was observed in all FB1 treatment groups. Biliary hyperplasia was
      evident in turkeys fed 150 to 300 mg FB1/kg. Results indicate that at equivalent
      dietary FB1 levels, F. moniliforme cultures producing different concentrations of
      FB1 differ in their effects on turkey poults.

PMID- 7794191
TI  - Microbiological analysis of the early Salmonella enteritidis infection in molted
      and unmolted hens.
AB  - A study was conducted in which the early kinetics (4 hr to 96 hr) of an infection
      by Salmonella enteritidis in older white leghorn hens was examined, and a molt
      was induced through withholding feed to determine its effect on the progression
      of this infection. Molted and unmolted hens were orally infected with 5-10 x
      10(6) S. enteritidis on day 4 of the feed removal. At 4, 24, 48, 72, and 96 hr
      postinfection, liver, spleen, ileum, colon, cecum, and feces were removed from
      six hens per group and sampled for the presence of the challenge organism. By 24
      hr postinfection, S. enteritidis was most prevalent in the cecum and feces of
      unmolted hens, and this prevalence continued throughout the experimental period.
      In molted hens, however, S. enteritidis could be detected in a high percentage
      (90-100%) of colon, cecum, and feces samples at 24 to 96 hr postinfection and in
      67% or more of ileum samples at 48 to 96 hr postinfection, indicating a much
      wider distribution of the S. enteritidis along the intestinal tract than in
      unmolted hens. The numbers of S. enteritidis recovered from these alimentary
      samples were also significantly higher in molted than unmolted hens. S.
      enteritidis could not be detected in livers or spleens of either treatment group
      at 4 or 24 hr postinfection. At 48, 72, and 96 hr postinfection, 50% or more of
      the livers and spleens in both the molted and unmolted hens were positive for the
      challenge organism, but significantly more S. enteritidis was recovered from the
      organs of the molted hens at these three sampling times.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7794192
TI  - Presence of avian influenza virus (AIV) subtypes H5N2 and H7N1 in emus (Dromaius
      novaehollandiae) and rheas (Rhea americana): virus isolation and serologic
      findings.
AB  - Avian influenza virus (AIV) subtypes H5N2 and H7N1 were isolated from emus
      (Dromaius novaehollandiae) and rheas (Rhea americana) in Texas and North
      Carolina. All the rheas and emus had a history of respiratory disease except one
      emu, which was clinically normal. The isolates were not pathogenic for chickens
      and turkeys under the conditions of the experiment. Humoral antibodies to all
      known hemagglutinin (H) subtypes except H10, H13, and H14 and to all nine
      neuraminidase (N) subtypes were found in emus and rheas in 11 states. Therefore,
      emus and rheas are susceptible to infection with several AIV subtypes.

PMID- 7794193
TI  - Effect of T-lymphocyte depletion on the pathogenesis of marble spleen disease
      virus infection in ring-necked pheasants.
AB  - The purpose of this study was to determine the effect of cyclosporine (CSP)
      mediated T-lymphocyte depletion on the pathogenesis of marble spleen disease
      virus (MSDV) infection in ring-necked pheasants. Seventy-two 6-week-old pheasants
      were divided into three groups; one group of 18 birds was inoculated with MSDV, a
      second group of 18 birds was treated with CSP, and a third group of 36 birds was
      both treated with CSP and inoculated with MSDV. Two birds each from both of the
      smaller groups and four birds from the largest study group were necropsied
      periodically over a 14-day period. T-lymphoblastogenesis assays documented
      significant T-cell depression in the CSP-treated groups. Routine histology and
      immunohistochemical staining for MSDV antigen demonstrated that the CSP-treated
      MSDV-inoculated birds had higher lesion incidence, had wider tissue distribution
      of virus, and retained virus in tissues longer than did the MSDV-inoculated-only
      birds. These results indicate that T-lymphocytes play a role in the host response
      to infection with MSDV.

PMID- 7794194
TI  - Comparative pathology of intravenously inoculated wild duck- and turkey-origin
      type A influenza viruses in chickens.
AB  - Five-week-old specific-pathogen-free chickens were inoculated intravenously with
      one of 16 low-pathogenicity type A influenza virus isolates; 14 were of wild duck
      origin, and two were of turkey origin. Tubulointerstitial nephritis was the most
      frequent specific histopathologic change. The frequency and severity of kidney
      lesions were independent of the virus hemagglutinin-neuraminidase subtype or
      titer of the challenge virus. Influenza nucleoprotein was most frequently
      demonstrated in the kidney and was consistently localized to necrotic proximal
      and/or distal renal tubule epithelium. Common nonspecific histopathologic changes
      were lymphoid hyperplasia of the spleen and cecal tonsils, as well as lymphocyte
      depletion in the cloacal bursa. Uncommon histopathologic changes, in decreasing
      order of frequency, were interstitial pneumonia, lymphoid follicular hyperplasia
      in the myocardium, and lymphocytic tracheitis. Histopathologic changes were rare
      or absent in the jejunum, duodenum, pancreas, and brain. The low-pathogenicity
      avian-origin type A influenza virus isolates were epitheliotropic in chickens,
      primarily nephrotropic. Such findings were dissimilar from findings with highly
      pathogenic avian-origin type A influenza virus isolates both in severity and in
      tissue distribution of histopathologic changes and influenza viral antigen.

PMID- 7794195
TI  - An enzyme-linked immunosorbent assay for detection of avian mycoplasmas in
      culture.
AB  - An antigen-capture enzyme-linked immunosorbent assay (ELISA), using monoclonal
      antibody (Myc-9) against Mycoplasma pneumoniae, was developed for the detection
      of M. gallisepticum, M. synoviae, M. meleagridis, M. iowae, M. anatis, M. iners,
      and M. gallinarum antigens in cultures. ELISA plates were coated with Myc-9 and
      reacted with the different avian mycoplasma antigens, which were detected with
      adsorbed polyclonal anti-mycoplasma serum followed by anti-rabbit enzyme-labeled
      conjugate antiserum. Nonspecific reactions and cross-reactivity were eliminated
      by adsorbing polyclonal antisera with a pool of heterologous antigens, and a high
      degree of sensitivity was obtained by both antigen enrichment and treatment with
      the detergent N-octyl glucoside. Under these conditions, the test detected less
      than 10 colony-forming units/ml. This antigen-capture ELISA appears to be a
      highly specific, sensitive, reproducible tool and efficient in the diagnosis of
      mycoplasma infection.

PMID- 7794196
TI  - Association between pathogenicity of infectious bursal disease virus and viral
      antigen distribution detected by immunohistochemistry.
AB  - Highly pathogenic infectious bursal disease virus (IBDV) strains (Ehime/91, DV86)
      and a moderately pathogenic strain (J1) were compared in order to clarify the
      association between the pathogenicity of IBDV and viral antigen distribution.
      Virus target cells in the bursa, thymus, spleen, and bone marrow were examined by
      transmission electron microscopy. Although all strains caused similar bursal
      atrophy, the highly pathogenic strains brought about a greater decrease in the
      thymic weight index and more severe lesions in the cecal tonsil, thymus, spleen,
      and bone marrow. Immunohistochemical detection of IBDV antigen in tissues from
      chickens infected with Ehime/91 and DV86 strains showed a higher frequency of
      antigen-positive cells in the spleen and bone marrow. Transmission electron
      microscopy indicated the presence of viral particles in the cytoplasm of
      epithelial reticular cells in the thymus and monocytes in the bone marrow. The
      results show that pathogenicity of field strains of IBDV correlates with lesion
      production in non-bursal lymphopoietic organs. The results also suggest that
      pathogenicity of IBDV may be associated with virus antigen distribution in non
      bursal lymphopoietic organs.

PMID- 7794197
TI  - Serotypes and DNA fingerprint profiles of Pasteurella multocida isolated from
      raptors.
AB  - Pasteurella multocida isolates from 21 raptors were examined by DNA fingerprint
      profile and serotyping methods. Isolates were obtained from noncaptive birds of
      prey found in 11 states from November 28, 1979, through February 10, 1993. Nine
      isolates were from bald eagles, and the remaining isolates were from hawks,
      falcons, and owls. Seven isolates were members of capsule group A, and 14 were
      nonencapsulated. One isolate was identified as somatic type 3, and another was
      type 3,4,7; both had unique HhaI DNA fingerprint profiles. Nineteen isolates
      expressed somatic type 1 antigen; HhaI profiles of all type 1 isolates were
      identical to each other and to the HhaI profile of the reference somatic type 1,
      strain X-73. The 19 type 1 isolates were differentiated by sequential digestion
      of DNA with HpaII; four HpaII fingerprint profiles were obtained. The HpaII
      profile of one isolate was identical to the HpaII profile of strain X-73.
      Incidence of P. multocida somatic type 1 in raptors suggests that this type may
      be prevalent in other wildlife or wildlife environments.

PMID- 7794198
TI  - Mental health law: institutionalised discrimination.
AB  - The aim of the paper is to propose that special mental health laws be replaced by
      generic protection and prevention legislation. The arguments used for the
      detention and compulsory treatment of persons with mental illnesses are analysed,
      and found not to justify protection and prevention rules which apply only to
      persons with mental illnesses. Two separate systems of legal intervention should
      be established to deal with (1) all persons in need of compulsory care and (2)
      all persons who require to be detained for the prevention of harm to others.

PMID- 7794199
TI  - Mental health law: an idea whose time has passed.
AB  - In this paper I argue that specific mental health law should not exist and should
      be replaced by modern guardianship law which is non-discriminatory and which
      intervenes according to need rather than diagnostic classification. Substituted
      consent provided by a guardian protects the patient and the treatment provider.
      Custody to prevent danger to others should remain with courts rather than
      informal proceedings where individual rights to freedom are less carefully
      protected. Special mental health law stigmatises people with mental illness and
      degrades their treatment. It also diminishes the standing of the psychiatric
      profession which advocates the continuation of such laws.

PMID- 7794201
TI  - Images of psychiatry in recent Australian and New Zealand fiction.
AB  - Psychiatry is variously portrayed in Australian and New Zealand fiction. This
      paper describes mental health professionals, settings, conditions, treatments,
      and social themes essayed in 128 works by 103 authors, published between 1957 and
      1992. The predominant images are negative or markedly ambivalent: possible
      reasons for this are discussed. The perception of psychiatry by the culture in
      which it is formed and located, as mediated by its creative artists, has
      important implications for psychiatrists' understanding and explication of their
      social role, and has an impact on patients' expectations and experiences of
      psychiatry.

PMID- 7794200
TI  - Abnormal illness behaviour: a 25th anniversary review.

PMID- 7794202
TI  - A review of dissociation and dissociative disorders.
AB  - There has been an explosion of activity concerning dissociation and dissociative
      disorders overseas, but little interest is apparent in Australian psychiatric
      publications. This article aims to critically examine the current
      conceptualisation of dissociation and its proposed relevance to the understanding
      of psychopathology, in order to create discussion about these issues in
      Australian psychiatry. Multiple personality disorder and post-traumatic stress
      disorder are critically examined.

PMID- 7794203
TI  - To see or not to see: the debate over pornography and its relationship to sexual
      aggression.
AB  - The role played by pornography in the generation of thoughts, feelings, impulses
      and behaviours in its viewers has long been a topic of debate and controversy.
      The uncertainty about its potential effects on human behaviour, especially its
      relationship to sexual aggression, has stimulated the recent debate with the
      possibility of tighter censorship laws being implemented throughout this country.
      A review of the topic from a number of different perspectives fails to establish
      that pornography in its purely erotic form has any significant detrimental effect
      on human behaviour. More difficult to determine are its effects on psychological
      development. If behavioural disturbances do occur following exposure to such
      material, they occur in the context of an individual who shows more global
      disturbances of personality. The current debate regarding pornography provides an
      opportunity to address in a broader social context issues perhaps more
      significant for our society: the relationships between men and women, and the
      roles and recognition provided to each of the sexes.

PMID- 7794204
TI  - The influence of illness duration on syndrome clarity and stability in functional
      psychosis: does the diagnosis emerge and stabilise with time?
AB  - This review aims to examine the relationship between phase and duration of
      illness and the clarity and stability of syndromes in psychotic illness.
      Originating from clinical experience with first episode psychosis, where Neo
      Kraepelinian templates and the underlying model have felt especially awkward and
      ill-fitting, a hypothesis that the clinical picture of functional psychosis might
      become clearer over time and stabilise in individual patients is proposed which
      involves the notion of differentiation. A broad range of psychopathological
      studies and historical papers which refer directly or indirectly to the evolution
      of the clinical picture in psychosis over time are reviewed. The findings are
      difficult to interpret, since few studies have focused directly on the issue;
      however there is evidence of evolution over time of the clinical picture,
      particularly within the schizophrenia spectrum, and instability beyond this.
      Further research is needed to clarify the longitudinal patterns of
      psychopathology in psychotic illness. The capacity for evolution and instability
      and consequent scope for reclassification of patients has important implications
      for research and psychoeducation in early psychosis.

PMID- 7794206
TI  - The reactivation of post-traumatic stress disorder in later life.
AB  - Forty-five World War II veterans reporting recent reactivation of chronic post
      traumatic stress disorder (PTSD) symptoms were clinically assessed in order to
      determine war pension disability. In the course of these examinations, factors
      implicated in the exacerbation of their re-experiencing and arousal symptoms were
      recorded. The most prominent of these factors was that of physical ill health.
      Retirement, loneliness, comorbid psychiatric illness, anniversaries, service
      reunions, and alcohol and psychotropic medication usage were other factors. The
      natural history of chronic PTSD was observed by reviewing the veterans' medical
      records, which had been commenced at enlistment, prior to active service. The
      masking of intrusive symptoms in mid-life was usual. A terminal phase of
      symptomatic reactivation in older age may occur. The indelibility of the memory
      of fear is demonstrated by these veterans. The reticence to retell the trauma
      story remains a major obstacle in the study of the mental health sequelae of
      warfare. War-related psychiatric disorder in the elderly male is easily missed.
      Direct questioning regarding military service is advisable. The ineffectiveness
      of the management strategies offered to World War II PTSD sufferers is clearly
      apparent.

PMID- 7794205
TI  - High prevalence of thyroid function test abnormalities in chronic schizophrenia.
AB  - The thyroid status of 249 patients with chronic schizophrenia (males = 136,
      females = 113) with a median age of 36 years (range: 16 to 58 years) and a median
      duration of hospitalisation of 10 years (range: 1 to 30 years) was assessed.
      Thyroid antibodies (TAb) were found in 51 patients (20%). In female patients, 32
      (28%) were TAb positive compared to 13% (n = 152, p = 0.01) in healthy female
      blood donors. In male patients, the prevalence of TAb was 14% compared to 7% (n =
      449, p = 0.01) in healthy male blood donors. Of the 183 patients who had thyroid
      hormone measurements, 60% had normal test, 5% had elevated TSH and 17% had low
      TSH. The T4, FT41 and FT31 were significantly lower in those with low or high TSH
      (p < 0.001) compared to those with normal TSH. Of the 143 patients with normal
      TSH, 33 (23%) had low T3. In conclusion, there is a spectrum of thyroid function
      test abnormalities in chronic schizophrenia; this may be related to an
      abnormality in the central regulation of the hypothalamo-pituitary thyroid axis
      as well as at the peripheral level. However the association between chronic
      schizophrenia and the presence of thyroid antibodies, and the clinical relevance
      of these biochemical abnormalities, are still not clear.

PMID- 7794207
TI  - Childhood depression, stressors and parental depression.
AB  - The relationship between depression and stressors and the relationship between
      depression in children and depression in their parents were investigated.
      Depressed children aged 7-11 years (n = 20) were compared with clinical non
      depressed children (n = 88) and normal children (n = 55). Children, mothers and
      fathers in the three groups were tested. Measures included the Children's
      Depression Inventory, Recent Life Events Scale, Stressor Scale and Beck
      Depression Inventory. The findings showed that children and mothers in the
      depressed group reported more stressors than other children and other mothers
      while fathers of children in the depressed group did not report more stressors.
      The findings also showed that mothers of depressed children were more depressed
      than mothers of normal children while there were no differences between the
      scores of fathers in the three groups.

PMID- 7794208
TI  - Depression in patients with HIV and AIDS.
AB  - In this paper we review studies of depression in patients with HIV/AIDS.
      Methodological issues of importance in understanding and evaluating depression in
      this patient population are described, and methodological variations between
      studies, particularly in reference to methods of case detection, diagnostic
      criteria used and characteristics of the populations studied, are identified. The
      findings reported in the current literature in general are contrary to what would
      be expected from an examination of the significant biological and psychosocial
      stresses of individuals with HIV, and are inconsistent with those of other life
      threatening illnesses and CNS diseases. Clear conclusions regarding the
      prevalence of depression and its effect in patients with HIV/AIDS cannot yet be
      made.

PMID- 7794209
TI  - Neural networks and psychiatry: candidate applications in clinical decision
      making.
AB  - Neural networks comprise a fundamentally new type of computer system inspired by
      the functioning of neurons in the brain. Such networks are good at solving
      problems that involve pattern recognition and categorisation. An important
      difference between a neural network and a traditional computer system is that in
      developing an application, a neural network is not programmed; instead, it is
      trained to solve a particular type of problem. This ability to learn to solve a
      problem makes neural networks adaptable to solving a wide variety of problems,
      some of which have proved intractable using a traditional computing approach.
      Neural networks are particularly suited to tasks involving the categorisation of
      patterns of information, such as is required in diagnosis and clinical decision
      making. In the last three years reports of applications involving neural networks
      have begun to appear in the medical literature, and these are described in this
      paper. However, a comprehensive search of the literature has shown that there
      have not as yet been reports of any applications in psychiatry. This paper
      discusses the nature of clinical decision making, outlines the sorts of problems
      in psychiatry which neural networks applications might be developed to address,
      and gives examples of candidate applications in clinical decision making.

PMID- 7794210
TI  - Intensive cognitive-behaviour group therapy for diagnostically heterogeneous
      groups of patients with psychiatric disorder.
AB  - This uncontrolled study evaluates the efficacy of a combined treatment of
      medications (for the majority of patients) and a closed group, intensive (two
      week) cognitive-behaviour therapy programme for heterogeneous groups of
      psychiatric patients. Five hundred and thirty-one patients at a private
      psychiatric clinic were included in the study. Self-report measures of
      depression, anxiety, self-esteem and "locus of control" were administered before
      and after treatment and at intervals up to one year later. Statistically and
      clinically significant improvements were found in all measures and these
      improvements were maintained up to one year. The results provide support for the
      efficacy of the treatment.

PMID- 7794211
TI  - Electrode placement, stimulus dosing and seizure monitoring during ECT.
AB  - Electroconvulsive therapy is one of the most useful, safe and predictable
      treatment modalities in psychiatry. For optimal results proper application of the
      procedure is essential. Over the years the procedure has undergone considerable
      refinement, yet not all those who administer the treatment are fully conversant
      with this. This paper addresses issues relating to electrode placement, stimulus
      dosing and seizure monitoring from practical and clinical points of view. Right
      unilateral ECT, if administered with high electrical stimulus, produces results
      close to bilateral treatment with substantially less cognitive impairment.
      However, certain patients may only respond to bilateral ECT. Adequate training
      for clinicians administering ECT is recommended.

PMID- 7794213
TI  - Catatonia and ECT.

PMID- 7794212
TI  - Demographic and readmission data in a therapeutic community for black psychiatric
      patients in South Africa.
AB  - Therapeutic communities have an important role in adult psychiatric care. Such a
      hospital unit is described within a Black psychiatric hospital in South Africa.
      However, owing to apartheid very few Black clinical psychologists have been
      trained. Translators frequently have to be used in the therapeutic context, which
      is an unorthodox approach. Nevertheless, various therapeutic groups are
      conducted. Demographic and clinical data for a 3 year period are presented,
      showing most of the patients to be male, unmarried and around 30 years of age.
      Schizophrenic conditions were the most common diagnoses, with problems of self
      care and low self-esteem predominating. Although a readmission rate of 22.1% was
      noted the lack of adequate control measures in this study must be taken into
      consideration.

PMID- 7794214
TI  - Dis-attachment.

PMID- 7794216
TI  - Self harm.

PMID- 7794215
TI  - Attention deficit disorder.

PMID- 7794218
TI  - Ritualised self harm in traditional aboriginal society.

PMID- 7794217
TI  - Serotonin and drug-induced movement disorders.

PMID- 7794221
TI  - Thermal study of anti-G ensembles aboard F-16 aircraft in hot weather.
AB  - Continuing advances in the performance of new fighter aircraft have engendered
      requirements for more sophisticated protective clothing and life support systems.
      A major goal is prevention of acceleration-induced loss of consciousness. The
      USAF's Advanced Technology Enhanced Design G-Ensemble (COMBAT EDGE) increases
      acceleration tolerance by providing positive pressure to the oxygen mask; the
      work of pressure breathing is reduced by adding a counter-pressure bladder over
      the chest. However, the addition of impermeable layers over the chest reduces the
      area available for evaporation of sweat. This study was designed to determine
      whether COMBAT EDGE (CE) was demonstrably hotter than standard summer flight
      clothing (ST) during F-16 sorties in hot weather. Eight male pilots served as
      volunteer subjects, each flying missions at 1430 and 1745 h on two consecutive
      days, one day with CE and the other with ST. Data were logged at 1-min intervals
      for rectal temperature (Tre), skin temperatures at the chest and thigh (Tch and
      Tth) and air temperatures outside the clothing at the same two sites (Tach and
      Tath). The weather was stable over the 4 d of data collection with highs of 34-36
      degrees C and simultaneous dewpoints of 19-23 degrees C (relative humidity 35
      45%). The mean Tach was stable at 28 degrees C in flight, while individual means
      for Tath ranged from 22 to 25 degrees C. The lower value and greater variability
      at the thigh reflect its proximity to the air conditioning vent. Despite the
      differences in air temperature, Tch and Tth remained in the range 34-36 degrees C
      throughout the flights.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794220
TI  - Comparison of bifocal and progressive addition lenses on aviator target detection
      performance.
AB  - The objective of this project was to determine if the type of presbyopic
      correction worn by aviators, conventional bifocal versus progressive addition
      lenses (PAL's), differentially affects aviator visual search performance.
      Experienced aviators, most with tactical fighter aircraft experience, searched
      for high-contrast targets under simulated dawn/dust (mesopic) lighting conditions
      (approximately 3.0 cd/m2) while wearing either a standard bifocal (ST-25) or PAL
      spectacle correction. Latency of locating high-contrast targets under these
      viewing conditions was differentially affected by the type of presbyopic
      correction used. Specifically, compared to a standard bifocal (ST-25), a PAL
      correction (Varilux Infinity) significantly lowered the time needed to locate
      static targets at a cockpit instrument viewing distance (83 cm). Accuracy of
      target location responses was not affected by the type of correction used. In
      addition, 7 months post-experiment, 7 of the 12 participants (58%) indicated that
      they used their PAL correction exclusively when flying the T-39 Sabre Liner.
      Three subjects (25%) used their PAL correction intermittently (primarily at
      night) when flying and two subjects preferred not to use the PAL's. These results
      suggest that relative to bifocals, speed of responding to static targets at
      intermediate viewing distances may be improved by wearing PAL's, and that
      subjects were able to adapt to PAL lenses quickly in a laboratory setting, using
      them later in a functional aviation environment.

PMID- 7794219
TI  - Jet pilot, helicopter pilot, and college student: a comparison of central vision.
AB  - Jet pilots (JP) (N = 44), helicopter pilots (HP) (N = 29), and college students
      (CS) (N = 41) were tested with a battery of vision tests designed to assess
      vision skills important for success as a naval aviator. Tests included measures
      of reaction time, high-contrast acuity, low-contrast acuity, spot detection, far
      to-near gaze shift, near-to-far gaze shift, low-contrast acuity with glare, and
      dark focus. A Multi-Variate Analysis of Variance (MANOVA) compared the vision
      test performance of the three subject groups (JP, HP, and CS). Only with the Far
      to-Near test was there no difference among the three groups. On all other tests,
      JP outperformed CS. The difference between HP and CS was less consistent and less
      dramatic than the difference between JP and CS. Only with the glare test were CS
      significantly better than HP. The results were interpreted as reflecting the
      influence of various selection factors, operational requirements, differential
      attrition, and age.

PMID- 7794222
TI  - The effects of tyrosine on cognitive performance during extended wakefulness.
AB  - Tyrosine, a large neutral amino acid found in dietary proteins, has received
      recent attention as a potential treatment for stress. The behavioral effects of
      tyrosine were examined during an episode of continuous nighttime work involving
      one night's sleep loss. Subjects performed nine iterations of a battery of
      performance tasks and mood scales for approximately 13 h, beginning at 1930 and
      ending at 0820. They remained awake throughout the day on which the experiment
      began and were awake for more than 24 h by the end of testing. Six hours after
      the experiment began, one-half of the subjects received 150 mg.kg-1 tyrosine in a
      split dose while the other half received cornstarch placebo in a double-blind
      procedure. Tyrosine administration was associated with a significant amelioration
      of the usual performance decline on a psychomotor task and a significant
      reduction in lapse probability on a high-event-rate vigilance task. The
      improvements lasted on the order of 3 h. The results of this study also suggest
      that tyrosine is a relatively benign treatment at this dose. After further
      testing with other doses and timing of administration, tyrosine may prove useful
      in counteracting performance decrements during episodes of sustained work coupled
      with sleep loss.

PMID- 7794223
TI  - The relationship between the U.S. Navy fleet diver physical screening test and
      job task performance.
AB  - The development of job-related selection and training methods will improve safety
      and lead to substantial cost savings to the U.S. Navy through enhanced screening
      and productivity. The present investigation determined the extent to which the
      current U.S. Navy fleet diver physical screening test predicted performance of
      five representative physically demanding job tasks. Subjects were 146 male diver
      candidates (age 25.1 +/- 4.3 years, X +/- SD, range 18-37 years) undergoing
      training at the Naval Diving and Salvage Training Center, Panama City, FL.
      Results indicate the current U.S. Navy fleet diver physical screening test
      provides a poor estimate of representative job task performance for the
      population of diver candidates tested. A finding of particular operational
      significance was that a substantial number of diver candidates who passed current
      physical screening test standards were unable to complete (i.e., failed) the tool
      bag swim (18.5%) and fin-kick (25.7%) tasks. Results suggest the current
      screening test has limited utility for physical selection purposes and underscore
      the need for developing a requirements-based selection battery to ensure that
      diver physical capabilities are aligned to the job.

PMID- 7794225
TI  - Psychological changes during altitude hypoxia.
AB  - We examined the effects of altitude hypoxia on the subject's cognitive functions
      and psychological state. Two assessment approaches were used, a cognitive-motor
      task and a structured interview. An experimental group of six subjects was tested
      three times: once under conditions of normoxia, once 8-20 h after a rapid climb
      to an altitude of 4383 m, and once 48-60 h after ascent to that altitude. A
      comparison of the experimental group's performance on the cognitive-motor task
      with that of a control group showed a difference on the second administration:
      the experimental group's performance did not improve, whereas the control group's
      performance did. This difference recovered on the third administration. A
      comparison of the subjects' verbalizations during the three interviews showed
      that they experienced a strong crisis during the first period at altitude, which
      improved partially during the second period. Evidence for use of certain defense
      mechanisms, e.g. self-concern, was found 8-20 h after ascent; both dependent
      measures were adversely affected. These measures recovered after 48-60 h.

PMID- 7794224
TI  - Effects of high altitude and cold exposure on resting thyroid hormone
      concentrations.
AB  - This study examined the effect of high altitude and cold exposure on thyroid
      hormone status during a mountaineering expedition. There were 15 males
      participating in an expedition to climb Mt. McKinley, AK. Resting blood samples
      were collected and analyzed for thyroid-stimulating hormone (TSH), total (T)-free
      (f) thyroxine (T4), triiodothyronine (T3), reverse T3 (rT3), and cortisol.
      Measurements were made on three occasions: baseline in the continental U.S. one
      week pre-expedition (PRE-I), baseline in Alaska immediately pre-expedition (PRE
      II), and immediately upon descent post-expedition (POST). Statistical analysis
      indicated that no significant trial PRE-I vs. PRE-II (p > 0.05) differences
      occurred. Significant (p < 0.05) reduction, however, occurred from PRE-II to POST
      expedition in TSH, TT3, and fT3. Also rT3 and cortisol increased significantly
      PRE-II to POST while TT4 and fT4 were unchanged. The increase (delta = POST minus
      PRE-II) in cortisol was negatively correlated with the decrease (delta) in TSH (r
      = -0.52, p = 0.05) and TT3 (r = -0.49, p < 0.06). Moreover, the reduction in TT3
      was inversely correlated with the rT3 increase (delta comparison, r = -0.66, p <
      0.01). The findings demonstrate that the resting concentrations of thyroid
      hormones are disrupted by a mountaineering expedition, specifically an
      environmental stress-related "low T3 condition" seems to develop. These changes
      would seem to be related to an impaired peripheral conversion of T4 to T3,
      possibly brought about by elevations in the circulating cortisol levels.

PMID- 7794226
TI  - Human tolerance and physiological responses to exercise while breathing oxygen at
      2.0 ATA.
AB  - Multiple physiological functions were monitored in ten men who performed two 30
      min periods of 150-W ergometer exercise during 120-min exposures to O2 at 2.0
      ATA. There were no convulsions or electroencephalographic manifestations of
      increased excitability. Sequential measurements of peripheral visual fields,
      pulmonary mechanical function, mental performance, and cardiovascular function
      during the resting recovery after each of the two exercise periods were not
      detectably altered from pre-exercise control values. Pre- and post-exposure
      measurements of visual acuity, accommodation, pupil diameter, visual cortical
      activity, and retinal electrical activity also revealed no significant
      differences. While CNS symptoms were absent, average arterial PCO2 rose by about
      5 mm Hg during both exercise periods. This finding was confirmed in six subjects
      who performed four 6-min periods of continuous exercise at 50, 100, 150, and 200
      W while breathing O2 at 2.0 ATA. Average arterial PCO2 rose nearly linearly from
      34.3 mm Hg at rest to 44.0 mm Hg at 200 W. Arterial PCO2-related increments in
      brain blood flow and PO2 may explain part or all of the known detrimental
      influence of exercise on CNS O2 tolerance.

PMID- 7794227
TI  - Reciprocity of hemodynamic changes during lower body negative and positive
      pressure.
AB  - Lower body negative pressure (LBNP) and lower body positive pressure (LBPP) are
      two opposite environments for the lower abdomen and lower extremities. We
      examined RR interval (RRI), blood pressure, forearm blood flow, cardiac output,
      plasma atrial natriuretic factor, and plasma catecholamines during sequentially
      administered LBNP and LBPP in order to define the cardiovascular and
      neuroendocrine reciprocity of these models of orthostasis (LBNP) and anti
      orthostasis (LBPP). Six healthy young men were studied with a ramped onset of
      LBNP followed by a similarly ramped LBPP, spaced between periods of data
      acquisition during rest. Forearm blood flow decreased during LBNP and increased
      during LBPP. However, LBNP and LBPP did not produce reciprocal changes in cardiac
      output. No reciprocal changes were found in plasma catecholamines and plasma
      atrial natriuretic factor. The variability of RRI and systolic/diastolic blood
      pressures were analyzed within two bandwidths of interest: the low bandwidth,
      corresponding to the frequency of baroreflex-mediated variability (0.04 to 0.12
      Hz), and the high bandwidth, representative of parasympathetically mediated
      variability at the frequency of respiration (0.22 to 0.28 Hz). The ratio of high
      to low bandwidth RRI variability was reciprocally diminished during LBNP and
      increased during LBPP, reflecting a relative decrease in the level of
      parasympathetic tone during LBNP and an increase during LBPP. In addition, the
      variability of the DBP within the low baroreflex bandwidth increased during LBNP
      and decreased during LBPP. The phase lag of RRI variability in relation to BP
      variability did not change reciprocally.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794228
TI  - Visually triggered migraine headaches affect spatial orientation and balance in a
      helicopter pilot.
AB  - The authors present a case of an attack helicopter pilot with recurrent spatial
      disorientation (SD) flying with night vision goggles (NVG's), diagnosed as having
      visually triggered migraine headaches. Serial Dynamic Platform Posturography
      testing during an acute migraine attack demonstrated balance dysfunction under
      visual and somatosensory deficient conditions, correlating with headache
      intensity. Vestibular symptoms are associated with migraine, and may be triggered
      by visual stimuli. NVG scintillations in susceptible individuals may act as a
      visual trigger for migraine. Migraine phenomenon may be a contributing factor to
      SD, especially during NVG operations. The association of visual and vestibular
      dysfunction with migraine and aeromedical disposition of migraine in aviators is
      discussed.

PMID- 7794230
TI  - Predicting human heat strain and performance with application to space
      operations.
AB  - This Institute has developed a USARIEM Heat Strain Prediction Model for
      predicting physiological responses and soldier performance in the heat, which has
      been programmed for use by hand-held calculators and personal computers, and
      incorporated into the development of a heat strain decision aid. This model is
      demonstrated to predict accurately (generally within +/- 1 SD/SEM) rectal
      temperature (Tre) responses for soldiers wearing various military clothing
      ensembles during U.S. or non-U.S. military scenarios in the heat at home or
      abroad. The value of this model is shown presently for three NASA scenarios
      involving the Launch and Entry Suit (LES). The LES (ventilated or unventilated)
      is modeled during pre-launch/launch, re-entry/landing, and emergency egress after
      re-entry/landing scenarios, predominately to evaluate heat acclimation and
      hydration state effects. During the pre-launch/launch scenario, predicted final
      Tre closely agrees with observed values suggesting minimal heat strain (Tre
      approximately 38.0 degrees C). In contrast, dehydrated (3%) unacclimated
      individuals show moderate levels of heat strain (Tre approximately 38.5 degrees
      C) for this same scenario. During the re-entry/landing and emergency egress
      scenarios, dehydrated unacclimated individuals are predicted to exhibit excessive
      heat strain (Tre > 39.0 degrees C). Thermal tolerance time is predicted to be
      only 6 min during emergency egress if individuals are dehydrated and unacclimated
      to heat while wearing the LES. If heat transfer values for space operations
      clothing are known, NASA can use this prediction model to help avoid undue heat
      strain involving astronauts for most scenarios during spaceflight.

PMID- 7794229
TI  - Aeromedical helicopter use following the 1989 Loma Prieta earthquake.
AB  - OBJECTIVE: To understand the role of aeromedical services in the 1989 Loma Prieta
      disaster response, a survey was conducted of aeromedical teams participating in
      the disaster. METHODOLOGY: An investigator interviewed flight team members from
      all six participating helicopter services. RESULTS: Aeromedical teams transported
      31 patients after the earthquake. Of six helicopter teams, four reported landing
      zone (LZ) hazards. One flight team made determinations of death on five patients
      at one scene; two teams performed CPR enroute; two teams reported acting as
      airborne radio repeaters between communication centers, ground field units, and
      counties. Of six services, four performed over flight reconnaissance. CONCLUSION:
      Regional disaster managers should incorporate aeromedical services into disaster
      plans. This planning should include all of the roles played by aeromedical
      services; patient and equipment transportation, disaster reconnaissance, and
      communications linkage. Aeromedical services can play an essential role in
      disaster mitigation.

PMID- 7794232
TI  - From brandy to antibiotics for peptic ulcer disease.

PMID- 7794231
TI  - A model to predict carboxyhemoglobin and pulmonary parameters after exposure to
      O2, CO2, and CO.
AB  - A computer-based physiological model of respiratory gas exchange, which
      considered variation in inhaled oxygen and carbon dioxide, was modified to
      include the effects of inhaled carbon monoxide. Output from the modified model
      consists of 60 variables, including blood, alveolar and tissue gases, ventilatory
      function and carboxyhemoglobin. Extensive testing demonstrated that this model
      produced accurate results for known problems and physiologically plausible
      results for situations in which the results were not empirically known. Estimates
      of the effects of simultaneous continuously varying exposure to carbon monoxide,
      oxygen and carbon dioxide cannot be practically obtained with other extant
      methods. The modified model receives input from two computer files containing
      environmental and subject physiological variables. These files allow a continuous
      dynamic multi-gas exposure simulation or actual exposure data profiles. Up to
      four outputs can be selected for plotting or stored in a file for later analysis.

PMID- 7794234
TI  - Motion sickness.

PMID- 7794233
TI  - You're the flight surgeon. Difficulty in swallowing.

PMID- 7794236
TI  - Biochemical identification of interbreeding between B-type and non B-type strains
      of the tobacco whitefly Bemisia tabaci.
AB  - Polyacrylamide gel electrophoresis and a kinetic microplate assay were used to
      detect heterozygotes resulting from a cross between B-type and non B-type strains
      of the whitefly Bemisia tabaci. Both strains were homozygous for different
      esterase and acetylcholinesterase (AChE) enzymes, and heterozygotes were produced
      in one of two crosses between B-type females (diploid) and non B-type males
      (haploid). In reciprocal crosses, however, no female offspring were produced,
      indicating that fertilization had not occurred. Despite the identification of
      individuals heterozygous for the esterase and AChE markers, there was clearly a
      significant degree of reproductive incompatibility between the two strains. The
      biochemical assays provided a vital component of this study and the advantages of
      their use are discussed.

PMID- 7794235
TI  - Mitochondrial DNA variation in North American oedipodinae.
AB  - Restriction fragment analysis of mitochondrial DNA (mtDNA) was used to examine
      genetic variation and population structure in 13 species of banded-winged
      grasshoppers (subfamily Oedipodinae). Total DNA of 246 individuals was digested
      with 11 restriction enzymes and probed with three cloned EcoRI fragments
      representing the entire mitochondrial genome of Melanoplus sanguinipes. On
      average, members of this subfamily were five times more variable than those in
      another subfamily, Melanoplinae, previously examined. This would appear to lend
      support to Vickery's claim that the time of origin of Nearctic oedipodines is
      more ancient than that of melanoplines. With respect to population structure, a
      few different patterns were exhibited. Species such as Camnula pellucida had
      populations containing a mixture of haplotypes, some widespread and some
      geographically restricted. In contrast, Chortophaga viridifasciata populations
      were characterized by unique assemblages of diverse haplotypes. Phylogeographic
      hypotheses are advanced to account for these observations.

PMID- 7794237
TI  - A triose-phosphate isomerase polymorphism in the Atlantic salmon Salmo salar L.
AB  - Atlantic salmon, Salmo salar L., from four European locations show allelic
      variation at one of three triose-phosphate isomerase (TPI) loci (TPI-3*) when
      separated on horizontal starch gel electrophoresis, using either eye or liver
      extracts. Two common alleles (*100 and *103) and one rare allele (*97) segregate
      at TPI-3* with unambiguous typing being possible by observing the interlocus
      heterodimers. Family studies demonstrate that TPI-3* 100 and *103 are of
      autosomal location and are inherited in a Mendelian fashion. TPI-3* variation can
      also be typed in adipose fin tissue, allowing nondestructive tissue sampling.
      Three loci are also active in brown trout, Salmo trutta, with two individuals
      being homozygous for TPI-3*, as are a small number of S. salar from eastern
      Canada. The presence of this additional variable allozyme locus in S. salar is
      important, since genetic studies in that species have been limited by the low
      level of allozyme variability detectable.

PMID- 7794238
TI  - Glutathione S-transferase class pi polymorphism in baboons.

PMID- 7794239
TI  - Expression of the acetylcholinesterase transcript in the chordotonal neurons of
      Drosophila embryos.
AB  - The transcript of the acetylcholinesterase gene (Ace) was detected in the central
      nervous system (CNS) and the lateral chordotonal neurons (lch3, lch5) of wild
      type Drosophila melanogaster embryos. Ace126, a representative mutation of the
      acetylcholinesterase gene, abolished expression in the lch3 and lch5 neurons and
      slightly reduced the number of lch5 cells in some abdominal segments. The number
      of lch5 neurons was also reduced in Ace hemizygous and transheterozygous mutant
      embryos. The correlation between the lack of Ace expression and the mild defect
      of lateral chordotonal neurons is discussed.

PMID- 7794240
TI  - Analysis of genetic diversity of domestic cattle in east and Southeast Asia in
      terms of variations in restriction sites and sequences of mitochondrial DNA.
AB  - There are three major groups of domestic cattle in East and Southeast Asia:
      European cattle, Zebu cattle, and Bali cattle. Ten restriction enzymes were used
      to analyze restriction site variants in the mitochondrial DNA (mtDNA) in 178
      individuals belonging to these three groups of cattle. The results indicate that
      each of the three groups has mtDNA with a specific haplotype. The sequence of the
      mitochondrial gene for cytochrome b in representative haplotypes of Zebu and Bali
      cattle was determined and was compared with that of European cattle in the
      literature. We calculated 51 pairwise nucleotide sequence differences between
      European and Zebu cattle and 91 between European and Bali cattle. Our results
      suggest that ancestral populations of Asiatic domestic cattle may have diverged
      into two lineages--Bali and European plus Zebu--more than 3 million years ago,
      and then the European and Zebu groups diverged more than 1 million years or so
      before domestication occurred.

PMID- 7794242
TI  - Amyloid P component promotes aggregation of Alzheimer's beta-amyloid peptide.
AB  - Amyloid P component (AP) has been recognized as a beta-amyloid-associated protein
      but the pathological role is not known. In the present experiments, it has been
      shown that AP promotes the aggregation of Alzheimer's beta-amyloid peptide (A
      beta) in the presence of a physiological concentration of Ca2+. The aggregation
      promotion was observed at a concentration of soluble A beta 1-40 in human
      cerebrospinal fluid. The results suggest that AP is possibly a pathogenic factor
      of the cerebral amyloidosis.

PMID- 7794243
TI  - Change in variant transthyretin levels in patients with familial amyloidotic
      polyneuropathy type I following liver transplantation.
AB  - Three patients with familial amyloidotic polyneuropathy (FAP) type I underwent
      liver transplantation from heart-beating cadaveric donors. Since 2 patients
      underwent blood transfusion during the operation, variant transthyretin (TTR)
      levels in the plasma did not decrease time dependently. However, in 1 patient
      without blood transfusion variant TTR levels decreased in a time dependent manner
      and plasma half life of variant TTR was calculated to be 2.1 days. Total protein,
      normal, and variant TTR levels in cerebrospinal fluid (CSF) remained unchanged
      after liver transplantation.

PMID- 7794244
TI  - Luminescence of aequorin is triggered by the binding of two calcium ions.
AB  - The photoprotein aequorin, capable of emitting light in the presence of a trace
      amount of Ca2+, is a useful indicator for studying intracellular calcium. The
      primary structure of aequorin indicated the presence of three Ca(2+)-binding
      sites, whereas log-log plots of the luminescence intensity versus Ca2+
      concentration gave slopes ranging from 2 to 3 depending on the conditions used,
      suggesting the involvement of two or three Ca2+ ions in the luminescence
      reaction. Accurate information on the stoichiometry of Ca2+ is essential in
      interpreting the assay results obtained with aequorin. This study clearly shows
      that aequorin luminescence is triggered by the binding of two Ca2+ ions, based on
      the results of titrating aequorin with Ca2+.

PMID- 7794247
TI  - Cloning of salicylate hydroxylase gene and catechol 2,3-dioxygenase gene and
      sequencing of an intergenic sequence between the two genes of Pseudomonas putida
      KF715.
AB  - The salicylate hydroxylase can convert the salicylate to catechol, and catechol
      2,3-dioxygenase catalizes the conversion of catechol to 2-hydroxymuconic
      semialdehyde. A salicylate hydroxylase gene and a catechol 2,3-dioxygenase have
      been cloned from chromosomal DNA of P. putida KF715. The two genes have different
      promoters. An open reading frame with 339 nucleotides preceded by a putative
      ribosome-binding sequence (GGAGG) was identified in the intergenic sequence
      between salicylate hydroxylase gene and catechol 2,3-dioxygenase gene of P.
      putida KF715 and its sequence analyzed. This open reading frame can encode a
      polypeptide of molecular weight 13 kDa containing 112 amino acids, whose sequence
      exhibited 87% homology with that of ferredoxin encoded in NAH7 of P. putida PpG7
      and significant homology with those of redox components in phenol hydroxylase,
      benzoate 1,2-dioxygenase, toluate 1,2-dioxygenase, xylene monooxygenase, and
      toluene 4-monooxygenase.

PMID- 7794241
TI  - Exon organization and sequence of the genes encoding alpha-lactalbumin and beta
      lactoglobulin from the tammar wallaby (Macropodidae, Marsupialia).
AB  - Clones encompassing the genes encoding alpha-lactalbumin and beta-lactoglobulin
      were isolated from a tammar wallaby genomic library, the exons localized using
      end-labeled oligonucleotides and the DNA sequences determined. The tammar beta
      lactoglobulin gene has the same 7 exon-6 intron structure as the sheep homologue.
      Potential binding sites for mammary gland-specific transcription factors were
      identified, on the basis of similarity to sites in the sheep gene, in the
      promoter region of the tammar beta-lactoglobulin gene. The tammar gene encoding
      alpha-lactalbumin appears to contain four introns rather than three as are
      present in the eutherian homologues, or the evolutionarily related lysozyme gene.
      The additional intron appears to occur within the 5' noncoding region of the
      tammar gene.

PMID- 7794245
TI  - Deletion and site-directed mutagenesis of EF-hand domain of phospholipase C-delta
      1: effects on its activity.
AB  - In order to elucidate a role of a putative EF-hand motif (144-172) in
      phospholipase C-delta 1 (PLC-delta 1), deletion and point mutation of the enzyme
      were performed and the mutated cDNAs were expressed in CHO cells and E. coli
      AD202 strain. Deletion of amino acid residues of 141-236 or 173-236 resulted in
      abolition of PLC activity. However, the decreased PLC activity to 15-20% by
      deletion of the EF-hand motif (144-172) was still Ca(2+)-dependent. Furthermore,
      mutants, in which conserved Asp153, Asp157, Glu164 or all these acidic amino
      acids in the EF-hand motif were replaced with alanine residues, showed nearly the
      same PLC activity and Ca(2+)-dependency as those of wild-type. These results
      suggest that the region containing the EF-hand motif may not play a role in
      regulation of Ca(2+)-sensitivity of PLC-delta 1, but is important for its
      activity.

PMID- 7794249
TI  - Serine palmitoyltransferase is the primary target of a sphingosine-like
      immunosuppressant, ISP-1/myriocin.
AB  - ISP-1/myriocin is a new type of remarkably potent immunosuppressant, the
      structure of which is homologous to sphingosine. ISP-1/myriocin inhibited the
      proliferation of an IL-2-dependent mouse cytotoxic T cell line, CTLL-2, at
      nanomole concentrations. ISP-1/myriocin inhibits serine palmitoyltransferase
      activity at picomole concentrations. This enzyme catalyzes the first step of
      sphingolipid biosynthesis and reduces the intracellular pool of sphingolipid
      intermediates. The growth inhibition induced by ISP-1/myriocin was completely
      abolished by the addition of sphingosines or sphingosine-1-phosphate, but not by
      sphingomyelin or glycosphingolipids. These results suggest that sphingosines or
      sphingosine-1-phosphate are associated with CTLL-2 proliferation, and ISP
      1/myriocin suppresses T cell proliferation by the modulation of sphingolipid
      metabolism. ISP-1/myriocin should be a useful tool for the study of the
      sphingolipid pathway, which has been associated with various kinds of signal
      transduction.

PMID- 7794248
TI  - Active-site analysis of ferric P450 enzymes: hydrogen-bonding effects on the
      circular dichroism spectra.
AB  - Active-site CD spectra were analyzed for P450's with known x-ray structures
      (P450terp, P450BM-3, P450cam). CD spectral patterns for Fe(3+)-substrate-free
      P450's reflect structure/function properties of the distal pocket. P450terp and
      P450BM-3 have an H-bond between 6th ligand and I-helix [Hasemann, C.A., et al.
      (1995) Structure, 3, 41-62], and the Soret CD band at approximately 410 nm is
      approximately 2-fold larger than that at approximately 350 nm. For P450cam, the
      two CD bands are more nearly equal, and the 6th ligand is not H-bonded to the I
      helix. The CD spectral pattern can be used to predict active-site structural
      properties, e.g., H-bonding and polarity.

PMID- 7794246
TI  - Plasma nitric oxide end products are increased in the ischemic canine heart.
AB  - Coronary arteriovenous difference in stable end-products of nitric oxide
      metabolism, nitrate and nitrite, was increased in ischemic canine hearts. In
      accordance with the reduction of coronary blood flow by 40, 67, 80 and 100%, the
      plasma nitrate+nitrite concentration increased from 3.2 +/- 0.6 to 8.7 +/- 1.3,
      12.5 +/- 1.8, 15.9 +/- 2.7, and 20.2 +/- 2.3 microM, respectively. The plasma
      nitrate+nitrite concentrations were further elevated during reperfusion.
      Administration of NG-nitro-L-arginine methyl ester decreased the production of
      both nitrate+nitrite and coronary blood flow; the former was restored by the
      concomitant administration of L-arginine. These findings suggest that the
      increases in the nitric oxide production result from the action of nitric oxide
      synthase during myocardial ischemia and reperfusion, decreasing coronary vascular
      resistance and attenuating myocardial ischemia.

PMID- 7794251
TI  - Translocation of recombinant p47phox cytosolic component of the phagocyte oxidase
      by in vitro phosphorylation.
AB  - Activation of superoxide-generating NADPH oxidase system of human neutrophils
      involves phosphorylation-dependent translocation of p47phox and other cytosolic
      components to the plasma membrane. In contrast to the stimulation of the NADPH
      oxidase in intact cells, however, the activation of cell-free system requires the
      addition of anionic amphiphiles such as sodium dodecyl sulfate (SDS) and
      arachidonate. In this system, translocation of p47phox is also an essential step
      for activation, but phosphorylation is not required. The basis of this difference
      in oxidase activation is not yet clear. We now report that in a cell-free oxidase
      system, phosphorylated recombinant p47phox can be translocated to the membrane in
      the absence of SDS or arachidonate. These findings suggest that both
      phosphorylation and SDS could cause a common change in conformation or charge of
      p47phox that may result in the association of p47phox with the plasma membrane.

PMID- 7794250
TI  - Homozygous deletions of the MTS1 gene are rare in non-astrocytic brain tumors.
AB  - Several studies support a role for the multiple tumor suppressor gene (MTS1) in
      the malignant progression of different tumor types. In this study we have
      examined the status of the MTS1 gene in a variety of non-astrocytic tumors of the
      central nervous system. It was not possible, using multiplex PCR with primers for
      MTS1 and D9S196, a chromosome 9q marker, to demonstrate deletions of MTS1 in 59
      primary non-astrocytic tumors. Two out of 5 (40%) secondary tumors showed
      evidence of homozygous deletion of MTS1. The results obtained here for primary
      non-astrocytic tumors contrast with those previously described for astrocytic
      tumors where a high frequency of deletions of MTS1 was associated with tumor
      progression.

PMID- 7794252
TI  - The neuroendocrine protein 7B2 acts as a molecular chaperone in the in vitro
      folding of human insulin-like growth factor-1 secreted from yeast.
AB  - The neuroendocrine protein 7B2 prevents premature activation of PC2, an enzyme
      involved in the processing of prohormones in the secretory pathway. We inquired
      if this chaperone-like function encompasses a broader role for 7B2 in the folding
      of hormone-like proteins. As a test, the fate of misfolded human insulin-like
      growth factor-1 (IGF1) was assessed, in the presence and absence of 7B2. Most of
      the recombinant IGF1 molecules, secreted from yeast, are a conglomeration of
      inactive multimers which are either disulfide-linked or mere physical aggregates.
      We find that yeast-produced 7B2 influences the in vitro conversion of inactive
      molecules into active monomers. However, the amounts of disulfide-linked dimers
      remain unaffected during this conversion. Interestingly, both 7B2 and the
      molecular chaperone DnaK interact with IGF1 in the yeast two-hybrid system. Like
      DnaK, 7B2 also binds the tumor suppressor protein p53. Binding of DnaK to exposed
      epitopes of aggregated proteins is known to be a prerequisite for deaggregation.
      It is conceivable that 7B2 participates in an analogous manner in the
      dissociation of non-covalently linked multimers of IGF1. Our results indicate
      that 7B2 might find an application in the deaggregation of potentially useful
      therapeutic proteins.

PMID- 7794253
TI  - Evidence for the presence of functional thyrotropin receptor in cardiac muscle.
AB  - There is increasing evidence that the membrane-bound thyrotropin receptor (TSHR)
      may be mediating clinically important direct effects of thyrotropin (TSH) and of
      TSHR antibodies (TSHRab) in extra-thyroidal tissues. TSHR mRNA has formerly been
      detected in thyroid, retroorbital muscle and fibroblasts, peripheral lymphocytes
      and rodent fat. It is well known that thyroid disease may aggravate or induce
      heart disease, but the pathophysiological role of TSH and TSHRab is not clear.
      The aim of this study was to investigate if TSHR is present in cardiac muscle.
      Reverse transcriptase polymerase chain reactions revealed TSHR in human heart and
      Northern blot on extracted RNA showed a RNA species of 4.4 kb. TSH stimulation of
      cultured mouse AT-1 cardiomyocytes elevated the levels of intracellular second
      messenger 3',5'-cyclic AMP. This effect of TSH could be inhibited by TSHR
      antibodies. In solution hybridization levels of TSHR mRNA in AT-1 cells were 50%
      of mRNA in crude mouse heart. In conclusion functional TSHR is present in
      cardiomyocytes.

PMID- 7794254
TI  - Depletion of intracellular calcium stores triggers transplasmamembrane chloride
      influx in human lymphocytes: regulation by tyrosine kinase.
AB  - The capacitative regulation of intracellular chloride concentration ([Cl-]i) was
      measured in intact human lymphocytes using the Cl(-)-sensitive fluorescence dye 6
      methoxy-1-(3-sulfonato-propyl)-quinolinium (SPQ). The fluorescence was measured
      at 433 nm with the excitation wavelength of 344 nm. The emptying of intracellular
      Ca2+ stores after the specific inhibition of the endoplasmic Ca2+ ATPase by
      thapsigargin produced a concentration-dependent transplasmamembrane Cl- influx.
      The thapsigargin-induced Cl- increase was also seen in the absence of
      extracellular Ca2+, but it was significantly reduced after the addition of the Cl
      exchange blocker, 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid. The
      thapsigargin-induced Cl- increase was significantly reduced after the specific
      inhibition of tyrosine kinase by genistein or tyrphostin A25. It is concluded
      that the depletion of intracellular Ca2+ pools triggers transplasmamembrane Cl-
      influx by a tyrosine kinase-dependent mechanism.

PMID- 7794256
TI  - Leucine zipper-like domain regulates the autophosphorylation and the transforming
      activity of P130gag-fps.
AB  - P130gag-fps, the product of Fujinami sarcoma virus, has a leucine zipper (LZ)
      motif located in 729-756 amino acid residues. To explore the role of LZ-like
      domain in the transformation by P130gag-fps, we made a deletion (delta FpsLZ/SH2)
      and a site-directed substitution mutation (L746P). Deletion mutant did not
      transform the 3Y1 cells and the resulting protein did not show kinase activity.
      Substitution of Leu746 with Pro (L746P) reduced the transforming activity by 6
      fold. Although the L746P mutant retained intact catalytic activity in vitro, it
      did not phosphorylate cellular proteins in vivo. We concluded that LZ-like domain
      might mediate the trans-activation of P130gag-fps tyrosine kinase by
      autophosphorylation, which is prerequisite for the transforming activity.

PMID- 7794255
TI  - Determination of a necdin cis-acting element required for neuron specific
      expression by using zebra fish.
AB  - To determine cis-acting elements required for neuron specific expression of a
      necdin gene, we tried to use zebra fish assay system in vivo instead of cell
      lines in vitro. Various expression vectors carrying upstream sequences of necdin
      gene fused to MEKA (lacZ) gene as a reporter were injected into fertilized zebra
      fish embryos and then the expression of the reporter gene was analyzed by the
      whole mount immunochemical method. No promoter activity was obtained with a
      construct carrying sequence from -63 to +63 of the necdin gene, while promoter
      activity with preferential skin expression was obtained with a construct having
      sequence from -86 to +28. Further upstream sequence from -173 to +28 exhibited
      neuron specific expression as well as that from -845 to +63. These results
      indicate that a cis-acting element responsible for neuron specific expression is
      located in an 87bp sequence from -173 to -87 of necdin gene.

PMID- 7794257
TI  - Effect of P2Y-purinoceptor stimulation on renal gluconeogenesis in rats.
AB  - In the freshly prepared rat renal cortical tubule suspension, the effects of ATP
      on intracellular free calcium mobilization and gluconeogenesis were investigated.
      ATP increased intracellular free calcium concentration ([Ca2+]i) in a dose
      dependent manner (10(-6) - 10(-3) M). The rank order in the potency of ATP
      analogs at 10(-4) M was 2-methylthio ATP > ATP > or = ADP. AMP, adenosine and
      alpha, beta-methylene ATP did not respond to [Ca2+]i. These results suggest that
      P2-purinoceptor in the rat kidney cortex should be specifically P2Y subtype.
      Renal gluconeogenesis from pyruvate was stimulated maximally by 10(-4) M ATP
      (48.3 +/- 13.2%). This effect was significantly inhibited by 10(-4) M suramin.
      Thus, the present study suggests that renal gluconeogenesis is increased via P2Y
      specific purinoceptor stimulation.

PMID- 7794258
TI  - Enhanced expression of rat obese (ob) gene in adipose tissues of ventromedial
      hypothalamus (VMH)-lesioned rats.
AB  - A responsible gene of genetically obese (ob/ob) mouse has recently been isolated.
      Genetic disruption of ob gene causes massive obesity. To elucidate the
      pathophysiological regulation of ob gene, we examined the gene expression in fat
      tissues of a non-genetical obese model, VMH-lesioned rats. The ob mRNA was
      identified in both subcutaneous and mesenteric fat tissues in the control rats.
      In VMH-lesioned rats, the abundance of ob mRNA increased after the gain of body
      weight and marked expression was observed on 15th day after making VMH lesion.
      These data suggest that ob gene might be up-regulated with fat accumulation even
      in non-genetically obese animals.

PMID- 7794260
TI  - Differential expression patterns of beta-actin mRNA in cells undergoing
      apoptosis.
AB  - Microfilaments play an important role in the formation of apoptotic bodies. This
      study examined expression patterns of beta-actin, a key component of
      microfilament, during apoptosis. The data suggest that continuous beta-actin
      expression is not required for formation of apoptotic bodies. beta-actin mRNA
      levels rapidly declined in HL-60 cells following induction of apoptosis by
      actinomycin D, but were transiently elevated by two other apoptosis-inducing
      agents, cycloheximide and ionophore A23187. Furthermore, changes in beta-actin
      mRNA levels were less marked in U937 cells in which apoptosis was also induced by
      actinomycin D, as well as in WISH cells which demonstrated no typical apoptotic
      characteristics following actinomycin D treatment.

PMID- 7794259
TI  - Lysophosphatidic acid activates phosphoinositide 3-kinase and phospholipase C in
      human platelets: inhibitory effects of Wortmannin on phosphoinositide 3-kinase
      and aggregation.
AB  - Lysophosphatidic acid is a biologically active serum phospholipid known to have
      growth factor-like activities and to cause platelet aggregation. Activated
      phosphoinositide 3-kinase has been suggested to be involved in cytoskeletal
      reorganization and mitogenesis. We report that lysophosphatidic acid causes
      platelet phosphoinositide 3-kinase activation, leading to accumulation of
      phosphatidylinositol (3, 4, 5) P3 and phosphatidylinositol (3, 4) P2, and
      stimulates phospholipase C. Worthmannin, a potent inhibitor of phosphoinositide 3
      kinase, blocks platelet aggregation induced by lysophosphatidic acid without
      impairing phospholipase C activation. Eristostatin, an antagonist of fibrinogen
      binding to platelet integrin, completely blocks platelet aggregation without
      inhibiting phosphoinositide 3-kinase or phospholipase C. We suggest that
      lysophosphatidic acid, in activating phosphoinositide 3-kinase, promotes platelet
      aggregation, but that platelet aggregation in response to lysophosphatidic acid
      does not significantly enhance phosphoinositide 3-kinase activation.

PMID- 7794262
TI  - Sickling in vitro at venous and arterial oxygen tensions of reticulocytes from
      patients with sickle cell disease.
AB  - Sickling of reticulocytes and mature erythrocytes from patients with sickle cell
      disease was compared at venous and arterial oxygen tensions (PO2 = 30 and 90 mm
      Hg). Reticulocyte-rich fractions (d < 1.06) were partially deoxygenated in two
      ways after incubation at PO2 = 180 mm Hg: (1) PO2 of 30 mm Hg for 1 hour, and
      reoxygenation to 90 mm Hg for 2 hours and (2) PO2 of 90 mm Hg and kept for 2
      hours. Percentages of sickled cells were always higher (3-5 times) in
      reticulocytes than in mature erythrocytes. Percentage of sickled reticulocytes
      measured at PO2 = 90 mm Hg after partial deoxygenation to PO2 = 30 mm Hg was 2
      times higher than that obtained directly at PO2 = 90 mm Hg. In contrast, there
      was no difference in percentage of sickled cells in the mature erythrocyte
      population under the two experimental conditions. These results suggest that
      reticulocytes are more susceptible to sickling under venous oxygen tension and
      less likely than mature erythrocytes to resume discoidal shape even at arterial
      oxygen tension.

PMID- 7794261
TI  - CYP1A2 and 2E1 expression in rat liver treated with combined inducers (3
      methylcholanthrene and ethanol).
AB  - The effects of combined ethanol and 3-methylcholanthrene treatment on rat hepatic
      cytochrome CYP1A2 and CYP2E1 expression were evaluated. Such a treatment attempts
      to mimic the simultaneous consumption of ethanol and cigarette smoke. Treatments
      involving 3-methylcholanthrene and combined ethanol + 3-methylcholanthrene
      decreased both CYP2E1 expression at the mRNA level (0.6 and 0.4 fold versus
      controls, respectively) and protein level (0.6 and 0.9 fold versus controls,
      respectively), while dramatically increasing CYP1A2 expression. Furthermore,
      combined treatment provokes a synergistic induction of CYP1A2 expression as
      determined by its catalytic activity and protein content.

PMID- 7794263
TI  - Membranes of human neuroblastoma SH-SY5Y cells contain specific binding sites for
      [3H]K-252A.
AB  - K-252a and the structurally similar compound staurosporine promote neurotrophic
      responses in several cell lines (PC12, SH-SY5Y human neuroblastoma) and in
      cultures of primary neurons. The molecular mechanisms involved in the induction
      of these neurotrophic activities are unknown. It is demonstrated in this report
      that [3H]K-252a binds to SH-SY5Y membranes and that the binding is specific and
      saturable with a Kd of 2.7 nM and a Bmax of 100,000 sites per cell. The
      association of [3H]K-252a with its binding site is rapid and reversible, and the
      binding was inhibited by unlabeled K-252a and by staurosporine. Binding of [3H]K
      252a was not inhibited by the potent protein kinase C (PKC) inhibitor GF109203X.
      Down regulation of PKC by treating SH-SY5Y cells with a phorbol ester did not
      cause a reduction in the specific binding of [3H]K-252a to membranes, suggesting
      that the binding is not to PKC. Treatment of the SH-SY5Y membranes with trypsin
      and by boiling destroyed all specific binding of [3H]K-252a. These results
      suggest that the [3H]K-252a binds to a specific protein site that is associated
      with membranes of SH-SY5Y cells.

PMID- 7794264
TI  - Regulation of FGF-4 enhancer activity by transcription factor NF-Y.
AB  - Regulation of FGF-4 gene expression is controlled both by elements in the
      promoter and by an enhancer domain located in the untranslated region of the
      third exon. We have determined that transcription factor NF-Y binds to the FGF-4
      promoter. We further show by mutational analysis that binding of NF-Y is
      essential for FGF-4 enhancer activity but has minimal effect on activity of the
      FGF-4 promoter alone.

PMID- 7794265
TI  - Catalytic properties of the two active sites of angiotensin I-converting enzyme
      on the cell surface.
AB  - Angiotensin I converting enzyme is a zinc metallopeptidase that contains two very
      similar domains, each with an active site. Enzymatic studies of these active
      sites have always been performed on solubilized enzyme, although angiotensin I
      converting enzyme is a transmembrane ectopeptidase. The availability of
      transfected CHO cells expressing wild-type recombinant enzyme and mutants in
      which one of the two active sites has been inactivated by site-directed
      mutagenesis allowed the properties of each active site on the cell surface and
      the effect of anchorage and membrane environment to be studied. Both active
      centers are catalytically active in the cell membrane-anchored enzyme and convert
      angiotensin I to angiotensin II. Comparison of the kinetic parameters for the
      transfected cells with those for the purified enzymes reveals differences in Kcat
      but suggests that no major conformational changes of these active sites occur
      upon anchorage of the enzyme to the cell membrane. The chloride activation
      profiles show that the two domains in the cell-bound enzyme also undergo the same
      anion-induced conformational changes as in the solubilized enzyme.

PMID- 7794266
TI  - Inhibitors of phosphoinositide 3-kinase block exocytosis but not endocytosis of
      transferrin receptors in 3T3-L1 adipocytes.
AB  - The role of PI 3-kinase in transferrin receptor recycling was investigated in 3T3
      L1 adipocytes. Wortmannin, a specific PI 3-kinase inhibitor, blocked insulin
      stimulated recruitment of transferrin receptors to the plasma membrane (IC50
      approximately 5-15 nM) with a similar potency to its inhibitory effects on PI 3
      kinase and glucose transport. Wortmannin also blocked insulin stimulated
      recruitment of IGF-2 receptors to the cell surface. However, wortmannin (up to
      200 nM) and another PI 3-kinase inhibitor, LY294002 (3 micrograms/ml), did not
      block transferrin receptor endocytosis. This demonstrates that while PI 3-kinase
      may be necessary for insulin stimulated exocytosis, it is not necessary for
      endocytosis of transferrin receptors.

PMID- 7794267
TI  - Purification and some of the properties of a novel secondary alcohol
      dehydrogenase from Alcaligenes eutrophus.
AB  - Alcaligenes eutrophus utilizing nerolidol, a sesquiterpene alcohol, as the sole
      source of carbon contains an inducible NAD(P)(+)-linked secondary alcohol
      dehydrogenase (SADH). The enzyme was purified to homogeneity by a combination of
      salt precipitation, ion exchange and affinity matrix chromatographies. The
      apparent molecular mass of the enzyme was estimated to be 139 KDa with four
      identical subunits of 38.5 KDa. The enzyme carried out both oxidation and
      reduction reactions. At pH 5.5, enzyme catalyzed the stereospecific reduction of
      prochiral ketones to secondary alcohols. The pH optimum for the oxidation
      reaction was 9.5. NADP+ and NADPH were respectively preferred over NAD+ and NADH
      for oxidation and reduction reactions. Some of the properties of this enzyme were
      found to be significantly different from those thus far described.

PMID- 7794268
TI  - Peritoneal macrophages from stroke-prone spontaneously hypertensive rats
      accumulate more cholesteryl ester than do macrophages from Wistar-Kyoto rats.
AB  - The intracellular cholesterol metabolism of peritoneal macrophages from stroke
      prone spontaneously hypertensive rats (SHRSP) was compared to that of
      normotensive Wistar-Kyoto rats (WKY) in order to examine the role of macrophages
      in the development of arterial fat deposits in the SHRSP. Scavenger receptor
      activity and intracellular acyl CoA:cholesterol acyltransferase (ACAT) activity
      were significantly higher in macrophages from SHRSP compared to findings in WKY,
      in the presence of modified low-density lipoprotein (LDL), acetylated-LDL (Ac
      LDL). Moreover, macrophages from the SHRSP accumulated more cholesteryl ester
      than seen in WKY in response to Ac-LDL. ACAT activity and cholesteryl ester
      accumulation were inhibited by specific ACAT inhibitor, HL-004, to a similar
      extent, in macrophages from WKY and SHRSP. These findings suggest the
      susceptibility of SHRSP to arterial fat deposits.

PMID- 7794270
TI  - A novel Ca2+/calmodulin-dependent protein kinase lacking autophosphorylation
      activity in the rabbit heart.
AB  - We report the discovery, semi-purification and characterization of a novel
      Ca2+/calmodulin-dependent protein kinase (peak I kinase) using syntide 2 as a
      substrate from the rabbit heart. In the study of dependence of peak I kinase on
      the concentration of calmodulin, half-maximal activation was obtained at approx.
      2.0 x 10(-7) M calmodulin. Peak I kinase did not undergo autophosphorylation.
      This kinase phosphorylates the synthetic peptides such as syntide 2, autocamtide
      2, site 3 in a Ca2+/CaM-dependent manner, but not myosin light chain-peptide,
      gamma-peptide, and cAMP Response Element Binding Protein (CREB) peptide.
      Elongation Factor-2, alpha-casein and histone-IIIs were not phosphorylated. These
      data indicate that this CaM kinase is different from other identified
      Ca2+/calmodulin-dependent protein kinases and therefore constitutes a novel
      protein kinase.

PMID- 7794269
TI  - Human colon cancer cell lines permanently expressing alpha 2,6-sialylated sugar
      chains by transfection with rat beta-galactoside alpha 2,6 sialyltransferase
      cDNA.
AB  - A role of alpha 2,6-linked sialic acid in the development of an invasive
      phenotype in colon cancer has been suggested by several observations but never
      conclusively demonstrated. An experimental model to clarify this tissue was
      established by the creation and characterization of a bank of cell lines that
      differ mainly, if not exclusively, in the degree of alpha 2,6-sialylation. Human
      colon cancer cell lines SW48 and SW948, normally unable to elaborate the alpha
      2,6-sialyl linkage, were transfected with the beta-galactoside alpha 2,6
      sialyltransferase (alpha 2,6ST) cDNA driven by the cytomegaloviral promoter and
      screened for cell surface alpha 2,6-sialylated sugar chains using fluorescein
      isothiocyanate-conjugated Sambucus nigra agglutinin (SNA-FITC). A panel of SNA
      FITC-positive clones was established that expresses alpha 2,6ST activity of
      varying degrees. Only the SNA-FITC-positive recombinants express the 1.2 Kb mRNA
      predicted to be generated from the transfected sequence. No 4.3-4.7 Kb
      transcripts that are indicative of transcription from the native alpha 2,6ST gene
      were detected.

PMID- 7794271
TI  - The guinea pig histamine H2 receptor: gene cloning, tissue expression and
      chromosomal localization of its human counterpart.
AB  - The guinea pig is the prototypic animal species for the histamine H2 receptor.
      Using a strategy based upon nucleotide sequence homology and starting from the
      sequence of the rat histamine H2 receptor (Ruat et al., Biochem. Biophys. Res.
      Commun. 1991, 179: 1470-78), we have cloned an intronless highly homologous DNA
      very likely encoding the guinea pig H2 receptor. The encoded 359 amino acid
      protein displays 83 to 86% identity with the rat-, human- or dog-H2 receptors.
      Northern blot analysis identified a single transcript of 4.6 kb in peripheral
      tissues and brain areas in which the presence of the H2 receptor had been
      revealed previously by either photoaffinity labeling or binding studies. In
      brain, the distribution of transcripts, established by either Northern blots or
      in situ hybridization studies, was consistent with the localization of the H2
      receptor. In addition, using Southern analysis of a chromosome mapping panel
      constructed from human x hamster hybridomas, we assigned the H2 receptor gene to
      human chromosome 5.

PMID- 7794272
TI  - Differential expression and mutation of NME genes in autologous cultured human
      melanoma cells with different metastatic potentials.
AB  - The putative metastasis suppressor genes, NME1(nm23-1) and NME2(nm23-2), were
      examined in a model system we developed to approximate the dissemination of
      melanoma from a primary skin tumor. We utilized two autologous human melanoma
      cell lines, IV Cl 1 and IV Cl 3, which displayed qualitatively different
      metastatic phenotypes following subdermal inoculation into nude mice. Highly
      metastatic IV Cl 1 cells expressed approximately 5 fold lower levels of protein
      encoded by NME genes than non-metastatic IV Cl 3 cells. Similar differences in
      NME protein levels were observed in tumors induced by the two cell lines in nude
      mice. There were no differences in NME mRNA levels between these two cell lines,
      suggesting that expression of these proteins is regulated at a post
      transcriptional level. We found a ser122-pro mutation in the NME2 gene of
      metastatic IV Cl 1 cells. A similar ser120-gly mutation in NME1 has been found in
      human neuroblastoma, suggesting that mutation in this region may be a general
      phenomenon related to tumor progression. These mutations may have functional
      consequences since they eliminate potential phosphorylation sites and may affect
      the tertiary structure of mature protein complexes.

PMID- 7794273
TI  - Primary substrate specificity of recombinant human stratum corneum chymotryptic
      enzyme.
AB  - Stratum corneum chymotryptic enzyme (SCCE) is a new human serine proteinase
      expressed by keratinocytes in the epidermis. Its function may be to catalyze the
      degradation of intercellular cohesive structures in the cornified layer of the
      skin in the continuous sheeding of cells from the skin surface. In this work the
      primary substrate specificity of recombinant SCCE was determined with oxidized
      bovine insulin B chain as substrate. Cleavage products were separated with high
      performance liquid chromatography and analyzed by amino acid sequence analysis
      and mass spectrometry. Cleavage sites were localized to Leu 6-cysteic acid 7, Tyr
      16-Leu 17, Phe 25-Tyr 26, and Tyr 26-Thr 27 in insulin B chain. It is concluded
      that SCCE belongs to the family of serine endoproteinases specific for amino acid
      residues with aromatic side chains in the P1 position.

PMID- 7794275
TI  - Potent inhibition of breast cancer cell lines by the isoflavonoid kievitone:
      comparison with genistein.
AB  - The isoflavonoid kievitone potently inhibited the proliferation of the oestrogen
      receptor (ER)-positive breast cancer cell lines MCF-7 and T47D and the ER
      negative breast cancer cell line SKBR3 (IC50 values 5-18 microM). DNA synthesis
      of MCF-7 cells stimulated by insulin-like growth factor 1, insulin-like growth
      factor 2, basic fibroblast growth factor or transforming growth factor alpha was
      inhibited by similar concentrations of kievitone (IC50 values 1-3 microM). DNA
      synthesis stimulated by 17, beta-oestradiol was also inhibited (IC50 = 6 microM).
      Compared with kievitone, genistein was 3-9 fold weaker as an inhibitor of the
      proliferation of the breast cancer cell lines and of growth factor-stimulated DNA
      synthesis. However, genistein was about 5-fold more potent than kievitone as an
      inhibitor of solubilised epidermal growth factor (EGF) receptor kinase activity
      and EGF receptor autophosphorylation.

PMID- 7794276
TI  - Calculated effects of the chemical environment of 2-phospho-D-glycerate on the
      pKa of its carbon-2 and correlations with the proposed mechanism of action of
      enolase.
AB  - The mechanism of action of enolase requires drastic lowering of the pK of the
      alpha carbon of the substrate to enable removal of the alpha hydrogen.
      Calculations suggest this is done primarily by rotation of the carboxyl ("carbon
      1") of the substrate around the carbon-1 carbon-2 bond by 90 degrees so that its
      oxygen atoms lie in the plane formed by the three carbon atoms and secondarily by
      effectively neutralizing the negative charges on the carboxylate and phosphate.
      These predictions are in very good agreement with the proposed mechanism of
      action of enolase which is based on X-ray crystallographic data.

PMID- 7794274
TI  - Farnesol is utilized for protein isoprenylation and the biosynthesis of
      cholesterol in mammalian cells.
AB  - Evidence has been obtained indicating that free farnesol (F-OH) can be utilized
      for isoprenoid biosynthesis in mammalian cells. When rat C6 glial cells and an
      African green monkey kidney cell line (CV-1) were incubated with [3H]F-OH,
      radioactivity was incorporated into cholesterol, ubiquinone (CoQ) and
      isoprenylated proteins. The incorporation of label from [3H]F-OH into cholesterol
      in C6 and CV-1 cells was blocked by squalestatin 1 (SQ) which specifically
      inhibits the conversion of farnesyl pyrophosphate (F-P-P) to squalene. This
      result strongly suggests that cholesterol, and probably CoQ and protein, is
      metabolically labeled via F-P-P. SDS-PAGE analysis of the delipidated protein
      fractions from C6 and CV-1 cells revealed several labeled polypeptides.
      Consistent with these proteins being modified by isoprenylation of cysteine
      residues. Pronase E digestion released a major labeled product with the
      chromatographic mobility of [3H]farnesyl-cysteine (F-Cys). A different set of
      polypeptides was labeled when C6 and CV-1 cells were incubated with
      [3H]geranylgeraniol (GG-OH). Both sets of proteins appear to be metabolically
      labeled by [3H]mevalonolactone, and [3H]-labeled F-Cys and geranylgeranyl
      cysteine (GG-Cys) were liberated from these proteins by Pronase E treatment.
      These cellular and biochemical studies indicate that F-OH can be used for
      isoprenoid biosynthesis and protein isoprenylation in mammalian cells after being
      converted to F-P-P by phosphorylation reactions that remain to be elucidated.

PMID- 7794277
TI  - The "in vitro motility assay" and phalloidin-F-actin.
AB  - We have compared the osmotic properties of the hydrated, native actin filament
      and of hydrated phalloidin-F-actin. We have found that phalloidin-F-actin
      interacts much more strongly with water than native F-actin. It is therefore very
      likely that the interaction with myosin (that requires the expulsion of the
      protein solvation water) is more problematic for phalloidin-F-actin that for
      native F-actin. We conclude that phalloidin-F-actin is not a bona fide substitute
      for native F-actin in the "in vitro motility assay".

PMID- 7794279
TI  - Chloride channels in brown adipocyte plasma membranes: candidates for mediation
      of alpha 1-adrenergic depolarization?
AB  - The presence of plasma membrane Cl- channels was investigated in brown-fat cells
      differentiated in culture. Single channel activity was followed by the patch
      clamp technique, with an NMDG+ Cl- pipette solution and a NaCl bath solution.
      Only rarely was putative Cl- channel activity encountered in the cell-attached
      mode. However, after excision, ion channel activity of two types was observed in
      inside-out patches: one type represented the earlier observed non-selective
      cation channel, and one a putative Cl- channel, with the following
      characteristics: practically non-rectifying current-voltage relationship with a
      conductance of approximately 50 pS and a reversal potential of approximately 0 in
      symmetrical Cl- solutions, voltage dependent channel activity (Po approached 0.5
      at positive holding potentials), and rapid flickering activity in the open state.
      It is discussed whether this Cl- channel may be responsible for the initial
      depolarization phase observed after alpha 1-adrenergic stimulation of brown-fat
      cells.

PMID- 7794278
TI  - Recombinant expression of hepatitis A virus protein 3A: interaction with
      membranes.
AB  - The function of hepatitis A virus (HAV) protein 3A and its structural
      requirements were studied in vitro and in a bacterial expression system by
      comparing the polypeptide precursor 3AB derived from a cytopathogenic strain with
      that of an attenuated strain. Although the precursor polypeptides 3AB of both HAV
      strains bind to microsomal membranes after translation in vitro they differ in
      inducing membrane permeability when expression is induced in bacteria. Intake and
      release of macromolecules was dramatically increased when 3AB of the
      cytopathogenic strain was expressed. Amino acid sequence alignments suggest that
      membrane binding might be due to a hydrophobic stretch near the C-terminus of 3A
      found in all picornaviruses whereas the ability to induce permeability of E. coli
      membranes is determined by an amphipathic helix formed at the N-terminus of 3A of
      HAVFG.

PMID- 7794280
TI  - Characterization of cDNA encoding novel pregnancy-specific glycoprotein variants.
AB  - The human pregnancy-specific glycoprotein (PSG) family consists of eleven closely
      related molecules mainly synthesized by placental syncytiotrophoblasts and whose
      function(s) are unknown. They belong to the carcinoembryonic antigen (CEA)
      family. As a step toward understanding PSG function, we have analysed 84 PSG cDNA
      clones from a fetal liver library with respect to domain arrangement and PSG
      identity. Four novel PSG cDNAs derived from the PSG4, PSG7, PSG11, and PSG13
      genes were characterized. The PSG11 and PSG13 cDNAs had novel domain
      arrangements: L-N-B2-C (named type III) and L-A1-B2-C (named type IV),
      respectively. These splice variants were also demonstrated in placenta. PSG4 cDNA
      had a type IIa (L-N-A1-B2-C) and PSG7 cDNA a type I (L-N-A1-A2-B2-C) domain
      arrangement. PSG1, PSG4, PSG5 were found at highest frequency while PSG8 and
      PSG12 cDNA clones were not detected.

PMID- 7794281
TI  - Lovastatin inhibits proliferation and differentiation and causes apoptosis in
      lipopolysaccharide-stimulated murine B cells.
AB  - Lipopolysaccharide-stimulated murine B lymphocytes were incubated with the
      pharmacologic drug lovastatin, a competitive inhibitor of 3-hydroxy-3
      methylglutaryl coenzyme A reductase at concentrations ranging from 10(-5)-10(-8)
      M. After 48 hr, treatment with 10(-5)M lovastatin inhibited [3H]thymidine
      incorporation 55%. Flow cytometric analysis indicated that the fraction of B
      cells in S phase was reduced from 26.7% +/- 5.44% to 11.6% +/- 2.9% when cells
      were incubated with 10(-5)M lovastatin. In addition, a large peak appeared to the
      left of the G1 peak that was indicative of apoptosis in cells treated with 10(
      5)M lovastatin. At 96 hr, the number of plaque-forming B cells was decreased 50%
      in the presence of lovastatin. Together these results suggest that high
      concentrations of lovastatin can inhibit B cell proliferation and differentiation
      of murine B lymphocytes in lipopolysaccharide-activated B cells, perhaps through
      induction of programmed cell death.

PMID- 7794282
TI  - Nitric oxide regulation of IL-8 expression in human endothelial cells.
AB  - The regulatory signals required to induce the production of IL-8, an important
      neutrophil chemoattractant and activator, have yet to be clearly defined. We
      examined the role of nitric oxide (NO) in IL-8 regulation. The NO synthase
      inhibitor, (L)-NG-nitroarginine methyl ester (L-NAME), inhibited the TNF
      stimulated IL-8 production in the human endothelial cell line, ECV304, in a dose
      dependent manner without affecting cellular viability (TNF alone, 5.5 +/- 0.9
      ng/ml; TNF + 5 mM L-NAME, 2.4 +/- 0.5 ng/ml). Moreover, exogenously added NO
      produced by the spontaneous NO generating compounds, S-Nitroso-N-acetyl-D,L
      pennicillamine (SNAP) and Ethanamine, 2,2'-(hydroxynitrosohydrazono)bis- (DETA
      NONOate), induced a dose-dependent release of IL-8 from these cells. Maximal
      stimulation of IL-8 was found to be 1.2 +/- 0.1 ng/ml with the 1 mM concentration
      of SNAP and 1.6 +/- 0.1 ng/ml with the 2 mM concentration of DETA NONOate. These
      results provide key evidence substantiating a regulatory role of NO in IL-8
      expression.

PMID- 7794283
TI  - Adrenocortical steroids, thyroid hormones and retinoic acid augment the
      production of adrenomedullin in vascular smooth muscle cells.
AB  - Adrenomedullin (AM) is produced and secreted from vascular smooth muscle cells
      (VSMCs), which express AM specific receptors. In the survey for substances
      regulating AM production, we found that dexamethasone, hydrocortisone and
      aldosterone stimulate AM production in cultured rat VSMC with ED50 values of 2.4
      nM, 16 nM and 270 nM, while progesterone, estradiol and testosterone induced weak
      or no effect. Maximal stimulation levels of dexamethasone, hydrocortisone and
      aldosterone were comparable and a little lower than those of the most potent
      stimulants, interleukin-1 and tumor necrosis factor. Hydrocortisone dose
      dependently activated AM gene transcription, and AM mRNA level was highest at 12
      h after stimulation. A physiological concentration of hydrocortisone was deduced
      to be enough to regulate AM production in VSMC. Retinoic acid and thyroid
      hormones increased AM production to 400% and 150% after 14 h incubation. These
      results demonstrate a complex regulation system of AM production in VSMC by
      hormones and related substances. Furthermore, effects of actinomycin D and
      cycloheximide suggest that biosynthesis of AM is designed for quick response to
      physiological stimulation.

PMID- 7794284
TI  - Human proadrenomedullin N-terminal 20 peptide in pheochromocytoma and normal
      adrenal medulla.
AB  - Proadrenomedullin N-terminal 20 peptide (PAMP) is a novel hypotensive peptide
      found in adrenomedullin precursor. Using a radioimmunoassay for human PAMP, we
      purified immunoreactive PAMP (ir-PAMP) from human pheochromocytoma and determined
      its complete amino acid sequence. The major component of PAMP-like
      immunoreactivity was found to be PAMP [1-20] NH2 with an amino acid sequence
      identical to that of the deduced amino acid sequence by cDNA analysis. Both ir
      PAMP and ir-adrenomedullin were found to be abundant in normal adrenal medulla as
      well as pheochromocytoma tissue arising from adrenal medulla, and there was a
      significantly (p < 0.05) positive correlation between ir-adrenomedullin and ir
      PAMP concentrations in these tissues. However, the PAMP/adrenomedullin ratio in
      pheochromocytoma tissues (0.197 +/- 0.013) was significantly (p < 0.005) lower
      than that in adrenal medullae (0.384 +/- 0.041). The present data indicate that
      PAMP is biosynthesized from adrenomedullin precursor, but the biosynthesis or
      metabolism of PAMP in pheochromocytoma may be different from that of normal
      adrenal medulla.

PMID- 7794286
TI  - [Urinary tract infections].

PMID- 7794285
TI  - Absence of the mitochondrial A7237T mutation in Parkinson's disease.
AB  - In recent years much has been speculated about a pathogenic role of mitochondrial
      defects in Parkinson's disease. Ozawa et al. (BBRC 176, 938-946, 1991) have
      described an A/T transversion at nucleotide 7237 of mitochondrial DNA affecting
      cytochrome-c-oxidase (complex IV) of the respiratory chain that could contribute
      to the pathogenesis of PD. Employing PCR based genomic sequencing and restriction
      enzyme analysis on 19 cases of Lewy-body parkinsonism, we exclude this mutation
      as a common cause of Parkinson's disease. This demonstrates the need for
      systematic sequencing of the mitochondrial genome in a large number of
      histologically verified cases of Parkinson's disease.

PMID- 7794287
TI  - Techniques of split-thickness skin grafting for lower extremity ulcerations.
AB  - OBJECTIVE: To discuss the role of skin grafts in the functional repair of lower
      extremity ulcerations. METHODS: The indications, types of skin grafts, and the
      methods of harvesting grafts are described. RESULTS: Detailed description of our
      method of bedside split-thickness skin grafting with both pinch and mesh grafts
      in hospitalized patients is given. We also discuss post-operative care and
      complications seen with skin grafting. CONCLUSION: Split-thickness skin grafting
      offers an important therapeutic option in the treatment of lower extremity
      ulcerations.

PMID- 7794288
TI  - Risk-taking behaviour of Cape Peninsula high-school students. Part IV. Alcohol
      use.
AB  - The prevalence of a wide range of risk-taking behaviour among high-school
      students in the Cape Peninsula, South Africa, was investigated. In this article,
      the results for alcohol use are presented. Cluster sampling techniques produced a
      sample of 7,340 students from 16 schools in the three major education
      departments. A self-administered questionnaire was completed in a normal school
      period. Estimates for each education department were weighted to produce an
      overall estimate. Of the sample, 53.2% reported ever using alcohol; 26.2% had
      used it recently and 15.4% reported episodes of binge drinking in the previous 14
      days. Drinking patterns varied according to school standard, home language, and
      gender. Males reported higher rates of alcohol use and for both genders rates
      increased with age. Overall, the prevalence of drinking was highest among
      adolescents whose home language was English. The proportion of Xhosa-speaking
      females who drank was very low. The prevalence of binge drinking in particular
      was identified as being of concern. The findings indicate a need for preventive
      action and further local research in this area.

PMID- 7794290
TI  - Comparison of polymerase chain reaction tests and faecal culture for detecting
      Mycobacterium paratuberculosis in bovine faeces.
AB  - A polymerase chain reaction (PCR) test for M. paratuberculosis was developed
      based on a 218 bp segment of a DNA insertion sequence, IS900, that is specific
      for this organism. The method involved two consecutive amplification reactions,
      with the second set of primers being nested inside the first set. The method
      reliably detected 50 organisms/g faeces. This PCR test was applied to 32 bovine
      faecal specimens containing high, moderate or low numbers of M. paratuberculosis
      organisms as determined by culture. The PCR test detected all specimens
      containing > or = 1600 colony forming units (cfu)/g faeces, six of ten specimens
      with 160-480 cfu/g faeces but only two of 13 specimens containing < or = 112
      cfu/g faeces. The sensitivity of this test was better than that of a commercial
      PCR test which was carried out on the same faecal specimens.

PMID- 7794289
TI  - A device for overcoming discoordination with metered-dose inhalers.
AB  - BACKGROUND: Despite widespread acceptance of metered-dose inhalers (MDIs) in the
      treatment of asthma, many patients fail to operate these devices correctly.
      Inability to properly coordinate activation with onset of inhalation is regarded
      as the major factor in suboptimal MDI therapy. METHODS: We evaluated Autohaler
      Inhalation Device (3M Pharmaceuticals, St. Paul, Minn.), a breath-activated MDI
      that is typically activated at a triggering flow rate of approximately 0.5 L/sec.
      We compared bronchodilator effect of pirbuterol acetate (Maxair), inhaled from
      Autohaler and a standard MDI, under conditions that ensured optimal technique in
      20 patients with asthma. Spirometric variables (forced expiratory volume in 1
      second [FEV1], forced expiratory flow between 25% and 75% of vital capacity
      [FEF25-75], forced vital capacity [FVC]) were measured before and at 15, 30, 60,
      and 90 minutes after two inhalations of full inspiratory reserve volume for each
      device. RESULTS: Both devices produced significant and similar bronchodilation.
      Mean FEV1 increased 32% above baseline 60 minutes after use of Autohaler and 31%
      after use of a standard MDI. Similar changes were noted in FEF25-75 and FVC for
      the two devices. Differences between devices for all spirometric variables were
      not statistically significant. CONCLUSION: Autohaler provides a promising
      alternative to the standard MDI by overcoming breath-hand discoordination.

PMID- 7794291
TI  - Intramucosal carcinoma developing in a hyperplastic gastric polyp.

PMID- 7794292
TI  - Divergent neuroprotective effects of nimodipine in PDD and MID provide indirect
      evidence of disturbances in Ca2+ homeostasis in dementia.
AB  - Evidence suggesting that increased cytotoxic Ca2+ concentrations due to
      disturbances of Ca2+ homeostasis are involved in neuronal deterioration in
      dementia has accumulated but has not yet been explicitly confirmed. Here we
      report of divergent neuroprotective effects of nimodipine, a Ca2+ channel blocker
      with high lipophilic properties, in primary degenerative dementia (PDD) and
      multiinfarct dementia (MID). Our clinical data show that nimodipine improves
      clinical symptomatology and cognitive functions in dementia significantly better
      than placebo but is more effective in PDD than in MID. This fact becomes
      explicitly apparent by comparison of the mean value differences of each of the 18
      SCAG items between onset and termination of treatment in the two diagnostic
      groups. The divergent therapeutic response in PDD and MID suggests that the
      neuroprotective effects of nimodipine can not be due mainly to unspecific
      cognition enhancing mechanisms or vasodilatation of cerebral blood vessels but
      must primarily be the consequence of a direct activity in depolarized neuronal
      cells and of its ability to protect neuronal tissue from Ca2+ overload. Hence, we
      conclude that disturbances in Ca2+ homeostasis play an important role in the
      process of neuronal deterioration in dementia. Although we can not entirely rule
      out the possibility that pharmacological activities besides the modulation of
      neuronal Ca2+ influx contribute to the effects of nimodipine, from a clinical
      view our results provide indirect evidence of disturbances in Ca2+ homeostasis as
      one of the primary factors in the demential process. Our results further support
      the usefulness of nimodipine in the pharmacotherapy of age-related mental
      deficits.

PMID- 7794293
TI  - Cardiovascular research in the pharmaceutical industry: a personal appeal for
      rationalizing development.

PMID- 7794294
TI  - Test reliability is critically important to molecular epidemiology: an example
      from studies of human papillomavirus infection and cervical neoplasia.
AB  - To demonstrate that it is critically important to achieve excellent test
      reliability before conducting full-scale molecular epidemiological studies, data
      were compared from two consecutive case-control studies of human papillomavirus
      (HPV) infection and cervical intraepithelial neoplasia. The major methodological
      difference between the two studies was the much greater reliability of the HPV
      test used in the second study. Although the first study used an assay considered
      state-of-the-art at that time, mediocre test reliability led to (a) a weakened
      association between HPV and risk of cervical intraepithelial neoplasia, (b) a
      weakened association between known risk factors for cervical intraepithelial
      neoplasia and HPV prevalence, (c) failure to demonstrate that HPV infection
      explains the known risk factors for cervical intraepithelial neoplasia, and (d) a
      marked reduction in the estimated proportion of cervical intraepithelial
      neoplasia attributable to HPV infection. With an improved assay, the second study
      strongly supported the idea that HPV infection is an intermediate end point
      explaining the known epidemiology of cervical intraepithelial neoplasia. Based on
      this experience and supportive theoretical considerations, we recommend that
      researchers optimize the reliability of innovative assays before application to
      full-scale molecular epidemiological projects.

PMID- 7794295
TI  - Kernicterus in a full term infant.

PMID- 7794296
TI  - Sodium arsenite induces heat shock protein-72 kilodalton expression in the lungs
      and protects rats against sepsis.
AB  - OBJECTIVE: To examine the hypothesis that induction of heat shock proteins by a
      nonthermal mechanism would confer protection against experimental sepsis. DESIGN:
      Prospective, blind, randomized, laboratory study. SETTING: University research
      laboratory. SUBJECTS: Sixty-two adult male Sprague-Dawley rats (weight range 250
      to 350 g). INTERVENTIONS: Administration of sodium arsenite or saline in an
      animal model of sepsis by cecal ligation and perforation. MEASUREMENTS AND MAIN
      RESULTS: Sixty-two rats were randomly divided into two groups: group 1 received
      sodium arsenite (6 mg/kg iv) and group 2 received saline injection, in a blinded
      fashion. Eighteen hours after receiving sodium arsenite or saline, cecal ligation
      and perforation were performed and the animals were monitored for mortality for
      96 hrs. Sodium arsenite injection, in the absence of an increase in body
      temperature, induced heat shock protein of 72-kilodalton molecular weight
      expression in the lung, which was detected 2 hrs after injection, peaked between
      9 and 24 hrs, and returned to baseline by 48 hrs. Prior administration of sodium
      arsenite conferred significant protection against cecal ligation and perforation
      induced mortality at 18 hrs (p = .002) and 24 hrs (p v .026) after cecal ligation
      and perforation, and correlated with expression of heat shock proteins in the
      lungs. However, at 48 and 96 hrs, when heat shock protein expression returned to
      basal values, the mortality rates of both groups were indistinguishable.
      CONCLUSIONS: We conclude that in vivo injection of sodium arsenite induces
      expression of HSP-72 in the lungs, and confers transient protection against
      experimental sepsis during the period that heat shock proteins are also
      expressed.

PMID- 7794297
TI  - Kidneys from pediatric donors: risk versus benefit.
AB  - We encountered four adult patients who received renal transplants from young
      children < 36 months of age, each of whom developed severe hypertension, heavy
      proteinuria, and progressive renal failure. Biopsies disclosed glomerular
      sclerosis with crescents in three patients and mesangial expansion in one. We
      thus analyzed our experience with 74 adults who received grafts from donors < or
      = 10 years of age and compared the results to those of 804 patients who were
      transplanted with kidneys from donors > 10 years of age. A Kaplan-Meier analysis
      revealed that graft survival was significantly worse in patients receiving grafts
      from younger, compared to older donors. This difference was apparent in patients
      treated either with or without cyclosporine. A subanalysis comparing patients
      with donor grafts aged < or = 5 or 6-10 years revealed a further adverse age
      related effect. Renal artery thrombosis and recurrent or de novo biopsy-proven
      glomerulonephritis were more common in patients receiving grafts from younger
      donors, while graft failure from rejection actually appeared less common. We
      conclude that severe hypertension and resultant glomerular hyperperfusion
      promoted glomerulosclerosis and crescent formation in our patients. Our results
      have caused us to pursue a more conservative approach towards transplanting
      grafts from donors aged < or = 10 years into adult recipients.

PMID- 7794298
TI  - Decisions about life-threatening risks.

PMID- 7794299
TI  - Recurrence of pemphigus vulgaris associated with interleukin 2 therapy.
AB  - BACKGROUND: Immunotherapy with recombinant interleukin 2 may result in regression
      of metastatic cancer, particularly malignant melanoma and renal cell carcinoma.
      OBSERVATIONS: We describe a patient who received interleukin 2 immunotherapy for
      metastatic renal cell carcinoma. After his second course of treatment, he
      developed a recurrence of pemphigus vulgaris that had been in remission for 10
      years. CONCLUSIONS: Interleukin 2 therapy may be associated with recurrence of an
      autoimmune disease, perhaps because of its ability to stimulate autoantibody
      production.

PMID- 7794300
TI  - The contribution of dystocia to the cesarean section rate.
AB  - OBJECTIVE: Our purpose was to examine the indications for performing cesarean
      sections in current obstetric practice and to define and measure the true
      contribution of dystocia ("difficult labor") to the overall cesarean section
      rate. STUDY DESIGN: A prospective audit was done of all cesarean sections
      performed during 1991 at The Queen Mother's Hospital, Glasgow, a teaching
      hospital and tertiary referral center. RESULTS: The cesarean section rate for
      1991 was 16.3%. Dystocia was the primary indication in 16% of all cesarean
      sections in 1991 but was actually a contributing factor, directly or indirectly,
      in the decision to operate in up to 38% of all cesarean sections that year.
      Seventy-eight percent of patients delivered because of dystocia were in
      spontaneous labor. We advocate more widespread use of a policy of active
      management in nulliparous women who labor spontaneously. If dystocia is addressed
      successfully, then many repeat cesarean sections may also be avoided.
      CONCLUSIONS: Improved management of dystocia in nulliparous women, such as the
      use of a policy of active management of labor, may be the most useful approach to
      reducing the cesarean section rate in modern obstetric practice.

PMID- 7794301
TI  - Significance of a first-time atypical Papanicolaou smear in a young, high-risk
      African-American and Latino-American population.
AB  - The first atypical Papanicolaou smear in young, sexually active Latino and
      African-American women of low socioeconomic status may be predictive of
      underlying cervical neoplasia and human papillomavirus infection of significant
      quantity. The optimal management of first-time atypia on routine Pap smear has
      not been established. In many clinics, colposcopically directed sampling of the
      cervix is recommended only if atypia persists following specific or nonspecific
      treatment of cervicitis or after an arbitrarily determined time interval. Others
      recommend immediate colposcopic evaluation. To determine the best approach to the
      first-time atypical Pap smear in young minority women at high risk for the
      development of cervical cancer, 250 such patients were evaluated with
      colposcopically directed biopsy of the cervix prior to any form of therapy. Pap
      smears were repeated at the time of colposcopy. Histologically, there was
      evidence of cervical intraepithelial neoplasia in 41% of patients and human
      papillomavirus infection in 86%. Repeat Pap smears predicted the presence of
      cervical intraepithelial neoplasia in only 24% of patients. Immediate colposcopic
      evaluation represents the most prudent approach to the first-time atypical Pap
      smear in young, high-risk minority women.

PMID- 7794302
TI  - Megestrol acetate in patients with AIDS-related cachexia.
AB  - OBJECTIVES: To compare the effects of oral suspensions of megestrol acetate, 800
      mg/d, and placebo on body weight in patients with acquired immunodeficiency
      syndrome (AIDS)-related weight loss. DESIGN: Randomized, double-blind, placebo
      controlled trial. SETTING: Outpatient community and university patient care
      setting. PATIENTS: Consecutive patients with AIDS who had substantial weight loss
      and anorexia were enrolled. Of 271 patients, 270 and 195 were evaluable for
      safety and efficacy, respectively. INTERVENTIONS: Patients were randomly assigned
      to receive placebo or megestrol acetate (100 mg, 400 mg, or 800 mg) daily for 12
      weeks. MAIN OUTCOME MEASURES: The primary efficacy criterion was weight gain.
      Patients were evaluated at 4-week intervals for changes in weight and body
      composition, caloric intake, sense of well-being, toxic effects, and appetite.
      RESULTS: For evaluable patients receiving 800 mg of megestrol acetate per day,
      64.2% gained 2.27 kg (5 pounds) or more compared with 21.4% of patients receiving
      placebo (P < 0.001). An intent-to-treat analysis showed significant differences
      (P = 0.002) between those receiving placebo and those receiving 800 mg of
      megestrol acetate for the number of patients who gained 2.27 kg (5 pounds) or
      more (8 of 32 [25%] compared with 38 of 61 [62.3%], respectively). Compared with
      patients receiving placebo at the time of maximum weight change, evaluable
      patients receiving megestrol acetate, 800 mg/d, reported improvement in overall
      well-being and had an increase in mean weight gain (-0.725 compared with 3.54 kg
      [-1.6 compared with +7.8 pounds]; P < 0.001), lean body mass (-0.772 compared
      with +1.14 kg [-1.7 compared with +2.5 pounds]; P < 0.001), appetite grade (P <
      0.001), and caloric intake (-107 compared with +645.6 calories/d; P = 0.001).
      CONCLUSIONS: In patients with AIDS-related weight loss, megestrol acetate can
      stimulate appetite, food intake, and statistically significant weight gain that
      is associated with a patient-reported improvement in an overall sense of well
      being.

PMID- 7794304
TI  - Endoscopic replacement of PEG.

PMID- 7794303
TI  - Comparison of biopsy sites for the histopathologic diagnosis of Helicobacter
      pylori: a topographic study of H. pylori density and distribution.
AB  - The histologic demonstration of characteristic curved, spiral bacilli on the
      gastric mucosa is considered the gold standard for the diagnosis of Helicobacter
      pylori infection. However, in some cases the urea breath test or serologic tests
      may be positive, yet gastric biopsy specimens fail to reveal H. pylori. The
      objectives of this study were (1) to analyze the density and distribution of H.
      pylori in different regions of the stomach, (2) to ascertain which area of the
      stomach is a preferential site for obtaining biopsy specimens, and (3) to
      determine whether the presence of neutrophils or lymphoid aggregates correlates
      with the presence of detectable organisms in the same biopsy specimen. Eighty
      nine patients with H. pylori infection underwent gastric mapping. The density of
      H. pylori, neutrophils, and lymphoid follicles was assessed semi-quantitatively
      in each biopsy site. The likelihood of getting a false-negative result was also
      calculated for each biopsy site. All biopsy specimens from the antral lesser
      curvature, at or near the incisura, had detectable H. pylori. Scores for this
      area and the cardia were higher than scores for the gastric corpus, but most
      differences were not significant. Fewer than 3% of antral biopsy specimens were
      false-negative, compared to between 6% and 9% of those from the corpus (p =
      0.02). Neutrophils were present in more than 94% of all antral biopsy specimens,
      compared to 60% to 86% of specimens from the corpus (p < 0.01). Lymphoid
      follicles were detected in approximately two-thirds of antral biopsy specimens
      but in fewer than half of those from the corpus.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794305
TI  - An audit of the treatment of cancer of the oesophagus.
AB  - The treatment of cancer of the oesophagus in The General Infirmary at Leeds
      between the years 1975 and 1988 was reviewed. All cases with histologically
      proved cancer of the oesophagus were included, data being obtained from case
      notes, theatre operation books, endoscopy records, pathology records, and the
      Yorkshire Cancer Registry. Three hundred and sixteen patients were identified.
      Demographic details, mode of presentation, preoperative investigations, surgical
      management, methods of palliation, and survival data were entered into a
      database. The male to female ratio was 3:2 and the median age at presentation was
      69 years (range 35-96). Surgical exploration was carried out in 134 of 316
      patients (42%). Resection of the tumour, whether curative or palliative, was
      possible in 106 of 134 patients (79%). Operative (30 day) mortality was 27%. In
      22 of 134 patients (16%), only intubation of the tumour was possible, while six
      patients (5%) had a thoracotomy or laparotomy alone. Median survival of the 106
      patients after surgical resection was 292 days (range 0-14.2 years) and seven of
      them (7%) were still alive five years later. Of the remaining 182 patients (58%)
      who were not operated upon, 36 patients (11%) had a radical course of
      radiotherapy with a median survival of 175 days (range 80-453) and 146 patients
      (46%) either had endoscopic intubation (n = 64) or received no specific treatment
      (n = 82) with a median survival of 106 days (1-725) and 91 days (1-358)
      respectively. None of the 182 patients who did not have surgical treatment was
      alive at five years.

PMID- 7794306
TI  - Detection of the BC 24 transforming fragment of the herpes simplex virus type 2
      (HSV-2) DNA in cervical carcinoma tissue by polymerase chain reaction (PCR).
AB  - The polymerase chain reaction (PCR) was used to investigate samples from
      Indonesian and Swedish patients with cervical intraepithelial neoplasia grade III
      (CIN III), squamous cell carcinoma or adenocarcinoma of the cervix for the
      presence of a transforming fragment (BC 24) of herpes simplex virus type 2 (HSV
      2) DNA. The PCR test for HSV-2 DNA was more sensitive than the infectivity
      endpoint titer in a cell culture system and no cross reactivity was found with
      either varicella-zoster virus, cytomegalovirus, Epstein-Barr virus, human
      papillomavirus 16 or 18, or human genomic DNA. Using this PCR test, 2 out of 5
      cases with CIN III, 10 of 71 squamous cell carcinomas, and 3 of 11
      adenocarcinomas of the uterine cervix were found to contain DNA sequences
      homologous to the BC 24 fragment of the HSV-2 genome. Only two of the samples
      containing this transforming region of the HSV-2 DNA were positive in a PCR assay
      for the HSV-2 DNA polymerase gene. The great majority of the HSV-2 BC 24 DNA
      positive (12 of 15) came from the Indonesian group of patients. All 15 CIN III or
      cancer samples positive for the HSV-2 BC 24 fragment were also positive for
      papillomavirus DNA. In line with observations made by others, our data support
      the hypothesis that HSV infection could represent one of several possible
      oncogenic cofactors leading to cervical carcinoma. The HSV cofactor might be more
      important in the Indonesian than in the Swedish population.

PMID- 7794307
TI  - A multicentre study of fluconazole versus oral polyenes in the prevention of
      fungal infection in children with hematological or oncological malignancies.
      Multicentre Study Group.
AB  - A randomized, comparative study was conducted in 502 patients in 23 centres world
      wide to assess the efficacy and safety of fluconazole versus nystatin and
      amphotericin B for prevention of fungal infection in a severely immunocompromised
      pediatric population. Patients scheduled within 48 hours to undergo chemotherapy
      or radiotherapy for hematological or oncological malignancies were randomly
      allocated to receive 3 mg/kg oral fluconazole once daily, 50,000 U/kg oral
      nystatin four times daily or 25 mg/kg oral amphotericin B four times daily.
      Prophylaxis began with the initiation of chemotherapy or radiotherapy and
      continued throughout a patient's hospital stay or period of neutropenia as
      necessary. The mean duration of fluconazole prophylaxis was 27.8 days and of the
      oral polyenes 29.2 days. The outcome of prophylaxis with fluconazole was
      significantly superior to that with the polyenes (p = 0.01). Mycologically
      verified infections occurred in 5 patients (2.1%) given fluconazole and in 21
      (8.4%) given polyenes (p = 0.002). Clinical evaluation at the end of prophylaxis
      showed that the clinical outcome was definitely or possibly successful in 87% in
      the fluconazole group and 82% in the polyenes group with no significant
      differences between the treatment groups. Mycological evaluation demonstrated
      reduction or control of colonization in 84% in the fluconazole group and 85% in
      the polyenes group, again with no significant between-group differences. Possibly
      drug-related side effects, mainly mild to moderate gastrointestinal disturbances,
      were reported in 38 patients given fluconazole, with eight subsequent
      withdrawals, and in 21 patients given oral polyenes, with three subsequent
      withdrawals. Laboratory test abnormalities occurred in 28 patients given
      fluconazole and 24 given polyenes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794308
TI  - Association of moderate alcohol consumption and plasma concentration of
      endogenous tissue-type plasminogen activator.
AB  - OBJECTIVE: To assess whether an association exists between moderate alcohol
      consumption and plasma concentration of endogenous tissue-type plasminogen
      activator (t-PA), a serine protease that plays a central role in the regulation
      of intravascular fibrinolysis. DESIGN: Survey of self-reported alcohol
      consumption and plasma fibrinolytic capacity, controlled for lipid and nonlipid
      cardiac risk factors. SETTING: Participants in the Physicians' Health Study.
      PARTICIPANTS: A total of 631 apparently healthy male physicians aged 40 to 84
      years with no history of myocardial infarction, stroke, or transient cerebral
      ischemia. MAIN OUTCOME MEASURE: Plasma concentration of t-PA antigen. RESULTS: A
      direct association was found between alcohol consumption and plasma level of t-PA
      antigen, such that mean plasma levels of t-PA antigen for daily, weekly, monthly,
      and rare or never drinkers were 10.9, 9.7, 9.1, and 8.1 ng/mL, respectively (P
      trend = .0002). The relation between alcohol consumption and t-PA antigen level
      was not materially changed in analyses that adjusted for total cholesterol and
      high-density lipoprotein cholesterol or nonlipid cardiovascular risk factors
      including age, body mass index, parental history of coronary heart disease,
      exercise frequency, and systolic and diastolic blood pressure. CONCLUSIONS: These
      data indicate a positive association between moderate alcohol intake and plasma
      level of endogenous t-PA antigen that is independent of high-density lipoprotein
      cholesterol. This finding supports the hypothesis that changes in fibrinolytic
      potential may be an important mechanism whereby moderate alcohol consumption
      decreases risk of heart disease.

PMID- 7794309
TI  - What to advise patients about drinking alcohol. The clinician's conundrum.

PMID- 7794310
TI  - Severe adverse cutaneous reactions to drugs.

PMID- 7794311
TI  - Neurologic manifestations of HIV infection.
AB  - PURPOSE: To review the clinical features, pathogenetic mechanisms, and management
      of neurologic manifestations of human immunodeficiency virus (HIV) infection.
      DATA SOURCES: Studies published from 1983 to 1994 identified by MEDLINE
      literature search; Centers for Disease Control and Prevention reports; recent
      communications and abstracts; and authors' published and unpublished data. STUDY
      SELECTION: We selected studies that described the clinical characteristics of
      neurologic disorders in the acquired immunodeficiency syndrome (AIDS), basic
      science studies addressing the mechanisms of direct or indirect neurologic damage
      in HIV infection, and clinical trials investigating the effects of therapeutic
      agents on the neurologic complications of AIDS. DATA EXTRACTION: We evaluated
      information and data on epidemiologic characteristics, clinical manifestations,
      pathogenetic mechanisms, and therapy for neurologic complications of HIV disease
      and outlined a practical approach to assess and manage these disorders. DATA
      SYNTHESIS: In the past decade, basic and clinical studies have provided
      considerable information about neurologic manifestations of AIDS. Dementia is the
      most important "primary" neurologic complication of HIV infection. Focal lesions
      of the central nervous system include cerebral toxoplasmosis, lymphoma, and
      progressive multifocal leukoencephalopathy. Other opportunistic infections
      include cytomegalovirus encephalitis, cryptococcal meningitis, and neurosyphilis.
      Various peripheral neuropathies and myopathies may occur in association with HIV
      infection or as toxic effects of antiretroviral agents. CONCLUSIONS: The
      prevalence of neurologic complications associated with HIV disease will increase
      as more effective therapies allow persons with AIDS to live longer. Early
      recognition and treatment of these disorders substantially affect patients'
      quality of life and survival.

PMID- 7794312
TI  - Case report: a gastroduodenal artery pseudoaneurysm presenting with obstructive
      jaundice and treated by arterial embolization.
AB  - A case of obstructive jaundice due to a pseudoaneurysm of the gastroduodenal
      artery is reported. This was successfully embolized, with relief of the jaundice.
      Relief of biliary obstruction by aneurysm embolization has not, to our knowledge,
      been previously described.

PMID- 7794313
TI  - Cosmetic breast fibrosis: it's the local boost!

PMID- 7794316
TI  - Euthanasia and physician-assisted suicide.

PMID- 7794315
TI  - A comparison of stress in surgically and non-surgically mulesed sheep.
AB  - A comparison has been made in 9- to 10-month-old castrated male Merino sheep of
      the changes in plasma total cortisol concentration and behaviour after being
      treated by either the modified Mules operation or by topical application of a
      quaternary ammonium compound to achieve non-surgical mulesing. After surgical
      mulesing, plasma total cortisol concentration increased immediately and rapidly
      and reached a peak value in 15 minutes, whereas after non-surgical treatment an
      immediate rise did not occur, but a similar peak value was observed in blood
      samples collected 24 hours after treatment. The concentrations were lower in both
      groups at 48 hours. Likewise postural changes indicative of discomfort were
      immediately apparent in the surgically treated sheep, but not until 3 to 4 hours
      later in those treated non-surgically. Arena testing revealed that a lasting
      aversion to the person who restrained them during treatment developed in the
      surgically mulesed sheep, but not in those treated non-surgically. The non
      surgical procedure did not create large open wounds, as did the surgical
      operation, but still achieved similar enlargement of the bare area on the breech,
      and healing was quicker in the non-surgically treated sheep.

PMID- 7794314
TI  - Exercise tomographic thallium-201 imaging in patients with severe coronary artery
      disease and normal electrocardiograms.
AB  - OBJECTIVE: To assess the incremental value and cost-effectiveness of exercise
      tomographic thallium-201 imaging compared with clinical and exercise
      electrocardiographic variables for detecting three-vessel or left main coronary
      artery disease in patients with normal at-rest electrocardiograms. DESIGN:
      Prospective cohort study. PARTICIPANTS: 411 patients (77 [19%] had three-vessel
      or left main disease) with normal at-rest electrocardiograms who underwent
      exercise tomographic thallium-201 studies and subsequently had coronary
      angiography. MEASUREMENTS: Clinical, exercise, and thallium-201 variables;
      univariate followed by multivariate logistic regression analysis to determine
      predictors of three-vessel or left main disease (clinical variables; clinical and
      exercise electrocardiographic variables; and clinical, exercise, and thallium-201
      variables). Patients were classified by each of these models into low-,
      intermediate-, and high-risk groups. SETTING: A tertiary referral center.
      RESULTS: Among the clinical variables, diabetes mellitus, sex, age, and typical
      angina were independently associated with severe coronary disease (46% of
      patients were correctly classified into low- or high-risk groups). The peak
      exercise heart rate-blood pressure product and the magnitude of the exercise
      induced ST depression added independent information to clinical variables. Among
      the thallium variables, the change in the global thallium-201 score (a measure of
      redistribution) added independent information to clinical and exercise variables,
      resulting in only 3% of the patients being reclassified regarding their predicted
      risk for severe coronary disease. The cost per additional reclassification was
      estimated to be $20,550. Twenty-one cardiac events occurred (7 cardiac deaths and
      14 myocardial infarctions) after thallium study (follow-up, 2.8 +/- 1.0 years).
      Event-free survival was 94% to 97% regardless of the predicted probability of
      developing three-vessel or left main coronary artery disease by any model.
      CONCLUSIONS: When the at-rest electrocardiogram is normal, thallium-201
      scintigraphy adds little information to clinical and exercise variables in
      identifying patients with severe coronary artery disease. The high cost of this
      information may not justify the routine use of sophisticated imaging for this
      purpose.

PMID- 7794317
TI  - Five-year follow-up of mandibular reconstruction with hydroxylapatite and the
      mandibular staple bone plate.
AB  - PURPOSE: To evaluate the results of hydroxylapatite augmentation of the mandible
      followed by placement of the mandibular staple. PATIENTS AND METHODS: Sixty
      patients 5 or more years postsurgery were evaluated. Patients were followed
      yearly with clinical and radiographic examinations. RESULTS: The decrease in
      augmentation height was 2.8 mm (33%) after the first year and only minimal in the
      following years. The following problems were seen: hyperplastic tissue around
      posts (eight patients), small dehiscences were seen in the saddle area after 2
      years (11 patients), large dehiscences with significant hydroxylapatite loss in
      five patients. One patient needed a secondary augmentation. CONCLUSION:
      Prosthetic stabilization and function were excellent throughout the study period
      and there was a uniformly high degree of patient satisfaction.

PMID- 7794318
TI  - Comparison of the proteins in salivary glands, saliva and haemolymph of
      Rhipicephalus appendiculatus female ticks during feeding.
AB  - To compare the proteins in salivary glands, saliva and haemolymph of
      Rhipicephalus appendiculatus female ticks, antisera were prepared from guinea
      pigs immunized with soluble denatured salivary gland extracts (SGE). The extracts
      were derived from R. appendiculatus female ticks that were either unfed (day 0)
      or partly fed (day 6). The sera were used in immunoblotting, following SDS
      polyacrylamide gel electrophoresis, to examine the antigen profiles during the
      course of tick feeding on guinea-pigs. Day 0 and day 6 SGE antisera appeared to
      detect common proteins in the different tick samples. For example, haemolymph
      apparently shared some of the small protein bands (31.5-34 kDa) detected in SGEs.
      These small proteins appeared in both samples at the same stage of feeding,
      suggesting that haemolymph and salivary glands not only have common antigens but
      may also share some functions. Furthermore, a number of protein bands were
      detected in haemolymph before they were apparent in the salivary glands or
      saliva. Thus some antigens detected in the salivary glands and saliva may be
      derived from the haemolymph. The results indicate that the host may be exposed to
      tick saliva antigens that are also present in the haemolymph. We discuss the
      significance of these observations with regard to the induction of host immunity
      to ticks and the development of tick vaccines.

PMID- 7794319
TI  - Excretion of host immunoglobulin in tick saliva and detection of IgG-binding
      proteins in tick haemolymph and salivary glands.
AB  - Host immunoglobulin G (IgG) crossed the gut wall into the haemocoel of adult
      Rhipicephalus appendiculatus female ticks when they fed on guinea-pigs. Guinea
      pig IgG was also found in saliva of the feeding ticks. The concentration and
      antibody activity of IgG in haemolymph, salivary gland extract (SGE) and saliva
      at different stages of tick feeding were detected by enzyme-linked immunoassay.
      Specific activity of the IgG in tick samples was determined by feeding ticks on
      guinea-pigs which were immunized with killed Escherichia coli: 35-42% of the
      antibody activity in guinea-pig immune serum remained in the tick samples. The
      high relative concentration of IgG in tick saliva at later stages of feeding
      suggests that the tick may have a mechanism for getting rid of foreign proteins
      via the salivary gland. Such a mechanism could involve IgG binding proteins
      (IGBPs) which were found in both haemolymph and SGE of female ticks at day 6 of
      feeding using a guinea-pig IgG-agarose affinity column. In female ticks, the M(r)
      of IGBPs in SGE (23 and 57 kDa) were less than those in haemolymph (78 and > 100
      kDa). The existence of IGBPs in both the tick salivary gland and haemolymph
      indicate that haemolymph and salivary gland cooperate to remove foreign proteins,
      e.g. host immunoglobulin, from the body during feeding. This mechanism may be a
      part of the tick self-defence system.

PMID- 7794321
TI  - Auramine fluorescence for acid-fast bacilli in formalin-fixed paraffin-embedded
      tissues.

PMID- 7794320
TI  - The CR-CO discrepancy and its effect on cephalometric measurements.
AB  - The purpose of the present study was to compare cephalometric measurements
      derived from a centric occlusion (CO) tracing with those of a converted centric
      relation (CR) tracing. The sample consisted of 68 consecutively treated patients,
      with a CR-CO discrepancy of 2 mm or greater in either the horizontal and/or
      vertical planes, measured at the condyles from mounted models. Comparisons were
      also made within the sample between the 39 females and 29 males; and the 35
      skeletal Class I and 33 Class II patients. In analyzing the CR-CO discrepancy,
      the vertical component was greater than the horizontal in 96% of the sample.
      Every patient had a vertical component, although 10% had no horizontal component.
      Correlations between the horizontal discrepancy and the two tracings showed high
      values for approximately 50% of the measures, whereas little correlation was
      found with the vertical discrepancy. Paired t tests used to compare the CO and CR
      cephalometric values demonstrated significant differences (p < 0.05) for the
      majority of the values studied. However, there generally were no differences
      between the groups of males and females, or between the skeletal Class I and
      Class II individuals. The results of this study suggest that to make a correct
      orthodontic diagnosis the mandible should be placed in centric relation rather
      than in the more traditional centric occlusion.

PMID- 7794322
TI  - Possible coumarin hepatotoxicity.

PMID- 7794323
TI  - Upper gastrointestinal tract.
AB  - Drug therapy for upper gastrointestinal disease in the elderly must be moderated
      by the likelihood of increased sensitivity to the side effects of drugs. For
      example, in the frail elderly with helicobacter-associated duodenal ulcers,
      maintenance therapy with an H2-receptor antagonist or omeprazole may be
      preferable to attempting to eradicate Helicobacter pylori with the current
      antimicrobial regimens.

PMID- 7794325
TI  - Divisions of general practice: too much too quickly.

PMID- 7794324
TI  - Chiropractic and the politics of health care.
AB  - Musculoskeletal disorders remain a common disability suffered by Australians, but
      the question of who should treat them remains a contentious issue as the first
      centenary of the original chiropractic adjustment approaches. This paper, part of
      a longitudinal study of the role of chiropractic in the Australian health system,
      analyses this ongoing debate. Recent events are analysed here in this commentary
      on the politics of health care in this field. These include meta-analysis to
      evaluate the effectiveness of spinal manipulation for the treatment of lower back
      pain, recent legal action in the United States, and the recent epistle against
      Australian chiropractors published by the Australian Medical Association.

PMID- 7794326
TI  - Drug resistant tuberculosis.

PMID- 7794327
TI  - Prevalence of Asperger's syndrome in a secure hospital.
AB  - BACKGROUND: The hypothesis that Asperger's syndrome (AS) may go unrecognised in
      forensic populations was examined by ascertaining the prevalence in Broadmoor
      Special Hospital. METHOD: The entire male patient population was screened by
      examination of case notes. Identified cases were subject to the next stage of the
      study, which involved observation and interviewing of patients, and a semi
      structured interview of key staff. RESULTS: A prevalence of 1.5% (0.6% to 3.3%,
      95% CI) was found. The addition of equivocal cases increased the prevalence to
      2.3%. CONCLUSION: The prevalence of AS in Broadmoor Hospital is greater than that
      reported for the general population.

PMID- 7794328
TI  - Lymphoma of the mucosa-associated lymphoid tissue of the lung. A multifocal case
      of common clonal origin.
AB  - Low-grade B-cell lymphomas of the mucosa-associated lymphoid tissue (MALT) are
      extranodal tumors that tend to be localized. In this case report, the authors
      describe an unusual multifocal pulmonary MALT lymphoma, which presented
      radiologically as three discrete lesions involving two separate lobes of the
      lung, in addition to numerous separate macroscopic and microscopic foci of
      disease. The lesions were composed of centrocyte-like cells and cytologically
      bland plasma cells surrounding reactive lymphoid follicles with focal areas
      resembling lymphoid interstitial pneumonia (LIP). Immunohistochemical studies
      demonstrated a predominance of immunoglobulin kappa light chain positive plasma
      cells in the largest lesion. A polymerase chain reaction (PCR) assay demonstrated
      conserved immunoglobulin heavy chain gene rearrangements in the large tumor
      nodules as well as microscopic foci resembling LIP. This case illustrates the
      utility of PCR for identifying the clonal nature of lymphoid lesions that are too
      small or heterogeneous to unequivocally assess by other means.

PMID- 7794329
TI  - Comparison of standardized echography with magnetic resonance imaging to measure
      extraocular muscle size.

PMID- 7794330
TI  - Failure of consultant expansion. "Subconsultant" posts are increasing
      dramatically.

PMID- 7794331
TI  - The perils of Prozac.
AB  - In seven years, Prozac has become a social phenomenon as well as a medical
      treatment. This paper reviews the background of the Prozac controversy and
      summarizes the current psychiatric and medical uses of the drug. Prozac and the
      other selective serotonin re-uptake inhibitors have been determined to be safe
      and effective treatment for depression. Physicians are sometimes asked to
      prescribe the drug for inconsequential reasons, but serious depressions are seen
      frequently in general medical practice. Physicians thus need a high level of
      awareness and the capability to treat depression, a major public health problem.

PMID- 7794332
TI  - p53 and bladder cancer.

PMID- 7794333
TI  - Severe adverse cutaneous reactions to drugs.

PMID- 7794334
TI  - Which research results should the public believe?

PMID- 7794335
TI  - Oncogenes and cancer.

PMID- 7794336
TI  - Invasion of the cabbage patch.

PMID- 7794337
TI  - Prostate cancer kills.

PMID- 7794338
TI  - Comment on rapid molar distalization.

PMID- 7794339
TI  - Re: "Greater case-fatality after myocardial infarction among Mexican Americans
      and women than among non-Hispanic whites and men: The Corpus Christi Heart
      Project".

PMID- 7794340
TI  - Leprosy. Report of a Meeting of Physicians and Scientists at the All India
      Institute of Medical Sciences, New Delhi.

PMID- 7794341
TI  - Drug promotion.

PMID- 7794342
TI  - Accidental hypothermia.

PMID- 7794343
TI  - Medical savings accounts. Finally, a reform concept with integrity.

PMID- 7794344
TI  - Isolation of a parapoxvirus from pox-like lesions in grey seals.

PMID- 7794345
TI  - [Intestinal parasitoses in the prison population in the Madrid area (1991-1993)].
AB  - BACKGROUND: Intestinal parasitoses are frequent in populations in tropical and
      subtropical areas, HIV infection has favoured an increase in the prevalence of
      some of these parasitoses . Both conditions concur in innate populations. The aim
      of this study was to determine the prevalence and clinical characteristics of the
      intestinal parasitosis in a penitentiary population from the Madrid area.
      METHODS: On the basis of the data from the Laboratory of Clinical Microbiology in
      the Hospital General Penitenciario, patients with the diagnosis of intestinal
      parasitosis were retrospectively reviewed. The study period covered 29 months
      (from 1/8/91 to 31/12/93). Samples were taken from patients admitted to, and
      attended, in the outpatient area of this hospital in addition to those held in
      dependents prisons. Processing was done by direct macroscopic and microscopic
      visualization (400x) of the sediment obtained by the formol-ether concentration
      method (Ritchie). Modified Ziehl staining was carried out. Demographic, clinical
      evolutive and microbiologic data of the patients were analyzed. RESULTS: One
      thousand two hundred eighty-one samples corresponding to 1,033 patients were
      studied 131 (10.2%) positives corresponding to 96 (9.3%) patients were observed.
      88.5% (n = 85) were males. The mean age was 31.2 years (CI 95%: 29.3-32.9). The
      patients were from Europe in 39.7% of the cases (Spain: 94%), Africa 28.9% and
      Latin America 28.9%. Twenty-five patients were HIV+ (46%) with a mean CD4 count
      of 160/mm3 (CI 95%: 65-255) and 29 were HIV-. Globally, the most frequently found
      parasites were uncinaria (22%), Giardia lamblia (21%) and Cryptosporidium parvum
      (20%). One case of intestinal capillariasis was diagnosed. Fifteen mixed
      parasitoses (15.6%) were observed and the most frequent association was Trichuris
      trichiura and uncinaria in 8 patients (5 HIV+ and 3 unknown HIV). Clinical
      manifestations were present in 63.7% (42/66) of the patients with diarrhea being
      the most frequent (25 cases). In patients in whom the clinical evolution could be
      evaluated, it was favorable in most of the cases except in those with
      Cryptosporidium parasitosis. CONCLUSIONS: Intestinal parasites are of relevance
      within a prison population, presenting some differences to the intestinal
      parasites observed in a general population. The most frequently observed parasite
      was uncinaria in HIV- patients and Cryptosporidium parvum in HIV+ patients. Mixed
      parasitosis was not infrequent (15.6%). 25% of the intestinal parasitosis are
      asymptomatic. When symptomatology does exist, diarrhea is the most common
      clinical manifestation. The clinical evolution is usually favourable with the
      exception of some cases of diarrhea by Cryptosporidium in severely
      immunosuppressed HIV+ patients.

PMID- 7794346
TI  - Treating mental health problems of health care workers.

PMID- 7794347
TI  - Effects of oral pentoxifylline on TNF-alpha levels, transplant-related toxicities
      and engraftment after bone marrow transplantation.

PMID- 7794348
TI  - "One patient's experience with pancuronium bromide".

PMID- 7794349
TI  - Transmission of HIV.

PMID- 7794350
TI  - Epistaxis due to hereditary hemorrhagic telangiectasia.

PMID- 7794351
TI  - Upper gastrointestinal tract.

PMID- 7794352
TI  - Discussion of "Did the 65 mph speed limit save lives?".

PMID- 7794353
TI  - Haemodynamic effects of subarachnoid block in the elderly.

PMID- 7794354
TI  - Phospholipid binding antibodies warrant continued investigation.

PMID- 7794355
TI  - A fundamental problem of consent. Patients' trust must be respected.

PMID- 7794356
TI  - A fundamental problem of consent. Chaperones are necessary for female patients.

PMID- 7794357
TI  - A fundamental problem of consent. Information on anaesthesia for caesarean
      section is tailored to the woman.

PMID- 7794358
TI  - Asthma care in general practice.

PMID- 7794359
TI  - Cardiac troponin-T and diagnostic test evaluation.

PMID- 7794360
TI  - Omitting side holes in biliary stents.

PMID- 7794361
TI  - Paradoxical reactions to diazepam.

PMID- 7794363
TI  - Reinterpreting mortality statistics.

PMID- 7794362
TI  - Therapeutic approach to microvascular angina (syndrome X)

PMID- 7794364
TI  - Alcohol consumption and tissue-type plasminogen activator.

PMID- 7794365
TI  - Management of first-trimester spontaneous abortion.

PMID- 7794367
TI  - Kernicterus in a full-term infant: the need for increased vigilance.

PMID- 7794366
TI  - Immunologic defects of the peritoneum determine the bacteriology of peritonitis.

PMID- 7794368
TI  - Late-onset psychosis with somatic delusions.

PMID- 7794370
TI  - Congestive heart failure associated with endoscopic cholecystectomy.

PMID- 7794369
TI  - Adverse effects of topical corticosteroid use.
AB  - Topical corticosteroid use, a common and often efficacious therapy for a wide
      variety of cutaneous conditions, may have substantial adverse effects. These
      range from the notable nondermatologic side effects of hypothalamic-pituitary
      adrenal axis suppression, Cushing's disease, femoral head osteonecrosis, and
      cataracts to a variety of less serious skin effects such as cutaneous tinea and
      contact dermatitis. The broad availability, efficacy, relative low cost, and ease
      of applying topical corticosteroids should not induce complacency or a cavalier
      attitude in prescribers. Physicians should have the same awareness of the
      possible side effects of topical steroid use as when prescribing parenteral
      medication.

PMID- 7794371
TI  - Don't upset my equilibrium again!

PMID- 7794372
TI  - Spurious data collection misleads authors.

PMID- 7794373
TI  - Group B streptococcal prophylaxis randomized trials.

PMID- 7794374
TI  - Treatment of schizophrenia with anticholinergic medications.

PMID- 7794375
TI  - Elective lymph node dissection (ELND) for malignant melanoma.

PMID- 7794376
TI  - The role of Chlamydia trachomatis in urethritis and urethral symptoms in women.
AB  - One hundred and fifty women who attended a genitourinary medicine clinic and who
      required a speculum examination were investigated to determine the association
      between Chlamydia trachomatis and urethral symptoms and signs. Those who had
      taken antibiotics with anti-chlamydial activity within 3 months or those who were
      menstruating, pregnant or using an intrauterine contraceptive device were
      excluded. C. trachomatis infection of the urethra, or infection of the urethra
      and cervix together, combined with each separately, were strongly associated with
      > = 5 polymorphonuclear (PMN) leucocytes per high-power field (x 1000) in a Gram
      stained urethral smear (P < 0.00005 and P < 0.0005, respectively). This appeared
      not to arise from leucocyte contamination from the lower genital tract. However,
      C. trachomatis infection of the urethra was not associated with symptoms of
      dysuria or frequency. In conclusion, it seems likely that C. trachomatis
      infection of the urethra in women probably causes urethritis which is usually
      asymptomatic. Women who have objective evidence of urethritis might best be
      managed by appropriate antibiotic therapy and counselling, and advice that
      partners should attend for review.

PMID- 7794377
TI  - Screening for breast cancer. Diagnostic performance of radiographers can be
      improved.

PMID- 7794378
TI  - Screening for the breast cancer. Two views mean twice the dose of radiation.

PMID- 7794379
TI  - United Kingdom prospective diabetes study. Compliance with diet will affect
      results.

PMID- 7794380
TI  - Services for cleft lip and palate. Plastic surgeons support centralisation of
      services.

PMID- 7794381
TI  - Non-insulin dependent diabetes mellitus and non-Hodgkin's lymphoma. Already
      reported.

PMID- 7794382
TI  - Lithium in steroid-induced depression.

PMID- 7794384
TI  - MD or MRCP? A dilemma for the Sri Lankan physician.

PMID- 7794383
TI  - Breaks in genomic DNA and within the p53 gene are associated with hypomethylation
      in livers of folate/methyl-deficient rats.
AB  - Male weanling Fischer 344 rats were fed either a semipurified diet deficient in
      the methyl donors methionine, choline, and folic acid or a supplemented control
      diet for a period of 9 weeks. At intervals of 2, 5, and 7 days, 3 weeks, and 9
      weeks after initiation of the respective diets, the relative level of DNA strand
      breaks and the degree of cytosine methylation were quantified in high molecular
      weight DNA and also within the p53 gene in liver samples from these rats. Genome
      wide strand break accumulation was associated with progressive genomic
      hypomethylation and increased DNA methyltransferase activity. With the use of
      quantitative PCR as a gene-specific DNA strand break assay, unique DNA strand
      breaks were detected in exon 5 but not in exons 6-8 of the p53 gene, and were
      accompanied by significant p53 gene hypomethylation. DNA hypomethylation has been
      shown to alter the conformation and stability of the chromatin structure,
      rendering affected regions more accessible to DNA-damaging agents. To determine
      whether methylation status alters the sensitivity of DNA to strand breakage, DNA
      in isolated nuclei was methylated in vitro and exposed to endogenous
      calcium/magnesium-dependent endonuclease activated under defined conditions. The
      incidence of enzyme-induced DNA strand breaks was decreased significantly with
      increased DNA methylation. In nuclei isolated from livers of methyl-deficient
      rats, the hypomethylated DNA was found to be more sensitive to enzyme- and
      oxidant-induced DNA strand break induction. Taken together, these results provide
      evidence that DNA strand breaks are induced in high molecular weight DNA and also
      within the p53 gene in liver tissue from methyl-deficient rats. The increased
      incidence of these strand breaks in DNA from methyl-deficient rats may be related
      to alterations in chromatin accessibility associated with DNA hypomethylation.

PMID- 7794385
TI  - Iron deficiency anaemia.

PMID- 7794386
TI  - Mitochondrial gene mutation as a cause of insulin resistance.

PMID- 7794387
TI  - The timeliness of new drug approvals in Canada.
AB  - In a recent article, Lexchin asks "who needs faster drug approval times in
      Canada?" and, on the basis of extremely limited and selective data, draws the
      conclusion that neither the public nor the pharmaceutical industry does. Whether
      the Canadian system is really slower is investigated by comparing Canadian and
      U.S. marketing approval dates and by using information on regulatory approval
      times from the two countries and elsewhere. Marketing approval dates in Canada
      are significantly later than those in the United States, although not
      consistently across all therapeutic categories; anti-cancer and gastrointestinal
      drugs have earlier approval dates in Canada. However, Canadian and U.S.
      regulatory approval times are not significantly different, indicating that
      marketing applications are submitted later in Canada, but both are considerably
      longer than those in the United Kingdom. The evidence shows that Canadians need
      faster drug approval times if individuals requiring the medications are not to
      suffer unnecessarily. A significant decrease in drug approval times and the
      establishment of comprehensive and effective postmarketing surveillance would
      reduce the time it takes for new drugs to be made available to Canadians while,
      at the same time, providing a high level of drug safety.

PMID- 7794388
TI  - Hematologic characteristics of greyhounds.

PMID- 7794389
TI  - The L-arginine:nitric oxide pathway is the major source of plasma nitrite in
      fasted humans.
AB  - 15N guanidino-labelled L-arginine was infused into fasted human volunteers
      giving, at equilibrium, a stable 1:10 ratio of 15N to 14N arginine in the plasma.
      Separate GC-MS assays were used to compare the degree of enrichment of plasma
      arginine, nitrite and nitrate and thus define the quantitative relationship
      between the L-arginine:nitric oxide (NO) pathway and the formation of these
      oxides of nitrogen. 15N nitrite enrichments rose to 8.3% (SD 0.5), five hours
      after the start of the infusion. In contrast, 15N nitrate enrichments apparently
      rose to only 1.6% (SD 0.4) at this time. This discrepancy could be explained by
      our finding that the commonly used Tesch GC-MS nitrate assay is subject to
      considerable interference from non-nitrate sources in plasma. Taking this into
      account, nitrate enrichments were similar to those observed for plasma nitrite.
      These results therefore indicate that the measurement of these compounds in
      plasma is a valid indicator of NO generation in fasted humans.

PMID- 7794390
TI  - Early days of Australian chiropractic.

PMID- 7794391
TI  - Wise words of Malleson accordant.

PMID- 7794393
TI  - One of the aims of interventional laparoscopy is anchored in aesthetics.

PMID- 7794392
TI  - Nitrous oxide has a very low abuse potential.

PMID- 7794394
TI  - Treatment of epiglottitis.

PMID- 7794395
TI  - Prenatal care key to breast-feeding.

PMID- 7794396
TI  - Post-streptococcal glomerulonephritis.

PMID- 7794397
TI  - Classification and diagnosis of erythromelalgia.

PMID- 7794398
TI  - Eyelid opening apraxia in focal cortical degeneration.

PMID- 7794400
TI  - Psychoanalysis: waning or waxing?

PMID- 7794399
TI  - The Barthel index in clinical practice.

PMID- 7794401
TI  - Core services and cardiac surgery.

PMID- 7794402
TI  - Consent to HIV testing.

PMID- 7794403
TI  - Alternative medicine.

PMID- 7794404
TI  - Screening for cervical cancer.

PMID- 7794405
TI  - Emergency medicine in South Africa.

PMID- 7794406
TI  - Classification of neuroendocrine carcinomas of the gastrointestinal tract.

PMID- 7794407
TI  - Megestrol for AIDS-related anorexia.

PMID- 7794408
TI  - Ready! Aim! Check the literature!

PMID- 7794409
TI  - Autoimmune disorders and interleukin-2 therapy: a step toward 'unanswered
      questions'.

PMID- 7794410
TI  - Plagiarism suit wins; experts hope it won't set a trend.

PMID- 7794411
TI  - Habits of death. Cultural variation in attitudes toward death.

PMID- 7794413
TI  - [Studies on the triterpenes from Bemeuxia thibetica Decne].
AB  - Four triterpenes were isolated from the alcoholic extract of Bemeuxia thibetica
      Decne. A new triterpene, 16 alpha, 21 beta, 22 alpha, 28-tetrahydroxyolean-12-en
      3-one, named bemeuxin (I), was identified on the basis of spectral evidences. The
      other three triterpenes were identified as 21-tigloylbarringtogenol C(II), 2
      alpha, 3 alpha-dihydroxyursolic acid (III) and 2 alpha, 3 beta-dihydroxyursolic
      acid (IV).

PMID- 7794412
TI  - An ICAM-related neuronal glycoprotein, telencephalin, with brain segment-specific
      expression.
AB  - Telencephalin (TLN) is a 130 kd glycoprotein expressed exclusively in neurons of
      the telencephalon, the most rostral brain segment. In the neurons, TLN is
      localized to soma-dendritic membrane but not to axonal membrane. In this study,
      we have cloned cDNA encoding rabbit and mouse TLN. The cDNA-derived primary
      structure of TLN predicts an integral membrane protein with nine tandem
      immunoglobulin-like domains in an extra-cellular region, a transmembrane domain,
      and a short cytoplasmic tail. The distal eight immunoglobulin-like domains of TLN
      show highest homology with the immunoglobulin-like domains of intracellular
      adhesion molecules (ICAMs) 1, 2, and 3/R. The structural similarity of TLN with
      ICAMs provides a new and strong link between immunoglobulin superfamily molecules
      in the nervous and immune systems. TLN is an example of a dendrite-associated
      cell adhesion molecule involved in the brain's segmental organization, cell-cell
      interactions during dendritic development, and maintenance of functional neuronal
      networks.

PMID- 7794414
TI  - Quantitative determination of intracellular depolymerase activity in Pseudomonas
      oleovorans inclusions containing poly-3-hydroxyalkanoates with long alkyl
      substituents.
AB  - Research regarding the accurate, quantitative degradation of novel poly-3
      hydroxyalkanoates has been restricted by the absence of an appropriate monitoring
      technique. The calibration of a gas chromatograph to poly-3-hydroxyoctanoate
      reveals a linear relationship between the area under gas chromatograph tracings
      and polymer weight. With this new method, poly-3-hydroxy-octanoate granules
      isolated from Pseudomonas oleovorans, which were incubated at 30 degrees C in an
      alkaline buffer, exhibited a linear degradation rate. Degradation was inhibited
      by the presence of Triton X-100 and phenylmethylsulfonyl fluoride. The
      depolymerase was demonstrated to be associated with the polymer granule complex
      and most likely possessed serine residues at its active site.

PMID- 7794416
TI  - Allosteric modulation of peripheral sigma binding sites by a new selective
      ligand: SR 31747.
AB  - The interactions of a new compound SR 31747 with sigma sites were examined in rat
      spleen membranes and in human peripheral blood leukocytes (PBL). Nanomolar
      concentrations of SR 31747 selectively inhibited in a non-competitive manner the
      binding of the prototypic sigma ligands [3H](+)-pentazocine, [3H](+)-3PPP and
      [3H]DTG on rat spleen membranes. Characterization of SR 31747 binding sites using
      [3H]SR 31747 as a ligand showed that this compound binds reversibly, with high
      affinity to one class of sites on rat spleen membranes (Kd 0.66 nM, Bmax 5646
      fmol/mg protein). The pharmacological profile of [3H]SR 31747 binding sites was
      consistent with the presence of specific sites distinct from classical sigma 1
      and sigma 2 receptor subtypes strongly suggesting an allosteric modulation of
      sigma sites by SR 31747. Similarly, [3H]SR 31747 binding sites were demonstrated
      on human PBL and also on purified subpopulations of human mononuclear cells
      (granulocytes, NK cells, T4, T8 and B lymphocytes). Administered to mice by i.p.
      or oral route 30 min before sacrifice, SR 31747 strongly inhibited the binding of
      [3H](+)-3PPP to mice spleen membranes with ED50 values of 0.18 and 1.43 mg/kg,
      respectively. Taken together these results could suggest a potential
      immunological activity of SR 31747 either directly or through allosteric
      modulation of peripheral sigma sites.

PMID- 7794415
TI  - Adenosine attenuates phorbol ester-induced negative inotropic and
      vasoconstrictive effects in rat hearts.
AB  - Phorbol esters reduce cardiac contractility and produce coronary vasoconstriction
      presumably by stimulating protein kinase C (PKC). We tested whether adenosine
      altered the response to phorbol 12-myristate 13-acetate (PMA) in isolated rat
      hearts. Hearts, perfused at constant flow and constant heart rate, were exposed
      to PMA (10 nM) for 30 min and then allowed 30 min of recovery. PMA reduced left
      ventricular developed pressure (LVDP) from 81 +/- 2 to 49 +/- 3 and 40 +/- 2 mmHg
      (51 +/- 3% of baseline LVDP) after 30 min infusion and 30 min recovery,
      respectively. PMA also increased coronary perfusion pressure to 224 +/- 13% of
      baseline after 60 min. The PKC inhibitor bisindolylmaleimide (0.5 microM) blocked
      the PMA-induced negative inotropy and vasoconstriction. Adenosine (100 microM)
      and the A1-agonist 2-chloro-N6-cyclopentyladenosine (CCPA, 0.1 microM)
      significantly attenuated the negative inotropic effect of PMA as LVDP was
      maintained at 81 +/- 4% and 99 +/- 7% of baseline, whereas CGS-21680, an A2
      agonist, had no beneficial effect on function (54 +/- 4% of baseline). Adenosine
      and CGS-21680 (0.1 microM), but not CCPA, significantly attenuated PMA-induced
      coronary vasoconstriction. These results suggest that adenosine receptor
      activation may modulate myocardial PKC activity or attenuate the effects of
      increased PKC activity.

PMID- 7794417
TI  - Pironetin, a novel plant growth regulator produced by Streptomyces sp. NK10958.
      II. Structural elucidation.
AB  - A novel plant growth regulator, pironetin was isolated from the culture broth of
      Streptomyces sp. NK10958. The structure of pironetin was determined to be (5R,6R)
      5-ethyl- 5,6-dihydro-6-[(E)-(2R,3S,4R,5S)-2-hydroxy-4-methoxy-3,5-dimethyl-7-
      nonenyl]-2H-pyran-2-one by FAB-MS, 1H and 13C NMR, COSY, COLOC, DEPT, IR, X-ray
      crystallographic analyses and adapted Mosher's method.

PMID- 7794418
TI  - A new photoaffinity analog of cGMP: potent inhibitor of cyclic nucleotide
      phosphodiesterase.
AB  - A purine nucleotide analog, 2'-O-(4-benzoylbenzoyl)guanosine cyclic 3',5'
      monophosphate (BBcGMP), was synthesized from 4-benzoylbenzoic acid and cGMP.
      BBcGMP was found to inhibit several types of cyclic nucleotide phosphodiesterases
      (PDEs) at low concentrations. Besides its activity as a PDE inhibitor, the
      benzophenone moiety of BBcGMP provides it with UV light-induced photoreactivity
      toward organic compounds. This photoreactivity of BBcGMP was exploited to
      radiolabel specifically the light-stimulated cGMP PDE of the rod outer segment
      with [alpha-32P]BBcGMP. These results suggest that benzoylbenzoic derivatives of
      cyclic nucleotides can be of general use in the inhibition of cyclic nucleotide
      PDEs. The results further suggest that radiolabeled cyclic nucleotide derivatives
      may be useful in the identification and active site determination of cyclic
      nucleotide-binding proteins and enzymes.

PMID- 7794420
TI  - Effects on feline pial arterioles in situ of bosentan, a non-peptide endothelin
      receptor antagonist.
AB  - The cerebrovascular actions of bosentan, a novel endothelin antagonist with
      effects at endothelin ETA and ETB receptors, have been examined in individual
      pial arterioles on the cortical surface of chloralose-anaesthetised cats.
      Subarachnoid perivascular microapplication of bosentan (0.3-300 microM) had
      minimal effect on pial arteriolar calibre. Subarachnoid perivascular
      microapplication of endothelin (10 nM) effected a marked reduction in pial
      arteriolar calibre (reduced by 39.2 +/- 2.7% from baseline). This vasomotor
      effect of topical endothelin could be attenuated either by co-administration of
      bosentan (IC50 approximately 1 microM) or by the intravenous administration of
      bosentan (17 mumol/kg). These investigations suggest that bosentan (applied
      topically or systemically) may be a valuable tool in the elucidation of the
      functional significance of endothelins in the cerebral circulation in vivo.

PMID- 7794419
TI  - Azidotetrafluorophenyl retinal analogue: synthesis and bacteriorhodopsin pigment
      formation.
AB  - The retinal derivative, all-trans-9-(4-azido-2,3,5,6-tetrafluorophenyl)-3,7-
      dimethyl-2,4,6,8-nonatetraenal, was synthesized by two routes as a potential
      photoactivatable cross-linking agent for studies in bacteriorhodopsin (BR) of the
      chromophore interaction with its apoprotein. The retinal analogue formed a
      stable, moderately functional BR pigment confirming that the ring cavity of the
      retinal binding site has a significant tolerance for derivatization on that
      portion of the molecule. Attempts to cross-link the azido chromophore to the
      protein by photoactivation were unsuccessful. The electron delocalization effect
      of the conjugated polyene side chain of the retinal appears to interfere with the
      formation or reactivity of the nitrene intermediate to the extent that
      photoactivated cross-linking is not achieved. These results demonstrate a
      limitation to the use of fluorinated aryl azides as photoaffinity reagents.

PMID- 7794422
TI  - Ankle arthroscopy in industrial injuries of the ankle.
AB  - Industry-related injuries to the foot and ankle are not uncommon. These cases are
      often difficult to evaluate with respect to degree of damage and even more
      difficult to quantitate with regard to functional impairment. This article
      represents an attempt to determine the role of ankle arthroscopy in the
      evaluation of ankle injuries that involve compensation or liability. A
      retrospective review was conducted. The study group consisted of 40 patients who
      underwent a total of 42 arthroscopic procedures. The patients were evaluated with
      regard to the mechanism of injury and clinical manifestations. Pain and swelling
      were the most common preoperative symptoms. The majority of patients had pain
      localized to the lateral and anterolateral ankle. There were a high percentage of
      positive bone scans that correlated well with bone pathology but poorly with soft
      tissue pathology. Computed tomography (CT) scans were equivalent to tomograms in
      the demonstration of bone pathology. Follow-up was obtained in 24 patients. At
      least 50% of the patients had some improvement in their symptoms. Thirty-three
      percent believed there was no change, and 17% said they were worse. Over 70% of
      the patients were able to return to work, although 20% had to change their
      occupation. Fifteen percent were considered disabled. In patients without a
      specific diagnosis, ankle arthroscopy was helpful in establishing a
      diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794421
TI  - Expression and selective inhibition of constitutive and inducible forms of
      cyclooxygenase.

PMID- 7794423
TI  - Trends in decreased hospitalization for anterior cruciate ligament surgery:
      double-incision versus single-incision reconstruction.
AB  - Over a 4-year period, hospital charges of 151 consecutive anterior cruciate
      ligament (ACL) reconstructions were retrospectively evaluated. Eighty-one
      patients who underwent a two-incision ACL central third autogenous patellar bone
      tendon bone reconstruction were compared with 72 patients who had a single
      incision endoscopic reconstruction with a similar graft. Charges were adjusted
      for inflation. There was a statistically significant difference in hospital days
      (2.8 v 1.57, P = .0001), total hospital charges ($15,063 v $13,520, P = .0001),
      as well as operating room/hospital ward charges (P = .0001), pharmacy charges (P
      = .035), and physical therapy charges (P = .001). No statistical difference was
      observed for anesthesia or laboratory charges. A matched comparison of patients
      from each group who were in the hospital for 2 days showed a statistically
      significant reduction in operating room/hospital ward charges (P = .037), but no
      significant reduction in total costs. There was a trend in both groups toward
      shorter hospital stays in each successive year. The reduction in charges observed
      for the endoscopic procedure correlated with a reduction in postoperative
      hospital days.

PMID- 7794424
TI  - The posteromedial portal in knee arthroscopy: an analysis of diagnostic and
      surgical utility.
AB  - We reviewed 400 consecutive knee arthroscopy cases in a predominantly sports
      medicine practice to determine (1) the frequency of posteromedial portal usage
      under a prospectively established set of indications, and (2) the impact of
      posteromedial portal access on patient diagnosis and management. Diagnostic
      posteromedial portals were used in 22% of anterior cruciate ligament (ACL)
      deficient knees, and in 11% of stable knees with nonpatellar (usually meniscal)
      lesions. When used, posteromedial portal visualization showed treatable lesions
      64% of the time, the majority of which were repairable peripheral meniscus tears.
      In 63% of these cases, no definite lesion had been identified by initial routine
      anterior portal viewing and probing. Of the 22 patients with posteromedial
      meniscus tears that were discovered only via posteromedial portal access, 9 had
      recently undergone anterior portal arthroscopy by other surgeons, during which
      none of these tears were detected. Posteromedial surgical portals (19 cases) were
      most useful for synovectomy, posterior cruciate stump resection before
      arthroscopic reconstruction, and posterior horn medial meniscectomy in
      exceptionally tight knees. Posteromedial portal access is often useful
      diagnostically in cases where (1) posteromedial meniscal lesions are frequent
      (i.e., ACL-deficient knees) and/or suspected on the basis of preoperative
      symptoms or imaging studies, and (2) full, direct visualization of the entire
      superior meniscosynovial junction is not possible via standard anterior portals.
      The option of a surgical posteromedial portal should be entertained whenever
      frontal approaches for posteromedial instrument work prove inefficient or
      unsuccessful.

PMID- 7794425
TI  - Failure strengths of different meniscal suturing techniques.
AB  - The aim of this study was to measure the failure strengths of three arthroscopic
      meniscal suturing methods. The techniques investigated were a single horizontal
      loop, a double vertical loop, and a single vertical loop. Eleven human, lateral
      menisci obtained at autopsy were cut with a scalpel to simulate peripheral
      longitudinal tears. The menisci were then repaired with one suture at a time,
      using each of the three methods in turn. The two parts of the meniscus were then
      pulled apart using a computer-controlled materials testing machine until failure
      occurred, either by the suture itself failing or by the suture pulling out
      because of tearing of the meniscus. The horizontal sutures had a mean failure
      strength of 29.3 N, whereas the double vertical loop failed at 63.2 N and the
      single vertical loop at 67.3 N. The horizontal loop sutures and the double
      vertical loop sutures all failed by pulling out of the meniscus. The single
      vertical loop sutures failed by rupture of the suture itself. This study showed
      the superior mechanical characteristics of the single vertical loop suturing
      system over the other techniques tested. Owing to the more consistent failure
      strength, decreased costs, and shorter surgical time over the double vertical
      loop system, the single vertical loop technique is recommended for arthroscopic
      meniscal repair.

PMID- 7794427
TI  - The arthroscopic Mumford procedure: an analysis of results.
AB  - A total of 50 arthroscopic distal clavicle resections were performed for
      acromioclavicular joint pathology at our institution between 1990 and 1993.
      Follow-up on 50 shoulders (100%) was obtained at an average postoperative time of
      2 years. Data were collected via physical examination, radiograph review,
      University of California at Los Angeles (UCLA) shoulder score, and questionnaire.
      Average patient age was 42 years. Preoperatively all patients showed
      acromioclavicular joint tenderness, whereas 80% had a positive adduction test.
      The diagnosis of acromioclavicular degeneration was made by a combination of
      physical examination and radiographs (100%), acromioclavicular joint injection
      (4%), bone scan (44%), and magnetic resonance imaging (30%). Intraoperatively, a
      Claviculizer (Smith-Nephew Dyonics, Andover, MA) burr was used through standard
      portals in a subacromial approach to the acromioclavicular joint. There were no
      intraoperative complications. Forty-one patients (82%) had their general
      anesthetic augmented with an intrascalene block, and all procedures were done on
      an outpatient basis. The average distal clavicle resection was 14.8 mm.
      Calcifications within the resected clavicle zone were noted in the shoulders of
      four of the patients (16%) who returned for radiographic follow-up. The UCLA
      shoulder score ranked 47 shoulders (94%) good to excellent and 3 fair (6%).
      Subjective patient satisfaction recorded 47 (94%) good to excellent results, with
      an average pain relief grade of 87%. Forty-five patients (98%) would recommend
      the procedure. The arthroscopic Mumford procedure effectively treats
      acromioclavicular joint pathology. The amount of bone removed can be precisely
      determined with the Claviculizer burr and reliably reproduced. The procedure has
      low associated morbidity and high patient satisfaction regarding functional
      outcome.

PMID- 7794426
TI  - A comparison of outpatient and inpatient anterior cruciate ligament
      reconstruction surgery.
AB  - The feasibility of outpatient anterior cruciate ligament (ACL) surgery has not
      been reported in the literature. We evaluated outpatient ACL surgery by comparing
      outpatient versus inpatient pain control, narcotic consumption, postoperative
      complications, recovery time, and cost analysis. Thirty-seven ACL reconstructions
      were performed in 37 patients over a 16-month period. Twenty-five of the patients
      had surgery performed as outpatients and 12 as inpatients. One of the outpatients
      required hospitalization because of excessive nausea and vomiting and another for
      urinary retention. Only 2 of the 25 outpatients (8%) believed that they should
      have been hospitalized for pain control. Based on a visual analog scale, pain
      severity, pain frequency, and pain relief were measured, and no statistically
      significant difference (P < .05) was noted between the groups, although the data
      suggested that the inpatients were slightly more comfortable. There were no
      differences in rehabilitation or in regaining full range of motion of the
      operated knee. Also, the only postoperative complication in both groups occurred
      in an inpatient who developed arthrofibrosis. Cost analysis showed that
      outpatient ACL reconstruction was cost effective. The average inpatient cost was
      $9,220 (2.4 hospital days) compared with the average outpatient cost of $3,905.
      This reflected a savings of 58%. These results show that outpatient ACL
      reconstruction surgery is possible in the appropriate patient without harm to the
      patient and with a significant cost savings.

PMID- 7794428
TI  - The use of topographical landmarks to improve the outcome of Agee endoscopic
      carpal tunnel release.
AB  - A modified approach to endoscopic carpal tunnel release has been developed and
      tested in 60 cadaveric specimens by three surgeons using the Agee endoscopic
      carpal tunnel release system. The modified approach, which includes specific
      localization of the hook of the hamate, flexor retinaculum, and the superficial
      palmar arch utilizing topographical landmarks, avoids entry into Guyon's canal
      and injury to the ulnar artery and nerve, median nerve, and common digital
      nerves. Use of the anatomic approach resulted in significantly superior results.
      There were fewer incomplete releases, and fewer surgical passes were required,
      for the inexperienced surgeons. When these anatomic considerations were not
      included, the learning curve was much steeper. For surgeons planning endoscopic
      surgical release of the transverse carpal ligament, the described topographical
      approach improves the technical competence with the procedure and reduces the
      number of complications and learning curve associated with new procedures. We
      recommend the use of topographical landmarks and other anatomic considerations
      during endoscopic carpal tunnel release.

PMID- 7794429
TI  - Arthroscopic stabilization for recurrent anterior shoulder dislocation: results
      of 59 cases.
AB  - Fifty-nine patients with recurrent anterior dislocation of the shoulder underwent
      the Morgan arthroscopic stabilization with transglenoidal suture of the inferior
      glenohumeral ligament. All patients were followed-up for an average of 49 months
      (range, 29 to 71 months). Using Rowe's scoring system, the overall objective
      results were disappointing. There were 33% excellent results, 9% good, 9% fair,
      and 49% poor. Twenty-six patients had a further dislocation, and 3 others had
      recurrent subluxation on average 13 months after the operation. The failures were
      associated with a preoperative clinical finding of inferior hyperlaxity as
      demonstrated by a positive sulcus sign, a preoperative radiological finding of a
      bony lesion on the anterior edge of the glenoid, or an arthroscopic finding of
      extended ligamentous lesions at the time of operation. The results of this study
      are clearly worse than those reported by other investigators. Direct comparison
      between the reported studies is problematic and is discussed. It was concluded
      that arthroscopic stabilization should only be performed by interested
      specialists as part of controlled clinical trials.

PMID- 7794430
TI  - Neural anatomy of the glenohumeral ligaments, labrum, and subacromial bursa.
AB  - The neural histology of the human shoulder ligaments, glenoid labrum, and
      subacromial bursae were studied using a modified gold chloride stain. Two
      morphological types of mechanoreceptors and free nerve endings were found in the
      ligaments. Slow adapting Ruffini end organs and rapidly adapting Pacinian
      corpuscles were identified in the superior, middle, inferior, and the posterior
      glenohumeral ligaments. These specialized proprioceptive nerve endings were also
      found in the coracoclavicular, and coracoacromial ligaments. Only free nerve
      endings were found in the glenoid labrum and these were located in the peripheral
      half. Scattered free nerve endings were found throughout the subacromial bursae.
      This is the first histological evidence of neural receptors in the human shoulder
      ligaments, glenoid labrum, and the subacromial bursae. Any disruption of the
      labrum or these ligaments by trauma or surgery can deprive the shoulder of
      mechanical stability, and may cause a decrease in proprioception because of the
      loss of these afferent neural receptors. Removal of symptomatic, inflamed bursae
      may decrease pain signals from this area of the shoulder.

PMID- 7794431
TI  - Treatment of articular defects with meniscal allografts in a rabbit knee model.
AB  - Deep-frozen allogeneic meniscal grafts for the treatment of articular cartilage
      defects were performed experimentally. Osteochondral defects 3 mm in diameter
      were created bilaterally on the medial femoral condyles of 50 Japanese white
      rabbits. A meniscus was then grafted into the defect in the left knee, and the
      right knee was left untreated. At various periods from 2 to 24 weeks
      postoperatively, the rabbits were killed and macroscopic and histologic
      examinations were performed. Two weeks after operation, the grafted meniscus was
      bonded to the floor of the defect. After 12 weeks, chondrocytes producing matrix
      granules was shown by electron microscopy. After 24 weeks, a congruous articular
      surface was formed. With time, cellular elements infiltrated into the graft from
      the surrounding tissues, and gradually increased in penetration. Weight bearing
      in the early stage after operation did not degrade the grafted menisci, and no
      changes were shown in the opposing cartilage of the tibia. Deep-frozen allogeneic
      menisci may be useful as a biological implant to repair articular cartilage
      defects in this model.

PMID- 7794433
TI  - Optimizing arthroscopic knots.
AB  - Arthroscopic repairs, such as those for shoulder instability, are commonly
      performed. However, the failure rate after arthroscopic repair appears to be
      higher than with open surgery. These failures may relate to the challenge of
      tying secure knots arthroscopically. Many knots tied arthroscopically commonly
      consist of an initial slip knot to remove slack, and a series of half-hitches.
      Half-hitches, instead of square throws, are difficult to avoid and result when
      asymmetrical tension is applied to the strands. For this reason, the security of
      knots tied arthroscopically may not be equivalent to square knots and a greater
      rate of failure may occur. The purpose of this study was to determine (1) the
      security of various arthroscopic knots under cyclic and peak loading conditions,
      (2) how the surgeon can modify the method or sequence of half-hitch throws to
      minimize knot slippage or breakage, and (3) whether using an arthroscopic knot
      pusher affects the security of the same knot tied by hand. The most secure knot
      configurations were achieved by reversing the half-hitch throws and alternating
      the posts. These knots performed significantly better than all other knots tested
      (P < .002). Thus the surgeon can control the holding capacity and minimize suture
      loop displacement by proper alternation of the tying strands and reversal of the
      loop when placing the hitches.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794432
TI  - Arthroscopic fixation of superior labral lesions using a biodegradable implant: a
      preliminary report.
AB  - Twenty-two patients were treated for symptomatic lesions of the superior glenoid
      labrum in association with instability of the tendinous insertion of the long
      head of the biceps brachii. A biodegradable implant was used to fix the labrum to
      the bony glenoid using an arthroscopic technique. At 2-year average follow-up,
      satisfactory results were obtained in 86% of the patients. Two patients, both of
      whom had undergone concomitant subacromial decompression, continued to complain
      of pain after the procedure; 3 patients had restricted motion postoperatively,
      and 1 required manipulation under anesthesia. Twelve of 13 overhead athletes were
      able to return to full premorbid function. Arthroscopic fixation of unstable
      lesions of the superior labrum led to a resolution of symptoms in the majority of
      patients. There were no complications related to the use of the biodegradable
      implant.

PMID- 7794434
TI  - Comparison of two regional anesthetic techniques for knee arthroscopy.
AB  - This study compares the efficacy of "3-in-1 block" versus femoral nerve block for
      knee arthroscopy. One-hundred patients had a 3-in-1 block; 180 patients had a
      femoral nerve block. The 3-in-1 block provided anesthesia in 75 patients; 20
      patients needed supplementary local anesthesia. Five patients required a general
      anesthesia to complete the operation. The femoral nerve block was effective in 88
      patients; 90 patients needed intravenous flunitrazepam and/or fentanyl; 2
      patients needed general anesthesia. The 3-in-1 block provided more satisfactory
      muscle relaxation and a longer postoperative analgesia than femoral nerve block.
      No side effects were recorded in either group. Our results suggest that the 3-in
      1 block is the most effective technique of regional anesthesia for knee
      arthroscopy.

PMID- 7794435
TI  - Tenosynovial giant-cell tumor in the knee joint.
AB  - We report the case of a tenosynovial giant-cell tumor causing limitation of
      extension of the knee. The tumor was treated successfully by arthroscopic
      removal.

PMID- 7794436
TI  - Arthroscopic resection of a chondroblastoma in the knee.
AB  - A 13-year-old boy with the diagnosis of osteochondritis dissecans underwent
      arthroscopic examination of his knee joint. At surgery a cartilaginous mass in
      the medial femoral condyle was identified. Biopsy samples confirmed the diagnosis
      of chondroblastoma, which was removed completely through the arthroscope. A
      second arthroscopic examination of the knee was conducted at 6 months, and showed
      no residual disease. Clinical and radiographic follow-up of the affected joint 5
      years after surgery was satisfactory. Arthroscopic removal of an intra-articular
      tumor is an attractive treatment alternative, provided the lesion is accessible
      and there is no suggestion of a malignancy.

PMID- 7794438
TI  - A unique complication following arthroscopic anterior cruciate ligament
      reconstruction.
AB  - The use of the middle third of a patellar tendon with bone blocks is a common and
      well-accepted technique for arthroscopic reconstruction of the anterior cruciate
      ligament. We report here a disconcerting fracture/avulsion pattern of the
      patella/patellar tendon mechanism that occurred in the early postoperative
      period.

PMID- 7794437
TI  - Osteonecrosis after arthroscopic medial meniscectomy.
AB  - Osteonecrosis of the medial femoral condyle is an uncommon complication of
      meniscal surgery. Whether this disease is associated with the original medial
      meniscus lesion or with the arthroscopic procedure is not yet known. We present
      two cases in which osteonecrosis has developed shortly after arthroscopy was
      performed for medial meniscus pathology. Magnetic resonance imaging has been the
      best tool to diagnose and follow up the changes in the involved area. Concerning
      the etiology, the authors raise the question of whether the medial compartment
      overloading observed in both of these cases had any significant meaning.
      Osteonecrosis following meniscal surgery in relatively young patients seems to
      have a good prognosis when correctly treated, with avoidance of weight bearing.

PMID- 7794439
TI  - Pseudoaneurysm complicating knee arthroscopy.
AB  - Pseudoaneurysm formation is a rare complication of knee arthroscopy. Cases
      reported in the literature have involved the popliteal, superior and inferior
      medial geniculate, and the inferior lateral geniculate arteries. These cases have
      all been described as presenting within 2 to 3 weeks of the arthroscopic
      procedure. Described here are two unique cases, the first a delayed presentation
      and the second involving the recurrent anterior tibial artery.

PMID- 7794440
TI  - Arthroscopic roofplasty: correction of an extension deficit following
      conservative treatment of a type III tibial avulsion fracture.
AB  - Extension loss following nonoperative treatment of a Type III tibial avulsion
      fracture does occur. Arthroscopic roofplasty (notchplasty) and scar excision are
      described to regain complete extension without compromising knee stability.

PMID- 7794441
TI  - Arthroscopic repair of a posterior cruciate ligament avulsion.
AB  - Isolated posterior cruciate ligament injuries are rare and their management is
      controversial. Bony avulsion fractures have commonly been repaired with open
      reduction and internal fixation using the posterior approach described by
      Trickey. However, this approach does not lend itself to detection and repair of
      associated injuries. We report the case of a posterior cruciate ligament avulsion
      that was arthroscopically reduced and stabilized with cannulated screws. This
      technique provided rigid fixation for early rehabilitation and allowed
      concomitant arthroscopic examination of the knee for any associated injuries.

PMID- 7794442
TI  - Arthroscopically assisted placement of a supracondylar intramedullary nail:
      operative technique.
AB  - The use of retrograde interlocking intramedullary nails has been described for
      the treatment of selected supracondylar fractures. A medial parapatellar incision
      and arthrotomy with its attendant morbidity is generally used for nail placement.
      Although a closed technique of nail placement has been described, the risks of
      damaging intra-articular structures with a blind approach have precluded the
      widespread use of this method. In this article, we present a simple,
      arthroscopically assisted method for the retrograde intramedullary nailing of
      supracondylar femoral fractures. This technique affords the potential benefits of
      intramedullary fixation of these fractures while avoiding the morbidity and
      complications associated with an arthrotomy. Potential benefits over the standard
      placement using an arthrotomy include earlier ambulation and soft tissue healing,
      decreased risk of damage to the knee joint, earlier convalescence with decreased
      hospitalization time, and better cosmesis.

PMID- 7794443
TI  - T-Fix endoscopic meniscal repair: technique and approach to different types of
      tears.
AB  - Endoscopic meniscus repair using the T-Fix suture device (Acufex Microsurgical,
      Inc, Mansfield, MA) allows ease of suture placement for meniscus stability
      without the problems associated with ancillary incisions such as neurovascular
      compromise. It is ideal for the central posterior horn tears that are difficult
      using conventional techniques. Vertical tears, bucket handle tears, flap tears,
      and horizontal tears can be approached using a temporary "anchor stitch" to
      stabilize the meniscus before T-Fix repair. The basic method of repair and our
      approach to these different types of tears is presented.

PMID- 7794444
TI  - An alternative cruciate reconstruction graft: the central quadriceps tendon.
AB  - The central quadriceps tendon, above the patella, is thicker and wider than the
      patella tendon. Using precise technique, one can obtain a tendon graft for
      cruciate reconstruction with 50% greater mass than a patellar tendon bone-tendon
      bone graft of similar width. The central quadriceps tendon graft may be harvested
      by a second surgeon while the first surgeon is simultaneously accomplishing notch
      plasty and tunnel placement for cruciate ligament reconstruction. Consequently,
      this cruciate ligament reconstruction graft offers time savings as well as
      greater tendon volume. The central quadriceps tendon graft is difficult to
      harvest, with significant risk of entering the suprapatellar pouch and losing
      knee distension during ACL reconstruction. By careful adherence to the technique
      described in this article, the surgeon can obtain this reconstruction graft
      safely. It is important to recognize the anatomic subtleties of the proximal
      patella, which include a curved proximal surface, dense cortical bone, and
      closely adherent suprapatellar pouch. Proper technique is of utmost importance in
      obtaining this tendon graft safely and efficiently.

PMID- 7794445
TI  - Ethics and health. Interview by Eilif Liisberg.

PMID- 7794446
TI  - Ethics of nursing and midwifery: responding to change.
AB  - Nurses and midwives are taking an increasing interest in ethical matters in their
      professions. Although the conditions in which they work vary immensely and are
      undergoing rapid change, it is possible to detect certain basic notions of
      patient care which transcend cultural, socioeconomic and technological
      differences.

PMID- 7794447
TI  - Reaching street youth on substance abuse.
AB  - Street children and youth involved in substance abuse are often felt to be the
      hardest people in the world to reach with counselling, as well as those most
      obviously in need of it. The idea of making a work of art that both captures
      their imagination and steers them towards a safer way of life may seem more like
      wishful thinking than a practical proposal, but the author explains how it is
      done.

PMID- 7794448
TI  - The Moscow street children project.
AB  - More and more young people are living on the streets of Moscow and getting
      involved in substance abuse and crime. The authors outline the effort being made
      by the International Health and Temperance Association to organize a response to
      this rapidly growing problem.

PMID- 7794449
TI  - Technology for the continuous improvement of the quality of health care.
AB  - Since medical technology impinges on the structure, process and outcome of health
      care it has a profound effect on attempts to achieve improvement in this field.
      The present article discusses the links between medical technology and continuous
      quality development, with particular reference to utilization, appropriateness
      and cost-benefit.

PMID- 7794450
TI  - Towards evaluation of the quality of care in health centres.
AB  - There is wide acknowledgement that quality assurance is desirable in primary
      health care. Considerable success has been achieved in this field by the Iberian
      Programme of Training and Implementation of Quality Assurance Activities in
      Primary Health Care, the basis for which is outlined below.

PMID- 7794452
TI  - Promoting the health of women of non-English-speaking backgrounds in Australia.
AB  - Immigrants with non-English-speaking backgrounds face many linguistic and
      cultural barriers when trying to use Australia's health services. Gender
      inequities make matters especially difficult for women with such backgrounds, who
      largely belong to the lower socioeconomic categories. The present article
      describes two health promotion projects whose success is largely attributable to
      their recognition of the difficulties faced by these women and to the strategies
      devised to overcome them with the aid of liaison workers and bilingual community
      educators.

PMID- 7794451
TI  - Trained traditional birth attendants as educators of refugee mothers.
AB  - Following training courses for traditional birth attendants among refugee Afghan
      women in Pakistan, a survey was conducted to test the knowledge and practices of
      the participants and of mothers whose babies had been delivered by them, using
      untrained birth attendants as the basis for comparison. Marked improvements in
      knowledge and skills were demonstrated, and recommendations made by the trained
      birth attendants about breast-feeding, maternal nutrition, immunization and
      hygiene were generally followed by mothers before and after delivery.
      Furthermore, far fewer complications and deaths were associated with deliveries
      performed by trained birth attendants than with those conducted by their
      untrained colleagues. The training of traditional birth attendants was clearly an
      effective way to educate women about hygiene and health.

PMID- 7794453
TI  - Interns as health educators.
AB  - Interns are being used in two experimental health education projects in a rural
      area of India. In one the interns talk to mothers waiting with their children at
      an immunization clinic; in the other they train volunteer schoolchildren to act
      as school health guides in a child-to-child programme.

PMID- 7794454
TI  - Confronting the health hazards of industrialization in Malaysia.
AB  - The authors outline the steps being taken in Malaysia aimed at persuading people
      to avoid the unhealthy lifestyles commonly associated with socioeconomic
      development and increased affluence, and to adopt health dietary and other
      habits.

PMID- 7794455
TI  - Health education in farming communities.
AB  - The author outlines the ways in which health messages have been given to agrarian
      communities in Tigray, Ethiopia. Special attention has been given to assessing
      the people's knowledge base initially, to communicating with them at the most
      appropriate times and places and in the local language, and to the use of role
      playing.

PMID- 7794456
TI  - Cost-effective screening of schoolchildren for refractive errors.
AB  - Uncorrected refractive errors are the main cause of severely impaired vision in
      India. This in itself indicates that there is a shortage of basic eye care
      services and spectacles, and too little public awareness of the need for them. A
      simple method for screening schoolchildren for refractive errors is described and
      the results are analysed. Evaluation of the materials used and the accuracy of
      the screening shows that this method can be used successfully by teachers.

PMID- 7794457
TI  - First WHO Collaborating Centre for Women's Health.

PMID- 7794458
TI  - Distances travelled to reach surgical eye camps.

PMID- 7794459
TI  - District health libraries in Tanzania.

PMID- 7794460
TI  - Sanitary wells versus boreholes for drinking-water.

PMID- 7794462
TI  - Organ transplants and donorship.

PMID- 7794461
TI  - Literacy campaign and health education go hand in hand.

PMID- 7794463
TI  - General practitioners for primary health care in Russia.
AB  - General practice is being introduced into the Russian health system to bolster
      primary care. The main features of this undertaking are outlined below.

PMID- 7794464
TI  - National health policy for traditional medicine in India.
AB  - External pressures have combined to erode the practice of India's traditional
      medical systems to such an extent that they are in danger of becoming extinct. A
      better balanced national health policy could go a long way towards reversing this
      trend.

PMID- 7794465
TI  - Viet Nam: profit and loss in health care.
AB  - The decline of Viet Nam's once highly effective commune health stations has
      resulted in the over-prescription of drugs and the danger of lower public health
      standards. It must be recognized that private and public activities form part of
      the same health system, and need firm supervision if it is to flourish.

PMID- 7794466
TI  - Choice of traditional or modern treatment in west Burkina Faso.
AB  - A recent survey shows that patients turn to modern medicine more than traditional
      medicine for most of their needs except rheumatic and neurological complaints.
      However, the preferences stated are influenced on the one hand by the much lower
      cost of traditional services, and on the other by official disapproval of
      animistic practices.

PMID- 7794467
TI  - The strengths and weaknesses of Turkish bone-setters.
AB  - Twelve bone-setters and 20 clients of bone-setters were interviewed to gather
      information about the nature and popularity of these traditional health services.
      The results suggest a high degree of confidence in the bone-setter's art, though
      this is not always well founded.

PMID- 7794468
TI  - The natural toothbrush.

PMID- 7794469
TI  - News about AIDS.

PMID- 7794470
TI  - Need for action against tuberculosis.

PMID- 7794471
TI  - Anticholinergic effects in a depressed parkinsonian patient.
AB  - Depression is commonly associated with idiopathic Parkinson's disease. Various
      antidepressants can be helpful in the treatment of this type of depression.
      Anticholinergic medications are at times used for treating the motor symptoms of
      parkinsonism. While some authors have reported euphorigenic effects from
      anticholinergics in other groups of patients, generally, they have not been used
      in the treatment of depression, with or without parkinsonism. In the case
      presented, a depressed patient with Parkinson's disease on levodopa/carbidopa and
      fluoxetine was given benztropine for his motor symptoms. The result was some
      improvement in his motor symptoms and a wide, dose-related spectrum of other
      central nervous system changes ranging from delirium to mania, hypomania, and
      euthymia from a "baseline" of residual depression. At a very low dose (0.25 mg
      per day), benztropine appeared to have an augmenting antidepressant effect that
      rendered the patient euthymic.

PMID- 7794472
TI  - Sundown syndrome in severely demented patients with probable Alzheimer's disease.
AB  - A retrospective review of 71 patients with probable Alzheimer's disease was
      analyzed with respect to nursing evaluations of sundowning status (recurring
      confusion or agitation in the late afternoon or early evening). The prevalence of
      sundowning (including probable sundowners) was 24%. Sundowners and non-sundowners
      differed with regard to number of sedatives received daily, particularly chloral
      hydrate, and the number of days on the inpatient unit. There were no differences
      between sundowners and non-sundowners with respect to other types of medications,
      medical diagnoses, current age, age of onset of Alzheimer's disease, or Mini
      Mental State Exam. Restlessness was the most common sundowning behavior, although
      multiple behavioral disturbances were seen. This survey suggests that the sundown
      syndrome is a common problem in severely demented Alzheimer's patients and
      requires further study.

PMID- 7794473
TI  - Disruptive nocturnal behavior in Parkinson's disease and Alzheimer's disease.
AB  - Disruptive nocturnal behavior, often referred to as sundowning, is a commonly
      encountered clinical problem in most forms of dementia. This study compared
      disruptive nocturnal behavior in patients with Alzheimer's disease (AD) and
      Parkinson's disease (PD). Questionnaire data were collected from 60 AD and 48 PD
      caregivers. Respondents were asked to record the typical time of day when any of
      seven disruptive behaviors were evidenced in their patients, if at all. Two
      scores were computed: (1) a sundowning score (number of nocturnal disruptive
      behaviors, range 0-7), and (2) a total score (number of disruptive behaviors
      without regard to time, range 0-7). Results indicated PD patients were more
      likely than AD patients to exhibit disruptive nocturnal behavior. The dose,
      timing, or number of years on antiparkinsonian medication were not related to
      nocturnal disruptive behavior within the PD patient group. These findings raise
      the possibility that sundowning in PD patients may be a manifestation of
      dopaminergic depletion within the basal ganglia or other abnormalities involving
      the cholinergic, serotoninergic and/or noradrenergic systems in the brainstem.

PMID- 7794474
TI  - Primitive reflexes in Alzheimer's disease and vascular dementia.
AB  - Data on the prevalence and clinical value of primitive reflexes (PRs) in dementia
      are controversial, mainly due to a lack of standardization of the methods by
      which these signs are elicited and scored. A standardized protocol was used to
      investigate eight PRs in 20 patients with Alzheimer's disease (AD), 20 patients
      with vascular dementia (VD), and 20 control subjects for each group. Both patient
      groups showed considerably more PRs than the control groups. The prevalence of
      PRs was related to the severity of dementia. No single reflex or combination of
      PR pathognomonic for dementia could be distinguished. The PR profile of AD and VD
      patients were similar.

PMID- 7794476
TI  - Delusions of infestation during delirium in a patient with restless legs
      syndrome.
AB  - A case is described in which delusions of infestation developed during delirium
      secondary to pneumonia in a patient with restless legs syndrome (RLS). This case
      demonstrates how tactile sensations may precede and give rise to delusional
      misinterpretations. Since RLS is relatively common in elderly people and may be
      due to a treatable cause such as iron deficiency, it is worth considering this
      syndrome in patients with delusions of infestation.

PMID- 7794475
TI  - Disabling parkinsonism due to lithium: a case report.
AB  - Two cases of disabling parkinsonism have been previously reported in association
      with lithium treatment and only one occurred without other signs of lithium
      toxicity. We report a case of an elderly female who suddenly developed disabling
      parkinsonism, apparently as a side effect from treatment with lithium carbonate
      without other signs of lithium toxicity. All neurologic symptoms completely
      resolved on discontinuation of lithium. Resuming lithium at serum levels below
      0.7 mmol/L resulted in no further neurologic side effects, but serum levels of
      0.7 to 0.9 mmol/L resulted in the return of mild Parkinson's symptoms. Older age,
      longer duration of lithium treatment, and high therapeutic levels of lithium may
      be risk factors for this side effect. Implications for clinicians are discussed.

PMID- 7794477
TI  - Clomipramine treatment of paraphilias in elderly demented patients.
AB  - Sexually inappropriate conduct often accompanies the disinhibition associated
      with dementia and neuropsychologic deficits. Management of these behaviors is
      problematic and time consuming. We report two cases in which paraphilias
      responded to treatment with clomipramine. This effect was not due to the sexual
      side effects of the drug (e.g., decreased ability to sustain an erection or
      orgasm). Careful monitoring of the elderly patient is required during treatment
      with clomipramine, particularly with regard to orthostasis, the increased risk of
      falls, and worsened confusion secondary to the potential risks of anticholinergic
      delirium and toxicity.

PMID- 7794478
TI  - Comparison of new and traditional methods for detection of senile plaques in
      Alzheimer's disease.
AB  - The pathologic diagnosis of Alzheimer's disease (AD) rests upon the
      identification of senile plaques and neurofibrillary tangles (NFT) in brain
      tissue. Methods for staining these structures vary in their sensitivity. Six
      different silver stains and immunocytochemistry for the beta-amyloid (A beta)
      peptide were compared for sensitivity in staining of plaques and tangles. For
      staining of plaques, the silver stains fell into two groups: one group stained
      primarily large, distorted neurites in classic plaques, and the other stained
      primarily fine, filamentous elements in diffuse plaques and at the periphery of
      classic plaques. Our recently developed "quick silver" method demonstrated the
      highest number of plaques. Sensitivity of NFT staining also varied considerably.
      The quick silver and Yamamoto-Hirano methods were best for staining both plaques
      and NFT.

PMID- 7794479
TI  - Memory deficits in a demented patient with probable corticobasal degeneration.
AB  - Anterograde and retrograde amnesia in a patient with probable corticobasal
      degeneration (pCBD) and dementia were studied in a university medical center
      setting. The patient with pCBD and four comparison patients of comparable global
      mental status (Mini-Mental State Exam) who met NINCDS-ADRDA criteria for
      Alzheimer's disease (AD) were included. Standard neuropsychological tests of
      naming, intelligence, achievement, verbal fluency, anterograde and remote verbal
      and visuospatial memory, and motor skill learning were given. The pCBD patient
      exhibited a progressive asymmetric akinetic-rigid syndrome, which was
      unresponsive to Sinemet. His initially mild, intellectual deficits consisted of
      apraxia, slowed speech, and word-finding and memory difficulties. Over a 2-year
      period, a dementia syndrome developed, which involved more-serious deficits in
      praxis and naming, as well as impairments in spelling, calculation, verbal
      fluency, IQ, anterograde verbal and visuospatial memory, and motor skill
      learning. When tested by recall methods, the pCBD patient exhibited marked
      deficits on several tests of remote memory; however, on recognition testing, he
      performed normally on the Famous Faces Test and on a test of geographical
      knowledge, which measures remote visuospatial memory. By contrast, the four AD
      patients, who showed equivalent naming difficulties, less-severe fluency
      deficits, and normal motor skill learning, showed severe impairments in recalling
      and recognizing the names of famous people from photographs. A magnetic resonance
      imaging (MRI) scan of the pCBD patient showed marked frontal and parietal lobe
      atrophy and central atrophy, with ventriculomegaly that was greater on the left
      side of the brain. The temporal lobes were relatively spared, and the amygdalae,
      hippocampi, and temporal horns were of normal size.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7794480
TI  - Pharmacotherapy of cognitive impairment in Alzheimer's disease: a review.
AB  - Experimental pharmacotherapy of cognitive impairment in Alzheimer's disease has
      seen a recent proliferation of drug trials involving a wide variety of drugs.
      Many of the earlier studies focused on cholinergic agents. However, subsequent
      advances in basic and biological sciences have broadened the scope of therapeutic
      strategies beyond the neurotransmitter approaches to include neurotrophic,
      metabolic-enhancing, membrane-modifying, and antitoxic agents, and have also
      provided rationale for developing antiamyloid and anti-infective therapies. For
      the clinician, it has not been easy to keep abreast of these developments. In
      this article, I present an overview of the cognition-enhancing drugs that have
      been used in the past, of those currently under investigation, and of new drugs
      and strategies that are likely to receive attention in the next few years.

PMID- 7794481
TI  - Depressive symptoms in Alzheimer's disease and multi-infarct dementia.
AB  - We examined the prevalence of major depression, depressed mood/anhedonia, and
      subjective and neurovegetative symptoms of depression that were unaccompanied by
      depressed mood/anhedonia in patients with clinically-diagnosed Alzheimer's
      disease (AD) and multi-infarct dementia (MID). The specificity of subjective and
      neurovegetative depressive symptoms for depressed mood in dementia was examined,
      as was the impact on depression of clinical variables such as family history,
      patient age, and dementia severity. Subjects were 105 outpatients who met DSM-III
      R criteria for AD (n = 67) or MID (n = 38). Depressed mood/anhedonia was
      frequently noted in both the AD (40.3%) and MID (34.2%) groups. One or more
      depressive symptoms, not accompanied by depressed mood/anhedonia, were also
      common in AD and MID (49.3% and 36.8%, respectively). Major depression was
      relatively uncommon in AD (10.5%) but was noted more frequently in MID (29.0%).
      Among AD patients, neurovegetative symptoms of depression were not any more
      common in patients with depressed mood/anhedonia than in those without depressed
      mood/anhedonia. Subjective symptoms of depression were also not significantly
      associated with depressed mood/anhedonia. The study highlights the importance of
      viewing major depression, depressed mood-anhedonia, and other depressive symptoms
      (subjective and neurovegetative) as separate entities in AD and MID.

PMID- 7794482
TI  - Implementation of the global strategy for health for all by the year 2000. Second
      evaluation. Eighth report on the world health situation.

PMID- 7794483
TI  - The incorporation of partial shielding of the spinal cord in a tissue deficit
      compensator in radiotherapy of the thorax.
AB  - A method to determine the shape of a patient by placing radiopaque wires and
      chains on the skin and taking two isocentric X-ray films is described. The wire
      locations are reconstructed by X-ray stereo photogrammetry, and a beam's eye view
      of the wire frame structure can be obtained with reference to the original setup
      of the "stereo-pair" films. An algorithm for paving between the wires with
      triangular plates is described which allows the calculation of the tissue deficit
      distance and compensator thickness. The depth and distance to points on the
      spinal cord are calculated, and the dose rate is calculated using a standard
      irregular field computation program. The limit for spinal cord tolerance is
      specified in terms of the maximum daily dose based on an equivalent dose formula.
      The additional thickness of compensator, required for the posterior field
      compensator to satisfy the tolerance limit, is calculated. The technique readily
      accommodates the kyphotic and scoliotic spine and has been in routine clinical
      use for seven years.

PMID- 7794484
TI  - 3D conformal radiotherapy in the sagittal plane for centrally located thoracic
      tumors.
AB  - One hundred patients, recently treated at the University of California, San
      Francisco (UCSF) with radiotherapy for lung and esophageal cancer, were studied.
      Three subsets of these patients were defined based on tumor location to test how
      commonly the use of three-dimensional (3D) conformal radiotherapy (3DCRT) could
      improve significantly the delivery of high dosages. Comparisons were made between
      isodose distributions and dose volume histograms (DVHs) of patients' prior
      computed tomography (CT)-based treatment plans and newly generated 3D-based
      treatment plans. The use of beam angles outside the conventional horizontal plane
      did not significantly improve the dose distribution for patients if a peripheral
      mass was the target volume. Patients with a target volume involving the central
      thorax represented a subset (> 40% of the patients) who would have benefited the
      most from the use of nonconventional beam angles. In these patients, sagittal
      coplanar beams (sagittal Y technique) reduced the dose to 30% of the lung volume
      from 30% to 5%. Doses to the spinal cord and heart were slightly higher than with
      conventional techniques but were within the tolerance of normal tissues. The
      sagittal Y technique allows an escalation in total dose to the tumor without
      increasing dose to normal tissues beyond their tolerance.

PMID- 7794485
TI  - Surface dose for tangentially incident photon beams in the presence of air gap
      and air cavity.
AB  - Dose to a surface parallel to an incident photon beam has been investigated in
      the presence of air gaps and air cavities. Measurements have been made in an
      acrylic phantom with a parallel plate chamber. Photon beams of Co 60, 4-MV, 6-MV,
      and 15-MV X-rays have been investigated. The results of our measurements show
      that in the case of air gaps, the dose reduction to a tangential surface is
      considerable. On the other hand, the dose reduction is 2% or less in the case of
      air cavity for volumes encountered in clinical situations.

PMID- 7794486
TI  - Dosimetric effects of matching electron fields with cobalt 60 fields in the
      management of head and neck cancer.
AB  - The dose distributions in a blocked Co 60 beam with the area under the block
      irradiated with a 9-MeV electron beam at a nominal source to surface distance
      (SSD) of 100 cm and at an extended SSD of 115 cm were determined. The photon
      block was simulating the spinal cord shielding used when treating the posterior
      neck. A hot spot of 10% appeared close to the junction on the side of the photon
      field when electron treatment was given at a nominal SSD of 100 cm. At 115 cm
      SSD, the magnitude of the hot spot on the side of photon field increased to 20%
      and a cold spot on the order of 10% appeared in the distal area of the irradiated
      volume treated with electrons. A gap of 0.5 cm between the light field edges of
      the photon field and the electron field reduced the hot spot from 20% to 10% on
      the side of photon field. However, the magnitude of the cold spot on the side of
      electron field increased to 20%, and it appeared across the irradiated volume.
      Considering the limitation of the design of the electron applicators, which
      precludes the use of a nominal SSD of 100 cm for head and neck treatments, it is
      recommended that no gap should be allowed between the photon fields and the
      extended SSD electron fields. Clinically a limited hot spot of 20% is considered
      more acceptable than a cold spot of 20% extending from proximal to distal areas
      of the treatment volume.

PMID- 7794487
TI  - Design specifications for a treatment stand used for total body photon
      irradiation with patients in a standing position.
AB  - One total body photon irradiation technique used to treat patients employs a
      standing treatment position and a horizontally directed high-energy photon field.
      This standing technique presents special problems, including keeping the patient
      immobile during treatment and offering protection from injury if the patient
      develops weakness or loss of consciousness due to either medication (anxiolytics,
      narcotics, or antiemetics) or other causes. In this article we describe a
      treatment stand designed to manage these problems and use effectively total body
      photon irradiation. This stand has been used successfully in our clinic at the
      University of Minnesota for several years and has met or exceeded the original
      design expectations.

PMID- 7794488
TI  - Evaluation of a well-type ionization chamber for calibration of HDL and LDR
      brachytherapy sources.
AB  - The Atomlab 44D well-type ionization chamber is being evaluated for calibration
      of high dose rate (HDR) Ir-192 and low dose rate (LDR) Cs-137 sources. The
      chamber has a flat response (sweet spot) of +/- 0.5% along approximately 3.5 cm
      for an Ir-192 HDR linear source and 3 cm for a Cs-137 LDR spherical source. The
      short-term stability of the chamber was determined using a cylindrical Cs-137
      source positioned in the sweet spot region. The chamber response over a range of
      17.4 mCi (644 MBq, Cs-137) and 8.82 Ci (326 GBq, Ir-192) is evaluated. The
      chamber may be used for calibrating the activities of both HDR Ir-192 and LDR
      brachytherapy sources.

PMID- 7794489
TI  - Multisectional planning for external beam radiotherapy: a "poor person's"
      alternative to three-dimensional treatment planning.
AB  - Recent technical advances in the field of computers have led to the use of three
      dimensional dose computation for optimizing a radiation therapy plan. However, in
      centers which lack such a state-of-the-art technology, one could explore the use
      of multisectional planning to obtain information about the dose profiles all
      along the target volume. This article highlights the utility of multisectional
      planning as an alternative to three-dimensional treatment planning systems for
      external beam radiation therapy.

PMID- 7794490
TI  - Constancy of wedge factors in a Siemens Mevatron 74 linear accelerator.
AB  - The variation of the wedge factor (WF) with field size is an important piece of
      data which determines the radiation output in treatments using wedge filters. WF
      is closely related with the accelerator head layout, and the choice of the wedge
      tray mounted above or below the jaws plays a predominant role. In this work we
      have studied the WF variations in our linac and found that, in apparent
      contradiction with the literature, the WF remains constant with field size.
      Nevertheless, these results cannot be used directly in other linacs, and
      individual dosimetry must be carried out.

PMID- 7794491
TI  - Description of a 3D conformal neutron and photon radiotherapy technique for
      prostate cancer.
AB  - Several methods have been described to improve the therapeutic ratio of
      radiotherapy in patients with locally advanced carcinoma of the prostate (LACaP).
      Studies have shown improved survival and local control in patients treated with
      neutron irradiation as opposed to photons alone. However, an increased
      complication rate was observed when conformal field design was not utilized. A 3D
      conformal mixed neutron/photon technique for LACaP has been developed at this
      institution. Field shaping for the neutron component is achieved with a multirod
      collimator. Prior to treatment, all patients undergo a conventional simulation
      followed by a treatment planning computed tomography (CT) scan. Contours of
      target and normal structures are entered into the 3D treatment planning system.
      Beam apertures are designed utilizing beam's eye view display. The photon dose is
      given in 10 fractions at 1.8 Gy each to the prostate and seminal vesicles (PSVs)
      and pelvic lymph node (PLN) volumes. The neutron dose is given in 15 fractions at
      1.0 Gy per fraction to the PSV volume and 0.6 Gy to the PLN volume. The neutron
      portion includes a partial transmission block to achieve this dose differential.
      The treatment planning process, including beam weighting and custom block design,
      is described. Using these techniques, the neutron dose distributions to the
      target volumes, bladder, and rectum were comparable to those seen with four-field
      conformal photon irradiation.

PMID- 7794492
TI  - Physical characteristics of photon and electron beams from a dual energy linear
      accelerator.
AB  - Clinically pertinent data of the photon beams of nominal energy 6 MV and 18 MV
      from a dual photon energy linear accelerator are measured using a radiation field
      analyser with semiconductor diodes and ionisation chambers. Percentage depth dose
      values are compared with available data from other linacs and BJR-17.
      Measurements made in the buildup region using a parallel plate chamber show a
      marked increase in the surface dose and dmax shifts by 3 mm and 14 mm for 6 MV
      and 18 MV photons, respectively as the field size is increased from 4 x 4 cm2 to
      the maximum. Variations of wedge angles with energy and field size are also
      determined up to wedge widths of 15 cm for all the four available wedge angles.
      Isodose plots of both the energies are plotted using semiconductor diodes in a
      RFA-3 system. Output factors, wedge transmission factors, and shielding tray
      factors were also measured in clear polystyrene phantom for both the photon
      energies at the depths of maximum ionisation. Beam characteristics of the
      electron beams of energies 6, 9, 12, 16, and 20 MeV produced by the Clinac-1800
      have also been studied. The characteristics include percentage depth dose,
      isodose distribution, depth of maximum dose, surface dose, photon contamination,
      uniformity index, and penumbra. Most of the measurements were carried out using
      semiconductor detectors, whereas small volume ionization chambers and a plane
      parallel chamber were kept as standards for comparison. Isodose distributions
      were drawn from the film densitometry method. Range-energy parameters are
      obtained from the observed depth dose data. These parameters vary from machine to
      machine and must be ascertained for individual units. The parameters differ to a
      considerable extent from their theoretically predicted values but generally
      follow the trend, experimentally observed by others, for similar types of units.

PMID- 7794493
TI  - Potential underdosing with the use of electron beam therapy in patients with
      cervical adenopathy and advanced head and neck cancer.
AB  - To define the adequacy of electron beam therapy in the treatment of N1-N3 head
      and neck cancer, 24 patients with primary head and neck cancers and N1-N3
      cervical adenopathy received primary radiation therapy with or without
      chemotherapy for definitive control of their disease. All patients underwent
      computerized tomography (CT) to assist in the design of treatment to the
      posterior neck with electron beams after photon therapy to the level of spinal
      cord tolerance. Treatment with electrons to the posterior neck in patients with
      N1 disease was adequate in 92% (11/12) of patients. However, in patients with N2
      and N3 disease, electron beam treatment failed, because of spinal cord tolerance
      problems, to cover the disease adequately in 92% (11/12). It is concluded that CT
      should be employed routinely in patients with N1-N3 neck disease to determine the
      proper electron energy prescription. For some patients, electron beam may not be
      appropriate, making it necessary to use individual planning to treat adequately
      the neck disease and avoid the spinal cord.

PMID- 7794494
TI  - Modulation of wound healing in Swiss albino mice by different doses of gamma
      radiation.
AB  - Changes in wound healing were studied using artificial wounds created either by
      surgical excision of full thickness skin or partial skin thickness dermabrasion
      of dorsal skin of Swiss albino mice exposed to 2, 4 and 6 Gy of gamma radiation.
      There was a significant delay in the wound healing process after exposure to 2 Gy
      when compared to the controls. With increasing doses of radiation wound healing
      time was also delayed. However, the differences in wound healing times between
      all three doses were not significant. The irradiation resulted in a dose
      dependent delay in the wound contraction and mean wound healing time. The
      abrasion group was followed until complete epithelialization in the animals
      exposed to 2, 4 and 6 Gy of gamma radiation. However, no significant difference
      was observed in the healing time with respect to non-irradiated controls for all
      the exposure doses used in the present study.

PMID- 7794495
TI  - A comparison of susceptibility to five antifungal agents of yeast cultures from
      burn patients.
AB  - Patients with significant degrees of immunocompromise, such as cancer, AIDS and
      large burns, who have received significant amounts of antibiotics, may develop
      infections with yeast organisms. Over a 3-year period, all patients with positive
      fungal blood cultures and most wounds of patients with large burns considered to
      be a risk of yeast infection were selected and tested for their susceptibility to
      five antifungal agents, amphotericin B, ketoconazole, miconazole, diflucan, and 5
      fluorocytosine. In all, 244 specimens of yeast were tested: 142 Candida albicans,
      52 Candida parapsilosis, 26 Candida tropicalis and 13 Trichosporon beigelii. A
      limited number of other isolates of Candida (12) were also encountered. All
      Candida organism were sensitive to amphotericin B. There was wide variation in
      regard to the susceptibility to the other four agents, with C. albicans and C.
      tropicalis being largely resistant to miconazole and ketoconazole. T. beigelii
      was recovered in 13 patients. One-half of these organisms was resistant to
      amphotericin B. Awareness of variations in species and susceptibility are helpful
      in the selection of appropriate therapeutic antifungal agents.

PMID- 7794496
TI  - The effect of thermal injury on gastric emptying in rats.
AB  - Gastric distension and gastrointestinal discomfort are common complications of
      burn injuries. This study was designed to examine the effect of thermal injury on
      the emptying rate of liquids in conscious rats fitted with stainless steel
      cannulae in the body of the stomach. In rats with partial-thickness burns
      emptying of the hyperosmolal saline was found to be delayed (P < 0.5) with
      respect to control only during the chronic phase of injury. However, full
      thickness burns delayed hyperosmolal saline emptying in both acute and chronic
      phases, together with delayed saline emptying in the acute state. Thermal injury
      did not influence the gastric emptying of peptone and acid solutions, which
      activate different pathways to delay gastric emptying. Delayed gastric emptying
      of hyperosmolal solutions may be explained by increased sympathetic and
      opiatergic nervous activities, resulting in reflex relaxation of gastric smooth
      muscle.

PMID- 7794497
TI  - Early basement membrane formation following the grafting of cultured epidermal
      sheets detached with thermolysin or Dispase.
AB  - The basement membrane zone is important for graft adhesion and stability. The aim
      of the present study was to visualize the regeneration of the basement membrane
      and determine the sequential appearance of its constituents in the early
      postgrafting period of cultured human epidermal sheets. A keratinocyte single
      cell suspension, devoid of dermal fibroblast contamination, was obtained from
      human skin by a two-step tissue digestion method with thermolysin and trypsin.
      After culturing, epidermal sheets were generated, detached enzymatically by
      incubating with thermolysin (for 20-30 min) or Dispase (for 45-60 min), and
      deposited on a muscular graft bed of athymic mice. Immunohistochemistry and
      ultrastructural analyses were performed on biopsies harvested 2, 4 and 21 days
      postgrafting. Bullous pemphigoid antigens and laminin were detected at the dermo
      epidermal junction, showing an almost continuous line 2 days postgrafting. Type
      IV collagen was generally absent at this time, but it was detected 4 days
      postgrafting. Type VII collagen was labelled as a discontinuous line of
      increasing intensity from 2 to 21 days postgrafting. Ultrastructural analysis
      revealed hemidesmosomes and a discontinuous lamina densa 2 days postgrafting, and
      a complete basement membrane with a continuous lamina densa, hemidesmosomes and
      anchoring fibrils 21 days postgrafting. The sequence of appearance of major
      basement membrane components was similar for cultured sheets detached with
      thermolysin or Dispase. However, it differed from that of other wound healing
      models. Results are discussed in terms of the variable keratinocyte migration
      requirement between various wound healing models.

PMID- 7794498
TI  - Nosocomial infections in a burn intensive care unit.
AB  - Although many studies have reviewed burn wound infections (BWIs) in burn
      patients, few have prospectively surveyed other nosocomial infections. Seriously
      burned patients are clearly at increased risk for infection due to the nature of
      the burn injury itself, immunocompromising effects of burn injury, prolonged
      hospital stays, and invasive diagnostic and therapeutic procedures. Over 6
      months, we prospectively reviewed all patients admitted to our burn intensive
      care unit (BICU) for nosocomial infections. We used standard CDC definitions of
      nosocomial infections (NIs). Because we had previously documented a high
      incidence of nosocomial pneumonias in these patients, we were particularly
      interested in determining risk factors for nosocomial pneumonia. The total census
      during the study period was 57. There were 40 discharges and deaths. Surveillance
      demonstrated 36 nosocomial infections in 26 patients, for a total of 90
      nosocomial infections per 100 discharges and deaths, or 32.3 NIs/1000 patient
      days. Infections included 22 pneumonias, 10 urinary tract infections, two
      bacteraemias, one BWI and one episode of cellulitis. Intubation was strongly
      associated with nosocomial infection, particularly with pneumonia, BWI and
      bacteraemia. Sixty per cent of all patients were intubated at some time during
      their BICU stay, but 88 per cent of those who developed a nosocomial infection
      were intubated (P < 0.001). Inhalation injury was less significant than
      intubation in the development of nosocomial infection. All patients who developed
      pneumonia or a BWI were intubated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794499
TI  - Use of hospital statistics to plan preventive strategies for burns in a
      developing country.
AB  - This study is based on hospital statistics using 1985 burn patients admitted to
      Maputo Central Hospital, Maputo, Mozambique, for a period of 42 months (1988-91).
      On the basis of the results obtained, some suggestions are made for the design of
      the targets and methods for a preventive strategy for burn injuries in Maputo.
      Strengthening of preventive measures should occur during the cold season of the
      year and particularly in the preceding months (March to May). Children under 5
      years old would be the main target, particularly the age group 2-3 years.
      Mothers' and older siblings' education would be the vector and they would be
      approached through continuing health education activities, regularly carried out
      at present, and educational programmes in schools. We also propose the use of a
      simple safety device aimed at preventing burns responsible for the highest
      lethality. Proposed preventing burns responsible for the highest lethality.
      Proposed interventions rely on extensive knowledge of the epidemiological
      parameters influencing the occurrence of burns severe enough to warrant admission
      to hospital. The beneficial impact of these interventions on hospital workload
      and economy would probably overcome costs for its implementation.

PMID- 7794500
TI  - Alcohol and drug abuse in burn injuries.
AB  - Two studies are described in this paper. In the first study 225 acutely, severely
      burned patients were retrospectively investigated as to admission blood alcohol
      level and history of chronic alcohol abuse. The influence of further risk
      factors, circumstances and therapeutic data was studied, in particular the
      influence of gender, full-thickness burns, smoke inhalation injury, smoking,
      length of total and ICU stay, and suicide attempt. The 70 patients with positive
      blood alcohol levels on admission had a significantly higher fatality rate (31.5
      per cent) in comparison with the 18.1 per cent fatality rate of patients with a
      negative blood alcohol level. Both groups had nearly identical mean TBSA and mean
      age. Chronic alcohol abuse was noted in 59 patients. These patients were found to
      have a higher fatality rate (31.4 per cent, 22/70) compared with that of patients
      without a history of chronic alcohol abuse who had an overall fatality rate of
      18.1 per cent (28/155). No significant difference was found between non
      intoxicated and acutely intoxicated alcoholics (31.4 vs 29.3 per cent). Our
      conclusion is that intake of alcohol before burn injury represents an independent
      risk factor. The second study was a prospective study of 16 consecutively
      admitted burn patients, who were evaluated for both drug and alcohol intake. Five
      patients had positive drug levels and five had positive alcohol levels. Five
      patients had a history of chronic drug and/or alcohol abuse. This incidence of
      alcohol and drug abuse supports the findings of our retrospective study.

PMID- 7794501
TI  - Burns in octogenarians.
AB  - With the aim of identifying patterns of burn injury, remediable risk factors, and
      policies in the overall surgical and medical management a retrospective review of
      111 octogenarian burn victims admitted between 1983 and 1993 is presented. The
      mean age was 84 years, with the mean percentage body surface area burned (%BSAB)
      being 9.6 per cent (range 0.5-65 per cent). Contrary to expectations, the annual
      incidence appears to be declining, the possible reasons for which are discussed.
      Surgery was required in 69 patients; in 11 this was performed within 1 week of
      injury. When compared to the more traditional delayed surgical approach, early
      surgery conveyed no benefits in either mortality (early group, 18 per cent;
      delayed group, 13 per cent) or length of hospital stay (early group survivors, 38
      days; delayed group survivors, 42 days). Medical and social problems were very
      common and led to an often difficult and frequently prolonged rehabilitation,
      with the mean length of hospital stay for all patients being 29 days. The
      mortality of the whole group was 26 per cent, the patients on average faring
      better than their predicted mortalities as derived using either the Baux index,
      the Bull table or the Abbreviated Burn Severity Score.

PMID- 7794502
TI  - Reducing the burn risk to elderly persons living in residential care.
AB  - A 45-month retrospective analysis of 70 geriatric burn admissions to the Welsh
      Regional Burns and Plastics Unit highlighted 13 (18.6 per cent) injuries that
      occurred whilst the patient was in residential care (six residential care homes,
      seven nursing homes). The mean age overall was 83 years. The residential care
      patients had a TBSA of 12.5 per cent with a mortality of 46 per cent, whilst the
      group living in the community had a TBSA of 8.63 per cent with a mortality of 14
      per cent. These results were not statistically comparable due to the unequal
      population grouping. The cause of injury in the residential group included five
      hot water scalds, six radiator contact burns, one flame burn and one flash burn.
      All 13 patients were found to have such severe dementia that they were unable to
      give a reliable history. In the majority of patients a lack of supervision was in
      part responsible. Some basic measures are presented that could reduce the
      incidence of accidental burn injury in this vulnerable group of the population.

PMID- 7794503
TI  - The use of tissue expansion in children with burns of the head and neck.
AB  - The outcome of 25 children who underwent reconstruction of the head and neck with
      tissue expanders is described. Fourteen boys and 11 girls with a mean age of 6.2
      years (range 3-11 years) had 36 tissue expanders inserted. Five of the expanders
      extruded and five children suffered other expander-related complications. The
      best aesthetic results were achieved in the scalp and the poorest results
      occurred where expanded neck skin was transposed into the face. Tissue expansion
      is a useful method for reconstruction of the head and neck in burned children.
      However patients require careful selection in order to achieve optimal results.
      Meticulous attention to detail is required to reduce the incidence of
      complications.

PMID- 7794505
TI  - A simple guide to burn epidemiology. International Society for Burn Injuries in
      collaboration with the World Health Organization.

PMID- 7794504
TI  - A metabolic complication of severe burns.
AB  - A 32-year-old male was referred to intensive care with possible respiratory
      sepsis 15 days after sustaining 73 per cent TBSA electrical burns. Investigation
      revealed previously undiagnosed hyperosmolar non-ketotic diabetic coma. The
      aetiology, pathogenesis and management of this recognized complication of major
      burns is discussed. An interesting feature of this case is recovery from 73 per
      cent burns, severe hyperosmolar non-ketotic diabetic coma and a serum osmolality
      of 429 mosmol/kg, each of which carry a high mortality probability.

PMID- 7794506
TI  - A simple guide to burn treatment. International Society for Burn Injuries in
      collaboration with the World Health Organization.

PMID- 7794507
TI  - A simple guide to burn prevention. International Society for Burn Injuries in
      collaboration with the World Health Organization.

PMID- 7794508
TI  - A simple guide to the burn registry. International Society for Burn Injuries in
      collaboration with the World Health Organization.

PMID- 7794509
TI  - Survival in non-immune hydrops fetalis without malformation or chromosomal
      abnormalities after invasive treatment.
AB  - The aim of the study was to determine the outcome of fetuses with non-immune
      hydrops (NIH) following modern invasive investigation and therapy. This
      prospectively planned observational study involved 23 women with singleton
      fetuses in whom a diagnosis of NIH was made in our fetal medicine unit in 1 year.
      After investigation and counselling 15 of the 23 women opted for termination of
      pregnancy (10 chromosomal and 5 structural abnormalities) and there was 1
      intrauterine fetal death before therapy was attempted. One case with
      diaphragmatic hernia was treated with shunting which successfully reversed the
      hydrops, the pregnancy continued to term, the malformation was surgically
      corrected but the neonate died from pulmonary hypoplasia. In the remaining 6
      cases structural and chromosomal abnormalities were excluded. One had amniotic
      fluid drainage for polyhydramnios but despite this delivered at 30 weeks'
      gestation and the neonate died on day 5. The remaining 5 cases had fetal therapy
      between 22 and 32 weeks' gestation (4 shunt insertions, 1 blood transfusion) and
      in all the hydrops reversed and the pregnancy continued to at least 35 weeks'
      gestation. All 5 neonates were discharged from hospital alive and well. Fetal
      therapy in cases of NIH with normal structure and karyotype was associated with a
      very good outcome. Giving a uniform poor prognosis is no longer justified because
      if other fetal abnormalities are excluded, in utero treatment, reversal of the
      hydrops and survival are often possible. We recommend urgent referral of these
      cases to a fetal medicine unit.

PMID- 7794510
TI  - Ominous normalization of middle cerebral artery flow velocity waveforms preceding
      fetal death: case report.
AB  - The loss of middle cerebral artery compensatory vasodilation appears to be
      ominous in fetuses with absent end-diastolic umbilical waveforms. The authors
      report a case with a loss of the 'brain-sparing effect' 24 h before fetal death.
      Current pathophysiological explanations are discussed.

PMID- 7794511
TI  - Are 'notched' uterine arterial waveforms of prognostic value for hypertensive and
      growth disorders of pregnancy?
AB  - In a case-control controlled study of 86 women identified as having bilaterally
      'notched' uterine arterial waveform patterns at 18 weeks, the presence of
      bilateral 'notched' uterine arterial waveforms at that time was associated with
      the subsequent development of hypertension and small-for-gestational-age infants,
      but the predictive value was poor. For those women in whom the bilateral uterine
      'notches' were observed to persist to 24 weeks, the relative risk of developing
      proteinuric hypertension increased 14 times, and in these women the positive
      predictive value for the subsequent development of hypertension increased to
      58.6% when compared with their matched controls. The identification of women with
      persistent bilateral uterine 'notches' provides a means of identifying women at
      significant risk of hypertensive and growth disorders at a stage when therapeutic
      intervention aimed at limiting the severity of the disease and its associated
      complications could be commenced.

PMID- 7794512
TI  - Iatrogenic gastroschisis decreases pulmonary hypoplasia in an ovine congenital
      diaphragmatic hernia model.
AB  - Pulmonary hypoplasia is a major problem in infants with congenital diaphragmatic
      hernia. Intrauterine reparative procedures are associated with a high
      complication rate. The development of less complex operations to reduce the
      degree of fetal lung hypoplasia may improve neonatal survival. Our objective was
      to investigate the effectiveness of an iatrogenic gastroschisis in reducing fetal
      pulmonary hypoplasia in a sheep model with an artificially created diaphragmatic
      hernia. A left-sided diaphragmatic hernia (Bochdalek type) was created at 75
      days' gestation in an ovine fetal model during the pseudoglandular phase of lung
      development. At 110 days' gestational age, a left-sided gastroschisis was created
      by excising part of the lower abdominal wall and buttressing the opening with a
      rubber ring. The fetus remained in utero until 135 days' gestation, at which time
      it was sacrificed for autopsy. Histopathologic and morphometric studies were
      performed on the lungs. Ten animals had creation of a diaphragmatic hernia. Four
      underwent the second surgery to create a gastroschisis. One animal completed the
      entire protocol, 3 fetuses aborted after the second surgery. Autopsy confirmed
      effective decompression of the herniated abdominal contents from the chest into
      the amniotic cavity in all 4 cases. The lungs of the animal that completed the
      protocol were appropriately developed, while those fetuses that died soon after
      gastroschisis creation had severe pulmonary hypoplasia, mainly involving the left
      lung. Artificially induced diaphragmatic hernia, in the ovine fetus, causes
      severe pulmonary hypoplasia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794513
TI  - In utero surfactant administration to preterm human fetuses using endoscopy.
AB  - Our purpose was to assess the feasibility of the endoscopic delivery of
      surfactant directly to the fetus during active preterm labor. A gas-sterilized
      intraoperative fiberscope was introduced through the cervical canal into the
      amniotic cavity after spontaneous rupture of membranes during preterm labor in 3
      patients. The flexible fiberscope was inserted under constant endoscopic visual
      control to avoid possible trauma to the fetus and the mother. Surfactant was
      injected into the mouths of 3 preterms fetuses through a catheter placed through
      the biopsy channel of the fiberscope. Fetal heart rate tracings as well as
      neonatal and maternal outcome are reported for each case. In utero surfactant
      placement was successful in each case. The fetal heart rate remained normal
      throughout the procedure. No maternal or neonatal complications/infections were
      detected. Our preliminary experience indicates that in utero endoscopic delivery
      of surfactant to a preterm human fetus is feasible. The usefulness of intrapartum
      endoscopy in the prophylactic administration of surfactant directly to the fetus,
      prior to the first breath, has to be assessed in a prospective controlled study.

PMID- 7794514
TI  - Fetal hepatosplenomegaly associated with transient myeloproliferative disorder in
      trisomy 21.
AB  - The in utero diagnosis of fetal myeloproliferative disease was made by
      cordocentesis following the ultrasound appearance of fetal hepatosplenomegaly and
      mild hydrops. The 2 fetuses reported both had leukocyte counts greater than
      75,000/mm3 with a predominance of blast forms. In both cases the karyotype
      revealed trisomy 21.

PMID- 7794515
TI  - A case of nondiabetic macrosomia with Simpson-Golabi-Behmel syndrome: antenatal
      sonographic findings.
AB  - The incidence of macrosomic infants weighing 5,000 g or more is rare. We
      experienced a case of nondiabetic macrosomia, in which the fetus weighed more
      than 5,000 g. The newborn was diagnosed as having Simpson-Golabi-Behmel syndrome.
      We discuss antenatal ultrasonographic findings in the case.

PMID- 7794516
TI  - Comment on the article by J. Wisser et al. Neonatal hemochromatosis: a rare cause
      of nonimmune hydrops fetalis and fetal anemia. [Fetal Diagn Ther 1993;8:273-278].

PMID- 7794517
TI  - In utero fetal muscle biopsy alters diagnosis and carrier risks in Duchenne and
      Becker muscular dystrophy.
AB  - OBJECTIVES: We have previously shown that Duchenne muscular dystrophy (DMD) can
      be diagnosed by fetal muscle biopsy and immunohistochemical staining showing the
      absence of dystrophin. In Becker muscular dystrophy (BMD), there is a variable
      dystrophin staining pattern. STUDY DESIGN: A 26-year-old, gravida 5, para 1, SAB
      2, VIP 1, white female had a son with the diagnosis of BMD, with no other
      affected family members. In the current pregnancy, the male fetus inherited the
      same X chromosome. RESULTS: Fetal muscle biopsy revealed no dystrophin,
      consistent with the diagnosis of DMD, prompting re-analysis of the sibling whose
      diagnosis was then changed to DMD. CONCLUSIONS: Molecular techniques in prenatal
      diagnosis in this case not only led to the diagnosis of a severe disorder in the
      current pregnancy, but changed the diagnosis in another child, allowing for more
      appropriate counseling of this couple.

PMID- 7794518
TI  - Very low maternal serum unconjugated estriol and prenatal diagnosis of steroid
      sulfatase deficiency.
AB  - Twenty-four women out of 7,875 pregnant women who enrolled in a prenatal
      screening program showed extremely low levels of unconjugated estriol (< 0.15
      MOM). In 19 cases, intrauterine fetal death was reported. In 1 case anencephalus
      was detected. In the remaining 4 cases apparently normal healthy babies (1 female
      and 3 males) were born following uneventful pregnancies. Physical examination of
      the 3 boys at 4-6 weeks revealed mild ichthyosis compatible with the X-linked
      type. Two of them had a positive family history of X-linked ichthyosis. The
      examination of the girl did not reveal any significant findings. In both cases in
      which amniocentesis was performed, low levels of steroid sulfatase and
      arylsulfatase C were found. The prevalence of X-linked ichthyosis in this study
      is higher than previously reported, i.e. 1:1,300 males. Our results suggest that
      the prenatal screening program for neural tube defects and for Down's syndrome is
      useful for the prenatal detection of X-linked ichthyosis as well. These results
      are in accordance with two recent reports. The implications regarding genetic
      counseling are discussed.

PMID- 7794519
TI  - Needle embryofetoscopy and early prenatal diagnosis.
AB  - Needle embroyfetoscopy (NEF) permits direct visualization of the embryo/fetus
      with a specially designed 16-gauge double-barrel instrument sheath which is
      passed transabdominally into the amniotic cavity. We report the case of a woman
      with a MSAFP of 2.5 MOM who had declined amniocentesis. A targeted ultrasound
      examination of the spine revealed what appeared to be spina bifida in the lumbar
      sacral segments from L2 to S1. The mother elected to undergo NEF at 15 weeks
      gestation, which was successfully performed and revealed no evidence of a neural
      tube defect. NEF has a tremendous potential for both early prenatal diagnosis,
      and possibly fetal treatment.

PMID- 7794520
TI  - Fetal responses to inadvertent contact with the needle during amniocentesis.
AB  - Fetal responses in 7 cases of mid-trimester amniocentesis, complicated by
      inadvertent contact between the amniocentesis needle and fetal parts, were
      analyzed by retrospective videotape review. The incidence of inadvertent needle
      contact with the fetus was 0.4% (7 of 1,458). Responses included brisk withdrawal
      of the 'involved' small part in all cases, with the exception of a fetus with
      lumbosacral meningomyelocele, which failed to withdraw the foot upon direct
      contact with the needle. Neurologic examination was normal in all neonates except
      for one with meningomyelocele whose defect was at the L3-L5 level. This patient
      exhibited paralysis of intrinsic foot muscles and hip extensors. Surgical closure
      of the defect was performed 12 h after birth. At 2 years of age, no significant
      improvement in this patient's neurologic condition was noted. Further research is
      needed to assess the validity of the response to needle contact as a predictor of
      neonatal neurologic compromise.

PMID- 7794522
TI  - Midtrimester thoracoamniotic shunting for the treatment of fetal hydrops.
AB  - The management of fetal hydrops in the second trimester is changing as the
      underlying etiologies are better understood. We report a case which was diagnosed
      at 18 weeks gestation. There was no underlying anatomical abnormality. Fetal
      blood sampling confirmed a normal karyotype and there was no evidence of fetal
      infection. Bilateral thoracocentesis and paracentesis caused temporary
      improvement of the fetal condition but subsequent fluid reaccumulation was noted
      within the left pleural cavity. A pleuroamniotic shunt inserted at 22 weeks
      caused permanent resolution of the hydrops. The infant was normal at 1-year
      follow-up.

PMID- 7794521
TI  - Fetal serum erythropoietin in twin pregnancies with discordant growth. A clue for
      the prenatal diagnosis of monochorionic twins with vascular communications.
AB  - Ten sets of diamniotic twins with discordant fetal growth (ultrasonographic
      estimated fetal weight difference > 25%) and abnormal amniotic fluid volume were
      assessed for fetal serum erythropoietin concentration (Epo). All 20 fetuses had a
      percutaneous umbilical blood sampling performed between 21 and 33 weeks
      gestation. Three sets of twins were dichorionic while 7 sets were monochorionic.
      In these 7 monochorionic sets a vascular communication between twins was
      demonstrated prenatally and postnatally. From 24 weeks gestation the smaller twin
      of the dichorionic group had a higher serum Epo than its larger cotwin; the
      larger cotwin's serum Epo was within normal limits for singleton controls. All
      fetuses with documented vascular communications had higher serum Epo
      concentration than singleton controls. These findings suggest that determination
      of fetal serum Epo in the large cotwin may be a clue to the diagnosis of vascular
      communications between twins with discordant growth.

PMID- 7794523
TI  - Predictive value of pleural effusions in fetal hydrops.
AB  - Twenty-eight cases of fetal hydrops are reported. A diverse aetiology was found.
      Fetal therapy was undertaken in 12 (42.9%). The overall survival rate was 36.8%
      (excluding elective terminations). However, when normal fetuses presenting from
      20 weeks were considered, the survival rate was 64%. The results were combined
      with those of two other studies (making a total of 182 cases with fetal hydrops)
      to ascertain the value of pleural effusions in predicting outcome in such cases.
      In the 143 cases that did not end in a therapeutic termination of pregnancy,
      fetal pleural effusions predicted death (fetal or neonatal) with a sensitivity of
      67%, a specificity of 53%, a positive predictive power of 68%, a negative
      predictive power of 52% and an overall accuracy of 62%.

PMID- 7794524
TI  - In vitro amyloid fibril formation from alpha 1-antitrypsin.
AB  - We have previously shown that the interaction between alpha 1-antitrypsin (AAT)
      and lithocholic acid (LA) results in changes of AAT properties leading to its
      polymerization and inactivation. To define the structural rearrangements of AAT
      induced by such interaction, we studied the in vitro binding between AAT and LA
      at molar ratio 1:5 for varying time intervals at a physiological pH. Complex
      formation was shown by electrophoretic techniques and autoradiography. Studies of
      the AAT in complex with LA by using far-UV spectra circular dichroism and
      fluorescence measurements indicated an increase of beta-structure of AAT and
      pronounced changes in surroundings of the chromophores. In addition, complexed
      AAT showed increase in thermal stability, compatible with that after proteolytic
      cleavage. Characterization of the AAT-LA complexes by Congo red binding,
      polarization and negative staining electron microscopy provided clear evidence
      that AAT, under chosen experimental conditions, can self-assemble into amyloid
      fibrils, compatible with accepted models of fibrillar structures. This propensity
      of AAT to form stable beta-structures in a hydrophobic surrounding may contribute
      to improved characterization of various amyloid deposits occurring in vivo and be
      a guide for understanding details of structure-function relationships in the
      intact AAT-molecule.

PMID- 7794526
TI  - Primary structure of the thermosome from Thermoplasma acidophilum.
AB  - The thermosome, a chaperonin from the archaebacterium Thermoplasma acidophilum,
      consists of two subunits (M(r) 58,000 and 60,000) which assemble into a
      cylindrical complex of pseudo eight-fold rotational symmetry. The sequences of
      the two subunits are approximately 60% identical to each other and to TF55 from
      Sulfolobus shibatae, and are 30-40% identical to the subunits of the TCP1
      containing ring complex (TRiC) from the eukaryotic cytosol. A dendrogram of this
      family of chaperonins contains eight eukaryotic branches of TRiC subunits and one
      archaebacterial branch of thermosome subunits. Alignment of thermosome/TRiC
      sequences with eubacterial and eukaryotic Hsp60 sequences reveals a statistically
      significant similarity in two large N- and C-terminal blocks of sequence. Based
      on this alignment and on the recently published crystal structure of GroEL, we
      propose that subunits of the thermosome/TRiC family of chaperonins have a similar
      equatorial domain and overall domain topology as GroEL but differ in the
      structure of the apical domain.

PMID- 7794525
TI  - Purification and characterisation of pyruvate decarboxylase from pea seeds (Pisum
      sativum cv. Miko).
AB  - Pyruvate decarboxylase (PDC) was purified from pea seeds. The catalytically
      active holoenzyme is an oligomer of two types of subunits with molecular masses
      of about 65 kDa and 68 kDa, respectively. The active enzyme is a mixture of
      tetramers, octamers and even higher oligomers. These differences in the
      quaternary structure compared with PDC from yeast (tetramer) do not result in a
      different kinetic behaviour. The activity of pea PDC as well as that of yeast PDC
      is regulated by its substrate pyruvate resulting in a sigmoid shape of the v/S
      plot. At the optimum pH of 6.0 a S0.5-value of 1 mM pyruvate is found that
      increases with rising pH and increasing concentrations of phosphate. The
      substrate analogue activator pyruvamide activates the enzyme resulting in a
      hyperbolic v/S-plot. The stability of PDC from pea seeds in solution is about one
      order of magnitude higher than that of yeast PDC. Despite the described
      similarities of the two enzymes no significant cross reactivity of the anti-pea
      PDC antibody with the enzyme from yeast occurs.

PMID- 7794527
TI  - Studies on S14 protein from Thermus thermophilus possessing zinc finger-like
      motifs.
AB  - The amino acid sequence of the ribosomal protein S14 of Thermus thermophilus has
      been determined both by automated sequence analysis of the intact protein as well
      as by DNA sequence analysis of the gene. The carboxy-terminal region was verified
      by both amino acid sequence analysis of the carboxy-terminal peptide produced
      after Glu-C digestion and by DNA sequence analysis. The protein contains 60 amino
      acid residues with a calculated molecular weight of 7008. The most extensive
      homology is observed in the carboxy-terminal regions of all S14 proteins
      compared. Interestingly, the carboxy-terminal region of most S14 proteins of all
      species studied so far, form zinc-finger domains in the variety of C2-C2 form.

PMID- 7794528
TI  - Mammalian cysteine protease inhibitors: biochemical properties and possible roles
      in tumor progression.
AB  - The endogenous cysteine protease inhibitors represent the final level at which
      cysteine protease activity can be regulated. These inhibitors are subdivided into
      three families (stefins, cystatins and kininogens) which belong to the protein
      superfamily, cystatins. Cystatins do not form a covalent bond with cysteine
      proteases, but instead cover the active site cleft blocking access to the active
      site. The most important biochemical characteristics of the cystatins are
      described in the first part of this review. Alterations in the balance between
      endogenous cysteine protease inhibitors and cysteine proteases have been
      postulated to contribute to malignant progression. A few studies have
      demonstrated the enrichment of cysteine protease inhibitor activity in the
      membrane fraction of tumors/cells. Evidence is accumulating that an inverse
      correlation exists between the level of stefin A, one of the cysteine protease
      inhibitors, and malignant progression. Stefin A has even been hypothesized to be
      a tumor suppressor. However, additional studies are necessary in order to prove
      functional roles for the individual cysteine protease inhibitors in tumor growth
      and progression.

PMID- 7794529
TI  - Determination of peptide regions exposed at the surface of the bacterial ribosome
      with antibodies against synthetic peptides.
AB  - We synthesized six peptides corresponding to regions that are predicted to be
      surface-exposed of the following ribosomal proteins: protein L2, positions (D263
      K272); protein L5, positions (I136-G150); protein L25, positions (Q75-D90);
      protein S3, positions (Q222-K232) derived from Escherichia coli; and protein L2,
      positions (K257-K275), and protein S3, positions (R130-T150) from Bacillus
      stearothermophilus. These peptides were employed to raise ribosomal protein-cross
      reactive antibodies. The anti-peptide antisera reacted specifically with their
      parent proteins, as demonstrated by immunoblotting experiments. In a competition
      assay proteins L2 from E. coli and B. stearothermophilus as well as proteins L5
      and L25 from E. coli were found to be accessible to the respective anti-peptide
      antibodies in the 50S subunits, but not in 70S ribosomes, proving their location
      at the 50S interface which is covered by the 30S subunit in the 70S complex. Two
      of the anti-peptide antisera directed against sequences deduced from protein S3
      of E. coli and B. stearothermophilus reacted with 30S subunits as well as with
      70S ribosomes, demonstrating their location at the backside, which is exposed to
      solvent. Thus, by the strategy applied specific short peptide stretches were
      located at the surface of the ribosome.

PMID- 7794531
TI  - Development of a polymer-enzyme immunoassay method and its application.
AB  - Both poly(N-isopropylacrylamide) and poly(N-isopropylacrylamide)-antibody (PINP
      Ab)-labelled enzyme adhered quickly and tightly to cellulose acetate/nitrate
      membrane either below (less efficiently) or above (more efficiently) the lower
      critical solution temperature, and the retention of PINP-Ab on the membrane
      increased over 30-fold when compared with the unconjugated Ab. These
      characteristics were used to develop a novel polymer-enzyme-linked immunoassay
      method: homogeneous antigen-antibody immune-complexation reaction and a
      heterogeneous separation process. By using a simple horseradish-peroxidase
      labelled antibody as a probe, we applied this method to the detection of human
      serum hepatitis B surface antigen (HBsAg). This immunoassay system can detect as
      little as 1 ng/ml of HBsAg. The advantages of this method are: (a) fast
      homogeneous immune complexation; (b) a rapid heterogeneous separation process;
      (c) high sensitivity; and (d) low non-specific background.

PMID- 7794530
TI  - Ras-GTP regulation is not altered in cultured melanocytes with reduced levels of
      neurofibromin derived from patients with neurofibromatosis 1 (NF1).
AB  - As derivatives of the neural crest, epidermal melanocytes are supposed to be
      clinically affected by NF1 gene defects. The NF1 gene shares sequence homology
      with the p120 GTPase activating protein (p120-GAP) and neurofibromin has been
      shown to participate in Ras-regulation. By immunoprecipitation and Western
      blotting, neurofibromin was found to be expressed in melanocytes from the
      unaffected skin and cafe au lait macules of NF1 patients, but the intensity of
      the neurofibromin band was decreased compared to control cultures. The Ras
      GTP/Ras-GDP ratios of NF1 derived melanocyte cultures were comparable to those
      derived from healthy donors. Furthermore, the total GAP-activity of cell lysates
      was not altered in NF1 melanocyte cultures compared to controls. However, lysates
      of proliferating melanocytes, both from NF1 patients and from healthy donors,
      showed an about 2-fold higher GAP-activity than poorly growing cells.
      Neurofibromin contributed approximately one third of total GAP-activity, in both
      control and NF1 melanocytes, indicating that it is not the major regulator of Ras
      in these cells. These results suggest that the function of neurofibromin in
      melanocytes is not limited to regulation of Ras activity.

PMID- 7794532
TI  - Isolation from bovine haemoglobin of a peptide that might be used as a potential
      hydrophobic photosensitizer carrier.
AB  - The isolation of a peptic hydrolysate and of a pure peptide from bovine
      haemoglobin is described. These peptides were used to solubilize an insoluble
      photosensitizer in order to study their utilization as a carrier for
      photochemotherapy. Protoporphyrin IX was used as a model of an insoluble
      photosensitizer. Solubilization of protoporphyrin IX was first performed with the
      total haemoglobin hydrolysate, then with peptide fractions, and finally with a
      pure peptide isolated from this fraction by reversed-phase HPLC. The molecular
      mass and the primary structure of the pure peptide were determined by fast-atom
      bombardment and tandem MS (molecular mass 1648 Da). The singlet oxygen quantum
      yield of the protoporphyrin IX-peptide complex was determined.

PMID- 7794533
TI  - Recombinant human acetylcholinesterase expressed in Escherichia coli: refolding,
      purification and characterization.
AB  - A large-scale preparation of a recombinant human acetylcholinesterase (rhAChE)
      mutant harbouring a CyS580-->Ser substitution, expressed in Escherichia coli, was
      refolded following solubilization of the inclusion bodies. Refolded active rhAChE
      was purified by DEAE-Sepharose and affinity chromatography to apparent
      homogeneity with a specific activity (4572 units/mg) similar to that of
      erythrocyte AChE. The stability of the purified enzyme at 22-37 degrees C was
      dependent on the presence of 0.5 mg/ml BSA, and the optimum pH for stability was
      9.0. rhAChE has a UV-absorbance spectrum typical of a tryptophan-rich protein,
      with a distinct shoulder at 290 nm and a high absorption coefficient at 280 nm
      (epsilon 1% = 23.1). The tryptophan residues in active rhAChE are located in an
      apolar environment, characteristic of a globular molecule. The difference in
      amino acid composition between red-blood-cell-derived and recombinant hAChE is
      probably reflected in their different pI values, namely 5.5-5.8 and 4.6-5.2
      respectively. The CD spectrum of rhAChE is typical for an alpha/beta protein,
      indicating 39% alpha-helix and 22% beta-sheet. This secondary structure is
      similar to that determined for the Torpedo (electric fish) AChE, by both CD and X
      ray crystallography. On the other hand, a purified misfolded and inactive
      molecule displays a decrease in alpha-helical content to 24%, accompanied by an
      increase in beta-sheet up to 42%, indicative of extensive changes in the
      conformation of the protein. On the whole, the recombinant enzyme has been
      refolded into a native-like conformation possessing full activity, and is thus
      similar to the naturally occurring red-blood-cell-derived hAChE.

PMID- 7794534
TI  - Properties of laccase isoenzymes produced by the basidiomycete Ceriporiopsis
      subvermispora.
AB  - Laccase is one of the ligninolytic enzymes found in liquid cultures of the fungus
      Ceriporiopsis subvermispora in defined medium. As an approach to a clarification
      of the role of laccases during the attack on lignin by the fungus, the enzyme has
      been characterized further. The levels of this phenol oxidase increase 2-fold in
      the presence of p-anisidine and are severely affected when addition of either
      Mn(II) or Cu(II) ions to the medium is omitted. Isoelectrofocusing allowed the
      resolution of two laccase isoenzymes, with pIs of 3.65 and 3.59. In rich medium,
      laccase activity is 10-fold higher than in salt medium, and it is not affected by
      the external addition of p-anisidine or Mn(II). Four isoenzymes were detected in
      these cultures, with pIs between 3.76 and 3.60. In a wheat bran medium, four
      isoenzymes with pIs in the range 3.63-3.46, plus a fifth isoenzyme of high pI
      (4.82), were also identified. The absorption spectrum of a pool containing the
      four isoenzymes from rich medium shows a maximum at 600 nm, typical of laccase
      possessing a type I copper atom. The molecular mass of the isoenzyme with pI 3.60
      is 79 kDa, as determined by SDS/PAGE. Upon treatment with endoglycosidase F, the
      molecular mass of this isoform decreases to 63 kDa, indicating a high degree of
      glycosylation. Substrate specificity studies conducted with the four isoenzymes
      from rich medium and a combination of isoenzymes from salt medium showed marked
      differences among them. The amino-terminal sequences (24 residues) of three
      isoenzymes isolated from rich medium were determined. Two of them are identical,
      whereas the third one differs from these in three amino acid residues. The
      consensus sequence reveals clear homology with laccases from other
      microorganisms.

PMID- 7794535
TI  - Preparation and characteristics of magnetite-labelled antibody with the use of
      poly(ethylene glycol) derivatives.
AB  - With a view to the application of magnetic particles in cancer thermotherapy
      (hyperthermia), methods of preparing a bio-applicable magnetite with targeting
      activity towards cancer cells were investigated, and the properties of the
      material examined. Poly(ethylene glycol) (PEG)-magnetite consisting of magnetite
      (Fe3O4) and PEG with terminal carboxy or amino groups was prepared. Monoclonal
      antibody was then immobilized covalently on to the PEG-magnetite. Among three
      different immobilization methods employed, the highest immobilization density of
      492 mg of protein/g of PEG-magnetite was achieved by using water-soluble carbodi
      imide. However, with respect to residual antibody activity, only the method in
      which IgG sugar chains were oxidized to give aldehyde groups for coupling to N
      terminal PEG-magnetite was satisfactory, with about 60% of the activity
      surviving. The immobilization density by this method (109 mg of protein/g of PEG
      magnetite) was also sufficiently high. The product, termed magnetite-labelled
      antibody, was of sub-micrometre size and showed easy magnetophoresis. It was
      further elucidated that cancer-specific magnetite-labelled antibody bound to
      cancer cells at an amount of 50 mg of magnetite/cm3 of cells. The PEG-magnetite
      generates heat at an evolution rate of 31.5 W/g, and the amount adsorbed to the
      cells was calculated to be high enough to heat a tumour 1 cm in diameter to more
      than 42 degrees C in 30 s under an alternating magnetic field [at an intensity of
      572 Oe (approx. 45.5 kA/m) and a frequency of 240 kHz]. This magnetite-labelled
      antibody is expected to be applicable clinically as a therapeutic agent for the
      induction of hyperthermia.

PMID- 7794536
TI  - Transgenic models of HIV-1.
AB  - Transgenic technology has been very successful at providing insights into
      possible processes involved in HIV-induced pathogenesis. The availability of
      these small animal models for the study of HIV-related syndromes including KS,
      epidermal proliferative lesions, HIV-associated nephropathy, AIDS-related growth
      failure and cachexia may well facilitate the development of novel therapies for
      these complications. Other phenotypes created in mice, such as cataracts and
      hepatic cancer [59], may not have human analogies but may still provide insight
      into pathogenesis. Thus, transgenic models have already provided resources to
      study many manifestations of AIDS and others are likely to be developed. The
      optimal strategy for designing future transgenic animals, however, is less clear.
      No transgenic mouse model has been generated to date that will provide an avenue
      for vaccine development. This advance awaits the further discovery of the host
      factors that facilitate the virus replicative cycle in humans and a better
      understanding of these pathways in the mouse. For the development of molecular
      based therapy, however, the currently available models may well be adequate to
      test molecular inhibitors of transcription [7,60,61] and post-transcriptional
      processing of viral mRNA [62]. Whether single or multigenic constructs under the
      control of the LTR are better or worse for this purpose is a debatable issue.
      Transgenic technology may yet make an additional contribution to the development
      of molecular therapy for AIDS. The best method of demonstrating that a gene
      therapeutic strategy is safe to administer to patients has not been determined.
      By introducing potentially therapeutic constructs into mice as transgenes, their
      safety can be assessed in many different cell types in vivo, analogous to
      toxicological testing in rodents for systemically administered drugs. Thus,
      transgenic technology has already provided insights into the pathogenesis of HIV
      1. While it has not yet proven its utility for vaccine development, transgenic
      technology holds the promise of being an active participant in the development of
      both safe and effective gene therapy approaches for the treatment of AIDS.

PMID- 7794537
TI  - Rates of p24 antigenemia and viral isolation in comparable white and black HIV
      infected subjects. Military Medical Consortium for Applied Retroviral Research.
AB  - OBJECTIVE: To determine the relative frequencies of HIV-1 p24 antigen and culture
      positivity in white and black patients. DESIGN: Volunteers in the US military's
      HIV natural history study were 46% white, 44% black, 7% Hispanic and 3% other.
      Focusing on the comparable groups of whites and blacks, a retrospective analysis
      was performed of the results of virologic assays collected over a 2-year period.
      METHODS: p24 antigen was quantitated in sera with and without immune complex
      dissociation (ICD); viral isolation was performed by coculture of peripheral
      blood mononuclear cells. RESULTS: Results of the two virologic assays were very
      similar in the two racial groups, both overall and after stratification by CD4
      cell count. As reported previously, the concentration of serum immunoglobulin G
      was found to be greater in black than white subjects. In contrast to results with
      ICD, sera tested without ICD resulted in differing (higher) rates of antigenemia
      in whites than blacks (P = 0.002). CONCLUSIONS: The frequencies of p24 antigen
      and culture positivity were found to be independent of race. Previously observed
      racial differences in antigen positivity were likely to be due to more extensive
      antibody binding in blacks than in whites.

PMID- 7794538
TI  - Unidirectional budding of HIV-1 at the site of cell-to-cell contact is associated
      with co-polarization of intercellular adhesion molecules and HIV-1 viral matrix
      protein.
AB  - OBJECTIVES: To explore the possibility that HIV-1 budding and cellular adhesion
      molecules co-polarize at cell-to-cell contact sites. To investigate the
      incorporation of host-cell-derived adhesion molecules into HIV-1. METHODS: The
      cellular sites involved in HIV-1 budding were examined by transmission electron
      microscopy. Single and double immunocytochemistry staining was used to evaluate
      the cellular distribution of the viral matrix protein and adhesion molecules.
      Quantitative flow cytometry was used to measure the cellular expression of
      adhesion molecules. An immunocapture technique was used to measure the presence
      of cell-derived proteins on HIV-1. The captured virus was measured by a p24
      antigen assay. The infectivity of virus captured by monoclonal antibodies was
      tested by measuring the virus antigen yield in supernatants after the addition of
      sensitive cells. RESULTS: Released and budding HIV-1 was mainly localized at the
      cell-to-cell contact regions. This feature was consistent with a polarized
      staining for the virus matrix protein p18 at cell-to-cell contact regions.
      Intercellular adhesion molecules (ICAM)-1 in HIV-1-infected cells were polarized
      on both isolated cells and syncytia, co-localizing with HIV-1 matrix protein. HIV
      1 incorporated all the adhesion molecules expressed by the host cells, although
      without quantitative correlation with their cellular expression. CONCLUSIONS: HIV
      1 is released at cell-to-cell membrane contact sites. Both ICAM-1 and virus
      matrix protein co-polarized on isolated cells and syncytia at the sites involved
      in the recruitment of uninfected cells. The impressive concentration of ICAM at
      cell sites where most virions are released may account for the acquisition of
      these membrane proteins by the HIV-1 progeny, and may be important for the cell
      mediated spread.

PMID- 7794539
TI  - High resolution analysis of HIV-1 quasispecies in the brain.
AB  - OBJECTIVE: To characterize HIV-1 quasispecies at high resolution to determine the
      in vivo sequence heterogeneity of virus infecting the brain. METHODS: A 1
      kilobase region of the envelope gene, which includes the five hypervariable
      regions, was amplified by polymerase chain reaction (PCR) using DNA obtained from
      brain tissue of an HIV-1-infected patient. PCR products were cloned and 50 clones
      sequenced. RESULTS: Thirty-nine unique nucleotide sequences producing 35 protein
      variants were found. A consensus sequence was identified along with three
      distinct subtypes, each present at a level of 12%. The sequence variation from
      the consensus was 0.1-2.1% at the nucleotide level with hypermutation and
      recombination responsible for the highest diversity. Sequence heterogeneity
      resulted in both the creation and the elimination of N-linked glycosylation
      sites. Only nine clones differed from the consensus sequence in the V3 loop. No
      inactivating mutations were found. CONCLUSIONS: HIV-1 proviruses found in the
      brain generally demonstrate a low level of genetic variability in env. However,
      genomes that vary considerably from the predominant species can be present at
      significant levels. This observation may be of importance for understanding viral
      pathogenesis in the central nervous system.

PMID- 7794541
TI  - Diarrhoea in HIV-infected patients: no evidence of cytokine-mediated inflammation
      in jejunal mucosa.
AB  - OBJECTIVE: To determine whether a mucosal cytokine-mediated inflammatory response
      is involved in cryptosporidial or microsporidial diarrhoea, as well as in
      diarrhoea of unknown origin in HIV-infected patients. DESIGN: Prospective study.
      METHODS: Jejunal biopsies were obtained from HIV-infected patients with
      diarrhoea. Controls were HIV-infected and HIV-seronegative patients without
      diarrhoea. Two biopsies were homogenized immediately and two other biopsies were
      first cultured for 20 h. Cytokines [tumour necrosis factor (TNF), interleukin
      (IL)-1 beta, IL-6, IL-8, IL-10], soluble TNF receptors (sTNFR) p55 and p75, and
      soluble IL-2 receptor (sIL-2R) were assessed in the homogenates and in the
      supernatants by sandwich enzyme-linked immunosorbent or enzyme-linked binding
      assays. The cytokine receptors were also measured in serum. RESULTS: Six HIV
      infected patients with cryptosporidiosis, six with microsporidiosis, seven with
      diarrhoea of unknown origin, seven without diarrhoea, and seven HIV-seronegative
      patients were eligible. Four patients were excluded because of the presence of
      other pathogens. No cytokines were detected in immediately homogenized jejunal
      tissue. Following culture, IL-6 and IL-8 levels were higher in HIV-infected
      patients with diarrhoea of unknown origin than in HIV-seronegative controls
      without diarrhoea, although this was not statistically significant. No
      differences in serum or post-culture supernatant sTNFR p55 and p75 levels existed
      between the HIV-infected patients with or without diarrhoea. sTNFR, IL-1 beta, IL
      10 and the sIL-2R were only detected in low amounts or not at all, and were
      equally distributed among all patient groups. CONCLUSIONS: This study indicates
      that mucosal cytokine-mediated inflammatory responses do not play an important
      role in the pathogenesis of different types of diarrhoea in HIV-infected
      patients. These results do not support the use of immunomodulatory therapy in
      these patients.

PMID- 7794540
TI  - Frequency of early in utero HIV-1 infection: a blind DNA polymerase chain
      reaction study on 100 fetal thymuses.
AB  - OBJECTIVE: To estimate the prevalence of in utero transmission of HIV-1 through
      the second trimester. MATERIAL AND METHODS: One hundred consecutive, unselected,
      intact fetuses, beyond 15 weeks gestational age (mean, 22.4 weeks) were studied.
      These were obtained following spontaneous intrauterine deaths (n = 4),
      miscarriages (n = 4), and elective mid-trimester terminations (n = 92), eight of
      which were fetuses with malformations from HIV-1-positive pregnancies. Coded DNA
      extracts from the fetal thymuses were tested blindly by polymerase chain reaction
      in three laboratories using a total of six different primer pairs. RESULTS: Two
      thymuses tested positive [95% confidence interval (Cl), 0.2-7]. Results from the
      three laboratories were consistent in all 100 cases. The two fetuses with HIV in
      the thymus both tested positive in other organs, demonstrating systemic HIV
      infection. The first fetus, whose mother had advanced AIDS, had died in utero and
      had diffuse toxoplasmosis. The second died following extremely premature delivery
      in a pregnancy complicated by repeated bleeding. HIV infection was observed in
      none of the 92 fetuses that resulted from elective mid-trimester terminations
      (95% Cl, 0-4). CONCLUSION: The frequency of early in utero HIV infection appears
      to be low, compared with transmission rates in infants born to HIV-1-infected
      mothers, suggesting that transmission occurs mostly later in pregnancy and/or at
      delivery. Specific risk factors may have implications in the occurrence of early
      as opposed to late transmission.

PMID- 7794542
TI  - Validating population surveys for the measurement of HIV/STD prevention
      indicators.
AB  - OBJECTIVE: To validate the World Health Organization/Global Programme on AIDS
      (GPA) protocol for measuring HIV/sexually transmitted disease prevention
      indicators pertaining to knowledge and sexual practices of the general
      population. METHODS: Data were collected in Uganda during 1993. Three different
      interview strategies were complemented with qualitative methods, including
      observations at visits and key-informant interviews. Two interview strategies
      consisted of structured questionnaires which were applied to 460 randomly
      selected people aged 15-49 years and 60 intentionally selected women who were
      known prostitutes. The third strategy involved in-depth interviewing and was
      applied to a random subset of all respondents (n = 75). RESULTS: The three
      interview strategies generated similar results for demographic characteristics.
      The strategies using structured questionnaires gave similar results with regards
      to the number of reported sex partners and the prevalence of condom use, but
      differed from in-depth interviews on these aspects. The high numbers of casual
      sex partners of female prostitutes was confirmed by in-depth interviews but not
      via the questionnaires. CONCLUSION: The GPA questionnaire may not be optimal to
      capture people at high risk and to assess sexual behaviour, especially of people
      at high risk. Nevertheless, the questionnaire provides the most realistic option,
      since in-depth interviews are expensive and not as objective in assessing trends
      over time. Evaluation studies of HIV interventions in the general population
      should therefore be complemented with small qualitative studies to detect and
      iron out biases in interpreting results.

PMID- 7794543
TI  - Sociodemographic predictors and temporal trends of extrapulmonary tuberculosis as
      an AIDS-defining disease in Spain.
AB  - OBJECTIVE: To identify the factors associated with the presentation of
      extrapulmonary tuberculosis (EPTB) in AIDS diagnosis and to analyse its temporal
      trend. DESIGN: Analysis of AIDS surveillance data. METHODS: The study was based
      on AIDS cases diagnosed in Spain between 1988 and 1993, and reported up to
      September 1994. The proportion of patients presenting with EPTB at AIDS diagnosis
      was analysed by sociodemographic characteristics and year of diagnosis. RESULTS:
      Of the 22,445 AIDS cases diagnosed in Spain from 1988 to 1993, 6526 patients
      (29.1%; 95% confidence interval, 28.5-29.7) presented with EPTB at diagnosis,
      making it the most frequent AIDS-defining disease. The highest proportions of
      EPTB reported at AIDS diagnosis were observed for injecting drug users (IDU;
      35.4%) and the heterosexual transmission category (23.5%). The proportion of EPTB
      was lower in women [relative risk (RR), 0.85; P < 0.001], and higher in 15-29
      year-olds (34.2%) and patients with a prison record (44.3 versus 25.4%; RR, 1.75;
      P < 0.001). AIDS patients resident in provinces with high respiratory TB
      mortality rates among the general population exhibited a higher proportion of
      EPTB (RR, 1.45; P < 0.001). The effect of any one variable was maintained by
      controlling for all others. The proportion of patients with EPTB at AIDS
      diagnosis revealed a downward trend from 1988 to 1993 (P = 0.007), which was
      observed in IDU and heterosexuals but not in homosexual/bisexual men (P = 0.421).
      CONCLUSIONS: Factors such as injecting drug use, prison record or residence in
      high TB-endemic areas are associated with a greater frequency of EPTB at AIDS
      diagnosis. These factors must be considered for specific prophylaxis to be
      efficiently applied.

PMID- 7794544
TI  - HIV-1 prevalence and risk factors among sexually transmitted disease clinic
      attenders in Trinidad.
AB  - OBJECTIVES: To study trends in prevalence and to ascertain risk factors for HIV-1
      among sexually transmitted disease (STD) clinic attenders in Trinidad. DESIGN AND
      METHODS: Serial cross-sectional studies were conducted in 1987-1988 and 1990-1991
      at a centralized STD clinic in Port of Spain. A case-control study was carried
      out to examine in greater detail the demographic and behavioral risk factors for
      HIV-1 among self-declared heterosexuals in this population. RESULTS: HIV-1
      prevalence increased from 3.0% [95% confidence interval (CI), 2.3-3.9] in 1987
      1988 to 13.6% (95% CI, 11.8-15.6) in 1990-1991. Age > or = 40 years [odds ratio
      (OR), 2.0; 95% CI, 1.4-2.8], urban residence (OR, 2.2; 95% CI, 1.6-3.0), and
      human T-lymphotropic virus-I seropositivity (OR, 3.1; 95% CI, 1.6-6.0) were
      significant risk factors for HIV-1 in 1990-1991. In the case-control analysis,
      significant independent risk factors for men included current genital ulcer
      disease (OR, 5.2; 95% CI, 2.2-12.5), current genital warts (OR, 3.9; 95% CI, 1.2
      12.0), having ever had syphilis (OR, 3.2; 95% CI 1.6-6.1), and use of crack
      cocaine in the preceding 6 months (OR, 6.2; 95% CI, 2.7-14.2). Corresponding risk
      factors for women were commercial sex work (OR, 5.7; 95% CI, 1.3-25.7),
      initiation of sexual activity before age 14 years (OR, 4.8; 95% CI, 1.5-16.0),
      and past non-gonococcal cervicitis (OR, 4.1; 95% CI, 1.3-13.1). CONCLUSIONS: HIV
      1 in this setting is primarily heterosexually transmitted in a milieu of
      unprotected sexual activity fuelled by a crack cocaine epidemic. Targeted
      interventions to prevent, detect and treat STD and crack cocaine addiction, as
      well as disrupt their adverse synergism, may substantially reduce HIV-1
      transmission in this population.

PMID- 7794545
TI  - Myeloradiculitis due to Cryptococcus curvatus in AIDS.

PMID- 7794547
TI  - Is AIDS-related cryptococcosis more frequent among men?

PMID- 7794546
TI  - Contribution of breastfeeding to the reported variation in rates of mother-to
      child HIV transmission.

PMID- 7794548
TI  - Low prevalence of HIV-1 proviral DNA in peripheral blood monocytes and dendritic
      cells from HIV-1-infected individuals.

PMID- 7794549
TI  - HIV-1 V3 envelope sequences required for macrophage infection.

PMID- 7794550
TI  - Willingness of dentists to treat an HIV-infected patient.

PMID- 7794552
TI  - Does zidovudine cause non-Hodgkin's lymphoma?

PMID- 7794551
TI  - Cerebral astrocytoma in HIV-infected patients.

PMID- 7794553
TI  - Serum levels of interleukin-12 in adult and paediatric patients with HIV-1
      infection.

PMID- 7794555
TI  - Statistics from the World Health Organization.

PMID- 7794554
TI  - Trimethoprim-sulphamethoxazole rechallenge in 20 previously allergic HIV-infected
      patients after homeopathic.

PMID- 7794556
TI  - Predictive testing for Huntington's disease: risk perception, reasons for testing
      and psychological profile of test applicants.
AB  - In the Center for Human Genetics in Leuven, predictive DNA-testing for
      Huntington's disease is available as a clinical service since November 1987,
      initially by DNA-linkage and since mid 1993 by direct mutation analysis. The
      multidisciplinary approach as well as the detailed test protocol are described.
      The present paper gives a sociodemographic description of the test applicants,
      their subjective evaluation of the risk and their motives for requesting the
      predictive test. Major attention is paid to the personality profile of the
      applicants who proceeded with testing. Psychometric testing revealed that this
      group of test applicants did not differ significantly from the general population
      for most characteristics and even had a number of more positive characteristics
      e.g. a higher ego-strength. The latter may reflect a self-selection of a more
      resourceful and emotionally healthier subgroup of at-risk persons. Nevertheless
      psychological evaluation also has identified a number of applicants with
      extremely high anxiety levels and other problems, who needed extra pretest and
      posttest counseling. The relatively high number of withdrawals from the test
      programme is another indication of the importance of adequate pretest counseling.

PMID- 7794557
TI  - Fetal akinesia sequence caused by glycogenosis type VII.
AB  - We report on the autopsy study of a premature boy with multiple joint
      contractures who died soon after birth of severe lung hypoplasia. Muscle
      histology showed PAS-positive vacuoles, and electronmicroscopy revealed massive
      subsarcolemmal and intermyofibrillar accumulation of glycogen. Biochemical
      analysis of fresh-frozen muscle tissue disclosed increased glycogen content and a
      complete lack of phosphofructokinase (PFK) activity. The brain showed focal
      cerebral and diffuse cerebellar white matter gliosis, and patchy loss of internal
      granular and Purkinje cells in the cerebellar cortex. The spinal cord was normal.
      This report describes the first case of PFK deficiency, presenting as a lethal
      fetal akinesia sequence.

PMID- 7794558
TI  - X-linked mental retardation and neurological symptoms: a nosological approach.
AB  - Various clinical classifications of XLMR have been reported. In a recent review
      on X-linked mental retardation (XLMR) genes, 127 conditions featuring XLMR as a
      primary or major manifestation were listed (32). In our clinical departments, we
      have a special interest in families of male patients with mental retardation and
      neurological symptoms. Since the combination of XLMR and neurological
      manifestations could be found in almost all categories of the previously reported
      classifications, we outlined a nosological approach meant for those cases where
      other specific symptoms are lacking.

PMID- 7794559
TI  - The Pallister-Killian syndrome in an African individual.
AB  - We report for the first time an individual of Zulu origin with the Pallister
      Killian syndrome. Apart from the commonly reported clinical signs, he also had
      frenula in all four quadrants of the mouth. A broad, short hallux was present. An
      unusually high level of mosaicism for the isochromosome 12p was found in the
      lymphocytes.

PMID- 7794561
TI  - Lysosomal storage diseases in Greece.
AB  - Over the last 13 years 2745 patients from all over Greece suspected to have a
      lysosomal storage disorder were referred to the Institute of Child Health. 1581
      of those were suspected of having a mucopolysaccharidosis (MPS). 94 cases (3.42%
      of the total referrals) were positive: 36 patients with MPS, 6 with mucolipidosis
      (1 type I, 1 type II and 4 type III) and 3 with mannosidosis. Sanfilippo B was
      not only the most frequent type III MPS but also the most frequent MPS identified
      in our study. Sphingolipidoses and other lysosomal disorders were diagnosed in 47
      cases and non-lysosomal disorders in 19 cases. In our experience Gaucher disease,
      Sanfilippo B and Hunter syndrome are the most frequent lysosomal disorders in
      Greece accounting for 23.4%, 17.0% and 7.6% respectively of all diagnosed cases.
      13% of the patients originated from Thessaly including 5/16 Sanfilippo B, 2/3
      Morquio B, 2/3 Maroteaux-Lamy, 2/6 Metachromatic leukodystrophy and 2/12 Gaucher
      type 1.

PMID- 7794560
TI  - Seckel syndrome in a family with three affected children and hematological
      manifestations associated with chromosome instability.
AB  - In the present communication we report on a family with three children affected
      by Seckel-syndrome with mental deficiency, microcephaly, micrognathia and severe
      growth deficiency. All patients had chromosome instability, which was employed
      for the prenatal diagnosis of a fourth fetus suspected as a potential Seckel
      syndrome patient, and one of them had additional hematological disorders. As this
      condition has been previously characterized as a Seckel syndrome subgroup we
      report our data concerning this distinct entity.

PMID- 7794562
TI  - Cytogenetics of the tissue involved in neural tube defects.
AB  - Cytogenetic techniques were used to study the tissue involved in neural tube
      defects. Eighteen patients have been evaluated and no specific alterations have
      been detected. We conclude that, whatever are the mechanisms that lead to neural
      tube defect, their origins must be searched for at the molecular level.

PMID- 7794563
TI  - Interstitial deletion of the short arm of chromosome 8: report of a patient and
      review of the literature.
AB  - We report a mentally retarded girl with minimal dysmorphic signs. Cytogenetic
      examination showed an interstitial deletion of chromosome 8: 46, XX,
      del(8)(p21.2p22). This deletion has not been reported before. We compare the
      patient with the literature data.

PMID- 7794564
TI  - Characteristic facial dysmorphism, arachnodactyly and mental retardation: another
      case.

PMID- 7794565
TI  - A lethal, unclassifiable form of micromelic dwarfism with posterior cleft palate,
      multiple cervicothoracal vertebral anomalies and iliac hypoplasia.

PMID- 7794566
TI  - Hydrocephalus with features of VATER.

PMID- 7794567
TI  - Conformationally defined cyclohexyl carnitine analogs.
AB  - Three diastereoisomers of racemic (3-carboxy-2-hydroxy-1
      cyclohexyl)trimethylammonium chloride [C10H20NO3+.Cl-; (1S,2S,3S) (2), (1R,2S,3S)
      (3) and (1S,2R,3S) (4)] were designed as rigid analogs for different low-energy
      conformational states of carnitine [(1), (3-carboxy-2-hydroxy-1
      propyl)trimethylammonium chloride]. Structures (2)-(4) all assume a chair
      conformation in the solid state, in which the bulky trimethylammonio group
      occupies the equatorial position. As such, the orientations about C2-C3 in (2),
      (3) and (4) are all essentially the same as that found for (1) in the solid state
      (torsion angles for C1-C2-C3-N1 near 180 degrees), while the orientations about
      C1-C2 in (2)-(4) are such that each diastereoisomer contains a different one of
      the three possible low-energy staggered conformations predicted for (1) in
      solution. Comparisons between (1) and (2)-(4) in the solid state revealed that
      diastereoisomers (2), (3) and (4) provide rigid models for the major low-energy
      conformations of carnitine.

PMID- 7794568
TI  - Two related potent antiviral compounds: 3-bromo-N-butyl-4-butylamino-1,8
      naphthalenedicarboximide (1) and 4-amino-3-bromo-N-butyl-1,8
      naphthalenedicarboximide (2).
AB  - The crystal structures of two brominated derivatives of 4-amino-N-butyl-1,8
      naphthalenedicarboximide [alternative systematic names: 8-bromo-2-butyl-7
      butylamino-1H-benzo[de]isoquinoline-1,3(2H)-dione, C20H23BrN2O2, and 7-amino-8
      bromo-2-butyl-1H-benzo[de]isoquinoline-1,3(2H)-dione, C16H15BrN2O2] are reported.
      The N-butyl groups, which are common to both compounds, are perpendicular to the
      plane of the naphthalenedicarboximide ring system. The butylamino group at
      position 4 in (1) is in the plane of the naphthalenedicarboximide ring, with the
      butyl group oriented towards the peri position of the naphthalenedicarboximide
      ring. This arrangement results in an opening of the (ring C)-N-(butyl C) angle.

PMID- 7794569
TI  - (Z)-5-(2-thienylmethylene)-2,4-imidazolidinedione.
AB  - The major product formed in the thermolysis of 5-diazouracil in thiophene at 423
      433 K has been identified as the unexpected compound (Z)-5-(2-thienylmethylene)
      2,4-imidazolidinedione, C8H6N2O2S, by X-ray analysis. The molecule is a hydantoin
      derivative with a thienylmethylene group substituted at the 5-position. The
      structure is disordered in that the thiophene ring exists in two orientations
      which are related by an approximate 180 degree rotation about the C(6)-C(7) bond.
      All of the N and O atoms are involved in an intermolecular hydrogen-bonding
      network via N-H...O interactions. This network consists of an infinite chain
      along the a-axis direction and a cyclic trimer arrangement which branches from
      this chain. The molecules are arranged in the unit cell in pleated sheets which
      are approximately perpendicular to the c axis.

PMID- 7794570
TI  - Magnetic resonance imaging compared to echocardiography to assess left
      ventricular mass in the hypertensive patient.
AB  - Echocardiography (ECHO) is useful to document changes in left ventricular mass
      (LVM) in groups of patients, but may be too variable for use in the individual
      patient. Magnetic resonance imaging (MRI) may be a more precise and reliable
      method to quantify the mass of the left ventricule. This study reports the
      accuracy, precision, and reliability of LVM estimates by MRI as compared to data
      obtained by ECHO in hypertensive patients. Accuracy referred to the comparison of
      LVM by MRI to anatomical LVM determined by autopsy. Precision was examined using
      34 duplicate MRI images and by blindly reading 24 duplicate M-mode strips.
      Reliability was assessed by MRI in four subjects over 2 months, and by ECHO in 22
      hypertensive patients over 2 weeks. Agreement between MRI and ECHO estimates of
      LVM was determined in the same 17 hypertensive patients using linear regression.
      MRI LVM estimates were within 17.5 g (95% CI) of the true LVM. The linear
      agreement between MRI and ECHO estimates of LVM could be described by the
      equation MRI = 0.61 x ECHO + 49.57 (r = 0.63, P < .01). The precision of LVM by
      MRI (11 g) was over twice that observed with ECHO (26 g). The reliability of MRI
      LVM estimates was more consistent (+/- 8 g) than that for ECHO (+/- 49 g). MRI
      appears to be a more precise and reliable method for measuring LVM, and would be
      more suitable than ECHO for the clinical evaluation of the individual patient.

PMID- 7794571
TI  - Progressive improvement in the structure of resistance arteries of hypertensive
      patients after 2 years of treatment with an angiotensin I-converting enzyme
      inhibitor. Comparison with effects of a beta-blocker.
AB  - To investigate the effects of antihypertensive drugs on resistance artery
      structure, 17 essential hypertensive patients were randomly assigned to be
      treated with an angiotensin I-converting enzyme inhibitor, cilazapril, or a beta
      blocker, atenolol, for 2 years. Blood pressure was well controlled throughout the
      2 years. Before starting treatment, at the end of the first year and at the end
      of the second year, patients were subjected to gluteal subcutaneous fat biopsies,
      from which resistance-size arteries were dissected to be studied. The media width
      to lumen diameter ratio of arteries from patients in the cilazapril group was 7.5
      +/- 0.3% before starting treatment, and decreased significantly (P < .05) to 6.3
      +/- 0.2% at the end of the first year, and to 5.8 +/- 0.2% at the end of the
      second year, at which time it was not different from that of arteries from
      normotensive subjects (5.2 +/- 0.2%). In patients treated with atenolol,
      resistance arteries exhibited a media-to-lumen ratio of 8.0 +/- 0.6% before
      treatment, 8.1 +/- 0.5% after 1 year of treatment, and 7.9 +/- 0.3% at the end of
      the second year of treatment, all significantly higher (P < .01) than that of
      arteries from normotensive subjects. Thus, treatment for 2 years with the
      angiotensin I-converting enzyme inhibitor cilazapril resulted in progressive
      normalization of the structure (media-to-lumen ratio) of gluteal subcutaneous fat
      resistance arteries of essential hypertensive patients, whereas there was no
      change in patients treated with the beta-blocker atenolol.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7794572
TI  - Comparison of intrabrachial and finger blood pressure in healthy elderly
      volunteers.
AB  - This study was performed to compare continuous Finapres (FIN) and intrabrachial
      (IAP) blood pressure in healthy elderly volunteers. Fifteen elderly subjects (age
      71 to 83) without cardiovascular disease and an intraarterial mean (range)
      systolic and diastolic blood pressure of 162 (122 to 195) and 73 (62 to 88) mm
      Hg, respectively, participated in the study. A 10-min head-up tilt, 10 min active
      standing, a 15-sec Valsalva, and a 5-min mental arithmetic were performed in
      random order. Beat-to-beat values of systolic, diastolic, and mean arterial
      pressure were analyzed. At rest, FIN underestimated IAP by 16.8 +/- 2.6 (SE),
      10.8 +/- 1.5, and 17.5 +/- 1.6 mm Hg for systolic, diastolic, and mean arterial
      blood pressure, respectively (P < .05). During head-up tilt, FIN overestimated
      the intraarterial systolic blood pressure response by 7.2 +/- 1.6 (SE) mm Hg (P <
      .05). Group-averaged changes in diastolic and mean arterial IAP were followed
      closely by FIN. During standing, Finapres closely followed intraarterial
      diastolic and mean arterial pressure but the increase in systolic blood pressure
      was higher at the finger as compared to intrabrachial recordings, resembling the
      results of head-up tilt. During the Valsalva maneuver, maximal responses in
      systolic, diastolic, and mean arterial pressure were underestimated by FIN by
      12.1 +/- 3.3 (SE), 6.8 +/- 2.7, and 7.1 +/- 1.7 mm Hg, respectively (P < .05 for
      all parameters). During mental arithmetic, FIN underestimated the intraarterial
      systolic blood pressure response by 6.1 +/- 2.7 (SE) mm Hg (P < .05), while
      diastolic and mean arterial pressure responses were followed correctly by FIN. It
      is concluded that apart from systolic blood pressure, FIN closely follows
      intraarterial blood pressure responses for the orthostatic maneuvers and mental
      arithmetic. During Valsalva, the rapid changes in blood pressure were followed in
      direction but not in magnitude.

PMID- 7794573
TI  - Ambulatory blood pressure in mild hypertensive women taking oral contraceptives.
      A case-control study.
AB  - The aim of the present study was to compare the ambulatory blood pressure levels
      in mild (stage 1) hypertensive women using oral contraceptives and respective
      values in nonusers of oral contraceptives with similar office blood pressure. The
      study group consisted of 24 mild hypertensive patients taking low dosage estrogen
      progestogen oral contraceptives. Seventy women of similar age and body mass index
      who had never used oral contraceptives served as a control group. Both daytime
      and nighttime systolic blood pressure values were significantly higher in oral
      contraceptive users. There was an average 8.3 mm Hg difference (95% confidence
      interval, 3.0 to 13.7 mm Hg; P = .003) for the daytime and 6.1 mm Hg difference
      (95% confidence interval, 0.4 to 11.8 mm Hg; P = .04) for the nighttime. No
      significant differences in ambulatory diastolic blood pressure between the two
      groups were found. These data provide evidence that hypertensive oral
      contraceptive users with the same office blood pressure as that in hypertensive
      noncontraceptive users have a significantly higher ambulatory systolic blood
      pressure. Our results support the opinion that alternative methods of
      contraception should be considered for hypertensive women in place of oral
      contraceptives.

PMID- 7794574
TI  - Metoprolol minimizes nighttime blood pressure dip in hypertensive black males.
AB  - Twelve hypertensive black males completed the study, which was conducted to
      evaluate the effect of metoprolol on 24-h ambulatory blood pressure (ABP). Study
      participants took 50 mg to 100 mg metoprolol twice daily for a minimum of 3
      weeks. Metoprolol had no significant effect on blood pressure (147/90 +/- 11/8 mm
      Hg v 151/88 +/- 16/8 mm Hg, baseline v treated, respectively) in spite of causing
      significant reductions in heart rate (87 +/- 9 beats/min v 69 +/- 7 beats/min, P
      < .001). Only one subject had a > or = 10 mm Hg decrease in 24-h diastolic blood
      pressure. The nighttime fall in blood pressure was minimized by metoprolol and
      clinically significant increases in daytime or nighttime blood pressure were
      noted in 58% of patients. Metoprolol therapy failed to lower blood pressure and
      eliminated the normal nighttime decline in blood pressure. Since the nighttime
      decline in blood pressure is thought to protect against target organ damage, it
      may be important to identify antihypertensive agents which preserve or enhance
      the nighttime blood pressure dip.

PMID- 7794575
TI  - Stimulation of aldosterone by ACTH in normal and hypertensive pregnancy.
AB  - The observation that plasma renin (PRC) is suppressed to a greater degree than
      aldosterone (Paldo) concentration in preeclampsia has led us to examine the role
      of nonangiotensin factors in the control of aldosterone release in pregnancy. The
      aim of this study was to determine whether the aldosterone response to
      adrenocorticotrophic hormone (ACTH) was altered in normal or preeclamptic
      pregnancy. After 4 days of a 100 mmol/day sodium diet, serum cortisol, PRC, and
      Paldo were measured every 20 min during an incremental low-dose ACTH infusion
      (over 80 min) in 10 nonpregnant, nine normal pregnant, and nine preeclamptic
      women. Baseline PRC, Paldo, and cortisol were significantly higher in normal
      pregnant than in nonpregnant women (P < .05), but serum ACTH concentration was
      similar. Following ACTH infusion there was significant stimulation of cortisol in
      both groups (P < .001) and the maximum rise (963[824,1163] nmol/L, median
      [interquartile range]) was greater in pregnant than in nonpregnant women
      (507[402,837]), P < .01. Plasma aldosterone also rose significantly following
      ACTH in both groups (P < .01) and the maximum rise was also greater in normal
      pregnant (1186[828,2609] fmol/mL) than nonpregnant women (874[598,1065]), P =
      .05. These changes were not related to basal cortisol or aldosterone
      concentrations in either group. Baseline PRC was significantly lower in
      preeclamptic than in normal pregnant women (P < .05) but Paldo, serum ACTH, and
      cortisol concentrations did not differ significantly. Following ACTH there was
      significant stimulation of cortisol in both groups (P < .0001) and the maximum
      increment in preeclamptic women following ACTH infusion (807[708,1007] nmol/L)
      was similar to that of normal pregnant women.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794576
TI  - Insulin sensitivity, sympathetic activity, and cardiovascular reactivity in young
      men.
AB  - The present study was undertaken to examine the relationships between insulin
      sensitivity, blood pressure (BP), and cardiovascular reactivity, and to assess
      sympathetic nervous system influence. Insulin sensitivity (GDR/I; euglycemic
      glucose clamp technique) was related to BP and heart rate (HR) in different
      situations in 40 healthy young men: in the laboratory, during a mental arithmetic
      stress test, and during baseline conditions at home. GDR/I correlated with supine
      diastolic BP in the laboratory and with maximum diastolic BP during mental stress
      (r = -0.46, P = .003; r = -0.62, P = .0001, respectively), but not so strongly
      with diastolic BP measured at home (r = -0.29, P = .09). Diastolic BP during
      stress and body mass index were the only independent explanatory variables of
      GDR/I in multiple regression analysis (multiple R = 0.71, R2 = 0.50, P < .0001).
      GDR/I and systolic BP were not significantly correlated at any time. GDR/I
      correlated negatively with HR in the laboratory and with maximum HR during mental
      stress, but not with HR at home. Maximum plasma epinephrine during stress
      correlated with stress BP and HR (r = 0.53, P = .001; r = 0.70, P < .0001,
      respectively) and negatively with GDR/I (r = -0.36, P < .05). In the present
      study, GDR/I is related to diastolic but not to systolic BP, and more closely
      correlated to diastolic BP and HR measured during mental stress than to diastolic
      BP and HR during baseline conditions at home.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794577
TI  - The effect of enalapril with and without hydrochlorothiazide on insulin
      sensitivity and other metabolic abnormalities of hypertensive patients with
      NIDDM.
AB  - The effect of 20 mg of enalapril with and without 12.5 mg of hydrochlorothiazide
      on glucose metabolism insulin sensitivity and lipids was evaluated in
      hypertensive non-insulin-dependent diabetes. Ten mild to moderate hypertensive
      patients with non-insulin-dependent diabetes mellitus were treated for 8 weeks
      with 20 mg enalapril once a day, and then divided into two groups of 5 patients
      each for a second 8 weeks of treatment with enalapril alone or in combination
      with hydrochlorothiazide, 12.5 mg once a day. Blood pressure, fasting plasma
      glucose, lipids and insulin, glycosylated hemoglobin, and insulin sensitivity
      were measured at baseline and after 8 and 16 weeks. Results were analyzed by the
      ANOVA test for repeated measures and all values are given as mean +/- SD.
      Diastolic blood pressure decreased significantly after the first and second
      period of enalapril and after the combination of enalapril and
      hydrochlorothiazide. Glycosylated hemoglobin dropped significantly after the
      first and second period of enalapril monotherapy. Plasma triglycerides and
      fasting plasma insulin decreased significantly after the 16 weeks of enalapril.
      Insulin-mediated glucose uptake increased significantly after 8 and 16 weeks of
      monotherapy with enalapril. No significant difference was observed in any of the
      metabolic characteristics, including insulin sensitivity, between the values
      after 8 weeks of enalapril alone and the final values of the enalapril-treated
      and the enalapril/hydrochlorothiazide-treated groups. It is concluded that
      enalapril improves some of the metabolic parameters, including insulin
      sensitivity, of hypertensive diabetic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794578
TI  - Clinical efficacy of force titrated doses of diltiazem extended-release. A
      placebo controlled study.
AB  - Thirty patients with clinical and ambulatory essential hypertension were treated
      in a double-blind fashion with force titrated doses of placebo or diltiazem once
      daily (OD) extended-release (ER) 120, 240, 360, and 540 mg to characterize the
      full-dose range of the new formulation. An incremental dose-response effect was
      observed both in clinic and ambulatory blood pressure parameters. Doses of > or =
      240 mg significantly decreased clinic diastolic blood pressure, whereas systolic
      blood pressure was significantly lowered by the 540-mg dose. Moreover, compared
      with placebo, ambulatory blood pressure was significantly decreased by the 360-
      and 540-mg dose levels. Trough/peak ratios for systolic and diastolic blood
      pressures were 50% and higher at dose levels of 240 mg and above. Adverse
      reactions with diltiazem OD ER were generally mild and similar to those observed
      with placebo. The findings of this study indicate that the most favorable effects
      of diltiazem OD ER were observed in response to the 360- and 540-mg dose levels.
      The dose escalation forced titration study design appears to be a valuable tool
      in obtaining rigorous dose-response data of new antihypertensive agents.

PMID- 7794580
TI  - In situ hybridization shows increased endothelin-1 mRNA levels in endothelial
      cells of blood vessels of deoxycorticosterone acetate-salt hypertensive rats.
AB  - Endothelin-1 is a potent vasoconstrictor peptide produced in blood vessels and
      other tissues that may play an important role in the control of local blood flow
      and could be involved in the pathogenesis of hypertension. Our previous studies
      have documented increases in endothelin-1 peptide content and gene expression in
      mesenteric arteries and thoracic aorta of deoxycorticosterone acetate (DOCA)-salt
      hypertensive rats. Although changes in endothelin-1 were observed in the blood
      vessels of hypertensive rats, the exact cellular sites of these changes were not
      identified clearly. In the present study we investigated endothelin-1 gene
      expression in DOCA-salt hypertensive rats by in situ hybridization histochemistry
      using a high specific activity 35S-labeled complementary RNA probe. Robust
      increases in endothelin-1 mRNA levels were observed in both mesenteric blood
      vessels and aorta of DOCA-salt hypertensive rats as compared with the vessels
      from the uninephrectomized control rats. In both cases it was shown clearly that
      these increased endothelin-1 mRNA levels only originated in the endothelial cell
      layer, not in the underlying smooth muscle cells. Higher expression levels of
      endothelin-1 mRNA by the endothelial cells of DOCA-salt hypertensive rats may
      play an important role in vascular hypertrophy and in the maintenance of elevated
      blood pressure in this and perhaps other models of experimental hypertension.

PMID- 7794581
TI  - Lack of placebo effect on ambulatory blood pressure.
AB  - Several studies have reported that, at variance with clinic blood pressure,
      ambulatory blood pressure is not reduced by treatment with placebo. However, this
      evidence has usually been obtained in small groups of subjects and no data are
      available from a larger sample of patients. To address this issue we have
      analyzed data from 116 outpatients involved in placebo-controlled studies on
      antihypertensive treatment. The patients were studied before and at the end of a
      6- to 8-week period of placebo. In all patients, blood pressure was measured by
      sphygmomanometry and over the 24 h by automatic ambulatory monitoring.
      Administration of placebo was accompanied by a significant reduction in systolic
      and diastolic clinic blood pressure (-5.3 +/- 1.1 and -4.4 +/- 0.6 mm Hg,
      respectively; P < .01), but not in 24-h, daytime and nighttime blood pressure.
      Hourly systolic and diastolic blood pressure profiles were virtually
      superimposable in the two different periods, except for the first 4 h, in which
      systolic blood pressure was slightly but significantly lower during than before
      placebo (149.5 +/- 1.2 v 146.4 +/- 1.2 mm Hg; P < .05). These results provide a
      large database indicating that 24-h average blood pressure is not reduced by
      placebo, thus it is not necessary to include a placebo control group in
      antihypertensive drug studies in which ambulatory blood pressure monitoring is
      employed. A small placebo effect occurs, however, in the first hours of
      ambulatory monitoring. This may lead to a slight overestimation of the peak blood
      pressure effect of a drug and an underestimation of its trough-to-peak ratio if
      placebo correction of the data is not made or if the first part of ambulatory
      blood pressure monitoring is not excluded from data analysis.

PMID- 7794579
TI  - Alteration of prejunctional alpha 2-adrenergic autoinhibition in DOCA-salt
      hypertension.
AB  - The possible involvement of prejunctional alpha 2-adrenergic autoinhibition in
      hypertension is still controversial. The aim of this study was to determine the
      functional integrity of this regulatory mechanism in conscious DOCA-salt
      hypertensive rats, a model characterized by an increased sympathetic tone and
      reactivity. Basal and hemorrhage-induced increases in catecholamine and
      immunoreactive neuropeptide Y (NPY) levels were compared between control and
      yohimbine (alpha 2-adrenergic receptor antagonist) pretreated normotensive and
      DOCA-salt hypertensive rats. DOCA-salt hypertensive rats had higher basal
      norepinephrine levels (NE), as well as increased NE and epinephrine (EPI)
      responses to a 15-mL/kg hemorrhage as compared to control normotensive rats. In
      normotensive animals, yohimbine (0.5 mg/kg, intravenous [iv]) doubled plasma NE,
      EPI, and NPY levels in basal conditions and in response to the hemorrhage. In
      contrast, the same treatment had smaller or no effect on basal NE levels and on
      the hemorrhage-induced responses in DOCA-salt hypertensive rats, although basal
      EPI levels were increased in this group. These results therefore suggest a
      decreased function of the prejunctional alpha 2-adrenergic autoinhibitory
      mechanism at the level of sympathetic nerve terminals and adrenal medulla during
      sympathetic hyperactivity in DOCA-salt hypertension. This dysfunction could in
      part explain the hyperactivity and hyperreactivity of the sympathetic nervous
      system observed in this model, and thus contribute to the elevation of blood
      pressure in DOCA-salt hypertension.

PMID- 7794582
TI  - Enhancement of insulin sensitivity by troglitazone lowers blood pressure in
      diabetic hypertensives.
AB  - The association of hypertension with insulin resistance has been reported.
      Troglitazone (CS-045) is a newly developed antidiabetic agent that enhances
      insulin sensitivity. Its antidiabetic effects have been confirmed in diabetic
      animals and patients. The present study was performed to evaluate whether the
      amelioration of hyperinsulinemia by troglitazone lowers blood pressure in
      essential hypertensives. Troglitazone was administered orally to 18 outpatients
      with essential hypertension complicated by mild diabetes at a dose of 200 mg
      twice a day for 8 weeks. Blood pressure was decreased from 164 +/- 3/94 +/- 2 mm
      Hg to 146 +/- 3 (P < .001)/82 +/- 3 (P < .05) mm Hg at 8 weeks of the treatment
      period. Pulse rate did not change. Fasting plasma glucose changed from 159 +/- 10
      mg/dL to 144 +/- 14 mg/dL at 8 weeks (P < .05). Plasma insulin (IRI) levels
      changes from 9.1 +/- 1.2 microU/mL to 6.3 +/- 0.8 microU/mL at the endpoint of
      treatment (P < .1). Decrease in mean blood pressure from the control period to
      the endpoint of the treatment correlated significantly with decrease in IRI (r =
      0.59, P < .05). In summary, troglitazone treatment induces improvement in both
      glucose metabolism and blood pressure control in essential hypertensive patients
      with diabetes mellitus. These results suggest that insulin resistance or plasma
      insulin level plays a role in the pathogenesis of essential hypertension.

PMID- 7794583
TI  - Maternal environment defines blood pressure and its response to troleandomycin in
      spontaneously hypertensive rats.
AB  - Relationship between family-3A cytochrome P-450-dependent (troleandomycin
      inhibitable) and maternal environmental-dependent systolic blood pressure (SBP)
      was investigated in spontaneously hypertensive rats (SHR). Adult SHR nursed by
      foster or natural SHR mothers had indistinguishable SBP. Troleandomycin reduced
      50% of Wistar-Kyoto (WKY)-SHR strain difference in SBP. SHR having WKY foster
      mothers had SBP similar to troleandomycin-reduced SHR levels, which was
      unaffected by troleandomycin. The two components of SBP elevation appear
      identical. Because observations of others demonstrated that WKY fostered to SHR
      show no SBP increase, the maternally dependent/troleandomycin-sensitive component
      of SBP elevation may reflect epistatic interaction between genes determining
      maternal differences and offspring sensitivity, respectively.

PMID- 7794584
TI  - Calcium channel blockers. Is it time to split the lump?
AB  - Antihypertensive drug classes such as thiazide diuretics, angiotensin-converting
      enzyme inhibitors, beta-adrenergic blocking agents, peripheral alpha 1
      antagonists, and central alpha 2-agonists all describe therapeutic agents that
      are quite similar to each other and strikingly different from members of the
      other classes. A glaring exception is the rubric "calcium channel blocker," under
      which strikingly dissimilar drugs have been lumped. Although the
      phenylalkylamines (verapamil and gallapamil) and benzothiazepines (diltiazem and
      TA3090) bind at different receptors on the alpha 1 component of the calcium
      channel, they are reasonably similar in their clinical pharmacology. For example,
      both types of drugs slow the heart rate and there are intravenous preparations
      that are used to treat supraventricular tachycardia. The dihydropyridines
      (nifedipine and many others) bind to another receptor on the alpha 1 component,
      but have markedly different pharmacologic properties. For example, they tend to
      increase the heart rate, do not cause constipation, but are more likely to cause
      peripheral edema. I propose that we refer to this entire class of drugs as
      "calcium antagonists," that we continue to refer to verapamil, diltiazem, and
      similar drugs as "calcium channel blockers," but recognize the very different
      properties of nifedipine and like drugs by referring to them as dihydropyridines
      or DHPs.

PMID- 7794585
TI  - Expert comments on the JNC V consensus guidelines.

PMID- 7794586
TI  - The Report of Fifth Joint National Committee on the Detection, Evaluation, and
      Treatment of High Blood Pressure: a "loose" constructionist view.

PMID- 7794587
TI  - High fructose diet and blood pressure.

PMID- 7794588
TI  - Community mental health care for former hospital in-patients. Predicting costs
      from needs and diagnoses.
AB  - BACKGROUND: In the UK the replacement of long-term in-patient care with community
      based support has been part of central government health policy for many years.
      One of the challenges of implementing such a policy is the prediction of support
      and service needs in the community and the associated costs. METHOD: Using
      research data from north London analyses were undertaken to examine the
      associations between service use and costs in the community and the
      characteristics of hospital in-patients. RESULTS: Although clinical diagnosis was
      not a useful predictor of either service utilisation or costs, more than a third
      of the variation in community care costs could be explained by symptoms,
      behaviour and personal characteristics at least one year earlier.

PMID- 7794589
TI  - The social costs of anxiety disorders.
AB  - BACKGROUND: The social costs of anxiety disorders, which afflict a substantial
      proportion of the general population in the United States, are considered.
      METHOD: Data from the National Institute of Mental Health (NIMH) Epidemiological
      Catchment Area Program were analysed. RESULTS: Over 6% of men and 13% of women in
      the sample of 18,571 had suffered from a DSM-III anxiety disorder in the past six
      months. Nearly 30% of those with panic disorder had used the general medical
      system for emotional, alcohol or drug-related problems in the six months prior to
      the interview. Those with anxiety disorders were also more likely to seek help
      from emergency rooms and from the specialised mental health system. Men with
      panic disorder, phobias or obsessive-compulsive disorder in the previous six
      months are more likely to be chronically unemployed and to receive disability or
      welfare. DISCUSSION: Once correctly diagnosed there are safe and effective
      psychopharmacologic and behavioural treatments for the anxiety disorders.
      Nevertheless the burden of anxiety disorders extends beyond the direct costs of
      treatment to the indirect costs of impaired social functioning.

PMID- 7794591
TI  - The economic consequences of not treating depression.
AB  - BACKGROUND: A conceptual framework is described for a broad cost-benefit
      evaluation of improved financial access to treatment of untreated affective
      disorders. METHOD: The analysis provides an estimate of the value of resources
      needed to provide improved access to treatment, and it compares these resources
      to the value of resources the improved access to treatment might save. RESULTS:
      The cost-benefit analyses based on recent cost of mental illness studies provide
      some evidence that appropriately treating people with untreated affective
      disorders is cost-beneficial. CONCLUSION: Patients, providers and buyers of
      health care should be further encouraged to pay more attention and to commit more
      financial resources to the treatment of affective disorders.

PMID- 7794590
TI  - Costs and offset effect in panic disorders.
AB  - BACKGROUND: The study is aimed at assessing the costs before and after the
      diagnosis and the provision of effective treatment for panic disorder (PD), and
      the offset effect related to the psychiatric encounter. METHOD: A 24-month
      prepost design was used to collect data on clinical status and health care
      services utilisation in a natural environment. The 61 PD patients' assessment
      included the SCID-UP, ratings on general functioning, improvement, severity of
      symptoms and level of disability. All health care services used and lost workdays
      were recorded. RESULTS: Both sociodemographic characteristics and the outcome
      show that this was a standard group of PD patients, who received effective
      treatment for their condition. The total direct costs of health care use during
      the previous year and the year after the diagnosis were, respectively, US$ 29,158
      and US$ 46,256. The indirect costs of lost productivity were US$ 65,643 in period
      I and US$ 13,883 in period II. CONCLUSIONS: A strong offset effect (94%) has been
      found in this study, significantly greater than the one described for psychiatric
      disorders as a whole. The costs of nondiagnosis are usually overlooked when
      estimating the global costs of PD. Methods for improving early detection of PD
      may substantially reduce the costs incurred before diagnosis.

PMID- 7794592
TI  - The economic burden of affective disorders.
AB  - BACKGROUND: This paper summarises the methods and sources of data used to
      estimate costs of affective disorders and presents the results. METHOD: A timing
      model employing regression analysis was developed to estimate morbidity costs.
      This model measures the lifetime effect on current income of individuals with
      affective disorders, taking into account the timing of onset and the duration of
      these disorders. RESULTS: Affective disorders imposed an estimated US$ 20.8
      billion burden in 1985 and US$ 30.4 billion in 1990 in the US. Affective
      disorders represent 21% of the costs of all mental illnesses. Direct treatment
      costs comprised 58.4% of the total in 1985; morbidity costs, 8.1%; mortality
      costs, the present value of future earnings lost due to premature mortality,
      28.9%, based on a 6% discount rate; and other related costs, including the cost
      of crime, lost productivity due to incarceration, and caregiver services, 4.6%.
      Private sources account for 49% of the total direct expenditures for treatment of
      persons with affective disorders; state and local funds, 26%; and federal funds,
      25%. CONCLUSION: In light of the high burden of affective disorders on societal
      resources, more attention should be directed at comprehensive, research-based
      strategies to reduce the prevalence of these disorders in the United States.

PMID- 7794593
TI  - Cost containment and mental health outcomes: experiences from US studies.
AB  - BACKGROUND: Cost containment mechanisms, such as prepayment, are being considered
      or implemented in the US and elsewhere, but there have been few studies of the
      effects of such mechanisms on quality or outcomes of care for individuals with
      serious psychiatric disorders. METHOD: Key results from US studies on cost
      containment and their implications are reviewed. RESULTS: Cost savings in out
      patient mental health care can be achieved through increasing the share of costs
      paid by the covered individual or through prepayment, but individuals with the
      greatest psychological distress or poor people may achieve worse outcomes under
      greater cost containment. Quality of care may be poorer under some forms of
      prepayment than under fee-for-service care, yet a national prospective payment
      mechanism for depressed elderly in-patients was not associated with a marked drop
      in quality or outcomes of care among those admitted. CONCLUSIONS: Prepayment,
      relative to fee-for-service is not always associated with lower outcomes or
      quality of care for affective disorders. Under cost containment, quality and
      outcomes of care, especially for the sick poor, should be monitored to identify
      adverse consequences.

PMID- 7794594
TI  - Costs and benefits of hospital and day treatment with community care of affective
      and schizophrenic disorders.
AB  - BACKGROUND: A randomised controlled trial of day treatment with community care
      for patients with schizophrenic and affective disorders, referred for in-patient
      psychiatric treatment, was conducted to evaluate patterns of treatment and the
      course of illness with its psychosocial consequences over a period of two years.
      METHOD: Seventy patients, of whom 34 had affective and 36 had schizophrenic
      disorder, were assigned to the experimental condition (day treatment with
      ambulatory and domiciliary care), and 33 patients, of whom 16 had affective and
      17 had schizophrenic disorder, were assigned to the control condition of standard
      clinical care. RESULTS: Day treatment with community care was feasible for 40.6%
      of the affective patients and 33.3% of the schizophrenic patients. The direct
      treatment costs of both disorders, based on numbers of in- and day-patient days
      and out-patient contacts over two years, appeared more or less the same. Patients
      benefited equally from day treatment as from in-patient treatment, although there
      were some gains in self-care and in functioning in the household among
      experimentals. Although schizophrenics were socioeconomically worse off, and also
      suffered from more (severe) symptoms and social disabilities than the affective
      patients at entry into the study, they were similar at two years. This finding is
      unexpected, compared with other follow-up studies. Extra cost for patients and
      families were not observed. Patients and their families in the experimental
      condition were significantly more satisfied with the treatment. Experimental
      patients spent much more time at home during admission, remained much less time
      in secluded wards, and were more compliant with treatment. CONCLUSIONS: Day
      treatment could be considered a cost-effective alternative to in-patient
      treatment.

PMID- 7794595
TI  - The economics of depression in primary care. Department of Health initiatives.
AB  - BACKGROUND: Most mental illness is treated in primary and not secondary care
      settings, with depression and anxiety the commonest conditions encountered.
      METHOD: The paper describes on-going Department of Health initiatives to optimise
      the primary care of common mental illnesses such as depression. DISCUSSION:
      Primary care attenders with depression are often higher consumers of general
      health care than non-depressed attenders. Further data will become available soon
      from these ongoing studies to inform the debate on the optimal use of available
      resources in primary care. There is a particular need to evaluate non
      pharmacological interventions in primary care.

PMID- 7794596
TI  - Economics of anxiety and depression. Introduction.

PMID- 7794597
TI  - [Modification of the pharmacokinetics of some antibiotics by oral administration
      with an L-(-)verbenone beta-cyclodextrin complex].
AB  - With the aim to evaluate the effect of L (-) Verbenone on the pharmacokinetic of
      some antibiotics, a compound has been prepared with beta cyclodextrin, allowing
      the administration per os. Pharmacological studies have been carried out using
      erythromycin and ampicillin, determining their kinetics in the hepatic and lung
      tissues after administration to albino mice. The results show that L (-)
      Verbenone modifies the distribution of the antibiotics used; it increases their
      concentration at lung level while the concentration at hepatic level remains
      unchanged.

PMID- 7794598
TI  - Development of a thin membrane glucose sensor using beta-type crystalline chitin
      for implantable biosensor.
AB  - A biocompatible thin membrane glucose sensor has been developed using beta-type
      crystalline chitin as a supporting material for the purpose of implantable
      biosensor. Gold electrode was formed by vapor deposition of the surface of
      glucose oxidase-immobilized beta-chitin membrane. The sensor showed rapid
      responses to glucose and H2O2 (< 45 s in batch operation), and addition of 2,6
      dichlorophenolindophenol as a mediator caused expansion of the measuring range.
      To investigate the possible uses for the implantable, the sensor sterilization
      and toxicity were studied. Sterilization with ethylene oxide was achieved by
      exposing samples, and a decrease in activity was permissible for measurements of
      body fluid. From the results of the toxicity assay using mouse fibroblast cells,
      beta-chitin sensor, constructed with chitin, glucose oxidase and gold electrode,
      showed no particular toxicity.

PMID- 7794599
TI  - Optimizing antibody production in batch hybridoma cell culture.
AB  - Optimizing productivity by hybridoma cells relies partly on developing suitable
      methods for screening and selection of high producing cultures and on
      understanding regulation of antibody production. In this study, the behavior of
      hybridoma cells in batch culture was investigated using flow cytometry, and a
      simple model for antibody production was used to explain production data obtained
      from these cultures. Surface antibody fluorescence values were found to closely
      follow the decreasing trend of specific antibody secretion rate over the course
      of several batch cultures. Therefore, for the hybridoma cell lines studied here
      (ATCC HB124 and TIB138), surface immunofluorescence levels can be used to select
      high producing cells as well as to monitor culture productivity. Surface and
      intracellular antibody fluorescence values were also found to be correlated for
      cells exhibiting a bimodal distribution with respect to intracellular antibody
      content. The population of cells containing a bimodal distribution with respect
      to intracellular antibody content. The population of cells containing lower
      levels of intracellular antibody was determined to secrete significantly less
      antibody than the population possessing high intracellular antibody
      concentrations. Factors which influence antibody production rates and possible
      strategies for optimizing monoclonal antibody yield are discussed.

PMID- 7794600
TI  - Transgenic rabbits as bioreactors for the production of human growth hormone.
AB  - Gene farming is one of the most promising areas in modern biotechnology. To assay
      the potential usefulness of transgenic rabbits as bioreactors, one call embryos
      were microinjected with a chimeric gene comprising 5' sequences from mouse whey
      acidic protein gene (mWAP) linked to the human growth hormone (hGH) gene.
      Transgenic animals were obtained and the presence of the foreign protein was
      detected in the milk and serum of these animals at levels of up to 50 micrograms
      ml-1 and 0.6 ng ml-1, respectively. Founder transgenics were able to transmit the
      microinjected gene to the first filial generation in a Mendelian fashion. These
      results showed that transgenic rabbits could constitute a suitable system for the
      rapid production of recombinant proteins in the milk of lactating females.

PMID- 7794601
TI  - CT of small-bowel neoplasms.
AB  - The diagnosis of neoplasms of the small intestine remains a difficult challenge
      owing to their nonspecific clinical presentation. CT is an efficient and
      contributive tool in their diagnosis and preoperative staging. Enabled by CT, the
      evaluation of the intramural and extramural portions of such tumors complements
      the mucosal analysis allowed by barium examination. Strict technical rules should
      be applied to minimize pitfalls mainly resulting from insufficient bowel
      opacification. Although characteristic appearances are rare, typical CT findings
      may suggest a specific diagnosis where lipomas and carcinoid tumors are
      concerned.

PMID- 7794602
TI  - CT for the evaluation of carcinomas in the colon and rectum.
AB  - The role of conventional CT in assessing patients with colorectal tumors is well
      established. The low accuracy of CT for identifying early stages of primary
      colorectal cancers prevents the routine use of CT for preoperative staging.
      Nevertheless, CT is useful in examining patients suspected of having extensive
      disease, in deciding whether a patient will benefit from preoperative radiation,
      in designing radiation ports, and in detecting complications related to the
      neoplasm. For recurrent colorectal neoplasm, CT has the premier role. CT
      surpasses colonoscopy in detecting early masslike tumor recurrence at the
      anastomotic site because of its extrinsic component, and CT and MRI are the only
      methods that can fully evaluate cases of total abdominoperineal resection. After
      total abdominoperineal resection, however, CT cannot determine with certainty
      that a soft tissue density in the surgical bed represents recurrent tumor. In
      patients with colorectal neoplasms, preliminary results with multiplanar and
      three-dimensional reconstructions of helical CT images are promising, but their
      role needs further investigation.

PMID- 7794603
TI  - Role of CT in evaluating patients with small-bowel obstruction.
AB  - The accurate and rapid diagnosis of acute small-bowel obstruction has troubled
      surgeons and radiologists for more than a century. With the advent of CT, solving
      the problem is now a possibility. CT can accurately diagnose obstruction,
      determine the likely cause and location, and even suggest whether there is
      associated bowel ischemia or strangulation.

PMID- 7794604
TI  - CT in the early detection of strangulation in intestinal obstruction.
AB  - The role of CT in evaluating the gastrointestinal tract has increased recently
      because CT demonstrates pathological conditions involving the bowels, mesenteric
      vessels, and peritoneal cavity well. In patients who have an intestinal
      obstruction, the observation of both bowel loop configuration and mesenteric
      vessels on CT is the key to identifying the site and cause of obstruction and
      determining the absence or presence of intestinal strangulation. Although many
      clinical and radiological findings reported in the literature are not seen in the
      early stages of intestinal strangulation, CT might assist in its early detection.
      This article reviews the clinical, pathophysiological, and radiological aspects
      of strangulating obstruction with emphasis on the role of CT in its early
      diagnosis.

PMID- 7794606
TI  - CT of the colon in frail elderly patients.
AB  - CT is presented as an alternative to barium enema examination for the
      investigation of the colon in frail elderly patients. Carcinomas can be detected
      reliably and the investigation is better accepted by patients and staff alike.
      Furthermore, extracolonic lesions are shown. Obviously small polyps are missed,
      but such lesions are less relevant in older patients. The CT technique is
      described, and some of the initial difficulties encountered during the adoption
      of this policy are discussed.

PMID- 7794605
TI  - Role of CT in the acute nontraumatic abdomen.
AB  - The diagnostic workup of the acute abdomen always begins with a precise clinical
      history, a complete physical examination, and careful reading of plain films.
      Commonly performed additional imaging studies include contrast examination and,
      more recently, ultrasound. CT offers the advantage of allowing a comprehensive
      diagnostic evaluation of both solid and hollow viscera in neoplastic as well as
      in inflammatory and vascular disorders.

PMID- 7794607
TI  - CT of blunt trauma to the bowel and mesentery.
AB  - Injuries to the bowel and mesentery are found in approximately 5% of all patients
      undergoing laparotomy after blunt abdominal trauma. Bowel and mesenteric injuries
      are often subtle and difficult to diagnose, and a delay in the diagnosis is
      associated with increased mortality and morbidity. CT is the best imaging method
      for diagnosing injuries to the bowel and mesentery. With meticulous scanning
      techniques, most significant bowel and mesenteric injuries can be reliably
      identified with CT preoperatively, and associated injuries to other abdominal
      viscera can be confirmed.

PMID- 7794608
TI  - CT of inflammatory disease of the colon.
AB  - CT plays an important role in the evaluation of patients with suspected colonic
      inflammation. High-resolution, thin-section imaging of the gastrointestinal tract
      allows assessment of both the intraluminal and extraluminal components of colonic
      disease, thereby enabling radiologists to detect and stage colonic pathology
      accurately. In addition, CT can be used to guide percutaneous drainage of abscess
      collections, often obviating the need for surgical intervention. This article
      describes CT techniques for diagnosing inflammatory diseases of the colon as well
      as the typical CT appearances.

PMID- 7794609
TI  - Rehospitalization and growth of infants with bronchopulmonary dysplasia: a
      matched control study.
AB  - OBJECTIVE: To determine the risk of hospitalization and the growth during the
      first year of life in infants with bronchopulmonary dysplasia (BPD) and
      birthweight matched controls. METHODOLOGY: The study population consists of 78
      infants of 26 to 33 weeks gestation with BPD of whom 20 were discharged on home
      oxygen therapy. The 78 control infants were matched with the study infants for
      broad based birthweight categories. Infants were reviewed at 4, 8 and 12 months
      corrected for prematurity at which time the history of rehospitalization was
      recorded and growth parameters were measured. RESULTS: Infants with BPD were
      found to have a higher overall rate of rehospitalization (58 vs 35%, relative
      risk (RR) 1.7, 95% confidence interval (Cl) 1.2-2.4) and were more likely to be
      readmitted for respiratory illnesses (39 vs 20%, RR 1.9, 95% Cl 1.1-3.2) and for
      poor growth (14 vs 1%, RR 14, 95% Cl 1.7-82) than the control group. Many
      infants, both study and control, remained below the 10th percentile at 1 year of
      age. More BPD infants were below the 10th percentile in weight at the 4 month
      visit than the control infants (30 vs 15%, P = 0.034). This difference was
      neither present at subsequent visits nor in the other major growth parameters.
      The 20 BPD infants who were on home oxygen therapy were more frequently
      hospitalized for concerns with failure to thrive (30 vs 9%, RR 3.3, 95% Cl 1.2
      8.9) than the remaining 58 BPD infants. No significant differences were detected
      in the overall rate of rehospitalization. Poor growth at the corrected age of 1
      year was similar in the two subgroups of infants. CONCLUSIONS: BPD infants are at
      increased for risk rehospitalization during the first year of life. While many
      infants with BPD have growth failure, it is suggested that the provision of
      appropriate supplemental oxygen at home may result in those infants having
      similar growth patterns when compared to birthweight matched preterm infants
      without BPD.

PMID- 7794610
TI  - The prevalence of respiratory symptoms in South Australian preschool children. I.
      Geographic location.
AB  - OBJECTIVE: This study was designed to ascertain the prevalence of respiratory
      symptoms in South Australian preschool children and to investigate the
      relationship between prevalence rates and geographic location. METHODOLOGY: Data
      were collected from 14,124 families with a child aged 4 years 3 months to 5 years
      of age. This sample represents 73% of the State preschool population of that age.
      At the time of a routine preschool health check, parents completed a
      questionnaire regarding their child's respiratory health and place of residence
      (postcode). RESULTS: Results showed that the prevalence rates were as follows:
      (i) ever having chest wheezing 38.6%; (ii) chest wheezing within the preceding 12
      months 25.2%; (iii) ever having asthma 22.5%; (iv) ever having a dry cough at
      night 33.7%; (v) ever having bronchitis or cough with sputum 55.3%; (vi) ever
      having hay fever 29.7%; (vii) prone to excessive head colds 32.6%; and (viii)
      ever having eczema 18.8%. Over 38% of parents claimed that winter was the season
      for the most frequent or severe attacks of wheezing and 31.7% claimed no seasonal
      difference. Winter was the season most associated with episodes of bronchitis
      (50.9%), with no seasonal difference in episodes for 29.8% of children.
      Prevalence rates differed by geographic location within South Australia and
      within the Adelaide metropolitan region. CONCLUSION: This population-based survey
      shows that over 22% of South Australian 4 to 5 year old preschool children have
      had (or continue to have) asthma. The study also documented the geographic
      distribution of respiratory symptom prevalence within South Australia.

PMID- 7794611
TI  - The prevalence of respiratory symptoms in South Australian preschool children.
      II. Factors associated with indoor air quality.
AB  - OBJECTIVE: This study investigated the relationship between indoor air quality
      and the prevalence of respiratory symptoms in South Australian preschool
      children. METHODOLOGY: Data were collected from 14,124 families with a child aged
      4 years 3 months to 5 years of age. This sample represents 73% of the targeted
      State preschool population. At the time of a routine preschool health check,
      parents completed a questionnaire regarding: their child's respiratory health and
      place of residence (postcode), parental smoking, type of fuel used for cooking
      and heating and method used for home cooling. RESULTS: For preschool children
      residing in the greater Adelaide region, logistic regression analyses found that
      having a natural gas stove compared to an electric stove was significantly
      associated with increased prevalence rates for: (i) asthma (odds ratio [OR]
      1.24); (ii) wheezing in the preceding 12 months (OR 1.16); excessive colds (OR
      1.14); and hay fever (OR 1.13). The use of a liquid petroleum gas stove compared
      to an electric stove was not associated with any respiratory symptoms. The use of
      a flueless gas heater compared to other forms of heating was significantly
      associated with increased prevalence rates for dry cough (OR 1.26), ever having
      wheezed (OR 1.15) and wheezing in the preceding 12 months (OR 1.18). The use of a
      wood fire/heater compared to other forms of heating was significantly associated
      with a reduced prevalence rate for dry cough (OR 0.84) and ever having wheezed
      (OR 0.82). Parental smoking was significantly associated with increased
      prevalence rates for bronchitis (OR 1.21) and ever having wheezed (OR 1.24). The
      form of home cooling used was not associated with prevalence rates, after
      accounting for geographic location. Socio-economic status (postcode level) was
      not generally associated with prevalence rates. CONCLUSIONS: These results
      suggest that respiratory symptom prevalence is related to the fuel used for
      cooking and heating and parental smoking. Prospective investigation regarding
      indoor air quality and respiratory symptoms is required.

PMID- 7794612
TI  - Trends in the use of fundoplication in children with gastro-oesophageal reflux.
AB  - OBJECTIVE: To document changing trends in the indications for fundoplication in
      children with gastro-oesophageal reflux and to identify the main shortcomings and
      complications of the procedure. METHODOLOGY: Retrospective review of 405
      consecutive children undergoing fundoplication between 1978 and 1992 inclusive.
      RESULTS: Trends in the indications for fundoplication related to broadening of
      its use in those with severe neurological impairment and uncontrolled reflux, and
      to changes in the management of patients in the neonatal period. Complications
      included unwrapping with recurrence of reflux, hiatal hernia, adhesive small
      bowel obstruction, dumping syndrome, post-operative persistence of oesophageal
      stricture, excessively tight wrap and poor oesophageal clearance (mostly in
      oesophageal atresia patients). CONCLUSIONS: This study identified those patients
      most likely to develop complications following fundoplication. This may assist in
      the pre-operative assessment of the likely benefit of fundoplication in children
      who often have other complex problems.

PMID- 7794613
TI  - Efficacy of phototherapy for hyperbilirubinaemia in infants with the respiratory
      distress syndrome.
AB  - OBJECTIVE: To evaluate the efficacy of phototherapy for hyperbilirubinaemia in
      preterm infants with and without the respiratory distress syndrome (RDS).
      METHODOLOGY: Prospective cohort study of preterm infants cared for at Kandang
      Kerbau Hospital, Singapore: 170 with RDS and 477 without RDS, sepsis or other
      complications (control group) presenting with non-haemolytic hyperbilirubinaemia
      at about the same time were exposed to daylight phototherapy when bilirubin
      concentrations exceeded 255 mumol/L or 222 mumol/L if < 48 h of age. Bilirubin
      values were monitored 6-hourly during exposure, and daily for at least 2 days
      post-phototherapy. RESULTS: The infants were comparable in birthweight,
      gestational age, postnatal age, haemoglobin, haematocrit and bilirubin values, at
      start. The response to phototherapy of the infants with RDS was comparable to
      that of the well preterm infants; the duration of exposure was 50.1 +/- 1.6 (mean
      +/- s.e.m.) versus 50.1 +/- 1.4 h, 24-hour decline rate 25.71 +/- 1.29% versus
      26.32 +/- 0.65, and overall decline rate 0.96 +/- 0.03%/h versus 0.95 +/-
      0.02%/h. CONCLUSION: The presence of RDS did not affect the efficacy of
      phototherapy for neonatal hyperbilirubinaemia in preterm infants.

PMID- 7794614
TI  - Improving asthma documentation in a paediatric emergency department.
AB  - OBJECTIVE: To improve documentation for children presenting to the Emergency
      Department (ED) of The Children's Hospital with acute asthma. METHODOLOGY: In
      phase I, the documentation process was analysed using a standard total quality
      management (TQM) approach to identify specific problems leading to poor
      documentation. Fifty-two medical records of children presenting over a 3 week
      period were reviewed for nursing and medical documentation. A set of minimum
      criteria, consistent with the Paediatric Asthma Management Plan, were established
      for documentation by both medical and nursing staff. Following dissemination and
      education, compliance with documentation was evaluated and compared to an asthma
      survey performed in the ED in 1991. In phase II, a specific proforma for medical
      assessment was developed and 80 medical records of children presenting over a 3
      week period were reviewed. Fifty-two (65%) with completed proformas were
      evaluated. The outcome measure was the documentation rate for minimum criteria
      established by TQM process. RESULTS: In phase I, nursing compliance with
      documentation ranged from 46% for signs of respiratory distress to 83% for a past
      history of asthma and 100% for pulse rate. Doctors were similarly poor at
      documenting essential elements such as severity (31%), palpable pulsus paradoxus
      (29%), the child's usual doctor (46%) and follow-up arrangements (21-56%). In
      phase II, the documentation of the severity of acute asthma (42%) and of the
      child's usual doctor (42%) remained poor but there were statistically significant
      improvements in documentation of interval medications, palpable pulsus paradoxus,
      respiratory rate, pre-treatment oximetry, education, follow-up arrangements and
      communication letters. CONCLUSION: The process of TQM has proved valuable in
      improving some aspects of documentation of children presenting to ED with acute
      asthma. It remains to be shown whether improved documentation will result in
      improved outcome.

PMID- 7794615
TI  - Retinopathy of prematurity in infants weighing 1000-1499 g at birth.
AB  - OBJECTIVE: To review the incidence and severity of retinopathy of prematurity
      (ROP) in infants with birthweights 1000-1249 g and 1250-1499 g, to establish
      whether the upper weight limit for routine ophthalmological examination might
      safely be lowered. METHODOLOGY: Prospective cohort study of infants born between
      1 January 1977 and 31 December 1992 cared for in the neonatal nurseries at the
      Royal Women's Hospital, Melbourne. Data were retrieved on 1373 infants who
      survived their initial hospitalization. They comprised 657 with birthweights 1000
      1249 g (group 1) and 716 with birthweights 1250-1499 g (group 2). There were 76
      outborn infants in group 1 and 97 in group 2; the remaining infants were all born
      at the Royal Women's Hospital. Ocular examinations commenced at 2 weeks of age,
      when possible, and at 2-weekly intervals after that. RESULTS: In group 1, ROP was
      detected in 14.6% (96/657) and severe ROP (bilateral stage 3-5) in 5.0% (33/657).
      Five (0.8%) children required surgical intervention (reaching threshold disease);
      following surgery, one was legally blind, one had severely impaired vision, and
      the other three had near-normal vision. Another child was blind; he was born at
      28 weeks gestational age with a birthweight of 1170 g, and was transferred to a
      Level II hospital at 9 weeks chronological age with no detectable retinopathy. He
      returned 1 year later totally blind with detached retinae (grade 5 ROP). The
      prevalence of bilateral blindness in this group was 0.3% (2/657). In group 2, ROP
      was detected in 6.4% (46/716) and severe ROP in 0.8% (6/716). No children
      required surgery; three were found to be myopic at follow-up but the corrected
      visual acuity was normal. No children in group 2 were blind. No significant
      difference was found between the rates of ROP in inborn and outborn infants.
      CONCLUSION: In neonatal units with similar rates of ROP and visual outcome,
      routine ophthalmological examination in the neonatal nursery of infants weighing
      more than 1249 g at birth is probably unnecessary.

PMID- 7794616
TI  - Another outcome of neonatal intensive care: first year mortality and hospital
      morbidity.
AB  - OBJECTIVE: To determine first year mortality and hospital morbidity after
      neonatal intensive care. METHODOLOGY: Cohort study of 6077 surviving infants
      inborn in one regional hospital in 1988. Nine hundred and eighty-eight received
      neonatal intensive care and 103 were very low birthweight (VLBW). RESULTS: For
      infants who required care in the neonatal intensive care unit (NICU), the
      relative risk of dying before their first birthday was 3.6 (95% confidence
      intervals [CI] 1.5-8.8). This increased risk was associated with low birthweight
      (LBW) rather than requirement for NICU care. Of all inborn survivors, 10.4% were
      readmitted to hospital in the first year and 2.4% more than once. The readmission
      rate was 20% for NICU survivors and 30% for VLBW infants. The risk of
      hospitalization was independently associated both with NICU admission (odds ratio
      2.3, CI 1.9-2.9) and with VLBW (OR 1.8, CI 1.1-3.0). The NICU survivors also had
      multiple admissions and prolonged hospital stays. CONCLUSIONS: Both low
      birthweight and neonatal illness requiring intensive care are important
      indicators of continuing medical vulnerability over the first year of life.

PMID- 7794618
TI  - Somatosensory evoked potentials predict neurologic outcome in full-term neonates
      with asphyxia.
AB  - OBJECTIVE: To investigate the ability of somatosensory evoked potentials (SSEP)
      to predict neurologic outcome in term neonates with birth asphyxia. METHODOLOGY:
      Upper limb SSEP were performed on nine infants of 1-7 weeks of age who had
      perinatal asphyxia and an encephalopathy still present at 7 days of age.
      Comparison was made between the cranial ultrasound, electroencephalogram (EEG),
      SSEP and neurologic outcome at 9-36 months. RESULTS: Normal SSEP were found in
      four infants, all of whom were normal on neurologic follow up at 9-12 months.
      Neonatal EEG performed on two out of four of these infants were also normal,
      while cerebral oedema was seen on cranial ultrasound in three of the four
      studies. No SSEP response was seen initially in three infants, all of whom had
      adverse outcomes (one death, two with spastic diplegia). In contrast, their
      neonatal EEG had shown normal background rhythms, while two of the three cranial
      ultrasounds revealed oedema. For two infants the initial SSEP was absent over one
      hemisphere and just present over the other. Both children were abnormal on follow
      up at 10-12 months but did not have a hemiparesis. CONCLUSIONS: Upper limb SSEP
      appear more sensitive than EEG or cranial ultrasounds in predicting the short
      term neurologic outcome of neonates with asphyxia.

PMID- 7794617
TI  - Recommended body mass index cutoff values for overweight screening programmes in
      Australian children and adolescents: comparisons with North American values.
AB  - OBJECTIVE: Guidelines for screening children and adolescents for overweight have
      recently been published by a North American Expert Committee. As Australian
      clinicians might uncritically adopt these recommendations, we explore the
      consequences of applying North American body mass index (BMI) cutoff values to an
      Australian population. METHODOLOGY: The Australian BMI cutoffs were calculated
      using the methods recommended from height and weight data for 8492 schoolchildren
      aged 7-15 years old. RESULTS: Smoothed Australian BMI cutoffs were similar to
      those derived from the first United States National Health and Nutrition
      Examination Survey (NHANES-I) values for whites. However, the NHANES-I cutoffs
      would result in systematic misclassification. Among 7 year olds, the NHANES-I
      85th percentile cutoff would wrongly classify 4.6% of normal males and 9.1% of
      normal females as 'at risk of overweight'. At age 14 years, the NHANES-I 95th
      percentile cutoff would misclassify 3.5% of children as 'overweight' instead of
      'at risk of overweight'. CONCLUSION: Australian screening programmes should use
      BMI cutoffs appropriately derived from local measurements, and these are given
      for Australian children.

PMID- 7794619
TI  - Upper and lower gastrointestinal complications with dexamethasone despite H2
      antagonists.
AB  - OBJECTIVE: To describe three preterm babies who developed gastrointestinal
      complications during treatment with dexamethasone for chronic lung disease,
      during a 10 month period. METHODOLOGY: Case reports in a tertiary neonatal
      intensive care unit. RESULTS: All three babies had received intravenous
      cimetidine since the commencement of steroid therapy, and developed
      gastrointestinal complications. There was no evidence of necrotizing
      enterocolitis in either of the two babies with gastrointestinal perforation. This
      is the first report of lower gastrointestinal complications associated with
      dexamethasone therapy. CONCLUSION: Recommendation of concomitant use of H2
      antagonists with steroid therapy may be premature, and requires testing with a
      randomized controlled trial.

PMID- 7794620
TI  - Phenytoin in the management of severe acute SIADH.

PMID- 7794621
TI  - Infants and the prone position and its relationship to SIDS.

PMID- 7794622
TI  - ISPAD declaration of Kos. International Study Group of Diabetes in Children and
      Adolescents.

PMID- 7794623
TI  - ISPAD Declaration of Kos. International Society for Pediatric and Adolescent
      Diabetes.

PMID- 7794624
TI  - Survival of low birthweight infants in central Queensland.

PMID- 7794625
TI  - Experience with ACS for infantile SGS.

PMID- 7794626
TI  - Cyclical vomiting syndrome.
AB  - Cyclical vomiting syndrome is an uncommon, disabling symptom complex of unknown
      cause, with features in common with migraine. It affects principally children and
      adolescents. Differential diagnosis and theories of pathogenesis are discussed.
      Therapy should be aimed at prophylaxis of vomiting bouts, 'switching off'
      episodes once they commence and preventing complications of established vomiting
      episodes. Families need rapid access to care to minimize morbidity and disruption
      to functioning.

PMID- 7794628
TI  - Adherence to recommended medical regimens in childhood and adolescence.
AB  - OBJECTIVE: Factors that appear to influence treatment adherence among adults have
      been the focus of considerable research in recent years. However, less research
      has focused on children's treatment adherence. This paper reviews current
      knowledge about factors that appear to influence adherence among children and
      adolescents. METHODOLOGY: Factors associated with adherence to medical regimens
      reviewed here include: (i) the psychosocial characteristics of children and their
      parents; (ii) the nature of the treatment regimen; and (iii) the relationship
      between health practitioners, parents and paediatric patients. CONCLUSIONS:
      Issues for future research include: (i) the adherence of both children and their
      parents to children's treatment, and the allocation of responsibility for
      treatment adherence; (ii) the wide range of behaviours involved in regimen
      adherence should be acknowledge; patients' adherence to one aspect of their
      regimen should not be considered indicative of their overall adherence; and (iii)
      longitudinal studies are required to examine the causal relations between patient
      adherence and its antecedents.

PMID- 7794627
TI  - Predicting the outcome of symptomatic congenital cytomegalovirus infection.
AB  - The prognosis of babies with symptomatic congenital cytomegalovirus (CMV)
      infection is worse than for those with asymptomatic CMV, but is difficult to
      quantify. Babies affected as a result of primary maternal CMV are at greater risk
      than after reactivation CMV. Chorioretinitis occurs in 10-15% of symptomatic
      babies and almost always indicates significant mental impairment. Microcephaly
      occurs in around 50% at birth, but does not always persist, and does not
      necessarily imply later neurological handicap. Investigative findings that
      increase the likelihood of handicap include radiographic or computerized
      tomography scan finding of intracranial calcification and raised cerebrospinal
      fluid protein. Late deafness is always unpredictable and all babies with
      congenital CMV infection should have an audiological follow up. The mortality of
      symptomatic congenital CMV infection is about 30%.

PMID- 7794629
TI  - Recommendations for dietary intervention in the prevention and treatment of
      hyperlipidaemia in childhood. The Dietitians' Association of Australia and the
      Australian College of Paediatrics.

PMID- 7794631
TI  - Effects of nasal continuous positive airway pressure on apnoea index and sleep in
      infants.
AB  - OBJECTIVE: We examined the effectiveness of nasal continuous positive airway
      pressure (CPAP) for treatment of sleep apnoea in infants. METHODOLOGY: We studied
      five infants who all had significant central and mixed apnoea and severe sleep
      fragmentation. Polysomnographic recordings were performed on 2 consecutive nights
      in these infants. One night was used as a control study and during the second
      night nasal CPAP was applied throughout the night. RESULTS: Nasal CPAP
      significantly reduced apnoea in each infant, with the apnoea index (apnoeas/h)
      decreasing from 65.6 +/- 14.6 during the control study to 10.5 +/- 14.6 during
      CPAP in non-rapid eye movement (non-REM) sleep, and from 106 +/- 13.9 during the
      control study to 26.6 +/- 13.9 during CPAP in REM sleep. Nasal CPAP also improved
      the sleep fragmentation markedly; REM sleep increased from 14.2 +/- 1.2% of sleep
      during the control study to 27.1 +/- 1.2% of sleep during CPAP. CONCLUSIONS: We
      conclude that nasal CPAP is an effective treatment for infantile apnoea. Sleep
      apnoea in these infants is associated with profound sleep fragmentation, which is
      reversed by nasal CPAP.

PMID- 7794630
TI  - A cross-sectional study of growth, puberty and endocrine function in patients
      with thalassaemia major in Hong Kong.
AB  - METHODOLOGY: A cross-sectional study of growth, puberty and endocrine function
      was performed on 35 girls and 33 boys with thalassaemia major. RESULTS: Despite
      regular transfusion and chelation therapy, 75% of the girls and 62% of the boys
      over the age of 12 years were below the third percentile for height.
      Hypogonadotropic hypogonadism was found in a similar percentage of patients.
      Moderate to marked zinc deficiency secondary to chelation therapy was considered
      unlikely because normal serum zinc levels were found in all but three of our
      patients, but we could not exclude the possibility of a marginal status of zinc
      nutrition causing growth failure. Growth hormone deficiency and diabetes mellitus
      were sometimes encountered but hypothyroidism, hypoparathyroidism and adrenal
      insufficiency were rare among our patients. Most of the patients with growth
      failure had normal growth hormone (GH) response to insulin induced hypoglycaemia.
      The serum insulin-like growth factor-1 (IGF-1) levels were low in our patients
      and no significant difference in the serum IGF-1 levels was found between
      prepubertal children with or without growth failure (0.4 +/- 0.1 mU/mL vs 0.37 +/
      0.11 mU/mL, P = 0.39). Similarly, no difference in the serum IGF-1 levels was
      found between pubertal children with or without growth failure (0.48 +/- 0.2 U/mL
      vs 0.56 +/- 0.14 U/mL, P = 0.26). CONCLUSIONS: Delayed sexual maturation and a
      possible defect in growth unrelated to the GH-IGF-1 axis may be responsible for
      the growth failure in adolescent children with thalassaemia major.

PMID- 7794632
TI  - Parental asthma knowledge: its association with readmission of children to
      hospital.
AB  - OBJECTIVE: To assess whether poor parental knowledge about asthma was a risk
      factor for readmission of their children to hospital. METHODOLOGY: Parents of
      children who were admitted to the paediatric facility at Newcastle Mater and John
      Hunter Hospitals were administered a previously validated asthma knowledge
      questionnaire with a maximum possible score of 31. RESULTS: The mean parental
      knowledge scores for three groups of children were determined: those with a
      previous diagnosis of asthma being readmitted to hospital (170 children, mean
      score 18.3); those with a previous diagnosis of asthma being admitted for the
      first time (114 children, mean score 17.2); and children being admitted with
      their first attack of asthma (65 children, mean score 15.6). There was a
      significant difference in parental asthma knowledge between the first and third
      group (P < 0.001) but not between the first and second group. A linear regression
      model with knowledge score as an outcome found that increased knowledge was
      associated with previously diagnosed asthma, higher parental occupation and no
      smoker in the home. CONCLUSIONS: Knowledge was poor in all groups. Readmission
      rate was related to the severity of the child's asthma.

PMID- 7794633
TI  - Clinical manifestations and outcome of Haemophilus influenzae type b disease.
AB  - OBJECTIVE: To document clinical manifestations, laboratory findings and outcome
      of childhood Haemophilus influenzae type b (Hib) infections. METHODOLOGY: Medical
      records of 235 children with Hib disease admitted to hospital during a 2 year
      period were reviewed; additional information was obtained by questionnaire and
      follow up 6 weeks after discharge. RESULTS: Three-quarters of patients presented
      with either meningitis or epiglottitis. Children with epiglottitis were older,
      had shorter illnesses and were less likely to have had antibiotics before
      admission than those with meningitis; 38% of the latter had been given some
      antibiotic therapy, with no apparent effect on the outcome. Fever persisted for 7
      days or more in 23% of patients with meningitis. Death from meningitis occurred
      in 3.8% of patients and was due to fulminating disease. CONCLUSIONS: These data
      will assist in recognition and appropriate management of Hib disease as the
      clinical manifestations become less familiar following the introduction of
      immunization. Specific laboratory diagnosis is required for accurate
      surveillance, which should be maintained in order to ensure high immunization
      rates.

PMID- 7794634
TI  - [Course of histological lesions of the gastric mucosa after eradication of H.
      pylori in patients with duodenal ulcer. Initial study and 6-month follow-up].
AB  - Helicobacter pylori is the major etiologic agent of chronic active gastritis, and
      it may be isolated from the gastric mucosa in a high proportion of patients with
      duodenal ulcer. AIM: To study, in duodenal ulcer patients, the histological
      changes associated with H. pylori infection in gastric antrum and body, and the
      improvement of such lesions after eradication, at an early stage and after 6
      months. METHODS: 76 patients with duodenal ulcer disease were investigated
      prospectively. Biopsy specimens taken by endoscopy from the duodenal bulb,
      antrum, body and gastric fundus were analyzed by microbiological and histological
      methods. A patient was considered to be H. pylori-positive when microbiology
      or/and histology demonstrated colonization in any of the locations. An endoscopy
      with biopsy samples from the antrum and gastric body was performed 1 month after
      therapy and 4 months later. Different therapy regimens were used:
      amoxicillin/clavulanic plus omeprazole or ranitidine; triple therapy; and
      omeprazole or ranitidine alone. RESULTS: All patients were positive by
      microbiology. Eradication was reached as a whole in 47% (N = 36). In those
      patients, in gastric antrum, rates of chronic gastritis/chronic active gastritis
      previous to treatment and 2 and 6 months later were 100%/96%; 38%/23% and
      16%/5.6% respectively. At gastric body they were: 54%/38%; 12%/12% and 12%/5.6%
      respectively. A favourable histologic evolution, globally and of the acute
      inflammatory component, was observed 1 month after therapy (p < 0.001). Six
      months later, there was further improvement which did not reach a statistically
      significant difference compared with the results obtained at the first month. No
      differences were observed when eradication failed. CONCLUSION: An improvement of
      antral and gastric body gastritis is associated with H. pylori eradication in
      duodenal ulcer patients. This successful evolution is observed immediately after
      eradication, and it is confirmed six months after the diagnosis.

PMID- 7794636
TI  - [Is there a relationship between cholelithiasis and colorectal cancer?].
AB  - PROBLEM: The pathogenesis of colorectal cancer must be perceived as a complex
      interaction between the genetic make-up of the individual and the environment.
      Recent publications stress the association between colorectal carcinoma and
      cholelithiasis. OBJECTIVE: A retrospective study was set up to compare the
      presence of cholelithiasis/cholecystectomy in patients with colorectal carcinoma
      vs gastric carcinoma. PATIENTS: In 481 patients with colorectal carcinoma, and in
      another group of 126 patients with gastric carcinoma, the incidence of prior
      cholelithiasis/cholecystectomy was investigated. RESULTS: In the colorectal
      carcinoma cases a personal history the cholelithiasis was observed more often
      than cholecystectomy, 88 vs 8 (P < 0.001) patients, and cholelithiasis was more
      commonly observed in cases of right-sided colonic cancer, than in cancer of the
      left colon and rectum. In the group with gastric carcinoma the cholelithiasis
      incidence was 5.6 percent. CONCLUSIONS: These findings suggest that a
      relationship was found more often between colorectal cancer and cholelithiasis,
      that with cholecystectomy.

PMID- 7794635
TI  - [Administration of growth hormone enhances the intestinal adaptive response after
      resection of small intestine in rats].
AB  - The aim of this study was to assess the proliferative effect of growth hormone
      (GH) on the remnant intestinal mucosa after small bowel resection in the rat.
      Three groups (n = 8/group) of adult Wistar rats were established as follows: 1)
      control, 2) 90% small bowel resection (SBR) and 3) 90% small bowel resection + GH
      1 mg/kg-day (SBR+GH) during 7 days. Ileal samples were taken prior to resection
      (basal), and at sacrifice, for assessment of intestinal mucosal growth by means
      of morphometric (crypt and villous length) and proliferative (proliferating cell
      nuclear antigen, PCNA) techniques. GH administered to resected rats (SBR+GH)
      significantly increased the number of proliferating cells and crypt and villous
      length when compared to resected non-treated animals (SBR). In conclusion, in the
      rat, GH markedly increases the trophic action of intestinal mucosa in
      hyperproliferative states like massive bowel resection, enhancing remnant bowel
      morphologic and proliferative adaptation.

PMID- 7794638
TI  - [Emergency laparoscopy. A 20-year experience].
AB  - We revised 7988 laparoscopies over twenty years. Three hundred and ninety three
      were urgent laparoscopies: 325 patients with acute spontaneous abdomen and 68
      acute traumatic abdomen. Emergency laparoscopy is made in patients with, both
      spontaneous and traumatic acute abdomen, when diagnosis is not made in 8 hours
      with the usual clinical and imaging methods. Acute diffuse peritonitis was the
      commonest finding in the first group (21%) and splenic rupture in the traumatic
      group (34%). There were two severe complications (0.5%): pulmonary oedema in a
      patient with myocardial disease and a respiratory failure in a old patient, which
      were resolved. We had two deaths related to laparoscopic diagnosis: massive
      mesenteric thrombosis and fecal peritonitis. There are few contraindications and
      tolerance is very good. This study shows a sensitivity of 98%, a specificity of
      90%, a predictive positive value greater than 98% and a negative predictive value
      of 100%. In summary, the present study demonstrates that emergency laparoscopy is
      a effective diagnostic method in acute abdominal pain of uncertain aetiology.

PMID- 7794637
TI  - [Sensitivity of the anal canal: study techniques and results in normal subjects].
AB  - AIM: To describe a technique for the study of the anal canal sensitivity to
      electric and thermal stimulation, and to investigate it prospectively in normal
      subjects. EXPERIMENTAL DESIGN: Mucosal electrosensitivity and thermal sensation
      of the anal canal is correlated with motor parameters: perineometry, manometry
      and electrophysiology. PATIENTS: 41 control subjects (20M & 21F) with normal
      anorectal anatomophysiology. RESULTS: In the middle anal canal minimum
      electrosensibility thresholds were present, and they were similar to the thermal
      profile. A significant impairment in electrosensitivity was observed as a
      function of age, but no differences between the sexes were found. Lower
      thresholds were obtained than cold temperatures (p < 0.001). Both tests of
      sensitivity correlated with pudendal motor parameters. The maximal thermal
      difference in the anal canal was 0.28 degree C, while the minimal detectable
      temperature change was 0.46 +/- 0.1 degrees C. CONCLUSIONS: The sensitivity of
      the anal canal is greatest in the zone of the anal valves and better in response
      to hot than cold stimulus. As the minimum detectable temperature change has been
      greater than the difference of temperature between the low and high anal canal,
      we suggest that discrimination is not possible on the basis of thermal
      differences.

PMID- 7794639
TI  - [Gastrointestinal diseases causing hematologic changes].

PMID- 7794640
TI  - [Undifferentiated small cell (oat cell) carcinoma of the esophagus].
AB  - A case of small cell carcinoma (oat cell) of the esophagus is presented.
      Esophagectomy and gastroplasty were performed followed by six cycles of
      combination chemotherapy and radiotherapy. Recovery was uneventful. The patient
      died nine months later with widespread disease. Literature is reviewed. To date,
      about 100 cases of this rare tumor have been reported. The aggressive behavior of
      the tumor is stressed and the different therapeutic modalities are discussed.

PMID- 7794641
TI  - [Gastric cavernous hemangioma as a cause of upper digestive hemorrhage].
AB  - Upper digestive bleeding caused by an isolated gastric hemangioma is a rather
      rare occurrence, even in cases of Osler-Weber-Rendu syndrome. The case reported
      here, which brings to 40 the number reported in the world literature, is that of
      a 68-year-old patient who presented with upper digestive bleeding. Endoscopy led
      us to suspect a hemangioma due to the abnormally large lesion, a suspicion that
      was confirmed preoperatively through arteriography, which detected a
      hypervascular mass of 6 x 4 cm dependent on the gastroduodenal artery. This
      finding was in turn confirmed by the surgical intervention. Diagnostic
      difficulties based on barium studies, endoscopy and surgical exploration have
      meant that preoperative diagnosis has been rare in the cases published to date.
      We consider that a more liberal use of arteriography could reverse this tendency,
      as indeed our case has shown. Furthermore, we feel that arteriography is
      indicated in cases of upper digestive bleeding of obscure origin, which might be
      due to small angiomas that may be overlooked in other diagnostic tests.

PMID- 7794643
TI  - [Appendiceal Crohn's disease].
AB  - Crohn's disease of the appendix is an uncommon process that is more frequent in
      young people. The most common preoperative diagnosis is acute appendicitis. At
      exploratory laparotomy the appendix is enlarged and malignancy may be suspected.
      The differential diagnosis may be difficult. Serologic tests and cultures should
      be performed to exclude Yersinia infections. Appendicectomy is a safe procedure
      when the disease is limited to the appendix. The postoperative course is usually
      uncomplicated with a low rate of complications and recurrence. Although it may be
      a different process than Crohn's disease and the recurrence rate is low, it is
      suggested that all the patients should be followed-up so that recurrences may be
      recognized and treated as early as possible. A new case is presented after two
      years of follow-up without recurrence.

PMID- 7794642
TI  - [Familial hyperphosphatasemia of intestinal origin].
AB  - To clarify the diagnostic laboratory procedures before a case of unknown origin
      hyperphosphatasemia, we have studied the electrophoretic separation of serum
      alkaline phosphatase activity on agarose gel with and without neuraminidase. Sera
      were collected from a family, four of whom showed hyperphosphatasemia. Alkaline
      phosphatase isoenzyme patterns on agarose gel electrophoresis demonstrated that
      two persons out of the six members tested had unusual isozymes, the hydrophilic
      and the hydrophobic intestinal isozyme representing more than 50% of total
      alkaline phosphatase. The advantages of this method are its simplicity and low
      cost. The early recognition of this benign abnormality should help to avoid
      unnecessary diagnostic tests (i.e. image or radioisotopic examination).

PMID- 7794644
TI  - [Inguino-crural hernia with neoplastic content].
AB  - We report a case of incarcerated crural hernia including omentum with metastases
      of pancreatic carcinoma. The scarce literature is reviewed. The possibility of
      mistaking an incarcerated crural hernia for an inguinal lymph node may result in
      a ganglionar biopsy ending up in a crural herniography under local anaesthesia.
      We recommend that all hernial sacs be examined, especially those of adult
      patients and, in such cases, a crural herniography with prolene should be made in
      view of its remarkably technical simplicity.

PMID- 7794645
TI  - [Pancreatic ascites and octreotide].

PMID- 7794646
TI  - [Somatostatin in refractory pancreatic ascites].

PMID- 7794647
TI  - [Perianal cutaneous metastasis of rectal adenocarcinoma].

PMID- 7794648
TI  - Celebrating our 30th anniversary as nurse practitioners and our 10th anniversary
      as an academy. 1973.

PMID- 7794649
TI  - Representative Edolphus Towns (D-New York). Interview by Carole Jennings.

PMID- 7794651
TI  - The beta-2 agonists.

PMID- 7794652
TI  - An economic analysis of AIDS--towards a proposed model of costing: a Singapore
      experience.
AB  - With the increasing prevalence of HIV infection/AIDS and the extending range of
      care and treatment, the economic implications of the various prevention and
      control strategies, and of treatment, have become the subject of interest to
      policy-makers, public health specialists and health economists. This paper
      presents an overview of the methods used for the economic analysis of AIDS/HIV
      infection. It proposes an activity-oriented, cost center-based model for the
      costing of the economic impact of AIDS, using cost figures in Singapore since
      1985, when the National AIDS Control Program was started. Priorities for future
      research are also identified.

PMID- 7794650
TI  - The moral reasoning of nurse practitioners.
AB  - This qualitative research study was conducted to describe the moral reasoning
      utilized by participating nurse practitioners to resolve moral dilemmas in their
      clinical practice. Five major essential features of moral reasoning emerged from
      the data: the contextual framework for moral reasoning, values, influencing
      factors, recognizing the dilemma, and outcomes. The interrelationship of the
      essential features of moral reasoning provided insight into how NPs deal with
      moral dilemmas as well as the role that caring and the nurse-patient relationship
      played as a part of the moral decision making process.

PMID- 7794654
TI  - A comparative study on the efficacy of a mass screening program for colorectal
      cancer--comparison between cancer cases detected by mass screening and by
      outpatient clinics.
AB  - The present study was carried out to investigate the efficacy of colorectal
      screening through a comparison of the characteristics of the cancer cases
      detected by screening programs and by outpatient clinics. A total of 78 cases
      with colorectal cancer diagnosed by screening programs using fecal occult blood
      test in Nagano Prefecture, Japan, was collected as the index group and the same
      cases (one matched cases) diagnosed through outpatient clinics served as the
      control group for the present study. A comparison of various factors, such as
      tumor site, Dukes' stage, histological type, and survival rate, was made between
      the index and control groups. No differences were noted in tumor site and
      histological type between the two groups examined. The proportion of early cancer
      and the survival rate, however, were significantly higher in the index group than
      in the control group (p < 0.01). These results suggest that colorectal screening
      is an efficient preventive measure.

PMID- 7794656
TI  - Denver Developmental Screening Test survey of Bangkok children.
AB  - A preliminary developmental survey (using DDST) of 1442 Bangkok children who were
      between the ages of two weeks and six years was conducted between June 1983 and
      December 1987. The results of this study showed that the 25th percentile for the
      development of Bangkok children in the areas of personal-social, fine motor
      adaptive, language and gross motor skills were comparable to the children in
      original samples in Denver. Although the Bangkok group seems to have passed many
      test items at earlier ages, the 75th-90th percentile in each test item was
      generally more delayed in the Bangkok group. The investigative team suggests that
      further research for the purpose of establishing a norm for the DDST be pursued
      on the basis of geographical sampling more than socioeconomical sampling that was
      used in this study.

PMID- 7794655
TI  - Health status comparison by urinalysis (dipstick test) among four populations in
      Papua New Guinea.
AB  - The health status of four populations depending on traditional subsistence in
      Papua New Guinea was compared by the dipstick test urinalysis. Conspicuous inter
      population difference in the distribution of urinary pH was attributed to the
      levels of protein intake and the balances of sodium and potassium intake. The
      percentage of positive findings on protein differed by population along with the
      percentages of urobilinogen and bilirubin; the higher percentage of protein
      positives (12-16%) found in less urbanized populations suggests a high risk of
      hepatic and/or renal disorders in traditional societies. The very low percentage,
      0.3 percent, of positive findings on glucose among 1,132 urine samples tested
      indicated that diabetes mellitus was not yet the major problem. Simultaneously,
      however, the fact that glucose positives were found only in the most urbanized
      villages indicates increasing risk of diabetes even in the traditional
      populations during future urbanization.

PMID- 7794653
TI  - Maternal and child health in urban Sabah, Malaysia: a comparison of citizens and
      migrants.
AB  - This paper describes selected maternal and child health indicators based on a
      cross-sectional study of citizens and migrants in Sabah, Malaysia. A total of
      1,515 women were interviewed from a multi-stage random sample of households in
      eight urban centers. Among the 1,411 women in the sample who had experienced a
      pregnancy before, 76% were local citizens and 24% were migrants. There were
      statistically significant differences between citizens and migrants in ethnicity,
      religion, education, household income, and access to treated water supply and
      sanitary toilet facilities. Significantly fewer migrants practiced any form of
      contraception and obtained any antenatal care during any pregnancy. Furthermore,
      citizens tended to initiate care as early as three months but migrants as late as
      seven months. Despite these differences, only the infant mortality rate, and not
      pregnancy wastage, was statistically significantly higher among migrants.
      Pregnancy interval was also similar between the two groups. The influence of
      several socioeconomic factors on pregnancy wastage and infant mortality was
      explored.

PMID- 7794658
TI  - Establishment of an International Information Network for International Health
      Development: a survey of public health administration and management courses.
AB  - The purpose of the present study was to examine the content emphasis of courses
      of public health administration and management (A & M) among member institutions
      of the Asia-Pacific Academic Consortium for Public Health (APACPH), to determine
      comparability of curricula across campuses. A survey of course syllabi from
      APACPH schools was conducted by three separate reviewers to identify topical
      subject matter presented in general and specialty A & M courses delivered to
      graduate students at each campus. Based on this review, three synthetic general
      content A & M courses, and one specialty A & M course (i.e. Hospital
      Administration) were created as a basis for intercampus cross-institutional
      comparisons conducted by the author. Despite the number of courses provided by
      the different APACPH institutions, specific content areas consistently appeared
      across institutions, suggesting possible foundational A & M content for public
      health students. In general, there was much better coverage of similar topics at
      the introductory level of instruction, and much greater consistency was observed
      across institutions that provided course work addressing the administration of
      hospitals. Several recommendations are made for further studies of other content
      areas, and for the development of minimum training content areas as a basis for
      cross-institutional studies.

PMID- 7794657
TI  - Health practices and indices of a poor urban population in Indonesia. Part I:
      Patterns of health service utilization.
AB  - This first section in a two-part study of health indices and practices among
      residents living in a Jakarta slum describes the use of public and private
      primary health care services in relation to socioeconomic and health status. As
      problems associated with urban poverty rapidly increase in developing countries,
      it is important to study the ethnic and economic diversity which exists in slums
      and shanty towns: results of such studies should inform the development of
      effective strategies for outreach and service delivery. Through a survey of 690
      mothers and 593 children, we found that 1) poorer residents were more likely than
      relatively affluent ones to rely on local government clinics (posyandus) for
      primary health care; 2) regular posyandu users were more likely than non-users to
      be fully immunized and to use ORT correctly; 3) delivery in hospital was common
      among all residents, but especially among the more affluent; and 4) prevalence of
      contraception was high and not associated with socioeconomic status or type of
      primary health care service used. Strengthening primary health care services at
      the government's local health posts could benefit all groups in the community if
      wealthier residents participated more in the posyandus. Standards of care in the
      private sector should also be improved.

PMID- 7794659
TI  - Knowledge and use of maternal and child health services by mothers in Papua New
      Guinea.
AB  - A survey was conducted in the coastal area of Morobe Province in Papua New Guinea
      between March to April 1992 in order to obtain and examine the current health
      knowledge and practices of mothers with children under two years of age. The
      purpose of the survey was to gather data for the detailed planning and
      implementation of a Child Survival Intervention Project funded by USAID. A total
      of 30 villages in the area were selected utilizing the WHO 30-cluster sampling
      technique. The results indicated that breastfeeding was a very common practice.
      However, because nutritional intake was not increased during pregnancy and
      lactation for many of the women, it is likely that their nutritional intake was
      insufficient. Although many mothers knew the importance of immunization, they
      were unclear about the importance of completing immunization series. The
      utilization of contraceptive methods was very low among women who did not want to
      have another child within the subsequent two years. The most common methods were
      injections and pills. The dissemination of health education to isolated rural
      villages is one of the most important interventions in reducing maternal and
      infant mortality. As there currently is no health education unit at the Morobe
      Provincial Department of Health. It is crucial to establish the unit and to
      emphasize the importance of health education as the tool for disease prevention
      and health promotion.

PMID- 7794660
TI  - Asia-Pacific Academic Consortium for Public Health (APACPH) representatives,
      member institutions, and addresses December 1994.

PMID- 7794662
TI  - The awesome possibilities of CD-ROM.

PMID- 7794661
TI  - Creating the conditions for healing and health: the challenge of patient care
      executives.

PMID- 7794663
TI  - New partnerships in care delivery: three hospitals and a school district combine
      their resources to deliver prenatal care.

PMID- 7794664
TI  - Nurse executives on-line: connecting to on-line services. Bulletin boards and the
      Internet--Part I.

PMID- 7794665
TI  - Downsizing: the nurse executive's roles and responsibilities.

PMID- 7794666
TI  - Social responsibility in the health care marketplace.

PMID- 7794667
TI  - Management prerogatives versus nurses' free speech: new precedents.

PMID- 7794668
TI  - Integrating ethical principles into operational decision making.

PMID- 7794669
TI  - False-negative surgical margins.

PMID- 7794670
TI  - Identification of those at highest risk for development of malignant melanoma.
AB  - Multiple factors have been identified to be associated with increasing risk for
      MM developing. These factors are summarized in Table 2. As the incidence of MM
      continues to rise and the magnitude of this problem becomes more significant, the
      issue of identifying those at increased risk for MM developing in the future will
      become even more important.

PMID- 7794671
TI  - Melanoma and Mohs' micrographic surgery.

PMID- 7794672
TI  - The clinical and biologic basis for radiation therapy of cutaneous carcinoma,
      melanoma, and lymphoma.

PMID- 7794673
TI  - Choosing the correct surgical instruments.

PMID- 7794674
TI  - Pain management for dermatologic procedures in children.
AB  - Simple explanations provided to children and their parents before a dermatologic
      procedure is attempted will decrease the time it takes to perform the procedure
      and make it a less difficult experience for all concerned. The dermatologist
      should always consider the availability of less painful but effective methods
      when treating children.

PMID- 7794675
TI  - A 10-year retrospective on Advances in Dermatology.

PMID- 7794676
TI  - Juvenile dermatomyositis and overlap syndromes.

PMID- 7794677
TI  - Life-threatening dermatoses in pediatric dermatology.

PMID- 7794678
TI  - Pruritus in the elderly.

PMID- 7794679
TI  - Molecular mechanisms of skin aging.
AB  - At the cellular and molecular levels, the limited ability of aged fibroblasts and
      keratinocytes to respond to changes in their environments fits nicely the concept
      of aging as inability of the organism to respond adaptively to environmental
      changes. Whether these molecular changes represent cumulative random genetic
      damage or programmed aging process cannot be determined. Nevertheless, the data
      correlate with the well-known differences in biologic responsiveness between
      newborn, young adult, and old adult cells. Thus, our findings represent a
      beginning from which more comprehensive understanding of molecular changes
      involved in cutaneous aging will evolve.

PMID- 7794680
TI  - Wound healing.
AB  - Wound healing is a dynamic biologic process of repairing insults to the
      integumentary system. It is commonly divided into three phases: inflammatory,
      proliferative, and maturation. Each phase has unique cellular and substance
      constituents without which it cannot progress normally. A large variety of
      factors may influence any part of wound healing, including local factors such as
      bacteria, oxygen tension, and bleeding, and systemic factors such as the mental
      and physical health of the patient. There are also extrinsic factors that can be
      influenced by the caretakers of the wound to enhance wound healing. Areas of
      intervention include using antiseptic technique when one is dealing with the
      wound, using good surgical technique, choosing the appropriate wounding method
      and repair for the individual patient, and using antibiotics and special wound
      dressings. Modern science and technology are giving us new insights into wound
      healing and leading us to exciting new ways of influencing it, including the
      topical use of growth factors, artificial skins, cultured epithelium with and
      without dermal components, and electrical stimulation. The future of wound
      healing holds a better understanding of the complexities of the physiologic
      events that occur and a translation of that into a biologically active and
      interactive wound care.

PMID- 7794681
TI  - Cytokine and genetic regulation of psoriasis.

PMID- 7794682
TI  - Phosphoinositidase C beta 1 isoform expression is modulated by interferon alpha
      in Burkitt lymphoma cells.
AB  - The expression of phosphoinositidase C (PIC) at nuclear and cytoplasmic level has
      been revealed in control and interferon treated Burkitt lymphoma cells by means
      of western blotting and immunocytochemical analysis employing specific monoclonal
      antibodies against beta 1, gamma 1 and delta 1 isozymes. Results have indicated
      that PIC isoform beta 1, mainly detectable in the nucleus, undergoes transient
      modifications early after interferon treatment. PIC delta 1 has been found only
      at cytoplasmic level, apparently insensitive to interferon treatment, while PIC
      gamma 1 was scarcely or not detected either in the cytoplasmic or in the nuclear
      compartment. These results suggest that interferon may exert its
      antiproliferative effect activating at least two distinct pathways of signal
      transduction, at cytoplasmic and nuclear level, involving inositol lipid cycle
      mainly in the nucleus by modulation of PIC beta 1 expression.

PMID- 7794683
TI  - Dissociation of phosphatidylinositol-3 kinase activity and mitogenic inhibition
      in vascular smooth muscle cells.
AB  - Phosphatidylinositol-3 kinase becomes activated upon association with stimulated
      tyrosine kinase coupled receptors, but it is also catalytically active in
      platelets incubated with the G-protein coupled growth factor receptor agonist,
      thrombin. Furthermore, phorbol esters have been shown to be growth inhibitory
      when added to vascular smooth muscle cells simultaneously with thrombin. In order
      to clarify the role of phosphatidylinositol-3 (PI-3) kinase in thrombin-induced
      mitogenesis, we asked whether PI-3 kinase activity is decreased in parallel to
      mitogenesis in cells stimulated with phorbol-12-myristate-13-acetate (PMA) and
      thrombin. Although PMA inhibits thrombin-stimulated growth by 92% when the two
      compounds are added simultaneously, the level of PI-3 kinase activity under
      similar conditions is not decreased. This phenomenon is independent of protein
      kinase C, since there is no difference in PI-3 kinase activity when similar
      experiments are performed after protein kinase C is down-regulated by 24 h pre
      incubation with PMA. We conclude that either (i) PI-3 kinase is not required for
      the mitogenic signalling of thrombin, or (ii) PMA is acting downstream of PI-3
      kinase in thrombin's signalling pathway.

PMID- 7794684
TI  - The effect of thrombin and serine proteases on intracellular Ca2+ in rat aortic
      smooth muscle cells.
AB  - Cultures of vascular smooth muscle cells (VSMC) are commonly used to study the
      events and defects found in hypertension and atherosclerosis. In particular Ca2+
      homeostasis in cellular signalling has been the focus of extensive research.
      Since trypsin has been shown to mobilise Ca2+ in some cell types, we have
      investigated its effect on various aspects of Ca2+ homeostasis in rat aortic
      smooth muscle cells (RASMC). The effects of trypsin, alpha-chymotrypsin and
      elastase (other serine proteases) on intracellular Ca2+ in cultured aortic cells
      isolated from Wistar rats have been investigated. Trypsin (24 micrograms/ml)
      elicits intracellular Ca2+ mobilisation, after which cells become nonresponsive
      to thrombin Ca2+ mobilisation but retain responsiveness to Angiotensin II (AII).
      alpha-Chymotrypsin (24 micrograms/m) inhibits the thrombin Ca2+ mobilising
      response, without itself initiating a Ca2+ transient or affecting AII Ca2+
      mobilisation. Elastase (24 micrograms/ml) was not effective in mobilising
      intracellular Ca2+ or inhibiting the thrombin response. We have also observed
      diminished thrombin Ca2+ mobilisation responses between cells in suspension and
      cell monolayers, which appeared to be unrelated to proteolysis but due to
      morphological changes of the cells. Our results suggest that trypsin acts on the
      thrombin receptor via a specific proteolysis mechanism to mobilise intracellular
      Ca2+ ([Ca2+]i) in RASMC. The amount of Ca2+ released by thrombin or trypsin is
      dependent on the morphology of the cell and the state of the tethered ligand of
      the thrombin receptor exposed by the protease.

PMID- 7794685
TI  - Actions of isoproterenol in frog proximal tubules.
AB  - In the present work, we compared biochemical and electrophysiological actions of
      isoproterenol on frog proximal tubular cells by using tubule suspensions and
      giant entities obtained by cell fusion. Isoproterenol (ISO) dose-dependently
      stimulated cAMP production in tubule suspension and depolarized the "giant cell"
      membrane. Both effects were triggered by beta receptor occupancy, but strongly
      differed in their concentration-dependency, since depolarization occurred with an
      ISO concentration as low as 10(-12) mol/l whereas cAMP accumulation could be seen
      only with more than 10(-8) mol/l ISO. ISO-induced membrane depolarization was
      mimicked by forskolin which directly stimulated the catalytic subunit of adenylyl
      cyclase. In both isoproterenol- and forskolin-stimulated giant cells, membrane
      depolarization was accompanied by a decrease in membrane conductance, and both
      effects were inhibited by tetraethylammonium (TEA) and 4-aminopyridine (4-AP). On
      the other hand, ISO- and forskolin-induced cAMP production were not affected by
      TEA. The present data thus show that isoproterenol produces two independent
      effects in frog proximal tubule: it depolarizes the cell membrane by blocking a
      K+ conductance and activates adenylyl cyclase.

PMID- 7794686
TI  - EGF causes hyperproliferation and apoptosis in T51B cells: involvement of high
      and low affinity EGFR binding sites.
AB  - We have recently described an in vitro model for liver homeostasis which involves
      growing T51B rat liver epithelial cells with 1 nM epidermal growth factor (EGF).
      There is an initial period of hyperplasia, lasting about 3 days, which is
      followed by an increase in apoptosis. The cell density returns to around the
      confluent control level 5 days after EGF addition. The dose response of T51B
      cells to EGF shows three distinct growth patterns. We have carried out EGF
      binding studies that suggest that the occupancy of the low affinity binding site
      of the EGF receptor, is responsible for the hyperproliferation seen when the
      cells are grown with high doses of EGF. These studies also suggest that the
      apoptosis could be triggered by down-regulation of the receptor, in a manner
      analogous to the removal of a trophic hormone in other systems.

PMID- 7794687
TI  - G-receptor antagonists increased the activating effect of mastoparan on low Km
      GTPase of mouse PAG.
AB  - Mastoparan activated in a concentration-dependent manner the low Km GTPase
      activity in P2 fractions from mouse periaquedultal grey matter (PAG). This
      peptide at 1-10 mM produced increases of 30-70% over the basal value of 90-120
      pmol Pi/mg/min. A series of substances displaying antagonist activity at cellular
      receptors and not modifying the GTPase function, when used at nanomolar and
      micromolar concentrations enhanced the effect of mastoparan upon this enzyme.
      These included antagonists of receptors coupling G proteins: naloxone (non
      selective opioid antagonist), CTOP (m opioid receptors), ICI 174,864 (d opioid
      receptors), nor-BNI (k opioid receptors), sulpiride (D2 dopaminergic antagonist),
      idazoxan (a2 adrenergic antagonist). Bicuculline, antagonist of a receptor not
      linked to G proteins, GABAA, did not alter the effect of mastoparan on the
      GTPase. The m opioid agonist, DAMGO, prevented naloxone from increasing the
      function of the mastoparan-activated enzyme. Thus, mastoparan appears to act on
      Gi/Go proteins at a site not directly related to the receptor binding domain.

PMID- 7794689
TI  - Structural and functional heterogeneity of insulin receptors.
AB  - It was long believed that the effects of insulin are mediated by a unique insulin
      receptor. However, there is considerable evidence suggesting that insulin
      receptors in brain, liver, adipocytes, and lymphocytes are heterogeneous in
      structure and function. This evidence is based on comparisons of concentration
      response curves in cells and tissues, and on comparisons of binding and effects
      of insulin-derivatives and receptor antibodies. Two receptor isoforms (IR-A and
      IR-B) generated by alternative mRNA splicing have been identified, but cannot
      fully account for the observed differences in ligand binding and receptor
      function. It is suggested that the differences in ligand binding reflect yet to
      be defined post-translational modifications, and that post-receptor events are
      responsible for the observed heterogeneity of insulin action.

PMID- 7794688
TI  - The inhibition of adenylyl cyclase activity in isolated lung membranes by
      muscarinic and alpha-adrenoceptor agonists: role of G-protein alpha and beta
      gamma sub-units.
AB  - Forskolin (10 microM) failed to abolish the GppNHp- (0.1 nM) dependent inhibition
      of adenylyl cyclase activity in isolated membranes. Whilst clonidine (1 microM),
      an alpha 2-adrenoceptor agonist, inhibited adenylyl cyclase activity it did not
      protentiate the GppNHp-dependent inhibition. This indicates that low
      concentrations of the guanine-nucleotide activate sufficient Gi to inhibit
      adenylyl cyclase activity maximally and that clonidine inhibits this enzyme via a
      similar route. These data support a role of alpha i sub-unit inhibition of
      adenylyl cyclase activity. In contrast, forskolin (10 microM) abolished the
      GppNHp (0.001-0.1 nM) dependent inhibition of adenylyl cyclase activity in
      membranes where adenylyl cyclase activity is limited, i.e. where activity has
      been depleted by approximately 80%. In this case, inhibition of adenylyl cyclase
      by beta gamma sub-units is implicated and only becomes evident under these
      conditions. Adenylyl cyclase is also inhibited by muscarinic receptor agonist,
      methacholine and by the alpha 2-adrenoceptor agonists, clonidine and nor
      adrenaline. Both classes of agonist also elicit an increase in the cholera toxin
      catalysed ADP-ribosylation of the splice variant forms of Gs alpha and of a
      polypeptide of 41,000 M(r). The ADP-ribosylation of the 41,000 M(r) polypeptide
      is inhibited by GTP (100 microM) and therefore displays characteristics similar
      to Gi alpha. Muscarinic receptor and alpha 2-adrenoceptor agonists appear to
      inhibit adenylyl cyclase activity in lung membranes predominantly via Gi alpha.
      Lung expresses both type II and IV adenylyl cyclase which are stimulated by
      direct interaction with beta gamma sub-units and this is conditional upon the co
      incident activation of Gs alpha.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794690
TI  - Calcium, calmodulin and cell cycle progression.
AB  - Proliferation of mammalian cells both in vivo and in vitro is dependent upon
      physiological concentrations of extracellular Ca2+. Growth factor stimulation of
      quiescent cells at the G0/G1 border usually results in a rapid mobilization of
      Ca2+ from both intra- and extracellular pools. However, Ca2+ influx is also
      required for later phases of cell cycle transition, especially in the late G1
      phase for initiation of DNA synthesis. Available evidence indicates that
      calmodulin plays the major and essential roles in the Ca(2+)-dependent regulation
      of cell proliferation. Ca2+ and calmodulin act at multiple points in the cell
      cycle, including the initiation of the S phase and both initiation and completion
      of the M phase. Ca2+ and calmodulin stimulate the expression of genes involved in
      the cell cycle progression, leading to activation of cyclin-dependent kinases
      p33cdk2 and p34cdc2. Ca2+ and calmodulin are also involved in activation of
      enzymes participating in nucleotide metabolism and DNA replication, as well as
      nuclear envelope breakdown and cytokinesis. Ca2+/calmodulin-dependent protein
      kinase II and protein phosphatase calcineurin are both involved in the Ca2+ and
      calmodulin-mediated signalling of growth regulation. As compared to normal cells,
      growth of transformed cells is independent of extracellular Ca2+ and much less
      sensitive to calmodulin antagonists, suggesting the existence of derangements in
      the Ca2+ and calmodulin-mediated growth regulation mechanisms.

PMID- 7794691
TI  - A new approach in exciton-coupled circular dichroism (ECCD)--insertion of an
      auxiliary stereogenic center.
AB  - There are cases in which exciton coupling between two chromophores does not occur
      because the two electric transition moments which should interact are coplanar.
      This is seen with cyclohexane-1,4-diols (both ee or ea) and a wide variety of 3
      hydroxy carotenoids, 3-hydroxyretinoids, etc. A general approach to deal with
      such cases is to acylate one of the hydroxyl groups with a chiral allenic acid
      substituted with a suitable chromophore, e.g., CHROM-CH = C = CH-COOH. The
      allenic bond introduces a 90 degrees twist at the italicized central carbon so
      that the allenic CHROM now couples with the second chromophore. This concept of
      introducing an auxiliary allenic center should be of general applicability in
      other similar cases.

PMID- 7794692
TI  - Macromolecular ionophores. 1. Chiral recognition properties of poly[(1-->6)-2,5
      anhydro-D-glucitol] toward racemic amino acid ester.
AB  - The chiral recognition property of poly[(1-->6)-2,5-anhydro-3,4-di-O-alkyl-D
      glucitol] (1) toward racemic RCH (CO2CH3)NH3+.PF6- (2.HPF6) has been studied
      using a transport system involving an aqueous source and receiving phases
      separated by a chloroform phase containing 1. Transport rates for aromatic guests
      2a (R = Ph) and 2b (R = CH2Ph) were faster than those for aliphatic guests, 2c (R
      = CH(CH3)2) and 2d (R = CH2CH(CH3)2), using the polymer substituted with methyl
      groups (1a). The enantiomeric excess (e.e.) was 10.9% for 2a as a maximum value
      and decreased in the order of 2a > 2c > 2b = 2d. When the transport of 2a.HPF6
      was carried out using the polymers with 3,4-di-O-methyl (1a), ethyl (1b), allyl
      (1c), and pentyl (1d) groups, the e.e. was 22.0% for 1d as a maximum value and
      increased in the order of 1a < 1b < 1c < 1d. The formation of a complex between
      1a and 2a.HPF6 was confirmed by 1H and 13C NMR spectral measurements.

PMID- 7794693
TI  - Myocardial uptake kinetics of tocainide enantiomers in the isolated perfused
      rabbit heart.
AB  - The extent of myocardial accumulation of tocainide, administered as single
      enantiomers and as well as racemate, was determined in the isolated, spontaneous
      beating rabbit heart. The heart was retrogradely perfused at a constant rate and
      fractions of the perfusate were collected during and after infusion. Kinetic
      parameters for myocardial accumulation and disposition of tocainide were
      indirectly determined from drug concentration/time course in the outflow
      perfusate. No stereoselectivity in myocardial accumulation was observed. A two
      compartment model with mean half-lives for distribution and elimination of 0.60
      and 3.78 min, respectively, was fitted to the accumulation and disposition data.
      At steady-state, tocainide enantiomers were accumulated about three times in the
      myocardium relative to the perfusion liquid.

PMID- 7794694
TI  - Stereoselective binding of isradipine to human plasma proteins.
AB  - Isradipine (PN 200-110) is a highly potent calcium entry blocker with an
      asymmetrically substituted dihydropyridine ring (methyl- and isopropylester,
      respectively). The binding of the (+)-(S)-isradipine and (-)-(R)-isradipine to
      isolated human serum albumin (HSA, 30 mumol/l) and alpha 1-acid glycoprotein
      (AAG, 10 mumol/l) has been studied in vitro over a wide range of isradipine
      concentrations (0.06-20 mumol/l) using high-performance liquid chromatography
      (HPLC). HPLC experiments revealed that both isradipine enantiomers were bound to
      one class of high-affinity binding sites on the AAG molecule (n(S) = 0.83 +/-
      0.05, Ka(S) = (1.33 +/- 0.25) x 10(6) l/mol, n(R) = 0.85 +/- 0.07, Ka(R) = (1.17
      +/- 0.44) x 10(7) l/mol). The (R)-enantiomer also exhibited an interaction with
      the secondary low-affinity binding sites (n'Ka'(R) = (2.66 +/- 0.65) x 10(4)
      l/mol). In contrast, the pharmacologically more potent (+)-(S)-enantiomer was
      more strongly bound to HSA than its optical antipode (n(S) = 1.07 +/- 0.07, Ka(S)
      = (1.76 +/- 0.26) x 10(5) l/mol, nKa(R) = (3.62 +/- 0.06) x 10(4) l/mol). In
      general, the resulting binding characteristics of individual isradipine
      enantiomers showed stereoselectivity, but this was opposite for the two most
      important plasma binding proteins. The process of accumulation of isradipine by
      human platelets in the therapeutically relevant range (10-80 ng/ml) at 37 degrees
      C was devoid of stereoselectivity.

PMID- 7794695
TI  - Chiral aspects of the metabolism of ethosuximide.
AB  - Ethosuximide is a chiral drug substance primarily indicated for the treatment of
      absence seizures. This drug is used clinically as the racemate. The urinary
      metabolites of ethosuximide (following i.p. administration of the racemate or
      individual enantiomers to rats) have been studied using chiral gas chromatography
      (GC) and gas chromatography-mass spectroscopy (GCMS). The metabolites identified
      were unchanged ethosuximide enantiomers, all four stereoisomers of 2-(1
      hydroxyethyl)-2-methylsuccinimide, and a single stereoisomer of 2-ethyl-3-hydroxy
      2-methylsuccinimide [derived from (R)-ethosuximide]. Preliminary quantitative
      studies indicate a degree of stereoselectivity in the fate of ethosuximide since
      the ratio of (R)- to (S)-ethosuximide in the urine was found to be 0.77:1 (0-24 h
      sample), 0.64:1 (24-48 h sample), and 0.83:1 (48-72 h sample). This would suggest
      that the (R)-isomer is preferentially metabolised. Results obtained following the
      administration of individual enantiomers of ethosuximide indicate that the 2-(1
      hydroxyethyl)-2-methylsuccinimide diastereoisomers derived from (R)-ethosuximide
      are produced in approximately equal proportions [ratio 1.05:1 (0-24 h sample),
      1.10:1 (24-48 h sample)], whilst those from (S)-ethosuximide are produced in
      unequal proportions [ratio 1.65:1 (0-24 h sample), 1.74:1 (24-48 h sample)].

PMID- 7794696
TI  - Planning a public health surveillance system.

PMID- 7794697
TI  - International Classification of Diseases, Tenth Revision.

PMID- 7794698
TI  - I Pan American Conference of Public Health Education and XVI Conference of the
      Latin American and Caribbean Association of Public Health Education (ALAESP).

PMID- 7794699
TI  - Nizatidine treatment of gastro-oesophageal reflux disease.

PMID- 7794700
TI  - Nizatidine versus placebo in gastro-oesophageal reflux disease: a 6-week,
      multicentre, randomised, double-blind comparison. Nizatidine Gastroesophageal
      Reflux Disease Study Group.
AB  - In a randomised, multicentre trial, nizatidine 150 mg or 300 mg or placebo was
      administered twice daily for 6 weeks to 515 patients with gastro-oesophageal
      reflux disease (GORD). Antacid tablets were taken as needed for pain.
      Significantly superior rates of endoscopically proven complete healing (normal
      appearing mucosa) versus placebo occurred after 3 weeks with nizatidine 150 mg
      and after 6 weeks with nizatidine 300 mg. Six-week healing rates were 38.5% for
      nizatidine 300 mg, 41.1% for nizatidine 150 mg, and 25.8% for placebo. The
      nizatidine 150 mg treatment group had significantly greater improvement in
      daytime and nighttime heartburn severity after 1 day of therapy versus placebo.
      Twice-daily administration of nizatidine 150 mg or 300 mg provides prompt relief
      from the major symptom of GORD, heartburn, and complete healing of oesophagitis
      is seen in many patients.

PMID- 7794701
TI  - Nizatidine versus placebo in gastro-oesophageal reflux disease: a 12-week,
      multicentre, randomised, double-blind study.
AB  - Two doses of nizatidine (150 mg twice daily and 300 mg at bedtime), an H2
      receptor antagonist, were compared with placebo in a 12-week, multicentre,
      randomised, double-blind, parallel study in 466 patients with endoscopically
      documented gastro-oesophageal reflux disease. Antacid tablets were given
      concomitantly as needed for pain. Compared with placebo, nizatidine 150 mg twice
      daily was highly effective in rapidly reducing the severity of heartburn,
      regardless of oesophagitis severity at entry. Significantly greater complete
      mucosal healing of oesophagitis occurred after 6 weeks of therapy with nizatidine
      150 mg bid (vs nizatidine 300 mg at bedtime or placebo) only in patients with
      erosive oesophagitis [16/68 (24%) vs 8/65 (12%)] and erosive and ulcerative
      oesophagitis combined [21/99 (21%) vs 10/94 (11%)]. At week 12, healing with
      nizatidine 150 mg bid was also significantly greater than placebo in erosive
      [19/68 (28%) vs 9/65 (14%)], ulcerative [10/31 (32%) vs 3/29 (10%)], and erosive
      and ulcerative oesophagitis combined [29/99 (29%) vs 12/94 (13%)]. These results
      show that twice-daily therapy with nizatidine 150 mg is very effective at
      relieving heartburn, and can also heal erosive and ulcerative oesophagitis.
      Nizatidine 300 mg at bedtime was not effective at healing oesophagitis, compared
      with placebo.

PMID- 7794703
TI  - Do patients who are treated with calcitriol for renal osteodystrophy also need
      vitamin D3 therapy?

PMID- 7794702
TI  - Urinary infection, reflux and renal scarring in females continuously followed for
      13-38 years.
AB  - This study describes the pattern of urinary tract infections (UTI) in 87 females
      prospectively followed for a median of 23 years from their first recognized
      symptomatic infection in childhood. At 16 years of age they were selected for
      follow-up into adulthood because of renal scarring (reflux nephropathy) in 45 and
      recurrent UTI in 42. The attack rate (number of urinary tract infections per
      individual per observation year) was highest during the 1st year of life (1.9),
      with a gradual decrease to the lowest rate (0.2) at age 11-15 years. A moderately
      increased attack rate (0.4), was seen in the late teens, extending through to the
      mid twenties. The proportion of infections having a pyelonephritic character
      decreased with age and number of infection episodes, but not in females with
      severe renal scarring. Pyelonephritic infections were correlated with
      vesicoureteric reflux, and renal scarring to low age at the index infection,
      total number of pyelonephritic episodes and reflux. Females with renal scarring
      continued to have a high proportion of pyelonephritic recurrences after 10 years
      of age, implying that they risk progressive renal disease and should be closely
      followed into adulthood.

PMID- 7794704
TI  - Steroid-resistant, cyclosporine-responsive, relapsing nephrotic syndrome.
AB  - Eighteen children with steroid-resistant nephrotic syndrome received cyclosporine
      A (CsA), including 7 patients with minimal change disease, 4 with focal segmental
      glomerulosclerosis and 7 with mesangial hypercellurarity. Doses were adjusted to
      maintain whole blood trough levels at 80-200 ng/ml and ranged from 5 to 10 mg/kg
      (mean 7 mg/kg). Fourteen patients responded after 2 months of therapy with either
      a complete or partial remission, and received a total of 12 months of CsA with
      low-dose corticosteroids. Remission rates were similar among the three
      histological types, although complete remissions occurred more commonly in
      minimal change disease, while the other two histological types tended to have
      partial responses. Serum creatinine values ranged from 0.3 to 1.2 mg/dl at the
      start of treatment and were stable in 17 of 18 patients during CsA therapy. CsA
      was discontinued after 12 months in 11 responders. Relapses were a significant
      problem. Nine patients had 16 relapses, all occurring within 6 months after
      discontinuing CsA; 13 of 16 relapses responded to CsA and corticosteroids. Five
      children had multiple relapses. Three patients who initially responded to
      treatment had CsA-resistant relapses. There were no differences among the
      histological types with respect to the occurrence of relapses or response to CsA
      after relapsing. Four patients developed chronic renal failure, including 2 of 4
      who failed initial therapy and 2 of 3 who developed CsA-resistant relapses. In
      conclusion, initial therapy with CsA was effective in resolving nephrotic
      syndrome in steroid-resistant patients. However, CsA dependency, frequent
      relapses and the development of chronic renal failure presented significant
      problems.

PMID- 7794705
TI  - Non-nephrotic children with membranoproliferative glomerulonephritis: are
      steroids indicated?
AB  - Alternate-day steroids are currently recommended to treat children with
      membranoproliferative glomerulonephritis (MPGN). This recommendation is based
      largely on uncontrolled studies demonstrating improved renal survival with
      steroid therapy. We reviewed the outcome of 39 children who presented with MPGN
      between 1968 and 1990; 27 children were treated with steroids and 12 children
      received no drug therapy. Life-table analysis comparing renal survival of treated
      versus untreated children demonstrated no difference by log rank analysis.
      Treated and untreated groups were compared on the basis of  nine features at
      presentation: age, sex, type of MPGN, presence and type of hematuria,
      hypocomplementemia renal insufficiency, hypertension, and nephrosis. Treated
      children were likely to be female (P < 0.01) and nephrotic (P < 0.02). Actuarial
      survival analyses were performed comparing the nine features with renal survival
      through 10 years of follow-up. Normotensive (P < 0.025) and non-nephrotic (P <
      0.05) children had improved renal survival. The 11 non-nephrotic children
      demonstrated 100% long-term renal survival, including 7 who received no steroid
      therapy. At last follow-up, all non-nephrotic children had normal renal function,
      serum albumin levels > 3 g/dl, and were normotensive. These data suggest that non
      nephrotic children with MPGN may forego steroid treatment without compromising
      long-term renal function. The current common practice of treating all children
      with MPGN with steroids should be re-examined.

PMID- 7794706
TI  - Localization of extracellular matrix components in congenital nephrotic
      syndromes.
AB  - While renal tissue from one fetus and a newborn with congenital nephrotic
      syndrome, Finnish type (FCNS), showed a normal basement membrane (BM)
      localization and composition, in another type of congenital nephrotic syndrome,
      diffuse mesangial sclerosis (DMS), most glomeruli demonstrated a completely
      disorganized matrix. In the latter, hyalinized glomerular segments were composed
      of irregular deposits of interstitial collagens I, III, V, and extensive deposits
      of heparin sulphate proteoglycan (HSPG), while collagen IV and laminin were
      completely absent in those areas. Apart from these sclerosed glomerular areas,
      normal capillarly loops revealed a matrix composition that was comparable to
      normal glomeruli. The additional immunolocalization of various extracellular
      matrix components during the development of normal human glomeruli revealed some
      significant age-dependent changes both in the localization of interstitial
      collagens and BM components: interstitial collagens I and III disappeared after
      the first S-shaped indentations appeared, while the interstitial collagen V
      remained along the glomerular BM and within the mesangium. The BM components
      showed no significant qualitative changes, but quantitative changes, with a post
      natal relative decrease in the collagen IV and laminin content when compared with
      the level of BM-associated HSPG. Our results provide circumstantial evidence that
      the composition of the extracellular matrix (and in particular of the BM) shows
      age-dependent quantitative changes which may be associated with functional
      adaptation processes of the developing kidney. The observed matrix composition in
      the two different congenital nephrotic syndromes suggests various pathomechanisms
      which may be located either in the molecular structure of the negatively charged
      molecules (e.g. abnormal sulphatation of HSPG in FCNS) or in the dysregulated
      synthesis of various matrix components (DMS).

PMID- 7794708
TI  - What, if any, is the appropriate neurological work-up for a child with autosomal
      dominant polycystic kidney disease and a family history of intra-cranial
      aneurysm?

PMID- 7794707
TI  - Glomerular hyperfiltration increases the risk of developing microalbuminuria in
      diabetic children.
AB  - An elevated glomerular filtration rate (GFR) is frequently detectable in type 1
      diabetic children and adolescents and in those without any other evidence of
      incipient diabetic nephropathy. In 1982 we detected 23 patients with
      hyperfiltration (GFR > 140 ml/min per 1.73 m2), aged 9-15 years, with diabetes
      for longer than 4 years; 23 age- and sex-matched patients with diabetes of a
      similar duration and without hyperfiltration served as controls. Both groups were
      followed until March 1992, by assessing GFR every 12 months, albumin excretion
      rate every 6 months, blood pressure and glycated haemoglobin (HbA1) every 3
      months. Dietary protein intake was similar in patients with hyperfiltration and
      in controls. No other drug except insulin was used throughout the study. The
      insulin regimen was similar in the two groups. There was no significant
      difference between the two groups regarding albumin excretion, blood pressure and
      HbA1 at the beginning of the study. Of the 23 patients with hyperfiltration, 7
      developed persistent microalbuminuria (defined as an overnight albumin excretion
      rate > 30 micrograms/min per 1.73 m2 on at least 5 consecutive measurements); 2
      of these patients had overt proteinuria. Only 1 of the diabetics with normal GFR
      developed persistent microalbuminuria. The positive predictive value for
      microalbuminuria of an initial GFR > 140 ml/min per 1.73 m2 was 63%; the negative
      predictive value of an initial GFR < 140 ml/min per 1.73 m2 was 94%. The increase
      of albumin excretion rate into the microalbuminuric range precedes the elevation
      of both systolic and diastolic blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794709
TI  - Mineral excretion following furosemide compared with bumetanide therapy in
      premature infants.
AB  - Mineral excretion following single doses of furosemide were compared with
      bumetanide in a random cross-over trial in 17 premature infants. The mean
      birthweight and gestational age were 889 +/- 85 g and 27 +/- 2 weeks. Following
      furosemide therapy, significantly higher chloride losses and urine volumes were
      noted in the first 8-h period compared with the second or third 8-h periods.
      Following bumetanide therapy, sodium, calcium, and chloride losses and urine
      volumes were significantly higher in the first 8 h compared with the second or
      third 8-h periods. Hourly sodium and chloride losses were significantly lower
      following bumetanide than furosemide during the first two 8-h periods. During the
      final 8-h period sodium, potassium, chloride, and calcium losses were
      significantly lower following bumetanide than following furosemide. Sodium loss
      per urine volume was lower with bumetanide than furosemide but calcium loss
      tended to be higher. Hence, bumetanide does not appear to be a calcium-sparing
      diuretic following single-dose therapy.

PMID- 7794710
TI  - Renal function in premature infants during aminoglycoside therapy.
AB  - The effect of three different aminoglycosides on renal function was evaluated in
      30 premature infants of similar gestational age who were treated within 24 h of
      birth with either amikacin (10 infants, group A), gentamicin (10 infants, group
      B) or netilmicin (10 infants, group C), for a period of 7 days. Ten infection
      free premature infants of similar post-conceptional age were used as controls.
      Serial determinations of plasma creatinine concentration (PCr), as well as the
      fractional excretion of sodium (FENa), potassium, magnesium (FEMg), phosphate
      (FEP) and uric acid (FEUA), and the urinary excretion of calcium (UCa/UCr ratio)
      were assessed before, during and after treatment. During the treatment period a
      significant increase in FENa, FEMg and UCa/UCr was observed in group B (P < 0.05
      and P < 0.01, respectively) and an increase in FENa and UCa/UCr in group C (P <
      0.01) compared with controls. These disturbances were observed with trough
      concentrations of aminoglycosides but were accentuated at peak serum
      concentrations and were restored to normal 2 days after stopping therapy. In
      addition, a significant correlation was demonstrated between FENa, FEMg and
      UCa/UCr ratio in treated patients. PCr levels decreased similarly in all patient
      groups, but in 8 of 30 infants (27%) they remained elevated and returned to
      control values only 10 days after stopping therapy. Such renal functional
      disturbances, although transient, may result in significant electrolyte and
      mineral imbalance in the sick premature infant.

PMID- 7794711
TI  - Ambulatory blood pressure monitoring in paediatric patients treated by regular
      haemodialysis and peritoneal dialysis.
AB  - Ambulatory blood pressure monitoring (ABPM) has been shown to be more
      representative of blood pressure (BP) levels than casual BP measurements in adult
      patients treated by haemodialysis (HD). In this study we compared ABPM using the
      oscillometric SpaceLabs 90207 monitor with casual BP measurements in 35
      paediatric patients [17 treated by peritoneal dialysis (PD) and 18 by HD]. Heart
      rate and plasma concentrations of atrial natriuretic peptide were also measured.
      No correlations were found between ABPM and causal BP measurements, except for
      systolic day-time BP in PD patients (r = 0.63). Seventy percent of PD and 33% of
      HD patients were regarded as hypertensive when evaluated by ABPM, while casual BP
      measurements demonstrated hypertension in 47% (P < 0.05) of PD patients and in
      44% (NS) of HD patients. One-third of patients were reclassified by ABPM either
      from normotensive to hypertensive (7/19) or from hypertensive to normotensive
      (5/16). BP assessed by ABPM was higher in PD than in HD patients. The
      physiological decline of BP at night was significant and more pronounced in PD
      than in HD patients. In HD patients day-time BP did not differ between the 1st
      and the 2nd interdialytic day, but increased in the night hours before the
      following dialysis session. A positive correlation was found between day-time BP
      and pre-dialysis plasma atrial natriuretic peptide in both treatment groups. In
      conclusion this study demonstrates that casual BP recordings are not
      representative of average BP in dialysed paediatric patients. ABPM is useful in
      the diagnosis and treatment of hypertension in children with end-stage renal
      disease.

PMID- 7794712
TI  - Nephrocalcinosis in X-linked hypophosphatemia: effect of treatment versus
      disease.
AB  - While the literature has suggested that vitamin D and phosphate therapy benefits
      children, and possibly adults, with X-linked hypophosphatemia (XLH), there have
      been increasing reports of nephrocalcinosis by renal ultrasound examination in
      treated patients. Although it has been assumed that nephrocalcinosis is the
      result of treatment, there has been no systematic comparison of treated and
      untreated XLH patients with long-term follow-up. Therefore, we studied 10 adults
      and 4 children by renal ultrasound examination with no history of medical therapy
      and 10 adults and 8 children with a history of medical therapy. None of the
      untreated patients had nephrocalcinosis; 5 treated adults and 5 treated children
      had nephrocalcinosis. In 3 of 4 treated children, serial renal ultrasounds did
      not show progression of the nephrocalcinosis. One patient progressed from
      baseline to year 1 only. Comparisons of means between treated patients without
      and with nephrocalcinosis showed statistically significant differences for urine
      calcium/creatinine ratios and urine phosphorus/creatinine ratios, differences not
      seen between untreated patients and treated patients without nephrocalcinosis.
      Phosphate dose, but not vitamin D dose, was statistically significantly different
      between the two treated groups. Our studies point to a convincing role for the
      association between nephrocalcinosis, as diagnosed by renal ultrasound
      examination, and medical therapy.

PMID- 7794713
TI  - Effects of growth hormone on kidney function in pediatric transplant recipients.
AB  - Recent evidence suggests that treatment with recombinant human growth hormone
      (rhGH) after a successful kidney transplant improves the growth rate of children
      with short stature. We prospectively investigated eight children (6 boys, 2
      girls), focusing on acute rejection episodes and changes in serum creatinine
      levels during rhGH treatment. The children (mean age 11.6 +/- 3.4 years) received
      rhGH daily (0.04-0.05 mg/kg subcutaneously). Seven patients completed at least 12
      months (20 +/- 8 months) of rhGH treatment. Their mean serum creatinine level was
      1.3 +/- 0.7 mg/dl 12 months before, and increased to 3.4 +/- 4.2 mg/dl after 12
      months of rhGH treatment, but did not achieve statistical significance (P =
      0.06). Their mean calculated glomerular filtration rate was 58 +/- 20 ml/min per
      1.73 m2 12 months before, and decreased to 38 +/- 21 ml/min per 1.73 m2 after 12
      months of rhGH treatment, but did not achieve statistical significance (P =
      0.08). Of the seven patients, two developed acute rejection after 5 and 6
      rejection-free years; three lost their grafts and returned to dialysis. These
      preliminary observations describe untoward renal events in children receiving
      rhGH treatment after a kidney transplant.

PMID- 7794714
TI  - Nephroblastoma and end-stage renal failure with bilateral cystic kidneys.
AB  - A child of 10 years 5 months presenting with chronic renal failure had bilateral
      cystic kidneys. Biopsy of a right lower-pole solid mass revealed nephroblastoma.
      At bilateral nephrectomy, both kidneys were both replaced by variable-sized cysts
      with a unifocal nephroblastoma on the right. Renal failure with nephroblastoma is
      uncommon and is usually either a manifestation of the Drash syndrome or a
      complication of chemotherapy. The need to assess both kidneys in a child with any
      other renal abnormality in addition to a renal mass should always be considered.

PMID- 7794715
TI  - IgG subclass levels in pediatric patients on chronic peritoneal dialysis.
AB  - Patients maintained on chronic peritoneal dialysis (CPD) have been reported to
      have a variety of abnormalities of humoral immunity, including
      hypogammaglobulinemia, altered response to vaccination, and selective absence of
      IgG2. We measured serum immunoglobulin and IgG subclass levels in 22 pediatric
      CPD patients followed at our institution; 8 patients had low total IgG; 4 of
      these had low levels of IgG2 and 3 also had low IgG1, but IgG2 levels were
      detected in all patients. Thus, many pediatric CPD patients may have low IgG, and
      some may have low IgG1 and IgG2 as a reflection of low total IgG. However, we did
      not demonstrate a selective absence of IgG2 in these patients.

PMID- 7794717
TI  - Tubulointerstitial nephritis and uveitis: an immunological disorder?
AB  - A 14-year-old boy with tubulointerstitial nephritis and uveitis (TINU syndrome)
      is described. Nephropathy improved without systemic cortisone treatment, whereas
      uveitis relapsed and was treated with topical steroids. Blood cell immunological
      analysis and serum analysis revealed signs of cytotoxic T-cell, macrophage and
      granulocyte activation, which declined as the clinical symptoms improved. This
      may be interpreted as an indication of their significance as markers in the
      pathogenesis of this syndrome or as part of a microbial-triggered immune
      response.

PMID- 7794716
TI  - Paediatric renal transplantation non-compliance.
AB  - The aim of this study was to quantify and where possible objectively confirm the
      magnitude of non-compliance (NC) in our paediatric renal transplant recipients. A
      total of 94 paediatric transplants were performed between 1984 and 1989; 17 were
      excluded due to graft loss (2), death (3), oxalosis (2) and transfer to the adult
      unit (10). NC was assessed as missed clinic visits plus medication shortages or
      actual admission of NC. NC was found in 22% (17/77) of transplanted patients. NC
      showed no correlation with parental marital status, sex, distance lived from the
      hospital, pre-emptive transplant status or total lymphoid irradiation. Most NC
      was peripubertal with a smaller NC in the late teenager group. Social class
      correlated positively with NC; 82.3% of NC was from social classes III and IV,
      who formed 52.4% of the patients. NC in social class II (3/26) was significantly
      different from social class IV (12/24) (P = 0.01); 91% of black patients with NC
      were from social class IV. Race, corrected for social class, failed to reach
      significance (P > 0.05). Confirmation of compliance was sought from retrospective
      cyclosporin A (CsA) trough levels (twice daily dosage). Concomitant phenytoin
      therapy and CsA given as a daily dosage were excluded as significant confounding
      variables. The CsA dosage was not significantly different between the compliant
      (C) and patients with NC. Patients with NC were 8 times more likely to have a CsA
      level < 10 ng/ml (P = 0.0026) than C patients.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794718
TI  - Improved absorption of cyclosporin A from a new microemulsion formulation:
      implications for dosage and monitoring.
AB  - Recently, a new oral microemulsion formulation of cyclosporin A (CsA)--Neoral
      (Sandoz, Basle, Switzerland)--with a higher bioavailability has become available.
      Ten stable paediatric renal transplant recipients with excessive variations in
      CsA trough levels with the original Sandimmun (Sandoz, Basle, Switzerland)
      preparation were switched to Neoral on a 1:1 basis. Pharmacokinetic studies
      revealed impaired absorption of Sandimmun in six patients. Compared with equal
      doses of Sandimmun, the 8-h area under the concentration-time curve increased
      from 1,422 to 2,657 ng x h/ml and the peak concentration rose from 319 to 824
      ng/ml (P < 0.01). In six patients with Sandimmun malabsorption, conversion on a
      1:1 basis led to a reduction in creatinine clearance which was reversible after
      dose reduction by 9%-25%. With trough levels at the lower end of the present
      target range, creatinine clearance stabilised around pre-conversion values.

PMID- 7794719
TI  - Balloon dilation of inferior vena cava stenosis causing hemodialysis graft
      failure.
AB  - Inferior vena cava stenosis developed after an unsuccessful renal transplant in a
      3-year-old child. Resulting venous outflow obstruction consequently prevented
      construction of a functional hemodialysis arteriovenous shunt at the femoral
      area. Transluminal balloon angioplasty of the stenosis completely eliminated the
      obstruction and allowed creation of the shunt.

PMID- 7794720
TI  - Renal biopsy in children: indications, technique and efficacy in 119 consecutive
      cases.
AB  - Consecutive renal biopsies were performed on native kidneys in 109 children and
      adolescents, aged 0.1-19.8 (mean 9.9) years (119 biopsies). Bleeding diatheses
      were excluded or treated pre-operatively with intravenous desmopressin acetate.
      Biopsies were performed by a radiologist under ultrasound imaging, using an
      automated spring-loaded device allowing selection of the length of the needle
      movement and score size. Diagnostically adequate tissue was retrieved in 118 of
      119 (99.2%) biopsy procedures; 24-h post-biopsy ultrasonography disclosed a small
      haematoma of the biopsied kidney in 26% of the cases. No correlation was seen
      between the occurrence of haematoma and (treated) prolonged bleeding time or a
      decrease in the haemoglobin level. No major complications occurred. Newly
      developed macroscopic haematuria was reported by 7% and micturition pain by 7% of
      patients. Painful body movements were reported by 37%. We conclude that the use
      of ultrasound imaging and an automated gunshot technique is a safe and efficient
      method for performing renal biopsies in paediatric patients.

PMID- 7794721
TI  - Anti-neutrophil cytoplasmic antibody associated glomerulonephritis in a patient
      with Down's syndrome.
AB  - A 9-year-old boy with Down's syndrome developed a glomerulonephritis associated
      with crescents and anti-neutrophil cytoplasmic antibodies (ANCA). The patient
      also had type 1 diabetes mellitus, chronic lymphocytic thyroiditis, and bronchial
      asthma. Prednisone therapy resulted in an improvement in renal function and a
      reduction in ANCA titers.

PMID- 7794722
TI  - Tumor lysis syndrome: pathogenesis and management.
AB  - Tumor lysis syndrome refers to the metabolic disturbances (hyperuricemia,
      hyperphosphatemia, hyperkalemia, and hypocalcemia) associated with
      lymphoproliferative malignancies which occur secondary to cell lysis. In some
      patients, tumor lysis results in acute renal failure. The nature and severity of
      the metabolic alterations are variable and may be influenced by the timing and
      intensity of chemotherapy, the magnitude of cell lysis, and the general condition
      of the patient with respect to hydration and glomerular filtration rate. Not only
      do hyperuricemia and hyperphosphatemia result from tumor lysis syndrome, they
      also contribute to oliguric acute renal failure in patients with tumor lysis. The
      pathogenesis of tumor lysis syndrome and current therapeutic strategies are
      discussed.

PMID- 7794723
TI  - The intravenous urogram in the detection and evaluation of renal damage following
      urinary tract infection.
AB  - Intravenous urography (IVU) still provides the most comprehensive structural
      assessment of the urinary tract. In particular, the radiological renal
      appearances approximate closely to the morphology of the renal scarring of reflux
      nephropathy or chronic atrophic pyelonephritis. It also provides reproducible
      renal measurements for follow-up assessment of renal growth and scarring. It is
      now less often used for first-line investigation of the acute urinary tract
      infection (UTI) because the swelling accompanying acute renal involvement is less
      easily recognised than the areas of defective function demonstrated on
      99mtechnetium-dimercaptosuccinic acid (DMSA) studies. Also IVU contributes a
      higher radiation dose when calculated for full IVU (dependent on the number of
      films exposed) and there is a slight risk of side effects from injected contrast
      media, reduced by using non-ionic compounds. Because of its value in confirming
      such a serious diagnosis as renal scarring, suspected on ultrasonography or DMSA
      scintigraphy, modification of the technique of IVU with adequate preparation and
      the use of a reduced number of films, or single films localised to the renal
      areas, should be considered. Expertise in the interpretation of IVU must also be
      maintained because of the ancillary information regarding bowel and bladder
      function, the spine and evidence of stones, pertinent to the management of
      children with UTI and renal scarring. IVU and DMSA study remain complementary
      investigations.

PMID- 7794724
TI  - Update on dimercaptosuccinic acid renal scanning in children with urinary tract
      infection.
AB  - The dimercaptosuccinic acid (DMSA) renal scan is a method for assessing kidney
      function. Indications for DMSA scanning in children with urinary tract infection
      (UTI), as well as timing, have changed. Pitfalls in interpreting DMSA scans
      include: (1) acute pyelonephritis (APN), (2) tubular dysfunction, (3)
      hypertension, (4) use of captopril in patients with renovascular hypertension and
      (5) duplex kidneys. Interpretation of DMSA scans in children with UTI vary
      according to timing and clinical setting. During the course of a febrile UTI a
      DMSA scan may reveal a normal kidney, APN or a non-functioning, small and/or
      ectopic kidney. In the absence of UTI (up to 6 months) in children with
      vesicoureteric reflux a DMSA scan may indicate a normal kidney, renal scarring
      (reflux nephropathy), occult duplex kidney and allows the progression of scarring
      and hypertrophy of normal areas of the kidney to be followed anatomically. The
      DMSA renal scan in now the most reliable test for the diagnosis of APN. The
      transient abnormalities due to APN can occur in normal or scarred kidneys.
      Lesions due to reflux nephropathy (defined as a defect in the renal outline or
      contraction of the whole kidney) are permanent. Intravenous urography reveals
      renal abnormalities later than the DMSA scan. If abnormalities are seen on a DMSA
      scan performed during the course of APN it is impossible to predict the outcome:
      they can progress to permanent scarring or heal completely. An abnormal DMSA scan
      during a febrile UTI allows the identification of children at risk of developing
      renal scars. These children should be carefully investigated, maintained on long
      term quimioprophylaxis and followed.

PMID- 7794726
TI  - Clinical quiz. Renal amyloidosis.

PMID- 7794727
TI  - Clinical quiz. Cerebral venous thrombosis.

PMID- 7794728
TI  - Reversible encephalopathy after intravenous ciprofloxacin therapy.

PMID- 7794725
TI  - Nitric oxide and endothelin in pathophysiological settings.
AB  - The role of the endothelium is now known to encompass the generation of many
      potent cytokines which impact endothelial cells, adjacent tissue such as smooth
      muscle cells, and distant sites in an autocrine, paracrine, and endocrine manner,
      respectively. This review addresses two of these cytokines, nitric oxide and
      endothelin, and describes how each effects the functions of endothelial cells,
      including regulation of platelet aggregation and coagulation, regulation of
      vasomotor tone, modulation of inflammation, and the regulation of cellular
      proliferation. The emphasis is on the increasingly recognized importance of the
      autocrine and paracrine mechanisms by which nitric oxide and endothelin act. In
      particular, autoinduction of endothelin is proposed as a central mechanism
      underlying endothelin's renowned effects. Additionally, specific nitric
      oxide/endothelin interactions are discussed by which each cytokine modulates the
      production and actions of the other. The net effect observed in a variety of
      physiological and pathophysiological settings, therefore, reflects a balance of
      these opposing functions.

PMID- 7794729
TI  - Do children with diffuse mesangial sclerosis in association with mutations of the
      Wilm's tumour suppressor gene (WT1) require bilateral nephrectomy?

PMID- 7794731
TI  - Approval of cysteamine for patients with cystinosis.

PMID- 7794730
TI  - Renal anomalies in Down syndrome.

PMID- 7794732
TI  - Computed tomography or intravenous urography in the evaluation of renal damage in
      children with urinary tract infection?

PMID- 7794734
TI  - Expanded programme on immunization (EPI). Progress towards the global elimination
      of neonatal tetanus, 1989-1993.

PMID- 7794733
TI  - Computed tomography or intravenous urography for renal damage in childhood
      urinary infection?

PMID- 7794735
TI  - Cerebrospinal meningitis.

PMID- 7794736
TI  - Diarrhoeal diseases in Bali.

PMID- 7794737
TI  - A man of standards. Interview by Graham Scott.

PMID- 7794738
TI  - Community care. Temporary address, permanent care.

PMID- 7794740
TI  - Male nurses: losing their job advantage?
AB  - Though the overall population of nurses remains at the same level, the number of
      male nurses is on the rise. With male nurses traditionally being an advantaged
      minority, this may increase competition for jobs.

PMID- 7794739
TI  - The role of the nurse: extended or expanded?
AB  - The subject of role extension has been much debated, particularly in recent years
      as a result of changing healthcare policies, growing demands by nurses and the
      public, and arguments about the very nature of nursing itself. The recent media
      furore over the theatre sister who performed an appendectomy is but one example.
      This article will take account of recent trends and look at the different
      concepts of role extension and role expansion. How nursing can best adapt these
      roles to meet patients' needs will also be considered.

PMID- 7794741
TI  - Blood transfusion (continuing education credit).

PMID- 7794742
TI  - Grief reactions and learning disabilities.
AB  - Although the past two decades have seen an unprecedented interest among
      professionals in issues related to death, bereavement and grief, there is still a
      great deal of ignorance about grief among people with learning disabilities. Such
      ignorance can affect the overall care of bereaved people and may cause
      professionals to interpret normal grief reactions incorrectly (1).

PMID- 7794743
TI  - Gender: know your place.

PMID- 7794744
TI  - Disabled rights: free wheeling.

PMID- 7794745
TI  - AIDS-related lymphomas: from pathogenesis to pathology.

PMID- 7794746
TI  - Trisomy 11: an association with stem/progenitor cell immunophenotype.
AB  - The clinicopathological features and the prognostic significance of acute myeloid
      leukaemia (AML) with trisomy 11 are currently unknown. In this study we describe
      15 adult AML cases with trisomy 11. Trisomy 11 was the sole chromosomal anomaly
      in eight cases; the remaining seven cases were characterized by +11 in
      association with other karyotypic aberrations. Patients ages ranged from 34 to 79
      years. 12 patients were male; three were female. Although there was no
      correlation of trisomy 11 with any specific FAB subgroup [M2 (n = 7), M1 (n = 5),
      M4/5 (n = 2), M3 (n = 1)] less mature forms predominated. Immunologically, the
      leukaemic blasts showed a strikingly consistent stem cell phenotype with
      expression of HLA-DR, CD34 and the myeloid antigens (CD15, CD33 and/or CD13). In
      addition, two cases expressed the B-cell associated antigen CD19. The presence of
      trilineage dysplasia, suggesting the presence of an underlying myelodysplasia
      (MDS), was observed at presentation in five cases; in another case MDS was
      evident at relapse only. Unexpectedly, MLL gene rearrangements were observed in
      two of four cases characterized by trisomy 11 as the sole karyotypic abnormality;
      however, MLL aberrations were not identified in three cases with trisomy 11
      accompanied by other karyotypic anomalies. The majority of patients in each
      subgroup (i.e. those with and without additional cytogenetic abnormalities)
      achieved a short first complete remission (CR) (mean 8 months) and failed to
      obtain a second CR. Only one patient in each trisomy 11 subgroup is in a
      continuous CR for > 34 months. These findings suggest that trisomy 11 leukaemia
      is characterized by a stem/progenitor cell immunophenotype with poor response to
      standard chemotherapeutic regimens and an unfavourable prognosis.

PMID- 7794747
TI  - A phase I/II trial of recombinant human interleukin-6 in patients with aplastic
      anaemia.
AB  - In a phase I/II study, 11 patients with marrow failure (10 with acquired aplastic
      anaemia and one with pancytopenic Fanconi anaemia) were treated with recombinant
      human interleukin-6 (rhIL-6) to assess the safety and tolerability of rhIL-6 and
      its effects on peripheral blood counts, bleeding complications and transfusion
      requirements. All patients with acquired aplastic anaemia were refractory to
      immunosuppressive treatment or had relapsed after immunosuppressive therapy and
      were not bone marrow transplantation candidates. Recombinant hIL-6 was to be
      given as a once-daily subcutaneous injection for 28 d at doses ranging from 0.5
      to 5.0 micrograms/kg. After an observation period of 2 weeks, five patients
      received a second treatment course of 28 d. Only one patient had a sustained
      increase in platelet count from 18,000 to 72,000/microliters. Bleeding occurred
      in four patients and caused premature discontinuation of rhIL-6 therapy in three
      patients. A deterioration of pre-existing anaemia was observed in nine patients.
      No significant changes of leucocyte counts were observed during the first cycle.
      During the second cycle the peripheral blood monocyte counts decreased
      significantly. No significant changes in bone marrow cellularity were observed.
      Recombinant hIL-6 induced a dose-dependent increase in acute-phase reactants in
      all patients. Other adverse events included fever, headache, arthralgia,
      tachycardia and hypertension. In conclusion, rhIL-6 given alone at low doses does
      not increase platelet counts in the majority of patients with aplastic anaemia
      and can precipitate a sudden worsening of pre-existing anaemia and
      thrombocytopenia. This study was discontinued prematurely on account of the
      toxicity of rhIL-6 seen in patients with aplastic anaemia.

PMID- 7794748
TI  - Flow cytometric analysis of homologous restriction factor 20KD (HRF20) expression
      on progeny cells during differentiation from haemopoietic progenitors in
      paroxysmal nocturnal haemoglobinuria.
AB  - Paroxysmal nocturnal haemoglobinuria (PNH) is an acquired clonal disorder with a
      deficiency of glycosylphosphatidylinositol (GPI) anchored proteins. Homologous
      restriction factor 20KD (HRF20, CD59) is a GPI-anchored and major complement
      regulatory protein which plays a key role in the haemolytic mechanism of PNH. We
      examined the differentiation stage at which the PNH abnormality occurs, by means
      of flow cytometric analysis of HRF20 expression. Non-phagocytic mononuclear
      marrow cells were labelled with anti-HRF20 monoclonal antibody and sorted into
      either HRF20-negative or -positive fractions. The sorted cells were cultured in
      methylcellulose and their progeny in the colonies or bursts were analysed for
      HRF20 expression. All colonies and bursts from HRF20-negative fractions remained
      negative, whereas those from HRF20-positive fractions were either positive or
      negative. The possibility of a sorting error was excluded, because the secondary
      colonies from the HRF20 positive primary colonies consisted of both positive and
      negative progeny. These results suggest that there are several stages during
      differentiation from early progenitors to mature cells, at which the PNH
      abnormality becomes manifest.

PMID- 7794749
TI  - Molecular analysis of the chromosomal breakpoint and fusion transcripts in the
      acute lymphoblastic SEM cell line with chromosomal translocation t(4;11).
AB  - The chromosomal breakpoint and fusion transcripts of the pre-B-leukaemia-derived
      SEM cell line carrying a reciprocal t(4;11)(q21;q23) translocation were analysed.
      The breakpoint from derivative chromosome der4 was cloned and sequenced. The
      crossover site was localized in intron 7 of the ALL-1 gene on chromosome 11q23
      and in a large intron of the AF-4 (FEL) gene. RNA transcripts from both wild-type
      genes and both hybrid genes were detected by reverse transcriptase polymerase
      chain reaction (RT-PCR) assays. In addition, alternatively spliced mRNA species
      derived from the der4 chromosome were found. They were generated by using the
      exon 5' of the breakpoint on der4 as a common splice donor site and the 5'
      boundaries of exons 8 or 9 of the ALL-1 gene as alternative splice acceptor
      sites. The hypothesis is proposed that selective pressure operators to maintain
      the presence of both derivative chromosomes as important elements in the
      leukaemogenic process.

PMID- 7794750
TI  - Antenatal screening for fetal alloimmune thrombocytopenia: the results of a pilot
      study.
AB  - Feto-maternal incompatibility for the human platelet antigen HPA-1a is an
      important cause of severe fetal thrombocytopenia. The incidence is 1 in 1000-2000
      pregnancies, which is more common than other conditions for which screening is
      presently carried out. Antenatal diagnosis and management are now available, but
      only for subsequent siblings following diagnosis of a previously affected infant.
      This study describes a pilot prospective screening programme for the antenatal
      detection of fetomaternal alloimmune thrombocytopenia (FMAIT) due to HPA-1a
      incompatibility. 3473 women were typed for HPA-1a using a method designed for
      large-scale typing. 71 women found to be HPA-1a negative were further tested for
      HLA-DR52a as a risk factor for alloimmunization. All women were monitored for the
      development of anti-HPA-1a throughout pregnancy and a cord full blood count was
      taken at delivery. Two affected pregnancies were found and treated: a singleton
      pregnancy was treated antenatally and a twin pregnancy after delivery. The study
      showed that screening for FMAIT could be established within the pre-existing
      antenatal red cell serology programme. It was concluded that screening should be
      based on platelet typing and offered regardless of parity. Further
      stratification, combining DR52a typing and HPA-1a antibody screening, although
      focusing on the group of women at greater risk, may not identify all affected
      pregnancies. Confirmation of the diagnosis and severity of FMAIT continues to
      depend on fetal blood sampling during pregnancy or cord blood samples after
      birth.

PMID- 7794751
TI  - The determination of spontaneous megakaryocyte colony formation is an unequivocal
      test for discrimination between essential thrombocythaemia and reactive
      thrombocytosis.
AB  - Spontaneous colony formation from bone marrow megakaryocyte progenitors (BMsCFU
      Mk) was studied in 24 patients with essential thrombocythaemia (ET), 20 patients
      with reactive thrombocytosis (RT), 20 patients with polycthaemia rubra vera with
      thrombocytosis (PRVtr), 16 patients with chronic myeloid leukaemia with
      thrombocytosis (CMLtr) and 18 normal control subjects (C). The culture medium
      which was used in the methylcellulose assay in vitro contained 30% of plasma from
      a single patient with hereditary haemochromatosis. Remarkable BMsCFU-Mk growth
      was recorded in all patients with ET but in none with RT or in C. BMs-CFU-Mk were
      present in 11/20 patients with PRVtr and 7/16 patients with CMLtr. Spontaneous
      bone marrow erythroid progenitors (BMsBFU-E) were also determined in these
      patients. BMsBFU-E were found in 21/24 patients with ET and none in the patients
      with RT and C. All patients with PRVtr and one patient with CMLtr showed BMsBFU
      E. We conclude that our implementation of the in vitro methylcellulose assay
      allows the BMsCFU-Mk to be used as an unequivocal test for discrimination between
      ET and RT which has not been shown in previously published studies. In addition,
      we present evidence that in 10 patients BMsCFU-Mk and/or BMsBFU-E growth in the
      test persisted after long-lasting haematological remission.

PMID- 7794752
TI  - Bacterial infection-associated improvement of platelet counts in two patients
      with chronic and unresponsive idiopathic thrombocytopenic purpura with normal
      platelet survival studies.
AB  - Approximately 20% of adult patients with idiopathic thrombocytopenic purpura
      (ITP) do not respond to splenectomy and require alternative therapies to achieve
      a clinically safe platelet count. A small percentage of these patients have very
      refractory disease and are either unresponsive or poorly responsive to almost any
      therapy. In this report we describe two patients with chronic and unresponsive
      ITP with normal platelet survivals. Neither patient had responded to a large
      variety of treatments including corticosteroids, splenectomy, IVIgG, anti-D,
      chemotherapy, and ascorbic acid. However, both had a rapid, but short-lived, rise
      in their platelet count following a bacterial infection. One patient had a rise
      in platelet count for 6 months following the acute episode of bacteraemia. The
      second patient had a shorter response of 1 week. It is possible that these two
      patients represent a subset of patients with ITP who may benefit from cytokine
      therapy.

PMID- 7794753
TI  - Direct evidence for dissociated megakaryocytic chimaerism in a Wiskott-Aldrich
      patient successfully allografted.
AB  - We report a Wiskott-Aldrich patient who underwent allogeneic bone marrow
      transplantation from his HLA-identical sister at the age of 25. Conditioning
      regimen consisted of cyclophosphamide (180 mg/kg) and thoraco-abdominal
      irradiation (6 Grays). Cytogenetic follow-up revealed rapid and complete lymphoid
      chimaerism, but prolonged mixed bone marrow chimaerism. Correlative interphase
      cytogenetics performed on bone marrow smears using dual-colour fluorescence in
      situ hybridization with X and Y specific probes showed that the proportion of
      donor cells was significantly higher within megakaryocytes than in other
      lineages. This patient therefore presented with dissociated lineage engraftment,
      which is not exceptional in congenital diseases and aplastic anaemia, but has not
      previously been described in Wiskott-Aldrich syndrome. Bone marrow
      transplantation was successful despite this delayed engraftment which ensured
      adequate production in the involved cell lines.

PMID- 7794754
TI  - Sustained increase in haemoglobin and RBC following long-term administration of
      recombinant human erythropoietin to patients with homozygous beta-thalassaemia.
AB  - Recombinant human erythropoietin (rHuEPO) was given subcutaneously three times
      per week in an escalating dose from 500 u/kg to 950 u/kg together with ferrous
      fumarate 305 mg and folic acid 5 mg/d, to 10 patients from four unrelated Arab
      families with homozygous beta-thalassaemia. Six splenectomized patients showed a
      mean (+/- standard error) increase in haemoglobin from 7.1 +/- 0.1 to 9.3 +/- 0.1
      g/dl (P = 0.0001), in RBC from 4.0 to 5.0 x 10(12)/l (P = 0.0001) and in
      nucleated RBC from 32 +/- 7 x 10(10)/l to 82 +/- 6 x 10(10)/l while receiving 750
      u/kg three times per week which persisted for 4-11 months. In two patients there
      was no need for further blood transfusions. In three out of four unsplenectomized
      patients there were no changes in Hb and RBC despite dose escalation. There were
      no significant changes in MVC, MCH and reticulocyte count, serum bilirubin, LDH,
      malonyldialdehyde (MDA) and vitamin E levels. After 13 weeks of rHuEPO there was
      a mean increase in the percentage of F cells from 31 +/- 10% to 86 +/- 6% (P <
      0.003) in three splenectomized patients and in one unsplenectomized patient from
      56.4% to 80% without changes in the levels of Hb F. Globin chain synthesis ratios
      did not change in four responding patients. Mean serum iron and transferrin
      saturation index did not change, whereas mean serum ferritin increased from 299
      +/- 45 micrograms/l to 480 +/- 20 micrograms/l (P < 0.001). In seven responding
      patients an accelerated linear growth was indicated by positive changes in height
      standard deviation score for chronological age. Side-effects were minimal
      throughout the treatment period.

PMID- 7794756
TI  - Rearrangement of the immunoglobulin heavy chain gene in juvenile chronic myeloid
      leukaemia.
AB  - Five patients with clinical and laboratory features typical for juvenile chronic
      myeloid leukaemia (JCML) are presented. Rearrangement of the j joining region of
      the immunoglobulin heavy chain (Jh) was demonstrated in three children out of
      five analysed. As no Vh to DhJh nor kappa light chain rearrangements were
      demonstrated, it is reasonable to speculate that the transforming event of the
      stem cell happened at the stage when Dh to Jh rearrangement took place. As the
      monocytic lineage is prominent in JCML, it is suggested that the transforming
      event happens in a unique stem cell with intermediate differentiation towards the
      myelomonocytic as well as the B-lymphatic lineage. This stem cell, which is
      present at a certain stage of embryogenesis, disappears later. Such an early
      'hybrid' cell is sometimes involved in leukaemias of early infancy, and may be
      the transformed cell in some cases of infantile leukaemia.

PMID- 7794755
TI  - Philadelphia chromosome-negative chronic myeloid leukaemia: a report of 14 new
      cases.
AB  - The Philadelphia chromosome (Ph) is the cytogenetic hallmark of chronic myeloid
      leukaemia (CML) and is used to confirm the diagnosis of CML based on clinical and
      morphological criteria. We investigated 14 patients with features of CML but
      without detectable Ph chromosome. In seven patients, referred to as BCR+, M
      bcr/abl rearrangement was detected by polymerase chain reaction (PCR). The seven
      remaining patients did not have M-bcr/abl rearrangement and are described as BCR
      . BCR- patients were younger, had lower white blood cell counts (WBC) and lower
      basophilia. Four BCR- and four BCR+ patients underwent blastic transformation
      (BT). Response to therapy was fairly similar in both populations. According to
      French-American-British (FAB) Cooperative Leukaemia Group guidelines, all BCR-
      patients were classified as having classic form CML or 'chronic granulocytic
      leukaemia' (CGL) when based only on morphological data. This study further
      confirms the existence of true CML cases without Ph chromosome or M-bcr/abl
      rearrangement and shows that this entity differs only slightly from classic form
      Ph+ CML. The Ph-BCR- subgroup raises two problems. First, the differential
      diagnosis with atypical CML or CMML, based on morphological data, and secondly,
      the therapeutic follow-up in the absence of a specific marker. In contrast, the
      residual disease of Ph-BCR- patients can be monitored by PCR. More advanced
      molecular and biochemical techniques will be required to understand which
      molecular mechanisms underlie Ph-BCR- CML, resulting in phenotypes sometimes
      indistinguishable from Ph+ CML.

PMID- 7794757
TI  - Abnormal TCR V beta repertoire in patients with chronic myeloid leukaemia.
AB  - We have used 25 sets of oligonucleotide primers specific for the 24 known major
      human T-cell receptor (TCR) V beta families in polymerase chain reactions to
      analyse the T-cell repertoire of the peripheral blood in seven patients with
      chronic myeloid leukaemia (CML). In contrast to normal healthy individuals, all
      seven patients exhibited variable degrees of TCR V beta-specific T-cell deletion,
      ranging from two to eight of the 24 major families. T cells bearing V beta 17 and
      8 were most commonly deleted. These results suggest a superantigen effect
      associated with CML. The patterns of deletion did not appear to correlate with
      either of the two bcr-abl transcripts. The reason and aetiological agent
      responsible for the T-cell deletion remain speculative. Further work is ongoing
      to characterize this phenomenon in animal models and patients with CML.

PMID- 7794759
TI  - Low incidence of MDR1 expression in acute promyelocytic leukaemia.
AB  - The MDR1 gene product, P-glycoprotein, functions as a transmembrane efflux pump
      for certain cytotoxic agents including anthracyclines. Based upon the clinical
      observation that patients with acute promyelocytic leukaemia (APL) respond
      favourably to anthracyclines, we hypothesized that APL cells may have low levels
      of MDR1 expression. We therefore investigated MDR1 expression in 10 patients with
      APL and compared results with those obtained in 18 patients with other subtypes
      of acute myelogenous leukaemia (AML). Prior to reverse transcriptase polymerase
      chain reaction with MDR1 specific primers, leukaemic cells were purified by
      fluorescence activated cell sorting to exclude normal haemopoietic cells, in
      particular lymphocytes, from the MDR1 analysis. In sorted APL cells, MDR1
      expression was detected in only two of 10 patients, which was significantly
      different from findings in other AML subtypes (MDR1 expression in 14/18 patients;
      P < 0.01). When unsorted specimens from APL patients were studied, five of six
      cases were MDR1 positive, whereas sorted APL cells were shown to express MDR1
      mRNA in only one of these cases. MDR1 mRNA levels expressed as MDR1/beta-2
      microglobulin ratios were significantly lower in APL (0.24 +/- 0.2, mean +/- SD)
      than in AML (0.75 +/- 0.48; P < 0.01). We conclude that low or absent expression
      of MDR1 in APL cells may contribute to the efficacy of anthracyclines in the
      treatment of APL.

PMID- 7794758
TI  - Polyclonal haemopoieses associated with long-term persistence of the AML1-ETO
      transcript in patients with FAB M2 acute myeloid leukaemia in continous clinical
      remission.
AB  - The t(8;21) (q22;q22) translocation is a recurring chromosomal abnormality
      observed in about 20-40% of AML patients with subtype FAB M2 (AML-M2). The
      molecular facet of this translocation is represented by the formation of a new
      hybrid gene, the AML1-ETO, which is regularly transcribed in a chimaeric mRNA and
      translated into a new fusion protein believed to have a key role in the
      pathogenesis of this type of leukaemia. We looked for the presence of AML1-ETO
      transcripts, by RT-PCR, in 49 unselected patients affected by AML-M2 diagnosed at
      various Italian Institutions. A hybrid transcript was detected in 11 cases (23%).
      Minimal residual disease status was investigated in three patients in continuous
      complete remission (CCR) after a median follow-up of 44 months; at least one
      sample from each subject was found positive for the AML1-ETO transcript
      suggesting a long-term persistence of t(8;21) leukaemic cells. In two female
      patients in CCR a 'clonality' analysis was performed on peripheral blood DNA by
      exploiting the X chromosome inactivation pattern of the human androgen-receptor
      gene (HUMARA); in both cases the results were consistent with the presence of a
      polyclonal haemopoiesis. Our data confirm that the persistence of residual cells
      expressing the AML1-ETO transcripts is a frequent occurrence even in patients
      with long-term remission; on the other hand, clonality assays indicate that in
      t(8;21) leukaemias long-term remission haemopoiesis is sustained by a polyclonal
      bone marrow reconstitution.

PMID- 7794760
TI  - Circumvention of P-glycoprotein-mediated drug resistance in human leukaemic cells
      by non-immunosuppressive cyclosporin D analogue, SDZ PSC 833.
AB  - Cyclosporin A (CSA) exhibits greater multidrug resistance (MDR) modulating
      activity in vitro than other MDR modulators such as verapamil and quinidine.
      However, the immunosuppressive and nephrotoxic effects of CSA may limit its
      clinical use. PSC 833, a new cyclosporin D derivative, exerts a higher MDR
      reversal activity but lacks toxic or immunosuppressive effects. The drug
      resistant sublines K/DAU100, K/DAU200, K/DAU300, K/DAU400, K/DAU500 and K/DAU600
      have been derived from the drug-sensitive parental cell line, K562 cl.6 and
      CEM/VLB100 is a drug-resistant derivative of CCRF-CEM. We report a comparison of
      the effects of PSC 833 and CSA on daunorubicin (DAU) transport kinetics and
      chemosensitivity in these cell lines. Both CEM/VBL100 and K562 cl.6 DAU-resistant
      cells displayed high levels of P-glycoprotein (PGP), decreased DAU accumulation
      and increased DAU efflux when compared to their parental cells. PSC 833 was 1.6-,
      3.4-, 4.9- and 4.6-fold more effective than CSA in reversing DAU resistance in
      higher resistance CEM/VLB100, K/DAU400, K/DAU500 and K/DAU600 cells respectively.
      DAU transport kinetics showed that PSC 833 was more effective than CSA in
      increasing cellular DAU accumulation and decreasing DAU efflux in higher
      resistant leukaemia subclones. PSC 833 could restore DAU retention at lower doses
      and was more active than CSA in all the resistant cells. A 89-100% restoration of
      intracellular DAU retention were gained by PSC 833 at 1.0 microM in K562 cl.6 DAU
      resistant sublines, whereas a 73-100% restoration of DAU retention was obtained
      by CSA only at 30.0 microM in the same resistant sublines. PSC 833 at 3.0 microM
      is sufficient to restore full DAU retention in all resistant cells. CSA, however,
      even at 30.0 microM, cannot confer full restoration of DAU retention in higher
      resistance K562 cl.6/DAU sublines. By measuring MDR modulator-mediated short-term
      inhibition of PGP function, PSC 833 was found to be at least 10-30 times more
      active than CSA. As no effect on DAU retention and sensitivity has been found in
      sensitive parental cells with PSC 833, it is suggested that PSC 833 may act by
      blocking the effluxing function of PGP in the resistant leukaemia cells.

PMID- 7794761
TI  - GST-pi and P-170 co-expression in multiple myeloma.
AB  - Bone marrow samples from 40 patients affected by multiple myeloma either treated
      or untreated were examined for expression of glutathione-S-transferase pi (GST
      pi), P-glycoprotein and the protein product of ras oncogenes family, p-21, on
      plasma cells, by immunocytochemical detection. 72% of evaluated samples were
      positive for P-170 and 82% for GST-pi without any correlation with clinical or
      prognostic parameters. A significant relationship between GST-pi expression and P
      170 positivity was found and co-expression was observed in 91% of evaluated
      samples. Expression of P-170 and GST-pi was found both in treated and untreated
      patients. However, patients evaluated before and after therapy showed an increase
      in the percentage of plasma cells positive for GST-pi or P-170 or both.
      Expression of p-21 was not associated with these mechanisms of drug resistance.
      These data suggest that different resistance mechanisms are present in multiple
      myeloma.

PMID- 7794762
TI  - T-cell-rich B-cell lymphoma and lymphocyte-predominant Hodgkin's disease: two
      closely related entities?
AB  - T-cell-rich B-cell lymphoma (TCRBCL) is a recently described variant of non
      Hodgkin's lymphoma. It may arise de novo or secondary to follicular lymphoma and
      large B-cell lymphoma. We present here seven cases of TCRBCL to emphasize a
      peculiar relationship to lymphocyte-predominant Hodgkin's disease.
      Morphologically, the neoplastic populations of all TCRBCLs, in addition to
      centroblast-like and immunoblast-like cells, comprised a few L+H-like elements.
      These neoplastic cells were all regularly scattered in a majority of reactive
      small T-lymphocytes as well as histiocytes. Moreover, tumour cells of TCRBCL,
      including the L+H-like elements of TCRBCL, expressed LCA and L26 but did not
      stain for Leu-M1 and BerH2, as is the case with the Reed-Sternberg cell L+H
      variant of lymphocyte-predominant Hodgkin's disease. Furthermore, the L26
      immunoreaction in one of the cases, which otherwise presented as typical TCRBCL,
      disclosed a small subcapsular area resembling nodular paragranuloma because some
      few foci consisting of mature B lymphocytes with occasional L+H-like elements
      were seen. This also holds true for a second of the TCRBCLs presented that
      obviously coexisted with recurrent Hodgkin's paragranuloma 10 years after the
      primary manifestation. These findings indicate a close connection between TCRBCL
      and lymphocyte-rich Hodgkin's disease, and it may even be speculated as to
      whether TCRBCL represents merely a phenotypically different manifestation of this
      Hodgkin's subtype. Although the data presented here will not provide sufficient
      proof of this hypothesis, it seems clear that the nosology of TCRBCL in the
      context of current lymphoma classifications requires further elucidation.

PMID- 7794763
TI  - Biallelic DNA rearrangements and deletions within the BCL-6 gene in B-cell non
      Hodgkin's lymphoma.
AB  - Chromosomal translocations involving band 3q27 are recently described common
      specific cytogenetic abnormalities in B-cell neoplasms, and the BCL-6 gene,
      identified on 3q27, was shown to be disrupted and over-expressed in lymphoma
      cells having these chromosomal translocations. In the present study we found
      rearrangements within the BCL-6 gene in seven out of 35 cases with B-cell non
      Hodgkin's lymphoma (NHL). Further analysis revealed that three of these patients
      with BCL-6 abnormality had multiple rearranged bands hybridized with probes from
      a single restriction fragment within the major translocation cluster (MTC),
      suggesting that independent DNA rearrangements would occur on both alleles.
      Additionally, Southern blot analysis indicated that three patients carry
      deletions encompassing the area containing the first exon of the BCL-6 gene. Our
      results suggest that biallelic DNA rearrangements and deletions would
      occasionally occur in NHL patients with BCL-6 abnormality.

PMID- 7794764
TI  - Atypical chronic lymphocytic leukaemia with t(11;14)(q13;q32): karyotype
      evolution and prolymphocytic transformation.
AB  - In order to define better the cytological and clinical features of atypical B
      cell chronic lymphocytic leukaemia (B-CLL) with t(11:14)(q13;q32), sequential
      morphologic immunological and cytogenetic studies were performed in seven
      patients belonging to a series of 72 consecutive cases presenting with a
      diagnosis of CLL or atypical CLL according to the FAB criteria. Cytologic
      diagnosis in these seven patients with t(11;14) was typical CLL in two cases
      presenting with < 10% large lymphocytes (LL) and prolymphocytes (PL) and atypical
      CLL in five cases in which LL and PL comprised between 10% and 55%. The diagnosis
      was supported by histologic findings on bone marrow biopsy (five cases) or
      splenectomy specimens (two cases). A progressive increase of peripheral LL and PL
      was observed, resulting in a switch of FAB diagnosis over a 6-60-month period
      from typical CLL into atypical CLL in two cases and from atypical CLL into
      prolymphocytic leukaemia in five cases. Immunophenotyping showed a mature B-cell
      phenotype with CD19, CD22, CD24 positivity and CD10 negativity in all patients. A
      bright-staining pattern for surface immunoglobulins (SIg) was detected in 6/7
      cases, CD5 positivity in 6/7 cases, and CD23 positivity in 1/7 cases. The FMC-7
      monoclonal antibody was positive in > 40% cells in 5/6 cases. Chromosome changes
      in addition to t(11;14) were seen in five cases; in two cases unbalanced
      translocations involving the 3q21 chromosome region, resulting in partial trisomy
      for the long arm of chromosome 3, were detected early in the course of the
      disease. Karyotype evolution that was associated with disease progression
      occurred in 3/6 assessable patients. Comparison of these findings with similar
      data from 65 B-CLL patients without t(11:14) showed that atypical morphology,
      switch of FAB diagnosis during the course of the disease, and karyotype evolution
      were more frequently seen in cases with t(11;14) (5/7 v 15/65 cases, P = 0.015,
      7/7 v 7/65 cases, P < 0.0001, and 3/6 v 5/45 assessable cases, P = 0.04,
      respectively). The frequency of positivity for CD23 and bright SIg staining
      differed significantly in the two groups. It is concluded that t(11;14)
      identifies a cytologically atypical subset of B-CLL, characterized by frequent
      cytologic and cytogenetic evolution and by a distinct immunological profile,
      sharing some biological features with mantle cell lymphoma.

PMID- 7794766
TI  - Characterization of protein disulphide isomerase released from activated
      platelets.
AB  - Protein disulphide isomerase (PDI) activity is released by activated platelets.
      In this study, PDI was purified from platelets and found to have an apparent
      mass, pI and N-terminal sequence similar to those for other human PDIs. Rabbit
      antibodies were generated and used to establish that, on activation, platelets
      release a protein immunologically identical to PDI in platelets. Approximately
      10% of total platelet PDI was released by thrombin and 20% by calcium ionophore.
      The antibody was used to demonstrate PDI on the external surface of platelets by
      electron microscopy. Flow cytometry was used to demonstrate that upon activation
      of platelets with ionophore PDI was released by vesiculation. Since platelets are
      present and become activated at sites of vascular injury, platelet PDI may play a
      role in the various haemostatic and tissue remodelling processes in which
      platelets are involved.

PMID- 7794767
TI  - An ELISA for factor X activation peptide: application to the investigation of
      thrombogenesis in cardiopulmonary bypass.
AB  - An ELISA for measurement of factor X activation peptide (FXAP) in plasma has been
      developed. The capture antibody was generated by immunization with a carrier
      coupled synthetic peptide based on the amino acid sequence of the C terminal
      region of native human FXAP: the tag antibody was a commercial polyclonal
      antibody to factor X. Because of limited specificity of the capture antibody to
      FXAP compared with factor X, a plasma processing step precipitated plasma factor
      X and also permitted a concentration step, enabling detection of FXAP below the
      lower limit of the normal range in plasma. The overall intra- and inter-assay
      coefficients of variation were approximately 5% and approximately 11%,
      respectively. 18 normal laboratory control subjects had FXAP levels of 2.12 +/-
      0.82 ng/ml (mean +/- SEM). Eight patients undergoing surgery and cardiopulmonary
      bypass progressively generated FXAP throughout the surgery with mean FXAP rising
      to 11.73 +/- 4.66 ng/ml, and this resulted in increased generation of thrombin
      detected by measurement of plasma levels of F1 + 2. Levels of FXAP rose
      significantly ahead of those of factor IX activation peptide (FIXAP), supporting
      a suggestion that contact system activation can not be the primary stimulus to
      coagulation in bypass. The ELISA to FXAP will be useful in the study of
      mechanisms of thrombogenesis in clinical situations where the coagulation system
      is activated.

PMID- 7794765
TI  - Establishment and characterization of IRTA17 and IRTA21, two novel acute non
      lymphocytic leukaemia cell lines with t(16;21) translocation.
AB  - The t(16;21)(p11;q22) translocation is an infrequent chromosomal abnormality, but
      seems specific to acute non-lymphocytic leukaemia (ANLL). We established two cell
      lines with t(16;21)(p11;q22) from the bone marrow of a patient with ANL in
      relapse. Their morphological, karyotypic, immunohistochemical and genetic
      features are examined. Although both cell lines show monocytoid features
      morphologically, they express only CD13 (My7) and CD34, and neither expressed
      monocytoid or lymphoid markers. Reverse transcription-polymerase chain reaction
      showed that both cell lines expressed a similar TLS-ERG chimaeric mRNA as a
      result of the t(16;21)(p11;q22) translocation. As far as we know, there is no
      report of a leukaemia cell line with t(16;21). These cell lines represent a
      useful tool for leukaemia research.

PMID- 7794768
TI  - The effect of endogenous oestradiol levels on protein S concentration during a
      menstrual cycle and after GnRH analogues and gonadotropin therapy.
AB  - We studied two groups of females to investigate the effect of endogenous
      oestradiol levels on total and free protein S (tPS, fPS) plasma concentrations.
      One group (group I) consisted of 12 healthy volunteers who were studied
      throughout one menstrual cycle; the other group (group II) consisted of 16 young
      women who were treated with GnRH analogues and gonadotropins before undergoing in
      vitro fertilization. Neither tPS nor fPS varied significantly with respect to the
      physiological changes of oestradiol or to the very low and high levels of
      oestradiol, achieved after GnRH analogues suppression and gonadotropin
      stimulation. These results indicate that endogenous oestradiol does not affect PS
      concentration.

PMID- 7794769
TI  - Screening for mutations in haemophilia A patients by multiplex PCR-SSCP, Southern
      blotting and RNA analysis: the detection of a genetic abnormality in the factor
      VIII gene in 30 out of 35 patients.
AB  - The molecular characterization of mutations in haemophilia A patients in this
      study was carried out by PCR-SSCP, Southern blotting, and reverse transcribed
      PCR. A multiplex PCR in which four to eight exons were co-amplified was developed
      to reduce the time needed for screening the coding region of the factor VIII
      gene. PCR-SSCP was used to screen for small molecular defects, and reverse
      transcriptase PCR combined with Southern blotting was used to screen DNA for the
      inversions that occur frequently in intron 22 of the factor VIII gene. A group of
      35 haemophilia A patients was analysed by these methods and 31 mutations were
      detected. In one patient two mutations were identified. The cases of mild and
      moderate haemophilia A showed changes in single nucleotides which predicted amino
      acid changes. The patients affected by severe haemophilia A showed two types of
      mutations. First, deletions or insertions that result in a frameshift in the
      coding DNA sequence were observed. Second, inversions were found which result in
      a disruption of the gene. With the screening strategies used we succeeded in
      elucidating an abnormality in the factor VIII gene in 30/35 haemophilia A
      patients.

PMID- 7794770
TI  - Severe hypophosphataemia during stem cell harvesting in chronic myeloid
      leukaemia.
AB  - Peripheral blood stem cell autografts for the treatment of chronic myeloid
      leukaemia (CML) are currently under evaluation. A patient with CML received
      intensive chemotherapy followed by granulocyte colony-stimulating factor prior to
      the collection of peripheral blood derived stem cells. He developed unusually
      severe, and fatal, hypophosphataemia and this coincided with the rapid rise of
      his peripheral blood white cell count. The hypophosphataemia was considered to be
      due to a combination of severe anorexia, sepsis and the rapid growth factor
      stimulated myeloid regeneration in CML.

PMID- 7794773
TI  - Karyotypic evolution in a granulocytic sarcoma developing in a myeloproliferative
      disorder with a novel (3;4) translocation.
AB  - A 59-year-old man presented with a granulocytic sarcoma arising in the manubrium,
      and splenomegaly. The blood count showed 1.2 x 10(9)/l eosinophils and a marrow
      aspirate was hypercellular with eosinophilia. Cytogenetic analysis of the marrow
      revealed a novel t(3;4) (p13;q12) and analysis of cells aspirated from the
      granulocytic sarcoma showed the same abnormality and an additional trisomy 8.
      Intensive chemotherapy and local radiotherapy led to resolution of the chest mass
      but persistence of the chromosome translocation in the marrow.

PMID- 7794772
TI  - CMV viraemia demonstrated in the serum of a patient with cytomegalovirus
      pneumonia.
AB  - We attempted to demonstrate the expression of cytomegalovirus (CMV) particles in
      the serum of an acute lymphocytic leukaemia patient with CMV pneumonia. The serum
      sample was applied to an affinity column coupled with human monoclonal antibody
      C23 which recognizes the envelope glycoproteins of CMV virus and neutralizes the
      viral activity. The DNA obtained from each fraction was amplified by double
      polymerase chain reaction (PCR) and analysed by gel electrophoresis. Bands were
      clearly observed in the eluted fraction. These results strongly suggest that CMV
      particles exist in the sera of patients with CMV pneumonia.

PMID- 7794774
TI  - Persistence of multilineage host haemopoiesis following allogeneic bone marrow
      transplantation.
AB  - The survival of host cells following high-dose cytotoxic therapy and allogeneic
      marrow transplantation has been established previously, but the identity of these
      cells has not been elucidated in detail. Four patients who received sex
      mismatched marrow have been studied for up to 12 months post-transplant using a
      simultaneous immunophenotyping/fluorescence in situ hybridization technique. The
      results demonstrate residual host T cells (CD3+), B cells (CD22+) and myeloid
      cells (CD11c+ and CD13+), and additionally cells of progenitor cell phenotype
      (CD34+). The long-term persistence of host haemopoiesis may have major relevance
      to the post-transplant complications of marrow rejection, graft-versus-host
      disease, and malignant relapse.

PMID- 7794771
TI  - Macrophage colony-stimulating factor-producing malignant histiocytosis.
AB  - We describe a patient with malignant histiocytosis who had a prominent
      neutrophilia uncommonly observed in this disease. Serum concentration of
      macrophage colony-stimulating factor (M-CSF) was markedly elevated, and
      correlated with clinical symptoms and neutrophil counts during clinical course.
      Moreover, M-CSF was detected in the cytoplasm of malignant histiocytes of the
      lymph node and bone marrow by immunohistochemical staining. These results
      indicate that the neutrophilia observed in this patient was caused by M-CSF
      produced by the malignant histiocytes.

PMID- 7794776
TI  - Dapsone for refractory chronic idiopathic thrombocytopenic purpura.
AB  - Fifteen patients with refractory chronic idiopathic thrombocytopenic purpura
      (ITP) were treated with dapsone (100 mg/d) for 1-31 months. The overall response
      rate to dapsone was 40%. Five patients responded in 1 month and one patient in 2
      months. No pretreatment characteristics--sex, age, platelet count or duration of
      ITP--were correlated with response to dapsone. Treatment was well tolerated. The
      most frequent adverse effect was dose-related haemolytic anaemia. In our
      experience, dapsone provides an inexpensive and well-tolerated alternative for
      patients with ITP who had inadequate responses to conventional therapy.

PMID- 7794775
TI  - Pearson's marrow/pancreas syndrome: haematological features associated with
      deletion and duplication of mitochondrial DNA.
AB  - Pearson's marrow/pancreas syndrome (PS) is a rare, often fatal, disorder of
      infancy that is characterized by impaired bone marrow, exocrine pancreatic,
      hepatic and renal function. Large-scale  rearrangements of mitochondrial DNA
      (mtDNA) are present in blood. We report a patient with PS who has predominantly
      impaired haemopoiesis manifesting as sideroblastic anaemia, vacuolization of bone
      marrow precursors, and neutropenia. 77% of bone marrow mtDNA was rearranged (64%
      deleted an 13% duplicated). We suggest that rearrangements of mtDNA should be
      sought in all infants presenting with sideroblastic anaemia.

PMID- 7794777
TI  - Deletion of chromosome 13 (band q14) but not trisomy 12 is a clonal event in B
      chronic lymphocytic leukaemia (CLL).
AB  - Chromosomal abnormalities are detected by conventional cytogenetic or FISH
      analysis in 50% of chronic lymphocytic leukaemias (CLL). Trisomy 12 and del 13q14
      account for 70% of these abnormalities. The incidence of these two abnormalities
      was studied in CLL patients by Southern blot analysis using a highly purified B
      cell malignant population (CD5 > 95%, CD3 < 5%). Probes for the D13S25 marker on
      chromosome 13 band q14 and for the RBTN3 gene on chromosome 12 band p12-13, were
      used. Deletion of the D13S25 was detected in 17/42 patients (43%) in a homozygous
      (9.5%) or heterozygous (30%) configuration. Deletion of the D13S25 marker appears
      to be a clonal and early event in CLL development since it is detected in > 95%
      of the malignant clonal population. Conversely, trisomy 12 is rarely a clonal
      event (5/33 patients, 15%) and a varying proportion of cells carrying this
      abnormality can be demonstrated in 30% of CLL patients (10/33 patients).

PMID- 7794778
TI  - Coronary artery bypass surgery in patients with inherited antithrombin
      deficiency.
AB  - Antithrombin (AT) replacement in coronary artery bypass grafting procedures in
      three individuals with inherited antithrombin deficiency is described. All three
      had a significant personal or family history of thrombotic disease. All patients
      achieved satisfactory AT levels throughout bypass and in the postoperative
      period. All received heparin prophylaxis in the postoperative period. None
      suffered thrombotic or bleeding complications.

PMID- 7794779
TI  - A promoter mutation, C-->T at position -92, leading to silent beta-thalassaemia.
AB  - This study describes the clinical phenotype of the C-->T mutation at position -92
      of the beta-globin gene. Excluding two cases with HbA2 levels within the range of
      the beta-thalassemia carrier state, heterozygotes for this mutation showed normal
      or borderline red blood cells count, Hb levels, MCV, MCH and HbA2 values, and
      unbalanced globin chain synthesis. Compound heterozygotes for the -92 C-->T
      mutation and a beta zero-thalassaemia mutation (beta zero 39) (two cases) or
      severe beta+-thalassaemia (beta+ IVSII nt 745) (two cases) developed thalassaemia
      intermedia. According to these characteristics, the -92 promoter mutation should
      be added to the list of silent beta-thalassaemias.

PMID- 7794780
TI  - Therapy-related acute myeloblastic leukaemia (M1) with a 9;11 translocation.

PMID- 7794781
TI  - A stage-theory model of cognitive development.
AB  - A model of the proportions of the population at various stages of cognitive
      development as a function of age is proposed. It is shown that a number of
      weaknesses in an earlier model proposed by Eckstein & Shemesh (1992a) are
      avoided. The new model accounts well for empirical data for the age range 13-18
      years. The uses of such models in research are discussed.

PMID- 7794782
TI  - A model of Pavlovian conditioning: variations in representations of the
      unconditional stimulus.
AB  - We present a model of Pavlovian excitatory conditioning in which associative
      strength and malleable central representations of unconditional stimuli determine
      the strength of conditional responding. Presentation of a conditioned stimulus
      acts through an experientially determined associative bond to activate a
      representation of the unconditional stimulus. The activation of the
      representation produces a conditioned response. A striking feature of the model
      is its ability to describe changes in conditioned response magnitude in terms of
      alterations of representations of the unconditional stimulus. Another is its
      acknowledgement of the capacity of associative bonds to survive behavioral
      extinction. The model describes much of the data reported from excitatory
      conditioning experiments and predicts counterintuitive phenomena.

PMID- 7794783
TI  - Dogmas that have hindered understanding.

PMID- 7794784
TI  - Effects of cold on human information processing: application of a reaction time
      paradigm.
AB  - Only a very few studies on the effects of cold on human information processing
      appear to exist. Therefore, the present experiment was designed to study the
      effects of the experimentally induced lowering of body core temperature on
      information processing, while applying a reaction time paradigm. Thirty healthy
      male volunteers performed a stimulus evaluation-response selection reaction time
      task after exposure to ambient temperatures of either 28 or 5 degrees C. A 0.5
      degree C-decrease in body core temperature resulted in a significant increase in
      both reaction and movement time indicating a general deteriorating effect of
      lowering of body core temperature on information processing. Mean reaction times
      were 538 ms and 549 ms for the control and the cold group, respectively (p <
      .05). The respective mean movement times were 298 ms and 269 ms (p < .001). Speed
      of stimulus evaluation was not sensitive to decreases in body core temperature.
      However, response complexity and body core temperature showed a significant
      interaction in their effect on movement time (p < .05), indicating that lowering
      of body core temperature is more likely to affect response-related stages of
      central information processing rather than stimulus evaluation. Furthermore,
      movement time appeared to be more sensitive to cold-induced effects on
      information processing as compared to reaction time. Additional correlational
      analyses suggest that the observed effects can be considered as independent of
      changes in skin temperature and experienced levels of thermal discomfort. Taken
      together, the results indicate that lowering of body core temperature
      differentially affects various stages of information processing.

PMID- 7794786
TI  - Shortening of the QT interval of the EKG is associated primarily with increased
      ventricular contractility rather than heart rate.
AB  - The objective of this study was to gather direct evidence on whether the duration
      of the QT interval relates primarily to heart rate or to ventricular
      contractility. The electrocardiographic and cardiodynamic consequences of
      electrical stimulation (15 V, 5 ms, 10Hz) of various intrathoracic sympathetic
      efferent neuronal structures were studied in 10 anesthetized mongrel dogs.
      Stimulation of efferent sympathetic axons in the right intraganglionic nerve,
      which innervates the sinoatrial node, induced tachycardia (110 +/- 5 - 133 +/- 6
      bpm; p < 0.01) without significantly altering right or left ventricular
      intramyocardial ventricular chamber pressures. The QT interval, as determined by
      leads I, II and III of the EKG and a transthoracic lead, was not affected by this
      intervention 310 +/- 8 - 302 +/- ms). Increasing heart rate to a similar degree
      (111 +/- 3 - 131 +/- 3 bpm) by right atrial pacing did not induce changes in the
      QT interval. When right (23 +/- 3 - 49 +/- 8 mm Hg; p < 0.01) and left (81 +/- 10
      - 127 +/- 19 mm Hg; p < 0.01) ventricular forces were augmented without
      concomitant increases in heart rate by stimulating efferent sympathetic axons in
      the left caudal pole cardiopulmonary nerve the QT interval shortened (322 +/- 11 
      290 +/- 12 ms; p < 0.01). Only when an efferent sympathetic nerve, that contains
      fibers destined for both the sinoatrial node and the ventricles was stimulated
      did both heart rate and ventricular contractility augment and QT shorten (318 +/-
      10 - 290 +/- 11 ms; p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794785
TI  - A behavioral link between the oculomotor and cardiovascular systems.
AB  - Although the eyes and the heart serve very different purposes, each receives
      autonomic innervation. Capitalizing on recent theoretical and technological
      innovations in the understanding and assessment of oculomotor and cardiovascular
      behavior, three experiments measured behavioral covariation between the
      oculomotor and cardiovascular systems. Measures of dark focus and dark vergence
      indexed oculomotor tone, and the spectral decomposition of variations in heart
      rate indexed cardiovascular control mechanisms. In Experiment 1, individual
      differences in cardiovascular parameters could predict individuals' dark vergence
      (R2 = .806) but not their dark focus (R2 = .404). In Experiment 2, the same
      parameters were measured from subjects who experience either panic attacks (n =
      11) or blood phobia (n = 9). Heart rate was positively correlated with dark
      vergence and the two subject groups were separable based on both oculomotor and
      cardiovascular variables. Using a within-subjects approach, Experiment 3 found
      that both dark vergence and dark focus tended to be nearer during sympathetic
      dominance of the heart than during parasympathetic dominance, within-subjects
      variations in cardiovascular parameters could predict dark focus, and between
      subjects variations in interbeat intervals could predict dark vergence. Shared
      patterns of autonomic activation may be responsible for this eye-heart link.

PMID- 7794788
TI  - The electrocardiograph.

PMID- 7794789
TI  - Psychosocial forces and neural mechanisms in disease: defining the question and
      collecting the evidence. Essay review.

PMID- 7794787
TI  - Sick-building syndrome fatigue as a possible predation defense.
AB  - Sick-building syndrome is an illness characterized by fatigue, headache, and
      upper-respiratory complaints. It is usually associated with modern office
      buildings, structures with an impervious outer shell and inoperable windows. Poor
      air quality, specific pollutants, and inadequate ventilation are considered
      common causes. The ability to smell faint odors requires air that is free of
      contamination. Human evolutionary ancestors depended on odors for survival. Even
      the slightest increase in the ability to smell a predator conveyed a distinct,
      immediate survival advantage. Conversely, an enormous survival advantage would
      also accrue to the animal that sought protection or avoided activity when this
      vital olfactory information was unavailable. Such would be the case with fire on
      the savannah. The foraging, olfactory dependent animal, unable to smell predators
      because of contaminated air, would be quickly snatched by a keen-sighted
      carnivore. There exist, however, well-described reflexes from the nose mediated
      through the trigeminal nerve that discourage activity when these free nerve
      endings are irritated. This mechanism may serve as a defense against predation.
      In adulterated atmosphere the animal, subdued by these reflexes, would be less
      likely to venture forth and, therefore, less vulnerable to predators. Similar
      reflexes may persist in humans, activated by poor air quality, air ill-suited for
      the dissemination of odors. I suggest that the human perception of these
      inhibitory reflexes is the feeling of fatigue associated with the sick building
      syndrome.

PMID- 7794790
TI  - Nuclear factor I interferes with transformation induced by nuclear oncogenes.
AB  - The four nuclear factor I genes (NFI-A, NFI-B, NFI-C, and NFI-X) give rise to
      multiple isoforms by alternative splicing in many tissues. These NFI proteins
      cooperate with AP-1, Myc, and other transcription factors in regulating
      transcription of numerous cellular and viral genes. We have investigated the
      growth-regulatory potential of NFI by overexpressing cDNAs from chicken NFI genes
      -A, -B, -C, and -X in chicken embryo fibroblasts (CEF). None of the NFI cDNAs
      induced oncogenic transformation of CEF. However, overexpression of each of the
      NFI proteins caused similar morphological alteration of the cells, inducing them
      to become flattened and polygonal and to show increased adherence. The growth
      properties of these cells were similar to normal CEF. When these morphologically
      altered CEF were challenged by superinfection with oncogenic retroviruses, they
      were resistant to transformation by the nuclear oncogenes jun, fos, junD, myc,
      and qin but were readily transformed by cytoplasmic oncogenes src, mil/raf, ras,
      and fps. The NFI-A1 protein was able to alter transactivation by the cellular and
      viral Jun proteins in a promoter-dependent manner. The changes in cell morphology
      and reduced susceptibility to nuclear oncogenes were not seen with a carboxy
      terminal truncation in the transactivation domain of NFI, suggesting that this
      region of the protein is essential for the observed effects. The dichotomy
      between the activities of nuclear and of cytoplasmic oncogenes in this system is
      discussed.

PMID- 7794791
TI  - A direct role of transcription factor E2F in c-myc gene expression during
      granulocytic and macrophage-like differentiation of HL60 cells.
AB  - The transcription factor E2F is known to play an important role in cell cycle
      progression through interaction with retinoblastoma protein. HL60 cells are able
      to differentiate into a granulocytic lineage by prolonged exposure to retinoids
      and into a macrophage-like lineage by exposure to tumor promoter 12-O
      tetradecanoylphorbol 13-acetate, with a rapid decrease of c-myc gene expression.
      In this study, we assessed the changes of the E2F-binding pattern to the P2
      promoter region of the c-myc gene during differentiation into both lineages. The
      observed changes of the E2F-binding pattern were a decrease of free E2F and an
      appearance of retinoblastoma protein-containing E2F complexes in both lineages.
      The effects of the anti-c-myc antibody and the recombinant c-Myc protein on the
      E2F-binding patterns suggest that the c-Myc protein is not involved directly in
      these changes. These changes also led the suppression of transcriptional
      initiation from the P2 promoter. The results indicate that, in the course of HL60
      cell differentiation, E2F plays a direct role in the transcriptional control of
      the c-myc gene through interaction with the retinoblastoma protein. A potential
      role for the c-Myc protein is discussed in relation to an existing state of E2F
      and E2F-RB complexes in the HL60 cells.

PMID- 7794792
TI  - Apoptosis in Pam212, an epidermal keratinocyte cell line: a possible role for bcl
      2 in epidermal differentiation.
AB  - Programmed cell death is a controlled process that leads to the elimination of
      single cells via apoptosis, a mode of cell death with a characteristic
      morphology. During epidermal differentiation, keratinocytes migrate outward to
      become terminally differentiated cornified cells in a process involving
      programmed cell death pathway(s) and apoptosis. The molecular mechanisms
      regulating epidermal differentiation and apoptosis have not yet been elucidated.
      Here we show that a mouse keratinocyte cell line, Pam212, undergoes spontaneous
      apoptosis in culture. Apoptosis of Pam212 cells is demonstrated by both
      morphology and DNA oligonucleosomal degradation. The expression of bcl-2, a gene
      implicated in the negative control of apoptosis, was down-regulated in these
      cells by transfecting a bcl-2-antisense expression vector. The cells that down
      regulate bcl-2 expression exhibit enhanced apoptosis and further progress in the
      epidermal differentiation pathway. We analyzed the expression patterns of several
      genes that have been implicated in apoptosis in other systems. We show that the
      mRNA levels of c-myc, c-myb, c-fos, tumor necrosis factors (TNF) alpha and beta,
      TNF receptors I and II, interleukin 1 alpha, IFN-gamma, and transforming growth
      factor beta increase in the antisense-transfected cells. We suggest that bcl-2
      influences epidermal differentiation in Pam212 keratinocyte cells, and maybe in
      vivo, by negatively regulating several genes that are involved in apoptosis.

PMID- 7794794
TI  - Insulin-like growth factor II overexpression in myoblasts induces phenotypic
      changes typical of the malignant phenotype.
AB  - The objective of this study was to examine the role of insulin-like growth factor
      II (IGF-II) in the pathogenesis of human rhabdomyosarcomas (RMS). We have
      demonstrated previously that RMS express high levels of IGF-II mRNA, secrete IGF
      II peptide, and express both IGF-I and IGF-II receptors. Moreover, we showed that
      IGF-II functions as an autocrine growth and motility factor in RMS. Since IGF-II
      is expressed at high levels in fetal muscle cells and RMS are tumors thought to
      derive from skeletal myoblasts arrested along the normal myogenic pathway,
      autocrine production of IGF-II by RMS may be an etiological event in the
      development of this tumor. We have developed a model system which enabled us to
      study the effects of endogenous IGF-II overprotection in muscle myoblasts. Human
      cDNA for pre-prohormone IGF-II was transfected into mouse myoblasts in order to
      achieve high, constant expression of this growth factor, which is normally down
      regulated at the end of the differentiation process. Expression of high IGF-II
      levels resulted in: (a) an increased proliferative rate; (b) impairment of the
      ability to differentiate into myoblasts; and (c) acquisition of the capability of
      anchorage-independent growth. No changes in the expression of IGF-I receptors
      were noted. We conclude that IGF-II overexpression in muscle myoblasts induces
      morphological and biological changes typical of the malignant phenotype and
      represents a fundamental event in the pathogenesis of RMS and possibly of other
      embryonal tumors.

PMID- 7794795
TI  - Serum growth factors up-regulate H-ras, K-ras, and N-ras proto-oncogenes in
      fibroblasts.
AB  - We have analyzed the expression of the ras gene family during the transit through
      quiescence-proliferation. H-, K- and N-ras steady-state mRNA levels and total Ras
      protein levels did not change significantly when NIH3T3 cells were made quiescent
      by density arrest in the presence of 10% calf serum. By contrast, levels of ras
      mRNAs in cells that had been made quiescent by serum deprivation were lower than
      those in growing cells. An induction of H-, K- and N-ras mRNA levels (3- to 5
      fold) was detected in these cells after serum addition. This induction was
      maximal around 8 h after serum addition for the three ras genes. Like the early
      response genes, ras induction was not dependent on protein synthesis; but in
      contrast to these genes, ras mRNAs showed long half-lives (5-7 h) in NIH3T3
      cells. Up-regulation of ras genes by serum was also observed in human primary
      fibroblasts, indicating that this may be a general effect in mammal cells. We
      obtained stable transfectants in NIH3T3 cells with the oncogenic N-ras. In these
      cells, expression of the transforming gene is also induced by serum, and the
      expression of the transfected N-ras gene did not modify the response to serum of
      endogenous H-, K-, and N-ras genes. The regions of murine N-ras gene responsible
      for serum inducibility seem to be intragenic because N-ras up-regulation occurred
      in cells transfected with a gene construct lacking the sequences upstream from
      the first exon.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794796
TI  - Epithelial rat thyroid cell clones, escaping from transforming growth factor beta
      negative growth control, are still inhibited by this factor in the ability to
      trap iodide.
AB  - Transforming growth factor beta (TGF beta) acts on epithelial thyroid cells,
      negatively controlling their proliferation and functions. The effects of TGF beta
      on epithelial rat thyroid cells (FRTL-5) and on two TGF beta-resistant rat
      thyroid cell clones (FRTL-5H2 and FRTL-R) were investigated. FRTL-5H2 represents
      a rat thyroid cell clone overexpressing active erbB-2 oncogene, recently obtained
      after FRTL-5 cell infection with a retrovirus vector carrying the erbB-2 human
      oncogene (G. Mincione et al., Cancer Res., 53: 5548-5553, 1993). FRTL-R is a FRTL
      5 subclone spontaneously isolated after long term in culture. FRTL-5H2 and FRTL-R
      cell clones were stimulated by TGF beta at the same concentration of 5 ng/ml that
      induced 70% inhibition of [3H]thymidine incorporation in control FRTL-5 thyroid
      cells. Nuclear events regulated by TGF beta, such as cyclin and cyclin-dependent
      kinase gene expression, were then analyzed. In FRTL-5 cells, TGF beta was found
      to reduce the expression of cdk2 and cyclin A genes; the same treatment did not
      modify nuclear gene expression in the resistant cell clones. TGF beta is known to
      reduce iodide uptake in thyroid cells; in both FRTL-5H2 and FRTL-R cells, TGF
      beta was found to inhibit the thyrotropin-induced iodide uptake. Thus, thyroid
      cell clones, resistant to the growth-inhibitory activity of TGF beta, were
      sensitive to TGF beta inhibition of iodide incorporation, suggesting that TGF
      beta activates divergent signaling pathways in these cells, separately
      controlling cell proliferation and differentiation parameters. Studies on TGF
      beta receptors showed similar amounts of TGF beta-binding species on FRTL-5 cells
      and TGF beta-resistant clones, while 125I-labeled TGF beta cross-linking
      experiments revealed differences; thus, the TGF beta-resistant cells showed a 40%
      decrease in the amount of labeled type II TGF beta receptor on the cell surface.
      However, this different pattern of TGF beta receptors cannot totally account for
      the shown TGF beta resistance to growth inhibition that might also be due to
      perturbation in signaling pathways.

PMID- 7794793
TI  - Differential dependence of the tumorigenicity of chemically transformed rat liver
      epithelial cells on autocrine production of transforming growth factor alpha.
AB  - The tumorigenic phenotype in rat liver epithelial cells overexpressing c-myc may
      depend on a transforming growth factor (TGF)-alpha/epidermal growth factor
      receptor autocrine loop (L. W. Lee et al., Cancer Res., 51: 5238-5244, 1991). In
      the present study, we have used constitutive sense and antisense TGF-alpha
      expression vectors to modify TGF-alpha production in carcinogen-transformed
      clonal derivatives of a rat liver epithelial cell line, WB-F344, that variably
      express c-myc, endogenous TGF-alpha, and tumorigenicity. Transgene-mediated TGF
      alpha protein production was elevated 2- to 9-fold in derivatives of a low c-myc
      expressing transformed cell line, GN4, and 35-fold in a derivative of a high c
      myc-expressing cell line, GN6. Although the GN4- and GN6-derived cell lines
      expressed functional EGF receptor and steady-state c-myc mRNA levels that were
      comparable to their respective parental cell lines, increased TGF-alpha
      expression did not increase the tumorigenicity of the derivatives relative to the
      parental cell lines. Similarly, in vitro growth characteristics of the GN4- and
      GN6-derived cell lines were not markedly altered by increased autocrine TGF-alpha
      production. Additionally, GN4, GN6, and their derivatives were, for the most
      part, unresponsive to exogenously applied TGF-alpha in vitro. In contrast,
      antisense TGF-alpha RNA expression significantly suppressed endogenous TGF-alpha
      production in a high c-myc-expressing, high TGF-alpha-expressing, highly
      tumorigenic clonal line, GP9; this suppression resulted in lowered steady-state c
      myc levels and attenuated in vitro growth. Antisense-mediated suppression of all
      of these in vitro phenotypes in GP9 was reversed by exogenous TGF-alpha. The
      latency of tumor formation by the antisense derivative of cell line GP9 was
      significantly lengthened (> 3-fold) relative to the time required for tumor
      formation by its parental cell line. These results demonstrate that a TGF
      alpha/epidermal growth factor receptor autocrine loop may be necessary for
      exaggerated in vitro and in vivo growth of some transformed rat liver epithelial
      cells (e.g., GP9); however, the autocrine loop is not generally sufficient to
      support tumorigenicity, even in transformed clonal lines expressing elevated
      levels of c-myc.

PMID- 7794797
TI  - Stimulation of receptor protein-tyrosine phosphatase alpha activity and
      phosphorylation by phorbol ester.
AB  - Receptor Protein-Tyrosine Phosphatase alpha (RPTP alpha) is a transmembrane
      protein with two cytoplasmic catalytic protein-tyrosine phosphatase (PTP) domains
      and a relatively short (123 amino acids) extracellular domain. Here we report
      that treatment of transfected cells that express RPTP alpha with the phorbol
      ester 12-O-tetradecanoyl-phorbol-13-acetate, a direct activator of protein kinase
      C, induced a rapid, transient increase in RPTP alpha activity due to a 2- to 3
      fold increase in substrate affinity. A transient increase in RPTP alpha serine
      phosphorylation was concomitant with the enhanced activity. Tryptic
      phosphopeptide mapping of RPTP alpha demonstrated that phosphorylation of three
      tryptic peptides was enhanced in response to phorbol ester. In vitro
      dephosphorylation of RPTP alpha from phorbol ester-treated cells reduced RPTP
      alpha activity to prestimulation levels, indicating that enhanced serine
      phosphorylation directly accounted for the increase in activity. Our results
      demonstrate that serine phosphorylation may play a key role in the regulation of
      the activity of transmembrane PTPs.

PMID- 7794798
TI  - Increased expression of diazepam binding inhibitor in human brain tumors.
AB  - Benzodiazepines, which are in extensive clinical use, can regulate neoplastic
      growth via benzodiazepine receptors. We have studied the expression of the
      diazepam binding inhibitor (DBI) polypeptide, a putative endogenous ligand for
      benzodiazepine receptors in normal and pathological human brain. In normal brain,
      DBI immunoreactivity (IR) and mRNA were detected in all brain areas, with the
      highest levels in the cerebellum, amygdala, and hippocampus. In light and
      electron microscope immunohistochemistry, DBI-IR was only detected in glial and
      ependymal cells. In brain tumors, such as astrocytomas, glioblastomas and
      medulloblastomas, a much higher content of DBI-IR and -mRNA was found in normal
      tissues. The highest level of DBI expression was found in the most anaplastic
      tumors. DBI-IR was virtually undetectable in meningiomas and pituitary adenomas.
      The high expression of DBI in brain tumors might play a role in the neoplastic
      growth of glial cells via the mitochondrial benzodiazepine receptor, or it may be
      involved in the regulation of the high energy consumption of these tumors via
      acyl-CoA metabolism.

PMID- 7794799
TI  - Expression of the neurofibromatosis 1 (NF1) isoforms in developing and adult rat
      tissues.
AB  - The neurofibromatosis 1 (NF1) gene encodes a large M(r) approximately 250,000
      phosphoprotein, the expression of which in adult tissues is limited to neurons,
      Schwann cells, oligodendrocytes, adrenal medulla, and leukocytes. The presence of
      two alternatively spliced exons (23a and 48a) in the NF1 gene allow for the
      generation of four possible neurofibromin isoforms. Type 1 neurofibromin contains
      neither 23a or 48a exon sequences, while type 2 neurofibromin contains only the
      23a exon insertion. Previous studies have demonstrated that types 1 and 2
      neurofibromin might have different functional properties relative to microtubule
      association and GTPase-activating protein activity towards p21-ras. To determine
      the normal pattern of expression of these NF1 isoforms, the adult and
      developmental expression of types 1 and 2 NF1 was examined. Herein, we
      demonstrate that NF1 mRNA is expressed at varying levels in adult tissues and is
      developmentally regulated during embryogenesis. Neurons in the central nervous
      system express predominantly type 1 NF1. Using mouse neocortical cultures
      enriched for neurons or glial cells, type 1 NF1 predominance was demonstrated in
      neurons, while type 2 NF1 predominated in glial cells. In contrast to central
      nervous system neurons, neurons expressing the type 2 NF1 isoform were identified
      in the developing dorsal root ganglia and spinal cord by in situ hybridization
      using a type 2-specific oligonucleotide probe. The elucidation of the
      differential expression pattern of these two NF1 isoforms during development and
      in adult life provides the foundations for future studies aimed at determining
      the functions of these neurofibromin isoforms.

PMID- 7794800
TI  - Expression of the v-Mos oncogene in male meiotic germ cells of transgenic mice
      results in metaphase arrest.
AB  - To explore the role of pp39mos in male germ cell meiosis, we have constructed
      transgenic mice carrying either the c-Mos or v-Mos genes linked to the human male
      germ cell-specific phosphoglycerate kinase-2 promoter. All male transgenic mice
      bearing the v-Mos but not the c-Mos construct were sterile due to arrest of germ
      cells at metaphase I. Immunocytochemistry performed on sections from control and
      c-Mos transgenic testes with eight different monoclonal and polyclonal antisera
      against either alpha-, beta- or gamma-tubulins demonstrated that all could
      recognize MI spermatocyte spindles from control and c-Mos transgenics, but only
      one monoclonal anti-microtubule sera decorated the spindles of v-Mos-arrested
      meiotic figures. Western blot analyses with this one serum revealed a change in
      proteins in the v-Mos samples. Immunocytochemistry with the MPM-2 monoclonal
      antibody, which is specific for epitopes phosphorylated during mitosis,
      demonstrated an increase in cytoplasmic and spindle-associated phosphoproteins in
      arrested v-Mos spermatocytes. Western analysis with MPM-2 showed an increase in a
      M(r) 50,000-55,000 and a M(r) 25,000-29,000 protein in Mos transgenic testes when
      compared to controls. An anti-MAP kinase antibody demonstrated an increase in all
      four MAP kinases in testes of transgenic mice. Thus, overexpression of pp39v-mos
      during male germ cell meiosis resulted in an alteration of various cell cycle
      related kinases and cytostatic factor-like arrest at MI.

PMID- 7794801
TI  - Coordinate regulation of Igf-2 and H19 in cultured cells.
AB  - The insulin-like growth factor 2 (Igf-2) and H19 genes are physically linked on
      mouse distal chromosome 7 and are reciprocally imprinted. We investigated the
      molecular basis of the parental imprints in somatic cell cultures derived from
      normal embryos or from their littermates with maternal uniparental disomy for
      distal chromosome 7 (MatDi7). In normal cells, the two genes appeared to respond
      to similar regulatory factor(s), since both genes were coordinately up-regulated
      upon growth arrest and cell clones which had lost expression of one gene had lost
      expression of the other. However, in a clone of MatDi7 cells (MatDi7 1-1a), which
      spontaneously began to express the maternally derived copy of Igf-2, Igf-2 and
      H19 were not coordinately regulated. MatDi7 1-1a cells showed de novo methylation
      of sites upstream of Igf-2 and also within the H19 promoter, epigenetic
      modifications normally seen only on the paternal chromosome. The data provide new
      experimental evidence for previously hypothesized mechanisms suggesting that Igf
      2 and H19 are coordinately regulated.

PMID- 7794803
TI  - Apoptosis inhibition by anti-M(r) 23,000 (Thy-1) monoclonal antibodies without
      inducing bcl-2 expression.
AB  - Mouse malignant T-lymphoma CS-21 cells grow in vitro in the presence of CA-12
      stromal cells, but they undergo apoptotic cell death with DNA fragmentation when
      cultured alone. Because apoptosis of CS-21 cells was not inhibited by soluble
      factors secreted from CA-12 stromal cells, cell-cell interactions between the two
      seemed to be important to inhibit apoptosis. We found that CS-21 cell adhesion
      was mediated by M(r) 168,000 and M(r) 23,000 proteins and that apoptosis
      inhibitory signals were transmitted through these proteins. In this study, we
      identified the M(r) 23,000 cell adhesion molecule as a
      glycosylphosphatidylinositol-anchored Thy-1 (CD90) glycoprotein. Cross-linking of
      M(r) 23,000 protein with anti-M(r) 23,000 mAb and a second antibody transiently
      raised the [Ca2+]i and activated calcineurin in CS-21 cells, as has been observed
      in normal T lymphocytes stimulated by cross-linking anti-Thy-1 mAbs. However,
      differing from normal T lymphocytes, CS-21 cells could grow either by the
      transient increase in [Ca2+]i or by the activation of protein kinase C.
      Furthermore, M(r) 23,000 protein-mediated cell survival of CS-21 cells was not
      accompanied by expression of the apoptosis-inhibiting protein bcl-2, although
      protein kinase C-activated cell survival was attended by bcl-2 expression. These
      results indicate that the M(r) 23,000 protein (Thy-1) of CS-21 lymphoma cells
      functions as a cell adhesion molecule capable of transducing signals of cell
      survival and growth that are not followed by bcl-2 expression.

PMID- 7794802
TI  - Overexpression of the class II P-glycoprotein gene in primary rat hepatocyte
      culture: evidence for increased mRNA stability.
AB  - The overexpression of P-glycoprotein (Pgp) appears to be responsible for
      multidrug resistance in some human cancers. The molecular basis of this
      overexpression is not understood. We have used primary monolayer cultures of
      adult rat hepatocytes as a model system to study the regulation of Pgp gene
      expression (Lee et al., J. Cell. Physiol., 157: 392-402, 1993). We observed a
      dramatic and specific overexpression of class II Pgp as a function of the time in
      culture. This isoform of Pgp, which is expressed at a very low level in normal
      liver, has also been shown to be predominantly overexpressed in several models of
      rat liver carcinogenesis. In the present study, we have used nuclear run-on
      assays and mRNA decay studies to investigate the mechanism for the overexpression
      of class II Pgp in cultured hepatocytes. We conclude that an increased mRNA
      stability is the major factor involved in the increased expression of class II
      Pgp. Studies using various drugs indicate that the integrity of the cytoskeleton
      is important for the maintenance of high expression of class II Pgp. Disruption
      of the cytoskeleton in cultured hepatocytes with cytochalasin D did not affect
      the transcriptional activity of the class II Pgp gene but rapidly destabilized
      its mRNA. This raises the possibility that an association between class II Pgp
      mRNA and cytoskeletal elements may underlie the mechanism that regulates class II
      Pgp mRNA stability. These findings have important implications for our
      understanding of the overexpression of class II Pgp during liver carcinogenesis.

PMID- 7794804
TI  - Overexpression of Bcl-XL by cytotoxic drug exposure confers resistance to
      ionizing radiation-induced internucleosomal DNA fragmentation.
AB  - Acquired resistance to diverse chemotherapeutic agents has been associated with
      overexpression of the P-glycoprotein. We have selected human U-937 cells for
      clones resistant to the cytotoxic agents doxorubicin (U-A20) and vincristine (U
      V20). The results demonstrate that P-glycoprotein-positive U-A20 and U-V20 cells
      exhibit resistance to inducers of internucleosomal DNA fragmentation. Although
      parental U-937 cells responded to ionizing radiation with the DNA laddering
      characteristic of physiological cell death, the drug-resistant lines were
      insensitive to this effect. The U-A20 and U-V20 clones were also resistant to
      endonucleolytic DNA cleavage associated with exposure to tumor necrosis factor or
      ceramide. Previous work has demonstrated that physiological cell death is
      inhibited by overexpression of the Bcl-2 protein. However, analysis of Bcl-2
      revealed similar levels in the parental and drug-resistant cells. In contrast, we
      show that U-A20 and U-V20 cells overexpress the Bcl-2-related protein, Bcl-xL.
      Moreover, studies with a U-937 cell line transfected with a Bcl-XL expression
      vector confirm resistance to ionizing radiation-induced DNA fragmentation and
      cell killing. These findings suggest that, unlike Bcl-2, Bcl-XL may be
      constitutively overexpressed as a result of selection for cytotoxic drug
      resistance and that Bcl-XL participates in an acquired form of multimodality
      resistance to chemotherapeutic agents and radiation.

PMID- 7794805
TI  - Phorbol ester treatment of U937 cells with altered protein kinase C content and
      distribution induces cell death rather than differentiation.
AB  - Overexpression of protein kinase C (PKC)-zeta, an atypical PKC isoform, in U937
      cells stimulates certain parameters of phenotypic maturation and increases
      expression of endogenous alpha and beta PKC isoforms. In response to 12-O
      tetradecanoylphorbol-13-acetate (TPA), parental U937 cells displayed growth
      arrest and differentiated into a monocyte/macrophage-like cell line, while PKC
      zeta cells underwent death. The ability of GF109203X to inhibit TPA-induced death
      of PKC-zeta cells suggested that activation of a conventional isoform was
      necessary to induce apoptosis. While exhibiting unique morphological changes,
      parameters indicative of a further degree of differentiation were not observed in
      TPA-treated PKC-zeta cells. TPA-induced down-regulation of PKC activity was
      similar in both cells. While modest quantitative differences in individual
      isoform down-regulation existed, intracellular localization of isoforms prior to
      activation differed significantly between U937 and PKC-zeta cells. Expression of
      gadd45 was induced by TPA in PKC-zeta but not parental cells and occurred as a
      primary response to TPA and prior to the onset of cell death. These data suggest
      that the decision of a cell to undergo death or differentiation in response to
      phorbol esters may, in part, be modulated by alterations within the PKC signal
      transduction pathway.

PMID- 7794807
TI  - G1 cyclins control the retinoblastoma gene product growth regulation activity via
      upstream mechanisms.
AB  - Inactivation of the retinoblastoma gene product (pRb) occurs concomitant with the
      appearance of its hyperphosphorylated form in mid to late G1. Multiple cyclin/CDK
      complexes are implicated in the cell cycle phosphorylation of pRb. Using in vivo
      expression systems, we show that cyclins A, E, D1, D2, and D3 each function to
      phosphorylate and inactivate pRb. In vivo, G1 cyclin/kinase complexes enhance the
      phosphorylation of pRb, and these effects of cyclin/kinases on pRb can be
      overcome by the addition of p21, a wide spectrum inhibitor of G1 kinases. Kinases
      associated with cyclins A, E, and D1 phosporylate pRb indistinguishably in vivo,
      according to proteolytic maps. Although cyclin D1 has been reported to bind to
      pRb directly, requiring the pRb-binding motif LXCXE, a mutant D1 lacking the pRb
      binding motif remains able to phosphorylate pRb in vivo and in vitro and is also
      able to reverse the growth-inhibitory properties of pRb in intact cells. Finally,
      coexpression of G1 cyclins and kinases represses pRb-mediated growth inhibition
      in Saos-2 cells. The multiplicity of mechanisms for pRb phosphorylation and
      inactivation suggests that several pathways exist for the regulation of pRb by
      phosphorylation.

PMID- 7794806
TI  - The human CCKB/gastrin receptor transfected into rat1 fibroblasts mediates
      activation of MAP kinase, p74raf-1 kinase, and mitogenesis.
AB  - The human cholecystokinin (CCK)B/gastrin receptor was stably transfected into
      Rat1 fibroblasts to examine the signaling pathways mediated by this seven
      transmembrane, G protein-linked receptor. We report here that binding of CCK-8 or
      gastrin to the CCKB/gastrin receptor induced phosphoinositide breakdown and led
      to a rapid, transient, and concentration-dependent increase in intracellular
      Ca2+, which was completely blocked by a specific CCKB receptor antagonist. The
      peptides also stimulated tyrosine phosphorylation of focal adhesion kinase
      (p125FAK) and paxillin. Both CCK-8 and gastrin induced a dose- and time-dependent
      activation of MAP kinase and p74raf-1 kinase in the transfected Rat1 cells. These
      effects could be dissociated from protein kinase C activation and were not
      dependent on a functional Gi protein. Finally, both CCK-8 and gastrin induced DNA
      synthesis in Rat1 cells transfected with the human CCKB/gastrin receptor through
      a pertussis toxin-insensitive pathway. These results indicate that the
      neuropeptides gastrin and CCK can activate multiple signal transduction pathways
      and act as sole mitogens by binding to the CCKB/gastrin receptor transfected into
      Rat1 fibroblasts.

PMID- 7794809
TI  - Rapid DNA binding by nuclear factor kappa B in hepatocytes at the start of liver
      regeneration.
AB  - Liver regeneration after two-thirds partial hepatectomy (PH) is a process in
      which quiescent, fully differentiated hepatocytes rapidly reenter the cell cycle
      and eventually divide until the original liver mass is restored. Although the
      exact nature of the growth-initiating signals is unknown, enhanced expression of
      growth-related genes has been detected during the first hour after operation.
      This suggests that activation of transcriptional and posttranscriptional
      regulatory factors is likely to be a very early event in liver regeneration. Here
      we report the rapid, transient induction of DNA binding by nuclear factor (NF)
      kappa B (p50/p65 heterodimer) and p50 homodimers within 30 min after PH. We also
      detected binding of post-hepatectomy factor. NF-kappa B binding peaks at 1 h
      after PH before declining and is not induced by sham operation. Liver cell
      separation studies indicated that the binding activation occurs in hepatocytes, a
      conclusion further supported by cell culture studies using the hepatocyte cell
      line AML-12. Furthermore, studies with the liver epithelial cell line LE-6
      indicated that these DNA-binding activities are mitogen inducible. One-third
      hepatectomy, a procedure which primes hepatocytes to respond to growth factors,
      also induced NF-kappa B binding. We also found that tumor necrosis factor alpha,
      which may be involved in the control of liver regeneration, rapidly induced NF
      kappa B DNA-binding activities in intact animals, similar to those induced by PH.
      These results suggest that NF-kappa B binding may play a role in making
      hepatocytes competent to proliferate.

PMID- 7794808
TI  - Localization of a cycloheximide-sensitivity response element in the human
      thymidine kinase gene promoter.
AB  - In order to localize the segment of the human thymidine kinase (TK) gene promoter
      that mediates sensitivity of TK mRNA expression to the presence of cycloheximide
      (CX), a series of promoter truncation mutants was prepared between the 460-base
      pair (bp) promoter that was demonstrated previously to be sensitive to CX and the
      83-bp promoter that was demonstrated previously to be insensitive to CX. TK
      promoters containing 370, 300, 160, or 130 bp of 5'-flanking sequence were all
      sensitive to inhibition by CX. Further truncation to 100 bp of 5'-flanking
      sequence eliminated CX sensitivity. Electrophoretic mobility shift assays using a
      probe containing most of this region (but omitting the SP1 binding site at the 5'
      end of the 130-bp promoter) identified some complexes whose formation was
      sensitive to the presence of CX. Comparison of the sequences of oligonucleotides
      that were able to compete for formation of mobility shift complexes identified
      the sequence GCGGCC as a putative CX-sensitivity response element. Two such
      sequences are found between 83 and 130 bp 5' of the TK capsite. Mutation of the
      distal sequence attenuated sensitivity of TK mRNA expression to CX, while
      mutation of the proximal sequence had minimal effect on CX sensitivity. Thus,
      these data have localized a CX-sensitivity response element to a segment of TK
      promoter about 120 bp 5' of the capsite that includes the hexamer GCGGCC.

PMID- 7794810
TI  - Erythropoietin exerts transcriptional and translational control over globin
      synthesis in J2E cells.
AB  - The J2E erythroid cell line, generated by transforming fetal liver cells,
      terminally differentiates in response to erythropoietin (epo). The cells
      expressed both adult and embryonic globin genes, although considerably more adult
      globin was produced, and transcripts for both species rose following exposure to
      epo. A 6-fold increase in transcription of the adult alpha and beta maj globin
      genes was observed after hormonal stimulation, which resulted in a substantial
      accumulation of mRNA. In addition, a modest but transient rise in translation
      enabled a 6-fold elevation in globin protein to occur. Concurrently, the total
      heme content rose markedly, enhancing hemoglobin synthesis 10-fold. The
      prosthetic group complexed entirely with globin proteins, and the hemoglobin
      produced was present as fully functional oxyhemoglobin, capable of gaseous
      exchange. We concluded, therefore, that hemoglobin synthesis in epo-induced J2E
      cells normally results from the coordinate stimulation of heme and globin
      synthesis. However, some mutant clones emerged where concomitant increases in
      globin and heme were not observed. Despite similar profiles for the appearance of
      hemoglobin and equivalent amounts of the oxygen carrier, several noticeable
      differences in globin synthesis were detected between epo-induced J2E cells and
      DMSO-stimulated murine erythroleukemia cells, i.e., the types of globin genes
      expressed, patterns of mRNA and protein production, and translation rates. These
      results demonstrate that the J2E cells provide a useful model system for
      investigating the molecular mechanisms of epo-initiated hemoglobin synthesis.

PMID- 7794813
TI  - Phenotypic modification of human osteosarcoma cells with the phorbol ester 12-O
      tetradecanoylphorbol-13-acetate.
AB  - Treatment of the U-2 OS human osteosarcoma cell line with the phorbol ester 12-O
      tetradecanoylphorbol-13-acetate (TPA) dramatically decreased the rate of DNA
      synthesis. This decrease in proliferation as well as the change in morphology of
      the TPA-treated cells can be blocked by the protein kinase C inhibitor GF
      109203X. The U-2 OS cells are known to express the c-sis oncogene [platelet
      derived growth factor (PDGF) B-chain], PDGF-A, and receptors for PDGF, thus
      providing a potential autocrine loop of growth stimulation. TPA was found to
      induce the expression of both the PDGF-A and the PDGF-B chains. However, the
      levels of the PDGF receptor beta subunits and of the PDGF-BB inducable tyrosine
      phosphorylation of the PDGF receptor were markedly reduced. The TPA treatment of
      the U-2 OS cells also induced changes typical for maturing bone cells, such as
      increased expression levels of alkaline phosphatase and osteopontin. The
      expression levels of type I collagen and bone sialoprotein were reduced. The
      results show a TPA-dependent down-regulation of the PDGF receptor beta subunits
      that correlates with an increased expression of osteoblast phenotypic markers.

PMID- 7794811
TI  - Emergence of myeloid cells from cultures of J2E erythroid cells is linked with
      karyotypic abnormalities.
AB  - J2E cells are an erythroid cell line immortalized at the proerythroblast stage of
      differentiation by the J2 retrovirus which contains the raf and myc oncogenes. In
      response to erythropoietin, these cells terminally differentiate into mature,
      hemoglobin-producing erythroid cells. We have shown previously that B cells
      overexpressing raf and myc acquired the phenotype of macrophages, and here we
      demonstrate that, under adverse growth conditions, myeloid cells can also emerge
      from J2E cultures. Morphologically, ultrastructurally, and by cytochemical
      analyses, these cells resembled monocytic precursor cells at different stages of
      differentiation. They no longer responded to erythropoietin, failed to express an
      erythroid-specific surface antigen, and ceased producing transcripts for globin
      genes, GATA-1 and SCL. Most of the converted cells displayed surface antigens
      typically found on myeloid cells and in vivo produced histiocytomas with severe
      cachexia, instead of erythroleukemias. All of the myeloid convertants had
      karyotypic abnormalities, and we speculate that these mutations may have
      triggered the transition from erythroid to myeloid phenotype. Overexpression of
      raf and myc oncogenes may have generated genetic instability, which then
      influenced the commitment of cells to specific lineages.

PMID- 7794814
TI  - Expression of transforming growth factor beta ligand and receptor messenger RNAs
      in lung cancer cell lines.
AB  - Specific cDNA probes for transforming growth factor beta s (TGF-beta s) 1, 2, and
      3 and TGF-beta types I, II, and III receptors were used to study expression of
      the mRNAs of the different TGF-beta ligand and TGF-beta receptor isoforms in
      cultured non-small cell lung cancer (NSCLC) cells and small cell lung cancer
      (SCLC) cells. Expression of TGF-beta 1 mRNA was detected in both cell types using
      Northern blot hybridization, with the level of expression of this mRNA being
      higher in several NSCLC cell lines. In addition, expression of TGF-beta 2 and TGF
      beta 3 mRNAs was also detected in NSCLC and SCLC cells but at levels that were
      lower than that of TGF-beta 1 mRNA. Besides expression of a 3.4-kilobase (kb) TGF
      beta 3 transcript, a smaller 2.8-kb TGF-beta 3 transcript was detected in some
      NSCLC and SCLC cells. TGF-beta 1 and TGF-beta 2 proteins were detected in the
      conditioned media of NSCLC and SCLC cells, with the levels being higher in
      several NSCLC cells than in SCLC cells. Expression of TGF-beta types I and II
      receptor mRNAs was also detected in most NSCLC and SCLC cells, with expression of
      a 5.5-kb type I receptor mRNA being higher than that of a 5.5-kb type II receptor
      mRNA in both cell types. In contrast, a 6-kb TGF-beta type III receptor mRNA was
      detected in only some NSCLC cells and could not be detected in the SCLC cells
      examined. Also, there was an inverse relationship between the level of expression
      of the 5.5-kb TGF-beta type I receptor mRNA and that of the 6-kb TGF-beta type
      III receptor mRNA. Addition of TGF-beta 1 and TGF-beta 2 proteins resulted in an
      increase in the mRNAs for TGF-beta s 1 and 2 and an increase in the amount of TGF
      beta 1 protein in some NSCLC cells, indicating that these cells are responsive to
      TGF-beta and its effects. At the same time, a differential change in expression
      of the 2.8- and 3.4-kb TGF-beta 3 transcripts was detected in some lung cancer
      cells following the addition of TGF-beta 1 and TGF-beta 2. Also, addition of TGF
      beta 1 to NSCLC cells inhibited colony formation of some of these cells in soft
      agarose in a dose-dependent manner.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7794815
TI  - Presence of the two growth hormone receptor messenger RNA isoforms in human
      breast cancer.
AB  - In the present study, we have investigated specific growth hormone (GH) receptor
      gene expression in breast cancer cell lines and tissues. By Northern blot
      analysis, using a human GH receptor cDNA probe, the classically observed 4.7
      kilobase GH receptor mRNA was evidenced in 2 of 29 cancer biopsies and in the
      MCF7 and T47-D cell lines. Reverse transcription coupled to PCR was used to
      amplify the GH receptor sequence encompassing a part of the extracellular domain
      as well as the transmembrane domain. An amplification product of the expected
      size (456 base pairs) was observed in 28 of 29 breast biopsies and in all the
      breast cancer cell lines studied (T47-D, MCF7, MDA-MB-231, and BT-20). The
      reverse transcription-PCR product was shown to be specific by Southern blot
      hybridization with the GH receptor cDNA probe and by specific cleavage of the
      amplified products with restriction enzymes. For the first time, the expression
      of GH receptor gene in breast cancer cell lines and biopsies is demonstrated in
      this study, suggesting a GH-specific action in tumor development. Additionally,
      the two isoforms of the human GH receptor (hGHR) mRNA, one containing exon 3
      (hGHR-wt mRNA) and one excluding exon 3 (hGHR-d3 mRNA), were found to be
      expressed independently or simultaneously (29 tumors analyzed). The presence of
      hGHR-d3 mRNA appears to be patient specific, as demonstrated by comparing the
      expression pattern of both mRNAs between tumor biopsy and lymphocytes of the same
      patient.

PMID- 7794812
TI  - Human neuroblastoma I-type cells are malignant neural crest stem cells.
AB  - Human neuroblastoma I-type cells isolated from cell lines in vitro are
      morphologically intermediate between neuroblastic (N) cells, with properties of
      embryonic sympathoblasts, and substrate-adherent (S) cells having properties of
      embryonic Schwann/glial/melanocytic cells of the neural crest. I cells have
      biochemical features of both N and S cells. We propose that the I-type cell
      represents a malignant neural crest stem cell. The strongest evidence in support
      of this hypothesis is that: (a) I cells can generate progeny that have neuronal
      properties, i.e., are committed neuroblasts, or properties of nonneuronal,
      embryonic neural crest-derived cells; and (b) I-type cells can generate
      multipotent I-type progeny, indicating their capacity for self-renewal, a feature
      of stem cells. We report here that I-type cells, derived from four different
      human neuroblastoma cell lines and experimentally induced to differentiate, give
      rise to cells with distinct N or S cell phenotypes, indicative of I cell
      multipotentiality. Experiments with a large panel of I-type subclones, isolated
      from clonal I-type BE(2)-C cells and exposed to retinoic acid to induce neuronal
      differentiation or 5-bromo-2'-deoxyuridine to obtain S-type cells, demonstrated
      that differentiation occurs via induction and selection and not by selection of
      spontaneously arising variants. The differentiation phenotype was stable. We
      conclude that human neuroblastoma I-type cells are multipotent embryonic
      precursor cells of the peripheral nervous system, capable of either neuronal or
      nonneuronal neural crest cell differentiation.

PMID- 7794816
TI  - Nickel and skin irritants up-regulate tumor necrosis factor-alpha mRNA in
      keratinocytes by different but potentially synergistic mechanisms.
AB  - A critical role of tumor necrosis factor (TNF)-alpha in irritant contact
      dermatitis and in the challenge phase of allergic contact dermatitis has recently
      been demonstrated in vivo. As in situ hybridization studies have indicated that
      keratinocytes were the cellular source of TNF-alpha in these reactions, we
      studied the mechanisms of TNF-alpha mRNA induction in keratinocytes by agents
      that induce contact dermatitis. Murine la-/CD3- epidermal cells were stimulated
      with phorbol myristate acetate (PMA), dimethylsulfoxide (DMSO), sodium dodecyl
      sulfate (SDS) and NiSO4, all of which up-regulated epidermal cell TNF-alpha mRNA
      production. In contrast, trinitrobenzenesulfonic acid and trinitrochlorobenzene
      did not significantly up-regulate TNF-alpha mRNA. These results were confirmed
      with murine keratinocyte cell lines. In keratinocytes transfected with a
      chloramphenicol acetyltransferase construct containing the -1059 to +138 base
      pair TNF-alpha promoter, increased promoter activity was observed upon
      stimulation with PMA and DMSO. In addition, PMA stimulation did not affect the
      stability of TNF-alpha mRNA. The PMA- but also the DMSO- and SDS- induced up
      regulation of TNF-alpha mRNA was abolished by an inhibitor of protein kinase C
      (PKC). In contrast, NiSO4 up-regulated TNF-alpha mRNA by a PKC-independent
      mechanism, did not increase TNF-alpha promoter activity, but markedly increased
      the stability of the TNF-alpha mRNA. Co-stimulation with PMA and NiSO4 induced a
      marked increase in TNF-alpha mRNA over that obtained with each agent alone. Thus,
      whereas PKC-dependent irritants act by up-regulating TNF-alpha promoter activity,
      nickel acts via post-transcriptional regulation. Our results also establish that
      some irritants and irritant sensitizers directly induce TNF-alpha in
      keratinocytes without intermediate Langerhans cell-derived signals.

PMID- 7794817
TI  - The positively selected T cell repertoire: is it exclusively restricted to the
      selecting MHC?
AB  - Transgenic lines of mice showing compartmentalized expression of MHC I-E in
      different thymic microenvironments and nearly normal expression in the periphery
      were used to ask whether the mature T cell repertoire is restricted exclusively
      to the selecting MHC molecules expressed on thymic cortical epithelial cells. We
      show that upon in vivo priming, mice with a T cell repertoire selected in the
      thymic cortex on MHC I-A, in the absence of MHC I-E, display a clearly
      significant T cell response to two I-E-restricted peptides. Our results suggest
      that expression of one isotype or allele of class II MHC molecules in the
      appropriate thymic environment enables the selection of a polyclonal repertoire
      restricted in part to non-selecting class II MHC molecules. Thus, although the
      requirement for interaction with the MHC by the TCR on developing thymocytes
      exists, the available adult repertoire need not be solely faithful to the
      specific MHC expressed on the thymic cortical epithelium: it can also be
      restricted to other isotypes and alleles of this same class of MHC molecule.

PMID- 7794818
TI  - Assembly and intracellular transport of the human B cell antigen receptor
      complex.
AB  - The B cell antigen receptor (BCR) complex consists of transmembrane (m) Ig, in
      non-covalent association with a disulphide-linked heterodimer of mb-1 and B29
      gene products. The MB-1-B29 heterodimer is required for deposition of the BCR at
      the plasma membrane, as well as for coupling of the antigen receptor to
      intracellular signal transduction cascades. We have performed biosynthetic
      labelling studies using the mature B cell line Ramos to investigate the process
      of assembly of the BCR components. We conclude that association of the four
      components, Ig-heavy chain (HC) and -light chain (LC), MB-1 and B29, is required
      and sufficient to permit exit of the BCR complex out of the endoplasmic reticulum
      (ER). With the short pulse labelling procedures used, no evidence was found for
      transient participation of other molecules in complex formation. A 32 kDa
      glycoprotein was identified, which is serologically related to MB-1, but has a
      more acidic isoelectric point (pl) and a protein backbone of 21 kDa, as compared
      with 25 kDa for MB-1. This protein did not appear to participate in BCR complex
      formation and is most likely degraded prior to reaching the cis-Golgi. The MB-1
      component was found to be the rate-limiting step in BCR complex formation, while
      Ig-HC, -LC and B29 are synthesized in excess. Ig-HC and -LC form disulphide
      linked tetrameric complexes within 3 min after biosynthesis, with which B29 and
      MB-1 components associate independently, followed by disulphide bond formation
      between these heterodimeric partners. While partial BCR complexes containing B29
      and mlg-H2L2 tetramers are rapidly formed and have a half-life of a few hours in
      the ER, entry of MB-1 into these complexes controls exit out of this compartment.

PMID- 7794820
TI  - IL-7 transgenic mice: analysis of the role of IL-7 in the differentiation of
      thymocytes in vivo and in vitro.
AB  - We have generated a high copy number transgenic mouse line in which expression of
      mouse IL-7 cDNA is under the control of the mouse MHC class II E alpha promoter.
      These mice were generated in order to see if IL-7 over-production in the thymus
      altered either thymocyte differentiation or the process of negative selection.
      Using in situ hybridization, IL-7 transcripts could be detected in the thymic
      cortex and medulla as well as the spleen and lymph nodes of transgenic mice but
      was undetectable in normal controls. Phenotypic and molecular analysis of
      thymocytes from embryonic and adult transgenic mice failed to reveal a dramatic
      effect of IL-7 on thymocyte differentiation and negative selection of the TCR V
      beta repertoire appeared to be intact. In peripheral lymph nodes, there was a
      massive (30-fold) increase in the number of T cells (CD8+ > CD4+) and
      simultaneous presence of immature (B220+, Ig-) B cells. TCR repertoire analysis
      showed that the expansion of peripheral T cells was polyclonal. Using the
      polymerase chain reaction (PCR), transgene-specific IL-7 transcripts could be
      detected in the thymus from day 14 of fetal development. However, using semi
      quantitative PCR, there was no dramatic increase in the degree of TCR beta or TCR
      alpha gene rearrangements during thymocyte ontogeny in vivo. Similarly, when
      fetal mouse thymus lobes were cultured with IL-7 in vitro, there was no dramatic
      increase in the degree of TCR beta or TCR alpha gene rearrangements. We conclude
      that IL-7 is probably not an important differentiation factor for immature mouse
      thymocytes.

PMID- 7794819
TI  - General role of HLA class I molecules in the protection of target cells from
      lysis by natural killer cells: evidence that the free heavy chains of class I
      molecules are not sufficient to mediate the protective effect.
AB  - Some HLA-C alleles have been shown to exert a specific protective effect
      preventing target cells from lysis by groups of natural killer (NK) clones
      displaying a defined specificity. In this study, we analyzed whether class I
      mediated protection is a more general phenomenon involving all NK cells. First,
      we utilized two anti-class I mAbs (6A4 of IgG1 isotype and A6-136 of IgM
      isotype), which had been shown to induce lysis of protected target cells by group
      1 and group 2 NK clones. Addition of A6-136 or 6A4 used as F(ab')2 mAb resulted
      in lysis of protected target cells by all NK clones analyzed. Target cells were
      represented by a panel of HLA homozygous Epstein-Barr virus-transformed B cell
      lines (B-EBV) while NK clones were representative of clones displaying different
      GL183/EB6 surface phenotypes and/or different abilities to lyse allogeneic cells.
      Unselected NK clones derived from seven different individuals were tested against
      autologous target cells represented by phytohemagglutinin-induced blasts or B-EBV
      transformed cell lines. In both instances, addition of a mixture of 6A4 F(ab')2
      and A6-136 mAbs resulted in lysis of autologous target cells, thus suggesting
      that class I molecules prevent lysis of normal cells by self NK cells. We further
      investigated whether the class I-mediated protection requires the complexed form
      of class I molecules (composed of alpha chain, beta 2-microglobulin and the
      antigen peptide) or rather the free alpha chain. Acidic treatment of the C1R
      (Cw4+) target cells or 81.22 (Cw3+, Cw4+) at pH 2.2 resulted in loss of
      reactivity with 6A4, A6-136 and W6-32 mAb (known to react with the assembled form
      of class I molecules) and in the de novo reactivity with L31 mAb (specific for
      the HLA-C free chain). While the untreated Cw+ C1R cells were resistant to lysis
      by the Cw4-specific group 1 NK clones, the pH 2.2-treated cells became highly
      susceptible to lysis by the same clones. These data indicate that, at least for
      the NK clones analyzed, the protection of target cells requires class I molecules
      in the complexed form.

PMID- 7794821
TI  - Lymphoproliferative disorders in IL-7 transgenic mice: expansion of immature B
      cells which retain macrophage potential.
AB  - Transgenic mice carrying the murine IL-7 gene under the MHC class II (E alpha)
      promoter are described which develop lymphoid tumours at a high incidence when
      maintained in conventional or specific pathogen-free environments. Cells obtained
      from the lesions were relatively monomorphic, expressed a variety of B cell
      associated markers (BP-1, B220, CD43) but lacked surface Ig. Some mice, showed
      expanded populations of cells phenotypically similar to the recently reported
      bipotent B/macrophage stem cell subset (AA4.1high, B220-, Ig-) which could be
      cloned and maintained in vitro. These cells expressed IL-7 receptors,
      proliferated in response to IL-7 and in most cases had germline configuration of
      the Ig heavy chain locus. Cell lines cloned from two such tumours generated
      macrophages spontaneously in culture, consistent with their bipotent B
      cell/macrophage phenotype. These results suggest that IL-7 plays a role in very
      early stages of B cell ontogeny prior to bona fide B cell commitment.

PMID- 7794822
TI  - Selective activation of VH3A10+ rheumatoid factor producing B cells by
      staphylococcal enterotoxin D.
AB  - Staphylococcal enterotoxin D (SED) is a T cell superantigen which selectively
      targets alpha beta TCRs bearing particular V beta elements. A second function of
      SED relates to the preferential activation of a B cell subset characterized by a
      high frequency of rheumatoid factor (RF) producing B cells. To define the
      molecular basis of the SED-induced B cell repertoire shift, we have analyzed Ig
      heavy chain genes in B cell clones expanded after SED stimulation and compared
      them with B cell clones established in the presence of anti-CD3 stimulated helper
      cells. Gene segments of the VH3 family were most frequently utilized under both
      stimulation conditions (42% anti-CD3; 47% SED). Sequence analysis of VH3 gene
      segments demonstrated that the repertoire of VH3 elements in B cell clones from
      SED driven and anti-CD3 driven cultures were distinct (P = 0.01). RF activity was
      closely associated with the expression of selected VH3 elements. B cell clones
      stimulated with SED preferentially expressed VH3A10, whereas VH26 was the gene
      segment dominantly used in B cell clones expanded with anti-CD3 stimulated helper
      cells. The usage of JH and DH elements was indistinguishable in SED and anti-CD3
      driven B cell clones, suggesting that SED targets VH3+ B cells through a VH
      specific mechanism. Comparison of the closely related sequences of the SED
      responsive VH3A10 and the SED non-responsive VH26 element suggested a role of a
      sequence polymorphism in the CDR2 reminiscent of B cell reactivity to
      conventional antigens. In contrast to conventional antigens, SED can induce
      differentiation of a high frequency of naive B cells. Thus, this staphylococcal
      enterotoxin combines selective activation of T cells with selective activation of
      B cells and might be able to direct T cell help to RF producing B cells.

PMID- 7794824
TI  - Differential sensitivity to transforming growth factor (TGF)-beta of CBA and of
      CBA/N B cells demonstrates that the IgG2b inducing factor in synovial fluid from
      rheumatoid arthritis patients is not identical to TGF-beta.
AB  - Synovial fluid from patients with rheumatoid arthritis (RA-SF) contains in vivo
      produced cytokines and inflammatory mediators, including a factor that induces
      IgG2b production of lipopolysaccharide (LPS) preactivated murine B lymphocytes.
      In order to determine the mechanism by which RA-SF acts on LPS activated mouse B
      cells, CBA/N mice were used as an experimental model. The X-linked
      immunodeficiency of these mice is caused by a point mutation in the Bruton's
      tyrosine kinase (btk) gene. We have earlier shown that RA-SF can reconstitute the
      CBA/N B cell deficiency in vitro and in vivo, with regard to IgG2b production
      after LPS stimulation. Since transforming growth factor (TGF)-beta has been
      suggested to be a switch factor for IgG2b, we aimed at investigating the role of
      TGF-beta in our experimental system. We found that TGF-beta could not mimic the
      effect of RA-SF on CBA spleen cells. A small increase of IgG2b secretion was
      observed with spleen cells from normal CBA mice, whereas Ig secretion of all
      isotypes was suppressed in CBA/N spleen cells treated with TGF-beta at any
      concentration. Neutralizing antibodies against TGF-beta suppressed the response
      of CBA B cells, whereas the response by CBA/N B cells was enhanced by the same
      antibody preparation. Here we also show that the abnormal B cell responsiveness
      to TGF-beta, typical of CBA/N, co-segregates with the btk mutation in male (CBA x
      CBA/N)F2 spleen cells. This was determined by allele specific PCR recognizing the
      identified base substitutions of the btk gene, typical of the two strains. We
      propose that RA-SF contains a factor, separate from TGF-beta, that is involved in
      the differentiation of IgG2b expressing cells.

PMID- 7794825
TI  - TCR repertoire in early fetal mouse thymus.
AB  - We investigated the rearrangement and expression of TCR genes in mouse fetal
      thymus organ culture, a system that avoids subsequent entry of hematopoietic
      precursor cells. The first observable rearranged TCR gene was homogeneous V gamma
      2-J gamma 2, detectable as early as fetal day 11 (d11) in the thymic primordia.
      The productive TCR was homogeneous V gamma 5-J gamma 1, first detectable in d13
      thymocytes, followed by adult-type TCR gamma (V gamma 4 and V gamma 7). Sequence
      analysis of TCR revealed five types of V-J junctional sequences. In the very
      early stage, a homogeneous V-J junction is generated via a short homology
      sequence in the coding region (Type I), while a short homology sequence in the P
      nucleotide rather than the coding region is used in the following stage (Type
      II). In the later embryonic stages, diverse V-J junctions are generated by well
      known mechanisms, such as P-nucleotide (Type III), N-region insertion (Type IV)
      or trimming of the coding ends (Type V). These findings suggest that the
      generation of homogeneous TCR gamma (V gamma 2 and V gamma 5) in the early fetal
      stages is due to the intrinsic rearrangement mechanisms and is in stage specific
      manner.

PMID- 7794823
TI  - Over-expression of CD3 epsilon transgenes blocks T lymphocyte development.
AB  - We have reported previously that mice carrying > 30 copies of the human CD3
      epsilon transgene completely lose their T lymphocytes and NK cells (36). Here we
      demonstrate by immunohistology that in the most severely immunodeficient mouse,
      tg epsilon 26, the thymus is very small, has sizeable vacuoles and does not
      contain recognizable T lymphocytes except for a small percentage of Thy-1+ cells
      and B cells. Cell surface phenotyping and TCR alpha and -beta rearrangement
      studies confirm that the arrest in T lymphocyte development precedes the arrest
      in rag-1null, rag-2null and TCR beta nuli mice. Since the T cell progenitors in
      which the arrest occurred were absent in the transgenic mice, indirect approaches
      were taken to examine the causes of the block in T cell development. Analyses of
      12 independently established mutant mouse lines, generated with five different
      transgenic constructs, revealed that the severity of the abrogation in T cell
      development was dependent on the number of copies of transgenes. Since the number
      of transgene copies generally correlated with the levels of expression of the
      transgenic CD3 epsilon proteins, we concluded that over-expression of the CD3
      epsilon protein was the likely cause of the block in T lymphocyte development.
      The T cell immunodeficiency was caused by either the human or the murine CD3
      epsilon protein. Since transgene coded mRNAs were found in significantly higher
      quantities than endogenous CD3 epsilon mRNAs in fetal thymi on days 13 and 14 of
      gestation, over-expression took place very early in development, probably
      prematurely. Over-expression of the CD3 epsilon transgene in thymocyte precursors
      may therefore affect T lymphocyte development in the absence of TCR and possibly
      in the absence of the other CD3 proteins. More importantly, over-expression of
      the CD3 epsilon protein in thymocytes of mice with a low copy number of
      transgenes had a significant effect on late thymic development. Over-expression
      of the CD3 epsilon protein in immature thymocytes mimicked the effects caused by
      exposure of CD4- CD8- thymocytes to anti-CD3 epsilon treatment: apoptosis and
      lack of TCR beta expression. We therefore speculate that in the homozygous tg
      epsilon 26 animals the arrest in T cell development was caused by excessive
      signal transduction events rather than by a toxic effect of the transgenic
      protein.

PMID- 7794827
TI  - Visualizing properties of atomic and molecular systems.
AB  - In this article scientific visualization techniques that allow for the
      interactive computation and display of molecular structures and properties are
      presented. The electronic properties are computed and displayed using the
      application visualization system (AVS). By combining the visualization techniques
      of AVS with an orbital description of molecular systems, a better understanding
      of the electronic behavior of the systems can be achieved. Molecular properties
      such as the electrostatic potential and chemical reactivity index (the Fukui
      function) are computed and mapped onto isodensity displays of the electron
      density of the system.

PMID- 7794826
TI  - CD4+ but not CD8+ T cells are required for the induction of oral tolerance.
AB  - It has been suggested that oral tolerance is mediated by CD8+ T lymphocytes, but
      the functional properties of these cells are unclear. Here we show that the
      induction of tolerance by feeding mice ovalbumin (OVA) does not prime antigen
      specific class I MHC-restricted cytotoxic T cells in vivo. Indeed, such responses
      are markedly suppressed in mice fed OVA, and the induction of oral tolerance is
      abolished by depletion in vivo of CD4+ but not CD8+ T cells. These results
      indicate that CD8+ lymphocytes are unlikely to play a major role in the induction
      of oral tolerance and are the first demonstration that specific cytotoxic
      responses to an exogenous antigen can be suppressed by feeding antigen.

PMID- 7794828
TI  - Development of quantitative structure property relationships for poly(arylene
      ether)s.
AB  - The technique of quantitative structure-activity relationships (QSAR) is well
      accepted by the drug design community. The analogous technique of quantitative
      structure-property relationships (QSPR) has applications in the field of polymer
      chemistry. A variety of molecular modeling and molecular orbital techniques was
      used to find molecular descriptors that could be used to derive an empirical
      equation to describe the glass transition temperature of two related classes of
      poly(arylene ether)s. The derived equation was then used to predict the thermal
      characteristics of another polymer of the same type.

PMID- 7794829
TI  - EXTRACT: a program to extract three-dimensional coordinates from stereo diagrams
      of proteins.
AB  - The program EXTRACT has been developed to extract accurate three-dimensional
      coordinates from published stereo alpha-carbon diagrams of protein structures.
      The approach is based on the display of scanned images of the left and right eye
      views of the diagram on a stereo-equipped workstation, allowing construction of a
      molecular model using the diagram as a guide. A number of structural checks
      assess the building, including probability maps derived for alpha-carbon geometry
      in protein structures. The procedure has also been extended to produce less
      accurate models from mono images.

PMID- 7794830
TI  - GAME: a computer graphics method for calculating and displaying the molecular
      electrostatic potential.
AB  - A new method for calculating and displaying the molecular electrostatic potential
      on the molecular surface is described. The main advantage of the method, besides
      some others, is its consistency. This means one only needs one data set for the
      surface and the MEP: a 3D field of the electron density from any source.

PMID- 7794832
TI  - Modeling cation/anion-water interactions in functional aluminosilicate
      structures.
AB  - A need for the computer simulation of hydration/dehydration processes in
      functional aluminosilicate structures has been noted. Full and realistic
      simulations of these systems can be somewhat ambitious and require the aid of
      interactive computer graphics to identify key structural/chemical units, both in
      the devising of suitable water-ion simulation potentials and in the analysis of
      hydrogen-bonding schemes in the subsequent simulation studies. In this article,
      the former is demonstrated by the assembling of a range of essential water-ion
      potentials. These span the range of formal charges from +4e to -2e, and are
      evaluated in the context of three types of structure: a porous zeolite, calcium
      silicate cement, and layered clay. As an example of the latter, the computer
      graphics output from Monte Carlo computer simulation studies of
      hydration/dehydration in calcium-zeolite A is presented.

PMID- 7794831
TI  - Self-organizing maps and molecular similarity.
AB  - Self-organizing maps generated by Kohonen neural networks provide a method for
      transforming multidimensional problems into lower dimensional problems. Here, a
      Kohonen network is used to generate two-dimensional representations of the
      electrostatic potential about the ring structures of histamine H2 agonists.
      Previous work by J. Gasteiger and X. Li (Angew. Chem. Int. Ed. Engl. 1994, 33,
      643) has shown the usefulness of such a method for classifying molecules as
      muscarinic or nicotinic agonists. Here, the method is extended to rank histamine
      H2 agonists in order of biological activity.

PMID- 7794833
TI  - An algorithm for smoothly tessellating beta-sheet structures in proteins.
AB  - An algorithm is presented for tiling the surface of beta-sheet structures,
      smoothed both along the strands and perpendicular to them. The algorithm is
      intended for creating graphical representations of beta structure within the
      three-dimensional context of proteins. This article presents sufficient detail to
      allow a programmer with some knowledge of protein structure to implement the
      tiling algorithm. Several examples of its use are illustrated.

PMID- 7794834
TI  - Use of TSAR as a new tool to analyze the molecular dynamics trajectories of
      proteins.
AB  - There is a lack of tools to analyze simulations of protein molecular dynamics
      quantitatively. Our aim is to use calmodulin, a prototypical calcium-binding
      protein, to describe a strategy and some tools for extracting relevant
      information from dynamics calculations. Our main conclusions are as follows:
      Autocorrelation vectors may be used to represent a 3D conformation in an n
      dimensional space, where n is variable (n < or = 20-30). On such a
      transformation, classic statistical tools (PCA, clustering, etc.) may be used to
      differentiate or characterize dynamics trajectories quantitatively. TSAR, an
      integrated package used for quantitative structure-activity relationships, is
      well suited (after minor modifications) for such a purpose. Finally, this type of
      strategy is able to point out the effects of the solvent screening parameters of
      the Amber software on the dynamics trajectories of calmodulin.

PMID- 7794836
TI  - XmMol: an X11 and motif program for macromolecular visualization and modeling.
AB  - XmMol is a desktop tool designed to provide both interactive molecular graphics
      on X11 displays and easy interface with external applications. A kernel provides
      an interactive wire-frame display of macromolecules. It supports depth cueing, 3D
      clipping, and stereo. Various representations, coloring, and labeling modes are
      proposed. Docking and interactive backbone deformation tools are also supported.
      Communication protocols allow the user to develop new external features or to use
      XmMol as a visualization tool for external numerical programs.

PMID- 7794838
TI  - The implications of the changing nature of gynaecological surgical practice on
      training.

PMID- 7794835
TI  - QMView: a computational chemistry three-dimensional visualization tool at the
      interface between molecules and mankind.
AB  - QMView is designed to facilitate the visualization and interpretation of quantum
      mechanical data. Capabilities include display of chemical structure, animation of
      quantum mechanically determined vibrational modes, and depiction of electronic
      properties and three-dimensional molecular orbitals. QMView has a user-friendly
      interface that allows users to interactively manipulate many features of the
      molecular structure and/or property, including positioning and structure
      representation, via mouse-activated dialog boxes. Although the interface allows
      input from results of any of the popularly used quantum mechanical software, we
      have focused on GAMESS, a widely distributed quantum chemistry code. QMView has
      been designed with the special feature of working in distributed mode with
      GAMESS, the latter running on a supercomputer, the former running on a Silicon
      Graphics platform. Ancillary programs provide a method of obtaining output of
      graphic images in various media, including hardcopy, PostScript files, slide,
      and/or video. These and other original features discussed in this article provide
      a graphic interface that is unique compared to others that are currently
      available. Examples of images produced by QMView are presented.

PMID- 7794837
TI  - VISTAS: a package for VIsualizing STructures and sequences of proteins.
AB  - VISTAS is a suite of programs for protein sequence and structure analysis. The
      system allows the simultaneous display, in separate windows, of multiple sequence
      alignments, of known or model 3D structures, and of 2D graphic representations of
      sequence and/or alignment properties. The displays are fully integrated, and
      therefore manipulations in one window can be reflected in each of the others.
      Beyond its display facilities, VISTAS brings together a number of existing tools
      under a single, user-friendly umbrella: these include a fully functional
      interactive color alignment procedure, conserved motif selection, a range of
      database-scanning routines, and interactive access to the OWL composite sequence
      database and to the PRINTS protein fingerprint database. Exploration of the
      sequence database is thus straightforward, and predefined structural motifs from
      the fingerprint database may be readily visualized. Of particular note is the
      ability to calculate conservation criteria from sequence alignments and to
      display the information in a 3D context: this renders VISTAS a powerful tool for
      aiding mutagenesis studies and for facilitating refinement of molecular models.

PMID- 7794839
TI  - Prolactinomas: present day management.

PMID- 7794841
TI  - Caesarean operations performed in Edinburgh during the 18th century.

PMID- 7794840
TI  - Should perinatal post mortems be carried out by specialist pathologists?

PMID- 7794842
TI  - Blood pressure changes during labour and whilst ambulating with combined spinal
      epidural analgesia.
AB  - OBJECTIVE: To determine the influence of combined spinal epidural analgesia with
      fentanyl and low dose bupivacaine on maternal blood pressure and pulse rate in
      labour. Also, to evaluate the maternal cardiovascular response to mobilising with
      this form of analgesia in labour. Finally, to define the changes that occur in
      blood pressure and pulse rate during the second stage of labour and immediately
      postpartum when using combined spinal epidural analgesia. DESIGN: A prospective
      observational study. SUBJECTS AND METHODS: Blood pressure and pulse measurements
      were made at least every 10 minutes, using the SpaceLabs 90207 ambulatory blood
      pressure monitor, on 62 women in labour with combined spinal epidural analgesia.
      RESULTS: A significant fall in systolic blood pressure (> 20%) occurred in eight
      women (12%), all within 30 minutes of the spinal injection. Fifty-two women
      subsequently received an epidural dose (mean interval 90 minutes after spinal)
      and none of these women had a fall in systolic blood pressure of greater than
      20%. No women had symptoms related to hypotension. Thirty-five women ambulated
      for more than 10 minutes on 65 occasions. Average blood pressure remained
      unchanged while ambulating (126/79 versus 126/79), but pulse rate was
      significantly increased (85 to 90, P < or = 0.001). The mean blood pressure in
      the second stage of labour (n = 41) did not rise with pushing (134/83 versus
      134/83), but the pulse rate increased significantly (94 to 108, P < or = 0.001).
      Blood pressure remained unchanged immediately postpartum (n = 33) (134/83 versus
      134/81) following ergometrine administration. CONCLUSION: The combined spinal
      epidural analgesia will only result in significant falls in systolic blood
      pressure within 30 minutes of the spinal injection. No further important changes
      in blood pressure occur when mobilising or with epidural top-ups. The combined
      spinal epidural analgesia may modify the normal compensatory mechanisms of blood
      pressure control, but does not cause significant maternal hypotension once the
      spinal injection has been given.

PMID- 7794843
TI  - Standing at work and preterm delivery.
AB  - OBJECTIVE: Guidelines in some European countries and the United States suggest
      that pregnant women should avoid prolonged standing and heavy lifting in the
      workplace during the second and third trimester of pregnancy. However, results
      from epidemiological studies on this topic are ambiguous. The aim of this study
      was to evaluate the influence of standing and walking at work in the second
      trimester on preterm delivery in a population with a low frequency of other
      workplace hazards. SUBJECTS AND DESIGN: A prospective cohort of 8711 women with
      singleton pregnancies was established during 1989 through 1991. Information was
      collected during the 16th week of pregnancy about medical and obstetrical
      history, general lifestyle factors and exposures at work. The analyses were
      restricted to 4259 respondents who worked at the 16th week. Potential confounders
      and effect modifiers were evaluated by stratification and multivariate analyses.
      RESULTS: After adjustment for confounders, women standing more than five hours
      per work day had an odds ratio (OR) for preterm delivery of 1.2 (95% CI 0.6 to
      2.4) compared with women standing two hours or less. For walking, the OR was 1.4
      (95% CI 0.7 to 2.5). Many women were unable to separate periods of standing from
      periods of walking; a combined measure of these two exposures was created to
      reflect exposure intensity. Women who reported more than five hours of both
      standing and walking had an adjusted OR of 3.3 (95% CI 1.4 to 8.0) compared with
      women who reported two hours or less on either of the exposures. No adverse
      effects were seen for lifting or other types of physical exertion. CONCLUSIONS:
      Our findings suggest that standing and walking at work during the second
      trimester may present a particular risk for preterm delivery, and workplace
      guidelines are justified. Further research is needed to address the specific
      mechanisms by which physical exertion, including standing and walking, might
      cause preterm delivery.

PMID- 7794845
TI  - The influence of maternal haemoglobin and ferritin on mid-pregnancy placental
      volume.
AB  - OBJECTIVE: To investigate whether low maternal haemoglobin and ferritin levels
      are associated with increased placental volume by mid-pregnancy. DESIGN:
      Prospective study of women attending hospital for shared antenatal care. SETTING:
      A teaching hospital in the south of England. SUBJECTS: Five hundred and sixty
      eight women booking for delivery in the hospital. MAIN OUTCOME MEASURES:
      Placental volume measured by ultrasound at 18 weeks gestation. RESULTS: At 14
      weeks gestation 9% of women had haemoglobin levels < or = 11 g/dl and 26% had
      ferritin levels < 13 micrograms/l. Placental volume at 18 weeks was inversely
      related to the maternal haemoglobin and ferritin levels. The influence of
      haemoglobin and ferritin concentrations was independent of maternal social class,
      parity, smoking, and weight. Larger placentae were found in taller women, those
      who had previously been pregnant, and in those who were smoking more than 15
      cigarettes daily at the time of their last menstrual period. CONCLUSION: These
      data suggest that placental development is influenced from early in pregnancy by
      the intrauterine environment provided by the mother. In conjunction with other
      studies they support the proposal that, as a result of these changes, programming
      of adult blood pressure may be initiated in early pregnancy.

PMID- 7794844
TI  - Fetal fibronectin detection for prediction of preterm birth in low risk women.
AB  - OBJECTIVE: To evaluate the clinical value of cervical fetal fibronectin detection
      by a quantitative enzyme-linked immunosorbent assay (ELISA) (PTDcheck, Adeza
      Biomedical, Sunnyvale, California, USA) as a screening tool for the prediction of
      preterm contractions and preterm delivery in an unselected population of pregnant
      women globally considered to be at low risk for preterm delivery (n = 133).
      DESIGN: A prospective study in which cervical fetal fibronectin samples were
      collected at two-week intervals between 26 and 36 weeks of gestation. SETTING: A
      regional training hospital. SUBJECTS: One hundred and thirty-three singleton
      pregnancies presenting consecutively at an antenatal clinic. MAIN OUTCOME
      MEASURE: Occurrence of preterm contractions and preterm delivery (delivery at <
      37 weeks of gestation). RESULTS: Twenty-four (18%) patients were considered
      positive for the presence of fetal fibronectin. Overall 15 patients (11%)
      developed preterm contractions and, despite therapeutic intervention, 10 patients
      (8%) were delivered preterm. As a predictor for preterm contractions, cervical
      fetal fibronectin detection had a sensitivity of 47%, a specificity of 86%, a
      positive predictive value of 29% and a negative predictive value of 93%. As a
      predictor for preterm delivery, cervical fetal fibronectin detection had a
      sensitivity of 60%, a specificity of 85% a positive predictive value of 25% and a
      negative predictive value of 96%. CONCLUSIONS: Cervical fetal fibronectin
      determinations at a two-week sampling frequency for prediction of preterm birth
      in a general obstetric population at low risk for preterm birth has limited
      clinical value as a routinely performed screening procedure.

PMID- 7794848
TI  - Obstetricians' views on prenatal diagnosis and termination of pregnancy: 1980
      compared with 1993.
AB  - OBJECTIVE: To examine the attitudes of obstetricians in England and Wales
      concerning prenatal diagnosis and termination of pregnancy and to compare these
      with a similar survey carried out in 1980. METHODS: Postal questionnaires, based
      on those used in 1980, were sent to a random sample of 555 nonacademic consultant
      obstetricians, 71% of whom replied. RESULTS: The proportion of consultant
      obstetricians with a conscientious objection to termination of pregnancy was the
      same in both surveys, although virtually all conscientious objectors said that
      they made an exception for serious fetal abnormality. A major change was in the
      proportion saying that they generally required an undertaking to terminate an
      affected pregnancy before proceeding with amniocentesis: 75% in 1980 compared
      with 34% in 1993. As in 1980, lower priority is given to telling women of
      negative test results than of positive. More obstetricians in 1993 are prepared
      to consider terminations later in pregnancy, both for fetal abnormality and for
      social reasons, than was the case in 1980, but many are not prepared to recommend
      termination as late in pregnancy as the law allows. In some cases this is due to
      misapprehensions about what is legal. There are particular problems concerning
      terminations for fetal anomalies that not all would consider serious. One in
      seven of the 1993 sample would not recommend termination for cystic fibrosis at
      any gestation. Only 13% would recommend termination for Down's syndrome beyond 24
      weeks. There is a need not only for clarification of the law, but also of
      obstetrician's willingness to implement it.

PMID- 7794847
TI  - Does early growth delay occur in diabetic pregnancy?
AB  - OBJECTIVE: To identify the date of ovulation in pregnant women with Type 1
      diabetes in order to assess the validity of the concept of early growth delay.
      DESIGN: Identification of ovulation by measurement of urinary luteinising hormone
      and assessment of fetal growth using ultrasound scan. SETTING: Diabetic pre
      pregnancy and antenatal clinic in a teaching hospital. SUBJECTS: Twenty women
      with Type 1 diabetes who had attended a pre-pregnancy clinic. MEASURES: Urinary
      LH, by laboratory and kit methods, during conception cycles. Human chorionic
      gonadotrophin measured in early pregnancy. Early ultrasound scans by a single
      observer blind to menstrual and ovulation dates. OUTCOME: Gestation calculated
      from ovulation date and gestation estimated from menstrual dates, compared with
      gestation at age indicated by early ultrasound scan. RESULTS: When the date of
      ovulation was identified in 20 women with Type 1 diabetes there was no evidence
      of growth delay in any pregnancy. When gestation was estimated from menstrual
      dates there was apparent early growth delay in six pregnancies. CONCLUSION: This
      study, together with others discussed, indicates that early growth delay is
      probably an artefact of incorrectly estimated ovulation date.

PMID- 7794846
TI  - First trimester amnifiltration: technical, cytogenetic and pregnancy outcome of
      104 consecutive procedures.
AB  - OBJECTIVE: To investigate the technical, cytogenetic and pregnancy complications
      of first trimester amnifiltration for the diagnosis of fetal karyotype. DESIGN:
      Observational study. SETTING: The fetal medicine unit, UMDS St Thomas' Campus,
      London. SUBJECTS: One hundred and four women seeking prenatal diagnosis of fetal
      karyotype. MAIN OUTCOME MEASURES: Sampling success, culture rate, harvest time
      and karyotype, pregnancy outcome and complications. RESULTS: Sampling was
      successful in all 104 cases, but equipment failure forced the procedure to be
      changed to early amniocentesis in eight (7%) cases. The karyotype was normal in
      101 (97%) cases, abnormal in three. The mean harvest time was 14 days (range 9-26
      days; SD = 3.4), and three cultures failed (2.8%). Pregnancies resulted in 99
      (95%) live births, with a mean gestation of 277 days (range 182-300 days; SD =
      16). There was one termination for trisomy 21 and four spontaneous miscarriages
      (3.8%). Amniotic fluid leakage occurred in six cases (5%), all resulted in live
      births, five at term and one at 35 weeks. CONCLUSIONS: This study demonstrates
      that amnifiltration is technically possible in the first trimester of pregnancy,
      and that samples can be successfully karyotyped. The harvest time for culture is
      similar to early amniocentesis and chorion villus sampling. The rate of fetal
      loss, adjusted by the estimated natural loss, is 1.7%, which compares favourably
      with both chorionic villus sampling and early amniocentesis.

PMID- 7794849
TI  - Measurement of creatine kinase activity and diagnosis of ectopic pregnancy.
AB  - OBJECTIVE: To investigate whether the measurement of maternal plasma creatine
      kinase concentration is of clinical value in the diagnosis of tubal ectopic
      pregnancy. DESIGN: A retrospective observational study covering a three month
      period. SETTING: The gynaecological emergency service of a UK teaching hospital.
      SUBJECTS: One hundred and twenty women presenting with clinical suspicion of an
      ectopic pregnancy such that plasma human chorionic gonadotrophin (hCG)
      concentration was measured. MAIN OUTCOME MEASURES: Plasma hCG and creatine kinase
      concentrations were measured. Pregnancies were classified as ectopic pregnancy,
      complete miscarriage, incomplete miscarriage or ongoing pregnancy. Pregnancies
      were further classified as uncertain diagnosis if the diagnosis was not clear
      after initial investigation. RESULTS: Twenty-one of the patients had an ectopic
      pregnancy. Diagnosis was classified as uncertain in 48% of pregnancies studied
      and in 54% of ectopic pregnancies during the study period. The mean plasma
      creatine kinase was higher in ectopic pregnancies than other pregnancies in the
      study group (P < 0.01) and remained higher in the subgroup of patients with
      uncertain diagnosis (P < 0.05) but there were significant overlaps in creatine
      kinase concentrations in all four clinical groups. When a cut-off point of 45
      iu/l is used, the measurement of plasma creatine kinase activity has a
      sensitivity of 0.57 and a specificity of 0.67 for the diagnosis of ectopic
      pregnancy.

PMID- 7794850
TI  - Increase in bone mass of older postmenopausal women with low mineral bone density
      after one year of percutaneous oestradiol implants.
AB  - OBJECTIVE: To evaluate the effect of 75 mg oestradiol implants on the bone mass
      of older postmenopausal women with osteoporosis. DESIGN: One year prospective
      controlled study. SUBJECTS: Thirty-two postmenopausal women over 60 years of age
      and more than five years postmenopausal with low bone density were recruited.
      Thirty women completed treatment for one year with 75 mg oestradiol implants. The
      changes in bone density were compared with a control group of 14 women. The side
      effects with treatment were documented. MAIN OUTCOME MEASURES: Dual energy X-ray
      absorptiometry of the lumbar spine and proximal femur using Hologic 1000 QDR
      before treatment and at one year. Plasma oestradiol assays were performed before
      and after one year. RESULTS: The median percentage changes in the treated group
      after one year was 12.6% at the lumbar spine and 5.22% at the total hip. The
      increase in vertebral bone density was greatest in women with low initial bone
      density (r = -0.35, P < 0.05) and those with highest treatment plasma oestradiol
      levels (r = 0.47, P < 0.01). Side effects were common but most were transient and
      mild in nature. CONCLUSION: 75 mg oestradiol implants significantly increase the
      bone mineral density at the spine and hip of older postmenopausal women with
      established osteoporosis.

PMID- 7794851
TI  - A dose-ranging study of the use of cyclical dydrogesterone with continuous 17
      beta oestradiol.
AB  - OBJECTIVE: To establish the lowest dose of cyclical dydrogesterone that protects
      against endometrial hyperplasia induced by continuous 2 mg 17 beta oestradiol,
      and to study the dose effect on vaginal bleeding and side effects. DESIGN: Double
      blind, prospectively randomised dose-ranging study. SETTING: Menopause clinics in
      the UK and The Netherlands. SUBJECTS: Three hundred and seventy-one
      postmenopausal women with intact uteri, aged 40 to 60. INTERVENTIONS:
      Administration of six 28-day treatment cycles of continuous daily micronised 17
      beta oestradiol with a randomly allocated dose of 5 to 20 mg of dydrogesterone
      added for the last 14 days of each. MAIN OUTCOME MEASURES: Histological
      assessment of adequate progestational endometrial response, bleeding patterns and
      adverse effects. RESULTS: The study was completed by 320 subjects (86%).
      Endometrial transformation occurred in over 94% of those taking 5 mg of
      dydrogesterone, and in over 97% of those on higher doses, without significant
      differences between the 10, 15 and 20 mg groups. Acceptable bleeding patterns
      were found at all doses, with the incidence of withdrawal bleeding rising with
      increasing dose. The day of onset of bleeding was predictable from cycle to
      cycle, and occurred later in the 20 mg group than in the others. The incidence of
      noncyclic bleeding was about 6% at all doses. Withdrawal occurred in 3.3% due to
      unacceptable bleeding and in 5.4% due to side effects. There was no relation with
      dose. CONCLUSIONS: A dydrogesterone-17 beta oestradiol combination hormone
      replacement therapy confers endometrial protection with an acceptable bleeding
      pattern and few side effects At least 10 mg of dydrogesterone for 14 days is
      required for acceptable endometrial protection.

PMID- 7794852
TI  - A Scottish audit of hysteroscopic surgery for menorrhagia: complications and
      follow up. Scottish Hysteroscopy Audit Group.
AB  - OBJECTIVE: To evaluate the efficacy and safety of hysteroscopic surgery
      undertaken by a cross section of gynaecologists. DESIGN: A prospective
      registration of cases of hysteroscopic surgery by gynaecologists. Patient
      satisfaction was assessed at six and twelve months post-operatively by postal
      questionnaire. SETTING: Thirteen hospitals in seven Scottish Health Boards.
      Secretariat in Aberdeen Royal Infirmary. SUBJECTS: Women having hysteroscopic
      surgery for menstrual problems. INTERVENTIONS: A few questions were added to the
      proforma during the audit. RESULTS: Between December 1991 and December 1993, 978
      cases were registered. Consultants performed the majority of procedures.
      Complications occurred in 12% of cases and included one death from toxic shock
      syndrome. Uterine perforation and significant fluid overload occurred in 1% of
      cases. To date, 732 women have been followed up at six months, 554 at twelve
      months and 80 at 24 months. Eighty-four percent of those returning their
      questionnaires were satisfied or very satisfied at twelve months. By twelve
      months, repeat procedures had been performed in 13% and hysterectomy in 11%.
      Sixty-six percent of women with a paid job had returned to work within two weeks
      and 88% within four weeks. CONCLUSIONS: Overall, hysteroscopic surgery had a low
      rate of morbidity and satisfactory efficacy with rapid post-operative recovery.
      Gynaecologists who have shown caution with the advent of this surgery can now be
      encouraged to take up endometrial ablation for dysfunctional uterine bleeding.
      Clinical guidelines are currently being prepared.

PMID- 7794854
TI  - The value of histopathological examination of conceptual products.

PMID- 7794853
TI  - Duplex ultrasound screening for deep venous thrombosis in the puerperium.

PMID- 7794855
TI  - Focal salmonellosis: an unusual presentation of uterine malignancy.

PMID- 7794856
TI  - Mouth-operated mucus extractors: safe to use?

PMID- 7794857
TI  - Planned vaginal delivery after two previous caesarean sections.

PMID- 7794858
TI  - Magnesium sulphate for pre-eclampsia and eclampsia: the evidence so far.

PMID- 7794859
TI  - Conserving the cervix at hysterectomy.

PMID- 7794861
TI  - Definition of pre-eclampsia.

PMID- 7794860
TI  - Definition of pre-eclampsia.

PMID- 7794862
TI  - Cancer associated human papillomavirus perinatal transmission and persistence.

PMID- 7794863
TI  - Failure to progress in the management of labour.

PMID- 7794864
TI  - A multicentre randomised trial of amniotomy in spontaneous first labour at term.

PMID- 7794865
TI  - A multicentre randomized trial of amniotomy in spontaneous labour at term.

PMID- 7794866
TI  - Ampicillin and metronidazole treatment in preterm labour: a multicentre,
      randomised trial.

PMID- 7794867
TI  - The role of the large intestine in post-ruminal digestion of feeds as measured by
      the mobile-bag method in cattle.
AB  - To study the importance of site of recovery and other factors related to mobile
      bag (MB) digestion values, two consecutive experiments in which diets were
      applied in a 3 x 3 Latin square design, were carried out with cannulated growing
      heifers. In Expt 1, several types of experimental feed were exposed to intestinal
      digestion in mobile bags made of two cloth types and filled with intact or rumen
      undegradable (RUD) feed material to be recovered either from the ileum (IB) or
      faeces (FB). In Expt 2, mean retention time (MRT) of Yb-labelled digesta
      particles within the intestine and in vivo digestibility of diets were measured.
      With vegetable concentrates, FB resulted generally in slight overestimation of
      small-intestinal dry matter and N digestion, while with meat-and-bone meal no
      difference between FB and IB was found. The respective N digestibility of RUD
      late-cut silage was clearly underestimated as measured from FB. The disappearance
      of neutral-detergent fibre (NDF) of all feeds under test was higher from FB than
      from IB. It was not possible to isolate the influence of the large intestine on
      the MB values by changing bag cloth type. Irrespective of the longer retention
      time of bags and longer MRT of Yb in the intestine on a low as compared with a
      high level of feeding, only NDF disappearance of feeds increased due to lower
      feeding level. Altering the diet type to increase large-intestinal fermentation,
      as indicated in vivo, usually had no effect on the MB values. It is concluded
      that the site of collection of bags does not practically affect small-intestinal
      digestion values of feed N, unless the feed is rich in fibre.

PMID- 7794868
TI  - Body mass index: a measure of fatness or leanness?
AB  - The relationship between body fat and stature-adjusted weight indices was
      explored. Assuming the term height2 is a valid indicator of a subject's lean body
      mass, height2/weight was shown to be an accurate measure of percentage lean body
      mass and, as such, a better predictor of percentage body fat than the traditional
      body mass index (BMI; weight/height2). The name, lean body mass index (LBMI), is
      proposed for the index height2/weight. These assumptions were confirmed
      empirically using the results from the Allied Dunbar National Fitness Survey
      (ADNFS). Using simple allometric modelling, the term heightp explained 74% of the
      variance in lean body mass compared with less than 40% in body weight. For the
      majority of ADNFS subjects the fitted exponent from both analyses was
      approximately p = 2, the only exception being the female subjects aged 55 years
      and over, where the exponent was found to be significantly less than 2. Using
      estimates of percentage body fat as the dependent variable, regression analysis
      was able to confirm that LBMI was empirically, as well as theoretically, superior
      to the traditional BMI. Finally, when the distributional properties of the two
      indices were compared, BMI was positively skewed and hence deviated considerably
      from a normal distribution. In contrast, LBMI was found to be both symmetric and
      normally distributed. When height and weight are recorded in centimetres and
      kilograms respectively, the suggested working normal range for LBMI is 300-500
      with the median at 400.

PMID- 7794869
TI  - The reproducibility of subjective appetite scores.
AB  - Although subjective appetite scores are widely used, studies on the
      reproducibility of this method are scarce. In the present study nine healthy,
      normal weight, young men recorded their subjective appetite sensations before and
      during 5 h after two different test meals A and B. The subjects tested each meal
      twice and in randomized order. Visual analogue scale (VAS) scores, 10 cm in
      length, were used to assess hunger, satiety, fullness, prospective food
      consumption and palatability of the meals. Plasma glucose and lactate
      concentrations were determined concomitantly. The repeatability was investigated
      for fasting values, delta-mean 5 h and mean 5 h values, delta-peak/nadir and
      peak/nadir values. Although the profiles of the postprandial responses were
      similar, the coefficients of repeatability (CR = 2SD) on the mean differences
      were large, ranging from 2.86 to 5.24 cm for fasting scores, 1.36 to 1.88 cm for
      mean scores, 2.98 to 5.42 cm for delta-mean scores, and 3.16 to 6.44 cm for peak
      and delta-peak scores. For palatability ratings the CR values varied more,
      ranging from 2.38 (taste) to 8.70 cm (aftertaste). Part of the difference in
      satiety ratings could be explained by the differences in palatability ratings.
      However, the low reproducibility may also be caused by a conditioned satiation or
      hunger due to the subjects' prior experience of the meals and therefore not just
      be a reflection of random noise. It is likely, however, that the variation in
      appetite ratings is due both to methodological day-to-day variation and to
      biological day-to-day variation in subjective appetite sensations.

PMID- 7794871
TI  - Food intake in a west African village. Estimation of food intake from a shared
      bowl.
AB  - Novel methodology is described for the estimation of food intake in the
      particularly difficult circumstance where groups of people eat directly from a
      shared bowl of cooked food. Detailed observation and measurement of meal
      preparation is combined with food table values for composition to calculate the
      nutrient content of each meal. The distribution of food between individuals is
      estimated by a suitable algorithm. The ability of the algorithm to identify
      seasonal changes in energy intakes is demonstrated by comparison of the
      calculated energy intakes with values for the total energy expenditure of free
      living adult male subjects, as measured by the stable isotope, doubly-labelled
      water technique. This comparison suggests that the energy intake calculated from
      detailed observation of two cooked meals per day is equivalent to approximately
      80% of the total energy expenditure and, by inference, total dietary energy
      intake. The remaining energy intake may well be derived from uncooked 'snack
      foods', such as raw fruit and vegetables, or from cooked food obtained, by
      purchase or as a gift, away from the home. This is the first description of a
      successful method for the estimation of food intake when people eat directly from
      shared bowls of food.

PMID- 7794870
TI  - Validation of weighed records and other methods of dietary assessment using the
      24 h urine nitrogen technique and other biological markers.
AB  - Results from analysis of 24 h urine collections, verified for completeness with
      para-amino benzoic acid, and blood samples collected over 1 year were compared
      with 16 d weighed records of all food consumed collected over the year, and with
      results from 24 h recalls, food-frequency questionnaires and estimated food
      records in 160 women. Using the weighed records, individuals were sorted into
      quintiles of the distribution of the urine N excretion:dietary N intake ratio
      (UN:DN). UN exceeded DN in the top quintile of this ratio; mean ratio UN:DN =
      1.13. Individuals in this top quintile were heavier, had significantly greater
      body mass indices, were reportedly more restrained eaters, had significantly
      lower energy intake:basal metabolic rate ratios (EI:BMR), and had correlated
      ratios of UN:DN and EI:BMR (r -0.62). Those in the top quintile reported lower
      intakes of energy and energy-yielding nutrients, Ca, fats, cakes, breakfast
      cereals, milk and sugars than individuals in the other quintiles but not lower
      intakes of non-starch polysaccharides, vitamin C, vegetables, potatoes or meat.
      Correlations between dietary intake from weighed records and 24 h urine K were
      0.74 and 0.82, and between dietary vitamin C and beta-carotene and plasma vitamin
      C and beta-carotene 0.86 and 0.48. Correlations between dietary N intake from
      weighed records and 24 h urine excretion were high (0.78-0.87). Those between N
      from estimated food records and urine N were r 0.60-0.70. Correlations between
      urine N and 24 h recalls and food-frequency questionnaires were in the order of
      0.01 to 0.5. Despite problems of underreporting in overweight individuals in 20%
      of this sample, weighed records remained the most accurate method of dietary
      assessment, and only an estimated 7 d diary was able to approach this accuracy.

PMID- 7794872
TI  - Energy expenditure, physical activity and basal metabolic rate of elderly
      subjects.
AB  - Energy expenditure, and therefore energy requirement, generally decreases with
      advancing age because of a decrease in basal metabolic rate (BMR) and physical
      activity. The aim of the present study was to measure total energy expenditure
      (EE) and activity level in a group of healthy elderly (sixteen men aged 71.3 (SD
      4.9) years; ten women aged 67.6 (SD 4.1) years) and young adults (nineteen men
      aged 30.4 (SD 5.0) years; ten women aged 27.2 (SD 3.9) years) by using the doubly
      labelled water method in combination with measurements of BMR. Age-related
      differences in body composition and their relationship to BMR and activity level
      were studied. EE was lower in elderly compared with young adults, partly due to a
      significantly lower BMR. The lower BMR was not fully explained by the lower fat
      free mass (FFM) in the elderly. Energy expended (MJ/d) on activity was higher for
      the younger subjects although there was no significant difference in the physical
      activity index (PAI = EE/BMR) between the two age groups. The effect of physical
      activity level is twofold: first it has a positive effect on the BMR, and second
      it has a positive effect on the FFM. Both effects involve an increase in the
      total EE with an increased level of physical activity. At energy balance this
      will lead to increased energy and nutrient intake, making especially the elderly
      less vulnerable to inadequate energy and nutrient intake.

PMID- 7794873
TI  - Characterization of an antithrombotic peptide from kappa-casein in newborn plasma
      after milk ingestion.
AB  - Bovine and human kappa-caseinoglycopeptides, two antithrombotic peptides derived
      from the corresponding kappa-caseins, were detected in physiologically active
      concentrations in the plasma of 5-d-old newborn infants after ingestion of cow's
      milk-based formula or human milk respectively. It is suggested that these two
      bioactive peptides are released from milk proteins during digestion.

PMID- 7794874
TI  - Feed consumption, growth and growth efficiency of rainbow trout (Oncorhynchus
      mykiss (Walbaum)) fed on diets containing a bacterial single-cell protein.
AB  - The aim of the present study was to compare the nutritive value of bacterial
      single-cell protein (BSCP) with that of fishmeal in rainbow trout (Oncorhynchus
      mykiss (Walbaum)). Four diets were formulated to contain a total of 458 g crude
      protein/kg of which 0% was from BSCP in diet 1 (BSCP-0), 25% in diet 2 (BSCP-25),
      62.5% in diet 3 (BSCP-62.5) and 100% in diet 4 (BSCP-100); the remainder of the
      protein was from fishmeal. There were two studies: in study 1, duplicate groups
      of twenty-five fish were fed on one of the four experimental diets at the rate of
      20 g/kg body weight per d for 132 d. Feed consumption rates of individual fish
      were measured using radiography and the overall apparent absorption efficiency
      for N in each group was measured over a 2-week period. In study 2, N intake,
      consumption, absorption and accretion were measured for each fish under
      controlled environmental conditions (12 h: 12 h light-dark regime; 14 degrees).
      Higher dietary levels of BSCP resulted in significantly higher feed consumption
      rates but reduced N absorption efficiency and growth rates. However, a diet
      containing 25% BSCP (75% fishmeal) did not significantly influence growth rates,
      feed consumption and absorption efficiency compared with a 100% fishmeal diet.
      The N growth efficiencies were highest in fish fed on the diet containing the
      highest level of fishmeal and significantly decreased with increasing BSCP
      content. Construction of N budgets demonstrated that the reduction in growth in
      fish eating an increasingly larger proportion of BSCP was due to a decrease in N
      absorption and an increase in the excretion of urea.

PMID- 7794875
TI  - The proportion of trans monounsaturated fatty acids in serum triacylglycerols or
      platelet phospholipids as an objective indicator of their short-term intake in
      healthy men.
AB  - Unfavourable effects of trans monounsaturated fatty acid (trans-C18:1) isomers on
      health variables have been reported. Reports on their actual intake, however, are
      scarce, because of the absence in many nutrient databases of values for trans
      C18:1, and the wide variation in the level of trans fatty acids between different
      brands of the same product. We therefore examined whether the intake of trans
      C18:1 is reflected by trans-C18:1 concentrations in serum triacylglycerols or
      platelet phospholipids. Thirty-eight men received two diets in random order.
      During the first experimental period twenty men consumed a Western-type control
      diet for six weeks, and eighteen men consumed a modified diet in which 70% of the
      fat was replaced by palm oil. After a wash-out period of 3 weeks, regimens were
      crossed over (second experimental period). The proportion of total fatty acids
      from trans-C18:1 in the diet decreased from 4.7 (SEM 0.27) during the control to
      2.1 (SEM 0.16) on the modified diet (P < 0.001). Trans-C18:1 in serum
      triacylglycerols decreased from 3.5 (SEM 0.13) to 2.8 (SEM 0.11)% (P < 0.001),
      and in platelet phospholipids from 1.0 (SEM 0.06) to 0.7 (SEM 0.04)% (P < 0.001).
      After the first experimental period trans-C18:1 in the diet correlated with trans
      C18:1 in serum triacylglycerols (r 0.41; P = 0.014), and platelet phospholipids
      (r 0.52; P = 0.001). Also, differences in the intake between the two periods
      correlated with changes in the proportion of trans-C18:1 in serum
      triacylglycerols (r 0.56; P = 0.001) and platelet phospholipids (r 0.58; P <
      0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794876
TI  - The glycaemic index of foods containing sugars: comparison of foods with
      naturally-occurring v. added sugars.
AB  - The primary aim of the present study was to expand the glycaemic index (GI)
      database by determining the GI and insulin index values of thirty-nine foods
      containing sugars in healthy adults. The second aim was to examine the hypothesis
      that glycaemic and insulin responses to foods which contain added sugar(s) are
      higher than responses to foods containing naturally-occurring sugars. Eight
      healthy subjects drawn from a pool of eighteen consumed 50 g carbohydrate
      portions (except 25 g carbohydrate portions for fruits) of the test foods. The GI
      and insulin index were determined according to standardized methodology and
      expressed on a scale on which glucose = 100. The median GI and insulin index
      values of all foods tested were 56 (range 14 to 80) and 56 (range 24 to 124)
      respectively. The median GI of the foods containing added sugars was similar to
      that of foods containing naturally-occurring sugars (58 v. 53 respectively, P =
      0.08). Likewise, the median insulin index of the foods containing added sugars
      was not significantly different from that of foods containing naturally-occurring
      sugars (61 v. 56 respectively, P = 0.16). There was no evidence of 'rebound
      hypoglycaemia' or excessive insulin secretion relative to the glucose response.
      We conclude that most foods containing sugars do not have a high GI. In addition,
      there is often no difference in responses between foods containing added sugars
      and those containing naturally-occurring sugars.

PMID- 7794878
TI  - Relationship between dietary Na+ intake, aldosterone and colonic amiloride
      sensitive Na+ transport.
AB  - The effect of changes in dietary Na+ intake on plasma aldosterone levels and
      electrogenic amiloride-sensitive Na+ transport (Iamil) was studied in the rat
      distal colon. Five groups of rats were fed on diets containing different amounts
      of Na+. Estimated Na+ intake ranged from about 400-80,000 mu equiv Na+/kg body
      weight (BW) per d. Both variables investigated, Iamil and plasma aldosterone,
      depended non-linearly on Na+ intake. Reduction of the daily Na+ intake increased
      plasma aldosterone levels and if these levels reached the value 200 pg/ml or more
      then Iamil was induced. The corresponding Na+ intake was 1300 mu equiv Na+/kg BW
      per d. Iamil was not observed at lower aldosterone levels and higher Na+ intakes.
      Aldosterone infusion for 7 d produced similar changes in Iamil compared with
      dietary Na(+)-depleted animals and made the estimation of maximum transport
      capacity of Iamil possible. We conclude that Iamil operates only if Na+ intake
      decreases below minimal Na+ requirement in growing rats and that the maximum
      transport capacity of this pathway is reached only after very severe Na+
      deprivation.

PMID- 7794877
TI  - Relationship between smoking and antioxidant nutrient status.
AB  - The present study was designed to investigate the relationship between smoking
      and antioxidant nutrient intake and status. Smoker (n 44) and non-smoker (n 44)
      male students attending Dhaka University, aged between 22 and 28 years and living
      in a University Hall of Residence, were selected for the present study. Mean age,
      body weight, BMI and blood pressure were similar for both the smokers and non
      smokers. Mean energy, protein and fat intakes were similar for both groups.
      Smokers had lower intakes of dietary vitamin C, carotenes and Zn but only the
      difference in Zn intake was statistically significant. There was no significant
      difference between smokers and non-smokers for either serum vitamin A (retinol)
      or vitamin E (alpha-tocopherol) level. The plasma vitamin C level of smokers was
      significantly lower than that of non-smokers (P = 0.0004). Smokers had
      significantly lower serum Cu (P = 0.04) and higher serum Zn levels (P = 0.003).
      Further, a significant dose-response relationship between smoking and vitamin C
      status was observed. Linear-regression analysis showed a significantly positive
      correlation between dietary intake and plasma vitamin C values in non-smokers (r
      0.50; P = 0.0005). On the contrary, no such association was observed in smokers.
      These findings suggest that smoking may cause an imbalance in antioxidant
      nutrient intake and status.

PMID- 7794879
TI  - Blood pressure changes induced by chronic insulin treatment in Wistar rats.
AB  - Hyperinsulinaemia may play a causal role in the development of hypertension in
      obese hypertensives. However, experimental evidence supporting this statement is
      inappropriate. The main purpose of this study was to evaluate the chronic effects
      of insulin administration on blood pressure, total-body glucose metabolism and
      urinary catecholamine excretion. After 10 weeks of insulin injection blood
      pressure was substantially increased in insulin-treated animals compared to those
      treated with saline (125 +/- 2 vs 108 +/- 2 mm Hg, p < 0.001). There were no
      differences in glycaemia, plasma triglyceride levels and free fatty acid levels
      between these two groups. Plasma level of corticosterone was increased in both
      insulin-treated and saline-treated rats as compared to untreated animals
      suggesting that the level of stress was similar in both injected groups. The
      urinary excretion of norepinephrine and dopamine was increased in the insulin
      injected group by about 120% and 310%, respectively. Our data clearly indicate
      that long-term insulin administration increased blood pressure but the underlying
      mechanisms remain to be elucidated.

PMID- 7794880
TI  - Amino acid transport in the small intestine.

PMID- 7794881
TI  - Circadian rhythm of the ventricular fibrillation threshold in female Wistar rats.
AB  - The circadian rhythm of ventricular fibrillation threshold (VFT) and its relation
      to the heart rate (HR) and the rectal temperature (RT) was studied in female
      Wistar rats. The animals were exposed to daily light-dark cycles of 12 h of light
      alternating with 12 h of darkness and were under pentobarbital anaesthesia (40
      mg/kg i.p.). The experiments were performed on open chest animals and VFT was
      measured by direct stimulation of the myocardium. VFT in female rats showed a
      circadian rhythm with the acrophase -338 degrees (at 22.53 h), with the mesor
      2.58 mA and the amplitude 0.33 mA. HR was not significantly changed during the
      experiments and no dependence was found between VFT and HR during the whole 24
      hour period (r = 0.08). The acrophase of the circadian rhythm of HR (on -47
      degrees, i.e. at 03.08 h) was shifted to the acrophase of VFT. The circadian
      rhythms of RT before the application of the anaesthetic agent and under general
      anaesthesia before the operative interventions had a very similar course with the
      nearly corresponding acrophases as the circadian rhythm of VFT. It is concluded
      that the electrical stability of the rat heart measured by VFT shows the
      significant circadian rhythm in a parallel with the circadian rhythm of RT and
      probably without dependence on the changes of HR.

PMID- 7794882
TI  - Can haloperidol disguise fever?
AB  - Haloperidol when applied intraperitoneally to cold-exposed febrile rabbits
      induces a strong hypothermic effect. This effect is due to the downward shift of
      the threshold central temperature for induction of cold thermogenesis and
      vasomotion. The shift occurs during the early phase of the fever and is less
      prominent during the late phase of the fever. The hypothermic effect of high
      doses of haloperidol can eliminate the increase of body temperature in febrile
      individuals.

PMID- 7794883
TI  - Interaction between glycine and glutamate in the development of spontaneous
      motility in chick embryos.
AB  - In this study we investigated whether also glycine fulfils the function as co
      activator in glutamatergic activation of NMDA receptors in the neuronal apparatus
      of spontaneous motility in chick embryos. The successive application of glycine
      (5 or 10 mg/kg egg weight (e.w.) and glutamate (15 mg/kg e.w.) in a 10 min
      interval significantly increased the activation of spontaneous motility of 17-day
      old chick embryos in comparison with the effect of glutamate alone. This effect
      did not depend on the order of application of the drugs. In 13-day-old embryos,
      glycine was ineffective in both doses. It is concluded from these results that
      the modulatory effect of glycine is evidently a later developmental acquisition
      (after day 15 of incubation) in the embryogenesis of NMDA-ergic activation of
      spontaneous motility in chick embryos similarly as glycinergic inhibition.

PMID- 7794885
TI  - Ontogenesis of melatonin receptors in anterior pituitary and pars tuberalis of
      golden hamsters.
AB  - The ontogenesis of melatonin receptors in the anterior pituitary and pars
      tuberalis of the Golden hamster was studied using [125I]iodomelatonin as a
      ligand. The affinity of the binding site to the ligand (Kd) was in the range 21
      to 54 pM and it did not change significantly during development. The
      concentration of the [125I]iodomelatonin binding sites in the anterior pituitary
      was highest in one-day-old hamsters (Bmax = 14 fmol/mg protein) and thereafter
      gradually decreased. In adults it reached to about 6% of the neonatal values. In
      contrast, the concentration of the binding sites in pars tuberalis did not change
      significantly during ontogenesis and it was in the range of 3 to 5 fmol/mg
      protein.

PMID- 7794884
TI  - The contribution of foot deformation to the changes of muscular length and angle
      in the ankle joint during standing in man.
AB  - This study was designed to evaluate the extent of foot deformation in healthy
      subjects during standing on an immobile support and during slow tilts of the
      support platform by 1 deg. The angle in ankle joint was evaluated by two methods:
      as an angle of skin inclination relative to the platform and as an angle,
      calculated on the basis of recording of the projective length of the soleus
      muscle. It was shown that the real changes of the angle in ankle joint during
      standing on an immobile platform were up to 2 times smaller than the changes of
      angular position of the shin relative to vertical axis. However, considerable
      intersubject variability was observed in this respect. During slow tilts of the
      support platform a marked divergence was observed in the shape of recordings of
      two "ankle angles" in subjects with high foot compliance. The vertical
      displacements of the calcaneus recorded by means of a clamp rigidly fixed at the
      heel were 0.5 +/- 0.3 mm (the range 0.1-1 mm) for each degree of body deviation
      in the forward or backward direction. In 12 subjects, the average foot compliance
      was 0.04 +/- 0.03 deg/Nm (maximal value 0.1 deg/Nm). It can be assumed that the
      mechanical properties of the foot can appreciably influence the afferent outflow
      during maintenance of orthograde posture in man.

PMID- 7794886
TI  - Hepatocyte proliferation in silicotic rat liver after partial hepatectomy.
AB  - Liver silicosis was induced in rats by an intravenous injection of silica
      particles. The presence of silicotic granulomas in the liver lowered the initial
      response of hepatocytes to partial (37%) hepatectomy and slowed down the decline
      in the number of dividing cells 6 days after the stimulus, but did not affect
      significantly the total number of mitotic cells.

PMID- 7794887
TI  - Protective effect of carnitine on lipoperoxide formation in rat brain.
AB  - Carnitine administration (by intraperitoneal injection) to 21-day-old-rats
      prevents the increase of thiobarbituric acid-reactive substances (index of lipid
      peroxidation and free radical damage) induced by 30 min hypobaric hypoxia in four
      different parts of the brain (cerebral cortex, subcortical structures, medulla
      oblongata and cerebellum).

PMID- 7794888
TI  - Acid-base catalytic mechanism and pH dependence of fructose 2,6-bisphosphate
      activation of the Ascaris suum phosphofructokinase.
AB  - A form of phosphofructokinase (PFK) from Ascaris suum desensitized to hysteresis
      in the reaction time course and ATP allosteric inhibition has been used to study
      the activation by fructose 2,6-bisphosphate (F26P2) at varied pH in both reaction
      directions. In the direction of phosphorylation of F6P, V and V/KMgATP are
      constant over the pH range 6-9, while V/KF6P decreases at low pH, giving a pK
      value of 7.0, and at high pH, giving a pK of 8.9. V and V/KMgATP are insensitive
      to the presence of F26P2, but V/KF6P is increased by a constant amount in the
      presence of saturating F26P2 over the entire pH range studied. The concentration
      of F26P2 that gives half the change in V/KF6P, Kact, increases as the pH
      decreases, giving a pK of 7.4, reflecting an enzyme group that must be
      unprotonated for optimum binding of F26P2. In the direction of phosphorylation of
      MgADP, V and V/KMgADP are pH-independent, and both are insensitive to the
      presence of F26P2. V/KFBP decreases at high pH, giving a pK of about 7.3, and is
      increased by a constant amount in the presence of F26P2 over the entire pH range
      studied.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794889
TI  - Biochemical characterization of a glycosylphosphatidylinositol-linked
      hyaluronidase on mouse sperm.
AB  - On the basis of DNA homology to bee venom hyaluronidase, it was recently
      suggested that the GPI-linked mammalian sperm antigen, PH-20, may function as a
      cell surface hyaluronidase [Gmachl, M., & Kreil, G. (1993) Proc. Natl. Acad. Sci.
      U.S.A. 90, 3569-3573]. We have quantified the activity of the soluble acrosomal
      hyaluronidase of mouse sperm and further demonstrate the existence of a membrane
      bound hyaluronidase, detected on both acrosome-intact and acrosome-reacted mouse
      sperm, distinct from the soluble form of the enzyme. The membrane-bound
      hyaluronidase was specifically released by PI-PLC, indicating that it is GPI
      linked. Acrosome-intact and acrosome-reacted sperm released several polypeptides
      (68, 44, 39, 34, 17, and 15 kDa) when treated with PI-PLC. In addition, GPI
      linked polypeptides unique to acrosome-intact or to acrosome-reacted sperm were
      identified. Fractionation of the PI-PLC-released components from acrosome-reacted
      sperm using size exclusion chromatography revealed a single peak of hyaluronidase
      activity which comigrates with a 68 kDa GPI-linked protein present in these
      fractions. Taken together, these data demonstrate the existence of at least two
      isoforms of hyaluronidase: a soluble form within the acrosomal vesicle which is
      released during acrosomal exocytosis and a GPI-linked form which is present on
      the surface of both acrosome-intact and acrosome-reacted sperm. Both forms may be
      necessary for successful penetration of the extracellular vestments that surround
      the egg prior to fertilization.

PMID- 7794891
TI  - Multiple enzymatic activities of the human cytosolic 85-kDa phospholipase A2:
      hydrolytic reactions and acyl transfer to glycerol.
AB  - The recombinant human 85-kDa cytosolic phospholipase A2 (cPLA2), when assayed in
      the presence of glycerol, catalyzes the transfer of acyl chains of radiolabeled
      phosphatidylcholine and para-substituted phenyl esters of fatty acids to
      glycerol, in addition to hydrolyzing these substrates. The product of the
      transacylation reaction is monoacylglycerol (MAG), and the acyl chain is
      predominantly esterified (> or = 95%) to a primary hydroxyl group of glycerol (sn
      1/3); the stereochemistry is not known. Increasing concentrations of glycerol
      accelerate enzyme turnover both by providing an additional mechanistic pathway
      for the enzyme-substrate complex to form products and by increasing the intrinsic
      hydrolytic and transacylation activities of the enzyme. Significant enzymatic
      hydrolysis of sn-1/3-arachidonylmonoacylglycerol was measured, while sn-1/3-alpha
      linolenoyl- and sn-2-arachidonylmonoacylglycerols were not detectably hydrolyzed.
      1,3-Propanediol also serves as an acyl acceptor for the enzyme. cPLA2 hydrolyzes
      analog of lysophosphatidylcholine that lacks the sn-2 hydroxyl group. The enzyme
      will hydrolyze sn-1-acyl chains of rac-1-(arachidonyl, alpha-linolenoyl,
      palmitoyl)-2-O-hexadecyl-glycero-3-phosphocholine lipids and transfer the acyl
      chain to glycerol. Thus, cPLA2 has phospholipase A1 activity but only if an ether
      linkage rather than an ester linkage is present at the sn-2 position, and it is
      shown that the sn-1 acyl chains of both enantiomers of phosphatidylcholine are
      hydrolyzed. Phenyl [14C]-alpha-linolenate and five para-substituted phenyl esters
      of [3H]-alpha-linolenic acid with pKa values ranging from 7.2 to 10.2 for the
      phenol leaving groups were incorporated into 1,2-ditetradecyl-sn-glycero-3
      phosphomethanol/Triton X-100 mixed micelles as substrates for the
      transacylation/hydrolysis reactions of the enzyme. Average product ratios, which
      are defined as the amount of monoacylglycerol formed to phenyl ester hydrolyzed,
      were 2.1 +/- 0.1 (n = 5) for the para-substituted phenyl esters and 2.0 +/- 0.3
      (n = 7) for phenyl alpha-linolenate. The similarity of the ratios, despite the
      range of pKa values for the leaving groups, is consistent with the formation of a
      common enzyme intermediate that partitions to give either fatty acid or MAG. That
      intermediate may be a covalent acyl enzyme. Finally, the acyl chain specificity
      of cPLA2 was investigated to better understand the preference of the enzyme for
      phospholipids with sn-2-arachidonyl chains.

PMID- 7794890
TI  - Enhancement of Agkistrodon piscivorus piscivorus venom phospholipase A2 activity
      toward phosphatidylcholine vesicles by lysolecithin and palmitic acid: studies
      with fluorescent probes of membrane structure.
AB  - The activity of phospholipase A2 from snake venom to hydrolyze bilayers of
      phosphatidylcholines is greatly enhanced by the presence of the hydrolysis
      products, lysolecithin and fatty acid, in the bilayer. The fluorescence of
      several probes of membrane structure was used to monitor changes in bilayer
      physical properties during vesicle hydrolysis. These changes were compared to
      emission spectra and fluorescence polarization results occurring upon direct
      addition of lysolecithin and/or fatty acid to the bilayer. The excimer to monomer
      ratio of 1,3-bis(1-pyrene)propane was insensitive to vesicle hydrolysis,
      suggesting that changes in the order of the phospholipid chains were not relevant
      to the effect of the hydrolysis products on phospholipase activity. The
      fluorescence of 6-propionyl-2-(dimethylamino)-naphthalene (Prodan) suggested that
      the polarity of the bilayer in the region of the phospholipid head groups
      increases as the hydrolysis products accumulate in the bilayer. The fluorescence
      of 6-dodecanoyl-2-(dimethylamino)naphthalene (Laurdan) confirmed that such
      effects were restricted to the bilayer surface. Furthermore, the lysolecithin
      appeared to be the product most responsible for these changes. These results
      suggested that lysolecithin increases the activity of phospholipase A2 during
      vesicle hydrolysis by disrupting the bilayer surface, making the phospholipid
      molecules more accessible to the enzyme active site.

PMID- 7794892
TI  - A nontransportable substrate for lactose permease.
AB  - A substrate for lactose permease of Escherichia coli was synthesized that binds
      to the protein with a relatively high affinity, but is not transported to any
      detectable extent. This substrate, 6'-[(N-phenylalanylphenylalanyl)amino]hexyl 1
      thio-beta-D-galactoside, is a peptide galactoside composed of a bulky aromatic
      dipeptide that is linked to galactose via an aminohexyl spacer. Binding of the
      peptide galactoside to lactose permease in cytoplasmic membranes was determined
      in a competition assay yielding a dissociation constant of 150 microM. Transport
      was measured by a counterflow assay using lipid vesicles with reconstituted
      lactose permease. An upper limit for the rate constant of transport was obtained
      as 0.02 s-1, 3 orders of magnitude smaller than the value for lactose.

PMID- 7794893
TI  - FT-IR spectroscopy of the major coat protein of M13 and Pf1 in the phage and
      reconstituted into phospholipid systems.
AB  - FT-IR spectroscopy has been applied to study the secondary structure of the major
      coat protein of Pf1 and M13 as present in the phage and reconstituted in DOPG and
      mixed DOPC/DOPG (4/1) bilayers. Infrared absorbance spectra of the samples were
      examined in dehydrated films and in suspensions of D2O and H2O. The secondary
      structure of the coat protein is investigated by second-derivative analysis,
      Fourier self-deconvolution, and curve fitting of the infrared bands in the amide
      I region (1600-1700 cm-1). It is found that, in dehydrated films of Pf1 and M13
      phage, the amide I region contains three bands located at about 1633, 1657, and
      1683 cm-1, that are assigned to hydrogen-bonded turn, alpha-helix/random coil,
      and non-hydrogen-bonded turn, respectively. From a comparison of the infrared
      spectra in dehydrated film with those in aqueous suspension, the percentages of
      secondary structure were found with an accuracy of about +/- 5%. For the coat
      protein of Pf1 phage, the FT-IR quantification gives 69% alpha-helix
      conformation, 19% turn structure, and 12% random coil structure. For Pf1 coat
      protein in the membrane-embedded state, the amount of alpha-helix is 57%, whereas
      42% is in a turn structure and 1% in a random coil structure. The same assignment
      strategy was used for the analysis of the data obtained for M13 coat protein
      reconstitution into phospholipid systems. For M13 coat protein in the phage, this
      gives 75% alpha-helix conformation, 21% turn structure, and 4% random coil
      structure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794894
TI  - Interactions of myogenic bHLH transcription factors with calcium-binding
      calmodulin and S100a (alpha alpha) proteins.
AB  - MyoD belongs to a family of myogenic basic helix-loop-helix (bHLH) transcription
      factors that activate muscle-specific genes. The basic helix I sequence of the
      bHLH motif contains a consensus sequence for protein kinase C (PKC) substrates.
      We show here that MyoD is indeed phosphorylated by PKC in vitro on Thr 115 within
      the basic part of the bHLH motif. By analogy with calmodulin-target peptide
      models, we also identified within the consensus basic helix I motif of myogenic
      proteins a conserved putative calmodulin/S100-binding domain. Calcium-dependent
      interaction between MyoD with calmodulin and the abundant muscle S100a(alpha
      alpha) proteins was demonstrated by affinity chromatography and cross-linking
      experiments. The binding of calmodulin and S100a inhibited MyoD phosphorylation
      by PKC as well as MyoD DNA binding activity. S100a was found to be more efficient
      than calmodulin in antagonizing DNA binding to MyoD. We next developed a rapid
      purification method for bacterial recombinant MyoD-bHLH domain by affinity
      chromatography using a calmodulin-Sepharose column and investigated the
      phosphorylation of that peptide by PKC and its interactions with calmodulin and
      S100a. We confirmed the phosphorylation of the threonine residue 115 in the MyoD
      bHLH by PKC with a Km of 0.8 microM. Calmodulin and S100a binding inhibited MyoD
      bHLH phosphorylation by PKC. A strict calcium-dependent interaction between
      calcium binding proteins and the MyoD-bHLH was identified by native gel
      electrophoresis and fluorescence spectroscopy with 5-(dimethylamino)naphthalene-1
      sulfonylcalmodulin. The MyoD-bHLH bound to fluorescently labeled 5
      (dimethylamino)naphthalene-1-sulfonylcalmodulin with a dissociation constant
      around 20 nM. S100a inhibited stoichiometrically the binding of the bHLH peptide
      for labeled calmodulin, suggesting an affinity of S100a for the bHLH peptide at
      least 1 order of magnitude higher than calmodulin. In favor of an in vivo
      interaction between S100a and MyoD, we report that S100a- and MyoD-like
      immunoreactivities colocalize in H9c2 cells, and that a significant amount of
      MyoD-like immunoreactivity is recovered in the S100a immunoprecipitate from crude
      H9c2 cell extract in the presence of calcium. We propose that myogenic proteins
      represent a new family of calmodulin/S100-binding PKC substrates and that
      calmodulin/S100a could participate in the regulation of the bHLH myogenic protein
      activities.

PMID- 7794895
TI  - Tyrosyl radical formation during the oxidative deposition of iron in human
      apoferritin.
AB  - The radical chemistry of ferritin is incompletely understood. The present study
      was undertaken to investigate the production of radicals in H-chain recombinant
      human ferritin (HuHF) and mixed H/L-chain horse spleen ferritin (HoSF) and the
      potential role of radicals in the oxidative deposition of iron in these proteins.
      Radical production follows distinct pathways for the two proteins; an intact H
      chain ferroxidase site is required for radical generation in both of them,
      however. With the H-chain HuHF, an EPR spectrum characteristic of a tyrosyl
      radical is seen following Fe2+ oxidation by O2 and, based on measurements with
      site-directed variants, is suggested to arise from residue Tyr-34 located in the
      vicinity of the ferroxidase site. The observation of this radical correlates with
      the observation of a 400-600 nm absorbance seen in stopped-flow kinetics studies
      which seems to require the presence of Tyr-34 (Bauminger et al. (1993) Biochem.
      J. 296, 709-714). The data are inconsistent, however, with the Tyr-34 radical
      being critically important in the protein-catalyzed mechanism of iron oxidation.
      Unlike HuHF, the radicals observed in L-chain-rich HoSF appear to arise from
      hydroxyl radical damage to the protein through Fenton chemistry. These latter
      radicals also appear to be centered on aromatic amino acids and may be derived
      from histidine.

PMID- 7794896
TI  - FT-IR and near-infrared FT-Raman study of aggregation of bacteriochlorophyll c in
      solutions: evidence for involvement of the ester group in the aggregation.
AB  - Ultraviolet-visible (UV-Vis) absorption, Fourier-transform infrared (FT-IR), and
      near-infrared (NIR)-excited FT-Raman spectra have been measured for
      bacteriochlorophyll c (BChl-c) in acetone, tetrahydrofuran (THF), pyridine-d5,
      carbon disulfide (CS2), and water-saturated carbon tetrachloride (CCl4) to
      investigate its aggregation in vitro. The UV-Vis absorption spectra can be
      classified into two groups. Group I (acetone, THF, and pyridine-d5 solutions)
      gives a spectrum with a Qy band around 665 nm while group II (CS2 and water
      saturated CCl4 solutions) shows a spectrum typical of BChl-c aggregates with a
      broader red-shifted Qy band. All the NIR-FT-Raman spectra, which are preresonant
      with the Qy band, are very close to those of chlorophyll a (Chl-a) measured in
      the corresponding solutions. Bands due to a C = O stretching mode of free and
      strongly hydrogen-bonded 13(1)-keto carbonyl groups appear near 1685 and 1645 cm
      1, respectively. In contrast to the FT-Raman spectra, FT-IR spectra of the
      pyridine-d5 solution and group II are largely different from those of Chl-a in
      the corresponding solutions, suggesting that BChl-c forms quite different types
      of aggregates. It is clear from the IR spectra that the ester carbonyl group
      plays an important role in the aggregation for the pyridine-d5 and group II
      solutions. Of particular note is that bands due to C = O stretching modes of the
      ester group are observed at 1733, 1719, and 1705 cm-1 in the spectrum of BChl-c
      in water-saturated CCl4.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794897
TI  - Evidence for a mixed-ligand [4Fe-4S] cluster in the C14D mutant of PsaC. Altered
      reduction potentials and EPR spectral properties of the FA and FB clusters on
      rebinding to the P700-FX core.
AB  - PsaC-C14D (cysteine 14 replaced by aspartic acid) contains a [3Fe-4S] and a [4Fe
      4S] cluster in the FB and FA sites of the free protein [Yu, L., Zhao, J., Lu, W.,
      Bryant, D. A., & Golbeck, J. H. (1993) Biochemistry 32, 8251-8258]. When PsaC
      C14D is rebound to a photosystem I (PS I) core, the g-values of 2.043, 1.939, and
      1.853 appear similar to FA in a wild-type PS I complex [Zhao, J. D., Li, N.,
      Warren, P. V., Golbeck, J. H., & Bryant, D. A. (1992) Biochemistry 31, 5093
      5099]. The reconstituted PsaC-C14D-PS I complex does not contain a [3Fe-4S]
      cluster; rather, a set of resonances with a rhombic line shape, a gav of
      approximately 1.97, and broad line widths indicate the presence of a mixed-ligand
      [4Fe-4S] cluster, termed FB', in the aspartate site. Both FA and FB' become
      photoreduced at 15 K, and show an interaction spectrum when reduced within the
      same reaction center. An electrochemical redox study shows that FA and FB'
      titrate with midpoint potentials near -600 mV at pH 10.0. Single-turnover flash
      experiments indicate that FA and FB' function as efficient electron acceptors at
      room temperature, and NADP+ photoreduction rates are about 70% that of a
      reconstituted PsaC-PS I complex. A population of S = 3/2, [4Fe-4S] clusters was
      tentatively identified in the free PsaC-C14D protein by characteristic EPR
      resonances in the g = 5.3 region.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794898
TI  - Long-range effects on the retinal chromophore of bacteriorhodopsin caused by
      surface carboxyl group modification.
AB  - Carboxyl groups of bacteriorhodopsin (bR) that are modified by 1-ethyl-3-[3
      (trimethylamino)-propyl]carbodiimide (ETC) have been identified. Reaction of
      deionized purple membrane with a 400-fold molar excess of ETC or [14C]ETC for 1 h
      at 0 degree C incorporates about 3.5 mol of ETC/mol of bR. Proteinase K cleavage
      of ETC-modified bacterioopsin (bO) produced small 14C-labeled peptides. Amino
      acid sequence analysis showed three major ETC-modified residues: Glu 234, Asp 38,
      and Glu 74. Proteolysis of purple membrane with papain removes the ETC site at
      Glu 234. Treatment of ETC-modified, papain-cleaved purple membrane with
      hydroxylamine removes half of the remaining ETC label. Subsequent cleavage with
      chymotrypsin, followed by amino acid sequence analysis, revealed that most of the
      remaining label was at Glu 74. bR modified by ETC primarily at Glu 74 displays
      two alterations in the retinal chromophore, located in the membrane interior at a
      distance more than 2 nm away from the modified carboxyl group. (1) The acid
      induced purple-to-blue transition undergoes a shift in apparent pK from 3.2 to
      2.3. (2) The second-order rate constant for chromophore regeneration from bO and
      retinal is diminished from 3600 to 1700 M-1 s-1 in membrane sheets. Most of the
      shift in the pK of the purple-to-blue transition can be explained by the
      quaternary ammonium ion of ETC attached to Glu 74 overlapping the postulated
      location of the guanidinium group of Arg 82.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794899
TI  - Mechanism of CO oxidation by carbon monoxide dehydrogenase from Clostridium
      thermoaceticum and its inhibition by anions.
AB  - Carbon monoxide dehydrogenase (CODH) performs two distinct reactions at two
      different metal centers. The synthesis of acetyl-CoA from a methyl group, CO, and
      coenzyme A occurs at center A and the oxidation of CO to CO2 occurs at center C.
      In the work reported here, we have studied the mechanism of CO oxidation by CODH
      and its inhibition by thiocyanate. Our data are consistent with a ping-pong
      mechanism. A scheme to explain the first half-reaction was developed that
      includes binding of water and CO to the oxidized form of center C, deprotonation
      of coordinated water to yield enzyme-bound hydroxyl, nucleophilic attack on
      coordinated CO by OH- to form enzyme-bound carboxyl, and deprotonation and
      decarboxylation to form CO2 and the reduced form of center C. In the second half
      reaction, the reduced enzyme is reoxidized by an electron acceptor. CO oxidation
      was pH dependent. The pH dependence of kcat/Km for CO gave a single pKa of 7.7
      and a maximum value at 55 degrees C and high pH of 9.1 x 10(6) M-1 s-1. The pH
      dependence of kcat followed a two-phase titration curve with pKa values of 7.1
      and 9.5 and maximum value of kcat at 55 degrees C and high pH of 3250 s-1 (1310
      mumol of CO oxidized min-1 mg-1). The pH dependencies of kcat/Km and kcat are
      interpreted to reflect the ionization of enzyme-bound water from binary and
      ternary complexes with center C. Reaction with thiocyanate, azide, or cyanate was
      found to cause a striking shift in the EPR spectrum of center C from gav = 1.82
      (g = 2.01, 1.81, 1.65) to a two-component spectrum with gav = 2.15 (g = 2.34,
      2.067, 2.03) and gav = 2.17 (g = 2.34, 2.115, 2.047). Thiocyanate acted as a
      mixed partial inhibitor with respect to CO. The inhibition constants were pH and
      temperature dependent. The pH dependencies of the inhibition constants gave pKa
      values of approximately 7.7. Binding of thiocyanate to the oxidized form of
      center C appears to be favored by a negative enthalpy that is offset by a
      decrease in entropy yielding a slightly unfavorable free energy of association.

PMID- 7794900
TI  - CYP4 isozyme specificity and the relationship between omega-hydroxylation and
      terminal desaturation of valproic acid.
AB  - The cytochrome P450-dependent terminal desaturation of valproic acid (VPA) is of
      both toxicological and mechanistic interest because the product, 4-ene-VPA, is a
      more potent hepatotoxin than the parent compound and its generation represents a
      rather novel metabolic reaction for the cytochrome P450 system. In the present
      study, lung microsomes from rabbits were identified as a rich source of VPA
      desaturase activity. Monospecific polyclonal antibodies directed against CYP4B1
      (anti-4B) inhibited 82% of 4-ene-VPA formation, whereas monospecific polyclonal
      antibodies directed against CYP2B4 (anti-2B) inhibited only 15% of 4-ene-VPA
      formation. Anti-4B also inhibited 95% of the 5-hydroxy-VPA formation, but only
      42% of 4-hydroxy-VPA formation. These data suggest that CYP4B1 accounts for more
      than 80% of the 4-ene- and 5-hydroxy-VPA metabolites generated by rabbit lung
      microsomes. CYP4B1 expressed in HepG2 cells metabolized VPA with a turnover
      number of 35 min-1 and formed the 5-hydroxy-, 4-hydroxy-, and 4-ene-VPA
      metabolites in a ratio of 110:2:1, respectively. In contrast, the lauric acid
      omega-hydroxylases, CYP4A1 and CYP4A3, did not give rise to detectable levels of
      any of these VPA metabolites. Therefore, these studies demonstrate a new
      functional role for CYP4B1 in the terminal desaturation and omega-hydroxylation
      of this short, branched-chain fatty acid.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794901
TI  - Mechanism of irreversible inactivation of phosphomannose isomerases by silver
      ions and flamazine.
AB  - Silver ions and silver-containing compounds have been used as topical
      antimicrobial agents in a variety of clinical situations. We have previously
      shown that the enzyme phosphomannose isomerase (PMI) is essential for the
      biosynthesis of Candida albicans cell walls. In this study, we find that PMI can
      be inhibited by silver ions. This process is shown to be irreversible, and is a
      two-step process, involving an intermediate complex with a dissociation constant,
      Ki, of 59 +/- 8 microM, and a maximum rate of inactivation of 0.25 +/- 0.04 min-1
      in 50 mM Hepes buffer, pH 8.0 at 37 degrees C. The enzyme can be protected
      against this inactivation by the substrate mannose 6-phosphate, with a
      dissociation constant of 0.31 +/- 0.04 mM, close to its Km value. Flamazine
      (silver sulfadiazine) is a silver-containing antibiotic which is used clinically
      as a topical antimicrobial and antifungal agent. We compared the ability of
      silver sulfadiazine and two other silver-containing compounds to irreversibly
      inactivate C. albicans PMI. The addition of the organic moiety increased the
      affinity of the compounds, with silver sulfadiazine showing a Ki of 190 +/- 30
      nM. In all cases, the maximum inhibition rate was similar, implying a similar
      rate-determining step. Silver sulfadiazine does not inhibit Escherichia coli PMI,
      and this suggests a role of the only free cysteine, Cys-150, in the inactivation
      process. To confirm this, we mutated this residue to alanine in C. albicans PMI.
      The resultant Cys150 --> Ala mutant protein showed similar Vm and Km values to
      the wild-type enzyme.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794902
TI  - Macromolecular arrangement in the aminoacyl-tRNA.elongation factor Tu.GTP ternary
      complex. A fluorescence energy transfer study.
AB  - The distance between the corner of the L-shaped transfer RNA and the GTP bound to
      elongation factor Tu (EF-Tu) in the aminoacyl-tRNA.EF-Tu.GTP ternary complex was
      measured using fluorescence energy transfer. The donor dye, fluorescein (Fl), was
      attached covalently to the 4-thiouridine base at position 8 of tRNAPhe, and
      aminoacylation yielded Phe-tRNAPhe-Fl8. The ribose of GTP was covalently modified
      at the 2'(3') position with the acceptor dye rhodamine (Rh) to form GTP-Rh.
      Formation of the Phe-tRNAPhe-Fl8.EF-Tu.GTP-Rh ternary complex was verified both
      by EF-Tu protection of the aminoacyl bond from chemical hydrolysis and by an EF
      Tu.GTP-dependent increase in fluorescein intensity. Spectral analyses revealed
      that both the emission intensity and lifetime of fluorescein were greater in the
      Phe-tRNAPhe-Fl8.EF-Tu.GTP ternary complex than in the Phe-tRNAPhe-Fl8.EF-Tu.GTP
      Rh ternary complex. These spectral differences disappeared when excess GTP was
      added to replace GTP-Rh in the latter ternary complex, thereby showing that
      excited-state energy was transferred from fluorescein to rhodamine in the ternary
      complex. The efficiency of singlet-singlet energy transfer was low (10-12%),
      corresponding to a distance between the donor and acceptor dyes in the ternary
      complex of 70 +/- 7 A, where the indicated uncertainty reflects the uncertainty
      in dye orientation. After correction for the lengths of the probe attachment
      tethers, the 2'(3')-oxygen of the GTP ribose and the sulfur in the s4U are
      separated by a minimum of 49 A. This large distance limits the possible
      arrangements of the EF-Tu and the tRNA in the ternary complex.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7794903
TI  - Stimulation of DNA synthesis by mouse DNA helicase B in a DNA replication system
      containing eukaryotic replication origins.
AB  - A number of DNA helicases have been isolated from mammalian cells, but their
      abilities to stimulate DNA replication accompanied with DNA unwinding have not
      been addressed so far. We constructed a model DNA replication system using the
      yeast autonomously replicating sequence (ARS) as the replication origin. In this
      system, SV40 T antigen as a DNA helicase assembles to the replication origin
      where the DNA duplex is unwound by torsional stress due to the negative
      supercoiling of template DNA, which leads to bidirectional DNA replication from
      the origin. We report here that DNA helicase B isolated from mouse FM3A cells can
      greatly stimulate DNA synthesis in this replication system in place of SV40 T
      antigen. DNA synthesis was dependent on the presence of single-stranded DNA
      binding protein (RP-A), DNA polymerase alpha/primase from mouse cells, and
      Escherichia coli DNA gyrase. DNA gyrase was required not only at elongation as a
      DNA swivelase but also at initiation to increase negative superhelical density of
      template DNA with the assistance of RP-A. A mammalian DNA fragment containing a
      replication initiation zone upstream of the c-myc gene as well as the yeast ARS
      fragment acted as a cis-element in this system using DNA helicase B. Both DNA
      helicase B and SV40 T antigen have the ability to extensively unwind the template
      DNA in the presence of RP-A and DNA gyrase, which may be crucial for stimulation
      of DNA synthesis in this system.

PMID- 7794904
TI  - Continuous fluorescence assay of phytochrome assembly in vitro.
AB  - Incubation of recombinant apophytochrome with the phycobiliprotein chromophore
      precursor phycoerythrobilin produces a covalent adduct that exhibits a
      fluorescence excitation maximum at 576 nm and an emission maximum at 586 nm.
      Using these fluorescence parameters, we have developed a kinetic assay for
      quantitative analysis of the assembly of the plant photoreceptor phytochrome in
      real time. Kinetic measurements performed with different phycoerythrobilin
      concentrations confirm that bilin attachment to apophytochrome involves two
      steps, an initial formation of a reversible non-covalent complex followed by
      thioether bond formation. The kinetic constants for both steps of
      phycoerythrobilin attachment to apophytochrome were estimated with this assay.
      Methodology for determining the kinetic constants for the assembly of both the
      natural phytochrome chromophore precursor, phytochromobilin, and the analog
      phycocyanobilin is also described. Since the latter two bilins yield covalent,
      nonfluorescent adducts with apophytochrome, their co-incubation with
      phycoerythrobilin reduces the rate of formation of the fluorescent
      phycoerythrobilin adduct in an irreversible, competitive manner. Competition
      experiments were also performed with biliverdin, a structurally related bilin
      which does not form a covalent adduct with apophytochrome. Such measurements show
      that biliverdin reversibly binds to apophytochrome with a submicromolar binding
      constant, an affinity which is very similar to that of phytochromobilin. The
      utility of this fluorescence assay for identification of novel inhibitors of
      phytochrome assembly and for characterization of the structural features of both
      bilin and apophytochrome necessary for photoreceptor assembly is discussed.

PMID- 7794906
TI  - Eukaryotic acidic phosphoproteins interact with the ribosome through their amino
      terminal domain.
AB  - Variable-size fragments of the four yeast acidic ribosomal protein genes rpYP1
      alpha, rpYP1 beta, rpYP2 alpha and rpYP2 beta were fused to the LacZ gene in the
      vector series YEp356-358. The constructs were used to transform wild-type
      Saccharomyces cerevisiae and several gene-disrupted strains lacking different
      acidic ribosomal protein genes. The distribution of the chimeric proteins between
      the cytoplasm and the ribosomes, tested as beta-galactosidase activity, was
      estimated. Hybrid proteins containing around a minimum of 65-75 amino acids from
      their amino-terminal domain are able to bind to the ribosomes in the presence of
      the complete native proteins. Hybrid proteins containing no more than 36 amino
      terminal amino acids bind to the ribosomes in the absence of a competing native
      protein. The fused YP1-beta-galactosidase proteins are also able to form a
      complex with the native YP2 type proteins, promoting their binding to the
      ribosome. The stability of the hybrid polypeptides seems to be inversely
      proportional to the size of their P protein fragment. These results indicate that
      only the amino-terminal domain of the eukaryotic P proteins is needed for the P1
      P2 complex formation required for interaction with the ribosome. The highly
      conserved P protein carboxyl end is not implicated in the binding to the
      particles and is exposed to the medium.

PMID- 7794905
TI  - Effects of C-terminal deletions on the conformational state and denaturation of
      phosphoglycerate kinase.
AB  - Phosphoglycerate kinase (PGK) contains two domains of approximately equal size,
      both of the alpha/beta type. An alpha-helix consisting of the middle section of
      the 415-amino acid polypeptide chain, and the N- and C-termini reside in the
      interdomain hinge region [Watson, H. C., et al. (1982) EMBO J. 1, 1635-1640]. The
      C-terminal end is an integral part of the N-terminal domain. The consequences of
      the deletion of fifteen and three C-terminal amino acids on the conformational
      state and on the guanidine hydrochloride-induced and thermal unfolding of PGK
      were investigated by using near- and far-UV CD, tryptophan fluorescence, 1
      anilinonaphthalene-8-sulfonic acid binding, accessibility to chemical
      modification, and differential scanning calorimetry. The results of these studies
      indicate that the conformations of both domains and of the interdomain region
      were altered by these deletions. In the absence of the 15-amino acid C-terminal
      peptide [delta(401-415)], the N-terminal domain exhibits several characteristics
      of a molten globule state, whereas the C-terminal domain retains native-like,
      although distinctly different, tertiary structure. Deletion of three C-terminal
      amino acids [delta(413-415)] also globally affects PGK conformation, although to
      a much lesser extent. Both C-terminal deletions resulted in a significant
      decrease in protein stability, as demonstrated by their increased susceptibility
      to guanidine-induced and thermal denaturation. These results suggest that the
      formation of a native tertiary fold of PGK requires the presence of a complete
      polypeptide chain.

PMID- 7794907
TI  - Identification of Asp258 as the metal coordinate of pigeon liver malic enzyme by
      site-specific mutagenesis.
AB  - Pigeon liver malic enzyme was inactivated by ferrous sulfate in the presence of
      ascorbate. Manganese and some other divalent metal ions provided complete
      protection of the enzyme against the Fe(2+)-induced inactivation. The inactivated
      enzyme was subsequently cleaved by the Fe(2+)-ascorbate system at Asp258-Ile259,
      which was presumably the Mn(2+)-binding site of the enzyme [Wei, C. H., Chou, W.
      Y., Huang, S. M., Lin, C. C., & Chang, G. G. (1994) Biochemistry 33, 7793-7936].
      For identification of Asp258 as the putative metal-binding site of the enzyme, we
      prepared four mutant enzymes substituted at Asp258 with glutamate (D258E),
      asparagine (D258N), lysine (D258K), or alanine (D258A), respectively. These
      mutant proteins were recombinantly expressed in a bacterial expression system
      (pET-15b) with a stretch of histidine residues attached at the N-terminus and
      were successfully purified to apparent homogeneity by a single Ni-chelated
      affinity column. Among the four mutants, only D258E possessed 0.8% residual
      activity after purification; all other purified mutants had < 0.0001% residual
      activity in catalyzing the oxidative decarboxylation of L-malate. The D258E
      mutant was susceptible to inactivation by the Fe(2+)-ascorbate system, albeit
      with much slower inactivation rate, and was protected by the Mn2+ to a lesser
      extent as compared to the wild-type enzyme. None of the mutants were cleaved by
      the Fe(2+)-ascorbate system under conditions that cleaved the natural or wild
      type enzyme at Asp258.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794909
TI  - Interruption of the water chain in the reaction center from Rhodobacter
      sphaeroides reduces the rates of the proton uptake and of the second electron
      transfer to QB.
AB  - A chain of bound water molecules was recently identified in the photosynthetic
      reaction center (RC) from Rhodobacter sphaeroides by X-ray crystallography
      [Ermler et al. (1994) Structure 2, 925-936]. The possible role of the chain in
      proton transfer from the solution to the secondary quinone (QB) was investigated
      by site-directed mutagenesis and flash-induced absorbance spectroscopy. Pro L209,
      situated along the water chain about 9 A from QB, was changed into the aromatic
      residues Phe and Tyr in order to interrupt the chain. In the PL209Y (Pro L209-
      >Tyr) mutant, the very small changes in the QA-QB<==>QAQB- equilibrium constant
      (K2) and the first electron-transfer rates (kAB(1)) indicate that the mutation
      does not lead to large structural changes. In the PL209F (Pro L209-->Phe) mutant,
      a 7-fold decrease of kAB(1) is observed. It follows a pH dependence parallel to
      that of the wild type. It is consistent with no modification of the pK of the Glu
      L212 determined from the pH dependence of K2. The decreased kAB(1) may reflect
      some slight structural modification in this mutant and/or rearrangement of the
      cluster of charged residues close to the L209 position. The major effect of the
      mutations observed is a concomitant decrease of the rates of the second electron
      transfer, kAB(2), and of the proton uptake upon the second flash. The relative
      decrease of the kAB(2) rate values in the mutants is more pronounced above pH 8.
      Our results indicate that the mutations have specifically altered the pathway of
      proton transfer to QB.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794908
TI  - Efflux of cellular cholesterol and phospholipid to lipid-free apolipoproteins and
      class A amphipathic peptides.
AB  - The mechanism(s) by which lipid-free apolipoprotein (apo) AI is able to stimulate
      efflux of cholesterol and phospholipid from cells in cultures has (have) been
      examined. This process was found to be enhanced when macrophages were enriched
      with cholesterol. There were 12- and 4-fold increases in cholesterol and
      phospholipid efflux, respectively, from cholesterol-enriched mouse macrophages
      when compared to cells not loaded with cholesterol. This enhancement in
      cholesterol efflux to lipid-free apo AI from macrophages enriched with
      cholesterol was found to be controlled by the level of free cholesterol in the
      cells. When cholesterol-enriched mouse macrophages were exposed to lipid-free apo
      AI at 20 micrograms/mL (706 nM), there was significant efflux of [14C]cholesterol
      and [3H]phospholipid (20% +/- 0.5%/24 h and 6% +/- 0.3%/24 h, respectively). In
      comparison, HDL at equivalent protein concentrations only stimulated 11% and 4%
      efflux of cholesterol and phospholipid, respectively. Synthetic peptides
      containing amphipathic helical segments that mimic those present in apo AI were
      used to examine the structural features of the apoprotein which stimulate lipid
      efflux. Peptides containing only one (18A) or two (37pA) amphipathic helical
      segments stimulated as much cholesterol efflux from both mouse macrophages and L
      cells as apo AI. The order of efficiency, as assessed by the mass concentration
      at which half-maximal efflux was reached (EC50), was apo AI > 37pA > 18A,
      indicating that acceptor efficiency was dependent on the number of amphipathic
      helical segments per molecule. When the helical content of 18A was increased by
      neutralizing the charges at the ends of the peptide (Ac-18A-NH2), there was a
      substantial increase in the efficiency for cholesterol efflux (EC50 18A = 17
      micrograms/mL vs Ac-18A-NH2 = 6 micrograms/mL). In contrast, when the
      amphipathicity of the helix in 18A was decreased by scrambling the amino acid
      sequence, thereby reducing its lipid affinity, cholesterol and phospholipid
      efflux were not stimulated. The efficiency with which the peptides stimulated
      cholesterol efflux was in order of their lipid affinity (37pA > Ac-18A-NH2 >
      18A), and this order was similar for phospholipid efflux. The time course of
      lipid release from mouse macrophages and L-cells indicated that phospholipid
      appeared in the extracellular medium before cholesterol. These results suggest
      that the apo AI or peptides first interacted with the cell to form
      protein/phospholipid complexes, that could then accept cholesterol.

PMID- 7794910
TI  - Three-dimensional structure of the binuclear metal center of phosphotriesterase.
AB  - Phosphotriesterase, as isolated from Pseudomonas diminuta, is capable of
      detoxifying widely used pesticides such as paraoxon and parathion and various
      mammalian acetylcholinesterase inhibitors. The enzyme requires a binuclear metal
      center for activity. Recently, the three-dimensional structure of the apoenzyme
      was solved (Benning et al., 1994) and shown to consist of an alpha/beta-barrel.
      Here we describe the three-dimensional structure of the holoenzyme, reconstituted
      with cadmium, as determined by X-ray crystallographic analysis to 2.0-A
      resolution. Crystals employed in the investigation belonged to the space group C2
      with unit cell dimensions of a = 129.5 A, b = 91.4 A, c = 69.4 A, beta = 91.9
      degrees, and two subunits in the asymmetric unit. There are significant
      differences in the three-dimensional architecture of the apo and holo forms of
      the enzyme such that their alpha-carbon positions superimpose with a root-mean
      square deviation of 3.4 A. The binuclear metal center is located at the C
      terminus of the beta-barrel with the cadmiums separated by 3.8 A. There are two
      bridging ligands to the metals: a water molecule (or possibly a hydroxide ion)
      and a carbamylated lysine residue (Lys 169). The more buried cadmium is
      surrounded by His 55, His 57, Lys 169, Asp 301, and the bridging water in a
      trigonal bipyramidal arrangement. The second metal is coordinated in a distorted
      octahedral geometry by His 201, His 230, Lys 169, the bridging water molecule,
      and two additional solvents.

PMID- 7794911
TI  - Characterization of a hormone-inducible, high affinity adenosine 3'-5'-cyclic
      monophosphate phosphodiesterase from the rat Sertoli cell.
AB  - In previous reports we have shown that FSH and beta-adrenergic agonists regulate
      the levels of mRNA and increase the activity of a high affinity cAMP
      phosphodiesterase (cAMP-PDE) in the immature rat Sertoli cell in culture. To
      identify and characterize the hormone-inducible form(s), the cAMP-PDE activity of
      the Sertoli cell was partially purified and its properties were determined using
      biochemical and immunological tools. The cAMP-PDE activity present in the
      100,000g supernatant of Sertoli cell extracts was purified more than 2000-fold by
      four HPLC chromatographic steps. The major purified form of cAMP-PDE had a
      specific activity of 1-2 mumol/(min.mg of protein). Polyacrylamide gel
      electrophoresis and silver staining analysis showed that a 67-68 kDa polypeptide
      comigrated with the major peak of cAMP hydrolytic activity. The molecular weight
      of the crude or purified enzyme determined by gel filtration and sucrose density
      gradients was 150,000, suggesting that the native enzyme is an oligomeric
      structure. This PDE hydrolyzed cAMP with a Km of 1.97 +/- 0.26 microM. The
      hydrolysis of cAMP was neither inhibited nor stimulated by cGMP concentrations
      lower than 50 microM. Cyclic nucleotide catalysis required Mg2+, but was
      insensitive to Ca2+. The activity of this form was competitively inhibited by
      several inhibitors with the following potency: rolipram > RO 20-1724 >
      methylisobutylxanthine > cilostamide = milrinone. Because mRNAs derived from two
      distinct PDE4B and PDE4D genes are present in the Sertoli cell, selective and
      nonselective PDE antibodies were used to determine the origin of the inducible
      PDE protein.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794912
TI  - "Prohormone thiol protease" (PTP) processing of recombinant proenkephalin.
AB  - The "prohormone thiol protease" (PTP) from adrenal medullary chromaffin granules
      has been demonstrated as a novel cysteine protease that converts the model
      enkephalin precursor, ([35S]Met)-preproenkephalin, to appropriate enkephalin
      related peptide products [Krieger, T. J., & Hook, V. Y. H. (1991) J. Biol. Chem.
      266, 8376-8383; Kreiger, T. J., Mende-Mueller, L., & Hook, V. Y. H. (1992) J.
      Neurochem. 59, 26-31; Azaryan, A. V., & Hook, V. Y. H. (1994) FEBS Lett. 341, 197
      202]. In this report, PTP processing of authentic proenkephalin (PE) was examined
      with respect to production of appropriate intermediate products, and kinetics of
      PE processing were assessed. Recombinant PE was obtained by high level expression
      in Escherichia coli, with the pET3c expression vector; PE was then purified from
      E. coli by DEAE-Sepharose chromatography, preparative gel electrophoresis, and
      reverse-phase HPLC. Authentic purified PE was confirmed by amino acid composition
      analyses and peptide microsequencing. In time course studies, PTP converted PE
      (12 microM) to intermediates of 22.5, 21.7, 12.5, and 11.0 kDa that represented
      NH2-terminal fragments of PE, as assessed by peptide microsequencing. Differences
      in molecular masses of the 22.5, 21.7, 12.5, and 11.0 kDa products reflect PTP
      processing of PE within the COOH-terminal region of PE, which resembles PE
      processing in vivo [Liston, D. L., Patey, G., Rossier, J., Verbanck, P., &
      Vanderhaeghen, J. (1983) Science 225, 734-737; Udenfriend, S., & Kilpatrick, D.
      L. (1983) Arch. Biochem. Biophys. 221, 309-314]. Products of 12.5, 11.0, and 8.5
      kDa were generated by PTP cleavage between Lys-Arg at the COOH-terminus of
      (Met)enkephalin-Arg6-Gly7-Leu8.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794914
TI  - Evidence for ternary complex formation by histone H1, DNA, and liposomes.
AB  - Using three different donor-acceptor pairs for resonance energy transfer,
      interactions in systems composed of histone H1, liposomes, and DNA were
      investigated. While weak attachment of H1 to phosphatidylcholine (PC) liposomes
      was observed, the inclusion of phosphatidylserine (PS), phosphatidylglycerol
      (PG), or phosphatidic acid (PA) strongly enhanced the membrane association of H1,
      the extent of binding increasing with the content of the acidic lipid. Increasing
      the content of the negatively charged lipid also made the membrane attachment of
      H1 less susceptible to dissociation by NaCl, thus indicating, in keeping with our
      previous studies, that protonation of the acidic lipid is an important factor.
      Whereas DNA binds to sphingosine-containing cationic liposomes, these vesicles
      did not bind H1. Instead, H1 effectively competed with sphingosine for binding
      with DNA. In systems comprising DNA, liposomes, and H1, the interactions were
      clearly dependent on the liposome composition. While moderately acidic liposomes
      (PS content < 30 mol%) seemed to form ternary complexes with DNA and H1, strongly
      acidic liposomes (PS content > 30 mol %) competed with DNA for binding H1, partly
      removing the histone from the nucleic acid. The tendency to form ternary
      complexes also seemed to depend on the type of the acidic lipid. Possible
      physiological consequences of the interactions detected in these simple model
      systems are discussed.

PMID- 7794913
TI  - Yeast TATA binding protein interaction with DNA: fluorescence determination of
      oligomeric state, equilibrium binding, on-rate, and dissociation kinetics.
AB  - A combination of steady-state, stopped-flow, and time-resolved fluorescence of
      intrinsic tryptophan and extrinsically labeled fluorescent DNA is utilized to
      examine the interaction of yeast TATA binding protein (TBP) with DNA. TBP is
      composed of two structural domains, the carboxy domain (residues 61-240), which
      is responsible for DNA binding and initiation of basal level transcription, and
      an amino terminal domain (residues 1-60), whose function is currently unknown.
      The steady-state fluorescence emission spectrum of the single tryptophan in the
      amino terminal domain of TBP undergoes a huge (30-40 nm) red-shift upon
      interaction with stoichiometric amounts of TATA box containing DNA. From time
      resolved tryptophan fluorescence anisotropy studies, we demonstrate that, in the
      absence of DNA, the protein exists as a multimer in solution and it contains (at
      least) two primary conformations, one with the amino terminus associated tightly
      with the protein(s) in a hydrophobic environment and one with the amino terminus
      decoupled away from the rest of the protein and solvent-exposed. Upon binding
      DNA, the protein dissociates into a monomeric complex, upon which only the
      solvent-exposed amino terminus conformation remains. Kinetic and equilibrium
      binding studies were performed on TATA box containing DNA which was extrinsically
      labeled with a fluorescent probe Rhodamine-X at the 5'-end. This "fluorescent"
      DNA allowed for the collection of quantitative spectroscopic binding, kinetic on
      rate, and kinetic off-rate data at physiological concentrations. Global analysis
      of equilibrium binding studies performed from 500 pM to 50 nM DNA reveals a
      single dissociation constant (Kd) of approximately 5 nM. Global analysis of
      stopped-flow anisotropy on-rate experiments, with millisecond timing resolution
      and TBP concentrations ranging from 20 to 600 nM (20 nM DNA), can be perfectly
      described by a single second-order rate constant of 1.66 x 10(5) M(-1) s(-1).
      These measurements represent the very first stopped-flow anisotropy study of a
      protein/DNA interaction. Stopped-flow anisotropy off-rate experiments reveal a
      single exponential k(off) of 4.3 x 10(-2) min-1 (1/k(off) = 23 min) From the
      ratio of on-rate to off-rate, a predicted Kd of 4.3 nM is obtained, revealing
      that the kinetic and equilibrium studies are internally consistent. Deletion of
      the amino terminal domain of TBP decreases the k(on) of TBP approximately 45-fold
      and eliminates classic second-order behavior.

PMID- 7794915
TI  - Transcriptional regulation of human CYP2C genes: functional comparison of CYP2C9
      and CYP2C18 promoter regions.
AB  - The cytochrome P4502C subfamily comprises a group of constitutive microsomal
      hemoproteins which are expressed primarily in liver. In humans, this subfamily is
      responsible for metabolism of a variety of therapeutic drugs such as warfarin,
      mephenytoin, omeprazole, and antiinflammatory drugs. In the present study, we
      analyzed the promoter activity of the 5'-flanking region of two human CYP2C
      genes, CYP2C9 and CYP2C18. The ability of the 2.2-kb 5'-flanking region of the
      CYP2C9 gene to direct expression of a luciferase reporter gene in HepG2 cells was
      25 times greater than that of the 1.3-kb 5'-flanking region of CYP2C18.
      Deletional analysis of CYP2C9 indicated that the minimal promoter was located
      between the translation start site and nucleotide -155, and an HPF-1 domain
      consensus sequence was identified in this region. Gel shift analysis demonstrated
      that nuclear proteins from HepG2 cells had a high binding affinity for a 20-bp
      oligonucleotide containing the HPF-1 site of CYP2C9. Antiserum to rat HNF-4
      supershifted this DNA--protein complex, and an oligonucleotide derived from an
      HNF-4 motif present in the human apolipoprotein CIII promoter competed for the
      supershifted complex. Cotransfection with an HNF-4 expression plasmid increased
      transcriptional activity of the CYP2C9 minimal promoter (approximately 2-fold) in
      HepG2 cells and elevated activity more substantially in nonhepatic NIH3T3 cells
      (26-fold) and Cos 1 cells (9-fold).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794916
TI  - Interaction of nucleolar protein B23 with peptides related to nuclear
      localization signals.
AB  - Nucleolar protein B23 is a putative ribosome assembly factor with a high affinity
      for peptides containing nuclear localization signals (NLSs). The interactions of
      various NLS-containing peptides with two B23 isoforms (B23.1 and B23.2) were
      examined using equilibrium dialysis and Scatchard analyses. The KD for protein
      B23 binding to a peptide containing the SV40 T-antigen NLS sequence was
      approximately 1 microM with a stoichiometry of 1:1 (peptide:protein). No
      significant differences were seen between the two B23 isoforms in their
      affinities for any of the peptides tested. Binding by a reverse sequence SV40 T
      NLS peptide showed a nonlinear Scatchard plot: this peptide was unable displace
      the correct sequence peptide, suggesting that the reverse sequence peptide binds
      to a different site on the protein. A peptide containing the sequence required
      for nucleolar localization of the HIV-1 Rev protein had an affinity for B23
      approximately 10-fold greater than that of the SV40 T-NLS. However, with a
      sequence sufficient only for Rev location in the nucleoplasm, the affinity for
      B23 was diminished to a level between that of the longer Rev sequence and the
      SV40 T-NLS. In competition binding assays, the Rev NLS peptide was able to
      displace the SV40 T NLS, indicating that both peptides bind to the same site on
      protein B23. There was no detectable binding to protein B23 by a peptide
      containing the bipartite NLS of nucleoplasmin. Phosphorylation of protein B23 by
      casein kinase II enhanced its affinity for the SV40 T- and Rev-derived peptides
      approximately 2-fold.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794917
TI  - Identification and quantitation of dibenzo[a,l]pyrene--DNA adducts formed by rat
      liver microsomes in vitro: preponderance of depurinating adducts.
AB  - Dibenzo[a,l]pyrene (DB[a,l]P) is the most potent carcinogen known among aromatic
      hydrocarbons. DB[a,l]P-11,12-dihydrodiol, precursor to the bay-region diol
      epoxide, is slightly less carcinogenic than the parent compound. DB[a,l]P and its
      11,12-dihydrodiol were covalently bound to DNA by cytochrome P-450 in 3
      methylcholanthrene-induced rat liver microsomes, and DB[a,l]P was also bound to
      DNA by horseradish peroxidase. The "stable" (remaining intact in DNA under normal
      conditions of purification) and "depurinating" (released from DNA by cleavage of
      the glycosidic link between the purine base and deoxyribose) adducts were
      identified and quantified. Stable adducts were analyzed by the 32P-postlabeling
      technique. Depurinating adducts were identified by comparison of their retention
      times with those of standard adducts on HPLC in two solvent systems. Confirmation
      of their identity was obtained by means of fluorescence line-narrowing
      spectroscopy. When DB[a,l]P was activated by horseradish peroxidase, the
      depurinating adducts 3-(DB[a,l]P-10-yl)adenine (DB[a,l]P-10-N3Ade, 33%), 7
      (DB[a,l]P-10-yl)adenine (DB[a,l]P-10-N7Ade, 27%), and 7-DB[a,l]P-10-yl)guanine
      (DB[a,l]P-10-N7Gua, 5%) were formed. Unidentified stable adducts comprised the
      remaining 35% of the detected adducts. When DB[a,l]P was activated by microsomes,
      the one-electron oxidation depurinating adducts DB[a,l]P-10-N3Ade (28%), DB[a,l]P
      10-N7Ade (14%), DB[a,l]P-10-N7Gua (2%), and DB[a,l]P-10-C8Gua (6%), as well as
      the diol epoxide depurinating adducts (+/-)-syn-DB[a,l]P-diol epoxide (DE)-14
      N7Ade (31%) and (+/-)-anti-DB[a,l]PDE-14-N7Gua (3%), were formed. Stable adducts
      predominantly formed via the DB[a,l]PDE pathway represented 16% of the adducts
      detected.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794919
TI  - Characterization of gastrin-releasing peptide receptor expressed in Sf9 insect
      cells by baculovirus.
AB  - Whereas baculovirus expression systems have been extensively used for high-level
      expression of steroid receptors and receptors coupled to adenylate cyclase, there
      are few studies on peptide receptors coupled to phospholipase C (PLC). In the
      present study we have expressed the murine gastrin-releasing peptide receptor
      (mGRP-R) in Sf9 cells using a recombinant baculovirus and characterized it
      structurally and functionally. mGRP-R was detectible 12 h post infection with
      recombinant baculovirus carrying mGRP-R cDNA and became maximal at 60 h post
      infection (Bmax = 6 pmol/mg protein), which is a 4-60-fold greater density than
      is found in native tissues. The mGRP-R in Sf9 cells assessed by affinity labeling
      or immunoblotting was smaller than that in native tissues (M(r) = 51 kD vs 82
      kD), and the difference was due to the extent of glycosylation. In Sf9 cells the
      mGRP-R had at least two of the four potential extracellular glycosylation sites
      glycosylated, whereas in the native receptor all four were approximately equally
      glycosylated. In Sf9 cells the glycosylation was entirely biantennary complex, in
      contrast to the native mGRP-R, where it was entirely tri- and tetraantennary
      complex N-linked oligosaccharides. Affinity labeling studies revealed a band with
      an apparent molecular mass about 40 kDa higher than the 51-kDa mGRP-R band. The
      intensity of this band correlated with the extent of functional G protein
      coupling, suggesting that it may represent an mGRP-R-G protein complex. In
      binding studies the affinity of the mGRP-r in Sf9 cells for the agonists bombesin
      (Bn), GRP, and neuromedin B (NMB) varied differently with infection time: with Bn
      the affinity decreased 3-fold with longer infection times, with GRP it remained
      unchanged, and with NMB it decreased 10-fold. GPP(NH)p inhibited binding of
      either [125I]Tyr4Bn or [125I]GRP at 24 h post infection, but not at 96 h post
      infection. Agonists activated PLC, increasing both [3H]IP and [Ca2+]i; however,
      the efficacy of each agonist decreased with infection time. These results
      demonstrate that by the use of recombinant baculovirus infected Sf9 cells the PLC
      linked receptor mGRP-R can be expressed in amounts significantly greater than
      those in native tissues. The mGRP-R expressed in these Sf9 cells is incompletely
      glycosylated and has less complex N-linked oligosaccharide chains, yet it is
      fully coupled to G proteins and activates phospholipase C, similar to the native
      receptor, if short infection times are used.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7794918
TI  - Binding of vinblastine to phosphocellulose-purified and alpha beta-class III
      tubulin: the role of nucleotides and beta-tubulin isotypes.
AB  - Vinblastine is an antimitotic drug that inhibits microtubule assembly and induces
      the self-association of tubulin into coiled spiral aggregates. Previous
      quantitative binding and sedimentation velocity results have been interpreted by
      a mechanism involving isodesmic ligand-mediated plus ligand-facilitated self
      association [Na, G., & Timasheff, S. N. (1986) Biochemistry 25, 6214-6222, 6222
      6228]. In this study, the vinblastine-induced self-association of porcine brain
      tubulin has been compared in the presence of 50 microM GDP or 50 microM GTP to
      investigate the role of nucleotides. Experiments at 1-4 microM tubulin in 10 mM
      Pipes, 1 mM MgSO4, 2 mM EGTA (pH 6.9), and varying concentrations of vinblastine
      (0.05-70 microM) demonstrate that GDP enhances self-association by 2-4-fold over
      GTP. In the presence of GDP or GTP, sedimentation velocity data can be best fit
      by either an indefinite ligand-mediated model or an indefinite ligand-mediated
      plus ligand-facilitated model. The association constant, K2, for the vinblastine
      tubulin complex binding to a polymer is larger when GDP is present, while the
      association constant, K1, for the binding of vinblastine to tubulin heterodimers
      is identical in the presence of either nucleotide. The enhancement of K2 by GDP
      is confirmed by micropartition binding experiments with [3H]vinblastine. The
      fitting of sedimentation velocity and binding studies gives parameters for the
      interaction of vinblastine with GTP-tubulin that are identical, within error, to
      the previous results of Na and Timasheff. van't Hoff analysis of multiple
      temperature data reveals that this enhancement in the presence of GDP is due to a
      change in the enthalpy of self-association. Additional results suggest that the
      interaction of vinblastine with tubulin is identical for all beta-isotypes.
      Sedimentation velocity experiments in the presence of GDP or GTP show that the
      vinblastine-induced association of affinity-purified alpha,beta-class III tubulin
      is identical to that of unfractionated tubulin, although there is a difference in
      the abilities of unfractionated tubulin and alpha,beta III-tubulin to associate
      into taxol-stabilized microtubules.

PMID- 7794920
TI  - Structure-activity analysis of a Conus peptide blocker of N-type neuronal calcium
      channels.
AB  - The synthetic peptide SNX-111 corresponding to the sequence of the omega
      conopeptide MVIIA from the venom of the marine snail Conus magus is a highly
      potent and selective antagonist of N-type calcium channels. We have synthesized
      and characterized a large number of analogs of SNX-111 in order to elucidate the
      structural features of the peptide involved in blocking N-type calcium channels.
      Comparison of the binding of SNX-111 and its analogs to rat brain synaptosomal
      membranes rich in N-type channels revealed that, among the four lysines and two
      arginines in the molecule, lysine in position 2 and arginines at position 10 and
      21 are important for the interaction of SNX-111 with N-type channels. The
      importance of the middle segment from residues 9 through 14 for this binding
      interaction was revealed by substitution of the individual residues as well as by
      the construction of hybrid peptides in which the residues 9-12 in SNX-111 and
      another conopeptide, SNX-183, corresponding to a peptide SVIB from Conus
      striatus, were interchanged. Introduction of the sequence SRLM from SNX-111 in
      place of RKTS in position 9-12 in SNX-183 resulted in a 38-fold increase in
      affinity.

PMID- 7794921
TI  - Structure-function assessment of the role of the helical stack domain in the
      properties of human recombinant protein C and activated protein C.
AB  - The role of the helical stack (HS) in defining the properties of human
      recombinant (r) protein C (PC) and activated protein C (APC) was assessed. To do
      so, several mutations were made in this region of the molecule and their effects
      on the proteins examined. Substitution of the entire HS of PC (residues 38-46) by
      that of human coagulation factor (f) IX (residues 39-47), yielding r-[HSIX]PC,
      did not result in any substantial changes in the gamma-carboxyglutamic acid
      domain (GD)-related Ca(2+)-dependent properties of PC or APC, suggesting that the
      conformation of the HS may play a more dominant role in these Ca(2+)-dependent
      properties than do the specific amino acids that differ between these two HS
      regions. On the other hand, the catalytic efficiency of activation of r-[HSIX]PC
      by the thrombin/thrombomodulin complex was reduced to approximately one-third of
      that of wtr-PC, a result that demonstrates a specific role for the HS of PC in
      this activation process. Another mutation, [Ser42-->Pro], was generated in the HS
      region of r-PC, providing r-[S42P]PC, a change that according to the empirical
      algorithm based on the Chou-Fasman secondary structure rules, would disrupt the
      alpha-helical conformation of the HS. The anticoagulant activity of the
      corresponding r-[S42P]APC was found to be approximately 35% of that of wtr-APC.
      Because of the lack of any notable effects of this mutation on other GD-related
      Ca(2+)-dependent properties of r-PC and r-APC, the basis of this anticoagulant
      activity loss may be due to its nonmaximal alignment with substrate on the PL
      surface. The results of this study indicate that the role of the HS of r-PC and r
      APC is to provide a region of the protein that is needed to assure optimal
      alignment on the PL or cell surface of the active site of the enzyme with that of
      the cleavage sites of the substrates, perhaps by functioning as a scaffold for
      separation of the active site of APC from the PL surface.

PMID- 7794922
TI  - Intracellular production of beta A4 amyloid of Alzheimer's disease: modulation by
      phosphoramidon and lack of coupling to the secretion of the amyloid precursor
      protein.
AB  - The amyloid precursor protein (APP) undergoes abnormal metabolism in Alzheimer's
      disease, resulting in the accumulation of beta A4 amyloid in the brain. Normal
      APP metabolism includes the release of a truncated form (sAPP) which has been
      cleaved at the alpha-secretase site within the beta A4 amyloidogenic domain.
      However, intact forms of beta A4 protein may also be generated by the beta- and
      gamma-secretases. Soluble forms of beta A4 have been detected in various cell
      lines and in cerebrospinal fluid. Previous studies of protein kinase C activation
      have suggested a reciprocal relationship between sAPP secretion and beta A4
      production and release. We find that phorbol ester activation of protein kinase C
      in untransfected SH-SY5Y neuroblastoma cells increases the release of sAPP
      without affecting beta A4 secretion. We provide further evidence for
      intracellular beta A4 production. Treatment of SY5Y cells with the protease
      inhibitor phosphoramidon results in a 2-fold increase in beta A4 secretion and an
      increase in the amount of beta A4 recovered from cell lysates, yet it does not
      affect sAPP secretion. The protease inhibitors thiorphan and N-[(RS)-2-carboxy-3
      phenylpropanoyl]-L-leucine had no effect on beta A4 or sAPP secretion. The
      lysosomotropic agents chloroquine and NH4Cl decreased beta A4 secretion,
      providing additional evidence for the involvement of intracellular acidic
      compartments in the production of beta A4. Our results therefore demonstrate a
      double dissociation between the secretion of sAPP and beta A4 in the SH-SY5Y cell
      line. The effect of phosphoramidon supports previous studies which show that
      metalloproteases are involved in the biogenesis of beta A4.

PMID- 7794923
TI  - Structural analysis of a novel interaction by calmodulin: high-affinity binding
      of a peptide in the absence of calcium.
AB  - The interaction of apocalmodulin (apoCaM) with a peptide (Neurop) based on the
      primary sequence of the calmodulin-binding domain of neuromodulin has been
      studied by nuclear magnetic resonance (NMR) methods. The NMR spectra of both
      apocalmodulin and its 1:1 complex with the Neurop peptide have been assigned by
      triple resonance and nuclear Overhauser effect-(NOE-) based strategies. ApoCaM
      displays many of the same basic structural features as calcium-saturated
      calmodulin. Analysis of observed chemical shifts and patterns of NOEs on the main
      chain indicates extensive and regular secondary structure throughout the N
      terminal domain. In contrast, the helices of the C-terminal domain are somewhat
      irregular and are dynamically averaged. The EF-hands are intact in the N-terminal
      domain with the loops forming a short antiparallel beta sheet. Under low-salt
      conditions, two helix-loop-helix EF-hand motifs are present in the C-terminal
      domain of apoCaM but do not show interstrand NOEs. The spectral perturbations of
      apoCaM upon complexation with the Neurop peptide are relatively small with the
      larger chemical shift perturbations occurring in the C-terminal domain. The
      general secondary structure and tertiary organization appears to remain roughly
      the same as in free apoCaM. Stoichiometric titration of the apoCaM.Neurop complex
      with calcium indicates that the C-terminal domain EF-hands have a higher affinity
      for calcium than N-terminal domain EF-hands. Thus, this complex offers a unique
      opportunity to examine the structural and energetic consequences of calcium
      dependent and calcium-independent binding of peptide to calmodulin.

PMID- 7794924
TI  - Minimum folding unit of dystrophin rod domain.
AB  - Fragments of the rod domain of dystrophin, which consists of spectrin-like
      repeating sequences, have been prepared by expression in Escherichia coli. The
      phasing established earlier for the dystrophin rod, as well as for Drosophila
      spectrin and smooth muscle alpha-actinin, suggested a length of less than 113
      residues for the dystrophin repeat that we have chosen. Fragments with a common N
      terminus and lengths between 113 and 119 residues were prepared. The formation of
      the stable native tertiary fold could be recognized by resistance to proteolysis,
      the circular dichroism spectrum in the regions of both peptide and aromatic
      absorption bands and the resolution of the long-wavelength component in the
      tryptophan absorption spectrum. It was found that the critical length for folding
      was 117 residues: shortening the chain by 1 further residue resulted in loss of
      the capacity to form a defined tertiary structure. Residue 117 is a glutamine;
      replacement of this by a methionine residue did not impair the ability of the
      chain to enter the folded conformation, implying that it is the length of the C
      terminal alpha-helix, rather than any specific side-chain interaction, that is
      critical in determining the stability of the native structure. The fragment of
      119 residues forms a significantly more stable structure than that of 117. It
      appears that the minimum unit capable of forming the native fold extends some
      residues into the adjoining sequence repeat.

PMID- 7794925
TI  - High resistance of Escherichia coli ribonuclease HI variant with quintuple
      thermostabilizing mutations to thermal denaturation, acid denaturation, and
      proteolytic degradation.
AB  - To test whether the combination of multiple thermostabilizing mutations is a
      useful strategy to generate a hyperstable mutant protein, five mutations, Gly23-
      >Ala, His62-->Pro, Val74-->Leu, Lys95-->Gly, and Asp134-->His or Asn, were
      simultaneously introduced into Escherichia coli ribonuclease HI. The enzymatic
      activities of the resultant quintuple mutant proteins, 5H- and 5N-RNases HI,
      which have His and Asn at position 134, respectively, were 35 and 55% of that of
      the wild-type protein. The far-UV and near-UV CD spectra of these mutant proteins
      were similar to those of the wild-type protein, suggesting that the mutations did
      not seriously affect the tertiary structure of the protein. The differences in
      the free energy change of unfolding between the wild-type and mutant proteins,
      delta delta G, were estimated by analyzing the thermal denaturation of the
      proteins by CD. The 5H-RNase HI protein, which was slightly more stable than the
      5N-RNase HI, was more stable than the wild-type protein by 20.2 degrees C in Tm
      and 5.6 kcal/mol in delta G at pH 5.5. In addition, the 5H-RNase HI was highly
      resistant to proteolysis and acid denaturation. The effects of each mutation on
      the thermal stability and the susceptibility to chymotryptic digestion were
      nearly cumulative, and the 5H-RNase HI undergoes chymotryptic digestion at a rate
      that is 41 times slower than that of the wild-type protein. Good correlation was
      observed between the thermal stability and the resistance to chymotryptic
      digestion for all proteins examined.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7794926
TI  - Interaction between casein kinase II and the 90-kDa stress protein, HSP90.
AB  - Purified casein kinase II (CKII) aggregates and loses activity under
      physiological salt conditions and within the range of physiological temperatures.
      In accord with our previous report [Miyata, Y., & Yahara, I. (1992) J. Biol.
      Chem. 267, 7042-7047], we report here that HSP90 protects CKII from the
      aggregation and inactivation by forming soluble CKII-HSP90 complexes. Surface
      plasmon resonance (SPR) measurements revealed that CKII binds to immobilized
      HSP90 within minutes. The KD of the binding is approximately 10(-7) M. ATP does
      not influence the interaction. The membrane-overlay method revealed that HSP90
      binds to the catalytic CKII alpha subunit. Heparin, which binds to CKII alpha,
      inhibited the binding of CKII to HSP90-Sepharose. In addition, HSP90 competed
      with DNA for binding to CKII. Finally, SPR experiments showed that a peptide
      corresponding to the heparin and DNA binding site of CKII alpha binds to
      immobilized HSP90. These results indicate that HSP90, DNA, and heparin compete
      with each other for binding to a common site of CKII alpha. If the binding of
      CKII to DNA is biologically significant, it could be possibly regulated also by
      HSP90.

PMID- 7794927
TI  - ENDOR studies of the primary donor cation radical in mutant reaction centers of
      Rhodobacter sphaeroides with altered hydrogen-bond interactions.
AB  - The electronic structure of the cation radical of the primary electron donor was
      investigated in genetically modified reaction centers of Rhodobacter sphaeroides.
      The site-directed mutations were designed to add or remove hydrogen bonds between
      the conjugated carbonyl groups of the primary donor, a bacteriochlorophyll dimer,
      and histidine residues of the protein and were introduced at the symmetry-related
      sites L168 His-->Phe, HF(L168), and M197 Phe-->His, FH(M197), near the 2-acetyl
      groups of the dimer and at sites M160 Leu-->His, LH(M160), and L131 Leu-->His,
      LH(L131), in the vicinity of the 9-keto carbonyls of the dimer. The single
      mutants and a complete set of double mutants were studied using EPR, ENDOR, and
      TRIPLE resonance spectroscopy. The changes in the hydrogen bond situation of the
      primary donor were accompanied by changes in the dimer oxidation midpoint
      potential, ranging from 410 to 710 mV in the investigated mutants [Lin, X.,
      Murchison, H. A., Nagarajan, V., Parson, W. W., Williams, J. C. & Allen, J. P.
      (1994) Proc. Natl. Acad. Sci. U.S.A. 91, 10265-10269]. It was found that the
      addition or removal of a hydrogen bond causes large shifts of the spin density
      between the two halves of the dimer. Measurements on double mutants showed that
      the unpaired electron can be gradually shifted from a localization on the L-half
      of the dimer to a localization on the M-half, depending on the hydrogen bond
      situation. As a control, the effects of the different hydrogen bonds on P.+ in
      the mutant HL(M202), which contains a BChlL-BPheM heterodimer as the primary
      donor with localized spin on the BChl aL [Bylina, E. J., & Youvan, D. C. (1988)
      Proc. Natl. Acad. Sci. U.S.A. 85, 7226-7230; Schenck, C. C., Gaul, D., Steffen
      M., Boxer S. G., McDowell L., Kirmaier C., & Holten D. (1990) in Reaction Centers
      of Photosynthetic Bacteria (Michel-Beyerle M. E., Ed.) pp 229-238, Springer,
      Berlin] were studied. In this mutant only small local changes of the spin
      densities (< or = 10%) in the vicinity of the hydrogen bonds were observed. The
      effects of the introduced hydrogen bonds on the spin density distribution of the
      dimer in the mutants are discussed in terms of different orbital energies of the
      two BChl a moieties which are directly influenced by hydrogen bond formation. The
      observed changes of the spin density distribution for the double mutants are
      additive with respect to the single mutations.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7794928
TI  - EPR and ENDOR investigation of the primary electron acceptor radical anion QA.-
      in iron-depleted photosystem II membrane fragments.
AB  - Photosystem II (PS II) membrane fragments were treated with trypsin at pH = 7.4
      followed by incubation with o-phenanthroline and lithium perchlorate. This
      procedure removes and/or decouples the non-heme Fe2+ associated with the quinones
      QA and QB in the PS II reaction center (RC). Treatment of such samples (referred
      to as iron-depleted) with sodium dithionite or illumination in the presence of
      dichlorophenol indophenol (DCIP) and sodium ascorbate yielded EPR spectra similar
      to those of the plastoquinone-9 (PQ-9) radical anion generated in organic
      solvents. Q-band EPR yielded the principal values of the g-tensor for PQ-9.- in 2
      propanol and QA.- in PS II. Electron nuclear double resonance (ENDOR) experiments
      were performed both on PQ-9.- in vitro and on QA.- in the iron-depleted PS II
      samples. For the former a complete set of isotropic 1H hyperfine coupling
      constants and hyperfine tensors of the two methyl groups and the alpha-proton
      were obtained. On the basis of H/D exchange experiments two different hydrogen
      bonds could be detected in frozen solution that are formed between the carbonyl
      oxygens of the radical and protons from the surrounding solvent molecules. The
      hydrogen bond distances were estimated using the point-dipole model. 1H-ENDOR
      spectra of QA.- in iron-depleted PS II samples have been measured in buffers made
      in H2O and D2O. The spectrum in deuterated buffer allowed the determination of
      two different methyl group hyperfine tensors. Differences detected between the
      spectra in protonated and deuterated buffer reveal the hyperfine tensors of two
      exchangeable protons belonging to hydrogen bonds between the oxygens of QA and
      specific protein residues. The assignment of these hydrogen bonds in PS II is
      discussed and compared with the situation found in the bacterial reaction center.

PMID- 7794929
TI  - Spinach thylakoid polyphenol oxidase: cloning, characterization, and relation to
      a putative protein kinase.
AB  - A 64-kDa protein was purified from an octyl glucoside/cholate extract of spinach
      thylakoids. N-Terminal analysis yielded 23 residues of sequence, of which the
      first 15 were identical to a sequence reported [Gal, A., Herrmann, R. G.,
      Lottspeich, F., & Ohad, I. (1992) FEBS Lett. 298, 33-35] for a protein kinase
      with specificity toward the photosystem II light-harvesting complex (LHC-II). We
      report the complete sequence of this 64-kDa protein, deduced from cDNA clones.
      The transit peptide has a chloroplast import signal at the N-terminus and a C
      terminal hydrophobic span bounded by basic amino acids that predicts localization
      of the protein to the thylakoid lumen. The mature protein sequence is about 50%
      identical to several polyphenol oxidases (PPOs). Canonical protein kinase motifs
      are absent, as are sequences characteristic of ATP-binding sites. The mature
      protein resembles arthropodan hemocyanin (Hc), possessing three major domains.
      The N-terminal domain is rich in cysteine residues and predicted alpha-helices.
      The central domain has a conserved motif, N-terminal to a presumptive Cu-A site,
      that is not found in tyrosinases or Hc and is proposed as the provider of a third
      imidazole ligand to Cu-A. An unusual 13-residue, glutamine-rich link begins a C
      terminal domain containing 7 predicted beta-strands which, by analogy with Hc,
      may form an antiparallel beta-barrel. We conclude that this 64-kDa polypeptide is
      a lumenal PPO and the precursor of a 42.5-kDa PPO form described previously
      [Golbeck, J. H., & Cammarata, K. V. (1981) Plant Physiol. 67, 977-984].(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7794930
TI  - Inhibition of in vitro transcription by a triplex-forming oligonucleotide
      targeted to human c-myc P2 promoter.
AB  - Triplex-forming oligonucleotides (TFOs) have been shown to bind in a sequence
      specific manner to polypurine/polypyrimidine sequences in several human gene
      promoters, including the c-myc P1 promoter. TFOs have been shown to inhibit
      transcription in vitro and the expression of target genes in cell culture. The
      human c-myc protooncogene contains a 23 base pair purine-pyrimidine-rich motif (
      62 to -40) within its predominant promoter, P2, that is a potential target for
      purine-purine-pyrimidine triplex formation. Using electrophoretic mobility shift
      analysis (EMSA) and competition experiments, we have demonstrated that a MAZ (myc
      associated zinc finger protein) consensus sequence is capable of competing with
      the purine-pyrimidine motif for the binding of a HeLa nuclear protein. We have
      shown the formation of an intermolecular triplex using a 23-base purine-rich
      oligonucleotide antiparallel to the purine-rich target sequence. DNase I
      footprinting was performed to confirm the exact location of triplex formation.
      Triplex formation by this oligonucleotide prevents binding of a HeLa nuclear
      protein (presumably MAZ) to the target site. We have also shown that the P2
      targeted TFO is a potent and specific inhibitor of c-myc transcription in vitro.
      These data demonstrate that this novel TFO inhibits transcription of the c-myc P2
      promoter. We propose that the P2-targeted TFO has its effect by blocking the
      binding of the regulatory factor MAZ.

PMID- 7794931
TI  - Peptide aldehyde inhibitors of hepatitis A virus 3C proteinase.
AB  - Picornaviral 3C proteinases are a group of closely related thiol proteinases
      responsible for processing of the viral polyprotein into its component proteins.
      These proteinases adopt a chymotrypsin-like fold [Allaire et al. (1994) Nature
      369, 72-77; Matthews et al. (1994) Cell 77, 761-771] and a display an active-site
      configuration like those of the serine proteinases. Peptide-aldehydes based on
      the preferred peptide substrates for hepatitis A virus (HAV) 3C proteinase were
      synthesized by reduction of a thioester precursor. Acetyl-Leu-Ala-Ala-(N,N'
      dimethylglutaminal) was found to be a reversible, slow-binding inhibitor for HAV
      3C with a Ki* of (4.2 +/- 0.8) x 10(-8) M. This inhibitor showed 50-fold less
      activity against the highly homologous human rhinovirus (strain 14) 3C
      proteinase, whose peptide substrate specificity is slightly different, suggesting
      a high degree of selectivity. NMR spectrometry of the adduct of the 13C-labeled
      inhibitor with the HAV-3C proteinase indicate that a thiohemiacetal is formed
      between the enzyme and the aldehyde carbon as previously noted for peptide
      aldehyde inhibitors of papain [Lewis & Wolfenden (1977) Biochemistry 16,4890
      4894; Gamcsik et al. (1983) J. Am. Chem. Soc. 105, 6324-6325]. The adduct can
      also be observed by electrospray mass spectrometry.

PMID- 7794932
TI  - A single substitution in the motif 1 of Escherichia coli lysyl-tRNA synthetase
      induces cooperativity toward amino acid binding.
AB  - The constitutive lysyl-tRNA synthetase (LysRS) of the Escherichia coli strain
      OEL134 differs from the wild-type enzyme by the single substitution of threonine
      208 with methionine. In vitro study of the isotopic [32P]PPi-ATP exchange
      reaction catalyzed by purified T208M LysRS revealed specific features that are
      not observed with the wild-type LysRS: (i) The steady state of the reaction was
      reached after a approximately 1-min lag when the addition of the enzyme was used
      to initiate the reaction. This lag disappeared upon preincubation of the enzyme
      with lysine and ATP. (ii) The variation of the steady state rate as a function of
      the lysine concentration in the assay was sigmoidal (Hill coefficient of 1.65),
      suggesting cooperativity of lysine binding to this dimeric enzyme. The allosteric
      behavior of the mutant enzyme was further established by showing that, at low
      concentrations of lysine, low amounts of cadaverine stimulated T208M LysRS
      activity. T208A LysRS, in which threonine 208 had been changed into alanine by
      site-directed mutagenesis, displayed the same properties as T208M LysRS.
      Remarkably, Thr 208 makes part of the first signature motif of class II aminoacyl
      tRNA synthetases, a motif likely to be involved in the dimerization of the enzyme
      subunits. Therefore, the behavior of the Thr 208 mutants of LysRS supports the
      idea that the dimerization of class II aminoacyl-tRNA synthetases is important
      for an efficient structuration of their active site.

PMID- 7794933
TI  - Mutation of arginine 276 to methionine changes Mg2+ cooperativity and the kinetic
      mechanism of fructose-1,6-bisphosphatase.
AB  - Arginine 276 of porcine liver fructose-1,6-bisphosphatase (FBPase) was mutated to
      methionine by site-directed mutagenesis on the basis of the crystal structure of
      the enzyme [Zhang, Y., Liang, J.-Y., Huang, S., Ke, H., & Lipscomb, W.N. (1993)
      Biochemistry 32, 1844-1857]. The mutant and wild-type forms of the enzyme were
      purified to homogeneity and characterized by circular dichroism spectrometry (CD)
      and initial-rate kinetics. There were no discernible differences between the
      secondary structures of the wild-type and the mutant enzymes on the basis of the
      CD data. Replacement of Arg 276 with methionine caused a significant decrease in
      the enzyme's activity. The kcat for the mutant enzyme was only about 0.67% of
      that of the wild-type enzyme. Most importantly, the mutation caused the total
      loss of cooperativity for Mg2+ and changed the kinetic mechanism to one in which
      the substrate adds to FBPase before Mg2+ and in which all steps equilibrate
      rapidly relative to the conversion of the ternary complex of enzyme, substrate,
      and Mg2+ to products. The Ka for Mg2+ increased by only about 5-fold relative to
      that of the wild-type enzyme. The mutation did not change the Ki for AMP or the
      Hill coefficient of this allosteric inhibitor. The Ki for fructose 2,6
      bisphosphate was increased by 16-fold compared with that of the wild-type enzyme.
      The Km for fructose 1,6-bisphosphate was similar to that of the wild-type enzyme.
      It is concluded that Arg 276 is critical for activity and Mg2+ cooperativity with
      FBPase and it determines the enzyme's kinetic mechanism.

PMID- 7794936
TI  - Interpreting the effects of specific protein modification on antiport coupling
      mechanisms: the case of the aspartate/glutamate exchanger.
AB  - Reaction of two cysteine residues in the aspartate/glutamate carrier of
      mitochondria is reported to abolish exchange but to actuate a passive one-way
      exit of extremely low substrate affinity and specificity, but with the same
      activation energy as antiport (Dierks, T., Salentin, A. and Kramer, R. (1990)
      Biochim. Biophys. Acta 1028, 281-288). This behaviour, reminiscent of a channel,
      becomes understandable when the required control over carrier mobility by the
      substrate is allowed for. Whether the transport mechanism involves a substrate
      site alternately exposed on opposite sides of the membrane or sites
      simultaneously exposed on both sides, and whether the substrate acts by
      converting an immobile carrier conformation to an inherently mobile intermediate
      or by stabilizing the transition state in carrier movement, the same fundamental
      relationship emerges: the ratio of coupled to uncoupled rates (antiport relative
      to net flux) is limited by the ratio of substrate dissociation constants in
      successive carrier conformations, one immobile, the other mobile; the increment
      in the binding energy in the two forms must therefore be large. Shifts in the
      equilibrium between these conformations and shifts in their relative affinities
      for the substrate can account for the properties of the modified transport
      system, which, it is concluded, functions as a carrier, not a channel.

PMID- 7794935
TI  - Characterization of the human glucocorticoid receptor promoter.
AB  - To elucidate the functional elements that are involved in the regulation of the
      human glucocorticoid receptor (hGR) gene, transient expression, DNase I
      footprinting, and gel mobility shift analyses were conducted. We found that the
      hGR promoter region between -700 and +38 bp contained 11 footprinted sites.
      Deletion of the -374 to -183 bp region, which is highly conserved between human
      and mouse (93%), induced a 5-24-fold reduction in promoter activity in HeLa,
      NIH3T3, CV1, and HepG2 cells. Three footprints, FP5, FP6, and FP7, were shown to
      map to this region. In particular, the FP7 site was found to be within the -374
      to -347 bp region. Deletion of this region triggered a significant decline in
      promoter activity in HeLa and NIH3T3 cells but not in HepG2 cells. AP2 was found
      to bind FP7. In HepG2 cells AP2 elicited transactivation of the hGR promoter
      activity. Transfection data revealed that the upstream GC box-rich fragment
      between -700 and -375 bp induced a 4-7-fold activation of the heterologous tk
      promoter in an orientation-independent manner. Our studies demonstrate that
      several transcription factors are involved in regulating GR expression and that
      AP2 could function as an important positive regulator of GR promoter activity.

PMID- 7794934
TI  - Conformational analysis of the xylose-containing N-glycan of pineapple stem
      bromelain as part of the intact glycoprotein.
AB  - The conformational behavior of the N-glycan Man alpha 1-6(Xyl beta 1-2)Man beta 1
      4GlcNAc beta 1-4(Fuc alpha 1-3)GlcNAc beta of stem bromelain as part of the
      intact glycoprotein was investigated and compared with that of the same N-glycan
      as part of a bromelain-derived glycopeptide. Proton chemical shifts of the
      glycoprotein N-glycan were determined by 2D HOHAHA and 2D NOESY measurements,
      making use of the glycopeptide 1H NMR data. During each 2D NMR experiment about
      4% of the glycoprotein denatured. Experimental data concerning interproton
      distances of the intact glycoprotein N-glycan were obtained by NOESY 1H NMR
      spectroscopy. Several theoretical models for the N-glycan, obtained by molecular
      dynamics simulations of the glycopeptide, were investigated. Comparison of
      experimental and theoretical NOESY cross peak intensities was performed with the
      program CROSREL. In comparison with the glycopeptide, the distribution of
      populations between two main conformations of the Fuc alpha 1-3GlcNAc linkage was
      altered. In addition, the omega = 60 degrees (gt) rotamer of the Man alpha 1-6Man
      linkage seems to be present for a significant period of time, whereas in the
      glycopeptide the omega = -60 degrees (gg) conformation exists exclusively. Except
      for the Xyl beta 1-2Man linkage, the mobilities around the glycosidic linkages in
      the glycoprotein were reduced compared with those in the glycopeptide, especially
      concerning the Fuc alpha 1-3GlcNAc and Man alpha 1-6Man linkages. These findings
      might be the result of an interaction of the polypeptide chain with the Fuc
      alpha/Man alpha side of the N-glycan. A qualitative analysis of the NMR spectra
      showed a larger degree of mobility in the denatured glycoprotein N-glycan than in
      the intact glycoprotein.

PMID- 7794937
TI  - Preferential association of membrane phospholipids with the human erythrocyte
      hexose transporter.
AB  - This study reports the results of an investigation to determine to what extent
      the influence of membrane lipids on the human erythrocyte sugar transporter
      protein activity (Caruthers, A. and Melchior, D.L. (1988) Annu. Rev. Physiol. 50,
      257-271) is related to lipid/protein associations in the membrane bilayer.
      Differential scanning calorimetry was carried out on the human erythrocyte
      transport protein reconstituted into artificial bilayers formed from preselected
      lipids. it was found that the transport protein displays a preferential and in
      some cases strongly preferential affinity for specific lipid types. This
      association is a function of lipid head group, backbone and hydrocarbon chain
      length. It appears that the affinity of the transport protein for various lipids
      can correlate with the lipid's ability to influence transporter activity. This
      study further suggests that certain lipids (in this case sphingomyelin) can
      induce an oligomeric association of HEST monomers in the bilayer.

PMID- 7794938
TI  - Structural interactions between alpha- and beta-subunits of the gastric H,K
      ATPase.
AB  - Structural and functional interactions between alpha- and beta-subunits of the
      H,K-ATPase were explored. The sensitivity to trypsinolysis of alpha-subunit was
      monitored by SDS-PAGE in control H,K-ATPase-enriched microsomes and in microsomes
      in which disulfide bonds of the beta-subunit were reduced using 2-mercaptoethanol
      (2-ME). Reduction of beta-subunit disulfide bonds increased the susceptibility of
      the alpha-subunit to tryptic digestion. Kinetics of trypsinolysis were also
      carried out in the presence of ligands known to bind with H,K-ATPase and favor a
      particular conformer state in the native enzyme. The time-course for release of
      tryptic peptides was monitored in protein stained gels and Western blots probed
      with monoclonal antibody alpha-H,K,12.18. In control preparations, where beta
      subunit disulfides remained intact, trypsinolysis in the presence of ATP or K+
      produced distinctive patterns of tryptic fragments, each characteristic of the
      conformational states induced by the respective ligand. For 2-ME-treated
      microsomes the altered alpha-subunit was unable to undergo ligand-induced
      conformational changes. The increased susceptibility of the alpha-subunit to
      trypsinization, the change in accessibility of tryptic cleavage sites and the
      inability of the alpha-subunit to undergo ligand-induced conformational changes
      after reduction of the beta-subunit disulfides suggest that the interactions
      between alpha- and beta-subunits are important for the conformational stability
      of the functional holoenzyme. A model localizing the most susceptible tryptic
      cleavage sites in control and 2-ME-reduced states is presented.

PMID- 7794940
TI  - Characterisation of endoplasmic reticulum and plasma membrane Ca(2+)-ATPases in
      pancreatic beta-cells and in islets of Langerhans.
AB  - We have investigated the plasma membrane (PMCA) and endoplasmic reticulum (SERCA)
      Ca(2+)-ATPases involved in active transport of Ca2+ in pancreatic beta-cell lines
      (MIN6, HIT T15, RINm5F) and in islets of Langerhans. Under selective membrane
      phosphorylation conditions (at low ATP concentration, in the presence of Ca2+ and
      La3+ and in the absence of Mg2+ at 4 degrees C) the only labelled proteins are
      the phosphoenzyme intermediates of the Ca(2+)-ATPases. Under these conditions,
      beta-cell membranes incorporated 32P from [gamma-32P]ATP into two proteins with
      molecular mass on acidic SDS-polyacrylamide gels of around 115 and 150 kDa. The
      150 kDa band was identified as PMCA (i) by reaction with a monoclonal anti-human
      erythrocyte plasma membrane Ca(2+)-ATPase antibody; (ii) by its typical tryptic
      cleavage pattern which generated an 80 kDa band; (iii) by lack of inhibition of
      its autophosphorylation by SERCA-specific inhibitors. The 115 kDa band was
      identified as SERCA (i) by reaction with a polyclonal anti-rat fast skeletal
      muscle Ca(2+)-ATPase antibody; (ii) by the concentration-dependent inhibition of
      its autophosphorylation by thapsigargin and 2,5-di(t-butyl)-1,4-benzohydroquinone
      (tBHQ), which are specific inhibitors of SERCA. The 115 kDa band was further
      characterised as the SERCA-2b isoform by reaction with a polyclonal rabbit
      antibody against the 12 C-terminal amino acids of SERCA-2b.

PMID- 7794939
TI  - Heme as an optical probe for studying the interactions between calmodulin and the
      Ca(2+)-ATPase of the human erythrocyte membrane.
AB  - The heme group was used as an optical probe to study the interactions between
      calmodulin and its targets: the peptide melittin and the enzyme Ca(2+)-ATPase. As
      already reported, melittin when present in Tris buffer binds hemin-CN which
      quenches the tryptophan fluorescence. Addition of calmodulin restores the
      fluorescence significantly accompanied by a blue shift. We show here that the
      recovery of fluorescence is very slow and takes about 120 min to become constant.
      In a hydrophobic buffer, the fluorescence spectrum of melittin is already shifted
      with a peak at 335 nm and intensity almost 2-fold relative to a similar
      concentration of melittin in Tris buffer. The quenching of tryptophan
      fluorescence is lesser in this buffer and further addition of calmodulin fails to
      restore the fluorescence. This indicates the absence of binding of calmodulin to
      melittin in hydrophobic conditions. Under similar conditions of hydrophobicity,
      hemin-CN quenches about 35% of the tryptophan fluorescence of the Ca(2+)-ATPase.
      The subsequent addition of calmodulin restores about half of the quenched
      fluorescence. The interaction of calmodulin with the Ca(2+)-ATPase even under
      hydrophobic conditions suggests its high specificity for the enzyme which may be
      expected for a physiological target.

PMID- 7794941
TI  - Relation between membrane fluidity and signal transduction in the human
      megakaryoblastic cell line MEG-01.
AB  - The fluidity of the plasma membrane is thought to affect the responsiveness of
      blood platelets. We measured membrane fluidity in a single cell by Fluorescence
      Recovery after Photobleaching (FRAP) of the lipophilic probe DiIC14. Since
      platelets are too small for this technique, we used the human megakaryoblastic
      cell-line MEG-01, which shares many properties with platelets. MEG-01 cells were
      cultured for 44 h with simvastatin or mevalonate to change the cholesterol
      content, enabling analysis of signal processing at cholesterol/phospholipid
      ratios (C/P) between 0.20 and 0.31. The diffusion of DiIC14 correlated inversely
      with the C/P ratio with lateral diffusion coefficients (D) of 3.28 x 10(-9) cm2/s
      at a low C/P decreasing to 2.55 x 10(-9) cm2/s at a high C/P ratio. The mobile
      fraction was 65% and constant at the different C/P ratios. The relation between
      lipid diffusion and signal processing was measured following stimulation with 10
      U/ml thrombin at 22 degrees C. There were only little differences in
      phosphatidylinositol metabolism, Ca2+ influx or mobilization and prostaglandin I2
      induced formation of cyclic AMP. At 37 degrees C, cells with a high C/P ratio
      showed increased phosphatidylinositol metabolism, but these differences had no
      major effect on the Ca2+ responses. These data demonstrate that in
      megakaryoblasts the lateral diffusion of lipids is inversely correlated with the
      C/P ratio, but within the range of 0.20-0.31 the influence on signal processing
      is minor.

PMID- 7794943
TI  - Uptake and passage of beta-lactoglobulin, palmitic acid and retinol across the
      Caco-2 monolayer.
AB  - Caco-2 cell line grown on collagen coated polycarbonate membranes in bicameral
      chambers has been used to study the effect of the binding of palmitic acid or
      retinol on the uptake and passage of iodinated beta-lactoglobulin and albumin
      across cell monolayers. The percentage of beta-lactoglobulin transported through
      the monolayer was higher than that of albumin, about 50% and 30% of the total
      protein after 24 h of incubation, respectively. In all cases, less than 1% of
      protein was retained intracellularly. No differences were found in the uptake and
      transport of beta-lactoglobulin or albumin in the presence or absence of ligands.
      Furthermore, uptake and passage across Caco-2 monolayer of retinol or palmitic
      acid added either bound to beta-lactoglobulin or to albumin have been compared.
      The percentage of retinol found in the lower chamber was about 35% of the total
      retinol after 24 h of incubation for both proteins. However, the amount of
      retinol associated to cells was higher when it was added bound to beta
      lactoglobulin than to albumin, about 26% and 10%, respectively. This fact
      suggests that the metabolic processing of retinol by Caco-2 cells is the rate
      limiting step for retinol transport. The percentage of palmitic acid that crossed
      the monolayer was about 7%, remaining approx. 90% in the cells for beta
      lactoglobulin and albumin. These data support the hypothesis that palmitic acid
      internalized by Caco-2 cells is mainly destined to serve the structural and
      energy needs. These results show evidence of retinol and palmitic uptake by Caco
      2 cells when beta-lactoglobulin or albumin are the donors, and indicate that the
      type of binding protein does not affect the transport of both ligands through
      Caco-2 monolayer.

PMID- 7794942
TI  - Adenine nucleotide binding and photoincorporation in Glanzmann's thrombasthenia
      platelets.
AB  - Adenosine 5'-(1-thiotriphosphate) (ATP alpha S) binds to about 25,000 high
      affinity sites in platelets (Kd approximately 3 nM), competes fully in inhibiting
      the binding of ADP and, despite the absence of a specific photoactivatable
      substituent, is directly photoincorporated into a specific 18 kDa domain
      beginning at Tyr-198 in the alpha chain of glycoprotein IIb (GPIIb alpha)
      following ultraviolet irradiation of fresh unfixed platelets (Greco et al. (1991)
      J. Biol. Chem. 266, 13627-13633). 8-azido ATP has now been shown to have similar
      binding parameters (Kd 8 nM, 20,000 sites/platelet) but, in this case,
      photoincorporation occurred equally in GPIIb and GPIIIa. To determine the
      possible function of GPIIb alpha in ADP-induced activation, platelets were
      isolated from two Glanzmann's thrombasthenia patients whose platelets contain
      approximately 6% of normal levels of GPIIb. ADP and ATP alpha S bound to intact,
      formaldehyde-fixed Glanzmann's platelets at high affinity sites with dissociation
      constants of approximately 30 nM and approximately 2 nM, respectively. Both
      nucleotides also bound to low affinity sites with dissociation constants of
      approximately 2 microM: these values are similar to those obtained with control
      platelets. ATP alpha S antagonized the shape ADP-induced shape change response of
      Glanzmann's platelets (EC50 5 microM) indicating that it bound to the P2T (ADP)
      receptor. However, photoincorporation was low (approximately 7% of control)
      similar to their content of GPIIb alpha. These results show that ADP binding and
      photoincorporation are occurring at different sites on the platelet surface but
      suggest that the ADP binding site may be located in proximity to GPIIb alpha.

PMID- 7794945
TI  - Collateral sensitivity of multidrug resistant cells to narcotic analgesics is due
      to effects on the plasma membrane.
AB  - It has previously been demonstrated that opiates interact directly with P
      glycoprotein in drug resistant Chinese hamster ovary (CHO) cells (Callaghan, R.
      and Riordan, J.R. (1993) J. Biol. Chem. 268, 16059-16064). In this study we have
      examined the effects of several opiates on the growth of drug sensitive and
      resistant CHO and human MCF7 cell lines. The growth of P-glycoprotein expressing
      cells was inhibited by the opiates pentazocine, pethidine and naloxone to a
      greater extent than in drug sensitive cells. Since P-glycoprotein is localised at
      the plasma membrane the effects of opiates on membrane biophysical properties
      were investigated. The opiates caused a fluidizing effect in membranes from P
      glycoprotein expressing cells and decreased the basal level of P-glycoprotein
      phosphorylation. In addition, they were able to increase the leakage of the
      membrane impermeant compound 6-carboxyfluorescein entrapped in model membrane
      vesicles. The ability to alter membrane biophysical properties correlated with
      the inhibitory effects on growth of drug resistant cells. These results suggest
      that the collateral sensitivity of P-glycoprotein expressing cell lines to
      opiates is mediated by the drugs' effects on the plasma membrane.

PMID- 7794944
TI  - Sodium-independent carrier-mediated inositol transport in cultured renal
      epithelial (LLC-PK1) cells.
AB  - In addition to the concentrative, Na(+)-dependent inositol transport system
      demonstrated in many cell types, carrier-mediated, Na(+)-independent inositol
      transport is also shown to exist in LLC-PK1 renal epithelia. Inhibition of
      inositol uptake in Na(+)-free saline by 0.1 mM phloretin, and self-inhibition by
      net concentrations of inositol exceeding 10 mM, demonstrate the carrier-mediation
      of the Na(+)-independent uptake and distinguish it from flux through anion
      channels. The Na(+)-dependent uptake exhibits higher affinity for inositol, as
      seen by the stronger self-inhibition at lower inositol concentrations in Na+
      saline. Kinetic analyses indicate a Km of 178 microM and a Vmax of 2447 pmol/min
      per microgram DNA for the Na(+)-dependent system, whereas the lower affinity,
      lower capacity Na(+)-independent system manifests a Km of 5.2 mM and a Vmax of
      249 pmol/min per microgram DNA. the Na(+)-independent uptake further differs from
      the Na(+)-dependent transport by the lack of inhibitory effect of 10 microM
      glucose, and the greater relative inhibition of phloretin compared to that of
      phlorizin. Both types of uptake appear to localize predominantly to the basal
      lateral cell surface. The Na(+)-independent transport is bidirectional,
      functioning in efflux as well as influx of inositol.

PMID- 7794946
TI  - Proliferation of intracellular membrane structures upon homologous overproduction
      of cytochrome P-450 in Candida maltosa.
AB  - In an alkane-assimilating yeast, Candida maltosa, a cultivation on alkane causes
      both induction of endoplasmic reticulum (ER)-resident membrane proteins, such as
      cytochrome P-450, and proliferation of ER. In this study, individual genes for
      alkane-inducible forms of cytochrome P-450 (P-450alk) were homologously
      overexpressed in C. maltosa using a galactose-inducible expression system
      developed in this yeast. Immunoelectron microscopy revealed that, upon the
      overexpression, a dramatic proliferation of ER occurred, in which overproduced P
      450alk protein accumulated. The proliferated membranes were mainly tubular forms
      and stacks of paired membranes were also observed after prolonged expression. The
      tubular forms were morphologically very similar to the proliferated ER in alkane
      induced C. maltosa cells. The observed proliferation of ER membranes by
      homologous overproduction of P-450alk, here depicted, will provide a unique
      opportunity for investigating the mechanisms by which cells regulate ER
      biogenesis, in comparison with the intrinsic form of ER proliferation.

PMID- 7794947
TI  - Effect of the modifications of ionizable groups of amphotericin B on its ability
      to form complexes with sterols in hydroalcoholic media.
AB  - The interaction of amphotericin B and some of its semisynthetic derivatives with
      cholesterol and ergosterol has been tested in 1:4 (v/v) ethanol/water mixture by
      circular dichroism and absorption spectroscopy. The effect of the chemical
      modification of the 'ionizable head' of the antibiotic, the pH of the medium, and
      the sterol/antibiotic ratio has been studied. The results obtained show that in
      the presence of the sterols, amphotericin B forms several spectroscopically
      different species. A high extent of polyene-sterol interaction is observed for:
      (i) amphotericin B in neutral or acidic media, (ii) esters and amides at neutral
      or alkaline media, (iii) N-acyl derivatives only in acidic medium. The extent of
      interaction at neutral pH is highly correlated with the biological activity of
      compounds tested. The implication of these findings on the nature of the forces
      responsible for the antibiotic-sterol interaction is discussed.

PMID- 7794948
TI  - Modification of fluid lipid and mobile protein fractions of reticulocyte plasma
      membranes affects agonist-stimulated adenylate cyclase. Application of the
      percolation theory.
AB  - The technique of fluorescence recovery after photobleaching was used to measure
      the lateral mobility of membrane integral proteins in reticulocyte plasma
      membranes which were treated to modify the 'fluid' lipid or immobilized protein
      fractions, hence increasing the relative prevalence of obstacles to protein
      lateral motion. This was achieved by either: (1) treating the plasma membranes
      with phospholipase A2 followed by extraction of the hydrolysis products using
      fatty-acid-free bovine serum albumin, resulting in a decrease in the membrane
      'fluid' lipid portion; or (2) preincubating the plasma membranes with
      polylysines, resulting in plasma membrane protein aggregation and immobilization.
      As the prevalence of obstacles to lateral motion increased in plasma membranes
      through the treatments described above, the mobility of the membrane integral
      proteins diminished. Experimental results for the dependence of protein mobility
      on the prevalence of obstacles to lateral motion were compared to theoretical
      data in order to verify the applicability of the percolation theory to
      reticulocyte plasma membranes. The influence of a decrease in the 'fluid' lipid
      and an increase in the immobilized membrane protein fractions upon the hormone
      stimulated adenylate cyclase activity has been studied as well. As the 'solid'
      lipid and immobilized membrane protein fractions decreased, both the hormone
      stimulated adenylate cyclase activity and the fraction of beta-adrenergic
      receptors with high affinity to hormone diminished. It was shown that this
      correlation can be caused by a decrease in membrane fraction accessible to the
      movement of the interacting proteins of the adenylate cyclase complex. Hormonal
      stimulation of adenylate cyclase is discussed in terms of the percolation theory.

PMID- 7794950
TI  - Species differences in 5-HT2A receptors: cloned pig and rhesus monkey 5-HT2A
      receptors reveal conserved transmembrane homology to the human rather than rat
      sequence.
AB  - Pig and rhesus monkey 5-HT2A receptor cDNA clones were isolated. The pig and
      rhesus monkey clones encode proteins that share a 94% and 95% homology,
      respectively, with the rat 5-HT2A receptor, and a 97% and > 99% homology,
      respectively, with the human 5-HT2A receptor. Within the transmembrane regions of
      the pig and monkey receptors, the deduced amino acid shows only three differences
      compared to that of the rat and are identical to the human 5-HT2A receptor clone.

PMID- 7794949
TI  - Calcium ions and interactions of pulmonary surfactant proteins SP-B and SP-C with
      phospholipids in spread monolayers at the air/water interface.
AB  - Spread monolayers containing hydrophobic pulmonary surfactant protein, SP-B or SP
      C, or SP-B/SP-C (2:1, w/w), alone or mixed with dipalmitoylphosphatidylcholine
      (DPPC) or dipalmitoylphosphatidylglycerol (DPPG), were formed on saline subphases
      containing calcium ions. Surface pressure-area characteristics of the films of
      the proteins were not affected by the presence of Ca2+ in the subphase. Calcium
      ions did not alter the surface properties of the binary and ternary films of DPPC
      plus either SP-B, or SP-C, or SP-B/SP-C (2:1, w/w). Surface pressure-area
      isotherms for the spread films of DPPG plus hydrophobic surfactant protein were
      Ca(2+)-dependent. The exclusion pressures of SP-B, SP-C and SP-B/SP-C (2:1, w/w)
      from protein-DPPG films in the presence of calcium were lower than the exclusion
      pressures in the absence of Ca2+. The divalent cation appeared to suppress the
      ability of SP-C and SP-B/SP-C (2:1, w/w) to remove phospholipid during squeeze
      out from their mixed films with DPPG. The effects of Ca2+ on the monolayers of
      DPPG plus hydrophobic surfactant proteins were consistent with calcium producing
      diminished lipid-protein interactions, possibly resulting from Ca(2+)-induced
      changes in the ionization state and molecular packing of DPPG.

PMID- 7794952
TI  - Evidence for an essential histidine residue located in the binding site of the
      cysteine-specific lysosomal transport protein.
AB  - Previously, we observed that the activity of the cysteine-specific lysosomal
      transport system increases 7-10-fold between pH 6 and 7.3 to be maximally active
      in the neutral pH range. To understand what factors contribute to this pH
      dependence, different chemical modifying agents were used to probe the nature of
      amino acid residues residing in the transport protein binding site. Diethyl
      pyrocarbonate (1 mM) and N-ethylmaleimide (5 mM) each strongly inactivated
      lysosomal cysteine uptake > or = 88%, whereas dicyclohexyl-carbodiimide (2.5 mM),
      phenylisothiocyanate (2 mM), N-acetylimidazole (33 mM), and phenylglyoxal (2 mM)
      had a moderate to small effect. Maximal inactivation by DEPC occurs within 12-15
      min upon exposure to DEPC concentrations > or = 1 mM. DEPC inactivation is
      consistent with modification of a histidine residue, displaying no inactivation
      at pH < 6, half-maximal inactivation at pH 6.6, and maximal inactivation at pH >
      or = 7.3. The close correspondence of DEPC inactivation to the pH activity curve
      of cysteine uptake suggests the large increase in lysosomal cysteine transport
      activity between pH 6 and 7.3 reflects deprotonation of an essential histidine
      residue. The substrate, L-cysteine (4 mM), fully protects the transport protein
      from DEPC inactivation suggesting that this histidine residue is located in the
      carrier's substrate binding site. Finally, part of the pH dependence of the
      lysosomal cysteine carrier appears to be due to responsiveness to the lysosomal
      transmembrane proton gradient as indicated by lysosomal membrane vesicles which
      display a 1.5-fold greater rate of cysteine uptake when pH 7.4out > pH 5.3in than
      when pH 7.4out = pH 7.4in.

PMID- 7794951
TI  - Cloning of an organ of Corti anion exchanger 2 isoform with a truncated C
      terminal domain.
AB  - We have isolated a cDNA clone from a guinea pig organ of Corti library encoding a
      new isoform of the Anion Exchanger 2 (AE2) protein. This cDNA clone shows an 83
      bp deletion in the region that encodes the membrane domain of AE2. Analysis of
      the overlapping regions of genomic and cDNA clones indicates that the missing
      portion does not correspond exactly to a constitutive exon. The alternate
      splicing process that generates this transcript involves internal donor and
      acceptor sites which introduces a shift in the open reading frame. The resulting
      polypeptide has a conserved cytoplasmic N-terminal domain but the membrane C
      terminal domain has only two of the fourteen membrane spanning regions. An
      affinity-purified antipeptide antibody to the novel C-terminus detects an 89 kDa
      polypeptide which agrees with the molecular mass predicted from the cDNA.

PMID- 7794953
TI  - Molecular mechanism for the relative binding affinity to the intestinal peptide
      carrier. Comparison of three ACE-inhibitors: enalapril, enalaprilat, and
      lisinopril.
AB  - The affinity of three substrates for the intestinal peptide carrier is explained
      based on their three-dimensional (3D) structural data. The kinetic transport
      parameters of three ACE-inhibitors, enalapril, enalaprilat, and lisinopril, have
      been determined in an in vivo system using rat intestine. The observed kinetic
      transport parameters (+/- asymptotic standard error) of enalapril are: 0.81 (+/-
      0.23) mM, 0.58 (+/- 0.37) mumol/h per cm2, and 0.56 (+/- 0.04) cm/h for the half
      maximal transport concentration (KT), the maximal transport flux (Jmax) and the
      passive permeability constant (Pm). Enalaprilat was transported by passive
      diffusional with a Pm of 0.51 (+/- 0.04) cm/h. For lisinopril the kinetic
      transport parameters were 0.38 (+/- 0.19) mM, 0.12 (+/- 0.07) mumol/h per cm2,
      and 0.18 (+/- 0.02) cm/h for KT, Jmax, and Pm, respectively. The affinity of the
      ACE-inhibitors for the intestinal peptide carrier has been evaluated based on
      their ability to inhibit the transport rate of cephalexin. The inhibition
      constants (Ki) of enalapril, enalaprilat and lisinopril were 0.15, 0.28 and 0.39
      mM, respectively. 3D structural analysis of lisinopril using molecular modelling
      techniques reveals that intramolecular hydrogen bond formation is responsible for
      decreased carrier affinity.

PMID- 7794954
TI  - Docosahexaenoic acid-induced alteration of Thy-1 and CD8 expression on murine
      splenocytes.
AB  - Here we test whether the incorporation of docosahexaenoic acid (DHA, 22:6), an (n
      3) fatty acid, into lymphocyte membranes affects the expression of the surface
      proteins Thy-1.2 and CD8. DHA was incorporated into splenocytes by three methods:
      feeding mice diets containing menhaden (fish) oil, fusing splenocytes with DHA
      containing phosphatidylcholine vesicles, and culturing splenocytes with DHA. Thy
      1.2 and CD8 expression were measured by flow cytometry and complement-mediated
      lysis using a panel of monoclonal antibodies. As (n-3) fatty acid incorporation
      into the lymphocytes increased, the expression of one Thy-1.2 epitope and one CD8
      epitope decreased; the expression of two CD8 epitopes increased. Although diet
      induced changes in surface protein expression may result from selective migration
      of cell populations or the diet's effect on protein biosynthesis, fusion with
      lipid vesicles demonstrated that DHA-containing phospholipids can mediate a
      direct and immediate effect. The decrease in Thy-1.2 expression was sustained for
      more than a week after removal of (n-3) fatty acids from the diet, most likely
      due to retention of membrane-bound (n-3) fatty acids. Because Thy-1.2 and CD8
      participate in T cell activation, modulation of their expression by DHA suggests
      that DHA, when serving as a membrane structural element, may alter immune
      function.

PMID- 7794955
TI  - Oleic acid uptake into rat and rabbit jejunal brush border membrane.
AB  - Oleic acid uptake was studied using adult rabbit and rat jejunal brush border
      membrane vesicles. There was a reduction of oleic acid uptake following trypsin
      treatment. Opposing Na+/H+ gradients (inward Na+ and outward H+ gradients)
      increased oleic acid uptake by about 40%, as compared with only an inward Na+
      gradient, only an outward H+ gradient, or the absence of either Na+ or H+
      gradients. The addition of mucin further increased the enhanced uptake of oleic
      acid observed in the presence of opposing Na+/H+ gradients. Amiloride, an
      inhibitor of the Na+/H+ exchanger, reduced by about 40% the uptake of oleic acid
      into sheets of rat jejunum, and this inhibitory effect was observed over a range
      of rates of stirring of the bulk phase. In rabbit jejunal brush border membrane
      vesicles, amiloride reduced oleic acid uptake in the presence but not in the
      absence of opposing Na+/H+ gradients, with a Ki of approx. 36 microM. Thus, oleic
      acid uptake occurs largely by partitioning of the lipid into the brush border
      membrane, influenced by a process which involves the activation of the brush
      border membrane Na+/H+ exchanger.

PMID- 7794956
TI  - Lamellar-phase polymorphism in interdigitated bilayer assemblies.
AB  - Bilayers composed of 1-octadecanoyl-2-decanoyl-sn-glycero-3-phosphocholine
      (C(18)C(10)PC) adopt a mixed-interdigitated gel-phase packing where the short
      chains of the C(18)C(10)PC molecules pack end-to-end while their long chains span
      the entire hydrocarbon width of the bilayer. Calorimetric cooling scans of
      freshly prepared hand-shaken bilayer suspensions of C(18)C(10)PC exhibit a single
      exothermic phase transition at 14.6 degrees C, whereas suspensions incubated at
      temperatures below 2 degrees C for several days exhibit an additional phase
      transition exotherm at 17.9 degrees C. Calorimetric and electron microscopic
      evidence is presented that low-temperature incubation of C(18)C(10)PC bilayer
      suspensions composed of liposomes of heterogeneous size leads to the conversion
      of those liposomes in the suspension below about 0.2 microns in diameter into
      planar lamellar sheets. These lamellar sheets are the origin of the phase
      transition exotherm at 17.9 degrees C, whereas the phase-transition exotherm at
      14.6 degrees C arises from the liposomes in the suspension. We also show that
      phosphatidylcholine bilayer suspensions, induced to interdigitate by ethanol,
      exhibit a similar thermotropic behavior. The implication of these findings for
      the reversibility of interdigitated gel to liquid-crystalline phase transitions
      and the role of phospholipid molecular geometry in the formation of
      interdigitated bilayers are addressed.

PMID- 7794957
TI  - Interaction of free fatty acids with phospholipid bilayers.
AB  - The partition of free fatty acids (FFA) to egg-phosphatidylcholine (egg-PC) and
      egg-phosphatidylethanolamine (egg-PE) vesicles was studied. Upon the addition of
      FFA to the suspension of vesicles, the pH of the aqueous phase changed depending
      on the length and saturation of the FFA hydrocarbon chain, as well as on the
      vesicle composition. The medium pH decreased faster if FFA was added to egg-PE as
      compared to egg-PC vesicles. The fluorescent free fatty acid indicator (ADIFAB)
      was used to measure the amount of FFA remaining in the aqueous phase. Most of the
      FFA added to the suspension of egg-PE vesicles remained in the aqueous phase,
      whereas in the presence of egg-PC vesicles the FFA partitioned preferentially
      into the lipid phase. The amount of FFA incorporated into the lipid bilayers was
      estimated by measuring the changes of pH at the lipid bilayer surface, using
      fluorescein-PE. At high surface concentrations of FFA, decreasing pH at the
      bilayer surface caused the protonation of FFA, and raised the pK of FFA at the
      bilayer surface from 5 to about 7. The partition of FFA in egg-PE vesicles was an
      order of magnitude lower than that in egg-PC vesicles. The incorporation amount
      was determined more by the molecular packing than by the nature of lipid
      headgroups, because steroylcaprioyl-PE, which preferred the bilayer structure,
      behaved more like egg-PC than egg-PE. Understanding FFA partition characteristics
      would help to interpret the hydrolysis measurements of phospholipids, and to
      explain many biological activities of FFA.

PMID- 7794958
TI  - The effect of protoporphyrin on the susceptibility of human erythrocytes to
      oxidative stress: exposure to hydrogen peroxide.
AB  - Binding of protoporphyrin caused a perturbation of the erythrocyte membrane, as
      reflected by a change in cell shape from discoid to echinocyte, and a concomitant
      increase in mean cellular volume and K(+)-loss. Protoporphyrin-induced changes
      could be prevented by the presence of BaCl2, whereas binding of protoporphyrin
      was not affected. Exposure of erythrocytes to hydrogen peroxide leads to K(+)
      leakage and lipid peroxidation. In de presence of protoporphyrin, H2O2-induced
      K(+)-leakage was enhanced, whereas lipid peroxidation was inhibited. The increase
      in H2O2-induced K(+)-leakage by protoporphyrin was not affected by diamide or
      various K+ channel blockers, but could be prevented by the addition of BaCl2. The
      inhibition of lipid peroxidation, on the other hand, was not affected by BaCl2.
      These results indicate that the enhancement of H2O2-induced K(+)-leakage was most
      likely caused by the change in cell shape. Addition of chlorpromazine and
      promethazine, positively charged molecules that induce stomatocytosis, did not
      cause an enhancement of H2O2-induced K(+)-leakage.

PMID- 7794959
TI  - Reconstitution of the Neurospora crassa plasma membrane H(+)-adenosine
      triphosphatase.
AB  - The purified H(+)-ATPase of the Neurospora crassa plasma membrane has been
      reconstituted by a gel filtration method into lipidic vesicles using sodium
      deoxycholate as the detergent. Reconstitution was performed for lipid/ATPase
      ratios ranging from 1000:1 to 5:1 (w/w). Whatever the lipid/ATPase ratio, the
      ATPase molecules completely associate with the lipid vesicles. The ATPase
      specific activity is identical for all proteoliposomes regardless of the
      lipid/ATPase ratio, but the H+ transport decreases at high protein/lipid ratios,
      suggesting that the proteoliposomes are more leaky to H+ as the amount of protein
      inserted into the lipidic membrane increases. Analysis of the fragments generated
      by trypsin proteolysis in the presence and in the absence of MgATP+ vanadate
      indicate that most of the reconstituted ATPase molecules are able to assume the
      transition state of the enzyme dephosphorylation reaction, and are therefore
      functional. The orientation (inside-out or rightside-out) of the ATPase molecules
      in the vesicles is independent of the lipid/ATPase ratio chosen for the
      reconstitution. For all the lipid/ATPase ratios tested, most of the ATPase
      molecules (> 99%) expose their cytoplasmic side to the outside of the
      reconstituted proteoliposomes. The size of the vesicles increases parallel to the
      ATPase amount. Although the H+ leakiness of our preparation at low lipid/protein
      ratios prevents proton pumping measurements, the reconstitution procedure
      described here has the main advantage on other procedures to allow the obtention
      of vesicles at high protein-to-lipid ratios, facilitating further structural
      characterization of the ATPase by biochemical and biophysical techniques.
      Therefore, the procedure described here could be of general interest in the field
      of membrane protein study.

PMID- 7794961
TI  - Dispersion state of phospholipids and fluorescence production with peroxidation
      in organic solvents: investigated by time-resolved fluorescence technique.
AB  - Fluorescent substances were found to be produced efficiently when phospholipids
      containing phosphatidylethanolamine (PE) and linoleic chains were autoxidized in
      non-polar solvents. By using these fluorescent substances as intrinsic probes,
      the dispersion state of phospholipids was investigated in various organic
      solvents. Fluorescence anisotropy decay measurements indicated that the
      aggregation size of phospholipids was much larger in hexane than in chloroform,
      methanol and tert-butyl alcohol. The average diameter of phospholipid aggregates
      in hexane was calculated to be 4-6 nm, which was dependent on the lipid
      composition. A consistent result was obtained when N-(7-nitrobenz-2-oxa-1,3
      diazol-4-yl)-1,2-dihexadecanoyl-sn-gly cer o-3- phosphoethanolamine (NBD-PE) was
      used as an extrinsic probe. Comparison of the fluorescence data with small-angle
      X-ray scattering (SAXS) data suggested that a reverse micellar structure of
      phospholipids formed in hexane. It was shown that phospholipid aggregation
      enhanced the extent of peroxidation as well as the production yield of
      fluorescent substances of phospholipid.

PMID- 7794960
TI  - Correct oligomerization is a prerequisite for insertion of the central molecular
      domain of staphylococcal alpha-toxin into the lipid bilayer.
AB  - Staphylococcal alpha-toxin is a primarily hydrophilic molecule that binds as a
      monomer to target membranes and then aggregates to form amphiphilic oligomers
      that represent water-filled transmembrane channels. Current evidence indicates
      that a region located in the center of the molecule inserts deeply into the
      bilayer. In the present study, we sought to determine whether membrane insertion
      was triggered by the oligomerization process, and whether insertion correlated
      with pore formation. Double mutants of alpha-toxin were prepared in which His-35
      was replaced by Arg, and cysteine residues were introduced at positions 69, 130
      and 186. Substitution of His-35 with Arg rendered the toxin molecules incapable
      of proper oligomerization, so that they remained in nonlytic form after binding
      to membranes. The sulfhydryl groups were labelled with the polarity-sensitive
      fluorescent dye acrylodan. Functionally intact, single mutant toxins containing
      only the cysteine residues were utilized as controls. Measurements of the
      fluorescence emission spectrum of acrylodan were performed for the active and
      inactive alpha-toxin mutants in free solution and in membrane-bound form. The
      collective results demonstrate that proper oligomerization is required for
      membrane insertion of the central region in the alpha-toxin molecule, and that
      lack of insertion correlates with absence of pore formation.

PMID- 7794962
TI  - Identification of antitumor sulfonylurea binding proteins of HeLa plasma
      membranes.
AB  - Plasma membranes of cultured HeLa S cells bound the tritiated antitumor
      sulfonylurea [3H]LY181984 with high affinity (Kd of about 25 nM). The number of
      binding sites, estimated to represent 30 to 35 pmol/mg protein, would represent a
      low abundance protein of the total plasma membrane proteins. The binding proteins
      appeared to contain one or more thiols in the binding site as high affinity
      binding of [3H]LY181984 was reduced by treatment with the covalent thiol blocking
      reagent, N-ethylmaleimide (NEM), or by oxidation with dilute hydrogen peroxide
      but was protected by glutathione or dithiothreitol. Elimination of binding of
      [3H]LY181984 by NEM was prevented by excess unlabeled LY181984 (an active
      sulfonylurea) but less so by excess LY181985 (an inactive sulfonylurea). The
      binding proteins were specifically labeled with thiol reagents following reaction
      of unprotected thiols with unlabeled thiol reagents. Binding proteins at ca. 34
      kDa were labeled. Plasma membrane proteins after solubilization with SDS under
      strongly reducing conditions still bound sulfonylurea. [3H]LY181984 binding to
      plasma membrane proteins resolved on SDS-PAGE correlated as well with proteins in
      the 30-40 kDa range.

PMID- 7794963
TI  - Riboflavin uptake by rat liver basolateral membrane vesicles.
AB  - The present study examined riboflavin (RF) uptake by purified rat liver
      basolateral membrane vesicle (BLMV). Uptake of RF was found to be Na(+)- and pH
      independent in nature. Studies on RF uptake by BLMV as a function of incubation
      medium osmolarity have indicated that the uptake is the result of transport
      (66.5%) into the intravesicular space as well as binding (33.5%) to membrane
      surfaces. The process of RF uptake by BLMV was saturable as a function of
      substrate concentration with an apparent Km of 3.55 +/- 0.70 microM and Vmax of
      39.89 +/- 3.24 pmol/mg protein/5 s, respectively. cis-Addition of unlabeled RF
      and its structural analogs lumaflavin and lumichrome inhibited the uptake of
      [3H]RF while trans-addition of unlabeled RF stimulated the efflux of [3H]RF from
      preloaded vesicles. No effect on RF uptake was found by the membrane transport
      inhibitors probenecid, 4,4-diisothiocyanotostilbene-2,2-disulfonic acid (DIDS)
      and 4-acetamido-4-isothiocyanatostilbene-2,2'-disulfonic acid (SITS). Induction
      of a transient positive intravesicular space led to a slight stimulation of RF
      uptake, while induction of a negative intravesicular space led to a slight
      inhibition in RF uptake. These results demonstrate the existence of a membrane
      associated carrier system for RF uptake by liver BLMV. This system appears to be
      Na(+)- and pH-independent and is influenced to a certain degree by changes in
      transmembrane electrical potential.

PMID- 7794964
TI  - Parasite-induced permeation of nucleosides in Plasmodium falciparum malaria.
AB  - A mechanism which mediates the transport of the nonphysiological nucleoside, L
      adenosine, was demonstrated in Plasmodium falciparum infected erythrocytes and
      naturally released merozoites. L-Adenosine was not a substrate for influx in
      freed intraerythrocytic parasites or in normal human erythrocytes nor was L
      adenosine transported in a variety of cell types including other parasitic
      protozoa such as Crithidia luciliae, Trichomonas vaginalis, Giardia intestinalis,
      or the mammalian cells, Buffalo Green Monkey and HeLa cells. L-Adenosine
      transport in P. falciparum infected cells was nonsaturable, with a rate of 0.13
      +/- 0.01 pmol/microliter cell water per s per microM L-adenosine, yet the
      transport was inhibited by furosemide, phloridzin and piperine with IC50 values
      between 1-13 microM, distinguishing the transport pathway from simple diffusion.
      The channel-like permeation was selective as disaccharides were not permeable to
      parasitised cells. In addition, an unusual metabolic property of parasitic
      adenosine deaminase was found in that L-adenosine was metabolised to L-inosine by
      both P. falciparum infected erythrocytes and merozoites, an activity which was
      inhibited by 50 nM deoxycoformycin. No other cell type examined displayed this
      enzymic activity. The results further substantiate that nucleoside transport in
      P. falciparum infected cells was significantly altered compared to uninfected
      erythrocytes and that L-adenosine transport and metabolism was a biochemical
      property of Plasmodium infected cells and merozoites and not found in normal
      erythrocytes nor any of the other cell types investigated.

PMID- 7794965
TI  - Comparison of phosphatidylcholines containing one or two docosahexaenoic acyl
      chains on properties of phospholipid monolayers and bilayers.
AB  - Docosahexaenoic acid (DHA) is the longest and most unsaturated of the n - 3 fatty
      acids found in membranes. Although a number of membrane properties have been
      demonstrated to be affected by the presence of this fatty acid, its mode of
      action has yet to be clearly elucidated. Prior reports on biological membranes
      have not distinguished the effect of mono-docosahexaenoyl phospholipids from
      those caused by phospholipids containing docosahexaenoic acid in both chains.
      This report compares properties of monolayers and bilayers composed of either 1
      stearoyl-2-linolenoyl-sn-glycero-3-phosphocholine (as a control), 1-stearoyl-2
      docosahexaenoyl-sn-glycero-3-phosphocholine or 1,2-di-docosahexaenoyl-sn-glycero
      3-phosphocholine. When compared to the mono-DHA phosphatidylcholine (PC), the di
      DHA PC occupies a much larger area/molecule, supports a more fluid and permeable
      bilayer, and is less susceptible to peroxidation. Monolayers made from either
      phospholipid are not condensable by cholesterol. We suggest many of the membrane
      properties linked to the presence of DHA may be the result of phospholipids which
      have lost their normal positional selectivity and have incorporated DHA into both
      positions.

PMID- 7794966
TI  - EPR study of annexin V-cardiolipin Ca-mediated interaction in phospholipid
      vesicles and isolated mitochondria.
AB  - The properties of the binding of annexin V to variously composed phospholipid
      vesicles have been studied by applying a recently developed EPR method, using an
      annexin V spin label. By this approach, this protein is seen to bind to acidic
      phospholipid-containing vesicles, as reported, thus confirming the reliability of
      the method. In addition, binding of this annexin to cardiolipin-containing
      vesicles has been studied in more depth, and the protein has been shown to have a
      distinct affinity for this phospholipid. As a cardiolipin-rich natural membrane
      system, mitochondrial membranes and mitoplasts from rat liver were considered,
      and a strong binding of AV to these membranes was observed. Having compared this
      binding with that to phospholipid vesicles, cardiolipin-rich microdomains in the
      mitochondrial membranes are proposed as the putative mitochondrial binding sites
      for annexin V.

PMID- 7794967
TI  - Effect of sphingosine and stearylamine on the interaction of phosphatidylserine
      with calcium. A study using DSC, FT-IR and 45Ca(2+)-binding.
AB  - The lamellar gel to lamellar liquid-crystalline phase transition of
      dipalmitoylphosphatidylserine (DPPS) multilamellar membranes is abolished by the
      presence of Ca2+ at DPPS/Ca2+ molar ratios of 2:1 or lower. However, when
      equimolar sphingosine (SPH) or stearylamine (SA), which are positively charged at
      the pH studied in this work, were included in DPPS vesicles, the phase transition
      of DPPS was still observed by differential scanning calorimetry, even in the
      presence of very high Ca2+ concentrations such as a DPPS/Ca2+ molar ratio of
      1:10. According to that, delta H was similar for samples formed by equimolar DPPS
      and SPH and SA, either in the presence or in the absence of Ca2+, whereas no
      phase transition was observed for the pure phospholipid in the presence of Ca2+
      at molar ratios lower than DPPS/Ca2+ 2:1. 45Ca(2+)-binding experiments showed
      that for DPPS/SPH or DPPS/SA molar ratios of 2:1, only half of the Ca2+ was bound
      to DPPS with respect to pure DPPS, i.e., in the absence of SPH or SA. At
      concentrations of SPH or SA equimolar with DPPS, the Ca2+ binding was nearly
      abolished. The effect of SPH and SA on the the apparent pKapp of the carboxyl
      group of DPPS was also studied in the presence and in the absence of Ca2+ by
      using Fourier transform infrared spectroscopy. The dehydration of the phosphate
      group of DPPS induced by the binding of Ca2+ was followed through the observation
      of the PO2- antisymmetric stretching, and the percentage of dehydrated PO2-
      groups quantitatively assayed. It was again confirmed that, in the presence of
      equimolar concentrations of SPH or SA, Ca2+, at concentrations which are
      saturating for pure DPPS, was not bound at all to DPPS. It was also found that
      the pKapp was considerably shifted to lower values in the presence of the amino
      bases, decreasing from 4.6 in pure DPPS to 2.1 and 2.2 for the equimolar mixtures
      of DPPS with SPH and SA, respectively. These results show that SPH and SA, being
      positively charged molecules anchored in the membrane, are able of preventing the
      binding of positively charged ions such as Ca2+ through an electrostatic charge
      neutralization.

PMID- 7794968
TI  - Analysis of effects of corticotropin, forskolin and fluoride on activity of
      adenylate cyclase of bovine adrenal cortex.
AB  - A mathematical model relating the activity of adenylate cyclase (AC) with
      concentrations of stimulators, equilibrium dissociation constants, specific
      activity and efficacies of AC depending on the states of its binding sites has
      been developed and used for analysis of the data on activation of AC of bovine
      adrenal cortex plasma membranes presented in (De Foresta et al. (1987) FEBS Lett.
      216, 107-112). Equilibrium dissociation constants. chi h and chi l, corresponding
      to high- and low-affinity forskolin-binding sites were estimated to be 0.37 and
      17 microM: these constants characterize forskolin's potency more adequately than
      does ED50, the concentration eliciting half-asymptotic activity of AC.
      Corticotropin does not affect the affinity of AC for forskolin whereas fluoride
      increases this affinity, thus augmenting forskolin's potency. Hormone receptor of
      adenylate cyclase of bovine adrenal cortex has been suggested to have two or more
      binding sites for corticotropin. Some unidentified factor(s) may be responsible
      for the differences found in adenylate cyclase activity in different experiments
      carried out under similar conditions. The model applied for the analysis may be
      thought to be the best means for the moment to relate dose-response dependencies
      with what is known or can be hypothesized about the mechanisms underlying
      activation of adenylate cyclase.

PMID- 7794969
TI  - Interaction of bovine heart pyruvate kinase with phospholipids.
AB  - The interaction between bovine heart pyruvate kinase and liposomes was
      investigated for various phospholipids as function of pH, and salt concentration
      using steady-state kinetics and ultracentrifugation. Liposomes made from
      erythrocyte total lipid fraction and individual phospholipids were used. Pyruvate
      kinase specific activity increases upon the interaction with the phospholipids.
      The activation is specifically sensitive to presence of phosphatidylserine in
      liposomes. L-serine, and phospho-L-serine which are main components of
      phosphatidylserine head group show also some activation effect. Efficient
      adsorption of pyruvate kinase to phosphatidylserine liposomes occurs in the pH
      range 6.0-8.0 and at low ionic strength. Interaction with phosphatidylserine
      liposomes results in the change of Vmax and Km values for phospho enol pyruvate
      without marked effect on Km value for ADP, and Hill coefficients for both
      substrates. The interaction does not seem to influence the cooperativity between
      binding sites.

PMID- 7794970
TI  - Alcohol inhibits the activation of NAD-linked dehydrogenases by calcium in brain
      and heart mitochondria.
AB  - The effect of ethanol on the Ca(2+)-dependent activation of mitochondrial
      dehydrogenases in rat brain and heart mitochondria was investigated. ADP
      stimulated respiration of isolated brain and heart mitochondria (state 3) was
      stimulated further by submicromolar concentrations of free calcium when respiring
      on non-saturating concentrations of NAD-linked substrates. The stimulation of
      oxidative phosphorylation by Ca2+ was correlated with an increase of the
      mitochondrial matrix free calcium concentration ([Ca2+]m), as measured by fura-2,
      and with an increased reduction of the mitochondrial NAD(P) pool, indicating an
      activation of Ca(2+)-dependent dehydrogenases. Sodium inhibited Ca(2+)-dependent
      stimulation of state 3 respiration and NAD(P) reduction as a result of
      stimulation of Ca2+ efflux through the Na+/Ca2+ antiporter which reduced the
      steady-state value of [Ca2+]m. Ethanol stimulated the Na+/Ca2+ antiporter both in
      brain and heart mitochondria. As a result of this stimulation, ethanol, at
      pharmacological concentrations (50-300 mM), enhanced the sodium-dependent
      reduction of [Ca2+]m, and thus attenuated the activation of NAD-linked
      dehydrogenases and the stimulation of oxidative phosphorylation, by submicromolar
      concentrations of Ca2+, both in brain and heart mitochondria. This
      pharmacological effect of ethanol, on brain and heart mitochondria, may be
      responsible, in part, for the acute and chronic effects of ethanol on brain and
      heart function and metabolism.

PMID- 7794971
TI  - Increase in fluidity of human placental syncytiotrophoblastic brush-border
      membrane with advancement of gestational age: a fluorescence polarization study.
AB  - The syncytiotrophoblastic brush-border membrane (BBM) of human placenta plays a
      vital role in the exchange of metabolites between mother and developing fetus.
      The fluidity of this membrane renders its selective permeable character. To meet
      the changing needs of the growing fetus with the progress of gestational age
      changes in the composition and properties of BBM occur. In the present study,
      decrease in cholesterol/phospholipid ratio of BBM indicated an increase in
      fluidity with advancement of gestational age. Measurement of the steady state
      fluorescence anisotropy of labeled liposomes prepared from lipid extract of BBM
      as well as that of labeled BBM vesicles prepared from native BBM shows decrease
      in restriction of the bound dye molecule with increased gestational age. Decrease
      in transition temperature of BBM and enhanced glucose transport through it have
      been observed with advancement of pregnancy.

PMID- 7794972
TI  - Target cell membrane sialic acid modulates both binding and fusion activity of
      influenza virus.
AB  - Influenza virus binds to cell surface sialic acid receptors, and following
      endocytosis fuses with the endosome membrane at low pH. Whether sialic acid plays
      a role in the virus-cell membrane fusion step is not known. We investigated the
      effect of the removal of cell membrane sialic acid on the fusion activity of
      influenza virus (A/PR/8/34 strain) toward human T lymphocytic leukemia (CEM)
      cells at low pH. Fusion was monitored by fluorescence dequenching of
      octadecylrhodamine incorporated in the virus membrane. Removal of sialic acid by
      neuraminidase resulted in a drastic reduction in both viral binding and fusion.
      The association of the virus with neuraminidase-treated cells was enhanced at pH
      5, compared to that at neutral pH, probably due to the unfolding of the
      hemagglutinin and the resulting increase in viral surface hydrophobicity, but the
      fusion capacity of the virus was reduced significantly. The results were analysed
      with a mass-action kinetic model which could explain and predict the kinetics of
      fusion. Our results indicate that binding of influenza virus to sialic acid
      residues on the cell surface leads to rapid and extensive fusion and partially
      inhibits the low pH-induced viral inactivation.

PMID- 7794973
TI  - Electrokinetic charge of the anesthetic-induced bR480 and bR380 spectral forms of
      bacteriorhodopsin.
AB  - The translational and rotational electrokinetics of the anesthetic-induced
      spectral transitions bR568-->bR480-->bR380 of bacteriorhodopsin have been
      investigated. Formation of the bR480 form is associated with an increase of the
      purple membrane negative electrokinetic charge, while the transformation of bR480
      into bR380 is accompanied by a decrease of the membrane negative charge as
      compared to that of the 480 nm-absorbing form. Removal of anesthetics leads to
      the back transitions bR480-->bR568 and (in part) bR380-->bR568; however, the
      electrokinetic charge of the native membranes is not restored. A strong decrease
      in the electric polarizability and the appearance of a slow polarizability
      component are also observed in anesthetic-treated membranes. Comparison with the
      electrokinetic behaviour of partially delipidated membranes and with that of
      liposomes composed of purple membrane total lipids suggests that: (i) anesthetic
      molecules partition mainly at the protein/lipid interface inducing irreversible
      rearrangement of the boundary lipid layer, and (ii) different mode(s) or site(s)
      of interaction are responsible for the spectral and surface charge effects. The
      data are compatible with the hypothesis of anesthetics acting through partial
      dehydration of the membrane surface.

PMID- 7794974
TI  - Arthritis hand function test: inter-rater reliability among self-trained raters.
AB  - OBJECTIVE: The purpose of this project was to examine the inter-rater reliability
      of the Arthritis Hand Function Test (AHFT), a new instrument for measuring hand
      strength and dexterity in adults with arthritis. METHODS: Six occupational
      therapists (two at each of three sites) trained themselves as AHFT administrators
      using the test manual and training videotape. They recruited 30 adult subjects
      (10 at each site) with rheumatoid arthritis or osteoarthritis affecting the
      hands. There were 21 women and 9 men in the sample (mean age, 57.5 years; average
      time since diagnosis, 14.8 years). Subjects were tested twice, once by each rater
      from that site. RESULTS: Inter-rater reliability ranged from 0.45 to 0.99
      (Pearson r). Because subjects were tested twice, AHFT scores were examined for an
      order effect. Although scores on all strength items declined by the second test
      session, and improved for all dexterity items, only the aggregate applied
      dexterity score showed significant change across all three sites (P = 0.002,
      0.001, and 0.031, respectively). CONCLUSIONS: These results suggest the AHFT is a
      reliable instrument for measuring hand strength and dexterity that requires
      minimal training on the part of occupational therapist raters.

PMID- 7794975
TI  - Predictors of hand function in patients with rheumatoid arthritis.
AB  - OBJECTIVES: The aims of this study were to determine: (1) what factors predict
      patient self-estimated hand function; (2) what factors predict actual hand
      function; and (3) the relationship among actual hand function, patient estimates
      of hand function, and self-assessed activities of daily living (ADL). METHODS:
      Fifty-two patients with rheumatoid arthritis completed wrist and hand mobility
      measures, grip strength, pain, stiffness, and estimated hand function tests,
      along with the Sollerman Grip Function Test (actual hand function), Health
      Assessment Questionnaire (HAQ), and subscales of the Arthritis Impact Measurement
      Scales (AIMS). RESULTS: Grip strength and stiffness were the strongest predictors
      of self-estimated hand function. Flexion and extension deficits in digits II
      through V were the strongest predictors of actual hand function. Actual hand
      function and self-estimated hand function were significantly correlated with each
      other and with the HAQ and AIMS subscales. CONCLUSIONS: Measures of deficit are
      the most useful in predicting actual hand function, whereas measures of strength
      and flexibility are most useful for estimated hand function.

PMID- 7794976
TI  - ARHP: poised for the future.

PMID- 7794977
TI  - Reliability and validity of the CSSRD functional assessment survey in rheumatoid
      arthritis. Cooperative Systematic Studies of Rheumatic Diseases.
AB  - OBJECTIVE: To demonstrate the reliability and validity characteristics of a fast,
      intensively focused functional assessment questionnaire that has been used in
      rheumatoid arthritis clinical trials by the Cooperative Systematic Studies of
      Rheumatic Diseases group (CSSRD). METHODS: Data from three double-blind,
      controlled clinical trials by CSSRD were used to examine the properties of the
      Functional Assessment Survey as a measure of physiologic function. RESULTS: The
      Functional Assessment Survey has reasonable test-retest reliability and
      convergent validity with the Steinbrocker et al. functional class. It
      demonstrated appropriate divergent validity with other clinical measures of
      response, as well as discriminant validity. CONCLUSIONS: The CSSRD Functional
      Assessment Survey is brief, intensive, and focused. Reliability and validity
      characteristics have been documented.

PMID- 7794978
TI  - The sense of coherence scale in patients with rheumatoid arthritis.
AB  - OBJECTIVE: To analyze Antonovsky's Sense of Coherence (SOC) Scale, in 828
      patients with rheumatoid arthritis (RA) from 15 private rheumatology practices.
      This scale is designed to evaluate strengths within individuals that allow them
      to select appropriate strategies to deal with stressors; both the total 29-item
      (SOC-29) total scale and a 13-item (SOC-13) short form of the 29-item scale were
      analyzed. METHODS: Data were collected through mailed self-report questionnaires
      as a component of a long-term monitoring program. Internal consistency was
      evaluated according to Cronbach's alpha. Split-halves reliability was estimated
      according to the Spearman-Brown prophecy formula. Associations of the SOC-29 and
      the SOC-13 scale scores with demographic, clinical, and psychological variables
      were analyzed according to Pearson product moment correlations. RESULTS: Lower
      SOC-29 and SOC-13 scale scores were correlated significantly with higher scores
      for difficulty in performing activities of daily living (ADL), a visual analog
      pain scale score, global health status, and perceived learned helplessness. The
      levels of correlation for these variables suggest that each measure represents a
      construct that differs from the SOC. Lower scale scores were also correlated
      significantly with fewer years of formal education, adjusted for age, sex, and
      disease duration. CONCLUSIONS: The SOC-29 and SOC-13 scales are reliable and
      valid in patients with RA. The SOC scale explained in part variation in clinical
      status in patients with RA. The SOC-13 provides utility comparable to the SOC-29
      in patients with RA.

PMID- 7794979
TI  - Predicting pain among children with juvenile rheumatoid arthritis.
AB  - OBJECTIVE: Children and adolescents with juvenile rheumatoid arthritis (JRA)
      often report pain as a major symptom that affects their daily activities. Little
      is known about the factors that contribute to pain, however. Demographic, disease
      status, and social-psychologic variables were used to predict pain of JRA.
      METHODS: Participants were 37 girls and 23 boys who were 7 to 17 years old.
      Measures included the Hopelessness Scale for Children, the Sadness Scale from the
      Differential Emotions Scale--IV, and the Social Support Questionnaire--Revised. A
      pain visual analogue scale served as the criterion measure. RESULTS: Reported
      pain was modestly correlated with disease duration and age. A hierarchical
      regression indicated that the predictor variables accounted for a modest amount
      of variance in pain scores. CONCLUSIONS: The results suggest that the factors
      contributing to pain in children with JRA are different from those in adults with
      rheumatoid arthritis (RA). Research is needed to identify the psychologic and
      socioenvironmental variables that influence pain among children with JRA.

PMID- 7794981
TI  - Self-efficacy, pain, and physical activity among fibromyalgia subjects.
AB  - PURPOSE: The purpose of this study was to examine the effects of self-efficacy on
      self-report pain and physical activities among subjects with fibromyalgia (FM).
      In addition, descriptive statistics of the Arthritis Impact Measurement Scale
      (AIMS), a measure developed for use with arthritis patients, were reported.
      METHODS: Seventy-nine subjects with FM, as classified by the American College of
      Rheumatology (ACR) criteria, completed the Visual Analogue Scale for Pain, the
      AIMS, and the Arthritis Self-Efficacy Scale. A myalgic score was obtained during
      a tender point evaluation. Hierarchical multiple regression analyses were used to
      assess the effect of self-efficacy on self-report pain and physical activities
      measures after controlling for demographic variables (age, education, and symptom
      duration), disease severity (myalgic scores), and psychological distress
      (negative affect from the AIMS). RESULTS: Higher self-efficacy was associated
      with less pain and less impairment on the physical activities measure after
      controlling for demographic and disease severity measures. CONCLUSIONS: This
      study underscores the unique importance of self-efficacy in understanding pain
      and physical activities impairment.

PMID- 7794980
TI  - Dissatisfaction, disability, and rheumatoid arthritis.
AB  - OBJECTIVES: To investigate dissatisfaction with function in patients with
      rheumatoid arthritis (RA), and to see if dissatisfaction can be adequately
      explained by level of function. METHODS: Fifty patients with RA were assessed for
      disease activity, psychological status, disability, expectation of future
      disability, and satisfaction with both global function and individual activities
      of daily living (ADL). RESULTS: Fifty percent of patients expressed
      dissatisfaction with global function, which correlated more strongly with pain (r
      = 0.474) and psychological status than with function (r = 0.398). Only 10%
      predicted improvement in global function. Seventy-two percent expressed
      dissatisfaction with performing at least one ADL. CONCLUSIONS: Patient
      dissatisfaction with both global function and individual ADL function is high and
      cannot adequately be explained by disability alone. Correlation with pain and
      psychological status implies that modifying these variables (perhaps through
      education programs about pain relief or relaxation) could reduce dissatisfaction.

PMID- 7794982
TI  - Iontophoresis: an overview of the mechanisms and clinical application.

PMID- 7794983
TI  - Evaluation of a community arthritis program in Australia: dissemination of a
      developed program.
AB  - OBJECTIVE: To evaluate the effectiveness of a community-based arthritis education
      program conducted in a number of locations throughout the Sydney, Australia,
      metropolitan area. METHODS: The program, based on earlier work, comprised 6
      weekly sessions of 2.5 hours' duration. The study sample included 175 men and
      women with different types of arthritis, divided into intervention (n = 104) and
      control (n = 71) groups. Five outcome measures were selected to evaluate
      effectiveness of the program: pain perception, knowledge level, self-efficacy,
      disability index, and self-management behavior. RESULTS: The results indicated
      that the program was effective in increasing knowledge level (F[1,222] = 10.3, P
      = 0.001 at 6 weeks; F[1,108] = 7.8, P = 0.006 at 6 months), and a statistically
      significant difference was found in disability satisfaction 6 months after
      intervention (F[1,98] = 5.9, P = 0.01], but no statistically significant
      difference was found in pain perception, self-efficacy, and disability index.
      CONCLUSION: This research supports some of the successful outcomes which follow
      an arthritis education program: increased knowledge level and increased
      disability satisfaction.

PMID- 7794984
TI  - Use of commercially produced elastic wrist orthoses in chronic arthritis: a
      controlled study.
AB  - OBJECTIVE: To examine the efficacy of wrist orthoses on pain, motion, and
      function of the wrist. METHODS: Consecutive patients were randomized to a
      treatment group using wrist orthoses or to a control group using no wrist
      orthoses, in a prospective, controlled, 6-month study. RESULTS: Changes in wrist
      joint variables and general disease activity variables were not statistically
      different between the orthosis group (n = 36) and the control group (n = 33).
      Patients in the orthosis group had 25% and 12% improvements in grip strength and
      pinch grip and 50% reduction in pain while using the wrist orthosis. CONCLUSION:
      Use of wrist orthoses improves function and reduces pain, but has no effects
      after 6 months, compared to a control group, on measures of local or general
      disease activity.

PMID- 7794985
TI  - Physical activity in children with juvenile rheumatoid arthritis: quantification
      and evaluation.
AB  - OBJECTIVE: To measure daily physical activity in patients with juvenile
      rheumatoid arthritis (JRA) and in healthy controls, and to identify variables
      that may influence physical activity in JRA patients. METHODS: Twenty-three
      prepubertal children, ages 5-11 years, with mild to moderate JRA and no prior
      exposure to systemic glucocorticosteroids, were compared to 23 healthy children
      of similar age. Physical activity was measured for 3 days (minimum of one weekend
      day) using 3 standardized methods simultaneously. Total body movement was
      assessed by the Caltrac accelerometer and the University of Cincinnati Motion
      Sensor (UCMS). The Caltrac measured movement in the vertical plane; the UCMS
      measured movement of 10 degrees or more from the horizontal plane. The type and
      intensity of daily physical activity was measured by the 3-day activity record,
      which also recorded the number of hours of daily sleep. Participation and
      duration of involvement in organized sports was ascertained by questionnaire.
      RESULTS: The mean physical activity was significantly lower in JRA patients than
      in controls for the activity diary (P = 0.05). However, daily body movement
      measured by the Caltrac and UCMS were similar for both groups. Differences were
      seen in the number of hours of sleep per day (P = 0.02) and participation in
      strenuous activities (P < 0.01). JRA patients had significantly less
      participation in organized sports (P = 0.01). CONCLUSION: There was less daily
      physical activity by this group of JRA patients than for healthy age- and sex
      matched control subjects.

PMID- 7794986
TI  - Parents of children with rheumatic disease as peer counselors.
AB  - OBJECTIVE: A parent consultant program was established to promote active family
      involvement in the health care process and to provide parent-to-parent support,
      education, and training. METHODS: Parents of children with rheumatic disease were
      hired by 7 pediatric rheumatology centers to serve as role models and advocates
      for other parents whose children attended the clinics. In the clinic, the parent
      consultants provided support, advocacy, and education regarding specific
      nonmedical issues. At the local level, they assisted parents in obtaining
      community-based services, such as individual educational plans at school, local
      physical therapy, or access to recreational resources. RESULTS: Program impact
      was evaluated by an anonymous, mail-response questionnaire sent to parents who
      met with a parent consultant during a clinic visit for their child. Surveys were
      sent within 6 months of the initial parent consultant meeting; 257 questionnaires
      were mailed, 33% were returned. The majority of respondents (87%) felt their
      interaction with the parent consultant was helpful. The general support received
      and the specific information and/or assistance received were found to be equally
      useful by respondents. The majority of respondents (98%) stated they would
      recommend that other parents meet with the parent consultant. CONCLUSION: Parents
      of children with rheumatic disease are effective peer counselors, providing
      general support and specific assistance to enhance family involvement in care.

PMID- 7794987
TI  - Awareness of the prevalence and impact of arthritis: the role of health
      professionals.

PMID- 7794988
TI  - Predicting health care use among older osteoarthritis patients in an HMO.
AB  - OBJECTIVE: To determine factors that predict health care use among members of
      Health Maintenance Organizations (HMOs). Demographic, health, and psychological
      factors were examined simultaneously. METHODS: Participants were HMO members 60
      years of age or older who had osteoarthritis (OA). All participants reported
      symptoms of OA, with 90% of the diagnoses confirmed by evaluation of physician
      records. RESULTS: Age, the presence of other medical conditions, quality of well
      being, and the Health Worries subscale from the Arthritis Impact Measurement
      Scales accounted for 11.2% of the total variance in health care contacts. A model
      including prior health care use, age, quality of well-being, physical impairment,
      and pain accounted for 29.5% of the variance in utilization rates. CONCLUSION:
      The best single predictor of health care utilization was prior use of the system.
      Being older, more impaired, and having lower well-being scores were also
      predictors of health care use.

PMID- 7794989
TI  - Physician visits by rheumatoid arthritis patients: a prospective analysis.
AB  - OBJECTIVE: To examine prospectively, using the behavioral model of health service
      utilization, patient-initiated physician visits, physician-requested visits, and
      visits for disease flares by 270 patients with rheumatoid arthritis (RA).
      METHODS: Four waves of telephone interviews were conducted over 2 years.
      Hierarchical regression analyses were used to assess the relative contributions
      to variance explained by blocks of variables indicating need for care and
      predisposing and enabling factors. RESULTS: Predisposing and enabling factors
      accounted for 50-67% of the explained variance in the 3 types of visits, while
      need accounted only for 33-50%. CONCLUSIONS: Studies seeking to identify factors
      other than need for care that facilitate or inhibit physician visits among RA
      patients are essential to analyzing the costs of care.

PMID- 7794990
TI  - Relative contributions of spousal support and illness appraisals to depressed
      mood in arthritis patients.
AB  - OBJECTIVE: To examine the ability of cognitive appraisals of illness and spousal
      support to modify depressed mood in arthritis patients. METHODS: Psychosocial
      data were collected from 64 married patients with rheumatoid arthritis (RA)
      within 2 years of diagnosis and at an 18-month followup. RESULTS: The interaction
      of challenge appraisals with positive support received from the spouse was
      related to changes in depression over time. There was an increase in depression
      as challenge appraisals increased when accompanied by greater receipt of positive
      support, whereas individuals who did not experience a sense of challenge in
      response to the diagnosis of RA had the lowest levels of residualized depression
      when they also received higher positive support from their spouses at the
      beginning of the study. CONCLUSION: The results are considered in terms of the
      cognitive-behavioral mediation model suggested by Kerns and associates concerning
      the relationship of chronic pain to depression and have implications for
      interventions aimed at arthritis patients and their spouses.

PMID- 7794991
TI  - Health-related quality of life in patients with osteoarthritis in a family
      practice setting.
AB  - OBJECTIVE: To study the impact of osteoarthritis (OA) on all areas of a patient's
      health-related quality of life. METHODS: The Sickness Impact Profile (SIP) was
      administered to a group of patients with OA selected from a family medicine
      setting. The results were compared to a reference population, stratified by age,
      and adjusted for sex. RESULTS: OA was associated with significant impairment, and
      had an important impact on, health-related quality of life in the areas of
      ambulation, body care and movement, emotional behavior, sleep and rest, home
      management, and work, especially in patients ages 41-60. The older patients
      differed less from the controls than did the younger ones. Items that contributed
      to the differences between OA patients and controls were mainly related to
      physical limitations. CONCLUSION: Most dysfunctions related to OA are physical.

PMID- 7794992
TI  - Concordant and discrepant views of patients' physical functioning.
AB  - OBJECTIVE: Although considerable research has been done on patient-physician
      interaction, few studies have examined discrepancies between patients and
      physicians in their assessments of the patient's physical functioning. One recent
      study reports such discrepancies between rheumatologists and 41% of their
      rheumatoid arthritis patients. This article reports data replicating that study
      and examining the relationships between such discrepancies and a number of other
      variables. METHODS: This is a longitudinal study of 158 patients with rheumatoid
      arthritis who were interviewed 4 times over a 2-year period and who reported
      their levels of physical functioning on the Arthritis Impact Measurement Scales.
      At the time of the fourth interview, the rheumatologists rated each patient's
      physical functioning on the revised criteria published by the American College of
      Rheumatology. RESULTS: Rheumatologists' assessments of their patients' physical
      functioning were discrepant with the patient's assessment for 35% of these
      patients. Twenty-seven patients were rated as worse than they rated themselves
      and 28 were rated as better. There were no differences between the concordant and
      the two discrepant groups in demographic or health status characteristics.

PMID- 7794993
TI  - [Profit sharing: a psychiatric management strategy].
AB  - This paper outlines the development and implementation of profit sharing, an
      innovative technique to motivate and empower chronically mentally ill members of
      a psychiatric rehabilitation program. In some ways, this intervention resembles a
      token economy. Members are paid script for program participation, which they then
      exchange for rewards. In contrast to token economies, however, the profit sharing
      system is financed, administered and monitored by program members. This method
      has the advantage of enhancing program participation and involvement by allowing
      members to keep the rewards earned through their own efforts. Data collected over
      a five-year period suggest that profit sharing increases program utilization,
      average daily attendance and the number of positive vocational outcomes.

PMID- 7794994
TI  - [The "Soft Approach": a program of rehabilitation of chronically mentally ill
      elderly patients].
AB  - The authors report on "The Soft Approach", a program for chronic mentally ill
      elderly patients, which they have implemented in a gero-psychiatric unit in New
      York City. Using a professional team, their approach treats the medical problems,
      and the various degrees of dementia encountered, in a positive and coordinated
      effort centered around daily recreational and socializing activities; these
      include off-ward events and outings away from the hospital. The goals of the
      program are increased independence and eventual community living. The importance
      of their medication regime is stressed with patients throughout the program.

PMID- 7794995
TI  - [Introduction of an evaluation strategy in the psychosocial rehabilitation of
      psychiatrically handicapped adults in Belgium: an approach matching programs to
      the needs of beneficiaries].
AB  - This article examines the implementation of an evaluation strategy in a socio
      professional rehabilitation centre. In this project, measuring instruments were
      developed with the double intention of providing a clinical evaluation that would
      be useful for the intervener, as well as ensuring an evaluation of the
      clientele's evolution that would assist in the observation of effects resulting
      from interventions within groups of beneficiaries. Following the first analysis
      of data, which showed that the program had difficulty in retaining its clientele,
      a second study was undertaken to establish the profile of beneficiaries on whom
      the program had a positive impact and those for whom the stay at the centre did
      not provide any significant effects.

PMID- 7794996
TI  - [Social reintegration: a dynamic program to help psychiatric patients acquire
      functional and interpersonal skills].
AB  - Since new mental health policies have been developed, government and community
      based organizations appear to be working closer toward facilitating the social
      reintegration process regarding persons experiencing psychiatric problems. This
      article describes a project which fosters the development of a patient's
      functional and interpersonal skills in a para-hospital environment: supervised
      apartments. The program's objective is to encourage awareness of an individual's
      situation and especially to allow him or her to acquire and experiment a certain
      number of skills for the ultimate purpose of reintegrating the community. This
      project is carried out by the psychiatry department of Notre-Dame Hospital in
      collaboration with the Maison l'Echelon Inc., a non-profit organization that
      manages a group of supervised apartments for psychiatric patients.

PMID- 7794997
TI  - [Single-parent mothers, poverty and mental health: review of the literature].
AB  - The goal of this article is to discuss an overview of literature published from
      1968 to 1993 and dealing with links between single-parenting, poverty and mental
      health. A total of 56 articles were selected based on the most current data
      banks. Results show that the population of single-parent mothers is growing and
      that they are becoming increasingly poor. Of the six mental health variables
      listed by the author, four (psychological distress, self-esteem, perception of
      one's own skills and psychological isolation) clearly demonstrate that single
      parent mothers are in a less healthy mental state than are mothers in two-parent
      families. Results also indicate that self-esteem, distress and psychological well
      being are affected by economic variables. Results therefore vary according to the
      variable being measured. Although single-parent mothers experience more
      psychological discomfort than mothers in two-parent families, they do not seem to
      experience more serious mental health problems. The authors argue that future
      research on the subject should take into consideration a certain number of
      aspects, discussed in the conclusion of this article, which account for links
      between single-parenting, poverty and mental health.

PMID- 7794998
TI  - [From deinstitutionalization to social rejection: the point of view of ex
      psychiatric patients].
AB  - A series of in-depth interviews conducted with ex-psychiatric patients who use
      alternative resources in the area of mental health has revealed several
      manifestations of rejection, stigmatization and discrimination. These are
      experienced as significant and determining with respect to the social integration
      of patients, as well as harmful to their quality of life in the community. Data
      shows that this population suffers from social isolation due to lack of
      communication with community members and from various forms of rejection and
      disparating attitudes on the part of entourage. Their fragile socio-economic
      conditions confine them to live in a sub-culture and at the fringe of society.

PMID- 7794999
TI  - [Rehabilitation and psychotherapy of chronic psychoses. Study of a cognitive
      approach in French speaking countries].

PMID- 7795000
TI  - [An evaluation of multi-faceted program: intervention with violent spouses].
AB  - This article presents the results obtained from a study on the efficiency of a
      treatment program aimed at violent spouses. More particularly, three dimensions
      are evaluated, namely the program's effect on the incidence of violent behaviour
      (physical, verbal, psychological and sexual), on the participant's attitude
      toward the roles of men and women, as well as on the self-esteem of participants.
      Data on the violent behaviour of men was collected from them and from their
      spouses. The study reveals that the program tends to reduce all forms of violence
      and that its maximum efficiency is mostly noticed in the period following the
      program. On a different note, the program is less efficient when basing results
      on women's declarations than on men's. Finally, the program's efficiency varies
      according to the form of violence observed.

PMID- 7795001
TI  - [The biomedical approach and perspectives of medical sociological contributions
      to psychosocial rehabilitation].

PMID- 7795004
TI  - [The integrated approach to social reintegration: beyond "case management" and
      psychosocial rehabilitation].
AB  - Recently in western countries mental health systems are, slowly but
      systematically, adopting case management (CM) as a system of service delivery.
      Nonetheless, case management remains undefined, poorly described and its
      characteristics uncharted and unresearched. Social reintegration is a
      comprehensive model that incorporates strategies of service delivery aimed at
      solving the problems encountered by CM in the maintenance, enhancement of clients
      quality of life and social functioning and, social and community acceptance are
      addressed and issues of costs and collaboration between institutions is explored
      in depth.

PMID- 7795003
TI  - [The power of professionals in rehabilitation: the example of service users'
      group in social care].
AB  - Increasingly the purposes and focus of mental health rehabilitation has turned
      away from a concern to maximise the functioning of individuals towards an
      interest in helping people with mental needs to interact sufficiently well with
      their environment so as to gain independence in everyday life (Wing, 1980).
      Rehabilitation is to be seen, therefore, as a process rather than an event
      (Sheppard, 1984). In other words, rehabilitation not simply a single treatment
      (or fixed series of treatment) but often will be a longer term intervention to
      maintain social functioning and support adaptation. A failure to understand this
      distinction or to translate it into guiding principle which informs all aspects
      of professional practice in psychiatric rehabilitation results in misdirected
      effort (or, worse, in a series of empty rituals which reinforce dependence)
      (Watts and Bennett, 1993; Brandon, 1991). A central question for all the caring
      professions engaged in psychiatric rehabilitation, therefore, is how to utilize
      their skills to enable and support this process.

PMID- 7795002
TI  - [Instrumentalism and psychosocial rehabilitation. Development of methodological
      processes related to the "intermediate spaces"].
AB  - In psychosocial rehabilitation, institutional actors which are not focused on the
      "intermediate space" (term coined by the authors to describe the time-space of
      interpersonal, solution-oriented communication filled by the actor and the
      patient) are faced with an identity crisis and other problems, some of which are
      linked to a instrumental vision of their practice. Such a vision leads to a
      discursive and theoretical approach, yet interferes with potential partnerships.
      Also, it traps open and solution-oriented relational situations by favouring that
      which is focused on acts of a prescriptive and normative nature. This state of
      affairs is encouraged by several factors linked to the actor's status, to health
      policies and to the evaluation of such policies. In future, effective work in
      this "intermediate space" will require that actors use other inductive models on
      which to base their practice which, incidentally, remains at the fringe of social
      care and support.

PMID- 7795005
TI  - [Assertive "case management": a complete evaluation of a hospital based program].
AB  - This study measured the effectiveness of a comprehensive community treatment
      program modeled after an Assertive Case Management structure. It used an
      experimental random assignment design. Over a six month period, patients in the
      ACM program, despite their acute symptoms, had better vocational and social
      outcomes, less symptomatology, lower recidivism and length of hospital stay
      rates. Most revealing was their reported quality of life and lower perceived
      family burden than the hospital program patients. Further, the ACM patients'
      overall treatment costs were lower than the patients in the hospital program.

PMID- 7795006
TI  - [Researchers: at the interstices of institutional and community levels].

PMID- 7795007
TI  - [Working with families in the long-term treatment of schizophrenic disorders].
AB  - The authors present and discuss, within a systems frame of reference, the main
      aspects of family interventions with adults affected by long-term schizophrenic
      disorders involved in psychosocial rehabilitation. Special attention is paid to
      mutual influence between the interventions aimed at individual disability and
      those centered on family attitudes, beliefs and interactional patterns.

PMID- 7795008
TI  - [Suicide in patients with borderline personality disorder].
AB  - Patients with borderline personality disorder present a clinical challenge,
      largely because of their chronic suicidality. Long-term outcome research shows
      that about 10 per cent of borderline patients will eventually complete suicide,
      but that is difficult to predict which patients are at highest risk. There is no
      evidence at present that treatment prevents suicide. Clinical recommendations are
      made, suggesting that suicide prevention should not be the major priority of
      therapy of these patients.

PMID- 7795010
TI  - [Research approaches in the meaning of suicide among teenage Inuit].
AB  - Is it possible to approach the suicide of teenage Inuit in the same way as in
      other communities, especially when taking into account the fact that suicide in
      Inuit is part of their traditions? The issue raised by the author essentially
      concerns the interpretation of data. This article offers new approaches to
      researching the meaning of suicide through a cultural viewpoint of the phenomenon
      and by taking into consideration the socio-political context. The author presents
      a new vision of suicide as an all-encompassing social fact that opens the door to
      more relevant interventions.

PMID- 7795009
TI  - [Suicide in hospitalized patients].

PMID- 7795012
TI  - [The family physician and the suicidal patient].
AB  - As a background for the discussion, a minor literary survey points out the
      potentiality for intervention and prevention of suicide and suicide attempts in
      the primary care setting. The main purpose of this paper is to discuss what
      options this implicates when it comes to improve the family physicians' ability
      to recognize and to handle suicidal signals from the patient. A summary of the
      important papers already published by Rutz and his group in Sweden clearly
      demonstrates the importance of education concerning depressive disorders and
      other immediate matters. The significance of communicative skills of the doctor
      in this clinical situation in undoubted but still mostly unexplored and finally
      this is shortly discussed.

PMID- 7795011
TI  - [The effectiveness of suicide prevention centers].
AB  - The basic services provided by suicide prevention services as well as research on
      the evaluation of these services are reviewed whether there is evidence that the
      services prevent suicide and also how the services might evaluate their internal
      activities. A plea is made for much greater involvement both by scholars and by
      counselors in the evaluation of these services, for only by formulating clear
      goals or hypotheses and examining whether they have been achieved or confirmed
      can we expect to improve the quality and range of suicide prevention services
      offered.

PMID- 7795013
TI  - [Evaluation of long-term effectiveness of a social reintegration program].
AB  - This study evaluates the impact of a rehabilitation program developed by a
      specific unit (304) of Louis H. Lafontaine Hospital to prepare severely disabled
      long-term psychiatric inpatients for discharge. Patients who participated in the
      program were evaluated three years after their discharge and compared to control
      patients paired to them by age, sex and years of hospitalization and discharged
      from other units of the hospital. The results suggest that the rehabilitation
      program, if coupled with an adequately staffed residential environment giving
      patients continuous care, offers a better outcome, at least in the case of the
      severely disabled long-term psychiatric inpatients.

PMID- 7795014
TI  - [Attitude of nursing personnel towards patients with AIDS: impact of an awareness
      program].
AB  - The goal of this study was to evaluate the impact of an awareness program aimed
      at experienced personnel and personnel in training who provide healthcare
      services to patients with AIDS. The purpose of the program was to prepare
      healthcare staff psychically in working with patients. Six groups of
      approximately ten people each watched a video showing a nurse stating her
      concerns about AIDS. After the video, people were encouraged to express their own
      emotions regarding the disease and people suffering from it. Other participants
      making up a control group did not attend the discussion. All subjects (N = 124)
      completed questionnaires on their attitudes and knowledge about AIDS before and
      after the discussion. Results show an improvement of attitudes with respect to
      homosexuality, as well as a better understanding of AIDS. However, these
      observations do not seem to correspond with a more favourable attitude towards
      AIDS patients. An analysis of these discussions reveals that there is a conflict
      between the will to help patients and the feeling of shame when faced with the
      difficulty of showing empathy. As a result, the authors recommend that training
      programs aimed at healthcare personnel be geared to alleviate this conflict.

PMID- 7795015
TI  - [Concrete and illustrative history of disunity in the town of Lille, France].

PMID- 7795016
TI  - [Social networks in a sample of adolescents in Quebec: closeness of relations and
      personal adaptation].

PMID- 7795017
TI  - [Suicide among young male adults in Quebec: psychopathology and utilization of
      medical services].
AB  - Seventy five young male adults between the age of 18 and 35 who had committed
      suicide were compared with 75 male adults still alive matched for age, residence,
      marital and employment status. For each group a principal respondent was
      interviewed in order to reconstitute the psychological profile of each
      individual, as well as their utilisation of health services. This was completed
      by the study of the coroner's reports and the medical records when available. At
      six months the prevalence for all axis I diagnosis was 88.8% for the suicide
      group and 37.3% for the control group. Among the subjects who had committed
      suicide 38.7% were afflicted by major depression, 24% by alcohol dependency and
      28.7% were dependent on drugs. Borderline personalities were present in 28% of
      the suicide group compared to 5% in the control group. Forty five percent (45%)
      of the subjects who had killed themselves had consulted a mental health
      professional in the year preceding the suicide compared to 5% in the control
      group. However, 78.5% of the suicide group had consulted during the same period a
      health professional compared to 73.3% of the controls.

PMID- 7795018
TI  - [Family ecology, social networks and suicidal behavior in the school milieu].
AB  - This article sums up the outcome of a research project conducted in Montreal
      schools in 1987 and 1988, and focusing on how family ecology and social networks
      relate to strong suicidal tendencies among teenagers. Two groups were involved in
      the study: one with 78 suicidal persons, the other with 72 non-suicidal persons.
      Teenagers in each group were interviewed separately. All subjects reported high
      lack of attention from at least one of the two parents. Results also show that
      parents of suicidal teens experience permanent break-ups less frequently in
      comparison to the other group. However, families of suicidal teens tend to
      experience deeper changes in the structure of the family unit following an
      initial separation. With respect to moving, there are no significant differences,
      whether in the number of moves or the important people, have access to as many
      different kinds of support and report the same number of conflicts. In all these
      comparisons, however, suicidal teenagers do name a proportionately higher number
      of adults. This leads the authors to hypothesize that a higher rate of parental
      separation among non-suicidal teens could represent a protective factor rather
      than a vulnerability factor, as is usually suggested. In terms of social
      networks, the fact that suicidal teens seek out adults to a greater degree could
      impede on their socializing with peers and, therefore, on their social
      integration.

PMID- 7795019
TI  - [After suicide: a unique mourning experience?].
AB  - Canada's national task force on suicide suggests that people who mourn a suicide
      make up a group that is itself at risk. Literature shows that mourners of a
      suicide have a suicide rate that is nine times higher than average. While some
      authors suggest that this type of mourning is more intense and of a longer
      duration that for other types of mourning, other authors doubt this hypothesis.
      But what happens in reality? Is suicide mourning truly different from other types
      of mourning? Is it really a unique mourning experience? These are some of the
      questions the authors of this article have attempted to answer. Following an in
      depth review of studies on the matter, the authors conclude that the mourning of
      a suicide encompasses certain characteristics that manifest themselves especially
      in more vulnerable people.

PMID- 7795020
TI  - [Mental disorders and suicide].

PMID- 7795021
TI  - [The impact of suicide on the caregiver].
AB  - Suicide ("the killing of one's self") raises one crucial question: what does the
      manifest desire of death bring out in oneself and in others? For those providing
      care and support who are confronted with the voluntary death of a client or
      patient, the question is particularly difficult to address. Using the story of a
      suicide in an institution, the authors reveal the nature of defense mechanisms at
      play within the group of caregivers. Whether it be a traumatic daze, denial,
      guilt or depression, these individual and collective reactions to the event
      hinder the mourning process and threaten cohesion within the institution. Members
      of an "institution in crisis" must try to relieve their tensions by refraining
      from withdrawal, banalities, being haunted by suicide and implementing pseudo
      solutions. The purpose of such an exercise is especially to avoid the
      cancellation or displacement of necessary thought process about the origins,
      implications and consequences of a suicide taking place within an institution.
      The authors discuss the founding principles and guidelines for group exploration
      of these phenomena. Without this coming-to-terms with the crisis, the authors
      point out that the institution could find itself in a rut where discussion
      focuses only on when and where things went wrong, and how it turned its back on a
      suffering patient.

PMID- 7795022
TI  - Violence in America: an integrated approach to understanding and prevention.
AB  - Violence in our country has reached epidemic proportions, especially among our
      youth. Of 22 industrialized nations, the United States has the highest homicide
      rate among young males 15 to 24 years of age. To reduce the incidence of
      violence, we must radically shift our approach to emphasize prevention and
      intervention. There are several ways of achieving violence reduction through
      these means. The scientific approach requires the determination of causation and
      risk factors to shed light on the patterns of violence and the effects on
      subgroups of the population. Also required is the development of targeted
      programs aimed at specific high-risk populations. In the area of youth violence
      intervention, programs must focus on young children and their parents, often
      children themselves, to prompt appropriate changes in knowledge, skills, and
      attitudes. Community-based programs can go a step further to initiate changes in
      the social environment that will create opportunities for adequate housing, job
      training or employment, or academic achievement. These efforts exemplify the
      notion that violence is not a factor of race, but rather is based on
      socioeconomic factors, particularly poverty and racism.

PMID- 7795023
TI  - Substance abuse and violence: cause and consequence.
AB  - Substance abuse has been associated with violent behavior for many decades. While
      the relationship is the same today as it was in the past, the pervasiveness of
      the association, and the consequences, are more dramatic. There are two ways in
      which substance abuse is related to violence. First, violence can be and is
      perpetrated under the influence of substances, and second, violence related to
      substance abuse stems from the trade in drugs, which is all too often focused in
      poor and underserved communities. The elimination of the market for drugs, and
      thus the reduction in the demand for drugs, will bring about a reduction in
      substance abuse-related violence.

PMID- 7795024
TI  - Proceedings of the 7th National Conference on Health Care for the Poor and
      Underserved. Preventing Violence and Abusive Behavior: A Public Health Agenda.
      Nashville, Tennessee, October 3, 1994.

PMID- 7795025
TI  - The cost of tolerance for violence.
AB  - Our society evinces a high tolerance for violence. This acceptance of certain
      forms of violent behavior is ingrained in the American value system, established
      through our history in the simple struggle to survive. Beginning with the
      colonial era, through the settlement of the western frontier, and during the wave
      of immigrant arrivals, Americans often used violence to establish basic rights.
      Sociobiological explanations of individual violent tendencies focus on genetic
      predisposition established through natural selection--or survival of the fittest-
      while psychoanalytical perspectives define extreme violence as a deviant form of
      natural aggression. On the other hand, criminologists define all violence as
      deviant. In today's society, physical force is considered to be justifiable when
      expressing political dissent and protecting self and property, and less so during
      domestic disputes.

PMID- 7795026
TI  - Domestic violence: Nashville's increased response.
AB  - Nashville is more actively responding to the problem of domestic violence with
      increased efforts on the part of both the courts and police. Two court dockets
      are now devoted solely to domestic dispute cases, with a team of special
      prosecutors assigned to such cases. In another recent move, the Nashville Police
      Department formed a team of 25 police officers trained to specifically deal with
      domestic confrontations. These efforts, together with the growing number of
      support groups for victims and treatment programs for batterers, indicate
      Nashville's commitment to breaking the cycle of domestic violence.

PMID- 7795027
TI  - Moving away from an emergency room mentality: an unorthodox view of the judicial
      role in violence prevention.
AB  - Discussions about the role of the judicial system in dealing with violence focus
      on cases of violent crime. While the criminal courts are an important component
      of any overall violence reduction strategy, the response is largely reactive
      rather than preventive. Family law cases, on the other hand, provide
      opportunities for the provision of prevention and early intervention services to
      families at risk. Such services are critical to successfully address the epidemic
      of violence.

PMID- 7795028
TI  - Research and policy directions in violence: a developmental perspective.
AB  - Violence and violence-related behaviors have become important research and policy
      considerations in the 1990s. Both private and public institutions have assembled
      considerable research associated with male violence directed against children,
      youth, women, and other males. Data currently available indicate that focusing on
      males as perpetrators is an appropriate direction for violence research. In this
      paper, suggestions are offered regarding a developmental-socialization hypothesis
      for further research in the area of male violence.

PMID- 7795029
TI  - Witnessing violence: making the invisible visible.
AB  - In his novel of Black life circa the 1950s, Invisible Man, Ralph Ellison laid
      bare the wasteful, destructive societal consequences of racism. At the close of
      the 20th century, we are faced with the phenomenon of another social problem,
      likewise unresolved and likely to haunt us similarly: urban violence. Following
      Ellison's example, this paper seeks to explore the impact of violence's stark
      invisibility by discussing a research strategy that better explains the
      terrifying phenomenon of violence. In order to comprehend the totality of
      violence, macro- and micro-level variables have to be introduced into the
      research design and measured over time. Therefore, research might best address
      violence if it was designed to include variables of poverty and racism, and was
      more inclusive of research from a broader range of scientific disciplines.

PMID- 7795030
TI  - Prior nonfatal firearm injuries in detainees of a large urban jail.
AB  - Detainees of large urban jails have may health risks including injuries related
      to violence and firearms. A survey of 582 randomly selected detainees entering
      the Cook County Department of Corrections during the summer of 1994 found that 51
      percent had previously entered hospitals for violence-related injuries, and 26
      percent survived prior gunshot wounds. Patterns of firearm injuries were
      different from patterns of violence affecting the general population. Factors
      common to those with prior firearm injuries included witnessing a shooting at an
      early age, tattoos, previous sexually transmitted diseases, easy access to a
      semiautomatic weapon, and prior incarceration. Implications and prevention
      strategies are discussed.

PMID- 7795031
TI  - The National Drug Control Strategy: the first-line approach to decreasing
      violence in our communities.
AB  - The National Drug Control Strategy is designed to address all aspects of drug
      abuse: drug use, drug trafficking, and drug-related crimes. The nine-pronged
      program encompasses efforts at the federal, state, and local levels, forming a
      partnership between government and the private and public sectors. The strategy
      includes prevention initiatives that reduce the demand for drugs; individualized
      treatment programs for high-risk groups; greater community policing efforts to
      reduce violent crimes by drug users and pushers; and education aimed at children
      and adults. It is a national strategy that strives to find solutions at the local
      level.

PMID- 7795032
TI  - Clinical violence intervention: lessons from battered women.
AB  - Attempts to address violence intervention and prevention in clinical practice are
      hampered by the difficulty of creating definitions and categories that accurately
      reflect community experience. Current medical and legal paradigms, for instance,
      do not integrate gendered experience into definitional understanding of domestic
      violence and, consequently, risk the development of systems of care that poorly
      address women's needs. A model of women's experience of domestic violence and key
      elements of clinical intervention are presented. Health and public health
      agencies need to actively integrate an understanding of gender relations in
      violence intervention and prevention.

PMID- 7795033
TI  - Gang violence.
AB  - During childhood and adolescence, the formation of groups or gangs is a normal
      part of the growing process. Playmates, school friends, Boy and Girl Scout troops
      are each examples of the natural inclination to form group attachments that
      provide a stable social outlet. However, gangs, as we now know them, are part of
      the pathological process brought on by the inability to disassociate from
      adolescent groupings, and more frightening, the result of infiltration by
      criminal elements, such as drug dealers, who exert violent influence on
      impressionable youngsters, particularly in major urban areas. The transition of
      gangs from innocent to deadly is due in large part to society's failure to
      respond to the environment that causes their pathology. In order to reverse the
      process, society must engage in programs that reinforce the gang or group
      experience as a positive one by incorporating adult supervision and mentoring as
      essential elements.

PMID- 7795034
TI  - Violence in schools: why--and what can we do about it?
AB  - This paper discusses the causes and effects of the violence that occurs in
      schools. The author explores the notion of need (to be a part of, to belong, and
      to be connected) as it relates to the tendency toward violence, and conversely,
      the association between success in school, which allows for the development of
      positive self-esteem and therein socially acceptable behavior, with a tendency
      toward nonviolence. The paper explains how behavioral factors common to poor and
      disadvantaged students, such as a lack of esteem for self and for their
      educational institution contributes to a failure cycle. The paper also suggests
      that the development of the affective domain, coupled with sensitivity to
      culture, good instruction, and an educational environment that nurtures success,
      leads to an effectively functioning individual with a social, economic,
      political, and ethnic identity.

PMID- 7795035
TI  - Clinical assessment of gang violence risk through history and physical exam.
AB  - Primary-care clinicians can assess gang involvement and gang violence risk during
      the routine history and physical exam. This paper forwards a model for history
      and risk assessment. The objective of creating the model was to develop a
      practical prototype for clinicians to use in this assessment. The history and
      physical exam variables were determined by a study of the etiology and correlates
      of gang membership and gang violence. The history and physical risk assessment
      tool is based on standard patient care algorithms. It works best in a managed
      care setting with a high incentive for violence prevention and cost reduction,
      and where access to a broad range of traditional and nontraditional referral
      sources exists. Representative referrals are discussed.

PMID- 7795037
TI  - Building community capacity to prevent violence through coalitions and
      partnerships.
AB  - This paper will explore the most effective strategic roles that coalitions can
      play in the prevention of complex, entrenched social and health problems such as
      violence, alcoholism, and other substance abuse problems. There is a growing body
      of "wisdom" and research literature that suggests that the most effective role
      for community coalitions and partnerships in terms of prevention is to build the
      capacity of community leaders and their institutions to better serve their
      constituencies. This can be accomplished through the use of the coalition to
      strengthen the enabling or support system for community initiatives. An enabling
      system provides a variety of services, including training and consultation,
      information and referral, networking and local coalition development,
      communication, incentive grants and recognition, information and social
      marketing, resource development, and research and evaluation services. This paper
      also outlines the key internal capacities a coalition will need in order to
      establish this system.

PMID- 7795038
TI  - Street Soldiers: violence prevention over the airwaves, a phenomenon.
AB  - Problems common to inner-city youths such as truancy, drug use, teen pregnancy,
      and the possession of weapons often consign them to a bleak future, one bereft of
      opportunities. Violence, therefore, becomes a means of survival. To break the
      cycle of violence among inner-city youth, it is essential to overcome the
      negative behaviors that give rise to this violence. The Omega Boys Club of San
      Francisco is founded on the notion of the extended family, and provides the
      active support and emotional guidance once found in the home and immediate
      community. Through a three-tiered program of change, the club has developed a
      plan to help stop the violence. This has been extended beyond the Bay Area via a
      radio call-in show called Street Soldiers, in which discussions focus on violence
      in the home and on the streets.

PMID- 7795036
TI  - Physical rehabilitation and violence: initiatives of the National Institute on
      Disability and Rehabilitation Research.
AB  - The paper presents an analysis of violence-related data from the National Spinal
      Cord Injury Database within the context of violence-related projects of the U.S.
      Department of Education's Office of Special Education and Rehabilitative
      Services. The National Spinal Cord Injury Database is managed by the Spain
      Rehabilitation Center at the University of Alabama at Birmingham, which is one of
      13 Model Spinal Cord Injury Care System centers funded under a grant from the
      U.S. Department of Education's Institute on Disability and Rehabilitation
      Research. There are 1,732 cases of spinal cord injury (SCI) due to violence
      enrolled in the database. This enrollment provides a longitudinal sample, an
      analysis of which shows that African American individuals and persons of Hispanic
      origin represent an increasing percentage of new cases, and that an increasing
      percentage of individuals within these populations is incurring SCI as a result
      of violence.

PMID- 7795039
TI  - A comprehensive approach to violence prevention.
AB  - Violence by and against youth has reached horrifying proportions. Debate
      continues about the causes of youth violence and appropriate solutions. This
      paper discusses a comprehensive holistic approach to violence prevention, as
      exemplified by the program at The Door--A Center of Alternatives in New York
      City, an organization that services at-risk youth aged 12 to 21. With a
      multinodal approach, The Door deals with the identified root causes of violence,
      such as the alienation and lack of empowerment experienced by many of today's
      youth, and provides lifeskills training and concrete services related to the
      consequences of poverty, unemployment, low levels of achievement, and
      hopelessness.

PMID- 7795040
TI  - An overview of Tennessee state legislation affecting violence prevention.
AB  - Homicide is the number one cause of death among African American youth, both male
      and female. Largely to blame for Black-on-Black violence is the sense of
      alienation our youth feel from society. To counter this phenomenon of violence it
      is essential to empower youth. Through education and community-based programs we
      can draw them away from the materialistic to the realistic. By banding together
      as mentors to our youth we can provide them with a sense of history and heritage,
      and thereby equip them with the self-identity originating from self-respect.

PMID- 7795042
TI  - Addressing domestic violence in the African American community.
AB  - This paper focuses on the problem of spouse abuse in the African American
      community and discusses intervention programs designed to reduce domestic
      violence. The problem of domestic violence is not new. However, there is
      increased concern about it, such that the criminal justice system has changed its
      policy toward this act. This policy considers domestic violence a crime, and
      arrest the most efficient way to prevent it. Further, providing counseling
      programs to men is one of the efforts some criminal justice departments are now
      using. The two programs discussed in this paper are programs used by the criminal
      justice system. They are designed to prevent repeated domestic violence by
      focusing on the education of conflict resolution to deal with anger, denial, and
      jealousy, and the development of interpersonal skills that assist in channeling
      anger and poor interpersonal communication into positive modes of conduct. Some
      characteristics of batterers are noted.

PMID- 7795041
TI  - "I have a future" comprehensive adolescent health promotion: cultural
      considerations in program implementation and design.
AB  - "I Have a Future" Adolescent Health Promotion Program is a life options program.
      The program uses the Nguzo Saba (seven principles) and African philosophy to
      systematically address violence and attitudes reinforcing the use of violence.
      The Nguzo Saba promotes self-respect, and commitment to and support for
      developing a positive community. Data was collected from four public housing
      developments--two served as match control sites. Adolescents residing in
      neighborhoods in which the program operated had greater acceptance of the Nguzo
      Saba than those in matched communities. Those who perceived themselves as having
      life options engaged in fewer delinquent/violent acts. There was a strong
      negative correlation between the acceptance of the Nguzo Saba and the number of
      reported delinquent/violent behaviors. There was a positive relationship between
      the acceptance of the Nguzo Saba and positive self-concept, psychosocial
      maturity, and clarity of goals.

PMID- 7795043
TI  - The epidemic of youth violence in America: using public health prevention
      strategies to prevent violence.
AB  - Violence is exacting an increasingly heavy toll on individuals across the
      country, causing a marked rise in fear and frustration. However, historical
      attempts to address violence have been both episodic and inconsistent. There has
      not been a comprehensive and coordinated, prevention-oriented approach. Many law
      enforcement experts now agree that violence must be met with solutions from
      disciplines other than law enforcement, those of public health included. These
      experts acknowledge that social conditions such as family stability, education,
      and other societal institutions directly affect the behavior of juveniles and
      thereby the safety of communities. No single strategy, institution, or discipline
      can create the changes needed to reduce violence in America. Preventing violence
      demands not only a long-term commitment but a comprehensive set of strategies and
      new partnerships. These combined efforts must focus on prevention and not solely
      on aggressive responses to violence.

PMID- 7795045
TI  - Vasculitides associated with infections, immunization, and antimicrobial drugs.
AB  - Many pathogenic microbes can induce a complex series of immunologic, endothelial
      cell, and hemorheological activation cascades and dysfunctions and can cause
      interactions of various components of the vessel wall with formed and noncellular
      elements of the blood. These interactions can result in manifold vasculitides.
      This article reviews the pathogenetic, clinicopathologic, and therapeutic aspects
      of infection-related vasculitides; it includes a brief discussion of parasitic,
      drug-related, and immunization-associated vasculitides as well as of the
      infection-related features of vasculitides of the central nervous system, retinal
      vasculitides, ecthyma gangrenosum, and erythema nodosum. Viruses are mainly
      associated with small-vessel vasculitides, whereas bacterial infections affect
      vessels of all sizes, including the aorta. The vasculitides associated with
      fungal infection usually are characterized by erythema nodosum and involve large
      vessels. The search for microbes as causes of or contributors to vasculitides
      should continue. Infectious vasculitides may become increasingly important as the
      number of immunocompromised patients grows.

PMID- 7795044
TI  - Bacterial vaccine vectors and bacillus Calmette-Guerin.
AB  - Recent advances in biotechnology now allow a more modern approach to the
      development of vaccines, particularly that of recombinant vaccines. Bacterial
      vaccine vectors have the advantage over viral vectors in that the former have the
      ability to express a greater number of antigens in different forms. Although no
      recombinant bacterial vaccines are currently in use, bacillus Calmette-Guerin
      (BCG), Salmonella species, and Escherichia coli are being developed as vaccine
      vectors. We review plasmid systems and mutant strains developed for the
      expression of foreign antigens, with particular emphasis on those developed for
      BCG. We describe the development of antigen expression systems as well as the
      immune response elicited by recombinant BCG vaccine strains to bacterial and
      human immunodeficiency virus (HIV) antigens. A modified recombinant BCG carrier
      with selection for the stable maintenance of rDNA is proposed.

PMID- 7795046
TI  - Sclerosing osteomyelitis and Actinomyces naeslundii infection of surrounding
      tissues.
AB  - We present the case of a young man with chronic Actinomyces naeslundii infection
      in the lower leg who underwent a below-the-knee amputation after unsuccessful
      attempts at diagnosing and eradicating the infection. Actinomycetic organisms
      from environmental sources can engender a dense fibrotic tissue response without
      fistulae. Such a response led to a painful, sclerosing, nonsuppurative infection
      of the bone and surrounding tissues in our patient. This clinical picture, at
      least the bony and periosteal reaction, was compatible with Garre's
      osteomyelitis.

PMID- 7795047
TI  - Cytomegalovirus ureteritis as a cause of renal failure in a child infected with
      the human immunodeficiency virus.
AB  - Cytomegalovirus (CMV) infection is common in patients infected with human
      immunodeficiency virus. Hemorrhagic cystitis and tubulointerstitial nephritis
      have been recognized as complications of CMV infection, and these complications
      lead to hematuria and compromised renal function. We describe a case of CMV
      infection of the ureters in a child with vertically acquired human
      immunodeficiency virus infection; the child presented with severe suprapubic
      pain, and prolonged macroscopic hematuria and intermittent acute renal failure
      developed subsequently.

PMID- 7795048
TI  - Bartonella (Rochalimaea) species as a cause of apparent "culture-negative"
      endocarditis.
AB  - Bartonella quintana (formerly Rochalimaea quintana) is a recently recognized
      cause of apparent "culture-negative" endocarditis. We describe a 39-year-old,
      homeless man who developed aortic valve endocarditis caused by B. quintana. He
      had a history of alcoholism and was seronegative for the human immunodeficiency
      virus. We established that B. quintana was the cause of the endocarditis on the
      basis of the isolation of B. quintana from blood cultures, the compatibility of
      histochemical stains of cardiac valve tissue, the reactivity of the polymerase
      chain reaction specific for B. quintana on cardiac valve tissue, and the failure
      to isolate an alternative causative organism despite extensive efforts. This is
      the second report of endocarditis caused by B. quintana and the fourth report of
      endocarditis caused by a Bartonella species. On the basis of the findings of this
      report and those of other recent reports, further study is warranted to determine
      the overall role of Bartonella species in apparent culture-negative endocarditis.

PMID- 7795049
TI  - High-level resistance to aminoglycosides: comparison of community and nosocomial
      fecal isolates of enterococci.
AB  - Fecal carriage of enterococci highly resistant to streptomycin, gentamicin, and
      kanamycin was examined in 64 healthy volunteers with no exposure to hospitals and
      in 53 hospitalized individuals. High-level resistance to streptomycin and
      gentamicin was found in fecal specimens from 3% and 0, respectively, of the
      healthy volunteers and in fecal specimens from 41% and 15%, respectively, of the
      hospitalized individuals. We found that high-level resistance to kanamycin was
      also more common among hospitalized individuals than among healthy volunteers
      (36% vs. 17%). The frequent occurrence of high-level resistance to kanamycin in
      fecal isolates confirms that amikacin is a poor choice when attempting to achieve
      synergistic therapy for enterococcal infections, in particular for those
      infections that are nosocomially acquired.

PMID- 7795051
TI  - Pasteurella multocida tonsillitis: case report and review.
AB  - Pasteurella multocida is frequently part of the normal flora of the nasopharynx
      and digestive tract of several wild and domestic animals. Although P. multocida
      can produce a variety of upper and lower respiratory tract infections, only four
      previous cases of tonsillitis caused by this organism have been reported. We
      present a case of pasteurella tonsillitis in a 30-year-old female who was exposed
      through her cat, which manifested upper respiratory symptoms.

PMID- 7795052
TI  - Varicella gangrenosa with toxic shock-like syndrome due to group A streptococcus
      infection in an adult: case report.
AB  - Varicella gangrenosa is a rare and serious complication of chickenpox that has
      been described in children only. We describe a case of an adult with varicella
      gangrenosa that presented as necrotizing fasciitis of a limb. This infection is
      caused by group A streptococcal superinfection of the skin lesions due to
      chickenpox. It can be misdiagnosed, with fatal consequences. Because of prompt
      recognition and aggressive surgical and medical treatment, the patient survived
      without loss of the affected limb.

PMID- 7795053
TI  - Trichoderma pseudokoningii as a cause of fatal infection in a bone marrow
      transplant recipient.

PMID- 7795050
TI  - Malignant external otitis due to Aspergillus flavus with fulminant dissemination
      to the lungs.
AB  - Malignant external otitis secondary to aspergillus infection is rare, and only 10
      cases have been reported in the literature. Nine of 10 patients responded to
      therapy and survived their infection. There have been no previous reports of
      dissemination of Aspergillus species from the ear to other organs. We describe a
      case of malignant external otitis due to Aspergillus flavus that disseminated
      hematogenously to the lungs. The result was an overwhelming, miliary pulmonary
      infection, which progressed very rapidly to respiratory failure and death.
      Pathological examination of lung tissue revealed multiple microabscesses and
      hyphal elements that had invaded the lung parenchyma from small pulmonary
      arteries.

PMID- 7795054
TI  - Fatal intravascular hemolysis in a patient with Clostridium perfringens
      septicemia.

PMID- 7795055
TI  - Fatal clostridial sepsis in a previously healthy woman.

PMID- 7795056
TI  - Long-term resolution of disseminated Mycobacterium avium complex infection in a
      patient with AIDS.

PMID- 7795057
TI  - Candida parapsilosis prosthetic joint infection unresponsive to treatment with
      fluconazole.

PMID- 7795058
TI  - Active human herpesvirus 6 infection in an adolescent male.

PMID- 7795059
TI  - Teicoplanin selects for Staphylococcus aureus that is resistant to vancomycin.

PMID- 7795061
TI  - Group C streptococcal bacteremia in patients infected with the human
      immunodeficiency virus.

PMID- 7795060
TI  - Clarithromycin-induced hepatotoxicity.

PMID- 7795062
TI  - Breakthrough cerebral toxoplasmosis in patients with AIDS who are being treated
      with clarithromycin.

PMID- 7795063
TI  - Primary coinfection with human immunodeficiency virus and cytomegalovirus
      presenting as acute rhabdomyolysis.

PMID- 7795065
TI  - Prosthetic hip-joint infection due to Listeria monocytogenes.

PMID- 7795064
TI  - Interaction between azoles and amphotericin B in the treatment of candidiasis.

PMID- 7795066
TI  - Meningitis due to lymphocytic choriomeningitis virus: four cases in France.

PMID- 7795067
TI  - Current therapeutic approaches to viral hepatitis.

PMID- 7795068
TI  - Cytomegalovirus infections of the nervous system in patients with AIDS.
AB  - Retinitis due to cytomegalovirus (CMV) infection is a widely recognized
      complication of advanced disease due to human immunodeficiency virus type 1 (HIV
      1). Less appreciated are other neurological manifestations of CMV infection in
      persons with AIDS. Dr. J. Allen McCutchan has comprehensively reviewed the
      various clinical presentations of CMV neurological disease as well as the methods
      of diagnosis, the neuropharmacology of available antiviral agents, the results of
      therapy, and the potential for prevention of these sequela of advanced
      immunosuppression. As the ability to prevent diseases such as Pneumocystis
      carinii pneumonia, bacteremia secondary to Mycobacterium avium, tuberculosis,
      serious fungal infections, and toxoplasma cerebritis is increasing, physicians
      must now treat more HIV-1-infected persons with CMV disease. This AIDS Commentary
      provides a timely update of the current state of our knowledge regarding this
      serious problem.

PMID- 7795071
TI  - Effect of splenectomy on T lymphocyte subsets in patients infected with the human
      immunodeficiency virus.
AB  - A case-control study was conducted at two institutions to determine whether the
      absolute CD4 lymphocyte count or the percentage of lymphocytes bearing the CD4
      marker (i.e., the CD4 percentage) is a more accurate indicator of underlying
      immune status in splenectomized patients infected with human immunodeficiency
      virus (HIV). Each of nine splenectomized HIV-infected cases was matched with six
      nonsplenectomized HIV-infected controls--three matched for CD4 lymphocyte count
      and three for CD4 percentage. In analyses including the eight cases with an
      initial CD4 lymphocyte count of > 200/mm3, controlling for the CD4 count revealed
      differences between cases and controls in terms of CD4 percentage (range, 10%-41%
      and 17%-54%, respectively; P < .01) and Centers for Disease Control and
      Prevention (CDC) clinical stage (P = .06). Controlling for the CD4 percentage
      revealed a significant difference between cases and controls in terms of CD4
      count (range, 396-1,040 and 55-784 cells/mm3, respectively; P < .01) but not CDC
      clinical stage (P > .7). These data suggest that the numerical relationship
      between the CD4 lymphocyte count and the CD4 percentage among splenectomized HIV
      infected patients with more than 200 CD4 cells/mm3 differs from that among
      nonsplenectomized patients. The CD4 percentage appears to be a more accurate
      indicator of the underlying level of immune function in the former group of
      patients.

PMID- 7795069
TI  - Pretreatment regimens for adverse events related to infusion of amphotericin B.
AB  - Infusion-related adverse events (IRAEs) such as nausea, vomiting, fever, chills,
      and thrombophlebitis that are associated with amphotericin B therapy often lead
      clinicians to prescribe a number of adjunctive pretreatment medications in an
      attempt to reduce the incidence and severity of these events. The purpose of this
      study was to determine the incidence of IRAEs during the first week of systemic
      amphotericin B therapy and to identify pretreatment regimens that are effective
      in preventing these IRAEs. Three hundred ninety-seven adult inpatients receiving
      amphotericin B therapy were prospectively monitored, and data regarding IRAEs and
      pretreatment regimens were collected. Of these patients, 282 (71%) developed at
      least one IRAE during the first 7 days of therapy. The IRAEs most commonly
      reported were fever (51% of patients) and chills (28%), followed by nausea (18%),
      headache (9%), and thrombophlebitis (5%). The most common regimens included
      diphenhydramine, a corticosteroid, acetaminophen, and heparin, administered alone
      or in combination with these or other drugs. Overall, common pretreatment
      regimens were similar in efficacy to no pretreatment in the prevention of IRAEs.
      Thus empirical premedication for IRAEs associated with amphotericin B cannot be
      routinely advocated; instead, patients should be treated when symptoms first
      arise and then premedicated for subsequent amphotericin B infusions.

PMID- 7795070
TI  - Leptotrichia buccalis bacteremia in patients treated in a single bone marrow
      transplant unit.
AB  - We describe four cases of bacteremia due to Leptotrichia buccalis (an organism
      that is part of the normal human oral flora) that occurred in a bone marrow
      transplant unit over a 3-month period. All of the patients were neutropenic, all
      had mucositis or esophagitis, and all were receiving antimicrobial prophylaxis
      with ciprofloxacin and vancomycin (drugs to which Leptotrichia is resistant). One
      patient died of adult respiratory distress syndrome; the others had minimal
      symptoms. Pulsed field gel electrophoresis of bacterial DNA digested with Sma 1
      demonstrated a unique banding pattern for each isolate, indicating that the
      isolates belonged to distinct strains. Quantitative gas-liquid chromatography of
      whole-cell free fatty acids confirmed the uniqueness of the strains, obviating
      the need to search for a common source of infection. We postulate that this
      outbreak resulted from antibiotic selection pressure on the oral flora in
      patients who had been compromised by severe neutropenia and mucosal disruption.

PMID- 7795072
TI  - Growth-deficient mycobacteria in patients with AIDS: diagnosis by analysis of DNA
      amplified from blood or tissue.
AB  - Amplification and sequencing of mycobacterial ribosomal RNA genes (16S rDNA) may
      permit the detection of growth-deficient species (i.e., those exhibiting no
      growth or those whose growth is delayed for more than 12 weeks). Of blood samples
      from 26 patients with AIDS and a liver sample from one additional AIDS patient,
      three samples (two of blood and the one of liver) were positive by polymerase
      chain reaction only; cultures of these three samples remained negative for more
      than 12 weeks. Analysis of amplified 16S rDNA from blood revealed a sequence
      characteristic of Mycobacterium genavense in the first case, in which one of many
      previous blood cultures had also been positive for M. genavense. The sequences
      found in the second and third cases were characteristic of Mycobacterium avium.
      The sample from the second patient was a liver biopsy specimen in which acid-fast
      bacilli were visualized; the culture of this specimen yielded M. avium after 7
      months. The third sample was a blood sample from a patient in whom a relapse of
      treated M. avium infection was suspected. These results indicate that
      amplification and sequencing of mycobacterial 16S rDNA may permit early diagnosis
      and provide a rationale for treatment of infections due to growth-deficient
      mycobacteria.

PMID- 7795073
TI  - Relapse of Mycobacterium leprae infection with ocular manifestations.
AB  - A case of ocular leprosy as the manifestation of persistent or relapsed
      Mycobacterium leprae infection approximately 20 years following treatment is
      reported. The clinical and pathological features of this case are described, and
      the molecular methods needed to arrive at the definitive diagnosis are examined.
      If blindness is to be averted, clinicians must have a high index of suspicion for
      the diagnosis of ocular leprosy when anterior segment changes are noted during
      ophthalmologic examination of a patient from an area in which M. leprae is
      endemic. The indolent nature of ocular leprosy may require lifelong surveillance
      and therapy to insure sight preservation.

PMID- 7795075
TI  - Nosocomial acquisition of multiresistant Acinetobacter baumannii: risk factors
      and prognosis.
AB  - To identify risk factors for and prognostic indicators of the nosocomial
      acquisition of multiresistant Acinetobacter baumannii in an intensive care unit,
      we prospectively studied 40 patients: 13 who were infected with this organism and
      27 who were colonized. Isolates were identified by pulsed-field gel
      electrophoresis; the infected/colonized patients were compared with 348
      noninfected, noncolonized patients by logistic regression analysis and with
      matched historical controls in a cohort study. The severity of illness (evaluated
      by the APACHE II score; P < .05) and previous infection (P < .001) were retained
      as independent risk factors for acquiring A. baumannii. Logistic regression
      analysis selected a high APACHE II score (P < .01) and the acquisition of A.
      baumannii (P < .01) as factors independently associated with death. The
      acquisition of A. baumannii was associated not only with high mortality but also
      with a length of stay on the intensive care unit in excess of that due to the
      underlying disease alone; specifically, the attributable mortality was 25%, with
      a risk ratio for death of 2.0 (95% confidence interval, 1.11-3.62), and the
      duration of stay for infected/colonized patients was 10.3 days longer than that
      for controls (P < .001).

PMID- 7795076
TI  - Fatal sepsis due to a beta-lactamase-producing strain of Fusobacterium nucleatum
      subspecies polymorphum.
AB  - A patient with Waldenstrom's macroglobulinemia was treated empirically with
      imipenem for sepsis related to oropharyngeal infection and responded within 24
      hours. When blood cultures yielded Streptococcus agalactiae, the regimen was
      changed to ampicillin and gentamicin. The patient's condition rapidly
      deteriorated, and she died 3 days later. After her death, a strain of
      Fusobacterium nucleatum subspecies polymorphum producing beta-lactamase (PEN-Y;
      group 2a) was isolated from blood cultures. A literature review revealed
      increasingly frequent isolation of beta-lactamase-producing strains of F.
      nucleatum. Thus strains of F. nucleatum isolated from blood and other specimens
      from patients with serious infections should be tested for beta-lactamase
      production.

PMID- 7795074
TI  - Studies on the serodiagnosis of toxoplasmic lymphadenitis.
AB  - The purpose of this study was to determine the value of conventional and newer
      serological tests (toxoplasmic serological profile) in the diagnosis of
      toxoplasmic lymphadenitis (TL). We studied 40 consecutive patients with biopsy
      proven TL. Cervical, axillary, or occipital adenopathy was present in 72.5%, 20%,
      and 7.5% of the patients, respectively. Low-grade fever, fatigue, general
      malaise, or sore throat were present in only 6 (15%) of the 40 patients. A
      positive result for all serological tests was time dependent from the clinical
      onset of lymphadenopathy. The initial serum samples were positive for antibody
      for each patient, as shown by a Sabin-Feldman dye test. Between 3 and 6 months
      after clinical onset of TL, all of the patients had antibody titers of > or =
      1:1,024. The ELISA was positive for IgM antibodies in all of the patients in the
      first 3 months. Detection of IgA or IgE antibodies or an acute pattern in the
      differential agglutination test was helpful in diagnosing TL in those patients
      who had negative, low-positive, or equivocal titers of IgM antibodies (as
      measured by ELISA) after 3 months. A toxoplasmic serological profile on the first
      serum specimen drawn after clinical onset of TL had a sensitivity of 100%. It is
      advisable to obtain such a serological profile in cases of asymptomatic
      lymphadenopathy before biopsy is carried out, especially for those individuals
      who have negative or equivocal IgM antibody titers.

PMID- 7795077
TI  - Fungal liver infection in marrow transplant recipients: prevalence at autopsy,
      predisposing factors, and clinical features.
AB  - To determine the prevalence of fungal liver infection at autopsy in marrow
      transplant recipients, we reviewed autopsy results for the period 1980-1989.
      Cases were compared to randomly chosen autopsied controls without fungal
      infection. Fungal liver infection was found in 67 (9%) of 731 patients. Fungal
      cultures of liver lesions were positive for 34 of 67 patients, most of whom had
      been culture-positive for the same fungal species (largely Candida) during life.
      Multivariate analysis revealed that independent predictors of fungal liver
      infection were deep fungal infection after transplantation (RR, 35), colonization
      or superficial infection after transplantation (RR, 13), and severe liver
      dysfunction caused by veno-occlusive disease of the liver and/or graft-versus
      host disease (RR, 7). Clinical and laboratory findings during the last month of
      life revealed no differences between cases and controls. Liver imaging studies
      performed during the last 15 days of life had a sensitivity of only 18% for
      detecting fungal liver lesions.

PMID- 7795078
TI  - Cutaneous Mycobacterium kansasii infection: case report and review.
AB  - A case of cutaneous Mycobacterium kansasii infection is reported, and 28 similar
      cases are reviewed. Cutaneous infection may resemble sporotrichosis and is often
      associated with systemic illness, immunosuppression, skin pathology, or contact
      with contaminated water. Immunosuppressed patients with M. kansasii infection may
      present with atypical clinical features (such as cellulitis and seroma) and
      atypical histology (absence of granulomas), which may delay diagnosis and
      effective treatment. The incidence of disseminated M. kansasii infection, which
      has a worse prognosis, is higher among immunosuppressed patients. When M.
      kansasii infection is confined to the skin, the disease is usually indolent.
      Chemotherapy with a variety of agents, including traditional antituberculous
      agents as well as erythromycin, minocycline, and doxycycline, has been
      successful, although in vitro resistance to isoniazid and p-aminosalicylic acid
      is common. Reducing the dose of corticosteroids may be a beneficial adjunct to
      therapy for M. kansasii infection.

PMID- 7795079
TI  - Postexposure rabies vaccination during pregnancy: effect on 202 women and their
      infants.
AB  - This prospective study of 202 pregnant Thai women who received postexposure
      treatment for rabies with a tissue culture-derived rabies vaccine and human or
      equine rabies immune globulin revealed an adverse reaction rate similar to that
      seen among nonpregnant Thai patients who received the same treatment. Tissue
      culture-derived rabies vaccines as well as immune globulins are safe to use for
      postexposure prophylaxis during pregnancy. Such treatment should never be
      withheld or delayed if the patient possibly was exposed to rabies.

PMID- 7795080
TI  - Ehrlichiosis--a cause of prolonged fever.
AB  - Human ehrlichiosis is a recently described illness that is thought to be tick
      borne. Most recognized cases of human ehrlichiosis manifest as an acute
      nonspecific febrile illness. The natural history of untreated symptomatic disease
      is largely unknown. Over a 4-year period, we identified 41 cases of human
      ehrlichiosis by serological testing, polymerase chain reaction analysis, or both
      methods. The principal finding for six of the patients was protracted fever. The
      duration of their fevers ranged from 17 to 51 days. At the time of presentation,
      all six patients had clinical features, laboratory features, or both consistent
      with a diagnosis of ehrlichiosis. Polymerase chain reaction analysis helped to
      rapidly confirm the diagnosis for four of five patients tested. The diagnosis of
      human ehrlichiosis should be considered for patients with prolonged fever who
      live in an area of endemicity.

PMID- 7795082
TI  - Epidemiological investigation of infections due to Alcaligenes species in
      children and patients with cystic fibrosis: use of repetitive-element-sequence
      polymerase chain reaction.
AB  - Twenty-one isolates of Alcaligenes species were recovered from the respiratory
      tract of 16 patients at Texas Children's Hospital over a 1-year period. All but
      one were identified as Alcaligenes xylosoxidans; the remaining isolate was
      identified as Alcaligenes faecalis (formerly Alcaligenes odorans). Thirteen of 21
      isolates were from the sputum of eight patients with cystic fibrosis (CF), two of
      whom were persistently colonized. The remaining isolates were recovered from
      intubated children. Patterns produced by repetitive-element-sequence polymerase
      chain reaction (rep-PCR), with use of either repetitive extragenic palindromic
      (REP) or enterobacterial repetitive intergenic consensus (ERIC) primers, showed
      that strains from different patients were distinct. This observation ruled out a
      common-source outbreak. Strains repeatedly cultured from the two persistently
      colonized patients over several months had identical rep-PCR patterns. We
      conclude that, similar to Pseudomonas aeruginosa, Alcaligenes species (most often
      A. xylosoxidans) colonize the respiratory tract of intubated children and of
      patients with CF. Colonization of patients with CF was associated with an
      exacerbation of pulmonary symptoms.

PMID- 7795081
TI  - High incidence of resistance to multiple antimicrobials in clinical isolates of
      Streptococcus pneumoniae from a university hospital in Korea.
AB  - One hundred thirty-one strains of Streptococcus pneumoniae isolated from clinical
      specimens between January 1991 and April 1993 were serotyped and tested for
      susceptibility to 10 antimicrobials by the agar dilution method. Five serotypes
      (6A, 6B, 14, 19F, and 23F) accounted for 67% of all isolates. Seventy percent of
      isolates were not susceptible to penicillin, exhibiting either intermediate
      resistance (37%) or high-level resistance (33%); 82% of isolates from children
      and 59% of those from normally sterile body fluids were resistant to penicillin.
      A significantly increased rate of penicillin resistance (P < .01, Fisher's exact
      or chi 2 test) was associated with hospitalization, an age of < or = 15 years,
      ongoing antimicrobial therapy at the time of isolation of the organism,
      nosocomial acquisition, and several specific serotypes (6, 14, 19F, and 23F). No
      penicillin-resistant strain showed beta-lactamase activity. Various proportions
      of the penicillin-resistant strains also displayed resistance to cefaclor (89%),
      cefotaxime (82%), chloramphenicol (65%), erythromycin (52%), and ciprofloxacin
      (15%), but none was resistant to teicoplanin or vancomycin. The prevalence of
      pneumococcal resistance documented in Korea in this study is among the highest
      figures published to date.

PMID- 7795083
TI  - Herpes simplex virus type 2 meningitis in the absence of genital lesions:
      improved recognition with use of the polymerase chain reaction.
AB  - Herpes simplex virus type 2 (HSV-2) is known to cause aseptic meningitis, which
      can be recurrent. The diagnosis of HSV-2 infection is suggested when meningitis
      occurs simultaneously with genital lesions but may be obscure if genital lesions
      are not present or are not appreciated. Viral culture of the CSF is sometimes
      positive, but it may also be negative, especially in cases of recurrent disease.
      We report three cases of HSV meningitis in young women who did not have a history
      of genital herpetic lesions and for whom genital lesions were not noted on
      presentation. With use of the polymerase chain reaction (PCR), HSV DNA was
      detected in CSF from all three patients. The diagnosis of HSV meningitis was
      further confirmed by a positive culture of CSF in one patient's case and by
      demonstration of intrathecal synthesis of HSV antibodies in a second patient's
      case. The use of PCR can improve the recognition of HSV meningitis in adults
      presenting with aseptic meningitis, even in the absence of herpetic lesions.

PMID- 7795084
TI  - Rapid oral desensitization to trimethoprim-sulfamethoxazole (TMP-SMZ): use in
      prophylaxis for Pneumocystis carinii pneumonia in patients with AIDS who were
      previously intolerant to TMP-SMZ.
AB  - Trimethoprim-sulfamethoxazole (TMP-SMZ) is the drug of choice as prophylaxis for
      Pneumocystis carinii pneumonia in patients with AIDS. However, adverse reactions
      ascribed to TMP-SMZ are common in such patients. We previously described a rapid
      method of oral TMP-SMZ desensitization in patients with AIDS and varying degrees
      of intolerance to the drug. To assess the feasibility, safety, and long-term
      clinical utility of our desensitization protocol, we retrospectively studied 22
      consecutive patients who underwent desensitization. Prior to the procedure each
      of the study subjects had exhibited moderate to severe reactions to TMP-SMZ.
      Desensitization was successfully completed in 19 (86%) of the patients. The three
      patients for whom desensitization failed experienced chills and/or vomiting that
      resolved promptly with symptomatic therapy. One of the 19 patients was
      unavailable for long-term follow-up. Of the remaining 18 patients, three
      discontinued taking TMP-SMZ within 2 weeks of desensitization because of macular
      rash and fever. The other 15 (71%) of the evaluable patients tolerated both
      desensitization and subsequent prophylaxis and took TMP-SMZ for a mean of 14
      months (in some cases, for as long as 41 months). None had P. carinii pneumonia
      while receiving TMP-SMZ. These results indicate that most patients who are
      presumed to be TMP-SMZ-intolerant can be rapidly desensitized with oral TMP-SMZ
      and subsequently receive the drug for protracted periods as effective prophylaxis
      for P. carinii pneumonia.

PMID- 7795085
TI  - Etiology of acute respiratory tract infections among children in a combined
      community and hospital study in Rio de Janeiro.
AB  - We reviewed data collected between January 1987 and December 1989 on the etiology
      of acute respiratory infections (ARI) among 827 children in two low-income
      communities and a hospital in Rio de Janeiro. Respiratory syncytial virus was
      identified in 38% of cases of ARI, influenza A virus in 1%, parainfluenza 3 virus
      in 1%, and multiple viruses in 1%. Respiratory syncytial virus was most prevalent
      among hospitalized children, with seasonal increases in the late fall and winter.
      The principal bacterial pathogens were Staphylococcus aureus, gram-negative
      bacteria, Streptococcus pneumoniae, and alpha-hemolytic streptococci. Specimens
      that were most often positive were pleural fluid (46%) and specimens from other
      normally sterile sites (24%); normally sterile sites included the CSF, trachea,
      and lungs. Urine counterimmunoelectrophoresis for S. pneumoniae and Haemophilus
      influenzae polysaccharide antigens was positive in 3% and 2% of cases,
      respectively. Pharyngeal cultures yielded low numbers of S. pneumoniae and H.
      influenzae organisms and higher numbers of gram-negative bacteria. This study
      demonstrates the high incidence of ARI (4.5 cases per 100 child-weeks) among
      children in Rio de Janeiro and the high morbidity associated with the illness
      (ARI is responsible for 25%-50% of all pediatric hospitalizations) and the fact
      that continued attention must be paid to both viral and bacterial agents of ARI.

PMID- 7795086
TI  - A randomized, double-blind, placebo-controlled trial of selective digestive
      decontamination in a medical-surgical intensive care unit.
AB  - A randomized, double-blind, placebo-controlled trial of selective decontamination
      of the oropharynx and gastrointestinal tract was conducted on 61 intubated
      patients in a medical-surgical intensive care unit (ICU) to determine the impact
      on nosocomial pneumonia, other infections, and emergence of colonization or
      infection with antibiotic-resistant bacteria. Over 8 months, 30 patients received
      an oral paste and solution containing polymyxin, gentamicin, and nystatin; 31
      patients received a placebo paste and solution. At study entry, patients in both
      groups were seriously ill (mean acute physiologic score, 27.2), frequently had
      pulmonary infiltrates (73.8%), and were likely to be receiving systemic
      antibiotics (86.9%). There were no differences between study patients and control
      patients in these characteristics or in frequency of any nosocomial infection
      (50% vs. 55%), nosocomial pneumonia (27% vs. 26%), febrile days (2.3 vs. 2.0),
      duration of antibiotic therapy (14.0 vs. 13.4), or mortality rates (37% vs. 48%).
      There was no difference in infections caused by antibiotic-resistant gram
      negative bacilli, although a trend towards more frequent infection with
      gentamicin-resistant enterococci was found for study patients. Selective
      decontamination did not appear to be effective in our very ill medical-surgical
      ICU patients, although the number of patients in our trial was sufficient to
      detect only a 50% or greater reduction in pneumonia rates.

PMID- 7795087
TI  - Saliva and serum as diagnostic media for antibody to hepatitis A virus in adults
      and in individuals who have received an inactivated hepatitis A vaccine.
AB  - Saliva was evaluated as a diagnostic fluid for screening individuals for evidence
      of previous hepatitis A virus (HAV) infection and for evidence of seroconversion
      after vaccination with inactivated hepatitis A vaccine. A new and simple saliva
      collection method and an assay for detection of HAV antibody were used; the assay
      used an antibody capture format. There was complete concordance between the
      results of saliva-based assays and those of serum-based assays, both of which
      were used for determining previous natural HAV exposure. However, for vaccine
      recipients, 100% concordance for saliva-based and serum-based assays occurred
      only at serum titers of > 9,000 mIU/mL, which were determined with use of the
      modified HAVAB assay. Saliva provides adequate sensitivity and specificity for
      determining naturally acquired HAV infection, although it is not useful in
      clinical trials for determining seroconversion after HAV vaccination.

PMID- 7795088
TI  - Fever of uncertain origin in patients infected with the human immunodeficiency
      virus.
AB  - To assess the frequency and etiology of fever of uncertain origin (FUO) in
      patients infected with the human immunodeficiency virus (HIV) and to evaluate the
      yield of diagnostic procedures used in their evaluation, we reviewed the clinical
      charts of all patients admitted to an AIDS unit during a 15-month period. FUO was
      defined by the endurance of a fever (temperature, > 38.2 degrees C) for at least
      4 weeks before admission and the uncertainty of diagnosis after 3 days, despite
      appropriate investigation. Of 580 patients evaluated, 50 (8.2%) had FUO. Patients
      with FUO were at advanced stages of HIV infection (median CD4+ cell count,
      71/mm3), and a vast majority (84%) had previously diagnosed AIDS. A cause of the
      fever was identified for 44 patients (88%), and infections accounted for 82% of
      all cases. Tuberculosis (42%), visceral leishmaniasis (14%), and disseminated
      Mycobacterium avium complex infection (14%) were the most frequent diagnoses.
      Examination of lymph node aspirates, bone marrow biopsy, and culture of clinical
      specimens for mycobacteria were the procedures with the highest diagnostic yield.
      Among 6 patients with fever of no identified etiology, 4 died while febrile, and
      fever was self-limited in the other 2 patients. FUO is common among patients with
      advanced HIV infection. Since a cause, usually infection, can be identified in
      most patients, long-lasting fever should not be attributed to HIV itself.

PMID- 7795090
TI  - Tuberculous pancreatic abscess as an initial AIDS-defining disorder in a patient
      infected with the human immunodeficiency virus: case report and review.
AB  - Tuberculosis (TB) is the most common opportunistic infection worldwide in human
      immunodeficiency virus (HIV)-infected patients. Intraabdominal TB includes
      lymphadenopathy and focal lesions of solid viscera. Symptomatic expression of
      tuberculous invasion of the pancreas (supplemented by demonstration of a mass on
      imaging) is rare among HIV-infected patients. We report the case of an HIV
      infected patient with a tuberculous pancreatic abscess and review nine similar
      cases. All patients presented with persistent fever and abdominal pain. The
      diagnosis was made on the basis of detection of pancreatic mass lesions on
      computed tomographic (CT) scans and the results of cultures and/or acid-fast
      stains of peripancreatic abscess material and/or other body fluids. Despite an
      excellent response to antituberculous therapy, three patients died of unrelated
      causes. In the setting of a febrile illness with abdominal symptoms, tuberculous
      pancreatic abscess should be considered in the differential diagnosis for HIV
      infected patients with a CT-identified mass lesion.

PMID- 7795089
TI  - Isolated peripheral tuberculous lymphadenitis in adults: current clinical and
      diagnostic issues.
AB  - Eight cases of isolated peripheral tuberculous lymphadenitis occurred over a 16
      month period at our institution, prompting a literature review to establish the
      epidemiology, clinical manifestations, and current approaches to diagnosis and
      treatment of this disorder. It occurs most commonly in young adult women who
      either are immigrants from areas where tuberculous is endemic or have histories
      of travel that are suggestive of exposure to Mycobacterium tuberculosis. The
      disease is indolent and usually presents as a unilateral painless neck mass.
      Constitutional symptoms are rare, except in individuals infected with the human
      immunodeficiency virus (HIV). The results of skin testing with purified protein
      derivative are invariably positive. Excisional biopsy for histopathologic and
      microbiological evaluations provides the highest diagnostic yield, although fine
      needle aspiration may be useful for HIV-infected individuals and in areas of the
      world with a high prevalence of disease. A 6-month course of combination
      antituberculous therapy is adequate for disease due to susceptible organisms.
      This infection may be readily diagnosed if suggestive epidemiological and
      clinical findings lead to expeditious tissue sampling.

PMID- 7795092
TI  - Fungemia in children infected with the human immunodeficiency virus: new
      epidemiologic patterns, emerging pathogens, and improved outcome with antifungal
      therapy.
AB  - We characterized 27 episodes of fungemia in 22 children infected with the human
      immunodeficiency virus (HIV). Fungemia in these patients presented as a community
      acquired infection in the setting of outpatient total parenteral nutrition or
      intravenous antibiotic therapy through a chronically indwelling central venous
      catheter (CVC). Fungemia developed only in patients with CVCs (P < .001). Non
      albicans Candida species, Torulopsis glabrata, Rhodotorula rubra, and Bipolaris
      spicifera constituted 52% of all causes. Fungemia was detected early, within a
      median of 2.4 days after the onset of new fever, which permitted prompt
      administration of amphotericin B (mean dosage, 0.7 mg/[kg.day]; median duration,
      19 days). CVCs were removed in 23 (85%) of the episodes. We conclude that
      fungemia in HIV-infected children often presents as a community-acquired
      infection, is frequently due to newly emerging opportunistic fungi, and can be
      managed, with a high level of success (95% survival with no posttherapeutic
      sequelae), by early diagnosis, prompt initiation of amphotericin B therapy, and
      removal of the CVC.

PMID- 7795091
TI  - Postoperative toxic shock syndrome.
AB  - We conducted a retrospective review of all cases of postoperative toxic shock
      syndrome (PTSS) occurring in two community hospitals from 1981-1993, during which
      time 390,000 surgical procedures were performed. The incidence was 0.003% (12
      cases). All wounds in these 12 cases, from those with scant superficial exudates
      to those with gross purulence, yielded Staphylococcus aureus. All tested isolates
      were susceptible to methicillin or cephalothin. Patients had a mean maximal
      temperature of 40 degrees C. All patients had a rash, most in a truncal,
      "sunburn" pattern. Eleven patients had desquamation. Mean time from surgery to
      onset of symptoms was 4 days. All patients required vigorous fluid resuscitation.
      No correlation could be demonstrated between the development of toxic shock
      syndrome and a patient's age, sex, preoperative skin preparation or
      administration of antibiotics, members of the surgical team, or duration of
      procedure. All patients with PTSS survived. PTSS should be considered in the
      differential diagnosis for the acutely febrile, systemically ill postoperative
      patient, even when surgical wounds are deceptively benign in appearance. Early
      recognition and treatment of PTSS is essential for successful outcome.

PMID- 7795093
TI  - Reduced requirement for antibiotic therapy targeting gram-negative organisms in
      febrile, neutropenic patients with cancer who are receiving antibacterial
      chemoprophylaxis with oral quinolones.
AB  - An open, nonrandomized, phase 2 study of 53 adult patients who had 60 neutropenic
      episodes was conducted to determine if quinolone antibacterial prophylaxis could
      reduce the need during febrile episodes for parenteral therapy directed at gram
      negative organisms. Suspected infections among recipients of quinolones were
      treated empirically with vancomycin and ceftazidime; therapy with the latter was
      discontinued after 24-48 hours in the absence of infection due to gram-negative
      organisms. In five neutropenic episodes, patients had no fever or infection. An
      aerobic gram-negative bacillus was isolated during only 1 (1.8%) of 55 febrile
      episodes. Febrile episodes occurred at a median of day 15 of cytotoxic therapy.
      Vancomycin monotherapy was successful in 22 (50%) of 44 evaluable cases.
      Modification of the vancomycin regimen by the addition of metronidazole or
      rifampin increased the response rate to 40 (91%) of 44. Response occurred after a
      median of 4.5 days. Parenteral empirical therapy with amphotericin B was required
      in only 3 (7%) of 44 cases. The study strategy safely permitted a reduction in
      the amount and duration of antibiotic therapy directed against gram-negative
      organisms in febrile neutropenic patients.

PMID- 7795094
TI  - Bloodstream infection due to Trichosporon beigelii in a burn patient: case report
      and review of therapy.
AB  - Trichosporon beigelii is a yeast that has recently been increasingly associated
      with systemic infections in immunocompromised patients. Few cases have been
      reported in nonleukopenic patients. We describe what we believe to be the first
      report of a bloodstream infection due to T. beigelii in a burn patient. Our
      patient was successfully treated with a combination of amphotericin B and
      flucytosine. Antifungal susceptibility testing of the T. beigelii isolate showed
      that the organism was inhibited but not killed by amphotericin B. Burn patients
      are known to have a transient defect in neutrophil function that can predispose
      them to some infections. We review the English-language literature of recently
      reported cases of trichosporonosis and review the various therapies for T.
      beigelii infection.

PMID- 7795095
TI  - Short course of ofloxacin for treatment of multidrug-resistant typhoid.
AB  - In recent years, multiresistant strains of Salmonella typhi have emerged in many
      tropical countries. These strains remain highly sensitive to the fluoroquinolone
      antibiotics, although use of these drugs by children is considered
      contraindicated because of their reported toxicity in the cartilage of
      experimental animals. In a paired, open, randomized study during an epidemic of
      multidrug-resistant typhoid in southern Vietnam, two short-course ofloxacin
      regimens (15 mg/kg daily for 3 days and 10 mg/kg daily for 5 days) were compared
      for the treatment of uncomplicated typhoid fever. Of 438 patients enrolled (of
      whom 286 were < or = 14 years old), 228 had blood cultures positive for
      Salmonella species (S. typhi, 207; S. paratyphi A, 19; and S. choleraesuis, 2).
      There was one treatment failure in a patient who took only one dose of ofloxacin.
      Otherwise, both regimens were completely effective; there were no proven
      carriers, and there was no evidence of toxicity, particularly in children. A 3
      day course of ofloxacin proved to be safe and highly effective in the treatment
      of uncomplicated, multidrug-resistant typhoid fever.

PMID- 7795096
TI  - Failure of treatment for chancroid in Rwanda is not related to human
      immunodeficiency virus infection: in vitro resistance of Haemophilus ducreyi to
      trimethoprim-sulfamethoxazole.
AB  - A comparative open study was performed to evaluate the efficacy of single doses
      of ciprofloxacin (500 mg) and trimethoprim-sulfamethoxazole (TMP-SMZ; 640
      mg/3,200 mg) for the treatment of culture-proven chancroid. Clinical cure or
      improvement was observed 7 days after treatment in 32 (76.2%) of the 42 patients
      who received ciprofloxacin and 21 (52.5%) of the 40 patients who received TMP-SMZ
      (P = .04). Cultures for one (4.5%) of 22 patients not cured with ciprofloxacin
      and 16 (59.3%) of 27 patients not cured with TMP-SMZ were still positive for
      Haemophilus ducreyi 7 days after treatment (P < .001). Although 77 (71.3%) of the
      108 patients tested were seropositive for HIV-1 antibody, HIV infection and the
      degree of CD4+ lymphocyte depletion had no effect on clinical and bacteriologic
      outcome. All isolates of H. ducreyi were highly susceptible to ciprofloxacin
      (MIC, 0.004-0.06 mg/L). In contrast, resistance to TMP-SMZ (MIC, > or = 4/76
      micrograms/mL) was observed in 48.9% of isolates (22 of 45) and was significantly
      associated with treatment failure. Therefore, the administration of TMP-SMZ, in
      single or multiple doses, is no longer indicated for the treatment of chancroid
      in Rwanda.

PMID- 7795097
TI  - Clinical characteristics, management strategies, and cost implications of a
      statewide outbreak of enterovirus meningitis.
AB  - A statewide outbreak of enterovirus meningitis occurred in Rhode Island in the
      summer of 1991. A comprehensive chart review was conducted for determining the
      demographic and clinical characteristics of the epidemic and for assessing the
      interinstitutional variation in treatment strategies. Four hundred eight cases
      were reported, and enteroviruses were recovered in 61 (68%) of 90 cases in which
      viral isolation was attempted. Of six isolates that were serotyped, all were
      echovirus 30. Analysis of cerebrospinal fluid revealed that an increased total
      white blood cell count and an increased protein concentration were associated
      with increasing patient age; however, the percentage of polymorphonuclear
      leukocytes in the cerebrospinal fluid decreased with increasing patient age and
      longer durations of illness. Marked variations in treatment strategies between
      institutions were noted in the use of computed tomography of the head, the
      administration of empirical antimicrobial agents, and the duration of
      hospitalization. Considerable health resources could have been saved by rapid
      detection of the virus, dissemination of information about the outbreak, and a
      conservative approach to clinical management.

PMID- 7795098
TI  - Abdominal tuberculosis in patients infected with the human immunodeficiency
      virus.
AB  - We compared the presentation of abdominal tuberculosis in 43 patients infected
      with the human immunodeficiency virus (HIV) and in 35 patients without HIV
      infection. Fever, weight loss, and extraabdominal lymphadenopathy were more
      common in HIV-infected patients, whereas ascites and jaundice were more frequent
      in patients without HIV infection. Intraabdominal lymphadenopathy and visceral
      lesions, visualized on computed tomography scans, were more common in HIV
      infected patients, whereas ascites and omental thickening were more frequent in
      patients without HIV infection. Aspirates of abdominal lymph nodes were the only
      samples revealing acid-fast bacilli in eight HIV-infected patients, yielding a
      rapid diagnosis. Disseminated tuberculosis was present in 93% of the HIV-infected
      patients, compared with 31% of those without HIV infection; tuberculosis
      contributed to death in 23% of HIV-infected patients and in 31% of those without
      HIV infection. We conclude that abdominal tuberculosis in HIV-infected patients
      is almost invariably a manifestation of disseminated disease and results in
      significant mortality.

PMID- 7795099
TI  - Encephalomyeloradiculopathy of infectious or parainfectious etiology--a new
      entity?
AB  - Between 19 March 1990 and 24 December 1992, six persons in Nova Scotia presented
      with a unique neurological illness. A prodrome of fever and headache was followed
      by neurogenic bladder, transverse myelitis, and encephalopathy in association
      with mononuclear pleocytosis of the CSF and nerve-conduction study findings
      consistent with polyradiculopathy. The spinal cords of three of the patients
      appeared abnormal on myelograms or magnetic resonance imaging studies. No
      microbial agent was isolated or demonstrated serologically. All of the patients
      were treated with antimicrobial agents and corticosteroids. Three recovered
      completely, but neurogenic bladder persisted in the remaining three. We suggest
      that this group of patients manifested an encephalomyeloradiculopathy that is
      likely a new clinical entity of infectious or parainfectious etiology.

PMID- 7795100
TI  - Mycobacterial lymphadenitis in children: a prospective study of 105
      nontuberculous cases with long-term follow-up.
AB  - Cases of nontuberculous mycobacterial lymphadenitis were analyzed in a
      prospective study spanning 32 years, from 1958 to 1990. The results are based on
      personal observations and long-term follow-up. There were 105 cases, all of which
      occurred in children aged 9 1/2 months to 12 years (median age, 2.92 years). The
      patients were predominantly female, and the cases occurred more often in the
      winter and spring. The cervical or facial nodes were involved in 96 cases. An
      abrupt change in the predominant etiologic agent (from Mycobacterium scrofulaceum
      to Mycobacterium avium complex) was noted in the 1970s. Positive tuberculin skin
      tests were the rule, and reactivity was long lasting. Complications included a
      prolonged initial phase of infection (n = 6) and recurrences 3 1/2 months to 7
      years later (n = 5). Resection during the early stage of infection produced the
      most satisfactory healing.

PMID- 7795101
TI  - Use of abdominal computed tomography for identifying disseminated fungal
      infection in pediatric cancer patients.
AB  - Disseminated fungal infection (DFI) is an important cause of morbidity and
      mortality among immunosuppressed patients with cancer. To determine the role of
      abdominal computed tomography (CT) in the diagnosis and management of DFI, we
      studied the records of patients treated in a pediatric oncology center over an 11
      year period. A total of 35 children had CT findings compatible with fungal
      abscesses in the liver, spleen, and/or kidneys and had fungal infection confirmed
      by culture, biopsy, or at autopsy. Patients were treated with antifungal agents
      (median duration of treatment, 57 days) until fever resolved and repeated CT
      scans demonstrated that the lesions had disappeared, regressed, or stabilized.
      The 3-month survival rate was 86%. An additional 29 patients with similar
      characteristics and risk factors had characteristic CT findings, but DFI was not
      documented with other procedures. These patients were empirically treated for
      presumed DFI; their courses and outcomes were similar to those for patients with
      documented DFI. These results suggest that it is reasonable to make a presumptive
      diagnosis of DFI for patients with characteristic CT findings and clinical
      features. With appropriate therapy, the prognosis for pediatric patients with
      cancer and documented or presumed DFI is good.

PMID- 7795102
TI  - Enteroviral infections of the central nervous system.
AB  - Infections of the CNS with the nonpolio enteroviruses are common and important
      causes of morbidity in both children and adults. Studies have recently defined
      the short-term and long-term outcomes of aseptic meningitis due to the
      enteroviruses. Focal encephalitis is increasingly recognized as a complication of
      enterovirus infection. Patients at greatest risk for sequelae of CNS enteroviral
      disease include neonates and those who are immunocompromised. The clinical
      presentation may mimic that of bacterial or other viral CNS infections, a
      circumstance making laboratory diagnosis of paramount importance for reducing
      unnecessary hospitalization and therapy. Recent advances in PCR technology,
      including its adaptation to a colorimetric microwell plate format, promise to
      greatly facilitate diagnosis of enteroviral infections. Promising antiviral drugs
      for CNS disease and other serious manifestations of enteroviral infections are
      under development.

PMID- 7795103
TI  - Geographic latitude and the efficacy of bacillus Calmette-Guerin vaccine.
AB  - In a meta-analysis of the efficacy of BCG vaccine for preventing tuberculosis,
      study sites at a greater distance from the equator were associated with a higher
      efficacy. In a random-effects regression analysis of prospective studies,
      geographic latitude alone accounted for 41% of the between-study variance. Many
      factors that vary with latitude may influence the effectiveness of BCG vaccine by
      modifying the susceptibility of human hosts, the pathogenecity of the organism,
      or host-agent interactions. These factors include socioeconomic conditions,
      genetic composition of the population, climate, exposure to sunlight, diet and
      nutrition, presence of nontuberculous mycobacteria in the environment,
      completeness of surveillance and follow-up in studies of BCG vaccine, virulence
      of locally prevalent strains of Mycobacterium tuberculosis, and storage and
      viability of BCG vaccine. This paper describes the biological plausibility,
      epidemiologic evidence, and other scientific data bearing on the influence of
      these factors on the efficacy of BCG vaccine.

PMID- 7795105
TI  - 1993 Sexually transmitted diseases treatment guidelines. Atlanta, Georgia, 19-21
      January 1993.

PMID- 7795104
TI  - Risks of chronicity following acute hepatitis B virus infection: a review.
AB  - A bibliographic search was conducted of English-language articles dealing with
      chronic hepatitis B virus (HBV) infection to evaluate the risk of chronicity
      following acute infection. Chronic HBV infection was defined as carriage of
      hepatitis B surface antigen (HBsAg) for at least 6 months. On the basis of
      incidence studies employing standard serological test methods, the highest risk
      (80%-90%) of chronic infection was found to be among infected neonates born to
      hepatitis B e antigen-positive carrier mothers. Of children infected before 6
      years of age, chronic infection was reported to develop in approximately 30%. A
      relatively wide range of risks (< 1%-12%) was found among diverse populations of
      older children and adults. However, most of the 10 identified incidence studies
      of generally healthy adults indicated that the risk of chronicity is very low: <
      or = 5% in eight studies. In addition, the pooled incidence of chronicity was <
      5% among two different adult population groups: initially uninfected subjects,
      who usually experienced asymptomatic infection, and patients presenting with
      acute hepatitis B. In addition to the primary influence of age, the studies
      revealed a higher risk of chronic HBV infection among males and among patients
      with impaired immunity due to various causes.

PMID- 7795107
TI  - Early intervention for persons infected with human immunodeficiency virus.
AB  - Early intervention for persons infected with human immunodeficiency virus (HIV)
      involves characterization of the stage of HIV disease, institution of therapy to
      prevent associated infections and postpone deterioration of immune function, and
      assistance in preventing transmission of the virus. This review examines the
      available data on the efficacy of current recommendations regarding the
      evaluation and management of persons with early HIV infection. Existing evidence
      supports the efficacy of physical examination, monitoring of the CD4+ cell count,
      tuberculin testing (with chemotherapy for persons who test positive), anergy
      testing, Papanicolaou testing and screening for gonorrhea and chlamydial
      infection (for high-risk women), screening for syphilis, antiretroviral therapy
      (for symptomatic patients), and guidance in reducing the transmission of HIV.
      Recommended measures for which evidence of clinical efficacy is less certain
      include immunization against infections due to influenza virus, Streptococcus
      pneumoniae, Haemophilus influenzae, and hepatitis B virus as well as
      antiretroviral therapy for asymptomatic persons. Quantitative measurement of
      viral titers appears promising for the monitoring of HIV disease and
      antiretroviral therapy; the correlations of these titers with clinical end points
      need to be confirmed.

PMID- 7795106
TI  - Treatment of syphilis, 1993.
AB  - Data on treatment of patients with syphilis were reviewed in preparation for
      revision of the Sexually Transmitted Disease Treatment Guidelines of the Centers
      for Disease Control and Prevention. Published studies of treatment regimens
      available and practical for use today were reviewed, particularly in regard to
      the following issues: treatment for primary, secondary, and latent stages of
      syphilis; treatment for syphilis during pregnancy; treatment for syphilis in
      human immunodeficiency virus (HIV)-infected patients; and serological criteria
      for evaluating response to treatment. The results of treatment and the
      methodological quality of the studies was considered. Most treatment
      recommendations must be based on expert judgment and with reliance on the
      clinical experience over 4 decades. For the treatment of early syphilis in HIV
      uninfected patients, this is probably sufficient. Data about HIV-infected
      patients are insufficient both for determining whether current therapy is
      adequate and for recommendation of an alternative if a change in therapy is
      deemed necessary.

PMID- 7795109
TI  - Drugs of choice for the treatment of uncomplicated gonococcal infections.
AB  - Resistance of Neisseria gonorrhoeae to antimicrobial agents continues to spread
      and intensify. Choosing an antimicrobial regimen requires knowledge of the
      comparative efficacy of candidate regimens, as delineated in properly conducted
      clinical trials; their activity against N. gonorrhoeae in vitro; and their
      pharmacokinetics and toxicity. We tabulated the results of trials of single-dose
      antimicrobial therapy for uncomplicated gonococcal infection published after
      1980. Thirty regimens comprising 21 antimicrobial drugs have been shown to be
      highly effective for rectal and urogenital infections; the agents involved are
      cefixime, cefodizime, cefotaxime, cefoxitin, ceftizoxime, ceftriaxone,
      cefuroxime, cefuroxime axetil, ciprofloxacin, fleroxacin, norfloxacin, ofloxacin,
      pefloxacin, temafloxacin, azithromycin, aztreonam, netilmicin, rifampin plus
      erythromycin stearate, sisomicin, and spectinomycin. Few regimens have been shown
      to be highly effective against pharyngeal infections. Among those antimicrobial
      agents available for the treatment of uncomplicated gonococcal infections in the
      United States, ceftriaxone (125 mg), cefixime (400 mg), ciprofloxacin (500 mg),
      and ofloxacin (400 mg) appear to offer the best balance of proven efficacy and
      safety.

PMID- 7795108
TI  - Recommendations for treatment of chancroid, 1993.
AB  - Since the 1989 Sexually Transmitted Diseases Treatment Guidelines were published
      by the Centers for Disease Control and Prevention, changes in the efficacy of the
      recommended and alternative regimens for the treatment of Haemophilus ducreyi
      infections have been described. Among recommended agents, erythromycin remains
      effective, and although a single dose of ceftriaxone appears to remain effective
      in the United States, limited data from Kenya have shown that this regimen has
      been associated with treatment failures. Of alternative treatment regimens,
      trimethoprim-sulfamethoxazole has been associated with widespread failure, but
      little work has been done to further evaluate the efficacy of the
      amoxicillin/clavulanic acid and ciprofloxacin regimens. Of the new
      antimicrobials, azithromycin has been very effective in the United States, but
      the efficacy of this drug elsewhere has not been thoroughly evaluated. Fleroxacin
      has been very effective in Kenya. Data from Africa indicate that patients who are
      infected with the human immunodeficiency virus do not respond to therapy as well
      as patients who are not, and patients who are uncircumcised may not respond as
      well to therapy as do patients who are circumcised.

PMID- 7795111
TI  - Bacterial vaginosis: review of treatment options and potential clinical
      indications for therapy.
AB  - We reviewed data on the treatment of bacterial vaginosis published from 1989
      through 1992 (articles published after the 1989 publication of the Centers for
      Disease Control and Prevention Sexually Transmitted Diseases Treatment
      Guidelines). This review suggests that oral metronidazole (500 mg twice daily for
      7 days) is the preferred treatment for bacterial vaginosis. Other effective (but
      alternative) treatment regimens include single-dose metronidazole (2 g orally),
      2% clindamycin vaginal cream (once daily for 7 days), 0.75% metronidazole vaginal
      gel (twice daily for 5 days), and oral clindamycin (300 mg twice daily for 7
      days). Data do not support the practice of routine treatment of male sex partners
      of infected females. Treatment of bacterial vaginosis during pregnancy should
      focus on the elimination of symptoms; data on adverse pregnancy outcomes for
      women with bacterial vaginosis remain insufficient to recommend treatment of
      asymptomatic patients. Before performing surgical abortion, treatment of
      bacterial vaginosis (symptomatic or asymptomatic) should be considered to prevent
      pelvic inflammatory disease.

PMID- 7795110
TI  - New treatments for Chlamydia trachomatis genital infection.
AB  - To provide information for the formulation of treatment guidelines, we review
      recently published articles and abstracts on advances in the treatment of
      Chlamydia trachomatis genital infection. We ask specific questions about new
      treatments that are answered on the basis of the results of clinical trials and
      efficacy studies. New, potentially effective treatments for C. trachomatis
      genital infection include azithromycin and ofloxacin. Clinical studies indicate
      that the efficacy of these agents is equivalent to that of the current
      recommended agent doxycycline. Both azithromycin and ofloxacin are substantially
      more expensive than doxycycline. Azithromycin has the advantage of being given as
      a single dose, while doxycycline and ofloxacin are administered for 1 week.
      Issues of compliance, cost, and toxicity for specific patients should be
      considered when deciding whether to treat C. trachomatis genital infections with
      these agents.

PMID- 7795112
TI  - Treatment options for vulvovaginal candidiasis, 1993.
AB  - Vulvovaginal candidiasis (VVC), the second most common form of vaginitis,
      particularly affects women of childbearing age. Since the 1970s, several new
      agents have become available for the treatment of VVC. This review focuses on
      options for the treatment of this condition, critically evaluating the relevant
      published studies. For the treatment of acute episodes of VVC in nonpregnant
      women, several topical and oral antifungal agents are clinically and
      mycologically effective. Topical agents should be considered the first line of
      therapy; however, oral agents are sometimes associated with better compliance
      among patients. For acute episodes in pregnant women, a topical agent is the
      treatment of choice. Until data become available on the treatment of VVC in women
      infected with human immunodeficiency virus (HIV), the same approach as that used
      for women without HIV infection should be considered as previously written. For
      recurrent VVC, the optimal maintenance therapy has not yet been established;
      however, administration of low-dose oral ketoconazole (100 mg/d) has proven
      effective. Well-designed studies of the best therapy for VVC in women with HIV
      infection and for recurrent VVC are urgently needed.

PMID- 7795113
TI  - Cervical cancer screening of women attending sexually transmitted disease
      clinics.
AB  - Prevention programs at clinics for sexually transmitted diseases (STDs) have
      traditionally focused on reducing the spread of STDs through prompt diagnosis and
      treatment of infections and through notification and treatment of sex partners.
      For women the clinic examination also offers an opportunity to prevent cervical
      cancer, a sequela of STDs. Women who have had STDs are at increased risk for
      cervical cancer, and women who seek health care at public clinics frequently have
      additional characteristics that place them at risk for not having had a recent
      Papanicolaou (Pap) smear. Despite the opportunity for cervical cancer screening
      that is afforded by a visit to an STD clinic, in most public clinics a Pap smear
      is not part of the routine examination of women. This report summarizes the
      evidence supporting cervical cancer screening for women with STDs (particularly
      women attending STD clinics) and addresses the advantages, disadvantages, and net
      yield of previous screening programs at STD clinics.

PMID- 7795114
TI  - [Prevention of arteriosclerosis and consumption of olive oil. Is there more to it
      than its effect on cholesterol?].

PMID- 7795115
TI  - [Community-acquired pneumonia in the aged: prognostic factors].
AB  - We studied the clinical characteristics and the initial supplementary test
      available in the emergency service, in aged patients with community-acquired
      pneumonia, as well as their mortality prognosis value. We assessed 190 patients
      attended consecutively during one year. Clinical, analytical and radiological
      data were registered. The parameters associated to a higher mortality were: age,
      absence of thoracic pain, reduction in the level of consciousness, leukocytosis,
      increased urea levels, aminotransferases, lactate dehydrogenase and reduction in
      prothrombin activity and pH. The data associated to a greater relative risk were:
      age above 80 years, absence of thoracic pain, prothrombin activity lower than 70%
      and ALT < 40 U/l. The presence of three to four of these variables had a
      sensitivity of 62% and a specificity of 94% in the prediction of mortality. In
      the multivariable analysis, the following variables remained significative: age,
      obnubilation and decrease of prothrombin. We stress the relevance of a high
      clinical suspicion, given the frequency of these cases with little
      symptomatology, in order to allow for an early treatment and the identification
      of right risk patients at the initial assessment.

PMID- 7795116
TI  - [Cholecystectomy: a choice technique in biliary microlithiasis].
AB  - The purpose of our study is to show results obtained after a cholecystectomy on
      25 patients in order to present a suggestive clinic of bile origin and a positive
      result for determination of microcrystals in the bile probe even in the case of
      negative radiologic diagnoses (echography, cholecystography). Out of 25 patients
      operated on the following results were obtained: microscopic cholelithiasis in
      12, granular cholelithiasis in 3, acute cholecystitis in 2, cholesterolosis in 2
      and without pathologic findings in 6 patients after an observation period of 24
      months following the operation it was demonstrated that almost all the patients
      (96%) had no symptoms. On the other hand, the above mentioned results are
      compared to the findings obtained during an observation period of a group of 34
      patients with positive probe results with the same clinic characteristics and not
      having been operated on refusing the operation suggested.

PMID- 7795117
TI  - [Abdominal echography in patients with human immunodeficiency virus (HIV)
      infection. Diagnostic usefulness in the evaluation of associated medico-surgical
      pathology].
AB  - BASIS: The abdominal manifestations in the patient with HIV infection are
      increasingly frequent. We have conducted the present study in order to determine
      the diagnostic usefulness of the abdominal echography in the clinical assessment
      of the patient. MATERIALS AND METHODS: We review the echographic findings of 112
      patients carrying the HIV with or without the Acquired Immunodeficiency Syndrome
      (AIDS). Seventy eight patients were men and 34, women, with an average age of 30
      years. The main risk group was parenterally drug addiction (72%). The stage of
      the HIV infection was IVC1 in 41% of the cases, II in 23%, III in 13% and IVC2 in
      13%. The echographic exploration was performed using a real-time echography, with
      a probe of 3.5 Mhz, assessing according to conventional criteria the abdominal
      organs and their pathology, masses and free intraabdominal fluid. The echographic
      characteristics were first broadly assessed in the patients from the series and
      later on, according to the patient's pathology. (Infectious, acute abdominal,
      hepatic biochemical disorders, HIV carrier-associated pathology). RESULTS: In 33%
      of the cases, the echography was normal. Hepatomegaly was the most frequent
      echographic sign: 56 patients (50%), followed by splenomegaly in 43 patients
      (38.3%), standing out the affection of the biliary and/or vesicular ductus in 7
      patients (6.2%). The echographic findings were not related to the HIV infection
      stage, nor with the presence of hepatic biochemical disorders. However, the
      presence of organomegaly (hepatosplenomegaly associated or not to retroperitoneal
      adenopathies) were more frequent in the group with infectious complication, 33.3%
      vs 19.6% (p < 0.01), that in the patients without associated infectious
      processes. In patients with medical or surgical acute abdominal pathology, the
      echography was diagnostic in 9 out of 10 patients. CONCLUSION: In the HIV
      patient, the echography allows an specific initial diagnostic assessment, being
      able in most of the patients with abdominal manifestations to diagnose the causal
      pathology.

PMID- 7795118
TI  - [Efficacy and tolerance of doxazosin in the treatment of isolated systolic
      hypertension in hypertensive patients over 60 years of age].
AB  - Isolated Systolic Arterial Hypertension (ISAH) is the most frequent form of AHT
      in the aged population, resulting in an increase of the cardiovascular risk,
      mainly at the cerebrovascular level. In this open non-comparative study, we
      analyze the effect of doxazosin, an alpha-adrenergic blocker in 40 patients older
      than 60 years, diagnosed of isolated systolic hypertension. After 2 weeks of
      lavage, the patients received treatment with doxazosin according to a monotherapy
      scheme, with progressive increase of the dose, from 1 to 16 mg/day during a
      period of 14 weeks. Doxazosin significantly reduces the systolic and diastolic
      arterial pressure (p < 0.001) with a therapeutical response in 86.5% of the
      cases, using an average dose of 3.4 mg/day and without observing modifications in
      the heart rate. This drug improves the lipidic profile, with a reduction of the
      plasmatic levels of total cholesterol and cholesterol linked to low density
      proteins (LDL) with p < 0.05 and a reduction of triglycerides. Among the 40
      patients included in the study, 10 (25%) referred side effects; there were 2 drop
      outs (5%) and the dose had to be reduced in 2 patients (5%). In conclusion,
      doxazosin shows its antihypertensive effectiveness in the treatment of isolated
      systolic hypertension in patients older than 60 years and it is well tolerated by
      most of the patients, improving at the same time the lipidic profile. Hence, it
      contributes to the reduction of the cardiovascular morbidity-mortality in this
      group of patients.

PMID- 7795119
TI  - [Nephrotic syndrome associated with symmetrical multiple lipomatosis (Madelung's
      disease)].
AB  - We present a case of multiple symmetric lipomatosis Type I (Madelung's disease)
      with severe organic affection, hepatic cirrhosis, sever sensitive polyneuropathy
      and neuropathic ulceration at the left lower limb. A nephrotic syndrome developed
      in a larval form due to proliferative glomerulonephritis as the result of a
      metainfectious complications of the infection at the lower limb. We discuss the
      etiopathogenicity of the organic affection and we highlight the pathogenic links
      between the disease and its complications.

PMID- 7795120
TI  - [Langerhans cell granulomatosis with unifocal bone disease and asymptomatic
      pulmonary infiltration].
AB  - Langerhans' cell granulomatosis is a usually benign disease, characterized by the
      proliferation of Langerhans' cell containing S-100 protein. Disease is related
      with the smoking habit and immunological alterations, and is able to affect any
      organ in isolated or multisystem form. Diagnosis is provided by biopsy of the
      lesion and bronchoalveolar lavage if the lung is injured. We present a case of a
      smoker man with lytic lesion in the skull, which biopsy was diagnostic, and with
      an asymptomatic interstitial infiltrates lungs, with a restrictive spirometry.
      Remission was achieved with prednisone (0.75 mg x kg) and stop smoking.

PMID- 7795121
TI  - [Refractory idiopathic liquefying panniculitis].
AB  - We present a 28-year-old patient with liquefying idiopathic lobular panniculitis,
      a variant of the Weber-Christian's disease and intermittent episodes of arthritis
      in the left foot refractory to sequential treatment with anti-inflammatory drugs,
      high doses of prednisone, chloroquine, dapsone, colchicine, cyclosporine and
      methotrexate.

PMID- 7795122
TI  - [Acute rhabdomyolytic alcoholic myopathy associated with acute alcoholic
      hepatitis].
AB  - Acute rhabdomyolysis (ARM) is a clinico-biological syndrome characterized by the
      lesion of the skeletal muscle resulting in a disorder of the permeability at the
      membrane of the muscle cells, with the release of intracellular substances to the
      plasma, mainly proteins and ions. We present the case of a chronic alcoholic
      patient which, after a period of several days in which he increased his
      consumption of alcohol, developed clinical signs of acute rhabdomyolytic
      alcoholic myopathy (AREM) associated to acute alcoholic hepatitis (AAH). In the
      review of the literature, we did not find any description of the association
      between AREM and acute hepatitis of alcoholic origin. We consider the
      nonspecificity of the clinical signs of the AREM and we suggest the systematic
      assessment of creatine-phosphokinase in patients at risk.

PMID- 7795124
TI  - [Collagenous sprue].

PMID- 7795125
TI  - [Cefixime in the treatment of lower respiratory tract infections in patients with
      chronic bronchitis].

PMID- 7795123
TI  - [Oxidative stress and infectious pathology].
AB  - Pathogenic organism can be considered as pro-oxidant agents because they produce
      cell death and tissue damage. In addition organism can be eliminated by specific
      cell defense mechanism which utilize in part, reactive oxygen radicals formed by
      oxidative stress responses. The cause of the necessarily defense process results
      in cell damage thereby leading to development of inflammation, a characteristic
      oxidative stress situation. This fact shows the duality of oxidative stress in
      infections and inflammation: oxygen free radicals protect against microorganism
      attack and can produce tissue damage during this protection to trigger
      inflammation. Iron, a transition metal which participates generating oxygen free
      radicals, displays also this duality in infection. We suggest also that different
      infectious pathologies, such as sickle cell anemia/malaria and AIDS, may display
      in part this duality. In addition, it should be noted that oxidative damage
      observed in infectious diseases is mostly due the inflammatory response than to
      the oxidative potential of the pathogenic agent, this last point is exemplified
      in cases of respiratory distress and in glomerulonephritis. This review analyzes
      these controversial facts of infectious pathology in relation with oxidative
      stress.

PMID- 7795126
TI  - [Atypical presentation of Pneumocystis carinii pneumonia].

PMID- 7795127
TI  - [Sublingual thyroid tissue and ovarian tumor: is it more than a coincidence?].

PMID- 7795128
TI  - [Oxygen therapy in the hospital: a too often incorrect therapy].

PMID- 7795129
TI  - [A further case of cervical actinomycosis].

PMID- 7795130
TI  - [Coronary vasospasm induced by intravenous adrenaline].

PMID- 7795131
TI  - European Self-sufficiency and Haemophilia Prophylaxis: Achievable Goals or
      Idealistic Concepts? An accord meeting on the future of haemophilia care.

PMID- 7795132
TI  - Can the supply and demand for plasma-derived products ever be reconciled? Self
      sufficiency from the viewpoint of a blood transfusion service.
AB  - Sufficiency is the balance between supply and demand. The problems of estimating
      future demands and of maintaining adequate supplies of blood for the preparation
      of blood products, will be discussed from the viewpoint of a well-established
      blood transfusion service.

PMID- 7795133
TI  - Can the supply and demand for plasma-derived products ever be reconciled?
AB  - With regard to self-sufficiency, supply and demand for plasma-derived products
      can only be reconciled if there is a free exchange of source materials and
      products with European harmonization of products. It is essential that safety
      aspects are agreed upon internationally and free access is guaranteed.

PMID- 7795134
TI  - Is the unpaid/paid donation debate for better or for worse?--advantages of unpaid
      donations.
AB  - It is suggested that the best quality blood and blood products are obtained from
      voluntary unpaid donations as these are given for genuine altruistic reasons.
      Voluntary donors have no reason to give false information about lifestyle factors
      which might place them at risk of transmitting infectious agents. There is
      therefore a reduced risk of obtaining blood during the 'window' period of HIV
      infection. In addition if a component of a donation transmits an infectious
      agent, the fractionation plant can be informed to exclude the plasma from that
      donation or even recall the pertinent blood products. Several countries are
      already self-sufficient in blood and blood products, based on a voluntary, unpaid
      donor system.

PMID- 7795135
TI  - Is the unpaid/paid donation debate for better or for worse?--a commercial
      viewpoint.
AB  - The European Association of the Plasma Products Industry represents the private
      sector member companies that manufacture and provide plasma products throughout
      Europe. EAPPI believes that the most important aspect of self-sufficiency is a
      sufficient supply of safe and efficacious product; the question of paid or unpaid
      donations is of lower importance. To achieve a supply of high quality plasma,
      EAPPI considers it is necessary to harmonize standards throughout Europe, and
      suggests a five-point programme towards improving public confidence in the
      available plasma products.

PMID- 7795136
TI  - Is self-sufficiency financially viable and ethically justifiable?--the role of
      the National Blood Authority.
AB  - The National Blood Authority is committed to the principle of self-sufficiency
      but also supports the principle of clinical freedom and aims to improve patient
      care. Methods of increasing plasma yields are being investigated. On-going
      discussions are being held with the commercial sector concerning the range of
      products available and methods of improving manufacturing efficiency. It is
      believed that the NBA can become largely self-sufficient using blood given by the
      2,000,000 voluntary donors.

PMID- 7795137
TI  - Is self-sufficiency financially viable and ethically justifiable?--legal aspects.
AB  - There is no legislation specifically designed to compensate haemophilia patients
      who have been damaged by defective blood products. But there is a general regime,
      created as a result of the thalidomide tragedy, which deals with defective
      'products'. It was introduced at the European level by the European Directive on
      Product Liability in 1985 and has been given effect in England by the Consumer
      Protection Act 1987. The rights of haemophilia patients who are injured by
      defective blood products depends on this Directive.

PMID- 7795138
TI  - Is self-sufficiency financially viable and ethically justifiable?--a commercial
      viewpoint.
AB  - Manufacturers of blood products have to maintain the highest possible standards
      for plasma screening and good manufacturing practices to ensure maximum purity
      and viral safety. The private sector companies have much experience in
      implementing and complying with national and international regulations. These
      requirements involve considerable cost in the areas of (1) plasma collection
      facilities, (2) research and clinical research, (3) manufacture, and (4) quality
      control. Total self-sufficiency would mean the loss of many existing resources.
      An alternative would be a collaboration between the public and private sectors to
      meet the needs of all patients who require plasma derived products. The current
      definition of self-sufficiency suggests that it is not financially viable.

PMID- 7795139
TI  - Should clinical freedom be constrained in the name of self-sufficiency?
AB  - Clinical freedom should enable a physician to decide in a free and unbiased
      manner which is the most appropriate therapy to use for a particular patient. In
      order to implement the four aims of the German Haemophilia Society an average of
      4-4.5 units of Factor VIII per capita of the general population per year is
      needed. At present European countries do not produce this amount, but to reduce
      the consumption of F VIII in therapy lowers treatment levels. Until plasma
      collection services in Europe can be expanded it is necessary that the
      additional, imported, sources of plasma are available, otherwise clinical freedom
      will be curtailed.

PMID- 7795140
TI  - Economic issues in European self-sufficiency.
AB  - Future clinical practice in haemophilia care must make optimum use of resources
      and provide the highest quality products and services in an efficient and
      effective manner. Studies show that prophylactic therapy, compared with on-demand
      therapy, results in less time off work--that is, a smaller loss in productivity.
      However, prophylactic therapy requires a three- to five-fold greater annual
      amount of factor VIII than does on-demand therapy. Further study is needed to
      determine the optimum therapeutic strategy that gives the best cost v. benefit
      situation.

PMID- 7795141
TI  - European regulatory issues.
AB  - Current EU regulations do not cover all aspects of the manufacture and control of
      blood products. Recent legislation coming into force on 1 January 1995 has
      established the European Medicines Evaluation Agency and introduced revised
      systems for approving pharmaceutical products, including blood products. There
      remains a need for comprehensive harmonized legislation covering plasma
      collection and screening, virus validation studies, and batch release.

PMID- 7795142
TI  - Do safety issues of plasma products constrain self-sufficiency?
AB  - The ultimate responsibility for selecting and administering plasma products to
      patients rests with the prescribing physician, and it is for him/her to choose
      the safest product available. However, liability for a product with a full
      licence rests exclusively with the licence holder. After the problems of HIV and
      hepatitis C the safety of plasma-derived products has become of paramount
      importance. Particularly in the public sector, financial, strategic and political
      obstacles may adversely influence the quantity, quality and safety of plasma
      collection. The safety of blood products can be substantially enhanced by the
      harmonization of technical standards across both public and private sectors, thus
      supporting EC Directive 89/381. Additionally, the goal of European rather than
      national self-sufficiency should be encouraged.

PMID- 7795143
TI  - Is haemophilia prophylaxis achievable in the context of self-sufficiency?
AB  - In Sweden prophylactic treatment in haemophilia was introduced in 1958. Patients
      receiving prophylactic treatment have less time off school or work, require less
      hospitalization, have fewer joint bleeds, and generally lead as near normal life
      as possible. Although prophylaxis is expensive the cost is off-set by the
      improvement in quality of life and in productivity. At present, Sweden is almost
      self-sufficient in blood products for prophylactic treatment of haemophiliacs.

PMID- 7795144
TI  - How will immune tolerance protocols affect self-sufficiency goals?
AB  - Inhibitor development is a serious complication in haemophilia, and its
      treatment, immune tolerance therapy, is an expensive part of haemophilia
      treatment. However, the therapy can lead to an increased lifespan and improved
      quality of life. If commenced sufficiently early in the disease, it can help to
      reduce the overall amount of factor VIII concentrate, or other plasma derived
      therapeutic agents required during life.

PMID- 7795145
TI  - Will recent innovations in therapy save perceived deficiencies in self
      sufficiency policies.
AB  - Future treatment for patients with haemophilia may include the use of either gene
      therapy, recombinant factor VIII, recombinant factor IX, or high-purity factor
      IX. Studies on gene therapy are still at the pre-clinical stage, while clinical
      trials of recombinant factor IX are expected to start by mid-1995. High-purity
      factor IX concentrates are available and are the treatment of choice for patients
      with haemophilia B in the absence of a source of recombinant factor IX.
      Recombinant factor VIII provides a renewable and unlimited source of factor VIII,
      and is a safe and effective treatment for haemophilia A.

PMID- 7795146
TI  - A comparison of the European Accord and the Recommendations of the American
      National Hemophilia Foundation.

PMID- 7795147
TI  - Self-sufficiency--20 years on.
AB  - The opening paper of this symposium discusses the theme [European self
      sufficiency and haemophilia prophylaxis: achievable goals or idealistic
      concepts?' from four aspects: (a) the meaning and interpretation of self
      sufficiency in the European Community; (b) a summary of the facts, discussions
      and developments of the last 20 years; (c) a description of future aims and
      objectives; and (d) a discussion of what this symposium hopes to achieve. The
      author suggests that one most important point is to find an adequate definition
      of the term [self-sufficiency' in this context.

PMID- 7795148
TI  - Hybrid peptide containing RGDF (Arg-Gly-Asp-Phe) coupled with the carboxy
      terminal part of alpha 2-antiplasmin capable of inhibiting platelet aggregation
      and promoting fibrinolysis.
AB  - The aim of this study was to synthesize and investigate hybrid peptides which
      contain the RGD (Arg-Gly-Asp) sequence coupled with lysine residues in special
      arrangements (antiplasmin carboxyterminal peptide) in an effort to simultaneously
      inhibit platelet aggregation and promote fibrinolysis. The in vitro haemostatic
      modifying properties of the synthesized peptides were tested by ADP-induced
      platelet aggregation, plasmin-generation tests and fibrin-clot lysis assays. The
      hybrid peptide RGDFAP, composed of RGDF (Arg-Gly-Asp-Phe) coupled to a synthetic
      peptide residue of the carboxyterminal part of antiplasmin (AP26) inhibited
      platelet activation and increased plasmin generation and in vitro fibrin-clot
      lysis.

PMID- 7795149
TI  - Long-term effects of n-3 polyunsaturated fatty acids on haemostatic variables and
      bleeding episodes in patients with coronary artery disease.
AB  - The long-term effects of fish-oil supplementation on haemostatic parameters and
      bleeding episodes were investigated in patients undergoing coronary artery bypass
      surgery. They were investigated before and 9 months after the operation.
      Following randomization postoperatively, 260 patients received 4 g fish-oil
      concentrate per day, whereas 251 patients comprised the control group. All
      patients received either aspirin (300 mg/day) or warfarin (international
      normalized ratio aimed at 2.5-4.2). Compliance was affirmed by determination of
      serum phospholipid fatty acids. No excess of bleeding episodes could be
      attributed to the use of fish oil, given in addition to either aspirin or
      warfarin. The supplementation of fish oil did not affect the bleeding time or
      plasma levels of beta-thromboglobulin, whereas an increase in the platelet count
      after the operation was slightly less pronounced in the fish-oil group. Apart
      from a small increase in PAI-1 antigen of borderline significance, no long-term
      effects by fish oil on parameters of coagulation and fibrinolysis were seen.

PMID- 7795150
TI  - Rapid identification of gene defects in protein C deficiency by temperature
      gradient gel electrophoresis.
AB  - Protein C deficiency is an autosomally inherited disorder that is associated with
      a high risk of recurrent venous thrombosis. The authors have shown that
      temperature gradient gel electrophoresis (TGGE) is a simple and rapid screening
      method for the detection of mutations in the protein C gene. Samples from eleven
      patients with sequence defined point mutations in the promoter region of exon I,
      and in exons II, III, VII, VIII and IX were analysed by TGGE. In all cases the
      mutations were readily detected. The exons IV, V and VI were not submissive to
      TGGE analysis due to amplification difficulties. However, specific computer
      calculations predict a more general applicability of TGGE for the detection of
      any mutation in the protein C gene. The presented data establish the usefulness
      of TGGE as a simple and rapid screening method for the detection of hereditary
      mutations in the protein C gene.

PMID- 7795151
TI  - The successful removal of a bleeding intracranial tumour in a severe haemophiliac
      using an adjusted dose continuous infusion of monoclonal factor VIII.
AB  - Ten per cent of patients with haemophilia A develop intracranial haemorrhage
      (ICH) with a mortality rate of 30% and an incidence of psycho-neurological
      sequelae in 50% of survivors. ICH may be spontaneous or in association with
      trauma and other pathology. The generally recommended management is conservative
      replacement therapy using bolus injections of factor VIII and no neurosurgical
      intervention. Adjusted dose continuous infusion therapy provides an alternative
      method of factor VIII administration that is simple, more cost effective and
      safer through the maintenance of stable plasma VIII:C levels. This method has
      been successfully used to cover general surgery and the conservative treatment of
      subarachnoid haemorrhage but is not widely used due to unfamiliarity with the
      technique. This paper describes the use of continuous infusion of factor VIII
      concentrates to cover the successful neurosurgical management of a young man with
      severe haemophilia A who presented with an ICH associated with a bleeding choroid
      plexus tumour. Surgery was complicated by the development of a factor VIII
      inhibitor which disappeared following treatment with an immune-tolerance
      induction programme.

PMID- 7795152
TI  - Protein C infusion in a patient with inherited protein C deficiency caused by two
      missense mutations: Arg 178 to Gln and Arg-1 to His.
AB  - This paper reports the case of an adult patient with severe protein C(PC)
      deficiency. She had the first deep vein thrombosis when she was 14 years old and
      developed skin necrosis when oral anticoagulant treatment was started. The same
      sequence of thrombotic complications recurred several times. Analysis of the PC
      gene coding sequences allowed two mutations (Arg-1 to His and Arg 178 to Gln) to
      be identified in this compound heterozygote. Oral anticoagulant treatment during
      PC concentrate infusion and low-molecular-weight heparin administration was
      successful and uncomplicated.

PMID- 7795153
TI  - Relationship between elevation in the plasma concentration of elastase-alpha 1
      proteinase inhibitor complex (E-alpha 1 PI) and haemostatic parameters during
      haemodialysis.
AB  - To investigate the relationship between changes in plasma concentrations of
      polymorphonuclear elastase (PMN-E) and haemostatic effects during haemodialysis
      (HD), changes in the plasma concentrations of elastase-alpha 1 proteinase
      inhibitor complex (E-alpha 1 PI) and fibrinogen (Fbg), cross-linked fibrin
      degradation products (XDP), thrombin-antithrombin III complex (TAT), plasmin
      alpha 2 plasmin inhibitor complex (PIC) and soluble thrombomodulin (TM) in 49
      patients with end-stage chronic glomerulonephritis maintained on chronic HD were
      measured. Plasma concentrations of TAT, PIC, TM and E-alpha 1 PI significantly
      increased during a single HD. There was a statistically significant correlation
      between change in plasma E-alpha 1 PI concentration and changes in plasma
      concentrations of TAT, PIC and TM during a single HD, as well as between changes
      in plasma concentrations of TM and TAT during a single HD. These observations
      suggested that activation of coagulation and fibrinolysis, endothelial cell
      damage, and activation of polymorphonuclear cells occur during HD. Activation of
      polymorphonuclear cells may induce activation of coagulation and fibrinolysis,
      leading to endothelial cell damage, augmented by release of proteases such as
      elastase.

PMID- 7795154
TI  - Two novel antithrombin variants, Asn187Asp and Asn187Lys, indicate a functional
      role for asparagine 187.
AB  - Three unrelated families have been identified with mutations involving asparagine
      187. Two of these families are asymptomatic and were identified during the
      screening of random blood donors, whilst the third has a history of recurrent
      thromboembolic disease. In two families the mutation (6460 AAC-->GAC) results in
      an asparagine to aspartate substitution and is associated with normal
      immunological levels of antithrombin but a reduction in functional activity. In
      the third family the mutation (6462 AAC-->AAA) results in an asparagine to lysine
      substitution at residue 187 and is associated with a parallel reduction in both
      immunological and functional antithrombin levels. Asparagine 187 is located in
      the middle of the F helix of antithrombin and forms the major link between the F
      helix and strand 3 of the A sheet. The F helix is seen to overlie the A sheet of
      the molecule and moves with strands 2 and 3 of this sheet as they open to allow
      entry of the reactive site loop to form strand 4. Substitutions of asparagine 187
      are, therefore, likely to disrupt this sliding movement leading to a loss of
      inhibitory activity.

PMID- 7795156
TI  - A flow dynamic technique used to assess global haemostasis.
AB  - Global haemostasis was assessed on blood from patients with established blood
      clotting abnormalities using a hollow fibre flow device. The instrument monitors
      pressure changes across a polyethylene fibre through which non-anticoagulated
      whole blood is perfused. This method of analysis is significant because it (1)
      minimizes or eliminates common problems associated with routine clinical
      evaluations, such as sample dilution, completion time, and anticoagulant
      artifacts, (2) rapidly (under 90 min) and accurately calculates in vitro bleeding
      time (IVBT) and whole blood clotting time (WBCT), (3) presents a reliable means
      of distinguishing coagulation defects from platelet dysfunction, and (4) reduces
      the need for a series of screening tests to a single test that requires a small
      amount of non-anticoagulated whole blood. Using this technology, global
      haemostasis of normal volunteers was studied using blood samples spiked with
      PPACK and prostacyclin. Blood from patients with acquired factor VIII deficiency
      and Glanzmann's thrombasthenia and from those receiving Coumadin therapy were
      also studied. The hollow fibre device detailed haemostatic abnormalities of both
      congenital and therapeutic conditions.

PMID- 7795157
TI  - Fibrin structure and concentration alter clot elastic modulus but do not alter
      platelet mediated force development.
AB  - During clot retraction, platelets interact with fibrin resulting in marked
      reduction of clot volume. Altered fibrin structure has been reported to affect
      clot retraction as measured by serum expression. This study was performed to test
      whether such altered retraction was the result of increased resistance to network
      collapse or due to decreased force development by platelets. Altered fibrin
      structure was documented as variation of fibre mass/length ratios (mu) and shifts
      in clot elastic modulus. The force developed by platelets during clotting was
      measured directly. Increasing the fibrinogen concentration led to thinner fibre
      formation (decreased mu), and a linear increase in gel elastic modulus. Over a
      fibrinogen concentration range of 100 to 400 mg/dl, force development was
      minimally affected. Force development and clot elastic modulus increased in a
      linear fashion with increasing platelet concentration. Increasing the calcium
      concentration from 5 to 20 mM caused a 160% increase in fibrin fibre size (mu),
      and a 52% decline in clot modulus. Force developed at 1200 s declined by 17%. At
      15 mg/ml, dextran and hydroxyethyl starch (HES) also increased mu, and decreased
      clot modulus; however, both agents markedly reduced force development. Increasing
      ionic strength or the addition of IgG decreased mu and increased gel elastic
      modulus. Force development increased modestly with increased ionic strength, did
      not change with addition of IgG in saline and declined with addition of IgG in
      maltose. This study indicates that force development is primarily dependent on
      platelet function while clot modulus depends on both fibrin structure and
      platelet function.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7795155
TI  - No influence of beta-carotene on haemostatic balance in healthy male smokers.
AB  - A high intake of beta-carotene has been associated with a decreased risk for
      cardiovascular disease. To evaluate whether beta-carotene may exert a protective
      effect through an impact on haemostasis a randomized, placebo-controlled trial
      was conducted in male smokers (n = 149) using 20 mg/day beta-carotene for 14
      weeks. For comparisons, haemostatic indicators were also evaluated in a group of
      non-smokers (n = 54). Smokers compared with non-smokers had higher fibrinogen
      (3.5 vs. 3.1 mg/ml, P < 0.01), higher tissue-type plasminogen activator antigen
      (t-PA; 8.03 vs. 6.60 ng/ml, P < 0.05), lower levels of soluble fibrin (3.40 vs.
      5.16 micrograms/ml, P < 0.01) and slightly higher plasma levels of total
      degradation products of fibrin and fibrinogen (TDP; 47.0 vs. 41.3 ng/ml, P =
      0.21). Within the group of smokers, there were no initial differences in the four
      haemostatic indicators between the placebo (n = 77) and beta-carotene (n = 72)
      groups, and in both groups there was virtually no change in the indicators during
      the 14 weeks treatment. It is concluded that the different haemostatic profile in
      smokers may partly explain their increased risk for cardiovascular disease. beta
      Carotene has no influence on the measured haemostatic indicators, and
      cardiovascular protection for beta-carotene via a beneficial effect on
      haemostasis seems improbable.

PMID- 7795158
TI  - Cytological features of a cystic nodular hidradenoma: potential pitfalls in
      diagnosis.

PMID- 7795159
TI  - Adenoid basal carcinoma of the cervix: an unusual cytological appearance.

PMID- 7795160
TI  - Organotypic thymic carcinoma; case report with histological and cytological
      correlates.

PMID- 7795161
TI  - Sclerosing haemangioma of lung mimicking carcinoma diagnosed by fine needle
      aspiration (FNA) cytology.

PMID- 7795163
TI  - Cytological changes associated with tubo-endometroid metaplasia of the uterine
      cervix.

PMID- 7795162
TI  - Diagnosis by fine needle aspiration cytology of sclerosing haemangioma of the
      lung.

PMID- 7795164
TI  - FNA cytology of oncocytic carcinoma of the parotid gland.

PMID- 7795165
TI  - Cytological scoring system in primary breast cancer.

PMID- 7795166
TI  - Bancroftian microfilaria in the breast clinically mimicking malignancy.

PMID- 7795167
TI  - Screening for cervical cancer in developing countries; need for new thinking.

PMID- 7795168
TI  - Implications of gynaecological abnormalities in pre-selection criteria for
      cervical screening: preliminary evaluation of 3602 subjects in south India.
AB  - Early detection and eradication of cervical cancer and its precursor lesions
      through organized mass cytological screening programmes have recently gained
      considerable attention in developing countries. Strategies for both cost saving
      and effective implementation are however required for mass cervical screening in
      developing countries. In an early cancer detection programme conducted in South
      India, we analysed cytological abnormalities in 3602 women and correlated the
      results with other factors, including age, gynaecological complaints, number of
      years of married life and parity to see if pre-selection for cytologic screening
      was possible. Only lower grades of dysplasia were found in asymptomatic women
      below the age of 40 years. In asymptomatic women, malignancy and higher grades of
      dysplasia were confined to women with a clinically abnormal cervix only.
      Univariate analysis also revealed that subjects with a parity of more than 3 and
      a married life of more than 20 years had a significantly higher number of
      cytological abnormalities. However, on a multivariate analysis the increased
      number of marital years was not found to be an independent variable. These
      results suggest that asymptomatic women below the age of 40 years with a married
      life of less than 20 years and parity below 3, may be excluded from screening
      campaigns, and that pre-selection for cytologic screening is possible by
      introducing a programme of clinical and speculum examination of the cervix.

PMID- 7795170
TI  - Rapid rescreening of cervical smears: an improved method of quality control.
AB  - Rapid rescreening of approximately 30% of all negative and inadequate consecutive
      smears was carried out over a 26-month period. Smears (n = 24,012) were
      rescreened using a x6.3 objective only. Two minutes were allowed for each slide.
      Thirty-nine smears were found to have been incorrectly diagnosed as negative, a
      rate of 0.16%. This can be compared with the previous 26 months during which the
      traditional 1 in 10 random rescreening of unsatisfactory and negative smears had
      been carried out at a routine pace and with an objective of x10. A total of 6866
      smears were rescreened. Eleven were found to have been incorrectly diagnosed as
      negative, a rate of 0.16%. Rapid rescreening is as sensitive as 1 in 10
      rescreening, and allows a greater proportion of smears to be rescreened. We
      propose rapid rescreening should replace the traditional 1 in 10 rescreening
      methods.

PMID- 7795169
TI  - DNA quantification is technically feasible and of value in cervical smear
      samples: possible applications for determination of progression in low grade
      dyskaryosis.
AB  - This study evaluates the feasibility of DNA analysis of cervical intraepithelial
      neoplasia III (CIN III) lesions on cervical smear and formalin-fixed paraffin
      embedded tissue (FFPET) blocks with a view to extending this type of analysis to
      milder grades of dyskaryosis. DNA ploidy was determined by image analysis using a
      CAS 200 Image Analyser. Seventeen patients with a diagnosis of CIN III were
      studied. Results show that all smear and tissue samples were non-diploid with
      nine aneuploid and eight tetraploid lesions. In 6/7 patients whose smears and
      corresponding biopsies were examined there was complete agreement as to the DNA
      profile. We conclude that DNA quantification is technically feasible in archival,
      routinely prepared cervical smears. This technique should now be applied to CINI
      and CINII cervical smears to determine if it is of value in identifying those
      lesions that will progress to CIN III. This study is particularly timely with the
      possibility in the near future of estimation of ploidy by image analysis using
      instruments such as the Highly Optimized Microscope Environment (HOME) system.

PMID- 7795171
TI  - The role of Bcl-2 protein and autocrine growth factors in a human follicular
      lymphoma-derived B cell line.
AB  - We have shown that the ability of the human follicular lymphoma-derived cell line
      SU-DHL-6 to proliferate and survive in vitro depends on both Bcl-2 expression and
      multiple autocrine growth factors. Treatment with Bcl-2 antisense (AS Bcl-2)
      decreased Bcl-2 protein levels. However, a cytotoxic effect was seen only at very
      restricted cell densities. Below such densities cells underwent spontaneous death
      without any treatment, while above these cell densities no cytotoxic effect of AS
      Bcl-2 could be seen. The conditioned medium of SU-DHL cells supported the
      survival and growth of these cells cultivated at low cell densities and partially
      reversed the cytotoxicity associated with Bcl-2 depletion. RT/PCR analysis
      revealed autocrine expression of IL-1 beta, IL-2, IL-5 and TNF-beta in SU-DHL
      cells. Neutralizing antibodies against these cytokines inhibited SU-DHL
      proliferation. Thus, development of autocrine GF secretion may be the second step
      in the pathogenesis of follicular lymphomas.

PMID- 7795172
TI  - Identification of differentially glycosylated forms of the soluble p75 tumor
      necrosis factor (TNF) receptor in human urine.
AB  - Human urine is known to contain a 30 kDa soluble form of the p75-TNF receptor
      (sTNF-R2). In this work we have purified sTNF-R2 from the urine of normal
      subjects and further characterized its structure and activity. sTNF-R2 was
      resolved by reducing SDS-PAGE in a major band of 30 kDa, similar in size to the
      previously described urinary sTNFR2, and in a minor band of 45 kDa. "Western"
      blotting analysis with anti-TNF-R1 and anti-TNF-R2 antibodies showed that both
      bands were immunologically related to the membrane TNF-R2. Glycosylation studies
      indicated that the 30 kDa is N-glycosylated while the 45 kDa form is N- and O
      glycosylated, and suggested that both forms contain terminally linked sialic acid
      that is differentially recognized by lectins. These results indicate that human
      urine contains, besides the 30 kDa form, a new form of 45 kDa characterized by
      different glycosylation type and degree.

PMID- 7795174
TI  - Endogenous nitric oxide production by human monocytic cells regulates LPS-induced
      TNF production.
AB  - The ability to produce nitric oxide (NO) of human monocytes macrophages is object
      of debate. While studying the regulation of tumor necrosis factor (TNF) synthesis
      induced by endotoxin (LPS) in a human cell line of monocyte origin (THP-1) and in
      human peripheral blood mononuclear cells (PBMC) we found an indirect evidence of
      such production. We showed that L-N-monomethyl-arginine (L-NMMA), an inhibitor of
      NO synthase, and hemoglobin, a chelator of NO, are able to significantly reduce
      TNF synthesis, indicating that NO production is induced by LPS and contributes to
      the induction of TNF. Since NO is a known cytostatic agent, we also studied the
      cytostatic effect of LPS, and demonstrated that it is reverted by L-NMMA.
      Although we were unable to show any nitrites/nitrates accumulation in the culture
      media, taken together our data give an indirect evidence of a physiologically
      relevant LPS-induced NO production in human monocytes-macrophages.

PMID- 7795175
TI  - An amplified ELISA for human tumour necrosis factor alpha.
AB  - An immunoassay for tumour necrosis factor alpha (TNF-alpha) is described using a
      sandwich system which employs a mouse monoclonal as the capture antibody and a
      polyclonal rabbit anti-TNF-alpha as the detection antibody. The assay utilises a
      novel enzyme cycling system to amplify the colourimetric signal generated by
      alkaline phosphatase in the enzyme immunoassay. The assay sensitivity is
      increased by the use of the AMPAK system. The detection limit of the assay is in
      the order of 1 pg/ml which is many times greater than is possible with
      conventional methods of measurement. The advantages of the enzyme-amplified
      method will be particularly useful in the quantitative determination of low
      levels of TNF-alpha in body fluids. This assay system was used to measure
      peripheral serum TNF levels in a group of women with non-malignant gynaecological
      conditions, the mean TNF-alpha concentration in these subjects was 10 pg/ml.

PMID- 7795173
TI  - C-reactive protein-induced colony-stimulating factors production by macrophages.
AB  - Purified human C-reactive protein(CRP: 0.5-50.0 micrograms/kg) given
      intravenously to monkeys (Macaca mulatta) induced serum colony-stimulating
      activity (CSF); maximum induction occurred at 10.0 micrograms/kg. In vitro also,
      purified human CRP (0.1-50.0 micrograms/ml) stimulated monkey blood monocyte
      derived macrophages to release CSF in to the medium (CM); 5.0 micrograms/ml CRP
      appeared optimal. Both in vivo and in vitro, the kinetics of the production of
      CSF were similar with maximal response occurring 6 h after stimulation and return
      to background levels by 48 h. Rabbit anti-CRP antibody completely abrogated the
      production of CSFs in vitro, suggesting a specific interaction between CRP and
      macrophages. A neutralizing concentration of rabbit anti-human interleukin-1 (IL
      1) polyclonal antibody had no effect on CRP induction of CSF-activity, indicating
      it to be IL-1 independent. CRP-induced CSFs, both in the serum and CM, were
      functionally similar as they supported the formation of granulocyte (G),
      macrophage (M) and GM colonies, in similar proportions. The macrophage production
      of CSFs appeared to be lipopolysaccharide-independent as polymyxin B (25.0
      micrograms/ml) had no inhibitory effect. Heat-treated (80 degrees C, 1 h, pH 7.0)
      CRP did not stimulate the macrophages to produce CSFs. The CSF release was
      dependent on protein synthesis as it was completely inhibited by cycloheximide
      (50.0 micrograms/ml). This study demonstrates that purified human CRP can induce
      the production of serum CSF activity in monkeys, and can stimulate monkey
      macrophages to produce CSFs in vitro.

PMID- 7795176
TI  - Protective effect of chlorpromazine on TNF-mediated hapten-induced irritant
      reaction.
AB  - Picryl chloride-induced irritant reaction (IR) was shown to be mediated by tumor
      necrosis factor (TNF). Anti-TNF monoclonal antibodies, but not interleukin 1
      receptor antagonist (IL-1 Ra), had a protective effect. Chlorpromazine (CPZ), an
      inhibitor of TNF synthesis, protected against IR and inhibited the IR-associated
      TNF induction in ear homogenates. Investigation of the role of polymorphonuclear
      leukocyte (PMN) in neutropenic mice showed that neutropenia did not prevent the
      development of the IR.

PMID- 7795178
TI  - Immunomodulation by cytokine antisense oligonucleotides.
AB  - The cytokine network is involved in normal immune reaction and in the progression
      of several pathologies. Antisense (AS) oligonucleotides, which allow specific
      inhibition of expression of proteins, offer a new methodology to investigate this
      complex network. This review focuses on the use of AS to modulate cytokine
      expression. AS may act in different ways such as blocking fixation or progression
      of the ribosome along the mRNA, mRNA cleavage by RNase H, or preventing normal
      RNA maturation. In order to improve AS efficiency, chemical modifications have
      been developed, and improvement of oligonucleotide uptake has been achieved with
      different systems of vectorization including liposomes (neutral, cationic,
      immunoliposome), nanoparticles, or covalent attachment of a carrier. In
      oncogenesis, intracellular or extracellular autocrine loops have been
      demonstrated by the use of cytokine AS. Involvement of cytokines in immunological
      reactions (TH1 and TH2 subset, IgE response, lymphokine activated killer,
      cytotoxic T lymphocyte...) and in hematopoiesis have also been studied with this
      approach. Therapeutic application of AS has been suggested by inhibition of
      inflammatory cytokines in vivo. Clinical trials using AS are under investigation
      in virological and in oncological diseases. At present, cytokine antisenses
      primarily represent a tool for dissecting the function of a cytokine in vitro,
      but they may offer in the future a new way for immunomodulation intervention.

PMID- 7795177
TI  - Measurements of cytokines and their receptors in the brain. International
      workshop organized within the context of the BIOMED concerted action "Cytokines
      in the brain". Amsterdam, 21-22 October 1994.

PMID- 7795179
TI  - High and low surgical procedure rates in census divisions across Canada.
AB  - This paper identifies outliers (unusually high or low values) among rates of 39
      surgical procedures in 255 Canadian census divisions. Surgery rates for the two
      year period from April 1988 through March 1990 were standardized for age and sex,
      and then "normalized" to adjust for differences in census division population
      sizes. Among the 39 procedures, a total of 402 outlying census division rates
      were found, of which 48 were deemed to be very high, 254 high, 79 low, and 21
      very low. The results are presented for individual procedures, by province, and
      for the 16 census divisions in which medical schools and their associated
      teaching hospitals are located.

PMID- 7795180
TI  - Second trimester abortions: trends and medical complications.
AB  - As a proportion of total abortions, those performed in the second trimester
      declined from 21% in 1974 to 10% in 1991. Second trimester (13 to 24 weeks)
      abortions were more frequent among women who were single, under age 20, and
      without prior deliveries or abortions. The stage of pregnancy at which an
      abortion was performed and the method used were associated with the risk of
      medical complications. Complication rates increased directly with the period of
      gestation. The complication rate for second trimester abortions was 13 times
      higher than that of first trimester abortions (under 13 weeks). The lowest
      complication rates were found among abortions performed using surgical D&C and
      suction D&C. The procedures primarily used for abortions at 16 or more weeks'
      gestation (i.e. the administration of prostaglandin, urea or saline) were
      associated with higher complication rates.

PMID- 7795181
TI  - The Canadian Organ Replacement Register.

PMID- 7795182
TI  - [The soluble form of guanylate cyclase in the molecular mechanism of the
      physiological effects of nitric oxide and in regulating platelet aggregation].

PMID- 7795183
TI  - [Electrophysiological characteristics of visual perception upon exposure to
      fluoracizine].

PMID- 7795184
TI  - [Discoordination of gastroduodenal myoelectrical activity during immobilization
      stress in rabbits].

PMID- 7795185
TI  - [Relationship of physiological and bioenergetic characteristics of neurotic aged
      rats].

PMID- 7795186
TI  - [Dependence of the antiarrhythmic effect of laser radiation on power, duration,
      and site of action].

PMID- 7795187
TI  - [Increase in sensitivity of mice to a convulsant after adoptive transfer of
      splenocytes from mice, subjected to corazole kindling].

PMID- 7795188
TI  - [Effect of azaleptin and its new derivative seleptin on spontaneous EEG and
      activation reaction in rabbits].

PMID- 7795190
TI  - [Regulatory activity of Kupffer cells in acute blood loss].

PMID- 7795189
TI  - [Increase in the resistance of the isolated heart to heat shock while adapting to
      moderate physical loads].

PMID- 7795192
TI  - [The effect of extracorporeal treatment of blood with an ozone-oxygen mixture on
      lung function of dogs under normal conditions and in disease].

PMID- 7795191
TI  - [The role of mast cells in regenerative phenomena in inflammation].

PMID- 7795193
TI  - [The effect of the organophosphorus pesticide antio on cerebral blood supply].

PMID- 7795195
TI  - [The effect of a hypothalamic cardioactive protein-hormone complex on the cholino
      sensitivity of the rat small intestine and contraction of the vas deferens].

PMID- 7795194
TI  - [Effect of the organophosphorus compound antio on pulmonary and systemic blood
      circulation in unanesthetized cats].

PMID- 7795196
TI  - [Dependence of the regulation of tracheal smooth muscle contractile activity on
      epithelium].

PMID- 7795197
TI  - [Effect of low dose gamma-radiation on nuclear RNA polymerase activity and liver
      cell protein synthesis in chicks of various ages].

PMID- 7795198
TI  - [Some cytochemical features of the motor system of the rat brain after space
      flight].

PMID- 7795199
TI  - [Anti-edemic activity of cerebrocrast in cerebral ischemia].

PMID- 7795200
TI  - [Effect of purine antagonists on the cyclic AMP level in lymphocytes and bone
      marrow lymphoblasts].

PMID- 7795201
TI  - [Effect of cerebrocrast on local cerebral circulation and EEG in awake rats in
      cerebral ischemia].

PMID- 7795202
TI  - [Comparison of neurotropic and stress-protective properties of piracetam and the
      derivative pyrido]1,2-a]pyrimidine].

PMID- 7795203
TI  - [The effect of bromantane, a new immunostimulant with psychostimulating action,
      on release and metabolism of dopamine in the dorsal striatum of freely moving
      rats: a microdialysis study].

PMID- 7795204
TI  - [Correlated interconnection between pharmacokinetic and dynamic development of
      the pharmacologic effects of bromantane].

PMID- 7795205
TI  - [The status of spermatogenesis in rats after administration of the anthracycline
      antibiotic farmorubicin].

PMID- 7795206
TI  - [Immune response to Epstein-Barr virus terminal repeat protein in patients with
      undifferentiated nasopharyngeal cancer].

PMID- 7795208
TI  - [Effect of enriching rations with selenium and vitamin E on some indicators of
      immunity in rats].

PMID- 7795209
TI  - [Effect of lymphokines on platelet cytotoxicity].

PMID- 7795207
TI  - [Detection of STLV-1 integration in DNA extracted from formalin-fixed and
      paraffin-embedded material from M. arctoides lymphoma by the polymerase chain
      reaction].

PMID- 7795210
TI  - [Expression of human interleukin-10 in Escherichia coli cells].

PMID- 7795211
TI  - [Differences in the effects of glucocorticoids on beta-adrenergic receptor
      density in lung and cerebral cortex].

PMID- 7795212
TI  - [Informative capacity of the rat sensomotor cortex in the post-reanimation period
      (a morphometric analysis of neuronal population)].

PMID- 7795213
TI  - [Effect of the type of damage on regional changes of some parameters of the
      endocrine system].

PMID- 7795215
TI  - Analysis of optimal conditions for retroviral-mediated transduction of primitive
      human hematopoietic cells.
AB  - We sought to define optimal conditions for retroviral-mediated transduction of
      long-lived human hematopoietic progenitors from bone marrow and peripheral blood.
      CD34+ cells were transduced by the LN and G2 retroviral vectors in the presence
      or absence of stromal support and with or without cytokine addition. After
      transduction, a portion of the cells was plated in methylcellulose colony-forming
      assay, with or without G418, to assess the extent of gene transfer into committed
      progenitors. The remaining cells from each experiment were transplanted into
      immunodeficient mice to allow analysis of transduction of long-lived progenitors.
      Human colony-forming cells contained within the murine bone marrow were analyzed
      after engraftment periods of 2 to 11 months. Cells were plated in a human
      specific colony-forming assay with and without G418 to assess the extent of
      transduction of primitive progenitors. Individual human colonies were also
      analyzed by polymerase chain reaction for the presence of provirus. Bone marrow
      progenitors were efficiently transduced only when stroma was present, whereas
      mobilized peripheral blood progenitors were effectively transduced in the
      presence of either stroma or cytokines. Inclusion of the cytokines interleukin-3,
      interleukin-6, and stem cell factor did not further augment the extent of gene
      transfer in the presence of a stromal support layer. Additionally, human CD34+
      progenitors from bone marrow or mobilized peripheral blood that had been
      transduced for 3 days in the absence of stroma failed to produce sustained, long
      term engraftment of bnx mice. Mice transplanted with the same pools of human
      progenitors that had been transduced in the presence of stroma for 3 days had
      significant levels of human cell engraftment at the same timepoints, 7 to 11
      months after transplantation. Our data show loss of long-lived human progenitors
      during 3-day in vitro transduction periods in the absence of stromal support.
      Therefore, the presence of bone marrow stroma has dual benefits in that it
      increases gene transfer efficiency and is essential for survival of long-lived
      human hematopoietic progenitors.

PMID- 7795217
TI  - Variations in radiation sensitivity and repair among different hematopoietic stem
      cell subsets following fractionated irradiation.
AB  - The radiation dose-survival of various hematopoietic cell subsets in murine bone
      marrow (BM) was determined in the cobblestone area forming cell (CAFC) assay
      under conditions of single-, split-, and multiple-dose irradiation. A greater
      recovery in cell survival with decreasing dose per fraction, or increasing
      fraction number, was observed for primitive CAFC day-28 and day-35 than for CAFC
      day-6 and day-12 (colony-forming unit (CFU)-granulocyte macrophage and CFU-spleen
      day-12 equivalents). Linear quadratic (LQ) model analysis of CAFC survival data
      provided an estimate of the alpha/beta ratio that is an inverse index of the
      fractionation effect and is known to be lower for late than for acutely
      responding tissues. This analysis gave decreasing alpha/beta ratios with
      increasing primitiveness of the CAFC subset. These values were found to be
      comparatively low (about 4 Gy) for CAFC day-28 and day-35 and are in general
      agreement with previous studies on long-term repopulation in vivo. In contrast,
      alpha/beta ratios of CAFC day-6 and day-12 were relatively high (above 6 Gy) and
      are consistent with values obtained from acute marrow failure. Delayed harvesting
      of BM after a single dose of 6 Gy showed little evidence of proliferative
      repopulation over 1 week and hence the differential dose-sparing effect of
      fractionation among the CAFC subsets appears to be mostly attributable to the
      influence of sublethal damage repair. These results require a reevaluation of
      previous notions of marrow stem cell radiosensitivity and repair based on acute
      marrow lethality (LD50/30) or spleen colony (CFU-S) data, especially when applied
      to fractionated total body irradiation effects on long-term repopulating stem
      cells in a BM transplant setting.

PMID- 7795216
TI  - Efficient expression of functional human MDR1 gene in murine bone marrow after
      retroviral transduction of purified hematopoietic stem cells.
AB  - A procedure for efficient transfer of the human MDR1 (multi-drug resistance) gene
      into murine hematopoietic stem cells was developed. Cells expressing Sca-1 but no
      lineage-specific or major histocompatibility complex (MHC) class II antigens (Lin
      MHC II-Sca-1+) were enriched from 5-fluorouracil-pretreated bone marrow by Ficoll
      density-gradient and immunomagnetic sorting. Purified cells were cocultured with
      growth factors and fibroblasts producing replication-deficient retroviruses
      containing human MDR1 cDNA. Fluorescence-activated cell sorter analysis and
      rhodamine-123 efflux experiments showed that greater than 60% of cocultured
      hematopoietic cells expressed functional human P-glycoprotein. After 6 to 8 days,
      hematopoietic cells were injected intravenously into sublethally irradiated SCID
      mice. Stem cell properties of the isolated population were confirmed by sustained
      expression of MDR1 marker cDNA for greater than 4 to 6 months after
      transplantation, multilineage engraftment, and presence of MDR1 cDNA in bone
      marrow of secondary recipient mice after retransplantation. Reconstitution of H
      2K-mismatched SCID mice showed high engraftment capacity of Lin-MHC II-Sca-1+
      cells. MDR1 cDNA was detected in blood of 78% of recipients. P-glycoprotein was
      expressed in bone marrow of 71% of mice, in both lymphocytes and myelomonocytoid
      progenitors. P-glycoprotein function in host marrow was confirmed by rhodamine
      123 efflux. Transduction of P-glycoprotein may be useful for gene therapy in two
      ways: to protect bone marrow from myelosuppression after chemotherapy and as a
      selectable marker in vivo for the introduction of otherwise nonselectable genes.

PMID- 7795214
TI  - AML1 and the 8;21 and 3;21 translocations in acute and chronic myeloid leukemia.

PMID- 7795219
TI  - Murine granulocytic cell adhesion to bone marrow hemonectin is mediated by
      mannose and galactose.
AB  - Hemonectin (HN) is a bone marrow (BM) protein that promotes specific attachment
      of immature granulocytes and their precursors within the BM. We report that HN is
      a glycoprotein containing both mannose and galactose residues, and provide
      evidence that these carbohydrates mediate granulocytic cell adhesion to HN.
      Carbohydrate structure was determined by digoxigenin-conjugated lectin binding to
      HN and indicated the presence of mannose, galactose, sialic acid, and the absence
      of fucose-linked oligosaccharides. The role of carbohydrates in mediating cell
      adhesion was examined by chemical and enzymatic deglycosylation. Deglycosylation
      of HN with trifluoromethanesulfonic acid, which cleaves N- and O-linked
      oligosaccharides, inhibits 66% of cell attachment to HN, and results in an
      apparent decrease in molecular weight from 60 to 50 kD. Enzymatic deglycosylation
      with endo-B-N-acetylglucosaminidase H, which hydrolyzes specific N-linked mannose
      residues, inhibits 30% of cell adhesion to HN. Finally, the role of these
      specific sugars in hemonectin-mediated cell adhesion was confirmed with
      neoglycoprotein blocking. Preincubation of BM cells with mannosyl- and galactosyl
      BSA probes produces a dose-dependent inhibition of cell attachment to HN, whereas
      fucosyl-BSA does not inhibit cell adhesion to HN. These results show that mannose
      and galactose partially mediate adhesion of BM granulocytes to HN.

PMID- 7795218
TI  - Interleukin-11 stimulates multilineage progenitors, but not stem cells, in murine
      and human long-term marrow cultures.
AB  - Interleukin-11 (IL-11) is a bone marrow microenvironment-derived growth factor
      with pleiotropic effects on a variety of hematopoietic cells. To more accurately
      assess the effects of IL-11 on stem and progenitor compartments within the
      hematopoietic microenvironment (HM), we added recombinant human (rh) IL-11 to
      human and murine long-term bone marrow cultures (LTMC) and analyzed primitive
      (high proliferative potential-colony forming cells [HPP-CFC], long-term culture
      initiating cells [LTC-IC], and long-term reconstituting stem cells) and
      progenitor (day 12 colony forming unit-spleen [CFU-S12], colony forming unit
      megakaryocyte [CFU-Mk] and colony forming unit-granulocyte/macrophage [CFU-GM])
      compartments throughout the duration of the cultures. rhIL-11 (100 ng/mL) added
      twice weekly resulted in significantly increased nonadherent (NA) cellularity,
      CFU-GM, and CFU-Mk production in human LTMC. Addition of rhIL-11 to murine LTMC
      was associated with a 5- to 40-fold increase in CFU-GM and a four- to 20-fold
      increase in day 12 CFU-S in NA cells. However, IL-11 had no significant effect on
      total HPP-CFC concentration and decreased the size of the more primitive
      stem/progenitor compartment as evidenced by both decreased LTC-IC frequency in
      human LTMC and decreased frequency of long-term reconstituting stem cells in
      murine LTMC. These data suggest that IL-11 may increase commitment of stem cells
      into a multipotential progenitor compartment.

PMID- 7795220
TI  - The human leukocyte integrin CD11a promoter directs expression in leukocytes of
      transgenic mice.
AB  - The human CD11a molecule is expressed specifically on lymphocytes,
      monocyte/macrophages, and neutrophils, in which it mediates important adhesion
      related functions. We used 1.7 kb of regulatory sequences upstream from the human
      CD11a gene transcription start site to drive expression of a modified human CD4
      reporter gene in transgenic mice. The transgene was expressed in a tissue
      specific fashion on all leukocytes and paralleled endogenous mouse CD11a
      expression. All five founder mice expressed the transgene, providing evidence for
      integration site-independent expression. However, expression was not proportional
      to transgene copy number. These studies indicate that (1) the mutated human CD4
      serves as an excellent reporter for analysis of leukocyte-specific promoters; (2)
      the CD11a regulatory unit used here represents a novel reagent for targeting gene
      expression to leukocytes; and (3) additional regulatory regions will be required
      for copy-number-dependent activity of CD11a regulatory sequences.

PMID- 7795221
TI  - Primary familial polycythemia: a frameshift mutation in the erythropoietin
      receptor gene and increased sensitivity of erythroid progenitors to
      erythropoietin.
AB  - Primary familial and congenital polycythemia (PFCP) is characterized by
      erythrocytosis with normal arterial PO2, blood P50, and serum erythropoietin
      (EPO) levels. In two PFCP families EPO receptor (EPOR) polymorphisms cosegregated
      with PFCP. A heterozygous insertion of G at EPOR nucleotide 5975 was identified
      in genomic DNA from polycythemic members of family no. 2. 5974insG shifts the
      reading frame at codon 430, predicting amino acid substitutions and truncation of
      the last 64 amino acids. Wild-type and mutant EPOR transcripts were detected in
      erythroid progenitors from affected individuals. Burst-forming units-erythroid
      from patients exhibited increased colony size and sensitivity to EPO. Transfected
      Ba/F3 cells expressing EPOR 5974insG exhibited increased EPO sensitivity compared
      with cells expressing wild-type EPOR. The functional effect of this EPOR mutation
      was directly compared with the other C-terminal mutations reported in unrelated
      PFCP families by expression in Ba/F3 cells. The transfected cells with another
      primary polycythemia associated EPOR mutant construct (G6002A) also exhibited
      increased sensitivity to EPO.

PMID- 7795222
TI  - Initiation of hematopoiesis and vasculogenesis in murine yolk sac explants.
AB  - The blood islands of the visceral yolk sac (VYS) are the initial sites of
      hematopoiesis in mammals. We have developed a yolk sac explant culture system to
      study the process of blood cell and endothelial cell development from
      extraembryonic mesoderm cells. No benzidine-positive cells or beta H1-globin mRNA
      expression was detected at the primitive streak or neural plate stage of
      development (E7.5). However, when isolated E7.5 dissected tissues were cultured
      for 36 to 72 hours in serum-free medium, hundreds of hemoglobin-producing cells
      and embryonic globin gene expression were identified in both intact yolk sac and
      VYS mesoderm explants. Explanted E7.5 extraembryonic mesoderm tissues thus
      recapitulate in vivo primitive erythropoiesis and do not require the presence of
      a vascular network or the VYS endoderm. Yolk sac blood islands also contain
      endothelial cells that arise by vasculogenesis and express flk-1. We detected flk
      1 mRNA as early as the primitive streak stage of mouse embryogenesis. Culture of
      embryo proper and intact VYS explants, which contain both mesoderm and endoderm
      cells, produced capillary networks and expressed flk-1. In contrast, vascular
      networks were not seen when VYS mesoderm was cultured alone, although flk-1
      expression was similar to that of intact VYS explants. The addition of vascular
      endothelial growth factor to VYS mesoderm explants did not induce vascular
      network formation. These results suggest that the VYS endoderm or its
      extracellular matrix is necessary for the coalescence of developing endothelial
      cells into capillary networks.

PMID- 7795223
TI  - Circulation of human hematopoietic cells in severe combined immunodeficient mice
      after Cl2MDP-liposome-mediated macrophage depletion.
AB  - Intravenous injection of dichloromethylene diphosphonate (Cl2MDP) encapsulated in
      liposomes results in specific elimination of macrophages in the spleen and liver
      of normal mice. Severe combined immunodeficient (SCID) mice were treated with
      Cl2MDP-liposomes followed by injection of human peripheral blood leukocytes.
      Control SCID mice had no detectable human cells within 72 hours as determined by
      fluorescence-activated cell sorting (FACS) analysis. However, Cl2MDP-liposome
      treated animals maintained a large proportion (%) of human cells in peripheral
      blood and spleen for at least 12 days. Cl2MDP-liposome-injected SCID mice that
      had previously been implanted with human fetal thymus and liver showed a
      transient increase in human cell content in peripheral blood, and an accumulation
      of human cells specific to the white pulp of the spleen. These results indicate
      that murine mononuclear phagocytic cells may play an important role in the
      clearance of human cells injected intravenously or generated endogenously in SCID
      mice and that Cl2MDP-liposome-mediated macrophage depletion allows human
      hematopoietic cells to circulate and survive in SCID mice, thereby expanding the
      potential for studying human cellular processes in vivo.

PMID- 7795224
TI  - Sphingosine-1-phosphate: a platelet-activating sphingolipid released from agonist
      stimulated human platelets.
AB  - Sphingosine-1-phosphate (Sph-1-P) is the initial product of catabolism of
      sphingosine by sphingosine kinase and is cleaved by Sph-1-P lyase to a fatty
      aldehyde and ethanolamine phosphate. This phosphorylated sphingoid base is not
      only an intermediary catabolite, but also a bioactive lipid with important
      functions, including stimulation of cell proliferation in Swiss 3T3 fibroblasts
      and inhibition of tumor cell motility. In the present study, we examined
      functional roles of Sph-1-P in human platelets. Sph-1-P induced platelet shape
      change and aggregation reactions, although it failed to elicit secretion.
      Sphingosine, ceramide, sphingomyelin, and N,N-dimethylsphingosine did not mimic
      the positive effects of Sph-1-P on platelets. Subthreshold concentrations of Sph
      1-P and weak platelet agonists such as adenosine diphosphate (ADP) and
      epinephrine synergistically elicited aggregation, which may be important for
      efficient amplification of platelet activation. Sph-1-P induced intracellular
      Ca2+ mobilization and the dose-response for Ca2+ release correlated closely with
      the concentration required for induction of shape change. On addition of
      [3H]sphingosine to intact platelets, the label was rapidly converted to Sph-1-P,
      and subsequently to ceramide and sphingomyelin. Interestingly, the Sph-1-P formed
      was specifically released into medium on stimulation of platelets with
      physiologic agonists. The amount of Sph-1-P in platelets, as measured by its
      conversion into radiolabeled N-acetyl-Sph-1-P, was 1.4 nmol/10(9) cells and was
      about four times higher than the mass of Sph present. When compared by mole
      percent Sph-1-P/phospholipid, the value for platelets is over 10 times higher
      than that for neutrophils. Our results suggest that Sph-1-P, rapidly converted
      from sphingosine, abundantly stored in platelets, and released on the cell
      activation, may play a physiologic role in thrombosis, hemostasis, and the
      natural wound-healing processes.

PMID- 7795226
TI  - Retinoic acid reduces induction of monocyte tissue factor and tissue
      factor/factor VIIa-dependent arterial thrombus formation.
AB  - Agents that downregulate the induction of monocyte/macrophage tissue factor (TF)
      activity may attenuate the thrombotic risk associated with mechanical restoration
      of vessel patency or artificial arterial grafting. In such events, procoagulant
      macrophages in the atherosclerotic plaque and procoagulant monocytes adherent to
      artificial materials may be exposed to the blood stream. Ishii et al (Blood
      80:2556, 1992) reported that induction of endothelial TF is downregulated by all
      trans retinoic acid (ATRA), and Conese et al (Thromb Haemost 66:662, 1991)
      reported that retinoids downregulate monocyte procoagulant activity (PCA). These
      findings led us to investigate the effect of ATRA on monocyte TF expression, and
      to study the effect of ATRA on monocyte-induced thrombus formation in a model
      system of human arterial thrombogenesis. Induction of PCA in human peripheral
      blood monocytes by 0.5 microgram/mL lipopolysaccharide (LPS) was dose dependently
      reduced by ATRA, reaching a reduction of 56% at 10(-5) mol/L ATRA (P < .0001). A
      38% reduction (P < .0007) in LPS-induced TF antigen expression was observed at an
      ATRA concentration of 10(-6) mol/L. Adherence of monocytes to plastic cover slips
      (Thermanox, Miles Laboratories, Naperville, IL) also triggered induction of
      cellular PCA, which was inhibited by more than 80% by an anti-TF monoclonal
      antibody (MoAb) (P < .002). Inclusion of ATRA (10(-6) mol/L) reduced this PCA by
      40% (P < .03), and the TF antigen expression by 30% (P < .0001). Exposure of
      Thermanox adherent monocytes to flowing nonanticoagulated human blood in a
      parallel-plate perfusion chamber device at an arterial wall shear rate of 650 s-1
      elicited significant fibrin deposition and platelet thrombus formation. Partial
      interruption of this thrombus formation was achieved by 10(-6) mol/L ATRA, which
      reduced the fibrin deposition by 80% (P < .02) and platelet thrombus formation by
      50% (P < .05). In comparison, incubation of adherent monocytes with the anti-TF
      MoAb before the blood exposure, reduced the fibrin deposition by 83% (P < .02)
      and platelet thrombus volume by 75% (P < .0008). Thus, ATRA is an effective down
      regulator of monocyte TF-PCA, and may reduce thrombotic complications at sites of
      plaque rupture, at plaque disruption after percutaneous transluminal angioplasty
      procedures, or on surfaces introduced by artificial arterial grafting.

PMID- 7795225
TI  - Enzyme-linked immunoabsorbent assay detection of a soluble form of urokinase
      plasminogen activator receptor in vivo.
AB  - The receptor for urokinase plasminogen activator (uPA-R, CD87) is a
      glycosylphosphatidylinositol (GPI)-anchored 50 to 65 kD glycoprotein that, by
      regulating membrane-associated plasmin activity, may facilitate the invasion of
      inflammatory and malignant cells. Certain other GPI-anchored glycoproteins are
      shed from the cell membrane and exist as soluble products in vitro and in vivo.
      To determine if uPA-R undergoes a similar phenomenon, we have developed a
      sensitive enzyme-linked immunoabsorbent assay (ELISA) (using a rabbit antiserum
      as both capture and detection reagents) to measure the quantity of soluble uPA-R
      (suPA-R) in tissue culture supernatants and biologic fluids. Using this ELISA, we
      have detected suPA-R in the culture supernatants of U-937 cells and human
      monocytes stimulated in vitro by certain soluble inflammatory mediators (Sitrin
      et al, Blood 84:1268, 1994; Mizukami et al., Clin Res 42:115A, 1994). To
      determine if suPA-R exists in vivo, we have screened the plasma of 20 normal
      volunteers (mean +/- SD, 3 +/- 3 ng/mL; median, 2 ng/mL; range, 1 to 11 ng/mL
      [serum values slightly higher]); the plasma of 13 ICU patients with clinical
      sepsis syndrome (mean +/- SD, 30 +/- 11 ng/mL; median, 11 ng/mL; range, 4 to 221
      ng/mL); and the extravascular fluids (pleural, pericardial, and peritoneal) of 84
      individuals with presumed inflammatory or malignant conditions (mean +/- SD, 21
      +/- 39 ng/mL; median, 10 ng/mL; range, 2 to 253 ng/mL). Among the latter
      specimens, most were inflammatory exudates (only six were malignant by positive
      cytology) with the highest quantities of suPA-R associated with neutrophilic
      exudates. The solubility of suPA-R contained within these fluids was confirmed by
      reanalysis after ultracentrifugation to remove particulate material. When tested
      in a uPA ligand capture ELISA, representative specimens of extravascular body
      fluids and sepsis plasma contained suPA-R capable of binding uPA ligand
      (generally representing a small fraction of the immunoreactive material). We
      conclude from these data that suPA-R is immunologically detectable in vitro and
      in vivo with high concentrations of receptor found under conditions of
      inflammatory stimulation. The possibility of suPA-R's biologic activity is
      suggested by its partial retention of ligand binding capacity.

PMID- 7795227
TI  - Incidence of activated protein C resistance caused by the ARG 506 GLN mutation in
      factor V in 113 unrelated symptomatic protein C-deficient patients. The French
      Network on the behalf of INSERM.
AB  - Because multiple risk factors in one patient may increase the clinical expression
      of thrombophilia, we assessed the presence in protein C-deficient patients of the
      factor V Arg 506 Gln mutation responsible for activated protein C resistance.
      Using a strategy allowing rapid screening of factor V exon 10, we studied 113
      patients with protein C deficiency and 104 healthy volunteers. We detected the
      Arg 506 Gln mutation in 15 patients (14%) and in one healthy subject (1%). We
      identified a previously unpublished sequence variation leading to an Arg 485 Lys
      substitution in three normal subjects and seven protein C-deficient patients. A
      significant difference in the allelic frequency of the Arg 506 Gln factor V
      mutation was found between protein C-deficient patients heterozygous for an
      identified protein C mutation (n = 84; allelic frequency, 4.8%) and protein C
      deficient patients with no identified mutation in the protein C gene coding
      regions (n = 25; allelic frequency, 14%). The results demonstrate that a
      significant subset of thrombophilic patients has multiple genetic risk factors
      although additional secondary genetic risk factors remain to be identified for
      the majority of symptomatic protein C-deficient patients.

PMID- 7795228
TI  - The epidermal growth factor-like domain of recombinant human thrombomodulin
      exhibits mitogenic activity for Swiss 3T3 cells.
AB  - Thrombomodulin (TM) is an anticoagulant endothelial cell surface glycoprotein
      containing six tandem epidermal growth factor (EGF)-like structures. We prepared
      a recombinant TM peptide (rTME1-6, from R214GHWA to DSGK466 of native TM)
      composed of these six EGF-like structures and investigated the effect of rTME1-6
      peptide on the growth of the Swiss 3T3 fibroblast cell line. It was found that
      rTME1-6 induced proliferation of Swiss 3T3 cells and accelerated [3H]thymidine
      uptake into their DNA. [3H]Thymidine uptake increased in a dose-dependent manner,
      plateauing at 50 ng/mL rTME1-6, which was 1.8 times the control level. rTME1-6
      peptide (50 ng/mL) also accelerated the DNA synthesis of human dermal fibroblasts
      (HDFs), A549 (a human lung cancer cell line), HepG2 (a human hepatocarcinoma cell
      line), and U937 cells (a human monocytic cell line) to 1.5, 1.6, 1.4, and 1.2
      times the control level, respectively. The magnitude of the acceleration of DNA
      synthesis in Swiss 3T3 induced by rTME1-6 was approximately 20% of that of EGF on
      a molar basis. The uptake of [3H]thymidine was accelerated synergistically by
      coculture of the cells with rTME1-6 and insulin, similar to the coculture with
      EGF and insulin. The effects of rTME1-6 were abolished by addition of polyclonal
      antihuman TM IgG, whereas the actions of insulin and EGF were not influenced.
      Glucose uptake in Swiss 3T3 cells also increased 1.6 times over control levels by
      culture with 50 ng/mL rTME1-6 (1.25 nmol/L), compared with 2.7 times by 10 ng/mL
      EGF (1.66 nmol/L). Binding of [125I]EGF (0.5 ng/mL, 0.083 nmol/L) by the cells
      was inhibited by about 60% by addition of an eight-fold molar excess of
      nonlabeled EGF (0.664 nmol/L), whereas no inhibition of [125I]EGF binding was
      observed, even in the presence of a 1,000-fold molar excess (83 nmol/L) of rTME1
      6. Specific binding of [125I]rTME1-6 on the cells showed a saturation curve, and
      the apparent concentration of rTME1-6 required for half maximum binding of the
      peptide on the cells was calculated to be 31.5 ng/mL. Thus, the overall results
      indicated that the rTME1-6 peptide had mitogenic activity for Swiss 3T3 cells,
      accelerated DNA synthesis and glucose uptake, and that the mitogenic activity
      might be mediated by binding of the peptide to a specific site different from the
      EGF receptor.

PMID- 7795229
TI  - Recombinant thrombopoietin induces rapid protein tyrosine phosphorylation of
      Janus kinase 2 and Shc in human blood platelets.
AB  - A cDNA for the thrombopoietin has been cloned by several groups. The recombinant
      thrombopoietin has been reported to stimulate the megakaryocytopoiesis and
      thrombopoiesis. Little is known regarding the molecular basis of its effects. To
      elucidate the molecular mechanism involved in signal transduction, we have
      investigated the effects of thrombopoietin on platelet tyrosine phosphorylation.
      We report here that thrombopoietin induced time- and dose-dependent tyrosine
      phosphorylation of several proteins including Janus kinase 2 (Jak2) and a 52-kD
      protein, Shc, in human blood platelets. Both Jak2 and Shc were tyrosine
      phosphorylated within 15 seconds after stimulation. The tyrosine phosphorylation
      of Jak2 was accompanied by increased kinase activity, whereas Shc tyrosine
      phosphorylation induced its association with a 25-kD protein, Grb2. Thus, our
      data suggest that Jak2, Shc, and Grb2 may be involved in signal transduction
      after ligand binding to c-mpl in human platelets.

PMID- 7795230
TI  - Th1 and Th2 T-helper cells exert opposite regulatory effects on procoagulant
      activity and tissue factor production by human monocytes.
AB  - The role of T-cell subsets in the induction of tissue factor (TF) production by
      human monocytes in vitro was investigated. Mitogen stimulation enabled both
      unfractionated T cells and their CD4+ or CD8+ subsets to promote procoagulant
      activity (PCA). After mitogen or antigen activation, all seven T-cell clones with
      Th1 cytokine profile, but none of seven Th2 clones, induced TF production and
      PCA. T-cell blasts from four Th1 activated clones were fixed with
      paraformaldehyde and added to monocytes in the presence of medium alone or their
      supernatants. Addition of either fixed Th1 cells or their supernatants induced
      low TF production (0.2 to 0.6 ng/mL), whereas addition of both resulted in much
      higher TF synthesis (1.8 to 3.4 ng/mL). Among Th1-type cytokines, only interferon
      gamma (IFN-gamma) induced minimal TF production (0.1 to 0.4 ng/mL). No TF
      synthesis was induced by activated and fixed Th2 cells and/or their supernatants,
      whereas combined addition of fixed Th2 cells and Th1 supernatants or IFN-gamma
      induced noticeable TF production. The addition of either anti-IFN-gamma antibody
      or Th2 supernatants to monocytes stimulated with activated and fixed Th1 cells
      plus their supernatant resulted in a dose-dependent inhibition of TF synthesis,
      which was partially restored by neutralization of interleukin-4 (IL-4) or IL-10.
      Addition of recombinant IL-4, IL-13, or IL-10, but not IL-5, inhibited the Th1
      induced TF production by monocytes. Data indicate that both CD8+ and CD4+ Th1,
      but not Th2, T cells can help TF production and PCA. Both cell-to-cell contact
      with activated T cells and Th1-type cytokines, in particular IFN-gamma, are
      required for optimal TF synthesis, whereas Th2-derived cytokines (IL-4, IL-13,
      and IL-10) are inhibitory. This may be of potential interest for future
      therapeutic strategies.

PMID- 7795231
TI  - Increased levels of oxidized glutathione in CD4+ lymphocytes associated with
      disturbed intracellular redox balance in human immunodeficiency virus type 1
      infection.
AB  - We investigated the intracellular glutathione redox status in isolated lymphocyte
      subpopulations and monocytes in patients with human immunodeficiency virus type 1
      (HIV-1) infection and in healthy controls. CD4+ lymphocytes from HIV-1-infected
      patients were primarily characterized by a substantial increase in oxidized
      glutathione levels and a considerable decrease in the ratio of reduced to total
      glutathione, in most cases below 0.5 in patients with symptomatic HIV-1
      infection, rather than decreased levels of reduced glutathione. The increase in
      oxidized glutathione was strongly correlated with low numbers of CD4+ lymphocytes
      in peripheral blood and impaired stimulated interleukin-2 production and
      proliferation in peripheral blood mononuclear cells, which is compatible with an
      immunopathogenic role for these redox disturbances. The HIV-1-infected patients
      with the most advanced clinical and immunologic disease were also characterized
      by an increase in levels of reduced glutathione in monocytes, suggesting that the
      glutathione redox cycle may be differentially regulated in CD4+ lymphocytes and
      monocytes. We could not confirm previous reports suggesting cysteine deficiency
      as a major cause of disturbed glutathione homeostasis during HIV-1 infection. The
      demonstrated glutathione abnormalities were correlated with raised serum levels
      of tumor necrosis factor alpha. These findings suggest that a therapeutical
      approach, which can restore the glutathione redox dysbalance in CD4+ lymphocytes
      and decrease the inflammatory stress, may be worthwhile exploring in HIV-1
      infection.

PMID- 7795232
TI  - Apoptosis in bone marrow biopsy samples involving stromal and hematopoietic cells
      in 50 patients with myelodysplastic syndromes.
AB  - Cell-cycle kinetics were measured in situ after infusions of iododeoxyuridine
      and/or bormodeoxyuridine in 50 patients with myelodysplastic syndromes (MDS) and
      the median labeling index in bone marrow (BM) biopsy samples was 28.6%.
      Unfortunately, 26 of 50 patients showed that > or = 75% of hematopoietic cells of
      all three lineages were undergoing programmed cell death (PCD) in their biopsy
      samples as shown by the in situ end labeling (ISEL) technique. Ten patients had
      1/3 and eight had 2/3 ISEL+ cells. Stromal cells were frequently ISEL+ and often
      S-phase cells were also found to be simultaneously ISEL+. Nucleosomal DNA
      fragments as a ladder in agarose gel were present in BM aspirates of four
      patients who showed high ISEL and were absent in two who had no ISEL staining in
      biopsy samples, but only when DNA was extracted after a 4-hour in vitro
      incubation in complete medium. Therefore, laddering data confirmed the ISEL
      findings that the majority of hematopoietic cells in MDS are in early stages of
      PCD. We conclude that extensive intramedullary cell death may explain the paradox
      of pancytopenia despite hypercellular marrows in MDS patients. Investigating
      approaches that protect against PCD in some MDS subsets would be of interest.

PMID- 7795233
TI  - RT-PCR diagnosis of patients with acute nonlymphocytic leukemia and
      inv(16)(p13q22) and identification of new alternative splicing in CBFB-MYH11
      transcripts.
AB  - As acute nonlymphocytic leukemia (ANLL) with inv(16) (p13q22) or
      t(16;16)(p13;q22) has been shown to result from the fusion of transcription
      factor subunit core binding factor (CBFB) to a myosin heavy chain (MYH11), we
      sought to design methods to detect this rearrangement using reverse transcriptase
      polymerase chain reaction (RT-PCR). In all of 27 inv(16)(p13q22) and four
      t(16;16)(p13;q22) cases tested, a chimeric CBFB-MYH11 transcript coding for an in
      frame fusion protein was detected. In a more extensive RT-PCR analysis with
      different primer pairs, we detected a second new chimeric CBFB-MYH11 transcript
      in 10 of 11 patients tested. The CBFB-MYH11 reading frame of the second
      transcript was maintained in one patient but not in the others. We show that the
      different CBFB-MYH11 transcripts in one patient arise from alternative splicing.
      Translation of the transcript in which the CBFB-MYH11 reading frame is not
      maintained leads to a slightly truncated CBFB protein.

PMID- 7795234
TI  - BCL-6 gene product, a 92- to 98-kD nuclear phosphoprotein, is highly expressed in
      germinal center B cells and their neoplastic counterparts.
AB  - The BCL-6 gene is known to be located on chromosome 3q27, at the breakpoint of
      the 3q27-associated translocations that occur frequently in human non-Hodgkin's
      lymphomas (NHLs). To identify the BCL-6 protein, two antibodies that recognized
      distinct domains of this protein were raised in rabbits. Immunoprecipitation and
      immunoblotting of lysates of BCL-6-expressing cells using both antibodies showed
      a broad 92- to 98-kD band. Dephosphorylation of BCL-6 protein reduced the size of
      this band to 87 kD, suggesting that BCL-6 may be expressed in a phosphorylated
      form. Immunostaining with both antibodies showed that BCL-6 protein was localized
      in the nuclei of most of the germinal center B cells and a small number of
      marginal zone B cells. Furthermore, BCL-6 protein was expressed in follicular,
      Burkitt's, and diffuse large B-cell lymphomas. These results suggest that the BCL
      6 protein, expressed in B cells of the germinal centers which are important in
      the maturation of immune responses, may play some physiological role(s) in the
      germinal center B cells.

PMID- 7795236
TI  - Overexpression of cyclin D1 in the Dami megakaryocytic cell line causes growth
      arrest.
AB  - The maturation of megakaryocytes in vivo requires polyploidization or repeated
      duplication of DNA without cytokinesis. As DNA replication and cytokinesis are
      tightly regulated in somatic cells by cyclins and cyclin-dependent kinases, we
      sought to determine the pattern of cyclin gene expression in cells that undergo
      megakaryocytic differentiation and polyploidization. The Dami megakaryocytic cell
      line differentiates and increases ploidy in response to phorbol 12-myristate 13
      acetate (PMA) stimulation in vitro. We used Northern blotting to analyze mRNA
      levels of cyclins A, B, C, D1, and E in PMA-induced Dami cells and found that
      cyclin D1 mRNA levels increased dramatically (18-fold). Similar increases in
      cyclin D1 mRNA were obtained for other cell lines (HEL and K562) with
      megakaryocytic properties, but not in HeLa cells. The increase in cyclin D1 was
      confirmed by Western immunoblotting of PMA-treated Dami cells. This finding
      suggested that cyclin D1 might participate in megakaryocyte differentiation by
      promoting endomitosis and/or inhibiting cell division. To address these
      possibilities, we constructed two stable Zn+2-inducible, cyclin D1-overexpressing
      Dami cell lines. Cyclin D1 expression alone was not sufficient to induce
      polyploidy, but in conjunction with PMA-induced differentiation, polyploidization
      was slightly enhanced. However, unlike other cell systems, cyclin D1
      overexpression caused cessation of cell growth. Although the mechanism by which
      cyclin D1 may affect megakaryocyte differentiation is not clear, these data
      demonstrate that cyclin D1 is upregulated in differentiating megakaryocytic cells
      and may contribute to differentiation by arresting cell proliferation.

PMID- 7795235
TI  - Identification of B-cell growth factors (interleukin-14; high molecular weight-B
      cell growth factors) in effusion fluids from patients with aggressive B-cell
      lymphomas.
AB  - The molecular basis of neoplastic B-cell growth is complex and poorly understood.
      Cytokines have been postulated to contribute to neoplastic cell growth, and many
      in vitro studies have confirmed this prediction, but little is known about the in
      vivo role of these growth factors. We have examined the production of interleukin
      14 (IL-14) (high molecular weight [HMW], B-cell growth factor [BCGF]) by
      aggressive intermediate (diffuse large cell) lymphomas of the B-cell type non
      Hodgkin's lymphoma (NHL-B) in four patients with lymphomatous effusions. In these
      studies, IL-14 was detected in the effusion fluids by Western blots and IL-14
      mRNA was constitutively expressed in the freshly isolated lymphoma cells that
      also expressed the receptor for IL-14 (IL14R). Lymphoma B cells placed at low
      serum and cell density proliferated in vitro to either purified IL-14 or IL-14
      derived from effusion fluids. Antibodies to IL-14 removed the growth-stimulating
      cytokine(s) from the effusions. Cell lines developed from these patients produced
      IL-14 in vitro and antisense oligos to IL-14 blocked their growth in vitro. Thus,
      autocrine or paracrine production of IL-14 may play a significant role in the
      rapid proliferation of aggressive NHL-B. Interrupting this pathway could be a
      useful goal of therapy for patients resistant to conventional chemotherapy.

PMID- 7795237
TI  - Cutaneous T-cell infiltrates: analysis of T-cell receptor gamma gene
      rearrangement by polymerase chain reaction and denaturing gradient gel
      electrophoresis.
AB  - In cutaneous T-cell infiltrates, the demonstration of a clonal T-cell receptor
      (TCR) gene rearrangement has been considered helpful to distinguish Cutaneous T
      cell lymphomas from reactive lymphoproliferation. Hence, a polymerase chain
      reaction (PCR) method using GC-clamp primers and denaturing gradient gel
      electrophoresis has been developed in our laboratory to analyze the TCR gamma
      locus configuration. Two hundred eleven cutaneous samples from 155 patients were
      analyzed. A detectable clonal TCR gamma rearrangement was significantly
      associated with cutaneous T-cell lymphomas as defined by morphologic and
      immunologic criteria. A clonal TCR gamma rearrangement was also detected
      frequently in lymphomatoid papulosis, never in reactive lymphocytic infiltrates
      and B-cell lymphomas, and rarely in parapsoriasis en plaque and cutaneous
      lymphoid hyperplasia. Forty five patients had both a cutaneous and a peripheral
      blood sample. Fifteen had a detectable clonal rearrangement in the two samples
      and 22 were negative. Six patients had a positive skin sample and a negative
      blood sample, whereas two patients had a positive blood sample and a negative
      skin sample. Four lymph node samples were analyzed and the PCR results were the
      same as in the skin. Finally, 21 patients had sequential samples of recurrent
      skin lesions. The PCR results were concordant in all and, when detectable, the
      clonal TCR gamma rearrangement remained unchanged in a given patient. Because of
      its simplicity and accuracy, the newly designed PCR procedure improves the
      monitoring of diagnosis, staging, and follow-up in cutaneous T-cell infiltrates.

PMID- 7795239
TI  - Magnetic resonance imaging of femoral marrow in patients with myelodysplastic
      syndromes or leukemia.
AB  - We evaluated magnetic resonance imaging (MRI) of femoral marrow in 85 untreated
      adult patients with myelodysplastic syndromes (MDS) (N = 27), aplastic anemia (N
      = 9), and leukemia (N = 49). Images of femoral marrow were obtained using a T1
      weighted spin-echo (SE) method and a short T1 inversion recovery (STIR)
      technique. In patients with MDS, the change in MRI pattern from a fatty or
      nodular pattern to a uniform pattern correlated with disease progression.
      Evolution to acute leukemia in MDS patients was associated with a higher signal
      intensity on STIR images (lower signal intensity on T1-weighted SE images) and an
      extended area of involvement. The femoral marrow in patients with de novo acute
      myeloid leukemia (AML) showed increased signal and varied patterns (scattered to
      uniform) on STIR images. However, the faint pattern (grade 4a) was characteristic
      of M2 AML. In patients with chronic myelogenous leukemia (CML) in the chronic
      phase, increased leukemic mass was represented by replacement of the femoral
      marrow with a region of abnormal signal intensity. The extent of involved areas
      in these CML patients correlated with the spleen size. This study indicates that
      MRI of femoral marrow is an important tool for the accurate diagnosis and
      management of patients with MDS and leukemia that may function as an adjunct to
      bone marrow aspiration and biopsy.

PMID- 7795238
TI  - p16INK4A and p15INK4B gene deletions in primary leukemias.
AB  - The 9p21 locus has been deleted at a high frequency in a wide variety of tumors.
      Recently, two genes, p16INK4A and p15INK4B (also called MTS1 and MTS2), have been
      localized in close proximity at the 9p21 locus, encoding cyclin-dependent kinases
      4/6 inhibitors of relative molecular mass 16 kD and 15 kD, respectively and also
      found to be deleted at a high frequency in tumor cell lines. We analyzed p16INK4A
      and p15INK4B genes in 178 cases of primary leukemias including 81 cases of
      chronic lymphocytic leukemia (CLL), seven of hairy cell leukemia (HCL), seven of
      chronic myelogenous leukemia (CML), 43 of acute myelogenous leukemia (AML), 27 of
      acute lymphoblastic leukemia (ALL), and 13 of myelodysplastic syndrome (MDS) by
      Southern blot analyses. The ALL cases showed a relatively high frequency of
      homozygous deletions (22%, 6 of 27) at the p16INK4A gene locus. Interestingly, of
      the six cases with p16INK4A homozygous deletions, only three showed homozygous
      deletions at the p15INK4B gene. In 81 CLL patients, we detected one homozygous
      and five heterozygous deletions at both the p16INK4A and p15INK4B genes and two
      heterozygous deletions at the p16INK4A gene alone. Deletion of these two genes in
      AML cases is relatively low (9%). We did not detect deletions in any of the MDS,
      HCL, and CML cases examined. Sequence analyses of p16INK4A gene of six CLL cases
      with heterozygous deletion at this locus showed a 27-bp deletion at the splice
      acceptor site of intron 1 in one case and changes in the coding sequence in three
      other cases. The data presented in this report showed that (1) p16INK4A and
      p15INK4B genes are preferentially deleted homozygously in ALL and heterozygously
      in CLL cases with frequent mutation in the second allele, and (2) p16INK4A gene
      appears to be more frequently deleted than p15INK4B gene.

PMID- 7795240
TI  - Constitutive expression of GATA-1, EPOR, alpha-globin, and gamma-globin genes in
      myeloid clonogenic cells from juvenile chronic myelocytic leukemia.
AB  - Juvenile chronic myelocytic leukemia (JCML) is a rare disorder of early
      childhood. Characteristic of JCML are the progressive appearance of high levels
      of fetal hemoglobin (HbF), reflecting a true reversion to a fetal type of
      erythropoiesis, and the presence of colony-forming cells able to grow in vitro
      spontaneously in the absence of growth factors. To better understand the
      relationship between the erythroid abnormalities and the leukemic process, we
      analyzed the expression pattern of specific genes related to erythroid
      differentiation--GATA-1, EPOR, alpha-globin, beta-globin, and gamma-globin genes-
      in JCML peripheral blood (PB) cells and in vitro-derived colonies. Northern blot
      analysis of PB cells from five JCML patients indicated levels of GATA-1
      transcripts much higher than those usually found in other types of leukemic
      cells, and S1 nuclease protection assay detected significantly increased
      expression of gamma-globin mRNA. Reverse transcription-polymerase chain reaction
      (RT-PCR) analysis of single granulocyte-macrophage colony-forming unit (CFU-GM)
      colonies, obtained in vitro in the absence of added growth factors from four JCML
      patients, detected GATA-1, EPOR, and globin (alpha and gamma) transcripts in most
      of the colonies tested, in contrast with control CFU-GM from normal bone marrow,
      which were positive only for GATA-1. Single JCML colonies were tested for the
      presence of two different transcripts; whereas alpha- and gamma-globin genes
      appeared mostly coexpressed, beta-globin mRNA was detected only in a minority of
      the gamma-globin-positive colonies, indicating that the leukemic pattern of
      hemoglobin synthesis is mainly fetal. In addition, the leukemic cells occurring
      during blast crisis of one of our patients displayed the typical features of a
      stem cell leukemia (CD34+, CD19-, CD2-, myeloperoxidase-). In this sorted CD34+
      population, we detected the presence of a marker chromosome, der(12)t(3;12),
      previously identified in bone marrow cells at diagnosis and an expression pattern
      superimposable to that of the JCML colonies, consistently displaying a high gamma
      globin:beta-globin mRNA ratio. The expression of erythroid markers within
      populations of leukemic cells, both in vivo and in vitro, supports the hypothesis
      that abnormal JCML erythroid cells may originate from the same mutated progenitor
      that sustains the growth of the leukemic cells.

PMID- 7795241
TI  - AG dinucleotide insertion in a patient with chronic granulomatous disease lacking
      cytosolic 67-kD protein.
AB  - The 67-kD cytosolic protein (p67-phox) is an essential component of the
      superoxide-generating system in phagocytes, and its defect is known to cause
      chronic granulomatous disease (CGD). We sequenced p67-phox cDNA from one of seven
      patients found in Japan and his parents. In the patient's cDNA, homozygous AG
      dinucleotide insertion at position 399 (or 401) was found together with three
      other homozygous substitutions in a coding region (A-542 to G, T-895 to C and A
      983 to G) compared with the sequence reported for HL-60 cells. In cDNA from his
      parents, the AG insertion was found to be heterozygous. In contrast, the other
      three substitutions were found homozygously in his father's specimen and the
      latter two in his mother's specimen. The substitution of A-542 to G was
      heterozygous in his mother's cDNA. The AG insertion would induce a frame shift
      and bring about a stop codon at the position of 433. However, the other three
      differences would give insignificant changes for the protein function, if any,
      because the substitutions of A-542 to G and A-983 to G result in the conservative
      amino acid transitions, ie, Lys-180 to Arg and Lys-327 to Arg, and that of T-895
      to C no amino acid change. Neutrophils from the patients completely lacked
      superoxide generating activity whereas those from his parents generated
      substantial amounts of superoxide anion upon stimulation. Thus, it is concluded
      that the AG dinucleotide insertion is responsible for the disease in this
      patient.

PMID- 7795242
TI  - Generation of normal human red cell volume, hemoglobin content, and membrane area
      distributions by "birth" or regulation?
AB  - Using flow cytometry and osmotic lysis measurements, we document here the means
      and coefficients of variation of the following red cell (RBC) properties:
      hemoglobin (Hb) content, volume, Hb concentration, and relative lytic tonicity
      distributions in populations of normal human RBCs, before and after density
      fractionation. The distributions showed a pattern characterized by much larger
      coefficients of variation of the Hb content and volume distributions than of the
      Hb concentration and relative lytic tonicity distributions. From analysis of the
      factors that determine those RBC properties, the patterns were interpreted as
      reflecting previously unrecognized statistical proportionalities between cell
      osmolyte content, Hb content, and membrane area. The possible origin of these
      statistical links was analyzed by considering alternative models with and without
      the participation of regulatory processes during cell maturation. A model was
      shown to be feasible in which mature RBC variability with proportional volume,
      area, and Hb content arises solely from cell size variability at the last
      erythroid cell division.

PMID- 7795243
TI  - Perturbation of red blood cell membrane rigidity by extracellular ligands.
AB  - It is known that binding of extracellular antibodies against the major
      sialoglycoprotein, glycophorin A, reduced the deformability of the red blood cell
      membrane. This has been taken to result from new or altered interactions between
      the glycophorin A and the membrane skeleton. We have shown by means of the
      micropipette aspiration technique that antibodies against the preponderant
      transmembrane protein, band 3, induce similar effects. A definite but much
      smaller reduction in elasticity of the membrane is engendered by univalent Fab
      fragments of the anti-band 3 antibodies. By examining cells genetically devoid of
      glycophorin A or containing a variant of this constituent, truncated at the inner
      membrane surface, we have shown that the anti-band 3 antibodies do not act
      through the band 3-associated glycophorin A. We examined the effect of anti
      glycophorin A antibodies on homozygous Wr(a+b-) cells, in which an amino acid
      replacement in band 3 annihilates the Wright b (Wrb) epitope (comprising sequence
      elements of glycophorin A and band 3) and thus, by implication disrupts or
      perturbs the band 3-glycophorin A interaction; these cells show a much smaller
      response to an anti-glycophorin A antibody than do normal controls. We infer that
      in this case anti-glycophorin A antibodies exert their rigidifying effect through
      the associated band 3. Another anti-glycophorin A antibody, directed against an
      epitope remote from the membrane surface, however, increases the rigidity of both
      Wr(a+b-) and normal cells. This implies that not all antibodies act in the same
      manner in modifying the membrane mechanical properties. The effect exerted by
      anti-band 3 antibodies appears not to be transmitted through the band 3-ankyrin
      spectrin pathway because the rigidifying effect of the intact antibody persists
      at alkaline pH, at which there is evidence that the ankyrin-band 3 link is
      largely dissociated. The large difference between the effects of saturating
      concentrations of the divalent and univalent anti-band 3 antibodies implies the
      existence of an overriding effect on rigidity, resulting from the bifunctionality
      of the intact antigen. Freeze-fracture electron microscopy shows that the anti
      band 3 promotes the formation of small clusters of intra-membrane proteins.
      Extracellular ligands may in general act by promoting strong or transient
      interactions between integral membrane proteins, thereby impeding local
      distortion of the membrane skeletal network in response to shear.

PMID- 7795244
TI  - Molecular basis of altered red blood cell membrane properties in Southeast Asian
      ovalocytosis: role of the mutant band 3 protein in band 3 oligomerization and
      retention by the membrane skeleton.
AB  - Southeast Asian ovalocytosis (SAO) is an asymptomatic trait characterized by
      rigid, poorly deformable red cells that resist invasion by several strains of
      malaria parasites. The underlying molecular genetic defect involves simple
      heterozygous state for a mutant band 3 protein, which contains a deletion of
      amino acids 400 through 408, linked with a Lys 56-to-Glu substitution (band 3
      Memphis polymorphism). To elucidate the contribution of the mutant SAO band 3
      protein to increased SAO red blood cell (RBC) rigidity, we examined the
      participation of the mutant SAO band 3 protein in increased band 3 attachment to
      the skeleton and band 3 oligomerization. We found first that SAO RBC skeletons
      retained more band 3 than normal cells and that this increased retention
      preferentially involved the mutant SAO band 3 protein. Second, SAO RBCs contained
      a higher percentage of band 3 oligomer-ankyrin complexes than normal cells, and
      these oligomers were preferentially enriched by the mutant SAO protein. At the
      ultrastructural level, the increased oligomer formation of SAO RBCs was reflected
      by stacking of band 3-containing intramembrane particles (IMP) into longitudinal
      strands. The IMP stacking was not reversed by treating SAO RBCs in alkaline pH
      (pH 11), which is known to weaken ankyrin-band 3 interactions, or by removing the
      cytoplasmic domain of band 3 from SAO membranes with trypsin. Finally, we found
      that band 3 protein in intact SAO RBCs exhibited a markedly decreased rotational
      mobility, presumably reflecting the increased oligomerization and the membrane
      skeletal association of the SAO band 3 protein. We propose that the mutant SAO
      band 3 has an increased propensity to form oligomers, which appear as
      longitudinal strands of IMP and exhibit increased association with membrane
      skeleton. This band 3 oligomerization underlies the increase in membrane rigidity
      by precluding membrane skeletal extension, which is necessary for membrane
      deformation.

PMID- 7795245
TI  - Hemoglobin-spectrin complexes: interference with spectrin tetramer assembly as a
      mechanism for compartmentalization of band 1 and band 2 complexes.
AB  - The irreducible complexation of hemoglobin with spectrin is a natural phenomenon
      of red blood cell aging, positively correlating with increasing cell density and
      decreasing cell deformability. The current study begins to address the role of
      these complexes in the disruption of membrane skeletal physiology and structure.
      The effect of bound hemoglobin on spectrin dimer self-association was
      investigated in vitro. The extent of conversion of isolated spectrin dimers to
      tetramers was evaluated as a function of peroxide-induced globin complexation
      before the conversion incubations. The incremental accumulation of tetramer was
      observed to decrease with increasing peroxide concentration used in the globin
      complexation step. The role of oxidized heme in this process was made apparent by
      the inability of carboxyhemoglobin to inhibit tetramer accumulation. A Western
      blot analysis of naturally formed globin-spectrin conjugates demonstrated
      irreducible complexes of globin with both bands 1 and 2. The complexes are
      tentatively designated "h1" and "h2". This analysis also demonstrated that h1 is
      completely extractable from cell ghosts, whereas h2 is only 50% extractable.
      These findings are incorporated into a hypothesis linking globin-spectrin
      complexation and the consequent inhibition of spectrin dimer self-association to
      the clustered band 3 senescence antigen (Low et al, Science 227:531, 1985).

PMID- 7795247
TI  - Frequent loss of heterozygosity at the TEL gene locus in acute lymphoblastic
      leukemia of childhood.
AB  - TEL is a new member of the ETS family of transcription factors which is
      rearranged in a number of hematologic malignancies with translocations involving
      chromosome band 12p13. In some cases, both TEL alleles are affected, resulting in
      loss of wild-type TEL function in the leukemic cells. In addition, 5% of children
      with acute lymphoblastic leukemia (ALL) have 12p12-p13 deletions, suggesting that
      a tumor suppressor gene resides on 12p. These observations led us to consider
      whether TEL loss of function may contribute to the pathogenesis of ALL. In this
      report we show that the TEL gene maps between the polymorphic markers D12S89 and
      D12S98, and we use these flanking markers to screen paired diagnosis and
      remission samples from 81 children with ALL for loss of heterozygosity (LOH) at
      the TEL gene locus. Fifteen percent of informative patients showed TEL LOH which
      was not evident on cytogenetic analysis. Detailed examination of patients with
      LOH at this locus showed that the critically deleted region included two
      candidate tumor suppressor genes: TEL and KIP1, the gene encoding the cyclin
      dependent kinase inhibitor p27. These studies show that LOH at the TEL locus is a
      frequent finding in childhood ALL.

PMID- 7795246
TI  - Collection and transplantation of peripheral blood stem cells in very small
      children weighting 20 kg or less.
AB  - The safety and efficacy of harvesting peripheral blood hematopoietic stem cells
      (PBSC) were evaluated in 38 children weighing 20 kg or less, with the smallest
      patient weighing 7 kg. The patients had a median age of 42 months and included 26
      children with acute leukemias or lymphoma and 12 with various solid tumors. A
      total of 81 aphereses were performed, mostly in the recovery phase of
      chemotherapy, with or without granulocyte colony-stimulating factor, using a CS
      3000 cell separator and regular procedure no. 3. Blood was withdrawn at a mean
      rate of 30 mL/min (range, 17 to 46 mL/min) through a temporary radial arterial
      catheter (20 to 24 guage) and returned through a larger catheter in a peripheral
      vein. Morbidity related to PBSC harvest was low and all aphereses were completed
      within 3 hours. The volume of blood per kilogram processed for each apheresis
      ranged from 85 to 615 mL (median, 270 mL). The median number of colony-forming
      units--granulocyte-macrophage (CFU-GM) and CD34+ cells collected were,
      respectively, 34 x 10(4)/kg and 15 x 10(6)/kg per apheresis and 126 x 10(4)/kg
      and 31 x 10(6)/kg per patient. Thirty-three patients (87%) required only a single
      apheresis to collect the minimum requirement of 10 x 10(4) CFU-GM/kg, including
      28 patients (74%) from whom 30 x 10(4) CFU-GM/kg was obtained in a single
      apheresis. Twenty-three of the patients subsequently underwent autografts with
      PBSC. The median number of days required to achieve an absolute granulocyte count
      of 0.5 x 10(9)/L and a platelet count of 50 x 10(9)/L were, respectively, 10
      (range, 6 to 15) and 14 (range, 9 to 46). The patients remained dependent on
      platelet transfusion support for a median of 10 days (range, 5 to 35). Thus,
      harvesting PBSC in very small children with active cancers is effective and safe
      and does not involve the risk of anesthesia or multiple invasive marrow
      aspirations.

PMID- 7795248
TI  - Human/mouse radiation chimera are capable of mounting a human primary humoral
      response.
AB  - Lubin et al recently described a new approach that enables the generation of
      human/mouse chimera by adoptive transfer of human peripheral blood mononuclear
      cells (PBMC) into lethally irradiated normal strains of mice, radioprotected with
      bone marrow (BM) from donors with severe combined immune deficiency (SCID). In
      the present study, we demonstrate in such human/mouse chimera a marked humoral
      response to recall antigen, such as tetanus toxoid (TT) or hepatitis B surface
      antigen (HBsAg), as well as a significant primary response to keyhole limpet
      hemocyanin (KLH). Maximal anti-KLH response in human/Balb chimera was attained 2
      to 4 weeks after the immunization and declined thereafter. One week after
      transplantation, the predominant anti-KLH subtype was IgM, while after 2 weeks,
      the dominance had shifted to IgG. Similar primary antibody response was also
      demonstrated against the human immunodeficiency virus (HIV) Nef protein.
      Comparison between human/Balb and human/SCID chimera showed a major difference in
      their ability to mount a primary response against KLH. In Balb/c recipients, more
      than half of the mice exhibited marked IgM titers against KLH, while there was
      hardly any anti-KLH IgM response in the SCID recipients. From the earliest time
      point onwards, when anti-KLH antibodies were found in the latter chimera, they
      were predominantly of the IgG type. We have previously shown that in human/Balb
      chimera, unlike in SCID recipients, dissemination of transplanted PBMC into the
      spleen and other internal organs occurs within 24 hours. Therefore, it is likely
      that the early seeding in the appropriate microenvironment of the lymphoid
      tissues, is crucial for the maintenance of virgin human B cells.

PMID- 7795250
TI  - Neurologic complications after bone marrow transplantation for sickle cell
      anemia.

PMID- 7795249
TI  - Bicentric origin of sickle hemoglobin among the inhabitants of Mauritius Island.

PMID- 7795251
TI  - Wider benefits of leukodepletion of blood products.

PMID- 7795252
TI  - Parvovirus B19 induced red blood cell aplasia in a patient with hereditary
      pyropoikilocytosis.

PMID- 7795253
TI  - Recombination activating gene-expression in lymphoma cell lines and lymphomas.

PMID- 7795254
TI  - Pulse cyclophosphamide to treat idiopathic thrombocytopenic purpura.

PMID- 7795256
TI  - Recombinant human megakaryocyte growth and development factor stimulates
      thrombocytopoiesis in normal nonhuman primates.
AB  - Megakaryocyte growth and development factor (MGDF) is a novel cytokine that binds
      to the c-mpl receptor and stimulates megakaryocyte development in vitro and in
      vivo. This report describes the ability of recombinant human (r-Hu) MGDF to
      affect megakaryocytopoiesis in normal nonhuman primates. r-HuMGDF was
      administered subcutaneously to normal, male rhesus monkeys once per day for 10
      consecutive days at dosages of 2.5, 25, or 250 micrograms/kg of body weight. Bone
      marrow and peripheral blood were assayed for clonogenic activity and peripheral
      blood counts were monitored. Circulating platelet counts increased significantly
      (P < .05) for all doses within 6 days of r-HuMGDF administration and reached
      maximal levels between day 12 and day 14 postcytokine administration. The 2.5,
      25.0, and 250.0 micrograms/kg/d doses elicited peak mean platelet counts that
      were 592%, 670%, and 449% of baseline, respectively. Bone marrow-derived
      clonogenic data showed significant increases in the concentration of
      megakaryocyte (MEG)-colony-forming unit (CFU) and granulocyte-erythroid
      macrophage-megakaryocyte (GEMM)-CFU, whereas that of granulocyte-macrophage (GM)
      CFU and burst-forming unit-erythroid (BFU-e) remained unchanged during the
      administration of r-HuMGDF. These data show that r-HuMGDF is a potent stimulator
      of thrombocytopoiesis in the normal nonhuman primate.

PMID- 7795255
TI  - BCL-6 protein is expressed in germinal-center B cells.
AB  - Structural alterations of the 5' noncoding region of the BCL-6 gene have been
      found in 40% of diffuse large cell lymphoma (DLCL) and 5% to 10% of follicular
      lymphomas (FL), suggesting that deregulated BCL-6 expression may play a role in
      lymphomagenesis. Nucleotide sequencing of BCL-6 cDNA predicted a protein
      containing six zinc-finger domains, suggesting that it may function as a
      transcription factor. Using antisera raised against N- and C-terminal BCL-6
      synthetic oligopeptides in immunoprecipitation, immunoblot, and
      immunocytochemical assays, this study identifies the BCL-6 gene product as a 95
      kD nuclear protein. Western blot analysis of human tumor cell lines
      representative of various hematopoietic lineages/stages of differentiation showed
      that the BCL-6 protein is predominantly expressed in the B-cell lineage where it
      was found in mature B cells. Immunohistochemical analysis of normal human
      lymphoid tissues indicated that BCL-6 expression is topographically restricted to
      germinal centers including all centroblasts and centrocytes. The BCL-6 protein
      was also detectable in inter- and intra-follicular CD4+ T cells, but not in other
      follicular components including mantle-zone B cells, plasma cells, dendritic
      cells, and macrophages. Immunohistochemical analysis of DLCL and FL biopsy
      samples showed that the BCL-6 protein is detectable in these tumors independent
      of the presence of BCL-6 gene rearrangements. These results indicate that the
      expression of the BCL-6 gene is specifically regulated during B-cell
      differentiation and suggest a role for BCL-6 in germinal center development or
      function. Because DLCL derive from germinal-center B cells, deregulated BCL-6
      expression may contribute to lymphomagenesis by preventing postgerminal center
      differentiation.

PMID- 7795257
TI  - Granulocyte-macrophage colony-stimulating factor is not responsible for the
      correction of hematopoietic deficiencies in the maturing op/op mouse.
AB  - Osteopetrotic (op/op) mice are characterized by an autosomal recessive
      inactivating mutation resulting in the absence of biologically active colony
      stimulating factor-1 (CSF-1). Consequently, young op/op mice have a severe
      deficiency of macrophages and osteoclasts resulting in excessive bone formation,
      occlusion of the marrow cavity, and reduced marrow hematopoietic activity.
      Recently, we showed that the osteopetrosis and hematopoietic deficiencies evident
      in young op/op mice are not permanent but are progressively corrected with age.
      There are increases in osteoclast activity; bone resorption; femoral marrow
      space; and marrow hematopoietic activity, cellularity, and macrophage content. In
      the present study we show that CSF-1-/- granulocyte-macrophage colony-stimulating
      factor (GM-CSF)(-/-)-deficient mice also undergo the same pattern of
      hematopoietic correction as the op/op mouse. Also, like the op/op mouse, the
      peritoneal cellularity and macrophage content of CSF-1/GM-CSF-deficient mice
      remains severely reduced. Our data show that the "knockout" of GM-CSF does not
      change the op/op phenotype, and that GM-CSF is not essential for the correction
      of the hematopoietic deficiencies in the op/op mouse. Importantly, the data also
      show that neither GM-CSF nor CSF-1 is an absolute requirement for the commitment
      of primitive hematopoietic stem cells to the macrophage lineage or for the
      differentiation of at least some classes of macrophages. This finding suggests
      that an alternate regulatory factor can be involved in macrophage and osteoclast
      commitment, differentiation, and function in vivo.

PMID- 7795259
TI  - Computer games as a means of movement rehabilitation.
AB  - In order to improve arm control in a child with Erb's palsy, a computer game was
      used in which participation required the movement of a lever, controlled by the
      child's arm. Counter-balancing weights were used to facilitate movement but
      counteract pathological compensatory movements. The use of this system (with
      appropriate modifications at successive stages of therapy) produced a substantial
      improvement in arm control. It was concluded that the use of such techniques
      capitalizes on the child's motivation to succeed, and has advantages over
      traditional physiotherapy that relies on passive, repetitive movements and
      sometimes painful limb manipulation. In this situation the child made
      spontaneous, voluntary movements, concentrating on the outcome of movements
      rather than the actions per se.

PMID- 7795258
TI  - Human interleukin-3 receptor modulates bcl-2 mRNA and protein levels through
      protein kinase C in TF-1 cells.
AB  - Upon withdrawal of interleukin-3 (IL-3) from human factor-dependent
      erythroleukemic cell line TF-1, bcl-2 mRNA and protein levels decrease within 8
      to 24 hours. Accompanying this decrease is the onset of apoptosis as determined
      by flow cytometric analysis of DNA degradation. By 8 to 18 hours of deprivation
      approximately 70% to 80% of the cells have entered apoptosis. Downregulation of
      protein kinase (PK) by a 24-hour incubation in 100 nmol/L 12-O-tetradecanoyl
      phorbol-13-acetate (TPA) in the presence of IL-3 dramatically reduced bcl-2 mRNA
      levels, and induced apoptosis in the presence of IL-3. We have also found that
      even in the presence of IL-3, two inhibitors of PKC, light-activated calphostin
      and H-7, substantially reduced the levels of bcl-2 mRNA between 8 and 24 hours as
      measured by a semi-quantitative reverse transcriptase/polymerase chain reaction
      assay method; however, the cyclic nucleotide-dependent PK inhibitor HA 1004, that
      is a structural analog of H-7 but a poor inhibitor of PKC, did not reduce bcl-2
      levels in the presence of IL-3. This decrease in bcl-2 mRNA was accompanied by a
      decline in bcl-2 protein levels by 8 to 24 hours after addition of light
      activated calphostin. In addition to interfering with the maintenance of bcl-2
      mRNA levels, inhibition of PKC with H-7 inhibited the induction of bcl-2 mRNA in
      factor-deprived TF-1 cells restimulated with IL-3. The cyclic nucleotide
      dependent PK inhibitor HA 1004 did not inhibit IL-3-induced bcl-2 mRNA. Studies
      with actinomycin D showed that transcription plays a major role in maintaining
      bcl-2 levels in TF-1 cells, and it is therefore likely that IL-3 plays a role in
      maintaining bcl-2 transcription through activation of PKC in these cells.

PMID- 7795261
TI  - Lifestyle activities of the elderly: composition and determinants.
AB  - Recent work suggests that lifestyle can be considered using a 2 x 2 model of
      indoor/outdoor and work/leisure activities. This paper replicates the factor
      analysis of the Frenchay Activities Index (FAI) reported by Bond et al., using a
      group of subjects living independently in the community. Results confirmed
      empirically the existence of the four hypothesized dimensions of lifestyle.
      Further analyses demonstrated the construct validity of these dimensions by
      establishing their sensitivity to age, sex, domestic circumstances, and physical
      and cognitive status. We discuss ways in which various deficiencies in the FAI
      might be rectified in a revised index of activities designed to retain and
      clarify the four established dimensions of lifestyle. Future directions include
      the development of such an instrument, and its application as a rehabilitation
      outcome measure.

PMID- 7795262
TI  - Disability in late adolescence. II: Follow-up of perceived limitation.
AB  - The disabilities experienced by a large cohort of 18-year-olds have been reported
      in the previous paper of this series. In this paper, we present the results of a
      detailed examination of the extent to which the disabilities caused limitation in
      the everyday activities of this group of young people. The results showed that
      nearly three-quarters of the members of the sample reported having one or more
      difficulties in performing activities in their daily lives, though the extent of
      limitation on their activities was low for most adolescents. Of this group who
      reported any type of disablement, 23% indicated it imposed very little general
      limitation on their lives (on a five point scale) and 6% rated it at the highest
      degree of limitation. Approximately half those with a disability felt the
      condition was improving, but 28% required an aid or help from another person.
      From 8% to 11% of those with a disability rated it as serious in relation to
      aspects of their daily living (education, leisure, social and work) and about
      half of those with a serious degree of limitation had sought help. The most
      common disabilities related to behaviour, communication and situations, for
      example environmental factors. As part of an ongoing study, the results provide a
      base from which to examine the extent and severity of disability among young
      people and change in disability as a result of the ageing process.

PMID- 7795260
TI  - The genesis of handicap: definition, models of disablement, and role of external
      factors.
AB  - Handicap has proved to be the most contentious and arguably most misunderstood
      concept of the International Classification of Impairments, Disabilities, and
      Handicaps (ICIDH). This paper reviews the definition and characteristics of
      handicap as presented in the original introduction to the ICIDH, and presents
      some of the alternative suggested definitions. Limitations in the way the
      original conceptual model for the consequences of disease was depicted have led
      to the development of alternative models which draw attention to the importance
      of external factors, particularly for the genesis of handicap. The nature of
      these external factors and the implications of alternative models for the testing
      of the conceptual framework are discussed. The expression of handicap as a
      product of an interaction of a person with impairment and disability and the
      environment draws attention to the options available for the decrease of handicap
      through the modification of the environment, and not only by attempting to
      ameliorate the impairment or disability.

PMID- 7795263
TI  - A perspective on occupational concerns of rehabilitation service providers.
AB  - While the roles, functions and personality characteristics of rehabilitation
      service providers have been widely researched, much less is known about the
      correlates and consequences of occupational stress in these groups. In the
      present study measures of occupational stress, job tension, job satisfaction,
      life satisfaction, and affective well-being were completed by 52 rehabilitation
      service providers drawn from a range of agencies in New Zealand. Respondents also
      completed two open-ended questions assessing significant stresses in their work
      and strategies whereby stress could be reduced. There were consistently high
      negative correlations between job stress and job satisfaction. The correlations
      of job tension with overall life satisfaction and affect were generally
      significant. Surprisingly there was no significant relationship between job
      satisfaction and general life satisfaction. There were some significant
      associations between job satisfaction and ratings of affect, but the pattern of
      results was inconsistent. Open-ended stresses identified by subjects included
      time pressure/workload problems, interpersonal issues, agency-created problems,
      and problems keeping up with the implications, for rehabilitation, of rapidly
      changing Government policy. Strategies for stress reduction that were identified
      involved more resources, training and skills; intra-agency reorganization and
      more effective management and communication; more networking with other
      professionals; and more stable, realistic and caring Government policy.
      Limitations of the study and future research directions were identified.

PMID- 7795264
TI  - Assessment of disability and handicap associated with dyspnoea in elderly
      subjects.
AB  - In a sample of 2792 community dwellers, aged 65 and over, randomly selected in an
      administrative area of southwestern France, eight items of the functional
      assessment scales had an independent association with dyspnoea, adjusting for
      age, visual or hearing impairments, depressive symptomatology, and cognitive
      impairment. These eight items included: two activities of daily living (dressing
      and continence), two instrumental activities of daily living (shopping and use of
      transportation), three Rosow items (walking half a mile, climbing stairs, and
      doing heavy housework), and a mobility scale. Disability increased with
      breathlessness grade in each of these items, but with different patterns,
      suggesting a hierarchical relationship between some Rosow, IADL and ADL items for
      the association of dyspnoea with disability.

PMID- 7795265
TI  - Stroke outcome in elderly people living alone.
AB  - We prospectively followed 178 elderly people living alone prior to stroke who
      survived at least 30 days. At the time of hospital discharge and at months 2, 6
      and 12 post-stroke one-third of survivors were living alone and half were living
      at home, either alone or with another person. Seventy-five per cent of survivors
      discharged to live alone were still living alone 6 months after stroke. Subjects
      discharged to live alone did not differ from other subjects with respect to age,
      gender or pre-stroke Barthel ADL score. The group discharged to live alone had
      less severe stroke deficits and higher ADL scores 1 week after stroke. This
      difference in ADL scores was maintained at hospital discharge and maximal
      recovery. Eleven variables were significant univariate predictors of discharge
      home to live alone. In multivariate models the strongest predictors of discharge
      home to live alone were high Barthel ADL score at day 7, high Mini-Mental State
      Score, high leg power and absence of homonymous hemianopia.

PMID- 7795266
TI  - Cross-sectional assessment and subgroup comparison of functional disability in
      patients with rheumatoid arthritis in a Swedish health-care district.
AB  - A cross-sectional study was undertaken on 222 patients with rheumatoid arthritis
      (RA) within a Swedish health-care district. An exploratory analysis of functional
      status, according to a Swedish version of the Health Assessment Questionnaire
      (HAQ), was carried out in order to explore the extent and pattern of functional
      disability in an unselected group of individuals with RA. The mean score of
      functional disability according to HAQ increased with more clinical manifest
      disease. There were no significant differences between the mean score in men and
      women. Most functional disability was related to hand-grip function and the
      ability to take care of personal hygiene. Increased functional disability was
      significantly associated with increasing age and disease duration. There was no
      significant relation between functional status and housing condition and
      educational level. A strong correlation was found between pain and functional
      disability. Multiple regression analysis was performed and predictive functional
      scores were tabulated based upon sex, age at onset and duration of RA disease.

PMID- 7795268
TI  - Topoisomerases II alpha and beta as therapy targets in breast cancer.
AB  - Topoisomerase II enzymes play an essential role in human DNA metabolism. They are
      also recognized as primary targets of a number of anti-cancer drugs used in the
      treatment of breast cancer, which remains a leading cause of cancer-related death
      in women. While topoisomerase inhibitors have produced significant response rates
      in this disease, their use has been limited both by toxicity and by the
      development of resistance. In this article we review the extensive work which has
      not only increased our understanding of the biochemistry and molecular biology of
      type II topoisomerases but also enabled more rational drug design. Such knowledge
      should translate into increased clinical efficacy in the treatment of breast
      cancer and other malignancies.

PMID- 7795269
TI  - Multidrug resistance.
AB  - Since we found verapamil as a multidrug resistance (MDR) reversing agent in 1981,
      many MDR reversing compounds have been reported. This type of drug must have
      strong effects with little side effects. We recently found MS-209 and PSC-833 as
      reversing agents. These two compounds interacted directly with P-glycoprotein,
      and showed a good MDR reversing effect in vitro and in vivo. MRK16, an antibody
      against P-glycoprotein, also showed a good therapeutic effect against drug
      resistant human tumors. MS-209, PSC-833 and the antibody against P-glycoprotein
      are interesting candidates for clinical use in the future.

PMID- 7795267
TI  - Design of synthetic branched-chain polypeptides as carriers for bioactive
      molecules.
AB  - New groups of synthetic biodegradable branched chain polypeptides have been
      prepared with the general formula poly[Lys-(Xi-DL-Alam)] or poly[Lys-(DL-Alam
      Xi)] [AXK], where m approximately 3 and i < 1, and used to elucidate structural
      and functional properties required for the selection of macromolecular carriers
      for (i) targeting/delivery of antitumor agents (e.g. daunomycin, methotrexate,
      boron derivatives), peptide hormones (e.g. GnRH antagonist) or radionuclides for
      imaging (e.g. 123I, 111In, 51Cr) or therapy (e.g. 153Sm, 131I) or (ii) the
      construction of synthetic antigens with peptide epitopes of mucin or Herpes
      Simplex virus glycoprotein D. Principles applicable for a rational carrier design
      are outlined based on chemical (size, charge, solution conformation) and
      biological (cytotoxicity, pirogenicity, biodegradation, immunogenicity,
      immunomodulatory potential, biodistribution) characterization of these
      biopolymers and their conjugates.

PMID- 7795271
TI  - Intensive consolidation chemotherapy for newly diagnosed acute myeloid leukemia
      using a regime containing moderate dose cytosine arabinoside and mitoxantrone.
AB  - Fifty patients with previously untreated acute myeloid leukemia were treated with
      an induction regimen consisting of cytosine arabinoside 100 mg/m2 per day by 18 h
      i.v. infusion for 7 days, daunorubicin 50 mg/m2 per day by i.v. bolus injection
      for 3 days and etoposide 75 mg/m2 per day by 1 h i.v. infusion for 7 days. Thirty
      seven of them (74%) went into complete remission (CR) and they all then received
      two consecutive courses of consolidation chemotherapy consisting of cytosine
      arabinoside 500 mg/m2 per day by 1 h i.v. infusion every 12 h for 4 days (total
      eight doses) and mitoxantrone 12 mg/m2 daily by 30 min i.v. infusion for 3 days.
      They were followed by maintenance chemotherapy with cytosine arabinoside and
      thioguanine 2 monthly. With a median follow up time of 24 months, 20 of the 37
      complete responders had relapsed (54%). The disease-free survival (DFS) of 37 CR
      patients and the overall survival of all patients at 24 months were 37 and 44%,
      respectively. Age of patients and number of courses of induction chemotherapy to
      achieve CR were significant factors predicting DFS. Myelosuppression was the
      major toxic side effects. Ten patients had prolonged marrow suppression following
      consolidation chemotherapy. In conclusion, despite the significant
      myelosuppression observed, overall improvement in treatment outcome was not
      demonstrable with the use of this intensive consolidation therapy.

PMID- 7795270
TI  - A randomized trial of two schedules of trimetrexate versus 5-fluorouracil in
      advanced colorectal cancer: a Southwest Oncology Group study.
AB  - Trimetrexate (TMQ), a non-classical folate antagonist, was studied in a
      randomized controlled trial in patients with advanced colorectal cancer and
      without prior chemotherapy. Patients were randomly assigned to one of three
      treatments: TMQ at 200 mg/m2 i.v. q 2 weeks, TMQ at 12 mg/m2 i.v. daily x 5 or 5
      fluorouracil (5-FU) at 15 mg/kg i.v. weekly. Overall response rates were: 6%
      (four partial responses in 71 patients, 95% CI of 2-14%) for q 2 week TMQ, 0%
      (zero of 29, 95% CI of 0-29%) for daily x 5 TMQ and 18% (two complete and nine
      partial responses in 62 patients, 95% CI of 9-30%) for 5-FU. Median survival
      estimates were 10.3 months for the q 2 week TMQ schedule, 8.7 months for the
      daily x 5 TMQ schedule and 13.6 months for the 5-FU schedule. Grade < or = 3
      toxicities were significantly more common with TMQ. TMQ does not appear to have
      significant antitumor activity against colorectal cancer.

PMID- 7795272
TI  - Deoxyspergualin: phase I clinical, immunologic and pharmacokinetic study.
AB  - Deoxyspergualin (DSG) is an analog of the polyamine spergualin with preclinical
      evidence of activity in murine and human tumor models. This phase I study
      examined a 120 h continuous infusion schedule in 56 patients with refractory
      solid tumors at doses ranging from 80 to 2792 mg/m2/day. Dose-limiting toxicity
      was reversible hypotension and appeared to be associated with plasma levels of
      DSG > 4 micrograms/ml. Other dose-dependent effects noted were pruritus and
      circumoral paresthesias. Myelosuppression and gastrointestinal toxicities were
      mild and sporadic. Two patients with refractory head and neck cancer had minor
      responses. The recommended phase II dose on this schedule is 1800 mg/m2.
      Additional monitoring to identify immunologic properties included
      immunophenotyping of peripheral lymphocytes and cytotoxic activity by means of
      standard 51Cr-release assays. These studies revealed a non-dose-dependent
      increase in the number of cells expressing T cell antigens predominantly the T
      suppressor (CD8) phenotype posttreatment. In three patients, a mild increase in
      LAK activity was noted post-treatment without a consistent relationship to dose
      or change in cell surface antigens. Pharmacokinetic studies were completed on 26
      patients ranging from doses of 80 to 2792 mg/m2. The average plasma concentration
      ranged from 0.07 to 7 micrograms/ml. DSG was rapidly cleared from the plasma with
      a mean terminal half-life of 1.9 h. Mean total body clearance was 25.24 l/h/m2.
      Further in vivo immunologic studies should be pursued while the agent is studied
      in fixed dosage phase II clinical trials.

PMID- 7795273
TI  - Cost effectiveness of 5-hydroxytryptamine3 receptor antagonists: a retrospective
      comparison of ondansetron and granisetron.
AB  - As clinical and economic analyses to date have shown clear benefits of using the
      new 5-hydroxytryptamine3 receptor antagonists (5-HT3RAs) over traditional
      antiemetics, the choice between them may necessitate the assessment of
      comparative cost-effectiveness. This paper presents the results of an assessment
      of the relative cost-effectiveness of two current 5-HT3RAs: ondansetron and
      granisetron. The analysis was based on a retrospective assessment of the cost and
      effectiveness (defined as no vomiting and no worse than mild nausea) of these new
      antiemetics. Efficacy data were based on the results of two recently published
      directly comparative clinical studies of ondansetron versus granisetron in the
      treatment of chemotherapy-induced emesis following both single-dose and
      fractionated chemotherapy. The cost of treatment was derived by combining
      clinical data from these studies with manufacturers' drug prices, and published
      costs of drug administration and emetic episodes. Costs for inpatient stay and
      side-effects were assumed to be equal across both treatment alternatives. The
      results were expressed in terms of the total cost per patient of emetic treatment
      and the cost per well-controlled patient. On this basis, granisetron was found to
      be more than 50% more cost-effective than ondansetron. This result was robust to
      variation in key assumptions concerning efficacy and cost, although ondansetron
      would become the more cost-effective if the dose was reduced to one 8 mg i.v.,
      with no concomitant loss of efficacy.

PMID- 7795275
TI  - In vitro assessment of Taxol for human glioblastoma: chemosensitivity and
      cellular locomotion.
AB  - Although the antineoplastic efficacy of Taxol against a variety of tumors has
      been established, it has only recently been used for malignant brain tumors. We
      evaluated in vitro chemosensitivity of glioblastoma to Taxol and the affect of
      Taxol on glioblastoma cell locomotion. The clonogenic assay was used to evaluate
      the chemosensitivity of five human glioblastomas and the C6 rat glioma. Cells
      exposed to Taxol (0-250 nM) were suspended in agar in capillary tubes. Following
      incubation, colonies were counted to determine percent survival. All six cell
      lines demonstrated sensitivity to Taxol (LD50 1 nM to > 250 nM). However, even at
      concentrations exceeding those achievable clinically, all cell lines had
      surviving cells, indicating a saturation threshold for Taxol cytotoxicity. Cell
      locomotion was evaluated using the radial dish assay to determine the rate of
      egress of cells from a region of high cell density to the periphery. Increasing
      Taxol concentration caused increased locomotion in all six cell lines (p <
      0.0001). Although Taxol has significant cytocidal impact, it increases in vitro
      locomotion of glioblastoma cells. These findings suggest that the clinical use of
      Taxol for glioblastoma may slow the growth of bulk disease, but may also lead to
      increased tumor invasion.

PMID- 7795274
TI  - Fused pyrazine mono-N-oxides as bioreductive drugs. III. Characterization of RB
      90740 in vitro and in vivo.
AB  - RB 90740 is the lead compound in a series of aromatic mono-N-oxide bioreductive
      drugs. The compound shows considerably greater toxicity towards hypoxic verses
      aerobic mammalian cells in vitro. The differential in concentration required to
      give the same level of cell killing under these conditions ranges from 3.5 in a
      human bronchio-alveolar tumor cell line up to 120 in a rodent cell line defective
      in the repair of DNA strand breaks. The ability of RB 90740 to cause DNA strand
      breaks under hypoxic conditions was confirmed by alkaline sucrose gradient and
      pulsed field gel electrophoresis techniques. Despite these properties
      demonstrated in vitro, RB 90740 was shown not to be cytotoxic to hypoxic cells in
      experimental murine tumors in vivo. This may be due, in part, to the level of
      hypoxia (< 0.02% O2) necessary to produce toxicity in vitro.

PMID- 7795276
TI  - Schedule-dependent enhancement of antitumor activity of ethyldeshydroxy
      sparsomycin in combination with classical antineoplastic agents.
AB  - The efficacy of the protein synthesis inhibitor ethyldeshydroxy-sparsomycin
      (EDSM) as a biochemical response modifier of several antitumor agents against
      L1210 leukemia and B16 melanoma is described. Seven drugs with different
      intracellular targets were selected for this combination study. Tumor
      implantation and drug treatment were both i.p., and the time interval between the
      administration of EDSM and the cytostatic agent was varied. Our results show that
      in the B16 tumor model EDSM is not able to potentiate any of these drugs, whereas
      antagonism is seen in combination with doxo-rubicin (DX). In the L1210 tumor
      model, however, no loss of activity is seen for this specific combination. The
      effect of the combination of cytosar (Ara-C), 5-fluorouracil (5-FU) or
      vincristine (VCR) with EDSM in the L1210 model is strongly time interval
      dependent. Loss of 5-FU antitumor activity is seen when EDSM is given 3 or 24 h
      after 5-FU; however, no effect is observed when EDSM is given 6 h after 5-FU.
      Enhancement of the 5-FU activity is not noticed. The VCR activity is potentiated
      when EDSM is given at least 6 h after VCR administration, which increases the
      antitumor response from 32 to > 60 days and the percentage survivors from 33 to
      83% (p = 0.04). In combination with Ara-C, potentiation of antitumor activity is
      seen only when EDSM is given 24 h after Ara-C, which increases the antitumor
      response from 32 to > 55 days and the percentage survivors from 11 to 50% (p =
      0.008). No modulatory effects are found when EDSM is combined with carmustine or
      DX.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7795277
TI  - Selection of three out of 24 anti-cancer agents in poorly-differentiated gastric
      cancer cell lines, evaluated by the AUC/delta IC50 ratio.
AB  - The purpose of this study was to screen 24 anti-cancer drugs, either in use or in
      clinical study, using four cell lines, all of which originated from poorly
      differentiated gastric cancers. The MTT assay was used at 1, 6, 24 or 72 h
      exposure times as the chemosensitivity test. We also examined P-glycoprotein
      expression, mdr-1 gene amplification and the modifier effect of verapamil. All
      four cell lines generally showed the same chemosensitivity pattern, while GCIY
      cells showed mdr-1 gene amplification and P-glycoprotein expression, and KATOIII
      cells showed the multidrug resistant pattern without P-glycoprotein expression.
      Both cell lines acquired higher chemosensitivity after verapamil addition. All
      IC50 data (with or without verapamil) were multiplied by exposure time (delta
      IC50) and compared with the clinical 'area under the concentration curve (AUC)'.
      SN-38 with/without verapamil, cisplatin with verapamil and pirarubicin
      with/without verapamil seemed to be the best candidates for poorly-differentiated
      gastric cancer chemotherapy. Plant alkaloids could also be candidates. With
      further experiments, we may be able to deduce commonly effective chemotherapy for
      poorly-differentiated gastric cancer from these drugs.

PMID- 7795278
TI  - Cisplatin and carboplatin-mediated activation of murine peritoneal macrophages in
      vitro: production of interleukin-1 alpha and tumor necrosis factor-alpha.
AB  - Analysis of tissue culture supernatants collected from cisplatin (10
      micrograms/ml) and carboplatin (50 micrograms/ml)-treated macrophages show
      enhanced activity of interleukin-1 alpha and tumor necrosis factor-alpha.
      Cytotoxicity of these supernatants was demonstrated using mouse sarcoma-180
      cells. These results demonstrate the ability of cisplatin and carboplatin to
      enhance the immune system suggestive of yet another mechanism of their action in
      the regression of tumors.

PMID- 7795279
TI  - Efficacy of sulofenur and a second generation diarylsulfonylurea, N-[5-(2,3
      dihydrobenzofuryl)sulfonyl]-N'-(3,4-dichlorophenyl)urea (LY295501), against colon
      adenocarcinoma xenografts.
AB  - Sulofenur and a second generation diarylsulfonylurea (DSU), N-[5-(2,3
      dihydrobenzofuryl)sulfonyl]-N'-(3,4-dichlorophenyl)urea (LY295501), were
      evaluated against a panel of eight colon adenocarcinoma xenografts. Of these
      tumors, four were derived from adult patients and four from young patients (age
      range 11-26 years). Both drugs were administered twice daily by oral gavage, 5
      days each week for two or three consecutive weeks. The maximum tolerated dose for
      sulofenur was 300 mg/kg/dose for three courses and 200 mg/kg/dose for LY295501.
      Against 'adult' derived tumors, sulofenur caused a high proportion of objective
      regressions of advanced xenografts in two of four lines, with significant
      inhibition of growth in three tumor lines. Colon adenocarcinomas from young
      patients were similarly sensitive to sulofenur with a high proportion of complete
      and partial responses in two of three lines. LY295501 demonstrated a very similar
      spectrum of activity against this panel of xenografts. Tumors intrinsically
      resistant to sulofenur were resistant to LY295501, although this agent was
      slightly more active than sulofenur against tumors from younger patients. In
      addition, xenografts were established from a cloned colon adenocarcinoma line
      (GC3/c1) and its derivative GC3/LYC5) selected in vitro for resistance to
      sulofenur. GC3/c1 xenografts were highly responsive to both sulofenur and
      LY295501, whereas GC3/LYC5 xenografts were completely resistant to both agents
      administered at the maximum tolerated dose and schedule. These results indicate
      that the second generation DSU, LY295501, demonstrates a similar spectrum of
      activity against colon tumors as does sulofenur, and that the mechanism of action
      and/or resistance to the two drugs is probably similar.

PMID- 7795280
TI  - Platin salts-induced hemolytic anemia: cisplatin- and the first case of
      carboplatin-induced hemolysis.
AB  - Anemia is a common side effect of cisplatin, especially after repeated infusions.
      The primary mechanisms is a myelosuppression caused by cisplatin's interference
      with iron metabolism, resulting in a lower count of red cell precursors. Some
      authors report a hemolytic anemia similar to penicillin-induced anemia, in which
      hemolysis is caused by an antiglobulin antibody directed against red cell
      membrane-bound cisplatin. The authors report two cases of cisplatin-induced
      anemia and suggest that the immune-complex hypothesis is responsible for
      hemolysis. The first case of carboplatin-induced hemolysis is also reported.
      Mechanisms of hemolysis and clinical practice are discussed.

PMID- 7795281
TI  - Re: "Liposome encapsulated vincristine: preclinical toxicologic and pharmacologic
      comparison with free vincristine and empty liposomes in mice, rats and dogs".

PMID- 7795282
TI  - Irritable bowel syndrome in children: an Italian multicentre study. Collaborating
      Centres.
AB  - A multicentre study was carried out on 285 children suffering from irritable
      bowel syndrome (IBS). Patients were divided according to clinical symptoms and
      age: Toddler's diarrhoea (TD) under 3 years of age and recurrent abdominal pain
      (RAP) over 3 years of age characteristics in children with TD and RAP were
      compared with those found in 114 subjects suffering from various gastrointestinal
      diseases (GIC) and in 192 normal children. This analysis allowed a complete
      profile of children with IBS in Italy to be obtained. The TD group, and to a
      lesser extent the RAP group, differ from the GIC and healthy controls (HC) on the
      basis of telephone calls to the doctor, physician visits, inappropriate dietary
      restrictions, multiple medications and multiple non-GI complaints. For children
      under 3, a history of food intolerance and the presence of mucus and undigested
      food in the feces are the variables that discriminate patients with IBS from
      those with GIC; for children over 3, colics in the first 3 months of life, a
      history of food intolerance, loose feces with abdominal pain, pain relieved by
      evacuation and undigested vegetables in the feces most discriminate the two
      groups. Finally, we tried to compute a diagnostic score to discriminate IBS
      children from GIC: this proved to be sensitive to IBS but not specific enough to
      be of clinical utility.

PMID- 7795283
TI  - Twelve-month omeprazole vs ranitidine in the treatment of Helicobacter pylori
      positive patients with healed duodenal ulcer.
AB  - We evaluated the results of a 12-month treatment using different regimens of
      omeprazole at the dose of 20 mg daily (three day week-end treatments and every
      other day) and of 150 mg nocte of ranitidine on Helicobacter pylori status and on
      preventing duodenal ulcer relapses in 140 Helicobacter pylori positive patients
      with healed duodenal ulcer. Only every-other-day omeprazole suppresses
      Helicobacter pylori after 3 month therapy (p < 0.001), after 6 months (p < 0.001)
      and 12 months (p < 0.05). After 3 months (T1) no significant effectiveness was
      found in the prevention of ulcer relapses by omeprazole and ranitidine. After 6
      months (T2) a significant reduction of relapses (p < 0.05) was recorded when
      comparing every- other-day omeprazole to the weekend regimen. After 12 months
      every-other-day omeprazole treatment significantly reduced the relapses compared
      with the week-end therapy (p = 0.05) and with ranitidine (p < 0.05).

PMID- 7795284
TI  - Peptic ulcer and duodenal stenosis: role of Helicobacter pylori infection.
AB  - A 17-year-old boy who developed a symptomatic duodenal ulcer at 10 years of age
      with melena, and was then treated continuously for 6 years with ranitidine
      therapy that only partially controlled symptoms and peptic lesions, came to us
      with vomiting due to duodenal bulb stenosis and active ulcer. Four months of
      omeprazole (40 mg/die o.m.) did not modify the endoscopic picture. The diagnosis
      of H. pylori infection and its treatment with triple therapy led to the cure of
      both duodenal ulcer and bulbar stenosis. Afterwards he remained asymptomatic
      without any lesions or complications for 18 months. This case illustrates that H.
      pylori eradication: a) is able to cure refractory duodenal ulcer; b) resolves
      severe complications such as duodenal stenosis.

PMID- 7795285
TI  - Gastrointestinal complications of liver transplantation.
AB  - Liver transplantation (OLTx) has become a common procedure at many centers in
      Europe and North America. The 1 and 5 year survival of patients receiving liver
      transplants at most centers is 75-85% and 60-65% respectively. As such, many
      physicians, in addition to those at transplant centers, will be called upon to
      see and care for recipients surviving liver transplants. The gastrointestinal
      tract is a common site of post-transplantation problems. These problems involve
      all components of the gastrointestinal tract. Many have characteristic, if not
      unique, presentations and clinical courses. They are reviewed for the physician
      in clinical practice who does not practice at a transplant center.

PMID- 7795286
TI  - Clinical course of inflammatory bowel disease during treatment with interferon
      for associated chronic active hepatitis.
AB  - Seven patients with inactive ulcerative colitis and seven patients with Crohn's
      disease (5 inactive, 2 mildly active) received interferon treatment for
      associated chronic active hepatitis. Neither relapse (except in one patient) nor
      worsening of the clinical course of the inflammatory bowel disease was observed
      during treatment. According to these results chronic active hepatitis associated
      with inflammatory bowel disease can be treated with interferon without the risk
      of deteriorating the course of the inflammatory bowel disease.

PMID- 7795287
TI  - Monoethylglycinexylidide production and prediction of hepatic histology.

PMID- 7795289
TI  - Richard Wilhelm Gottlieb Faltin 1867-1952.

PMID- 7795288
TI  - Flow cytometry DNA content and morphobiological characteristics in chronic and
      neoplastic human liver disease.
AB  - In the search for parameters that can indicate changes in the behaviour of liver
      tissue from normal to chronic to neoplastic disease, DNA content by FCM (ploidy
      and percent of 4N cells) and morphobiological characteristics were investigated
      in fresh liver specimens of 16 patients with normal liver, 21 with persistent
      hepatitis (CPH), 23 with chronic active hepatitis (CAH), 17 with cirrhosis, and
      13 with hepatocellular carcinoma (HCC). Aneuploidy was mostly found in HCC
      specimens (54%), whereas the percentage of 4N peak decreased in chronic hepatitis
      and cirrhosis patients but increased to 11.09% in HCC samples (r = -0.02; p =
      0.05). Finally, the binuclearity rate decreased gradually from normal to
      flogistic to HCC specimens. The 4N peak and the binuclearity rate were closely
      correlated in non-HCC (p = 0.0006, by T-test) but not in HCC samples. Only DNA
      ploidy and the binuclearity rate have been confirmed as being significantly and
      independently related to the histology of liver tissue by multivariate regression
      analysis.

PMID- 7795290
TI  - Faciocraniosynostosis: from infancy to adulthood.

PMID- 7795291
TI  - The Goteborg protocol for treatment of craniosynostosis.

PMID- 7795292
TI  - Personal contributions to craniofacial surgery.

PMID- 7795294
TI  - Advances in craniofacial fracture repair.

PMID- 7795293
TI  - Vertical orbital dystopia: definition, classification and treatment.
AB  - Correction of vertical orbital dystopia is an important component part of
      providing facial symmetry in a number of conditions of varied etiology having
      facial imbalance and asymmetry. The most important step is the initial one of
      making a proper diagnosis, since some conditions represent globe dystopia rather
      than true orbital dystopia, and can be treated by extracranial procedures.
      However, if an intracranial procedure is felt indicated, it adds to the safety
      rather than the complexity of the procedure, and one should not hesitate
      advocating this to the patient.

PMID- 7795295
TI  - Craniofacial osteotomies and rigid fixation in the correction of post-traumatic
      craniofacial deformities.
AB  - Post-traumatic craniofacial deformities may result from failure to diagnose
      craniomaxillofacial injuries or from less than adequate repair. The skeletal
      deformities may be corrected by procedures employing extended craniofacial
      exposure, segmental osteotomies and bony repositioning. A graduated approach to
      the correction of regional bony post-traumatic deformities has been formulated.
      Bony depressions are corrected by onlay grafts, rigidly fixed with lag screws.
      Malposition of anatomically normal bone is corrected by osteotomy and
      repositioning. Anatomically abnormal bone is replaced with bone grafts. The use
      of rigid fixation techniques prevents the late skeletal relapse seen with
      previous techniques. In the established post-traumatic deformity, soft tissue
      distortion from contracted underlying scar tissue and adherence to bony
      depressions and defects is the limiting factor in restoring the pre-injury
      appearance.

PMID- 7795296
TI  - The names that we give to vitamins.

PMID- 7795297
TI  - How much can we learn from history?

PMID- 7795298
TI  - Occupation: teller of tales and physician.

PMID- 7795299
TI  - Scientists discover new element.

PMID- 7795300
TI  - Grass-roots of dependency.

PMID- 7795301
TI  - Public health in RI: a strategic allocation perspective.

PMID- 7795302
TI  - Technology and the cost of medical care.

PMID- 7795303
TI  - Preventive health attitudes and practices of elderly persons attending senior
      centers.

PMID- 7795304
TI  - Inpatient hospice care: a new option for the terminally ill.

PMID- 7795305
TI  - Lead poisoning among Rhode Island preschoolers.

PMID- 7795306
TI  - Lead poisoning among RI preschoolers: the cost.

PMID- 7795308
TI  - Effects of pronounced haemodilution on the plasma protein binding of lidocaine.
AB  - The effects of pronounced haemodilution on the protein binding of lidocaine was
      investigated in vitro in plasma from five healthy adult volunteers. The plasma
      was diluted with a phosphate buffer to reach a plasma protein concentration
      normally seen during paediatric cardiopulmonary bypass (CPB) and protein binding
      was determined at a low (1.5 micrograms/ml) and a moderate (4 micrograms/ml)
      total plasma concentration of lidocaine. The effects of different haematocrits on
      plasma protein binding was also determined over the haematocrit range 20-60%. The
      binding of lidocaine was found to be inversely related to the degree of dilution,
      i.e. the free fraction increased significantly with increasing dilution (p <
      0.0001). Furthermore, the binding was dependent on the total plasma concentration
      of lidocaine, since a significantly higher percentage of free drug was found at
      the higher total lidocaine level (4 micrograms/ml) compared with the lower level
      (1.5 micrograms/ml) (p < 0.05). No significant difference in the free fraction of
      lidocaine could be found over the studied haematocrit range. The results of the
      present study indicate that plasma protein levels commonly associated with CPB in
      neonates and infants are associated with a significant increase in the free,
      unbound and pharmacologically active fraction of lidocaine compared with normal
      conditions. The use of commonly recommended dosages of lidocaine might result in
      toxic-free concentration in this setting.

PMID- 7795307
TI  - Factor XII deficiency and cardiopulmonary bypass.
AB  - Factor XII initiates the intrinsic coagulation cascade and may affect the
      fibrinolytic system. Routine coagulation tests used during cardiopulmonary bypass
      (CPB) are abnormal in factor-XII-deficient patients and are useless for
      monitoring anticoagulation in these patients. A factor-XII-deficient patient
      requiring CPB is described. The baseline celite activated clotting time (ACT) was
      greater than 1400 seconds and the thrombin time was 12.4 seconds (control, 11.9
      seconds). Two units of plasma were given resulting in an ACT of 173 seconds.
      Following 300 units/kg of heparin and during CPB, the ACT ranged from 670-596
      seconds with the thrombin time greater than 200 seconds. Plasma provides
      exogenous factor XII allowing an endpoint on the ACT test and may protect against
      possible postoperative hypofibrinolytic complications. A commercially available
      modified thrombin time may also be useful and provide an endpoint during high
      dose heparinization.

PMID- 7795309
TI  - The role of N-acetylcystein administration on the oxidative response of
      neutrophils during cardiopulmonary bypass.
AB  - The role of N-acetylcystein (NAC) administration on the oxidative response of
      neutrophils during cardiopulmonary bypass (CPB) was evaluated in a double-blind
      study. Twenty-four adult patients undergoing coronary artery bypass were included
      in the study. Twelve patients received NAC as a bolus of 100 mg/kg followed by a
      continuous infusion of 20 mg/kg/h in the bypass circuit from the beginning to the
      end of bypass. A further 12 patients received placebo. Citrated blood samples for
      measurement of oxidative burst response of neutrophils were obtained at different
      time points during bypass. The oxidative burst response of neutrophils in the
      patients receiving NAC was significantly low at all times during bypass. Based on
      these findings NAC appears to act as an oxygen free radical scavenger during open
      heart surgery.

PMID- 7795310
TI  - Cardiopulmonary bypass with adequate flow and perfusion pressures prevents
      endotoxaemia and pathologic cytokine production.
AB  - Endotoxin and cytokine inflammatory mediators comprise the afferent and efferent
      limbs of the 'acute phase response'. During cardiopulmonary bypass (CPB) there
      may be gut translocation of endotoxin and contact activation of lymphocytes. It
      has been hypothesized that the haemodynamic instability encountered following CPB
      is caused by the 'acute phase response'. In this study we attempted to quantify
      the acute phase response in patients undergoing open-heart surgery and determine
      the influence of these cytokines on perioperative morbidity. Four perioperative
      blood samples were drawn from 20 consecutive patients undergoing coronary artery
      bypass grafting (CABG). These samples were assayed for endotoxin and four
      cytokines. In all cases the cardiac index was maintained > 2.4 l/min/m2 during
      nonpulsatile normothermic bypass (37 degrees C) and > 1.8 l/min/m2 during
      nonpulsatile hypothermic bypass (28 degrees C), and the perfusion pressure > 60
      mmHg. Endotoxin was not detected in any of the test samples despite positive
      nonpatient controls. Interleukin 6 (IL-6) and tumour necrosis factor (TNF) were
      not detected despite an assay sensitivity of 80 and 10 pg/ml, respectively. TNF
      was detectable with an assay sensitivity of 0.5 pg/ml although there were no
      significant differences within the group. Interleukin 1 (IL-1) was detected
      (range = 0.98 - 9.09 ng/ml) in patients and again there were no trends within the
      group. The platelet activating factor (PAF) values peaked at crossclamp release
      (1.3 ng/ml versus a baseline of 0.2 ng/ml); however, there was no significant
      difference within the study.

PMID- 7795312
TI  - The influence of vascular pressure and different primes on the fluid balance of,
      and oxygen supply to, the patient during CABG.
AB  - Detrimental changes of blood and erythrocyte rheology, and fluid exchange between
      the vascular and interstitial spaces, which influence the rate that oxygen is
      supplied to the patient, occur during cardiac bypass surgery. Venous flow is
      subject to a pulsatile and uncertain variation, because the vena cava is more
      than 30 mmHg below atmospheric pressure. This occurs because the patient is about
      1 m above the air-blood surface of the bypass reservoir. Before any reliable
      study of fluid exchange can be undertaken this effect must be controlled. It was
      then established that optimum oxygen exchange occurs when equilibration of the
      plasma oncotic pressure and the capillary hydrostatic pressure is achieved
      without alteration of the interstitial fluid volume. At the lower arterial blood
      pressures used during bypass, it is necessary to reduce the plasma oncotic
      pressure by using an appropriate volume of crystalloid prime.

PMID- 7795311
TI  - Pulsatile compared with nonpulsatile perfusion using a centrifugal pump for
      cardiopulmonary bypass during coronary artery bypass grafting. Effects on
      systemic haemodynamics, oxygenation, and inflammatory response parameters.
AB  - The present study investigated the influence of pulsatile or nonpulsatile flow
      delivery with a centrifugal pump for cardiopulmonary bypass (CPB) during coronary
      artery bypass grafting (CABG) in two randomized groups of 19 patients each. All
      patients received a standard anaesthetic and surgical protocol. Pulsatile
      perfusion during CPB was created by accelerating the baseline pump speed of the
      Sarns centrifugal pump at a rate of 50 cycles per minute. Measurements included
      perioperative systemic haemodynamics and oxygen exchange, total haemolytic
      complement (CH50), polymorphonuclear (neutrophil) granulocyte (PMN) count and
      plasma granulocyte elastase bound to alpha 1-proteinase inhibitor (E-alpha 1-PI).
      Laboratory measurements were corrected for haemodilution. During and after CPB
      there were only a few significant differences between the groups in systemic
      haemodynamics and oxygenation, i.e. a lower mean arterial blood pressure after
      the end of CPB in the nonpulsatile group (65 mmHg, SD = 11 vs 76 mmHg, SD = 11)
      and a lower SvO2 during rewarming on CPB in the nonpulsatile group (62%, SD = 8
      vs 67%, SD = 8). The decrease in percentage of PMNs in the total white blood cell
      count during CPB was greater in the nonpulsatile group than in the pulsatile
      group (from 61 to 46% vs 63 to 53% of prebypass value). The steep increase of PMN
      count at the end of CPB and postoperatively was comparable in both groups. The
      maximal decrease of CH50 levels, occurring after surgery, was significantly
      higher in the nonpulsatile group (70% SD = 15 vs 79%, SD = 16, of baseline
      value), suggesting a greater complement activation. E-alpha 1-PI levels increased
      significantly in both groups during and after CPB with higher peak levels,
      obtained at one hour after admission to an intensive care unit, in the
      nonpulsatile group (316 micrograms/l, SD = 102) than in the pulsatile group (247
      micrograms/l, SD = 106). There was a partly inverse correlation between the peak
      postoperative elastase levels and the PaO2/FiO2 ratios at the first postoperative
      morning. This ratio was significantly lower in the nonpulsatile group (211, SD =
      56) than in the pulsatile group (247, SD = 62). Postoperative respiratory tract
      infection was more frequent in the nonpulsatile group (n = 9) than in the
      pulsatile group (n = 2). Adding a pulsatile component to centrifugal blood
      pumping during CPB may have benefits with regard to the possibly detrimental
      whole body inflammatory response to CPB. Further studies are warranted to
      investigate whether these differences will affect clinical outcome.

PMID- 7795313
TI  - Activation of the intracellular glutathione system by oxydative stress during
      cardiopulmonary bypass and myocardial perfusion.
AB  - The glutathione (GSH) system is the main defence of tissues against free radicals
      and red blood cells (RBC) are the most efficient sites for GSH redox cycle
      activation. Total GSH was assayed during cardiopulmonary bypass (CPB) in RBC and
      serum from the coronary sinus, peripheral arteries and veins in 18 children
      corrected of their cardiac defect. Our conclusions are: (1) RBC-GSH redox cycle
      is activated during heart ischaemia and reperfusion; (2) the activation of
      intracellular GSH system is preponderant compared with the extracellular one; (3)
      variations in intraerythrocytic total GSH during heart ischaemia and perfusion
      are detectable in peripheral veins and arteries, which can be the convenient
      sites for monitoring changes in the GSH cycle; and (4) increased total GSH levels
      are present in RBC before aortic crossclamping: at the beginning of mechanical
      ventilation in veins and, when CPB is started, also in arteries.

PMID- 7795314
TI  - Retrograde cerebral perfusion: overview, techniques and results.
AB  - Cardiovascular surgical repair of arch aneurysms is taking a step forward by
      going backwards by utilizing retrograde cerebral perfusion. Drs ME DeBakey, ES
      Crawford, DA Cooley and GC Morris first reported successful resection and repair
      of a fusiform aneurysm of the aortic arch with replacement graft in 1957. Since
      then, Crawford and Coselli have pursued materials and techniques which have made
      this procedure, one which generally resulted in high morbidity and mortality,
      more viable with decreased morbidity and mortality. Increased numbers of patients
      are now having this repair and are resuming normal healthy lives after the
      operation. From February 1992 to October 1993, 88 patients were surgically
      treated by Coselli who utilized retrograde cerebral perfusion with profound
      hypothermia and circulatory arrest, thus allowing for repairs that under any
      other conditions probably could not have been achieved successfully. It is
      evident that a major determinant for the successful clinical results, in addition
      to surgical technique and skill, was the employment of profound hypothermia and
      circulatory arrest. This article will review the techniques and results of aortic
      arch repair utilizing retrograde cerebral perfusion during circulatory arrest
      with profound hypothermia to lessen the chance of neurological morbidity
      following surgical replacement of the transverse aortic arch.

PMID- 7795315
TI  - A bivariate limiting distribution of tumor latency time.
AB  - The model of radiation carcinogenesis, proposed earlier by Klebanov, Rachev, and
      Yakovlev [8] substantiates the employment of limiting forms of the latent time
      distribution at high dose values. Such distributions arise within the random
      minima framework, the two-parameter Weibull distribution being a special case.
      This model, in its present form, does not allow for carcinogenesis at multiple
      sites. As shown in the present paper, a natural two-dimensional generalization of
      the model appears in the form of a Weibull-Marshall-Olkin distribution.
      Similarly, the study of a randomized version of the model based on the negative
      binomial minima scheme results in a bivariate Pareto-Marshall-Olkin distribution.
      In the latter case, an estimate for the rate of convergence to the limiting
      distribution is given.

PMID- 7795316
TI  - Deterministic models for the eradication of poliomyelitis: vaccination with the
      inactivated (IPV) and attenuated (OPV) polio virus vaccine.
AB  - Currently two polio vaccines, IPV and OPV, are in use which differ markedly in
      their epidemiological parameters. A simple epidemiological model in terms of
      ordinary differential equations is proposed to study the effects of vaccination
      campaigns using these vaccines. The numbers of interest are the reproduction
      number of the disease in the presence of vaccination and the critical vaccination
      coverage necessary to prevent an outbreak. For these numbers explicit
      representations are determined which can be used in comparing different
      vaccination strategies.

PMID- 7795317
TI  - On the simultaneous distribution of size and costs of an epidemic in a closed
      multigroup population.
AB  - A multitype stochastic epidemic model in which the infectivities and
      susceptibilities differ between subgroups is considered. To each infected are
      associated random effects of the infection, such as the development of a
      subsequent disease and the length of the infectivity period. Sums of the
      corresponding random variables are called costs of the epidemic. The asymptotic
      simultaneous distribution of the size and costs of large epidemics is derived.

PMID- 7795318
TI  - Phyllotaxis: the status of the field.
AB  - In the last decade important progress has been made regarding pattern recognition
      and generation of the phenomenon of phyllotaxis. Phyllotaxis, a central area in
      plant morphogenesis, proposes a challenge that reaches beyond the field of botany
      and whose resolution must be sought through evolutionary biology and general
      comparative morphology. This review summarizes the contributions in the area,
      redefines the challenge, and proposes an adequate framework for the study of the
      phenomenon.

PMID- 7795319
TI  - The effect of household distribution on transmission and control of highly
      infectious diseases.
AB  - Two epidemic threshold parameters are derived for the spread of a highly
      infectious disease in a community of households, where a household is any group
      whose members have frequent contacts with each other. It is assumed that the
      infection of any member of a household results in the infection of all
      susceptible members of that household. The threshold parameters have simple
      expressions in terms of the mean household size and the mean and variance of the
      number of susceptibles per household. They provide a basic reproduction number R0
      for the spread of infection from individual to individual and a basic
      reproduction number RH0 for the spread of infection from household to household.
      The threshold parameters are used to derive the levels of immunity required for
      the prevention of major epidemics in the community. They are also used to
      evaluate various vaccination strategies having the same vaccination coverage. For
      a community with households of equal size, it is found that random vaccination of
      individuals is better than immunizing all members of a corresponding fraction of
      households. In contrast, when households have varying sizes, immunizing all
      members of large households can be better than a corresponding vaccination
      coverage of randomly selected individuals. It is illustrated that these threshold
      parameters can also be used for a community of households with schools or day
      care centers. In particular, the effectiveness of immunizing all members of a
      school is quantified.

PMID- 7795320
TI  - Prevention by chelating agents of metal-induced developmental toxicity.
AB  - Chelating agents such as calcium disodium ethylenediaminetetraacetate (EDTA), 2,3
      dimercaptopropanol (BAL), or D-penicillamine (D-PA) have been widely used for the
      past 4 decades as antidotes for the treatment of acute and chronic metal
      poisoning. In recent years, meso-2,3-dimercaptosuccinic acid (DMSA), sodium 2,3
      dimercapto-1-propanesulfonate (DMPS) and sodium 4,5-dihydroxybenzene-1,3
      disulfonate (Tiron) have also shown to be effective to prevent against toxicity
      induced by a number of heavy metals. The purpose of the present article was to
      review the protective activity of various chelating agents against the
      embryotoxic and teratogenic effects of well-known developmental toxicants
      (arsenic, cadmium, lead, mercury, uranium, and vanadium). DMSA and DMPS were
      found to be effective in alleviating arsenate- and arsenite-induced
      teratogenesis, whereas BAL afforded only some protection against arsenic-induced
      embryo/fetal toxicity. Also, DMSA, DMPS, and Tiopronin were effective in
      ameliorating methyl mercury-induced developmental toxicity. Although the
      embryotoxic and teratogenic effects of vanadate were significantly reduced by
      Tiron, no significant amelioration of uranium-induced embryotoxicity was observed
      after treatment with this chelator.

PMID- 7795321
TI  - Immune response of adult rats is altered by administration of diazepam in the
      first postnatal week.
AB  - The potential immunotoxic risk of perinatal treatment with diazepam was
      investigated using early postnatal administration of the drug to the rat and
      monitoring the immune response until the age of 24 months. Rats given a single
      dose of diazepam 10 mg/kg SC on the seventh postnatal day revealed at the age of
      6 months a depression of cell-mediated immune response, and at the age of 12
      months significant decrease of humoral immune response. The latter persisted
      until senescence (age 24 months). Also, a repeated dosage of diazepam (3 x 5
      mg/kg/day SC on postnatal days 5 to 7) induced a significant depression of
      humoral immune response in 7-month-old rats. The results demonstrate that both
      the humoral and cell-mediated immune response of adult rats can be altered by
      administering diazepam in early postnatal life.

PMID- 7795322
TI  - Effect of a metallothionein antisense oligonucleotide on embryo development.
AB  - The effect of a metallothionein (MT) antisense oligodeoxynucleotide (ODN) on
      mouse preimplantation embryo development was investigated. Preimplantation
      embryos were cultured for 72 h and examined following exposure to either an MT
      antisense or sense ODN. Blastocyst formation (cavitation) and embryo cell number
      were lower in embryos exposed to the MT antisense ODN than in controls or in
      embryos exposed to the MT sense ODN. In embryos cultured in medium containing
      free nucleotides, cavitation frequency was not affected, although mean embryo
      cell number was lower than in controls. Combined, this work shows that an
      antisense ODN against MT can significantly affect blastocyst formation of
      preimplantation embryos; some, but not all, of the observed effects on embryo
      cell number may have been due to nucleotide toxicity.

PMID- 7795323
TI  - The use of cultured ovarian fragments to assess toxicant alterations in
      steroidogenesis in the Sprague-Dawley rat.
AB  - This study was conducted to determine the utility of using steroid production by
      cultured ovarian fragments to assess toxicant-induced alterations in ovarian
      steroidogenesis in Sprague-Dawley rats. To this end, serum steroid concentration
      and steroid production (progesterone (P4), testosterone (T), estradiol (E2)) by
      cultured ovarian fragments is described during a normal 4-day estrous cycle. This
      culture system was then used to profile the effects of aminoglutethimide shown to
      have two sites of steroidogenic inhibition, side chain cleavage enzyme and
      aromatase. LH, FSH, P4, and E2 concentrations in serum during the 4-day estrous
      cycle confirmed that described in the literature for untreated rats. All of the
      steroids measured had peak production levels during proestrus. The patterns of P4
      and E2 production by the ovaries in an unstimulated culture mimics that seen in
      serum. Stimulation with hCG (100 mIU/mL) after the initial 1 h culture tends to
      even out the production of P4, while T production rises faster and peaks earlier.
      The pattern and levels of estradiol production in hCG-stimulated cultures are
      very similar to those in the unstimulated culture, both in pattern and in
      production levels. When cultured ovarian fragments from proestrous rats were
      treated in vitro with aminoglutethimide (1 to 16 microM), the pattern of steroid
      production that characterized the inhibitory effects were similar to those
      reported in the literature using isolated cell culture procedures. This pattern
      showed a rapid decrease in E2 production (IC50 of 2.43 microM), a concurrent rise
      in T production, and a decrease in P4 production (IC50 of 15.5 microM). This
      culture system is an appropriate system to rapidly assess toxicant effects on
      ovarian steroidogenesis following in vivo or in vitro exposure.

PMID- 7795324
TI  - Morphine induces reproductive changes in female rats and their male offspring.
AB  - The effect of intrauterine morphine exposure on the development of reproductive
      functions has been investigated in the rat. Female rats were treated daily ip
      with morphine sulfate, doses increasing at 10-d intervals from 5, 7.5, 10, to 15
      mg/kg. These rats were mated between day 38 and 45, and morphine treatment
      continued at 20 and 30 mg/kg over pregnancy and at up to 40 mg/kg for 10 d
      postpartum. The treatment mainly disrupted ovarian cyclicity; only 48% exhibited
      normal cyclicity. Of these, 43% became pregnant when mature male rats were placed
      with them. Litter size was normal but with significantly more stillbirths in each
      litter and live pups had decreased body weights. Male offspring had reduced body
      weight at the time of weaning that persisted until 60 d of age. At 120 d, animals
      showed complete abolition of spermatogenesis and drastically reduced testicular
      steroidogenesis. Plasma LH levels were low, and hypothalamic noradrenaline was
      high.

PMID- 7795325
TI  - Effect of counseling on maternal reporting of adverse effects in nursing infants
      exposed to antibiotics through breast milk.
AB  - In a recent trial, we found that nursing women reported diarrhea in their nursing
      infants after maternal use of antibiotics. However, because they were told that
      this could occur during a medication counseling session, the observed effect
      could have been due to a reporting bias. The objectives of this study were to
      determine if counseling nursing women about side effects of antibiotic they used
      could (a) influence the adverse event reporting rate or (b) influence maternal
      nursing and medication compliance behavior. In a randomized, controlled trial,
      nursing women calling a teratogen information service for advice about selected
      antibiotics received one of two possible counseling formats (A and B). Both
      groups were informed that the antibiotics were safe to use. Mothers in group B
      were also informed about a theoretical risk of diarrhea in the infant. Mothers
      later reported clinical events they noted in the infants and judged whether they
      were due to the antibiotic. Eighty-seven percent (54/62) of group A subjects
      compared to 68% (52/76) of group B subjects reported clinical events in their
      infants during their antibiotic therapy (P = 0.017). The incidence of reported
      diarrhea was 26% in group A compared to 17% in group B (P = 0.3); 34% of subjects
      in both groups attributed clinical events to antibiotic therapy (P = 1.0).
      Diarrhea was attributed to antibiotic therapy in 13% of group A and 12% of group
      B subjects (P = 1.0). No differences were observed between groups in
      breastfeeding pattern and antibiotic compliance. Breastfeeding women counseled
      about adverse effects were not more likely to report side effects in their
      infants or to change nursing behavior and medication compliance.

PMID- 7795326
TI  - Teratogenic effects of DA-125, a new anthracycline anticancer agent, in rats.
AB  - DA-125 is a new anthracycline antitumor antibiotic derived from adriamycin.
      Preclinical studies suggest that it may have greater activity and less cardiac
      toxicity than adriamycin. The potential of DA-125 to induce embryotoxicity was
      investigated in the Sprague-Dawley rat. One hundred twenty mated SD rats (sperm
      in vaginal lavage = day 0) were distributed among three treated groups and a
      control group. DA-125 was given at dose levels of 0, 0.1, 0.3, and 1.0 mg/kg/day
      administered intravenously to pregnant rats from days 7 to 17 of gestation. All
      dams were subjected to caesarean section on day 20 of gestation. At 1 mg/kg/day,
      reduced food intake, reduced body weight, and decreased spleen weight were
      observed in dams. An increase in the resorption rate and a reduction in the fetal
      weight were also found. In addition, various types of external, visceral, and
      skeletal malformations occurred at an incidence of 11.9, 41.8, and 14.5%,
      respectively. Characteristic malformations included exencephaly, gastroschisis,
      cleft lip, dilatation of lateral and third ventricles, and fused ribs, among
      others. There were no signs of maternal toxicity or embryotoxicity at 0.1 and 0.3
      mg/kg. The results show that DA-125 is teratogenic at a minimally maternally
      toxic dose in rats.

PMID- 7795327
TI  - Opioid peptides involvement in endotoxin-induced suppression of LH secretion in
      ovariectomized Holstein heifers.
AB  - Three groups of ovariectomized Holstein heifers were used in this study. Group I
      heifers (n = 6) were pretreated with saline (SAL), followed 3 h later by three
      injections of naloxone hydrochloride (NLX) given 1 h apart. In the same sequence,
      group II heifers (n = 3) received lipopolysaccharide (LPS), followed by the
      opioid antagonist NLX. Group III heifers (n = 3) received LPS followed by SAL.
      Concentrations of cortisol and progesterone increased (P < 0.05) following LPS
      injections in both groups II and III, whereas luteinizing hormone (LH)
      concentrations were suppressed (P < 0.05). Administration of NLX to heifers
      pretreated with LPS elicited significant increases (P < 0.05) in LH
      concentrations, whereas SAL infusion had no effect. These results indicate that
      the inhibitory actions of opiate mu-delta receptors, and possibly other POMC gene
      products, were at least partially involved in LPS-induced suppression of the
      gonadotropic hormone. These results are discussed, including the possibility that
      feedback suppression by LPS-triggered adrenal gland steroids may have interfered
      with complete restoration of LH secretion by the opioid antagonist.

PMID- 7795328
TI  - An assessment of lithium using the IEHR Evaluative Process for Assessing Human
      Developmental and Reproductive Toxicity of Agents. IEHR Expert Scientific
      Committee.

PMID- 7795329
TI  - The P blood group system: biochemical, serological, and clinical aspects.

PMID- 7795330
TI  - Centralized transfusion service: a novel approach to the delivery of transfusion
      services.
AB  - The development and expansion of the CTS in Pittsburgh shows the feasibility of
      this transfusion medicine delivery system. Few of the changes driven by health
      care reform both improve patient care and reduce costs. When properly
      implemented, a CTS achieves these objectives, benefits the community as a whole,
      and enhances the role of transfusion medicine specialists and the blood center in
      the region.

PMID- 7795331
TI  - Hemoglobin determination in blood donors.

PMID- 7795332
TI  - The mechanisms of leukocyte removal by filtration.

PMID- 7795333
TI  - The proficiency testing of platelet counting.
AB  - Ontario's laboratory professionals have shown that they are able to successfully
      operate a proficiency testing program by making use of volunteers. The program
      serves and assists the laboratory directors in their own quality assurance
      program. The two prime reasons for the success of LPTP are that it is not seen by
      the professions to be regulatory and that it emphasizes education, not punitive
      action. Whereas platelet performance below 100 x 10(9)/L is not as accurate as
      the remainder of the clinical range, most Ontario laboratories seem to perform
      platelet determinations at clinically acceptable levels.

PMID- 7795334
TI  - How safe is autologous donation before cardiac surgery?

PMID- 7795335
TI  - Applications of flow cytometry in transfusion medicine.

PMID- 7795336
TI  - AHNA certificate program in holistic nursing courses. ANHA certificate program in
      healing touch courses.

PMID- 7795337
TI  - Aromatherapy: the scents for survival.

PMID- 7795338
TI  - Role modelling "warm fuzzies" at work.

PMID- 7795339
TI  - The power of love.

PMID- 7795340
TI  - The Chernobyl accident and pregnancy outcome.

PMID- 7795341
TI  - Aminophylline versus caffeine citrate for apnea and bradycardia prophylaxis in
      premature neonates.
AB  - We investigated the efficacy and adverse effects of aminophylline and caffeine
      citrate in 180 premature neonates for 10 days and nights. Aminophylline (n = 98)
      and caffeine citrate (n = 82) were equally effective in preventing apnea and
      bradycardia. The caffeine citrate group had a lower median heart rate on day 3,
      fewer neonates with tachycardia and a smaller amount of gastric aspirate on day
      7. The need for mononasal continuous positive airway pressure and respirator
      therapy was similar in both groups. We conclude that caffeine citrate is the drug
      of choice for apnea and bradycardia prophylaxis in premature neonates with a
      gestational age < or = 33 full weeks.

PMID- 7795342
TI  - Methaemoglobinaemia among neonates in a neonatal intensive care unit.
AB  - After detection of a few clinical cases of methaemoglobinaemia (methb) in our
      NICU, a prospective clinical study was undertaken to determine the extent of the
      problem and to identify the causes. Consequently, during the following 8 months
      all haemoglobin tests included simultaneous measurements of methb on an OSM 3
      hemoximeter (Radiometer): 8% (n = 33) of 415 neonates were found to be methb
      positive (defined as > or = 6% methb). Mean methb was 19% (range 6.5-45.5%).
      Maximum methb concentrations were found on day 4-31 postpartum (mean 12 days) and
      the number of days with a positive methb sample ranged from 1 to 18 days (mean 6
      days). About 40% of the neonates born at 25-30 weeks of gestation and 60% with a
      birth weight < 1000 g were methb positive. Also, there was a negative correlation
      between the size of the methb positive concentration and gestational age (r = 
      0.38, p = 0.02). Measurements of C-reactive protein and leucocytes, NADH
      reductase, pH, Cl, nitrate and nitrite were carried out in methb positive
      patients. The tests were repeated 1 week after cessation of methb. The only
      significant difference was an increase in NADH reductase at the second
      measurement. Likewise, a wide range of clinical parameters were registered and
      they occurred with a higher frequency among the methb positive patients when
      compared with a methb negative control group matched with regard to gestational
      age and the closest possible birth weight. The mean birth weight of methb
      positive patients was 1170 g and that of negative controls 1380 g (p <
      0.006).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7795343
TI  - Cord blood cells and indices: smoking-related differences between the sexes.
AB  - The values of whole blood cell count, leucocyte differential, and platelet and
      reticulocyte counts were determined in cord blood of both male (n = 64) and
      female (n = 75) newborns of 87 non-smoking and 52 smoking mothers. Leucocytes and
      neutrophils in cord blood from the male newborns of smokers were significantly
      lower than those in their female counterparts and in male newborns of non
      smokers. These results suggest that male newborns are more affected by cigarette
      exposure than females with regard to some haematological parameters.

PMID- 7795344
TI  - Sleeping position and sudden infant death syndrome (SIDS): effect of an
      intervention programme to avoid prone sleeping.
AB  - The proportion of prone sleeping among sudden infant death syndrome (SIDS)
      victims and infants in general, and the rate of SIDS were prospectively studied
      in the county of Hordaland, Norway, three years before (1987-89) and three years
      after (1990-92) a campaign to discourage prone sleeping. Before the campaign, 64%
      of random reference infants were put prone versus 8% after (p < 0.0001).
      Concurrently, the rate of SIDS decreased from 3.5 to 1.6 per 1000 live births (63
      infants before and 30 after the campaign, p = 0.0002). Prone sleeping was not
      considered a statistically significant risk factor for SIDS before (OR 2.0, 95%
      CI 0.8-4.5), but was highly significant (OR 11.3, 95% CI 3.6-36.5) after the
      campaign. Prone sleeping is an important risk factor for SIDS, but the
      association may be missed in epidemiological studies if prone is the predominant
      sleeping position. Behaviour with regard to sleeping position may be changed
      rapidly by means of a simple campaign.

PMID- 7795345
TI  - Arterial oxygen saturation in infants at risk of sudden death: influence of
      sleeping position.
AB  - To study the possible influence of sleeping position on arterial oxygen
      saturation, measured by pulse oximetry (SpO2), 7-h overnight recordings of
      breathing movements and ECG were performed in 43 infants (median age 2.4 months,
      range 0.2-11 months) at increased risk of sudden infant death syndrome (SIDS).
      Infants were randomly allocated to start sleeping either in their usual sleeping
      position or in the opposite position. After 3.5 h, all infants were gently turned
      over. Thus, each infant served as their own control. Recordings were analysed for
      sleep time, baseline SpO2 (only during regular breathing), and the number and
      duration of desaturations (a decrease in SpO2 to < or = 80%). In the prone
      position, a significantly higher proportion of time was spent asleep (median 79%
      versus 70%; p < 0.05). Median baseline SpO2 was 98.8% (91.7-100%) in the prone
      and 99.0% (92.0-100%) in the supine position (ns). A total of 191 desaturations
      were found in 29 recordings; 96 in the prone and 95 in the supine position (ns).
      One infant subsequently died of SIDS while sleeping in the prone position. He had
      a relatively high number of desaturations (n = 12) which all occurred in the
      prone position. These results confirm earlier studies which could not find a
      significant influence of sleeping position on baseline oxygenation. The
      occurrence of desaturations in the prone position only in the infant who
      subsequently died requires further investigation.

PMID- 7795346
TI  - Rate of radial bone mineral accretion in healthy children.
AB  - Radial bone width and mineral content were measured in 392 healthy Cambridge
      children aged 6-12 years from a cohort of 420 children studied 2 years
      previously. The typical rate of bone mineral accretion was 0.044 g/cm/year for
      boys across the whole age range and 0.042 g/cm/year for girls up to a mean age of
      9 years, rising rapidly thereafter in association with changes in body size. The
      factors best predicting bone mineral accretion rate were mean bone mineral
      content, mean height, height velocity, weight velocity and bone width velocity.
      After adjusting for anthropometry, age did not contribute to the model. These are
      the first available longitudinal reference data for the rate of radial bone
      mineral accretion in healthy children.

PMID- 7795347
TI  - Dietary calcium, saturated fat, fiber and vitamin C as predictors of forearm
      cortical and trabecular bone mineral density in healthy children and adolescents.
AB  - Diet, weight-bearing physical activity (WPA) and daylight hours spent outdoors
      (DE) were related to bone mineral density in the distal (BMDd) and ultradistal
      (BMDud) forearm of 495 healthy children (8-11 years) and adolescents (11-17
      years). BMD was assessed by single photon absorptiometry. Using multiple
      regression, BMDd was predicted by saturated fat and BMDud by fiber in children.
      In adolescents, BMDd was predicted by saturated fat and vitamin C, and BMDud by
      calcium and vitamin C. WPA and DE were not related to BMD. In conclusion, our
      results showed that current intake of calcium, saturated fat, fiber and vitamin C
      were positively associated with forearm BMD in children and adolescents. These
      associations depended on age and bone type. If our findings are verified, dietary
      recommendations, especially when aimed at young people, may have to be
      reconsidered.

PMID- 7795348
TI  - Does age at the start of breast feeding influence infantile diarrhoea morbidity?
      A case-control study in periurban Guinea-Bissau.
AB  - Colostrum protects the newborn from intestinal infection by its content of
      secretory immunoglobulin A and other immediately acting factors. It may also
      induce maturation of the child's gastrointestinal immune defences, thus
      contributing to the protection against diarrhoeal disease later in infancy. To
      test this hypothesis, a case-control study on breast feeding and diarrhoea was
      carried out in a periurban community in Guinea-Bissau. The child's age at the
      start of breast feeding was ascertained soon after birth (n = 279). Subsequent
      cases of acute diarrhoea (n = 66) were identified at 3-monthly examinations, and
      four concurrent controls were randomly selected among attendants. Three separate
      estimates of association showed that the cases tended to have started breast
      feeding later after birth than the diarrhoea-free controls, but no single test
      was statistically significant. Early breast feeding might have consequences for
      diarrhoeal morbidity after the neonatal period.

PMID- 7795349
TI  - Contact allergy in relation to hand eczema and atopic diseases in north Norwegian
      schoolchildren.
AB  - Patch testing was carried out in 424 schoolchildren (223M, 201F), aged 7-12
      years, in northern Norway. In 99 (23.3%) of these children, one or more allergic
      patch test reactions were demonstrated; 30 children reacted to two and 6 to three
      or more substances; 53 irritant reactions were recorded in 33 (7.8%) of those
      tested. From a total of 144 positive tests, the most common allergen was nickel
      (14.9%), followed by cobalt (5.7%), kathon CG (5.2%), lanolin (1.7%) and neomycin
      (1.4%). Both allergic and irritant reactions were found twice as frequently in
      girls as in boys. Positive patch tests were significantly more frequent in atopic
      (28.8%) than in non-atopic (17.9%) children, being most pronounced in atopic
      girls (37.4%). Hand eczema was reported to have occurred or to be present in 6.5%
      of cases. Twenty-nine of 36 children reporting hand eczema participated in the
      clinical examination. Altogether 15 (3.5%) children had hand eczema at the time
      of the clinical examination but 12 of these children had no previous history of
      hand eczema. In 14 of these 15 subjects, the eczema was localized to the back of
      the hands, with 13 having atopic dermatitis. In 4 of these 15 children, an
      allergic patch test reaction was found; however, in only 2 of these 4 was the
      test considered to be clinically relevant for the diagnosis allergic hand eczema.
      In conclusion, irritant hand eczema may occur in early childhood and is most
      prevalent in children with atopic dermatitis.

PMID- 7795350
TI  - Factors triggering the first febrile seizure.
AB  - The symptomatology of infections as well as immunological and virological
      findings were analysed using a logistic model in a survey of 58 children
      experiencing their first febrile seizures. These were then compared with findings
      in 116 age- and sex-matched controls with infections but no seizures. There were
      no statistically significant differences in the aetiology of infections between
      patients and controls. High temperature was the only variable to explain the
      occurrence of febrile seizures in the logistic model after adjusting for duration
      of symptoms (partial correlation coefficient in logistic model, r = 0.31). The
      duration of symptoms before hospitalization was shorter in patients than in
      controls (mean 1.0 and 3.6 days). With a longer duration of symptoms, the
      likelihood of seizures diminished (r = -0.34). Patients in the seizure group had
      a significantly higher temperature at home than controls before hospitalization
      (39.4 versus 38.8 degrees C). Our findings of higher temperatures in children
      with febrile seizures supports its importance as the most important triggering
      factor in febrile convulsions.

PMID- 7795351
TI  - Neurological findings in early treated phenylketonuria.
AB  - Twenty early treated, normal intelligent patients (IQ: mean 101.4, SD 10.0; age:
      mean 10.11, SD 1.3 years) with classical phenylketonuria and 20 age-, sex- and IQ
      matched healthy controls were investigated for neurological outcome, especially
      with regard to fine motor ability using the motor performance task ("Motorische
      Leistungsserie"). No pathological findings were seen on clinical neurological
      examination. The patient group had significantly poorer results in a
      concentration task (Test-d-2) as well as in some subtests of the motor
      performance task. Patients had difficulties in tasks which needed speed and
      precision of arm-hand-finger movements. High serum phenylalanine concentrations
      were significantly correlated with these deficiencies in fine motor ability. Our
      data demonstrated mild neurological impairment even in early and relatively
      strictly treated patients with phenylketonuria.

PMID- 7795352
TI  - Outcome of pregnancy in women with myotonic dystrophy and analysis of CTG gene
      expansion.
AB  - Pregnancy outcome was investigated in 32 women with clinically obvious myotonic
      dystrophy. The results indicated that there are two groups of women, those whose
      children have the adult type of myotonic dystrophy and those whose children have
      the congenital type. The overall perinatal mortality was 14%. Polyhydramnios was
      an obvious sign of the congenital type. No subclinical gene carrier was found
      among the children. We conclude that prenatal diagnosis should be offered to
      women with myotonic dystrophy, particularly to those who have previously given
      birth to a child with the congenital type.

PMID- 7795353
TI  - Incidence of acute otitis media associated with group A and B respiratory
      syncytial virus infections.
AB  - The comparative association of respiratory syncytial virus group A and B
      infections with acute otitis media was determined by analysing the hospital
      records of children with community-acquired respiratory syncytial virus infection
      during three successive outbreaks from 1987 to 1992. Of 326 episodes analysed,
      192 (59%) were caused by group A and 134 (41%) by group B infections. Acute
      otitis media was diagnosed in 101 (75%) children with group B infection, compared
      with 119 (62%) with group A infection (p = 0.01). Group A infections were more
      often associated with wheezing (71% versus 59% in group B; p = 0.02) and oxygen
      therapy in inpatients (48% versus 31%, respectively; p = 0.008). The higher
      incidence of acute otitis media associated with group B infections was observed
      both after adjustment for potential confounding variables and during each
      outbreak.

PMID- 7795354
TI  - Deep Candida infection in child liver transplant recipients: serological
      diagnosis and incidence.
AB  - Nineteen children who received 22 orthotopic liver grafts on 20 occasions were
      studied with regard to Candida infection. Serum samples were analysed to
      determine Candida, IgA, IgM and IgG antibodies and detect free C. albicans
      glucoprotein antigen. Five children (25%) had a confirmed deep C. albicans
      infection (DCI) during the first 2 weeks after transplantation. In all children
      with DCI, serology was positive, a median of 6 days (range 2-9 days) before
      Candida infection was verified by fungal culture, direct microscopy and/or
      autopsy. The positive predictive values for Candida IgG, IgM and IgA antibodies
      in children with DCI were 100%, 78% and 100%, respectively, and for free C.
      albicans antigen, 45%. Pathological titres of IgM and IgA antibodies against
      Candida before liver transplantation were present in three of four children who
      later developed a DCI and in no child without infection. In conclusion, regular
      screening by Candida serology is recommended both before and after liver
      transplantation.

PMID- 7795355
TI  - Assessment of an abbreviated odorant identification task for children: a rapid
      screening device for schools and clinics.
AB  - To validate the level of olfactory performance of children, we tested 825
      volunteers, aged 4-17 years, with an abbreviated form of our pediatric odorant
      identification task. The test consisted of sniffing and identifying five odorants
      (baby powder, bubble gum, candy cane, licorice and peach). Mean olfactory scores
      increased as a function of age, reaching a plateau of about 94-95% correct at 8
      years of age. In general, girls out-performed boys. Physicians require a test
      instrument such as the one we have devised to allow them to diagnose olfactory
      dysfunction in children. The present task is particularly applicable in screening
      large numbers of children in clinics or schools because it can be administered
      easily and rapidly. Adult subjects with olfactory dysfunction also performed
      poorly on this odorant identification task designed for children. Therefore, we
      expect that our odorant identification task will also detect children with severe
      olfactory dysfunction.

PMID- 7795356
TI  - Adverse drug reactions in a paediatric intensive care unit.
AB  - Adverse drug reactions (ADRs) were prospectively studied in critically ill
      infants and children. Seventy-six ADRs were reported in 63 patients out of a
      study group of 899 patients. The majority of the ADRs were mild (49), although 19
      were of moderate severity and 8 were severe. Thirty-five ADRs required treatment
      or alteration in treatment. Midazolam, morphine, salbutamol, vecuronium,
      hydrocortisone and theophylline were the drugs most likely to cause an ADR. One
      third of the ADRs were due to drugs used outside their product licence. The
      majority of the ADRs were reported by nurses (36) and pharmacists (30). We
      believe that it is possible to prospectively study drug toxicity in critically
      ill infants and children.

PMID- 7795357
TI  - Pediatric ECMO for pulmonary support: experience from 12 cases.
AB  - Extracorporeal membrane oxygenation (ECMO), which can be described as treatment
      with a modified heart-lung machine over a prolonged period of time, is used to
      support patients with life-threatening but potentially reversible lung failure.
      ECMO by itself does not cure the patient but gives the lungs a chance to rest
      while awaiting spontaneous or therapeutic healing. The method is well documented
      in the neonatal age group. In the non-neonatal age group, however, experience is
      less extensive. This report of the initial result from our hospital with 12 non
      neonatal pediatric cases shows high survival and low morbidity. Nine of the 12
      patients were able to be weaned from ECMO (75% survival) and 8 of these 9
      patients were long-term survivors. Medium time on the ventilator after
      discontinuation of ECMO was 4 days. At follow-up, all long-term survivors had no
      signs of neurological or pulmonary sequelae. These encouraging results point to
      the fact that ECMO should be considered more often in cases of life-threatening
      but potentially reversible pulmonary failure.

PMID- 7795358
TI  - The child group used as a reference system when analysing frequency of morbidity
      in day-care centres.
AB  - Morbidity frequency was analysed among children attending six day-care centres in
      a suburb of Stockholm, Sweden. Absence due to illness was calculated annually for
      each child and correlated with each child's own group. Thus a child was
      classified as "often sick" or "mainly healthy" in relation to the other children
      in the child's own group, constituting a reference system. In almost every group
      a "sick third" was found, whose absence due to illness was twice that of the rest
      of the group. Children from families of lower social standing, those with a
      relatively large number of siblings and those living in poor social conditions
      were found to be among those most often reported as sick. In such families,
      smoking was more commonplace. These parents more often lived in a rented
      apartment than in a single detached owner house. Multiple linear regression
      analysis revealed that young mothers and children with several siblings had the
      strongest correlation with absence due to illness of the proband child.
      Increasing maternal age revealed improvement vis-a-vis all socioeconomic
      parameters investigated, reflecting an improvement in standing correlated to less
      sick children.

PMID- 7795359
TI  - Enteropathogenic Escherichia coli O111ab:H2 penetrates the small bowel epithelium
      in an infant with acute diarrhoea.

PMID- 7795360
TI  - Biological zero in laser Doppler perfusion measurements: studies in neonates.

PMID- 7795362
TI  - Prophylaxis of Candida infections in transplanted patients.

PMID- 7795361
TI  - Two cases suggesting a role for the L-arginine nitric oxide pathway in neonatal
      blood pressure regulation.
AB  - Endogenous nitric oxide produced from L-arginine is a potent vasodilator that may
      be involved in blood pressure regulation. A male infant with argininosuccinate
      lyase deficiency, who could not synthesize L-arginine, was hypertensive prior to
      L-arginine replacement. The infusion of L-arginine resulted in a decrease in
      blood pressure. A three-fold increase in the dose of L-arginine further decreased
      blood pressure. On discontinuing the infusion of L-arginine, the patient's blood
      pressure increased. A female infant undergoing an L-arginine challenge test had a
      decrease in blood pressure during L-arginine infusion which resolved when the L
      arginine infusion was discontinued. These two cases suggest that nitric oxide
      production from L-arginine may play a role in the normal regulation of systemic
      blood pressure.

PMID- 7795363
TI  - Legislative approaches to assisted reproduction.

PMID- 7795364
TI  - Egg yolk enhances the receptiveness of zona pellucida to sperm binding.
AB  - PURPOSE: Our purpose was to test whether treatment of zona pellucida with egg
      yolk enhances its receptiveness to sperm binding. Hams F-10 supplemented with
      0.06 g% freeze-dried egg yolk (TM) was evaluated using the hemizona assay. Ham's
      F-10 supplemented with 7.5% human serum served as the control medium (CM). Salt
      stored zona pellucida were bisected and each matched hemizona processed in either
      TM or CM for the preincubation study or both hemizona processed in CM for the
      coincubation study. TEST yolk-treated sperm from 10 ejaculates were then
      incubated with the hemizona preincubated in TM and CM but coincubated in CM or
      coincubated with hemizona in TM and CM. RESULTS: A significantly (P < 0.02)
      higher number of tightly bound sperm and hemizona index for the hemizona either
      preincubated or coincubated in TM compared to the respective hemizonae in CM were
      observed.

PMID- 7795365
TI  - Reproductive capacity of the nucleus of the male gamete after completion of
      meiosis.
AB  - PURPOSE: Our purpose was to investigate the possibility of achieving
      fertilization and subsequent normal embryonic development by injecting round
      spermatid nuclei into rabbit oocytes. RESULTS: Two-to four-cell-stage embryos
      developed after round spermatid nuclear injections into rabbit ooplasma could
      further develop in vitro up to the expanding blastocyst stage or in vivo up to
      complete gestation. CONCLUSION: The current findings show that the haploid set of
      chromosomes of round spermatid can pair with the chromosomes of the ootid to
      participate in complete fertilization and subsequent embryonic and fetal
      development. In addition, we suggest that postmeiotic modifications of the round
      spermatid are not required for the pairing of male gamete chromosomes with those
      of the ootid.

PMID- 7795366
TI  - Covering embryo cultures with mineral oil alters embryo growth by acting as a
      sink for an embryotoxic substance.
AB  - PURPOSE: Assisted reproductive technologies require the use of culture media for
      gametes and embryos. Culture media and conditions intended for use in human in
      vitro fertilization are tested prior to use by evaluating their ability to
      support normal development of mouse embryos. RESULTS: Development to blastocysts
      of two-cell mouse embryos was equivalent for embryos cultured in center well
      dishes alone (93 +/- 10%, mean +/- SD) and embryos cultured in center well dishes
      with an overlay of 1 ml of mineral oil (94 +/- 5%). In contrast, no development
      of two-cell-stage mouse embryos occurred in an embryotoxic medium when cultured
      in center well dishes. However, when this medium was covered with an overlay of
      mineral oil, development to blastocyst was no different than that of controls (96
      +/- 5%). Similar results were found with cultures of one-cell-stage mouse
      embryos. CONCLUSION: These results indicate that in some circumstances the
      presence of mineral oil can significantly alter the outcome of embryo culture.
      Further, these results reinforce the necessity of directly testing the exact
      culture conditions to be used for assisted reproductive technologies.

PMID- 7795368
TI  - Minimal stimulation with simplified monitoring for in vitro fertilization.
AB  - PURPOSE: This retrospective, descriptive study was designed to determine the
      effectiveness of using clomiphene citrate in relatively high daily doses (100,
      150, and 200 mg) with simplified monitoring for in vitro fertilization in a
      private office and surgical center. The self-selected study population comprised
      109 women who were 25-42 years old, including 26 women whose husbands had mild
      male-factor infertility. RESULTS: During January 1992 through December 1993, 165
      stimulation cycles resulted in 137 egg retrievals, 24 clinical pregnancies
      (17.5%), and 20 viable pregnancies (14.5%). Cycles that could not be completed
      (28/165 or 16.9% of all cycles) involved luteinizing hormone surges, insufficient
      follicles, or low estradiol levels. There were no pregnancies in patients who
      were 40 years or older or who received 200 mg daily doses of clomiphene citrate.
      The viable pregnancy rate among patients with male factor infertility was 7.7%
      (2/26). For non-male-factor infertility patients who were younger than 40, the
      viable pregnancy rate was 17.6% (18/102). CONCLUSION: The simplified monitoring
      method did not appear to compromise the results.

PMID- 7795367
TI  - The screening of embryonic viability in early asymptomatic pregnancy by a single
      endosonographic scan associated with plasma human chorionic gonadotropin
      determination.
AB  - PURPOSE: Our purpose was to assess, with a prospective study with random
      assignment of the day of the first evaluation, whether a single transvaginal
      ultrasonographic evaluation together with the determination of plasma hCG levels
      could be used to screen embryonic viability in early asymptomatic pregnancy.
      METHODS: In 260 pregnant women observed from January 1991 to November 1993 with
      spontaneous pregnancies where the exact date of ovulation was known, a single
      transvaginal ultrasonographic measurement of gestational sac with determination
      of plasma hCG levels, transformed to their natural logarithm (lnhCG), was
      performed. An abnormal result was defined as a value of lnhCG per mean
      gestational sac below the 95% lower confidence limit of the viable pregnancy
      group. RESULTS: The sensitivity was 31%, with a specificity of 97%. CONCLUSION:
      The study demonstrates that this method has a poor predictive capacity to
      distinguish viable pregnancy from nonviable pregnancy with a kappa value less
      than 0.4.

PMID- 7795369
TI  - The effect of dam's strain on the intrauterine craniofacial growth of mouse
      fetuses.
AB  - PURPOSE: The maternal effect is one of the important factors in mammalian growth
      in conjunction with the genetic effect. The present study investigated the
      prenatal maternal effect of a dam on the intrauterine craniofacial growth of a
      mouse fetus using embryo transfer and cephalometry. DDD/Qdj strain mouse embryos
      were transferred to four strains of recipient female mice (DDD/Qdj, C3H/Qdj,
      C57BL/Qdj, and DBA/1J Sea). Just after parturition cephalometric observation of
      the newborn offspring, which developed in the uteri of the four strains of dams,
      was performed and then the craniofacial size of the newborn offspring was
      calculated on the lateral cephalogram. Statistical analyses were performed to
      examine the correlation between the dam's weight and the craniofacial size of the
      newborn offspring, to test the significance of the effect of the dam's strain on
      the craniofacial size of the newborn offspring, and to evaluate the interstrain
      difference of the intrauterine craniofacial growth of the mouse fetuses. RESULTS:
      It was disclosed that there were a direct relation between the dam's weight and
      the craniofacial size of the newborn offspring, a significant effect of the dam's
      strain on the craniofacial size of the newborn offspring, and a significant
      interstrain difference in the craniofacial size of the newborn offspring after
      eliminating the effects of litter size and gestation period on the craniofacial
      size of the newborn offspring (DDD/Qdj > C3H/Qdj = C57BL/Qdj > DBA/1J Sea).
      CONCLUSION: Thus, it could be concluded that the four strains of dams affected
      differently the intrauterine craniofacial growth of the DDD/Qdj strain fetuses
      through each uterine condition, indicating that the dam's weight played an
      important role as one of the prenatal maternal effects on the intrauterine
      craniofacial growth of mouse fetuses.

PMID- 7795370
TI  - Coculture of mouse embryos with cryopreserved human oviduct epithelial cells.
AB  - PURPOSE: The effect of coculturing mouse embryos with cryopreserved human oviduct
      epithelial cells was investigated. The cryopreserved cells in Cellbanker were
      thawed and cultured in Richard D. Goldsby culture medium to establish monolayers.
      Two-cell-stage mouse embryos were cultured alone (control group) or cocultured
      with monolayers established from cryopreserved cells (cryopreserved coculture
      group) or from fresh cells (fresh coculture group). The rates of embryo
      development and the qualities of the blastocysts in the three groups were
      compared. RESULTS: The two coculture groups had significantly higher blastocyst
      development rates (cryopreserved coculture group, 81.6%; fresh coculture group,
      82.2%) than the control group (63.1%). The two coculture groups had significantly
      more blastomeres (cryopreserved coculture group, 108.3 +/- 25.9; fresh coculture
      group, 108.4 +/- 25.1) than the control group (87.7 +/- 31.9). CONCLUSION: The
      method of cryopreservation of human oviduct epithelial cells using Cellbanker is
      simpler than conventional cryopreservation methods. These cryopreserved human
      oviduct epithelial cells may provide a constant supply of cells for coculture for
      in vitro fertilization and embryo transfer.

PMID- 7795371
TI  - Transabdominal embryoscopy for the detection of Carpenter syndrome during the
      first trimester.

PMID- 7795372
TI  - Vitamin supplements improve the fertility potential of a subfertile male with
      macrocytic anemia--a case study.

PMID- 7795373
TI  - Evaluation of endocarditis and its complications by biplane and multiplane
      transesophageal echocardiography.
AB  - Echocardiography is currently the method of choice for the diagnosis of
      endocarditis-associated vegetations or complications such as abscess formation.
      Thereby, the transesophageal approach (TEE) is clearly superior to precardial
      echocardiography and, at present, biplane TEE can be considered as the standard
      TEE technique. Compared with the monoplane technique, biplane TEE provides
      additional qualitative and quantitative information concerning the presence and
      amount of valvular destruction. Multiplane TEE facilitates (and abbreviates) the
      examination procedure, and may be helpful for easier detection of small initial
      abnormalities, those developing on native valves with preexisting lesions, or on
      prosthetic valves. It allows more accurate measurements and three-dimensional
      reconstruction of vegetations and abscess areas and provides more anatomical
      details of the disease. However, it remains to be shown by future studies if
      multiplane TEE will identify endocarditis-associated lesions more frequently than
      the biplane technique doses.

PMID- 7795374
TI  - Transesophageal echocardiography in the evaluation of prosthetic valves.
AB  - Biplane and multiplane TEE, with its relatively low risk, has become an
      invaluable complement to a comprehensive transthoracic two-dimensional Doppler
      and color flow examination. It should be undertaken in all instances when the
      transthoracic information is not adequate or if there is suspicion of abnormality
      that is not detected by TTE. One can advocate the use of TEE in the operating
      room in all instances wherein a patient is going to be implanted with a
      prosthetic valve because it will permit one to obtain baseline information that
      may be valuable in the management of patients seen subsequently with questionable
      findings when comparison is valuable. The role of cardiac catheterization is
      limited. Hemodynamic cardiac catheterization should only be used in instances in
      which there is discrepancy between echocardiographic findings and clinical
      presentation. Visualization of coronary arteries may be indicated in some
      situations, and a limited coronary arteriogram could be performed, the procedure
      being less morbid if separated from hemodynamic right and left heart
      catheterization. Echocardiography represents the state of the art in evaluation
      of patients with valvular prosthesis. Biplane TEE and multiplane TEE are valuable
      complementary technology to be used in conjunction with TTE, when the situation
      dictates its use, because it provides useful information that alters management
      of the patient.

PMID- 7795375
TI  - Advantages of biplane and multiplane transesophageal echocardiography for the
      morphology of the aorta.

PMID- 7795377
TI  - Biplane and multiplane transesophageal echocardiography: evaluation of congenital
      heart disease.
AB  - Congenital heart disease can be a diagnostic challenge. Transesophageal
      echocardiography (TEE) has markedly extended the diagnostic power of the
      ultrasound examination. Outpatient TEE is most useful in the assessment of adult
      congenital heart disease. Outside the acute care setting, TEE is not commonly
      used to diagnose pediatric congenital heart disease. Most anomalies can be
      accurately assessed with transthoracic echocardiography. In the intensive care
      unit, cardiac catheterization laboratory, and operating room, TEE is used in
      patients of all ages to assess the anatomic and functional spectrum of
      preoperative and postoperative congenital heart disease. A consistent anatomic
      presentation is used to show various congenital cardiac anomalies.

PMID- 7795376
TI  - Multiplane transesophageal echocardiographic evaluation of mitral valve disease.
AB  - With the additional ability to rotate the image around the axis of the centerline
      of the sector, multiplane transesophageal echocardiography (TEE) improves over
      single or biplane TEE in ease of use and diagnostic accuracy. This article
      reviews the anatomic, physiological, and topographic considerations that affect
      the use of multiplane TEE in evaluation of patients with mitral valve disease.
      The optimum mitral valve examination includes a true "short-axis" view, obtained
      by a transverse (zero-degree angle) transgastric image orientation with the probe
      tip flexed anteriorly, and several "long-axis" views, obtained from various
      rotations of the basilar multiplane TEE image planes. This provides a useful and
      accurate means to determine the mechanism of mitral regurgitation, which is
      useful in planning and timing, determining the likelihood, and predicting the
      surgical techniques that will be required for mitral valve repair. The
      postcardiopulmonary bypass (postpump) TEE examination in a patient with mitral
      regurgitation is a second important component of the process of repair, to
      determine the presence and severity of residual mitral regurgitation, and
      identify any complications of surgery. Of 1,550 mitral repair operations studied
      with postpump echocardiography at our hospital since 1987, a total of 105 (7%)
      have had second pump runs. Multiplane TEE is also useful to pinpoint the exact
      site of periprosthetic regurgitation around a mitral prosthesis, enabling direct
      surgical closure in some cases. Understanding special technical features of
      multiplane TEE is an important component for optimum utilization of this powerful
      diagnostic modality.

PMID- 7795378
TI  - Improved detection of wall motion by transesophageal stress echocardiography
      using a biplane transducer.
AB  - Transesophageal stress echocardiography using simultaneous transesophageal atrial
      pacing or pharmacological agents, eg, dobutamine, is a valuable addendum to
      conventional stress echocardiography. Initial experiences with combined
      transesophageal echocardiography (TEE) and atrial pacing or during
      pharmacological infusion are reported with monoplane techniques. Potential
      advantages of biplane application can be expected in detection or exclusion wall
      motion abnormalities (WMA). Twenty-one consecutive patients underwent
      transesophageal stress echocardiography with a biplane transducer. WMA were
      observed in 19 patients. In 9 of 19 patients (47%) the transverse plane was the
      only diagnostic section for WMA; the longitudinal plane was the only diagnostic
      section in 3 of 19 patients (additional yield: 16%). In 7 patients (37%), both
      planes were diagnostic. Thus, advantages include a higher diagnostic yield
      compared with monoplane TEE because of better visualization of basal and apical
      segments. An important limitation of the biplane probe during transesophageal
      atrial pacing is its restricted mobility. Using pharmacological agents, the
      ventricle can be monitored from the transgastric as well as from the
      transesophageal position. Transesophageal stress echocardiography using a biplane
      transducer is feasible, and allows more successful imaging of the regional basal
      and apical segments compared with the monoplane technique and increases its
      diagnostic yield. In conjunction with transesophageal atrial pacing, the biplane
      technique is limited to one single position only because of restricted mobility
      during the entire stress procedure.

PMID- 7795379
TI  - Three-dimensional reconstruction of cardiac structures from transesophageal
      echocardiography.
AB  - Although tomographic imaging has been very successful in cardiology,the
      quantitation of volumes, surfaces, and masses,as well as understanding of complex
      morphologies would improve by three-dimensional imaging. This review focuses on
      approaches to 3-D reconstruction from transesophageal echocardiography. In the
      past, several attempts using either stepwise parallel translation or stepwise
      rotation of the transducer have been made. In vitro and, to a limited extent, in
      vivo studies have confirmed high accuracy in calculating left ventricular volumes
      in such manner. Complex cardiac structures and their motion, such as the mitral
      annulus, mitral leaflets, atrial septal defects, and others have been
      reconstructed from patient studies. Although potentially a powerful tool for
      cardiac imaging with promising quantitation capabilities, progress is needed in
      particular in the field of border detection to make 3-D imaging practical enough
      for clinical use.

PMID- 7795381
TI  - Standard views in cardiac multimodality tomographic imaging.
AB  - In cardiology, it is often necessary to acquire more than one type of image to
      investigate a given clinical problem of a single patient. Images obtained from
      different imaging modalities are usually recorded and displayed in different
      orientations, at different positions, and at different scale factors. It is then
      necessary for the physician to mentally integrate the image information from the
      different imaging modalities. This phenomenon is particularly true with
      tomographic imaging techniques that allow complete freedom of the acquisition
      plane. In particular, when comparing images obtained from ultrasound, computed
      tomography, magnetic resonance imaging, positron-emission tomography, and single
      photon emission computed tomography. The purpose of this article is to propose a
      standard set of slice orientations that could be easily applied to all
      modalities. Such common views could greatly facilitate the user's perception of
      the regional abnormalities observed in the different imaging modalities. This
      standardization is certainly useful for clinical application but also for every
      research study that requires a comparative evaluation of the different imaging
      modalities. Although exact registration of the images from the different
      modalities requires sophisticated computer programs, the simple reference method
      in plane positioning proposed here based on plane orientation according to the
      cardiac geometry can certainly provide a practical and convenient method for the
      reasonably accurate image registration required for visual comparative studies.

PMID- 7795382
TI  - Transesophageal transducer technology: an overview.
AB  - Early developments and basic principles in the field of Transesophageal
      Echocardiography (TEE) probe technology are summarized. Mechanical and
      electronical sector scanners are compared, and several probe characteristics and
      image parameters are discussed. A short review of recent developments in TEE is
      given.

PMID- 7795383
TI  - Biplane and multiplane transesophageal echocardiography: methodology and echo
      anatomic correlations.
AB  - Transesophageal echocardiography (TEE) is one of the most significant
      developments in cardiology and cardiac imaging in the last decade. While
      monoplane TEE clearly showed the advantages of imaging from the esophagus,
      biplane TEE was the next important step forward. The combination of transverse
      and longitudinal axis images served to provide incremental information about
      various cardiac pathologies. Multiplane TEE is a further advancement that allows
      continuous visualization of cardiac anatomy by electronic or manual steering of
      the ultrasound beam through 180 degrees. The intermediate views obtained by beam
      steering provides an unlimited perspective of normal and abnormal cardiac
      anatomy. This ability to view cardiac structures in multiple planes aids the
      understanding of the spatial arrangement of normal cardiac structures and complex
      disorders of cardiac anatomy. Multiplane TEE technology also eases the
      examination by reducing the need for probe manipulation. The ability to obtain
      multiplane images in a sequential manner lays the foundation for three
      dimensional imaging of the heart. Ongoing developments in transducer technology
      should further strengthen the clinical role of TEE.

PMID- 7795380
TI  - Reliability of electron beam computed tomography to detect coronary artery
      calcification.
AB  - Electron beam computed tomography (CT) provides a safe, rapid, and noninvasive
      means to detect the presence and quantitate the deposition of calcium in the
      coronary arteries. To examine the reproducibility of a coronary calcification
      screen using electron beam CT, 50 subjects underwent two studies, averaging 12
      minutes between studies. The number, volume, and calcification scores were
      determined for each artery as well as a total score of coronary calcification.
      Thirty-four of the 50 subjects had evidence of coronary calcification. The
      reliability score for total coronary artery calcification was 0.99. The
      reliability score for the total number of lesions and total volume was at or
      above 0.98. There were 8 cases in which a negative calcium score on retest was
      positive or where a positive calcium score on retest was negative. In both
      instances, the amount of calcium detected was very small. Therefore, evidence
      suggests that electron beam CT is reliable in the detection of coronary artery
      calcification and may be a useful tool for the early detection of coronary
      atherosclerosis before flow impairment.

PMID- 7795385
TI  - Occurrence of D-aspartic acid in rat brain pineal gland.
AB  - We found a high concentration (1030 pmol per pineal gland) of D-aspartic acid (D
      Asp) in the pineal gland of 6-week-old Sprague-Dawley (SD) rats. The content of D
      Asp decreased with age, being 210 and 33 pmol per pineal gland in 28- and 45-week
      old rats respectively. The proportion of D-Asp [(D-Asp/total Asp) x 100] also
      decreased with age, declining from 66% to 10% between 6 and 45 weeks after birth.
      The proportion of D-Asp did not differ between the sexes. The concentration of D
      Asp was higher at night (at 2.00 a.m. 2830 +/- 485 pmol per pineal gland) than
      during the day (at 10.00 a.m. 1030 +/- 200 and at 3:00 p.m. 682 +/- 194 pmol per
      pineal gland), suggesting that biosynthesis of D-Asp in the pineal gland occurs
      at night. D-Asp was found to be distributed in the cytosol of pinealocytes, but
      its biological role remains unclear.

PMID- 7795384
TI  - Determination of chondroitin sulphates in human whole blood, plasma and blood
      cells by high-performance liquid chromatography.
AB  - A simple HPLC method for determination of chondroitin sulphates as their
      unsaturated disaccharides by chondroitinases has been applied to measure the
      glycosaminoglycans (GAGs) in human whole blood, plasma and blood cells. This
      method may be useful for the investigations on the role of blood GAGs and the
      metabolic fates of the exogenous GAG.

PMID- 7795387
TI  - N-glycosylation site mapping of recombinant tissue plasminogen activator by
      micellar electrokinetic capillary chromatography.
AB  - This report describes the N-glycosylation mapping of recombinant tissue
      plasminogen activator (rt-PA) using micellar electrokinetic capillary
      chromatography. The carbohydrate structures were tentatively assigned by
      comparison with the anion-exchange fractionated oligosaccharides and by a
      comparison with previously reported data. The separation was shown to rely mainly
      on the degree of sialylation of the oligosaccharides, allowing a quantitative
      determination of the proportion of neutral and mono- to tetrasialylated
      structures. Significant differences in the oligosaccharide distribution of the
      two variants of rt-PA, which differ by the presence (type I) or the absence (type
      II) of oligosaccharides at the Asn-184 site, were observed. The distribution of
      the oligosaccharides at each of the rt-PA glycosylation sites was then
      determined. Glycopeptides were prepared by tryptic digestion of rt-PA and
      isolated using two consecutive chromatographic procedures. The glycopeptides were
      finally treated with N-glycanase, and the resulting oligosaccharides were
      analysed by capillary electrophoresis. Oligosaccharide mapping revealed that the
      Asn-448 and Asn-184 sites carry the same population of complex-type
      oligosaccharides but that the relative amounts of each oligosaccharide vary
      markedly. High-pH anion-exchange chromatography performed on the desialylated
      oligosaccharides at each glycosylation site showed that the degree of
      microheterogeneity was related not only to the degree of sialylation but also to
      structural differences in the oligosaccharide sequences. From the results as a
      whole, we concluded that the Asn-448 site contains a greater proportion of
      heavily sialylated structures and has a higher degree of
      microheterogeneity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7795386
TI  - Reversed-phase high-performance liquid chromatography of fullerenes with
      tetrahydrofuran-water as a mobile phase and sensitive ultraviolet or
      electrochemical detection.
AB  - Fullerenes (C60 and C70) were separated on a reversed-phase high-performance
      liquid chromatography column with a mobile phase of tetrahydrofuran-water (70:30,
      v/v) and detected with ultraviolet or electrochemical detection. A baseline
      resolution of C60 and C70 was achieved with a capacity factor values of 7.6 and
      10.8 respectively and a resolution of 3.7. The detection limit for C60 was 0.1
      pmol on column and was nearly the same for both detection methods.

PMID- 7795389
TI  - High-performance liquid chromatographic assay for the quantitation of nadolol in
      human plasma using fluorescence detection.
AB  - A rapid and sensitive HPLC-fluorescence assay was developed and validated for the
      determination of nadolol, a beta-blocker, in human plasma. Nadolol and the
      internal standard (desmethyl nadolol) were extracted from alkalinized plasma into
      methyl-tert.-butyl ether. The organic solvent was evaporated under nitrogen at 40
      degrees C. The residue was reconstituted in the mobile phase and injected on to a
      C18 silica column (25 cm x 4.6 mm i.d.) at a flow rate of 1.4 mL/min. The mobile
      phase was 0.05 M monobasic ammonium phosphate (pH 4.2) and acetonitrile (84: 16,
      v/v). Fluorimetric detection was performed at excitation 230 nm and emission 330
      nm. The nominal retention times were 3.3 and 4.3 min for the internal standard
      and nadolol, respectively. The lower limit of quantitation was 5 ng/mL and
      linearity (R2 > or = 0.994) of the standard curve was demonstrated between 5 and
      500 ng/mL. The analysis of quality control (QC) samples at 60, 200 and 400 ng/mL
      resulted in precision estimates < or = 7.0% relative standard deviation (RSD) for
      the inter-assay and < or = 6.3% RSD for intra-assay. The predicted concentrations
      of the QC samples deviated < 10% from the nominal values. The extraction recovery
      of nadolol from human plasma was 64%. Nadolol was stable in human plasma at -20
      degrees C for at least 5 months and for at least three freeze-thaw cycles.
      Nadolol and the internal standard were stable in the autosampler at 5 degrees C
      for at least 40 h. Overall, the assay was accurate, precise, sensitive, specific,
      and reproducible for the analysis of nadolol in plasma.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7795388
TI  - Investigation of enantioselective ofloxacin-albumin binding and displacement
      interactions using capillary affinity zone electrophoresis.
AB  - The direct chiral separation of ofloxacin by capillary affinity zone
      electrophoresis using serum albumins from different animal sources as chiral
      selector in the supporting electrolyte is described. In addition, the effects of
      displacers on the mobility and enantioselectivity of ofloxacin were studied.
      Firstly, the separation behaviour of the enantiomers of the ofloxacin (OFLX) and
      tryptophan (Trp) was compared. The influence of albumin types, including
      chemically modified bovine serum albumins (BSAs), and buffer types on the
      migration behaviour of enantiomers was investigated. The results showed that
      stereoselectivity of Trp is independent of the type of albumin used. However,
      chiral separation of OFLX depends on the biological species of albumin. Use of
      chemically modified BSA led to poorer resolution of enantiomers. Only with
      acetylated BSA could chiral separation of Trp be achieved. Using Good's buffer
      solutions (DIPSO and HEPES) as a supporting electrolyte affected the migration
      times of OFLX enantiomers. Finally, a variety of displacers were added to the
      buffer along with the protein, and the effects on separation behaviour were
      observed. The displacers included warfarin, ketoproten, diazepam, propranolol,
      benzoinphenylbutazone, digitoxin and octanoic acid. From the results obtained, it
      is concluded that capillary affinity zone electrophoresis using albumin as a
      chiral selector may allow screening of OFLX-displacer interactions.

PMID- 7795390
TI  - Dye-ligand affinity chromatography on continuous beds.
AB  - Continuous beds derivatized with three triazine dyes (Cibacron Blue 3G-A, Pricon
      Red HE-3B and Pricon Red H-3B) were used for chromatographic purification of
      dehydrogenases from yeast enzyme concentrate. All three columns, which were
      prepared by a very simple and cost-effective method, provided strong binding of
      glucose-6-phosphate dehydrogenase and lactate dehydrogenase. The Cibacron Blue 3G
      A column showed high affinity for alcohol dehydrogenase. Under the same
      conditions, the Pricon Red HE-3B column showed a lower affinity and the Pricon
      Red H-3B column showed none. The adsorbed dehydrogenases were eluted specifically
      from the columns in high yields (71-113% by desorption with the coenzymes NADP,
      NADH and NAD respectively). Non-specific binding of human serum albumin and
      transferrin to these columns was also investigated. Enzyme assays and analyses by
      capillary electrophoresis showed that the continuous beds derivatized with
      triazine dyes gave a high degree of purification.

PMID- 7795391
TI  - Determination of glutathione and related aminothiols by gas chromatography with
      flame photometric detection.
AB  - A selective and sensitive method for the determination of glutathione (GSH) and
      related aminothiols such as cysteine (Cys), cysteinylglycine (CysGly) and gamma
      glutamylcysteine (gamma-GluCys) by gas chromatography (GC) has been developed.
      GSH and related aminothiols were converted into their N,S-isopropoxycarbonyl
      methyl ester derivatives and measured by GC with flame photometric detection
      using a short capillary column (5 m x 0.53 mm i.d.) of cross-linked DB-1. The
      calibration curves were linear in the range 1-25 nmol for GSH and in the range
      0.2-5 nmol for other aminothiols, and the detection limits of GSH, Cys, CysGly
      and gamma-GluCys were approximately 5, 0.2, 0.3 and 0.5 pmol per injection
      respectively. This method was successfully applied to blood samples without prior
      clean-up, and GSH and related aminothiols in these samples could be analysed
      without any influence from coexisting substances. Overall recoveries of GSH and
      other aminothiols added to blood samples were 88-107%. The analytical results of
      free and total blood GSH and related aminothiols in normal subjects are
      presented.

PMID- 7795392
TI  - High-performance liquid chromatographic separation of penicillamine enantiomers
      labelled with N-[4-(6-dimethylamino-2-benzofuranyl)phenyl] maleimide on a chiral
      stationary phase.
AB  - Penicillamine enantiomers derivatized with N-[4-(6-dimethylamino-2
      benzofuranyl)phenyl]maleimide (DBPM) were separated and determined by high
      performance liquid chromatography. A fluorogenic reagent, DBPM easily reacted
      with D- or L-penicillamine to give each two kinds of strong fluorescent
      derivatives (D1-, D2-, L1- and L2-DBPM), which could be separated on a Pirkle
      type chiral stationary phase using an eluent of 75% aqueous methanol solution
      containing 0.15 M CH3COONH4 and 0.05 M tetra-n-butylammonium bromide. Two of the
      peaks (D1- or L1-DBPM), having a shorter retention time than the others, had
      almost the same retention times (25 min for D1-DBPM and 25.7 min for L1-DBPM).
      The retention times of the peaks eluted later were 28 min and 31.6 min for D2-
      and L2-DBPM respectively. Linear calibration curves over the range of 2-50 pmol
      per injection were obtained for D- and L-penicillamines with a detection limit of
      290 and 350 fmol at respectively at a signal-to-noise ratio of 3. Using the
      proposed method, the absence of contamination of L-penicillamine in a
      commercially available D-penicillamine preparation (capsule) was confirmed.

PMID- 7795393
TI  - A sensitive high-performance liquid chromatographic assay for the cholecystokinin
      B antagonist, CI-988, in human and monkey plasma.
AB  - A sensitive and specific high-performance liquid chromatographic assay for the
      non-peptide cholecystokinin subtype B receptor antagonist, CI-988, in human and
      cynomolgus monkey plasma has been developed and validated. The method involves
      isolation of CI-988 and internal standard by batch robotic solid phase extraction
      with a C18 cartridge, liquid chromatographic separation on a C18 column and
      quantitation by fluorescence detection. The human plasma assay is linear from
      0.25 to 500 ng/mL for a 1.00-mL plasma aliquot. Assay precision for CI-988 based
      on human plasma quality control samples was within +/- 7.2% relative standard
      deviation with an accuracy of +/- 5.6% relative error. The monkey plasma assay is
      linear from 1.00 to 250 ng/mL for a 0.500-mL plasma aliquot. Assay precision
      based on monkey plasma quality control samples was within +/- 11.0% relative
      standard deviation with an accuracy of +/- 2.6% relative error.

PMID- 7795394
TI  - Direct separation of tranylcypromine enantiomers and their profile in an atypical
      depressive patient.
AB  - An isocratic and simple high-performance liquid chromatographic method is
      developed for the direct resolution of the tranylcypromine (TCP) enantiomers. The
      method involves the use of an S-18-crown-6-ether chiral stationary phase known as
      the Crownpak CR (+) column. The stereochemical separation factor (alpha) obtained
      was 1.30 and the stereochemical resolution factor (Rs) was 0.69 when using a
      mobile phase consisting of 0.1 N perchloric acid containing 12% methanol at 23
      degrees C. The method has been used to monitor and identify, qualitatively, the
      profile of enantiomers of TCP in urine of an atypical depressive patient. It was
      found that the (-)-S-TCP concentration is significantly higher than the (+)-R
      enantiomer.

PMID- 7795395
TI  - Myopia and stature: findings in a population of 106,926 males.
AB  - We conducted a nation-wide study of the relationship of myopia with height,
      weight and body-mass index in order to confirm observations that myopic persons
      are taller than non-myopes. From a review of the data of 106,926, consecutive
      male military recruits aged 17 to 19 years, we found that myopia is associated
      neither with higher stature nor with greater weight. Persons with severe myopia
      were slightly shorter (172.8 +/- 7.1 cm) and weighed less (62.6 +/- 11.0 kg) than
      those with mild myopia (173.3 +/- 6.9 cm and 63.8 +/- 10.5 kg respectively),
      while the non-myopes were taller (173.7 +/- 6.7 cm) and heavier (63.9 +/- 10.2
      kg) than the myopes (p = 0.0001). The mean body-mass index was only slightly
      smaller among the myopes (21.1 +/- 3.1 kg/m2) than among the non-myopes (21.2 +/-
      2.9 kg/m2, p = 0.0001).

PMID- 7795396
TI  - Fluorophotometric study of lens autofluorescence and the blood-retinal barrier in
      56 diabetic patients.
AB  - We examined lens autofluorescence and the permeability of the blood-retinal
      barrier in 56 diabetic patients (34 insulin-dependent and 22 non-insulin
      dependent), using the Fluorotron Master (R), a commercially available
      fluorophotometer. Significant relationships were found between age and lens
      autofluorescence (p < 0.01), between duration of diabetes and lens
      autofluorescence in insulin-dependent diabetics (p < 0.01), and between duration
      of diabetes and blood-retinal barrier permeability in all diabetics (p < 0.05).
      The relationships between lens autofluorescence and duration of diabetes in non
      insulin dependent patients (p > 0.05), and between lens autofluorescence or the
      penetration ratio and HBA Ic during the five preceding years (p > 0.05) were not
      significant. Fluorophotometry provides an objective and reproducible method for
      in vivo investigation of the ocular complications of diabetes and of the factors
      influencing them.

PMID- 7795397
TI  - Effect of oral captopril (SQ 14225) on intraocular pressure in man.
AB  - The effects of the angiotensin converting enzyme (ACE) inhibitor captopril (SQ
      14225) on intraocular pressure (IOP) were studied. Four groups were analyzed:
      group A, ten control subjects; group B, ten hypertensive patients with normal
      IOP; group C, ten normotensive patients with primary open angle glaucoma (POAG);
      and group D, ten hypertensive patients with POAG. Systolic and diastolic blood
      pressure, heart rate, pupil diameter, IOP and total outflow facility were
      recorded at baseline and at 1-h intervals up to 3h after an oral dose of 25 mg
      captopril or placebo, given in a randomized, double-blind cross-over fashion. The
      alternative treatment was given a week later. Captopril significantly lowered IOP
      in all patients, with no effects on heart rate and pupil diameter. Blood pressure
      changed only in patients with hypertension (groups B and D). Total outflow
      facility, measured by conventional tonography, increased significantly in all
      groups. These findings indicate that oral captopril could represent a new
      antiglaucomatous compound.

PMID- 7795398
TI  - Conjunctival fibrosis after application of mitomycin C: an animal experimental
      study.
AB  - Mitomycin C (MMC) is widely used as an antimetabolite to minimize scarring of
      filtering blebs. Its effectiveness has been demonstrated in several clinical
      studies. The drug's mechanism of action is attributed to its antiproliferative
      effect on the subconjunctival cells, reducing the wound healing response. We
      placed sponges soaked with various concentrations of MMC, from 0.05 to 1.0 mg/ml,
      under the conjunctiva of 18 rabbits. Four weeks later, there was marked
      concentration-dependent scarring of the substantia proppria of the conjunctiva.
      Macrophages were more numerous in treated eyes, as determined by
      immunohistochemistry. The reason for MMC-related fibrosis in this animal model is
      not clear but may be related to the substances toxic effects. Whether it is only
      present in rabbits remains to be clarified.

PMID- 7795399
TI  - Contact transscleral cyclophotocoagulation with diode laser in refractory
      glaucoma.
AB  - OBJECTIVE: To evaluate the clinical effectiveness of contact transscleral
      cyclophotocoagulation (CTCP) with diode laser. DESIGN AND PATIENTS: Forty-eight
      seeing eyes and 20 blind and painful eyes of 68 patients suffering from
      refractory glaucoma were treated using a diode laser (EOS3000, Laser Science)
      coupled with a 400-microns optic fiber ending in a 3-mm focusing tip. Sixteen to
      twenty 3.9-J (2.6 W x 1.5 to 2.5 s) laser spots were placed over 360 degrees, 1.5
      mm from the corneolimbal junction. RESULTS: In the seeing-eye group, the follow
      up was 20.7 +/- 8.14 months, pre- and posttreatment IOPs were 37.1 +/- 11.27 and
      19.5 +/- 8.73 mmHg respectively (p < 0.0001), and success (IOP > 2 and < or = 21
      mmHg) was 70.8%. No significant visual acuity change was found in the successful
      eyes, whereas a significant visual acuity reduction was found in the unsuccessful
      cases (p = 0.03). In the blind-eye group, the follow-up was 20.5 +/- 8.54 months,
      pre- and post-treatment IOPs were 50.7 +/- 15.05 and 20.6 +/- 13.99 mmHg
      respectively (p < 0.0001), and success (remission of pain) was 100%. As for
      complications, one seeing eye developed a spontaneously-resolved vitreous
      hemorrhage and one seeing and one blind eye became hypotonic, though no phthysis
      was observed. No conjunctival or lens damage was detected, and no scleral
      thinning was revealed by ultrasound biomicroscopy. No case of sympathetic
      ophthalmia was found. CONCLUSIONS: Diode laser can be successfully employed for
      CTCP in refractory glaucoma.

PMID- 7795400
TI  - Factors predisposing to postoperative intraocular inflammation.
AB  - This prospective study of 123 patients undergoing cataract extraction determined
      the preoperative and surgical factors predisposing to an exaggerated
      postoperative inflammatory response. It is important to identify the patients at
      increased risk of complications requiring additional prophylaxis or more
      intensive postoperative care, particularly when selecting patients for day case
      surgery. Previous intraocular inflammation or surgery was the factor most
      strongly associated with marked inflammation on the first postoperative day (p <
      0.01, compared to uncomplicated patients). As a result, patients stayed in
      hospital an average of one day longer (p < 0.001) and required significantly more
      steroid drops (p < 0.001). Other factors of significance, but reducing importance
      were: difficult surgery, non-caucasian race and brown irides. Amongst
      uncomplicated patients, the difficulty of surgery was most significantly related
      to a high inflammation score (p < 0.01). Non-caucasian patients stayed in
      hospital significantly longer than their caucasian counterparts (p < 0.05), and
      required more steroid drops (p < 0.001). Of caucasian patients, those with brown
      irides were inpatients for significantly longer than those with blue or hazel (p
      < 0.05). No other factors studied significantly altered postoperative
      inflammation: neither the presence of diabetes, nor the technique of cataract
      extraction.

PMID- 7795401
TI  - Surgical removal of subretinal neovascular membranes.
AB  - Since 1991 we have been gaining experience in the surgical removal of submacular
      subretinal membranes in patients with presumed ocular histoplasmosis syndrome
      (POHS), idiopathic subretinal neovascularisation, myopia and age-related macular
      degeneration (AMD). Seventeen patients were operated between 1991 and 1993.
      Significant improvement of vision was achieved in 4 out of 5 patients with POHS,
      3 out of 5 with idiopathic neovascularisation, 2 out of 4 with myopia but none of
      3 patients with AMD. The results suggest that subretinal neovascularisation can
      be successfully removed in POHS and in some forms of idiopathic
      neovascularisation and myopia but probably not in AMD.

PMID- 7795402
TI  - Pathogenesis of primary internal ophthalmoplegia after head injury.
AB  - Primary internal ophthalmoplegia is a rare ocular syndrome after head injury. Its
      pathogenesis remains unclear and it is only a hypothesis that the pupillomotor
      fibres on the ventromedial aspect of the oculomotor nerve are slightly contused
      against the petroclinoid ligament at the moment of impact. We observed a patient
      after head injury who presented with a fixed, dilated pupil and died within 15
      hours of the accident. The postmortem examination revealed an isolated group of
      fibres on the medial aspect of her oculomotor nerve, which had been torn out of
      the midbrain. This suggests an alternative explanation in terms of partial injury
      to the oculomotor nerve to account for primary internal ophthalmoplegia.

PMID- 7795403
TI  - Relapsing bilateral uveitis and papilledema in sinus histiocytosis with massive
      lymphadenopathy (Rosai-Dorfman disease).
AB  - Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) is a non
      hereditary histiocytic proliferative disorder affecting young people, with
      extranodal manifestations in 28-43% of cases. Eye involvement is infrequent.
      Lymphoproliferation in the soft tissues of the orbit and in the lids has been
      reported in 12% of cases but intraocular involvement is rare. We describe the
      case of a 12-year-old boy affected by Rosai-Dorfman disease with bilateral
      relapsing uveitis and papilledema that appeared four years before the onset of
      lymphadenopathy.

PMID- 7795404
TI  - The use of continuous pupillary dilatation of a blind born child in the early 8
      months, to achieve partial recovery of vision.

PMID- 7795405
TI  - The role of serum calcium in the development of the acute red eye in chronic
      renal failure.
AB  - In patients with chronic renal failure treated by long-term dialysis,
      inflammatory reactions occasionally develop in the bulbar conjunctiva; the
      episcleral tissue is only rarely involved. Diffuse congestion of both the
      conjunctiva and episclera was present in 5.3% of our patients and was associated
      with a sudden, marked rise in serum calcium. Histopathological examination
      suggests that this form of hyperemia, clinically preceded by a marked shedding of
      calcific precipitates, is the result of a neurogenic-driven inflammatory reaction
      in which mast cell degranulation is mediated by the axon reflex. Focal hyperemia
      associated with elastosis ("pingueculitis") was present in 6.7% of the patients.
      This type of hyperemia was observed after an extended period of increasing levels
      of BUN and seemed independent of both serum calcium and phosphorus. Diffuse
      hyperemia of the conjunctiva, being clinically distinctly different from the
      combined diffuse conjunctival and episcleral hyperemia, was also observed in
      6.7%. Diffuse conjunctival hyperemia seemed to be associated with low BUN. Here,
      again, there was no association with serum calcium and phosphorus levels.

PMID- 7795406
TI  - 3rd International Workshop on Carcinoma-Associated Mucins, August 7-11 1994,
      Cambridge, UK.

PMID- 7795407
TI  - Molecular Cell Biology of Cytokines and Matrix, September 21-23 1994, Cardiff,
      UK.

PMID- 7795408
TI  - Importance of lectins for the prevention of bacterial infections and cancer
      metastases.
AB  - Adhesion of bacteria and of metastasizing tumour cells have much in common,
      especially the participation of lectins in this process. In the future it might
      be possible to inhibit the metastatic process and bacterial adhesion by blocking
      with lectins specific for appropriate (oligo) saccharides or glycoconjugates.
      Initial clinical trials are very promising.

PMID- 7795410
TI  - Lectins and also bacteria modify the glycosylation of gut surface receptors in
      the rat.
AB  - Oral exposure to lectins or the presence or absence of bacteria in the rat small
      intestine were shown by histological methods using anti-lectin antibodies or
      digoxigenin-labelled lectins to have major effects on the state of glycosylation
      of lumenal membranes and cytoplasmic glycoconjugates of epithelial cells. Taken
      together with the dramatic effects of exposure to lectins on gut function,
      metabolism and bacterial ecology, this can be used as a basis for new
      perspectives of biomedical manipulations to improve health.

PMID- 7795409
TI  - Isolation of a melibiose-binding protein from human spleen.
AB  - A melibiose-binding protein was isolated from human spleen by serial affinity
      chromatography on lactose-, mannose-, and melibiose-Sepharose. The purified
      protein agglutinated rabbit erythrocytes and re-bound to melibiose, but did not
      bind to murine nor human laminin. The protein was composed of approximately 58
      kDa and 26 kDa polypeptides. The polypeptides were detected in buffy coat cell
      extracts and they were synthesized in vitro by B lymphoblastoid cells. The
      polypeptides did not react with anti-galaptin, anti-C-reactive protein, anti
      amyloid P, anti-keratin, and anti-rat lung lectin 29 sera. The 58 kDa polypeptide
      reacted very weakly with anti-core-specific lectin serum and reacted with anti
      IgG serum. The data suggest that the major protein isolated is an anti-Ga1 alpha
      1-->6 immunoglobulin.

PMID- 7795412
TI  - Water-soluble poly(acrylamide-allylamine) derivatives of saccharides for protein
      saccharide binding studies.
AB  - Water-soluble poly(acrylamide-allylamine) copolymers containing covalently bound
      amino groups, prepared by copolymerization of acrylamide and allylamine, can be
      used as general carriers for coupling of different types of saccharides or
      saccharide derivatives. The water-soluble macromolecular carbohydrate derivatives
      can be easily labelled and used in various solid-phase techniques to study
      protein-saccharide interaction. Two types of coupling reaction were used to
      prepare polyacrylamide derivatives of saccharides: reductive amination was
      applied to couple the reducing disaccharides and a carbodiimide reaction was used
      to couple heparin via its carboxyl groups to the amino groups of the
      poly(acrylamide-allylamine) derivative. Peroxidase labelled or biotinylated
      derivatives were shown to be useful in studies on the binding properties of
      lectins and proteins from boar seminal plasma.

PMID- 7795413
TI  - Use of sialylated or sulfated derivatives and acrylamide copolymers of Gal beta
      1,3GalNAc alpha- and GalNAc alpha- to determine the specificities of blood group
      T- and Tn-specific lectins and the copolymers to measure anti-T and anti-Tn
      antibody levels in cancer patients.
AB  - Sialylated or sulfated derivatives and acrylamide copolymers of blood group T
      (Gal beta 1,3GalNAc alpha-) and Tn-(GalNAc alpha) haptens were studied for their
      interaction with the lectins of peanut (PNA), Agaricus bisporus-(ABA), Helix
      pomatia-(HPA) and Vicia villosa B4-(VVA), using asialo Cowper's gland mucin
      (ACGM), which contains both T and Tn epitopes, as the coating substrate in enzyme
      linked lectin assay. Both T and Tn copolymers (-40 haptens) showed high affinity
      and strict specificity; although the T-copolymer at 0.05-0.07 microM
      concentration caused 50% inhibition of interaction of either PNA or ABA with
      ACGM, there was little inhibition of the HPA and VVA interactions even at over
      100 times that concentration. The Tn-copolymer at 0.02-0.05 microM inhibited HPA
      or VVA interaction with ACGM by 50% but gave virtually no inhibition of PNA and
      ABA binding. Sialyl, sulfate or methyl group substitution on C-6 of GalNAc of the
      T-haptene did not prevent interaction with PNA but almost abolished interaction
      with ABA. In contrast, sialyl or sulfate group on C-6 and sulfate on C-3 of Gal
      in Gal beta 1,3GalNAc alpha- inhibited almost completely the interaction of PNA
      with ACGM but had only a slight effect on the interaction of ABA; C-6
      substitution with either sialic acid or sulfate on GalNAc alpha- almost abolished
      the interaction of both HPA and VVA with ACGM.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7795414
TI  - Synthesis of an endogeneous lectin, galectin-1, by human endothelial cells is up
      regulated by endothelial cell activation.
AB  - The pattern of expression of an endogenous lectin, galectin-1, was examined in
      human lymphoid tissue. Galectin-1 was detected in the endothelial cells lining
      specialized vessels, termed high endothelial venules, in activated lymphoid
      tissue, but not in a resting lymph node. Cultured endothelial cells (human aortic
      and umbilical vein endothelial cells (HAECs and HUVECs)) expressed galectin-1.
      Activation of the cultured endothelial cells increased the level of galectin-1
      expression, as determined by ELISA. Northern blot analysis and high throughput
      cDNA sequencing. These results suggest that galectin-1 expressed by endothelial
      cells may bind to and affect the trafficking of cells emigrating from blood into
      tissues.

PMID- 7795411
TI  - alpha 1,3-Fucosylation of branched blood group I-type oligo-(N
      acetyllactosamino)glycans by human milk transferases is restricted to distal N
      acetyllactosamine units: the resulting isomers are separated by WGA-agarose
      chromatography.
AB  - A partially purified preparation of alpha 1,3-fucosyltransferase(s) from human
      milk was used to [14C]fucosylate oligosaccharides containing Gal beta 1-4GlcNAc
      units. Substitution of N-acetyllactosamine at position 3' with a beta-linked N
      acetyl-glucosamine enhanced the reactivity of the acceptor, whereas similar
      substitution at position 6' was inhibitory. Thus, the trisaccharide GlcNAc beta 1
      6Gal beta 1-4GlcNAc (5), the branched tetrasaccharide GlcNAc beta 1-3(GlcNAc beta
      1-6)Gal beta 1-4GlcNAc (11) and the triply branched decasaccharide GlcNAc beta 1
      3(GlcNAc beta 1-6)Gal beta 1-4GlcNAc beta 1-3[GlcNAc beta 1-3(GlcNAc beta 1-6)Gal
      beta 1-4GlcNAc beta 1-6]Gal beta 1-4GlcNAc (26) gave remarkably poor yields of
      alpha 1,3-fucosylated products in comparison to GlcNAc beta 1-3Gal beta 1-4GlcNAc
      (3). beta 1,4-Galactosyl derivatives of 5 and 11, however, gave good yields of
      alpha 1,3-fucosylated products, but the fucosylation was restricted to the distal
      N-acetyllactosamine units of Gal beta 1-4GlcNAc beta 1-6Gal beta 1-4GlcNAc (16),
      Gal beta 1-4GlcNAc beta 1-3(Gal beta 1-4GlcNAc beta 1-6)Gal beta 1-4GlcNAc (18)
      and also in Gal alpha 1-3Gal beta 1-4GlcNAc beta 1-3(Gal alpha 1-3Gal beta 1
      4GlcNAc beta 1-6)Gal beta 1-4GlcNAc (22). Immobilized wheat germ agglutinin
      (WGA), possessing high affinity for 16 [1], revealed no affinity for the
      fucosylated derivative Gal beta 1-4(Fuc alpha 1-3)GlcNAc beta 1-6Gal beta 1
      4GlcNAc (17). The isomeric heptasaccharides Gal beta 1-4(Fuc alpha 1-3)GlcNAc
      beta 1-3(Gal beta 1-4GlcNAc beta 1-6)Gal beta 1-4GlcNAc (19) and Gal beta 1
      4GlcNAc beta 1-3[Gal beta 1-4(Fuc alpha 1-3)GlcNAc beta 1-6]Gal beta 1-4GlcNAc
      (20) were readily separated from each other on WGA agarose, and so were the
      isomeric nonasaccharides Gal alpha 1-3Gal beta 1-4(Fuc alpha 1-3)GlcNAc beta 1
      3(Gal alpha 1-3Gal beta 1-4GlcNAc beta 1-6)Gal beta 1-4GlcNAc (23) and Gal alpha
      1-3Gal beta 1-4GlcNAc beta 1-3[Gal alpha 1-3Gal beta 1-4(Fuc alpha 1-3)GlcNAc
      beta 1-6]Gal beta 1-4GlcNAc (24).

PMID- 7795415
TI  - Strategy for the investigation of O-linked oligosaccharides from mucins based on
      the separation into neutral, sialic acid- and sulfate-containing species.
AB  - A method for the separation of O-linked oligosaccharides into neutral, sialic
      acid-containing and sulfated species was applied to oligosaccharides released by
      alkaline borohydride from mucin glycopeptides from porcine small intestine. The
      released mixture of reduced oligosaccharides was applied to an anion exchange
      column, and the neutral oligosaccharides were collected as the unretarded
      fraction. A mixture of dimethyl sulfoxide and iodomethane was passed through the
      column to convert the sialic acid-containing oligosaccharides into methyl esters
      that were eluted and converted to methyl amides by methyl amine. Finally the
      sulfated oligosaccharide fraction was eluted with salt. The neutral and the
      derivatized sialic acid-containing oligosaccharides were analysed by gas
      chromatography-mass spectrometry after permethylation and the sulfated
      oligosaccharide fraction was analysed by high performance anion exchange
      chromatography.

PMID- 7795417
TI  - The asparagine-linked carbohydrate of honeybee venom hyaluronidase.
AB  - Hyaluronidase from the venom of the honeybee (Apis mellifera) has been purified
      by gelpermeation and cation exchange chromatography. Its asparagine-linked
      carbohydrate chains were released from tryptic glycopeptides with N-glycosidase A
      and reductively aminated with 2-aminopyridine. Separation of the fluorescent
      derivatives by size-fractionation and reversed-phase HPLC afforded eighteen
      fractions which were analysed by two-dimensional HPLC mapping combined with
      exoglycosidase digestions. The bulk of the N-linked glycans of hyaluronidase
      consisted of small oligosaccharides (Man1-3GlcNAc2), most of which were either
      alpha 1,3-monofucosylated or alpha 1,3-(alpha 1,6-)difucosylated at the innermost
      GlcNAc residue. High-mannose type structures constituted the minor fractions,
      together making up about 5% of the oligosaccharide pool from hyaluronidase. Four
      fractions, making up 8% of the N-linked glycans, contained the terminal
      trisaccharide GalNAc beta 1-4[Fuc alpha 1-3]GlcNAc beta 1- in beta 1,2-linkage to
      the core alpha 1,3-mannosyl residue. No evidence for the presence of O-glycans or
      sialic acids could be found.

PMID- 7795416
TI  - alpha 1-Acid glycoprotein binds human immunodeficiency virus type 1 (HIV-1)
      envelope glycoprotein via N-linked glycans.
AB  - In the present study, we demonstrate a specific low-affinity interaction between
      recombinant precursor gp160 (rgp160) or surface unit gp120 (rgp120) of human
      immunodeficiency virus type 1 (HIV-1) and alpha 1-acid glycoprotein (AGP), a
      human glycoprotein displaying complex type N-glycans. Binding of rgp160/rgp120 to
      agarose-coupled AGP was dose-dependent, saturable, calcium-, pH- and temperature
      dependent. Binding was inhibited by soluble AGP, asialo-AGP, fetuin, beta-D
      GlcNAc47-BSA, alpha-D-Man20-BSA, mannan, complex-type asialo-agalacto
      tetraanternary precursor oligosaccharide from human AGP and oligomannose 9 from
      porcine thyroglobulin; fully deglycosylated AGP was not inhibitory. The three AGP
      glycoforms separated on immobilized ConA bound rgp160 to the same extent as did
      unfractionated AGP. These findings extend our previous results on the
      carbohydrate-binding properties of HIV-1 envelope (Env) glycoprotein in that they
      demonstrate the involvement of AGP glycan moieties in the binding to
      rgp160/rgp120. Preincubation of rgp160 with AGP or mannan significantly reduced
      its binding to monocyte-derived macrophages (MDM), suggesting that AGP may play a
      role in preventing binding of soluble or virus-bound Env glycoprotein to CD4+
      monocytic cells.

PMID- 7795418
TI  - Characterization of the peptide-N4-(N-acetylglucosaminyl) asparagine amidase
      (PNGase Se) from Silene alba cells.
AB  - The peptide-N4-(N-acetylglucosaminyl) asparagine amidase (PNGase Se) earlier
      described [Lhernould S., Karamanos Y., Bourgerie S., Strecker G., Julien R.,
      Morvan H. (1992) Glycoconjugate J 9:191-97] was partially purified from cultured
      Silene alba cells using affinity chromatography. The enzyme is active between pH
      3.0 and 6.5, and is stable in the presence of moderate concentrations of several
      other protein unfolding chemicals, but is readily inactivated by SDS. Although
      the enzyme cleaves the carbohydrate from a variety of animal and plant
      glycopeptides, it does not hydrolyse the carbohydrate from most of the
      corresponding unfolded glycoproteins in otherwise comparable conditions. The
      substrate specificity of this plant PNGase supports the hypothesis that this
      enzyme could be at the origin of the production of 'unconjugated N-glycans' in a
      suspension medium of cultured Silene alba cells.

PMID- 7795419
TI  - Glycan structure of the S-layer glycoprotein of Bacillus sp. L420-91.
AB  - Preliminary taxonomic characterization of isolate L420-91 has revealed that this
      organism is closely related to the species Bacillus aneurinolyticus. The
      bacterium is covered by a squarely arranged crystalline surface layer composed of
      identical glycoprotein subunits with an apparent molecular mass in the range of
      109 kDa. A total carbohydrate content of approximately 3.5% (wt/wt) was
      determined in the purified surface layer glycoprotein. Glycopeptides were
      obtained after exhaustive Pronase digestion and purification including gel
      filtration, ion exchange chromatography and HPLC. From the combined evidence of
      composition analysis. Smith degradation and nuclear magnetic resonance
      spectroscopy experiments we propose the following structure for the glycan chain
      of the surface layer glycoprotein: [formula: see text]

PMID- 7795420
TI  - The regulation of megakaryocytopoiesis.
AB  - The process of megakaryocytopoiesis begins with the commitment of a pluripotent
      hematopoietic stem cell to a differentiation pathway that culminates in the
      release of mature platelets into the circulation. A variety of megakaryocyte
      precursor cells have been identified after stem cell commitment has occurred and
      these may be recognized by their morphologic or immunophenotypic characteristics.
      Megakaryocytopoiesis is regulated by a number of cytokines with either
      stimulatory or inhibitory effects and by a variety of cell-cell interactions.
      Some factors potentiating platelet development promote the proliferation of
      megakaryocyte progenitor cells, while others result in their maturation.
      Thrombopoietin, a cytokine with specific megakaryocyte maturational activity
      recently has been identified as the c-Mpl ligand, and it will be evaluated as a
      therapeutic agent in the setting of thrombocytopenia due to impaired
      megakaryocytopoiesis.

PMID- 7795421
TI  - Maintaining quality in blood banking.
AB  - Regulation of transfusion or blood banking facilities has followed, rather than
      preceded the regulation of the pharmaceutical industry and today we find, in
      Europe and the United States, the basic regulations developed for the
      pharmaceutical industry being extended to blood transfusion centres (BTC)*. In
      this article we explore the role of voluntary accreditation or registration to
      quality systems standards such as ISO 9000 and discuss how these can be used to
      advantage and how these standards can provide a substantial base for meeting
      legislative requirements. In the UK there is also a voluntary accreditation
      procedure available for all clinical laboratories, known as Clinical Pathology
      Accreditation (CPA). Comparisons between ISO 9000, CPA and other standards are
      made. We also discuss how voluntary registration, particularly to ISO 9000 can
      provide an excellent basis for moving into more extensive and progressive Total
      Quality Management (TQM) programmes which in turn bring a variety of benefits,
      not least of which is increased staff involvement in your organisation.
      Experience of the route to quality through voluntary accreditation suggests that
      external assessment delivers new insights into the organisation that cannot
      easily be supplanted by internal audit. In Europe legislation relating to
      pharmaceuticals has steadily increased in scope and in detailed requirements from
      those set out in the 1965 Directive 65/65/EEC. The legislative framework has
      steadily increased, bringing plasma and plasma products as well as others such as
      radiopharmaceuticals, into the product licensing requirements. The progression of
      legislation seems unlikely to cease and it is debatable how long the Medicines
      Control Agency (MCA) and its Inspectorate will accept that BTCs can operate at a
      level which is different from that of the majority of pharmaceutical
      manufacturers. The change in emphasis in legislation particularly in Europe means
      that harm that is caused to a patient by a blood component will warrant redress.
      The degree of fault attributed to the producer will in part depend on whether
      they have met the best available standards at all stages in the preparation of
      the product. If a Transfusion Service can show that it's operation has external
      accreditation, particularly to an internationally recognised standard such as ISO
      9000 and they can show that staff have been properly trained, that equipment is
      properly supplied and maintained and that the facility is appropriate to the work
      being carried out, then the liability that exists when something goes wrong will
      be reduced.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7795422
TI  - Thalassemia major 1995: older patients, new therapies.
AB  - There have been many advances in supportive treatment used for beta-thalassemia
      major. Survival has increased substantially, and an increasing number of patients
      reach adolescence and adulthood. These older patients present new clinical
      challenges. Complications of transfusion, most commonly hepatitis C, are still a
      cause of mortality and morbidity. The achievement of optimal growth and
      development, including fertility, is an important goal of conservative
      management. Long-term survival has also been achieved with bone marrow
      transplantation. Assessment of growth, development and iron balance in the years
      after transplantation reveals residual problems requiring treatment despite cure
      of thalassemia. New therapies of beta-thalassemia are still being developed, both
      supportive and curative in nature. Supportive care improvements include oral
      chelation and methods to increase HbF production. Advances in curative modalities
      include use of new sources of stem cells, such as cord blood and fetal liver. In
      the future, gene therapy may allow for cure of the older patient without the
      mortality and morbidity of allogenic transplantation. Treatment of thalassemia
      major requires consideration of the available therapeutic options for each
      patient, and the risk/benefit ratio of a supportive versus curative approach.

PMID- 7795424
TI  - Leucodepletion of blood products by filtration.
AB  - The leucocytes present in red cell and platelet components have been implicated
      in several important immunological and infective complications of blood
      transfusion. Recent developments in blood filtration technology allow the
      production of leucodepleted blood products (residual leucocytes < 5 x 10(6) per
      transfused unit) in the laboratory or at the bedside with the potential to
      prevent these adverse effects. Quality assurance remains an important problem,
      particularly for bedside filtration. Prestorage filtration may have significant
      advantages for red cell and platelet production. There is strong clinical
      evidence that 3 log10 leucodepletion prevents or delays febrile reactions in
      patients receiving multiple red cell transfusions and can reduce cytomegalovirus
      transmission. Leucodepletion to prevent HLA alloimmunisation, platelet
      refractoriness and febrile reactions in patients receiving red cell and platelet
      support remains controversial. Transfused leucocytes induce 'immunosuppressive'
      changes in the recipient, but recent studies cast doubt on the association with
      cancer recurrence after surgery. However, leucodepleted blood may reduce the
      incidence of postoperative infection. Leucodepletion by filtration is expensive
      and there is a requirement for well-designed prospective clinical studies
      focusing on appropriate filtration technology (and alternatives), clinical
      outcome and cost-effectiveness.

PMID- 7795423
TI  - Iron: mammalian defense systems, mechanisms of disease, and chelation therapy
      approaches.
AB  - During the past 6 decades, much attention has been devoted to understanding the
      uses, metabolism and hazards of iron in living systems. A great variety of heme
      and non-heme iron-containing enzymes have been characterized in nearly all forms
      of life. The existence of both ferrous and ferric ions in low- and high-spin
      configuration, as well as the ability of the metal to function over a wide range
      of redox potentials, contributes to its unique versatility. Not surprisingly, the
      singular attributes of iron that permit it to be so useful to life likewise
      render the metal dangerous to manipulate and to sequester. All vertebrate animals
      are prone to tissue damage from exposure to excess iron. In order to protect them
      from this threat, a complex system has evolved to contain and detoxify this
      metal. This is known as the iron withholding defense system, which mainly serves
      to scavenge toxic quantities of iron and also for depriving microbial and
      neoplastic invaders of iron essential for their growth. Since 1970, medical
      scientists have become increasingly aware of the problems involved in cellular
      iron homeostasis and of the disease states related to its malfunctioning. Scores
      of studies have reported that excessive iron in specific tissue sites is
      associated with development of infection, neoplasia, cardiomyopathy, arthropathy
      and a variety of endocrine and neurologic deficits. Accordingly, several research
      groups have attempted to develop chemical agents that might prevent and even
      eliminate deposits of excess iron. A few of these drugs now are in clinical use,
      e.g. deferiprone (L1). In the present review, we focus on recent developments in
      (i) selected aspects of the iron withholding defense system, and (ii)
      pharmacologic methods that can assist the iron-burdened patient.

PMID- 7795425
TI  - Spiritual emergency treatment of the newborn.

PMID- 7795426
TI  - Helping women with postpartum depression: midwives' expanding role.

PMID- 7795427
TI  - The health care system was in serious need of reform.

PMID- 7795428
TI  - Helping new mothers.

PMID- 7795429
TI  - Unplanned pregnancy.

PMID- 7795430
TI  - What is the best treatment for treating thrush?

PMID- 7795431
TI  - Birth story.

PMID- 7795433
TI  - Midwifery in Jamaica.

PMID- 7795434
TI  - Interview with Lea Rizack, CNM. Interview by Ina May Gaskin.

PMID- 7795432
TI  - Breastfeeding education needed.

PMID- 7795435
TI  - Treating hyperkinetic disorders in childhood.

PMID- 7795436
TI  - Do we need an Ofhealth?

PMID- 7795438
TI  - Integrating pharmacy fully into the primary care team.

PMID- 7795439
TI  - Chemoprophylaxis in tuberculosis and HIV infection.

PMID- 7795437
TI  - Hepatitis C and haemophilia.

PMID- 7795440
TI  - Colleges call for safe drink limits to stay.

PMID- 7795441
TI  - Pensioners win test case over care cuts.

PMID- 7795442
TI  - Dutch report advises prescribing heroin for misusers.

PMID- 7795443
TI  - Medical records need better management.

PMID- 7795444
TI  - Spanish abortion reform faces opposition.

PMID- 7795445
TI  - South African GPs consider health insurance.

PMID- 7795446
TI  - Hardliners and liberals unite on drugs policy.

PMID- 7795447
TI  - Reasons for non-uptake of measles, mumps, and rubella catch up immunisation in a
      measles epidemic and side effects of the vaccine.
AB  - OBJECTIVE: To investigate the reasons for poor uptake of immunisation (non
      immunisation) and the possible side effects of measles, mumps, and rubella
      vaccine in a catch up immunisation campaign during a community outbreak of
      measles. DESIGN: Descriptive study of reasons for non-immunisation and
      retrospective cohort study of side effects of the vaccine. SETTING: Secondary
      schools in South Glamorgan. SUBJECTS: Random cluster sample of the parents of 500
      children targeted but not immunised and a randomised sample of 2866 of the
      children targeted. MAIN OUTCOME MEASURES: Reasons for non-immunisation; symptoms
      among immunised and non-immunised children. RESULTS: Immunisation coverage of the
      campaign was only 43.4% (7633/17,595). The practical problems experienced
      included non-return of consent forms (6698/17,595), refusal of immunisation
      (2061/10,897 forms returned), and absence from school on day of immunisation
      (1203/8836 children with consent for immunisation). The most common reasons cited
      for non-immunisation were previous measles infection (145/232), previous
      immunisation against measles (78/232), and concern about side effects (55/232).
      Symptoms were equally common among immunised and non-immunised subjects. However,
      significantly more immunised boys than non-immunised boys reported fever
      (relative risk 2.31 (95% confidence interval 1.36 to 3.93)), rash (2.00 (1.10 to
      3.64), joint symptoms (1.58; 1.05 to 2.38), and headache (1.31 (1.04 to 1.65)).
      CONCLUSIONS: Many of the objections raised by parents could be overcome by
      emphasising that primary immunisation does not necessarily confer immunity and
      that diagnosis of measles is unreliable. Measles, mumps, and rubella vaccine is
      safe in children aged 11-15.

PMID- 7795450
TI  - ABO and Rh blood groups in patients with cholelithiasis and carcinoma of the gall
      bladder.

PMID- 7795448
TI  - Serum cholesterol concentrations in parasuicide.
AB  - OBJECTIVE: To evaluate whether people who have committed parasuicide have low
      serum cholesterol concentrations. DESIGN: Results of blood tests in subjects
      admitted to hospital for parasuicide compared with those of a control group of
      non-suicidal subjects; comparison in subgroup of parasuicide subjects of two sets
      of blood test results (one set from admission for parasuicide and the other from
      admission for some other illness). SETTING: General hospital, Ferrara, Italy.
      SUBJECTS: 331 parasuicide subjects aged 44 (SD 21) years (109 with two sets of
      blood test results) and 331 controls. MAIN OUTCOME MEASURES: Serum cholesterol
      concentrations and possible association with parasuicide, considering sex,
      violence of method of parasuicide, and underlying psychiatric disorder. RESULTS:
      Lower serum cholesterol concentrations (4.96 (SD 1.16) mmol/l) were found in the
      parasuicide subjects than in the controls (5.43 (1.30); P < 0.001), regardless of
      sex and degree of violence of parasuicide method. Both men and women with two
      sets of blood test results had lower cholesterol concentrations after
      parasuicide. Linear regression analysis showed that the difference in cholesterol
      concentrations was significantly related to the length of time between the taking
      of the two sets of blood samples. CONCLUSION: The study showed low cholesterol
      concentrations after parasuicide. This finding agrees with previous studies,
      which suggest an association between low cholesterol concentration and suicide.

PMID- 7795449
TI  - Strategies for dealing with problems associated with use of services for HIV
      infection and AIDS out of region: views of providers and users.
AB  - OBJECTIVES: To identify reasons why people with HIV infection and AIDS living
      within the former South West Thames Regional Health Authority use HIV and AIDS
      services outside the region, and to identify strategies for dealing with the
      problems associated with such use. DESIGN: Qualitative study consisting of
      interviews with individual subjects and focus groups. SETTING: Providers of
      services for patients with HIV infection and AIDS in South West Thames, central
      London, and Brighton. Users of such services resident in South West Thames.
      SUBJECTS: Thirty four South West Thames residents with HIV infection and AIDS who
      use or used services outside the former region; and 70 providers of services
      within and beyond South West Thames. RESULTS: Principal reasons for use of
      services out of the region were accessibility (15) and negative appraisals of
      local services (14). Three main strategies for dealing with the problems of such
      use were suggested by providers. These entailed introducing users of services
      outside the region to services in their locality (16); sharing the responsibility
      for care between providers in specialist centres and in the person's locality
      (10); and involving the person's general practitioner in their care (12). These
      strategies were deemed acceptable by 29, 30, and 20 service users respectively.
      CONCLUSION: The reasons underlying use of services for patients with HIV
      infection and AIDS outside the region offer suggestions for developing services
      in areas with a high incidence of such use. The suggestions advanced by service
      providers offer an acceptable framework for dealing with the problems.

PMID- 7795451
TI  - GR106642X: a new, non-ozone depleting propellant for inhalers.

PMID- 7795452
TI  - Contraceptive services for teenagers: do we need family planning clinics?
AB  - OBJECTIVE: To determine whether the effectiveness of contraceptive services for
      teenagers is related to the balance of service provision between general
      practitioners and specialist family planning services. DESIGN: Cross sectional
      study with routinely collected data from family planning clinics and family
      health services authorities and published data on births and abortions. SETTING:
      Eight health districts in the former Oxford region. SUBJECTS: Girls aged under 16
      and women aged 16-19 who attended a contraceptive service during 1991-2 or who
      gave birth or had an abortion during 1990-2. MAIN OUTCOME MEASURES: Attenders at
      family planning clinics as a percentage of all users of contraceptive services.
      The conception rate:uptake of contraceptive services ratio was used as a measure
      of effectiveness. RESULTS: In comparisons between districts the percentage of all
      users of contraceptive services who attended a clinic varied from 38% (95%
      confidence interval 28% to 48%) to 79% (72% to 86%) among 13-15 year olds and
      from 14% (12% to 15%) to 44% (42% to 46%) among women aged 16-19 years. The
      conception rate: uptake of contraceptive services ratio varied twofold in the
      older age group and more than threefold in the younger age group. It was lowest
      in districts where clinic attenders comprised a large percentage of all users of
      contraceptive services. CONCLUSION: Contraceptive services for teenagers may be
      more effective in districts where clinics play a large part in delivering the
      service, particularly for girls aged under 16.

PMID- 7795453
TI  - Pregnant teenagers' knowledge and use of emergency contraception.

PMID- 7795454
TI  - Reflex sympathetic dystrophy.

PMID- 7795455
TI  - Lesson of the week. Reflex sympathetic dystrophy in children.

PMID- 7795457
TI  - Is there convergence between Britain and the United States in the organisation of
      health services?. Interview by Penny Newman.
AB  - Is the organisation of health care in Britain becoming similar to that in the
      United States? Since the introduction of the internal market radical change has
      gripped the NHS. In the United States, despite the failure to implement coherent
      health care reform, a health care revolution is under way, driven by cost
      containment. At the centre of these changes is managed competition. Alain
      Enthoven, Marriner S Eccles professor of public and private management at
      Stanford University, has been the principal proponent of managed competition in
      both countries. His writings inspired the NHS reforms in 1989 and President
      Clinton's advisers to adopt managed competition in 1994, though ultimately he
      became opposed to the Clinton plan. In this interview with Penny Newman he
      redefines managed competition, explores the similarities and differences that
      have arisen between Britain and the United States, and describes recent trends in
      the United States, many of which are being mirrored in Britain. He illustrates a
      degree of convergence between the two countries. This was unthinkable 10 years
      ago when comparing the fee for service system in the United States with the NHS.

PMID- 7795456
TI  - ABC of medical computing. An introduction to computing in medical practice.

PMID- 7795458
TI  - Dilemmas in rationing health care services: the case for implicit rationing.
AB  - With tension between the demand for health services and the cost of providing
      them, rationing is increasingly evident in all medical systems. Until recently,
      rationing was primarily through the ability to pay or achieved implicitly by
      doctors working within fixed budgets. Such forms of rationing are commonly
      alleged to be inequitable and inefficient and explicit rationing is advocated as
      more appropriate. Utilisation management in the United States and quasi-markets
      separating purchasing from provision in the United Kingdom are seen as ways of
      using resources more efficiently and are increasingly explicit. There is also
      advocacy to ration explicitly at the point of service. Mechanic reviews the
      implications of these developments and explains why explicit approaches are
      likely to focus conflict and dissatisfaction and be politically unstable.
      Explicit rationing is unlikely to be as equitable as its proponents argue and is
      likely to make dissatisfaction and perceived deprivation more salient. Despite
      its limitations, implicit rationing at the point of service is more sensitive to
      the complexity of medical decisions and the needs and personal and cultural
      preferences of patients. All systems use a mix of rationing devices, but the
      clinical allocation of services should substantially depend on the discretion of
      professionals informed by practice guidelines, outcomes research, and other
      informational aids.

PMID- 7795460
TI  - Remembrance of conversations past: oral advance statements about medical
      treatment.
AB  - Polls show increasing public interest in advance statements or directives about
      medical treatment ("living wills") but that few people, apart from Jehovah's
      Witnesses, carry such documents. Patients' firm, witnessed oral decisions are
      often sufficient to aid clinical decision making but should still be recorded in
      medical notes. Without documentation, dilemmas arise when others claim to know
      patients' views on the basis of past unrecorded conversations and demand
      withdrawal of treatment when patients are not terminally ill and cannot speak for
      themselves. Legal and ethical considerations oblige doctors to act in the best
      interests of an incapacitated patient; these considerations are now formally
      defined in draft legislation as including consideration of the patient's past
      wishes. The practicalities of ascertaining the strength and validity of such
      wishes from conversations reported second hand are complex. The paucity of legal
      and ethical guidance on reported oral advance statements makes debate imperative
      and renders the alternative of having designated surrogate decision makers
      increasingly attractive.

PMID- 7795459
TI  - Financial ties as part of informed consent to postmarketing research. Attitudes
      of American doctors and patients.
AB  - Postmarketing research, often called phase IV trials, is intended to familiarise
      doctors and patients with newly approved drugs. La Puma and colleagues, in
      Chicago, studied doctors' and patients' attitudes to whether doctors should
      receive payment for taking part in such research. We asked for commentaries on
      their findings from four ethical experts, who put the study in a British context,
      present the views of patients, and examine some methodological assumptions.

PMID- 7795461
TI  - Diagnosis and treatment of Parkinson's disease. Anosmia is a common finding.

PMID- 7795462
TI  - Diagnosis and treatment of Parkinson's disease. Anticholinergic drugs are not
      contraindicated after iridotomy.

PMID- 7795463
TI  - Alcoholism and rising mortality in the Russian Federation.

PMID- 7795464
TI  - Improving the detection of glaucoma. Intraocular pressure of greater than 21 mm
      Hg is an indication to refer.

PMID- 7795465
TI  - Lipid lowering dietary advice.

PMID- 7795466
TI  - Magnesium in acute myocardial infarction.

PMID- 7795467
TI  - Mutual trust.

PMID- 7795468
TI  - Practising public health in primary care is easier said than done.

PMID- 7795469
TI  - Professional negligence. Candid disclosure is right.

PMID- 7795470
TI  - Professional negligence. Doctors may make mistakes that are less obvious than
      lawyers' mistakes.

PMID- 7795471
TI  - Ethics and economics of health care. Prognosis, a traditional alternative to
      futility.

PMID- 7795472
TI  - Ethics and economics of health care. British medicine has lessons for North
      American medicine.

PMID- 7795473
TI  - Incidence of diabetes in children.

PMID- 7795474
TI  - Specialists in the United States.

PMID- 7795475
TI  - Coping with psoriasis.

PMID- 7795476
TI  - Malaria prophylaxis.

PMID- 7795477
TI  - Unified training grade. Purchasers cannot put the cart before the horse.

PMID- 7795478
TI  - Vitamin E deficiency.

PMID- 7795479
TI  - Deprivation payments to general practitioners.

PMID- 7795480
TI  - Hospital doctors' work.

PMID- 7795482
TI  - BMJ on the internet. Neuroscience on the internet.

PMID- 7795481
TI  - Unified training grade. Vocational training for GPs should be community based.

PMID- 7795483
TI  - Hormonal effect on the osmotic, electrolyte and nitrogen balance in terrestrial
      Amphibia.
AB  - Two main hormones regulate water balance in amphibian. First, mesotocin (MT)
      acting as a diuretic agent, and second arginine vasotocin (AVT) being an anti
      diuretic hormone. In addition, prolactin (PRL), aldosterone, corticosterone,
      angiotensin II and atriunatriuretic hormones, play a role too in regulating water
      and ion balance. The hormones affect the epidermis and bladder permeability to
      water and ions as well as the kidney through the control of the glomerular
      filtration rate (GFR). The main questions concern the presence and action of
      these hormones during the amphibian's life history. Are they present in both
      larval and adult stages? Are these hormones being synthesized in both aquatic and
      terrestrial adult phases? Under what circumstances are they being stored or
      released? Would the target organs (epidermis, bladder, kidney) respond in a
      similar way during all periods? The problem is the fact that under most
      circumstances an amphibian while in an aquatic environment responds
      physiologically differently than when on land. Only partial information
      concerning hormone presence, release and control of water balance is available at
      the moment, and even that is fragmentary and based on only a very small number of
      amphibian species.

PMID- 7795484
TI  - Quantitative analysis of metamorphosis induced by L-glutamine in embryos of the
      sea urchin, Hemicentrotus pulcherrimus.
AB  - Metamorphosis of the sea urchin, Hemicentrotus pulcherrimus, can be induced by L
      glutamine as reported previously for Pseudocentrotus depressus [15]. To analyze
      more precisely the process of metamorphosis induced by L-glutamine, the
      development of the echinus rudiment (ER) was classified into six stages. The
      stage at which the larvae underwent the normal metamorphosis by glutamine
      treatment was confirmed. The time of the glutamine treatment required for
      metamorphosis (the eversion of ER) was over 10 hr but treatment for more than 25
      hr tended to decrease the number of metamorphosed larvae, although the larval
      arms had mostly been resorbed. The time of glutamine treatment to induce the
      metamorphosis, depended on the development of ER; more time was required for the
      younger larvae and less time for the older. The high mitotic activities observed
      in the cells of the ciliary bands were markedly decreased in the glutamine
      treated larvae to metamorphose. These findings suggested that a degenerative
      process of metamorphosis including cell death is induced by L-glutamine.

PMID- 7795485
TI  - Amphibian amplexus in microgravity.
AB  - We report here on the amplectic behavior of the Japanese treefrog (Hyla japonica)
      in microgravity. Treefrogs were exposed to 35 cycles of altered gravity,
      including approximately 1.5 sec of G < 0.1 every 3 min and 15 sec, on the
      FreeFall "G.0" ride at Space World amusement park in Kitakyushu, Japan. During
      this period a pair of frogs spontaneously entered and maintained amplexus for 1
      hr 20 min, before being removed from the ride. In freefall, the pair extended
      their hindlimbs in the characteristic posture of treefrogs in microgravity. This
      is the first report of a vertebrate entering and sustaining a copulatory or
      amplectic posture under gravitational extremes, including true freefall. These
      observations bode well for the potential of anurans to breed in microgravity and
      to be used for biological research in space.

PMID- 7795486
TI  - Numbers of olfactory receptor cells and fine structure of olfactory nerves in
      various birds.
AB  - The numbers of olfactory receptor cells from electron micrographs in various
      species of birds were counted and the fine structure of their olfactory nerves
      was observed using electron micrographs. The birds were domestic ducks, a slay
      backed gull, quails, budgerigars and bengalees. Data from pigeons obtained from a
      previous study were also included for comparison. The approximate numbers of
      olfactory cells on each side were 5,800,000 in the duck, 2,700,000 in the gull,
      570,000 in the quail, 130,000 in the budgerigar, and 110,000 in the bengalee.
      From a cross section of an olfactory nerve, the nerve was observed to be divided
      roughly into several fascicles by perineurium. Each fascicle was composed of many
      small bundles which were surrounded by endoneurium. Each small bundle was
      separated into several divisions by mesaxon which originated from Schwann cells.
      In the anterior part of the nerve, the number of axons surrounded by mesaxon
      ranged between one and several dozen. The number in the middle part was much
      larger than in the anterior part. In the posterior part the number decreased
      again. The diameter of an axon was 0.21-0.26 microns on average. The axon
      contained neurotubules, neurofilaments, mitochondria and axonal smooth ER. The
      fine structure of the olfactory nerve and the numbers of olfactory cells in these
      birds are discussed and compared with those of other vertebrates.

PMID- 7795487
TI  - Structure, function and biosynthesis of sperm-activating peptides and fucose
      sulfate glycoconjugate in the extracellular coat of sea urchin eggs.
AB  - A decapeptide (GFDLNGGGVG) isolated from the solubilized jelly layer of the sea
      urchin Hemicentrotus pulcherrimus stimulates the respiration and motility of H.
      pulcherrimus spermatozoa and, in addition, produces a number of biological
      effects on H. pulcherrimus spermatozoa including increases in cAMP and cGMP
      levels, activation of a Na+/H+ exchange system, and increases in intracellular pH
      (pHi) and [Ca2+] ([Ca2+]i). The peptide activates the metabolism of endogenous
      phosphatidylcholine and promotes the acrosome reaction as a specific co-factor of
      a major acrosome reaction-inducing substance, fucose sulfate glycoconjugate. The
      peptide also induces an electrophoretic mobility change in the guanylate cyclase
      of the sperm plasma membrane with concomitant dephosphorylation and inactivation
      of the enzyme. Seventy-four peptides producing similar biological effects, named
      sperm-activating peptide (SAP), have since been purified from the solubilized
      jelly layer of seventeen species of sea urchins distributed over five taxonomic
      orders. These peptides show essentially the same biological effects on sea urchin
      spermatozoa although their activity and structures are specific at the ordinal
      level. Equilibrium binding experiments using a radioiodinated SAP-I analogue
      [GGGY(125I)GFDLNGGGVG] to H. pulcherrimus spermatozoa suggests the presence of
      two classes of receptors (high affinity and low affinity) specific for SAP-I
      binding. Based on the Kd values and EC50's for SAP-I's biological activity, we
      presume that the high affinity receptor is associated with respiration
      stimulating activity and elevations in pHi, while the low affinity receptor is
      coupled to elevations in cGMP and [Ca2+]i. The radioiodinated SAP-I analogue
      crosslinks to a 71 kDa protein which contains a single membrane-spanning domain
      at almost near C-terminus. A SAP-I precursor which is synthesized in the
      accessory cells contains five SAP-I and seven SAP-I-like decapeptides, each
      separated by a single lysine residue.

PMID- 7795488
TI  - The mutant gene product of a Tetrahymena cell-division-arrest mutant cdaA is
      localized in the accessory structure of specialized basal body close to the
      division furrow.
AB  - A division arrest mutant, cdaA, of Tetrahymena thermophila is known to have a
      temperature sensitive-defect in the determination of the division plane, and its
      gene product had been shown to be a protein designated as p85 (Mr = 85,000; pI =
      4.7). Here the localization of p85 was shown to be the accessary structure of
      specialized basal body close to the division furrow by immunoelectron microscopy
      using anti-p85 antiserum.

PMID- 7795489
TI  - Intracellular alkalinization enhances inward rectifier K+ current in retinal
      horizontal cells of catfish.
AB  - Isolated cone-driven horizontal cells dissociated from catfish retina were
      voltage-clamped using the whole-cell patch-clamp technique. The effects of
      acidification and alkalinization on an anomalous type, inwardly-rectifying K+
      current (IRK+) were investigated. The magnitude of IRK+ was enhanced by raising
      the intracellular pH above 7.4, however, in contrast, intracellular acidification
      had little effect on this current. The range over which intracellular pH ([pH]i)
      modulates IRK+ is different from that for modulation of a sustained high-voltage
      activated calcium current in these same cells and also for proton-sensitive,
      inward rectifier currents in starfish oocytes, skeletal muscle and heart
      myocytes.

PMID- 7795490
TI  - Up- and down-modulation of a cloned Aplysia K+ channel (AKv1.1a) by the
      activators of protein kinase C.
AB  - Modulation of a cloned Aplysia K+ channel, AKv1.1a, by protein kinase C (PKC)
      activators was examined in Xenopus oocytes expression system. Following the
      application of phorbol esters (phorbol 12-myristate 13-acetate, PMA; phorbol
      12,13-dibutyrate, PDBu), or a diacylgrycerol analogue (1-oleoyl-2-acetyl-sn
      glycerol, OAG), the fast inactivation of the AKv1.1a became slower and the peak
      current increased (up-modulation). However, the effect was transient. The
      expressed current was decreased even below control level about 15 to 20 min after
      the treatment (down-modulation). Both effects by PMA was blocked by the kinase
      inhibitor, H7, suggesting that phosphorylation by PKC is involved. The amino acid
      sequence of AKv1.1a contains three putative phosphorylation sites by PKC (Ser24,
      Thr345, Ser349). We tested their contributions to the PMA-induced modulation by
      site-directed mutagenesis. The results suggest that the up-modulation by PKC
      activators is due to the inhibition of the fast inactivation by the amino
      terminal domain (N-type inactivation), thereby increase the time the channels are
      conductive. Phosphorylation of Ser24 may enhance the PKC-induced down-modulation,
      while phosphorylation of Thr345 may inhibit the down-modulation. By contrast,
      mutation of Ser349 did not affect the modulation. The N-type inactivation were
      not indispensable for the down-modulation because the amino-terminal deletion
      mutant also showed some down-modulation although its onset was quite slow. Thus,
      the down-modulation of AKv1.1a may be heterogeneous.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7795491
TI  - Quinine-HCl-induced modification of receptor potentials for taste stimuli in frog
      taste cells.
AB  - After frog taste cells were adapted to 1 mM quinine-HCl (Q-HCl) for 10 sec,
      modification of receptor potentials in the taste cells induced by salt, acid,
      sugar and bitter stimuli was studied with microelectrodes. The phasic component
      of receptor potentials induced by 0.1 M NaCl, KCl, NH4Cl and MgCl2 was enhanced
      following adaptation to Q-HCl. The rate of rise of receptor potentials in
      response to the salts was increased after Q-HCl adaptation. The amplitude and the
      rate of rise of receptor potentials induced by 1 mM acetic acid were larger after
      Q-HCl adaptation than after water adaptation. The amplitude of phasic component
      and rate of rise of receptor potentials for 0.5 M sucrose after Q-HCl were the
      same as those after water. The amplitudes of tonic receptor potentials for 1 mM Q
      H2SO4, brucine and picric acid after Q-HCl adaptation were the same as those
      after 1 mM NaCl adaptation. Correlation coefficient between taste cell responses
      induced by 1 mM Q-HCl and 1 mM Q-H2SO4 was very high, but those between 1 mM Q
      HCl and 1 mM brucine responses and between 1 mM Q-HCl and 1 mM picric acid
      responses were low. This indicates that Q-HCl and Q-H2SO4 bind to the same
      receptor site, but brucine and picric acid bind to different receptor sites to
      which Q-HCl does not bind.

PMID- 7795493
TI  - Identification of peanut agglutinin-binding glycoproteins on lizard lymphocytes.
AB  - The expression of PNA-binding glycoproteins on lizard lymphocytes was
      investigated by studying the reactivity of FITC-PNA towards lizard lymphocytes
      obtained from the different lymphoid organs. Direct immunofluorescence assays
      have demonstrated that the majority of lizard thymocytes (70%) and only a
      fraction of lymphocytes in the spleen, peripheral blood and bone marrow were PNA
      positive. This positivity was selectively inhibited by galactose as well as
      lactose, indicating the specificity of binding. Putative PNA receptors were
      purified from lizard thymocytes and splenocytes by affinity chromatography on a
      PNA-Sepharose 4B column and resulted in fractions enriched 1,792-fold and 3,141
      fold for the PNA-binding component expressed on lizard thymocytes and
      splenocytes, respectively. Analysis on reducing and non-reducing SDS-PAGE
      revealed that both thymic and splenic PNA-binding glycoproteins migrated as a
      single component of 35 KDa, with no evidence for the association into higher
      multimers in both tissues. Analyses for amino acid and carbohydrate compositions
      indicated that the thymic and splenic glycoproteins have similar amino acid
      composition and differed in the content of neutral and amino-sugars as well as
      sialic acid. The content of the latter residue was relatively higher in the
      splenic form of the receptor compared to its thymic counterpart, and was
      inversely correlated with the content of galactosyl residues in both forms of the
      receptor. The functional significance of PNA-binding glycoproteins during
      vertebrate evolution is discussed.

PMID- 7795494
TI  - Occurrence of a latent serine protease in the follicular fluid of porcine ovary.
AB  - Porcine ovary follicular fluid contains a latent form of a protease which is
      activatable with trypsin. The active enzyme hydrolyzed peptide 4-methylcoumaryl-7
      amide (MCA) substrates with a preference for the Arg-MCA bond. The enzyme was
      strongly inhibited by diisopropylfluorophosphate, aprotinin, leupeptin and
      antipain, but not by soybean trypsin inhibitor. The apparent molecular weight of
      the enzyme was approximately 630,000 as estimated by gel filtration. No
      significant difference in molecular size was seen between the inactive precursor
      and trypsin-activated enzyme. The results suggest that the present enzyme is a
      novel type of serine protease.

PMID- 7795492
TI  - A proteinous factor mediating intercellular communication during the transition
      of Dictyostelium cells from growth to differentiation.
AB  - In general, cell differentiation and proliferation are mutually exclusive.
      Transition of the cellular slime mold Dictyostelium discoideum from growth to
      differentiation is triggered mainly by a secreted factor(s) in addition to
      nutritional deprivation. To purify and identify the factor required for the
      growth/differentiation transition, a new assay system was designed. Under low
      nutrient conditions, cells could grow to multiply, but never developed. The
      cellular development including aggregation, however, was induced by the addition
      of conditioned medium (CM) in which growing or starving Dictyostelium cells had
      been cultured. The CM inhibited the synthesis of nuclear DNA and induced the
      cells to acquire chemotactic competence to cAMP, thus suggesting the presence of
      a secreted factor(s) required for growth/differentiation transition in the CM.
      The active factor(s) in CM (referred to as CMF450; conditioned medium factor) was
      found to be sensitive to heat and have a large molecular size. The CMF450 was
      purified using FPLC through a gel filtration column, and was identified to be a
      proteinous macromolecule of Mr 450 kDa, which was mainly composed of 94 kDa, 79
      kDa, and 49 kDa subunits under a native condition.

PMID- 7795495
TI  - Effect of hypoglycemic stress on the pars intermedia of the mouse pituitary
      gland: an ultrastructural analysis.
AB  - The present study was made to clarify the relationship between functions of the
      pars intermedia of the mouse pituitary gland and hypoglycemic stress.
      Morphometrical analysis of the ultrastructures of the pars intermedia cells
      showed (1) a rise in the percentage volume of rough endoplasmic reticulum (r-ER)
      indicative of an increase in protein synthesis, (2) an increase in the number of
      Golgi granules per unit Golgi area showing an induction of granule-forming
      activity and (3) a decrease in the numerical density of secretory granules
      reflecting a release of the secretory granules. These findings suggest that
      hypoglycemic stress induced by daily treatment with insulin or restriction of
      food intake was able to elicit heightened secretory activity of the pars
      intermedia cells of the mouse pituitary gland. However, acute hypoglycemic stress
      induced by food deprivation did not cytologically affect the pars intermedia.
      These observations suggest that repeated hypoglycemic stress, rather than acute
      hypoglycemic stress, may be a natural physiological stimulus of the pars
      intermedia of the mouse pituitary gland.

PMID- 7795496
TI  - Addiction research in a wealthy nation: is there an expanding German research
      presence?

PMID- 7795497
TI  - The Severity of Dependence Scale (SDS): psychometric properties of the SDS in
      English and Australian samples of heroin, cocaine and amphetamine users.
AB  - The Severity of Dependence Scale (SDS) was devised to provide a short, easily
      administered scale which can be used to measure the degree of dependence
      experienced by users of different types of drugs. The SDS contains five items,
      all of which are explicitly concerned with psychological components of
      dependence. These items are specifically concerned with impaired control over
      drug taking and with preoccupation and anxieties about drug use. The SDS was
      given to five samples of drug users in London and Sydney. The samples comprised
      users of heroin and users of cocaine in London, and users of amphetamines and
      methadone maintenance patients in Sydney. The SDS satisfies a number of criteria
      which indicate its suitability as a measure of dependence. All SDS items load
      significantly with a single factor, and the total SDS score was extremely highly
      correlated with the single factor score. The SDS score is related to behavioural
      patterns of drug taking that are, in themselves, indicators of dependence, such
      as dose, frequency of use, duration of use, daily use and degree of contact with
      other drug users; it also shows criterion validity in that drug users who have
      sought treatment at specialist and non-specialist agencies for drug problems have
      higher SDS scores than non-treatment samples. The psychometric properties of the
      scale were good in all five samples, despite being applied to primary users of
      different classes of drug, using different recruitment procedures in different
      cities in different countries.

PMID- 7795498
TI  - Alcohol abuse and dependence: consistency in reporting of symptoms over ten
      years.
AB  - The present study assesses the stability of the diagnosis of alcoholism among a
      sample of St Louis, USA Epidemiological Catchment Area Study participants. The
      Diagnostic Interview Schedule was used at Time 1 and the Composite International
      Diagnostic Interview--Substance Abuse Module was used at 10-year follow-up.
      Alcohol abuse and dependence were diagnosed using DSM-III criteria. Kappa values
      and Yule's statistics for agreement in diagnoses, criterion groups and individual
      symptoms are reported. Fair to good measurement of agreement was shown for any
      diagnosis of alcohol abuse or dependence versus no diagnosis. The criterion group
      for "impairment in social or occupational functioning" showed the highest
      agreement of the three criterion groups studied. Agreement was lower for
      individual symptoms of alcoholism. Incident cases accounted for some of the
      inconsistency in responses over 10 years. Other types of inconsistency found were
      changing response from yes to no, changing response from no to yes but not
      meeting the definition of an incident case, and misstating age of onset of
      symptoms. Mean per cent inconsistency across all symptoms was 11.4%. Further
      research regarding reasons for inconsistencies is needed.

PMID- 7795499
TI  - Withdrawal and dependency symptoms among adolescent alcohol and drug abusers.
AB  - Due to differences in duration, intensity and topography of alcohol and drug use
      patterns, the withdrawal and dependency symptoms of adolescent substance abusers
      may differ from those of adult substance abusers. To explore these potential
      differences, 166 adolescents recruited from inpatient alcohol and drug treatment
      programs in the USA were assessed for alcohol and other drug withdrawal and
      dependency symptoms. Teens were administered the Customary Drinking and Drug Use
      Record following 2 weeks of abstinence and evaluated for recent (< 3 months) DSM
      III-R psychoactive substance withdrawal and dependency symptoms. Adolescents were
      all multiple substance users with a life-time average of 4.27 drugs used in
      addition to alcohol. Amphetamines were the most frequently used drug (50% of
      sample) and the most prevalent withdrawal symptoms were those associated with
      central stimulant use. However, the number of different withdrawal symptoms (M =
      11.27) was greater than expected for uncomplicated stimulant withdrawal or
      withdrawal from any single substance. On average, participants reported
      dependency symptoms more than DSM-III-R criteria for the diagnosis of alcohol
      dependency (M = 3.30), as well as dependency on their two most frequently used
      drugs. Heavy alcohol and cigarette use were found to exacerbate withdrawal
      symptoms of other drugs. These findings highlight the importance of assessing
      adolescent substance abusers for withdrawal from and dependency on multiple
      substances.

PMID- 7795500
TI  - Factor analysis of alcohol abuse and dependence symptom items in the 1988
      National Health Interview Survey.
AB  - The findings presented in this report are of general interest for the development
      of survey instruments for alcohol use disorders. They show which items represent
      the same dimension of alcohol problems when presented to respondents in a general
      population survey setting. The note determines the major dimensions underlying
      the complete set of 41 symptom items in the 1988 National Health Interview
      Survey, relates the item sets of the DSM- and ICD-criteria to these dimensions,
      and studies the measurement characteristics of items not used for DSM- or ICD
      criteria.

PMID- 7795501
TI  - The role of peer affiliations, social, family and individual factors in
      continuities in cigarette smoking between childhood and adolescence.
AB  - The continuity between early smoking experimentation and smoking at age 16 years
      was analysed for a birth cohort of New Zealand children. This analysis suggested
      that when due allowance was made for errors in reports of smoking behaviours,
      there was evidence of relatively strong continuity (r = 0.60) between early
      smoking experimentation and cigarette smoking at age 16 years. Further analysis
      suggested that the continuities between early smoking experimentation and later
      smoking arose from three pathways that linked early smoking experimentation to
      later smoking. First there was evidence to suggest that children who engaged in
      early smoking experimentation tended to affiliate with adolescent peer groups
      whose members smoked. In turn, these peer group affiliations reinforced pre
      existing tendencies to cigarette smoking. Secondly, a small component of the
      apparent continuity between early smoking experimentation and later smoking arose
      because of common social, individual and contextual factors that were associated
      with both smoking experimentation and later smoking. Finally, there was evidence
      of moderate direct continuity in cigarette smoking behaviour over time. The
      implications of these findings for the development of smoking prevention
      programmes are discussed and it is concluded that effective programmes need to be
      embedded in a developmental approach which attempts to reduce both early smoking
      experimentation and the effects of peer pressure in adolescence on the
      development of cigarette smoking.

PMID- 7795502
TI  - The effects of expectancy and alcohol on cognitive-motor performance.
AB  - Previous studies have found equivocal evidence for expectancy effects on
      cognitive-motor performance. The effects of expectancy and alcohol on a dual
      tracking and reaction-time task analogous to some driving skills, and on choice
      reaction-time, were studied in a balanced-placebo design (n = 90). A dose of
      alcohol achieving 80 mg/100 ml (high dose) had large effects on both tasks, but a
      low dose (40 mg/100 ml) had no significant effects. Expecting alcohol led to
      subjects who received the high dose performing significantly better on the
      primary tracking task than subjects expecting placebo (but also receiving the
      high alcohol dose). By contrast, on a secondary reaction-time task, subjects who
      had received placebo performed worse 100-130 minutes after drinking, if they had
      expected alcohol. All groups felt more drunk than baseline and expecting alcohol
      made subjects feel more able to perform, whatever drink they had received. The
      implications of these findings for the nature of expectancy effects on
      performance and the relationship between expectations and strategy are discussed.

PMID- 7795503
TI  - New beverages, new drinking contexts? Signs of modernization in Finnish drinking
      habits from 1984 to 1992, compared with trends in the European Community.
AB  - The dynamics of change in drinking patterns is discussed using the data from the
      drinking habits surveys conducted in Finland in 1984 and 1992. The results are
      compared with a respective analysis on the EU countries from 1988 by Hupkens,
      Knibbe & Drop (1993). The analysis is based on changes in beverage preferences.
      In the Finnish case, both wine and mild beer appear as new beverages, gaining
      popularity in the late 1980s. For beer, both the elites and the population at
      large were involved in that process. For wine, the interest in the new beverage
      was stronger among the elites. There were notable gender differences in adopting
      the new beverage. Some of the differences were related to the older cultural
      patterns of wine as a woman's drink and beer as a male beverage. The results also
      point to difficulties in analysing the dynamics of change on the basis of cross
      sectional data, as was done in the earlier analysis on the EC countries. The
      Finnish data shows that even the inter-group dynamics of drinking patterns may
      change over a relatively short period of time.

PMID- 7795504
TI  - Alcohol abuse and suicide: a 40-year prospective study of Norwegian conscripts.
AB  - Suicide mortality among alcohol abusers and the prevalence of alcohol abusers
      among suicides were assessed in a 40-year follow-up study of 40,000 Norwegian
      military conscripts. Alcohol abuse was operationalized as either admission to
      alcohol treatment clinic, alcohol related cause of death, or both. The relative
      risk of suicide among alcohol abusers was estimated to 6.9. The relative risk of
      committing suicide among alcohol abusers appeared to be higher in middle age
      (more than 40 years) than in younger age groups (RR = 12.8 and 4.5,
      respectively). The life-time risk of suicide, i.e. before the age of 60 years,
      was estimated to 0.63% for those not categorized as alcohol abusers and 4.76% for
      those categorized as alcohol abusers.

PMID- 7795505
TI  - Alcoholism in Brazil--the role of personality and susceptibility to stress.
AB  - One hundred alcohol-dependent Brazilian males were investigated in relation to
      variables dealing with the course of alcoholism, family history and behaviour.
      Seven of the most representative were standardized and then subjected to a factor
      analysis. The factors thus obtained were afterwards included in a cluster
      analysis, which identified three groups of alcoholics. Two of these groups agree
      with those established on recent previous classifications, while the third
      revealed a characteristic not identified in these typologies: lower levels of
      stress. Other distinctive features were lower scores of harm avoidance and higher
      proportion of alcoholic relatives. In relation to other conditions these subjects
      presented intermediary values, suggesting that they may constitute an
      intermediate between the two other, polar types. It will be important to verify
      if these results are confirmed in populations with biological and cultural
      characteristics different from the Brazilian one.

PMID- 7795506
TI  - Social relationships and abstinence from cocaine in an American treatment sample.
AB  - In an extension of earlier work relating social-relationship variables to post
      treatment abstinence from abused drugs, 104 cocaine users were studied for 6
      months after completing drug treatment. Social-relationship variables included
      social integration, perceived support and social-network cocaine use. The effects
      of social relationships on cocaine abstinence tended to be conditional on race.
      Greater social integration predicted abstinence for Caucasian Ss (n = 54), but
      not African-Americans (n = 50). Similar results occurred for perceived support.
      Social network drug-use data also showed race differences: the absence of current
      cocaine users and the presence of former users predicted abstinence only for
      Caucasians. Interpretation of these findings is complicated by the relationship
      we observed between race and route of cocaine administration, with African
      American Ss far more likely than Caucasians to be crack smokers or injection
      users as compared to intranasal users. The effects of race could not be
      disentangled from the effects of route. Future studies of social relationships
      and cocaine abstinence should focus on identifying social factors that are
      protective for African-Americans and for smokers/injectors. Such studies are
      critical precursors to designing successful social-support interventions.

PMID- 7795508
TI  - Recognition performance of subjects with color-vision deficiencies on a
      polychromatic sonar screen for ship navigation.
AB  - To facilitate differentiation between objects that are approaching, stationary,
      and moving away, these objects are represented in different colors on the screens
      of sonar locating devices used in ship navigation. Yellow represents stationary
      objects, and represents approaching objects, and green represents those objects
      moving away. A total of 46 subjects with normal color vision and 184 individuals
      with color-vision deficiencies, among them 29 deuteranopic, 100 deuteranomalous,
      21 protanopic and 34 protanomalous individuals, were investigated for their
      ability to identify different signals. Ten different objects were presented for a
      period of 64 s each. As a minimal requirement it was established that 50% of the
      respective experimental group be capable of recognizing the objects within half
      of this time. Whereas 73.3% of the subjects with normal color vision could meet
      this requirement, none of the subjects in the different groups with color-vision
      deficiencies could do so. Only 16.1% of the deuteranopic subjects, 33.1% of the
      deuteranomalous individuals, 16.2% of the protanopic subjects, and 37.6% of the
      protanomalous individuals detected all objects within 32 s. No appreciable
      difference in the ability to recognize signals occurred among the different
      groups of subjects with color-vision deficiencies.

PMID- 7795507
TI  - Mortality among HIV-infected intravenous drug addicts in Stockholm in relation to
      methadone treatment.
AB  - The aim of the study was to estimate the mortality rate and evaluate the causes
      of death in all diagnosed HIV-positive IDUs in the Stockholm area, 1986-90, and
      to compare the risk of death of those who received methadone treatment with that
      of those never admitted to or discharged from the programme. Data were collected
      from the Swedish National Bacteriological Laboratory, the Methadone Maintenance
      Programme (MMTP) and the Department of Forensic Medicine, as well as from
      hospitals in the Stockholm region. In Sweden 90% of all IDUs are HIV-tested. Most
      deceased IDUs are examined forensically. This examination always includes HIV
      testing. During the observation period, 472 HIV-infected IDUs were reported from
      the Stockholm area. Of these addicts 135 participated in the methadone
      maintenance programme for a shorter or longer time during the study period. Most
      of them had received the HIV-diagnosis more than 1 year before first entering the
      programme. Sixty-nine subjects died during the observation period. A majority, 52
      persons, died from violence or poisoning. Seventeen died from somatic
      complications of drug abuse. Nine of them were diagnosed as suffering from AIDS.
      Eight of the deceased had participated in the MMTP. The relative risk of death
      from external violence and poisoning was 0.25 (95% confidence interval 0.1-1.0)
      when participants in the MMTP were compared with HIV-infected IDUs never
      attending the programme. When all causes of death are compared the relative risk
      was 0.8. Those patients discharged from the programme have a higher mortality
      rate than those who never participated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7795510
TI  - Bilateral herpes simplex virus type 2 keratitis: a clinicopathologic report with
      immunohistochemical and ultrastructural observations.
AB  - This report describes the clinical, histopathologic, ultrastructural, and
      immunohistochemical findings in two corneal buttons from a 13-year-old girl who
      developed bilateral progressive corneal stromal opacification during childhood.
      As determined by light microscopy, both corneal buttons were edematous with a
      chronic inflammatory infiltrate confined to the deep layers of the stroma. We
      detected intranuclear eosinophilic inclusions in some epithelial cells. We
      detected herpesvirus particles in stromal keratocytes and endothelial cells by
      transmission electron microscopy. Immunohistochemistry studies identified
      concurrent expression of specific herpes simplex virus type 2 antigen in corneal
      epithelial cells, in keratocytes in the deep layers of the stroma, and in
      endothelial cells. The cause of progressive bilateral stromal corneal
      opacification in this child was herpes simplex virus type 2 keratitis. This
      condition should be considered in the differential diagnosis of progressive,
      bilateral corneal opacification in children.

PMID- 7795509
TI  - Involvement of anterior chamber angle structures in disseminated histoplasmosis:
      report of three cases.
AB  - This study describes the involvement of anterior chamber (AC) angle structures in
      patients with disseminated histoplasmosis. The postmortem eyes from three
      patients (aged 33, 41, and 42 years, respectively) with disseminated
      histoplasmosis, two of whom had acquired immunodeficiency syndrome, were examined
      by light microscopy using hematoxylin-eosin, periodic acid-Schiff (PAS), and
      Gomori's methenamide silver (GMS) stains. Electron microscopy studies of the
      choroid were performed in one eye. Significant numbers of budding yeast forms of
      Histoplasma capsulatum measuring 2-5 microns in diameter were observed within the
      trabecular meshwork, Schlemm's canal and in the deep intrascleral plexuses. All
      eyes showed massive involvement of the choroidal vasculature, including the
      choriocapillaris. The organisms were observed freely as well as in small clusters
      within the cytoplasm of circulating monocytes. The vessels of the limbal
      conjunctiva (two eyes) and ciliary body (three eyes) contained many Histoplasma
      organisms. In one eye, several budding yeast were noted in an iris vessel and in
      occasional histiocytes within the ciliary muscle. Blood smears containing
      Histoplasma organisms were observed in two cases. None of the patients had an
      ophthalmologic examination prior to death. Involvement of the intravascular
      structures of the eye as well as the AC angle was observed in three patients with
      disseminated histoplasmosis. The fungus most likely reached the AC angle
      structures by direct hematogenous dissemination or via the aqueous humor by
      migration from vessels in the ciliary body and iris. An abnormal retrograde blood
      flow into the AC angle structures may have also played an important role. We
      suggested that the intraocular pressure be monitored in cases of suspected
      disseminated histoplasmosis to detect functional alterations indicative of a
      blockage in the outflow channels.

PMID- 7795511
TI  - HLA-DR antigen expression in pterygium epithelial cells and lymphocyte
      subpopulations: an immunohistochemistry study.
AB  - The purpose of our study was to investigate the role of immune mechanisms in the
      pathogenesis of pterygium using an immunohistochemical technique. Our material
      consisted of 35 surgically excised pterygia and 7 samples of normal conjunctiva
      obtained from an equal number of patients. HLA-DR antigen expression in
      epithelial cells, B-cells, suppressor and helper lymphocytes, Langerhans' cells,
      and monocytes/macrophages were studied immunohistochemically in frozen sections
      using anti-human HLA-DR, anti-CD22, anti-CD8, anti-CD4, anti-CD1a, and anti-LeuM5
      monoclonal antibodies. Aberrant HLA-DR antigen expression in epithelial cells was
      detected in 30 of 35 cases of pterygium. Epithelial cells in samples of normal
      conjunctiva were found to be negative in HLA-DR antigen expression. HLA-DR
      antigen expression in pterygium was found to be closely related to the density of
      T4 cells and, especially, of CD4 lymphocytes. The present findings suggest that
      an immunopathologic mechanism plays a role in the pathogenesis of pterygium.

PMID- 7795512
TI  - Tissue plasminogen activator for the treatment of postoperative intraocular
      fibrinous membranes following cataract surgery.
AB  - We report on our first two patients treated by intracameral application of tissue
      plasminogen activator (tPA) for dissolving fibrinous exsudates. Both patients had
      developed fibrin membranes in the pupillary plane and in the anterior chamber
      several days after cataract surgery. Injection of 25 micrograms tPA into the
      anterior chamber resulted in complete dissolution of the fibrin within 1 h of its
      application.

PMID- 7795513
TI  - Transscleral suture fixation of posterior-chamber lenses after cataract
      extraction associated with vitreous loss.
AB  - From 1987 to 1993, 21 patients who had undergone complicated cataract extraction
      that was associated with vitreous loss and transscleral suture fixation of the
      posterior-chamber lens (PC-IOL) in one eye (group A) and uncomplicated in-the-bag
      implantation of the PC-IOL in the fellow eye (group B) were followed
      prospectively. The follow-up period was 29.5 months (SD, +/- 17.0 months) in
      group A and 36.6 months (+/- 24.0 months) in group B. Visual acuity did not
      differ significantly between the two groups (P = 0.60, Wilcoxon test). In all,
      17/21 patients in group A and 16/21 patients in group B achieved a visual acuity
      of > or = 20/40. Postoperative refractions measured in group A were +0.68 D more
      hyperopic than those measured in group B (P < 0.04). This result was consistent
      with the postoperative finding of a significantly deeper anterior chamber in
      group A (mean, 0.44 mm; P < 0.03). The accuracy of the desired postoperative
      refraction was poorer in group A. The risk for retinal detachment, cystoid
      macular edema, and intraocular pressure elevation was increased in patients who
      had had capsular defects and vitreous loss during cataract extraction.
      Nevertheless, transscleral suture fixation of PC-IOLs in patients with
      complicated cataract extractions associated with vitreous loss can give
      acceptable visual results. We recommend that +0.5 D be added to the calculated
      IOL power when severe complications require transscleral suture fixation of the
      PC-IOL during cataract extraction.

PMID- 7795514
TI  - Endothelial cell morphology after phototherapeutic keratectomy.
AB  - The purpose of the present study was to investigate endothelial vital reactions
      after the performance of large central excimer laser keratectomies at various
      depths. Central 5 mm keratectomies were performed in porcine eyes. The ablations
      were carried out at depths of 0 (controls), 200, and 400 micron or until
      perforation occurred. One-third of the corneas were immediately stained with
      trypan blue and alizarin red, and two-thirds of the eyes were perfused for 1 or 6
      h prior to vital staining. The numbers of endothelial cells and damaged cells
      were assessed. No significant difference was found between 200- and 400 microns
      deep keratectomies as compared with control corneas at any given time. Perforated
      corneas showed endothelial and stromal cell damage surrounding the perforation.
      We conclude that deep excimer laser keratectomies do not affect endothelial cell
      density and viability for up to 6 h postoperatively. Therefore, excimer laser
      lamellar keratoplasties appear to be a safe procedure for the underlying
      endothelium.

PMID- 7795516
TI  - Perilimbal aneurysms of conjunctival vessels in glaucoma patients.
AB  - Aneurysms of the conjunctival vessels occur frequently. Such aneurysms have even
      been described in glaucomatous patients but their significance in this condition
      is not clear. Because they may be of clinical value in some conditions, the
      extent of perilimbal aneurysms of the conjunctiva was evaluated in 20 normal
      tension-glaucoma patients, 20 primary open-angle-glaucoma patients, and 60
      controls. The extent of these aneurysms was graded as follows: none (0), faint (1
      2), moderate (3-5), and copious (> or = 6). The group frequencies of these
      categories were 5%, 25%, 10%, and 60% in normal-tension-glaucoma patients; 40%,
      40%, 20%, and in primary open-angle-glaucoma patients; and 43%, 32%, 12%, and 13%
      in control patients, respectively. The incidence of copious perilimbal aneurysms
      of the conjunctiva was significantly higher in normal-tension-glaucoma patients
      than in primary open-angle-glaucoma patients and controls (P < 0.0001). Because
      local medication cannot account for the differences in relation to the control
      group and because glaucoma patients differed mainly in that normal-tension
      glaucoma patients had vascular risk factors, the reason for our finding might be
      related to circulation problems.

PMID- 7795515
TI  - Comparative effects of atracurium and vecuronium on intraocular pressure.
AB  - The non-depolarising muscle relaxants atracurium and vecuronium have been found
      to exert variable effects on intraocular pressure (IOP). The aim of the present
      study was to assess the influence of atracurium and vecuronium on IOP under
      standardized clinical conditions. A total of 40 patients undergoing ophthalmic
      surgery were randomly allocated to 2 study groups. Following oral premedication
      with dipotassium clorazepate (0.3 mg/kg), anaesthesia was induced with
      thiopentone (3-4 mg/kg) and alfentanil (15 micrograms/kg). Muscle relaxation was
      provided according to randomisation, with patients in group 1 receiving 0.3 mg/kg
      atracurium and patients in group 2 0.07 mg/kg vecuronium. Anaesthesia was
      maintained with isoflurane (0.5-0.8 vol%) and 70% nitrous oxide in oxygen. The
      trachea was intubated 4 min after induction and muscle relaxation. A total of
      nine measurements of IOP were taken in each patient, starting before
      premedication and ending 5 min after endotracheal intubation. In both groups,
      there was a significant decrease in IOP after induction of anaesthesia with
      thiopentone, alfentanil, and atracurium or vecuronium. No difference in IOP was
      found between the groups. We conclude that both muscle relaxants can be given
      when increases in IOP have to be avoided.

PMID- 7795517
TI  - Comparison of temporal and spatiotemporal contrast-sensitivity tests in normal
      subjects and glaucoma patients.
AB  - Contrast sensitivity (CS) is reduced in glaucoma diseases. This study compares
      the value of different CS measurements in glaucoma diagnosis. The study
      population consisted of age-matched groups of 31 normal subjects (age, 36-59
      years; median, 47 years; mean +/- SD, 47.4 +/- 7 years) and 59 glaucoma patients
      with optic disk damage and visual field defects (age, 36-63 years; median, 53
      years; mean +/- SD, 52.3 +/- 7 years). Three types of CS determination were
      carried out in all subjects: (1) temporal CS of a sinusoidally flickering light
      (37 Hz) in a ganzfeld bowl, (2) spatiotemporal CS (alternating pattern: 2.5 Hz, 1
      cycle/degree; screen size, 5.3 degrees x 4.3 degrees) in a temporal upper retinal
      area (13.8 degrees horizontal, 4.2 degrees vertical), and (3) spatial CS of a
      static pattern (three spatial frequencies: 0.6, 3.0, and 12 cycles/degree; screen
      size, 5.3 degrees x 4.3 degrees) with central fixation. In glaucoma patients the
      results of CS tests with flickering stimuli were highly significantly correlated
      with the perimetric mean sensitivity (MS; Octopus G1 program: temporal CS, r =
      0.67, P < 0.001; spatiotemporal CS, r = 0.8, P < 0.001). For spatial CS the
      frequency of 3.0 cycles/degree showed the strongest correlation with MS (r =
      0.64, P < 0.001). Only the peripherally localized, spatiotemporal CS showed a
      strong correlation with optic disk damage (r = 0.59, P < 0.001). On the other
      hand, the full-field flicker test achieved the best separation between normal
      subjects and glaucoma patients (specificity, 90%; sensitivity, 71%). These
      results indicate that tests for temporal resolution are more sensitive to
      glaucoma defects than are tests for spatial resolution.

PMID- 7795519
TI  - Approaches to labeling and identification of active site residues in
      glycosidases.
AB  - Glycosidases play a key role in a number of biological processes and, as such,
      are of considerable clinical and biotechnological importance. Knowledge of the
      identifies of catalytically important active site residues is essential for
      understanding the catalytic mechanism, for enzyme classification, and for
      targeted bioengineering of glycosidases with altered characteristics. Here we
      review and discuss traditional strategies and novel approaches based on tandem
      mass spectrometry for the identification of the key active site residues in
      glycosidases.

PMID- 7795520
TI  - Binding of phosphorus-containing inhibitors to thermolysin studied by the Poisson
      Boltzmann method.
AB  - Zinc endopeptidase thermolysin can be inhibited by a series of phosphorus
      containing peptide analogues, Cbz-Gly-psi (PO2)-X-Leu-Y-R (ZGp(X)L(y)R), where X
      = NH, O, or CH2; Y = NH or O; R = Leu, Ala, Gly, Phe, H, or CH3. The affinity
      correlation as well as an X-ray crystallography study suggest that these
      inhibitors bind to thermolysin in an identical mode. In this work, we calculate
      the electrostatic binding free energies for a series of 13 phosphorus-containing
      inhibitors with modifications at X, Y, and R moieties using finite difference
      solution to the Poisson-Boltzmann equation. A method has been developed to
      include the solvation entropy changes due to binding different ligands to a
      macromolecule. We demonstrate that the electrostatic energy and empirically
      derived solvation entropy can account for most of the binding energy differences
      in this series. By analyzing the binding contribution from individual residues,
      we show that the energy of a hydrogen bond is not confined to the donor and
      acceptor. In particular, the positive charges on Zn and Arg 203, which are not
      the acceptors, contribute significantly to the hydrogen bonds between two amides
      of ZGpLL and the thermolysin.

PMID- 7795521
TI  - Direct evidence of a heterotrimeric complex of human interleukin-4 with its
      receptors.
AB  - The mode of binding of interleukin-4 (IL-4) to its two known receptors, specific
      receptor IL-4R and a shared receptor gamma c, was investigated using gel
      filtration and gel electrophoresis. A ternary complex between IL-4 and the
      soluble domains of the two receptors was shown to exist in solution. The
      association constant between gamma c and the stable complex of IL-4/sIL-4R is in
      the millimolar range, making the ternary complex a feasible target for
      crystallization studies.

PMID- 7795523
TI  - Isoforms of a cuticular protein from larvae of the meal beetle, Tenebrio molitor,
      studied by mass spectrometry in combination with Edman degradation and two
      dimensional polyacrylamide gel electrophoresis.
AB  - Simultaneous sequencing, using a combination of mass spectrometry and Edman
      degradation, of three approximately 15-kDa variants of a cuticular protein
      extracted from the meal beetle Tenebrio molitor larva is demonstrated. The
      information obtained by matrix-assisted laser desorption ionization mass
      spectrometry (MALDI MS) time-course monitoring of enzymatic digests was found
      essential to identify the differences among the three variants and for alignment
      of the peptides in the sequence. To determine whether each individual insect
      larva contains all three protein variants, proteins extracted from single animals
      were separated by two-dimensional gel electrophoresis, electroeluted from the gel
      spots, and analyzed by MALDI MS. Molecular weights of the proteins present in
      each sample could be obtained, and mass spectrometric mapping of the peptides
      after digestion with trypsin gave additional information. The protein isoforms
      were found to be allelic variants.

PMID- 7795522
TI  - Conservative and nonconservative mutations in proteins: anomalous mutations in a
      transport receptor analyzed by free energy and quantum chemical calculations.
AB  - Experimental studies on a bacterial sulfate receptor have indicated anomalous
      relative binding affinities for the mutations Ser130-->Cys,Ser130-->Gly, and
      Ser130-->Ala. The loss of affinity for sulfate in the former mutation was
      previously attributed to a greater steric effect on the part of the Cys side
      chain relative to the Ser side chain, whereas the relatively small loss of
      binding affinity for the latter two mutations was attributed to the loss of a
      single hydrogen bond. In this report we present quantum chemical and statistical
      thermodynamic studies of these mutations. Qualitative results from these studies
      indicate that for the Ser130-->Cys mutation the large decrease in binding
      affinity is in part caused by steric effects, but also significantly by the
      differential work required to polarize the Cys thiol group relative to the Ser
      hydroxyl group. The Gly mutant cobinds a water molecule in the same location as
      the Ser side chain resulting in a relatively small decrease in binding affinity.
      Results for the Ala mutant are in disagreement with experimental results but are
      likely to be limited by insufficient sampling of configuration space due to
      physical constraints applied during the simulation.

PMID- 7795518
TI  - Structural basis of substrate specificity in the serine proteases.
AB  - Structure-based mutational analysis of serine protease specificity has produced a
      large database of information useful in addressing biological function and in
      establishing a basis for targeted design efforts. Critical issues examined
      include the function of water molecules in providing strength and specificity of
      binding, the extent to which binding subsites are interdependent, and the roles
      of polypeptide chain flexibility and distal structural elements in contributing
      to specificity profiles. The studies also provide a foundation for exploring why
      specificity modification can be either straightforward or complex, depending on
      the particular system.

PMID- 7795524
TI  - Conformationally constrained analogs of protein kinase inhibitor (6-22)amide:
      effect of turn structures in the center of the peptide on inhibition of cAMP
      dependent protein kinase.
AB  - The high-affinity interaction between protein kinase inhibitor (PKI)(6
      22)amide(Thr6-Tyr-Ala-Asp-Phe-Ile-Ala-Ser-Gly-Arg-Thr-Gly- Arg-Arg-Asn- Ala-Ile22
      NH2) and the catalytic subunit of cAMP-dependent protein kinase requires both the
      N-terminal Thr6 to Ile11 sequence of the inhibitor peptide and its C-terminal
      pseudosubstrate site comprised of Arg15 to Ile22. Small angle X-ray scattering
      data indicate that PKI(6-22)amide has a compact, rather than extended, structure
      in solution (Reed J et al., 1989, Biochem J 264:371-380). CD spectroscopic
      analysis of the PKI peptide led to the suggestion that a beta-turn structure
      might be located in the -Ala12-Ser-Gly-Arg15-connecting sequence in the middle of
      the molecule (Reed J, Kinzel V, Cheng HC, Walsh DA, 1987, Biochemistry 26:7641
      7647). To investigate this possibility further, conformationally constrained and
      flexible analogs of PKI(6-22)amide were synthesized and used to study the
      structure-function relationships of this central portion of the inhibitor. (Des12
      14)PKI(6-22) amide exhibited over a 200-fold loss in inhibitory activity.
      Replacement of the omitted -Ala12-Ser-Gly14-sequence with aminocaprylic acid
      yielded an analog that regained more than 90% of the lost binding energy. The D
      alanine14 PKI analog was as potent as the parent peptide, whereas the beta
      alanine14 and the sarcosine14 analogs were only 10-fold less active. Several
      peptides that promoted a beta-turn structure at residues 12-15 showed about 200
      fold decreases in inhibitory activity. Two constrained analogs that could not
      assume a beta-turn conformation were only 30-fold less potent than PKI(6
      22)amide. Thus, the structure of the central connecting portion of the PKI
      peptide, encompassing residues 12-15, greatly influences its ability to
      effectively bind to and inhibit the catalytic subunit. We conclude, however, that
      a formal beta-turn at this position is not required and is actually detrimental
      for a high-affinity interaction of PKI(6-22)amide with the enzyme. These results
      are interpreted in light of the Fourier-transform infrared spectra of the peptide
      analogs and the crystal structure of the peptide bound at the active site of the
      protein kinase (Knighton DR et al., 1991b, Science 253:414-420).

PMID- 7795525
TI  - Stability of ribonuclease T2 from Aspergillus oryzae.
AB  - The stability of ribonuclease T2 (RNase T2) from Aspergillus oryzae against
      guanidine hydrochloride and heat was studied by using CD and fluorescence. RNase
      T2 unfolded and refolded reversibly concomitant with activity, but the unfolding
      and refolding rates were very slow (order of hours). The free energy change for
      unfolding of RNase T2 in water was estimated to be 5.3 kcal.mol-1 at 25 degrees C
      by linear extrapolation method. From the thermal unfolding experiment in 20 mM
      sodium phosphate buffer at pH 7.5, the Tm and the enthalpy change of RNase T2
      were found to be 55.3 degrees C and 119.1 kcal.mol-1, respectively. From these
      equilibrium and kinetic studies, it was found that the stability of RNAse T2 in
      the native state is predominantly due to the slow rate of unfolding.

PMID- 7795528
TI  - Structures of partridge egg-white lysozyme with and without tri-N
      acetylchitotriose inhibitor at 1.9 A resolution.
AB  - The three-dimensional structures of native partridge egg-white lysozyme (PEWL)
      and PEWL complexed with tri-N-acetylchitotriose inhibitor have been determined
      crystallographically and refined at 1.9 A resolution. Crystals of native and
      complexed protein are isomorphous and have space group and cell dimensions that
      are identical to those of hen egg-white lysozyme (HEWL) under similar
      crystallization conditions. Full occupancy of the trisaccharide in the inhibitor
      complex has allowed definitive modeling and refinement of all three sugar
      residues, located at subsites A, B, and C in the PEWL active site. A comparison
      has been made with HEWL/inhibitor complexes in which coordinates were either not
      refined (Blake CCF, et al., 1967, Proc R Soc B 167:378-388) or were refined at
      partial occupancy (Cheetham JC, Artymiuk PJ, Phillips DC, 1992, J Mol Biol
      224:613-628). Although the loop comprising residues 70-75 is located on the
      surface of the protein and not near the active site, it appears to be affected
      indirectly by trisaccharide binding such that the loop shifts toward the active
      site and becomes relatively immobilized. The source of this loop movement appears
      to be the anchoring of Trp62, located in the active site cleft, as it forms a
      hydrogen bond with O6 of the N-acetylglucosamine at site C. Good electron density
      for the trisaccharide in the PEWL complex structure shows that Asp 101 is
      involved in hydrogen bonding interactions with the terminal sugar residue.

PMID- 7795527
TI  - Purification and preliminary crystallographic studies of penicillin G acylase
      from Providencia rettgeri.
AB  - Two isoforms of the heterodimeric enzyme penicillin G acylase (EC 3.5.1.11) from
      Providencia rettgeri ATCC 31052 (strain Bro1) were purified to near homogeneity.
      The isoforms exhibited comparable enzymatic activities but differed slightly in
      the molecular weight and pI of their respective alpha-subunit. The origin of this
      difference was traced to the partial conversion of the N-terminal Gln of the
      alpha-subunit to pyrrolidonecarboxylic acid (pyro-Glu). The boundaries of the
      mature enzyme within the translated DNA sequence of the wild-type propeptide
      (GenBank M86533) were determined. The results conclusively identified the length
      of the signal peptide and the position of the spacer cleaved from the propeptide
      to form the active heterodimer. The molecular weights of the alpha- and beta
      subunits, based on these termini, were 23.7 and 62.2 kDa, respectively. Both
      isoforms were crystallized independently as hexagonal bipyramids up to 0.60 mm in
      diameter in either space group P6(1)22 or P6(5)22 (a = b = 140.5 A and c = 209.5
      A) from ammonium sulfate solutions buffered by 50 mM potassium phosphate at pH
      7.5. The presence of glycerol, although not required, facilitated crystal growth.
      Native and heavy atom derivative data were collected to 3.0 A resolution, and the
      calculation of isomorphous replacement phases is under way.

PMID- 7795526
TI  - Recombinant immunoglobulin variable domains generated from synthetic genes
      provide a system for in vitro characterization of light-chain amyloid proteins.
AB  - The primary structural features that render human monoclonal light chains
      amyloidogenic are presently unknown. To gain further insight into the physical
      and biochemical factors that result in the pathologic deposition of these
      proteins as amyloid fibrils, we have selected for detailed study three closely
      homologous protein products of the light-chain variable-region single-gene family
      VkIV. Two of these proteins, REC and SMA, formed amyloid fibrils in vivo. The
      third protein, LEN, was excreted by the patient at levels of 50 g/day with no
      indication of amyloid deposits. Sequences of amyloidogenic proteins REC and SMA
      differed from the sequence of the nonpathogenic protein LEN at 14 and 8 amino
      acid positions, respectively, and these amino acid differences have been analyzed
      in terms of the three-dimensional structure of the LEN dimer. To provide a
      replenishable source of these human proteins, we constructed synthetic genes
      coding for the REC, SMA, and LEN variable domains and expressed these genes in
      Escherichia coli. Immunochemical and biophysical comparisons demonstrated that
      the recombinant VkIV products have tertiary structural features comparable to
      those of the patient-derived proteins. This well-defined set of three clinically
      characterized human kIV light chains, together with the capability to produce
      these kIV proteins recombinantly, provide a system for biophysical and structural
      comparisons of two different amyloidogenic light-chain proteins and a
      nonamyloidogenic protein of the same subgroup. This work lays the foundation for
      future investigations of the structural basis of light-chain amyloidogenicity.

PMID- 7795529
TI  - Refined solution structure of human profilin I.
AB  - Profilin is a ubiquitous eukaryotic protein that binds to both cytosolic actin
      and the phospholipid phosphatidylinositol-4,5-bisphosphate. These dual
      competitive binding capabilities of profilin suggest that profilin serves as a
      link between the phosphatidyl inositol cycle and actin polymerization, and thus
      profilin may be an essential component in the signaling pathway leading to
      cytoskeletal rearrangement. The refined three-dimensional solution structure of
      human profilin I has been determined using multidimensional heteronuclear NMR
      spectroscopy. Twenty structures were selected to represent the solution
      conformational ensemble. This ensemble of structures has root-mean-square
      distance deviations from the mean structure of 0.58 A for the backbone atoms and
      0.98 A for all non-hydrogen atoms. Comparison of the solution structure of human
      profilin to the crystal structure of bovine profilin reveals that, although
      profilin adopts essentially identical conformations in both states, the solution
      structure is more compact than the crystal structure. Interestingly, the regions
      that show the most structural diversity are located at or near the actin-binding
      site of profilin. We suggest that structural differences are reflective of
      dynamical properties of profilin that facilitate favorable interactions with
      actin. The global folding pattern of human profilin also closely resembles that
      of Acanthamoeba profilin I, reflective of the 22% sequence identity and
      approximately 45% sequence similarity between these two proteins.

PMID- 7795530
TI  - A proposed structural model of domain 1 of fasciclin III neural cell adhesion
      protein based on an inverse folding algorithm.
AB  - Fasciclin III is an integral membrane protein expressed on a subset of axons in
      the developing Drosophila nervous system. It consists of an intracellular domain,
      a transmembrane region, and an extracellular region composed of three domains,
      each predicted to form an immunoglobulin-like fold. The most N-terminal of these
      domains is expected to be important in mediating cell-cell recognition events
      during nervous system development. To learn more about the structure/function
      relationships in this cellular recognition molecule, a model structure of this
      domain was built. A sequence-to-structure alignment algorithm was used to align
      the protein sequence of the fasciclin III first domain to the immunoglobulin
      McPC603 structure. Based on this alignment, a model of the domain was built using
      standard homology modeling techniques. Side-chain conformations were
      automatically modeled using a rotamer search algorithm and the model was
      minimized to relax atomic overlaps. The resulting model is compact and has
      chemical characteristics consistent with related globular protein structures.
      This model is a de novo test of the sequence-to-structure alignment algorithm and
      is currently being used as the basis for mutagenesis experiments to discern the
      parts of the fasciclin III protein that are necessary for homophilic molecular
      recognition in the developing Drosophila nervous system.

PMID- 7795531
TI  - Stabilization of a strained protein loop conformation through protein
      engineering.
AB  - Staphylococcal nuclease is found in two folded conformations that differ in the
      isomerization of the Lys 116-Pro 117 peptide bond, resulting in two different
      conformations of the residue 112-117 loop. The cis form is favored over the trans
      with an occupancy of 90%. Previous mutagenesis studies have shown that when Lys
      116 is replaced by glycine, a trans conformation is stabilized relative to the
      cis conformation by the release of steric strain in the trans form. However, when
      Lys 116 is replaced with alanine, the resulting variant protein is identical to
      the wild-type protein in its structure and in the dominance of the cis
      configuration. The results of these studies suggested that any nuclease variant
      with a non-glycine residue at position 116 should also favor the cis form because
      of steric requirements of the beta-carbon at this position. In this report, we
      present a structural analysis of four nuclease variants with substitutions at
      position 116. Two variants, K116E and K116M, follow the "beta-carbon" hypothesis
      by favoring the cis form. Furthermore, the crystal structure of K116E is nearly
      identical to that of the wild-type protein. Two additional variants, K116D and
      K116N, provide exceptions to this simple "beta-carbon" rule in that the trans
      conformation is stabilized relative to the cis configuration by these
      substitutions. Crystallographic data indicate that this stabilization is effected
      through the addition of tertiary interactions between the side chain of position
      116 with the surrounding protein and water structure. The detailed trans
      conformation of the K116D variant appears to be similar to the trans conformation
      observed in the K116G variant, suggesting that these two mutations stabilize the
      same conformation but through different mechanisms.

PMID- 7795532
TI  - An automatic method involving cluster analysis of secondary structures for the
      identification of domains in proteins.
AB  - With a growing number of structures available in the Brookhaven Protein Data
      Bank, automatic methods for domain identification are required for the
      construction of databases. Domains are considered to be clusters of secondary
      structure elements. Thus, helices and strands are first clustered using
      intersecondary structural distances between C alpha positions, and dendrograms
      based on this distance measure are used to identify domains. Individual domains
      are recognized by a disjoint factor, which enables the automatic identification
      and classification into disjoint, interacting, and conjoint domains. Application
      to a database of 83 protein families and 18 unique structures shows that the
      approach provides an effective delineation of boundaries and identifies those
      proteins that can be considered as a single domain. A quantitative estimate of
      the interaction between domains has been proposed. The database of protein
      domains is a useful tool for understanding protein folding, for recognizing
      protein folds, and for understanding structure-activity relationships.

PMID- 7795533
TI  - Transmembrane helices predicted at 95% accuracy.
AB  - We describe a neural network system that predicts the locations of transmembrane
      helices in integral membrane proteins. By using evolutionary information as input
      to the network system, the method significantly improved on a previously
      published neural network prediction method that had been based on single sequence
      information. The input data were derived from multiple alignments for each
      position in a window of 13 adjacent residues: amino acid frequency, conservation
      weights, number of insertions and deletions, and position of the window with
      respect to the ends of the protein chain. Additional input was the amino acid
      composition and length of the whole protein. A rigorous cross-validation test on
      69 proteins with experimentally determined locations of transmembrane segments
      yielded an overall two-state per-residue accuracy of 95%. About 94% of all
      segments were predicted correctly. When applied to known globular proteins as a
      negative control, the network system incorrectly predicted fewer than 5% of
      globular proteins as having transmembrane helices. The method was applied to all
      269 open reading frames from the complete yeast VIII chromosome. For 59 of these,
      at least two transmembrane helices were predicted. Thus, the prediction is that
      about one-fourth of all proteins from yeast VIII contain one transmembrane helix,
      and some 20%, more than one.

PMID- 7795534
TI  - Structural features of the uniporter/symporter/antiporter superfamily.
AB  - The uniporter/symporter/antiporter superfamily is an evolutionarily related group
      of solute transporters. For the entire superfamily, we have used a new predictive
      program to identify the transmembrane domains. These transmembrane domains were
      then analyzed with regard to their overall hydrophobicity and amphipathicity. In
      addition, the lengths of the hydrophilic loops connecting the transmembrane
      domains were calculated. These data, together with structural information in the
      literature, were collectively used to produce a general model for the three
      dimensional arrangement of the transmembrane domains.

PMID- 7795535
TI  - Deletion mutants of tyrosine hydroxylase identify a region critical for heparin
      binding.
AB  - Phenylalanine hydroxylase, tyrosine hydroxylase, and tryptophan hydroxylase
      constitute a family of tetrahydropterin-dependent aromatic amino acid
      hydroxylases. It has been proposed that each hydroxylase is composed of a
      conserved C-terminal catalytic domain and an unrelated N-terminal regulatory
      domain. Of the three, only tyrosine hydroxylase is activated by heparin and binds
      to heparin-Sepharose. A series of N-terminal deletion mutants of tyrosine
      hydroxylase has been expressed in Escherichia coli to identify the heparin
      binding site. The mutants lacking the first 32 or 68 amino acids bind to heparin
      Sepharose. The mutant lacking 76 amino acids binds somewhat to heparin-Sepharose
      and the proteins lacking 88 or 128 do not bind at all. Therefore, an important
      segment of the heparin-binding site must be composed of the region from residues
      76 to 90. All of the deletion mutants are active, and the Michaelis constants for
      pterins and tyrosine are similar among all the mutant and wild-type enzymes.

PMID- 7795537
TI  - Integrated case management: the AID Atlanta Model.
AB  - This article describes the integrated case management model being developed by
      AID Atlanta, Inc., a community-based AIDS service organization. The case
      management system features centralized supervision and coordination with
      decentralized delivery of case management services that avoid duplication of
      services. The model establishes a system that links clients to appropriate levels
      of service. The integrated model seeks to address the client's physical,
      psychological, emotional, and spiritual needs across a continuum of care
      delivery. The cornerstone of the system is the development of standards of
      service, systematic documentation, and outcome evaluation criteria.

PMID- 7795536
TI  - Development of the spectrophotofluorometer and its commercialization.

PMID- 7795538
TI  - Case management comes of age.

PMID- 7795539
TI  - A case management program for chemically dependent clients with multiple needs.
AB  - As part of a 3-year federal demonstration project, San Francisco health clinics
      provided case management services to chemically dependent individuals who were
      low-income and often homeless. Many of those participating in the project had
      also been diagnosed with HIV infection and/or mental illness. The intent of the
      demonstration project was to use case management as a mechanism for strengthening
      the linkages between substance abuse treatment and primary care systems. Case
      management was adopted as the catalyst for increased communication between
      medical personnel and other service providers to develop a more comprehensive
      approach to responding to the myriad of client needs. A specially designed
      management information system (MIS) was developed to help document client
      information and case management activities, as well as provide a tickler system
      to improve client continuity. This report integrates both qualitative and
      quantitative findings to provide a context for understanding case management
      activities, client problems and successes, and the systemic problems facing
      clients and case managers in linking primary care, substance abuse treatment, and
      mental health services.

PMID- 7795540
TI  - A tool to assess the cognitively impaired elderly.
AB  - When elderly persons become cognitively impaired, decision-making and case
      management can be intensely frustrating for health care providers who must make
      provisions for both short-term and long-term care. Numerous barriers pose
      challenges to the case managers in addition to those that occur when health care
      terminology does not fit easily into the legal vocabulary of the judge who makes
      the ultimate decision naming a guardian or conservator. Ongoing research by the
      authors has been involved in identifying criteria to determine incompetency by
      both formal and informal caregivers of cognitively impaired elderly. A scale,
      currently consisting of 10 criteria, has been developed and continues to be
      refined by the authors.

PMID- 7795541
TI  - Coordinated care partnership: case management with physician practices.
AB  - This article describes the Coordinated Care Partnership Project, operated by The
      St. Joseph Healthcare System. Funded as one of several demonstration sites by The
      John A. Hartford Foundation, this project places social work and nurse care
      managers in selected primary care physician practices in Albuquerque, NM. Lessons
      learned from the first year of operation are presented, along with implications
      for the role of case management in primary care practice.

PMID- 7795542
TI  - Advancing the state of the art: establishing guidelines for long-term care case
      management.
AB  - This article describes the results of a 15-month project, supported by a grant
      from The Robert Wood Johnson Foundation, to develop case management practice
      guidelines for long-term care. Connecticut Community Care, Inc. (CCCI), a
      nationally recognized case management agency, was the primary contractor for the
      grant. CCCI established and convened the National Advisory Committee on Long-Term
      Care Case Management, a group of case management experts from academia, provider
      organizations, and state and federal government. CCCI facilitated the work of the
      committee and had overall responsibility for financial management, data
      processing, and staff support. The committee's work culminated in a definition of
      long-term care case management, a set of principles underlying its practice, and
      the formulation of guidelines. Results and recommendations from the National
      Advisory Committee will be disseminated to government officials, policymakers,
      administrators, academicians, geriatricians, care providers, and long-term care
      community-based case managers.

PMID- 7795543
TI  - [In memoriam Professor Sir John Mac Michael, foreign honorary member].

PMID- 7795545
TI  - [AIDS Commission].

PMID- 7795544
TI  - [Academic eulogy of Professor Albert Bruce Sabin, foreign honorary member].

PMID- 7795546
TI  - [Type VII C Ehlers-Danlos disease or human dermatosparaxia: the product of a
      fruitful union of so-called fundamental sciences with human and veterinary
      clinical medicine].
AB  - Ehlers-Danlos type VII C disease is a heritable disorder of the connective
      tissues and a disease similar to dermatosparaxia in bovine and other animal
      species. The determination of the pathomechanism of these diseases, the
      inactivity of the specific protease excising the aminoterminal extension of the
      type I collagen precursor, resulted of interactive basic and clinical research.

PMID- 7795547
TI  - [Atrial natriuretic factor and water-sodium homeostasis: concepts and
      perspectives].
AB  - The discovery of an endocrine activity of the heart in 1981 was fundamental in
      order to understand the regulation of the effective circulatory volume. Indeed,
      the hormone which is secreted by the atrial cells (ANF) when these are distended
      suddenly in the presence of an enhanced preload of the heart, acts very rapidly
      upon the kidneys and the vasomotor tone. Its action restores without delay the
      effective circulatory volume following the renal elimination of an appropriate
      fraction of salt and water and attenuates the pressor effects of the increased
      intravascular volume. In this regard, the hormone is an emergency mediator. ANF
      may also be a long-term regulator of salt and water homeostasis by modulating the
      renal excretion of sodium. Finally, its role in pathological conditions such as
      congestive heart failure or essential hypertension remains to be elucidated.
      Nevertheless, interesting therapeutic perspectives may be considered, based on
      the unusual inactivation of ANF by clearance receptors.

PMID- 7795548
TI  - [Academic eulogy of Professor Albert De Vuyst, titular member and former
      president].

PMID- 7795549
TI  - [In memoriam Professor Andre Lemaire, foreign honorary member].

PMID- 7795551
TI  - [The transplantation of syngeneic Schwann cells in medullary lesions: results,
      limitations and perspectives].
AB  - After a central nervous system (CNS) injury, there is only an "abortive
      regeneration" of axons, while injured axons regenerate vividly in the peripheral
      nervous system (PNS). This difference is due, at least in part, to the existence
      in the periphery of Schwann cells and of growth promoting proteins they
      synthetize. One strategy to promote regrowth of central axons can be therefore,
      to modify (i.e. "peripheralize") the microenvironment by transplanting
      biologically active Schwann cells into the lesion site. In a rat model of
      traumatic paraplegia by inflation of a subdural microballoon, we performed
      syngeneic transplants of Schwann cells. These cells are cultured from adult
      dorsal root ganglia and can be kept in vitro for several months. They are
      transplanted in the injured spinal cord. The grafted Schwann cells are well
      integrated in the host tissue without detectable inflammatory reaction. Cystic
      cavitation and astrogliosis are reduced in grafted animals as compared to
      injured, non-grafted animals. The transplant is invaded by abundant, mainly
      unmyelinated axons which are immunoreactive for substance P, VIP or CGRP, i.e.
      transmitters known to be present in DRG afferents. Supraspinal afferents
      containing 5HT, TH or CCK accumulate at the rostral margin of the graft.
      Experimental procedures trying to stimulate the invasion of the graft by
      descending fibers, i.e. by inducing a chemoattraction are therefore of crucial
      importance for functional recovery.

PMID- 7795550
TI  - [Molecular cloning and functional expression of glucagon receptors in the liver,
      the heart and various other tissues].
AB  - The mRNA for a glucagon receptor is present in five glucagon-responsive tissues
      of rat, including the liver, heart, pancreatic islets, kidneys and adipose
      tissue. The mature mRNA of this receptor is likely to derive from one gene only
      in all tissues investigated. The maturation of the pre-mRNA requires the splicing
      of 11 introns. This proceeds stepwise at the 5' end but a single intronless ORF
      is finally operative. The receptor is a glycoprotein endowed with 485 amino acids
      (including the signal peptide).

PMID- 7795552
TI  - [Role of carotid surgery in the prevention of cerebral infarction].
AB  - A significant part of transient or permanent cerebral ischemic attacks (CIA) are
      due to arterio-arterial emboli issued from carotid plaques. Surgery for carotid
      disobstruction aims to take out emboligenic plaques by endarterectomy (associated
      to angioplasty or not). The adversaries of surgical treatment sustain two main
      assertions: 1. carotid stenoses are not very dangerous, because the definitive
      thromboses they create are easily compensated by the development of collaterals,
      so that the risk for stroke is low. 2. this low and late risk of spontaneous
      carotid thrombosis is not greater than the immediate one following carotid
      surgery. Those objections have been encountered in randomized North American
      studies (Nascet & Veterans) that have been published in 1991 and 1993. They show
      the usefulness of correctly done surgical correction as well as for symptomatic
      as asymptomatic stenoses. So do we it, presenting the results of our series
      (2.282 procedures in 1.868 patients). The results of our series show a low
      combined morbidity-mortality rate (1.7%), and a yearly stroke of 1.4%.

PMID- 7795553
TI  - Hantavirus pulmonary syndrome in Canada.

PMID- 7795554
TI  - Preliminary report: comparative evaluation of the effectiveness of gas
      sterilizers.

PMID- 7795555
TI  - Concise overview of the clinical pharmacokinetics of dideoxynucleoside
      antiretroviral agents.
AB  - In this paper aspects of the clinical pharmacokinetics of the antiretroviral
      agents zidovudine, didanosine and zalcitabine are reviewed. Special attention is
      paid to possibly altered pharmacokinetics in special circumstances, such as
      hepatic and renal dysfunction, pregnancy, stage of disease, etc. The
      dideoxynucleoside antiretroviral agents have some clinical pharmacokinetic
      properties in common (rapid absorption and elimination), but substantial
      differences exist in their degree of absorption, metabolism and penetration into
      the cerebrospinal fluid. All agents display wide interpatient variability in
      pharmacokinetic parameters. The relevance of therapeutic drug monitoring of
      antiretroviral agents is also discussed.

PMID- 7795557
TI  - Preparation and evaluation of sodium diclofenac controlled-release tablets. II.
      Dibasic calcium phosphate as a retardant in mixtures for direct compression.
AB  - The dissolution behaviour of a direct compression compact prepared with sodium
      diclofenac and dibasic calcium phosphate (DCP) in different weight ratios with or
      without Biosoluble polymer (acrylic-based resin) was investigated in distilled
      water and in a medium with changing pH. The results indicate that the amount of
      sodium diclofenac released from the compact was dependent on the amount of drug
      and DCP used in the compact, and was also controlled by the amount of Biosoluble
      polymer added. A chemical reaction forming diclofenac acid might occur on the
      surface of the sodium diclofenac compact during exposure to the acidic medium,
      which was confirmed by diffuse-reflectance spectroscopy. The tablet with a 1:2
      weight ratio of sodium diclofenac to DCP exhibited a sustained-release behaviour,
      similar to commercial sustained-release products (Voltaren SR-100 and Grofenac
      Retard), but a lower release rate was found as compared to the commercial
      products. The dissolution behaviour of the study tablet and the commercial
      products was found to be dependent on the dissolution medium and the rotating
      speeds. Glass beads were added to the dissolution assembly to simulate the
      influence of food, and the enhanced friction between tablet and glass beads might
      result in a higher dissolution rate of the tablet and the commercial products.

PMID- 7795558
TI  - Information about drugs in family magazines.
AB  - Family magazines can play an important role in the diffusion of medical
      information and information regarding drugs to a 'lay audience'. We describe what
      kind of drugs are discussed in the family magazines and which information
      regarding these drugs is given. Furthermore, we look into the information sources
      for journalists; special attention is paid to the role of the pharmacist: is
      (s)he recognized by journalists as one of the experts on drugs? Two approaches
      were used in order to answer the above described research questions: a content
      analysis of family magazines and in-depth interviews of journalists.
      Gynaecological products as well as drugs for the central nervous system receive
      much attention in family magazines. The kind of information given about drugs is
      limited. Only part of the publications pays attention to side-effects. Patients
      asking questions about drugs in response to publications in family magazines know
      the name of a drug but are rarely informed about other aspects of the therapy,
      such as side-effects. In the provision of information physicians and medical
      specialists play an important role as sources of information for journalists.
      There is, however, until now no role for the pharmacist as a source of
      information on drugs in family magazines.

PMID- 7795556
TI  - Corticosteroid receptor antagonists: a current perspective.
AB  - This review aims to highlight a selection of antagonists for the
      mineralocorticoid and glucocorticoid receptors. Concepts of these receptor
      systems are described, as is the mechanism of action of these steroids in the
      brain and periphery. Examples of commonly available and newly synthesized
      antimineralocorticoids and antiglucocorticoids are given, together with their
      pharmacological profiles and, when appropriate, clinical and therapeutic
      applications.

PMID- 7795559
TI  - Colorimetric determination of some amino acids containing a sulfur group.
AB  - A simple and rapid colorimetric method for the determination of some amino acids
      containing a sulfur group is described. The studied compounds are cysteine,
      cystine and methionine. The method is based on the formation of ferroin, from the
      reaction of the studied drugs with a mixture of iron(III) and 1,10-phenanthroline
      and measurement of the absorbance at 512 nm. The procedure has been successfully
      applied to the assay of the pharmaceutical preparations of the studied drugs
      after thin-layer chromatographic separation and the results of the studied
      compounds compare favourably with the official methods.

PMID- 7795560
TI  - In memoriam Sydney R. Smith, PhD (December 27, 1923-December 12, 1994).

PMID- 7795561
TI  - Integrating feminist and psychodynamic principles in the treatment of an eating
      disorder patient: implications for using countertransference responses.
AB  - Patients who struggle with a tenacious eating disorder commonly stir strong
      countertransference feelings in therapists. The author describes a patient who
      for a number of years had been unresponsive to traditional treatment
      interventions for anorexia nervosa and bulimic tendencies. By combining
      principles derived from psychodynamic treatment and contemporary feminist
      thought, the therapist was gradually able to help the patient engage in the
      treatment process. Managing a variety of strong countertransference feelings was
      instrumental to the process. The author underscores the need for patients to take
      greater personal responsibility, develop self-critical and self-analytical
      capacities, learn to embrace contradictions in the self, and disavow the tendency
      to harbor fantasies of utopia, perfection, and "cure."

PMID- 7795562
TI  - Eating disorders, addictions, and unconscious fantasy.
AB  - Using concepts from object relations theory, the author extends the theories of
      eating disorders advanced by Freud and Bruch. Ogden's sensation-based autistic
      contiguous position, Tustin's related concepts of autistic shapes and objects,
      and Fairbairn's theory of object relations are related to the addictive nature of
      eating disorders. A clinical illustration demonstrates how these recent
      theoretical concepts can help explain the unique qualities of the transference
      and countertransference that develop when working with eating disorder patients.

PMID- 7795563
TI  - Medical procedures as a source of trauma.
AB  - Many medical procedures, while necessary and appropriate, may be experienced by a
      child or adolescent as a trauma, with the medical personnel considered as
      perpetrators in collusion with the parents. The medical procedures and the
      conditions requiring them are seldom the focus of routine history-taking or
      therapeutic process. Nevertheless, the long-range effects of these events may
      have serious and adverse effects on future development and psychopathology. The
      author presents several clinical examples.

PMID- 7795564
TI  - Trauma and violence: the role of early abuse in the aggressive behavior of two
      violent psychotic women.
AB  - The author explores the impact of early-life physical and sexual abuse on later
      life violent behavior in two psychotic women. He proposes that their defending
      against the aftermath of early and severe abuse is a dynamic factor in the
      development and maintenance of violent behavior. He also focuses on the influence
      of maladaptive defensive operations and the impact of abuse on violence
      triggering hallucinations and delusions. Finally, he contends that psychotherapy
      can contribute positively to enhanced control of violent behavior, even in
      severely violent and psychotic patients.

PMID- 7795566
TI  - Effects of depression and antidepressants on sexual functioning.
AB  - With serotonergic antidepressants dominating the treatment of depressive
      disorders, antidepressant-induced sexual side effects have emerged as a major
      clinical issue. Surprisingly, the effects of depression on sexuality are less
      well established and more variable than previously thought. It is likely that
      antidepressants with strong serotonergic effects--selective serotonin reuptake
      inhibitors, clomipramine, and monoamine oxidase inhibitors--are associated with
      higher rates of sexual side effects, compared to other antidepressant classes.
      Orgasmic and ejaculation difficulties are prominent with these medications,
      although alterations in libido, arousal, and erectile function are also common.
      Treatment of these side effects includes both general strategies and specific
      antidotes, such as cyproheptadine, yohimbine, dopamine agonists, and buspirone.

PMID- 7795565
TI  - Using the SCID-D to assess dissociative identity disorder in adolescents: three
      case studies.
AB  - The authors report on the diagnostic assessment of dissociative identity disorder
      in three adolescents using the Structured Clinical Interview for DSM-IV
      Dissociative Disorders (SCID-D; Steinberg, 1993b), a semistructured instrument
      for the diagnosis and assessment of dissociative symptoms and disorders. Although
      the SCID-D has received good-to-excellent ratings for reliability and validity in
      the adult population, these three cases are the first reports of the results of
      its administration to younger patients. Comparison of the three adolescent SCID-D
      interviews with findings in adults indicates that the profiles of the five
      dissociative symptoms measured by the SCID-D are virtually identical in
      adolescents and adults. The authors conclude with suggestions for future research
      regarding dissociative symptomatology in adolescents and outcome studies.

PMID- 7795567
TI  - The impact of homelessness on children's level of aspiration.
AB  - In a sample of 39 school-age homeless children, their length of stay in shelters
      for the homeless was significantly correlated with an index of their level of
      aspiration. This correlation remained significant even when the effects of the
      children's intelligence and their performance on a related cognitive task were
      partialed out. Stories given in response to two Thematic Apperception Test cards
      by a small sample of these children illustrate the potentially traumatic
      consequences of homelessness on children's hopes and aspirations.

PMID- 7795568
TI  - Transactions of the Topeka Psychoanalytic Society.

PMID- 7795569
TI  - Integrated treatment of social phobia.
AB  - The importance of recognizing and properly treating social phobia is emphasized
      by its surprising prevalence and the accompanying marked disability. The author
      describes how substantial treatment gains can be provided with both
      psychopharmacological and psychotherapeutic approaches. For those who are
      significantly affected, a combination approach may be most useful. Appropriate
      treatment also requires appreciation of comorbid disorders. The author concludes
      that overall outcome can be enhanced by giving special attention to the dynamic
      aspects of the therapeutic relationship, as well as by being aware of possible
      changes in patients' relationships with others as treatment progresses.

PMID- 7795570
TI  - Anxiety disorders in women.
AB  - Existing research indicates that anxiety disorders are three times as common in
      women as in men. Yet true gender-based research is still in its infancy. The
      author discusses key areas affecting the occurrence of anxiety disorders in
      women, including medical conditions, epidemiological and diagnostic perspectives,
      work and the reproductive cycle, trauma (including abuse), and marriage and the
      family. She notes that future research is likely to produce rapid change and
      reevaluation in many of these core issues. She concludes that both genders will
      benefit because evaluation and treatment can truly be tailored to the specific
      needs of each individual man or woman.

PMID- 7795572
TI  - Anxiety and addiction: a clinical perspective on comorbidity.
AB  - Substance use disorders and the anxiety disorders, the two most prevalent mental
      disorders in the United States, are often comorbid, undiagnosed, and poorly
      treated. Confusion and controversy over comorbidity can complicate the treatment
      of both disorders. The author reviews the connections between addiction and
      anxiety and offers four practical guidelines for clinicians dealing with this
      comorbidity.

PMID- 7795571
TI  - Integrated treatment of panic disorder.
AB  - Epidemiological studies suggest that about 3.5% of the adult United States
      population meet criteria for panic disorder, and that an additional 2-5% suffer
      from agoraphobia with or without panic. Both biological and behavioral models
      have been proposed to elucidate the nature of this disorder. The authors review
      research findings regarding these models, as well as pharmacological and
      cognitive-behavioral treatment approaches. The complexity of factors contributing
      to the disorder suggests the need for an integrated treatment approach involving
      considerations of combination drug therapy and psychosocial interventions.

PMID- 7795573
TI  - Anxiety disorders in primary care.
AB  - Studies indicate that persons with anxiety disorders seek treatment from general
      medical facilities as often as they do from mental health care settings. Yet
      primary care providers often do not recognize and treat these individuals
      effectively, perhaps because anxiety disorders present differently in the general
      health setting. In light of this situation, the authors note the need to
      disseminate efficacious treatment approaches to primary care settings. With this
      goal in mind, they review the prevalence of anxiety in the community and in
      primary care patients, the presentation of anxiety disorders in primary care, how
      to improve recognition of anxiety and depression in primary care, and treatment
      strategies for primary care providers.

PMID- 7795574
TI  - Challenges to providing integrated treatment of anxiety disorders.
AB  - Although anxiety disorders are among the most common psychiatric conditions, a
      number of factors in the current health care scene pose challenges to providing
      effective, integrated treatment. The author describes nine specific challenges,
      including lack of recognition of the disorder by both patients and physicians.
      Other challenges include lack of gender-based research, comorbidity issues,
      differing etiological and ideological perspectives, the burgeoning of
      pharmacological treatments, and the tendency to adopt an "either/or,"
      pharmacological versus psychotherapeutic approach to treatment. The author
      concludes that the overarching challenge is to disseminate the increasing
      knowledge of these disorders so that practitioners can provide the most
      effective, integrated treatment.

PMID- 7795575
TI  - Transgenic animals as models for human disease.
AB  - Since its first description in 1981 (1), transgenic technology has greatly
      influenced the focus and direction pace of biomedical research. Introduction of
      foreign DNA into the genome of animals by microinjection into fertilized oocytes
      is now used in almost every field of research spanning from oncology, immunology
      and neurology to cardiovascular medicine. The ability to integrate genes in the
      germline and their successful expression in the host provides an opportunity to
      study the role of a certain gene in the initiation and propagation of disease.
      Transgenic methodology serves as the link between molecular biology, introducing
      in vitro a defined genetic modification and whole animal physiology, with the
      resulting in vivo alteration of body function. This potential has been exploited
      to study the pathophysiological role of human genes. Transgenic animals have been
      used to study aspects of tumor development, immune regulation, cardiovascular
      development and atherosclerosis. These studies have provided new insights into
      the genetic origin of certain diseases and have improved our understanding of
      pathological processes on the cellular level. As a future goal, these studies may
      also serve the development of new diagnostic tools or novel therapeutic
      strategies such as gene therapy.

PMID- 7795576
TI  - The mechanism responsible for hypertension in a patient with Guillain-Barre
      syndrome.
AB  - We report a case of hypertension associated with Guillain-Barre syndrome. In this
      case, the circadian variation of blood pressure was interrupted. Examination of
      neurohumoral factors revealed a hyperactive sympathetic nervous system and an
      increase in plasma renin activity. Clonidine, which acts centrally to inhibit
      sympathetic outflow, did not suppress serum norepinephrine or epinephrine. These
      observations suggest that autonomous hyperactivity of the efferent pathway of the
      sympathetic nervous system may cause the sustained hypertension throughout the
      day in this case.

PMID- 7795578
TI  - Alterations of cardiac alpha- and beta-adrenoceptors and inotropic responsiveness
      in hypertensive transgenic rats harbouring the mouse renin gene (TGR(mREN2)27).
AB  - In the present study, we investigated the alpha- and beta-adrenoceptor-mediated
      effects on myocardial force of contraction (using phenylephrine in the presence
      of propranolol and isoprenaline) and receptor densities (binding studies using
      [3H]-prazosin and [125I]-iodocyanopindolol) in hypertensive transgenic rats
      (TGR(mREN2)27) and age-matched Sprague-Dawley rats (SP) as controls. In
      TGR(mREN2)27 the positive inotropic effects of isoprenaline and phenylephrine
      were reduced, while the effect of Ca2+ was unchanged. The EC50-values did not
      differ in both groups. A down-regulation of the beta-adrenoceptors was observed
      in the hypertrophied left ventricles of transgenic rats, which is postulated to
      be involved in the reduced beta-adrenoceptor-mediated positive inotropic effect.
      The alpha-adrenoceptor density was increased, which could represent a
      compensatory mechanism for the impaired effectiveness of the beta-adrenergic
      pathway. However, since the effect of alpha-adrenoceptor agonist is not enhanced
      but even reduced, an uncoupling of alpha-adrenoceptors from post receptor events
      could play a role in the observed effects.

PMID- 7795577
TI  - BNP plasma levels during acute volume expansion and chronic sodium loading in
      normal men.
AB  - Since the isolation of porcine brain natriuretic peptide (pBNP) in 1988, many
      aspects of this new endocrine and paracrine system have been elucidated. However,
      the precise role of human BNP (hBNP) in the regulation of sodium balance and
      blood pressure in men is still unclarified. We investigated the impact of acute
      volume expansion and high sodium intake on ANP and BNP plasma levels of 21
      healthy male subjects. Following acute infusion of 2000 ml 0.9% saline into a
      peripheral vein over 30 minutes in a lying position, ANP levels in plasma
      increased from 110 +/- 14 pg/ml to 199 +/- 18 pg/ml (p < 0.001), while BNP levels
      remained constant (26 +/- 3 pg/ml before, 28 +/- 3 pg/ml after volume expansion).
      In a second experiment we investigated the change of ANP and BNP plasma levels
      after five days of controlled sodium intake (Here blood tests were taken from the
      probands in an upright position). ANP levels averaged 42 +/- 5 pg/ml after low
      and 73 +/- 14 pg/ml after high sodium intake. Before starting the diet, the ANP
      fasting blood level was 56 +/- 6 pg/ml. During both diets, plasma BNP was not
      altered significantly, but we found a slight insignificant increase after high
      sodium intake. At the end of each diet we tested ANP and BNP secretion by a
      physical exercise in an upright position. After high salt intake, BNP plasma
      levels rose from 32 +/- 4 pg/ml at rest to 45 +/- 7 pg/ml (p < 0.025) after 15
      minutes of exercise, while ANP rose from 73 +/- 14 pg/ml to 120 +/- 20 pg/ml (p <
      0.001). These results suggest a different regulation of ANP and BNP in normal
      subjects. ANP secretion is modulated by volume loading and by low or high salt
      intake while BNP responses to physical exercise.

PMID- 7795579
TI  - The role of the adrenal medulla in neural control of blood pressure in rats.
AB  - The role of the adrenal medulla in the regulation of blood pressure was assessed
      in rats. In conscious intact (SHAM) and adrenal demedullated (DEMED) animals,
      baseline blood pressures and heart rates were not different. Moreover, equivalent
      pressor and depressor response curves to norepinephrine and sodium nitroprusside
      were obtained. Plasma concentration and 24 hr urinary excretion of norepinephrine
      were not altered by demedullation. However, epinephrine was undetectable in the
      urine of the DEMED rats. The effectiveness of the demedullation was further
      evidenced by a greater than 99% decrease in the epinephrine and norepinephrine
      content of the adrenal glands of DEMED animals. In pithed SHAM rats, electrical
      stimulation of preganglionic sympathetic neurons (.5 to 16 hz) elicited marked
      increases in plasma epinephrine indicating adrenal stimulation, whereas in DEMED
      rats there were no increases. Furthermore, increments in plasma norepinephrine
      were significantly reduced in DEMED rats, yet the blood pressure increases were
      greater than in SHAM rats. Thus, adrenal catecholamine release did not contribute
      to the blood pressure responses, but in fact, may have had an opposite action due
      to the vasodilatory actions of epinephrine. The results demonstrate that the
      adrenal medulla is not essential for reflex compensation to a hypotensive
      challenge or to the blood pressure increases produced to direct neural
      stimulation.

PMID- 7795581
TI  - Effect of enalapril on hemorheology in hypertensive patients with renal disease.
AB  - An open, prospective study was undertaken to investigate the effects of enalapril
      on hemorheology in patients with renal disease and complicating hypertension.
      Cellular and plasma determinants of blood viscosity and renal function were
      measured in 19 patients at baseline and 2, 60 and 120 days after treatment with
      enalapril (mean dose 5.4; range 2.5-20 mg/day). Within 2 days of starting
      enalapril there was a significant decrease in apparent blood viscosity measured
      at high shear rate (-0.15 mPa.s; p < 0.05) which fell further by day 60. The
      decrease in blood viscosity was primarily the result of hemodilution, as
      evidenced by a concurrent fall in plasma albumin concentration and plasma
      viscosity. A small, but significant decrease, in hemoglobin concentration (
      7.4g/l; p = 0.03), and a trend of improved red blood cell (RBC) and white blood
      cell (WBC) rheological properties may have also contributed to the decrease in
      blood viscosity. We conclude that enalapril had a beneficial effect on
      hemorheology in patients with renal disease. The mechanism of the rheological
      changes appeared to be multifactorial and would be expected to decrease vascular
      resistance to blood flow.

PMID- 7795580
TI  - Autoradiographic localization of dopamine D2-like receptors in the rat adrenal
      gland.
AB  - The pharmacological profile and the anatomical localization of dopamine D2-like
      receptors were studied in sections of the rat adrenal gland using combined
      radioligand binding and autoradiographic techniques with [3H]-spiroperidol as a
      ligand. [3H]-Spiroperidol was bound to sections of the rat adrenal gland in a
      manner consistent with the labelling of dopamine D2-like receptor sites. The
      binding was time-, temperature- and concentration-dependent and of high affinity
      with a dissociation constant (Kd) value of 1.6 +/- 0.04 nM and a maximum density
      of binding sites (Bmax) of 60 +/- 3.6 fmol/mg tissue. Experiments on the
      pharmacological specificity of [3H]-spiroperidol binding to sections of the rat
      adrenal gland suggest the labelling of dopamine D3 and/or D4 receptors. The
      presence of dopamine D3 and D4 receptors in the rat adrenal gland was confirmed
      by the demonstration of a specific binding for the D3 radioligand [3H]-7-hydroxy
      N,N-di-n-propyl-2-aminotetralin (DPAT) and for the D4 radioligand [3H]-clozapine.
      Light microscope autoradiography showed the highest accumulation of silver grains
      which correspond to [3H]-spiroperidol binding sites in the rat adrenal medulla.
      In the adrenal cortex, where density of silver grains is about 40% lower than in
      the medulla, the radioligand is accumulated primarily in the zona glomerulosa and
      to a lesser extent in the zona reticularis. These findings suggest that dopamine
      D2-like receptor sites in the rat adrenal gland cortex are primarily involved in
      the modulation of catecholamine secretion from the medulla and of aldosterone
      secretion from the cortex. The possible relevance of the occurrence of dopamine
      D3 and D4 receptor subtypes in the adrenal gland is discussed.

PMID- 7795582
TI  - Effect of nicorandil on cardiac dysfunction during reperfusion in normotensive
      and spontaneously hypertensive rats.
AB  - The cardioprotective effect of nicorandil, an opener of ATP-sensitive potassium
      channels, was studied in the isolated perfused hearts of the spontaneously
      hypertensive rat (SHR) and normotensive Wistar-Kyoto (WKY) rat. The hearts were
      subjected to 30 min of global ischemia followed by 30 min of reperfusion.
      Controls received no drug. In the nicorandil group, the hearts were treated with
      0.03 to 0.3 mmol/L nicorandil for 15 min before ischemia. Left ventricular
      developed pressure (LVDP) and end diastolic pressure (LVEDP) at 30 min of
      reperfusion were significantly lower and larger, respectively, in SHR than in WKY
      rats. Nicorandil improved LVDP and decreased LVEDP at 30 min of reperfusion in
      both SHR and WKY rats dose-dependently. The hypertensive heart in the early stage
      is already susceptible to reperfusion-cardiac dysfunction. Nicorandil has a
      beneficial effect on the post-ischemic dysfunction in both SHR and WKY rats.

PMID- 7795583
TI  - Mutations in FGFR1 and FGFR2 cause familial and sporadic Pfeiffer syndrome.
AB  - Pfeiffer syndrome (PS) is an autosomal dominant skeletal disorder which affects
      the bones of the skull, hands and feet. Previously, we have mapped PS in a subset
      of families to chromosome 8cen by linkage analysis and demonstrated a common
      mutation in the fibroblast growth factor receptor-1 (FGFR1) gene in the linked
      families. Here we report a second locus for PS on chromosome 10q25, and present
      evidence that mutations in the fibroblast growth factor receptor-2 (FGFR2) gene
      on 10q25 cause PS in an additional subset of familial and sporadic cases. Three
      different point mutations in FGFR2, which alter the same acceptor splice site of
      exon B, were observed in both sporadic and familial PS. In addition, a T to C
      transition in exon B predicting a cysteine to arginine substitution was
      identified in three sporadic PS individuals. Interestingly, this T to C change is
      identical to a mutation in FGFR2 previously reported in Crouzon syndrome, a
      phenotypically similar disorder but one lacking the hand and foot anomalies seen
      in PS. Our results highlight the genetic heterogeneity in PS and suggest that the
      molecular data will be an important complement to the clinical phenotype in
      defining craniosynostosis syndromes.

PMID- 7795585
TI  - Familial adenomatous polyposis: desmoid tumours and lack of ophthalmic lesions
      (CHRPE) associated with APC mutations beyond codon 1444.
AB  - An earlier study has shown that FAP patients with mutations in codons 136-302 of
      the APC gene do not develop congenital hypertrophy of the retinal pigment
      epithelium (CHRPE), whereas those with mutations in codons 463-1387 regularly do.
      Here we present data on 36 patients from 20 families with mutations in codons
      1445-1578. These patients lack CHRPE. Furthermore, with the exception of three
      prepubertal children all patients with mutations in codons 1445-1578 developed
      desmoid tumours. This relationship between certain extracolonic manifestations
      and site of the APC mutation points to a specific role of the APC protein in
      different tissues.

PMID- 7795584
TI  - Dp140: a novel 140 kDa CNS transcript from the dystrophin locus.
AB  - We have identified a 7.5 kb transcript from the dystrophin locus which encodes a
      novel 140 kDa protein (Dp140). Based on immunoblotting Dp140 consists of the
      distal rod domain and C-terminus of 427 kDa dystrophin and is found throughout
      the CNS. This protein is transcribed from an alternative promoter in the
      dystrophin locus upstream to exon 45. The unique 5' first exon is conserved
      between rat and human. The transcript has a 1 kb 5' untranslated region, and the
      first methionine initiation codon occurs in exon 51, predicting a protein of 140
      kDa. Several studies report that Duchenne dystrophy patients with deletions in
      the exon 45-52 region have an increased incidence of cognitive impairment. Such
      deletions would affect expression of 427 kDa dystrophin and this shorter 140 kDa
      isoform but not the recently described small distal transcripts Dp116 or Dp71,
      suggesting particular importance to CNS function.

PMID- 7795586
TI  - Mucopolysaccharidosis IVA: screening and identification of mutations of the N
      acetylgalactosamine-6-sulfate sulfatase gene.
AB  - Mutations causing mucopolysaccharidosis IVA in 15 Japanese and one Caucasian
      patient were characterized. To screen these mutations, we used a combination of
      single strand conformation polymorphism analysis and heteroduplex analysis for
      PCR products of targeted cDNA or genomic DNA. Various small mutations were
      identified in 23 of 26 alleles, while the other six alleles had large
      rearrangements. Cycle sequencing of PCR products revealed 15 different mutations,
      including 12 missense, one nonsense, one frame shift (2 bp deletion) and one
      splice site mutation, in accord with the broad range of clinical phenotypes. Two
      alleles have different mutations in the same nucleotide position of exon 3 (R94C,
      CGC-->TGC; R94G, CGC-->GGC), diagnosed by sequencing and by allelic-specific
      oligohybridization (ASO). One allele had two amino acid changes, E450V in exon 12
      and V488M in exon 13, thereby indicating a double point mutation. All 16
      mutations reported were confirmed by restriction enzyme assay or by allelic
      specific oligohybridization. Transfection of mutagenized cDNAs into patients'
      fibroblasts showed that all mutations caused completely deficient or markedly
      decreased N-acetylgalactosamine-6-sulfate sulfatase (GALNS) activity, thereby
      indicating that these mutations were responsible for the enzyme deficiency.

PMID- 7795587
TI  - DNA binding capacity of the WT1 protein is abolished by Denys-Drash syndrome WT1
      point mutations.
AB  - Constitutional point mutations in the zinc finger (ZF) region of the Wilms'
      tumour suppressor gene 1 (WT1) lead to Denys-Drash syndrome (DDS). Patients with
      this syndrome display renal failure, Wilms' tumour (WT) and
      pseudohermaphroditism. DDS WT1 mutations fall into three major categories: (a)
      missense mutations altering amino acids which directly interact with the DNA
      target; (b) substitution of amino acids involved in zinc complexing; and (c)
      nonsense mutations leading to the removal of at least two zinc fingers. We have
      expressed the WT1 zinc fingers as glutathione-S-transferase fusion proteins, with
      the lysine-threonine-serine (KTS) alternate splice between ZF3 and ZF4 either
      present or absent. WT1 fusion constructs with all three classes of DDS mutation
      were also created. Wild-type and mutant fusion proteins were assayed for their
      DNA-binding affinity using four previously identified WT1 DNA targets: an EGR1
      consensus site; murine insulin-like growth factor 2 promoter 2 (IGF2P2); a (TCC)n
      motif from the PDGFA-chain promoter; and +P5, a genomic fragment isolated by its
      affinity for WT1 + KTS. WT1-KTS bound all four targets, but WT1 + KTS only bound
      +P5. All three classes of DDS mutation investigated, with or without KTS,
      abolished binding to all four targets. This provides evidence that DDS mutations
      act either as dominant-negative antimorphs, or elicit their effect through
      disturbed isoform dosage balance.

PMID- 7795588
TI  - Tissue-specific expression of a FMR1/beta-galactosidase fusion gene in transgenic
      mice.
AB  - Fragile X syndrome is one of the most common genetic causes of mental
      retardation, yet the mechanisms controlling expression of the fragile X mental
      retardation gene FMR1 are poorly understood. To identify sequences regulating
      FMR1 transcription, transgenic mouse lines were established using a fusion gene
      consisting of an E.coli beta-galactosidase reporter gene (lacZ) linked to a 2.8
      kb fragment spanning the 5'-region of FMR1. Five transgenic mouse lines showed
      lacZ expression in brain, in particular in neurons of the hippocampus and the
      granular layer of the cerebellum. Expression of the reporter gene was also
      detected in Leydig cells and spermatogonia in the testis, in many epithelia of
      adult mice, and in the two other steroidogenic cell types, adrenal cortex cells
      and ovarian follicle cells. Embryonic tissues which showed strong activity of the
      reporter gene included the telencephalon, the genital ridge, and the notochord.
      This expression pattern closely resembles the endogenous one, indicating that the
      5' FMR1 gene promoter region used in this study contains most cis-acting elements
      regulating FMR1 transcription.

PMID- 7795589
TI  - Molecular basis of p(CCG)n repeat instability at the FRA16A fragile site locus.
AB  - Rare, folate-sensitive fragile sites are the result of the unstable expansion of
      trinucleotide p(CCG)n repeats, which are normally polymorphic in copy number.
      Differences in the number and frequency of alleles of the fragile site FRA16A
      p(CCG)n repeat were observed between different ethnic populations suggesting that
      certain alleles might be predisposed to instability. Sequence analysis
      demonstrated that the longer and more variable alleles were associated with loss
      of repeat interruption. Perfect repeat configuration therefore appears to be a
      necessary precondition for the instability associated with fragile site genesis.

PMID- 7795590
TI  - Cloning of a human homologue of the Xenopus laevis APX gene from the ocular
      albinism type 1 critical region.
AB  - Ocular albinism type 1 (OA1) is an X-linked recessive disorder characterized by a
      major impairment of visual acuity, nystagmus, strabismus, photophobia and retinal
      hypopigmentation. From the analysis of patients carrying deletions and
      translocations involving the distal short arm of the X chromosome (Xp22.3) we
      have identified a region of approximately 110 kb in which the OA1 gene must lie.
      We have extensively searched for genes in this region using a variety of
      techniques which included exon amplification, cDNA selection and direct
      hybridization of cosmid inserts to cDNA libraries. Putative exons identified by
      exon amplification were used to screen a human retina cDNA library and several
      cDNA clones corresponding to an approximately 7.5 kb transcript were isolated and
      characterized. Transcripts of this newly identified gene were found to be
      abundant in retina and melanoma and could also be detected in brain, placenta,
      lung, kidney and pancreas. Interestingly, sequence analysis revealed that this
      new gene encodes a 1616 amino acid protein sharing significant similarities with
      the Apical Protein from Xenopus laevis (APX) which is implicated in amiloride
      sensitive sodium channel activity. The gene, termed APXL (APX-Like), spans
      approximately 160 kb, contains 10 exons and covers over 70% of the 110 kb
      critical region for OA1. A truncated pseudogene sharing very high levels of
      homology with the rat eIF-5 gene, a eukaryotic translation initiation factor, was
      found to lie in the middle of intron 1. APXL was found deleted in two patients
      with contiguous gene syndromes including OA1 and in one patient with isolated
      OA1. Mapping, expression and patient analysis data led us to consider the APXL
      gene a strong candidate for the OA1 gene. DNA from 57 unrelated patients with OA1
      was, therefore, scanned for mutations in the coding region, using both SSCP
      analysis and direct sequencing. No functionally significant mutation was
      identified, suggesting that APXL is not directly involved in OA1. Further studies
      are needed to clarify the physiologic role of this highly conserved gene.

PMID- 7795591
TI  - Spectrum of germline mutations in the RB1 gene: a study of 232 patients with
      hereditary and non hereditary retinoblastoma.
AB  - Germline mutations in the RB1 gene confer hereditary predisposition to
      retinoblastoma. We have performed a mutation survey of the RB1 gene in 232
      patients with hereditary or non hereditary retinoblastoma. We systematically
      explored all 27 exons and flanking sequences as well as the promotor. All types
      of point mutations are represented and are found unequally distributed along the
      RB1 gene sequence. In the population we studied, exons 3, 8, 18 and 19 are
      preferentially altered. The range of frequency of detection of germline mutations
      is about 20%, indicating that other mechanisms of inactivation of RB1 should be
      involved. The spectrum of mutations presented here should help to improve the
      clinical management of retinoblastoma and to understand the molecular mechanisms
      leading to tumorigenesis.

PMID- 7795592
TI  - Expression of the myotonin protein kinase gene in preimplantation human embryos.
AB  - We have examined the expression of the myotonin protein kinase gene (MPK) in
      individual human preimplantation embryos. An allele-specific, reverse
      transcriptase polymerase chain reaction assay was developed to the required
      sensitivity using human buccal cells. Human cleavage stage embryos, derived by in
      vitro fertilisation, were assayed for MPK transcription directly, or after biopsy
      of a single blastomere used to determine the genotype of the embryo. The maternal
      and paternal genotypes were determined from cumulus cells and sperm,
      respectively. MPK gene transcripts were detected in embryos at the 1-cell--4-cell
      stage of development. Detection of transcripts from the paternally-inherited
      allele confirmed onset of embryonic MPK gene expression at this very early
      preimplantation stage.

PMID- 7795593
TI  - Single cell analysis demonstrating somatic mosaicism involving 11p in a patient
      with paternal isodisomy and Beckwith-Wiedemann syndrome.
AB  - Partial isodisomy of 11p has been observed in some patients with Beckwith
      Wiedemann syndrome. In this study, we demonstrate somatic mosaicism directly
      through PCR and single cell analysis on blood lymphocytes from a patient with
      Beckwith-Wiedemann syndrome. Whole genome amplification was performed on single
      cells and the resultant product was subjected to locus specific microsatellite
      marker analysis using PCR. Two populations of cells were detected, a population
      of cells with normal biparental inheritance for chromosome 11 and a population of
      cells with partial paternal isodisomy of 11p between markers D11S922 (11p15.5)
      and D11S904 (11p14-p13). These results are consistent with somatic recombination
      resulting in mosaicism for paternal isodisomy. The use of single cell PCR is
      ideal for studying the distribution of mosaicism within and between tissues and
      has been used in this study to identify a cell line with uniparental disomy in a
      patient with Beckwith-Wiedemann syndrome.

PMID- 7795594
TI  - Analysis of the CTG repeat in skeletal muscle of young and adult myotonic
      dystrophy patients: when does the expansion occur?
AB  - The purpose of this investigation was to analyze the CTG expansion in muscle as
      compared to lymphocytes DNA in a sample of selected myotonic dystrophy (DM)
      patients of different ages and degrees of clinical severity, ranging from severe
      congenital to minimally affected. Results from the present study showed that the
      size of the CTG repeat was markedly larger in skeletal muscle than in lymphocytes
      in all DM patients. In contrast to lymphocytes, no significant correlation was
      found between the size of the CTG expansion in muscle and age at onset. In
      addition, large expansions were observed in muscle from all adult symptomatic
      patients independently of the presence of muscle weakness, which raises the
      question of the value of analyzing CTG expansions in muscle for predicting the
      severity of the phenotype. Differences between the size of the CTG expansions in
      muscle as compared to lymphocytes were smaller in affected children suggesting an
      apparent tendency to increase with aging and reaching a plateau in adulthood.

PMID- 7795595
TI  - Cloning of a putative human voltage-gated chloride channel (CIC-2) cDNA widely
      expressed in human tissues.
AB  - We have cloned a cDNA from the human epithelial cell line T84 whose predicted
      amino acid sequence shows 93.9% identity with rat CIC-2. Mapping by somatic cell
      hybrids and polymerase chain reaction localizes the gene corresponding to this
      cDNA to chromosome 3q26-qter. The major transcription start site assessed by RNA
      primer extension is 100 nt upstream of the putative translation initiation codon.
      Analysis of the 5' flanking sequence revealed a high GC content and lack of
      common transcriptional elements such as TATA and CCAAT boxes. Northern blot
      analysis indicated wide organ distribution including tissues affected in cystic
      fibrosis (CF) and expression in an airway epithelial cell line derived from a CF
      patient. The high degree of sequence similarity and similar tissue distribution
      to rat CIC-2 suggests that this cDNA encodes the human CIC-2 voltage-gated
      chloride channel. Since this chloride channel is present in epithelial tissues it
      may be amenable to manipulation to circumvent the chloride secretion defect
      observed in CF.

PMID- 7795596
TI  - Aniridia-associated cytogenetic rearrangements suggest that a position effect may
      cause the mutant phenotype.
AB  - Current evidence suggests that aniridia (absence of iris) is caused by loss of
      function of one copy of the PAX6 gene, which maps to 11p13. We present the
      further characterisation of two aniridia pedigrees in which the disease
      segregates with chromosomal rearrangements which involve 11p13 but do not disrupt
      the PAX6 gene. We have isolated three human YAC clones which encompass the PAX6
      locus and we have used these to show that in both cases the chromosomal
      breakpoint is at least 85 kb distal of the 3' end of PAX6. In addition, the open
      reading frame of PAX6 is apparently free of mutations. We propose that the PAX6
      gene on the rearranged chromosome 11 is in an inappropriate chromatin environment
      for normal expression and therefore that a 'position effect' is the underlying
      mechanism of disease in these families.

PMID- 7795597
TI  - Recombination rates across the HLA complex: use of microsatellites as a rapid
      screen for recombinant chromosomes.
AB  - Meiotic recombination does not appear to occur randomly across chromosomes, but
      rather seems to be restricted to specific regions. A striking example of this
      phenomenon is illustrated by the HLA class II region. No recombination within the
      100 kb encompassing the DRB1-DQA1-DQB1 loci has been reported, whereas the random
      association of TAP1 with TAP2 alleles suggests the presence of a hotspot for
      recombination within the 15 kb separating the closest variant sites of these two
      loci. Recombination rates between loci may provide clues to the functional
      properties of haplotypes. Absence of recombination may suggest the necessity to
      keep alleles of certain genes in phase and, alternatively, high recombination
      rates may suggest selective pressure to diversify haplotypes within the
      population. To address this issue, recombination rates across the HLA complex
      were determined using the 59 Centre d'Etude Polymorphisme Humain (CEPH)
      pedigrees. The allele frequencies of four microsatellite markers which map at
      sites ranging from the telomeric to centromeric ends of the complex were
      determined and the markers were used as a rapid means for identification of
      recombinant chromosomes. Typing these as well as other polymorphic loci within
      the HLA class I, II and III regions allowed assignment of the segments where
      recombination occurred. Recombination rates within the class II region (defined
      here as DRB1 to DPB1) and class III region (defined here as HLA-B to DRB1)
      regions were 0.74% and 0.94%, respectively, both of which are within an expected
      range given the standard of 1% recombination rate per megabase of DNA per
      meiosis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7795599
TI  - Deletion of the C-terminal end of aspartylglucosaminidase resulting in a
      lysosomal accumulation disease: evidence for a unique genomic rearrangement.
AB  - Aspartylglucosaminuria (AGU) is an inborn error of glycoprotein catabolism and
      represents the only known human deficiency of an amidase, aspartylglucosaminidase
      (AGA, EC 3.5.1.26). We report here a detailed characterization of a unique 2 kb
      deletion of the AGA gene in a North American AGU patient. To facilitate the
      characterization of the deletion, genomic lamda clones spanning the 3' flanking
      region of human AGA were isolated and sequenced. The breakpoint of the deletion
      was determined from the patient's DNA by sequencing the genomic region containing
      the novel junction. The rearrangement involved a nonhomologous recombination with
      only 2 bp of homology at the deletion breakpoint. The deletion's 5' breakpoint
      was located in the last intron of AGA, thus abolishing the normal C-terminal
      exon. This is in contrast to our previous findings indicating that the deletion
      in the AGA gene would contain only the complete 3' untranslated region and leave
      the coding region intact (1). The unique feature of this deletion is a
      triplication of 19 thymidine nucleotides of an inverted Alu repeat, which is
      located at the deletion 3' breakpoint. The analysis of the patient's AGA cDNA
      revealed an open reading frame containing a novel C-terminal exon, coding for a
      64 amino acid sequence, which has no homology to the normal exon 9 of AGA. This
      new exon has a functional splice acceptor site at its 5' end, a stop codon, and a
      polyadenylation signal at the 3' end. Expression of the mutant AGA cDNA in COS
      cells showed that mutant mRNA is synthesized in equal amounts compared with
      normal.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7795598
TI  - The oculopharyngeal muscular dystrophy locus maps to the region of the cardiac
      alpha and beta myosin heavy chain genes on chromosome 14q11.2-q13.
AB  - Oculopharyngeal muscular dystrophy (OPMD) is a late-onset autosomal dominant
      muscular dystrophy which presents typically after the age of 50 with progressive
      eyelid drooping and an increasing difficulty in swallowing. Though OPMD has a
      world-wide incidence, it is more common in the French Canadian population. We
      have identified a homogeneous group of families and studied 166 polymorphic
      markers as part of a genome search before establishing linkage to chromosome 14.
      We determined that the OPMD locus maps to a less than 5 cM region of chromosome
      14q11.2-q13. The maximum two-point lod score in three French Canadian families of
      14.73 (theta = 0.03) was obtained for an intronic cardiac beta myosin heavy chain
      gene (MYH7) marker. The regional localization for the OPMD locus raises the
      intriguing possibility that either the cardiac alpha or beta myosin heavy chain
      genes may play a role in this disease.

PMID- 7795600
TI  - Blepharophimosis syndrome is linked to chromosome 3q.
AB  - Blepharophimosis syndrome (BPES, blepharophimosis eyelid syndrome) is a
      distinctive congenital eyelid malformation which can occur sporadically or be
      inherited in an autosomal dominant fashion. Previous reports have described
      associated cytogenetic abnormalities on chromosome 3q. We have ascertained and
      sampled two BPES families with apparent autosomal dominant inheritance and have
      tested for linkage with 17 polymorphic markers on 3q. Multipoint analysis
      generated a maximum LOD score of 3.23 using the markers RHO, ACPP and D3S1238. No
      evidence of genetic heterogeneity was observed. These studies provide the first
      non-cytogenetic evidence that a defective gene responsible for BPES is located on
      3q22.

PMID- 7795603
TI  - Genetic heterogeneity of autosomal recessive limb-girdle muscular dystrophy in a
      genetic isolate (Amish) and evidence for a new locus.
AB  - Limb-girdle muscular dystrophy (LGMD) is a hereditary myopathy presenting
      clinical and genetic heterogeneity. In 1991, a recessive form (LGMD2A) was linked
      to chromosome 15q in a genetic isolate from the Isle of La Reunion. Confirmation
      of this localization was subsequently reported in Brazilian and northern Indiana
      Amish pedigrees. Here we report the exclusion of the LGMD2A locus in six Amish
      kindreds from southern Indiana that are related by multiple consanguineous links
      to the same northern Indiana families in which the involvement of the chromosome
      15 locus was previously demonstrated. These findings indicate unexpected genetic
      heterogeneity of LGMD in an Indiana Amish isolate. Furthermore, genetic analyses
      also ruled out the possible involvement of the chromosome 2 locus recently
      described (LGMD2B), thus demonstrating that a mutation within at least one
      additional locus leads to this condition. Several candidate genes putatively
      involved in neuromuscular disorders were also excluded.

PMID- 7795601
TI  - Sets of short tandem repeat polymorphisms for efficient linkage screening of the
      human genome.
AB  - For the purpose of initial screening of the human genome in linkage mapping, two
      overlapping sets of high quality short tandem repeat polymorphisms (STRPs) which
      span the autosomes have been assembled. The higher density set contains a total
      of 363 markers with an average heterozygosity of 79% and an average sex-equal
      genetic distance between markers of 10.5 cM. The lower density set, which is a
      subset of the other, contains 156 markers with an average heterozygosity of 80%
      and an average spacing of 26.5 cM. Tri- and tetranucleotide STRPs comprised 47
      and 63%, respectively, of the markers within the higher and lower density sets.
      Markers within the screening sets were selected to have maximum quality, where
      quality was defined as a blend of high informativeness, strong amplification
      under standard PCR conditions, low amplification background, and ease in scoring.
      The screening sets along with combinations of STRPs which can be amplified and
      electrophoresed simultaneously are available electronically through anonymous
      ftp.

PMID- 7795602
TI  - A gene responsible for cavernous malformations of the brain maps to chromosome
      7q.
AB  - Cavernous malformations of the brain are vascular lesions which are present in up
      to 0.4% of all individuals and which are often accompanied by seizures, migraine,
      hemorrhage and other neurologic problems. Using linkage analysis and a set of
      short tandem repeat polymorphisms, a gene responsible for cavernous malformations
      in a large Hispanic kindred was mapped to the q11-q22 region of chromosome 7. A
      maximum pairwise lod score of 4.2 was obtained at zero recombination with marker
      PY5-18 at locus D7S804. Lod scores in excess of 3.0 were obtained with four
      additional markers closely linked to PY5-18. A broad chromosome 7q haplotype of
      33 cM length on the sex average map was shared by all affected individuals
      indicating that the gene lies between loci D7S502 and D7S479.

PMID- 7795604
TI  - Evidence from antibody studies that the CAG repeat in the Huntington disease gene
      is expressed in the protein.
AB  - The neurodegenerative disorder Huntington disease (HD) appears to be caused by an
      increase in the number of repeats of the trinucleotide CAG located near the 5'
      end of the gene. The nucleotide sequences of the cDNA and the gene predict that
      the HD protein has a molecular weight of 347,000 (3144 amino acids) and that the
      CAG repeats encode a segment of polyglutamine beginning 17 amino acids from the
      amino terminus. Because the CAG repeat plays such a critical role in the etiology
      of the disease, we sought to obtain evidence that the polyglutamine segment is
      indeed present in the protein. We used two peptides, hd1-peptide (FESLKSFQQ),
      predicted to lie at amino acid positions 11-19, just amino-terminal to the
      polyglutamine segment, and hd2-peptide (QQPRNKPLK), predicted to lie at amino
      acid positions 2531-2539, to induce polyclonal antibodies in NZW rabbits. Both
      antibodies recognize a protein on Western blots of about 350 kDa in cell lysates
      from human brain tissue and human and monkey cell lines, including cells from
      individuals heterozygous and homozygous for the disease. These results suggest
      that the HD protein in these cells contains the predicted amino terminal segment,
      and by inference, the segment of polyglutamine, and that the protein is expressed
      even when only mutant copies of the gene are present. Interestingly, the antibody
      to hd1-peptide does not recognize the HD protein on Western blots containing
      lysates from rodent cell lines, whereas the antibody to hd2-peptide does. This
      discrimination provides a useful means to assay for the presence of the human HD
      protein in a rodent cell background.

PMID- 7795606
TI  - Mapping the locus of atrophia areata, a helicoid peripapillary chorioretinal
      degeneration with autosomal dominant inheritance, to chromosome 11p15.
AB  - Atrophia areata (AA) is an early onset autosomal dominant helicoid peripapillary
      chorioretinal degeneration, which was first demonstrated to be hereditary in an
      Icelandic family. It is characterized by bilateral wing-shaped atrophic areas of
      the retina, radiating from the optic disk. Primary complaints of affected
      individuals are due to refractive errors and scotomata associated with myopia
      which increases with age. A genome linkage search with 112 microsatellite DNA
      markers resulted in the highest probability of location for AA on chromosome 11.
      We genotyped 18 polymorphic markers on chromosome 11 and seven showed significant
      linkage to AA. The markers D11S1323 and D11S902 on 11p15 flank the region
      encompassing the gene for AA.

PMID- 7795607
TI  - Linkage of posterior polymorphous corneal dystrophy to 20q11.
AB  - Posterior polymorphous dystrophy (PPMD) is an autosomal dominant disorder of the
      cornea that is clinically recognized by the presence of vesicles on the
      endothelial surface of the cornea. The corneal endothelium is normally a single
      layer of cells that lose their mitotic potential after development is complete.
      In PPMD, the endothelium is often multi-layered and has several other
      characteristics of an epithelium including the presence of desmosomes,
      tonofilaments, and microvilli. These abnormal cells retain their ability to
      divide and extend onto the trabecular meshwork to cause glaucoma in up to 40% of
      cases. A large family with 21 members affected with PPMD was genotyped with short
      tandem repeat polymorphisms distributed across the autosomal genome. Linkage was
      established with markers on the long arm of chromosome 20. The highest observed
      LOD score was 5.54 (theta = 0) with marker D20S45. Analysis of recombination
      events in four affected individuals revealed that the disease gene lies within a
      30cM interval between markers D20S98 and D20S108.

PMID- 7795608
TI  - Missense mutations in the NDP gene in patients with a less severe course of
      Norrie disease.

PMID- 7795605
TI  - Expression of the neurofibromatosis 2 (NF2) gene isoforms during rat embryonic
      development.
AB  - The neurofibromatosis 2 (NF2) gene product, merlin, encodes a 595 amino acid
      protein with sequence similarity to a family of proteins linking cell membrane
      proteins to the cytoskeleton. Two isoforms of merlin have been described which
      differ by the presence (type 2 merlin) or absence (type 1 merlin) of exon 16
      sequences inserted into the extreme carboxyl terminus of the protein. To
      determine the role of this important negative growth regulator during normal
      embryonic development, the expression of these two merlin isoforms was examined
      at representative stages of rat embryogenesis and in adult tissues. Partial
      sequence analysis of the rat merlin gene demonstrated striking amino acid
      identity to the published mouse and human merlin gene sequences. In situ
      hybridization and RT-PCR analyses demonstrated that rat merlin is widely
      expressed during embryogenesis and early postnatal life in most tissues but
      becomes restricted to the brainstem, cerebellum, dorsal root ganglia, spinal
      cord, adrenal gland and testis in adult animals. The elucidation of the pattern
      of merlin gene expression in adult and embryonic tissues provides the foundations
      for future studies aimed at determining the function(s) of this protein during
      cell differentiation and embryonic development.

PMID- 7795610
TI  - A G-to-T transversion at the +5 position of intron 1 in the glutaryl CoA
      dehydrogenase gene is associated with the Island Lake variant of glutaric
      acidemia type I.

PMID- 7795609
TI  - A novel point mutation in the Cu/Zn superoxide dismutase gene in a patient with
      familial amyotrophic lateral sclerosis.

PMID- 7795611
TI  - Systemic lupus erythematosus in Sao Paulo/Brazil: a clinical and laboratory
      overview.

PMID- 7795612
TI  - New York University/Hospital for Joint Diseases experience with intravenous
      cyclophosphamide treatment: efficacy in steroid unresponsive lupus nephritis.
AB  - The medical records of patients receiving cyclophosphamide for lupus nephritis
      between 1987 and 1993 at the New York University/Hospital for Joint Diseases
      Lupus Study Group Institutions were retrospectively reviewed. We identified 45
      patients (38 female, seven male) who received a mean of 9 +/- 1 (range 2-23)
      pulses of intravenous cyclophosphamide for diffuse proliferative
      glomerulonephritis (n = 28), focal proliferative glomerulonephritis (n = 7),
      membranous nephropathy (n = 5), mesangial nephropathy with sclerosis (n = 1) or
      nephritis without biopsy (n = 4). Forty-two of the 45 patients received
      cyclophosphamide after failing steroid therapy. During a follow-up period of 52
      +/- 3 months, nine patients progressed to end-stage renal disease (ESRD) with
      three additional patients experiencing a doubling of the creatinine and two
      patients persistent nephrotic range proteinuria. There were no deaths directly
      attributable to cyclophosphamide and no patients developed hemorrhagic cystitis
      or malignancy. Ten of 37 women had ceased menstruating prior to cyclophosphamide
      therapy. Treatment-associated amenorrhea occurred in only three patients all over
      27 years of age. Intermittent intravenous cyclophosphamide therapy of lupus
      nephritis is well tolerated and usually effective in maintaining renal function
      in patients unresponsive to steroids although, in our experience, 20% of patients
      developed ESRD and a total of 14 of 45 (30%) patients had unsatisfactory
      outcomes.

PMID- 7795614
TI  - In utero identification and therapy of congenital heart block.
AB  - To determine the feasibility and effectiveness of prenatal therapy of congenital
      heart block (CHB), information was sought regarding the timing of identification
      of CHB in 72 pregnancies and the outcome of those pregnancies in which the
      mothers were administered corticosteroids. Mailed questionnaires with telephone
      follow-up, data from primary physicians and chart review were utilized. In 38
      (53%) of affected pregnancies CHB was identified between 16 and 24 weeks of
      gestation, in 17 (24%) between 25 and 30 weeks of gestation, in 8 (11%) between
      31 and 37 weeks, and in 5 (7%) between 38 and 40 weeks. In four pregnancies the
      timing was unknown. Five women were taking prednisone for disease activity prior
      to the discovery of CHB and in six other women prednisone therapy was initiated
      at or about the time CHB was identified. In 19 pregnancies, women were given
      fluorinated steroids (available to the fetus in an active form) as attempted
      therapy after the discovery of CHB. Of these, one fetus with second degree block
      reverted to sinus rhythm and two with third degree block exhibited an improvement
      in the degree of block. In eight fetuses pleural and/or pericardial effusions
      resolved. In conclusion, the gestational period of heightened fetal vulnerability
      for the development of heart block is in the mid second to early third trimester.
      Although there is no evidence that maternal prednisone should be used
      prophylactially, fluorinated steroids may be efficacious after the identification
      of heart block, particularly with regard to an associated myocarditis.

PMID- 7795613
TI  - Prognostic determinants in lupus nephritis: a long-term clinicopathologic study.
AB  - Over the past 50 years, survival has improved in patients with systemic lupus
      erythematosus and associated nephritis. Yet, there are few long-term outcome
      studies in patients with well-defined nephropathy. We examined the outcome of 439
      patients with lupus nephritis who were seen at the Mayo Clinic between 1964 and
      1986 in whom renal biopsies were assessed using the World Health Organization
      (WHO) classification. There were 341 women and 98 men (mean +/- s.d., age 33.5 +/
      14 years); 200 (46%) patients were hypertensive and 249 (57%) had impaired renal
      function at renal biopsy. All WHO morphologic classes were represented and 339
      (77%) patients had class III, IV and V (the more severe forms of nephritis).
      Follow-up averaged 10.2 years per patient. At last contact, 286 (65%) patients
      were alive and 153 (35%) were dead. Overall patient survival was 80%, 69% and 53%
      at 5, 10 and 20 years after biopsy that was significantly worse than expected
      survival (P < 0.001). Ten-year cumulative patient survival improved comparing
      earlier to more recent time spans: 64% in 231 patients seen during 1964-75; 76%
      in 2089 patients studied during 1976-86 (P = 0.03). Survival free of renal
      failure was 83%, 74% and 64% at 5, 10 and 20 years, and survival was unfavorably
      influenced by progressive WHO class, hypertension, impaired renal function,
      nephrotic range proteinuria, hypoalbuminemia and anemia. Multivariate analysis
      found impaired renal function, increased urine protein, anemia and younger age to
      be independent predictors of renal failure. WHO class was not a significant
      predictor when adjusted for these four factors. Cardiovascular events accounted
      for 48% of the known deaths and were equally distributed across all WHO classes,
      followed by infections, renal failure, malignancy, respiratory failure and
      gastrointestinal bleeding.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7795616
TI  - False positive seroreactivity to Borrelia burgdorferi in systemic lupus
      erythematosus: the value of immunoblot analysis.
AB  - The object of this study was to determine the incidence of seropositivity to B.
      burgdorferi by the commonly available enzyme-linked immunosorbent assay (ELISA)
      in patients with SLE and other rheumatic diseases and to evaluate immunoblot
      analysis as a tool to differentiate true from false positive ELISA. Sera were
      obtained from patients with SLE (n = 35), rheumatoid arthritis (n = 26),
      seronegative arthritis (n = 28) and Lyme disease (n = 18). Reactivity to B.
      burgdorferi antigens was analysed by two available diagnostic techniques: ELISA
      and immunoblot. Correlations were made between seroreactivity to B. burgdorferi
      and standard serological tests of autoimmunity: antibodies to nuclear antigens,
      dsDNA, cardiolipin, SSA and SSB. Seroreactivity to B. burgdorferi antigens by the
      ELISA system was detected in 40% of patients with SLE, 8% of patients with
      rheumatoid arthritis and 4% with seronegative arthritis. Among patients
      seropositive by ELISA, immunoblots were negative in all cases. However, eight of
      14 patients with rheumatoid arthritis (57%) showed cross-reactivity to multiple
      borreli antigens. No significant correlations were found between Lyme
      seropositivity by ELISA and other autoantibodies except IgM rheumatoid factor (r
      = 0.61, P < 0.01) in patients with rheumatoid arthritis. IN CONCLUSION: a
      positive ELISA for Lyme disease was found in up to 40% of patients with
      established SLE and also in other rheumatic diseases. However, specific serum
      antibodies to Borrelia were not confirmed by the more specific immunoblot
      technique.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7795615
TI  - Anti-beta 2-glycoprotein I antibodies: a marker of antiphospholipid syndrome?
AB  - Anticardiolipin (aCL) and anti-beta 2-glycoprotein I(anti beta 2GPI) antibodies
      have been shown in animal models as not cross-reacting antibody populations. This
      observation prompted us to prove if anti-beta 2GPI exist in human sera by using a
      reliable method and then to investigate if these are independent from aCl
      antibodies. We have developed a new ELISA for the detection of anti-beta 2GPI
      antibodies employing the coating of the protein in carbonate buffer to irradiated
      microtitre plates and the filtration of serum samples, that makes irrelevant the
      binding to the uncoated wells. IgG F(ab)2 fragments from IgG positive sera were
      shown bind beta 2GPI, providing that the binding was a specific antibody binding,
      mediated by the antigen binding site of the antibody molecule: moreover the
      antibodies were not able to differentiate native and delipidated beta 2GPI coated
      plates, making a possible role of a phospholipid contaminant unlikely. On the
      other hand, the phosphorus content of native as well as delipitated beta 2GPI was
      undetectable. IgG, but not IgM, anti-beta 2GPI antibodies were classically
      inhibited by the addition of soluble beta 2GPI, while cardiolipin liposomes
      appear to modify the reaction in a completely different way, possibly by the
      described interaction between cardiolipin and beta 2GPI.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7795618
TI  - Association of anticardiolipin antibodies and abnormal nailfold capillaroscopy in
      patients with systemic lupus erythematosus.
AB  - Anticardiolipin antibodies (aCL) are found in about 40-50% of patients suffering
      from systemic lupus erythematosus (SLE) and their presence carries an increased
      risk of thromboembolism. Since there is a high prevalence of nailfold capillary
      abnormalities in patients with SLE, we studied the relationship between aCL and
      skin microcirculatory changes or vascular symptoms in 51 consecutive patients
      with SLE (49 women, 2 men, 34.8 +/- 13.7 years). Twenty-two patients (43.1%) had
      positive aCL (IgG 22 (5-60) GPL; IgM 5 (3-16.5) MPL; median titre and range) and
      12 (54.5%) of them had abnormal capilloscopic findings. By contrast, among the 29
      patients without aCL, only six (20.7%) had an abnormal capillaroscopy (P =
      0.027). There was no correlation between either aCL or capillaroscopy and
      Raynaud's phenomenon. These results show a relationship between aCL and nailfold
      capillary changes in patients with SLE, suggesting a direct damage of the
      vascular endothelium by aCL.

PMID- 7795617
TI  - IgA antiphospholipid antibodies in HTLV-1-associated tropical spastic
      paraparesis.
AB  - A retrovirus, human T cell lymphotropic virus type 1 (HTLV-1), is an essential
      but not a sufficient aetiologic factor for tropical spastic paraparesis (TSP).
      Because some TSP patients have biological false positive tests for treponemal
      infections (BFP-STS), we used ELISA to study BFP-STS and anticardiolipin
      antibodies in 42 Jamaican TSP patients. The data indicate that in TSP
      anticardiolipin antibodies occur in about 26% of patients, are associated with
      biological false positive treponemal serology, are relatively restricted to the
      IgA isotype and may be induced by HTLV-1 or other nontreponemal infections.

PMID- 7795619
TI  - Anti-neuronal antibodies in antiphospholipid syndrome with central nervous system
      involvement: the difference from systemic lupus erythematosus.
AB  - The presence of antineuronal antibodies was compared in 43 patients with primary
      aPLS and 57 patients with neuropsychiatric SLE. Fifty-eight patients with
      Guillain-Barre syndrome and 72 normal healthy donors served as control groups.
      Seventeen patients in the study group had aPLS associated with CNS involvement.
      Antineuronal antibodies were studied in the sera employing a novel flow
      cytometric assay. The frequency of antineuronal antibodies in patients with aPLS
      and CNS involvement was not significantly different from that of patients with
      aPLS without CNS disease or from that found in the control groups (12%, 19% and
      7%, respectively). However, it was significantly different from that found in SLE
      patients with CNS involvement (60%) (P < 0.001). Our results provide further
      evidence that unlike CNS-SLE, the major mechanism of CNS involvement in patients
      with primary aPLS might not be autoantibody (antineuronal) mediated, but rather
      'thrombotic' in origin, or due to yet unknown factors.

PMID- 7795620
TI  - Skeletal muscle lymphocytic vasculitis in systemic lupus erythematosus: relation
      to disease activity.
AB  - Lymphocytic vasculitis (LV) characterises systemic lupus erythematosus (SLE) and
      this potentially reversible lesion, which may be subclinical, may imply overt
      systemic disease activity. Needle quadriceps muscle biopsy was performed in 26
      unselected patients with SLE and the presence of LV in these muscle specimens was
      compared with SLE disease activity scored using the British Isles Lupus
      Assessment Group Index (BILAG). Ten of the 22 patients with active disease showed
      evidence of LV compared with none of the four patients with inactive disease. In
      the patient group with LV, significantly higher ESR and urine neopterin values
      were found with P = 0.002 and P = 0.02, respectively compared with patients
      without LV. Features of vasculitis (as defined by BILAG) were also significantly
      more common in these patients (P = 0.005). None of the other parameters,
      including creatine kinase, were significantly different between the two patient
      subgroups. Thus, LV in needle quadriceps muscle biopsy specimens is a further
      valuable marker of disease activity in patients with SLE and might provide
      histological evidence of a systemic vasculitic process in a group of patients
      with diverse clinical manifestations.

PMID- 7795621
TI  - Clinical manifestations of hepatic arteritis in systemic lupus erythematosus.
AB  - Hepatic arteritis is a rare complication in systemic lupus erythematosus (SLE).
      Information about its clinical manifestations is still very limited. Elevated
      serum r-glutamyl transpeptidase and alkaline phosphatase levels, but without
      elevated bilirubin and transaminase levels, were found in the present report to
      be the clinical presentation of hepatic arteritis. This clinical picture
      originally suggested a disease of the biliary tree. Hepatic arteritis must be
      included in the differential diagnosis of biliary tract disorders in SLE.

PMID- 7795622
TI  - Ischemic optic neuropathy and high-level anticardiolipin antibodies in primary
      Sjogren's syndrome.
AB  - A 39-year-old woman with recurrent severe anterior ischemic optic neuropathy in
      the setting of Sjogren's syndrome was found to have high-titer IgM
      anticardiolipin antibodies (aCL) that were enhanced by the phospholipid-binding
      glycoprotein beta 2GP1. The recognition of IgM aCL-associated vasculopathy as a
      possible etiologic factor in the optic neuropathy in Sjogren's syndrome may be
      relevant in deciding appropriate therapy.

PMID- 7795623
TI  - Systemic lupus erythematosus flare-up manifesting as a cilioretinal artery
      occlusion.
AB  - In this report we describe a patient with systemic lupus erythematosus who was
      clinically stable after treatment with the antimalarial drug chloroquine and
      pulse cyclophosphamide therapy. Three months after the discontinuation of
      chloroquine, the patient developed cilioretinal artery occlusion that was the
      only the manifestation of a clinical flare-up without evidence of clinical
      disease activity elsewhere. This case report confirms the clinical belief that
      the antimalarial agents can maintain the clinical quiescence of systemic lupus
      erythematosus and its discontinuation is associated with an increase in the risk
      of clinical flare-up.

PMID- 7795625
TI  - Prevalence of antinuclear antibodies in a Huichol population of Mexico.

PMID- 7795624
TI  - Lymphocytic interstitial pneumonitis in a patient with systemic lupus
      erythematosus.
AB  - A 34-year-old woman with stable systemic lupus erythematosus (SLE) treated with
      low-dose prednisone and hydroxychloroquine developed multiple bilateral pulmonary
      nodules. Open lung biopsy documented lymphocytic interstitial pneumonitis (LIP).
      LIP should be considered in the differential diagnosis of nodular pulmonary
      lesions in patients with SLE.

PMID- 7795626
TI  - Thrombomodulin in human brain microvasculature.

PMID- 7795627
TI  - The definition for coexistent rheumatoid arthritis and systemic lupus
      erythematosus.

PMID- 7795628
TI  - Systemic lupus in children: daughter of the Hydra?

PMID- 7795629
TI  - Serological markers of disease activity in systemic lupus erythematosus.
AB  - When measured serially by Farr assay at a frequency of approximately once a
      month, changes in levels of anti-dsDNA appear to be a good predictor of clinical
      disease activity. Although the role of antibodies to the RNA component of snRNP
      awaits further studies, measurement of anti-UsnRNP antibody levels seems to be of
      limited value in monitoring lupus patients in clinical practice. The same holds
      for antibodies to SSA (Ro) and anti-histone antibodies. More recently described
      antibodies to C1q are probably useful in the follow-up of SLE patients suspected
      of proliferative renal involvement. The best alternative to measuring levels of
      the antibodies mentioned before is probably serial analysis of activation of the
      complement cascade. Levels of complement factors like C3, C4 and, functionally,
      CH50 remain a useful parameter for monitoring disease activity in SLE, although
      fluctuations in anti-dsDNA as measured by Farr assay seem superior with respect
      to sensitivity and specificity for an ensuing relapse. Despite the problems in
      sampling, measuring levels of activated split products of complement factors like
      C3a, C3d or C5a may prove to be a valuable tool in the follow-up of lupus
      patients. The involvement of the endothelial surface is illustrated by rising
      sVCAM-1 levels prior to relapses in SLE. Although one could expect that
      subsequent inflammation should be reflected by increased levels of inflammatory
      molecules like CRP and IL-6, the use of these molecules as predictors of lupus
      activity seems limited. Interferon-alpha as a direct reflector of the effector
      phase seems, however, rather promising in this respect and awaits longitudinal
      studies to analyse the possible relation with clinical disease activity and other
      serological parameters.

PMID- 7795630
TI  - Mosaic of anti-endothelial antibodies. Review of the first international workshop
      on anti-endothelial antibodies: clinical and pathological significance Milan, 9
      November 1994.

PMID- 7795631
TI  - Pax genes--paired feet in three camps.

PMID- 7795632
TI  - BRCA1: more than a hereditary breast cancer gene?

PMID- 7795633
TI  - Progress in prostate cancer.

PMID- 7795634
TI  - Triad-DNA: a model for trinucleotide repeats.

PMID- 7795635
TI  - Towards fully automated genome-wide polymorphism screening.

PMID- 7795637
TI  - Unique features of the CAG repeats in Machado-Joseph disease.

PMID- 7795636
TI  - A somatic BRCA1 mutation in an ovarian tumour.

PMID- 7795638
TI  - Anastasia and Anna Anderson.

PMID- 7795639
TI  - Positional cloning moves from perditional to traditional.
AB  - The technique of positional cloning has become a familiar component of modern
      human genetics research. After a halting start in the mid-1980s, the number of
      disease genes succumbing to cloning efforts based solely on pinpointing their
      position in the genome is growing exponentially. More than 40 genes have been
      identified so far. But the positional candidate approach, which combines
      knowledge of map position with the increasingly dense human transcript map,
      greatly expedites the search process and will soon become the predominant method
      of disease gene discovery. The challenge ahead is to apply such methods to
      identifying genes involved in complex polygenic disorders.

PMID- 7795641
TI  - Sequence analysis reveals a beta-thalassaemia mutation in the DNA of skeletal
      remains from the archaeological site of Akhziv, Israel.
AB  - beta-Thalassaemia is manifested by severe anaemia and extensive bone pathology.
      Similar pathology may also result from other forms of anaemia. To clarify the
      precise cause, we performed DNA analyses on archaeological remains of a child
      with severe bone pathology. We found homozygosity for frameshift in codon 8 of
      beta-globin, causing a beta-null phenotype. Paradoxically, the child died when
      eight years old, whereas such patients are transfusion dependent from early
      infancy. An infrequent polymorphic marker in the child's DNA, and information
      from present-day patients, indicated that amelioration of the clinical condition
      was due to elevated fetal haemoglobin production. Thus this analysis provided not
      only precise diagnosis of a genetic disease but also allowed clarification of the
      molecular mechanism underlying the clinical presentation.

PMID- 7795640
TI  - Mutation of the PAX2 gene in a family with optic nerve colobomas, renal anomalies
      and vesicoureteral reflux.
AB  - Paired box (PAX) genes play a critical role in human development and disease. The
      PAX2 gene is expressed in primitive cells of the kidney, ureter, eye, ear and
      central nervous system. We have conducted a mutational analysis of PAX2 in a
      family with optic nerve colobomas, renal hypoplasia, mild proteinuria and
      vesicoureteral reflux. We report a single nucleotide deletion in exon five,
      causing a frame-shift of the PAX2 coding region in the octapeptide domain. The
      phenotype resulting from the PAX2 mutation in this family was very similar to
      abnormalities that have been reported in Krd mutant mice. These data suggest that
      PAX2 is required for normal kidney and eye development.

PMID- 7795642
TI  - Chromosome specific paints from a high resolution flow karyotype of the mouse.
AB  - Chromosomes from antigen stimulated B-cells from spleens of inbred mice have been
      separated using flow cytometry into 18 distinguishable peaks. Using locus
      specific oligonucleotides and fluorescence in situ hybridization to banded
      metaphase spreads, 15 individual chromosomes were identified: 1, 2, 3, 6, 7, 8,
      9, 11, 12, 16, 17, 18, 19, X and Y. The remaining six chromosomes, occurring as
      pairs in three peaks, 4 with 5, 10 with 13, and 14 with 15, were resolved by flow
      sorting chromosomes from mice carrying an appropriate homozygous translocation
      and 4, 5 and 14 have been isolated in this way. This is the first demonstration
      of how a complete set of mouse chromosome paints can be produced.

PMID- 7795643
TI  - A site-directed chromosomal translocation induced in embryonic stem cells by Cre
      loxP recombination.
AB  - We have developed a strategy for chromosome engineering in embryonic stem (ES)
      cells that relies on sequential gene targeting and Cre-loxP site-specific
      recombination. Gene targeting was first used to integrate loxP sites at the
      desired positions in the genome. Transient expression of Cre recombinase was then
      used to mediate the chromosomal rearrangement. A genetic selection relying on
      reconstruction of a selectable marker from sequences co-integrated with the loxP
      sites allowed detection of cells containing the Cre-mediated rearrangement. A
      programmed translocation between the c-myc and immunoglobulin heavy chain genes
      on chromosomes 15 and 12 was created by this method. This strategy will allow the
      design of a variety of chromosome rearrangements that can be selected and
      verified in ES cells or activated in ES cell-derived mice.

PMID- 7795644
TI  - Domain organization of allele-specific replication within the GABRB3 gene cluster
      requires a biparental 15q11-13 contribution.
AB  - Imprinting marks the parental origin of chromosomes, resulting in allele-specific
      changes in chromatin organization, transcription and replication. We report a 50
      60 kb domain of allele-specific replication between the gamma-aminobutyric acid
      receptor subunit beta 3 (GABRB3) and alpha 5 (GABRA5) genes. Replication of this
      domain occurs in early S phase on the maternal chromosome 15 but is delayed until
      the end of S phase on the paternal homologue. In contrast, the genomic regions
      flanking this domain exhibit paternal earlier replication in mid to late S phase.
      Uniparental disomy or hemizygous deletion of chromosome 15 results in altered
      allele-specific replication kinetics compared with normals, suggesting that
      allele-specific replication within the GABRB3/A5 region may be regulated by
      reciprocal imprints on the maternal and paternal chromosomes.

PMID- 7795645
TI  - Inherited microdeletions in the Angelman and Prader-Willi syndromes define an
      imprinting centre on human chromosome 15.
AB  - A subset of patients with Angelman and Prader-Willi syndrome have apparently
      normal chromosomes of biparental origin, but abnormal DNA methylation at several
      loci within chromosome 15q11-13, and probably have a defect in imprinting. Using
      probes from a newly established 160-kb contig including D15S63 (PW71) and SNRPN,
      we have identified inherited microdeletions in two AS families and three PWS
      families. The deletions probably affect a single genetic element that we term the
      15q11-13 imprinting centre (IC). In our model, the IC regulates the chromatin
      structure, DNA methylation and gene expression in cis throughout 15q11-13.
      Mutations of the imprinting centre can be transmitted silently through the
      germline of one sex, but appear to block the resetting of the imprint in the
      germline of the opposite sex.

PMID- 7795646
TI  - In vivo amplification of the androgen receptor gene and progression of human
      prostate cancer.
AB  - Overexpression of amplified genes is often associated with the acquisition of
      resistance to cancer therapeutic agents in vitro. We have identified a similar
      molecular mechanism in vivo for endocrine treatment failure in human prostate
      cancer which involves amplification of the androgen receptor (AR) gene.
      Comparative genomic hybridization shows that amplification of the Xq11-q13 region
      (the location), is common in tumours recurring during androgen deprivation
      therapy. We found high-level AR amplification in seven of 23 (30%) recurrent
      tumours, but in none of the specimens taken from the same patients prior to
      therapy. Our results suggest that AR amplification emerges during androgen
      deprivation therapy by facilitating tumour cell growth in low androgen
      concentrations.

PMID- 7795647
TI  - A paternal-specific methylation imprint marks the alleles of the mouse H19 gene.
AB  - Imprinting, the differential expression of the two alleles of a gene based on
      their parental origin, requires that the alleles be distinguished or marked. A
      candidate for the differentiating mark is DNA methylation. The maternally
      expressed H19 gene is hypermethylated on the inactive paternal allele in somatic
      tissues and sperm, but to serve as the mark that designates the imprint,
      differential methylation must also be present in the gametes and the pre
      implantation embryo. We now show that the pattern of differential methylation in
      the 5' portion of H19 is established in the gametes and a subset is maintained in
      the pre-implantation embryo. That subset is sufficient to confer monoallelic
      expression to the gene in blastocysts. We propose that paternal-specific
      methylation of the far 5' region is the mark that distinguishes the two alleles
      of H19.

PMID- 7795648
TI  - X-linked thrombocytopenia and Wiskott-Aldrich syndrome are allelic diseases with
      mutations in the WASP gene.
AB  - X-linked thrombocytopenia (XLT) is a rare recessive hereditary disorder
      characterized by isolated thrombocytopenia with small-sized platelets. The XLT
      locus has been located to chromosome Xp11 by linkage analysis, which is also
      where the recently cloned Wiskott-Aldrich syndrome (WAS) gene, maps. The
      relationship between XLT and WAS has long been debated; they might be due to
      different mutations of the same gene or to mutations in different genes. We now
      show that mutations in the WAS gene, different from those found in WAS patients,
      are present in three unrelated male patients with isolated thrombocytopenia and
      small-sized platelets. Our results demonstrate that XLT and WAS are allelic forms
      of the same disease, but the causes of the differences need to be further
      investigated.

PMID- 7795649
TI  - A gene for maturity onset diabetes of the young (MODY) maps to chromosome 12q.
AB  - Maturity-onset diabetes of the young (MODY) is a subtype of non-insulin dependent
      diabetes mellitus, with early age of onset. MODY is genetically heterogeneous,
      associated with glucokinase mutations and a locus on chromosome 20q; in about 50%
      of cases, its genetic background is unknown. We have studied 12 families in which
      MODY is unlinked to either glucokinase or chromosome 20q markers, and find
      significant evidence for linkage with microsatellite markers on chromosome 12q,
      most likely within a 7 centimogran interval bracketed by D12S86 and D12S342. The
      disease was estimated to be linked to this chromosome region in approximately 50%
      of families in a heterogeneity analysis. These MODY patients exhibit major
      hyperglycaemia with a severe insulin secretory defect, suggesting that the causal
      gene is implicated in pancreatic beta-cell function.

PMID- 7795650
TI  - The apolipoprotein(a) gene is regulated by sex hormones and acute-phase inducers
      in YAC transgenic mice.
AB  - High plasma concentrations of apolipoprotein (a) (apo(a)) have been implicated as
      a major independent risk factor for atherosclerosis in humans. Apo(a) is a large,
      evolutionarily new gene (present primarily in primates) for which considerable
      controversy exists concerning the factors that regulate its expression. To
      investigate the in vivo regulation of apo(a), we have created several lines of
      YAC transgenic mice containing a 110-kb human apo(a) gene surrounded by greater
      than 60 kb of 5' and 3' flanking DNA. Studies in humans have suggested that acute
      phase inducers increase and sex steroids decrease apo(a) concentrations, but
      these results are controversial. Analysis of the YAC transgenic mice conclusively
      supports the hypothesized role of sex steroids and refutes the suggested role of
      acute-phase inducers in regulating the apo(a) gene.

PMID- 7795651
TI  - Optical mapping of lambda bacteriophage clones using restriction endonucleases.
AB  - Optical mapping is an emerging single molecule approach for the rapid generation
      of ordered restriction maps, using fluorescence microscopy. We have improved the
      size resolution of optical mapping by imaging individual DNA molecules elongated
      and fixed onto derivatized glass surfaces. Averaged fluorescence intensity and
      apparent length measurements accurately determined the mass of restriction
      fragments 800 basepairs long. We have used optical mapping to create ordered
      restriction maps for lambda clones derived from the mouse pygmy locus.

PMID- 7795653
TI  - Decreased expression of BRCA1 accelerates growth and is often present during
      sporadic breast cancer progression.
AB  - We have characterized expression of the familial breast and ovarian cancer gene,
      BRCA1, in cases of non-hereditary (sporadic) breast cancer and analyzed the
      effect of antisense inhibition of BRCA1 on the proliferative rate of mammary
      epithelial cells. BRCA1 mRNA levels are markedly decreased during the transition
      from carcinoma in situ to invasive cancer. Experimental inhibition of BRCA1
      expression with antisense oligonucleotides produced accelerated growth of normal
      and malignant mammary cells, but had no effect on non-mammary epithelial cells.
      These studies suggest that BRCA1 may normally serve as a negative regulator of
      mammary epithelial cell growth whose function is compromised in breast cancer
      either by direct mutation or alterations in gene expression.

PMID- 7795652
TI  - Somatic mutations in the BRCA1 gene in sporadic ovarian tumours.
AB  - The BRCA1 gene on chromosome 17q21 is responsible for an autosomal dominant
      syndrome of increased susceptibility to breast and ovarian cancer but no somatic
      mutations in tumours have yet been described. To study the potential role of
      BRCA1 in sporadic carcinogenesis, we analysed the genomic DNA of tumour and
      normal fractions of 47 ovarian cancers for mutations in BRCA1 using the single
      strand conformation polymorphism technique. We now describe somatic mutations in
      the DNA of four tumours which also had loss of heterozygosity (LOH) at a BRCA1
      intragenic marker. Our data support a tumour suppressor mechanism for BRCA1;
      somatic mutations and LOH may result in inactivation of BRCA1 in at least a small
      number of ovarian cancers.

PMID- 7795654
TI  - Ipsilateral visual projections in non-eutherian species: random variation in the
      central nervous system?
AB  - The published descriptions of ipsilateral visual pathways in non-eutherian
      species are reviewed. Such pathways exist in members of all vertebrate classes;
      since they exist in agnathans, it is suggested that the presence of ipsilateral
      visual projections is the ancestral condition. None of the published attempts to
      explain the considerable interspecific variation of these pathways can be
      generalised to all vertebrate species: in particular, this variation is not
      generally related to the degree of overlap of the visual fields, to a particular
      mode of life, nor to taxonomic position within a given vertebrate category and
      cannot consistently be explained by variation at the albino locus. It is
      suggested that this variation is the result of purely random variation of
      unidentified elements of the genetic material or of epigenetic mechanisms and
      hence that ipsilateral visual projections are functionally neutral. This
      conclusion is supported by some extremely fragmentary behavioral data indicating
      that the information they provide is redundant.

PMID- 7795655
TI  - Role of glial-derived nexin in neuronal differentiation and in acute brain injury
      and potential involvement in exacerbation of neurodegeneration in Alzheimer's
      disease.

PMID- 7795656
TI  - Cell types in the rostral nucleus of the solitary tract.
AB  - The rostral subdivision of the nucleus of the solitary tract (rNST) is not
      laminated or otherwise organized into clearly segregated cell types. Although a
      variety of experimental approaches have yielded a wealth of information, the
      definition of cell types in this nucleus has been difficult, as reflected in the
      sometimes contradictory literature on morphological cell typing. The present
      review discusses how rNST neurons have been classified in the past and adds to
      the evidence that distinct neuron types exist in this nucleus. Consistencies in
      the literature, as well as inconsistencies among studies, are discussed.
      Furthermore, we have included a summary of our own results that help provide
      additional data relevant to cell typing. The definition of cell types in other
      central nervous system nuclei has helped our understanding of the organization of
      these nuclei and our understanding of the relationships between the morphology
      and function of neurons. It is hoped that this synthesis of the extant literature
      will facilitate the many ongoing efforts to correlate neuronal morphology and
      physiology in the gustatory system.

PMID- 7795657
TI  - Immunohistochemical mapping of neuropeptides in the premamillary region of the
      hypothalamus in rats.
AB  - The topographical distribution of neuropeptide-containing cell bodies, fibers and
      terminals was studied in the premamillary region of the rat hypothalamus using
      light microscopic immunohistochemistry. Alternate coronal sections through the
      posterior third of the hypothalamus of normal and colchicine-treated male rats
      were immunostained for 19 different neuropeptides and their distributions were
      mapped throughout the following structures: the ventral and dorsal premamillary,
      the supramamillary, the tuberomamillary and the posterior hypothalamic nuclei, as
      well as the premamillary portion of the arcuate nucleus and the postinfundibular
      median eminence. Seventeen of the investigated neuropeptides were present in
      neuronal perikarya, nerve fibers and terminals while the gonadotropin associated
      peptide and vasopressin occurred only in fibers and terminals. Growth hormone
      releasing hormone-, somatostatin-, alpha-melanocyte stimulating hormone-,
      adrenocorticotropin-, beta-endorphin- and neuropeptide Y-immunoreactive neurons
      were seen exclusively in the premamillary portion of the arcuate nucleus.
      Thyrotropin-releasing hormone-, dynorphin A- and galanin-containing neurons were
      distributed mainly in the arcuate and the tuberomamillary nuclei. A high number
      of methionine- and leucine-enkephalin-immunoreactive cells were detected in the
      arcuate and dorsal premamillary nuclei, as well as in the area ventrolateral to
      the fornix. Substance P-immunoreactive perikarya were present in very high number
      within the entire region, in particular in the ventral and dorsal premamillary
      nuclei. Cell bodies labelled with cholecystokinin- and calcitonin gene-related
      peptide antisera were found predominantly in the supramamillary and the terete
      nuclei, respectively. Corticotropin-releasing hormone-, vasoactive intestinal
      polypeptide- and neurotensin-immunoreactive neurons were scattered randomly in
      low number, mostly in the arcuate and the ventral and dorsal premamillary nuclei.
      Peptidergic fibers were distributed unevenly throughout the whole region, with
      each peptide showing an individual distribution pattern. The highest density of
      immunoreactive fibers was presented in the ventral half of the region including
      the arcuate, the ventral premamillary and the tuberomamillary nuclei. The
      supramamillary nucleus showed moderately dense fiber networks, while the dorsal
      premamillary and the posterior hypothalamic nuclei were poor in peptidergic
      fibers.

PMID- 7795658
TI  - The N-methyl-D-aspartate antagonists phencyclidine, ketamine and dizocilpine as
      both behavioral and anatomical models of the dementias.
AB  - Phencyclidine (PCP) and ketamine can induce a model psychosis in drug addicts and
      exacerbate the symptoms of chronic schizophrenics. The model psychoses these
      drugs induce mimic a variety of schizophrenic symptoms, including flattened
      affect, dissociative thought disorder, depersonalization and catatonic states.
      These symptoms can persist for prolonged periods and chronic PCP and ketamine
      addicts have persisting memory deficits. Dizocilpine (MK-801) is a simpler drug
      than PCP or ketamine in its actions, but it shares with both the property of
      blocking in a non-competitive manner the N-methyl-D-aspartate (NMDA) ion-channel.
      Behavioral observations and drug-discrimination studies in animals indicate that
      PCP and dizocilpine are similar in their effects and they both have a neurotoxic
      effect on neurons in posterior cingulate cortex. Recent studies have indicated
      that both of these drugs, when given continuously for several days, further
      induce neuronal degeneration in other limbic structures. These include brain
      regions of rats related to olfaction, associated limbic structures such as
      piriform cortex and posterior regions of entorhinal cortex and in it's
      projections, through the perforant pathway, to dentate gyrus and other cells in
      ventral hippocampus. These degenerative consequences may be excitatory neurotoxic
      effects, for these compounds also induce an elevation in glucose metabolism
      maximal in just those structures where degeneration is observed and the
      degeneration involves entire cells, with all of their processes. It has been
      suggested these non-competitive NMDA antagonists induce an increase in firing
      rate in a limbic circuit which includes the perforant pathway. At least some
      competitive NMDA antagonists induce the same pattern of degeneration and altered
      glucose utilization. There is anatomical and functional evidence that alterations
      in these same limbic structures are present in the dementia syndrome manifested
      by some schizophrenics and most Alzheimer's patients. This suggests that these
      non-competitive NMDA antagonists may provide a more complete model of psychoses
      and memory disturbances than previously recognized, in that they can mimic both
      persisting symptomatology and neuroanatomical abnormalities. While the
      neurochemical underpinnings of this effect remain elusive, it appears to be both
      age and sex dependent. Further studies of the mechanisms by which NMDA
      antagonists induce increased glucose utilization and neurotoxicity in these
      limbic structures may clarify these alterations in this simplified Papez-like
      circuit.

PMID- 7795659
TI  - Regulation of human protein C gene expression by the mouse WAP promoter.

PMID- 7795660
TI  - Progress in Drosophila genome manipulation.
AB  - The introduction of cloned and manipulated genetic material into the germline of
      an experimental organism is one of the most powerful tools of modern biology. In
      the case of the fruit fly, Drosophila melanogaster, there is also an unparalleled
      range of sophisticated genetic tools to facilitate subsequent analysis. In
      consequence, Drosophila remains a most favourable model organism for the
      dissection of gene structure and function in vivo. In this review we look at some
      of the achievements to date in Drosophila genome manipulation, and at what may be
      possible in the near future.

PMID- 7795662
TI  - In ovo transfection of chicken embryos using cationic liposomes.
AB  - It is reported that cationic liposomes are capable of transfecting embryos in
      unincubated fertile chicken eggs and that the cationic liposome, TransfectAce,
      has superior properties to Lipofectin. In order to determine the duration of
      expression of genes introduced in this way, embryos were transfected with an
      expression vector encoding the firefly luciferase cDNA under the control of the
      Rous sarcoma virus long terminal repeat (LTR). Luciferase activity could be
      observed consistently in day 3 embryos and activity was detectable up to day 8 of
      incubation. The relative expression of luciferase under the control of different
      viral promoters was compared in transfected chicken embryo fibroblasts and day 3
      embryos. The cytomegalovirus immediate early promoter and the SV40 early promoter
      directed the highest amount of expression in fibroblasts while the Rous sarcoma
      virus LTR caused the highest amount of expression in embryos. Chicken embryo
      fibroblasts were transfected with the luciferase vector in order to examine
      duration of reporter gene expression in vitro. Luciferase expression was
      decreased exponentially over a 24-day period after which point luciferase
      activity could no longer be detected. These data suggest that stable integration
      of transfected DNA using liposomes is a rare event. Nevertheless, liposome
      mediated transfection of embryos is suitable for the examination of promoter
      activity in vivo and may be a useful method to transfect genes to study embryonic
      development.

PMID- 7795661
TI  - B-cell maturation in chimaeric mice deficient for the heat stable antigen
      (HSA/mouse CD24).
AB  - The murine differentiation marker heat stable antigen (HSA) is a GPI-anchored
      surface glycoprotein showing strong expression on immature B- and T-lymphocytes
      and gradually reduced expression during maturation. Although HSA has been
      suggested to be involved in adhesion and/or signalling, its function has not been
      clearly demonstrated so far. In order to elucidate the function of HSA, we
      analysed chimaeric mice that were generated by targeted disruption of both HSA
      alleles in ES cells. These mice contain normal numbers of peripheral B-cells and
      normal serum IgM and IgG titres of ES cell-derived allotype, demonstrating that
      HSA expression on B-cells is not an absolute requirement for their maturation.
      However, a reduction in immature B-cells in the bone marrow and an altered degree
      of bone marrow and blood chimaerism suggest that HSA expression influences the
      maturation of B-cells.

PMID- 7795664
TI  - Pharmacokinetics of cadmium following intravenous and oral administration to non
      lactating ewes.
AB  - In a preliminary study, ewes received daily oral cadmium chloride administrations
      and cadmium concentration was measured in blood and tissues. A pharmacokinetic
      analysis of cadmium disposition was then carried out in ewes administered cadmium
      chloride iv and, 21 months later, orally in the same ewes. Pharmacokinetic
      parameters were analysed using a 3-compartment open model. The systemic
      availability was 0.15-0.5%, the half-life of elimination was 100-150 d, the blood
      clearance was 0.12-0.16 l.kg-1.d-1 and the steady-state volume of distribution
      was 17-35 l/kg. Following iv administration cadmium was found in tissues about 2
      years later.

PMID- 7795663
TI  - Production of transgenic mice by microinjection of DNA into vitrified pronucleate
      stage eggs.
AB  - Vitrification is a technique for cryopreserving cells without crystallization due
      to elevation of the viscosity during the cooling process. We have developed a
      rapid and convenient mean of cryopreserving mouse preimplantation embryos by
      vitrification using a solution (hereafter named DPS) consisting of 2.75 M
      dimethylsulfoxide, 2.75 M propylene glycol and 1.0 M sucrose. In vitro fertilized
      pronucleate stage eggs were used because a large number of stage-matched eggs can
      be obtained at once. Only successfully fertilized eggs were collected and
      vitrified in DPS. After warming, two DNA constructs were injected into a total of
      257 cryopreserved eggs, of which 175 (68%) survived the injection and were
      transferred into six recipients. All recipients became pregnant and gave birth to
      a total of 20 pups. When these DNA constructs were concomitantly injected into
      fresh eggs, 18% of eggs that were transferred developed into live pups, which was
      the same as the 18% figure for the cryopreserved eggs. With respect to
      transgenesis, 40% of the pups (8/20) developed from vitrified eggs were
      transgenic. In terms of the injected eggs that had been transferred, 4.5% of the
      213 fresh eggs and 3.1% of the 112 vitrified eggs developed into transgenic mice.
      These results indicate that the efficiency of production of transgenic mice from
      vitrified eggs is comparable to that from fresh eggs.

PMID- 7795666
TI  - Parasite nematode infections in Awassi adult sheep: distribution through Syrian
      farm flocks.
AB  - A survey was conducted on 1,474 adult sheep from 73 flocks distributed in the 13
      provinces of Syria. Faecal egg and larval nematode outputs were studied.
      Marshallagia and Nematodirus infections were higher in the driest areas;
      infections by other nematodes, Dictyocaulus and small lungworms (Cystocaulus and
      Muellerius) were higher in the more rainy areas. A long transhumance limited
      small lungworm infections, which were higher in flocks using wet night shelters.

PMID- 7795665
TI  - Ginseng-enhanced oxidative and phagocytic activities of polymorphonuclear
      leucocytes from bovine peripheral blood and stripping milk.
AB  - This study investigated the effect of a dried ginseng extract on
      polymorphonuclear leucocytes (PMNL) in bovine blood and milk. In a test for
      chemiluminescence (CL), PMNL were pre-incubated in ginseng solution at 37 degrees
      C in 5% CO2 for 60 min, and then stimulated with bovine serum opsonized zymosan.
      The CL was about 30% higher for the cells pre-treated with ginseng solutions 100
      1,000 micrograms/ml as compared with the non-ginseng-treated cells. In a test for
      phagocytosis, PMNL and fluorescent microspheres were incubated with ginseng in
      RPMI-1640 supplemented with 10% bovine serum at 37 degrees C for 60 min. The
      proportion of actively phagocytic cells in the ginseng-treated group was greater
      than that in the non-ginseng treated group.

PMID- 7795667
TI  - Disposition kinetics and dosage regimen of cefotaxime in cross-bred male calves.
AB  - The disposition kinetics and dosage regimen of cefotaxime were investigated in
      cross-bred calves following a single intravenous administration of cefotaxime (10
      mg/kg). The elimination rate constant and elimination half-life were 0.273 +/-
      0.060 h-1 and 3.48 +/- 1.17 h, respectively. The apparent volume of distribution
      (Vd area) and total plasma clearance were 3.51 +/- 0.66 l/kg and 0.81 +/- 0.10
      l.kg-1.h-1, respectively. To maintain a minimum therapeutic concentration of 0.6
      microgram/ml, a satisfactory intravenous dosage regimen of cefotaxime in calves
      should be 11 mg/kg followed by 9 mg/kg at 6 h.

PMID- 7795668
TI  - An alternative method for direct sequencing of PCR products, for epidemiological
      studies performed by nucleic sequence comparison. Application to rabbit
      haemorrhagic disease virus.
AB  - A sequencing strategy based on the use of commercially available fluorescent
      labeled universal primers for directly sequencing polymerase chain reaction (PCR)
      amplified material has been developed. The PCR reactions were performed with
      hybrid primers, specific to the viral sequence and possessing the sequence of the
      standard sequencing primers at their 5' end (M13 and reverse primers). These
      amplified fragments were sequenced by a classical dye-primer kit on an automated
      sequencer. As opposed to the use of fluorescent dideoxynucleotides, this
      sequencing method yielded accurate, high-grade sequences and had several
      advantages. First, the intensity of the sequencing peaks was much more
      homogeneous with the dye primer method. In addition, the problem of altered
      electrophoretic mobility, which may occur during the sequencing of custom
      synthesised fluorescent primers, was avoided. This method was successfully
      reproduced using several different sets of chimeric primers. We believe that it
      is suitable for epidemiological studies conducted by nucleic sequence comparison,
      as in the case of rabbit haemorrhagic disease virus, as well as in other systems.

PMID- 7795669
TI  - Changes in the coagulation profile of lambs intoxicated with aflatoxin in their
      feed.
AB  - Twenty-three male lambs were intoxicated with 2.5 ppm aflatoxins in their feed
      for a period of 3 weeks. Thirteen lambs were maintained as a control group (0 ppm
      aflatoxins in their feed). The coagulation profiles were determined from blood
      samples that were obtained at 0, 7, 14 and 21 d during the intoxication period
      and at 1, 2, 4 and 8 d of an 8-d clearance period. Aflatoxicosis in the animals
      was characterized by an increase in prothrombin time (P < 0.01) from d 14 of the
      intoxication period until the end of the experiment. An increase (P < 0.05) in
      fibrinogen concentration was detected beginning on d 21, instead of the expected
      decrease. This was probably due to the inflammation found in the lungs of the
      intoxicated animals. No difference in activated partial thromboplastin time was
      found between intoxicated and control animals. These results suggest that there
      was a significant change in some coagulation factors of the extrinsic pathway in
      the intoxicated lambs and that prothrombin time determination could be used as an
      indicator of aflatoxicosis in lambs.

PMID- 7795670
TI  - Vaccination and control of infectious and parasitic diseases.

PMID- 7795671
TI  - Veterinary vaccines. Specificities and the weight of regulations.

PMID- 7795672
TI  - [Vaccination in the sanitary and economic context of animal production].

PMID- 7795673
TI  - [Vaccination of ruminants against brucellosis].

PMID- 7795674
TI  - [Vaccination of swine against Aujeszky's disease].

PMID- 7795675
TI  - Vaccination in fish.

PMID- 7795676
TI  - [Recombinant vaccine against rabbit hemorrhagic disease virus].

PMID- 7795677
TI  - Defective adenoviruses as virus vectors for veterinary vaccines.

PMID- 7795678
TI  - [Pseudo-particles of rotavirus: properties and prospects of utilization].

PMID- 7795679
TI  - [Proposed vaccination strategy agaist mastitis of dairy cows].

PMID- 7795680
TI  - [Vaccination against abortive chlamydia infections of small ruminants].

PMID- 7795681
TI  - [Vaccines against respiratory diseases of swine: example Mycoplasma
      hyopneumoniae].

PMID- 7795682
TI  - Mucosal vaccination against toxoplasmosis.

PMID- 7795683
TI  - [Vaccination against avian coccidiosis].

PMID- 7795684
TI  - Vaccination of rabbits against coccidiosis with precocious Eimeria lines.

PMID- 7795685
TI  - DNA-based immunization and the immune response to the hepatitis B surface
      antigen.

PMID- 7795686
TI  - Prospects in vaccine adjuvants.

PMID- 7795687
TI  - Vaccine delivery systems.

PMID- 7795688
TI  - Molecular events in production and transport of secretory IgA: a basis for design
      of reagents for passive immune protection.

PMID- 7795690
TI  - [Gastrointestinal flora and oral immunization].

PMID- 7795689
TI  - [Lactogenic immunity and vaccinal protection in swine].

PMID- 7795691
TI  - Epidemiology and vaccination strategy: Babesia divergens bovine babesiosis
      example.

PMID- 7795692
TI  - Powerhouse purchasing.

PMID- 7795693
TI  - Medical director raises barely a blip.

PMID- 7795695
TI  - Quality watch. Stroke rehab: all the right moves.

PMID- 7795694
TI  - How the Supreme Court saved NY hospitals $200 million.

PMID- 7795696
TI  - Riding the express. Is your subacute strategy on track?
AB  - For many health care providers, it's time to catch the bullet train called
      subacute care, an area of health care that's booming and offers new opportunity.
      But riding the rails of this new mode of transport isn't as easy as it seems. In
      fact, it can be downright tricky. That's why experts are warning hospital
      executives, in particular, to know beforehand exactly what they're getting into.

PMID- 7795697
TI  - If you want to play, you've got to pay. Community outreach is the name of the
      game, but how do hospitals pay for it?

PMID- 7795698
TI  - New wave equity. Surf's up for doctors as equity players.
AB  - For-profit capital is rushing into health care at an unparalleled rate. And a lot
      of it is finding its way toward physician groups and new combinations of
      physician-run organizations. It's true that hospital-based organizations
      understand the whys and wherefores of the new equity game.

PMID- 7795699
TI  - Tapping into teams.
AB  - Team management has a definite cachet in management circles in general industry;
      business magazines like Fortune regularly write about the concept, and executives
      in a wide variety of business fields are excited by it. But there's a lot of
      confusion behind the buzz, and the reality, say experts and those who've tried
      it, is a lot more complex than it might seem at first. Can the idea even be
      applied to hospitals and other large health care organizations?

PMID- 7795701
TI  - Winning CEOs. Score one for good coaching. Interview by Anne M. Nordhaus-Bike.

PMID- 7795700
TI  - Profiles in Service (1986-1995). 1993 Foster G. McGaw Prize winner. Cambridge
      Hospital, Cambridge, Massachusetts.

PMID- 7795702
TI  - Quality patrol. A front-line strategy.

PMID- 7795703
TI  - Doctors turned programmers.

PMID- 7795704
TI  - Clowning for comfort. Interview by Jim Montague.

PMID- 7795705
TI  - Managed care. Southern gumption.

PMID- 7795706
TI  - Long term care. Insurance for life.

PMID- 7795707
TI  - Restoring public trust.

PMID- 7795708
TI  - Transmembrane helix-helix interactions and accessibility of H2DIDS on labelled
      band 3, the erythrocyte anion exchange protein.
AB  - 4,4'-Diisothiocyanodihydrostilbene-2,2'-disulphonate (H2DIDS), a bifunctional
      inhibitor of anion exchange in erythrocytes, reacts with Lys-539 in band 3 at
      neutral pH and crosslinks to Lys-851 at alkaline pH. The accessibility of H2DIDS
      labelled band 3 was determined using an anti-H2DIDS antibody and proteolysis.
      Competitive enzyme-linked immunosorbent assays (ELISAs) showed that a polyclonal
      antibody raised against H2DIDS-labelled keyhole limpet hemocyanin bound a variety
      of stilbene disulphonates in the following order of affinities, H2DIDS having the
      highest affinity: H2DIDS > 4,4'-diisothiocyanostilbene-2,2'-disulphonate (DIDS) >
      4-acetamido-4'-isothiocyanostilbene-2,2'disulphonate (SITS) > 4,4'
      dinitrostilbene-2,2'-disulphonate (DNDS) > 4,4'-diaminostilbene-2,2'-disulphonate
      (DADS). The antibody readily detected mono- or bifunctionally H2DIDS-labelled
      band 3 and proteolytic fragments on immunoblots. H2DIDS attached to Lys-539 is
      retained in a 7.5 kDa membrane-associated peptide after papain treatment of ghost
      membranes while the sequence around Lys-851 is more accessible. The band 3
      proteolytic fragments protected by the membrane from proteolysis remained
      associated as a specific complex with a Stokes radius slightly smaller than the
      dimeric membrane domain after solubilization in detergent solution and retained
      82% of the amino acid content of the membrane domain. Circular dichroism (CD)
      measurements of this H2DIDS-labelled complex showed that it had a very high
      helical content (86%). The loops connecting the transmembrane segments in H2DIDS
      labelled band 3 are therefore not required to maintain transmembrane helix-helix
      interactions. Denatured band 3 prelabelled with H2DIDS was more readily
      immunoprecipitated with the anti-H2DIDS antibody than was native band 3 in
      detergent solution. Deglycosylation of band 3 or proteolytic cleavage of the
      extramembranous loops did not enhance immunoprecipitation of H2DIDS-labelled band
      3. The stilbene disulphonate inhibitor site is therefore relatively inaccessible
      and is bound by a bundle of helices in the native band 3 protein.

PMID- 7795709
TI  - The use of fluoresceinphosphatidylethanolamine (FPE) as a real-time probe for
      peptide-membrane interactions.
AB  - The characterization of fluoresceinphosphatidylethanolamine (FPE) as a real-time
      indicator of the electrostatic nature of a membrane surface is described. The
      conditions appropriate for the labelling of membranes and the implementation of
      FPE as a tool to monitor the interactions of various peptides with model
      membranes are outlined. It is shown that of the membrane-active peptides studied,
      Naja naja kaouthia cardiotoxin and pyrularia thionin bind to certain model
      membranes without insertion. Whereas the leader sequence of the nuclear encoded
      subunit IV of mammalian cytochrome c oxidase (E.C. 1.9.3.1), known as p-25, and
      melittin appear to bind and then partially insert into the membrane. It seems
      evident also that melittin does not adopt a fully transmembrane configuration.
      Melittin is known to promote membrane lysis and by employing a rapid-kinetic
      technique it is shown that the time-course of such lysis does not appear to
      correlate with peptide binding, but following binding a significant proportion of
      melittin must become inserted into the membrane before lysis appears to commence.

PMID- 7795710
TI  - Topological and segmental phylogenetic analyses of the anion exchanger (band 3)
      family of transporters.
AB  - Eleven sequenced anion exchanger (AE; band 3) proteins, including five AE1, four
      AE2 and two AE3 proteins, comprise the anion exchanger family (AEF) of homologous
      proteins. Eliminating the rat and rabbit proteins that are nearly identical to
      the corresponding mouse proteins, seven dissimilar members of this family were
      selected for study, divided into N-terminal, central and C-terminal segments
      (designated segments 0, 1 and 2, respectively) and analysed separately for
      sequence similarity and phylogenetic relatedness. Segments 0 are variable in
      length and sequence, are essentially lacking in some of the members of the AEF,
      and are not demonstrably homologous in other members of the family. All segments
      1 and 2 are homologous, but they exhibit widely differing degrees of sequence
      divergence. Segments 2 are highly conserved in all AEF proteins. Segments 1 of
      the AE2 and AE3 proteins are as conserved as are segments 2, but segments 1 of
      the AE1 proteins have diverged from each other and from the AE2 and AE3 segments
      1 much more than have segments 2 of these same proteins. The distributions of
      various types of amino acid residues in the putative transmembrane helical
      spanners of the seven dissimilar members of the AEF, based on a modification of
      the 14-spanner model of Wang et al. (1994) was determined, and this distribution
      was compared with those of other transmembrane transport proteins of known
      structure (bacterial rhodopsins, outer membrane porins of Gram-negative bacteria
      and bacterial photosynthetic reaction centres.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7795712
TI  - Partitioning of 1,4-benzodiazepines into natural membranes.
AB  - The partition coefficients of several 1,4-benzodiazepin-2-ones (BZDs) were
      determined in a synaptosomal membrane-buffer system (Pm/b) by a two-component
      model analysis of the experimental data and the following values were obtained:
      flunitrazepam (FNTZ) = 32.2 +/- 1.5; diazepam (DZ) = 79 +/- 9; clonazepam (CNZ) =
      30 +/- 4; nitrazepam (NTZ) = 38 +/- 2 and chlorodiazepoxide (CDZX) = 15.7 +/-
      0.6. Correlations between these Pm/b and other chemical properties were performed
      by a principal component analysis. Hydrophobicity of BZDs, measured as the
      partition coefficients in different solvent systems, could be correlated with the
      presence of a methyl group at position 1 of the seven-member ring of the BZD
      molecule. The values of the partition coefficients of benzodiazepine in the
      synaptosomal membrane-buffer system were one order of magnitude lower than those
      obtained in an octanol-water or in ethyl acetate-water systems. The complexity of
      the membrane, unlike the isotropy of a pure solvent phase, provides a wide
      spectrum of types of interactions which, in turn, can be modulated in a dynamic
      manner by local or generalized changes in the lipid phase state. In that sense,
      the present values of Pm/b should be interpreted as an average tendency of BZDs
      to establish non-specific interactions with the molecules present in the
      different phases within biological membranes. Conversely, these Pm/b values
      reflect a consequence of the difference in complexity between natural membranes
      and the systems currently used as membrane models for drug partitioning.

PMID- 7795711
TI  - SecA-dependence of the translocation of a large periplasmic loop in the
      Escherichia coli MalF inner membrane protein is a function of sequence context.
AB  - We have analysed the translocation of a large periplasmic loop in the Escherichia
      coli MalF inner membrane protein when placed in different sequence contexts and
      under conditions when the function of the SecA protein is inhibited. The results
      show that the degree of SecA-dependence varies with sequence context: while
      translocation of the large loop in its normal context is only minimally affected
      by SecA inhibition, translocation is much more sensitive to SecA inhibition when
      the loop is placed in the context of other inner membrane proteins. Conversely,
      when the large MalF loop is replaced by segments from other proteins,
      translocation of those segments is again very sensitive to SecA inhibition. Thus,
      SecA-dependence is not an all-or-none phenomenon and is not only a simple
      function of, e.g. the length of a translocated segment or the hydrophobicity of
      the flanking transmembrane segments.

PMID- 7795714
TI  - NEUREX: a tutorial expert system for the diagnosis of neurogenic diseases of the
      lower limbs.
AB  - Specialist tutors have to transfer two types of knowledge to doctors who are
      specialising in a particular clinic: public declarative knowledge, including
      facts, notions, principles in that particular field; and their own private
      procedural knowledge acquired in years of direct experience. Embodying this
      knowledge into an expert system means that this information can be shared more
      rapidly, and tutoring is easier. This paper presents a tutorial expert system for
      neurological clinics which can emulate the diagnostic process of an expert
      neurologist for neurogenic diseases of the lower limbs, assist users in planning
      the optimal sequence of NG and EMG tests, interpret the results of these tests,
      and help users to achieve the most suitable diagnosis.

PMID- 7795713
TI  - Development and retrospective evaluation of Hepaxpert-I: a routinely-used expert
      system for interpretive analysis of hepatitis A and B serologic findings.
AB  - Hepaxpert-I is an expert system that interprets the results of routine serologic
      tests for infection with hepatitis A or B virus. The tests measure antibody to
      the hepatitis A virus (anti-HAV), IgM antibody to the hepatitis A virus (IgM anti
      HAV), hepatitis A virus (HAV) in the stool, hepatitis B surface antigen (HBsAg)
      and antibody (anti-HBs), antibody to hepatitis B core antigen (anti-HBc and IgM
      anti-HBc), and hepatitis B envelope antigen (HBeAg) and antibody (anti-HBe). The
      knowledge base of Hepaxpert-I contains 13 If-Then rules for hepatitis A and 106
      If-Then rules for hepatitis B serology. Formally, knowledge acquisition was done
      by forming a partition of each of the two sets of possible serologic finding
      patterns that contain patterns of serologic test results, 64 for hepatitis A and
      4096 for hepatitis B, respectively. After entering an input pattern of serologic
      test results in Hepaxpert-I, a rule pattern matching algorithm based on indexing
      is internally employed as efficient access method for providing the respective
      interpretive text. Since 1 September 1989, Hepaxpert-I has been routinely applied
      at the Hepatitis Serology Laboratory of the 2nd Department of Gastroenterology
      and Hepatology at the University of Vienna Medical School (Vienna General
      Hospital). Beforehand, a retrospective evaluation of the expert system based on
      23,368 hepatitis A and 24,071 hepatitis B serology requests was carried out.

PMID- 7795715
TI  - Evaluation of a knowledge-based decision-support system for ventilator therapy
      management.
AB  - Evaluation of knowledge-based systems differs from that of conventional systems
      in terms of verification and validation techniques. Furthermore, evaluating
      medical decision-support systems is difficult because the field is thus far
      comparatively unexplored. This paper presents an evaluation of a medical
      knowledge-based system called VentEx that supports decision-making in the
      management of ventilator therapy. Real patient data from 1300 hours of patient
      care involving 12 patients with 6 diagnoses are used to validate the knowledge
      base. The results range from 4.5% to 15.6% disagreement between the setting
      recommendations produced by VentEx and a gold standard, and 22.2% disagreement
      for recommendations for weaning. A comparison between the standard and two
      physicians showed that VentEx produced advice of the same quality as the
      physicians.

PMID- 7795716
TI  - Neural network assisted cardiac auscultation.
AB  - Traditional cardiac auscultation involves a great deal of interpretive skill.
      Neural networks were trained as phonocardiographic classifiers to determine their
      viability in this role. All networks had three layers and were trained by
      backpropagation using only the heart sound amplitude envelope as input. The main
      aspect of the study was to determine what topologies, gain and momentum factors
      lead to efficient training for this application. Neural networks which are
      trained with heart sound classes of greater similarity were found to be less
      likely to converge to a solution. A prototype normal/abnormal classifier was also
      developed which provided excellent classification accuracy despite the sparse
      nature of the training data. Future directions for the development of a full
      scale computer-assisted phonocardiographic classifier are also considered.

PMID- 7795717
TI  - Neural network classification of infrared spectra of control and Alzheimer's
      diseased tissue.
AB  - Artificial neural network classification methods were applied to infrared spectra
      of histopathologically confirmed Alzheimer's diseased and control brain tissue.
      Principal component analysis was used as a preprocessing technique for some of
      these artificial neural networks while others were trained using the original
      spectra. The leave-one-out method was used for cross-validation and linear
      discriminant analysis was used as a performance benchmark. In the cases where
      principal components were used, the artificial neural networks consistently
      outperformed their linear discriminant counterparts; 100% versus 98% correct
      classifications, respectively, for the two class problem, and 90% versus 81% for
      a more complex five class problem. Using the original spectra, only one of the
      three selected artificial neural network architectures (a variation of the back
      propagation algorithm using fuzzy encoding) produced results comparable to the
      best corresponding principal component cases: 98% and 85% correct classifications
      for the two and five class problems, respectively.

PMID- 7795718
TI  - Early history of venogenic impotence.
AB  - As early as 1860, innovative research defined the neural and vascular phenomena
      which generate male sexual tumescence. Sophisticated animal experiments provided
      important data about enhanced arterial inflow and occlusion of venous outflow
      which cause and maintain erection of the penis. On the basis of these
      observations, various treatment strategies for impotence, like sclerotherapy or
      surgical ligation to improve penile venous occlusion, have been attempted since
      1873. In this historical review, I assert that contemporary theories of the role
      of penile venous occlusion during tumescence reiterate ideas proposed more than a
      century ago.

PMID- 7795719
TI  - Adenosine: a new agent in the diagnosis of impotence.
AB  - The haemodynamic effects of different dosages of adenosine were studied using
      colour flow Doppler sonography (CFDS) in 33 men, whose penile vascular bed
      responded well to papaverine. In six cases, we injected 25, 50, 100, 250
      micrograms dosages of adenosine intracavernously at 15 min intervals and no
      erection occurred. However, 500 and 1000 micrograms doses of adenosine increased
      the arterial blood velocities for a few seconds in five cases. Later on, in eight
      cases, we infused 80 and 120 micrograms/kg/min adenosine for 3 min and only with
      120 micrograms/kg/min dosage, did we observe clinical response and significant
      changes in CFDS parameters. Finally, 120 micrograms/kg/min adenosine dosage was
      infused for 10 min in 14 men and eight showed full erection while six had only
      tumescence. As adenosine was rapidly metabolized by adenosine deaminase, the
      erection lasted for only 5 to 13 min. No prolonged erection and no other side
      effect was observed. In addition no fibrosis and curvature was detected 6 months
      after the injections. We found that, in men, 10 min infusion of 120
      micrograms/kg/min adenosine increased the arterial flow and to some extent venous
      resistance, resulting in full erection or tumescence. Therefore, adenosine may be
      used as an agent for the diagnosis of vasculogenic impotence, but further studies
      for determining the standard dosage of adenosine are needed.

PMID- 7795720
TI  - Characteristics of men interested in evaluation of erectile dysfunction.
AB  - Erectile dysfunction is a common disorder. However, not all dysfunctional men
      want to pursue evaluation. To delineate the characteristics of men interested in
      evaluation of erectile dysfunction, we conducted a mailed survey of 1031 randomly
      selected male veterans aged 30-99 years. We received 427 completed surveys. Using
      logistic regression, we found loss of sexual pleasure, loss of stiffness and
      duration of erection, and the ability to have orgasm to be predictors of which
      men were interested in evaluation of erectile dysfunction. Age, functional
      status, availability of a partner, marital status, sexual interest, partner's
      sexual interest, and duration of dysfunction were not significantly different
      between men interested and not interested in evaluation of erectile dysfunction.

PMID- 7795721
TI  - Minoxidil versus nitroglycerine: a prospective, double-blind, controlled trial in
      transcutaneous therapy for organic impotence.
AB  - Minoxidil (1 ml, 2% solution) has been tested against nitroglycerine (2.5 g, 10%
      ointment) and placebo in a prospective, double-blind controlled trial in
      transcutaneous therapy for organic impotence. A total of 116 patients
      participated in the study. Impotence aetiology breakdown was as follows:
      arterial, 61 cases; neurogenic, 34; arterial plus neurogenic, 12; venous leakage,
      9. The application sites for treatment were: glans penis (minoxidil and placebo),
      penile shaft (nitroglycerine). All patients underwent through sexological
      counselling sessions (at outset and prior to subsequent changes in drug used).
      The results were considered positive if all symptoms of impotence (ie 'slow'
      erection, loss of erection, insufficient erection) were resolved; if even one
      symptom remained the results were considered negative. Side-effects were also
      considered. Minoxidil proved significantly more active than nitroglycerine which
      was, in turn, more effective than placebo. Minoxidil proved significantly more
      active in neurogenic impotent patients. Fewer side-effects were found with
      minoxidil than with nitroglycerine. These data lead one to consider minoxidil
      useful in the treatment of selected cases of organic impotence, as long as
      psychological conflict regarding sex and drug use are carefully removed.

PMID- 7795723
TI  - Visual sexual stimulation and penile vibration in screening men with erectile
      dysfunction.

PMID- 7795722
TI  - Assessment of local sympathetic function in patients with erectile dysfunction.
AB  - Fifty men with erectile dysfunction (ED) were urologically investigated for
      autonomic deficit by evaluation of the sympathetic skin response at the penis.
      They were additionally subjected to thorough urological, vascular, psychiatric
      and neurological examinations, and well-established neurophysiological tests of
      the somatosensory, sympathetic, and parasympathetic function. Patients with
      clinical evidence of neurological deficit showed abnormal results (68%) in at
      least one test of the autonomic nervous system. The sympathetic skin response at
      the penis was absent in 11 cases (37%) with clinical evidence of neuronal
      aetiology of the erectile dysfunction and was normal in all cases with positive
      evidence of a psychiatric origin of erectile dysfunction and no clinical
      indication of a neuronal deficit. Moreover, the sympathetic skin response at the
      penis was abnormal in three cases with normal results in the other
      neurophysiological tests. The results emphasize that the local sympathetic skin
      response at the penis is a useful extension of autonomic testing in ED patients
      since this method tests local sympathetic pathways and is sometimes the only
      evidence for autonomic deficit. From a clinical viewpoint, the sympathetic skin
      response at the penis is a very simple and time-saving neurophysiological method
      suitable for clinical routine and also for the investigation of outpatients.

PMID- 7795724
TI  - Tumours of the meninges: an overview of new entities.

PMID- 7795726
TI  - Immunostaining for calcineurin, a Ca2+/calmodulin-regulated protein phosphatase,
      in the diagnostic tumor pathology.
AB  - The present immunochemical study concerns the distribution of calcineurin (CaN),
      a Ca2+/calmodulin-regulated protein phosphatase, in the nervous and
      neuroendocrine systems of mammals, and discloses the CaN-immunostaining results
      of human neoplasms. CaN immunoreactivity (ir) was present throughout the nervous
      system with a marked regional variation in strength of the staining intensity.
      Light microscopic observations showed that CaN-ir was localized in neurons, but
      was not detected in non-neuronal cells including astrocytes. Ultrastructural
      study also revealed that CaN-ir was present only in neuronal elements such as
      somata, dendrites including postsynaptic densities and spines, and nerve
      terminals. CaN-ir was also detected in neuroendocrine cells of some endocrine
      tissues including the pineal gland, pituitary gland, adrenal grand, pancreas and
      thyroid gland. Immunostaining results of 107 surgical specimens of human
      neoplasms, including 9 cases of peripheral tumors, disclosed that CaN
      immunopositive tumor cells were found to be present in the neuronal tumors
      including neuroblastomas, ganglioglioma, ganglioneuroma, ganglioneuroblastoma,
      retinoblastomas, medulloblastomas and central neurocytomas. Also, some
      neuroendocrine tumors, such as pineocytomas, olfactory neuroblastomas and
      paragangliomas, specifically reacted for anti-CaN antibody. On the basis of these
      immunochemical findings, we have proposed that CaN can be a marker protein for
      detection of neuronal and neuroendocrine tumor cells in the diagnostic pathology
      of human neoplasms.

PMID- 7795725
TI  - Localization of apoptotic cells in situ of brain tumors.
AB  - The apoptotic cells in situ of normal tissues and human brain tumors were
      analyzed by the modified method of TUNEL, and the relationship between the
      localization of apoptotic cells and the expression of bcl-2 protein was examined.
      The localization of apoptotic cells in normal tissue was situated at fast
      renewing tissues, and differed from the localization of the expression of bcl-2
      protein. In the cases of medulloblastoma, 7 out of 8 cases (87.5%) showed
      apoptotic cells. In contrast to the results of high frequency of apoptotic cells
      in medulloblastoma and germinoma, the expression of bcl-2 protein was found very
      low incidence in those tumors, which were thought to be sensitive against
      radiation or chemotherapy. These results suggested that the detection of
      apoptosis in situ by this method could predict the sensitivity of radiation or
      chemotherapy of the tumor cells.

PMID- 7795727
TI  - Clinicopathological study on pineocytoma.
AB  - Six cases of pineocytoma, which had developed in the parenchyma of the adult
      pineal body, were examined immunohistochemically and under an electron
      microscope, after the malignancy of each case had been determined using our
      classification. One case was rated as grade 1 showing a lobular structure and
      resembling the normal pineal body. Two cases were rated as grade 2 without a
      lobular structure but with pineocytomatous rosettes (P-rosettes). Two cases were
      rated as grade 3 without P-rosettes but with few mitotic figures. One case was
      rated as grade 4 with marked cellular pleomorphism, numerous mitotic figures and
      necrotic foci. When examined immunohistochemically, neuron-specific enolase was
      positive but glial fibrillary acidic protein was negative in all cases. Under an
      electron microscope, all cases showed abortive synapses, and clear or dense core
      vesicles. These findings allow us to make two conclusions. First, pineocytoma is
      always a tumor of neuronal lineage, regardless of their grade of malignancy.
      Second, the grade 4 pineocytoma should be distinguished from the type of tumor
      classically called "pineoblastoma." That is, the former seems to be a
      biologically dedifferentiated tumor, while the latter seems to be biologically
      undifferentiated tumor.

PMID- 7795728
TI  - The analysis of p53 tumor suppressor gene in pineal parenchymal tumors.
AB  - p53 gene mutation was examined in 9 pineal parenchymal tumors, 4 pineoblastomas
      and 5 pineocytomas, by the immunohistochemical and the polymerase chain reaction
      mediated single strand conformation polymorphism (PCR-SSCP) analyses. In each
      case, immunohistochemical analysis revealed no positive staining for p53 protein
      with either PAb1801 or DO-1 antibody and PCR-SSCP analysis revealed no abnormal
      migration in exons 5 to 8 of the p53 gene. These findings suggested that p53 gene
      mutation is rarely related with the tumorigenesis of pineal parenchymal tumors.

PMID- 7795729
TI  - Hypothalamic hamartoma: anatomic, immunohistochemical and ultrastructural
      features.
AB  - Four patients with hypothalamic hamartoma were examined by CT and/or MR imaging,
      immunohistochemistry and electron microscopy. The hamartomas arose from the
      hypothalamus and extended inferiorly. LH-RH neurons were detected in three cases
      by immunohistochemistry. Electron microscopy revealed large myelinated axons,
      axon terminals containing dense-core vesicles and axon terminals with clear
      vesicles forming asymmetrical synapses. The development of hypothalamic hamartoma
      and its functional manifestations (precocious puberty and laugh attacks) are
      discussed in reference to the migration of LH-RH neurons from the olfactory
      placode.

PMID- 7795730
TI  - Clear cell (glycogen-rich) meningioma with special reference to spherical
      collagen deposits.
AB  - A detailed immunohistochemical and electron microscopic study of a case of clear
      cell (glycogen-rich) meningioma is presented. The neoplasm recurred three times
      and the patient died of the disease. The specimens obtained at all three
      operations showed similar basic histologic patterns. The tumor was comprised
      mainly of a syncytial, sheet-like proliferation of polygonal cells with clear
      cytoplasm containing abundant glycogen. The immunohistochemical features included
      epithelial membrane antigen- and vimentin-positive cytoplasm. The ultrastructural
      examination revealed distinctive meningocytic cells which contained large amounts
      of glycogen granules. In addition, the presence of numerous blocky, collagen
      conglomerations were a conspicuous feature of this tumor. The collagen deposits
      exhibited intensive immunopositivity for types I, III, IV and VI collagen, and
      their fine structure suggested the production of the extracellular matrix
      substance from the contiguous meningothelial cells with well developed Golgi
      complexes and frequent vesicles near the cell membrane. Proliferating cell
      nuclear antigen cell kinetics study revealed high labeling index of this
      neoplasm. The findings for this clear cell (glycogen-rich) meningioma may be
      useful in the differential diagnosis and treatment of this distinctive subtype of
      meningioma.

PMID- 7795731
TI  - Nuclear characterization and G2M ploidy in human brain tumors using semiautomated
      image analysis.
AB  - We used image analysis to study nuclear morphometry and DNA content in relation
      to time to tumor progression in a series of 88 patients with brain tumors.
      Clinical follow-up was obtained for 73 patients. The patients with diploid tumors
      had a longer time to tumor progression than those with triploid, tetraploid, or
      hypertetraploid tumors. Mean SG2M-DNA indices (DIs) increased significantly with
      a increase in mean DIs in all tumors. The mean DIs appeared to be dependent on
      the number of SG2M phase cells. We conclude that tumors with hypertetraploid in
      G2M ploidy are highly malignant. Those tumor cells have a large nuclear size,
      much deformity in nuclear shape, and great proliferative potential. The G2M
      tetraploid tumors showed a shorter time to tumor progression when the number of
      SG2M fractions was large. In contrast, the G2M-hypotetraploid tumors showed a
      longer time to tumor progression in comparison with other tetraploid and
      hypertetraploid tumors, but the difference was not significant.

PMID- 7795732
TI  - Immunohistochemical localization of the glucose transporter GLUT1 in choroid
      plexus papillomas.
AB  - Normal chroid plexus tissue and five choroid plexus papillomas were examined with
      antibody specific for the glucose transporter GLUT1, one isoform of facilitated
      diffusion glucose transporters, using the avidin-biotin-peroxidase complex (ABC)
      technique. GLUT1 in normal choroid plexus was localized at the basolateral plasma
      membrane of almost all epithelial cells. In three of five tumors, GLUT1
      immunoreactivity was observed. A positive reaction was demonstrated at the plasma
      membrane of tumor cells. The number of GLUT1-positive cells was, however, much
      smaller than that of the normal choroid plexus. Our results suggest that GLUT1
      expression in the choroid plexus is restrained during the course of
      transformation and that choroid plexus papilloma is composed of various
      differentiation tumor cells.

PMID- 7795734
TI  - Cytogenical analysis of brain tumors by FISH (fluorescence in situ hybridization)
      and FCM (flow cytometry).
AB  - In the present study, an analysis was made of chromosomal aberrations in brain
      tumors using the fluorescence in situ hybridization (FISH) technique. At the same
      time DNA histograms were obtained by flow cytometry (FCM) to make a comparative
      study of histological malignancy and prognosis. The subjects included 30 gliomas
      (7 of astrocytoma grade II, 15 of anaplastic astrocytoma (grade III), 8 of
      glioblastoma (grade IV)) and 26 meningiomas. In the study of FISH, DNA probes for
      chromosomes No. 7, 9, 10, and 17, were used to cause a reaction with chromosome
      No. 22 added for meningiomas. In the study with FCM, DNA index from DNA histogram
      was calculated using lymphocytes as the internal standard. In gliomas as a whole,
      chromosomes No. 7 and 17 showed high values, whereas, chromosomes No. 9 and 10
      low values. Analysis by the grades of glioma showed that compared with gliomas of
      other grades, grade IV gliomas were higher for chromosome No. 17 and lower for
      chromosome No. 10. In meningiomas, while many cases showed a low value for
      chromosome No. 22, most cases of recurrent and atypical meningiomas showed a high
      value for chromosome No. 17. In gliomas, DNA index showed a correlation with the
      grade, and a positive correlation particularly with chromosome No. 17 in FISH.
      Recurrent and atypical meningiomas had a high DNA index.

PMID- 7795733
TI  - Histopathological study on the effect of octreotide.
AB  - The present investigation was performed to clarify the mechanism of action of
      octreotide. On a quantitative study by electron microscopy showed that lysosomes
      were markedly increased in the patients receiving octreotide. Growth hormone (GH)
      was shown to be in the secretory granules by the postembedding immunogold
      technique, but no GH immunostaining was noted of the lysosomes. The present
      investigation suggests that retention of secretory granules and subsequent
      lysosomal increase are the mechanism of GH-lowering effect of octreotide.

PMID- 7795736
TI  - Incidence of leukaemia and lymphoma in young people in the vicinity of the
      petrochemical plant at Baglan Bay, South Wales, 1974 to 1991.
AB  - OBJECTIVE: To determine whether there was an increased incidence of leukaemias
      and lymphomas in young people aged less than 25 years in the locality of a
      petrochemical plant at Baglan Bay, South Wales. METHODS: Geographical population
      based study to compare the observed and expected incidence of leukaemia and
      lymphoma with onset before the age of 25, in the years 1974 to 1991. The
      population was aged 0-24 years and lived within 1.5 and 3 km of the plant. The
      observed number of cases in various categories were compared with the expected
      numbers of cases calculated from the Welsh cancer registration rates. RESULTS:
      Although the observed numbers were generally greater than would be expected, none
      of the comparisons showed significant excess of leukaemias or lymphomas for any
      period of years. CONCLUSIONS: The study shows that the incidence of leukaemias
      and lymphomas in children and young people in the area around the BP Chemical
      site at Baglan Bay, South Wales, between the years 1974 and 1991 was not
      significantly greater than normal.

PMID- 7795735
TI  - Cancer incidence and mortality near the Baglan Bay petrochemical works, South
      Wales.
AB  - OBJECTIVES: To study incidence and mortality of leukaemias, cancer of the larynx,
      and other cancers near the petrochemical plant at Baglan Bay, in response to
      local concerns of an alleged cluster of cancers in the vicinity. METHODS: This is
      a small area study of cancer incidence, 1974-84 and of mortality, 1981-91 based
      on the national postcoded data held by the Small Area Health Statistics Unit and
      with population and socioeconomic data from the 1981 census. The study is centred
      on BP Chemicals Ltd, Baglan Bay, Port Talbot, West Glamorgan, South Wales and
      includes a general population sample of 115,721 people (1981 census) living
      within 7.5 km of the plant. Cancer incidence and mortality for all cancers,
      leukaemias, and cancer of the larynx were examined within 7.5 km and 3 km of the
      plant, and tests for decline in risk of these cancers with distance from the
      plant were carried out. Mortality from several other cancers possibly associated
      with the petrochemical industry was also studied. RESULTS: There were 5417
      incident cancer cases and 2458 cancer deaths within 7.5 km of the plant during
      the periods of study. There was an 8% excess incidence of all cancers within 7.5
      km, and a 24% excess of cancer of the larynx, consistent with a general excess of
      these cancers in West Glamorgan, but no apparent decline in incidence with
      distance from the plant, nor excess mortality. There was also no evidence of
      decline in leukaemia incidence or mortality with distance, at all ages or in
      children. Among the other causes included in the mortality study, there was an
      excess of multiple myeloma within 7.5 km, especially among women, and a
      significant decline in mortality from non-Hodgkin's lymphomas although there was
      no excess overall within 7.5 km. CONCLUSIONS: The apparent excess incidence of
      all cancers and cancer of the larynx within 7.5 km of the BP Chemical Ltd works
      was consistent with an excess more generally in West Glamorgan, possibly related,
      at least to some extent, to cancer registration in Wales. There was no excess
      mortality from these cancers. The results for multiple myeloma and especially non
      Hodgkin's lymphomas may have been chance findings in view of the multiple tests
      of significance carried out in the study. A study of lymphatic and haematopoietic
      cancers near oil refineries in Great Britain is to be undertaken that will help
      put the findings of the present study in wider context.

PMID- 7795737
TI  - Lead and cadmium in human placentas and maternal and neonatal blood (in a heavily
      polluted area) measured by graphite furnace atomic absorption spectrometry.
AB  - OBJECTIVE: To measure the concentrations of the trace elements lead and cadmium
      in human placenta and in maternal and neonatal (cord) blood. To assess the
      influence of the strongly polluted environment on the content of metals in
      tissues and on the permeability of placenta to cadmium and lead. Various methods
      of mineralisation were tested before analysis. METHODS: Graphite furnace atomic
      absorption spectrometry was used for the determination of lead and cadmium. The
      samples for analysis were prepared by mineralisation under pressure in a Teflon
      bomb (HNO3, 110 degrees C), by wet ashing under normal pressure (HNO3 + H2O2 for
      12 hours), and by microwave digestion in concentrated nitric acid. RESULTS: In
      analysed samples the following mean concentrations of cadmium and lead were
      found: in venous blood Pb = 72.50 ng/ml, Cd = 4.90 ng/ml; in placenta Pb = 0.50
      microgram/g, Cd = 0.11 microgram/g; in cord blood Pb = 38.31 ng/ml, Cd = 1.13
      ng/ml. CONCLUSION: High concentrations of lead and cadmium were found in
      placentas and in maternal blood whereas in neonatal blood there was an increased
      concentration of lead and only traces of cadmium. It is concluded that the
      placenta is a better barrier for cadmium than for lead. Among the examined
      methods of mineralisation, microwave digestion was the best.

PMID- 7795738
TI  - Study of morbidity of personnel with potential exposure to vinclozolin.
AB  - OBJECTIVES: To examine internal exposure and targeted health outcomes of
      employees exposed to 3-(3,5-dichlorophenyl)-5-methyl-5-vinyl-1,3-oxazolidine-2,4
      dione; chemical abstracts service (CAS) number: 50471-44-8 (vinclozolin).
      METHODS: A cross sectional study of 67 men exposed to vinclozolin for one to 13
      years during synthesis and formulation operations and 52 controls. Biomonitoring
      was based on determination of urinary metabolites that contained a 3,5
      dichloroaniline (3,5-DCA) moiety. Targeted health endpoints were the same as in
      previous subchronic and chronic animal studies--namely, reversible changes in the
      concentrations of hormones of the adrenocorticotrophic and gonadotrophic feedback
      systems, signs of liver injury, haemolytic anaemia, cataract formation (uniquely
      in rats), and hormonally induced hyperplasia and tumours at high doses. The
      clinical investigation consisted of a medical and occupational history
      questionnaire, physical examination, laboratory determinations (including
      testosterone, LH, and FSH measurements), ultrasonography of the liver and
      prostate, a detailed eye examination, and routine spirometry. RESULTS: The mean
      3,5-DCA concentration for two thirds of the study group exceeded an equivalent of
      the vinclozolin acceptable daily intake (ADI) used for consumer regulatory
      purposes. Even the highest concentrations were, however, at least 10 times below
      the no observable adverse effect level (NOAEL) based on animal studies. Analysis
      of physical examination and laboratory data provided no evidence of hormonal
      responses induced by vinclozolin. Furthermore, no evidence of liver injury,
      prostate changes, cataract formation, or haemolytic anaemia was found.
      CONCLUSION: There was no evidence of any health effects induced by vinclozolin
      among employees with potential long term exposure. In particular, no
      antiandrogenic effects were found.

PMID- 7795739
TI  - Mortality and cancer morbidity in workers from an aluminium smelter with prebaked
      carbon anodes--Part I: Exposure assessment.
AB  - OBJECTIVES: To design a job-exposure matrix for epidemiological studies of men
      who had worked in a Norwegian aluminium smelter between 1922 and 1975. METHODS:
      Jobs held by cohort members were identified from personnel records. Tasks and
      their locations were determined for all jobs, and information was gathered about
      changes in exposure conditions over time. The jobs were combined into categories
      thought to have experienced similar exposure conditions, and time weighted
      average exposures were estimated on a relative scale. The results were reviewed
      by a panel of former smelter employees and an experienced industrial hygienist.
      RESULTS: 96 different jobs could be identified from the cohort members' work
      histories. These were grouped into 18 categories, and relative exposure
      intensities were estimated for 31 different combinations of category and period.
      The most prevalent exposure in the cohort was pot emissions (fluorides, sulphur
      dioxide, and carbon monoxide; 74% ever exposed), followed by magnetic fields and
      heat stress (65-68%), asbestos (40%), and coal tar pitch volatiles (33%).
      CONCLUSIONS: Although the use of this job-exposure matrix in the subsequent
      epidemiological studies may result in some misclassification of exposure, this is
      unlikely to seriously attenuate true risks in a stratified analysis based on
      cumulative exposure.

PMID- 7795740
TI  - Mortality and cancer morbidity in workers from an aluminium smelter with prebaked
      carbon anodes--Part II: Cancer morbidity.
AB  - OBJECTIVE: To investigate associations between cancer incidence and exposure to
      coal tar pitch volatiles, asbestos, pot emissions (fluorides, sulphur dioxide),
      heat stress, and magnetic fields in workers from a Norwegian aluminium smelter
      that operated from 1914 to 1975. METHODS: Cancer incidence between 1953 and 1991
      was recorded in a cohort of 1137 men hired between 1922 and 1975. The expected
      number of cancer cases was calculated from incidence rates in Norwegian men. A
      job exposure matrix with semiquantitative exposure estimates was used to
      investigate associations between cumulative exposure estimates was used to
      investigate associations between cumulative exposure and cancer incidence through
      exploring temporal relations by considering exposures only within specific time
      windows. RESULTS: A significant excess of cancer cases, 90 observed v 59.0
      expected, was found in workers who had been employed for less than three years.
      No such excess was found in men with at least three years' employment, with 120
      cases observed v 129.7 expected. In this subcohort an association was found
      between the incidence of bladder cancer and exposure to coal tar pitch volatiles
      40 years or more before each person-year under observation, and between incidence
      of lung cancer and tar exposure 35-50 years before observation. An association
      was also found between incidence of kidney cancer and exposure to heat stress 20
      35 years before observation. CONCLUSIONS: The results support previous findings
      that exposure to coal tar pitch volatiles in the aluminium industry has been
      associated with increased risk of bladder and lung cancer. They also add
      information about temporal relations, suggesting that exposure to tar in this
      smelter has acted on an early stage in the development of these cancers, followed
      by a latency period of 30-40 years.

PMID- 7795741
TI  - Mortality and cancer morbidity in workers from an aluminium smelter with prebaked
      carbon anodes--Part III: Mortality from circulatory and respiratory diseases.
AB  - OBJECTIVE: To investigate associations between exposure to pot emissions
      (fluorides, sulphur dioxide) and mortality from chronic obstructive lung disease,
      coal tar pitch volatiles and mortality from diseases related to atherosclerosis,
      and carbon monoxide and mortality from ischaemic heart disease. METHODS:
      Mortality between 1962 to 1991 was investigated in a cohort of 1085 men hired by
      a Norwegian aluminium smelter between 1922 and 1975. Associations between
      cumulative exposure and mortality were investigated through SMR analysis based on
      national mortality rates; temporal relations were explored by considering
      exposures only within specific time windows. Circulatory mortality was also
      investigated by Poisson regression analysis. RESULTS: There were 501 deaths v
      471.3 expected in the cohort. The excess was confined to short term workers and
      did not seem to be associated with exposures in the smelter. Analysis of
      mortality among the 661 men with at least three years employment showed
      associations between cumulative exposure to tar 40 years before observation and
      atherosclerotic mortality (P = 0.03), and between exposure to pot emissions 20-39
      years before observation and mortality from chronic obstructive lung disease (P =
      0.06). No association was found between exposure to carbon monoxide and mortality
      from ischaemic heart disease, but cerebrovascular mortality was associated with
      exposure to pot emissions (P = 0.02). Results for atherosclerotic and
      cerebrovascular diseases were confirmed through Poisson regression analysis.
      CONCLUSIONS: The data support previous findings of increased mortality from
      ischaemic heart disease in workers exposed to tar, and some support is also
      provided for earlier reports of increased respiratory mortality in potroom
      workers.

PMID- 7795742
TI  - Chest radiography and high resolution computed tomography in the evaluation of
      workers exposed to silica dust: relation with functional findings.
AB  - OBJECTIVES: To compare the usefulness of high resolution computed tomography
      (HRCT) with chest radiography (CR) in the diagnosis and assessment of severity of
      silicosis. METHODS: 27 workers exposed to silica underwent CR, HRCT, and
      pulmonary function tests. Two experienced readers independently evaluated CR by
      International Labour Office classification, and grouped the results into four
      categories. HRCT categories of nodule profusion and the extent of emphysema were
      graded on a four point scale; in 20 subjects the percentage distribution of lung
      densities were measured by HRCT. RESULTS: Concordance between readers was higher
      for HRCT than for CR (K statistic = 0.49 and 0.29 respectively). There was poor
      concordance between CR and HRCT in the early stage of silicosis. No significant
      difference in pulmonary function tests was found among different CR categories,
      but forced expiratory volume in one second (FEV1), maximal expiratory flow at 50%
      and 75% of FVC (MEF50, MEF75), and diffusion capacity significantly decreased
      with increasing HRCT categories. Subjects with simple silicosis detected by HRCT
      had a lower FEV1 than subjects without silicosis, whereas subjects with
      conglomerated silicosis showed higher residual volume and functional residual
      capacity than subjects with simple silicosis. These relations were not affected
      by smoking or symptoms of chronic bronchitis. Different grades of emphysema
      detected by HRCT were significantly different in diffusion capacity. Only the
      HRCTs of the lowest and the highest categories of profusion of parenchymal
      opacities were significantly different in their distribution of density classes.
      CONCLUSION: HRCT is more reproducible and accurate than CR, as suggested by the
      higher agreement between readers and the better correlation with pulmonary
      function tests, irrespective of smoking and chronic bronchitis; however, these
      data do not support the hypothesis that HRCT is more sensitive than CR in the
      early detection of silicosis.

PMID- 7795743
TI  - Byssinosis in Guangzhou, China.
AB  - OBJECTIVES: To study the prevalence of byssinosis and other respiratory
      abnormalities in workers exposed to cotton dust in Guangzhou in two factories
      that processed purely cotton. METHODS: All the 1320 workers exposed were
      included. The controls were 1306 workers with no history of occupational dust
      exposure. Total dust and inhalable dust were measured by Chinese total dust
      sampler and American vertical elutriator respectively. A World Health
      Organisation questionnaire was used. Forced vital capacity (FVC) and forced
      expiratory volume in one second (FEV1) were measured by a Vitalograph spirometer.
      RESULTS: The median inhalable dust concentrations ranged from 0.41 to 1.51 mg/m3
      and median total dust concentrations from 3.04 to 12.32 mg/m3. The prevalence of
      respiratory abnormalities in the cotton workers were (a) typical Monday symptoms
      9.0%; (b) FEV1 fall by > or = 5% after a shift 16.8%; (c) FEV1 fall by > or = 10%
      after a shift 4.2%; (d) FEV1 < 80% predicted 6.1%; (e) FEV1/FVC < 75% 4.0%; (f)
      cough or phlegm 18.2%; (g) chronic bronchitis 10.9%; and (h) byssinosis, defined
      by (a) plus (b) 1.7%. With the exception of (d), most of the prevalences
      increased with increasing age, duration of exposure, and cumulative inhalable
      dust exposure. No increasing trends of respiratory abnormalities were found for
      current total dust, inhalable dust, and cumulative total dust concentrations.
      Compared with controls, after adjustment for sex and smoking, with the exception
      of (d), all the pooled relative risks of respiratory abnormalities were raised
      for cotton exposure. CONCLUSION: It is concluded that cumulative inhalable cotton
      is likely to be the cause of byssinotic symptoms, acute lung function decrements,
      cough, or phlegm, and chronic bronchitis.

PMID- 7795744
TI  - Evaluation of the respiratory health of dock workers who load grain cargoes in
      British Columbia.
AB  - OBJECTIVES: To investigate the respiratory health of dock workers who load grain
      cargoes. METHODS: The respiratory health of 118 dock workers who load grain
      cargoes in the ports of Vancouver and Prince Rupert was compared with that of 555
      grain elevator workers from the same regions. 128 civic workers were used as an
      unexposed control group. RESULTS: The prevalences of chronic cough and phlegm
      were at least as high in dock workers as those found in the elevator workers, and
      when adjusted for differences in duration of employment and smoking, dock workers
      had an eightfold higher risk of developing chronic phlegm than did civic workers.
      Symptoms of eye and skin irritation that were experienced at least monthly were
      highest for dock workers. Average percentage of the predicted FEV1 and FVC for
      dock workers (mean 100.6% and 105.3% respectively) were similar to the civic
      workers but significantly higher than those found for elevator workers. Higher
      subjective estimates of duration of exposure to grain dust (hours/day) were
      associated with lower values of FEV1. CONCLUSIONS: The more intermittent grain
      dust exposure patterns of dock workers may have allowed for some recovery of lung
      function, but chronic respiratory symptoms were less labile.

PMID- 7795745
TI  - Pre-employment screening among trainee bakers.
AB  - OBJECTIVES: To assess the prevalence of atopy in a vocational school so as to
      evaluate the feasibility of pre-employment screening. METHODS: The prevalence of
      atopy by family diathesis, prick tests, immunoglobulin E (IgE) concentrations,
      and personal history of allergic respiratory diseases was investigated in 144
      trainee bakers and 81 students on a graphic artists course (mean age 15.4 years).
      Skin sensitisation to wheat, rye, and barley flours, to alpha amylase, and to
      storage mites was also evaluated. RESULTS: Personal allergic symptoms were
      reported by 13.2% of the bakers and 14.7% of the graphic artists and there was a
      significant association between symptoms and atopy by prick tests (odds ratio
      (OR) 17.2; 95% confidence interval (95% CI) 5.27-56.4) and by family history (OR
      3.11; 95% CI 1.02-9.53). When bakers were grouped according to the presence of
      allergic symptoms and results of immunological tests, 6.9% had asthma, 6.3% had
      rhinoconjunctivitis, and a high percentage (28.5%) were without symptoms but
      scored positive on prick tests or family symptoms. Skin sensitisation to storage
      mites had similar prevalences (16%) in the two groups of trainees and occurred
      nearly always in atopic people. Positive skin tests to wheat flour (3.5%), rye
      (0.7%), and alpha amylase (0.7%) were specific to bakers. CONCLUSIONS: Pre
      employment screening is a useful source of medical information and allows for
      counseling. The presence of asthma, or of another allergic disease in a severe
      form, is suggested as a criterion for excluding students of a vocational school
      from training as bakers. Student bakers without allergic symptoms but atopic by
      other criteria should be informed about their risks of developing occupational
      asthma, and periodic check ups must be recommended. Screening studies in
      vocational school provide a better understanding of specificity of skin
      sensitisation to occupational allergens.

PMID- 7795747
TI  - Assessment of risk of lung cancer among mild steel and stainless steel welders.

PMID- 7795746
TI  - Sex ratio of offspring of men exposed to sodium borates.

PMID- 7795748
TI  - Urinary N-acetyl-beta-D-glucosaminidase (NAG) and exposure to inorganic lead.

PMID- 7795749
TI  - Cause of occupational disease.
AB  - The concept of causality is reviewed with special emphasis on occupational
      diseases. Separate approaches from the philosophical, scientific, and legal
      points of view are identified. There is controversy over the methodology of
      logical causality; inductive and deductive methods are described and reference is
      made to the verification or refutation approach. Application of the methods to
      epidemiology are reviewed. It is likely that many diseases have multiple causes
      and that only a component of occupational causality can be identified in each
      patient. Methods of assigning such a component are discussed. The difficulties of
      developing an equitable compensation policy in such circumstances are reviewed.
      The possible benefits of proportional compensation are noted.

PMID- 7795750
TI  - Developments in reproductive risk management.
AB  - Internationally, the debate on aims for occupational health policy is expanding
      its horizons. Included among the issues are not only concerns about safety for
      workers, but also for their progeny. Equality among the sexes is also assuming a
      prominent position. In several countries, existing and proposed legislation
      already considers these matters. In the course of this article it is argued that
      this legislation and its implementation are inadequate. There are several reasons
      for this. Firstly, what constitutes health risks for workers exposed to chemical
      substances is subject to different interpretations. This is further complicated
      when one includes risks to reproductive function and to the progeny: the
      reproductive risks of toxicity. The different interpretations of the concepts of
      safety and equality are also discussed. There are differences in regulations and
      in standards about whether or not safety factors should be used when knowledge is
      uncertain. The operation of reasonable measures with a generic or sex specific
      policy also differs. Secondly, the current occupational exposure limits are set
      too high. These aspects are considered and it is probable that the policy aims
      should be made more specific. An elaborated approach that includes the
      "precautionary principle" in safety standards is proposed. To advise employers in
      their role as managers of reproductive risks of toxicity, a recently developed
      system for occupational health and safety services is described. This system is
      based on two criteria: effectiveness and reasonableness of proposed measures. The
      effectiveness criterion includes the precautionary principle; the reasonableness
      criterion includes equal rights and opportunities for men and women. Finally, a
      supportive governmental policy that is consistent with the most recent
      international development is recommended.

PMID- 7795751
TI  - Implementation of the precautionary principle in standards for the workplace.
AB  - The objectives were to describe and discuss the current and proposed European
      occupational health policy on two categories of substances that pose serious
      effects: those potentially carcinogenic or genotoxic and those with toxic effects
      on reproduction. The precautionary principle was applied to setting standards for
      the workplace for those two categories of substances, to give an impression of
      the resulting limit values and the consequences of the implementation of this
      precautionary principle. A pragmatic approach was chosen as this starts with
      substantial indications of health risks. For the suspected carcinogenic or
      genotoxic substances 0.1 mg/m3 as a precautionary occupational exposure limit
      (precautionary OEL) is proposed. For the substances suspected of causing
      reproductive toxicity the precautionary OEL was derived in three ways, depending
      on the availability of data and of a current Dutch workplace standard (MAC,
      maximum accepted concentration): (a) by calculation based on available inhalatory
      animal data on the risks of reproductive toxicity; (b) by adding a safety factor
      of 10 to the current MAC, if no inhalatory animal data on reproductive toxicity
      are available; (c) by using 0.1 mg/m3 as precautionary OEL for substances
      suspected of having reproductive toxicity but without inhalatory animal data on
      reproductive toxicity and without a MAC.

PMID- 7795752
TI  - Physical work load and gestational age at delivery.
AB  - OBJECTIVE: To assess the impact of physical activity on the gestational age at
      delivery in women performing physical tasks in their jobs during pregnancy.
      METHODS: Qualified nurses at 15 weeks of pregnancy were asked through a
      questionnaire to describe the tasks in their regular job, the physical activities
      involved, and their exposure to other occupational stressors. The physical
      activities to be identified were walking, standing, lifting, stooping, squatting,
      and sitting. RESULTS: A high degree of daily physical work load during pregnancy
      seemed to be a significant predictor for the gestational age at delivery, whereas
      chemical and infectious agents were not. CONCLUSIONS: Physical work load during
      pregnancy should be diminished to avoid adverse effects on gestational age at
      delivery.

PMID- 7795753
TI  - Tumour necrosis factor-alpha (TNF-alpha) in patients who have asbestosis and
      develop cancer.
AB  - OBJECTIVES: Concentrations of tumour necrosis factor-alpha (TNF-alpha) were
      assayed by radioimmunoassay in serum samples collected between 1981 and 1987 from
      111 patients with asbestosis who were at a high risk of cancer. Follow up of
      these patients until 1993 showed that 38 had developed cancer (27 lung, three
      mesotheliomas, and eight diverse malignancies). RESULTS: The mean serum
      concentrations of TNF-alpha given in fmol/100 microliters serum in all the cases
      with cancer (14.1) and the cases with lung cancer (13.6) were significantly
      higher (P < 0.05) than the mean concentrations in the exposed controls (10.5). A
      positive increase was considered to be any value that was > 2 SDs above the mean
      of the exposed controls. 22% (six of 27) of the cases with lung cancer were
      positive compared with 4% (three of 73) of the exposed controls, a significant
      difference (P < 0.001). The serum concentrations of TNF-alpha correlated
      moderately with cancer (r = 0.3), lung cancer (r = 0.3), and Neu oncoproteins and
      epidermal growth factor receptor (EGFR) (r = 0.3, 0.5 respectively). Also, there
      was a significant correlation between development of cancer and severity or
      progression of asbestosis. There was no correlation between the concentrations of
      TNF-alpha and severity or progression of asbestosis. CONCLUSIONS: These results
      showed high concentrations of TNF-alpha in the patients who had cancer. TNF-alpha
      may offer an auxiliary method in early diagnosis of cancers related to
      asbestosis.

PMID- 7795754
TI  - Exposure to styrene and chronic health effects: mortality and incidence of solid
      cancers in the Danish reinforced plastics industry.
AB  - OBJECTIVES: To study the occurrence of non-malignant diseases and solid cancers
      in workers exposed to styrene in the Danish reinforced plastics industry.
      METHODS: All 36,610 workers of 386 reinforced plastics companies and 14,293
      workers not exposed to styrene from similar industries were followed up from 1970
      to 1990. This industry is characterised by simple exposure conditions, exposure
      to high concentrations of styrene, and a high proportion of small companies, and
      the exposure assessment was based on experts' classification on a company level.
      The mortality from non-malignant causes and the incidence of solid cancers were
      compared with the national rates. Poisson models were used for internal
      comparisons. RESULTS: A total of 3031 deaths and 1134 newly diagnosed cases of
      solid cancer were reported in the workers in the reinforced plastics industry. In
      companies where 50% or more of the workers produced reinforced plastics an
      increased mortality rate ratio (MRR) for degenerative disorders of the nervous
      system (multiple sclerosis, parkinsonism, and motor neurone disease; MRR 1.8, 16
      cases, 95% confidence interval (95% CI) 0.9-3.8) and an increased incidence rate
      ratio (IRR) for pancreatic cancer (IRR 2.2, 17 cases, 95% CI 1.1-4.5) was found.
      For both disease categories increased occurrence was also found among long term
      workers, workers of the 1960s (the period with the highest exposure to styrene),
      and workers with a latent period of more than 10 years after the start of
      employment. No other non-malignant diseases or solid cancers showed these
      patterns. CONCLUSION: The findings have to be interpreted with caution, due to
      the company based exposure assessment, but the possible association between
      exposures in the reinforced plastics industry, mainly styrene, and degenerative
      disorders of the nervous system and pancreatic cancer, deserves attention.

PMID- 7795755
TI  - Longitudinal study of the health of cotton workers.
AB  - OBJECTIVES: To follow up a group of newly employed workers in a cotton mill, and
      to report changes in symptoms over time. METHODS: A group of 110 mill workers at
      a cotton mill in Shijiazhuang, China, was investigated by questionnaire, skin
      testing, and spirometric measurements of airway responsiveness through forced
      expiratory volume in one second (FEV1). The workers were examined before starting
      work, at 10 weeks, and at one year. RESULTS: Decreases in FEV1 over shifts were
      small at 10 weeks and one year, and slightly higher among people with skin
      reactions to cotton dust extracts. Airway responsiveness, defined as the average
      decrease in FEV1 after 1.25 mg methacholine was increased at 10 weeks. It
      remained about the same after one year, except in the workers positive for the
      skin test, in whom it was further increased. Subjective symptoms of chest
      tightness and cough with phlegm increased progressively at 10 weeks and one year;
      nasal irritation remained unchanged and dry cough decreased between 10 weeks and
      one year. CONCLUSION: The results suggest that the airway inflammation caused by
      cotton dust increases with increasing exposure time and that the changes are more
      notable in workers with reactivity to cotton dust extract.

PMID- 7795756
TI  - Dose-response relation between exposure to two types of hand-arm vibration and
      sensorineural perception of vibration.
AB  - OBJECTIVES: 31 railway workers and 32 lumberjacks were examined to compare the
      dose-response relation between the exposure to two types of hand-arm vibration
      and the sensory disturbances in peripheral nerves as evaluated by the vibration
      perception thresholds (VPTs). METHODS: Clinical examinations were carried out
      that included measurements of the VPTs, and electroneuromyography (ENMG), and an
      inquiry to confirm the use of vibrating tools. Diseases of the central nervous
      system and neuropathies were checked by inquiry and a clinical examination,
      diabetes was excluded by a blood sample analysis, and the subjects with carpal
      tunnel syndrome confirmed with ENMG were excluded from the study. RESULTS:
      Lifetime use of hand held tamping machines (railway workers) and chain saws
      (lumberjacks) had a significant correlation with the VPTs at frequencies from 32
      to 500 Hz. The increase of the VPTs (250 Hz) in relation to use of vibrating
      tools was 1.8-fold higher on average in the whole group and 2.3-fold higher in
      the young (< 45) railway workers who had used hand held tamping machines, than in
      the corresponding groups of lumberjacks, who had used chain saws, whereas the
      frequency weighted acceleration of vibration in tamping machines was fourfold.
      CONCLUSION: There was a significant dose-response relation between the exposure
      to hand-arm vibration and the VPTs. The VPTs as a function of the frequency
      weighted acceleration of vibration and the exposure to vibration gave promising
      results for assessment of the risk of damage to sensory nerves induced by
      vibration.

PMID- 7795757
TI  - Ocular effects of exposure to triethylamine in the sand core cold box of a
      foundry.
AB  - OBJECTIVES: To assess the acute and chronic ophthalmological effects of
      triethylamine exposure among foundry workers. METHODS: Ocular effects on people
      currently, previously, and never exposed to triethylamine in a foundry cold box
      were studied at two points in time. The initial phase included an ocular
      examination with a slit lamp to assess corneal health, a visual acuity test, and
      a questionnaire to assess vision symptoms. The follow up included measurements of
      corneal thickness with an ultrasonic pachymeter and the vision symptoms
      questionnaire before and after the shift and at the beginning and end of the
      week. Personal air measurements for triethylamine were also obtained during the
      follow up. RESULTS: The vision symptoms of blurriness, halos around lights, and
      blue hazy vision occurred more often in currently exposed workers than those
      previously or never exposed to triethylamine. Air concentrations of triethylamine
      ranged from < 0.33 mg/m3 to 20.3 mg/m3. Among currently exposed workers, symptoms
      were more common among those with exposure to > 10 mg/m3 of triethylamine (odds
      ratio (OR) = 3.0, 95% confidence interval (95% CI) 0.35-25.6). No differences in
      corneal thickness were found in currently or previously exposed workers and those
      never exposed. No increase in corneal thickness was found after v before the
      shift. CONCLUSION: Despite low concentrations of triethylamine and no corneal
      oedema, workers exposed to triethylamine reported vision symptoms. Possible
      explanations for these symptoms without corneal oedema are that triethylamine
      affects ciliary muscle function or that the corneal oedema was transient and not
      present when corneal thickness measurements were taken. No chronic effects were
      found in previously exposed workers. Further research is needed to elucidate the
      mechanism for the reported vision symptoms, which occurred below the current
      United States eight hour time weighted standard of 100 mg/m3 and the American
      Conference of Governmental Industrial Hygienists (ACGIH) recommended value at the
      time of our study of 40 mg/m3. We recommend that air concentrations be maintained
      to meet the current recommended ACGIH threshold of 4.1 mg/m3.

PMID- 7795758
TI  - Physiologically based pharmacokinetic model for acetone.
AB  - OBJECTIVE: This study aimed to develop a physiologically based pharmacokinetic
      model for acetone and to predict the kinetic behaviour of acetone in the human
      body with that model. METHODS: The model consists of eight tissue groups in which
      acetone can be distributed: the mucous layer of the inhaled air tract, the mucous
      layer of the exhaled air tract, a compartment for gas exchange (alveolus of the
      lung), a group of blood vessel rich tissues including the brain and heart, a
      group of tissues including muscles and skin that have low perfusion rates, a
      group of fatty tissues, an organ for metabolism (liver), and a compartment for
      urinary excretion (kidney). A mucous layer in the model is only the outermost
      layer of the mucus lining the wall of the air tract during inhalation and
      exhalation. To check the relevance of the model, the simulated results were
      compared with the experimental data. Next, simulation was conducted by changing
      the volume of the mucous layer and the respiratory rate to clarify the effect of
      these variables. Finally, simulation of an occupational situation was performed.
      RESULTS: With an appropriate value for the volume of mucous layer, the simulated
      acetone concentrations in arterial blood, end exhaled air, urine, and fatty
      tissue were found to agree well with the experimental data. The volume of mucous
      layer and rate of respiration were critical for the appropriate simulation. The
      simulated occupational situation fitted the observed regression line in field
      studies quite well. The simulation also enabled predictions to be made about the
      characteristic kinetics for water soluble solvents. CONCLUSION: The model is
      useful for understanding and explaining the kinetics of acetone.

PMID- 7795760
TI  - The Jones criteria for guidance in the diagnosis of rheumatic fever. Another
      perspective.

PMID- 7795759
TI  - Upper airway response in workers exposed to fuel oil ash: nasal lavage analysis.
AB  - OBJECTIVES: Among other constituents, fuel oil ash contains vanadium pentoxide, a
      known respiratory irritant. Exposure to ambient vanadium pentoxide dust has been
      shown to produce irritation of the eyes, nose, and throat. The usefulness of
      nasal lavage in detecting an inflammatory response to exposure to fuel oil ash
      among 37 boilermakers and utility workers was investigated. METHODS: A baseline
      lavage was performed on the morning of the first day back to work after an
      average of 114 days away from work (range 36 hours to 1737 days). A lavage was
      performed after exposure on the morning three days after the baseline lavage.
      Exposure to respirable particulate matter of diameter < or = 10 microns (PM10)
      and respirable vanadium dust were estimated with daily work diaries and a
      personal sampling device for respirable particulates. These estimates were made
      for each subject on each workday during the three days between lavages. For each
      subject, the adjusted change in polymorphonuclear cells was calculated by
      dividing the change in polymorphonuclear cell counts by the average of the counts
      before and after exposure. The association between the adjusted polymorphonuclear
      cell counts and exposure was assessed with multiple linear regression, adjusted
      for age and current smoking. RESULTS: Personal sampling (one to 10 hour time
      weighted average) showed a range of PM10 concentrations of 50 to 4510
      micrograms/m3, and respirable vanadium dust concentration of 0.10 to 139
      micrograms/m3. In smokers the adjusted polymorphonuclear cell count was not
      significantly different from zero (-0.1%, P > 0.5), but in nonsmokers it was
      significantly greater than zero (+50%, P < 0.05). In both non-smokers and
      smokers, there was considerable variability in adjusted polymorphonuclear cell
      counts and a dose-response relation between these adjusted cell counts and either
      PM10 or respirable vanadium dust exposure could not be found. CONCLUSION: A
      significant increase in polymorphonuclear cells in non-smokers but not smokers
      was found. This suggests that in non-smokers, exposure to fuel oil ash is
      associated with upper airway inflammation manifested as increased
      polymorphonuclear cell counts. The lack of an increase in polymorphonuclear cells
      in smokers may reflect either a diminished inflammatory response or may indicate
      that smoking masks the effect of exposure to fuel oil ash.

PMID- 7795761
TI  - Guideline maintenance and revision. 50 years of the Jones criteria for diagnosis
      of rheumatic fever.
AB  - OBJECTIVE: To understand better the factors that led to revisions of the Jones
      criteria, a widely used diagnostic guideline for diagnosis of rheumatic fever.
      DESIGN: The original publication of the Jones criteria and the four revisions
      were examined to identify changes. A computer software maintenance paradigm was
      applied, and modifications were categorized as corrective (error correction),
      perfective (enhancements in response to user needs), or adaptive (responses to
      new knowledge). RESULTS: Modifications of the Jones criteria were primarily
      corrective and perfective. Disease characteristics, originally characterized as
      major manifestations, were subsequently categorized as minor manifestations and
      vice versa. Twenty years after the initial publication, a requirement was added
      to enhance specificity (evidence for antecedent streptococcal infection).
      Descriptions of rheumatic manifestations became more detailed over time to
      eliminate ambiguous definitions and provide information to help clinicians decide
      about borderline cases. This emphasis on corrective and perfective maintenance
      contrasts with an expectation that adaptive changes would predominate, as with
      most knowledge-based systems. In fact, despite 50 years of technologic and
      methodologic advances in medicine, only echocardiography and new antibody testing
      contributed new knowledge that bears on the diagnosis of rheumatic fever.
      CONCLUSIONS: Corrective and perfective maintenance can be avoided by making
      effective use of knowledge that exists at the time a guideline is published.
      Despite the apparent durability of the Jones criteria, carefully structured,
      evidence-based guidelines should require less corrective and perfective
      maintenance. Adaptive maintenance can be anticipated if the quality of evidence
      or the level of consensus that supports each recommendation is explicitly
      recorded.

PMID- 7795763
TI  - The Pediatric Symptom Checklist. Support for a role in a managed care
      environment.
AB  - OBJECTIVES: To gather data based on studies of the Pediatric Symptom Checklist,
      identify risk factors associated with high levels of dysfunction in primary care
      pediatric settings, and explore the relationship between common risk factors and
      psychosocial problems identified by pediatricians. DESIGN: Retrospective review
      and cross-sectional, case-referent survey. SETTING: Subjects were selected from
      three primary care pediatric clinics in Massachusetts: a private practice in a
      predominantly white, middle-class suburb, an urban health maintenance
      organization clinic, and an inner-city clinic. PARTICIPANTS: Of 423 outpatients
      aged 6 to 12 years screened for psychosocial problems, 72 children and their
      families were seen for in-depth structured and clinical interviews (24 from each
      site). INTERVENTIONS: None. MEASUREMENTS/MAIN RESULTS: Children with a single
      parent and/or those who were economically disadvantaged were significantly more
      likely to show psychosocial impairment. The specificity of the Pediatric Symptom
      Checklist was 100% in samples with a lower socioeconomic status compared with 68%
      in middle-class samples, and sensitivity was 95% in middle-class samples compared
      with 80% in lower-class samples. Pediatricians identified psychosocial problems
      in eight of 15 children with a history of familial mental illness or substance
      abuse and seven of eight children with a history of physical or sexual abuse, but
      only six of 17 cases from single-parent families and four of 11 cases from poor
      families. CONCLUSIONS: Pediatricians should be sensitive to psychosocial
      dysfunction especially in single-parent and low-income families. Use of the
      Pediatric Symptom Checklist for psychosocial screening in a managed health care
      delivery system could target capitated resources efficiently by providing early
      identification and secondary prevention of psychosocial morbidity.

PMID- 7795762
TI  - Relation of alcohol expectancies to changes in problem drinking among college
      students.
AB  - OBJECTIVE: To evaluate the relation between alcohol expectancies and problem
      drinking during 3 years of college. DESIGN: Cohort with 3-year follow-up.
      SETTING: Private university campus. PARTICIPANTS: A random sample of 260 students
      entered a longitudinal study of alcohol use at the beginning of their freshman
      year. One hundred eighty-four students completed follow-up measures at the end of
      their junior year. Respondents were 90% white, with a mean (+/-SD) age of 17.9 +/
      0.5 years. INTERVENTIONS: None. MAIN OUTCOME MEASURES: A standardized measure of
      expectations and subjective evaluations of outcomes associated with drinking,
      quantity and frequency of alcohol use, and a composite measure of alcohol-related
      problems. RESULTS: Students were divided into nondrinking, low-risk, and high
      risk groups for problem drinking. A repeated-measures multivariate analysis of
      variance indicated significant interaction effects for risk group by expectancy
      scale (P < .009) and for expectancy scale by time (P < .001). The three risk
      groups differed significantly from each other on positive outcome expectations at
      entry into college and positive expectations and negative outcome evaluations at
      the end of the junior year. Students who became problem drinkers during college
      had significantly higher positive outcome expectation scores at both times and
      developed less concern for negative outcomes by the end of their junior year. The
      few initial problem drinkers who moderated their drinking during college
      demonstrated an increased concern for negative outcomes by their junior year.
      CONCLUSIONS: Alcohol expectancies are associated with differing patterns of
      alcohol use and are longitudinally related to subsequent changes in alcohol use
      and problem drinking.

PMID- 7795764
TI  - Stress in pediatric faculty. Results of a national survey.
AB  - OBJECTIVES: To determine current levels of pediatric faculty stress experienced
      by pediatric faculty and to examine contributors to and consequences of this
      stress. DESIGN: Random survey, using attitude questionnaire. SETTING: Twenty-six
      medical school-based pediatric programs nationwide. PARTICIPANTS: Two hundred
      fifty-two full-time pediatric faculty members. MAIN OUTCOME MEASURES: Stress
      level; importance of specific sources of stress and fulfillment; satisfaction
      with time allotted to various activities; social support; satisfaction with
      career choices. RESULTS: The return rate was 64%. Forty-six percent of
      respondents reported "high" or "very high" levels of usual stress; 64% were
      stressed beyond a "comfortable" level at least "frequently." Women (P < .05),
      assistant or associate professors (P < .001), and faculty on the tenure track (P
      < .006) reported feeling "overstressed" more often. Major sources of stress were
      pressure to do research, family needs (48%), and lack of personal time (40%).
      About half (51%) agreed that the recent emphasis on reducing resident stress has
      led to increased pressure on faculty members. Frequency of feeling overstressed
      was reduced if respondents felt valued by their chairperson (P < .001) and by
      other faculty (P < .01). Within the last year, 47% had considered moving to
      another medical school. Another 43% had considered leaving academia. The more
      frequently the respondent felt overstressed, the more likely he or she was to
      have considered such changes (P < .001). CONCLUSIONS: The stress currently
      experienced by pediatric faculty is substantial and seems to affect long-term
      commitment to academic medicine. Creative solutions to this issue should be
      explored.

PMID- 7795765
TI  - Relationship of infant feeding to recurrent wheezing at age 6 years.
AB  - OBJECTIVES: To investigate the relationship of infant feeding to recurrent
      wheezing at age 6 years and to assess whether this relationship is altered by a
      history of wheezing lower respiratory tract illnesses. DESIGN: Prospective,
      longitudinal study of healthy infants followed up from birth to 6 years of age.
      SETTING: Nonselected health maintenance organization population in Tucson,
      Arizona. PARTICIPANTS: There were 1246 healthy infants enrolled at birth, 988 of
      whom had data on both infant feeding and wheezing at age 6 years. INTERVENTIONS:
      None. MAIN OUTCOME MEASURES: Recurrent wheeze (four or more episodes in the past
      year) was assessed by a questionnaire that was completed by parents when the
      children were 6 years old. Children were classified by atopic status on the basis
      of skin prick tests. RESULTS: Breast-feeding information was collected
      prospectively, and lower respiratory tract illnesses in the first 3 years of life
      were diagnosed by the pediatrician. Being breast-fed was associated with lower
      rates of recurrent wheeze at age 6 years (3.1% vs 9.7%, P < .01) for nonatopic
      children; this relationship was not significant for atopic children. The
      relationship of breast-feeding with recurrent wheeze was apparent among nonatopic
      children both with and without a wheezing lower respiratory tract illness in the
      first 6 months of life. When potential confounders, including early wheezing
      lower respiratory tract illness, were included in a multivariate model, nonatopic
      children who had not been breast-fed had three times the odds of wheezing
      recurrently (odds ratio, 3.03; confidence interval, 1.06 to 8.69). Eleven percent
      of recurrent wheeze among nonatopic children could be attributed to not breast
      feeding. CONCLUSIONS: Recurrent wheeze at age 6 years is less common among
      nonatopic children who were breast-fed as infants. This effect is independent of
      whether the child wheezed with a lower respiratory tract illness in the first 6
      months of life.

PMID- 7795767
TI  - California pediatricians' knowledge of and response to recommendations for
      universal infant hepatitis B immunization.
AB  - OBJECTIVE: To assess California pediatricians' level of agreement with and
      implementation of universal infant hepatitis B immunization. RESEARCH DESIGN:
      Mailed questionnaire in the summer and fall of 1993 to a random sample of 1030
      California pediatricians to determine whether they universally immunize infants
      with hepatitis B vaccine. The response rate was 71%. RESULTS: More than 81% said
      they universally immunize infants against hepatitis B infection; however, 18.3%
      stated that they do not. Pediatricians were more likely to immunize infants
      universally against hepatitis B if they (1) agreed with the recommendations (90%
      vs 54%, P < .01), (2) practiced in a health maintenance organization setting vs
      private group practice (92% vs 79%, P < .05), or (3) practiced in settings with
      predominantly low-income patients (89% vs 78%, P = .01). Pediatricians who
      universally immunize infants against hepatitis B virus were in practice an
      average of 1.7 years longer than those who do not (13.3 years vs 11.6 years, P =
      .01). In multivariate analyses, the most powerful predictor of universal
      immunization was agreement with the recommendations. Among those who disagreed
      with the recommendations, the most common reasons for disagreement included the
      following: (1) the long-term efficacy of hepatitis B vaccine is not proved--54%;
      (2) an additional immunization would make the visits too costly--53%; and (3)
      three shots would be too much at one visit--53%. CONCLUSIONS: A majority (81.6%)
      of our sample of California pediatricians universally immunize infants against
      hepatitis B; however, a significant minority (18.4%) do not agree with the
      recommendations and do not plan to implement them. Many of their objections are
      being addressed through combination vaccine development and ongoing research;
      however, alternative policies and additional research should also be considered.

PMID- 7795766
TI  - Postoperative neurologic complications after open heart surgery on young infants.
AB  - OBJECTIVE: To ascertain the relation between postoperative neurologic
      complications and variables occurring before, during, and after hypothermic
      cardiopulmonary bypass surgery to correct congenital heart disease in young
      infants. DESIGN: Prospective analysis of mortality and neurologic morbidity
      before hospital discharge; systematic comparison with patient characteristics,
      metabolic status, surgery variables; and preoperative neurologic findings of the
      patients. SETTING: Intensive care unit in tertiary care center. PATIENTS:
      Consecutive sample of 91 full-term infants who underwent 100 operations between
      January 1989 through December 1992. Nine infants had more than one operation
      during the study period. MAIN OUTCOME MEASURES: Levels of alertness, tone, focal
      signs, dyskinesia, pyramidal signs, seizures, and death. RESULTS: Reduced level
      of alertness at discharge from the hospital in 19% of patients; seizures in 15%
      (70% focal); severe hypotonia in 11% before surgery, and in 7% at discharge from
      hospital; generalized pyramidal findings in six (7%); asymmetry of tone in 5%;
      and chorea that did not persist in 11%. Results of cranial ultrasound tests were
      abnormal in 20% of patients. Of these those with abnormal cranial ultrasound
      examinations 55% were abnormal before surgery. Overall mortality was 18%. Of the
      patients who died, 59% had interrupted aortic arch or hypoplastic left heart
      syndrome. Mortality for patients with these lesions was 40%. Alertness (P =
      .005), chorea (P = .03), and hypotonia (P = .02) were associated with duration of
      deep hypothermia longer than 60 minutes. No association was found among other
      outcomes and study variables, except the relation between severe left-sided heart
      lesions and mortality. CONCLUSIONS: Mortality and neurologic morbidity after open
      heart surgery on young infants may be due to several factors, including type of
      lesion, preexisting brain abnormalities, duration of deep hypothermia, and
      strokes.

PMID- 7795768
TI  - Mumps outbreak in a highly vaccinated school population. Evidence for large-scale
      vaccination failure.
AB  - OBJECTIVES: To describe an outbreak and to identify risk factors for mumps
      occurring in a highly vaccinated high school population. (Note: Highly vaccinated
      means a population in which more than 95% have been vaccinated.) DESIGN AND
      PARTICIPANTS: Survey and cohort study of 307 (97%) of 318 students. OUTCOME
      MEASURES: Mumps was defined as an illness with 2 or more days of parotid
      swelling. Serologic confirmation of infection was obtained in eight cases, seven
      of which were evaluated for presence of IgM antibody using immunofluorescent
      antibodies. Vaccination records were verified for 297 (97%) students. RESULTS:
      Between October 3 and November 23, 1990, clinical mumps developed in 54 students
      (attack rate, 18%), 53 of whom had been vaccinated. Most cases (40 [77%] of 52)
      occurred 12 to 20 days after a school-wide pep rally. Immunofluorescent antibody
      testing of all seven specimens demonstrated IgM antibody to mumps. Risk factors
      for clinical mumps identified in multivariate analyses included female gender
      (odds ratio, 3.0; 95% confidence interval, 1.6 to 5.7) and source of vaccination
      other than the local public health clinic (students vaccinated by private
      providers [odds ratio, 3.0; 95% confidence interval, 1.3 to 5.2] or in other
      districts [odds ratio, 2.4; 95% confidence interval, 1.1 to 5.3]). CONCLUSIONS:
      The overall attack rate is the highest reported to date (and to our knowledge)
      for a population demonstrating virtually complete mumps vaccine coverage. Even
      verified documentation of vaccination may not be an accurate indicator of an
      individual's protection against mumps. Vaccination failure may play an important
      role in contemporary mumps outbreaks. We found no evidence to indicate that
      waning immunity (secondary vaccine failure) contributed significantly to this
      outbreak. A second dose of mumps vaccine, as recommended using measles-mumps
      rubella vaccine, could potentially prevent similar outbreaks in secondary school
      populations in the future.

PMID- 7795769
TI  - Results of 12 nationwide epidemiological incidence surveys of Kawasaki disease in
      Japan.
AB  - OBJECTIVE: To describe the long-term trend of incidence and other epidemiological
      pictures of Kawasaki disease in Japan, by using the results of 12 nationwide
      epidemiological surveys on Kawasaki disease that have been conducted throughout
      Japan (ie, surveys that have encompassed the pediatric departments of hospitals
      with more than 100 beds) every 2 years since 1970. RESULTS: At the end of
      December 1992, the total number of patients with this disease was 116,848 (males,
      67,815; females, 49,033; male-female ratio, 1.38). The number of cases increased
      year by year, with three outbreaks in 1979, 1982, and 1986. There have been no
      cyclical changes since 1986. The incidence was higher in males and in those
      children who were 1 year of age or younger. The fatality rate decreased from 1%
      in 1974 to 0.04% in 1992. CONCLUSIONS: The patterns of descriptive epidemiology,
      such as seasonality and cyclical changes in incidence, supported the theory of an
      infectious agent as the causal agent. However, the incidence data since 1986
      provide less support for an infectious theory.

PMID- 7795770
TI  - Inappropriate infant bottle feeding. Status of the Healthy People 2000 objective.
AB  - OBJECTIVE: To provide information on baby bottle use in the United States because
      of the important consequences, including early childhood caries, associated with
      inappropriate feeding practices. METHODS: Data from the child supplement to the
      1991 National Health Interview Survey were examined. Information was collected on
      one randomly selected child from each family with children in the survey; data
      were weighted to represent the corresponding US population. Questions about the
      "ever use" and "still use" of baby bottles, and selected sociodemographic and
      health behavior variables were assessed. RESULTS: About 95% of children 6 months
      to 5 years old have ever used a baby bottle. Nearly one fifth of the children in
      this age range were put to bed with a bottle that had contents other than water.
      More than 8% of children 2 to 5 years old still use the bottle. Bivariate and
      multivariate analyses showed differences in bottle practices by education level
      of the adult caretaker, dental visits, Hispanic background, race, and geographic
      region. CONCLUSION: The high prevalence of feeding with a baby bottle requires
      pediatricians and other health care professionals to help reduce the risks to
      health.

PMID- 7795771
TI  - Immunization status and birth order.
AB  - OBJECTIVE: To determine whether an association exists between immunization status
      and birth order. DESIGN: Medical record review of immunization dates for matched
      siblings. SETTING: Pediatric clinic at a university medical center. SUBJECTS: A
      total of 892 children (446 sibling pairs of firstborn and secondborn children)
      born between 1983 and 1991 who received regular pediatric care at the clinic.
      OUTCOME MEASURES: Median ages at which firstborn children and their secondborn
      siblings had been immunized with the initial four doses of diphtheria and tetanus
      toxoids and pertussis vaccine (DTP1, DTP2, DTP3, and DPT4) and the initial dose
      of measles-mumps-rubella vaccine; point prevalences of firstborn and secondborn
      children up-to-date with all immunizations at each month of life to 2 years of
      age. RESULTS: Between 5 and 12 months of life, the percentage of secondborn
      children who were fully immunized was significantly lower than the percentage of
      fully immunized firstborn children (P values ranging from < .0001 to < .05).
      Firstborn children were much more likely than their secondborn siblings to have
      been immunized on time with DTP2 (z = 3.80, P = .0001) and DTP3 (z = 3.31, P =
      .0009). Overall, DTP2 immunizations were given at median ages 10 days later, and
      DTP3 immunizations, 20 days later to secondborn children than to their firstborn
      siblings. In addition, late immunization of a firstborn child was found to
      increase the risk that a secondborn sibling would also be immunized late.
      CONCLUSIONS: Secondborn children are likely to be immunized later than firstborn
      children. Secondborn children with an older sibling who was immunized late are at
      particular risk for delayed immunizations.

PMID- 7795772
TI  - Breast-feeding in a low-income population. Program to increase incidence and
      duration.
AB  - OBJECTIVE: To evaluate the efficacy of an intervention program to increase breast
      feeding in a low-income, inner-city population. DESIGN: A randomized, nonblinded
      clinical control trial. Patients were followed up through pregnancy, delivery,
      and the first year of the infant's life or until the time of weaning from the
      breast, whichever came first. SETTING: The ambulatory care center for prenatal
      and pediatric care and the inpatient maternity unit of a primary care center that
      serves a low-income, inner-city population. PATIENTS: There were a total of 108
      patients: 51 were randomized to the intervention group that received prenatal and
      postnatal lactation instruction from a lactation consultant, and 57 were
      randomized to the control group that received the standard of care at the
      institution. Patients in the control group were not seen by the lactation
      consultant. The two groups were similar demographically. INTERVENTION: This
      program consisted of individual prenatal lactation consultation, daily rounds by
      the lactation consultant on the postpartum unit, and outpatient follow-up at 48
      hours after discharge, at the time that the infant was 1 week of age, and at all
      future health supervision visits for infants up to 1 year of age. MAIN OUTCOME
      MEASURES: The incidence and duration of breast-feeding. RESULTS: There was a
      markedly higher incidence of breast-feeding in the intervention group, as
      compared with that of the control group (61% vs 32%, respectively; P = .002). The
      duration of breast-feeding was also significantly longer in the intervention
      group (P = .005). CONCLUSIONS: This lactation program increased the incidence and
      duration of breast-feeding in our low-income cohort. We suggest that similar
      efforts that are applied to analogous populations may increase the incidence and
      duration of breast-feeding in low-income populations in the United States.

PMID- 7795773
TI  - Predictors of sunscreen use in childhood.
AB  - OBJECTIVE: To identify risk factors predictive of sunscreen use in children.
      DESIGN: Cross-sectional review of convenience sample. SETTING: Emergency
      department of a regional referral pediatric hospital. SUBJECTS: Nine hundred
      twenty-five parents of children presenting to the emergency department in August
      1993. MAIN OUTCOME MEASURES: Parental risk factors assessed were use of
      sunscreen, tanning behaviors, previous blistering sunburn, knowledge of cancer
      risk related to sunburn and sun protection factor definition, education level,
      and other health-promoting behaviors. The parents were asked about perceived risk
      for their child's being sunburned in the next month or development of skin cancer
      in their lifetime, as well as an estimation of safe sun exposure time for their
      child. Child risk factors included a history of previous painful sunburn and
      parental assessment of their child's skin type based on susceptibility to
      sunburn. RESULTS: Eighty-four percent of parents reported that their children had
      used sunscreen at least once in the previous 2 months. The use of sunscreen in
      children younger than 1 year was 54%, from 1 to 12 years of age was 91%, and
      older than 12 years was 68%. Factors associated with increased likelihood of
      sunscreen use were age of 1 to 12 years, parental use of sunscreen, estimation of
      safe sun exposure of less than 30 minutes, description of child skin type as
      burns "sometimes," "easily," or "always," and correct definition of sun
      protection factor. Application of a multivariate model yielded a sensitivity of
      96%, specificity of 36%, and positive predictive value of sunscreen use of 89%.
      CONCLUSIONS: Sunscreen use in parents is predictive of use in their children and
      relates more to experience with sunburn than with concerns about future skin
      cancer risk.

PMID- 7795774
TI  - Comparison of 1% and 2.5% selenium sulfide in the treatment of tinea capitis.
AB  - OBJECTIVE: To determine whether an over-the-counter shampoo containing 1%
      selenium sulfide would have sporicidal activity equal to that of a 2.5% selenium
      sulfide prescription lotion in the adjunctive treatment of tinea capitis
      infection. DESIGN: Prospective randomized nonblinded clinical trial. SETTING:
      Outpatient clinics and emergency department of a children's hospital. PATIENTS:
      Fifty-four patients between the ages of 1 and 15 years with culture-proved tinea
      capitis infection caused by Trichophyton tonsurans enrolled during a 14-month
      period. METHODS: Patients were randomized to receive 2.5% selenium sulfide
      lotion, 1% selenium sulfide shampoo, or a bland, nonmedicated shampoo with which
      they were instructed to shampoo twice weekly. All received 15 mg/kg per day of
      griseofulvin. Dermatophyte cultures of the affected area of each patient's scalp
      were obtained on enrollment and every 2 weeks until a negative culture was
      obtained from a previously infected area. RESULTS: Survival data analysis
      demonstrated that both the 2.5% selenium sulfide and 1% selenium sulfide
      preparations were superior to the nonmedicated control shampoo in terms of the
      time required to eliminate shedding of viable spores. When compared with each
      other, there was no difference between the 2.5% selenium sulfide and 1% selenium
      sulfide preparations in time required to produce a negative culture. CONCLUSION:
      Commercially available 1% selenium sulfide shampoo is an equally effective yet
      less expensive alternative sporicidal therapy in the adjunctive treatment of
      tinea capitis infection.

PMID- 7795775
TI  - When patients and pediatricians say good-bye in a pediatric resident continuity
      clinic.
AB  - Pediatric residency programs require a 3-year continuity clinic experience for
      residents. To our knowledge, no authors have examined the impact of termination
      at the end of the residency among the child, parent, and pediatrician. This
      article discusses an exploration that evolved in response to the questions that
      third-year pediatric residents asked concerning how to say good-bye to their
      primary care patients in the context of their continuity clinic. The first panel
      addressed parental and patient issues, and the second addressed the impact on the
      pediatrician. The parents on the panel stated that it was important that they be
      notified in advance of their pediatrician's departure, that they believed they
      had played an important role in the resident's education, and that they wanted a
      voice in the selection of their child's future pediatrician. The pediatricians on
      the panel all felt sadness, relief, and guilt as a result of the termination, but
      guilt that the family would feel abandoned was the strongest emotion. Few
      pediatricians on the panel acknowledged the impact of the relationship on
      themselves and the importance of including the parents in the decision to choose
      the child's future pediatrician. The issue of termination needs more deliberate
      attention in pediatric training programs. A structured system for teaching
      residents to manage the termination process is proposed.

PMID- 7795776
TI  - Radiological case of the month. Granulocytic sarcoma.

PMID- 7795777
TI  - Picture of the month. Loose anagen syndrome.

PMID- 7795778
TI  - Thrombocytopenia in neonates with trisomy 21.

PMID- 7795779
TI  - High-performance liquid chromatographic analysis with electrochemical detection
      of biogenic amines using microbore columns.
AB  - High-performance liquid chromatography with electrochemical detection (HPLC-ED)
      is a popular method for measuring biogenic amines, owing to its simplicity,
      versatility, sensitivity, and specificity. Recent developments in microbore
      column HPLC-ED have been facilitated by miniaturization of solvent delivery,
      column packing, sample injection and micro-flow cell construction. The aim of
      this paper is to present an overview of recent developments in microbore column
      HPLC-ED, in terms of advantages and limitations. This paper covers the recent
      advancements and important factors of HPLC-ED analysis of biogenic amines using
      microbore columns. Particular emphasis is placed on applying this technique to
      microdialysis, for which great sensitivity is required. Its potential in future
      biomedical applications is also discussed.

PMID- 7795780
TI  - Quantitative determination of diol metabolites of CS-670, a new antiinflammatory
      agent, by capillary column gas chromatography-mass spectrometry.
AB  - CS-670(I), being developed as a non-steroidal anti-inflammatory agent, is a
      racemic prodrug. It has been found to be readily metabolized to active
      metabolites: trans and unsaturated mono-ols (trans-OH, unsaturated-OH). We report
      here a method for the quantitative determination of the eight diol stereoisomers
      excreted in urine after administration I. The diols were well separated and
      quantitated using capillary column GC-MS after a rather simple derivatization
      with diazomethane-trifluoroacetic anhydride. Sex differences in rats and species
      differences between rats and mice were observed in the metabolism of I: the trans
      diols originating from trans-OH were predominantly excreted in male and female
      rat urine but the excretion rate was greater in the male rats; the cis-diols
      originating from cis mono-ol (cis-OH) were the major urinary metabolites in mice.
      The hydroxy groups were mainly introduced at the respective equatorial hydrogen
      atoms at the 4'-carbon of trans-OH and the 5'-carbon of cis-OH. The 4'- and 5'
      hydroxy groups in the diols were in the cis conformation with respect to the
      original 2'-hydroxy group. As approximately 9% of the trans-diols were excreted
      in urine after administration of cis-OH to rats, the chiral inversion from cis-OH
      to trans-OH was suggested to occur through the saturated ketone intermediate.

PMID- 7795781
TI  - Determination of berberine in plasma, urine and bile by high-performance liquid
      chromatography.
AB  - A high-performance liquid chromatographic method for the determination of
      berberine in plasma, urine and bile samples is described. Plasma samples were
      pretreated by protein precipitation with acetonitrile and urine and bile samples
      were pretreated by organic solvent extraction using 5% 2-propanol in methylene
      chloride. Berberine was determined in all samples using an octyl reversed-phase
      column with a mobile phase of 60-63% acetonitrile in 0.1% phosphoric acid (pH
      6.0) and with UV detection at 267 nm. The detection limits for berberine in
      plasma, urine and bile were 18.1 ng/ml, 2.3 ng/ml and 90.4 ng/ml, respectively.
      The recoveries of berberine by simple deproteinization of plasma and by solvent
      extraction of urine were 78.3 and 82.9%, respectively. The intra-day and inter
      day accuracy and precision for plasma reported as coefficients of variation and
      relative errors were both less then 6%. The applicability of the assay to
      pharmacokinetic and bioavailability studies was demonstrated by the determination
      of berberine in plasma, urine and bile after intravenous and intramuscular
      administration to rabbits at a dose of 2 mg/kg.

PMID- 7795782
TI  - High-performance liquid chromatographic determination of (S)- and (R)-propranolol
      in human plasma and urine with a chiral beta-cyclodextrin bonded phase.
AB  - The determination of propranolol enantiomers in microsamples of human plasma and
      urine by HPLC using a chiral stationary phase is described. After extraction from
      200 microliters of plasma or urine with racemic alprenolol as internal standard
      (I.S.), the enantiomers are separated on a beta-cyclodextrin column with a polar
      organic mobile phase and determined by fluorescence detection. The retention
      times of I.S. and propranolol enantiomers are about 12-13 min and 16-18 min,
      respectively. Peak resolutions are 1.4 for I.S. and 2.2 for propranolol. The use
      of alprenolol as I.S. improves significantly the coefficients of variation (C.V.:
      0.6-4.2%). Sensitivity is approximately 1.5 ng/ml per propranolol enantiomer. The
      assay is applied to pharmacokinetic studies of racemic propranolol in human
      biological fluids. The (S)-propranolol levels are always higher than the (R)
      antipode concentrations in plasma and urine.

PMID- 7795783
TI  - Enantioselective determination of thiamylal in human serum by high-performance
      liquid chromatography.
AB  - Thiamylal, a widely used anesthetic drug, has two enantiomers. We developed a
      novel and simple method for measuring thiamylal enantiomers in human serum using
      reversed-phase high-performance liquid chromatography. R(+)- and S(-)-Thiamylal
      were separated using a chiral mobile phase containing beta-cyclodextrin, and
      detected at the range of 50 ng/ml-25 micrograms/ml in serum. The relative
      standard deviations of R(+)- and S(-)-thiamylal were 3.4-8.7% and 2.8-8.7% for
      the intra-day assay, and 2.8-12.0% and 2.8-13.0% for the inter-day assay. This
      method may be applied to enantioselective pharmacokinetic studies of thiamylal.

PMID- 7795784
TI  - Achiral and chiral analysis of camazepam and metabolites by packed-column
      supercritical fluid chromatography.
AB  - Supercritical fluid chromatography, using carbon dioxide as the mobile phase and
      ethanol as a modifier, has been applied to the analysis of products formed in rat
      liver microsomal metabolism of racemic camazepam, a hypnotic/anxiolytic drug in
      clinical use. An achiral (amino) column and a chiral (Chiralcel OD-H) column were
      used. The results suggest that achiral and chiral packed-column supercritical
      fluid chromatography gives a shorter analysis time and higher selectivity and
      efficiency than achiral and chiral stationary-phase high-performance liquid
      chromatography in the analysis of camazepam and its derivatives.

PMID- 7795785
TI  - Determination of metyrapone and the enantiomers of its chiral metabolite
      metyrapol in human plasma and urine using coupled achiral-chiral liquid
      chromatography.
AB  - A coupled achiral-chiral liquid chromatographic assay has been developed to
      determine the concentrations of metyrapone and the enantiomers of its chiral
      metabolite metyrapol in plasma and urine. The chromatographic system consisted of
      a silica precolumn (75 x 4.6 mm I.D.) coupled in-line to a 250 x 4.6 mm I.D.
      column containing cellulose tris(4-methylbenzoate) coated on silica gel
      (Chiralcel OJ-CSP). When plasma samples were analyzed, the mobile phase was
      hexane-ethanol (92:8, v/v) modified with 0.1% diethylamine and when urine samples
      were analyzed the mobile phase was hexane-ethanol (94:6, v/v) modified with 0.2%
      diethylamine. Under these chromatographic conditions the chromatographic
      retentions [expressed as capacity factors (k')] for metyrapone were k' = 2.35
      (plasma) and 2.52 (urine); for (-)-metyrapol k' = 4.22 (plasma) and 4.62 (urine);
      for (+)-metyrapone k' = 5.16 (plasma) and 5.86 (urine); enantioselectivities
      (alpha) were 1.09 (plasma) and 1.13 (urine). The assay has been validated for use
      in metabolic studies. The analyses of plasma and urine samples from one subject
      following oral administration of 750 mg of metyrapone indicated that the
      enzymatic reduction of myterapone by aldo-keto reductase was enantiospecific.

PMID- 7795786
TI  - Capillary gas chromatographic determination of proteins and biological amino
      acids as N(O)-tert.-butyldimethylsilyl derivatives.
AB  - Forty-seven biological amino acids containing all 22 protein amino acids were
      derivatized to N(O)-tert.-butyldimethylsilyl (tBDMSi) derivatives by a single
      step reaction with N-methyl-N-(tert.-butyldimethylsilyl)trifluoroacetamide and
      successfully separated on an HP-1 capillary column. The relative standard
      deviations of the relative molar responses of most amino acids were < 5%. Cystine
      seems to be partially converted into cysteine during derivatization. An increase
      in carrier gas flow-rate towards the end of the analysis by inlet pressure
      programming with electron pressure control avoided the peak broadening and
      adsorption of the derivatives with high boiling points on the column and
      especially increased sensitivity of cystine to 5 pmol. Glutamine was converted
      almost completely into pyroglutamic acid during prolonged storage of a standard
      solution prepared in 0.01 M HCl but not during derivatization. These results
      compared with those for the phenylthiocarbamyl derivatives analysed by HPLC and
      the analytical results reported in the literature on soybean hydrolysate showed
      good agreement except for cysteine. The results for the amino acid composition of
      bovine serum albumin also showed good agreement with results in the literature
      except for cysteine. In human urine, seventeen free amino acids were detected as
      tBDMSi derivatives.

PMID- 7795787
TI  - High-performance liquid chromatographic assay for sodium
      mercaptoundecahydrododecaborate in rat tissues.
AB  - Mercaptoundecahydrododecaborate (BSH) is an important agent for the boron neutron
      capture therapy (BNCT). A sensitive high-performance liquid chromatographic
      (HPLC) method was developed for measuring BSH concentrations in rat tissues.
      Various tissue samples containing the drug were homogenized in a 1:1 (g/ml)
      mixture with phosphate buffered saline. The samples were then deproteinised with
      4 volumes of acetonitrile and centrifuged. An aliquot of the supernatant was
      dried and reconstituted in 200 microliter of Tris-HC1 buffer. The samples were
      subjected to precolumn derivatization using the thiol reactive monobromobimane
      (mBB). The drug-mBB adduct was resolved by isocratic elution from a C18 reversed
      phase column. The optimized mobile phase was methanol-0.02 M phosphate buffer
      (43:57, v/v) containing 0.01 M tetrabutylammonium dihydrogen phosphate as the ion
      pairing agent with the final pH adjusted to 7.0. The flow-rate was set at 2.0
      ml/min. The adduct was monitored by UV absorption at 373 nm. The analysis was
      completed in less than 15 min. The detection limit was 0.5 microgram/ml (0.25
      microgram of boron). The assay method was linear over a concentration range of
      0.5 to 50 micrograms/ml. This assay method could be used to evaluate the BSH
      concentrations in different tissues in studies on the targeted delivery of BSH.

PMID- 7795788
TI  - Simultaneous quantitation of methotrexate and its two main metabolites in
      biological fluids by a novel solid-phase extraction procedure using high
      performance liquid chromatography.
AB  - We have developed an assay for the simultaneous determination of methotrexate
      (MTX) and its main metabolites, 7-hydroxymethotrexate (7-OHMTX) and 2,4-diamino
      N10-methylpteroic acid (DAMPA) in plasma, urine and saliva meeting the
      requirement of rapidity for routine use in high-dose MTX therapy and the
      requirement of sensitivity for its potential use in therapeutic drug monitoring
      in low-dose MTX therapy. Sample preparation is based on solid-phase extraction
      using C8 Isolute cartridges. Chromatographic separation was achieved with a
      reversed-phase column (C18), and quantitation by subsequent exposure to UV light
      of 254 nm, which converted MTX and its two metabolites by photolytic oxidation to
      fluorescent products. The recoveries of MTX, 7-OHMTX and DAMPA from plasma at 100
      nmol/l were 85.8, 91.1 and 102.3%, respectively. The limits of detection for MTX,
      7-OHMTX and DAMPA in plasma and saliva were 0.1 nmol/l. In urine the limit of
      detection was 10 nmol/l for all compounds. The limits of quantitation in plasma
      and saliva were 0.5 nmol/l for all compounds.

PMID- 7795789
TI  - Validated assays for the determination of gemcitabine in human plasma and urine
      using high-performance liquid chromatography with ultraviolet detection.
AB  - Procedures are described for the determination of gemcitabine, a new anti-tumor
      agent, and its uridine metabolite in human plasma and in human urine. The sample
      preparation for the plasma assay involves precipitation of plasma proteins with
      isopropanol and ethyl acetate. Following this, the solids are discarded and the
      supernatant is evaporated to dryness. For the urine assay, the sample is diluted
      with methanol and evaporated to dryness. For both procedures, the residue is
      reconstituted in mobile phase prior to injection into a normal-phase (amino
      column) liquid chromatographic system followed by UV detection at 272 nm. The
      limits of quantitation for both compounds are 50 ng/ml in plasma and 20
      micrograms/ml in urine. The procedures were used to provide pharmacokinetic data
      for both compounds in man following the intravenous administration of a 1000
      mg/m2 dose of gemcitabine.

PMID- 7795791
TI  - Sensitive high-performance liquid chromatographic method for a dopamine receptor
      agonist, CI-1007, and its metabolite PD 147693 in monkey plasma.
AB  - A sensitive gradient high-performance liquid chromatographic (HPLC) method for
      the simultaneous quantitation of a dopamine autoreceptor agonist CI-1007 (I) and
      its metabolite PD 147693 (II) is described. Monkey plasma samples were purified
      by liquid-liquid extraction using hexane. Liquid chromatographic separation was
      achieved on two C18 analytical columns (installed in series) using gradient
      elution. Column effluent was monitored using a fluorescence detector programmed
      to change wavelengths at specified times. Minimum quantitation limits of I and II
      were 3.0 and 5.0 ng/ml, respectively, for a plasma sample volume of 0.100 ml.
      Linearity was demonstrated up to 300 ng/ml. The assay has been applied to the
      analysis of I and II in plasma from monkeys following intravenous and oral doses
      of I.

PMID- 7795790
TI  - Highly sensitive high-performance liquid chromatographic assay for 1-beta-D
      arabinofuranosylcytosine-5'-stearyl phosphate (cytarabine-ocfosfate).
AB  - An ion-pair HPLC method for the determination of 1-beta-D
      arabinofuranosylcytosine-5'-stearyl phosphate (cytarabine-ocfosfate I) was
      developed, using a phenyl-bonded column under reversed-phase conditions with a
      mobile phase of acetonitrile-buffered water (pH 6.8) (50:50) for isocratic
      elution. A reproducible sample clean-up was achieved by solid-phase extraction.
      In order to reach the low limit of detection of 2 ng/ml, an enrichment switching
      system was used. The present validation leads to a limit of quantification of 5
      ng/ml with a coefficient of variation (C.V.) of 10%. The total time of
      measurement was shortened by a back-flush procedure to restore the conditions
      after each run. UV detection at 275 nm was applied. The recoveries for plasma
      samples ranged from 56.4 to 64.1%, regardless of drug concentrations. The intra
      assay C.V. was about 4% (40 measurements at four different concentrations). The
      inter-assay recovery (ten measurements over ten days) at a plasma concentration
      of 50 ng/ml was 57% with a C.V. of 8.25%. Based on this HPLC method, the
      pharmacokinetics of I were measured during a clinical phase I/II study.

PMID- 7795792
TI  - Determination of theophylline and its metabolites in rat liver microsomes and
      human urine by capillary electrophoresis.
AB  - A capillary electrophoretic (CE) method has been developed for the determination
      of theophylline and all of its identified and potential metabolites. The method
      is rapid, resolves all metabolites to baseline, and requires extraction of only
      some biological fluids. It has been applied to the analysis of theophylline
      metabolism by hepatic microsomes from rats treated with a variety of inducing
      agents for different forms of P450 enzymes which metabolize theophylline, and to
      human urine spiked with theophylline and its metabolites, and concentrated by
      solid-phase extraction.

PMID- 7795793
TI  - High-performance liquid chromatographic determination of primary aromatic amines
      in urine after derivatization to an azo dye with 2-aminoanthracene.
AB  - A sensitive HPLC method for the determination of primary aromatic amines (anilino
      compounds) is described. Samples were prepared by derivatization of the substrate
      to an azo dye with 2-aminoanthracene (2-AA). 2-AA was found to react with the
      diazonium salts prepared from substituted anilines such as 4-halo, -sulfonyl, 
      carboxyl, -nitro or -acetyl derivatives, but not 4-hydroxy or -alkyl derivatives.
      In this work, three model compounds [sulfanilamide, 4-aminobenzoyl-beta-alanine
      and 4-aminobenzoic acid (PABA)] were used to test the linearity and accuracy of
      the method. Chromatographic separation was carried out using a reversed-phase
      column (ODS) and ultraviolet detection at 279 nm. Good linearity for the three
      compounds was found within the range 50-2000 ng/ml. The intra-day coefficient of
      variation for the three compounds (at 100, 500, 1000 ng/ml) was below 10%. Using
      this method, the urinary excretion of PABA and its metabolites was studied after
      oral administration of PABA to rats.

PMID- 7795794
TI  - Determination of thiopurine nucleotides in human lung tissue by high-performance
      liquid chromatography.
AB  - A method for the analysis of thiopurine nucleotides in human transbronchial lung
      biopsy was developed. The sample treatment procedure is based on perchloric acid
      homogenisation and deproteinisation with dithiothreitol and hydrolysis of
      thiopurine nucleotides into their free bases by heating of the acid extract.
      Then, the free bases were analyzed in the gradient elution mode on a Hypersil
      ODS, 3-microns column using dihydrogenphosphate buffer-methanol as eluent. Mean
      analytical recoveries for 6-thioguanosine monophosphate and 6-thioinosinic acid
      from lung tissue were 97.0 +/- 2.0 and 98.0 +/- 1.8% at a concentration of 3.0
      nmol/ml and the minimum detectable amounts were 3.5 and 2 pmol, respectively. The
      procedure described is simple and represents a suitable method for the
      investigation of thiopurine nucleotides in tissues.

PMID- 7795796
TI  - Determination of chlorhexidine in saliva using high-performance liquid
      chromatography.
AB  - A reversed-phase high-performance liquid chromatographic method for the
      determination of chlorhexidine in saliva is reported. The method developed
      includes a simple and short sample preparation with a one-step extraction
      procedure and a short total chromatographic run time of 5 min. In a preliminary
      pharmacokinetic study with a healthy volunteer the chlorhexidine concentration
      found in saliva after 12 h was 0.8 microgram/ml.

PMID- 7795795
TI  - Simultaneous determination of midazolam and flumazenil concentrations in human
      plasma by gas chromatography.
AB  - A gas chromatographic method for the simultaneous determination of midazolam and
      flumazenil concentrations in human plasma has been developed, using clinazolam as
      the internal standard. A mixture of chloroform and ethyl acetate (80:20) was used
      to extract the two compounds. A 2-microliters volume of the reconstituted sample
      was injected using a 1:20 split injection mode. Intra-day coefficients of
      variation ranged from 2 to 6.9%. The assay was linear over the range 3-1000
      ng/ml. This assay was subsequently used to analyze samples from a human
      pharmacokinetic study.

PMID- 7795797
TI  - Determination of a novel cognitive enhancer, X9121, and its mono N-oxide
      metabolite, XG696, in dog plasma by reversed-phase high-performance liquid
      chromatography with ultraviolet detection.
AB  - A selective and sensitive high-performance liquid chromatographic assay for a
      novel cognitive enhancer, X9121 (I), and its mono N-oxide metabolite, XG696 (II),
      in dog plasma has been developed. Compounds I, II and internal standard (I.S.)
      were first extracted from dog plasma using a solid-phase Bond Elut Certify I 10
      ml LRC reservoir extraction cartridge. Chromatographic separation of I, II and
      I.S. was conducted on a reversed-phase Zorbax Stable Bond cyano column. Ammonium
      acetate buffer (0.05 M, pH 6)-acetonitrile-triethylamine (75:25:0.1, v/v) was
      used as the mobile phase. Detection of all three compounds was by UV light
      absorbance at 313 nm. Using 0.5 ml of dog plasma for extraction, the minimum
      quantifiable limit was 10 ng/ml and the assay was linear from 10 to 5400 ng/ml.
      The coefficients of variation for intra-day precision ranged from 2.2 to 8.5% for
      I and from 2.5 to 9.8% for II. The coefficients of variation for the inter-day
      precision for these two compounds ranged from 2.6 to 9.0% and from 3.6 to 16.2%,
      respectively. The absolute percent differences for the accuracy results were
      within 11.0% of the spiked concentrations. Compounds I and II were stable in
      frozen plasma at -20 degrees C for at least 67 days.

PMID- 7795798
TI  - Determination of oxalate in urine and plasma using reversed-phase ion-pair high
      performance liquid chromatography with tris(2,2'-bipyridyl)ruthenium(II)
      electrogenerated chemiluminescence detection.
AB  - Oxalate is quantitated in both urine and plasma samples using reversed-phase ion
      pair high-performance liquid chromatography (HPLC) with tris(2,2'
      bipyridyl)ruthenium(II) [Ru(bpy)2+(3)]-electrogenerated chemiluminescent (ECL)
      detection. Underivatized oxalate was separated on a reversed-phase column (Zorbax
      ODS) using a mobile phase of 10% methanol in 100 mM phosphate buffer at pH 7.0.
      The eluted compounds were combined with a stream of 2 mM Ru(bpy)2+(3) at a mixing
      tee before the ECL flow-cell. In the flow-cell, Ru(bpy)2+(3) is oxidized to
      Ru(bpy)3+(3) at a platinum electrode, and reacts with oxalate to produce
      chemiluminescence (CL). Urine samples were filtered and diluted prior to
      injection. Plasma samples were deproteinized before injection. A 25-microliters
      aliquot of sample was injected for analysis. Possible interferants, including
      amino acids and indole-based compounds, present in biological samples were
      investigated. Without the separation, amino acids interfere by increasing the
      total observed CL intensity; this is expected because they give rise to CL
      emission on their own in reaction with Ru(bpy)3+(3). Indole compounds exhibit a
      unique interference by decreasing the CL signal when present with oxalate.
      Indoles inhibit their own CL emission at high concentrations. By use of the
      indicated HPLC separation, oxalate was adequately separated from both types of
      interferants, which thus had no effect on the oxalate signal. Urine samples were
      assayed by both HPLC and enzymatic tests, the two techniques giving similar
      results, differing only by 1%. Detection limits were determined to be below 1
      microM (1 nmol/ml) or 25 pmol injected. The working curve for oxalate was linear
      throughout the entire clinical range in both urine and plasma.

PMID- 7795799
TI  - Automatic determination of hydroperoxides of phosphatidylcholine and
      phosphatidylethanolamine in human plasma.
AB  - An automatic method for the determination of hydroperoxides of
      phosphatidylcholine (PC) and phosphatidylethanolamine (PE) is reported. Sample
      plasma was deproteinized with a fourfold volume of methanol. After
      centrifugation, the supernatant was injected directly into an HPLC system without
      further treatment. The hydroperoxides of PC and PE were concentrated and washed
      on an ODS column followed by introduction into two analytical columns, a silica
      gel and an aminopropylsilica gel column, which were connected in series, by
      column switching. After the separation, they were detected by postcolumn
      detection with diphenyl-1-pyrenylphosphine. The compounds were determined at
      picomole levels within 30 min with good reproducibilities. By using only a silica
      gel column as an analytical column, PC hydroperoxides were determined within 20
      min, and samples could be injected into it at 15-min intervals. Those methods
      made it possible to inject a sample of up to 2 ml at one time and up to 8 ml by
      repeated injections and to determine phospholipid hydroperoxides in human plasma
      at picomole levels.

PMID- 7795800
TI  - Assay of urinary free and conjugated 3-methoxy-4-hydroxyphenylethyleneglycol by
      high-performance liquid chromatography with amperometric detection.
AB  - The aim of this study was to develop an analytical method for free and conjugated
      3-methoxy-4-hydroxyphenylethyleneglycol (MHPG) in urine. After hydrolysis of the
      conjugated forms, the urinary MHPG was purified by solid-phase extraction on
      anion exchanger and eluted with a water-methanol (1:1, v/v) mixture. After
      addition of ethyl acetate to the eluate and back-extraction into acetic acid, the
      aqueous phase was separated on a C18 column by HPLC and detected
      amperometrically. The results obtained from forty healthy human subjects were
      compared with the literature values. The precision and accuracy of the assay were
      studied using 4-methoxy-3-hydroxyphenylethyleneglycol (iso-MHPG) as internal
      standard.

PMID- 7795802
TI  - Evaluation of 2-iminoimidazolidin-4-one and thymine as respective internal
      standards for normal-phase and reversed-phase high-performance liquid
      chromatographic determination of creatinine in human serum.
AB  - We evaluated two internal standards for HPLC determination of creatinine in human
      serum after ultrafiltration: 2-iminoimidazolidin-4-one for normal-phase HPLC on
      aluminium oxide, and thymine for C18 reversed-phase HPLC. Detection of 2
      iminoimidazolidin-4-one was done at the same wavelength as that used for
      creatinine, i.e. 240 nm. For thymine, the wavelength was switched to 280 nm. The
      suitability of the selected compounds to serve as an internal standard in the
      described measurement procedures, including ultrafiltration of serum, was
      evaluated from the precision and accuracy obtained. The method based on normal
      phase HPLC with 2-iminoimidazolidin-4-one showed an imprecision expressed as
      R.S.D. ranging from 0.8 to 3.4% (mean: 2.1%) and an inaccuracy, calculated from
      the deviations from target values determined by isotope-dilution gas
      chromatography-mass spectrometry, ranging from -1.3 to +1.8% (mean: +0.4%). For
      the reversed-phase HPLC procedure with thymine, the imprecision ranged from 0.3
      to 1.3% (mean: 1.0%) and the inaccuracy from +0.1 to +3.9% (mean: +1.7%). The
      occasional observation of interferences with 2-iminoimidazolidin-4-one limited
      the application of the normal-phase method to a certain extent.

PMID- 7795801
TI  - Isolation of individual amino acids from various microbiological sources using
      reversed-phase high-performance liquid chromatography.
AB  - A new method for the preparative isolation of individual amino acids on a
      milligram scale based on reversed-phase high-performance liquid chromatography
      (RP-HPLC) after pre-column derivatization with carbobenzoxychloride (Z-Cl) has
      been developed. The chromatographic procedure was tested by the investigation of
      jack bean urease hydrolysate. The method has been applied to the preparative
      separation of Z-amino acids (from 10 up to 16) obtained from protein hydrolysates
      of various sources (green microalgae, blue-green algae, halophilic and
      methylotrophic microorganisms) and was proved to be reliable by the separation of
      deuterated amino acids (enrichment 97-99%) from Methylobacillus flagellatum (due
      to the bioconversion of CD3OD and D2O). Independent of the biological source of
      the protein, the amino acids were isolated with high recovery (from 68% up to
      89%) and chromatographic purity (from 96% up to 99%). The method was also applied
      for the isolation of phenylalanine and leucine excreted by amino-acid
      overproducing microorganisms.

PMID- 7795803
TI  - High-performance liquid chromatographic determination of nicotinic acid and
      nicotinamide in biological samples applying post-column derivatization resulting
      in bathmochrome absorption shifts.
AB  - An ion-pair reversed-phase high-performance liquid chromatographic procedure for
      the rapid separation and sensitive quantitation of nicotinic acid (NA) and
      nicotinamide (NAM) in biological samples was developed. The vitamers were
      separated within 10 min on an octadecylsilica column applying a linear gradient
      of tetrabutylammonium phosphate and methanol. NA and NAM were converted to highly
      absorbing derivatives by a modified Konig's reaction using a double post-column
      derivatization arrangement consisting of two pumps and two knitted tubular
      reactors. The proposed method is highly sensitive and specific and applicable to
      biological materials as was shown by the analysis of rat intestinal tissue.

PMID- 7795804
TI  - Analysis of dipalmitoyl phosphatidylcholine in amniotic fluid by enzymatic
      hydrolysis and high-performance thin-layer chromatography reflectance
      spectrodensitometry.
AB  - A novel test for the determination of dipalmitoyl phosphatidylcholine (DPPC) in
      amniotic fluid (AF) as free dipalmitoylglycerol (DPG), is described. Aliquots of
      amniotic fluid were hydrolyzed with Bacilus cereus phospholipase C, and the
      resulting diglycerides analyzed by AgNO3-modified high-performance thin-layer
      chromatography (HPTLC)-reflectance spectrodensitometry. This HPTLC system
      provided resolution of DPG and palmitoylpalmitoleoylglycerol (POG) from other 1,2
      diglycerides and cholesterol. The turn-around analysis time for triplicate
      aliquots of amniotic fluid was 40 min. Recoveries ranged between 90 and 98%. In
      summary, this method provides a quantitative, specific, highly reproducible, and
      fast turn-around means of analysis of DPPC in amniotic fluid.

PMID- 7795805
TI  - Determination of vitamin A in dried human blood spots by high-performance
      capillary electrophoresis with laser-excited fluorescence detection.
AB  - We have developed a high-performance capillary electrophoresis (HPCE) method to
      analyze the retinol (vitamin A) concentration as retinol-retinol binding protein
      (holo-RBP) from microvolumes of serum (5-10 microliters) or one to two drops
      (approximately 20 microliters) of blood collected and air-dried on blood
      collection filter paper. A 0.64-cm diameter disk was cut from the dried whole
      blood specimens and the samples were dissolved in a pretreatment buffer and
      filtered. Filtrate was injected onto the HPCE column for analysis. The separation
      was carried out in a 60 cm x 50 microns I.D. fused-silica capillary and the
      running voltage was 20 kV. A He-Cd laser with a wavelength of 325 nm was used for
      excitation, and the fluorescence of the holo-RBP complex was monitored at 465 nm
      by a photodiode. A virtual linear relationship was obtained for the retinol
      concentrations between HPCE and HPLC for 28 serum samples, 19 dried venous blood
      samples and 9 capillary dried blood spot samples, indicating that valid measures
      of serum retinol can be obtained from one to two drops of capillary blood
      collected on filter paper. The absolute detection limit for retinol by HPCE is
      below 3 micrograms/l. The method is very useful for vitamin A level screening,
      especially for children and premature new-born babies.

PMID- 7795806
TI  - Improved methodology for the detection and quantitation of urinary metabolites of
      sulphur mustard using gas chromatography-tandem mass spectrometry.
AB  - Gas chromatography-tandem mass spectrometry (GC-MS-MS) with selected-reaction
      monitoring was applied to the analysis of urinary metabolites of sulphur mustard,
      derived from the beta-lyase pathway and from hydrolysis. In the case of beta
      lyase metabolites, a limit of detection of 0.1 ng/ml was obtained, compared to 2
      5 ng/ml using single stage GC-MS with selected-ion monitoring. GC-MS-MS
      methodology was less useful when applied to the analysis of thiodiglycol
      bis(pentafluorobenzoate) using negative-ion chemical ionisation although selected
      reaction chromatograms were cleaner than selected-ion chromatograms. The
      advantage of using GC-MS-MS was demonstrated by the detection of low levels of
      beta-lyase metabolites in the urine of casualties who had been exposed to sulphur
      mustard.

PMID- 7795809
TI  - Rapid reversed-phase high-performance liquid chromatographic method with double
      derivatization for the assay of urinary hydroxyproline.
AB  - An HPLC method with two derivatizations, the first with o-phthaldehyde in order
      to eliminate interferences due to some primary amino acids eluting with retention
      times similar to those of hydroxyproline and the second with dabsyl chloride, was
      developed and evaluated. Calibration graph linearity, influence of agitation and
      temperature on the preparation of the first derivative and the influence of the
      detection wavelength were assessed. The analysis time is shorter in comparison
      with other available methods, and therefore this method is suitable for
      laboratories that analyse both small and large series of samples.

PMID- 7795808
TI  - High-performance liquid chromatographic-electrospray mass spectrometric analysis
      of bile acids in biological fluids.
AB  - The present work describes the development of HPLC-mass spectrometric systems
      equipped with an electrospray interface for the quantitative analysis of bile
      acids. Good separation of free as well as glycine- and taurine-conjugated bile
      acids was achieved with a C18 reversed-phase column (3 microns particle size, 70
      x 4.6 mm I.D.) employing methanol-15 mM ammonium acetate as the mobile phase for
      both isocratic and gradient mode, at a flow-rate of 0.3 ml/min. This system
      permits post-column splitting of the eluate for analysis by two different
      detectors: (1) electrospray-mass spectrometer with a flow-rate of 18
      microliters/min; and (2) a complementary evaporative light scattering mass
      detector. When bile salts were ionized in the electrospray interface operating in
      the negative-ion mode, only [M-H]- molecular ions were generated; the detection
      limit was 15 pg injected for all bile acids studied. In the second system, a semi
      micro pre-column splitting apparatus (Acurate, LC Packings) was utilized: with
      this device the flow-rate from the HPLC pump was reduced to 1.4 microliters/min
      and bile acids were separated with a micro-bore C18 column (3 microns particle
      size, 150 x 0.30 I.D.), using the same mobile phase as above. With this latter
      system, a head-column enrichment technique can be used: the amount injected can
      be increased from 60 to 200 nl, permitting an improvement in the detection limit
      to 5 pg injected. Application of the HPLC-electrospray-mass spectrometric method
      to bile and serum bile acid analysis is described; preliminary data on the
      ability of the first system to determine the 13C/12C isotope ratio in 13C-labeled
      bile acid enriched serum is also critically discussed.

PMID- 7795807
TI  - Measurement of volatile organic compounds in exhaled breath as collected in
      evacuated electropolished canisters.
AB  - A set of three complementary analytical methods were developed specifically for
      exhaled breath as collected in evacuated stainless steel canisters using gas
      chromatographic-mass spectrometric detection. The first is a screening method to
      quantify the carbon dioxide component (generally at 4-5% concentration), the
      second method measures the very volatile high-level endogenous compounds [e.g.
      acetone and isoprene at 500-1000 parts per billion by volume (ppbv), methanol,
      ethanol, dimethylsulfide at 2-10 ppbv], and the third method is designed to
      measure trace-level environmental contaminants and other endogenous volatile
      organic compounds (VOCs) (sub-ppbv) in breath. The canister-based sample format
      allows all three methods to be applied to each individual sample for complete
      constituent characterization. Application of these methods is shown to be useful
      in the following ways: analysis of CO2 levels indicates the approximate quantity
      of alveolar breath collected (as opposed to whole breath) in a sample; levels of
      major endogenous compounds are shown to be influenced by physical activities and
      subsequent recovery periods; and environmental exposures to xenobiotic VOCs can
      be characterized by assessment of post-exposure breath elimination curves. The
      instrumentation and methodology are described and example chromatograms and
      quantitative data plots demonstrating the utility of the methods are presented.

PMID- 7795810
TI  - Characterization of thyroxine-albumin binding using high-performance affinity
      chromatography. II. Comparison of the binding of thyroxine, triiodothyronines and
      related compounds at the warfarin and indole sites of human serum albumin.
AB  - High-performance affinity chromatography was used to examine the binding of
      thyroid hormones and related compounds at the warfarin and indole sites of human
      serum albumin (HSA). This was studied by continuously applying L-triiodothyronine
      (L-T3), L-reverse triiodothyronine (L-rT3) or structural analogs of these
      compounds to an immobilized HSA column while making injections of site-specific
      probe molecules (i.e. R-warfarin and L-tryptophan). The results were compared
      with those obtained previously for L-thyroxine (L-T4). Equilibrium association
      constants and thermodynamic parameters measured by this approach showed good
      agreement with previous models reported for L-T4 and L-T3 at their high-affinity
      sites on HSA. This data confirmed that the phenol groups of L-T4 and L-T3 played
      a significant role in the binding of these compounds at the indole site. Work
      performed at the warfarin site and with other solutes (e.g. L-rT3) indicated that
      additional factors, such as interactions through the thyronine backbone or
      terminal amine and carboxyl groups of these compounds, could also be involved in
      the binding of thyroid hormones to HSA.

PMID- 7795811
TI  - Determination of 2-butoxyethanol and butoxyacetic acid in rat and human blood by
      gas chromatography-mass spectrometry.
AB  - A sensitive and selective gas chromatographic-negative-ion chemical ionization
      mass spectrometric method was developed to simultaneously quantitate 2
      butoxyethanol (BE) and butoxyacetic acid (BAA) in rat and human blood at low ng/g
      levels as pentafluorobenzoyl and pentafluorobenzyl derivatives, respectively.
      Analysis of 13C-labeled analogs of BE and BAA were found to improve the limits of
      quantitation to below 2 ng/g. Deuterium-labeled BE and BAA were used as internal
      standards. Calibration curves were generally linear over three orders of
      magnitude, with limits of quantitation of 16-18 ng/g for both BE and BAA, and 1.5
      and 0.4 ng/g for [13C2]BE and [13C2]BAA, respectively, in human blood. Linearity
      in rat blood was similar, with limits of quantitation of 22 ng/g for BE and 5
      ng/g for BAA. This method was developed for the support of mammalian metabolism
      studies and human biomonitoring studies involving exposure to BE or [13C2]BE.

PMID- 7795812
TI  - Determination of Ro 19-6327 (Lazabemide) in human plasma and urine by gas
      chromatography-negative chemical ionization mass spectrometry.
AB  - A sensitive and specific analytical method was developed for determination of Ro
      19-6327 (Lazabemide) in human plasma and urine samples to provide pharmacokinetic
      data from clinical trials. The new method employs a simple liquid-liquid
      extraction to isolate the drug from biological samples. The extract is reacted to
      form the trifluoroacetyl derivative of Ro 19-6327 and then analyzed by gas
      chromatography-negative chemical ionization mass spectrometry (GC-NCIMS). The
      lower limit of quantitation of the assay is 0.05 ng/ml for plasma and 5.0 ng/ml
      for urine, based on 1-ml aliquots. No interferences from anticoagulants,
      collection devices, or endogenous constituents of plasma and urine were observed.
      Recovery (64.3%), inter-assay precision (< 8% R.S.D.), and accuracy (> 85%) of
      the method were considered acceptable. The assay proved reliable enough to be
      automated for unattended sample analysis of approximately 50 samples daily. In an
      additional series of tests, Ro 19-6327 was shown to be stable under conditions
      that might be encountered during the analysis of samples from clinical trials.

PMID- 7795813
TI  - Determination of xanomeline (LY246708 tartrate), an investigational agent for the
      treatment of Alzheimer's disease, in rat and monkey plasma by capillary gas
      chromatography with nitrogen-phosphorus detection.
AB  - A GC method is described for the determination of xanomeline (LY246708 tartrate)
      and selected metabolites in rat and monkey plasma. The analytes, including an
      internal standard, were extracted from plasma at basic pH with hexane. The
      organic extract was evaporated to dryness and the residue was reconstituted in
      hexane. The analytes were separated from metabolites and endogenous substances
      using a DB1701 capillary column. The analytes were detected using nitrogen
      phosphorus detection (NPD). The limit of quantitation was determined to be 8
      ng/ml, and the response was linear from 8 to 800 ng/ml. The method has been
      successfully applied to rat and monkey samples pursuant to the development of
      xanomeline as an agent for the symptomatic treatment of Alzheimer's disease.

PMID- 7795814
TI  - Biosynthesis, characterisation and direct high-performance liquid chromatographic
      analysis of gemfibrozil 1-O-beta-acylglucuronide.
AB  - Gemfibrozil 1-O-beta-acylglucuronide was purified from the urine of a volunteer
      administered gemfibrozil, and an isocratic reversed-phase HPLC method was
      developed for its direct measurement. Quantitation of gemfibrozil and gemfibrozil
      1-O-beta-acylglucuronide was carried out from plasma, following extraction from
      acidified specimens into ethyl acetate, on a 5-microns CN reversed-phase column
      with a mobile phase (pH 3.5) containing acetonitrile, tetrabutylammonium sulphate
      and distilled water, using fluorescence detection at 284 nm excitation and 316 nm
      emission. Calibration curves were linear for both compounds over a concentration
      range of 0.1 to 40 mg/l, with intra-assay coefficients of variation < 5% at
      concentrations of 20.0, 2.0 and 0.2 mg/l, and inter-assay coefficients of
      variation < 10%. No degradation of gemfibrozil 1-O-beta-acylglucuronide was
      detected as a result of the analytical procedure. However, a preliminary
      application of the method indicates that gemfibrozil acylglucuronide is
      chemically unstable undergoing intra-molecular rearrangement and hydrolysis under
      physiological conditions.

PMID- 7795816
TI  - Rapid determination of sulbactam and tazobactam in human serum by high
      performance liquid chromatography.
AB  - A simple and rapid HPLC method for the determination of tazobactam and sulbactam,
      two beta-lactamase inhibitors, in serum for the therapeutic follow-up of patients
      is described. The effect of the pH of the aqueous mobile phase and column
      temperature on column efficiency and retention were examined and equations for
      their dependences were derived. The use of a chromatographic response function
      showed that methanol-buffer (5:95, v/v) (pH 6.3) as the mobile phase and a 45
      degrees C column temperature were optimum values for chromatographic separation.
      The analytical method was linear from 10 to 200 micrograms/ml. This assay limit
      range is sufficient for the analysis of human serum. The limit of detection was
      10 micrograms/ml for sulbactam and 5 micrograms/ml for tazobactam. The
      coefficient of variation was less than 5%. The speed at which this assay can be
      performed makes it especially useful for estimating the levels of these drugs in
      human serum.

PMID- 7795815
TI  - Simultaneous determination of lofepramine and desipramine by a high-performance
      liquid chromatographic method used for therapeutic drug monitoring.
AB  - A simple reversed-phase HPLC method with ultraviolet detection for the
      simultaneous measurement of lofepramine and desipramine is described. Only a
      single alkaline extraction was used, with clomipramine as internal standard. The
      column used was a Supelco PCN column, and the mobile phase was acetonitrile
      methanol-0.015 M phosphate buffer (120:35:100, v/v). The average recoveries were
      78.8% for desipramine and 103.8% for lofepramine, and limits of quantitation were
      25 and 5 nmol/l, respectively. The inter-assay C.V.s for lofepramine and
      desipramine were 6.0 and 7.6%, respectively. The method is specific and has
      excellent accuracy, and has been used for therapeutic drug monitoring of patients
      with depressions treated with lofepramine. Mean steady-state plasma
      concentrations found for lofepramine and desipramine were 8.5 +/- 6.1 and 123.6
      +/- 120.6 nmol/l, respectively. It is concluded that lofepramine in itself has an
      antidepressive effect.

PMID- 7795818
TI  - Determination of (+)-catechin in plasma by high-performance liquid chromatography
      using fluorescence detection.
AB  - A high-performance liquid chromatographic method, using fluorescence detection,
      was developed for the determination of (+)-catechin in rabbit plasma. The
      procedure involved the precipitation of plasma protein using acetonitrile,
      followed by solid-phase adsorption onto alumina. After washing with water and
      methanol, the residue was vortex-mixed with perchloric acid solution to release
      the adsorbed (+)-catechin. Separation was performed on a reversed-phase column
      using an eluent consisting of phosphoric acid solution with 12% acetonitrile. The
      excitation and emission wavelengths were set at 280 and 310 nm, respectively. The
      retention times for (+)-catechin and the internal standard (deoxyhigenamine) were
      6.87 and 8.47 min respectively, without any interference. Validations of accuracy
      and precision were satisfactory in both within- and between-run assays. All
      coefficients of variance were less than 6% and mean relative errors were within
      +/- 3.75%. The average recovery was 73.77%. The limit of detection and
      quantitation were 1 ng and 0.02 micrograms/ml, respectively. Application of this
      method was successfully assessed by intravenous administration of a 15 mg/kg dose
      of (+)-catechin in rabbits. This new method provides a simple, specific and
      sensitive determination for (+)-catechin in rabbit plasma and is suitable for
      pharmacokinetic studies.

PMID- 7795817
TI  - Determination of the renin inhibitor Ro 42-5892 in human plasma by automated pre
      column derivatization, reversed-phase high-performance liquid chromatographic
      separation and electrochemical detection after post-column irradiation.
AB  - The renin inhibitor Ro 42-5892 has been found to be very potent, thereby
      necessitating a sensitive assay method for the evaluation of its pharmacokinetics
      in man. We report here the development of a very sensitive and selective HPLC
      assay for the analysis of this compound in human plasma. Ro 42-5892 was extracted
      from plasma with dichloromethane, derivatized with 2,4-dinitrofluorobenzene and
      then chromatographed on a Novapak C18 column (150 x 3.9 mm I.D.) with acetic acid
      buffer (pH 7)-acetonitrile (100:85). Detection was performed by irradiation at
      254 nm, followed by electrochemical oxidation at 550 mV. The extraction recovery
      of Ro 42-5892 from human plasma (mean 102%) was quantitative. With this method a
      limit of quantitation of 0.3 ng/ml was achieved. The assay was linear up to 5
      ng/ml, had acceptable inter-assay precision (12.2%) and accuracy (9.3%) and was
      successfully tested for selectivity. This assay was successfully applied to over
      250 samples from a pharmacokinetic study in hypertensive patients.

PMID- 7795819
TI  - Improved high-performance liquid chromatographic method for the determination of
      polycyclic aromatic hydrocarbon metabolites in human urine.
AB  - A reversed-phase HPLC method with fluorescence detection was evaluated for
      utility in determination of urinary metabolites of polycyclic aromatic
      hydrocarbons as biomarkers of environmental exposure. The method, which was
      developed for use in studies of high-level occupational exposure, was found to be
      unreliable for relatively low-level environmental exposures. The method was
      modified to include quantitation by standard addition in order to compensate for
      matrix effects at levels as low as 0.1 ng/ml. The standard addition modification
      increased both qualitative and quantitative performance, with recovery of 1
      hydroxypyrene spikes improved from 164% to 114% at 0.36 ng/ml. The modified
      method was successfully applied in an environmental exposure study.

PMID- 7795820
TI  - Possibilities for confirmatory analysis of some beta-agonists using two different
      derivatives simultaneously.
AB  - A previously described method for the confirmatory analysis of clenbuterol with
      chemical ionization GC-MS was extended to fit more beta-agonists. The method has
      been used routinely for about one year and a large number of samples have been
      analysed according to the described procedure. This paper summarizes the results
      obtained with this method with regard to clenbuterol and furthermore discussion
      is focused on applicability to beta-agonists other than clenbuterol with respect
      to the European Community requirements for confirmatory analysis.

PMID- 7795821
TI  - Solid-phase extraction of isosorbide dinitrate and two of its metabolites from
      plasma for gas chromatographic analysis.
AB  - A rapid, accurate and selective method for the determination of isosorbide
      dinitrate and its 2- and 5-isosorbide mononitrate metabolites in 1.0 ml of human
      plasma has been developed. Before chromatographic quantitation by gas-liquid
      chromatography with electron-capture detection, the compounds are subjected to
      solid-phase extraction, using ENVI 18 cartridges (Supelco). The intra-day and
      inter-day coefficients of variation are less than 10%, except the inter-day
      coefficient of variation for the assay of 5-isosorbide dinitrate which is less
      than 15%. Limits of quantitation are 10, 10 and 20 ng/ml for isosorbide
      dinitrate, 2-isosorbide mononitrate and 5-isosorbide mononitrate, respectively.
      Recoveries are in excess of 90% for isosorbide dinitrate and 70% for its two
      metabolites.

PMID- 7795823
TI  - Simple method for the analysis of tenoxicam in human plasma using high
      performance liquid chromatography.
AB  - A simple, rapid and cost-effective method for the determination of tenoxicam in
      human plasma is described, using ketorolac as the internal standard. The
      extraction procedure utilised 5% zinc sulphate and methanol. A nucleosil C18
      column and 35:65 acetonitrile-water phosphate buffered mobile phase (pH 2.8) were
      used, with ultraviolet detection at 355 nm. The assay was linear in the range 40
      ng/ml-10 micrograms/ml, with recovery of extraction ranging from 87 to 102%. The
      intra- and inter-assay reproducibility had coefficients of variation of 3.9-7.7
      and 1.6% respectively. The limit of detection for this method was 40 ng/ml.

PMID- 7795822
TI  - Determination of ticlopidine in human plasma by high-performance liquid
      chromatography and ultraviolet absorbance detection.
AB  - A simple HPLC method has been developed for the determination of ticlopidine in
      human plasma. Plasma samples were buffered at pH 9 and extracted with n-heptane
      isoamyl alcohol (98.5:1.5, v/v). Imipramine was used as internal standard.
      Chromatography was performed isocratically with acetonitrile-methanol-0.05 M
      KH2PO4 (20:25:55, v/v) at pH 3.0 containing 3% triethylamine at a flow-rate of 1
      ml/min. A reversed-phase column, Supelcosil LC-8-DB, 15 cm x 4.6 mm I.D., 5
      microns particle size, was used. The effluent was monitored by UV absorbance
      detection at 235 nm. The method showed good accuracy, precision and linearity in
      the concentration range 5-1200 ng/ml. The limit of quantitation was 5 ng/ml, with
      a precision (C.V.) of 8.91%, which is the same as that achieved by other authors
      with a previously published GC-MS method. The procedure described in this paper
      is simple and allows the routine assessment of ticlopidine plasma concentration
      in pharmacokinetic studies following therapeutic doses in human subjects.

PMID- 7795825
TI  - A foot in the door.

PMID- 7795824
TI  - Colors of the spectrum. The challenges of addiction nursing.

PMID- 7795826
TI  - Management perspectives. I am the head nurse on a very large, and very busy
      pediatric unit.

PMID- 7795827
TI  - School-based health services fill a need for disadvantaged youth.

PMID- 7795828
TI  - Dealing with sexual harassment.

PMID- 7795829
TI  - Rationale and design of the Dietary Approaches to Stop Hypertension trial (DASH).
      A multicenter controlled-feeding study of dietary patterns to lower blood
      pressure.
AB  - Epidemiologic studies have found that dietary patterns characterized by high
      intakes of certain minerals and fiber are associated with low blood pressure.
      Dietary Approaches to Stop Hypertension (DASH) is a multicenter, randomized,
      controlled-feeding trial designed to test the effects on blood pressure of two
      such dietary patterns consumed for 8 weeks. The two experimental diets will be
      compared with each other and with a control dietary pattern that is relatively
      low in potassium, magnesium, calcium, and fiber, and has a fat and protein
      profile mirroring current consumption. The first experimental diet, arguably
      termed "ideal," is high in fruits, vegetables, whole cereal products, low-fat
      dairy products, fish, chicken, and lean meats designed to be low in saturated fat
      and cholesterol; moderately high in protein; and high in minerals and fiber. The
      second experimental diet tests the effect of fruits and vegetables alone. Its
      potassium, magnesium, and dietary fiber content will be at the same high levels
      as the ideal dietary pattern, while its fat, protein, and calcium content will
      resemble that of the control dietary pattern. The study population will consist
      of 456 healthy men and women, aged 22 years or older, with systolic blood
      pressure less than 160 mm Hg and diastolic blood pressure 80 to 95 mm Hg. African
      American and other minority groups will comprise 67% of the population.
      Participants will eat one of the three dietary patterns. The DASH trial has
      unique features. First, dietary patterns rather than single nutrients are being
      tested. Second, all food for the experimental diets is provided to the
      participants using a standardized multicenter protocol. Because the dietary
      patterns are constructed with commonly consumed food items, the results, if
      positive, may be conveniently implemented in dietary recommendations to the
      general public.

PMID- 7795830
TI  - Trial of Nonpharmacologic Intervention in the Elderly (TONE). Design and
      rationale of a blood pressure control trial.
AB  - National and international policy-making organizations advocate nonpharmacologic
      therapies to reduce blood pressure (BP). However, data to support such
      recommendations in older persons are virtually nonexistent. The Trials of
      Nonpharmacologic Intervention in the Elderly (TONE) is a randomized, controlled
      trial that will test whether weight loss or a reduced sodium (Na) intake or both
      can maintain satisfactory BP control, without unacceptable side effects, after
      withdrawal of antihypertensive drug therapy. Medication-treated hypertensives
      (aged 60 to 80 years) with a systolic BP less than 145 mm Hg and a diastolic BP
      less than 85 mm Hg who are taking one antihypertensive medication are randomly
      assigned to one of four groups: (1) weight loss alone, (2) reduced Na intake
      alone, (3) combined weight loss and reduced Na intake, or (4) usual life-style
      (control group). Overweight participants are randomized to one of these four
      groups, while nonoverweight individuals are assigned to either the reduced Na
      intake or the usual life-style group. The interventions, tailored to the needs of
      older persons, use behavioral approaches to accomplish intervention-specific
      goals (weight loss > or = 10 lb, daily Na intake < or = 80 mEqa). Three months
      after the start of intervention, antihypertensive drug therapy is withdrawn. The
      primary trial end point is a BP of 150/90 mm Hg or higher, resumption of
      antihypertensive drug therapy, or the occurrence of a BP-related clinical
      complication during 2 to 3 years of follow-up. It is anticipated that TONE
      findings may identify an effective and acceptable nonpharmacologic approach to
      control hypertension in the increasingly large number of older persons treated
      with antihypertensive drug therapy.

PMID- 7795831
TI  - Design of a multicenter trial to evaluate long-term life-style intervention in
      adults with high-normal blood pressure levels. Trials of Hypertension Prevention
      (phase II). Trials of Hypertension Prevention (TOHP) Collaborative Research
      Group.
AB  - Phase II of the Trials of Hypertension Prevention (TOHP) is a multicenter,
      randomized trial sponsored by the National Heart, Lung, and Blood Institute
      designed to test whether weight loss alone, sodium reduction alone, or the
      combination of weight loss and sodium reduction will decrease diastolic (DBP) and
      systolic blood pressure (SBP) as well as the incidence of hypertension (DBP > or
      = 90 mm Hg, SBP > or = 140 mm Hg, and/or use of antihypertensive medications) in
      subjects with high-normal DBP (83 to 89 mm Hg) and SBP less than 140 mm Hg at
      entry. These interventions were chosen for longer-term testing with end points
      including hypertension prevention as well as blood pressure (BP) change based on
      their demonstrated short-term efficacy in reducing BP in phase I of TOHP. The
      phase II study population is comprised of 2382 participants (1566 men and 816
      women) who are 110 to 165% of desirable body weight, allocated at random to the
      four treatment arms using a 2 x 2 factorial design. The trial has 80% power to
      detect an overall treatment effect on DBP of 1.2 mm Hg for weight loss or sodium
      reduction and a difference of 1.6 mm Hg between the combined intervention and
      placebo groups. BP observers are blinded to participant treatment assignments.
      Participants will be followed for 3 to 4 years. This trial may have important
      public policy implications concerning the ability of life-style modifications to
      reduce BP and prevent the development of hypertension over the long term, thereby
      avoiding the need for drug therapy which while effective is costly and may have
      side effects.

PMID- 7795832
TI  - Recruitment for phase II of the Trials of Hypertension Prevention. Effective
      strategies and predictors of randomization. Trials of Hypertension Prevention
      (TOHP) Collaborative Research Group.
AB  - Phase II of the Trials of Hypertension Prevention is a multicenter, randomized,
      controlled trial designed to determine the efficacy of weight loss and reduction
      of sodium intake for lowering blood pressure and incidence of hypertension among
      persons with high-normal levels of blood pressure. The 2 x 2 factorial study
      design includes weight loss alone, restricted sodium intake alone, the
      combination of weight loss and sodium restriction, and a control group. Nine
      clinical centers used a variety of recruitment strategies to enroll 2382
      participants over 17 months, which exceeded the sample size goal of 2250. Among
      randomized participants, 21% were minorities and 34% were women. Overall, direct
      mail generated the most randomized participants (73%), followed by community
      screening (12%) and media advertisement (11%). Referrals from community health
      care providers yielded few participants. Prescreening improved overall efficiency
      and reduced costs. Participants who were more likely to drop out voluntarily
      during the three-visit screening regimen tended to be younger, single, male,
      smokers, and less educated.

PMID- 7795833
TI  - Baseline characteristics of participants in phase II of the Trials of
      Hypertension Prevention (TOHP II). Trials of Hypertension Prevention (TOHP)
      Collaborative Research Group.
AB  - Phase II of the Trials of Hypertension Prevention (TOHP II) is a multicenter,
      controlled clinical trial designed to test whether weight loss, a reduced sodium
      intake, or a combination of weight loss and a reduced sodium intake will lower
      blood pressure (BP) and prevent the occurrence of hypertension. The study
      population consists of middle-aged, moderately overweight individuals with a
      diastolic BP between 83 and 89 mm Hg. Of the 2382 randomized participants, 816
      (34%) are female and 494 (21%) are from a racial or ethnic minority background.
      At baseline, mean dietary intakes of sodium, based on measurements of 24-hour
      urinary excretion, were 199 mmol/d in men and 154 mmol/d in women. The average
      body mass index was 30.9 kg/m2. Across the four randomized groups, there was no
      substantial imbalance in the distribution of baseline variables; however, the
      mean age in the four groups was slightly but significantly different (range: 43.2
      to 44.2 years, P = 0.02). A comparison of baseline characteristics of TOHP II
      participants with those of participants in three other primary prevention trials
      reveals a high level of mean dietary sodium intake in each study. Data reported
      in this article indicate that any subsequent differences in BP among the
      randomized groups are unlikely to result from maldistribution of known
      confounding variables at baseline. Finally, because of the high prevalence of
      overweight and excessive sodium intake in the United States, results from TOHP II
      should be broadly applicable to the general population.

PMID- 7795835
TI  - Progress in life-style intervention for prevention and treatment of high blood
      pressure.

PMID- 7795834
TI  - Trials of Hypertension Prevention, phase II. Structure and content of the weight
      loss and dietary sodium reduction interventions. Trials of Hypertension
      Prevention (TOHP) Collaborative Research Group.
AB  - Identifying effective, nonpharmacologic means of preventing or significantly
      delaying the onset of hypertension would be a major advance in the primary
      prevention of cardiovascular disease. In the first phase of the Trials of
      Hypertension Prevention (TOHP I), adults with high-normal diastolic blood
      pressure were randomly assigned to one of seven nonpharmacologic interventions.
      Only weight loss and reduction of dietary sodium proved to be effective
      strategies for reducing blood pressure. The second phase of TOHP (TOHP II) will
      test the effectiveness of weight loss, reduction of dietary sodium, and their
      combination of lowering blood pressure and preventing the onset of hypertension
      over a 3- to 4-year follow-up period. This article describes the three
      interventions used in TOHP II, methods used to maintain continued participation
      in this long-term trial, and protocol enhancements designed to maximize
      intervention effectiveness.

PMID- 7795836
TI  - The effect of potassium supplementation in persons with a high-normal blood
      pressure. Results from phase I of the Trials of Hypertension Prevention (TOHP).
      Trials of Hypertension Prevention (TOHP) Collaborative Research Group.
AB  - We conducted a randomized, double-blind, placebo-controlled trial of oral
      potassium chloride supplementation (60 mmol/d) in 353 men and women with an
      initial average diastolic blood pressure between 80 and 89 mm Hg. In the active
      (n = 178) compared to the placebo (n = 175) treatment group, the urinary
      potassium level was significantly (p < 0.001) increased by an average of 44.0 and
      42.3 mmol/24 h following 3 and 6 months of therapy, respectively. Compared to
      placebo, active treatment was associated with a small (mean = 1.8 mm Hg) but
      significant (p = 0.04) reduction in diastolic blood pressure following 3 months
      of therapy. Following 6 months, however, this apparent treatment effect had
      virtually disappeared (mean reduction in diastolic blood pressure = 0.3 mm Hg).
      There was no significant effect of potassium supplementation on systolic blood
      pressure at either follow-up visit. There was a significant, independent, dose
      response relationship between change in both 24-hour urinary potassium excretion
      and urinary sodium-potassium ratio and the corresponding change in diastolic
      blood pressure (-1.49 mm Hg for the highest versus the lowest quartile of change
      in urinary potassium excretion.

PMID- 7795837
TI  - Lack of blood pressure effect with calcium and magnesium supplementation in
      adults with high-normal blood pressure. Results from Phase I of the Trials of
      Hypertension Prevention (TOHP). Trials of Hypertension Prevention (TOHP)
      Collaborative Research Group.
AB  - Phase I of the Trials of Hypertension Prevention (TOHP) was a randomized,
      multicenter investigation that included double-blind, placebo-controlled testing
      of calcium and magnesium supplementation among 698 healthy adults (10.5% blacks
      and 31% women) aged 30 to 54 years with high-normal diastolic blood pressure
      (DBP) (80 to 89 mm Hg). Very high compliance (94 to 96% by pill counts) with
      daily doses of 1 g of calcium (carbonate), 360 mg of magnesium (diglycine), or
      placebos was corroborated for the active supplements by significant net increases
      in all urine and serum compliance measures in white men and for urine compliance
      measures in white women. Overall, neither calcium nor magnesium produced
      significant changes in blood pressure at 3 and 6 months. Analyses stratified by
      baseline intakes of calcium, magnesium, sodium, or initial blood pressures also
      showed no effect of supplementation. These analyses suggested that calcium
      supplementation may have resulted in a DBP decrease in white women and that
      response modifiers in this subgroup might have included lower initial urinary
      calcium levels, urinary sodium levels, or lower body mass index. However, overall
      analyses indicated that calcium and magnesium supplements are unlikely to lower
      blood pressure in adults with high-normal DBP. The subgroup analyses, useful to
      formulate hypotheses, raise the possibility of a benefit to white women, which
      requires testing in future trials.

PMID- 7795838
TI  - In vivo confocal microscopy of the cornea and tear film.

PMID- 7795839
TI  - Scanning force microscopy of chromatin fibers in air and in liquid.
AB  - We have adapted specimen preparation techniques of conventional electron
      microscopy for visualizing chromatin structures in the scanning force microscope
      (SFM) in air and in liquid. The beaded substructure of the nucleoprotein filament
      was obtained after hypotonic lysis of chicken erythrocytes and air drying,
      whereas supranucleosomal structures were preserved after treatment of cell nuclei
      with detergent. In the latter case, the nucleosomes were still distinct but
      appeared more condensed. A modified droplet diffusion-spreading technique of
      chromatin from Namalwa cells (a human B-lymphoid line) yielded a uniform
      filamentous morphology and similar fiber appearance. A reversible swelling of
      spread chromatin was observed upon exposure of air-dried samples to solutions
      differing in salt concentrations.

PMID- 7795840
TI  - Effects of brefeldin-A on Golgi morphology in human cultured fibroblasts observed
      in three-dimensional stereo scanning electron microscopy.
AB  - Brefeldin A (BFA) has been reported to cause disassembly of the Golgi. We have
      used three-dimensional (3-D) high-resolution scanning electron microscopy (HRSEM)
      to investigate these effects in human skin fibroblast cells. The spontaneous
      reassembly during prolonged exposure to BFA and some effects of forskolin were
      observed. A BFA concentration of 5 micrograms/ml caused Golgi complexes to become
      vesicular, resulting in a progressive decrease in the size of the Golgi.
      Morphologic changes were visible within 2 min of BFA incubation, and by 30 min no
      identifiable Golgi could be found. Spontaneous reassembly of the Golgi apparatus
      upon the removal of the BFA or with continued long-term exposure with BFA could
      not be confirmed. Preliminary experiments with forskolin were not effective in
      reversing or inhibiting the effects of BFA in human fibroblast cells grown in
      culture. This inability for spontaneous reassembly and nonreversal by forskolin
      may reflect a differential effect of BFA in various cell types. HRSEM has proven
      to be useful for observing 3-D morphologic effects of BFA in Golgi.

PMID- 7795841
TI  - Culture of Schwann cells from adult animals.

PMID- 7795843
TI  - Spontaneous pulmonary adenocarcinoma cell shows osseous metaplasia in vivo.

PMID- 7795842
TI  - Tissue culture of a mixed cell thymic tumor from Xenopus laevis.

PMID- 7795844
TI  - Glycosylation of antibody in a lectin-resistant human hybridoma is insensitive to
      glucose.

PMID- 7795845
TI  - The gap junctional intercellular communication is no prerequisite for the
      stabilization of xenobiotic metabolizing enzyme activities in primary rat liver
      parenchymal cells in vitro.
AB  - In primary monocultures of adult rat liver parenchymal cells (PC), the activities
      of the xenobiotic metabolizing enzymes microsomal epoxide hydrolase (mEHb),
      soluble epoxide hydrolase (sEH), glutathione S-transferases (GST), and
      phenolsulfotransferase (ST) were reduced after 7 d to values below 33% of the
      initial activities. Furthermore, the gap junctional intercellular communication
      (GJIC), measured after microinjection by dye transfer, decreased from 90% on Day
      1 to undetectable values after 5 d in monoculture. Co-culture of PC with
      nonparenchymal rat liver epithelial cells (NEC) increased (98% on Day 1) and
      stabilized (82% on Day 7) the homotypic GJIC of PC. Additionally, most of the
      measured xenobiotic metabolizing enzyme activities were well stabilized over 1 wk
      in co-culture. Because GJIC is one of several mechanisms playing an important
      role in cell differentiation, the importance of GJIC for the stabilization of
      xenobiotic metabolizing enzymes in PC was investigated. PC in monoculture were,
      therefore, treated with 2% dimethyl sulfoxide (DMSO), a differentiation promoting
      factor, and 1,1,1-trichloro-2,2,-bis (p-chlorophenyl) ethane (DDT) (10
      micrograms/ml), a liver tumor promotor and inhibitor of GJIC, was given to co
      cultures of PC with NEC. DMSO significantly stabilized (68% on Day 7), while DDT
      significantly inhibited (8% on Day 7) homotypic GJIC of PC in the respective
      culture systems. In contrast, the activities of mEHb, sEH, GST, and ST were not
      affected in the presence of DMSO or DDT. These results lead to the assumption
      that the differentiation parameters measured in this study (i.e., homotypic GJIC
      and the activities of xenobiotic metabolizing enzymes) are independently
      regulated in adult rat liver PC.

PMID- 7795847
TI  - Growing a stratified, cornified primary culture of rat keratinocytes with
      epidermis-like water permeation barrier function.
AB  - The culture of cutaneous keratinocytes grown on a Puropore nylon microporous
      membrane at the air-liquid interface has been shown to be similar to the
      epidermis in a number of molecular and morphologic characteristics but to exhibit
      a significantly greater degree of tritiated water permeation. Various culture
      conditions have been altered in an effort to improve the water barrier
      properties. A Kp value in the range of 5.5 +/- 1.6 x 10(3) has been obtained for
      79% of the cultures a) by plating 0.9 x 10(6) viable basal cells on a piece (13
      mm diameter) of membrane for 7 days of submerged growth, b) by placing two
      membranes on two stacked glass fiber filters (47-mm extra-thick) in a culture
      dish (60 mm) for 14 days of growth at the air-liquid interface, c) by replacing
      the growth medium, i.e., 1 ml of complete minimum essential medium (CMEM) every
      24 h after lifting, d) by using 10% fetal bovine serum (FBS) in the CMEM during
      the submerged culture period and 15% FBS in the CMEM during the lifted culture
      period, and e) by adding a dialysis membrane on top and a Puropore nylon membrane
      below the culture when the cultures were inserted in the permeation cell for
      testing. The percentage of cultures with this value for Kp can be increased to
      90% if only cultures with yellow, smooth, and shiny surfaces are tested. This
      system should be useful as a replacement for skin in testing the cutaneous
      permeation of some chemicals.

PMID- 7795846
TI  - Transforming growth factor-beta inhibition of mineralization by neonatal rat
      osteoblasts in monolayer and collagen gel culture.
AB  - The latent form of transforming growth factor-beta (TGF-beta) is a component of
      the extracellular matrix of bone. The active form, when locally injected in vivo,
      stimulates both inflammation and ectopic bone formation. The present study was
      undertaken to determine if TGF-beta also stimulated mineralization by isolated
      rat calvarial osteoblasts cultured in collagen gels. Gels were used because they
      should mimic in vivo conditions better than classical monolayer culture. Compared
      to cells in monolayers, osteoblasts cultured in collagen gels exhibited slower
      growth, but higher alkaline phosphatase activity and mineral deposition. Cultured
      cells also synthesized the osteoblast-specific marker, osteocalcin. The increase
      in osteocalcin in cell layers was parallel to the increase in mineral deposition.
      In the presence of TGF-beta, neither cell growth nor alkaline phosphatase
      activity increased. Instead, a small decrease occurred in both parameters when
      compared to untreated cultures. Accumulation of collagen, the major component of
      the extracellular matrix where mineralization occurs, was similar in untreated
      and TGF-beta 1-treated cultures. However, 8 pM TGF-beta 1 dramatically suppressed
      mineral deposition in both types of cultures. Despite TGF-beta 1 stimulating a
      fourfold increase in lactic acid, the consequent increase in culture medium
      acidity did not account for the inhibitory effects of TGF-beta 1 on
      mineralization. These results demonstrate that collagen gel culture is an
      improved technique over conventional monolayer culture for demonstrating
      differentiated osteoblast function and sensitivity to TGF-beta 1. TGF-beta 1, at
      a concentration that has little effect on cell growth, alkaline phosphatase
      activity, or collagen accumulation, is a potent inhibitor of
      mineralization.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7795848
TI  - Alteration of epithelial cell lipid synthesis by N-nitrosonornicotine.
AB  - Changes in the lipid composition of a cell membrane due to the binding of one
      cell modulator may affect binding of a second modulator, whether that binding is
      receptor-mediated (specific) or non-receptor-mediated (nonspecific). Such altered
      binding interactions have been demonstrated in oral epithelial cells, wherein N
      nitrosonornicotine (NNN), a nonspecific ligand, enhances phorbol ester binding.
      To characterize membrane changes that may be responsible for such an effect, the
      current study examined lipid changes in hamster oral epithelial (HCP) cells
      associated with NNN binding. HCP cultures at two cell densities, 5 x 10(6)
      cells/100 mm plate (subconfluent cultures) or 10 x 10(6) cells/100 mm plate
      (confluent cultures) were incubated in Keratinocyte-Serum-Free Medium and exposed
      to 10 microM NNN or DMSO (solvent control) for 48 h. Lipids were labeled with 14C
      acetate, then extracted, separated by thin layer chromatography, and the 14C
      lipids located by autoradiography and counted. Exposure of subconfluent cultures
      to NNN for 48 h, with 14C-acetate present during the final 24 h, resulted in
      altered phospholipid and fatty acid labeling. Phospholipid labeling increased
      slightly in the presence of NNN compared to controls, while fatty acid labeling
      showed a modest but significant decrease in the presence of NNN. Similar changes
      occurred in the confluent cultures. Prelabeling of lipids in subconfluent
      cultures, followed by exposure to NNN in the absence of radiolabel, resulted in
      significantly (P < 0.05) greater phospholipid labeling in the presence of NNN
      compared to control cultures. At the same time, fatty acid labeling decreased
      significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7795849
TI  - Ovarian mesothelial and extramesothelial cells in interactive culture.
AB  - The ovarian mesothelium (OM) represents the tissue of origin of ovarian
      epithelial cancer. To gain insight into the regulation of this tissue, OM
      organoids and submesothelial ovarian stromal cells (SC) were isolated from New
      Zealand White rabbits by a stepwise tissue dispersal technique, while granulosa
      cells (GC) were aspirated from mature follicles (14 +/- 4 groups/animal). OM and
      SC dispersal were sequentially accomplished by: a) 1-h incubation in collagenase
      type I (300 U/ml), gentle scraping of the ovarian surface, and 1 g sedimentation
      of OM organoids (equivalent to 0.93 +/- 0.40 x 10(6) cells/animal) on 5% bovine
      serum albumin (BSA); b) 2-h incubation in pronase-collagenase (0.5%-300 U/ml)
      under periodical resuspension and gentle scraping of SC (1.40 +/- 0.25 x
      10(6)/animal) from OM-denuded ovaries. After a week-long in vitro expansion, OM
      cells (OMC) were cultured alone and with SC or GC within monocameral vessels or
      bicameral transfilter vessels in serumless, fibronectinrich (4 micrograms/ml) HL
      1 medium. After 7 d of contact cell-cell interaction, cytokeratin-positive OMC
      became surrounded by fibroblastoid, vimentin-positive SC or by cytokeratin and
      vimentin-weakly positive GC. Filter-bound OMC humorally interacting with
      underlying SC or GC displayed a biphasic, epithelioid and spindle, morphology
      with universal cytokeratin expression. Bromo-2'-deoxyuridine (BrdU)
      immunoperoxidase revealed mean cell proliferation indices of 14.88% for OMC
      cultured alone, 11.21% and 19.39% for OMC cultured with GC or SC in monocameral
      dishes, and 15.25% or 22.47% for OMC cultured in bicameral vessels over GC or SC,
      respectively. This model provides an experimental tool for investigating the
      unexplored role of stromal-mesothelial interaction in OM pathobiology.

PMID- 7795850
TI  - In situ fluorescence labeling of sheep lung microvascular endothelium.
AB  - Endothelial cells are intimately involved in a variety of biological processes
      such as inflammatory disorders, wound healing, and tumor invasion. The finding of
      endothelial heterogeneity in various tissues has led to major efforts to isolate
      and culture microvascular endothelial cells in human and animal tissue. In this
      report we have used phosphatidyl ethanolamine (PE)-labeled liposomes to
      fluorescently label the sheep lung microvasculature in situ. Using normotensive
      perfusion pressure, the PE-labeled liposomes did not extravasate into
      extravascular lung tissue. Mechanical and enzymatic digestion of the lung tissue
      demonstrated that the PE-labeled liposomes provided a stable label of the
      vascular lining cells during ex vivo processing. After digestion, the
      overwhelming majority of the fluorescent label appeared in cellular aggregates.
      Approximately 80% of these cells demonstrated an in vitro phenotype consistent
      with microvascular endothelium. A novel monoclonal antibody selective for sheep
      endothelial cells was developed to confirm the presence of lung endothelium in
      the fluorescently labeled cellular aggregates. We conclude that in situ
      fluorescence labeling of vascular lining cells provides an anatomic marker for
      relevant vascular lining cells and an opportunity to study these cells in vitro.

PMID- 7795852
TI  - Initial stability of uncemented hip stems: an in-vitro protocol to measure
      torsional interface motion.
AB  - The difficulty in quantitatively assessing the inherent variables of surgical
      stem insertion and interfemur differences continues to be a problem in
      experimental methodologies which assess hip stem stability. An in-vitro torsional
      stability protocol was developed which limited the mechanical testing variability
      and provided a reproducible micromotion measurement of an uncemented stem in
      synthetic composite femurs. Using a controlled mechanical stem insertion resulted
      in less interfemur variability within each group with the coefficient of
      variation being reduced from 35% overall to less than 20%. Femurs with shallow
      stem insertion depths had significantly larger micromotion than femurs having
      deep stem insertion depths. The sensitivity of the experimental protocol and the
      synthetic composite femurs to the varied functional behaviour of three different
      stem designs was demonstrated. The stem with a hollowed anterior-to-posterior
      proximal section experienced significantly more motion than the two stems with
      full proximal sections, reinforcing the need for proximal contact to ensure
      minimal micromotion in torsional loading.

PMID- 7795853
TI  - Estimation of the effective amount entering the body for drugs subject to
      enterohepatic recirculations.
AB  - A pharmacokinetic model is used to take into account multiple recirculations of
      drug occurring at various times after gall bladder emptying. If a dose D is
      initially administed, due to recirculation, an effective amount A* reaches the
      body. This value A* is expressed as a function of D and the model parameters,
      after oral administration or intravenous injection. Using areas under curves in
      two different situations, the reabsorption rate may be identified.

PMID- 7795854
TI  - Sensitivity analysis for estimating urea kinetics parameters during hemodialysis.
AB  - In this paper a time-varying volume, double-pool urea kinetics model is
      considered and a sensitivity analysis is carried out to determine those patient
      parameters that have greater influence on the time course of blood urea nitrogen
      concentration (BUN) during and between dialysis treatment. The model parameters
      include the urea generation rate, the initial distribution volume of the urea,
      the ratio between intracellular and extracellular volumes, and the mass transfer
      coefficient between the two pools. The analysis demonstrates that BUN is highly
      sensitive to the urea generation rate and total distribution volume whereas it is
      influenced by the remaining parameters to a much lesser extent. In addition, the
      location of the absolute maxima of BUN sensitivity functions suggests the
      rational placement of a reduced number of blood samples that may still allow
      sufficiently accurate estimates for the parameters of clinical interest, such as
      the urea generation rate, total distribution volume, and the ratio between
      intracellular and extracellular volumes. This conclusion has been confirmed by
      simulation studies where parameter estimation has been performed with a varying
      number of observation points.

PMID- 7795851
TI  - Characterization of a rat anterior pituitary cell bioassay.
AB  - We have described the protocols and characterization of a pituicyte culture,
      which became established as a reliable and reproducible bioassay for the
      secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The
      bioassay was used to measure the bioactivity of factors that inhibit and
      stimulate gonadotrophin secretion. The protocol that was used involved the
      culling of female Wistar rats (200 to 250 g weight), at random stages of their
      cycle, and dispersal of their pituicytes in a concentration of 0.4 x 10(6)
      cells.ml-1.well-1 in serum-free medium (Dulbecco's modified Eagle's medium/Ham's
      F12 mixture, supplemented with insulin and transferrin) in Falcon 3047 24-well
      culture plates. After 24 h of pre-culture, the medium was changed and the cells
      cultured for a further 48 h. The supernatant was removed and assayed for basal
      secretion of FSH and LH. The cells were then stimulated with 10(-8) M GnRH for 4
      h and the supernatant assayed for gonadotrophin-releasing hormone (GnRH)
      stimulated FSH and LH secretion. All samples were assayed as pairs of duplicates
      (i.e. quadruplicate samples) which were randomly added to the plates to minimize
      plate effects. Random number tables were used to achieve this randomization.

PMID- 7795855
TI  - Alignment of total knee arthroplasty: the relationship to radiolucency around the
      tibial component.
AB  - Between January 1982 and July 1985, 122 cemented 'Accord' total knee replacements
      were performed. Out of this number, 21 were lost to follow-up because of death
      (in 16), revision (2) due to infection, and failure to attend (3). The post
      operative alignment of 101 prostheses were compared to the incidence of
      radiolucencies around the tibial component at 5 years follow-up. The mechanical
      axis was used as a reference. The mean alignment was 0.99 degrees valgus with a
      standard deviation of 2.48 degrees. Some 72% of knees were within 3 degrees and
      94% within 5 degrees of true alignment. Using two methods of assessing
      radiolucencies there was a non-significant relationship between the alignment and
      radiolucencies. The alignment tolerance with this prosthesis is, therefore, at
      least 5 degrees.

PMID- 7795856
TI  - Iterative method to derive an approximate matched filter template for fetal
      electrocardiogram signals.
AB  - Fetal electrocardiogram (FECG) signals that are extracted from the maternal
      abdomen have a signal-to-noise ratio that is so low that the determination of the
      times of location of the R-waves can be difficult. A matched filter could, in
      principle, be used, but in theory this requires prior knowledge of the shape of
      the QRS complex of the FECG. In the work that is described in this paper, a
      digital low-pass filter, with an impulse response that is triangular in shape, is
      applied to the first M complexes of a simulated FECG signal. An average based on
      the detected R-wave locations is determined and this is used as an approximation
      to the matched filter template for the next block of M complexes. It is shown
      that this method can be iterated to obtain an effectiveness in detecting R-wave
      locations that is competitive with the corresponding performance that is obtained
      with the pure matched filter. The resilience of this technique to increasing
      noise levels is investigated.

PMID- 7795857
TI  - A dynamic Fourier series for the compression of ECG using FFT and adaptive
      coefficient estimation.
AB  - In this article, a new ECG data compression technique is proposed. The method
      relies on modelling quasi-periodic ECG signals as a dynamic Fourier series.
      Fourier coefficients are continuously estimated using either an FFT algorithm or
      the adaptive least mean square algorithm. Results from simulated normal and
      pathological ECGs are presented and discussed. The merits of each of the above
      two methods are also illustrated. Furthermore, a comparison with other
      compression techniques is also discussed.

PMID- 7795859
TI  - Validation of a computer model of haemorrhage and transcapillary refill.
AB  - A computer model is described which uses blood volume deficit and its duration to
      simulate the first two hours of haemorrhage, including an estimation of the blood
      volume added by Starlings transcapillary refill mechanism. Computer prediction of
      the haematocrit was compared with published data on haemorrhage in animals. There
      was close correlation with data on the haemodilution caused by Starling's
      transcapillary refill mechanism in conscious swine (r = 0.84).

PMID- 7795858
TI  - A mathematical analysis of intestinal peristaltic waves.
AB  - Gut motility is usually investigated by introducing probes in the intestinal
      lumen. Image analysis could be used instead of intraluminal pressure measurements
      to avoid the inconvenience of this invasive procedure. The present study exposes
      the theoretical principles of intestinal peristalsis in terms of indirect
      intraluminal pressure and content velocity measurements. A geometrical model of
      intestinal contractions is mathematically described by using Stokes' equations in
      order to evaluate velocities and pressures in the equations established by
      quantitative analysis of cinematography pictures. The couple velocity-pressure is
      calculated at each point of the geometrical model for a viscous and non
      compressible fluid. This fluid flows in a geometrical structure, the boundaries
      of which vary with time and behave in a periodic and regular way by simulating
      the movements of intestinal contractions. A comparison is made between
      experimental pressure recordings in isolated rat intestines and pressure values
      calculated by utilizing the geometrical model. Velocity values calculated at
      every grid node show positive and negative zones in the geometrical model output.
      The position of these zones vary from one geometrical model to another. Moreover,
      the calculated pressure and velocity values change according to the applied
      vector efforts. The similarity of the results obtained shows the efficiency of
      the finite element technique in the case of Stokes' equations.

PMID- 7795860
TI  - Non-invasive identification of gastric contractions from surface
      electrogastrogram using back-propagation neural networks.
AB  - Gastric contractions play an important role in the digestive process of the
      stomach. The established method for the measurement of gastric contractions is
      invasive and involves the insertion through the nose of a manometric probe into
      the stomach. A non-invasive method is introduced in this paper for the
      identification of gastric contractions using the surface electrogastrogram. The
      electrogastrogram (EGG) was measured by placing surface electrodes on the
      abdominal skin over the stomach in ten subjects. Gastric contractions were
      simultaneously monitored using an intraluminal manometric probe. The back
      propagation neural network was applied to identify gastric contractions from the
      EGG. The input of the neural network was composed of spectral data points of the
      EGG which was computed using the exponential distribution method. Experiments
      were conducted to optimize network structures and parameters. Using the EGG data
      in five subjects as the training set and the EGG data in another five subjects as
      the testing set, an overall accuracy of 92% was achieved in the identification of
      gastric contractions with an optimized three-layer back-propagation neural
      network (number of nodes for input:hidden:output layers being 64:10:2).

PMID- 7795861
TI  - Fading characteristics of a 2.3 GHz radio telemetry channel in a hospital
      building.
AB  - This paper reports on radio path attenuation measurements made in a hospital
      complex at a spot frequency of 2.340 GHz. Power loss figures for fixed path
      propagation in a variety of building types have been determined for proposed
      telemetry use in operational ward situations. Throughout the hospital, the radio
      paths assessed all exhibited a loss in excess of that calculated for free-space
      communications. Modern buildings had external wall losses of 10-25 dB, with
      dividing walls in wards contributing an additional 5 dB. Received signal strength
      levels indicated a Rayleigh distribution for obstructed paths. Temporal testing
      was used to find the rate and depth of signal fades caused by the movement of
      personnel and equipment during normal ward usage; signal level reductions of
      greater than 35 dB were common during busy periods.

PMID- 7795862
TI  - Improved late potential analysis in frequency domain.
AB  - This work presents a technique to improve the identification of late potentials
      (LP) in patients affected by greater arrhythmogenic right ventricular disease
      (GARVD). Several authors have documented the correlation between GARVD and LP by
      means of time domain analysis. Moreover, the high incidence of bundle branch
      block in patients affected by GARVD suggests LP analysis in the frequency domain
      be performed. The method of spectral mapping of the ECG with Fourier transform
      was adopted. This consists in dividing the ST segment into 25 subsegments and
      estimating their frequency components by means of the fast Fourier transform.
      Recently, it was documented that this technique suffers from poor reproducibility
      of results. Low reproducibility is the consequence of an improper localization of
      the analysed QRS segments. An algorithm to increase the QRS end point
      identification reproducibility is proposed. An optimal QRS filter was adopted as
      well as a technique based on the Hilbert transform. This technique allowed the
      reliability of the normality factor estimates to be improved. The computed
      normality factors on the XYZ leads and on the vector magnitude were used to
      classify patients and healthy subjects; 28 patients affected by greater
      arrhythmogenic right ventricular disease and 35 healthy subjects were analysed in
      the study. High sensitivity was obtained with respect to GARVD and clinical
      sustained ventricular tachycardia by means of a cluster analysis technique. By
      applying the technique proposed in this paper the identification of LP in GARVD
      was increased from 47% to 88%, when clinical sustained ventricular tachycardia
      was documented, whereas in patients affected by GARVD but not prone to sustained
      ventricular tachycardia LP identification increases from 18% to 64%.

PMID- 7795863
TI  - Risk factors associated with having a pressure ulcer: a secondary data analysis.
AB  - Data obtained through five hospital-wide pressure ulcer audits were pooled for
      exploratory analysis. The purpose of this secondary data analysis was (1) to
      delineate the association of various risk factors and the presence of pressure
      ulcers and (2) to generate specific, testable hypotheses. Risk factors studied
      included fecal incontinence, urinary incontinence, malnutrition, impaired
      mobility, decreased mental status, diabetes mellitus, peripheral vascular
      disease, spinal cord injury, multiple sclerosis, and metastatic carcinoma.
      Stepwise logistic regression resulted in a best-fitting model that included fecal
      incontinence, impaired mobility, malnutrition, decreased mental status, and an
      interaction effect between fecal incontinence and impaired mobility. This model
      suggested that the odds of having a pressure ulcer were 22 times greater for
      hospitalized adult patients with fecal incontinence compared to hospitalized
      adult patients without fecal incontinence.

PMID- 7795864
TI  - Tracking the diabetic foot: adjunctive treatment with collagen material.
AB  - Many people with diabetes mellitus have foot lesions that can lead to amputation
      if they do not receive excellent care. Coordinating patient care with other
      specialists, using new treatment technology, educating the patient, and including
      the patient as a significant part of the team are all required for effective
      patient care. The use of a new, technologically advanced product, Kollagen, is
      illustrated in two case studies. Collagen plays a significant part in almost
      every function of the body. Previously, the broad use of collagen was stifled
      because of cost. Recent advances have made it possible to develop cost-effective
      gels, powders, pouches, and thin dressings.

PMID- 7795865
TI  - Comparative ability of various prescription and over-the-counter topical
      antifungal drug products to inhibit the growth of C. albicans.
AB  - On September 23, 1993, the Food and Drug Administration (FDA) published the final
      monograph and rule for topical antifungal drug products. This monograph specifies
      the ingredients, concentration, and labeling under which over-the-counter (OTC)
      topical antifungal drug products may be marketed without further FDA approval.
      Currently, the nine products tested are labeled as antifungal because of their
      ability to inhibit the growth of yeast (C. albicans) in vitro. Over-the-counter
      products containing 2% miconazole nitrate--an ingredient and concentration
      identified as safe and effective--were found to inhibit the growth of C. albicans
      as effectively as mycostatin cream. Two percent miconazole nitrate was also
      inhibitory to C. albicans at greater dilutions than five other antifungal
      products containing chloroxylenol and clotri mazole. Chloroxylenol and
      clotrimazole are nonmonographed ingredients.

PMID- 7795867
TI  - Continuum of care.

PMID- 7795866
TI  - Pressure ulcer incidence on a spinal cord injury unit.
AB  - Because of the high risk for pressure ulcers among hospitalized, spinal cord
      injured patients, one quality improvement measure is to monitor incidence of
      pressure ulcers. A retrospective chart review of each patient who developed an
      ulcer during an 18-month period revealed patient characteristics associated with
      pressure ulcer risk. Of 468 inpatient admissions, 35 patients developed 81
      pressure ulcers. Patient variables associated with an incidence rate of 7.5% were
      an admission diagnosis of pressure ulcer, surgical repair of pressure ulcers,
      length of stay, new spinal cord injury, longstanding injury (> 10 years), and the
      use of condom catheters.

PMID- 7795868
TI  - Pressure ulcers: no more excuses-assess institutions instead of patients.

PMID- 7795869
TI  - Critical paths for wound care.
AB  - Critical paths and clinical algorithms are an adjunct for quality management of
      an average person's health problems. A critical path attempts to achieve
      continuous quality improvement by aligning actions of the care team. Critical
      paths are difficult to construct for chronically ill patients with comorbidities.
      Therefore, clinicians are challenged to consider key elements of critical paths:
      describing normalcy, identifying variances, creating differential diagnoses,
      handling individual responses to care, managing continuity of care, communicating
      among team members, discerning chronic disease dilemmas, and developing a common
      pathway model. Continuity of care and cost effectiveness can be the result of
      close attention to aspects of critical pathways. Medicine is frequently described
      as art blended with science. Nowhere is the art of medicine more apparent than in
      the management of wounds. The challenge of wound care has taxed the ingenuity of
      countless caregivers from the days when therapeutic armaments consisted of only
      salves, balms, and poultices to the present plethora of high-tech therapies.
      Unfortunately, the treatment of patients with wounds for the most part has been
      relegated to a little-appreciated segment of an equally unappreciated and
      "unattractive" category of chronic disease.

PMID- 7795872
TI  - Template for pressure ulcer research.
AB  - Synthesizing scientific information from the literature, even in a well-defined
      area, is difficult because not all studies report similar information. A template
      was developed by the authors to abstract information from articles reviewed for
      the Agency for Health Care Policy and Research (AHCPR) Clinical Practice
      Guideline on Pressure Ulcer Treatment. The research template specifies content to
      be included in a study reprot (e.g. variables, methods, endpoints, statistics,
      and conclusions). The authors also propose the use of the template to guide
      researchers so that future studies include important elements and provide greater
      methodologic consistency.

PMID- 7795871
TI  - AHCPR treatment guideline for pressure ulcers.

PMID- 7795870
TI  - The cost of treating pressure ulcers following implementation of a research-based
      skin care protocol in a long-term care facility.
AB  - Although concern for the costs associated with pressure ulcer treatments
      persists, studies that precisely quantify costs are limited. A retrospective
      research design was used to describe the costs incurred by an 830-bed, long-term
      care facility to treat 81 pressure ulcers over a one-year period following
      implementation of a research-based, skin care protocol. The total cost for the
      study period was $30,079 with 73% of these expenditures attributable to nursing
      care. Mean cost of treatment was $3.74/pressure ulcer/day, which was a reduction
      from the $5.35/pressure ulcer/day cost prior to implementation of the skin care
      protocol. These findings suggest that implementing a research-based, skin care
      protocol can promote a reduction in treatment costs.

PMID- 7795873
TI  - Evaluation of the effectiveness of two support surfaces following myocutaneous
      flap surgery.
AB  - Recurrence of pressure ulcers is a serious problem following myocutaneous flap
      surgery and can lead to prolonged and expensive hospitalization. One of the most
      important aspects of patient care after surgery is the monitoring of reduced
      pressure in the area of the flap. Usually reducing pressure requires an expensive
      high-tech support surface. The purpose of this study was to evaluate the
      effectiveness of a less expensive support surface. There were 12 patients
      involved in a clinical trial that lasted 14 days and compared the effectiveness
      of the ROHO dry-floatation mattress to that of the Clinitron bed. Findings
      indicated that post-operative patients were effectively treated on either support
      surface.

PMID- 7795876
TI  - Wound care products resource.

PMID- 7795874
TI  - Nursing and industry: a time for collaboration.
AB  - Collaboration between industry and clinical sites is an excellent way to foster
      research and improve patient care. A seven-step program for collaboration was
      illustrated by a clinical trial of a new dressing, Ventex (Kendall Health Care
      Products Co.). The seven steps are (1) Establish basis for collaboration; (2)sign
      agreements or contracts; (3) develop a project plan; (4) develop the protocol;
      (5) implement the study; (6) analyze the data and report results; and (7) present
      conclusions and publish results. Dressing performance, clinician and patient
      acceptance, and healing indicate that the dressing is feasible for a variety of
      wounds in a variety of settings.

PMID- 7795875
TI  - A review of the skin and its appendages.
AB  - Descriptions of the skin and its appendages tend to be a repetition of the basic
      facts well known by most clinicians. This article provides a more in-depth
      description of the epidermal cell layers, the dermis, and the appendages, as well
      as migrating cells, collagen, mast cells, macrophages, and lymphocytes. The
      appendages--hair, nails, sweat and sebaceous glands, and sensory receptors--are
      also described in depth.

PMID- 7795877
TI  - Nurses' knowledge of pressure ulcer prevention, staging, and description.
AB  - The purpose of this study was to examine registered nurses' (N = 228) knowledge
      of pressure ulcer prevention, pressure ulcer staging, and wound description. A 47
      item, true-false Pressure Ulcer Knowledge Test was developed for he study.
      Nurses' knowledge was significantly higher the more recently they had heard a
      lecture or read an article about pressure ulcers. Knowledge scores were not
      related to educational background, age, or years of work experience.

PMID- 7795878
TI  - Applicants needed for research funds.

PMID- 7795879
TI  - Questions about antifungal drug products.

PMID- 7795880
TI  - Efficacy of a comprehensive pressure ulcer prevention program in an extended care
      facility.
AB  - The effects of a comprehensive pressure ulcer prevention program on the incidence
      of nosocomial skin breakdown and cost effectiveness were evaluated in this 8
      month prospective study and follow-up after an 11-month interval. Baseline data
      were collected on all residents of a 125-bed nursing home who were present at the
      study start or were subsequently admitted during the initial 8-month interval.
      Reassessments were conducted on all residents at 2-month intervals during the
      initial 8-month study period. New admissions were similarly assessed. The
      program, which was modeled in accordance with the AHCPR's guideline on pressure
      ulcers, was implemented after staff education and a 2-month evaluation of
      residents. A total of 241 residents were entered in the study, the majority of
      whom were female, incontinent, and at high risk for pressure ulcers. After
      program implementation, the incidence of pressure ulcers decreased significantly
      (p < .001) at each of the four initial post-program measurement periods and the
      11-month follow-up. The cost analysis for the 8-month study period revealed
      savings that totalled more than $230,000 for the prevention program versus
      treatment costs. Findings support the implementation of comprehensive pressure
      ulcer prevention programs in extended care facilities to decrease the dollar cost
      of care and the cost of human suffering with a pressure ulcer.

PMID- 7795881
TI  - An essay on the science of reimbursement.

PMID- 7795882
TI  - Basement membrane (type IV) collagen.
AB  - The collagen IV molecule is 400 nm long and consists of two alpha 1 (IV) and one
      alpha 2 (IV) chains. Their genes COL4A1 and COL4A2 form a transcription unit in
      which they are arranged head-to-head and connected by a short common promoter
      region. Recently, four additional genes have been discovered. They are similarly
      arranged in the pairs COL4A3-A4 and COL4A5-A6 and code for additional collagen IV
      isoforms. in the macromolecular network of collagen IV, which provides the
      scaffold for basement membranes, the molecules are attached and cross-linked via
      their like end-regions and they interact laterally with their triple-helical
      domains in a not yet fully understood manner. Collagen IV is involved in
      interactions with cells and possesses two specific recognition sites for the
      integrins alpha 1 beta 1 and alpha 2 beta 1.

PMID- 7795883
TI  - Cloning and expression of laminin alpha 2 chain (M-chain) in the mouse.
AB  - Laminins are a family of heterotrimeric glycoproteins specific to basement
      membranes. Laminin-2, consisting of alpha 2, beta 1 and gamma 1 chains, was
      originally identified in the basement membranes of skeletal muscle and peripheral
      nerve. We have isolated and sequenced the full-length cDNA for the mouse laminin
      alpha 2 chain. Four overlapping clones spanning 9,330 bp encode a predicted
      polypeptide of 3,106 amino acids having a calculated molecular mass of 390 kDa
      including a 23-amino-acid signal peptide. The amino acid sequence of the alpha 2
      chain shares a 45.9% identify with that of the alpha 1 chain. Similar to the
      structure of the alpha 1 chain, the alpha 2 chain consists of several domains
      beginning at the N-terminus with three globular domains alternating with three
      epidermal growth factor-like domains followed by two alpha-helical domains and a
      C-terminal globular domain. The most N-terminal globular domain is highly
      conserved (77.3% identity) between the alpha 2 and alpha 1 chains, whereas the
      alpha-helical domains have low homology (30.3% identity). Northern blot and
      ribonuclease protection analysis revealed expression of mRNA for the alpha 2
      chain in heart, kidney, liver, skin, lung and skeletal muscle of newborn mice.
      such a tissue distribution suggests a role for the alpha 2 chain and,
      consequently, laminin-2 or -4 not only in the organization and the function of
      nerve and muscle tissue but possibly also in the mesenchymal components of
      certain tissues.

PMID- 7795885
TI  - A quantitative analysis of the incorporation of fibulin-1 into extracellular
      matrix indicates that fibronectin assembly is required.
AB  - Fibulin-1 is an extracellular matrix glycoprotein found in both loose and dense
      connective tissues, elastic fibers and some basement membranes. Cultured cells
      such as fibroblasts assemble endogenously synthesized or exogenously added
      fibulin-1 into matrix fibrils that also contain fibronectin. Since we have
      previously shown that fibulin-1 binds to fibronectin (Balbona, K., Tran, H.,
      Godyna, S., Ingham, K. C., Strickland, D. K. and Argraves, W. S. J. Biol. Chem.
      267: 20120-20125, 1992), we sought to investigate fibulin-1 incorporation into
      fibroblast extracellular matrix with an emphasis on evaluating the potential role
      of fibronectin in the process. In this study, we have used quantitative assays to
      measure the binding of 125I-fibulin to monolayers of cultured fibroblasts. Our
      results show that the kinetics of fibulin-1 incorporation into the cell layer and
      its partitioning into detergent-soluble and -insoluble fractions were similar to
      those of fibronectin. It was found that antibodies to fibronectin or to the
      fibulin-1-binding domain of fibronectin-inhibited fibulin-1 incorporation. Cell
      lines that fail to assemble fibronectin into the matrix, such as HT1080 or PFHR
      9, do not incorporate fibulin-1 into their cell layers. However, when HT1080
      cells were induced to assemble fibronectin by treatment with dexamethasone, they
      subsequently acquired the ability to incorporate fibulin-1. Moreover, treatment
      of cultured fibroblasts with antibodies that inhibit fibronectin assembly
      significantly inhibit fibulin-1 incorporation into the matrix. When increased
      amounts of fibronectin were incorporated into cells layers by incubating the
      cells for varying lengths of time with exogenous fibronectin, a corresponding
      increase in fibulin-1 incorporation was also observed. Taken together, the data
      indicate that the incorporation of fibulin-1 requires fibronectin assembly and
      suggests a dependence on the amount of fibronectin in a matrix. These results
      highlight the potential of fibronectin to control the deposition of fibulin-1
      into those extracellular matrices where both proteins coincide and may have
      implications in the formation of fibulin-1-containing matrix structures such as
      basement membranes or elastic fibers.

PMID- 7795886
TI  - Identification and characterization of human tissue inhibitor of
      metalloproteinase-3 and detection of three additional metalloproteinase inhibitor
      activities in extracellular matrix.
AB  - We have identified and characterized a novel human tissue inhibitor of
      metalloproteinase (TIMP). It is found exclusively in the extracellular matrix of
      a large number of cultured human cells, including: primary embryonal kidney
      (293), neuroblastoma (SK-N-SH), normal whole embryo (FHs 173We), cervical
      carcinoma (HeLa S3), colon adenocarcinoma (Caco-2), ileocecal adenocarcinoma (HCT
      8), fibrosarcomas (SW 684 and Hs 913T) and normal gingival fibroblasts (GF11 and
      1292). It was not detected in the conditioned media from any of these cell lines.
      Its apparent molecular mass of 24-25 kDa, as determined by its migration on
      protease-substrate gels, is intermediate between TIMP-1 (28.5 kDa) and TIMP-2 (21
      kDa). Like the latter two proteins, human TIMP-3 contains intrachain disulfide
      bonds and displays altered electrophoretic mobility in the presence of beta
      mercaptoethanol. The N-terminal, amino acid sequence of the protein is identical
      to that of chicken TIMP-3 (ChIMP-3), and its amino acid composition is similar.
      The protein is not N-glycosylated, as determined by treatment with N-glycosidase
      F. Finally, it is recognized by antisera raised against pure ChIMP-3 but not by
      anti-human TIMP-1 or anti-human TIMP-2 antibodies. Based on these properties, we
      propose that this protein is TIMP-3 and is the human counterpart of ChIMP-3
      (Pavloff et al., J. Biol. Chem. 267: 17321-17326, 1992). Two additional
      inhibitors detected in the matrix of human cell lines, designated inhibitor of
      metalloproteinase (IMP)-a and IMP-b, migrate with apparent masses of 29 kDa and
      30 kDa. Both are N-glycosylated. A fourth inhibitor activity, which is smaller in
      mass than TIMP-3 and is also pecifically located in the matrix, is detectable in
      some cell lines.

PMID- 7795884
TI  - Perlecan in human bone marrow: a growth-factor-presenting, but anti-adhesive,
      extracellular matrix component for hematopoietic cells.
AB  - Human perlecan is a heparan sulfate proteoglycan with a large core protein of 467
      kDa to which three glycosaminoglycan side chains are attached. It belongs to the
      heparan sulfate proteoglycan family which has been implicated in strong
      interactions between developing hematopoietic cells and their microenvironment in
      the bone marrow. Here we report that perlecan is highly expressed in the human
      bone marrow, as well as in long-term bone marrow cultures which are thought to
      mimic hematopoiesis in vitro. Expression of perlecan in this tissue was shown by
      Northern blotting of the 14-kb mRNA of the core protein and by immunofluorescence
      stainings. Functionally, perlecan shows a strong anti-adhesive effect on
      unfractionated bone marrow cells and on various hematopoietic cell lines,
      repelling the cells from the perlecan-coated area. In contrast, perlecan is
      adhesive for fibroblasts and endothelial cells. It is suggested that the anti
      adhesive site is located within the core protein of perlecan since heparitinase
      treated perlecan still shows the repellent effect. Although anti-adhesive for
      hematopoietic cells, perlecan is able to bind growth factors like
      granulocyte/macrophage-colony stimulating factor and present them to
      hematopoietic progenitor cells in a semi-solid colony assay. The functional role
      of a growth-factor-binding extracellular matrix component in the bone marrow
      microenvironment with anti-adhesive properties is uncertain but may be related to
      compartmentalization.

PMID- 7795888
TI  - Type VI collagen beaded microfibrils from bovine cornea depolymerize at acidic
      pH, and depolymerization and polymerization are not influenced by hyaluronan.
AB  - Type VI collagen beaded microfibrils were extracted from bovine cornea or pig
      cartilage by limited collagenase digestion. Depolymerization of the microfibril,
      without strong denaturing reagents linke guanidinium hydrochloride or urea under
      mild acidic conditions, led to single tetramers and multiples of two to three.
      However, hyaluronidase digestion in accordance with a published method (Kielty et
      al. J. Cell Biol. 118:979-990, 1992) was unsuccessful in depolymerizing type VI
      collagen microfibrils. Also, repolymerization into microfibrils by incubation
      with hyaluronan was not observed. We further found no binding of native type VI
      collagen microfibrils to a hyaluronan-Sepharose column. Although a recombinant
      fragment comprising alpha 3(VI) domains N9-N2 showed apparent binding to the
      column, electron microscopy did not give any indication of binding of either type
      VI collagen or fragment N9-N2 to hyaluronan. The present findings suggest that
      the role of hyaluronan in polymerization of type VI collagen has been
      overestimated in previous work.

PMID- 7795887
TI  - The human laminin beta 2 chain (S-laminin): structure, expression in fetal
      tissues and chromosomal assignment of the LAMB2 gene.
AB  - The sequence of the human laminin beta 2 chain (previously s-laminin) was derived
      from cloned cDNAs. The complete translation product has 1798 amino acid residues,
      including a 32-residue signal peptide. The human chain lacks the tripeptide
      sequence LRE in domain I which is present in the rat polypeptide chain and has
      been shown to promote motor neuronal cell adhesion. The human gene (LAMB2) was
      localized to chromosome 3p21 using somatic cell hybrids and fluorescent in situ
      hybridization analysis. Northern and in situ hybridization analyses from numerous
      fetal tissues revealed that the beta 2 chain is generally widely expressed. beta
      2, but not beta 1, was shown by in situ hybridization to be expressed in fetal
      brain and renal glomeruli. In fetal skin, beta 2 was expressed both in epidermal
      and dermal cells, while beta 1 was expressed only in the dermis. Expression of
      beta 2 in fetal liver was seen in hepatocytes, while no signals were observed for
      beta 1. In lung, both beta 1 and beta 2 were expressed in alveoli and bronchial
      smooth muscle cells, whereas only the beta 2 chain was expressed in bronchial
      epithelial cells. In striated muscle, however, the beta 1 chain, but not beta 2,
      was expressed. These results indicate different biological roles for the laminin
      beta 1 and beta 2 chains.

PMID- 7795889
TI  - Crystallization studies on avian eggshell membranes: implications for the
      molecular factors controlling eggshell formation.
AB  - The avian eggshell is a natural biopolymer and mineral composite. It is a very
      useful model for biomimetic mineralization, since it is among the fastest forming
      hard tissues known. Isolated eggshell membranes, which were demineralized in
      vitro, were used to investigate the in vitro modulation of CaCO3 crystal
      deposition by organic matrix materials. Crystallization on the demineralized
      eggshell membrane occurred almost exclusively at the peripheries of residual
      calcium reserve assemblies, which contain a high concentration of sulfur. Similar
      structures are observed for eggshell membranes after natural demineralization.
      The characteristic rhombohedral crystal morphologies of the calcite crystals
      grown in this in vitro system are much less regular when grown in the presence of
      organic matrix or partially purified dermatan sulfate proteoglycans obtained from
      the eggshell. The effect of these macromolecules on the morphology and size of
      CaCO3 crystals is concentration-dependent. These studies indicate the complexity
      of the molecular and ionic interactions involved in the initiation and formation
      of the eggshell, with the focus on the role of the organic matrix.

PMID- 7795890
TI  - Fatal familial insomnia: sleep, neuroendocrine and vegetative alterations.
AB  - Fatal Familial Insomnia (FFI) is an autosomal dominant prion disease,
      characterized by prominent degeneration of the thalamus and involving impaired
      control of the sleep-wake cycle and of autonomic and endocrine functions.
      Profound alterations in the sleep-wake cycle consist of progressive decrease or
      complete absence of sleep activity and loss of any intrinsic cyclic organization
      of residual sleep. Unbalanced sympathergic activation with preserved
      parasympathetic drive, associated with chronic secondary hypertension and loss of
      the physiological nocturnal decrease in blood pressure constitute the
      characteristic autonomic changes. Neuroendocrine studies document
      hypercortisolism with abnormal feed-back suppression of adrenocorticotrophic
      hormone, constantly elevated catecholamine levels and abnormal secretory patterns
      of growth hormone, prolactin and melatonin. Advanced stages of the disease are
      invariably characterized by the disappearance of any circadian autonomic and
      neuroendocrine rhythmicity. FFI represents a model disease emphasizing the
      correlations among the different sleep, autonomic and neuroendocrine functions.
      Clinico-pathological correlations demonstrate the role of the thalamus as an
      integrative neural structure placed between the limbic system and the
      hypothalamus and controlling the homeostatic balance of the organism.

PMID- 7795892
TI  - Sleep, neuroimmune and neuroendocrine functions in fibromyalgia and chronic
      fatigue syndrome.
AB  - The justification for disordered chronobiology for fibromyalgia and chronic
      fatigue syndrome (CFS) is based on the following evidence: The studies on
      disordered sleep physiology and the symptoms of fibromyalgia and CFS; the
      experimental studies that draw a link between interleukin-1 (IL-1), immune
      neuroendocrine-thermal systems and the sleep-wake cycle; studies and preliminary
      data of the inter-relationships of sleep-wakefulness, IL-1, and aspects of
      peripheral immune and neuroendocrine functions in healthy men and in women during
      differing phases of the menstrual cycle; and the observations of alterations in
      the immune-neuroendocrine functions of patients with fibromyalgia and CFS
      (Moldofsky, 1993b, d). Time series analyses of measures of the circadian pattern
      of the sleep-wake behavioural system, immune, neuroendocrine and temperature
      functions in patients with fibromyalgia and CFS should determine whether
      alterations of aspects of the neuro-immune-endocrine systems that accompany
      disordered sleep physiology result in nonrestorative sleep, pain, fatigue,
      cognitive and mood symptoms in patients with fibromyalgia and CFS.

PMID- 7795893
TI  - Sleep as a neuroimmune phenomenon: a brief historical perspective.

PMID- 7795891
TI  - Narcolepsy and immunity.
AB  - Narcolepsy is a neurological disorder known to be associated with human leukocyte
      antigen (HLA)-DQB1*0602 in humans. In a canine model, the disorder is also
      genetically linked to a gene of high homology with the human mu-switch-like
      immunoglobulin (Ig) gene (current LOD score 13.6 at 0% recombination). Since
      association with HLA or other immune function polymorphic genes (T cell receptor
      of Ig, mainly) is a hallmark of most autoimmune diseases, it is proposed that
      autoimmunity may also play a role in the development of narcolepsy. Arguments for
      and against this hypothesis are reviewed. It is shown that both on the basis of
      the most recent molecular studies, and because of some of its clinical features,
      narcolepsy may be an autoimmune disorder. However, neither systemic nor central
      nervous system (CNS) evidence of any autoimmune abnormality have ever been found.
      To reconcile this discrepancy, it is suggested that the pathological immune
      process involved in narcolepsy could be difficult to detect because it is
      restricted to a very small region of the brain or targets a low abundance
      neuroeffector. Alternatively, it is possible that a more fundamental relationship
      is involved between sleep generation and immune regulation. The pathophysiology
      of narcolepsy may then involve new CNS-immune mechanisms that may shed new light
      on the sleep process itself.

PMID- 7795894
TI  - Lentiviral infection, immune response peptides and sleep.
AB  - The aberrant sleep documented in subjects with human immunodeficiency virus (HIV)
      infection is uniquely important because of the contribution this poor quality
      sleep makes to the fatigue, disability, and eventual unemployment that befalls
      these patients. Especially given this importance in clinical care, the research
      on the prominent sleep changes described in HIV infection remains modest in
      quantity. The chronic asymptomatic stage of HIV infection is associated with the
      most intriguing and singular sleep structure changes. Especially robust is the
      increase in slow wave sleep, particularly in latter portions of the sleep period.
      This finding is rare in other primary or secondary sleep disorders. The sleep
      structure alterations are among the most replicable of several pathophysiological
      sequelae in the brain associated with early HIV infection. It is unlikely that
      these sleep architecture changes are psychosocial in etiology, and they occur
      before medical pathology is evident. They are not associated with stress,
      anxiety, or depression. Evidence is accumulating to support a role for the
      somnogenic immune peptides tumor necrosis factor (TNF)alpha and interleukin (IL-1
      beta) in the sleep changes and fatigue commonly seen in HIV infection. These
      peptides are elevated in the blood of HIV-infected individuals, and are
      somnogenic in clinical use and animal models. The peripheral production of these
      peptides may also have a role in the regulation of normal sleep physiology. The
      lentivirus family contains both HIV and the feline immunodeficiency virus (FIV).
      The use of the FIV model of HIV infection may provide a way to further
      investigate the mechanism of a neurotropic, neurotoxic virus initiating the
      immune acute phase response and affecting sleep. Neurotropic lentivirus infection
      is a microbiological probe facilitating neuroimmune investigation.

PMID- 7795895
TI  - Sleep, sleep deprivation and infectious disease: studies in animals.
AB  - Common perceptions that the desire for sleep is increased during mild infectious
      diseases like colds and 'the flu' have fostered beliefs that sleep promotes
      recovery from infectious disease and that lack of sleep increases susceptibility
      to infections. However, until recently, the relationship between infectious
      disease and vigilance received relatively little systematic study. At present,
      several model systems provide evidence that infectious disease is accompanied by
      alterations in sleep. Indeed, increased sleepiness, like fever and anorexia, may
      be viewed as a facet of the acute phase response to infectious challenge. Recent
      studies also suggest that sleep, sleep deprivation and infectious disease may be
      related via mechanisms of the immune system (Fig. 1). Data are now accumulating
      to address questions such as whether immune processes alter sleep, whether sleep
      or sleep deprivation influences immune competence, and whether sleep facilitates
      recovery from infectious disease.

PMID- 7795897
TI  - Chromaffin cell survival prolonged by nerve growth factor from pretransected
      sciatic nerve.

PMID- 7795896
TI  - Cell therapy with encapsulated xenogeneic tumor cells secreting beta-endorphin
      for treatment of peripheral pain.
AB  - The purpose of this study was to assess whether xenogeneic tumor cells secreting
      beta-endorphin and immunologically isolated in polymer capsules could survive and
      continue to reduce pain when transplanted into the spinal cerebro-spinal fluid
      (CSF) space of rats. Also, a silicone container for polymer capsules was designed
      for the clinical application of this method of cell therapy. The mouse tumor cell
      lines, proopiomelanocortin gene transfected Neuro2A which secrete beta-endorphin,
      were enclosed in polymer capsules at a density of 5 x 10(6)/mL, and transplanted
      into the spinal CSF space from the occipito-atlantal junction of male Sprague
      Dawley rats. Three analgesiometric tests--the tail pinch test, the hot plate
      test, and electrical stimulation test--showed that the rats with encapsulated
      Neuro2A (n = 6) were significantly less sensitive to pain after transplantation
      than control animals (n = 8). The analgesia induced by the encapsulated cells
      secreting beta-endorphin was attenuated by the opiate antagonist naloxone.
      Morphological study revealed that the encapsulated cells survived for 1 mo after
      transplantation into the CSF space. An in vitro experiment on cultured capsules
      (3 cm long) with a silicone container (Kaneka Medics Co) showed that the
      encapsulated Neuro2A (5 x 10(6) mL) could secrete peptides for 1 mo. The results
      of this study indicate that immunologically isolated xenogeneic tumor cells can
      secrete opiate in the CSF space, and that a silicone container may help the
      application of this method to the treatment of cancer pain.

PMID- 7795898
TI  - Preliminary results of gene transfer to central nervous system by continuous
      injection of DNA-liposome complex.

PMID- 7795899
TI  - Delivery of neurotrophic factors to the CNS using encapsulated cells: developing
      treatments for neurodegenerative diseases.

PMID- 7795900
TI  - Ammonia removal activity of agarose-encapsulated rat hepatocytes.

PMID- 7795901
TI  - Recent topics in the management of pain: development of the concept of preemptive
      analgesia.
AB  - Recent studies concerned with the relationship between injury responses and acute
      and chronic pain were reviewed. Basic and clinical studies of pain have revealed
      that a large proportion of the mechanisms that produce strange signs and
      symptoms, such as allodynia, hyperalgesia and hyperpathia, after tissue injury
      are ascribed to increased excitability, or to sensitization derived from
      biological changes in spinal dorsal horn cells subjected to excessive noxious
      stimuli from injured tissues. Preemptive analgesia has been under consideration
      as a means of preventing the predictable sensitization to pain that follows
      surgery. The findings of many clinical investigations, however, remain
      controversial. This report discusses the importance of preemptive analgesia
      including the possibilities of prevention, and of extension to the control, of
      chronic pain syndromes.

PMID- 7795902
TI  - Long-term developmental expression and inductivity of cytochrome P450s within
      intrasplenically transplanted fetal hepatocytes from spontaneously hypertensive
      rats.

PMID- 7795903
TI  - Proliferative activity of rat hepatocytes transplanted into the spleen.

PMID- 7795904
TI  - Long-term effect of intrasplenic hepatocyte transplantation in congenitally
      ascorbic acid biosynthetic enzyme-deficient rats.

PMID- 7795905
TI  - Analysis of survival of allogeneic fetal liver fragments in rats.
AB  - The survival of allogeneic fetal liver fragments in the omentum was analyzed in
      rats. The lymphocyte subsets of the spleen and peripheral blood were also
      examined. When the fetal liver fragments were transplanted into the omentum, they
      survived for 2 wk, whereas adult liver fragments survived only 1 wk. In fetal
      liver fragments transplantation, the CD8 positive lymphocyte percentage in
      peripheral blood decreased significantly 3 wk after transplantation in comparison
      with that in adult liver fragment transplantation. The skin graft of the donor
      party showed a longer median survival time in rats receiving fetal liver fragment
      transplants than that in recipients of adult liver fragments. Although further
      study is needed, allogeneic fetal liver fragments survived longer in the omentum
      than reported elsewhere, and the decrease of CD8 positive peripheral blood
      lymphocytes may have been the reason for this.

PMID- 7795906
TI  - Comparison of different collagenases in isolation of adult pig islets.

PMID- 7795907
TI  - Effect of antiadhesion antibodies on pancreatic islet xenotransplantation.

PMID- 7795908
TI  - Role of micro-chimerism in inducing immunological tolerance by intraportal
      injection of donor spleen cells in rats.
AB  - Recently, we reported that intraportal (IP) injection of donor spleen cells
      (SPCs) prevented liver allograft rejection. Moreover, we developed a new method
      using polymerase chain reaction (PCR)-mediated restriction fragment length
      polymorphism (RFLP) analysis, and demonstrated micro-chimerism (MC) at the DNA
      level in the spleen 14 days after IP injection. In the present study, the long
      term presence of injected allogeneic SPCs was investigated at the cellular level
      by immunofluorescence staining as well as the DNA level using RFLP analysis. Male
      ACI (RT1a) rats were used as the donors and Lewis (RT1(1)) rats as the
      recipients. After DNA preparation from the lymphoid organs, RT1B beta domain 1
      region was amplified by PCR, and RFLP analysis was performed with PvuII
      restriction enzyme. In the immunofluorescence staining, the monoclonal antibody,
      MN4-91-6, was used to detect the injected donor ACI SPCs in a frozen specimen. We
      did not detect MC in Lewis rats intravenously injected with 5 x 10(7) ACI SPCs on
      day 14. On the other hand, stable chimerism in the spleen was observed in
      intraportally injected rats up to 28 days after injection at not only the DNA
      level but also the cellular level. No chimerism was detected in other organs
      (including the thymus, lymph nodes, and liver). In conclusion, the long-term
      presence of injected allogeneic SPCs in the spleen was demonstrated after IP
      injection but not after IV injection, and this phenomenon may be one of the
      mechanisms involved in portal venous immunosuppression.

PMID- 7795909
TI  - T cell clonality and transplantation.

PMID- 7795910
TI  - Temporal pattern of synaptophysin expression in cryopreserved fetal hippocampal
      cells transplanted into ischemically damaged adult rat hippocampus.

PMID- 7795911
TI  - The challenge of individual rights. Mental health review tribunals.

PMID- 7795912
TI  - Categorising the behavioural toxicities of antidepressants. Proposals and
      requirements.

PMID- 7795913
TI  - Efficacy of drug treatment in obsessive-compulsive disorder. A meta-analytic
      review.
AB  - BACKGROUND: A review of the efficacy of antidepressant drug treatment in patients
      with obsessive-compulsive disorder (OCD), using a meta-analytic approach. METHOD:
      Randomised double-blind clinical trials of antidepressant drugs, carried out
      among patients with OCD and published in peer-reviewed journals between 1975 and
      May 1994, were selected together with three studies currently in press. Forty
      seven trials were located by searching the Medline and Excerpta Medica-Psychiatry
      data bases, scanning psychiatric and psychopharmacological journals, consulting
      recent published reviews and bibliographies, contacting pharmaceutical companies
      and through cross-references. Hedges' g was computed in pooled data at the
      conclusion of treatment under double-blind conditions or at the latest reported
      point of time during this treatment period. For each trial, effect sizes were
      computed for all available outcome measures of the following dependent variables:
      obsessive-compulsive symptoms considered together; obsessions; compulsions;
      depression; anxiety; global clinical improvement; psychosocial adjustment; and
      physical symptoms. RESULTS: Clomipramine was superior to placebo in reducing both
      obsessive-compulsive symptoms considered together (g = 1.31; 95% CI = 1.15 to
      1.47) as well as obsessions (g = 0.89, 95% CI = 0.36 to 1.42) and compulsions (g
      = 0.79; 95% CI = 0.34 to 1.24) taken separately. Also, selective serotonin re
      uptake inhibitors (SSRIs) as a class were superior to placebo, weighted mean g
      being respectively 0.47 (95% CI = 0.33 to 0.61), 0.54 (95% CI = 0.34 to 0.74) and
      0.52 (95% CI = 0.34 to 0.70) for obsessive-compulsive symptoms considered
      together, and obsessions and compulsions taken separately. Although on Y-BOCS the
      increase in improvement rate over placebo was 61.3%, 28.5%, 28.2% and 21.6% for
      clomipramine, fluoxetine, fluvoxamine, and sertraline respectively, the trials
      testing clomipramine against fluoxetine and fluvoxamine showed similar
      therapeutic efficacy between these drugs. Finally, both clomipramine and
      fluvoxamine proved superior to antidepressant drugs with no selective
      serotonergic properties. CONCLUSION: Antidepressant drugs are effective in the
      short-term treatment of patients suffering from OCD; although the increase in
      improvement rate over placebo was greater for clomipramine than for SSRIs, direct
      comparison between these drugs showed that they had similar therapeutic efficacy
      on obsessive-compulsive symptoms; clomipramine and fluvoxamine had greater
      therapeutic efficacy than antidepressant drugs with no selective serotonergic
      properties; concomitant high levels of depression at the outset did not seem
      necessary for clomipramine and for SSRIs to improve obsessive-compulsive
      symptoms.

PMID- 7795914
TI  - Cognitive therapy with obsessive-compulsive disorder.
AB  - BACKGROUND: People with obsessive-compulsive disorders (OCD) are widely treated
      with a combination of medication and behavioural techniques. The success rate is
      50-85%, but both relapse and drop-out rates appear high. The use of cognitive
      therapy (CT) for the treatment of OCD has been suggested. The empirical evidence
      supporting the use of CT for OCD is examined. METHOD: A manual and computer
      (Medline) literature search was performed. RESULTS: Fifteen empirical studies
      were found: ten non-controlled, and five controlled. CONCLUSIONS: There are few
      controlled CT studies, and these show little evidence of improvement when CT is
      added to existing therapeutic techniques.

PMID- 7795915
TI  - One hundred cases of suicide in elderly people.
AB  - BACKGROUND: The White Paper The Health of the Nation targets a reduction in
      suicide rates. Preventive strategies must be guided by an understanding of the
      demography and antecedents of suicide. These issues are examined in relation to
      suicide by old people in Manchester. METHOD: One hundred consecutive coroners'
      inquisitions on people aged over 65 occurring between 1980 and 1991 in which the
      verdict was suicide were scrutinised and related to Health Service notes.
      RESULTS: Suicides were rare, numbers ranging from 0 to seven per annum per Health
      District. Rates did not vary between district but did within smaller sub
      populations. Most individuals died at home; 65% were physically ill, of whom 23%
      had been hospitalised within the previous year. At least 60% were clinically
      depressed, with 25% being prescribed antidepressants. A total of 43% had seen
      their general practitioner in the previous month but only 14% were in contact
      with psychiatric services. CONCLUSIONS: Many elderly people who commit suicide
      are not in close contact with primary care services; those who are may not be
      prescribed appropriate treatment, and few are referred for specialist care.
      Specialist services will fail to reduce suicide rates unless they embark upon
      programmes to increase public awareness of therapeutic possibilities and work
      more closely with primary care agencies to realise these possibilities.

PMID- 7795916
TI  - The limitations of official suicide statistics.
AB  - BACKGROUND: This study explored some of the problems associated with current
      procedures for the ascertainment of suicide. METHOD: A sample of 242 deaths which
      were known to have been self-inflicted was followed up through the coroners'
      courts where causes of death were legally established. RESULTS: Verdicts other
      than suicide were returned on half of the men, and on one-quarter of the women.
      CONCLUSIONS: For suicide statistics to become valid indicators of suicide rates
      it might be more appropriate to apply the civil, rather than the criminal,
      standard of proof during inquest proceedings.

PMID- 7795917
TI  - Anorexia nervosa. No evidence of an increase.
AB  - BACKGROUND: This paper examines the evidence that rates of anorexia nervosa have
      increased over time. METHOD: Epidemiological studies that have provided time
      trends in incidence rates in specific countries or psychiatric registers and
      prevalence surveys were reviewed to assess whether or not prevalence estimates
      are higher in the most recent studies. RESULTS: Estimated trends in incidence
      rates showed an increase but no study ruled out plausible alternative
      explanations. Studies showing no upward trend were as numerous and were generally
      based on larger samples. Analysis of 29 cross-sectional surveys conducted over
      the last 25 years indicated that the median prevalence rate was 1.3 per 1000
      females. There was no indication that more recent surveys yielded higher
      prevalence rates. CONCLUSION: Anorexia nervosa remains a rare disorder and there
      is no evidence of a secular increase in its incidence.

PMID- 7795919
TI  - Towards a sociobiological model of depression. A marsupial model (Petaurus
      breviceps).
AB  - BACKGROUND: This is a sociobiological approach to depression using hierarchy and
      its hypothesised relevance to self-esteem in the marsupial sugar glider (Petaurus
      breviceps). METHOD: Differential access to resources between the dominant and
      submissive animal is measured by observation in four stable colonies. The
      dominant animals from two of these colonies are then introduced into the other
      two, resulting in the transferred former dominants becoming subordinate.
      Behavioural and biochemical measures relevant to depression and involving access
      to resources are then repeated. These measures include eating, drinking, social
      and sexual access, motility, grooming and biochemical estimates of cortisol and
      testosterone. RESULTS: Subordinate animals have significantly less access to
      resources, both in the stable colony and when the formerly dominant animals
      become subordinate. CONCLUSIONS: A sociobiological approach using a hierarchy
      model equating resource-holding potential with self-esteem, exemplified by this
      study, may provide new concepts and insights into the phenomenology and
      pathophysiology of depression. It allows comparisons to be made between animal
      behaviour and cognition: the lack of such has been a major difficulty in animal
      studies hitherto. The findings are possibly more relevant to dysthymia than to
      affective disorder and imply a relationship between low resource-holding
      potential in sub-human animals as a phylogenetic antecedent of some of the
      cognitive and affective aspects of depression in man.

PMID- 7795918
TI  - Defining subgroups of dieting disorder patients by means of the Eating Disorders
      Examination (EDE).
AB  - BACKGROUND: It is important to determine the optimal manner of categorising
      eating disorder patients so as to aid in the understanding of their specific
      psychopathological state. METHOD: We compared subgroups of eating disorder
      patients divided according to different sets of factors, using a structured
      interview which elicits the specific psychopathological features of these
      illnesses. The patients, comprising 116 consecutive women admitted to two
      university-affiliated eating disorder clinics, were grouped according to DSM-III
      R criteria, clinical presentation (purging, binge eating), nutritional status,
      and age. RESULT: The clearest separation of groups was afforded by the clinical
      dimension of purging as opposed to not purging. This was superior to DSM-III-R
      criteria. Other systems, such as presence of binge eating, and various levels of
      nutritional status and of age, were clearly inferior. CONCLUSION: The presence or
      absence of purging behaviour appears to offer the most heuristic means of
      categorising eating disorder patients with respect to their specific
      psychopathological state.

PMID- 7795921
TI  - Child and adolescent (juvenile onset) schizophrenia. A case control study of
      premorbid developmental impairments.
AB  - BACKGROUND: The study tests the hypothesis that juvenile-onset schizophrenia is
      associated with premorbid developmental impairments. It was predicted that the
      pattern of developmental impairments would vary with age of onset and with
      gender. METHOD: A case-control design was used to examine developmental
      impairments in 61 consecutive juvenile-onset (age 7-17) referrals with ICD-9
      schizophrenia; 61 non-psychotic psychiatric controls were matched on age and
      gender. Cases and controls were divided into childhood-onset (age 7-13) and
      adolescent-onset (age 14-17). RESULTS: The schizophrenic cases had a
      significantly higher risk of premorbid social (chi 2 = 9.1, P < 0.005), motor
      (chi 2 = 9.1, P < 0.005) and language impairments (chi 2 = 10.1, P < 0.005).
      Specific impairments of language production and comprehension were associated
      with childhood-onset schizophrenia and were independent of gender. CONCLUSIONS:
      Juvenile-onset schizophrenia is associated with a range of developmental
      antecedents. There may be a specific link between cases with a very early onset
      and an impairment in the processes underlying the development of language.

PMID- 7795922
TI  - Schizophrenic and manic brains in Nigerians. Computerised tomography findings.
AB  - BACKGROUND: We highlight the profile of brain computerised tomography (CT)
      measures among Nigerian psychiatric patients for comparison with findings from
      developed countries, and study of the relationship between CT values and clinical
      variables. METHOD: Seven brain ventricle measures of 50 schizophrenic patients,
      14 manic patients, and 41 healthy control subjects were compared. RESULTS:
      Patients had a significantly higher mean Sylvian fissure area. The third
      ventricle of schizophrenic patients was significantly larger than those of
      control subjects. CT measures were not significantly correlated with duration of
      illness. CONCLUSION: The so-called functional psychotic states are most probably
      associated with non-specific brain abnormality.

PMID- 7795920
TI  - Assessment of the prevalence of psychiatric disorder in young adults.
AB  - BACKGROUND: The effectiveness of different assessment procedures for determining
      prevalence rates of psychiatric disorder in young adults was investigated.
      METHOD: In a two-stage multi-method procedure, the Young Adult Self-Report, the
      Schedules for Clinical Assessment in Neuropsychiatry (SCAN), the Structured
      Interview for Personality Disorders (Revised), and the Global Assessment of
      Functioning (GAF) Scale were used to assess prevalence rates in 706 19-24-year
      olds from the general population. Furthermore, individuals' subjective perception
      of distress and referral to mental health services were assessed. RESULTS: The
      prevalence of any SCAN/DSM-III-R disorder was 19.3% (95% confidence interval:
      11.2-27.4%). Most subjects who received a SCAN/DSM-III-R diagnosis were only
      mildly impaired. The highest prevalence rates of dysfunctioning (GAF score below
      61) without referral to mental health services were for dissociative disorder
      (2.3%), sleep disorder (2.1%), alcohol dependence (1.3%) and affective disorder
      (1.8%). CONCLUSION: Instruments that assess functional impairment in addition to
      DSM-III-R diagnoses are indispensable in prevalence studies.

PMID- 7795924
TI  - Bereavement after homicide. A comparison of treatment seekers and refusers.
AB  - BACKGROUND: This brief report presents initial findings from a prospective
      descriptive study of adults after the homicide of a family member. Within the
      first year of bereavement, the responses and risk factors associated with
      unrecovered grief and post-traumatic stress disorder in subjects who requested or
      refused supportive psychotherapy were compared. METHOD: Fifty-two adult members
      of 237 families contacted within three months of a homicide attended a
      specialised out-patient clinic (32 requested, and 20 refused, supportive therapy)
      after a structured interview and completion of measures of grief (TRIG), trauma
      (RIES and DES), and death imagery. RESULTS: Only two risk factors (childhood
      history of sexual abuse and lack of religious faith) were associated with
      treatment seeking. Treatment-seeking subjects also scored significantly higher (P
      < 0.001) on all measures of grief, trauma, and intrusive re-enactment imagery of
      the dying. CONCLUSION: Adults who seek therapy after the homicide of a family
      member are highly reactive to all measures of trauma, grief, and death imagery.

PMID- 7795923
TI  - Disordered water homeostasis in schizophrenia and cerebral ventricular size.
AB  - BACKGROUND: A possible association between disordered water homeostasis and
      cerebral ventricular size in patients with schizophrenia was investigated.
      METHOD: In a cross-sectional study of hospitalised patients, cerebral ventricular
      size was measured in 16 schizophrenic patients with disordered water homeostasis
      and 16 matched schizophrenic controls by magnetic resonance imaging. RESULTS:
      Ventricle to brain ratio, third ventricular index, bicaudate index and bifrontal
      index tended to be greater in those with schizophrenia with disordered water
      homeostasis, although differences were significant only for the bifrontal index
      (P < 0.05). Strong negative correlations were found between ventricular size and
      performance on neuropsychological testing in the disordered water homeostasis
      group. CONCLUSION: These results provide evidence for an association between
      structural brain abnormality and disordered water homeostasis in a subset of
      schizophrenic patients.

PMID- 7795925
TI  - Ondansetron and opiate craving. A novel pharmacological approach to addiction.
AB  - BACKGROUND: Pharmacological approaches to opiate addiction have for the most part
      been limited to a role in detoxification. A high percentage of patients who
      complete detoxification programmes relapse. METHOD: In the present study, we used
      a simple laboratory method to investigate suggestions from preclinical studies
      that 5-(hydroxytryptamine) HT3 receptor antagonists have a role in the treatment
      of addiction. RESULTS: We showed that addicts stably maintained on methadone
      experienced significant craving, dysphoria, and withdrawal-like symptoms when
      exposed to a video containing drug-related cues. The craving was not lessened by
      treatment with the 5-HT3 receptor antagonist, ondansetron (4 mg orally).
      CONCLUSION: Our current findings do not support a role for 5-HT3 receptor
      agonists in the reduction of craving in opiate addicts.

PMID- 7795927
TI  - Psychiatric and social outcome of liver transplantation.
AB  - BACKGROUND: This study measures psychiatric morbidity, quality of life, and
      cognitive function after liver transplantation. METHOD: We undertook a cross
      sectional study, with a longitudinal subgroup. The setting was a tertiary
      referral centre for liver transplantation. The subjects were 30 post-liver
      transplantation patients, including 11 also interviewed before the operation. The
      main outcome measures were the Clinical Interview Schedule (CIS), the General
      Health Questionnaire (GHQ), the Nottingham Health Profile (NHP), and the Mini
      Mental State Examination (MMSE). RESULTS: Of the patients, 8/30 were CIS cases,
      and 7/30 were GHQ cases. NHP scores were higher than a previous postal study
      indicated, with less impairment after than before transplant. MMSE scores were 24
      30. Median GHQ was 7.0 before operation and 1.0 after operation (P = 0.03), with
      no significant change in CIS score. CONCLUSION: Liver transplantation improves
      quality of life, but not to the level of the general population; post
      transplantation patients have a prevalence of psychiatric morbidity comparable
      with that of general medical patients.

PMID- 7795928
TI  - Post-traumatic stress disorder (PTSD) after childbirth.
AB  - BACKGROUND: There has been discussion about the possible occurrence of post
      traumatic stress disorder (PTSD) in mothers after difficult childbirth. METHOD:
      Four cases with a symptom profile suggestive of PTSD commencing within 48 hours
      of childbirth are presented. RESULTS: The PTSD was in each case associated with
      the delivery. In each case, there was an associated depressive illness. All four
      had persistent disorders, and two had difficulties with mother/infant attachment.
      CONCLUSION: As confirmed by other reports, the prevalence of PTSD associated with
      childbirth is a matter of concern.

PMID- 7795926
TI  - Quality of life in liaison psychiatry. A comparison of patient and clinician
      assessment.
AB  - BACKGROUND: This exploratory study investigates the performance of the Health
      Measurement Questionnaire (HMQ), as compared with the Psychiatric Assessment
      Schedule (PAS) and the Nottingham Health Profile (NHP), and compares self- and
      observer-completed measures. METHOD: A total of 138 medical patients scoring over
      the screening threshold for probable psychiatric illness completed the HMQ, NHP
      and PAS, and were rated by a psychiatrist on Rosser disability and distress.
      RESULTS: HMQ disability correlated well with NHP and PAS physical health items,
      while HMQ distress correlated well with the NHP emotional reactions and PAS Index
      of Definition. There was significant correlation between self-report and
      psychiatrist ratings, the latter being more sensitive to distress. CONCLUSION:
      The HMQ is a useful measure of generic health status in liaison psychiatry
      settings.

PMID- 7795929
TI  - Prediction of dangerous behaviour in male erotomania.
AB  - BACKGROUND: New cases of erotomania in men, plus cases from the literature, were
      analysed to explore any association between erotomania and dangerousness, and to
      identify possible predictors. METHOD: Files at two in-patient facilities were
      examined to determine the presence of DSM-III-R delusional disorder, erotomanic
      type. The sample (13 cases) was divided into dangerous and benign groups on the
      basis of serious antisocial behaviour directly related to erotomanic delusions.
      These cases were combined with all reports of erotomania in men (16 cases), found
      in the English language psychiatric literature, to allow for statistical
      analysis. RESULTS: Two factors, multiple delusional objects (P < 0.0005) and
      serious antisocial behaviour unrelated to the delusions (P < 0.05), were found to
      be significantly associated with dangerousness. Using a combination of these two
      variables it was possible to predict dangerousness with an accuracy of 88.9%
      (weighted prediction accuracy or 'hit rate'). We identified no false negatives
      but three false positives. CONCLUSIONS: The presence of multiple objects, and a
      history of serious antisocial behaviour unrelated to the erotomanic delusions,
      are useful predictors of dangerous behaviour in men with erotomania.

PMID- 7795930
TI  - Neuroleptic malignant syndrome.

PMID- 7795931
TI  - Predictors of psychiatric morbidity in cancer patients.

PMID- 7795932
TI  - Worcester Development Project and Powick Hospital.

PMID- 7795933
TI  - Effectiveness and efficiency in psychiatry.

PMID- 7795934
TI  - Statistical design, analysis and correspondence.

PMID- 7795935
TI  - Predictors of outcome in the behavioural treatment of OCD.

PMID- 7795936
TI  - Cognitive therapy for panic.

PMID- 7795937
TI  - Home-based versus in/out-patient care for people with serious mental illness.

PMID- 7795938
TI  - Imagery and motor processes.

PMID- 7795939
TI  - Use of different imagery perspectives on the learning and performance of
      different motor skills.
AB  - Two experiments are reported which examine the relative efficacy of different
      imagery perspectives on a slalom type and a gymnastic type task. Twenty-four able
      bodies sport, health and physical education students were allocated to either an
      internal visual imagery group or an external visual imagery group. In both
      experiments subjects watched video-recordings of someone completing the tasks,
      then performed five blocks of three trials with feedback after each block, and
      internal/external visual imagery before each trial. A transfer/retention trial
      was performed one week later. The tasks were a wheelchair slalom task and a
      pseudogymnastics routine performed using rhythmic gymnastics clubs to show static
      positions. The slalom task results suggested that in the retention test, the
      external visual imagery group focused on the speed of performance, whilst the
      internal visual imagery group focused on the accuracy of performance. These
      findings were interpreted as suggesting that internal visual imagery was more
      effective for the planning of action in response to changes in a visual field.
      However, in the gymnastics task, contrary to previous suggestions, external
      visual imagery was found to be more effective than internal visual imagery for
      both learning and subsequent retention. The roles of internal and external visual
      imagery are discussed in terms of task characteristics and the observational
      learning literature.

PMID- 7795940
TI  - Interference effects of mental imagery on a motor task.
AB  - It can be argued that imaginary practice and physical practice are functionally
      similar. Evidence in support of this hypothesis comes from several experiments
      demonstrating that interference effects from imaginary practice in motor learning
      and motor memory are similar in both direction and size to those resulting from
      physical practice. The purpose of the present study was to provide additional
      support for this finding using a retroactive interference paradigm. Sixty
      participants were required to practise performing a simple motor task that was to
      be completed in a criterion time of 700 ms. They then were randomly assigned to
      one of six groups. These groups differed in the amount and type of interpolated
      practice they experienced. One physical practice group attended one session of
      interpolated activity involving physical practice of another motor task. The
      other physical practice group participated in two such sessions. One imagery
      group attended a single session entailing imaginary practice of the same
      interpolated motor task, while the other imagery group had two such sessions. A
      fifth group experienced a combination of physical practice and rest periods for
      two interpolated sessions. A control group did not experience any interpolated
      activity sessions. Following the interpolated activity sessions, all groups were
      given a retention/reacquisition test on the original motor task. Imaginary and
      physical practice during the interpolated activity sessions caused similar
      interference effects on retention/reacquisition. All groups showed greater
      deviation from the criterion movement time (700 ms) during the retention test
      than the control group, and these deviations were in the expected direction given
      the nature of the interpolated motor task.

PMID- 7795941
TI  - On relations between perceiving, imagining and performing in the learning of
      cyclical movement sequences.
AB  - In three experiments, the effects of observational, mental and physical practice
      on the performance of cyclical movement sequences were investigated. Experiment 1
      revealed that repeated demonstrations of the criterion motion were sufficient for
      adequate reproductions of the movement form and that mental or physical practice
      had only small additional effects. Furthermore, consistency of movement tempo and
      consistency of relative timing, normally seen as dependent on physical practice,
      were similar in all experimental conditions at the end of practice. Experiment 2
      confirmed this counter-intuitive finding by demonstrating equivalent improvements
      in the consistency of relative timing after physical and mental practice and
      after practice in a perceptual discrimination task. In Expt 3, discrimination of
      a nonspatial version of the criterion motion from similar patterns was also found
      to enhance consistency, indicating that eye movements were not a crucial factor
      in the observed effects. The findings suggest that performance, observation and
      imagery of sequential patterns involve a common process, characterized as event
      generation, which is either coupled to an articulatory system (in the case of
      physical practice), synchronized with an external event (in the case of
      observational practice), or 'runs free' without such articulatory or perceptual
      coupling in the case of imagery.

PMID- 7795942
TI  - Representation and performance: reproduction of form and quality of movement in
      dance by eight- and 11-year-old novices.
AB  - This study examined the effects of age on the cognitive representations in
      modelling. A total of 48 eight- and 11-year-olds were asked to watch a dancer
      performing a ballet sequence of three steps in order to reproduce it. They were
      able to see the film as many times as they wanted. All subjects were novices to
      dance. Both quantitative (number of observations required to learn the sequence,
      number of steps executed) and qualitative (form and quality of the performance)
      factors were assessed. The results indicated an effect of age on the number of
      requested observations and on the number of subjects able to perform the entire
      movement series. The mean form scores did not differ significantly between the
      two groups, but the mean quality score was higher for the 11-year-olds. We also
      noted a great heterogeneity in the performances. The results are discussed in
      terms of the role of cognitive and motor factors in observational learning by age
      and of the possibilities that cognitive representations offer for coding the
      different properties of movement.

PMID- 7795943
TI  - Visual imagery and enactment of actions in memory.
AB  - It was assumed that self-performing an action necessarily focuses information
      processing on action-relevant information in order to guarantee smooth enactment.
      As a consequence, enacting an action should provide the subjects with excellent
      item-specific information and hinder the subjects from encoding contextual
      information that is not a part of the action proper. These hypotheses were tested
      in paired-associate learning experiments in which unrelated action-verb-pairs
      served as stimuli. Free recall (FR) of the action verbs was considered to
      indicate item-specific encoding, and cued recall (CR)--with one element of a pair
      serving as a cue for the other--to reflect context encoding. The verb-pairs were
      learned essentially under four types of instructions: under standard learning
      instructions (as a control), under enactment instructions, under self-imagery
      instructions, and under other-imagery instructions. The results demonstrated that
      enactment led to better FR than standard learning and the two imagery conditions,
      showing that enactment provides excellent item-specific information. CR was
      equally poor after overt enactment and self-imagined performance and worse after
      standard learning and after imagining somebody else performing an action, showing
      that motor encoding hinders pair integration--i.e. efficient context encoding.

PMID- 7795944
TI  - Visuospatial working memory, movement control and executive demands.
AB  - Developments in the concept of a specialist visuospatial resource in working
      memory owe much to a pair of tasks originally developed by Brooks (1967),
      involving respectively the generation and retention of a mental image of a matrix
      pattern and the retention of a verbal sequence. Previous literature has
      demonstrated that the matrix task calls on cognitive resources which are involved
      in both the processing of visual input and the generation of movement sequences.
      Using dual task methodology, the study reported here demonstrates that the matrix
      and verbal versions of the task do indeed rely on separate, specialized cognitive
      resources, one of which is also involved in generation of action. However, when
      the secondary task (random generation of numbers) was very demanding of general
      purpose cognitive resources both the matrix and verbal tasks were performed
      poorly, suggesting that each of these tasks draw heavily on a common, general
      purpose resource as well as on their respective specialist resources. It is
      argued that random generation offers a means to assess general purpose cognitive
      resources and that the cognitive processes involved in the Brooks tasks may be
      more complex than has been previously assumed.

PMID- 7795946
TI  - Psychophysiological correlates of dynamic imagery.
AB  - Brain Electrical Activity Maps were recorded from 20 subjects whilst performing:
      (a) the Vandenberg & Kuse Mental Rotation Test (MRT) and: (b) the Isaac, Marks &
      Russell Vividness of Movement Imagery Questionnaire (VMIQ), and under control
      conditions. Subjects were classified as good or poor imagers, first on the basis
      of their VMIQ scores, and secondly on their MRT scores. Alpha, beta 1 and beta 2
      at different cortical regions were compared between groups and between task
      performance and control conditions. During MRT significant reductions in alpha
      amplitude were found over both right and left parietal areas and over the left
      frontal region. In beta 1 non-significant trends in the same direction were
      observed in the same regions found to be significant in alpha. Non-significant
      trends in beta 2 were observed over the right parietal and frontal regions. No
      differences in amplitude at any frequency band were found between good and poor
      VMIQ scorers but subjects with high MRT scores showed greater alpha amplitude at
      many sites in the parietal, parieto-occipital and frontal areas than subjects
      with low MRT scores. During VMIQ testing the VMIQ high imagers showed a non
      significant trend towards higher alpha amplitude at frontal regions and some
      scattered parietal and occipital sites and significantly higher levels of beta 2
      in the left frontal region. However, no differences were found between imagery
      and control conditions. The results confirm the involvement of motor as well as
      spatial processes in dynamic imagery.

PMID- 7795945
TI  - Topographical distribution of EEG activity accompanying visual and motor imagery
      in vivid and non-vivid imagers.
AB  - Brain mapping techniques were used to investigate the topographical distribution
      of electroencephalographic (EEG) activity accompanying visual and motor imagery
      in four different tasks. Participants were selected for their self-reported vivid
      or non-vivid imagery using the Vividness of Visual Imagery Questionnaire (VVIQ)
      and the Vividness of Movement Imagery Questionnaire (VMIQ). Topographical maps of
      EEG activation revealed that alpha power was attenuated in vivid images during
      visual imagery, particularly in the left posterior quadrant of the cortex, but
      enhanced during motor imagery. The imagery vividness variable interacted with
      experimental condition or with experimental condition and location in all four
      tasks. Because demand characteristics and instrument artifacts can be eliminated
      as possible explanations of the results, these data provide strong evidence of
      the construct validity of the VVIQ and VMIQ as measures of visual and motor
      imagery experience.

PMID- 7795947
TI  - Global and multidimensional self-concept as a predictor of health practices in
      middle adolescents.
AB  - OBJECTIVE: To describe the relationship between global and multidimensional
      aspects of self-concept and the health practices of adolescents. METHODS: A total
      of 195 adolescents, ages 14-17, who attended two Senior high schools within rural
      county in a Southeastern state completed research questionnaires. RESULTS: The
      adolescents in this sample scored average or slightly above average for global
      self-concept on the Piers-Harris Self-Concept Scale. Adolescents scored lowest in
      the health-related behavior of time spent eating a balanced diet and highest in
      the area of safety. The single highest correlation between self-concept and self
      care practices was between the total health practice score and global self
      concept. CONCLUSIONS: The results suggest that an individual's knowledge,
      feelings of worth related to status at school, and level of anxiety and stress
      are important predictors of health behavior.

PMID- 7795948
TI  - Understanding separation anxiety disorder.
AB  - BACKGROUND: When children are acutely ill and life is threatened, separation
      anxiety can develop in parents and children. Separation anxiety has been studied
      through two traditions--as a normative phenomenon and as a disorder. SOURCE: A
      comprehensive review of the literature. OBJECTIVE: To analyze and evaluate the
      literature to derive clinical and research implications. CONCLUSIONS: Support was
      found for the development of interventions beyond the developmental stage of
      early childhood. The need for a family approach was evident.

PMID- 7795949
TI  - For want of a nail, the kingdom was lost.

PMID- 7795951
TI  - Sadistic statistics.

PMID- 7795950
TI  - Reflection on children and families in bipartisan politics.

PMID- 7795952
TI  - Clomipramine and obsessive-compulsive disorder.
AB  - Clomipramine is a tricyclic antidepressant that was the first effective agent in
      the treatment of OCD. Its capacity to block serotonin reuptake appears to be
      essential to reducing the primary symptoms of OCD. Like other tricyclic agents,
      CMI has an array of possible side effects including gastrointestinal, autonomic,
      hepatic, and cardiac problems that need to be considered in the clinical
      management of children and adolescents treated with CMI. Evaluation of clinical
      response begins with the identification of target symptoms and monitoring the
      change in these target symptoms over time. This effort can be aided by the use of
      clinical rating instruments such as the Children's Yale-Brown Obsessive
      Compulsive Scales and, to a limited degree, drug plasma levels. Although many OCD
      patients manifest a positive response to CMI, some patients do not. This
      variation suggests that other neurochemical systems may be implicated in OCD.

PMID- 7795953
TI  - An interview with Kathleen Scharer, MS, RN, CS, FAAN. Interview by Linda M. Fink.

PMID- 7795954
TI  - It's clear: seclusion is controversial.

PMID- 7795955
TI  - Child bereavement after paternal suicide.
AB  - BACKGROUND: Studies of child suicide survivors are rare and often these studies
      have not included direct interviews with children. OBJECTIVES: To describe the
      bereavement process in a sample of prepubertal children whose fathers died by
      suicide within the previous three years. METHODS: Sixteen prepubertal children,
      their mothers, and a relative or caretaker were interviewed to examine grief,
      trauma, and behavior within 25 months of paternal suicide. RESULTS: Reminiscing
      was the most frequently endorsed grief behavior. Males were more likely than
      females to score above the standard means for CBCL scores. PTSD scores were
      significantly related to parental threats of divorce and exposure to death by
      discovery of the body. CONCLUSIONS: The concept of grief and trauma as separate
      and overlapping phenomena is supported by the study findings.

PMID- 7795957
TI  - Appropriateness of medical care in Europe: a commentary.

PMID- 7795956
TI  - Concerted action programme on quality assurance in hospitals 1990-1993
      (COMAC/HSR/QA). Global results of the evaluation.
AB  - This article describes the global results of the evaluation of a concerted action
      programme on quality assurance in hospitals that was executed between 1990 and
      1993 in a total of 262 hospitals in 15 European countries. The programme aimed to
      introduce quality assurance notions into European hospitals and focused on four
      specific topics; record keeping, prophylactic antibiotic use in surgery,
      preoperative assessment and the prevention of bedsores. Evaluation took place on
      a national level (descriptive country reports), hospital level (questionnaire)
      and topic level (questionnaire and results of QA studies performed in the
      participating hospitals). Different situational and operational factors on
      national, hospital and topic level, that seem to influence the effectiveness of
      strategies for the implementation of quality assurance, are identified. The
      relative importance of these factors is discussed and supported with empirical
      evidence. Part of the analysis is based on quantitative data based on comparing
      the situation in 113 hospitals in 1990 and 1993, before and after the
      intervention.

PMID- 7795959
TI  - Should we assess appropriateness of care in Europe?

PMID- 7795958
TI  - Variation in use of breast surgery and characteristics of hospitals' surgical
      staff.
AB  - OBJECTIVE: To assess whether and how the characteristics of hospitals' surgical
      staff can predict utilization of breast conserving surgery. We anticipated that
      the use of the procedure was more frequent in hospitals with a greater proportion
      of younger and female surgeons on their staff. SETTING: Sixty-two hospitals with
      different level of organization for the care of cancer patient from eight Italian
      regions were included. DESIGN: We collected information on the personal
      characteristics (age and sex) of all surgeons on the staff of the participating
      centers. A concurrent pattern of care study was undertaken, in order to assess
      the utilization of breast conserving procedures. RESULTS: The use of conservative
      surgery was 16%, 20%, 31%, in centers with 0%, < 20% and 20-50% female surgeons
      respectively (p = 0.003), while no associations emerged between the mean age of
      the surgical staff and the use of conservative surgery. This relationship also
      held true after adjusting for other patients' characteristics, such as stage of
      disease, age and presence of comorbidity. However, overall the use of patient
      related and staff-related characteristics to predict the number of breast
      conserving surgeries performed in each area was able to explain only 16% of the
      observed variability in the use of breast conserving surgery. CONCLUSIONS: Even
      though in this study a large proportion of the observed variation in the use of
      breast conserving surgery was still left unexplained, this finding suggests that
      assessing the relationship between doctors' characteristics and the use of
      scientific evidence is an important topic for health service research and can be
      of some help in exploring variations in clinical practice styles.

PMID- 7795960
TI  - The appropriateness of performing coronary angiography in two major teaching
      hospitals in Israel.
AB  - OBJECTIVE: To assess the appropriateness of using coronary angiography in two
      major medical centers in Israel. METHODS: (a) Development of dichotomous
      appropriateness rating by concensus of an expert panel for possible indications
      to use coronary angiography; (b) applying the panel's rating to clinical data
      gathered from interviews and records of 499 patients who underwent coronary
      angiography. RESULTS: Angiographies were performed inappropriately in 58% of
      patients: in 56% neither prognostic stratification was performed, nor was
      comprehensive medical therapy prior to angiography undertaken. Referral to
      catheterization from an acute care hospital, compared to ambulatory referral,
      correlated independently with an inappropriate angiogram. CONCLUSION: In the
      Israeli public health system there is still a high rate of inappropriate coronary
      angiography, most of the cases being due to error in management before performing
      angiographies.

PMID- 7795961
TI  - Effect of panel composition on appropriateness ratings.
AB  - Cholecystectomy is performed frequently and for relatively few indications. An
      all surgical panel agreed on more indications and fewer contra-indications for
      cholecystectomy than a mixed specialty panel but did not approve indications for
      patients with higher comorbidity. In mixed panels subspecialists
      (gastroenterologists) were more conservative than generalists and surgeons.
      Similar findings have been shown for carotid endarterectomy. Comparing the
      results of British and Israeli panels showed variations in rating appropriateness
      that indicate differences in approach between countries. We conclude that the
      composition of panels will influence the assessment of appropriateness.

PMID- 7795962
TI  - Implementing guidelines in general practice. Evaluation of process and outcome of
      care in chronic diseases.
AB  - In a prospective longitudinal study over 21 months the performance of general
      practitioners and the disease status of their patients was measured during the
      formulation and implementation of guidelines on follow-up care. Data on 15
      general practitioners and on 613 patients with hypertension, 95 with diabetes
      mellitus, 66 with chronic ischemic heart disease, 115 with chronic respiratory
      disease, and 17 with osteoarthritis were used for analysis. Performance measures
      were defined and for each disease a disease status indicator was used. The
      possibly modifying effect of compliance of the general practitioner, and of
      patient compliance with the guidelines was taken into account. The general
      practitioners formulated consensus guidelines on follow-up care and implemented
      these guidelines in their practices. The implementation was supported by peer
      review. The performance of general practitioners tended to conform more with the
      guidelines during the study period, especially with regards to actions that
      should be performed routinely. There were no major changes in the disease status
      indicators. Compliant hypertensive patients had a normotensive status more
      frequently than non-compliant patients. Diabetic patients were more likely to be
      normoglycaemic when they received care according to guidelines. None of the
      differences were statistically significant over time.

PMID- 7795963
TI  - Measuring unmet needs to assess the quality of home health care.
AB  - Until now home care research has been primarily focused on functional
      limitations. The instrument presented in this article also takes into account
      needs for psychosocial care, extra information, nursing care, and extra
      arrangements such as adaptations of the house. Elderly people with a chronic
      disease (n = 311) were interviewed using structured questions concerning the
      presence of unmet needs. The six need scales represented two dimensions: needs
      referring to physical functioning and needs referring to psychosocial well-being.
      However, considerable differences were found in the amount of formal and informal
      care and in the presence of unmet needs between the need scales constituting one
      dimension. Indications for construct validity were found for five out of six need
      categories. The results show that, when evaluating home health care, the full
      range of needs has to be considered and the presence of unmet needs can be used
      as an indicator of the quality of home health care.

PMID- 7795964
TI  - Data quality in a DRG-based information system.
AB  - The aim of this study initiated in May 1990 was to evaluate the quality of the
      medical data collected from the main hospital of the "Hospices Civils de Lyon",
      Edouard Herriot Hospital. We studied a random sample of 593 discharge abstracts
      from 12 wards of the hospital. Quality control was performed by checking multi
      hospitalized patients' personal data, checking that each discharge abstract was
      exhaustive, examining the quality of abstracting, studying diagnoses and medical
      procedures coding, and checking data entry. Assessment of personal data showed a
      4.4% error rate. It was mainly accounted for by spelling mistakes in surnames and
      first names, and mistakes in dates of birth. The quality of a discharge abstract
      was estimated according to the two purposes of the medical information system:
      description of hospital morbidity per patient and Diagnosis Related Group's case
      mix. Error rates in discharge abstracts were expressed in two ways: an overall
      rate for errors of concordance between Discharge Abstracts and Medical Records,
      and a specific rate for errors modifying classification in Diagnosis Related
      Groups (DRG). For abstracting medical information, these error rates were 11.5%
      (SE +/- 2.2) and 7.5% (SE +/- 1.9) respectively. For coding diagnoses and
      procedures, they were 11.4% (SE +/- 1.5) and 1.3% (SE +/- 0.5) respectively. For
      data entry on the computerized data base, the error rate was 2% (SE +/- 0.5) and
      0.2% (SE +/- 0.05). Quality control must be performed regularly because it
      demonstrates the degree of participation from health care teams and the coherence
      of the database.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7795965
TI  - Quality in alternative medicine--a rejoinder.

PMID- 7795966
TI  - A dosage system for gamma ray therapy. 1934.

PMID- 7795967
TI  - Magnetic resonance imaging of endocrine tumours of the pancreas.
AB  - Seven patients who had functioning or non-functioning endocrine pancreatic
      tumours were investigated by magnetic resonance imaging. Combinations of fat
      suppressed T1 weighted spin echo and gradient recalled echo (n = 7), T2 weighted
      spin echo (n = 3) and gadolinium diethylamine triamine pentaacetic acid (Gd-DTPA)
      enhanced fat suppressed T1 images were acquired. Magnetic resonance imaging
      detected five of seven tumours prospectively (three of which were smaller than 10
      mm) and a further 10 mm tumour retrospectively. Tumours were low signal on T1
      weighted images and showed enhancement after Gd-DTPA. On T2 weighted images one
      tumour was hyperintense, and two were isointense with normal pancreas. Computed
      tomography, transabdominal ultrasound and angiography were performed in six
      patients but detected only one tumour each. Intraoperative palpation and
      ultrasound detected all tumours. If pre-operative imaging is required magnetic
      resonance imaging is the technique of choice to detect small endocrine pancreatic
      tumours.

PMID- 7795968
TI  - Mediastinal lymph node size in an Asian population.
AB  - There is a high incidence of respiratory tuberculosis in the British population
      of Indian subcontinent (Asian) ethnic origin. Granulomatous diseases can cause
      long term lymph node enlargement. Separate computed tomography (CT) criteria for
      normal nodal size could therefore be necessary when staging thoracic malignancy
      in Asian patients. The objective of this study was to measure mediastinal lymph
      node size in an Asian population, and to correlate nodal size with previous
      tuberculosis. Chest CT scans on all Asian patients over a 5 year period were
      reviewed and those with pulmonary disease, malignancy or grossly distorted
      anatomy were excluded. The study group consisted of 48 patients (26 male, 22
      female) aged 10-75 years (mean 47 years). All nodes were measured and the site of
      those greater than 7 mm was recorded using the American Thoracic Society (ATS)
      lymph node map. 81.3% of patients had nodes less than or equal to 7 mm at all ATS
      stations, 10.4% had nodes of 8-10 mm and 8.3% had nodes greater than 10 mm. All
      nodes measuring more than 7 mm were in regions 4R, 10R and 7. Fourteen patients
      had signs of previous tuberculosis, and in this group 50% had nodes greater than
      7 mm as compared with 6% in the group with no signs of previous tuberculosis (p <
      0.001, X2 test). Despite these differences only four of the 48 patients (8.3%)
      had nodes greater than 10 mm, which is in keeping with other general population
      studies. Thus the generally accepted size criteria for mediastinal lymph node
      enlargement (greater than 10 mm) can reasonably be applied to all Asian patients
      when staging lymphoma or bronchogenic carcinoma.

PMID- 7795969
TI  - Two-dimensional time-of-flight magnetic resonance angiography in the coronal
      plane for abdominal disease: its usefulness and comparison with conventional
      angiography.
AB  - Using two-dimensional time-of-flight magnetic resonance angiography (2D-TOF MRA)
      in the coronal plane, 54 cases of arterial disease and 46 cases of venous disease
      were evaluated. The results were compared with those of conventional angiography
      to establish their relative usefulness for diagnosing abdominal diseases. Using
      2D-TOF MRA, relatively large vessels such as the splenic artery, the trunks of
      the superior mesenteric artery (SMA) and the renal artery were clearly
      visualized. However, smaller vessels such as the gastroduodenal artery, main
      hepatic artery, branches of the SMA and the renal artery were not clearly imaged.
      The diameters of stenotic arteries correlated well with their images on
      conventional angiography (r = 0.953). In the venous system, the splenic, renal
      and portal veins and the first branches of the portal vein bilaterally were
      clearly imaged. Veins, normal or abnormal, less that 5 mm in diameter were not
      clearly imaged using 2D-TOF MRA. 2D-TOF MRA in the coronal plane provided useful
      diagnostic information, especially regarding venous diseases, tumour thrombi in
      the portal vein, renal vein or inferior vena cava (IVC), collateral vessels or
      shunts, vascular malformations, and the relationships between the portal and
      hepatic veins. Limitations encountered in arterial disease did not interfere with
      evaluations of venous disease.

PMID- 7795970
TI  - Audit of the value of double reading magnetic resonance imaging films.
AB  - 100 consecutive magnetic resonance imaging (MRI) examinations were reviewed
      independently by two radiologists. Patients were selected so that the anatomical
      areas of clinical interest coincided with the special interests of the reviewers.
      The reviewers were both consultant radiologists, one with 3 years' and the other
      with 6 years' experience of MRI. Hard copy images from the MRI examinations were
      reported independently by both reviewers. Of the 100 MRI examinations, there was
      full concordance of opinion in 61/100. Of the remaining 39 cases, four (10%) were
      considered "minor unrelated" differences, 12 (31%) "minor related" differences
      and 23 (59%) "major related" differences resulting in a significant change in
      patient management.

PMID- 7795971
TI  - The diagnostic implication of falcine calcification on plain skull radiographs of
      patients with basal cell naevus syndrome and the incidence of falcine
      calcification in their relatives and two control groups.
AB  - The purpose of our study was to identify the incidence of falcine calcification
      shown on plain skull radiographs in people with basal cell naevus syndrome (BCNS)
      and in their relatives compared with a normal population. A population of people
      with BCNS and their relatives was identified on non-radiological grounds and the
      incidence of falcine calcification on skull radiographs in each of these two
      groups was compared with the incidence of falcine calcification in a control
      group of people and of a larger group who attended casualty departments. Falcine
      calcification was graded into dense, fine but definite, and faint. 85 people with
      BCNS had nearly 100% incidence of falcine calcification in adults. 83 first
      degree unaffected relatives showed no excess over "normal" incidence of falcine
      calcification. In the 970 casualty patients some falcine calcification was common
      (> 20%) in males over 30 and in females over 50 years of age. It occurred earlier
      and was more common in males than in females. Dense calcification occurred in 5
      7% of females and males over 60 years of age. Dense calcification was rare (< 2%)
      under the age of 40 years. In conclusion, falcine calcification should be
      regarded as the fourth major feature and a very important diagnostic feature of
      BCNS. An adult labelled as a BCNS sufferer without falcine calcification probably
      has not got the syndrome. The genetic defect responsible for the metabolic defect
      resulting in dural calcification is probably the same as, or in close linkage
      disequilibrium to, that responsible for the major clinical features of the
      syndrome. The age and sex distribution of falcine calcification in a general
      hospital casualty population is described.

PMID- 7795972
TI  - Functional magnetic resonance imaging at 1 T: motor cortex, supplementary motor
      area and visual cortex activation.
AB  - Functional activation of the brain has been visualized using magnetic resonance
      imaging (MRI). Early studies used echo planar imaging and magnetic fields of 2 T
      and above. However, recent studies have successfully shown the activation of
      visual and motor areas of the brain using conventional clinical 1.5 T MRI
      systems. The purpose of the present study was to replicate these studies at a
      lower field strength. Eight motor and two visual activation studies were
      performed using a 1 T clinical scanner. Activation was seen in the contralateral
      motor cortex during motor stimulation in six of the eight volunteers. Activation
      was also documented within the contralateral supplementary motor area in four of
      the six volunteers with motor cortex activation. The supplementary motor area was
      located in the posteromedial aspect of the superior frontal gyrus. Both
      volunteers subjected to photic stimulation showed activation within the visual
      cortex. Results show that functional imaging can be successfully carried out with
      a 1 T clinical scanner. The size of the image intensity on activation change
      suggests that contrast may not be due solely to susceptibility changes.

PMID- 7795973
TI  - Clinical amplitude/velocity reconstructive imaging (CARI)--a new sonographic
      method for detecting breast lesions.
AB  - X-ray mammography and breast ultrasound are methods for the detection of breast
      lesions, especially cancers. They work in a complementary manner, but only X-ray
      mammography can be used for screening purposes because the recent sonographic
      techniques are not as cost-effective, not as fast as mammography, observer
      dependent and, in some instances, not reliable enough. A new ultrasound method is
      described which uses an X-ray-identical examination set-up and the following two
      properties of breast lesions: change of echo patterns behind the lesion and
      increased sound velocity, especially within malignant lesions. These features can
      be imaged on a reference structure, a reflecting plate positioned on the side of
      the breast which is opposite to the transducer. Results of pre-operative
      examinations of 80 patients with 39 benign and 52 malignant lesions are reported.
      Clinical, histopathological, and especially X-ray mammography findings are
      compared. Five cancers were not detectable by ultrasound but had clear suspicious
      signs on X-ray mammography. Nine cancers were not detected by X-ray mammography
      but were clearly visible with the new sonographic examination. By the combination
      of X-ray mammographic findings and their behaviour with the new sonographic
      method some lesions could correctly be identified as benign. The new sonographic
      method works in a complementary way to X-ray mammography. By further technical
      development it could be automated and probably performed as easily, as fast and
      as reproducibly as X-ray mammography. Using this method systematically in
      combination with X-ray mammography the detection rate of breast cancer could
      possibly be increased and unnecessary biopsies of benign lesions could be
      prevented.

PMID- 7795974
TI  - Selection of appropriate ultrasound methods for the estimation of fetal weight.
AB  - Many methods for fetal weight estimation have been proposed. Earlier formulae
      were derived solely by regression analysis but more recently formulae based on
      physical models have been developed. Some of these formulae are lengthy and
      difficult to use. The main purpose of this study was to evaluate a concise area
      based formula developed several years ago against popular and recently published
      formulae. Data from 388 patients over a 5 year period were collected from
      clinically required ultrasound scans performed within 10 days of delivery. Four
      of the seven formulae evaluated proved to be equally accurate over a broad range
      of birthweights (mean absolute deviations 245-249 g), including the area based
      formula and a circumference based formula derived from it. On the grounds of the
      number of terms, the precision of coefficients, the physical meaning and the
      greater accuracy of individual area measurements compared with those derived from
      circumference, the area based formula should be the method of choice.

PMID- 7795975
TI  - A population study of the screening potential of assessment of trabecular pattern
      of the femoral neck (Singh index): the Chingford Study.
AB  - The trabecular pattern of the femoral neck (Singh index) has been used as a
      measure of osteopenia and fracture risk but the value of this method is
      controversial. This study assessed the usefulness of the Singh index (SI) by
      using dual energy X-ray absorptiometry (DXA) as the "gold standard". 659
      Caucasian women (45-70 years) from an age-sex register of a general practice had
      their femoral neck and lumbar spine bone densities measured by DXA and had antero
      posterior hip X-rays performed which were then categorized into six osteopenia
      grades using the SI method. The intraobserver and interobserver reproducibility
      of this method was good (kappa = 0.64 and 0.61, respectively). The SI grades
      correlated significantly with body mass index (r = 0.35) and age (r = 0.17) (p <
      0.001). The mean femoral neck and lumbar spine bone densities were significantly
      higher with increasing SI grade even after adjustment for age and body mass index
      (p < 0.001). The proportion of subjects below the fracture threshold (2 SD below
      mean peak bone mass) decreased with increasing SI grade, ranging from 100% in SI
      grade 2 to 16.8% in SI grade 6. There was, however, wide overlap of bone
      densities between the grades. Using the criteria "osteoporosis < or = SI grade
      4", the sensitivity and specificity of the SI method diagnosing low bone mass was
      35.1% and 90.0%, respectively. These data suggest that the SI is a reproducible
      tool which may detect differences in bone mass between populations or subgroups
      within populations, although caution should be used in classifying individual
      patients because of the wide variation in bone density. The method has a low
      sensitivity but a relatively high specificity in diagnosing low bone mass.

PMID- 7795976
TI  - A method for estimating compressed breast thickness during mammography.
AB  - Measurements of compressed breast thickness during mammography is necessary for
      the calculation of breast dose. In theory, it should be possible to calculate
      breast thickness from the separation of images of radio-opaque markers attached
      to the compression paddle. Such a technique has been evaluated on two models of X
      ray set using simulated and real breasts. The results show that breast thickness
      at a given position can be determined with an average error of about 2 mm by this
      method, which is likely to be adequate for dosimetry.

PMID- 7795977
TI  - Radiotherapy for stages I and II testicular seminoma: results and morbidity in
      238 patients.
AB  - We have undertaken a retrospective analysis of 238 patients with Stages I and II
      seminoma of the testis treated with radiotherapy in Edinburgh between 1974 and
      1989. There were five deaths from seminoma. Cause-specific survival for the whole
      group at 2 and 5 years was 99.2% and 98.1%, respectively. Cause-specific survival
      at 2 and 5 years by stage (Royal Marsden staging classification) was: Stage I,
      99.5% and 98.7% and Stage II, 98.1% and 96.1%. Fourteen (5.9%) patients relapsed
      (one after treatment for his second testicular seminoma). Eight were given
      successful salvage treatment, five died of seminoma and one died of intercurrent
      disease. 13 (5.5%) patients developed World Health Organisation (WHO) grade 3
      gastrointestinal or haematological toxicity and two developed grade 4
      gastrointestinal toxicity as a result of abdominal radiotherapy. 22 patients
      (9.2%) developed problems ascribed to late morbidity of abdominal radiotherapy
      including 18 with peptic ulcer disease. Contralateral testicular tumours occurred
      in seven (2.9%) patients and five (2.1%) patients developed malignancies at other
      sites.

PMID- 7795978
TI  - A comparison of the effects of methotrexate and misonidazole on the germinal
      cells of the subependymal plate of the rat.
AB  - The cytotoxic effects of the drugs methotrexate (MTX) and misonidazole have been
      assessed in the rat brain by quantifying changes in the constituent cell
      populations of a glial cell progenitor layer, the subependymal plate (SEP). Three
      distinct cell types can be identified in the SEP on the basis of their nuclear
      morphology: cells with small dark (SD), small light (SL) or large light (LL)
      nuclei. The cells with SD nuclei may present pluripotential glial cell
      precursors. A reduction in the total nuclear density of the SEP, after the local
      ventricular administration of MTX, could be accounted for largely by a loss of
      cells with SD nuclei; to approximately 45% of control values 2 days after MTX
      followed by a full recovery in numbers by day 5. A further decline in the number
      of cells with SD nuclei occurred at 12 weeks after MTX administration. The
      pattern of changes in the cellularity of the SEP, after misonidazole
      administration, were similar to those observed after MTX treatment, although the
      magnitude of the response was reduced. It was concluded that both drugs, but MTX
      in particular, could have a potential additive effect on glial progenitor cells
      when used in combination with other forms of cancer therapy including radiation.

PMID- 7795980
TI  - Case report: pseudotumoral pelvic retroperitoneal fibrosis associated with
      orbital fibrosis.
AB  - We report the case of a man with bilateral orbital fibrous pseudotumours and a
      large pelvic mass which was initially thought to be malignant. Sonographically
      guided transrectal core biopsies showed it to be a fibrotic retroperitoneal
      pseudotumour. The mass decreased after steroid therapy. The computed tomography
      and magnetic resonance imaging features of this unusual form of pelvic fibrosis
      as well as the association with heterotopic fibrosis are discussed.

PMID- 7795979
TI  - Technical note: multimedia clinical records: results of a pilot project at the
      Radiation Therapy Department of Florence.
AB  - A system based on Macintosh, Hypercard and a local network was developed at the
      University and Hospital Department of Radiation Therapy, Florence, Italy, to
      manage the clinical records as a complex data structure (data, texts, drawings
      and image storage and retrieval). After 4 years, the system produces over 2000
      new charts a year and manages more than 15,000 clinical records. Electronic
      records are produced, printed and updated in their traditional form to be put on
      file in our archive. On-line consultation of the clinical records is possible
      from every workstation of the structure even as it is producing, updating, or
      printing a chart. Physicians and clinical clerks, with different access
      privileges, currently use the system for all these purposes. The clinical records
      are typed by secretaries who receive dictation on microcassettes. No extra staff
      were necessary to set up and manage the system and training was simple. The new
      system changed neither the organization and structure of the traditional records,
      nor the flux of information; new tools (computers, printers and a network) were
      introduced to manage the information and the charts. The author describes the
      aims of the original project and the results.

PMID- 7795981
TI  - Case report: sixth nerve palsy following radiculography.
AB  - Complications following myelography do not usually cause serious disability.
      However, we report a case of sixth nerve palsy where the disability lasted a few
      months. We also discuss the possible pathogeneses.

PMID- 7795982
TI  - Case report: simulated thoracic aortic dissection on magnetic resonance in a
      patient with interruption of the inferior vena cava.

PMID- 7795984
TI  - Case report: therapeutic transcatheter embolotherapy in the control of recurrent
      haemorrhage from lymphoma of the small bowel.
AB  - Lymphoma is one of the commonest primary malignancies of the small bowel.
      Gastrointestinal tract haemorrhage is a relatively infrequent presenting feature
      or complication. We describe the use of repeated transcatheter embolization as
      the primary treatment in the control of recurrent haemorrhage from the small
      bowel in a patient with B-cell lymphoma. Few cases of transcatheter embolotherapy
      have been described in such situations. This form of treatment is a therapeutic
      option in those unfit for transcatheter vasoconstrictor infusion or surgery.

PMID- 7795983
TI  - Case report: intraventricular meningioma with cerebellopontine angle and drop
      metastases.
AB  - A 34-year-old Chinese woman underwent successful gross total excision of a benign
      fibroblastic meningioma, pre-operatively diagnosed by computed tomography (CT),
      arising from the left lateral ventricle of the brain. After a quiescent period of
      5 years, CT and magnetic resonance imaging (MRI) demonstrated tumour recurrence
      at the same site. Despite two further excisions of progressively malignant
      intraventricular meningiomas and treatment with radiotherapy, the patient rapidly
      developed bilateral cerebellopontine angle and spinal drop metastases. CT and MRI
      were useful in demonstrating the location and extent of recurrent
      intraventricular meningiomas, as well as metastatic spread via the cerebrospinal
      fluid.

PMID- 7795985
TI  - Case of the month: all's well that ends well (with apology to W Shakespeare).

PMID- 7795986
TI  - Technetium-99m HMPAO labelled leucocyte scanning in the initial diagnosis of
      Crohn's disease.

PMID- 7795987
TI  - Comparison of conventional Lewis-Tanner two-stage oesophagectomy with the
      synchronous two-team approach.
AB  - Twenty-seven patients with oesophageal carcinoma had subtotal oesophagectomy by
      the Lewis-Tanner operation (group 1, n = 14) or a synchronous modification (group
      2, n = 13). Synchronous operations were completed more quickly (230 versus 305
      min, P < 0.01), but with more time spent under single-lung anaesthesia (160
      versus 120 min, P < 0.01) and a greater fall in systolic blood pressure during
      hiatal manipulation (60 versus 30 mmHg, P < 0.01). Operative blood loss was not
      significantly greater in group 2, but the total volume of blood transfused in the
      peri-operative period was greater in this group (5 versus 3 units, P < 0.01).
      Four patients in group 1 suffered significant postoperative complications,
      compared with seven in group 2; three postoperative deaths occurred in group 2.
      This study suggests that the synchronous two-team oesophagectomy produces a
      higher incidence of complications than the conventional operation. Continued use
      of the Lewis-Tanner two-stage oesophagectomy is recommended for patients with
      carcinoma of the oesophagus.

PMID- 7795988
TI  - Endovascular repair of aortic aneurysm.

PMID- 7795990
TI  - Port site metastases after laparoscopic colorectal surgery for cure of
      malignancy.
AB  - Laparoscopic surgery is excellent for treating benign disease of the colon and
      rectum, and for palliative operations for malignancy. Its application for cure of
      colorectal malignancy, however, must be approached with caution. Port site
      recurrence of tumour is a particular, and increasingly recognized, drawback. This
      review discusses the evidence to date to support prospective randomized trials of
      laparoscopic colectomy for cure of carcinoma.

PMID- 7795989
TI  - Postoperative pain relief.

PMID- 7795991
TI  - Neoplastic lesions of the appendix.
AB  - Neoplasms occur in 0.5 per cent of appendices. Ultrasonography or computed
      tomography is beneficial, but preoperative detection is rare. At operation, the
      diagnosis is considered in under half of cases. Mucocele, localized pseudomyxoma
      peritonei, benign tumours and most appendiceal carcinoids are cured by
      appendicectomy alone. Right hemicolectomy is indicated for: (1) invasive
      adenocarcinoma; (2) tumours close to the caecum; (3) lesions larger than 2 cm;
      (4) mucin production; (5) invasion of the lymphatics, serosa or mesoappendix; and
      (6) cellular pleomorphism with a high mitotic rate. Tumours of 1-2 cm, small
      mucinous carcinoids, adenocarcinoma confined to the mucosa, and tumours in
      children may be treated by appendicectomy alone at the surgeon's discretion. The
      5-year survival rate associated with classical carcinoid is more than 90 per
      cent. The prognosis of mucinous carcinoid is intermediate between that of
      classical carcinoid and well differentiated adenocarcinoma. The prognosis of
      adenocarcinoma is determined by Dukes' stage and is similar, stage for stage, to
      that of colorectal carcinoma.

PMID- 7795993
TI  - Proctographic changes after rectopexy for solitary rectal ulcer syndrome and
      preoperative predictive factors for a successful outcome.
AB  - Rectopexy is advocated as treatment for solitary rectal ulcer syndrome despite
      variable outcome. Sixteen patients with this condition, who remained symptomatic
      after surgery, were examined before and after operation by evacuation
      proctography and compared with a matched group of seven patients whose symptoms
      had been relieved, to investigate the effect of rectopexy on rectal configuration
      or emptying, or both, and to identify any preoperative factor associated with a
      good outcome. Rectal prolapse, demonstrated in 19 of 23 patients before operation
      (internal in 12, external in seven), was seen in only one patient after surgery.
      The rectal axis became more vertical at rest (median 44 degrees before operation
      versus 35 degrees after surgery, P = 0.006) and on evacuation (median 38 degrees
      versus 31 degrees, P = 0.023). Preoperative evacuation time was increased in
      patients with poor outcome (median (range) 22 (8-60)s versus 10 (5-15)s, P =
      0.008). Rectopexy successfully treats rectal prolapse in patients with solitary
      rectal ulcer syndrome and alters rectal configuration. These features, however,
      are unrelated to outcome. Prolonged preoperative evacuation time, suggesting a
      defaecatory disorder, may predict poor symptomatic outcome.

PMID- 7795992
TI  - Bile duct injury and bile leakage in laparoscopic cholecystectomy.
AB  - The introduction of laparoscopic cholecystectomy has been associated with an
      increased incidence of bile duct injury. This review presents the incidence of
      bile duct injury in reported series and examines the role of the learning curve
      and other contributing factors. There is good evidence to suggest that, with
      adequate training and experience, the incidence of biliary injury can be reduced
      to a level comparable to that of open cholecystectomy. Continued audit is
      required to ensure that the low complication rates achieved in selected centres
      with wide experience are reproduced by the surgical community in general.

PMID- 7795994
TI  - Faecal occult blood testing and colonoscopy in the surveillance of subjects at
      high risk of colorectal neoplasia.
AB  - Colonoscopy is the established method of surveillance of subjects at high risk of
      developing colorectal neoplasia but the procedure is expensive, time consuming
      and occasionally hazardous. Faecal occult blood tests can be prepared at home and
      are cheap, simple and safe. Hemeselect is an immunological faecal occult blood
      test that is more sensitive for colorectal cancer than Haemoccult. The aim of
      this study was to determine the sensitivity of the Hemeselect test for
      asymptomatic colorectal neoplasia in subjects at high risk of the disease who
      were undergoing colonoscopy, thus assessing its suitability as an alternative
      means of screening high-risk groups. A total of 919 asymptomatic subjects were
      asked to complete Hemeselect tests. These were completed satisfactorily by 808
      individuals (compliance rate 88 per cent) and were positive in 164 patients (20
      per cent). At colonoscopy 11 cancers were detected in ten patients (seven
      Hemeselect positive) and 36 (16 Hemeselect positive) had at least one adenoma 1
      cm or more in diameter. The test sensitivites of Hemeselect for carcinoma and
      large (1 cm or more) adenomas were 70 and 44 per cent respectively. In a subset
      of 417 subjects who also completed Haemoccult tests, the sensitivities were 33
      and 18 per cent. Hemeselect specificity is 88 per cent compared with 98 per cent
      for Haemoccult. While the sensitivity of Hemeselect is higher than that of
      Haemoccult, it is still insufficient to replace colonoscopy in high-risk groups.

PMID- 7795995
TI  - Risk factors in patients presenting as an emergency with colorectal cancer.
AB  - Of 905 patients with colorectal cancer admitted to a single district general
      hospital, 272 (30 per cent) were admitted as emergencies. Emergency patients had
      more advanced tumours (Dukes stage B and C 96 per cent versus 88 per cent of
      those admitted electively, P < 0.006), a shorter history (median 3 versus 11
      weeks, P < 0.0001), were less likely to be fully ambulatory (44 versus 80 per
      cent, P < 0.0001) and more likely to have abdominal pain (74 versus 51 per cent,
      P < 0.001) and vomiting (40 versus 10 per cent, P < 0.0001). More emergency
      patients were given stomas (56 versus 35 per cent, P < 0.0001) and died in
      hospital (19 versus 8 per cent, P < 0.0001). Of those who survived to be
      discharged, patients admitted as an emergency spent longer in hospital (median
      stay 16 versus 13 days, P < 0.0001) and had a poorer overall 5-year survival rate
      (29 versus 39 per cent, P = 0.0001). Emergency patients were significantly older
      (median 74 versus 72 years, P = 0.04) and much more likely to be widowed (41
      versus 27 per cent, P = 0.0002) than those admitted for elective surgery. If the
      personal and resource disaster of emergency colorectal cancer admission is to be
      reduced, screening strategies targeted by demographic characteristics require
      investigation.

PMID- 7795996
TI  - Laparoscopic caecopexy for caecal volvulus.

PMID- 7795997
TI  - Foley catheter-assisted sutured colorectal anastomosis.

PMID- 7795998
TI  - Seat-belt compression appendicitis.

PMID- 7795999
TI  - Island advancement flaps in the management of anal fissures.
AB  - The classic high-pressure fissure responds well to lateral internal
      sphincterotomy. The management of recurrent fissures and those that occur in
      patients with weak sphincters is open to debate. An island advancement flap
      technique used in 21 patients is described with the above criteria. Preoperative
      median resting anal pressure was 66 (range 43-90) cmH2O and median maximal
      squeeze pressure was 132 (range 76-193) cmH2O, values that were significantly
      lower than in controls and those with classic fissure. Endoanal ultrasonography
      in 15 of these patients showed defects in the anal sphincters. All flaps healed
      primarily with preservation of sensation. Perfect continence was maintained in
      all patients. Follow-up was for a median of 18 (range 2-28) months. There were no
      serious complications. All fissures healed with minimal postoperative discomfort.
      This procedure provides a useful alternative for symptomatic anal fissures, in
      which a sphincter-weakening procedure might jeopardize continence.

PMID- 7796000
TI  - Presentation of comparative audit data.
AB  - The Royal College of Surgeons of England organizes a voluntary comparative audit
      service for its general surgical fellows. To date, the information from the audit
      has been presented purely descriptively, which does not take account of
      statistical variability and the effects of differences in case mix between the
      participants. A new approach to the presentation of these data, based on
      statistical modelling of the effects of case mix, is presented. The approach is
      illustrated in an application based on data relating to 136203 admissions
      reported by 110 surgeons. The result of adjusting for case mix is a substantial
      change in the relative performance of the participating surgeons, which
      demonstrates the folly of attempting to compare surgical performance on the basis
      of a measure as crude as the unadjusted mortality rate. Further development of
      the statistical modelling is required, but this new statistical approach appears
      to enhance greatly the credibility of the audit data, by quantifying its
      strengths and limitations.

PMID- 7796001
TI  - Oesophageal acid clearance in patients with severe reflux oesophagitis.
AB  - Previous studies examining oesophageal acid clearance have employed a variety of
      techniques to induce or simulate acid reflux. Clearance abnormalities have been
      deduced from abnormal standard motility studies, barium radiology or from 24-h pH
      recordings. In this study a 24-h pH and oesophageal motility recording system was
      used to study naturally occurring acid reflux episodes in control subjects and in
      two groups of patients with severe acid reflux disease (erosive oesophagitis and
      oesophageal stricture). Acid clearance was compared between the subject groups.
      Patients with oesophageal stricture were found to have poor oesophageal
      peristaltic ability and particularly poor oesophageal acid clearance. Those with
      erosive oesophagitis had normal peristaltic swallowing but abnormal acid
      clearance. This study has characterized, for the first time, the abnormalities in
      acid clearance during naturally occurring acid reflux episodes in patients with
      severe reflux disease. A more complete understanding of these clearance
      abnormalities could influence future medical and surgical strategies in the
      management of severe gastro-oesophageal reflux disease.

PMID- 7796004
TI  - Radical orchidectomy and benign testicular conditions.
AB  - The records of 149 patients who underwent testicular exploration for suspected
      malignancy were reviewed retrospectively. Malignancy was confirmed in 102
      patients but benign pathology was noted in 47. Patients with benign disease were
      older, more likely to be Asian, gave a longer history and on examination were
      less likely to have a testicular mass. Increased levels of tumour markers, and
      ultrasonographic and operative appearance of the testis were highly predictive;
      with ultrasonography having a sensitivity of 100 per cent but a specificity of
      only 36 per cent for malignancy. Preoperative ultrasonography and an awareness of
      the potentially benign nature of many lesions with the use of frozen-section
      biopsy, where appropriate, may allow a decrease in the currently high rate of
      unnecessary orchidectomy without missing testicular malignancy.

PMID- 7796003
TI  - Breast cancer in a trans-sexual man receiving hormone replacement therapy.

PMID- 7796005
TI  - New method to evaluate the therapeutic value of lymph node dissection for gastric
      cancer.
AB  - The results of 1281 potentially curative resections for advanced gastric cancer
      performed at the National Cancer Center Hospital between 1972 and 1986 were
      studied using a novel approach which circumvents the stage migration phenomenon.
      The incidence of metastasis and the 5-year survival rate of patients with
      positive nodes were calculated independently for each lymph node 'station',
      without any reference to overall pathological nodal stage. The therapeutic value
      of extended lymph node dissection was estimated by multiplication of incidence of
      metastasis and percentage 5-year survival rate of patients with metastasis for
      each station. The incidence of metastasis ranged from 2.4 per cent to 66 per cent
      and the 5-year survival rate of affected patients from 0 to 58.7 per cent in
      perigastric stations, depending on the site of the primary tumour. The incidence
      of metastasis was between 3.0 per cent and 44.4 per cent in the second tier of
      nodes (n2), and the 5-year survival rate ranged from 0 per cent to 47.5 per cent.
      The majority of second-tier stations showed evidence of benefit from node
      dissection.

PMID- 7796002
TI  - Immediate and early follow-up results of purse spray thrombolysis in patients
      with peripheral ischaemia.
AB  - Pulse spray thrombolysis is a technique of accelerated peripheral thrombolysis
      which has been evaluated in 38 patients, 29 with threatened limb viability and
      nine with a viable but critically ischaemic limb. The median length of occlusion
      was 26.5 (range 3-65) cm. The lytic agent used was recombinant tissue plasminogen
      activator (rtPA), injected manually via a pulse spray catheter at a concentration
      of 0.33 mg/ml and a bolus size of 0.2 ml. The median total dose of rtPA was 18
      (range 5-35)mg. Patency and flow were completely restored in 34 of 38 patients
      and clinical success at 30 days was maintained in 27 of 38. The median lysis time
      was 120 (range 35-1125) min, compared with a median duration of 1545 (range 42
      5760) min in 120 consecutive patients previously treated with conventional low
      dose infusion thrombolysis using rtPA. This represents a 12-fold reduction in
      lysis time (P < 0.001). The overall estimated cumulative limb salvage rate for
      the 38 patients who entered the study was 84 per cent and the cumulative patency
      rate for the 34 patients in whom patency was restored was 74 per cent at 18
      months follow-up. Pulse spray thrombolysis rapidly restores patency with good
      limb salvage at 30 days; the benefit is sustained even in patients with limbs at
      immediate risk of irreversible ischaemic injury who are not considered suitable
      for conventional thrombolysis.

PMID- 7796006
TI  - Laparoscopy in the management of patients with cancer of the gastric cardia and
      oesophagus.
AB  - The role of laparoscopy in determining suitability for resection was
      prospectively evaluated in 244 patients with cancer of the gastric cardia and
      oesophagus. Laparoscopy enabled detection of inoperable disease in 92 patients
      (38 per cent), several of whom had more than one contraindication to surgery.
      Hepatic metastases (n = 75, 31 per cent), extensive peritoneal (n = 25, 10 per
      cent) or lymph node involvement (n = 5, 2 per cent) and direct invasion of the
      liver or colon (n = 5, 2 per cent) were considered contraindications to surgery.
      Laparoscopy was poorly tolerated in a further 11 (5 per cent) patients, who were
      not considered suitable for resection. Extra-abdominal metastatic disease was
      detected in 17 patients who appeared normal at laparoscopy, and a further six
      patients refused surgery. The remaining 118 patients underwent laparotomy with a
      view to resection which was successful in 85 (72 per cent). Laparoscopy thus
      prevented ill-advised laparotomy in 103 patients (42 per cent), either because of
      extensive intra-abdominal disease or poor tolerance to anaesthesia. Laparoscopy
      may be a valuable investigation when used to assess the feasibility of resection.

PMID- 7796007
TI  - Splenic abscess.

PMID- 7796008
TI  - Preoperative assessment of lymph nodes in the prediction of disease spread and
      outcome in cancer of the thoracic oesophagus.
AB  - Prospective assessment of lymph node status, based on the findings of computed
      tomography, external ultrasonography and palpation, was compared with clinical
      results in 179 patients who underwent oesophagectomy with systematic node
      dissection. Preoperative findings for each node group were classified into four
      grades: involvement not suspected (-); possible involvement (+/-); probable
      involvement (+); and definite involvement (++). When only (++) or (+) assessment
      was categorized as positive, the specificity was more than 94 per cent, although
      the sensitivity was less than 40 per cent. The preoperative assessment correlated
      significantly with the incidence of node involvement (P < 0.02), the degree of
      lymphatic invasion (P < 0.0001) and outcome after operation. For patients with
      all nodes assessed as (-), the 5-year survival rate was 70 per cent, compared
      with 26 per cent for those with nodes assessed as (++), P = 0.001. Preoperative
      assessment provided useful information on nodal status.

PMID- 7796009
TI  - Helicobacter pylori infection in perforated peptic ulcer disease.
AB  - This study examined a possible aetiological agent, namely, Helicobacter pylori,
      in perforated peptic ulcer disease and its relationship to persisting ulcer.
      Twenty-nine patients with perforated peptic ulcer underwent simple closure of the
      perforation at laparotomy. A 13C urea breath test carried out on the eighth day
      after operation was positive in 24 patients. Fourteen of 17 patients who
      underwent upper gastrointestinal endoscopy 6 weeks after discharge from hospital
      had a positive 13C urea breath test. The biopsy urease test performed on mucosal
      samples taken at endoscopy was positive in 12 of these 14 patients, indicating
      continuing active infection with H. pylori. Seven patients with positive 13C urea
      breath and biopsy urease tests had persisting duodenal ulceration. None of the
      three patients with a negative 13C urea breath test had evidence of duodenal
      ulceration at endoscopy. The association between a high rate of duodenal ulcer
      persistence and a high incidence of H. pylori infection suggests that antibiotic
      therapy to eradicate this microorganism should be given to all patients with
      perforated peptic ulcer disease.

PMID- 7796010
TI  - Laparoscopic technique for small bowel biopsy.

PMID- 7796011
TI  - High amplification of the hst-1 gene correlates with haematogenous recurrence
      after curative resection of oesophageal carcinoma.
AB  - Amplification of the hst-1 gene was examined in 82 patients with oesophageal
      carcinoma by dot blot hybridization to assess the potential of haematogenous
      recurrence after curative resection. Intensity of amplification was considered
      negative (one- to twofold increase) in 45 patients, low (three-sixfold increase)
      in 19 and high (greater than sevenfold) in 18. Haematogenous recurrence after
      curative resection was found in seven of eight patients with high amplification
      and was significantly higher in such patients than in those without amplification
      (P < 0.05). The finding that sevenfold or greater amplification of the hst-1 gene
      seems to be associated with haematogenous recurrence of oesophageal cancer after
      resection may serve to assess the clinical outcome.

PMID- 7796012
TI  - Effect of starch-containing glove powder on wound healing in the rat.
AB  - The effect of the starch-containing powder BioSorb on wound healing was examined
      in an immunocompetent and a T cell-deficient animal model. Wounds were tested by
      tensionometry to give values of resilience, ultimate strength, toughness and
      extension. Starch significantly decreased the resilience (P < 0.03), ultimate
      strength (P < 0.004), and toughness (P < 0.006) of wounds in the immunocompetent
      model but was not shown to affect the healing of wounds in T cell-depleted
      animals. When the uncontaminated wounds of the two groups were compared, those
      from T cell-depleted animals were tougher (P < 0.04) and less extensile (P <
      0.0002). These results suggest that starch impairs wound healing by its effect on
      the T cell-mediated immune system, and that this system may also be involved in
      regulation of the reparative process because its absence leads to tougher wounds.

PMID- 7796013
TI  - H-hernioplasty: a tension-free repair for umbilical hernia.

PMID- 7796014
TI  - Long-term survival in children with renal carcinoma: report of two surgically
      treated cases.

PMID- 7796017
TI  - Choledochal cysts in adults.
AB  - Fourteen adults who presented with choledochal cysts were studied. Symptoms in
      most cases were non-specific, which resulted in delayed diagnosis. Associated
      extracystic hepatobiliary disease occurred in 11 patients, including two with
      cholangiocarcinoma. Nine patients underwent total cyst excision (eight Todani
      classification type I and one type II), while four with type IVa cysts had
      excision of the extrahepatic cyst component. There were no surgical deaths. One
      patient with metastases was treated conservatively. Median follow-up was 6.5
      years. Two of three patients who developed anastomotic strictures underwent
      successful revision surgery, while one with secondary sclerosing cholangitis
      developed biliary cirrhosis and died from hepatic failure after 8 years. Both
      patients with cholangiocarcinoma have died. Ten survivors are well and one
      patient was lost to follow-up. This study highlights the complexity of
      choledochal cysts in adults and emphasizes the need for earlier diagnosis and
      treatment. Cyst excision should be performed where possible, with reconstruction
      modified to deal with the cyst type as well as associated hepatobiliary
      pathology.

PMID- 7796016
TI  - Morbidity and mortality after hepatic resection of metastases from colorectal
      cancer.
AB  - A review was carried out of morbidity and mortality after hepatic resection for
      metastatic colorectal cancer in 208 consecutive patients who underwent this
      procedure between 1980 and 1992. Overall postoperative morbidity and mortality
      rates were 35 and 2.4 per cent respectively. The major morbidity rate was 18 per
      cent, the main complications being intra-abdominal sepsis, biliary fistula and
      haemorrhage. Of the different factors examined, morbidity was significantly
      related to the extent of liver resection (53 versus 21 per cent after major and
      minor resections respectively), amount of blood transfused (18 versus 52 per cent
      for no transfusion and more than 300 ml transfused respectively) and the date of
      the operation (53 versus 24 per cent before and after 1986 respectively).
      Multivariate analysis showed that only the extent of hepatic resection and the
      period at which surgery was performed retained their statistical significance.
      These data support the opinion that surgical treatment of hepatic metastases from
      colorectal cancer is an effective procedure with acceptable mortality and
      morbidity rates. An extensive experience of hepatic surgery is, however,
      necessary to optimize results.

PMID- 7796015
TI  - Laparoscopic cholecystectomy minimally impairs postoperative cardiorespiratory
      and muscle performance.
AB  - Surgery elicits a subjective feeling of postoperative fatigue, at least partly
      related to an impairment in cardiorespiratory function and muscle performance.
      Laparoscopic surgery is reported to impair the patient's condition minimally. The
      aim of this study was to assess exercise performance in patients scheduled for
      elective laparoscopic cholecystectomy. Nine patients assessed as having American
      Society of Anesthesiologists (ASA) grade I were enrolled in the study. Subjective
      feelings of fatigue (measured on a visual analogue scale), and heart rate,
      systemic arterial pressure oxygen consumption and carbon dioxide production
      responses to graded exercise testing, were assessed before operation and on days
      3 and 10 after operation. There were no significant differences in any of these
      measurements, at rest or during exercise, between the preoperative and
      postoperative values. Uncomplicated laparoscopic cholecystectomy does not impair
      postoperative cardiorespiratory and muscle performance or induce significant
      postoperative fatigue in patients with ASA I, allowing rapid recovery.

PMID- 7796019
TI  - Experimental laparoscopic liver resection with a multimodal water jet dissector.

PMID- 7796018
TI  - Improved outcome for children with hepatoblastoma.
AB  - Between 1981 and 1993, 41 children were treated for hepatoblastoma. Clinical,
      radiological and pathological data were reviewed retrospectively, focusing on
      surgical aspects of treatment and outcome. Fourteen children underwent primary
      resection of the hepatic tumour. One infant with severe congenital anomalies
      received only palliative treatment. Of 26 with irresectable disease, pulsed
      cytotoxic chemotherapy (cisplatin and doxorubicin) enabled subsequent surgical
      excision in 22 and one child with persistent extensive intrahepatic disease was
      successfully treated by liver transplantation. Thus, with a policy of selective
      preoperative chemotherapy, 90 per cent of hepatoblastomas were resectable. There
      were no perioperative deaths from haemorrhage but one child died from an
      intraoperative tumour embolus. A total of 28 survivors, 27 of whom are disease
      free, were followed for a median of 5 years. The cumulative probability of
      survival in patients treated with intent to cure was 67 per cent. Analysis of
      survival data suggested a favourable outcome for those with a pure fetal
      histological tumour subtype. These results demonstrate significant progress in
      the treatment of hepatoblastoma.

PMID- 7796020
TI  - Peritoneal seeding of pancreatic cancer following transperitoneal biliary
      procedures.

PMID- 7796021
TI  - A triple bypass procedure for advanced carcinoma of the neck of gallbladder.

PMID- 7796022
TI  - Management of Mirizzi syndrome by laparoscopic cholecystectomy and laparoscopic
      ultrasonography.

PMID- 7796023
TI  - Combined liver transplantation and pancreatoduodenectomy for irresectable hilar
      bile duct carcinoma.

PMID- 7796025
TI  - Intraluminal stapled laparoscopic cystogastrostomy for treatment of pancreatic
      pseudocyst.

PMID- 7796024
TI  - Lymph node metastases in carcinoma of the head of the pancreas region.
AB  - Histopathological examination of lymph node metastatic involvement in 139
      specimens obtained from patients who underwent pancreatoduodenectomy or total
      pancreatectomy combined with wide resection of lymph nodes was performed, to
      clarify the critical areas of lymph node dissection in patients with carcinoma of
      the head of the pancreas region. Perigastric lymph node involvement in patients
      with carcinoma of the head of the pancreas was 14 per cent, in those with
      carcinoma of the distal bile duct 0 per cent and in those with carcinoma of the
      papilla of Vater 4 per cent. Para-aortic lymph node involvement in patients with
      carcinoma of the head of the pancreas, the distal bile duct and the papilla of
      Vater was 26, 9 and 0 per cent, respectively. On the basis of these results,
      pylorus-preserving pancreatoduodenectomy is indicated in almost all patients with
      carcinoma of the distal bile duct and the papilla of Vater. In patients with
      carcinoma of the head of the pancreas, however, wide dissection of lymph nodes,
      including para-aortic lymph nodes, should be carried out because of the
      relatively high incidence of para-aortic lymph node involvement.

PMID- 7796026
TI  - Modified dunking pancreatojejunostomy for a soft pancreas.

PMID- 7796027
TI  - Spontaneous splenic rupture during total vascular occlusion of the liver.

PMID- 7796028
TI  - Risk-adjusted analysis of surgeon performance: a 1-year study.
AB  - A 1-year prospective analysis was undertaken of all non-day-case general surgery
      in a district general hospital. Using the Physiological and Operative Severity
      Score for the enUmeration of Mortality and Morbidity (POSSUM) scoring system 3004
      patients were assessed. From the predictions of mortality and morbidity so
      obtained, a quality measure, the ratio of observed to expected numbers of deaths
      and complications (O:E ratio) was determined for each surgeon, both overall and
      within specialty zones. The present study demonstrates the serious hazard in
      using 'raw' uncorrected mortality and morbidity statistics to compare surgeon
      performance. Mortality rates varied from 1.0 to 4.9 per cent whereas O:E ratios
      ranged from 0.83 to 1.06; morbidity rates varied from 5.3 to 12.6 per cent with
      O:E ratios 0.86-1.02. Great misunderstanding may result from the publication of
      surgeon or hospital 'league tables'. The present study demonstrates a technique
      that might allow surgeon performance to be monitored adequately and accurately.

PMID- 7796029
TI  - Lateral tracheostomy in patients with cervical spinal cord injury.

PMID- 7796032
TI  - Early results with Lichtenstein tension-free hernia repair.

PMID- 7796031
TI  - Early results with Lichtenstein tension-free hernia repair.

PMID- 7796030
TI  - Human intraperitoneal fibrinolytic response to elective surgery.
AB  - Intra-abdominal adhesions develop in over 90 per cent of patients undergoing
      laparotomy. Peritoneal fibrinolysis is believed to be important in the
      pathophysiology of adhesion formation. This study investigated the fibrinolytic
      response of postoperative peritoneal fluid in 12 patients undergoing elective
      laparotomy. There was a significant reduction in the plasminogen activating
      activity to undetectable levels at 24 h, which was sustained at 48 h (P < 0.05).
      While there was an early reduction in the concentration of tissue plasminogen
      activator (median 40.0, 28.2, 16.3 and 31.9 ng/ml at 2, 6, 24 and 48 h
      respectively; P < 0.05), the abolition of functional fibrinolytic activity
      appeared to be secondary to a marked increase in the concentration of plasminogen
      activator inhibitor (PAI) 1 (median 86, 196, 800 and 730 ng/ml at 2, 6, 24 and 48
      h respectively; P < 0.05) and PAI-2 (median less than 6, 12, 155 and 245 ng/ml at
      2, 6, 24 and 48 h respectively; P < 0.05). This reduction in the plasminogen
      activating activity of peritoneal fluid may favour the formation of permanent
      fibrous adhesions following surgery.

PMID- 7796034
TI  - Randomized trial of modified Bassini versus Shouldice inguinal hernia repair.
      Further comment.

PMID- 7796033
TI  - Early results with the Lichtenstein tension-free hernia repair.

PMID- 7796035
TI  - Long-term results of highly selective vagotomy: a prospective study with
      implications for future laparoscopic surgery.

PMID- 7796036
TI  - Stripping of the long saphenous vein in the treatment of primary varicose veins.

PMID- 7796037
TI  - Radiotherapy and management of the axilla in early breast cancer.

PMID- 7796038
TI  - Portal pyaemia following flexible sigmoidoscopy.

PMID- 7796039
TI  - Diabetes impairs the development of early strength, but not the accumulation, of
      collagen during intestinal anastomotic healing in the rat.

PMID- 7796040
TI  - Kidney retrieval from asystolic donors: a valuable and viable source of
      additional organs.

PMID- 7796041
TI  - Patterns of reflux in recurrent varicose veins assessed by duplex scanning.

PMID- 7796042
TI  - Comparative audit of colorectal resection with the POSSUM scoring system.

PMID- 7796043
TI  - Simple method of tightening cutting setons.

PMID- 7796044
TI  - Enantioselective deoxygenation of alkyl aryl sulfoxides by DMSO reductase from
      Rhodobacter sphaeroides f.s. denitrificans.
AB  - The substrate specificity and enantioselectivity of DMSO reductase from
      Rhodobacter sphaeroides f.s. denitrificans were studied on a series of alkyl aryl
      sulfoxides as substrate. The enzyme was found to catalyze deoxygenation of (S)
      sulfoxides predominantly. (R)-Sulfoxides were recovered with a high enantiomeric
      excess.

PMID- 7796045
TI  - The receptor binding affinity of monocyclic [Ala3,Xaa11]endothelin-1 analogs
      correlates with inducible helix length.
AB  - Endothelin-1, a bicyclic 21-amino acid peptide with disulfide bridges between
      cysteines 1 and 15 as well as between cysteines 3 and 11, has been reported to be
      partially helical based on both CD and NMR data. However, this remains an area of
      controversy with some claims that CD data indicate no alpha-helical structure
      (Calas, B.; Harricane, M.-C.; Gulmard, L.; Heitz, F.; Mendre, C.; Chabrier, P.E.;
      Bennes, R. Peptide Res. 1992, 5, 97) and a recent X-ray crystal structure placing
      the helix at a different locus (Janes, R.W.; Peapus, D.H.; Wallace, B.A.
      Structural Biology 1994, 1, 311). The CD studies reported herein indicate that
      the helical structures reported in NMR studies (e.g. Andersen, N.H.; Chen, C.;
      Marschner, T.M.; Krystek, Jr. S.R.; Bassolino, D.A. Biochemistry 1992, 31, 1280)
      apply to pure aqueous media as well. The helix located from Lys9 to the
      Cys15/His16 juncture is ca 75% populated in pH 4 aqueous buffer. Titration
      difference CDs reveal that the helix extent increases by one to two residues and
      that the 'helical conformation' is more completely populated upon addition of TFE
      to 50+ volume-%. Comparison with a more helical analog suggests that the helix
      propagates towards (but not to the end of) the C-terminus upon fluoroalcohol
      addition. A variety of monocyclic derivatives of [Nle7] ET-1 lacking the 3,11
      disulfide were evaluated for biological activity and examined by TFE titration
      difference CD. The series included an Aib11 and a Pro11 analog. The helix
      promoting Aib analog was the most active while the Pro analog exhibited
      significantly lower vasoconstrictor activity and binding affinity for the ETA
      receptor. All of the monocyclic analogs became significantly more helical upon
      addition of fluoroalcohols. The inclusion of a proline residue at position 11
      does not preclude helix formation upon addition of fluoroalcohols. Rather, helix
      formation is relatively easily induced but limited to a 5 residue span.
      Apparently this is insufficient to orient required side chains optimally for
      interaction with the ETA receptor. For the 1,15-monocyclic analogs differing only
      at position 11, ETA binding affinity and vasoconstrictor potency correlate with
      the facility which a 7-8 residue long helix can be induced. This presumably
      includes the segment Glu10-->Cys15 in all cases and may represent the full
      sequence from Lys9-->His16. CD studies also reveal that the C-terminal fragment
      of endothelins is not a fully disordered 'random coil' either alone or attached
      to the endothelin core.

PMID- 7796046
TI  - Isoxazoline derivatives as potential inhibitors of the proteolytic enzymes human
      leukocyte elastase, cathepsin G and proteinase 3: a structure-activity
      relationship study.

PMID- 7796047
TI  - Synthesis and biological properties of a series of optically active 2
      oxaisocephems.
AB  - A novel series of (6S, 7S)-3,7-disubstituted-8-oxo-1-aza-4-oxabicyclo[4.2.0]oct-2
      ene-2- carboxylic acids 9a-o, parenteral optically active 2-oxaisocephems, was
      synthesized, and in vitro and in vivo activities were determined against Gram
      positive and Gram-negative bacteria. The 7-[2-(2-aminothiazol-4-yl)-2-(Z)
      cyclopentyloxyimino]acet arnido derivatives, 9g, 9m and 9o, had enhanced
      antibacterial activity against Gram-positive organisms including methicillin
      resistant Staphylococcus aureus (MRSA) and Enterococcus faecalis while
      maintaining Gram-negative activity. It is also significant that these compounds
      showed more potent activity against MRSA and E. faecalis isolates than cefuzonam
      (10) and flomoxef (12), which are the most popular third-generation antibiotics.
      The combination of the 7-[2-(aminothiazol-4-yl)-2-(Z)
      cyclopentyloxyimino]acetamido group and 2-oxaisocephem nucleus contributes to the
      increased antibacterial activity against these clinical isolates. The 7-[2-(2
      aminothiazol-4-yl)-2-(Z)-cyclopentyloxyimino]acet ami do derivative 9g provided
      good subcutaneous efficacy and exhibited more potent activity than cefmenoxime
      (11) against the systemic infection with S. aureus Smith in mice. The compound 9a
      with a [2-(2-aminothiazol-4-yl)-2-(Z)-methoxyimino]acetamido group at the 7
      position showed high in vivo efficacy on the experimental infection caused by
      Escherichia coli No. 29 in mice.

PMID- 7796048
TI  - Synthesis and anti-HIV activity of new urea and nitrosourea derivatives of
      diamino acids.
AB  - A series of N1-methyl,N1-allyl,N1-(2-chloroethyl) and N1-propargyl urea and
      nitrosourea derivatives of diamino acids (L-ornithine and L-lysine) was
      synthesized and was shown to have weak activity in counteracting the cytopathic
      effects of the HIV-1 on a T4 lymphocyte cell line (CEM-IW). However, selected
      compounds may possess some immunomodulatory activity.

PMID- 7796049
TI  - Facile synthesis of a new type of iminosugar: a nitrogen atom is in the anomeric
      position.

PMID- 7796050
TI  - Structure-activity studies of sulfate transfer: the hydrolysis and aminolysis of
      3'-phosphoadenosine 5'-phosphosulfate (PAPS).
AB  - The pH-rate profile for the hydrolysis of 3'-phosphoadenosine 5'-phosphosulfate
      (PAPS) in aqueous solution has been measured. Comparison with other data suggests
      that hydrolysis occurs by almost complete unimolecular elimination of sulfur
      trioxide, with weak involvement of a molecule of water in the transition state.
      The catalytic power (kcat/kuncat) of the sulfotransferases is estimated to be in
      the order of 10(10)-10(12). Amines--exemplified by morpholine--react
      spontaneously with PAPS in water at 39 degrees C by attack at both sulfuryl and
      (5')phosphoryl groups in a ratio of 2:3. The mechanism of activation of the
      coenzyme, PAPS, by the sulfotransferases that catalyse N-sulfation must involve
      suppression of its native N-phosphorylating reactivity and specific enhancement
      of its N-sulfating reactivity. Studies of the aminolysis of the coenzyme in
      aprotic solvent-water mixtures suggest how this might be accomplished.

PMID- 7796051
TI  - The cyano-NNO-azoxy function in the design of an irreversible label for alpha 1
      adrenoreceptors.
AB  - A potential alpha 1-adrenergic irreversible antagonist 6, containing the cyano
      NNO-azoxy function was synthesized and tested. The effects of norepinephrine on
      rat thoracic aorta were irreversibly blocked by this compound at the
      concentration of 1 x 10(-5) M after 60 minutes. Binding studies showed that 6, at
      1 x 10(-6) M, did not modify the KD of Prazosin and caused a 30% decrease of the
      Bmax. Substitution in 6 of the bis (2-chloroethyl)amino moiety for the cyano-NNO
      azoxy function afforded 7 which behaves as an irreversible antagonist able to
      change KD of Prazosin without influencing Bmax.

PMID- 7796052
TI  - Dioxides of bicyclic thiadiazines: a new family of smooth muscle relaxants.
AB  - The synthesis of dioxides of bicyclic thiadiazine related to diazoxide has been
      achieved. In a preliminary test, some of these compounds show smooth muscle
      relaxation similar to that obtained with the reference standard diazoxide.

PMID- 7796053
TI  - The Gabriel-Colman rearrangement in biological systems: design, synthesis and
      biological evaluation of phthalimide and saccharin derivatives as potential
      mechanism-based inhibitors of human leukocyte elastase, cathepsin G and
      proteinase 3.
AB  - The results of a structure-activity relationship study focusing on the
      interaction of a series of phthalimide and saccharin derivatives with leukocyte
      elastase, cathepsin G and proteinase 3 are described. The phthalimide derivatives
      were found to be inactive while some of the saccharin derivatives were found to
      be fair inhibitors of these enzymes.

PMID- 7796054
TI  - The mechanism of Escherichia coli tryptophan indole-lyase: substituent effects on
      steady-state and pre-steady-state kinetic parameters for aryl-substituted
      tryptophan derivatives.
AB  - We have examined the reaction of Escherichia coli tryptophan indole-lyase with
      fluoro, chloro, methyl and hydroxytryptophans using steady-state kinetics, rapid
      scanning and single wavelength stopped-flow spectrophotometry, and rapid chemical
      quench methods. All of the 16 tryptophan derivatives examined are substrates for
      alpha, beta-elimination catalyzed by tryptophan indole-lyase. The steady-state
      kinetic parameter, kcat/Km, did not show a consistent trend with the steric bulk
      of the substituent, but Km increased for larger substituents. Rapid-scanning
      stopped-flow spectra show that all tryptophan analogues undergo covalent reaction
      with the pyridoxal-5'-phosphate cofactor to give equilibrating mixtures of
      external aldimine and quinonoid intermediates, but the relative amounts of each
      intermediate are strongly dependent on the nature and position of the
      substituent. The dissociation constants for external aldimine formation, Kd,
      obtained from single-wavelength stopped-flow experiments decreased for most
      substituted tryptophans, which suggests that part of the binding energy is
      derived from hydrophobic interactions between the enzyme and the indole ring of
      tryptophan. In contrast, the rate constants of quinonoid intermediate formation
      and reprotonation and of indole elimination were quite variable, depending on the
      position and the nature of the substituent. Overall, 6-substituted tryptophans
      have the most consistent reactivity, which indicates that there may be space in
      the enzyme active site near the 6-position. There is a good linear correlation
      between log (kcat/Km) and log (kf/Kd) (apparent second order rate constant for
      quinonoid intermediate formation), with a slope of 0.66. This suggests that
      quinonoid intermediate formation contributes only about 66% of the activation
      energy for the reaction, and thus a later step in the reaction must be partially
      rate-limiting. Rapid chemical quench experiments demonstrate a 'burst' of indole
      in the reaction of L-tryptophan under single turnover conditions, confirming that
      a step subsequent to the elimination is partially rate-determining. In contrast,
      5-methyl-L-tryptophan does not exhibit a significant 'burst', suggesting that 5
      methylindole elimination is nearly completely rate-determining. These results
      support the proposed mechanism and demonstrate that there are significant effects
      of aryl substituents on the distribution of covalent intermediates and on the
      rate-determining step in the alpha, beta-elimination reaction catalyzed by E.
      coli tryptophan indole-lyase.

PMID- 7796055
TI  - Visualizing taste papillae in vivo with scanning electron microscopy of a high
      resolution cast.
AB  - A method using polyvinylsiloxane (PVS), a high-resolution dental impression
      material, to obtain negative images of lingual surfaces is described. Epoxy-resin
      tongue replicas made from these impressions were examined with scanning electron
      microscopy (SEM). This method has been developed to visualize structural details
      of the tongue surface of living human beings and laboratory animals. The utility
      of the method is demonstrated with hamster tongues, which have well-defined
      fungiform papillae with single taste pores, and human tongues, which have more
      variable surface structures. Replicas made from PVS impressions of tongues of
      living hamsters were compared with the same tongues after fixation. The replicas
      contained much of the detail present in fixed tongues. With SEM, it was possible
      to identify individual fungiform papillae, which contained depressions with the
      size and the location of hamster taste pores. Individual papillae could also be
      recognized in human-tongue replicas, but taste pores could not be identified with
      certainty. These replicas provide permanent, three-dimensional records of tongue
      topography that could be used to document changes due to trauma, disease and
      aging.

PMID- 7796056
TI  - Taste bud cell generation in the perihatching chick.
AB  - Chick taste bud primordia initially appear in late gestation on embryonic day 17
      (E17), 4 days before hatching. To track DNA synthesis and subsequent taste bud
      cell proliferation between E17 and the second day post-hatching (H2), single 25
      muCi injections of tritiated thymidine (specific activity = 72.5 Ci/mmol) were
      administered in ovo during E15, E16, E17 or E18. Anterior mandibular oral
      epithelium was processed for light microscopic autoradiography. Sections through
      each taste bud's center were analysed for label (> or = 6 silver grains/gemmal
      cell nucleus), and bud diameter. Results indicated a major part of gemmal cell
      DNA synthesis does not occur until after E19 irrespective of the day of thymidine
      injection, suggesting postmitotic or quiescent (decycled) cells assemble to form
      the early bud primordium (E17-19) based on local tissue interactions. All buds
      examined from E20-H2 contained labelled cells. The day of injection was important
      since 5-day survival cases after E16 injection yielded about 25% the number of
      labelled cells/bud as compared with equivalent survival cases following E17-18
      injections. These results are discussed with respect to parallel changes in bud
      shape and increasing bud diameter, and cell proliferation in possible extra- and
      intragemmal sources of bud cells.

PMID- 7796058
TI  - Effect of amiloride on the taste of NaCl, Na-gluconate and KCl in humans:
      implications for Na+ receptor mechanisms.
AB  - Sodium-salt transduction in many species may be mediated by both apical and
      submucosal ion channels on the taste receptor cell membrane. The apical ion
      channel is blockable by the diuretic amiloride, whereas the submucosal pathway is
      not. Sodium salts with small anions, such as NaCl, can stimulate submucosal as
      well as apical ion channels; sodium salts with large anions, such as Na
      gluconate, activate primarily the apical channels. In humans, reports on the
      effects of amiloride on the taste of NaCl are conflicting and no data exist on
      the effects of amiloride on organic sodium salts. In the present experiment,
      subjects gave magnitude estimates of the total intensity and of each of the basic
      taste qualities for NaCl, Na-gluconate and KCl. Five concentrations of each of
      these stimuli were presented to the anterior tongue following distilled water
      adaptation and after amiloride treatment. There was a significant decrease in the
      total taste intensity of NaCl and Na-gluconate after amiloride, but no effect on
      KCl. The saltiness of all three salts was unaffected, but amiloride decreased the
      perceived sourness of the sodium salts. KCl sourness was unaffected by amiloride.
      There was a proportionately larger effect of amiloride on Na-gluconate than on
      NaCl, which is consistent with a larger role for the apical ion channel in Na
      gluconate transduction. However, an appreciable amiloride-insensitive component
      is present for both NaCl and Na-gluconate, suggesting that an amiloride
      insensitive pathway also plays a role in the transduction of both sodium salts.
      These data support the hypothesis that an amiloride-sensitive transduction
      component exists in humans, but suggest that it is considerably smaller than in
      many other species.

PMID- 7796057
TI  - Pain-reducing properties of sucrose in human newborns.
AB  - To assess the characteristics of sucrose as a pain-reducing substance, crying in
      72 newborn humans during and after blood collection via heel prick was
      determined. In the first study infants drank 2 ml of water or 2 ml of a 0.17-0.34
      or 0.51-M sucrose solution 1 min prior to blood collection. In the second
      experiment, a delay of 30, 60, 90, 120 or 240 s was imposed between sucrose
      intake and the initiation of blood collection. The dose-response function for
      concentration was flat. The most effective time delay was 120 s. The
      effectiveness of the 2-min interval accords with previous findings of endogenous
      opioid release caused by sucrose taste. The flat dose-response function extends
      findings in rats and humans that the calming and pain-reducing effects of sucrose
      are not influenced by either concentration or volume, suggesting that the
      transduction from gustatory afferent to opioid-mediated efferent is of an on-off
      nature and not graded.

PMID- 7796059
TI  - The taste-active regions of monellin, a potently sweet protein.
AB  - Monellin, a protein found in the berries of the West African plant
      Dioscoreophyllum cumminsii, is one of the most potently sweet compounds known.
      The native three-dimensional structure of monellin is required for sweetness, and
      this protein has been the subject of intense research in an attempt at
      understanding the structural basis for its taste activity. We have used structure
      based site-directed mutagenesis to delineate the taste-active site(s) of
      monellin, and we present these results, along with similar work from M. Kohmura,
      Y. Ariyoshi and coworkers, in the light of the three-dimensional structure of
      this protein. The mutagenesis work suggests that at least four residues, located
      N-terminal to the alpha-helix, form part of a taste-active region of monellin. In
      addition, there is evidence that a second region, formed by residues in the
      fourth and fifth beta-strands, may also be contributing to monellin's activity.

PMID- 7796060
TI  - Porcine VEG proteins and tear prealbumins.
AB  - Small soluble proteins, belonging to the lipocalin family are secreted in large
      amounts by tongue von Ebner's glands and lachrymal glands. In humans, the lingual
      protein, called VEG, and the lachrymal protein, called tear prealbumin, have
      shown identical cDNA sequences. In the pig, we have purified homodimeric proteins
      with subunits of 17 kDa, both from von Ebner's glands and from lachrymal glands.
      In both cases, the proteins can be resolved into two isoforms on a
      chromatofocusing column. Partial aminoacid sequences and full cDNA sequences have
      been obtained for the more abundant forms purified from both tissues. The two
      proteins appear to be identical, as in humans. The reason why the same protein is
      expressed in different tissues, as well as its physiological function, still
      remain to be clarified.

PMID- 7796062
TI  - ECT at mid-decade: two steps forward, one step back.

PMID- 7796061
TI  - Variation in odor thresholds for l-carvone and cineole and correlations with
      suprathreshold intensity ratings.
AB  - Specific anosmias have been reported for l-carvone and cineole, two compounds of
      importance in food flavor perception. Detection thresholds were assessed in
      groups of 50+ individuals by ascending forced-choice tests conducted in
      quadruplicate. Wide individual differences in thresholds were observed. Within
      the same session, threshold correlations were in the range of +0.8 to +0.9,
      showing good short-term reliability. Correlations with suprathreshold ratings
      were moderate (in the range of r = -0.5) after subtraction of false positive
      ratings for blank samples. However, a cineole mixture experiment failed to show
      any differences between subgroups that were previously classified as high or low
      sensitivity on the basis of threshold measurements. Re-testing selected groups
      after a period of months showed considerable within-individual variation in the
      thresholds, especially for l-carvone. These results call into question the
      stability and utility of threshold classification for these two compounds.

PMID- 7796063
TI  - Maintenance ECT: indications and outcome.
AB  - Maintenance electroconvulsive therapy (M-ECT) is used to prevent recurrence of
      depression. Indications regarding patient selection criteria and efficacy are
      uncertain, in part because data are lacking. Comparison of M-ECT patients (N =
      21) with controls demonstrates that M-ECT is chosen for patients whose course is
      characterized by multiple hospitalizations and failure to adequately respond to
      other therapies. M-ECT patients were exposed, on average, to 10 different
      psychotropic medications, including five trials of tricyclic antidepressants.
      Greater than half of their cumulative hospitalizations were for ECT. Their rate
      of rehospitalization decreased by 67% after institution of prophylactic M-ECT,
      demonstrating treatment efficacy. A tendency toward relapse and rehospitalization
      remains when M-ECT patients are compared to controls.

PMID- 7796064
TI  - Prolactin release and clinical response to electroconvulsive therapy in depressed
      geriatric inpatients: a preliminary report.
AB  - Fifteen inpatients (nine women, six men) aged 50-86 years with DSM-IIIR major
      depression were treated with electroconvulsive therapy (ECT). Electrode placement
      (unilateral versus bilateral) and total number of treatments were determined by
      the patients' own psychiatrists according to clinical indications. Prolactin
      (PRL) was determined after the 1st, 6th, 7th, 9th, 11th, and final ECT
      treatments. Subjects were rated with the Hamilton Depression Rating Scale (HDRS)
      at baseline, after the sixth ECT treatment, and upon completion of ECT. PRL
      response to unilateral ECT was consistent across treatment for each subject.
      Percentage PRL increase was significantly higher for bilateral than unilateral
      ECT (alpha = 0.05). Subjects with final HDRS of < 12 tended to have greater peak,
      increase, and percentage increase PRL at the first unilateral treatment than
      subjects with final HDRS of at least 12; these trends approached statistical
      significance (Kruskal-Wallis one-way analysis of variance; peak: p = 0.059, chi =
      3.556, df = 1; increase: p = 0.099, chi = 2.722, df = 1; percentage increase: p =
      0.099, chi = 2.722, df = 1). Decrease in HDRS after the sixth treatment failed to
      show a statistically significant relationship to any PRL parameter at the initial
      unilateral treatment. Further studies are needed to characterize the relationship
      between PRL response, seizure activity, and stimulus dosing.

PMID- 7796065
TI  - Effects of electroconvulsive therapy on plasma GABA.
AB  - There are no published data on the effects of seizures on indices of gamma
      aminobutyric acid (GABA) function in human subjects. In study 1, the effects of
      electroconvulsive therapy (ECT) on free plasma GABA were studied in 39 inpatients
      with major depressive disorder. Acutely after ECT, free plasma GABA was
      significantly reduced for up to 1 h after seizure termination, and this finding
      replicated strongly in a subgroup of six patients who received a second course of
      ECT. In a second study at a different site that compared sham ECT and real ECT in
      seven patients, some doubt was raised about the replicability of the acute effect
      of ECT on GABA levels. Nonetheless, the strength of the findings in the larger
      study 1 sample suggests that, unlike virtually all other biochemical indices,
      free plasma GABA may be reduced acutely after ECT. This acute decrease could
      reflect decreased levels of GABA in brain extracellular space or decreased brain
      turnover. In study 1, compared with ECT nonresponders, ECT responders had higher
      GABA levels at both baseline and after a course of ECT. Because plasma GABA
      levels are known to be low in a subset of patients with major depression, the
      higher GABA levels observed in clinical responders before and after the ECT
      course indirectly suggest that patients least abnormal in GABA levels may show
      superior clinical response. This also suggests that low plasma GABA is not a
      state marker for depression.

PMID- 7796066
TI  - Patient knowledge about electroconvulsive therapy: effect of an informational
      video.
AB  - We wished to ascertain whether the addition of an informational video to the
      informed consent procedure for electroconvulsive therapy (ECT) results in
      improved patient knowledge about ECT. Eighteen ECT patients were randomized to
      consent using the usual written document or using the written document and an
      informational video. The two groups were similar when compared on demographic
      variables and scores on the Brief Psychiatric Rating Scale (BPRS) and Mini-Mental
      State Examination (MMSE). Each subject, just after signing the informed consent
      document, was administered an 8-question ECT knowledge questionnaire. The
      addition of an informational video to the consent process for ECT did not result
      in improved knowledge about ECT. Poor knowledge about ECT might be accounted for
      by unsuccessful communication from the doctors or cognitive impairment and apathy
      on the part of the patients. One benefit of the video was increased interest from
      family members in ECT and the consent process.

PMID- 7796067
TI  - Radiographic screening for ECT: use and usefulness.
AB  - Members of the Association for Convulsive Therapy were surveyed by mail about use
      of muscle relaxants and radiologic studies for ECT. One hundred eleven completed
      responses were received (69%), indicating that 40% routinely acquire pre-ECT
      spine and skull radiographs taking from 1 to 10 films. From patients receiving
      more than one course of ECT, 57 pre- and post-ECT pairs of films taken within 1
      month of the start and end of a course, respectively, were selected. The films
      were identified only by age and sex of the patient and were evaluated by a
      radiologist. A senior psychiatrist reviewed the pre-ECT radiographic reports to
      determine whether a change in routine ECT procedure was required. Few clinically
      significant radiologic findings in the pre- or post-ECT films were noted.

PMID- 7796068
TI  - ECT as a therapeutic option in severe brain injury.
AB  - Electroconvulsive therapy (ECT) is a safe, highly effective, and rapidly acting
      treatment for certain major psychiatric illnesses, most notably severe mood
      disorders. Disturbances in mood and behavior as symptoms of delirium may
      complicate recovery from traumatic brain injury, but virtually no data exist on
      the role of ECT as a treatment modality in such clinical situations. We describe
      a patient with severe, unremitting, agitated behavior following a severe closed
      head injury from a motor vehicle accident. The initial Glasgow Coma Scale score
      was 3, with computed tomographic evidence of bilateral frontal and left thalamic
      contusions. After awakening from a 21-day coma, the patient failed to improve
      beyond a Ranchos Los Amigos level 4 recovery stage. He exhibited persistent
      severe agitation with vocal outbursts and failed to assist in performing
      activities of daily living. His difficulties proved unresponsive to combined
      behavioral therapy and multiple trials of various psychopharmacologic agents. As
      an intervention of "last resort," he then received six brief-pulse, bilateral ECT
      treatments that resulted in marked lessening of his agitation and improvement in
      his ability to express his needs and participate in his self-care. Also,
      following the ECT, he showed a markedly enhanced response to psychopharmacologic
      agents. These findings may have important clinical implications for treatment of
      prolonged delirium after traumatic brain injury.

PMID- 7796070
TI  - Privileging for ECT.

PMID- 7796069
TI  - Generalized nonconvulsive status epilepticus after electroconvulsive therapy.
AB  - Status epilepticus is a rare complication of conventional single-stimulus
      electroconvulsive therapy (ECT). We report a case of ECT-induced nonconvulsive
      generalized status epilepticus (NGS) that lasted 3.5 days. The patient showed
      regressed psychotic behavior coupled with waxing and waning mutism and
      unresponsiveness as well as subtle unilateral motor signs. The diagnosis of NGS
      requires electroencephalographic confirmation.

PMID- 7796071
TI  - ECT: changing in Uruguay.

PMID- 7796072
TI  - Therapeutic use of fructose: professional freedom, 'pharmacovigilance' and
      Europe.

PMID- 7796073
TI  - Management and outcome of severe Guillain-Barre syndrome.
AB  - Seventy-nine patients with Guillain-Barre syndrome admitted to a neurological
      intensive therapy unit (ITU) between 1985 and 1992 were studied retrospectively.
      The mean age was 49.8 years (range 16-86) and the time between the first
      neurological symptom and admission to ITU was 10.2 days (0-62). Admission was
      precipitated by a combination of respiratory failure requiring ventilatory
      support (73.4%), bulbar weakness (57.0%), autonomic features (11.4%) and general
      medical factors (10.1%). Specific treatments included plasma exchange (65.8%),
      intravenous immunoglobulin (13.9%) and methylprednisolone/placebo (12.7%).
      Significant complications included lower respiratory tract infections (45.6%),
      hyponatraemia (25.3%), dysautonomia (19.0%), urinary tract infection (12.7%) and
      cognitive disturbances (8.9%). Four patients (5.1%) died during the acute
      illness. Duration of nadir correlated with duration of ventilation, duration of
      ITU stay and outcomes at 3 months, 6 months and 1 year. However, time to nadir,
      an indicator of rapidity of deterioration, did not correlate with any outcome.
      The low mortality in this series of acutely ill and severely disabled patients
      suggests that specialized intensive therapy units continue to have an important
      role in the management of acutely ill patients with Guillain-Barre syndrome.

PMID- 7796075
TI  - Insulin and C-peptide secretion in non-insulin-dependent diabetes mellitus and
      its response to dietary therapy.
AB  - We studied insulin and C-peptide levels in patients with non-insulin-dependent
      diabetes mellitus (NIDDM) during standard oral or intravenous glucose tolerance
      tests (GTT) at the time of diagnosis and after 3 months dietary therapy. On the
      second occasion they also had an 'augmented' GTT, in which slow intravenous
      infusion of glucose raised basal plasma glucose to a level similar to that at the
      time of diagnosis. Eight patients had oral tests, and seven patients intravenous
      tests. In both groups, dietary therapy significantly reduced fasting and peak
      plasma glucose (p < 0.05 for oral; p < 0.01 for intravenous GTT). Serum insulin
      levels during conventional oral GTT were not significantly different after
      dietary therapy compared to diagnosis, but were significantly higher during the
      'augmented' oral GTT (p < 0.05). In those patients who underwent intravenous GTT,
      there was a significant increase in both the total amount of insulin secreted (0
      60 min) and in first-phase insulin secretion (0-10 min) during the 'augmented'
      test compared to diagnosis (p < 0.01), but first-phase insulin secretion during
      the conventional intravenous GTT was unchanged. Serum C-peptide responses were
      also greater during 'augmented' tests (p < 0.05), similar in pattern to serum
      insulin. There is a relative deficiency in insulin secretion in untreated NIDDM,
      which can be reversed by dietary therapy. It is essential to study insulin and C
      peptide secretion in controlled 'fasting' glucose conditions.

PMID- 7796074
TI  - Postural hypotension enhanced by exercise in patients with chronic autonomic
      failure.
AB  - The effect of supine exercise on blood pressure (BP), measured while recumbent
      and after head-up postural change, was investigated in three groups with marked
      postural hypotension due to chronic autonomic failure: 15 with associated
      neurological impairment (Shy-Drager syndrome, SDS, multiple system atrophy); 15
      with pure autonomic failure (PAF) and two with a deficiency of the enzyme
      dopamine beta hydroxylase (DBH deficiency). Fifteen normal subjects were
      controls. In controls, exercise increased supine BP, and there was no postural
      fall before or after exercise. In SDS and PAF, however, exercise produced a
      substantial fall in BP, which was greater in PAF. In both groups, BP fell to a
      lower level on standing after than before exercise. In DBH deficiency, there was
      little change in BP with exercise, but BP fell to a lower level on standing after
      exercise. In all three groups with autonomic failure, there were more symptoms of
      postural hypotension on standing after exercise. The influence of exercise on
      both supine and postural BP, therefore, should be considered in the clinical and
      laboratory assessment of autonomic dysfunction.

PMID- 7796076
TI  - Assessing the hypothalamo-pituitary-adrenal axis in patients on long-term
      glucocorticoid therapy: the short synacthen versus the insulin tolerance test.
AB  - The short synacthen test (SST) is an effective method of assessing the
      hypothalamo-pituitary-adrenal (HPA) axis in patients with pituitary disease.
      Chronic glucocorticoid therapy may result in suppression of the HPA axis, and use
      of the SST has not been evaluated in these patients. This study compares the SST
      with the insulin tolerance test (ITT) in patients on long-term corticosteroid
      therapy. Both tests were done on 22 patients on long-term, stable-dose
      prednisolone (< 10 mg/day). A pass was defined as a 30 minute plasma cortisol >
      550 nmol/l for the SST and a maximal cortisol of > 500 nmol/l for the ITT. Five
      patients passed both tests; nine failed both. Eight patients had discrepant
      results; all passed the ITT but failed the SST. There was a significant
      correlation (p < 0.001) between the maximum cortisol level achieved during the
      ITT and the 30 min SST value and the incremental rise. There was an inverse
      correlation between the dose and duration of use of steroids and the cortisol
      response during both tests. The SST is a reliable, safe and easily performed
      initial assessment of the HPA axis in patients on long-term corticosteroids. The
      ITT remains a valuable test for those who fail the SST.

PMID- 7796077
TI  - Bronchoalveolar lavage in pulmonary tuberculosis: a decision analysis approach.
AB  - We assessed the utility of bronchoalveolar lavage (BAL) in the diagnosis of
      pulmonary tuberculosis (PTB) in 50 consecutive HIV-negative patients with
      clinical and radiographic findings suggestive of PTB, but with negative
      microscopy for acid-fast bacilli (AFB) on sputum smear. Patients were grouped,
      using a scoring system, into relative likelihoods of having PTB (I-IV, in
      descending probability). Patients were started on anti-tuberculosis treatment
      according to the BAL results. Bacteriological diagnosis of PTB was confirmed in
      22/50 BAL; 11 (91.6%), seven (37%) and four (40%) of groups I-III, respectively.
      In 13 cases, an early diagnosis of PTB was made by positive microscopy for AFB on
      BAL; an alternative diagnosis was made in six cases (bacterial pneumonia 4,
      carcinoma 2). A decision analysis model was created to assess the overall utility
      of BAL. This suggested that in a region of high PTB prevalence, and when the
      clinical diagnosis of PTB is likely, empirical treatment is the best course of
      action, with BAL being reserved for further investigation of non-responders.
      Early BAL should be considered when the diagnosis of PTB is uncertain.

PMID- 7796078
TI  - Fever as the presenting complaint of travellers returning from the tropics.
AB  - We investigated prospectively the cause of fever in patients requiring
      hospitalization after returning from the tropics. All consecutive admissions (n =
      195) with oral temperature > 37.0 degrees C at the time of admission were
      enrolled. Final diagnosis as recorded on the discharge summary by the attending
      physician and results of any relevant laboratory or radiological investigations
      were recorded on standard proforma. Malaria accounted for 42% of admissions; two
      patients had returned to Britain more than 6 months before presentation. The
      second largest group was assumed to have a non-specific viral infection (25%).
      Cosmopolitan infections (urinary tract infection, community-acquired pneumonia,
      streptococcal sore throat, etc.) accounted for 9%. Coincidental infections
      (schistosomiasis, filariasis, intestinal helminths) were found in 16%. Serology
      was positive for HIV infection in 3%. The most useful investigation was a malaria
      film, which was positive in 45% of cases in which it was performed. The
      combination of thrombocytopaenia (platelet count < 100 x 10(9)) and
      hyperbilirubinaemia (bilirubin > 18 IU/ml) were useful predictive markers of
      malaria: all 23 patients with both abnormalities had positive malaria films.
      Malaria must be excluded in any febrile patient returning from the tropics. In
      the absence of a positive malaria film, the combination of a low platelet count
      and raised bilirubin may suggest the need for an empirical course of therapy.

PMID- 7796079
TI  - Perceptions, emotions and immunity: an integrated homeostatic network.

PMID- 7796080
TI  - Pathophysiology of hyperventilation.

PMID- 7796081
TI  - Lupus, C3 nephritic factor and partial lipodystrophy.

PMID- 7796082
TI  - Prospects for using a blood sample in the diagnosis of heart failure.

PMID- 7796083
TI  - Tamoxifen: oestrogen or anti-oestrogen in bone?

PMID- 7796084
TI  - Some determinants of whole-gut transit time: a population-based study.
AB  - Slow whole-gut transit time may be associated with an increased risk of
      gallstones, and possibly bowel cancer, but its determinants are unknown. We
      looked for these determinants in a community-based study of 884 women aged 25-69
      years and 677 men aged 40-69 years. Transit time was estimated using prospective
      examination of three stools and a questionnaire about bowel habit. Diet and
      alcohol intake were assessed using a validated food frequency questionnaire. In
      women < 50 years not taking oral contraceptives, mean transit time was relatively
      constant across 10-year age bands (62 to 63 h). In older women it was also
      relatively constant, but was significantly shorter (58 to 59 h), suggesting an
      effect of female sex hormones. In women taking oral contraceptives, mean transit
      time was 6 h longer than in women of the same age not taking them (95% CI 1.4 to
      10.6 h). In men drinking > 40 g alcohol/day, mean transit time was 49 h compared
      with 54 h in those drinking < 20 g/day (p < 0.0001). In alcohol-abstaining men,
      an effect of dietary NSP (non-starch polysaccharide or fibre) intake was clearly
      apparent. Alcohol consumption quickened transit in both sexes; oral contraceptive
      usage slowed it in women. Body mass index in both sexes, soluble NSP in men, and
      insoluble NSP in women also significantly and negatively affected transit time.
      The food groups which were related to transit time were potatoes and cooked fruit
      in men, and pulses and bread in women.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796085
TI  - Serodiagnosis of pericardial tuberculosis.
AB  - The AIDS epidemic has led to the resurgence of tuberculosis. Extrapulmonary
      manifestations may appear in over half of the patients who are dually infected.
      This has resulted in a rising incidence of tuberculous pericarditis in several
      parts of Africa such as Tanzania. We tested a solid-phase antibody competition
      sandwich ELISA (SACT-SE) as a potential means of diagnosing tuberculous
      pericarditis. Fifty-one African patients with clinically diagnosed tuberculous
      pericardial effusion (of whom 25 had confirmation by pericardial fluid culture)
      were tested using a monoclonal antibody (CDC/WHO ref. no. IT39) which was raised
      against a specific epitope on the Mycobacterium tuberculosis 30 kDa antigen. All
      but one patient had negative sputum microscopy for acid-fast bacilli. A
      sensitivity of 61% (at 96% specificity) was achieved. Sera from 25 African
      patients with smear-positive tuberculosis were also examined; of which 20 tested
      positive (sensitivity 80%). This is the largest study to date on the potential
      application of serology in diagnosing pericardial tuberculosis.

PMID- 7796087
TI  - QT dispersion in essential hypertension.
AB  - Increased QT dispersion is associated with sudden cardiac death in congestive
      heart failure, hypertrophic cardiomyopathy, and following acute myocardial
      infarction. Patients with hypertension, in particular those with left ventricular
      hypertrophy, are also at greater risk of sudden cardiac death. We examined
      whether QT dispersion, which is easily obtained from a routine ECG, correlates
      with echo LVH. Sixty-nine untreated patients with essential hypertension had QT
      dispersion measured from a surface 12-lead electrocardiogram, and two-dimensional
      echocardiography performed to measure interventricular septal thickness,
      posterior wall thickness, and left ventricular internal diameter. Office blood
      pressure was recorded, and in 56 patients, 24 h ambulatory blood pressure
      monitoring was also done. Multivariate analysis demonstrated significant
      relationships between QT dispersion and office systolic blood pressure, and left
      ventricular mass index. Similar findings were obtained when QT dispersion was
      corrected for heart rate (QTc dispersion). After patients with
      electrocardiographic left ventricular hypertrophy (n = 5) were excluded from the
      analysis, the above relationships persisted. Increased QT dispersion is thus
      found in those essential hypertensives at greatest risk of sudden death. Since
      this relationship persists even in the absence of electrocardiographic left
      ventricular hypertrophy, measurement of QT dispersion might be a simple, non
      invasive screening procedure to identify those hypertensives at greatest risk of
      sudden death.

PMID- 7796088
TI  - The haematologist as watchdog of community health by full blood count.
AB  - Although full blood counts (FBC) are among the most commonly performed laboratory
      tests, the contribution of routine FBCs to the diagnosis of new problems is
      controversial. This study represents a unique linkage of a consultant haematology
      team, reviewing all abnormal blood counts, to an organization providing
      ambulatory health care to 350,000 patients. The objective was to establish the
      underlying clinical disorders responsible for all abnormal FBCs during a 2-month
      period, and to estimate the impact of the haematology team on the diagnostic work
      up and management of newly identified problems. 572 (2.55%) of the 22,454 FBCs
      were abnormal. Of these, 357 showed microcytosis, caused by iron deficiency
      (58%), thalassaemia minor (35%), inflammation (6%) or chronic renal failure (1%).
      The most common causes of normocytic anaemia (25 patients) were disseminated
      malignancy and acute blood loss; of macrocytosis (27 patients), chronic liver
      disease and cancer; of erythrocytosis (16 patients), chronic hypoxia; of
      thrombocytopaenia (48 patients), chronic liver disease and ITP; of thrombocytosis
      (47 patients), iron deficiency and inflammation; of leukopaenia or pancytopaenia
      (20 patients), cirrhosis and disseminated malignancy; and of leukocytosis (26
      patients), chronic leukaemias in the elderly and infection in children. Major new
      haematological abnormalities were encountered in 0.24% of all blood counts,
      representing about one new diagnosis per day. Routine blood counts do contribute
      to the health care of a population. Screening for haematological disease through
      a central clinical laboratory covering a large high-risk ambulatory population
      offers a cost-effective way of searching for serious clinical problems, alerting
      the primary physicians of their existence, and offering advice in continued
      evaluation and problem management.

PMID- 7796086
TI  - Lipoprotein(a) as a determinant of the severity of angiographically defined
      carotid atherosclerosis.
AB  - We measured fasting serum lipids, lipoproteins, apolipoproteins and
      lipoprotein(a) [Lp(a)] in 49 Caucasian patients with transient ischaemic attacks
      undergoing carotid angiography. The severity of extracranial cerebrovascular
      disease was assessed visually by a highly reproducible grading system that
      focused on the internal carotid artery and carotid bifurcation. Compared with a
      healthy reference group, patients had significantly higher serum concentrations
      of: total cholesterol (mean +/- SD), 6.2 +/- 1.6 vs. 5.6 +/- 1.0 mmol/l, p =
      0.02; apolipoprotein B, 1.4 +/- 0.5 vs. 1.2 +/- 0.3 g/l, p = 0.03; triglyceride
      [geometric mean(95% CI)], 2.02(1.75-2.32) vs. 1.66(0.67-4.06) mmol/l, p = 0.03;
      and Lp(a), 0.33(0.26-0.42) vs. 0.17(0.40-0.76) g/l, p < 0.001. Regression
      analysis showed that of the lipoprotein-related variables, only Lp(a) was
      significantly related to the severity of carotid artery disease (p = 0.04) in the
      patients; this association remained significant after adjusting for age, sex,
      blood pressure, and a history of stroke. Serum Lp(a) concentration was
      significantly higher in patients with carotid artery disease severity score above
      the median value of the sample population compared with those below the median:
      0.45 vs. 0.24 g/l (95% CI for difference 0.35-0.88), p = 0.01. Elevated serum
      Lp(a) is a significant determinant of the extent of carotid atherosclerosis and
      may be useful in identifying patients most at risk of stroke.

PMID- 7796090
TI  - Critical illness poly-neuropathy following severe hyperpyrexia.
AB  - Two patients developed critical illness polyneuropathy after severe hyperpyrexia.
      Fever was secondary to a phaeochromocytoma in one patient and sepsis in the
      other. These observations suggest that high fever may be one possible aetiology
      of critical illness polyneuropathy.

PMID- 7796089
TI  - Pharmacokinetics and pharmacodynamics of dichloroacetate in children with lactic
      acidosis due to severe malaria.
AB  - Lactic acidosis frequently complicates severe malaria in African children, and is
      a strong independent predictor of mortality. We tested the hypothesis that sodium
      dichloroacetate (DCA), an activator of pyruvate dehydrogenase, rapidly reduces
      hyperlactataemia in this patient population. Eighteen children with severe
      malaria and capillary plasma lactate > or = 5 mM were randomized to receive
      either intramuscular quinine plus a single 50 mg/kg intravenous infusion of DCA
      in saline, or quinine plus intravenous saline alone. Two patients in each
      treatment group died following randomization. Thirty minutes after treatment, the
      mean plasma lactate was 28% below pretreatment baseline values in the DCA group,
      but was unchanged in the placebo group. Throughout the first 4 h after treatment,
      mean plasma lactate in the DCA-treated patients was significantly less than that
      in controls (p = 0.003). Thereafter, mean plasma lactate declined in both groups
      and was < 2 mM 10 h after treatment. DCA was well tolerated and did not alter
      quinine pharmacokinetics. A single intravenous dose of DCA rapidly improved
      lactic acidosis in African children with severe malaria, suggesting that DCA may
      be a useful adjunct in the initial treatment of these patients, and may increase
      their chance of survival by improving a major complication of their illness.

PMID- 7796091
TI  - Does folic acid harm people with vitamin B12 deficiency?
AB  - Oral folic acid given before and during pregnancy can prevent about 75% of fetal
      neural tube defects. Even in large dose (20 mg daily) folic acid has never been
      shown to harm normal people, but it has acquired a bad reputation in pernicious
      anaemia. Before 1930, if untreated patients survived the anaemia, they succumbed
      to peripheral neuritis, subacute combined degeneration of the spinal cord, and
      death. The speed of this progression was extremely variable. From 1947 onwards,
      there were many reports of rapid neurological deterioration during administration
      of folic acid as sole therapy to people with pernicious anaemia. However, a
      review of clinical studies published before the introduction of liver and vitamin
      B12 therapy shows that neurological deterioration was often quite as rapid and
      severe in untreated patients. Oral folic acid can usually correct or prevent the
      anaemia of pernicious anaemia. Thus it could mask the underlying disease, and
      allow the development or progression of neurological deterioration, if diagnosis
      depended on the presence of anaemic symptoms. This possibility can readily be
      overcome by adequate education of doctors, so that a macrocytic anaemia is not
      regarded as a necessary accompanying sign of the neurological disorder. The
      hypothetical and avoidable side-effects of food fortification with folic acid
      have to be balanced against the certain benefit of preventing neural tube defects
      in unplanned pregnancies, and also against the probability that adults may be
      spared the neuropsychiatric and other ill-effects which result from inadequate
      dietary folic acid.

PMID- 7796092
TI  - A Golgi and horseradish peroxidase study of the sonic motor nucleus of the oyster
      toadfish.
AB  - The sonic motor nucleus (SMN) of the oyster toadfish Opsanus tau, a single
      midline structure in the occipital spinal cord and caudal medulla, contains large
      electrically-coupled motoneurons. Although interpretation is complicated by
      multiyear growth in soma size, neurons in males may be either large (L) or small
      (S), whereas females have exclusively S neurons. Golgi stains have allowed
      separation of five neuron variants (rostral, dorsal, stellate, ventral and
      caudal) which differ in location, soma shape and size, and direction and pattern
      of dendritic branching. All variants are present in L and S males and in females,
      and retrograde transport of horseradish peroxidase indicates that all variants
      are motoneurons. The SMN is organized into three horizontal layers with rostral
      and dorsal neurons forming a rostrocaudally arrayed network across the dorsal
      dorsolateral surface. Stellate cells are found in the middle layer, and ventral
      cells with laterally directed dendrites that exit the SMN line the inferior
      surface. Caudal neurons with caudally directed exiting dendrites are arranged in
      parallel rows in the caudal fifth of the SMN. We suggest that variant differences
      in dendritic orientation relate to different patterns of innervation by multiple
      afferents to the SMN and function to maximize contacts between neurons as a means
      of facilitating synchronization within the nucleus. Sexual dimorphism has been
      demonstrated to a minor degree: all variants have larger somas in L fish than S
      fish, but no difference has been found in primary dendrite diameter. Larger somas
      would potentially support the greater amount of sound production by nesting males
      who produce a mating boatwhistle call. Equivalent dendrite diameter in females,
      who are just as likely as males to grunt, an agonistic call, suggests that female
      Opsanus have a well developed sonic circuitry compared to Porichthys, another
      toadfish in which females are typically silent.

PMID- 7796093
TI  - Development of the visual cortex in a wallaby--phylogenetic implications.
AB  - The visual cortex of one of the smallest macropod marsupials, a wallaby, the
      quokka Setonix brachyurus, was examined at maturity and during development from
      postnatal day 1 to 150 in Nissl-stained or Golgi-stained sections. Injections of
      horseradish peroxidase into the primary visual centres in adults identified
      cortical neurons projecting to these regions. The pattern of cell generation was
      determined by tritiated thymidine/autoradiography. The adult visual cortex was
      composed of the usual six layers of cells with dendritic morphologies similar to
      those seen in eutherian (placental) mammals. The margin of Layer 6 overlapped
      slightly with the white matter, and pyramidal cells projecting to subcortical
      regions were located at all depths of Layer 6. Cortical development was similar
      to that of eutherian mammals, with the formation of transient cellular layers
      below the developing cortical plate. Autoradiographic studies confirmed that the
      cortical plate was composed of two layers: a compact zone of densely packed cells
      located pial to a striated layer containing more loosely packed cells. Postnatal
      cell generation of Layers 6-2 took place from postnatal day 3 to day 85, with
      Layer 4 neurons, the main target of incoming visual axons, being generated around
      postnatal day 40. Cells located at maturity in the white matter, mostly of glial
      morphology, were generated from postnatal day 40. A subplate zone containing
      early differentiating cells was not evident, and postnatal 3H-thymidine labelling
      did not identify a population of early generated neurons below the cortical
      plate. In the tammar wallaby Macropus eugenii, the majority of target neurons for
      incoming geniculate axons are generated about 20 days after the first axons enter
      directly into the cortical plate without a waiting period in a subplate.
      Geniculate axons in the wallabies have a relatively longer 'wait' for their
      target neurons than do those in cats or monkeys. Therefore, if geniculate axons
      in marsupials make temporary synapses, while they wait for their target neurons
      to be generated, their temporary connections must, unlike those in cats or
      monkeys, be with cells already in the cortical plate.

PMID- 7796095
TI  - Anthony H.M. Lohman: reflections on a distinguished career in anatomy.

PMID- 7796094
TI  - Localization of met-enkephalin and vasoactive intestinal polypeptide in the
      brains of male zebra finches.
AB  - An interconnected series of brain nuclei controls song learning and behavior in
      male zebra finches (Poephila guttata). This study examined the distribution of
      fibers, terminals, and somata immunoreactive for two neuropeptides, methionine
      enkephalin (ENK) and vasoactive intestinal polypeptide (VIP), in song-control
      nuclei of adult males. In addition, the broad pattern of major regions of
      labeling throughout the forebrain and midbrain was determined. The telencephalic
      song-control nuclei MAN (magnocellular nucleus of the anterior neostriatum), Area
      X of the striatum, HVC (higher vocal center), and RA (robust nucleus of the
      archistriatum) contained abundant ENK immunoreactivity, including labeled fibers
      and somata. In addition, intensely labeled fibers and terminals were seen in the
      thalamic nucleus DLM (medial portion of the dorsolateral nucleus of the anterior
      thalamus). High levels of VIP immunoreactivity were also seen in MAN, HVC, and
      RA, but this label consisted of fiber and terminals only. Area X and surrounding
      striatum contained extremely sparsely distributed VIP-labeled processes. Somata
      positive for VIP were not seen throughout cortical regions such as the
      neostriatum and hyperstriatum but were abundant in the lateral striatum
      (paleostriatum augmentatum, PA) and may contribute to a dense field of terminal
      labeling seen in the globus pallidus. The apparent presence of a robust VIP
      positive striato-pallidal projection is not typical of major basal ganglia
      pathways in vertebrates, raising the possibility that passerine birds have
      diverged from the typical amniote pattern.

PMID- 7796096
TI  - Co-localization of aromatase enzyme and estrogen receptor immunoreactivity in the
      preoptic area during reproductive aging.
AB  - Immunoreactive aromatase enzyme (AROM-IR) was studied in the preoptic and septal
      ares of the male Japanese quail brain relative to the age-related decline in
      endocrine and behavioral components of reproduction. Additional analyses were
      conducted to determine if the co-localization of AROM-IR and estrogen receptor
      immunoreactivity (ER-IR) in the medial preoptic area change during aging. Young,
      sexually active, male quail (6 months of age) were compared to aged sexually
      active or inactive, male quail (36 months of age). Testis size decreased in old,
      sexually inactive males, similar to our previous observations. The numbers of
      AROM-IR neurons in the medial preoptic area (POM) and the lateral septum (LS)
      decreased significantly with aging and sexual activity. The number of cells that
      co-localized both AROM-IR and ER-IR did not differ with age. As a consequence of
      the age-related change in AROM-IR cells, the relative percentage of dual labelled
      (AROM-IR and ER-IR) and single labelled cells (AROM-IR) increased in aged males.
      These data provide histochemical evidence that alterations in the aromatase
      enzyme system in the medial preoptic area may underlie behavioral and endocrine
      events associated with reproductive aging.

PMID- 7796097
TI  - Delayed increase of tyrosine hydroxylation in the rat A2 medullary neurons upon
      long-term hypoxia.
AB  - In vivo and in vitro activity of tyrosine hydroxylase (TH) was estimated in the
      catecholaminergic A2 cell group of the nucleus tractus solitarius (NTS) in rats
      exposed to normobaric hypoxia (10% O2 in nitrogen) for 2 h, 3, 7, 14 or 21 days.
      The A2 cell group was subdivided into two subgroups. In the caudal A2 subgroup
      located caudal to the calamus scriptorius, long-term but not acute hypoxia
      elicited an increase of in vivo tyrosine hydroxylation rate after 7 days of
      exposure (+60% above normoxic controls). The increase of in vivo TH activity was
      maintained at the same level at the end of hypoxic exposure. In vitro TH activity
      was increased transiently after 7 days of hypoxia (+92% above normoxic
      (controls). In thr rostral A2 subgroup, hypoxia elicited a significant increase
      of in vivo tyrosine hydroxylation at 7 days (+38%) but did not alter in vitro TH
      activity throughout the whole exposure. Hypoxia produced no detectable change in
      TH activity in other noradrenergic cell groups of the brain stem (locus
      coeruleus, A5) except for a transient inhibition of in vivo TH activity in A5
      after 2 h. Immunocytochemical analyses confirmed that the catecholaminergic
      neurons in the caudal A2 area are not only of a noradrenergic nature. The neurons
      were located in the commissural subnucleus of the NTS. On the other hand, the
      rostral A2 area contains noradrenergic neurons intermingled with a small number
      of adrenergic cell bodies.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796098
TI  - [3H]GBR 12935 labels mainly the piperazine acceptor site in the rat prefrontal
      cortex.
AB  - The binding characteristics of [3H]GBR 12935, a ligand for the dopamine (DA)
      transporter, have been extensively investigated in the striatum. The present
      study was designed to characterize [3H]GBR 12935-binding to prefrontal cortex
      (PFC) in rats. This region receives a dense DA input from the ventral tegmental
      area and is suspected to play a major role in higher associative functions. We
      demonstrated high-affinity, saturable, mazindol-sensitive [3H]GBR 12935-binding
      in the rat PFC; however, in contrast to the striatum, such binding was inhibited
      by increasing concentrations of Na+. This fact, together with the irregular
      pattern of the association kinetics and the marked sensitivity of [3H]GBR 12935
      binding to piperazine derivatives, indicates the possible presence of more than
      one [3H]GBR 12935-binding site in the PFC. Furthermore, it appears that [3H]
      12935 in the rat PFC labels mainly 'the piperazine acceptor site' and not the DA
      transporter.

PMID- 7796099
TI  - Indomethacin reduces both Krox-24 expression in the rat lumbar spinal cord and
      inflammatory signs following intraplantar carrageenan.
AB  - This study evaluated the 'evoked' expression of Krox-24 protein in the lumbar
      spinal cord after peripheral carrageenan-induced inflammation and its
      modification by preadministration of indomethacin, a non-steroidal anti
      inflammatory drug, in freely moving rats. Three h after intraplantar carrageenan
      (6 mg/150 microliters saline) a maximal 'evoked' Krox-24 expression was observed
      in L2-L6 segments of the dorsal horn ipsilateral to carrageenan inflammation. A
      maximal number of 'evoked' Krox-24 neurons was observed in L4-L5 segments,
      predominantly in the superficial laminae (I-II) and to a lesser extent in the
      medial part of neck (laminae V-VI) of the dorsal horn. Such an increase was not
      observed after an intraplantar injection of control vehicle saline. increase
      doses of carrageenan (1, 3 and 6 mg) induced a dose-dependent increase (r2 =
      0.617, P < 0.0001) in the number of evoked' Krox-24 neurons observed in the
      superficial dorsal horn 3 h after carrageenan. Systemic preadministration of
      indomethacin (1, 2.5 and 5 mg/kg) dose-dependently reduced (r2 = 0.508, P <
      0.0001) the total number of carrageenan (6 mg at 3 h)-'evoked' Krox-24 neurons
      (29 +/- 5, 45 +/- 4 and 57 +/- 2% reduction as compared with control,
      respectively). Systemic indomethacin dose-dependently reduced the inflamed paw
      and ankle diameter (16 +/- 8, 34 +/- 12, 54 +/- 6% and 48 +/- 14,. 75 + 16, 90 +/
      7% reduction as compared with the control carrageenan inflammation,
      respectively). There was a positive correlation between the effect of systemic
      indomethacin on both 'evoked' Krox-24 expression in superficial laminae and the
      inflammatory signs (r2 = 0.25, P < 0.01 for the paw diameter; r2 = 0.22, P < 0.05
      for the ankle diameter). In addition, the total number of 'evoked' Krox-24
      neurons was significantly reduced (43 +/- 5% reduction as compared with control)
      by an oral pretreatment of indomethacin (10 + 10 mg/kg). Oral indomethacin
      totally blocked the ankle diameter and reduced the paw diameter (100 + 14 and 30
      +/- 6% reduction of the control carrageenan inflammation, respectively).

PMID- 7796100
TI  - The role of the medial prefrontal cortex of rats in short-term memory
      functioning: further support for involvement of cholinergic, rather than
      dopaminergic mechanisms.
AB  - The putative involvement of the dopaminergic innervation of the medial part of
      the prefrontal cortex (PFC) in short-term memory functioning was investigated by
      evaluating the effects of local infusions of dopaminergic drugs into the ventral
      part of the medial PFC of rats in an operant delayed-matching-to-position (DMTP)
      task. Two separate groups of rats were tested after bilateral microinfusion of
      several doses of either the dopamine receptor agonist apomorphine (APO) or the
      dopamine receptor antagonist cis-flupenthixol (FLU) into the ventromedial PFC. In
      addition, all animals were tested after infusion of several doses of the
      muscarinic receptor antagonist scopolamine (SCO) and the dopamine DI receptor
      antagonist SCH-23390 (SCH). The drugs tested affected DMTP performance
      differentially. APO had no effect on response accuracy, although it dose
      dependently affected nose poke activity and response latencies. FLU and SCH both
      induced a dose-dependent, but delay-independent deterioration of response
      accuracy that was paralleled by increases in response latencies and decreases in
      nose poke frequencies, causing some animals to stop responding after infusion of
      the highest doses of both drugs. In contrast, SCO infusions into the ventromedial
      PFC induced a dose- and delay-dependent deterioration of response accuracy, that
      was accompanied by an increase in response latencies only. Taken together, these
      results provide additional support for the involvement of cholinergic, rather
      than dopaminergic mechanisms in short-term memory supported by the medial PFC of
      the rat, and they are not in favor of a functional dissociation between the
      dorsomedial PFC and the ventromedial PFC in the role.

PMID- 7796101
TI  - Olfactory bulb glycogen metabolism: noradrenergic modulation in the young rat.
AB  - The olfactory bulb exhibits high glycogen phosphorylase activity, the rate
      limiting enzyme in the mobilization of glycogen. The bulb also receives dense
      noradrenergic innervation and noradrenaline is known to stimulate glycogen
      breakdown. We determined the levels of glycogen in the bulb over the course of
      development and then determined the ability of noradrenaline to mobilize bulb
      glycogen. At birth, olfactory bulbs have very high levels of glycogen, with
      levels declining as the pups develop. Picomolar levels of noradrenaline mobilize
      glycogen in the bulb,. Initially, beta-adrenergic receptors mediate teh
      glycogenolysis and subsequently, the alpha-noradrenergic receptors in the bulb
      stimulate the breakdown of glycogen. Carnosine is involved in the repletion of
      bulb glycogen levels. The stimulation of glycogen breakdown by noradrenaline may
      play a role in allowing the increased activity that accompanies early olfactory
      stimulation.

PMID- 7796102
TI  - Subtype-specificity of the presynaptic alpha 2-adrenoceptors modulating
      hippocampal norepinephrine release in rat.
AB  - In vivo brain microdialysis and high-performance liquid chromatography with
      electrochemical detection were used to study the effect of different selective
      alpha 2-antagonists on hippocampal norepinephrine (NE) release in freely moving
      awake rat. Systemic administration (0.5 mg/kg i.p.) of either the alpha 2AD
      antagonist BRL 44408 or the alpha 2BC-antagonist ARC 239 did not significantly
      change the basal release of NE. At a higher dose (5 mg/kg i.p.) ARC 239 was still
      ineffective, whereas BRL 4408 caused a significant increase of the extracellular
      level of NF. Similar results were obtained from in vitro perfusion experiments.
      Rat hippocampal slices were loaded with [3H]NE and the electrical stimulation
      evoked release of [3H]NE was determined. The alpha 2-antagonists were applied in
      a concentration range of 10(-8) to 10(-6) M, ARC 239 was ineffective, whereas BRL
      44408 significantly increased the electrically induced release of [3H]NE. In
      agreement with the data of microdialysis and perfusion experiments, BRL 44408
      displaced [3H]yohimbine from hippocampal and cortical membranes of rat brain with
      high affinity whereas ARC 239 was less effective. The pKi values of eight
      different alpha 2-adrenergic compounds showed a very good correlation (r = 0.98,
      slope = 1.11 P < 0.0001) in hippocampus and frontal cortex have the alpha 2
      adrenoceptors have been characterized as alpha 2d-subtype. Our data indicate that
      hippocampal NE release in rat is regulated by alpha 2D-adrenoceptors, a species
      variation of the human alpha 2A-subtype.

PMID- 7796103
TI  - Olfactory experience modulated apoptosis in the developing olfactory bulb.
AB  - Early sensory stimulation plays a key role in shaping the structure and function
      of the developing olfactory system. Here, we provide the first direct evidence
      for apoptotic cell death in the olfactory bulbs of rat pups during normal
      development and we also demonstrate that olfactory deprivation by unilateral
      naris occlusion causes a dramatic increase in apoptotic cell death in the
      glomerular and granule cell layers of the deprived bulb. The accessory olfactory
      bulbs displayed a remarkably high basal level of apoptosis but the occluded
      accessory bulb did not differ in that regard from the control accessory bulb.
      These results suggest that apoptosis may be an important mechanism by which the
      olfactory system can adjust its cell numbers in response in sensory stimuli
      experienced in early life, thereby underlying one form of plasticity in the
      developing olfactory system.

PMID- 7796104
TI  - Improved learning and memory in aged rats with chronic administration of the
      nicotinic receptor agonist GTS-21.
AB  - The ability of two synthetic nicotine receptor ligands, TGS-21 and DMAB, to
      chronically enhance the cognitive function of aged rats was evaluated in three
      diverse tasks and compared to the cognition-enhancing effects of nicotine
      administration. 15 min prior to daily behavioral testing, aged 22-24 month old
      rats received an i.p. injection of nicotine (.02 mg/kg), GTS-21 (1 mg/kg), DMAB
      (2mg/kg), or saline vehicle and were tested in either one-way active avoidance
      pole jumping, Lashley III maze, or a 17-arm radial maze. GTS-21 pretreatment was
      as effective as nicotine for enhancing the acquisition of aged rats in both one
      way active avoidance and Lashley III maze training. In 17-arm radial maze
      testing, GTS-21 improved both general learning and reference (long-term) memory
      to the same extent as nicotine. Although DMAB pretreatment enhanced reference
      memory in 17-arm radial maze testing to the same as nicotine, it did not affect
      general learning in this complex task and did not exert any cognition-enhancing
      effects in Lashley III maze training. These results indicate that GTS-21 has
      cognition-enhancing abilities in aged rats that are comparable to those of
      nicotine in a variety of behavioral tasks. Since GTS-21 acts preferentially on
      brain nicotinic receptors and is less toxic than nicotine, thses results further
      indicate that GTS-21 may have substantive therapeutic value in the treatment of
      age-associated memory impairment (AAMI) and/or Alzheimer's disease.

PMID- 7796105
TI  - Enhanced restoration of striatal dopamine concentrations by combined GM1
      ganglioside and neurotrophic factor treatments.
AB  - Intraperitoneal injection of GM1 ganglioside or intracerebroventricular infusion
      of basic fibroblast growth factor (FGF-2) or epidermal growth factor (EGF)
      partially restored dopamine and 3,4-dihydroxyphenylacetic acid (DOPAC) levels in
      the striatum of young MPTP-treated mice. Combined treatments of GM1 ganglioside
      with FGF-2 or EGF produced a greater restoration of striatal dopamine levels than
      treatments with GM1 or either of the neurotrophic factors alone. GM1 treatment,
      but not trophic factor treatments caused significant sparing of substantia nigra
      pars compacta (SNc) tyrosine hydroxylase (TH)-positive neurons. These results
      confirm previous findings that GM1 provides trophic support for damaged dopamine
      neurons and suggests that GM1, FGF-2, and EGF may also enhance dopaminergic
      function in residual neurons. The results also suggest that a potentially
      fruitful approach to treating degenerative disorders of the dopamine system may
      be the use of combined trophic factor therapies.

PMID- 7796106
TI  - c-fos immunoreactivity in the brain following electrical or chemical stimulation
      of the medial hypothalamus of freely moving rats.
AB  - c-fos immunoreactivity was used to map brain areas in which neurons reacted
      either to electrical stimulation or to microinjection of the excitatory amino
      acid kainate and of the GABAA antagonist, SR-95531, applied to the medial
      hypothalamus of freely moving rats. All these stimulations induced flight
      behavior of moderate intensity. Immunoreactive cells were found within a radius
      of 0.5 mm around the stimulated area. Distally, clusters of labeled cells were
      found ipsilaterally in the piriform and entorhinal cortices, in several
      amygdaloid nuclei, in the bed nucleus of the stria terminalis, in the septo
      hypothalamic nucleus, in the paraventricular, anterior and dorsomedial
      hypothalamic nuclei, the the paraventricular thalamic nucleus, in the dorsal
      periaqueductal gray extending to the cuneiform nucleus, and bilaterally in the
      supramammillary decussation and the locus coeruleus. The specificity of the brain
      areas thus labeled was indicated by the unilateral pattern of activation as well
      as by the different pattern obtained after control microinjection of saline.
      Therefore, these results are likely to provide sound information about the brain
      structures involved in defensive-aversive behavior evoked from the medial
      hypothalamus.

PMID- 7796107
TI  - A retrograde double-labelling study of retinal ganglion cells that project
      ipsilaterally to vLGN and LPN rather than dLGN and SC, in albino rat.
AB  - We studied ipsilaterally projecting, double-labeled retinal ganglion cells that
      have bifurcating axons by retrograde fluorescent double-labeling in albino rats.
      Ten albino (Wistar, Japan Ceca) rats of either sex, weighing 350-400 g were used.
      With the rats in a state of deep anesthesia, we pressure-injected 0.02 microliter
      of 15% Evans blue (EB) into the right ventral lateral geniculate nucleus (vLGN),
      and 4% Fluoro-gold (FG) iontophoretically into the right posterior lateral
      thalamic nucleus (LP). The animals were perfused with formol-saline 48-72 h later
      and both the brain and eyes were exercised. The brain was sectioned coronally,
      and each retina was removed and mounted flat on a glass slide. Double-labeled
      cells were found in the ventral temporal crescent of the retina. In one animal
      and total number of ipsilaterally labeled cells was 566, and the percentage of
      double-labeled vLGN and LP projecting cells, single-labeled vLGN projecting
      cells, and single-labeled LP projecting cells were 29.8, 58.8 and 11.3,
      respectively.

PMID- 7796108
TI  - Phase-dependent phase shift of methamphetamine-induced circadian rhythm by
      haloperidol in SCN-lesioned rats.
AB  - Haloperidol, a non-selective dopamine receptor antagonist, was injected
      intraperitoneally in to suprachiasmatic nucleus (SCN)-lesioned rats at various
      phases of the locomotor activity rhythm induced by methamphetamine (MAP)
      treatment. A single injection of haloperidol shifted the phase of MAP-induced
      locomotor rhythm phase dependently, while saline injection had no effect on the
      phase. A phase-response curve of MAP-induced rhythm for haloperidol had a small
      phase-advancing area at CT 13 to 15, a large phase-delaying area at CT 3 to 7 and
      a dead zone at CT 17 to 1. Although the day-to-day variation of MAP-induced
      locomotor rhythm was about 2.5-times as great as that of light entrainable
      circadian rhythm, the phase shifts of both directions were statistically
      significant. Phase delay shifts at CT 5 depended on the dose of haloperidol. In
      addition to the phase-shifting effect, haloperidol suppressed the MAP-induced
      locomotor activity for activity for about 10 h regardless of the phase of the
      injection. Pentobarbital also suppressed ther locomotor activity for a similar
      duration. However, significant phase shift was not detected with pentobarbital
      injected at CT 5 or CT 13, at the phase where haloperidol induced the maximal
      phase delay or advance, respectively. Present findings suggest that the
      dopaminergic mechanism is involved in the entrainment and/or oscillatory
      mechanism of the MAP-induced rhythm.

PMID- 7796109
TI  - Influence of novel versus home environments on sensitization to the psychomotor
      stimulant effects of cocaine and amphetamine.
AB  - The acute psychomotor response (rotational behavior in rats with a unilateral 6
      OHDA lesion), and the development of sensitization, were studied in rats that
      received seven consecutive daily injections of amphetamine (Experiment 1) or
      cocaine (Experiment 2) either at home or in a 'novel' test environment. The home
      (HOME) and novel (NOVEL) cages were physically identical, but one group lived and
      was tested in these cages, whereas the rats in the other group were transported
      from the stainless steel hanging cages where they lived, to those NOVEl test
      cages, for each test session. In Exp. 1, the acute psychomotor response to 3.0
      mg/kg of amphetamine i.p. and the development of sensitization (increase in the
      rotational response between the first and the the seventh test session) were
      greater in the NOVEL than in the HOME environment. In Expt. 2, there were no
      significant group differences in the acute response to 20 mg/kg of cocaine i.p.,
      but the animals tested in the NOVEL environment showed greater sensitization than
      animals tested in the HOME environment. In addition, the animals pretreated with
      cocaine in the NOVEL environment, but not those pretreated with cocaine in the
      HOME environment, showed conditioned rotational behavior in response to an
      injection of saline. These data indicate that: (i) sensitization to the
      psychomotor activating effects of both amphetamine and cocaine is enhanced in a
      NOVEL environment; (ii) this phenomenon appears to the independent of the effects
      of the NOVEL environment on the acute response to these drugs; (iii) a robust
      conditioned psychomotor response to contextual cues develops only when cocaine
      treatments are given in the NOVEL test environment.

PMID- 7796110
TI  - Behavioral sensitization to cocaine: modulation by the cyclic AMP system in the
      nucleus accumbens.
AB  - We have previously observed that chronic cocaine administration increases levels
      of adenylyl cyclase and cAMP-dependent protein kinase (PKA) in the nucleus
      accumbens (NAc). In the present work we directly examined the involvement of the
      cAMP system at the level of the NAc in cocaine-induced locomotor activity and
      sensitization. Groups of rats were pretreated on 3 consecutive days with cocaine
      (10 mg/kg, i.p.) concurrently with intraacumbens infusion saline, 8-bromo-cAMP (2
      micrograms/side; a membrane permanent analogue of cAMP which activates PKA), or
      RP-CPT-cAMP (20 nmol/side; which inhibits PKA). In a separate experiment, control
      animals received total infusion of either 8-bromo-cAMP or saline plus i.p.
      saline. All animals were tested for locomotor activity on pretreatment days, and
      following an additional cocaine challenge ona subsequent day. Over pretreatment
      days, animals given 8-bromo-cAMP showed greater cocaine-induced activity, while
      animals given RP-CPT-cAMP tended to be less active, compared to saline infused
      animals. When subsequently challenged with cocaine, animals pretreated with
      intraaccumbens 8-bromo-cAMP showed greater locomotor activity during the last 30
      min of the 60 min test session than animals pretreated with saline or RP-CRT
      cAMP. No differences in locomotor activity were evident between the two control
      groups on pretreatment or challenge days. These data suggest that PKA activation
      at the level of the NAc may have a facilitative role with respect to acute and
      long-term stimulant-induced locomotor activity.

PMID- 7796111
TI  - Widespread and lateralization effects of acute traumatic brain injury on
      norepinephrine turnover in the rat brain.
AB  - Norepinephrine (NE) has been implicated in recovery of function following
      traumatic brain injury (TBI). While bilateral decrease in brain NE turnover occur
      at 6-24 h after TBI, it is unknown what effects unilateral TBI might have on
      brain NE turnover the first few minutes after injury. Her male Sprague-Dawley
      rats had unilateral confusions of either the right or left somatosensory cortex
      produced by an air between piston. At 30 min after TBI, brain NE turnover was
      assessed by measuring the ratio of 3-methoxy-4 hydroxyphenylglycol (MHPG) to NE
      levels in various brain regions. Both right and left TBI produced 32-103%
      increases in NE turnover at the injury site and in the ipsilateral cerebral
      cortex surrounding, rostral and caudal to the injury as compared to the
      contralateral, uninjured site or to the homologous sites in uninjured controls.
      NE turnover was also altered selectively in some brain areas not affected by
      right TBI. Left TBI decreased NE turnover by 29% in the frontal cortex
      contralateral to the injury and by 24% bilaterally in the hypothalamus while
      increasing locus coeruleus NE turnover by 72% compared to uninjured controls.
      Thus, unilateral cortical TBI produced predominantly ipsilateral increases in
      cortical NE turnover but variable, bilateral changes in NE turnover in
      subcortical areas which were dependent upon the side of injury. These subcortical
      differences may explain some of the lateralized effects of cortical injury on
      post-injury behavior.

PMID- 7796112
TI  - The role of extracellular ionic changes in upregulating the mRNA for glial
      fibrillary acidic protein following spreading depression.
AB  - While spreading depression has been shown to be a powerful stimulus in
      upregulating glial fibrillary acidic protein (GFAP) mRNA expression, the specific
      physiological signal underlying the upregulation is unknown. During spreading
      depression, extracellular ionic concentrations are altered markedly. The present
      study evaluates the role of these changes in extracellular ionic concentrations
      as potential signals influencing GFAP mRNA expression. Gel foam pledgets
      saturated with artificial cerebrospinal fluid (CSF) solutions in which [Na+],
      [Ca2+], [K+] and [H+] were altered one at a time to match concentrations seen in
      spreading depression were applied to exposed parietal cortex for one hour. Dot
      and in situ hybridization techniques were used to evaluate GFAP mRNA levels. We
      found that CSF containing 60 mM KCl produced a dramatic upregulation of GFAP mRNA
      levels throughout the cerebral cortex of the ipsilateral hemisphere without
      causing detectable tissue damage. The pattern and time course of the change were
      similar to those following application of 3 M KCl. Alteration of other ionic
      species did not affect GFAP mRNA levels. However, the upregulation of GFAP mRNA
      was not likely due directly to the increased [K+], but rather to the spreading
      depression that the elevated [K+] induced. This was demonstrated by the finding
      that the upregulation in GFAP mRNA induced by the potassium exposure was totally
      blocked by prior administration of MK-801, an NMDA antagonist that blocks
      spreading depression. These results demonstrate that an upregulation in GFAP mRNA
      can occur in the absence of degeneration debris and that the initiating events
      can be related to physiological changes, but that changes in extracellular ionic
      concentrations are not the likely molecular signals underlying the upregulation.

PMID- 7796113
TI  - Spinoparabrachial tract neurons showing substance P receptor-like
      immunoreactivity in the lumbar spinal cord of the rat.
AB  - By using substance P receptor (SPR) immunofluorescence histochemistry combined
      with fluorescent retrograde labeling, SPR-like immunoreactive (SPR-LI) neurons
      sending their axons to the lateral parabrachial region were observed in the
      lumbar spinal cord of the rat. After injection of Fluoro-Gold into the lateral
      parabrachial region, retrogradely labeled neurons with SPR-LI were seen
      frequently in lamina I and the lateral spinal nucleus, and occasionally in
      laminae IV and V, with a predominantly contralateral distribution. Some of these
      neurons, especially those in lamina I, may convey nociceptive information to the
      lateral parabrachial region.

PMID- 7796115
TI  - Calretinin-immunoreactive neurons in the human striatum.
AB  - The human striatum contains two types of neurons displaying immunoreactivity for
      the calcium-binding protein calretinin (CR): (1) large (22, 44 microns>),
      multipolar neurons with 5-7 long, aspiny and tightly branched dendrites, and (2)
      medium-sized (9-18 microns), round-to-oval neurons with 2-3 long, varicose and
      poorly branched dendrites. These CR neurons represent only a small proportion of
      the total neuronal population and they are heterogeneously distributed in the
      striatum. The large CR neurons are more numerous in the putamen than in the
      caudate nucleus, whereas the inverse is true for the medium-sized CR neurons. The
      ratio of large- to medium-size CR neurons is 1:4 in the putamen compared to 1:6
      in the caudate nucleus. The existence of these two distinct subsets of
      chemospecific striatal neurons suggest that CR may play an important role in the
      intrinsic organization of the human striatum.

PMID- 7796114
TI  - Complete cerebral ischemia with short-term survival in rat induced by cardiac
      arrest. II. Extracellular and intracellular accumulation of apolipoproteins E and
      J in the brain.
AB  - The distribution of apolipoprotein E (apo E) and apolipoprotein J (apo J) was
      investigated immunocytochemically in rats at various time intervals after 10 min
      global cerebral ischemia (GCI) induced by cardiac arrest. Strong apo E and weaker
      apo J immunoreactivity was found extracellularly in multiple deposits located
      close to the microvessels. These deposits appeared 3 h after GCI and were
      present, but not in all the animals, at all time intervals studied post-GCL. In
      some rats, apo E immunoreactivity was also found in small necrotic foci.
      Widespread, neuronal apo E immunostaining appeared 6 h post-GCI. However, the
      strongest neuronal apo E immunoreactivity was found 7 days post-GCI in those
      neurons, most often observed in the CA1 hippocampal region, exhibiting signs of
      ischemic cell damage. These ischemically damaged neurons displayed weaker
      immunoreactivity to apo J, despite its increase in the response to GCI in the
      various brain regions examined. Our data show that mechanisms operating in
      ischemia are able to supply large amounts of apo E and apo J to the brain tissue
      and suggest involvement of both apo E and apo J in a complex series of events
      occurring in the ischemic brain. Perivascular deposits of apo E/apo J colocalized
      with amyloid beta protein precursor epitopes that have been disclosed by us
      previously in this model. Whether this phenomenon is limited to postischemic
      brain tissue, or can be encountered also in other pathological conditions will
      require further elaboration.

PMID- 7796116
TI  - Increases in NMDA receptor binding are specifically related to memory formation
      for a passive avoidance task in the chick: a quantitative autoradiographic study.
AB  - One-day-old chicks (Gallus domesticus) were trained on a one-trial passive
      avoidance task in which the aversive stimulus was an unpleasant lasting
      substance, methylanthranilate (MeA). Control birds were presented with a water
      (W) coated bead. Five minutes after training a group of McA-trained chicks were
      given a brief sub-convulsive trans-cranial electric shock, which rendered half
      amnesic whilst the remainder were able to show recall for the aversive stimulus.
      Thirty minutes after training birds were killed and quantitative receptor
      autoradiography was used to determine NMDA sensitive [3H]L-glutamate binding in
      specific regions of the forebrain of: (i) MeA-trained chicks; (ii) water-control
      chicks; (iii) MeA-trained electroshocked chicks showing recall; and (iv) MeA
      electroshocked chicks amnesic for the aversive stimulus. Increases (805 in the
      left lobus parolfactorius and 67% in the left intermediate medial hyperstriatum
      ventrale) in NMDA sensitive [3H]L-glutamate binding occurred in electro-shocked
      chicks which showed recall of the aversive experience but were absent in MeA
      trained chicks rendered amnesic by electro-shock. The increased binding in
      electroshocked MeA-trained birds which showed recall was similar to that observed
      previously in MeA-trained birds (without electroshock), compared to water control
      birds, whereas binding levels in McA-trained electroshocked amnesic birds were
      not different from those of water control birds. These data argue strongly in MeA
      trained electroshocked amnesic birds were not different from those of water
      control birds. These data argue strongly that alterations in binding to glutamate
      receptor sub-types are specific to memory formation for the passive avoidance
      task.

PMID- 7796118
TI  - Suppression of interleukin-1 beta production in the circumventricular organs in
      endotoxin-tolerant rabbits.
AB  - Interleukin-1 beta (IL-1 beta) production in the brain and the spleen was
      investigated in rabbits which show febrile tolerance to bacterial endotoxin,
      lipopolysaccharide (LPS). Febrile tolerance to LPS was induced by daily
      intravenous (i.v.) injections of LPS (4 micrograms/kg, i.v.) for 5 days. In the
      LPS-tolerant rabbits, the second phase of the biphasic fever induced by i.v.
      injection of LPS (4 micrograms/kg) disappeared, although the first phase remained
      intact. In situ hybridization and immunohistochemical studies revealed that IL-1
      beta production was observed in the circumventricular organs, such as the organum
      vasculosum laminae terminalis (OVLT), subfornical organ (SFO) and area posterema
      (AP), 1 h after the first exposure to i.v. injection of LPS (4 micrograms/kg)
      (acute rabbits). In contrast, IL-1 beta production in these circumventricular
      organs disappeared in the LPS-tolerant rabbits. IL-1 beta production was observed
      in the spleens of the acute and the LPS-tolerant rabbits after i.v. injections of
      LPS. The cells which produced IL-1 beta in the spleen following LPS injections
      were confirmed to be monocytes/macrophages and polymorphonuclear leukocytes by
      immunohistochemistry in both the acute and the LPS-tolerant rabbits. The LPS
      injected acute rabbits showed a significant increase in the number of IL-1 beta
      immunoreactive monocytes/macrophages, compared with that in the saline-injected
      acute rabbits. However, there was no significant difference in immunoreactive
      cell numbers between the saline-injected acute and LPS-injected tolerant rabbits,
      or between the LPS-injected acute and the LPS-injected tolerant rabbits.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7796117
TI  - Alzheimer paired helical filaments, untreated and pronase digested, studied by
      vertical platinum-carbon replication and high resolution transmission electron
      microscopy.
AB  - Untreated paired helical filaments (PHF) and pronase treated PHF filaments have
      been stereoscopically imaged with a freeze-drying vertical platinum-carbon
      replication preparation method for TEM. The untreated PHF have an average wide
      region, W = 22.8 +/- 2.4 nm, a narrow region width, T = 10.6 +/- 1.7 nm, and a
      helical turn period, L = 78.6 +/- 13.4. The widths of the pronase treated PHF
      were significantly reduced and had average measurements of W = 14.8 +/- 1.2 nm, T
      = 5.7 +/- 1.0 nm, with the helical period unchanged, L = 75.4 +/- 17 nm. The
      surfaces of the untreated PHF contained approximately 1.0 and approximately 0.4
      nm strands, the size of normal and denatured tau monomer. The pronase treated PHF
      contained approximately 1.0 and approximately 0.4 nm strands as well as
      approximately 2.0 nm strands. The stereoscopic images of the untreated and the
      pronase digested PHF do not support a double helical morphology for the PHF. The
      PHF appear to be long helical ribbons. The approximately 1.0 and approximately 2
      nm substructure has been organized both parallel and orthogonal to the PHF-core
      axis for distances less than 80 nm. The most frequent structural appearance is of
      a disorganized PHF core. The surfaces of the untreated PHF also have a similar
      disorganized appearance.

PMID- 7796119
TI  - Distinct neuroprotective profiles for sigma ligands against N-methyl-D-aspartate
      (NMDA), and hypoxia-mediated neurotoxicity in neuronal culture toxicity studies.
AB  - Substantiating evidence has raised the possibility that sigma ligands may have
      therapeutic potential as neuroprotective agents in brain ischemia. It has been
      suggested that the neuroprotective capacity of sigma ligands is related primarily
      to their affinity for the NMDA receptor complex and not to any selective action
      at the sigma binding site. However, sigma specific ligands, devoid of significant
      affinity for the NMDA receptor, are also neuroprotective via an inhibition of the
      ischemic-induced presynaptic release of excitotoxic amino acids. In the present
      study, we have investigated the potential neuroprotective effect of a
      comprehensive series of sigma ligands, with either significant (sigma/PCP) or
      negligible (sigma) affinity for the PCP site of the NMDA receptor, in order to
      delineate a selective sigma site-dependent neuroprotective effect. For this aim,
      we have employed two different neuronal culture toxicity paradigms implicating
      either postsynaptic-mediated neurotoxicity, (brief exposure of cultures to a low
      concentration of NMDA or Kainate) or pre- and postsynaptic mechanisms (exposure
      to hypoxic/hypoglycemic conditions). Only sigma ligands with affinity for the
      NMDA receptor [(+) and (-) cyclazocine, (+) pentazocine, (+) SKF-10047,
      ifenprodil and haloperidol] were capable of attenuating NMDA-induced toxicity
      whereas the sigma [(+)BMY-14802, DTG, JO1784, JO1783, and (+)3-PPP] and kappa
      opioid [CI-977, U-50488H] ligands, with very low affinity for the NMDA receptor,
      were inactive. The rank order of potency, based on the 50% protective
      concentration (PC50) value, of sigma/PCP ligands against NMDA-mediated
      neurotoxicity correlates with their affinity for the PCP site of the NMDA
      receptor, and not with their affinity for the sigma site. In addition sigma/PCP,
      sigma or kappa-opioid ligands failed to attenuate kainate-mediated neurotoxicity.
      On the other hand, sigma/PCP, sigma and kappa-opioid ligands were potent
      inhibitors of hypoxia/hypoglycemia-induced neurotoxicity, although their
      neuroprotective potency did not correlate with their affinity for either the
      sigma or PCP binding sites. In conclusion, the ability of sigma and kappa-opioid
      ligands to attenuate hypoxia/hypoglycemia, but not NMDA or kainate-induced
      toxicity, suggests that these drugs exert their neuroprotective role by a
      predominantly presynaptic mechanism possibly by inhibiting ischemic-mediated
      glutamate release.

PMID- 7796120
TI  - Cerebral protein synthesis alterations in response to acute and chronic
      immobilization stress in the rat.
AB  - The quantitative autoradiographic method with L-(35S)methionine was used to
      determine the effects of 1-acute (4h) and 2-chronic (14 days) immobilization
      stress followed by one week of recovery. Acute stress induced a significant
      decrease in methionine incorporation into proteins in 17 of the 35 brain
      structures examined (mean effect: -22%), and a significant increase in the
      prepositus hypoglossal nucleus (+23%). Chronic stress induced a significant
      decrease in methionine incorporation into proteins in 8 of the 35 structures
      analyzed. Only 4 structures were similarly affected in both these conditions. Our
      results indicate that stress-induced specific molecular changes in brain are also
      associated with changes in more general molecular components of cellular
      metabolism.

PMID- 7796121
TI  - Fos induced in brain of spontaneously hypertensive rats by angiotensin II and co
      localization with AT-1 receptors.
AB  - The induction of Fos-like immunoreactivity (FLI) by peripheral administration of
      angiotensin II (Ang II) was used to determine whether central activation was
      greater in spontaneously hypertensive rats (SHR) than in normotensive WKY and
      outbred Wistar controls. FLI was induced in the same brain regions
      (circumventricular organs and neurosecretory hypothalamic cell groups) in all
      three groups of rats, but the FLI in several of these regions was markedly less
      in WKY than in either SHR or Wistar. This reduced responsiveness in supraoptic
      and paraventricular nuclei was selective to Ang II, because the FLI induced in
      these nuclei by hypertonic NaCl did not differ between groups. We also report
      that a considerable number of cells in the SON and PVH expressing FLI to these
      stimuli show immunostaining with an antibody to the AT-1 Ang II receptor. These
      data indicate that central angiotensinergic pathways may be more sensitive in SHR
      than WKY, and that WKY are less sensitive than outbred Wistars.

PMID- 7796122
TI  - Neonatal monosodium glutamate treatment prevents effects of constant light on
      circadian temperature rhythms of adult rats.
AB  - Housing rats under continuous illumination (LL) disrupts circadian rhythms
      controlled by a pacemaker located in the hypothalamic suprachiasmatic nucleus
      (SCN). The neural mechanisms underlying this effect are not well understood. The
      present study examined the effects of LL on circadian rhythms and on light
      induced expression of Fos protein in the SCN, intergeniculate leaflet (IGL), and
      ventrolateral geniculate nucleus (vLGN) in adult rats treated neonatally with
      monosodium glutamate (MSG). Such treatment is known to lead to acute degeneration
      of retinal ganglion cells. Despite degeneration of the optic nerve, neonatal MSG
      treatment (2 mg/g SC on postnatal days 1,3,5,7, and 9) had no effect on daily
      temperature rhythms in the adult animal under a light-dark cycle. However, the
      disintegration of circadian rhythms under LL conditions observed in adult rats
      treated neonatally with 10% saline was prevented in MSG-treated rats.
      Furthermore, neonatal MSG treatment attenuated light-induced expression of Fos
      protein in the IGL and vLGN, but not in the SCN. These data suggest that neonatal
      MSG treatment alters the response of the circadian system to LL and that cells
      within the IGL/vLGN region may mediate this response.

PMID- 7796124
TI  - Alterations in the N-methyl-D-aspartate (NMDA) receptor complex in the frontal
      cortex of suicide victims.
AB  - Chronic antidepressant treatment results in adaptation of the NMDA receptor
      complex in the rodent cortex. This adaptation consists of a reduction in the
      potency of glycine to displace [3H]5,7-dichlorokynurenic acid from strychnine
      insensitive glycine receptors and a reduction in high affinity, glycine
      displaceable [3H]CGP-39653 binding to glutamate receptors. We hypothesized that
      dysfunction of NMDA receptors might occur in frontal cortices from human suicide
      victims. We now report that the proportion of high affinity, glycine displaceable
      [3H]CGP-39653 binding to glutamate receptors is reduced from 45 +/- 5% in
      controls to 27 +/- 6% in age- and post-mortem interval-matched suicide victims.
      In contrast, neither the potency nor the maximum efficacy of glycine to inhibit
      [3H]CGP-39653 binding is altered in the frontal cortex of suicide victims
      compared to controls. Moreover, neither the potency of glycine to inhibit [3H]5,7
      dichlorokynurenic acid binding to the strychnine-insensitive glycine receptor nor
      the specific binding of [3H]5,7-dichlorokynurenic acid binding differed in
      suicide victims compared to controls. Likewise, neither basal nor glycine- or
      glutamate enhanced non-equilibrium binding of [3H]dizocilpine was altered in the
      frontal cortex of suicide victims compared to controls. These data represent the
      first demonstration supporting the hypothesis that glutamatergic dysfunction is
      involved in psychopathology underlying suicide and, potentially in human major
      depression.

PMID- 7796123
TI  - Lateralized effect of unilateral somatosensory cortex contusion on behavior and
      cortical reorganization.
AB  - Previous studies have shown that rats recover function after unilateral
      somatosensory cortex lesions, possibly by transfer of information processing to
      other brain areas not normally involved in those functions. In the present study,
      adult rats underwent unilateral contusions of the somatosensory cortex with
      ablation of the barrel receptor field. Behavioral testing with modified beam
      walking and sensory neglect tasks demonstrated persistent somatosensory deficits
      in rats with left contusions but no apparent deficits in right injured animals.
      After 2 months, the [14C]2-deoxyglucose (2-DG) method was used to show the
      metabolic activity produced by unilateral stimulation of the facial vibrissae. In
      left injured animals, cortical metabolic activity rostral and caudal to the
      injury site was depressed both under basal conditions and during right vibrissal
      stimulation. On the other hand, comparison of the pattern of [14C]2-DG uptake in
      the intact, right cortex revealed changes in the pattern of glucose utilization
      associated with left injury combined with right vibrissal stimulation. Pattern
      changes were quantified by measuring the area in which glucose utilization was
      within the highest 25% of this range (high activity area; HAA). Right vibrissal
      stimulation in left injured rats caused an expansion of this HAA in the intact
      occipital/temporal cortex. Also, in the intact somatosensory cortex of left
      injured rats, there was an enlarged HAA whether or not vibrissal stimulation was
      performed. Thus, a combination of depressed peri-injury metabolic activity and
      aberrant activity in remote brain areas occurs following unilateral somatosensory
      cortex injury. It remains to be shown whether these factors ameliorate or
      contribute to persistent behavioral deficits.

PMID- 7796125
TI  - Pelvic and pudendal reflexes in the in vitro neonatal rat preparation.
AB  - Pudendal-to-pelvic and pudendal-to-pudendal reflexes are described in an in vitro
      brainstem-spinal cord neonatal rat preparation. Cystometrograms and peripheral
      pelvic nerve recordings were used to monitor excitatory micturition reflexes
      evoked by tactile perineal stimulation or by continuous electrical stimulation of
      the sensory pudendal nerve. Micturition was characterized by an increased bladder
      pressure and a period of tonic pelvic nerve activity during which time fluid was
      expelled from the urethra. Single stimuli delivered to the sensory pudendal nerve
      evoked a phasic response in the pelvic nerve (pudendal-to-pelvic reflex) or
      pudendal motor nerve (pudendal-to-pudendal reflexes). The pudendal-to-pelvic
      reflex consisted of a single response occurring after a mean latency of 98 +/- 24
      ms. The pudendal-to-pudendal reflex was comprised of two responses, the first
      occurred at a mean latency of 105 +/- 11 ms and the second at 383 +/- 36 ms.
      Cervical or lower thoracic spinal transection did not alter the pudendal-to
      pelvic reflex, however, the second component of the pudendal-to-pudendal reflex
      was abolished. The use of preganglionic pelvic and pudendal peripheral nerve
      recordings described in this study provide a direct measure of the reflex outflow
      from the CNS and can be used to examine developmental changes and neurochemical
      substrates within the CNS which contribute to micturition and coital reflexes in
      the rat.

PMID- 7796126
TI  - Noradrenergic enhancement of GABA-induced input resistance changes in layer V
      regular spiking pyramidal neurons of rat somatosensory cortex.
AB  - Previous in vivo studies have shown that microiontophoretic application of
      norepinephrine (NE) and isoproterenol (ISO) can enhance gamma-aminobutyric acid
      (GABA)-induced depressant responses of rat somatosensory cortical neurons. In the
      present investigation we have examined the transmembrane electrophysiological
      events which are associated with interactions between NE and GABA in layer V
      pyramidal neurons of rat barrel field cortex. Intracellular recordings were made
      from electrophysiologically identified cells in a superfused cortical tissue
      slice preparation before, during and after bath or microdrop application of GABA,
      NE and ISO, alone or in combination. GABA application produced a small
      depolarization from resting membrane potential associated with a reduction (22%)
      in input resistance. NE and ISO (10-100 microM) also produced in some cases small
      membrane depolarizations (1-4 mV) but little concomitant changes in input
      resistance. Simultaneous application of NE with GABA potentiated amino acid
      induced changes in input resistance in 4 cases and antagonized (n = 4) or had no
      effect (n = 4) on GABA-associated membrane events in 8 other cases. When the
      alpha-blocker, phentolamine (20 microM), was added to the medium, NE-induced
      enhancement of the GABA response was observed in 3 of 5 cases (60%), suggesting
      both, a beta-adrenergic mediation and a possible alpha-receptor masking of this
      noradrenergic-potentiating action. Consistent with this interpretation was the
      finding that the beta-agonist, ISO (10-100 microM), produced net increases in
      GABA-induced input resistance changes in 64% of cases tested (9 of 14). The
      potentiating effect of NE and ISO was mimicked by the adenyl cyclase activator,
      forskolin (n = 2), and a membrane permeant analog of cyclic-AMP, 8-bromo-cyclic
      AMP (n = 3); and could also be demonstrated when the GABAA agonist muscimol (0.5
      1 microM) was substituted for GABA. The reversal potential for GABA and GABA + NE
      remained the same. These findings suggest that previous demonstrations of NE
      potentiating effects on GABA inhibition may be mediated by beta-receptor/cyclic
      AMP-linked actions on mechanisms which regulate GABAA receptor-induced membrane
      conductance changes.

PMID- 7796127
TI  - Detection of D-aspartate in tau proteins associated with Alzheimer paired helical
      filaments.
AB  - Paired helical filaments (PHF) characteristic of Alzheimer neurofibrillary
      lesions are known to contain a modified form of microtubule associated protein
      tau. These proteins, PHF-tau, differ from normal tau in the extent and the site
      of phosphorylation. To determine whether PHF-tau, tau proteins from normal adult
      brains (N-tau), tau proteins from Alzheimer brains not associated with PHF (A
      tau), and tau proteins from fetal brains (F-tau) differ in racemization, these
      proteins were compared for their D-aspartate content. The results demonstrated
      that PHF-tau contain more D-aspartate than N-tau, A-tau and F-tau. The average
      percentage D-aspartate for these proteins, after a correction for background, are
      4.9%, 2.8%, 1.6%, and 1% for PHF-tau, N-tau, A-tau and F-tau, respectively. It
      remains to be determined if the increase in D-aspartate is a consequence of PHF
      formation. It is also unknown if the change in D-aspartate content in PHF-tau is
      associated with phosphorylation, which alters the susceptibility of tau to
      proteolysis.

PMID- 7796128
TI  - Involvement of nitric oxide in intracerebroventricular beta-endorphin-induced
      neuronal release of methionine-enkephalin.
AB  - Previous work has suggested that the antinociceptive effect of nitrous oxide
      (N2O) in rats is mediated, at least in part, by beta-endorphin (beta-EP) and that
      centrally administered beta-EP stimulates release of methionine-enkephalin (ME)
      in the rat spinal cord. Since inhibition of central nitric oxide (NO) production
      has been found to suppress N2O antinociception, we examined the possible
      involvement of NO in the release of spinal cord ME by i.c.v. beta-EP. Urethane
      anesthetized, male Sprague-Dawley rats were intrathecally (i.t.) perfused with
      artificial cerebrospinal fluid (aCSF) and fractions of perfusate were assayed for
      immunoreactive (i.r.) ME. The beta-EP-induced increase in ME concentration in the
      i.t. perfusate was significantly suppressed by perfusing the animal with aCSF
      containing 100 microM L-NG-nitro arginine (L-NOARG), an inhibitor of NO synthase
      (NOS). The further addition of 50 microM L-arginine (L-ARG), but not D-arginine
      (D-ARG), to the aCSF reversed the suppression of the ME change by L-NOARG.
      However, the potency of L-ARG decreased with increasing concentrations of L-ARG.
      On the other hand, increasing the concentration of L-NOARG in the aCSF to 250
      microM failed to produce a greater suppression of the beta-EP-induced increase in
      ME. These findings suggest that NO may mediate the beta-EP-induced release of ME
      in the spinal cord and that interference with this mechanism might be an
      explanation for the antagonism of N2O antinociception in rats by NOS inhibitors.

PMID- 7796130
TI  - The role of strain/vendor differences on the outcome of focal ischemia induced by
      intraluminal middle cerebral artery occlusion in the rat.
AB  - This study investigated the role of strain and vendor differences on the outcome
      of focal cerebral ischemia in the rat induced by occlusion of the middle cerebral
      artery by an intraluminal thread. The cortical infarct volumes (Mean +/- S.E.M.)
      were: 14.2 +/- 6.2 mm3 in Simonsen Laboratories Sprague-Dawley rats; 84.0 +/-
      22.9 mm3 in Simonsen Laboratories Wistar rats; 223.3 +/- 23.6 mm3 in Taconic
      Laboratories Sprague-Dawley rats; and 239.5 +/- 30.7 mm3 in Charles River
      Laboratories Sprague-Dawley rats. Middle cerebral artery occlusion combined with
      bilateral common carotid artery occlusion for 60 min increased cortical infarct
      volumes to: 113.0 +/- 18.8 mm3; 152.4 +/- 21.1 mm3; 227.8 +/- 19.3 mm3; and 248.4
      +/- 24.0 mm3, respectively. To control the effect of blood pressure as a variable
      contributing to the outcome of ischemia, additional experiments where performed
      in which the blood pressure in Simonsen Laboratories Sprague-Dawley rats was
      lowered to the level of the blood pressure in Taconic Laboratories Sprague-Dawley
      rats. Although this manipulation increased the cortical infarct volumes in
      Simonsen Laboratories Sprague-Dawley rats, the volumes were still less than those
      in Taconic Laboratories Sprague-Dawley rats. The results of the present study
      indicate that the outcome of ischemia in the intraluminal thread model may
      dramatically differ depending on the strain and vendor of animal used.

PMID- 7796129
TI  - Effects of the histaminergic system on the morphine-induced conditioned place
      preference in mice.
AB  - The effects of an H2 receptor antagonist, a histidine decarboxylase inhibitor and
      a histamine precursor on the morphine-induced place preference in mice were
      examined. Morphine (1-7 mg/kg) produced a place preference in a dose-dependent
      manner. This morphine-induced place preference was significantly antagonized by
      the dopamine (DA) D1 receptor antagonist SCH 23390. The histamine precursor, L
      histidine, attenuated the morphine (7 mg/kg)-induced place preference. On the
      other hand, the histidine decarboxylase inhibitor, alpha-fluoromethylhistidine
      (alpha-FMH), significantly potentiated the morphine (1 mg/kg)-induced place
      preference. This potentiation was antagonized by SCH 23390. The H2 receptor
      antagonist zolantidine (0.3 mg/kg) significantly potentiated the morphine-induced
      place preference. Surprisingly, zolantidine (1 mg/kg) alone also produced a
      significant place preference. The zolantidine-induced place preference was
      antagonized by SCH 23390. In addition, zolantidine (1, 3 and 10 mg/kg)
      significantly increased DA turnover (DA ratio) in the limbic forebrain (nucleus
      accumbens and olfactory tubercle), implying that zolantidine may activate the
      mesolimbic DA system. Moreover, co-administration of zolantidine dose-dependently
      increased morphine (10 mg/kg)-induced DA turnover in the limbic forebrain. These
      results suggest that the activation of histaminergic neurons may attenuate the
      rewarding effect of morphine, while the inhibition of histaminergic neurons may
      potentiate the rewarding effect of morphine. Furthermore, potentiation of the
      morphine-induced rewarding effect by inhibition of histaminergic neurons may be
      mediated by D1 receptors. We also demonstrated that the H2 receptor antagonist
      zolantidine may activate the mesolimbic DA system, and as a result, zolantidine
      itself produces a rewarding effect and potentiates the morphine-induced rewarding
      effect.

PMID- 7796131
TI  - Electrophysiological evidence for glutamate as a vomeronasal receptor cell
      neurotransmitter.
AB  - Bipolar receptor cells in the vomeronasal organ send axonal projections to the
      accessory olfactory bulb where they synapse with mitral cell dendrites. Although
      the nature of the synapse is thought to be excitatory, the neurotransmitter(s)
      involved has not yet been identified. Electrophysiological recordings of single
      neurons in the mitral cell layer of the AOB in response to vomeronasal nerve
      stimulation were conducted to characterize the synaptic response and the
      underlying neurotransmitter substance. Extracellular activity was recorded in
      vivo (whole animal) and in vitro (AOB slice) from female rats. In vivo, the
      predominant response to stimulation of the VNO was excitation. In many instances
      in the whole animal preparation, the excitation was followed by an inhibitory
      response. Attempts to block the excitatory response by ejecting kynurenic acid in
      close proximity to the mitral cell being recorded were not successful. Since this
      failure may have been due to inability of the antagonist to reach its presumed
      site of action at the dendrite, further recordings were carried out in vitro. In
      the AOB slice preparation, the predominant response to stimulation of the VN
      nerve endings was excitation. Superfusion of the non-NMDA antagonist, CNQX, into
      the medium resulted in a reduction of the orthodromic excitation in 5 of 8 cells.
      The NMDA antagonist, AP-5, was found to blunt orthodromic excitation in 1 of 4
      cells. These results suggest that the excitatory response evoked in mitral cells
      followng stimulation of the VN nerve is mediated by glutamate.

PMID- 7796132
TI  - Short and long-term changes in dopamine and serotonin receptor binding sites in
      amphetamine-sensitized rats: a quantitative autoradiographic study.
AB  - The biochemical changes in DA and 5HT systems were investigated in amphetamine
      (AMPH)-sensitized rats, 1 and 15 days after cessation of treatment (5 mg/kg AMPH,
      i.p., twice a day for 6 days). At both times, AMPH-treated rats exhibited
      behavioral sensitization, as revealed by an enhancement of the stereotypic
      response to a challenge dose of 2 mg/Kg, ip. AMPH. Basal dopamine (DA) and
      serotonin (5-HT) metabolism was not significantly modified in different brain
      areas of AMPH-sensitized rats. Quantitative autoradiographic analysis of DA and
      serotonin 5-HT receptor subtypes was performed in the following brain regions:
      medial prefrontal cortex, nucleus accumbens, striatum, substantia nigra, ventral
      tegmental area, dorsal and median raphe nuclei. A significant increase of [3H]SCH
      23390 binding to D1 DA receptors was observed in the substantia nigra pars
      reticulata 1 day but not 15 days after the cessation of AMPH treatment, whereas
      [3H]8-OH-DPAT binding to 5-HT1A sites was found to be significantly enhanced in
      the dorsal raphe nucleus at both time points. No change in D2 DA nor in 5-HT1B or
      5-HT2A receptors was found in any of the brain structures examined at either time
      point. The obtained results suggest that DA and 5-HT systems are differently and
      time-dependently involved in AMPH-induced behavioral sensitization.

PMID- 7796134
TI  - Angiotensin II receptor subtypes in the human central nervous system.
AB  - The distribution of the AT1 and AT2 subtypes of angiotensin II receptor was
      mapped in the adult human central nervous system using quantitative in vitro
      autoradiography. Binding in all forebrain, midbrain, pontine, medullary and
      spinal cord sites where angiotensin II receptors have previously been described
      is of the AT1 subtype, as is binding in the small and large arteries in the
      adjacent meninges and in choroid plexus. By contrast, both AT1 and AT2 receptors
      occur in the molecular layer of the cerebellum. Angiotensin II AT1 receptors in
      the brain show a moderate degree of conservation across mammalian species studied
      so far, whereas expression of AT2 receptors is more variable, and is more
      restricted in the human CNS than in many other mammals. These differences between
      the subtype distributions in humans and other animals indicate the need for care
      when extrapolating the results of animal studies involving the brain angiotensin
      system.

PMID- 7796133
TI  - Chronic hypoxia causes opposite effects on glucose transporter 1 mRNA in mature
      versus immature rat brain.
AB  - We have shown previously that chronic hypoxia can regulate the expression of
      membrane proteins. Since there are virtually no glucose stores in the brain and
      glucose transport can be rate-limiting during stress, the role of glucose
      transporters becomes crucial for cell survival under stress. In the present
      study, we asked whether mRNA levels for glucose transporter 1 (GT1), which is
      expressed in a variety of cells in the brain, especially in the microvessels for
      glucose transport from blood vessels to brain, change in response to chronic
      hypoxia. Because major developmental changes occur in the rat CNS in-utero and in
      the first few weeks postnatally, we studied brain GT1 mRNA using Northern blot
      analysis at different ages after exposure of fetuses (from embryonic day 10 to
      birth), developing rats (from birth to 30 day old) or adult rats (from 90 to 120
      day old) to hypoxia (Fractional inspired O2 9%). Our data show that (i) GT1 mRNA
      level was much lower in the newborn than in the adult and increased with age;
      (ii) chronic hypoxia caused a decrease of approximately 65% in GT1 mRNA in adult
      brain but induced an increase in fetal (more than 50%) and developing
      (approximately 80%) rats and (iii) the response of housekeeping gene
      (glyceraldehyde 3-phosphate dehydrogenase) was not similar to that of GT1,
      suggesting that the changes of GT1 mRNA are specific to glucose
      transporter.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796135
TI  - Experimental analysis of the method of 'peeling' exponentials for measuring
      passive electrical properties of mammalian motoneurons.
AB  - Trigeminal motoneurons of the guinea pig brain stem slice preparation were
      studied using intracellular recording techniques. The voltage response to a 100
      ms constant-current pulse was studied and a population of cells was found which
      did not exhibit sag or overshoot of their voltage response to a pulse of
      hyperpolarizing current of < 1 nA but did exhibit both phenomena when a current
      pulse of > 1 nA was used. The sag and overshoot observed with large-current
      pulses were reduced or blocked when 4 mM CsCl was added to the bathing solution.
      This observation supports the hypothesis that these phenomena were due to the
      voltage- and time-dependent activation of the Q-current. The method of peeling
      exponentials was then used to correct raw voltage data from cells in which the Q
      current was present. The mean membrane time constant was within 1% and the mean
      input resistance was within 2% of the means for these parameters when measured in
      these same cells under conditions in which the Q-current was absent. We conclude
      from these experiments that the method of peeling exponentials is valid for
      obtaining estimates of the membrane time constant and input resistance from cells
      that exhibit sag and overshoot due to voltage- and time-dependent changes in the
      magnitude of the Q-current.

PMID- 7796137
TI  - The role of nitric oxide in opioid-induced pial artery vasodilation.
AB  - The present study was designed to investigate the role of nitric oxide (NO) and
      the production of cGMP in the vasodilator response to opioid agonists in newborn
      pigs equipped with a closed cranial window. Methionine-enkephalin (10(-8), 10(-6)
      M), an endogenous mu opioid agonist, produced pial artery dilation that was
      attenuated by L-nitroarginine (LNA, 10(-6) M), an NO synthase inhibitor (10 +/- 1
      vs. 4 +/- 1 and 16 +/- 1 vs. 7 +/- 1% for 10(-8), 10(-6) M methionine-enkephalin,
      respectively). Methionine-enkephalin-induced vasodilation was associated with
      increased cortical periarachnoid CSF cGMP and these changes in CSF cGMP were
      attenuated by LNA (354 +/- 11 and 596 +/- 32 vs. 278 +/- 13 and 266 +/- 19
      fmol/ml for control and methionine-enkephalin 10(-6) M before and after LNA,
      respectively). Leucine enkephalin, an endogenous delta agonist, elicited similar
      changes in pial diameter and CSF cGMP while dynorphin, an endogenous k agonist,
      produced dilation associated with large increases in CSF cGMP (374 +/- 18 vs.
      1054 +/- 45 fmol/ml for control and dynorphin 10(-6) M, respectively). Vascular
      and biochemical changes for these two opioids were similarly attenuated by LNA.
      The synthetic selective opioid receptor agonists, DAMGO, DPDPE, deltorphin, and
      U50,488H (10(-8), 10(-6) M) mu, delta 1, delta 2, and kappa agonists,
      respectively, also elicited increases in pial artery diameter and CSF cGMP that
      were similarly attenuated by LNA.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796138
TI  - Quantitative autoradiographic localization in rat brain of alpha 2-adrenergic and
      non-adrenergic I-receptor binding sites labelled by [3H]rilmenidine.
AB  - alpha 2A-Adrenergic receptor (AR) and non-adrenergic imidazoline receptor (I-R)
      binding sites have been previously characterized in rat cerebral cortex membranes
      using the N-substituted oxazoline, [3H]rilmenidine ([3H]Ril) [King, P.R. et al.,
      Eur. J. Pharmacol., 218 (1992) 101-108]. In the present study, in vitro
      autoradiography was used to quantify the regional distribution of these receptors
      throughout the rat neuroaxis. The distribution and relative density (fmol/mg
      tissue) of I-Rs was examined in the presence of 1 microM adrenaline to block the
      adrenergic component of 40 nM [3H]Ril binding and non-specific binding was
      measured in the presence of another oxazoline, Bay a6781 (10 microM). Both alpha
      2A-ARs and I-Rs were broadly, but heterogeneously, distributed. In forebrain,
      high levels of [3H]Ril-labelled alpha 2A-AR sites were observed in the anterior
      olfactory nucleus, the piriform, entorhinal and perirhinal cortices, lateral
      septum, bed nucleus of the stria terminalis, several thalamic nuclei, the
      amygdala and the arcuate, dorsomedial and posterior hypothalamic nuclei. In
      hindbrain, alpha 2A-AR sites were concentrated in locus coeruleus, lateral
      parabrachial nucleus, nucleus of the solitary tract and area postrema. I-R sites
      accounted for 50% or more of specific [3H]Ril binding (40 nM) in most cortical
      and hypothalamic nuclei, nucleus of the solitary tract, cranial motor nuclei and
      most spinal cord layers. The highest densities of I-Rs were found in the arcuate,
      dorsomedial and posterior hypothalamic nuclei, the locus coeruleus, the area
      postrema, the cranial motor nuclei and associated with spinal motor neurones. A
      very high concentration of I-Rs was also detected in the pineal gland. The
      distribution of alpha 2-AR sites determined resembled that reported with [3H]p
      aminoclonidine which appears to specifically label alpha 2-ARs and not I1-R sites
      in rat brain sections, and [3H]methoxyidazoxan which is a selective alpha 2-AR
      antagonist. The regional and cellular distribution of I-R binding sites was
      unlike the distribution of putative I1-R sites labelled by [3H]clonidine in human
      brain, although comparable autoradiographic mapping studies in rat brain have not
      been done using this ligand. The regional and cellular distribution of [3H]
      labelled I-R binding sites had both similarities and differences to that reported
      using the imidazoline ligand, [3H]idazoxan, with common labelling of areas such
      as area postrema, arcuate and interpeduncular nuclei and pineal gland with the
      two ligands, and differential relative binding levels ([3H]Ril > [3H]idazoxan)
      associated with hippocampal pyramidal cells and brainstem and spinal motor
      neurones.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7796136
TI  - Ca(2+)- and Cl(-)-dependent, NMDA receptor-mediated neuronal death induced by
      depolarization in rat hippocampal organotypic cultures.
AB  - The neurotoxicity induced by depolarization with high-K+ was investigated in rat
      hippocampal organotypic slice cultures. The exposure of cultures to 90 mM K+
      solution for 30 min caused a severe neuronal injury in CA1 region while less
      damage was observed in CA3 and dentate gyrus over the following day. This
      neurotoxicity was prevented in a concentration dependent manner by NMDA
      antagonist MK-801 or CPP. Non-NMDA antagonist, DNQX, had no protective effect.
      Omission of Ca2+ from the exposure solution prevented the neurotoxicity. Voltage
      dependent Ca2+ channel blockers, nifedipine and flunarizine, failed to prevent
      the neurotoxicity. These results suggest that the Ca2+ influx through the NMDA
      receptor is predominantly involved in this neurotoxicity. Apparent tissue
      swelling was observed immediately after the depolarization. This swelling was
      completely inhibited by omission of Cl- from the exposure solution, accompanied
      with complete protection against neurotoxicity. This suggests that Cl(-)
      dependent tissue swelling also largely contributes to the neurotoxicity.
      Depolarization with application of MK-801 (10 microM) or omission of Ca2+ from
      the solution still caused apparent swelling, despite these treatment protected
      neuronal death. We hypothesize that Cl(-)-dependent tissue swelling may be
      involved in the release of the excitatory amino acid, which activates the NMDA
      receptor.

PMID- 7796139
TI  - Inhibition of growth factor-induced DNA synthesis in astrocytes by ligands of
      peripheral-type benzodiazepine receptors.
AB  - The effect of diazepam and specific ligands of peripheral-type benzodiazepine
      receptors (PBRs) on growth factor-induced DNA synthesis in quiescent cultures of
      rat astrocytes has been examined. It was found that diazepam inhibited the
      ability of basic fibroblast growth factor (bFGF) to stimulate [3H]thymidine
      incorporation; the IC50 was approximately 5 microM. Ro5-4864, a specific agonist
      of PBRs, also blocked bFGF-induced DNA synthesis. PK11195, which in some cases
      functions as an antagonist of PBRs, did not prevent the effect of Ro5-4864 on
      bFGF-induced DNA synthesis; rather, addition of PK11195 also inhibited bFGF
      induced DNA synthesis. In addition, diazepam reduced the stimulation of DNA
      synthesis caused by epidermal growth factor (EGF) and platelet-derived growth
      factor (PDGF), polypeptide growth factors coupled to receptor tyrosine kinases,
      as well as thrombin, an activator of G protein-coupled receptors. These data
      suggest that ligands of PBRs may limit astrocyte mitosis, a phenomenon that
      occurs following CNS injury.

PMID- 7796140
TI  - Methyl-beta-carbolinium analogs of MPP+ cause nigrostriatal toxicity after
      substantia nigra injections in rats.
AB  - Eleven beta-carbolinium compounds (beta C+s) and MPP+ were stereotaxically
      injected (40-200 nmol in 5 microliter of vehicle) unilaterally into the
      substantia nigra of anesthetized adult male Sprague-Dawley rats. The rats were
      sacrificed after three weeks. The ipsilateral striatum was analyzed for dopamine
      and DOPAC levels with HPLC. The brainstem injection site was fixed and cut
      coronally. The largest lesion area in each animal was measured using NIH IMAGE.
      Three beta C+s produced lesions whose mean areas were nearly as large as that
      produced by MPP+ (defined as 100%): 2,9-Me2-harman (94%), 2-Me-harmol (74%), and
      2,9-Me2-norharman (57%). Three other compounds produced somewhat smaller lesions:
      2-Me-harmaline (34%), 6-MeO-2-Me-harman (29%), and 2-Me-harmine (25%). The
      remaining compounds were ineffective (< or = 12%): norharman, 2-Me-norharman, 2
      Me-harman, harmine, and 2-Me-6-MeO-harmalan. A 40 nmol dose of MPP+ reduced
      ipsilateral striatal dopamine to 0.6% of control. None of the beta C+s approached
      this, although several did significantly reduce striatal dopamine at doses of
      either 40 nmol (2,9-Me2-harman (37%), 2,9-Me2-norharman (42%), and 2-Me-harman
      (63%)) or 200 nmol (2-Me-harmaline (23%), norharman (63%), and 2-Me-norharman
      (64%)). There was a moderate negative correlation between lesion size and
      dopamine level (r = -0.65). There were also moderately strong correlation between
      lesion size and dopamine level (r = -0.65). There were also moderately strong
      correlations (r = 0.39-0.78) between the beta C+ nigral lesion area or striatal
      dopamine level potencies and their previously described IC50 values for
      inhibiting mitochondrial respiration or their toxicity to PC12 cells in culture.
      Interestingly, our correlation analysis revealed a remarkably strong correlation
      between beta C+ Ki MAO-A values and their toxicity to PC12 LDH release (r = 
      0.84) or PC12 protein loss (r = 0.79). Although beta C+s appear to be less
      specific toxins than MPP+, their levels in human substantia nigra are 8-20-fold
      higher than in cortex, making their role as relatively selective nigral toxins in
      Parkinson's disease plausible.

PMID- 7796141
TI  - Contribution of L- and N-type calcium currents to exocytosis in rat adrenal
      medullary chromaffin cells.
AB  - The excitation-secretion coupling process requires Ca2+ influx through voltage
      dependent Ca2+ channels (VDCC) but the contribution of L-type or N-type VDCC
      during the secretion from adrenal chromaffin cell is still on debate. In this
      study we explored the contribution of each VDCC to exocytosis in single rat
      adrenal chromaffin cells. Chromaffin cells were voltage-clamped clamped in the
      whole-cell recording mode. Ca2+ inward current (ICa) was elicited by
      depolarization from -70 mV to +10 mV and the change in cell membrane capacitance
      (Cm) was monitored as an indicator of the resultant exocytosis. The increase in
      Cm had positive correlation with the amount of ICa and replacing the internal
      Ca2+ buffer to high EGTA (5 mM) decreased the sensitivity of Cm increase to Ca2+
      influx. After blockage of ICa with 100 microM Cd2+, there was no increase in Cm
      following membrane potential depolarization while INa was intact. To clarify the
      contribution of each type of VDCC to induce exocytosis during membrane potential
      depolarization, L- and N-type ICa were blocked selectively by Ca2+ channel
      antagonists. After blockage of L-type ICa with nicardipine (1 microM), ICa was
      blocked to 35 +/- 6.2% (mean +/- standard error) of control and the resultant
      change in Cm was reduced to 38 +/- 4.6% of control. Bay K-8644 (1 microM)
      enhanced ICa and the similar proportion of Cm was increased by this L-type VDCC
      agonist. On the other hand omega-conotoxin GVIA (1 microM), an N-type VDCC
      antagonist, blocked ICa to 60 +/- 4.3% of control and reduced the change in Cm to
      58 +/- 3.9% of control.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796142
TI  - Prenatal stress increases corticotropin-releasing factor (CRF) content and
      release in rat amygdala minces.
AB  - Corticotropin-releasing factor (CRF) is a neuropeptide found throughout the
      central nervous system that has a proposed role in modulating emotional and
      behavioral states, including stress and anxiety. The amygdala, which is important
      in the control of emotional and autonomic responses to stress, contains CRF nerve
      terminals, CRF cell bodies, and CRF receptors. In rats, exposure to prenatal
      stress results in offspring that display a hyperemotional state and increased
      anxiety. In this study the effects of prenatal stress on CRF release was measured
      in amygdala minces (1 mm3) obtained from adult (8-16 weeks of age) male offspring
      of dams subjected to daily saline injection (0.1 ml, s.c.) from gestational day
      14 to 21. CRF release from amygdala was time- and calcium-dependent, and
      stimulated by KCl-induced depolarization. Depolarization-induced CRF release was
      significantly increased by 42% from the amygdala of prenatally stressed offspring
      versus controls. Prenatally stressed offspring also showed a 49% increase in CRF
      levels in the amygdala. The increased amounts of CRF released in response to
      depolarization were likely the consequence of increased tissue content of CRF, as
      fractional release under basal or KCl-stimulated conditions was not different in
      the prenatal stress group versus control. This suggests that a long-lasting up
      regulation of the CRFergic neurotransmission may occur in the amygdala, which may
      be important in the generation of hyperemotional offspring after exposure to
      prenatal stress.

PMID- 7796143
TI  - Distribution of calbindin-D28K in the brain of the fetal sheep in late gestation.
AB  - Immunocytochemical distribution of calbindin-D28K was examined in the brains of
      fetal sheep at 100-105 and 120-125 days of gestation (dGA) and at term in labor
      (term approximately 150 dGA) and compared to adult sheep. Brains were perfused,
      cut frozen and immunostained as freely floating sections with a polyclonal anti
      calbindin-D28K antibody. Light microscopy revealed that calbindin-D28K
      immunogenicity in fetal cerebellum, rhombencephalon, mesencephalon, diencephalon
      and telencephalon was overall very similar to that seen in the brains of adult
      sheep. In addition even though fetal sheep peripheral plasma cortisol
      concentrations increase 10-20 times over the last 3-4 weeks of gestation to peak
      during labor and delivery, no glucocorticoid dependent increases in calbindin
      D28K in the hippocampal formation could be seen in the sheep fetus as have been
      demonstrated for the adult rat given exogenous glucocorticoids. It is concluded
      that: (1) the basic pattern of calbindin-D28K distribution seen in adult sheep
      brains is established by at least 100 dGA in the sheep fetus; and (2) the pattern
      of calbindin-D28K expression in fetal sheep hippocampal formation is not related
      to peripheral plasma glucocorticoid concentrations.

PMID- 7796144
TI  - Inhibition of morphine tolerance and dependence by diazepam and its relation to
      cyclic AMP levels in discrete rat brain regions and spinal cord.
AB  - Diazepam inhibits morphine tolerance and dependence and reverses a decrease in
      the met-enkephalin level in brain induced by morphine. In this study, we
      investigated whether inhibition of morphine-induced tolerance and dependence by
      diazepam involved a change in cyclic AMP levels in discrete rat brain regions and
      spinal cord. Male Sprague-Dawley rats were made tolerant and dependent by
      subcutaneous (s.c.) implantation of six morphine pellets (two pellets on the
      first day, and four on the second day). Diazepam (0.25 mg/kg b. wt) was injected
      once daily intraperitoneally (i.p.) for 5 days. Control rats were implanted with
      placebo pellets and injected once daily with saline or diazepam (i.p.). Tail
      flick antinociception was measured 1 h after injections everyday. Animals were
      administered s.c. naloxone (10 mg/kg) to induce naloxone-precipitated withdrawal
      syndrome on the final day of the experiment (day 5), and the jumping behavior was
      observed for 30 min. Concomitant treatment with diazepam (0.25 mg/kg)
      significantly decreased the development of morphine tolerance and dependence.
      Diazepam (0.25 mg/kg) treated rats also showed a significant decrease in the
      jumping behavior compared to animals treated with morphine alone. Rats were
      sacrificed 2 h after the injection of saline or diazepam (0.25 mg/kg) on the
      fifth day. Cyclic AMP was estimated by RIA. In the control rats, the
      concentration of cyclic AMP in cortex was > hippocampus > cerebellum >
      hypothalamus > striatum > midbrain > pituitary > pons/medulla > spinal cord.
      There was no change in the concentration of cyclic AMP in any of the brain
      regions examined from morphine tolerant animals.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796145
TI  - Immunocytochemical evidence for vesicular storage of glutamate in cat
      spinocervical and cervicothalamic tract terminals.
AB  - The densities of synaptic vesicles and gold particles, signaling fixed glutamate,
      were examined in spinocervical and cervicothalamic tract terminals. Statistically
      significant positive correlations between these parameters were detected in both
      terminal populations, whereas presumed inhibitory profiles displayed
      insignificant or negative correlations. These findings indicate a vesicular
      storage of glutamate in spinocervical and cervicothalamic tract terminals, and
      thus provide further evidence for glutamate as a neurotransmitter in the
      spinocervicothalamic pathway.

PMID- 7796146
TI  - Selective activation of dopamine transmission in the shell of the nucleus
      accumbens by stress.
AB  - A microdialysis probe was placed in either the shell or core compartment of the
      nucleus accumbens and rats were exposed to mild footshock. Extracellular dopamine
      levels in the shell of the nucleus accumbens were elevated during the 20-min
      collection period immediately after discontinuing footshock. In contrast, the
      levels of dopamine remained unaltered in the core of the nucleus accumbens.

PMID- 7796147
TI  - Herpes simplex virus induces Fos expression in rat brainstem neurons.
AB  - After the injection of Herpes Simplex Virus type 1 into the rat cervical vagus
      nerve, transneuronally labelled virus-containing neurons and glial cells were
      present in the medulla oblongata. Fos-containing nuclei were present in the same
      regions of the brain. A double-labelling procedure revealed that most of the
      virus-positive neurons also contained Fos-positive nuclei. Appearance of HSV1
      antigen within the CNS is associated with Fos expression in neurons and glial
      cells.

PMID- 7796149
TI  - Parvalbumin and calbindin D-28k in vagal and glossopharyngeal sensory neurons of
      the rat.
AB  - Parvalbumin- and calbindin D-28k-immunoreactivities (ir) were examined in the
      glossopharyngeal and vagal sensory ganglia (petrosal, nodose and jugular
      ganglia), the carotid sinus nerve and the carotid body. Parvalbumin-ir nerve
      cells were mostly localized in the petrosal and nodose ganglia and were rare in
      the jugular ganglion. Calbindin D-28k-ir nerve cells were found in moderate and
      large numbers in the petrosal and nodose ganglia, respectively. Only a few
      calbindin D-28k-ir nerve cells were observed in the jugular ganglion. The carotid
      sinus nerve and carotid body contained numerous calbindin D-28k-ir nerve fibers
      but few parvalbumin-ir nerve fibers. Studies of the coexistence of these calcium
      binding proteins with calcitonin gene-related peptide (CGRP)- and tyrosine
      hydroxylase (TH)-ir showed that CGRP-ir was rarely colocalized in parvalbumin- or
      calbindin D-28k-ir nerve cells in the petrosal or nodose ganglion. Moreover, TH
      ir was not generally contained in parvalbumin-ir nerve cells in the petrosal,
      nodose and jugular ganglia while a portion (15-19%) of calbindin D-28k-ir neurons
      in the petrosal and nodose ganglia colocalized TH-ir. These findings are
      consistent with the involvement of calcium-binding proteins, particularly
      calbindin D-28k, in the function of visceral sensory neural systems of the
      glossopharyngeal and vagus nerves and, perhaps, in baro- and chemoreceptor
      neurotransmission.

PMID- 7796148
TI  - Bicuculline blocks neuropeptide Y-induced phase advances when microinjected in
      the suprachiasmatic nucleus of Syrian hamsters.
AB  - Microinjection of neuropeptide Y (NPY) into the suprachiasmatic nucleus of the
      hypothalamus (SCN) during the middle of the subjective day (i.e. circadian time
      6) causes large phase advances in circadian rhythms. The present study
      demonstrates that microinjection of the gamma-aminobutyric acid (GABA)
      antagonist, bicuculline, completely blocks NPY-induced phase advances. These data
      indicate that GABAA activity within the SCN may mediate the phase shifting
      effects of some stimuli on the circadian pacemaker.

PMID- 7796150
TI  - Radioligand-binding study of noribogaine, a likely metabolite of ibogaine.
AB  - Radioligand-binding studies were performed to ascertain the actions of
      noribogaine, a suspected metabolite of ibogaine, on opioid receptors. Consistent
      with previous results, ibogaine showed highest affinity for kappa opioid
      receptors (Ki = 3.77 +/- 0.81 microM), less affinity for mu receptors (Ki = 11.04
      +/- 0.66 microM) and no affinity for delta receptors (Ki > 100 microM).
      Noribogaine showed a higher affinity than ibogaine for all of the opioid
      receptors: kappa Ki = 0.96 +/- 0.08 microM, mu Ki = 2.66 +/- 0.62 microM and
      delta Ki = 24.72 +/- 2.26 microM. These data suggest that noribogaine is active
      in vivo and that it may contribute to ibogaine's pharmacological effects.

PMID- 7796151
TI  - Effect of constant temperatures, darkness and light on the secretion of melatonin
      by pineal explants and retinas in the gecko Christinus marmoratus.
AB  - The effects of temperature and lighting conditions on the secretion of melatonin
      by the pineal organ of the nocturnal gecko Christinus marmoratus was studied
      using in vitro perifusion. In a 12L:12D lighting regime, a high-amplitude
      melatonin rhythm was detectable at a constant temperature of 20 and 30 degrees C
      but not at 10 or 37 degrees C. There were sustained high levels of melatonin in
      constant darkness and sustained low levels in constant light. No retinal
      melatonin was detected using static and perifusion culture techniques. These
      results show that the pineal organ of C. marmoratus maintains light sensitivity
      in vitro but does not contain an oscillator coupled to the melatonin synthetic
      pathway.

PMID- 7796152
TI  - Glycine site NMDA receptor antagonists provide protection against ischemia
      induced neuronal damage in hippocampal slice cultures.
AB  - Ischemia-induced neuronal injury can be reduced by glutamate antagonists acting
      at the N-methyl-D-aspartate (NMDA) receptor. 7-Chlorokynurenic acid and the
      recently synthesized compound Acea 1021 block NMDA receptors by acting at the
      strychnine-insensitive glycine site. The anti-ischemic properties of these
      compounds were tested by evaluating their ability to reduce CA1 neuronal damage
      in hippocampal slice cultures deprived of oxygen and glucose. Acea 1021 and 7
      chlorokynurenic acid significantly reduced CA1 injury produced by oxygen and
      glucose deprivation in a dose-dependent manner. The neuroprotective effect of
      these compounds was reversed by the addition of glycine. The phencyclidine site
      NMDA antagonist MK-801 also provided significant protection to CA1 neurons
      against the same insult, and this protection was not affected by the addition of
      glycine. These results indicate that Acea 1021 and 7-chlorokynurenic acid can
      provide protection to CA1 neurons against ischemia-induced injury by a glycine
      sensitive mechanism.

PMID- 7796153
TI  - Brain chimeras for the study of an avian model of genetic epilepsy: structures
      involved in sound and light-induced seizures.
AB  - The epileptic homozygotes of the Fayoumi strain of chickens (Fepi) are affected
      by photogenic reflex epilepsy with complete penetrance. Here we demonstrate that
      they are equally affected by audiogenic reflex epilepsy induced by intense sound
      stimulation. All the Fepi display sound-induced seizures from hatching to
      adulthood consisting of initial 'ictal arousal' and running fits usually followed
      by generalized clonico-tonic convulsions. A running fit is the preconvulsive
      motor symptom specifically induced by auditory stimulation while neck myoclonus
      is the preconvulsive motor symptom specifically induced by photic stimulation.
      The EEG interictal spikes and spike and waves are suppressed and replaced by a
      desynchronized trace during the seizures of both kinds. Viable neural chimeras
      were obtained by graft of embryonic brain vesicles from Fepi donors into normal
      chick embryos. Transfer of the complete audiogenic and photogenic phenotypes was
      obtained in chimeras resulting from embryonic substitution of both the
      prosencephalon and mesencephalon. The substitution of the prosencephalon alone
      resulted in transfer of interictal paroxysmal EEG activity accompanied by the
      sound and light-induced desynchronization and 'ictal arousal' with no motor
      seizures. Chimeras with embryonic substitution of the mesencephalon alone
      displayed running fits and convulsions induced by sound stimulation but only neck
      myoclonus following light stimulation. The conclusions are reached that: (i) the
      Fepi is a model of audiogenic and photogenic reflex epilepsy; (ii) in both types,
      the seizure initiator and the convulsion generator are localized in the
      brainstem, although reinforcement from telencephalic visual structures is needed
      to trigger photogenic generalized convulsions.

PMID- 7796154
TI  - Caffeine intake (200 mg) in the morning affects human sleep and EEG power spectra
      at night.
AB  - Adenosine has been implicated in the physiological regulation of sleep
      propensity. The adenosine-receptor-antagonist, caffeine (100 mg), administered
      immediately prior to a nocturnal sleep episode, has previously been shown to
      lower sleep propensity as indexed by a reduced sleep efficiency, a reduced EEG
      power density in low delta frequencies and enhanced power density in the
      frequency range of sleep spindles. To further investigate the role of adenosine
      in sleep regulation we administered 200 mg of caffeine at 07.10 h and analyzed
      the sleep stages and EEG power spectra during the subsequent night in nine
      healthy men. Caffeine levels in saliva decreased from a maximum of 17 mumol/l one
      hour after intake, to 3 mumol/l immediately prior to the sleep episode starting
      at 23.00 h. Compared to placebo, sleep efficiency and total sleep time were
      significantly reduced. EEG power density in nonREM sleep was suppressed in the
      0.25-0.5 Hz band and enhanced in the frequency range of sleep spindles (11.25
      12.0 Hz and 13.25-14.0 Hz). In REM sleep EEG power density was suppressed in the
      frequency range of 0.75-4.5 and 5.25-6.0 Hz. The data indicate that a saliva
      level of caffeine as low as 3 mumol/l directly affects sleep propensity or,
      alternatively, that the presence of caffeine in the central nervous system during
      the waking episode reduces the progressive increase of sleep propensity
      associated with wakefulness.

PMID- 7796155
TI  - Complement C1 inhibitor is produced by brain tissue and is cleaved in Alzheimer
      disease.
AB  - C1 inhibitor was identified in human brain tissue by Western blotting and by
      immunohistochemistry using multiple antibodies to the native protein. The
      presence of C1 inhibitor mRNA was identified by reverse transcriptase-polymerase
      chain reaction analysis of brain mRNA extracts. The mRNA was also detected in
      cultured postmortem human microglia and in the IMR-32 human neuroblastoma cell
      line. Immunohistochemically, the native protein was detected in residual serum of
      capillaries and pyramidal neurons of both control and Alzheimer disease cases, as
      well as in occasional senile plaques of Alzheimer tissue. The reacted protein was
      detected on dystrophic neurites and neuropil threads in Alzheimer tissue by 4C3
      monoclonal antibody, which recognizes a neoepitope following suicide inhibition.
      These data indicate that C1 inhibitor, a regulatory molecule controlling multiple
      inflammatory proteolytic cascades, is produced in normal brain. In Alzheimer
      disease, C1 inhibitor undergoes a prominent reaction in abnormal neuronal
      processes, such as dystrophic neurites and neuropil threads.

PMID- 7796156
TI  - Gonadal steroid hormone-dependence of beta-endorphin-like immunoreactivity in the
      medial preoptic area of the rat.
AB  - Gonadal steroid hormones are known to alter the expression of proopiomelanocortin
      (POMC) mRNA in neurons of the arcuate nucleus (ARC). These neurons send
      projections to the medial preoptic area (MPOA), wherein mu-opiate receptor
      density is cyclical and gonadal steroid hormone-dependent. Although beta
      endorphin-(beta-Endo) content in the MPOA is known to vary across the estrous
      cycle, the effect of gonadal hormones on the distribution and density of beta
      Endo-like immunoreactive (IR) fiber density in the preoptic area is unknown. In
      the present study, immunohistochemical staining was used to investigate the
      effects of gonadal steroid hormone treatment on beta-Endo-like IR fibers in the
      MPOA of ovariectomized (OVX) female rats. The density of beta-Endo-like IR fibers
      was low in the MPOA of OVX rats, but increased slightly following treatment with
      17 beta-estradiol (E2) or 3 h after subsequent progesterone (P) injection.
      However, beta-Endo-like IR fiber density increased significantly 27 h after E2P
      treatment, and remained elevated 51 h after E2P treatment in the periventricular
      zone and in the medial portion of the medial preoptic nucleus, although the
      general distribution of fibers was unchanged. These results suggest that the
      density of MPOA beta-Endo innervation is normally gonadal steroid hormone
      dependent and that the medial MPOA contains greater opioid tone than the lateral
      MPOA regardless of the hormonal state. Furthermore, since beta-Endo-like IR fiber
      density remained elevated even though gonadal hormone levels decreased,
      additional factors might modulate the release or turnover of beta-Endo in the
      MPOA during normal estrous cycling.

PMID- 7796158
TI  - Psychophysiological stress induces heat shock cognate protein (HSC) 70 mRNA in
      the cerebral cortex and stomach of rats.
AB  - Families of 70 kDa heat shock proteins have essential roles in cellular coping to
      noxious stimuli. However, their roles in psychophysiological stress have not been
      precisely clarified. We tested our hypothesis that heat shock cognate protein
      (HSC)70 messenger RNA would increase in stress-vulnerable organs under
      psychophysiological stress. In control rats, cerebral HSC70 mRNAs were
      constitutively expressed while gastric HSC70 mRNAs were scarcely identified.
      Restraint-water immersion stress significantly increased the level of cerebral
      HSC70 mRNAs for 6 h and 12 h. Stress for 6 h with recovery for 6 h induced more
      gastric HSC70 mRNA levels than that without recovery, while stress for 12 h
      expressed the highest gastric HSC70 mRNA levels. Hypothermia, induced by water
      immersion, excluded a possible role of hyperthermia in inducing HSC70 mRNA. Our
      results point to a crucial cytoprotective role for families of heat shock
      proteins in stress-vulnerable brain-gut link in mammals under psychophysiological
      stress.

PMID- 7796157
TI  - Brain corticotropin-releasing factor mediates 'anxiety-like' behavior induced by
      cocaine withdrawal in rats.
AB  - Anxiety is a key symptom of the cocaine withdrawal syndrome in human addicts, and
      it is considered to be one of the major factors in precipitating relapse to
      chronic cocaine abuse. Corticotropin-releasing factor (CRF) plays an important
      role in the pathophysiology of anxiety and depression, and it may also be
      involved in the acute behavioral and neuroendocrine actions of cocaine. The role
      of endogenous CRF in cocaine withdrawal-induced anxiety was investigated in the
      present study. Animals were subjected to chronic cocaine (20 mg/kg,
      intraperitoneally, once a day for 14 days) administration. Rats tested 30 min
      after the last cocaine injection did not show withdrawal anxiety on the elevated
      plus maze or any alterations in brain CRF levels. Withdrawal (48 h) from chronic
      cocaine administration produced an intense anxiety-like behavior characterized by
      decreased open arm exploration. Immunoreactive CRF (CRF-LI) levels were
      selectively altered in the hypothalamus, in the amygdala and in the basal
      forebrain structures at the time of the behavioral anxiety, reflecting an
      increased activity of brain CRF systems. Daily intracerebroventricular (i.c.v.)
      pretreatment with an immunoserum raised against CRF completely prevented the
      development of anxiety induced by cocaine withdrawal. These data suggest that
      extrahypothalamic-limbic CRF hypersecretion may be involved in the development of
      anxiety related to cocaine withdrawal and that the CRF system may be a useful
      target for new pharmacotherapies for cocaine withdrawal and relapse.

PMID- 7796160
TI  - On the cellular localization and distribution of carbonic anhydrase II
      immunoreactivity in the rat brain.
AB  - Evidence is provided that carbonic anhydrase-II is localized in the central
      nervous system to wide spread systems of oligodendrocytes and restricted
      astroglia populations, involving both fiber bundles and neuropil. It is suggested
      that CO2 formed in activated axons may, via carbonic anhydrase-II, give rise to
      protons controlling the excitability of surrounding neuropil. Thus, CO2 may
      represent an important, highly diffusible, signal in brain, involved in the tonic
      control of neuronal activity.

PMID- 7796159
TI  - Demonstration of parathyroid hormone-related protein in meninges and its receptor
      in astrocytes: evidence for a paracrine meningo-astrocytic loop.
AB  - In contrast to the nervous and glial tissue of the adult rat brain the meninges
      are immunoreactive for parathyroid hormone-related protein (PTHrP), a hormone
      that binds with high affinity to the recently cloned PTH/PTHrP receptor.
      Accordingly immunoreactivity is found in cultured meningeal cells but not in
      astrocytes. In contrast, astrocytes but not meningeal cells synthesize the mRNA
      for the PTHrP receptor shown by reverse transcription of total RNA preparations
      and subsequent polymerase chain reaction with primers specific for the PTHrP
      receptor. The expression of the PTH/PTHrP receptor was confirmed by the dose
      dependent activation of the adenylate cyclase in astrocytes and the rapid
      development of cellular processes following on incubation with PTHrP. We conclude
      that PTHrP secreted by meninges forms a paracrine meningo-astrocytic loop and may
      cause astrocytic differentiation, possibly involved in the formation of the glial
      limiting membrane.

PMID- 7796161
TI  - Synaptic organization of excitatory and inhibitory boutons associated with spinal
      neurons which project through the dorsal columns of the cat.
AB  - The cell bodies and proximal dendrites of postsynaptic dorsal column neurons were
      examined for synaptic boutons which displayed immunoreactivity for the principal
      excitatory and inhibitory neurotransmitters, glutamate and GABA. The neurons were
      labelled by retrograde transport of horseradish peroxidase and GABA or glutamate
      containing boutons were revealed by performing postembedding immunogold reactions
      on electron microscope sections. Five neurons were examined and all of them were
      postsynaptic to boutons which contained either GABA or glutamate. Quantitative
      analysis of two of the cells revealed that more than 90% of the synaptic profiles
      associated with them displayed immunogold reactions for these transmitters.
      Analysis of series of alternate sections, which were reacted for either GABA or
      glutamate, showed that there was no overlap in the populations of immunoreactive
      boutons. Furthermore, GABA and glutamate immunoreactions were associated with
      boutons which had different morphological characteristics. In addition, some
      large glutamate-enriched boutons were postsynaptic to small boutons which
      displayed immunogold reactions for GABA. This study demonstrates morphological
      bases for direct excitation, postsynaptic inhibition and presynaptic inhibition
      of postsynaptic dorsal column cells.

PMID- 7796162
TI  - The hyper-reinnervation of rat skeletal muscle.
AB  - This study examines muscle recovery and related changes in the motor unit
      population of 'hyper-reinnervated' rat skeletal muscle. Medial gastrocnemius (MG)
      muscles were hyper-reinnervated by either cutting the MG nerve and implanting it
      on the MG muscle together with additional hind limb nerves, or by crushing the MG
      nerve and excising the medial portion (50-70%) of the MG muscle. Our findings
      were that muscles hyper-reinnervated with multiple nerves recovered muscle mass
      and strength more fully than did the self-reinnervated muscles, more motor units
      were formed (up to three times the normal number were found), and the mean motor
      unit size was significantly smaller. A relatively small percentage of muscle
      fibers became polyneuronally innervated. In contrast, the number of motor units
      that were formed in the muscle reduction experiments were not significantly
      larger than was expected considering the mass of the muscles. We conclude that
      hyper-reinnervation improves muscle recovery, it may be a useful technique for
      improving function in denervated muscle, and may serve to provide added sources
      of EMG control signals in some amputees.

PMID- 7796163
TI  - Systemic hemodynamic and regional circulatory effects of centrally administered
      endothelin-1 are mediated through ETA receptors.
AB  - Central endothelin (ET) has been implicated in the regulation of the
      cardiovascular system. The effect of intracerebroventricular (i.c.v.)
      administration of ET-1 or IRL 1620 (5, 15 and 45 ng) on the systemic hemodynamics
      and regional circulation was studied in anesthetized rats using a radioactive
      microsphere technique. Systemic hemodynamics and regional blood circulation were
      determined before (baseline) and at 30 min after the injection of each dose of ET
      1 or IRL 1620. Administration of saline (5 microliters, i.c.v.) did not produce
      any significant cardiovascular effects. The lower doses of ET-1 (5 and 15 ng) did
      not produce any significant effect on blood pressure (BP), heart rate (HR),
      cardiac output (CO), stroke volume (SV), total peripheral resistance (TPR) and
      regional blood circulation. However, the higher dose (45 ng) produced a transient
      rise (26%) followed by a sustained fall (48%) in BP. The decrease in BP was
      accompanied by significant decreases in CO (44%) and SV (39%), while HR and TPR
      were not affected. ET-1 (45 ng, i.c.v.) also produced a significant reduction in
      blood flow to the brain (75%), heart (49%), kidneys (66%), GIT (40%), portal
      system (52%) and musculo-skeletal system (38%), while blood flow to the skin was
      not affected. To determine pharmacological specificity of the central effects of
      ET-1, studies were performed in rats pretreated with BQ-123, a specific ETA
      receptor antagonist. Pretreatment with BQ-123 (10 micrograms, i.c.v.), 15 min
      prior to the administration of ET-1, completely antagonized the systemic
      hemodynamic as well as the regional circulatory effects of ET-1 (45 ng, i.c.v.).
      In order to determine whether stimulation of central ETB receptors produces any
      cardiovascular effects, studies were performed using IRL 1620, a specific ETB
      receptor agonist. Administration of IRL 1620 (5, 15 and 45 ng, i.c.v.) did not
      produce any effect on systemic hemodynamics and regional blood circulation in
      rats. It is concluded that ETA but not ETB receptors are involved in the central
      cardiovascular actions of ET.

PMID- 7796164
TI  - Adrenocorticotropin secretagog release: stimulation by frustration and
      paradoxically by reward presentation.
AB  - Colchicine blockade of axonal transport from the paraventricular nucleus to the
      median eminence was used to indirectly infer adrenocorticotropin (ACTH)
      secretagog release in response to a reward presentation and the psychological
      stressor of frustration. After training rats to drink at the same time of day for
      30 min for 2-3 weeks, basal arginine vasopressin (AVP), but not corticotropin
      releasing factor (CRF) or oxytocin (OT), concentrations were elevated. The
      frustration of presenting empty water bottles resulted in increased
      corticosterone concentrations. Concordantly, CRF, AVP, and OT contents in the
      median eminence decreased compared to controls. All three secretagogs are thus
      apparently involved in the corticosterone response to frustration. As expected,
      water presentation decreased both ACTH and corticosterone. Paradoxically,
      however, CRF, AVP, and OT contents also decreased compared to controls. The
      discrepancy of ACTH and corticosterone concentrations declining despite release
      of secretagogs cannot be explained by decreased adrenal or pituitary
      sensitivities since both exogenous ACTH and CRF elevated corticosterone and ACTH,
      respectively, in rewarded rats. Secretagog release, therefore, may not always be
      associated with stimulation of ACTH release.

PMID- 7796165
TI  - The distribution of 5-HT1A and 5-HT2A receptor mRNA in human brain.
AB  - We have examined the distribution of 5-HT1A and 5-HT2A receptor mRNAs in post
      mortem human hippocampus, neocortex, raphe nuclei, cerebellum and basal ganglia
      using in situ hybridization histochemistry. Receptor transcripts in brains from
      two males and two females (mean age +/- S.D. = 70 +/- 4 years; post-mortem
      interval = 29 +/- 6 h) were visualised with 35S-radiolabelled synthetic
      oligodeoxyribonucleic acid probes. In the hippocampus, 5-HT1A receptor mRNA was
      present in all fields, especially CA1. In the parahippocampal gyrus and
      neocortical regions 5-HT1A receptor mRNA was enhanced in superficial and middle
      laminae. 5-HT1A receptor mRNA was particularly abundant in the raphe and other
      serotonergic cell groups of the brainstem. The analysis of emulsion dipped
      sections showed 5-HT1A receptor mRNA to be concentrated in pyramidal neurons,
      together with the granule cells of the dentate gyrus. In neocortical areas lamina
      III pyramidal neurons were more heavily labelled than those in lamina V. There
      was no evidence of glial expression of 5-HT1A receptor mRNA in grey matter or
      white matter compartments. 5-HT2A receptor mRNA was present in all neocortical
      areas examined, where it was located in pyramidal neurons, of lamina V more than
      in those of lamina III, as well as in putative interneurons, especially within
      lamina IVc of the striate cortex. 5-HT2A receptor mRNA was observed at minimal
      levels in the hippocampus and not in the raphe. Neither 5-HT1A nor 5-HT2A
      receptor mRNA were detected in the cerebellum, substantia nigra or striatum. The
      ability to detect these transcripts at the regional and cellular level will help
      reveal important details of the 5-HT receptor system in the human brain. This
      includes the investigation of their putative roles in the normal
      chemoarchitecture and in pathophysiological brain processes.

PMID- 7796166
TI  - Tongue adaptation temperature influences lingual nerve responses to thermal and
      menthol stimulation.
AB  - Menthol, a tangible substance present in many orally administered products, can
      produce a powerful influence on the perceived intensity of subsequent thermal
      stimulation in humans as well as the response magnitudes of thermally sensitive
      neurons in rats. However, there are no prior studies examining the influence of
      adaptation temperature on perceived intensity and/or response magnitudes of
      thermally sensitive neurons to subsequent menthol stimulation. We identified 32
      thermally sensitive neurons that increased their discharge rate to a gradual
      temperature decrement beginning from 35 degrees C and dropping to 10 degrees C at
      1 degree C/s. Based on their response threshold, time-to-peak, and range of
      sensitivity, these thermally sensitive lingual neurons were found to be divisible
      into two distinct groups. Group 1 neurons (n = 21) responded best to the upper
      cool range (34-15 degrees C) of the temperature decrement, whereas Group 2
      neurons (n = 11) responded to the lower cold range (32-10 degrees C) of the
      temperature decrement. Our Group 1 and Group 2 neurons may be analogous to low
      threshold and high threshold cold receptors identified previously in primates. We
      also examined the responses of lingual neurons to 0%, 25%, 50% and 75% dilution's
      of a stock menthol concentration (1.28 mM) at 25 and 35 degrees C adaptation
      temperatures. Menthol responses across all concentrations were far larger after
      adaptation to 35 degrees C compared to 25 degrees C. Furthermore, only during 35
      degrees C adaptation did responses to menthol stimulation persist during the
      ensuing 20 s after menthol off-set and water on-set.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7796168
TI  - Muscimol injected into the right or left amygdaloid complex differentially
      affects retention performance following aversively motivated training.
AB  - The effects of intra-amygdala infusion of the GABAA agonist, muscimol, prior to
      retention testing was examined. In Expt. 1, rats were trained in a one-trial
      inhibitory-avoidance task and given bilateral intra-amygdala infusions of vehicle
      or muscimol or simultaneous unilateral infusions of each, 5 min before the
      retention test 24 h after training. Expt. 2 used the same procedures as those in
      Expt. 1 but two retention measures were taken: initial step-through latency and
      the number of trials to reach criterion during continuous multiple-trial
      inhibitory-avoidance (CMIA) training. Groups given bilateral infusions of
      muscimol or unilateral infusion of muscimol into the right amygdala had
      significantly shorter latencies to enter the dark compartment than groups given
      bilateral infusions of vehicle or unilateral infusion of muscimol into the left
      amygdala. Bilateral muscimol infusions impaired acquisition of CMIA relative to
      bilateral vehicle infusions or unilateral muscimol infusion into the left
      amygdala. These results suggest differential involvement of the right and left
      amygdala in memory.

PMID- 7796169
TI  - Enhanced nociceptive behaviour following conditioning injection of formalin in
      the perioral area of the rat.
AB  - The possible existence of long-term modifications in response to a transient
      nociceptive conditioning stimulation was investigated in the rat in three
      experiments. (1) A nociceptive conditioning stimulus was delivered in the form of
      a s.c. formalin injection (conditioning injection) in the left upper lip.
      Evaluation of the nociceptive behaviour triggered by another formalin injection
      (testing injection) made in the controlateral right upper lip was carried out in
      distinct groups of rats 7, 14 or 28 days after the conditioning. An enhanced
      nociceptive response at day 7 and 14 and a return to the baseline at day 28 were
      observed. (2) A similar protocol was developed with formalin used for both
      conditioning and testing but an anaesthetic blockade of the infraorbital nerve
      was performed just before the conditioning injection to suppress the initial
      barrage. The change observed at day 7 was suppressed by the nerve block. (3) A
      conditioning nociceptive stimulus was applied either ipsilaterally to the right
      lower lip or to the tail. An increased nociceptive response was observed when the
      conditioning stimulus was applied to the same side as the test stimulus but no
      increase in the formalin test response was detected when the conditioning
      stimulus was applied to the tail. These results indicated that, after a single
      formalin injection in the left upper lip, a hyperexcitability developed that
      depended on the initial barrage, lasted for at least 2 weeks, was no longer
      present at 4 weeks and might rely on a segmental mechanism. The hypothesis of a
      central sensitization triggered by an initial barrage and maintained by an
      ongoing input induced from the periphery is discussed.

PMID- 7796170
TI  - Induction of the immediate early gene c-jun in human spinal cord in amyotrophic
      lateral sclerosis with concomitant loss of NMDA receptor NR-1 and glycine
      transporter mRNA.
AB  - The aetiology of the sporadic form of amyotrophic lateral sclerosis (ALS) is
      poorly understood although abnormalities in glutamate and glycine transport have
      been implicated which both could contribute to a neurodegenerative process
      mediated through the N-methyl-D-aspartate (NMDA) receptor. In this study we have
      used in situ hybridization to investigate whether any changes in the expression
      of NMDA receptors, the glycine transporter or glutamate-mediated injury responses
      are detectable in ALS. Two immediate early genes were investigated as markers of
      neuronal injury responses, c-jun and zif-268, both constitutively expressed in
      the spinal cord. Levels of c-jun mRNA were most abundant in intermediate grey and
      layer IX of the ventral horn containing motor neurones. This pattern was markedly
      changed in ALS with large increases (2-3 fold) in c-jun mRNA occurring in dorsal
      and ventral horn. The marked increase in c-jun mRNA was also substantiated by
      slot blot analysis of tissue homogenates of spinal cord and a parallel induction
      of zif-268 mRNA was also seen. NMDA receptor NR-1 mRNA was widely distributed in
      control spinal cord with the highest concentrations occurring in layers IX, X,
      intermediate grey and dorsal horn. The ALS cases showed a selective decrease in
      the level of NR-1 mRNA in the ventral region (50%) whilst no significant decrease
      was detected in the dorsal region. Quantitation of tissue homogenates with dorsal
      and ventral regions combined also yielded a significant decrease of 40% which
      supports the analysis from in situ hybridization densitometry.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7796171
TI  - Neuroprotective effects of PKC inhibition against chemical hypoxia.
AB  - The effect of potassium cyanide-induced chemical hypoxia on protein kinase C
      (PKC) translocation and cell injury was studied in differentiated PC12 cells. The
      cellular distribution of PKC in control cells and cells exposed to 100 microM and
      1 mM KCN for 30 min. was visualized by use of an anti-PKC antibody and confocal
      laser scanning microscope. In control differentiated PC12 cells, PKC was
      localized perinuclearly, while following 12-phorbol 13-myristate acetate (PMA) or
      KCN it was translocated to the plasma and organelle membranes. Western blot
      analysis was used to quantify the translocation. Chemical hypoxia increased the
      membrane-bound PKC to 210% of control levels, while chelerythrine, a PKC
      inhibitor, and block of calcium influx into the cells (with calcium channel
      blocker and calcium-free medium) prevented this effect. Cyanide-induced PKC
      translocation persisted for at least 120 min. Cell injury was monitored by
      measuring lactate dehydrogenase (LDH) efflux from the cells 24 hr after addition
      of cyanide. PKC activation plays a role in hypoxic damage, since PKC down
      regulation (by overnight exposure to PMA) or inhibition (with chelerythrine or
      staurosporine) conferred protection against KCN-induced cytotoxicity. Ca2+
      channel blocker nifedipine also protected against chemical hypoxia. None of the
      pretreatments rendered complete protection against cyanide-induced hypoxia,
      indicating that PKC-independent mechanism(s) are also activated during chemical
      hypoxia and contribute to cell injury.

PMID- 7796172
TI  - Succinate dehydrogenase activity and soma size relationships among cat dorsal
      root ganglion neurons.
AB  - A large range in succinate dehydrogenase (SDH) activity and soma size among
      neurons in the dorsal root ganglion (DRG) and the dorsolateral region of the
      ventral horn (DLVH) at spinal cord level L7 was observed. Mean soma sizes were
      similar for the two populations. DLVH, but not DRG, neurons showed an inverse
      relationship between SDH activity and soma size. DRG neurons had a higher mean
      SDH activity than DLVH neurons, reflecting the observation that there was a
      population of DRG neurons with a higher oxidative capacity than DLVH neurons.

PMID- 7796167
TI  - Effects of dehydration and salt-loading on hypothalamic vasopressin mRNA level in
      male and female rats.
AB  - Experiments were carried out on 9- to 11-week-old male and female Sprague-Dawley
      rats. Dot-blot analysis and 3'-end digoxigenin-labeled 26mer oligonucleotide
      probe were used in the investigation of vasopressin (AVP) mRNA level in the
      hypothalamus of male and female rats. The normal hypothalamic AVP-mRNA level in
      males was 48% higher than that in females (P < 0.05). Plasma osmolality was also
      higher in males than in females (P < 0.05). In dehydrated rats, the hypothalamic
      AVP-mRNA level was 2.47 and 1.98 times in females (P < 0.001) and males (P <
      0.01), respectively, as much as in their normal controls; the difference in
      hypothalamic AVP-mRNA level between dehydrated females and males was
      statistically insignificant. Plasma osmolality was higher in dehydrated females
      than in dehydrated males (P < 0.01). In salt-loaded rats, hypothalamic AVP-mRNA
      level was 2.47 and 2.17 times in females (P < 0.001) and males (P < 0.01),
      respectively, as much as in their controls. The difference in hypothalamic AVP
      mRNA level between salt-loaded males and females was not statistically
      significant. Plasma osmolality in salt-loaded females was also higher than that
      in salt-loaded males (P < 0.001). These findings indicate that there is sex
      difference in hypothalamic AVP mRNA level and plasma osmolality under normal
      conditions; during dehydration and salt-loading AVP mRNA level increases and the
      difference in AVP mRNA level between males and females becomes insignificant.

PMID- 7796173
TI  - Different amyloidogenic peptides share a similar mechanism of neurotoxicity
      involving reactive oxygen species and calcium.
AB  - The amyloid beta-peptide (A beta) that accumulates as insoluble plaques in the
      brains of Alzheimer's victims can be neurotoxic, by a mechanism that may involve
      generation of reactive oxygen species (ROS) and destabilization of cellular
      calcium homeostasis. We now provide evidence that the mechanism of neurotoxicity
      of two other amyloidogenic peptides (APs), human amylin and beta 2-microglobulin,
      also involves induction of ROS and elevation of [Ca2+]i. Human amylin, beta 2
      microglobulin and A beta 1-40 all caused significant death of neurons in rat
      hippocampal cell cultures during 24-48 h exposure periods. Rat amylin, a non-AP,
      was not neurotoxic. Each AP caused an elevation of rest [Ca2+]i during a 20 h
      exposure period, and promoted a sustained elevation of [Ca2+]i following exposure
      to glutamate which was significantly greater than controls. Each AP induced
      accumulation of ROS in neurons which preceded elevation of [Ca2+]i. Several
      antioxidants, including propyl gallate, vitamin E and the spin-trapping compound
      N-tert-butyl-alpha-phenylnitrone attenuated the elevation of [Ca2+]i and
      neurotoxicity induced by the peptides. The data indicate that different APs share
      a common mechanism of neurotoxicity involving free radical accumulation and
      destabilization of [Ca2+]i homeostasis.

PMID- 7796174
TI  - Secretion and accumulation of Alzheimer's beta-protein by cultured vascular
      smooth muscle cells from old and young dogs.
AB  - Cultured smooth muscle cells isolated from beta-amyloid-affected blood vessels
      from old dogs accumulate beta-protein at early passages [5,24]. Now, we show that
      smooth muscle cells derived from amyloid-free brain blood vessels and peripheral
      arteries from old and young animals are induced by culture conditions to deposit
      intracellularly fibrillar and non-fibrillar beta-protein. Accumulation of beta
      protein is associated with a higher secretion of beta-protein, but not with a
      higher secretion of beta-amyloid precursor protein (beta APP) or higher cellular
      content of beta APP. Gradual cessation of proliferative activity was observed in
      cultures that accumulate beta-protein.

PMID- 7796175
TI  - Asymmetrical motor behavior in rats with unilateral striatal excitotoxic lesions
      as revealed by the elevated body swing test.
AB  - Severe degeneration of basal ganglia neurons, particularly the intrinsic neurons
      of the striatum, is the major underlying neuropathology implicated in clinical
      attributes of Huntington's disease (HD). The excitotoxin-lesioned striatum
      provides a useful model for evaluating behavioral parameters of HD. Animals with
      unilateral excitotoxic lesions exhibit asymmetrical rotational behavior in
      response to dopamine agonists, such as apomorphine. However, the observed
      behavior is a pharmacological reaction, and subject to sensitization effects. A
      behavioral test using undrugged animals may demonstrate a more natural response
      of the animals to the lesion effects. Recently, we have developed the 'drug-free'
      elevated body swing test (EBST), and demonstrated that hemiparkinsonian rats
      exhibited significant biased swing activity. In the present study, we observed
      that animals with unilateral intrastriatal 3-nitropropionic acid or quinolinic
      acid lesions displayed a significant biased swing activity with the direction
      ipsilateral to the lesioned side of the brain. This ipsilateral swing
      corresponded to the ipsilateral rotational behavior exhibited by the lesioned
      animals when challenged with apomorphine. The present results demonstrated that
      the EBST is a sensitive measure for characterizing asymmetrical behavior in
      animals with striatal lesions.

PMID- 7796176
TI  - Neuropathological changes in two lines of mice carrying a transgene for mutant
      human Cu,Zn SOD, and in mice overexpressing wild type human SOD: a model of
      familial amyotrophic lateral sclerosis (FALS).
AB  - Two different lines of mice, G1 and G20, carrying a transgene for a mutant form
      of Cu,Zn SOD, found in a family with familial amyotrophic lateral sclerosis
      (FALS), develop clinical and pathological changes which are, in their late
      stages, strikingly similar to those in human disease. We have analyzed the
      distribution and characteristics of lesions in the central and peripheral nervous
      systems of such mice. The most affected structure was the spinal cord, followed
      by the medulla, pons and midbrain. The early stages of the disease were
      characterized by vascular degeneration of anterior horn neurons and their
      processes, while, in the late stages, the main changes consisted of neuronal loss
      and atrophy of the anterior horns and the deposition in these areas of multiple
      filamentous inclusions resembling Lewy bodies. In the late stages of the disease,
      the white matter of the spinal cord was also involved, particularly in the
      anterior and lateral columns. Posterior columns were also involved, but to a much
      lesser degree. The brainstem structures also showed vacuolar degeneration of
      several motor nuclei and of several groups neurons in the reticular formation.
      Anterior roots and peripheral nerves showed the classical features of Wallerian
      degeneration. The dorsal root ganglia, with rare exceptions, were unremarkable.
      The posterior roots showed mild changes in the most severely affected mice.
      Changes in these two affected lines were compared to changes in mice
      overexpressing wild type, rather than mutant human Cu,Zn SOD. These mice never
      developed clinical disease, although, pathologically, they developed very mild
      vacuolar changes in the anterior horns of the spinal cord and in motor axons.
      This study shows that although simple overexpression of SOD may be injurious to
      motor neurons, albeit very mildly, the mutant form is necessary to produce both
      clinical disease and severe pathological changes which, in the chronic stage of
      the disease, have striking similarities to human familial ALS. A dominant gain of
      function, therefore, is the most likely pathogenesis of tissue injury induced by
      mutations in Cu,Zn SOD.

PMID- 7796177
TI  - Differential distribution of protein kinase C (PKC alpha beta and PKC gamma)
      isoenzyme immunoreactivity in the chick brain.
AB  - Protein kinase C (PKC) is involved in neural plasticity. The phosphorylation of
      the myristoylated alanine-rich protein kinase C substrate (MARCKS) in the left
      intermediate and medial hyperstriatum ventrale (IMHV) of the chick brain has been
      shown previously to correlate significantly with the strength of learning in
      filial imprinting. The distribution of PKC alpha, beta I, beta II and PKC gamma
      in the brain of 1-day-old dark-reared chicks was determined immunocytochemically,
      using the monoclonal antibodies MC5 and 36G9, raised against purified PKC alpha
      beta and PKC gamma, respectively. PKC gamma-stained cells were distributed widely
      in the telencephalon, including all hyperstriatal structures (including the
      IMHV), the hippocampus, neostriatum, ectostriatum and archistriatum. There were
      fewer stained cells in the septum and the least cellular staining was in the
      paleostriatum primitivum. Fluorescent double-labelling with neuron-specific
      enolase (NSE) and with the glial calcium-binding protein S100 suggested that PKC
      gamma immunoreactivity was present in neurones but not in glia. The distribution
      of PKC alpha beta-stained cells was more limited, with staining in the
      archistriatum, hippocampus and septum but not in the hyperstriatum. However,
      there was PKC alpha beta-staining of some fibres in the IMHV (but little
      elsewhere in the hyperstriatum ventrale), in the neostriatum, paleostriatal
      complex and the lobus parolfactorius. Double-labelling with NSE and S100 revealed
      PKC alpha beta/S100-positive glial cells present in the paleostriatal region
      only. There was some PKC alpha beta-staining of putative neurones in the
      hippocampus, septum and archistriatum. The differential distribution of PKC
      isoenzymes suggests that in the IMHV some axonal inputs contain PKC alpha beta
      whereas some postsynaptic cells contain the gamma form of PKC.

PMID- 7796178
TI  - Protein kinase C in the hippocampus is altered by spatial but not cued
      discriminations: a component task analysis.
AB  - The exact role of the mammalian hippocampus in memory formation remains
      essentially as an unanswered question for cognitive neuroscience. Experiments
      with humans and with animals indicate that some types of mnemonic associative
      processes involve hippocampal function while others do not. Support for the
      spatial processing hypothesis of hippocampal function has stemmed from the
      impaired performance of rats with hippocampal lesions in tasks that require
      spatial discriminations, but not cued discriminations. Previous procedures,
      however, have confounded the interpretation of spatial versus cued discrimination
      learning with the number and kinds of irrelevant stimuli present in the
      discrimination. An empirical set of data describing a role of protein kinase C
      (PKC) in different mnemonic processes is similarly being developed. Recent work
      has implicated the activation of this serine-threonine kinase in a variety of
      learning paradigms, as well as long-term potentiation (LTP), a model system for
      synaptic plasticity which may subserve some types of learning. The present study
      employs the principles of component task analysis to examine the role of membrane
      associated PKC (mPKC) in hippocampal-dependent memory when all factors other than
      the type of learning were equivalent. The results indicate that hippocampal mPKC
      is altered by performance in hippocampally-dependent spatial discriminations, but
      not hippocampally-independent cued discriminations and provide a general
      experimental procedure to relate neural changes to specific behavioral changes.

PMID- 7796179
TI  - Electrophysiological characterization of the inhibitory effect of a novel peptide
      gurmarin on the sweet taste response in rats.
AB  - The effect of an anti-sweet peptide, gurmarin purified from the leaves of Gymnema
      sylvestre, was studied electrophysiologically on taste responses of the rat
      chorda tympani. The action of gurmarin was highly specific to sweet taste so that
      responses to various sweeteners including sugars, sweet amino acids and an
      artificial sweetener, saccharin were all suppressed. The most effective pH at
      which the rat tongue was treated with gurmarin was found to be 4.5, which
      corresponds to the isoelectric point of the peptide. At this condition about 5
      microM of gurmarin was sufficient to reveal maximal effect and this was still
      significant at 0.5 microM (2 micrograms/ml). Although the suppressed responses
      required several hours to attain complete recovery, anti-gurmarin serum shortened
      the recovery time considerably. On the other hand, intravenous injection of
      gurmarin did not cause any significant effects on taste responses at all. These
      results suggest that gurmarin acts on the apical side of the taste cell, possibly
      by binding to the sweet taste receptor protein.

PMID- 7796180
TI  - SPARC, an extracellular matrix glycoprotein containing the follistatin module, is
      expressed by astrocytes in synaptic enriched regions of the adult brain.
AB  - Although extracellular matrix (ECM) glycoproteins play important roles in neural
      development, their levels are generally believed to decrease in the adult brain.
      Immunohistochemical analysis indicates that the anti-adhesive ECM glycoprotein
      SPARC/osteonectin, which contains a follistatin 'module,' is expressed in the
      adult rabbit nervous system. In the cerebellum, SPARC is present in Bergmann
      glia, with a strong signal along their radial fibres. SPARC, while enriched in
      membrane fractions, is not a transmembrane protein. In the hippocampus,
      colocalization of SPARC is observed in cells which express the astrocytic marker
      GFAP. The expression of SPARC by a subset of astrocytes, particularly in synaptic
      enriched areas, suggests a continuing role for the ECM in the adult brain.

PMID- 7796181
TI  - Immunolocalisation of protein phosphatase inhibitor-1 in the cerebral cortex of
      the rat, cat and ferret.
AB  - The distribution of inhibitor-1 was analysed in the neocortex of cat, ferret and
      rat by immunocytochemistry (at the light and electron microscope levels) and by
      immunoblotting using an affinity purified antibody which recognises both the
      phosphorylated and dephosphorylated forms of the protein. In each mammalian
      cortex immunocytochemical techniques identified inhibitor-1 predominantly in
      infragranular pyramidal neurons and, at a lower concentration, in supragranular
      pyramidal neurons of cortical layers II-III, and V-VI. Within the cortical
      layers, neuronal cell bodies and apical dendrites were stained strongly but no
      immunoreactivity was associated with dendritic spines. Regional differences in
      intensity of staining were revealed when appropriate antibody concentrations were
      used; the concentration of inhibitor-1 appeared to follow a gradient with the
      highest levels in layer VI and the lowest in layer I. The results were confirmed
      by immunoblotting of microdissected cortical regions which identified the
      inhibitor-1 protein unambiguously. The distribution of inhibitor-1 is different
      from that reported by other investigators.

PMID- 7796182
TI  - Pharmacology of selective and non-selective metabotropic glutamate receptor
      agonists at L-AP4 receptors in retinal ON bipolar cells.
AB  - Retinal ON bipolar cells possess metabotropic glutamate receptors (mGluRs) which
      are sensitive to L-2-amino-4-phosphonobutyric acid (L-AP4). Recent studies
      suggest there are multiple subtypes of L-AP4 receptors. In order to provide a
      more complete description of the pharmacology of the retinal L-AP4 receptor, we
      examined the actions of a number of compounds which are active at L-AP4 receptors
      and other mGluRs. Four groups of compounds were studied: (1) AP4 analogues (e.g.
      L-AP5, L-SOP, cyclobutylene AP5, and N-Me-AP4), (2) non-selective mGluR agonists
      (ibotenate and quisqualate), (3) selective mGluR agonists (L-CCG-I), and (4)
      agonists proposed to be selective for specific mGluR subtypes (DCG-IV and t-ADA).
      Concentration-response curves were obtained using the b-wave of the
      electroretinogram (ERG) as an assay for L-AP4 receptor activation. Whole cell
      voltage clamp recordings from ON bipolar cells in the retinal slice preparation
      of the mudpuppy were used to determine whether the compounds acted as L-AP4
      receptor agonists. All compounds were L-AP4 receptor agonists, except t-ADA which
      was ineffective. The results reveal pharmacological differences between L-AP4
      receptors in mudpuppy ON bipolar cells and those in other systems, consistent
      with the proposal that there are multiple L-AP4 receptor subtypes. For example,
      retinal L-AP4 receptors are more potently activated by L-AP5 than L-SOP, whereas
      L-SOP has been shown to be more potent than L-AP5 in L-AP4 receptors in the
      lateral perforant path (LPP) of the rat hippocampus. L-SOP is also relatively
      more potent at the cloned L-AP4 receptors mGluR4, 6, and 7 than in mudpuppy ON
      bipolar cells in situ. The different potencies of these compounds in retina and
      LPP is ascribed to both steric and charge factors. The results with DCG-IV and t
      ADA are consistent with the proposal that these are subtype-selective agonists,
      but DCG-IV is likely to be selective only at very low concentrations (< or = 1
      microM).

PMID- 7796183
TI  - Patients' rights in hospital: an empirical investigation in Finland.
AB  - The purpose of this study was to examine patients' rights in Finnish hospitals
      from the patients' own points of view. In 1993, a new Act on the status and right
      of patients in health care came into force. In this Act patients' rights are
      divided into three categories: the right to good health care, the right to be
      informed, and the right to self-determination and participation. These same
      categories of rights were used in this empirical investigation during 1993, in
      which a questionnaire was answered by 204 patients in two Finnish hospitals. The
      results indicate that Finnish hospital patients do not know enough about their
      rights. Information seems to be one of the most problematic areas for hospital
      patients. The study will be repeated in five years' time.

PMID- 7796185
TI  - Ethical dilemmas in the lived experience of nursing practice.
AB  - Through a series of semistructured interviews with 12 nurses delivering direct
      patient care in acute, long-term and home care settings, information was sought
      regarding the ethical concerns of practicing nurses. Although these nurses
      frequently did not specifically identify the areas of expressed concern as
      ethical in nature, thematic analysis of the transcribed interviews uncovered four
      major ethical areas of concern common to these 12 nurses. These areas are: (1)
      Withholding of information and truth-telling; (2) Unequal access or inequalities
      in care; (3) Differences between business and professional values; (4) Breaking
      and reporting broken rules. Several reasons are offered to explain the failure of
      nurses accurately to identify specific practice dilemmas as ethical in nature and
      the sequelae of these failures. Possibilities involving ongoing education and
      mentored experiences in practice areas are reported.

PMID- 7796184
TI  - Nursing home staff attitudes to ethical conflicts with respect to patient
      autonomy and paternalism.
AB  - Six case studies on nursing home staff attitudes to patient autonomy have been
      analysed. The case studies are based on six polarities within autonomy, as
      developed by Collopy. In total, 189 professional caregivers, comprising the staff
      of 13 nursing homes in the county of Stockholm, Sweden, responded to questions
      based on the case studies. Results show that the attitudes within each
      professional category had a high level of internal correspondence. Nurses
      consistently supported patient preferences to the highest degree, followed by
      assistant nurses and auxiliary staff. Nurses' aides ranked lowest in supporting
      patient preferences. In only one of the cases were background variables of
      significance.

PMID- 7796186
TI  - Comprehensive patient-family care: fact or fiction?
AB  - The ICN 1973 Code for nurses states that 'Nurses render health services to the
      individual, the family and the community...'. It goes on to say that, 'The
      nurse's primary responsibility is to those people who require nursing care.'
      Thus, our primary responsibility to provide comprehensive care to patients and
      their families is a concept we teach and preach, but can it be achieved? In this
      paper, I would like to present the ethical dilemmas expressed by nurses as
      inherent in the care of patients and their families, address the difficulties in
      treating patients and their families in the light of these dilemmas and propose a
      different approach to dealing with the problem.

PMID- 7796187
TI  - Best interests: a concept analysis and its implications for ethical decision
      making in nursing.
AB  - The purpose of this paper is to analyse the concept of 'best interest' in order
      to give nurses, who use it to justify their actions, a clear picture of what this
      means, and to identify the skills needed for doing so. The process for concept
      analysis developed by Walker and Avant was used in the analysis of data generated
      from the literature. Themes were identified from which the defining attributes,
      antecedents and consequences emerged. The congruence of the findings with current
      values in nursing, such as promotion of patient autonomy, and the nurse as
      advocate, are discussed, together with the underpinning ethics theory. The skills
      needed for nursing practice are identified and recommendations for nurse
      education are made.

PMID- 7796189
TI  - Professional nurses should have their own ethics: a response.

PMID- 7796190
TI  - Rights to minimal standards of quality and courtesy.

PMID- 7796192
TI  - International Conference on Women's Health: Occupation and Cancer. III.
      Proceedings. Baltimore, Maryland, November 1993.

PMID- 7796188
TI  - Suicide and voluntary active euthanasia: why the difference in attitude?
AB  - It appears that the attitudes of health professionals differ towards suicide and
      voluntary active euthanasia. An acceptance of, if not an agreement with,
      voluntary active euthanasia exists, while there is a general consensus that
      suicide should be prevented. This paper searches for a working definition of
      suicide, to discover ethical reasons for the negative value that suicide assumes,
      and also to provide a term of reference when comparing suicide with euthanasia.
      On arriving at a working definition of suicide, it is compared with voluntary
      active euthanasia. An analysis of utilitarian and deontological considerations is
      provided and proves to be inconclusive with respect to the ethical principles
      informing the attitudes of professionals. Therefore, a search for other
      influences is attempted; this indicates that psychological influences inform
      attitudes to a greater degree than ethical principles.

PMID- 7796191
TI  - Medical and nursing ethics: never the twain?
AB  - Since the publication of Carol Gilligan's In a different voice in 1982, there has
      been much discussion about masculine and feminine approaches to ethics. It has
      been suggested that an ethics of care, or a feminine ethics, is more appropriate
      for nursing practice, which contrasts with the 'traditional, masculine' ethics of
      medicine. It has been suggested that Nel Noddings' version of an 'ethics of care'
      (or feminine ethics) is an appropriate model for nursing ethics. The 'four
      principles' approach has become a popular model for medical or health care
      ethics. It will be suggested in this article that, whilst Noddings presents an
      interesting analysis of caring and the caring relationship, this has limitations.
      Rather than acting as an alternative to the 'four principles' approach, the
      latter is necessary to provide a framework to structure thinking and decision
      making in health care. Further, it will be suggested that ethical separatism
      (that is, one ethics for nurses and one for doctors) in health care is not a
      progressive step for nurses or doctors. Three recommendations are made: that we
      promote a health care ethics that incorporates what is valuable in a
      'traditional, masculine ethics', the why (four principles approach) and an
      'ethics of care', the 'how' (aspects of Noddings' work and that of Urban Walker);
      that we encourage nurses and doctors to participate in the 'shared learning' and
      discussion of ethics; and that our ethical language and concerns are common to
      all, not split into unhelpful dichotomies.

PMID- 7796193
TI  - Women in the public sector: cancer mortality.
AB  - Very few mortality occupational studies of female workers have been published,
      even though the number of women in the workforce has increased dramatically to
      reach more than 45%. Public sector employees comprise 12% of the female
      workforce. This article reports the findings of a retrospective cohort mortality
      study of 1371 full-time female employees of the city of Buffalo, New York, who
      were employed between January 1, 1950, and October 1, 1979, and have worked a
      minimum of 5 years. The majority of women were hired in the 1940s and early 1950s
      and began employment after age 30. This predominantly white-collar, service
      oriented female cohort demonstrated significantly lower all-cause mortality than
      that expected based on US mortality rates for white females. The highest observed
      numbers of cancer deaths were for breast, digestive, and respiratory cancers. The
      majority of person-years were accrued in clerical and service occupations. Higher
      than-expected mortality was shown for reproductive and respiratory cancers among
      professional employees; digestive cancers, diseases of the nervous system, and
      pneumonia among clerical workers; and cancers of the lung and brain and diseases
      of the digestive system, especially ulcers, among service employees. Because
      these results are based on few observed cases, they must be interpreted
      cautiously.

PMID- 7796194
TI  - Cancer incidence among women in the workplace: a study of the association between
      occupation and industry and 11 cancer sites.
AB  - Few studies of the occupational etiology of cancer have focused upon the risks
      that women experience in the workplace. In this case-referent study of 11 cancer
      sites (lung, colon, rectum, bladder, esophagus, liver, salivary gland, stomach,
      eye, melanoma of the skin, mesothelioma), 7686 women in the Detroit area were
      interviewed to obtain lifetime histories of employment, tobacco use, and adult
      health, as well as demographic information. The results provide both methodologic
      and substantive leads for future investigations of the association between
      women's employment and their risk of cancer. We found that 63% of respondents had
      a usual occupation of housewife. Methodologic issues are discussed about the
      implications of this finding for sample size and statistical analysis when
      conducting such studies. New observations that merit further investigation
      include an association between salivary gland cancer and employment in
      hairdressing shops, esophageal cancer and employment in restaurants, and bladder
      cancer and employment in computer manufacturing. Further research is needed to
      understand the occupational etiology of cancer among women; such studies must
      consider specific methodologic issues.

PMID- 7796196
TI  - Occupation and female papillary cancer of the thyroid.
AB  - This article presents the joint results of two Swedish case-control studies
      regarding occupational exposure and female papillary thyroid cancer.
      Questionnaires inquiring about lifetime occupations and specific occupational
      exposures were mailed to cases and controls, aged 20 to 70 years. Some 185 female
      papillary or mixed cancer cases and 426 female controls were included in the
      analysis. Increased risks were seen for women who had worked as a dentist/dental
      assistant, teacher, shoemaker, or warehouse worker. In addition, occupational
      contacts with undefined chemicals, x-rays, or video display terminals were
      indicated as risk factors.

PMID- 7796197
TI  - Cancer mortality patterns among women who served in the military: the Vietnam
      experience.
AB  - In response to concerns of women veterans regarding the long-term health effects
      of military service in Vietnam, the Department of Veterans Affairs has been
      conducting a retrospective cohort mortality study of women Vietnam veterans.
      Military records were used to identify approximately 4600 women who served in
      Vietnam between July 4, 1965, and March 28, 1973, and a comparison cohort of
      nearly 5300 women who served during the same time frame but not in Southeast Asia
      or the Pacific theater. Current data include vital status determinations as of
      December 31, 1991, with a total of 532 deaths and an average follow-up of just
      over 20 years for both groups. Both the Vietnam and non-Vietnam women cohorts had
      a significant deficit of deaths from all causes compared to women in the US
      population. The two cohorts showed no difference in total mortality or in deaths
      from all cancers. A significant excess risk of pancreatic cancer was observed
      among Vietnam nurses compared to either non-Vietnam nurses (relative risk = 5.74)
      or women in the US population (standardized mortality ratio (SMR) = 2.78).
      Vietnam nurses also had an elevated risk of dying from cancer of the uterine
      corpus. Non-Vietnam nurses had a higher lung cancer mortality rate than women in
      the general population (SMR = 1.55) or nurses who served in Vietnam. Observed
      deficits of deaths from all causes and circulatory system diseases generally
      confirm a healthy selection bias for entry into and retention in the military
      that has been observed among men serving in the Armed Forces.

PMID- 7796198
TI  - Cancer incidence among Icelandic nurses.
AB  - This study investigated cancer incidence among Icelandic nurses, with a special
      focus on breast cancer. Cancer incidence in the study group was compared with
      that of the general female population. Elevated standardized incidence ratios
      (SIRs) were seen for some cancer sites, including breast cancer. For all cancers,
      breast cancer, and selected cancer sites, SIR increased with increasing length of
      time intervals allowed to elapse before the study period began. The nurses with a
      shorter employment time had a higher incidence of cancer than those with a longer
      one. Known confounding factors--parity and age at first birth--do not appear to
      be a convincing explanation of the excess of breast cancer. The possibility
      cannot be excluded that the nursing occupation constitutes an independent risk
      factor for breast cancer.

PMID- 7796195
TI  - Occupational risk factors for brain tumors among women in Shanghai, China.
AB  - The etiology of brain cancer is not well understood and few studies have
      evaluated occupational risk factors among women. We evaluated occupation and
      industry at time of diagnosis for 276 incident primary brain tumor cases among
      women in Shanghai, China, for the period 1980-1984, identified through the
      Shanghai Cancer Registry. Standardized incidence ratios (SIRs) and their 95%
      confidence intervals (CIs) were calculated for all occupations and industries
      with at least three female cases. SIRs compared observed to expected numbers of
      cases, based on incidence rates for Shanghai and the number of women in each
      occupation and industry according to the 1982 census. Statistically significant
      excesses of brain tumors were seen among grain farmers (SIR = 6.5, 95% CI = 1.3
      19.1), rubber workers (SIR = 5.0, 95% CI = 1.6-11.6), and workers in
      transportation equipment manufacture and repair (SIR = 2.3, 95% CI = 1.1-4.3).
      Risks among textile spinners and winders were of borderline significance (SIR =
      1.7, 95% CI = 1.0-2.8). Elevated but nonsignificant risks of 2.0 or greater were
      seen among nurses, plastic products workers, sanitation workers, painters, and
      workers in manufacture of equipment for electrical generation, transmission, and
      distribution. Results for farmers, rubber workers, and painters are consistent
      with previously reported excesses among these occupations in men. The increase
      among nurses is a new finding, although elevated risks have been observed among
      male medical professionals. Risks were elevated with likely exposure to
      pesticides, particularly among those thought to have a high probability and a
      high level of exposure (SIR = 3.6, 95% CI = 1.2-8.5).

PMID- 7796199
TI  - Molecular, cytogenetic, and hematologic effects of ethylene oxide on female
      hospital workers.
AB  - Women comprise the majority of workers exposed to ethylene oxide during
      sterilization of medical instruments and supplies. This article evaluates
      molecular, cytogenetic, and hematologic effects of ethylene oxide on 68 women
      workers employed in nine hospitals in the United States and one hospital in
      Mexico. Workers were classified by three exposure categories: none (0), low (> 0
      32 ppm-hrs), and high (> 32 ppm-hrs). Hematologic effects were evaluated using
      complete blood count with differential, which has been questioned as a test for
      screening ethylene oxide-exposed workers. A statistically significant decrease in
      hematocrit (n = 0.02) and hemoglobin (P = 0.03) levels, an increase in lymphocyte
      percentages (P = 0.04), and a relative decrease in neutrophil percentages (P =
      0.03) with exposure were observed in US workers. The absolute number of
      lymphocytes, however, showed no relationship with exposure. No statistically
      significant results were seen for Mexican workers, although hematocrit decreased
      with exposure. An exposure-response relationship for the percentage for
      lymphocytes (positive) and neutrophils (negative) in US subjects and for
      neutrophils (positive) in Mexican subjects was seen. No overall relation with
      exposure was observed for total number of white cells. Molecular and cytogenetic
      results are also reported for the 68 women, who constitute a subgroup from a
      previous report. US women workers showed a statistically significant exposure
      response relationship for ethylene oxide and hemoglobin adducts (P = 0.0002) and
      sister chromatid exchanges (P = 0.001). For micronuclei, the difference (P =
      0.02) between low and high exposure was statistically significant. In Mexican
      workers, an exposure-response relationship was observed (P = 0.002) for
      hemoglobin adducts but not for sister chromatid exchanges or micronuclei.

PMID- 7796200
TI  - Employment practices and breast cancer among radiologic technologists.
AB  - A case-control study of breast cancer and employment practices among female
      radiologic technologists was conducted. The cohort from which cases and controls
      were derived included over 105,000 female medical radiation workers certified by
      the American Registry of Radiologic Technologists during 1926-1980. Breast cancer
      cases (n = 528) were individually matched to an average of five control subjects
      (n = 2628) based on year of birth, year of certification, and length of follow
      up. Procedures most commonly performed by controls included fluoroscopy (93%),
      portable radiographs (92%), routine radiographs (92%), multifilm procedures
      (87%), dental x-rays (46%), radium therapy (31%), orthovoltage (23%), and cobalt
      60 (21%). Breast cancer was not significantly increased with occupational
      experience with any of these procedures. Furthermore, risk was not related to
      number of years worked with a particular procedure. This study is reassuring in
      indicating that medical radiation workers are not at substantial risk for
      developing radiation-induced breast cancer. However, because only surrogate
      measures of radiation exposure were available, possibility of a small risk cannot
      be discounted. Ongoing follow-up of this cohort for incident cancers will
      incorporate detailed exposure assessment schemes, providing additional
      information on effects of long-term low-dose radiation through occupation.

PMID- 7796202
TI  - Occupational exposures and female breast cancer mortality in the United States.
AB  - Mortality records from 24 states, gathered from 1984 to 1989 and coded for
      occupation and industry, were used to develop leads to workplace exposures as
      possible breast cancer risk factors. A case-control approach was used, with
      separate analyses for blacks and whites. After excluding homemakers, 33,509 cases
      and 117,794 controls remained. A job exposure matrix was used to estimate the
      probability and level of 31 workplace exposures. After adjusting for
      socioeconomic status, suggestive associations for probability and level of
      exposure were found for styrene, several organic solvents (methylene chloride,
      carbon tetrachloride, formaldehyde), and several metals/metal oxides and acid
      mists. Because of the methodologic limitations of this study, its primary value
      is in suggesting hypotheses for further evaluation. The findings for styrene,
      selected solvents, and metals and metal-related exposures deserve additional
      study.

PMID- 7796201
TI  - Major differences in breast cancer risks among occupations.
AB  - Breast cancer incidence and mortality measured for the population of a major
      metropolitan center included 7368 cases and 2357 deaths over 15 years,
      ascertained according to National Cancer Institute Surveillance, Epidemiology,
      and End Results program procedures. Occupational risks were estimated with a
      census-based occupation coding system for cases and deaths, mean annual age
      standardized rates, and age-truncated occupation allocation. Data limitations
      include absence of population frequencies of personal risk factors for breast
      cancer, occupation designation errors, lack of knowledge about chemical exposures
      in apparently high-risk occupations, and the possibility that the number of
      comparisons could produce significant differences by chance. Compared to
      community-wide reference incidence and mortality rates, significant excess breast
      cancer risks were identified for housewives, registered nurses, clinical
      laboratory technicians, schoolteachers, social workers, secretaries and typists,
      and meat wrappers and cutters. High incidence rates with unremarkable mortality
      rates were identified for dental hygienists, religious workers, electronic
      engineering technicians, authors and journalists, restaurant and bar managers,
      realty and insurance saleswomen, bank tellers and cashiers, telephone operators,
      canning and bottling workers, chemical and gas handlers, and papermill workers.
      These findings agree in part with similar reports and will contribute to the
      generation of hypotheses to be tested by more specific, in-depth studies.

PMID- 7796203
TI  - Occupation and breast cancer risk in middle-aged women.
AB  - The authors analyzed data from a population-based case-control study of breast
      cancer in middle-aged women residing in King County, Washington, to examine the
      relation between occupation and breast cancer risk. A total of 537 cases and 492
      controls completed in-person interviews. Subjects provided job titles and years
      of employment for their three main occupations since age 18. While there were
      case-control differences in the frequency with which certain jobs were reported,
      all were within the limits of chance, given no true association. Also, few
      additional increases in risk were associated with long-term employment. Relative
      risk (RR) estimates were elevated for women working in precision textile and
      apparel jobs (six cases and one control, RR = 5.2). To a lesser extent, RR
      estimates were also elevated for receptionists, cosmetologists, and the category
      of painters/sculptors/printmakers. A slight increase in risk was associated with
      several occupations, including nursing and teaching.

PMID- 7796205
TI  - Parity is not enough.

PMID- 7796204
TI  - Occupation and cervical cancer.
AB  - Data collected for a multicenter case-control study of invasive cervical cancer
      and carcinoma in situ of the cervix were analyzed with regard to occupation. Odds
      ratios comparing 481 invasive cases and 293 carcinoma in situ cases to 801
      controls were calculated and adjusted for potential confounding factors. Working
      women and homemakers had a similar risk of invasive cervical cancer, with several
      groups of service and industrial workers showing elevated risks (particularly
      maids, cleaners, and cooks). Risk of carcinoma in situ was slightly increased for
      working women, but no occupational groups had notable associations. The principal
      strengths of this analysis were the ability to address both invasive cervical
      cancer and carcinoma in situ and to control for multiple potential confounding
      factors. However, occupational information was limited and risk estimates for
      women in specific occupations were imprecise.

PMID- 7796206
TI  - Predicting suicide.

PMID- 7796207
TI  - Treatment of bipolar depression.

PMID- 7796208
TI  - Evaluating changes in symptoms and functioning of dually diagnosed clients in
      specialized treatment.
AB  - OBJECTIVE: The authors outline a minimal set of outcome indicators to assess the
      effects of specialized treatment for people with severe mental illness and
      substance use disorders and report on use of these indicators in a longitudinal
      study of such treatments. METHODS: A total of 147 clients with dual disorders
      participated in a controlled clinical trial of three interventions--behavioral
      skills training, case management, and 12-step recovery--in a county mental health
      program. The clients were assessed every six months over a two-year period using
      multidimensional self-report and observer-rated outcome measures encompassing
      psychosocial functioning, psychiatric and substance abuse symptoms, and service
      utilization. RESULTS: Client self-reports showed changes in psychosocial
      functioning, especially increased functioning in residential stability and work,
      and reductions in alcohol and drug symptoms and usage. Data on service
      utilization showed decreased use of acute and subacute mental health services and
      increased use of outpatient and case management services over time. Ratings by
      trained observers of psychiatric symptoms and psychosocial functioning improved
      dramatically. CONCLUSIONS: A minimal set of outcome indicators for clinical
      trials and demonstrations of interventions for clients with dual disorders should
      include client self-reports of social adjustment, life satisfaction, psychiatric
      and substance abuse symptoms, and current substance use; interviewers' ratings of
      psychosocial functioning and psychiatric symptoms; data on utilization of mental
      health treatment and support services; and data on clients' personal income, use
      of medical services, and contact with the criminal justice system.

PMID- 7796209
TI  - A state management planning system for addressing high levels of use of inpatient
      psychiatric services.
AB  - Research on psychiatric hospital admissions shows that a small group of patients
      use a disproportionate amount of inpatient services. In the late 1980s Washington
      State developed initiatives to target outpatient community mental health services
      to mentally ill persons with high rates of inpatient psychiatric service use.
      Services to the targeted group are provided by regional support networks under
      contract with the state. Diverse funding sources were consolidated to give the
      regional authorities flexibility to tailor funding to local needs, and new
      appropriations were tied to the region's commitment to increase capacity for
      community mental health services. To support those initiatives, the state
      developed a specialized client-focused database to identify individuals with high
      rates of hospital utilization, provide information to regional authorities about
      use of hospital services by those individuals, and assess whether they were
      receiving outpatient services. Analyses of statewide data showed wide variation
      among regions in hospital use and delivery of community services.

PMID- 7796211
TI  - Long-term course of substance use disorders among patients with severe mental
      illness.
AB  - OBJECTIVE: This study assessed the long-term course of substance abuse and
      dependence among severely mentally ill patients. METHODS: A prospective,
      naturalistic, seven-year follow-up of severely mentally ill outpatients (most
      with schizophrenia and schizoaffective disorder) successfully located and
      reassessed 79.1 percent (N = 148) of the patients from the original study group.
      The follow-up study group was assessed for alcohol and drug use at baseline and
      seven-year follow-up by their case manager or primary clinician using the Case
      Manager Rating Scale (CMRS) for the assessment of substance-related problems
      among severely mentally ill patients. RESULTS: The prevalence of active substance
      use disorder changed little from baseline to follow-up. Alcohol abuse or
      dependence was present in 24 percent of the patients at baseline and 21 percent
      at follow-up, and drug abuse or dependence was present in 20 percent at baseline
      and 17 percent at follow-up. However, those with initial alcohol abuse had a
      higher rate of remission (67 percent) than those with initial alcohol dependence
      (33 percent). Similarly, those with initial drug abuse had a higher rate of
      remission (54 percent) than those with initial drug dependence (31 percent).
      CONCLUSIONS: The higher rates of change for those with initial substance abuse
      compared with substance dependence suggest that distinguishing between abuse and
      dependence may have important implications for assessment and prognosis of
      individuals with a dual diagnosis of a substance use disorder and severe mental
      illness.

PMID- 7796210
TI  - A collaborative approach to reduce hospitalization of developmentally disabled
      clients with mental illness.
AB  - Developmentally disabled clients with a concomitant mental illness are often
      underserved or inappropriately treated because of interorganizational barriers,
      leading to unnecessary hospitalization and lengthy delays in community placement.
      To overcome these barriers, agencies responsible for developmental disabilities
      and mental health services in Spokane County in Washington State developed a
      collaborative system of care in 1989. An interagency consortium was established
      to promote coordination of services between the community mental health center,
      the state hospital, the county human services agency, the state's regional
      developmental disability service agency, the state institution for the
      developmentally disabled, and several community agencies serving developmentally
      disabled persons. Between 1990 and 1992, admissions of developmentally disabled
      persons to the state hospital were more likely to be appropriate admissions of
      persons suffering from a mental illness, developmentally disabled clients were
      discharged more efficiently, and crisis respite services were used in place of
      hospitalization. In addition, anecdotal reports indicated a reduction of
      interagency tensions.

PMID- 7796212
TI  - A treatment-team model of managed mental health care.
AB  - Many models of managed care have been criticized as inflexible and intrusive,
      including those in which decisions about level of care are made by third-party
      reviewers, in-house staff, or other clinicians not involved in the patient's
      treatment. The treatment-team model of managed care, which has been implemented
      in the emergency psychiatric service of a midsized, non-profit community hospital
      in a metropolitan area, addresses these criticisms. Major features of the model
      are in-person assessment by a clinician who acts as the managed care agent;
      immediate accessibility of this clinician; referral services with a broad range
      of intensity, including crisis intervention; and participation of the managed
      care clinician on the treatment team. The advantages of this model include the
      incentive to employ qualified managed care clinicians and an increased ability to
      provide individualized services. Limitations of the model include the diffusion
      of decision-making power within the treatment team, the potential for overuse of
      emergency services by primary providers, and the potential for the managed care
      agent to lose decision-making power due to personal or systems issues.

PMID- 7796213
TI  - Clozapine treatment in Russia: a review of clinical research.
AB  - OBJECTIVE: This paper is intended to help American clinicians and investigators
      further their understanding of the clinical use of clozapine by reviewing
      experience with the drug in Russia, where it was introduced 17 years before it
      became available in the United States. METHODS: Key articles on clozapine from
      the Russian clinical research literature were reviewed by the first two authors,
      former Russian clinical investigators. The third author comments briefly about
      the implications of this work from a contemporary American perspective. FINDINGS
      AND CONCLUSIONS: The review found that although clozapine was not widely
      distributed in Russia, it was investigated at several large psychiatric research
      institutions and hospitals. It was not reserved for neuroleptic-resistant
      disorders but instead was used with some success as a first-line treatment in
      acute disorders. Although no controlled clinical trials were conducted, results
      of long-term outcome studies of treatment-resistant schizophrenia were largely in
      agreement with those of controlled trials and clinical follow-up studies in the
      U.S. The studies found short-term gains for previously refractory patients as
      well as improvements in social functioning that continued for extended periods in
      some cases. Russian investigators described clozapine as an effective
      antipsychotic agent that lacked the extrapyramidal side effects of other
      neuroleptics.

PMID- 7796214
TI  - Relating functional skills of severely mentally ill clients to subjective and
      societal benefits.
AB  - OBJECTIVE: This study explored the relationship between the functional skills of
      clients with severe mental disorder and the benefits to the client and society as
      reflected by residential and vocational status, self-efficacy, self-esteem, and
      life satisfaction. METHODS: Relationships between various outcome variables and
      the demographic and clinical characteristics and staff ratings of the functional
      skills of 139 clients at three psychosocial rehabilitation programs for adults
      with severe mental disorders were analyzed using correlational techniques. The
      outcome variables considered were the clients' level of independence in their
      residential and vocational settings and their levels of self-esteem, self
      efficacy, and satisfaction with life. RESULTS: Ratings of functional skills
      correlated positively with clients' levels of residential and vocational
      independence and with self-efficacy, but were unrelated to self-esteem and life
      satisfaction. Age, education, work and hospitalization history, psychiatric
      diagnosis, and length of program membership were also related to these outcome
      measures. Skill level remained the strongest predictor of residential and
      vocational status after demographic and diagnostic factors were controlled for.
      CONCLUSIONS: Clients' functional skills have a strong, positive relationship with
      their level of residential and vocational independence, and skill level is a
      better predictor of benefits to clients and society than are demographic and
      diagnostic variables.

PMID- 7796215
TI  - Maintenance electroconvulsive therapy for chronic mentally ill patients: a case
      series.
AB  - OBJECTIVE: Maintenance electroconvulsive therapy (maintenance ECT) has emerged as
      an alternative treatment for patients who relapse repeatedly or cannot tolerate
      psychotropic medications. The pattern of maintenance ECT use in two university
      affiliated hospitals was surveyed to evaluate its effectiveness in treating
      several disorders, establish treatment guidelines, and identify adverse side
      effects. METHODS: Records of 161 patients who received ECT from 1976 through 1988
      were reviewed retrospectively. Nine patients who received maintenance ECT-
      prophylactic ECT treatments administered for longer than six months--were
      identified. The presence of target symptoms and behaviors in the periods before
      and after administration of maintenance ECT was compared. RESULTS: All nine
      patients experienced a complete or a significant partial remission of target
      symptoms. Six of the nine patients were ready for transfer to less restrictive
      settings. Given the small number of patients, treatment guidelines could not be
      established; however, patients with mood disorder required less frequent
      treatments than patients with thought disorder. Adverse effects were documented
      for two of the nine patients, but they were not severe enough to discontinue
      treatment. CONCLUSIONS: For this sample, maintenance ECT was a safe, efficacious,
      and well-tolerated treatment with minimal side effects. Further, controlled
      studies are warranted.

PMID- 7796216
TI  - Characteristics and service use of long-term members of self-help agencies for
      mental health clients.
AB  - OBJECTIVE: This study examined the characteristics of long-term members of self
      help agencies managed and staffed by mental health clients, why they sought help
      from the agencies, and how they differed from clients of community mental health
      agencies. METHODS: A survey and assessment instruments were used to obtain
      information on the service utilization of 310 long-term agency members as well as
      on their resources, history of disability, functional status, psychological
      disability, health problems, and DSM-III-R diagnosis. Data from management
      information systems of the self-help and community mental health agencies were
      used to compare service populations. RESULTS: The self-help agencies served a
      primarily African-American population (64 percent), many of whom were homeless
      (46 percent). Eighty-seven percent had confirmed DSM-III-R diagnoses, and 50
      percent had dual diagnoses with moderate to severe substance or alcohol abuse or
      dependence. They had sought help from the self-help agencies primarily for
      resources such as food or clothing, for "a place to be," or because they were
      homeless. Obtaining counseling or help for substance or alcohol abuse was a less
      important reason for coming to the self-help agencies. CONCLUSIONS: A high
      proportion of the persons served by the self-help agencies in the study were
      homeless and had a dual diagnosis of mental disorder and substance abuse. The
      self-help agencies provided their clients with material resources while community
      mental health agencies provided psychotherapeutic and medical care.

PMID- 7796217
TI  - Use of a brief behavioral skills intervention to prevent HIV infection among
      chronic mentally ill adults.
AB  - OBJECTIVE: Research shows that many chronic psychiatric patients are at risk for
      infection by the human immunodeficiency virus (HIV). This study investigated the
      effects of a behavioral skills training program designed to prevent HIV infection
      among chronic mentally ill adults living in an inner-city area. METHODS: Twenty
      seven men and 25 women were randomly assigned either to a four-session AIDS
      prevention program emphasizing risk education, sexual assertiveness, condom use,
      risk-related behavioral self-management, and problem-solving skills or to a
      waiting-list group, who later received the same intervention. RESULTS: Compared
      with the waiting-list control group, participants in the prevention program
      demonstrated significant gains in AIDS-related knowledge and intentions to change
      risk behaviors. The prevention program also significantly reduced rates of
      unprotected sexual intercourse and increased the use of condoms over a one-month
      follow-up period. A subset of participants who provided two-month follow-up data
      maintained some behavior changes. CONCLUSIONS: A relatively brief, skills-focused
      AIDS prevention program for chronic psychiatric patients produced reductions in
      HIV risk behaviors. Such HIV risk reduction intervention programs may be of use
      in inpatient, outpatient, and community-based settings.

PMID- 7796218
TI  - Characteristics of male and female veterans who use VA psychiatric emergency
      services.
AB  - Retrospective chart review was used to compare the demographic characteristics
      and psychiatric diagnoses of 150 consecutive female patients seen in psychiatric
      consultation in the emergency service at a Veterans Affairs medical center
      between 1987 and 1991 with those of two groups of 150 male patients matched by
      age or psychiatric diagnosis. Compared with the men, the women were younger and
      more likely to be divorced, to complain of anxiety or psychotic symptoms, and to
      have a diagnosis of a depressive disorder or borderline personality disorder. Men
      were more likely to have a diagnosis of schizophrenia or antisocial personality
      disorder.

PMID- 7796219
TI  - Psychiatric crisis intervention in the general emergency service of a Veterans
      Affairs hospital.
AB  - An after-hours crisis intervention program staffed by psychiatric residents
      between 5 p.m. and 11:30 p.m. on weekdays was developed in the general emergency
      room at a Veterans Affairs hospital to reduce inpatient psychiatric admissions.
      The program offered medication, family interventions, and referrals to outpatient
      services. In the programs's first year, inpatient admissions during the hours
      covered by the program decreased by 34 percent, for a net savings of nearly
      $400,000 in inpatient treatment costs.

PMID- 7796220
TI  - Repeat users of substance abuse services at a VA Medical Center.
AB  - To examine patterns of use of acute walk-in services by substance abusers, the
      authors studied demographic characteristics and type of substance abuse among
      1,838 patients treated at a Veterans Affairs substance abuse triage unit. They
      found that African-American and male substance abusers appeared most likely to
      return for triage services. Among heroin users, the strongest predictor of return
      was gender. Among alcoholics, homelessness was the sole predictor of return. No
      predictors were found for cocaine users. The authors conclude that the
      relationship between return rates and type of substance abuse needs further
      study.

PMID- 7796222
TI  - The Charles Bonnet syndrome: a brief review and case report.
AB  - A case of a woman with visual hallucinations in the absence of other organic or
      psychiatric findings--symptoms consistent with a diagnosis of Charles Bonnet
      syndrome--is reported. The women was HIV positive, although asymptomatic for
      conventional complications of HIV infection. After considering possible causes of
      the hallucinations, including prescription drug effects and conversion or
      factitious disorder, the authors suggest that the woman's symptoms may have been
      associated with undetectable effects of HIV on the brain.

PMID- 7796221
TI  - Psychosocial functioning of severely disturbed adolescents after short-term
      hospitalization.
AB  - Forty-two severely emotionally disturbed adolescents discharged after a brief
      hospitalization for an acute psychiatric episode were assigned to two groups--one
      for whom clinicians recommended continued intensive treatment in an inpatient,
      residential, or day treatment setting, even though such services were not
      available, and the other for whom clinicians recommended only outpatient
      treatment. The two groups were compared on rates of rehospitalization, self
      harmful actions, and suicide attempts and on severity of problems with peers
      during the six months after discharge. The two groups showed significant
      differences only in the extent of their problems with peers.

PMID- 7796224
TI  - Funding health care reform.

PMID- 7796223
TI  - Isolated sleep paralysis.

PMID- 7796225
TI  - Scurvy in schizophrenia.

PMID- 7796226
TI  - Data from five federal demonstration projects indicate homeless mentally ill can
      be helped.

PMID- 7796228
TI  - Administration of intravenous immunoglobulins for prophylaxis or treatment of
      infection in preterm infants: meta-analyses.
AB  - AIMS: To determine the effectiveness of intravenous immunoglobulin administration
      to premature infants in the prevention and/or treatment of bacterial infection.
      METHODS: Computer searches of MEDLINE, EMBASE, SCISEARCH and Oxford Database of
      Perinatal Trials were made. Two independent researchers applied inclusion
      criteria of: randomised controlled trial; premature and/or low birthweight
      infant; use of intravenous immunoglobulin; and infection or mortality. Nineteen
      of 44 identified studies fulfilled these criteria. Study quality was assessed and
      information on study population, intervention, and outcomes were collected.
      RESULTS: Studies were divided into prophylaxis or treatment; results were
      tabulated for infection, sepsis, and death from all causes. For 17 studies of
      prophylaxis (n = 5245), the relative risk and confidence interval were, for
      proved infection 0.81, 0.67-0.97; for sepsis 0.87, 0.66-1.13; for death from all
      causes 0.85, 0.64-1.14. Some outcome results were heterogeneous. Two treatment
      studies showed no reduction in mortality when combined. CONCLUSIONS: Routine
      administration of intravenous immunoglobulin to preterm infants is not
      recommended.

PMID- 7796227
TI  - Excitatory amino acids in neonatal brain: contributions to pathology and
      therapeutic strategies.

PMID- 7796229
TI  - Longitudinal changes in the diameter of the ductus arteriosus in ventilated
      preterm infants: correlation with respiratory outcomes.
AB  - This study aimed to examine the early natural history of ductal shunting in
      ventilated preterm infants (< 1500 g) and to document the association between
      this shunting and respiratory outcomes. The size of the ductal shunt was assessed
      in 48 infants using serial echocardiographic measurement of colour Doppler
      internal ductal diameter and pulsed Doppler postductal aortic diastolic flow
      (PADF). At all postnatal ages, normal antegrade PADF was invariably seen when the
      ductal diameter was 1.5 mm or less, and was usually abnormal (absent or
      retrograde) when more than 1.5 mm. Longitudinal progress of ductal diameter fell
      into three groups: (i) asymptomatic spontaneous closure (n = 31)--in 20 of these
      infants closure occurred within 48 hours; (ii) symptomatic PDA which enlarged
      after a postnatal constriction (n = 9); and (iii) symptomatic PDA that showed
      minimal postnatal constriction (n = 8). Infants in group 2 were significantly
      less mature and had PDAs which became symptomatic significantly later than those
      in group 3. Logistic regression showed that ductal shunting had a significant
      correlation with mean oxygenation index over the first five days but not with
      ventilator or oxygen days. Gestation had the most significant association with
      the latter two variables, with atrial shunting also being related to days in
      oxygen. The preterm duct displays a wide spectrum of postnatal constrictive
      activity. Symptomatic PDAs usually showed slower early postnatal constriction.
      Ductal shunting independently related to short term but not long term respiratory
      outcomes.

PMID- 7796231
TI  - Fetal behaviour and the sudden infant death syndrome (SIDS).
AB  - To examine whether differences in sleep maturation could be identified before
      birth, behavioural studies were carried out in 28 fetuses. Studies were possible
      in all 28 fetuses at 28 weeks, but only in 26 fetuses at 36 weeks (two fetuses
      delivered before 36 weeks). The risk of sudden infant death syndrome (SIDS) was
      determined using the Oxford SIDS scoring system. The fetuses at greater risk of
      SIDS had coincidence of behavioural characteristics for a significantly lower
      percentage of the time than those at low risk. This difference reached
      significance (p < or = 0.05) only at 36 weeks.

PMID- 7796230
TI  - Blood pressure, heart rate, and skin temperature in preterm infants: associations
      with periventricular haemorrhage.
AB  - The mean arterial blood pressure (MABP), heart rate, and skin temperature were
      monitored every 15 minutes in the first 10 days after birth in 34 preterm
      infants, gestational age 24 to 33 weeks. Ultrasound brain scans carried out daily
      showed that a periventricular haemorrhage (PVH) occurred in a subgroup of infants
      (n = 15) of lower birthweight and gestational age. In infants without PVH the
      daily median of MABP increased with birthweight and postnatal age; that of heart
      rate was not affected by postnatal age, body weight, or gestational age; and that
      of skin temperature showed a slight fall with postnatal age. In infants with PVH,
      on or before the day of PVH, daily medians of MABP and skin temperature were not
      significantly different from those of infants without PVH, but the daily median
      of heart rate tended to be slightly higher. The percentage of positive
      correlations between the 96 15 minute values per day for heart rate and MABP
      increased with postnatal age and with birthweight, but did not differ in infants
      who developed a PVH. The coefficient of variation (CV) of the 96 15 minute values
      for MABP tended to be higher in infants on the day of PVH, and a similar trend
      was apparent on the day before. The processes of development of blood pressure,
      heart rate, and skin temperature are similar in infants with or without PVH but
      at lower gestational ages altered blood pressure control may cause brain
      haemorrhage.

PMID- 7796232
TI  - Concentrations of main serum opsonins in early infancy.
AB  - The evolution of the main serum opsonins in neonates and infants of varying
      gestational age was investigated to provide reference values for these opsonins
      in early infancy. Serum concentrations of immunoglobulins, IgG subclasses, C3, C4
      and fibronectin were serially measured from birth until the age of 6 months in
      term and preterm infants. Measurements were performed by rate nephelometry. Five
      hundred and sixty six neonates (gestational age 26-41 weeks) were examined at
      birth, 233 at 1 month, 218 at 3 months, and 147 at 6 months, respectively. The
      same measurements were performed in 54 pairs of neonatal/maternal samples and in
      230 apparently healthy adults. Gestational age had a significant impact on serum
      IgG, IgG subclasses, C3 and C4 up till the third month, and on fibronectin until
      the first month. No such impact was observed for IgA and IgM. Sixteen per cent of
      the neonates had IgM concentrations higher than 0.2 g/l at birth, suggesting that
      the critical concentration of serum IgM at birth for suspected intrauterine
      infection should be reconsidered. Concentrations of all opsonins at birth were
      significantly lower than adult reference values. They only approached or even
      reached adult values by the third or the sixth month. Data from analysis of the
      neonatal and the corresponding maternal sera indicate that there is a
      preferential active transplacental transport of IgG subclasses in the order of
      IgG1, IgG3, IgG2 and IgG4. These results show that concentrations of
      immunoglobulins, C3, C4 and fibronectin undergo changes during the first months
      of life, depending not only on the infants' postnatal age but also on gestational
      age.

PMID- 7796233
TI  - Changes in pulmonary artery pressure in infants with respiratory distress
      syndrome following treatment with Exosurf.
AB  - The pulmonary artery pressure (PAP) changes were studied using Doppler
      echocardiography in preterm infants treated with an artificial surfactant
      (Exosurf) during the acute phase of respiratory distress syndrome (RDS). The
      ratio of pulmonary artery acceleration time to the right ventricular ejection
      time (AT:RVET), measured from the Doppler wave form, was determined in 38 infants
      before the first dose of Exosurf, at one and six hours after the first dose,
      immediately before the second dose of Exosurf, and at one, six, 12, 36, and 60
      hours subsequently. The median AT:RVET ratio corrected for heart rate
      (AT:RVET(c)) increased significantly an hour after administration of the first
      dose of Exosurf from 0.330 (0.273-0.410) to 0.380 (0.303-0.445) and similarly an
      hour after the second dose from 0.426 (0.252-0.495) to 0.440 (0.373-0.500). These
      changes occurred against a steady increase in the median AT:RVET(c) over the
      first 72 hours. It is concluded that the reduction in PAP correlates well with
      clinical parameters of disease severity and raises questions regarding the mode
      of action of Exosurf.

PMID- 7796234
TI  - Measurement of lung volume and optimal oxygenation during high frequency
      oscillation.
AB  - Twelve infants, median gestational age 27 weeks and postnatal age 1 day, were
      examined to determine whether oxygenation improves on transfer to high frequency
      oscillation (HFO). Lung volume was assessed before transfer to HFO by measuring
      functional residual capacity (FRC) using a helium gas dilution technique and
      specially designed infant circuit. On transfer to HFO, the inspired oxygen was
      initially kept constant, but the mean airway pressure (MAP) increased until
      maximum oxygenation was achieved (optimal MAP). The median FRC of the 12 infants
      before HFO was 8.1 ml/kg (range 4.7 to 28.7) and their median alveolar-arterial
      oxygen gradient (A-aDO2) 484 mm Hg. On transfer to HFO, oxygenation did not
      improve in two infants, but, overall, the A-aDO2 fell to a median of 289 mm Hg (p
      < 0.05). The median optimal MAP was 18.5 cm H2O (range 10.6 to 24.4) and this had
      an inverse correlation with the FRC before starting HFO (p < 0.01). The median
      change in MAP needed to maximise oxygenation on HFO also correlated negatively
      with FRC (p < 0.01).

PMID- 7796236
TI  - Synchronous intermittent mandatory ventilation modes compared with patient
      triggered ventilation during weaning.
AB  - The efficacy of combining rate and pressure reduction during weaning by
      synchronous intermittent mandatory ventilation (SIMV) were compared with weaning
      by patient triggered ventilation (PTV) (pressure reduction alone) in two
      randomised trials. Regardless of ventilation mode, pressure was reduced to the
      same level according to the size of the infant. In the first trial, the SIMV rate
      was also reduced progressively to a minimum of 20 breaths/minute, and in the
      second to five breaths/minute. Forty premature infants aged 15 days of age or
      less were randomly allocated into each trial. No significant differences were
      found in the first trial between ventilation modes in either the duration of
      weaning or the number of infants in whom weaning failed. In the second trial, the
      duration of weaning was shorter by PTV than by SIMV (median 24 hours, range 7-432
      v 50 hours, range 12-500; p < 0.05); weaning failed in two infants in the PTV
      group and in five in the SIMV group. It is concluded that weaning by a
      combination of pressure and rate reduction, such as can be achieved during SIMV,
      offers no significant advantage over pressure reduction alone.

PMID- 7796235
TI  - Magnesium sulphate as an alternative and safe treatment for severe persistent
      pulmonary hypertension of the newborn.
AB  - Eleven newborns admitted consecutively to the neonatal unit with respiratory
      failure and severe persistent pulmonary hypertension (PPHN) were included in a
      clinical trial to assess the efficacy of magnesium sulphate (MgSO4) in the
      treatment of PPHN. A loading dose of 200 mg/kg MgSO4 was given over 20 minutes,
      followed by a continuous infusion of 20-150 mg/kg/hour to obtain a magnesium
      blood concentration between 3.5 and 5.5 mmol/l. Mean (SD) duration of treatment
      was 75.5 (19.8) hours. No other vasodilatory drug was administered before or
      during the treatment and patients were not hyperventilated. Mean (SEM) PaO2
      values significantly increased from 42.6 (8.8) before treatment to 70.3 (24.1) mm
      Hg after 24 hours, with no change in pH or PCO2. Oxygen index and alveolar
      arterial oxygen gradient (A-aDO2) were significantly lower after 24 hours;
      respectively, 46.8 (15.2) to 28.0 (9.0) and 624.3 (11.3) to 590 (58) mm Hg. Mean
      airway pressure could be significantly reduced from 19.5 (3.1) to 13.9 (3.9) cm
      H2O after 72 hours. Mean ventilatory time support was 131 hours and mean total
      oxygen dependency 10 days. No systemic hypotension nor any other adverse effect
      were noted. All infants survived and the neurodevelopmental assessment was normal
      at 6 and 12 months of age. It is concluded that magnesium sulphate is a non
      aggressive and low-cost treatment of short duration which is easy to apply. It
      may have a role in the various treatment of PPHN.

PMID- 7796237
TI  - Application of nasal continuous positive airway pressure to early extubation in
      very low birthweight infants.
AB  - Using a preset protocol for early extubation, 50 babies were randomly selected to
      post-extubation headbox or post-extubation nasal continuous positive airway
      pressure (N-CPAP). All infants weighed less than 1500 g, had a gestational age of
      less than 34 weeks, and had been weaning from mechanical ventilation within seven
      days of life. The criteria for extubation included stable condition, fraction of
      inspired oxygen (FIO2) of < or = 35%, peak inspiratory pressure (PIP) of < or =
      15 cm H2O (1.47 kPa), and ventilator rate of 6/minute. Before extubation, a
      loading dose of aminophylline was given followed by maintenance treatment. If
      reintubation was not required within 72 hours of the initial extubation the
      procedure was considered successful. The reintubation criteria included FIO2 > or
      = 70% to maintain arterial oxygen tension (PaO2) of > or = 50 mm Hg (6.67 kPa) or
      pulse oximetry between 90-96% and pH of < 7.25, and arterial carbon dioxide
      tension (PACO2) of > 60 mm Hg (8.00 kPa) and severe or recurring apnoea. The
      overall success rate of early extubation was 66% (33/50). The individual
      successful extubation rate of post-extubation in the N-CPAP group and the post
      extubation headbox group were 84% (21/25) and 48% (12/25), respectively (p =
      0.017; chi 2). There were no significant differences in clinical characteristics
      between the two groups. The most common cause of failure in early extubation was
      apnoea, and most occurred in the headbox group (9/12). These results suggest that
      application of N-CPAP to a preset protocol for extubation can achieve a better
      success rate of early extubation in very low birthweight (VLBW) infants.

PMID- 7796238
TI  - Effect of blood transfusion on cardiorespiratory abnormalities in preterm
      infants.
AB  - The effects of red blood cell transfusion on the incidences of apnoea,
      bradycardia, tachycardia and oxygen desaturation over periods of 72 hours before
      and after transfusion were assessed in 25 infants with a gestational age of < or
      = 32 weeks (mean (SEM) 29.2 (0.4) weeks, birthweight 1170 (73) g; postnatal age
      at transfusion 39 (4) days). During transfusion haemoglobin rose from 78 (2) g/l
      to 117 (2) g/l. Significant decreases were observed in daily frequencies of
      apnoeas longer than 15 seconds (median from 2.7 to 0.9 events a day),
      tachycardias of more than 200 beats per minute (from 34 to 25 events per day),
      bradycardias below 100 beats per minute (from 65 to 12 events per day) and 80
      beats per minute (from 8.4 to 3.3 events per day). Oxygen saturation improved in
      20 of the infants. Transfusion improves cardiorespiration in preterm infants for
      several days.

PMID- 7796239
TI  - Absence of acidosis in the initial presentation of propionic acidaemia.
AB  - The clinical presentation and results of the initial biochemical and
      haematological investigations in 11 newborn term infants with propionic acidaemia
      are described. All patients had neurological symptoms. Only four had clinically
      important acidosis, but all had a raised blood ammonia. A diagnosis of propionic
      acidaemia should be considered in all newborn infants with unexplained
      neurological deterioration even in the absence of a metabolic acidosis.

PMID- 7796240
TI  - Gall bladder contractility in neonates: effects of parenteral and enteral
      feeding.
AB  - The gall bladder size was measured in 30 newborn infants: 18 had been fed
      parenterally and 12 enterally. The two groups were comparable for gestational
      age, birthweight, postnatal age and study weight. Exclusion criteria were
      haemodynamic instability, septicaemia, abdominal disease and opioid treatment.
      Gall bladder size was measured at 15 minute intervals for 90 minutes using real
      time ultrasonography and the volume calculated using the ellipsoid method.
      Parenterally fed infants had further measurements at 120, 150, and 360 minutes.
      The gall bladder was significantly larger in parenterally fed infants than in
      enterally fed infants (p = 0.0001). In enterally fed infants a 50% reduction in
      gall bladder volume was observed 15 minutes after starting the feed with a return
      to baseline volume by 90 minutes. In parenterally fed infants there was no gall
      bladder contraction. Such information may give insight into the pathophysiology
      of hepato-biliary complications during parenteral nutrition in infants.

PMID- 7796241
TI  - Lignocaine ointment and local anaesthesia in preterm infants.
AB  - The ability of topically applied lignocaine ointment to produce surface
      anaesthesia was examined in 45 preterm infants (gestational age 25 to 35 weeks)
      at a median age of 2 days. Two strengths of ointment, 5% and 30%, were tested at
      30 and 60 minutes after application to the dorsum of the foot. Anaesthesia was
      assessed by comparing the response to skin stimulation at the test and control
      sites, using von Frey hairs. In 84% of cases responses indicated that there was
      no surface anaesthesia. Topically applied lignocaine ointment is not an effective
      local anaesthetic in preterm infants, presumably due to poor absorption.

PMID- 7796242
TI  - Aplasia cutis congenita with chromosome 12q abnormality.
AB  - A 32 week, small for dates baby with aplasia cutis congenita had an unbalanced
      translocation, being monosomic for distal 12q and trisomic for distal 1q. As far
      as is known, the association between extensive skin defects and a chromosomal
      abnormality has not been reported before. Keratin genes have been located in a
      different area of 12q, but this case may indicate other candidate areas to
      explore. Karyotyping should be undertaken in all babies with aplasia cutis.

PMID- 7796243
TI  - Intra-abdominal extravasation complicating parenteral nutrition in infants.
AB  - Two infants receiving total parenteral nutrition via a central venous catheter
      positioned in the inferior vena cava developed an acute abdomen secondary to
      extravasation of the infusate. The presence of an associated abdominal mass
      necessitated a laparotomy in one patient. Both infants recovered completely after
      the catheter had been removed.

PMID- 7796244
TI  - Dr William Little (1810-1894) of London and cerebral palsy.

PMID- 7796245
TI  - Randomised trial of early tapping in neonatal post haemorrhagic ventricular
      dilatation: results at 30 months.

PMID- 7796246
TI  - Pro- or antioxidant activity of vitamin C in preterm infants?

PMID- 7796247
TI  - Extensive necrotising enterocolitis after a prolonged period of supraventricular
      tachycardia.

PMID- 7796248
TI  - A longitudinal study of depression in an urban Spanish pubertal population.
AB  - Depression characteristics were investigated in 507 adolescents using a two-stage
      longitudinal study design. The three-year longitudinal study started when the
      girls and boys were 11 and 12 years, respectively. In the initial (screening)
      phase the Children's Depression Inventory (CDI) was used to select subjects for
      phase-II of the study in which the Children's Depression Rating Scale-Revised
      (CDRS-R) interview was used. The caseness definition of Major Depression (MD) and
      Dysthymia (D) was based on the DSM-III-R criteria. Pubertal development was
      assessed by Tanner's staging. Estimated prevalence of Major Depression in the
      female sample for each increasing year of age was 2.2%, 2.7% and 4.1%. In the
      male sample the prevalence for the three years was 0.9%, 0.3% and 0.6%. There was
      no relation to age. The estimated mean prevalence of Dysthymia was 1.4% in girls
      and 0.8% in boys. No association between pubertal development and depression was
      found. Longitudinal data support the notion of chronic depression in early
      adolescence.

PMID- 7796249
TI  - Obsessive-compulsive disorder in children and adolescents. A 6-22 year follow-up
      study of social outcome.
AB  - Twenty-eight adult males and 19 females with childhood obsessive-compulsive
      disorder (OCD) were followed-up in young adulthood, six to 22 years after their
      first referral, and their social outcome was described. The overall, social
      outcome was illustrated with The Global Assessment Scale (GAS). Ten patients
      (21.2%) had a poor outcome with GAS-scores under 50; 19 patients (40.4%) had a
      GAS-score between 50 and 70; and 18 (38.3%) of the patients had a good prognosis
      with GAS-scores over 70. Childhood OCD-patients were more socially isolated in
      adulthood than a non-OCD psychiatric comparison group and an age and sex
      standardised group from the normal population: more still lived with their
      parents, and fewer had partnerships. Seventeen percent had been granted
      disability pension, which was significantly different from the normal population,
      but not from that of the psychiatric comparison group. Age of onset of OCD,
      social background factors, and symptomatology in childhood did not seem to
      predict the social outcome. OCD at follow-up was strongly associated with a poor
      outcome.

PMID- 7796251
TI  - Children of a transsexual father: a successful intervention.
AB  - Following gender reassignment, transsexuals are often assessed in many different
      areas with regard to how they are functioning. However, there is little attention
      paid to the children they may have had prior to the operation and change in
      lifestyle. Children may present with problems related to the parents
      transsexualism, or with more generalised difficulties secondary to break-up of
      the family. A family of a transsexual father is described in which the children
      presented with difficulties and in which the intervention was successful.

PMID- 7796250
TI  - Quantified multidimensional assessment of autism and other pervasive
      developmental disorders. Application for bioclinical research.
AB  - A large number of investigation techniques are used to establish the
      relationships between the clinical and biological data which are necessary for
      physiopathological analysis in the field of developmental disorders. It therefore
      seemed necessary to develop a quantified grouping system, based on developmental
      assessments, which could allow closer matching between clinical evaluations and
      biological numerical data. Two hundred and two subjects presenting developmental
      disorders (autistic disorder, pervasive developmental disorder not otherwise
      specified and mental retardation) were examined. For each child, a quantification
      of autistic behaviour, intellectual impairment, neurological signs and language
      and communication disorders was performed. A cluster analysis of these quantified
      data elicited four subgroups according to the scores obtained in these four
      different areas. We showed the value of this approach by applying it to one of
      the studies of monoamines routinely examined in childhood autism--dopamine and
      HVA, its main urinary derivative. Moreover, this method revealed a subgroup
      within the total population which was independent of nosographic classification
      and which had a particular clinical and biochemical profile. Other applications
      could follow, for example in the fields of neurophysiology, cerebral imaging,
      molecular biology and genetics.

PMID- 7796252
TI  - Empirically based assessment and taxonomy of psychopathology: cross-cultural
      applications. A review.
AB  - This paper provides an overview of empirically based assessment and taxonomy, as
      illustrated by cross-cultural research on psychopathology. The empirically based
      approach uses standardized assessment procedures to score behavioral and
      emotional problems from which syndromes are derived by multivariate analyses.
      Items and syndromes are scored quantitatively to reflect the degree to which
      individuals manifest them, as reported by particular informants. Although the
      approach to assessing problems and to constructing taxonomic groupings differs
      from the ICD/DSM approach, there are no inherent contradictions between either
      their models for disorders nor the criterial features used to define disorders.
      Cross-cultural comparisons have yielded relatively small differences in problem
      rates and syndrome structure, plus considerable similarity in associations of
      problems with sex and SES, as well as similar correlations between reports by
      different types of informants. Research on variations in problems in relation to
      culture, sex, age, SES, and type of informant can contribute to improving both
      the ICD/DSM and empirically based approaches and to a more effective synthesis
      between them.

PMID- 7796253
TI  - Psychological adjustment of children with mild and moderately severe asthma.
AB  - The relationship between the severity and duration of asthma and psychological
      adjustment was investigated in 29 children with mild and 31 children with
      moderately severe asthma, who were compared with 60 healthy control children. The
      severity of asthma was evaluated using the Pearlman-Bierman classification.
      Psychological adjustment was measured using the Achenbach Child Behavior
      Checklist (CBCL) and a semi-structured interview. The results of the interviews
      indicated that regressive symptoms such as clinging, childish behaviour,
      dependence, and a demanding nature were widespread. Using the illness in the
      service of achieving other aims was also common in the asthmatic children. CBCL
      total problem behaviour scores, social competency, and broad band scores were
      significantly higher in the asthmatic group than the control sample. Problem
      scores for asthmatic children were significantly correlated with parental
      friction at home, unsatisfactory relationships with siblings and other health
      problems in children. However, neither the CBCL total problem scores nor the
      social competency scores were correlated with the severity and the duration of
      illness.

PMID- 7796255
TI  - A comparison of individual and family approaches to initial assessment.
AB  - The study aimed to examine the influence of initial mode of assessment on
      attendance, and later assessment and treatment. 100 children newly referred to a
      child mental health service were randomly assigned to (i) initial family
      assessment; child and family seen together, or (ii) individual assessment, child
      and parents seen in parallel. Those invited were more likely to attend following
      "individual" appointment letters because parents did not always bring all the
      children in response to "family" appointment letters. Failure to attend the
      second appointment occurred twice as often if there was a change in who was asked
      to attend. Psychometric assessment was more often requested following an initial
      family interview. Long term mode of therapy appeared to be partly but not wholly
      influenced by initial assessment method. Results suggest that sustained co
      operation with long term therapy is more likely to occur when clinicians vary the
      family members they are working with according to the needs of the case.

PMID- 7796254
TI  - Fears of children and the cultural context: the Turkish norms.
AB  - The present study was undertaken to identify children's fears in terms of their
      age, gender and Socio Economic Status (SES) characteristics. Another aim of the
      study was the adaptation and the standardization of the "Fear Survey Schedule for
      Children" (FSSC) to Turkish population and to determine its psychometric
      properties. FSSC was given to 1237 Lower SES children aged 9-13 years. To
      understand the effects of social and environmental factors the results were
      compared with 644 children from high socio-economic level and 118 children of
      Turkish immigrant labourer families residing in Holland. The most prevalent 10
      fear items in all three groups were also determined. Results indicated that girls
      had more intense and frequent fears at all age levels than boys. Low SES children
      reveal more fears compared to their high SES pears of their self reported fears.
      Fears related to death and separation occupy the top positions and religious
      fears that are mentioned very often by children especially by those in the lower
      SES group. Test-retest reliability, internal consistency and the factorial
      structure of the scale have proved it to be a valuable and reliable tool for
      research and clinical purposes in Turkey.

PMID- 7796256
TI  - Ironing out the angles in p53.

PMID- 7796257
TI  - The importance of being floppy.

PMID- 7796258
TI  - From sticky zippers to morphology.

PMID- 7796259
TI  - Cystine nooses and protein specificity.

PMID- 7796260
TI  - Mutation of a buried residue causes loss of activity but no conformational change
      in the heat-labile enterotoxin of Escherichia coli.

PMID- 7796261
TI  - Picture story. Interacting with actin.

PMID- 7796262
TI  - Picture story. Pax and paired.

PMID- 7796263
TI  - Flexibility and function in HIV-1 protease.
AB  - HIV protease is a homodimeric protein whose activity is essential to viral
      function. We have investigated the molecular dynamics of the HIV protease,
      thought to be important for proteinase function, bound to high affinity
      inhibitors using NMR techniques. Analysis of 15N spin relaxation parameters, of
      all but 13 backbone amide sites, reveals the presence of significant internal
      motions of the protein backbone. In particular, the flaps that cover the proteins
      active site of the protein have terminal loops that undergo large amplitude
      motions on the ps to ns time scale, while the tips of the flaps undergo a
      conformational exchange on the microsecond time scale. This enforces the idea
      that the flaps of the proteinase are flexible structures that facilitate function
      by permitting substrate access to and product release from the active site of the
      enzyme.

PMID- 7796265
TI  - The substrate-binding site in Cu nitrite reductase and its similarity to Zn
      carbonic anhydrase.
AB  - Here we investigate the structure of the two types of copper site in nitrite
      reductase from Alcaligenes xylosoxidans, the molecular organisation of the enzyme
      when the type-2 copper is absent, and its mode of substrate binding. X-ray
      absorption studies provide evidence for a fourth ligand at the type-2 Cu, that
      substrate binds to this site and indicates that this binding does not change the
      type-1 Cu centre. The substrate replaces a putative water ligand and is
      accommodated by a lengthening of the Cu-histidine bond by approximately 0.08 A.
      Modelling suggests a similarity between this unusual type-2 Cu site and the Zn
      site in carbonic anhydrase and that nitrite is anchored by hydrogen bonds to an
      unligated histidine present in the type-2 Cu cavity.

PMID- 7796264
TI  - Bipartite structure of the alpha-lactalbumin molten globule.
AB  - Molten globules are thought to be general intermediates in protein folding.
      Apparently conflicting studies have failed to clarify whether one of the best
      characterized molten globules, that of alpha-lactalbumin, resembles an expanded
      native-like protein or a nonspecific collapsed polypeptide. Here we show that the
      molten globule properties of alpha-lactalbumin are largely confined to one of its
      two domains. The alpha-helical domain forms a helical structure with a native
      like tertiary fold, while the beta-sheet domain is largely unstructured. Molten
      globules thus possess a native-like backbone topology, but this topology does not
      necessarily encompass the entire polypeptide chain. Our studies indicate that
      molten globules provide an approximate solution to, and considerable
      simplification of the protein folding problem.

PMID- 7796266
TI  - Comparison of the free and DNA-complexed forms of the DNA-binding domain from c
      Myb.
AB  - The DNA-binding domain of c-Myb consists of three imperfect tandem repeats (R1,
      R2 and R3). The three repeats have similar overall architectures, each containing
      a helix-turn-helix variation motif. The three conserved tryptophans in each
      repeat participate in forming a hydrophobic core. Comparison of the three repeat
      structures indicated that cavities are found in the hydrophobic core of R2, which
      is thermally unstable. On complexation with DNA, the orientations of R2 and R3
      are fixed by tight binding and their conformations are slightly changed. No
      significant changes occur in the chemical shifts of R1 consistent with its loose
      interaction with DNA.

PMID- 7796267
TI  - Refined solution structure of the oligomerization domain of the tumour suppressor
      p53.
AB  - The NMR solution structure of the oligomerization domain of the tumour suppressor
      p53 (residues 319-360) has been refined. The structure comprises a dimer of
      dimers, oriented in an approximately orthogonal manner. The present structure
      determination is based on 4,472 experimental NMR restraints which represents a
      three and half fold increase over our previous work in the number of NOE
      restraints at the tetramerization interface. A comparison with the recently
      solved 1.7 A resolution X-ray structure shows that the structures are very
      similar and that the average angular root-mean-square difference in the
      interhelical angles is about 1 degree. The results of recent extensive
      mutagenesis data and the possible effects of mutations which have been identified
      in human cancers are discussed in the light of the present structure.

PMID- 7796269
TI  - Simulating efficiently the evolution of DNA sequences.
AB  - Two menu-driven FORTRAN programs are described that simulate the evolution of DNA
      sequences in accordance with a user-specified model. This general stochastic
      model allows for an arbitrary stationary nucleotide composition and any
      transition-transversion bias during the process of base substitution. In
      addition, the user may define any hypothetical model tree according to which a
      family of sequences evolves. The programs suggest the computationally most
      inexpensive approach to generate nucleotide substitutions. Either reproducible or
      non-repeatable simulations, depending on the method of initializing the pseudo
      random number generator, can be performed. The corresponding options are offered
      by the interface menu.

PMID- 7796268
TI  - Flap opening in HIV-1 protease simulated by 'activated' molecular dynamics.
AB  - We have used an 'activated' molecular dynamics approach to simulate flap opening
      in HIV-1 protease. An initial impulse for flap opening was provided by applying
      harmonic constraints to non-flap residues. After an initial 'melting' phase, the
      two beta-hairpin structures that constitute the flaps opened to a 25 A gap within
      200 ps of simulation. Analysis of backbone torsion angles suggests that flap
      opening is related to conformational changes at Lys 45, Met 46, Gly 52 and Phe
      53. In contrast, similar molecular dynamics simulations on the M46I mutant, which
      is associated with drug resistance, indicates that this mutation stabilizes the
      flaps in a closed conformation.

PMID- 7796270
TI  - Comprehensive study on iterative algorithms of multiple sequence alignment.
AB  - Multiple sequence alignment is an important problem in the biosciences. To date,
      most multiple alignment systems have employed a tree-based algorithm, which
      combines the results of two-way dynamic programming in a tree-like order of
      sequence similarity. The alignment quality is not, however, high enough when the
      sequence similarity is low. Once an error occurs in the alignment process, that
      error can never be corrected. Recently, an effective new class of algorithms has
      been developed. These algorithms iteratively apply dynamic programming to
      partially aligned sequences to improve their alignment quality. The iteration
      corrects any errors that may have occurred in the alignment process. Such an
      iterative strategy requires heuristic search methods to solve practical alignment
      problems. Incorporating such methods yields various iterative algorithms. This
      paper reports our comprehensive comparison of iterative algorithms. We proved
      that performance improves remarkably when using a tree-based iterative method,
      which iteratively refines an alignment whenever two subalignments are merged in a
      tree-based way. We propose a tree-dependent, restricted partitioning technique to
      efficiently reduce the execution time of iterative algorithms.

PMID- 7796271
TI  - An investigation into the use of hypertext as a user interface to taxonomic keys.
AB  - In an attempt to overcome some of the drawbacks of existing taxonomic keys, we
      have experimented with a computerized version of a key, changing the interface to
      the key, but leaving the information contained in the key essentially unchanged.
      This is in contrast to most previous work on the use of computers in taxonomy,
      where work has concentrated on alternative identification techniques and
      techniques for manipulating taxonomic data. Hopkin's (1991) Key to the Woodlice
      of Britain and Ireland was converted (including the diagrams and colour
      photographs), into a hypertext document using the Unix Guide hypertext system. An
      experiment was conducted where test subjects with a wide range of experience of
      taxonomic keys and computing skills were asked to identify woodlouse specimens
      using the paper and hypertext forms of the keys. The results showed that test
      subjects were more likely to obtain an identification with the hypertext version
      of the key, they found it easier to use and preferred using it to the paper
      version of the key. However, there were indications that test subjects were more
      likely to obtain a misidentification using the hypertext key than the paper
      version of the key. Further work is needed to discover the possible causes of the
      increased frequency of misidentifications, and ways in which the usability of
      hypertext keys can be further enhanced.

PMID- 7796272
TI  - Detection of compositional constraints in nucleic acid sequences using neural
      networks.
AB  - We describe in this paper a neural network method for the detection of
      compositional constraints in introns and exons. The first part of the algorithm
      (learning phase) consisted in presenting examples of intron and exon sequences to
      the network and in modifying its connections using the back-propagation
      algorithm. Previous connectionist methods achieved the learning of exons and
      introns using the latter as negative examples to the former. However, we chose to
      learn introns and exons jointly, using junk DNA as a common counter-example. In a
      second part (generalization phase), we tested the neural networks in the search
      for exons and introns in the human globin cluster. Their performances were also
      checked on the classification of unknown examples. As with the previous
      approaches, this technique discriminates introns and exons: values of the
      correlation coefficients are respectively 0.50 and 0.64 for the best achieved
      network. Moreover, using junk DNA sequences in the learning phase allows one to
      detect constrained regions inside the intron and the exon sequences (i.e.
      sequences that differ, by their nucleic acid compositions, from junk DNA). The
      application of our approach could be useful in the study of the internal
      organization of these sequences.

PMID- 7796274
TI  - A rapid retrieval tool for operating on large, flat archive files.
AB  - Computer-aided sequencing and analysis facilities need to efficiently search flat
      archive files. Retrieval by e-mail or network server connections can become
      impractical in cases where large numbers of selected entries need to be accessed.
      Public versions of these archives can be retrieved via ftp and installed on a
      local hard disk as an alternative to network-based retrieval. After installation,
      a scheme is required for rapid access of the archive that is consistent with the
      other production needs of the sequencing facility. We have developed a retrieval
      system for entries inside a flat-file database. The system works for any flat
      file database system such as those used in the public DNA and protein archives.

PMID- 7796273
TI  - Implementations of BLAST for parallel computers.
AB  - The BLAST sequence comparison programs have been ported to a variety of parallel
      computers-the shared memory machine Cray Y-MP 8/864 and the distributed memory
      architectures Intel iPSC/860 and nCUBE. Additionally, the programs were ported to
      run on workstation clusters. We explain the parallelization techniques and
      consider the pros and cons of these methods. The BLAST programs are very well
      suited for parallelization for a moderate number of processors. We illustrate our
      results using the program blastp as an example. As input data for blastp, a 799
      residue protein query sequence and the protein database PIR were used.

PMID- 7796275
TI  - Parameterized complexity analysis in computational biology.
AB  - Many computational problems in biology involve parameters for which a small range
      of values cover important applications. We argue that for many problems in this
      setting, parameterized computational complexity rather than NP-completeness is
      the appropriate tool for studying apparent intractability. At issue in the theory
      of parameterized complexity is whether a problem can be solved in time O(n alpha)
      for each fixed parameter value, where alpha is a constant independent of the
      parameter. In addition to surveying this complexity framework, we describe a new
      result for the Longest Common Subsequence problem. In particular, we show that
      the problem is hard for W[t] for all t when parameterized by the number of
      strings and the size of the alphabet. Lower bounds on the complexity of this
      basic combinatorial problem imply lower bounds on more general sequence alignment
      and consensus discovery problems. We also describe a number of open problems
      pertaining to the parameterized complexity of problems in computational biology
      where small parameter values are important.

PMID- 7796276
TI  - Finding flexible patterns in a text: an application to three-dimensional
      molecular matching.
AB  - Finding certain regularities in a text is an important problem in many areas,
      e.g. in the analysis of biological molecules such as nucleic acids or proteins.
      In the latter case, the text may be sequences of amino acids or a linear coding
      of three-dimensional structures, and the regularities then correspond to lexical
      or structural motifs common to two, or more, proteins. We first recall an earlier
      algorithm that found these regularities in a flexible way. Then we introduce a
      generalized version of this algorithm designed for the particular case of protein
      three-dimensional structures, since these structures present a few peculiarities
      that make them computationally harder to process. Finally, we give some
      applications of our new algorithm on concrete examples.

PMID- 7796277
TI  - ALIGNMENT SERVICE: creation and processing of alignments of sequences of
      unlimited length.
AB  - A package for the creation and processing of multiple sequence alignment is
      described. There is no limit on the lengths of the processed nucleotide or amino
      acid sequences, and the number of sequences in the alignment is also unlimited.
      The main groups of functions are: a semiautomatic alignment editor; a wide set of
      functions for technical processing of alignments; nucleotide alignment mapping
      and translation; and similarity search functions. A user-friendly interface and a
      set of generally used file actions provide a special operational subsystem for
      everyday tasks.

PMID- 7796278
TI  - Conformational analysis of molecular chains using nano-kinematics.
AB  - We present algorithms for 3-D manipulation and conformational analysis of
      molecular chains, when bond lengths, bond angles and related dihedral angles
      remain fixed. These algorithms are useful for local deformations of linear
      molecules, exact ring closure in cyclic molecules and molecular embedding for
      short chains. Other possible applications include structure prediction, protein
      folding, conformation energy analysis and 3D molecular matching and docking. The
      algorithms are applicable to all serial molecular chains and make no assumptions
      about their geometry. We make use of results on direct and inverse kinematics
      from robotics and mechanics literature and show the correspondence between
      kinematics and conformational analysis of molecules. In particular, we pose these
      problems algebraically and compute all the solutions making use of the structure
      of these equations and matrix computations. The algorithms have been implemented
      and perform well in practice. In particular, they take tens of milliseconds on
      current workstations for local deformations and chain closures on molecular
      chains consisting of six or fewer rotatable dihedral angles.

PMID- 7796279
TI  - An automated computer vision and robotics-based technique for 3-D flexible
      biomolecular docking and matching.
AB  - The generation of binding modes between two molecules, also known as molecular
      docking, is a key problem in rational drug design and biomolecular recognition.
      Docking a ligand, e.g., a drug molecule or a protein molecule, to a protein
      receptor, involves recognition of molecular surfaces as molecules interact at
      their surface. Recent studies report that the activity of many molecules induces
      conformational transitions by 'hinge-bending', which involves movements of
      relatively rigid parts with respect to each other. In ligand-receptor binding,
      relative rotational movements of molecular substructures about their common
      hinges have been observed. For automatically predicting flexible molecular
      interactions, we adapt a new technique developed in Computer Vision and Robotics
      for the efficient recognition of partially occluded articulated objects. These
      type of objects consist of rigid parts which are connected by rotary joints
      (hinges). Our approach is based on an extension and generalization of the
      Geometric Hashing and Generalized Hough Transform paradigm for rigid object
      recognition. Unlike other techniques which match each part individually, our
      approach exploits forcefully and efficiently enough the fact that the different
      rigid parts do belong to the same flexible molecule. We show experimental results
      obtained by an implementation of the algorithm for rigid and flexible docking.
      While the 'correct', crystal-bound complex is obtained with a small RMSD,
      additional, predictive 'high scoring' binding modes are generated as well. The
      diverse applications and implications of this general, powerful tool are
      discussed.

PMID- 7796280
TI  - Bacillus Calmette-Guerin immunotherapy for superficial bladder cancer. New
      prospects for an old warhorse.
AB  - The use of live M. bovis BCG to treat superficial bladder cancer has endured its
      seemingly anachronistic origin in the early days of tumor immunology to emerge as
      the therapy of choice for superficial bladder cancer. Its superiority over
      conventional intravesical therapy has been established for tumor prophylaxis and
      treatment of residual disease and CIS, providing long-term results that have
      translated into improvements in disease progression and survival. Although its
      exact mechanism of action remains elusive, extensive studies suggest that this
      intracellular pathogen stimulates the immune system to produce powerful cytokine
      mediators and effector cells that act locally to destroy bladder tumors. Although
      unique toxicities occur by virtue of BCG's use as a live vaccine, this same
      liability has opened the door for new opportunities through the use of
      recombinant DNA technology. Exciting prospects include the use of BCG as a
      cytokine carrier and as a tumor antigen depot. Genetic engineering may also yield
      varients that are both intrinsically safer and more specific in bladder tumor
      targeting.

PMID- 7796281
TI  - Gene therapy approaches in urologic oncology.
AB  - The tools and concepts of cytokine gene-based immunotherapy are being applied to
      the development of potentially effective new adjuvant treatment modalities for
      urologic malignancies. In preclinical models for the most prevalent urologic
      cancers, such as renal cell, bladder, and prostate carcinoma, it was shown that
      cytokine secreting, growth inactivated, tumor cell preparations (1) are capable
      of inducing a T-cell response against even nonimmunogenic tumors, (2) have
      considerable therapeutic benefit in tumor bearing animals, and (3) establish
      effective immunologic memory in cured animals. These studies have advanced
      further our understanding of the efficacy and therapeutic use of cytokine
      secreting tumor cells and form the rationale for translating these preclinical
      results into a clinical setting. It is realistic to speculate that in the
      foreseeable future alternative or complementary approaches to cytokine gene-based
      immunotherapy will be developed that would augment immune responses in cancer
      patients. Genetically modified dendritic cells transduced with genes encoding
      isolated tumor rejection antigens or costimulatory signals, such as B7, may be
      even more potent immune stimulators to induce systemic immune responses. Although
      animal studies have shown considerable promise and investigational clinical
      trials are underway, additional research and further development still is
      required to realize the full benefit of this approach, and some forms of cancer
      eventually may respond to this form of cancer immunotherapy.

PMID- 7796282
TI  - Renal cell carcinoma. Molecular genetics and clinical implications.
AB  - The combined efforts of a number of investigators have led to the identification
      of the VHL gene, which appears to function as a tumor suppressor gene and is
      implicated in both sporadic and familial forms of RCC. These findings should
      increase our understanding of the molecular biology of this malignancy; however,
      there is much work to be done. Identification of the mechanism of inactivation of
      the VHL gene, as well as the structure and function of the VHL gene product,
      ultimately may provide clinicians with greater understanding of this malignancy
      as well as with methods for earlier diagnosis. The role of other tumor suppressor
      genes, such as p53, is incompletely understood. It is hoped that the techniques
      that have been applied to the study of RCC also will result in advances in our
      knowledge of other urologic malignancies.

PMID- 7796283
TI  - Tumor suppressor gene alterations in bladder carcinoma. Translational correlates
      to clinical practice.
AB  - The most common tumor suppressor genes involved in the prediction of bladder
      tumor progression are the Rb and the p53 genes. This article summarizes current
      data on the use of these markers in prognostic evaluation.

PMID- 7796284
TI  - Genetic alterations in prostate adenocarcinoma.
AB  - The genetic alterations associated with prostate carcinogenesis, its progression,
      and the emergence of androgen independence gradually are being defined. This
      article focuses on a number of genetic defects that have been identified in
      prostate cancer, specifically as they relate to disease progression, radiation
      resistance, and androgen independence.

PMID- 7796285
TI  - The association of oncogenic human papillomaviruses with urologic malignancy. The
      controversies and clinical implications.
AB  - Sexually transmitted human papillomaviruses (HPV) are linked to both benign and
      malignant lesions of the genitourinary tract. Evidence links oncogenic HPV types
      with carcinomas of the penis and urethra. An association with other common sites
      of urologic malignancies (prostate, bladder) is controversial. Whereas the
      screening of sexually active females for HPV has received substantial attention,
      the presence of a potential male carrier state has received little scrutiny.
      Systemic immunotherapies based on expression of HPV-related proteins by infected
      or transformed human epithelia, however, may be possible in the near future.

PMID- 7796286
TI  - Continent and orthotopic urinary diversion following radical cystectomy. Should
      these reconstructive procedures now be considered standard of care?
AB  - Our extensive operative experience with various forms of the continent ileal
      reservoir in more than 1000 patients over the past 12 years has demonstrated
      clearly the extreme reliability and durability of this diversion system. Reflux
      reliably can be prevented and the upper urinary tracts protected. Patients can
      void or catheterize with confidence. Orthotopic diversions should now be
      available to most patients, both male and female. Patients should be able to live
      a more normal life style with a positive self image. We believe that because our
      modifications of the ileal reservoir systems have decreased the need for
      reoperation, these forms of continent urinary diversion have emerged as optimal
      operations and even as the standard of care in cystectomy patients. Ileal
      conduits should be reserved for poor-risk candidates with short-term life
      expectancy or for those patients not motivated for continent diversion. The most
      vocal advocates of the procedures remain those continent diversion patients who
      have had urinary diversion by another method. Patients still must be aware that
      complications can occur. Appropriate patient motivation and a thorough
      understanding of the continent diversion technique and its potential problems
      continue to be essential prerequisites of the operation. Although minor
      refinements to these systems will continue to be made, we feel that continent
      diversion, most often in the form of orthotopic reconstruction, can be offered
      safely and wisely most to patients.

PMID- 7796287
TI  - Adjuvant chemotherapy for bladder cancer. Standard of care or unproven therapy?
AB  - The failure of radical cystectomy to cure the majority of patients with muscle
      invasive transitional cell carcinoma of the bladder has prompted clinical trials
      evaluating adjuvant chemotherapy. No properly conducted prospective trials are
      available to support unequivocally the application of pre- or postsurgical
      chemotherapy. A large trial comparing chemotherapy with no chemotherapy and
      standard treatment (cystectomy) is nearing completion. The results will determine
      whether or not adjuvant chemotherapy becomes the standard of care.

PMID- 7796290
TI  - Controversies in the treatment of prostate cancer with maximal androgen
      deprivation.
AB  - The concept of maximal androgen deprivation (MAD) has become the accepted therapy
      for metastatic prostate cancer. MAD is also under investigation as neoadjuvant
      therapy prior to radical prostatectomy and radiation therapy. Innovative new
      approaches, such as intermittent androgen deprivation and new combination
      therapies, will emerge over the next decade.

PMID- 7796289
TI  - Laparoscopic urologic surgery. The financial realities.
AB  - Since 1990, laparoscopic surgery has gained an important role in the specialty of
      urology. This article provides a financial analysis of the three most common
      urolaparoscopic procedures compared with their open surgical counterpart. The
      intraoperative costs of laparoscopic surgery are more expensive, but the
      postoperative expenses are less compared with open surgery. The financial
      ramifications of a shorter period of convalescence following laparoscopic surgery
      must be considered.

PMID- 7796288
TI  - Conservative renal surgery. Has it a role in renal cell carcinoma?
AB  - Conservative renal surgery is a viable alternative for patients in whom
      preservation of renal function is important. The long-term survival is similar to
      that of radical nephrectomy, especially in low-grade malignancies. The technique
      is unproven in patients with a normally functioning contralateral renal unit,
      although it may be an option in small, peripheral, low-grade lesions.

PMID- 7796291
TI  - Computer modeling of prostate cancer treatment. A paradigm for oncologic
      management?
AB  - This article discusses the relevance of computer modeling to the management of
      prostate cancer. Several computer modeling techniques are reviewed and the
      advantages and disadvantages of each are discussed. An example that uses a
      computer model to compare alternative strategies for clinically localized
      prostate cancer is examined in detail. The quality of the data used in computer
      models is critical, and these models play an important role in medical decision
      making.

PMID- 7796292
TI  - Limited capacity for tolerization of CD4+ T cells specific for a pancreatic beta
      cell neo-antigen.
AB  - Mice transgenic for SV40 T antigen (Tag) under control of the rat insulin
      promoter (RIP) develop two alternative immunological phenotypes: tolerance or
      autoimmunity towards Tag. We utilized the T cell receptor (TCR) genes expressed
      in a Tag-specific CD4+ cell from an autoimmune RIP-Tag mouse to generate two
      lines of TCR transgenic mice in which either 10% or 90% of peripheral T cells
      express the transgenic TCR. When cross-bred to the tolerant RIP1-Tag2 line, mice
      from the low frequency TCR line showed partial deletion of peripheral Tag
      specific T cells and nonresponsiveness of those that remained. In contrast,
      crossbred mice in which transgenic T cells comprised a majority of the T cell
      population were nontolerant both in vivo and in vitro. Thus, tolerization of CD4+
      T cells specific for a rare self-antigen may fail if too many autoreactive T
      cells develop.

PMID- 7796293
TI  - Mechanisms underlying the formation of the T cell receptor repertoire in
      rheumatoid arthritis.
AB  - The contributions of germline-encoded T cell receptor segments and of HLA-DR
      polymorphisms in shaping the repertoire of human CD4+ CD45RO- T cells were
      investigated in healthy unrelated individuals and in patients with rheumatoid
      arthritis, an HLA-DRB1 04-associated disease. By comparing frequencies of V beta
      J beta combinations, healthy individuals segregated into independent clusters,
      which strongly correlated with the HLA-DRB1 allele expression. The repertoire
      fingerprint imposed by the HLA-DRB1 alleles involved only a selected group of J
      beta elements, whereas the distribution of the other J beta segments was HLA
      independent. The HLA-restricted J beta elements are characterized by a Gly-Pro
      Gly sequence within the conserved Phe-Gly-X-Gly motif, which induces rigidity in
      an otherwise more flexible protein backbone. The T cell receptor repertoire
      distinguished patients with RA from healthy HLA-DR-matched individuals,
      suggesting that patients share a selection mechanism that significantly distorts
      the composition of the T cell receptor repertoire.

PMID- 7796294
TI  - Development of B cells in scid mice with immunoglobulin transgenes: implications
      for the control of V(D)J recombination.
AB  - The inability of scid pro-B cells to progress to the pre-B and B cell stages is
      believed to be caused by a defective recombinase activity that fails to resolve
      chromosomal breaks resulting from attempted V(D)J recombination. In support of
      this model, we report that certain immunoglobulin transgenes, specifically those
      which strongly inhibit endogenous VH-to-DJH and V kappa-to-J kappa rearrangement
      in wild-type mice, allow scid pro-B cells to progress to the pre-B and B cell
      stages. This rescue of scid B cell differentiation is associated with a dramatic
      reduction in expression of the recombination activation genes, RAG1 and RAG2, and
      with reduced transcription of the kappa locus.

PMID- 7796295
TI  - In-frame TCR delta gene rearrangements play a critical role in the alpha
      beta/gamma delta T cell lineage decision.
AB  - Using a quantitative multiprobe Southern blot analysis, we demonstrate the
      surprising result that a significant proportion of alpha beta T cells and
      thymocytes retain T cell receptor delta locus sequences. A substantial portion of
      the retained delta locus is in a fully V-to-D-to-J rearranged configuration and
      20% of these delta rearrangements are functional, significantly less than the 33%
      predicted for random gene rearrangements. Our observations are in conflict with
      the idea that alpha beta and gamma delta T cells derive from distinct precursors
      and suggest that commitment of a common precursor to the gamma delta lineage
      depends upon expression of a gamma delta T cell receptor. We propose that the
      intrathymic T cell lineage decision is determined by a competition between the
      production of functional gamma delta and beta-pre-T cell receptor complexes.

PMID- 7796296
TI  - Coordination of immunoglobulin chain folding and immunoglobulin chain assembly is
      essential for the formation of functional IgG.
AB  - The first constant domain (CH1) of immunoglobulin heavy (H) chains is essential
      for BiP-mediated retention of unassembled H chains in the endoplasmic reticulum
      (ER). Here, we demonstrated that both wild-type and a mutant gamma chain lacking
      the CH1 domain bind BiP when they are reduced in vivo. However, only oxidized
      mutant H chain dimers are released from BiP interaction, whereas oxidized wild
      type gamma chain dimers still bind BiP. In light (L) chain-producing cells, some
      of the mutant H chains accumulate with L chains in ER-derived vesicles and some
      are secreted as IgG. Furthermore, only half of the secreted antibodies bind
      antigen. We found the same with a mutant gamma chain, in which the CH1 domain was
      replaced by a CH3 domain. Therefore, we propose that BiP interaction with
      incompletely folded CH1 domains is required to mediate correct assembly of H and
      L chains.

PMID- 7796297
TI  - Rapid turnover of the CD3 zeta chain independent of the TCR-CD3 complex in normal
      T cells.
AB  - The function of CD3 zeta in the assembly and transport of the T cell receptor
      (TCR)-CD3 complex was analyzed in normal T cells. The zeta chain, but not other
      chains in the surface TCR complex, rapidly exchanged with newly synthesized zeta.
      Because zeta was expressed independently from the complex, the TCR complex may be
      transported to the surface along the zeta turnover pathway by association with
      zeta. These data suggest the dynamic nature of zeta metabolism and provide the
      evidence that a single component in a multisubunit receptor exhibits independent
      metabolism from the rest of the complex.

PMID- 7796298
TI  - Developmental commitment to the Th2 lineage by extinction of IL-12 signaling.
AB  - Developmental-commitment to Th1 or Th2 responses critically influences host
      susceptibility to particular pathogens. We describe a novel mechanism governing
      stable commitment to Th2 differentiation. Naive T cells develop strongly
      polarized Th1 and Th2 profiles by 7 days after activation. However, commitment of
      these developing cells differs substantially. Although IL-4 reverses early Th1
      differentiation, IL-12 cannot reverse early Th2 differentiation. Th1
      reversibility results from maintenance of IL-4 signal transduction, whereas Th2
      commitment results from rapid loss of IL-12 signaling. The IL-12 signaling defect
      in Th2 cells results in failure to phosphorylate Jak2, Stat3, and Stat4. Since
      Th2 cells express the mRNA for the cloned murine IL-12 receptor beta subunit, the
      signaling defect may involve expression or function of unidentified receptor
      components. The rapid extinction of IL-12 signaling in Th2 cells provides a
      demonstration of a mechanism for the stable commitment to a T helper phenotype.

PMID- 7796299
TI  - Stat recruitment by tyrosine-phosphorylated cytokine receptors: an ordered
      reversible affinity-driven process.
AB  - Herein, we demonstrate that purified Stat1 binds to its tyrosine-phosphorylated
      docking site on the IFN gamma receptor alpha chain in a direct, specific, and
      reversible manner. Using surface plasmon resonance, we determine the affinity (KD
      = 137 nM) and specificity of the interaction and define the minimum affinity
      needed for receptor-mediated Stat1 activation. In addition, we quantitate the
      relative ability of purified Stat1 to interact with tyrosine-phosphorylated
      binding sites on other Stat proteins. Finally, we describe experiments that imply
      that the unidirectional release of activated Stat1 from the IFN gamma receptor
      reflects the preference of free tyrosine-phosphorylated Stat1 monomers to form
      high avidity reciprocal homodimers rather than reassociating with the receptor
      binding site. Our results demonstrate that IFN gamma-induced Stat1 activation is
      an ordered and affinity-driven process and we propose that this process may serve
      as a paradigm for Stat activation by other cytokine receptors.

PMID- 7796300
TI  - Components of a Stat recognition code: evidence for two layers of molecular
      selectivity.
AB  - Latent and activated forms of Stat1 and Stat6 have been expressed and purified,
      enabling biochemical experiments relating to their functional activities. Stat1
      bound to a phosphotyrosine peptide derived from the IFN gamma receptor with a KD
      of 50 nM, whereas Stat6 bound to an IL-4 receptor peptide with a KD of 300 nM.
      Stat-receptor peptide interactions were specific and dependent upon tyrosine
      phosphorylation. Activated forms of Stat1 and Stat6 were used to select their
      optimal DNA binding sites. Stat1 selected a recognition site having dyad half
      sites separated by 3 bp. Stat6 selected a recognition site composed of the same
      dyad half-sites, yet separated by 4 bp. Chimeric Stat1-Stat6 recombinants were
      expressed, purified, and assayed for receptor coupling and DNA binding
      specificity. Such studies led to the identification of polypeptide domains that
      specify these activities. These observations provide a framework for
      understanding how different cytokines elicit distinctive patterns of gene
      expression.

PMID- 7796301
TI  - Mathematical and connectionist models of human memory: a comparison.
AB  - Recent convolution-based models of human memory (e.g. Lewandowsky & Murdock,
      1989), have accounted for a wide range of data. However such models require the
      relevant mathematical operations to be provided to the network. Connectionist
      models, in contrast, have generally addressed different data, and not all
      architectures are appropriate for modelling single-trial learning. Furthermore,
      they tend to exhibit catastrophic interference in multiple list learning. In this
      paper we compare the ability of convolution-based models and DARNET
      (Developmental Associative Recall NETwork), to account for human memory data.
      DARNET is a connectionist approach to human memory in which the system gradually
      learns to associate vectors, in one trial, into a memory trace vector. Either of
      the vectors can than be retrieved. It is shown that the new associative mechanism
      can be used to account for a wide range of relevant experimental data as
      successfully as can convolution-based models with the same higher-level
      architectures. Limitations of the models are also addressed.

PMID- 7796302
TI  - Learning the names of people: the role of image mediators.
AB  - Four experiments are reported involving the effects of bizarre and common imagery
      mediation techniques on the learning and 1-week retention of surnames, given
      videotaped faces as cues. The videotapes contained 24 undergraduates who were
      photographed from about the chest up, and who introduced themselves at a 20
      second rate. Experiment 1 showed that for both concrete and abstract names,
      immediate recall of the list was better under imagery mediation instructions than
      under control instructions. Experiment 2 studied the same conditions using
      immediate recognition memory of the list as a retrieval measure for the names,
      and found, despite ceiling effects, that bizarre imagery instructions facilitated
      recognition for concrete names. Experiment 3 showed that immediate recall could
      be improved if subjects were given an image mediator for every face-name pair as
      opposed to generating their own image mediators. Experiment 4 yielded three
      important findings: (a) 84% of the variance in the 1-week retention of initially
      recalled names was explained by the presence of absence of the original mediator
      during 1-week recall; (b) instructions to form image mediators facilitate recall
      not because image mediators are more effective than other types of mediators, but
      because they increase the likelihood that a mediator will be formed; (c) 1-week
      retention could be enhanced with an increased focus during encoding on the points
      where the mediation process is most likely to fail. The results of these studies
      are discussed within the context of mediation model wherein recall can fail at
      any of four stages.

PMID- 7796303
TI  - Age differences in reported recollective experience are due to encoding effects,
      not response bias.
AB  - Three experiments examined whether reduced recollective experience reported in
      old age is due to a criterion shift towards more cautious responses by older
      subjects. In Experiment 1 Young and Old subjects took a recognition test without
      specific instructions on how they should encode the presented words. For
      recognised items subjects indicated whether they recollected the item's previous
      occurrence or whether they just knew it had been on the list. They then rated
      their confidence that the word came from the study list. Although overall
      recognition levels were equivalent, older adults recollected less and reported
      more know responses than the younger subjects. However, there was no overall
      difference in confidence, contrary to a criterion shift explanation. In
      Experiment 2A specific encoding instructions removed the age-related change in
      recollective experience entirely. Experiment 2B reproduced the test conditions of
      Experiment 2A, but without specific encoding instructions, and replicated the
      pattern of know responding found in Experiment 1. Thus the three experiments
      together suggest that the amount of recollection experienced by the elderly is
      not explicable in terms of cautiousness, but is driven by the encoding carried
      out by the elderly at presentation.

PMID- 7796304
TI  - The constituent structure of subjective memory questionnaires: evidence from
      multiple sclerosis.
AB  - A number of different instruments have been devised for investigating individual
      differences in memory on the basis of subjective reports. One such questionnaire
      was mailed to individuals on a register of patients with multiple sclerosis, a
      condition that is known to be associated with objective impairments in cognition
      and memory. A similar questionnaire was enclosed to be completed about each
      patient by a close relative. The patients' and relatives' responses were found to
      share a factor structure identifying memory problems in five areas: receptive
      communication, route finding, absent-mindedness, face recognition, and expressive
      communication. These were dominated by a single second-order factor representing
      a global subjective memory impairment. There were some minor differences between
      the patients and relatives in their factor scores, but there was generally a high
      degree of concordance in their responses.

PMID- 7796305
TI  - Functions of external cues in prospective memory.
AB  - A simulation of an air traffic control task was the setting for an investigation
      of the functions of external cues in prospective memory. External cues can
      support the triggering of an action or memory for the content of the action. We
      focused on memory for the content, and manipulated the temporal characteristics
      of the external cue to disentangle two possible functions the cue can support:
      (1) an external cue visible during a retention interval could support rehearsal
      of the to-be-performed action; (2) an external cue visible at the end of a
      retention interval could support retrieval of the to-be-performed action. Two
      experiments were conducted that converge on the same conclusion: the primary
      function of an external cue is to support retrieval. Implications for the design
      of a computer interface to present prospective cues are discussed.

PMID- 7796306
TI  - No-observed-effect level of diborane on the respiratory organs of male mice in
      acute and subacute inhalation experiments.
AB  - In order to clarify the acute and subacute toxicity of diborane (B2H6, CAS: 19287
      45-7) at low concentrations, male ICR mice were exposed to diborane for 1, 2, 4
      or 8 h at concentrations of 1 or 5 ppm (phase I study), and for 6 h/day, 5
      days/wk, over 2 or 4 wk at concentrations of 0.02 or 0.7 ppm (phase II study).
      Hematological and biochemical tests, and histopathological examinations of the
      cornea, nasal mucosa, respiratory tract and lung were carried out. All mice in
      both studies survived until they were sacrificed. In the phase I study, lung
      weight increased significantly in mice exposed to 5 ppm of diborane for 8 h.
      Histopathologically diffuse panbronchiolitis-like lesion was observed in mice
      exposed to 5 ppm of diborane for 2, 4 or 8 h. In the phase II study, slight
      infiltration of polymorphous neutrophil was observed mainly in the
      peribronchiolar region in mice exposed to 0.2 ppm or 0.7 ppm of diborane for 2 or
      4 wk. In both studies, hematological and biochemical examinations failed to
      reveal any exposure-related changes. These results suggest that no-observed
      effect level of diborane inhalation on the respiratory organs were 1 ppm in acute
      exposure, but 0.2 ppm of diborane inhalation for 2 or 4 wk seems to be unsafe.

PMID- 7796308
TI  - The relationship between job status, gender and work-related stress amongst
      middle-aged employees in a computer manufacturing company.

PMID- 7796307
TI  - The relationship between being satisfied with one's health, good health practices
      and personal symptoms of ill health.
AB  - The focus of this study was satisfaction with health and its relationship to good
      health practices, symptoms and current use of medication. A self-administered
      questionnaire was circulated to employees of a railroad company. 3,639 males aged
      18 to 54 (41.4 +/- 7.61) were selected. Seven good health practices each scored 1
      were not smoking including quitting, not drinking or drinking less than six days
      a week, exercise more than two days per week, body mass index (BMI) being 20 to
      28, total nightly sleeping time between six and nine hours, having breakfast
      everyday, and not eating between meals. Each score was summed up as health
      practice index (HPI). We also asked about health satisfaction for the past year,
      subjective symptoms over the last two to three months, and present medication
      history. HPI increased significantly in the group aged 45 to 54, this group being
      satisfied with their health. A decrease in the percentage of eating between meals
      in the under 35 group, inappropriate BMI in the 45 to 54 group, and regular
      exercise in the group aged 50 or older was recognized. Health satisfaction was
      predicted using symptoms, present medication, age and health practice.
      Standardized discriminant coefficients of symptoms and present medication were
      0.672 and 0.610, and they were more associated to health satisfaction than health
      practice.

PMID- 7796309
TI  - [Studies on factors influencing the attack of subarachnoid hemorrhage during
      labor].
AB  - We analyzed factors affecting attacks of subarachnoid hemorrhage (SAH)
      retrospectively in 411 patients and studied the relation of the attacks with
      labor. The onset time of SAH has two peaks of the time: one is 7:00 a.m. and the
      other is between 16:00 and 17:00 in the afternoon. The attacks of SAH during
      labor were observed in 15.1% of all the patients. It was noted that 66.7% of all
      the attacks were observed at the time with certain external stress such as
      working, sporting, sexual intercourse, etc. The number of patients who suffered
      from attacks during labor with history of hypertension and insomnia were not
      significantly different compared with those suffered from attacks during other
      activities, but 40-59 aged men those who have a history of smoking were
      significantly more in number compared with those that suffered attacks during
      other activities. Transient increase of blood pressure due to external stress is
      suggested as an initiative factor of the bleeding during working. Reactivity of
      the individuals against physical and mental stress (external stress) might be
      considered to be the major problem, although it remains not to be unexplained
      whether labor itself participates in the onset of SAH. Regarding the prevention
      of SAH during labor, new methods of medical examination and health control is
      required.

PMID- 7796310
TI  - [A study for the practical use of the mask fitting tester].
AB  - The standards require replaceable dust respirators to be designed so that the
      wearer can easily check facepiece-to-face fitting at any time. The common
      practice adopted is an air leakage examination between the facepiece and the face
      in a negative pressure created by sealling-off inhalation area and breathing-in
      (called "a negative pressure method"). This method offers only subjective testing
      made by the wearer himself or herself, no objective testing is possible by the
      third party including supervisors and hygiene staff. Accordingly, we conducted
      the practical use test of the Mask Fitting Tester (Model MT-02, Roken type) by
      letting wearers to use the tester at a sanitaryware plant where workers are well
      instructed for how to wear respirators and also respirators are used in good care
      and maintenance. In addition, a questionnaire survey was conducted to investigate
      how wearers perceive the practical use of the Mask Tester. The following are the
      conclusions of the study and the survey for the practical use of the Mask Tester.
      1) At the first fitness test, when examinees wear the respirator as in the usual
      manner without given particular instructions, 50% of examinees are found
      unachieved with the leakage rate of the desired value of 5% of less. 2) All the
      examinees unachieved were instructed by hygiene staff followed by fitting test to
      check their leakage rate until they pass the desired value. After repeating this
      three times, there were no examinees found unachieved. 3) 88.2% of these
      examinees could achieve the desired value only by adjusting headbands and
      correcting the position of facepiece under instructions.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7796312
TI  - [Effects of physical exercise on the mercuric chloride-induced acute renal
      failure in mice].

PMID- 7796313
TI  - [Study on quantitative analysis of free silica content in sample dust made by
      established specific gravity].

PMID- 7796314
TI  - [A survey of the inclinations of medical students towards becoming occupational
      physicians].
AB  - We conducted a survey to investigate medical students awareness of the activities
      of occupational physicians and their willingness to do postgraduate courses in
      this field. Those surveyed were fifth grade students in six universities in the
      Kinki district of Japan in 1993. In analyzing the responses of 368 eligible
      subjects, the response rate was 68.4% and the following results were obtained. 1)
      Only one of the 368 subjects expressed a desire to become an occupational
      physician after graduation, however 24.2% of those surveyed had considered
      becoming occupational physicians. More female students and, males over the age of
      25, had considered becoming occupational physicians. Anxiety about a possible
      surplus of medical doctors in the near future was a factor that led them to
      consider becoming occupational physicians. 2) There were few negative responses
      concerning the activities of occupational physicians, even among those who had
      not considered becoming occupational physicians. 88.3% of those surveyed
      complained of a lack of information regarding postgraduate courses. 3) Responses
      were varied concerning conditions in the practice of occupational physicians.
      Those who had considered becoming occupational physicians were mostly concerned
      with the establishment of a system for the acceptance of occupational physicians
      in industry, while those who had not thought of becoming occupational physicians,
      considered practicing as occupational physicians as a sideline to regular clinic
      duties. 4) Having considered the above results and those of other researchers, we
      concluded that supplying more information related to the activities of
      occupational physicians and offering further postgraduate training programs in
      occupational medicine would encourage more medical students to become
      occupational physicians.

PMID- 7796311
TI  - [7 years of annual mass screening for colorectal cancer in office workers-
      usefulness of 3-day RPHA method].
AB  - Immunological fecal occult blood test have been proved to be useful in the mass
      screening for colorectal cancer. Since 1986, we have started annual mass
      screening by the use of 3-day RPHA method and medical questionnaire for office
      workers over 40 yr old. During 7 yr, 261 out of 5386 examinees were testing
      positive for fecal occult blood, a test positive rate was 4.8% and 12 colorectal
      cancer (7: early, 5: advanced) were found. Among 12 cases, 10 were detected by
      positive results of RPHA test and 2 by questionnaires of symptoms or family
      history. The sensitivity and specificity of this method were calculated at 83.3%
      and 95.3% respectively. But as for advanced cancers, the sensitivity of this
      method was 100%. 75% of patients with colorectal cancer were over 55 yr old. The
      predictive value of positive test (PV) were much more higher in subjects with 2
      or 3 times test positive (high risk group: PV = 14.3%) than in subject with only
      1 time test positive (low risk group: PV = 0.6%). So it is considered to be
      reasonable that the high risk group (24% of total test positive) should be
      immediately undergone further examinations (Ba. enema or colonoscopy), and the
      low risk group should be undergone re-examinations of 3-day RPHA method. By this
      system, almost 50% of further examinations will be reduced. In conclusion, 3-day
      RPHA method with this further examination system is reasonable and efficient for
      screening of colorectal cancer in office workers, considering the high
      reliability in cancer detection and decreased further examinations.

PMID- 7796315
TI  - [Experimental techniques for developing new drugs acting on dementia (9)--Brain
      ischemia models].
AB  - Many brain ischemia models have so far been developed and used for investigating
      the pathophysiology of ischemic stroke. Among these stroke models, gerbil models
      of brain ischemia have been widely used because of several advantages such as
      easy operability and convenience. In the present paper, we first discuss several
      subjects related to the use of animal models of brain ischemia for the
      development of new therapeutic agents against vascular dementia, and the
      theoretical, technical and clinical implications of gerbil models of brain
      ischemia have been outlined. Secondly, we describe the detailed procedures for
      obtaining forebrain ischemia or four different grades of unilateral cerebral
      ischemia in Mongolian gerbils. The advantages and drawbacks of these models are
      also discussed and compared with other models for investigation of the
      pathophysiology of vascular dementia.

PMID- 7796316
TI  - [Assessment of anxiolytics (1)--Geller-type conflict tests].
AB  - The Geller-type conflict test and its modified tests, which are based on operant
      conditioning, have been applied for preclinical evaluation of the anxiolytic
      effect of drugs in parallel with the clinical use of benzodiazepines. Here, the
      author describes the experimental procedures of the Geller-type conflict test,
      including its modified tests, using mice and rats in detail. The effects of
      drugs, particularly benzodiazepines and 5-HT1A receptor agonists, on the
      established conflict behaviors in rats and mice are also presented.

PMID- 7796317
TI  - [Assessment of anxiolytics (2)--An elevated plus-maze test].
AB  - When rodents are placed on an elevated plus-maze which consisted of two enclosed
      arms and two open arms, they enter the enclosed arms more frequently and spend
      more time on the enclosed arms than on the open arms since they prefer the
      enclosed arms to the open arms. The elevated plus-maze test can measure effects
      of drugs based on this tendency of rodents. Anxiolytics increase the time spent
      on the open arms and number of entries into open arms, and anxiogenics decrease
      them. We investigated the basal behavior of mice and the effects of diazepam in
      the elevated plus-maze test using 4 mazes with different size. The basal behavior
      of mice were changed by the maze size, especially by the width of the open arms.
      Further, we suggested that the maze size might affect anxiolytic activity of
      drugs detected in this test. This test is very useful because it needs neither
      complicated training for rodents nor an expensive apparatus, and the anxiolytic
      effects of drugs can be easily measured. However, this test is difficult to
      detect putative anxiolytics acting on serotonin receptors. When this method is
      used for measuring the activity of drugs, the choice of experimental conditions
      and evaluation of the results should be carefully done.

PMID- 7796318
TI  - [Effect of monoamines and antidepressant drugs on calcium-dependent current
      generating the afterhyperpolarization of hippocampal pyramidal cells].
AB  - A single-electrode voltage-clamp technique was employed on in vitro hippocampal
      slices to investigate the membrane current responsible for the slow
      afterhyperpolarization (AHP) in CA3 pyramidal cells and the effects of monoamines
      and antidepressant drugs on this current were studied. This was achieved by using
      conventional procedure to evoke an AHP in current clamp, followed rapidly by a
      switch into voltage clamp (hybrid voltage clamp). The current generating the AHP
      (IAHP) could be blocked by cadmium- or Ca(2+)-free medium and showed a
      requirement for voltage-dependent Ca2+ entry. Noradrenaline and serotonin, 10
      microMs in bathing medium, respectively, reduced the IAHP evoked by short
      duration depolarizing current. Pharmacologically different antidepressants such
      as maprotiline or fluvoxamine, 10 microM in bathing medium also reduce the IAHP.
      Chlorpromazine and haloperidol which have no antidepressant effect had no effect
      on IAHP. These results suggest that the enhancement of neuronal excitability
      which reflect the blocking of Ca(2+)-dependent potassium conductance may be the
      common mechanism of action of pharmacologically different antidepressant drugs.

PMID- 7796320
TI  - Prevention by minaprine of ischemic neuronal damage and memory impairment in
      Mongolian gerbils.
AB  - This study examines the effect of the psychotropic drug minaprine on memory
      impairment in Mongolian gerbils subjected to a 5-min bilateral common carotid
      artery occlusion, as assessed by their performance in an 8-arm radial maze task.
      Gerbils were initially trained on the 8-arm radial maze until their mean error
      was 0-1 for 5 days. This task was repeated before the ischemia was performed and
      again 7 days after it. Then the animals were immediately sacrificed for
      histopathological examination. Severe memory impairment occurred in the control
      gerbils; whereas when minaprine 75 mg/kg was given orally 30 min before the 5-min
      occlusion, memory impairment was significantly reduced. Histopathological
      analysis of the control gerbils showed nearly complete loss of the pyramidal
      neurons in the CA1 region of the hippocampus, whereas the minaprine-treated
      gerbils showed complete preservation of the pyramidal neurons. These findings
      suggest that minaprine has memory-impairment-prevention and neuroprotective
      effects against short-term ischemia in gerbils.

PMID- 7796322
TI  - [Proteoglycans in the developing brain].
AB  - The occurrence of multiple proteoglycan species is a characteristic of the brain.
      To identify each proteoglycan molecule, we have raised several monoclonal
      antibodies against either the soluble or membrane-bound proteoglycan fraction
      from 10-day-old rat brains. The monoclonal antibody 1G2 recognized neurocan, a
      soluble chondroitin sulfate proteoglycan (CSPG) unique to the brain.
      Immunohistological and cell biological results suggested that neurocan regulates
      neurite outgrowth through specific binding to N-CAM and Ng-CAM at the surface of
      neurons. In addition, the expression of neurocan was dependent upon neuronal
      activity evoked by environmental stimuli at least in the developing barrel field.
      Another CSPG, 6B4-PG, was expressed specifically in the cerebellar mossy fiber
      system in the rat hindbrain, suggesting that it plays roles in the establishment
      of this particular neuronal circuit. A membrane-bound heparan sulfate
      proteoglycan with a 140 kDa core glycoprotein (tentatively designated growth-can)
      was shown immunohistologically to be transiently expressed in association with
      growing axons and at the sites of synapse formation. Thus, many neuronal
      proteoglycans may be involved in various phases of neuronal network formation in
      the brain. In the near future, progress both in molecular cloning of core
      proteins and in glycobiology of carbohydrates of proteoglycans will probably
      produce much experimental evidence to show that neural proteoglycans play pivotal
      roles during various stages of brain development.

PMID- 7796321
TI  - Effect of diabetes on the morphine-induced inhibition of gastrointestinal
      transit.
AB  - The effect of diabetes on the morphine-induced inhibition of gastrointestinal
      transit was examined in mice. Morphine dose-dependently inhibited
      gastrointestinal transit after s.c. administration in both non-diabetic mice and
      diabetic mice. There was no significant difference between the ED50 values for
      this antitransit effect of morphine in non-diabetic and diabetic mice. The
      gastrointestinal antitransit effect of morphine was significantly antagonized by
      pretreatment with beta-funaltrexamine (40 mg/kg, s.c.), a selective mu-opioid
      receptor antagonist, in both non-diabetic and diabetic mice. However,
      pretreatment with naloxonazine (35 mg/kg, s.c.), a selective mu 1-opioid receptor
      antagonist, had no effect on the antitransit properties of morphine. These
      results suggest that diabetes failed to alter the mu 2-opioid receptor-mediated
      antitransit effect of morphine.

PMID- 7796319
TI  - [In vivo neurochemical effects of electroconvulsive shock on the forced swimming
      rat].
AB  - The effects of electroconvulsive shock (ECS) on monoamine metabolism in the
      forced swimming rat were studied using on-line microdialysis. In the present
      experiment, we measured forced swimming-induced immobility time and interstitial
      concentrations of dopamine (DA), its metabolites 3,4-dihydroxyphenylacetic acid
      (DOPAC), homovanillic acid (HVA) and serotonin (5-HT), its metabolite 5
      hydroxyindoleacetic acid (5-HIAA) in the anterior hypothalamus. Mean immobility
      time was short in the ECS-treated group compared with shamECS group but the
      difference was not statistically significant. DA and 5-HT tended to increase
      following a single ECS. Interstitial concentration of 5-HIAA increased
      significantly. Forced swimming test caused an increase in both DA and 5-HT
      turnover in the hypothalamus. In contrast, pretreatment with ECS tends to
      suppress these forced swimming-induced increases in DA and 5-HT turnover. These
      data suggest that ECS may regulate excess activation in central dopaminergic and
      serotonergic system following forced swimming stress.

PMID- 7796323
TI  - [Discovery of HTLV-I associated myelopathy].

PMID- 7796324
TI  - [Recent progress in development of psychotropic drugs (1)--Anti-anxiety drugs].
AB  - Anti-anxiety drugs are widely used for patients with neurosis or psychosomatic
      diseases due to the stress of contemporary society. The high efficacy of
      benzodiazepine (BZD) or its analog, which contains diazepam, is well-known. While
      these compounds have strong anti-anxiety effects, it has recently been pointed
      out that they have some side effects when used as daytime tranquilizers and
      induce drug dependence. The cause of these side effects is thought to be that
      typical BZD is a full agonist of BZD receptors. For this reason, partial
      agonists, inverse agonists and antagonists of BZD receptors are being developed.
      Furthermore, some non-BZD anti-anxiety drugs are also being developed to avoid
      the side effects of BZD. One of these is a 5-HT1A agonist, which has a high
      affinity for 5-HT receptors, because it is reported that 5-HT is related to
      anxiety in the septum-hippocampus system. In addition, the anti-anxiety effect of
      5-HT3 agonist is being investigated, while the anti-anxiety effect of
      cholecystokinin agonists is also attracting attention. Because these new anti
      anxiety drugs are more potent and have fewer side effects than BZD, they may
      achieve widespread clinical use.

PMID- 7796325
TI  - [Possible roles of brain histamine H3 receptors and the pharmacology of its
      ligands].
AB  - The discovery of the presynaptic histamine H3 receptors confirmed the idea that
      histamine is a neurotransmitter in the mammalian brain. The H3 receptors
      (autoreceptors) regulate the release and synthesis of histamine. The H3 receptors
      also modulate the other neurotransmitters (heteroreceptors). Subclasses of H3
      antagonist binding sites were found in the brain (H3A and H3B). The regulation of
      noradrenaline release is reported to be mediated by H3A rather than H3B. The H3
      binding site belongs to the class of receptors coupled to G-proteins. Besides the
      molecular data, this review focuses on the functional roles of H3 receptors in
      the brain and discusses the possible use of H3 ligands for neurobehavioral
      disorders. The pharmacological data of H3 ligands may provide clinical candidates
      for CNS disorders in which histamine plays important roles in mental and
      behavioral functions. Especially, H3 antagonists may be useful for CNS disorders
      such as narcolepsy, dementia, epilepsy, and obesity, while H3 agonists may
      provide for anxiety, insomnia, migraine. However, these suggestions are still
      preliminary and further clinical research is needed, although potent and safe
      novel H3 ligands are being developed.

PMID- 7796327
TI  - Surgical techniques for preparation of teaser bulls.
AB  - Each method of surgical preparation of teaser bulls has distinctive advantages
      and disadvantages. The selection of a method is influenced by the veterinarian,
      the owner, and the circumstances involved. The goal of surgery is safe,
      effective, and economical production of teaser bulls.

PMID- 7796326
TI  - Teat and udder surgery.
AB  - Teat and udder surgery is certainly one of the major areas of soft tissue
      surgery. In recent years, there have been great advances in what can be
      accomplished with teat and udder surgery. This article reviews teat and udder
      surgery from the simplest technique to the most complex. Diagnosis and prognosis
      are covered, as well as the actual surgical techniques.

PMID- 7796329
TI  - Ocular surgery.
AB  - The techniques described are considered field techniques. Adequate restraint and
      the ability to perform the blocking techniques are critical. Selection of a
      technique should be based on severity of the lesion, type of lesion, function of
      the animal, and economics. Application of less radical techniques should be
      preformed when possible; alternatives to enucleation exist in many cases.

PMID- 7796330
TI  - Surgical (cosmetic) dehorning in cattle.
AB  - Numerous methods have been developed through the ages to dehorn cattle. Some are
      clever and sophisticated; others are crude. Most methods can be used effectively
      and humanely, and with desirable cosmetic results. This article discusses the
      cosmetic and ethical considerations for dehorning, as well as surgical
      preparation and techniques used.

PMID- 7796328
TI  - Umbilical hernias, umbilical abscesses, and urachal fistulas. Surgical
      considerations.
AB  - Swellings of the umbilical stalk, with or without herniation, are common findings
      in calves. Differentiation of involved structures is helpful in deciding the
      surgical approach and type of anesthesia required. This article deals with
      clinical signs, diagnostic procedures, and surgical techniques used to repair
      problems related to the umbilical stalk.

PMID- 7796333
TI  - Dehorning the adult goat.
AB  - Although goats are ideally disbudded as infants, occasionally they are not. Goats
      grow horns much more rapidly than most owners realize and use these horns on
      other goats and, occasionally, people. Dehorning adult goats is not as easy as
      dehorning cattle. The techniques for tranquilizing, anesthetizing, and dehorning
      adult goats is described and aftercare is discussed.

PMID- 7796331
TI  - Tracheal collapse.
AB  - Tracheal collapse in calves usually is associated with dystocia at birth,
      especially breech presentations. Inspiratory dyspnea typically is seen within the
      first several months of life and may worsen progressively. Lateral cervical
      radiographs are useful in defining the affected segments as well as identifying
      previously fractured ribs. Surgical stenting of the trachea will improve the
      calf's condition, but because this procedure is done on young calves, the
      tracheal diameter of the affected segment is permanently limited by the size of
      the prosthesis.

PMID- 7796332
TI  - Surgical treatment of pleuritis and pericarditis.
AB  - Surgery of the bovine chest is rarely attempted; however, there are distinct
      indications and procedures available to treat both pericarditis, suppurative
      pleuritis and pleural effusions. Open lavage of the pericardial sac or pleural
      space has proven successful in carefully selected cases. The surgical procedures
      for pericardiotomy and thoracotomy are discussed.

PMID- 7796337
TI  - Urinary surgery.
AB  - This article describes diagnosis, prognosis, pathophysiology, and methods to
      surgically correct abnormalities of the urinary system of ruminants. Surgery of
      the urinary system in ruminants most frequently is required to alleviate urethral
      obstruction or correct urinary bladder rupture. Several options for surgical
      management of those conditions are presented, but the prognosis for long-term
      survival or a return to reproductive function is poor if a urethrostomy is
      performed. Nephrectomy, translocation of ectopic ureters, removal of urachal
      remnants, and urethral extension to treat urovagina are performed less often in
      ruminants because animals requiring these procedures often are culled because of
      economic considerations or decreased productivity. Consequently, much of what has
      been described for ruminants is based on a limited number of cases or
      extrapolated from what has been learned from other species.

PMID- 7796335
TI  - Female reproductive surgery.
AB  - Although cesarean section is covered in a separate article, this article on
      miscellaneous female reproductive surgery will hopefully help to get and keep the
      cow pregnant. Procedure such as rectovaginal lacerations, vaginal tumors,
      prolapsed cervical rings, and vaginal prolapse repair are covered. In addition to
      procedures that will help with pregnancy, ovariectomy and hysterectomy are also
      covered.

PMID- 7796334
TI  - Cesarean section.
AB  - Cesarean section has become a common surgical procedure and there is a tendency
      for both veterinarians and their clients to regard it as routine. It is important
      to remember, however, that a cesarean section entails major abdominal surgery,
      with inherent risks, irrespective of the prevailing conditions or personnel
      involved.

PMID- 7796336
TI  - Male reproductive surgery.
AB  - Copulation failure in food animals can be economically devastating to producers.
      Many pathological conditions can result in the inability of an animal to breed.
      In this article, diagnosis, pathophysiology, and treatment of penile and
      preputial injuries and anomalies, and inguinal hernias are presented. Surgical
      procedures are described for castration, seminal vesiculitis, circumcision,
      preputial diverticulectomy, penile hematoma, inguinal herniorrhaphy,
      phallorrhaphy, correction of filling defects of the corpus cavernosum,
      fibropapilloma, persistent penile frenulum, penile hair ring, and urethral
      fistulae.

PMID- 7796339
TI  - Demonstration that bone mineral density of the lumbar spine, trochanter, and
      femoral neck is higher in black than in white young men.
AB  - The incidence of osteoporosis and fractures of the hip and spine is lower in
      black than in white subjects. To determine whether bone mass is increased in
      black men and to assess the influence of body weight and age, bone mineral
      density (BMD) of the lumbar spine, trochanter, and femoral neck was measured by
      dual-photon absorptiometry in 59 normal white men and 40 black men between the
      ages of 20 and 50 years. Body weight and age were not different from each other
      in the two groups. BMD of the midradius was measured by single-photon
      absorptiometry. Multivariate regression was used for independent analysis of each
      group and for analysis of the two groups together. After adjusting for body
      weight, age was inversely related to BMD of the femoral neck in both blacks and
      whites and of the trochanter in blacks. When body weight was analyzed
      independently of age, it was a positive predictor for BMD of the midradius of
      black men and of the femoral neck in white men. Despite the racial differences in
      age and weight on BMD, there were no significant interactions between race and
      age or race and weight when the data from black and white men were combined. Race
      had a highly significant effect on BMD of the lumbar spine, trochanter, and
      femoral neck midradius, and BMD was higher in blacks than in whites at these
      sites.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796338
TI  - Perspectives: on a "paradigm shift" developing in skeletal science.

PMID- 7796340
TI  - Dual-energy X-ray absorptiometry of the calcaneus: comparison with vertebral dual
      energy X-ray absorptiometry and quantitative computed tomography.
AB  - The purpose of this study was to determine the efficacy of using bone mineral
      measurements of the calcaneus to evaluate osteoporosis. Dual energy X-ray
      absorptiometry (DXA) of the calcaneus was compared with posteroanterior lumbar
      absorptiometry (DXA) and vertebral quantitative computed tomography (QCT)
      measurements in 171 white women (78 normal and 93 osteoporotic). DXA measurement
      of os calcis mineralization decreased significantly in osteoporosis, but to a
      lesser extent than in vertebral sites. In normal subjects, good correlations were
      observed between calcaneal and lumbar DXA (0.69) and QCT (0.56). In subjects with
      vertebral fractures, there was also good correlation between calcaneal DXA and
      QCT (0.59-0.69). This suggests that trabecular bone in calcaneus and vertebrae
      have related involution in cases of vertebral osteoporosis. However, the extent
      of bone loss is less marked in the calcaneus than in the vertebrae and is not
      sufficient to be accurately measured over time. We conclude, therefore, that
      although the global densitometric measurement at this site is not sufficiently
      sensitive for general use, it can be useful as a epidemiological research tool.

PMID- 7796342
TI  - Bilateral comparison of femoral bone density and hip axis length from single and
      fan beam DXA scans.
AB  - Dominant/nondominant differences in bone mineral density (BMD) have been observed
      in the upper extremities. However for the proximal femur, the distinction between
      dominant and nondominant hips is not clear. The purpose of this study is to
      evaluate left/right variations in femoral BMD and hip axis length (HAL) in both
      single beam and fan beam dual x-ray absorptiometry (DXA) scans. A total of 36
      women aged 41-76 years (average age 60 +/- 10 years) received single beam and fan
      beam DXA scans of both proximal femora with a Hologic QDR-2000 scanner. Femoral
      BMD and hip axis length were determined for each scan. Left/right and single
      beam/fan beam correlations were determined and differences were evaluated using a
      two-way analysis of variance. Femoral BMD at corresponding measurement regions in
      opposing femora were highly correlated (r = 0.81-0.96). No significant left/right
      differences were detected. At the femoral neck, the mean BMD difference (+/-
      standard deviation) was 1.5% +/- 4.7% in a single beam mode and -0.6% +/- 6.3% in
      fan beam mode. Though mean values of femoral BMD were equivalent, the observed
      individual left/right differences were occasionally large (as high as 26% in the
      femoral neck). The hip axis length of the left and right hips were highly
      correlated and statistically equivalent. However, hip axis length using fan beam
      was significantly larger (7.5%) than the single beam measurement with a larger
      observed variation. We conclude that measurement of a single proximal femur will
      usually be sufficient for clinical evaluation of BMD and/or hip axis
      length.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796341
TI  - Factors influencing short-term precision of dual X-ray bone absorptiometry (DXA)
      of spine and femur.
AB  - In this study we analyzed the effect of variations in bone area size, baseline
      soft tissue composition represented by the R-value, and bone region of interest
      positioning on the precision in vivo of bone mineral density (BMD) and content
      (BMC) as measured by dual X-ray absorptiometry (DXA). The posterior-anterior (PA)
      spine, decubitus lateral, and femur modes were evaluated. Eleven (PA-spine), 9
      (dec-lat), and 14 (femur) postmenopausal women were scanned twice on a Norland XR
      26 with repositioning to determine short-term precision of BMD, BMC, AREA, and
      the R-value. Phantom precisions (CV[%] of 10 consecutive scans) for BMD (BMC)
      were PA spine: 0.66% (0.57%), neck: 1.1% (1.2%), and trochanter: 0.55% (1.0%).
      Precisions in vivo (CV[%]; two consecutive scans averaged over all patients) were
      PA spine: 0.9% (1.0%), dec-lat: 7.1% (18%), neck: 1.3% (1.9%), and trochanter:
      2.5% (4.9%). BMD precision could be fully explained by BMC and AREA variations.
      However, BMC alone was a particularly poor predictor of BMD in the dec-lat (r2 =
      0.05) and in the neck (r2 = 0.13) modes. AREA was a strong predictor for BMC
      precision explaining between 41% and 88% of the BMC changes. Changes in soft
      tissue composition contributed significantly in explaining the BMC changes in the
      dec-lat projection. A higher dependence of BMC changes on AREA changes resulted
      in a larger difference between BMC and BMD precision.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7796343
TI  - Serum calcitonin forms and concentrations in young and elderly healthy females.
AB  - To further investigate the role of calcitonin (CT) in normal physiology we
      studied circulating forms and the secretion after "calcium clamp" in young and
      elderly healthy females. Heterogeneity of CT in serum was disclosed after
      immunoextraction, fast protein liquid chromatography, and radioimmunoassay in
      young (27 +/- 3 years; mean +/- SD, n = 6) and elderly females (69 +/- 6 years, n
      = 11). Three distinct molecular forms appeared with approximate mol wt of 30, 10,
      and 3-4 kDa. All young women studied had considerable amounts of circulating
      monomer-like CT whereas several elderly had undetectable or low levels. The
      influence of age on basal and calcium stimulated, immunoextracted CT in serum was
      also studied in young (26 +/- 4 years; mean +/- SD, n = 13) and elderly (63 +/- 6
      years; n = 12) healthy females. The calcium stimulation was carried out by means
      of the standardized calcium clamp method, where calcium was kept on a presettled
      level at 1.45 mmol/liter (+/- 2%) for 60 minutes. CT was immunoextracted from
      serum in all series of experiments with a polyclonal antiserum directed against
      the mid- and carboxyterminal region of the CT molecule, and the amount of
      extracted CT was determined by radioimmunoassay using another polyclonal
      antiserum against the carboxyterminal portion. After calcium infusion, the
      increase in CT was significantly higher in young women than in elderly (P <
      0.05). At basal conditions, the CT levels were not significantly different but
      slightly higher in young than in elderly females. In conclusion, several elderly
      women lack monomer-like calcitonin in serum in contrast to young women.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7796344
TI  - Prevention of bone loss in early nonsurgical and nonosteoporotic high turnover
      patients with salmon calcitonin: the role of biochemical bone markers in
      monitoring high turnover patients under calcitonin treatment.
AB  - Annual bone loss rate was estimated in a group of randomly selected 150
      nonsurgical and nonosteoporotic early postmenopausal women, 42-56 years, with the
      use of the mathematical equation proposed by Christiansen et al. (OSTEOTREND-R)
      [1]. Fifty-six women were characterized as high turnover patients (estimated
      annual bone loss more than 2.7%). These high turnover patients were included in a
      double-blind, placebo-controlled clinical study. Patients were divided into two
      groups of 28 women each. The first group of patients received 100 IU of salmon
      calcitonin intranasally daily for 1 year and the second group intranasal spray of
      placebo daily. Blood and urine biochemical parameters as well as bone mineral
      content of the spine and proximal forearm were determined initially and at the
      end of 6 and 12 months. No other side effects were noted apart from discomfort of
      nasal mucosa in two patients (one in each group). The group of calcitonin-treated
      patients showed a dramatic decrease in bone loss rate as estimated with the use
      of biochemical bone markers at the end of 6 and 12 months (3.7% versus 0.8% and
      0.0% at the end of 6 and 12 months, respectively, P < 0.001) whereas in the
      placebo group, bone loss rate remained unchanged (4.2% versus 4.1% and 4.3% at
      the end of 6 and 12 months, respectively). The calcitonin-treated patients showed
      a significant increase in bone mineral content of spine and proximal forearm (P <
      0.001 at the end of 6 and 12 months, respectively). On the other hand, a
      significant decrease in all measurement sites appeared in the placebo
      group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796345
TI  - Low dose phenytoin is an osteogenic agent in the rat.
AB  - Long-term use of phenytoin for the treatment of epilepsy has been associated with
      increased thickness of craniofacial bones. The aim of the present study was to
      evaluate the possibility that low doses of phenytoin are osteogenic in vivo by
      measuring the effects of phenytoin administration on serum and bone
      histomorphometric parameters of bone formation in two rat experiments. In the
      first experiment, four groups of adult male Sprague-Dawley rats received daily
      I.P. injections of 0, 5, 50, or 150 mg/kg/day of phenytoin, respectively, for 47
      days. Serum alkaline phosphatase (ALP) and osteocalcin were increased by 5 and 50
      mg/kg/day phenytoin. The increases in osteocalcin and ALP occurred by day 7 and
      day 21, respectively. The tibial diaphyseal mineral apposition rate (MAR) at
      sacrifice (day 48) was significantly increased in rats receiving 5 mg/kg/day
      phenytoin. At a dose of 150 mg/kg/day, the increase in serum ALP, osteocalcin and
      MAR was reversed. No significant differences in serum calcium, phosphorus, or
      1,25(OH)2D3 levels were seen. In a second experiment, three groups of rats
      received daily I.P. injection of lower doses of phenytoin (i.e., 0, 1, or 5
      mg/kg/day, respectively) for 42 days. Phenytoin also did not affect the growth
      rate or serum calcium, phosphorus, and 25(OH)D3 levels. Daily injection of 5
      mg/kg/day phenytoin significantly increased several measures of bone formation,
      i.e., serum ALP and osteocalcin bone ALP, periosteal MAR, and trabecular bone
      volume.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796346
TI  - Bone-resorbing activities of 24-epi-1 alpha-hydroxyvitamin D2 and 24-epi-1
      alpha,25-dihydroxyvitamin D2.
AB  - Bone-resorbing activities of 24-epi-1 alpha-hydroxyvitamin D2 [24-epi-1
      alpha(OH)D2], 24-epi-1 alpha,25-dihydroxyvitamin D2 [24-epi-1,25(OH)2D2], and 1
      alpha,24S,25-trihydroxyvitamin D2 [1,24S,25(OH)3D2], which might be a metabolite
      of 24-epi-1,25(OH)2D2, were investigated. In an in vitro bone resorption test,
      the activity of 24-epi-1 alpha(OH)D2 was similar to that of 1 alpha
      hydroxyvitamin D3 [1 alpha(OH)D3] at 10(-9) M-10(-6) M. The activity of 24-epi
      1,25(OH)2D2 was weaker than that of 1 alpha,25-dihydroxyvitamin D3 [1,25(OH)2D3]
      at 10(-11) M-10(-8) M. On the other hand, the activity of 1,24S,25(OH)3D2 was
      similar to that of 24-epi-1,25(OH)2D2 at 10(-11) M-10(-9) M. In the formation
      assay of osteoclast-like cells, the activity of 24-epi-1 alpha(OH)D2 was weaker
      than that of 1 alpha(OH)D3 at 10(-7) M. The activity of 24-epi-1,25(OH)2D2 was
      almost similar to that of 1,25(OH)2D3 at 10(-11) M-10(-7) M. The activity of
      1,24S,25(OH)3D2 was significantly weaker than that of 24-epi-1,25(OH)2D2 at 10(
      11) M-10(-9) M. In the two experiments, the potencies of 24-epi-1,25(OH)2D2 were
      about 100 times higher than those of 24-epi-1 alpha(OH)D2. In an in vivo/in vitro
      bone resorption test, the activity of 24-epi-1 alpha(OH)D2 was almost similar to
      those of 1 alpha(OH)D3 and 1,25(OH)2D3 and higher than those of 24-epi
      1,25(OH)2D2 and 1,24S,25(OH)3D2. 24-epi-1 alpha-(OH)D2 and 1 alpha(OH)D3 were
      longer lasting than 24-epi-1,25(OH)2D2 and 1,25(OH)2D3 in this
      experiment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796347
TI  - Menopause-related changes in bone mineral density in Japanese women: a
      longitudinal study on lumbar spine and proximal femur.
AB  - We investigated 2-year longitudinal changes of bone mineral density (BMD) in
      lumbar spine and proximal femur in 64 Japanese women aged 38-67. Forty subjects
      were premenopausal (mean age 44.9) and 24 postmenopausal (mean age 54.6) at
      enrollment of the study. Six subjects experienced menopause during the 2-year
      study period and were defined as the perimenopausal group. Measurements of BMD
      were performed using dual-energy X-ray absorptiometry at L2-4, femoral neck,
      greater trochanter, and Ward's triangle. Paired t test revealed no significant
      decrease in BMD at any site in the premenopausal group. Significant annual
      decrease in BMD was observed in the perimenopausal group at L2-4, femoral neck,
      and greater trochanter. A similar tendency was observed in Ward's triangle, but
      did not reach statistical significance. In the postmenopausal group, significant
      decrease in BMD was found at the proximal femur, but not at L2-4. Significant
      inverse correlation between age and change rate of BMD was found at L2-4, but not
      at the proximal femur, in premenopausal women. In postmenopausal women, there was
      a significant association between body weight (BW) change and change rate in BMD
      at L2-4, femoral neck, or greater trochanter. This association was not found in
      the premenopausal group. These results suggest that effect of menopause on BMD
      may be different in individuals and sites of the skeleton. BW change may affect
      change in BMD in postmenopausal women.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796349
TI  - Mineral concentration gradients in rat femoral diaphyses measured by X-ray
      microtomography.
AB  - The bone mineral concentrations of five rat femora were measured as a function of
      distance from the distal metaphysis by quantitative X-ray microtomography (XMT)
      at a resolution of approximately 23 x 23 x 15 microns3. Assuming the mineral
      phase of bone to be hydroxyapatite, Ca10 (PO4)6(OH)2, the mean cortical mineral
      concentration (CM) per transverse section was found to range from 1.33 to 1.47 g
      cm-3. Detectable variations in the bone mineral concentration between sections of
      femora from different animals could not be attributed to the age when the
      particular animal was sacrificed. An increase in CM with distance, L, from the
      distal growth plate was observed and a saturating exponential equation, CM = a -
      be-alpha L, was used to describe the changes. Each section of bone tissue was
      considered as a population of elementary volumes of bone (EVB) and L was related
      to the age of the EVB (TEVB). A simple model for the mineralization process of an
      EVB was then proposed. Each newly formed EVB accumulated mineral rapidly to give
      an initial mineral concentration of approximately 1.3 g cm-3 (parameter a-b).
      Their mineral concentrations then increased asymptotically to approximately 1.5 g
      cm-3 (parameter a) with a time constant of approximately 330 days. This slow
      maturation process is attributed to Ostwald ripening of the bone crystals with
      further crystal growth using ions from the extracellular fluid.

PMID- 7796350
TI  - The mandibular condylar growth center: separation and characterization of the
      cellular elements.
AB  - The developing mandibular condylar growth center consists of a number of
      histologically distinct cell types. There is an increase in cell volume that
      takes place from the condylar surface layer through the center of ossification,
      resulting in a disorganized, irregular cellular pattern. Consequently, the
      isolation and separation of the different cells from this tissue is difficult
      using standard methodologies. Countercurrent centrifugal elutriation, whereby
      cells are separated on the basis of size, was applied to bovine mandibular
      condylar growth center cells. The cell volume, alkaline phosphatase content,
      proteoglycan synthesis, and type X collagen synthesis all showed a positive
      correlation with increasing cell size. The largest cells had characteristics that
      are consistent with hypertrophic chondrocytes; the smallest cells, on the other
      hand, had many fibroblastic characteristics.

PMID- 7796348
TI  - Amylin increases bone volume but cannot ameliorate diabetic osteopenia.
AB  - Amylin is normally secreted in a regulated fashion by the pancreatic beta-cells
      in parallel with insulin and has been reported to have bone-conserving
      properties. Type I diabetes mellitus results in a low-turnover osteopenia in the
      presence of decreased amylin, which is in contrast to type II diabetes where less
      bone loss, in the presence of high amylin levels, occurs. We investigated the
      effects of amylin on bone mineral metabolism in normal and diabetic
      (streptozotocin-induced) rats, in order to ascertain whether amylin would modify
      the streptozotocin-induced diabetic osteopenia. Ten-week-old male Sprague-Dawley
      rats were randomized as follows: group A (n = 18) received normal saline; group B
      (n = 18) received amylin; group C, diabetic rats (n = 23), received normal
      saline; and group D, diabetic rats (n = 23), received amylin. Amylin (100
      pmol/100 g b.w.) was administered by a daily subcutaneous injection. Double
      calcein-labeled tibiae were removed for histomorphometric analysis followed
      sacrifice on day 19. Results showed no difference in blood ionized calcium
      between groups. Blood glucose remained above 600 mg/dl in the diabetic animals
      and was not affected by the administration of amylin. Serum osteocalcin, insulin
      like growth factor-1 (IGF-1), parathyroid hormone (PTH), and 1,25
      dihydroxyvitamin D [1,25(OH)2D] were significantly lower in the diabetic rats
      compared with control group A by day 19. Amylin produced higher levels of serum
      osteocalcin in group B on day 9 (P < 0.05) compared with controls but returned to
      control values (group A) by day 19; no such change occurred in the diabetic
      group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796351
TI  - Effect of decalcification on bone mineral content and bending strength of feline
      femur.
AB  - The relationships between bone mineral content (BMC), bone calcium, and bone
      strength were studied in fractionally demineralized feline femurs. In 44 pairs of
      cat femurs, the right bones were decalcified in ethylene diaminetetra acetic acid
      (EDTA) to 20%, 40%, 60%, 80%, and 100% of the mineral content of the intact left
      bone (= control). The bones were then loaded to failure, and maximum strength
      values were recorded. The data were then used to calculate the percentage
      strength of the right relative to the left femurs. A correlation coefficient (r)
      of 0.970 was found between the percentage decalcification and percentage bending
      strength. A direct relationship (r = 0.876) was also observed between the total
      calcium extracted and total loss in BMC. The EDTA solutions were spot checked for
      protein content to determine if the organic matrices had been altered by
      demineralization. Protein was never detected. Nor did the demineralized tissues
      display histologic evidence of gross microscopic damage. This study has shown
      that in cat femurs, 20% decalcification led to about 35% loss in bending
      strength, and 60% decalcification caused 75% loss in strength. These values are
      significant as they highlight the importance of calcium to the strength of
      osteopenic bone.

PMID- 7796354
TI  - Assessment of dose and risk to the body following conventional and spiral
      computed tomography.
AB  - BACKGROUND: Computed tomography (CT) is one of the most frequently used
      examination procedures in diagnostic radiology and the dose given to the patients
      is higher than in general radiographic procedures. In this study LiF chip
      thermoluminescent dosimeters (TLD-100) were placed in each relative organ or
      tissue position, including head, chest and abdomen, in a Rando phantom. CT was
      performed using both conventional and spiral modes, and effective dose and
      effective dose equivalent were assessed for each organ or tissue scanned.
      METHODS: The TLD reader used in this experiment was controlled at a nitrogen flow
      rate of 450 ml/min, preheat time of 14 seconds, reading time of 16 seconds and
      annealing time of 16 seconds. This CT scanner can be used to perform both
      conventional and spiral tomography. Operating conditions for spiral tomography
      were 120 kV, 80 mA for scout film, and 120 kV, 200 mA, 1 sec/slice for each
      scanning. However, for conventional tomography, the operating conditions were 120
      kV, 80 mA for scout film and 120 kV, 160 mA, 1.5 sec/slice for each scanning.
      These operating conditions are satisfactory to most clinical applications, and
      therefore were adopted for the present studies. RESULTS: Results showed that, in
      both effective dose and effective dose and effective dose equivalent,
      conventional tomography was higher than spiral tomography. The average effective
      doses for each part were measured to be 1.89 and 4.95 mSv for the head, 30.01 and
      40.65 mSv for the chest, and 12.85 and 19.62 mSv for the abdomen of spiral and
      conventional CT, respectively. Higher carcinogenic risk was assessed in organs
      such as liver, lung, stomach and bone marrow, other organs had a relatively lower
      incidence of risk. CONCLUSIONS: The main purpose of this study was to obtain
      distribution values of effective dose and effective dose equivalent, and to know
      the probability of carcinogenic effect upon each organ or tissue after CT
      scanning. Results showed the average effective dose for spiral CT to be less than
      conventional CT, and the dose in the body surface was generally lower than the
      dose in the central region.

PMID- 7796352
TI  - A new rapid and reproducible homologous immunoradiometric assay for amino
      terminal parathyroid hormone in the rat.
AB  - Measurement of parathyroid hormone (PTH) in the rat is most often performed with
      competitive ligand radioimmunoassays (RIA) utilizing heterologous antibodies. We
      report here the validation of a newly developed homologous immunoradiometric
      assay (IRMA) for rat PTH. Two different goat antibodies to the amino-terminal
      sequence of rat PTH are utilized; one is immobilized onto plastic beads to
      capture the PTH molecules and the other is radiolabeled for detection. To test
      this new IRMA, 30 Sprague-Dawley rats were randomized into three treatment groups
      to receive by intraperitoneal injection: (1) saline 1 ml/kg (control); (2)
      calcium chloride 40 mg/kg (hypercalcemic); and (3) EDTA 300 mg/kg (hypocalcemic).
      Blood samples were taken at 0, 30, 60, 180, and 300 minutes after administration
      of the assigned treatment for measurement of ionized calcium (Ca2+) and serum
      PTH. Most of the variance in PTH levels was found to be due to changes in Ca2+
      (r2 = 0.780, P < 0.0001). There was also a close temporal relationship between
      the two, with the highest levels of PTH occurring at the same measured time
      points as the lowest Ca2+, and vice versa. The measured detection limit of the
      IRMA was 3 pg/ml with intra- and interassay coefficients of variation of 1.74%
      and 3.07%, respectively. Serial dilutions with pooled rat serum, synthetic rat
      PTH-(1-34), and synthetic human PTH-(1-34) showed good parallelism with increased
      specificity for the pooled and synthetic PTH, despite a degree of crossreactivity
      with hPTH.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796353
TI  - Investigation of the relationship between osteoporosis and the collagenase gene
      by means of polymorphism of the 5'upstream region of this gene.
AB  - Osteoporosis is a slowly progressing disease resulting from an imbalance between
      bone accretion and degradation. As interstitial collagenase is a key enzyme in
      the degradation of bone matrix, we investigated a possible relationship between
      the collagenase gene and osteoporosis. Analysis of an amplified genomic DNA
      fragment from -524 to +52 by denaturing gradient gel electrophoresis and
      sequencing allowed us to detect three dimorphic sites upstream of base -300, one
      of them leading to a BanI restriction site. None of the sites could be directly
      associated with osteoporosis. The allele frequencies of the three dimorphic sites
      were estimated. The interallelic ratios were high, thus providing new useful
      genetic markers for linkage analysis. When comparing these ratios in osteoporotic
      and nonosteoporotic subjects, no significant differences could be observed.

PMID- 7796355
TI  - Gingival overgrowth induced by different dosages of cyclosporin in rats.
AB  - BACKGROUND: The purpose of the study was to assess the dose effect on the
      severity of cyclosporin(CSA)-induced gingival overgrowth by an established rat
      model. METHODS: A total of 60 Sprague-Dawley male rats which weights were about
      250 gm were selected and randomly divided into four groups. Three experimental
      groups of rats were provided different gastric feedings of 3mg, 10mg, 30mg CSA
      per kilogram body weight, daily; the last group of rats was fed with mineral oil
      as the control. Stone impression models of the mandibular incisal region were
      taken and three-dimensional analyses of the overgrown gingiva were made biweekly.
      RESULTS: In the 30 mg CSA-treated rats, all three-dimensional measurements of the
      gingiva were observed to be greater than those of the control rats from the
      second week after CSA administration. In the 10 mg CSA-treated rats, most of
      gingival measurements were found to be greater from the fourth week after CSA
      administration. The bucco-lingual width of interdental papilla on the sixth week
      after CSA administration was the only significant measurement showing a
      difference between the 3mg treated rats and the control group. CONCLUSIONS:
      Because of a significant correlation between CSA-induced gingival overgrowth and
      CSA dosage, the dose effect on the severity of this gingival overgrowth was
      established in the rat model.

PMID- 7796356
TI  - Cytogenetic studies in de novo acute nonlymphocytic leukemia.
AB  - BACKGROUND: There is currently considerable interest in the cytogenetic analysis
      of leukemia. The improvement of banding techniques has made it possible to rather
      precisely identify deletion, translocation, inversions, and other structural
      chromosome abnormalities. Specific recurring chromosome abnormalities associated
      with distinctive morphologic features are thus increasingly recognized in acute
      nonlymphocytic leukemia. For example, uneven geographic distribution of nonrandom
      specific chromosome aberrations has been reported. We herein report the results
      of chromosome studies on 30 Chinese patients with de novo acute nonlymphocytic
      leukemia. METHODS: Cytogenetic studies were performed at Veterans General
      Hospital-Taipei, from 1988 to 1993, on unselected samples of 30 patients with de
      novo acute nonlymphocytic leukemia. Chromosome analysis was performed by short
      term culture techniques on bone marrow material obtained from patients at
      diagnosis. Metaphase chromosomes were banded by the conventional trypsin-Giemsa
      banding technique and then karyotyped according to the International System for
      Human Cytogenetic Nomenclature (ISCN). Classification of leukemia was based on
      the criteria of the French-American-British cooperative group. RESULTS: Of the 30
      patients with adequate specimens, 17 (56%) demonstrated clonal chromosome
      abnormalities. Six patients were found to have structural rearrangements and
      seven patients have a numerical change as the sole abnormality. Four patients
      showed both structural and numerical anomalies. t(8;21) was found in 1 of the 8
      M2 type ANLL patients and two of them had monosomy 21. Four of the 6 patients
      with acute promyelocytic leukemia (APL; M3 subtype) showed t(15;17). Two patients
      with M4 type leukemia and abnormal bone marrow eosinophils showed
      inv(16)(p13q22). One patient with M4 type leukemia demonstrated the loss of
      chromosome #7 and none showed the loss or deletion of chromosome #5. CONCLUSIONS:
      This study revealed a consistent finding of t(15;17) in APL; however, a low
      incidence of t(8;21), -5/5q- and -7/7q- in our patients demonstrated the possible
      difference in the incidence of chromosomal abnormalities in ANLL between the
      oriental peoples and the whites.

PMID- 7796358
TI  - Complications of continuous ambulatory peritoneal dialysis: one surgeon's
      experience with 668 patient-month follow-up.
AB  - BACKGROUND: The technique of continuous ambulatory peritoneal dialysis (CAPD)
      catheterization is critical to patient success. To clarify how important a
      surgeon's experience to CAPD is, the experience exclusively from a single surgeon
      was presented and compared with those from a group of surgeons. The roles of
      intraoperative fluoroscopy and laparoscopy in CAPD catheterization and the rescue
      of tube migration in the authors' experience would also be introduced. METHODS:
      Fifty-five patients followed for a total of 668 patient-months between July 1990
      and July 1993 were included for analysis. All of the catheterization procedures
      were done by one surgeon. RESULTS: The overall complication rate was 56%. Twenty
      two percent of the patients had peritonitis, with an incidence of 0.56/patient
      year, and 25% of the patients had exit-site infection, with an incidence of
      0.36/patient-year. Tube migration occurred in two patients (4%). There was no
      dialysate leakage or incisional hernia. These incidences were much lower than
      previous reports by groups of surgeons. Laparoscopy successfully rescued a
      migrated tube. The cumulative 1-year, 2-year and 3-year catheter survival rates
      were 81%, 75% and 63% respectively. The previous abdominal operation, catheter
      type and catheterization site were not the prognostic factors of catheter
      survival. CONCLUSIONS: Based on this favorable outcomes, an experienced CAPD
      surgeon may be one of the factors in minimizing the complications and improving
      the catheter survival in CAPD. Intraoperative fluoroscopy for every
      catheterization procedure and laparoscopy for the migrated or dysfunctional tube
      are highly recommended.

PMID- 7796357
TI  - A randomized comparative study on the safety and efficacy of clarithromycin and
      erythromycin in treating community-acquired pneumonia.
AB  - BACKGROUND: Clarithromycin, a new macrolide, has distinct microbiological and
      pharmacokinetic advantages compared with erythromycin. This study was designed to
      compare the safety and efficacy of clarithromycin and erythromycin in the
      treatment of community-acquired pneumonia. METHODS: Forty adult patients,
      diagnosed with community-acquired pneumonia, were randomly arranged to received
      either clarithromycin 250 mg twice daily (20 patients) or erythromycin 500 mg
      four times daily (20 patients), over a period of 14 days each. RESULTS: There
      were no statistically significant differences between the two groups in terms of
      clinical cure (65% for clarithromycin, 65% for erythromycin), clinical success
      (clinical cure and improvement: 95% for clarithromycin, 90% for erythromycin) and
      radiological response (95% for clarithromycin, 90% for erythromycin). However,
      adverse effects, mainly gastrointestinal, were significantly higher among
      patients treated with erythromycin than among patients treated with
      clarithromycion (p < 0.05). CONCLUSIONS: These results demonstrate that
      clarithromycin 250 mg twice daily is at least as effective as erythromycin 500 mg
      four times daily for the treatment of community-acquired pneumonia, and is much
      better tolerated.

PMID- 7796359
TI  - Vecuronium dissolved in normal saline exaggerates pain on intravenous injection.
AB  - BACKGROUND: On some anesthetic occasions, many patients complained of pain at the
      site of injection when vecuronium, dissolved in normal saline, was administered
      intravenously. The aims of this study was to compare the incidence of pain on
      i.v. injection of vecuronium either dissolved in normal saline or in a solvent
      provided by the pharmaceutical manufacturer. METHODS: We studied eighty patients
      of ASA physical status class I-II undergoing elective surgery under general
      anesthesia. Patients were arranged randomly to receive intravenous 0.1 mg/kg
      vecuronium dissolved either in solvent (n = 40) or in normal saline (n = 40)
      through the catheter indwelling in a vein on the dorsum of hand over 5 seconds.
      Immediately after injection, a nurse was appointed to score the degree of pain.
      Induction of anesthesia was accomplished with thiopental and fentanyl 30 seconds
      after vecuronium administration. RESULTS: Vecuronium dissolved in normal saline
      induced severe pain more frequently during injection than that dissolved in
      solvent (27.5% versus 10%). There was no significant difference in pH between
      these two solutions (3.87 versus 4.08). However, vecuronium dissolved in normal
      saline showed higher osmolality than that dissolved in solvent (425 +/- 7 mOsm/kg
      versus 149 +/- 3 mOsm/kg). CONCLUSIONS: Pain resulting from intravenous injection
      of vecuronium can be aggravated if normal saline was used as the solvent.
      Increased osmolality may also be responsible for this phenomenon.

PMID- 7796361
TI  - Primary non-Hodgkin's lymphoma of the mediastinum: a clinicopathological report
      of six cases.
AB  - BACKGROUND: Primary mediastinal non-Hodgkin's lymphoma [NHL] predominates in
      young adult with diffuse large B-cell histologic characteristics, and favorable
      prognosis. Six patients with this disease were diagnosed and treated at the Tri
      Service General hospital during the period of 1986 to 1991. METHODS: Pathology
      data were reviewed. All cases were classified according to the International
      Working Formulation. All specimens were studied immunohistologic for
      immunoglobulin kappa and lambda light chains, common leukocyte antigen (CLA), B
      cell marker (L26) and T cell marker (MT1 & UCHL1). All patients were treated with
      cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP) and adjuvant
      radiotherapy. RESULTS: Most of the patients were young adults with bulky disease
      in the anterior mediastinum. All presented with symptoms attributed to a rapidly
      growing mass. Four patients had superior vena cava syndromes. The histologic
      types were B-cell type lymphoma, including immunoblastic cell in two, and diffuse
      large cleaved cells in four patients. Three were in stage II and the others were
      in stage IV. Complete response was achieved in four patients and partial response
      in two, with an overall response rate of 100%. CONCLUSIONS: The results suggest
      that primary non-Hodgkin's non-lymphoblastic lymphoma commonly occurs in young
      adults and had an associated aggressive clinical course. In view of these
      results, observation have also suggested that intensive chemotherapy and bone
      marrow transplantation are needed for patients who relapse or fail to get
      complete remission.

PMID- 7796360
TI  - Ipratropium bromide and intraoperative bronchospasm.
AB  - BACKGROUND: Ipratropium bromide (IB) is a synthetic anticholinergic
      bronchodilator which is effective when administered by inhalation. Therefore, IB
      may be effective for the management of intraoperative bronchospasm. This study
      was designed to evaluate the effects of inhaled IB in the management of
      intraoperative bronchospasm induced by endotracheal intubation. METHODS: Nine
      asthmatics who were asymptomatic preoperatively were investigated. They developed
      bronchospasm after endotracheal intubation. IB 120 micrograms was aerosolized
      through the endotracheal tube. Heart rate, peak inspiratory pressure (PIP),
      airway resistance (Raw) and pulmonary resistance (Rpul) before and after IB
      administration were recorded and calculated. RESULTS: IB 120 micrograms relieved
      wheezing in 11 +/- 4 min (mean +/- SD), and significantly decreased PIP in 5 min
      and reached peak effects at 120 minutes after administration. Raw and Rpul also
      decreased during similar time intervals. Heart rates had no significant change
      after IB administration. CONCLUSIONS: The present study indicated that IB 120
      micrograms could abate the intraoperative bronchospasm caused by airway
      hyperreactivity induced by endotracheal intubation in preoperatively asymptomatic
      asthmatic patients, and may have a role in the management of intraoperative
      bronchospasm.

PMID- 7796363
TI  - Spontaneous tendon rupture in rheumatoid hand-successful reconstruction with
      tendon transfer: a case report.
AB  - Rheumatoid arthritis is not as common a problem in Taiwan as it is in western
      countries. Compared with traumatic tendon rupture, tendon rupture in rheumatoid
      arthritis has its complex and peculiar pathophysiological mechanism which
      includes chemical erosion by hypertrophic synovium and mechanical attrition by
      deformed joints and bony spurs. In management, all these pathological foci must
      be eradicated to prevent recurrent failure. Tendon transfer is a simple and
      effective method for reconstructing lost tendon function.

PMID- 7796364
TI  - Pulmonary carcinoid tumor--tumorlet type: a case report.
AB  - A rare case of bronchiectasis with carcinoid tumor, tumorlet type, is reported.
      The patient was a 53-year-old female who underwent lobectomy of the right middle
      and lower lobes for severe hemorrhage secondary to bronchiectasis. No tumor was
      seen on chest X-ray or by gross examination of the lung. Microscopically, there
      were multiple tumorlets in the pulmonary parenchyma surrounding the bronchiole
      and small bronchus. The tumor cells stained positive for neuron-specific enolase,
      keratin and chromogranin stain. The morphology, and staining properties suggested
      that the pulmonary tumorlets were carcinoid tumor. No tumor cells were identified
      in the four peribronchial lymph nodes. The patient is disease-free after four
      years of follow-up.

PMID- 7796362
TI  - Congenital muscular dystrophy (non-Fukuyama type): a case report.
AB  - A Taiwanese girl, aged 12 years, presented with early myogenic hypotonia,
      multiple joint contractures, mental subnormality and epilepsy. Computerized
      tomography scanning of the brain showed white matter hyperlucency. According to
      her clinical manifestations and radiological pictures, the patient could be the
      fourth oriental case who had the features of occidental-type cerebromuscular
      dystrophy.

PMID- 7796365
TI  - Mesoblastic nephroma: a case report.
AB  - Mesoblastic nephroma is a rare tumor of kidney characterized by interlacing
      bundles of spindle mesenchymal cells. The tumor usually occurs in the newborn,
      and scarcely in the old child. In this article, the authors report a case of an
      unusual age, a 12-year-old boy, with mesoblastic nephroma which was found by
      routine physical examination.

PMID- 7796366
TI  - Therapeutic computing: teaching therapeutic communications utilizing a videodisc.
AB  - Effective communication skills for nurses are essential and serve as the
      interface between patients and health care providers. Yet, teaching communication
      skills is subject to only limited success. Results vary according to the mix of
      students, the talent and interest of the instructor, and the availability of
      teaching time for the topic. The nursing program at Indiana University Kokomo is
      addressing the needs of nursing students with a multimedia computer system. A
      videodisc on therapeutic communication was purchased to supply the desired video
      based examples. The programming of the computer interface was done by a senior
      information systems department major. Student attitudes measured after using the
      system the first year were very good.

PMID- 7796367
TI  - A psychometric examination of the Stronge-Brodt Nurses' Attitudes Toward
      Computers Questionnaire.
AB  - The purpose of this study was to examine the factor structure and reliability of
      the Stronge-Brodt Nurses' Attitudes Toward Computers Questionnaire. The
      instrument was administered to nurses before (T1, n = 391) and after (T2, n =
      265) the implementation of a computerized patient care information system. A
      factor analysis of each sample was carried out using the SPSS/PC+ factor
      procedure with varimax rotation and Kaiser normalization. The factor analyses for
      T1 and T2 were consistent and identified three factors that parallel those
      generated in a factor analysis performed by Schwirian et al (1989). In both
      samples of the current study, the internal consistency reliability for the first
      factor was high (T1 alpha = .91, T2 alpha = .92), whereas the second and third
      factors demonstrated diminished reliability. Overall instrument reliability was
      .93 at T1 and .92 at T2. This study, with relatively large sample sizes, provided
      further clarification of the factor structure and supported the high reliability
      of the instrument.

PMID- 7796368
TI  - The who, what, where, when, and how of computer education.
AB  - Using a "Who, What, Where, When, and How" approach, the author addresses multiple
      issues that must be considered during computer education planning and
      development. The nursing department usually has the largest number of people
      requiring computer education and their training must be coordinated with other
      departments, so a well-thought-out training plan is required. This article
      presents practical hints and helpful strategies for developing such a plan.

PMID- 7796369
TI  - Applied information technology: a clinical perspective. Feature focus: the
      computer-based patient record (Part 2).

PMID- 7796370
TI  - Implementation of a variety of computerized bedside nursing information systems
      in 17 New Jersey hospitals.
AB  - This article examines issues of implementing nursing information computer systems
      in 17 hospitals in New Jersey and the initial effects of such systems as
      perceived by users. Unlike previous studies that examined the effects of one
      system in one hospital, this study examines the effects of several major systems
      in a variety of settings. Many of the hospitals experienced major delays or other
      problems with implementation; the hospitals in which timely implementation
      occurred were the ones that had purchased a commercially available stand-alone
      nursing system and did not try to develop interfaces or do extensive development.
      While these hospitals did meet with difficulties and needed some software
      customization, the problems were not so severe as to impede timely
      implementation. On the other hand, most of the hospitals that had major delays
      had planned more ambitious projects. These hospitals either required development
      work with vendors or were implementing a nursing information system while
      simultaneously putting in place a hospital system. Initial staff impressions of
      the effects of the system were positive; nursing department staffs reported that
      they liked the nursing systems. They said that documentation was better (more
      readable, complete, and timely) and they also believed that care was improved
      because the computer prompted nurses on what to look for and what to do. Support
      for these systems from hospital administration, outside of nursing, was cautious
      and based primarily on cost/benefit results.

PMID- 7796371
TI  - Health care costs: hospital-bed view versus the larger picture.

PMID- 7796372
TI  - Hemophilia and von Willebrand's disease: 1. Diagnosis, comprehensive care and
      assessment. Association of Hemophilia Clinic Directors of Canada.
AB  - OBJECTIVE: To present current strategies for the assessment and comprehensive
      care of patients with hemophilia and von Willebrand's disease. OPTIONS: Hospital
      care, home care, single-provider care and multidisciplinary care. OUTCOMES:
      Morbidity and quality of life associated with bleeding and treatment. EVIDENCE:
      Relevant clinical studies and reports published from 1974 to 1994 were examined.
      A search was conducted of own reprint files, MEDLINE, citations in the articles
      reviewed and references provided by colleagues. In the MEDLINE search the
      following terms were used singly or in combination: "hemophilia," "von
      Willebrand's disease," "Factor VIII," "Factor IX," "von Willebrand factor,"
      "diagnosis," "management," "home care," "comprehensive care," "inhibitor,"
      "AIDS," "hepatitis," "life expectancy," "complications," "practice guidelines,"
      "consensus statement" and "controlled trial." The in-depth review included only
      articles written in English from North America and Europe that were relevant to
      human disease and to a predetermined outline. The availability of treatment
      products in Canada was also considered. VALUES: Minimizing morbidity and
      maximizing functional status and quality of life were given a high value.
      BENEFITS, HARMS AND COSTS: The optimal use of treatment procedures and home care
      offers patients the advantages of minimized disability, improved survival and
      financial benefit. It is also cost effective. Potential harm, including the risk
      of hepatitis B, hepatitis C and HIV infection, has now been minimized through
      viral inactivation of plasma-derived coagulation-factor concentrates and through
      the use of recombinant clotting factor concentrates and other non-plasma-derived
      hemostatic agents. RECOMMENDATIONS: Patients with hemophilia and severe von
      Willebrand's disease should be followed in comprehensive care centres that offer
      expertise in the diagnosis, assessment and management of bleeding and
      complications and that can meet the educational and counselling needs of
      patients, family members and health care providers. Eligible patients should be
      enrolled in a home self-infusion program. Patients with hemophilia and von
      Willebrand's disease should wear or carry Medic Alert identification. They should
      be vaccinated against hepatitis B and attend for routine follow-up examinations.
      Laboratory testing should be carried out as required, and dental and surgical
      care should be undertaken in consultation with a hematologist. VALIDATION: These
      recommendations were reviewed and approved by the Association of Hemophilia
      Clinic Directors of Canada (AHCDC) and the Medical and Scientific Advisory
      Committee of the Canadian Hemophilia Society. No similar consensus statements or
      practice guidelines are available for comparison. SPONSORS: These recommendations
      were developed at the request of the Canadian Blood Agency, which funds the
      provision of all coagulation-factor concentrates for people with congenital
      bleeding disorders, and were developed and endorsed by the AHCDC and the Medical
      and Scientific Advisory Committee of the Canadian Hemophilia Society.

PMID- 7796373
TI  - Complementary health care services: a survey of general practitioners' views.
AB  - OBJECTIVE: To determine the referral practices, perceived usefulness, knowledge,
      prior training and desire for training of general practitioners (GPs) in Quebec
      with regard to complementary health care services such as acupuncture,
      chiropractic and hypnosis. DESIGN: Cross-sectional mail survey. SETTING: Province
      of Quebec. PARTICIPANTS: Random sample of 200 GPs. Of the 146 who responded, 25
      were excluded because they were no longer in practice; this left 121 (83%).
      OUTCOME MEASURES: Self-reported referral practices for complementary health care
      services, perceived usefulness and self-assessed knowledge of such services, and
      prior training and desire for training in these services. RESULTS: Sixty percent
      (72/121) of the GPs knew at least one practitioner of a complementary health care
      service for referral; 59% (70/119) reported referring patients to physicians who
      practise such services and 68% (80/118) to nonmedical practitioners. At least one
      of the three services studied were regarded as having some use by 83% (101/121).
      Overall, self-reported knowledge was poor: the proportions of GPs who reported
      knowing a lot about acupuncture, chiropractic and hypnosis were 11% (13/121), 10%
      (12/121) and 8% (10/121) respectively. Prior training was also lacking: only 8%
      (9/118) of the GPs had received previous training in acupuncture, 2% (2/111) in
      chiropractic and 3% (3/103) in hypnosis. In all, 48% (57/118) indicated that they
      would like further training in at least one of the services studied, and 13%
      (16/121) indicated that they currently provided one service. CONCLUSIONS:
      Referral of patients by GPs to practitioners of complementary health care
      services is common in Quebec. Although self-assessed knowledge about such
      services is relatively poor, interest in learning more about them is high. These
      findings identify a demand for future educational initiatives.

PMID- 7796374
TI  - Frequent users of ambulatory health care in Quebec: the case of doctor-shoppers.
AB  - OBJECTIVE: To examine the patterns of use of ambulatory care in Quebec in 1991,
      with special emphasis on patients who received care from more than 20 physicians.
      DESIGN: Retrospective study of population-based data. SETTING: Province of
      Quebec. PARTICIPANTS: All 7,154,591 people eligible for coverage under the Regie
      de l'assurance-maladie du Quebec (RAMQ) (Quebec Health Insurance Plan) in 1991,
      including 3639 people who received ambulatory care from more than 20 physicians.
      DATA EXTRACTION: The databanks of the RAMQ. OUTCOME MEASURES: Mean number (and
      standard deviation) of physician visits and services received, place of visit
      (clinic or private office), mean cost of services, patient's age, diagnosis, type
      of specialist visited and social assistance status of frequent users. RESULTS:
      The patients who obtained ambulatory care from more than 20 physicians received
      10 times more medical services than the overall patient population (59.6 v. 5.8),
      and the mean cost per patient for ambulatory care was also 10 times higher ($1379
      v. $136). Almost all of the frequent users visited at least one outpatient
      clinic, as compared with 37.3% of the overall population. A higher proportion of
      the frequent users than of the overall population obtained care from specialists
      (98.9% v. 54.7%), mainly general surgeons and psychiatrists. The most frequent
      diagnoses among the frequent users were anxiety (36.0%), abdominal pain (24.3%),
      drug or alcohol dependence (22.2%) and depression (16.4%). CONCLUSIONS: A small
      proportion of the population obtained ambulatory care from a high number of
      physicians during the year, leading to high expenses. Identifying and
      understanding this type of frequent user may be useful in developing strategies
      to promote more effective health-care-seeking behaviours and reduce overuse.

PMID- 7796375
TI  - Integrating complementary medicine and health care services into practice.
AB  - Complementary medicine and health care services constitute a significant
      proportion of the use of health care services in Canada, despite a history of
      limited acceptance of these therapies by the medical profession. However,
      physician attitudes appear to be changing. A survey of a random sample of general
      practitioners in Quebec (see page 29 of this issue) shows that four out of five
      general practitioners perceive at least one of three complementary health care
      services to be useful. Similar surveys of samples in Alberta and Ontario suggest
      that physicians there, although somewhat less enthusiastic than their
      counterparts in Quebec, have also begun to be more open-minded about these types
      of therapies. However, physicians have reported little understanding of
      complementary health care services, which suggests the need for more research on
      and education about these services. The Medical Society of Nova Scotia has
      responded to this need by establishing a Section of Complementary Medicine. The
      authors believe that fair, accountable, scientific and rigorous research on
      complementary therapies will benefit physicians and patients. The problems
      inherent in applying reductionist analysis to a holistic approach to care can be
      largely circumvented by focusing on outcomes research. In light of the popularity
      of these therapies, inquiry into patient use of complementary health care
      services should become a part of a complete patient history. This measure would
      promote greater patient-physician communication and integration of complementary
      health care services into patient care.

PMID- 7796376
TI  - Laboratory reports of human viral and selected nonviral agents in Canada--1993.

PMID- 7796377
TI  - Debate about parents' right to spank causes divisions among MDs.
AB  - Does spanking involve child abuse, or is it an acceptable form of discipline in
      Canada? Section 43 of the Criminal Code allows "reasonable" force on the part of
      a teacher or parent as a disciplinary measure, but an advocacy group believes
      that this section of the code should be repealed. However, a recent court case
      indicates that abolition of corporal punishment is not a black-and-white issue.

PMID- 7796378
TI  - Barer and Stoddart revisit the issue of funding academic health centres.
AB  - Four years after Drs. Morris Barer and Greg Stoddart presented their landmark
      report, Toward Integrated Medical Resource Policies for Canada, to the country's
      deputy ministers of health, not much progress has been reported on the
      reformation of Canada's academic health centres. A recent survey of respondents
      consulted for the original report showed "a deafening lack of responses" that
      indicated the situation has improved since the report was issued. Government
      respondents had a more positive opinion than administrators of the centres.

PMID- 7796379
TI  - Canada must be alert to threat of imported wild poliovirus, working group says.
AB  - Even though the Western Hemisphere is certified as being polio free, countries
      such as Canada must be alert to the continuing threat posed by the importation of
      wild poliovirus from polio-endemic regions, according to a report from Canada's
      Working Group on Polio Eradication and the Laboratory Centre for Disease Control.
      The working group recommends the maintenance of high immunization-coverage levels
      and strengthened surveillance activities for polio.

PMID- 7796381
TI  - The brave new world of managed care.
AB  - Canadian hospitals that think they can charge higher-than-normal rates to foreign
      visitors are learning a lesson as US-style managed care moves north of the
      border. Dr. Robert MacMillan, president and medical director of Florida-based
      Insurance Claims Management Systems and past president of the Ontario Medical
      Association, says that south of the border US-style managed care has already
      hauled in the reins on wild expectations about high payments, and it is expected
      to do the same for Canadian hospitals that charge private insurers "as much as
      the traffic will bear." He says it is no longer uncommon for a large Toronto
      hospital to charge a foreign patient $3000 a day for care that can now be
      purchased in a US hospital for one-third that price.

PMID- 7796380
TI  - After years of steady growth, winds of restraint blowing on prescription-drug
      industry.
AB  - Tough fiscal times are forcing cutbaks in many areas of health care, and the
      prescription-drug industry is no exception. The Pharmaceutical Manufacturers
      Association of Canada says Canada's brand-name drug companies face two major
      hurdles: restricted market access, as drug formularies limit the number of new
      drugs, and restricted price increases, as allowed by the Patented Medicine Prices
      Review Board and provincial formularies. The Canadian Drug Manufacturers
      Association, which represents Canada's generic-drug industry, says its message to
      physicians is that generic products are important agents of cost control and that
      the health care community is more aware of this than it once was. "If you don't
      maximize your savings while you can," cautions the association's Brenda
      Drinkwalter, "you'll never be able to afford the high-priced drugs of tomorrow".

PMID- 7796382
TI  - Indoor air quality a major public-health issue, workshop told.
AB  - Indoor pollution is a major public-health issue, say representatives from
      government and the medical profession who participated in a recent workshop in
      Ottawa. Researchers are certain that indoor pollution causes many of the allergy
      related problems and asthma, bronchitis, rhinitis, coughing and others
      respiratory problems experienced by North Americans. They urge physicians to
      learn about indoor air quality and to educate patients to improve their
      environment, particularly with respect to second-hand smoke, dust mites and
      mould.

PMID- 7796383
TI  - Spas accepted part of health care in Czech Republic.
AB  - Although the days are gone when a spa holiday was offered as a reward to
      Communist Party leaders and factory workers who exceed their quotas, spas are
      still popular in the former Czechoslovakia. Government health care coverage
      relating to spas extends to fewer medical conditions and may not cover the
      expense of room and board, but more patients are footing the bill themselves,
      even though a 3-week stay costs more than the average monthly earnings. Officials
      predict spas will prosper under new private health insurance plans and expanding
      consumer spending power.

PMID- 7796384
TI  - Fusion between enveloped viruses and erythrocyte membranes is induced by the
      isoprenoid alkane pristane (2,6,10,14-tetramethylpentadecane).
AB  - Pristane (2,6,10,14-tetramethylpentadecane) is an isoprenoid alkane that induces
      plasma cell tumors in mice. Infection with certain retroviruses accelerates
      tumorigenesis but the nature of the cooperation between pristane and viruses is
      unknown. The purpose of this study was to investigate the potential influence of
      pristane on the fusion between enveloped viruses and mammalian plasma membranes.
      Using a fluorescence dequenching assay, we found that micromolar amounts of
      pristane induced fusion between erythrocyte membranes and both vesicular
      stomatitis virus and influenza virus. Induction of fusion occurred with as little
      as 5 microM pristane and reached saturation at roughly 50 microM alkane. Control
      experiments revealed that induction of fluorescence dequenching was not due to
      extraneous phenomena such as lipid transfer or non-specific interactions with the
      carrier for pristane (beta-cyclodextrin). Fusion was also induced by standard
      protocols which involve lowering the pH of the incubation medium. In the presence
      of pristane, low pH-triggered fusion was enhanced. The extent to which pristane
      induced fusion was dependent upon the orientation of the lipids in the target
      membrane. That is, fusion was most effective with erythrocyte ghosts which had a
      symmetric lipid distribution and was less effective with ghosts in which the
      native lipid asymmetry was maintained. Intact erythrocytes, which have an
      asymmetric lipid distribution, were the least effective targets. This result
      exactly parallels the pattern observed with acid-induced fusion. Similar patterns
      were also observed in the temperature dependence of fusion induced by these two
      protocols. The novel fusogenic activity of pristane is discussed with regard to
      current models of virus/membrane fusion.

PMID- 7796385
TI  - Increase in postirradiation survival of rat 3Y1 fibroblasts by a protein kinase
      inhibitor, staurosporine.
AB  - Protein kinases play an important role in the response of mammalian cells to
      ionizing radiation. In this study, we examined the effect of staurosporine, a
      potent inhibitor of protein kinases, on cell survival after X-irradiation, using
      the normal rat fibroblast line 3Y1. Treatment with 30 ng/ml staurosporine 1 h
      before irradiation resulted in the increase in survival of 3Y1 cells. This
      phenomenon was drug dose-dependent and maximal reduction of radiation-induced
      cell killing occurred when more than, or equal to, 30 ng/ml staurosporine was
      added. In contrast, treatment with 30 ng/ml staurosporine after irradiation did
      not increase cell survival. There was no change in cell cycle distribution by
      treatment for 1 h with 30 ng/ml staurosporine. These data suggest that the
      inhibition of protein kinase activities by staurosporine influences the
      radiosensitivity of 3Y1 cells.

PMID- 7796386
TI  - On the relationship between rate of uptake of Photofrin and cellular responses to
      photodynamic treatment in vitro.
AB  - The Burkitt's lymphoma cell line Namalva was used as an in vitro model to study
      the accumulation and photocytotoxic properties of Photofrin, the photosensitizer
      currently in clinical trials. Photofrin uptake and intracellular protein binding
      were evaluated as a function of the incubation time using fluorescence
      spectroscopy. The drug concentration strongly affected the intracellular
      distribution pattern of Photofrin, which in turn was shown to correlate with the
      Namalva cell response to photodynamic action. At low drug load, a gradual cell
      response varying from transient cell cycle arrest (predominantly S-phase) to
      marked photocytotoxicity modulated by incubation time and light dose was
      observed. High drug load resulted in lethality without cell cycle selectivity.
      The data suggest possible Photofrin targeting of protein factors involved in cell
      proliferation.

PMID- 7796387
TI  - Mucin coding sequences are remarkably conserved.
AB  - Mucins are complex glycoproteins expressed by glandular epithelia and the
      carcinoma which develop from these tissues. The core protein is aberrantly
      glycosylated in cancers, and some antibodies show specificity in their reactions
      with the cancer-associated mucins, which also contains epitopes recognized by T
      cells from pancreatic and breast cancer patients. Based on the PCR amplification
      of the mucin coding sequences, hybridization analysis and determination of the
      sequence divergence we present the evidence that mucin coding sequences are
      conserved in a number of species. A broad series of organisms were examined for
      analogous sequences. Data show that mucin-type sequences are present in a variety
      of mammals, but less apparent in chicken and yeast. Divergence increased in the
      order human, monkey, rabbit/rat/cow, mouse; chicken and yeast exhibited minimal
      homology. Furthermore, nucleotide sequences not included in the tandem repeats, a
      common feature of mucin core structure, are more conserved than the flanking
      sequences which also suggests that the flanking sequences may be functionally
      significant while repeats are structurally important. The hybridization bands
      showed different restriction patterns (suggesting for the existence of the
      restriction fragment length polymorphism). Northern analysis indicates message
      polydispersity, commonly seen with this class of RNA. The major features of the
      protein appear broadly conserved in the different mammalian species examined. The
      evolutionary significance of the above studies has been discussed.

PMID- 7796389
TI  - Relationship between the levels of purine salvage pathway enzymes and
      clinical/biological aggressiveness of human colon carcinoma.
AB  - A large series of samples obtained after surgical resection of intestinal mucosa
      of patients affected by intestinal carcinoma was examined in order to define
      possible relationships between levels of enzymes involved in the purine salvage
      pathway and clinical/biological parameters of aggressiveness and invasiveness.
      The results confirm our previous observation on a different pattern of purine
      salvage enzymes in tumor as compared to normal colon tissues (Camici et al.,
      1990). In fact, we observed in human colon tumor tissues a significant
      enhancement of the three enzymes involved in the synthesis of IMP, hypoxanthine
      guanine phosphoribosyltransferase (HGPRT), adenosine deaminase (ADA) and purine
      nucleoside phosphorylase (PNP). On the other hand, no variation was observed in
      the 5'-nucleotidase and alkaline phosphatase activities. While we could not find
      a significant correlation between HGPRT, ADA and PNP activities and histologic
      grading or biological parameters of tumor aggressiveness, the significant
      correlation with the extent of disease, as expressed by the Dukes' stage, would
      demonstrate at least for human colon tumors, a relationship between enzyme
      activity and tumor invasiveness.

PMID- 7796388
TI  - Leukocyte arylsulphatase A activity in acute leukemia.
AB  - Lysosomal arylsulphatase A of peripheral leukocytes from patients with acute
      lymphoblastic and myeloblastic leukemia and from healthy subjects, were studied.
      Arylsulphatase A activity of both types of leukemic cells was significantly
      higher than those of cells from healthy subjects. From our present observations,
      it can be concluded that estimation of lysosomal arylsulphatase A of leukocytes,
      may be of value clinically as a biochemical assay which can serve to demonstrate
      the presence of malignancy.

PMID- 7796390
TI  - Inhibition of x-ray induced transformation and effect on myc and fos gene
      expression by the nucleotide analog, 2-aminopurine.
AB  - Ionizing radiation is a carcinogen that is known to induce malignant
      transformation of C3H/10T1/2 fibroblasts in vitro. Radiation is also known to
      induce c-myc expression and protease inhibitors that suppress radiation
      transformation reduce myc and fos gene expression. The antiproliferative protein
      kinase inhibitor 2-aminopurine has been shown to selectively inhibit serum
      induced c-fos and c-myc expression in human hemopoetic cells. The myc and fos
      oncogenes are thought to play a role in the regulation of cell proliferation and
      may be involved in early stages of carcinogenesis. We determined the ability of 2
      aminopurine to affect x-ray-induced transformation in C3H/10T1/2 cells in vitro
      and its effect on myc and fos gene expression in these cells. Treatment with 2
      aminopurine (5 x 10(-4) M) resulted in a 50-100% reduction in transformation
      yield when C3H/10T1/2 cells were irradiated with 6 Gy of x-irradiation. The 2
      aminopurine had to be present during the post-confluent stage of cell growth in
      order to exert its inhibitory effect. Treatment of cells with 2-aminopurine
      significantly reduced the level of myc gene expression; the inhibitory effect of
      2-aminopurine on fos gene expression in these cells was not statistically
      significant.

PMID- 7796391
TI  - Loss of expression of the p16/cyclin-dependent kinase inhibitor 2 tumor
      suppressor gene in melanocytic lesions correlates with invasive stage of tumor
      progression.
AB  - Sporadic and familial malignant melanoma susceptibility has been linked to
      defects in the chromosomal region 9p21. Recently, a putative 9p21 tumor
      suppressor gene, the cyclin dependent kinase inhibitor 2 (CDKN2) or p16 gene, has
      been shown to be deleted, mutated, or rearranged in a high percentage of sporadic
      melanoma cell lines, as well as mutated in the germline of a proportion of
      familial melanoma patients. CDKN2 encodes a M(r) 16,000 protein (p16) that plays
      a key role in cell cycle control by binding to the cyclin-dependent kinase 4
      enzyme and inhibiting its ability to phosphorylate critical substrates necessary
      for transition past the G1 phase of the cell cycle. Thus, mutations or deletions
      of the CDKN2 gene could result in abnormal proliferation via defective cell cycle
      control. The correlation of 9p21 cytogenetic and molecular alterations with the
      clinical stages of melanoma progression suggests that dysfunction of a gene
      within this chromosomal region is critical to the evolution of melanoma. However,
      it remains unclear whether this gene is the CDKN2 gene. If so, then loss of p16
      is potentially an initiating or early event in melanoma progression. To address
      the issues of what is the potential involvement of the CDKN2 gene in sporadic
      melanoma and precisely when during the clinically evident stages of melanoma
      progression defects in CDKN2 occur, we have evaluated by immunohistochemistry the
      expression of p16 protein in 103 melanocytic lesions representing all stages in
      the progression of melanoma. Our results suggest that loss of p16 protein
      expression is (a) not necessary for tumor initiation in malignant melanoma
      because all melanomas in situ and the majority of primary invasive melanomas
      retain expression of this protein; and (b) potentially more related to
      invasiveness or the ability to metastasize, because 52% of primary invasive
      tumors and 72% of metastatic lesions show partial or complete loss of expression
      of p16.

PMID- 7796392
TI  - Evidence against dominant negative mechanisms of intestinal polyp formation by
      Apc gene mutations.
AB  - Mutations in the adenomatous polyposis coli (APC) gene are responsible for not
      only familial adenomatous polyposis but also many sporadic cancers of the
      digestive tract. Most mutations found in familial adenomatous polyposis patients
      are of the truncation type, and the phenotype is affected by the mutation sites
      in the gene. Truncated APC proteins can associate with the wild-type protein.
      Accordingly, it has been proposed that the polyposis is caused by a dominant
      negative mechanism. To test this possibility, we constructed transgenic mice that
      contained mutant minigenes. They expressed the APC protein truncated either at
      codon 716 (Apc delta 716) or 1287 (Apc delta 1287) at high levels in the
      intestinal epithelium. Contrary to our expectation, no intestinal polyps or
      tumors were found in any of such mice, even after 7 months. These results rule
      out any dominant negative mechanisms in which the truncated APC protein is
      directly involved in the formation of intestinal polyps in the mouse.

PMID- 7796394
TI  - A variant glucocorticoid receptor messenger RNA is expressed in multiple myeloma
      patients.
AB  - In multiple myeloma cells resistant to glucocorticoids, we have previously
      identified a variant glucocorticoid receptor (GR) transcript (P. A. Moalli et
      al., Cancer Res., 53: 3877-3879, 1993). Here, we report a reverse transcription
      PCR assay to assess whether this aberrant GR transcript is present in myeloma
      patients. We detected both the wild-type and variant GR transcripts in the
      patient isolate that was the source of our myeloma cell lines, in patients
      refractory to steroid treatment, and in healthy control subjects. Simultaneous
      amplification of wild-type and variant GR mRNAs indicates that the variant GR is
      more highly expressed in cells that are resistant to glucocorticoids. We
      hypothesize that the variant GR is a normal mRNA transcript that acts to modulate
      glucocorticoid responsiveness, and increased expression contributes to a
      resistant phenotype.

PMID- 7796393
TI  - Transcriptional activation of the proto-oncogene c-jun by asbestos and H2O2 is
      directly related to increased proliferation and transformation of tracheal
      epithelial cells.
AB  - Asbestos causes persistent increases in c-jun mRNA and AP-1 DNA binding activity
      in hamster tracheal epithelial (HTE) cells, the progenitor cell type of asbestos
      induced bronchogenic carcinoma. Studies here were designed to determine
      mechanisms of c-jun induction by asbestos and the phenotypic consequences of Jun
      expression in HTE cells. To examine whether asbestos or H2O2 induced
      transcription of c-jun, we transiently transfected HTE cells with a plasmid
      containing a fragment of the c-jun promoter coupled to a luciferase reporter
      gene. In addition, c-jun was overexpressed in cells using a full-length human c
      jun construct, and effects on proliferation and transformation were examined. HTE
      cells transfected with the jun-luciferase construct showed increased luciferase
      activity when exposed to crocidolite asbestos or H2O2. These results demonstrate
      that asbestos and H2O2 activate AP-1-dependent gene transcription. Overexpression
      of c-jun led to increased proliferation and enhanced ability of HTE cells to grow
      in soft agar, an indication of cellular transformation. Data suggest that
      overexpression of c-jun may contribute to asbestos and oxidant-induced
      proliferation and carcinogenesis.

PMID- 7796395
TI  - Telomerase activity in human liver tissues: comparison between chronic liver
      disease and hepatocellular carcinomas.
AB  - Telomerase activity was examined in 105 frozen samples from human normal liver
      tissues, chronic liver disease, and hepatocellular carcinoma (HCC). Telomerase
      activity was positive in 28 of 33 HCC tissues regardless of tumor stage or size.
      Telomerase was expressed in 15 of 18 differentiated HCC nodules smaller than 3
      cm. HCC tissues from all eight hepatitis B virus-positive patients were
      telomerase positive, while telomerase activity was not detected in normal liver
      tissues (0 of 4). Weak telomerase activity was only detected in 1 of 22 nontumor
      liver tissues from HCC patients. Interestingly, in 19 of 38 hepatitis tissues and
      6 of 8 cirrhotic liver tissues from apparently cancer-free patients, very weak
      telomerase activity was detected. These results indicate that the expression of
      telomerase may play a crucial role in hepatocarcinogenesis.

PMID- 7796396
TI  - Mch2, a new member of the apoptotic Ced-3/Ice cysteine protease gene family.
AB  - We have developed a PCR approach to clone new apoptotic Ced-3/Ice-like cysteine
      protease genes. This approach uses degenerate oligonucleotides encoding the
      highly conserved pentapeptides QACRG and GSWFI that are present in all known
      apoptotic cysteine proteases. Using this approach, we have cloned a novel
      apoptotic gene from human Jurkat T lymphocytes. The new gene encodes a
      approximately 34-kilodalton protein that is highly homologous to human CPP32,
      Caenorhabditis elegans cell death protein CED-3, mammalian Ich-1 (Nedd2), and
      mammalian interleukin-1 beta converting enzyme. Because of its high homology to
      the C. elegans Ced-3 gene, we named the new gene mammalian Ced-3 homologue Mch2.
      Two Mch2 transcripts (Mch2 alpha, 1.7 kb; Mch2 beta, 1.4 kb) were detected in
      Jurkat T lymphocytes and other cell lines. We believe that the Mch2 alpha
      transcript encodes the full-length Mch2, whereas the Mch2 beta transcript encodes
      a shorter Mch2 isoform, probably as a result of alternative splicing. Like
      interleukin-1 beta converting enzyme and CPP32, recombinant Mch2 alpha, but not
      Mch2 beta, possesses protease activity, as determined by its ability to cleave
      the fluorogenic peptide DEVD-AMC. CPP32 and Mch2 alpha can also cleave poly(ADP
      ribose) polymerase in vitro, suggesting that these enzymes participate in
      poly(ADP-ribose) polymerase cleavage observed during cellular apoptosis. In
      addition, overexpression of recombinant Mch2 alpha, but not Mch2 beta, induces
      apoptosis in Sf9 insect cells. Our data suggest that Mch2 is a Ced-3/interleukin
      1 beta converting enzyme-like cysteine protease and could be another important
      mediator of apoptosis in mammalian cells.

PMID- 7796397
TI  - Ovarian carcinoma-associated TaqI restriction fragment length polymorphism in
      intron G of the progesterone receptor gene is due to an Alu sequence insertion.
AB  - Alu sequences, short, repetitive transposable DNA elements, are factors in a
      number of genetic diseases. We previously identified a germline TaqI RFLP,
      located in intron G of the human progesterone receptor gene, that showed an
      association with the incidence of sporadic ovarian carcinoma. Furthermore, the
      polymorphism was characterized as a small (approximately 300-bp) insertion that
      was inherited in a Mendelian fashion. Because of its insertional character, we
      named this polymorphism PROGINS. We report the identification of PROGINS as a 306
      bp Alu element of the PV or HS-1 Alu subfamily.

PMID- 7796398
TI  - Loss of wild-type p53 bestows a growth advantage on primary cortical astrocytes
      and facilitates their in vitro transformation.
AB  - Primary cortical astrocytes were isolated from normal (+/+), heterozygous (+/-),
      or homozygous (-/-) p53-knockout mice. The normal astrocytes grew slowly and
      underwent crisis after limited division, while the homozygously defective cells
      grew rapidly and without contact inhibition. These -/- cells could not initially
      form colonies in soft agarose but acquired this capability after 10 passages in
      FCS or basic fibroblast growth factor but not epidermal growth factor. Almost all
      -/- astrocytes weakly expressed glial fibrillary acidic protein at passage 10 and
      were also A2B5+ when cultured in basic fibroblast growth factor. Most
      heterozygous cells resembled normal ones; however, some survived crisis, grew
      rapidly, and formed colonies. Outgrowing cells had all lost the wild-type p53
      allele. These molecular and cellular events mimic the early stages of human brain
      tumors, suggest a role for p53 in the earliest stages of disease progression, and
      provide an experimental system to analyze the effects of other tumor-specific
      mutations in the disease process.

PMID- 7796399
TI  - Overexpression of the focal adhesion kinase (p125FAK) in invasive human tumors.
AB  - The focal adhesion kinase (FAK) gene encodes a tyrosine kinase (p125FAK) thought
      to be involved in signal transduction pathways used in cell adhesion, motility,
      and anchorage-independent growth. Because alterations in these cellular processes
      occur in tumor invasion and metastasis, we studied the protein expression of FAK
      in a variety of human tumors and found that in the 119 samples studied, increased
      levels of p125FAK correlated with the invasive potential of a tumor. By comparing
      FAK expression in tumors with normal tissue from the same patient, we found that
      p125FAK was significantly elevated in 17 (100%) of 17 invasive and metastatic
      colonic lesions and in 22 (88%) of 25 invasive and metastatic breast tumors.
      Additional studies of FAK expression in 13 high grade sarcomas showed high levels
      in all samples compared to benign, noninvasive mesenchymal specimens.
      Furthermore, FAK protein levels were elevated in preinvasive lesions, such as
      large (> 2 cm) colonic villous adenomas, whereas noninvasive, yet hypercellular,
      neoplastic tissues such as parathyroid and hepatocellular adenomas did not
      overexpress FAK. These data provide evidence that both epithelial and mesenchymal
      tumor progression are accompanied by increased p125FAK expression and suggest
      that the level of FAK expression might be a marker for the invasive potential of
      a tumor.

PMID- 7796400
TI  - Mutations of p16Ink4/CDKN2 and p15Ink4B/MTS2 genes in biliary tract cancers.
AB  - p16Ink4 and p15Ink4B are cyclin-dependent kinase 4 inhibitors and link to the
      regulation of cell cycle in mammalian cells. The genes encoding these inhibitors
      are located at 9p21, which is a frequent site of allelic loss in various types of
      tumors. Twenty-five primary biliary tract cancers were examined for somatic
      mutations in p16Ink4/CDKN2, p15Ink4B/MTS2, p53, and K-ras genes and allelic loss
      of 9p21 by microsatellite analysis. Four biliary tract cancer cell lines were
      analyzed for homozygous deletions and point mutations. We found frequent
      homozygous deletions in p16Ink4/CDKN2 and p15Ink4B/MTS2 genes in the biliary
      tract cancer cell lines. Each cancer cell line had alteration of either
      p16Ink4/CDKN2, p15Ink4B/MTS2, or p53 genes. In primary tumors, 16 of 25 (64%)
      biliary tract cancers had point mutations in the p16Ink4/CDKN2 gene. These
      include 14 missense and 2 silent mutations. The frequency of mutations in gall
      bladder cancer and hilar bile duct cancer were 80% (8 of 10) and 63% (5 of 8),
      respectively. Each of codons 1, 80, and 111 was changed in two cases of these
      cancers. One of three intrahepatic bile duct cancers, one of two common bile duct
      cancers, and one of two ampullary cancers had mutations in the p16Ink4/CDKN2
      gene. In contrast, no mutation in the p15Ink4B/MTS2 gene, one base change in the
      K-ras gene, and one loss of heterozygosity at the IFN alpha locus in 25 cancers
      and one base change in the p53 gene in 19 cancers were observed. These results
      suggest that p16Ink4/CDKN2, rather than p15Ink4B/MTS2 or p53 genes, and its
      inactivation may be important in biliary tract carcinogenesis.

PMID- 7796402
TI  - Mucosa-preferential DNA adduct formation by 2-amino-3-methylimidazo-[4,5
      f]quinoline in the rat colonic wall.
AB  - The mechanism of mucosa-specific formation of DNA adducts, which was found
      recently in human intestines, was studied in male F344 rats treated with 2-amino
      3-methylimidazo[4,5-f]quinoline (IQ). There are three conceivable pathways for
      p.o. administered IQ to reach the target colonic mucosal cells: pathway 1,
      through the digestive canal which exposes from the lumenal direction; pathway 2,
      following enterohepatic circulation re-expose from the lumenal direction; and
      pathway 3, exposure via blood circulation. To investigate these possible
      pathways, the following surgical procedures were performed: (a) portal
      catheterization for IQ administration to eliminate pathway 1 and (b) choledochal
      catheterization for bile drainage to eliminate pathway 2. When both procedures
      are combined, only pathway 3 is active. Four types of IQ-DNA adducts were
      commonly observed in the colons of all experimental groups, with no qualitative
      difference between the mucosal and muscular layers. When IQ-HCl was administered
      by p.o. gavage at a dose of 100 mumol/kg body weight, approximately 70% of the IQ
      DNA adducts in the colonic mucosa (13.1 +/- 4.3 adducts/10(7) nucleotides) was
      induced through pathway 1. Pathway 3 induced the remaining 30% of mucosal
      adducts, producing equal adduct levels in both layers. Pathway 2 did not work for
      adduct formation. The DNA adduct formation was unaffected in the presence of
      intestinal flora, indicating that detoxified IQ does not reactivate by floral
      enzymes. In conclusion, mucosa-specific DNA adduct formation in the colon is
      caused most likely by the absorption of carcinogens through the lumen.

PMID- 7796401
TI  - Initiatives with platinum- and quinazoline-based antitumor molecules--Fourteenth
      Bruce F. Cain Memorial Award Lecture.
AB  - Carboplatin is a better-tolerated alternative to cisplatin. JM216, the first p.o.
      administrable platinum complex possesses toxicities comparable to carboplatin in
      Phase I studies. Together with the trans-platinum complex JM335, it provides new
      chemical guidelines for the development of compounds that may circumvent
      cisplatin resistance in tumors. Systematic structure-activity investigations have
      led to the discovery and development of ZD1694 (Tomudex), an inhibitor of
      thymidylate synthase that exploits both the reduced folate carrier and
      folylpolyglutamate synthetase as major determinants of its growth-inhibitory
      activity. Phase II studies have revealed encouraging activity against colon
      cancer, and Phase III studies are nearing completion. An associated structure
      activity investigation has led to the development of ZD9331, a potent thymidylate
      synthase inhibitor which exploits the reduced folate carrier for cell entry, but
      which is independent of polyglutamation for its thymidylate synthase-inhibitory
      activity. This compound possesses antitumor activity in vivo and has been
      selected for full development.

PMID- 7796403
TI  - GM2-KLH conjugate vaccine: increased immunogenicity in melanoma patients after
      administration with immunological adjuvant QS-21.
AB  - The cell surface gangliosides GM2, GD2, and GD3 are often overexpressed in
      malignant melanoma. We have shown previously that immunization of melanoma
      patients with GM2 and Bacillus Calmette-Guerin induced an IgM antibody response
      in most patients and that patients with high titer GM2 antibodies showed
      increased survival. As is commonly seen with carbohydrate antigens (which are T
      independent), the IgM response was short lived, and an IgG response was rarely
      observed. To increase immunogenicity, we conjugated GM2 covalently with keyhole
      limpet hemocyanin (KLH). GM2-KLH vaccine was given to melanoma patients alone or
      with one of the three adjuvants: Bacillus Calmette-Guerin, DETOX, or QS-21. The
      most effective vaccine was GM2-KLH with QS-21. It induced a much higher titer, a
      longer-lasting IgM GM2 antibody response, and a consistent IgG response (isotype
      IgG1 and IgG3). It also induced the highest titer anti-KLH response. The results
      suggest that the conjugate GM2-KLH plus QS-21 vaccine elicited significant T-cell
      help. Because there was no serious toxicity, this vaccine approach is attractive
      for augmenting the immunogenicity of other gangliosides, such as GD2 and GD3, and
      to determine the effects of ganglioside antibodies on the course of melanoma. In
      addition, the finding that QS-21 significantly increased the immunogenicity of
      GM2-KLH suggests that it may do the same for other conjugate vaccines, many of
      which are currently used without adjuvant.

PMID- 7796404
TI  - Glutathione S-transferase activity and glutathione S-transferase mu expression in
      subjects with risk for colorectal cancer.
AB  - The glutathione S-transferases (alpha, mu, and pi), a family of Phase II
      detoxication enzymes, play a critical role in protecting the colon mucosa by
      catalyzing the conjugation of dietary carcinogens with glutathione. We
      investigated the efficacy of using the glutathione S-transferase (GST) activity
      of blood lymphocytes and GST-mu expression as biomarkers of risk for colorectal
      cancer. GST activity was measured in the blood lymphocytes of control individuals
      (n = 67) and in the blood lymphocytes (n = 60) and colon tissue (n = 34) of
      individuals at increased risk for colon cancer. Total GST activity was determined
      spectrophotometrically with the use of 1-chloro-2,4-dinitrobenzene as a
      substrate. The ability to express the um subclass of GST was determined with the
      use of an ELISA. Although interindividual variability in the GST activity of
      blood lymphocytes was greater than 8-fold (range, 16.7-146.8 nmol/min/mg), the
      GST activity of blood lymphocytes and colon tissue within an individual was
      constant over time and was unrelated to sex, age, or race. The GST activity of
      blood lymphocytes from high-risk individuals was significantly lower than that of
      blood lymphocytes from control individuals (P < or = 0.004). No association was
      observed between the frequency of GST-mu phenotype and risk for colorectal
      cancer. Blood lymphocytes from high-risk individuals unable to express GST-mu had
      lower levels of GST activity than did those from control subjects with the GST-mu
      null phenotype; however, this difference was significant in male subjects only (P
      < or = 0.006). Analysis of paired samples of blood lymphocytes and colon tissue
      indicated a strong correlation between the GST activity of the two tissue types
      (Spearman's rank correlation, r = 0.87; P < or = 0.0001). The GST activity of
      blood lymphocytes may be used to identify high-risk individuals with decreased
      protection from this Phase II detoxication enzyme who may benefit from clinical
      trials evaluating GST modulators as chemopreventive agents for colorectal cancer.
      The GST activity of blood lymphocytes may also be used in colorectal cancer
      chemoprevention trials to monitor the responsiveness of colon tissue to regimens
      that modify Phase II detoxication enzymes.

PMID- 7796405
TI  - Tyrphostin AG17, [(3,5-Di-tert-butyl-4-hydroxybenzylidene)- malononitrile],
      inhibits cell growth by disrupting mitochondria.
AB  - [(3,5-Di-tert-butyl-4-hydroxybenzylidene)-malononitrile] (AG17), a "tyrphostin"
      tyrosine kinase antagonist, was found to inhibit tumor cell growth with 50%
      growth inhibition ranging from 0.7 to 4.0 microM in a panel of 13 human tumor
      cell lines, as evaluated by tetrazolium dye reduction and inhibition of precursor
      incorporation into macromolecules. The promyelocytic leukemia cell line HL
      60(TB), was the most sensitive with irreversible total growth inhibition after 12
      h of exposure to 1.5 microM drug. Antiproliferative effects of AG17 in HL-60(TB)
      cells were temporally related to disruption of mitochondrial function, which
      occurred within 1 h after drug exposure as demonstrated by a significantly
      decreased mass of ATP in drug-treated cells, loss of the fluorescent
      mitochondrial membrane potential probe rhodamine 123, and ultrastructural
      examination of mitochondria using fluorescence and electron microscopy. Specific
      decreases of total or tyrosine-phosphorylated substrate at concentrations of the
      drug not affecting ATP levels were not detected. These data raise the possibility
      that AG17 may act in part by altering mitochondrial function and/or structure,
      and that impairment of mitochondrial function may be exploitable as a potentially
      useful mechanism to modulate tumor cell proliferation. This study also emphasizes
      the importance of evaluating carefully the effects of potential protein kinase
      antagonists, since these structures have effects in intact cells in addition to
      what might be expected from in vitro enzyme assays.

PMID- 7796406
TI  - The interaction of hydroxyurea and iododeoxyuridine on the radiosensitivity of
      human bladder cancer cells.
AB  - Biochemical modulation of iododeoxyuridine (IdUrd) incorporation into the DNA of
      tumor cells is a potential clinical strategy to enhance radiosensitivity and to
      simultaneously differentiate the sensitivity of rapidly proliferating tumor cells
      and more slowly proliferating adjacent normal tissues to radiation. The
      interactions of hydroxyurea (HU) and IdUrd were studied in a human bladder cancer
      cell line, 647V. Exposure of exponentially growing 647V cells to HU
      concentrations of 10-100 microM for one cell population doubling (24 h) resulted
      in no cytotoxicity as assessed by clonogenic survival. Flow cytometric analysis
      showed a significant increase in an early S-phase population after a 12-h
      exposure but a return to a normal cell cycle distribution after a 24-h exposure
      to 100 microM HU. Incorporation of IdUrd into DNA was increased 2-fold by
      coincubation with HU (100 microM) and a clinically achievable concentration of
      IdUrd (2 microM) for 24 h. To elucidate the mechanism of modulation, IdUTP pools
      were compared in 647V cells treated with 2 microM IdUrd with or without 100
      microM HU. A 2-fold increase in IdUTP pools was evident within 2 h when this drug
      combination was used. With the use of multivariate statistical analysis, the
      radiosensitivity of 647V cells was compared after a 24-h exposure to various
      concentrations of IdUrd (0 and 2 microM) and HU (0, 10, and 100 microM). A 24-h
      exposure to 100 microM HU alone or to 2 microM IdUrd alone before irradiation
      resulted in significant (P < 0.02) radiosensitization with sensitizer enhancement
      ratios of 1.15 and 1.27, respectively. A 24-h exposure to 100 microM HU + 2
      microM IdUrd resulted in even more significant (P = 0.001) radiosensitization,
      which was found to be a greater than additive response (sensitizer enhancement
      ratio, 1.76 observed compared with 1.37 expected). No radiosensitization was
      found with a 12-h exposure to 100 microM HU alone. The mechanism of biochemical
      modulation of IdUrd by a noncytotoxic dose of HU is proposed as increasing the
      IdUTP pools by stimulating enzymes in the thymidine salvage pathway and
      subsequently enhancing IdUrd incorporation and radiosensitization.

PMID- 7796407
TI  - Antitumor activities of a new indolocarbazole substance, NB-506, and
      establishment of NB-506-resistant cell lines, SBC-3/NB.
AB  - The novel anticancer glucosyl derivative of indolo-carbazole (NB-506), an
      inhibitor of DNA topoisomerase I, exhibited strong in vitro cytotoxicity against
      various human cancer cell lines. In order to elucidate its cytotoxic mechanisms,
      we established nine NB-506-resistant sublines with different resistance ratios
      from human small cell lung cancer cells (SBC-3/P) by stepwise and brief exposure
      (24 h) to NB-506. Among them, SBC-3/NB#9 was 454 times more resistant to NB-506
      than the parent cell line. The SBC-3/NB#9 cells showed cross-resistance only to
      topoisomerase I inhibitors, such as 11,7-ethyl-10-[4-(1-piperidino)-1-piperidino]
      carbonyloxycamptothecia and 7-ethyl-10-hydroxy-camptothecin, and not to other
      anticancer drugs, such as vincristine, vinblastine, Adriamycin, etoposide, and
      teniposide. These results indicate that the difference on the effect of
      topoisomerase I was considered to be related to a resistance mechanism. The
      topoisomerase I activities of nuclear extracts eluted from SBC-3/NB#9 cells was
      only one-tenth of the parent cell activity. A Western blotting study indicated
      that this lower activity was due to a lower amount of DNA topoisomerase I.
      Furthermore, we found correlations between topoisomerase I activity and
      sensitivity to NB-506 in sublines with different degrees of resistance.
      Accumulation of 3H-labeled NB-506 by SBC-3/NB#9 cells was only one-fifth of that
      by the parent cells, whereas intracellular accumulation of 3H-labeled
      camptothecin by both cell lines did not differ. The reduction of accumulation was
      specific to NB-506, and this result may explain why the resistance ratio for NB
      506 was higher than those for 11,7-ethyl-10-[4-(1-piperidino)-1-piperidino]
      carbonyloxycamptothecin and 7-ethyl-10-hydroxy-camptothecin.

PMID- 7796408
TI  - Mechanism of action of the antineoplastic drug lonidamine: 31P and 13C nuclear
      magnetic resonance studies.
AB  - The mechanism of action of the antineoplastic drug lonidamine (LND) on MCF-7
      human breast cancer cells was studied with the use of 31P and 13C nuclear
      magnetic resonance (NMR) spectroscopy. The cells were embedded in alginate
      microcapsules, perfused with growth media and LND at physiological conditions in
      the NMR tube, and continuously monitored in vivo for the effects of LND. 31P NMR
      demonstrated intracellular acidification after LND perfusion concomitant with ATP
      depletion and changes in phospholipid metabolites. 13C NMR showed marked LND
      induced accumulation of lactate, and spectra of the perfusate disclosed that LND
      inhibited lactate transport. Kinetic 13C NMR also furnished information on LND
      effects on glucose metabolism; LND decreased initial glucose uptake and lactate
      formation, although the final intracellular glucose levels were higher compared
      with those in controls. Combined administration of LND and the metabolic
      inhibitor 2-deoxyglucose yielded additive but not synergistic cytotoxicity and
      enabled assessment of hexokinase activity. Overall, the results indicate that the
      major metabolic changes induced by LND are inhibition of lactate transport and
      its accumulation, which lead to intracellular acidification.

PMID- 7796410
TI  - Application of a tumor suppressor (C-CAM1)-expressing recombinant adenovirus in
      androgen-independent human prostate cancer therapy: a preclinical study.
AB  - Recently, we demonstrated that an androgen-regulated cell adhesion molecule, C
      CAM, acts as a tumor suppressor in prostate cancer development. In this study, we
      further explored the possibility of applying C-CAM as a potential agent for
      developing prostate cancer gene therapy using an adenoviral delivery system. We
      found that prostate cancer cells, in general, were sensitive to adenoviral
      infection. In vitro characterization indicated that C-CAM1 protein was detected
      only in C-CAM1 adenovirus-infected cells but not in antisense control virus
      infected cells, and the levels of expression showed dose dependency. Because of
      the stability of the protein, C-CAM expression in viral-infected cells appeared
      to be a long-lasting event, indicating that C-CAM may be superior to many other
      known tumor suppressors that have a short protein half-life. Most importantly,
      the delivery of a single dose of C-CAM adenovirus was able to repress the growth
      of PC-3-induced tumors in nude mice for at least 3 weeks. Taken together, these
      data indicate that C-CAM is a potential candidate for human prostate cancer
      therapy.

PMID- 7796409
TI  - 20-epi-vitamin D3 analogues: a novel class of potent inhibitors of proliferation
      and inducers of differentiation of human breast cancer cell lines.
AB  - We have studied the in vitro biological activities and mechanism of action of
      1,25-dihydroxyvitamin D3 (1,25D3) and four potent 1,25D3 analogues [20-epi-22oxa
      24a,26a,27a-tri-homo-1,25(OH)2D3 (KH 1060); 20-epi-1,25(OH)2D3; 1,25(OH)2-16ene
      D3; and 1,25(OH)2-16ene-23yne-D3] on proliferation and differentiation of
      estrogen receptor-negative (MDA-MB-436, BT-20, SK-BR-3, and MDA-MB-231), estrogen
      receptor-weakly positive (BT474), and estrogen receptor-positive (MCF-7) breast
      cancer cell lines. Dose-response studies showed that KH 1060 was the most potent
      analogue, because it was able to induce differentiation in all seven breast
      cancer cell lines (measured by lipid staining) and to suppress more than 50%
      clonal proliferation (ED50) at 10(-10) M in all cell lines, except MDA-MB-436 and
      BT-20. To explore how these compounds mediated antiproliferative actions, their
      effects on the cell cycle, on expression of bcl-2 and p53, and on apoptosis were
      assessed. Five of six cell lines have a mutant p53 gene, whereas MCF-7 has wild
      type p53. Immunohistochemical staining showed that the p53 protein was
      predominantly localized in the nucleus in each of the breast cancer cell lines
      except for MCF-7, which expressed the protein predominantly in the cytoplasm.
      After incubation with KH 1060 (3 days; 10(-7) M), expression of bcl-2 protein as
      determined by immunohistochemical localization was markedly decreased in BT-474,
      MCF-7, and MDA-MB-231; these same cells were profoundly inhibited in their clonal
      proliferation and arrested in the G0/G1 phase of the cell cycle when cultured
      with KH 1060. In contrast, BT-20 and MDA-MB-436 cells that were refractory to the
      antiproliferative effect of KH 1060 (ED50 < 10(-6) M) had no down-regulation of
      their bcl-2 expression and no cell cycle changes after exposure to KH 1060. MCF-7
      showed morphological changes and DNA fragmentation, indicative of apoptosis after
      48 h incubation with KH 1060 (10(-6) M), during which time p53 protein
      accumulated in the nucleus and decreased in the cytoplasm. In contrast, no
      apoptosis was detected in three other breast lines (MDA-MB-231, SK-BR-3, and BT
      474) that had a mutated p53. In conclusion, the data indicate that KH 1060 is an
      extremely potent 1,25D3 analogue inducing differentiation of all six breast
      cancer lines and potently inhibiting clonal growth of four of them with
      concomitant decreased bcl-2 and cell cycle arrest at G0/G1.(ABSTRACT TRUNCATED AT
      400 WORDS)

PMID- 7796411
TI  - Effect of the chemoprotective agent WR-2721 on disposition and biotransformations
      of ormaplatin in the Fischer 344 rat bearing a fibrosarcoma.
AB  - The effects of the phosphorothioate agent, WR-2721, have been investigated with
      respect to the biotransformations of ormaplatin in the Fischer 344 rat bearing a
      transplanted fibrosarcoma. A number of different paradigms of dosing route and
      schedule for the administration of the two agents have been investigated. In the
      first group of experiments, WR-2721 (200 mg/kg, i.p.) was administered 30 min
      before ormaplatin (12.5 mg/kg, i.p.), and then peritoneal fluid, plasma, and
      tissues were harvested at 30 min after the ormaplatin administration. Our results
      suggest that a significant interaction between WR-2721 and ormaplatin is
      occurring in the peritoneal cavity. The interaction was evident in terms of both
      effects on distribution and disposition of total platinum and in alterations of
      the profiles of biotransformation products formed in the various tissues and
      fluids. Plasma protein binding of ormaplatin was decreased by 50% in the presence
      of WR-2721. Total platinum in the spleen was decreased by 66% and in the liver by
      50%. There were no trends among the findings that would indicate any selectivity
      between tumor and nontumor tissue with respect to the effects of WR-2721 on the
      parameters measured. Subsequent investigations examined the effects of dosing the
      WR-2721 by the i.v. route while continuing with the i.p. administration of the
      ormaplatin. WR-2721 was administered either 30 or 5 min before the ormaplatin,
      and the plasma and tissues were harvested at 15, 30, or 60 min after ormaplatin
      administration. The reverse-phase HPLC peak, which behaved chromatographically as
      a Pt(dach)(WR-1065) standard, was less prominent after the i.v. administration of
      WR-2721 than it was after i.p. administration under any of the paradigms tested.
      There was again no evidence for selectivity between tumor and nontumor tissue in
      the findings from any of the paradigms. It is concluded that if WR-2721 is
      capable of selectively protecting nontumor tissue from the toxicities of platinum
      based chemotherapy, it is doing so by some mechanism other than its selective
      uptake into normal tissue and subsequent nonspecific inactivation of any reactive
      cytosolic platinum species formed. Other possible mechanisms are briefly
      discussed.

PMID- 7796412
TI  - Activity of temozolomide in the treatment of central nervous system tumor
      xenografts.
AB  - The activity of 8-carbamoyl-3-methylimidazo[5,1-d]-1,2,3,5-tetrazin- 4(3H)-one
      (temozolomide) in the treatment of a panel of xenografts derived from ependymoma,
      medulloblastoma, and childhood and adult high-grade glioma was evaluated in
      athymic nude mice bearing s.c. and intracranial tumors. Temozolomide administered
      daily for a total of five doses demonstrated marked activity against a panel of
      Mer+ xenografts despite marginal to moderate activity of 1,3-bis(2-chloroethyl)-1
      nitrosourea. The growth delays produced by temozolomide in these xenografts were
      1.8-7.5-fold greater than those produced by procarbazine. Although temozolomide
      demonstrated marginal activity against the Mer+ cell line D341 Med when a 5-day
      schedule was used, a high-dose 1-day schedule resulted in moderate activity.
      Temozolomide produced increases in median survival of 1285% (adult glioma D-54
      MG), 323% (childhood glioma D-456 MG), and 68% (ependymoma D612 EP). Pretreatment
      of mice with O6-benzylguanine increased temozolomide-induced mortality, requiring
      reduction of the dosage from 1200 to 750 mg/m2 on the single-day regimen. O6
      Benzylguanine pretreatment of mice bearing Mer+ D341 Med increased the growth
      delay of temozolomide, in duplicate experiments, from -3.1 to 4.8 and 1.1 to 4.9
      days. These studies suggest that temozolomide may be active in the treatment of a
      broad spectrum of central nervous system cancers, including Mer+ tumors resistant
      to 1,3-bis(2-chloroethyl)-1-nitrosourea.

PMID- 7796413
TI  - Improved tumor radioimmunodetection using a single-chain Fv and gamma-interferon:
      potential clinical applications for radioimmunoguided surgery and gamma scanning.
AB  - Previous studies have shown that (a) single-chain antibody binding proteins, or
      sFvs, localize experimental tumor xenografts (D.E. Milenic et al, Cancer Res.,
      51: 6363-6371, 1991) and (b) the administration of gamma-interferon (IFN-gamma)
      increases the expression of a high molecular weight glycoprotein, tumor
      associated glycoprotein 72 (TAG-72), which improves mAb-based tumor targeting as
      well as radioimmunotherapy (J. W. Greiner et al., Cancer Res., 53: 600-608,
      1993). The present experimental study was designed to determine whether
      exploiting those two observations in combination could augment tumor detection.
      Initial results revealed significant localization of a single-chain antibody
      binding protein of CC49 (i.e., CC49 sFv), a second generation anti-TAG-72 mAb, to
      human colon tumor xenografts (HT-29), which express low constitutive TAG-72
      levels. IFN-gamma treatment of mice bearing HT-29 tumors significantly increased
      TAG-72 levels in the tumor xenografts. Increased TAG-72 expression was
      accompanied by a 2-4-fold augmentation of CC49 sFv localized to the HT-29 tumors,
      measured by direct quantitation of 125I-labeled CC49 sFv tumor deposition as well
      as tumor:normal tissue ratios. Enhanced CC49 sFv tumor localization improved HT
      29 tumor visualization by external scintigraphy as well as when using a hand-held
      gamma-detecting probe to discriminate between normal (i.e., heart, hind leg) and
      tumor tissue. The gamma-detecting probe was the same as that used
      intraoperatively with 125I-labeled CC49 IgG to identify occult tumors in
      patients. The present experimental findings indicate that the efficiency by which
      125I-labeled CC49 sFv localizes tumor in vivo can be enhanced with IFN-gamma.
      Results of the present study suggest that (a) the incorporation of an IFN-gamma
      treatment schema prior to radioimmunscintigraphy may increase the signal from the
      tumor site(s), thus providing a better discrimination between tumor and
      background, and (b) combining 125I-labeled CC49 sFv with IFN-gamma will not only
      reduce the time interval between antibody injection and surgery, but will also
      increase the efficiency of tumor localization using the intraoperative gamma
      detecting probe.

PMID- 7796414
TI  - Somatic mutations detected by mini- and microsatellite DNA markers reveal clonal
      intratumor heterogeneity in gastrointestinal cancers.
AB  - We investigated clonal intratumor heterogeneity by comparing different areas of
      each tumor in 20 gastrointestinal cancers from female patients (1 esophageal
      cancer, 5 stomach cancers, and 14 colorectal cancers). In all 19 cases
      informative for X-inactivation analysis with the M27 beta and/or the
      phosphoglycerate kinase probes, the tumors were clonal. Separate areas from a
      given tumor showed identical X-inactivation patterns, providing evidence for its
      single-cell origin. Of 20 cancers, 11 showed p53 gene mutations (base pair
      insertions, point mutations, and one case of a base pair deletion) in exons 5-8.
      A particular p53 gene mutation was identical in all tumor areas investigated per
      case. The minisatellite probes detected loss of heterozygosity or new mutant
      alleles at 1p33, 1q21, 5q35, 17p13, or 18q21. In seven cases mutations at
      particular loci were restricted to one or two areas per tumor, while in another
      seven cases they were common to all tumor areas. Loss of heterozygosity or new
      alleles detected at the microsatellite loci D2S123, D3S1611, D5S107, D17S261, or
      D18S34 [(CA)n repeats] were common to all tumor areas in 7 of 19 cases. In
      another seven cases, however, microsatellite mutations at these loci were
      restricted to one to three areas per tumor. Tracing clonal intratumor
      heterogeneity would permit one to study the hierarchy of mutational events in
      cancers where no premalignant lesions can be harvested. Most important, our study
      indicates that clonal intratumor heterogeneity might lead to sampling errors in
      the molecular diagnosis of cancer biopsy specimens when using mini- or
      microsatellite markers.

PMID- 7796415
TI  - Loss of heterozygosity of tumor suppressor genes in testis cancer.
AB  - Little is known of the molecular changes that occur in germ cell tumors (GCT) of
      the testis. We studied three GCT cell lines and 44 tumors for loss of
      heterozygosity (LOH) of the tumor suppressor genes APC, MCC, DCC, RB, TP53, and
      WT-1. We observed that LOH occurred in 55% (21 of 38) of informative cases at
      DCC, in 28% (10 of 36) of informative cases at APC, in 23% (6 of 26) at MCC, in
      30% (13 of 43) at RB, and in 27% (6 of 22) at WT-1. The LOH level in these tumors
      using anonymous primers mapping to the short and long arms of chromosome 19,
      which is cytogenetically normal in GCT, revealed LOH of 11 and 5%, respectively.
      We also observed a LOH of 22% in the TP53 gene, despite the fact that mutations
      in TP53 do not occur in testis cancer. Since a high frequency of LOH at DCC
      (18q21.3) occurs equally at all histological subsets in GCT, we conclude that the
      loss of the function of this gene is an early event in testicular GCTs. However,
      the observed LOH levels at APC/MCC (5q21), RB (13q14), and WT-1 (11p13) could
      represent a functional loss of the corresponding tumor suppressor gene in some
      GCTs or reflect the loss of sequences in the same general chromosome region but
      involving a different tumor suppressor locus. Therefore, detailed mapping of
      these chromosomes is required to define the precise locations of maximal LOH in
      testis cancer.

PMID- 7796416
TI  - Frequent detection of bcl-2/JH translocations in human blood and organ samples by
      a quantitative polymerase chain reaction assay.
AB  - Using an ultrasensitive assay involving the PCR, we have examined the frequency
      of a follicular lymphoma-associated translocation in peripheral blood from 132
      individuals, most of whom were healthy blood donors. This translocation occurs
      between the bcl-2 proto-oncogene and the JH gene region and prolongs the life of
      lymphocytes. At a level of sensitivity of 1 translocation-bearing cell per 5 x
      10(6) cells, almost one-half of healthy human adults had this translocation in
      the mononuclear fraction of peripheral blood. However, the range of frequency of
      these translocations spanned almost three orders of magnitude among translocation
      positive individuals. Furthermore, there was a statistically significant increase
      with age in the percentage of individuals who were translocation positive. Such
      an age correlation was also seen for the percentage of blood donors with rather
      high translocation frequencies (> or = 20 per 5 x 10(6) peripheral blood
      mononuclear cells). However, the blood donor who had by far the highest
      concentration of this translocation was a healthy 35-year-old male containing
      approximately 900 apparently monoclonal, translocation-bearing cells per 5 x
      10(6) peripheral blood mononuclear cells. Our findings suggest that some
      individuals who may be at risk for follicular lymphoma might be able to be
      identified by this PCR assay on peripheral blood. Also, these data may help
      explain the age dependence of the occurrence of this cancer.

PMID- 7796417
TI  - Chromosome 9p allelic loss and p16/CDKN2 in breast cancer and evidence of p16
      inactivation in immortal breast epithelial cells.
AB  - To define the extent of involvement of chromosome 9p in breast carcinogenesis, we
      performed microsatellite length polymorphism analysis of markers spanning this
      region. Of 24 primary breast carcinomas analyzed, we observed a high frequency
      (58%) of loss of heterozygosity or allelic imbalance affecting subregion 9p21-22.
      Mutational analysis of CDKN2 (p16) was performed to determine whether this gene
      was the target of such alterations. Of 21 tumors analyzed, only 1 showed a
      mutation of probable consequence, suggesting that CDKN2 appears not to be the
      target of loss of heterozygosity and indicating the possible existence of another
      tumor suppressor gene within this region. Additionally, since it has been
      suggested that some CDKN2 deletions and mutations could be due to an in vitro
      phenomenon, four immortal breast cell lines derived from normal epithelium,
      MCF10F, MCF12F, 184A1, and 184B5, were examined for loss or mutation of CDKN2.
      Two lines (MCF10F and MCF12F) showed homozygous deletions of CDKN2, and one
      (184A1) revealed a hemizygous deletion and a nonsense mutation in the remaining
      allele. This could imply an important role of CDKN2 in the control of
      immortalization or in vitro adaptation and is the first evidence of such in
      nontumor-derived cell lines. Additionally, this is the first report of frequent
      loss of heterozygosity in the 9p21-22 chromosome subregion of uncultured primary
      breast tumors.

PMID- 7796418
TI  - A screening method to identify genes commonly overexpressed in carcinomas and the
      identification of a novel complementary DNA sequence.
AB  - We describe a differential screening method for cDNA libraries which used a
      combination of subtracted and PCR-amplified cDNA probes, and which can be applied
      to the selection of genes expressed in multiple tissues. This technique was used
      to identify genes commonly overexpressed in breast and basal cell carcinomas.
      These represent stromally dependent, invasive tumors with and without metastatic
      capacity. Thus, this screening sought to identify genes involved in the early
      stages of tumor progression. We identified a total of 16 genes, including c-erbB
      2 and tissue inhibitor of metalloproteinases 3 whose products have been
      implicated in tumorigenesis or invasion. We also identified a novel sequence
      (D52) showing little homology with others described in any species, which maps to
      the human chromosomal band 8q21. In situ RNA hybridizations of breast carcinoma
      sections indicated that the D52 gene was expressed in cancer cells, whereas other
      genes identified in the differential screening were expressed in fibroblastic or
      inflammatory cells within the tumor stroma. Thus, the procedure developed in this
      study selected genes expressed in a diversity of cell types, indicating its
      potential usefulness in other systems.

PMID- 7796419
TI  - Seven megabase yeast artificial chromosome contig at region 11p15: identification
      of a yeast artificial chromosome spanning the breakpoint of a chromosomal
      translocation found in a case of Beckwith-Wiedemann syndrome.
AB  - Genetic alterations of chromosome region 11p15 have been detected in neoplastic
      diseases as well as in cancer-predisposing syndromes. The cloning of the entire
      chromosomal region will be important for the identification and characterization
      of critical tumor suppressor genes. We have developed a yeast artificial
      chromosome contig that covers up to 7 Mb of this chromosome band. The most
      centromeric marker included in the contig is D11S932 and the most telomeric is
      D11S470. We have developed 18 new STS markers, which have been located in the
      contig in relation to 16 known markers. One of the yeast artificial chromosome
      clones was found to span the chromosome 11 breakpoint of the translocation
      t(11;18), associated with a case of Beckwith-Wiedemann syndrome. Cloning the
      regions in proximity to this translocation might reveal the presence of a gene
      altered in association with the development of Beckwith-Wiedemann syndrome.

PMID- 7796422
TI  - Symposium on advanced treatment options for the failing left ventricle. New
      Haven, Connecticut, June 10-11, 1994.

PMID- 7796421
TI  - Cyclic AMP-regulated synthesis of the tissue inhibitors of metalloproteinases
      suppresses the invasive potential of the human fibrosarcoma cell line HT1080.
AB  - Tissue inhibitors of metalloproteinases (TIMPs) play an important role in
      regulating the activity of matrix metalloproteinases (MMPs). Tumor cell invasion
      and metastasis closely correlate with the activities of two members of MMPs, MMP2
      and MMP9, both of which degrade type IV collagen in basement membranes. We herein
      report that the treatment of HT1080 cells with 8-bromo-cAMP and other chemicals
      that activate cyclic adenylase activity induces the expression of TIMP1 and TIMP2
      both at the mRNA and the protein levels and that this induction of TIMPs
      correlates with suppression of invasive phenotypes of HT1080 cells. Treatment
      with various cAMP-elevating reagents induced the expression of TIMPs and MMP2 in
      HT1080 cells, whereas the expression of MMP9 was not significantly affected. The
      protein amounts of TIMP1, TIMP2, and MMP2 secreted into the medium from HT1080
      cells treated with 1 mM 8-bromo-cAMP were 7.9-, 9.3-, and 8.5-fold higher than
      those secreted from untreated cells, respectively. Induction of these mRNAs by 8
      bromo-cAMP was blocked by HA1004, a protein kinase A inhibitor, but not by
      calphostin C, a protein kinase C inhibitor. Cycloheximide abolished the induction
      of TIMPs and MMP2 mRNAs by 8-bromo-cAMP, indicating that the induction depends on
      a newly synthesized protein(s) whose expression may be regulated by cAMP. Type IV
      collagenolytic activity and the invasiveness of HT1080 cells, both of which were
      suppressed by 8-bromo-cAMP, were efficiently restored when the cells were exposed
      to anti-TIMP antibodies, demonstrating the importance of the increased levels of
      TIMP1 and TIMP2 proteins for the cAMP-mediated suppression of both type IV
      collagenolytic activity and the invasiveness of HT1080 cells.

PMID- 7796420
TI  - Topological control of p21WAF1/CIP1 expression in normal and neoplastic tissues.
AB  - The p53-regulated gene product p21WAF1/CIP1 is the prototype of a family of small
      proteins that negatively regulate the cell cycle. To learn more about
      p21WAF1/CIP1 regulation in vivo, monoclonal antibodies were developed for
      immunohistochemistry. These revealed that p21WAF1/CIP1 expression followed
      radiation-induced DNA damage in human skin in a pattern consistent with its
      regulation by p53. A detailed comparison of the human, rat, and mouse
      p21WAF1/CIP1 promoter sequences revealed that this induction was probably
      mediated by conserved p53-binding sites upstream of the transcription start site.
      In unirradiated tissues, p21WAF1/CIP1 expression was apparently independent of
      p53 and was observed in a variety of cell types. Moreover, there was a striking
      compartmentalization of p21WAF1/CIP1 expression throughout the gastrointestinal
      tract that correlated with proliferation rather than differentiation. As
      epithelial cells migrated up the crypts, the Ki67-expressing proliferating
      compartment near the crypt base ended abruptly, with the coincident appearance of
      a nonproliferating compartment expressing p21WAF1/CIP1. In colonic neoplasms,
      this distinct compartmentalization was largely abrogated. Cell cycle inhibitors
      are thus subject to precise topological control, and escape from this regulation
      may be a critical feature of neoplastic transformation.

PMID- 7796423
TI  - Advanced treatment options for the failing left ventricle. Introduction.

PMID- 7796424
TI  - New frontiers in heart transplantation. Clinical applications of basic research
      and new surgical approaches.
AB  - The growing understanding of alloimmune responses may help elucidate the
      mechanisms a novel immunomodulatory strategies, affording insights into new
      single or combination regimens. These insights are currently elusive because of
      the number of immuno-suppressive agents and techniques, the array of possible
      organ transplants, and the variety of experimental in vitro and in vivo models in
      diverse species. These possibilities add a bewildering level of complexity to the
      usual therapeutic problems of selecting drug doses, vehicles, routes, and
      schedules of administration. Although the results of in vitro assays have been
      used as indices of alloreactivity, they show only inconsistent correlations with
      clinical events. Only stringently controlled in vivo studies in rodents, large
      animals models, and humans will determine which agents or procedures represent
      real improvements over conventional therapy. The results of preclinical
      transplantation models and initial clinical trials suggest that immunosuppression
      for transplant patients is likely to evolve into various combination regimens. It
      appears now that there will be a choice between cyclosporine and FK506 as
      baseline immunosuppression because clinical experience has shown that these two
      drugs cause excessive nephrotoxicity when used in combination. Ideally the
      combination of additional new agents will enable the doses of cyclosporine and
      FK506 to be lowered to levels that are nonnephrotoxic and at the same time
      minimize or completely eliminate the need for corticosteroids and anti-T cell
      antibody therapy. The diverse mechanisms of immunosuppressive action of the new
      drugs under investigation certainly offer the hope for creative and effective
      strategies for the control of many forms of graft rejection in the near
      future.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796425
TI  - Permanent mechanical replacement of the left ventricle.
AB  - Patients with congestive heart failure have a poor prognosis and their care is
      expensive. Treatment with the HeartMate left ventricular assist device (Thermo
      Cardiosystems Inc, Woburn, MA) has indicated that life for such patients can be
      prolonged, quality of life increased, and cost of care decreased. Although
      currently approved only as a bridge to transplantation, the HeartMate and other
      such devices may one day offer permanent support of the left ventricle as an
      alternative to cardiac transplantation.

PMID- 7796426
TI  - Dynamic cardiomyoplasty.
AB  - Dynamic cardiomyoplasty is a promising new technique that appears to effect
      symptomatic improvement in patients with NYHA class III heart failure. Objective
      improvement in systolic performance of the left ventricle appears small but
      remains to be further defined. No survival advantage has yet been realized,
      although this may be seen as the technique is further refined and operative risk
      curtailed. Mechanism of action may include a girdling effect that prevents
      progressive left ventricular dilatation. This effect may be independent of any
      role in augmenting systolic performance. Randomized clinical trials currently in
      progress will provide definitive answers within the next few years to these
      important questions.

PMID- 7796427
TI  - Skeletal muscle for cardiac assist.
AB  - Although current efforts at cardiomyoplasty have not produced the anticipated
      clear-cut benefits in cardiac function, replicable improvements in subjective
      function have resulted. Efforts at optimizing conditioning protocols, skeletal
      muscle strength, and timing of skeletal muscle assist devices should provide
      further improvements in cardiomyoplasty. Further work with alternative ways of
      configuring skeletal muscle for cardiac assist is extremely promising. SMVs, in
      particular, offer potential to augment cardiac function directly or indirectly
      powering pumps. Work in all these areas is in early stages, but the future is
      bright.

PMID- 7796428
TI  - Symposium on advanced treatment options for the failing left ventricle.
      Synthesis. Guidelines for selection among treatment options.

PMID- 7796429
TI  - New medical therapies for advanced left ventricular dysfunction.
AB  - The analysis of currently used therapeutic targets provides considerable input in
      the choice of current and future therapies for dilated cardiomyopathy and
      congestive heart failure. Of the ion flux agents, a definitive answer concerning
      digoxin will soon be available. Currently, digoxin is likely of benefit to
      patients with persistent heart failure and significantly enlarged hearts despite
      therapy with preload and afterload reducing agents. Most currently available
      calcium channel blocking agents do not appear to be effective, although newer
      agents such as amlodipine and felodipine have yet to be adequately tested.
      Vesnarinone, which operates through the sodium and potassium rectifying channels
      and has limited phosphodiesterase inhibition, appears to provide a significant
      improvement in mortality and in symptoms. Part of the latter effect may be due to
      its anticytokine properties, which are currently being investigated. Analysis of
      vascular endothelial agents indicate that not all of the vasoactive agents
      improve survival, as demonstrated with prazosin and flosequinan. The dose of
      agents may be important, again demonstrating that less is better. Finally, those
      with additional effects, such as inositol triphosphate stimulation, may offer
      additional unique properties that may, in the future, provide benefit.
      Phosphodiesterase inhibitors are potentially beneficial in the short term but
      clearly should be avoided for long-term use. Lower doses of these agents are now
      being investigated, but the weight of evidence is against agents that operate
      primarily through phosphodiesterase inhibition. Renin angiotensin agents are the
      most efficacious of therapies available at this time. New angiotensin converting
      enzyme inhibitors are likely to add little to what is already known.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7796430
TI  - CABG in advanced left ventricular dysfunction.
AB  - Concurrent, independent clinical series at Yale University and the University of
      Virginia demonstrate an important role for CABG in patients with advanced
      ischemic cardiomyopathy. It is found that CABG can be performed safely in these
      patients, both angina and congestive heart failure states improve, ejection
      fraction increases substantially, and good long-term longevity is achieved.
      Despite prior concerns, the internal mammary conduit can be used safely in these
      patients. It appears that CABG serves to protect viable noninfarcted muscle and
      to recruit hibernating ischemic muscle. CABG is suggested as an alternative to
      heart transplantation in this patient group.

PMID- 7796432
TI  - Medical therapy and prognosis in chronic heart failure. Lessons from clinical
      trials.
AB  - The past two decades have witnessed tremendous advances in the pharmacologic
      therapy of patients with left ventricular dysfunction and chronic heart failure.
      The pharmacologic repertoire has been and continues to be expanded with newer
      agents carefully subjected to the rigor of well-designed clinical trials.
      Treatment has consequently evolved from pathophysiologically guided therapy
      predicated on older concepts to evidence-guided therapy supported by results of
      major clinical trials that continue to expand the understanding of the
      pathophysiology of this complex syndrome. The goals of therapy have ambitiously
      evolved from the immediate symptomatic relief offered by diuretics; to the short
      term hemodynamic improvement in the circulation produced by direct vasodilators;
      to the intermediate-term improvement in functional capacity and exercise
      tolerance associated with vasodilators, nitrates, and digoxin; and to the final
      frontier of long-term improvement in morbidity and survival associated with ACE
      inhibitor therapy. In addition to the expansion of the understanding of the
      epidemiology, natural history, and pathophysiology of chronic heart failure,
      several important lessons in clinical pharmacology have been learned from the
      clinical trials of the last decade. Many other questions, however, remain
      unanswered. The role of diuretics, although uncontested in the acute
      stabilization of congested patients, has yet to be rigorously evaluated in stable
      patients with chronic left ventricular dysfunction on ACE inhibitors. The long
      term effects of nitrates on morbidity and mortality have not yet been established
      in patients with either ischemic or nonischemic ventricular dysfunction.
      Vasodilators as a class, and perhaps because they are not a homogeneous class,
      have had a mixture of successes and failures. There is no evidence that pure
      vasodilation in and by itself improves survival. There is ample evidence,
      however, that it improves the circulation and consequently the response to
      diuretics. This improvement may translate into intermediate-term improvement in
      functional capacity, but this benefit is seldom sustained. Hemodynamic
      improvement in the circulation may not always translate into longer-term
      improvement in morbidity and reduction in mortality. The syndrome of chronic
      heart failure from systolic left ventricular dysfunction has emerged as a disease
      of mechanical dysfunction and maladaptation. The maladaptation is a consequence
      of deleterious effects of compensatory neurohormonal mechanisms: the sympathetic
      nervous system, renin-angiotensin-aldosterone system, arginine vasopressin, and
      most likely a host of other mechanisms. The degree of activation of these
      mechanisms has been established as a marker of prognosis, and the effects of
      pharmacologic agents on these mechanisms may well determine their long-term
      effect.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7796431
TI  - Nuclear imaging techniques for the assessment of myocardial viability.
AB  - Regional and global left ventricular dysfunction caused by coronary artery
      disease may be reversible in a significant proportion of cases. This fact has
      important clinical implications. Apart from symptoms of angina and angiographic
      severity of coronary artery disease, potential for an improvement in left
      ventricular dysfunction should be taken into account when considering
      revascularization for the management of patients with coronary artery disease.
      Because left ventricular function is an important determinant of long-term
      prognosis in patients with coronary artery disease, identification and
      appropriate treatment of reversible left ventricular dysfunction may improve
      prognosis in many patients with significant left ventricular dysfunction. Table 1
      describes the impact of myocardial viability in relation to the clinical
      objectives in various groups of patients with coronary artery disease. The choice
      of the optimal technique for the detection of myocardial viability is a matter of
      ongoing debate. There is no consensus in the literature for an optimal
      investigative approach to predict an improvement in left ventricular function
      following revascularization. Most of the studies in this field are based on small
      numbers of patients. Further studies in larger patient populations are needed.
      This debate is further complicated by the fact that none of the available
      technologies provides a quantitative estimate of viable myocardium or the extent
      of improvement that can be expected following revascularization. Currently the
      choice of technique depends on the clinical question to be answered, the local
      availability of the technique, and local expertise. Obviously, cost
      considerations may also play an important role in choice of technique. In
      patients with chronic stable coronary artery disease in whom reversibility of
      stress-induced perfusion abnormalities is the question, stress-redistribution
      rest Tl-201 imaging may be the preferred modality. In patients with congestive
      heart failure, in whom reversibility of left ventricular function is the issue,
      PET imaging or rest Tl-201 imaging may provide the appropriate answer. In post
      infarction patients, choice of test may depend on whether detection of residual
      ischemia or stunned myocardium is the issue.

PMID- 7796433
TI  - Left ventricular aneurysmectomy in advanced left ventricular dysfunction.
AB  - Despite widespread application in clinical practice and extensive laboratory
      investigations, many basic issues regarding left ventricular aneurysmectomy
      remain to be resolved. Analysis of clinical data from the authors' three centers
      and application of powerful modern imaging techniques provide important
      information to resolve these issues.

PMID- 7796434
TI  - Valve replacement for regurgitant lesions of the aortic or mitral valve in
      advanced left ventricular dysfunction.
AB  - Patients with aortic regurgitation and severe left ventricular dysfunction remain
      candidates for aortic valve replacement, as long as the risks of late left
      ventricular dysfunction and congestive heart failure have been fully discussed
      with the patient, the patient's family, and the referring physician. In contrast,
      patients with mitral regurgitation and severe systolic dysfunction are at
      considerable risk of more severe left ventricular dysfunction after operation,
      especially if mitral valve repair or chordal-sparing procedure cannot be
      performed. In patients who are candidates for such procedures that preserve the
      integrity of the subvalvular mitral apparatus, operation may be successful in
      selected patients despite moderate-to-severe depression of systolic function.
      Prognosis is guarded to poor in patients with regurgitant valvular lesions and
      advanced left ventricular dysfunction, and the emerging alternative treatments
      discussed in other articles in this Cardiology Clinics deserve consideration in
      these patients.

PMID- 7796435
TI  - Ventricular arrhythmias in heart failure.
AB  - The management of ventricular arrhythmias in patients with heart failure
      continues to pose many challenges. Three principles of therapy can be identified:
      (1) Empiric therapy is not warranted for asymptomatic ventricular arrhythmias.
      (2) Therapy for asymptomatic ventricular arrhythmias must be individualized.
      Appropriate management of the underlying cardiac disease is critical, and careful
      identification of therapeutic goals is necessary. (3) Patients at high risk
      should be included in prospective, controlled clinical trials whenever possible.

PMID- 7796436
TI  - Candidate selection for heart transplantation.
AB  - The number of patients referred for heart transplantation continues to increase
      at a rate well beyond the number of available donors. Further attempts to expand
      the donor pool may be difficult and certainly cannot keep pace with the increased
      demand. Uniform criteria for candidate selection are critically needed.
      Significant functional impairment of cardiac origin, as demonstrated by oxygen
      consumption treadmill testing on maximal medical therapy, should be documented in
      all patients before considering definitive evaluation for heart transplant.
      Patients whose peak oxygen consumption is less than 50% of predicted should be
      seriously considered for transplantation. Similarly, those patients whose peak
      VO2 is greater than 60% of predicted probably do not warrant listing as
      transplant candidates in the absence of other significant risk factors, such as
      malignant ventricular arrhythmias unresponsive to drug therapy or ongoing
      ischemia not suitable for revascularization. Application of these fairly simple
      but definitive guidelines should help significantly reduce the number of patients
      on the transplant waiting list and allow patients with the greatest survival
      benefit to receive a graft in a much shorter period of time.

PMID- 7796437
TI  - Subcellular features of calcium signalling in heart muscle: what do we learn?

PMID- 7796438
TI  - Snakes and seaweed: a case of the swollen organ.

PMID- 7796439
TI  - Left atrial mechanical and biochemical adaptation to pacing induced heart
      failure.
AB  - OBJECTIVE: To determine the left atrial mechanical and biochemical adaptations to
      congestive heart failure, 10 dogs with rapid atrial and ventricular pacing and
      seven control dogs were studied. METHODS: Animals were instrumented with left
      atrial sonomicrometers and micromanometers and left atrial pressure-volume
      relationships were generated by phenylephrine boluses for maximum elastance
      (Emax) and end systolic elastance (Ees) calculations. Left atrial maximum volume,
      ejection fraction, and mean circumferential fibre shortening (Vcf) were compared
      at matched left atrial pressure. At necropsy, myosin heavy chain (MHC) isoforms
      from the left atrial body and appendage were separated with SDS-PAGE, stained
      with monoclonal antibodies to alpha and beta MHC, and quantified with laser
      densitometry. RESULTS: Left atrial ejection fraction and Vcf were significantly
      lower and maximum atrial volume and atrial systolic stroke volume were
      significantly greater in heart failure than in control. Emax was not
      significantly altered in heart failure, at 5.9(SD 2.9) v 4.5(1.6) mm Hg.ml-1 in
      controls. However, Vcf was lower (P < 0.05) and the A loop pressure-volume area
      (an index of eternal mechanical work performed by the left atrium) was greater (P
      < 0.05) in heart failure than in control dogs. The percent beta MHC in the left
      atrial body was greater in dogs with heart failure than in controls, at 42.6(9.8)
      v 17.3(9.0)%, P < 0.05. By contrast there was no significant beta MHC isoform
      switch in the left atrial appendage [14.4(7.6) v 17.9(9.7)%]. CONCLUSIONS: In
      this model of left atrial pressure and volume overload, there is significant
      upregulation of beta MHC in the left atrial body but not in the appendage and
      this isoform switch is associated with decreased velocity of left atrial
      contraction, increased atrial mechanical work, and unchanged force generation.

PMID- 7796440
TI  - Comparison of twitch force and calcium handling in papillary muscles from right
      ventricular pressure overload hypertrophy in weanling and juvenile ferrets.
AB  - OBJECTIVE: The aim was to compare differences in peak twitch force occurring
      despite similar degrees of right ventricular hypertrophy in ferrets with
      pulmonary artery banding at either weanling or juvenile age. METHODS: After
      inducing pressure overload hypertrophy by banding the pulmonary artery of
      weanling and juvenile age ferrets, mechanical function (that is, isometric twitch
      force and passive stiffness), intracellular [Ca2+] using the calcium indicator
      aequorin, markers of myocardial energy supply, and quantified connective tissue
      content were studied. RESULTS: It was previously found that there was a reduced
      peak isometric twitch force despite normal [Ca2+]i in juvenile banded ferrets age
      10-12 weeks with right ventricular pressure overload hypertrophy (POHj). In the
      present study we report findings in banded weanling ferrets (POHw) age 7 weeks.
      POHw animals showed a similar degree of hypertrophy to that found in the POHj.
      However, there was a greater peak twitch force in hypertrophied muscles at higher
      [Ca2+]o. There was no difference in peak [Ca2+]i: -3.1(SEM 0.1) v -3.1(0.3) (log
      fractional luminescence) at 16 mM [Ca2+]o for control and POHw, respectively.
      Connective tissue content for control animals was 10(1)% versus 10(2)% in POHw.
      Despite a lack of quantitative change in connective tissue content or resting
      [Ca2+]i in POHw, passive stiffness in papillary muscles was increased.
      Retrospective analysis of tissue from POHj revealed a connective tissue content
      of 24(6.8)% (P << 0.001). Thus the decreased peak twitch force reported in POHj
      might in part be due to an increase in fibrous connective tissue. In this study,
      lactate dehydrogenase was significantly higher (38%) in POHw animals. In
      contradistinction, total creatine kinase activity and total creatine content were
      significantly less (22%) in hearts from POHj animals, indicating differences in
      myocyte remodelling despite similar degrees and durations of hypertrophy.
      CONCLUSIONS: Comparison of POHw and POHj showed that, when there is restructuring
      of the extracellular space in terms of increased fibrosis, there is also
      molecular remodelling in the myocyte, as demonstrated by a decrease in the
      creatine kinase system.

PMID- 7796441
TI  - Effects of nicorandil and glyceryl trinitrate on infarct size, adenosine release,
      and neutrophil infiltration in the dog.
AB  - OBJECTIVE: The major aim of this study was to determine if nicorandil, a
      potassium channel opener nitrate, produces a reduction in myocardial infarct size
      at a non-hypotensive dose in dogs and to determine if this effect is the result
      of an increase in adenosine release or reduction in neutrophil infiltration into
      the ischaemic area. Glyceryl trinitrate was used for purposes of comparison.
      METHODS: Barbitone anaesthetised dogs were subjected to 60 min of left anterior
      descending coronary artery occlusion followed by 3 h of reperfusion. Nicorandil
      (100 microgram.kg-1 bolus followed by a 10 microgram.kg-1.min-1 infusion; NC/pre
      group), glyceryl trinitrate (10 microgram.kg-1 bolus followed by a 1 microgram.kg
      1.min-1 infusion; GTN/pre group), or an equivalent volume of saline (control
      group) were given intravenously 15 min before occlusion and continued to the time
      of reperfusion. In two other groups, nicorandil (NC/post group) or glyceryl
      trinitrate (GTN/post group) were given 10 min before reperfusion and continued
      until the end of the experiment. To measure the release of adenosine from the
      ischaemic region, coronary venous blood samples were collected before occlusion,
      during occlusion, and at various times following reperfusion. Myocardial infarct
      size was determined by triphenyltetrazolium chloride and transmural myocardial
      blood flow by radioactive microspheres. Transmural myeloperoxidase activity, an
      index of neutrophil infiltration, was measured in biopsies obtained from the area
      at risk. RESULTS: Pretreatment with nicorandil and glyceryl trinitrate caused a
      marked reduction in myocardial infarct size expressed as percent of the area at
      risk [NC/pre group, 7.8(SEM 1.6)%; GTN/pre group, 11.9(2.3)%; control group,
      31.0(5.6)%]. When nicorandil and glyceryl trinitrate were given before
      reperfusion, both drugs still produced a significant reduction in infarct size
      [NC/post group, 13.8(2.0)%; GTN/post group, 18.9(4.3)%]. Coronary venous
      adenosine concentrations during reperfusion were significantly lower in both
      nicorandil and glyceryl trinitrate pretreated groups, but not in the post-treated
      groups. Transmural myeloperoxidase activity was significantly lower in both
      nicorandil treated groups. CONCLUSIONS: Pretreatment with a non-hypotensive dose
      of nicorandil or glyceryl trinitrate markedly reduces myocardial infarct size and
      adenosine release from the ischaemic-reperfused area. These agents were also
      effective, but to a lesser degree, when given just before reperfusion. The
      cardioprotective actions of nicorandil appear to be related not only to its
      potassium channel opening activity but also in part to its nitrate activity.

PMID- 7796442
TI  - Identification of a new noradrenaline induced gene in the rat heart by
      differential mRNA display.
AB  - OBJECTIVE: Noradrenaline treatment of animals results in postnatal hypertrophy of
      the heart. This process requires many qualitative and quantitative changes in
      gene expression; however, the identities of the key regulatory genes which
      modulate the process are not known. The aim of this study was to investigate
      whether a recently developed technique, differential display, could provide a new
      route to the identification and characterisation of these critical genes.
      METHODS: The technique of differential display was modified for use on cardiac
      RNA samples and the expression of clones identified by this approach was
      characterised by northern analysis. RESULTS: Differential display was
      successfully adapted to the study of noradrenaline induced cardiac gene
      expression. A previously unsuspected gene was identified, the expression of which
      appears to be strongly modified during the onset of this process. CONCLUSIONS:
      Differential display offers the potential to identify and clone many of the genes
      critically important in regulation of growth of the mammalian heart.

PMID- 7796444
TI  - Digoxin affects potassium homeostasis during exercise in patients with heart
      failure.
AB  - OBJECTIVE: The aim was to evaluate whether digitalisation of heart failure
      patients affects extrarenal potassium handling during and following exercise, and
      to assess digoxin receptor occupancy in human skeletal muscle in vivo. METHODS:
      In a paired study of before versus after digitalisation, 10 patients with
      congestive heart failure underwent identical exercise sessions consisting of
      three bouts of increasing work rates, 41-93 W, on a cycle ergometer. The final
      bouts were followed by exercise to exhaustion. The femoral vessels and brachial
      artery were catheterised. Arterial blood pressure, heart rate, leg blood flow,
      cardiac output, plasma potassium, haemoglobin, pH, and skeletal muscle receptor
      occupancy with digoxin in biopsies were determined. RESULTS: Occupancy of
      skeletal muscle Na/K-ATPase with digoxin was 9% (P < 0.05). Following
      digitalisation femoral venous plasma potassium increased by 0.2-0.3 mmol.litre-1
      (P < 0.05) at work rates of 69 W, 93 W, and at exhaustion, as well as during the
      first 3 min of recovery. Following digitalisation the femoral venoarterial
      difference in plasma potassium increased by 50-100% (P < 0.05) during exercise,
      and decreased by 66-75% (P < 0.05) during early recovery. Total loss of potassium
      from the leg increased by 138%. The effects of digitalisation on plasma potassium
      were not the outcome of changes in haemodynamics, because cardiac output and leg
      blood flow increased by up to 13% and 19% (P < 0.05), nor was it the outcome of
      changes in haemoconcentration or pH. CONCLUSIONS: Extrarenal potassium handling
      is altered as a result of digoxin treatment. This is likely to reflect a reduced
      capacity of skeletal muscle Na/K-ATPase for active potassium uptake because of
      inhibition by digoxin, adding to the reduction of skeletal muscle Na/K-ATPase
      concentration induced by heart failure per se. In heart failure patients,
      improved haemodynamics induced by digoxin may, however, increase the capacity for
      physical conditioning. Thus the impairment of extrarenal potassium homeostasis by
      heart failure and digoxin treatment may be counterbalanced by training.

PMID- 7796443
TI  - Acadesine reduces myocardial infarct size by an adenosine mediated mechanism.
AB  - OBJECTIVE: The aim was to test the hypotheses that acadesine (1) augments
      endogenous interstitial fluid (ISF) adenosine during ischaemia, and (2) reduces
      infarct size by adenosine receptor mediated mechanisms. METHODS: To test these
      hypotheses, the left coronary artery of anaesthetised rabbits (n = 33) was
      occluded for 30 min and reperfused for 120 min. Acadesine (1 mg.kg-1.min-1 for 5
      min, then 0.2 mg.kg-1.min-1) was infused intravenously beginning 30 min before
      coronary occlusion and ending 30 min after reperfusion. The area at risk was
      comparable in all groups, averaging 34.7 (SEM 2.2%) of the left ventricle. In
      separate studies (n = 22), estimates of ISF adenosine and adenosine metabolites
      were obtained by cardiac microdialysis. Although dialysate adenosine levels
      increased significantly in the area at risk during ischaemia in the untreated
      group [from 0.044(0.008) to 0.339(0.146) microM], acadesine did not significantly
      augment dialysate adenosine levels before or during ischaemia [preischaemia =
      0.094(0.032) microM; ischaemia = 0.542(0.262) microM]. In addition, there was no
      significant difference in dialysate adenosine concentrations during the first 10
      min of reperfusion, after which adenosine levels returned to baseline levels. A
      2.5-fold large dose failed to increase interstitial fluid adenosine. However, the
      adenosine receptor blocker 8-p-sulphophenyltheophylline (SPT) in the presence of
      acadesine increased ISF adenosine fourfold. Acadesine significantly (P < 0.05)
      reduced infarct size [n = 8, 19.7(2.9)% of risk area] compared with the untreated
      group [n = 8, 29.4(1.3)%]. This infarct size reduction with acadesine was
      antagonised by SPT given during ischaemia-reperfusion [n = 8, 46.2(3.0)%] or only
      during reperfusion [n = 9, 42.7(2.6)%. CONCLUSIONS: Acadesine reduces infarct
      size by an adenosine mediated mechanism, but this cardioprotective action is not
      associated with significantly augmented interstitial fluid adenosine levels.

PMID- 7796446
TI  - Voltage dependent inhibition of ATP sensitive potassium channels by flecainide in
      guinea pig ventricular cells.
AB  - OBJECTIVE: The aim was to examine the effects of flecainide, a class Ic
      antiarrhythmic drug, on the ATP sensitive potassium channel (KATP channel)
      current in guinea pig ventricular cells, using the inside-out patch clamp
      technique. METHODS: KATP channel activities were recorded from inside-out
      membrane patches with 140 mM KCl solution bathing both the external and internal
      surfaces of the membrane (20-22 degrees C). Flecainide was added to the
      intracellular medium (ATP-free, pH = 7.3). RESULTS: Flecainide (1-300 microM)
      inhibited the outward KATP channel current evoked at the holding potential of +40
      mV, in a concentration dependent manner. The flecainide concentration for half
      maximum inhibition of the channel activity (IC50) and Hill coefficient of the
      flecainide inhibition were estimated to be 17.3 microM and 1.1, respectively.
      However, flecainide did not affect the inwardly directed KATP channel current
      measured at the potential of -40 mV. When the inhibitory effects of flecainide on
      the outward current were examined under conditions in which pH was decreased from
      7.3 (control) to 6.8, the IC50 and Hill coefficient became 27.3 microM and 1.2,
      respectively. Furthermore, in the presence of 0.1 mM ADP on the cytosolic side of
      the membrane (pH = 7.3), flecainide blocked the outward currents with the IC50 of
      47.0 microM and a Hill coefficient of 0.9. After 1 min exposure of the
      cytoplasmic side of the membrane to trypsin (1 mg.ml-1), glibenclamide (2 microM)
      did not inhibit the KATP channel currents, while flecainide (30 microM)
      reversibly inhibited this trypsin enhanced KATP channel activity. CONCLUSIONS:
      Flecainide at relatively high concentrations blocks the cardiac KATP channels
      only when the currents are directed outward, and in a concentration dependent
      manner. The potency of flecainide in blocking KATP channels decreased under
      conditions of increased H+ or ADP concentrations on the cytosolic side of the
      membrane, as may occur in myocardial ischaemia or hypoxia.

PMID- 7796445
TI  - Regulation of calcium pump function in back inhibited vesicles by calcium-ATPase
      ligands.
AB  - OBJECTIVE: The aim was to evaluate the effect of changes in substrate-product
      concentrations of the overall sarcoplasmic reticular Ca(2+)-ATPase reactions on
      calcium pump function with an emphasis on those factors that modify back
      inhibition of the pump by intrareticular free calcium. METHODS: Sarcoplasmic
      reticular vesicles were isolated from the rabbit heart. Calcium uptake by the
      vesicles was measured with a calcium sensitive minielectrode and was related to
      ATPase activity, which was measured by the rate of inorganic phosphate (Pi)
      production or NADH oxidation. Back inhibition was varied by changing [oxalate].
      RESULTS: At the high level of back inhibition and low calcium transport
      efficiency, calcium uptake by sarcoplasmic reticulum was stimulated by pH
      decrease, hydrophobic compounds, dimethyl sulphoxide, and ATP regeneration. These
      factors apparently modify either calcium binding to the low affinity binding site
      of Ca(2+)-ATPase or the effect derived from the binding of calcium to these
      sites. Under conditions where back inhibition was avoided and calcium transport
      efficiency was high, the same factors had a depressive effect on calcium uptake.
      Inorganic phosphate had a dual effect on the rate of calcium uptake supported by
      low [oxalate]: Pi < 2-3 mM strongly inhibited calcium uptake while further
      increase in [Pi] reversed this inhibition. At the lower level of back inhibition
      higher [Pi] was required to inhibit calcium transport. CONCLUSIONS: Changes in
      [H+], [ADP], and [Pi] can significantly affect calcium pump function, but the
      effect is dependent on the extent of back inhibition of calcium transport.
      Changes in the sarcoplasmic reticular Ca(2+)-ATPase environment which mimic those
      expected to take place at the start of reperfusion (pH increase to 7.0-7.1, high
      myoplasmic [Ca2+]) may have a depressive effect on the efficiency of calcium
      transport, provided that intrareticular free calcium is increased. Under those
      conditions factors able to decrease the inhibitory effect derived from the
      calcium binding to the low affinity binding sites are expected to improve the
      efficiency of calcium transport.

PMID- 7796447
TI  - Endothelin receptor subtypes in resistance arteries from humans and rats.
AB  - OBJECTIVE: Endothelins bind to different receptor subtypes identified as ETA and
      ETB receptors, ETA receptors are present on smooth muscle cells of blood vessels.
      ETB receptors seem to predominate on endothelial cells of blood vessels, but may
      also be present on smooth muscle in some vascular beds. The aim of this study was
      to investigate the distribution of ETA and ETB receptors in human and in rat
      resistance arteries. METHODS: Contractile responses to endothelin-1 and to the
      ETB agonist sarafotoxin S6c were investigated in human subcutaneous resistance
      arteries and in rat mesenteric resistance arteries mounted on a wire myograph.
      RESULTS: Contractile responses to endothelin-1 were significantly reduced by the
      ETA selective antagonists BQ123 or BQ610 in human resistance arteries, and were
      almost abolished by the antagonists in rat arteries. The ETB agonist sarafotoxin
      S6c induced smaller responses than endothelin-1. When responses to sarafotoxin
      S6c were obtained in the presence of BQ610, the relatively small contractile
      response remained. It was slightly enhanced if the responses were obtained in the
      presence of the nitric oxide synthase inhibitor L-NAME or after removal of the
      endothelium. CONCLUSIONS: Vasoconstrictor ETB receptors appear to be present in
      resistance vessels isolated from subcutaneous fat in humans and from the
      mesentery in rats, but their contribution to endothelin mediated constriction is
      small, particularly in rat resistance arteries. ETA receptors appear to be the
      more important endothelin receptor subtype in the human and rat resistance
      arteries examined.

PMID- 7796448
TI  - Reperfusion induced arrhythmias following ischaemia in intact rat heart: role of
      intracellular calcium.
AB  - OBJECTIVE: The aim was to test the hypothesis that reperfusion induced
      arrhythmias are associated with major alterations in intracellular calcium
      ([Ca2+]i) regulation. METHODS: Intracellular calcium, epicardial electrical
      potentials, and isovolumetric left ventricular pressure were simultaneously
      recorded in isolated perfused intact rat hearts during ischaemia (10 min) and
      reperfusion. [Ca2+]i was measured using the bioluminescent calcium indicator
      aequorin. RESULTS: Neither ventricular tachycardia nor ventricular fibrillation
      occurred during ischaemia. However, during the first minute of reperfusion
      ventricular tachycardia or fibrillation were frequently observed. Cellular
      calcium was altered by varying the perfusate calcium ([Ca2+]o; 0.5, 1.0, and 3.0
      mmol.litre-1). 0% (0/6), 50% (5/10), 91% (10/11), respectively, of hearts showed
      ventricular tachycardia, ventricular fibrillation, or both upon reperfusion (P <
      0.001, 0.5 v 3.0 mmol.litre-1). At all [Ca2+]o values examined, early ischaemia
      was associated with a rapid decrease in developed pressure and transient increase
      in the peak calcium transient followed by a gradual decline and subsequent
      increase in diastolic calcium during late ischaemia. The initiation of
      ventricular tachycardia/fibrillation upon reperfusion was immediately preceded by
      large increases in the amplitude of the calcium transient. These increases in
      systolic calcium were not seen in hearts in which ventricular arrhythmias did not
      occur. CONCLUSIONS: The association between reperfusion induced abrupt increases
      in peak calcium and the occurrence of ventricular tachycardia or fibrillation
      suggests that intracellular calcium transients may have a significant role in
      initiating these ventricular arrhythmias.

PMID- 7796449
TI  - Prevention of angiotensin II induced myocyte necrosis and coronary vascular
      damage by lisinopril and losartan in the rat.
AB  - OBJECTIVE: The aims were to determine: (1) if angiotensin converting enzyme (ACE)
      inhibition and angiotensin II receptor blockade can prevent angiotensin II
      induced coronary vascular damage; (2) if the cardioprotective properties of ACE
      inhibition are dose dependent; and (3) if the cardioprotective properties of ACE
      inhibition are independent of its ability to prevent the conversion of
      angiotensin I to angiotensin II. METHODS: Control rats and rats with either
      renovascular hypertension or continuous angiotensin II infusion (150 ng.min-1)
      for 14 d were subdivided into nine groups as follows: unoperated and untreated
      controls (n = 5); untreated renovascular hypertension (n = 8); untreated
      angiotensin II (n = 9); a renovascular hypertension group receiving one of the
      following doses of lisinopril 20 (n = 8), 2.5 (n = 4), and 0.6 (n = 6) mg.kg-1.d
      1; a renovascular hypertension group receiving losartan (7.5 mg.d-1, n = 4); and
      an angiotensin II group receiving either the high dose of lisinopril (n = 6) or
      losartan (n = 4). Treatment was started one day before initiation of renovascular
      hypertension and angiotensin II infusion and continued throughout the study
      period. The number and size of necrotic areas and numbers of damaged coronary
      vessels were determined in sections of right and left ventricular tissue.
      RESULTS: Both coronary vascular injury and myocyte injury induced by angiotensin
      II were prevented by losartan. In renovascular hypertension, the lowest dose of
      lisinopril prevented vascular and attenuated myocyte damage but to a lesser
      degree than the higher doses. The cardioprotective ability of ACE inhibition is
      primarily the result of its ability to prevent the conversion of angiotensin I to
      angiotensin II. CONCLUSIONS: Angiotensin II related cardiomyocyte necrosis and
      coronary vascular damage are angiotensin type 1 receptor mediated and completely
      preventable with the receptor antagonist losartan. The ability of ACE inhibition
      to prevent this damage is dose dependent and primarily related to the degree to
      which the inhibitor can prevent the conversion of angiotensin I to angiotensin
      II.

PMID- 7796450
TI  - Wall stress induced arrhythmia is enhanced by low potassium and early left
      ventricular hypertrophy in the working rat heart.
AB  - OBJECTIVE: The aim was to investigate the effect of lowering external potassium
      on the sensitivity of the normal and hypertrophied rat heart to arrhythmias
      induced by increases in ventricular wall stress. METHODS: The isolated working
      heart model was used to compare hypertrophied hearts from the spontaneously
      hypertensive rat (SHR) with hearts from normotensive control rats (NCR) from the
      Wistar and Wistar-Kyoto strains. Young animals [131.5(SEM 0.64) days] were used
      to ensure uncomplicated left ventricular hypertrophy. Arrhythmias were induced by
      20 s increases in ventricular wall stress. The ECG was recorded and the
      arrhythmic response of each heart was compared during perfusion with Tyrode
      solutions containing [K] 6, 4.8, 3.6, and 2.4 mM. RESULTS: Hypertrophied SHR
      hearts showed a significantly greater arrhythmic response than control hearts at
      all levels of afterload increase when perfused with [K] 3.6 and 2.4 mM (t test P
      < 0.05 and P < 0.01). Both the number and complexity of arrhythmias were
      increased in the SHR hearts; ventricular tachycardia occurred in 10/12 compared
      with 4/12 control hearts whereas ventricular fibrillation occurred in 5/12 hearts
      but in none of the control hearts. CONCLUSIONS: At higher levels of [K] the
      sensitivity of SHR and normal hearts to wall stress induced arrhythmias is
      similar. However, as [K] is lowered to 3.6 mM or below, hypertrophied hearts show
      a greatly enhanced response to increases in ventricular wall stress. They develop
      a larger number of ventricular ectopics and more complex ventricular arrhythmias
      when compared to normal hearts. This may be of relevance to arrhythmic sudden
      death in hypertensive patients in whom left ventricular hypertrophy, potassium
      depletion, and blood pressure lability is common. Excessive fluctuations in
      systolic pressure and therefore ventricular wall stress could provide a powerful
      arrhythmic stimulus in hypertensive patients with left ventricular hypertrophy,
      even before ischaemia, cardiac failure, or extensive extracellular fibrosis have
      developed.

PMID- 7796451
TI  - Altered expressions of cardiac Na/K-ATPase isoforms in copper deficient rats.
AB  - OBJECTIVE: The aim was to determine if copper deficiency affects the expression
      of Na/K-ATPase alpha isoforms in the rat heart. METHODS: Copper deficiency was
      induced by placing weanling rats on a copper deficient diet for 4-5 weeks. Adult
      ventricular tissue, isolated ventricular myocytes, and brain stems of the control
      and deficient rats were compared for Cu, Zn-superoxide dismutase (CuZn-SOD)
      activity and for protein and mRNA contents of Na/K-ATPase alpha isoforms.
      RESULTS: In brain stem, where copper deficiency did not alter CuZn-SOD activity,
      mRNA and protein levels of alpha isoforms also remained unchanged. In ventricular
      tissue and ventricular myocytes, copper deficiency reduced CuZn-SOD activity,
      mRNAs of alpha 1 and alpha 2 isoforms, and the alpha 2 isoform protein. The alpha
      1 isoform protein of ventricular tissue and its myocytes was marginally reduced
      by copper deficiency. CONCLUSIONS: In the rat ventricular tissue, oxidative
      stress resulting from copper deficiency (1) enhances the turnover of the more
      oxidant sensitive alpha 2 isoform to a greater extent than the turnover of the
      alpha 1 isoform; (2) regulates mRNA levels of alpha 1 and alpha 2 isoforms; and
      (3) contributes to the cardiomyopathy of copper deficiency.

PMID- 7796452
TI  - Adenosine and PAF dependent mechanisms lead to myocardial reperfusion injury by
      neutrophils after brief ischaemia.
AB  - OBJECTIVE: The aim was to establish whether polymorphonuclear neutrophils can, by
      themselves, elicit depression of postischaemic heart function immediately after
      short periods of ischaemia, and to examine the involvement of endogenous
      adenosine and platelet activating factor (PAF) in the observed phenomena.
      METHODS: Isolated buffer perfused guinea pig hearts performing pressure-volume
      work under standardised conditions were subjected to 15 min of global ischaemia.
      Constant flow reperfusion (5 ml.min-1) was carried out in the presence or absence
      of homologous neutrophils (approximately 2000 cells.microliters-1 perfusate).
      After 15 min of reflow, work was resumed and functional recovery assessed another
      20 min later. RESULTS: In hearts perfused only with Krebs-Henseleit buffer,
      postischaemic heart function recovered to 67(SEM 3)% (n = 13) of the preischaemic
      value. As early as the first minute of reperfusion, the application of
      neutrophils already led to a significant decrease in recovery to 39(3)% (n = 12;
      P < 0.05). Without ischaemia, neutrophils did not have any deleterious effect,
      recovery of external heart work amounting to 91(4)% (n = 6). Adenosine
      concentrations measured in the coronary effluent after ischaemia were
      substantially increased during reperfusion from preischaemic values of < 20 nM to
      about 800 nM. The adenosine A1 receptor antagonist dipropyl-8-cyclopentyl
      xanthine prevented the neutrophil dependent loss of heart function, as did
      application of the PAF receptor antagonist WEB 2086, recoveries being 60(4)% (n =
      6) and 58(8)% (n = 6), respectively. In contrast, the A2 antagonist 3,7-dimethyl
      1-propargyl-xanthine tended to worsen the neutrophil induced dysfunction of the
      heart, recovery amounting to 18(2)% (n = 5). CONCLUSIONS: Even after brief
      ischaemia, neutrophils introduced into the coronary system can exacerbate
      reperfusion injury. Adenosine, through its A1 receptor, and PAF appear to play a
      significant role as mediators of this action.

PMID- 7796453
TI  - Preischaemic as well as postischaemic application of a calcium antagonist affords
      cardioprotection in the isolated guinea pig heart.
AB  - OBJECTIVE: The aim was to answer the following questions: (1) Does treatment with
      calcium antagonists have to be begun before ischaemia or is postischaemic
      application also protective? (2) When applied before ischaemia, do calcium
      antagonists have to depress preischaemic cardiac function in order to elicit
      protection? (3) Is cardioprotection a matter of improved reflow or do the agents
      influence the degree of oxidative injury during reperfusion? METHODS: Isolated
      working guinea pig hearts underwent ischaemia (15 min) and reperfusion (15 min).
      The calcium antagonist gallopamil was given either before (0.1 nM and 1 nM) or
      after ischaemia (0.1 nM) during early reperfusion (first 5 min). Recovery was
      defined as postischaemic compared to preischaemic external heart work, expressed
      in percent. Oxidative stress was assessed by the release of glutathione (GSH).
      Lactate release served as a measure of the ischaemic challenge. The ability of
      gallopamil to scavenge oxygen radicals directly was investigated in an in vitro
      chemiluminescence assay. RESULTS: Pump function of control hearts recovered to
      only 28% after reperfusion. Pretreatment with 0.1 and 1 nM gallopamil improved
      recovery to the same extent (48.7% and 43.4%, respectively); however,
      postischaemic application of 0.1 nM gallopamil afforded equal protection (45.4%
      recovery). Only the higher concentration of 1 nM gallopamil depressed
      preischaemic external heart work (by 11%). During earliest reperfusion (1-5 min),
      release of GSH only tended to be lower in treated hearts. During the subsequent
      minutes of reperfusion (5-15 min), release of GSH was significantly less in
      hearts postischaemically treated with 0.1 nM gallopamil (40 pmol.min-1 v 940
      pmol.min-1 for controls). In contrast, ischaemia-induced lactate release did not
      differ between the groups. Gallopamil did not scavenge reactive oxygen species in
      vitro. CONCLUSIONS: Short term postischaemic application of the calcium
      antagonist gallopamil is almost as effective at restoring pump function as
      preischaemic application which, in turn, does not have to depress preischaemic
      cardiac function in order to elicit protection. A reduction of oxidative stress
      during reperfusion seems to contribute to the beneficial effects of postischaemic
      application of gallopamil, but a direct oxygen radical scavenging activity of
      gallopamil is not involved.

PMID- 7796454
TI  - Animals in research.

PMID- 7796455
TI  - Actin, its associated proteins and metastasis.
AB  - In this short article we have overviewed the effect of transformation on AAPs. We
      have not dealt with molecules indirectly associated with actin which are modified
      by transformation, such as the catenins, cadherins, vinculin, and integrins
      [Tsukita et al., 1993], although their relationship with and importance to the
      transformed phenotype cannot be overemphasised. Similarly, alterations in
      polyphosphoinositide metabolism that occur in transformed cells may also promote
      or induce alterations in the microfilament cytoskeleton via interactions with
      proteins such as gelsolin, alpha-actinin, and MARCKS [Bretscher, 1993]. At
      present, there are no clear-cut rules regarding the effect that oncogenesis has
      on AAPs, since the expression level of one oncogenically modified AAP can vary
      from one tumour to another, even within the same type of tumour [Yamamoto et al.,
      1993]. This apparent inconsistency may well be because we are "playing with an
      incomplete pack of cards" [Pollard, 1993], or it may reflect this highly complex
      control mechanism in which any perturbation of the normal expression levels of
      actin/AAPs unbalances the delicate equilibrium which controls normal cell
      behaviour [Bray and Vasiliev, 1989]. For example, it is possible that
      oncogenically induced alterations to actin isoform expression [Lin et al., 1985]
      exert a downstream effect on actin-associated protein expression. Oncogenically
      induced actin based cell movements may be activated by alterations to either a
      single AAP or a synergistic functional unit of these molecules [Shapland et al.,
      1993; Vandekerckhove et al., 1990].(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796457
TI  - Dynein inner arm heavy chain identification in cAMP-activated flagella using
      class-specific polyclonal antibodies.
AB  - While studying cAMP-dependent dynein alpha-heavy chain phosphorylation, we found
      previously [Stephens and Prior, 1992: J. Cell Sci. 103:999-1012] that high salt
      extraction of sperm flagella from the mussel Mytilus edulis or the clam Spisula
      solidissima removed most visible dynein arms, accompanied by an amount of Mg+2
      ATPase that correlated with the mass of dynein alpha- and beta-heavy chains
      removed. However, although almost devoid of ATPase activity, such extracted
      axonemes retained one third of the heavy chain mass as two sets of
      electrophoretically-distinct, vanadate-cleavable, non-phosphorylated proteins. To
      explore the nature of these dynein-like proteins, antibodies to the alpha- and
      beta-heavy chains were blot affinity-purified from a rabbit antiserum raised
      against gradient-purified Spisula 18-20S flagellar outer arm dynein. Although
      able to recognize common epitopes of the opposite chain type, neither the alpha-
      nor the beta-heavy chain antibody recognized the tightly-bound proteins in either
      species, proving that they are immunologically distinct. While the beta-antibody
      recognized its heavy chain homolog in gill cilia, the alpha-antibody did not,
      demonstrating immunological distinction between flagellar and ciliary dynein
      alpha-heavy chains. Immunization of a mouse with nitrocellulose strips containing
      one of the two tightly-bound Spisula flagellar proteins produced an antiserum
      that cross-reacted with each tightly-bound protein in both species and also
      recognized alpha- and beta-heavy chains. The anti-molluscan serum cross-reacted
      strongly with sea urchin sperm flagellar dynein B-, C-, and D-bands, considered
      to be inner arm components, but not with sea urchin outer arm alpha- or beta
      heavy chains. These data indicate that the electrophoretically and
      immunologically distinct, tightly-bound proteins of molluscan flagella are inner
      arm dynein heavy chains.

PMID- 7796456
TI  - Protein substrates for cGMP-dependent protein phosphorylation in cilia of wild
      type and atalanta mutants of Paramecium.
AB  - In the ciliated protozoan Paramecium, swimming direction is regulated by voltage
      gated Ca2+ channels in the ciliary membrane. In response to depolarizing stimuli,
      intraciliary Ca2+ rises, triggering reversal of the ciliary power stroke and
      backward swimming. One class of Ca(2+)-unresponsive behavioral mutants of
      Paramecium, atalanta mutants, cannot swim backward even though they have
      functional Ca2+ channels in their ciliary membrane. Several atalanta mutants were
      characterized with regard to several Ca(2+)-dependent activities, but no
      significant difference between wild type and the mutants was detected. However,
      one allelic group, atalanta A (initially characterized by Hinrichsen and Kung
      [1984: Genet. Res. Camb. 43:11-20]), showed a helical swimming path of opposite
      handedness from that of wild-type cells when detergent-permeabilized cells
      ("models") were reactivated with MgATP. When cGMP-dependent protein kinase
      purified from wild-type cells was added to atalanta A models, the handedness of
      the swimming path was reversed. Cyclic GMP stimulated in vitro phosphorylation of
      several proteins in isolated cilia, and the pattern of phosphoproteins was very
      similar for wild type and atalanta mutants, with one exception: a protein of 59
      kDa was phosphorylated much less in the mutant ata A. When ciliary proteins were
      separated by gel electrophoresis and then phosphorylated "on blot" by purified
      cGMP-dependent protein kinase, phosphoprotein patterns were similar in wild type
      and ata mutants except that a 48 kDa protein (p48) from ata A3 was more heavily
      phosphorylated. This difference in p48 phosphorylation was also observed with
      cGMP-dependent protein kinase purified from ata A3 mutant cells.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7796458
TI  - Differentiation dependent expression of tensin and cortactin in chicken
      osteoclasts.
AB  - The expression and localization of tensin and cortactin were examined in
      osteoclast precursors in comparison with isolated osteoclasts on various
      substrates. Initially, the ability of hen monocytes to differentiate into
      osteoclasts was evaluated on plastic or glass, and compared to differentiation on
      bone. Specifically, monocytes were isolated from the medullary bones of egg
      laying hens maintained on a Ca-deficient diet. Differentiation was monitored
      morphologically and by quantitation of the ability to form Howship's lacunae in
      bone slices or resorb radiolabeled bone particles of 20-53 microns diameter.
      These cells differentiated into tartrate resistant acid phosphatase (TRAP)
      positive, bone resorbing, multinucleated syncytia in the presence of cytosine-1
      beta-D-arabinofuranoside in a time dependent manner (day 1-6). Differentiation
      into osteoclast-like cells was similar whether cultured on plastic, on glass, or
      on bone. When compared to GAP-DH control levels, tensin and cortactin mRNA levels
      increased by 7- and 10-fold, respectively, by day 6. Tensin and cortactin protein
      levels also increased by 6- and 15-fold, respectively, by day 6.
      Immunofluorescence of differentiating precursors showed that tensin localized
      between regions of cell to cell contact and colocalized with vinculin in
      podosomes of osteoclast-like cells and of real osteoclasts. Cortactin
      immunofluorescence was not detectable in monocytes but localized inside
      tensin/vinculin podosome structures after fusion into osteoclast-like cells and
      in freshly isolated osteoclasts. Both tensin and cortactin were associated with
      attachment complexes used by osteoclast-like cells and osteoclasts to resorb
      bone. Specifically, punctate cortactin staining was observed inside tensin
      staining which formed a double ring structure at the membrane/bone interface of
      resorbing osteoclasts. These data showed that tensin and cortactin can be used as
      osteoclast differentiation markers, that participate in attachment complexes used
      to resorb bone, and that tensin may participate in the fusion process of
      osteoclast precursors.

PMID- 7796459
TI  - beta-Tubulin mutation suppresses microtubule dynamics in vitro and slows mitosis
      in vivo.
AB  - Microtubule (MT) dynamics vary both spatially and temporally within cells and are
      thought to be important for proper MT cellular function. Because MT dynamics
      appear to be closely tied to the guanosine triphosphatase (GTPase) activity of
      beta-tubulin subunits, we examined the importance of MT dynamics in the budding
      yeast S. cerevisiae by introducing a T107K point mutation into a region of the
      single beta-tubulin gene, TUB2, known to affect the assembly-dependent GTPase
      activity of MTs in vitro. Analysis of MT dynamic behavior by video-enhanced
      differential interference contrast microscopy, revealed that T107K subunits
      slowed both the growth rates and catastrophic disassembly rates of individual MTs
      in vitro. In haploid cells tub2-T107K is lethal; but in tub2-T107K/tub2-590
      heterozygotes the mutation is viable, dominant, and slows cell-cycle progression
      through mitosis, without causing wholesale disruption of cellular MTs. The
      correlation between the slower growing and shortening rates of MTs in vitro, and
      the slower mitosis in vivo suggests that MT dynamics are important in budding
      yeast and may regulate the rate of nuclear movement and segregation. The slower
      mitosis in mutant cells did not result in premature cytokinesis and cell death,
      further suggesting that cell-cycle control mechanisms "sense" the mitotic
      slowdown, possibly by monitoring MT dynamics directly.

PMID- 7796460
TI  - Purification of microtubule associated protein MAP1B from bovine brain: MAP1B
      binds to microtubules but not to microfilaments.
AB  - A simple procedure for the purification of MAP1B from bovine brain is described.
      The procedure requires two ion-exchange chromatographic steps and results in >
      95% pure MAP1B with a typical recovery of about 25-30 mg/kg of brain tissue. SDS
      PAGE analysis of the purified protein shows that it is composed of a high
      molecular mass (330kDa) heavy chain and two low molecular mass (32kDa and 18kDa)
      associated light chains. The estimated stoichiometry of heavy chain:light chain
      is 1:2 and 1:0.2 mole/mole protein for the 32kDa and 18kDa light chains
      respectively. Western blotting, using monospecific monoclonal antibodies, shows
      that only the heavy chain is recognised by the anti-MAP1B antibody and is not
      immunostained by either the MAP1A or MAP2 monoclonal antibodies. Purified MAP1B
      binds efficiently to both unpolymerised tubulin and polymerised tubulin and co
      sediments with taxol-stabilised microtubules. Co-incubation experiments show that
      MAP2 can compete with MAP1B binding to microtubules, indicating common or
      overlapping sites. However, MAP1B binds to neither G-actin nor F-actin nor co
      sediments with F-actin, suggesting that it is not an actin-binding protein.

PMID- 7796462
TI  - Axial rotation in rat embryos: involvement of changes in the shapes and
      arrangement of cells.
AB  - Rat embryos at the head-fold stage (9.5 days of gestation) were cultured for 32
      hours in rat serum. Embryos rotated their axes (changing from the shape of a
      concave mid-region to that of a convex mid-region) during the last 5 hours of
      culture (from 27 h to 32 h in culture). Addition of 0.1 micrograms/ml
      cytochalasin D to the culture medium for this 5-hour period prevented axial
      rotation in the embryos and disturbed the appearance of microfilaments in the
      dermatome, the dorsal region of the trunk neural tube, and the dorsal epidermis.
      During the period of axial rotation, the dermatome and the dorsal epidermis
      extended and showed the arrangement of microfilaments along the cranio-caudal
      axis in the control embryos but not in the treated embryos. The dorsal region of
      the trunk neural tube in the control embryos consisted of a seam of
      neuroepithelial cells in which microfilaments were apparently arranged along the
      cranio-caudal axis but the region in the treated embryos was crowded with the
      neuroepithelial cells piled up randomly and microfilaments showed no arrangement.
      These results suggest that changes in the shapes and arrangement of the cells in
      the dermatome, the dorsal region of the trunk neural tube, and the dorsal
      epidermis cause extension of these tissues along the cranio-caudal axis and
      result in axial rotation. Microfilaments may play an essential role in changes in
      the shapes and arrangement of the cells in these tissues.

PMID- 7796461
TI  - A 62-kDa mitotic apparatus protein required for mitotic progression is
      sequestered to the interphase nucleus by associating with the chromosomes during
      anaphase.
AB  - A protein component of 62-kDa (p62) in the mitotic apparatus of the sea urchin
      embryo has been shown to be important for the proper progression of mitosis
      [Dinsmore and Sloboda, 1989: Cell 57:127-134]. To study the subcellular
      distribution of p62 during the cell cycle of sea urchin embryos, indirect
      immunofluorescence microscopy was used coupled to a modified detergent extraction
      procedure. The improved fluorescent images obtained by this procedure provide new
      information concerning the subcellular localization of p62 during the cell cycle
      that could not be obtained with previous conventional staining procedures
      [Johnston and Sloboda, 1992: J. Cell Biol. 119:843-854]. Using affinity purified
      antibodies to p62, we observed a cell cycle-dependent localization of p62 to the
      chromosomes/chromatin. Prior to nuclear envelope breakdown of the first or second
      cell cycle, p62 localizes to chromatin in the nucleus. During mitosis, p62
      associates with the region of the spindle occupied by the microtubules of the
      mitotic apparatus. As anaphase proceeds, but before the nuclear envelope reforms,
      p62 becomes progressively associated with the chromosomes. Thus, p62 is
      incorporated into the forming interphase nucleus due to its association with
      chromosomes during late anaphase, rather than by active translocation into the
      newly formed daughter nuclei through the nuclear pores. The protein is not unique
      to marine embryos, as demonstrated by immunofluorescence of Y-1 cells, a mouse
      adrenal tumor cell line. In these cells, the localization of p62 is similar to
      the localization of the protein in echinoderm embryos, suggesting its possible
      function in mitotic progression in mammalian somatic cells as well.

PMID- 7796463
TI  - Alterations of expression of the cytoskeleton after immortalization of human
      fibroblasts.
AB  - Human diploid fibroblasts (HDF) have a limited in vitro lifespan of population
      doubling level (PDL) 50-70. The molecular mechanism underlying cellular
      senescence and immortalization is not thoroughly understood. It has been reported
      that the cytoskeleton has diverse functions and may have a role in growth
      regulation through association with other cellular components. To shed light on
      the relationship between functions of the cytoskeleton and senescence or
      immortalization, we investigated the alterations in gene expression after
      immortalization and measured the amounts of mRNAs for talin, vinculin, alpha
      actinin, tropomyosin 1 (TM1), vimentin, lamin A and C, and alpha-tubulin by slot
      blot and Northern blot analyses. We found that the mRNAs for vinculin and
      vimentin were reduced and the mRNA for lamin A was increased in immortalized
      cells. We also studied the cytoskeletal protein levels and their intracellular
      distributions by Western blot analysis and immunostaining. Most of the proteins
      studied behaved in a way similar to the mRNAs through senescence and
      immortalization. Vinculin, tropomyosins and vimentin showed their altered
      distributions in immortalized cells.

PMID- 7796464
TI  - An HL-60 variant cell line defective in cholesterol synthesis.
AB  - Human promyelocytic leukemia cell line, HL-60, is known to proliferate
      exponentially in a serum-free synthetic medium supplemented with insulin and
      transferrin (BREITMAN, T.R. et al. (1980). Exp. Cell. Res., 126: 494-498). Among
      four HL-60 cell lines tested in this medium (serum-free medium), however, a cell
      line, HL-60/Biken ceased to proliferate after two days culture and most of the
      cells died within a week. Addition of purified serum lipoprotein (LDL or HDL) to
      the serum-free medium almost completely restored the proliferating activity of
      the cells. Total lipids extracted from the lipoproteins could replace the
      lipoproteins in promoting cell proliferation. Among various lipid components of
      the lipoproteins, only cholesterol showed a high stimulatory effect on cell
      proliferation, whereas other lipids tested were ineffective, except for
      sphingomyelin, cerebroside, and phosphatidic acid which showed limited
      stimulatory effects. As for the intermediates of cholesterol biosynthesis,
      desmosterol was also effective, whereas lanosterol was rather inhibitory.
      Chromatographic analyses of the lipids synthesized by HL-60/Biken cells and wild
      type cells (HL-60/RCB) cultured in serum-free medium, clearly demonstrated that,
      in HL-60/Biken cells, cholesterol synthesis was almost completely blocked and
      lanosterol was accumulated 10-fold that in wild type HL-60/RCB cells. All of
      these results indicate that HL-60/Biken is a variant cell line defective in
      cholesterol synthesis in the process synthesizing desmosterol from lanosterol.
      The variant HL-60 cells showed a marked resistance to cell differentiation along
      both monocytic and granulocytic pathways when compared with wild type HL-60
      cells. The cell line may be useful for the study of the role of cholesterol in
      cell differentiation.

PMID- 7796465
TI  - Cellular structure and function of rat fat cells in the primary culture.
AB  - A primary culture of undigested fat tissue fragments was used to obtain fat cells
      in vitro. On day 2 of culture, immature fat cells, which are fibroblast-like fat
      cells containing fine lipid droplets, appeared, surrounding the fat tissue
      fragments, and began to proliferate extensively. Afterwards, these fibroblast
      like fat cells grew to become multilocular fat cells containing larger
      intracytoplasmic lipid droplets, and differentiated further into unilocular fat
      cells containing a single large intracytoplasmic lipid droplet. Treatment with
      dibutyryl-cAMP, which is a second messenger of the lipolytic factor, caused the
      cultured fat cells to retract, and the intracytoplasmic lipid droplets of those
      fat cells became finely granulated and decreased along with an increase of
      hormone-sensitive lipase activities. Conversely, administration of insulin caused
      the lipid droplets in the fat cells to increase and become larger along with an
      increase of alpha-glycerophosphate dehydrogenase activities. These findings
      indicate the occurrence of lipolysis and lipogenesis of fat cells in vitro.
      Immuno-cytochemistry revealed that vimentin surrounded intracytoplasmic lipid
      droplets, and became distinct with an increase of lipid droplets through
      lipogenesis in the fat cells. Vimentin seems to be correlated to the behavior of
      lipid droplets in the fat cells. Fat cells in this study showed the appropriate
      cellular structures and functions in response to stimulation of lipolysis and
      lipogenesis under culture conditions. It is expected that in vitro culture of fat
      cells will facilitate cell biological elucidation of obesity in the future.

PMID- 7796466
TI  - Expression and phosphorylation of BiP/GRP78, a molecular chaperone in the
      endoplasmic reticulum, during the differentiation of a mouse myeloblastic cell
      line.
AB  - To determine the functional significance of endoplasmic reticulum chaperones in
      hematopoietic cells, we analyzed the expression and post-translational
      modification of BiP/GRP78 and GRP94 as well as the cytoplasmic chaperones HSP70
      and HSC70 during the differentiation of a mouse myeloid leukemia cell line, M1.
      The amounts of BiP/GRP78 and GRP94 increased several-fold when M1 cells were
      induced to differentiate into macrophage-like cells by treatment with interleukin
      6 (IL-6). Synthesis began to increase at 4 hr after IL-6 treatment. The
      phosphorylated form of BiP/GRP78 increased during the later stages of
      differentiation. These data suggested that the chaperone activity of BiP/GRP78
      and GRP94 may be needed for differentiated macrophage-like cells or for the
      differentiation event itself, and that functionally different BiP/GRP78
      accumulate during the differentiation of M1 cells.

PMID- 7796467
TI  - Distribution of PCNA during postblastoderm cell division cycles in the Drosophila
      melanogaster embryo: effect of a string- mutation.
AB  - We used immunocytochemical methods and a specific antibody to identify
      proliferating cell nuclear antigen (PCNA) in Drosophila embryos during the
      postblastoderm cell division cycles. The strong nuclear staining observed during
      interphase disappeared at prophase, staining remained nil throughout the
      remaining mitotic (M) phases and reappeared in nuclei at the next interphase. As
      the embryos with the homozygous string- mutation sustained the strong staining
      signal in nuclei throughout embryonic development, disappearance of the staining
      signal probably depends on string function and is coupled with the onset of
      mitosis. When cells in embryos were arrested at M phase following treatment with
      TN-16 or Vinblastine, the staining signal with the anti-PCNA antibody was lost.
      However, Western blots showed that the level of PCNA protein in M phase-arrested
      embryos did not decrease. Therefore, the disappearance of staining signals is
      apparently due to reorganization of PCNA protein in the multiprotein complex in
      nuclei, rendering it inaccessible to the antibody, rather than to the degradation
      of PCNA protein. In contrast to findings in developing embryos, cultured
      Drosophila Kc cells stained strongly with the anti-PCNA antibody, during both
      interphase and the M phase. In genetic crossing experiments of transgenic flies
      carrying the lacZ gene under the control of the PCNA gene regulatory region (-607
      to +137 with respect to the transcription initiation site) with string- mutant
      files, the PCNA gene promoter seems to function in a manner independent of cell
      cycle progression or of functions of the string gene.

PMID- 7796468
TI  - Visualization of a single myelination process of an oligodendrocyte in culture by
      video microscopy.
AB  - We described the initial events in the interaction between an oligodendrocyte
      process and an axon in culture utilizing video time-lapse microscopy. Myelination
      of an axon by the lamellipodium of an oligodendrocyte was achieved in several
      steps of cellular process development and coordinated interaction between axon
      and oligodendrocyte. The initial stage of contact included the formation of a
      lamellipodium process at the end of an oligodendrocyte process. It appeared that
      this process contacted the axon several times and was then retracted, and that
      the filopodia and lamellipodium underwent morphological changes prior to the
      onset of the myelination. In the second stage, the lamellipodium appeared to
      thicken and anchor to the axon. Finally, when rippling of the lamellipodial
      ruffling occurred, the angle between the anchoring filopodium and the axon
      changed depending on the direction of lamellipodial movement, and the
      lamellipodium, which was folded in layers, wrapped around the axon like a
      transverse wave in one motion as observed on the video screen. Thereafter, the
      lamellipodium assumed a "bursting" form within minutes in real time. This is the
      first comprehensive overview of how an oligodendrocyte plasma membrane wraps
      around an axon to form myelin.

PMID- 7796469
TI  - Mechanism of the change in shape of human erythrocytes induced by lidocaine.
AB  - We studied the mechanism of the lidocaine-induced shape change in human
      erythrocytes. Immunohistochemical analysis of erythrocytes using spectrin
      specific antibodies revealed aggregation of fluorescence in lidocaine-treated
      cells, while the fluorescence was distributed diffusely in untreated cells. The
      intracellular pH in lidocaine-treated erythrocytes was examined by flow cytometry
      of the cells labeled with 3'-acetyl-2'-carboxy-ethyl-6',7'-(dihydropyran-2'-one)
      5-carboxyfluoresc ein diacethoxymethylester (BCECF-AM), and was found to decrease
      with increasing concentrations of lidocaine. Pre-treatment of erythrocytes with
      acetazolamide, an inhibitor of carbonic anhydrase, inhibited the lidocaine
      induced spectrin aggregation and decrease in intracellular pH. When erythrocytes
      were incubated in medium containing bafilomycin A1, an inhibitor of V-ATPase,
      followed by incubation with lidocaine, the cells changed shape slightly and the
      intracellular pH showed a small decrease in comparison with control. Spectrin
      dimers extracted from membranes normal erythrocytes were incubated in buffers of
      various pHs and analyzed by SDS-PAGE. The amounts of spectrin dimers and
      tetramers decreased, while that of oligomers increased with decreasing pH. These
      results suggest that the lidocaine-induced shape change in human erythrocytes may
      occur by the conformational change of spectrin in a process that may be mediated
      by carbonic anhydrase and activation of V-ATPase.

PMID- 7796471
TI  - Quantitative cryoimmunogold electron microscopic studies on induction of serine:
      pyruvate aminotransferase in rat liver mitochondria by administration of
      glucagon.
AB  - Induction of mitochondrial serine: pyruvate aminotransferase (SPT) in rat liver
      by administration of glucagon was studied quantitatively by immunoblot analysis
      and cryoimmunogold electron microscopy. Immunoblot analysis revealed that two
      daily injections of glucagon produced marked increase of SPT protein mass to a
      level as much as 18 times that of the untreated rat. Cryoimmunogold electron
      microscopic analysis showed that the labeling density of the mitochondria
      increased in a parallel manner. Thus the induction of SPT analyzed by two methods
      showed an excellent correlation with a relative correlation coefficient of 0.98,
      indicating that the induction of SPT can be analyzed quantitatively by immunogold
      electron microscopy on cryoultrathin sections.

PMID- 7796473
TI  - [Study on the effect of using medicated intratracheal tube pad in the prevention
      and care of tracheotomy].

PMID- 7796472
TI  - Establishment of cell lines from multipotent epithelial sheet in the budding
      tunicate, Polyandrocarpa misakiensis.
AB  - We report here the in vitro culture of the atrial epithelium, which is the major
      formative tissue of the budding tunicate, Polyandrocarpa misakiensis. Preliminary
      studies suggested that both pH and osmotic pressure of the basic seawater medium
      should be lowered significantly (pH 6.8, 800-830 mOsm). In the growth medium
      consisting of modified millipore-filtered seawater, Dulbecco's modified Eagle
      medium and 3% fetal bovine serum, cells spread out from the epithelial explant
      and proliferated with a doubling time of about 13 hours. They could be cloned and
      cultured successively. They contained the Polyandrocarpa lectin gene, showing
      that they were indeed of tunicate origin. At a low cell density (< 3 x 10(2)
      cells/mm2), clonal cells took a spherical form and contained several granules in
      the cytoplasma. At a high cell density (> 3 x 10(4) cells/mm2), on the other
      hand, they gave rise to smaller cells without any specialized features and,
      finally, to dark flattened cells. Consistent with this observation, confluent
      cells lost the atrial epithelium-specific antigen, which reappeared on the cell
      surface when they were re-plated at a low density. In conclusion, we have
      established for the first time tunicate cell lines. They appeared to
      differentiate and dedifferentiate repeatedly in our culture system.

PMID- 7796470
TI  - Hemocytes release phenoloxidase upon contact reaction, an allogeneic interaction,
      in the ascidian Halocynthia roretzi.
AB  - Contact reaction is the morphological expression of allogeneic recognition by
      hemocytes in the ascidian, Halocynthia roretzi; namely they undergo an exocytotic
      burst upon contact with non-self (allogeneic) hemocytes in vitro. We have found
      that contact reaction is accompanied by a burst of cyanide-insensitive oxygen
      consumption that, unlike exocytotic events of mammalian phagocytes, is Ca(2+)
      dependent and does not culminate in the production of superoxide anions or H2O2.
      Instead, the burst is due to the release of phenoloxidase from hemocytes as known
      for the self-defense systems in insects and crustaceans. The activity of
      phenoloxidase released from hemocytes corresponds well to the degree of contact
      reaction observed under the microscope. Therefore, it is possible to quantify the
      contact reaction simply by measuring the activity of phenoloxidase released from
      hemocytes into the medium.

PMID- 7796474
TI  - [Study on the factors correlated with the development of diaper rash of the
      newborn].

PMID- 7796475
TI  - [Speech rehabilitation of aphemia after cerebral infarct].

PMID- 7796477
TI  - [Care of congenital choledochocystectomy of infants under three].

PMID- 7796476
TI  - [Care of nerve root type cervical spondylosis treated by blocking the inferior
      cervical roots].

PMID- 7796479
TI  - [The correlation of psychosis with social environment and psychological factors
      and the management of patients].

PMID- 7796478
TI  - [The lying position of newborn pneumonia].

PMID- 7796480
TI  - [Care of pediatric pneumonia from the viewpoint of the characteristics of
      pediatric esophageal dynamics].

PMID- 7796481
TI  - [Care of nasopharyngeal cancer patients after radiotherapy].

PMID- 7796483
TI  - [Microcomputer used in burn nursing records].

PMID- 7796482
TI  - [Techniques of puncture of the maxillary sinus in children].

PMID- 7796484
TI  - [Comparison of evaluation of head nurses using the grey cluster method and the
      poll method].

PMID- 7796485
TI  - [Defects in nursing document writing and measures to prevent them].

PMID- 7796486
TI  - [A tentative research project of adding nursing applied anatomy in nursing
      education at polytechnic schools].

PMID- 7796487
TI  - [Management and training of clinical teaching nursing staff].

PMID- 7796489
TI  - Annual meeting of the Canadian Anaesthetists' Society. Ottawa, Ontario, June 23
      27, 1995. Refresher course outlines and abstracts.

PMID- 7796488
TI  - Properties of alkaline phosphatase in the gingival crevicular fluid.
AB  - The isoenzymic properties of the alkaline phosphatase (ALP) of the gingival
      crevicular fluid (GCF) were investigated and compared with those in other cells,
      such as human polymorphonuclear leukocytes (PMNs), and human periodontal ligament
      cells (PDLs), and with those of three species of periodontopathic bacteria:
      Porphyromonas gingivalis 381 (P. gingivalis), Prevotella intermedia ATCC25611 (P.
      intermedia), and Capnocytophaga sputigena ATCC33123 (C. sputigena). The
      biochemical properties of the isoenzymes were analyzed by the following methods:
      enzyme assays, inhibition pattern using three chemical inhibitors, 4 to 20%
      gradient polyacrylamide gel electrophoresis, thermostability, immunological
      specificity, and phosphatidylinositol-specific phospholipase C (PI-PLC)
      treatment. The inhibition experiment showed that ALP of the PMNs and PDLs
      possessed almost the same enzymatic properties of tissue-nonspecific ALP
      (bone/liver/kidney; TNSALP), and the ALP of the three species of periodontopathic
      bacteria possessed specific properties that were different from those of TNSALP,
      intestinal, or placental ALP. The ALP of the GCF was only slightly susceptible to
      levamisole (1 mM), L-phenylalanine (20 mM), and SDS (1%). An electrophoresis
      thermostability test demonstrated that the enzyme activity of the GCF was
      separated into one or two bands. The main heat-labile slow band contained the
      phosphatidylinositol (PI)-moiety-anchored ALP and possessed immunological
      specificity against anti-bone type ALP. The minor fast band was heat stable and
      showed mobility similar to that in P. gingivalis. These results indicated that
      the ALP of the GCF consisted of several ALP isoenzyme types whose possible
      origins are considered to be derived from phosphatidylinositol (PI) anchored ALP
      and periodontopathic bacterial ALP.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796490
TI  - The calcium channel blocker scare. Lessons for the future.

PMID- 7796491
TI  - Meeting highlights.

PMID- 7796492
TI  - Thrombolysis for acute myocardial infarction. Why is there no extra benefit after
      hospital discharge?

PMID- 7796493
TI  - Familial hypertrophic cardiomyopathy. Nonsense versus missense mutations.

PMID- 7796494
TI  - Has improvement in PTCA intervention affected long-term prognosis? The NHLBI PTCA
      Registry experience.
AB  - BACKGROUND: The NHLBI Percutaneous Transluminal Coronary Angioplasty (PTCA)
      Registry followed 1345 consecutive patients with first PTCA between 1977 and 1981
      (registry 1) and 2136 consecutive patients with PTCA between 1985 and 1986
      (registry 2). Changes in patient selection and in immediate and 1-year outcome
      are presented. This report extends to 5 years the comparison of the effects of
      early and more recent management with PTCA. METHODS AND RESULTS: Sixteen
      participating centers entered consecutive patients who had angioplasty for the
      first time between 1977 and 1981 and between 1985 and 1986. Patients with recent
      myocardial infarction (MI) were excluded. Vessel disease was defined according to
      the Coronary Artery Surgery Study. Successful dilatation required > or = 20%
      reduction in luminal narrowing and < 50% lumen diameter stenosis after
      intervention. Routine annual follow-up was conducted by telephone interview. The
      product-limit method was used to estimate freedom from untoward events, Cox
      regression analysis to model relative risk and adjusted relative risk of events
      between the two registries, and logistic regression when the exact time of
      outcome (such as recurrence of symptoms) was not known. Long-term event rates
      were computed by vessel disease for all patients and for the cohort of patients
      with initially successful PTCA. After adjustment for extent of disease, diabetes,
      prior bypass surgery (CABG), hypertension, age, and sex, the 5-year risk of death
      was similar in the two registry cohorts. However, rates of MI, CABG, and a
      combined outcome measure of death, MI, and/or CABG were significantly lower in
      the registry 2 cohort both for all patients and for patients who were initially
      treated successfully. Use of repeated PTCA was higher, and freedom from symptoms
      without adverse events was significantly better in the latter cohort.
      CONCLUSIONS: Compared with registry 1, the management of the registry 2 cohort
      resulted in lower 5-year morbid event rates and reduced CABG operations.
      Mortality rates remained similar. When symptomatic status was considered in
      combination with events, a significantly better outcome was seen overall and in
      the initially successful cohort. In registry 2, repeated PTCA was used with much
      greater frequency early after the initial procedure.

PMID- 7796495
TI  - Long-term outcome of women compared with men after successful coronary
      angioplasty.
AB  - BACKGROUND: Women who undergo coronary angioplasty have a higher in-hospital
      mortality than men, although much of this difference can be accounted for by
      their poorer clinical characteristics at the time of their procedures. However,
      whether or not there are important long-term differences in outcome between women
      and men after coronary angioplasty is not clear. METHODS AND RESULTS: A
      retrospective analysis was performed of 3027 consecutive patients (824 women and
      2203 men) who underwent successful angioplasty and who have been followed
      continuously for a mean of 5.5 years (range, 0.5 to 14 years). Follow-up is 100%
      complete. Event-free survival was assessed by the Kaplan-Meier method, and
      clinical end points were also examined by Cox proportional-hazards models to
      account for important baseline differences when appropriate. There was a trend
      toward lower survival among women during follow-up, but this was not significant
      (P = .06). The relative risk of death among women compared with men after
      adjustment for baseline differences was 0.94 (CI, 0.76 to 1.15; P = NS). No
      significant sex differences in occurrence of Q-wave myocardial infarction were
      observed. Women were less likely to remain free of angina after 10 years (34%
      versus 37%, respectively; P = .008), but after adjustment for baseline
      differences, this difference was not significant (relative risk of angina, 1.07;
      CI, 0.95 to 1.21). Women tended to have less coronary artery bypass surgery
      performed during follow-up (P = .06); adjusting for baseline differences made
      this difference more significant (relative risk, 0.79; CI, 0.64 to 0.96; P =
      .02). Among patients who were not treated in the setting of acute infarction, no
      sex differences in survival and freedom from myocardial infarction were noted.
      CONCLUSIONS: After successful coronary angioplasty, the long-term prognosis for
      women is excellent and is similar to that observed in men. Risk-adjusted survival
      did not differ significantly between the sexes, but less frequent use of
      subsequent surgical revascularization was observed in women.

PMID- 7796496
TI  - Bleeding complications with the chimeric antibody to platelet glycoprotein
      IIb/IIIa integrin in patients undergoing percutaneous coronary intervention. EPIC
      Investigators.
AB  - BACKGROUND: The potential for novel antiplatelet and antithrombin agents to
      contribute to periprocedural bleeding complications of percutaneous coronary
      revascularization is poorly defined. In the Evaluation of c7E3 Fab in Preventing
      Ischemic Complications of High-Risk Angioplasty (EPIC) trial, the periprocedural
      use of aspirin, heparin, and a chimeric antibody to the platelet glycoprotein
      IIb/IIIa integrin c7E3 Fab in 2099 patients significantly reduced postprocedural
      ischemic complications and 6-month clinical restenosis but was associated with
      increased procedural bleeding complications. We review these complications and
      describe clinical and procedural variables associated with increased bleeding
      complications in the EPIC trial. METHODS AND RESULTS: Patients with high-risk
      clinical or lesion morphological characteristics were randomized to receive
      placebo bolus plus placebo infusion, c7E3 Fab bolus plus placebo infusion, or
      c7E3 Fab bolus plus c7E3 Fab infusion. Patients received periprocedural aspirin
      and intravenous heparin continued for a minimum of 12 hours after the procedure.
      Outcomes reflecting bleeding complications were measured: transfusions, decreased
      hemoglobin, and an index including both parameters. Major bleeding complications
      unrelated to bypass surgery occurred in 3.3%, 8.6%, and 10.6%, and blood product
      transfusions were used in 7.5%, 14.0%, and 16.8% of patients treated with
      placebo, bolus c7E3 Fab, and bolus plus infusion c7E3 Fab, respectively (both P <
      .001). Most major bleeding complications occurred at the femoral access site,
      regardless of treatment. Intracranial hemorrhage (0.3%) and death (0.09%)
      attributable to major bleeding complications were rare. Multivariable regression
      analyses identified several variables significantly and independently related to
      major bleeding complications or greater blood loss, including greater age, female
      sex, lower weight, c7E3 Fab therapy, and duration and complexity of the index
      procedure. Major bleeding complications and blood loss in patients receiving
      bolus plus infusion were not significantly greater than in those receiving bolus
      alone (P = .38 and P = .14, respectively). CONCLUSIONS: Bleeding complications
      unrelated to bypass surgery were two to three times more frequent in patients
      receiving c7E3 Fab than in those receiving placebo, but most were transient and
      well tolerated. Risk-factor analysis and modification of concomitant
      antithrombotic and antiplatelet treatment strategies may aid in reducing bleeding
      complications and enhancing clinical benefit in patients receiving c7E3 Fab
      during percutaneous coronary revascularization.

PMID- 7796497
TI  - Effect of acute and long-term smoking on myocardial blood flow and flow reserve.
AB  - BACKGROUND: Cigarette smoking is a major preventable risk factor for coronary
      artery disease and sudden cardiac death. However, the effect of acute and long
      term cigarette smoking on coronary vasodilatory capacity and myocardial flow
      reserve has not been quantified in humans. METHODS AND RESULTS: To examine the
      effect of short-term and long-term smoking, myocardial blood flow was quantified
      at rest and during dipyridamole-induced hyperemia (0.56 mg/kg) in 12 smokers (10
      males and 2 females; mean age, 27 +/- 4 years) under baseline conditions
      (reflecting the effect of long-term smoking) and during short-term cigarette
      smoking with 13N ammonia, positron emission tomography, and a two-compartment
      model. Twelve sex- and age-matched nonsmokers served as control subjects. Smoking
      significantly increased the rate-pressure product at rest from 7525 +/- 1290 to
      9160 +/- 1125 (P < .001 versus baseline), which was paralleled by a proportional
      increase in myocardial blood flow at rest (0.70 +/- 0.17 versus 0.88 +/- 0.17
      mL.g-1.min-1; P < .05 versus baseline). In contrast, hyperemic blood flow
      declined from 2.23 +/- 0.35 at baseline (P = NS versus control) to 1.98 +/- 0.32
      mL.g-1.min-1 during smoking (P < .01 versus baseline). Accordingly, the
      myocardial flow reserve declined from 3.36 +/- 0.83 in smokers at baseline to
      only 2.28 +/- 0.28 during smoking (P < .0001 versus baseline). Thus, myocardial
      blood flow and flow reserve were similar in young, long-term smokers and young,
      healthy nonsmokers. CONCLUSIONS: Short-term smoking increases the coronary
      vasomotor tone during dipyridamole-induced hyperemia and markedly reduces the
      myocardial flow reserve. In contrast, long-term smoking does not attenuate the
      coronary vasodilatory capacity in young individuals with a relatively short
      smoking history. It might be speculated that the short-term reduction in the
      coronary vasodilatory capacity during smoking could lower the ischemic threshold
      in smokers with coronary artery disease and contribute to the increased risk for
      sudden cardiac death.

PMID- 7796499
TI  - Assessment of coronary artery distensibility by intravascular ultrasound.
      Application of simultaneous measurements of luminal area and pressure.
AB  - BACKGROUND: Atherosclerotic change in the coronary artery is associated with an
      impaired vessel wall distensibility. However, there are few data regarding the
      relation between vessel wall morphology and distensibility. Therefore, with
      intravascular ultrasound, we assessed coronary artery distensibility in
      angiographically normal coronary segments of humans. METHODS AND RESULTS: Data
      were analyzed at 35 angiographically normal coronary sites where circumferential
      or noncircumferential lesions were demonstrated by ultrasound in 22 patients
      (mean age, 55 years). After intracoronary injection of 500 micrograms
      nitroglycerin (NTG), coronary luminal area was measured with intravascular
      ultrasound (30 MHz, 3.5F to 4.3F, 1800 rpm). Intracoronary pressure was
      simultaneously measured with a 2F micromanometer-tipped catheter located at the
      left main coronary artery. The coronary distensibility index was calculated as 10
      fold the ratio of luminal area change to intracoronary pressure change during a
      cardiac cycle. Another pressure-independent vascular stiffness index, beta, was
      derived by the following formula: beta = [ln(SBP/DBP)]/(dD/diastolic mean
      diameter), where SBP is systolic intracoronary pressure, DBP is diastolic
      intracoronary pressure, and dD is the difference between systolic and diastolic
      diameters. At the sites where luminal areas were measured, thickness of intima
      media complex, defined as the distance between the intimal leading edge and the
      adventitial leading edge, was determined as an index of the severity of
      atherosclerosis. In seven segments, distensibility index was determined before
      and after NTG injection to examine the effect of NTG on coronary distensibility.
      In all examined sites, including circumferential and noncircumferential lesions,
      the luminal area was 12.6 +/- 5.0 mm2 during systole and 11.6 +/- 4.6 mm2 during
      diastole, and the calculated coronary distensibility index ranged from 0 to 0.83
      mm2/mm Hg. The thickness of the intima-media complex ranged from 0.12 to 1.30 mm,
      suggesting the presence of various grades of atherosclerosis even in the absence
      of angiographic lesions. There was a poor inverse correlation between thickness
      of the intima-media complex and distensibility index (r = .19, y = -0.17x + 0.41,
      P = .29). However, when noncircumferential lesions were excluded for evaluation,
      there was a significant inverse correlation between them (r = .58, y = -0.50x +
      0.72, P < .01). Under these conditions, the thickness of the intima-media complex
      also correlated with the value of beta (X10(-1), which ranged from 0.28 to 3.99
      (r = .70). After NTG injection, coronary distensibility increased by an average
      of 71% in the segments with a thin intima-media complex, whereas it did not
      substantially change in those with a relatively thick intima-media complex.
      CONCLUSIONS: These results suggest that coronary distensibility is impaired in
      the coronary sites accompanying occult atherosclerosis, none of which can be
      detected by the conventional angiography. NTG can augment coronary distensibility
      in the segments without a markedly thickened intima-media complex. We suggest
      that thickness of the intima-media complex can contribute to determining the
      coronary distensibility in clinical settings.

PMID- 7796498
TI  - In vitro responses of human peripheral small arteries in hypercholesterolemia and
      effects of therapy.
AB  - BACKGROUND: Studies in both animals and humans with raised lipid levels have
      demonstrated abnormalities in vascular function usually manifested by an
      impairment in endothelium-dependent vasorelaxation. This is believed to be an
      early event in atheroma formation. There are few data on the effects on vascular
      function in humans of lowering serum lipids. We conducted a study to investigate
      the effects of cholesterol reduction on the in vitro function of human peripheral
      small arteries in middle-aged patients with hypercholesterolemia. METHODS AND
      RESULTS: Subcutaneous gluteal fat biopsies were taken from 18
      hypercholesterolemic (HC) patients (mean +/- SEM serum total cholesterol, 9.7 +/-
      0.57 mmol/L) and 16 age- and sex-matched control subjects (mean cholesterol, 4.69
      +/- 0.18 mmol/L). Subcutaneous small arteries (internal diameter, < 330 microns)
      were dissected and mounted on a wire myograph for isometric tension measurements.
      The HC patients showed impaired relaxation to acetylcholine (10(-9) to 10(-6)
      mol/L) after preconstriction with the thromboxane A2 analogue U46619 (10(-6)
      mol/L, mean maximum relaxation, 42.9 +/- 5.4%) compared with control subjects
      (85.7 +/- 4.0%, P < .00001). Incubation with the nitric oxide substrate L
      arginine (3 mmol/L) improved the endothelium-dependent vasorelaxation response to
      acetylcholine (70.9 +/- 6.0%, P < .01) in patients but not in control subjects.
      Also, there was a smaller but significant difference in responses to the
      endothelium-independent agent sodium nitroprusside (10(-9) to 10(-6) mol/L)
      between the HC group (mean maximum relaxation, 76.9 +/- 6.0%) and the control
      subjects (89.7 +/- 6%; P < .01). A total of 10 patients had a second gluteal skin
      biopsy and repeat functional studies after successful cholesterol-lowering
      therapy after a mean period of 9.9 +/- 4.7 months. A significant reduction in
      total and LDL cholesterol was achieved (5.29 +/- 0.2 and 3.23 +/- 0.21 mmol/L,
      respectively; P < .001). This restored vasorelaxation to control values in
      response to both acetylcholine (mean maximum relaxation, 83.3 +/- 3.8%; P <
      .0001) and sodium nitroprusside (87.9 +/- 4.8%, P < .01). Although both groups
      were normotensive, there were significantly higher blood pressures in the HC
      group compared with control subjects (139 +/- 4.1 versus 123 +/- 3.0 mm Hg
      systolic, P < .01; 84 +/- 1.3 versus 75 +/- 2.2 mm Hg diastolic, P < .01). There
      was no difference in initial blood pressures between the entire group of 18 and
      the 10 patients who had repeat biopsies. The blood pressures fell to control
      values after cholesterol reduction (129.33 +/- 4.93 mm Hg systolic and 72.33 +/-
      2.93 diastolic mm Hg, P < .02 relative to pretreatment values). CONCLUSIONS:
      These results demonstrate abnormalities of both endothelium-dependent and 
      independent relaxation in human peripheral small arteries that are normalized
      with effective lipid lowering. The changes in blood pressure may have been
      secondary to the improvement in vascular function.

PMID- 7796500
TI  - A myosin missense mutation, not a null allele, causes familial hypertrophic
      cardiomyopathy.
AB  - BACKGROUND: Hypertrophic cardiomyopathy (HCM) is characterized by myocardial
      hypertrophy of unknown etiology. Missense mutations of the cardiac beta-myosin
      heavy-chain (beta-MHC) gene that may be responsible for cardiac hypertrophy have
      been detected in patients with HCM. On the other hand, gross structural
      abnormalities in the cardiac beta-MHC gene, ie, an alpha/beta hybrid gene and
      partial deletion of the gene, have also been reported. The direct correlation
      between gross abnormalities and development of HCM is not well understood.
      METHODS AND RESULTS: We analyzed the structure of the cardiac beta-MHC gene from
      patients with HCM by using polymerase chain reaction-DNA conformation
      polymorphism analysis and found two sequence variations in exons 3 and 22 in one
      patient. These sequence variations at codon 54 (exon 3; nonsense mutation) and
      codon 870 (exon 22; Arg-to-His mutation) were identified by direct sequencing and
      dot-blot hybridization with allele-specific oligonucleotide probes. Relatives of
      this patient were examined for the mutations. It was revealed that the missense
      mutation was inherited from the affected father and the nonsense mutation from
      the unaffected grandmother through the unaffected mother. In addition, the
      missense mutation was also found in seven other patients from two other unrelated
      multiplex HCM families. CONCLUSIONS: The Arg870His mutation was suggested to
      cause HCM. In contrast, the gene with the nonsense mutation would encode for a
      cardiac beta-MHC protein of only 53 amino acid residues, which may be too short
      to be incorporated into the thick filament assembly of cardiac myosin chains and
      showed no dominant phenotype of heart disease. This is the first report of a
      nonsense mutation in the human cardiac beta-MHC gene.

PMID- 7796501
TI  - Reduced epicardial coronary vasodilator capacity in patients with left
      ventricular hypertrophy.
AB  - BACKGROUND: Enlargement of the epicardial coronary arteries occurs in left
      ventricular (LV) hypertrophy as an adaptation to the increased coronary blood
      flow. METHODS AND RESULTS: Vasodilator capacity of the epicardial coronary
      arteries was determined in 44 patients. The dose-response relation of
      intracoronary nitroglycerin was assessed in 14 patients (7 control subjects and 7
      patients with aortic stenosis [study A]) using quantitative coronary angiography.
      In a second study (B), vasodilator capacity of the epicardial coronary arteries
      was determined in 15 control subjects and 15 patients with valvular heart
      disease. In study A, a curvilinear dose-response relation with maximal
      vasodilation after 90 micrograms intracoronary nitroglycerin was found in both
      control subjects and patients with aortic stenosis. Vasodilator capacity was
      reduced in those with aortic stenosis, although sensitivity to nitroglycerin was
      similar in both groups. In study B, coronary circumferential length at baseline
      was larger in those with LV hypertrophy (12.2 +/- 2.2 mm) than in control
      subjects (8.6 +/- 1.5 mm; P < .001); after 100 micrograms intracoronary
      nitroglycerin, it increased to 12.9 +/- 2.2 mm (6 +/- 5%) in those with LV
      hypertrophy and to 10.3 +/- 1.5 mm (21 +/- 8%; P < .001) in control subjects. An
      inverse relation between baseline circumferential length and its percent increase
      after nitroglycerin was found (r = -.71, P < .001). CONCLUSIONS: Vasodilator
      capacity of the epicardial coronary arteries is reduced in patients with LV
      hypertrophy, although sensitivity to nitroglycerin is normal. This may be due to
      a flow-mediated decrease in coronary vasomotor tone and/or the occurrence of
      vascular remodeling with an enlargement of the coronary arteries.

PMID- 7796502
TI  - Prolonged kinetics of recovery of oxygen consumption after maximal graded
      exercise in patients with chronic heart failure. Analysis with gas exchange
      measurements and NMR spectroscopy.
AB  - BACKGROUND: Patients with chronic heart failure (CHF) often complain of prolonged
      dyspnea after exercise. The determinants of oxygen consumption after exercise in
      these patients are unknown. We hypothesized that the kinetics of oxygen
      consumption recovery after graded exercise was prolonged in parallel with the
      recovery of muscle energy stores, was not affected by the exercise level, and
      could be used to assess the circulatory response to exercise. METHODS AND
      RESULTS: Seventy-two patients with CHF in Weber's class A (n = 28), B (n = 21),
      and C/D (n = 23) and 13 healthy subjects performed maximal upright bicycle
      exercise with breath-by-breath respiratory gas analysis. Kinetics of recovery of
      ventilation (VE), oxygen consumption (VO2), and CO2 production (VCO2) after
      exercise were characterized by T1/2, the time to reach 50% of the peak value.
      T1/2 VO2 (seconds) increased with the severity of CHF (97 +/- 17 for CHF A [P <
      .05 versus CHF B, P < .05 versus CHF C/D], 119 +/- 22 for CHF B [P < .05 versus
      control subjects, P < .05 versus CHF A, and P < .05 versus CHF C/D], 155 +/- 55
      for CHF C/D [P < .05 versus control subjects, P < .05 versus CHF A, and P < .05
      versus CHF B] compared with 77 +/- 17 for control subjects). T1/2 VCO2 and T1/2
      VE also increased similarly with the worsening of CHF. T1/2 VO2 was correlated
      negatively with peak VO2 (r = .65) and was reproducible (r = .96). To study the
      relation between T1/2 VO2 and the duration of exercise, 10 healthy subjects and
      22 patients underwent a second graded test at 75% and/or 50% of peak workload.
      T1/2 VO2 was minimally shortened, at only 50% of peak workload (P = .02).
      Finally, 19 patients underwent 31P nuclear magnetic resonance spectroscopy of the
      anterior compartment of the leg during exercise; the half-time of recovery of the
      ratio of inorganic phosphate to creatine phosphate (T1/2 Pi/PCr), reflecting the
      level of involvement of oxidative metabolism in the restoration of energetic
      metabolites after exercise, was linearly correlated with the half-time of VO2
      recovery (r = .70, P < .01). CONCLUSIONS: Postexercise T1/2 VO2 increases when
      CHF worsens, perhaps in part a result of slower kinetics of recovery of muscle
      energy stores. The time course of oxygen consumption recovery may represent a
      simple new criterion for measuring the impairment of the circulatory response to
      exercise in CHF, even submaximal exercise.

PMID- 7796503
TI  - Angiotensin-converting enzyme gene polymorphism has no influence on the
      circulating renin-angiotensin-aldosterone system or blood pressure in
      normotensive subjects.
AB  - BACKGROUND: Angiotensin-converting enzyme (ACE) is involved in the metabolism of
      two major vasoactive peptides, converting angiotensin (Ang) I into Ang II and
      inactivating bradykinin. An insertion/deletion (I/D) polymorphism is present in
      the 16th intron of the ACE gene and is strongly associated with plasma and
      cellular ACE levels. Contrasting with the lack of relation between ACE gene
      polymorphism and blood pressure level, a large case-control study has shown that
      the deletion marker allele of the ACE gene was associated with an increased risk
      of myocardial infarction. The pathophysiological link between ACE gene
      polymorphism and cardiovascular events remains hypothetical. One hypothesis is
      that this polymorphism influences Ang II and bradykinin concentrations in the
      peripheral and/or local circulations through its effects on ACE levels in plasma
      and endothelial cells. The aim of this study was to investigate the effect of the
      ACE gene I/D polymorphism on blood pressure, plasma active renin, and aldosterone
      regulation in normal subjects. METHODS AND RESULTS: Twenty-four normotensive male
      volunteers homozygous for the ACE I/D polymorphism (12 DD and 12 II) received a
      renin inhibitor infusion (remikiren 0.1 mg.kg-1.h-1 for 130 minutes) to suppress
      endogenous Ang I and Ang II production. Forty minutes after initiating the
      remikiren infusion, an exogenous Ang I infusion was begun and increased gradually
      every 15 minutes from 1 to 10 ng.kg-1.min-1. Median (range) plasma ACE levels
      (mU/mL) were 39 (32 to 57) and 24 (12 to 30) in the DD and II groups,
      respectively. Remikiren suppressed plasma Ang I and Ang II, increased plasma
      active renin (from 23 +/- 12 to 154 +/- 161 pg/mL), decreased plasma aldosterone
      (from 106 +/- 42 to 82 +/- 33 pg/mL), and slightly decreased diastolic blood
      pressure (from -2.4 +/- 2.7 mm Hg). The blood pressure and hormonal responses to
      Ang I infusion after renin inhibition and the slope of the rise in plasma Ang II
      with increasing Ang I dose were identical in both groups, as was the plasma Ang
      I/Ang II ratio before (DD, 2.09 +/- 1.04; II, 2.59 +/- 0.76) and after (DD, 0.15
      +/- 0.13; II, 0.09 +/- 0.03) combined renin inhibitor and Ang I infusion.
      CONCLUSIONS: Despite its association with a major difference in plasma ACE
      levels, the ACE I/D polymorphism did not influence the Ang II and plasma
      aldosterone production, plasma active renin decrease, or diastolic blood pressure
      increase induced by exogenous Ang I infusion, suggesting that ACE has no limiting
      influence on systemic Ang II generation and effects under these experimental
      conditions.

PMID- 7796505
TI  - Use of intravascular stents in systemic venous and systemic venous baffle
      obstructions. Short-term follow-up results.
AB  - BACKGROUND: Balloon-expandable intravascular stents are well accepted in the
      management of arterial obstructions. This study was undertaken to detail the
      immediate and short-term results of intravascular stent implantation in systemic
      venous and systemic venous baffle obstructions in children. METHODS AND RESULTS:
      Between September 1991 and June 1994, 12 patients had 21 stents implanted in 13
      systemic venous obstructions, 1 patient having stents placed in 2 separate
      obstructions. In the baffle group, 4 of 13 obstructions were at the superior vena
      cava/right atrial junction after atrial baffling for transposition of the great
      arteries. One of 4 patients had complete obstruction requiring transseptal needle
      perforation before stent implantation. There was an immediate gradient reduction
      from 12 +/- 8.4 mm Hg (range, 4 to 20 mm Hg) to 1.3 +/- 1.9 mm Hg (range, 0 to 4
      mm Hg, P = .05). The obstructed segment diameter increased from 3.5 +/- 3.9 mm
      (range, 0 to 8.5 mm) to 16 +/- 2.7 mm (range, 14 to 20 mm, P = .002). In the
      central vein group, 9 of 13 obstructions were in large central veins. Three of 9
      patients had complete obstruction requiring transseptal needle perforation before
      stent implantation. There was an immediate gradient reduction from 10.3 +/- 8.5
      mm Hg (range, 0 to 20 mm Hg) to 0.8 +/- 1.1 mm Hg (range, 0 to 3 mm Hg, P =
      .005). The obstructed segment diameter increased from 1.3 +/- 1.1 mm (range, 0 to
      2.8 mm) to 9.4 +/- 1.7 mm (range, 7.6 to 12 mm, P < .001). There were no acute
      complications in either group. In the follow-up group, patients were scheduled
      for clinical follow-up at 3, 6, and 12 months with echocardiography or magnetic
      resonance imaging (MRI) at 3 or 6 months and for repeat cardiac catheterization
      at 12 months. All stents were patent by echocardiography or MRI when studied at
      follow-up. Cardiac catheterization in 6 of 12 patients, 2 to 13 months after
      stent, demonstrated that all stents remained patent without compression or
      fracture. Follow-up and immediate poststent gradients were not significantly
      different (1 +/- 1.6 versus 0.7 +/- 1.2 mm Hg, P = NS). Neointimal hyperplasia (5
      of 6 patients) reduced the stent lumen only from 12.5 +/- 4.7 mm (range, 8 to 20
      mm) to 10.6 +/- 4.7 mm (range, 4.5 to 17.7 mm, P = NS). No stents required
      redilation. One of 18 stents placed in series had "unlocked" and rotated in the
      venous lumen but remained fully patent to flow. CONCLUSIONS: Balloon-expandable
      intravascular stents can be safely and effectively used to relieve systemic
      venous and systemic venous baffle obstructions, even when obstruction is
      complete. Short-term follow-up suggests excellent continued patency, but further
      follow-up is required to observe for progression of neointimal hyperplasia. We
      postulate that balloon-expandable intravascular stents will become the treatment
      of choice for the relief of selected systemic venous and venous baffle
      obstructions in the pediatric population.

PMID- 7796504
TI  - Modification of the Fontan procedure. Superior vena cava to left pulmonary artery
      connection and inferior vena cava to right pulmonary artery connection with
      adjustable atrial septal defect.
AB  - BACKGROUND: A modification of the Fontan procedure with unidirectional
      cavopulmonary connection is described in which the superior vena cava (SVC) is
      connected to the left pulmonary artery (PA) and the inferior vena cava (IVC) is
      connected to the right PA via a lateral tunnel with a snare-controlled,
      adjustable atrial septal defect (ASD). This allows matching of the SVC and IVC
      flows with the lung of appropriate size. The obligatory left Glenn shunt provides
      an adequate arterial oxygen saturation, and the elevation in SVC pressure is well
      tolerated. The adjustable ASD allows selective decompression of the IVC that
      maintains cardiac output and reduces fluid accumulation in the serous cavities.
      METHODS AND RESULTS: Since March 1992, we have performed this procedure in 18
      patients. There were 17 children and 1 adult. Median age was 3 years and 9 months
      (range, 13 months to 36 years). Six patients had been staged with a previous
      bidirectional Glenn shunt. Preoperative cardiac catheterization revealed a PA
      pressure of 13 +/- 2 mm Hg and a transpulmonary gradient of 5 +/- 3 mm Hg.
      Ventricular function was satisfactory in all patients. At the completion of
      bypass, the pressures in the SVC and IVC were 16 +/- 4 mm Hg and 10 +/- 3 mm Hg,
      respectively (P < .01). The left atrial pressure was 6.0 +/- 3.0 mm Hg and the
      arterial O2 saturation on 100% oxygen was 93 +/- 3%. There was one death as a
      result of intractable atrial arrhythmias. The remaining 17 patients had a mean
      hospital stay of 9.7 days (6 to 18 days). The length of pleural drainage was 7 +/
      3 days. The ASD was adjusted in 11 patients before discharge. Oxygen saturation
      at discharge was 85.4 +/- 4%. Nine patients had repeat catheterization. The ASD
      was completely closed in 6 patients, an average of 2.5 months after surgery
      (range, 3 weeks to 5 months). After ASD closure, the arterial oxygen saturation
      was 96 +/- 3%, and the SVC and IVC pressures were both 13 +/- 3 mm Hg.
      CONCLUSIONS: The Fontan procedure with unidirectional cavopulmonary connection
      and adjustable ASD has several advantages that may reduce mortality and morbidity
      for the high-risk Fontan candidate.

PMID- 7796506
TI  - Assessment of left-to-right intracardiac shunting by velocity-encoded, phase
      difference magnetic resonance imaging. A comparison with oximetric and indicator
      dilution techniques.
AB  - BACKGROUND: Velocity-encoded, phase-difference magnetic resonance imaging (MRI)
      has been shown to provide an accurate assessment of shunt magnitude in patients
      with large atrial septal defects, but its ability to determine shunt magnitude in
      patients with intracardiac left-to-right shunts of various locations and sizes
      has not been evaluated in a prospective and blinded manner. The objective of the
      present study was to determine whether velocity-encoded, phase-difference MRI can
      assess the magnitude of intracardiac left-to-right shunting in humans. METHODS
      AND RESULTS: Twenty-one subjects (15 women and 6 men; age range, 15 to 72 years)
      underwent velocity-encoded, phase-difference MRI measurements of flow in the
      proximal aorta and pulmonary artery, followed immediately by cardiac
      catheterization. The presence of left-to-right intracardiac shunting was assessed
      with hydrogen inhalation, after which shunt magnitude was measured by the
      oximetric and indocyanine green techniques. Of the 21 patients, 12 had left-to
      right intracardiac shunting detected by hydrogen inhalation. There was a good
      correlation (r = .94) between the invasive and MRI assessments of shunt
      magnitude. In comparison to oximetry and indocyanine green, MRI correctly
      identified the 12 patients with a ratio of pulmonary to systemic flow (Qp/Qs) of
      < 1.5 (9 without intracardiac shunting and 3 with small shunts) and the 9
      patients with a Qp/Qs of > or = 1.5 (6 with atrial septal defect, 1 with
      ventricular septal defect, 1 with patent ductus arteriosus, and 1 with both
      atrial septal defect and patent ductus arteriosus). CONCLUSIONS: Compared with
      measurements obtained during cardiac catheterization, velocity-encoded, phase
      difference MRI measurements of flow in the proximal great vessels can reliably
      assess the magnitude of intracardiac left-to-right shunting.

PMID- 7796508
TI  - Failure of heparin to inhibit intimal hyperplasia in injured baboon arteries. The
      role of heparin-sensitive and -insensitive pathways in the stimulation of smooth
      muscle cell migration and proliferation.
AB  - BACKGROUND: Heparin is a potent inhibitor of smooth muscle cell (SMC) growth and
      intimal hyperplasia in animal models but has been ineffective in inhibiting
      restenosis in humans. This difference may relate to flaws in clinical study
      design or, alternatively, to interspecies differences in SMC response to heparin.
      To determine whether heparin could inhibit intimal hyperplasia in a species more
      closely related to humans, we studied the effect of a low-molecular-weight
      heparin (LMWH) on baboon SMC proliferation and migration in culture and in
      arteries subjected to experimental angioplasty. METHODS AND RESULTS: LMWH or
      saline was infused continuously after experimental angioplasty of baboon
      peripheral arteries (six animals per group). After 28 days, bromodeoxyuridine
      (BrdU) was given to label proliferating cells, and balloon-injured arteries were
      perfusion-fixed in situ and removed for analysis. All arteries had
      reendothelialized (Evans blue dye exclusion). LMWH increased partial
      thromboplastin time (LMWH, 81.7 +/- 8.4 seconds versus saline, 34.7 +/- 0.8
      seconds [mean +/- SEM]; P = .004) but failed to inhibit intimal thickening or SMC
      proliferation (intimal area: LMWH, 0.19 +/- 0.03 mm2 versus saline, 0.21 +/- 0.03
      mm2; BrdU labeling: LMWH, 2.9 +/- 0.6% versus saline, 2.4 +/- 0.4%; P = NS). In
      culture, LMWH and standard heparin (100 micrograms/mL) significantly inhibited
      serum-induced but not platelet-derived growth factor (PDGF-BB)-induced SMC
      proliferation (% control, serum: LMWH, 60.5 +/- 4.0%, P = .0002; standard
      heparin, 29.4 +/- 8.2%, P = .0001; % control, PDGF-BB: LMWH, 117.7 +/- 11.3%, P =
      NS; standard heparin, 90.9 +/- 14.4%, P = NS) and SMC migration (% control,
      serum: LMWH, 15.3 +/- 1.9%, P = .0198; standard heparin, 26.4 +/- 13.8%, P =
      .0032; % control, PDGF-BB: LMWH, 98.5 +/- 14.3%, P = NS; standard heparin, 100.0
      +/- 13.5%, P = NS). CONCLUSIONS: LMWH failed to inhibit intimal hyperplasia in a
      baboon angioplasty model. Furthermore, LMWH blocked serum-induced but not PDGF-BB
      induced SMC proliferation and migration in culture. Thus, heparin-sensitive and 
      insensitive pathways exist for SMC activation. The relative importance of each
      pathway induced by injury may vary between species and thus account for different
      responses to heparin.

PMID- 7796507
TI  - An antibody against the exosite of the cloned thrombin receptor inhibits
      experimental arterial thrombosis in the African green monkey.
AB  - BACKGROUND: Thrombin inhibitors have been shown to be efficacious in animal
      models of thrombosis and in initial human clinical trials. It is unknown if their
      efficacy is due to their prevention of thrombin-mediated fibrin formation or to
      an inhibitory effect on thrombin-stimulated platelet activation. Appropriate
      tools to address this question have not been available. Therefore, to evaluate
      the role of the platelet thrombin receptor in intravascular thrombus formation, a
      polyclonal antibody was raised against a peptide derived from the thrombin
      binding exosite region of the cloned human thrombin receptor. This antibody
      serves as a selective inhibitor of the thrombin receptor for in vivo evaluation.
      METHODS AND RESULTS: The immune IgG (IgG 9600) inhibited thrombin-stimulated
      aggregation and secretion of human platelets. In contrast, it had no effect on
      platelet activation induced by other agonists including ADP, collagen, or the
      thrombin receptor-derived peptide SFLLR-NH2. IgG 9600 also inhibited thrombin
      induced aggregation of African Green monkey (AGM) platelets. By Western blot
      analysis, the IgG identified a protein of approximately 64 kD in homogenates of
      both human and AGM platelets. The effect of thrombin receptor blockade by this
      antibody on arterial thrombosis was evaluated in an in vivo model of platelet
      dependent cyclic flow reductions (CFRs) in the carotid artery of the AGM. The
      intravenous administration of IgG 9600 (10 mg/kg) abolished CFRs in three monkeys
      and reduced CFR frequency by 50% in a fourth monkey. Ex vivo platelet aggregation
      in response to up to 100 nmol/L thrombin was completely inhibited during the 120
      minute postbolus observation period in all four animals. There was a twofold
      increase in bleeding time, which was not statistically different from baseline,
      and ex vivo clotting time (APTT) was not changed. The glycoprotein IIb/IIIa
      receptor antagonist MK-0852 and the thrombin inhibitor recombinant hirudin also
      demonstrated inhibitory effects on CFRs at doses that did not significantly
      prolong template bleeding time. Control IgG had no effect on CFRs, ex vivo
      platelet aggregation, bleeding time, or APTT. CONCLUSIONS: These results
      demonstrate that blockade of the platelet thrombin receptor can prevent arterial
      thrombosis in this animal model without significantly altering hemostatic
      parameters and suggest that the thrombin receptor is an attractive antithrombotic
      target.

PMID- 7796510
TI  - Absence of lethal reperfusion injury after 3 hours of reperfusion. A study in a
      single-canine-heart model of ischemia-reperfusion.
AB  - BACKGROUND: Whether reperfusion can cause necrosis of previously viable myocytes
      (lethal reperfusion injury) remains controversial. Numerous studies examined the
      ability of various agents to prevent or limit reperfusion injury, but the results
      were contradictory. In a single-canine-heart model of ischemia-reperfusion, we
      previously demonstrated that 5 minutes of reperfusion does not increase the
      transmural extent of necrosis. Since the 5-minute period of reperfusion is
      considered by some to be too short for the full manifestation of reperfusion
      injury, we reexamined the issue of lethal reperfusion injury using a modification
      of the single-heart model of ischemia-reperfusion that allowed extending the
      reperfusion period to 3 hours. METHODS AND RESULTS: In anesthetized, open-chest
      dogs, the distal half of the left anterior descending coronary artery (LAD)
      segment between the last diagonal branch and the apex was perfused via a shunt
      from the left carotid artery. The shunt was closed for periods of 90 to 180
      minutes, depending on the ECG severity of ischemia, and reperfused for 3 hours.
      While the distal region was perfused from the carotid artery, the LAD was
      occluded proximal to the last diagonal branch for the same period of time as the
      distal region had been earlier. The time of occlusion was chosen such that the
      end of the occlusion period coincided with the end of the experiment. Thus, both
      regions of the LAD territory were subjected to identical periods of ischemia, but
      only the distal region was reperfused. At the end of the experiment, the boundary
      between the proximal (nonreperfused) and distal (reperfused) area was delineated
      by blue dye, and the heart was arrested, cut into slices 1 cm thick parallel to
      the LAD, and placed in triphenyltetrazolium chloride. The epicardial edges of
      necrosis in the reperfused and the nonreperfused regions were examined for any
      shift that might suggest a difference in the transmurality of necrosis. The areas
      of necrotic and viable myocardium were measured by planimetry within 1 cm on
      either side of the boundary. In all 14 dogs, the epicardial edges of necrosis ran
      as a single line across the boundary, and no shift was present. There was also no
      difference in the transmurality of necrosis between the reperfused and
      nonreperfused regions (64.9 +/- 20.7% versus 66.1 +/- 17.0% of left ventricular
      wall thickness, respectively, P = .32 by paired t test). CONCLUSIONS: In a single
      canine-heart model of ischemia-reperfusion, there was no evidence of lethal
      reperfusion injury after 3 hours of reperfusion.

PMID- 7796509
TI  - Pharmacodynamics of plasma nitrate/nitrite as an indication of nitric oxide
      formation in conscious dogs.
AB  - BACKGROUND: The present investigation was undertaken to better understand the
      production of nitric oxide (NO) in vivo as measured by alterations in plasma
      nitrite or nitrate in blood samples from studies in experimental animals or
      clinical studies in humans. METHODS AND RESULTS: Plasma samples were taken from
      the aorta, the coronary sinus, a peripheral vein in the leg (skeletal muscle), or
      the right ventricle (mixed venous) in chronically instrumented conscious dogs.
      Plasma nitrite was converted to NO gas in an argon environment by use of
      hydrochloric acid, and plasma nitrate was converted first to nitrite with nitrate
      reductase and then to NO gas with acid. Standard curves were constructed, and the
      amount of nitrite and nitrate in plasma was determined. The primary metabolite
      was nitrate, whereas nitrate was approximately 10% of the total and remained
      constant. In the resting dog, the only vascular bed with a positive arterial
      venous nitrate difference, evidence for production of NO, was the heart. Nitrate
      infusion into quietly resting dogs resulted in increases in plasma nitrate up to
      38 +/- 3.4 mmol/L, increases in systemic arterial pressure, and a marked
      diuresis. The plasma half-life was calculated as 3.8 hours. The volume of
      distribution was calculated as 0.215 L/kg, or equivalent to the extracellular
      volume. CONCLUSIONS: These studies indicate that nitrate is a reliable measure of
      NO metabolism in vivo but that because of the long half-life, nitrate will
      accumulate in plasma once it is produced. Because of the large volume of
      distribution (21% of body weight versus the 4% of body weight usually attributed
      to plasma volume, the compartment in which nitrate is measured), simple measures
      of plasma nitrate underestimate by a factor of 4 to 6 the actual production of
      nitrate or NO by the body. In disease states, such as heart failure, in which
      renal function and extracellular volume are altered, caution should be exercised
      when increases in nitrate in plasma as an index of NO formation are evaluated.

PMID- 7796511
TI  - Endovascular stent design dictates experimental restenosis and thrombosis.
AB  - BACKGROUND: Vascular interventions that maximize initial lumen diameter provoke
      extensive neointimal hyperplasia but minimize its effects, causing long-term
      lumen size to be greater. Nevertheless, interventions such as endovascular
      stents, which increase lumen size above that achieved with balloon angioplasty,
      are subject to frequent thrombosis and restenosis. It has been unclear whether
      the response to stent-induced injury is determined solely by the degree of stent
      induced arterial expansion or whether the geometric configuration of the stent or
      the material left in contact with the vessel wall also contribute. METHODS AND
      RESULTS: We examined the vascular response to steel stents deployed in denuded
      rabbit iliac arteries for 14 days. In one set of experiments, the effects of sten
      configuration were examined, holding diameter, mass, surface area, and stent
      surface material constant. In another set, stent surface material was changed,
      with mass, configuration, and diameter unaltered. Changing stent configuration to
      reduce strut-strut intersections by 29% without affecting mass or surface area
      reduced vascular injury by 42%, thrombosis by 69%, and neointimal hyperplasia by
      38%. Monocyte adhesion to stented arteries correlated linearly with vascular
      trauma and neointimal hyperplasia (r = .96, P < .01 for each). When the stainless
      steel surface was coated with an inert polymer material, vascular injury and
      neointimal hyperplasia were unchanged but thrombosis was eliminated. CONCLUSIONS:
      Surface material and geometric configuration of stents may be more important than
      postplacement diameter in determining neointimal hyperplasia and thrombosis.
      Alterations in configuration affect vascular injury and neointimal hyperplasia,
      while surface material plays a greater role in thrombosis. Monocytes may be
      important modulators of stent-induced intimal thickening. Clinical confirmation
      of these findings may alter coronary stent deployment techniques and future stent
      designs.

PMID- 7796512
TI  - Effect of cocaine on left ventricular function. Relation to increased wall stress
      and persistence after treatment.
AB  - BACKGROUND: To determine whether alterations in left ventricular (LV) function
      after a cocaine infusion are due to reduced myocardial contractility or changes
      in loading conditions, we examined LV function in 30 morphine-sedated, closed
      chest dogs. We also wanted to determine the time course of the effects of cocaine
      on LV function after the infusion was stopped. METHODS AND RESULTS: Two
      dimensional echocardiography and hemodynamics provided LV fractional shortening
      and end-systolic wall stress data. Radionuclide ventriculography was also
      performed. Four groups of dogs received saline or cocaine infusions of 10, 30, or
      100 micrograms.kg-1.min-1. Cocaine was infused for 90 minutes with ECG and
      arterial pressure monitoring. Animals were monitored for an additional 120
      minutes after the infusion ended. Arterial pressure rose over the course of the
      experiment in all four groups, but saline and cocaine 10 micrograms.kg-1.min-1
      did not significantly change ejection fraction. Cocaine 30 and 100 micrograms.kg
      1.min-1 acutely increased arterial pressure and heart rate but decreased ejection
      fraction from 0.64 +/- 0.06 to 0.45 +/- 0.08 and from 0.65 +/- 0.10 to 0.46 +/-
      0.11, respectively. Additionally, cocaine 100 micrograms.kg-1.min-1 decreased
      fractional shortening from 36 +/- 9% to 23 +/- 12%. However, cocaine 30 and 100
      micrograms.kg-1.min-1 also increased wall stress from 42 +/- 15 to 65 +/- 11
      g/cm2 and from 37 +/- 15 to 90 +/- 33 g/cm2, respectively. These results were
      analyzed by use of the relation between wall stress and fractional shortening as
      an index of contractility. Fractional shortening after cocaine infusion was
      displaced downward as a result of increased wall stress rather than changes in
      contractility. In addition, alteration of afterload with phenylephrine (6
      micrograms/kg) and sodium nitroprusside (10 micrograms/kg) before and during
      infusion of cocaine 100 micrograms.kg-1.min-1 showed similar regression lines for
      wall stress to fractional shortening. CONCLUSIONS: Ejection-phase indexes of LV
      function were reduced by cocaine in this model of conscious, sedated dogs, but
      effects were attributable to increased wall stress rather than to reduced
      myocardial contractility. These effects persisted for at least 2 hours after the
      infusion was stopped.

PMID- 7796514
TI  - Sudden loss of consciousness, dyspnea, and hypoxemia in a previously healthy
      young man.

PMID- 7796513
TI  - Erythromycin blocks the rapid component of the delayed rectifier potassium
      current and lengthens repolarization of guinea pig ventricular myocytes.
AB  - BACKGROUND: Administration of erythromycin to humans has been associated with
      lengthening of cardiac repolarization and even proarrhythmia. The objectives of
      our study were to describe effects of erythromycin on repolarization of isolated
      hearts and to determine effects of the drug on major K+ currents involved in
      cardiac repolarization. METHODS AND RESULTS: A first set of experiments was
      conducted in isolated, buffer-perfused guinea pig hearts electrically stimulated
      at a basic cycle length of 250 ms. In this model, erythromycin 10(-4) mol/L
      increased monophasic action potential duration measured at 90% repolarization
      (MAPD90) by 40 +/- 7 ms. Increase in MAPD90 was reproducibly observed in seven
      hearts studied. To study the mechanism of these effects on cardiac
      repolarization, a second set of experiments was performed in isolated guinea pig
      ventricular myocytes using the whole cell configuration of the patch-clamp
      technique. In these cells, erythromycin 10(-4) mol/L decreased by about 40% (P <
      .05 versus baseline) the time-dependent outward K+ current elicited by short
      depolarizations (250 ms) to low depolarizing voltages (-20 to 0 mV). In contrast,
      the drug was without significant effects on the time-dependent K+ current
      elicited by long pulses (5000 ms) to high depolarizing voltages (+10 to +50 mV),
      on the time-independent background current (mostly IKl), and on the slow inward
      calcium current. CONCLUSIONS: The outward time-dependent K+ current blocked by
      erythromycin in isolated guinea pig ventricular myocytes had characteristics
      similar to those described for IKr. Selective block of this component of IK gives
      an explanation for the effects of erythromycin on cardiac repolarization. These
      effects were observed at clinically relevant concentrations reached after
      intravenous administration of the drug and warn for potential interactions with
      other action potential-lengthening drugs.

PMID- 7796515
TI  - Images in cardiovascular medicine. Metallic mercury embolism.

PMID- 7796516
TI  - Anxiety and risk of coronary heart disease.

PMID- 7796517
TI  - Sidestream cigarette smoke and arteriosclerosis.

PMID- 7796518
TI  - Hemodynamic effects of sympathetic efferent reinnervation after orthotopic
      cardiac transplantation.

PMID- 7796519
TI  - Benefits of ventilation for CPR.

PMID- 7796520
TI  - Quantitative comparison of Acanthamoeba castellanii adherence to rigid versus
      soft contact lenses.
AB  - We evaluated quantitative differences in adherence of Acanthamoeba castellanii
      trophozoites and cysts to new unworn contact lenses as a function of contact lens
      type and duration of exposure. Daily wear soft (polymacon), disposable soft
      (etafilcon A), rigid gas permeable (RGP) (siloxane acrylate), and
      polymethylmethacrylate (PMMA) contact lenses were exposed to 1 x 10(5)/mL log
      phase A. castellanii (trophozoite:cyst ratio 90:10) for 10 seconds, 30 minutes,
      60 minutes, and 120 minutes. The number of adherent organisms was determined by
      light microscopy and confirmed by scanning electron microscopy. Rates of cyst
      adherence were similar among contact lens types. We observed significantly
      greater adherence of trophozoites to RGP and PMMA lenses compared with soft
      contact lenses (P < 0.05). This difference in trophozoite adherence was
      significant at all four time periods (P < 0.05). Our findings show that A.
      castellanii trophozoites and cysts adhere to both soft and rigid contact lens
      types. We also found that although trophozoite adherence increases as a function
      of duration of exposure, adherent organisms were observed with exposure times as
      brief as 10 seconds. This suggests that all contact lens types may be at risk for
      Acanthamoeba attachment and that even minimal exposure times may be sufficient
      for lens contamination.

PMID- 7796521
TI  - Normal protein and glycoprotein profiles of reflex tears and trace element
      composition of basal tears from heavy and slight deposits on soft contact lenses.
AB  - We investigated the hypothesis that lacrimal component accumulation on soft
      contact lenses (SCL) may be induced by an abnormal protein, glycoprotein, or
      trace element composition of the tear fluid. Individual tear samples were
      collected from healthy non-SCL wearers (normal patients) and SCL wearers grouped
      as either "slight-depositor" or "heavy-depositor" following SCL spoilage rate and
      frequency. The reflex tear proteins were analyzed by three electrophoretic
      procedures: sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE)
      on minigels, isoelectric focusing (IEF) on immobilized pH gradients (IPG 4-7),
      and two-dimensional separation combining IEF in the first dimension to orthogonal
      SDS-PAGE. After separation, the proteins were detected by silver staining and
      identified by immunologic probes. The reflex tear glycoproteins were analyzed by
      lectin affinity associated electrotransfer of SDS-PAGE with a panel of five
      biotinylated lectin probes: Canavalia ensiformis (Con A), Artocarpus integrifolia
      (Jacalin), glycine max (SBA), Ulex europaeus (UEA 1), and Triticum vulgaris (WGA)
      agglutinins. The basal tear trace elements were analyzed by Synchrotron Radiation
      X-ray Fluorescence. Despite the highly sensitive techniques used in the study,
      the profiles of reflex tear proteins, glycoproteins, and trace elements appeared
      to vary slightly among individuals. No evident qualitative difference in reflex
      tear fluid related to SCL wear or deposit formation susceptibility was found. The
      presence or absence of a particular protein, glycoprotein, or trace element could
      not be correlated with a different reactivity to SCL. However, potassium and
      carbohydrate residues having affinity with Jacalin and WGA presented little but
      not significant variations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796523
TI  - Phototherapeutic keratectomy for the treatment of nodular subepithelial corneal
      scars in patients with keratoconus who are contact lens intolerant.
AB  - The management of keratoconus with contact lenses may be complicated by punctate
      epithelial keratopathy, epithelial breakdown, and nodular, raised subepithelial
      scars. We report four consecutive cases of contact lens intolerance due to pain
      in patients with keratoconus and raised, nodular scars. Excimer laser
      phototherapeutic keratectomy (PTK) was used to treat all patients. Follow-up
      ranged from 7 to 14 months (mean: 10 months). All patients resumed rigid gas
      permeable (RGP) contact lens wear 2 to 4 weeks after surgery. Visual acuities
      ranged from 20/40 to 20/70 before surgery and improved to 20/25 or better in all
      patients postoperatively. PTK flattened the central cornea by an average of 5.43
      D (range: 1.13-10.19 D); and refractive cylinder was reduced an average of 4.00 D
      (range: 3.25-5.25 D). We conclude that PTK may delay or avoid penetrating
      keratoplasty in selected patients with keratoconus who are contact lens
      intolerant due to nodular subepithelial scars.

PMID- 7796522
TI  - Bacterial contamination in soft contact lens wearers.
AB  - We prospectively analyzed bacterial contamination in 15 soft contact lens wearing
      subjects. Contact lenses, cases, tips of saline solution bottles, and conjunctiva
      were cultured. Cultures were positive for 13 subjects (86.6%). Contamination was
      present in 13 contact lens cases (86.6%), 12 contact lenses (80.0%), nine saline
      solution bottles (60.0%), and in the conjunctiva of three patients (20.0%). Gram
      negative bacteria (Pseudomonas aeruginosa and Proteus mirabilis) were the most
      frequently isolated organisms. Staphylococcus aureus was the only gram-positive
      organism isolated. We discuss the possible sources of contamination, and
      emphasize the importance of contact lens care instruction.

PMID- 7796524
TI  - Videokeratography.
AB  - Our ability to assess corneal topography has improved tremendously in the last 10
      years. Current placido disk-based videokeratography units have made the process
      of image analysis simple, yet current systems are not perfect in their
      quantitative assessment of human corneas. The choice of a system depends on the
      user's needs and the evaluation of the differences in hardware, software, format
      of data output, service, frequency of software updates, user friendliness, and
      control of focusing errors. This article reviews the development of technology
      for assessing corneal topography.

PMID- 7796525
TI  - Learning from others.

PMID- 7796526
TI  - Will young children comply and follow instructions to successfully wear soft
      contact lenses?
AB  - We fit eighty-five children between the ages of 11 years and 13 years, 11 months
      with soft contact lenses to study safety of soft contact lens wear in children.
      We report the results at 6 months of a 3 year longitudinal study. Contact lens
      care compliance, a critical factor in successful lens wear, was evaluated using a
      questionnaire. The questionnaire was completed by 74 subjects at dispensing and
      at 1-week and 6-months post-dipensing visits. Subjects found contact lens removal
      to be the easiest and lens insertion the most difficult procedures. After 6
      months, 85% of the children correctly identified the purpose of lens care
      solutions, 90% knew that daily cleaning was necessary, 96% understood lens
      disinfection, and 99% expressed confidence in their ability to care for their
      lenses.

PMID- 7796528
TI  - Clinical experience with the SimulVue soft bifocal contact lens.
AB  - We fit the SimulVue bifocal contact lens, a soft lens with a simultaneous vision
      design, in 30 presbyopic patients. The lens has a central near correction
      surrounded by a concentric peripheral distance correction. Patients were
      evaluated prior to inclusion in the study and followed for a period of 1 year.
      The evaluation included visual acuity and contrast sensitivity at both distance
      and near with and without lenses. In addition, patients completed a questionnaire
      at the end of the study. At the end of 1 year, 16 of 30 (53%) patients were
      successfully wearing the contact lenses. Of these, 13 of 16 patients (81%)
      achieved J2 or better near vision, and 10 of 16 (63%) achieved 20/25 or better
      distance vision in both eyes. Greater reduction of contrast sensitivity occurred
      at near, with only 38% of patients (6/16) retaining their normal contrast
      sensitivity; whereas at distance, 81% of patients (13/16) retained normal
      contrast sensitivity. Fourteen patients failed to complete the study. The most
      common reasons cited were poor vision at distance (6/14, 43%), poor vision at
      near (6/14, 43%), and ghosting of images (4/14, 29%). We believe that the
      SimulVue contact lens is a viable option for the correction of many presbyopic
      patients.

PMID- 7796527
TI  - Gentle Touch, a lens material resistant to protein deposition.
AB  - We investigated the ability of the Gentle Touch, a non-ionic contact lens
      material containing 35% netrafilcon A and 65% water, to repel protein deposits.
      Studies were conducted in vivo (lenses worn by patients) and in vitro (lenses
      coated by artificial tears). Acuvue soft contact lenses, an ionic lens material
      containing 42% etafilcon A and 58% water, were used as controls. After 1 to 2
      weeks of wear, protein deposits on Gentle Touch lenses averaged 1.5-2.8
      micrograms per lens versus 338-444 micrograms per lens for Acuvue. Gentle Touch
      lenses that were heat-coated with an FDA tear solution recommended for testing
      protein deposition averaged 6.5 micrograms of protein deposits per lens, whereas
      almost 100 micrograms of protein was deposited on each Acuvue lens. Lenses
      treated with an artificial tear solution deposited a non-detectable amount of
      protein on each Gentle Touch lens versus more than 358 micrograms on each Acuvue
      lens. These studies demonstrated that Gentle Touch lenses are highly resistant to
      protein deposits.

PMID- 7796529
TI  - A comparative study of the microbiologic effectiveness of chemical disinfectants
      and peroxide-neutralizer systems.
AB  - We evaluated the antimicrobial activity of chemical and hydrogen peroxide
      neutralizer contact lens disinfection systems. The acute activity, storage, and
      recontamination potential of the two disinfection methods were compared by
      challenging the disinfectants with Staphylococcus spp., Pseudomonas aeruginosa,
      Serratia marcescens, Candida spp., and Aspergillus fumigatus. Chemical
      disinfectants preserved with polyquaternium-1 and polyhexamethylene biguanide and
      hydrogen peroxide-neutralizer systems with no additional preservatives were
      tested. Additionally, lens cases from patients using both systems were evaluated.
      Lens cases from patients using peroxide-neutralizer systems tended toward heavier
      contamination (31.8%) than the cases disinfected with a chemical system (20.3%, P
      = 0.16). The laboratory results showed that the differences in activity of
      chemical and peroxide-neutralizer systems was not statistically significant at
      the disinfection times against Staphylococcus epidermidis, S. marcescens, Candida
      parapsilosis, and A. fumigatus (P = 0.1037 to P = 0.5412). A statistical
      difference was shown against C. albicans (P = 0.0176) in favor of the peroxide
      neutralizer systems. The reverse was true during storage. Although the chemical
      disinfectants maintained the population of microorganisms, the bacteria and yeast
      increased to over 10(7) CFU/mL in neutralized peroxide systems. Overall, the
      results emphasize the importance of contact lens products containing
      preservatives for lasting protection from microorganisms.

PMID- 7796530
TI  - 8th International Congress of Mucosal Immunology. San Diego, California, July 17
      20, 1995. Abstracts.

PMID- 7796531
TI  - Positive and negative feedback loops affect the transcription of IME1, a positive
      regulator of meiosis in Saccharomyces cerevisiae.
AB  - The IME1 gene of Saccharomyces cerevisiae encodes a transcription factor that is
      required for the expression of meiosis-specific genes. Like many of the genes it
      regulates, IME1 itself is expressed according to the following complex pattern:
      barely detectable levels during vegetative growth, and high induced levels under
      starvation conditions, followed by a subsequent decline in the course of meiosis.
      This report examines the influence of Ime1 protein on its own expression,
      demonstrating feedback regulation. Disruption of either IME1 or IME2 leads to
      constantly increasing levels of Ime1-lacZ expression, under meiotic conditions.
      This apparent negative regulation is due to cis elements in the IME1 upstream
      region, which confer transient meiotic expression to heterologous promoter-less
      genes. A specific DNA/protein complex, whose level is transiently increased under
      meiotic conditions, is detected on this element. In ime1- diploids, the level of
      this DNA/protein complex increases, without any decline. These results indicate
      that the transient expression of IME1 is apparently due to transcriptional
      regulation. This report also presents evidence suggesting that Ime1p is directly
      responsible for regulating its own transcription. Positive feedback regulation in
      mitotic conditions is suggested by the observation that overexpression of Ime1p
      leads to increased levels of IME1-lacZ. Negative autoregulation in meiotic
      cultures is demonstrated by the observation that a specific point mutation in
      IME1, ime1-3, permits expression of meiosis-specific genes, as well as induction
      of meiosis, but is defective in negative-feedback regulation of IME1.

PMID- 7796533
TI  - Developmental regulation of the ovine beta-lactoglobulin/human serum albumin
      transgene is distinct from that of the beta-lactoglobulin and the endogenous beta
      casein genes in the mammary gland of transgenic mice.
AB  - We compared the developmental pattern of expression of the sheep beta
      lactoglobulin (BLG), the chimeric BLG/human serum albumin (HSA), and the
      endogenous murine beta-casein genes in the mammary gland of virgin, pregnant and
      lactating transgenic mice, both at the RNA (expression) and protein (synthesis
      and secretion) levels. The BLG and casein genes were expressed at very low levels
      in virgin animals and during early stages of pregnancy. The increase in the
      expression of these genes started at the second half of pregnancy and reached a
      peak between the end of pregnancy and day 10 of lactation. The accumulation of
      their RNA coincided with that of the corresponding proteins, indicating a
      transcriptional control of expression of these genes. The expression and
      secretion patterns of the endogenous casein gene in transgenic and nontransgenic
      mice were indistinguishable. The hybrid BLG/HSA gene constructs displayed
      distinct patterns of expression in virgin animals and at early stage of
      pregnancy, from that of the BLG transgene or the endogenous mouse milk protein
      gene. High levels of expression (17-60% of that on day 18 of pregnancy) were
      detected in the mammary gland of virgin animals. At day 5 of pregnancy there was
      a dramatic decrease in HSA synthesis and secretion in all transgenic strains
      tested. The down-regulation, revealed by immunoprecipitation and
      immunohistochemical studies, demonstrated that at that stage of pregnancy only 10
      18% of ductal structures contained HSA expressing cells in contrast to the
      majority of ducts expressing HSA in virgin animals. These morphological studies
      also demonstrated that the down-regulation in HSA synthesis and secretion was
      correlated with the transition from ducts comprised of a single layer of
      epithelial cells (characteristic of the virgin state) to ducts composed of
      multilayers of such cells. In two of the three transgenic strains tested, the
      down-regulation at the protein level was associated with a similar decrease in
      HSA transcripts. In the exceptional strain no. 23, HSA transcripts continued
      accumulating even at this stage. The differences in the control of expression at
      the RNA level between these transgenic strains were also confirmed by in situ
      hybridization. Our results suggest the involvement of at least two regulatory
      mechanisms effective at early stages of gestation in the control of
      expression/secretion of the HSA transgene targeted for expression in the mammary
      gland by the BLG milk protein promoter. These putative mechanisms may play key
      roles in the interplay between normal mammogenesis and lactogenesis.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 7796534
TI  - Developmental variability of metallothionein Mtn gene expression in the species
      of the Drosophila melanogaster subgroup.
AB  - Developmental expression of the Drosophila melanogaster metallothionein Mtn gene
      has been analysed. Transcripts of this gene accumulate during the vitellogenic
      phase of oogenesis in a ring of follicular cells at the oocyte-nurse cell margin
      and in the follicular cells surrounding the oocyte. There is also strong
      expression of the Mtn gene during the second half of embryogenesis in hemocytes,
      the endoderm midgut, and Malpighian tubules. A banded expression pattern is
      observed transiently in the midgut at stage 13. The two Mtn alleles, Mtn and Mtn,
      show quantitative differences in their expression patterns. Copper intoxication
      of flies does not induce ectopic expression of the Mtn gene, but rather leads to
      over-expression of the gene in the structures where it is normally transcribed.
      Mtn transcription is not altered in homozygous mutants of four genes (lab, wg,
      dpp, bap) known to be involved in midgut morphogenesis. Expression of Mtn has
      been also studied in six other species of the melanogaster subgroup. This
      analysis demonstrates that regulation of Mtn gene transcription has changed
      during evolution of the Drosophila lineage. For example, Mtn is expressed
      specifically in the Malpighian tubules of D. melanogaster, while in D. mauritiana
      and D. sechellia the amnioserosa is a specific location of expression.
      Nonetheless, expression of Mtn in the midgut is common to the seven species,
      suggesting a basic role for the MTN protein during embryogenesis in this organ,
      possibly in the release of metallic ions from vitellogenins. In contrast, two
      genes also expressed in the embryonic midgut, lab and dFRA, display identical
      patterns in all species of the melanogaster subgroup. The diversity of Mtn
      patterns in closely related Drosophila species exemplifies the rapid evolution of
      a gene regulatory system.

PMID- 7796532
TI  - Serum response element associated transcription factors in mouse embryos: serum
      response factor, YY1, and PEA3 factor.
AB  - Many mammalian transcription factors, including human and mouse serum response
      factors (SRFs), are post-translationally modified with O-linked N
      acetylglucosamine monosaccharides on multiple serine and/or threonine residues.
      Nuclear extracts were prepared from 9.5 to 19 days postcoitum mouse embryos and
      subsequently were fractionated by wheat germ agglutinin (WGA)-agarose affinity
      chromatography. SRF binds WGA-agarose and apparently is O-glycosylated. On the
      other hand, the low molecular weight serum response element (SRE)-binding
      proteins, including the previously named band I and band II factors, did not bind
      WGA-agarose. Furthermore, we showed that the fastest migrating complex contains
      the Yin-Yang 1 (YY1) factor. YY1 binds to the c-fos SRE and skeletal alpha-actin
      muscle regulatory element (MRE), but not the cardiac alpha-actin MRE. Nuclear
      extracts from NIH/3T3 fibroblasts contain similar, if not identical, SRE-binding
      complexes. Besides these SRE-binding factors, mouse PEA3-binding factor,
      presumably an ETS domain-containing protein, was found to bind SRF protein. This
      physical interaction, between SRF and ETS domain proteins, was shown to involve
      the DNA-binding domain-containing region of SRF and not the carboxyl-terminal
      transactivation domain.

PMID- 7796535
TI  - Genetic mosaic analysis of the equatorial-less mutation in Drosophila
      melanogaster.
AB  - eql (equatorial-less) is a recessive lethal mutation on the second chromosome of
      Drosophila melanogaster. J. Campos-Ortega found that eql clones in somatic mosaic
      flies have reduced numbers of photoreceptor cells, and he suggested that only the
      R1, R6, and R7 photoreceptor cells were missing in this mutant. These
      photoreceptor cells help to define the inverted orientation of ommatidial facets
      along the equatorial midline of the fly eye, hence the mutation was named
      "equatorial-less." We have conducted a detailed analysis of the eql mutation, by
      serial section reconstruction of eql clones marked with bw- or w- in somatic
      mosaic flies. We found that all photoreceptor cell types (R1-R8) could be deleted
      by the eql mutation, and in rare cases the number of photoreceptor cells was
      increased. The apparent lack of photoreceptor cell type specificity was confirmed
      by our analysis of genetically mosaic facets, which indicated that no single
      photoreceptor cell, or subset of photoreceptor cells, was uniquely required to
      express eql+. Rather, eql appears to function in all photoreceptor cells, and
      possibly in all eye precursor cells. The distribution of photoreceptor cell
      numbers in w eql facets was consistent with the hypothesis that each
      photoreceptor cell was deleted independently of the others. The eql gene is
      located on the right arm of chromosome 2 at map location 2-104.5 +/- 0.7 and lies
      between the polytene chromosome bands 59D8 and 60A7.

PMID- 7796536
TI  - Evaluation of an antisense RNA transgene for inhibiting growth hormone gene
      expression in transgenic rats.
AB  - We compared the levels of growth hormone (GH) mRNA in the pituitary, plasma GH
      concentration, and altered phenotype in rats heterozygous and homozygous for an
      antisense RNA transgene targeted to the rat GH gene, with those in nontransgenic
      rats. We initially investigated whether the transgene promoter, which is
      connected to four copies of a thyroid hormone response element (TRE) that
      increases promoter activity, affected in vivo transgene expression in the
      pituitary of the transgenic rats. Plasma GH concentration correlated negatively
      with T3 injection in surgically thyroidectomized heterozygous transgenic rats.
      There was a reduction of about approximately 35-40% in GH mRNA levels in the
      pituitary of homozygous animals compared with those in non-transgenic rats.
      Plasma GH concentration was significantly approximately 25-32 and approximately
      29-41% lower in heterozygous and homozygous transgenic rats, respectively,
      compared with that in nontransgenic animals. Furthermore, the growth rates in
      homozygous transgenic rats were reduced by approximately 72-81 and approximately
      51-70% compared with those of their heterozygous and nontransgenic littermates,
      respectively. The results of these studies suggested that the biological effect
      of GH in vivo is modulated dose-dependently by the antisense RNA transgene. The
      rat GH gene can therefore be targeted by antisense RNA produced from a transgene,
      as reflected in the protein and RNA levels.

PMID- 7796537
TI  - Embryonic regulation of histone ubiquitination in the sea urchin.
AB  - We have used quantitative 2-D protein electrophoresis and immunoprecipitation to
      study the patterns of histone ubiquitination at 10 h and 36 h of embryonic
      development in Strongylocentrotus purpuratus. Variants csH2A, alpha H2A, beta
      H2A, gamma H2A, delta HA, H2AF./Z, alpha H2B, beta H2B, and gamma H2B showed up
      to sevenfold differences in level of monoubiquitination between variants, and
      individual variants showed up to sixfold changes during development. At 36 h of
      embryogenesis, the late variants were less ubiquitinated than the early variants,
      although the overall level of ubiquitination was appreciably greater than at 10
      h. Antiubiquitin antibodies were used to precipitate formaldehyde-fixed chromatin
      fragments in order to estimate the degree of ubiquitination of the early histone
      genes. The 5' regulatory region of the active H3 gene appeared to be at least
      twice as ubiquitinated as the adjacent upstream spacer. However, the absolute
      level of ubiquitination of the early histone gene repeat seemed to be independent
      of transcriptional activity. These results show that variant-specific
      ubiquitination of histones is a part of the developmental program in sea urchin
      embryos, but is not clearly correlated with transcriptional activity of the early
      histone genes, except perhaps in the regulatory regions.

PMID- 7796538
TI  - Antepartum fetal surveillance.

PMID- 7796539
TI  - The contraction stress test.
AB  - The CST is one of the first forms of fetal surveillance; it is still the only
      form that tries to use the principle of induced stress to reveal marginal
      placental insufficiency. With the expansion of biophysical evaluation, there are
      many choices in antenatal testing. Clearly the CST should not be the only form of
      testing to follow high-risk pregnancies. However, its proved efficacy and close
      correlation with intrapartum monitoring make it an essential tool. With nipple
      stimulation techniques, it is an easy and quick method for evaluating the fetus.
      Clinicians who follow high-risk pregnancies need to understand fully the
      administration and proper interpretation of the CST.

PMID- 7796540
TI  - Computerized analysis of the fetal heart rate.

PMID- 7796541
TI  - Computerized fetal biophysical assessment.

PMID- 7796543
TI  - Primary care in ob/gyn.

PMID- 7796544
TI  - Upper respiratory and pulmonary problems.

PMID- 7796542
TI  - Antenatal fetal assessment: overview and implications for neurologic injury and
      routine testing.

PMID- 7796545
TI  - Evaluation and treatment of uncomplicated hypertension.
AB  - The gynecologist is competent to perform an initial evaluation and workup on the
      patient with hypertension. The use of effective medications, such as the
      thiazides, beta-blockers, calcium-channel blockers, and angiotensin-converting
      enzyme inhibitors should control most patients. Patients with mild hypertension
      who have abnormal laboratory values or multiple other systemic diseases, or do
      not respond to therapy should be referred to an internist. Patients who present
      with markedly elevated systolic or diastolic pressure (e.g., a systolic reading
      higher than 160 mm Hg and a diastolic higher than 110 mm Hg) also should be
      referred to an internist for further evaluation.

PMID- 7796546
TI  - Common gastrointestinal syndromes diseases.
AB  - Gastrointestinal syndromes are an important contributory cause of morbidity for
      women, although in many cases, the gynecologist may primarily diagnose and treat
      uncomplicated disease. The role of endoscopy in the management of more difficult
      cases requires referral. The role of flexible sigmoidoscopy performed by the
      gynecologist for colorectal screening is intriguing.

PMID- 7796549
TI  - The role of the obstetrician/gynecologist in primary health care.

PMID- 7796547
TI  - Gallbladder disease and the gynecologist.
AB  - Gallbladder disease continues to be a common problem for women. Diagnostic tools
      such as ultrasonography have allowed earlier and more accurate diagnoses to be
      made. Therapies have changed significantly in the past few years, and the new
      treatments are associated with lower morbidity than is the classic
      cholecystectomy. The gynecologist should be aware of evolving technologies to
      assist his or her patient in choosing the safest and most cost-effective
      therapies.

PMID- 7796548
TI  - Headache.
AB  - An attempt has been made to provide an overview of headache management for the
      primary healthcare provider for women. No attempt has been made to delineate for
      the clinician all care related to the difficult-to-manage headache patient, but
      at the same time, information has been provided that should assist the clinician
      in treating this common disorder. Often, a comprehensive approach is needed, and
      appropriate referral may be necessary to other healthcare providers who are
      capable of providing more specific services. The women's healthcare provider
      often has important psychologic and environmental information necessary to
      provide meaningful early intervention. This common complaint in patients is often
      overlooked and/or dismissed as "happening to everybody," thus patients are
      unnecessarily neglected. Not only can specific therapy be provided for the
      headache patient, but this complaint can serve to alert caregivers to other
      organic and emotional problems.

PMID- 7796551
TI  - Nonstress test.

PMID- 7796550
TI  - Dynamic ultrasound-based fetal assessment: the fetal biophysical profile score.
AB  - The advent of ultrasound fetal imaging and the evolution of dynamic imaging (real
      time) methods have opened great new vistas in which fetal responses can be
      monitored with remarkable precision and clarity. Contained within this new wealth
      of information may lie the key to direct determination of the fetus at risk for
      death or injury in utero. Consideration of fetal activities so plainly recognized
      by conventional dynamic ultrasound methods and an assessment of fetal environment
      appear to be integral parts of this process. It is reasonable to assume that
      composite assessment by the dynamic ultrasound-based PBS will remain a valuable
      adjunct in caring for the high-risk fetus.

PMID- 7796553
TI  - Fetal movement monitoring.
AB  - Monitoring fetal movement serves as an indirect measure of central nervous system
      integrity and function. The coordination of whole-body movement, which requires
      complex neurologic control, is similar to that of the preterm newborn infant.
      Short-term observations of the fetus are best performed using real-time
      ultrasound imaging or Doppler ultrasound. Daily fetal movement charting by the
      compliant patient is a worthwhile adjunct in determining the frequency of fetal
      surveillance tests in the office and in predicting abnormal FHR patterns and
      perhaps impending stillbirth. Monitoring has its greatest value when placental
      insufficiency is long-standing, and its routine role in low-risk pregnancies
      requires further clinical investigation. The presence of a vigorous fetus is
      reassuring. Perceived inactivity requires reassessment of any underlying
      antepartum complication and more precise evaluation by FHR testing or real-time
      ultrasonography before delivery is considered.

PMID- 7796552
TI  - Fetal biophysical assessment in premature rupture of the membranes.

PMID- 7796555
TI  - Assessment of amniotic fluid volume in at-risk pregnancies.

PMID- 7796554
TI  - Vibroacoustic stimulation.
AB  - Vibroacoustic stimulation of the human fetus profoundly alters fetal behavior and
      heart rate. Many authors have reported success using this technique to improve
      the efficiency of antepartum fetal heart rate testing without changing the
      predictive reliability of the tests. Vibroacoustic stimulation has other
      potential advantages in the antepartum assessment of fetal well-being and in
      provoking fetal activity to improve ultrasonic visualization. From an
      experimental standpoint, vibroacoustic stimulation offers a unique opportunity to
      assess how the fetus responds to the external environment. The available
      information suggests that exposure of the fetus to vibroacoustic stimulation is
      clinically safe. Additional research is needed to characterize the optimal
      frequency, duration, intensity, and choice of stimulus to provide consistent
      responses. The literature presents a confusing array of studies using different
      methods, which makes comparison of results among institutions and investigators
      difficult. Vibroacoustic stimulation appears to be a reasonable and safe clinical
      technique. Additional prospective investigation is necessary to characterize
      further how this technique can be more useful clinically.

PMID- 7796556
TI  - Doppler ultrasound velocimetry for fetal surveillance.

PMID- 7796557
TI  - [The role of diuretics in antihypertensive therapy].
AB  - Hypertensive therapy based on diuretics is time-honored. Thiazides represent the
      most commonly used class of diuretics for uncomplicated hypertension because of
      economic motivations, their tolerance and efficacy both as monotherapy and in
      combined treatment with other agents. Clinical studies using diuretics and beta
      blockers reported that thiazide treatment prevents the development of malignant
      hypertension, renal and heart failure, hypertensive retinopathy, and reduces in
      five years overall mortality of 33%, cardiovascular mortality of 41%, fatal and
      non-fatal cerebrovascular events of 51% and the risk of coronary events of 15%.
      The less than expected risk reduction of cardiovascular disease raised many
      concerns about the possibility of adverse biochemical changes of thiazides
      through their effects on lipids, electrolytes and glucose metabolism. However,
      the real clinical significance of these metabolic effects remains actually
      uncertain and needs further investigation. The treatment of the hypertensive
      patient cannot be adequately managed using a merely adjunctive step-care
      criterium. Hypertensive subjects have different haemodynamic, metabolic and
      endocrine disorders and a tailored treatment should consider the different
      activities of the various agents as monotherapy or in association in the single
      patient.

PMID- 7796559
TI  - [Gingival hyperplasia induced by amlodipine].

PMID- 7796560
TI  - [Obesity and arterial hypertension. Relation between insulin secretion,
      peripheral insulin resistance and pressure indices].
AB  - The association between obesity and hypertension has been well documented. Both
      conditions are often linked to an insulin resistance state. In a group of
      homogeneously obese hypertensive subjects, the presence of a significant
      correlation between degree of insulin resistance and severity of hypertension was
      found. These results confirm that, independently of obesity and insulin
      secretion, equally present in all the subjects, high blood pressure is inversely
      correlated to hormone sensitivity.

PMID- 7796558
TI  - [Evaluation of the action of glucomannan on metabolic parameters and on the
      sensation of satiation in overweight and obese patients].
AB  - The authors studied the behavior of body weight, blood glucose, total serum
      cholesterol, and hunger and satiety sensation in 30 patients treated for 60 days
      with a 1.200 kcal (5040 kj) diet plus either placebo or glucomannane. All the
      variables considered show that the low-calorie diet plus glucomannane is more
      effective than the low-calorie diet alone.

PMID- 7796561
TI  - [The role of the endothelium of the microcirculation in the physiopathology of
      critical ischemia in the lower limbs as well as other forms of ischemic
      pathology].
AB  - Critical ischemia of the lower limbs, the condition of decompensation of chronic
      obstructive arterial disease, is the upshot of a series of pathophysiologic
      events involving both the macrocirculatory and microcirculatory systems. It ist,
      however, the latter modulator of the decompensatory stage of arterial disease
      that conditions the severity and hence the anatomical and clinical pattern of
      ischemia.

PMID- 7796563
TI  - [Tumors of the temporal bone and the cerebellopontine angle. Diagnosis,
      characterization and assessment of extension by using imaging technics].
AB  - We discuss in this paper the reliability of neuroimaging techniques in the
      diagnosis of neoplastic masses of the posterior-lateral skull base. We also
      discuss the role of TC and MRI in the evaluation of the extension pattern of
      these masses.

PMID- 7796562
TI  - [Orbital cellulitis in pediatric age. Report of a case and review of the
      literature].
AB  - The authors report about 2-year-old female affected by orbital cellulitis. The
      most recent advances about physiopathology, diagnosis and therapy of orbital
      cellulitis are described.

PMID- 7796564
TI  - [Overdosing on diltiazem in heptic insufficiency].
AB  - In a patient with hepatic failure of middle grade diltiazem at standard
      therapeutic dosis for unstable angina caused collateral fuss on atrioventricular
      conduction. This event is not considered in medical literature or on the schedule
      of the product. Because of the pharmacokinetics features of diltiazem, a higher
      risk of side effects can be expected if a abnormality of hepatic function is
      present.

PMID- 7796565
TI  - [Current orientation in medical management of ulcerative colitis].
AB  - Authors synthetically remind epidemiology, eziopathogenesis and clinic of
      ulcerative colitis; they after describe the drugs employed in therapy of disease,
      stressing the mechanism of action, efficacy, collateral effects. Authors remember
      the choice of cortisonic therapy in the acute and severe periods of disease and
      the specific activity of salazopyrine and its metabolite 5-aminosalycilic acid in
      the ulcerative colitis and refer about the use of drugs as immunodepressors,
      fatty acids omega 3, zileuton, short chain fatty acids. Practical patterns of
      therapy in the diverse stages and clinical forms of the disease are exposed.

PMID- 7796566
TI  - [Tolerability and side effects of interferon alpha in the treatment of chronic
      viral hepatitis].
AB  - It is reported a review on side effects and toxicity of alfa interferon in
      treatment of chronic viral hepatitis. The clinical experience in 44 patients
      affected by chronic hepatitis and treated with 3MU of alfa interferon is
      analysed.

PMID- 7796568
TI  - [Sarcoidosis with pulmonary abscess caused by emerging microorganisms].
AB  - The association sarcoidosis-lung abscess due to emerging microorganisms-mycetoma
      has prompted the authors to report the above clinical case which is interesting
      in view of the rarity of the disease and of its infective complications. The
      authors also review the literature on the subject.

PMID- 7796567
TI  - [Retrospective study of 135 cases of lung neoplasms diagnosed between 1983 and
      1993].
AB  - The authors expose the results of a retrospective study concerning 135 cases of
      neoplasia diagnosed by their Department between 1983 and 1993. The patients' age,
      their sex, their consume of tobacco, their survival from the moment of the
      diagnosis have been considered in the study. Likewise the clinical instrumental
      researches and their reliability, the different incidence of the examined
      pathology in the first and in the second part of the period considered. It is
      emerged from the collected data, that also in our territory there is an
      increasing tendency in the incidence of lung neoplasia, a generally short
      survival after the diagnosis, a strong prevalence of smokers among those people
      affected from the disease, the difficulty of an early diagnosis due to scarce
      specificity of the commonest symptoms. The final auspicious is that a more
      incisive diligence in prevention and significant progresses in clinical
      pharmacological research may determine a notable reduction of the incidence of
      such a dramatic pathology.

PMID- 7796570
TI  - [Tumors of the sphenoid. Contribution of imaging technics with special reference
      to the role of magnetic resonance].

PMID- 7796569
TI  - Prolonged treatment with ursodeoxycholic acid for primary biliary cirrhosis.
AB  - Eighteen patients affected with biopsy-proved primary biliary cirrhosis (PBC)
      (histological stage III and IV) received ursodeoxicholic acid (UDCA) 600 mg for 1
      year. Signs and symptoms and biochemical tests (glutamic and oxalcetic
      transaminase, glutamic and pyruvic transaminase, bilirubine, gamma-glutamyl
      transpeptidase, alkaline phosphatase, leucine aminopeptidase, bile acids, plasma
      proteins electrophoresis, immunoglubulins A, G and M) and antimitochondrial
      antibodies were evaluated before the treatment and every four months during the
      treatment. The results were compared with those obtained in 8 untreated patients
      affected PBC. The control group of patients were comparable (as far as age,
      histological stage, biochemical tests are concerned) to the group who received
      UDCA. Bilirubine, ALP, gamma-GT and LAP decreased during the treatment with UDCA
      and remained lower than baseline values until the end of the observation (12
      months), while no changes occurred in the untreated patients. Both in the treated
      and untreated group plasma protein electrophoresis, serum immunoglubulins A, G
      and M remained unchanged, as well as anti-mitochondrial antibody. A moderate
      reduction of transaminases and bile acids was observed in the group of patients
      receiving UDCA but it did not reach statistical significance. In 16 out of the 18
      treated patients pruritus disappeared and resulted diminished in the remaining 2
      patients. No significant amelioration of pruritus was observed in the patients
      who did not receive UDCA. In conclusion, our data show that prolonged treatment
      with UDCA drastically reduces pruritus and improves cholestasis biochemical tests
      in patients affected with symptomatic PBC.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796571
TI  - [A case of pulmonary aspergillosis effectively treated with itraconazole.
      Possible interaction of the antimycotic agent with hydroquinidine].
AB  - This study describes a case of pulmonary aspergilloma in a neutropenic patient
      affected with myelodysplastic syndrome. It reports the therapeutic efficacy of
      itraconazole, emphasizing in particular the possible interaction with quinidine,
      with QT prolongation--at ECG--disappeared after quinidine withdrawal.

PMID- 7796573
TI  - Hidden assumptions in the critique of occult blood testing.

PMID- 7796572
TI  - Diagnosis and management of fulminant hepatic failure.
AB  - Fulminant hepatic failure is defined as the development of hepatic encephalopathy
      within 8 weeks of the onset of illness. While there are many causes of FHF, viral
      hepatitis, particularly hepatitis B, remains the most common etiology. Several
      drugs and toxins can also lead to FHF, most notably acetaminophen. Even with
      improvements in ICU care, mortality remains very high for these patients.
      Conservative management focuses on invasive monitoring and the prevention and
      treatment of complications like cerebral edema, infection, renal failure, and
      coagulopathy. Only orthotopic liver transplantation has reduced mortality from
      80% to 30% to 50%. Therefore, the goals of management and treatment now include
      determining which patients are appropriate for liver transplant and finding a
      donor in a timely fashion.

PMID- 7796575
TI  - Transjugular intrahepatic portosystemic shunt (TIPS) in the management of
      esophageal variceal hemorrhage.

PMID- 7796574
TI  - Acquired immunodeficiency syndrome enteropathy: a perspective.

PMID- 7796576
TI  - Management of ascites.

PMID- 7796577
TI  - Extrahepatic manifestations of chronic viral hepatitis.

PMID- 7796578
TI  - A test of the association of a time-dependent state variable to survival.
AB  - An SAS macro which implements a more general version of the Mantel-Byar method is
      presented. Patients are assumed to potentially change between any number of
      states any number of times until censored or reaching a predefined endpoint. The
      macro employs methodology which generalizes that of the well-known logrank test
      to assess the association between state and endpoint.

PMID- 7796579
TI  - High performance computing for the human genome project.
AB  - Human Genome Analysis and Image Processing are part of the 'Grand Challenges' in
      High Performance Computing. The traditional mainframe has become insufficient for
      these applications in Biocomputing. New scalable parallel processor systems enter
      the marketplace with superior price/performance. The evaluation process of such a
      system by an application-oriented benchmark test suite is described. The system
      is integrated in the client/server structure of the Deutsches
      Krebsforschungszentrum where 'rightsizing' will eliminate the mainframe
      completely in the near future.

PMID- 7796581
TI  - Construction of molecular evolutionary phylogenetic trees from DNA sequences
      based on minimum complexity principle.
AB  - Ever since the discovery of a molecular clock, many methods have been developed
      to reconstruct the molecular evolutionary phylogenetic trees. In this paper, we
      deal with the problem from the viewpoint of an inductive inference and apply
      Rissanen's minimum description length principle to extract the minimum complexity
      phylogenetic tree. Our method describes the complexity of the molecular
      phylogenetic tree by three terms which are related to the tree topology, the sum
      of the branch lengths and the difference between the model and the data measured
      by logarithmic likelihood. Five mitochondrial DNA sequences, from the human, the
      common chimpanzee, the pygmy chimpanzee, the gorilla and the orangutan, are used
      for investigating the validity of this method. It is suggested that this method
      might be superior to the traditional method in that it still shows good accuracy
      even near the root of phylogenetic trees.

PMID- 7796580
TI  - Supercomputer algorithms for efficient linear octree encoding of three
      dimensional brain images.
AB  - We designed and implemented algorithms for three-dimensional (3-D) reconstruction
      of brain images from serial sections using two important supercomputer
      architectures, vector and parallel. These architectures were represented by the
      Cray YMP and Connection Machine CM-2, respectively. The programs operated on
      linear octree representations of the brain data sets, and achieved 500-800 times
      acceleration when compared with a conventional laboratory workstation. As the
      need for higher resolution data sets increases, supercomputer algorithms may
      offer a means of performing 3-D reconstruction well above current experimental
      limits.

PMID- 7796582
TI  - X-HUSAR, an X-based graphical interface for the analysis of genomic sequences.
AB  - Management and analysis of nucleotide and protein sequence and structure data
      constitute a traditional area of bioinformatics. Since the analytical programs
      are frequently developed by researchers, rather than software engineers, they
      tend to suffer from idiosyncratic and non-ergonomic man-machine interfaces. We
      report on HUSAR, our 140+ collection of third-party, as well as in-house
      developed or adapted, sequence manipulation and analysis tools, well integrated
      into the UNIX operating system environment and accessible via consistent menu
      aware interface. Most of the HUSAR programs can be completely specified by UNIX
      command-line options; they can thus be run in batches or combined into pipes.
      Adding such a program into the HUSAR environment is almost a 'plug-and-play'
      exercise. HUSAR has been recently complemented with a graphical client interface,
      X-HUSAR, to support users on UNIX platforms with X11 windowing systems. The whole
      X-HUSAR interface is based on a single generic program, COMLIGEN, and a number of
      specific configuration files. COMLIGEN interprets those files and renders
      appropriate windows, menus, and other interactive elements, which help the end
      user in selecting application programs and specifying their options. Efforts of
      extending both HUSAR and X-HUSAR are roughly linear to the size of the
      collection.

PMID- 7796583
TI  - SEQPWR and SEQOPR: computer programs for design of maximum information trials
      based on group sequential logrank tests.
AB  - The maximum information trial paradigm for clinical trials with failure time data
      was recognized and has been investigated. With the maximum information trial
      paradigm, a study is concluded when a prespecified maximum number of events of
      interest, thus maximum information, has been accrued if there was no early
      stopping due to treatment difference or lack thereof. We present two interactive
      FORTRAN programs for use in designing maximum information trials based on group
      sequential logrank tests. The program SEQPWR computes the attainable power of
      group sequential logrank tests given the combinations of the accrual and follow
      up durations. The program SEQOPR allows the users to investigate the operating
      characteristics of the maximum information trial given the information fractions
      of interim analyses. A clinical trial from the Eastern Cooperative Oncology Group
      is provided to illustrate the usage and features of the programs.

PMID- 7796584
TI  - A computer program linking physiologically based pharmacokinetic model with
      cancer risk assessment for breast-fed infants.
AB  - The risk assessment process predicts the chances of adverse health effects that
      the toxicant possibly can do to the target organism under expected conditions of
      exposure. Regulators chose among several mathematical approaches to estimate the
      risk, but in each case it is necessary to link the dosemetrics of the toxicant
      with its predicted health effect. In this paper, a computer program is described
      that allowed us to link a physiologically based pharmacokinetic (PBPK) model for
      tetrachloroethylene (PCE) in the lactating mother with the estimate of extra
      cancer risk for breast-fed infants, according to the U.S. Environmental
      Protection Agency (EPA) methodology. When inhaled by a lactating woman, PCE may
      partition into breast milk and may be transferred to the breast-fed infant. We
      have developed and validated experimentally a PBPK model for lactational transfer
      of PCE in rats, including a quantitative description of a milk compartment and
      the nursing pup. Subsequently, the model has been scaled to describe human
      physiology, and was validated with literature data for human cases of PCE
      exposure. Finally, we linked the dosage predictions of the PBPK model with
      equations used by EPA to estimate the cancer risk from PCE. The model predictions
      are in good agreement with both the measured values and those reported in the
      literature for exposure to PCE. This comparison confirms the usefulness of PBPK
      modeling in risk assessments.

PMID- 7796585
TI  - The pragmatics of clinical hypermedia: experiences from 5 years of participatory
      design in the MEDEA project.
AB  - To explore a medical hypermedia design process where requirements engineering and
      participatory design are used in a naturalistic setting, 5 years of participatory
      action research (PAR) have been performed in the development of a hypermedia
      system to be used in primary care practice. In PAR, the participating
      organizations cooperate with the researchers in deciding and later evaluating
      organizational actions, and the results are concluded cooperatively. A new type
      of system emerged from the study, in that the resulting design has its focus on
      the management of large volumes of hypermedia material, the traceability of
      authority in the documents, and teamwork support. Regarding the participatory
      design process, it was found to be essential to deal with social and
      organizational issues in the design group and its surroundings--and not to cover
      these over. For instance, an agreement was reached with the managers responsible
      for health care in the county where the design process took place, whereby the
      design activity was also given priority at the highest local administrative
      level. Since health care is a practice organization, there is a potential market
      for similar systems if only ways of organizing design and marketing the products
      of participatory design are further developed. Modified versions of structured
      product specification methods could be a valuable complement. The conclusion of
      the study is that the development and spread of hypermedia systems in health care
      may require considerable changes in current design routines and organizations.

PMID- 7796586
TI  - Bone mass and long-term monophasic oral contraceptive treatment in young women.
AB  - A prospective study has been designed to investigate bone metabolism in young
      women taking an oral monophasic contraceptive formulation (ethinylestradiol 20
      micrograms + desogestrel 0.150 mg) over 5 years. Healthy women (n = 200) between
      19 and 22 years of age were divided into two groups. Group A received oral
      contraception, Group B did not receive any treatment. All the subjects underwent
      a bone mass density (BMD) evaluation at spinal level L2-L4 with Dexa (Norland XR
      26) and a measurement of the serum alkaline phosphatase levels and urinary
      excretion of OH-proline at baseline and every 12 months over 5 years. Our results
      demonstrated that Group A did not show any significant BMD change after 5 years
      of oral contraceptive treatment, while Group B demonstrated a significant
      increase (p < 0.01) in the bone mass content at the end of the time of
      observation (+7.8% after 5 years). No significant changes were found in serum
      alkaline phosphatase levels and in urinary excretion of OH-proline at the end of
      the study in comparison with basal levels in both groups. Our data suggested that
      long-term treatment with an oral monophasic contraceptive formulation
      (ethinylestradiol 20 micrograms + desogestrel 0.150 mg) did not modify the BMD
      but prevented the occurrence of the physiologic peak of bone mass in young women.

PMID- 7796587
TI  - Multicenter trial of two monophasic oral contraceptives containing 30 mcg
      ethinylestradiol and either desogestrel or gestodene in Thai women.
AB  - The efficacy and acceptability of two third generation oral contraceptives in
      Thai women were evaluated in a prospective, open, group-comparative, randomized,
      multicenter trial of women asking for contraception. In six Family Planning
      Centers and Outpatient Gynaecological Clinics in urban areas in Thailand, 783
      healthy women who were at risk for pregnancy and did not have contraindications
      to oral contraceptive use were randomly allocated to one of the two study groups.
      An oral contraceptive containing 30 mcg ethinylestradiol and 150 mcg desogestrel
      was given to 394 women and an oral contraceptive with the same amount of
      ethinylestradiol and 75 mcg gestodene to 389 women during 6 cycles. Criteria of
      cycle control, side effects and the presence and severity of acne vulgaris were
      assessed and blood pressure and body weight measured at pretreatment and after
      cycles 1, 3 and 6. Furthermore, the efficacy was evaluated after the last cycle.
      No pregnancies occurred with either of the contraceptives. The incidences of
      irregular bleeding and minor side effects in both groups were very low and
      decreased after an initial increase in the first cycle. Acne improved in both
      groups. Blood pressure and body weight remained unchanged. The two oral
      contraceptives were found to be effective and acceptable in Thai women. Compared
      to Caucasian women, the incidences of irregular bleeding and side effects were
      apparently lower in these Asian women. Furthermore, the effects of both oral
      contraceptives were comparable.

PMID- 7796588
TI  - Levonorgestrel intrauterine device in the treatment of menorrhagia in Chinese
      women: efficacy versus acceptability.
AB  - Ten Chinese women who had menorrhagia without organic cause and suffered from
      anaemia were treated with levonorgestrel intrauterine device for a total of 129
      woman-months. There was a 54%, 87% and 95% reduction in menstrual blood loss at
      the first, third and sixth month of treatment when compared with the pretreatment
      cycle. These percentages of reduction were statistically significant, with p
      values of 0.004, 0.03 and 0.008, respectively. There was a median increase in
      menstrual cycle length of 12 days in nine months. Fifteen percent of the
      menstrual cycles were longer than 60 days. The total bleeding days increased by 4
      days at the third menstrual cycles, but reduced to a median of 6 days at 6
      months. Seventy-six percent of the menstrual bleeding was in the form of
      spotting. These Chinese women accepted such menstrual alterations. There was no
      hormonal side effects. All women preferred the device to hysterectomy.
      Levonorgestrel intrauterine device appeared to be an effective and acceptable
      treatment for menorrhagia in perimenopausal Chinese women.

PMID- 7796590
TI  - Endometrial morphometry in users of intrauterine contraceptive devices and women
      with ovulatory dysfunctional uterine bleeding: a comparison with normal
      endometrium.
AB  - Copper-bearing intrauterine contraceptive devices (IUCD) are commonly associated
      with menorrhagia. They cause certain morphological changes in the endometrium.
      These have been extensively reported and the mechanisms of menorrhagia have been
      investigated in a number of studies. By contrast, ovulatory dysfunctional uterine
      bleeding has not been as widely studied and mechanisms of menorrhagia in these
      patients are still not well understood. In this study, we examined endometrial
      morphometry in a group of women using IUCD, a group of women with ovulatory
      dysfunctional bleeding, and a control group of women with entirely normal cycles.
      There was increased leukocytic infiltration of the endometrium in both groups of
      women with menorrhagia compared to control cases. In addition, IUCD use was
      associated with greater luteal phase glandular epithelial height, supporting the
      concept of a secretory function defect in glandular epithelium. Possible links
      are postulated between static morphometric observations and dynamic biochemical
      changes.

PMID- 7796589
TI  - Return of fertility following discontinuation of Norplant-II subdermal implants.
      ICMR Task Force on Hormonal Contraception.
AB  - A total of 627 women who had discontinued the use of the Norplant-II implants for
      various reasons and were exposed to the risk of pregnancy were followed-up for
      two years for return of fertility. The cumulative conception rates in women who
      had discontinued due to planning pregnancy were 80.3 per 100 women at one year
      and 88.3 per 100 women at two years. The majority of women who did conceive (90
      percent), had full-term normal live births; about 4 percent of women had
      spontaneous abortions, the remaining 6 percent decided on elective termination of
      pregnancy (ETP). The cumulative conception rates in women who discontinued due to
      bleeding irregularities and 'other reasons' were 64.5 and 55.8 per 100 women at
      one year and 77.9 and 75.1 per 100 women at two years, respectively. These rates
      were significantly lower as compared to those observed in women who discontinued
      due to planning pregnancy. A large proportion, about 40 percent, of women who
      conceived after discontinuation of the method due to bleeding irregularities and
      "other reasons," opted for ETP indicating that many women in these two groups did
      not desire another child and that such women need to be counselled for adopting
      another method of contraception. The spontaneous abortion rates observed in ex
      users of Norplant-II implants (1.7 to 4.4% pregnancies) were comparable to the
      spontaneous abortion rates prior to Norplant-II implant use (3.6% pregnancies)
      indicating that ex-users of Norplant-II implants were not at a higher risk of
      spontaneous abortion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796591
TI  - Effects of mifepristone and progesterone on collagen synthesis in the human
      uterine cervix.
AB  - Antiprogestins are used to induce first trimester abortion and to dilate the
      cervix before vacuum aspiration. Cervical dilatation is associated with profound
      changes in the connective tissue. In what respect antiprogestins interfere with
      this process has hitherto been sparsely investigated. The aim of present study
      was to examine the influence of the antiprogestin mifepristone on cervical
      collagen synthesis in nonpregnant, early and late pregnant women. The effects
      were compared with those of progesterone. The content of collagen in cervical
      tissue was determined by measuring hydroxyproline. Collagen synthesis was studied
      in vitro either by incubation of cervical tissue specimens from women, pretreated
      with mifepristone in vivo, in the presence of 14C-proline or by incubation of
      cervical tissue of not pretreated women in the presence of the isotope and
      mifepristone or progesterone. Pretreatment with mifepristone, but not
      progesterone, induced a significant increase in cervical dilatation. The cervical
      concentration of collagen was not altered after mifepristone administration.
      Pretreatment with mifepristone did not quantitatively influence the time course
      of radiolabeling in vitro or the pattern of radiolabeling in different protein
      components as revealed by electrophoresis. In vitro mifepristone, like
      progesterone, reduced the incorporation of 14C-proline. From the present data we
      conclude that mifepristone pretreatment in connection with first trimester
      abortion is not associated with any major changes, qualitatively or
      quantitatively, of collagen synthesis. However, we cannot exclude that
      mifepristone still may affect the de novo formation of collagen since
      mifepristone, administered in vitro, did reduce collagen synthesis.

PMID- 7796593
TI  - The change of carnitine content in seminal plasma after reversible injection
      occlusion of vas deferens.
AB  - The change in carnitine content in seminal plasma after reversible injection
      occlusion of vas deferens (RIOVD) was observed. RIOVD is a safe, effective and
      simple method of male fertility control. Carnitine was determined by
      microenzymatic method. The incidence of sperm disappearance increased with the
      duration of RIOVD and reached 90% at the end of 12 months after operation. Before
      RIOVD, the mean value of carnitine in seminal plasma was 336.9 +/- 78.1 nmol/ml
      (X +/- SD, n = 58); after RIOVD, the mean value of seminal plasma carnitine was
      112.7 +/- 50.7 nmol/ml (n = 172) in the group with sperm disappearance, and 172.5
      +/- 71.7 nmol/ml (n = 51) in the group without sperm disappearance. There was a
      significant difference in carnitine content between pre-operation and
      postoperation (p < 0.01). After RIOVD, the carnitine concentration in seminal
      plasma of the group with sperm disappearance was lower than that of the group
      without sperm disappearance (p < 0.01). The results suggest that carnitine
      content in seminal plasma following RIOVD may be a reference index for judging
      the success or failure of the operation.

PMID- 7796594
TI  - Lactational anovulation in non-human primates: restriction of nursing inhibits
      Prl secretion without precipitating the return of ovulatory menstrual cyclicity
      in cynomolgus monkeys.
AB  - To test the hypotheses that nighttime suckling and elevated nocturnal prolactin
      concentrations are essential for the continuation of lactational anovulation, the
      effects of restricting nursing to twelve h per day (either day or night) on
      maternal prolactin (Prl) levels and resumption of ovulatory menstrual cycles were
      studied in five groups of cynomolgus monkeys: Group 1: baby weaned: Group 2: baby
      fully nursed: Group 3: baby nursed night only; Group 4: baby nursed day only; and
      Group 5: baby housed with mother but not allowed to nurse. Restrictions were
      initiated at approximately 150 days postpartum and were achieved by placing a non
      nursing jacket over the nursing jacket, which was worn 24 h/day. Fifteen out of
      seventeen monkeys remained anovulatory while housed with their infants,
      irrespective of the type of nursing restriction. First postpartum ovulations
      occurred approximately two months post-weaning. Plasma prolactin concentrations
      during both day and nighttime were significantly (p < 0.05) greater in the fully
      nursing group(s) than in all other groups. Fully nursing mothers had
      significantly (p < 0.01) greater prolactin concentrations at night than during
      the day. Among the restricted groups, the night only suckling group had
      significantly greater prolactin concentrations at night than the other restricted
      groups. There were no differences between daytime values, and within each
      restricted group there were no significant differences between day and night
      prolactin levels. We conclude that 1) nighttime suckling is not an absolute
      prerequisite for sustained lactational anovulation, and 2) suckling-induced
      hyperprolactinemia is not the principle mediator of lactational anovulation.

PMID- 7796592
TI  - The effect of small doses of progesterone released from two types of vaginal
      rings on ovarian activity and bleeding patterns during the first postpartum year.
AB  - A total of 20 breastfeeding women used progesterone-releasing vaginal rings for
      up to 12 months. The women were divided into two groups, one (n = 9) using rings
      with an initial release rate of 5 mg/24 h, the other (n = 11) with a release rate
      of 20 mg/24 h. Individual women started to give breast milk supplements and
      ceased to breastfeed after various periods of time. Urinary estrone and
      pregnanediol glucuronide levels were measured by radioimmunoassay three times
      weekly during the entire trial. Individual diary cards were used to register
      bleeding and spotting. A significantly higher concentration of pregnanediol
      glucuronide was seen when the 20 mg/24 h ring was used in the lactation period,
      in comparison with the 5 mg/24 h ring. In the post-lactation period, pregnanediol
      glucuronide levels dropped when the 20 mg/24 h ring was used. Estrone glucuronide
      levels increased after the termination of breastfeeding, indicating an enhanced
      suppression of ovarian activity in the lactation period with both rings. Although
      the degree of suppression was dose-related, both rings were likely to offer a
      sufficient contraceptive effect in the lactation period. No significant changes
      were observed when milk supplements were added to breastfeeding. The use of the
      20 mg/24 h ring resulted in a much better bleeding pattern (significantly less
      bleeding days) than the 5 mg/24 h ring during the lactation period. In the post
      lactation period, the 20 mg/24 h ring the bleeding because much worse than in the
      lactation period.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796595
TI  - Early abortifacient action of RU 486 by continuous intravenous infusion in rat.
AB  - RU 486 administered through constant intravenous infusion at 20 mg/kg dose on day
      8 of pregnancy induced frank vaginal bleeding and resorption of all implantations
      in 100% rats. This was associated with an almost 4-fold reduction in progesterone
      secretion rate by the dispersed luteal cells ex-vivo. At 12 mg/kg dose, an
      incomplete resorption of implantations was observed in all treated animals.
      Results indicate that slow and continuous intravenous infusion of this
      antiprogestin was highly effective in terminating pregnancy shortly after
      implantation in the rat and this could, at least partially, be related to its
      luteolytic action in this species.

PMID- 7796596
TI  - A tribute to Christian Robert Klimt (1918-1994).

PMID- 7796597
TI  - Observational versus randomized medical device testing before and after market
      approval--the atherectomy-versus-angioplasty controversy.
AB  - Percutaneous transluminal coronary angioplasty was developed in the late 1970s as
      a nonsurgical alternative for revascularization of atherosclerotic coronary
      arteries. It gained widespread acceptance without a controlled trial. Introduced
      in 1986, directional coronary atherectomy was the first of other recently
      developed coronary devices that sought to improve on the results of angioplasty.
      It was approved in 1990 by the Food and Drug Administration (FDA) on the basis of
      observational data. Its use expanded rapidly, reaching over 35,000 procedures in
      1992, accounting for more than 10% of all interventions. After premarket
      approval, two major randomized trials tested the hypothesis that atherectomy
      would be superior to angioplasty. Their results raised a cautionary flag and
      stood in contrast to projections made from prior observational data. It is
      concluded that randomized controlled trials validate claims of relative efficacy
      and safety of competing medical technologies, a lesson reflected in recent
      changes in policy at the FDA.

PMID- 7796598
TI  - A simple measure in defining optimal strata in clinical trials.
AB  - This paper deals with balancing groups with respect to prognostic factors in
      clinical trials, as a means of increasing the power of a study. We use the Mantel
      Haenszel statistic to obtain a simple measure for assessing the relative
      efficiency of different factors for stratification and to find optimal cutpoints
      for the given factors. For any available database, the measure can be used to
      construct optimal strata for a clinical trial. The paper also presents a
      practical approach for reducing the number of strata using discriminant regions
      with a method of assessing the effectiveness of this approach. An example from a
      large database of severe head trauma patients illustrates the utility of the
      measure.

PMID- 7796599
TI  - UKCCCR Register of U.K. Cancer Trials.
AB  - The UKCCCR Register of U.K. Cancer Trials comprises an on-line database of all
      randomized trials of cancer therapy, whether phase III or randomized phase II
      trials. Both current or open trials, and closed or completed trials, are
      included. Abstracts of any publications associated with the trials are also
      included. The UKCCCR Register is the initial component of a larger European
      register of trials. This article describes the structure and content of the
      database, the PC program for data entry, and the Unix-based browsing software for
      interactive access over networks. Problems of ensuring complete and comprehensive
      registration of trials, and sources of information, are also reviewed.

PMID- 7796600
TI  - The effect of topical retinoic acid (Etretinate) on mouse conjunctival Langerhans
      cells.
AB  - Four groups of BALB/c mice were treated locally with different concentrations
      (0.1-1.0%) of retinoic acid (Etretinate) ointment for a period of one to four
      weeks. A fifth group was treated with the ointment base only. Ia-positive
      dendritic cells were identified by an indirect immunofluorescence technique which
      was confirmed by ADPase staining. Quantitative counts of Langerhans cells were
      performed for each group. After four weeks, the 0.1 and 0.2% Etretinate-treated
      conjunctiva showed no significant reduction in Langerhans cell concentration.
      However, following 0.5 and 1.0% Etretinate treatment for four weeks, the
      concentration of Langerhans cells was significantly reduced, and the cells showed
      morphologic changes, consisting mainly of loss of dendritic processes. Between
      one and two weeks of therapy at these two high concentrations, no significant
      changes were found. Light microscopy of the conjunctival epithelium showed marked
      atrophic changes following four weeks of 0.5 and 1.0% Etretinate treatment
      compared to no changes with 0.1 and 0.2% Etretinate treatment.

PMID- 7796601
TI  - Endogenous ascorbate regenerates vitamin E in the retina directly and in
      combination with exogenous dihydrolipoic acid.
AB  - Vitamin E (alpha-tocopherol) is the major lipid-soluble antioxidant of retinal
      membranes whose deficiency causes retinal degeneration. Its antioxidant function
      is realized via scavenging peroxyl radicals as a result of which phenoxyl
      radicals of alpha-tocopherol are formed. Our hypothesis is that alpha-tocopherol
      phenoxyl radicals can be reduced by endogenous reductants in the retina,
      providing for alpha-tocopherol recycling. The results of this study demonstrate
      for the first time that: (i) endogenous ascorbate (vitamin C) in retinal
      homogenates and in rod outer segments is able to protect endogenous alpha
      tocopherol against oxidation induced by UV-irradiation by reducing the phenoxyl
      radical of alpha-tocopherol, (ii) in the absence of ascorbate, neither endogenous
      nor exogenously added glutathione (GSH) is efficient in protecting alpha
      tocopherol against oxidation; (iii) GSH does not substantially enhance the
      protective effect of ascorbate against alpha-tocopherol oxidation; (iv) exogenous
      dihydrolipoic acid (DHLA), although inefficient in direct reduction of the alpha
      tocopherol phenoxyl radical, is able to enhance the protective effect of
      ascorbate by regenerating it from dehydroascorbate. Thus, regeneration of alpha
      tocopherol from its phenoxyl radical can enhance its antioxidant effectiveness in
      the retina. The recycling of alpha-tocopherol opens new avenues for
      pharmacological approaches to enhance antioxidants of the retina.

PMID- 7796603
TI  - Co-transplantation of embryonic retina and retinal pigment epithelial cells to
      rabbit retina.
AB  - The retinal pigment epithelium (RPE) is important for normal development of the
      neural retina. We sought to investigate whether cografting RPE cells affected the
      differentiation and survival of retinal grafts. Pigmented embryonic day 16 (E16)
      rabbit retina was dissected either with or without attached RPE and injected into
      a lesion site in retinas of young adult rabbit hosts. Each host obtained a pure
      retina graft in one eye and a retina/RPE cograft in the other. Animals were
      sacrificed after 4, 8 and 12 weeks. After 4 weeks, grafts (1-2 mm in diameter)
      were seen in both experimental groups at the lesion site or in the subretinal
      space. However, 8 and 12 weeks after transplantation, the graft survival rate
      decreased. The grafts developed cell layers in folded sheets and many rosettes (a
      rosette consists of photoreceptors and cells of other retinal layers around a
      central lumen defined by an outer limiting membrane). Cografts of retina with RPE
      had areas of more distinct cell lamination than transplants of pure retina.
      Grafted RPE cells were organized in clusters of cells surrounded by extracellular
      matrix and often associated with blood vessels. If the extracellular matrix of
      RPE cell clusters was outside the rosettes close to inner retinal layers in the
      graft, transplant Muller cell endfeet developed an inner limiting membrane.
      Muller cell endfeet could also be observed in subretinal transplants attached to
      the denuded Bruch's membrane of the host. In 12-week grafts, when RPE cell
      clusters were inside rosettes, the surrounded photoreceptors survived better. No
      RPE effect could be seen if single RPE cells were dispersed among retinal donor
      cells.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796602
TI  - Alteration of glutamine concentration in the vitreous humor in patients with
      proliferative vitreoretinopathy.
AB  - Using sensitive high performance liquid chromatography (HPLC), we measured free
      amino acid concentrations in the undiluted vitreous samples of patients who
      underwent pars plana vitrectomy for treatment of idiopathic preretinal macular
      fibrosis (PMF, n = 8), proliferative diabetic retinopathy (PDR, n = 12), or
      proliferative vitreoretinopathy (PVR, n = 15) to investigate the effect of
      vitreoretinal diseases on the concentrations of free amino acids in human
      vitreous. The most abundant amino acid was glutamine in all of three groups.
      Other major amino acids commonly found in the human vitreous samples were serine,
      alanine, arginine, valine, and lysine. Patients with PDR and PVR showed
      significantly lower concentrations of glutamine in vitreous (PDR: 655 +/- 230
      nmoles/ml, PVR: 683 +/- 302 nmoles/ml) than those with PMF (PMF: 975 +/- 247
      nmoles/ml; significance level, PDR: p < 0.01, PVR: p < 0.05). In addition,
      patients with grade D PVR showed significantly lower concentration of glutamine
      (357 +/- 117 nmoles/ml) than those with grade C PVR (802 +/- 256 nmoles/ml, p <
      0.005), or PMF (p < 0.005). These results suggest two possible mechanisms for the
      alteration of intravitreal glutamine in the pathologic conditions. The first
      possibility is a reduced amount of supply of glutamine that is normally
      transported or released from surrounding tissues into vitreous humor. The second
      possibility is an increased amount of uptake and utilization of glutamine by
      cells within vitreous and pathologic tissues.

PMID- 7796604
TI  - The human lens intrinsic membrane protein MP70 (Cx50) gene: clonal analysis and
      chromosome mapping.
AB  - We have isolated and characterized a human genomic clone containing the complete
      coding region of lens intrinsic membrane protein MP70 (Cx50). The coding region
      of this DNA is completely contained within one exon, as is common of all
      connexins investigated to date. The size of the Cx50 coding region, from the
      initiating ATG to the terminating TGA is 1,299 nucleotides, coding for a
      polypeptide of 432 amino acids and having a translated molecular weight of 48,171
      daltons. This Cx50 coding region DNA was used as a probe to analyze a panel of
      Southern blots of human-Chinese hamster somatic cell hybrid DNAs to assign the
      gene coding for Cx50 to its human chromosome. Control human and Chinese hamster
      DNAs displayed a distinct Eco R1 restriction fragment pattern when hybridized
      with the human Cx50 DNA probe. When somatic cell hybrid DNAs were restricted with
      Eco R1 and Southern blots hybridized with the human Cx50 DNA probe, the
      characteristic human restriction pattern was observed only when human chromosome
      1 was present in the hybrid panel. Of the other six connexin genes which have
      previously been assigned to a human chromosome, two of these, Cx37 and Cx40, are
      also found on chromosome 1.

PMID- 7796606
TI  - Effectiveness of specific antibiotic/steroid combinations for therapy of
      experimental Pseudomonas aeruginosa keratitis.
AB  - Ciprofloxacin and prednisolone, but not an aminoglycoside and dexamethasone, were
      previously found to be effective in killing bacteria and reducing inflammation
      for the treatment of Pseudomonas keratitis. We investigated the therapeutic
      effectiveness of tobramycin/prednisolone and ciprofloxacin/dexamethasone in a
      rabbit model of experimental keratitis to increase our understanding of the
      effectiveness of antibiotic/steroid combinations. To our knowledge, this is the
      first analysis of the effectiveness of a combination of ciprofloxacin and
      dexamethasone for experimental keratitis. Two experiments were conducted. In the
      first experiment, 36 rabbits were divided into six groups: 1) untreated; 2)
      prednisolone acetate, 1.0%; 3) prednisolone phosphate, 1.0%; 4) tobramycin,
      1.36%; 5) tobramycin plus prednisolone acetate; 6) tobramycin plus prednisolone
      phosphate. In the second experiment, 23 rabbits were divided into four groups: 1)
      untreated; 2) ciprofloxacin, 0.3%, plus dexamethasone alcohol, 0.1%; 3)
      ciprofloxacin; 4) dexamethasone alcohol. Topical antibiotic and/or steroid was
      given for 10 h, from 16 to 26 h postinfection, one drop every 15 min for the
      first hour and then every 30 min for the remaining 9 h. At 27 h postinfection,
      eyes were evaluated by slit lamp examination (SLE) and assayed for the presence
      of bacteria in terms of colony forming units (CFU) per cornea. Both prednisolone
      acetate and prednisolone phosphate reduced ocular inflammation (as determined by
      SLE), compared with no treatment (P < or = 0.036); the phosphate was more
      effective (P = 0.005). Tobramycin alone and in combination with prednisolone also
      significantly reduced SLE, compared with no treatment (P < or = 0.006). The
      bactericidal activity of tobramycin was not affected by either steroid
      formulation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796605
TI  - A new fluorescent imaging procedure in vivo for evaluation of the retinal
      microcirculation in rats.
AB  - We investigated a new method for in vivo evaluation of the retinal
      microcirculation in rats using a cell-permeant fluorescent dye, acridine orange
      (AO), which stains cell nuclei and cytoplasm, and a scanning laser ophthalmoscope
      (SLO). AO, which binds and interacts with DNA and RNA, and thus stains cell
      nuclei and cytoplasm, was administered intravenously to rats. Fluorescein
      angiography was performed after administration of the AO, and fundus images were
      recorded on S-VHS videotape by means of an SLO. Argon laser was used as an
      exciter of the dye. The retinal vessels were stained with the dye, rendering the
      retinal microvasculature clearly visible. Cell nuclei and vessel walls were
      observed as greater fluorescence and lesser fluorescence, respectively.
      Leukocytes were also observed as highly fluorescent dots moving through the
      vessels. The results suggest that SLO visualization of AO uptake by cells may be
      a useful procedure for the evaluation of retinal microcirculation in vivo in
      rats.

PMID- 7796608
TI  - Molecular diagnostic tests for ascertainment of genotype at the rod cone
      dysplasia 1 (rcd1) locus in Irish setters.
AB  - Rod-cone dysplasia type 1 (rcd1) is one of several canine photoreceptor
      degenerations, collectively termed progressive retinal atrophy (PRA), that
      afflict different breeds of dogs. The rcd1 phenotype is an early onset autosomal
      recessive disease caused by a nonsense amber mutation, at codon 807, in the
      canine gene for the beta-subunit of rod cyclic GMP phosphodiesterase (canine
      PDEB). The mutation involves a G to A transition at nucleotide position 2420,
      which presumably would cause premature termination of the canine PDEB protein by
      49 amino acid residues. In both a small pedigree study of Irish setters from the
      United Kingdom and in larger canine pedigree studies in the United States, this
      gene defect has been found to be the only mutation causing rcd1. Here we report
      development of a diagnostic test which unequivocally distinguishes the three
      genotypes at the rcd1 locus: rcd1/rcd1 (homozygous mutant, affected); rcd1/+
      (heterozygous, carrier); and +/+ (homozygous normal, wildtype).

PMID- 7796607
TI  - Transforming growth factor-beta 1, -beta 2 and -beta 3 mRNA expression in human
      cornea.
AB  - The expression of TGF-beta 1, TGF-beta 2 and TGF-beta 3 precursors mRNA
      transcripts in in vivo human corneal cells were studied. Complementary DNA (cDNA)
      was generated from poly A+RNA extracted from in vivo human corneal epithelial
      cells, stromal keratocytes and endothelial cells. With the cDNAs as template,
      polymerase chain reaction (PCR) was carried out using specific primers of TGF
      beta 1, TGF-beta 2 and TGF-beta 3 precursors, synthesized by choosing specific
      nucleotide sequences in the latency-associated peptide region of each precursor.
      Southern blot analysis of the PCR products was carried out. In corneal epithelial
      cells, TGF-beta 2 mRNA transcript was strongly expressed; TGF-beta 1 and -beta 3
      mRNA transcripts were also expressed; stromal keratocyte samples expressed TGF
      beta 1 and -beta 2 mRNA transcripts but not TGF-beta 3 mRNA transcript.
      Endothelial cells expressed all three transcripts. The present study, together
      with the authors' previous immunohistochemical study demonstrates that both
      protein and mRNA of TGF-beta 2-LAP are present in human corneal epithelium,
      indicating that TGF-beta 2 may play a crucial role in corneal epithelial cell
      layers.

PMID- 7796609
TI  - Direct access to dermatologic care is desirable.

PMID- 7796611
TI  - A dermatologic diary. Portrait of a practice.

PMID- 7796612
TI  - Miliaria.

PMID- 7796610
TI  - Consort contact dermatitis due to musk ambrette.

PMID- 7796613
TI  - Factitial panniculitis induced by cupping and acupuncture.

PMID- 7796614
TI  - Sweat gland carcinoma with metastases to the skin: response to 5-fluorouracil
      chemotherapy.
AB  - A 68-year-old white man presented to the inpatient service at Columbia
      Presbyterian Hospital with a chief complaint of a progressively enlarging tumor
      of the right infraorbital region for many years and multiple, pink papulonodules
      on his head, neck, and trunk. A biopsy specimen of the right infraorbital and
      back lesions demonstrated an infiltrating adenocarcinoma with prominent signet
      ring cells, and small lumen formation. Results of an extensive work-up revealed
      bone marrow metastases and no evidence of a primary malignancy. We present a case
      of primary sweat gland carcinoma with metastases to the skin based upon history,
      clinical presentation, results of physical examination, histopathologic
      examination, immunohistochemical studies, and response to 5-fluorouracil
      chemotherapy. Due to the rarity of the tumor, the diagnosis is usually not made
      until the tumor(s) is invasive. An excellent response to systemic chemotherapy
      with 5-fluorouracil in metastatic sweat gland carcinoma was noted in this case.

PMID- 7796615
TI  - Epidermotropic metastatic malignant melanoma.
AB  - Epidermotropic metastatic malignant melanoma can simulate a primary malignant
      melanoma. However, since therapeutic management can be drastically different for
      these two lesions, care must be taken in evaluating them. We report a woman with
      forty-eight metastatic lesions of malignant melanoma, twenty-two of which were
      removed and found on histologic examination to be epidermotropic metastatic
      malignant melanoma.

PMID- 7796616
TI  - Acrokeratosis paraneoplastica (Bazex syndrome) with oropharyngeal squamous cell
      carcinoma.
AB  - A 65-year-old white man presented with all the clinical features of acrokeratosis
      paraneoplastica of Bazex, characterized by violaceous erythema and scaling of the
      nose, aural helices, fingers, and toes, with keratoderma and severe nail
      dystrophy. Examination of the patient for possible associated malignancy
      disclosed an asymptomatic squamous cell carcinoma at the oropharyngeal region.
      The skin lesions resolved almost completely following radiation therapy of the
      neoplasm, but the onychodystrophy persisted. This case report illustrates the
      importance of early recognition of Bazex syndrome.

PMID- 7796618
TI  - Granulomatous glossitis as an unusual manifestation of Melkersson-Rosenthal
      syndrome.
AB  - The case of a 59-year-old man with granulomatous glossitis is presented. The
      patient complained of increasing swelling of his tongue for years and a recent
      onset of perioral edema. Because of sarcoid-like granulomas found in a first
      lingual biopsy specimen, the disease was initially misdiagnosed as a localized
      form of sarcoidosis. A second biopsy specimen from the tongue revealed
      lymphonodular-plasmocytic granuloma-like infiltrates, which, in connection with
      the labial swelling, led to the diagnosis of Schuermann's glossitis granulomatosa
      as a peculiar manifestation of Melkersson-Rosenthal syndrome. The surface of the
      tongue showed deep furrows characteristic of lingua plicata. However, no history
      or signs of facial or trigeminal nerve paralysis were present; thus the patient
      did not show the complete triad of symptoms typical of Melkersson-Rosenthal
      syndrome. After treatment with clofazimine the perioral and lingual swelling
      disappeared within two weeks. Recurrences have been suppressed with a reduced
      maintenance dosage of this agent.

PMID- 7796617
TI  - Deep dermatophyte infection with chronic draining nodules in an immunocompromised
      patient.
AB  - Chronic superficial dermatophyte infection may predispose the immunocompromised
      patient to invasive or disseminated involvement. We report a case of deep
      dermatophyte infection in a patient treated with long-term corticosteroid therapy
      for lung disease. The patient responded well to oral griseofulvin. Previously
      reported cases are reviewed along with recent investigative findings in the
      pathogenesis of chronic dermatophyte infections. Recommendations are made for
      diagnosis and therapy.

PMID- 7796619
TI  - Erythema multiforme associated with superficial fungal disease.
AB  - An extremely rare case of erythema multiforme associated with dermatophytosis by
      Trichophyton rubrum infection was reported in a 19-year-old woman. She had a
      reddish plaque resembling annular ringworm on her left arm. Treatment with an
      antifungal cream (clotrimazole) on the infected site cleared the condition in
      three weeks. Spontaneous regression of erythema multiforme in different parts of
      the body was recognized when the ringworm infection resolved. In recent years,
      only two cases have been reported in the English literature.

PMID- 7796620
TI  - The present and the future of higher medical education in China.

PMID- 7796621
TI  - Current status of rheumatic fever.

PMID- 7796622
TI  - Current means in the diagnosis and treatment of oral and maxillofacial tumors in
      China.

PMID- 7796623
TI  - Recent advances of otorhinolaryngology in China.

PMID- 7796624
TI  - LDL receptor research in China.

PMID- 7796625
TI  - Morphometric evaluation on myocardial protection of cold crystalloid versus warm
      blood cardioplegia.
AB  - Twenty patients undergoing open-heart valve replacement were divided randomly
      into two groups in this study; intermittent perfusion of cold crystalloid (St.
      Thomas Hospital solution) with hypothermic cardiopulmonary bypass (CPB)
      (hypothermic group) and continuous administration of warm blood cardioplegia with
      normothermic CPB (normothermic group) respectively. Tissue samples were taken
      from the right atrium before weaning from CPB and from the right appendage 30
      minutes after removal of the cross-clamp. The results of pathological study in
      these two groups were as follows: the structural alterations were most severe
      during the ischemic period in the hypothermic group. Damages of the myocardial
      mitochondria examined with transmission electron microscope were found more
      severe in the hypothermic group than in the normothermic group, and in the
      reperfusion period than in the ischemic period. Loss of integrity of the
      mitochondrial membrane could be noted during reperfusion in the hypothermic
      group. The surface to volume ratios of mitochondria of each period of the two
      groups were calculated by computerizing the microphotographs of the myocardium.
      It was shown that the average of the surface to volume ratios was smallest in the
      reperfusion period in the normothermic group. It seemed that the volumes of the
      mitochondria were larger in the warm group than in the cold one. Probably the
      results were due to more severe damages of the mitochondrial membranes in the
      hypothermic group, which led to the release of the contents out of the
      mitochondria while in the normothermic group, the sodium-pump was disordered and
      it made the mitochondria swell. Pathologically, blood cardioplegic perfusion with
      the use of normothermic CPB is a feasible method for myocardial protection in
      open-heart surgery.

PMID- 7796627
TI  - Endolymphatic stromal myosis of the uterus. Clinicopathological analysis of five
      cases.
AB  - Five cases of endolymphatic stromal myosis (ELSM) were studied using
      histological, histochemical and immunohistochemical methods. ELSM is a well
      differentiated tumor resembling the normal endometrial stoma, with a low mitotic
      activity. So ELSM is considered as a kind of potentially malignant tumor
      different from endometrial stomal sarcoma and benign stromal nodules as well,
      though it can metastasize to the outside of uterus. ELSM may be derived from the
      stem cells that are normally present in the stroma of uterus, and can manifest
      multidifferentiation.

PMID- 7796626
TI  - Beneficial effects of NTG on left ventricular volumes and systolic function in
      patients with myocardial infarction.
AB  - The effect of sublingual administration and intravenous drip of nitroglycerin
      (SLNTG and IVNTG) on left ventricular volumes (LVVs) were studied and systolic
      function was quantitatively assessed with two-dimensional echocardiography (2DE)
      in 28 patients with myocardial infarction (MI), including 13 cases without heart
      failure (MI-NHF) in one group and 15 with heart failure (MI-HF) in another. The
      results showed that after SLNTG and IVNTG in both groups the heart rate (HR)
      increased significantly (P < 0.05-0.001); the systolic blood pressure (SBP)
      decreased significantly (P < 0.05-0.001); the diastolic blood pressure (DBP) was
      not significantly changed (all P > 0.05); the left ventricular end-diastolic and
      end-systolic volumes (EDV and ESV) both significantly reduced [EDV: decreased by
      5.8-11.6% (-13.2-19.0 ml), P < 0.05-0.001; ESV: decreased by 9.6-16.6% (-8.6-17.3
      ml), P < 0.05-0.001)]; the left ventricular ejection fraction (LVEF) all
      significantly elevated (increased by 6.6%-9.4% (3.2%-3.4%), P < 0.05-0.001]
      except in MI-NHF group after IVNTG; the segmental EF of normal and hypokinetic
      segments also significantly increased (P < 0.05-0.001). The results suggest that
      NTG could beneficially reduce left ventricular EDV and ESV; and improve or
      strengthen its global and segmental systolic function in MI patients,
      particularly noticeable in patients with heart failure.

PMID- 7796628
TI  - Factors related to long-term effects of thymectomy on myasthenia gravis.
AB  - The authors report the results of long-term follow-up after thymectomy on 92
      cases with myasthenia gravis (MG), including 22 cases of thymomatous MG. These
      patients were followed up for 6-73 months with an average of 23 months. The
      surgically effective rate was 88.0% and the late mortality, 6.5%. The sex of the
      patients and the durations of disease were not obviously related to the
      prognosis, however the effect of thymectomy was much better in patients aged 10
      39 years than in other age groups. The modified Osserman's clinical
      classification, acetylcholine receptor (AchR) antibodies and citric acid extract
      (CAE) antibodies titers in plasma and pathological patterns of the surgical
      specimens of thymus including immunohistochemical observation play an important
      role among various factors related to the long-term effects.

PMID- 7796630
TI  - Value of polymerase chain reaction assay in diagnosis of intestinal tuberculosis
      and differentiation from Crohn's disease.
AB  - It is difficult to make a precise diagnosis of intestinal tuberculosis and to
      differentiate it from Crohn's disease. For evaluating Polymerase Chain Reaction
      (PCR) assay in these two aspects, 36 specimens of intestinal tuberculosis from
      surgical resections and endoscopic biopsies and 26 Crohn's disease samples were
      subjected to PCR assay. 21 specimens of normal colon tissue surrounding cancer
      were used as the control. Oligonucleotides derived from the IS 6110 sequence,
      which is repeated in M. tuberculosis chromosome and highly specific for the M.
      tuberculosis complex, were used as a primer. The amplified PCR products were
      detected by examination of ethidium-bromide-stained polyacrylamide gels. The
      specificity of PCR products was confirmed by digestion with Sal I restrictive
      endonuclease and southern blot hybridization using digoxigenin-labeled probe. The
      results showed that the M. tuberculosis DNA was identified in 27/36 intestinal
      tuberculosis, but none of 26 Crohn's disease. Acid fast bacilli were only found
      in 16/36 intestinal tuberculosis. In conclusion, as a rapid, sensitive, and
      specific pathogenic method in diagnosis of intestinal tuberculosis, PCR assay has
      been developed in this study, and is considered valuable in the differentiation
      between intestinal tuberculosis and Crohn's disease.

PMID- 7796629
TI  - Clinical value of urinary and serum pseudouridine in diagnosis and monitoring of
      primary liver cancer.
AB  - Urinary and serum pseudouridine concentrations were determined by high
      performance liquid chromatography in 80 patients with primary liver cancer, 32
      with benign space occupying lesions of the liver, 42 with liver cirrhosis and 40
      healthy subjects. Their mean urinary and serum pseudouridine levels were 39.2 +/-
      11.5 nmol/mumol creatinine and 3.4 +/- 1.3 mumol/L, 24.5 +/- 5.4 nmol/mumol
      creatinine and 2.5 +/- 0.5 mumol/L, 22.8 +/- 7.8 nmol/mumol creatinine and 2.3 +/
      0.4 mumol/L, 26.4 +/- 4.6 nmol/mumol creatinine and 2.3 +/- 0.4 mumol/L,
      respectively. Exceeding the mean plus 2SD of pseudouridine of healthy control was
      considered as positive value for the diagnosis of primary liver cancer. Thus the
      positivity of urinary and serum pseudouridine in hepatoma was 71.3% and 70.0%,
      respectively. The positive rate of combined pseudouridine and alpha-fetoprotein
      assay was 91.3% in patients with hepatoma. Besides, pseudouridine levels could
      elevate before positive localization and reduce to normal levels after tumor
      resection. The results showed that the determination of pseudouridine is of
      clinical significance in the diagnosis and monitoring of primary liver cancer.

PMID- 7796631
TI  - Neuron-specific enolase in patients with acute ischemic stroke and related
      dementia.
AB  - Neuron-specific enolase (NSE) levels of cerebrospinal fluid (CSF) were measured
      in 39 patients with ischemic stroke and 15 controls. There was a significant
      increase of CSF NSE in acute ischemic stroke patients as compared with the
      controls. The altered CSF NSE levels correlated well with the infarct size in CT
      scan. The CSF NSE levels were higher in 6-multiinfarct dementia (MID) patients
      who were diagnosed after 6-month follow-up than those in 22 non-MID patients of
      this series. Our research supports the view that CSF NSE can be a useful
      biochemical marker for brain ischemia. The importance of CSF NSE in the study of
      dementia related to ischemic stroke is worth further studies.

PMID- 7796632
TI  - The biological function of retinoblastoma gene.

PMID- 7796633
TI  - Abstracts from the first annual conference of the Chinese Society of Medicine in
      Germany.

PMID- 7796634
TI  - Responses of respiratory-modulated facial nerve activity to activation of the
      ventrolateral subarea of the nucleus of the tractus solitarius.
AB  - The purpose of the present study was to examine respiratory-modulated facial
      nerve activity (FNA) in response to activation of the ventrolateral subarea of
      the nucleus of the tractus solitarius (vlNTS). The cat was anesthetized with
      sodium pentobarbital and then vagotomized bilaterally, paralyzed and ventilated
      artificially. End-tidal fractional concentration of CO2 was maintained at
      hyperoxic normocapnia. Partial occipital craniotomy was performed to expose the
      obex. Activities of the phrenic and the facial nerves were simultaneously
      recorded. The vlNTS was excited by electrical current (80 Hz frequency, 0.5 ms
      pulse duration and a variety of current from 12.5 to 50 microA) and glutamate (30
      100 nl, 0.5 M). Three responsive patterns for both nerves were observed in
      response to vlNTS activation. First, inspiratory facial nerve activity (iFNA) and
      phrenic nerve activity (PNA) were decreased (p < 0.01), while expiratory facial
      nerve activity (eFNA) was not changed. Second, iFNA and PNA were diminished (p <
      0.01) but eFNA was enhanced. Third, iFNA was decreased whereas PNA was enhanced.
      These results suggest that there might be a neural pathway projecting from the
      vlNTS to the facial nuclei to modulate respiratory-modulated facial nerve
      activities.

PMID- 7796635
TI  - Surface temperature change, cortical evoked potential and pain behavior elicited
      by CO2 lasers.
AB  - The performance of a self-designed CO2 laser stimulator, TL#2, was evaluated
      against a commercial product, model DE20XL of the Direct Energy Inc. (Irvine).
      The major items evaluated were the temperature change of the irradiated surface
      and the electrophysiological and behavior changes in the rat elicited by single
      laser pulse irradiation. Single shots of TL#2 produced a profile of surface
      temperature change similar to those of the DE20XL, as quantified by their maximal
      temperature change, rate of rise (half time to maximum) and rate of temperature
      drop. TL#2 and DE20XL elicited the same pain behaviors and the same pattern of
      cortical evoked potential in awake, behaving rats. TL#2 differed from the DE20XL
      in its laser beam shape and focal depth. The cross sectional energy profile of
      the TL#2 was a Gaussian shape, i.e., most intense at its center point, whereas
      that of the DE20XL with the FL20XL attachment had a shape of an inverted
      Gaussian, i.e., most intense in the periphery. Consequently, the peak energy of
      the center of the TL#2 laser beam grows rapidly with an increase in the pulse
      intensity. Caution must be taken not to use this machine at high intensity or for
      long duration less permanent damage should be produced on tested animal or human
      subject. In summary, TL#2 when used properly, should be a useful tool in the
      study of pain mechanism.

PMID- 7796636
TI  - Involvement of hippocampal NMDA and AMPA receptors in acquisition, formation and
      retrieval of spatial memory in the Morris water maze.
AB  - This study investigated the roles of hippocampal N-methyl-D-aspartate (NMDA)
      receptors and alpha-amino-3-hydroxyl-5-methyl-4-isoxazole propionate (AMPA)
      receptors in acquisition, consolidation and retrieval processes of spatial
      memory. Male Wistar rats with indwelling cannulae in the dorsal hippocampus
      received 4 training trials on the Morris water maze for consecutively 6 days.
      Rats received infusion of the NMDA receptor antagonist 2-amino-5
      phosphonopentanoic acid (AP5) or the AMPA receptor antagonist 6-cyano-7
      nitroquinoxaline-2,3-dione (CNQX) into the hippocampus under one of the three
      schedules: 5 min prior to each daily training session, immediately after each
      daily training session or 5 min prior to the final testing trial. Pretraining
      intra-hippocampal infusion of 5.0 micrograms AP5 retarded acquisition. The same
      dose of AP5 given after training had little effect but a higher dose (10.0
      micrograms) did slow down progress in the acquisition curve. Pretest infusion AP5
      failed to affect memory retrieval. Pretraining intra-hippocampal infusion of 1.0
      micrograms CNQX also impaired acquisition, but posttraining infusion of CNQX at
      1.0 or 2.0 micrograms had no effect. However, pretest infusion of 1.0 micrograms
      CNQX markedly impaired retrieval of the already-formed spatial memory. These
      findings taken together suggest that acquisition in a spatial task involves
      hippocampal NMDA and AMPA receptors, consolidation of spatial memory involves
      NMDA receptors and retrieving such memory involves AMPA receptors.

PMID- 7796637
TI  - Betel quid chewing damaged gastric mucosa: protective effects of cimetidine and
      sodium bicarbonate.
AB  - The effects of cimetidine and NaHCO3 on gastric acid back-diffusion (either the
      H+ loss or the Na+, K+ and CA++ gain in the gastric lumen) and mucosal ulceration
      were studied in rats with chronic feeding of betel quid chewing (BQC)- or its
      individual component-containing food. After 30 and 90 days of feeding, the animal
      was fasted for 24 hrs and vagotomized. An acid solution (100 mM HCl plus 54 mM
      NaCl) with or without drugs was irrigated in the rat stomach for 3 hrs. The
      results indicated that BQC and its individual component produced a variety of
      change in enhancement in acid solution-induced acid back-diffusion and mucosal
      hemorrhagic ulceration but in decrease of gastric mucus secretion. These
      parameters were dose-dependently reversed by intragastric cimetidine (50-300
      mg/kg) in BQC-treated rats. Similar but lesser effect than cimetidine (300 mg/kg)
      was obtained by intragastric administration of NaHCO3 (52 mg/kg). It is concluded
      that in BQC- or its component-feeding rats, the enhancement in acid back
      diffusion and the reduction in mucus secretion are at least in part responsible
      for the formation of hemorrhagic ulceration which can be inhibited by
      intragastric cimetidine or NaHCO3.

PMID- 7796638
TI  - The influence of body size to the parameters of gastric slow wave: studied with
      an assembled electrogastrography.
AB  - An electrogastrographic (EGG) device has been assembled, it consisted of the
      following main components: amplifiers, band-pass filter, analog/digital
      converter, low band-pass digital filters which could pick up signals between 0.02
      Hz (1.2 cpm) and 0.1 Hz (6 cpm), and a personal computer. The analysis softwares
      employed autoregressive moving average modelling to compute frequency of slow
      wave, and overlapping Welch periodogram of fast Fourier transform for power
      computation. In order to study the influence of body size to the EGG parameters,
      28 healthy males (age: 18-45 years) without any gastric dysmotor disorders were
      enrolled to record fasting EGG. Another 28 age-matched females were enrolled to
      record and to compare the EGG parameters. Of the EGG frequencies, both males and
      females were approximate to 0.05 Hz (NS). However, the EGG power values were
      markedly different between the male and female measurements (Mean +/- SD: 57.3 +/
      16.6 dB vs. 46.8 +/- 14.7 dB, p < 0.01). Correction with body mass index
      eliminated this difference. Of all measured EGG power values, a positive
      correlation with body mass index was seen (r = 0.39, p < 0.005). We conclude that
      a different EGG power value exists between the male and female subjects, body
      size is probable an important factor to elicit this difference.

PMID- 7796639
TI  - Radial asymmetry characterized the upper esophageal sphincter pressures.
AB  - The characteristics of the upper esophageal sphincter (UES) motor functions
      remain unknown in Chinese. Twenty-three volunteers (M/F: 10/13, age: 19-40)
      without any pharyngeal/esophageal motor disturbance underwent UES measurement in
      the left decubitus position using a low compliance pneumohydraulic infusion
      system. These measurements included the location of UES from nostril, its resting
      pressure, and the responses to swallow. Mean UES resting pressures measured with
      three 120 degrees oriented manometric orifices were 22.6 +/- 7.7 mmHg, 16.9 +/-
      8.6 mm Hg and 20.7 +/- 9.6 mmHg respectively (p < 0.05). In regard with the
      swallow-induced UES relax ability, the relax interval, the post-relax contractile
      amplitude and interval, neither dry swallow nor wet swallow led to a different
      result. Mean measured UES location from the nostril with the most proximal
      orifice of probe was 29.3 +/- 2.3 cm. This location did correlate very well with
      body height (r = 0.60, p < 0.01). In conclusion, this study demonstrates that the
      UES resting pressures exhibit a radial asymmetry, and that the type of swallow
      does not influence UES responses. Furthermore, an equation based on the body
      height may predict the most appropriate UES position.

PMID- 7796640
TI  - Age-related difference in the in vitro response of erythropoietin to
      triiodothyronine in male rats.
AB  - The effect of aging on medium erythropoietin (EPO) levels after triiodothyronine
      (T3, 1 nM) stimulation in vitro and on the EPO content of kidney extract were
      investigated. Middle (mid)-aged (17 months), adult (6 months) and young (3
      months) male rats were decapitated. The kidneys were decapsulated and cut into 6
      equal pieces. One sixth of the kidney was extracted by phosphate buffer before
      measuring the content of EPO in kidney and one sixth of the kidney was incubated
      in vitro with T3 (1 nM) at 37 degrees C for 30 min. The concentration of EPO in
      both medium and kidney extract was measured by a radioimmunoassay (RIA). The EPO
      content in kidney was higher (p < 0.05) in the mid-aged than in the young rats.
      The basal level of medium EPO was not changed by age. Only young rather than
      adult or mid-aged rats showed an increase of EPO secretion after T3 stimulation
      (p < 0.01). These data suggest that the EPO concentration in rat kidney and the
      action of T3 on EPO release from the kidney are age-dependent.

PMID- 7796642
TI  - [Mosaicism confined to placenta in pregnancies with adverse outcome].
AB  - Chorionic villi and fetal tissues from 50 pathological human conceptions at
      gestational weeks 9-40 were cultured and cytogenetically analyzed to explore the
      existence of chromosomal mosaicism confined to the extraembryonic tissues and to
      clarify the relationship between confined placental mosaicism and adverse outcome
      of pregnancy. Chorionic villi and fetal tissues from 12 second trimester
      gestations terminated served as a control group. In two pathological gestations
      true mosaicism was found exclusively in chorionic cells and could not be
      confirmed in cells derived from the fetal tissues. One of these was severely
      growth retarded. Concordant results were obtained in all other cases.

PMID- 7796641
TI  - Effects of age on open-field behavior of male rats.
AB  - As age advances, the performance of animal behavior declines gradually. The
      purpose of this study was to investigate the onset of age-related changes in open
      field behavior of rats from a wide age spectrum. Male Long-Evans rats, ranging
      from 2 to 22 months, were placed in an open-field apparatus during the dark phase
      for a cumulative period of 28 min. Data were collected for the following
      parameters of open-field behavior: horizontal activity (HA), total distance (TD),
      stereotypy count (SC), vertical activity (VA), movement time (MT) and margin time
      (MGT). The highest value of HA, TD, SC and MT was found in rats at the age of 3
      months. After 3 months, the values for these parameters gradually declined,
      subsequently reaching statistical significance by 6 months (HA, TD and SC) or 8.5
      months (MT) of age. Maximum activity of VA occurred at 8.5 months of age and
      thereafter gradually declined with increasing age, however, no significantly
      statistical difference was reached as compared to the highest value. In contrast,
      the values for MGT gradually declined after 2 months of age, thereby reaching
      statistical significance by 11 months of age. These results indicate that the
      onset of age-related decline in open-field behavioral parameters can differ and
      the age-related changes in open-field behavior depends on observational
      parameters.

PMID- 7796643
TI  - [The effects of progestin on the bone metabolism in postmenopausal women].
AB  - Thirty postmenopausal women, including 26 with history of hysterectomy and
      bilateral salpingooophorectomy due to uterine myoma and 4 with natural menopause
      without any diseases were randomly allocated into two groups. Fifteen subjects
      received medroxyprogesterone acetate (MPA) 10 mg twice daily for three months,
      the other 15 received both MPA 10 mg twice daily and cyclopentylethinyl estriol
      (CEE3) 5 mg once a month for three months. Fasting urinary calcium/creatinine
      (Ca/Cr) and hydroxyproline/creatinine (OHpr/Cr) ratio, serum calcitonon (CT) and
      alkaline phosphatase (AKP) concentrations were measured before and after
      treatment in all subjects. The results showed that in both groups, the fasting
      urinary Ca/Cr and OHpr/Cr ratio reduced significantly, while serum CT and AKP
      increased significantly after treatment. The changes of these parameters were not
      significantly different between these two groups. These data indicated that
      progestin alone appeared effective in preventing postmenopausal osteoporosis.

PMID- 7796644
TI  - [Laparoscopic treatment of endometriosis with Nd: YAG laser and microwave].
AB  - A series of 200 cases of endometriosis were treated laparoscopically by Nd: YAG
      laser and microwave at Peking Union Medical College Hospital. All the operations
      were performed under local and topical anesthesia follow-up for 10-48 months
      revealed good results. Of 76 cases with infertility, 46 (60.5%) conceived after
      treatment. Of 114 cases with ovarian endometriomas, the cysts were no longer
      found in 81 cases (71.1%), decreased in size in 24 cases (21.0%). Of 180 cases
      with pain symptoms, 105 patients (58.3%) were achieved complete relief, Partial
      relief in 61 cases (33.9%). It has been found that laparoscopic surgery is
      effective to improve fertile rate for the patients with all the stages of
      endometriosis. The results showed that the microwave and Nd: YAG laser can be
      achieved with safety and success. The microwave is safer than Nd: YAG laser and
      is easier to operate and less expensive.

PMID- 7796645
TI  - [Study on chromosomal centromeric dots in couples with spontaneous abortion].
AB  - Chromosomal centromeric dots (Cd) of peripheral blood in 20 couples with
      spontaneous abortion and 10 normal couples were studied by Cd-banding technique.
      The frequencies of Cd loss and centromeric dots-nucleolar organizer region (Cd
      NOR) fusion were 0.36 +/- 0.15/cell and 0.31 +/- 0.20/cell in the couples with
      abortion, 0.22 +/- 0.13/cell and 0.20 +/- 0.19/cell in normal couples
      respectively. These results showed that frequencies of Cd loss and Cd-NOR fusion
      in couples of spontaneous abortion were significantly higher than those in the
      normal couples. We suggested that the occurrence of spontaneous abortion in human
      might casually relate to the changes of Cd.

PMID- 7796646
TI  - [Fecundify after treatment of tubal pregnancy].
AB  - This study is a follow-up analysis of 103 patients who desired to preserve their
      fertile ability after treatment of tubal pregnancy. Among the 103 cases, 58 were
      treated by unilateral salpingectomy, 15 by salpingostomy and 30 by drug
      conservative therapy. RESULTS: 67 cases had intrauterine pregnancy and 9 cases
      repeated ectopic pregnancy. The intrauterine pregnancy rate of the surgical group
      (71.2%) was higher than that of the nonsurgical group (50.0%). And the pregnancy
      rate of salpingostomy group (86.7%) was higher than that of salpingectomy group
      (67.2%). No repeated ectopic pregnancy occurred in the salpingostomy group. After
      three months of treatment, 45 cases were randomly sampled for tubal patency test.
      Bilateral tubal patency rate in salpingostomy group was 93.3% and in drug
      treatment group was 20.0%. These results indicated that tubal patency is an
      essential factor for normal pregnancy. Prevention of post-operative adhesion and
      treatment of pelvic inflammatory disease are important for increasing
      intrauterine pregnancy rate and decreasing repeated ectopic pregnancy rate.

PMID- 7796647
TI  - [Chemotherapy against lymphatic metastases of gynecologic cancer via pelvic
      retroperitoneal cannulation: a preliminary report].
AB  - Lymphatic metastasis is one of the most important problems in the treatment of
      gynecologic malignancy. We conducted a preliminary investigation on the
      feasibility and practicality of chemotherapy against lymphatic metastases of
      gynecologic cancer via pelvic retroperitoneal cannulation. 5-FU mixed with
      Isovist-300 was injected into the pelvic retroperitoneal space. X-ray films
      revealed that the external iliac, hypogastric, obturator, deep inguinal and most
      of the common iliac lymph nodes were submerged in the 5-FU solution. 5-FU
      concentrations in the lymph nodes were measured by high pressure liquid
      chromatography, which showed that 5-FU concentration of the study group was 2 to
      10 times that of the control group. Pathologic findings revealed that most of the
      metastatic cancer cells in the study group showed obvious degeneration and
      necrosis while no changes were observed in the control group. No major
      complications or adverse effects were observed. Our results suggest that this
      method may be used to treat the lymphatic metastases of gynecologic cancer.

PMID- 7796648
TI  - [Overexpression of p53 in transitional cell carcinoma of the ovary].
AB  - To determine the prevalence of p53 abnormal protein expression in transitional
      cell carcinoma of the ovary in Peking Union Medical College hospital, and to
      analyse the correlation between the overexpression of p53 protein and prognostic
      parameters of transitional cell carcinoma of the ovary, thirty-two transitional
      cell carcinoma of the ovary and 20 normal ovaries were analysed. Detection of
      overexpression of p53 protein was carried out by immunohistochemical staining
      (IHS) using the monoclonal antibody DO-1 on paraffin sections. 41% of 32 samples
      of transitional cell carcinoma of the ovary showed positive IHS with DO-1,
      whereas only 5% of 20 normal ovaries showed weakly positive cytoplasmic staining
      (P < 0.01). p53 overexpression did not correlate with age, CA125 levels,
      histological grade and lymph node metastasis, but patients with overexpression of
      p53 had a poor prognosis. Overexpression of p53 is a more common event in
      transitional cell carcinoma of the ovary. Further studies are warranted to
      clarify the role of p53 in transitional cell carcinoma of the ovary.

PMID- 7796649
TI  - [The analysis of tumor growth rate and histopathology of xenografts of nude mice
      bearing human ovarian carcinoma in immunocompetent mice].
AB  - Xenografts of nude mice bearing human ovarian carcinoma cell line SKOV3 were
      transplanted using subrenal capsule assay (SRCA) in immunocompetent C57BL/6 mice.
      Multiple locations were chosen on both sides of the kidneys obtaining a total of
      129 tumors. The volumes of the tumors were measured and histopathological
      examinations were conducted on the 4th, 6th, 8th, 10th, 12th and 14th days after
      transplantation surgery. The growth rates were noticed to be high on the 6-8th
      days. Lymphocytic infiltration reached a peak on the 8-12th day. On the 14th days
      the leukocytic infiltration and fibrosis almost surrounded the tumors. Tumor
      cells that could be found amounted to about 77.25%, 65.38%, and 52.17%
      respectively on the 4th, 6th and 8th days, but significantly decreased on 12-14th
      days. The above results suggested: (1) multiple SRCA on both sides proved to be
      practical and economical; (2) the xenografts of nude mice bearing hman ovarian
      carcinoma could be transplanted viably by SRCA for 8-10 days; (3) microscopic
      measurements of the transplanted tumor volume did not represent the real status
      of the tumor growth, and microscopic evaluation was necessary.

PMID- 7796650
TI  - [A research on serum, urine and tumor tissue hyaluronate assays for detecting
      malignant ovarian tumors].
AB  - Hyaluronate contents were determined by radioimmunoassay in 91 samples of serum,
      88 samples of urine and 32 samples of ovarian tumor tissue from patients with
      benign and malignant tumors and from healthy subjects. The mean serum hyaluronate
      level in patients with malignant ovarian tumors (mean, 155.99 micrograms/L,
      range, 20 to 680 micrograms/L) was significantly higher than that in patients
      with benign ovarian tumors (mean, 84.2 micrograms/L; range, 20 to 188
      micrograms/L) and that in healthy subjects (mean, 57 micrograms/L; range, 2 to
      110 micrograms/L). The mean urine hyaluronate level in the malignant group (mean,
      307.83 micrograms/L; range 50 to 750 micrograms/L) also was significantly higher
      than that in the normal control group (mean, 146 micrograms/L; range, 40 to 242
      micrograms/L). The results suggest that serum and urine hyaluronate determination
      in the detection of malignant ovarian tumors is of clinical value.

PMID- 7796651
TI  - [Perinatal asphyxia].

PMID- 7796652
TI  - [Advances in the research of neu proto-oncogene in ovarian cancer].

PMID- 7796653
TI  - [Effect of epimedium sagittatum on soluble IL-2 receptor and IL-6 levels in
      patients undergoing hemodialysis].
AB  - By using ELISA and assay of MTT participating in IL-6 dependent cell clone. The
      authors measured the circulating levels of soluble IL-2 receptor (sIL-2R) and IL
      6 in patients undergoing hemodialysis (HD). Alterations of the above-mentioned
      parameters before and after a three-month course of treatment with Chinese drug
      Epimedium sagittatum on the same HD patients. It is confirmed that in patients
      with end-stage renal failure (ESRF), sIL-2R level elevated significantly, while
      IL-6 level decreased apparently (P < 0.01). Furthermore, levels of both sIL-2R
      and IL-6 could be restored to normal after treatment with Epimedium sagittatum.
      These findings indicated not only the presence of immunodeficiency in ESRF, but
      also the effectiveness of regulation with Chinese drug Epimedium sagittatum.

PMID- 7796654
TI  - [Detection of thyroid stimulating antibodies and TSH binding inhibitor
      immunoglobulins in patients with thyroid diseases and its clinical applications].
AB  - Thyroid stimulating antibodies (TSAb) and TSH binding inhibitor immunoglobulins
      (TBII) were assessed in patients with thyroid diseases. The activity of TSAb and
      TBII was significantly higher in patients with untreated Graves' disease (GD) as
      compared with that in patients with remitted GD and Hashimoto's thyroiditis,
      while the latter two groups had higher TSAb and TBII activity than patients with
      thyroid adenoma or control subjects. Of 24 patients with untreated GD, TSAb and
      TBII were detected in 22 and 19 respectively. The positive rates of TSAb and TBII
      in patients with remitted GD or Hashimoto's thyroiditis were 0.48 and 0.44 or
      0.231 and 0.615. Both TSAb and TBII were negative in patients with thyroid
      adenoma or controls. No statistical correlation was found between TSAb and TBII
      activity, suggesting the coexistence of heterogeneous populations of TSH receptor
      antibodies.

PMID- 7796655
TI  - [Effect of dietary and/or exercise intervention on incidence of diabetes in 530
      subjects with impaired glucose tolerance from 1986-1992].
AB  - 577 subjects with impaired glucose tolerance (IGT) aged from 25 to 74 were
      identified in Daqing in 1986. They were stratified according to BMI > or = 25
      (352 cases) and BMI < 25 (225 cases) and subjects in each BMI group were randomly
      assigned to four groups: control, diet, exercise and diet plus exercise
      intervention groups (each group had similar age, BMI, fasting and 2-hour plasma
      glucose level). A six-year follow up study indicated that incidence of diabetes
      per 100-person-year was 15.7, 10.0, 8.3 and 9.6 in control, diet, exercise and
      diet plus exercise groups respectively. Proportional hazards regression analysis
      controlling for differences in baseline factors (age, sex, BMI and plasma
      glucose) showed that diet and/or exercise intervention were inversely related to
      the incidence of diabetes. The better the actual intervention, the less the
      incidence of diabetes. Therefore, the results strongly indicate that diet and/or
      exercise intervention treatment are effective methods to reduce the incidence of
      diabetes.

PMID- 7796656
TI  - [Early diagnosis of tuberculosis after kidney transplantation by determining
      serum anti-PPD-IgG].
AB  - Tuberculosis is a common complication after kidney transplantation and is not
      easy to diagnose in the early stage. Determination of serum anti-PPD-IgG level in
      our laboratory indicated that it was positive in patients with active
      tuberculosis. The mean time (20.5 days) required to diagnose with this method was
      obviously shorter than that (66.8 days) required with bacteriology, pathology or
      imaging. There was no obvious rise in the serum level of anti-PPD-IgG in fever
      caused by other infections and rejection and the serum anti-PPD-IgG level in
      patients with tuberculosis controlled returned to normal. It is shown that
      determination of serum specific antibody is a better index for early diagnosis of
      tuberculosis complicating kidney transplantation.

PMID- 7796658
TI  - [Pharmacokinetics of oximes in organophosphorus poison].

PMID- 7796657
TI  - [Progress in the study on the pathogenesis and therapy of anemia in rheumatoid
      arthritis].

PMID- 7796660
TI  - [Strategy of drug treatment of gout].

PMID- 7796659
TI  - [Research on osteoarthritis].

PMID- 7796661
TI  - [Rheumatic diseases in China].
AB  - To determine the prevalence of rheumatic diseases in Chinese of Han nationality
      in the north and the south of China, samples of 4,192 adults in Beijing (north)
      and 5,057 in Shantou (south) area were studied. The same questionnaire was
      administered to each subject surveyed. Physical examinations were done in all who
      gave positive answers. For those who gave positive response to certain set of
      questions, blood antinuclear antibody and rheumatoid factor tests and radiographs
      of hand and/or sacroiliac joint were done. The prevalence of definite rheumatoid
      arthritis (RA) was 0.34% in the north (95% confidence interval 0.20-0.51) and
      0.32% (0.95% CI 0.16-0.47) in the south and ankylosing spondilitis was noted in
      0.26% of both samples (95% confidence interval in the north 0.11-0.42 and in the
      south 0.14-0.40). Only 3 cases of systemic lupus erythematosus in the north and
      one in the south were identified. General rheumatic pain was reported more
      frequently in the north. Lumbar problems were recorded on examinations 5 times
      more commonly in the north than in the south (men 25.0% vs 5.3%, women 38.0% vs
      6.5%) and knee problems 10 times (men 24.0% vs 1.8%, women 36.0% vs 3.4%) more
      commonly in the north; the difference was greatest in the age of 55-64. A further
      study in the south is planned to assess the contribution of inter-observer error
      and/or difference in cultural response to the north/south difference observed in
      the prevalence of general rheumatic symptoms and back pain. A search for
      environmental risk factors such as climate, diet, degeneration or overuse would
      then be indicated to explain these differences.

PMID- 7796662
TI  - [An epidemiological study of knee osteoarthritis].
AB  - 2,063 adult people of a Beijing suburban village were surveyed for osteoarthritis
      of the knees. Questionnaire was completed in all. 799 (38.7%) responded to have
      knee joint pain. 311 with knee joint pain and 212 without knee joint pain were
      selected randomly for X-ray films of the knees. In the former group, 79 showed
      osteoarthritic X-ray changes and were thus diagnosed as such, accounting 24.7% of
      those with knee pain. In the latter group, all were not diagnosed as clinical
      osteoarthritis, yet 54 (25.5%) showed also X-ray osteoarthritic changes. In both
      groups the X-ray osteoarthritic changes increased in parallel with increase of
      age, reaching 78% in those aged 60 and more in the former group and 67% in the
      latter group. 100 retired cadres were similarly surveyed but all had X-ray films
      of the knees taken. 51 of 100 responded knee pain, out of whom 49 (95.9%) showed
      X-ray osteoarthritic changes and were thus diagnosed as such. The overall
      prevalence rate of osteoarthritis of knee in rural population as judged by the
      523 who had taken X-ray films (people with and without knee pain are not entirely
      proportional) is about 9.6% and that of 100 aged retired cadres is 49%. Those
      with X-ray knee osteoarthritic changes but without knee pain were not categorized
      as clinical osteoarthritic cases.

PMID- 7796663
TI  - [Osteoarthritis: clinical and epidemiological investigation].
AB  - A population study of 1,722 adults in Chenghai city, Guangdong province showed
      that the prevalence of osteoarthritis (OA) was 8.3% and there was no significant
      difference between male and female. The prevalence of OA increased after the age
      of 40 and reached a peak at 50-55 years. The prevalence of osteoporosis (OP) in
      OA patients of this population survey and in patients in our clinic was around
      30%. OA accompanying OP was more frequently seen in female than male, especially
      in postmenopausal women. The results of CT screen of lumbar spine in 66 OA
      patients showed: 89.4% (59 cases) was associated with the protrusion of
      intervertebrale disc, occurring frequently at L4 and L5. MR imaging of 20 knee
      joints in 10 cases of OA patients with knee involvement showed: all of the
      patients were associated with one or all of the following conditions:
      chondropathies, degeneration or injury of semilunar plate, bursitis and
      synovitis. It is suggested that OA is a heterogeneous disorder and must be
      treated with different ways.

PMID- 7796664
TI  - [The role of intestinal permeability in the pathogenesis of ankylosing
      spondylitis].
AB  - By use of low molecular weight polyethlene glycol (PEG400) as tracer, a revised
      Chedwick method with capillary gas chromatography was used to examine the
      intestinal permeability in 49 subjects including patients with ankylosing
      spondylitis (AS) and rheumatoid arthritis (RA) and healthy controls. Recovery
      percentage, maximal recovery percentage [Rmax(%)] and Rmax(w) were used to find
      the effect of bowel permeability in the pathogenesis and disease flare up of AS,
      as well as the role of HLA-B27 for the bowel permeability. The results showed
      that in AS group, the recovery of first component (242D) was higher and the
      Rmax(%) was lower than those in the controls. No statistical difference was found
      with other indexes. The results indicated that bowel permeability is not elevated
      in AS. The passage of enteral bacteria antigen into the host may not result from
      the process of nonspecific penetration. We postulate that there may somehow be a
      process of "active transportation" in the pathogenesis of AS. More studies of the
      process are necessary to clarify its importance in the early stage of AS.

PMID- 7796665
TI  - [Dynamic observation and significance of autoantibody against ADP/ATP carrier in
      dilated cardiomyopathy].
AB  - The presence and dynamic change of autoantibody against ADP/ATP carrier in
      patients with dilated cardiomyopathy (DCM) was studied by using indirect micro
      solid-phase radioimmunoassay. A significant antibody titre was present in 16 of
      48 DCM patients and most of them were in early stage of the disease. The titre of
      anti-ADP/ATP carrier antibody in DCM patients decreased gradually in a follow-up
      period of three months. The titre of this antibody in the serum from patients
      with coronary and rheumatic heart disease were within normal limits. Anti-ADP/ATP
      carrier antibody may play an important role in the pathogenesis, diagnosis and
      treatment of DCM.

PMID- 7796666
TI  - [The effect of prostaglandin E1 on myocardial ischemia reperfusion injury].
AB  - The effect of prostaglandin E1 (PGE1) on ischemia reperfusion injury (IRI) was
      investigated. The changes of leucocytes in venous blood and infarcted myocardial
      tissue and the level of lipid peroxide (LPO), superroxide dismutase (SOD) and
      catalase (CAT) were also studied in these animal models at the same time. The
      experimental results were as follows: the count and activity of leucocytes and
      the level of LPO in IRI were obviously increased. The activity of SOD and CAT in
      the untreated group was much lower than that in the treated group (P < 0.01). The
      infarcted size (IS) was larger in the untreated group. The count of leucocytes
      was positively related with the level of LPO and IS, but negatively related with
      the activity of SOD and CAT. However, the relationship disappeared after the
      administration of PGE1. These data suggested that leucocyte plays an important
      role in IRI. PGE1 can inhibit leucocyte activity, decrease peroxidation, reduce
      LPO production and increase the activity of SOD and CAT. It can decrease the
      infarct size. PGE1 takes the main role in protecting IRI.

PMID- 7796667
TI  - Hepatitis B virus infection, the immune response and hepatocellular carcinoma.
AB  - More than 250 million people worldwide are chronically infected with the
      hepatitis B virus (HBV) and have a 200-fold increased risk of developing
      hepatocellular carcinoma (HCC). This is one of the most common cancers in the
      world with a geographical distribution highest in areas where HBV is endemic. A
      number of molecular mechanisms have been proposed to explain this correlation
      including an acutely transforming viral oncogene; chromosomal aberrations due to
      HBV integration (i.e. deletions, translocations, duplications); activation of
      cellular proto-oncogenes; inactivation of cellular anti-oncogenes; and
      transactivation of cellular genes by HBV gene products. HCC usually develops only
      after 20-30 years of persistent HBV infection accompanied by hepatocyte necrosis,
      inflammation and regenerative hyperplasia. Because HBV is not directly
      cytopathic, liver injury must be immune mediated. Factors that predispose HBV
      infected individuals to develop HCC are chronicity, an immune response and liver
      injury rather than a direct genetic event. Hepatic injury and continuous
      hepatocyte regeneration may allow an accumulation of multiple mutational events
      sufficient for the emergence of HCC. Pathways which lead to chronicity, the
      immune response during HBV infection, mechanisms of pathogenesis and methods to
      prevent HBV infection are all relevant to the development of HCC. Recent studies
      characterizing the humoral and cellular immune responses in patients chronically
      infected with HBV and transgenic mouse models of HBV-specific immune tolerance
      and pathogenesis are providing new insights into the complex association between
      HBV infection and HCC.

PMID- 7796668
TI  - The role of superantigens in the immunobiology of retroviruses.
AB  - Murine mammary tumour viruses (MMTVs) are retroviruses that encode superantigens
      capable of stimulating T cells via superantigen-reactive T cell receptor V beta
      chains. MMTVs are transmitted to the suckling offspring via the milk. We have
      established that class II and B cell-deficient mice that were foster nursed by
      virus-secreting mice do not transfer infectious MMTVs to their offspring. No MMTV
      proviruses could be detected in the spleen and mammary tissue of these mice and
      there was no deletion of MMTV superantigen-reactive T cells. These results
      confirm that superantigen expression in the context of MHC class II molecules is
      required for MMTV transmission. We conclude that B cells are essential for the
      completion of the viral life cycle in vivo. This indicates that B cells are
      infected first and that viral amplification takes place only if infected B cells
      present the MMTV superantigen on their surface which, in turn, results in
      activation of T cells expressing the appropriate T cell receptor V beta chains.
      These activated T cells stimulate B cells which enables viral replication. Human
      T cells carry all the structural features required for an efficient response to
      murine retrovirally encoded superantigens. Superantigen-like stimulation of human
      T cells has been demonstrated in both infectious and autoimmune diseases. Human
      immunodeficiency virus may encode a superantigen but this has not been proven.

PMID- 7796670
TI  - Induction and regulation of CD4+ T cell subsets.
AB  - It is now generally accepted that CD4+ T cells can be divided into at least two
      distinct subsets: Th1 and Th2. Th1 cells characteristically secrete interleukin 1
      (IL-2) and gamma-interferon (IFN-gamma) whereas Th2 cells produce mainly IL-4, IL
      5 and IL-10. Studies from many laboratories have demonstrated that the balance
      between these two subsets of T cells frequently determines the outcome of
      infectious and autoimmune diseases. Several factors influence the preferential
      induction and regulation of Th1 or Th2 cells in vitro and in vivo. Mice were
      infected with the protozoan parasite Leishmania to show that the gene encoding a
      major surface glycoprotein of the parasite, delivered orally in a plasmid carried
      by an auxotrophic Salmonella typhimurium vaccine strain (BRD509), preferentially
      induced Th1 cells and protective immunity against a challenge infection. The
      protective effect of the vaccine was augmented by administration of BRD509
      carrying the genes encoding IL-2, IFN-gamma or tumour necrosis factor alpha.
      Cloned mouse Th1 cells specific for malarial antigens have been used to show that
      nitric oxide (NO) can inhibit the production of IFN-gamma by Th1 cells. Oral
      delivery of antigen and selective cytokines may preferentially induce CD4+ T cell
      subsets. Modulation of NO synthesis may further influence this induction and
      sustain such selective responses leading to effective therapy.

PMID- 7796669
TI  - Assembly and transport of class I MHC-peptide complexes.
AB  - Peptides that are presented to T-cells by class I major histocompatibility
      complex molecules are derived from cytosolic proteins. They are generated in the
      cytosol and translocated into the endoplasmic reticulum (ER) by the transporters
      associated with antigen processing (TAP molecules). Competition experiments
      suggest that TAP molecules can specifically translocate a wide range of peptides
      from 8-13 amino acids long; longer peptides are less likely to be transported. A
      photoactivatable peptide derivative has been used to demonstrate that competition
      for transport into the ER reflects competition for a specific peptide-binding
      site on the TAP molecule. Class I molecules bind the translocated peptides in the
      ER thereby allowing their transport to the cell surface. The assembly of the
      class I-peptide complex in the ER is tightly regulated. The evidence suggests
      that class I heavy chains first dimerize with beta 2-microglobulin in a process
      mediated by the chaperone calnexin. The class I-beta 2-microglobulin dimer then
      physically associates with TAP molecules and is released for transport when it
      binds a peptide.

PMID- 7796671
TI  - The host response to lesions induced by human papillomavirus.
AB  - Human papillomaviruses (HPVs) are strictly intraepithelial pathogens: in the
      natural productive infection they induce benign epithelial proliferations of
      mucocutaneous surfaces, some of which may progress to malignancy. Benign HPV
      induced lesions are chronic persistent growths; high levels of viral antigen are
      expressed in the apparent absence of a host immune response suggesting that these
      viruses have evolved efficient mechanisms of immune evasion. Cell-mediated
      responses are central in the pathogenesis of HPV and regression of both cutaneous
      and genital warts histologically resembles a delayed-type hypersensitivity
      response (DTH). The antigen(s) in the wart against which this response is
      initiated are not known but in an experimental murine model DTH responses to the
      E6 and E7 proteins of HPV-16 can be elicited when viral antigen is presented via
      the epithelial route. Priming with low levels of viral antigen in this model
      induces non-responsiveness and the loss of DTH. In HPV-associated cancers the
      E6/E7 genes are expressed and an antibody response to the proteins is found in at
      least 50% of cases indicating that these oncoproteins are potential targets for
      immunotherapy.

PMID- 7796672
TI  - Genetic modification of T cell clones to improve the safety and efficacy of
      adoptive T cell therapy.
AB  - Our laboratory has developed methods to isolate human antigen-specific cytolytic
      CD8+ T cell clones and to expand such clones in vitro to numbers sufficient for T
      cell therapy of human diseases. Studies in immunocompromised bone marrow
      transplant patients at high risk for disease associated with cytomegalovirus have
      demonstrated that administration of more than 10(9) CD8+ T cell clones is safe
      and can effectively reconstitute a deficient human immune response. Our
      laboratory is applying this strategy of adoptive therapy to the treatment of
      human cancer, starting with the subset of patients with Hodgkin's disease who
      show expression of proteins encoded by the Epstein-Barr virus in their malignant
      Reed-Sternberg cells. The development of efficient systems such as retroviral
      vectors for the introduction of genes into primary cells has made it possible to
      consider overcoming some of the limitations of the effector T cells that normally
      mediate response to an antigen. Our laboratory is attempting to modify T cell
      clones by the introduction of genes before transfer as a means to improve the
      safety and/or efficacy of T cell therapy.

PMID- 7796673
TI  - Bone marrow-derived cells present MHC class I-restricted tumour antigens in
      priming of antitumour immune responses.
AB  - Many tumours express tumour-specific antigens capable of being presented to CD8+
      T cells by major histocompatibility complex (MHC) class I molecules. Current
      models of antigen presentation predict that the tumour cell itself should present
      its own MHC class I-restricted antigens to T cells. Earlier cross-priming
      experiments have demonstrated that at least some MHC class I-restricted antigens
      may also be presented by bystander cells. There is no detectable presentation of
      MHC class I-restricted tumour antigens by the tumour itself during priming of
      tumour-specific responses. The tumour antigens are presented exclusively by host
      bone marrow-derived cells. These results imply that an efficient mechanism exists
      in vivo for transfer of MHC I-restricted antigens to bone marrow-derived antigen
      presenting cells. They also suggest that HLA matching may not be critical in the
      clinical application of allogeneic tumour vaccines.

PMID- 7796675
TI  - Potential antigenic targets on Epstein-Barr virus-associated tumours and the host
      response.
AB  - There is considerable variation in the degree of expression of viral genes among
      different tumours associated with Epstein-Barr virus (EBV). Immune control of
      tumours in immunosuppressed patients (immunoblastic lymphomas) can be exercised
      through a range of epitopes from cytotoxic T lymphocytes (CTL) covering the full
      spectrum of latent EBV gene products. A subunit vaccine based on an EBV CTL
      epitope from one of the latent genes is about to undergo human trial. The options
      for immune control of Burkitt's lymphoma are more restricted. Antigen expression
      is limited to a single nuclear antigen, EBNA1, and Burkitt's lymphoma cells are
      unable to process EBV latent antigens, presumably because of a transcriptional
      defect in TAP1 and TAP2 genes. In contrast with earlier suggestions that EBNA1 is
      not a target for CTL, there is a class II-restricted epitope within EBNA1. EBV
      infected B cells are unable to process this epitope endogenously. The most
      promising strategy for developing a vaccine against these tumours is to use a
      single subunit vaccine that incorporates multiple CTL epitopes from several human
      pathogens.

PMID- 7796676
TI  - Human T cell lymphotropic virus: necessity for and feasibility of a vaccine.
AB  - Human T cell lymphotropic virus types I and II (HTLV-I/II) are endemic in certain
      areas of the world. They cause two life-threatening diseases, adult T cell
      leukaemia/lymphoma and tropical spastic paraparesis. A vaccine is needed because
      in developing countries there are no other feasible preventive interventions
      against these diseases and in Western countries intravenous drug users at high
      risk for HTLV-I and HTLV-II infections and the health workers in contact with
      such populations must be protected. We have developed a rat model in which we
      observed variations of susceptibility to viral infection between inbred strains,
      the most susceptible being the Fischer F344, and the possibility of viral latency
      in the nervous system. We have prepared a recombinant adenovirus vector that
      expresses the HTLV-I envelope glycoprotein env in HeLa cells. A target human
      population in French Guyana, in which the prevalence rate reaches 5.6% in one
      ethnic group (Bonis), has been identified for possible intervention.

PMID- 7796674
TI  - Evasion of host immune responses by tumours and viruses.
AB  - Viruses and tumours use various mechanisms to avoid immune surveillance.
      Oncogenic viruses have achieved a balance with the immune system through
      evolutionary time to ensure long-term persistence. Mutations that promote escape
      mechanisms favouring tumour growth to the detriment of host survival through
      reproductive age offer no selective advantage and will not generally be
      maintained in the viral genome that persists in nature. Conventional (non
      oncogenic) and tumour viruses interact with various immune mediators and T cells
      in different ways. Oncogenic viruses cannot operate solely in the context of a
      lytic cycle, though this may be characteristic of the initial phase of infection
      that is limited by the acute immune response. Some oncogenic viruses interact
      with normal cellular growth control and signalling mechanisms. Synthesis of key
      viral proteins may be tightly controlled in replicating cells that are subject to
      T cell surveillance, such as basal epithelia, while productive infection occurs
      in non-proliferating progeny that are lost under normal physiological conditions,
      such as desquamating epithelia. Tumorigenesis may be an aberrant consequence of
      the molecular mechanisms needed to maintain this pattern of viral growth
      regulation in the context of the cell cycle. Vaccines designed to limit the acute
      phase of infection with cell-free oncogenic viruses should be as effective as
      those for conventional viruses.

PMID- 7796677
TI  - Vaccination against cutaneous and mucosal papillomavirus in cattle.
AB  - Viruses are responsible for approximately 15% of human cancer worldwide. Human
      papillomavirus and hepatitis B virus are the recognized agents of cervical and
      liver cancer, respectively, which together constitute 80% of all virally induced
      cancers. If measures could be found to bring viral infection under control, a
      great proportion of human cancer would be greatly reduced. Experimental vaccines
      are being developed against papillomavirus. In principle two different types of
      vaccine can be envisaged: prophylactic vaccines that would elicit virus
      neutralizing antibodies and would prevent infection and therapeutic vaccines that
      would induce regression of established lesions before progression to malignancy
      took place. The research on vaccines against human papillomavirus is hampered by
      the difficulties encountered in growing the virus in tissue culture and by the
      unacceptable nature of experimentation in humans. Effective vaccines, both
      natural and genetically engineered, have been developed against bovine
      papillomavirus and cottontail rabbit papillomavirus. The success obtained with
      the animal models supports the optimistic prediction that in the relatively near
      future vaccines will be available against the most problematic or potentially
      dangerous forms of papillomatosis in humans.

PMID- 7796678
TI  - Prospects for T cell immunotherapy of tumours by vaccination with immunodominant
      and subdominant peptides.
AB  - Immunotherapy of tumours by adoptive transfer of cytotoxic T lymphocytes (CTL) is
      now feasible in experimental murine systems. These CTL recognize peptide
      sequences of defined length presented by major histocompatibility complex (MHC)
      class I molecules. Effective eradication of large tumour masses requires co
      administration of interleukin 2. Tumour escape strategies are numerous but in
      various instances can be counteracted by defined measures. Initiation of CTL
      responses against poorly immunogenic virally induced tumours and other tumours
      requires novel strategies to overcome T cell inertia. We propose a strategy in
      which CTL are raised against target molecules of choice including differentiation
      antigens of restricted tissue distribution (autoantigens) or
      mutated/overexpressed oncogene products. The steps proposed include: (1)
      identification of target molecules of choice. (2) Identification in these target
      molecules of peptides fitting MHC allele-specific peptide motifs involved in
      peptide binding to MHC molecules. (3) Evaluation of actual binding of such
      peptides to specific MHC class I molecules. (4) In vitro CTL response induction
      by such peptides, presented by highly efficient antigen-presenting cells such as
      antigen processing-defective cells carrying empty MHC class I molecules loaded
      with a single peptide or dendritic cells. Both types of cells are capable of
      primary CTL response induction in vitro. (5) Evaluation of proper processing by
      the demonstration of tumour cell lysis by these CTL. (6) Adoptive transfer of
      tumour-specific CTL generated in vitro or vaccination with peptides. These
      various steps have now been taken for several viruses, virally induced tumours
      and other types of tumours and the first indications that this strategy is useful
      have been obtained.

PMID- 7796679
TI  - [Relationship between bone fluoride content, pathological change in bone of
      aborted fetuses and maternal fluoride level].
AB  - Relationship between bone fluoride content, pathological change in bone of
      aborted fetuses and maternal fluoride level was studied in 46 pregnant women and
      their inducedly-aborted fetuses. Results showed fluoride content in fetal femur
      averaged 368.2 micrograms/g, and 41.4% of the bone with pathological change.
      Fluoride levels in maternal urine and amniotic fluid and fluoride content in
      fetal femur and pathological change in fetal femur appeared a positive
      correlation between them. Femur fluoride content and pathological change of bone
      in fetuses born to mothers with mottling teeth were significantly greater than to
      those without them. Pathological change in fetal femur presented dose-response
      relationship with their bone fluoride content. When the latter reached greater
      than 500 micrograms/g, pathological changes occurred in 90% of the bone.

PMID- 7796681
TI  - [Comparison and evaluation of the methods of diet survey].

PMID- 7796682
TI  - [Interventional measures in occupational hazards in village-and town-run
      industries and occupational health services].

PMID- 7796680
TI  - [Effects of dust particle inhalation on pulmonary surfactant system].

PMID- 7796683
TI  - [An epidemiologic study on pulmonary fibrosis caused by hard alloy dust].
AB  - A cross-sectional study, with 1,237 employees solely exposed to hard alloy dust
      and 502 controls in four hard metal works and two tool and grinder manufacturers
      in China, was conducted. Results showed prevalence of symptoms of respiratory
      system, and abnormalities in lung function and serum level of ceruloplasmin and
      urine cobalt content in exposed group were significantly higher than those in
      controls. Eight cases of pneumoconiosis were detected by chest X-ray films with a
      prevalence of 0.65% and an average length of employment in dust environment of
      25.2 years. It suggested hard alloy dust could cause pulmonary fibrosis and
      pneumoconiosis in exposed workers.

PMID- 7796684
TI  - [Studies on diagnosis for occupationally chronic toxic hepatopathy].
AB  - Data from 10-to-17-year periodical physical examinations for 10,858 employees
      exposed to hepatotoxic chemicals were sorted out and analyzed, and 1,514 cases of
      suspected chronic toxic hepatopathy were detected. Causes of under-recognition of
      those were: (1) liver function tests now available being not sensitive enough;
      (2) limitations of conventional methods for diagnosis of hepatopathy by excluding
      other disorders; and (3) lack of diagnostic criteria for it. In the light of
      existing problems, the following diagnostic procedures were applied in the
      studies: (1) analyzing data dynamically to understand when and to what extent the
      liver damaged during their work; (2) exploring several more sensitive liver
      function tests to be used in the diagnosis, and (3) incorporating industrial
      hygienic files into clinical data to get preliminary diagnosis for it, and then
      to differentiate from other disorders and to establish a definite conclusion.
      With these procedures, diagnosis of occupationally chronic toxic hepatopathy was
      established in 1,035 cases of 1,514 suspected ones.

PMID- 7796685
TI  - [Studies on inhibitive effects of organic selenium on cell damage caused by
      SiO2].
AB  - Changes in potassium content of macrophage in guinea pigs and in membrane protein
      of erythrocytes in rats caused by quartz dust, and the effects of selenium
      protein and selenium-containing polysaccharide of cell membrane on them were
      determined with atomic absorption spectrometry and electronic spin label. Results
      showed quartz could significantly decrease potassium content of macrophage with a
      dose-effect relationship. Potassium content in the exposed group could return to
      normal level as the control group by adding Se-protein into quartz dust.
      Rotational correlation times of the membrane protein in erythrocytes could be
      decreased by quartz dust, and Se-protein and Se-containing polysaccharide could
      make them normal. It suggested quartz could cause cell permeability significantly
      increased, cleavage of peptide-chain of membrane protein, degradation and cross
      linkage of protein, and cell damage, but organic selenium could decrease
      cytotoxicity caused by quartz dust and protect cells from the damage.

PMID- 7796687
TI  - [An epidemiological study on reproductive effects in female workers exposed to
      acrylonitrile].
AB  - Four hundred and seventy-seven female workers exposed to acrylonitrile and 527
      controls were studied by retrospective cohort method. Results showed incidence
      rates of pernicious vomiting and anemia, preterm delivery, and birth defects in
      exposed women were obviously higher than those in controls, with statistical
      significance. Logistic regression analysis revealed exposure to acrylonitrile in
      pregnant workers caused increasing risk of preterm delivery and birth defects. In
      addition, illness, medicine taking and X-ray irradiation during pregnancy related
      to the increase of incidence of preterm delivery in exposed women.

PMID- 7796686
TI  - [Effects of lead on neurobehavior and neurochemistry in rats].
AB  - Effects of exposure to lead on neurobehavioral function, content of monoamine
      neurotransmitter in hippocampus, and brain level of lipid peroxide were studied
      in 45 SD rats. Results showed learning and memory abilities of the rats were
      affected in exposure to lead of 1333.3 mg/kg (with their blood lead level of 6.23
      mumol/L), their motor activities changed and emotional status became unsteady
      with 266.7 mg/kg of lead (with blood lead of 4.20 mumol/L) and 1333.3 mg/kg of
      lead, respectively, and levels of dopamine neurotransmitter and its metabolites
      declined and those of lipid peroxide increased with increasing exposure to lead.
      It is postulated changes in levels of neurotransmitter, such as monoamine and
      lipid peroxide, could explain the mechanism for damage in neurobehavioral
      function caused by lead exposure.

PMID- 7796688
TI  - [Comprehensive evaluation of protective measures in electric welding].
AB  - Protective effects of safety masks, eyewear, work clothes, gloves, periodically
      physical examination system, and ventilation and barriers at workplace, were
      evaluated by one-way analysis for handtorch welding, carbon dioxide gas
      protective welding, and argon-arc welding operations, etc. in township and
      village enterprises and state-owned enterprises by interviewing managers in the
      departments of technology and work safety and field investigating. Based on the
      results of one-way analysis of protective measures, comprehensive evaluations of
      various enterprises were made with a fussy mathematical model. Both enterprises
      in township and village level and of state-owned were graded as A on a basis of
      the evaluation, which will be helpful to the better management of occupational
      health in the future.

PMID- 7796690
TI  - [Preparation and identification of monoclonal antibody against sterigmatocystin].
AB  - Compound antigen, bovine serum albumin-sterigmatocystin (BSA-ST) or hemocyanin
      sterigmatocystin (H-ST) was prepared by converting ST to its hemiacetal group in
      ST and taking ST conjugated to BSA or H. Balb/c mice were immunized with BSA-ST,
      and then their spleen cells were isolated and fused with SP2/0 murine myeloma
      cells. A hybridoma cell strain that could stably secrete monoclonal antibody
      against ST (McAb-ST) was selected, and both of their ascites and serum were rich
      in McAb-ST induced by cells of this strain. McAb-ST was identified as Ig-Gi with
      a molecular weight of 168,000 kd (53,000 for heavy chain and 31,000 for light
      one), and with an affinity constant of H-ST reaction of 1.29 x 10(9) mol/L
      measured by indirect competitive enzyme-linked immunosorbent assay (IC-ELISA).
      Relative cross reaction of McAb-ST with ST analogues was less than 2%. The
      minimal 0.5 pg/25 microliters of ST can be detected with IC-ELISA using McAb-ST
      and ST simultaneously, with a linear range of 0.1-10 ng/ml.

PMID- 7796689
TI  - [Inhibition of glutamate uptake in rat brain synaptosome by pyrethroids].
AB  - In vitro studies showed deltamethrin (1 x 10(-7)-1 x 10(-4) mol/L) could inhibit
      3H-DL-glutamate uptake in rat cerebral cortex and hippocampus synaptosome by 7.2%
      21.5% and 10.4%-25.1%, respectively, with a dose-response pattern. But only in
      high-dose permethrin (1 x 10(-4) mol/L) can significantly reduce 3H-DL-glutamate
      uptake in rat hippocampus synaptosome. In addition, deltamethrin also can reduce
      3H-DL-glutamate uptake in cerebellum and striatum of rats by 16.5% and 31.8%,
      respectively. It is suggested that both deltamethrin and permethrin, especially
      the former, can disturb the function of brain tissue in high-affinity-glutamate
      uptake with their alpha-cyano-group. So pyrethroids could play an important role
      in cerebral stimulation in mammals.

PMID- 7796691
TI  - [Monitoring of lead content in foodstuff in China].
AB  - Lead contents in six kinds of foodstuff in China were monitored in 1992. Six
      hundred and three specimens of food were collected from the markets in Beijing,
      Shanghai, Jiangsu, Sichuan and Guangdong. Results showed that 96.2% of cereals,
      84.4% vegetables, 97.6% dairy products, 96.0% eggs and, 100% meat and fish met
      the national food hygienic standards for lead allowable content. Daily dietary
      intake of lead of residents in six areas of China was lower than the provisional
      standard for Daily Allowable Intake of lead set by World Health Organization.

PMID- 7796692
TI  - [Changes and trend prediction in cancer morbidity of urban residents in Beijing].
AB  - Data from a long-term cancer morbidity registry and notification system were
      analyzed dynamically. A theoretical model of grey system was established based on
      time-series changes in cancer morbidities to predict its trend by the year of
      2001 in Beijing. Results show cancer morbidities in Beijing will increase yearly
      from 1991 to 2001, and overall morbidity rate of malignant tumor will increase to
      179.9/100,000 from 162.5/100,000. Proportions of malignant tumor in different
      sites will change greatly. Morbidities of lung cancer and breast cancer will
      increase rapidly, of liver and colon-rectal cancer shoes an increasing trend,
      too, of esophageal and cervical cancer will decline steadily, and of stomach
      cancer will begin to decline. All these facts laid a scientific basis for the
      study on cancer prevention and control.

PMID- 7796693
TI  - Image processing algorithms for the automated micronucleus assay in binucleated
      human lymphocytes.
AB  - The frequency of micronuclei in binucleated lymphocytes (cytochalasin B assay)
      may serve as a biological dosimeter after radiation exposure. The automation of
      the micronucleus assay in binucleated human lymphocytes has been considerably
      advanced in recent years. In our studies for this purpose the detection of
      binucleated cells (BNCs) and the scoring of micronuclei (MN) was divided into two
      parts. First, detection of BNCs was feasible with low microscopic magnification
      (x 100). The positions of classified BNCs were stored. Second, after an automatic
      change of microscope objective, the stored BNCs were automatically analyzed in
      sequence at high microscopic magnification (x 630) for occurrence of MN. For both
      phases of image analysis we used empirical methods based on mathematical
      morphology. The system is able to recognize nearly 65% of BNCs with false
      positive decisions of 6% and about 75% of the MN with false positive decisions of
      7%.

PMID- 7796695
TI  - Mouse testis cell sorting according to DNA and mitochondrial changes during
      spermatogenesis.
AB  - Flow cytometry can measure variations in DNA content and chromatin structure as
      well as dramatic changes in the mitochondria of germ cells during maturation from
      spermatogonia to elongated spermatids. Using 10-N nonyl acridine orange (NAO), an
      inner mitochondrial membrane dye, it is easy to follow mitochondria
      rearrangements. Mouse testis cells stained with the DNA fluorescent probe
      propidium iodide (PI) and analyzed by flow cytometry can be discriminated on the
      basis of their ploidy levels into five main regions corresponding to elongated
      spermatids, round spermatids, diploid, S-phase, and tetraploid cells. The
      simultaneous use of PI and NAO demonstrated the presence of cells having low and
      high mitochondrial content in the haploid, diploid, and tetraploid compartments.
      Eleven sorting windows were selected from the bivariate analysis (PI/NAO) and the
      corresponding cells were identified by microscopic observation. Cells were also
      discriminated by two parameter analysis of DNA content vs. cell diameter. The
      definition of seven different regions allowed us to determine NAO or rhodamine
      123 (Rh 123) uptakes in each compartment. We observed that the ratio (Rh 123/NAO)
      dramatically changed according to the progression of cell differentiation which
      occurs during spermatogenesis.

PMID- 7796694
TI  - Comparative sperm chromatin structure assay measurements on epiillumination and
      orthogonal axes flow cytometers.
AB  - The sperm chromatin structure assay (SCSA) measures the susceptibility of sperm
      nuclear DNA to acid-induced denaturation in situ, and was developed on two Ortho
      flow cytometers, an FC200 [Becton Dickinson Immunocytometry Systems (BDIS),
      Westwood, MA] and a Cytofluorograf 30 (BDIS), both having orthogonal axes of
      fluorochrome excitation, emission, and sample flow. Sperm cells are first treated
      with a pH 1.4 buffer to denature DNA in situ and then stained with the
      metachromatic dye acridine orange (AO). The metachromatic fluorescence measured
      reflects relative amounts of denatured (red fluorescence) and native (green
      fluorescence) DNA present per cell. The extent of DNA denaturation is quantified
      by the calculated parameter alpha t [alpha t = red/(red+green) fluorescence].
      Alpha t variables important for correlations with fertility and toxicant-induced
      chromatin damage include mean (X alpha t), standard deviation (SD alpha t), and
      cells outside the main population (COMP alpha t). Mean green fluorescence
      intensity is an important measure for DNA content and/or degree of sperm
      chromatin condensation. This study showed that the SCSA can be successfully run
      on two epiillumination-type instruments, an Ortho ICP22A (BDIS, San Jose, CA) and
      Skatron Argus (Tranby, Norway), and two additional orthogonal axes instruments, a
      Becton Dickinson FACScan (BDIS) and a Coulter Elite (Coulter Corporation,
      Hialeah, FL). Epiillumination instruments produced a different fluorescence
      distribution than orthogonal instruments, but the resulting alpha t values showed
      strong conformity and interpretation of results was the same. SCSA values
      obtained on the Coulter Elite were most similar to the Cytofluorograf 30; the
      FACScan green fluorescence distribution was narrower and allowed resolution of
      cell doublets.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796696
TI  - Flow cytometric measurement of NK cell immunoconjugates by pulse width
      processing.
AB  - Pulse width analysis, in flow cytometry, has been widely used for optimal cell
      size resolution in cell kinetics analysis. Pulses, generated by scattered light
      or fluorescence of cells, are electronically analyzed for their height and width.
      The information generated from these two properties of the pulses is utilized to
      distinguish signals from single cells vs. signals from cell clumps or aggregates.
      Pulse width, unlike pulse height, is more sensitive to differences in cell
      diameter, and therefore can discriminate very small differences in it, which
      pulse height cannot. We have exploited this property of pulse widths to measure
      immunoconjugates between NK cells and their targets. Discrimination of the free
      target cells from the conjugated ones is possible by the pulse widths of only
      light scatter signals, both forward and/or orthogonal. This resolution was not
      obtained if pulse height of the same signals was visualized. Using this
      resolution it was possible to distinguish single cells from the aggregates
      between target and effector cells. We propose that this is a better method for
      distinguishing conjugates than the method in which prior vital staining of cells
      is used.

PMID- 7796698
TI  - Induction of cell cycle perturbations by the tear gas 2-chlorobenzylidene
      malonitrile in synchronously and asynchronously proliferating mammalian cells.
AB  - The effects of the tear gas 2-chlorobenzylidene malonitrile (CS) on mammalian
      cell proliferation were studied in detail using bromodeoxyuridine/Hoechst flow
      cytometry. In synchronized (G0/G1-phase) Chinese hamster embryo (CHE) cells,
      exposure to CS (60 microM) caused a permanent arrest in the G0/G1 phase in 50% of
      the cells and a delayed G0/G1 phase exit. In asynchronously growing CHE cells,
      the CS-induced cell kinetic perturbations varied with the cell cycle stage during
      treatment. While G1-phase cells showed a delayed progression through S and G2/M
      phases, S-phase cells were mainly inhibited in the G2/M compartment of the first
      cell cycle. In contrast, CS-treated, asynchronous, amniotic fluid-derived,
      fibroblast-like (AFFL) cells exhibited a prolonged transit through the G2/M phase
      of the first cell cycle regardless of the cell cycle stage during treatment. This
      indicates that the induced cytotoxicity of CS is a function of both the cell
      cycle phase and the particular type of cells.

PMID- 7796697
TI  - S-phase arrest of nutrient deprived lung cancer cells.
AB  - The human small cell lung cancer cell line NCI-H82 was used to study the effect
      of nutritional status on cell proliferative parameters. Incorporation of
      bromodeoxyuridine (BrdUrd) was used to characterize actively proliferating cells
      and to obtain information on cell cycle dynamics. During several days, in which
      the culture medium was not changed, a gradual decrease in overall cell growth,
      labeling index, and vitality was observed. Simultaneously, an increase in the
      number of S-phase cells that did not incorporate BrdUrd was noticed. From a more
      detailed kinetic study on d 6 of nutrient depletion, it appeared that, although
      the cells incorporated BrdUrd, they stopped cycling. When the same cells were
      regrown in fresh culture medium, a delay of 10 h in G1-phase entry and exit was
      measured. After this delay the cells resumed the cell cycle at normal phase
      transit rates. In addition, BrdUrd unlabeled S-phase cells were gradually lost
      from the culture. Bivariate flow cytometric DNA/proliferating cell nuclear
      antigen (PCNA) and DNA/Ki67-antigen analyses confirmed a delay in G1 phase entry
      and exit. In this paper we show that nutrient depletion can cause cell cycle
      arrest as indicated by the occurrence of BrdUrd unlabeled S-phase cells. This
      arrest could lead to overestimation of kinetic parameters such as S-phase transit
      time (Ts) and potential time (Tpot) as determined after in vivo labeling of
      tumors.

PMID- 7796700
TI  - Chromosome specific DNA hybridization in suspension for flow cytometric detection
      of chimerism in bone marrow transplantation and leukemia.
AB  - Flow cytometry was used to measure the fluorescence intensity of nuclei that were
      subjected to fluorescent in situ hybridization in suspension with chromosome
      specific DNA probes. Paraformaldehyde-fixed nuclei were protein digested with
      trypsin and hybridized simultaneously with a biotin- and DIG labeled chromosome
      specific centromere probe. A number of probes were tested in the suspension
      hybridizations. The method yielded fluorescent hybridization signals that allow
      discrimination between Y chromosome positive and negative nuclei when analyzed by
      flow cytometry. The method is especially suited for analysis of bone marrow cells
      derived from patients who have received a sex-mismatched allogeneic bone marrow
      transplantation. Male leukemia cells with a trisomy for chromosome 8 were mixed
      with normal female cells and simultaneously hybridized in suspension with a DIG
      labeled probe specific for chromosome 8 and the biotin labeled Y chromosome
      probe. Y chromosome positive or negative nuclei were sorted onto microscope
      slides and subsequently classified as being leukemic or not by fluorescence
      microscopy, on the basis of the presence of a trisomy for chromosome 8. A 120
      fold enrichment could be achieved when 300 Y positive nuclei were sorted from a
      mixture originally containing 0.5% leukemia cells. Given the specificity of the
      flow cytometry and FISH procedure, the combination of the two methods can reach a
      lower detection level of 1 per 250,000.

PMID- 7796699
TI  - Phenotype transition of CD4+ T cells from CD45RA to CD45R0 is accompanied by cell
      activation and proliferation.
AB  - An investigation of proliferation and activation events in subsets of human CD4+
      cells, defined by their expression of CD45RA and CD45R0, is reported. A single
      laser based assay for the study of multiple surface antigens and two-parameter
      cell cycle analysis was used for sorting of and subsequent analysis of
      proliferation in CD4+CD45RA+ CD45R0-, CD4+CD45RA-CD45R0+ subsets and
      phenotypically intermediate stages. After labelling with BrdUrd, cells were
      sorted with flow cytometry on the basis of light-scattering properties and
      staining with anti-CD45RA, anti-CD45R0, and anti-CD4 markers. Sorted cells were
      double stained with anti-BrdUrd-antibodies and PI, and the frequencies of
      proliferating cells were determined. After 48 h, the highest rate of
      proliferation was found among cells with a phenotype intermediate between CD4+
      CD45RA+CD45R0- and CD4+CD45RA-CD45R0+. After 72 h of culture, the situation was
      changed insofar as the point of highest proliferation had shifted towards the
      CD4+CD45RA-CD45R0+ population. These findings were further corroborated by four
      colour staining with anti-CD4, anti-CD45RA, anti-CD45R0, and Hoechst 33342. This
      indicates that the phenotype transition is accompanied by cell proliferation. The
      correlated temporal expression of antigens related to activation (HLA-DR, CD25,
      CD69, CD71) and cell adhesion (CD11a, CD54, L-selectin) in each of the different
      subsets was also investigated. All the activation markers CD25, CD69, and CD71
      show a more heterogeneous pattern of expression among the CD4+ CD45RA-CD45R0+
      cells than the CD4+ CD45RA+CD45R0- cells, indicating a subpopulation of
      CD4+CD45RA-CD45R0+ cells responding more slowly to the mitogenic stimulation.

PMID- 7796702
TI  - Differential effects of two fluorescent probes on macrophage migration as
      assessed by manual and automated methods.
AB  - Fluorescent probes have been utilized to label leukocytes for both in vivo and in
      vitro studies of cell migration; however, the effects of such probes on migration
      have not been determined. The aim of this study was to examine the effects of two
      commonly used fluorescent probes on leukocyte chemotaxis. J774 macrophages were
      labeled with either calcein-acetoxymethyl ester (calcein-AM) or 2',7'-bis-(2
      carboxyethyl)-5-(and 6)-carboxyfluorescein, acetomethyl ester (BCECF-AM), then
      assayed for their ability to migrate to zymosan-activated serum (ZAS). Cell
      migration was quantified by two methods: visual counting of cells and measuring
      cell fluorescence. Using the cell counts, comparison of unlabeled and
      fluorescently labeled macrophages demonstrated that BCECF-AM decreased the number
      of cells responding to ZAS, while calcein-AM had essentially no effect. Neither
      probe significantly affected the number of cells migrating to medium alone. The
      inhibitory effects of BCECF-AM on cell migration increased with probe
      concentration (0.1-1.0 microM) and cell fluorescence. Cell viability was
      unaffected by either probe. In contrast to the results obtained by visual
      counting, measuring fluorescence of migrated cells did not reveal a significant
      difference between the chemotactic response of macrophages labeled with BCECF-AM
      and those labeled with calcein-AM. These experiments indicated that fluorescent
      probes can affect the chemotactic response and that inhibitory activity of these
      probes may not be detected when chemotaxis is quantified solely by automated
      methods.

PMID- 7796701
TI  - Flow cytometric monitoring of allergen induced basophil activation.
AB  - Human basophils express many clustered differentiation antigens (CD), including
      CD45; however, none are specific for these cells. In a previous study, we
      described a two-color immunofluorescence procedure, employing antibodies to CD45
      and IgE for the cytometric evaluation of basophils. In the present work, we show
      that when sensitized basophils are stimulated by allergenic preparations, they
      demonstrate an upregulation of CD45 as well as a decrease in anti-IgE binding.
      Since CD45 antigen modulation was observed with all aeroallergens tested and the
      decrease in IgE expression varied with allergenic preparations, the measurement
      of CD45 upregulation was used to evaluate basophil activation. Using this
      approach, reproducible results were observed when atopic patients were tested at
      different time intervals. In addition, we show that the upregulation of CD45 on
      allergen stimulated basophils is a very rapid phenomenon that is observed after a
      few minutes and that this rapid flow cytometric method can also be used for
      investigations on nonallergenic mediators of basophil stimulation such as calcium
      ionophores.

PMID- 7796703
TI  - Superantigens as etiopathogenetic factors in the development of insulin-dependent
      diabetes mellitus.

PMID- 7796704
TI  - Diabetic cardiovascular autonomic neuropathy: prognosis, diagnosis and treatment.

PMID- 7796705
TI  - Genetic epidemiology of non-insulin-dependent diabetes.

PMID- 7796706
TI  - The regulation of pancreatic islet blood flow.

PMID- 7796707
TI  - Antiherpetic activities of N-alpha-acetyl-nona-D-arginine amide acetate.
AB  - N-alpha-acetyl-nona-D-arginine amide acetate (ALX40-4C) was developed as a
      competitive inhibitor of the binding of the HIV Tat protein to its RNA target
      TAR, which is an intracellular interaction dependent on a short, arginine-rich
      sequence in Tat. ALX40-4C is a simple mimic of that domain, which is stabilised
      against enzymatic degradation through inclusion of D-amino acids and terminal
      protection. The drug inhibits HIV-1 in vitro and is currently being assessed in
      vivo. In the work reported here, potential activities of the compound against
      other viruses were examined. As expected, there was little or no activity against
      most viruses examined, except against some herpesviruses: HSV-1, HSV-2 and CMV.
      Maximal inhibition of HSV-1 in a plaque reduction assay required pre-incubation
      with the drug. Maximal inhibition of HCMV, which replicates more slowly than HSV
      1, requires exposure to the compound within the first few hours of infection. It
      appears that the drug inhibits an early step in HSV and HCMV infection. Such a
      mechanism is consistent with that of other cationic, herpesvirus inhibitors.

PMID- 7796708
TI  - Imipenem and immune response: in vitro and in vivo studies.
AB  - Imipenem is a new beta-lactam antibiotic endowed with very high antimicrobial
      activity; it is used in severe infections which often occur in those conditions
      characterized by impairment of the immune system. The aim of this study was to
      evaluate the effect of imipenem on some immune functions, both in vitro and in
      vivo. The authors studied the effect in vitro of three different drug
      concentrations (15, 30 and 60 mg/l) on polymorphonuclear leucocyte (PMN)
      phagocytosis and superoxide anion production, as well as on lymphomonocyte
      proliferative response and cytokine production. Preincubation of PMN with the
      highest dosages (30 and 60 mg/l) was found to increase phagocytosis evaluated via
      both cytofluorimeter and chemiluminescence, while no effect was detected on
      superoxide anion production or on lymphomonocyte tests. In the in vivo study, the
      authors administered imipenem/cilastatin (1500 mg/day) to 15 elderly and diabetic
      patients, in whom both PMN functions (phagocytosis and superoxide anion
      production) and lymphocyte tests (CD3, CD4, CD8, CD19, IL2 and sIL2R serum
      levels) were studied before and on the 3rd and 7th days of treatment. The drug
      assimilation did not modify the lymphocyte parameters, whereas it increased PMN
      superoxide anion production and phagocytosis which were depressed in basal
      conditions. In the former case, such increase was slight and insignificant,
      whereas in the latter it was significant.

PMID- 7796709
TI  - Pharmacokinetic optimization of the treatment of oral candidiasis with
      fluconazole: studies with a suspension.
AB  - An open crossover study was performed in 12 healthy subjects to investigate the
      pharmacokinetics in saliva and plasma of a 100 mg oral dose of fluconazole,
      administered as either a capsule or as a suspension, the latter being used to
      rinse the mouth and retained for 2 min before being swallowed. In terms of
      fluconazole plasma concentrations the capsule and the suspension were essentially
      bioequivalent. While the saliva concentrations of fluconazole after capsule
      administration reached their peak at 3.0 +/- 0.8 micrograms/ml 4 h after dosage,
      administration of the suspension resulted in a mean peak concentration of 551.1
      +/- 425.6 micrograms/ml 5 min after ingestion. The saliva concentrations
      decreased gradually after ingestion of the suspension, but were higher for 4 h
      than the corresponding levels from the capsule. The area under the curve (AUC)
      from 0 to 96 h of fluconazole in saliva was 227.7 +/- 73.8 h micrograms/ml after
      the suspension, compared to 123.5 +/- 25.5 h micrograms/ml after the capsule,
      indicating that the total drug exposure to the oral mucosa by the salivary route
      was enhanced more than 80% with use of the suspension. Four h after
      administration of the suspension, saliva and plasma concentrations of fluconazole
      were in equilibrium, at a saliva: plasma ratio of around 1.2. Taken together, the
      present results suggest that the treatment of oral candidiasis with fluconazole
      may be optimized by use of an oral suspension, as this delivers pharmacologically
      active levels of the drug to the site of infection by both topical and systemic
      routes.

PMID- 7796710
TI  - Further evidence for a peripheral sympathicolytic action of the antihypertensive
      cicletanine in rats.
AB  - The site and mechanism of action of the antihypertensive agent cicletanine have
      been studied. In the pithed rat model, intravenous (i.v.) cicletanine was able to
      reduce the elevated blood pressure induced by continuous infusion of the alpha 1
      adrenergic agonist, methoxamine, in a dose-related manner. In strip preparation
      of the aorta from deoxycorticosterone (DOCA)-salt-treated rats, cicletanine was
      found to prevent the contraction induced by 1 microM noradrenaline. When
      subeffective doses of phentolamine (0.25 mg/kg p.o.) plus cicletanine (3 mg/kg
      p.o.) were given together, a clear-cut antihypertensive effect was observed in
      DOCA-salt rats. Moreover, subchronic administration of cicletanine (30 mg/kg
      p.o.), during the one month period of DOCA-salt administration to produce high
      blood pressure readings, was able to prevent cardiac noradrenaline depletion.
      These data suggest that the antihypertensive effect of cicletanine, which is
      clinically well tolerated, may be due to a multifactorial mechanism of its
      action, through which it might alter a number of physiological mediators while
      exercising a slight potency on each of them.

PMID- 7796711
TI  - Effects of sumatriptan on isolated rabbit heart.
AB  - Sumatriptan provokes, in healthy subjects as well as in those who suffer from
      hemicrania, a slight increase in both systolic and diastolic arterial pressure.
      It has also been shown to increase the pressure of pulmonary circulation and to
      reduce the calibre of coronary arteries. The present investigation was undertaken
      to study the effects of sumatriptan (75 ng/l) on isolated rabbit hearts. Fifteen
      isolated rabbit hearts, perfused according to Langerdoff's procedure, were
      divided into two groups: Group I (5 hearts), perfused with Krebs-Henseleit
      solution, as a control, and Group II (10 hearts), perfused with Krebs-Henseleit
      mixed with sumatriptan succinate (75 ng/l). After 30 min of perfusion, the basal
      values of heart rate (HR) dp/dt, systolic ventricular pressure (SVP), diastolic
      ventricular pressure (DVP) and coronary flow (CF) were measured. The above values
      in either control or treated hearts were measured 5, 15, 30, 45, 60 min after
      recording the baseline values. HR, SVP, DVP, dp/dt and CF did not show
      significant differences in the two groups. The present data suggest that
      sumatriptan does not exert any action on isolated rabbit hearts.

PMID- 7796712
TI  - Everninomicin, a new oligosaccharide antibiotic: its antimicrobial activity, post
      antibiotic effect and synergistic bactericidal activity.
AB  - Antimicrobial activity of everninomicin (SCH) 27899) in comparison with two
      glycopeptides (vancomycin, teicoplanin) and six beta-lactam agents was evaluated
      against recent clinical isolates of Gram-positive bacteria. Everninomicin showed
      the highest activity against the species tested and MICs90% of everninomicin
      against Streptococcus pneumoniae, Streptococcus pyogenes, Enterococcus faecalis,
      Enterococcus faecium and Clostridium difficile were 0.1, 0.1, 0.2, 0.39, 0.1
      microgram/ml, respectively. MICs90% of everninomicin against methicillin
      resistant Staphylococcus aureus (MRSA) and Staphylococcus epidermidis (MRSE) were
      0.78 microgram/ml. Laboratory induced resistance to everninomicin in strains of
      S. aureus and E. faecalis occurred in a stepwise manner and at a very slow rate.
      Post-antibiotic effect against strains of S. aureus and E. faecalis were 1.8 and
      2.6 h, respectively, and a little longer than that of vancomycin. Adherence to
      glass surface of an MRSA strain was strongly repressed by the addition of sub MIC
      of everninomicin in combination with fosfomycin.

PMID- 7796713
TI  - Pharmacological mechanisms in cocaine's cardiovascular effects.
AB  - The squirrel monkey is a reliable model for the cardiovascular effects of cocaine
      in that it mimics the human response to cocaine; low to moderate doses of cocaine
      produce a sustained pressor effect and tachycardia. Pretreatment experiments have
      indicated the importance of alpha-1 and beta-1 adrenoceptor mechanisms in
      mediating the pressor and tachycardiac effects of cocaine, respectively. Little
      support for a role of dopaminergic mechanisms in the hemodynamic effects of
      cocaine has been found. Toxicity to cocaine is often observed hours after its
      administration, pointing to a potential role of the cocaine metabolites. Studies
      on the direct effects of a variety of cocaine metabolites indicate that their
      cardiovascular effects do not necessarily mimic those produced by cocaine, and
      therefore these differing effects of the metabolites should be considered when
      evaluating the cardiovascular toxicity of cocaine. Further, as these metabolites
      are present in the body for long periods of time, these results suggest a role of
      the metabolites in producing toxicity long after cocaine administration. Finally,
      studies using both dopaminergic and calcium channel antagonists indicate that the
      pharmacological mechanisms involved in the cardiovascular effects of cocaine are
      not the same as those involved in its behavioral effects.

PMID- 7796714
TI  - Cardiovascular effects of cocaine in humans: laboratory studies.
AB  - Studies in which healthy, carefully screened, experienced cocaine users receive
      cocaine under controlled laboratory conditions, although often overlooked by the
      medical community, are an excellent source of data on the cardiovascular effects
      of cocaine. Cocaine is generally self-administered in repeated-dose 'binges', and
      studies simulating this pattern provide interesting cardiovascular information,
      such as the selective development of acute tolerance or the unique effects of
      some drug combinations. Studies with intranasal, intravenous, and smoked cocaine
      all show that under conditions in which subjects are allowed to take cocaine
      repeatedly, heart rate generally returns to near baseline levels between doses
      despite gradually increasing cocaine blood levels. Blood pressure either shows
      the same pattern, or gradual increases with repeated dosing. Analyses of
      cardiovascular activity as a function of cocaine plasma level indicate the rapid
      development of acute (i.e., within session) tolerance to cocaine. Cocaine self
      administration often occurs in the presence of behavioral stressors, or in
      combination with other drugs of abuse or cocaine abuse treatment medications.
      Performance of a behaviorally-demanding task increases heart rate and blood
      pressure. When cocaine is taken prior to task performance larger increases in
      heart rate are observed than with either drug or task alone. An unexpected
      cardiovascular interaction was observed in subjects who inhaled cocaine and drank
      ethanol-containing beverages. This combination resulted in heart rate increases
      that were significantly larger than observed with either drug alone. Combinations
      of i.v. cocaine and smoked marijuana also increased heart rate above levels seen
      with either drug alone. A single intravenous dose of cocaine and morphine in
      combination, however, produced cardiovascular effects similar to those produced
      by cocaine alone. The effects of these drug combinations on blood pressure were
      often equal to the effect of one drug alone. Since cocaine is frequently taken in
      combination with potential treatment drugs, these interactions can be assessed
      under controlled settings prior to large-scale treatment studies. For instance,
      maintenance on the antidepressant desipramine increased baseline heart rate and
      diastolic pressure. Cocaine administration engendered increases in heart rate and
      blood pressure above the desipramine-elevated baselines. Clearly, drug
      interactions can have unexpected cardiovascular effects, and laboratory studies
      provide a controlled setting for understanding and studying these interactions.

PMID- 7796715
TI  - Effect of cocaine on vagal tone: a common factors approach.
AB  - This paper discusses a distinct cardiovascular pattern that is common to a wide
      variety of abused substances. The pattern consists of tachycardia that appears
      mediated by withdrawal of vagal inhibition, as indicated by decreases in cardiac
      vagal tone. This decrease in vagal tone was particularly robust with i.v. cocaine
      given to experienced cocaine abusers in a residential research setting. Following
      40 mg i.v. cocaine, heart rate increased by approximately 30 beats/min at the
      same time that vagal tone decreased by approximately 2 log units. The theoretical
      significance of these findings is based on evidence that the results reflect a
      common factor among many abused drugs, but not the few aversive drugs that have
      been studied in this paradigm.

PMID- 7796717
TI  - Pharmacological evaluation of dimethylheptyl analogs of delta 9-THC: reassessment
      of the putative three-point cannabinoid-receptor interaction.
AB  - The basic premise underlying the cannabinoid pharmacophore is that at least three
      functional groups are involved in the interaction between the ligand and the
      receptor and that these functional groups in delta 9-THC comprise (a) C11, (b)
      the phenolic hydroxyl, and (c) the side chain. In order to assess the relative
      importance of the C11 position and the side chain, a series of C11 substituted
      analogs were prepared which contained a dimethylheptyl side chain. Consistent
      with previous studies, incorporation of a dimethylheptyl side chain dramatically
      enhanced both pharmacological potency in mice and receptor affinity.
      Incorporation of a hydroxy at C11 along with this branched side chain resulted in
      an extremely potent cannabinoid with ED50S of 0.01, 0.04, 0.16 and 0.04 mumol/kg
      in depression of spontaneous activity, reduction in body temperature,
      antinociception, and immobility, respectively. This compound was also very potent
      as a discriminative stimulus in a drug discrimination procedure and exhibited an
      extended duration of action. Its high affinity for the cannabinoid receptor (Ki =
      400 pM) was consistent with this pharmacological potency. Incorporation of an oxo
      rather than a hydroxy reduced potency somewhat, although this analog was much
      more potent than delta 9-THC in most behavioral assays. The most striking
      observation was that incorporation of a carboxylic acid to form 11-nor-delta 9
      THC-DMH-9-carboxylic acid did not eliminate pharmacological activity. This analog
      was as potent as delta 9-THC. The improbability that all three of the functional
      groups are interacting in a similar fashion with the receptor provides further
      support that the C11 position is not an essential requirement for activity. On
      the other hand, it is possible that substituents in the C9 region are interacting
      somewhere within or near the same site, but differently.

PMID- 7796716
TI  - Sympathetic nervous system mediated cardiovascular effects of cocaine are
      primarily due to a peripheral site of action of the drug.
AB  - Currently, augmentation of sympathetic nervous system function produced by
      cocaine is thought to be due primarily to stimulation of sympathetic centers in
      the brain (central effect) and to inhibition of catecholamine uptake into
      postganglionic sympathetic nerve terminals (peripheral effect). In this review of
      our work, we present the following evidence that cocaine-induced changes in
      cardiovascular function, particularly those that peak within 1 to 5 min after an
      i.v. bolus injection of the drug, are due to a peripheral effect of the drug: (1)
      In both dogs and cats, cocaine potentiates the tachycardiac effect of neurally
      released and injected norepinephrine (NE). The time course of action and dosage
      range of cocaine that produces potentiation follows that which increases blood
      pressure (BP), heart rate (HR), rate-pressure product and coronary
      vasoconstriction. (2) Cocaine given in i.v. doses that increase BP in decerebrate
      cats (0.25-1.0 mg/kg) has no significant effect on directly monitored spontaneous
      cardiac sympathetic nerve activity (SNA). In fact, higher doses of cocaine (2-4
      mg/kg, i.v.) consistently inhibit preganglionic cardiac and splanchnic nerve
      activity. (3) Cocaine (0.1-1.0 mg) administered directly into the blood supply of
      the hindbrain via the vertebral artery produces no increase in BP, HR or SNA in
      cats; instead, decreases in BP and sympathetic activity occur. The same dose (1
      mg), injected i.v., does not depress BP or SNA. In addition, cocaine injected
      into the forebrain via the carotid artery or into the cerebral ventricles (0.1
      1.0 mg) has very little effect on BP. Our results indicate that there is no
      significant excitatory effect of cocaine on CNS sympathetic centers, and that the
      sympathomimetic effects of cocaine on the cardiovascular system are likely to be
      mediated at peripheral sites.

PMID- 7796718
TI  - Assessment of attentional bias and mood in users and non-users of anabolic
      androgenic steroids.
AB  - Forty-six male strength athletes took part in a study to measure the effects of
      anabolic-androgenic steroids on attentional bias to aggressive cues. They were 16
      current users of anabolic steroids, 16 former users and 14 non-users.
      Testosterone, deca-durabolin and anadrol were the three most commonly taken
      steroids during the last cycle. Users generally took 2-3 drugs during each cycle;
      the average cycle lasted 8-11 weeks and they had completed 3-4 cycles. The
      subjects completed visual analogue scales of current feelings and were presented
      with a modified Stroop Colour Word Conflict Task containing sets of neutral,
      verbally aggressive and physically aggressive words. Current users tended to rate
      themselves more negatively. Users took longer than former users to name the
      colours of all word sets but there were no significant differences between word
      sets. Therefore, attentional bias did not differ between groups but current
      steroid use produced subtle mood changes and slowed performance compared to users
      not currently taking steroids.

PMID- 7796719
TI  - Neuropsychological performance of recently abstinent alcoholics and cocaine
      abusers.
AB  - To examine possible influences of premorbid and comorbid factors on the
      neuropsychological test performance of recently abstinent (3-5 weeks) drug
      abusers, we studied 24 alcoholics, 23 cocaine abusers, and 22 healthy controls of
      comparable age and education. Both alcoholics and cocaine abusers performed
      significantly more poorly than controls on most measures of learning and memory,
      problem solving and abstraction and perceptual-motor speed, but the groups did
      not differ on the measure of sustained attention. Correlational analyses revealed
      no significant relationships between measures of childhood and residual
      hyperactivity and neuropsychological performance; scores on the Beck Depression
      Inventory were related only to performance on the Wisconsin Card Sorting Test.
      The findings indicate that abuse of cocaine or alcohol is associated with
      deficits on neuropsychological tests which cannot be attributed to specific
      premorbid or comorbid factors such as depression or childhood or residual
      attention deficit disorder.

PMID- 7796720
TI  - Substance use among schoolchildren in the north of England.
AB  - A confidential and anonymous survey of 3623 adolescents was carried out in eight
      schools (six state comprehensive and two independent) in Newcastle upon Tyne. The
      survey enquired about cigarette use, alcohol consumption and illicit drug use
      together with key demographic variables. The results showed that 21% were
      currently smoking and 11% on a frequent basis. Regular smoking was more prevalent
      among girls. There was substantial use of alcohol, with 75% having used, and 20%
      drinking on a regular basis. This high level of alcohol consumption may be
      characteristic of northern Britain. The relatively low reported use of cannabis
      and relatively high reported use of naturally occurring hallucinogens may
      constitute a further regional variation. A minority of the sample (1.5%) were
      using illicit substances on a regular basis. Findings are discussed in terms of
      previous literature.

PMID- 7796721
TI  - Adherence to zidovudine (AZT) among HIV-infected methadone patients: a pilot
      study of supervised therapy and dispensing compared to usual care.
AB  - Twenty-seven HIV-infected methadone maintenance patients who demonstrated
      problems adhering to zidovudine (AZT) were randomly assigned to a group that
      received eight weeks of weekday supervised therapy and dispensing of AZT or a
      group that received usual care of the clinic. Adherence was assessed by self
      report, erythrocyte mean corpuscular volume (MCV), Medication Event Monitoring
      Systems (MEMS), and pill counts. Subjects in the intervention group demonstrated
      significantly higher MCV levels during the intervention period than usual care
      subjects, with similar but non-significant trends for the three other adherence
      measures. MEMS percent indicated significant group differences on weekdays, but
      not weekend days. There were no differences at a one-month follow-up. Results
      suggest supervised therapy and dispensing may be an effective strategy for
      improving AZT adherence, but only while provided. Further research is needed to
      establish the effects of larger and longer lasting interventions.

PMID- 7796724
TI  - [Amyloid struma].
AB  - A 71-year-old woman with a seven-year history of seronegative polyarthritis had
      to be intubated and ventilated because of acute respiratory failure. The chest
      radiograph and computed tomography revealed bilateral pleural effusions and
      massive enlargement of the thyroid which compressed the trachea. Concentration of
      the thyroid-stimulating hormone was slightly reduced, while that of peripheral
      thyroid hormone was normal. Histological examination of a goitre specimen after
      strumectomy showed macrofollicular goitre with massive amyloid deposits. Amyloid
      was subsequently also demonstrated in the gastrointestinal tract. The patient
      died 5 months later from respiratory failure. A second patient, 47 years old at
      hospitalization, had been suffering from arthritic psoriasis since she was a
      child and had been undergoing haemodialysis for renal failure caused by amyloid.
      She had undergone angiography because the haemodialysis shunt had become
      occluded. She had been admitted because of an increase in goitre size during the
      last 6 months and a malignancy was suspected. Computed tomography showed the
      thyroid enlargement with retrosternal extension and a nodule in the thyroid
      isthmus. After injection of contrast medium for the angiography she developed, on
      the basis of probably already existing hyperthyroidism with an increased level of
      thyroid-stimulating immunoglobulin, clinically and biochemically manifest
      hyperthyroidism, which was treated with thiamazole (15 mg daily) and propranolol
      (40 mg twice daily). Cytological examination of a fine-needle biopsy of thyroid
      tissue revealed amyloid deposits. The patient died 4 years later, shortly after
      bilateral hip replacement for femoral neck fractures. At autopsy a large amyloid
      goitre and amyloid deposits in the kidneys, gastrointestinal tract and coronary
      arteries were found.

PMID- 7796723
TI  - [Sarcoidosis in monozygotic twins].
AB  - Identical (monozygotic) female twins both simultaneously developed acute
      sarcoidosis with unusual manifestations. Additional to pulmonary involvement they
      both also had hypercalcaemia with compensated renal failure. When seen at the age
      of 33 years, these findings were more marked in one of them (case 2) than in the
      other, and she also had granulomatous conjunctivitis, while in the other one
      (case 1) the dominant sign was widespread lymph node enlargement. Both were also
      found by magnetic resonance imaging to have multiple lesions in the white matter,
      interpreted as the morphological correlate of neurosarcoidosis. But they caused
      clinical symptoms (visual disorder, unsteady gait) in only one sister (case 1).
      Treatment with prednisolone largely normalized the lung functions in case 2,
      completely in case 1, and renal functions in both. But when the daily
      prednisolone dose was reduced to below 10 mg, the pulmonary symptoms recurred.
      These observations indicate that even in chronic sarcoidosis acute episodes may
      occur, with involvement of multiple organs and other rare complications. The
      manifestations of the underlying disease in identical twins and the similarities
      of its course in the two sisters underline the possible role of genetic factors
      in the pathogenesis of sarcoidosis.

PMID- 7796722
TI  - [The clinical importance of scintigraphy with the murine monoclonal
      antigranulocyte antibody BW 250/183 for the diagnosis of prosthesis-related
      endocarditis].
AB  - Thirty-eight patients (16 men, 22 women; median age 62.5, range 7 to 80 years)
      were enrolled in a prospective study to assess the clinical utility of
      radioimaging using the antigranulocyte antibody BW 250/183 in suspected valve
      endocarditis. Eighteen patients had prosthetic valve endocarditis according to
      clinical criteria (surgical confirmation in 8 patients), the remaining 20
      patients served as controls. All patients underwent transthoracic and
      transesophageal echocardiography. Eight to 10 MBq of technetium-99m-labeled
      antibody were intravenously injected and single-photon emission computed
      tomography (SPECT) of the thorax was performed after 20 to 24 h. Echocardiography
      revealed pathological findings in 16 of 18 patients with endocarditis
      (sensitivity 89%) and was false positive in one of 20 control subjects
      (specificity 95%). Scintigraphy was true positive in 14 of 18 patients with
      endocarditis (sensitivity 78%) and false positive in three of 20 control subjects
      (specificity 85%). Scintigraphy was true positive in the patients with false
      negative echocardiography and vice versa (sensitivity for both methods combined
      100%, specificity 80%). In all five follow-up patients, scintigraphy became
      negative parallel to clinical improvement. This suggests that scintigraphy
      indicates the floridity of the inflammatory process. In clinically suspected
      prosthetic valve endocarditis with equivocal echocardiographic findings, SPECT
      using the antigranulocyte antibody BW 250/183 may provide valuable additional
      diagnostic information.

PMID- 7796725
TI  - [The current status of funnel chest treatment].

PMID- 7796726
TI  - [The hyperventilation syndrome].

PMID- 7796729
TI  - [Is peptic ulcer an infectious disease?].

PMID- 7796728
TI  - [The meaning of the carcinoembryonic antigen].

PMID- 7796727
TI  - [The duty of fee reduction according to Article 6 a GOA. Gebuhrenordnung fur
      Arzte].

PMID- 7796730
TI  - [Is peptic ulcer an infectious disease?].

PMID- 7796732
TI  - [The recurrent risk for birth defects].

PMID- 7796733
TI  - The implications of acquired immunodeficiency syndrome (AIDS) in otolaryngology.

PMID- 7796731
TI  - [Milk consumption and bone mineral content].

PMID- 7796734
TI  - Temporal bone fracture with dislocation of the incus.

PMID- 7796735
TI  - Vocal fold masses associated with leukoplakia.

PMID- 7796736
TI  - Nasal osteotomies--two parts.

PMID- 7796738
TI  - CAT-astrophic allergies (a kitty letter).

PMID- 7796737
TI  - Endoscopic excision of an antral lesion via inferior meatal antrostomy.

PMID- 7796739
TI  - AIDS in the field of otolaryngology.

PMID- 7796740
TI  - AIDS: lessons from the last decade and prospects for the future.

PMID- 7796741
TI  - Universal precautions for the otolaryngologist: techniques and equipment for
      minimizing exposure risk.
AB  - HIV infection transmitted from a patient to a surgeon is a real concern but a
      remote possibility. However, given the professional and personal impact of HIV
      seroconversion on a physician, preventive measures need to be instituted. The CDC
      has developed a policy of universal precautions to help to minimize this risk. We
      review various measures to institute this policy and other measures that can
      reduce exposure to HIV. These protocols, when instituted, can maximize safety for
      all health care professionals and their patients.

PMID- 7796742
TI  - OSHA standards for blood-borne pathogens--strategies to increase compliance among
      otolaryngologists.

PMID- 7796743
TI  - Audiological changes associated with HIV infection.

PMID- 7796744
TI  - The management of sinusitis in patients infected with the human immunodeficiency
      virus (HIV).
AB  - As the Human Immunodeficiency Virus (HIV) has extended its influence across the
      United States, otolaryngologists have been increasingly called upon to manage its
      various head and neck manifestations. Sinusitis is a very prevalent, yet
      difficult, management problem in this patient population. The pathophysiology of
      sinusitis in this setting relates to altered helper T-lymphocyte function, an
      abnormal inflammatory response as well as increased IgE-mediated inflammation.
      Chronic HIV-related sinusitis is often due to Pseudomonas aeruginosa,
      Staphylococcus aureus, or anaerobic bacteria, and empiric antibiotic therapy must
      include these potential pathogens. Early cultures can facilitate organism
      specific antibiotic therapy. Aggressive treatment with decongestants, topical
      nasal steroids, mucoevacuants and occasionally antihistamines should be included
      at maximal tolerated doses. When medical therapy fails, surgical drainage can be
      a safe and effective management option. Appropriately directed medical, and
      occasionally surgical, therapy can lead to a dramatic clinical response and
      provide an improved quality of life in this patient population.

PMID- 7796745
TI  - The human immunodeficiency virus and facial plastic surgery.
AB  - The Human Immunodeficiency Virus (HIV) has imparted a number of concerns
      involving patient care and management as well as health care worker safety upon
      most surgical practices. Although these concerns are not often discussed in the
      context of facial plastic surgery (or particularly cosmetic surgery), they remain
      important issues. These issues are discussed with respect to public health
      policy, ethics and legality. The pathophysiological considerations for decision
      making and care for HIV disease in the facial plastic surgery practice are
      addressed.

PMID- 7796746
TI  - Complications following bilateral turbinectomy.
AB  - Thirty four patients undergoing bilateral inferior turbinectomy for obstruction
      of the upper airway are prospectively reviewed. The indication for the operation
      was persistent nasal obstruction interfering with sleep and speech. Their ages
      ranged from seven years to 50 years. The most common post operative complications
      were synaechiae (15%), atrophic rhinitis (15%), persistent obstruction (12%) and
      abnormal nasal sensation (9%).

PMID- 7796747
TI  - Prevalence and risk factors of parasitic infections among under-five Sudanese
      children: a community based study.
AB  - A community based prospective study was conducted among randomly selected 300
      children aged less than five years selected from three camps of the police force
      in Khartoum from 534 households representing a total population of 4962
      individuals. The study was planned to determine the prevalence and type of
      parasitic infestations and the related risk factors in that community. From the
      300 children, 298 stools specimens were examined: 116 were positive for a single
      parasite, while samples from 15 children showed ova and cysts for two types of
      parasites giving a prevalence rate of 44%. The commonest infestations were
      Giardiasis (21.1%), Taeniasis (10.4%) and Enterobiasis (7.4%). Non pathogenic E.
      coli, E. histolytica and Taenia saginata were detected in 2.7%, 0.7% and 1.7% of
      stools specimen respectively. Children aged between 3 years and above were the
      most affected group and the infection rate was highest among the illiterate,
      overcrowded and large sized families. Malnourished children comprised 9.4% of the
      study group but there was no significant association between undernutrition and
      the overall prevalence of intestinal infestations, although Giardia lamblia
      significantly affected the undernourished group.

PMID- 7796748
TI  - Age and sex graded helminth infections in a Nigerian village.
AB  - Prevalence of helminth parasites was carried out in both male and female
      villagers graded into three age groups (5-14 years, 15-25 years, 26-55 years).
      Children between 5 and 14 years of age had the highest prevalence of Ascaris,
      Schistosoma haematobium and Trichuris while the villagers between 26-55 years of
      age had lowest prevalence of these parasites. However, hookworms were highly
      common among the villagers aged between 26 and 55 years and least common among
      the school children aged between 5 and 14 years. Female children between the ages
      of 5 and 14 years and males of the same age group were highly infested with
      Ascaris and Trichuris. This finding in a Nigerian village suggested that helminth
      infestation is age and sex dependent which is therefore a factor of the frequency
      in host-parasite contact determined by mode of life of the parasites and the
      hosts.

PMID- 7796750
TI  - Bacteraemia in patients presenting with fever.
AB  - In three studies, in Ghana and Kenya, blood from 639 patients admitted with fever
      was cultured. Standard treatments were antimalarials (54-100%) and antibiotics
      (39-90%). According to the criteria in use, however, only 10-31% had malaria
      alone; of those who received antibiotics, 66% were diagnosed with malaria,
      gastrointestinal infections, post-operative recuperations, circulatory problems,
      central nervous system disorders or FUO, and did not need antibiotics at the
      first encounter. For those with wounds and abscesses (8%), generalised antibiotic
      treatment can also be questioned. Bacteraemia was found in 71 (11.3%) patients;
      in the HIV patients, however, 5 (23%) of 22 had bacteraemia. This is a minimum
      incidence, since culture techniques were not optimal for the isolation of
      fastidious microorganisms. The most prevalent organisms isolated were Salmonella,
      Klebsiella/Enterobacter and S. aureus. Resistance (intrinsic and extrinsic) in
      the Gram- bacteria was high: 31-100% were resistant to amoxycillin, 0-80% to
      cotrimoxazole, 15-95% to chloramphenicol and 9-15% to gentamicin. The need for
      cultures and sensitivity tests for patients with prolonged or undiagnosed fever
      is stressed. Specific treatment should be given only when infections, whether
      malarial or bacterial, have been positively diagnosed.

PMID- 7796749
TI  - Sero-prevalence to hepatitis B and C virus infection in refugees from Mozambique
      in southern Africa.
AB  - Serological markers for evidence of past exposure to hepatitis B virus (HBV) and
      hepatitis C virus (HCV) were investigated in a cohort of refugees from
      Mozambique. Serological markers for past exposure to HBV were detected in 56% of
      the population and, in addition, 13.2% carried the HBV surface antigen. Anti-HCV
      antibodies could be confirmed in 3.2% of the population and occurred mostly in
      the older individuals. Only one anti-HCV antibody positive individual was
      positive for HBsAg. Immunity to rubellavirus had reached 85% by 11 years of age.

PMID- 7796751
TI  - Successful management of vesicovaginal fistulae at St. Gaspar Hospital, Itigi,
      Singida, Tanzania: a preliminary report.
AB  - Twenty five patients with vesicovaginal fistulae were managed at St. Gaspar
      Hospital, Itigi, Tanzania between February 1993 and March 1994. Most of them, 92%
      were repaired vaginally routinely using the Martius labial flap and 8% were
      repaired transabdominally because the fistulae were inaccessible vaginally as
      they were vesicouterine or vesicocervical fistulae. The success rate was 96%
      after the first operative attempt.

PMID- 7796752
TI  - The status and consequences of Mansonella perstans infection in Calabar, Nigeria.
AB  - Two aetiological studies on filariasis were conducted from January to June, 1993.
      In the first study, 690 blood samples clinically diagnosed of filariasis were
      examined. In the other, 150 blood samples and 150 skin snips collected from the
      same group of eye clinic Patients clinically diagnosed of filariasis were
      investigated. Of the 690 subjects, 108 (15.64%) had filariasis with M. perstans
      and Loa loa accounting for 98.15 and 1.85% of positive cases respectively. Among
      the eye clinic patients, 16% had M. perstans while O. volvulus was seen in 4% of
      patients. There was no concurrent infection with these two agents. A
      statistically significant association existed in the frequency of M. perstans in
      the different ages treated (p > 0.01) while non existed by sex (p > 0.01). The
      possible involvement of M. perstans in ocular filariasis and its treatment are
      discussed.

PMID- 7796753
TI  - Hospital catchment areas and surgery in Meru district, Kenya.
AB  - This study of the geographical locations of homesteads of patients undergoing
      surgery at three hospitals in Meru district, Kenya, showed largely overlapping
      catchment areas. It also showed catchment areas varying in size with the type of
      surgical operation under study: Caesarean section, exploratory laparotomy,
      uterine evacuation, tubal ligation, and normal child delivery. We conclude that
      catchment areas vary with the disease condition and the health care intervention
      under study. A precise definition of the catchment area population concept should
      be developed by ministries of health and then explained to district health teams
      and health care facility managers for local use in epidemiological surveillance
      and health care planning.

PMID- 7796754
TI  - Anorectal malformation presenting as Hirschsprung's disease: a case report.
AB  - A 3.8 kg female baby, who was born on 7-2-92 by normal vaginal delivery at a
      zonal hospital in the Southern Highlands of Tanzania, was initially noted to have
      had an "ectopic" anus (an ano-perineal fistula) but was otherwise normal. She had
      delay in the passage of meconium upto the third day, and by the fifth day had
      developed marked abdominal distension. Following a period of unsuccessful saline
      "enemas" she had to undergo a right transverse colostomy in the fourth week
      (which relieved the distension) for what was then presumed to be Hirschsprung's
      Disease. She was referred to the National Referral hospital in Dar es Salaam a
      year later, where she was found to have an entirely intra-pelvic sacrococcygeal
      teratoma in association with a "low" anorectal malformation. This unusual case is
      of interest because of the rare association of intrapelvic sacrococcygeal
      teratoma with anorectal malformation which led to the initial mis-diagnosis of
      hirschsprung's disease.

PMID- 7796755
TI  - Early cessation of breast feeding as a major cause of severe malnutrition in
      under twos: a hospital based study--Dodoma Region, Tanzania.
AB  - One hundred and ten consecutive children under two years of age were admitted
      because they were affected by severe Protein Energy Malnutrition. They were
      investigated to know the precipitating cause of their condition. 68 (62%) of them
      had a history of early weaning from the breast before 2 years, which was followed
      by a drastic drop of the growth curve. 16 (15%) of them adopted unilateral breast
      feeding. The study confirms the danger of stopping breast feeding before two
      years. This contrasts with other findings from Uganda, Zambia and Botswana which
      indicate that prolonged breast feeding is associated with higher prevalence of
      malnutrition in children. Further studies from other countries are necessary and
      opportune since the basic socio-economic conditions of the population, especially
      when these are as low as the case in Dodoma Region.

PMID- 7796756
TI  - Orofacial lesions as indicators of HIV/AIDS among dental patients in Kenya.
AB  - Despite an estimated prevalence of 3-5% of HIV infection in Kenya, little has
      been reported on the occurrence of oral lesions amongst the afflicted
      individuals. We report ten cases who presented with orofacial lesions and
      subsequent serological evaluation confirmed them seropositive. In the light of
      the numerous problems facing clinical staff in less developed countries, these
      findings underscore the significance of clinical identification of more probable
      HIV patients on the basis of orofacial signs. Continuing education with respect
      to HIV infection through wider dissemination of information on orofacial signs to
      clinical staff especially in the context of invasive care and containment of
      infection are recommended.

PMID- 7796758
TI  - Cost effectiveness in routine radiological investigations.

PMID- 7796757
TI  - The Spectrum Anaemia Banding Index (SABI): a new tool to assess collective
      anaemia levels.

PMID- 7796759
TI  - Radiological behaviour of the thymus in chest infection in the underfives.
AB  - The thymus in the paediatric chest will often give radiological appearances of
      very intriguing nature. It is known to react dramatically to stress factors such
      as infection or trauma. Gross hypertrophy following atrophy has been documented
      in many cases. In this paper the author scrutinizes one hundred anteroposterior
      chest radiographs of children under the age of five years suspected of having
      chest infection. Thymocardiac ratio is determined. It is concluded that in
      children under five years, the thymus generally decreases in size with age and
      that often the thymus will undergo atrophy as a primary response to infection.

PMID- 7796760
TI  - Ecology of Sergentomyia garnhami, (Diptera:Psychodidae) in a kala-azar endemic
      area of Tseikuru, Kitui District, Kenya. I: The breeding sites.
AB  - The breeding sites of S. garnhami and other phlebotomine sandflies were
      investigated from February 1989-June 1990. Sandflies were recovered from 15 out
      of the 17 ecological habitats studied while S. garnhami was recovered from
      fourteen. Termite hills were the most preferred breeding sites for most
      phlebotomine sandflies but it was not possible to identify the preferred breeding
      sites of S. garnhami as all the sites yielded only one to three flies. S.
      garnhami were recovered from soil samples from both inside and outside human
      homes as well as from sylvatic sites. Daily pattern of emergence of sandflies
      showed that 60 days were sufficient for most sandflies to emerge while at least
      100 days were required for S. garnhami.

PMID- 7796761
TI  - Ecology of Sergentomyia garnhami, (Diptera:Psychodidae) in a kala-azar endemic
      area of Tseikuru, Kitui District, Kenya. II: Day resting sites.
AB  - A search for the day resting sites of S. garnhami and other phlebotomine
      sandflies in ten ecological habitats in Tseikuru area of Kitui District, Kenya,
      was carried out between November and December 1990. S. garnhami was collected in
      nine out of ten sites investigated, suggesting a wide distribution of the resting
      sites. S. garnhami constituted 23.4% of the total collections with termite hills
      being the most preferred site. Weekly trapping records showed that S. garnhami
      appeared in the field three weeks after the first rains of the season.

PMID- 7796763
TI  - Breastfeeding: past, present and future.

PMID- 7796762
TI  - Pattern of Schistosoma mansoni infection after intervention in Mwea irrigation
      scheme in Kenya.
AB  - A longitudinal study of Schistosoma mansoni reinfection rate was carried out in
      an endemic area of Kenya, after intervention. Intervention measures applied
      involved chemotherapy, community mobilization to effect change in water contact
      habits and faecal disposal. This paper focuses on S. mansoni reinfection pattern
      over a two-year period. The age group 5-19 years showed an increasing trend of
      reinfection as compared to the 30-59 years age group. More than 50% in the 5-19
      year age group had been reinfected by twelve months of follow-up. They were also
      responsible of 91% of all the egg-load and 83% of all the infections at the end
      of the study period. Since majority of the 5-19 year age group comprises school
      children, there is an urgent need of including issues related to schistosomiasis
      in the school curriculum especially in the endemic areas.

PMID- 7796764
TI  - A study of breastfeeding and the return of menses in Hoima District, Uganda.
AB  - The effect of breastfeeding on reestablishment of ovulation and fertility and on
      birth spacing are now well known. A study was conducted on lactational
      amenorrhoea (LAM) at 180 days in Hoima District, Uganda in order to understand
      whether and how LAM could be applied in fertility control and birth spacing.
      Since the introduction of supplementary food by Ugandan women does not replace or
      substitute for breastfeeding, a study was designed to determine if LAM was
      effective irrespective of supplementation of infant's diet. One hundred and fifty
      four mother/child pairs were entered into the study and 134 women completed the
      sixth month of the study. At the end of the period, eighty four women (62.7%)
      were amenorrhoeic of whom only 33 (39.3%) were exclusively breastfeeding and no
      woman had dropped out of the study because of pregnancy or the use of other
      family planning methods other than LAM. The study confirmed that LAM could be
      applicable in Uganda to the majority of the breastfeeding women (62.7%). It is
      expected that if health workers increase the intensity of breastfeeding support
      as well as the women's knowledge and motivation to use LAM for family planning,
      this would contribute to children's health as well as to birth spacing that is
      one of the major factors related to infant deaths. According to data from this
      study, the return of menses is irrespective of whether supplements have been
      introduced and their frequency.

PMID- 7796765
TI  - Breastfeeding and immunity to intestinal infections.
AB  - The purpose of this study was to compare immune response in breast and non
      breastfed children presenting with diarrhoea at Paediatric Observation Ward,
      Kenyatta National Hospital (KNH-POW) and Maternal and Child Health Clinic,
      Pumwani Maternity Hospital (PMH-MCH). Blood and stool samples were collected from
      the first four consecutive children aged 5 years and below per day, presenting
      with or without diarrhoea from January to December, 1992. The stools were tested
      for total IgA by single radial immunodiffusion (SRID) and specific IgA by enzyme
      linked immunosorbent assay (ELISA). Peripheral blood CD4 and CD8 enumeration was
      done by flow cytometry. Stools were cultured for bacteria on selective media
      while ova and cysts of parasites were identified by wet preparation microscopy. A
      total of 457 children were enrolled into the study, 69.6% of whom presented with
      diarrhoea. Breastfed children tended to have a shorter duration of diarrhoea than
      either mixed fed or bottle fed (8.3 vs 9.8 vs 11.2 days, p = 0.2). In general, E.
      coli were more commonly isolated from breastfed than mixed fed or bottle fed
      (56.7% vs 43.9% vs 28.9%, p = 0.004) while intestinal parasites were mostly in
      bottle fed than mixed or breastfed children (28.8% vs 8.2 vs 0.8, p < 0.004).
      However, when children with diarrhoea were considered, E. coli was more
      frequently isolated from bottle fed children who presented with diarrhoea than
      without (26.7% vs 7.7%, p = 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796766
TI  - Measles in infants: a review of studies on incidence, vaccine efficacy and
      mortality in east Africa.
AB  - Control of measles in developing countries is complicated by high incidence and
      mortality among infants. Hospital-based and community-based studies from East
      Africa were reviewed with respect to the reported incidence and mortality of
      measles and vaccine efficacy/seroconversion rates after the administration of
      measles vaccine to infants. The studies reviewed confirm that measles is
      particularly severe in infants, and some indicate that vaccination before 9
      months with standard vaccine could be effective and have beneficial effects for
      children aged 6-9 months, while other studies refute this finding. Due to the
      high incidence and mortality of measles in infants, alternative control
      strategies are essential to reduce measles mortality. Further studies are needed
      on the effects of a two-dose schedule vaccinating at 6 and 9 months, which in
      mathematical modelling shows considerable benefit. Improved management of measles
      cases, including the administration of vitamin A could be considered as a
      complementary strategy for reducing measles mortality, especially in infants.

PMID- 7796767
TI  - Typhim Vi vaccine against typhoid fever: a clinical trial in Kenya.
AB  - Safety, tolerance and immunogenicity of the purified Vi polysaccharide vaccine
      (Typhim Vi) against typhoid fever was evaluated in primary school children aged 5
      15 years. A total of 435 children were vaccinated, each with a single
      intramuscular injection in the left deltoid muscle. One hundred and ten children
      were randomly selected for blood samples on day 0 (pre vaccination) and day 30
      (post vaccination). Vi antibodies studied by Radio immuno assay (RIA) on 97(88%)
      paired sera showed a seroconversion rate of 76.2% and seroprotection rate after
      vaccination was 74.2%, while 6.2% of children already had protective immunity
      before vaccination. The vaccine was well tolerated. Most commonly reported
      reactions were mild pain at site of injection (83%), and a few complained of mild
      swelling (4.6%), induration (1.1%), itching (1.1%) and headaches (1.4%). All
      reactions were of mild severity and disappeared within 24 to 48 hours.

PMID- 7796768
TI  - Paediatric morbidity and mortality at the Eldoret District Hospital, Kenya.
AB  - Over an 18 month period, there were 4,720 paediatric admissions at the Eldoret
      District Hospital in Western Kenya. The most frequent 20 diseases were identified
      and their respective case fatality rates calculated. Malaria was the most common
      cause for admission (33.0%) but the fourth most common cause of death with a case
      fatality rate of 2.2%. The overall mortality rate on the paediatric wards was
      8.2% with 64.9% of the deaths occurring within the first 24 hours of
      hospitalization. Three-fourth of all admissions were due to four diseases:
      malaria, pneumonia, gastroenteritis and measles. Targeted interventional
      programmes aimed at these 4 diseases, coupled with a comprehensive primary health
      care system, would most likely result in much less morbidity and mortality for
      the children in the district. The systems for routinely collecting and storing
      medical records were found to be substandard, making it very difficult to
      accurately monitor morbidity and mortality.

PMID- 7796769
TI  - Choice of resting sites by Anopheles gambiae (Diptera: Culici) in Mwea Rice
      Irrigation Scheme, Kirinyaga District, Kenya.
AB  - Investigations on Anopheles gambiae were carried out in Mwea Rice Irrigation
      Scheme, Kenya, to determine their preference for resting on various colours of
      fabrics and bare walls inside rural houses. The inside wall surface of each house
      was divided into upper, middle and lower sections and the section further
      partitioned into subsections measuring 0.6 x 0.3m. Two sets of experiments were
      conducted: one in which the walls were partly fitted with one colour of fabric at
      a time (double-choice situation), while in the other the walls were fitted with a
      combination of six colours (red, black, yellow, white, green and blue) of fabric
      at once, (multiple-choice situation). The number of mosquitoes resting on each of
      the pieces of cloth pinned to the walls and the uncovered subsections of the wall
      were recorded for each section of the wall after 24 hours. The results showed
      resting preference for cloth covered parts of the walls. The white colour was
      found to best attract mosquitoes followed by colours red, yellow, black, blue and
      green. The hanging strips in the middle of the houses had fewer mosquitoes
      resting on them than those on the wall.

PMID- 7796771
TI  - Comparison of urine filtration and a chemical reagent strip in the diagnosis of
      urinary schistosomiasis in Ethiopia.
AB  - The diagnostic efficacy of a chemical reagent strip (Ames Multistix) was compared
      with syringe-Nytrel urine filtration technique in the detection of S. haematobium
      infection at varying disease endemicity levels in the Awash Valley of Ethiopia.
      In low endemicity area (Afambo), the reagent strip showed highest sensitivity,
      specificity, positive predictive value and negative predictive value of 80%, 96%,
      40% and 99% respectively at "1+ limit" of microhaematuria. In the moderate
      (Dahitele) to high (Enta Doyta) areas, the highest diagnostic values of 77%, 83%,
      56% and 93% respectively and 78%, 67%, 51% and 87% respectively were obtained at
      "trace limit". Using these cut-off points of haematuria, the prevalence of S.
      haematobium were 4.5%, 30.8% and 47% at low, moderate and high endemicity areas
      compared to 3.2%, 21% and 31% respectively using the filtration technique. A
      highly significant (maximum Kendall's tau = 0.44271; p < 0.002) was observed
      between N + 1 transformed geometric mean egg counts and micro-haematuria in the
      10-19 years of age at all levels of endemicity. The efficacy and simplicity of
      chemical reagent strips and limitations of single parasitological examinations
      are discussed.

PMID- 7796770
TI  - Loa loa antigen detection by ELISA: a new approach to diagnosis.
AB  - Circulating immune complexes associated Loa loa antigen in sera of 27 subjects
      with Loa loa (13 'occult' and 14 microfilaraemic infections) was detected with
      Polyethylene glycol enzyme linked immunosorbent assay (PEG-ELISA) in a controlled
      study. Loa loa antigen was detected in all 27 sera. There was no correlation
      between antigen levels and microfilaraemia density. Cross reaction with
      Mansonella perstans was found. Although this serological test is able to detect
      all Loa loa infections, its use is limited by cross reaction with other
      filariasis. It is hoped that sensitivity will be improved by using monoclonal
      antibodies.

PMID- 7796772
TI  - Evaluation of the use of plain cervical spine radiography in patients with head
      injury.
AB  - The records of 457 head trauma patients who underwent plain cervical spine
      radiography following head injury between January 1991 and December 1991
      inclusive were reviewed. Seventy-six patients (17%) all above ten years of age
      had abnormalities; forty five were clinically suspected to have cervical spine
      injury because of cervical tenderness and/or neurological deficits and in the
      remaining thirty-one patients the cervical spine injuries were detected first on
      plain radiograph. The 31 vertebral injuries consisted off fracture-dislocations
      12 fractures, 4 dislocations and one odontoid fracture. None of the 235 patients
      below the age of 10 years had cervical vertebral or cord injury. It is
      recommended that plain cervical spine radiography be performed on all patients
      with head injury associated with altered level of consciousness and who are above
      ten years of age.

PMID- 7796773
TI  - An outbreak of influenza A/H3N2 in a Zambian school dormitory.
AB  - There was an outbreak of "a mysterious disease" at a Zambian school dormitory in
      September, 1993. Investigation with questionnaire and collection of throat swab
      specimens for virus isolation were carried out on 46 patients to identify the
      causative agent. In this outbreak, most of the patients showed similar symptoms
      such as fever, headache, sore throat, cough, etc. The disease had spread to all
      dormitories within a couple of days after the onset of the first cases. From
      these patients, 13 influenza viruses A/H3N2 were isolated on MDCK cell line. This
      was a first ever confirmed outbreak of influenza virus infection in Zambia.

PMID- 7796776
TI  - The prevalence of hepatitis B surface antigen (HBsAg) among drug-dependent
      patients in Jeddah, Saudi Arabia.
AB  - This study was undertaken to determine the prevalence of HBsAg among drug
      dependent patients in Jeddah, Saudi Arabia. Over a period of 10 months, 1498
      patients admitted for drug dependence were tested for HBsAg. For each patient,
      the age and route of drug abuse were recorded. All the HBsAg positive patients
      were further tested for HBeAg and anti-Hbe. 244 patients were positive in HBsAg,
      giving a prevalence of 16.3%. Considered separately, the prevalence of HBsAg
      among drug users and non-intravenous drug users were 18.5% and 6.7% respectively.
      225 (92.2%) of the 244 HBsAg positive patients were intravenous drug users. Of
      the 244 HBsAg positive patients, 35 (14.4%) were positive for HBeAg. The
      persistence for years of HBeAg in chronic HBsAg carriers may cause chronic liver
      disease and primary liver carcinoma. There is a need for more public education on
      this condition in order to control its spread and to prevent future
      complications.

PMID- 7796775
TI  - The neutralizing capacity and sodium content of antacid brands on the Kenyan
      market.
AB  - Seventeen brands of antacid products available on the Kenya market were
      investigated for their acid neutralising capacity and sodium content. Thirteen
      tablet products gave neutralising capacity per tablet of between 4.7 to 14.12
      mMol hydrochloric acid. The neutralising capacities for the suspensions ranged
      between 11.97 to 34.32 mMol hydrochloric acid for 10ml suspension. The lowest
      neutralising capacities were obtained for products based on compound magnesium
      trisilicate and higher capacities for those containing magaldrate, or magnesium
      hydroxide or magnesium carbonate in combination with other ingredients. The
      fastest rate of neutralization was obtained with preparations containing
      carbonates and the lowest by compound magnesium trisilicate. The sodium content
      for the preparations was between < 0.001 mEq to 0.732 mEq sodium per minimum
      recommended dose. The study shows a high degree of variation in both the acid
      neutralising capacities and the sodium content of the different brands
      investigated.

PMID- 7796774
TI  - Evaluation and surgical treatment of solitary thyroid nodules.
AB  - This is a prospective study based on 146 consecutive thyroidectomies over a two
      year period (July 1990 to June 1992). All patients with solitary thyroid nodules
      which were suspicious or equivocal on fine needle aspiration cytology (FNAC) were
      subjected to a hemithyroidectomy plus isthmal resection. 60% of all the
      thyroidectomies were for solitary thyroid nodules of which 15% were malignant.
      This mode of surgery is suggested for these patients as it is an acceptable
      although controversial method of treatment for early localized differentiated
      thyroid cancer. This is justified by the high incidence of malignancy and the
      difficulty encountered in most of our hospitals regarding adequate assessment of
      such patients to decide whether surgery is indicated or not. There is also the
      problem of all those "enucleated" nodules especially in remote areas which are
      not subjected to histopathological diagnosis. What about the patient who never
      returns for follow-up?

PMID- 7796778
TI  - Phytobezoars: a revisit to an unusual cause of acute small bowel obstruction.
AB  - Phytobezoars or undigested food concretions in the gastrointestinal tract are
      mostly due to ingestion of astringent immature fruits following gastric surgery
      and can lead to the serious complication of acute small bowel obstruction. We are
      reporting a case of acute small bowel obstruction in a 40 year old Turkish male,
      48 months following bilateral vagotomy and pyloroplasty. Important clinical
      pathological features are emphasised to increase the awareness of this rather
      uncommon cause of acute intestinal obstruction.

PMID- 7796779
TI  - Validation of methods for estimating habitual diet: proposed guidelines.

PMID- 7796777
TI  - Retrospective study of alleged sexual assault at the Aga Khan Hospital, Nairobi.
AB  - A retrospective audit of all the rape cases reported at the Aga Khan Hospital,
      Nairobi over a two year period was carried out. Out of 37 victims, 86.6% were
      less than 30 years old and 73.4% did not know who the assailant was. 80% of the
      victims reported to the hospital within 24 hours of the incident taking place and
      in 4 (10.8%) of the victims-vaginal swabs grew N. gonorrhoea. None of the victims
      opted for prosecution and none were referred for further counselling. We
      recommended that alleged rape victims be seen by a qualified gynaecologist or
      police surgeon and that they should be examined, investigated and managed by a
      standard protocol.

PMID- 7796780
TI  - Urban/rural differences in red blood cell fatty acid composition, plasma lipids
      and diet in Melanesian Fijians.
AB  - OBJECTIVE: The aim of the study was to compare red blood cell (RBC) fatty acid
      composition, plasma lipids and lipoproteins and dietary intake between urban and
      rural Melanesian Fijians. DESIGN: A cross-sectional study was performed in a
      random subsample (n = 154) from a total survey population of 589 subjects.
      SETTING: Melanesian Fijians living in the relatively urban settlement of Nabua,
      Suva and On the remote island of Qamea (rural) were studied. RESULTS: The
      proportions of myristic acid (1.4% versus 0.3%, P < 0.001) and arachidonic acid
      (10.1% versus 11.4%, P < 0.01) were significantly higher and proportions of oleic
      acid (14.4% versus 13.2%, P < 0.05) and linoleic acid (11.9% versus 8.1%, P <
      0.001) were significantly lower in RBC from rural compared with urban men, and a
      similar pattern was seen in women. Plasma cholesterol levels were significantly
      (P < 0.05) higher in the rural subjects. Urban/rural differences in plasma
      cholesterol levels were not significant when the proportion of RBC myristate was
      taken into account. CONCLUSIONS: The results suggest that consumption of myristic
      acid from coconut fat is greater and the intake of linoleic acid is less in
      Fijians living on a remote island and may contribute to their higher plasma
      cholesterol levels compared with their urban counterparts.

PMID- 7796781
TI  - Effect of neutralized and native vinegar on blood glucose and acetate responses
      to a mixed meal in healthy subjects.
AB  - OBJECTIVE: To investigate the influence of sodium acetate and acetic acid from
      vinegar on blood glucose and acetate response to a mixed meal in healthy
      subjects. DESIGN: Five healthy subjects consumed in random order six test meals
      consisting of 100 g of sliced lettuce dressed with olive oil (Blank), olive oil
      plus 1 g acetic acid in the form of vinegar (AcOH), or olive oil plus sodium
      acetate in the form of vinegar neutralized to pH 6.0 with sodium bicarbonate
      (AcNa). On three occasions test meals were followed by a challenge consisting of
      50 g carbohydrate portions of white bread (Bread). Glucose and acetate
      concentrations were measured in arterialized capillary blood before and until 95
      min after the meals. Ultrasonography was performed in four other subjects to
      measure gastric emptying times after AcOH + Bread and AcNa + Bread. RESULTS:
      Blood acetate response over 95 min was markedly reduced after AcOH and AcOH+Bread
      meals compared to AcNa and AcNa + Bread. Similarly, the glucose response was
      depressed by 31.4% (P = 0.0228) after AcOH+Bread with respect to AcNa + Bread and
      Blank + Bread. No difference was observed between gastric emptying times after
      AcOH + Bread and AcNa + Bread. CONCLUSIONS: The results suggest that oral acetic
      acid and acetate might have a different effect on acetataemia and that a limited
      dose of vinegar, in the form of salad dressing, is sufficient to influence
      significantly the glycaemic response to a mixed meal in normal subjects by a
      mechanism related to acidity but not to gastric emptying.

PMID- 7796783
TI  - Multi-frequency bioelectrical impedance for assessing total body water and
      extracellular water in elderly subjects.
AB  - OBJECTIVE: The objective of this study was to investigate the utility of
      multifrequency bioelectrical impedance for the estimation of total body water
      (TBW) and extracellular water (ECW) in an elderly population. DESIGN: Body
      impedance at 8 frequencies (1-1350 kHz) was measured in duplicate within 1 week.
      TBW and ECW were determined using deuterium oxide and potassium bromide dilution
      respectively. SETTING: At the Department of Human Nutrition. SUBJECTS: 81 women
      and 36 men, aged 63-87 years, volunteered as subjects. RESULTS: Application of
      prediction equations from the literature, which are mostly based on impedance
      measurements in young and middle-aged subjects, resulted in large prediction
      errors of TBW and ECW which were related to the water distribution of the body.
      New sex-specific prediction equations for the estimation of TBW and ECW were
      developed for the elderly population and internally validated in random sub
      groups. TBW and ECW were best predicted using impedance at frequencies of 5 and
      50 kHz respectively, and by using body weight. Prediction errors for TBW were 3.1
      kg (7.3%) and 2.7 kg (8.5%) and for ECW 2.2 kg (12.3%) and 1.0 kg (7.4%) for men
      and women respectively. CONCLUSIONS: Multi-frequency impedance measurements are
      useful to assess TBW and ECW in groups of elderly subjects. However, the
      prediction errors are larger compared to young and middle-aged subjects, and are
      related to body water distribution. Individual errors are sometimes unacceptably
      large.

PMID- 7796782
TI  - The influence of body build on estimates of body composition from anthropometric
      measurements in premenopausal women.
AB  - OBJECTIVE: To assess the influence of body build on the bias and limits of
      agreement for estimates of body fat obtained from anthropometric prediction
      equations when compared with the same data obtained by dual energy X-ray
      absorptiometry (DEXA). SURVEY DESIGN AND SUBJECTS: Ninety-one premenopausal
      women, aged between 20 and 54 years, were chosen to represent a range of skeletal
      body build (relative sitting height 0.50-0.56) and body fatness [body mass index
      (BMI) 18-34 kg/m2]. Measurements of weight, sitting height, stature, skinfold
      thickness, waist, umbilical and hip circumference and total body resistance and
      reactance were made on all subjects by standard techniques after an overnight
      fast. A DEXA measurement of total body fat, fat-free soft tissue and total body
      bone mineral mass was also obtained within 2 weeks of the anthropometric
      assessment. RESULTS: At the group level the mean difference (bias) between DEXA
      and the anthropometric estimates of body fat was similar for all three
      anthropometric estimates ranging from 2.7 kg with impedance to 1.8 kg with
      skinfold thickness. The 95% limits of agreement were also similar, ranging from
      +/- 5.3 kg with body mass index to +/- 4.1 kg with impedance. Umbilical
      circumference, BMI and the amount of bone mineral expressed as a proportion of
      the fat-free soft-tissue mass were all significantly (P < 0.01) correlated with
      the level of bias between DEXA and the anthropometric estimates of body fat. This
      was not the case for relative sitting height or measures of body fat
      distribution. Regression equations which included BMI or umbilical circumference
      in combination with the predicted estimates of body fat essentially eliminated
      the association between the level of bias in predicted body fat and the level of
      body fatness. They also reduced the 95% limits of agreement between DEXA and the
      anthropometric estimates of body fat. CONCLUSIONS: Using DEXA estimates of body
      fat as the standard of reference our results suggest that the comparability and
      precision of body fat estimates derived from age- and/or sex-specific
      anthropometric prediction equations based on skinfolds and BMI, but not
      impedance, can be improved by adjusting for differences in BMI and umbilical
      circumference respectively.

PMID- 7796786
TI  - Lipid peroxidation in insulin-dependent diabetic patients with early retina
      degenerative lesions: effects of an oral zinc supplementation.
AB  - DESIGN: Placebo for 3 months, followed by 30 mg/day zinc gluconate in identical
      capsules. SETTING: Diabetic out patients clinic at the University Hospital,
      Grenoble. SUBJECTS: Diabetic patients cared for type I diabetes mellitus. 22
      patients began the study, 4 dropped out. 10 patients suffered of an early
      retinopathy, 8 patients had no retinopathy. INTERVENTIONS: In this order: T0
      biological measurements, 3 months placebo treatment, T1 biological measurements,
      3 months zinc gluconate treatment, T2 biological measurements. Plasma Zn, Cu, Se,
      thiobarbituric acid reactants and antioxidant enzymes were measured [plasma and
      red glutathione peroxidase (Se-GPx), red cell superoxide dismutase (Cu-Zn-SOD)].
      RESULTS: Lower plasma zinc level in the two groups. An increase in zinc level was
      observed and was more important in diabetic patients with no retinopathy (P =
      0.05). The thiobarbituric acid reactants were above the reference values in all
      the patients, and were decreased at T2 (P < 0.05). Increase of GPx activity after
      zinc supplementation in patients with retinopathy. CONCLUSIONS: Zinc deficiency
      in insulin-dependent diabetic patients is corrected by a zinc supplementation.
      Moreover this supplementation decreases lipid peroxidation. The effects of zinc
      are different in diabetic patients with or without retinopathy. The increase in
      Se-GPx activity observed in patients with retinopathy could be linked to the
      protective effect of zinc on the protein itself.

PMID- 7796785
TI  - Effects of low-fat milk and fermented low-fat milk on cholesterol absorption and
      excretion in ileostomy subjects.
AB  - OBJECTIVE: To study small bowel cholesterol absorption and sterol excretion in
      order to explain possible serum cholesterol-lowering mechanisms of low-fat milk
      products. DESIGN: Two 24-h sterol balance studies with 1 litre of low-fat milk or
      one litre of fermented milk, in random order, added to a controlled diet.
      [3H]Cholesterol absorption was measured during each period. The results were
      compared to those on two 24-h periods with isocaloric amounts of lemonade given
      to the same basic diet, before and after the study. One litre of the two milk
      products was also consumed in addition to their normal diets in a cross-over
      design of 3 weeks and with run-in and run-out periods of 2 weeks each with 1000
      ml of lemonade preceding the balance studies: SETTING: Outpatient clinic, where
      the subjects were eating their meals during the day and ileostomy bags collected.
      SUBJECTS: Nine ileostomy subjects, who have earlier participated in similar
      studies, volunteered for the study. All subjects completed the study. RESULTS:
      Cholesterol absorption was highest (66%) in the lemonade period, intermediate in
      the low-fat milk period (61%) and lowest in the fermented low-fat period (55%) (P
      < 0.05 for differences). Net cholesterol excretion (excretion minus intake) and
      calculated endogenous cholesterol excretion were significantly (P < 0.05 for
      differences) higher in the low-fat milk period than in the lemonade period and
      the fermented low-fat milk period. No significant change in serum cholesterol
      was, however, seen after 3 weeks on each milk regimen. CONCLUSION: Assimilation
      of cholesterol by microorganisms could possibly explain the reduced uptake of
      cholesterol with fermented milk. The mechanism behind the increased endogenous
      cholesterol excretion, induced by low-fat milk, is unclear.

PMID- 7796784
TI  - Smoking and its effects on maternal body composition in late pregnancy.
AB  - OBJECTIVE: To assess the possible impact of smoking on body composition at the 34
      39 weeks of pregnancy, and its consequences on birth weight. SUBJECTS: 31 smokers
      and 31 non-smokers matched by age, gestational age and percentage of standard
      weight (PSW). Smoking mothers had 5 cigarettes or more per day during the whole
      period of pregnancy and non-smoking mothers never smoked. METHODS: A cross
      sectional study was conducted in an urban Public Health Center. Anthropometry and
      the deuterium dilution technique were used to determine body composition. The
      statistical analysis used a t-test for matched pairs to assess significance of
      the means difference for each variable. RESULTS: Suprailiac and subscapular
      skinfolds were found to be larger in non-smokers; this difference was significant
      for the suprailiac skinfold (P < 0.05). No significant difference was found in
      total body fat, total body water and fat-free mass obtained with the deuterium
      dilution technique, or FFM determined by anthropometry. Infants' birth weight was
      similar in the two groups of mothers. CONCLUSION: These findings suggest that
      pregnancy does not modify the pattern of body fat distribution already present in
      smokers before conception. Infants' birth weight was similar in both groups,
      probably due to no difference in fat-free mass and body fat. The physiological
      effect of nicotine (e.g. on prolactin, micronutrients), seems to be clearer
      during lactation and infant growth.

PMID- 7796787
TI  - Relationship between mothers' and newborns' nutritional and blood lipid
      variables.
AB  - OBJECTIVE: To study the relation between anthropometry, diet and blood lipids
      during pregnancy and anthropometry and cord blood lipids in newborns. DESIGN:
      Longitudinal study during pregnancy. SETTING: Population study. SUBJECTS: A group
      of 70 volunteer pregnant women attending the Maternity Advisory Service were
      recruited at the 1st trimester and studied during pregnancy. By the end of the
      study 17 women had dropped out of anthropometry and diet assessments and 21 had
      left blood lipid analysis. Anthropometric measurements and cord blood lipid
      determinations were carried out respectively on 43 and 28 newborns.
      INTERVENTIONS: Diet history; current methods for anthropometry and blood lipid
      determinations. RESULTS: The highest values for energy and other nutrient intakes
      were observed at the 2nd trimester. According to the recommendations usually
      made, protein and fat intakes were high, and carbohydrate intake too low. This
      was observed especially at the 3rd trimester. Significant relationships between
      protein, fat and carbohydrate intake (as a percentage of energy) during pregnancy
      and anthropometric variables in newborns and cord blood lipids (particularly for
      boys) were found in the group of mothers and their respective newborns. Few
      correlations between mothers' and newborns' levels of blood lipids were observed
      for girls. CONCLUSIONS: The results do not show considerable diet changes during
      pregnancy. The impact of mothers' diet on fat deposition in newborns and cord
      blood lipids seems to be sex-linked and more important for boys.

PMID- 7796788
TI  - Assessment of sodium and potassium in processed foods in an urban area in China.
AB  - OBJECTIVE: To identify commonly consumed processed foods with high sodium (Na)
      content and sodium to potassium (Na:K) ratio for the purpose of using this
      information in a community-based nutrition education programme. DESIGN:
      Calculations of Na and K intake were based on the data of a dietary survey
      carried out in Tianjin in 1992. All processed foods were randomly sampled based
      on manufacturers and market survey. SETTING: The survey was conducted in the
      urban area in Tianjin, China. PARTICIPANTS: 2317 subjects aged 15-64 years old
      were included in the dietary survey. The response rate was 95%. MAIN RESULTS: The
      mean sodium intake was 6517 mg in men and 5708 mg in women. 38% of the total Na
      intake came from processed foods and condiments in both of the urban men and
      women in Tianjin. 122 processed foods with sales volumes were identified. Most of
      the processed foods had high Na content and high Na:K ratio, especially Na-rich
      condiments, salted vegetables, fried dough cake and sausages. The Na content of
      most processed foods in Tianjin was higher than the mean value reported in the
      Chinese Food Composition Table. CONCLUSION: Processed foods contribute an
      important part of dietary Na in the urban diet in Tianjin. It is necessary to
      initiate nutrition intervention activities aiming at regulations on the Na
      content of processed foods and to advise the people to reduce consumption of
      salty foods.

PMID- 7796789
TI  - Differences between immature and adult rats in brain glutamate decarboxylase
      inhibition by 3-mercaptopropionic acid.
AB  - Glutamate decarboxylase (EC 4.1.1.15, GAD) activity was studied in the brain of
      12-day-old and adult rats treated with 3-mercaptopropionic acid (3-MPA), an
      inhibitor of GAD competitive with glutamate. Control GAD activity in the brains
      of immature animals (91.8 +/- 18.2 nmol/h/mg of protein) was lower than that of
      the adult rats (228 +/- 37.5 nmol/h/mg of protein). Brain GAD inhibition in adult
      rats was 58% at the onset of seizures (9 min on the average after administration
      of 70 mg 3-MPA/kg). At the same time, 3-MPA-treated young rats exhibited 76%
      inhibition of GAD despite the fact that at 9 min these animals were not yet
      having seizures. At the onset of seizures (19 min after 3-MPA on the average)
      their GAD activity remained at the same level. The difference between the groups
      was not related to the presence of the coenzyme pyridoxal-5'-phosphate in the
      enzyme assay. The inhibition of GAD by 3-MPA in vitro in the immature and adult
      brains was similar (Ki at 5.1 microM and 4.8 microM concentrations of 3-MPA,
      respectively). Identical values were found for Km of GAD (at 4.5 mM concentration
      of L-glutamate). Calculations based on the results suggest that 3-MPA enters the
      immature brain more easily than the brain of the adult animals. While GAD
      inhibition by 3-MPA is the primary cause of seizures, their onset is influenced
      by other factors, in which the immature brain differs from the adult one and
      which may include less sensitivity to GABA decrease due to relative overactivity
      of the GABA system.

PMID- 7796791
TI  - Gabapentin potentiates the conductance increase induced by nipecotic acid in CA1
      pyramidal neurons in vitro.
AB  - The anticonvulsant gabapentin (1-(aminomethyl)cyclohexane acetic acid) has been
      found to be effective for treatment of partial seizures, but the mechanism of
      action is unknown. Recent evidence from the rat optic nerve suggests that
      gabapentin may enhance promoted release of GABA, which is thought to be due to
      reverse operation of the GABA transporter. We have used whole-cell patch clamp
      recordings from CA1 pyramidal neurons in hippocampal slices to directly measure
      currents induced by nipecotic acid (NPA) during exposure to gabapentin. Under
      control conditions, pressure microejection of NPA increased whole-cell
      conductance with a reversal potential equal to the chloride equilibrium
      potential. This response was mimicked by GABA application, and blocked by
      bicuculline. The response to NPA was also present after blockade of synaptic
      transmission in the presence of calcium-free solution. These results are
      consistent with NPA promoting nonvesicular release of GABA from neighboring
      neurons or glia via reverse operation of the GABA uptake system, which then
      activated GABAA receptors on the recorded neurons. In control solution, the
      response to NPA slowly decreased over 45 min to approximately 50% of the initial
      response, consistent with GABAA receptor 'rundown'. However, in the presence of
      gabapentin there was a slow increase in the response, reaching approximately 170%
      of the control level after 45 min of gabapentin exposure. These results
      demonstrate that gabapentin enhances the promoted release of GABA by more than
      three-fold. The potentiation of the NPA response may be due to gabapentin
      increasing cytosolic GABA in neighboring cells via a delayed metabolic effect,
      and would have the functional effect of increasing neuronal inhibition during
      periods of hyperexcitability.

PMID- 7796790
TI  - Role of choroid plexus epithelium in the removal of valproic acid from the
      central nervous system.
AB  - Previous experiments suggest the primary route of valproic acid (VPA) removal
      from the rabbit central nervous system (CNS) is by probenecid-sensitive
      transporters at the blood-brain barrier but not at the choroid plexus. The
      purpose of this study was to determine if other transport mechanisms at the
      choroid plexus played a significant role in the removal of VPA from the CNS. In
      six rabbits, silicone oil was perfused into both cerebral ventricles and out
      through the cisterna magna to physically block exchange of VPA between
      cerebrospinal fluid (CSF) and blood and between brain and CSF. In six control
      rabbits, perfusion was performed with mock CSF. Both groups received a loading
      dose followed by continuous intravenous infusion of VPA for 210 min.
      Ventriculocisternal perfusion with silicone oil had no significant effect on the
      steady-state brain concentrations or brain-to-plasma concentration ratios of VPA,
      further confirming that efflux of VPA at the choroid plexus is negligible.

PMID- 7796792
TI  - Chronic administration of sodium valproic acid slows pubertal maturation in
      inbred DBA/2J mice: skeletal, histological, and endocrinological evidence.
AB  - Sodium valproic acid (VPA) has been reported to occasionally delay pubertal
      maturation in children. In the current study, we sought to establish a valid
      animal model with which to further investigate the neuroendocrinological sequelae
      of VPA administration. Male and female DBA/2J mice were weaned at 2 weeks of age
      and administered either VPA (17-20 mg/kg/day) or control solution via drinking
      water. Animals were weighed and sacrificed via decapitation at 4, 6, or 8 weeks
      of age. Testes and ovaries were prepared for histological analyses. In addition,
      the length of the left humerus bone from each animal was obtained as an index of
      skeletal growth, and trunk blood was assayed for circulating follicle-stimulating
      hormone (FSH) and prolactin (PRL). For males, testicular weights of the animals
      receiving VPA were significantly lower than those of control animals at all three
      sampling ages. No between-group differences were found for body weight at any
      sampling age, and yet the rate of skeletal maturation (as indexed by humerus
      length) was decreased significantly for the VPA-treated males at all three
      sampling periods. Additionally, while hormone levels did not consistently differ,
      histological analyses of the gonadal tissue demonstrated significantly decreased
      rats of spermatogenesis at all sampling points for VPA-treated animals. For
      females, chronic VPA administration led to a significant reduction in uterine
      weight at the 4 and 6 week sampling periods, and yet by 8 weeks of age the
      uterine weights for the two groups did not differ.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7796793
TI  - Simultaneous monitoring of the seizure-related changes in extracellular glutamate
      and gamma-aminobutyric acid concentration in bilateral hippocampi following
      development of amygdaloid kindling.
AB  - We simultaneously monitored the seizure-related changes in extracellular
      hippocampal glutamate (Glu) and gamma-aminobutyric acid (GABA) concentration in
      brain dialysates in order to clarify the role of Glu and GABA in the development
      of kindling. Brain dialysates were collected every 5 min from 10 min prior to 80
      min after stimulus in the three developing conditions consisting of pre-kindling
      state, stage 3 (C-3), and five consecutive stage 5 (5*C-5) following kindling in
      the same rat. Extracellular Glu level increased rapidly, lasting for only 5 min
      after stimulus. The post-stimulus ratio of Glu increase in partially kindled rats
      (C-3) was 2.5-3.5 times of the baseline, and in fully kindled rats it was about 5
      times of the baseline. Extracellular GABA concentration enhanced gradually,
      reaching a plateau level at 15-20 min and lasting for several hours after
      stimulus at each stage. The enhancement of GABA level was about 1.5 times of the
      baseline in partially kindled stage, and was about 2.5 times of the baseline in
      fully kindled stage. There was no significant difference between the two
      hemispheres with respect to either the time-course or the magnitude of Glu and
      GABA increase respectively. These data show that progressive, transient and
      stimulus-induced enhancement of extracellular Glu levels combined with long
      lasting elevation of extracellular GABA levels in the bilateral ventral
      hippocampi results in imbalance between the excitatory and inhibitory neuronal
      systems, causing excessive propagation of seizure activity, culminating in the
      secondary generalized seizure of amygdaloid kindling.

PMID- 7796794
TI  - Effects of vagus nerve stimulation on amino acids and other metabolites in the
      CSF of patients with partial seizures.
AB  - Electrical stimulation of the vagus nerve (VNS) is a new method for the treatment
      of patients with medically intractable epilepsy. Sixteen patients, ten of whom
      participated in a larger multicenter double-blind trial on the efficacy of VNS in
      epilepsy, and six who participated in pilot studies, consented to participate in
      the present study. Ten patients received HIGH stimulation and six patients LOW
      stimulation for the 3-month trial. Cerebrospinal fluid (CSF) samples (16 ml) were
      collected both before and after 3 months of VNS. Amino acid and neurotransmitter
      metabolites were analyzed. Four patients responded to VS with more than a 25%
      seizure reduction after 3 months. Mean and median concentrations of
      phosphoethanolamine (PEA) increased in responders and decreased in nonresponders.
      Free GABA increased in both groups but more so in the nonresponders. After 9
      months of VS (6-9 months on HIGH stimulation) 4 of 15 patients had more than 40%
      seizure reduction. There were significant correlations between seizure reduction
      and increases in asparagine, phenylalanine, PEA, alanine and tryptophan
      concentrations. Comparison between patients with HIGH or LOW stimulation showed a
      significant increase in ethanolamine (EA) in the HIGH group and a decrease in
      glutamine in the LOW group. All patients regardless of response or stimulation
      intensity showed significantly increased total and free GABA levels. A decrease
      in CSF aspartate was marginally significant. Other trends were decreases in
      glutamate and increases in 5-hydroxyindoleacetic acid. Chronic VNS appears to
      have an effect on various amino acids pools in the brain.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7796795
TI  - The Neurotoxicity Scale: the validity of a patient-based scale, assessing
      neurotoxicity.
AB  - The validity of a patient-based scale, presumably measuring adverse effects of
      drugs on cognitive function, was examined in a normal volunteer study. Thirty
      subjects were randomly assigned to placebo or one of two doses of a
      benzodiazepine, temazepam (10 mg and 20 mg), in a double-blind placebo-controlled
      parallel group design. Plasma samples were taken before the scale was completed
      and up to 8 hours post-dose. After administration of the medication the subjects
      were asked to maintain their normal daily routine as much as possible (reading,
      studying, conversations). The inventory was administered twice, at 50 minutes and
      2 hours post-dose (peak level). The overall score was different between the three
      groups, only for the second assessment, 2 h post-dose (ANOVA, P < 0.02). Multiple
      t-testing between the three groups revealed statistically significant differences
      between placebo and the 10 mg temazepam group (P = 0.02) and between placebo and
      the 20 mg temazepam group (P = 0.006). No significant difference was found
      between the two temazepam groups. Analysis of the separate questions showed least
      sensitivity for questions related to the domain of 'hyperexcitability' and most
      sensitivity for 'fatigue' and 'slowing.' The overall score appeared to be
      sensitive already for the lower toxicity range suggesting an 'all or nothing
      effect'. The subjective reports, collected by using this scale, may therefore be
      used for the detection of gross overall changes in cognitive functioning.

PMID- 7796796
TI  - Efficacy of felbamate monotherapy in patients undergoing presurgical evaluation
      of partial seizures.
AB  - The efficacy and safety of felbamate monotherapy were evaluated in 52 patients
      with refractory partial seizures with or without secondary generalization in a
      double-blind, randomized, placebo-controlled trial. Each patient completed a
      routine evaluation for epilepsy surgery and was randomized to receive either
      felbamate, titrated to a maximum daily dose of 3600 mg over 2 days, or placebo
      during the 10-day, inpatient, treatment phase. An intent-to-treat analysis was
      performed on the data of all 52 patients who received study medication, while a
      separate efficacy analysis also was performed on the data of 43 evaluable
      patients, which excluded protocol violators. The endpoint of the trial was
      completing 10 days of treatment or the occurrence of a fourth seizure. The
      primary efficacy variable was the average daily seizure frequency during the
      treatment phase for each patient. For the intent-to-treat analysis based on all
      52 patients who received study medications, the mean rank of the daily seizure
      frequency for patients treated with felbamate was 21.6 compared to 29.6 for
      patients treated with placebo (P = 0.065). In the analysis based on the 43
      evaluable patients, the mean rank of the daily seizure frequency for felbamate
      treated patients was 17.0 compared to 25.4 for placebo-treated patients. This
      difference was statistically significant (P = 0.032) in favor of felbamate.
      Seizure frequency was decreased by 89.5% compared to baseline in nine patients
      who completed 10 days of felbamate therapy. This study permitted the rapid
      determination of the anticonvulsant activity of felbamate and demonstrated that
      felbamate is effective as monotherapy for the treatment of partial seizures.

PMID- 7796797
TI  - Postictal psychosis: a case control series of 20 patients and 150 controls.
AB  - We compared clinical data, EEG, and video-EEG studies in a consecutive series of
      20 patients with postictal psychosis (PP) to 150 consecutive epilepsy patients
      with complex partial (CPS) or generalized tonic-clonic (GTCS) seizures but
      without PP. There was a lucid interval between last seizure and onset of
      psychosis ranging from 2.3 to 72 h (mean, 25 h). Duration of PP ranged from 16 to
      432 h (mean, 83 h). Age, sex, epilepsy type (partial vs. generalized), and
      history of febrile seizures were similar in the PP and control groups. Patients
      with PP had more frequent GTCS during monitoring than controls (2.8 vs. 1.3; P <
      0.001). Patients with PP were more likely to have a history of encephalitis (P <
      0.0001) and psychiatric hospitalization (P < 0.002). More patients with PP had
      bilateral interictal epileptiform discharges during monitoring than controls (P <
      0.0002). Postictal psychosis most often develops in patients with bilateral
      dysfunction following a cluster of GTCS.

PMID- 7796798
TI  - Crystal structure of dimeric human ciliary neurotrophic factor determined by MAD
      phasing.
AB  - Ciliary neurotrophic factor (CNTF) promotes the survival and differentiation of
      developing motor neurons and is a potential therapeutic for treating
      neurodegeneration and nerve injury. The crystal structure of human CNTF has been
      determined at 2.4 A resolution using multi-wavelength anomalous diffraction (MAD)
      phasing from a single Yb3+ ions. The structure reveals that CNTF is dimeric, with
      a novel anti-parallel arrangement of the subunits, not previously observed for
      other cytokines. Each subunit adopts a double crossover four-helix bundle fold,
      in which two helices contribute to the dimer interface, whilst two different
      helices show pronounced kinks. Analysis of the electrostatic surface of CNTF
      identified residues within these kinked helices that may contact the CNTF
      receptor-alpha. Solution experiments show that CNTF dimerizes at concentrations >
      40 microM. Such dimers are likely to be relevant to the storage of CNTF in the
      peripheral nerve given the high concentrations present in this tissue. However,
      it is unlikely that they play a role in engaging the three distinct receptor
      subunits that comprise the CNTF receptor, given the low concentration of
      extracellular CNTF and its high potency.

PMID- 7796799
TI  - Gadolinium-sensitive, voltage-dependent calcium release channels in the
      endoplasmic reticulum of a higher plant mechanoreceptor organ.
AB  - The lipid bilayer technique was adapted to the functional reconstitution of ion
      channels from the endoplasmic reticulum of a higher plant. This was obtained at
      high purity from touch-sensitive tendrils of Bryonia dioica. In this preparation,
      a calcium-selective strongly rectifying channel is prevailing whose single
      channel properties have been characterized. The single-channel conductance is 29
      pS in 50 mM CaCl2. The Ca2+: K+ selectivity was determined to be approximately
      6.6. The channel is voltage-gated and, more importantly, the gating voltage is
      strongly shifted towards more negative voltages when a transmembrane Ca2+
      gradient is applied. Thus, at physiological voltages across the endoplasmic
      reticulum membrane, the channel's open probability will be governed largely by
      the chemical potential gradient of Ca2+, generated by the Ca(2+)-ATPase in that
      same membrane. The calcium release channel described here is effectively blocked
      by Gd3+ which also completely suppresses a tendril's reaction to touch,
      suggesting that this channel could be a key element of calcium signaling in
      higher plant mechanotransduction. Its molecular characteristics and inhibitor
      data show it to be the first known member of a hitherto unrecognized class of
      calcium channels.

PMID- 7796800
TI  - A new type of signal peptide: central role of a twin-arginine motif in transfer
      signals for the delta pH-dependent thylakoidal protein translocase.
AB  - The delta pH-driven and Sec-related thylakoidal protein translocases recognise
      distinct types of thylakoid transfer signal, yet all transfer signals resemble
      bacterial signal peptides in structural terms. Comparison of known transfer
      signals reveals a single concrete difference: signals for the delta pH-dependent
      system contain a common twin-arginine motif immediately before the hydrophobic
      region. We show that this motif is critical for the delta pH-driven translocation
      process; substitution of the arg-arg by gln-gln or even arg-lys totally blocks
      translocation across the thylakoid membrane, and replacement by lys-arg reduces
      the rate of translocation by > 100-fold. The targeting information in this type
      of signal thus differs fundamentally from that of bacterial signal peptides,
      where the required positive charge can be supplied by any basic amino acid.
      Insertion of a twin-arg motif into a Sec-dependent substrate does not alter the
      pathway followed but reduces translocation efficiency, suggesting that the motif
      may also repel the Sec-type system. Other information must help to specify the
      choice of translocation mechanism, but this information is unlikely to reside in
      the hydrophobic region because substitution by a hydrophobic section from an
      integral membrane protein does not affect the translocation pathway.

PMID- 7796801
TI  - VAMP-2 and cellubrevin are expressed in pancreatic beta-cells and are essential
      for Ca(2+)-but not for GTP gamma S-induced insulin secretion.
AB  - VAMP proteins are important components of the machinery controlling docking
      and/or fusion of secretory vesicles with their target membrane. We investigated
      the expression of VAMP proteins in pancreatic beta-cells and their implication in
      the exocytosis of insulin. cDNA cloning revealed that VAMP-2 and cellubrevin, but
      not VAMP-1, are expressed in rat pancreatic islets and that their sequence is
      identical to that isolated from rat brain. Pancreatic beta-cells contain
      secretory granules that store and secrete insulin as well as synaptic-like
      microvesicles carrying gamma-aminobutyric acid. After subcellular fractionation
      on continuous sucrose gradients, VAMP-2 and cellubrevin were found to be
      associated with both types of secretory vesicle. The association of VAMP-2 with
      insulin-containing granules was confirmed by confocal microscopy of primary
      cultures of rat pancreatic beta-cells. Pretreatment of streptolysin-O
      permeabilized insulin-secreting cells with tetanus and botulinum B neurotoxins
      selectively cleaved VAMP-2 and cellubrevin and abolished Ca(2+)-induced insulin
      release (IC50 approximately 15 nM). By contrast, the pretreatment with tetanus
      and botulinum B neurotoxins did not prevent GTP gamma S-stimulated insulin
      secretion. Taken together, our results show that pancreatic beta-cells express
      VAMP-2 and cellubrevin and that one or both of these proteins selectively control
      Ca(2+)-mediated insulin secretion.

PMID- 7796802
TI  - Targeting of Listeria monocytogenes ActA protein to the plasma membrane as a tool
      to dissect both actin-based cell morphogenesis and ActA function.
AB  - Actin assembly on the surface of Listeria monocytogenes in the cytoplasm of
      infected cells provides a model to study actin-based motility and changes in cell
      shape. We have shown previously that the ActA protein, exposed on the bacterial
      surface, is required for polarized nucleation of actin filaments. To investigate
      whether plasma membrane-associated ActA can control the organization of
      microfilaments and cell shape, variants of ActA, in which the bacterial membrane
      signal had been replaced by a plasma membrane anchor sequence, were produced in
      mammalian cells. While both cytoplasmic and membrane-bound forms of ActA
      increased the F-actin content, only membrane-associated ActA caused the formation
      of plasma membrane extensions. This finding suggests that ActA acts as an actin
      filament nucleator and shows that permanent association with the inner face of
      the plasma membrane is required for changes in cell shape. Based on the
      observation that the amino-terminal segment of ActA and the remaining portion
      which includes the proline-rich repeats cause distinct phenotypic modifications
      in transfected cells, we propose a model in which two functional domains of ActA
      cooperate in the nucleation and dynamic turnover of actin filaments. The present
      approach is a new model system to dissect the mechanism of action of ActA and to
      further investigate interactions of the plasma membrane and the actin
      cytoskeleton during dynamic changes of cell shape.

PMID- 7796803
TI  - The role of Saccharomyces cerevisiae type 2A phosphatase in the actin
      cytoskeleton and in entry into mitosis.
AB  - We have prepared a temperature-sensitive Saccharomyces cerevisiae type 2A
      phosphatase (PP2A) mutant, pph21-102. At the restrictive temperature, the pph21
      102 cells arrested predominantly with small or aberrant buds, and their actin
      cytoskeleton and chitin deposition were abnormal. The involvement of PP2A in bud
      growth may be due to the role of PP2A in actin distribution during the cell
      cycle. Moreover, after a shift to the non-permissive temperature, the pph21-102
      cells were blocked in G2 and had low activity of Clb2-Cdc28 kinase. Expression of
      Clb2 from the S.cerevisiae ADH promoter in pph21-102 cells was able to partially
      bypass the G2 arrest in the first cell cycle, but was not able to stimulate
      passage through a second mitosis. These cells had higher total amounts of Clb2
      Cdc28 kinase activity, but the Clb2-normalized specific activity was lower in the
      pph21-102 cells compared with wild-type cells. Unlike wild-type strains, a PP2A
      deficient strain was sensitive to the loss of MIH1, which is a homolog of the
      Schizosaccharomyces pombe mitotic inducer cdc25+. Furthermore, the cdc28F19
      mutation cured the synthetic defects of a PP2A-deficient strain containing a
      deletion of MIH1. These results suggest that PP2A is required during G2 for the
      activation of Clb-Cdc28 kinase complexes for progression into mitosis.

PMID- 7796804
TI  - A pre-start checkpoint preventing mitosis in fission yeast acts independently of
      p34cdc2 tyrosine phosphorylation.
AB  - We have monitored the tyrosine (Y15) phosphorylated and dephosphorylated forms of
      p34cdc2 from Schizosaccharomyces pombe as cells proceed through the cell cycle.
      Y15 is dephosphorylated in G1 before start and becomes phosphorylated only after
      cells pass start and enter late G1. This transition is associated with a switch
      from one checkpoint which restrains mitosis in pre-start G1, by a mechanism
      independent from Y15 phosphorylation, to a second checkpoint acting post-start
      during late G1 and S phase operating through Y15 phosphorylation. The pre-start
      checkpoint may act by preventing formation of the p34cdc2/p56cdc13 complex. The
      complex between Y15-phosphorylated p34cdc2 and p56cdc13 accumulates during S
      phase and G2, but the level generated is not solely dependent on the amount of
      p34cdc2 and p56cdc13 present in the cell. The extent of p56cdc13 breakdown at the
      end of mitosis may be determined by the amount complexed with p34cdc2. We have
      also shown that an insoluble form of p34cdc2 is associated with the progression
      of the cell through late G1 into S phase.

PMID- 7796805
TI  - Enhancement and destruction of antibody function by somatic mutation: unequal
      occurrence is controlled by V gene combinatorial associations.
AB  - We examined the positive and negative effects of somatic mutation on antibody
      function using saturation mutagenesis in vitro to mimic the potential of the in
      vivo process to diversify antibodies. Identical mutations were introduced into
      the second complementarity determining region of two anti-phosphocholine
      antibodies, T15 and D16, which share the same germline VH gene sequence. T15
      predominates in primary responses and does not undergo affinity maturation. D16
      is representative of antibodies that co-dominate in memory responses and do
      undergo affinity maturation. We previously reported that > 50% of T15 mutants had
      decreased antigen binding capacity. To test if this high frequency of binding
      loss was unique to T15 or a consequence of random point mutations applicable to
      other combining sites, we analyzed the same mutations in D16. We show that D16
      suffers a similar loss of function, indicating an equally high potential for B
      cell wastage. However, only D16 displayed the capacity for somatic mutation to
      improve antigen binding, which should enhance its persistence in memory
      responses. Mutation of residues contacting the haptenic group, as determined by
      molecular modeling, did not improve binding. Instead, productive mutations
      occurred in residues that either contacted carrier protein or were distant from
      the antigen binding site, possibly increasing binding site flexibility through
      long-range effects. Targeting such residues for mutation should aid in the
      rational design of improved antibodies.

PMID- 7796806
TI  - An immunoglobulin-like domain determines the specificity of neurotrophin
      receptors.
AB  - The neurotrophins influence survival and maintenance of vertebrate neurons in the
      embryonic, early post-natal and post-developmental stages of the nervous system.
      Binding of neurotrophins to receptors encoded by the gene family trk initiates
      signal transduction into the cell. trkA interacts preferably with nerve growth
      factor (NGF), trkB with brain-derived neurotrophic factor (BDNF) and neurotrophin
      4/5 (NT-4/5) and trkC with neurotrophin-3 (NT-3). By constructing 17 different
      chimeras and domain deletions of the human trk receptors and analyzing their
      binding affinities to the neurotrophins we have shown that an immunoglobulin-like
      domain located adjacent to the transmembrane domain is the structural element
      that determines the interaction of neurotrophins with their receptors. Chimeras
      of trkC where this domain was exchanged for the homologous sequences from trkB or
      trkA gained high affinity binding to BDNF or NGF respectively, while deletion of
      this domain in trkC or trkA abolished binding to NT-3 or NGF respectively. This
      domain alone retained affinities to neurotrophins similar to the full-length
      receptors and when expressed on NIH 3T3 cells in fusion with the kinase domain
      showed neurotrophin-dependent activation.

PMID- 7796808
TI  - A novel cytokine-inducible gene CIS encodes an SH2-containing protein that binds
      to tyrosine-phosphorylated interleukin 3 and erythropoietin receptors.
AB  - Cytokines manifest their function through alteration of gene expression. However,
      target genes for signals from cytokine receptors are largely unknown. We
      therefore searched for immediate-early cytokine-responsive genes and isolated a
      novel gene, CIS (cytokine inducible SH2-containing protein) which is induced in
      hematopoietic cells by a subset of cytokines including interleukin 2 (IL2), IL3,
      granulocyte-macrophage colony-stimulating factor (GM-CSF) and erythropoietin
      (EPO), but not by stem cell factor, granulocyte colony-stimulating factor and
      IL6. The CIS message encodes a polypeptide of 257 amino acids that contains an
      SH2 domain of 96 amino acids in the middle. To clarify the function of CIS in
      cytokine signal transduction, we expressed CIS in IL3-dependent hematopoietic
      cell lines under the control of a steroid-inducible promoter. The CIS product
      stably associated with the tyrosine-phosphorylated beta chain of the IL3 receptor
      as well as the tyrosine-phosphorylated EPO receptor. Forced expression of CIS by
      steroid reduced the growth rate of these transformants, suggesting a negative
      role of CIS in signal transduction. CIS induction requires the membrane-proximal
      region of the cytoplasmic domain of the EPO receptor as well as that of the
      common beta chain of the IL3, IL5 and GM-CSF receptor, whereas CIS binds to the
      receptor that is tyrosine phosphorylated by cytokine stimulation. Thus CIS
      appears to be a unique regulatory molecule for cytokine signal transduction.

PMID- 7796807
TI  - The 5-HT4 receptor: molecular cloning and pharmacological characterization of two
      splice variants.
AB  - Molecular cloning efforts have provided primary amino acid sequence and signal
      transduction data for a large collection of serotonin receptor subtypes. These
      include five 5-HT1-like receptors, three 5-HT2 receptors, one 5-HT3 receptor, two
      5-HT5 receptors, one 5-HT6 receptor and one 5-HT7 receptor. Molecular biological
      information on the 5-HT4 receptor is notably absent from this list. We now report
      the cloning of the pharmacologically defined 5-HT4 receptor. Using degenerate
      oligonucleotide primers, we identified a rat brain PCR fragment which encoded a
      '5-HT receptor-like' amino acid sequence. The corresponding full length cDNA was
      isolated from a rat brain cDNA library. Transiently expressed in COS-7 cells,
      this receptor stimulates adenylyl cyclase activity and is sensitive to the
      benzamide derivative cisapride. The response is also blocked by ICS-205930.
      Interestingly, we isolated two splice variants of the receptor, 5-HT4L and 5
      HT4S, differing in the length and sequence of their C-termini. In rat brain, the
      5-HT4S transcripts are restricted to the striatum, but the 5-HT4L transcripts are
      expressed throughout the brain, except in the cerebellum where it was barely
      detectable. In peripheral tissues, differential expression was also observed in
      the atrium of the heart where only the 5-HT4S isoform was detectable.

PMID- 7796809
TI  - The LAR transmembrane protein tyrosine phosphatase and a coiled-coil LAR
      interacting protein co-localize at focal adhesions.
AB  - Focal adhesions are sites of cell-extracellular matrix interactions that function
      in anchoring stress fibers to the plasma membrane and in adhesion-mediated signal
      transduction. Both focal adhesion structure and signaling ability involve protein
      tyrosine phosphorylation. LAR is a broadly expressed transmembrane protein
      tyrosine phosphatase comprised of a cell adhesion-like ectodomain and two
      intracellular protein tyrosine phosphatase domains. We have identified a novel
      cytoplasmic 160 kDa phosphoserine protein termed LAR-interacting protein 1
      (LIP.1), which binds to the LAR membrane-distal D2 protein tyrosine phosphatase
      domain and appears to localize LAR to focal adhesions. Both LAR and LIP.1
      decorate the ends of focal adhesions most proximal to the cell nucleus and are
      excluded from the distal ends of focal adhesions, thus localizing to regions of
      focal adhesions presumably undergoing disassembly. We propose that LAR and LIP.1
      may regulate the disassembly of focal adhesions and thus help orchestrate cell
      matrix interactions.

PMID- 7796810
TI  - Pseudosubstrate sequence may not be critical for autoinhibition of smooth muscle
      myosin light chain kinase.
AB  - It has been hypothesized that basic residues in the autoinhibitory region of
      myosin light chain (MLC) kinase, which resemble the substrate sequence, interact
      with the catalytic core via charge interaction and thus inhibit the kinase
      activity (pseudosubstrate inhibitory hypothesis). In the present study, we
      produced seven MLC kinase mutants in which the residues in the autoinhibitory
      region are deleted to various extents, and determined the residues crucial for
      the autoinhibition of the kinase activity. The activities of MT799 (1-799) and
      MT796 (1-796) were completely inhibited, whereas MT793 (1-793), MT791 (1-791),
      MT787 (1-787) and MT783 (1-783) were constitutively active. The tryptic
      proteolysis of MT799 and MT796 activated the kinase activity, presumably due to
      the removal of the residues essential for autoinhibition. The mutants which
      showed the constitutively active kinase activity were not further activated by
      tryptic proteolysis, suggesting that the residues crucial for autoinhibition were
      already deleted. On the other hand, MT795 (1-795) was partially constitutively
      active (33% of maximum activity) and the tryptic proteolysis further activated
      the enzyme activity, suggesting that MT795 loses part of the residues essential
      for autoinhibition. The substitution of the residues Tyr794-Met795 but not Lys793
      of untruncated MLC kinase significantly increased the Ca2+/calmodulin-independent
      kinase activity. These results clearly show that the region Tyr794-Met795-Ala796
      is critical for autoinhibition. This study shows that the pseudosubstrate
      sequence is not critical for the autoinhibition mechanism of MLC kinase.

PMID- 7796811
TI  - Thrombopoietin activates a STAT5-like factor in hematopoietic cells.
AB  - Thrombopoietin (TPO) is a newly cloned cytokine which is the major regulator of
      circulating platelet levels, acting on both proliferation and differentiation of
      megakaryocytes. We have investigated the ability of TPO to activate the JAK/STAT
      pathway in megakaryocytic cell lines. We used either the granulocyte-macrophage
      colony-stimulating factor (GM-CSF)- and/or erythropoietin (EPO)-dependent UT7
      cell line in which the murine TPO receptor (mumpl) had been transfected (mumpl
      UT7 transfectants) or the MO7E and DAMI cells which express endogenous human TPO
      receptors. We demonstrated that TPO activates the kinase JAK2 and a STAT5-like
      transcriptional factor but not STAT1, STAT2, STAT3 or STAT4, in a very rapid and
      transient manner. In order to better ascertain the specificity of the activation
      of STAT5-related factor by TPO, we investigated the effect of other
      cytokines/growth factors. Both GM-CSF and EPO activated the STAT5-like factor. In
      contrast, neither interferon (IFN)-gamma nor the mitogenic stem cell factor (SCF)
      activated STAT5, although IFN-gamma did activate STAT1 in those cells. The
      hematopoietic DNA binding activity related to STAT5 was identified as a p97
      tyrosine-phosphorylated protein band which exhibited identical gel mobility to
      the mammary STAT5. Because v-mpl, a truncated form of the TPO receptor c-mpl, was
      shown to be oncogenic, we tested the activity of v-mpl on STAT5 and found STAT5
      constitutively activated in two different v-mpl-expressing cells, the transiently
      transfected Cos7 cells and the stable v-mpl-UT7 transfectants. Overall, our data
      indicate that STAT5 is widely expressed in hematopoietic cells and activated by a
      number of cytokines, including TPO, GM-CSF and EPO, but not by IFN-gamma or SCF.

PMID- 7796812
TI  - Activation of a Drosophila Janus kinase (JAK) causes hematopoietic neoplasia and
      developmental defects.
AB  - In mammals, many cytokines and growth factors stimulate members of the Janus
      kinase (JAK) family to transduce signals for the proliferation and
      differentiation of various cell types, particularly in hematopoietic lineages.
      Mutations in the Drosophila hopscotch (hop) gene, which encodes a JAK, also cause
      proliferative defects. Loss-of-function alleles result in lethality and
      underproliferation of diploid tissues of the larva. A dominant gain-of-function
      allele, Tumorous-lethal (hopTum-l), leads to formation of melanotic tumors and
      hypertrophy of the larval lymph glands, the hematopoietic organs. We show that a
      single amino acid change in Hop is associated with the hopTum-l mutation.
      Overexpression of either wild-type hop or hopTum-l in the larval lymph glands
      causes melanotic tumors and lymph gland hypertrophy indistinguishable from the
      original hopTum-l mutation. In addition, overexpression of Hop in other tissues
      of the larva leads to pattern defects in the adult or to lethality. Finally,
      overexpression of either hop or hopTum-l in Drosophila cell culture results in
      tyrosine phosphorylation of Hop protein. However, overexpression of hopTum-l
      results in greater phosphorylation than overexpression of the wild-type. We
      conclude that hopTum-l encodes a hyperactive Hop kinase and that overactivity of
      Hop in lymph glands causes malignant neoplasia of Drosophila blood cells.

PMID- 7796813
TI  - Phosphorylation of human I kappa B-alpha on serines 32 and 36 controls I kappa B
      alpha proteolysis and NF-kappa B activation in response to diverse stimuli.
AB  - Post-translational activation of the higher eukaryotic transcription factor NF
      kappa B requires both phosphorylation and proteolytic degradation of the
      inhibitory subunit I kappa B-alpha. Inhibition of proteasome activity can
      stabilize an inducibly phosphorylated form of I kappa B-alpha in intact cells,
      suggesting that phosphorylation targets the protein for degradation. In this
      study, we have identified serines 32 and 36 in human I kappa B-alpha as essential
      for the control of I kappa B-alpha stability and the activation of NF-kappa B in
      HeLa cells. A point mutant substituting serines 32 and 36 by alanine residues was
      no longer phosphorylated in response to okadaic acid (OA) stimulation. This and
      various other Ser32 and Ser36 mutants behaved as potent dominant negative I kappa
      B proteins attenuating kappa B-dependent transactivation in response to OA,
      phorbol 12-myristate 13-acetate (PMA) and tumor necrosis factor-alpha (TNF).
      While both endogenous and transiently expressed wild-type I kappa B-alpha were
      proteolytically degraded in response to PMA and TNF stimulation of cells, the
      S32/36A mutant of I kappa B-alpha remained largely intact under these conditions.
      Our data suggest that such diverse stimuli as OA, TNF and PMA use the same kinase
      system to phosphorylate and thereby destabilize I kappa B-alpha, leading to NF
      kappa B activation.

PMID- 7796815
TI  - The nucleolar architecture of polymerase I transcription and processing.
AB  - The nucleolus, the site of transcription and processing of the major ribosomal
      genes, generally reveals three distinct ultrastructural components in
      conventional thin-section electron micrographs (fibrillar centres, dense
      fibrillar component and granular component). We show here that different parts of
      the transcription and transcript processing pathway can be mapped to the
      different nucleolar components in pea root cells. This study shows the full three
      dimensional arrangement of the different domains by in situ hybridization and
      confocal microscopy, and their correspondence with the major ultrastructural
      components of the nucleolus is revealed by parallel serial section electron
      microscopy. The active rDNA is widely dispersed in discrete foci, the larger of
      which, at least, correspond to well-defined fibrillar centres. A probe to the
      external transcribed spacer (ETS) sequence of the pre-rRNA transcripts labels
      clearly demarcated regions surrounding the foci of rDNA, and which we show
      correspond to the dense fibrillar component. Finally, a probe to the entire 45S
      transcript shows a higher concentration in regions corresponding to the granular
      component, surrounding the dense fibrillar component labelled by the ETS probe.
      The changes in structure that occur with heat shock show that nucleolar
      organization is dynamic and dependent upon transcriptional activity. These
      results show that the various RNA processing events are spatially highly
      organized and suggest a vectorial or radial model of transcription and transcript
      processing, where nascent and newly completed transcripts occupy zones
      surrounding the genes, which are in turn surrounded by regions containing the
      older more mature transcripts.

PMID- 7796814
TI  - Male-specific lethal 2, a dosage compensation gene of Drosophila, undergoes sex
      specific regulation and encodes a protein with a RING finger and a
      metallothionein-like cysteine cluster.
AB  - In Drosophila the equalization of X-linked gene products between males and
      females, i.e. dosage compensation, is the result of a 2-fold hypertranscription
      of most of these genes in males. At least four regulatory genes are required for
      this process. Three of these genes, maleless (mle), male-specific lethal 1 (msl
      1) and male-specific lethal 3 (msl-3), have been cloned and their products have
      been shown to interact and to bind to numerous sites on the X chromosome of
      males, but not of females. Although binding to the X chromosome is negatively
      correlated with the function of the master regulatory gene Sex lethal (Sxl), the
      mechanisms that restrict this binding to males and to the X chromosome are not
      yet understood. We have cloned the last of the known autosomal genes involved in
      dosage compensation, male-specific lethal 2 (msl-2), and characterized its
      product. The encoded protein (MSL-2) consists of 769 amino acid residues and has
      a RING finger (C3HC4 zinc finger) and a metallothionein-like domain with eight
      conserved and two non-conserved cysteines. In addition, it contains a positively
      and a negatively charged amino acid residue cluster and a coiled coil domain that
      may be involved in protein-protein interactions. Males produce a msl-2 transcript
      that is shorter than in females, due to differential splicing of an intron of 132
      bases in the untranslated leader. Using an antiserum against MSL-2 we have shown
      that the protein is expressed at a detectable level only in males, where it is
      physically associated with the X chromosome. Our observations suggest that MSL-2
      may be the target of the master regulatory gene Sxl and provide the basic
      elements of a working hypothesis on the function of MSL-2 in mediating the 2-fold
      increase in transcription that is characteristic of dosage compensation.

PMID- 7796816
TI  - EBF contains a novel zinc coordination motif and multiple dimerization and
      transcriptional activation domains.
AB  - Early B cell factor (EBF) was identified and cloned as a transcription factor
      expressed specifically in B lymphocytes and adipocytes. This protein was also
      identified as olfactory factor 1 (Olf-1) in olfactory neurons. In this study, we
      analyzed the structural requirements for DNA binding, homodimerization and
      transcriptional activation by EBF. A carboxyl-terminal region, containing a
      repeat of alpha-helices related to the helix-loop-helix motif, is important for
      dimerization of EBF in solution and can confer dimerization upon a heterologous
      DNA binding protein. The amino-terminal DNA binding domain by itself is
      monomeric, but can mediate assembly of dimers on optimized and correctly spaced
      half-sites. Mutational analysis of the DNA binding domain of EBF indicated that a
      novel zinc coordination motif consisting of H-X3-C-X2-C-X5-C is important for DNA
      recognition. Deletion analysis and transfer of regions of EBF onto a heterologous
      DNA binding domain identified a serine/threonine-rich transcriptional activation
      domain. Moreover, the DNA binding domain of EBF can mediate transcriptional
      activation from optimized binding sites. Thus, EBF contains both a complex DNA
      binding domain that allows for dimerization and transcriptional activation, and
      additional dimerization and activation domains.

PMID- 7796817
TI  - Rapid responses to oxidative stress mediated by iron regulatory protein.
AB  - Reactive oxygen intermediates (ROIs), including superoxide anion (O2.-) and
      hydrogen peroxide (H2O2), are by-products of aerobic metabolism with potential
      toxicity towards cellular macromolecules, including lipids, proteins and DNA.
      Excess ROIs, a condition referred to as oxidative stress, is considered to be a
      major contributor to ageing, degenerative diseases and reperfusion injury. The
      reactivity of H2O2 with iron (Fenton reaction) intimately connects oxidative
      stress and cellular iron metabolism. We have found a novel oxidative stress
      response pathway in mammalian cells which links oxidative stress to the
      regulation of iron metabolism. Exposure of cells to H2O2 leads to reduced
      synthesis of the intracellular iron storage protein ferritin and stimulates
      transferrin receptor (TfR) mRNA expression. Both responses are post
      transcriptional and result from induction of iron regulatory protein (IRP)
      binding to iron-responsive elements (IREs) in ferritin and TfR mRNAs. IRP
      induction by H2O2 appears to involve the disassembly of its cubane 4Fe-4S cluster
      and occurs even in the presence of the protein synthesis inhibitor cycloheximide.
      The induction kinetics by H2O2 far exceed those by iron starvation. The response
      requires cellular integrity and cannot be elicited in cell extracts. Whereas the
      activation of IRP by iron depletion is insensitive to okadaic acid, the rapid
      induction by H2O2 is blocked by this inhibitor of type I/IIa protein
      phosphatases. Thus okadaic acid separates the activation pathways by iron
      depletion and oxidative stress, suggesting the involvement of stress-induced
      kinase/phosphatase pathways in the latter.

PMID- 7796818
TI  - The 3'-terminal region of the mRNAs for VSG and procyclin can confer stage
      specificity to gene expression in Trypanosoma brucei.
AB  - The variant surface glycoprotein (VSG) and procyclin are the respective major
      surface antigens of the bloodstream and the procyclic forms of Trypanosoma
      brucei. These proteins and their mRNAs are both the most abundant and absolutely
      characteristic of their respective life cycle stages. We show that the 3'
      terminal region of these mRNAs regulates expression of a reporter gene in an
      inverse manner, depending on the developmental form of the parasite. In the case
      of VSG mRNA, the 97 nt sequence upstream from the polyadenylation site is
      responsible for these effects. The regulation occurs through a variation of mRNA
      abundance which is not due to a change in primary transcription. In the
      bloodstream form this effect is manifested by an increase in RNA stability,
      whereas in the procyclic form it seems to be related to a reduction in the
      efficiency of mRNA maturation. The 3'-end of VSG mRNA can obviate the 5- to 10
      fold stimulation of transcription driven by the procyclin promoter during
      differentiation from the bloodstream to the procyclic form. The predominance of
      posttranscriptional over transcriptional controls is probably linked to the
      organization of the trypanosome genome in polycistronic transcription units.

PMID- 7796819
TI  - Macromolecular recognition through electrostatic repulsion.
AB  - In the process of genetic translation, each aminoacyl-tRNA synthetase
      specifically aminoacylates its cognate tRNAs and rejects the 19 other species of
      tRNAs. A decrease in the specificity of this reaction can result in
      misincorporations of amino acids into proteins and be deleterious to the cell. In
      the case of tyrosyl-tRNA synthetase from Bacillus stearothermophilus, the change
      of residue Glu152 into Ala results in erroneous interactions with non-cognate
      tRNAs. To analyse how Glu152 contributes to the discrimination between tRNAs by
      tyrosyl-tRNA synthetase, 11 changes to this residue were created by mutagenesis.
      The misaminoacylations of tRNA(Phe) and tRNA(Val) with tyrosine in vitro (on a
      scale going from 1 to 30) and the toxicity of tyrosyl-tRNA synthetase in vivo (on
      a scale from 1 to 10(7)) increased in a correlated way when the nature of the
      side chain in position 152 varied from negatively charged to uncharged then to
      positively charged. The aminoacylation of tRNA(Tyr) was unaffected by the
      mutations. The results show that the role of Glu152 in the discrimination between
      tRNAs is purely negative, that it acts by electrostatic repulsion of non-cognate
      tRNAs and that this mechanism has been conserved throughout evolution.

PMID- 7796822
TI  - Proceedings from the 2nd International Symposium on Fibrinogen and Cardiovascular
      Disease. Edinburgh, Scotland, 1-2 November 1994.

PMID- 7796820
TI  - Site-specific factor involved in the editing of the psbL mRNA in tobacco
      plastids.
AB  - In tobacco plastids, functional psbL mRNA is created by editing an ACG codon to
      an AUG translation initiation codon. To determine if editing may occur in a
      chimeric mRNA, the N-terminal part of psbL containing the editing site was
      translationally fused with the aadA and kan bacterial genes. The chimeric
      constructs were introduced into the tobacco plastid genome by targeted gene
      insertion. Editing of the chimeric mRNAs indicated that the 98 nt fragment
      spanning the psbL editing site contains all cis information required for editing.
      Expression of the chimeric gene transcripts led to a significant decrease in the
      editing efficiency of the endogenous psbL mRNA. However, the efficiency of
      editing in the transplastomic lines was unchanged for four sites in the rpoB and
      ndhB mRNAs. Reduced efficiency of psbL editing, but not of the other four sites,
      in the transplastomic lines indicates depletion of psbL-specific editing
      factor(s). This finding implicates the involvement of site-specific factors in
      editing of plastid mRNAs in higher plants.

PMID- 7796821
TI  - Type III restriction endonucleases translocate DNA in a reaction driven by
      recognition site-specific ATP hydrolysis.
AB  - Type III restriction/modification systems recognize short non-palindromic
      sequences, only one strand of which can be methylated. Replication of type III
      modified DNA produces completely unmethylated recognition sites which, according
      to classical mechanisms of restriction, should be signals for restriction. We
      have shown previously that suicidal restriction by the type III enzyme EcoP15I is
      prevented if all the unmodified sites are in the same orientation: restriction by
      EcoP15I requires a pair of unmethylated, inversely oriented recognition sites. We
      have now addressed the molecular mechanism of site orientation-specific DNA
      restriction. EcoP15I is demonstrated to possess an intrinsic ATPase activity, the
      potential driving force of DNA translocation. The ATPase activity is uniquely
      recognition site-specific, but EcoP15I-modified sites also support the reaction.
      EcoP15I DNA restriction patterns are shown to be predetermined by the enzyme-to
      site ratio, in that site-saturating enzyme levels elicit cleavage exclusively
      between the closest pair of head-to-head oriented sites. DNA restriction is
      blocked by Lac repressor bound in the intervening sequence between the two
      EcoP15I sites. These results rule out DNA looping and strongly suggest that
      cleavage is triggered by the close proximity of two convergently tracking EcoP15I
      DNA complexes.

PMID- 7796823
TI  - Fibrinogen, fibrin and the arterial wall.
AB  - Virtually all plasma proteins, including fibrinogen, low density lipoprotein and
      lipoprotein(a), are present in normal arterial intima and in atherosclerotic
      lesions, and their concentrations are related to plasma concentrations. Fibrin is
      also a significant component of many lesions, particularly early proliferative
      (gelatinous) lesions, where it may be muscle cells migrate and proliferate, bind
      thrombin, and are a source of fibrin degradation products (FDPs), which are
      mitogenic. Very recent studies suggest that free a-thrombin may be present in
      lesions despite an apparent excess of antithrombin III, so this may promote
      fibrin formation within the lesion. Furthermore, fibrinolysis and FDP generation
      may be mediated by catheptic enzymes in addition to plasmin.

PMID- 7796824
TI  - Genetic regulation of fibrinogen.
AB  - Prospective epidemiological studies have shown that elevated levels of fibrinogen
      are associated with thrombosis and ischaemic heart disease. Several sequence
      changes in the promoter region of the beta-fibrinogen gene have been detected
      that are associated with slightly raised plasma fibrinogen levels in healthy, non
      smoking carriers, but which have much larger genotype-associated effects in
      smokers. In in vitro assays, these sequence changes affect the binding of liver
      nuclear proteins and may alter the rate of transcription of the gene and thus the
      rate of fibrinogen production. One sequence change is close to the consensus
      sequence for the binding of a nuclear factor responsive to interleukin-6, one of
      the cytokines responsible for the acute-phase changes seen upon infection or
      injury. This provides a molecular explanation for the different effects on
      fibrinogen levels seen in smokers, who are experiencing a 'chronic' and low-grade
      response to injury. Thus, for elevated plasma fibrinogen, which is associated
      with a risk of thrombosis, a genetic variation has been detected that determines,
      in part, its plasma level; but the variability in an individual's response to
      environmental changes may also be determined in part by their genotype at this
      locus. In the future, such individual-specific genetic information may be of
      prognostic and therapeutic use.

PMID- 7796825
TI  - Fibrinogen and cardiovascular disease: historical introduction.

PMID- 7796826
TI  - Epidemiology of fibrinogen.
AB  - As evidence accumulates to implicate fibrinogen as a risk factor for
      cardiovascular disease (CVD) it becomes important to characterize the levels and
      correlates of fibrinogen in diverse populations. Knowledge of the correlates of
      fibrinogen may help researchers to disentangle the independent contribution of
      elevated fibrinogen concentrations to CVD. Characterization of the normal range
      and possible determinants of fibrinogen concentrations, likewise, may aid CVD
      risk assessment and intervention research. Fibrinogen concentrations vary widely
      among populations and increase with age. Levels are consistently higher in women
      than men and rise after menopause. Smoking is the most important lifestyle
      correlate of fibrinogen. People with diabetes and hypertension have elevated
      fibrinogen levels, as do sedentary and obese individuals. Alcohol intake and
      oestrogen replacement therapy are associated with lower fibrinogen levels. Most
      other CVD risk factors are correlated positively with fibrinogen. Fibrinogen is
      clearly a marker of CVD risk. Yet, the strikingly non-specific pattern of higher
      fibrinogen with every CVD risk factor suggests that proving an independent causal
      role of fibrinogen will remain elusive in the absence of trials selectively
      lowering fibrinogen with the aim of reducing CVD.

PMID- 7796827
TI  - Recent progress in the pathophysiology of fibrinogen.
AB  - A great deal of evidence suggests that fibrinogen is implicated in many vascular
      disorders resulting from atherothrombosis. However, it has not yet been possible
      either to establish with certainty whether elevated plasma fibrinogen levels
      cause, or arise as a consequence of, vascular pathology; or to include fibrinogen
      in the battery of laboratory tests widely used to predict the risk of thrombosis.
      This article provides an overview of the progress that has taken place in recent
      years in our understanding of the pathogenetic role of high plasma fibrinogen
      levels; the identification of genetic markers of atherothrombotic disease; and
      the clarification of the complex epidemiology of plasma fibrinogen levels as it
      relates to genotype and environment. The recent improvement in methodology used
      to measure plasma fibrinogen levels (which should lead to the wider use of
      fibrinogen assays in clinical practice) is also reviewed.

PMID- 7796828
TI  - Fibrinogen in ischaemic heart disease.
AB  - Fibrinogen contributes to both pathological and clinical manifestations of
      ischaemic heart disease (IHD). Several cross-sectional angiographic studies have
      shown correlations between the fibrinogen level and the extent of coronary artery
      disease. The largest of these studies suggests that this relationship is due
      mainly to luminal occlusion, strengthening the evidence that high fibrinogen
      levels are thrombogenic. The growing number of prospective studies that have
      included fibrinogen measurements consistently show a direct, independent and
      statistically significant association between fibrinogen level and the subsequent
      incidence of IHD, this association being about as strong as the relation between
      cholesterol and IHD, for example. The fibrinogen level is also associated with
      the recurrence of IHD in those who have survived a myocardial infarction and with
      the onset and recurrence or progression of cerebrovascular disease and lower
      extremity arterial disease. Besides a contribution to coronary artery changes,
      high fibrinogen levels predispose to IHD through influences on blood and plasma
      viscosity, platelet aggregability and the amount of fibrin produced when
      coagulation is initiated. Progress towards the standardization of methods for
      measuring fibrinogen increasingly justifies its inclusion in the IHD risk
      profile. Establishing the value of agents that lower fibrinogen levels is now a
      high research priority, mainly for clinical reasons but also as part of the
      evidence for clarifying the nature of the association of raised levels with
      arterial disease.

PMID- 7796829
TI  - Fibrinogen and peripheral arterial disease.
AB  - Both hospital and epidemiological studies have reported elevated plasma
      fibrinogen levels in patients with intermittent claudication. Fibrinogen levels
      have also been positively related to the degree of asymptomatic peripheral
      arterial disease (PAD). In claudicants, raised fibrinogen is predictive of future
      cardiovascular events, particularly coronary death. These associations between
      plasma fibrinogen and PAD are independent of diabetes mellitus and serum lipid
      concentrations. Lifetime cigarette smoking and plasma fibrinogen interact
      synergistically in their association with PAD. However, most of the increased
      risk of PAD due to cigarette smoking is not mediated via plasma fibrinogen, and
      conversely the relationship between fibrinogen and PAD is not wholly dependent on
      smoking. The association between fibrinogen and PAD is stronger in men than in
      women, and in women does not occur independently of smoking. When comparing sex
      differences in a wide range of aetiological factors associated with PAD, plasma
      fibrinogen is one of the few factors showing a stronger relationship in men than
      in women, and may be important in explaining sex differences in susceptibility to
      disease.

PMID- 7796830
TI  - Fibrinogen and cerebrovascular disease.
AB  - The importance of fibrinogen has been identified in two prospective observational
      studies. Reactive elevations in fibrinogen levels that occur within hours of a
      major stroke invalidate most cross-sectional case-control studies evaluating
      fibrinogen as a risk factor. However, as no elevation is seen following fresh
      episodes of transient ischaemic attacks, reliable conclusions drawn from a case
      control study using such patients support the findings of the prospective
      studies. The association is related to occlusive stroke, but the relationship
      with intracerebral haemorrhage is unclear. The relationship has been found to be
      independent of other haemostatic and haemorheological factors (e.g. von
      Willebrand factor, tissue plasminogen activator and packed cell volume).
      Adjustment for regression dilution bias would further strengthen the observed
      relationship. Therefore, after blood pressure, fibrinogen is the most important
      potentially treatable risk factor for ischaemic stroke. There are several
      mechanisms whereby fibrinogen could promote athero-thromboembolism: thrombosis
      through a hypercoagulable state; the acceleration of atherosclerosis; or the
      reduction of blood flow due to high blood or plasma viscosity. The mechanism,
      however, is unlikely to be mediated through high blood viscosity per se as
      secondary erythrocytosis (another major determinant of blood viscosity) has not
      consistently been found to be a risk factor for stroke. Studies relating
      fibrinogen levels to the degree of carotid artery stenosis support the
      accelerating influence of fibrinogen on atherosclerosis. Fibrinogen should be
      considered a risk factor for ischaemic stroke and included in the assessment of
      individual risk factors.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796831
TI  - Therapeutic interventions to lower plasma fibrinogen concentration.
AB  - A causal link between plasma fibrinogen levels and the risk of cardiovascular
      disease is now reasonably well established. Therefore the therapeutic lowering of
      fibrinogen has become a relevant area of research. Several options to achieve
      this aim have been reported in the literature. Changes in lifestyle can affect
      the fibrinogen level, of which smoking cessation is by far the most effective;
      weight or stress reduction or an increase in regular physical activity may have
      less pronounced effects; dietary changes appear to have even less effect, though
      a regular, moderate alcohol consumption may result in a small reduction. Many
      oral drugs have been shown to lower fibrinogen; however, the data should be
      viewed critically. In particular, the clinical situation in which a drug is
      administered must be considered and risk:benefit analyses should be performed
      before a drug is recommended for this indication. Among the oral fibrinogen
      lowering drugs, fibrates rank first (e.g. bezafibrate has been reported to reduce
      increased fibrinogen by as much as 40%, and ticlopidine can induce a reduction of
      about 15% if fibrinogen was elevated at baseline). Whether concentration within
      the normal range can be altered by oral medication is less clear. Finally (and
      obviously), intravenous fibrinolytic agents or heparin-induced extracorporeal low
      density lipoprotein precipitation will lower fibrinogen dramatically; yet these
      procedures are rarely indicated for this purpose alone. All options to lower
      fibrinogen also have prominent effects on other cardiovascular functions; thus,
      an intervention trial may not be the most appropriate method of testing the
      validity of the hypothesis of fibrinogen as a cardiovascular risk factor.

PMID- 7796832
TI  - Recent progress in the clinical aspects of fibrinogen.
AB  - This article provides an overview of recently accumulated evidence on the
      pathogenetic role of fibrinogen in various vascular beds; and tries to elucidate
      determinants for patients' susceptibility so that subgroups at particular risk of
      severe clinical complications can be characterized more accurately. Based on the
      considerably elevated risk of cardiovascular complications associated with
      increased levels of plasma fibrinogen, the potential value of lowering fibrinogen
      in the primary or secondary prevention of atherosclerotic disease is now
      recognized as an important topic for consideration. Recent progress in this field
      will also be reviewed.

PMID- 7796833
TI  - Biochemistry and measurement of fibrinogen.
AB  - Fibrinogen is a large heterogeneous family of closely related molecules
      consisting of three pairs of non-identical polypeptide chains: two A alpha-, two
      B beta- and two gamma-chains, held together by disulphide bridges. The
      heterogeneity of fibrinogen is due to heterogeneities in all three chains. Four
      main types of assay are used to determine fibrinogen:clotting rate (Clauss),
      clottable protein, precipitation and immunological assays. Heterogeneities may
      differ from person to person and may affect the apparent fibrinogen
      concentrations in different assays. A further complicating factor was, until
      recently, the lack of an international fibrinogen standard. The ratio of
      Clauss:enzyme immunoassay (EIA) for high + low molecular weight fibrinogen
      decreases during therapy for acute myocardial infarction and increases again
      after thrombolytic therapy to above normal values. Furthermore, high molecular
      weight fibrinogen tends to clot more easily than low molecular weight fibrinogen.
      This suggests that high molecular weight fibrinogen might be associated with
      increased thrombotic risk. Fibrinogen assessed by a functional assay (Clauss)
      alone is strongly associated with ischaemic heart disease. Although not proven,
      it is conceivable that a fibrinogen with a Clauss:EIA ratio of > 1 has an even
      stronger association in epidemiological studies.

PMID- 7796834
TI  - Fibrinogen and cardiovascular disease in clinical practice.
AB  - Plasma fibrinogen is not measured routinely in clinical practice for prediction
      of cardiovascular disease (CVD) but further modest advances in the research
      investigating fibrinogen and CVD may make this a reality. First, agreement must
      be reached on the most appropriate method of measurement in clinical practice
      taking account of the type of fibrinogen to be assayed, the sources and degree of
      measurement variability, the development of standards and the financial costs.
      Secondly, further information is required on the value of plasma fibrinogen as a
      useful risk marker in the primary and secondary prediction of future
      cardiovascular events. There is a need to express risks in a format which is
      useful to the general public and to clinicians, and which takes account of
      associated risks of cigarette smoking, blood pressure, and serum lipids. Finally,
      the effectiveness of lowering plasma fibrinogen levels in patients with CVD is
      not yet established. Fibrate drugs are warranted in patients with high-risk lipid
      profiles, but their effects on cardiovascular outcome due to lowering of plasma
      fibrinogen await the results of current randomized trials.

PMID- 7796835
TI  - Motor neuron disease and monoclonal gammopathy.
AB  - In a study to determine the prevalence of monoclonal gammopathy (MG) among
      patients with motor neuron disease (MND), 6 out of 56 (10.7%) were found to have
      a monoclonal paraprotein. Of these 6 patients, 4 had an IgG and 2 had an IgA
      paraprotein. The clinical syndromes consisted of amyotrophic lateral sclerosis in
      2 patients, lower motor neuron syndrome with preserved reflexes in at least one
      limb in 3 patients, and motor neuropathy with multifocal conduction block in 1
      patient. The presence of gammopathy appears to correlate with the absence of
      marked upper motor neuron involvement and with elevated CSF protein
      concentration. An underlying malignant disorder was ruled out in all 6 patients,
      and they were considered to have MG of undetermined significance (MGUS). In a
      control group of 121 age-matched patients with other neuroimmunological
      disorders, 5 patients (4.13%) had MG. Four of these had gammopathy associated
      with malignant myeloma, and 1 had MGUS. These results support previous reports of
      increased prevalence of MGUS in patients with MND and suggest that an autoimmune
      mechanism may play a role in the disease.

PMID- 7796836
TI  - Endothelial cell damage in sarcoidosis and neurosarcoidosis: autoantibodies to
      endothelial cells.
AB  - Damage to the vascular system, of which endothelial cells are the main
      constituent, may occur in sarcoidosis. Evidence of blood-brain barrier (BBB)
      disruption is shown in sarcoidosis with central nervous system (CNS) involvement
      by means of magnetic resonance imaging or computed tomography. We investigated
      the presence of antiendothelial cell antibodies by culture of endothelial cells
      derived from human umbilical cord vein and from human brain using an enzyme
      linked immunosorbent assay, and the presence of circulating immune complexes
      using a Raji cell assay, in the sera of patients with sarcoidosis. The patients
      with sarcoidosis displayed significantly high levels of immunoglobulin G (IgG)
      binding to endothelial cells after blocking Fc receptor compared to controls (p <
      0.01). The sera of neurosarcoid patients with CNS involvement still showed
      significantly increased levels of IgG binding to brain endothelial cells after
      blocking Fc receptor compared to controls and those of pulmonary sarcoidosis (p <
      0.001 and p < 0.01 respectively). These results suggest that the presence of
      autoantibodies to endothelial cells may be involved in endothelial cell damage,
      including BBB disruption.

PMID- 7796837
TI  - Seronegative chronic relapsing neuroborreliosis.
AB  - We report an unusual patient with evidence of Borrelia burgdorferi infection who
      experienced repeated neurologic relapses despite aggressive antibiotic therapy.
      Each course of therapy was associated with a Jarisch-Herxheimer-like reaction.
      Although the patient never had detectable free antibodies to B. burgdorferi in
      serum or spinal fluid, the CSF was positive on multiple occasions for complexed
      anti-B. burgdorferi antibodies, B. burgdorferi nucleic acids and free antigen.

PMID- 7796838
TI  - Handling of single brain metastasis.

PMID- 7796839
TI  - Treatment of amyotrophic lateral sclerosis using a gene therapy approach.
AB  - Neurotrophic factors which act on motor neurons may provide an efficient
      treatment for amyotrophic lateral sclerosis. In order to overcome the difficulty
      of administering proteins into the central nervous system, it is possible to use
      a gene therapy approach, i.e. the polymer encapsulation of cells which have been
      genetically engineered to release one of these neurotrophic factors. The polymer
      encapsulated cells can be implanted subcutaneously or even intrathecally and
      permit continuous, slow release of proteins. There is no rejection of the cells
      due to their isolation by a semi-permeable membrane, no risk of tumor formation
      and the polymer device can be removed in the event of a problem.

PMID- 7796841
TI  - Spatial and perceptual impairment related to cortical cerebral blood flow and EEG
      in deep white matter infarcts of the right hemisphere.
AB  - A study was performed in order to investigate how infarcts located in the white
      matter of the right hemisphere may affect processing of spatial and perceptual
      abilities. A battery of neuropsychological tests was applied to 7 right-handed
      patients with CT-verified infarcts of the right internal capsule or
      periventricular white matter. Examinations were performed 1-3 weeks post stroke
      and 3-7 months later. The patients were assessed by neurological examinations,
      EEG, and cortical regional cerebral blood flow (rCBF) measurements. This study
      suggested that deep white matter infarcts of the right hemisphere may result in
      persistent spatial impairment in the absence of decreased cortical rCBF.
      Perception was disturbed in cases of low mean cortical CBF of both hemispheres.

PMID- 7796840
TI  - Familial young-adult-onset arteriosclerotic leukoencephalopathy with alopecia and
      lumbago without arterial hypertension.
AB  - Here we review a total of 17 patients, including 4 of our own, with young-adult
      onset arteriosclerotic leukoencephalopathy, alopecia and lumbago without
      hypertension. All were Japanese and the illness seemed to be transmitted in an
      autosomal recessive fashion. The male to female ratio was 7.5:1. The age of onset
      usually ranged from 25 to 30 years. Acute lumbago, spondylosis deformans, diffuse
      baldness, and progressive motor and mental deterioration were common clinical
      features. Cerebral arteriosclerosis and white mater disease were demonstrated
      pathologically or radiologically. Although the pathogenesis has remained obscure,
      we think this is a new clinico-pathological entity distinct from the classic type
      of Binswanger's disease.

PMID- 7796843
TI  - Neurophysiological and urodynamic examinations in the functional assessment of
      the spinal cord below the injury site.
AB  - We examined the characteristics of specific components of the evoked
      electrospinogram (EESG) in response to tibial nerve stimulation in 28 patients
      with traumatic injury of the dorsal and cervical spinal cord. The data were
      correlated with clinical, urodynamic and additional neurophysiological findings.
      In the majority of patients (82%), 11 with complete and 12 with partial spinal
      cord lesions, the lumbar components of the EESG were normal. In 4 of these
      patients with complete lesion above T2 the dorsal EESG was absent. In 5 cases
      (18%), the lumbosacral EESG was altered in the presence of an atypical clinical
      syndrome characterized by persistent urinary retention associated with lower leg
      atrophy and reduced tendon jerks. In these cases, MRI provided evidence of an
      unexpected sacral lesion. Unlike the dorsal EESG reflecting the afferent dorsal
      column volley, the lumbar components of the EESG are usually unaffected by
      interruption of the cord pathways; these last events thus originate from
      segmental neuronal activity, the involvement of which bears witness to additional
      lumbosacral damage.

PMID- 7796842
TI  - Evaluation of influential factors of cognitive impairments in idiopathic
      Parkinson's disease.
AB  - Using multivariate analysis, we investigated the influence on cognitive functions
      of aging, brain atrophy, incidental cerebral hyperintensities (CHs), medication,
      and severity, duration and the initial symptoms of the disease in 53 patients
      with idiopathic Parkinson's disease (PD). We semiquantitatively assessed the
      degree of brain atrophy and CHs based on previously established methods.
      Cognitive functions were significantly and diffusely impaired in PD when compared
      with controls who were matched for age as well as for the degree and location of
      CHs. Patients with PD, however, had larger ventricles. Prefrontal dysfunctions
      were associated with a variety of predictors such as CHs, brain atrophy, severity
      of PD and medication whereas dorsolateral frontal functions were related simply
      to age and CHs in the periventricular region. Posterior brain functions had
      association with severity of illness, ventricular dilatation and total CH score.
      Clinically observed cognitive impairments in PD may consist of cognitive defects
      intrinsic to the disease which are variously modified by these factors. It is
      essential to consider all these predictors simultaneously in any discussion of
      cognitive functions in PD.

PMID- 7796844
TI  - Grades of exophthalmos and thyrotropin-binding inhibitory immunoglobulin in
      patients with myasthenia gravis.
AB  - Exophthalmos and thyrotropin-inhibitory immunoglobulin (TBII) were examined in
      myasthenia gravis (MG) patients with normal thyroid function. Exophthalmos was
      found in 7 of 31 (22.6%) MG patients, and TBII was detected in 4 of 21 (19.0%) MG
      patients. The grades of exophthalmos did not decrease after extraocular muscle
      weakness was improved by treatment. Patients with MG whose diplopia was Tensilon
      unresponsive were only found among those with exophthalmos. TBII was more
      frequently detected in MG patients with exophthalmos than in those without. The
      present study revealed that exophthalmos is not rare in MG patients, even if they
      do not show any signs of Graves' disease other than exophthalmos and their
      thyroid functions are within the normal limit. The presence of TBII in MG
      patients may relate to the development of exophthalmos, and exophthalmos itself
      might enhance ocular symptoms of MG.

PMID- 7796847
TI  - Motility pattern of isolated rat proximal colon and excitatory action of
      neurotensin.
AB  - The investigation concerned the effects of neurotensin on mechanical activity of
      isolated rat proximal colon. An isometric-isovolumic preparation was used.
      Colonic segments showed spontaneous contractile activity, consisting of regular
      changes in both endoluminal and isometric tension. Neurotensin (1 pM to 0.1
      microM) induced a concentration-dependent tonic contraction of both circular and
      longitudinal muscle accompanied by high frequency oscillatory activity.
      Desensitization of the neurotensin receptors antagonized the contractile activity
      of neurotensin. The excitatory effects of neurotensin were partially blocked to
      the same degree by tetrodotoxin and atropine, indicating that a component of the
      neurotensin-mediated contraction involves the release of endogenous
      acetylcholine. The tetrodotoxin-resistant component of the neurotensin-induced
      effect seems to be due to a direct action on the smooth muscle cells.

PMID- 7796845
TI  - Strychnine-insensitive glycine site antagonists attenuate a cardiac arrest
      induced movement disorder.
AB  - Male Sprague-Dawley rats underwent experimentally induced cardiac arrest and
      resuscitation, subsequently exhibiting involuntary jerking movements (myoclonus)
      with salient features similar to the human form of the disorder. The novel
      strychnine-insensitive glycine site antagonists ACEA-1011 (5-chloro-7
      trifluoromethyl-1,2,3,4-tetrahydroquinoxaline-2,3,-dio ne) and ACEA-1021 (5-nitro
      6,7-dichloro-quinoxalinedione) significantly attenuated the myoclonus in cardiac
      arrested rats. (+)-HA-966, (+/-)-HA-966 (3-amino-1-hydroxy-2-pyrrolidinone), and
      felbamate (2-phenyl-1,3-propanediol dicarbamate) were also effective. Although
      the drugs vary in their selectivity for strychnine-insensitive glycine sites,
      they all possess antagonist activity at these sites. Vehicle injections (saline,
      dimethyl sulfoxide, water) were without effect and no obvious side effects were
      observed with any of the ligands tested in this study. Since hyperexcitability in
      the central nervous system is thought to underlie myoclonus, the attenuation of
      excitatory amino acid neurotransmission through antagonism of strychnine
      insensitive glycine sites provides a logical mechanism of action for the
      antimyoclonic effects observed herein.

PMID- 7796846
TI  - FR144420, a novel, slow, nitric oxide-releasing agent.
AB  - We report that (+/-)-(E)-ethyl-2-[(E)-hydroxyimino]-5-nitro-3-hexeneamide (FK409)
      decomposes and releases nitric oxide (NO) spontaneously in solution. (+/-)-N-[(E)
      4-Ethyl-3-[(Z)-hydroxyimino]-5-nitro-3-hexen-1- yl]-3- pyridinecarboxamide
      (FR144420) was synthesized with the aim of discovering a compound with longer
      duration of effects in vivo, compared with FK409. FR144420, like FK409, released
      NO spontaneously in solution, but the amount of NO released from FR144420 during
      a 5-min incubation was half the amount from FK409. In addition, FR144420
      spontaneously decomposed and generated nitrite, which is an oxidative metabolite
      of NO, at half the rate of FK409. In a vasorelaxant study with isolated rat
      aorta, FR144420 had a weaker potency than FK409 (EC50 = 54 and 8.1 nM,
      respectively). In in vivo studies, FR144420 decreased mean blood pressure
      immediately after intravenous and oral administration to conscious rats. The
      maximum hypotensive effects of FR144420 were less than those of FK409. However,
      the durations of FR144420-induced (i.v. and p.o.) hypotensive effects were longer
      than those of FK409-induced effects. In conclusion, FR144420 is more stable and
      releases NO more slowly in solution than does FK409. In in vivo experiments,
      FR144420 showed a longer duration of effects than FK409. FR144420 may be very
      useful for investigating the in vivo actions of NO.

PMID- 7796848
TI  - A 5-HT3 receptor antagonist fails to prevent cisplatin-induced toxicity in
      immature rat spinal cord.
AB  - The use of high doses of cisplatin in treating cancers has been limited by two
      major adverse effects--emesis and peripheral neuropathies. The emesis has become
      largely controlled by the introduction of a new class of drugs--the 5-HT3
      receptor antagonists. The current study was undertaken to determine if these
      drugs would also prevent cisplatin-induced neuropathy. We have used a developing
      rat as an animal model and determined the effects of cisplatin on morphology
      (loss of spinal cord calcitonin gene-related peptide (CGRP)-containing neurons)
      and behavior (gait abnormalities and pain perception). Rat pups from the age of 5
      days were treated twice weekly for 4 weeks with cisplatin (1 mg/kg), the 5-HT3
      antagonist MDL 72222 (3 mg/kg) or both. The animals were tested for pain
      perception (using tail-flick latencies) at 17 and 21 days of age and for a gait
      abnormality at 24 days of age. At 34 days of age, the animals were perfused and
      the lumbar region of the spinal cords stained immunocytochemically for CGRP. Our
      results show that cisplatin treatment resulted in a dramatic loss of CGRP neurons
      in the dorsal horn of the spinal cord and a corresponding increase in the
      animals' threshold for pain. In addition, the animals showed a pronounced gait
      abnormality, characterized by 'toeing-in'. Treatment with MDL 72222 not only
      failed to protect against the loss of CGRP neurons but also worsened the gait
      abnormalities seen after cisplatin treatment alone. These studies confirm and
      extend the list of morphological and functional adverse effects of cisplatin
      treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796850
TI  - The spinal potentiating effect and the supraspinal inhibitory effect of midazolam
      on opioid-induced analgesia in rats.
AB  - The authors investigated the effects of spinal and supraspinal administration of
      the benzodiazepine receptor agonist midazolam alone and with opioids on tests of
      nociception (tail-flick and hot-plate tests) and motor function (catalepsy) in
      rats. At the spinal level, the dose-response curves for peak effect and area
      under the curve for morphine were shifted to the left (indicating potentiation)
      by a submaximal dose of intrathecal (i.t.) midazolam (20 micrograms) in both
      nociceptive tests. Additionally, 2.5 micrograms of i.t. midazolam, a dose having
      no effect when given alone, increased antinociception in both tests when given
      with i.t. morphine. Isobolographic analysis confirmed that i.t. injection of
      midazolam potentiated antinociception induced by i.t. morphine. At the
      supraspinal level, intracerebroventricular (i.c.v.) injection of 4 micrograms of
      midazolam inhibited morphine antinociception, i.e., the dose-response curve for
      morphine in the hot-plate test shifted to the right. Midazolam did not affect
      morphine antinociception in the tail-flick test. Catalepsy occurred only when the
      highest doses of i.t. or i.c.v. morphine or midazolam were injected alone. The
      differing effect of midazolam on morphine-induced antinociception suggests that
      different mechanisms are involved in the spinal cord and brain.

PMID- 7796849
TI  - Hydroxocobalamin and haemoglobin differentiate between exogenous and neuronal
      nitric oxide in the rat gastric fundus.
AB  - In longitudinal strips of rat gastric fundus, hydroxocobalamin (30 microM)
      significantly reduced relaxations to sodium nitroprusside (100 nM), nitric oxide
      (NO; 5 microM) and S-nitrosocysteine (3 microM), whereas responses to non
      adrenergic, non-cholinergic (NANC) nerve stimulation were only slightly reduced.
      The stimulation-induced relaxations were markedly reduced by the NO synthase
      inhibitor NG-nitro-L-arginine (100 microM). Hydroxocobalamin (30 microM) enhanced
      relaxations to S-nitrosoglutathione (1 and 3 microM), and had no effect on
      responses to vasoactive intestinal polypeptide (1 nM). Haemoglobin (10 microM)
      significantly reduced relaxations to sodium nitroprusside, NO, S-nitrosocysteine
      and S-nitrosoglutathione, but did not affect responses to NANC nerve stimulation
      or vasoactive intestinal polypeptide. The results suggest that hydroxocobalamin
      and haemoglobin can differentiate between exogenous and neuronally released NO,
      and that the transmitter released from nitrergic nerves in the rat gastric fundus
      is not free NO or the nitrosothiols, S-nitrosocysteine and S-nitrosoglutathione.

PMID- 7796851
TI  - Neuronal mechanism of the inhibitory effect of calcitonin on N-methyl-D-aspartate
      induced aversive behavior.
AB  - To elucidate the mechanism of antinociceptive effects of calcitonin, we
      investigated whether receptor antagonists for various neurotransmitter receptors
      alter the inhibitory effect of calcitonin on intrathecally injected N-methyl-D
      aspartate-induced aversive behavior in mice. Neither naloxone, an opioid receptor
      antagonist, phentolamine and benextramine, alpha-adrenoceptor antagonists, nor
      ritanserin, a 5-HT2A receptor antagonist, inhibited the calcitonin-induced anti
      aversive effects. Pindolol and (--)-propranolol, non-selective antagonists of
      beta-adrenoceptors and 5-HT1 receptors, 1-(2-methoxyphenyl)-4-[4-(2-phethalimido)
      butyl]-piperazine hydrobromide (NAN-190), a 5-HT1A receptor antagonist, 3
      tropanyl-3,5-dichlorobenzoate (MDL72222) and metoclopramide, 5-HT3 receptor
      antagonists, significantly inhibited the calcitonin-induced anti-aversive
      effects. (--)-Bicuculline, a GABAA receptor antagonist, phaclofen and 5
      aminovaleric acid, GABAB receptor antagonists, also attenuated the calcitonin
      induced anti-aversive effects. These results suggest that beta-adrenoceptor, 5
      HT1A, 5-HT3, GABAA and GABAB receptors, but not alpha-adrenoceptor, opioid nor 5
      HT2A receptors, are involved in the inhibitory effect of calcitonin on
      intrathecally injected N-methyl-D-aspartate-induced aversive behavior in mice.

PMID- 7796852
TI  - Dopamine-independent and adenosine-dependent mechanisms involved in the effects
      of N-methyl-D-aspartate on motor activity in mice.
AB  - The involvement of dopamine and adenosine mechanisms in the motor effects of
      systemically administered N-methyl-D-aspartate (NMDA) was studied in non
      reserpinized and in reserpinized mice. In non-reserpinized mice NMDA induced
      motor depression (with 8, 25 and 75 mg/kg i.p.) during the first hour and motor
      activation (with 25 and 75 mg/kg i.p.) during the second hour after its
      administration. The non-selective adenosine antagonist, theophylline (3, 10 and
      30 mg/kg i.p) induced motor activation during both 1-h periods of observation.
      NMDA-induced motor depression in non-reserpinized mice was antagonized by
      theophylline. Higher doses of theophylline were needed to counteract the motor
      depressant effect induced by higher doses of NMDA. The motor activation induced
      by NMDA and theophylline in non-reserpinized mice was not additive and
      theophylline did not enhance the motor activation induced by high doses of NMDA.
      Both NMDA (25 and 75 mg/kg i.p.) and theophylline (10 and 30 mg/kg) induced motor
      activation in reserpinized mice and, when coadministered, NMDA counteracted the
      effect of theophylline. NMDA (8 and 25 mg/kg i.p.) antagonized and theophylline
      (3, 10 and 30 mg/kg i.p.) potentiated the motor activation induced by the non
      selective dopamine agonist, apomorphine (0.1 mg/kg s.c.), in reserpinized mice.
      In reserpinized mice, the non-selective dopamine antagonist, haloperidol (0.5
      mg/kg s.c.) antagonized the motor activation induced by apomorphine (0.1 mg/kg
      s.c.) and the induced by theophylline (10 mg/kg i.p.) and did not modify NMDA
      induced motor activation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796853
TI  - Histamine chloramines have a persistent stimulating effect on histamine H2
      receptors and gastric acid secretion.
AB  - Histamine plays an important role in the control of gastric acid secretion.
      Recently, chlorinated derivatives of histamine have been identified as having
      multiple effects on the intestinal tract. The aim of this study was to
      investigate the role of histamine chloramines on gastric acid secretion. We
      compared the effects of histamine and histamine chloramines on the histamine H2
      receptors in vitro using guinea pigs and on gastric acid secretion in rats. With
      respect to the effects on histamine H2 receptors, histamine monochloramine showed
      agonist effects similar to those seen with histamine, but the agonist effects of
      histamine dichloramine were about half those of histamine. Unlike histamine
      effects, the histamine H2 receptor agonist effects of histamine monochloramine
      and histamine dichloramine did not disappear after repeated washout. With respect
      to the stimulation of gastric acid secretion in vivo, histamine monochloramine
      was similar to histamine, while the effect of histamine dichloramine was 42.2
      52.7% of that of histamine. The recovery time to the basal secretory level after
      completion of stimulation by histamine chloramines was significantly prolonged
      compared with histamine. These results suggest that histamine chloramines, which
      bind strongly with histamine H2 receptors, may delay the termination of gastric
      acid secretion and increase the burden on the gastric and duodenal mucosa.

PMID- 7796854
TI  - Contrasting actions of acute or chronic paroxetine and fluvoxamine on morphine
      withdrawal-induced place conditioning.
AB  - The acute and chronic effects of paroxetine and fluvoxamine on naloxone
      withdrawal-induced place aversion in morphine dependent rats were investigated.
      Acutely administered fluvoxamine (25 mg/kg s.c. given 30 min prior to naloxone
      withdrawal pairing) and chronic daily paroxetine (10 mg/kg s.c.) coadministration
      with a morphine induction protocol, both attenuated morphine withdrawal place
      aversion. Conversely, acutely administered paroxetine (up to 25 mg/kg s.c.) or
      chronic daily fluvoxamine (10 mg/kg s.c.) coadministration with morphine did not
      modify subsequent withdrawal place aversion. Previous radioligand binding studies
      indicate that fluvoxamine has opioid-displacing properties. It is suggested
      therefore that acute fluvoxamine may have decreased withdrawal aversion, probably
      through serotonin and also, in part, via an opioid-like mechanism whereas chronic
      paroxetine decreased withdrawal aversion by a serotonergic mechanism, but it is
      not clear whether opioid systems play any role in the action of paroxetine.

PMID- 7796855
TI  - Beta 2- but not beta 3-adrenoceptors mediate prejunctional inhibition of non
      adrenergic non-cholinergic contraction of guinea pig main bronchi.
AB  - We studied the effects of selective beta-adrenoceptor agonists on the cholinergic
      and non-adrenergic non-cholinergic (excitatory NANC) contractions elicited by
      electrical field stimulation of guinea pig main bronchi in vitro. Addition of the
      selective beta 2-adrenoceptor agonists, fenoterol and salbutamol, and the
      selective beta 3-adrenoceptor agonist, BRL 37344 (4-[2-[(2-hydroxy-2-(3-chlor
      phenyl)ethyl)amino]-propyl]-phenoxyac etic acid), induced a dose-dependent
      inhibition of the cholinergic contraction (pD2 7.89, 6.71 and 4.56, respectively)
      and the excitatory NANC response (pD2 9.11, 8.16 and 7.42, respectively).
      Fenoterol- and BRL 37344-induced inhibition of the excitatory NANC response was
      blocked with high potency (pKB 8.77 and 9.07, respectively) by the selective beta
      2-adrenoceptor antagonist, ICI 118,511 (erythro-1-(7-methylindan-4-yloxy)-3
      (isopropylamino)-but an-2-ol). A comparable contraction induced by neurokinin A
      (2 or 5 nM) was also inhibited by fenoterol, salbutamol and BRL 37344, but at
      significantly higher concentrations than for the inhibition of the excitatory
      NANC response (pD2 8.72, 7.56 and 6.66, respectively). Such a preferential
      inhibition of electrical field stimulation- versus agonist-induced effects was
      not observed for cholinergic contractions (pD2 versus methacholine-induced tone
      7.86, 6.93 and 5.10, respectively). The results clearly exclude the involvement
      of beta 3-adrenoceptors in these responses. Furthermore they show that beta 2
      adrenoceptors are involved in the prejunctional inhibition of excitatory NANC
      contractions, presumably via modulation of tachykinin release from sensory
      nerves, and solely in the postjunctional inhibition of cholinergic contractions.

PMID- 7796857
TI  - Melatonin improves evening napping.
AB  - Twelve young adults were treated with either melatonin, 3 mg or 6 mg, or placebo,
      at two different times before an early evening nap (18.00-20.00 h) according to a
      balanced double-blind Latin square design. Polysomnographic monitoring revealed
      that both dosages of melatonin significantly shortened sleep latency and
      increased total sleep time in comparison to placebo, irrespective of the time of
      administration. Subjects also tended to assess their sleep as 'deeper' after
      melatonin treatment. Based on previous data and the present results, it was
      concluded that exogenous melatonin exerts hypnotic effects only when circulating
      levels of endogenous melatonin are low.

PMID- 7796858
TI  - Endothelium-dependent contraction induced by acetylcholine in isolated rat renal
      arteries.
AB  - We investigated whether or not acetylcholine elicited an endothelium-dependent
      contraction and whether an arachidonic acid metabolite was involved in the
      acetylcholine-induced contraction in ring preparations of rat renal arteries.
      Acetylcholine (0.1-100 microM) caused a transient contraction in endothelium
      intact arteries in a concentration-dependent manner. The contraction induced by
      acetylcholine (10 microM) was enhanced by pretreatment with NG-nitro-L-arginine
      (100 microM), a nitric oxide synthase inhibitor, and was abolished by mechanical
      removal of the endothelium. Atropine (0.1 microM), quinacrine (1 and 3 microM),
      manoalide (0.1 and 1 microM), aspirin (1 and 10 microM), indomethacin (30 and 300
      nM), ONO-3708 (9,11-dimethyl-methane-11,12-methano-13,14-dihydro-13-aza-14- oxo
      15(beta)-cyclophenyl-omega-pentenor-thromboxane A2 L-arginine salt) (10 nM), S
      1452 (calcium (5Z)-1R,2S,3S,4S-7-[3-phenylsulphonyl-aminobicyclo[2.2.1]hep t-2yl]
      5- heptenoate hydrate) (3 nM) and SQ29,548 ([1S- [1 alpha,2 beta(5Z),3 beta,4
      alpha]]-7-[3-[[2-[(phenylamino) carbonyl]hydrazino]methyl]-7
      oxabicyclo[2.2.1]hept-2-yl]-5-heptenoi++ + c acid) (3 and 10 nM), but not
      hexamethonium (1 microM), OKY-046 (sodium (E)-3-[4-(1- imidazolylmethyl)phenyl]-2
      propenoic acid hydrochloride monohydrate) (100 microM) and CS-518 (sodium 2-(1
      imidazolylmethyl)-4,5- dihydrobenzo[b]thiophene-6-carboxylate) (10 microM)
      significantly attenuated the acetylcholine (10 microM)-induced endothelium
      dependent contractions in renal arteries pretreated with NG-nitro-L-arginine.
      These findings suggest that acetylcholine causes endothelium-dependent
      contraction by stimulation of muscarinic receptors in rat renal arteries, and
      that an arachidonic acid metabolite(s) of the cyclooxygenase pathway is involved
      in this endothelium-dependent contraction.

PMID- 7796856
TI  - Antagonism of leukotriene responses in human airways by BAY x7195.
AB  - Contractions induced by leukotriene and anti-IgE (sheep antiserum to human IgE)
      were antagonized by pretreatment of human airways with the cysteinyl leukotriene
      receptor antagonist BAY x7195 ((4S)-[4-carboxyphenylthio]-7-[4-(4-phenoxybutoxy)
      phenyl]-h ept-5-(z)- enoic acid). However, this receptor antagonist did not
      inhibit either leukotriene D4- or leukotriene C4-induced contractions in human
      pulmonary veins. The pA2 value for BAY x7195 in human airways against leukotriene
      D4 was 7.83 +/- 0.16 with a slope of 1.07 +/- 0.15 (means +/- S.E.M; n = 11). The
      IC50 value for BAY x7195 in human airways contracted with anti-IgE was 0.31 +/-
      0.08 microM (n = 11). These results were comparable to those obtained with ICI
      204,219 (4-(5-cyclopentyl-oxycarbonylamino-1-methylindol-3-ylmeth yl)-3-methoxy-N
      otolyl - sulfonylbenzamide). These data demonstrate that BAY x7195 is a potent
      selective leukotriene receptor antagonist which may block allergic reactions in
      the lung.

PMID- 7796860
TI  - Persistence of the effects of ethanol in vitro on the lipid order and enzyme
      activities of chick-liver membranes.
AB  - Results demonstrate for the first time that ethanol exerts two different effects
      on the lipid order of chick-liver mitochondria and microsomes: a fluidizing
      effect both in the core and at the surface of the membrane, which depends on its
      physical presence, and a rigidization of the surface of these membranes which
      occurs after its removal. In addition, and directly related to the reduction in
      fluidity produced in the membrane surface after ethanol removal, we have detected
      a persistent alteration in different enzyme activities involved in the hepatic
      mitochondrial and microsomal electron-transport systems. The persistence of the
      alterations in the lipid order and enzyme activities may result from a structural
      rearrangement of the lipid and protein components produced in the lipid bilayer
      surface when ethanol is no longer present in the membrane.

PMID- 7796862
TI  - Liver tumour promoting activity of 3,4,5,3',4'-pentachlorobiphenyl and its
      interaction with 2,3,7,8-tetrachlorodibenzo-p-dioxin.
AB  - This study was undertaken to compare the tumour promoting effects induced by
      3,4,5,3',4'-pentachlorobiphenyl (PCB 126) and 2,3,7,8-tetrachlorodibenzo-p-dioxin
      (TCDD). In addition, interactive effects in rats treated with combinations of PCB
      126 and TCDD were studied. Partially hepatectomized female Sprague-Dawley rats
      were initiated with nitrosodiethylamin. After 5 weeks of recovery the promotion
      treatment started and continued for 20 weeks. The results from the present study
      demonstrate that PCB 126 elicit approximately 10% of TCDD's tumour promoting
      activity measured as enhancement of the development of gamma-glutamyl
      transpeptidase-positive altered hepatic foci in the liver. The factor required
      for the PCB to match the response of TCDD was adopted as a toxic equivalency
      factor and was in this case 0.1, which is the same as the factor suggested by
      Ahlborg et al. (1994). In the groups treated with a mixture of PCB 126 and TCDD
      the tumour promoting effect indicated an additive response. This result suggests
      that PCB 126 and TCDD act by the same mechanistical pathway, which in turn,
      supports that the toxic equivalency factor-concept can be used for TCDD-like
      tumour promoters.

PMID- 7796861
TI  - A rat cytomegalovirus infection model as a tool for immunotoxicity testing.
AB  - A rat cytomegalovirus infection model for use in immunotoxicity testing has been
      developed. In resistance against viruses, natural killer cells and cytotoxic T
      cells play an important role. Therefore, this model complements other rat host
      resistance models for immunotoxicity testing, i.e. existing bacterial and
      parasitic infection models in which cytotoxic T-cells and natural killer cells
      play a minor role. Host resistance against cytomegalovirus infections in the rat
      was determined by titrating infectious virus levels in organs after
      cytomegalovirus infection in an in vitro infectivity test denoted as the Plaque
      Forming Unit (PFU) Test. In this test, homogenates of different organs were
      investigated for infectious virus titers on rat embryonic cell monolayers. We
      demonstrated that in the salivary gland, the major target organ for rat
      cytomegalovirus, virus was detectable from 8 days onward after intraperitoneal
      infection. To show that this model is suitable for the detection of
      immunotoxicity four different methods for immunosuppression were investigated: 1.
      gamma-irradiation, 2. congenitally athymic rats, 3. chemically induced
      immunosuppression, 4. ultraviolet-B (UVB) irradiation. Rat cytomegalovirus titers
      in the salivary glands of irradiated (500 rad 1 day prior to infection) or
      congenitally athymic rats were significantly increased as compared to non
      irradiated rats and euthymic control rats respectively. In TOX-Wistar rats, given
      20 or 80 mg bis(tri-n-butyltin)oxide (TBTO) per kg food beginning 6 weeks before
      cytomegalovirus infection, a regimen known to have immunotoxic effects,
      cytomegalovirus titers in the salivary glands were significantly increased as
      compared to non-TBTO-treated cytomegalovirus infected rats.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7796863
TI  - Platelet-activating factor mediates the ozone-induced increase in airway
      microvascular leakage in guinea pigs.
AB  - In the present study, we asked whether platelet-activating factor (PAF) mediates
      the ozone-induced increase in airway microvascular leakage. To answer this
      question, we examined the effect of a PAF receptor antagonist on the ozone
      induced increase in airway microvascular leakage quantified by the extravasation
      of Evans blue dye in the guinea pig trachea and main bronchi. Guinea pigs were
      pretreated with the PAF receptor antagonist, E6123 ((S)-(+)-6-(2-chlorophenyl)-3
      cyclopropane-carbonyl-8,11-dimethyl-2,3,4, 5- tetrahydro-8H
      pyrido[4',3':4,5]thieno[3,2- f][1,2,4]triazolo[4,3-a][1,4]diazepine) (0.01, 0.1
      and 1.0 mg/kg i.v.) and then exposed to 3 ppm ozone for 30 min. The PAF receptor
      antagonist significantly reduced the ozone-induced increase in microvascular
      leakage in a dose-dependent manner in both the trachea and main bronchi. Our
      results indicate that PAF mediates the ozone-induced increase in airway
      microvascular leakage. We therefore suggest that PAF may be involved in ozone
      induced airway inflammation.

PMID- 7796859
TI  - Tumor necrosis factor alpha differentially modulates the cellular response of rat
      hepatocytes in periportal- and pericentral-equivalent cultures.
AB  - Alterations of cellular functions induced by recombinant human tumor necrosis
      factor alpha (TNF alpha) were compared in rat hepatocytes cultured under either
      periportal-equivalent (10 nM insulin; 10 nM glucagon; 13% O2) or perivenous
      equivalent conditions (10 nM insulin; 1 nM glucagon; 4% O2). TNF alpha induced a
      time- and dose-dependent increase in nitric oxide (NO) production and an acute
      phase response (inhibition of albumin secretion and elevation of alpha 2
      macroglobulin production) under both culture conditions. NO production was more
      pronounced in periportal cultures, while the acute phase response was stronger in
      pericentral cultures. This suggests that NO production and the acute phase
      response are controlled by different pathways. After exposure to TNF alpha, DNA
      content was measured fluorimetrically and biochemically. A marked decrease in
      nuclear DNA content was found exclusively in pericentral cultures after an 8-h
      exposure, followed by an elevation of lactic dehydrogenase (LDH) release after a
      12-h exposure. Aurintricarboxylic acid (100 microM), an inhibitor of
      endonuclease, significantly inhibited the TNF alpha-induced decrease in nuclear
      DNA content but only partially inhibited the LDH release. This indicates that the
      loss of nuclear DNA content in pericentral cultures is due to an activation of
      endonuclease and the resulting DNA fragmentation and does not correlate with NO
      production. Furthermore, the release of LDH seems to be only partially associated
      with DNA damage. Dexamethasone (100 nM) completely inhibited both TNF alpha
      induced DNA fragmentation and the elevation of LDH release. The results clearly
      indicate that the toxicity of TNF alpha is influenced by the metabolic state of
      hepatocytes. Accordingly, the preferential perivenous cell injury observed after
      exposure to endotoxins in vivo seems to be due to a higher sensitivity of the
      pericentrally localized hepatocytes towards TNF alpha rather than a TNF alpha
      concentration gradient.

PMID- 7796864
TI  - Mechanisms of interleukin-2-induced depression of hepatic cytochrome P-450 in
      mice.
AB  - Interleukin-2 (15 micrograms/mouse, i.p. twice daily for 4 days and once on the
      5th day) significantly lowered cytochrome P-450 and heme content and increased
      heme oxygenase mRNA accumulation; the activities of 7-ethoxycoumarin O
      deethylase, ethoxy- and pentoxyphenoxazone O-dealkylases were decreased. The
      activity of the type O form of hepatic xanthine oxidase increased, but there was
      no increase in lipid peroxide, expressed in terms of microsomal malondialdehyde.
      In vivo inactivation of xanthine oxidase activity by feeding mice with tungstate
      did not substantially change the degree of interleukin-2-induced cytochrome P-450
      depression, suggesting that the two processes are not causally linked. Induction
      of tolerance to endotoxin by a 4-day pretreatment with lipopolysaccharide
      resulted in 50% protection against this depression despite inhibition of the
      interleukin-2 induced formation of tumor necrosis factor. This suggests that the
      release of tumor necrosis factor per se does not fully account for the depression
      of cytochrome P-450. Dexamethasone, already used in patients to reduce the
      toxicity of interleukin-2 therapy, provided full protection against the
      cytochrome P-450 depression.

PMID- 7796865
TI  - Relaxation of rat thoracic aorta induced by pyridine.
AB  - The pharmacological and toxicological activity of pyridine was determined in rat
      thoracic aorta. Pyridine inhibited norepinephrine (3 microM)-induced phasic and
      tonic contractions in the thoracic aorta as well as the endothelium-denuded aorta
      of the rat. The tonic pre-contraction elicited by norepinephrine was also relaxed
      by the addition of pyridine and this relaxing effect was not affected by
      indomethacin (20 microM), NG-monomethyl-L-arginine acetate (50 microM) or
      methylene blue (50 microM). In high-K+ medium (80 mM), pyridine inhibited the
      Ca2+ concentration-dependent vasocontraction. Moreover, in Ca(2+)-free medium,
      the norepinephrine (3 microM)-induced phasic contraction was also suppressed by
      pyridine, while the caffeine (10 mM)-induced contraction remained unaffected. The
      cAMP and cGMP levels of rat aorta were not changed by pyridine. The 45Ca2+ influx
      elicited by either norepinephrine or high-K+ was inhibited by pyridine in a
      concentration-dependent manner. All of these findings indicated that pyridine
      relaxes rat thoracic aorta by virtue of its Ca2+ channel-blocking properties in
      vascular smooth muscle.

PMID- 7796866
TI  - Effects of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors on
      mitochondrial respiration in ischemic rat hearts.
AB  - The aim of the present study was to examine the effects of 3-hydroxy-3
      methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors on mitochondrial
      respiration in ischemic rat hearts, and to compare the effects between water
      soluble pravastatin and lipid-soluble simvastatin. Either vehicle (0.5%
      carboxymethyl cellulose), pravastatin (2 or 4 mg/kg per day), or simvastatin (1
      or 2 mg/kg per day) was orally administered for 3 weeks. Ischemia was induced by
      ligating the aorta for 60 min in anesthetized open chest rats under artificial
      respiration. The hearts were removed, mitochondria were isolated, and the
      respiration was determined by polarography using glutamate and succinate as
      substrates. When succinate was used as a substrate, the ADP-stimulated
      respiration (QO3) and ATP production per unit oxygen (ADP/O ratio) were decreased
      by ischemia. The decreases in QO3 and ADP/O ratio in the pravastatin- and
      simvastatin-treated groups appeared to be more prominent than those in the
      vehicle-treated group. This was especially true in the simvastatin-treated group.
      The ADP-limited respiration (QO4) with succinate in the vehicle-treated heart was
      slightly increased by ischemia, while that in the pravastatin- or simvastatin
      treated hearts was decreased. In conclusion, HMG-CoA reductase inhibitors may
      result in worsening of myocardial mitochondrial respiration during ischemia.

PMID- 7796867
TI  - Modulation of TCDD-induced wasting syndrome by portocaval anastomosis and
      vagotomy in Long-Evans and Han/Wistar rats.
AB  - Portocaval anastomosis and vagotomy operations were performed in Long-Evans (L-E)
      and Han/Wistar (H/W) rats to elucidate the mechanism of anorexia induced by TCDD
      (2,3,7,8-tetrachlorodibenzo-p-dioxin). TCDD-sensitive L-E rats were given a
      sublethal (5 micrograms/kg) or a lethal dose (20 micrograms/kg) by gavage 5-8
      weeks after portocaval anastomosis. TCDD-resistant H/W rats were given a
      nonlethal dose (500 or 7200 micrograms/kg). The shunt operation did not reduce
      lethality from TCDD. The effect on wasting of the marginally toxic dose of 5
      micrograms/kg in L-E rats was potentiated by the portocaval operation, and the
      lethal dose was effective in both shunted and sham-operated L-E rats. TCDD failed
      to decrease food intake and body weight in shunted rats of H/W strain at either
      dose level though it did so in sham-operated controls. The lack of effect may be
      due to the already reduced weight of shunted rats at the time of TCDD dosing.
      TCDD anorexia was not explained by changes in histamine or serotonin (5-HT)
      turnover in the brain. Vagotomy did not influence lethality after TCDD, although
      reduction in food intake was somewhat blunted in H/W rats. The results seem to
      indicate that the anorectic effect of TCDD is modified when portal blood bypasses
      the liver. The mechanisms remain to be elucidated in detail, but the results do
      not favor the role of liver as the only or the major initiator of TCDD anorexia.
      Little evidence was found to support a crucial role of vagal afferent input.

PMID- 7796868
TI  - Nanomolar concentrations of ouabain block ethanol-inducible Na+,K(+)-ATPase
      activity in brain.
AB  - The effect of low concentrations of ethanol on Na+,K(+)-ATPase activity, defined
      as ouabain-inhibitable 86Rb+ (K+) uptake, was investigated in a crude synaptosome
      preparation which was subject to minimal subcellular fractionation procedures.
      Moderate (20-30%) but potent (EC50 = 3.8 mM) stimulation of total ouabain (1 mM)
      inhibitable K+ uptake by ethanol was observed following incubation periods of up
      to 20 min. The activity of the ethanol-induced component of K+ uptake was
      antagonized by nanomolar concentrations of ouabain. Thus, the moderate
      stimulation of total ouabain-inhibitable K+ uptake by ethanol was attributable to
      the activation of a component of K+ uptake which was very sensitive (VS; IC50 =
      2.8 x 10(-10) M) to inhibition by ouabain. Slightly higher concentrations of
      ouabain (10(-9) - 10(-6.6) M) stimulated K+ uptake above control (no ethanol or
      ouabain) in both the absence and presence of ethanol. The selectivity of the VS
      ethanol interaction was demonstrated by the lack of any ethanol effect on two
      other components of ouabain-inhibitable K+ uptake which accounted for inhibition
      of K+ uptake by concentrations of ouabain above 10(-6.6) M and were defined as
      sensitive (S; IC50 = 10(-6) M) and insensitive (I; IC50 = 10(-4) M) to ouabain.
      These results define the ethanol-inducible component of ouabain-inhibitable
      Na+,K(+)-ATPase activity and promote the view that changes in Na+,K(+)-ATPase
      dependent ion translocation may contribute to ethanol intoxication in vivo.

PMID- 7796869
TI  - Pertussis and cholera toxins modulate kappa-opioid receptor agonists-induced
      hypothermia and gut inhibition.
AB  - In mice pretreated intracerebroventricularly (i.c.v.) with either saline (10
      microliters/mouse), pertussis (1 microgram/mouse) or cholera (2.5
      micrograms/mouse) toxins, effect of kappa-opioid receptor agonists on the colonic
      temperature and charcoal meal transit time were assessed. The kappa-opioid
      receptor agonist, trans-(+)-3,4-dichloro-N-methyl-[2-(1- pyrrolidinyl)cyclohexyl]
      benzeneacetamide methane sulfonate hydrate (U-50488H, 50, 100 and 200
      micrograms/mouse, i.c.v.) produced dose dependent hypothermia. Pertussis toxin
      pretreatment (72 and/or 144 h before) antagonized (P < 0.05) the hypothermic
      effect of U-50488H (100 micrograms/mouse) and (+)-trans-N-methyl-N-[2-(1-
      pyrrolidinyl)cyclohexyl[benz[b]-thio-phene-4-acetamide (PD 117302, 30
      micrograms/mouse). In contrast, cholera toxin pretreatment (48 and/or 96 h
      before) did not antagonize the hypothermic effect of the kappa-opioid receptor
      agonists. Moreover, both i.c.v. and intrathecal (i.t.) administration of kappa
      opioid receptor agonists, U-50488H, }[5R-(5 alpha,7 alpha,8 beta)]-(+/-)-N-methyl
      N-[7-(1- pyrrolidinyl)-1-oxaspiro[4,5]dec-8-yl]-benzeneacetamide? (U-69593) and
      PD 117302, produced dose dependent inhibition of the charcoal meal transit.
      Cholera toxin pretreatment (48 and 96 h before) augmented (P < 0.05) the
      antitransit effect of i.c.v. administered U-50488H (100 micrograms/mouse), U
      69593 (100 micrograms/mouse) and PD 117302 (50 micrograms/mouse). However,
      pertussis toxin pretreatment did not affect the gastrointestinal inhibitory
      effect of the kappa-opioid receptor agonists. The present results extend our
      previous results on the effect of kappa-selective agonists on gastrointestinal
      motility and indicate, like the prototype opiate agonist morphine, kappa-opioid
      receptor agonists are effective in inhibiting the gastrointestinal motility when
      administered either by intrathecal or intracerebroventricular routes.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7796870
TI  - Possible involvement of Ca(2+)-induced Ca2+ release mechanism in Ag(+)-induced
      contracture in frog skeletal muscle.
AB  - To determine if an Ag(+)-induced contracture is associated with the Ca(2+)
      induced Ca2+ release mechanism in the sarcoplasmic reticulum, effects of Ca(2+)
      induced Ca2+ release modulators on the Ag(+)-induced contracture were studied
      with single fibers of frog toe skeletal muscle. The fiber treated with 1 mM
      caffeine contracted significantly much more than controls without caffeine at Ag+
      concentrations below 1 microM. Procaine shifted the Ag+ concentration-tension
      curve to the right, dose-dependently. When 10 mM procaine was applied to
      contracting fibers not treated with caffeine, the duration of 5 microM Ag(+)
      induced contracture was shortened with a little decrease in tension amplitude,
      that was different from the effect of procaine on caffeine contracture. In
      caffeine solution, 0.5 microM Ag+ caused a long-lasting contracture with
      sometimes two peaks. 2 mM procaine led to disappearance of such two peaks,
      resulting in shortening of the contracture. K+ contracture was potentiated by 1
      mM caffeine only at lower concentrations of K+, and inhibited by 10 mM procaine.
      These results suggest that the Ag(+)-induced contracture is composed of two
      components: Ca(2+)-induced Ca2+ release-dependent and -independent. 5 microM
      Ag(+)-induced contracture slowly relaxed with a wavy tension pattern to the
      resting level when 0.05 mM dithiothreitol was applied around peak of the tension.
      This relaxation was accelerated by procaine application. These findings may be
      explained by attributing a portion of Ag(+)-induced contracture to the effect of
      Ca2+ released through the Ca(2+)-induced Ca2+ release mechanism in the
      sarcoplasmic reticulum.

PMID- 7796872
TI  - Antagonism by paraquat of the relaxing effects of acetylcholine and A23187 in rat
      thoracic aorta.
AB  - Paraquat, a widely used herbicide, has been reported to be capable of producing
      superoxide. In the present paper, therefore, the possibility of paraquat
      inhibiting endothelium-dependent relaxation, mediated by the production of nitric
      oxide, was tested. The relaxing effects of acetylcholine and A23187, but not that
      of sodium nitroprusside, in the rat thoracic aorta were found to be inhibited by
      paraquat in a concentration-dependent manner. In contrast, paraquat was totally
      inactive with regard to the aortic contractions induced by either norepinephrine
      or prostaglandin F2 alpha. The inhibitory action of paraquat could be antagonized
      by superoxide dismutase but not by catalase and indomethacin. All of these
      findings indicate that superoxide anions produced by paraquat in the endothelium
      contribute to a decrease in the relaxation response to acetylcholine and A23187
      by interfering with endothelium-derived nitric oxide.

PMID- 7796871
TI  - The tyramine-labelled vesicular transporter for dopamine: a putative target of
      pesticides and neurotoxins.
AB  - This study defined the ability of a large sample of heterogeneous pesticides and
      neurotoxins to interact with the [3H]tyramine-labelled vesicular transporter of
      dopamine in rat striatum. Botanical (with rotenone as the most potent), and
      organochlorine (Kepone) insecticides, as well as fungicides (Zineb), as a whole,
      consistently inhibited [3H]tyramine binding, with Ki values ranging from 5 nM to
      10 microM. ATP/Mg(2+)-dependent [3H]tyramine uptake to purified striatal synaptic
      vesicles was also inhibited by rotenone. Organophosphate and carbamate
      insecticides, and miscellaneous herbicides poorly antagonized [3H]tyramine
      binding, yielding Ki values exceeding 10 microM. Several, though not all, of the
      best recognized central neurotoxins tested were major binding antagonists. Their
      rank order of potency was 1-methyl-4-phenylpyridinium ion (MPP+) > trimethyltin >
      or = 6-hydroxydopamine > N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine (DSP-4) > 1
      methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), with Ki values ranging from 35
      nM to 3 microM. Overall, the potent interaction of selected pesticides and
      chemicals with the vesicular transporter for dopamine, although, by itself, not
      synonymous with neurotoxicity, would argue for a likely impairment of transmitter
      homeostasis, or the putative formation of neurodegenerative toxin pools.

PMID- 7796873
TI  - Inhibition of mitochondrial complexes I and IV by 6-hydroxydopamine.
AB  - The enzymes of mitochondrial respiratory chain, NADH dehydrogenase (complex I)
      and cytochrome c oxidase (complex IV), were completely inhibited by 6
      hydroxydopamine with IC50 = 10.5 microM and IC50 = 34 microM respectively. The
      enzyme inhibition was insensitive to the change of NADH or cytochrome c
      concentrations. The extent of complex I inhibition decreased as a consequence of
      both non-enzymatic and monoamine oxidase-catalyzed oxidation of 6
      hydroxydopamine. Monoamine oxidase A and B inhibitors, tranylcypromine and
      clorgyline but not l-deprenyl increased the extent of 6-hydroxydopamine induced
      inhibition of complex I. Thus, 6-hydroxydopamine itself and not its oxidation
      products may be responsible for the neurotoxicity of this agent via inhibition of
      respiratory chain enzymes.

PMID- 7796874
TI  - N-acetylcysteine protects against age-related decline of oxidative
      phosphorylation in liver mitochondria.
AB  - Since it has been proposed that oxygen radical inactivation of key enzymes plays
      a critical role in cell aging, we have investigated the effects of a thiolic free
      radical scavenger on the oxidative phosphorylation enzymes of liver mitochondria
      from female OF-1 mice. At 48 weeks of age a control group was fed standard food
      pellets and another group received pellets containing 0.3% (w/w) of N
      acetylcysteine. A 24-week treatment resulted in a significant increase in the
      specific activities of complex I, IV and V in the hepatic mitochondria of the N
      acetylcysteine-treated animals as compared to aged controls.

PMID- 7796876
TI  - Effect of N-acetyl-L-cysteine on sepsis in mice.
AB  - The effect of the antioxidant N-acetyl-L-cysteine was studied in a model of
      polymicrobial sepsis induced in CD-1 mice by cecal ligation and puncture. N
      Acetyl-L-cysteine significantly improved survival during the 6 days following
      sepsis induction and caused lower liver toxicity. This effect was not related to
      free radicals generated by xanthine oxidase which was significantly induced in
      liver after cecal ligation and puncture. A specific inhibitor of xanthine
      oxidase, allopurinol, significantly reduced this enzyme and reduced the early
      survival rate. The effect of N-acetyl-L-cysteine was not related either to a
      reduction in tumor necrosis factor production or to a modulation of nitrites or
      to liver glutathione content. These results show that the induction of xanthine
      oxidase is not deleterious in this model of sepsis and suggest that N-acetyl-L
      cysteine works as a direct antioxidant and scavenger of free radicals generated
      from other sources.

PMID- 7796875
TI  - Free radicals irreversibly decrease Ca2+ currents in isolated guinea-pig
      ventricular myocytes.
AB  - The effects of free radicals on voltage-gated Ca2+ currents (ICa) were
      investigated in single guinea-pig ventricular myocytes using the whole-cell clamp
      technique. ICa was measured in the baseline state and after the application of
      free radicals from cumene hydroperoxide or generated from the addition of purine
      to xanthine oxidase. ICa decreased from 846 +/- 533 (S.D.) pA to 688 +/- 444 pA
      (n = 7, P < 0.05) in the presence of 100 microM cumene hydroperoxide and from 708
      +/- 157 pA to 457 +/- 163 pA (n = 5, P < 0.0001) in the presence of 500 microM
      cumene hydroperoxide. ICa also decreased from 1303 +/- 560 pA to 965 +/- 360 pA
      in the presence of the free radical generating system (2.3 mM purine plus 20 U/l
      xanthine oxidase). The reduced ICa could not be restored by washing for up to 5
      min using normal recording solution. We conclude that ICa is decreased in the
      presence of cumene hydroperoxide and an oxygen-derived free radical generating
      system in single guinea-pig ventricular myocytes. The cellular Ca2+ overload
      observed in free radical mediated reperfusion injury is therefore unlikely to
      result from an increase in sarcolemmal Ca2+ entry via voltage-gated Ca2+
      channels.

PMID- 7796877
TI  - Origins and developmental potential of the neural crest.
AB  - Neural crest cells are a migratory population that forms most of the peripheral
      nervous system, facial skeleton, and numerous other derivatives. These cells
      arise from the neural ectoderm and are first recognizable as discrete cells after
      neural tube closure. In this review, I summarize the results of studies from our
      laboratory on neural crest cell lineage and origin. Our recent experiments
      demonstrate that interactions between the presumptive neural plate and the
      nonneural ectoderm are likely to be instrumental in the induction of the avian
      neural crest. Juxtaposition of these tissues at early stages results in the
      formation of neural crest cells at the interface. However, neural crest cells do
      not appear to be segregated from other neuroepithelial cells; cell lineage
      studies have demonstrated that individual precursor cells within the neural tube
      can give rise to both neural crest and neural tube derivatives as diverse as
      sensory, commissural, and motor neurons. This suggests that individual
      neuroectodermal cells are multipotent, such that a precursor within the neural
      tube has the ability to form both neural tube (central nervous system) and neural
      crest (peripheral nervous system and other) derivatives. Further support for
      flexibility in the developmental program of neuroepithelial cells comes from
      experiments in which the cranial neural folds are ablated; this results in
      regulation by the remaining ventral neural tube cells to form neural crest cells
      after the endogenous neural crest is removed. At later stage of development, this
      regulative capacity is lost. Following their emigration from the neural tube,
      neural crest cells become progressively restricted to defined embryonic states.
      Taken together, these experiments demonstrate that: (1) the neural crest is an
      induced population that arises by interactions within the ectoderm; (2)
      initially, progenitor cells are multipotent, having the potential to form
      multiple neural crest and neural tube derivatives; and (3) with time, the
      precursors become progressively restricted to form neural crest derivatives and
      eventually to individual phenotypes.

PMID- 7796878
TI  - Differentiation capacity toward mesenchymal cell lineages of bone marrow stromal
      cells established from temperature-sensitive SV40 T-antigen gene transgenic
      mouse.
AB  - Stromal cell lines were established from bone marrow of temperature-sensitive T
      antigen gene transgenic mice. These stromal cell lines consisted of fibroblasts,
      endothelial cells, and preadipocytes. We found that these stromal cell lines
      exhibited phenotypic changes depending on the inactivation of T-antigen and
      growth condition; one preadipocyte line was induced toward adipocytes and
      osteogenic cells, and several preadipocyte and endothelial cell lines were
      induced toward muscle cells and adipocytes. Some cell lines showed bipotential
      characters. These results indicated that stromal cells consisting of bone marrow
      hematopoietic microenvironment are derived from multipotent mesenchymal stem
      cells.

PMID- 7796879
TI  - Changes in protein kinase C isoenzyme expression associated with apoptosis in
      U937 myelomonocytic cells.
AB  - Spontaneously apoptotic U937 cells from exponentially growing cell cultures were
      enriched on discontinuous Percoll density gradients. Increased PKC-beta and
      reduced PKC-zeta expression were detected in apoptotic cells by Western blotting.
      Using confocal microscopy, changes in the level of PKC isoenzymes were confirmed
      and in addition alterations in the subcellular location of PKC isoenzymes were
      detected in apoptotic cells compared with nonapoptotic cells. The data indicate
      that the expression of specific PKC isoenzymes is modulated during apoptosis and
      that PKC-beta and PKC-zeta may play specific roles in the regulation of the
      apoptotic program.

PMID- 7796880
TI  - A novel protein expressed in mammalian cells undergoing apoptosis.
AB  - Human and rodent cells undergoing apoptosis were observed to express high levels
      of a novel 45,000 M(r) protein. The protein, which we have termed apoptosis
      specific protein (ASP), was found in Burkitt lymphoma (BL) cells and in
      adenovirus-transformed human and rat embryo cells induced into apoptosis by a
      variety of stimuli, including serum deprivation, exposure to the Ca2+ ionophore,
      ionomycin, treatment with inhibitors of macromolecular synthesis (cycloheximide
      and actinomycin D), and cold shock. In BL cells treated with apoptotic stimuli,
      expression of the oncoprotein Bcl-2 was found to both protect from apoptosis and
      prevent expression of ASP. ASP was not detected either in viable cells or in
      cells dying passively by necrosis. Laser scanning confocal microscopy showed high
      levels of ASP in the cytoplasm of cells displaying the chromatin condensation and
      fragmentation patterns typical of apoptosis. Retention of ASP was observed even
      when DNA was no longer detectable, and two-color immunofluorescence staining
      indicated that the protein primarily colocalized with, but was clearly distinct
      from, non-muscle actin. These findings, together with the observation that
      biochemical extraction of ASP was only possible under conditions which caused
      solubilization of the cytoskeleton, leads us to conclude that ASP forms part of,
      or at least strongly associates with, a modified cytoskeleton unique to cells
      undergoing apoptosis. While elucidation of its function will require further
      work, ASP constitutes a powerful marker for the diagnosis and quantitation of
      apoptosis in vivo and in vitro.

PMID- 7796882
TI  - Pamlin, a primary mesenchyme cell adhesion protein, in the basal lamina of the
      sea urchin embryo.
AB  - Pamlin, a primary mesenchyme cell (PMC) adhesion protein, was isolated from the
      blastocoel of embryos of the sea urchin Hemicentrotus pulcherrimus. PMCs isolated
      from mesenchyme blastulae bound exclusively to pamlin. Pamlin is a distinctive
      extracellular matrix (ECM) component from reported ECM molecules in sea urchin
      embryos in its motility on SDS-PAGE gels both with and without 2-mercaptoethanol
      and histological localization. A monoclonal antibody was raised against pamlin,
      and this protein was immunoaffinity purified. The Mr of pamlin shown by SDS-PAGE
      gel analysis under nonreduced conditions was 255 kDa. Under reduced conditions,
      pamlin was cleaved to 180-, 52-, and 23-kDa subunits, indicating the 255-kDa
      protein is an SS-bonded heterotrimer. PMCs bound exclusively to the 52-kDa
      subunit. Mannose residues occur in the larger two subunits, but not in the
      smallest subunit. Pamlin does not run into 4% nondenatured PAGE gels, suggesting
      that the native glycoprotein forms a large polymeric supramolecular configuration
      in vivo. Immunohistochemistry showed that pamlin is seen on the entire basal
      lamina in the blastocoel and hyaline layer of mesenchyme blastulae. In vitro PMC
      migration assays on pamlin show that an optimum amount of pamlin for PMC
      migration was 2.5 micrograms/ml and that a synthetic RGDS peptide inhibited PMC
      migration dose dependently.

PMID- 7796881
TI  - The glucagon gene is transcribed in beta-like pancreatic cells.
AB  - In this report we demonstrate that approximately 1.1 kb of the rat glucagon gene
      promoter upstream of the transcriptional start site specifically directs the
      transcription of the reporter gene chloramphenicol acetyl transferase (CAT) (p[
      1.1]GLU-CAT) in insulinoma beta-TC1 cells. On the contrary, the 350 bp closest to
      the transcription start site (p[-0.35]GLU-CAT) are ineffective in beta-TC1 cells.
      Both constructs are transcriptionally active in InR1-G9 glucagonoma cells. While
      protein kinase A and protein kinase C activators, acting through independent
      pathways, strongly increase both the transcription of p[-1.1]GLU-CAT and the
      accumulation of glucagon transcript in beta-TC1 cells, they are weaker activators
      in InR1-G9 cells. Our experiments suggest that some positive transcription
      control elements, necessary for the glucagon gene transcription in insulinoma
      beta-TC1 cells, are localized in the -350/-1100 region of the glucagon gene.
      Furthermore, our data indicate that glucagon gene transcription can be strongly
      activated through the protein kinase A pathway in some specific cellular
      contexts.

PMID- 7796883
TI  - A monoclonal antibody raised against rat ovarian antigen recognizes Leydig cell
      surface: an immunocytochemical study.
AB  - Using a monoclonal antibody (Mab) against constituents of rat ovarian granulosa
      cells, we found a 59-kDa protein located on the plasma membrane of a number of
      granulosa cells in follicles at different stages of development. This Mab (5G5)
      was found to bind to Leydig cells in rat male gonads. The localization of the
      antigen, recognized by Mab 5G5 in rat testis, was studied by light and electron
      microscopic immunocytochemistry (ABC method and IGS technique). Even though
      Sertoli cells in male gonads are regarded as the counterpart of granulosa cells
      in ovaries, the results of the experiments described here do not allow such an
      interpretation because staining with this antibody was restricted to the Leydig
      cell surface. The immunoreactivity in testicular sections from immature rats was
      similar to that found in adult testicular tissue. Our immunocytochemical results
      indicate that the plasma membrane of Leydig cells in rat male gonads shares
      certain biochemical and molecular properties with rat ovarian granulosa cells. On
      the basis of the immunocytochemical studies reported here, we suggest that the
      antigen recognized by Mab 5G5 may be common to all rat steroidogenic organs.
      Further studies are needed to establish the identity of the antigen in Leydig
      cells as well as its site of synthesis and its site of action. Thus, Mab 5G5
      appears to hold significant potential as a powerful tool for future
      investigations.

PMID- 7796884
TI  - Apoptosis is induced in BHK cells by the tsBN462/13 mutation in the CCG1/TAFII250
      subunit of the TFIID basal transcription factor.
AB  - A temperature-sensitive (ts) mutant of the BHK21 cell line derived from golden
      hamsters, tsBN462 has a mutation in the gene encoding the largest subunit of the
      TFIID complex, TAFII250/p230/CCG1, and arrests in the G1 phase at the
      nonpermissive temperature, 39.5 degrees C. We found that tsBN462 cells underwent
      apoptosis following growth arrest at 39.5 degrees C, suggesting a role for CCG1
      as a repressor of apoptosis. By electron microscopic observation, tsBN462 cells
      at 39.5 degrees C showed characteristic features of apoptosis. Apoptosis was not
      suppressed by expression of Bc1-2 or the adenovirus E1B 19 kDa protein. Cell
      death was suppressed completely by expression of wild-type CCG1 and partially by
      wild-type p53, a growth suppressor protein. Cell cycle arrest induced by p53 may
      help survival of tsBN462 cells at 39.5 degrees C. Apoptosis was accelerated in
      SV40 large T antigen-transformed tsBN462 cells at 39.5 degrees C where SV40 large
      T antigen formed a complex with p53, implying that the apoptosis of tsBN462 cells
      at 39.5 degrees C occurred in a p53-independent manner. Our results suggest that
      CCG1/TAFII250 is required for the expression of factors regulating apoptosis.

PMID- 7796885
TI  - Characterization of human ovarian surface epithelial cells immortalized by human
      papilloma viral oncogenes (HPV-E6E7 ORFs).
AB  - Primary human ovarian surface epithelial (HOSE) cells were immortalized by a
      retroviral vector (LXSN-16E6E7) expressing HPV-E6E7 open reading frames (ORF).
      Immortalizations of primary ovarian epithelial cells were achieved in three of
      three attempts. Detailed analysis was carried out in one line, HOSE 6-3, selected
      on the basis of its epithelial morphology. The immortalized line (HOSE 6-3) was
      nontumorigenic in nude mice when examined at subculture number 20. Cytogenetic
      analysis confirmed its human origin and detailed karyotypic analysis revealed a
      mixed karyotype made up of about 60% of diploid and 40% of near-tetraploid cells.
      Clonal chromosomal aberration was observed in a subpopulation of cells involving
      a ring chromosome number 9. Immunofluorescence and two-dimensional gel
      electrophoresis revealed the presence of vimentin and several species of
      cytokeratin (K7, K8, K18, K19). The profile of the cytoskeletal filaments of HOSE
      6-3 cells is largely identical with that of normal ovarian epithelial cells
      before immortalization. The immortalized ovarian epithelial cells have a lower
      sensitivity to TGF-beta 1 inhibition compared to normal ovarian epithelial cells.
      The immortalized line, HOSE 6-3, has altered growth properties including a higher
      proliferation rate, plating efficiency, and saturation density. The establishment
      of a continuous line of human ovarian epithelial cells may provide an in vitro
      model for study of carcinogenesis in human ovarian cancers.

PMID- 7796886
TI  - Constitutive production of 92-kDa gelatinase B can be suppressed by alterations
      in cell shape.
AB  - We have examined the effect that cell shape has on production of the 92-kDa
      gelatinase B, an enzyme of the matrix metalloproteinase family thought to
      contribute to the invasiveness of both normal and malignant cells. Using the
      agent poly(HEMA) and a human melanoma cell line that constitutively produces both
      the 72- and 92-kDa gelatinases, we have found that alteration in cell shape, that
      is, a change in cell "roundness," resulted in a specific loss of the constitutive
      production of the 92-kDa gelatinase B. To examine this phenomenon further, cells
      were treated with an inhibitor of actin polymerization, cytochalasin D. This
      treatment also resulted in a loss of 92-kDa gelatinase B production, provided the
      cells were treated with drug from the out-set of the experiment. If the cells
      were allowed to attach and spread prior to drug exposure, no loss of 92-kDa
      gelatinase B production was observed. Similar to the poly (HEMA) results,
      cytochalasin D had little effect on production of the 72-kDa gelatinase A.
      Treatment with the tubulin polymerization inhibitor colchicine had no effect on
      92-kDa gelatinase B production, nor did growth of the cells as three-dimensional
      tumor spheroids, although an alteration in cell morphology was observed in both
      instances. This phenomenon was studied in another system, namely, HL-60 cells,
      which were induced to differentiate into macrophage-like cells in response to TPA
      treatment and consequently produce the 92-kDa gelatinase B. HL-60 cells treated
      with TPA and cytochalasin D failed to produce the 92-kDa gelatinase B. These
      results suggest that the 92-kDa gelatinase B can be regulated by alterations in
      cell shape but more specifically, by alterations in the organization of the actin
      cytoskeleton. Furthermore, the mechanism responsible for cell shape/actin
      cytoskeletal down-regulation of the 92-kDa gelatinase B may be common to many
      cell types competent to produce this enzymatic activity.

PMID- 7796887
TI  - Retinoic acid-induced heparin binding protein (RIHB) binds to embryonal
      chondrocytes and cartilage primarily via proteoglycans.
AB  - Retinoic acid-induced heparin binding protein (RIHB) is a highly basic, secreted
      polypeptide expressed during early chick embryogenesis. We have characterized the
      binding of 125I-labeled RIHB to embryonal chondrocytes in culture. No saturable,
      high-affinity binding can be observed on these cells. Furthermore, no 125I
      labeled RIHB was internalized into the chondrocytes at 37 degrees C. The low
      affinity binding of 125I-labeled RIHB observed can be competed with another
      heparin binding factor, fibroblast growth factor 2, as efficiently as with
      unlabeled RIHB. The binding can also be almost completely inhibited by
      preincubation of the 125I-labeled RIHB with heparin or with a monoclonal antibody
      which recognizes the heparin binding site of both RIHB and HBNF. When cross
      linking experiments are performed with 125I-labeled RIHB, specific RIHB
      containing high-molecular-weight complexes are observed; however, these represent
      only a very small fraction of the bound material. Immunohistochemical analyses of
      embryonic wing cartilage demonstrate that a significant fraction of bound RIHB
      can be removed from unfixed tissue simply by rinsing with phosphate-buffered
      saline. The remaining RIHB can be removed partially by incubation with
      heparitinase I or III and completely when the incubation is performed with
      chondoitinase A, B, C. These results demonstrate that RIHB binds to embryonal
      chondrocytes and cartilage primarily through proteoglycans of both heparan
      sulfate and chondroitin sulfate types.

PMID- 7796889
TI  - Cell cycle-related changes in F-actin distribution are correlated with glycolytic
      activity.
AB  - XTH-2 cells, a cell line derived from tadpole heart endothelial cells, were
      blocked at the end of the G1 phase of the cell cycle using desoxyguanosine (dG).
      Stress fibers are the dominant actin fibril structure in blocked cells. They
      disappear starting with the release of the dG block until the G2 phase of the
      cell cycle. In addition, after the release peripheral lamellae and microspikes
      appear, indicating increased surface motility of the cells. Concomitantly with
      these changes, net lactic acid production is increased while oxygen consumption
      remains constant. Increase in the content of F-actin per cell takes place only in
      subconfluent cultures. Similar morphological changes (organization of F-actin)
      have been induced by phorbol myristate acetate treatment. These are also
      accompanied by an increase in lactic acid production and unaltered oxygen
      consumption. Therefore, the changes in energy metabolism are supposed to result
      from the rearrangement of the F-actin network: The emanating loose fibrillar
      pattern provides an increased surface for the association with glycolytic
      enzymes, which enhances enzyme activity and represents a more motile state. The
      increased energy demand of the more motile structures is supplied predominantly
      by ATP derived from glycolysis.

PMID- 7796888
TI  - Microtubule integrity is necessary for the epithelial barrier function of
      cultured thyroid cell monolayers.
AB  - Vectorial transport in the thyroid epithelium requires an efficient barrier
      against passive paracellular flux, a role which is principally performed by the
      tight junction (zonula occludens). There is increasing evidence that tight
      junction integrity is determined by integral and peripheral membrane proteins
      which interact with the cell cytoskeleton. Although the contribution of the actin
      cytoskeleton to tight junction physiology has been intensively studied, less is
      known about possible interactions with microtubules. In the present study we used
      electrophysiological and immunohistochemical approaches to investigate the
      contribution of microtubules to the paracellular barrier in cultured thyroid cell
      monolayers which displayed a high transepithelial electrical resistance (6000
      9000 ohm.cm2). Colchicine (1 microM) caused a progressive fall in electrical
      resistance to < 10% of baseline after 6 h and depolarization of the
      transepithelial electrical potential difference consistent with a significant
      increase in paracellular permeability. The effect of colchicine on TER was not
      affected by agents which inhibit the major apical conductances of thyroid cells
      but was reversed upon removal of the drug. Immunofluorescent staining for tubulin
      combined with confocal laser scanning microscopy demonstrated that thyroid cells
      possessed a dense microtubule network extending throughout the cytoplasm which
      was destroyed by colchicine. Colchicine also produced changes in the localization
      of the tight junction-associated protein, ZO-1: its normally continuous
      junctional distribution was disrupted by striking discontinuities and the
      appearance of many fine strands which extended into the cytoplasm. A similar
      disruption in E-cadherin staining was also observed, but colchicine did not
      affect the distribution of vinculin associated with adherens junctions nor the
      integrity of the perijunctional actin ring. We conclude that microtubules are
      necessary for the functional and structural integrity of tight junctions in this
      electrically tight, transporting epithelium.

PMID- 7796890
TI  - Analysis of the plasminogen system on rat glomerular epithelial cells.
AB  - Rat glomerular epithelial cells were grown to confluency on semipermeable tissue
      culture inserts and the plasminogen system of these cells was analyzed using
      enzyme assays, Western analysis, zymography, and reverse transcriptase-PCR. The
      glomerular epithelial cells are capable of activating exogenous plasminogen to
      plasmin by endogenous plasminogen activators. The cells produce both tissue
      plasminogen activator and urokinase-plasminogen activator with urokinase being
      the prominent activator. Both activators are present primarily on the basolateral
      side of the cells with urokinase found primarily at the cell surface presumably
      bound to its receptor and tissue-plasminogen activator found primarily in the
      matrix secreted by the cells on the semipermeable insert. The cells also produce
      plasminogen activator inhibitor-1 and urokinase-plasminogen activator receptor.
      Inhibition of plasminogen activation occurred with plasminogen activator
      inhibitor-1, anti-catalytic anti-tissue-plasminogen activator antibody, epsilon
      aminocaproic acid, which inhibits the binding of plasminogen through its lysine
      binding sites, and amiloride, which specifically inhibits urokinase.

PMID- 7796891
TI  - Mechanisms of activation and suppression in rat Nb 2 lymphoma cells: a model for
      interactions between prolactin and the immune system.
AB  - Rat Nb 2 lymphoma cells have been widely used to bioassay human growth hormone
      and many species of prolactin. Because their morphologic characterization
      suggests a T-cell lineage, Nb 2 cells were examined for their response to the T
      cell mitogens concanavalin A, pokeweed mitogen, and phytohemagglutinin P. As
      expected, a dose-response to rat prolactin was observed; however, attempts to
      induce proliferation using the conventional T-cell mitogens failed at
      concentrations normally stimulatory for rat primary lymphocytes. Moreover, when
      Nb 2 cells were simultaneously incubated with lectin plus a suboptimal
      concentration of prolactin, a dose-dependent suppression of the stimulatory
      effects of prolactin was observed with phytohemagglutinin P and pokeweed mitogen,
      although not with concanavalin A. Culture medium of prolactin-stimulated Nb 2
      cells also contained a factor which inhibited normal rat lymphocyte activation by
      concanavalin A. The factor did not block induction of the IL-2 receptor and
      proliferation of IL-2-dependent CTLL-2 cells could be restored by exogenous IL-2.
      Because Nb 2 cells evolved from a lactogen-dependent lymph node tumor, these
      results may have implications for further understanding the role of pituitary
      hormones, particularly prolactin, in the immune response to hormone-dependent
      tumor progression.

PMID- 7796892
TI  - The presence and role of transmembrane transforming growth factor-alpha in
      cultures of rat liver epithelial cells.
AB  - We assessed the presence and the role of membrane TGF-alpha in two rat liver
      epithelial cell lines, either parental or transfected with c-fos proto-oncogene.
      c-fos overexpressing cells had more TGF-alpha-like activity in their membranes.
      When TGF-alpha was removed by elastase or neutralized, the growth rates of both
      cell lines were markedly reduced, but to a higher extent for parental cells. If
      membrane TGF-alpha seemed to play a key contribution in normal cell growth, both
      cell lines were unable to react to the addition of soluble TGF-alpha, showing
      that these two forms of growth factors are not equivalent.

PMID- 7796893
TI  - Prohibitin antiproliferative activity and lack of heterozygosity in immortalized
      cell lines.
AB  - Experiments were performed to determine whether prohibitin, an evolutionarily
      conserved gene with antiproliferative activity, has a role in cellular
      immortalization. A cell proliferation assay was used to examine one human cell
      line from each of four established immortal complementation groups, termed A, B,
      C, and D, and a normal human diploid fibroblast line. Only normal and Group B
      cells were inhibited from traversing the cell cycle after introduction of wild
      type prohibitin transcript. All of the immortalized cells expressed elevated
      levels of prohibitin mRNA and protein. Prohibitin gene structural
      characterization using Southern and single-strand conformation polymorphism
      (SSCP) analyses distinguished two alleles. One is cleaved at a polymorphic
      intronic EcoRI site, exhibits an exon 6-associated SSCP, and is homozygous only
      in Group B cells. The other is not cleaved at the EcoRI site, has a different
      exon 6 SSCP pattern, and is homozygous in Groups A, C, and D. In contrast, normal
      cells are heterozygous for the alleles. These results suggest that prohibitin may
      play a role as a tumor suppressor in the immortalization of Group B cells.

PMID- 7796894
TI  - Apoptosis induced by IL-2 withdrawal is associated with an intracellular
      acidification.
AB  - It is known that phorbol esters can protect IL-2-dependent lymphocytes against
      apoptosis induced by IL-2 withdrawal. However, the mechanism of this effect
      remains unclear. In this article we show that apoptosis induced by IL-2
      withdrawal in the CTLL-2 cell line correlates with a decrease in intracellular pH
      (pHi). Supplementing the incubation medium with phorbol esters during IL-2
      deprivation protects CTLL-2 cells against both apoptosis and intracellular
      acidification. Interestingly, IL-4 also supports short-term cell survival and
      maintenance of normal pHi. The protein kinase inhibitor staurosporine prevents
      the protective effects of IL-2, PMA, and IL-4 on apoptosis and intracellular
      acidification. In contrast, inhibition of the Na+/H+ antiporter by 5-N-ethyl-N
      isopropyl amiloride reverts the protective effects of PMA and IL-4, but only
      weakly affects IL-2-mediated suppression of apoptosis. Taken together, these
      results indicate that intracellular acidification may be an important event
      during apoptosis induced by IL-2 deprivation in the CTLL-2 cell line. Moreover,
      they suggest a key role for protein kinase C activation both in the maintenance
      of pHi and in the suppression of apoptosis, through mechanisms which rely on the
      activation of the Na+/H+ antiporter to a different extent, depending on the
      rescuing factor employed.

PMID- 7796895
TI  - Accumulation of histone H1(0) during early Xenopus laevis development.
AB  - It is known that a transition in the linker-histone variants takes place within
      chromatin during early development of Xenopus laevis; a cleavage-type H1 is
      replaced by the somatic type. Based on cytofluorimetric analysis of the
      distribution of the embryo cells in the cell cycle, we showed that this
      previously described transition occurs when significant modifications of the
      proliferative capacities of the cells occur. Moreover, this analysis allowed us
      to show that cell proliferation decreases gradually after the gastrula stage of
      development. This period terminates with the arrest of more than 90% of cells in
      the G0/G1 phase of the cell cycle at stage 45. We showed that the major
      accumulation of the differentiation-specific H1 subtype, histone H1(0), occurs at
      this time. H1(0), first detected in a restricted set of tissues, is then widely
      expressed during the later development at stage 45. Moreover, the double staining
      of nuclei isolated from embryo cells, for H1(0) and DNA, allowed us to show that
      this accumulation of H1(0) is not restricted to arrested cells. The example of
      the Xenopus early development shows that there may be an adaptation of the type
      of H1 expressed to the proliferative abilities of cells. This observation may
      provide insight into the significance of the expression of different H1 subtypes
      during development.

PMID- 7796896
TI  - Factors hindering access to abortion services.
AB  - Although abortion services are readily available in large urban areas to those
      able to pay, a 1993 survey of U.S. abortion providers shows that access to
      service is still problematic for many women because of barriers related to
      distance, gestation limits, costs and harassment. Among women who have
      nonhospital abortions, an estimated 24% travel at least 50 miles from their home
      to the abortion facility. Although 98% of providers will perform abortions at
      eight weeks after the last menstrual period, only 48% will perform abortions at
      13 weeks and 13% at 21 weeks. Half of nonhospital abortion providers estimate
      that more than four days elapse on average between their patients' first
      telephone contact and the date of the procedure; one in seven say that more than
      one week elapses. Most women are able to obtain abortion services in one visit to
      a clinic. The average woman having a first-trimester nonhospital abortion with
      local anesthesia paid $296 for the procedure in 1993, up from $251 in 1989. On
      average, nonhospital facilities charged $604 at 16 weeks of gestation and $1,067
      at 20 weeks. Eighty-six percent of nonhospital facilities providing 400 or more
      abortions in 1992 were the targets of antiabortion harassment. Picketing at
      facilities and the homes of staff members, vandalism and chemical attacks
      increased significantly between 1988 and 1992, but the incidence of bomb threats
      decreased.

PMID- 7796897
TI  - The impact of an increase in family planning services on the teenage population
      of Philadelphia.
AB  - In an assessment conducted 30 months after a Philadelphia-area project increased
      the resources that community family planning agencies devoted to teenage
      services, teenagers in targeted communities showed no generalized improvement in
      rates of pregnancy and childbearing, in knowledge or use of clinic services, or
      in attitudes toward contraception compared with those of teenagers in the entire
      city. Samples of adolescents aged 14-18 from the clinics' catchment areas and
      from the entire city were interviewed in mid-1988, when the project's activities
      began, and 2.5 years later. The results suggest that while community family
      planning clinics may provide effective services to the teenagers who seek them
      out, they may not be the most effective strategy for decreasing rates of
      pregnancy and childbearing in the overall teenage population.

PMID- 7796899
TI  - Using induced abortion to measure contraceptive efficacy.
AB  - Data from a 1989-1990 case-control study of contraceptive efficacy in Norway
      compare contraceptive use among women who requested an abortion (1,386 cases)
      with women who responded to a general fertility survey (2,627 controls). In a
      logistic regression analysis measuring contraceptive efficacy as the odds of
      avoiding a pregnancy that terminated in an induced abortion compared with the
      odds for nonuse, consistent condom use was found to lower fecundity by 88.9%,
      diaphragm use by 89.3%, the pill by 97.8%, the IUD by 97.6%, vasectomy by 99.5%,
      and female sterilization by 99.8%. The relative contraceptive efficacy of the
      condom, the IUD and the pill did not vary by marital status or parity but did
      vary with age; the proportion by which each of these methods reduced fecundity
      declined among successively older age-groups.

PMID- 7796898
TI  - Are primary care residents adequately prepared to care for women of reproductive
      age?
AB  - A 1991 study of 115 internal medicine and 28 family practice residents at a large
      inner-city public hospital finds that both groups would perform poorly in
      providing preconception counseling to women of reproductive age. More than 40% of
      residents failed to indicate that they would provide a healthy woman with
      information on rubella immunization and family planning or counseling on sexually
      transmitted diseases and safer sex. When counseling a diabetic woman seeking
      pregnancy, 74% would not have discussed congenital anomalies with her and 45%
      would not have considered discontinuing oral hypoglycemics if she became
      pregnant. Furthermore, 58% would have neglected to review or change hypertension
      medications in a newly diagnosed pregnant woman. Although both internal medicine
      and family practice residents had positive attitudes toward offering
      preconception care, family practice residents had significantly higher attitude
      scores. No clear improvement was found in patient management, attitude or
      knowledge scores as residents progressed from their first to their third year of
      training.

PMID- 7796900
TI  - Combined use of condoms with other contraceptive methods among inner-city
      Baltimore women.
AB  - Data from a street survey conducted among 717 women aged 17-35 in two inner-city
      Baltimore communities in 1991-1992 indicate that 17% of the entire sample, 38% of
      women using the pill and 11% of users of methods other than the pill used a
      condom in addition to another method the last time they had intercourse. Although
      adolescents reported the highest rate of combined condom and pill use (22% of 17
      19-year-olds), condom use was significantly associated with pill use among adult
      women (odds ratio of 1.57) but not among adolescents (odds ratio of 1.03). Condom
      use was negatively associated with use of methods such as the diaphragm, the IUD,
      the implant and the sponge (odds ratio of 0.21) among both adolescents and
      adults. Logistic regression analyses show that positive attitudes toward safer
      sex, ever having refused sex without a condom and believing in condom efficacy
      all significantly predicted use of the condom with another method. Having ever
      been tested for HIV was negatively related to combined use, while behavioral risk
      factors showed no association.

PMID- 7796901
TI  - High-risk sexual behavior at a midwestern university: a confirmatory survey.
AB  - According to a 1991 study of sexual behavior based on a random sample of
      heterosexual undergraduates at a Midwestern university, 80% of the males and 73%
      of the females had experienced vaginal or anal intercourse. The average age at
      first vaginal intercourse was 17.2 years for both sexes. Seventeen percent of the
      sexually experienced males and 18% of the sexually experienced females had
      engaged in heterosexual anal intercourse; among these respondents, the average
      age at first anal intercourse was 20.3 for males and 19.1 for females. Although
      less than four years, on average, had elapsed since the respondents had first had
      vaginal intercourse, males reported an average of 8.0 lifetime vaginal-sex
      partners and females reported an average of 6.1. Overall, the findings from this
      random sample of students are similar to those from a 1988 convenience sample of
      the same college population.

PMID- 7796903
TI  - Cyclin-dependent kinases and pRb: regulators of the proliferation-differentiation
      switch.
AB  - The retinoblastoma susceptibility gene (RB1) is essential for normal embryonic
      development. Loss of RB1 leads to uncontrolled proliferation of a number of cell
      types but may also prevent proper terminal differentiation. The growth
      suppressive and differentiation-inducing properties of pRb are impaired by cyclin
      dependent kinase (cdk)-mediated phosphorylation. Hence, inhibition of cdk
      activity is probably a prerequisite for terminal differentiation. Indeed, forced
      cyclin or cdk expression can prevent terminal differentiation in various cell
      types, probably through inhibition of pRb and, possibly, differentiation-specific
      transcription factors.

PMID- 7796902
TI  - State actions on reproductive health issues in 1994.

PMID- 7796904
TI  - The proton-pumping respiratory complex I of bacteria and mitochondria and its
      homologue in chloroplasts.
AB  - The proton-pumping NADH:ubiquinone oxidoreductase, also called complex I, is the
      first of the respiratory complexes providing the proton motive force which is
      essential for the synthesis of ATP. Closely related forms of this complex exist
      in the mitochondria of eucaryotes and in the plasma membranes of purple bacteria.
      The minimal structural framework common to the mitochondrial and the bacterial
      complex is composed of 14 polypeptides with 1 FMN and 6-8 iron-sulfur clusters as
      prosthetic groups. The mitochondrial complex contains many accessory subunits for
      which no homologous counterparts exist in the bacterial complex. Genes for 11 of
      the 14 minimal subunits are also found in the plastidial DNA of plants and in the
      genome of cyanobacteria. However, genes encoding the 3 subunits of the NADH
      dehydrogenase part of complex I are apparently missing in these species. The
      possibility is discussed that chloroplasts and cyanobacteria contain a complex I
      equipped with a different electron input device. This complex may work as a
      NAD(P)H: or a ferredoxin:plastoquinone oxidoreductase participating in cyclic
      electron transport during photosynthesis.

PMID- 7796905
TI  - A kinetic model for comparing proteolytic processing activity and inhibitor
      resistance potential of mutant HIV-1 proteases.
AB  - A kinetic model is presented for the comparison of potential proteolytic
      processing activities of wild-type and mutant human immunodeficiency virus
      proteases in the presence and absence of protease inhibitors. The protease
      processing of gag substrate in the immature virions is assessed by the kinetic
      parameters, kcat, Km and Ki. The relationship of the estimated potential
      processing activities to the viability of the HIV mutants and their tendencies to
      resist inhibitors also are discussed. A fully developed model has the potential
      to stimulate the results of inhibitor resistance either in vivo or in cell
      culture.

PMID- 7796906
TI  - STE2/SCG1-dependent inhibition of STE4-induced growth arrest by mutant STE4 delta
      C6 in the yeast pheromone response pathway.
AB  - The yeast pheromone response pathway involves the activation of a heterotrimeric
      G protein composed by SCG1 (alpha) (also GPA1), STE4 (beta), and STE18 (gamma)
      subunits by the pheromone-activated receptors STE2 and STE3 in a and alpha cells,
      respectively. Upon exchange of bound GDP for GTP in the SCG1 subunit, the release
      of STE4/STE18 dimer occurs which, in turn causes activation of downstream
      effectors leading growth arrest and mating competence. Over-expression of STE4
      also leads to growth arrest in a STE18 dependent manner. Removal of 6 amino acids
      from the C-terminus of STE4 rendered a subunit incapable of downstream signalling
      but still able to interact with STE18. This delta C6 mutant acts as a dominant
      negative because it blocks the growth arresting effect obtained by over
      expression of STE4. The inhibitory effect of STE4 delta C6 is dependent on the
      presence of the SCG1 subunit in a STE2 but not ste2 background. Inhibition of the
      growth arresting effect of STE4 by the delta C6 mutant is not due to competition
      at the effector site, but rather involves an intrinsic activity of STE2 that is
      dependent on SCG1.

PMID- 7796907
TI  - Cloning, functional expression and mRNA distribution of an inwardly rectifying
      potassium channel protein.
AB  - In GH3/B6 cells at least two different inward K+ currents are observed that are
      regulated by thyrotropin-releasing hormone and somatostatin, respectively. Using
      a polymerase chain reaction based approach a cDNA was isolated and functionally
      expressed in human embryonic kidney cells that encodes an inward rectifier K+
      channel, rIRK3, with a predicted molecular mass of 49.7 kDa. Corresponding
      transcripts of 2.6 kb have been detected in rat brain, pituitary and GH3/B6
      cells. In situ hybridization revealed that rIRK3 mRNA is distributed throughout
      the brain and occurs predominantly in the piriform cortex, indusium griseum,
      supraoptic nucleus, facial nucleus and cerebellar Purkinje cells.

PMID- 7796908
TI  - Identification of a mitochondrial form of kynurenine aminotransferase/glutamine
      transaminase K from rat brain.
AB  - A soluble aminotransferase with kynurenine aminotransferase (KAT) activity has
      been recently isolated from rat brain. This enzyme corresponds to a cytosolic
      form of glutamine transaminase K (GTK). In addition to the cytosolic enzyme, a
      mitochondrial-associated form of this KAT/GTK also exists. In the present work we
      have isolated a rat brain cDNA clone encoding a KAT/GTK enzyme identical to the
      soluble form but carrying an additional stretch of 32 amino acids at its NH2
      terminus. Several structural features of this sequence resemble those of leader
      peptides for mitochondrial import. Evidence that the isolated cDNA encoded for
      mitochondrial KAT/GTK was obtained after transfection of HEK-293 cells with the
      cDNA coding for this new KAT/GTK isoenzyme. In fact, a significant enrichment of
      both KAT and GTK enzymatic activities was found in the crude mitochondrial
      fraction of the transfected cells.

PMID- 7796909
TI  - Cloning and expression of the cDNA coding for the erythrocyte isoenzyme of human
      acylphosphatase.
AB  - Three independent cDNAs coding for the erythrocyte isoform of human
      acylphosphatase were isolated and characterized. All the clones were incomplete
      at the 5' end, but Northern blot analysis using the cDNA as a probe showed the
      presence of an unusually long mRNA 5'-untranslated region. The transcript was
      present in a variety of human cell lines of different origins, although at
      different levels. Southern blot analysis on DNA from different individuals
      revealed a simple hybridization pattern. Large amounts of pure enzyme with
      kinetic characteristics very similar to those of the native protein were
      expressed in E. coli.

PMID- 7796910
TI  - Site specificity of p72syk protein tyrosine kinase: efficient phosphorylation of
      motifs recognized by Src homology 2 domains of the Src family.
AB  - Protein tyrosine kinase p72syk purified from rat spleen has been assayed for its
      ability to phosphorylate a number of peptide substrates derived from naturally
      occurring phospho-acceptor sites. The phosphorylation efficiency is extremely
      variable, depending on the peptide sequence, with Km values in the 3-1500 microM
      range. The by far best peptide substrates, with Km values of 3 and 4 microM are
      those reproducing the phospho-acceptor sites of Vav and HS1 proteins,
      respectively. These sites include multiple acidic residues flanking tyrosine on
      both sides and they also display the consensus sequences (YEDL and YEEV)
      preferred by the SH2 domains of the Src family. Alteration of this consensus in
      the HS1 peptide, by replacing either the glutamic acid or valine, also reduces
      the phosphorylation efficiency by p72syk. Also the replacement of acidic residues
      at position -1 and, to a lesser extent at positions -3 and -4 (but not at
      positions +3 and +5) are detrimental. These observations may suggest a role of
      p72syk in the recruitment of ligands/substrates for the Src family enzymes. We
      also show that the HS1 peptide can be used for the specific monitoring of p72syk
      since neither the two Src-related c-Fgr and Lyn kinases (needing a hydrophobic
      instead of acidic residue at position -1) nor CSK appreciably phosphorylate it.

PMID- 7796911
TI  - Complete separation of the beta,epsilon- and beta,beta-carotenoid biosynthetic
      pathways by a unique mutation of the lycopene cyclase in the green alga,
      Scenedesmus obliquus.
AB  - The mutant, C-2A'-34, lacks the beta, epsilon-carotenoids, alpha-carotene, lutein
      and loroxanthin. When grown under heterotrophic or mixotropic conditions this
      strain develops significantly higher levels of beta-carotene and violaxanthin
      than does the original developmental mutant of Scenedesmus, C-2A'. The decrease
      in chlorophyll a and chlorophyll b observed in C-2A'-34 is accompanied by the
      near absence of the LHC. The light intensity dependence of greening of this
      strain is comparable to that of C-2A'; the loss of the beta,epsilon-carotenoids
      and modification of the pool of beta,beta-carotenoids neither prevent the
      proximal pigment-protein complexes of photosystems I and II from developing nor
      cause any short term photosensitivity. The increase in the beta,beta-carotenoids
      in C-2A'-34 apparently compensates for the loss of the beta,epsilon-carotenoids
      required in formation of the proximal and distal antennae systems but not in the
      LHCs.

PMID- 7796912
TI  - Green-fluorescent protein mutants with altered fluorescence excitation spectra.
AB  - Using random mutagenesis and visual selection of fluorescent clones, we have
      isolated a T203I and a E222G mutant of the Aequorea green-fluorescent protein.
      Each mutant has one of the two fluorescence excitation bands of the wild type
      deleted and retains the other without a wavelength shift. This finding is
      consistent with each excitation band corresponding to a distinct spectroscopic
      state of the chromophore. Both mutations are single amino acid exchanges which in
      the linear sequence are located remotely from the chromophore but in the folded
      protein may be situated in its vicinity. We conclude that the mutations influence
      the fluorescence properties by changing the interactions between the chromophore
      and its protein environment.

PMID- 7796913
TI  - Unreliability of carotenoid electrochromism for the measure of electrical
      potential differences induced by ATP hydrolysis in bacterial chromatophores.
AB  - ATP hydrolysis induces the activation of the proton ATPase in chromatophores of
      Rhodobacter capsulatus supplemented with nigericine and 50 mM K+ (i.e. when delta
      pH < 0.2 units). The value of transmembrane electric potential (delta phi)
      driving this activation was measured using three different approaches: carotenoid
      electrochromism, uptake of SCN- and responses of the dye oxonol VI. The value of
      delta phi calculated from the SCN- uptake, on the basis of an internal volume
      determined experimentally, was about 140 mV, while that indicated by the
      electrochromic signal ranged between 35 and 70 mV. Only the value indicated by
      SCN- distribution is consistent with the energetic requirement for the activation
      of H(+)-ATPase.

PMID- 7796914
TI  - Effect of the Ca2+ channel activator CGP 28392 on reactivation of oxygen
      evolution of Ca(2+)-depleted photosystem II.
AB  - The effect of the Calcium channel activator, CGP 28392, on the reactivation of
      oxygen evolution in Ca(2+)-depleted Photosystem II (PS II) particles has been
      investigated. Ca(2+)-binding is associated with a functional water splitting
      complex of PS II. In the presence of the activator, a low affinity site of Ca(2+)
      binding is converted into a high affinity binding site. Following removal of the
      extrinsic proteins (17 and 23 kDa), any effect of the activator is no longer
      observed. Ca2+ channel inhibitors can inhibit the Ca(2+)-dependent reactivation
      of oxygen evolution. The activator partially protects against this type of
      inhibition. It is suggested that the extrinsic proteins form a Ca2+ channel-like
      structure at the donor side of PS II.

PMID- 7796915
TI  - A novel enzyme, maltose 1-epimerase from Lactobacillus brevis IFO 3345.
AB  - A novel enzyme, maltose 1-epimerase (MER), that catalyzes the interconversion of
      alpha and beta anomers of maltose was found in a cell-free extract of
      Lactobacillus brevis IFO 3345, and MER was purified to homogeneity from the crude
      extract. The M(r) of the enzyme was estimated to be 43,000 and 45,000 by HPLC gel
      filtration and SDS-PAGE, respectively. It showed optimum activity at pH 6.5-7.0.
      This novel enzyme catalyzed the conversion of beta-maltose more effectively than
      disaccharides such as alpha-lactose and beta-cellobiose, whereas the relative
      velocities for beta- and alpha-D-glucose were about one forth of that for beta
      maltose.

PMID- 7796916
TI  - Behavior of Rhizobium meliloti in oxygen gradients.
AB  - Rhizobium meliloti cells responded to an abrupt change in oxygen concentration by
      changing the cell speed (chemokinesis), but they did not alter the frequency at
      which swimming cells stopped briefly (aerotaxis). Changes in cell speed upon
      stimulation with oxygen coincided with changes in membrane potential. The cells
      did not form an aerotactic band in a spatial gradient of oxygen as do the cells
      of other bacterial species. The fixL and fixJ genes which encode a heme
      containing protein kinase that senses oxygen and a response regulator,
      respectively, were not involved in the behavior of R. meliloti in oxygen
      gradients.

PMID- 7796918
TI  - Apoptosis without decrease of cell DNA content.
AB  - Apoptosis of human B cells and murine T and B cells was analyzed by DNA agarose
      gel electrophoresis, clamped homogeneous electric field, measurement of cell DNA
      content by flow cytometry, transmission electron microscopy and by UV microscopy.
      Apoptosis was induced by etoposide (an inhibitor of topoisomerase II), by the
      calcium ionophore ionomycin or by cross-linking of membrane immunoglobulins (Ig)
      with anti-Ig-antibodies. Two types of apoptosis could be defined. Apoptosis
      resulting in small DNA fragments (180-200 base pairs and multiples thereof) was
      associated with a typical 'ladder' in agarose gel electrophoresis and a decrease
      in cell DNA content assessed by flow cytometry. Conversely apoptosis with large
      DNA fragments (100-150 kilobase pairs) was only demonstrated by clamped
      homogeneous electric field but was not associated with decreased cell DNA content
      or the observation of DNA ladders. Nuclear condensation without fragmentation was
      more frequent when apoptosis generated large DNA fragments. The type of apoptosis
      appears to be an intrinsic property of each cell type.

PMID- 7796917
TI  - Atomic structure at 2.5 A resolution of uridine phosphorylase from E. coli as
      refined in the monoclinic crystal lattice.
AB  - Uridine phosphorylase from E. coli (Upase) has been crystallized using vapor
      diffusion technique in a new monoclinic crystal form. The structure was
      determined by the molecular replacement method at 2.5 A resolution. The
      coordinates of the trigonal crystal form were used as a starting model and the
      refinement by the program XPLOR led to the R-factor of 18.6%. The amino acid fold
      of the protein was found to be the same as that in the trigonal crystals. The
      positions of flexible regions were refined. The conclusion about the involvement
      in the active site is in good agreement with the results of the biochemical
      experiments.

PMID- 7796919
TI  - Characterization and variation of a human inwardly-rectifying-K-channel gene
      (KCNJ6): a putative ATP-sensitive K-channel subunit.
AB  - The ATP-sensitive K-channel plays a central role in insulin release from
      pancreatic beta-cells. We report here the cloning of the gene (KCNJ6) encoding a
      putative subunit of a human ATP-sensitive K-channel expressed in brain and beta
      cells, and characterisation of its exon-intron structure. Screening of a somatic
      cell mapping panel and fluorescent in situ hybridization place the gene on
      chromosome 21 (21q22.1-22.2). Analysis of single-stranded conformational
      polymorphisms revealed the presence of two silent polymorphisms (Pro-149: CCG-CCA
      and Asp-328: GAC-GAT) with similar frequencies in normal and non-insulin
      dependent diabetic patients.

PMID- 7796920
TI  - Peroxisomal-microsomal communication in unsaturated fatty acid metabolism.
AB  - The addition of 1-acyl-sn-glycero-3-phosphocholine (1-acyl-GPC) to peroxisomes
      decreased the production of acid-soluble radioactivity formed by beta-oxidation
      of [1-(14)C]arachidonate due to substrate removal by esterification into the
      acceptor. This peroxisomal-associated acyl-CoA:1-acyl-GPC acyltransferase
      activity was due to microsomal contamination. The production of acid-soluble
      radioactivity from [1-(14)C]7,10,13,16-22:4, but not from [3-(14)C]7,10,13,16
      22:4 was independent of 1-acyl-GPC, with and without microsomes. By comparing
      rates of peroxisomal beta-oxidation with those for microsomal acylation, it was
      shown that the preferred metabolic fate of arachidonate, when added directly to
      incubations, or generated via beta-oxidation, was esterification by microsomal 1
      acyl-GPC acyltransferase, rather than continued peroxisomal beta-oxidation.

PMID- 7796921
TI  - Intracellular transport of inositol-containing sphingolipids in the yeast,
      Saccharomyces cerevisiae.
AB  - Organelles of the early protein secretion pathway (ER, Golgi) are involved in
      biosynthesis and intracellular migration of the yeast sphingolipids,
      inositolphosphorylceramide (IPC), mannosylinositolphosphorylceramide (MIPC), and
      mannosyldiinositolphosphorylceramide (M(IP)2C). Cycloheximide and nocodazole
      neither block biosynthesis of sphingolipids, nor ER to Golgi transport of IPC. In
      contrast, treatment of yeast cells with brefeldin A, which affects integrity of
      the Golgi, decreases formation of IPC and MIPC. Interruption of late steps of
      protein secretion (Golgi to plasma membrane transport) in temperature-sensitive
      secretory mutants prevents sphingolipids from being transported to the cell
      periphery.

PMID- 7796922
TI  - [ATP-sensitive potassium channel and hormone/neuropeptide].
AB  - ATP-sensitive potassium channels (KATP) are the ion channels which are closely
      associated with cellular metabolism. A number of chemical compounds which block
      KATP facilitate the release of hormones or neuropeptides. For example, KATP
      blocking agents such as antidiabetic sulfonylureas and imidazolines stimulate
      insulin secretion from pancreatic beta-cells by decreasing KATP activity. On the
      other hand, so-called potassium channel openers, KATP-activating drugs which
      constitute a chemically diverse group of compounds, inhibit growth hormone
      secretion from anterior pituitary cells and release of gamma-aminobutylic acid
      from substantia nigra. Several endogenous substances also modulate release of
      hormone or neuropeptide by affecting KATP activity. Acetylcholine and histamine
      stimulate the release of endothelium-derived hyperpolarizing factor, which
      activates KATP in the plasma membrane of vascular smooth muscle cells. Both
      galanin and somatostatin inhibit insulin release from pancreatic beta-cells by
      opening KATP through the activation of G-protein. Glucagon-like peptide-1[7-36],
      which stimulates insulin secretion by indirectly blocking KATP in beta-cells,
      shows antidiabetic effects in patients with non-insulin-dependent diabetes
      mellitus. Endosulphine, an endogenous inhibitor of KATP, stimulates insulin
      secretion from pancreatic beta-cells. Accumulating knowledge of the modulation
      and function of KATP would help our understanding of the regulation and
      physiological role of hormones and neuropeptides.

PMID- 7796923
TI  - [The changes in natriuretic peptide receptors (NP-R) in the lung and kidney in
      DOCA-salt hypertensive rats].
AB  - To elucidate the pathophysiological significance and the regulation of
      natriuretic peptide receptors (NP-R) in hypertension, we investigated the changes
      of NP-R in the lung, renal cortex and medulla using radioreceptor assay. We also
      examined the concentrations of atrial natriuretic peptide (ANP) and brain
      natriuretic peptide (BNP) in the atria and ventricles and plasma ANP
      concentration by specific radioimmunoassays. Elevated plasma ANP level, decreased
      atrial ANP concentration and increased ventricular ANP and BNP contents were
      observed in the DOCA-salt group when compared with the control group (p < 0.01).
      The ratio of BNP/ANP in the ventricle of the DOCA-salt rats was 50% of the
      control rats. The elevated plasma ANP secreted from the heart seems to reflect a
      defensive compensatory mechanism to counteract hypertension, and that ANP is the
      major natriuretic peptide secreted from the cardiac ventricle in DOCA-salt
      hypertensive rats. Scatchard plot analysis revealed that the maximal binding
      capacities (Bmax) of NP-R of the lung and renal cortex in DOCA-salt rats were
      significantly decreased from 71.0 +/- 10.4 to 38.4 +/- 5.9 (p < 0.05) and from
      32.7 +/- 1.8 to 21.7 +/- 0.4 (fmol/mg. protein) (p < 0.01) compared with those in
      the control rats. The values of Bmax of the renal medulla between the two groups
      were not different. There was no significant change in the apparent dissociation
      constant (Kd) in the lung, renal cortex and medulla between the two groups. A
      competitive binding study using 125I- alpha-rANP1-28 and C-ANF4-23, a
      biologically silent clearance receptor (C-receptor) specific ligand, revealed
      that C-receptors are abundantly present in the renal cortex, while a relatively
      small quantity of C-receptor was detected in the renal medulla. In the lung, a
      substantial amount of C-receptor was detected. In the DOCA-salt treated rats, C
      receptors were decreased in the lung and renal cortex compared with the control
      rats. These results indicate that the down-regulation of NP-R, especially C
      receptor, was induced in the lung and renal cortex when plasma ANP levels were
      elevated in DOCA-salt hypertensive rats. In conclusion, our results suggest that
      down-regulation of C-receptor in the lung and kidney contributes to maintaining
      higher plasma ANP levels and maybe responsible for the counter-regulatory role of
      endogenous ANP in DOCA-salt rats. Our results show that the down-regulation of NP
      R in the lung was larger than that in the kidney, suggesting that the lung may
      play a dominant role in the regulation of the clearance of ANP through C
      receptors in vivo.

PMID- 7796924
TI  - [Microsatellite polymorphism of muscle glycogen synthase gene and non-insulin
      dependent diabetes mellitus].
AB  - It has been reported recently that A2 allele of muscle glycogen synthase gene
      determined by Xba I RFLP (restriction fragment length polymorphism) is related to
      the frequency of NIDDM in Finland. Using PCR-RFLP analysis, we detected no A2
      allele in Japanese patients with NIDDM and control. We found a new microsatellite
      of CA repeat in the human muscle glycogen synthase gene, and the polymorphism of
      the repeat number was detected by the polymerase chain reaction. Six different
      alleles were observed, indicating the highly polymorphic nature of this marker.
      We analyzed the repeat numbers and the genotypes in diabetics and control. The
      allele frequencies were not significantly different between NIDDM and control.
      However, the allele frequencies in the patients without high total
      cholesterolemia was significantly different from those of control. These findings
      suggest that the muscle glycogen synthase gene or neighboring genes are related
      to one of the disease genes of diabetes mellitus without high total
      cholesterolemia.

PMID- 7796925
TI  - [Testicular findings, endocrine features and therapeutic responses of men with
      idiopathic hypogonadotropic hypogonadism].
AB  - The purpose of this study is to clarify the pathological and endocrinological
      variations of male idiopathic hypogonadotropic hypogonadism (IHH) from the
      viewpoint of testicular maturation. Twenty-five patients with IHH were classified
      into 3 groups according to the degree of germ cell maturation. The most mature
      germ cells in patients with severe IHH, moderate IHH and mild IHH were
      spermatogonia, primary spermatocytes and postmeiotic germ cells, respectively.
      All patients were treated with hCG alone or a combination of hMG-hCG for 1 year
      or more. The therapeutic efficacy of gonadotropin therapy was evaluated by
      findings of semen analysis, spermatogenesis and sexual maturation. The total GCI,
      which was expressed as the number of germ cells per Sertoli cell, diameter of the
      seminiferous tubules and testicular volume in mild IHH were the largest among the
      3 IHH groups, and those in severe IHH were the smallest. Even in mild IHH,
      spermatogonial proliferation and meiotic activity were quantitatively smaller
      than those of normal pubertal boys. All patients showed extremely low basal
      testosterone levels. Response of serum testosterone to hCG administration
      correlated to the maturity of germ cells. Basal serum gonadotropin levels and
      responses to GnRH administration varied widely among the 3 groups. In particular,
      the response of serum gonadotropin to GnRH correlated to the maturity of the germ
      cells. Spermatogenesis could be initiated by hCG alone in IHH patients without
      cryptorchidism. Normal sperm density was obtained by hCG alone in the case of
      mild IHH; however, in moderate and severe IHH groups, hMG-hCG therapy was
      required for sufficient spermiogenesis. Sexual maturation was completely obtained
      by gonadotropin therapy within 1 year in moderate and mild IHH. However, in
      severe IHH, satisfactory sexual maturation could not be obtained within 1 year.
      The therapeutic prognosis for sexual maturation could be made based on the
      response to the hCG test at 6 months of gonadotropin therapy. In conclusion, the
      maturity of germ cells before treatment, which varies widely among patients with
      IHH, is a sensitive parameter for hypothalamo-pituitary-testicular function and
      the efficacy of gonadotropin therapy for testicular function. In severe IHH
      groups, to obtain satisfactory sexual maturation, the administration of
      testosterone should be considered in addition to gonadotropin replacement.

PMID- 7796926
TI  - [Effect of the GH-PRL superfamily on circulating plasma insulin-like growth
      factor-1].
AB  - To elucidate the effects of growth hormone (GH), prolactin (PRL), and human
      placental lactogen (hPL) on the regulation of insulin-like growth factor (IGF-1),
      we compared plasma IGF-1 levels, the pattern of circulating IGF-1-IGF-binding
      protein complexes (IGF-1 complexes), and unsaturated binding protein (USBP)
      levels among 1) naturally growing Wistar rats at several developmental stages, 2)
      rats subcutaneously administered GH, and 3) hypophysectomized rats treated with
      each of the three hormones. We further evaluated the in vitro secretion of IGF-1
      by primary cultured rat hepatocytes, following exposure to the hormones singly or
      in combination. Plasma IGF-1 and USBP levels were determined by radioimmunoassay
      and competitive radioassay, respectively. IGF-1 complexes were separated from
      plasma and culture medium by Sephadex G150 and HPLC gel-chromatography,
      respectively. The results were as follows. 1) In naturally growing rats, plasma
      IGF levels were low during fetal life and after birth until 28 days of age, and
      thereafter increased rapidly to reach an adult level by 35 days. At 35 days, the
      molecular distribution of IGF-1 switched from an infantile pattern (only 40Kd IGF
      1 complex) to an adult form (IGF-1 complexes with both 40Kd and 150Kd proteins).
      In addition, 150Kd USBP became detectable after 28 days. 2) Administration of GH
      for 3 days to 13-day-old rats induced 150Kd USBP 9 days earlier than in controls,
      while plasma IGF-1 levels remained comparable throughout the period examined. 3)
      In the hypophysectomized rats, plasma IGF-1 levels decreased to approximately one
      fifth of those in untreated rats, accompanied by the disappearance of 150Kd USBP
      and 150Kd IGF-1 complex. However, when GH (but not PRL or hPL) was continuously
      administered for 72 hrs, plasma IGF-1 levels and the circulating profile of IGF-1
      complexes were nearly restored to those in control rats. 4) Addition of GH (but
      not PRL) to the culture medium caused hepatocytes to secrete IGF-1, consisting of
      only the 40Kd IGF-1 complex. This effect was blocked by the simultaneous addition
      of hPL with GH. These findings indicate that, of the hormones analyzed, GH is the
      most important regulator of the plasma IGF-1 concentration and circulating
      complex forms during the developmental periods in rats, as is also thought to be
      the case in humans.

PMID- 7796927
TI  - [Phosphaturic effect of PTH during hypoxia and hypocapnia in rats].
AB  - This study examined the effect of acute hypoxia or hypocapnia on renal phosphate
      excretion in thyroparathyroidectomized rats. Hypoxia is usually accompanied by a
      secondary hypocapnia due to hypoxic hyperventilation. Respiratory alkalosis has
      been described as blunting the phosphaturic effect of parathyroid hormone (PTH).
      In the present study, to know the effect of hypoxia on renal phosphate excretion
      in the absence of hypocapnia, the rats were ventilated mechanically, and arterial
      PCO2 levels were controlled. The rats were divided into three groups depending on
      the arterial PO2 and PCO2 levels: 1) hypoxic normocapnic group; 2) normoxic
      normocapnic group; 3) normoxic hypocapnic group. Hypoxia was achieved by
      ventilating with 10% oxygen, and hypocapnia by hyperventilating with 25-30%
      oxygen. PTH infusion significantly increased fractional excretion of phosphate
      (FEPi) from 4.1 +/- 0.9 (mean +/- SE) to 37.7 +/- 2.6% in the hypoxic group (n =
      7), from 1.4 +/- 0.3 to 27.4 +/- 2.5% in the normoxic group (n = 8), and from 1.5
      +/- 0.4 to 19.5 +/- 1.2% in the hypocapnic group (n = 10). The change of FEPi
      (delta FEPi) after PTH infusion during hypoxia was significantly greater (33.6 +/
      2.1%) than that during normoxia (26.1 +/- 2.4%, p < 0.05). In contrast to this,
      hypocapnia blunted the phosphaturic response to PTH (18.0 +/- 1.1% delta FEPi, p
      < 0.05). Urinary adenosine 3', 5'-cyclic monophosphate (cAMP) increased similarly
      after PTH infusion in all three groups. To test whether the enhanced phosphaturic
      effect of PTH during hypoxia and the blunted phosphaturic effect of PTH during
      hypocapnia are due to steps beyond the production of cAMP, cAMP was administered
      to the three groups. Cyclic AMP infusion displayed greater phosphaturia in the
      hypoxic group (n = 6, 30.0 +/- 1.4%) and less phosphaturia in the hypocapnic
      group (n = 7, 11.3 +/- 1.8%) as compared the the normoxic group (n = 6, 24.1 +/-
      1.0%). In conclusion, acute hypoxia enhances the phosphaturic effect of PTH,
      whereas acute hypocapnia attenuates the phosphaturic effect of PTH.

PMID- 7796928
TI  - Adenosine 3',5'-cyclic monophosphate and the self-priming effect of gonadotrophin
      releasing hormone.
AB  - An in vitro perifusion system was used to ascertain the role of cAMP in the
      genesis of the self-priming effect of gonadotrophin-releasing hormone (GnRH) in
      rat pituitaries. Ten-minute pulses of 20 nmol/l GnRH administered 150 min apart
      resulted in the manifestation of the self-priming effect, an effect which was
      inhibited by 5 mumol/l cycloheximide. Forskolin (1 mumol/l) which does not
      stimulate luteinizing hormone (LH) secretion or affect the initial LH response to
      GnRH significantly potentiated the second response through protein synthesis
      dependent mechanisms. Additionally, an initial 10-min pulse of forskolin alone
      was sufficient to prime the pituitary to a subsequent pulse of GnRH 150 min
      later. Interestingly, similar amounts of LH were secreted in response to
      forskolin + GnRH or GnRH administered 150 min after forskolin. Flufenamate, an
      inhibitor of GnRH-stimulated increases in cAMP production prevented the
      manifestation of the self-priming effect of GnRH. Forskolin which bypasses the
      inhibitory effects of flufenamate on cAMP production reversed the flufenamate
      induced inhibition of the self-priming effect of GnRH through protein synthesis
      dependent processes. These results suggest that cAMP does not mediate the LH
      response to an initial exposure of GnRH, but does play a pivotal role in the
      genesis of the self-priming effect of GnRH through the stimulation of de novo
      protein synthesis. Once the newly synthesized proteins are available, the
      nucleotide is not required for the manifestation of the phenomenon.

PMID- 7796929
TI  - Growth hormone releasing factor and vasoactive intestinal peptide stimulate rat
      granulosa cell plasminogen activator activity in vitro during follicular
      development.
AB  - Growth hormone-releasing factor (GRF) and vasoactive intestinal peptide (VIP) are
      two structurally homologous peptides sharing common target cell receptor and
      known to enhance FSH-induced steroidogenesis of undifferentiated granulosa cell
      in vitro. Although VIP, has been reported to stimulate plasminogen activator (PA)
      activity in rat granulosa cells, our knowledge on the actions and interactions of
      these two peptides with FSH in the regulation of rat granulosa cell PA system
      during follicular development remains incomplete. Undifferentiated and
      differentiated rat granulosa cells from pre-antral (DES-treated rats) and antral
      (eCG-treated rats) follicles, respectively, were cultured in a chemically defined
      medium in the absence and presence of FSH (400 ng/ml), GRF (10(-8)-10(-5) M)
      and/or VIP (10(-9)-10(-5) M). Net secreted (PAs) and cell-associated (PAc) PA
      activities was measured by the fibrinolysis assay and characterized by the fibrin
      overlay method. Granulosa cell differentiative (progestin secretion) and
      proliferative (DNA synthesis) responses were analyzed by radioimmunoassay and
      [3H]thymidine incorporation, respectively. Both GRF and VIP stimulated PAs and
      PAc activities in a concentration-dependent manner in 24-h cultures of granulosa
      cells from the two stages of follicular development. They (10(-5) M) enhanced FSH
      stimulated PAs activity in granulosa cell cultures of pre-antral follicles, with
      GRF being more effective than VIP. On the contrary, only GRF (10 microM)
      potentiated FSH-induced PAs and PAc activities in cultures of granulosa cell from
      antral follicles. The stimulation of PA activity by these agonists decreased with
      the duration of culture irrespective of the stage of follicular
      development.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796930
TI  - The proximal milk protein binding factor binding site is required for the
      prolactin responsiveness of the sheep beta-lactoglobulin promoter in Chinese
      hamster ovary cells.
AB  - To identify cis-acting prolactin (PRL) response elements within the sheep beta
      lactoglobulin (BLG) promoter, CHO cells were co-transfected with a rabbit PRL
      receptor (PRL-R) expression plasmid and a number of BLG-CAT constructs. Resection
      through the 4200 bp BLG promoter diminished the PRL response. Mutation of the
      proximal binding site for milk protein binding factor (MPBF), a previously
      described mammary gland transcription factor, abolished the PRL inducibility of
      full length and shorter forms of the promoter. MPBF was shown to be similar to
      the Stat protein mammary gland factor (MGF) which has been shown to mediate PRL
      responsiveness of the rat beta-casein gene in mammary cells. MPBF binding
      activity was detected in the nucleus of CHO cells and was increased 2-6-fold in
      cells stably transfected with the PRL-R. The lactating mammary gland has high
      levels of MPBF binding activity and it is likely that this has an important role
      in the PRL induction of a variety of milk protein genes.

PMID- 7796931
TI  - Inhibition of renal ornithine decarboxylase activity fails to reduce kidney size
      and urinary albumin excretion in diabetic rats with manifest kidney hypertrophy.
AB  - Formation of polyamines has previously been shown to play an important role for
      initial kidney growth in experimental diabetes, as treatment of diabetic rats
      with a selective ornithine decarboxylase (ODC) inhibitor, initiated immediately
      after diabetes induction, abolishes the initial kidney growth. In order to
      investigate the role of polyamine formation for the maintenance of diabetic
      kidney hypertrophy, ODC inhibition was initiated after manifest kidney
      hypertrophy had occurred. The kidney weight in diabetic rats was significantly
      larger than in control rats after a diabetes duration of 7, 14, 50 and 71 days
      and the total glomerular volume was increased in kidneys from diabetic rats after
      a diabetes duration of 71 days. Renal activity of ODC was increased in diabetic
      rats throughout the study period of 71 days. Treatment of diabetic rats with the
      selective ODC inhibitor di-fluoro-methyl-ornithine (DFMO) was maintained for two
      periods (days 7-14 and days 50-71). DFMO treatment had no effect on 24-h food
      consumption, blood glucose concentration or body weight. However, despite almost
      total inhibition of the kidney ODC activity, there was no effect on kidney growth
      or total glomerular volume in the DFMO treated diabetic rats compared to placebo
      treated diabetic rats. Finally, the urinary albumin excretion was markedly
      increased in diabetic rats with no effects of ODC-inhibition. In conclusion,
      inhibition of ODC initiated in diabetic rats with manifest kidney enlargement had
      no effect on renal size, glomerular volume or urinary albumin excretion. These
      findings together with our previous findings indicate that the role of polyamines
      in diabetic kidney enlargement is restricted to the first week after diabetes
      induction.

PMID- 7796932
TI  - Mitogenic effects and nuclear localisation of procorticotrophin-releasing hormone
      expressed within stably transfected fibroblast cells (CHO-K1).
AB  - To investigate the intracellular localisation and biological activity of
      procorticotrophin-releasing hormone (proCRH), we have established stably
      transfected CHO-K1 cells expressing the rat pre-proCRH cDNA. Using immunoblot
      analysis of cell lysates of transfected CHO-K1 cells, we detected a major CRH
      immunoreactive band with an apparent molecular weight of approximately 19 kDa.
      This 19 kDa band could account for full length proCRH molecule which has not
      undergone post-translational modifications. Metabolic labelling followed by
      immunoprecipitation, SDS-PAGE and autoradiography indicated that no
      endoproteolytic processing of proCRH takes place within the transfected CHO-K1
      cells. Immunofluorescence staining localises the CRH precursor to both the
      cytoplasm and to the nucleus in transfected CHO-K1 cells. This result was
      confirmed using subcellular fractionation techniques on radiolabelled CHO-K1
      cells expressing immunoreactive CRH. A major CRH-immunoreactive band of 19 kDa
      was detected both in the microsomal and secreted fractions, indicating the
      presence of proCRH within the secretory pathway of these cells. This was also
      evident in the nuclear fraction, therefore confirming the nuclear localisation of
      proCRH. Analysis of DNA concentration, cell number and DNA synthesis showed that
      stably transfected CHO-K1 cells expressing proCRH have a higher proliferation and
      DNA synthesis rate than wildtype CHO-K1 cells or CHO-K1 cells transfected with
      pEE14 alone. Our results therefore suggest a mitogenic role for the intact proCRH
      molecule within CHO-K1 cells. Furthermore, treatment of mouse corticotrophic
      tumour cells (AtT20/D16-16) with conditioned medium from transfected CHO-K1 cells
      expressing proCRH, stimulated both DNA synthesis and cell proliferation above
      basal levels. Our results constitute the first reported direct evidence of a
      mitogenic role for proCRH acting on a corticotrophic cell population.

PMID- 7796934
TI  - Charge heterogeneity in wildtype and variant glucocorticoid receptors.
AB  - Two-dimensional electrophoresis was used to examine charge heterogeneity in
      glucocorticoid receptors (GCRs) from sublines of the thymic-derived, mouse P1798
      lymphosarcoma which were sensitive (S) or resistant (R) to glucocorticoid
      mediated apoptosis. Previous work had identified the 97 kDa wildtype GCR (WT-GCR)
      in S cells and two variant GCRs in R cells: a 45 kDa, steroid-binding truncated
      GCR (TR-GCR), and a 97 kDa non steroid-binding GCR (NSB-GCR). Using denaturing
      isoelectric focusing, we now show that S cells as well as adult mouse thymus
      gland also express the NSB-GCR at pI 5.6 in addition to the WT-GCR which resolves
      between pH 5.9-7.1. Thus, the NSB-GCR is detected in steroid-sensitive cells and
      is not unique to R cells. Separation of receptors by native isoelectric focusing
      suggested that the TR-GCR in R cells resolved at a single, high pI (8.1) relative
      to the WT-GCR which resolved in a broad range (pI 5.8-8.0). The high pI of the TR
      GCR may alter its functional activity thereby contributing to the resistance
      phenotype.

PMID- 7796936
TI  - Hypothalamic GLUT 4 expression: a glucose- and insulin-sensing mechanism?
AB  - The insulin-regulatable glucose transporter, GLUT 4, is expressed primarily in
      peripheral tissues (skeletal muscle and adipose tissue). In response to insulin
      this transporter  moves rapidly from an intracellular storage site to the plasma
      membrane, thus accounting for the substantial increase in glucose uptake by these
      tissues following insulin stimulation. The recent finding that GLUT 4 is also
      expressed in the hypothalamus suggests that this brain region, which is outside
      the blood-brain barrier and therefore sensitive to circulating insulin, may
      experience stimulation of glucose uptake in response to insulin. We propose that
      this may allow regions of the hypothalamus to respond directly to elevated blood
      glucose, constituting a form of metabolic regulation by allowing circulating
      glucose (and therefore insulin) in concert with other mechanisms to maintain
      blood glucose homeostasis. We consider the possible physiological role of such a
      mechanism and speculate that disturbances of this mechanism may occur in
      endocrine disease associated with insulin resistance.

PMID- 7796935
TI  - Modulation of thyroid hormone action by mutant thyroid hormone receptors, c-erbA
      alpha 2 and peroxisome proliferator-activated receptor: evidence for different
      mechanisms of inhibition.
AB  - Thyroid hormone action is not only determined by hormone availability, but also
      by target organ sensitivity. A dominant negative interaction is known to occur
      between thyroid hormone receptors (TRs) and the non-ligand binding splicing
      variant c-erbA alpha 2 as well as mutant TR beta 1 from kindreds with resistance
      to thyroid hormone. We compared the inhibitory effect of naturally occurring
      mutant hTR beta 1, artificially created hTR alpha 1 mutants, c-erbA alpha 2 and
      the human peroxisome proliferator-activated receptor (hPPAR) on three prototypic
      T3-response elements (TREs), TRE-PAL, DR + 4 and TRE-LAP. The inhibitory effect
      of mutant hTR alpha 1 and beta 1 occurred only on TRE-LAP and to a minor degree
      on DR + 4 when equimolar ratios of mutant/wildtype receptor were present. In
      contrast, the c-erbA alpha 2 splicing variant and the hPPAR inhibited TR action
      on all three TREs. Gel mobility shift experiments in the presence of T3 showed
      increased binding of mutant hTR alpha 1 and beta 1 only to TRE-LAP compared to
      the binding of wildtype hTRs, thereby explaining their TRE-selective dominant
      negative potency. Contrarily, equal amounts of c-erbA alpha 2 or hPPAR protein
      did not bind to either of the three response elements even in the presence of
      RXR. Since the TR:RXR heterodimers were only partially displaced from DNA in the
      presence of excess amounts of c-erbA alpha 2, it is likely that the TRE
      unspecific dominant negative action of c-erbA alpha 2 is due in part to
      competition for DNA-binding and for TR-auxiliary proteins. In contrast, equimolar
      amounts of hPPAR completely inhibited the DNA-binding of hTR beta 1:RXR
      heterodimers, but not of TR:TR homodimers, suggesting that hPPAR has a higher RXR
      binding affinity and is therefore a potent competitor for intranuclear RXR. Since
      thyroid hormones and peroxisome proliferators regulate in part a similar subset
      of target genes involved in fatty acid metabolism, these results suggest the
      possibility of cross-talk among the thyroid hormone and peroxisome proliferator
      signalling pathways. In summary, the results suggest that thyroid hormone action
      can be modulated by at least three different mechanisms: (i) increased binding of
      mutant hTRs to specific TREs; (ii) efficient competition for limiting amounts of
      RXR through the preferential formation of hPPAR:RXR, rather than TR:RXR
      heterodimers; and (iii) competition for binding to DNA and to auxiliary proteins
      other than RXR in the case of c-erbA alpha 2.

PMID- 7796938
TI  - Protein kinase C inhibition of in vitro FSH-induced differentiation in pig
      granulosa cells.
AB  - In granulosa cells, growth factor IGF I plays a major role in both growth and
      differentiation, acting through an autocrine/paracrine mechanism, and its
      production is regulated by FSH, via cyclic AMP (cAMP). As protein kinase C is
      also involved in granulosa cell function, we investigated the possibility that
      its activation could balance the positive effects of FSH. Using pig granulosa
      cells cultured in vitro, we studied the effects of protein kinase C activation by
      tetradecanoylphorbol acetate (TPA) on IGF I mRNA level. We also checked
      morphological modifications, cAMP production and steroidogenesis at the P450 side
      chain cleavage mRNA and progesterone levels. Our data demonstrate that protein
      kinase C activation antagonizes the in vitro FSH-induced differentiation,
      particularly morphological modifications and accumulation of IGF I mRNA. These
      inhibitory effects on FSH responses suggest that there could be a balance between
      protein kinase A and protein kinase C pathways in regulating differentiation in
      pig granulosa cells.

PMID- 7796933
TI  - Multiple intracellular signallings are involved in thyrotropin-releasing hormone
      (TRH)-induced c-fos and jun B mRNA levels in clonal prolactin cells.
AB  - In mammosomatotropes GH3B6 cells, one of the primary responses to thyrotropin
      releasing hormone (TRH) is the parallel induction of two proto-oncogenes, c-fos
      and jun B, which code for constituents of AP1 transcription factor. To better
      understand the mode of action of TRH and to look for possible functions of c-fos
      and jun B in these cells, we have investigated the role of different
      intracellular signals in the induction of each proto-oncogene on the one hand,
      and on prolactin (PRL) release and PRL gene expression on the other hand.
      Northern and dot-blot analyses revealed that the activation of protein kinase C
      (PKC)-, Ca(2+)- or adenylyl cyclase-dependent pathways acutely increased both c
      fos and jun B transcripts. However, a gene specific responsiveness was revealed
      using phorbol 12-myristate 13-acetate (TPA) and several combined treatments. The
      simultaneous activation of PKC and Ca(2+)-dependent pathways resulted in
      synergistic stimulations of c-fos mRNA levels only. Consistently, ionomycin plus
      low doses of TPA solely reproduced the potent effect of TRH on c-fos transcripts.
      Data collected from TRH and TPA down-regulated cells indicated that TRH probably
      recruits TPA-dependent PKC isoforms for stimulating c-fos but not jun B
      transcripts. On the contrary, the TRH-induced stimulation of either proto
      oncogene likely involves Ca(2+)-dependent mechanisms because calcium agonists and
      the peptide exert non-additive effects. Finally, the synergistic stimulations
      observed in response to TRH combined with forskolin, indicate that adenylyl
      cyclase-dependent mechanisms are interconnected with TRH-induced proto-oncogene
      expression. The overall study also reveals that among the agonists tested, the
      dihydropyridine Bay K 8644 and forskolin only were capable to induce a long
      lasting stimulation of c-fos and jun B mRNA levels, concomitant to increased
      levels of PRL transcripts, as does TRH. Considering that AP1 is assumed to be
      involved in signal transmission from the cell surface to the nucleus, it might be
      thus proposed that a common stimulation of c-fos and jun B gene expression is
      possibly involved in the activation of the PRL gene. On the other hand, the
      systematic coincidence between acute PRL release and proto-oncogenes expression
      suggest a role for c-fos and jun B in the control of genes involved in the
      secretory process.

PMID- 7796937
TI  - Pituitary adenylate cyclase activating polypeptide (PACAP) and vasoactive
      intestinal peptide stimulate two signaling pathways in CHO cells stably
      transfected with the selective type I PACAP receptor.
AB  - The properties of the pituitary adenylate cyclase activating polypeptide (PACAP)
      type I receptor were studied on a clone of Chinese hamster ovary cells (CHO)
      stably transfected with the recombinant receptor. PACAP(1-27), PACAP(1-38) and
      VIP inhibited [125I-acetyl-His1]PACAP (1-27) binding, stimulated cyclic AMP and
      inositol phosphates production and induced [Ca2+]i increase with the same order
      of potency: PACAP(1-27) = PACAP(1-38) > VIP. The concentrations required for half
      maximal receptor occupancy, IP3- and [Ca2+]i increase were not different for both
      PACAPs (1 nM) and 100-fold higher than those required for cyclic AMP increase
      (0.010 nM). These data suggest that the occupancy of a portion of the total
      receptors available was sufficient for maximal cyclic AMP production but not for
      maximal IP3 production. It is concluded that the possibility of the type I PACAP
      receptor being coupled to a transduction pathway is not located at the level of
      the ligand but rather at the level of the G-proteins.

PMID- 7796941
TI  - Non-Target Effects of Live Vaccines. Langen, Germany, November 3-5, 1993.
      Proceedings of a workshop.

PMID- 7796939
TI  - Aging in rats is associated with an increase in adrenal apolipoprotein E.
AB  - Extrahepatic tissues including the adrenal cortex are capable of synthesizing
      apolipoprotein E (apoE). Locally synthesized apoE is believed to affect cellular
      uptake, transport and redistribution of cholesterol within that organ. We and
      another laboratory have previously reported that the adrenal cortex of aged rats
      has an elevated cholesteryl ester content. The aim of this work was to
      investigate whether this elevation is accompanied by increased adrenal apoE
      levels in aged rats. A Western blotting technique with polyclonal goat anti-human
      apoE antiserum was employed as a probe for studies. The results showed that: (a)
      anti-human-apoE antiserum not only detected apoE in human plasma and adrenal
      homogenate, but also cross-reacted with a protein (or proteins) resembling apoE
      in rat plasma and adrenal homogenate (or supernatant) with a molecular weight of
      34,000-36,000; (b) rat adrenal apoE concentration (per unit weight of protein)
      increased with age; (c) the increase did not result from blood trapped in the
      gland, because after organ perfusion the adrenal of aged rats persistently
      exhibited 58% more apoE than that of young animals. In conclusion, rat adrenal
      apoE concentration appears to increase with age. Whether this increase
      mechanistically causes the accumulation of cholesteryl esters in the aged rat
      adrenal remains to be investigated.

PMID- 7796940
TI  - Activin and inhibin have opposite effects on steroid 5 alpha-reductase activity
      in genital skin fibroblasts.
AB  - The transforming growth factor beta (TGF-beta) superfamily includes several
      closely related peptides including the activins and inhibins. Since we recently
      reported that TGF-beta 1 and beta 2 are potent inducers of steroid 5 alpha
      reductase (5 alpha R), we have now studied the effects of these other peptides
      using primary cultures of human scrotal skin fibroblasts. Recombinant human
      activin A or inhibin A were added to cultured cells (2 x 10(5) cells) for 2 days
      in a serum free media and 5 alpha R activity was measured by the %-conversion of
      tracer [3H]-testosterone to dihydrotestosterone (DHT) over a 4-h period. Activin
      significantly stimulated 5 alpha R activity in a dose related manner (control 3.0
      +/- 0.4%, activin (1.2 x 10(-9) M) 6 +/- 0.7%, P < 0.01, (2.4 x 10(-9) M) 8.5 +/-
      0.6%, P < 0.001). In comparison, androgen (DHT 10(-7) M) induction of 5 alpha R
      was 4.7 +/- 0.2%, P < 0.05. Combined exposure of fibroblasts to activin (1.2 x
      10(-9) M) and androgen (10(-7) M) did not result in additive or synergistic
      effect on 5 alpha R activity. In contrast, exposure of cells to an androgen (10(
      7) M) and TGF-beta (2 x 10(-10) M) led to synergistic effects on 5 alpha R
      activity (control 1.5 +/- 0.1%, DHT 2.6 +/- 0.2% TGF-beta 1 4.8 +/- 0.5, TGF-beta
      1 + DHT 9.2 +/- 1.2%).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796943
TI  - An historical outline of the development of live poliovaccine and its non-target
      effects.

PMID- 7796942
TI  - Viral vaccines in historical perspective.

PMID- 7796944
TI  - Recombinant polioviruses as candidate strains of oral poliovaccines.

PMID- 7796945
TI  - Manipulation of the cellular binding properties of poliovirus: implications for
      non-target effects of recombinant vaccines.

PMID- 7796946
TI  - Safety aspects of oral poliovirus vaccine campaigns.

PMID- 7796947
TI  - Tropism and immunoprotection in transmissible gastroenteritis coronaviruses.

PMID- 7796952
TI  - Capripoxvirus-based multivaccines.

PMID- 7796951
TI  - First EBV vaccine trial in humans using recombinant vaccinia virus expressing the
      major membrane antigen.
AB  - In the absence of a truly representative animal model, the question of whether
      EBV-related diseases can be prevented by a vaccine has been studied for the first
      time in humans. A live recombinant virus based on the licensed vaccinia strain
      Tien Tan, expressing under the 11K vaccinia promoter the major EBV membrane
      antigen BNLF-1 MA (gp 220-340), was constructed and tested in three different
      human populations: EBV-positive and vaccinia-virus-exposed adults; EBV-positive,
      non-vaccinia-virus-exposed juveniles; and EBV and vaccinia virus-naive infants.
      No significant titre variations for EBV were observed in the adults, but EBV
      neutralising titres increased in the vaccinated juveniles, while antibodies to
      VCA of EBV remained unchanged. All nine vaccinated infants developed antibodies
      to MA (membrane antigen) with neutralising properties in vitro; three of these
      infants were infected by EBV via natural routes over a period of 16 months after
      vaccination and all ten unvaccinated control infants became infected. It has been
      shown for the first time that protection against and/or delay of EBV infection by
      the natural route is possible in humans and that live vaccinia vectors can be
      used and are efficacious.

PMID- 7796949
TI  - Highly attenuated poxvirus vectors: NYVAC, ALVAC and TROVAC.
AB  - Three highly attenuated and efficacious poxvirus-based vectors, NYVAC, ALVAC and
      TROVAC, are available for targeted applications as recombinant vaccines in both
      human and veterinary medicine. The attenuated phenotype of the three vectors is
      consistent with safe use for vaccination purposes, for the vaccinee, for
      unvaccinated contacts, and for introduction into the environment. The precise
      deletion of virulence and host range genes in the NYVAC vector precludes
      reversion to the virulent phenotype by back mutation. Dissemination of
      recombinant vaccines based on the NYVAC, ALVAC and TROVAC vectors is highly
      diminished, because of the genetic engineering in NYVAC and the natural
      attenuated phenotype of ALVAC and TROVAC. Studies have demonstrated that these
      recombinant vectors are genetically and phenotypically stable after serial
      passage in vitro as well as in vivo. NYVAC, ALVAC and TROVAC vectors are the only
      three poxvirus-based vectors that are classified as BSL1 agents.

PMID- 7796948
TI  - Adenovirus as vector for HIV: efficacy and safety issues.

PMID- 7796953
TI  - Target and non-target effects of a recombinant vaccinia-rabies virus developed
      for fox vaccination against rabies.

PMID- 7796955
TI  - Vaccinia virus recombinant vaccines for rinderpest.

PMID- 7796954
TI  - Novel vaccinia vector derived from the host range restricted and highly
      attenuated MVA strain of vaccinia virus.

PMID- 7796950
TI  - The safety and use of canarypox vectored vaccines.
AB  - ALVAC recombinants have been administered to humans and animals by parenteral and
      oral routes without giving signs of replication, systemic dissemination or severe
      reaction. In principle, it should be impossible for canarypox recombinants to
      disseminate in the environment as they would not be synthesised in mammalian
      cells as complete virus. Canarypox vectors have been safe for humans, in whom
      there has been no evidence of replication, but more work needs to be done to
      prove absence of replication. Recombinants are immunogenic by the intramuscular
      and subcutaneous routes. They are also immunogenic when given orally, but the
      dose required is still under study. Canarypox recombinants effectively prime the
      immune system for induction of antibodies and CD8 cell-mediated cytotoxicity by
      protein antigens. Antibody responses are not influenced by prior inoculation of
      canarypox, of subunit vaccine corresponding to the gene insert, or of vaccinia.
      Canarypox virus is attenuated for canaries, in which species it is already widely
      used. In principle, it is non-infectious for humans or other mammals. It may be
      infectious for other birds.

PMID- 7796957
TI  - Live bacterial vaccines for animals.

PMID- 7796958
TI  - Efficacy and safety of live recombinant BCG vaccines.
AB  - BCG has a long history of safe use in humans and is one of the best adjuvants
      known. The use of newer production methods may further reduce the risk of adverse
      side-effects. Early results with experimental animals have shown BCG to be an
      effective live recombinant delivery vehicle for several foreign vaccine antigens.
      Additional refinements to the safety and efficacy of the recombinant BCG vaccine
      vehicle are under development.

PMID- 7796956
TI  - The history of live bacterial vaccines.
AB  - Recent developments have made it possible to construct non-reverting live
      bacterial vaccine candidates with defined deletions of two or more genes. Such
      vaccines have proven safe and immunogenic in human volunteers. Since the virulent
      parent strains are only pathogenic to man (S. typhi, S. flexneri, and V.
      cholerae), they pose no threat to the environment. Besides holding promise as
      efficacious vaccines for protection against typhoid fever, bacillary dysentery
      and cholera, the attenuated strains are well suited as vectors for delivery of
      heterologous antigenic epitopes from micro-organisms such as Helicobacter pylori,
      Neisseira gonorrhoeae, rotavirus, HIV and many others. Instead of using a
      virulent parent bacterium as the starting organism for making a vector, attempts
      have recently been made to employ non-pathogenic bacteria of the normal human
      flora, such as Streptococcus gordonii for delivery of foreign antigens. At
      present, the feasibility of this approach for human beings remains to be proven.

PMID- 7796960
TI  - Vibrio cholerae CVD103-HgR live oral attenuated vaccine: construction, safety,
      immunogenicity, excretion and non-target effects.
AB  - In many controlled studies, CVD103-HgR has been shown to be safe and immunogenic
      and to offer a significant degree of protection against experimental cholera
      after a single dose. Its minimal excretion and limited ability to compete and
      survive in various ecosystems indicate that this strain presents little risk to
      the environment. Furthermore, the potential of CVD103-HgR to regain virulence by
      acquisition of the CT A or LT A gene is extremely remote even under optimal
      conditions. Therefore, CVD103-HgR possesses those traits desired in a live oral
      attenuated vaccine produced by recombinant DNA technology.

PMID- 7796961
TI  - Salmonellae as oral vaccine carriers.

PMID- 7796962
TI  - OmpA fusion proteins for presentation of foreign antigens on the bacterial outer
      membrane.
AB  - The ompA genes of Escherichia coli and Shigella dysenteriae have been used to
      construct a group of enterobacterial surface expression vectors for foreign
      genes. Linker oligonucleotides were inserted into the sequence corresponding to
      the third or fourth outer domain to allow in-frame sandwich fusion of foreign
      genes or epitopes into ompA. Influenza haemagglutinin was inserted without its
      leader peptide and anchor sequences and shown to be transferred as an ompA fusion
      protein to the bacterial surface in large amounts. The stability of this system
      depends on the stem structure (i.e. the bottom part) of the haemagglutinin unit
      which apparently initiates the folding process that extends into the ompA
      segment. This fusion construct can be used as a vector system and has been used
      to transfer to the bacterial surface several other proteins inserted into it,
      including beta-galactosidase, foot-and-mouth disease virus (FMDV) and malaria
      antigens. All are exported from the cytoplasm across both the inner and outer
      membranes to become exposed on the bacterial surface. Very hydrophobic segments
      or inserts with distinct secondary structures, such as the capsid protein, VP1 of
      FMDV, will, however, block this process.

PMID- 7796959
TI  - An overview of vaccine vectors.

PMID- 7796963
TI  - Aromatic vitamin-dependent Salmonellae as vaccines in food animals: efficacy and
      persistence.

PMID- 7796964
TI  - Safety and efficacy of modified live feline Toxoplasma gondii vaccine.

PMID- 7796966
TI  - Live virus vaccines for use in animals.

PMID- 7796965
TI  - Non-target effects of live vaccines: myth, reality and demagoguery.

PMID- 7796967
TI  - Rabies virus vaccines.
AB  - Many years of research and observations on bait uptake, efficacy, behavioural
      studies of foxes, reduction and elimination of rabies, population dynamics of
      foxes following oral vaccination, as well as annual exchanges of researchers'
      experiences, formed the scientific background for field trials extending over
      many years. These are the most extensive field studies for the testing of a
      rabies vaccine so far. The use of the techniques and strategies of oral
      immunisation of foxes against rabies using SAD B19 can eliminate wildlife rabies
      among foxes and raccoon dogs, as European experience has shown. The disease then
      also disappears completely in domestic animals and man.

PMID- 7796969
TI  - Target and non-target effects of retrovirus vectors used for gene therapy and
      vaccination.

PMID- 7796968
TI  - Potential hazards associated with influenza virus vaccines.
AB  - There is general agreement that human reassortant vaccine strains should be used
      only for the preparation of the viral glycoproteins (split vaccine), and not in
      toto after UV-inactivation. Live vaccines with lowered pathogenicity obtained by
      reassortment between human and avian strains may carry a risk of causing
      epizootics in other species, even though they are useful for the host for which
      they were designed. It has been argued that this dangerous situation is avoided
      when both parent strains are of human origin. For this reason, cold-adapted human
      master strains are used for reassortment with the most recent isolates from cases
      of human influenza. There is, however, convincing evidence that a reassortant
      between two human strains has caused severe epizootics among camels, which were
      not regarded as natural hosts for influenza A viruses. This sudden appearance of
      a reassortant camel virus had a precedent in experiments in which, starting from
      parent strains that are non-pathogenic for mice, highly pathogenic reassortants
      for this species were created. Safety requirements for cold-adapted reassortants
      must therefore take account of the fact that these new strains may have a high
      pathenogenicity for other species.

PMID- 7796971
TI  - New developments in the construction of safer and more versatile pseudorabies
      virus vaccines.

PMID- 7796970
TI  - Safety aspects in the development of an infectious bovine rhinotracheitis marker
      vaccine.
AB  - Clinical trials in cattle demonstrated that the IBR marker modified live vaccine
      based on the gE-deleted IBR strain Difivac is immunogenic and safe for bovines of
      all ages. Potential effects of the vaccine virus have also been tested in swine
      and sheep and proved safe for these species as well. For evaluation of other
      environmental aspects, the spread of the vaccine virus after immunisation was
      investigated. The data indicated that the vaccine virus may be shed by immunised
      animals but that it has a limited ability to pass from animal to animal. It was
      also demonstrated that the attenuated Difivac strain does not revert to virulence
      during calf passage. Preliminary results indicated that the gE-deleted vaccine
      virus of the IBR marker vaccine cannot be reactivated after dexamethasone
      treatment, an important advantage for a vaccine strain. Furthermore, immunisation
      with the Difivac strain reduced the ability of a superinfecting challenge virus
      to become latent or to be reactivated.

PMID- 7796972
TI  - Characterization of live pseudorabies virus vaccines.

PMID- 7796973
TI  - The influence of recombination on the genetic stability of pseudorabies vaccine
      virus.

PMID- 7796974
TI  - Effects of physiological state on oral habituation in developing rats: cellular
      and extracellular dehydration.
AB  - Hydrational state has been demonstrated to influence intake of various solutions
      in young rat pups. For instance, both cellular and extracellular dehydration
      produce an enhancement of intake in pups tested at 6 days of age. However, the
      behavioral mechanisms that result in increased intake following manipulations of
      hydrational state have been less extensively studied. The impact of hydrational
      state on behavioral responsiveness in young rat pups was examined by assessing
      the pattern of responding to a series of repeated oral infusions of diet. Pups
      were tested at 6, 12, or 18 days of age following either acute cellular
      dehydration produced by injection of 1 M NaCl or acute extracellular dehydration
      produced by injection of 10% polyethylene glycol (PEG). Oral responsiveness to a
      series of 30 brief infusions of one of four taste solutions (water, 10% sucrose,
      0.135 M NaCl, or 1 M NaCl) was measured. Each infusion lasted 3 s and there was 1
      min between infusions. The pattern of oral responding to solutions was affected
      by the developmental age of the pup, the hydrational state of the pup, and the
      solution offered, with the largest effects of dehydration observed in the
      youngest animals. In all conditions except one, pups habituated to repeated
      infusions. The exception was the failure of extracellularly dehydrated 6-day-old
      pups to display habituation to oral infusions of sucrose. These results suggest
      that, although intake is enhanced by both cellular and extracellular dehydration
      in very young pups, the behavioral changes responsible for the enhancement of
      intake after cellular dehydration are different from the behavioral changes
      resulting from extracellular dehydration. This dissociation of behavioral effects
      of dehydration in young pups demonstrates that intake measures alone may obscure
      subtle differences in behavior and argues for the utility of dissection of
      behavioral components in understanding the neural and physiological control of
      behavior.

PMID- 7796975
TI  - Systematic changes in gaping during the ontogeny of pecking in ring doves
      (Streptopelia risoria).
AB  - Food pecking in the ring dove is a skilled prehensile response that is similar
      to, but simpler than, many other prehensile responses. Previous work has shown
      that this response is initially poorly executed and requires experience for its
      accurate direction and coordination. The response involves two components: the
      thrusting of the bird's head toward food, and the opening and closure of the beak
      around food. Here, this second component, called gape, is followed through
      development with a precise measurement system. Four squabs moved through a
      similar sequence of three gape topographies, each of which is more efficient in
      picking up seed, during development. The present outcome, together with other
      work, argues for a substantial contribution of experience with pecking to the
      development of food pecking. We discuss the implications of these findings for
      understanding the ontogeny of motor control and for understanding how experience
      affects behavioral development.

PMID- 7796976
TI  - Effects of rearing condition on activity-induced weight loss.
AB  - This study evaluated the effects of differential rearing conditions on a rat
      protocol for various human syndromes. Subjects were 26 male Sprague-Dawley rats,
      24 days old at the start of the experiment, matched according to weight, and
      randomly assigned to an isolation- or group-reared (4 rats/cage) condition. At 60
      days of age (273 +/- 13 g), subjects were individually housed in cages allowing
      access to running wheels. Weight loss was produced through voluntary exercise and
      restricted food access. Animals in the isolation-reared condition lost weight at
      a faster rate and had heavier relative thymus weights than those in the group
      reared condition. Animals in both conditions ran equivalent distances and ate
      equivalent amounts of food. The data show that postweaning rearing conditions
      impact the interpretation of behavioral and physiological outcomes of animal
      models. The results implicate a shift from maternal regulation of pup
      physiological and behavioral systems to the broader social niche.

PMID- 7796977
TI  - Molecular cloning of a group of mouse pancreatic islet beta-cell-related genes by
      random cDNA sequencing.
AB  - To understand the molecular basis of glucose concentration-responsive insulin
      synthesis and secretion from pancreatic islet beta cells, a group of pancreatic
      islet beta-cell-related cDNAs was cloned. A pair of cDNA libraries was
      constructed from a mouse pancreatic islet beta-cell line of MIN6, which was
      cultured in either high glucose or low glucose media. By applying a random cDNA
      sequencing approach, 503 and 395 independent species were obtained from a total
      of 1,011 and 762 clones in the high glucose and low glucose library,
      respectively. The unknown genes comprised the majority of about 70% independent
      clones in both libraries. In Northern blot analysis, 311 (69.4%) of 448
      independent clones showed positive signals within 72 h of autoradiographic
      exposure. Surprisingly, 150 (48.2%) out of 311 positive clones showed positive
      signals to MIN6 cells, but not to NIH/3T3 fibroblasts. The expression level of
      three unknown clones were glucose-concentration dependent. Combination of a
      random cDNA sequencing approach and Northern blot analysis is useful to obtain a
      large number of novel genes and islet beta-cell-related genes.

PMID- 7796979
TI  - Non-parallelism of islet amyloid polypeptide (amylin) and insulin gene expression
      in rats islets following dexamethasone treatment.
AB  - Islet amyloid polypeptide (IAPP), a novel islet hormone candidate, has been
      reported to be over-expressed relative to insulin in rats following dexamethasone
      treatment. In order to investigate the expression of IAPP and insulin following
      dexamethasone treatment of rats for 12 days, we applied in situ hybridization and
      immunocytochemistry, allowing us to evaluate islet changes in gene expression and
      morphology. Tissue concentrations of IAPP and insulin were measured by
      radioimmunoassay. A low dose of dexamethasone (0.2 mg/kg daily) increased the
      islet levels of IAPP and insulin mRNA to 249 +/- 13% and 150 +/- 24% of controls,
      respectively (p < 0.001 and p < 0.01). A high dose of dexamethasone (2.0 mg/kg
      daily) increased the islet levels of IAPP and insulin mRNA to 490 +/- 13% and 203
      +/- 9% of controls, respectively (p < 0.001 and p < 0.001). The pancreatic
      concentration of IAPP increased more than that of insulin (p < 0.05).
      Morphometric analysis revealed that dexamethasone treatment induced both
      hyperplasia and hypertrophy of insulin cells. Changes in the cellular
      localization of IAPP and insulin mRNA were not observed. Thus, we conclude that
      the increased level of IAPP mRNA is due to both an increase at the cellular level
      as well as hyperplasia/hypertrophy of insulin cells. In contrast, the increased
      level of insulin mRNA appears to be due to hyperplasia/hypertrophy of insulin
      cells, since insulin gene expression decreased at the cellular level (p < 0.001
      vs controls). These observations provide further evidence that IAPP and insulin
      gene expression are regulated in a non-parallel fashion, which may be relevant to
      the pathogenesis of non-insulin-dependent diabetes mellitus.

PMID- 7796980
TI  - Vanadate treatment rapidly improves glucose transport and activates 6
      phosphofructo-1-kinase in diabetic rat intestine.
AB  - The effect of oral vanadate on intestinal sodium-dependent glucose transport and
      6-phosphofructo-1-kinase (EC 2.7.1.11) activity was examined in male Sprague
      Dawley rats following a 30-day period of non-treated streptozotocin-induced
      diabetes. Non-treated diabetic rats were hyperglycaemic and demonstrated
      increased intestinal sodium-dependent glucose transport and Na,K-ATPase activity
      compared with controls. These increases were associated with a significant
      decrease in the total activity and activity ratios (activity at 0.5 mmol/l
      fructose 6-phosphate at pH 7.0/activity at pH 8.0) of intestinal 6-phosphofructo
      1-kinase and decreased levels of fructose 2,6-bisphosphate. Supplementation of
      drinking water with vanadate (0.5 mg/ml) resulted in a rapid decline in blood
      glucose levels to a slightly hyperglycaemic level. Jejunal glucose transport and
      Na,K-ATPase activity were normalized after 48 h of vanadate treatment. In
      contrast, ileal glucose transport was significantly reduced 12 h following
      beginning vanadate treatment even though Na,K-ATPase activity did not normalize
      until 36 h later. Km was significantly decreased in both jejunum and ileum by
      vanadate treatment indicating an increased affinity of the sodium-dependent
      intestinal glucose transporter for glucose. 6-phosphofructo-1-kinase total
      activity and susceptibility to ATP inhibition was completely restored after 12 h
      of vanadate treatment. This increase was associated with a rise in fructose 2,6
      bisphosphate levels. Fasting rats for 12 h had no effect on glucose transport or
      6-phosphofructo-1-kinase activity, indicating the anorectic effect of vanadate
      was not responsible for changes in either parameter. In contrast, cycloheximide
      prevented both the rise in 6-phosphofructo-1-kinase activity and the rise in
      fructose 2,6-bisphosphate levels, and the subsequent reduction in glucose
      transport, indicating a requirement for protein synthesis. The removal of
      vanadate resulted in an immediate return to pre-treatment blood glucose levels.
      In contrast, intestinal glucose transport and 6-phosphofructo-1-kinase activity
      remained at treatment levels up until 72 h, indicating that oral vanadate
      treatment can have prolonged beneficial effects on intestinal function. In
      conclusion, the treatment of streptozotocin-induced diabetic rats with oral
      vanadate results in an activation of 6-phosphofructo-1-kinase coupled with a
      normalization of intestinal sodium-dependent glucose transport. Vanadate may thus
      have a beneficial effect on intestinal function and may prove useful as oral
      adjunctive diabetic therapy.

PMID- 7796978
TI  - The relative roles of advanced glycation, oxidation and aldose reductase
      inhibition in the development of experimental diabetic nephropathy in the Sprague
      Dawley rat.
AB  - Advanced glycation is an important pathogenic mechanism in the development of
      diabetic complications. However, other biochemical processes, such as the polyol
      pathway or lipid and protein oxidation which can interact with advanced glycation
      can also yield tissue fluorescence and may also be implicated in the genesis of
      diabetic microangiopathy. Aminoguanidine is an inhibitor of advanced glycation,
      but it is not known if all of its effects are mediated by this mechanism. The
      present study explores the relative contributions of aldose reductase, oxidative
      stress and advanced glycation on the development of aortic and renal fluorescence
      and urinary albumin excretion in streptozotocin diabetic rats. The study groups
      included non-diabetic (control), streptozotocin diabetic rats and diabetic rats
      receiving aminoguanidine, the anti-oxidants butylated hydroxytoluene and probucol
      and the aldose reductase inhibitor, ponalrestat. Serial measurements of glycaemic
      control and urinary albumin excretion were performed every 8 weeks. At 32 weeks,
      animals were killed, tissues removed and collagen extracted for measurement of
      fluorescence. Diabetic rats had increased fluorescence in aorta, glomeruli and
      renal tubules. Aminoguanidine prevented an increase in fluorescence at all three
      sites suggesting that diabetes-related tissue fluorescence is predominantly due
      to advanced glycation. Ponalrestat retarded fluorescence in aorta only and
      butylated hydroxytoluene attenuated fluorescence at the renal sites but not in
      the aorta. Diabetic rats had increased renal cortical sorbitol levels.
      Ponalrestat normalized renal cortical sorbitol levels but aminoguanidine did not
      affect this parameter. The only agent to decrease plasma thiobarbituric acid
      reactive substances was butylated hydroxytoluene. Diabetic rats developed
      albuminuria over the 32-week period.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796981
TI  - Capillary surface area is reduced and tissue thickness from capillaries to
      myocytes is increased in the left ventricle of streptozotocin-diabetic rats.
AB  - The left ventricles of normal and diabetic rats, fixed by vascular perfusion were
      examined using modern stereological techniques to quantify changes in the
      morphology accompanying streptozotocin-induced diabetes. The heart weight to body
      weight ratio increased in diabetic rats whilst left ventricular volume remained
      unchanged. Papillary muscles from the diabetic animals showed prolonged time to
      peak tension and relaxation, and altered sensitivity to adrenalin and calcium.
      The apparent cardiomyopathy observed when body weight loss exceeds heart weight
      loss in experimental diabetes was accompanied by specific pathological changes in
      the composition of the left ventricle. In the diabetic animals the volume of
      extracellular components increased threefold and the volume of capillaries fell.
      The surface density and total surface area of capillaries was reduced, and oxygen
      diffusion distance to myocyte mitochondria increased. The volume fraction of
      myocyte mitochondria was reduced during streptozotocin-induced diabetes.

PMID- 7796982
TI  - Expression of insulin receptor on clonal pancreatic alpha cells and its possible
      role for insulin-stimulated negative regulation of glucagon secretion.
AB  - In pancreatic alpha cells, the existence and function of the insulin receptor has
      not yet been fully established. In this study, to confirm the expression of
      functional insulin receptors in pancreatic alpha cells, we performed: 1) insulin
      receptor binding assay, 2) Northern blot analysis and RT-PCR (reverse
      transcription-polymerase chain reaction) amplification of insulin receptor mRNA,
      3) immunocytochemical staining, 4) biosynthetic labelling of insulin receptor
      protein using [35S]methionine, 5) analysis of insulin-stimulated
      autophosphorylation of the insulin receptor in glucagon secreting cell lines, In
      R1-G9 and alpha TC clone 6 cells. Glucagon secretion decreased with the addition
      of insulin in both cells. The receptor binding studies using [125I-Tyr-A14]
      insulin revealed that both cells possessed a significant number of insulin
      receptors (In-R1-G9:K1 = 2.1 x 10(9) mol/l-1, K2 = 6.2 x 10(7) mol/l-1, R1 = 0.27
      x 10(4), R2 = 1.86 x 10(4) sites/cell; alpha TC clone 6: K1 = 2.1 x 10(9) mol/l
      1, K2 = 7.3 x 10(7) mol/l-1, R1 = 0.27 x 10(4), R2 = 1.95 x 10(4) sites/cell).
      Northern blot analysis as well as RT-PCR amplification showed the mRNA specific
      for insulin receptor in both cells. By immunocytochemical staining using anti
      insulin receptor alpha-subunit antibody, positive immunostaining for insulin
      receptor was observed in both cells. [35S]Methionine labelling of both cells
      followed by immunoprecipitation using anti-insulin receptor antibody showed the
      correct size of the insulin receptor protein. The insulin receptor expressed in
      these cells underwent autophosphorylation by insulin stimulation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7796984
TI  - Methodology for retinal photography and assessment of diabetic retinopathy: the
      EURODIAB IDDM complications study.
AB  - We present the methodology for 45 degrees retinal photography and detail the
      development, application and validation of a new system of 45 degrees field
      grading standards for the assessment of diabetic retinopathy. The systems were
      developed for the EURODIAB IDDM Complications Study, part of a European Community
      funded Concerted Action Programme into the epidemiology and prevention of
      diabetes (EURODIAB). Assessment of diabetic retinopathy was carried out centrally
      by a trained reader of colour retinal photographs using the newly-developed
      system. The system proved to be acceptably accurate, repeatable repeatable and
      relatively simple to apply. It compared well with the recognised 'gold standard'
      7-field 30 degrees stereo photography (assessed using a modified Airlie House
      classification scheme), against which the new system was validated in a series of
      48 eyes. Selection was as a stratified random sample based on clinical
      retinopathy status: 5, no retinopathy; 25, non-proliferative retinopathy; 16,
      proliferative or photocoagulated; plus 2, eyes with potentially confounding
      lesions (vein occlusion). Simple presence of retinal lesions was correctly
      detected by both systems in 43 of the 48 eyes, giving 100% agreement on
      detection. Both systems correctly identified the two known cases of confounding
      vein occlusion. In eyes with diabetic retinopathy (n = 41), when severity was
      expressed in three groups: mild background, moderate/severe background and
      proliferative/photocoagulated, at least one grader (out of five) using the new
      system matched the verified results in 38 out of 31 (93%) eyes and three or more
      graders matched in 31 (76%) eyes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7796983
TI  - Effect of high glucose on formation of extracellular matrix components by
      cultured rat heart endothelial cells.
AB  - In an attempt to define the basis for the microvascular changes observed in
      diabetic myocardium, a study was undertaken on the effect of elevated glucose on
      the synthesis by rat heart endothelial cells of the extracellular matrix
      components, types VI, IV and I collagen, as well as fibronectin. Confluent
      cultures of these cells, isolated by fluorescence-activated cell sorting after
      treatment with rhodamine-labelled acetylated low density lipoprotein, showed a
      three to fivefold enhancement in the synthesis of type VI collagen after exposure
      for 48 h to high glucose (20 to 30 mmol/l), as determined by immunoblot analysis.
      Increased production of type IV collagen and fibronectin was also observed, but
      the change was smaller and no effect on type I collagen was found. Measurement of
      mRNA levels by hybridization with cDNA probes indicated that 48-h exposure to
      high glucose significantly increased the level of transcripts for type VI and IV
      collagens but not for type I collagen. While glucose consumption by endothelial
      cells in high glucose doubled in the initial 24-h period, utilization returned to
      normal by 48 h, concomitant with a reduction in GLUT1 transcript levels,
      suggesting that signals for stimulation of collagen synthesis must be active
      during the initial period of exposure to elevated glucose levels.

PMID- 7796985
TI  - Peptide-based radioimmunoassay for the two isoforms of the human insulin
      receptor.
AB  - The insulin receptor exists in two isoforms differing by the absence (HIR-A) or
      presence (HIR-B) of 12 amino acids in the COOH-terminus of the alpha-subunit as a
      consequence of alternative splicing of exon 11. In this study, we developed a
      radioimmunoassay for the two isoforms employing antibodies raised against two
      peptides, one (Pep-12) corresponding to residues encoded by exon 11, and the
      other (Pep-13) corresponding to a COOH-terminal domain of the alpha-subunit which
      is common to both HIR-A and HIR-B isoforms. These peptides were iodinated and
      used as both ligands and standards. The assay is specific, highly reproducible,
      and sensitive with a detection limit of 10 fmol of receptor. One mole of purified
      insulin receptor, measured by Scatchard analysis, is read as one mole of receptor
      in the radioimmunoassay with either Pep-12 or Pep-13 as standards. The
      radioimmunoassay is applicable to the measurement of total content and relative
      abundance of the two isoforms in extracts from various tissues. We applied the
      radioimmunoassay to measure the relative abundance of the two isoforms in fat and
      muscle from normal, obese non-diabetic and non-insulin-dependent diabetic (NIDDM)
      subjects. Results demonstrate that expression of the low-affinity HIR-B form is
      significantly increased in obese and NIDDM subjects compared with control
      subjects. In addition, the increased expression of the HIR-B isoform was
      significantly correlated with both body mass index (r = 0.52; p = 0.006) and
      fasting glucose levels (r = 0.59; p = 0.001).

PMID- 7796987
TI  - Molecular and linkage analysis of type-1 protein phosphatase catalytic beta
      subunit gene: lack of evidence for its major role in insulin resistance in Pima
      Indians.
AB  - Insulin resistance is believed to be a prediabetic condition that results from
      reduced rates of insulin-mediated glycogen synthesis in skeletal muscle. A
      decrease in activities of skeletal muscle glycogen synthase and of its regulatory
      enzyme type-1 protein phosphatase (PP 1) have been previously identified in
      insulin-resistant Pima Indians. Because the PP1 catalytic beta-subunit is
      presumed to be the major isoform in the glycogen-bound PP1 complex, we have
      selected the structural gene for this subunit (PPP1CB) as a candidate for a
      detailed genetic analysis. We have determined the exon-intron structure of
      PPP1CB, and have identified a polymorphic (CA)-repeat marker (D2S1237) at this
      gene. No sequence abnormalities were detected in PPP1CB by Southern blot analysis
      or by single-stranded conformational polymorphism analysis of all eight coding
      exons. Using sib-pair linkage analyses, no evidence for linkage was found between
      the D2S1237 marker at this locus and fasting insulin, insulin-stimulated glucose
      uptake in vivo, obesity, or non-insulin-dependent diabetes mellitus. Similarly,
      we have found no evidence for association of D2S1237 with any of these
      phenotypes. Based on our data we conclude that the structural gene for the PP1
      catalytic beta-subunit does not appear to be a major genetic determinant
      responsible for the PP1 abnormalities characteristic of insulin resistance in
      Pima Indians.

PMID- 7796986
TI  - Association between left ventricular hypertrophy and erythrocyte sodium-lithium
      exchange in normotensive subjects with and without NIDDM.
AB  - The determinants of left ventricular mass in normal control subjects and subjects
      with non-insulin-dependent diabetes (NIDDM) are ill-defined. We therefore
      recorded M-mode and pulsed Doppler echocardiograms and 24-h ambulatory blood
      pressure in 57 normotensive subjects, 34 with NIDDM and 23 matched non-diabetic
      control subjects. Measurements of erythrocyte sodium-lithium counter-transport,
      plasma angiotensin II, plasma and platelet catecholamines and fasting plasma
      insulin were also made. Six control subjects (26%) and 15 diabetic subjects (44%)
      had some degree of left ventricular hypertrophy. Subjects with left ventricular
      hypertrophy (n = 21) had an elevated mean rate of sodium-lithium countertransport
      (0.40 +/- 0.13 vs 0.31 +/- 0.09 mmol.l-1.h-1; p < 0.01), parallel differences
      being observed in both the diabetic and control groups. Twelve of the subjects
      with left ventricular hypertrophy (57%) had elevated rates of sodium-lithium
      counter-transport compared to only seven (19%) of those without (p < 0.05). There
      was no consistent difference between those with and without left ventricular
      hypertrophy in any other clinical or biochemical variable. Multivariate analysis,
      with the presence or absence of left ventricular hypertrophy as the dependent
      variable, demonstrated that the maximal rate of sodium-lithium countertransport
      was the only variable that independently contributed to left ventricular
      hypertrophy (partial r = 0.35; F1.55 = 7.74; p = 0.007). This study demonstrates
      for the first time an association between left ventricular hypertrophy and
      erythrocyte membrane cation transport that is independent of hypertension, is
      present in both diabetic and non-diabetic groups, and may represent a link
      between elevated rates of membrane sodium transport and cardiovascular risk.

PMID- 7796988
TI  - The effect of insulin on the vascular reactivity of isolated resistance arteries
      taken from healthy volunteers.
AB  - Impaired reactivity of the resistance vasculature may contribute to the
      development of diabetic microangiopathy by altering microvascular haemodynamics.
      This study investigates the acute effects of insulin on the contractility and
      relaxation properties of isolated human resistance arteries (< 300 microns
      internal diameter) taken from gluteal subcutaneous fat of 33 (18 male: 15 female)
      normotensive healthy volunteers (supine blood pressure 115.6 +/- 1.6/70.0 +/- 1.5
      mm Hg [mean +/- SEM], with no family history of hypertension or diabetes
      mellitus. Resistance arteries were mounted in a small vessel myograph to measure
      isometric tension. Contractile responses to noradrenaline were reduced after
      incubation in 1 mU/ml of insulin for 20 min (p < 0.01; Group 1). Increasing
      concentrations of insulin were found to reduce the contractile response to
      noradrenaline in a dose-dependent manner (Group 2; 0.1 mU/ml by 8% [p < 0.01], 1
      mU/ml by 17% [p < 0.02] and 10 mU/ml by 22% [p < 0.01]). Sensitivity to insulin
      (ED50) only decreased at the highest concentration of insulin. However,
      acetylcholine-induced relaxation was not altered by insulin (Group 2). Time
      control studies (Group 3) showed that contractile and relaxation responses over
      the 4-h study period were unchanged. Furthermore, the length of time the vessels
      were exposed to insulin did not progressively impair responses (Group 4). These
      findings suggest that insulin may induce abnormalities in vascular smooth muscle
      contractility, a factor that may contribute to or exacerbate the abnormal
      haemodynamics observed in the capillary microcirculation of numerous vascular
      beds in diabetes.

PMID- 7796989
TI  - Skin capillary circulation severely impaired in toes of patients with IDDM, with
      and without late diabetic complications.
AB  - We have recently shown that the skin microcirculation of toes is significantly
      impaired in patients with diabetes and peripheral vascular disease, and this may
      be one major reason why these patients are highly susceptible to developing skin
      ulcers. The aim of the present study was to investigate whether the skin
      microcirculation is impaired also in diabetic patients free from macroangiopathy.
      One foot in each of 20 patients with insulin-dependent diabetes was investigated:
      10 patients with and 10 patients without late complications. All patients had
      normal arterial circulation of their lower extremities. Two groups of age- and
      sex-matched healthy subjects served as controls. The capillary blood cell
      velocity in the nailfold of the great toe was investigated by computerised
      videophotometric capillaroscopy, and the total microcirculation within the same
      area evaluated by laser Doppler fluxmetry. The capillary blood cell velocity and
      the total skin microcirculation were studied during rest, and during
      postocclusive reactive hyperaemia. The total microcirculation was similar in
      patients and control subjects, whereas the capillary circulation was markedly
      reduced (p < 0.01) in the patients. The ratio between the capillary and total
      microcirculation was significantly decreased (p < 0.05-0.01) in the patients as
      compared to the control subjects, indicating a local maldistribution of blood in
      the skin microcirculation of the diabetic patients. The results of the present
      study show that in spite of a normal total skin microcirculation in the toes of
      insulin-dependent diabetic patients, both with and without late complications,
      the nutritional capillary circulation is severely impaired.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7796993
TI  - Learning environmental and occupational medicine as a resident.

PMID- 7796991
TI  - Does NIDDM increase the risk for coronary heart disease similarly in both low-
      and high-risk populations?
AB  - Finland has marked regional differences in the occurrence of coronary heart
      disease (CHD). Although the causes for these differences in CHD mortality and
      morbidity in the Finnish population are unknown, it offers an excellent
      opportunity to investigate the effects of non-insulin-dependent diabetes mellitus
      (NIDDM) on CHD risk in two populations differing significantly with respect to
      the occurrence of CHD. Therefore, we carried out a 7-year prospective population
      based study including a large number of patients with NIDDM (East Finland: 253
      men and 257 women; West Finland: 328 men, 221 women) and corresponding non
      diabetic subjects (East Finland: 313 men, 336 women; West Finland: 325 men, 399
      women). In both study populations the presence of NIDDM increased significantly
      the risk for CHD events (CHD mortality or all CHD events including CHD mortality
      or non-fatal myocardial infarction). Diabetic men had 3-4 fold higher and
      diabetic women 8-11-fold higher risk for CHD than corresponding non-diabetic
      subjects. Both non-diabetic and diabetic subjects had odds ratios (East vs West)
      for CHD events of about 2 indicating a similar East-West difference in the CHD
      risk. Regional difference was quite similar in men and women. These results imply
      that factors related to NIDDM, independently of conventional risk factors and the
      occurrence of atherothrombosis in the background population, must play a major
      role in the pathogenesis of atherosclerotic vascular disease in NIDDM diabetes.

PMID- 7796992
TI  - Evaluation of a standardized hyperglucidic breakfast test in postprandial
      reactive hypoglycaemia.
AB  - The oral glucose tolerance test is not specific for diagnosing postprandial
      reactive hypoglycaemia, since it too frequently induces low blood glucose values
      in subjects who have never complained of symptoms of this. By contrast, the mixed
      meal tests are deceptive for this purpose because they do not induce
      hypoglycaemia in subjects who have complained of of hypoglycaemic symptoms. We
      investigated the frequency of hypoglycaemia after a standardized hyperglucidic
      breakfast test in three groups of subjects:group A, 43 control subjects; group B,
      38 postprandial reactive hypoglycaemic patients; group C, 1193 asymptomatic
      subjects undergoing assessment of glycoregulation. In the 38 subjects with
      suspected reactive hypoglycaemia the mean blood glucose nadir was 3.48 +/- 0.08
      mmol/l, i.e. lower than in control subjects (4.83 +/- 0.13 p < 0.0001). Blood
      glucose levels less than 3.3 mmol/l were found in 47.3% of subjects with
      suspected postprandial reactive hypoglycaemia (group B), i.e more frequently than
      in control subjects (group A: 2.2% p = 1.6 x 10(-6)) and asymptomatic subjects
      (group C: 1% p = 8 x 10(-22)). This markedly higher frequency of low blood
      glucose values in subjects with postprandial symptoms compared with control and
      asymptomatic subjects suggests that this test detects a tendency to hypoglycaemia
      after a standardized hyperglucidic breakfast. Since this test mimics average
      French eating habits, the results suggest that the patients undergo such symptoms
      in their everyday life, and that the hyperglucidic breakfast test is a simple
      alternative to ambulatory glucose sampling for diagnosis of postprandial reactive
      hypoglycaemia.

PMID- 7796995
TI  - International medical graduates series inspires readers' comments.

PMID- 7796996
TI  - International medical graduates series inspires readers' comments.

PMID- 7796997
TI  - International medical graduates series inspires reader's comments.

PMID- 7796990
TI  - Insulin receptor substrate-1 gene mutations in NIDDM; implications for the study
      of polygenic disease.
AB  - Variations in the coding regions of the insulin receptor substrate-1 (IRS-1) gene
      have recently been suggested to contribute to the susceptibility of non-insulin
      dependent diabetes mellitus (NIDDM). The purpose of this study was to examine the
      role of the IRS-1 missense mutations at codons 972 (glycine to arginine) and 513
      (alanine to proline) in two diverse populations from South India and Finland at
      high risk for NIDDM. DNA was amplified and digested with restriction enzymes
      BstN1 to detect the codon 972 mutation and Dra III to detect the codon 513
      mutation. The codon 513 mutation was not found in the study subjects. The codon
      972 mutation was present in 10.3% of 126 middle-aged NIDDM subjects and 5.3% of
      95 matched control subjects in the South Indians (p = 0.17). In elderly Finnish
      subjects the frequency of the mutation was 7.5% in 40 NIDDM subjects and 7% in 42
      matched control subjects. The frequency of codon 972 mutation in the South Indian
      NIDDM subjects was very similar to the two previously published studies in Danish
      and French subjects although each study individually fails to reach conventional
      levels of significance. The data from all four ethnic groups were analysed
      together after ascertaining that significant heterogeneity did not exist between
      the studies. Overall, the frequency of the codon 972 mutation is found in 10.7%
      NIDDM subjects and 5.8% control subjects (p = 0.02). These studies suggest that
      the codon 972 mutation of the IRS-1 gene might act as a susceptibility gene
      predisposing to NIDDM in certain ethnic groups.

PMID- 7796994
TI  - Debate journal club teaches critical appraisal skills.

PMID- 7796998
TI  - International medical graduates series inspires readers' comments.

PMID- 7796999
TI  - AFMO--leaders' foresight pays off.

PMID- 7797000
TI  - A family practice death.

PMID- 7797002
TI  - Family physicians and human rights: a case example from former Yugoslavia.
AB  - BACKGROUND: The role of family physicians in the protection of human rights is
      unclear. The purpose of this article is to explore this role through examination
      of the specific case of former Yugoslavia. METHODS: In January/February 1993, we
      investigated medical aspects of human rights abuses as part of a fact-finding
      mission for the Physicians for Human Rights organization. We used primarily
      qualitative methods, including direct observation, key informant interviews,
      focus groups, and key document review. RESULTS: We observed pervasive violations
      of medical neutrality, as indicated by the shelling of Kosevo Hospital, the major
      tertiary care hospital in Sarajevo. Forty-one percent of former prison camp
      detainees from north Bosnia housed at the Karlovac, Croatia, refugee camp had
      scars consistent with physical abuse. Civilians in north central Bosnia and
      Sarajevo were targeted through physical violence, artillery shelling, and
      strangulation of the public health infrastructure--food, water, electricity,
      heat, and medical supplies. CONCLUSIONS: Physicians can be uniquely useful in the
      investigation of human rights. The flexibility of family physicians and their
      attention to the biopsycosocial aspects of health can be especially useful.
      Family physicians should become actively involved in the protection of human
      rights.

PMID- 7797001
TI  - The importance of geriatrics to family medicine: a position paper by the Group on
      Geriatric Education of the Society of Teachers of Family Medicine.
AB  - The role of geriatrics and geriatricians in family medicine remains unsettled.
      Despite a rapidly aging population, a tremendous shortage now exists of faculty
      with interest and expertise in geriatrics. Relatively few family practice
      residents choose to enter geriatric fellowship programs, and federal funding for
      such programs has been reduced. Despite accreditation requirements, residency
      programs are not always able to provide the range of geriatric experiences needed
      to properly prepare graduates to provide care for the broad range of older
      patients. Medical students' exposure to geriatrics remains limited. The Group on
      Geriatric Education of the Society of Teachers of Family Medicine believes that
      family medicine faculty must recognize and be committed to the notion that
      geriatrics is integral to family medicine. Both undergraduate and residency
      training programs should emphasize experience with geriatric patients in multiple
      settings. In particular, the nursing home should not be the main focus of
      geriatric training. The small number of certified geriatric faculty will be able
      to provide leadership, but a broad range of faculty must become involved in
      teaching geriatrics. Faculty development activities and continuing education
      programs to foster the necessary expertise will be essential to the
      accomplishment of this task.

PMID- 7797003
TI  - Primary care specialty selection: application of a vocational behavior theory.
AB  - BACKGROUND AND OBJECTIVES: This study was designed to determine whether medical
      school graduates who completed undergraduate degrees in particular college majors
      were more likely to enter primary care residencies. John L. Holland's theory of
      vocational personalities and work environments was used to cluster undergraduate
      disciplines sharing distinctive qualities. These clusters were evaluated to
      determine if graduates from similar fields were more likely to pursue residencies
      in family practice, general internal medicine, or general pediatrics. METHODS:
      Students who graduated from US and Puerto Rican medical schools in 1987 were
      eligible for the study; college majors of 2,661 graduates entering primary care
      specialties were analyzed. RESULTS: Students completing undergraduate studies in
      the following majors selected primary care residencies by a twofold difference
      over the expected frequency: agriculture, black studies, civil engineering,
      general studies, literature, occupational therapy, and speech. Chi-square tests
      revealed no differences across Holland types in the frequency with which science
      and nonscience students selected primary care residencies. CONCLUSIONS: Primary
      care specialties tend to accommodate students from varied academic backgrounds
      and appear to be tolerant of individuals who have completed undergraduate course
      work in either bioscientific or biosocial nonscience disciplines.

PMID- 7797004
TI  - An educational intervention to increase faculty publication productivity.
AB  - BACKGROUND: Writing is an essential skill for academic family physicians. It is
      essential in all of the academic physicians' roles, and publications are critical
      for promotion and tenure. This study describes a three-part faculty development
      instructional program designed to teach writing skills. The instructional program
      was repeated over a 3-year period involving two different institutions with
      departments of family medicine. METHODS: Educational interventions included
      seminars, workshops, and independent practice, with feedback from senior
      advisors. The practice and feedback sections centered on the faculty members' own
      written products. RESULTS: This series resulted in the publication of 16 papers
      from 13 of the 40 faculty participants. CONCLUSIONS: Our experience suggests that
      a writing series is one effective method that departments of family medicine may
      use to facilitate the writing productivity of faculty.

PMID- 7797006
TI  - Beliefs and attitudes of persons with diabetes.
AB  - BACKGROUND AND OBJECTIVES: Physicians seem to agree that noncompliance by
      diabetic patients is a problem. Despite this, there have been few qualitative
      studies on the actual behaviors, beliefs, and attitudes of diabetic patients. The
      present study was conducted to explore these parameters to help discover ways
      that physicians might enhance diabetic patients' compliance. METHODS: This
      research used a variation of grounded qualitative theory to assess the beliefs
      and attitudes of 14 non-insulin, adult-onset diabetic patients with a disease
      duration of at least 3 years. Of these, seven were considered compliant and seven
      noncompliant by their primary physician. RESULTS: Most of the patients felt they
      had a good understanding of diabetes, were compliant with their medical regimen,
      and considered diabetes a serious disease. Although many of the patients
      expressed strong emotions of frustration and anger, a majority felt that diabetes
      had led them to a healthier and/or happier lifestyle. Noncompliant patients were
      more likely to believe that diabetes would not affect the eventual outcome of
      their lives. They were less likely to want no further information from their
      physician and less likely to report following their physician's instructions.
      CONCLUSIONS: A better understanding of patients' beliefs and attitudes may help
      physicians increase motivation, understanding, and compliance of diabetic
      patients.

PMID- 7797007
TI  - Small area variation analysis: a tool for primary care research.
AB  - Small area variation analysis is a research tool used by health services
      researchers to describe how rates of health care use and events vary over well
      defined geographic areas. Significant variation has been shown to exist in the
      rates of hospitalization for chronic obstructive lung disease, pneumonia,
      hypertension, and in surgical procedures, such as hysterectomy, cholecystectomy,
      and tonsillectomy. Potential sources of variation include differences in
      underlying morbidity, access to care, physician judgment, quality of care
      delivered, patient demand for services, and random variation. Small area
      variation studies have been used to determine if significant variation exists
      across geographic areas and to describe relationships between the observed
      variation and potential causal factors. Methodologic concerns include the
      definition of small areas, defining the at-risk population within each small
      area, sample size, case mix adjustments, and stability of rates over time. The
      use of small area analysis in primary care will require definition of appropriate
      small areas for ambulatory care, description of the variation in ambulatory
      events across small areas, development of appropriate measures for ambulatory
      case mix, and development of appropriate tools to measure the outcomes of
      ambulatory care.

PMID- 7797005
TI  - Implementation and evaluation of a computer-based preventive services system.
AB  - BACKGROUND AND OBJECTIVES: Insufficient attention has been paid to the role that
      modern information systems can play in improving the delivery of and education
      about preventive services in family medicine training and practice sites. From
      September 1990-September 1993, the Department of Family Medicine at the Medical
      University of South Carolina conducted a demonstration project designed to
      develop, implement, and evaluate a comprehensive, computer-based preventive
      services delivery and educational system, based on the recommendations in the US
      Preventive Services Task Force (USPSTF) Report. METHODS: A computer-based patient
      record (CPR) system was implemented. The system had sophisticated preventive
      services tracking and reminder, physician, and patient education features. Twenty
      nine basic USPSTF recommendations were incorporated in the system. An extensive
      physician education series was also implemented. A multi-method evaluation
      system, including patient exit surveys, physician interviews, and practice audits
      was used to evaluate and design improvements to the CPR and education systems.
      RESULTS: Although the system initially had no effect on patient perceptions about
      the frequency of preventive services delivery, there was reasonable concordance
      between patient desires and physician behavior for the discussion of preventive
      services (Kappa = .5 to .6). Physician acceptance of the system was good--in
      1992, 30% of physicians used the preventive services reminders in most of their
      patient visits, and in 1993, 88% of physicians reported more frequent use.
      Practice audits from February 1992-July 1993 showed increased adherence with all
      seven counseling services, 10 of 15 screening services, and one of five
      immunization services. CONCLUSIONS: A CPR-based preventive services system
      coupled with an adaptable physician education about and delivery of preventive
      services. an ideal solution to improving the education about and delivery of
      preventive services.

PMID- 7797008
TI  - Family medicine and human rights.

PMID- 7797009
TI  - Oral immunization with Helicobacter pylori urease B subunit as a treatment
      against Helicobacter infection in mice.
AB  - BACKGROUND & AIMS: Eradication of Helicobacter pylori infections in humans
      results in the healing of gastritis and gastric ulcers. This study used a mouse
      model to test whether oral vaccination can cure Helicobacter infection and
      gastritis. METHODS: Mice were infected with Helicobacter felis. Three weeks after
      infection, the mice were orally immunized with H. pylori urease B subunit.
      Control mice were simultaneously infected but sham immunized. RESULTS: Three to 8
      weeks after oral immunization of H. felis-infected mice with recombinant H.
      pylori urease B subunit, the infection cleared and there was no evidence of
      gastritis. Vaccinated mice remained protected against two consecutive H. felis
      challenges. CONCLUSIONS: These results show that the lack of natural immunity
      against Helicobacter can be overcome by oral immunization and that vaccination
      offers a novel therapeutic approach to Helicobacter-induced gastritis.

PMID- 7797010
TI  - Bone mass and metabolism in patients with celiac disease.
AB  - BACKGROUND & AIMS: Several aspects of the pathogenesis of osteopenia in celiac
      disease are still unclear. Therefore, bone mass and metabolism were evaluated in
      adults with celiac disease in a cross-sectional study. METHODS: Bone mineral
      density (BMD), assessed by total body dual-photon absorptiometry, and serum
      indices of bone metabolism and remodeling were evaluated in 17 patients with
      untreated celiac disease, 14 with celiac disease on a gluten-free diet, and 24
      healthy volunteers. RESULTS: BMD, expressed as a z score, was significantly lower
      in patients with untreated celiac disease than in patients with treated celiac
      disease and volunteers and lower in patients with treated celiac disease than in
      volunteers. Similar changes were observed in serum calcium level, whereas intact
      parathyroid hormone level was significantly higher in untreated than in treated
      patients with celiac disease and volunteers, and no difference was found between
      the latter two groups. 25-Vitamin D level was significantly lower and 1,25
      vitamin D level significantly higher in untreated celiac disease than in treated
      celiac disease and volunteers. Indices of bone remodeling were significantly
      higher in untreated than in treated patients and volunteers and significantly and
      positively correlated with iPTH in untreated patients with celiac disease.
      CONCLUSIONS: BMD is almost invariably low in patients with untreated celiac
      disease. Results in treated patients suggest that gluten-free diet improves but
      does not normalize BMD. Untreated celiac disease is characterized by high levels
      of 1,25-vitamin D and by increased bone turnover, caused by the increase in
      intact parathyroid hormone level.

PMID- 7797011
TI  - Treatment of Crohn's disease with anti-tumor necrosis factor chimeric monoclonal
      antibody (cA2).
AB  - BACKGROUND & AIMS: Increased concentrations of tumor necrosis factor (TNF), a
      potent proinflammatory cytokine, can be shown in the mucosa of patients with
      active Crohn's disease. Neutralization of TNF has been shown to decrease
      recruitment of inflammatory cells and granuloma formation in several animal
      models. The aim of this study was to investigate the safety and potential
      efficacy of an anti-TNF monoclonal antibody in the treatment of active Crohn's
      disease. METHODS: Ten patients with active Crohn's disease that was unresponsive
      to therapy were administered a single infusion of an anti-TNF human/mouse
      chimeric monoclonal antibody (cA2) in an open-label treatment protocol while the
      baseline anti-inflammatory therapy was continued. RESULTS: Eight patients showed
      normalization of Crohn's Disease Activity Index scores and healing of ulcerations
      as judged by colonoscopy within 4 weeks after treatment. One patient had a
      perforation after colonoscopy and recovered completely after surgery. One elderly
      patient showed a poor response. The average duration of response after a single
      infusion was 4 months. No adverse experiences related to cA2 were observed.
      CONCLUSIONS: The results support the hypothesis that TNF is of major importance
      in the pathogenesis of Crohn's disease. Treatment with cA2 was safe and may be
      useful in patients with Crohn's disease that is unresponsive to steroid
      treatment.

PMID- 7797012
TI  - Morphological factors influencing transepithelial conductance in a rabbit model
      of ileitis.
AB  - BACKGROUND & AIMS: Infection of rabbits with coccidia (Eimeria magna) causes
      chronic ileal inflammation and diarrhea. Inflamed ileum also shows decreased
      transmural conductance. The aim of this study was to characterize morphological
      factors known to affect paracellular permeability that may alter transmural
      conductance in inflamed ileum. METHODS: Ileal mucosa was mounted in Ussing
      chambers for study of [3H]mannitol and [3H]inulin fluxes. Light and electron
      microscopy were used for morphometric studies. Alterations in the zonula
      occludens of epithelial cells were evaluated in freeze-fracture replicas.
      RESULTS: Inflamed ileum showed diminished paracellular fluxes. Inoculated rabbits
      showed marked lymphoplasmocytic infiltration and villus blunting in ileum. Villus
      linear junctional density was unaffected. However, total villus apical surface
      area per square centimeter of tissue was reduced in inflamed ileum, causing a
      diminished total villus linear junctional pathway per square centimeter of apical
      surface. Villus zonula occludens strand number was reduced in inflamed ileum,
      whereas the frequency of both villus and crypt lateral surface extrajunctional
      strands increased. CONCLUSIONS: Chronic inflammation exerts a profound effect on
      ileal paracellular permeability. Morphological data suggest that this effect may
      be caused in part by alterations in inflamed ileal mucosal structure and tight
      junctional organization and density, particularly on villi.

PMID- 7797013
TI  - Spontaneous intestinal inflammation and nitric oxide metabolism in HLA-B27
      transgenic rats.
AB  - BACKGROUND & AIMS: It has been reported that transgenic rats expressing the HLA
      B27 and the beta 2- microglobulin genes develop spontaneous gastrointestinal (GI)
      inflammation; however, no systematic or quantitative evaluation of this GI
      inflammation has been reported. Therefore, the objective of this study was to
      characterize quantitatively the GI injury and inflammation observed in
      commercially available HLA-B27 transgenic rats. METHODS: HLA-B27 rats and Fisher
      344 male controls were used for these studies. Gastric, ileal, and colonic blood
      to-lumen clearances of 51Cr-ethylenediaminetetraacetic acid, tissue
      myeloperoxidase activities, and wet/dry ratios of the various tissues as well as
      plasma nitrate and nitrite levels were quantified for each control and transgenic
      animal. RESULTS: Spontaneous ileitis and colitis developed in 5 of 10 HLA-B27
      transgenic rats beginning at approximately 17 weeks of age and persisting for an
      additional 13 weeks. Increases in mucosal permeability and myeloperoxidase
      activities as well as histological analysis showed intestinal injury and chronic
      inflammation. Plasma levels of nitrate and nitrite, the stable decomposition
      products of nitric oxide, were found to be significantly enhanced (fourfold) only
      in those rats that developed the intestinal inflammation. CONCLUSIONS: The
      chronic ileitis and colitis observed in HLA-B27 transgenic rats seems to be
      associated with enhanced NO metabolism.

PMID- 7797014
TI  - A germline substitution in the human MSH2 gene is associated with high-grade
      dysplasia and cancer in ulcerative colitis.
AB  - BACKGROUND & AIMS: The DNA mismatch repair gene human MSH2 shows a germline
      mutation in certain family members with hereditary nonpolyposis colorectal
      cancer. There is an increased risk of colorectal cancer in patients with
      ulcerative colitis (UC) with extensive disease of > 8 years' duration; however,
      specific constitutional predisposing genetic abnormalities have not yet been
      identified. METHODS: A germline human MSH2 abnormality was sought in patients
      with UC with high-grade dysplasia or carcinoma. RESULTS: After direct sequencing
      of exon 13 and flanking regions of human MSH2, a germline T to C substitution was
      shown at the -6 intronic splice acceptor site of exon 13. This substitution was
      found in 14 of 53 patients with UC with high-grade dysplasia or carcinoma (26%)
      compared with 4 of 36 high-risk patients with UC without dysplasia or cancer
      (11%) (P < or = 0.04) and in 7 of 80 healthy adult blood donors (9%) (P < or =
      0.003). The patients with UC who had the substitution were three times more
      likely to develop neoplasia than patients with UC who did not carry it.
      CONCLUSIONS: An intronic splice-site substitution in the human MSH2 gene is
      present in the general population but may predispose to cancer in the setting of
      UC.

PMID- 7797015
TI  - Tumor necrosis factor-induced hepatic DNA fragmentation as an early marker of T
      cell-dependent liver injury in mice.
AB  - BACKGROUND & AIMS: The injection of mice with anti-CD3 monoclonal antibody causes
      activation of T lymphocytes and leads to a lethal shock syndrome. The aim of this
      study was to investigate T cell-dependent, cytokine-mediated target cell death
      that leads to organ injury. METHODS: Anti-CD3 monoclonal antibody or
      staphylococcal enterotoxin B was injected into mice sensitized by D
      galactosamine. Liver injury was assessed biochemically and histologically, and
      circulating cytokines were determined. RESULTS: Mice sensitized with D
      galactosamine developed severe liver injury within 8 hours after injection of
      anti-CD3 monoclonal antibody or staphylococcal enterotoxin B. Apoptotic bodies
      and chromatin condensation were detectable 5 hours after anti-CD3 monoclonal
      antibody challenge. DNA fragmentation in the liver preceded the increase in
      plasma alanine aminotransferase activity. Anti-CD3 monoclonal antibody induced
      the release of tumor necrosis factor and other cytokines. Passive immunization
      against tumor necrosis factor or pretreatment with immunosuppressive drugs
      protected mice from liver injury. Liver injury associated with apoptotic cell
      death and DNA fragmentation was also noted in D-galactosamine-sensitized mice
      injected with staphylococcal enterotoxin B. CONCLUSIONS: Tumor necrosis factor
      induced hepatic apoptosis followed by necrosis may represent a general
      pathomechanism of T-cell shock models using D-galactosamine-sensitized mice.

PMID- 7797017
TI  - Role of Kupffer cells in cold ischemia/reperfusion injury of rat liver.
AB  - BACKGROUND & AIMS: Kupffer cell activation is hypothesized to play an
      etiopathogenic role in storage-related graft failure after liver transplantation.
      The aim of this study was to verify whether the elimination of Kupffer cells
      modifies the magnitude of cold ischemia/reperfusion injury of the liver. METHODS:
      Rat Kupffer cells were eliminated by an intravenous injection of liposome
      encapsulated dichloromethylene diphosphonate. Livers from control and treated
      rats were isolated and perfused before and after 24-hour cold ischemia in the
      University of Wisconsin solution (4 degrees C). Hepatocyte and sinusoidal
      endothelial cell functions were evaluated by taurocholate and hyaluronic acid
      elimination, respectively. Liver transplantation was also performed using control
      and treated donor livers stored under identical conditions. RESULTS: Compared
      with baseline values, similar alterations were found in both groups after cold
      ischemia for hepatocyte function (intrahepatic resistance, bile secretion,
      lactate dehydrogenase release, oxygen consumption, and taurocholate intrinsic
      clearance) and for sinusoidal endothelial cell function (hyaluronic acid
      intrinsic clearance). The 10-day survival rate of animals undergoing
      transplantation was not different between the groups (6 of 15 vs. 4 of 15,
      control vs. treated donor livers, respectively). CONCLUSIONS: The presence or
      absence of Kupffer cells does not modify the effect of 24-hour cold
      ischemia/reperfusion on the rat liver.

PMID- 7797016
TI  - Screening blood donors for hereditary hemochromatosis: decision analysis model
      based on a 30-year database.
AB  - BACKGROUND & AIMS: The high prevalence, morbidity, premature death, and benefit
      of early diagnosis and treatment make hemochromatosis a prime target for
      screening in the white population. Decision analysis techniques were used to
      compare the outcome, utility, and incremental cost savings of a plan to screen
      voluntary blood donors for hemochromatosis. METHODS: The screening strategy
      includes sequential testing of serum unsaturated iron-binding capacity, serum
      transferrin saturation, serum ferritin, and either hepatic iron index or
      venesections to measure exchangeable body iron. Estimates of prevalence,
      asymptomatic intervals, probabilities of life-threatening clinical complications,
      symptom-specific life expectancy, and sensitivity and specificity of screening
      tests are based on our database of 170 hemochromatosis homozygotes and the
      published literature. RESULTS: The screening strategy led to an incremental
      increase in utility of 0.84 quality-adjusted life days with an incremental cost
      savings of $3.19 per blood donor screened. When the potential of identifying
      asymptomatic homozygous siblings was included, these values increased to 1.18
      quality-adjusted life days and $12.57 per person screened. Screening remained a
      dominant strategy given a prevalence of hemochromatosis of > 0.0026 or an initial
      screening test cost of < $8. CONCLUSIONS: Screening blood donors for
      hemochromatosis has the potential to improve overall societal health status and
      decrease third-party payer health care costs over the long-term.

PMID- 7797018
TI  - Pretranslational down-regulation of cytochromes P450 2C11 and 3A2 in male rat
      liver by tumor necrosis factor alpha.
AB  - BACKGROUND & AIMS: The cytokine tumor necrosis factor alpha (TNF-alpha) is a
      primary inflammatory mediator after liver injury. Several cytokines impair the
      regulation of cytochrome P450 (CYP) genes in liver, but the specificity of these
      effects remains unclear. This study investigated the effects of recombinant
      murine TNF-alpha on the expression of specific constitutive CYPs in male rat
      liver. METHODS: Microsomal steroid hydroxylation was used to indicate the
      activities of specific CYPs after TNF-alpha treatment and immunoblotting to
      correlate CYP activities with protein contents. CYP messenger RNA levels were
      measured by solution hybridization. RESULTS: Testosterone 2 alpha/16 alpha- and 6
      beta-hydroxylations, mediated respectively by CYPs 2C11 and 3A2, were decreased
      after TNF-alpha treatment, whereas 7 alpha-hydroxylation (CYP 2A1) was unchanged.
      Similarly, progesterone 2 alpha/16 alpha- (CYP 2C11) and 6 beta-hydroxylations
      (CYP 3A2), but not 21-hydroxylation (CYP 2C6), were decreased after TNF-alpha
      treatment. 2C11 and 3A2 apoproteins and messenger RNAs, but not 2A1 apoprotein,
      were decreased after TNF-alpha treatment; changes in messenger RNAs were evident
      4 hours after treatment. CONCLUSIONS: TNF-alpha down-regulates CYPs 2C11 and 3A2
      in male rat liver at a pretranslational level, whereas two other constitutive
      CYPs, 2A1 and 2C6, seem refractory to TNF-alpha. Thus, impaired CYP regulation by
      TNF-alpha resembles the combined effects of autologous interferons (on 3A2) and
      interleukins (on 2C11).

PMID- 7797020
TI  - Evidence for autoregulation of cholecystokinin secretion during diversion of bile
      pancreatic juice in rats.
AB  - BACKGROUND & AIMS: The mechanism regulating cholecystokinin (CCK) secretion
      during prolonged diversion of bile pancreatic juice (BPJ) is unknown. We examined
      the hypothesis that the decrease of plasma CCK levels after prolonged diversion
      of BPJ is mediated by an increase in plasma somatostatin levels evoked by
      hypercholecystokinemia and somatostatin in turn inhibits CCK-releasing peptide
      (CCK-RP) bioactivity and decreases plasma CCK levels. METHODS: Pancreatic
      secretion, plasma CCK levels, and somatostatin levels were monitored for 7 hours
      after diversion of BPJ in anesthetized rats. Secretion of CCK-RP bioactivity
      during diversion of BPJ was examined in the presence or absence of somatostatin.
      RESULTS: Diversion of BPJ for 2 hours caused a 13- and 2.5-fold increase in
      plasma CCK and somatostatin levels. The increase in somatostatin levels was
      blocked by the CCK antagonist L364,718. At 5 hours after diversion of BPJ, plasma
      CCK and somatostatin levels and luminal CCK-RP bioactivity decreased to basal
      levels. The decrease in plasma CCK levels was prevented by the administration of
      a specific somatostatin antagonist. We also showed that the stimulatory effect of
      the CCK-RP bioactivity was eliminated when the donor rat was pretreated with
      somatostatin. CONCLUSIONS: Autoregulation of CCK secretion occurs during the
      diversion of BPJ and this is mediated by somatostatin, which inhibits the
      secretion of CCK-RP bioactivity and decreases plasma CCK levels.

PMID- 7797021
TI  - Up-regulation of transforming growth factor alpha binding sites in experimental
      rabbit colitis.
AB  - BACKGROUND & AIMS: Transforming growth factor alpha (TGF-alpha), a member of the
      epidermal growth factor family, has been proposed to mediate protection against
      mucosal injury and promote healing of the gastrointestinal mucosa. TGF-alpha acts
      via a plasma membrane receptor, which is distributed throughout the digestive
      system with the highest density in epithelia. The aim of this study was to
      investigate the pattern of TGF-alpha binding sites in the normal and inflamed
      rabbit colon. METHODS: The immune complex/formalin model of acute colitis and
      tissue section receptor autoradiography were used. Inflammation was characterized
      by cellular infiltration, edema, and necrosis. TGF-alpha binding relative density
      was determined by densitometry on film autoradiograms. RESULTS: The normal colon
      had a low to moderate density of specific TGF-alpha binding sites in the mucosa
      and external muscle. TGF-alpha binding density was significantly increased in the
      mucosa at 4 hours and remained higher than normal for up to 48 hours. The density
      of binding sites in the mucosa and the inflammatory index returned to near normal
      values at 96 hours, when colitis had subsided. CONCLUSIONS: The increase in TGF
      alpha binding in the mucosa during experimental colitis supports the hypothesis
      that members of the epidermal growth factor family play a role in inflammation,
      perhaps acting as mediators of mucosal protection and repair.

PMID- 7797022
TI  - Pancreatitis is a risk factor for pancreatic cancer.
AB  - BACKGROUND & AIMS: The Department of Veterans Affairs (VA) maintains a
      computerized file of all hospital discharges since 1970. In taking advantage of
      this large database, the present study aimed to determine whether pancreatitis is
      a risk factor for pancreatic cancer. METHODS: A case control study compared the
      occurrence of pancreatitis in 2639 patients with pancreatic cancer and a matched
      control group of 7774 subjects using multivariate conditional logistic
      regression. RESULTS: The odds ratio associated with pancreatitis increased from
      2.04 (95% confidence interval [CI], 1.53-2.72) 7 or more years before the first
      diagnosis of cancer to 2.14 (CI, 1.68-2.72) 3 or more years before cancer
      diagnosis and to 2.31 (CI, 1.87-2.86) 1 or more years before cancer diagnosis. In
      a multivariate analysis, all types of pancreatitis or chronic pancreatitis alone
      were associated with a significant risk, their odds ratios being 3.42 (CI, 1.98
      5.91) and 2.23 (CI, 1.43-3.49), respectively. No influence was exerted by other
      variables, such as history of gallstone disease or alcoholism, frequency of
      hospital discharges with pancreatitis, and length of coverage in the VA system.
      CONCLUSIONS: A history of pancreatitis constitutes a significant risk for
      subsequent development of pancreatic cancer. The increase of the risk with
      decreasing time before the diagnosis of cancer may indicate that a fraction of
      pancreatic cancers are initially misdiagnosed as pancreatitis.

PMID- 7797019
TI  - Aquaretic effect of the kappa-opioid agonist RU 51599 in cirrhotic rats with
      ascites and water retention.
AB  - BACKGROUND & AIMS: It has recently been described that kappa-opioid receptor
      agonists inhibit antidiuretic hormone secretion and promote water excretion in
      humans and experimental animals. The aim of this study was to evaluate the
      aquaretic efficacy of the kappa-opioid receptor agonist RU 51599 in conscious
      cirrhotic rats with ascites and water retention. METHODS: In protocol 1, arterial
      pressure, heart rate, and renal water metabolism were measured in basal
      conditions and then were measured for 120 minutes after the administration of
      Ringer's solution (n = 8; 0.4 mL) or RU 51599 (n = 7; 1 mg/kg). In protocol 2,
      plasma antidiuretic hormone concentration was measured (n = 6) before and 60
      minutes after administration of RU 51599 (1 mg/kg). In protocol 3, the effect of
      RU 51599 (n = 9; 1 mg/kg) was compared with that of the V2-receptor antagonist
      SKF 100398 (n = 9; 30 micrograms/kg). RESULTS: RU 51599 administration induced a
      profound diuretic and aquaretic effect without altering arterial pressure and
      heart rate. In protocol 2, the kappa-opioid agonist reduced by about 50% plasma
      antidiuretic hormone levels (from 6.6 +/- 0.9 to 3.4 +/- 0.6 pg/mL; P < 0.05).
      Finally, the improvement in renal water metabolism induced by RU 51599 was
      similar to that produced by the V2-receptor antagonist. CONCLUSIONS: RU 51599 has
      a potent aquaretic effect in cirrhotic rats with water retention, suggesting that
      kappa-opioid receptor agonists may be useful for the treatment of water retention
      and dilutional hyponatremia in cirrhosis.

PMID- 7797023
TI  - The role of endoscopic retrograde cholangiopancreatography in patients with
      laparoscopic cholecystectomies.
AB  - BACKGROUND & AIMS: The best clinical strategy for using endoscopic retrograde
      cholangiopancreatography (ERCP) with laparoscopic cholecystectomy is unknown. The
      aim of this study is to use decision analysis to assess four different approaches
      to using ERCP in patients undergoing laparoscopic cholecystectomy. METHODS:
      Decision trees were designed for four clinical strategies: (1) preoperative ERCP,
      with sphincterotomy for choledocholithiasis; (2) selective preoperative ERCP for
      patients at high risk for choledocholithiasis, choledocholithiasis found at
      surgery treated by postoperative ERCP; (3) no preoperative ERCP,
      choledocholithiasis detected intraoperatively treated by postoperative ERCP; and
      (4) no preoperative ERCP, choledocholithiasis detected intraoperatively treated
      with open common bile duct exploration. Using decision analysis with literature
      derived data, the impact on outcome parameters was calculated. RESULTS:
      Postoperative ERCP resulted in the lowest cost, procedure numbers, and hospital
      and back-to-work days. With high preoperative likelihood of choledocholithiasis,
      selective preoperative ERCP was probably a clinically equivalent strategy.
      Sensitivity analysis supported these conclusions when the probabilities and
      utilities were varied over a wide range. The open operative approach to
      choledocholithiasis was only favored if ERCP had < 75% diagnostic and < 50%
      therapeutic success rates or lengthened hospitalization by > 7 days. CONCLUSIONS:
      This study suggests that performing ERCP after laparoscopic cholecystectomy
      minimizes costs and morbidity; however, when choledocholithiasis is likely,
      selective preoperative ERCP may be a clinically equivalent strategy.

PMID- 7797025
TI  - Hyperammonemic coma due to parenteral nutrition in a woman with heterozygous
      ornithine transcarbamylase deficiency.
AB  - Ornithine transcarbamylase deficiency is an X-linked disorder of the urea cycle
      that can cause hyperammonemic encephalopathy in hemizygous males and heterozygous
      females. Affected females typically limit protein intake in their diet. This case
      report describes a 36-year-old woman with ulcerative colitis who went into
      hyperammonemic coma after administration of total parenteral nutrition. A similar
      episode of coma had occurred 7 years earlier after she delivered a normal boy.
      Heterozygous ornithine transcarbamylase deficiency was diagnosed based on a
      positive allopurinol tolerance test result after elevated levels of plasma
      glutamine and low plasma citrulline were detected. The protein load associated
      with parenteral alimentation resulted in symptomatic expression of this partial
      enzyme deficiency in this unique case. Partial ornithine transcarbamylase
      deficiency must always be considered in adult women and men with hyperammonemia
      who have normal liver function test results.

PMID- 7797026
TI  - Eicosanoids and the gastrointestinal tract.
AB  - Determining the role of eicosanoids in gastrointestinal physiology and
      pathophysiology has been an active area of investigation over the past 20 years.
      The landmark discovery of prostaglandin endoperoxide synthase and other enzymes
      involved in the production of arachidonic acid products (lipoxygenases and
      epoxygenases) ushered in a new era of research. The goal of this review is to
      distill a large body of work pertaining to studies of eicosanoids in the
      gastrointestinal tract. This review has been organized according both to
      functional (secretion and motility) and disease-related (inflammation, mucosal
      injury, and neoplasia) effects. The aim of this article is to present a clear
      summary of this area of gastroenterology so that future research can be directed
      in a logical and productive manner.

PMID- 7797027
TI  - Production of immunoglobulin G and G1 antibodies to cytoskeletal protein by
      lamina propria cells in ulcerative colitis.
AB  - BACKGROUND & AIMS: Recent studies suggest an autoantigenic role for tropomyosin
      related protein(s) in ulcerative colitis (UC). This study examined whether
      immunoglobulin G and G1 subclass antibodies against tropomyosins are produced
      spontaneously by the lamina propria mononuclear cells (LPMCs) that infiltrate the
      inflamed UC tissue. METHODS: LPMCs were isolated from colonic biopsy specimens
      from 29 patients with UC, 15 with colonic Crohn's disease (CD), and 13 with non
      inflammatory bowel disease (IBD). The autologous peripheral blood mononuclear
      cells (PBMCs) were obtained. Cells were cultured in vitro and unstimulated for 10
      days. Spontaneous production of immunoglobulin G and G1 antibodies against
      tropomyosins was measured by enzyme-linked immunosorbent assays using highly
      enriched tropomyosins from skeletal muscle and colonic mucosa. RESULTS: The total
      immunoglobulin G produced by LPMCs from both patients with UC and CD was
      comparable but higher than from patients with non-IBD (P < 0.05). However,
      immunoglobulin G antibodies to tropomyosins were higher in patients with UC than
      in patients with CD (P < 0.04) and non-IBD (P < 0.02). LPMCs from patients with
      symptomatic UC produced higher immunoglobulin G antibodies to tropomyosins than
      patients with UC in remission (P < 0.03), symptomatic CD (P < 0.04), and non-IBD
      (P < 0.02). Immunoglobulin G antibodies to tropomyosins predominantly belonged to
      immunoglobulin G1 subclass. The autologous PBMCs showed comparable results.
      CONCLUSIONS: Immunoglobulin G antibodies predominantly belonging to
      immunoglobulin G1 subclass and reactive against tropomyosin-related protein(s)
      are spontaneously produced by LPMCs from the colonic mucosa in patients with UC.

PMID- 7797028
TI  - A primer on outcomes research for the gastroenterologist: report of the American
      Gastroenterological Association task force on outcomes research.

PMID- 7797031
TI  - Screening for hemochromatosis.

PMID- 7797029
TI  - Autoimmunity and ulcerative colitis: can two enigmas make sense together?

PMID- 7797030
TI  - Helicobacter pylori: a diagnostic dilemma and a dilemma of diagnosis.

PMID- 7797024
TI  - Model bile and bile salts accelerate mucin secretion by cultured dog gallbladder
      epithelial cells.
AB  - BACKGROUND & AIMS: Hypersecretion of gallbladder mucin has been proposed as a
      pathogenic factor in gallstone formation. We investigated whether mucin secretion
      is modulated by biliary constituents using normal, well-differentiated dog
      gallbladder epithelial cells. METHODS: Model biles or bile salts were applied to
      monolayers of epithelial cells. Mucin secretion was studied by measuring the
      secretion of [3H]N-acetyl-D-glucosamine-labeled glycoproteins. RESULTS: Model
      biles with different cholesterol saturation indices increased mucin secretion by
      the cells to an average 251% after 5 hours of incubation (P < 0.01). Mucin
      secretion remained elevated during a 24-hour period, suggesting a sustained
      effect on mucin secretion. There was no relation between the cholesterol or
      phospholipid concentration and the extent of stimulation of mucin secretion.
      Taurocholate caused a dose-dependent increase in mucin secretion, suggesting that
      bile salt was the bile component responsible for the stimulatory effect. At a
      concentration of 0.5 mmol/L, only the more hydrophobic bile salts
      taurochenodeoxycholate and taurodeoxycholate, but not the hydrophylic bile salts
      taurocholate and tauroursodeoxycholate, stimulated mucin secretion (P < 0.01).
      CONCLUSIONS: Bile salts play an important role in the regulation of mucin
      secretion. A shift in the bile salt composition of bile towards the more
      hydrophobic bile salts may cause mucin hypersecretion, thereby initiating
      cholesterol gallstone formation.

PMID- 7797032
TI  - Motor cycles and other cycles in chronic pancreatitis.

PMID- 7797033
TI  - Erythromycin enhances fasting and postprandial proximal gastric tone in humans.
AB  - BACKGROUND & AIMS: Low doses of erythromycin induce antral contractions and
      accelerate gastric emptying. However, the effect of erythromycin on the proximal
      stomach remains unknown. The aim of this study was to assess the effect and
      mechanism(s) of action of erythromycin on proximal gastric tone in humans.
      METHODS: Gastric tone was measured using an electronic barostat in two groups of
      6 subjects both in the fasting state and after a 200-kcal meal. On different
      occasions, subjects received saline, atropine alone (6 micrograms.kg-1.h-1 for 30
      minutes), erythromycin alone (1.5 mg/kg in the fasting state and 1.5 and 3.0
      mg/kg in the postprandial state), and erythromycin plus atropine. RESULTS: Low
      dose (1.5 mg/kg) erythromycin enhanced fasting gastric tone, but only the 3.0
      mg/kg dose reduced the duration of meal-induced relaxation (37 +/- 14 vs. 105 +/-
      20 minutes; P < 0.01). Atropine did not change the fasting or postprandial
      gastric tone as well as the erythromycin-induced responses. Plasma motilin levels
      were unaffected by erythromycin infusion. No correlation was observed between
      gastric tone and plasma motilin or erythromycin levels. CONCLUSIONS: Erythromycin
      enhances fasting and postprandial proximal gastric tone in humans by a mechanism
      that does not seem to involve endogenous motilin release or a cholinergic
      pathway.

PMID- 7797034
TI  - Management of choledocholithiasis in the laparoscopic era.

PMID- 7797036
TI  - Eradication of Helicobacter pylori: in search of a regimen the patient may
      accept.

PMID- 7797035
TI  - Antibiotics and cholangitis.

PMID- 7797037
TI  - Gastrointestinal sensory function in functional dyspepsia.

PMID- 7797038
TI  - Hexamethonium and secretory diarrhea.

PMID- 7797039
TI  - Portal hypertensive vasculopathy and mucosal vascular ectasias.

PMID- 7797040
TI  - Cure of gastric lymphoma with antibiotics.

PMID- 7797041
TI  - Altered rectal perception is a biological marker of patients with irritable bowel
      syndrome.
AB  - BACKGROUND & AIMS: Lowered visceral perception thresholds have been suggested as
      a biological marker of irritable bowel syndrome (IBS). The current study sought
      to determine the prevalence of altered rectal visceral perception in patients
      with IBS and the correlation of altered perception thresholds with subjective
      symptoms. METHODS: Anorectal manometry and rectal perception thresholds to
      balloon distention were determined in 100 patients with IBS and 15 control
      subjects. Gastrointestinal and psychological symptoms were assessed by
      questionnaire. Perception thresholds and symptoms were reassessed after 3 months
      in 15 patients with IBS. RESULTS: Ninety-four percent of patients showed altered
      rectal perception in the form of lowered thresholds for aversive sensations
      (discomfort), increased intensity of sensations, or altered viscerosomatic
      referral. Hypersensitivity was found only for aversive sensations in response to
      rapid phasic distention; stool thresholds and thresholds in response to slow ramp
      distention were normal. Cluster analysis by physiological parameters identified
      three IBS subgroups with predominant patterns of symptoms. Longitudinal
      evaluation indicated a correlation between changes in perception thresholds and
      symptom severity. CONCLUSIONS: Because altered rectal perception is present in
      almost all patients with IBS and perception thresholds correlate with temporal
      changes in retrospective symptom severity, altered rectal perception represents a
      reliable biological marker of IBS.

PMID- 7797042
TI  - Genetic instability associated with adenoma to carcinoma progression in
      hereditary nonpolyposis colon cancer.
AB  - BACKGROUND & AIMS: Genetic instability related to defective DNA mismatch repair
      genes may be involved in the pathogenesis of carcinoma in hereditary nonpolyposis
      colon cancer (HNPCC). However, nonneoplastic tissues from patients inheriting
      defects in human MSH2 or human MLH1 do not show significant genetic instability.
      The aim of this study was to determine whether acquisition of genetic instability
      at the adenoma stage promotes malignant transformation by studying adenoma
      carcinoma progression in HNPCC. METHODS: Dinucleotide repeat loci were analyzed
      by polymerase chain reaction from microdissected adenoma and/or carcinoma stages
      from formalin-fixed paraffin-embedded HNPCC tumors. RESULTS: Although genetic
      instability was observed at some loci in almost all cases, the proportion of
      microsatellite loci altered was significantly less (P < 0.01) in completely
      benign adenomas (24%) than in benign areas of adenomas with malignancy (54%).
      Molecular fingerprints indicated intratumor heterogeneity, with evolution of
      related subclones of neoplastic cells. However, in all cases of tumor
      progression, at least one subclone from the adenoma stage was closely related to
      the carcinoma. CONCLUSIONS: Some genetic instability develops at the benign
      adenoma stage in most HNPCC tumors. Adenomas with a greater rate of genetic
      instability are more likely to progress to carcinoma. Topographic genotyping data
      provides evidence supporting the hypothesis of adenoma-carcinoma progression in
      HNPCC.

PMID- 7797043
TI  - Endogenous bacterial toxins are required for the injurious action of platelet
      activating factor in rats.
AB  - BACKGROUND & AIMS: Platelet-activating factor (PAF), an endogenous mediator for
      experimental sepsis, has been shown to induce shock and intestinal necrosis in
      vivo. However, it is unclear whether PAF exerts its injurious effects on the
      intestinal tissue directly or via synergism with other endogenous products. The
      aim of this study was to examine the role of endogenous bacterial products, such
      as endotoxin, in PAF-induced intestinal injury. METHODS: PAF (3 micrograms/kg)
      was injected intravenously into normally colonized rats, germfree rats, and
      normal rats pretreated with a combination of antibiotics, and the systemic
      response and intestinal injury were assessed. RESULTS: PAF did not cause
      prolonged shock, leukopenia, hemoconcentration, and bowel necrosis in germfree
      rats. When germfree rats were primed with a low dose (0.5 mg/kg) of endotoxin,
      the protection was lost. Combined treatment of the normally colonized rats with
      neomycin, polymyxin B, and metronidazole for 7 days largely protected the animal
      from PAF-induced shock and intestinal necrosis. CONCLUSIONS: PAF does not
      directly induce prolonged hypotension, hemoconcentration, persistent leukopenia,
      and gross intestinal necrosis but causes these changes via a synergism with
      endogenous bacterial toxins, presumably from the gut flora.

PMID- 7797045
TI  - State-of-the-art potential clamp device for myelinated nerve fibres using a new
      versatile input probe.
AB  - A potential clamp device for myelinated axons is presented which, for the first
      time, systematically optimizes all the methodological parameters that limit the
      reliability of ionic current measurements. A crucial step toward this end
      consisted in the development of a new input probe with broad-band, extremely low
      capacitance characteristics. In combination with a simple-to-use compensation
      criterion for optimum positive feedback, based on plausible assumptions, and with
      additional technological improvements, it enables the measurement of ionic
      currents with a reliability never previously achieved. The consequences with
      respect to evaluation of several earlier findings are discussed.

PMID- 7797044
TI  - A simulation approach to the two-point stochastic model of olfactory neurons.
AB  - Neurons need two basic properties to carry out their functions. The first is
      their ability to transduce the changes of the dendritic potential and to sum them
      in spatial and temporal dimensions. The second is their ability to elicit an
      action potential which can be transmitted along the axon at a long distance. This
      simulation study demonstrates how these two properties can be retracted to the
      two points of the neuron model. First we discussed the definition and general
      properties of the so-called two-point or spiking neuron model. Then a simple
      simulated solution of the first passage time problem of the birth and death
      process applied in this model was discussed. In case of olfactory cells, the
      model exhibited a behaviour similar to the experimental data with parameter
      values corresponding to the suprathreshold concentrations of an odorant.

PMID- 7797046
TI  - Interpretation of the inotropic effect of 2,3-butanedione monoxime on the
      isometric twitch of guinea-pig papillary muscle.
AB  - The negative inotropic effect of 2,3-butanedione monoxime (BDM) on the isometric
      twitch of guinea-pig papillary muscle was analysed by parameters characterizing
      the time course of the mechanogram. BDM at concentrations of up to 4 mmol/l
      produced a clear negative inotropic effect, whereas the Ca transient measured in
      isolated cardiomyocytes was only slightly affected. Peak force was more reduced
      than dF/dtmax and dF/dtmin. This led to an earlier, more narrow peak and a
      shortening of twitch duration. Based on a reaction scheme for the cross-bridge
      cycle, a mathematical model using a Ca transient and mechanograms as input data
      has been developed. The kinetic parameters were estimated by fitting the model to
      various time courses of force obtained at rising concentrations of BDM. BDM
      decreased the ratio of rate constants for cross-bridge attachment and detachment
      in a concentration-dependent manner: the formation of cross-bridges became
      inhibited, whereas dissociation was promoted. Above 4 mmol/l BDM the more marked
      alterations of the parameters of the mechanogram indicated an additional
      suppressing effect on intracellular Ca supply. The computer analysis suggests how
      the cellular mechanism(s) of the BDM-induced negative inotropic effect are
      reflected in the time course of the mechanogram.

PMID- 7797047
TI  - The effect of albumin on incorporation of merocyanine 540 into phospholipid
      liposomes.
AB  - Absorption and fluorescence emission spectroscopy was applied to study the
      changes in albumin modified incorporation of merocyanine 540 into liposomes
      composed of different lecithins (DMPC, DPPC, POPC, and egg PC). Our results
      confirmed high affinity of merocyanine molecules toward albumin and revealed that
      albumin competed with all phospholipids used for binding merocyanine 540
      molecules. However, the extent of this competition was determined by the kind of
      phospholipid. Albumin competed very successfully with lecithins containing
      saturated fatty acid chains (DPPC, DMPC) and weakly with unsaturated lecithins
      (POPC, egg PC) for binding merocyanine 540 molecules.

PMID- 7797048
TI  - Enzyme kinetics and the activation energy of (Na,K)-ATPase in ischaemic hearts:
      influence of the duration of ischaemia.
AB  - Hearts from male rats were incubated at 37 degrees C for variable periods of
      global ischaemia. Estimation of kinetic parameters of (Na,K)-ATPase at 37 degrees
      C in the presence of increasing concentrations of ATP revealed a significant
      decrease of Vmax in the first 15 minutes of ischaemia with further stabilization
      at the lowest level in 45-60 minutes of ischaemia. The changes in ATP binding
      site occurred later after 45 minutes of ischaemia as showed by the decrease of
      the Km value. As to the activation energy, there were no significant differences
      between control and ischaemic hearts.

PMID- 7797049
TI  - Influence of salmon melanin concentrating hormone on vasopressin analogue (dDAVP)
      activity and sodium transport in frog skin.
AB  - Salmon melanin-concentrating hormone (sMCH) is a peptide known to regulate skin
      pigmentation both in fish and tetrapod (frog and lizard). To evaluate the
      influence of sMCH on ionic transport in frog skin, standard voltage-clamp
      technique for the measurement of transepithelial short-circuit current (ISC)
      reflecting net sodium transport was used. It was found that sMCH alone applied at
      concentrations of 0.5; 5 or 10 mumol/l failed to influence ISC. The application
      of 5 mumol/l of sMCH, however, inhibited ISC across the skin stimulated by a
      synthetic analogue of vasopressin (dDAVP), whereas no influence on natriferic
      effect of 1 mumol/l forskolin by the studied peptide was observed. The results
      indicate that cAMP was presumably not involved in the mediation of sMCH action in
      frog skin. We assume that the interaction of sMCH with the basolateral membrane
      could lead either (1) to changes of membrane structure including organization of
      its lipid surrounding or (2) to modification of AVP/dDAVP receptor activity and
      binding capacity. The nature of these interactions and change(s) in cell membrane
      and signal(s) which trigger processes responsible for the inhibitory effect of
      sMCH on dDAVP-stimulated frog skin sodium transport remains to be elucidated.

PMID- 7797050
TI  - Inhibition of fructose diphosphate aldolase by phosphatidylserine liposomes.

PMID- 7797051
TI  - Inhibition of (Na/K)-ATPase by NFE induces an increase in mechanical activity of
      perfused guinea-pig heart.
AB  - The effect of 1-(5-nitro-2-furyl)-2-(phenylsulfonyl)-2-(furylcarbonyl)- ethylene
      (NFE) on stimulation of (Na/K)-ATPase by sodium and potassium ions was tested in
      isolated, partially purified sarcolemmal preparation from guinea-pig hearts. NFE
      inhibited competitively the stimulation of the enzyme by increasing
      concentrations of potassium. This inhibition was characterized by a significant
      (p < 0.001) increase of the K0.5 value, a considerable decrease of the Hill's
      cooperativity constant n as well as by an insignificant diminution of the Vmax
      value. Contrary to the effect on stimulation by potassium, NFE inhibited non
      competitively the stimulation of the ATPase by sodium ions with a significant (p
      < 0.001) depression of Vmax but without any considerable effect on the K0.5 and n
      values. These results indicated that NFE may interact with the molecule of (Na/K)
      ATPase in a locus close to or identical with the potassium binding site of the
      enzyme, i.e., in a similar mode as it was well documented for ouabain. This
      possibility was strongly supported by the finding that NFE administered at the
      concentration of 0.1 mumol/l in the perfusion medium increased significantly (p <
      0.01) the mechanical activity of isolated perfused guinea-pig heart (Langendorff
      preparation). Nevertheless, it also caused some adverse effects such as a slight
      increase in coronary flow resistance and in heart rate as well as in the left
      ventricular end-diastolic pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7797052
TI  - Na(+)-Ca++ exchange mechanism in smooth muscle of the ureter.
AB  - The participation of Na+ in regulation of intracellular Ca++ content and in
      formation of spontaneous action potentials of guinea-pig ureter was studied. It
      was shown that the fast decrease of intracellular Ca++ in the Ca(++)-loaded
      muscles was accompanied by enhancement of Na+ content in the cells. The
      concentration gradient of Na+ was found to define the effectiveness of Ca(++)
      extrusion from Ca(++)-loaded cells. The decrease of intracellular Ca++ showed a
      sigmoidal dependence on Na+ content in the medium. A correlation was established
      between the concentration gradient of Na+ and the formation of action potential
      plateau of ureter smooth muscle cells. The duration of action potential plateau
      decreased in accordance with Ca++ efflux and Na+ influx. The results confirmed
      the participation of Na(+)-Ca++ exchange mechanism in support of Ca++ cellular
      homeostasis as well as in the generation of action potentials of guinea-pig
      ureter.

PMID- 7797053
TI  - Effect of metabolic inhibitors on K+ transport across the lamprey (Lampetra
      fluviatilis) erythrocyte membrane.
AB  - In order to assess the contribution of oxidative metabolism to K+(86Rb+)
      transport across the lamprey red cell membrane, the effects of various metabolic
      inhibitors were examined. The influx of K+ was reduced markedly in the presence
      of 20 mumol/l 2,4-dinitrophenol (2,4-DNP) or rotenone, and to a lesser extent by
      1 mmol/l cyanide. Rotenone produced complete inhibition of the K+ active
      transport and a partial blockade of K+ channels by 28% on the average. Addition
      of 2,4-DNP to incubation media resulted in a significant reduction of both active
      transport of K+ (by 47%) and of K+ movement via channels (by 57%). The inhibitory
      effect of 2,4-DNP on total K+ influx was independent on decreasing extracellular
      pHe from 7.4 to 6.5. The blocking action of 1 mmol/l Ba2+ on K+ channels was
      abolished in the red cells incubated at pHe 6.5. Treatment of the red cells with
      1 mmol/l cyanide diminished active transport of K+ to about 34% of control values
      but did not affect K+ channels. The obtained data indicate that in the lamprey
      red blood cells at least a half of energy needed for the active transport of K+
      is supplied with ATP produced by oxidative phosphorylation. It may be suggested
      that NADH dehydrogenase is the key enzyme required for active transport of K+ in
      the cells, as rotenone, a selective blocker of this enzyme, causes a complete
      blockade of the Na+, K(+)-pump.

PMID- 7797054
TI  - Immobilization stress enhances lipid peroxidation in the rat lungs. Materials and
      methods.
AB  - The present work was carried out to study the involvement of lipid peroxidation
      in immobilization-induced damage of the rat lung. Thirty-hour immobilization
      stress was found to result in a marked morphological alteration of the lung
      ultrastructure and in significant increases of both acid and alkaline phosphatase
      for immobilization times exceeding 12 and 24 hours respectively. Also, increased
      concentrations of conjugated dienes and fluorescent products of lipid
      peroxidation were measured in the lungs of rats immobilized over 12 h.
      Immobilization stress was followed by significant changes in the fatty acid
      contents of lung phospholipids. The levels of polyunsaturated fatty acids C-18:2
      (linoleic acid) and C-20:4 (arachidonic acid) were decreased even during the
      alarm phase. The contents of monounsaturated fatty acids did not change, while
      those of saturated fatty acids slightly increased. The involvement of lipid
      peroxidation in immobilization-induced damage of the rat lung was indirectly
      supported by the observation of decreased levels of vitamin E at 12 h
      immobilization. All the above data suggest that lipid peroxidation is somehow
      involved in the immobilization-induced damage of the rat lung. The observed
      changes in lipid peroxidation preceded the immobilization stress-induced damage
      of the lung cell membranes. Therefore, it seems likely that lipid peroxidation is
      the cause, rather than a consequence of the stress-altered lung structure.

PMID- 7797056
TI  - Can a single bacteriorhodopsin molecule change the structural state of one
      liposome?
AB  - Using ultrasonic velocity measurements the interaction of bacteriorhodopsin (BR)
      with large unilamellar liposomes of dipalmitoylphosphatidylcholine (DPPC) was
      studied in gel (25 degrees C) and in liquid crystalline state (50 degrees C) of
      lipid bilayer. We could show that with the increasing BR concentration the
      increment of ultrasonic velocity increases and a saturation occur at a
      BR/Liposomes of ratio approximately 0.5 mol/mol. BR incorporation into the lipid
      bilayer in gel state leads to an increase of the increment of the ultrasonic
      velocity of the lipid to 9.51 +/- 1.47 ml/mol. This could be mainly attributed to
      a decrease in membrane compressibility or an increase in membrane volume or both.
      No changes of ultrasonic velocity increment were observed with the membrane in
      liquid crystalline state. In this case, BR probably is not able to change the
      mechanical properties of a considerably disordered membrane.

PMID- 7797055
TI  - Effects of Cu(II) complexes on photosynthesis in spinach chloroplasts.
      Aqua(aryloxyacetato)copper(II) complexes.
AB  - The inhibitory effect of 14 aqua(aryloxyacetato) copper(II) complexes on oxygen
      evolution rate in spinach chloroplasts has been investigated. The inhibitory
      effect of these effectors on photosynthesis was confirmed by Hill reaction as
      well as by EPR and fluorescence spectroscopies. The results of the EPR study
      showed that the sites of action of the studied effectors are Z+ and Y+
      intermediates at the donor side of the photosystem (PS) 2. The EPR study also
      showed that another site of action is the oxygen evolving complex, namely its
      manganese cluster. The above suggestions were supported by the results of the
      fluorescence study as well. Based on the restoring of the photosynthetic electron
      transport to 2,6-dichlorophenol-indophenol in chloroplasts inhibited by the
      studied Cu(II) complexes using sym-diphenylcarbazide it can be assumed that the
      own core of PS2 (P680) and a part of the electron transport chain-at least up to
      plastoquinone-remain intact.

PMID- 7797057
TI  - Stochastic description of protein conformational motion.
AB  - Green function analysis of the Fokker-Planck equation was used to describe
      protein conformational motion for approximate variational derivation of typical
      rate constant of protein relaxation from excited nonequilibrium state to the
      equilibrium. This approach was illustrated on a simple one-dimensional
      conformational potential.

PMID- 7797058
TI  - Mediator assays and modulation of inflammation in asthma: introduction.
AB  - The vital role of inflammation in the induction and perpetuation of asthmatic
      responses is now a widely accepted concept. Effective management of asthma
      requires modulation of asthmatic inflammatory responses. Eosinophils play a
      critical role in producing inflammation within the asthmatic lungs. Serologic
      assessment of the level of eosinophilic cationic protein (ECP) may be useful in
      assessing the degree of activation of eosinophils in asthma and the effect of
      pharmacotherapy on activated eosinophils. Several clinical trials have noted that
      ECP levels fluctuate in direct relationship to the amount of ongoing bronchospasm
      and asthmatic inflammation. Modulation of inflammation in asthma can occur
      through pharmacologic means. Nedocromil sodium has been demonstrated to
      significantly affect both early-phase and late-phase inflammatory events
      including effects on mast cell activation and effects on eosinophil function.
      Nedocromil sodium has also been noted to affect production and activity of
      cytokines that are vital to the perpetuation of the asthmatic late-phase
      response. Unlike cromolyn sodium, nedocromil sodium inhibits late-phase
      inflammation even when administered after the early phase of the allergic
      response and has also been demonstrated to be a steroid-sparing agent in mild-to
      moderate asthmatics who require inhaled beclomethasone. Modulation of the
      metabolism of arachidonic acid, thereby affecting levels of prostaglandins and
      leukotrienes, may be extremely useful in selective asthmatic patients. Those
      patients having aspirin sensitivity and chronic rhinitis associated with asthma
      seem to be particularly responsive to arachidonic acid metabolites. In such
      patients, use of aspirin desensitization may be considered. Newer anti
      inflammatory agents being investigated as treatments for asthma include
      methotrexate, hydroxychloroquin, auronifin, and sulfonylureas, among
      others.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7797059
TI  - Clinical application of eosinophilic cationic protein in asthma.
AB  - Among the inflammatory cells involved in the pathogenesis of asthma, eosinophils
      have been recognized as highly significant participants in the late-phase of the
      inflammatory response. Bronchial challenge with allergen inducing inflammation
      and exacerbation of asthma results in activation of eosinophils and release of
      specific eosinophil mediators, including eosinophil cationic protein (ECP).
      Recent studies have demonstrated that activation of eosinophils and increase of
      their release of ECP occur in patients naturally exposed to allergen, and in
      patients having inflammatory exacerbations of asthma, including development of
      bronchial hyperreactivity. ECP is elevated during exacerbation of extrinsic and
      intrinsic asthma in direct relationship to concomitant decrease in pulmonary
      function and increasing asthma symptoms. The elevated serum levels of ECP decline
      subsequent to effective therapy. Monitoring modulation of ECP levels may be
      useful in evaluating the treatment of asthmatic patients and as a marker for the
      efficacy of therapy. Several investigations have strongly suggested that serial
      determination of ECP in asthmatics may be especially useful as an inflammatory
      correlate to the mechanical abnormalities assessed by determination of pulmonary
      function in asthmatic patients.

PMID- 7797060
TI  - Inhaled corticosteroid treatment for asthma.
AB  - Increased numbers of goblet cells associated with decrease in the ciliated
      epithelium occur at an early stage in the patient with asthma. Recent bronchial
      biopsy studies have demonstrated that these changes may occur even in the mildest
      asthmatic patient. The protective function of the epithelium is thus compromised
      and secretion enhanced in early asthma. Anti-inflammatory therapy should be
      employed at an early stage in the asthmatic patient. Avoidance of allergen is
      also essential if the source of the inflammation is atopic disease. Inhaled
      corticosteroids not only reduce bronchial hyperresponsitivity, but also improve
      the diurnal variation that occurs in lung function in the asthmatic patient.
      Inhaled corticosteroid therapy is associated with the normalization of the
      ciliated to goblet cell ratio and a reduction in the inflammatory cell
      infiltrate, including most notably a reduction in eosinophil within the lamina
      propria and respiratory epithelium. These changes induced by inhaled
      corticosteroids are not noted when inhaled beta 2-agonists are employed alone as
      therapy for asthma. The use of inhaled corticosteroids may thus potentially
      reverse the pathologic changes that occur even in the early asthmatic patient,
      whereas utilization of inhaled beta 2-agonists failed to improve histologic
      abnormalities that occur in early asthma.

PMID- 7797061
TI  - Immunopharmacologic profile of nedocromil sodium.
AB  - Nedocromil sodium, a pyranoquinolone, was specifically designed as an agent to
      suppress allergic inflammation. Nedocromil sodium significantly affects not only
      the early-phase of allergen-induced responses, but also expression of late-phase
      inflammation, even when administered after the onset of early-phase responses.
      Nedocromil sodium also limits bronchoconstriction induced by nonallergic factors,
      including cold air and sulfur dioxide at dosages lower than required with
      cromolyn sodium. Nedocromil sodium is more potent than cromolyn sodium in
      preventing mast cell degranulation in selective animal models. In addition,
      nedocromil sodium limits leukotriene C4 production by calcium ionophore
      stimulated eosinophils and also limits the activity of platelet activating factor
      to induce neutrophil generation of superoxides. Diurnal variation of peak flow
      rates in asthmatics and requirement for both beta 2-agonists and inhaled
      beclomethasone have been noted to be reduced in several trials employing
      nedocromil sodium, suggesting that its in vivo activity parallels its in vitro
      activity as an anti-inflammatory agent.

PMID- 7797062
TI  - Clinical overview of nedocromil sodium.
AB  - Nedocromil sodium is a novel anti-inflammatory agent that has been demonstrated
      to significantly improve pulmonary function and decrease bronchial
      hyperreactivity in asthmatic patients. Currently available only as an inhaled
      drug, nedocromil sodium has an excellent safety profile, the only adverse effect
      being a slightly unpleasant taste. Nedocromil sodium has been used as a
      replacement for sustained-release theophylline therapy; the overall efficacy of
      nedocromil sodium is at least equivalent to that of theophylline, with less
      adverse effects occurring in those patients treated with nedocromil sodium rather
      than with theophylline. Nedocromil sodium also appears to be equal in efficacy to
      low doses of beclomethasone when employed in patients with mild to moderate
      asthma. Addition of nedocromil sodium to an ongoing regimen of beclomethasone may
      also allow for reduction in the dosage of inhaled corticosteroid. The overall
      safety of therapy with nedocromil sodium suggests that it be considered as
      initial therapy for those patients having mild to moderate asthma.

PMID- 7797063
TI  - Aspirin sensitive rhinosinusitis and asthma.
AB  - Although aspirin sensitive asthma has been recognized as a clinical entity since
      the beginning of this century, the mechanism for the production of this syndrome
      still remains obscure. Recent studies have indicated a higher than previously
      appreciated incidence of aspirin sensitive asthma, perhaps approaching 40% of
      steroid-dependent asthmatics. Challenge with both oral and bronchial instilled
      aspirin may be useful to identify aspirin-sensitive individuals. During aspirin
      induced reactions, increased vascular permeability is noted. In addition, aspirin
      sensitive individuals have altered levels of production of leukotriene E4 and
      enhanced sensitivity to inhaled leukotriene E4. However, nasal secretions of
      aspirin-sensitive individuals demonstrate enhanced leukotriene C4 concentration
      after aspirin challenge. It has also been noted that nonaspirin-sensitive
      patients have enhanced leukotriene C4 concentration. Thus, the specific defect
      leading to the pathogenesis of aspirin-sensitive asthma and rhinosinusitis in
      selected individuals remains obscure. Eosinophil activation has been noted in
      aspirin-sensitive rhinosinusitis patients; however, other cell types, including
      platelets and monocytes, have also been noted to exhibit metabolic abnormalities
      in this syndrome. Aspirin desensitization may be a useful option in selected
      patients with significant aspirin sensitive rhinosinusitis and asthma.

PMID- 7797064
TI  - Immunosuppressive therapy for asthma.
AB  - Over the last four or five years, there have been some serious attempts to look
      for alternatives to corticosteroids in the management of severe bronchial asthma.
      Rheumatologists and dermatologists long ago recognized the importance of
      replacing corticosteroids with other agents. Some agents such as methotrexate are
      now clearly established through multiple double-blind trials as being appropriate
      substitutes for corticosteroids, whereas other agents which have been
      investigated, such as cyclosporin, are very promising. Finally, a third group of
      agents, including troleandomycin (TAO), have been found to be totally
      inappropriate as possible substitutes for corticosteroids.

PMID- 7797065
TI  - Stevens-Johnson syndrome presenting as intravenous line sepsis.
AB  - A 25-year-old Hispanic female with insulin dependent diabetes mellitus (IDDM) and
      endstage renal disease on chronic hemodialysis was hospitalized with paroxysms of
      fever and chills for a day. A day after starting piperacillin for presumed
      intravascular line infection, she developed a maculopapular dermatitis and
      abnormal liver function tests, at which point the drug was discontinued. However,
      the rash persisted for 10 days, after which it progressively worsened. She
      continued to have high fevers, abnormal liver function tests, and marked
      leukocytosis, despite multiple negative cultures and other nondiagnostic
      examinations. She was treated as a patient with sepsis of unknown etiology and
      received multiple antibiotics on an empiric basis without response. A diagnosis
      of Stevens-Johnson syndrome was then made based on the triad of cutaneous
      dermatitis, mucosal, and hepatic involvement. She received high dose
      corticosteroids and her fever, dermatitis, mucosal lesions, leukocytosis, and
      abnormal liver function tests improved dramatically.

PMID- 7797067
TI  - Detection of airborne natural rubber latex by immunoelectrophoresis, RAST
      inhibition, and immunospot method.
AB  - Occupational dermal and respiratory allergies caused by natural rubber latex
      (NRL) have been encountered with increasing frequency in health care workers. In
      order to measure the amount of airborne NRL, area and personal air sampling was
      performed in three hospital laboratories where workers used latex gloves. The
      total dust levels in laboratory air samples were lower than 0.17 mg/m3. RAST
      inhibition suggested that NRL antigens may exist both in the area and personal
      samples. Immunospot measurements, rocket immunoelectroporesis, and rocket
      radioimmunoelectrophoresis did not show any NRL activities in laboratory
      airsamples, although they were able to detect immunoactive material in positive
      control filter specimens. We conclude that the airborne NRL concentration was
      undetectable in daily hospital laboratory environment where workers used
      disposable NRL gloves. Airborne NRL, however, can be measured by using
      immunological assays.

PMID- 7797069
TI  - Oncogenes: 20 years later.

PMID- 7797066
TI  - Sensitization to inhalant allergens in children diagnosed with food
      hypersensitivity.
AB  - In order to characterize the profile of inhalant allergen sensitizations in
      patients with food hypersensitivity, we carried out a screening process using a
      standard panel of inhalant allergens by SPT. We screened 437 patients (mean age
      5.4 years, 4.1 SD) who showed anti-allergen IgE to one or several foods,
      determined by both SPT and RAST. In each case in which a positive SPT to inhalant
      appeared, a new individualized search for these allergens was performed by both
      SPT and Phadezym RAST. We found sensitization to aeroallergens in 272 of the 437
      children (62%) with sensitization to foods (52% of all patients were sensitized
      to pollens, 17% to dermatophagoides, and 26% to animal allergens). The number
      with sensitization to aeroallergens was proportionally increased in relation to
      the number of food sensitizations (p < 0.05). Sensitization to pollen allergen
      were found with higher frequency (p < 0.001) in patients with sensitization to
      fruits, legumes, and other vegetables (mainly walnuts, chestnuts, melons, or
      sunflower seeds) than in those sensitive to foods of animal origin. Sensitization
      to dermatophagoides and animal allergens did not show any special distribution
      relative to the kind of food sensitization. Seventeen patients with sensitization
      to egg showed sensitization to avian feathers. This type of sensitization did not
      appear in the remainder of patients evaluated.

PMID- 7797068
TI  - Commentary: rename our field allergy, asthma, and clinical immunology.

PMID- 7797070
TI  - Thinking about Howard Temin.

PMID- 7797071
TI  - Cancer: the rise of the genetic paradigm.

PMID- 7797072
TI  - A conjugation-like mechanism for prespore chromosome partitioning during
      sporulation in Bacillus subtilis.
AB  - Spore formation in Bacillus subtilis begins with an asymmetric cell division that
      superficially resembles the division of vegetative cells. Mutations in the
      spoIIIE gene of B. subtilis partially block partitioning of one chromosome into
      the smaller (prespore) compartment of the sporulating cell. Point mutations that
      specifically block prespore chromosome partitioning affect a carboxy-terminal
      domain of SpoIIIE that shows significant sequence similarity to the DNA transfer
      (Tra) proteins of several conjugative plasmids of Streptomyces. In wild-type
      sporulating cells, the prespore chromosome passes through an intermediate stage
      resembling the state in which spoIIIE mutant cells are blocked. The prespore
      chromosome is then transferred progressively through the newly formed spore
      septum. We propose that translocation of the prespore chromosome occurs by a
      mechanism that is functionally related to the conjugative transfer of plasmid
      DNA.

PMID- 7797073
TI  - Distinct modes of cyclin E/cdc2c kinase regulation and S-phase control in mitotic
      and endoreduplication cycles of Drosophila embryogenesis.
AB  - Drosophila cyclin E (DmcycE) is required in embryos for S phase of mitotic and
      endoreduplication cycles. Here, we describe regulatory differences characteristic
      for these two cell cycle types. While DmcycE transcript levels decline in DmcycE
      mutant cells programmed for mitotic proliferation, they are maintained and no
      longer restricted to transient pulses in DmcycE mutant cells programmed for
      endoreduplication. Moreover, DmcycE expression in endoreduplicating cells is down
      regulated by ectopic expression of a heat-inducible cyclin E transgene. DmcycE
      expression in endoreduplicating tissues, therefore, is restricted by a negative
      feedback to the transient pulse triggering entry into S-phase. Conversely, during
      mitotic cycles, where S phase entry is not only dependent on cyclin E but also on
      progression through M phase, cyclin E and associated Dmcdc2c kinase activity are
      present throughout the cell cycle. Reinitiation of DNA replication during the G2
      phase of the mitotic cell cycle, therefore, is prevented by cyclin E/Dmcdc2c
      kinase-independent regulation. Observations in cyclin A mutants implicate G2
      cyclins in this regulation. Our results suggest molecular explanations for the
      different rules governing S phase during mitotic and endoreduplication cycles.

PMID- 7797074
TI  - Regulation of the retinoblastoma protein-related p107 by G1 cyclin complexes.
AB  - The orderly progression through the cell cycle is mediated by the sequential
      activation of several cyclin/cyclin-dependent kinase (cdk) complexes. These
      kinases phosphorylate a number of cellular substrates, among which is the product
      of the retinoblastoma gene, pRb. Phosphorylation of pRb in late G1 causes the
      release of the transcription factor E2F from pRb, resulting in the
      transcriptional activation of E2F-responsive genes. We show here that
      phosphorylation of the pRb-related p107 is also cell cycle regulated. p107 is
      first phosphorylated at 8 hr following serum stimulation of quiescent
      fibroblasts, which coincides with an increase in cyclin D1 protein levels.
      Consistent with this, we show that a cyclin D1/cdk4 complex, but not a cyclin
      E/cdk2 complex, can phosphorylate p107 in vivo. Furthermore, phosphorylation of
      p107 can be abolished by the overexpression of a dominant-negative form of cdk4.
      Phosphorylation of p107 results in the loss of the ability to associate with E2F
      4, a transcription factor with growth-promoting and oncogenic activity. A p107
      induced cell cycle block can be released by cyclin D1/cdk4 but not by cyclin
      E/cdk2. These data indicate that the activity of p107 is regulated by
      phosphorylation through D-type cyclins.

PMID- 7797075
TI  - Activation of the TFIID-TFIIA complex with HMG-2.
AB  - The nonhistone chromosomal protein HMG-2 was identified as a factor necessary for
      activation in a defined transcription reaction in vitro containing RNA polymerase
      II and purified factors. Activation occurred on all promoters assayed except that
      of the immunoglobulin IgH gene. TFIIA was required for stimulated levels of
      transcription. The activation process depended on the presence of TAFs in the
      TFIID complex and generated a preinitiation complex from which TFIIB dissociated
      more slowly. However, titration of TFIIB over three orders of magnitude did not
      obviate the requirement of activator and HMG-2 to achieve stimulated levels of
      transcription. Analysis of the activated reaction identified the TFIID-TFIIA
      complex as the first stage of modification during activation. These results
      suggest that activation can occur solely in the presence of the basal factors,
      activator protein, and an "architectural" HMG factor, which probably stabilizes
      an activated conformation of the TFIID-TFIIA-promoter complex.

PMID- 7797076
TI  - Dissection of progesterone receptor-mediated chromatin remodeling and
      transcriptional activation in vivo.
AB  - We have investigated whether constitutive binding by the progesterone receptor
      (PR) to a promoter is required for the maintenance of an open chromatin structure
      in vivo. For these experiments, we used human T47D breast cancer cells in which
      the mouse mammary tumor virus (MMTV) promoter, stably assembled as chromatin, is
      constitutively hypersensitive to endonucleolytic cleavage. In vivo footprinting
      revealed that transcription factors nuclear factor 1 and the PR were
      constitutively bound to the MMTV promoter in these cells. Treatment of these
      cells for 1 hr with the steroid antagonist ZK98299 prevented PR binding to
      chromatin in vivo and reversed hypersensitivity, leading to the loss of
      transcription factor binding. The reduction in hypersensitivity induced by
      ZK98299 was readily reversed by treatment with the progestin R5020. The chromatin
      organization of the promoter could be cycled between the open and closed states
      by consecutive treatments with agonist or antagonist. The antagonist RU486 also
      blocked activation of transcription and the assembly of a transcription
      preinitiation complex, but in contrast to ZK98299, maintained the hypersensitive
      chromatin state. Taken together, these results suggest that PR binding to
      chromatin is sufficient to induce hypersensitivity to endonucleolytic cleavage.
      Furthermore, they indicate that the PR binding to DNA and the resulting chromatin
      hypersensitivity is functionally separate from transcriptional activation in
      vivo.

PMID- 7797077
TI  - Pip, a novel IRF family member, is a lymphoid-specific, PU.1-dependent
      transcriptional activator.
AB  - The immunoglobulin light-chain gene enhancers E kappa 3', E lambda 2-4, and E
      lambda 3-1 contain a conserved cell type-specific composite element essential for
      their activities. This element binds a B cell-specific heterodimeric protein
      complex that consists of the Ets family member PU.1 and a second factor (NF-EM5),
      whose participation in the formation of the complex is dependent on the presence
      of DNA-bound PU.1. In this report we describe the cloning and characterization of
      Pip (PU.1 interaction partner), a lymphoid-specific protein that is most likely
      NF-EM5. As expected, the Pip protein binds the composite element only in the
      presence of PU.1; furthermore, the formation of this ternary complex is
      critically dependent on phosphorylation of PU.1 at serine-148. The Pip gene is
      expressed specifically in lymphoid tissues in both B- and T-cell lines. When
      coexpressed in NIH-3T3 cells, Pip and PU.1 function as mutually dependent
      transcription activators of the composite element. The amino-terminal DNA-binding
      domain of Pip exhibits a high degree of homology to the DNA-binding domains of
      members of the interferon regulatory factor (IRF) family, which includes IRF-1,
      IRF-2, ICSBP, and ISGF3 gamma.

PMID- 7797078
TI  - Inactivation of the myogenic bHLH gene MRF4 results in up-regulation of myogenin
      and rib anomalies.
AB  - The myogenic basic helix-loop-helix (bHLH) proteins MyoD, myf5, myogenin, and
      MRF4 can initiate myogenesis when expressed in nonmuscle cells. During
      embryogenesis, each of the myogenic bHLH genes is expressed in a unique
      temporospatial pattern within the skeletal muscle lineage, suggesting that they
      play distinct roles in muscle development. Gene targeting has shown that MyoD and
      myf5 play partially redundant roles in the genesis of myoblasts, whereas myogenin
      is required for terminal differentiation. MRF4 is expressed transiently in the
      somite myotome during embryogenesis and then becomes up-regulated during late
      fetal development to eventually become the predominant myogenic bHLH factor
      expressed in adult skeletal muscle. On the basis of its expression pattern, it
      has been proposed that MRF4 may regulate skeletal muscle maturation and aspects
      of adult myogenesis. To determine the function of MRF4, we generated mice
      carrying a homozygous germ-line mutation in the MRF4 gene. These mice showed only
      a subtle reduction in expression of a subset of muscle-specific genes but showed
      a dramatic increase in expression of myogenin, suggesting that it may compensate
      for the absence of MRF4 and demonstrating that MRF4 is required for the down
      regulation of myogenin expression that normally occurs in postnatal skeletal
      muscle. Paradoxically, MRF4-null mice exhibited multiple rib anomalies, including
      extensive bifurcations, fusions, and supernumerary processes. These results
      demonstrate an unanticipated regulatory relationship between myogenin and MRF4
      and suggest that MRF4 influences rib outgrowth through an indirect mechanism.

PMID- 7797079
TI  - Overexpression of the arginine-rich carboxy-terminal region of U1 snRNP 70K
      inhibits both splicing and nucleocytoplasmic transport of mRNA.
AB  - Transient transfection of the U1 snRNP 70K protein into COS cells induced nuclear
      reorganization and redistribution of the splicing factor SC-35, whereas hnRNP
      proteins were not affected. Correspondingly, splicing and nucleocytoplasmic
      transport of a coexpressed mRNA substrate was reduced by overexpression of U1
      70K. The carboxy-terminal portion of U1-70K-encompassing repeats of Arg/Ser,
      Arg/Glu, and Arg/Asp localizes to the nucleus independently of U1 RNA and was
      responsible for these inhibitory effects. This region of U1-70K contains amino
      acid residues similar to those found in splicing factors SC-35, U2AF, su(wa), and
      in other SR proteins suggesting that U1-70K protein may serve as a focus of
      assembly for functional components of the splicing/transport machinery. These
      findings are compatible with models that propose that direct interaction between
      U1-70K and SR proteins play a regulatory role in early events of spliceosome
      assembly.

PMID- 7797080
TI  - Exonucleolytic processing of small nucleolar RNAs from pre-mRNA introns.
AB  - Many small nucleolar RNAs (snoRNAs) in vertebrates are encoded within introns of
      protein genes. We have reported previously that two isoforms of human U17 snoRNA
      are encoded in introns of the cell-cycle regulatory gene, RCC1. We have now
      investigated the mechanism of processing of U17 RNAs and of another intron
      encoded snoRNA, U19. Experiments in which the processing of intronic RNA
      substrates was tested in HeLa cell extracts suggest that exonucleases rather than
      endonucleases are involved in the excision of U17 and U19 RNAs: (1) Cutoff
      products that would be expected from endonucleolytic cleavages were not detected;
      (2) capping or circularization of substrates inhibited formation of snoRNAs; and
      (3) U17 RNA was faithfully processed from a substrate carrying unrelated flanking
      sequences. To study in vivo processing the coding regions of snoRNAs were
      inserted into intron 2 of the human beta-globin gene. Expression of resulting pre
      mRNAs in simian COS cells resulted in formation of correctly processed snoRNAs
      and of the spliced globin mRNA, demonstrating that snoRNAs can be excised from a
      nonhost intron and that their sequences contain all the signals essential for
      accurate processing. When the U17 sequence was placed in a beta-globin exon, no
      formation of U17 RNA took place, and when two U17 RNA-coding regions were placed
      in a single intron, doublet U17 RNA molecules accumulated. The results support a
      model according to which 5'-->3' and 3'-->5' exonucleases are involved in
      maturation of U17 and U19 RNAs and that excised and debranched introns are the
      substrates of the processing reaction.

PMID- 7797081
TI  - The Hermann Wacker Prize Awarded to Prof. Franz Fankhauser, Switzerland.

PMID- 7797082
TI  - Galactose-containing glycoconjugates of the iris, the aqueous outflow passages
      and the cornea in capsular glaucoma. A lectin histochemical study.
AB  - BACKGROUND: The aim of the study was to compare galactose-containing
      glycoconjugates of the iris, the aqueous outflow passages and the cornea with
      exfoliation material in capsular glaucoma. METHODS: Six formalin-fixed, paraffin
      embedded human eyes with capsular glaucoma and six control eyes were studied by
      using a panel of 11 biotinylated lectins to galactose- and N-acetylgalactosamine
      containing glycoconjugates. RESULTS: The Gal (beta 1-->3) GalNAc-reactive lectins
      peanut agglutinin (PNA) and Bauhinia purpurea alba agglutinin (BPA) and the Gal
      (beta 1-->4)GlcNAc-reactive lectins Ricinus communis agglutinin (RCA-I) and
      Phaseolus vulgaris erythroagglutinin (PHA-E) gave the strongest label with
      exfoliation material. Lectin binding to the iris was variable. The binding of
      PNA, BPA, RCA-I, Erythrina cristagalli agglutinin (ECA), PHA-E and Glycine max
      agglutinin (SBA) to the subendothelial region of iris blood vessels closely
      resembled their binding to exfoliation material. RCA-I and PHA-E bound moderately
      to the aqueous outflow passages. The surface of the corneal epithelium showed
      positive reaction with most lectins studied, but the keratocytes reacted with RCA
      I and PHA-E only. Neuraminidase pretreatment generally increased the reaction
      intensity. CONCLUSIONS: The findings suggest that the glycoconjugate composition
      of exfoliation material in the classical locations along the anterior and
      posterior chamber closely resembles that in the subendothelial region of iris
      blood vessels.

PMID- 7797083
TI  - Optic disc morphology in diabetes mellitus.
AB  - BACKGROUND: Diabetes mellitus is a systemic disease affecting multiple tissues
      throughout the body. This study was performed to evaluate intravitally the
      diabetic changes of the optic disc. METHODS: Color photographs of 115 eyes with
      varying severity of diabetic retinopathy and of 29 normal eyes were
      morphometrically examined. RESULTS: We found that the size and shape of the optic
      disc, the neuroretinal rim and the parapapillary atrophy did not differ
      significantly between the diabetic eyes and the normal eyes. These variables were
      independent of the degree of diabetic retinopathy. There was a tendency toward
      decreased visibility of the retinal nerve fiber layer and increased optic disc
      pallor in the diabetic eyes. CONCLUSION: The results indicate that the area and
      form of the optic disc, the neuroretinal rim and parapapillary atrophy are not
      altered by diabetes mellitus. This is important for the diagnosis of glaucoma in
      diabetic patients, since glaucoma leads to a decrease of rim area and an
      enlargement of parapapillary atrophy. The reduced visibility of the retinal nerve
      fiber layer, the increased optic disc pallor and the unchanged size of the
      neuroretinal rim and parapapillary atrophy suggest that diabetes mellitus may be
      associated with nonglaucomatous optic nerve atrophy.

PMID- 7797084
TI  - Cryotherapy for eyelid and periocular basal cell carcinomas: outcome in 166 cases
      over an 8-year period.
AB  - BACKGROUND: Basal cell carcinoma (BCC) is the most common of all malignant
      tumours and often appears on the periocular skin. In the present study, patients
      with 166 eyelid and periocular BCCs were treated with cryotherapy at the Eye
      Clinic of the Kuopio University Hospital. Seven patients with a total of eight
      BCCs died during the first year after cryotherapy, of causes unrelated to BCC.
      These cases were excluded from the analysis of outcome. METHOD: The tumours were
      photographed before excisional biopsy and histopathological examination. The BCCs
      were frozen twice with liquid nitrogen in a closed cryoprobe; a tissue
      thermometer was used. RESULTS: During the mean follow-up of 5 years for 158 BCCs,
      recurrences were observed in 12 cases (7.6%). The most important prognostic
      factors for recurrence were large tumour size (maximum diameter exceeding 10 mm),
      tumour extension into the lid margin, and cicatrising (morpheaform) BCC. The
      complications of cryotherapy were slight, but in some cases lid ectropion needed
      surgical correction. The functional and cosmetic results were very satisfactory
      in most cases. CONCLUSION: Ninety-two percent of BBCs treated with cryotherapy
      did not recur during mean follow-up of 5.0 years (range 1.6-8.4 years).

PMID- 7797086
TI  - beta-Galactosidase transgene expression in transplanted rabbit retinal pigment
      epithelial cells in vivo.
AB  - BACKGROUND: Intraocular transplantation of genetically modified cells that
      release a particular substance could have a major impact on the treatment of
      various ocular diseases. We studied the expression of the reporter gene beta
      galactosidase (lacZ) in transplanted retinal pigment epithelial (RPE) cells in
      vivo. METHODS: RPE cells from pigmented rabbits were transduced with the beta
      galactosidase gene in a retroviral vector. Cells were then assayed for gene
      expression and transplanted subretinally into the eyes of New Zealand White
      rabbits. RPE cells that were transduced with a similar vector without the beta
      galactosidase gene were used as controls. Rabbits were killed on days 1, 7, and
      21 and the eyes processed for transmission electron microscopy RESULTS: Neomycin
      resistant rabbit RPE cells that showed beta-galactosidase activity were generated
      within 2-5 weeks. After transplantation, viable RPE cells that expressed the
      transgene and that phagocytosed rod outer segments were observed on days 1, 7,
      and 21 CONCLUSIONS: The results show that generation of genetically modified RPE
      cells is feasible and that the transplanted cells remain viable and continue to
      express the transgene in the subretinal space of the host animal for at least 21
      days. Transplantation of such genetically modified RPE cells could provide a new
      tool for studying retinal diseases and, potentially, for correcting metabolic
      abnormalities in retinal degenerations and dystrophies.

PMID- 7797087
TI  - Oxygen-induced retinopathy in the newborn rat: effects of hyperbarism and topical
      administration of timolol maleate.
AB  - BACKGROUND: Lesions resembling those of human retinopathy of prematurity can be
      provoked in newborn Wistar rats by exposure to an FiO2 of 80% for the first 5
      days of life followed by 5 days recovery under room-air conditions. METHODS: We
      evaluated the effects of moderate hyperbarism (+60.75 kPa, i.e. 455 mmHg or 0.6
      atm) and topical administration of 0.25% timolol maleate on oxygen-induced
      retinopathy (OIR) in this experimental model. RESULTS: OIR (including
      neovascularization in most cases) was observed in 100% of the retinas of
      normobaric oxygen-reared ratlings that did not receive timolol. OIR was less
      frequent in oxygen-reared ratlings treated with hyperbarism (60%) or timolol
      (65%). Hyperbaric oxygen supplementation combined with timolol treatment during
      both the hyperoxic and room-air phases reduced the incidence of OIR to 30%. There
      was no sign of vasoproliferation in any of the retinas from the latter three
      groups. CONCLUSIONS: The highly significant protective effects of hyperbarism and
      timolol observed in this study are not fully understood. We speculate that
      vasoconstriction induced by the hyperbarism reduces the amount of oxygen that
      reaches the retina from the choroid during O2 supplementation, while an increased
      ocular perfusion pressure caused by timolol-induced reduction of the intraocular
      pressure might decrease the stimulus to vasoproliferation that normally occurs
      with room-air recovery.

PMID- 7797085
TI  - Adhesion molecules in normal and pathological corneas. An immunohistochemical
      study using monoclonal antibodies.
AB  - BACKGROUND: Adhesion molecules are cell surface receptors that are probably
      important in various cell-cell and cell-extracellular matrix interactions of the
      cornea. METHOD: In this immunohistochemical light-microscopic study we analyzed
      the expression pattern of adhesion molecules in normal and pathological human
      corneas (cases of corneal inflammation and degenerative disorders). The analyzed
      molecules included the beta 1 integrin or VLA family VLA-1-6, the beta 2
      integrins or leukocyte integrins LFA-1, Mac-1, and p150,95, the immunoglobulins
      LFA-3, CD2, ICAM-1 and VCAM-1 and the selectins ELAM-1 and GMP-140. RESULTS:
      Inflamed cornea (in contrast to normal cornea). On corneal epithelium, increased
      expression of the alpha 2 subunit of VLA-2 was detected and ICAM-1 was induced on
      the basal epithelial cells. On corneal stromal keratocytes, LFA-3 was induced and
      expression of the alpha subunits of VLA-1-6 and ICAM-1 was increased. On vascular
      endothelium, VCAM-1 and ELAM-1 were induced and ICAM-1 and GMP-140 expression was
      increased. On corneal endothelium, ELAM-1 was induced and increased levels of the
      alpha 1 subunit of VLA-1 and GMP-140 were expressed. Degenerative disorders (in
      contrast to normal cornea): In corneas with degenerative disorders we found
      decreased expression of adhesion molecules. CONCLUSION: Inflammatory cytokines
      increase the expression of the adhesion molecules. Increased expression of the
      VLAs probably promotes cell-extracellular matrix and cell-cell interactions. ICAM
      1, VCAM-1, LFA-3, ELAM-1 and GMP-140 expression was increased on vascular
      endothelium in inflamed corneas. Corresponding receptors on leukocytes probably
      enable a selective recruitment of different leukocyte populations in inflammatory
      corneal diseases. The decreased expression of adhesion molecules in corneal
      degenerative disorders is probably a sign of reduced cell-cell and cell
      extracellular matrix interactions.

PMID- 7797088
TI  - Release of lysosomal protease from retinal pigment epithelium and fibroblasts
      during mechanical stresses.
AB  - BACKGROUND: Mechanical expansion in tissues or in cells may occur under
      physiological and pathological conditions and is accompanied by increased
      activity of proteolytic enzymes. In traction detachment, retinal cells are
      subjected to mechanical strain. The purpose of this study was to ascertain
      whether retinal pigment epithelium (RPE) cells and fibroblasts in tissue culture
      release proteases due to mechanical stress and to investigate the importance of
      the cytoskeleton for mechanotransduction to the lysosomes during cellular stress
      reactions. METHODS: Cell layers were grown on silicone-rubber membranes and
      subjected to mechanical stresses by expansion of the membrane. Concentrations of
      N-acetyl-beta-glucosaminidase (NAG), acid phosphatase (AP), and lactate
      dehydrogenase (LDH) were determined in extracellular fluid. Colchicine 0.5 x 10(
      5) M was used to disrupt the cytoskeleton prior to expansion. RESULTS: RPE cells
      and fibroblasts separated during mechanical expansion, which was accompanied by
      extracellular release of proteolytic activity of NAG (RPE 37.50%; fibroblasts
      23.22% above control value), but not of AP. LDH activity did not increase,
      indicating preserved integrity of the cell membranes during stretching.
      Colchicine caused immediate detachment of fibroblasts, and RPE did not release
      significant activity of NAG under subsequent extension. CONCLUSION: In traction
      detachment, RPE may release in vivo proteases to cut intercellular adhesions in
      order to escape mechanical strain. Our results indicate that release of proteases
      from RPE may be involved in the pathophysiology of traction detachment,
      facilitating by their degradative action the disconnection between RPE and outer
      segments. Similarly, fibroblasts may respond to changes in tension of scleral or
      corneal tissue. Release of proteases following mechanical stress seems to require
      an intact cytoskeleton.

PMID- 7797089
TI  - Macular capillary particle velocities: a blue field and scanning laser
      comparison.
AB  - BACKGROUND: Two different techniques are available for measurement of macular
      capillary particle velocities. The psychophysical blue field simulation technique
      gives data on macular leukocyte flow velocities, while the scanning laser
      technique provides information on capillary blood velocities of hypofluorescent
      segments in the macular network. Published velocity data differ considerably
      between the two methods. The current study was undertaken to compare the two
      measuring techniques in a group of healthy volunteers. METHODS: Thirty-two
      healthy subjects (12 man, 20 women, mean age 27 years) participated in this
      study. All subjects underwent entoptic leukocyte visualization by means of blue
      field simulation followed by fluorescein angiography using scanning laser
      ophthalmoscopy. RESULTS: The capillary blood velocities measured using the
      scanning laser technique were significantly higher (P < 0.01) than the flow
      velocities estimated with the blue field simulation technique (2.68 +/- 0.3 mm/s
      vs 0.89 +/- 0.2 mm/s). No significant correlation between the flow velocities was
      found (r = -0.22). CONCLUSION: The differences may be related to different
      measuring locations and/or measurements of different phenomena. The blue field
      technique estimates average leukocyte flow in the macular network, whereas the
      scanning laser technique quantifies the velocity of erythrocyte aggregates in the
      capillary lumen of the para- and perifoveal network. A combination of both
      techniques may be helpful in interpreting physiological responsiveness and
      altered velocity pattern in diseased eyes.

PMID- 7797090
TI  - The effects of desferrioxamine and ascorbate on oxidative stress in the
      streptozotocin diabetic rat.
AB  - Oxidative stress and protein glycation are closely related processes that may
      contribute to the development of complications in diabetes mellitus. Treatment
      with antioxidants could protect against these processes at a biochemical level,
      and we have therefore investigated the effects of ascorbate and desferrioxamine
      treatment in the streptozotocin diabetic rat. Diabetic animals were given
      ascorbate 1 g/l in drinking water or desferrioxamine 6 mg/kg/day by subcutaneous
      injection and were killed after 6 weeks. In diabetic animals, oxidative stress
      was increased as shown by increased levels of conjugated dienes (CD) in plasma
      and malondialdehyde (MDA) in plasma, erythrocyte membranes, and urine. In
      addition, there was depletion of the nutritional antioxidants ascorbate, alpha
      tocopherol, and retinol. Insulin treatment returned all of these parameters to
      normal. Ascorbate supplementation or desferrioxamine treatment alone failed to
      reduce oxidative stress, but a combination of both interventions restored MDA,
      CD, and antioxidant vitamins to control values. Both ascorbate and
      desferrioxamine also reduced HbA1c and glycated albumin levels. Treatment with
      antioxidants can reduce both oxidative stress and protein glycation and may help
      to reduce the risk of developing diabetic complications. However, ascorbate can
      have both prooxidant and antioxidant effects in vivo, and its use in
      pharmacological doses should be approached with caution.

PMID- 7797091
TI  - Radical mechanisms of cephalosporins: a pulse radiolysis study.
AB  - Radiosterilization induces radicals, and it is very important to describe radical
      mechanisms before the possible use of cephalosporins gamma sterilization.
      Moreover, physiological or radiotherapeutically induced free radicals also
      initiate radical mechanisms. For this study, pulse radiolysis was used. This
      method permits to avoid in vivo direct study difficulties of bioradical processes
      and gives quantitative data. Reactions of solvated electron (eaq-), hydroxyl
      radical (.OH), azide radical (N3.), dibromine radical anions (Br2.-), oxygen, and
      superoxide radical (O2.-) with three cephalosporins have been studied. Absorption
      spectra and rate constants have been determined. It has been found that both eaq-
      and .OH quickly react (k congruent to 10(10) mol-1 L s-1) with the molecules to
      give radicals with similar absorption spectra. N3. gives an absorption spectra
      that has been attributed to an electron transfer, whereas a part of .OH and Br2.-
      could add themselves to an unsaturated bond.

PMID- 7797092
TI  - Enhanced resistance to oxidation of low density lipoproteins and decreased lipid
      peroxide formation during beta-carotene supplementation in cystic fibrosis.
AB  - We investigated the effect of correcting beta-carotene deficiency in cystic
      fibrosis (CF) patients on two parameters of lipid peroxidation. The resistance to
      oxidation of low density lipoprotein (LDL) was measured by the lag time preceding
      the onset of conjugated diene formation during exposure to copper(II) ions, and
      lipid peroxide formation was quantitated by malondialdehyde concentrations in
      plasma (TBA/HPLC method). Simultaneously, alpha-tocopherol and beta-carotene
      concentrations were determined in LDL and in plasma. Thirty-four CF patients were
      investigated before and after 3 months of oral beta-carotene supplementation.
      Beta-carotene concentrations increased (p < 0.0001) in plasma (mean +/- SD) (0.09
      +/- 0.06 vs. 1.07 +/- 0.86 mumol/l) and in LDL (0.02 +/- 0.02 vs. 0.31 +/- 0.28
      mol/mol), without significant changes in alpha-tocopherol, either in plasma (24.7
      +/- 5.9 vs. 25.4 +/- 7.6) or in LDL (8.47 +/- 2.95 vs. 9.05 +/- 4.13). Lag times,
      being shorter (p < 0.05) in patients than in controls, increased from 48.5 +/-
      21.3 to 69.1 +/- 27.9 min (p < 0.001) and plasma MDA concentrations, being
      greater (p < 0.0001) in patients than in controls, decreased from 0.95 +/- 0.32
      to 0.61 +/- 0.15 mumol/l (p < 0.0001). At 3 months, lag times and MDA
      concentrations did not any longer differ between patients and controls. These
      data suggest that excess lipid peroxidation occurring in beta-carotene deficiency
      can be limited and normalized during efficient beta-carotene supplementation in
      CF patients.

PMID- 7797094
TI  - Simultaneous generation of nitric oxide and superoxide by inflammatory cells in
      rats.
AB  - It has recently been shown that peroxynitrite anion is a powerful oxidant than
      can initiate lipid peroxidation. As this oxidant is the product of the reaction
      between nitric oxide and superoxide, we have studied whether cells isolated from
      an inflammatory exudate can release both radicals simultaneously under
      physiological conditions. The carrageenin-induced granuloma model in rats was
      used. Cells from the inflammatory pouch were stimulated with opsonized zymosan in
      the absence or in the presence of exogenous L-arginine. Nitric oxide production
      without exogenous L-arginine was detectable after 15 min (0.29 nmol NO2-) and
      increased with time (1.65 nmol NO2- at 4 h). When nitrite released from cells was
      expressed as a rate a burst was shown in the first few minutes. Between 0 and 15
      min, cells produced NO2- at the following rates: 20 pmol NO2-/1 x 10(6) cells/min
      without exogenous L-arginine and 83 pmol NO2-/1 x 10(6) cells/min with exogenous
      L-arginine. Production was further stimulated with opsonized zymosan (92 pmol NO2
      /1 x 10(6) cells/min), and inhibited by L-NMMA and L-NIO. The production of
      superoxide increased for up to 2 h and then stabilized. A significant increase in
      nitrite was observed in the presence of SOD, whereas L-NIO increased superoxide
      generation. These results suggest that peroxynitrite anion may be formed by
      inflammatory cells.

PMID- 7797095
TI  - Free radical production in nicotine treated pancreatic tissue.
AB  - The ability of nicotine to induce oxidative stress in the pancreatic tissue of
      rats was investigated. Homogenized pancreatic tissue of Sprague-Dawley rats was
      incubated with nicotine in a dose of 200 ng/mg protein/ml for 15, 30, 45, and 60
      min or was incubated for 30 min with nicotine in a dose of 50, 100, 200, 400, and
      800 ng/mg protein/ml. Pancreatic tissue was also incubated with 200 ng/mg
      protein/ml nicotine with or without the scavengers superoxide dismutase (SOD),
      catalase, SOD+catalase, inactivated SOD, inactivated catalase, or albumin.
      Incubation with 0.9% NaCl served as control. There was a positive correlation
      between the duration of nicotine incubation and chemiluminescence (r = 0.6) or
      lipid peroxidation (r = 0.71) and also between the nicotine dose and
      chemiluminescence (r = 0.54) or lipid peroxidation (r = 0.66). Thirty minutes
      incubation of pancreatic tissue with nicotine in a dose of 200 ng/mg protein/ml
      increased chemiluminescence 5 fold and lipid peroxidation 2.5 fold. This response
      was dampened by SOD or catalase and abolished by SOD+catalase. Inactivated
      enzymes or albumin had no scavenging effect. These results demonstrate that
      nicotine causes oxidative stress to the pancreatic tissue of rats.

PMID- 7797097
TI  - Metal-catalyzed oxidation of bovine neurofilaments in vitro.
AB  - Neurofilaments (NF) are important determinants of the shape and size of nerve
      cells. The oxidation of NF, relevant to aging, neurodegenerative disorders, and
      axonal (Wallerian) degeneration, has not been studied. In this investigation, we
      have combined biochemical and ultrastructural methods to study the metal
      catalyzed oxidation (MCO) of bovine NF using an ascorbate/Fe+3/O2 system. The
      oxidation of NF proteins was documented by increases in carbonyl content, which
      were time- and concentration-dependent. Polyacrylamide gel electrophoresis (PAGE)
      and immunoblot analyses revealed the fragmentation of oxidized NF proteins,
      predominantly NF-H and NF-M. Electron microscopy (EM) showed that oxidized NF
      formed dense aggregates and bundles of laterally aggregated filaments. Finally,
      we also demonstrated that oxidized NF proteins were more susceptible to calpain
      proteolysis. In view of the growing evidence supporting increased oxidative
      stress on the nervous system in aging and the report of Cu/Zn superoxide
      dismutase mutation in familial motor neuron disease, oxidative injury of NF may
      be relevant to cell atrophy and degeneration of nerve cells and to the formation
      of abnormal cytoskeletal structures.

PMID- 7797093
TI  - Paraquat--a superoxide generator--kills neurons in the rat spinal cord.
AB  - Microdialysis was used to administer paraquat into the spinal cord of the
      anesthetized rat to determine the effects of the in vivo generation of the
      superoxide anion (O2.-) on neurons. Exposure to paraquat caused blockage of
      axonal conduction, destruction of the cell bodies of neurons, and a general
      release of amino acids. Thus, paraquat is quite harmful to neuronal tissue.
      Similarities between paraquat-induced damage and that previously observed from
      the hydroxyl radical are consistent with paraquat, causing damage by generation
      of reactive oxygen species and the widespread belief that generation of O2.-
      initiates the formation of destructive reactive oxygen species in a wide variety
      of traumas and other disorders.

PMID- 7797096
TI  - Hazards of antioxidant combinations containing superoxide dismutase.
AB  - Oxygen free radical scavengers protect against ischemia/reperfusion injury of the
      kidney in vivo and against hypoxia/reoxygenation (H/R) injury of renal cells in
      several in vitro systems. In an attempt to maximize renal protection we tested
      several antioxidants in combination; the individual components had previously
      reduced reoxygenation injury of hypoxic renal epithelial cells. Both glutathione
      (GSH; 1 mM) and Cu,Zn-SOD provided significant protection against posthypoxic
      injury. Surprisingly, the combination of Cu,Zn-SOD plus GSH eliminated protection
      entirely and was highly toxic to normoxic cells. The toxicity of Cu,Zn-SOD+GSH
      was not prevented by the iron chelator deferoxamine and was only slightly reduced
      by the hydroxyl scavenger DMTU. Catalase reversed the toxicity of Cu,Zn-SOD+GSH
      and provided net protection. Direct measurement of intracellular peroxides using
      2,7-dichlorofluorescein quantitated by laser cytometry also revealed enhanced
      generation of peroxides by cells during H/R when Cu,Zn-SOD+GSH was present. GSSG
      was less toxic than GSH when combined with Cu,Zn-SOD. Importantly, the
      combination of Mn-SOD+GSH provided superior protection to either agent alone. In
      the presence of added GSH, heated or autoclaved Cu,Zn-SOD was still toxic,
      whereas SOD free of chelatable Cu++ was benign. In the presence of GSH, Cu++
      derived from SOD may promote the formation of toxic thionyl radicals, metal
      centered radicals, and/or H2O2, thereby causing cell injury. Great care should be
      used in designing and interpreting studies employing combinations of
      antioxidants.

PMID- 7797098
TI  - Redox intermediates of flavonoids and caffeic acid esters from propolis: an EPR
      spectroscopy and cyclic voltammetry study.
AB  - The redox properties of flavonoids: chrysin (1), tectochrysin (2), galangin (3),
      isalpinin (4), pinostrobin (5), pinobanksin (6), pinobanksin-3-acetate (7), and
      of caffeic acid ester (8) and diacetylcaffeic acid ester (9), all isolated from
      propolis, were investigated by cyclic voltammetry in acetonitrile. The choice of
      aprotic solvent lowered the reactivity of the radical intermediates and made
      possible to identify redox steps and intermediates not detected so far. The
      oxidation potentials (vs. saturated calomel electrode) of the investigated
      compounds were in the region of 1.5 V for 3 and 4; 1.9 V for 1, 2, and 5; 2.0 V
      for 6 and 7; 1.29 V for 8; and 2.3 V for 9. These oxidation potentials were
      mainly influenced by the presence of a double bond in 2,3-position and
      substituent R1 in position 3. Comparison with our earlier data revealed that
      flavonoids, 1-4, and caffeic acid ester 8 with lower oxidation potentials showed
      the maximal lipid antioxidant activity, whereas those with higher potentials (5,
      6, 7, and 9) are less active. On reduction of 1-9 several one-electron-steps were
      typically observed in the potential regions: -1.5 V, -1.8 V, and -2 V. where in
      simultaneous EPR experiments anion radicals of 1 and 3 were observed with the
      center of unpaired spin density on ring A. Upon oxidation of flavonoids 1-4
      carbonyl carbon-centered radicals, .C(O)R, were identified as consecutive
      products using the EPR spin trapping technique.

PMID- 7797099
TI  - Cytolysis does not per se induce lipid peroxidation: evidence in man.
AB  - An increasing bulk of data counters the opinion that cell death and lysis
      necessarily trigger the formation and release of detectable amounts of molecules
      that are markers of lipid peroxidation. Plasma levels of thiobarbituric-acid
      reacting compounds, protein-aldehyde fluorescent adducts, lipid peroxides, and
      endogenous antioxidant compounds were monitored versus controls, during intensive
      care treatment, in six patients seriously poisoned by ingestion of the mushroom
      Amanita Phalloides. All six patients showed cytolysis, and four of them massive
      tissue necrosis, as monitored in terms of serum transaminases. In all six
      patients, however, the blood parameters of redox equilibrium measured were within
      the normal range for the whole observation period.

PMID- 7797100
TI  - Effects of indolinic and quinolinic aminoxyls on protein and lipid peroxidation
      of rat liver microsomes.
AB  - A study on peroxyl radical induced oxidation of rat liver microsomal membranes in
      the presence of different indolinic and quinolinic aminoxyls (Scheme 1) was
      carried out in order to test their efficiency as antioxidants in lipid and
      protein peroxidation. The extent of lipid peroxidation was quantified by the
      amount of malondialdehyde (MDA) produced, and the measurement of carbonyl
      residues was used as an index of microsomal protein oxidation. The results
      obtained suggest that lipid soluble indolinic and quinolinic aminoxyls are
      efficient in protecting lipids and proteins of biological membranes against
      oxidation. The efficacy of these aminoxyls as protectors of lipids and proteins
      was much higher than the water soluble TEMPOL. Moreover, the hydrophobic
      aminoxyls were more effective in preventing protein than lipid oxidation at low
      concentrations (1-20 microM). However, at high concentration (100 microM), lipid
      as opposed to protein oxidation was almost completely inhibited. The data
      supports the hypothesis that proteins probably have a different oxidation pattern
      from lipids.

PMID- 7797101
TI  - Artemia salina as a test organism for measuring superoxide-mediated toxicity.
AB  - The purpose of this study was to examine the possibility of using Artemia salina
      as a test organism in the search for compounds having the ability to protect
      against superoxide-mediated toxicity. The basic procedure for the assay using
      Artemia salina was performed as described in previous literature, with minor
      modifications. We found that Artemia salina are extremely sensitive to menadione
      bisulfite, a compound whose toxicity is probably mediated by intracellular
      superoxide generation. Desferrioxamine (desferal), a compound with known
      protective effects, was shown to display dramatic protective activity in our
      system. We also observed that an inhibitor of endogenous superoxide dismutase
      (SOD) activity increased the toxicity of menadione toward Artemia salina. In
      conclusion, this simple, inexpensive, and convenient assay could be a valuable
      addition to a screening effort in the search for compounds that will be
      protective against damage by superoxide or other active oxygen species.

PMID- 7797103
TI  - Reactions of copper(II)-oligopeptide complexes with hydrogen peroxide: effects of
      biological reductants.
AB  - Cu(II) complexes with oligopeptides containing histidyl residue in the second or
      third position could scarcely activate hydrogen peroxide (H2O2), but they could
      activate H2O2 to yield hydroxyl radical (.OH) in the presence of biological
      reductants such as cysteine and ascorbic acid. Further, DNA single strand
      breakage was also observed during the reactions of Cu(II)
      glycylglycylhistidylglycine (GGHG) with H2O2 in the presence of same biological
      reductants.

PMID- 7797102
TI  - Direct measurement of superoxide-dependent chemiluminescence from rat skin
      following UV-dependent fluoroquinolone-induced dermatitis.
AB  - Fluoroquinolones are widely used for the treatment of bacterial infection.
      However, some members of the group cause UV-dependent dermatitis. Therefore,
      animal models are required to screen and predict if a derivative is likely to
      cause photodermatitis. Under anaesthesia, the hair on the dorsal side of rats was
      shaved, then a fluoroquinolone derivative, Y-26611 or ofloxacin was administered
      subcutaneously (SC) followed by irradiation of a 3 cm diameter circular area of
      the skin with UV-B(ultraviolet-B) for 45 min. Peak photodermatitis was observed
      24 h after irradiation in Y-2611-treated skin. Leucocyte infiltration into the
      skin, mostly polymorphonuclear leucocytes, was verified by histological
      techniques. O2.- radical generated by activated leucocytes was detected directly
      from the skin by SC application of a sensitive O2.- -dependent luminescence
      reagent, MCLA. O2.- -dependent photon emission (chemiluminescence) from the skin
      was amplified by phorbol myristate acetate and was markedly suppressed by
      superoxide dismutase. This is the first report of direct detection of
      chemiluminescence from the skin of a living animal.

PMID- 7797105
TI  - The effect of fatty acid unsaturation on the antioxidant activity of beta
      carotene and alpha-tocopherol in hexane solutions.
AB  - The effect of fatty acid unsaturation on the antioxidant ability of beta-carotene
      and alpha-tocopherol to inhibit azobis-isobutyronitrile AIBN)-induced
      malondialdehyde (MDA) formation is investigated in a hexane solution. A positive
      correlation is shown between the fatty acid unsaturation and MDA production in
      homogeneous solutions. Both beta-carotene and alpha-tocopherol act as chain
      breaking antioxidants in our model, effectively suppressing AIBN-induced MDA
      formation. When alpha-tocopherol is added to fatty acid solutions, a lag phase of
      about 30 min is observed and a propagation phase is produced at a rate dependent
      on the degree of unsaturation and similar to that observed in the absence of the
      antioxidant. A specific inhibition of initiation phase by alpha-tocopherol is
      confirmed by its total consumption after 30 min of incubation with AIBN. On the
      other hand, when beta-carotene is added, a lag period is not observed and the
      inhibition of propagation phase progressively increases in relation to the degree
      of fatty acid unsaturation. These data present different antioxidant roles for
      beta-carotene and alpha-tocopherol in AIBN-induced lipid peroxidation and suggest
      that beta-carotene can be a very effective antioxidant in highly unsaturated
      membranes, such as those enriched with n-3 polyunsaturated fatty acids (PUFA).

PMID- 7797104
TI  - Vitamin E, pulmonary functions, and phagocyte-mediated oxidative stress in
      smokers and nonsmokers.
AB  - Relationships among the plasma levels of vitamin E (VE), the numbers and
      prooxidative activities of circulating phagocytes, serum alpha-1-protease
      inhibitor (API), and pulmonary functions were investigated in 83 asymptomatic
      male cigarette smokers and 65 nonsmoking controls. Plasma levels of VE, of
      cholesterol, and of API were measured using high performance liquid
      chromatography, spectrophotometry, and nephelometry, respectively, whereas
      reactive oxidant (ROS) generation by activated blood phagocytes was measured
      using a whole blood luciginen-enhanced chemiluminescence method. Smoking was
      associated with significantly increased circulating neutrophil counts (p 0.0001),
      serum API (p 0.0001) and phagocyte-derived ROS-generation (p 0.0001), and
      decreased spirometric values (FEV1: p 0.0138 and FEF25-75: p 0.0654). Plasma VE
      and cholesterol levels were not significantly different between smokers and
      nonsmokers. However, in smokers both plasma VE and cholesterol correlated
      significantly and positively with serum API (r 0.24, p 0.03 and r 0.30, p 0.005,
      respectively), neutrophil counts (r 0.24, p 0.03 and r 0.25, p 0.03,
      respectively), and phagocyte-derived ROS-generation (r 0.32, p 0.003 and r 0.32,
      p 0.003, respectively), and significantly and inversely with FEV1 (r -0.23, p
      0.03 and r -0.22, p 0.04, respectively) and FEF25-75 (r -0.32, p 0.003 and r 
      0.26, p 0.02, respectively). In nonsmokers plasma VE, but not cholesterol, was
      positively correlated with FEV1 (r 0.34, p 0.007) and FEF25-75 (r 0.40, p 0.001).
      The results suggest that VE protects the lungs of both smokers and nonsmokers and
      may act as a mobilizable antioxidant in response to smoking-induced oxidative
      stress.

PMID- 7797107
TI  - Comments on the glutathione-ascorbic acid redox couple.

PMID- 7797106
TI  - Protection of vitamin E, selenium, trolox C, ascorbic acid palmitate,
      acetylcysteine, coenzyme Q0, coenzyme Q10, beta-carotene, canthaxanthin, and (+)
      catechin against oxidative damage to rat blood and tissues in vivo.
AB  - Male Sprague-Dawley rats were fed either a vitamin E and selenium deficient diet,
      a diet supplemented with vitamin E and selenium, or a diet supplemented with
      vitamin E, selenium, trolox C, ascorbic acid palmitate, acetylcysteine, Beta
      carotene, canthaxanthin, coenzyme Q0, coenzyme Q10, and (+)-catechin. Rats were
      injected with CBrCl3 (0.05 mmol/100 g body weight) intraperitoneally. Oxidative
      damage to tissues was measured by formation of oxidized heme proteins (OHP) in
      blood, liver, kidney, heart, lung, and spleen. Diets supplemented with
      antioxidants showed protection against oxidative damage caused by CBrCl3. The
      protection was dependent on the diversity and quantity of antioxidants in the
      diet. In general, diets supplemented with both fat soluble and water soluble
      antioxidants provided better protection than diets supplemented only with vitamin
      E and selenium or with vitamin E, selenium, and fat soluble antioxidants.

PMID- 7797108
TI  - A new class of colorectal cancer gene.

PMID- 7797110
TI  - Recent advances in the endoscopic management of variceal bleeding.
AB  - For the first time the endoscopist has more than one option for the management of
      gastro-oesophageal varices. It is now feasible to select the appropriate therapy
      on the basis of the clinical setting. Acute injection sclerotherapy remains a
      quick and simple technique for the control of active bleeding from oesophageal
      varices, and could be followed two or three days later by banding ligation.
      Earlier obliteration of varices with this technique may offer the prospect of
      only two or three sessions of therapy. The availability of the tissue adhesives
      and thrombin as injectates for fundal gastric varices provide the option of an
      initial attempt at endoscopic therapy in this high risk group.

PMID- 7797109
TI  - Liver transplantation for hepatocellular carcinoma.

PMID- 7797111
TI  - Effect of topical oesophageal acidification on human salivary and oesophageal
      alkali secretion.
AB  - Recent human studies suggest that oesophageal HCO3- secretion, in conjunction
      with salivary HCO3- secretion and secondary oesophageal peristalsis, is important
      for the protection of oesophageal mucosa from refluxed gastric contents. This
      study evaluated simultaneously the responsiveness of oesophageal and salivary
      HCO3- secretion to oesophageal acidification in eight healthy subjects. A 10 cm
      segment of oesophagus was perfused at a constant rate of 5 ml/min with a
      specially designed tube assembly. Saline was used initially, and then 10 mM and
      100 mM HCl. The perfusates contained 3H-polyethylene glycol (PEG) as a
      concentration marker to determine volumes. Corrections were applied for a small
      degree of contamination by swallowed saliva and refluxed gastric alkali.
      Oesophageal perfusion with 10 mM HCl did not cause symptoms (nausea and
      heartburn), but tripled the oesophageal HCO3- output from a baseline of 51
      mumol/10 cm/10 min (p = 0.021), while doubling the rate of salivary HCO3-
      secretion from a median basal value of 140 mumol/10 min (p = 0.021). Oesophageal
      perfusion with 100 mM HCl was associated with symptoms of nausea and heartburn in
      all subjects. The median oesophageal HCO3- output increased 32 fold to 1659
      mumol/10 cm/10 min (interquartile range 569 to 3373; p = 0.036), and salivary
      HCO3- secretion approximately tripled from basal values (p = 0.036). In
      conclusion, oesophageal acidification stimulates both salivary and oesophageal
      HCO3- secretion, responses which may be protective to the oesophageal epithelium.

PMID- 7797112
TI  - Endoscopic detection of ischaemia with a new probe indicates low oxygenation of
      gastric epithelium in portal hypertensive gastropathy.
AB  - Changes in mucosal blood flow may be important in the pathogenesis of many
      conditions. Study of mucosal blood perfusion is difficult, and available methods
      have significant technical limitations. This study describes the development of
      an instrument for endoscopy, which indicates blood flow indirectly, by measuring
      the quantity of tissue oxygen that can diffuse from the mucosa to a luminal
      surface electrode. The instrument was used through an endoscope in patients with
      portal hypertension (n = 14), scleroderma (n = 3), disease controls (n = 7), and
      normal controls (n = 11). In portal hypertension readings were one quarter that
      in normal controls in both antrum (geometric mean (SEM) 35 (1.1)), nanoamps v 137
      (1.1), and upper corpus 34 (1.1) v 125 (1.1)). Scleroderma patients showed
      greatly reduced oxygen readings in both antrum (18 (1.2)) and corpus (24 (1.2)),
      an expected but hitherto undiscovered result. These differences are highly
      significant (p = 0.0001), and the findings suggest that tissue hypoxia may
      contribute to mucosal changes in portal hypertensive gastropathy and in
      scleroderma.

PMID- 7797113
TI  - Non-steroidal anti-inflammatory drugs and prostaglandin effects on pepsinogen
      secretion by dispersed human peptic cells.
AB  - The effects of aspirin and ibuprofen on pepsinogen secretion were studied in
      isolated human peptic cells prepared from endoscopically obtained biopsy
      specimens after collagenase digestion, mechanical disruption, and percoll
      gradient centrifugation. Pharmacological concentrations of aspirin and ibuprofen
      (10(-8)-10(-4) M), potentiated histamine (10(-6)-10(-4)M) and forskolin (10(-5)M)
      stimulated pepsinogen secretion without affecting basal secretion, acetylcholine
      (10(-6)M) stimulated pepsinogen secretion or cell vitality. Augmentation of
      secretagogue stimulated pepsinogen secretion was dependent on extracellular
      calcium because potentiation was abolished by calcium depletion of the medium.
      Cimetidine inhibited the potentiation effect on histamine but not on forskolin
      stimulated pepsinogen secretion, thus suggesting that this augmentation was
      independent of histamine H2 receptors. Of interest, potentiation was also
      independent of endogenous prostaglandin inhibition because exogenous addition of
      prostaglandin E2 and D2 increased both basal and acetylcholine stimulated
      pepsinogen secretion in a dose dependent way, but they did not modify histamine
      or histamine plus aspirin or ibuprofen stimulated pepsinogen secretion. In
      conclusion, aspirin and ibuprofen potentiate secretagogue stimulated pepsinogen
      secretion by dispersed human peptic cells and this might be an additional
      mechanism of non-steroidal anti-inflammatory drug (NSAID) induced gastric injury.
      This potentiation effect is regulated by calcium, independent of endogenous
      prostaglandin inhibition and seems to act on pepsinogen secretion at a post
      receptor site.

PMID- 7797115
TI  - Prevalence of Helicobacter pylori in patients with gall stones before and after
      cholecystectomy: a longitudinal study.
AB  - Fifty six patients with gall stones were enrolled in this study to assess the
      presence of Helicobacter pylori in gastric mucosa before and after
      cholecystectomy. Samples were taken from gastric juice and antral mucosa through
      endoscopy performed on these patients before and after the operation. Gastric
      juice was examined for bile salt concentration as an indicator of duodenogastric
      reflux. Antral mucosa was studied for the presence of H pylori and inflammatory
      response. Duodenogastric reflux was significantly increased (p < 0.001) and H
      pylori significantly decreased (p < 0.01) in the postoperative period. Mucosal
      inflammation and its activity were less in the postoperative period but the
      differences did not reach statistically significant values.

PMID- 7797114
TI  - Detection of the intragastric sites at which Helicobacter pylori evades treatment
      with amoxycillin and cimetidine.
AB  - Treatment of Helicobacter pylori infection with amoxycillin is known to reduce
      the bacterial load to undetectable levels, while not eradicating the infection.
      It seems, therefore, that bacteria escape treatment at a 'sanctuary site'. This
      study examined whether such a site existed in the gastric antrum, body, or
      fundus. Twenty two patients with H pylori infection and duodenal ulcer disease
      were treated for one week with amoxycillin (500 mg three times a day) and
      cimetidine (800 mg at night). Before treatment, H pylori was detected throughout
      all stomachs, and 13C-urea breath testing at least 28 days after treatment
      confirmed that eradication of H pylori had occurred in no patients. While under
      treatment, H pylori was sought by conventional methods and by polymerase chain
      reaction assay and was found in the gastric fundus in 13 of 22 subjects, in the
      body in 10 of 22, and the antrum in three of 22: the difference between fundus
      and antrum was significant (p < 0.01). The continued antral infection in three
      subjects may have resulted from generalised treatment failure as two of three had
      H pylori detected throughout the stomach, and these two had compiled relatively
      poorly with treatment. This study suggests that amoxycillin and cimetidine are
      relatively effective at clearing H pylori from the gastric antrum, but that
      escape from treatment may occur in the gastric body, and especially the fundus.

PMID- 7797116
TI  - Primary gastric lymphoma in clinical practice 1973-1992.
AB  - This study assessed the presentation, treatment, and prognosis of primary gastric
      lymphoma in general hospital practice and its relation to infection with
      Helicobacter pylori. The number of patients that would on the current
      recommendations have been suitable for H pylori eradication therapy was also
      examined. All lymphomas were graded according to a standard classification of gut
      lymphoma into high and low grade disease. Forty five patients (mean age 65 years)
      were identified. The overall five year survival was 40% with a trend in favour of
      an improved prognosis for low grade and stage I disease. H pylori was present in
      80%. Only one of 18 patients with a low grade mucosa associated lymphoid tissue
      tumour had mucosal disease alone, which responded to omeprazole and amoxycillin.
      All other patients had bulk disease. These patients were treated by surgery,
      chemotherapy or radiotherapy or a combination of these treatments. In district
      hospital practice, most cases of primary gastric lymphoma have bulk disease at
      presentation. Even in patients with low grade gastric lymphoma on histological
      examination, many on the current evidence would not be suitable for anti-H pylori
      therapy alone.

PMID- 7797117
TI  - Preservation of the spleen improves survival after radical surgery for gastric
      cancer.
AB  - One hundred and ninety five consecutive, potentially curative resections for
      adenocarcinoma of the stomach were performed in one surgical department between
      1970 and 1989: 76 patients underwent gastrectomy with splenectomy and 119
      gastrectomy without splenectomy. Operative mortality was 12% after gastrectomy
      with splenectomy, but only 2.5% after gastrectomy without splenectomy (p < 0.05).
      Postoperative complications were also significantly more common when splenectomy
      was combined with gastrectomy (41% v 14%, p < 0.01). Cumulative five year
      survival was 45% after gastrectomy with splenectomy, compared with 71% after
      gastrectomy alone (p < 0.01). When the results of the two groups of patients were
      compared, stage for pathological stage, no evidence was found that splenectomy
      improved survival. Application of Cox's proportional hazards model, which makes
      allowance for other variables such as the T and N stages, showed that splenectomy
      had an adverse influence on patients' survival. Splenectomy does not benefit the
      patient and its routine use in the course of radical resections for carcinoma of
      the stomach should be abandoned.

PMID- 7797119
TI  - South Asian and European colitics show characteristic differences in colonic
      mucus glycoprotein type and turnover.
AB  - South Asians in Britain have a high incidence of ulcerative colitis and a low
      incidence of colorectal cancer. The pattern of mucus production in 12 South Asian
      and 16 European colitics and a control group of 19 South Asians was studied.
      Three types of mucin were identified after organ culture of colonic biopsy
      specimens with a dual label of [3H]-glucosamine and sodium [35S]-sulphate: type A
      had a high [35S]:[3H] ratio and high incorporation ([3H] dpm/micrograms DNA >
      500); type B had a low ratio and high incorporation; and type C had low
      incorporation but with either high (C1) or low (C2) ratios. European colitic
      mucins show a significant reduction in the level of sulphation detected by mucin
      histochemistry with high iron diamine/Alcian blue staining, together with
      predominantly type B or C2 mucins (low sulphation). South Asian colitics showed
      histochemically normal patterns of high sulphation and largely type A and C1
      mucins (high sulphation). There was no correlation of mucin type with disease
      activity index in either ethnic group. The appearance of apparently normal mucin
      in patients with ulcerative colitis may be a useful marker for the identification
      of a subgroup at low risk of colorectal cancer.

PMID- 7797118
TI  - Colonic cell proliferation in two different ethnic groups with contrasting
      incidence of colon cancer: is there a difference in carcinogenesis?
AB  - Most studies on colorectal carcinogenesis suggest a field defect, preceding overt
      development of cancer. The low incidence of adenomatous polyps in the African
      population, however, suggests that there may be an alternative route for cancer
      development. The aim of the study was to discover if the difference in incidence
      of colorectal cancer in Africans compared with the white population is reflected
      in a different pattern of cell proliferation. Histological normal mucosa from 30
      patients (15 white South African (W), 15 South African Africans (A)) with
      confirmed colon cancer were examined. Proliferating cells were detected using the
      Ki-67 antigen. In addition, cell proliferation data were obtained, from 30 age
      matched controls (15 Africans, 15 white South Africans), without colorectal
      disease. The African controls were significantly younger (mean (SD) (A: 42 (20),
      W: 66 (13), p < 0.05)) than the white controls. The second control group had a
      significantly higher mean (SD) total labelling index (W: 11 (3), A: 6 (4), p <
      0.05). In addition the proliferative pattern of the white group without evidence
      of colorectal cancer showed a comparatively large amount of dividing cells in
      compartment 2, compared with African controls (mean (SD) (W: 21 (8), A: 9 (8), p
      < 0.05)). Mucosa from Africans with cancer showed a proliferative pattern with
      the same increased total labelling index (A: 15 (5), W: 16 (6), p = NS, phase II
      proliferative lesion) and an even more pronounced upward expansion (phase I
      proliferative lesion) compared with white cancer patients. This suggests that the
      mechanism of colorectal carcinogenesis is similar in Africans and the white
      population. The lack of clinical evidence of the adenoma-carcinoma sequence, and
      the incidence of cancer at a comparatively young age in Africans may be explained
      by the fact that colorectal cancer in this ethnic group behaves more aggressively
      and that adenomatous polyps are rapidly converted into overt cancer before
      detection.

PMID- 7797121
TI  - Osteoporosis in treated adult coeliac disease.
AB  - Forty five women and 10 men with coeliac disease diagnosed in adult life, who
      were already on a gluten free diet, had serial bone mineral density measurements
      at the lumbar spine and femoral neck over 12 months. Osteoporosis, defined as a
      bone mineral density (BMD) < or = 2 SD below the normal peak bone mass was found
      in 50% of male and 47% of female coeliac patients. Patients with a BMD < or = 2
      SD below age and sex matched normal subjects, had a significantly lower body mass
      index (21.3 kg.m-2 compared with 25.2 kg.m-2, p < 0.02 Wilcoxon rank sum test)
      and lower average daily calcium intake (860 mg/day compared with 1054 mg/day, p <
      0.05 Wilcoxon rank sum test) than patients with normal bone mineral density. In
      postmenopausal women with coeliac disease there was a strong correlation between
      the age at menopause and BMD at both the lumbar spine (r = 0.681, p < 0.01,
      Spearman's rank correlation) and femoral neck (r = 0.632, p < 0.01). No overall
      loss of bone was shown over the 12 months of follow up, and relative to the
      reference population there was a significant improvement in BMD at the lumbar
      spine in women (p < 0.025, paired t test) and at the femoral neck in men (p <
      0.05, paired t test). There was a significant negative correlation between the
      annual percentage change in BMD at the lumbar spine and the duration of gluten
      free diet (r = -0.429, p<0.01, Spearman's rank correlation), with the largest
      gain in BMD in patients with most recently diagnosed coeliac disease.
      Osteoporosis was shown in 47% of patients with treated adult coeliac disease.
      Recognised risk factors for osteoporosis in the general population including low
      body mass index, dietary calcium intake, and early menopause are particularly
      important in coeliac disease. Treatment of coeliac disease with a gluten free
      diet probably protects against further bone loss, and in the early stages is
      associated with a gain in bone mineral density.

PMID- 7797120
TI  - Translocation of gliadin into HLA-DR antigen containing lysosomes in coeliac
      disease enterocytes.
AB  - Coeliac disease is triggered by ingestion of wheat gliadin and is probably immune
      mediated. There is evidence by light microscopy that expression of class II major
      histocompatibility complex (MHC) molecules is increased in the small intestinal
      epithelium of patients with untreated coeliac disease and that gliadin can be
      taken up by small intestinal enterocytes. The pathway by which gliadin is
      transported to class II MHC proteins has not been demonstrated. Using an
      immunogold technique and thin frozen sections of jejunal biopsy specimens,
      gliadin, HLA-DR antigens, and IgA were localised at an ultrastructural level in
      the jejunal epithelium of patients with both untreated and treated coeliac
      disease and controls. Cathepsin D was used as a marker for late endosomes or
      lysosomes. The results show that gliadin is translocated into vacuoles positive
      for HLA-DR antigens as well as cathepsin D in jejunal enterocytes of patients
      with untreated coeliac disease. Secretory IgA may have a role in this
      translocation of gliadin, which is a specific event that occurred only in jejunal
      enterocytes from patients with untreated coeliac disease but not in a patient
      maintained on a gluten free diet or in controls. These results support a central
      role for epithelial cells of the human intestinal mucosa in the transport of
      gliadin to an HLA-DR positive compartment which precedes antigen presentation of
      gliadin to antigen sensitive T lymphocytes.

PMID- 7797122
TI  - Duration of recurrent ileitis after ileocolonic resection correlates with
      presurgical extent of Crohn's disease.
AB  - Crohn's disease of the terminal ileum recurs in a predictable sequence proximal
      to the ileocolonic anastomosis after surgical resection. To confirm the suspicion
      that the duration of recurrent ileitis correlates with the extent of presurgical
      disease, this study investigated 23 consecutive patients with recurrent Crohn's
      disease symptoms who had undergone ileocaecal resections between 1982 and 1992 at
      our institution and had both preoperative and postoperative small bowel follow
      through studies available for comparison. All films were reviewed by a blinded
      gastrointestinal radiologist using uniform criteria. Symptomatic recurrence was
      reported at a mean (SEM) of 29 (25) months after resection. Presurgical length of
      inflammation averaged 26 (15) (8-57) cm and at recurrence 24 (14) (7-55) cm. The
      correlation coefficient (r) between pre and postsurgical extent of ileal disease
      was 0.70 (p < 0.0001). Seven patients had sequential small bowel series after 20
      (10) (7-36) months without intervening surgery. The extent of measured
      inflammation between examinations correlated with r = 0.995 (p < 0.0001), showing
      the consistency of the measurement process. The close correlation between the
      duration of postoperative recurrence with the extent of presurgical disease is
      another example of individual patterns of recurrent Crohn's disease and is an
      additional factor to be considered when contemplating surgical resections.

PMID- 7797123
TI  - Novel germline APC gene mutation in a large familial adenomatous polyposis
      kindred displaying variable phenotypes.
AB  - The APC gene is mutated in the germline of people from families where there is a
      predisposition to develop polyposis coli. Many mutations have been described but
      the relation between their site and the phenotypic expression of the disease
      remains unclear. The most commonly seen mutation occurs at codon 1309. Many other
      mutations have been described towards the 5' end of exon 15 of the APC gene but
      comparatively few have been seen towards the 3' end. Recent reports have
      indicated the possibility of a functional boundary with respect to severity and
      age of onset of disease, which lies towards the 5' end of the gene. This report
      describes a large family whose affected members present with a very variable
      phenotype ranging from an early onset and severe form to a comparatively mild
      later onset one. The mutation that predisposes to disease in this family is at a
      previously undescribed site that lies towards the 3' end of exon 15 of the APC
      gene, which results in a stop codon. Interestingly, the stop codon is 63 codons
      downstream of the mutation and therefore may affect the expression of the
      disease. The addition of this mutation to the growing list of mutations described
      in the APC gene may provide some insight into the genotype/phenotype relation of
      the disease thus contributing to the understanding and significance of mutations
      at specific sites in the APC gene.

PMID- 7797124
TI  - Constitutive and cytokine induced expression of HLA molecules, secretory
      component, and intercellular adhesion molecule-1 is modulated by butyrate in the
      colonic epithelial cell line HT-29.
AB  - Normal colonic epithelial cells play an important part in the mucosal immune
      system and use butyrate, a bacterial fermentation product, as an important energy
      source. Butyrate deficiency has been associated with inflammatory bowel disease,
      diversion colitis, and pseudomembranous colitis. Butyrate effects on important
      molecules for epithelial immune functions were studied in a colonic epithelial
      cell line (HT-29): the constitutive and cytokine regulated expression of
      secretory component (poly-Ig receptor), HLA class I and II molecules, and
      intercellular adhesion molecule-1 (ICAM-1). Butyrate facilitated the constitutive
      expression of secretory component and HLA class I. Butyrate furthermore tended to
      enhance cytokine mediated stimulation of protein expression, although tumour
      necrosis factor alpha (TNF) and interleukin 4 (IL 4) responses on HLA class I and
      secretory component, respectively, were relatively inhibited by butyrate.
      Cytokine mediated accumulation in the various mRNAs usually increased even more
      in the presence of butyrate, with the exception of TNF response on HLA class I
      and secretory component mRNA concentrations. In conclusion, butyrate may
      substantially influence constitutive and cytokine mediated expression of
      molecules with immune functions in a complex and differentiated manner, and
      butyrate deficiencies, as seen in various clinical conditions, might influence
      mucosal immune responses.

PMID- 7797125
TI  - Differential regional effects of octreotide on human gastrointestinal motor
      function.
AB  - The effects of octreotide on regional motor function in the human gut are
      unclear. In a randomised, blinded study the effects of octreotide (50 micrograms,
      subcutaneously, three times daily) and placebo on gastric, small bowel, and
      colonic transit, and colonic motility and tone were assessed in 12 healthy
      volunteers whose colon had been cleansed. Octreotide accelerated initial gastric
      emptying (p = 0.05), inhibited small bowel transit (p < 0.01), and reduced
      ileocolonic bolus transfers (p < 0.05). Colonic transit was unaltered by
      octreotide; the postprandial colonic tonic response was inhibited (p < 0.05 v
      placebo), whereas colonic phasic pressure activity was increased by octreotide (p
      < 0.05 v placebo). These data support the use of octreotide in diarrhoeal states
      but not in diseases that cause small bowel stasis and bacterial overgrowth.
      Simultaneous measurements of colonic transit, tone, and phasic contractility are
      valid in studying the effects of pharmacological changes and may be applicable to
      the study of the human colon in health and disease.

PMID- 7797126
TI  - Liver cytosolic 1 antigen-antibody system in type 2 autoimmune hepatitis and
      hepatitis C virus infection.
AB  - Within the multiform liver/kidney microsomal (LKM) family, a subgroup of sera
      that reacts with a liver cytosolic (LC) protein has been isolated and the new
      antigen-antibody system is called LC1. Unlike LKM antibody type 1 (anti-LKM1),
      anti-LC1 is said to be unrelated to hepatitis C virus (HCV) infection and has
      therefore been proposed as a marker of 'true' autoimmune hepatitis type 2.
      Altogether 100 LKM1 positive sera were tested by immunodiffusion (ID). Twenty
      five gave a precipitation line with human liver cytosol; 17 of the 25 also
      reacted with rat liver cytosol. Thirteen of the 25 sera were anti-HCV positive by
      second generation ELISA: anti-HCV positive patients were significantly older (p <
      0.001) and tended to have less active disease. No difference in anti-LC1 titre or
      ID immunoreactivity was found between anti-LC1/anti-HCV positive and anti
      LC1/anti-HCV negative cases. In Western blotting experiments, 14 of 24 ID
      positive sera recognised a 58 kD protein of the human cytosolic fraction and 11
      gave a similar reactivity when tested with human microsomes, suggesting the
      presence of the LC1 target antigen also in the microsomal preparation. Western
      blotting reactivity was similar for both anti-HCV positive and negative sera.
      These data confirm the existence of the LC1 antigen-antibody system that
      partially overlaps with LKM1, and that it is an additional marker of juvenile
      autoimmune hepatitis type 2. It does not, however, discriminate between patients
      with and without HCV infection.

PMID- 7797128
TI  - Is biliary lithiasis associated with pancreatographic changes?
AB  - The aetiological role of biliary lithiasis for chronic pancreatitis remains
      controversial. Previous studies based on pancreatographic studies reported
      changes in the pancreatic duct system caused by biliary lithiasis. This study
      analysed retrospectively the endoscopic retrograde cholangiopancreatography of
      165 patients presenting with biliary lithiasis and of 53 controls. Among the 165
      patients, 113 had choledochal stones (53 with gall bladder stones, 50 had had a
      cholecystectomy, 10 with a normal gall bladder), 35 had gall bladder stones
      without choledochal stones, 17 had cholecystectomy for gall bladder stones.
      Pancreatograms were analysed by measuring the diameter of the pancreatic duct in
      the head, the body, and the tail of the pancreas, and evaluating the regularity
      of the main pancreatic duct and the presence of stenosis, the regularity or the
      dilatation of secondary ducts, and the presence of cysts. In addition, we
      established a score, based on the above parameters, by which pancreatograms were
      classified as normal or with mild, intermediate, moderate or severe
      abnormalities. A multivariate analysis (stepwise multiple discriminant analysis)
      was performed for age, sex, presence of gall stones, presence of choledochal
      stones. Patients were comparable with controls for sex, alcohol consumption but
      were younger (55 v 68 years, p < 0.01). In patients and in controls, the
      frequency of pancreatographic abnormalities increased significantly with age. The
      pancreatographic features of patients and controls were not significantly
      different. In the multivariate analysis, age was the only factor with significant
      predicting value for pancreatographic abnormalities. In conclusion, biliary
      lithiasis in itself is not an aetiological factor for chronic pancreatitis, older
      age being responsible for the abnormalities seen by pancreatography of patients
      with biliary lithiasis.

PMID- 7797130
TI  - Diagnosis of pancreatic cancer by 2[18F]-fluoro-2-deoxy-D-glucose positron
      emission tomography.
AB  - The detection of pancreatic cancer or the discrimination between pancreatic
      cancer and chronic pancreatitis remains an important diagnostic problem. The
      increased glucose metabolism in malignant tumours formed the basis for this
      investigation, which focused on the role of positron emission tomography (PET)
      with 2[18F]-fluoro-2-deoxy-D-glucose (FDG) in the detection of pancreatic cancer
      and its differentiation from chronic pancreatitis. Eighty patients admitted for
      elective pancreatic surgery received preoperatively 250-350 mBq FDG intravenously
      and emission scans were recorded 45 minutes later. Intense focal activity in the
      pancreatic region was taken at the time of scanning as showing the presence of
      pancreatic cancer. The presence of cancer was later confirmed by histological
      examination of the surgical specimens and histological findings were compared
      with the preoperative PET results. Forty one patients with pancreatic cancer
      (group I: n = 42) had a focally increased FDG uptake in the pancreatic region.
      Two patients with a periampullary carcinoma (group II: n = 6) failed to develop
      FDG accumulation. In 28 patients with chronic pancreatitis (group III: n = 32) no
      FDG accumulation occurred. Overall sensitivity and specificity of PET for
      malignancy (group I + II) were 94% (45 of 48) and 88% (28 of 32), respectively.
      The standard uptake value of the patients with pancreatic carcinoma was
      significantly higher than in patients with chronic pancreatitis (3.09 (2.18) v
      0.87 (0.56); p < 0.001; median (interquartile range)). These findings show that
      FDG-PET represents a new and non-invasive diagnostic procedure for the diagnosis
      of pancreatic cancer and to differentiate pancreatic cancer from chronic
      pancreatitis. However, the diagnostic potential of this technique requires
      further evaluation.

PMID- 7797127
TI  - Effect of octreotide on fasting gall bladder emptying, antroduodenal motility,
      and motilin release in acromegaly.
AB  - Subcutaneous octreotide (Sandostatin) injections lead to gall stone formation in
      13-50% of acromegaly patients during one year of therapy. This study explored the
      effects of octreotide on interdigestive gall bladder emptying, antroduodenal
      motility, and motilin release. Ambulatory antroduodenal manometry was performed
      in six acromegaly patients before and after two months of octreotide therapy (100
      micrograms thrice daily, subcutaneously). Ultrasonographic gall bladder volume
      measurements and plasma motilin concentrations were obtained during two migrating
      motor complex (MMC) cycles. Before octreotide treatment, nine of 26 phase III
      activities started in the antrum and 17 of 26 in the duodenum whereas during
      treatment 47 of 48 of phase III activity started in the duodenum (p < 0.05).
      Before treatment, interdigestive gall bladder emptying (mean (SEM) 39.9 (4.0)% of
      maximal fasting volume) and plasma motilin peaks preceded antral phase III but
      not duodenal phase III. During octreotide therapy no significant motilin
      fluctuation or gall bladder emptying was seen. Fasting gall bladder volume
      increased from 40.9 (9.1) ml before to 68.0 (14.8) ml (p < 0.05) during
      octreotide treatment. In conclusion, two months' treatment with octreotide
      increases the number of duodenal phase III like activity and virtually abolishes
      antral phase III, plasma motilin peaks, and interdigestive gall bladder emptying.
      These effects might contribute to the high risk of gall stone formation during
      longterm octreotide treatment.

PMID- 7797129
TI  - Somatostatin prevents the postoperative increases in plasma amino acid clearance
      and urea synthesis after elective cholecystectomy.
AB  - The importance of glucagon on postoperative changes in hepatic amino-nitrogen
      conversion were investigated in six patients undergoing elective cholecystectomy
      for uncomplicated gall stones. Patients were given infusions of somatostatin
      (bolus of 6 micrograms/kg followed by continuous infusion of 6 micrograms/kg/h)
      from induction of anaesthesia to the end of investigation, the first
      postoperative day (30 hours). Controls were 16 patients undergoing the same
      procedures omitting the somatostatin infusion. In all patients blood
      concentration and plasma clearance of total alpha-amino-nitrogen, and amino acid
      stimulated rate of urea synthesis were measured. Elective cholecystectomy
      decreased blood alpha-amino-nitrogen concentration from mean (SEM) 2.9 (0.2) to
      2.4 (0.1) mmol/l (p < 0.05), increased the clearance of total alpha-amino
      nitrogen from 5.2 (0.3) to 6.6 (0.3) ml/s (p < 0.05), and increased the rate of
      amino acid stimulated urea synthesis from 27 (1) to 37 (2) mumol/s (p < 0.05)
      pointing to increased hepatic removal of amino-nitrogen at expense of plasma
      amino-nitrogen. Infusion of somatostatin prevented increase of glucagon for 24
      hours after surgery, and prevented the negative changes in postoperative nitrogen
      homeostasis resulting from the postoperative changes in hepatic nitrogen
      conversion, suggesting glucagon as mediator. The exact mechanism remains in
      doubt, however, because of the multiple effects of somatostatin.

PMID- 7797131
TI  - Detection of c-Ki-ras gene codon 12 mutations from pancreatic duct brushings in
      the diagnosis of pancreatic tumours.
AB  - Differential diagnosis of pancreatic cancer and chronic pancreatitis is sometimes
      difficult and cytological examination of brushings or aspirated material
      collected during endoscopic retrograde cholangiopancreatography (ERCP) remains
      disappointing. As point mutations in codon 12 of the c-Ki-ras 2 gene are found in
      most pancreatic adenocarcinoma and not in chronic pancreatitis, this study
      analysed prospectively the presence of these mutations in brushing samples
      collected during ERCP in 45 patients (26 males, 19 females) showing a dominant
      stricture of the main pancreatic duct at pancreatography: 24 with pancreatic
      adenocarcinoma, 16 with chronic pancreatitis, and five intraductal mucin
      hypersecreting neoplasms. Twenty of 45 patients presented equivocal ERCP findings
      that did not permit a definite diagnosis. Ki-ras mutations at codon 12 were
      detected using a rapid and sensitive method based on polymerase chain reaction
      mediated restriction fragment length polymorphism analysis and confirmed by
      direct sequencing of polymerase chain reaction products. Results were compared
      with those provided by routine brush cytology. A definitive diagnosis was
      established for each patient. Mutations were detected in 20 of 24 patients with
      pancreatic adenocarcinoma (83%), but in none of the chronic pancreatitis patients
      and intraductal mucin hypersecreting neoplasms, irrespective of their location.
      By contrast, only 13 of 24 pancreatic adenocarcinoma (54%) were detected by
      conventional cytological examination, which yielded four false negative and seven
      non-contributive results. Sensitivity, specificity, and accuracy of molecular
      biological and cytological methods were 83%-76%, 100-83%, and 90%-58%,
      respectively. Notably the mutations could be detected in six patients with small
      tumour size (< or = 2 cm). In conclusion, Ki-ras analysis performed on pancreatic
      brushing samples is an efficient procedure, more accurate than cytology in the
      diagnosis of pancreatic adenocarcinoma, and highly specific in the
      differentiation between neoplastic and chronic inflammatory ductal changes,
      especially in patients showing inconclusive ERCP findings.

PMID- 7797133
TI  - Fulminant hepatic failure caused by tuberculosis.
AB  - A 54 year old Asian woman developed fulminant hepatic failure followed by renal
      failure. Because of a past history of possible tuberculosis, she was given
      antituberculous drugs. The chest x ray was normal. A transjugular liver biopsy
      showed caseating necrosis, granulomas, and acid fast bacilli indicative of
      miliary tuberculosis. Despite full supportive therapy, her condition deteriorated
      and she died. Postmortem examination showed widespread miliary tuberculosis;
      culture confirmed the presence of Mycobacterium tuberculosis. Tuberculosis causes
      fulminant hepatic failure rarely and only three cases have been described. In
      this, as with the other cases, hyponatraemia and hepatomegaly were features at
      presentation. This is the first report of treatment being given before death.

PMID- 7797134
TI  - The nurse endoscopist. British Society of Gastroenterology.

PMID- 7797132
TI  - Intestinal fatty acid binding protein is available for diagnosis of intestinal
      ischaemia: immunochemical analysis of two patients with ischaemic intestinal
      diseases.
AB  - Mesenteric infarction and other acute ischaemic intestinal diseases are still a
      challenging diagnostic problem. Based on animal experiments, intestinal fatty
      acid binding protein (I-FABP), which is uniquely localised to the bowel, has
      recently been proposed as a new serum marker for intestinal ischaemia. This paper
      reports on two cases with acute intestinal ischaemic diseases, and the
      measurement of serum I-FABP by western blot analysis. The concentrations of
      ordinary serum markers were normal and the bowel necrosis was not diagnosed until
      surgical exploration. Immunochemical analysis showed that the I-FABP
      concentrations in the patients' serum samples were high at the time of admission,
      and that I-FABP was undetectable in the samples obtained after bowel resection
      and in healthy control subjects. This paper suggests that I-FABP is released into
      the circulation in the acute phase of intestinal ischaemia and that I-FABP can be
      used in establishing the diagnosis of ischaemic intestinal diseases.

PMID- 7797135
TI  - Light of my life.

PMID- 7797136
TI  - Postprandial function in gastroparesis.

PMID- 7797137
TI  - Autoimmunity and chronic pancreatitis.

PMID- 7797138
TI  - Diagnosis of invasive amoebiasis: renaissance of the morphology era.

PMID- 7797140
TI  - Cancer surveillance in ulcerative colitis.

PMID- 7797139
TI  - Relation of acupuncture and vagal gastric acid secretion.

PMID- 7797141
TI  - [Italian Society of Experimental Hematology. Workshops. Firenze, 24 March and 16
      June 1994. Abstracts].

PMID- 7797143
TI  - Functional heterogeneity of in vitro selected variants from an IgM-secreting rat
      immunocytoma.
AB  - A long-term tissue culture line of highly metastatic IR202 immunocytoma of LOU
      rats, and five of its clones (B4, C2, C4, C5, and D3) were established and
      studied comparatively. All such cells were similar in terms of: (i) light
      microscopic morphology, (ii) growth rate, (iii) saturation density, (iv) cell
      cycle progression, and (v) cell surface IgM, major histocompatibility complex
      (MHC) class I and class II antigen expression, but (vi) showed a non-homogeneous
      pattern of chromosomal constitution, with both numerical and structural
      abnormalities detected in variable proportions of the different cell variants.
      Moreover, IR202 variants exhibited a marked difference in the production of
      soluble factors which was closely associated with the ability of their
      supernatants to inhibit mitogen (affinity-purified goat F(ab')2 fragments
      specific for rat mu-chains (anti-mu antibody), lipopoly saccharide (LPS), or
      concanavalin A (ConA))-induced proliferation of normal splenic B and/or T
      lymphocytes. These results are consistent with the concept of intratumor
      heterogeneity and the ability of immunoglobulin-secreting tumors to induce severe
      immune dysfunction in host animals and humans.

PMID- 7797142
TI  - Autoimmune haemolysis and red cell autoantibodies with ABO blood group
      specificity.
AB  - In order to study red cell autoantibodies with ABO specificity, the records of
      4668 patients seen over 32 years were examined. Five group A patients had high
      thermal amplitude cold agglutinins showing anti-A, -A1 or -AI specificity; none
      had ever received blood or blood products. They presented as chronic cold
      haemagglutinin disease, autoimmune haemolytic anaemia or were discovered during
      investigation of pregnancy, carcinomatosis or anaemia. In vivo haemolysis was
      evident in all but the antenatal case; only the patient with autoimmune
      haemolytic anaemia required treatment, responding well to steroids. ABO-specific
      autoantibodies thus appear similar in reactions and clinical manifestations to
      autoantibodies in general.

PMID- 7797144
TI  - Cytochemical determination of monoamine oxidase activity in lymphocytes and
      neutrophils of schizophrenic patients.
AB  - Monoamine oxidase (MAO) activity was determined cytochemically in peripheral
      blood lymphocytes and neutrophils of 14 schizophrenic patients and normal
      controls. The cytochemical method of Glenner modified for smear preparations was
      utilized. Schizophrenic patients show a tendency to express a lower percentage of
      MAO-positive neutrophils as compared to the non-schizophrenic controls. This
      biochemical difference in schizophrenic patients needs further clarification.

PMID- 7797145
TI  - Urinary N-acetyl-beta-D-glucosaminidase activity in leukaemic children during
      high-dose methotrexate therapy.
AB  - Urinary N-acetyl-beta-D-glucosaminidase (NAG-ase) activity is a very sensitive
      parameter of kidney proximal tubular damage. Using urinary NAG-ase
      activity/urinary creatinine as the NAG index, the serum methotrexate (MTX) level
      and urinary pH were investigated simultaneously. These parameters were measured
      in 17 leukaemic children. During MTX treatment, NAG indices were normal in 5
      children and only slightly elevated occasionally in 9 patients. Among them,
      transiently high serum MTX levels (Patient A) or low urinary pH (Patient B) were
      accompanied by high NAG indices. MTX toxicity has been diagnosed in 3 cases, when
      permanently high NAG indices were in accordance with other clinical signs.

PMID- 7797146
TI  - Platelet ultrastructural and functional studies in myelodysplasia.
AB  - We studied the platelets of 8 patients with myelodysplasia aged 49-77 years,
      using both ultrastructural and functional techniques. Five of the 8 patients were
      classified as having refractory anaemia, and 3 as refractory anaemia with excess
      of blasts (RAEB). Electron microscopically, the myelodysplastic patients had in
      addition to normal ones, platelets containing significantly less alpha-granules.
      In part of these hypogranular platelets, the dense tubular system was abundant,
      but in contrast with normal platelets, it was not dispersed between the other
      organelles, nor did it form a membrane complex with the open cannalicular system.
      From a functional point of view, collagen-induced shape change was the most
      frequently disturbed parameter: there was a total loss of collagen-induced shape
      change in 5 patients. In 2 patients, there was a complete lack of response to
      collagen in platelet-rich plasma (both shape change and aggregation); in one of
      them, there was also a total loss of adenosine triphosphate secretion in response
      to all inducers tested. After 4 years of follow-up, 5 patients had died, of whom
      3 were RAEB patients. An initial complete absence of collagen-induced shape
      change was found in these 5 patients, while in the 3 patients who were still
      alive at the end of the follow-up period, collagen-induced shape change was
      normal in 2 and slightly diminished in one.

PMID- 7797147
TI  - Hemorrhagic pleural effusion as a complication of chronic lymphocytic leukemia.
AB  - We report a case of hemorrhagic pleural effusion in a 59-year-old-man with
      chronic lymphocytic leukemia (CLL). The association between pleural effusion and
      CLL has been rarely reported and we believe that the pleural effusion probably
      reflected an advanced and refractory disease in our patient. Early detection of
      this complication is essential for appropriate therapy.

PMID- 7797149
TI  - [Treatment of obstructive sleep apnea with anterior mandibular positioning
      device].
AB  - The efficacy of the anterior mandibular positioning (AMP) device in obstructive
      sleep apnea syndrome was assessed. This device advances the mandible anteriorly
      by approximately 5-7 mm. 29 patients were examined and questioned about
      temporomandibular (TM) and facial pain before and after treatment with the
      device. Polysomnographic sleep studies were performed on all before, and 2 weeks
      after continuous use of the AMP device. 10 of the patients also underwent
      polysomnographic follow-up after 1 year. The mean apnea index (AI) before
      treatment was 40.1, which decreased to 24.3 (p < 0.0001) after 14.3 days of
      treatment with the AMP device. O2 saturation also increased, from 84.2% before,
      to 89.2% after treatment (p < 0.002). In 10 patients the mean AI after 1 year was
      24.9, not different from that after only 2 weeks of treatment, but significantly
      different from their mean AI before treatment (39.8). Use of the AMP device did
      not change blood saturation levels; neither did it affect dental status, action
      of the masticatory muscles, nor did it cause TM joint dysfunction. 21 patients
      (72.4%) have now been fitted with an AMP device, and the mean follow-up is 13.4
      months (range 2-22); 3 have been using the AMP only intermittently for TM joint
      pain or discomfort. We conclude that the AMP device helps the majority of
      patients and is an alternative, nonsurgical method for treating obstructive sleep
      apnea syndrome.

PMID- 7797150
TI  - [Flexible bronchoscopy in the diagnosis of foreign body aspiration].
AB  - Foreign body aspiration (FBA) should be suspected in every child with acute onset
      of cough or wheezing. Although a choking episode occurs in 80-90% of cases of
      FBA, it is not necessarily diagnostic. Furthermore, in many cases neither
      physical examination nor chest x-ray, including fluoroscopy, are diagnostic;
      their results may be completely normal in up to 17-25% of cases of FBA.
      Bronchoscopy is therefore mandatory when there is a convincing history of FBA,
      regardless of physical or radiologic findings. This can be done with either the
      flexible or rigid bronchoscope, or with both.

PMID- 7797152
TI  - [Laparoscopic splenectomy for immune thrombocytopenic purpura].
AB  - Splenectomy is effective in treating immune thrombocytopenic purpura (ITP).
      Recent advances in laparoscopic technique and technology have made laparoscopic
      splenectomy feasible. We performed it in 8 cases of ITP (16-34 years old, and 2
      24 months after the diagnosis was made and appropriate treatment started).
      Indications for splenectomy were no response to corticosteroid therapy (2
      patients), decrease in platelet count when attempting to taper off therapy (3),
      or severe side-effects of the treatment (3). 4-5 ports were used. The splenic
      artery was first double-clipped through an opening in the gastrocolic ligament
      and then the lower splenic pole and the posterolateral attachments were dissected
      using endoclips and electrocautery. The hilum and short gastric vessels were
      separated using an endostapler. The spleen was placed in a plastic bag whose open
      end was pulled out through an umbilical incision and the spleen fragmented and
      aspirated out of the bag, while it was still inside the abdomen. Blood or
      platelet transfusions were not needed and the postoperative course was uneventful
      in all, with early return to full normal activity. Postoperatively, platelets
      increased to more than 150,000/mm3 in all patients, and there was no further need
      for corticosteroids during a follow-up of 2-12 months. We recommend laparoscopic
      splenectomy for ITP because of the reduced operative trauma, better recovery and
      rehabilitation, less postoperative pain, cosmetic advantage, and possibly fewer
      postoperative complications.

PMID- 7797148
TI  - [Screening and treatment of hyperlipidemias in Israel].
AB  - Hyperlipidemias are a major risk factor for cardiovascular disease. Screening and
      treatment guidelines for the metabolic disorders associated with them have been
      adopted and published by the Israel Atherosclerosis Society. We examined the
      frequency of plasma lipid determinations and treatment of hyperlipidemia by a
      sample of family practitioners, primary physicians, cardiologists and internists
      working in ambulatory, primary medical care who filled out questionnaires for
      consecutive adult clinic patients. Of 2015 patients, 1029 (51%) were reported to
      be free of cardiovascular disease or its risk factors, 606 (30%) had at least 1
      risk factor, 171 (8%) had peripheral or cerebrovascular atherosclerotic disease,
      131 (7%) had had a myocardial infarction and 78 (4%) had undergone coronary
      angioplasty or bypass surgery. Although the frequency of determinations of total
      HDL and LDL cholesterol increased from those without a risk factor to those after
      bypass surgery, the overall rates were lower than expected in all groups. With
      regard to risk factors, in those with a family history of cardiovascular disease
      lipid determinations were done most frequently, approaching the frequency in the
      bypass group. Combined hypercholesterolemia and hypertriglyceridemia was the most
      common metabolic aberration in all categories. The rate of drug therapy increased
      from those with no risk factor to those after bypass surgery. Therapy with resin
      was reported in 3-14%, fibric acid derivatives in 29-53% and statins in 33-57% of
      the various patient groups. Again, the drug therapy profile of the group with a
      positive family history was similar to that of the bypass group.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7797153
TI  - [Renal tubular dysgenesis].
AB  - Renal tubular dysgenesis (RTD) is a very rare malformation, only 24 cases having
      been described. We present the case of twins born after 28 weeks gestation to a
      newly-arrived Ethiopian immigrant in whom oligohydramnios was diagnosed when she
      was admitted. 1 twin had developed polyhydramnios, died before birth and was born
      with hydrops fetalis. The other newborn suffered from pulmonary distress and
      anuria, and died 2 days after birth. At autopsy there were no apparent changes in
      the kidneys or urinary tract, but histological examination showed absence of
      proximal convoluted tubules. This was attributed to RTD and confirmed by
      histochemical examination.

PMID- 7797154
TI  - [Polymyalgia rheumatica as the presenting symptom of multiple myeloma].
AB  - Polymyalgia rheumatica is a clinical syndrome which appears after the age of 50
      and is characterized by pain and stiffness of proximal muscles, rapid
      sedimentation rate and a dramatic response to small doses of corticosteroids. The
      linkage between polymyalgia rheumatica and temporal arteritis is well-known, but
      the connection with monoclonal gammopathy and lympho-proliferative disorders has
      rarely been reported. We present a 74-year-old man admitted with the typical
      clinical picture of polymyalgia rheumatica, which was the presenting symptom of
      monoclonal gammopathy and subsequently-diagnosed multiple myeloma.

PMID- 7797155
TI  - [Importance of early diagnosis of hyperlipidemias in the prevention of
      atherosclerosis].

PMID- 7797156
TI  - [Laparoscopic surgery].

PMID- 7797151
TI  - [Laparoscopic colonic resection].
AB  - We present our initial experience with laparoscopic colonic resection in 15
      patients: adenocarcinoma of the colon, 10 cases, giant villous adenoma (2),
      arteriovenous malformation (2), and a case of benign stricture. Mean operating
      time was 190 minutes and there were no intraoperative complications. The margins
      of resection and number of resected lymph nodes in patients with malignancy were
      comparable to those in the conventionally operated. Mean postoperative hospital
      stay was 6.1 days. During a maximum follow-up of 15 months there were no wound or
      trocar-site recurrences. We conclude that laparoscopic colonic resection is
      technically feasible and safe. However, its use for treating malignant diseases
      of the colon needs further study.

PMID- 7797157
TI  - [Detection and treatment of high blood cholesterol for prevention of coronary
      heart disease--attitude of the Israel Society of Atherosclerosis].

PMID- 7797159
TI  - [Impact of hormone replacement therapy on the cardiovascular system].

PMID- 7797158
TI  - [Principles of dietary treatment in hyperlipidemia].

PMID- 7797160
TI  - [Drug therapy for the treatment of hypercholesterolemia in adults].

PMID- 7797161
TI  - [Technology in need of assessment: total hip arthroplasty].

PMID- 7797163
TI  - [Fragile X syndrome: molecular aspects and prenatal diagnosis].

PMID- 7797162
TI  - [Prevention and treatment of infected total hip arthroplasty].

PMID- 7797167
TI  - Exotic plant species can serve as staple food sources for wild howler
      populations.

PMID- 7797165
TI  - Influence of infants on female social relationships in monkeys.
AB  - A critical evaluation of the literature and a cost/benefit analysis suggest that
      changes in affiliation patterns in female monkeys following the birth of infants
      should be mediated by female reproductive state and dominance rank and infant
      characteristics such as age and sex. Several predictions concerning the effects
      of these variables were tested on dyadic interactions between lactating pigtail
      macaque (Macaca nemestrina) females and other lactating or pregnant females.
      Dyads composed of lactating females spent more time in proximity, contact and
      grooming than dyads composed of lactating and pregnant females. Association with
      other lactating females was mainly due to lower-ranking females that may gain
      benefits such as increased tolerance and support from their partners. Infant
      handling by lactating females had a higher percentage of harassment episodes than
      handling by pregnant females. Among dyads composed of two lactating females,
      affiliative interactions were inversely correlated with rank distance. It is
      suggested that the presence of infants may influence female social dynamics at
      the group level to a greater extent than previously thought.

PMID- 7797168
TI  - Gular scent glands in adult female white-faced saki, Pithecia pithecia pithecia,
      and field observations on scent-marking behaviour.

PMID- 7797164
TI  - Contrasting chimpanzees and bonobos: nearest neighbor distances and choices.
AB  - In an effort to understand factors underlying differences in the social
      organization of Pan troglodytes and P. paniscus, we measured the nearest neighbor
      distances and choices for chimpanzees in Kibale National Park, Uganda, and for
      bonobos in Lomako Forest, Zaire. We assume that the spatial organization of a set
      of individuals should reflect the underlying relationships between them. Bonobos
      were found to have smaller nearest neighbor distances than chimpanzees. The
      distribution and variability of the distances suggested that chimpanzees have a
      more restricted range of nearest neighbor distances than bonobos, avoiding
      situations of very close proximity. Selection of the sex of the nearest neighbor
      by a focal animal differed between the species. For example, male bonobos rarely
      had another male as their nearest neighbor, while male chimpanzees frequently
      did. Similarly, male bonobos tended to move apart when observed together, while
      it was female chimpanzees who tended to move apart when together. These
      observations are considered with respect to the nature of the social interactions
      in these species.

PMID- 7797166
TI  - Temporal patterns in primate leaf eating: the possible role of leaf chemistry.

PMID- 7797169
TI  - Activity budget and diet of Alouatta caraya: an age-sex analysis.

PMID- 7797170
TI  - Social organisation and SIV sero-epidemiology of a patas monkey population in
      Senegal.

PMID- 7797171
TI  - Effects of vomitoxin (deoxynivalenol) and cycloheximide on IL-2, 4, 5 and 6
      secretion and mRNA levels in murine CD4+ cells.
AB  - The effects of continuous in vitro exposure to the trichothecene, vomitoxin (VT)
      or another protein synthesis inhibitor, cycloheximide (CHX), on interleukin (IL)
      secretion and mRNA levels were evaluated in murine splenic CD4+ cells.
      Significant increases were seen in supernatant IL-2, IL-4 and IL-5 obtained from
      7 day Concanavalin A (Con A)-stimulated CD4+ cultures containing VT
      concentrations of 250, 100 and 100 ng/ml, respectively, compared with controls
      run in the absence of VT. The effect of VT on CD4+ cell proliferation was also
      assessed after culturing for 3, 5 and 7 days with Con A. Although total cell
      numbers were not affected at day 3, cultures at day 5 with 50 or more ng VT/ml
      and at day 7 with 100 or more ng VT/ml had significantly lower cell numbers than
      controls. In addition, viable cell number was unaffected at day 3, but was
      significantly decreased at day 5 by VT concentrations of 12.5 ng or more ml and
      at day 7 by 100 or more ng VT/ml. Elevations in IL-2, IL-4 and IL-5 were also
      observed in 7-day Con A-stimulated CD4+ cell cultures containing CHX at 50-100,
      50 and 10 ng/ml, respectively. When CD4+ cells were stimulated with Con A in the
      absence of inhibitors and then subjected to reverse transcriptase-polymerase
      chain reaction coupled with Southern analysis, maximal IL-2, IL-4 and IL-6 mRNA
      levels were induced at 48 hr whereas peak IL-5 mRNA was observed at 72 hr.
      Superinduction of IL-2 mRNAs was observed in the presence of VT at 50-100 ng/ml
      and CHX at 50-250 ng/ml. IL-4 and IL-5 mRNAs were superinduced by VT at 100 ng/ml
      and CHX at 50 ng/ml. The results suggest that VT and CHX could superinduce both
      interleukin secretion and mRNA transcript levels in CD4+ cell cultures and that,
      for VT, these effects occurred concurrently with inhibition of cell
      proliferation.

PMID- 7797172
TI  - Toxicity and cell proliferation in the liver, kidneys and nasal passages of
      female F-344 rats, induced by chloroform administered by gavage.
AB  - Dose-response relationships were determined for the induction of cytolethality
      and regenerative cell proliferation in the established target organs (liver,
      kidneys, and nasal passages) of female F-344 rats given chloroform daily by
      gavage. Rats were administered chloroform dissolved in corn oil at doses of 0,
      34, 100, 200 or 400 mg/kg/day for 4 consecutive days or for 5 days/wk for 3 wk.
      Bromodeoxyuridine (BrdU) was administered through an implanted osmotic pump 3.5
      days prior to autopsy to label cells in S-phase. Cells in S-phase were visualized
      immunohistochemically in tissue sections and the labelling index (LI) calculated
      as the percentage of cells in S-phase. Mild degenerative centrilobular changes
      and dose-dependent increases in the hepatocyte LI were observed after
      administration of 100 mg or more chloroform/kg/day. Rats given 200 or 400
      mg/kg/day for 4 days or 3 wk had degeneration and necrosis of the proximal
      tubules of the renal cortex. Regenerating epithelium lining proximal tubules was
      seen histologically and as an increase in LI. Dose-dependent increases in LI were
      observed in the kidneys at doses of 100 mg or more chloroform/kg/day at both 4
      days and 3 wk. Two distinct treatment-induced responses were observed in specific
      regions of the olfactory mucosa lining the ethmoid region of the nose. A
      peripheral lesion was seen at all doses used and included new bone formation,
      periosteal hypercellularity and increased cell replication. A central lesion was
      seen at doses of 100 mg or more chloroform/kg/day and was characterized by
      degeneration of the olfactory epithelium and superficial Bowman's glands. These
      observations define the dose-response relationships for the liver, kidneys and
      nasal passages as target organs for chloroform administered by gavage in the
      female F-344 rat.

PMID- 7797173
TI  - Toxicological consequences of aroclor 1254 ingestion by female rhesus (Macaca
      mulatta) monkeys. Part 2. Reproduction and infant findings.
AB  - A group of 80 menstruating rhesus (Macaca mulatta) monkeys were randomly
      allocated to four similar test rooms (20 monkeys/room) and then randomly
      allocated within each room to one of five dose groups (four females/dose
      group/room). Each day, the monkeys self-ingested capsules containing doses of 0,
      5, 20, 40 or 80 micrograms Aroclor 1254/kg body weight. After 25 months of
      continuous dosing, approximately 90% of the treated females had attained a
      qualitative pharmacokinetic steady state with respect to the concentration of
      polychlorinated biphenyl (PCB) in their adipose tissue. Commencing on test month
      37, each female was paired with an untreated male until either an impregnation
      occurred or the 29-month breeding phase of the study was completed. The females
      continued to receive their daily test dose during mating and gestation. To
      preclude an infant ingesting the mother's dosing capsule, dosing of the dam was
      discontinued when a nursing infant was approximately 7 wk old. Treatment was
      restarted when the infant was weaned at 22 wk of age. At parturition, and every 4
      wk until weaning, milk and blood samples were obtained from the dam and a blood
      sample was obtained from the infant for PCB analysis. When the infant was 20 wk
      old, immunological testing was initiated and an adipose sample was obtained from
      the infant and dam for PCB analysis. Subsequently, further adipose and blood
      samples were obtained from the infant and blood specimens were obtained from the
      dam for PCB analysis. Concurrently, each infant was subjected to anthropometric
      measurements and detailed clinical examinations until it was approximately 122 wk
      old. At 122 wk some of the control and all of the treated infants were killed
      humanely and autopsied. A statistical analysis of the reproduction data provided
      evidence for a significant decreasing dose-related trend in conception rates and
      a significant increasing dose-related trend in foetal mortality. Several
      comparisons between impregnated and non-impregnated females did not implicate
      'age' as a confounding factor regarding these results. The major findings with
      the infants involved some immunological test differences and mild clinical
      manifestations of PCB ingestion.

PMID- 7797174
TI  - Migration of styrene from polystyrene foam food-contact articles.
AB  - Polystyrene foam is used in many food-contact articles such as plates, cups,
      bowls, egg cartons, meat trays and hinged 'carryout' containers. In most of these
      applications the food is in contact with the article for a relatively short
      period of time at mild temperatures (up to 130 degrees F), or for longer periods
      of time at refrigerated temperatures (40 degrees F). The extent of migration of
      residual styrene from foam articles under these conditions is of interest in
      order to predict potential exposure of consumers to styrene from food-contact
      polymers. Studies of styrene migration from all polystyrene foam articles except
      egg cartons were completed using food oil as the simulant. Results showed that
      the amount of styrene migrating from the various food-contact articles made with
      thermoformed polystyrene sheet into food oil was proportional to the square root
      of time of exposure. The mean diffusion coefficients derived from these data,
      assuming the migration was Fickian in nature, showed a linear relationship
      between the log of the diffusion coefficient and the inverse of the absolute
      temperature of exposure from 70 to 150 degrees F (21-66 degrees C). The mean
      diffusion coefficients ranged from about 4.5E-11 cm2/s at 70 degrees F to 3.4E-9
      cm2/s at 150 degrees F. Among the four thermoformed articles exposed to food oil,
      the diffusion coefficients varied by a factor of four or less at a given
      temperature. The migration of styrene from egg cartons was examined using
      conditions simulating 'typical' exposure temperature and time with 8% ethanol as
      the simulant (31 days at 40 degrees F (4 degrees C)). No migration of styrene was
      observed under this condition, with a detection limit of < 0.01 micrograms/cm2.

PMID- 7797175
TI  - Acute and subchronic toxicity of 1,1-dichloro-1-fluoroethane (HCFC-141b).
AB  - The acute and subchronic toxicity of 1,1-dichloro-1-fluoroethane (HCFC-141b), a
      CFC alternative, was evaluated in several acute and subchronic studies to assist
      in establishing proper handling guides. Data from acute toxicity studies in rats
      and rabbits demonstrated that HCFC-141b has very low acute toxicity. HCFC-141b
      was not a skin irritant, but was a mild eye irritant, in rabbits and was not a
      skin sensitizer in guinea pigs. Skin application of HCFC-141b to rabbits at 2000
      mg/kg body weight produced no adverse effects. Oral administration at 5000 mg/kg
      body weight did not cause any deaths or clinical signs of toxicity in rats. The 4
      hr LC50 for HCFC-141b was about 62,000 ppm in rats. Repeated exposures of rats
      for 6 hr/day, 5 days/wk for up to 90 days at concentrations of 2000, 8000 or
      20,000 ppm did not result in significant adverse effects. Minor, but dose
      dependent, reductions in body weight were observed in male and female rats during
      the 90-day study. Decreased responsiveness was also observed in rats but only at
      20,000 ppm. An increase in serum cholesterol or triglycerides was observed in
      male and female rats at 20,000 ppm, and in males at 8000 ppm. No specific organ
      pathology was noted in these subchronic inhalation studies. The no-observable
      adverse-effect level (NOAEL) from these studies was 8000 ppm. Results from other
      studies demonstrate that HCFC-141b was not neurotoxic in rats. As with
      trichlorofluoroethane (CFC-11), a cardiac sensitization response to an
      intravenous epinephrine challenge occurred in dogs with HCFC-141b at 5000 ppm and
      higher concentrations in experimental screening studies.

PMID- 7797176
TI  - Evaluation of the genotoxicity potential and chronic inhalation toxicity of 1,1
      dichloro-1-fluoroethane (HCFC-141b).
AB  - A battery of in vitro and in vivo tests were conducted on HCFC-141b as a vapour.
      Bacterial gene mutation assays with Escherichia coli and Salmonella typhimurium
      were negative in all tester strains. In vitro chromosomal aberration assays were
      positive on CHO cells but negative on human lymphocytes. Moreover, HCFC-141b was
      negative in vivo in a mouse micronucleus inhalation assay. On the basis of these
      data and previously reported genotoxicity testing, HCFC-141b is considered non
      genotoxic. Groups of 80 male and 80 female Sprague-Dawley rats were exposed, by
      inhalation (6 hr/day, 5 days/wk) to vapours of HCFC-141b for 104 wk at target
      concentrations of 0 (control), 1500, 5000 and 20,000 ppm (increased from 15,000
      ppm after 17 wk of exposure). No exposure-related effects of toxicological
      significance were noted with respect to survival, clinical signs, ophthalmoscopy,
      haematology, clinical chemistry, urinalysis or organ weight analysis. Reduced
      food intake and body weight gain were noted in both sexes of the 15,000 ppm group
      during the first 16 wk; thereafter, body weight gains in all groups were similar
      although the intergroup differences in body weight remained evident. Reduced food
      intake persisted in both sexes through wk 52 and in females during the second
      year of exposure. Treatment-related effects on macroscopic pathology were
      confined to increased incidences of testicular masses and altered appearance.
      Microscopic pathology examinations confirmed the testes as the target organ with
      findings of increased incidences of benign interstitial cell tumours and
      hyperplasia at 5000 and 20,000 ppm. The no-observable-adverse-effect level
      (NOAEL) was 1500 ppm. The testicular changes at high exposure levels were
      considered to be due to a change of the senile hormonal imbalance in geriatric
      rats and of little significance for the assessment of human health effects.

PMID- 7797177
TI  - Genotoxic effects of two industrial effluents and ethyl methane sulfonate in
      Clarias lazera.
AB  - The genotoxic effects of industrial effluents from a brewery and a textile mill
      and of ethyl methane sulfonate (EMS) were investigated by the micronucleus test
      in Clarias lazera, a tropical freshwater fish. Fish obtained from a local market
      were kept in laboratory aquaria for 3 wk and then exposed to different
      concentrations (0.5 to 8 mg/litre) of EMS or brewery or textile-mill effluent (10
      60%, v/v) for 14 days. The frequency of micronucleated erythrocytes was
      determined from blood smears and the results were analysed by linear regression
      and variance analysis. Exposure to EMS or effluent resulted in statistically
      significant increases in micronucleus frequency and there was a positive dose
      response effect over the entire dose range. The textile-mill effluent dose
      response curve was significantly higher than that of the brewery effluent. The
      suitability of the micronucleus test in fish for the screening of aquatic
      genotoxicants is highlighted and the importance of intensified monitoring of the
      aquatic environment is emphasized.

PMID- 7797178
TI  - Comparison of the maximum tolerated dose (MTD) dermal response in three strains
      of mice following repeated exposure to acrylic acid.
AB  - The dermal response of three strains of mice (ICR, C3H and B6C3F1) exposed to
      repeated doses of 0, 1 or 4% acrylic acid was examined over 13 wk. Microscopic
      and gross changes to the skin were classified as being indicative of exceeding
      the maximum tolerated dose (MTD), reaching the MTD, or tolerating the dose based
      on proposed MTD guidelines established in US Environmental Protection Agency
      (EPA) Workshops on dermal carcinogenesis bioassays. A significant number of
      animals in all three strains with repeated exposure to 4% acrylic acid
      experienced skin irritation that was classified as having reached or exceeded the
      MTD compared with animals exposed to either 1% acrylic acid or the 0% acrylic
      acid acetone control. These results were observed within the first 3 wk of
      exposure, but there was some accommodation to irritation by 8 wk of exposure.
      Microscopic findings provided a more sensitive index for exceeding MTD than gross
      observations taken only at autopsy, but generally correlated well for MTD if
      gross observations were taken at regular intervals during treatment. That is, to
      set MTD, gross observations could be used if taken over the entire course of the
      exposure, but using microscopic findings was generally a more reliable or
      sensitive measure. EPA guidelines suggest that it is inappropriate to conduct a
      dermal bioassay at concentrations that exceed the MTD. Acrylic acid at 4% in
      acetone clearly exceeded the MTD based on microscopic or gross observation
      criteria. At 4%, strain differences were evident by gross observation only, with
      the ICR strain being less susceptible to irritation than C3H or B6C3F1 strains.
      These strain differences were not apparent with microscopic examination. Acrylic
      acid at 1% in acetone, although demonstrating signs of minimal irritation, was
      fairly well tolerated by all mice in all strains. Thus, acrylic acid at 1% in
      acetone, one-quarter of the concentration that was in clear excess of the MTD,
      would be the appropriate dose concentration for lifetime skin studies based on
      MTD criteria.

PMID- 7797179
TI  - The safety and regulatory status of food, drug and cosmetics colour additives
      exempt from certification.
AB  - Colour additives exempt from certification (also known as 'natural colour
      additives') are commonly used in the United States to colour foods, drugs and
      cosmetics. The US Food and Drug Administration established regulations governing
      the use of these colour additives, and the labelling of the products that contain
      them. The safety of these colour additives has been demonstrated by safety
      testing programs that have yielded a significant amount of toxicology data, and
      also by a long and well documented history of safe use in the United States and
      elsewhere. In this report we review the data supporting the safety of the colour
      additives that are exempt from certification and approved for use in the USA, and
      conclude that the safety of these colour additives is well supported by the
      available data. Relevant aspects of the regulation of these colour additives are
      also described.

PMID- 7797180
TI  - Multiple linear regression analysis of hypertrophy, calcium and cadmium in
      hypertensive and non-hypertensive states.
AB  - Heart disease remains a major public health issue. In this study we aimed to
      achieve a greater mathematical and mechanistic understanding of the relationship
      between exposure to heavy metals and heart disease. Measurements of calcium and
      cadmium levels were made by flame atomic absorption spectrophotometry in tissue
      from hypertensive and non-hypertensive rabbits. Relationships between
      hypertrophy, calcium and cadmium were tested using multiple regression analysis.
      Multiple linear relationships occurred that showed the dependence of hypertrophy
      on calcium and cadmium levels, and of calcium accumulation on cadmium and
      hypertrophy. These data provide an insight into the mechanisms of heavy metal
      accumulation and the development of cardiovascular hypertrophy.

PMID- 7797181
TI  - Bioactive organosulfur phytochemicals in Brassica oleracea vegetables--a review.
AB  - Sulfur-containing phytochemicals of two different kinds are present in all
      Brassica oleracea (Cruciferae) vegetables (cabbage, broccoli, etc.). They are
      glucosinolates (previously called thioglucosides) and S-methyl cysteine
      sulfoxide. These compounds, which are derived in plant tissue by amino acid
      biosynthesis, show quite different toxicological effects and appear to possess
      anticarcinogenic properties. Glucosinolates have been extensively studied since
      the mid-nineteenth century. They are present in plant foods besides Brassica
      vegetables with especially high levels in a number of seed meals fed to
      livestock. About 100 different kinds of glucosinolates are known to exist in the
      plant kingdom, but only about 10 are present in Brassica. The first toxic effects
      of isothiocyanates and other hydrolytic products from glucosinolates that were
      identified were goitre and a general inhibition of iodine uptake by the thyroid.
      Numerous studies have indicated that the hydrolytic products of at least three
      glucosinolates, 4-methyl-sulfinylbutyl (glucoraphanin), 2-phenylethyl
      (gluconasturtiin) and 3-indolylmethyl (glucobrassicin), have anticarcinogenic
      activity. Indole-3-carbinol, a metabolite of glucobrassicin, has shown inhibitory
      effects in studies of human breast and ovarian cancers. Kale poisoning, or a
      severe haemolytic anaemia, was discovered in cattle in Europe in the 1930s, but
      its link with the hydrolytic product of S-methyl cysteine sulfoxide was only
      shown about 35 years later. S-methyl cysteine sulfoxide and its metabolite methyl
      methane thiosulfinate were shown to inhibit chemically-induced genotoxicity in
      mice. Thus, the cancer chemopreventive effects of Brassica vegetables that have
      been shown in human and animal studies may be due to the presence of both types
      of sulfur-containing phytochemicals (i.e. certain glucosinolates and S-methyl
      cysteine sulfoxide).

PMID- 7797182
TI  - A new surgical method from the viewpoint of personal identification: a case of
      identification based on the presence of a metallic Z-stent.
AB  - To the best of our knowledge, the first case of successful personal
      identification based on the characteristic finding of a metallic Z-stent,
      unexpectedly discovered in the common bile duct, is reported. An unknown human
      male cadaver was found at the seaside. The age was estimated to be approximately
      50-70 years and the postmortem interval was considered to be approximately 2
      weeks. There was a small surgical scar of 1.5 cm in diameter in the epigastrium.
      The cadaver was group A in the ABO blood group system. Internally, the following
      severe injuries were observed: the dislocation of the occipito-atlantal joint,
      fractures of the cervical and thoracic portions of the spinal column, multiple
      fractures of the bilateral ribs, and ruptures of the spleen, left kidney and
      liver. Furthermore, a 4.5 cm long metallic stent was found in the common bile
      duct, and the gallbladder was not thoroughly identified because of the severely
      tight adhesion of the surrounding tissues. In every cut surface of the liver,
      multiple bile plaques, signifying the presence of long-standing cholestasis, were
      conspicuous. A microscopic examination revealed the invasion of cancer cells into
      the liver, which was diagnosed as well or moderately differentiated
      adenocarcinoma, although the primary origin of the adenocarcinoma could not be
      determined. The cause of his death was diagnosed as traumatic shock. According to
      the police investigation after the autopsy, it was revealed that a 60-year-old
      male, suffering from gallbladder carcinoma, had disappeared.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7797183
TI  - A fatal case of drug-induced multi-organ damage in a patient with Hansen's
      disease: dapsone syndrome or rifampicin toxicity?
AB  - An elderly patient with borderline tuberculoid Hansen's disease (leprosy)
      developed the diaminodiphenylsulphone syndrome after approximately 8 weeks of
      multi-drug therapy comprising dapsone and rifampicin. Postmortem histological
      examination, following autopsy, demonstrated features consistent with drug
      induced hepatitis, tubulo-interstitial nephritis and myocarditis. Although these
      could have been engendered by dapsone toxicity, it was thought that a
      concommitant adverse reaction to rifampicin, which is known to be hepatotoxic,
      nephrotoxic and possibly capable of predisposing to the dapsone syndrome, could
      not be excluded.

PMID- 7797184
TI  - Iatrogenically-related, fatal haemorrhage occurring in end-stage renal failure: a
      series of three cases.
AB  - Three patients with end-stage renal failure died from acute haemorrhage which, in
      the first two cases, was related to the use of internal jugular catheters for
      haemodialysis. In the third instance, severe haemorrhage was caused by the
      apparent self-insertion of a 16-gauge butterfly needle, connected to a
      siliconised cannula (also designed for haemodialysis) into the superficial median
      cubital vein of the left forearm. The hazards associated with the use of internal
      jugular catheters and the medicolegal implications of these cases are briefly
      discussed.

PMID- 7797185
TI  - Sudden death arising from a congenital coronary artery fistula.
AB  - A medico-legal autopsy conducted on a young Chinese man, a victim of sudden
      unexpected death, with a vague and unconfirmed history of congenital
      cardiovascular disease, revealed the presence of a congenital right coronary
      artery (arteriosystemic) fistula communicating with the markedly hypertrophied
      left ventricle, which showed microscopic evidence of myocardial ischaemia. The
      pathology of this rare condition is described and briefly reviewed.

PMID- 7797186
TI  - An unusual case of pneumatically-induced facial and cervical injuries.
AB  - An army mechanic sustained a penetrating mandibular injury, associated with right
      atlantooccipital dislocation, when the inner tube of a military truck tyre burst.
      It is thought that he had used a sledgehammer, having wielded it lengthwise with
      the free end of its hollow cylindrical handle held uppermost, to reposition the
      locking ring of the fully inflated tyre. In all probability, the sudden release
      of highly pressurised air disloged the locking ring and forced the circular end
      of the handle into his right lower jaw, thereby fracturing the mandible and
      causing an acute hyperextension injury of the cervical spine, with resultant
      profound spinal shock and instantaneous death.

PMID- 7797187
TI  - Accidental death by nitrous oxide inhalation.
AB  - Nitrous oxide is a popular inhalation anesthetic-analgesic agent. Its euphoric
      action and its availability have led to its abuse. We report a case of fatal
      accidental asphyxia due to nitrous oxide abuse. The deceased was a hospital
      worker who had access to the hospital supply of nitrous oxide. His death was due
      to hypoxemia and asphyxiation, secondary to nitrous oxide inhalation.

PMID- 7797188
TI  - Ingestion of lye.
AB  - This paper reports on the case of a 13-year-old white male who committed suicide
      by ingestion of heavy duty drain and sewer opener. He left behind a note
      indicating his suicide. This teenager was grieving over the suicide of one of his
      friends and was under counseling by a mental health therapist at school. Results
      of autopsy and toxicological analyses indicated the ingestion of a highly
      alkaline substance that is consistent with the ingredients of the drain opener
      mentioned.

PMID- 7797189
TI  - Vitreous humor alcohol.

PMID- 7797190
TI  - Vitreous alcohol.

PMID- 7797191
TI  - Psychiatric morbidity among Finnish prisoners with special reference to socio
      demographic factors: results of the Health Survey of Finnish Prisoners (Wattu
      Project).
AB  - The present study is part of the Health Survey of Finnish Prisoners (Wattu
      Project). The project dealt with a sample of 1099 Finnish prisoners, of which 82%
      participated in the study. Because of the representativeness of the sample the
      results can be generalized to all Finnish prisoners. The methods used consisted
      of questionnaires, interviews, a clinical examination by prison physicians and
      gathering of register data. The total prevalence rate of psychiatric cases was
      56%. This is much higher than the rate for the Finnish population in general. The
      high number of mental disorders was due to alcoholism (43%) and personality
      disorders (18%). These disorders became even more prevalent as the number of
      prison sentences increased. There was no difference between the prisoners and the
      general population in the prevalence of psychoses and neuroses. Alcoholism is the
      most important mental disorder in Finnish prisoners, while drug abuse is rarely
      found among them in comparison to prisoners in many other countries.

PMID- 7797193
TI  - Current awareness in hematological oncology.

PMID- 7797192
TI  - Simultaneous determination of opiates, cocaine and major metabolites of cocaine
      in human hair by gas chromotography/mass spectrometry (GC/MS).
AB  - A procedure is presented for the simultaneous identification and quantification
      of morphine (MOR), codeine (COD), ethylmorphine (EM), 6-monoacetylmorphine (6
      MAM), cocaine (COC), benzoylecgonine (BZE), ecgonine methylester (EME) and
      cocaethylene (CE), contained in the hair of opiates and cocaine addicts. The
      method involves decontamination in dichloromethane, pulverization in a ball mill,
      heat-acid hydrolysis, addition of deuterated internal standards, liquid-liquid
      extraction and gas chromatography/mass spectrometry (GC/MS) after silylation. The
      limit of detection (LOD) was approximately 0.1-0.8 ng/mg for each drug, using a
      30-mg hair sample. The method is reproductible, with a coefficient of variation
      (CV) of approximately 8-17%. Cocaine and 6-monoacetylmorphine were the major
      compounds detected in cases of cocaine (14 cases) and heroin (68 cases) intake.
      Concentrations were in the range 0.4-78.4 ng/mg (COC), 0.0-36.3 ng/mg (BZE), 0.0
      1.6 ng/mg (EME), 0.0-2.1 ng/mg (CE), 0.0-84.3 ng/mg (6-MAM), 0.2-27.1 ng/mg (MOR)
      and 0.1-19.6 ng/mg (COD). An application in forensic sciences, involving multi
      sectional analysis, is given.

PMID- 7797194
TI  - Simultaneous presentation of hairy cell leukemia and follicular small cleaved
      cell lymphoma in a patient with previous diagnosis of renal cell carcinoma.
AB  - Hairy cell leukemia is a lymphoproliferative disorder of the B lymphoid system
      that is associated with an increased incidence of second malignancies. Most of
      these second neoplasma have been solid tumours and few reports of lymphoid
      malignancies exist. We report here a case of simultaneous presentation of hairy
      cell leukemia diagnosed in the spleen of a patient under therapy for follicular
      lymphoma who had an antecedent history of renal cell carcinoma. The hairy cell
      leukemia and the follicular lymphoma were studied by means of molecular
      techniques and they were found to contain two different clonal B cell
      proliferations. This suggests an independent origin of these two B cell
      neoplasms. As far as we know, this is the first report of the coexistence of
      hairy cell leukemia and follicular lymphoma.

PMID- 7797195
TI  - Multiple myeloma: an immunoclinical study of disease and response to treatment.
AB  - Plasma cytokines and immune markers were assessed during the clinical management
      of 42 patients with multiple myeloma, MM. Of the patients 22/42 (all with
      progressive disease) were studied from the time of diagnosis, through various
      treatment regimes, to remission, progression or death. 5/42 patients had
      monoclonal gammopathy of undetermined significance (MGUS), 8/42 others had either
      indolent MM or stable MM, and a further 7/42 with progressive disease were also
      studied. IL-6, TNF-alpha, IL-1 alpha, IL-1 beta, beta 2 microglobulin (beta 2M),
      and neopterin were estimated in bloods taken under optimal conditions for
      cytokine detection. The levels were compared with a panel of samples from healthy
      volunteers. Both immunoreactive and biologically active plasma IL-6 levels were
      measured. Pretreatment IL-6 levels (both immunoreactive and biologically active)
      were found to correlate with severity of disease. In 13/22 patients with
      progressive disease who had been followed from the time of diagnosis over a 12
      month period or until death, pretreatment IL-6 levels were predictive of response
      to therapy. Elevated plasma levels of TNF-alpha, beta 2M and neopterin were found
      in patients with progressive multiple myeloma, and this correlated with renal
      impairment. The analytes measured during the course of chemotherapy did not show
      correlation with disease progression or response to therapy.

PMID- 7797197
TI  - High grade non-Hodgkins lymphoma in the elderly--12 year experience in the
      Grampian Region of Scotland.
AB  - A retrospective examination of patients with high grade non-Hodgkin's lymphoma
      (HG NHL) presenting in the Grampian Region of Scotland from 1980-1992 was
      undertaken to determine the disease characteristics and outcome in patients over
      the age of 60 years at diagnosis. This group of patients was found to account for
      68 per cent of HG NHL presenting in this region. No difference in clinical stage
      or histology was noted compared to their younger counterparts. The elderly had a
      significantly poorer survival with an increase in lymphoma-related and unrelated
      deaths. On Cox regression analysis the main survival advantage was conferred by
      completion of 'radical' treatment; elderly patients who were given 'radical'
      therapy had a median survival of 50 months compared to median survival of 10
      months in the 'non-radical' group. Patients who had a good performance status at
      diagnosis had also a significant survival advantage. Histology, clinical stage at
      diagnosis and age over 60 had no independent significant effect on survival. Not
      all the factors that resulted in 'non-radical' therapy being given are explicable
      but we conclude that 'radical' therapy is achievable in 50 per cent of patients
      over the age of 60 years with an effective outcome and should be pursued in the
      elderly when the condition of the patient allows.

PMID- 7797198
TI  - The polymerase chain reaction in histopathology.
AB  - Thanks to the advent of the polymerase chain reaction (PCR) molecular genetic
      study of histological samples is now a relatively straightforward task and the
      vast histopathology archives are now open to molecular analysis. In this review
      we outline technical aspects of PCR analysis of histological material and
      evaluate its application to the diagnosis and study of genetic, infectious and
      neoplastic disease. In addition, we describe a number of newly developed methods
      for the correlation of PCR analysis with histology, which will aid the
      understanding of the molecular basis of pathological processes.

PMID- 7797196
TI  - Hepatosinusoidal leukaemia/lymphoma consisting of Epstein-Barr virus-containing
      natural killer cell leukaemia/lymphoma and T-cell lymphoma; mimicking malignant
      histiocytosis.
AB  - Previously diagnosed cases of hepatosinusoidal T-cell lymphoma and malignant
      histiocytosis (MH) may include lymphoid neoplasms of natural killer (NK) cell
      lineage associated with Epstein-Barr virus (EBV). Such hepatosinusoidal neoplasms
      were found to demonstrate hepatomegaly but not lymphadenopathy, and all were
      diagnosed by a liver biopsy. Sixteen adult patients diagnosed with
      hepatosinusoidal leukaemia/lymphoma (six NK-cell leukaemia/lymphomas [NKLLs],
      five instances of MH, three T-cell malignant lymphomas [T-MLs], and two adult T
      cell leukaemia/lymphomas [ATLLs] were examined for EBV by in situ hybridization,
      then were studied immunohistochemically and subjected to a DNA analysis. Among
      our five patients with MH, neoplastic cells showed T-cells, but no histiocytic
      markers, and they were considered to have either a T-cell or NK-cell lineage. All
      NKLLs, MHs and T-MLs, except for ATLLs accompanied by reactive hemophagocytic
      histiocytes, varied in number in each case. In situ hybridization revealed the
      presence of EBV in the nuclei of atypical cells in all of the six lymphoid
      neoplasms of NK-cell lineage. Each case of MH and each T-ML which represented EBV
      demonstrated no definite T-cell or histiocytic markers. Patients with ATLL did
      not reveal EBV. In all patients with hemophagocytosis, EBV was present in the
      nuclei of the neoplastic lymphocytes, but not in the hemophagocytic cells.
      Finally, the 16 cases were reclassified into eight cases with EBV-containing
      NKLLs, six T-MLs, and two ATLLs. In addition, no true histiocytic neoplasms were
      observed. The mechanism of hemophagocytosis may be therefore the production of
      lymphokines (macrophage-activating factors) by neoplastic lymphocytes. EBV
      associated hepatosinusoidal leukaemia/lymphoma may thus contain a lymphoid
      neoplasm of NK-cell lineage, which made it difficult to be distinguished from the
      previously designated malignant histiocytosis.

PMID- 7797199
TI  - Expression of proliferating cell nuclear antigen (PCNA) and Ki-67 in unicystic
      ameloblastoma.
AB  - The expression of proliferating cell nuclear antigen (PCNA) and Ki-67 was studied
      in unicystic and solid ameloblastoma (follicular and plexiform types) using a
      biotin-streptavidin method on routinely processed paraffin sections. To determine
      percentage PCNA and Ki-67 labelling indices, positive tumour cells and total
      tumour cells were counted in areas of each unicystic ameloblastoma corresponding
      to cystic linings, intraluminal nodules and invading tumour islands, and in solid
      ameloblastomas. Positive cells in basal and suprabasal layers of cystic tumour
      lining were also counted with respect to the length of basement membrane
      determined by image analysis. In unicystic ameloblastoma the invading islands
      exhibited a significantly higher PCNA labelling index (29.2 +/- 16.4%) than
      intraluminal nodules (13.6 +/- 5.4%; P < 0.05). Cystic tumour lining had
      relatively few PCNA positive cells and a labelling index (5.5 +/- 3.3%)
      significantly lower than invading islands (P < 0.001) or intraluminal nodules (P
      < 0.003). The labelling indices of solid ameloblastomas of follicular type (48.1
      +/- 12.9%) were significantly higher than those of cystic tumour lining (P <
      0.0001), intraluminal nodules (P < 0.001) and invading islands (P < 0.04) in
      unicystic ameloblastoma. Similar relationships were found for Ki-67 expression
      except that comparisons involving invading islands and intraluminal nodules were
      not significant, a finding probably due to the smaller number of specimens
      available for quantitative analysis. These results indicate differences in
      proliferative potential between different areas of unicystic ameloblastoma and
      between unicystic and solid lesions. The fact that invading tumour islands within
      the fibrous tissue wall showed high labelling indices is in agreement with the
      clinical observation that their presence may be related to recurrence after
      conservative surgery. This provides a biological basis for indicating more
      radical surgical excision as the treatment of choice for this subgroup of
      lesions.

PMID- 7797200
TI  - Low grade fibromyxoid sarcoma: clinicopathological analysis of eleven new cases
      in support of a distinct entity.
AB  - Low grade fibromyxoid sarcoma is a recently recognized, uncommon soft tissue
      neoplasm with a tendency to develop in deep soft tissue of young adults.
      Diagnostic criteria have not been well defined and this tumour has not been
      widely accepted as a distinct entity. Eleven new cases are reported here for
      which reproducible histological features are described and in which the
      immunohistochemical profile of the tumour cells is documented for the first time.
      Ten of the eleven patients were male and the majority were young or middle-aged
      adults (median age 45 years). All except one of the tumours were situated in deep
      soft tissue. Lower limb (four cases) and chest wall (three cases) were the
      commonest primary sites; one case each arose in the groin, buttock, axilla and
      retroperitoneum. Follow-up (median duration 6 years) was available in nine
      patients. Six developed local recurrence and in five cases recurrences were
      multiple. Pulmonary metastasis occurred in one patient. All tumours were
      characterized by the presence of bland spindle cells, showing a mainly whorled or
      focally linear arrangement, set in alternating areas with a fibrous or myxoid
      stroma. Tumour cells were small, spindle to stellate, with poorly defined, palely
      eosinophilic cytoplasm and hyperchromatic ovoid nuclei. Most tumour cells showed
      strong staining with antibodies to vimentin, while occasional cells stained
      positively for actin, desmin and cytokeratin, in keeping with focal
      myofibroblastic differentiation. Ultrastructural examination in one case revealed
      features of fibroblasts. Careful consideration of the morphological and
      immunohistochemical features of these tumours permits a positive diagnosis of low
      grade fibromyxoid sarcoma and allows its distinction from a number of other
      benign and malignant soft tissue neoplasms.

PMID- 7797201
TI  - A study of the association of Epstein-Barr virus with Burkitt's lymphoma
      occurring in a Chinese population.
AB  - There is a strong association (approximately 95%) of endemic Burkitt's lymphoma
      with Epstein-Barr virus (EBV), whereas the association is weak for the sporadic
      form occurring in Western countries (approximately 15%). In the Middle East,
      North Africa and South America, 60-80% of Burkitt's lymphomas harbour EBV. These
      epidemiological differences suggest that either the endemicity of EBV or socio
      economic conditions, or both, may influence the pathogenetic role of EBV in
      Burkitt's lymphoma. Since only meagre data are available on Asians, this study
      was performed to address this issue by studying cases from Hong Kong, where EBV
      seroconversion occurs in the first few years of life but the socio-economic
      conditions approach those of Western countries. In situ hybridization for EBV
      encoded RNAs (EBERs) was performed on paraffin sections of 18 cases of Burkitt's
      lymphoma. Labelling of the neoplastic cells was detected in five cases (27.7%).
      In contrast, among 54 cases of B-cell lymphomas of various subtypes studied for
      comparison, signals for EBER were detected in only one case each of T-cell-rich
      large B-cell lymphoma, anaplastic large cell lymphoma and Reed-Sternberg-like
      cells occurring in B-cell chronic lymphocytic leukaemia/small lymphocytic
      lymphoma. The strong labelling with oligo-dT probe (which hybridized with the
      polyadenylated ends of mRNA) in all cases suggested that the negative results
      were genuine and not due to poor preservation of RNA in the tissues. Thus, among
      B-cell neoplasms occurring in Chinese, Burkitt's lymphoma shows a statistically
      stronger association (P < 0.01) with EBV than with other types of B-cell
      lymphoma.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7797202
TI  - Primary pulmonary tumours of nerve sheath origin.
AB  - Primary intrapulmonary tumours of nerve sheath origin are extremely rare. We
      describe the clinicopathological features of four such peripheral nerve sheath
      tumours, two benign and two malignant. Of the benign tumours, one was a typical
      schwannoma and the other an ancient or degenerated schwannoma. The typical
      schwannoma was endobronchial in origin, diagnosis being established by small
      bronchoscopic biopsy. The histological diagnosis of malignant peripheral nerve
      sheath tumour required immunohistochemical and/or ultrastructural evidence of
      nerve sheath differentiation. One malignant tumour arose in a patient with Von
      Recklinhausen's disease. Both malignant tumours behaved aggressively with the
      development of multiple intrapulmonary metastases, despite the markedly different
      histological appearance of the two tumours. Flow cytometric analysis of nuclear
      DNA content was performed on the four tumours, all of which showed a diploid DNA
      profile.

PMID- 7797203
TI  - Salivary duct carcinoma.
AB  - Twelve cases of salivary duct carcinoma were examined clinically, pathologically
      and by flow cytometry to quantify their histological features as well as attempt
      to identify factors predictive of patient outcome. All of the tumours arose in
      the parotid gland. Eight of the twelve patients were male. Four patients died of
      disease (median survival 12.5 months); three are alive with disease; and five are
      alive with no evidence of disease (mean follow-up of 50 months). Two tumours
      arose in a pre-existing pleomorphic adenoma. Positive lymph nodes were present in
      eight of ten patients sampled; patients with two or more positive lymph nodes
      tended to die of their disease or be alive with metastases. Comedo necrosis,
      perineural invasion and vascular invasion were common findings by light
      microscopy. Ten of the twelve tumours were aneuploid. Neither clinical stage,
      tumour size, aneuploidy nor histological features correlated with patient
      outcome. This study confirms the aggressive nature of salivary duct carcinoma.

PMID- 7797205
TI  - Melanotic oncocytic metaplasia of the nasopharynx.
AB  - Two cases of melanotic oncocytic metaplasia occurring in the nasopharynx are
      reported. One presented with serous otitis media and the other with tinnitus.
      Nasoscopic examination revealed a small brown nodule obstructing the Eustachian
      tube in both cases. While oncocytic metaplasia of the nasopharynx is not too
      uncommon, melanin pigmentation of the nasal or nasopharyngeal mucosa is very
      rare. To our knowledge, their combination has not been described.

PMID- 7797204
TI  - Localized amyloid deposition in cartilage is glycosaminoglycans-associated.
AB  - Localized amyloid deposition is known to occur commonly in the articular
      cartilage of elderly patients. Its pathogenesis is uncertain and it is not known
      if other cartilage-containing tissues also contain amyloid deposits. Systemic
      amyloid deposits are known to contain highly sulphated glycosaminoglycans, a
      major constituent of cartilage. As the composition of articular cartilage
      glycosaminoglycans is known to change with age, we sought to identify whether
      localized amyloid deposition in cartilage was glycosaminoglycan-related. We
      examined specimens of articular cartilage over a wide age range and also examined
      a variety of cartilaginous tumours and tumour-like lesions for the presence or
      absence of amyloid deposits. Using mucin histochemistry (alcian blue: MgCl2
      critical electrolyte concentration) and immunohistochemistry, we found that
      highly sulphated glycosaminoglycans (0.9 M and 1 M MgCl2), in particular keratan
      sulphate, localized to amyloid deposits in both articular cartilage and loose
      bodies derived from the articular surface. Other cartilaginous lesions (including
      loose bodies of primary synovial chondromatosis) were negative for amyloid and
      did not contain highly sulphated glycosaminoglycans. These findings suggest that
      changes in specific highly sulphated glycosaminoglycans may play a role in
      localized amyloid deposition in articular cartilage.

PMID- 7797206
TI  - Cutaneous verruciform xanthoma arising on a congenital lymphoedematous leg.

PMID- 7797207
TI  - Sclerosing osteosarcoma of the great toe phalanx in an 11-year-old girl.

PMID- 7797209
TI  - Recurrence of lupus nephritis in a renal allograft with histological
      transformation of the lesion.

PMID- 7797208
TI  - Focal myositis of the tongue--a pseudotumoral lesion.

PMID- 7797210
TI  - Infective endocarditis--recent trends.

PMID- 7797212
TI  - Ventricular tachycardia with left bundle branch block morphology in the absence
      of ischaemic heart disease--clinical and electrophysiological observations.
AB  - Clinical and electrophysiological features of 20 patients presenting with
      ventricular tachycardia (VT) of left bundle branch block (LBBB) morphology
      without evidence of coronary artery disease were studied. The mean age of the
      patients was 35.2 +/- 12 (range 15-57 years). The rate of VT varied between 140
      240/min (182 +/- 80). Six (30%) patients experienced giddiness or syncope during
      palpitations. Structural heart disease was found in 10 (50%) of these patients,
      which included arrhythmogenic right ventricular dysplasia in five, submitral left
      ventricular (LV) aneurysm in one, anterolateral LV dyskinesis in one, dilated
      cardiomyopathy in one, endomyocardial fibrosis in one and nonobstructive
      hypertrophic cardiomyopathy in one case. Ten patients were free of structural
      heart disease. Electrophysiological study was done in all patients. VT with same
      morphology as spontaneous VT was inducible in only 14 patients. Seventeen
      patients were treated medically with total or partial amelioration of symptoms.
      In three patients, two with arrhythmogenic right ventricular dysplasia and one
      with structurally normal heart, who were unresponsive to drug therapy, the VT
      focus could be mapped in right ventricular outflow tract and successful
      electrical ablation was done. Thus in patients who present with VT with LBBB
      morphology, the heart is often structurally normal but organic disease is not
      uncommon, and should be carefully searched.

PMID- 7797211
TI  - Idiopathic ventricular tachycardia--characterisation and radiofrequency ablation.
AB  - Forty patients (14 women and 26 men; mean age 40 +/- 13 years, range 7 to 60)
      diagnosed to have idiopathic ventricular tachycardia (right ventricular 28, left
      ventricular 12) underwent electrophysiologic study and radiofrequency catheter
      ablation. Echocardiography, signal averaging, magnetic resonance imaging and
      cardiac catheterisation with angiography were used as indicated to rule out
      identifiable underlying etiologies. Gross localisation of the area of origin of
      the ventricular tachycardia from the surface electrocardiogram could be made in
      all cases. Accurate localisation of the site of origin was done by activation
      mapping and pace mapping. Radiofrequency application was successful in achieving
      a cure in 34 (85%) patients, with a mean of 8.3 +/- 4.7 energy applications and a
      fluoroscopy time of 38 +/- 19 minutes. Unsuccessful cases were characterised by
      wide and slurred QRS complexes during ventricular tachycardia, possibly
      indicating a deeper intramyocardial or epicardial site of origin of the
      tachycardia. Radiofrequency ablation appears to be the treatment of choice for
      symptomatic idiopathic ventricular tachycardia, having a high success and safety
      rate.

PMID- 7797213
TI  - Our experience with Palmaz-Schatz coronary stent.
AB  - Between September 1993 and August 1994 we have implanted Palmaz-Schatz coronary
      stents in 44 patients. Twenty eight patients presented with stable angina and 16
      with unstable angina. Stenting was carried out for denovo, focal lesions in large
      coronary arteries (n = 27), significant dissection during PTCA with acute
      threatened closure (n = 9), suboptimal results (n = 5), restenosis after PTCA (n
      = 2) and saphenous vein graft stenosis (n = 1). Successful delivery of the stent
      was achieved in 43 cases. Percent diameter stenosis was reduced from 77 +/- 11%
      to 10 +/- 8% and minimal luminal diameter increased from 1.08 +/- 0.28 mm to 2.92
      +/- 0.39 mm. There was 1 death due to left main dissection secondary to guiding
      catheter trauma in a patient taken up for bail out stenting. Vascular/bleeding
      complications occurred in 3 patients (6.7%). There was no instance of acute or
      subacute stent thrombosis. Forty patients are symptom free. Eighteen patients
      underwent six month angiography. Restenosis (> 50% diameter reduction) was seen
      in 2 and a new lesion distal to stent occurred in 1 case. All have been
      successfully redilated. A high rate of successful delivery of the Palmaz-Schatz
      coronary stent can be achieved in a wide spectrum of patients with very few
      complications. Long term results are very gratifying and encouraging.

PMID- 7797214
TI  - Beneficial effects of long-term metoprolol therapy on cardiac haemodynamics in
      patients with mitral stenosis in sinus rhythm--a randomised clinical trial.
AB  - We conducted a placebo controlled randomised clinical trial to evaluate the
      effects of 6 months therapy with metoprolol on resting and exercise haemodynamics
      in 31 patients with isolated mitral stenosis in sinus rhythm. Twenty six of them
      (placebo n = 13, metoprolol n = 13) completed the study protocol. Their mean age
      was 23.1 +/- 7.9 years and the mean mitral valve area was 0.93 +/- 0.25 cm2. The
      dose of metoprolol ranged between 50-100 mg per day. The primary outcome
      variables for the study were the resting and exercise mean pulmonary capillary
      wedge pressure (PCWP) and cardiac index (CI) and the secondary outcome variables
      consisted of resting and exercise heart rate, mean pulmonary artery pressure
      (PAP), mean pulmonary vascular resistance (PVR) and clinical improvement on
      visual analog scale. These outcome variables were assessed blindly. The resting
      and exercise mean PCWP (mmHg) increased by 9.1 +/- 3.1 and 16.4 +/- 6.4 on
      placebo and 2.5 +/- 2.1 and -4.6 +/- 2.3 on metoprolol after 6 months therapy.
      These differences were statistically significant (p < 0.01). The resting and
      exercise CI (liters/min/m2) decreased by 0.2 +/- 0.1 and 0.1 +/- 0.1 on placebo
      and 0.3 +/- 0.5 and 0.3 +/- 1.0 on metoprolol. These haemodynamic effects were
      accompanied with much better symptomatic improvement in patients treated with
      metoprolol. The differences in change in mean PAP and PVR in two groups were
      statistically not significant. Our results suggest that the symptomatic patients
      with MS, waiting for definitive intervention for 6 months or less, would benefit
      if given beta blockers during this period.

PMID- 7797215
TI  - Comparative evaluation of left ventricular function in sick sinus syndrome on
      different long-term pacing modes.
AB  - Single-chamber ventricular pacing has been implicated in the development or
      progression of congestive heart failure in patients with sick sinus syndrome
      (SSS). To define the exact role of pacing modality in causation of congestive
      heart failure, quantitative two-dimensional echocardiographic examination was
      performed in 51 consecutive patients with SSS who received an initial pacemaker
      from January 1979 to September 1989 and were free of any structural heart disease
      at the time of implant. Atrial or dual chamber pacemakers were implanted in 21
      patients (Group I) and ventricular pacemakers in 30 (Group II). The two groups
      were matched for age, gender, paced rate, blood pressure and duration of pacing.
      After a mean follow-up of 64 +/- 34 months, congestive heart failure developed in
      one patient in group I and 3 in Group II. Patients in group II, had larger left
      atrium (41 +/- 5 vs 37 +/- 6 mm, p < 0.05) and left ventricular end-diastolic
      volume (64 +/- 18 vs 54 +/- 12 ml/m2, p < 0.01) but similar left ventricular end
      systolic volume (27 +/- 12 vs 24 +/- 9 ml/m2, p = NS), ejection fraction (59 +/-
      10 vs 57 +/- 8%, p = NS), left ventricular mass (84.8 +/- 31 vs 85.6 +/- 29.2
      gm/m2, p = NS), meridian end-systolic wall stress (48.3 +/- 22.1 vs 49.8 +/- 25
      Kdynes/cm2, p = NS) and wall stress/end-systolic volume ratio (1.27 +/- 0.94 vs
      1.42 +/- 0.59, p = NS). Pacing mode does not appear to influence left ventricular
      systolic function in patients with SSS.

PMID- 7797216
TI  - Effect of posture in immediate post-exercise period on ischaemic ST-changes
      during stress electrocardiographic testing.
AB  - In this study of stress testing, the posture in which patients were put had
      effect on heart rate, blood pressure, rate pressure product and ST-segment
      depression integral in the recovery phase. The systolic blood pressure in
      recovery phase of stress testing fell more rapidly towards normal pre-exercise
      value in sitting (Group I) than in lying down (Group II) posture (p < 0.05) from
      2nd to 5th minute. The changes in heart rate were less and slower in lying
      posture than with sitting up. The decrease in rate pressure product (RPP), a
      determinant of myocardial oxygen requirement was lower in lying down than in
      sitting up posture (p < 0.05) from 2nd to 5th minute of recovery. Consequently,
      ST-depression, a marker of ischaemia was more marked in lying down than sitting
      up. The ST-depression integral was 4.15 +/- 1.2 and 7.10 +/- 1.65 in 2nd minute
      in group I and group II respectively, and the difference was statistically
      significant in 2nd, 7th (p < 0.05) and 8th minute (p < 0.01) of recovery. These
      changes are important in interpretation of results of exercise testing.

PMID- 7797217
TI  - Evaluation of coronary artery disease by dipyridamole echocardiography test.
AB  - Role of oral dipyridamole echocardiography test (DET) was evaluated in 50
      patients with effort angina. All patients underwent coronary angiography, the day
      after oral DET. The echo studies were performed at rest and 65 +/- 15 minutes
      after 300 mg of oral dipyridamole. Segmental wall motion was analysed in a 16
      segment model and a wall motion score index (WMSI) was generated for the entire
      left ventricle both at rest and following the drug. WMSI was significantly higher
      after oral dipyridamole, (p < 0.001) compared to resting condition with increased
      sensitivity (86% vs 74%). When results of DET were compared with coronary
      angiography, the correlation of WMSI was statistically significant in three
      vessel disease (p < 0.001), two vessel disease (p < 0.001) as well as for left
      anterior descending lesions (p < 0.001). However, it was insignificant for single
      vessel disease, viz, right coronary artery and circumflex artery. Thus we
      conclude that oral DET is a safe, inexpensive, sensitive and non-exercise
      dependent method for demonstrating myocardial ischaemia with high diagnostic
      accuracy.

PMID- 7797218
TI  - Profile of coronary risk factors in patients with manifest ischaemia and normal
      coronary arteries.
AB  - Risk factor profile of 142 patients with normal epicardial coronary arteries (86
      males, 56 females, mean age 47 +/- 11 years) out of 1,508 consecutive patients
      undergoing coronary angiography was analysed. The mode of presentation in these
      patients was old or recent myocardial infarction (16.1%), unstable angina
      (12.0%), angina on effort (43.7%), atypical chest pain (8.5%), and anginal
      equivalent (19.7%). One or more stress test was positive in the majority (88%) of
      patients. Though the majority (39.5%) of patients had one risk factor, multiple
      (two or more) risk factors were not uncommon. Risk factor profile in patients
      with normal coronaries included hypertension (45.7%), dyslipidemia (33.8%),
      obesity (19.7%), positive family history of coronary artery disease (18.3%),
      cigarette smoking (16.1%), and minor risk factors (hyperuricemia, sedentary life
      style, Type A personality, oral contraceptive intake -15.4%). The mechanism of
      myocardial ischemia in patients with normal coronary arteries is not fully
      understood. We conclude that approximately one tenth of patients with clinically
      manifest coronary artery disease and one or more conventional risk factors do not
      have atherosclerotic changes in their epicardial coronary arteries as seen on
      coronary angiography.

PMID- 7797219
TI  - Epidemiology of coronary heart disease in a rural Punjab population--prevalence
      and correlation with various risk factors.
AB  - An epidemiological study to find out the prevalence of coronary heart disease
      (CHD) and the influence of risk factors on the prevalence of CHD in a total rural
      community of Punjab was conducted in Pohir, situated near Ludhiana. A total of
      1100 individuals (623 males and 477 females) out of a possible 1617 individuals
      (> 30 yrs) living in 3 villages were studied. In each case a detailed history,
      physical examination and a 12 lead electrocardiogram (ECG) were recorded. Samples
      for blood sugar and serum cholesterol were taken. By Epstein's criteria of ECG
      (using the Minnesota coding), the prevalence of CHD was 30.8/1000, being higher
      in women (37.7/1000) than in men (25.6/1000). By a clinical judgement method
      considering history, ECG and treadmill testing (TMT) collectively, prevalence was
      31.8/1000, being still higher in women (33.5/1000) than in men (30.5/1000). The
      prevalence of various risk factors like hypertension, smoking,
      hypercholesterolemia and diabetes was found to be 14.5%, 8.9%, 7.0% and 4.6%
      respectively. Of the various risk factors tested, hypertension,
      hypercholesterolemia and a positive family history showed an association with
      CHD. Only 38% of patients with CHD, 37% of the hypertensives and 52% of the
      diabetics were aware of its presence. The knowledge in the general population
      about risk factors causing CHD is poor.

PMID- 7797220
TI  - What is 'desirable' lipid profile.
AB  - The lipid profile of subjects with and without coronary heart disease (CHD) was
      studied in two epidemiological studies conducted in an urban and rural
      population. The prevalence of CHD was 96.7/1000 in the urban area and 27.1/1000
      in the rural area. The lipid levels of the rural population, with an entirely
      different life style, was significantly lower compared to the urban normal
      population. The data suggest that if the prevalence of CHD is to be reduced in
      the urban population, the desirable levels of lipids should be those obtained in
      the rural normal population rather than the urban, CHD free, population.

PMID- 7797221
TI  - Ultrastructural and histological study of endomyocardial biopsies from patients
      of dilated cardiomyopathy--a comparative evaluation and their clinical
      correlation.
AB  - Morphological studies of dilated cardiomyopathy reveal nonspecific light and
      electron microscopic features. This study was designed to perform a comprehensive
      qualitative and semi-quantitative evaluation of histological and ultrastructural
      parameters in endomyocardial biopsies in 20 cases of DCM. Semi-quantitation of
      parameters increases the accuracy and precision of evaluation by reducing
      interobserver variation in assessment. The semi-quantitative score ratios in our
      study were further correlated with the clinical and hemodynamic data to identify
      parameter(s) of prognostic significance. In the histological evaluation, myofibre
      hypertrophy appeared to be the most frequent (95%) and severely affected
      parameter followed by myocardial degeneration (70%). The ultrastructural features
      were more diffuse, impressive and severely altered. The most prominent features
      were mitochondrial degeneration and myofibrillar lysis seen in 100% of our cases.
      Severe mitochondrial degeneration appeared to be an indicator of poor prognosis
      in DCM as it was seen in patients with the lowest left ventricular ejection
      fraction obtained angiographically. Moreover, unlike the light microscopic
      evaluation, ultrastructural score ratios correlated significantly with the
      ejection fraction.

PMID- 7797222
TI  - Coronary artery reoperations using arterial conduits: immediate and early
      results.
AB  - This study deals with results of coronary artery reoperations in 21 males aged
      54.4 +/- 6.6 years. Native vessel coronary disease at first and second operation
      was nearly the same (2.7 +/- 0.6 vs 2.8 +/- 0.4 vessel, p = NS). Graft attrition
      and deterioration in left ventricular ejection fraction (55.9 +/- 9.2 initial vs
      36 +/- 15 at reoperation, p < 0.001) necessitated reoperation in majority.
      Recurrence of angina (71%) and left ventricular failure (23.8%) were the clinical
      indicators for reoperation. Procedure was successful in 20 (95%) and had to be
      abandoned in 1 due to severe pericardial and sternal adhesions. Arterial grafts
      were utilised in 90% (18 cases, Group A and B). Total arterial revascularisation
      (Group A) was done in 9 (45%) using Y graft 6, combination of both mammary
      arteries 2, and by both mammary and inferior epigastric artery in 1. Group B
      patients had arterial grafts (bilateral IMA 1, Y graft 1, bilateral IMA +
      gastroepipolic 1, RIMA 4, and LIMA 2) in addition to a venous graft. Two patients
      (group C, 10%) had only venous grafts. There was no in hospital mortality or
      morbidity and at 10 +/- 5.2 months follow up, all are asymptomatic with negative
      stress test at 3 months followup in 8 cases. We conclude that coronary artery
      reoperations using arterial conduits can be performed safely with excellent
      immediate and early results.

PMID- 7797223
TI  - Use of aspirin as the sole antiplatelet agent following prosthetic valve
      replacement in rheumatic heart disease.
AB  - Aspirin was administered as the sole antiplatelet agent in 147 patients following
      valve replacement, who were at low risk for thromboembolism. Of these, 67
      underwent mitral valve replacement (MVR), 61 aortic valve replacement (AVR) and
      19 combined aortic and mitral valve replacement (DVR). The mean follow up period
      was 6.63 years (range 1-14 years). The incidence of thromboembolic episodes (TEE)
      in patients following MVR, AVR, and DVR was 0.41, 0.80 and nil respectively. The
      TEE free survival at the first year follow-up was 98.4%, 99.3% and 100% in
      patients following MVR, AVR and DVR respectively. Fatal intracranial haemorrhage
      was not encountered. Valve thrombosis in this patient population was not seen. In
      conclusion, aspirin as the sole antiplatelet agent appears to be safe and
      effective following prosthetic valve replacement in selected patients. Further
      studies involving larger number of patients are necessary to confirm these
      results.

PMID- 7797225
TI  - Percutaneous closure of patent ductus arteriosus with coil.

PMID- 7797226
TI  - A rare combination of Marfan's syndrome, rheumatic heart disease and muscular
      dystrophy--a case report.

PMID- 7797227
TI  - Situs inversus with dextrocardia with corrected transposition of great vessels
      with rheumatic systemic atrio-ventricular valve regurgitation: a 63 year old
      adult survivor.

PMID- 7797224
TI  - Alteration in pulmonary mechanics after coronary artery bypass surgery:
      comparison using internal mammary artery and saphenous vein grafts.
AB  - Pulmonary function tests, arterial blood gas tensions and morbidity were compared
      in 50 patients undergoing coronary artery bypass graft surgery. Thirty patients
      had bilateral internal mammary grafts (Group 1), 5 patients had only saphenous
      vein grafts (Group 2) and 15 patients had a single arterial graft in addition to
      vein grafts (Group 3). Pleural effusion and wound infection were more common in
      patients with internal mammary artery grafts (p < 0.05). Patients in Group 2
      required prolonged ventilation but this could be related to their underlying left
      ventricular dysfunction. Patients in all the three groups developed a severe
      restrictive ventilatory defect in the postoperative period and the degree of
      impairment was maximum in Group 1 patients (p < 0.01). These patients also had
      evidence of small airway obstruction. Thus an overall decrease in pulmonary
      function occurs in the postoperative period by 30 to 40% (p < 0.001). The
      derangement is greater in patients with arterial grafts, as a result of impaired
      blood supply, increase in pleural drains and additional surgical trauma secondary
      to mobilization of internal mammary arteries leading to delayed recovery. The
      awareness of these findings can be of great value in postoperative management of
      these patients. In addition, these observations should also be kept in mind while
      planning the choice of grafts in a patient undergoing coronary artery bypass
      graft surgery.

PMID- 7797228
TI  - Omentopexy in limb revascularisation in Buerger's disease.

PMID- 7797229
TI  - "Over the wire Inoue technique".

PMID- 7797230
TI  - Ehrlich and Darwin: homochauvinism in immunology.

PMID- 7797232
TI  - Humoral immune responses to systemic Candida albicans infection in inbred mouse
      strains.
AB  - The protective role of humoral antibodies in the resolution of systemic
      candidiasis remains controversial. Investigation of the humoral immune responses
      in mouse strains of varying susceptibility to infection may demonstrate a link
      between mouse strain susceptibility, antibody production and specificity, and the
      ability to resolve an infection. The antibody response in five different strains
      of mice during primary immune response to systemic infection with Candida
      albicans was investigated. Immune sera were fractionated by protein A affinity
      chromatography to yield fractions containing IgG1, IgG2a and IgG2b
      immunoglobulins. BALB/c mice of low susceptibility to the infection and DBA/2J
      mice of high susceptibility produced increased levels of the IgG1 isotype and
      decreased levels of the IgG2a isotype. AKR, CBA/H and C57B1/6J mice of moderate
      susceptibility produced antibodies predominantly of the IgG2a isotype. The
      patterns of antigen recognition by antibodies in immune sera and in fractions
      obtained after protein A chromatography of immune sera were investigated by
      western blotting and immunostaining. Antibodies from AKR(H-2K) and CBA/H (H-2k)
      mice reacted strongly after immunoblotting with antigens of 87 and 96 kDa. In
      contrast, immune sera from both the highly susceptible DBA/2J (H-2d) mice and the
      resistant BALB/c (H-2d) mice reacted strongly with an antigen of 48 kDa. C57B1/6J
      (H-2b) mice produced variable antibody reactivity to antigens of 48, 65, 66 and
      79 kDa depending on the IgG subclass tested. The IgG subclass responses and the
      patterns of antigen recognition in these mice suggest that humoral responses to
      C. albicans may be restricted by H-2 haplotype.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7797231
TI  - Comparative analysis of the ability of leucocytes, endothelial cells and
      platelets to degrade the subendothelial basement membrane: evidence for cytokine
      dependence and detection of a novel sulfatase.
AB  - The subendothelial basement membrane (BM) is regarded as an important barrier to
      the entry of leucocytes into inflammatory sites. This study compares the ability
      of leucocytes, platelets and endothelial cells (EC) to degrade a [35SO4]-labelled
      subendothelial extracellular matrix (ECM) and assesses the effect of PMA and
      various pro-inflammatory cytokines on this degradative activity. The different
      products of degradation, identified by fast protein liquid chromatography (FPLC)
      gel filtration chromatography, were indicative of protease, endoglycosidase
      (heparanase) and exoglycosidase and/or sulfatase activity. In terms of ECM
      degradation, EC and platelets were the most active, with PMA stimulation further
      enhancing the degradative activity of these two cell types. Platelets exhibited
      predominantly heparanase activity whereas the EC degradation products suggested a
      range of enzymic activities, namely proteases, heparanases and sulfatases.
      Interestingly, EC in suspension expressed these three enzymic activities whereas
      confluent EC monolayers only exhibited sulfatase activity, suggesting that the
      former situation might represent an angiogenic response. In the case of
      leucocytes, neutrophils and lymphocytes degraded the ECM to a much greater extent
      than monocytes. Each cell type also differed in the predominant enzymic
      activities it expressed, for example, heparanase activity by lymphocytes,
      protease activity by neutrophils and sulfatase activity by monocytes.
      Furthermore, PMA stimulation was shown to have differential effects on these
      enzymic activities. Some pro-inflammatory cytokines were found to be cell-type
      specific in their effects on ECM degradation. Thus, IL-1 + TNF enhanced
      neutrophil and EC degradation of the ECM but inhibited lymphocyte ECM
      degradation. In contrast, the chemokine IL-8 enhanced ECM degradation by
      neutrophils, lymphocytes and EC. Of particular interest was the unique sulfatase
      activity expressed by EC and monocytes which was induced in EC by TNF + IL-1 and
      IL-8, whereas in monocytes the sulfatase activity was exclusively induced by the
      chemokine monocyte chemotactic and activating factor (MCAF). Collectively, the
      results of this study show that leucocytes differ markedly in the enzymes they
      express to degrade the BM during extravasation and that PMA and cytokines are
      cell-type specific in their induction of hydrolytic enzyme activity. These
      results also indicate that EC may play an important role, not only in the
      recruitment of leucocytes, but also via sulfatase activity in the preparation of
      vascular BM for leucocyte extravasion.

PMID- 7797233
TI  - Productive in vitro infection of human umbilical vein endothelial cells and three
      colon carcinoma cell lines with HIV-1.
AB  - The objective of this study was to assess the ability of HIV-1 to establish an in
      vitro infection of primary human umbilical vein endothelial cells (HUVEC). The
      HUVEC and colon carcinoma cell lines were inoculated with different isolates of
      HIV-1 (HIV-1SF2, HIV-1Mck and HIV-1LAI) and productive viral infection was
      assessed by both the detection of p24 core antigen in the culture supernatants
      and the presence of specific spliced HIV mRNA. The infection which was detected
      in the inoculated HUVEC and all the colon carcinoma cell lines could not be
      blocked using an antibody targeted against the CD4 receptor. Furthermore, the HIV
      inoculated HUVEC secreted elevated levels of IL-6 and this increase was found to
      be proportional to the size of the viral inoculum. No changes in the production
      of IL-1 beta, TNF-alpha, IFN-alpha and IFN-gamma were detected following HIV
      infection. The colon carcinoma cells, however, did not secrete increased levels
      of these cytokines following HIV-1 inoculation. These results confirm that non
      CD4 expressing cells, such as endothelial cells and certain colon epithelial
      cells, serve as targets and reservoirs for HIV. Moreover, the production of IL-6
      by HIV-infected endothelial cells may be a contributing factor to the aberrant
      immunoregulation associated with HIV infection in vivo.

PMID- 7797234
TI  - An analysis, using monoclonal antibodies, of the role of interferon-gamma in
      ovine immune responses.
AB  - A mAb (IFN-9) which neutralizes biologically active ovine and bovine IFN-gamma
      was used to deplete levels of the cytokine in vivo in sheep and examine the
      consequences for immune responses to adjuvanted antigen and skin reactivity to
      Bacillus-Calmette-Guerin (BCG). Groups of sheep were immunized with ovalbumin in
      the adjuvants, Quil A or dextran sulphate (MW 500,000; DXS), both of which elicit
      production of IFN-gamma. MAb anti-IFN-gamma or an isotype control mAb (anti
      carbonic anhydrase positive particles) were inoculated i.v. during primary and/or
      secondary responses. Reactions monitored in efferent prefemoral lymph indicated
      that anti-IFN-gamma effectively depleted levels of IFN-gamma in lymph but had no
      effects on the magnitude and kinetics of lymphocyte and lymphoblast traffic, or
      total or isotypic titres of specific Ig. When incubated in vitro with ovalbumin,
      antigen-reactive cells from anti-IFN-gamma treated sheep did not produce IFN
      gamma, suggesting an on-going modification to cytokine production. In contrast,
      skin reactions to purified-protein derivative in sheep immunized with BCG were
      reduced by < 40% by anti-IFN-gamma. The results indicate that IFN-gamma
      production may not be obligatory for delayed-type hypersensitivity reactions or
      for the adjuvant action of Quil A or DXS, and that specific mAb can alter the
      profile of cytokines produced by antigen-reactive cells in sheep.

PMID- 7797236
TI  - The trouble with transgenic mice.
AB  - Observations on many antigen-receptor transgenic models with anti-self
      specificities have been interpreted as proof for clonal deletion or for
      mechanisms involved in clonal deletion. At the same time, there is increasing
      evidence that many lymphocytes that recognize self exist, are activated and
      produce end products, even in individuals without clinical autoimmunity. Except
      perhaps for the amount of anti-self activity, there is little agreement on what
      distinguishes immune products normally recognizing self from those associated
      with clinical autoimmunity. To resolve this paradox, the tendency in immunology
      is to accept conclusions from transgenic models as normal, while judging those
      from the unmanipulated state as suspect. However, transgenics have a major
      weakness. Transgenes encoding antigen-receptors are derived from highly selected
      mature lymphocytes and are expressed in developing lymphocytes that normally do
      not display the antigen-receptors of mature lymphocytes. Such precocious
      expression of antigen-receptors could have profound abnormal effects on
      lymphocyte development. Other transgenic models suggest that processes in
      lymphocyte differentiation not involving antigen-receptor binding specificity
      exert powerful influences on lymphocyte development; therefore, mechanisms other
      than classical positive and negative selection are important.

PMID- 7797235
TI  - The effect of IL-4 on antigen expression: a comparison of fluorescence intensity
      and antigen density.
AB  - We have compared the membrane expression of MHC class II antigen and Ig on murine
      splenic B lymphocytes by two flow cytometric methods. The first method, commonly
      used, determined the mean immunofluorescence intensity; the second measured
      antigen density as a ratio of mean fluorescence intensity to cell volume. The
      data generated by the two methods allow for different interpretations of antigen
      density in comparison to antigen expression. By mean fluorescence intensity,
      activated B lymphocytes expressed more MHC class II antigen and membrane Ig than
      did resting B cells. However, resting B cells had the same density of MHC class
      II antigen and membrane Ig as activated B cells. Next we examined the effect of
      IL-4 on antigen expression by the two methods. We found that although IL-4
      increased the mean fluorescence intensity and density of MHC class II and
      membrane Ig on each B cell population, the density of expression of membrane Ig
      tended to be greater on the resting B cells than on the activated, while the
      density of MHC class II antigen was essentially the same on each of the IL-4
      treated B cell populations.

PMID- 7797237
TI  - Hypothesis: a memory lymphocyte-specific soma-to-germline genetic feedback loop.
AB  - Analysis of recently published DNA sequence data obtained for related germline Ig
      variable (IgV) genetic elements of several vertebrate species revealed the
      presence of a number of extremely non-random patterns of sequence variability
      among these genes. Strikingly, the patterns were also observed in two sets of
      chicken IgV pseudogenes. Since the observed patterns are clearly incompatible
      with existing theories of multigene family evolution, a new model that can
      account for all of the data is presented in this paper. The model is a
      modification and extension of an earlier proposed mechanism whereby somatically
      expressed genes can be returned to the germline by endogenous retroviruses that
      may act as soma-to-germline genetic vectors. The mechanism described proposes
      that the interactions that may result in the soma-to-germline transfer of
      somatically selected IgV genes occur in the epididymis of the male reproductive
      tract and are restricted to memory lymphocytes. This mechanism makes a number of
      predictions that are amenable to experimental testing. From the data presently
      available in the literature it is not possible to extend the mechanism to the
      female reproductive tract.

PMID- 7797238
TI  - Recombinant expression of vaccinia virus-encoded TAP1 and TAP2 promotes MHC class
      I-restricted antigen presentation in a Syrian hamster cell line.
AB  - Transporter associated with antigen presentation (TAP) molecules supply small
      peptides to the lumen of the endoplasmic reticulum for assembly with MHC class I
      glycoproteins. Here we report that a Syrian hamster cell line, BHK, which is
      commonly used in cell biological and virological investigations, is deficient in
      antigen presentation in a xenogeneic model. Thus when the mouse MHC class I
      restriction element, Kd, is expressed in BHK cells via a vaccinia virus (VV)
      recombinant, no significant recognition by VV-immune and Kd-restricted cytotoxic
      T cells is induced. This defect is apparently a consequence of a deficiency in
      TAP-dependent peptide transport and can be repaired when rat TAP1 and TAP2 are
      provided by recombinant VV expression.

PMID- 7797239
TI  - Recognition sites on human IgG for Fc gamma receptors: the role of glycosylation.
AB  - Human IgG subclass proteins exhibit more than 95% primary amino acid sequence
      homology in their Fc regions, but each has a unique profile for recognition by
      the 3 human Fc gamma receptors. The Fc gamma Rs are themselves highly homologous
      members of the immunoglobulin supergene family. Consistent with these data we
      have proposed that Fc gamma RI, Fc gamma RII and Fc gamma RIII recognise
      overlapping non-identical interaction sites in the lower hinge region of the CH2
      domain of the IgG molecule. Evidence in support was provided by protein
      engineering effecting single amino acid replacements in the proposed site.
      Alternatively, we have demonstrated that the primary amino acid sequence alone is
      not sufficient for IgG molecules to fold with the generation of Fc gamma R
      interaction sites and that glycosylation of Asn 297 of the CH2 domain is
      essential. We have further defined a 'core' oligosaccharide structure that
      provides for the generation of Fc gamma R interaction sites which suggests that
      the addition of outer-arm sugar residues does not affect this primary activity;
      although in vivo it could influence other essential biological activities. These
      findings have opened up a new approach to engineering antibody function--by
      protein engineering of amino acid residues that form contacts with the
      oligosaccharide moiety. In the present report we demonstrate that replacement of
      contact residues for galactose on the alpha(1-6) arm does not affect Fc gamma RI
      and Fc gamma RII recognition while replacement of Asp 265, a contact for a 'core'
      N-acetylglucosamine residue, results in a loss of Fc gamma RI and Fc gamma RII
      recognition.

PMID- 7797240
TI  - Regulation of tyrosine-containing activation motif-dependent cell signalling by
      Fc gamma RII.
AB  - Crosslinking of the B-cell receptor (BCR) for antigen to low-affinity receptors
      for IgG (Fc gamma RII) inhibits B-cell activation induced by BCR aggregation. The
      cell-triggering properties of the BCR depend on tyrosine-containing activation
      motifs (TAM), in the intracytoplasmic domain of its Ig alpha and Ig beta
      subunits. TAMs also account for the cell-triggering capabilities of the T-cell
      receptor (TCR) for antigen, in T lymphocytes, and of the high-affinity receptor
      for IgE (Fc epsilon RI), in mast cells. Using as a model, rat basophilic leukemia
      cells (RBL-2H3) stably transfected with cDNA encoding wild-type or mutated murine
      or human Fc gamma RIIB and chimeric molecules having the intracytoplasmic domain
      of the FcR gamma subunit or of TCR-CD3 zeta subunit, we found that the inhibitory
      properties of Fc gamma RII are neither restricted to B cells nor to BCR-dependent
      cell activation, but can be extended to other cells and, as a general rule, to
      TAM-dependent cell activation.

PMID- 7797242
TI  - Molecular dissection of Fc gamma receptor-mediated phagocytosis.
AB  - Using an experimental model in COS-1 cells, we have examined the structural
      requirements for phagocytosis of IgG-sensitized cells by Fc gamma receptors. We
      have established that isoforms of each of the 3 classes of the Fc gamma
      receptors, Fc gamma RI, Fc gamma RII and Fc gamma RIII, are able to transmit a
      phagocytic signal in the absence of the other receptor class. Fc gamma I and Rc
      gamma RIIIA require a gamma-subunit for this signaling event, but Fc gamma RIIA
      does not. Fc gamma RIIA and the gamma-subunit associated with Fc gamma RI and Fc
      gamma RIIIA contain 2 copies of a conserved tyrosine-containing cytoplasmic
      sequence, YXXL. This sequence is important for phagocytosis and is phosphorylated
      on tyrosine after receptor ligation. The Fc gamma receptors Fc gamma RIIB1 and Fc
      gamma RIIB2 which contain only 1 copy of the YXXL cytoplasmic sequence do not
      include the phagocytosis of IgG-coated cells. Thus, the Fc gamma receptor
      isoforms differ in their ability to transmit a phagocytic signal.
      Structure/function studies also indicate that the Fc gamma receptors which induce
      phagocytosis differ in their requirements for phagocytic signaling.

PMID- 7797241
TI  - Interaction of signaling molecules with human Fc gamma RIIb1 and the role of
      various Fc gamma RIIb isoforms in B-cell regulation.
AB  - The low-affinity type-IIb IgG Fc-binding receptors (Fc gamma RIIb) are expressed
      on B cells. When cross-linked with mIgM Fc gamma RIIb are known to down-regulate
      B-cell activation by interrupting signal transduction upstream from G-protein
      activated events. We have studied Fc gamma RII isoforms expressed on resting and
      activated B cells and the interaction of Fc gamma RIIb1 with molecules
      transducing the antigen receptor-mediated signals. Expression of Fc gamma RII
      isoforms was studied by reverse transcription and polymerase chain reaction.
      Resting B cells express both Fc gamma RIIb2 and Fc gamma RIIb1 isoforms.
      Activation with anti-IgM or IL-4 induces the splicing of Fc gamma RIIb1 mRNA,
      while the alternative splicing of Fc gamma RIIb2 mRNA is down-regulated,
      resulting in the surface expression of Fc gamma RIIb1. Functional differences
      were found between the two isoforms in inhibiting B-cell activation, suggesting
      that Fc gamma RIIb2 might influence the threshold of signals necessary for
      activation of resting B cells, while Fc gamma RIIb1 may regulate in later phases
      of antibody response. To explore the mechanism by which Fc gamma RII may uncouple
      antigen receptor-mediated signal transduction, we have investigated the
      association of signaling molecules with Fc gamma RII. Beside the protein tyrosine
      kinase (PTK) fyn, protein kinase C (PKC) was found to be co-isolated with Fc
      gamma RIIb1, suggesting a tight connection between these kinases and Fc gamma
      RII. We suggest that PKC might be responsible for the activation-induced
      phosphorylation of Fc gamma RII on serine residues.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7797243
TI  - Functional consequences of the interaction between T-cell antigen receptors and
      Fc gamma Rs on T cells.
AB  - Two series of experiments are presented indicating that Fc gamma II receptors can
      interfere with the antigen receptor-induced signaling on T cells. It has been
      previously described that a 13 amino acid motif on the cytoplasmic portion of Fc
      gamma II beta 1 can abrogate the antigen receptor-initiated signals mediated
      through consensus motifs present on the cytoplasmic portion of Ig alpha and Ig
      beta chains. Similar activating motifs are crucial to T-cell receptor (TCR)
      signaling. A splenic gamma/delta T-cell hybridoma that expressed the Fc gamma RII
      beta 1 receptor helped to establish that this receptor can also interfere with
      TCR-induced activation. The cytoplasmic portion of human Fc gamma RIIa has an
      activation motif similar to the activation motifs present on the TCR. Using a
      transgenic mouse in which the T cells express the human Fc gamma RIIa transgene,
      we demonstrated that despite the common activation motif, the TCR and human Fc
      gamma RIIa-induced signals are different. Additionally, the human Fc gamma RIIa
      expressing T cells exhibit an enhanced TCR response both in vitro and in vivo.

PMID- 7797244
TI  - Prognostic value of cytokine and soluble Fc gamma receptor assays in oncology.
AB  - The clinical course of a cancer is influenced by the interaction of tumour cells
      with the patient's immune system. It is thus conceivable that immunological
      parameters may be used as markers of prognostic or predictive value. We report
      here that increased serum levels of IL-6 is a signal of poor prognosis and
      predicts unresponsiveness to immunotherapy in patients with metastatic melanoma.
      In cervical cancer, IL-6 produced by infiltrating macrophages is a marker of
      invasive cancer. In patients with multiple myeloma, the plasmatic levels of
      soluble Fc gamma receptors are markers of the disease, sCD16 being drastically
      decreased and sCD32 being slightly increased.

PMID- 7797245
TI  - Developmental regulation of Fc epsilon RII/CD23 expression in B-lineage cells:
      evidence for transcriptional and post-transcriptional levels of control.
AB  - The present studies show that the expression of cell surface Fc epsilon RII/CD23,
      detected with the monoclonal anti-Fc epsilon RII/CD23 antibody B3B4 or by the
      binding of IgE, is not restricted to the stage of resting mature virgin B
      lymphocytes. Murine CD23 was detected as a cell surface protein on two sIgG+ B
      cell lines. Moreover, we detected full-length transcripts for Fc epsilon RII/CD23
      in several members of a panel murine B lymphoid lineage cell lines representative
      of all stages of murine B lymphocyte development. Our findings suggest that
      regulation of CD23 translation may differ between B-cell lines at various stages
      of differentiation. The detection of mRNA transcripts for Fc epsilon RII/CD23 was
      not restricted to transformed cell lines. Fc epsilon RII/CD23 transcripts were
      amplified by RT-PCR from peritoneal and splenic B lymphocyte subpopulations that
      were sorted by flow cytometry into populations that did not express surface Fc
      epsilon RII/CD23. Our findings suggest that Fc epsilon RII/CD23 transcription and
      translation are not necessarily restricted to the narrow developmental window of
      murine B lymphocyte differentiation as previously thought. Our findings imply
      that Fc epsilon RII/CD23 may be expressed at the protein level at various stages
      of murine B lymphocyte differentiation. Investigations into the expression
      patterns and potential mechanisms of regulation of Fc epsilon RII/CD23 could
      provide insight into the basis for the wide range of immunological functions that
      have been proposed for Fc epsilon RII/CD23.

PMID- 7797246
TI  - Functional significance of CD23- on CD23-transfected Th2 clone.
AB  - CD23, a low-affinity IgE Fc receptor, is not displayed on most resting T cells
      but its expression has been shown to be transiently induced in vivo and in vitro
      on some CD4+ T cells [1-4] and in vivo on CD8+ T cells by IgE-secreting hybridoma
      tumors [5]. To investigate the functional role of CD23 on T cells, we inserted a
      CD23 construct into an expression vector driven by a CD2 promoter and transfected
      it into a murine Th2 clone D10.G4.1 (D10). We stimulated the transfected D10
      cells (D10.3M.24) with anti-TCR antibody in the presence or absence of IgE, and
      measured IL-4, IL-5 and IL-6 production in the culture supernatants. Activation
      of D10.3M.24 cells by anti-TCR antibody induced greater levels of IL-4, IL-5 and
      IL-6 production, when the TCR and CD23 were co-crosslinked by TNP anti-TCR and
      IgE anti-TNP antibodies. IgG anti-TNP antibody did not enhance lymphokine
      production by D10.3M.24 cells. The enhanced lymphokine production by IgE was
      blocked by monoclonal anti-CD23 antibody. IgE anti-TNP antibody did not enhance
      lymphokine production by the wild-type D10 cells induced by TNP anti-TCR
      antibody. These studies show that when co-crosslinked with the TCR, CD23 can
      modulate the lymphokine production in activated Th2 cells. Since CD23 binds to
      IgE and also binds to CD21 [6], a complement receptor commonly expressed on B
      cells, T-cell CD23 could play an immunoregulatory role during cognate T-B cell
      interaction and during IgE antibody responses.

PMID- 7797248
TI  - Ligands and biological activities of soluble Fc gamma receptors.
AB  - Soluble forms of low-affinity Fc gamma receptors (sFc gamma R) circulate in
      biologic fluids. Their plasmatic levels vary in immunological disorders or
      related diseases. They are produced by enzymatic cleavage of the membrane
      receptors or by alternative splicing. They bind IgG with the same isotype
      specificity as their cell surface counterparts and thus modulate Fc-dependent
      immune functions. Recent data suggest that they also bind non-Ig ligands present
      on leukocytes. Functional implications of these findings are discussed.

PMID- 7797247
TI  - Identification of novel CD23 transcripts on human T and B lymphocytes and
      eosinophil cell line.
AB  - The main aim of the present studies was to investigate the structure of the human
      low-affinity IgE Fc receptor (CD23) present on T and B lymphoid cells and
      eosinophil cell line. A novel finding in these studies has been the detection and
      sequence analysis of CD23 transcripts in human T lymphocytes. These studies have
      established that some of the human T-cell populations analyzed express CD23 mRNA
      and that its structure is quite similar to that previously described for human B
      lymphocytes. A second major finding in these studies is that some human T- and B
      cell lines and eosinophil cell line contain multiple forms of CD23 transcripts.
      These appear to be generated via alternative splicing, resulting in transcripts
      that may encode a truncated, possibly secretory form of CD23. These findings in
      human T and B lymphocytes and eosinophils provide new information about the
      structure of lymphocyte CD23 and suggest that alternative processing of
      transcripts generates CD23 mRNA that encodes CD23 isoforms. These studies are the
      first experimental evidence showing that CD23 isoforms may occur in the human and
      are the first direct evidence for production of CD23 by human T lymphocytes. In
      addition, these studies provide the first experimental evidence that T and B
      lymphocytes express CD23 transcripts lacking exon 3-encoded sequences, raising
      the possibility that a secretory form of CD23 may be synthesized by human T and B
      lymphocytes, and eosinophils.

PMID- 7797249
TI  - Expression of the complement C5a anaphylatoxin receptor (C5aR) on non-myeloid
      cells.
AB  - The expression of the complement C5a anaphylatoxin receptor (C5aR) has
      traditionally been thought to be limited to myeloid blood cells, including
      neutrophils, monocytes, macrophages, and eosinophils. Immunohistochemistry and
      ligand-binding studies reported here demonstrate, however, that C5aR is expressed
      by parenchymal cells of several solid organs, including human liver hepatocytes,
      lung bronchial and alveolar epithelial cells, and lung vascular smooth muscle and
      endothelial cells. In addition to C5aR expression in liver and lung, C5aR
      specific message is found in other tissues, including the spleen, heart, kidney,
      and intestine. Collectively, these data indicate that the C5aR is expressed in
      several different types of cells in liver and lung and in yet undetermined cell
      types in spleen, heart, intestine, and kidney. Moreover, these data suggest that
      the C5aR mediates previously unrecognized functions by binding to tissue cells
      that express the C5aR.

PMID- 7797250
TI  - Induction of ADF/TRX by oxidative stress in keratinocytes and lymphoid cells.
AB  - Adult T-cell leukemia-derived factor (ADF)/human thioredoxin (TRX) has thiol
      dependent reducing activities and is known to have regulatory roles on the DNA
      protein interaction and cell activation. Inducive effect of ultraviolet (UV) has
      been indicated because of the enhanced expression of ADF/TRX in epidermal cells
      of sun-exposed skin, as determined by immunohistochemical staining with antibody
      against recombinant ADF (rADF). We studied the effect of UVB irradiation and
      other oxidative stress on the expression of ADF/TRX in epithelial cells as well
      as lymphoid cells, as HTLV-1 and Epstein-Barr virus-transformed lymphoid cells
      constitutively produce ADF/TRX. Using immunohistochemical staining anti-ADF
      antibody, the enhancement of ADF/TRX expression on primary culture of human
      keratinocytes was demonstrated, 12 h after 20 mJ/cm2 UVB irradiation. Western
      blot analysis of the ADF/TRX protein in the cell lysates also showed the
      significant induction. In in situ hybridization, induction of ADF/TRX mRNA was
      detected after 4 h of UV exposure. ADF/TRX was also induced in a HTLV-1 (+) T
      cell line, MT-1, by UVB or H2O2 dose dependently. The augmentation of ADF/TRX was
      observed 6 h after treatment of H2O2.

PMID- 7797251
TI  - Selective steady-state and time-resolved fluorescence spectroscopy of an HLA-A2
      peptide complex.
AB  - The human class I major histocompatibility complex (MHC) encoded molecule HLA-A2
      loaded with the high-affinity peptide GILGRVFTL (p790), was studied by means of
      steady-state and picosecond fluorescence intensity and fluorescence anisotropy
      methods. The large number of tryptophan residues (W) (10 W/heavy chain, 2 W/beta
      2m) as well as their fluorescence sensitivity to the microenvironment, determine
      the emission of the studied complex. The HLA-A2/peptide complex exhibits a
      considerable static inhomogeneous broadening (IB) of the W electronic spectra,
      which results in a dependence of the steady-state fluorescence spectrum on the
      excitation wavelength. The high concentration of W's chromophores and the
      spectral IB cause a directed non-radiative migration of electronic excitation
      energy by Foerster's mechanism from 'blue' W residues to 'red' ones. This
      phenomenon manifests itself in a nanosecond fluorescence spectral shift and an
      accelerated fluorescence depolarization at the red edge of the emission spectrum.
      Selective excitation at the red edge of the W absorption band (310 nm) provided a
      space selective reduction in the number of excited chromophores and enabled
      resolution of the emission of the 'red' subset of the protein's tryptophans. This
      avoided the non-radiative homo-energy transfer and enabled to study the
      fluorescence anisotropy decay kinetics of these residues without a distortion by
      the energy transfer (ET) process. Under these experimental conditions the
      fluorescence anisotropy decays practically from the limiting anisotropy value
      (0.3) for W in a bi-exponential process. The longer decay constant has a value
      larger than that expected for a global rotation of the HLA-A2/peptide complex
      suggesting that the protein molecules exist in an oligomeric form.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7797252
TI  - Distinct association of transferrin receptor with HLA class I molecules on HUT
      102B and JY cells.
AB  - The topological relationship of transferrin receptor (TfR) has been studied
      relative to the heavy and light chains of the HLA class I molecules, class II
      molecules, interleukin-2 receptor alpha-chain and ICAM-1 molecule in the plasma
      membrane of HUT-102B2 T and JY B lymphoblastoid cell lines using the flow
      cytometric fluorescence energy transfer technique (FCET). The effect of different
      growing conditions (logarithmic and plateau phases) on the relative surface
      density of the receptors and the lateral organization of the TfR was also
      studied. The TfR showed a high degree of self-association on the surface of both
      cell lines regardless of the growing phase. TfR was in close vicinity to HLA
      class I heavy and light chains on HUT-102B cells in both plateau and logarithmic
      phases, while it was not associated with HLA class I on the surface of JY cells.
      HLA class II molecules form a cluster with TfR on HUT-102B cells, while only a
      modest association was found on JY cells, and only in the logarithmic phase. The
      possible explanation of this distinct association and a two dimensional model of
      the antigen and receptor distributions are presented in this paper.

PMID- 7797253
TI  - Microenvironmental factors regulate Ly-6 A/E expression on PyV-transformed BALB/c
      3T3 cells.
AB  - In previous studies non-lymphoid murine tumor cells were sorted by flow
      cytometry, into 2 subpopulations. The one expressed high levels of the T-cell
      activation protein Ly-6 A/E and the other low levels of this protein. High Ly-6
      A/E expression was associated with very high tumorigenicity and metastatic
      phenotypes. Cells expressing low levels of this protein expressed a significantly
      reduced malignancy phenotype as compared to unsorted tumor populations. In view
      of its direct (or indirect) involvement in tumor progression we studied, in the
      present work, the regulation by microenvironmental factors of Ly-6 A/E expression
      on A3C polyoma-virus transformed cells. Ligation of membrane Ly-6 A/E by the
      corresponding monoclonal antibodies resulted in up-regulated expression of this
      protein. Similar results were obtained by exposing A3C cells to interferon-alpha.
      In contrast, exposing tumor cells to tumor necrosis factor-alpha or to the
      extracellular matrix protein laminin resulted in a down-regulation of Ly-6 A/E
      expression on these cells. These results provide an additional insight into the
      role microenvironmental factors might play in tumor progression.

PMID- 7797254
TI  - Interleukin-2 induces an early step in the activation of interferon-gamma gene
      expression.
AB  - Establishment of protective immunity depends critically on IFN-gamma. We show
      that in human peripheral blood mononuclear cells, low doses of IL-2 greatly
      potentiate the response of the IFN-gamma gene to mitogen, by over 100-fold. By
      itself, IL-2 is unable to induce IFN-gamma mRNA to a significant extent. Yet,
      exposure to IL-2 leads to cellular commitment within a few hours, expressed by
      greatly enhanced accumulation of IFN-gamma mRNA upon subsequent exposure to
      phytohemagglutinin. Changes induced by IL-2 do not relieve the requirement for de
      novo protein synthesis during the early phases of induction of IFN-gamma gene
      expression. IL-2 may induce a component essential for induction of IFN-gamma mRNA
      that is utilized during subsequent exposure to a mitogenic signal. Our results
      demonstrate synergy between IL-2 and mitogen in IFN-gamma gene induction.

PMID- 7797257
TI  - Proceedings of the 8th Symposium on Signals and Signal Processing in the Immune
      System. Kecskemet, Hungary, 18-22 September 1994.

PMID- 7797256
TI  - Cytokine receptor architecture, structure and genetic assembly.
AB  - In this review major structural and molecular characteristics of interleukin-6
      type cytokine receptors consisting of ligand-specific (e.g., IL-6 receptor) and
      public (gp130) elements are outlined. The peculiar shedding feature of the ligand
      binding receptor subunit provides a possibility to form a receptor-ligand complex
      in the soluble phase, followed by an autocrine or paracrine re-attaching to the
      membrane bound gp130. This situation provides a dynamic 4-chain model for IL-6
      type receptors, depending on a critical balance between membrane bound and
      soluble cytokine receptors. The generation and transduction of intracellular
      signal for IL-6-type cytokine receptors based primarily on generation of phospho
      tyrosine proteins. In this set of events kinases of the JAK family are basically
      involved. Although not all primary substrates are uncovered, gp130 and stat
      proteins are phosphorylated. The variability of the JAK/Stat system and its still
      not clear relation to the specificity of cytokine actions are discussed.

PMID- 7797255
TI  - Cholinergic signals to and from the immune system.
AB  - This article reviews recent data from our laboratory towards the impact of the
      autonomous nervous system on mutual interactions between the immune system and
      the central nervous system. Using a pharmacological approach in rats it is shown
      that shifts in the adrenergic/cholinergic balance in vivo affect in vitro
      functions of the non-specific and specific immune system, whereby adrenergic and
      cholinergic stimulation in general have opposite effects. A high degree of
      integration appears to exist between cells of the immune system with the
      cholinergic system. Lymphocytes were found to react to acetylcholine, but are
      also able to produce and to degradate this neurotransmitter. In addition, changes
      in the cholinergic tonus were found to affect immune signaling to the brain and
      to protect thymocytes from apoptosis, possibly via a direct effect on thymic
      epithelial cells.

PMID- 7797258
TI  - Differential binding activity of ARH1/TAM motifs.
AB  - T- and B-cell antigen receptors, and certain receptors for IgG and IgE constant
      regions, transduce signals via a conserved amino acid sequence motif, termed ARH1
      or TAM. Receptor ligation leads to phosphorylation of 2 tyrosines found within
      the motif and this phosphorylation appears critical for signal transduction.
      Although this 26-residue motif exhibits some functional redundancy, its
      variability in sequence and occurrence in multiple forms in individual receptor
      complexes, e.g., as many as 8 copies in TCR, suggests that individual ARH1 motifs
      may exhibit partially unique function. To begin to address this possibility, we
      compared the binding activity of doubly phosphorylated and non-phosphorylated Ig
      alpha, Ig beta, TcR zeta c and CD3 epsilon ARH1 motifs. Results demonstrate a
      clear difference in binding activity determined by both motif phosphorylation and
      primary structure. Among non-phosphorylated motifs, Ig alpha exhibits the most
      readily detectable binding activity; binding src-family kinases [1], CD22, MAPK,
      PI3-k, and Shc, but not CD19. Among doubly phosphorylated motifs, Ig alpha, Ig
      beta, TCR zeta c and CD3 epsilon all exhibit binding activity but have distinct
      effector preferences. For example, while Ig alpha prefers src-family kinases over
      the Syk kinase and binds Shc avidly, CD3 epsilon prefers Syk over src-kinases and
      does not bind Shc. TCR zeta c seems to bind Syk, src-kinases and Shc. These data
      are consistent with the possibility that ARH1 motifs may be coupled to distinct
      signal propagation mechanisms.

PMID- 7797259
TI  - Function of B-cell antigen receptor of different classes.
AB  - Most mature B lymphocytes co-express two classes of antigen receptor, IgM and
      IgD. The differences in the signal transduction from the 2 receptors are still a
      matter of controversy. We have analysed B-cell lines expressing IgM or IgD
      antigen receptors with the same antigen specificity. Cross-linking of these
      receptors with either antigen or class-specific antibodies results in the
      activation of protein tyrosine kinases and the phosphorylation of the same
      substrate proteins. The kinetics and intensity of phosphorylation, however, were
      quite different between the 2 receptors when they were cross-linked by antigen.
      In membrane IgM-expressing cells, the substrate phosphorylation reached a maximum
      already after 1 min and diminished after 60 min whereas in the membrane IgD
      expressing cells, the substrate phosphorylation increases further over time,
      reached its maximum at 60 min and persisted longer than 240 min after exposure to
      antigen. Recently prolonged signaling has been found to be responsible for
      signaling differences between tyrosine kinase receptors using otherwise similar
      signaling routes. Thus, the duration of a signal may be an important biological
      feature of signal transducing cascades.

PMID- 7797260
TI  - A signal strength hypothesis of thymic selection: preliminary considerations.
AB  - During their differentiation, thymocytes are subjected to two rounds of
      selection. First, CD4-8- double-negative (DN) thymocytes with a functional TCR
      beta chain express a alpha-beta+ CD3 complex on their surface and, as a
      consequence, are selected to mature to the CD4+8+ double-positive (DP) stage.
      This round ends after the initial proliferation of young DP thymocytes and is
      termed beta-chain selection. Second, DP thymocytes are selected on the basis of
      their alpha+beta+ CD3 complex. This is termed repertoire selection and the cells
      are given three choices: death by neglect selection, death by positive selection,
      or deletion by negative selection. Using anti-CD3 epsilon mAb as invariant
      ligand, signals for beta-chain selection of DN cells including proliferation of
      DP cells do not require a Ca2+ response, are independent of CD3 zeta, and are
      only slightly impaired in the absence of p56lck (lck). Signals that induce
      positive selection of DP thymocytes require a partial Ca2+ response and CD3 zeta
      but are independent of lck. Deletion of DP thymocytes requires a full-blown Ca2+
      response and both, CD3 zeta and lck. Thymic selection thus appears to be governed
      by a gradient of signal intensities.

PMID- 7797261
TI  - Ion-channel activities regulate transmembrane signaling in thymocyte apoptosis
      and T-cell activation.
AB  - Several examples have shown that plasma membrane ion channels (e.g., Ca2+ and K+
      channels) make an important contribution to lymphocyte activation or thymocyte
      apoptosis. Here we report on the importance of these ion channels in the
      sensitivity or resistance of lymphoid cells to extracellular ATP-induced
      apoptosis. Thymocytes of Balb/c mice responded to extracellular ATP (ATPex)
      sensitively, with an immediate increase in the intracellular calcium level and
      later with an increased membrane permeability to low MW markers. Mature
      (medullary) thymocytes showed a higher sensitivity than did cortical thymocytes.
      Three human lymphoma cell lines, including SUPT13, a cell line reported to be
      sensitive to TcR/CD3 activation-induced apoptosis, showed a high resistance to
      ATPex action. These observations suggest that maturation/differentiation state
      dependent activity or disappearance of early ATP-receptor operated signaling
      systems (including ion channels) are critical for the cells in developing towards
      apoptosis. Using the patch-clamp technique we demonstrated that bretylium
      tosylate (a particular K(+)-channel blocker) known as inhibitor of T-lymphocyte
      proliferation also influences the single-channel properties of voltage-gated K+
      channels through depressing whole-cell K+ currents. This finding is yet another
      example underlying the importance of K+ channel activity in T-lymphocyte
      proliferation.

PMID- 7797263
TI  - Sequence analysis of the human alpha beta T-cell receptor CDR3 region.
AB  - Although the three-dimensional structure of the T-cell receptor (TCR) has not yet
      been determined, several groups have proposed that the outline structure of the
      TCR will closely resemble that of immunoglobulin (Ig). Hypervariable regions can
      be identified within the TCR variable (V) domains, and by analogy to similar
      regions in the Ig molecule which together form the antigen combining site these
      have been termed the complementarity determining regions (CDR) 1, 2, and 3. By
      far the greatest extent of variability occurs at CDR3 and this has led to the
      proposal that CDR3 is involved in interaction with the peptide bound within the
      cleft of a major histocompatibility complex (MHC) molecule. We have cloned and
      sequenced the CDR3 region of several hundred human TCRA and TCRB transcripts from
      different T-cell populations and studied the amino acid usage in this region.
      Results show that the average length of the CDR3 region is 10 amino acids with
      less variation in length than is seen for the Ig heavy chain. There is no
      difference in CDR3 length between fetal and adult T cells or between CD4 and CD8
      populations. The pattern of amino acid usage in the CDR3 region is dissimilar
      between TCRA and TCRB transcripts. In particular there is a predominance of
      charged and polar residues in the region of the TCRA transcript thought to
      interact with peptide. These data provide information on the general pattern of
      CDR3 length and composition for both TCRA and TCRB.

PMID- 7797262
TI  - Cloning and sequencing of expressed DRB genes of the red deer (Cervus elaphus)
      Mhc.
AB  - The expressed major histocompatibility complex (Mhc) class II DRB genes of 50
      unrelated deer were examined by reverse transcription polymerase chain reaction,
      cloning, and sequencing of DRB exon 2. Deer, like other mammals, have at least
      one highly polymorphic Mhc class II DRB gene. Thirty-four different sequences
      were identified. Most of the variation in amino acid composition occurred at
      positions that have been shown to form the peptide binding site (PBS). Eighteen
      deer-specific substitutions were found, 11 of these occurred in the PBS.
      Significantly higher rates of replacement substitutions than silent substitutions
      were found in the deer sequences, indicating strong positive selection pressure
      for diversity in DRB sequences. Between one and four DRB sequences were found per
      deer. Inheritance of these sequences in pedigrees showed Mendelian segregation
      with up to two expressed DRB genes per haplotype. Sheep are the only other
      ruminant in which the presence of more than one expressed DRB gene has been
      demonstrated. Phylogenetic trees were constructed in an attempt to assign the
      deer DRB sequences to specific loci, but no clear segregation of the DRB
      sequences for different loci was found. It would seem likely that sequence
      exchange between the loci has occurred. As has been shown in other species, the
      alpha-helix and beta-sheet regions of exon 2 appeared to have different
      evolutionary histories.

PMID- 7797265
TI  - Characterization and mapping of the gene encoding mouse proteasome subunit DELTA
      (Lmp19).
AB  - The proteasome subunit DELTA is unusually closely related to the major
      histocompatibility complex (MHC)-linked proteasome subunit, LMP2. The sequence of
      a mouse cDNA for DELTA confirms that this 22,100 M(r) proteasome subunit is
      highly conserved across species. Sequence analysis of the mouse gene encoding
      DELTA, designated Lmp19, indicates that it consists of six exons and five
      introns, similar to the Lmp2 gene. The 5' upstream region lacks a TATA regulatory
      sequence, which is also absent from proteasome genes isolated from Drosophila.
      BXD recombinant inbred (RI) mice were used to map the potential chromosomal
      location of Lmp19, and revealed that the DELTA subunit has related sequences
      present on two different mouse chromosomes, chromosomes 1 and 11. Typing of 89
      progeny from a C57BL/6J X Mus spretus DNA backcross panel (BSS) confirmed the
      chromosome 1 assignment. Southern hybridization with a polymerase chain reaction
      generated Lmp19 intron 2-specific probe indicates that the Lmp19 genomic clone
      corresponds to the sequence on chromosome 11, and further suggests that the
      chromosome 1 copy represents a processed pseudogene (Lmp19-ps1).

PMID- 7797266
TI  - Polymorphism of the MHC class II Eb gene determines the protection against
      collagen-induced arthritis.
AB  - Collagen-induced arthritis (CIA) is an animal model of auto immune polyarthritis,
      sharing similarities with rheumatoid arthritis (RA). Paradoxally, susceptibility
      to mouse CIA is controlled by the H2A loci (DQ homologous) while RA is linked to
      HLA.DR genes (H2E homologous). We recently showed that the E beta d molecule
      prevents CIA development in susceptible H2q mice. We addressed the question of
      whether H2Eb polymorphism will influence CIA incidence as HLA.DRB1 polymorphism
      does in RA. In F1 mice, only H2Ebd and H2Ebs molecules showed protection. Using
      recombinant B10.RDD (Ebd/b) mice, we found that CIA protection was mediated by
      the first domain of the E beta d molecule. Using peptides covering the third
      hypervariable region of the E beta chain, we found a perfect correlation between
      presentation of E beta peptides by the H2Aq molecule and protection on CIA.
      Therefore, the mechanism by which H2Eb protects against CIA seems to rely on the
      affinity of E beta peptides for the H2Aq molecule.

PMID- 7797264
TI  - HLA-B alleles of the Cayapa of Ecuador: new B39 and B15 alleles.
AB  - Recent data suggest that HLA-B locus alleles can evolve quickly in native South
      American populations. To investigate further this phenomenon of new HLA-B
      variants among Amerindians, we studied samples from another South American tribe,
      the Cayapa from Ecuador. We selected individuals for HLA-B molecular typing based
      upon their HLA class II typing results. Three new variants of HLA-B39 and one new
      variant of HLA-B15 were found in the Cayapa: HLA-B*3905, HLA-B*3906, HLA-B*3907,
      and HLA-B*1522. A total of thirteen new HLA-B alleles have now been found in the
      four South American tribes studied. Each of these four tribes studied, including
      the Cayapa, had novel alleles that were not found in any of the other tribes,
      suggesting that many of these new HLA-B alleles may have evolved since the Paleo
      Indians originally populated South America. Each of these 13 new alleles
      contained predicted amino acid replacements that were located in the peptide
      binding site. These amino acid replacements may affect the sequence motif of the
      bound peptides, suggesting that these new alleles have been maintained by
      selection. New allelic variants have been found for all common HLA-B locus
      antigenic groups present in South American tribes with the exception of B48. In
      spite of its high frequency in South American tribes, no evidence for variants of
      B48 has been found in all the Amerindians studied, suggesting that B48 may have
      unique characteristics among the B locus alleles.

PMID- 7797267
TI  - Complement component C4 gene intron 9 as a phylogenetic marker for primates: long
      terminal repeats of the endogenous retrovirus ERV-K(C4) are a molecular clock of
      evolution.
AB  - The complement component C4 genes of Old World primates exhibit a long/short
      dichotomous size variation, except that chimpanzee and gorilla only contain short
      C4 genes. In human it has been shown that the long C4 gene is attributed to the
      integration of an endogenous retrovirus, HERV-K(C4), into intron 9. This 6.36
      kilobase retroviral element is absent in short C4 genes. Here it is shown that
      the homologous endogenous retrovirus, ERV-K(C4), is present precisely at the same
      position in the long C4 gene of orangutan and African green monkey. Determination
      of the short C4 gene intron 9 sequences from human, three apes, two Old World
      monkeys, and a New World monkey allowed the establishment of consistent
      phylogenetic trees for primates, which favors a chimpanzee-gorilla clade. The 5'
      long terminal repeats (LTR) and 3' LTR of ERV-K(C4) in long C4 genes of human,
      orangutan, and African green monkey have similar sequence divergence values of
      9.1%-10.5%. These values are more than five-fold higher than the sequence
      divergence of the homologous intron 9 sequences between the long and short C4
      genes in higher primates. The latter is probably a result of homogenization or
      concerted evolution. We suggest that the 5' LTR and 3' LTR of an endogenous
      retrovirus can serve as a reliable reference point or a molecular clock for
      studies of gene duplication and gene evolution. This is because the 5'/3' LTR
      sequences were identical at the time of retroviral integration and evolved
      independently of each other afterwards. Our data provides strong evidence for the
      short C4 gene being the ancestral form in primates, trans-species evolution, and
      the "slow-down" phenomenon of the sequence divergence in great apes.

PMID- 7797269
TI  - Physical and genetic linkage of the genes encoding Ly-9 and CD48 on mouse and
      human chromosomes 1.
AB  - By virtue of sequence similarity, the genes encoding CD2, CD48, CD58, and Ly-9
      have been assigned to a distinct subset within the immunoglobulin superfamily.
      Previous gene mapping studies in human and mouse have suggested that CD2, CD48,
      and CD58 arose by gene duplication. Here we show the gene encoding Ly-9 to be
      located adjacent to CD48 and the Na,K-ATPase alpha 2 subunit gene on human and
      mouse chromosome 1. The proximity in human and mouse genomes of the genes
      encoding CD2, CD58, and the Na,K-ATPase alpha 1 subunit, and of the Ly-9, CD48,
      and the Na,K-ATPase alpha 2 subunit genes may be explained by the occurrence of
      two, successive duplication events during vertebrate evolution, and suggest that
      Ly-9 may also participate in adhesion reactions between T lymphocytes and
      accessory cells by homophilic interaction.

PMID- 7797268
TI  - Diversity of TCRAV and TCRBV sequences used by human T-cell clones specific for a
      minimal epitope of Bet v 1, the major birch pollen allergen.
AB  - T-cell clones (TCC) were raised from the peripheral blood of patients suffering
      from tree pollen allergy. All TCC were restricted by HLA-DR molecules. In order
      to investigate possible intervention targets in Type I allergic diseases, we
      examined T-cell receptor (TCR) alpha and beta chain nucleotide sequences of five
      allergen-reactive human CD4+ TCC specific for a C-terminal epitope (BV 144) of
      Bet v 1, the major birch pollen allergen. Proliferation assays using synthetic
      peptides revealed the 10-mer LRAVESYLLA as minimal epitope for three TCC; two TCC
      also displayed reactivity with the nonapeptide LRAVESYLL. Two TCC expressed
      TCRBV2S3, all other BV144-specific TCC used diverse TCRAV and TCRBV gene
      segments. Moreover, the junctional regions encoding the third complementary
      determining regions (CDR3) of the TCR showed a striking heterogeneity in length
      and amino acid composition. Nevertheless, all TCC showed an arginine residue in
      the N-terminal region of their TCRBV CDR3 loops. Therefore, therapeutical
      strategies aimed at the clonal deletion of allergen-specific T-cell clones,
      providing help for IgE synthesis, will not be feasible. Our results cast a doubt
      on the theory that the CDR3 exclusively provides the primary contact with the
      peptide bound in the major histocompatibility (MHC) groove, and suggest
      additional interaction with MHC class II.

PMID- 7797270
TI  - Rat RT1 orthologs of mouse H2-M class Ib genes.

PMID- 7797271
TI  - Rfp-Y-like sequences assort independently of pheasant Mhc genes.

PMID- 7797272
TI  - The MHC class I-like Zn-alpha 2-glycoprotein gene maps to mouse chromosome 5.

PMID- 7797273
TI  - Cattle cDNA clones encoding MHC class II DQB1 and DQB2 genes.

PMID- 7797274
TI  - Gastroesophageal reflux and asthma.

PMID- 7797275
TI  - Airway response to acid instillation in esophagus in bronchial asthma.
AB  - OBJECTIVE: An increased incidence of gastroesophageal reflux has been reported in
      patients with bronchial asthma. We studied the pulmonary effects of acid
      instillation in the esophagus. METHODS: Fifteen patients with bronchial asthma
      and 15 healthy adults in the age group 15-50 years were studied. The control
      subjects were first screened for bronchial hyperreactivity by a methacholine
      challenge test. Patients and controls were both subjected to modified Bernstein
      test. Spirometry was done at baseline and after each instillation of either acid
      or saline. Respiratory and reflux symptoms were noted after each infusion and
      antacid administration. RESULTS: Five patients and one control subject had
      history of reflux symptoms (p < 0.05) and six patients had nocturnal asthma.
      There was a significant fall in FEV1/FVC after acid infusion patients; this
      improved significantly after antacid administration. All six patients with
      nocturnal asthma had respiratory signs or symptoms and had more than 20% fall in
      FEV1 on acid instillation in the esophagus, while none in the control group
      developed the same. CONCLUSIONS: Gastroesophageal reflux occurs more frequently
      in patients with bronchial asthma and acid instillation in the esophagus triggers
      bronchoconstriction.

PMID- 7797276
TI  - Effect of sucralfate on gastric bicarbonate secretion in patients with duodenal
      ulcer.
AB  - BACKGROUND: Sucralfate is known to protect gastroduodenal mucosa and thereby
      facilitate healing of peptic ulcer. The mechanism of action of this drug is still
      not fully known. METHODS: We studied the effect of sucralfate treatment on
      gastric bicarbonate secretion in 16 patients with duodenal ulcer. RESULTS:
      Sucralfate administration (3 g daily for 4 weeks) stimulated bicarbonate
      secretion from 3.1 +/- 1.2 mmol/h to 4.6 +/- 2.0 mmol/h (p < 0.05). Gastric juice
      volume as well as non-parietal volume secretion also increased significantly
      after sucralfate therapy (p < 0.05). CONCLUSION: Sucralfate causes stimulation of
      non-parietal volume-dependent gastric bicarbonate secretion.

PMID- 7797278
TI  - Primary repair or colostomy in the management of civilian colonic trauma.
AB  - BACKGROUND: Management of civilian colonic trauma remains controversial. AIM: To
      determine prognostic factors in patients with civilian colonic trauma undergoing
      different modes of therapy. METHODS: Sixty-five patients with colonic injuries
      were retrospectively analyzed. RESULTS: Right and left colon injuries were
      present in 30 and 35 cases respectively. Colon-related complications occurred in
      27.7%. One death (1.5%) was directly due to colonic injuries. Left sided colon
      injuries led to a higher incidence of complications and longer duration of
      hospital stay; a higher number of complications occurred in relation to colostomy
      than primary closure. CONCLUSIONS: Primary repair can be done in more cases than
      is routinely done. The presence of multiple abdominal injuries or shock does not
      exclude primary repair. The site of injury may affect the outcome, but does not
      exclude primary repair. Gross fecal contamination, extensive colonic damage and
      type of feces in affected colon should be considered as indications favoring
      colostomy.

PMID- 7797277
TI  - Serum zinc levels in hepatic encephalopathy.
AB  - BACKGROUND: Zinc is essential for various metabolic processes of the body. Since
      serum zinc levels are lowered in liver diseases, it has been postulated to be a
      precipitating factor for hepatic encephalopathy. METHODS: We prospectively
      studied serum zinc levels in consecutive patients with fulminant hepatic failure,
      subacute hepatic failure and chronic liver disease with encephalopathy. Serum
      zinc levels were correlated with various clinical and biochemical parameters and
      final outcome of patients. Serum zinc levels were estimated by atomic absorption
      spectrometry at admission and also 24 hours after recovery in survivors. RESULTS:
      Of the 55 patients (age 17-65 years, 35 men) studied, 30 had acute, 5 subacute
      and 20 chronic liver disease. Patients with hepatic encephalopathy had
      significantly lower serum zinc levels as compared to 20 age and sex matched
      controls. High serum bilirubin levels and prothrombin time showed inverse
      relationship with serum zinc levels. There was no relationship of serum zinc
      levels with age, sex, grade and duration of encephalopathy, liver size, ascites
      or splenomegaly. CONCLUSIONS: Hepatic encephalopathy is associated with low serum
      zinc levels. Recovery occurred in 17 patients despite persisting low serum zinc
      levels. Serum bilirubin > 23 mg/dL and prothrombin time prolongation > 12 seconds
      above control have inverse correlation with serum zinc level.

PMID- 7797280
TI  - Mechanisms of cholesterol gallstone formation.

PMID- 7797279
TI  - Malondialdehyde levels in patients with duodenal ulcer.
AB  - Malondialdehyde (MDA) is a stable product of lipid peroxidation of membrane
      lipids. In view of its role in membrane lipid damage in various inflammatory
      disorders, MDA levels were estimated in 83 duodenal ulcer patients and 48
      controls. MDA levels were found to be significantly higher in duodenal ulcer
      patients as compared to controls (mean +/- SD 280.2 +/- 109.0 versus 216.5 +/-
      81.4 nm/dL, p < 0.001). These increased levels of MDA may represent either the
      result of peroxidative damage in the disease process or a pathogenetic factor
      enhancing the risk for duodenal ulcer.

PMID- 7797282
TI  - Conversion of loop colostomy to end colostomy: is dismantling necessary?
AB  - Twelve patients who had previously undergone preliminary pelvic loop colostomy
      were treated by conversion of loop colostomy to end colostomy by alternative
      technique ie without dismantling of loop and conversion to end stoma. The results
      of this technique were compared with those of conventional procedure which was
      performed in ten patients. The new technique results in a 'mature' end colostomy
      in situ with little pain at the stoma site, no risk of retraction and lower risk
      of peristomal infection. We therefore recommend this procedure for all patients
      needing such conversion.

PMID- 7797281
TI  - Treating irritable bowel syndrome.

PMID- 7797283
TI  - Esophageal candidiasis following omeprazole therapy: a report of two cases.
AB  - Esophageal candidiasis was diagnosed at endoscopy in two patients receiving
      omeprazole therapy. There was no clinical evidence of immunosuppression or any
      obstructive lesion in the esophagus. There was prompt response of oral
      ketoconazole. These cases suggest that marked acid reduction may predispose to
      esophageal candidial infection.

PMID- 7797285
TI  - Sigmoido-rectal intussusception.
AB  - Sigmoido-rectal intussusception is the least common type of intussusception seen
      in infants and children and is therefore usually misdiagnosed as rectal prolapse.
      Delay in diagnosis and treatment is due to lack of its awareness amongst
      surgeons, incomplete assessment of the prolapsed bowel at the anal orifice, and
      absence of classical traid of intussusception i.e. palpable abdominal mass,
      colicky abdominal pain, and bleeding per rectum.

PMID- 7797284
TI  - Colovesical fistula complicating colonic diverticulosis.
AB  - Two cases of colovesical fistulae secondary to colonic diverticulosis are
      reported. Urinary symptoms were the prominent presenting features. Barium enema
      was helpful in documenting the fistulae, which cystoscopically was not localised.
      Definitive treatment included resection of the fistula and the diseased segment
      of the intestine. Both patients are well on follow-up. Diverticulosis coli should
      be considered in the differential diagnosis of colovesical fistulae even in
      tropical countries.

PMID- 7797286
TI  - Gastric wall necrosis in an HIV-positive patient.
AB  - Perforation of the gastrointestinal tract is rare in HIV infection and occurs
      most often in the colon and small intestine. Gastric perforation in HIV-positive
      patients has not been reported so far. We report an HIV-positive patient who
      developed gastric perforation.

PMID- 7797287
TI  - Gallstone obstruction of the duodenum (Bouveret's syndrome).
AB  - Bouveret's syndrome is a rare complication of gallstones, leading to duodenal
      obstruction. We report a 25-year-old woman with this condition, probably the
      youngest patient reported.

PMID- 7797288
TI  - Obstructive jaundice due to Fasciola hepatica.
AB  - A middle aged woman presented with obstructive jaundice of 6 months duration.
      Radiological investigations revealed multiple pyogenic liver abscesses with the
      possibility of choledocholithiasis. Exploration of common bile duct revealed that
      Fasciola hepatica was responsible for the illness. The case is reported because
      of its rarity.

PMID- 7797289
TI  - Unusual foreign body in intestine: marble chips.

PMID- 7797290
TI  - Auto-amputation of vermiform appendix.

PMID- 7797291
TI  - Basic issues in estimating and comparing the survival of cancer patients.

PMID- 7797292
TI  - The EUROCARE database.

PMID- 7797293
TI  - Methods of data analysis.

PMID- 7797294
TI  - General mortality and its effect on survival estimates.

PMID- 7797295
TI  - Survival of cancer patients in Europe. Summary and discussion of results.

PMID- 7797297
TI  - Health care system, cancer registration and follow-up of cancer patients in
      Estonia.

PMID- 7797296
TI  - Health care system, cancer registration and follow-up of cancer patients in
      Denmark.

PMID- 7797298
TI  - Health care system, cancer registration and follow-up of cancer patients in
      Finland.

PMID- 7797299
TI  - Health care system, cancer registration and follow-up of cancer patients in
      France.

PMID- 7797300
TI  - Health system, cancer registration and follow-up of cancer patients in Germany
      (West).

PMID- 7797301
TI  - Health care system, cancer registration and follow-up of cancer patients in
      Italy.

PMID- 7797302
TI  - Health care system, cancer registration and follow-up of cancer patients in The
      Netherlands.

PMID- 7797303
TI  - Health care system, cancer registration and follow-up of cancer patients in
      Poland.

PMID- 7797304
TI  - Health care system, cancer registration and follow-up of cancer patients in
      Spain.

PMID- 7797305
TI  - Health-care system, cancer registration and follow-up of cancer patients in
      Switzerland.

PMID- 7797306
TI  - Health care system, cancer registration and follow-up of cancer patients in the
      United Kingdom.

PMID- 7797308
TI  - Survival of cancer patients in Europe. Results.

PMID- 7797307
TI  - Survival of cancer patients in Europe. Guide to tables.

PMID- 7797309
TI  - Plague.

PMID- 7797310
TI  - Maternal behaviour and feeding practices as determinants of childhood diarrhoea:
      some observations among rural Begalee mothers.

PMID- 7797311
TI  - Health economic concepts, issues & challenges.

PMID- 7797312
TI  - Study of the impact of epidemiological factors on intelligence of rural children
      of 3 to 6 years age group belonging to low socio-economic status.
AB  - There are many factors which affect intelligence as well as physical growth of
      children, although genetic factor plays a prime role but social, environmental
      and psychological factors influence significantly the physical growth and
      intelligence of the child and the same can be improved through intervention.
      Community based studies are therefore useful to understand effect of these
      factors for future planning. The present study was therefore undertaken in
      Burdwan district of West Bengal with the objectives of studying level of
      intelligence of children of 3 to 6 years age group and impact of the factors
      related to the level of intelligence of these children. 72 children of 3 to 6
      years age group were studied, of which 2/3 were either normal or having Grade-I
      undernutrition and the rest were either Grade-II or Grade-III. A significant
      positive association was found between DST IQ score (Bharat Raj) and the
      nutritional grade. Non-formal education also was found to have significant
      bearing on the IQ level. No significant relationship was however found between
      DST IQ score and the religion indicating culture independence of the scoring
      system.

PMID- 7797313
TI  - Resurgence of malaria in eastern and north-eastern region of India: a critical
      appraisal.
AB  - The implication of recent resurgence of malaria in eastern (E) and
      northeastern(NE) states of India critically urges an in-depth viewpoint into the
      rationale of implementation of National Malaria Eradication Programme (NMEP). The
      article highlights the regional scenario, considering the programme performance
      in this context.

PMID- 7797314
TI  - Measuring the interactions of the determinants of health.

PMID- 7797315
TI  - Factors influencing mode of claims settlement in workers' compensation cases.
AB  - This paper examines the variables that influence the means by which 10,192
      injured workers settled their compensation claims during 1990. The data on which
      this study is based come from a state in Australia where there are three means by
      which workers' compensation claims can be settled by lump sum payment: settlement
      following a specific injury payment, early settlement payment and settlement
      following a common law payment. This paper is specifically concerned with
      identifying the variables that determine whether the claim will be settled by a
      lump sum payment and whether different modes of claims settlement by lump sum are
      unique and predictable from a range of variables that include injury
      characteristics and demographics. The results of logistic regression modelling
      revealed that those who received a lump sum settlement could be reliably
      distinguished from those who did not receive such a payment. Each mode of
      settlement varied in the extent to which it could be predicted. Contrary to
      expectations, the most difficult form of settlement mode to predict was that of
      specific injury payments (4% accurate) with the most predictive being early
      settlement payments (81% accurate). Common law payments were also highly
      predictable (48% accurate). The form of lump sum payment received by injured
      workers was found to depend on a range of injury characteristics, indices of
      severity and for common law payments, gender and potential income loss. It is
      argued that although injury characteristics play a part in the process of claims
      settlement, personal circumstances and insurance company policies are influential
      in dictating the form by which workers compensation cases are finalized.

PMID- 7797316
TI  - Factors influencing the disabled's employment in the competitive labour market.
AB  - Factors influencing the disabled's job search outcome were studied by means of
      material representing disabled job seekers (n = 1353) in three Finnish Employment
      Service Agencies during 1988-89. The job search outcome was defined successful if
      a job seeker was employed in the competitive labour market according to the ESA
      files during a follow-up period of 12-18 months and no unemployment was
      registered. The factors studied were age, gender, domicile, basic education,
      vocational training and disability. First, the relationship of the above factors
      to job search outcome was described bivariately, then it was studied by means of
      logistic regression models for men and women separately. The results were
      somewhat gender specific. For men, inadequate basic education had a negative
      influence on job search outcome, while for women, the outcome was influenced by
      domicile. Older disabled job seekers, both male and female, were disadvantaged.
      The problems created by age and disability are a challenge to rehabilitation. The
      results also point out adult training as a means for improving the disabled's
      labour market status. Finally, all of the disabled's problems are not on the
      individual level: it is not only who you are but also where you live that
      matters.

PMID- 7797317
TI  - Analysing work performance problems--methods and their effectiveness.
AB  - This paper explores methods of analysing work performance problems. It begins by
      looking at what can be understood by the term 'work performance problems' and
      offers a definition. The author clarifies the differences between work
      performance problems and negative work behaviours, to eliminate any confusion
      that may exist. There follows a review of some possible causes of work
      performance problems, as identified by a number of writers. Eight methods for
      analysing work performance problems are described. The difficulties of evaluating
      the effectiveness of methods for analysing work performance problems are
      highlighted and the range of variables that need to be accounted for are
      discussed.

PMID- 7797318
TI  - Perceptions of positive attitudes toward people with spinal cord injury.
AB  - This study identified differences in perceptions of positive attitudes toward
      persons with spinal cord injury (SCI). The four groups surveyed included 35
      people with SCI, 27 rehabilitation workers from an acute spinal rehabilitation
      unit, 16 rehabilitation workers from an out-patient hospital rehabilitation unit
      and 37 people from the general population. Participants completed the Modified
      Issues in Disability Scale-Transitional Version. The people with SCI were
      considered the judges of what a positive attitude consisted of and scored higher
      on the measure than all other groups. The results showed that the acute spinal
      rehabilitation workers and the general population group differed significantly
      from the people with SCI in their perceptions of positive attitudes, whereas the
      out-patient hospital rehabilitation workers did not. Age and ethnic identity were
      significantly related to perceptions of attitudes, with younger adults and
      European New Zealanders being more aware of positive attitudes than older adults.
      Maori New Zealanders and Pacific Islanders. Professionally trained rehabilitation
      workers had a greater awareness than in-service trained workers of what
      constituted a positive attitude towards people with SCI. However, gender and
      amount of contact with people with disabilities were not related to perceptions
      of positive attitudes.

PMID- 7797319
TI  - Inter-rater reliability of a paediatric outcome measure in Nepal.
AB  - The Hospital and Rehabilitation Centre for Disabled Children (HRDC) in Nepal
      identified the need to evaluate their in-hospital and community programmes. An
      instrument was developed to provide information regarding the functional level of
      the children treated by the HRDC as well as to provide information regarding care
      givers' attitudes towards disability. Inter-rater reliability of the measure was
      tested in three regions of Nepal with 49 children. Six HRDC field workers
      travelled in pairs to the childrens' homes and alternated in roles as test
      administrator and observer. Correlations between the scores documented by the
      administrator and observer were used to estimate inter-rater reliability. Inter
      rater reliability coefficients, calculated using a weighted kappa statistic,
      varied from 0.60 to 1.0. We conclude that the instrument demonstrated an
      acceptable level of inter-rater reliability in the field setting. Future studies
      to measure construct and concurrent validity, test-retest reliability and
      responsiveness of the instrument are recommended as well as testing the
      instrument in different cultures.

PMID- 7797320
TI  - Pressure sores: impact on rehabilitation following surgically treated hip
      fractures.

PMID- 7797321
TI  - Rehabilitation practitioner competencies: some New Zealand data.

PMID- 7797322
TI  - Family response to paranoid and non-paranoid schizophrenic patients.

PMID- 7797324
TI  - The use of non-specific comments in a conversation aid for non-speaking people.

PMID- 7797323
TI  - Increasing the occupational level of a passive man through the employment of
      mentally handicapped peer caregivers.

PMID- 7797325
TI  - Effects of differential reinforcement, physical restraint and verbal reprimand on
      stereotyped body-rocking.

PMID- 7797326
TI  - Deaf people's perception of social interaction in working life.

PMID- 7797327
TI  - Preference for static or revolving cane tips by visually impaired travellers.

PMID- 7797328
TI  - Readiness for community residence: the AKIM-Jerusalem demonstration project.

PMID- 7797329
TI  - Basic models for disease occurrence in epidemiology.
AB  - BACKGROUND: One of the epidemiologist's most basic tasks is estimation of disease
      occurrence. To perform this task, the epidemiologist frequently models
      variability in disease occurrence using one of three distributions--the binomial,
      the Poisson or the exponential distribution. Although epidemiologists often use
      them and their properties appear in standard texts, we know of no text or review
      that compares and contrasts epidemiological application of these distributions.
      METHODS: In this commentary, we discuss these three basic distributions. We note
      key assumptions as well as limitations, and compare results from analyses based
      on each distribution. RESULTS AND CONCLUSIONS: We illustrate that the three
      distributions, although superficially different, often lead to similar results.
      We argue that epidemiologists should often obtain similar results regardless of
      which distribution they use. We also point out that application of all three
      distributions can be inappropriate if assumptions of independence or homogeneity
      of risks fail to hold. Finally, we briefly review how these basic distributions
      can be used to justify use of other distributions, such as the Gaussian
      distribution, for studying disease-exposure associations.

PMID- 7797330
TI  - Alcohol consumption and all-cause mortality.
AB  - BACKGROUND: Prospective studies of alcohol and mortality in middle-aged men
      almost universally find a U-shaped relationship between alcohol consumption and
      risk of mortality. This review demonstrates the extent to which different studies
      lead to different risk estimates, analyses the putative influence of abstention
      as a risk factor and uses available data to produce point and interval estimates
      of the consumption level apparently associated with minimum risk from two studies
      in the UK. METHOD: Data from a number of studies are analysed by means of
      logistic-linear modelling, taking account of the possible influence of abstention
      as a special risk factor. Separate analysis of British data is performed.
      RESULTS: Logistic-linear modelling demonstrates large and highly significant
      differences between the studies considered in the relationship between alcohol
      consumption and all-cause mortality. The results support the identification of
      abstention as a special risk factor for mortality, but do not indicate that this
      alone explains the apparent U-shaped relationship. Separate analysis of two
      British studies indicates minimum risk of mortality in this population at a
      consumption level of about 26 (8.5 g) units of alcohol per week. CONCLUSIONS: The
      analysis supports the view that abstention may be a specific risk factor for all
      cause mortality, but is not an adequate explanation of the apparent protective
      effect of alcohol consumption against all-cause mortality. Future analyses might
      better be performed on a case-by-case basis, using a change-point model to
      estimate the parameters of the relationship. The current misinterpretation of the
      sensible drinking level of 21 units per week for men in the UK as a limit is not
      justified, and the data suggest that alcohol consumption is a net preventive
      factor against premature death in this population.

PMID- 7797332
TI  - Regional and social class variation in the relative risk of death from amenable
      causes in the city of Helsinki, 1980-1986.
AB  - BACKGROUND: Relative risk of death from causes amenable to health services'
      intervention was studied in a case-control design to ascertain regional and
      social class differences. METHODS: The data were 2091 deaths from amenable causes
      and 8364 randomly drawn living controls in 1980-1986 in the seven health
      districts in Helsinki, Finland. Logistic regression was used to adjust relative
      risk estimates for age, sex and marital status. RESULTS: Adjustments decreased
      the risk ratios. Compared with the Southern District, the Middle District had
      significantly higher adjusted relative risk (RR = 1.4; 95% confidence interval
      [CI]: 1.1-1.7). People with no address had even higher relative risk (RR = 3.1;
      95% CI: 2.3-4.2). Compared with social group I, increased relative risks were
      found in social group II (RR = 1.3; 95% CI: 1.1-1.6), group III (RR = 2.0; 95%
      CI: 1.6-2.4), group IV (RR = 1.9; 95% CI: 1.5-2.5) and group VI (RR = 8.5; 95%
      CI: 6.9-10.6). Males had higher relative risk than females (RR = 2.4; 95% CI: 2.1
      2.8). Of the dead with no address, 29% were pensioners and 41% had been
      registered unemployed or occupation was unknown; 48% were single and 17%
      divorced. CONCLUSIONS: Our results suggest that regional inequalities in health
      care between various districts in Helsinki are small. However, to a large extent
      two overlapping groups, social group VI and people with no address, seem to
      delineate a deprived group likely to need special help from health care.

PMID- 7797331
TI  - Time trends in cause-specific mortality in Estonia from 1965 to 1989.
AB  - BACKGROUND: During the last 30 years, in most developed countries, life
      expectancy has increased considerably. In Estonia, over the past half century,
      health and social policy was dictated by the Soviet socioeconomic system. In
      order to evaluate the consequences to health and to evaluate trends in health,
      cause-specific mortality was studied in Estonia. METHODS: The study was based on
      national death records from 1965 to 1989. Mortality rates were computed for all
      causes of death combined and for 16 cause groups. Age-standardization (European
      population) was performed using 5-year age groups. RESULTS: From 1965-1969 to
      1985-1989, the age-standardized mortality rate for all causes combined increased
      by 4.0% for males and decreased by 1.5% for females. The greatest increase was
      observed for ages 45-54 among males (26.3%) and for ages 55-64 among females
      (7.0%). Very high death rates from circulatory diseases and high mortality from
      injuries and poisoning are of specific concern, particularly for males. Mortality
      from circulatory diseases continues to rise for ages 45-74 among males and for
      ages 55-64 among females. Mortality rates for neoplasms and endocrine disorders
      are also increasing; however, the mortality rates from respiratory and infectious
      diseases have shown a substantial decrease. CONCLUSIONS: Chronic diseases,
      together with injuries and poisoning, remain a serious public health problem in
      Estonia. Preventive measures, including earlier detection of diseases as well as
      changes in social security and individual health behaviour are needed to improve
      the health of the population.

PMID- 7797333
TI  - Educational level of spouses and risk of mortality: the WHO Kaunas-Rotterdam
      Intervention Study (KRIS).
AB  - BACKGROUND: A 9.5-year follow-up of the Kaunas-Rotterdam Intervention Study
      (KRIS) provided the opportunity of investigating whether the educational level of
      wives was associated with their husbands' risk of mortality and coronary heart
      disease (CHD), independently of the educational level of the husbands themselves.
      METHODS: The data represent populations consisting of 2452 Lithuanian men and
      3365 Dutch men. These men were extensively screened for cardiovascular risk
      factors in the period 1972-1974. During the follow-up 303 Kaunasians and 350
      Rotterdammers died. We used the Cox proportional hazards and the logistic
      regression models to analyse the data. RESULTS: We found that men whose spouses
      had little education apparently had an increased risk of all-cause mortality,
      even when their own educational level was taken into account. The relative risks
      (RR) were 1.57 in Kaunas and 2.15 in Rotterdam. The results for fatal and non
      fatal myocardial infarctions were compatible with this finding, especially in
      Rotterdam. The prevalence of smoking was higher among men whose wives had primary
      schooling only. Nonetheless, adjusting the effect of the wife's educational level
      on her husband's mortality risk for all coronary risk factors in the husband only
      partially explained the association. CONCLUSIONS: The spouse's educational level
      appears to have independent effects on a man's risk of mortality in both eastern
      and western European communities. The results strongly suggest that including
      characteristics of the socioeconomic status of an individual's spouse would
      improve studies of socioeconomic differences in health.

PMID- 7797334
TI  - Risk factors for child mortality in northern Ghana: a case-control study.
AB  - BACKGROUND: A population-based case-control study was carried out to investigate
      potential risk factors for post-neonatal and child mortality in northern Ghana
      were child survival rates are among the lowest in Africa. METHOD: Cases were post
      neonatal infant and child deaths identified within a large population under
      continuous demographic surveillance. For each case, one living control, matched
      for age, sex and locality, was selected from the demographic database. Mothers of
      each case and control were interviewed to obtain information on social,
      enconomic, demographic, environmental and other possible risk factors. Matched
      analyses of the 317 cases and their controls were performed using discordant
      pairs analysis and conditional logistic regression. RESULTS: The mortality rate
      for children aged 6 months to 4 years was estimated as 23.9/1000 children/year.
      An increased risk of death was observed where the delivery was not performed by a
      trained person (OR = 1.8, 95% CI: 1.0-3.2), if the preceding birth interval was <
      24 months (OR = 2.2, 95% CI: 1.1-3.9), if the father beat the child's mother (OR
      = 4.3, 95% CI: 1.2-15.6) or if the water source was unprotected (OR = 1.6, 95%
      CI: 1.0-2.7). No association was found between weaning practices, parental
      education, or any of the socioeconomic or hygiene variables considered.
      CONCLUSIONS: Few strong risk factors for mortality were identified, perhaps
      because living conditions within the study population are relatively homogeneous.
      While mortality rates may be reduced by targeted interventions, such as
      increasing deliveries by trained people, more general improvements in the
      socioeconomic status in the region are essential.

PMID- 7797335
TI  - International comparisons of injury mortality in the elderly: issues and
      differences between New Zealand and the United States.
AB  - BACKGROUND: International comparisons of mortality rates for injury, as for other
      conditions, can suggest priorities for further research and intervention.
      However, variability in the assignment of underlying cause, especially among the
      elderly, may lead to difficulty in interpreting cross-national differences in
      death rates. Despite similarities between the two countries, the injury death
      rate for ages < or = 65 in New Zealand is substantially higher than the United
      States rate. The objective of this study was to investigate possible reasons for
      this difference. METHODS: We used data not previously reported for New Zealand to
      calculate the cause-specific injury death rates for ages > or = 65, compared them
      with US rates, and examined other injury rates that could help explain the
      observed difference. RESULTS: The New Zealand death rate from falls for ages > or
      = 65 was nearly three times the US rate (92 versus 32 per 100,000), causing the
      death rate for all injuries in this age group to be 34% higher in New Zealand
      (153 versus 114 per 100,000). However, hospitalization rates for both falls and
      hip fractures are similar for the two countries. CONCLUSIONS: The substantially
      higher fall injury death rates for older New Zealanders are not fully explained
      by differences in the incidence of falls resulting in injury nor the case
      fatality rate for fall-related injury. US injury death rates based on underlying
      cause of death might be similar to New Zealand rates, and thus substantially
      higher, if subjected to comparable procedures for the completion and coding of
      death certificates. As in studies of other conditions, international comparisons
      of injury death rates based on underlying cause, especially in studies of the
      elderly, must consider variation between countries in death certification and
      coding practices.

PMID- 7797336
TI  - Tornado injuries related to housing in the Plainfield tornado.
AB  - BACKGROUND: On 28 August 1990, a tornado in Will County, Illinois, caused 29
      deaths and more than US $200 million in damage. Risk factors for impact-related
      morbidity and mortality were studied. METHODS: A case-control study was conducted
      of 26 people hospitalized or killed, and 116 injured, randomly selected people
      who were in houses damaged by the tornado. To obtain information on study
      subjects, telephone interviews were conducted, and hospital records, coroners'
      reports, and American Red Cross records were abstracted. Structural details on
      houses were collected from tax assessor records. RESULTS: Cases were more likely
      than controls to have been in multistorey houses than in single-storey houses (OR
      = 3.9; 95% CI: 1.2-13.2). The risk associated with houses built after 1972 (OR =
      7.9) and those built from 1962 to 1972 (OR = 2.2) was greater than for those
      built before 1962 (OR = 1.0; chi 2 for trend = 12.1; P < 0.01). Being in the
      basement when the tornado hit was protective (OR = 0.1; 95% CI: 0.0-0.4).
      CONCLUSIONS: One-storey houses were safer than multistorey houses, and basements
      were safer than other rooms. The association of risk with the construction date
      of the house is a new finding and should be examined in further studies.

PMID- 7797337
TI  - A non-invasive measure of photoageing.
AB  - BACKGROUND: Photoageing develops in skin due to chronic sun exposure and a method
      of measuring photoageing would be useful in monitoring solar damage in
      populations, in studies of sun exposure as an aetiological agent, and in the
      evaluation of the effects of cosmetics and therapeutics. Methods of measuring
      photoageing include several invasive techniques as well as non-invasive
      techniques which are often difficult to use and have not been validated. The non
      invasive measure of photoageing described here is a new method for grading
      silicone-rubber casts of the skin surface. This paper describes the development
      of the measure (named the sigma system) and compares its reliability and validity
      with the most widely-used similar measure (the Beagley and Gibson system).
      METHODS: Useable punch biopsies and silicone-rubber casts were obtained from 82
      subjects. Two random subgroups of silicone casts were created and the first
      subgroup was used for the development of the sigma system, while the second
      subgroup was used to test validity. All casts were graded twice using the sigma
      system and twice using the Beagley and Gibson system by two observers. The
      gradings of the second subgroup of casts were compared with the degree of
      photoageing seen on histological examination of the biopsies. RESULTS: The
      intraclass correlation coefficient (ICC) for inter-observer reliability of the
      sigma system was 0.89, with 73 of the 82 casts graded at the same level of
      photoageing by the two observers. Intra-observer ICC were 0.84 and 0.87 for the
      two observers. The Goodman-Kruskal tau for agreement between the grade on the
      sigma system and histological degree of photoageing was 0.22. While these values
      are very similar to the reliability and validity estimates obtained using the
      Beagley and Gibson system, the sigma system is easier to learn and to use.
      CONCLUSIONS: The sigma system is a reliable and easy-to-use measure of
      photoageing which has many possible applications in monitoring and studying the
      effects of solar exposure.

PMID- 7797339
TI  - Misclassification of social disadvantage based on geographical areas: comparison
      of postcode and collector's district analyses.
AB  - BACKGROUND: Analysis of socioeconomic status (SES), defined on the basis of
      geographical area, will always be subject to misclassification of individuals. We
      studied the relationship between SES and selected health-related measures when
      SES was defined firstly on the basis of postcode and secondly on the basis of the
      smaller spatial area of collector's district (CD). METHOD: A Census population of
      1.4 million was used to investigate the misclassification of individuals to SES
      group using postcode as opposed to CD. A field survey of 1000 respondents and a
      mortality register of 1756 deaths were used to compare the relationship between
      SES and certain outcome variables, when SES group was assigned using postcode and
      CD. Misclassification probability matrices were used to try to adjust the
      postcode-based results to approximate CD-based results. RESULTS: The Census data
      showed that nearly 50% of residents were misclassified into SES groups by the
      postcode-based system compared with a CD-based system. In comparing the most
      socially disadvantaged group with the least disadvantaged group, the postcode
      analysis underestimated the absolute effects of SES by 58% for the increased
      prevalence of smoking, by 19% for the reduced prevalence of participation in
      junior sporting clubs and by 13% for the increased mortality rate at ages 0-64
      years. Adjustment of postcode-based results using misclassification matrices
      proved fruitless due to differential misclassification and technical
      difficulties. CONCLUSIONS: Misclassification of individuals to SES groups on the
      basis of postcode has caused an underestimation of the true relationship between
      SES and health-related measures. A reduction of this misclassification by using
      smaller spatial areas, such as CD or census enumeration districts, will provide
      improved validity in estimating the true relationship.

PMID- 7797338
TI  - Nutritional change and economic crisis in an urban Congolese community.
AB  - BACKGROUND: In 1986, the government of Congo undertook a structural adjustment
      programme to cope with the economic crisis. We present the results of a study
      whose objectives were to assess the evolution of nutritional status of an urban
      community between 1986 and 1991 and to identify specific groups for which the
      nutritional status may have worsened. METHODS: Two cross-sectional surveys were
      carried out on representative samples of Brazzaville children < 6 years old: 2295
      children were surveyed in 1986 and 2373 in 1991. Anthropometric assessment of
      nutritional status was performed. For children, weight-for-height and height-for
      age indices were used according to WHO recommendations. Wasting and stunting were
      respectively defined as indices under -2 z-scores. Body mass index of mothers was
      calculated and risk of chronic energy deficiency (CED) was defined as < 18.5
      kg/m2. Socioeconomic data relative to the households were also collected.
      Multivariate statistical methods were used to obtain adjusted estimates of
      nutritional changes in the community. RESULTS: Data analysis led to several
      converging results: increase in the percentage of low birthweight (10.2% in 1985
      versus 18.7% in 1990), increase in the percentage of CED (from 7.9% to 10.5%),
      and increase in the prevalence of wasting (from 2.9% to 4.2%). By contrast, the
      overall prevalence of stunting decreased from 13.9% to 11.0%. After statistical
      adjustment, the factors found to influence the evolution of anthropometric status
      were: age of child, age of mother, schooling of mother and household
      characteristics such as number of preschool children, economic level and head of
      household's occupation. CONCLUSIONS: The study enables the negative effects of
      the economic crisis to be quantified. Body mass index is shown to be sensitive to
      economic changes. It could be recommended as a possible indicator for monitoring
      the nutritional status at population level. The results also call for a new
      impetus in preventive health programmes and the implementation of nutritional
      surveillance activities.

PMID- 7797341
TI  - Prognostic models and the propensity score.
AB  - Subjects in observational studies of exposure effects have not been randomized to
      exposure groups and may therefore differ systematically with regard to variables
      related to exposure and/or outcome. To obtain unbiased estimates and tests of
      exposure effects one needs to adjust for these variables. A common method is
      adjustment via a parametric model incorporating all known prognostic variables.
      Rosenbaum and Rubin propose adjustment by the conditional exposure probability
      given a set of covariates which they call the propensity score. They show that,
      at any value of the propensity score, covariates are on average balanced between
      exposure groups. Thus matching on the propensity score leads to unbiased
      estimators and tests of exposure effect. However, the validity of the method
      depends on knowing the exposure probability. This quantity is usually not known
      in observational studies and needs to be estimated.

PMID- 7797340
TI  - Application of Markov process modelling to health status switching behaviour of
      infants.
AB  - BACKGROUND: This study is an attempt to apply Markov process modelling to health
      status switching behaviour of infants. The data for the study consist of monthly
      records of diagnosed illnesses for 1152 children, each observed from the month of
      first contact with Kasangati Health Centre, Kampala, Uganda, until age 18 months.
      METHODS: Only two states of health are considered in the study, a 'Health' state,
      denoted by W: (for Well), and an 'Illness' state denoted by S: (for Sick). The
      data are thus reduced to monthly records (W or S) of the states of health of the
      study sample. The simplest model of dependence of current health state on the
      past is one that links the current state to the immediately preceding month only;
      that is a Markov model. The starting point of this study was therefore to
      determine the proportions of children making the transitions W-->W, W-->S, S-->W,
      S-->S, from one month to the next, for each month from birth (month 0) to 18
      months of age (month 18). These were used as estimates of the probabilities of
      making these transitions for each month from birth. This paper discusses the main
      features emerging from the study of these transition probabilities. RESULTS: In
      the first 5 months after birth, the probabilities of making the transitions W-
      >W, W-->S, S-->W, S-->S from one month to the next, showed some dependence on the
      age of the child. From the sixth month on, however, the dependence on age seemed
      to wear off. The transition probabilities remained the same from then on,
      suggesting that the switching pattern between health states behaves, eventually,
      like a time-homogeneous Markov Chain. This time-homogeneous chain attained a
      steady state distribution at about 12 months from birth. CONCLUSIONS: The study
      has shown that the transitions between Health and Illness for infants, from month
      to month, can be modelled by a Markov Chain for which the (single-step)
      transition probabilities are generally time-dependent or age-dependent. After the
      first few months of life the dependence on age may wear off, as in this study,
      leading to a time-homogeneous Markov Chain, which eventually attains a steady
      state distribution in about 12 months. Interpretations of the transition
      probabilities as measures of disease prevalence are discussed.

PMID- 7797343
TI  - Combined oral contraceptives and risk of cervical carcinoma in situ. WHO
      Collaborative Study of Neoplasia and Steroid Contraceptives.
AB  - BACKGROUND: Although the possible influence of oral contraceptives on risk of
      cervical carcinoma in situ has been the subject of multiple prior investigations,
      the results have been inconsistent. METHODS: Data from a multinational,
      collaborative case-control study were analysed to investigate further this
      possible relationship. To assess potential screening bias, some statistical
      analyses were restricted to subgroups of cases with and without symptoms at the
      time of their diagnosis. RESULTS: Relative risk estimates in relation to various
      features of oral contraceptive use tended to be highest for asymptomatic disease,
      lowest for disease presenting with vaginal bleeding, and intermediate for disease
      presenting with other symptoms, suggesting the presence of a screening bias. In
      women with vaginal bleeding, who are least likely to have been detected by
      routine screening, no elevated risk of cervical carcinoma in situ was observed in
      relation to ever having used combined oral contraceptives, but there was an
      increased risk in users of over 60 months' duration. An increasing trend in risk
      with duration of use was most pronounced in these women who first used oral
      contraceptives in the past 5-10 years; and in women who used oral contraceptives
      for more than 60 months, risk declined with time since last use. CONCLUSION:
      These findings could reflect a reversible effect of long-term use of oral
      contraceptives at an intermediate stage in the carcinogenic process, or a non
      causal relationship due to unidentified sources of bias or confounding.

PMID- 7797342
TI  - Modelling AIDS reduction strategies.
AB  - BACKGROUND: Mathematical models of the AIDS epidemic have not been able to give
      accurate predictions about the size of the epidemic because it is not possible to
      obtain sufficiently accurate measurements of the factors that enable HIV
      transmission. The uncertainties inherent in models of the AIDS epidemic appear to
      limit their relevance to epidemiologists. However, it is shown here that the
      uncertainties need not prevent models being used to make reliable decisions about
      which preventive strategy will be most effective. METHOD: A range of strategies
      are simulated in a model of the AIDS epidemic. The simulations are repeated as
      the value of what seems to be the most important uncertain factor, is varied. The
      effect of this variation on the effectiveness of each strategy is noted. In
      principle, the process could be repeated whilst all other uncertain factors are
      varied as well. RESULTS: Although varying one uncertain factor created enormous
      variation in the size of the epidemic, it is remarkable that for most preventive
      strategies the relative effectiveness of the strategies was barely altered. Hence
      for the most part the ranking of strategies in order of effectiveness is not
      affected by the area of uncertainty explored here. The results also highlight the
      potential effectiveness not only of general condom promotion, but also the use of
      circumcision and spermicides and general screening or targetted screening in
      sexually transmitted disease clinics. CONCLUSIONS: Epidemiological modelling may
      accurately rank the effectiveness of interventions although it may fail to
      predict the size of the epidemic.

PMID- 7797344
TI  - Evidence of serological cross-reactivities with human immunodeficiency virus
      types 1 and 2 and human T-lymphotropic virus types I and II in sera of pregnant
      women in Ibadan, Nigeria.
AB  - BACKGROUND: Our previous studies have indicated that the human immunodeficiency
      virus (HIV) and human T-lymphotropic virus (HTLV) groups of retroviruses are
      endemic among various populations in Nigeria. These viruses are antigenically
      distinct and antibodies to HIV and HTLV do not cross-react, so we studied the
      prevalence of HIV-1, HIV-2, HTLV-I and HTLV-II antibodies in sera of pregnant
      women attending an antenatal clinic in Ibadan, Nigeria. METHODS: In all, 364 sera
      were screened using three different enzyme immunoassays, including those that
      distinguished HIV-1 antibodies from HIV-2, and HTLV-I antibodies from HTLV-II.
      All repeatedly reactive sera were confirmed by Western blots and synthetic
      peptide assays for the respective viruses. RESULTS: Overall, 71 sera (19.5%) had
      antibodies to HIV, HTLV or both groups of retroviruses. Most (95.8%) of the
      reactive samples were from women 20-29 years old. Two of five sera from
      individuals < 20 years old reacted for HIV antibodies while one serum from a 40
      year old woman was reactive for HTLV-I antibodies. Of the 71 reactive sera, 29
      (8%) had antibodies to HIV (HIV-1 = 14, HIV-2 = 9, HIV-1/2 = 6) and 42 samples
      (11.5%) showed antibodies to HTLV (HTLV-I = 20, HTLV-II = 14, HTLV-I/II = 8).
      Seven of 71 seropositive samples (9.8%) reacted for both HIV and HTLV antibodies
      in various combinations, including one serum that showed antibody reactivities to
      all four retroviruses (i.e. HIV-1, HIV-2, HTLV-I and HTLV-II). CONCLUSIONS: The
      high prevalence of antibodies to subtypes of the two entirely distinct retrovirus
      groups in young women has important implications for defining epidemiological
      patterns of diseases associated with co-infections with two or more retroviruses.

PMID- 7797345
TI  - Epidemiology and control of infant and early childhood malaria: a competing risks
      analysis.
AB  - BACKGROUND: Against increasing malaria problems in most tropical countries, very
      little is known about the socio-epidemiological determinants of this condition.
      METHODS: Using extensive information on a representative sample of 9774 newborns
      followed for 2 years and multi-state hazards models, this study investigates
      jointly the determinants of paediatric mortality from malaria and other causes.
      RESULTS: Malaria contributes to one out of every 10 infant deaths. Malarial
      mortality covaries with dwelling conditions, antenatal care attendance, parity,
      infant feeding practices, intercurrent infections, and child's immunization
      status. Lack of antenatal care, lack of immunization in childhood and sub
      standard living conditions of overcrowding are the major risk factors of malarial
      and non-malarial mortalities, even after correcting for unobserved heterogeneity.
      CONCLUSIONS: These findings suggest that the impact of malaria on infant and
      early childhood health and survival might be much more important than usually
      thought. Antenatal care attendance, improved housing conditions and childhood
      immunization practices are potentially cost-effective strategies for malaria
      control. The competing risks analysis formulated here is offered as a suitable
      means of analysing cause-specific mortality differentials.

PMID- 7797346
TI  - An outbreak of hepatitis A among homosexual men in Amsterdam, 1991-1993.
AB  - BACKGROUND: When in August 1992 it became evident that an outbreak of hepatitis A
      virus infections (HAV) was taking place in the male homosexual community in
      Amsterdam a case-control study was conducted to validate the assumption that the
      outbreak was associated with sexual practices involving oro-anal and digital-anal
      contact and frequent visits to gay saunas and darkrooms. METHODS: In all, 37
      cases reported to the Amsterdam Municipal Health Service (AMHS) in the period
      December 1991 to March 1993 and 68 anti-HAV negative controls completed an
      anonymous questionnaire concerning the practice of different sexual techniques
      and the number of visits to gay saunas and darkrooms in the 2 months preceding
      the onset of illness or date of interview. Controls were recruited from healthy
      homosexual men participating in a prospective study on HIV/AIDS conducted by the
      AMHS. RESULTS: In univariate analysis a statistically significant association was
      found between visits to gay saunas and darkrooms, the number of visits to these
      locations (OR = 8.2) and HAV infection. In the logistic regression analysis the
      association for visits to saunas and darkrooms remained significant (OR = 10)
      whereas high-risk sexual techniques could not be included in the model.
      CONCLUSIONS: These results indicate that to prevent future outbreaks of HAV in
      male homosexuals in Amsterdam there is a need to stress in the 'safe sex'
      campaigns, directed at the prevention of HIV infection or in additional
      campaigns, the prevention of other sexually transmitted disease including HAV
      infection with emphasis on routes associated with certain sexual techniques and
      on visits to gay saunas and darkrooms.

PMID- 7797348
TI  - Helicobacter pylori infection in rural settlements (Kibbutzim) in Israel.
AB  - BACKGROUND: Helicobacter pylori (HP) is accepted as a major cause of type B
      gastritis, which is strongly associated with peptic ulcer disease.
      Epidemiological studies have indicated a correlation of HP infection and
      socioeconomic class. METHODS: To determine the prevalence of HP infection and to
      evaluate symptoms and risk factors associated with HP infection in a rural
      population, 377 asymptomatic individuals were studied out of a random sample of
      453 people. Subjects were randomly chosen in a ratio of 1:4 of all the adults
      over 30 years, living in eight communal settlements in Israel. Blood samples were
      taken and subjects answered a questionnaire in which sociodemographic
      information, clinical gastrointestinal background and the use of medication were
      included. A sensitive enzyme-linked immunoassay was used to determine antibodies
      to HP in serum. RESULTS: The overall prevalence of HP infection was 72%. In a
      multivariant discriminant analysis: age, country of origin and ethnic group were
      found to be the most closely associated variables for HP infection and the
      discriminant analysis succeeded in predicting correctly, in 62% of the
      population, whether they had or did not have HP infection. There was no
      significant difference with gender, occupation, educational level, blood group,
      smoking, gastrointestinal symptoms and use of medication. CONCLUSIONS: The
      prevalence of HP infection was higher than that in industrialized countries, but
      lower than in developing countries. The prevalence in a rural population was
      slightly higher than that of an urban population in Israel (65%). The country of
      origin and ethnic group influenced the prevalence of HP infection and not birth
      and growing up on the Kibbutz.

PMID- 7797349
TI  - Age-standardization in epidemiological data.

PMID- 7797347
TI  - Respiratory virus antibodies in adults of a Norwegian community: prevalences and
      risk factors.
AB  - BACKGROUND: The aims were to examine prevalences as well as demographic and
      environmental predictors of respiratory virus antibodies in serum. METHODS: In a
      cross-sectional study of 18-73 year old Norwegian adults a random stratified
      sample (n = 1512) was invited to attend an examination at an outpatient clinic.
      Seven respiratory virus antibodies were assessed by the complement fixation test.
      RESULTS: The attendance rate was 84%. The most frequent virus antibodies with
      titre of > or = 1:8 were influenza virus type A with a population standardized
      prevalence of 44%, adenovirus 25% and influenza virus type B 22%. The prevalences
      of antibodies against parainfluenza virus type 1, 2 and 3 increased with age.
      Smokers compared to non-smokers had an adjusted odds ratio (OR) of 1.7 (95%
      confidence interval [CI]: 1.3-2.4) for having one or more of the seven examined
      virus antibodies. The presence of one or more of the virus antibodies increased
      from summer to winter months (adjusted OR = 1.3 per month; 95% CI: 1.2-1.4) and
      it was higher in occupational dust or gas exposed smokers (adjusted OR = 2.0; 95%
      CI: 1.1-3.7) compared with unexposed smokers. CONCLUSIONS: Ageing, smoking,
      occupational dust or gas exposure as well as season of the year may thus be
      predictors for levels of respiratory virus antibodies in adults. These
      observations should be taken into account when comparing prevalences of virus
      antibodies in various communities as well as when examining the relationship
      between presence of virus antibodies and airway disease.

PMID- 7797350
TI  - Age-standardization in epidemiological data.

PMID- 7797351
TI  - Coffee and blood lipids in women.

PMID- 7797352
TI  - Excess female fatalities among patients with meningococcal disease.

PMID- 7797353
TI  - Infant breastfeeding and the risk of childhood lymphoma and leukaemia.
AB  - BACKGROUND: A protective effect of breastfeeding on childhood lymphoma has been
      indicated but supportive evidence is limited. METHOD: Data from a population
      based case-control study of childhood cancer in Shanghai, including 82 lymphoma
      cases and 159 acute leukaemia cases and their age- and sex-matched community
      controls, were analysed. RESULTS: After adjustment for potentially confounding
      variables, a slight, although non-significant, reduction in risk of lymphoma was
      observed among children who were breastfed as infants versus those who were not
      (odds ratio [OR] = 0.69; 95% CI: 0.3-1.7). The reduction was somewhat greater for
      children who had been breastfed longer and appeared to pertain primarily to
      Hodgkin's disease and to cases diagnosed before the age of 6 years. As expected,
      there was no reduction in risk of acute leukaemia associated with breastfeeding.
      CONCLUSIONS: Although providing neither strong support for nor refuting the study
      hypothesis, these data suggest that if breastfeeding does reduce the risk of
      lymphoma, its protective effect among Chinese children is likely modest in
      magnitude and concentrated in certain subgroups defined by length of
      breastfeeding, age at diagnosis and histological subtype of cancer.

PMID- 7797354
TI  - Dietary factors and stomach cancer: a case-control study in Korea.
AB  - BACKGROUND: Stomach cancer is the most common cancer among Koreans. There is wide
      agreement that dietary factors are important in gastric carcinogenesis, but the
      role of many Korean food items remains unknown. METHODS: A case-control
      investigation involving 213 incident cases of histologically confirmed stomach
      cancer and an equal number of controls, matched by age (within 2 years) and sex,
      was conducted from June 1990 to October 1991. RESULTS: An increased risk of
      stomach cancer was noted among those with high consumption of stewed foods such
      as soybean paste stew and hot pepper-soybean stew, broiled fish, and those who
      liked salty food. However, mung bean pancake, tofu (soybean curd), cabbage,
      spinach, and sesame oil decreased the risk of stomach cancer. Stratified analysis
      by salt in combined foods, such as stewed foods and pickled vegetables, disclosed
      salt as being an important risk factor. Analysis of cooking methods showed that
      broiling and salting increased the risk of stomach cancer, but that frying tended
      to decrease the risk. These results suggest that the cooking method might modify
      the gastric carcinogenicity of foods. As non-dietary factors, smoking and a
      family history of stomach cancer increased the risk, but use of a refrigerator
      decreased the risk of cancer. CONCLUSIONS: Heavy salt consumption and cooking
      methods like broiling and salting seem to play a major role in gastric
      carcinogenesis among Koreans.

PMID- 7797355
TI  - A case-control study of physical activity in relation to risk of cancer of the
      right colon and rectum in men.
AB  - BACKGROUND: Epidemiological data suggest that physical activity is modestly or
      moderately protective against colorectal cancer. Additional data are needed to
      define better the slope of the dose-response curve and to clarify the types of
      activities that appear most protective. METHODS: We examined the relation between
      occupational and vigorous leisure time physical activity and risk of cancer of
      the right colon and rectum in data from a case-control study conducted in New
      England from 1986 to 1988. We interviewed 163 cases with cancer of the right
      colon, 242 cases with cancer of the rectum, and 703 community controls. RESULTS:
      Vigorous leisure time physical activity was associated with a decreased risk of
      cancer of the right colon; for men exercising > or = 2 hours per week the odds
      ratio was 0.60 (95% confidence interval [CI]: 0.35-1.00) compared with those who
      did not exercise. Adjustment for potentially confounding factors, including diet,
      had essentially no effect on the association. Self-reported occupational activity
      was less strongly related to risk of right colon cancer; the odds ratio for heavy
      work was 0.70 (95% CI: 0.32-1.51). Occupational activity coded according to job
      title was essentially unrelated to risk of right colon cancer. An association
      between physical activity and decreased risk of rectal cancer was not present in
      these data. CONCLUSIONS: Our data add weight to the evidence that physical
      activity is related to decreased risk of colon cancer.

PMID- 7797356
TI  - Occupation, smoking and demographic factors, and renal cell carcinoma in Germany.
AB  - BACKGROUND: The role of occupational exposure in the aetiology of renal cell
      cancer is still not clear. In a population-based, case-control study we
      investigated occupational and smoking history as well as place of residence,
      marital and socioeconomic status. METHOD: In a case-control study in Germany, 277
      adult cases with incident renal cell cancer and 286 controls frequency-matched to
      the cases for age and gender have been interviewed. The data were analysed by
      standard methods using unconditional logistic regression models, to estimate the
      relative risk (RR) and the corresponding 95% confidence interval (95% CI).
      RESULTS: Socioeconomic status was inversely associated (RR = 0.61, 95% CI: 0.3
      1.2 for highest category) with the risk for renal cell cancer. Heavy smoking gave
      an increased, but not significant (about twofold) RR in men and women for ex
      smokers and current smokers. Employment in metal-related industries (RR = 1.63,
      95% CI: 1.1-2.5) was also identified as a risk factor. Additionally, we found an
      elevated risk associated with exposure to perchloroethylene and
      tetrachlorocarbonate (RR = 2.52, 95% CI: 1.2-5.2) but no time trend could be
      observed. No associations were found for other occupational exposures, such as
      working in the chemical industry, transportation or farming nor for exposure to
      pesticides. CONCLUSIONS: The results of our study lead to the suggestion that
      smoking, occupation and demographic factors probably play a minor role in the
      aetiology of renal cell cancer.

PMID- 7797357
TI  - Long-term prognosis of different forms of coronary heart disease: the Reykjavik
      Study.
AB  - BACKGROUND: While coronary heart disease (CHD) is a serious and often fatal
      disease the prognosis is variable and major effort has been invested in risk
      stratification. The purpose of this study was to examine the relation between
      long-term prognosis and risk factors in different clinical categories of CHD.
      METHODS: A general population sample of 9141 men, aged 34-79 at entry into the
      study was divided into six groups with respect to manifestations of CHD at entry:
      I. Symptomatic infarction. II. Silent or unrecognized infarction. III. Angina
      pectoris with ischaemic changes on ECG. IV. Angina without ischaemic changes. V.
      Angina by Rose questionnaire but not confirmed by a physician. VI. No
      manifestations of CHD. RESULTS: The risk factor profile varied considerably
      between the different categories and by life-table analysis marked differences in
      survival were demonstrated between the groups. The risk factors maintained their
      detrimental effects on prognosis in the presence of CHD. Thus, age, serum total
      cholesterol, impaired glucose tolerance and smoking were found by Cox's
      regression to be statistically significant independent risk factors of CHD
      mortality among men having manifestations of CHD (groups I-V). Furthermore, the
      composite risk score, a measure of the overall risk factor exposures had marked
      effect on the prognosis of the various CHD groups. When the comprehensive risk
      factor score for both CHD mortality and all-cause mortality was accounted for
      marked differences persisted in the long-term prognosis. Compared to those
      without CHD the infarct groups had about a 7.6- and 3.7-fold risk of dying from
      CHD and all causes respectively. Those with angina had from 2.5- to 3.2-fold risk
      of CHD mortality and 1.7- to 2.2-fold risk of all-cause mortality depending on
      the subgroup of angina, again compared to those without manifestations of CHD.
      CONCLUSION: Different categories of CHD had different risk factor profiles and
      the long-term prognosis resulted from a complex interplay between those factors
      and the diagnostic category of CHD. The risk factors maintained their detrimental
      effects on prognosis in the presence of CHD and after accounting for the
      comprehensive risk factor score marked differences persisted in the long-term
      prognosis, being worst for those having suffered a myocardial infarction, either
      symptomatic or silent.

PMID- 7797358
TI  - Longitudinal development of lipoprotein levels in males and females aged 12-28
      years: the Amsterdam Growth and Health Study.
AB  - BACKGROUND: In the Amsterdam Growth and Health Study, the longitudinal
      development of risk factors for coronary heart disease (CHD) was investigated.
      METHODS: Serum cholesterol (TC), high density lipoprotein (HDL) and the TC/HDL
      ratio were measured at the ages of 13, 14, 15 and 16 years (adolescence) and at
      the ages of 21 and 27 years ([young] adulthood). RESULTS: No cohort, time of
      measurement, drop-out or test/learning effects were found for TC, HDL and the
      TC/HDL ratio. For males the longitudinal development of TC showed a dip in the
      adolescent period, while females showed constant values. For both males and
      females TC values increased during young adulthood, but females had higher (P <
      or = 0.001) absolute values than males. The HDL values for males decreased
      throughout the measurement period, while for females a stable period during
      adolescence was followed by a slight increase during adulthood. For the TC/HDL
      ratio males showed an increase during young adulthood, while females stayed more
      or less constant over the whole measurement period. The percentages of subjects
      above (or below for HDL) objective risk values increased with age: from 0% to 1%
      during adolescence to 11% (males) and 14% (females) for TC, 5% (males) and 1%
      (females) for HDL and 13% (males) and 1% (females) for the TC/HDL ratio.
      CONCLUSIONS: In a relatively young and healthy population TC and TC/HDL values
      tended to rise with age (especially in males) indicating that prevention related
      to these risk factors for CHD should start early in life.

PMID- 7797360
TI  - Cancer mortality in migrant populations within Italy.
AB  - METHODS. Mortality rates for four types of cancer (stomach, colorectal, lung, and
      breast cancer) in migrant populations were compared to those of individuals who
      still resided in the political region in which they were born. The effects on
      mortality rates of place of birth and of place of residence were studied,
      comparing different regression models. RESULTS. Overall, people who were born in
      the South and who later migrated had significantly higher mortality rates than
      the southern population, but lower than the population in the area of residence,
      for most cancers. Place of birth and place of residence showed different power in
      explaining the observed mortality rates for different cancer sites: place of
      birth was a stronger predictor for stomach and breast cancers, while residence
      was a stronger predictor for lung and colorectal cancers. The status of 'migrant'
      was found to be an overall risk factor. The compatibility of the results obtained
      with different aetiological hypotheses is discussed.

PMID- 7797359
TI  - Pubertal serum lipoprotein (a) and its correlates in Belgian schoolchildren.
AB  - BACKGROUND: Serum lipoprotein (a) (Lp(a)) is an independent risk factor for
      premature coronary artery disease in Caucasians. Generally Lp(a) serum levels
      remain fairly constant throughout an individual's life, but are presumably
      modulated by sex hormones. This study documents the distribution and correlates
      of serum Lp(a) during sexual maturation in Belgian children. A comparison with
      Lp(a) levels in Belgian adults is made. METHODS: Serum Lp(a), lipid and
      apolipoprotein A-I and B levels were determined cross-sectionally in 266 Belgian
      schoolchildren and adolescents in relation to sexual maturation, anthropometrics
      and socioeconomic status. Sexual maturity was scored according to Tanner's
      classification. RESULTS: Median Lp(a) levels were 82, 117, 110, 100 and 73 mg/l
      at the five subsequent genital development stages in boys (ANOVA, P = 0.816), and
      73, 78, 204, 110 and 114 mg/l at the five breast development stages in girls
      (ANOVA, P = 0.087). The Lp(a) distributions in boys and girls were skewed to the
      right, overall medians being 82 and 94 mg/ml (P = 0.2537). The 90th and 95th
      percentiles were 515 and 712 mg/l respectively. The geometric Lp(a) mean in
      children was significantly higher compared to that in 683 sex-matched Belgian
      adults (89 mg/l versus 69 mg/l, P = 0.006). Multiple linear regression pointed
      out that developmental age, chronological age, body mass index and/or systolic
      blood pressure predicted serum lipid and apolipoprotein levels, but none of the
      Lp(a) variance. CONCLUSION: Pubertal stage was not correlated with Lp(a) levels
      in Belgian schoolchildren, supporting the contention that serum Lp(a) is
      predominantly genetically controlled.

PMID- 7797361
TI  - Comparison of three methods for estimating environmental tobacco smoke exposure
      among children aged between 12 and 36 months.
AB  - BACKGROUND: The methods currently used for measuring environmental tobacco smoke
      (ETS) exposure among small children all have their limitations. The aim of this
      study was to compare the results of questionnaire assessments of children's ETS
      exposure with cotinine measurements in urine and nicotine measurements in hair, a
      new method for estimating average ETS exposure. METHODS: Questionnaire
      information on ETS exposure and a sample of hair were collected from 94 children
      aged 12-36 months. A urine sample for cotinine analysis was obtained from 72 of
      the children. RESULTS: Nicotine was found in all hair samples and cotinine in all
      urine samples. Compared to children registered as unexposed by the questionnaire,
      hair nicotine levels were 12.4 times higher among children exposed to more than
      10 DNC (daily number of cigarettes) (P < 0.001) and 3.6 times higher among
      children exposed to 1-10 DNC (P < 0.001). The median cotinine creatinine ratio
      (CCR) was 2.4 times higher among children exposed to more than 10 DNC compared to
      unexposed children (P < 0.001). No significant difference in median CCR was found
      between unexposed children and children exposed to 1-10 DNC. The correlation
      coefficient was 0.64 between children's hair nicotine levels and DNC, 0.50
      between CCR and DNC and 0.56 between children's hair nicotine levels and CCR.
      CONCLUSION: Nicotine measurement in hair is a practical and valid method for
      estimating average ETS exposure in children. An underreporting of ETS exposure
      was indicated.

PMID- 7797363
TI  - Tubulovesicular elements in Blastocystis hominis from the caecum of
      experimentally-infected rats.
AB  - By transmission electron microscopy (TEM), tubulovesicular elements were seen in
      Blastocystis hominis obtained from the caecum of experimentally-infected rats.
      These appeared to arise from the peripheral cytoplasm and were rounded, oval or
      elongate in sections. It is suggested that these elements form a network for
      transfer of nutrients to the periphery during the process of encystation.

PMID- 7797364
TI  - Echinococcus multilocularis protoscoleces and hepatic cell activity in vitro.
AB  - E. multilocularis protoscoleces were co-cultured with hepatic cells in the
      presence of IAR 20 or BALB/c 3T3 cells. Hepatocyte activity was determined by
      assaying transferrin and albumin secretion in culture media. The level of these 2
      plasma proteins is higher in hepatic/BALB/c 3T3 co-culture medium. In the
      presence of parasites, the transferrin level is unchanged while the production of
      albumin is stimulated during the first 48 h. Our results suggest that the albumin
      production could be attributed to a complex cellular cooperation between
      hepatocytes and activated Kupffer cells as previously observed in the acute
      inflammatory reaction.

PMID- 7797365
TI  - Comparison of the course of infection with Giardia muris in male and female mice.
AB  - The infection with Giardia muris in male and female C57BL/6 mice was
      characterized by enumerating cyst release in the feces and trophozoite burden in
      the small intestine. Cyst release differed between males and females during the
      course of the primary and challenge infections. Males and females released
      similar numbers of cysts in the feces during the acute phase of the infection.
      However, the trophozoite burden was significantly higher in males during the same
      period. Males released cysts in their feces longer than females and trophozoites
      present in their intestines for a longer period than females. From day 18 of
      infection the females did not release cysts in their feces, while males continued
      to do so for at least 60 days. Thus, distinct differences exist between male and
      female mice in their ability to harbor and eliminate this intestinal parasite.

PMID- 7797362
TI  - Chronic bronchitis and the type of cigarette smoked.
AB  - BACKGROUND: Smoking is a well known primary risk factor for chronic bronchitis.
      However, little is known about the relationship between different types of
      cigarettes smoked and chronic bronchitis. OBJECTIVE: To determine the association
      between chronic bronchitis and the type of cigarette smoked. METHODS: A cross
      sectional prevalence study was conducted in an urban area (Pelotas) of Southern
      Brazil. A total of 1053 subjects aged > or = 40 years were interviewed about
      respiratory symptoms and some risk factors for chronic bronchitis. RESULTS: After
      adjustment for confounding factors, the number of daily cigarettes smoked was
      strongly associated with the risk of chronic bronchitis (odds ratio [OR] = 8.10,
      95% CI: 4.46-14.71 for smokers of > or = 20 cigarettes per day compared to non
      smokers). Among smokers, maize leaf cigarettes showed the highest risk (OR = 5.43
      compared to non-smokers, 95% CI: 2.65-11.13) and filter cigarettes the lowest (OR
      = 2.19, 95% CI: 1.19-4.03). CONCLUSIONS: In addition to the number of cigarettes
      smoked, the use of maize leaf cigarettes was shown to have an important
      independent association with chronic bronchitis.

PMID- 7797366
TI  - Dictyocaulus viviparus: nucleotide sequence of Dv3-14.

PMID- 7797367
TI  - The fatty acids of each lipid fraction and their use in providing energy source
      of the plerocercoid of Spirometra erinacei.
AB  - The fatty acid concentration of each lipid fraction of plerocercoids of
      Spirometra erinacei and the host snake serum was investigated. The major fatty
      acids of phospholipid of the plerocercoids were C18:1, C18:0 and C16:0, and those
      of the host snake serum were C16:0, C18:1 and C18:0, in order of amount in both
      cases. The changes of the fatty acid composition of phospholipid of the
      plerocercoids when they were incubated in physiological saline at 18 degrees C
      and at 37 degrees C for 24 h were investigated in both cases. Polyunsaturated
      fatty acids increased at 18 degrees C, and saturated fatty acids increased at 37
      degrees C. Michaelis constants (Km) of beta-hydroxyacyl-CoA dehydrogenase (HAD),
      NADH: ubiquinone oxidoreductase (complex I) (NADH: ferricyanide reaction) and
      complex I (NADH: ubiquinone reaction) for NADH were 20.6, 50 and 13.3 microM,
      respectively. The ATP production in mitochondria of the plerocercoids was
      accelerated by adding ADP and inhibited by adding such electron transport system
      inhibitors as rotenone, antimycin A and sodium cyanide. These results suggested
      that the fatty acids in the plerocercoids played an important role in regulating
      the fluidity of membrane by changing the composition in membrane lipid
      corresponding with the change of temperature circumstance. The NADH reduced by
      HAD might be accepted by the complex I in the electron transport system, and thus
      the parasites were capable of ATP production in a classical pathway of the
      oxidative phosphorylation system.

PMID- 7797369
TI  - Effects of haemagglutination (lectin) inhibitory sugars on Theileria parva
      infection in Rhipicephalus appendiculatus.
AB  - We have previously described the presence of haemagglutinins in tissues of the
      tick, Rhipicephalus appendiculatus and determined their sugar specificities by
      inhibition experiments. In this study, haemagglutination inhibitory sugars are
      shown to have an effect in vivo on the abundance of Theileria parva infected
      salivary gland acini in Rhipicephalus appendiculatus. A significant increase (P <
      0.05) was observed in T. parva acinar infection rates in the salivary glands of
      R. appendiculatus fed on ears of rabbits infused with melibiose and raffinose. In
      contrast, mannose and turanose (non-haemagglutination inhibitory sugars) did not
      cause elevation of T. parva acinar infection rates. The effect of melibiose in
      elevating acinar infections was observed when used only during T. parva
      maturation in the salivary glands but not during parasite pick-up from an
      infected bovine host. Stabilates produced from ticks with elevated acinar
      infections did not differ from control stabilates in infectivity to cattle, by
      comparison of prepatent periods to pyrexia, or parasitosis, or in the severity of
      reactions.

PMID- 7797370
TI  - Histopathology of cultured sea bass (Lates calcarifer) (Centropomidae) infected
      with Cruoricola lates (Trematoda: Sanguinicolidae) from Pulau Ketam, Malaysia.
AB  - Cruoricola lates are found throughout sea bass (Lates calcarifer), most commonly
      in the mesenteric blood vessels, kidney, pericardial vessels, and eye. Eggs of C.
      lates were predominantly found in the gills, ventricle, hepatopancreas, and
      kidneys, but only develop to miracidia regularly in the gills and heart. Single
      miracidia escaping appear to cause little damage, but groups induce an
      inflammatory response and haemorrhage. Endocardial macrophages encapsulate eggs
      trapped between trabeculae in the heart. The reaction to eggs in the kidneys,
      hepatopancreas and spleen consists of fibrocytic encapsulation. Infection at the
      levels observed in this study were insufficient to cause lethal pathological
      changes, but could result in reduced food conversion ratios or impaired
      immunological capacity.

PMID- 7797371
TI  - Geographic compatibility of the freshwater snail Bulinus globosus and
      schistosomes from the Zimbabwe highveld.
AB  - Populations of Bulinus globosus were sampled from two rivers, 60 km apart, in
      northern Zimbabwe, and offspring from each geographic strain reared in the
      laboratory. Schistosomes were harvested from each strain and also maintained in
      the laboratory. Cross-infection experiments were conducted, whereby snails of
      both geographic strains were exposed to parasites of both geographic strains.
      Compatibility was found to be related to: (i) the geographic origin of the snail,
      and (ii) an interaction between the geographic origin of snail and parasite, such
      that sympatric combinations of snails and parasites produced a greater proportion
      of compatible infections than allopatric combinations. Cercarial output of
      infected snails was found to be related to the geographic origin of the parasite,
      but not of that of the snail. It is suggested that, as the snails used were
      laboratory bred and naive to schistosome infection, differences in snail
      schistosome compatibility were genetically determined, rather than an adaptive
      response. This study supports earlier work which suggests the existence of
      geographic compatibility amongst natural populations of snails and trematodes,
      indicative of either increased infectivity by the parasite, or decreased
      resistance by the snail.

PMID- 7797368
TI  - Physiology of two strains of Trichostrongylus colubriformis resistant and
      susceptible to thiabendazole and mucosal response of experimentally infected
      rabbits.
AB  - Two strains of Trichostrongylus colubriformis of ovine origin, one resistant and
      one susceptible to thiabendazole, were compared during experimental infection in
      rabbits. Groups of rabbits were infected with 5000 infective larvae (L3) of
      either the resistant or the susceptible strain. On days 21 and 42 post-infection
      (p.i.), 5 rabbits of each group were killed and the small intestine divided into
      three sections for worm counts and histological or biochemical analysis. Faecal
      egg counts were performed twice a week from day 15 to day 42 p.i. The physiology
      of the worms was characterised by in vitro acetylcholinesterase secretion of
      adult worms. The host inflammatory response was determined by peroxidase activity
      in mucosal homogenates and by histological counts of mast cells and eosinophils.
      Infectivity was not significantly different between the two strains. However, egg
      production was delayed and was significantly lower for the resistant strain.
      Conversely, in vitro secretion of resistant worms was significantly higher than
      the susceptible ones. The mucosal homogenetates of rabbits infected with the
      resistant strain had significantly higher levels of peroxidase activity in the
      duodenum on days 21 and 42 p.i. Mast cell counts were also significantly higher
      in the duodenum on day 42 p.i., in rabbits infected with the resistant strain. No
      difference was observed in the eosinophil counts. These results suggest that
      genetic variation in the nematode, such as anthelminthic resistance, is
      associated with variations in worm biology and physiology as well as differences
      in the inflammatory response of the host.

PMID- 7797372
TI  - Ultrastructure of the surface structures of Allodiscocotyla diacanthi
      (Polyopisthocotylea: Monogenea) from the gills of the marine teleost fish,
      Scomberoides tol.
AB  - Scanning and transmission electron microscopic studies have been made of the
      surface architecture of the fish-gill parasite, Allodiscocotyla diacanthi.
      Observations of the haptor region have revealed the presence of cushion-like
      supports at the base of each clamp, together with a pair of anchor-hooks. Other
      topographical features observed included a mid-ventrally positioned genital
      atrium and a ventrolateral vaginal pore. Tegumental serrations, composed of
      electron-dense bars, partially cover the hindbody, and their presence may serve
      in the adhesive attitude of the worm, in response to the flow of displacement
      water currents. The tegumental syncytium contains numerous dense granules and
      lucent vesicles, the contents of which are released into the cytosol of the
      syncytium. The clamp sclerites are invested with tegument which, in some
      specimens, contained inclusions resembling bacteria. Groups of neurons containing
      characteristic dense-cored vesicles were observed frequently in the clamp region.
      Each jaw of the clamp is distinguished by the presence of approximately 175 non
      ciliated putative sensory endings, and a pair of cone-like sensillae occurs on
      the ventral surface of the lappet. Additionally, the entire body surface of the
      worm is covered with some 3000-4000 unicilated structures that are presumed to be
      sensory in nature.

PMID- 7797373
TI  - Studies on the morphological changes in the midguts of two ixodid tick species
      Boophilus microplus and Rhipicephalus appendiculatus during digestion of the
      blood meal.
AB  - Light and electron microscopy were used to study the morphological changes which
      accompanied feeding and digestion of the blood meal in the midgut epithelium of
      two ixodid tick species Boophilus microplus and Rhipicephalus appendiculatus. In
      unfed ticks of both species, the midgut epithelium was lined by stem cells and
      empty digest cells in which haematin accumulated with starvation. On attachment
      to its hosts, differentiation of the stem cells and the loss of haematin from the
      midgut epithelium, seemed to be synchronous. Digestive activity with the
      appearance of the digest cell series started in the anterior end of the midgut
      when it came in contact with the blood meal. Although various stages can be
      distinguished, it would appear that these are in reality phases of activity of a
      single cell type--the digest cell. No additional evidence was obtained on other
      cell types.

PMID- 7797374
TI  - The effect of level of feed intake on the pharmacokinetic disposition of
      oxfendazole in sheep.
AB  - Oxfendazole (OFZ) containing a trace of [14C]-OFZ was administered intraruminally
      and intravenously to sheep fitted with rumen and abomasal cannulae and which were
      being fed 800 and 400 g of 50:50 lucerne:wheaten chaff daily. The [14C] was
      extensively associated with rumen particulate digesta, the shorter residence time
      of digesta in sheep on high compared to low feed intake reduced the duration of
      OFZ absorption. Abomasal fluid flow was greater in sheep on high than low intake
      and was attributed to increased gastric secretions. At high intake a greater
      proportion of the [14C] dose flowed from the abomasum in digesta fluid, but its
      residence time in the abomasum was of shorter duration compared with low intake.
      The more rapid passage of digesta through the gastrointestinal tract in the
      former sheep reduced the duration for drug desorption from particulate material
      and absorption into the bloodstream. In these high intake sheep and availability
      of [14C]-compounds in plasma was lower and more rapidly cleared than in sheep on
      low feed intake. Concomitant with the reduced absorption a greater proportion of
      the dose was excreted in faeces, and a lower proportion in the urine of sheep on
      high compared with low feed intake. The extensive association of OFZ and its
      metabolites with rumen digesta, is a principal determinant of OFZ kinetics.

PMID- 7797375
TI  - The effect of reduced feed intake on the efficacy of oxfendazole against
      benzimidazole resistant Haemonchus contortus and Trichostrongylus colubriformis
      in sheep.
AB  - Within 12 h of reducing the daily intake of a 50:50 lucerne and wheaten hay
      ration from 800 to 400 g, there was an increase in digesta marker concentration
      indicating a reduction in the flow rate of digesta fluid and particulates through
      the abomasum of sheep. The efficacy of the recommended dose of oxfendazole (OFZ)
      was then tested against benzimidazole resistant Trichostrongylus colubriformis
      and Haemonchus contortus in sheep whose feed intake was halved 36 h before and
      after drug treatment. In animals fed the reduced ration there was a 60% reduction
      of T. colubriformis and 94% reduction of H. contortus compared with a 19% and 60%
      reduction respectively on the higher feed intake. It is therefore suggested that
      greater anthelmintic efficacy can be achieved in sheep by temporary feed
      reduction.

PMID- 7797376
TI  - Differences in the second internal transcribed spacer (ribosomal DNA) between
      five species of Trichostrongylus (Nematoda: Trichostrongylidae).
AB  - The second internal transcribed spacer (ITS-2) of the ribosomal DNA of 5 species
      of Trichostrongylus has been sequenced. The ITS-2 of the 5 species was 237 or 238
      bases in length, and had a GC content of approximately 30%. No evidence of
      intraspecific variation was detected in the ITS-2 sequence of T. colubriformis,
      T. vitrinus or T. retortaeformis, irrespective of the life cycle stage examined.
      There was evidence, however, of variation at five positions in the ITS-2 sequence
      of T. vitrinus samples and at one position in T. axei, indicating intra
      individual variation in the sequence of different copies of the ribosomal DNA.
      Nonetheless, there were consistent sequence differences between the five
      Trichostrongylus species examined. The level of interspecific differences in
      nucleotide sequence was low (1.3-7.6%), with the species infecting birds (T.
      tenuis) being genetically more different to the four species found in mammals.
      Some of the nucleotide differences between species occurred at the recognition
      sites of endonucleases, which makes them of important diagnostic value for
      species identification. Also of significance are the recognition sites for
      several enzymes located within the regions of sequence homology for the five
      species of Trichostrongylus. These may prove useful in distinguishing between
      genera of trichostrongyle nematodes.

PMID- 7797377
TI  - Wuchereria bancrofti filariasis in French Polynesia: age-specific patterns of
      microfilaremia, circulating antigen, and specific IgG and IgG4 responses
      according to transmission level.
AB  - The age-specific patterns of microfilaremia, Og4C3 antigenemia, anti-Brugia
      malayi IgG and IgG4 were assessed in 3 villages of low, medium and high
      transmission level for Wuchereria bancrofti filariasis. The prevalence rates for
      each of the 4 markers were clearly age dependent and their patterns strongly
      associated with the transmission level. The antigenemia prevalence rate was
      consistently higher than the microfilaremia prevalence rate, in all age groups.
      The prevalences of anti-B. malayi IgG and IgG4 responses were very similar and
      much higher than those of microfilaremia or antigenemia. Antibody responses
      reached the plateau at an earlier age and at a higher prevalence with increased
      intensity of transmission. For all the markers, the prevalence rates were
      significantly higher in males than in females.

PMID- 7797378
TI  - Immunodiagnosis of human trichinellosis and identification of specific antigen
      for Trichinella spiralis.
AB  - Crude antigens obtained from the infective stage larvae of Trichinella spiralis
      were used in an ELISA for detecting IgG antibodies to T. spiralis in serum
      samples collected from three groups of individuals. The individuals of the first
      group were parasitologically confirmed trichinellosis patients, while those of
      group 2 were patients with other helminthiasis and group 3 were healthy, parasite
      free individuals. The specificity of the assay was 96.8% when performed on sera
      of groups 2 and 3. Cross-reaction was observed with the sera of patients with
      capillariasis, gnathostomiasis, opisthorchiasis, and strongyloidiasis and
      opisthorchiasis with hookworm infection. The sensitivity of the test was 100%
      when performed on sera of group 1, which were collected 57 days after infection.
      Western blot analysis revealed that a specific antigen for T. spiralis was a
      component of M(r) 109.

PMID- 7797379
TI  - Protective immunisation of guinea pigs against Dictyocaulus viviparus using
      excretory/secretory products of adult parasites.
AB  - Parasite preparations were examined for their ability to induce protective
      immunity against Dictyocaulus viviparus in guinea pigs. Dunkin-Hartley strain
      guinea pigs were immunised with somatic extracts of adult parasites, somatic
      extracts of third stage larvae or excretory/secretory (ES) products from adult
      parasites. The groups were immunised twice with Freund's adjuvant four weeks
      apart and challenged with 6000 infective L3. Significant levels of protective
      immunity were observed only in the adult ES-immunised animals. The antibody
      responses of the different groups were compared following analysis by ELISA and
      immunoprecipitation. To examine the protective role of antibody, guinea pigs were
      passively immunised with serum from animals immunised with adult ES products or
      serum from guinea pigs exposed to experimental D. viviparus infection. Following
      challenge with infective L3, lung-worm burdens of these groups were significantly
      lower than in guinea pigs which received normal sera. The results suggest that D.
      viviparus adult ES products contain protective antigens and that antibody
      mediated mechanisms contribute to immune protection.

PMID- 7797381
TI  - Photochemical bleaching of fluorescent glycosylation products.
AB  - We have examined the effect of visible light and ultraviolet on the non-enzymatic
      glycosylation of lysine in vitro. Glucose and L-lysine were mixed and incubated
      under white light, UV-A, UV-B, or in the dark. During 15 days of incubation in
      the dark, a heterogeneous mixture of intensely brown chromophores developed, with
      a dominant fluorescence excitation maximum at 350 nm and emission maxima near 425
      nm. The process was delayed or inhibited to a moderate extent by white light,
      whereas under UV-A and UV-B this effect was more pronounced. We conclude that non
      enzymatic glycosylation can be photochemically modulated by both visible light
      and ultraviolet.

PMID- 7797382
TI  - Axial and para-axial fluorophotometry in diabetic macular edema.
AB  - The vitreous fluorophotometric examinations were used in nonproliferative
      diabetic retinopathy to recognize early diabetic macular edema. Thanks to
      additional fixation light, axial and para-axial fluorophotometry in patients with
      nonproliferative diabetic retinopathy was achieved (Fluorotron Master, Coherent).
      The angle of deviation from the foveal scan (f) was 10 degrees in temporal (t)
      and nasal (n) directions. In case of non clinically significant macular edema,
      the posterior vitreous penetration ratio (PVPR) in the foveal scan (f) was
      significantly higher (p < 0.05) than in the other results (trend PVPRt < PVPRf >
      PVPRn).

PMID- 7797380
TI  - Protein glycation and in vivo distribution of human lens fluorescence.
AB  - Glycated proteins formed by the Maillard reaction were measured by furosine
      determination in human normal lenses and in senile and diabetic cataracts.
      Furosine, an hydrolysis product of fructose-lysine adduct formed in the early
      stages of the Maillard reaction, was measured by high performance liquid
      chromatography (HPLC). Furosine levels in diabetic cataracts were found to be 3
      to 4 times higher than those observed for senile cataracts. The increased
      glycation levels both in cortex and nucleus were related to the increase of
      fluorescence determined in vitro by fluorometry and in vivo by Scheimpflug
      photography. Lens proteins were incubated with glucose and it has been
      demonstrated that protein glycation occurred parallel with the increase in
      concentration of fluorescent chromophores that present similar characteristics as
      those observed in vivo. The results indicate that protein insolubilization seemed
      to involve preferentially glycated proteins and at least in diabetic cataracts,
      the process seems to be initiated in the cortical region.

PMID- 7797384
TI  - Corneal autofluorescence in diabetic and normal eyes.
AB  - Corneal autofluorescence has been lately studied as a predictor of retinopathy
      severity in diabetic patients. We measured corneal autofluorescence in 138 eyes
      of 69 diabetic patients and 64 eyes of 32 healthy controls. Diabetic patients
      were subdivided by the severity of retinopathy according to the Modified Airlie
      House Classification (stage 1: no or minimal retinopathy; stage 2: minimal
      background retinopathy; stage 3: background retinopathy; stage 4: (pre-)
      proliferative retinopathy. The fluorescence peak value and the area underlying
      the corneal autofluorescence curve were measured with a scanning fluorophotometer
      (Fluorotron Master, Coherent Radiation Palo Alto CA) Healthy controls' values of
      corneal autofluorescence (peak value: mean 11.03 +/- 3.77 ng. equivalent
      fluorescein/ml; area: mean 163.85 +/- 61.40 scan-point x ng. equivalent
      fluorescein/ml) resulted similar (peak value: p = 0.83; area: p = 0.61) to those
      of diabetic patients without retinopathy (peak value: mean 11.2 +/- 3.4 ng.eq/ml;
      area: 170.07 +/- 57.23 scan-pnt.ng.eq/ml). A statistically significant difference
      was found between diabetic patients without retinopathy and patients with stage
      2, 3, 4 retinopathy. No statistically significant difference was found both for
      the peak value (p = 0.50) and for the area (p = 0.61) between stage 3 and stage 4
      retinopathy. The sensitivity and specificity of corneal autofluorescence as a
      screening test for diabetic retinopathy were 82% and 62% for the peak value, 87%
      and 60% for the area; the positive predictive value for the presence of diabetic
      retinopathy was 65% for the peak and 63% for the area.

PMID- 7797383
TI  - The relation between corneal autofluorescence, endothelial cell count and
      severity of the diabetic retinopathy.
AB  - We measured the corneal autofluorescence in groups with different levels of
      diabetic retinopathy severity (72 eyes of 46 patients) and in age-matched non
      diabetic controls (34 eyes of 24 controls). We also estimated the corneal
      endothelium cell count and pachymetry with a contact specular microscope. For the
      controls, mean corneal autofluorescence was 8.8 ng equivalents fluorescein/ml (SD
      0.3). Results showed increased autofluorescence of the cornea in diabetic
      patients (mean 17.9 ng equivalents fluorescein/ml, SD 4.2), related to the
      duration of diabetes (P < 0.05) and to the severity of diabetic retinopathy (P <
      0.0001). Corneal endothelial cell count results showed no statistically
      significant relation to corneal autofluorescence (P < 0.6), indicating that the
      increased autofluorescence cannot be attributed to a change in corneal cell
      density.

PMID- 7797386
TI  - Aqueous penetration of orally administered ciprofloxacin in humans.
AB  - The aqueous penetration of orally administered Ciprofloxacin (CPX) was studied in
      twenty-two human volunteers undergoing cataract surgery. CPX in a dose of 250 mg,
      was given p.o. at 12 hourly intervals in 3 groups such that a maximum dose of 0.5
      grams was delivered in one group, 1.0 grams in another and 1.5 grams in the last
      group. A fourth group consisted of 6 individuals who were controls and received
      lactose tablets. Twelve hours after the last dosing aqueous samples were
      collected and assayed by the Grove-Randall technique. The aqueous penetration of
      Ciprofloxacin achieved was 1.51 +/- 0.15 mgL-1 in group II and 2.49 +/- 0.52 mgL
      1 in group III. In group I, the aqueous concentration was experimentally
      indeterminate and the control samples in group IV did not show any antibacterial
      activity. Divided oral doses of 1.5 grams of CPX were found to produce an aqueous
      titre up to 2.5 times the MIC of Ps. aeruginosa.

PMID- 7797385
TI  - Ivermectin dosing based on physical appearance.
AB  - Ivermectin is a safe and effective microfilaricide which has been shown to have a
      beneficial impact on some onchocercal eye lesions. Current requirements for the
      distribution of ivermectin are that patients be weighed, and that their dose be
      determined according to their weight. This requirement increases the cost of
      distributing the drug to communities in need of treatment and, when scales
      breakdown, may lead to the suspension of distribution. Data are presented on a
      simple, alternative method of dose assessment based on the physical appearance of
      the patient. Fifteen assessors achieved an overall level of agreement with the
      weight-based schedule of 86% on a sample of 6420 patients. The level of agreement
      varied between assessors, from 73% to 95%. About 6% of the population would have
      received doses outside the range of the current weight-based schedule. We believe
      that the current insistence that each individual's dose of ivermectin be
      determined by weighing will hamper efforts to distribute the drug to those most
      in need of it and that our data indicate that workers can be trained to
      distribute ivermectin safely without weighing every individual. We would welcome
      confirmation of our findings from other populations.

PMID- 7797387
TI  - Frequency and complications of chronic iridocyclitis in ANA-positive
      pauciarticular juvenile chronic arthritis.
AB  - Chronic iridocyclitis (CI) is among the most important extra-articular
      manifestations of juvenile chronic arthritis (JCA) and is most often observed in
      young girls with pauciarticular JCA and circulating antinuclear antibodies
      (ANAs). The frequency of CI found in 39 children with ANA-positive pauciarticular
      JCA was 56%. None of the patients developed ocular complications during follow
      up. We think that this favourable outcome was primarily due to the early
      diagnosis and to our choice of using atropine as a mydriatic agent and to prolong
      atropine, after having spaced its administration further apart, up to one year or
      longer after the remission of ocular manifestations.

PMID- 7797388
TI  - Immunopathological findings in posterior scleritis.
AB  - Posterior scleritis can present with a variety of symptoms, and its clinical
      diagnosis is therefore difficult. Little is known about the pathogenesis and the
      cellular effector mechanisms. This case report presents the immunopathological
      findings of posterior scleritis in the enucleated eye of a 28-year-old female
      with no known underlying disease. The cells infiltrating the scleral fibers
      consisted predominantly of T cells. Many of them were CD4 cells. Clusters of T
      and B cells were found in perivascular areas. No signs of primary vasculitis were
      seen. The cellular infiltrate in posterior scleritis shows features compatible
      with a T-cell-mediated (autoimmune) disorder.

PMID- 7797389
TI  - Blood-aqueous barrier permeability determination in HLA B27-positive acute
      anterior uveitis patients.
AB  - The blood-aqueous barrier (BAB) permeability was studied by fluorophotometry in
      17 healthy control subjects and in 27 eyes from 27 patients with HLA-B27-positive
      acute anterior uveitis (HLA-B27 AAU). Twenty of these patients had an associated
      spondyloarthropathy. BAB permeability was studied during the ocular inflammatory
      crisis and in the disease-free periods in the same patients. Anterior chamber
      fluorophotometric scans were performed before and 30 minutes after the
      intravenous injection of 14 mg/kg of sodium fluorescein. The diffusion
      coefficient (Kd) was obtained from the ratio between the fluorescein
      concentration in the anterior chamber and the NPBF. Data were analyzed using the
      Student's t test and analysis of variance. A statistically significant difference
      (P < 0.001) was found between the Kd of active HLA-B27 AAU (61.4 +/- 16.8 x 10(
      4) min-1) and the Kd of inactive HLA-B27 AAU (4.8 +/- 1.6 x 10(-4) min-1). No
      statistically significant differences were found between the Kd of inactive HLA
      B27 AAU and the Kd of the control subjects (4.3 +/- 1.0 x 10(-4) min-1). We also
      failed to detect significant differences between patients with and without
      spondyloarthropathy either during the acute attack or during the disease-free
      period. On the basis of these results we conclude that the permeability of the
      BAB remains intact in inactive HLA-B27-positive AAU. The parallel
      fluorophotometric behaviour of HLA-B27-positive AAU with spondyloarthropathy and
      without spondyloarthropathy suggests that both share a common pathogenetic
      mechanism.

PMID- 7797390
TI  - Fluid air exchange in vitreo retinal surgery.
AB  - This study evaluates the efficiency of fluid-air exchange on the reattachment of
      the retina and clarifies the possibility that a posterior retinotomy is a cause
      for intra- and postoperative complications. A consecutive series of 211 eyes with
      retinal detachments due to P.V.R. (47%), diabetic traction, perforating trauma,
      macular hole or giant tears is presented. All eyes underwent pars plana
      vitrectomy, fluid-air exchange, internal drainage of subretinal fluid, laser
      endophotocoagulation and scleral buckling of the tears; 56% of the eyes were
      phakic and 55% underwent a posterior retinotomy, 54% underwent tamponade with
      C3F8 and 46% with silicone oil. Intraoperatively the retina was completely
      flattened in 91% cases. The causes of incomplete reattachment were residual
      membranes (6.6%), poor visualization (1.4%) and suprachoroidal hemorrhage (1%).
      These complications were isolated as being the cause of the bad final results (p
      < 0.001). Postoperatively, the retina remained attached in 66% of cases after the
      first procedure and with further surgery in 81% (mean follow up 16 months). Best
      corrected visual acuity was improved in 73% of eyes, unchanged in 17%, and worse
      in 10%. Complications were retraction of the retinotomy site in 3 cases and
      peripheral choroidal hemorrhage in 4 cases. We concluded that fluid air exchange
      with internal subretinal fluid drainage was an efficient and safe technique even
      if a posterior retinotomy was necessary.

PMID- 7797392
TI  - [Classification of health benefits of the national health system].

PMID- 7797394
TI  - [Definition of health benefits covered by the national health system].

PMID- 7797393
TI  - [Classification of benefits: health aspects].

PMID- 7797391
TI  - Decreased corneal complications after no-reflux, low-dose 5 fluorouracil
      subconjunctival injection following trabeculectomy.
AB  - In order to reduce corneal complications in 27 glaucomatous eyes that underwent
      trabeculectomy and postoperative subconjunctival injection of 5-fluorouracil we
      tried 1) a low-dose administration of 5-fluorouracil and 2) a modified
      subconjunctival injection technique. The mean total 5-fluorouracil dose was 18.0
      +/- 6 mg. A life-table analysis showed a success rate, at 15 months, of 78% (+/-
      7 S.E.). Four of the 27 eyes (13%) had corneal complications, limited to punctate
      keratopathy, with no corneal epithelial defects and/or abrasions. Our study shows
      that corneal complications decreased when the contact between 5-fluorouracil and
      the ocular surface was reduced.

PMID- 7797396
TI  - [Health benefits in preventive medicine and public health].

PMID- 7797395
TI  - [Health benefits of the national health system: legal aspects].

PMID- 7797397
TI  - [Benefits of the national health system: rationalization criteria].

PMID- 7797398
TI  - [Analysis of the draft of classification and cataloguing of health benefits in
      the national health system: primary care].

PMID- 7797399
TI  - [Oro-dental health: brief note regarding the Draft of the Royal Decree on the
      prescription of health benefits of the national health system].

PMID- 7797400
TI  - [Text of the royal decree on the classification of health benefits of the
      national health system].

PMID- 7797402
TI  - Proinflammatory effects of morphine in the rat adjuvant arthritis model.
AB  - Morphine has been shown to alter various aspects of the immune response. We
      examined its effect on progression of the T-cell-mediated model, rat adjuvant
      arthritis. Saline, morphine or the opioid antagonist naloxone were administered
      to male Wistar rats via subcutaneous osmotic pumps implanted three days prior to
      adjuvant disease induction by an intra-dermal injection of Mycobacterium
      tuberculosis in oil. The time of disease onset was found to be accelerated (day
      11) for the morphine group as compared to the saline control (day 13). In
      addition morphine produced a significant increase in paw swelling (days 13 and
      14), bone demineralization and bone erosions. A significant decrease in body
      weight as compared to the saline control was also observed. Naloxone had no
      significant effect on the degree of the inflammation seen, although like morphine
      it significantly increased bone demineralization and bone erosions as assessed by
      radiography.

PMID- 7797401
TI  - Effects of cytogenin, a novel anti-arthritic agent, on type II collagen-induced
      arthritis in DBA/1J mice and adjuvant arthritis in Lewis rats.
AB  - The anti-arthritic effects of cytogenin (8-hydroxy-3-hydroxymethyl-6-
      methoxyisocoumarin) on type II collagen-induced arthritis in DBA/1J mice and
      adjuvant arthritis in Lewis rats were examined. Prophylactic treatment with
      cytogenin (30, 100 mg/kg) had a potent inhibitory effect on type II collagen
      induced arthritis. Prophylactic or therapeutic treatment with cytogenin (10, 30
      and 100 mg/kg) also had a potent inhibitory effect on adjuvant arthritis. In
      contrast to nonsteroidal anti-inflammatory drugs (NSAIDs), cytogenin (10, 30 and
      100 mg/kg) had neither an anti-inflammatory effect on carrageenan-induced paw
      oedema in rats nor an analgesic effect on acetic acid-induced writhing in mice.
      These results suggest that the mode of the anti-arthritic action of cytogenin is
      different from that of NSAIDs and that cytogenin may become a useful drug for the
      treatment of rheumatoid arthritis.

PMID- 7797403
TI  - Modulation of proteoglycan composition in cultured anatomically intact joint
      cartilage by cyclic loads of various magnitudes.
AB  - The anatomically intact articular cartilage (area approximately 2.5 cm2) of 6
      month-old bovine sesamoid bones was cyclically (0.3 Hz) loaded with 0, 5, 25 and
      50 kg in vitro for 7 days. The amount and composition of the proteoglycans that
      were synthesized during the last 17 hours of incubation under each regime were
      studied. Loads of all magnitudes produced a 45% overall increase in synthesis,
      which included a disproportionate increase in the synthesis of small
      proteoglycans. Loading with either 25 or 50 kg induced the synthesis of much
      larger glycosaminoglycan side-chains and a species of small proteoglycan rich in
      keratan sulfate. Under these greater loads, synthesis in the deep layer of the
      cartilage was reduced and there was focal damage to the cartilage surface.

PMID- 7797404
TI  - Further studies on satellite nucleoli of lymphocytes in patients suffering from B
      chronic lymphocytic leukaemia.
AB  - Satellite nucleoli were studied in lymphocytes of patients suffering from various
      stages of B chronic lymphocytic leukaemia without and after treatment with
      cytostatic monotherapy with chlorambucil. The percentage of lymphocytes with
      satellite nucleoli in the peripheral blood of investigated patients was very
      constant and showed only a statistically non-significant slight trend to decrease
      in the most advanced stage of the disease. In contrast, the count of these cells
      increased in advanced stages of the disease, and decreased after the cytostatic
      chemotherapy. From the methodological point of view, satellite nucleoli may be
      easily visualized by means of a simple staining for RNA with acidified basic dyes
      without fixation. Such staining provided similar results as cytochemical
      immunoreactions for the characteristic nucleolar protein B23.

PMID- 7797405
TI  - Effect of L-propionyl carnitine on in-vitro membrane alteration of sickle-cell
      anaemia erythrocytes.
AB  - Sickle-cell anaemia erythrocytes are under oxidative stress which contributes to
      some of the reversible and irreversible modifications observed in these cells. L
      Propionyl carnitine, which protects myocardium, endothelium and erythrocytes from
      peroxidative damages and is able to stabilize damaged cell membranes, is also
      able to decrease the formation of thiobarbituric acid reactive substances which
      are produced by incubating erythrocytes with hydrogen peroxide in the presence of
      atmospheric oxygen or 95% N2-5% CO2 mixture. In these experimental conditions the
      increase of thiobarbituric-acid-reactive substances is significantly lower at 5
      mM and 10 mM L-propionyl-carnitine concentrations. The formation of irreversibly
      sickled cells induced by 24-h incubation of sickle-cell anaemia erythrocytes
      under 95% N2-5% CO2 mixture is significantly decreased in the presence of 1 mM or
      higher L-propionyl-carnitine concentrations. The percent filtration of sickle red
      blood cells through micropore filters is significantly decreased at oxygen
      tensions between 20 and 40 mmHg. These in-vitro observations suggest that L
      propionyl carnitine may be beneficial in maintaining the normal shape of sickle
      cell anaemia erythrocytes at low oxygen tension and in decreasing the
      peroxidative damages which accumulate during the life of red blood cells.

PMID- 7797406
TI  - Identifying nurses vulnerable to role conflict.
AB  - To remedy the nursing shortage in the US, hospitals initially focused on
      expensive recruitment efforts to fill nursing vacancies. Few addressed a core
      component of the problem: role conflict, which when reduced can be instrumental
      in hospitals attracting and retaining nurses.

PMID- 7797408
TI  - The role and use of support personnel.
AB  - In 1991 a research team from the University of Alberta was given the go-ahead by
      the National Health Research and Development Program, Health and Welfare Canada
      to investigate the role and use of support personnel in the rehabilitation
      disciplines and to provide a preliminary database in nursing. Below, the study
      findings on the future use, supervision and training of support personnel.

PMID- 7797409
TI  - When to begin a doctoral programme in nursing.
AB  - The future of the nursing profession is strengthened by the expansion of nursing
      science and its integration with nursing practice, the hallmarks of doctoral
      education. Launching a doctoral programme in nursing is a monumental venture into
      the main stream of higher education; consequently, the readiness to begin such an
      effort must be carefully assessed.

PMID- 7797410
TI  - Magnetization transfer and high-dose contrast in early brain infection on
      magnetic resonance.
AB  - RATIONALE AND OBJECTIVES: The authors studied the effect of contrast dose, use of
      magnetization transfer (MT), and temporal delay on the visualization of contrast
      enhancement with gadoteridol (Gd HP-DO3A) in a canine brain abscess model.
      METHODS: Alpha streptococcus brain abscesses were studied in five dogs at 1.5
      tesla (T) 1 and 5 days after implantation. Scans were performed 1, 11, and 21
      minutes after contrast was administered, using an initial dose of 0.1 mmol/kg. A
      supplemental contrast injection of 0.2 mmol/kg was given (for a cumulative dose
      of 0.3 mmol/kg), with scans repeated at 31, 41, and 51 minutes. RESULTS: Lesion
      conspicuity on day 1 was greater at high-contrast doses (0.3 mmol/kg) compared
      with standard doses (0.1 mmol/kg), regardless of whether imaging was performed
      without (0.89 +/- 0.02 compared with 0.26 +/- 0.08) or with (0.97 +/- 0.04
      compared with 0.28 +/- 0.06) MT. High-dose, MT, and a delay after contrast was
      injected all produced a statistically significant improvement. On blinded review
      of films obtained 11 and 14 minutes after injection, enhancement of the lesion
      could not be identified with certainty in two of five dogs at a dose of 0.1
      mmol/kg, regardless of whether MT was used. Enhancement was seen consistently in
      all lesions at 0.3 mmol/kg. On day 5, results were comparable, with greater
      absolute enhancement. CONCLUSIONS: In early brain infection, high-contrast doses
      (0.3 mmol/kg), MT, and a moderate delay after injection all improve visualization
      of lesion enhancement.

PMID- 7797407
TI  - Planning nursing resources.
AB  - In the UK the health service is undergoing radical changes to become more
      responsive to local needs, consumer feedback and modern medical technology. To
      keep up with this constantly changing health care environment, nurse resource
      planning must be flexible and responsive. Below, an outline of some of the
      information, tools and skills required to formulate nursing resource plans.

PMID- 7797412
TI  - Application of the maximum entropy method for evaluating phosphorus-31-magnetic
      resonance spectra in patients with liver metastases.
AB  - RATIONALE AND OBJECTIVES: The clinical feasibility and application of the maximum
      entropy method for data analysis from in vivo phosphorus-31-magnetic resonance (P
      31-MR) spectra of the liver were determined. METHODS: Image-guided localized P-31
      MR spectroscopy was performed in 24 patients with liver metastases and in 20
      healthy volunteers. The spectra were obtained with a whole body scanner operating
      at 1.5 T using a surface coil. Phosphomonoester/beta-adenosine triphosphate
      (ATP), phosphodiester/beta-ATP, and inorganic phosphate/beta-ATP were calculated
      from the maximum entropy method-spectra and from spectra evaluated with standard
      data processing (Fourier transformation spectra). RESULTS: Phosphomonoester/beta
      ATP and phosphodiester/beta-ATP were increased significantly with both methods in
      patients' spectra. Maximum entropy method spectra showed a distinct pattern with
      low noise. It was easier to determine peak borders and to attach resonances to
      the different metabolites using this method. CONCLUSIONS: Maximum entropy method
      is an alternative method for evaluation and quantification of P-31-MR spectra
      data and is preferred to standard data processing with Fourier transformation in
      cases of reduced signal-to-noise ratio of spectra.

PMID- 7797411
TI  - Effects of iopromide on vasoactive peptides and allergy-mediated substances in
      healthy volunteers.
AB  - RATIONALE AND OBJECTIVES: Little information is available about the direct action
      of angiographic contrast media on vasoactive peptides and allergy-mediated
      substances in humans. This study defined the acute effects of iopromide, a
      nonionic contrast medium (370 mg/mL iodine), on vasoactive peptides, allergy
      mediated substances, and hemodynamic parameters in healthy volunteers. METHODS:
      Pulmonary digital subtraction angiography was performed in seven healthy
      volunteers with no cardiovascular or pulmonary disease. Iopromide was
      administered as a total volume of 100 mL through a 7-Fr catheter inserted in the
      right femoral vein. The injected volumes and duration of injection (15-20
      mL/second) were kept constant. The following hemodynamic parameters were
      monitored continuously: results of electrocardiogram, heart rate, and phasic and
      mean pulmonary arterial and peripheral arterial pressures. Blood samples were
      obtained before and 3 to 5 minutes after injection of contrast media to determine
      the concentrations of the following vasoactive peptides: renin, angiotensin I
      converting enzyme, angiotensin II, aldosterone, atrial natriuretic peptide,
      antidiuretic hormone, cyclic guanosine monophosphate, and myoglobin; and to
      allergy-mediated substances such as tryptase, eosinophil protein X, and
      eosinophil cationic protein, using radioimmunoassay techniques. RESULTS:
      Iopromide substantially increased atrial natriuretic peptide (48.8 +/- 8.9 to
      85.8 +/- 13.0) and antidiuretic hormone (3.4 +/- 0.3 to 4.6 +/- 0.5) levels,
      whereas renin decreased (0.9 +/- 0.1 to 0.8 +/- 0.2) slightly but not
      significantly. Iopromide did not induce substantial changes in the other
      vasoactive peptides or in allergy-mediated substances after the contrast medium
      was injected. Similarly, cardiovascular parameters (heart rate, pulmonary and
      systemic blood pressures, and results of electrocardiogram) also remained
      unchanged after contrast injection. CONCLUSION: Iopromide caused no appreciable
      hemodynamic alterations associated with the changes in atrial natriuretic peptide
      and antidiuretic hormone and no evidence of allergy-mediated reactions in all
      volunteers.

PMID- 7797413
TI  - Transplacental passage and milk excretion of iobitridol.
AB  - RATIONALE AND OBJECTIVES: Iobitridol, a new nonionic, low-osmolality urographic
      and angiographic contrast medium, is a marker of extracellular fluid. Excretion
      of iobitridol in goat's milk and transplacental passage in the gestating rabbit
      were evaluated compared with iohexol. METHODS: Both products were determined in
      biologic samples by two analytic methods: ultraviolet spectrometry (milk) and
      high-pressure liquid chromatography (maternal and fetal blood and amniotic
      fluid). RESULTS: Excretion in the milk represents 0.7% of the administered dose
      for iobitridol and 1.6% for iohexol. Transplacental passage is nonexistent.
      Iobitridol and iohexol behave in a similar manner. CONCLUSIONS: These preclinical
      results allow more effective prediction of the safety of iobitridol in pregnant
      or lactating women. However, precautions for use must be respected in the absence
      of specific studies in this population group.

PMID- 7797414
TI  - Effects of manganese dipyridoxyl diphosphate, dipyridoxyl diphosphate--, and
      manganese chloride on cardiac function. An experimental study in the Langendorff
      perfused rat heart.
AB  - RATIONALE AND OBJECTIVES: Manganese dipyridoxyl diphosphate (MnDPDP) is a
      promising contrast agent for magnetic resonance imaging of the liver. The authors
      explored the possibility that high concentrations of MnDPDP may cause manganese
      ion (Mn++)-induced side effects on cardiac function. METHODS: Potential
      cardiodepression by MnDPDP, DPDP--, and manganese chloride (MnCl2) (100-3,000
      mumol/L) was investigated in the isolated rat heart, with left ventricular
      developed (systolic--end-diastolic) pressure and heart rate as the primary
      indices of cardiac function. RESULTS: During 5-minute exposures, 10% and 50%
      decreases in left ventricular developed pressure were observed for MnDPDP, 250
      mumol/L and 1580 mumol/L; DPDP--, less than 100 mumol/L and 1000 mumol/L; MnCl2,
      30 mumol/L and 250 mumol/L. Heart rate changes were not observed with MnDPDP.
      Cardiodepression was reversed within 2 minutes during a 14-minute recovery period
      for all investigated concentrations of MnDPDP and was less rapid for the highest
      concentrations of MnCl2. CONCLUSIONS: Manganese dipyridoxyl diphosphate is well
      tolerated in the rat heart at concentrations as high as 200 to 250 mumol/L and is
      approximately 10 times less cardiotoxic than MnCl2. Cardiodepressive effects of
      MnDPDP in the present rat heart model, perfused in the absence of blood and
      proteins, are related primarily to the release of free Mn++ ions and in part to
      the simultaneous release of DPDP--.

PMID- 7797415
TI  - Doppler sonography in experimentally induced acute renal failure in rabbits.
      Resistive index versus serum creatinine levels.
AB  - RATIONALE AND OBJECTIVES: The purpose of this study is to investigate the
      temporal relation between the change in the resistive index (RI) from renal
      Doppler sonography and that of serum creatinine values in the course of
      experimentally induced reversible acute renal failure (ARF) in rabbits. METHODS:
      Reversible ARF was induced in 10 New Zealand white rabbits by injecting a
      glycerol solution (6.0 mL/kg) into the thigh muscle. Doppler sonography was
      performed before injection, and 6, 12, and 24 hours, and 3, 5, 7, and 14 days
      after injection of glycerol. Blood samples for measuring serum creatinine levels
      were obtained in the same time sequence. Three rabbits, which died during the
      course of the experiment, were excluded from the study group. RESULTS: The RI
      elevated rapidly after glycerol injection, peaked at 12 hours, and then decreased
      to normal values by 7 days. Conversely, serum creatinine values were elevated and
      peaked at 1 day and then decreased to normal by 14 days. The change in the RI
      preceded the change in serum creatinine levels in the course of reversible ARF.
      There was a weak linear correlation between RI and serum creatinine levels, with
      a correlation coefficient of 0.33. CONCLUSION: Doppler sonography with
      measurement of resistive index may be useful in predicting the course of ARF.

PMID- 7797417
TI  - Reliability of three methods of radiologic assessment in patients with rheumatoid
      arthritis.
AB  - RATIONALE AND OBJECTIVES: To assess the intraobserver reliability of three
      methods used frequently to evaluate joint destruction in rheumatoid arthritis:
      the Sharp method, the Larsen method, and the carpo:metacarpal ratio. METHODS: One
      observer analyzed twice within a 6-week interval 71 radiographs from patients
      with rheumatoid arthritis. Reliability was estimated by intraclass correlation
      coefficient (R) and by Altman-Bland graphical method. Correlations were examined
      by the Spearman's coefficient (r). RESULTS: The intraobserver reliability of each
      method appeared satisfactory with a good result for the Sharp method (R = 0.97).
      The correlation was strong (r > 0.80) between the results obtained by Sharp's and
      Larsen's methods and weaker between the results of the two former methods and the
      carpo: metacarpal ratio. CONCLUSIONS: Sharp's method should be used
      preferentially in studies evaluating the radiologic changes in rheumatoid
      arthritis over time, especially in clinical trials. The carpo:metacarpal ratio
      may be considered as a complementary method, when wrist destruction is of
      conceptual importance.

PMID- 7797416
TI  - Contractile responses to electrolyte changes during coronary bolus perfusion. A
      comparative study in isolated rat, guinea pig, and rabbit hearts.
AB  - RATIONALE AND OBJECTIVES: The authors studied cardiac contractile responses
      during coronary bolus perfusion, as in coronary angiography, in three species and
      related the responses to the bolus content of electrolytes and to patterns of
      cardiac electrolyte regulation. METHODS: Isolated, paced hearts from the rat,
      guinea pig, and rabbit were subjected to coronary perfusion in the global mode
      with recording of left ventricular developed pressure during exposure (< 7.5
      seconds) and recovery (30 seconds). RESULTS: In series 1 of the experiments, the
      perfusate reduction to one fifth of normal Ca, Na, K, Mg, and Ca/Na/K/Mg, and the
      removal of all ions, led to the following percentage changes in left ventricular
      developed pressure: rat -64, +84, -38, +7, +40, and +79; guinea pig -43, +48,
      +18, +5, +28, and +37; and rabbit -32, +60, +14, +4, +22, and +33. CONCLUSIONS:
      Except for K reduction, inducing negative inotropy in the rat but positive
      inotropy in the guinea pig and the rabbit, the three species responded similarly.
      Thus, changes in left ventricular developed pressure were related to changes in
      direction and rate of the sarcomal Na-Ca exchange. In series 2 of the
      experiments, iohexol (150 mg I/mL) +/- minor electrolyte additives were studied.
      Additives with Na 30 mmol/L only or with Na, Ca, K, and Mg carefully balanced
      reduced positive and negative inotropic responses in all three species.

PMID- 7797418
TI  - Conventional film-screen versus computed storage phosphor radiography. Simulated
      miliary lung disease in an anthropomorphic phantom.
AB  - RATIONALE AND OBJECTIVES: In this experimental study, the authors examined
      whether laser printed hardcopies from digital storage phosphor radiographs yield
      diagnostic performance equal to conventional film-screen radiographs in the
      detection of simulated miliary disease, using a standardized object. METHODS: A
      commercially available anthropomorphic chest phantom was used for radiographic
      evaluation. Miliary disease was simulated by superimposing one to four sheets of
      millet seeds on the lungs, resembling a miliary disease pattern with varying
      degrees of detectability. An observer study (receiver-operating characteristic)
      with eight radiologists was conducted to compare the reader performance using
      hardcopies of computed storage phosphor radiography versus the conventional film
      screen system, optimized for chest x-rays. The digitally generated images were
      presented as a double-image hardcopy, with a conventionally adopted version and
      an edge enhanced image version. RESULTS: When analyzed separately, one out of the
      eight observers performed slightly better using the conventional films. When
      treated as a group, analysis of the areas under the receiver-operating
      characteristic curves demonstrated no significant difference in reader
      performance for each of the systems under investigation (t = 0.286). The Wilcoxon
      test could not prove a statistical difference. CONCLUSION: Storage phosphor
      technology is a method that yields equal diagnostic performance as conventional
      film in evaluating miliary disease of the chest.

PMID- 7797419
TI  - Effects of carbon dioxide arterial infusion on hepatic biochemistry and histology
      in a rabbit model.
AB  - RATIONALE AND OBJECTIVES: The objective of this study was to determine the effect
      of carbon dioxide (CO2) infusion on hepatic biochemistry and histology in a
      rabbit model. METHODS: The study population consisted of 24 anesthetized rabbits
      that received hepatic infusion of either CO2 or saline (control) at doses of 10
      mL/kg, comparable with those doses used in human clinical trials. Blood for
      clinical chemistry analysis was collected at baseline, 1 hour, 24 hours, and 168
      hours (7 days) postprocedure. The rabbits were killed at 7 days postprocedure and
      the liver examined histologically for hepatic damage. RESULTS: There were no
      significant differences between the CO2 and the control groups in dorsal,
      ventral, and dorsal/ventral scores. Increases in alanine, an important indicator
      of hepatocellular membrane injury, in the CO2 group were significantly greater at
      1 hour and 24 hours posttreatment (P = 0.037 and 0.013). However, the mean levels
      at 168 hours (7 days) were not significantly different (P = 0.22). The increases
      at 1 and 24 hours were small, transient, and considered clinically insignificant.
      CONCLUSION: No long-term hepatic effects in these animals were suggested by
      biochemical and histological examinations.

PMID- 7797420
TI  - Effects of simvastatin on liver and plasma levels of cholesterol, dolichol and
      ubiquinol in hypercholesterolemic rats.
AB  - Increased levels of blood cholesterol are considered as a major factor in the
      development of atherosclerosis. Simvastatin, a drug which blocks
      hydroxymethylglutaryl coenzyme A reductase (HMGCoAR), reduces plasma cholesterol
      and increases HDL-cholesterol in rats fed a hypercholesterolemic diet. Moreover,
      simvastatin produces a significant decrease of ubiquinol and dolichol in plasma
      and in liver.

PMID- 7797421
TI  - Symposium on Polyamines: Biological and Clinical Aspects. Trento, June 8-11,
      1994. Abstracts.

PMID- 7797422
TI  - Follicular dendritic cells and apoptosis: life and death in the germinal centre.
AB  - The germinal centre forms a specialized microenvironment thought to play a key
      role in the induction of antibody synthesis, affinity maturation of B cells and
      memory B cell formation. Clonal-expanded follicular B lymphocytes with mutated
      antigen receptors (centrocytes) have to be selected on the basis of their
      capacity to compete for binding to antigen held in limited amounts on the
      follicular dendritic cells. In this way, only high-affinity B cells are selected.
      Binding to a follicular dendritic cell is an unconditional prerequisite for
      centrocytes to survive. Cells that do not succeed in binding to a follicular
      dendritic cell die rapidly by apoptosis. Apoptosis is a common form of cell death
      characterized by the activation of an endonuclease culminating in nuclear
      destruction. The pathway by which apoptosis is triggered varies from cell type to
      cell type. However, for germinal centre B cells this process is still poorly
      understood.

PMID- 7797423
TI  - Immunogold labelling indicates high catalase concentrations in amorphous and
      crystalline inclusions of sunflower (Helianthus annuus L.) peroxisomes.
AB  - Immunogold labelling and electron microscopy were used to investigate whether
      catalase was present in peroxisomal inclusions, the composition of which has not
      yet been determined in plant cells. In the mesophyll cells of sunflower
      (Helianthus annuus L.) cotyledons, the catalase gold label was confined to
      peroxisomes. At day 2 of postgerminative growth in darkness, peroxisomes were
      free of inclusions, and the matrix was homogeneously labelled with gold
      particles. Thereafter, amorphous inclusions appeared, but by day 5 of growth,
      conspicuous crystalline inclusions (cores) were the predominant type. This
      developmental change, first observed in cotyledons grown in continuous light
      between day 2.5 and 5, also took place in cotyledons kept in permanent darkness.
      Both amorphous and crystalline inclusions showed a much higher immunogold label
      than did the peroxisomal matrix, indicating that catalase was a component of both
      types of peroxisomal inclusions. In contrast to catalase, the immunogold label of
      glycolate oxidase was almost completely absent from cores and was confined to the
      peroxisomal matrix. Together with reports on the absence of other enzymes from
      peroxisomal inclusions in sunflower and other species (Vaughn, 1989) our results
      suggest that catalase is a major constituent of amorphous and crystalline
      peroxisomal inclusions in plants.

PMID- 7797425
TI  - Glycans of the early human yolk sac.
AB  - The pattern of glycan distribution in the early human yolk sac has been
      investigated using a panel of lectins. Two 6-week and one 8-week human yolk sacs,
      and one 8-week fetal liver from live, ectopic pregnancies were fixed and embedded
      in epoxy resin. Lectin histochemistry was carried out on sections of these
      tissues using 23 biotinylated lectins and an avidin-biotin peroxidase revealing
      system. Mesothelial surfaces expressed most subsets of N-glycans (other than high
      mannose types), N-acetyl-lactosamine, sialic acid, and alpha 1,6-N
      acetylgalactosamine. Endodermal surface and lateral membranes resembled those of
      mesothelium, but showed a preponderance of alpha 2,6-sialyl residues. Most
      intracellular granules contained N-glycan. There was a marked heterogeneity of
      granules in the endodermal cells, with different subsets varying in both staining
      and positional characteristics. The mesenchymal matrix bound most of the lectins
      used in the study, and expressed fucosyl residues which were also detected in the
      endothelium. Fetal liver parenchyma showed very similar staining patterns to
      those seen in the endoderm except for the distribution of N-acetylglucosamine,
      which was sparse. Despite some common features, each germ cell layer had a
      distinct 'glycotype', with some saccharides showing extreme topographical
      restriction.

PMID- 7797424
TI  - Cell proliferation in prostatic carcinoma: comparative analysis of Ki-67, MIB-1
      and PCNA.
AB  - Antibodies to assess the proliferative index of tumours are being increasingly
      employed together with established markers for prognostic evaluation. This study
      set out to compare three cell proliferation markers, Ki-67, MIB-1 and PCNA,
      utilizing a semi-quantitative method of assessment, in 20 human prostatic
      carcinomas. The streptavidin-biotin immunostaining system was used for the
      monoclonal antibodies MIB-1 and PCNA and an indirect immunoperoxidase assay for
      the monoclonal antibody Ki-67. Significant correlations were found between the
      expression of Ki-67 in frozen tissues and MIB-1 in formal saline-fixed wax
      embedded tissues (p = 0.0003); between Ki-67 and PCNA expression in Bouin's-fixed
      tissues (p < or = 0.0001); and MIB-1 (formalin-saline-fixed tissues) and PCNA
      (Bouin's-fixed tissues) (p < or = 0.0001). A more intense nuclear staining
      pattern with less heterogeneity was observed for MIB-1 compared with PCNA,
      suggesting the antibody of choice, on formal saline-fixed tissues, is MIB-1,
      which closely correlated with Ki-67, a marker we have previously shown to be of
      prognostic value in prostatic carcinoma.

PMID- 7797426
TI  - A comparison of membrane enzymes of human and pig oesophagus; the pig oesophagus
      is a good model for studies of the gullet in man.
AB  - The distribution and relative catalytic activities of five plasma membrane
      enzymes (alkaline phosphatase, dipeptidyl peptidase IV, gamma-glutamyl
      transpeptidase, microsomal alanyl aminopeptidase and glutamyl aminopeptidase)
      were examined in human and pig oesophagus. In both species, alkaline phosphatase
      activity occurred in basal and suprabasal cells of the epithelium and in
      capillaries. Stromal cells in the human submucosa were particularly reactive.
      Dipeptidyl peptidase IV was present in blood vessels and capillaries in man and
      pig and in submucous glands in the pig. The enzyme was also present in both
      species in the lamina propria cells immediately adjacent to the epithelial basal
      lamina. In the human, gamma-glutamyl transpeptidase occurred in the epithelial
      basal cells and in isolated basal and lower prickle cells in the pig. Stromal
      cells in the human submucosa were strongly reactive and capillaries in the
      muscularis propria in both species moderately active. Microsomal alanyl
      aminopeptidase was detected in lamina propria cells adjacent to the epithelial
      basal cell layer in man and pig and at the apices of mucous cells in pig
      submucous glands. Weak glutamyl aminopeptidase activity was confined to
      capillaries in both species. The findings of this study, along with the ready
      availability of pig oesophagus, suggest that the pig may be a suitable model for
      studies of the gullet in man.

PMID- 7797427
TI  - Postembedding alpha-tubulin immunolabelling of isolated centrosomes.
AB  - Accurate ultrastructural localization of the components of centrosomes is an
      important step toward the determination of their function. We have used an
      electron microscopy procedure to preserve centrosome-associated antigens which
      enables their high-resolution localization. The unique part of our procedure is
      the application of a post-sectioning fixation step which overcomes the poor
      section contrast and morphological appearance that limits the use of low
      temperature processing and Lowicryl embedding. The efficacy of our approach is
      demonstrated by the efficient labelling of alpha-tubulin in the well-preserved
      and contrasted microtubule barrels of the centrides of isolated mammalian
      centrosomes.

PMID- 7797429
TI  - Women's healthcare comes to the forefront in the 1990s: are physicians ready?

PMID- 7797428
TI  - Detection of a glycosphingolipid antigen in bladder cancer cells with monoclonal
      antibody MRG-1.
AB  - The monoclonal antibody MRG-1 has been evaluated for the immunohistochemical
      detection of the type 3 chain of blood group A in human normal bladder epithelium
      and bladder tumours. Light microscope examination of paraffin sections
      demonstrated that this antigen was present in normal epithelium and superficial
      bladder tumour in patients with blood group A or AB, but was absent in the
      invasive type of bladder tumour. In normal epithelium, the plasma membrane was
      positive for this antigen, and the cytoplasm was diffusely stained. In
      superficial transitional cell carcinoma, the plasma membrane was negative,
      whereas the cytoplasm was intensely stained in the perinuclear region. This
      pattern was different from that observed for type 1 and 2 group A antigen, which
      was recognized mainly at the plasma membrane. However, in superficial
      transitional cell carcinoma, the staining was also seen on the plasma membrane.
      The pattern of the localization of this antigen in this carcinoma was influenced
      by the treatment of organic solvents. Electron microscopical observations
      confirmed that this antigen was localized on the plasma membrane and also in the
      Golgi apparatus of the superficial tumour. These results proved that the type 3
      chain of blood group A is present in human bladder epithelium and low grade
      tumours in correspondence with the blood type, but disappears in tumours with
      high malignant potential. However, its expression is independent of the
      expressions of the other subtypes which have been studied. Furthermore, the
      changes in the staining pattern caused by pretreatment with organic solvents
      suggested possible differences in the microenvironment of the glycolipids
      containing this type of sugar chain.

PMID- 7797430
TI  - Changes in presence of a segmental dysfunction pattern associated with
      hypertension: Part 2. A long-term longitudinal study.
AB  - The short-term portion of this study (part 1) showed an association between
      somatic dysfunction and the regulation of blood pressure. To study long-term
      relationships, follow-up examinations were made of 61 subjects studied 3 to 10
      years earlier. They were heterogeneous Family Practice Clinic patients with a
      mean age of 45 years. By methods used in part 1 and in our previous studies of
      systemic interactions, palpatory examination was done to support presence or
      absence of a C6T2T6 pattern of segmental motion dysfunctions, and blood pressure
      status was established by the medical history. The C6T2T6 pattern persisted in 16
      of 16 subjects with grade 2 or greater hypertension and 4 of 9 normotensive
      subjects who had shown the pattern initially. At follow-up, the pattern first
      appeared in 7 subjects who had hypertension previously diagnosed and who remained
      hypertensive; the pattern disappeared in 5 normotensive subjects who remained
      normotensive. The C6T2T6 pattern's long-term persistence in hypertensive subjects
      and changes in its presence corresponding to the subjects' hypertensive status
      indicate an important relationship between this pattern of segmental motion
      dysfunctions and disturbances in regulation of blood pressure.

PMID- 7797431
TI  - Nerve compression syndromes as models for research on osteopathic manipulative
      treatment.
AB  - Experimental and clinical studies of nerve compression syndromes show that
      ischemia or edema, singly or combined, causes responses in nerves that lead to
      alterations in impulse conduction and to commonly observed clinical signs.
      Because osteopathic manipulative treatment (OMT) is thought to affect
      microcirculation and anatomic positioning of structures, nerve compression
      syndromes appear ideal as models for studying how OMT accomplishes results. We
      recommend that researchers develop experimental protocols or clinical studies of
      nerve compression syndromes that will use anatomic, histologic, and physiologic
      criteria to monitor the effects of OMT. Techniques such as soft tissue, muscle
      energy, counterstrain, or myofascial release are appropriate for study in nerve
      compression syndromes. Such studies are necessary to understand the biologic
      basis of OMT.

PMID- 7797432
TI  - Making sense of federal GME reforms: the need for secondary reforms.
AB  - Physician workforce issues in the healthcare reform debate have led to
      considerable agreement on the need to reform graduate medical education (GME) in
      order to control the cost, mix and supply of physician manpower. The osteopathic
      medical profession's infrastructure is ill-prepared to respond to many of the
      changes that policymakers are suggesting. In last month's issue, the author
      reviewed the Gephardt and Mitchell bills, which emerged during the last Congress,
      identified the reforms recommended for GME, and examined the elements of
      agreement between the bills. The position of osteopathic medicine vis-a-vis
      healthcare reform was explored and distinctions between the two bills were drawn.
      In this article, the author recommends comprehensive secondary reforms in the
      osteopathic medical profession's three institutions--its colleges, its hospitals,
      and its political organization, the American Osteopathic Association.

PMID- 7797433
TI  - 'But doctor, someone has to do something': resolving interpersonal conflicts in
      the workplace.
AB  - Physicians are often called on to address interpersonal conflicts among office
      staff and colleagues. Because such strife can interfere with patient care,
      physicians should learn to diffuse these situations as adeptly and quickly as
      possible. The authors outline one approach, which they developed while working at
      the Oklahoma Department of Mental Health. Designated by the mnemonic LIFT
      (Listen, Inquire, ask for Feedback, Test), this approach has been used
      successfully to resolve interpersonal conflict in small groups.

PMID- 7797434
TI  - The discovery of australifungin, a novel inhibitor of sphinganine N
      acyltransferase from Sporormiella australis. Producing organism, fermentation,
      isolation, and biological activity.
AB  - Potent antifungal activity was detected in fermentation extracts of Sporormiella
      australis and two related components were isolated from solid fermentations using
      silica gel and high speed countercurrent chromatography. The most active
      antifungal component, australifungin, contained a unique combination of alpha
      diketone and beta-ketoaldehyde functional groups. Australifungin exhibited broad
      spectrum antifungal activity against human pathogenic fungi with MICs against
      Candida spp., Cryptococcus neoformans, and Aspergillus spp. between 0.015 and 1.0
      microgram/ml. Mode of action studies revealed that australifungin interfered with
      fungal lipid metabolism by specifically inhibiting sphingolipid synthesis at the
      step converting sphinganine to ceramide.

PMID- 7797436
TI  - AKD-2A, B, C and D, new antibiotics from Streptomyces sp. OCU-42815. Taxonomy,
      fermentation, isolation, structure elucidation and biological activity.
AB  - An antibiotic complex, AKD-2, was isolated from the mycelial cake of Streptomyces
      sp. OCU-42815. The lipophilic substances in this complex were further purified by
      a recycling HPLC procedure and were designated AKD-2A, C and D. AKD-2B was
      obtained as a mixture of AKD-2B1 and AKD-2B2. These substances were identified as
      monoglycerides having branched chain fatty acids and exhibited both antibacterial
      and antifungal activities.

PMID- 7797435
TI  - Trachyspic acid, a new metabolite produced by Talaromyces trachyspermus, that
      inhibits tumor cell heparanase: taxonomy of the producing strain, fermentation,
      isolation, structural elucidation, and biological activity.
AB  - Trachyspic acid, a new metabolite that inhibited heparanase, was isolated from
      the culture broth of Talaromyces trachyspermus SANK 12191. Its structure was
      deduced from NMR spectral analyses and chemical reactions as a tricarboxylic acid
      derivative containing a spiroketal. The IC50 value of trachyspic acid against
      heparanase was 36 microM.

PMID- 7797437
TI  - Phenamide, a fungicidal metabolite from Streptomyces albospinus A19301. Taxonomy,
      fermentation, isolation, physico-chemical and biological properties.
AB  - A new derivative of phenylalanine, phenamide, was discovered from the
      fermentation broth of an actinomycete identified as a member of the Streptomyces
      albospinus cluster. Phenamide was purified using successive C18 reverse phase and
      cation exchange chromatography. Its structure was determined by spectroscopic and
      chemical methods. Its molecular formula, C14H20N2O3, was determined by HRFAB-MS.
      Phenamide showed activity against Septoria nodorum, the causal agent of wheat
      glume blotch.

PMID- 7797438
TI  - Isolation, characterization and structure of a new allenic polyine antibiotic
      produced by fungus LL-07F275.
AB  - Antibiotic 07F275 (1), produced by submerged fermentations of fungal culture LL
      07F275, was isolated and characterized despite its inherent instability. Its UV
      spectrum was identical with that of nemotin, a member of the allenic
      polyacetylene family, but a molecular weight of 218 daltons indicated a new
      compound. Structure 1 was determined on the basis of spectroscopic evidence,
      particularly NMR. Since 1 is a thirteen carbon-containing allenic diyne, it is
      closely related to mycomycin.

PMID- 7797439
TI  - Simple aromatics identified with a NFAT-lacZ transcription assay for the
      detection of immunosuppressants.
AB  - Determination of the mechanism of action of FK506 and cyclosporin A has yielded
      new molecular targets involved in signal transduction during T cell activation. A
      common target of FK506 and cyclosporin A is inhibition of activation of the NFAT
      transcription factor, for which a specific binding region is present in the
      promoter of the IL-2 gene. A reporter gene assay has been used to screen for
      agents that interfere with this early step in T cell activation. Simple aromatic
      compounds that block NFAT-dependent transcription and show in vitro
      immunosuppressive activity were isolated from the broth and mycelia of two
      Streptomyces sp. fermentations. The compounds were active at concentrations that
      were not directly cytotoxic.

PMID- 7797440
TI  - Inhibition of phosphatidylinositol-specific phospholipase C activity by
      fluvirucin B2.
AB  - We isolated fluvirucin B2 from the culture broth of Streptomyces as an inhibitor
      of phosphatidylinositol-specific phospholipase C (PI-PLC). It inhibited PI-PLC of
      A431 cell cytosol with an IC50 of 1.6 micrograms/ml. Fluvirucin B2 also inhibited
      PI-PLC in cultured A431 cells, whereas it did not inhibit phosphatidylinositol
      synthesis and macromolecular synthesis markedly. It also inhibited epidermal
      growth factor-induced rapid rounding of A431 cells, in which PI turnover is
      involved.

PMID- 7797441
TI  - Structures and absolute configurations of antibiotics of the oligosporon group
      from the nematode-trapping fungus Arthrobotrys oligospora.
AB  - Spectroscopic data define the structures of three new antibiotics, 4',5'-dihydro
      oligosporon (4), hydroxyoligosporon (5) and 10',11'-epoxyoligosporon (6) from the
      nematode-trapping fungus Arthrobotrys oligospora, and confirm the structures of
      the recently reported antibiotics oligosporon (1) and oligosporol B (3). The
      absolute configuration of the substituted 7-oxabicyclo[4.1.0]hept-3-ene nucleus
      of these metabolites is determined by circular dichroic spectroscopy. Oligosporon
      (1) and its dihydro-derivative (4) represent the second and most complex
      structural type of nematocidal metabolite to be characterised from cultures of
      nematophagous fungi.

PMID- 7797442
TI  - Synthesis of novel 6-alpha and 6-beta-alkylcarbonylmethyl substituted penems.
AB  - 6-alpha and 6-beta Alkylcarbonylmethyl penems were synthesized from 6-alpha-bromo
      and 6-oxo penicillanates respectively and their in vitro antibacterial activity
      was studied. The compounds were generally active against Gram-positive but not
      against Gram-negative strains, the compounds of the 6-beta series being more
      active. Relatively to imipenem, taken as reference compound, the penems resulted
      more stable towards chemical hydrolysis in Tris-HCl buffered medium (pH 7.4) but
      more sensitive towards dehydropeptidase-I (DHP-I).

PMID- 7797443
TI  - Structural features resulting in convulsive activity of carbapenem compounds:
      effect of C-2 side chain.
AB  - The neurotoxicity of meropenem was much lower than that of both imipenem and
      panipenem after intraventricular administration to mice. To clarify the major
      structural features responsible for the induction of convulsions by carbapenem
      antibiotics, the structure-activity relationship on convulsant activity was
      investigated in N-acetyl-2-pyrroline and cyclopentene derivatives which
      correspond to the 5-membered ring containing the C-2 side chain of carbapenem
      antibiotics. Among these derivatives, compounds with strong basicity in the side
      chain showed convulsant activity similar to that of the parent carbapenem
      compounds. In addition to the strength of the basicity of the amino group, the
      distance from the carboxyl to the amino group and steric crowding around the
      amino group also appeared to play an important role in the induction of
      convulsions. The results of gamma aminobutyric acid (GABAA) receptor binding
      assays indicated that the induction of convulsions was caused predominantly by
      the inhibition of GABAA-mediated inhibitory transmission. However, the in vivo
      convulsant activity of some of these compounds did not correlate with their in
      vitro inhibitory effect on GABAA receptor binding.

PMID- 7797444
TI  - Structure-activity relationships within a series of C(7)
      substitutedoxyiminocephalosporins containing the C(3)
      methylaminopyridiniumthiomethyl substituent. Synthesis and biological properties
      of BRL 57342 and some close analogues.
AB  - (6R,7R)-7-[2-(2-Amino-4-thiazolyl)-2-[(Z)-[(S)-carboxy(3,4-
      dihydroxyphenyl)methyl]oxyimino]acetamido]-3-(1-methylaminopyri dinium-4
      thiomethyl)ceph-3-em-4-carboxylate sodium salt (BRL 57342, 1f) combines excellent
      in vitro antibacterial potency against Gram-positive and Gram-negative bacteria,
      including P. aeruginosa and Acinetobacter spp., with excellent stability to
      extended spectrum beta-lactamases. This potency is reflected in in vivo efficacy
      studies.

PMID- 7797445
TI  - The microbial modification of A58365A, an angiotensin converting enzyme
      inhibitor.

PMID- 7797446
TI  - Production of the staurosporine aglycon K-252c with a blocked mutant of the
      staurosporine producer strain Streptomyces longisporoflavus and by
      biotransformation of staurosporine with Streptomyces mediocidicus ATCC 13279.

PMID- 7797447
TI  - Metabolic products of microorganismen. 270. The structures of the exfoliamycins.

PMID- 7797448
TI  - Siamycins I and II, new anti-HIV peptides: I. Fermentation, isolation, biological
      activity and initial characterization.

PMID- 7797449
TI  - Pyralomicins, new antibiotics from Actinomadura spiralis.

PMID- 7797450
TI  - Life on Club Road.

PMID- 7797451
TI  - Parenting their adolescents: the experiences of Jordanian immigrant women in
      California.
AB  - Having their children enter adolescence presents new demands on the role
      functions of Jordanian immigrant women in the United States. Such demands require
      modifications in traditional parenting approaches. The authors attempted to
      uncover and describe the experiences of Jordanian immigrant mothers (N = 30) in
      parenting their adolescents in the United States. Content and narrative analysis
      revealed the dynamic processes that the mothers used in raising their children.
      They continuously attempted to balance the need for their teens to maintain a
      Jordanian ethnic identity and the need for them to become integrated into the new
      community. Their parenting was driven by an attempt to avoid loss of honor and
      bad reputation. Four aspects of the maternal role emerged from the analysis:
      mothering through nurturing the adolescents and promoting cultural identity,
      disciplining for cultural adherence, advocacy and mediation, and vigilant
      parenting. The findings support a dynamic interplay between cultural and
      structural conditions in shaping the experiences of Jordanian immigrant women.

PMID- 7797452
TI  - Jordanian nursing students' interpersonal behaviors.
AB  - The interpersonal behaviors of Jordanian nursing students (N = 536) in relation
      to type of nursing program, year and level, and gender were identified. The
      Fundamental Interpersonal Relations Orientation Behavior Test (Schutz, 1978), a
      self-report questionnaire, was used to assess six dimensions of interpersonal
      behavior. The findings indicated that (a) there was no significant difference in
      the interpersonal behaviors of baccalaureate and diploma program nursing
      students, (b) male nursing students had more desire to control interpersonal
      relations than did female nursing students, and (c) third- and fourth-year
      nursing students had a greater need to associate with and become close to others
      than did first- and second-year nursing students. These findings have important
      implications for nursing curricula, the future status of male and female nurses,
      and the interpersonal relationships of nurses.

PMID- 7797453
TI  - HIV and AIDS: issues for women in Australia.
AB  - The major HIV/AIDS-related issues facing women in Australia are outlined. From a
      global epidemiological perspective, women in Australia have almost gone unscathed
      by HIV infection. However, the potential for widespread infection cannot be
      ignored. The greatest threat for the majority of women in Australia is infection
      through sexual transmission. Although HIV infection is preventable, there are
      many social and economic factors that may hinder women's efforts to protect
      themselves. A major result of the global AIDS epidemic for women in Australia has
      been caring for a family member who has been infected with HIV. When a member of
      the family, usually a son, develops AIDS and is cared for at home, it is usually
      his mother who cares for him. She may face many difficult issues that may affect
      her health and well-being. Thus the small number of women infected with HIV in
      Australia does not accurately represent the impact the disease has had, and may
      potentially have, on the women of Australia.

PMID- 7797454
TI  - Drug advertisements and the medicalization of unipolar depression in women.
AB  - Unipolar depression occurs twice as frequently among women as among men, and the
      pharmacological industry maintains a massive advertising campaign that encourages
      psychiatric professionals to rely on antidepressant medication as the solution to
      this problem. The pictorial content of drug advertisements shows women as victims
      of depression. The social problems and situational stresses associated with
      unipolar depression are never shown, and depression is assumed to be a personal
      and biological illness, its etiology decontextualized. In these advertisements,
      women are not offered a choice between medical and nonmedical treatment and are
      not empowered to become more active participants in their health decisions.
      Therapists are urged to become alert to this oversimplification.

PMID- 7797455
TI  - Women and depression.
AB  - As Western society increases in complexity and becomes more reliant on
      technology, women who thrive as integrators in interactional modes will face new
      dilemmas. Many women will view these changes as challenges, but for many other
      women, who view these changes as threats, the response will be depression. We lay
      a foundation to an understanding of depression in women, evaluating the current
      concept of depression and pointing out its limitations. We then review the
      traditional theories of women's increased vulnerability to depressive disorders,
      which have failed to explain adequately this phenomenon. A more recent theory of
      women's depression, based on the self-in-relation theory of women's development,
      is offered as an alternative.

PMID- 7797456
TI  - Psychological and sexual well-being, philosophical/spiritual views, and health
      habits of long-term cancer survivors.
AB  - The results of a survey on various aspects of quality of life for 191 women who
      were long-term cancer survivors are presented. We explored six areas--somatic
      concerns, health habits, psychological state, sexual satisfaction,
      social/emotional support giving, and philosophical/spiritual view--and whether
      differences existed in them among the women on the basis of age, educational
      level, income level, length of survival, location of residence (urban, suburban,
      or rural), cancer site, and whether a recurrence of the cancer had been
      experienced. Generally, the women reported good psychological states and relative
      satisfaction with their sexual lives. However, women who had experienced a
      recurrence of their cancer, were longer term survivors, or suffered from breast
      cancer all reported higher levels of somatic concerns. Women with higher levels
      of education or income and those who had had a recurrence of their cancer
      indicated a greater willingness to provide social and emotional support to other
      women newly diagnosed with cancer. Women who had a positive
      philosophical/spiritual outlook were more likely to have good health habits and
      be supportive of others. There was no statistically significant variation among
      the women in either health habits or psychological state for any of the factors
      considered.

PMID- 7797457
TI  - Contribution of generalized negative affect to elevated menstrual cycle symptom
      reporting.
AB  - We investigated women's belief that they suffered from premenstrual syndrome
      (PMS) by monitoring patterns of symptom reporting over a 5-week period in
      relation to the underlying trait of negative affect. We expected that women
      reporting high negative affect would be more likely to report menstrual cycle
      distress than those reporting low negative affect. One hundred twenty-one women
      rated the typical occurrence and severity of premenstrual changes on a
      retrospective questionnaire and then made daily ratings of their changes for the
      duration of one cycle. In addition, they completed a questionnaire measuring
      positive and negative affect. Data analysis revealed a clear subgroup whose
      retrospective reports of premenstrual change were not substantiated by the cycle
      of their daily ratings. Although this subgroup also reported more negative
      affect, the magnitude of the effect was relatively small. The possible
      contribution of both negative outlook and the meaning of the self-identified
      label of PMS are discussed.

PMID- 7797458
TI  - Electronic performance monitoring and social context: impact on productivity and
      stress.
AB  - In a laboratory study, the presence of individual- or work-group-level electronic
      performance monitoring (EPM) was manipulated as participants worked on a data
      entry task alone, as a member of a noninteracting aggregate, or as a member of a
      cohesive group. The pattern of results suggested the operation of a social
      facilitation effect, as highly skilled monitored participants keyed more entries
      than highly skilled nonmonitored participants. The opposite pattern was detected
      among low-skilled participants. No signs of social loafing were detected among
      group-monitored participants. Nonmonitored workers and members of cohesive groups
      felt the least stressed. The implications of these findings for organizations
      adopting EPM systems are discussed.

PMID- 7797459
TI  - How MAP kinases are regulated.

PMID- 7797461
TI  - A novel type of protein modification by isoprenoid-derived materials.
      Diphytanylglycerylated proteins in Halobacteria.
AB  - Previous work from this laboratory has shown that a derivative of [3H]mevalonic
      acid is incorporated into a number of specific proteins in Halobacterium halobium
      and Halobacterium cutirubrum and that the major radioactive material released by
      treatment with methyl iodide was neither farnesyl nor geranylgeranyl compound,
      which have been generally accepted to be prenyl groups of a number of prenylated
      proteins found in eukaryotic cells, but an unknown compound (Sagami, H., Kikuchi,
      A., and Ogura, K. (1994) Biochem. Biophys. Res. Commun. 203, 972-978). In the
      current study, the unknown compound was prepared in a large amount from H.
      halobium cells and analyzed by reverse and normal phase high performance liquid
      chromatographies followed by mass spectrometry. The mass spectrum of this
      compound exhibited a parent ion peak (M+) at m/z 682, suggesting that it is a 1
      methylthio-2,3-di-O-(3',7',11',15'-tetramethylhexadecyl)glycerol
      (diphytanylglyceryl methylthioether). Diphytanylglyceryl methyl thioether was
      chemically synthesized, and its mass fragmentation pattern was completely
      coincident with that of the mevalonic acid-derived material from H. halobium.
      These results indicate that Halobacteria contains specific proteins with a novel
      type of modification of a cysteine residue of the proteins with a
      diphytanylglyceryl group in thioether linkage.

PMID- 7797460
TI  - Separate signaling mechanisms are involved in the control of STAT protein
      activation and gene regulation via the interleukin 6 response element by the box
      3 motif of gp130.
AB  - The cytoplasmic receptor sequences required for the transcriptional control via
      the IL-6 response element (IL-6RE) and the hematopoietin receptor response
      element (HRRE) in hepatoma cells were defined by transient expression of wild
      type and mutant granulocyte-colony stimulating factor receptor-gp130 chimeric
      receptors. gp130 generated two separate transcriptional signals, one of which was
      directed to IL-6RE and required an intact box 3 motif, and another, which was
      directed to HRRE and was box 3-independent. The activation of DNA-binding of
      STAT3 required the same gp130 domains as the IL-6RE response. A box 3-independent
      activation of STAT proteins was achieved by overexpression of the kinases JAK2 or
      TYK2. The increase in the DNA-binding activity of STAT proteins, however, did not
      result in a corresponding increase in transcription via either IL-6RE or HRRE.
      The data indicate that activation of the DNA-binding potential of STAT proteins
      via gp130 is not sufficient to achieve transcriptional up-regulation of specific
      target genes.

PMID- 7797463
TI  - Sodium dodecyl sulfate-stable complexes between serpins and active or inactive
      proteinases contain the region COOH-terminal to the reactive site loop.
AB  - Recently inhibitors of the serpin family were shown to form complexes with
      dichloroisocoumarine (DCI)-inactivated proteinases under native conditions
      (Enghild, J. J., Valnickova, Z., Thogersen I., and Pizzo, S. V. (1994) J. Biol.
      Chem. 269, 20159-20166). This study demonstrates that serpin-DCI/proteinase
      complexes resist dissociation when analyzed in reduced SDS-polyacrylamide gel
      electrophoresis. Previously, SDS-stable serpin-proteinase complexes have been
      observed only between serpins and catalytically active proteinases. The stability
      of these complexes is believed to result from an acyl-ester bond between the
      active site Ser195 of the proteinase and the alpha-carbonyl group of the scissile
      bond in the reactive site loop. We have further analyzed the structure of the SDS
      stable serpin-proteinase and serpin-DCI/proteinase complexes. The results of
      these studies demonstrate the presence of the COOH-terminal region of the serpin
      in both complexes. Since (i) modification of Ser195 does not prevent formation of
      SDS-stable complexes and (ii) COOH-terminal peptides are present in both
      complexes, the previously described mechanism does not sufficiently explain the
      formation of SDS-stable complexes.

PMID- 7797464
TI  - The p60 tumor necrosis factor (TNF) receptor-associated kinase (TRAK) binds
      residues 344-397 within the cytoplasmic domain involved in TNF signaling.
AB  - The p60 form of the tumor necrosis factor (TNF) receptor lacks motifs
      characteristic of tyrosine or serine/threonine protein kinases. Our recent
      observations have indicated that a p60 TNF receptor-associated kinase (p60-TRAK)
      from U-937 cells physically interacts with and causes the phosphorylation of the
      cytoplasmic domain of the TNF receptor. To define which region of the cytoplasmic
      domain is necessary for physical interaction with p60-TRAK, we constructed a
      series of deletions (grouped into three sets delta 1-delta 5, delta 6-delta 12,
      and delta 13-delta 16) of the p60 cytoplasmic domain, expressed them as
      glutathione S-transferase (GST) fusion proteins, and used them in affinity
      precipitations, followed by in vitro kinase assays. Our detailed analysis
      indicated that a serine-, threonine-, and proline-rich region (residues 243-274,
      delta 2) and the N-terminal half of the cytoplasmic domain (residues 243-323,
      delta 3) neither associated with p60-TRAK nor underwent phosphorylation. We found
      that out of 222 residues (205-426) in the cytoplasmic domain, only 54 (344-397,
      delta 12) were sufficient for binding p60-TRAK and for phosphorylation of the
      cytoplasmic domain. A region of approximately 30 residues (397-426) at the C
      terminal end was found to interfere with optimal binding of the p60-TRAK
      activity. Thus, our results indicate that the minimal region of the cytoplasmic
      domain necessary for interacting with p60-TRAK and for phosphorylation resides
      within the domain previously reported to be needed for signaling the cytotoxic
      effect of TNF.

PMID- 7797462
TI  - Nitric oxide activates the glucose-dependent mobilization of arachidonic acid in
      a macrophage-like cell line (RAW 264.7) that is largely mediated by calcium
      independent phospholipase A2.
AB  - Herein, we demonstrate that nitric oxide is a potent (> 20% release) and highly
      selective inducer of [3H]arachidonic acid mobilization in the macrophage-like
      cell line RAW 264.7. Treatment of RAW 264.7 cells with (E)-6-(bromomethylene)-3
      (1-naphthalenyl)-2H-tetrahydropyran-2-one resulted in the inhibition of the large
      majority (86%) of nitric oxide-induced [3H]arachidonic acid release into the
      medium (IC50 < 0.5 microM) and the concomitant inhibition of in vitro measurable
      calcium-independent phospholipase A2 activity (92% inhibition) without
      demonstrable effects on calcium-dependent phospholipase A2 activity. Since nitric
      oxide is a potent stimulator of glycolysis (and therefore glycolytically derived
      ATP) and since cytosolic calcium-independent phospholipase A2 exists as a
      catalytic complex comprised of ATP-modulated phosphofructokinase-like regulatory
      polypeptides and a catalytic subunit, we examined the role of glucose in
      facilitating nitric oxide-mediated arachidonic acid release. Nitric oxide-induced
      release of [3H]arachidonic acid possessed an obligatory requirement for glucose,
      was highly correlated with the concentration of glucose in the medium, and was
      dependent on the metabolism of glucose. Thus, [3H]arachidonic acid release is
      coupled to cellular glucose metabolism through alterations in the activity of
      calcium-independent phospholipase A2. Collectively, these results identify a
      unifying metabolic paradigm in which the generation of lipid second messengers is
      coordinately linked to the signalstimulated acceleration of glycolytic flux,
      thereby facilitating integrated metabolic responses to cellular stimuli.

PMID- 7797466
TI  - Cleavage at arginine 145 in human blood coagulation factor IX converts the
      zymogen into a factor VIII binding enzyme.
AB  - The transition of the factor IX zymogen into the enzyme factor IXa beta was
      investigated. For this purpose, the activation intermediate factors IX alpha and
      IXa alpha were purified after cleavage of the Arg145-Ala146 and Arg180-Val181
      bonds, respectively. These intermediates were compared for a number of functional
      properties with factor IXa beta, which is cleaved at both positions. Factor IXa
      alpha was equal to factor IXa beta in hydrolyzing the synthetic substrate CH3SO2
      Leu-Gly-Arg-p-nitroanilide (kcat/Km approximately 120 s-1 M-1) but was less
      efficient in factor X activation. Factor IX alpha was incapable of generating
      factor Xa but displayed reactivity toward p-nitrophenol p-guanidinobenzoate and
      the peptide substrate. The catalytic efficiency, however, was 4-fold lower
      compared with factor IXa alpha and factor IXa beta. Factor IX alpha and factor
      IXa beta had similar affinity for the inhibitor benzamidine (Ki approximately 2.5
      mM), and amidolytic activity of both species was inhibited by Glu-Gly-Arg
      chloromethyl ketone and antithrombin III. Unlike factor IXa beta, factor IX alpha
      was unable to form SDS stable complexes with antithrombin III. Moreover,
      inhibition of factor IXa beta and factor IX alpha by Glu-Gly-Arg-chloromethyl
      ketone followed distinct pathways, because factor IX alpha was inhibited in a
      nonirreversible manner and displayed only minor incorporation of the dansylated
      inhibitor into its catalytic site. These data demonstrate that the catalytic site
      of factor IX alpha differs from that of the fully activated factor IXa beta.
      Factor IX and its derivatives were also compared with regard to complex assembly
      with factor VIII in direct binding studies employing the immobilized factor VIII
      light chain. Factor IX alpha and factor IXa beta displayed a 30-fold higher
      affinity for the factor VIII light chain (Kd approximately 12 nM) than the factor
      IX zymogen. Factor IXa alpha showed lower affinity (Kd approximately 50 nM) than
      factor IX alpha and factor IXa beta, which may explain the lower efficiency of
      factor X activation by factor IXa alpha. Collectively, our data indicate that
      cleavage of the Arg180-Val181 bond develops full amidolytic activity but results
      in suboptimal binding to the factor VIII light chain. With regard to cleavage of
      the Arg145-Ala146 bond, we have demonstrated that this results in the transition
      of the factor IX zymogen into an enzyme that lacks proteolytic activity.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7797467
TI  - Molecular cloning of a new interferon-induced factor that represses human
      immunodeficiency virus type 1 long terminal repeat expression.
AB  - Transcriptional induction of genes is an essential part of the cellular response
      to interferons. To isolate yet unidentified IFN-regulated genes we have performed
      a differential screening on a cDNA library prepared from human lymphoblastoid
      Daudi cells treated for 16 h with human alpha/beta interferon (Hu-alpha/beta
      IFN). In the course of these studies we have isolated a human cDNA which codes
      for a protein sharing homology with the mouse Rpt-1 gene; it will be referred as
      Staf-50 for Stimulated Trans-Acting Factor of 50 kDa. Amino acid sequence
      analysis revealed that Staf-50 is a member of the Ring finger family and contains
      all the features of a transcriptional regulator able to initiate a second cascade
      of gene induction (secondary response). Staf-50 is induced by both type I and
      type II IFN in various cell lines and down-regulates the transcription directed
      by the long terminal repeat promoter region of human immunodeficiency virus type
      1 in transfected cells. These data are consistent with a role of Staf-50 in the
      mechanism of transduction of the IFN antiviral action.

PMID- 7797468
TI  - Developmental regulation of elastin production. Expression of tropoelastin pre
      mRNA persists after down-regulation of steady-state mRNA levels.
AB  - To assess the mechanisms controlling the developmental regulation of tropoelastin
      expression in vivo, we developed a reverse-transcription-polymerase chain
      reaction (RT-PCR) assay to detect tropoelastin pre-mRNA as an indicator of
      ongoing transcription in intact tissue. RNA was isolated from mid-fetal (early
      elastogenic), neonatal (peak tropoelastin expression), and adult (very low
      tropoelastin expression) rat lungs and reverse transcribed, and the cDNA was
      amplified with intron specific primers. A weak hybridization signal for
      tropoelastin pre-mRNA was seen in mid-fetal samples, and paralleling the increase
      in steady-state mRNA levels, a strong signal for pre-mRNA was detected in
      neonatal samples, indicating transcriptional regulation. Stimulation of fetal
      lung tropoelastin expression by maternal administration of dexamethasone also led
      to an increase in pre-mRNA levels. However, signal for tropoelastin pre-mRNA in
      adult samples was equal to that detected in neonatal samples, even though mRNA
      levels had dropped about 80-fold. Persistence of tropoelastin transcription in
      adult tissue was also seen in cell culture models and was verified by nuclear
      runoff assay. In addition, an RT-PCR assay for alpha 1 (I) procollagen pre-mRNA
      accurately revealed the known transcriptional regulation of this gene. Our
      results demonstrate that the induction and maintenance of elastogenesis is
      controlled by a transcriptional mechanism, whereas, the cessation of tropoelastin
      expression is controlled by a post-transcriptional mechanism.

PMID- 7797465
TI  - Isolation and characterization of human casein kinase I epsilon (CKI), a novel
      member of the CKI gene family.
AB  - The casein kinase I (CKI) gene family is a rapidly enlarging group whose members
      have been implicated in the control of cytoplasmic and nuclear processes,
      including DNA replication and repair. We report here the cloning and
      characterization of a novel isoform of CKI from a human placental cDNA library.
      The cDNA for this isoform, hCKI epsilon, predicts a basic polypeptide of 416
      amino acids and a molecular mass of 47.3 kDa. It encodes a core kinase domain of
      285 amino acids and a carboxyl-terminal tail of 123 amino acids. The kinase
      domain is 53-98% identical to the kinase domains of other CKI family members and
      is most closely related to the delta isoform. Localization of the hCKI epsilon
      gene to chromosome 22q12-13 and the hCKI delta gene to chromosome 17q25 confirms
      that these are distinct genes in the CKI family. Northern blot analysis shows
      that hCKI epsilon is expressed in multiple human cell lines. Recombinant hCKI
      epsilon is an active enzyme that phosphorylates known CKI substrates including a
      CKI-specific peptide substrate and is inhibited by CKI-7, a CKI-specific
      inhibitor. A budding yeast isoform of CKI, HRR25, has been implicated in DNA
      repair responses. Expression of hCKI epsilon but not hCKI alpha rescued the slow
      growth phenotype of a Saccharomyces cerevisiae strain with a deletion of HRR25.
      Human CKI epsilon is a novel CKI isoform with properties that overlap those of
      previously described CKI isoforms.

PMID- 7797469
TI  - Biochemical discrimination between luminal and abluminal enzyme and transport
      activities of the blood-brain barrier.
AB  - Luminal and abluminal membrane vesicles derived from bovine brain endothelial
      cells, the site of the blood-brain barrier, were fractionated in a discontinuous
      Ficoll gradient. A mathematical analysis was developed to determine the membrane
      distribution of membrane marker enzyme activities as well as the ratio of luminal
      to abluminal membrane in each fraction of the gradient. The results of this
      analysis indicate that gamma-glutamyl transpeptidase and amino acid transport
      system A are located on the luminal and abluminal membranes, respectively.
      Conversely, 5'-nucleotidase and alkaline phosphatase activities are evenly
      distributed between both membranes. Although Na+/K(+)-ATPase activity is
      primarily located on the abluminal membrane, approximately 25% of the activity is
      of luminal origin. Na+/K(+)-ATPase activities associated with each membrane
      showed different ouabain sensitivities, suggesting that different isoenzymes are
      located in luminal and abluminal membranes. The analytical procedure used in this
      study provides a quantitative means to determine the distribution of marker
      enzymes and transport proteins in partially purified membrane vesicle
      populations.

PMID- 7797470
TI  - Neutral amino acid transport characterization of isolated luminal and abluminal
      membranes of the blood-brain barrier.
AB  - The neutral amino acid carrier composition of luminal and abluminal membranes of
      the blood-brain barrier has been studied using isolated membrane vesicles.
      Phenylalanine was carried almost exclusively by a high affinity (Km = 10 +/- 2
      microM), Na(+)-independent amino acid transport system, presumably L1 system,
      that was found to be symmetrically distributed between luminal and abluminal
      membranes. Inhibition of phenylalanine uptake was used to determine the
      affinities (Ki values) toward leucine (17 +/- 3 microM), tryptophan (8 +/- 1), 2
      aminobicyclo(2,2,1)-heptane-2-carboxylic acid (BCH) (11 +/- 2), alanine (628 +/-
      117), and glutamine (228 +/- 51). Alanine was found to be transported by two
      Na(+)-dependent transport systems that were located exclusively on the abluminal
      membrane. Kinetic and inhibition experiments indicated that one of these
      activities was due to system A, which is probably the main route for Na(+)
      dependent alanine transport (Km = 0.6 +/- 0.2 mM) under physiological conditions.
      The other Na(+)-dependent activity was attributed to a B(o,+)-like system based
      on its sensitivity toward BCH. This latter system showed greater affinity for
      large neutral amino acids. The affinities of these two transport systems for
      several other amino acids were also studied.

PMID- 7797471
TI  - Deletion of the PEST-like region of photosystem two modifies the QB-binding
      pocket but does not prevent rapid turnover of D1.
AB  - The rapid turn-over of the D1 polypeptide of the photosystem two complex has been
      suggested to be due to the presence of a "PEST"-like sequence located between
      putative transmembrane helices IV and V of D1 (Greenberg, B. M., Gaba, V.,
      Mattoo, A. K. and Edelman, M. (1987) EMBO J. 6, 2865-2869). We have tested this
      hypothesis by constructing a deletion mutant (delta 226-233) of the
      cyanobacterium Synechocystis sp. PCC 6803 in which residues 226-233 of the D1
      polypeptide, containing the PEST-like sequence, have been removed. The resulting
      mutant, delta PEST, is able to grow photoautotrophically and give light-saturated
      rates of oxygen at wild type levels. However electron transfer on the acceptor
      side of the complex is perturbed. Analysis of cells by thermoluminescence and by
      monitoring the decay in quantum yield of variable fluorescence following
      saturating flash excitation indicates that Q-B, but not Q-A, is destabilized in
      this mutant. Electron transfer on the donor side of photosystem two remains
      largely unchanged in the mutant. Turnover of the D1 polypeptide as examined by
      pulse-chase experiments using [35S]methionine was enhanced in the delta PEST
      mutant compared to strain TC31 which is the wild type control. We conclude that
      the PEST sequence is not absolutely required for turnover of the D1 polypeptide
      in vivo although deletion of residues 226-233 does have an effect on the redox
      equilibrium between QA and QB.

PMID- 7797472
TI  - Platelet-activating factor induces NF-kappa B activation through a G protein
      coupled pathway.
AB  - The capability of platelet-activating factor (PAF) to induce transcription factor
      activation was examined. In stably transfected Chinese hamster ovary cells
      expressing the PAF receptor (CHO-PAFR), PAF stimulation resulted in the nuclear
      expression of a DNA binding activity with specificity to the kappa B sequence.
      The p50 and p65 proteins, constituents of the prototypic nuclear factor kappa B
      (NF-kappa B), were identified as components of the DNA protein complexes by
      antipeptide antibodies in gel supershift as well as UV cross-linking experiments.
      PAF induced an initial decrease and subsequent increase of cytoplasmic I kappa B
      alpha levels, accompanied by up-regulation of the I kappa B alpha messenger RNA,
      a feature of NF-kappa B activation. PAF-induced kappa B binding activity was
      detected within 15 min after agonist stimulation, peaked at 30-40 min, and
      remained detectable by 2.5 h. SR 27417, a PAF receptor antagonist, blocked PAF
      induced kappa B binding activity but not that induced by tumor necrosis factor
      alpha (TNF alpha). Cholera toxin treatment markedly reduced PAF-induced kappa B
      binding activity, whereas pertussis toxin had no significant inhibitory effect.
      Neither of the two toxins affected the kappa B binding activity induced by TNF
      alpha in the same cells. In addition to the CHO-PAFR cells, PAF stimulated kappa
      B binding activity in the murine P388D1 macrophage and the human ASK.0 B cell
      lines that express endogenous PAF receptors. These results imply a potential role
      of PAF in the regulation of gene expression through a G protein-coupled
      transcription factor activation pathway.

PMID- 7797473
TI  - Partial purification and characterization of Arf-sensitive phospholipase D from
      porcine brain.
AB  - Phospholipase D (PLD) activity from membranes of cultured cells can be activated
      by guanosine 5'-O-(3-thiotriphosphate) and the small GTP-dependent protein, Arf.
      While this activity was readily apparent in membranes from HL60 cells, it was
      much lower or not observable in membranes from various mammalian tissues.
      However, extraction of porcine brain membranes with detergent and subsequent
      chromatography with SP-Sepharose revealed a large peak of Arf-sensitive PLD
      activity. This activity has been enriched through several steps of chromatography
      and characterized with respect to size, nucleotide specificity, and sensitivity
      to different Arf and Arf-like proteins. Hydrodynamic analysis indicated that the
      enriched PLD had an s20,w of 5.1 and a Stokes radius of 4.3 nm. These parameters
      indicate that the enzyme has an apparent molecular mass of 95,000 Da. Effective
      stimulation of the enriched enzyme was achieved with GTP as well as
      nonhydrolyzable analogs. All of the Arf subtypes tested were effective activators
      of PLD activity. Arf derived from yeast could activate mammalian PLD but with
      lower potency. The Arf-related Arl proteins were ineffective. PLD that has been
      highly enriched retained a requirement for phosphatidylinositol 4,5-bisphosphate
      for efficient expression of activity. Additionally, the ability of recombinant or
      purified porcine brain Arf to stimulate PLD activity was reduced relative to
      impure fractions of Arf activity. Thus, porcine PLD that has been purified about
      5,000-10,000-fold is synergistically activated by Arf in combination with other
      cytosolic components that are described in the accompanying paper (Singer, W. D.,
      Brown, H. A., Bokoch, G. M., and Sternweis, P. C. (1995) J. Biol. Chem. 270,
      14944-14950). Taken together, these data suggest that physiological regulation of
      Arf-sensitive PLD may involve the coordinate assembly of several interacting
      regulatory subunits.

PMID- 7797474
TI  - Resolved phospholipase D activity is modulated by cytosolic factors other than
      Arf.
AB  - Phospholipase D, which has been extracted from porcine brain membranes and
      chromatographically enriched 100-fold, was activated better by impure
      preparations of Arf than by purified or recombinant Arf. Examination of brain
      cytosol with this enriched preparation of PLD activity revealed at least three
      stimulatory components. One of these is Arf or the first cytoplasmic factor. A
      second peak of PLD-stimulating activity (cytoplasmic factor II, CFII) was
      resolved from Arf by anion exchange and gel filtration. This CFII can be further
      separated into multiple activities by chromatography with heparin-agarose. The
      activities were differentiated by their stimulatory properties as measured in the
      absence or presence of guanosine 5'-O-(3-thiotriphosphate) (GTP gamma S) alone
      and in the presence of added Arf and GTP gamma S. While all of the CFII pools
      stimulated PLD activity to some degree and showed synergistic activation when
      administered in conjunction with Arf, they could be classified into two groups
      with distinct behavior. When used together, pools from the two respective groups
      showed synergistic activation of PLD. The first set of pools contained the RhoA
      monomeric G protein. Recombinant RhoA was used to show that it could indeed
      activate this enriched PLD activity and act synergistically with Arf proteins. A
      related monomeric G protein, Cdc42, was also effective. The second set of CFII
      pools were devoid of RhoA and, in contrast to the first group, demonstrated
      significant stimulating activity in the absence of guanine nucleotides. These
      data indicate that the PLD activity from brain can be modulated by several
      cytosolic factors and that Arf-sensitive PLD may represent a complex activity
      that can be regulated in an interactive fashion by a variety of cellular
      signaling events.

PMID- 7797475
TI  - A possible role of ER-60 protease in the degradation of misfolded proteins in the
      endoplasmic reticulum.
AB  - Wild-type human lysozyme (hLZM) is secreted when expressed in mouse L cells,
      whereas misfolded mutant hLZMs are retained and eventually degraded in a pre
      Golgi compartment (Omura, F., Otsu, M., Yoshimori, T., Tashiro, Y., and Kikuchi,
      M. (1992) Eur. J. Biochem. 210, 591-599). These misfolded mutant hLZMs are
      associated with protein disulfide isomerase (Otsu, M., Omura, F., Yoshimori, T.,
      and Kikuchi, M. (1994) J. Biol. Chem. 269, 6874-6877). From the observation that
      this degradation is sensitive to cysteine protease inhibitors, such as N-acetyl
      leucyl-leucyl-norleucinal and N-acetyl-leucyl-leucyl-methioninal, but not to the
      serine protease inhibitors, 1-chloro-3-tosylamido-7-amino-2-heptanone and (p
      amidinophenyl)methanesulfonyl fluoride, it was suggested that some cysteine
      proteases are likely responsible for the degradation of abnormal proteins in the
      endoplasmic reticulum (ER). ER-60 protease (ER-60), an ER resident protein with
      cysteine protease activity (Urade, R., Nasu, M., Moriyama, T., Wada, K., and
      Kito, M. (1992) J. Biol. Chem. 267, 15152-15159), was found to associate with
      misfolded hLZMs, but not with the wild-type protein, in mouse L cells.
      Furthermore, denatured hLZM is degraded by ER-60 in vitro, whereas native hLZM is
      not. These results suggest that ER-60 could be a component of the proteolytic
      machinery for the degradation of misfolded mutant hLZMs in the ER.

PMID- 7797476
TI  - The activity of COOH-terminal domain phosphatase is regulated by a docking site
      on RNA polymerase II and by the general transcription factors IIF and IIB.
AB  - Each cycle of transcription appears to be associated with the reversible
      phosphorylation of the repetitive COOH-terminal domain (CTD) of the largest RNA
      polymerase (RNAP) II subunit. The dephosphorylation of RNAP II by CTD
      phosphatase, therefore, plays an important role in the transcription cycle. The
      following studies characterize the activity of HeLa cell CTD phosphatase with a
      special emphasis on the regulation of CTD phosphatase activity. Results presented
      here suggest that RNAP II contains a docking site for CTD phosphatase that is
      essential in the dephosphorylation reaction and is distinct from the CTD. This is
      supported by the observations that (a) phosphorylated recombinant CTD is not a
      substrate for CTD phosphatase, (b) RNAP IIB, which lacks the CTD, and RNAP IIA
      are competitive inhibitors of CTD phosphatase and (c) CTD phosphatase can form a
      stable complex with RNAP II. To test the possibility that the general
      transcription factors may be involved in the regulation of CTD phosphatase, CTD
      phosphatase activity was examined in the presence of recombinant or highly
      purified general transcription factors. TFIIF stimulates CTD phosphatase activity
      5-fold. The RAP74 subunit of TFIIF alone contained the stimulatory activity and
      the minimal region sufficient for stimulation corresponds to COOH-terminal
      residues 358-517. TFIIB inhibits the stimulatory activity of TFIIF but has no
      effect on CTD phosphatase activity in the absence of TFIIF. The potential
      importance of the docking site on RNAP II and the effect of TFIIF and TFIIB in
      regulating the dephosphorylation of RNAP II at specific times in the
      transcription cycle are discussed.

PMID- 7797477
TI  - Gibberellin biosynthesis in gib mutants of Gibberella fujikuroi.
AB  - The Ascomycete Gibberella fujikuroi synthesizes gibberellins, fujenal,
      carotenoids, and other terpenoids. Twelve gib mutants, isolated through the
      modified gibberellin fluorescence of their culture media, were subjected to
      chemical and biochemical analyses. Two mutants were specifically defective in the
      hydroxylation of carbon 13; their total gibberellin production was normal, but
      their main gibberellin was GA7 instead of GA3. Four mutants were blocked in the
      early reactions between geranylgeranyl pyrophosphate and 7-hydroxy-kaurenoic
      acid; two of them could not synthesize kaurene and another one was blocked in
      several oxidative steps. Six mutants had partial defects in early reactions,
      leading to the production of one-fifth to one-third of the wild type amounts of
      gibberellins and fujenal. Two of these produced considerable amounts of
      kaurenolides due to a defect in the conversion of kaurenoic acid to 7
      hydroxykaurenoic acid. Another one produced no carotenoids, but attempts to
      isolate mutants of reactions shared by the carotenoid and gibberellin pathways
      failed. The gib mutations did not modify the ability of the fungus to live as a
      saprophyte.

PMID- 7797478
TI  - Localization of the insulin-like growth factor II binding site to amino acids
      1508-1566 in repeat 11 of the mannose 6-phosphate/insulin-like growth factor II
      receptor.
AB  - The mannose 6-phosphate/insulin-like growth factor II receptor (M6P/IGF-II
      receptor) binds insulin-like growth factor II (IGF-II) with high affinity. To
      localize the IGF-II binding site within the 15 repeating units that form the
      extracytoplasmic domain of the receptor, purified human M6P/IGF-II receptor was
      digested with thermolysin, and the fragments were analyzed for their ability to
      bind 125I-IGF-II in a cross-linking assay. Two IGF-II-binding receptor fragments
      of 23 and 37 kDa were purified. Sequence analysis revealed that the fragments
      consist of disulfide connected peptides comprising amino acids 1331-1566 and 1331
      1697 of the receptor repeats 9-12. In a second approach we expressed truncated
      forms of the M6P/IGF-II receptor fused to the C terminus of the extracytoplasmic
      domain of the 46-kDa mannose 6-phosphate receptor. Fusion proteins containing
      M6P/IGF-II receptor repeats 10-15, 10-11, or 11-15 bound IGF-II, whereas a fusion
      protein containing the single repeat 10 failed to bind. This result indicates
      that repeat 11 (amino acids 1508-1650) is sufficient for binding of IGF-II.
      Residues 1508-1566, which are shared by the 23-kDa IGF-II-binding fragment and
      repeat 11, are proposed to form the IGF-II binding site of the M6P/IGF-II
      receptor.

PMID- 7797480
TI  - Identification and functional characterization of an erythroid-specific enhancer
      in the L-type pyruvate kinase gene.
AB  - The rat L-type pyruvate kinase gene is transcribed either from promoter L in the
      liver or promoter L' in erythroid cells. We have now cloned and functionally
      characterized an erythroid-specific enhancer, mapped in the fetal liver as
      hypersensitive site B (HSSB) at 3.7 kilobases upstream from the promoter L'.
      Protein-DNA interactions were examined in the 200-base pair core of the site by
      in vivo footprinting experiments. In the fetal liver, footprints were revealed at
      multiple GATA and CACC/GT motifs, whose association is the hallmark of erythroid
      specific regulatory sequences. Functional analysis of the HSSB element in
      transgenic mice revealed properties of a cell-restricted enhancer. Indeed, this
      element was able to activate the linked ubiquitous herpes simplex virus thymidine
      kinase promoter in erythroid tissues. The activation was also observed in a
      variety of nonerythroid tissues known to synthesize GATA-binding factors. In the
      context of L'-PK transgenes, HSSB was not needed for an erythroid-specific
      activation of the L' promoter, while it was required to stimulate the L' promoter
      activity to a proper level. Finally, HSSB cannot be replaced by strong ubiquitous
      viral or cellular enhancers, suggesting a preferential interaction of the HSSB
      region with the L' promoter.

PMID- 7797479
TI  - Phosphorylation of CTP synthetase from Saccharomyces cerevisiae by protein kinase
      C.
AB  - Phosphorylation of CTP synthetase (EC 6.3.4.2, UTP:ammonia ligase (ADP-forming))
      from Saccharomyces cerevisiae protein kinase C was examined. Using pure CTP by
      synthetase as a substrate, protein kinase C activity was dose- and time-dependent
      and required calcium, diacylglycerol, and phosphatidylserine for full activation.
      Protein kinase C activity was also dependent on the concentration of CTP
      synthetase. Protein kinase C phosphorylated CTP synthetase on serine and
      threonine residues in vitro whereas the enzyme was primarily phosphorylated on
      serine residues in vivo. Phosphopeptide mapping analysis of CTP synthetase
      phosphorylated in vitro and in vivo indicated that the enzyme was phosphorylated
      on more than one site. Most of the phosphopeptides derived from CTP synthetase
      phosphorylated in vivo were the same as those derived from CTP synthetase
      phosphorylated by protein kinase C in vitro. The stoichiometry of the
      phosphorylation of native CTP synthetase was 0.4 mol of phosphate/mol of enzyme
      whereas the stoichiometry of the phosphorylation of alkaline phosphatase-treated
      CTP synthetase was 2.2 mol of phosphate/mol of enzyme. This indicated that CTP
      synthetase was purified in a phosphorylated state. Phosphorylation of CTP
      synthetase resulted in a 3-fold activation in enzyme activity whereas alkaline
      phosphatase treatment of CTP synthetase resulted in a 5-fold decrease in enzyme
      activity. Overall, the results reported here were consistent with the conclusion
      that CTP synthetase was regulated by protein kinase C phosphorylation.

PMID- 7797481
TI  - Topoisomerase II binds to ellipticine in the absence or presence of DNA.
      Characterization of enzyme-drug interactions by fluorescence spectroscopy.
AB  - Although a number of drugs currently in use for the treatment of human cancers
      act by stimulating topoisomerase II-mediated DNA breakage, little is known
      regarding interactions between these agents and the enzyme. To further define the
      mechanism of drug action, interactions between ellipticine (an intercalative drug
      with clinical relevance) and yeast topoisomerase II were characterized. By
      utilizing a yeast genetic system, topoisomerase II was identified as the primary
      cellular target of the drug. Furthermore, ellipticine did not inhibit enzyme
      mediated DNA religation, suggesting that it stimulates DNA breakage by enhancing
      the forward rate of cleavage. Finally, ellipticine binding to DNA, topoisomerase
      II, and the enzyme-DNA complex was assessed by steady-state and frequency domain
      fluorescence spectroscopy. As determined by changes in fluorescence intensity and
      emission maximum wavelength, and by lifetime analysis, only the protonated
      species of ellipticine bound to a double-stranded 40-mer oligonucleotide
      containing a topoisomerase II cleavage site (KD approximately 65 nM). In
      contrast, predominantly deprotonated ellipticine bound to the enzyme.DNA complex
      (KD approximately 1.5 microM) or to the enzyme in the absence of nucleic acids
      (KD approximately 160 nM). These findings suggest that ellipticine interacts
      directly with topoisomerase II and that the enzyme dictates the ionic state of
      the drug in the ternary complex. A model is presented in which the topoisomerase
      II.ellipticine.DNA complex is formed via initial drug binding to either the
      enzyme or DNA.

PMID- 7797482
TI  - Structural analysis of the mannan region of lipoarabinomannan from Mycobacterium
      bovis BCG. Heterogeneity in phosphorylation state.
AB  - Lipoarabinomannan (LAM) is a major antigen of mycobacterial cell walls, involved
      in host-Mycobacterium interactions. In a previous work, LAM from the vaccine
      strain, Mycobacterium bovis BCG, was found to exhibit mannooligosaccharides at
      its arabinan nonreducing ends (ManLAM). The present report concerns the mannan
      core structure of this ManLAM. After partial hydrolysis of ManLAM, two
      populations of mannans (Ma1 and Ma2) were obtained by gel filtration
      chromatography. Their structural features were defined by means of two
      dimensional homo- and heteronuclear (1H-13C) NMR sequences and methylation
      analysis. They were both found to be composed of an alpha-(1-->6)-linked mannan
      backbone with alpha-(1-->2)-Manp-linked side chains. They are highly branched,
      and Ma2 presents a higher frequency of branching than Ma1. Moreover, chemical
      analysis indicates that only Ma1 is phosphorylated. By a two-dimensional
      heteronuclear 1H-31P total correlation experiment, the phosphate was found to be
      involved in a phosphodiester bond between inositol C-1 and glycerol C-3. Then,
      the molecular mass of mannan was established by mass spectrometry, which revealed
      a molecular mass of 3517 Da for the major molecular species of Ma1. Likewise,
      analysis of unfractionated mannans showed the occurrence of other, quantitatively
      minor molecular species, endowed with two phosphates. This study clearly
      indicates that the mannan region of M. bovis BCG ManLAM exists as a heterogeneous
      population of molecules whose structures differ in their degree of glycosylation,
      level of branching, and phosphorylation state. The hypothesis that the relative
      abundance of these different molecules modulates the biological functions of LAM
      is discussed.

PMID- 7797485
TI  - VMA8 encodes a 32-kDa V1 subunit of the Saccharomyces cerevisiae vacuolar H(+)
      ATPase required for function and assembly of the enzyme complex.
AB  - The isolated Saccharomyces cerevisiae vacuolar proton-translocating ATPase (V
      ATPase) is composed of at least 10 subunits. We have identified VMA8, the gene
      encoding the 32-kDa subunit of the V-ATPase, by 100% match between the sequences
      of tryptic peptides and the predicted protein sequence of ORF11. The VMA8 gene
      contains a 768-base pair open reading frame encoding a 256-amino acid protein
      with a predicted molecular mass of 29,176 Da. Disruption of VMA8 resulted in a
      mutant exhibiting pH-sensitive growth, slowed growth under all conditions, and an
      inability to grow on nonfermentable carbon sources. Vacuolar membranes isolated
      from vma8 delta yeast cells exhibited no V-ATPase activity. Immunoblot analysis
      of vma8 delta cells revealed normal levels of both V1 and Vo subunits. Whereas
      the V1 subunits failed to associated with the vacuolar membrane in vma8 delta
      cells, the Vo polypeptides were transported to and stable in the vacuolar
      membrane. Density gradient fractionation revealed that Vma8p associated only with
      the fully assembled V-ATPase and did not associate with a separate lower density
      Vo subcomplex fraction. Finally, Vma8p was unable to assemble onto the vascular
      membranes in the absence of other V1 subunits.

PMID- 7797483
TI  - gp180, a host cell glycoprotein that binds duck hepatitis B virus particles, is
      encoded by a member of the carboxypeptidase gene family.
AB  - Duck hepatitis B virus particles bearing the L and S envelope proteins bind a
      cellular glycoprotein of 180 kDa (gp180) with high affinity and specificity.
      Binding is mediated by the pre-S region of the L protein and is blocked by
      neutralizing but not by non-neutralizing monoclonal antibodies to the virus.
      These and other properties have suggested that gp180 may be a component of the
      viral entry machinery. Here we report the purification of gp180 from duck liver
      and the isolation and characterization of cDNA encoding it. DNA sequence analysis
      of this cDNA indicates that gp180 is a novel member of the basic carboxypeptidase
      gene family.

PMID- 7797484
TI  - 5-Oxo-eicosanoids are potent eosinophil chemotactic factors. Functional
      characterization and structural requirements.
AB  - Human eosinophils produce upon treatment with 5-oxo-eicosatetraenoic acid or
      (5S,15S)-dihydroxyeicosatetraenoic acid a potent eosinophil-chemotactic
      eicosanoid, 5-oxo-15-hydroxy-(6E,8Z,11Z,13E)-eicosatetraenoi c acid (5-oxo-15
      HETE). 5-Oxo-15-HETE induces human eosinophil (Eo) chemotaxis at nanomolar
      concentrations with an efficacy in vitro comparable to that seen for platelet
      activating factor. Comparison of Eo chemotactic activities of several
      structurally related eicosanoids with different substituents and/or double bound
      geometry led to the conclusion that maximal potency and efficacy of eosinophil
      chemotactic and chemokinetic activity is present in 5-oxo-(6E,8Z,11Z,14Z)
      eicosatetraenoic acid (5-oxo-ETE). The presence of a hydroxyl group at position C
      15 is not necessary for potent chemotactic activity, whereas a geometric isomer
      having trans instead of cis double bond at C-atom 8, as well as esterified 5-oxo
      ETE usually show a 5-10-fold lower potency. 5-Oxo-eicosanoids elicit a dose
      dependent transient rise of intracellular Ca2+ levels in human Eos, however, in
      contrast to some other Eo chemotaxins do not induce degranulation. Cross
      desensitization of Ca2+ mobilization and Eo chemotaxis revealed that the
      geometric isomers of 5-oxo-eicosanoids, 5(S)-HETE, and (5S,15S)-di-HETE cross
      deactivate Eo responses to each other, whereas other, unrelated stimuli did not
      interfere with these lipids indicating that 5-oxo-eicosanoids activate Eos via a
      separate receptor.

PMID- 7797486
TI  - Characterization of the enhanced transport of L- and D-lactate into human red
      blood cells infected with Plasmodium falciparum suggests the presence of a novel
      saturable lactate proton cotransporter.
AB  - Human erythrocytes parasitized with the malarial protozoan Plasmodium falciparum
      showed rates of L-lactate, D-lactate, and pyruvate uptake many fold greater than
      control cells. Thus it was necessary to work at 0 degrees C to resolve true
      initial rates of transport. Studies on the dependence of the rate of transport on
      substrate concentration implied the presence in parasitized cells of both a
      saturable mechanism blocked by alpha-cyano-4-hydroxycinnamate (CHC) and a
      nonsaturable mechanism insensitive to CHC. The former was dominant at
      physiological substrate concentrations with Km values for pyruvate and D-lactate
      of 2.3 and 5.2 mM, respectively, with no stereoselectivity for L- over D-lactate.
      CHC was significantly less effective as an inhibitor of lactate transport in
      parasitized erythrocytes than in uninfected cells, whereas p
      chloromercuribenzenesulfonate, a potent inhibitor in control cells, gave little
      or no inhibition of lactate transport into parasitized erythrocytes. Inhibition
      of transport into infected cells was also observed with phloretin, furosemide,
      niflumic acid, stilbenedisulfonate derivatives, and 5-nitro-2-(3
      phenylpropylamino)benzoic acid at concentrations similar to those that inhibit
      the lactate carrier of control erythrocytes. These compounds were more effective
      inhibitors of the rapid transport of chloride into infected cells than of lactate
      transport, whereas CHC was more effective against lactate transport. This implies
      that different pathways are involved in the parasite-induced transport pathways
      for lactate and chloride. The transport of L-lactate into infected erythrocytes
      was also inhibited by D-lactate, pyruvate, 2-oxobutyrate, and 2-hydroxybutyrate.
      The intracellular accumulation of L-lactate at equilibrium was dependent on the
      transmembrane pH gradient, suggesting a protogenic transport mechanism. Our data
      are consistent with lactate and pyruvate having direct access to the malarial
      parasite, perhaps via the proposed parasitophorous duct or some close contact
      between the host cell and parasite plasma membranes, with transport across the
      latter by both a proton-linked carrier (CHC-sensitive, saturable, and the major
      route) and free diffusion of the undissociated acid (CHC-insensitive,
      unsaturable, and a minor route).

PMID- 7797488
TI  - Platelet factor-4 inhibits the mitogenic activity of VEGF121 and VEGF165 using
      several concurrent mechanisms.
AB  - The 121-amino acid form of vascular endothelial growth factor (VEGF121) and the
      165-amino acid form (VEGF165) are mitogenic for vascular endothelial cells and
      induce angiogenesis in vivo. VEGF165 possesses a heparin binding ability and in
      the absence of heparin-like molecules does not bind efficiently to the VEGF
      receptors of vascular endothelial cells. The binding of 125I-VEGF165 to the VEGF
      receptors of endothelial cells, and the heparin-dependent binding of 125I-VEGF165
      to a soluble extracellular domain of the VEGF receptor KDR/flk-1, were inhibited
      by the angiogenesis inhibitor platelet factor-4 (PF4). In contrast, PF4 was not
      able to inhibit the binding of VEGF121, a VEGF isoform which lacks a heparin
      binding capacity, to the VEGF receptors of the cells or to KDR/flk-1. These
      results indicate that PF4 may inhibit VEGF165 binding to VEGF receptors by
      disrupting the interaction of VEGF165 with cell surface heparan sulfates. Since
      PF4 mutants lacking a heparin binding ability retain their anti-angiogenic
      activity, alternative inhibitory mechanisms were also examined. 125I-PF4 bound
      with high affinity (Kd 5 x 10(-9) M) to VEGF165-coated wells. The binding of 125I
      PF4 to the VEGF165-coated wells was inhibited by several types of heparin binding
      proteins, including unlabeled PF4 and unlabeled VEGF165. The binding was not
      inhibited by proteins which lack a heparin binding capacity, nor was it inhibited
      by VEGF121. Heparinase did not inhibit the binding of 125I-PF4 to VEGF165,
      indicating that heparin-like molecules are not required. These experiments
      suggest that PF4 can bind to heparin binding proteins such as VEGF165 leading to
      an inhibition of their receptor binding ability. In agreement with these results,
      we have observed that PF4 inhibits efficiently the VEGF165 induced proliferation
      of vascular endothelial cells. Unexpectedly, PF4 also inhibited efficiently the
      VEGF121-induced proliferation of the cells, indicating that PF4 can disrupt VEGF
      receptor mediated signal transduction using an unknown mechanism which does not
      interfere with VEGF121 binding.

PMID- 7797487
TI  - Cloning, bacterial expression, and characterization of the Mason-Pfizer monkey
      virus proteinase.
AB  - We have cloned and expressed the 3' region of the Mason-Pfizer monkey virus pro
      gene in Escherichia coli. The recombinant 26-kDa precursor undergoes rapid self
      processing both in E. coli and in vitro at the NH2 terminus, yielding a
      proteolytically active 17-kDa protein, p17. This initial cleavage is followed in
      vitro by a much slower self-processing that leads to emergence of proteolytically
      active p12 and a COOH-terminal cleavage product p5. We have found the NH2
      terminal processing site of both the p17 and p12 to be identical and similar to
      the amino terminus of the mouse mammary tumor virus proteinase. We have also
      identified the COOH-terminal processing site of the p12 form. Using purified
      recombinant proteins and synthetic oligopeptide substrates based on naturally
      occurring retroviral processing sites, we have determined the enzymatic activity
      and specificity of the Mason-Pfizer monkey virus proteinase to be more closely
      related to that of myeloblastosis-associated virus proteinase rather than that of
      the Human immunodeficiency virus type 1 proteinase. Inhibition studies using
      peptide inhibitors support these results.

PMID- 7797489
TI  - Expression screening reveals an orphan receptor chick ovalbumin upstream promoter
      transcription factor I as a regulator of neurite/substrate-cell contacts and cell
      aggregation.
AB  - A rat homologue of chick ovalbumin upstream promoter transcription factor I (COUP
      TF I) was isolated using an expression cloning method developed to isolate
      neurite outgrowth inhibitors. Overexpression of COUP-TF I in 3T3 fibroblasts
      resulted in reduction of stable contact formation between neurites and
      transfected cells. Additionally, COUP-TF I enhanced retinoic acid response
      element-dependent reporter gene expression in 3T3 fibroblasts, indicating that
      COUP-TF I can modulate transcriptional activation in these cells. Our data
      suggest that COUP-TF transcription factors are involved in the regulation of cell
      surface molecules during neruogenesis.

PMID- 7797491
TI  - Thermodynamics of fatty acid binding to fatty acid-binding proteins and fatty
      acid partition between water and membranes measured using the fluorescent probe
      ADIFAB.
AB  - Using the fluorescent probe ADIFAB (acrylodan-derivatized intestinal fatty acid
      binding protein) to determine the equilibrium concentration of the free (unbound)
      fatty acid (FFA), dissociation constants were measured between 10 and 50 degrees
      C for the interaction of five different long chain fatty acids (FA) with fatty
      acid-binding proteins (FABP) from adipocyte, intestine, and heart. Gibbs free
      energies (delta G) determined from the dissociation constants were between about 
      9 and -11 kcal/mol at 25 degrees C. Thermodynamic parameters for binding were
      determined using van't Hoff plots of the dissociation constants, which range,
      over the entire temperature region, between 2 and 3000 nM. For all the unlabeled
      FABPs, free energies of binding were dominated by large negative enthalpies that
      ranged from -7 to -12 kcal/mol, and the enthalpies tended to decrease with
      increasing FA unsaturation. The entropic contributions (-T detla S) at 25 degrees
      C between -4 and +2 kcal/mol and tended to increase with increasing FA
      unsaturation. To assess the role of FA aqueous solubility in FABP binding,
      measurements of the partition of FA between unilamellar lipid vesicles and water
      were also done using ADIFAB; the lipid/water partition coefficients (Kp)
      determined from these measurements were found to be independent of temperature.
      The binding of FA to FABP is governed by the sum of contributions of various
      interactions between FA, water, and FABP. An analysis of the individual
      contributions suggests that the net free energy of binding results from the
      canceling in part of a number of separate quite large contributions. The entropic
      contributions sum almost to zero for most FA and FABPs as a result of the
      canceling of a large increase in bulk solvent entropy by decreases in
      configurational entropy upon FA binding to FABP. The net, approximately -10
      kcal/mol enthalpy of binding, probably results from an increase in FA
      configurational enthalpy upon binding to FABP plus a large negative enthalpy from
      the interaction between the FA and the FABP. This large enthalpy of the FA-FABP
      interaction suggests that in addition to previously identified specific
      interactions between the carboxylate portion of the FA and charged amino acids
      within the binding cavity, other significantly larger enthalpic interactions,
      presumably involving the hydrocarbon portion of the FA, must contribute to the
      binding energy.

PMID- 7797490
TI  - Catalytic cleavage of an RNA target by 2-5A antisense and RNase L.
AB  - 2-5A antisense (2-5A-AS) molecules are chimeric oligonucleotides that cause 2-5A
      dependent RNase (RNase L) to catalyze the selective cleavage of RNA in human
      cells. These composite nucleic acids consist of a 5'-monophosphorylated, 2',5'
      linked oligoadenylate known as 2-5A (an activator of RNase L) covalently attached
      to antisense 3',5'-oligodeoxyribonucleotides. Here, we characterize the targeted
      cleavage of the double-stranded RNA-dependent protein kinase (PKR) mRNA by
      purified, recombinant human RNase L. A 2-5A-AS chimera, which contains
      complementary sequence to PKR mRNA, and unmodified 2-5A, which causes general RNA
      decay, were about 20- and 40-fold more active, respectively, than 2-5A-AS
      chimeras in which the DNA domains are not complementary to sequences in PKR mRNA.
      Directed cleavage was efficient because each 2-5A-AS chimera targeted many RNA
      molecules. Moreover, RNase L caused the catalytic cleavage of the RNA target
      (kcat of approximately 7 s-1). The precise sites of PKR mRNA cleavage caused by 2
      5A-AS were mapped, using a primer extension assay, to phosphodiester bonds
      adjacent to the 3' terminus of the chimera binding site (5' on the RNA target) as
      well as within the chimera's oligonucleotide binding site itself. The selectivity
      of this approach is shown to be provided by the antisense arm of the chimera,
      which places the RNA target in close proximity to the RNase.

PMID- 7797492
TI  - Role of the endoplasmic reticulum chaperone calnexin in subunit folding and
      assembly of nicotinic acetylcholine receptors.
AB  - The nicotinic acetylcholine receptor (AChR) is a pentameric complex assembled
      from four different gene products by mechanisms that are inadequately understood.
      In this study we investigated the role of the endoplasmic reticulum (ER)-resident
      molecular chaperone calnexin in AChR subunit folding and assembly. We have shown
      that calnexin interacts with nascent AChR alpha-subunits (AChR-alpha) in muscle
      cell cultures and in COS cells transfected with mouse AChR-alpha. In chick muscle
      cells maximal association of labeled alpha-subunits with calnexin was observed
      immediately after a 15-min pulse with [35S]methionine/cysteine and subsequently
      declined with a t1/2 of approximately 20 min. The decrease in association with
      calnexin was concomitant with the folding of the alpha-subunit to achieve
      conformational maturation shortly before assembly. Brefeldin A did not inhibit
      AChR subunit assembly or the dissociation of calnexin from the assembling
      subunits, confirming that the ER is the site of AChR assembly and that calnexin
      dissociation is not affected under conditions in which the exit of assembled AChR
      from the ER is blocked. These results indicate that calnexin participates
      directly in the molecular events that lead to AChR assembly.

PMID- 7797494
TI  - Low density lipoprotein (LDL) cholesterol is converted to 27-hydroxycholesterol
      in human fibroblasts. Evidence that 27-hydroxycholesterol can be an important
      intracellular mediator between LDL and the suppression of cholesterol production.
AB  - The formation of oxysterols in cultured human fibroblasts and their physiological
      roles as intracellular regulators of cholesterol production have been
      investigated. In the presence of low density lipoproteins (LDL) normal
      fibroblasts converted LDL cholesterol to the oxysterol 27-hydroxycholesterol in
      quantities apparently sufficient to down-regulate 3-hydroxy-3-methylglutaryl
      coenzyme A (HMG-CoA) reductase. The production of 27-hydroxycholesterol started 3
      8 h after the addition of LDL to the incubation medium, and during this time the
      activity of HMG-CoA reductase decreased by 73%. Formation of other biologically
      active oxysterols such as 7 alpha-hydroxycholesterol, 24-hydroxycholesterol, and
      25-hydroxycholesterol was not observed. When 27-hydroxylation of LDL cholesterol
      in mitochondria was selectively prevented by treating normal fibroblasts with
      cyclosporin A or by using fibroblasts genetically lacking sterol 27-hydroxylase,
      the suppressive effect of LDL on HMG-CoA reductase was reduced by a factor of
      about 10. In the absence of LDL or when the fibroblasts lacked LDL-receptors, the
      cells did not produce detectable amounts of 27-hydroxycholesterol, and HMG-CoA
      reductase was up-regulated. The results provide strong evidence that 27
      hydroxycholesterol is an important intracellular mediator between LDL and the
      suppression of HMG-CoA reductase in human fibroblasts. The mitochondrial
      uptake/metabolism of LDL cholesterol seems to be a biologically important
      extension of the LDL pathway in human cells, since the mitochondrial products of
      LDL cholesterol may regulate cholesterol homeostasis or be precursors of steroid
      hormones or bile acids. This pathway, which has now been demonstrated in
      fibroblasts, may link together the two 22-year-old observations that LDL as well
      as oxysterols can down-regulate HMG-CoA reductase in cells.

PMID- 7797493
TI  - Segmental conservation of sapA sequences in type B Campylobacter fetus cells.
AB  - Campylobacter fetus cells may exist as either of two defined serogroups (type A
      or B) based on their lipopolysaccharide (LPS) composition. Wild-type strains
      contain surface array proteins (S-layer proteins) that have partial antigenic
      cross-reactivity but bind exclusively to LPS from homologous (type A or B) cells.
      Type A cells possess 8 homologs of sapA, which encodes a 97-kDa S-layer protein;
      the gene products of these homologs have a conserved N terminus of 184 amino
      acids. To further explore the structural relationships between the C. fetus S
      layer proteins and their encoding genes, we sought to clone and express an S
      layer protein from type B strain 84-91. The cloned type B gene (sapB) was similar
      in structure to the previously cloned type A gene (sapA) and encoded a full
      length 936-amino acid (97-kDa) S-layer protein. Sequence analysis of sapB
      indicated that the conserved N-terminal encoding region in sapA was absent but
      that the remainder of the ORF (encoding 751 amino acids) was identical to that of
      sapA in spite of the nonconserved nature of this region among sapA homologs.
      Noncoding sequences both 300 base pairs 5' and 1000 base pairs 3' to the sapB and
      sapA ORFs, including the sapA promoter and transcriptional terminator sequences,
      were essentially identical. Southern analyses revealed that the sapB N-terminal
      encoding region was conserved in multiple copies in type B strains but was absent
      in type A strains. Recombinant sapA and sapB products bound to a substantially
      greater degree to cells of the homologous LPS type compared with the heterologous
      LPS type, indicating that the conserved sapA- and sapB-encoded N termini are
      critical for LPS binding specificity. The parallel genetic organization and
      identity at the nucleotide level in both coding and noncoding regions for sap
      homologs in types A and B cells indicates the necessity of both homolog
      conservation and high fidelity DNA replication in the biology of sap diversity.

PMID- 7797495
TI  - The fatty acid bimodal action on superoxide anion production by human adherent
      monocytes under phorbol 12-myristate 13-acetate or diacylglycerol activation can
      be explained by the modulation of protein kinase C and p47phox translocation.
AB  - We studied the translocation of protein kinase C (PKC), the endogenous
      phosphorylation and presence in the membrane fraction of p47phox (the 47-kDa
      cytosolic component of the phagocyte NADPH oxidase), and the O-.2 production in
      human adherent monocytes (HAMs). This was performed under phorbol myristate
      acetate (PMA) or diacylglycerol stimulation after cell preincubation in the
      presence of either 13-methyltetradecanoate or arachidonate. At 3 nM and 30
      microM, both fatty acids had enhancing and depressing effects, respectively, on
      PKC translocation and O-.2 production strictly depending on the PMA- or
      diacylglycerol-stimulated state of the cell. Endogenous phosphorylation and
      membrane presence of p47phox were markedly reinforced in PMA-stimulated HAMs in
      the presence as compared to the absence of 13-methyltetradecanoate. These results
      emphasize the fact that in intact cells the capacity of both FAs to potentiate or
      depress the HAM O-.2 production is mediated by a direct action on the PKC
      membrane translocation leading to a simultaneous endogenous phosphorylation and
      membrane translocation of p47phox. They confirm the recent findings (Kadri
      Hassani, N., Leger, C. L., and Descomps, B. (1995) J. Lipid Med. Cell Signal. 11,
      159-173) on the PKC-mediated, adherent monocyte-specific capacity of these fatty
      acids and others (with the exception of linear saturated fatty acids) to enhance
      the PMA-stimulated O-.2 production at nanomolar concentrations and to depress it
      at micromolar concentrations.

PMID- 7797496
TI  - Transactivation of LAP/NF-IL6 is mediated by an acidic domain in the N-terminal
      part of the protein.
AB  - LAP/NF-IL6 is a member of the C/EBP family of transcriptional activators and has
      been shown to be involved in the regulation of the acute-phase response. We have
      previously shown that phosphorylation of the liver-enriched transcriptional
      activator protein (LAP) Ser-105 enhances the activation of LAP-dependent genes.
      To identify the region which is important for gene activation, a series of LAP
      mutants were constructed, and domain swapping experiments with the DNA-binding
      domain of GAL4 were performed. These experiments point to an acidic region
      located between amino acids 21 and 105 of LAP/NF-IL6 which activates genes
      independent of the DNA-binding domain and the leucine zipper of LAP/NF-IL6.
      Computer-assisted predictions reveal two regions, a helical and a hydrophobic
      region in the transactivation domain, which could be important in mediating the
      direct interaction with the basal machinery. Site-directed mutagenesis of acidic
      residues in both regions demonstrates that the hydrophobic region located between
      amino acids 85 and 95 is the likely motif for the interaction with the basal
      machinery. Our results demonstrate that a hydrophobic region in the acidic
      transactivation domain of LAP/NF-IL6 seems to be relevant in mediating gene
      activation of LAP-dependent genes.

PMID- 7797497
TI  - Inhibition of low threshold calcium channels by angiotensin II in adrenal
      glomerulosa cells through activation of protein kinase C.
AB  - In adrenal glomerulosa cells, low threshold voltage-activated (T-type) calcium
      channels play a crucial role in coupling physiological variations of
      extracellular potassium to aldosterone biosynthesis. Angiotensin II markedly
      reduced the activity of these channels by shifting their activation curve toward
      positive voltage values. This inhibition of the channels resulted in a marked
      decrease of the cytosolic free calcium concentration maintained by potassium.
      This effect was abolished by losartan, a specific antagonist of the angiotensin
      II AT1 receptor. Hormone action on T-type channels appeared to be mediated by
      protein kinase C because 1) it was mimicked by phorbol ester and diacylglycerol,
      and 2) it was significantly reduced by decreasing protein kinase C activity with
      specific inhibitors such as chelerythrine chloride or a pseudosubstrate of the
      enzyme, as well as by protein kinase C down-regulation. Similarly, protein kinase
      C activation reduced the cytosolic calcium response to potassium and the
      steroidogenic action of this agonist. Low threshold T-type calcium channels
      therefore appear as potential sites for the modulation of steroidogenesis by
      protein kinase C in adrenal glomerulosa cells.

PMID- 7797498
TI  - The neuronal nicotinic acetylcholine receptor alpha 2 subunit gene promoter is
      activated by the Brn-3b POU family transcription factor and not by Brn-3a or Brn
      3c.
AB  - The regulatory region of the neuronal nicotinic acetylcholine receptor alpha 2
      subunit gene, which contains six copies of the octamer-related sequence
      CCCCATGCAAT, is activated by the Brn-3b POU family transcription factor but not
      by the closely related factors Brn-3a and Brn-3c. This effect is in contrast to
      the previously documented inhibitory effect of Brn-3b on octamer-containing
      promoters that are activated by Brn-3a and Brn-3c. Activation of the alpha 2 gene
      by Brn-3b requires that both the POU domain and other N-terminal sequences are
      derived from Brn-3b and is dependent on the intactness of the alpha 2 gene
      regulatory region, being lost in truncated derivatives containing one, two, or
      four copies of the octamer-related sequence. Surprisingly, however, these
      truncated derivatives are activated by Brn-3c. These effects are discussed in
      terms of both the influence of the target sequence and its context in the
      promoter on activation by the various forms of Brn-3 as well as of the processes
      that restrict expression of the alpha 2 subunit gene to a few cells in the
      nervous system.

PMID- 7797499
TI  - Alpha-scorpion toxins binding on rat brain and insect sodium channels reveal
      divergent allosteric modulations by brevetoxin and veratridine.
AB  - At least six topologically separated neurotoxin receptor sites have been
      identified on sodium channels that reveal strong allosteric interactions among
      them. We have studied the allosteric modulation induced by veratridine, binding
      to receptor site 2, and brevetoxin PbTx-1, occupying receptor site 5, on the
      binding of alpha-scorpion toxins at receptor site 3, on three different neuronal
      sodium channels: rat brain, locust, and cockroach synaptosomes. We used 125I-AaH
      II, the most active alpha-scorpion toxin on vertebrates, and 125I-Lqh alpha IT,
      shown to have high activity on insects, as specific probes for receptor site 3 in
      rat brain and insect sodium channels. Our results reveal that brevetoxin PbTx-1
      generates three types of effects at receptor site 3:1) negative allosteric
      modulation in rat brain sodium channels, 2) positive modulation in locust sodium
      channels, and 3) no effect on cockroach sodium channel. However, PbTx-1 activates
      sodium channels in cockroach axon similarly to its activity in other preparation.
      Veratridine positively modulates both rat brain and locust sodium channels but
      had no effect on alpha-toxin binding in cockroach. The dramatic differences in
      allosteric modulations in each sodium channel subtype suggest structural
      differences in receptor sites for PbTx-1 and/or at the coupling regions with
      alpha-scorpion toxin receptor sites in the different sodium channels, which can
      be detected by combined application of specific channel modifiers and may
      elucidate the dynamic gating activity and the mechanism of allosteric
      interactions among various neurotoxin receptors.

PMID- 7797500
TI  - The zinc-binding site of Escherichia coli glutamyl-tRNA synthetase is located in
      the acceptor-binding domain. Studies by extended x-ray absorption fine structure,
      molecular modeling, and site-directed mutagenesis.
AB  - The zinc contents of fragments of Escherichia coli glutamyl-tRNA synthetase, as
      well as the conservation of the CYC sequence only in zinc-containing glutamyl
      tRNA synthetases, suggested that the 98CYCX24-CRHSHEHHADDEPC138 includes some or
      all residues involved in binding its zinc atom (Liu, J., Lin, S.-X., Blochet, J.
      E., Pezolet, M., and Lapointe, J. (1993) Biochemistry 32, 11390-11396). Extended
      x-ray absorption fine structure (EXAFS) shows that this zinc atom has a four
      coordinate non-planar coordination environment with 3 sulfur and 1 nitrogen atoms
      with bond lengths, respectively, 2.37 +/- 0.02 A and 2.01 +/- 0.02 A, presumably
      belonging to 3 cysteine residues and 1 histidine residue. Conservative
      replacement of each histidine and cysteine residue of the 98C-138C segment,
      respectively, with glutamine (Q) and serine (S), yields variants H129Q, H131Q,
      H132Q, and C138S (which sustain the growth at 42 degrees C of E. coli JP1449,
      whose glutamyl-tRNA synthetase is thermosensitive) and C98S, C100S, C125S, and
      H127Q (which do not). The amount of this enzyme in these mutants is at least 1
      order of magnitude larger than that in a wild type strain; however, no glutamyl
      tRNA synthetase activity is detectable in extracts of the variants C100S and
      C125S, whereas its specific activity in those of C98S and H127Q is about 10-fold
      lower than in cells overproducing the wild type enzyme or the variants H129Q,
      H131Q, H132Q, and C138S. These results indicate that the zinc atom present in E.
      coli glutamyl-tRNA synthetase is bound by the 2 evolutionarily conserved
      cysteines at positions 98 and 100, and by Cys125 and His127. Molecular modeling
      of the N-terminal half of this enzyme, using the known structure of E. coli
      glutaminyl-tRNA synthetase, supports this conclusion and suggests that the 98C
      127H segment does not have the characteristics of the classical zinc fingers.

PMID- 7797501
TI  - G alpha 15 and G alpha 16 couple a wide variety of receptors to phospholipase C.
AB  - The murine G-protein alpha-subunit G alpha 15 and its human counterpart G alpha
      16 are expressed in a subset of hematopoietic cells, and they have been shown to
      regulate beta-isoforms of inositide-specific phospholipase C. We studied the
      ability of a variety of receptors to interact with G alpha 15 and G alpha 16 by
      cotransfecting receptors and G-protein alpha-subunits in COS-7 cells. Activation
      of beta 2 adrenergic and muscarinic M2 receptors in cells expressing the
      receptors alone or together with G alpha q, G alpha 11, or G alpha 14 led to a
      very small stimulation of endogenous phospholipase C. However, when the receptors
      were coexpressed with G alpha 15 and G alpha 16, addition of appropriate ligands
      caused a severalfold increase in inositol phosphate production which was time-
      and dose-dependent. A similar activation of phospholipase C was observed when
      several other receptors which were previously shown to couple to members of the
      Gi and Gs family were coexpressed with G alpha 15/16. In addition, stimulation of
      inositol phosphate formation via receptors naturally coupled to phospholipase C
      was enhanced by cotransfection of G alpha 15 and G alpha 16. These data
      demonstrate that G alpha 15 and G alpha 16 are unique in that they can be
      activated by a wide variety of G-protein-coupled receptors. The ability of G
      alpha 15 and G alpha 16 to bypass the selectivity of receptor G-protein
      interaction can be a useful tool to understand the mechanism of receptor-induced
      G-protein activation. In addition, the promiscuous behavior of G alpha 15 and G
      alpha 16 toward receptors may be helpful in finding ligands corresponding to
      orphan receptors whose signaling properties are unknown.

PMID- 7797502
TI  - Carbohydrate-binding property of peptide: N-glycanase from mouse fibroblast L-929
      cells as evaluated by inhibition and binding experiments using various
      oligosaccharides.
AB  - Carbohydrate binding to peptide: N-glycanase from mouse fibroblast L-929 cells (L
      929 PNGase) and inhibition by oligosaccharides of its catalytic activity were
      studied. L-929 PNGase was found to bind strongly with oligosaccharides having
      triomannosido-N,N'-diacetyl-chitobiosyl (Man3GlcNAc2) structure (Kd =
      approximately 10 microM). This binding was inhibited by mannotriose (Man3; Man
      alpha 1-->3[Man alpha 1-->6]Man) but not by N,N'-diacetylchitobiose (GlcNAc2;
      GlcNAc beta 1-->4GlcNAc). Scatchard analysis indicated that there exist two
      binding sites for Man3 on a homodimeric form of a 105-kDa subunit.
      Oligosaccharides having Man3GlcNAc2 structure were also shown to be strong
      inhibitors for the PNGase-catalyzed reaction (Ki = approximately 10 microM). The
      minimum structural requirements for inhibition of the PNGase activity were Man3
      and GlcNAc2. Enzyme kinetic studies showed that the mechanism of inhibition by
      the oligosaccharides and Man3 fits well with a model wherein two inhibitor
      binding sites reside on L-929 PNGase. The conformity of Kd with IC50 values may
      be taken as an evidence for inhibition of the catalytic activity by the
      oligosaccharides and Man3 through the occupation of the binding sites with these
      molecules. On the other hand, inhibition by GlcNAc2 followed the simple
      competitive mode. Since the minimum substrate for the L-929 PNGase was shown to
      be Man beta 1-->4GlcNAc beta 1-->4GlcNAc beta 1-->peptide, GlcNAc2 may be
      directly accessible to the catalytic site in competition with substrate.
      Interestingly, alkylation of -SH group in L-929 PNGase caused complete loss of
      the catalytic activity, but the carbohydrate binding activity was completely
      retained, indicating that the catalytic site(s) is discriminated from the
      carbohydrate-binding sites in the active site of this enzyme. The carbohydrate
      binding property seems to be unique to soluble PNGases from mammals and may be
      associated not only with regulation of the enzyme activity, but also with
      receptor and carrier functions for glycoconjugates in certain intracellular
      processes.

PMID- 7797503
TI  - Structure of human parathyroid hormone 1-37 in solution.
AB  - Human parathyroid hormone (hPTH), amino acids Ser1 to Leu37, is biologically
      active with respect to both receptor binding and activation of adenylate cyclase
      to influence the serum calcium concentration. It induces DNA synthesis via an
      unknown signal pathway. We investigated the structure of hPTH(1-37) in H2O/buffer
      solution under near physiological conditions, that is pH 6.0 and 270 mM salt, by
      circular dichroism, ultracentrifugation, nuclear magnetic resonance spectroscopy,
      and molecular dynamics calculations. Complete sequence specific assignments of
      all 1H resonances were performed by using 1H two-dimensional NMR measurements
      (double quantum-filtered correlated spectroscopy, nuclear Overhauser effect
      spectroscopy (NOESY), and total correlation spectroscopy with suppression of
      NOESY-type cross-peaks spectra). hPTH(1-37) obtained helical structure and showed
      hydrophobic interactions defining a tertiary structure. The NH2-terminal four
      amino acids of hPTH(1-37) did not show a stable conformation. Evidence for an
      alpha-helical region between Ile5 and Asn10 was found. This region was followed
      by a flexible link (Gly12, Lys13) and a well defined turn region, His14 to Ser17.
      The latter was stabilized by hydrophobic interactions between Trp23 and Leu15.
      Ser17 through at least Leu28 formed an alpha-helix. Arg20 and Lys27 were involved
      in the core built by His14 to Ser17. Unrestrained molecular dynamics simulations
      indicated that the structure was stable on the 200 ps time scale.

PMID- 7797504
TI  - Long-lasting changes of calcium oscillations in astrocytes. A new form of
      glutamate-mediated plasticity.
AB  - Long-term changes of synaptic strength in the central nervous system are mediated
      by an increase of cytosolic calcium concentration ([Ca2+]i) following activation
      of excitatory neurotransmitter receptors. These phenomena, which represent a
      possible cellular basis for learning and memory processes in eukaryotes, are
      believed to be restricted to neurons. Here we provide evidence for a long-term
      change of the response elicited by the excitatory neurotransmitter glutamate in a
      non-neuronal cell population of the central nervous system, i.e. visual cortical
      astrocytes in culture. Stimulation with glutamate induces in astrocytes a regular
      pattern of [Ca2+]i oscillations. A second stimulation, after an interval ranging
      from 2 to 60 min, induces an oscillatory response characterized by an increased
      frequency. Induction of this change in the astrocyte response is abolished by a
      specific inhibitor of the nitric oxide synthase and recovers upon exogenous
      nitric oxide generation or addition of a permeant cGMP analogue. Local brief
      pulses of glutamate to individual astrocytes, at a rate of 1 Hz, also elicit
      [Ca2+]i oscillations whose frequency increases following a second series of
      pulses. The long-lasting modification in the [Ca2+]i oscillatory response induced
      by glutamate in astrocytes demonstrates that in the central nervous system
      cellular memory is not a unique feature of neurons.

PMID- 7797505
TI  - Molecular cloning and expression of cDNA encoding the rat UDP-N
      acetylglucosamine:alpha-6-D-mannoside beta-1,2-N-acetylglucosaminyltransferase
      II.
AB  - UDP-N-acetyl-D-glucosamine:alpha-6-D-mannoside beta-1,2-N
      acetylglucosaminyltransferase II (EC 2.4.1.143) (GnT II) is a Golgi resident
      enzyme that catalyzes an essential step in the biosynthetic pathway leading from
      high mannose to complex N-linked oligosaccharides. Sodium dodecyl sulfate
      polyacrylamide gel electrophoresis analysis of the enzyme purified from rat liver
      revealed a polypeptide of 42 kDa. Amino acid sequences were obtained from the N
      terminus and a tryptic peptide. Overlapping cDNA clones coding for the full
      length rat GnT II were obtained. The complete nucleotide sequence revealed a 1326
      base pair open reading frame that codes for a polypeptide of 442 amino acids,
      including a presumptive N-terminal membrane-anchoring domain. The region of cDNA
      coding for the C-terminal 389 amino acids of rat GnT II was linked in frame to a
      cDNA segment encoding the cleavable signal sequence of the human interleukin-2
      receptor and transiently expressed in COS-7 cells. A 77-fold enhancement of GnT
      II activity over a control carrying the GnT II cDNA out-of-frame was detected in
      the culture medium at 72 h after transfection. 1H-NMR spectroscopy confirmed that
      the oligosaccharide synthesized in vitro by the recombinant enzyme was the
      product of GnT II activity. These data verify the identity of the cloned GnT II
      cDNA and demonstrate that the C-terminal region of the protein includes the
      catalytic domain.

PMID- 7797507
TI  - Regulation of 3-hydroxy-3-methylglutaryl coenzyme A reductase gene expression in
      FRTL-5 cells. I. Identification and characterization of a cyclic AMP-responsive
      element in the rat reductase promoter.
AB  - Thyrotropin (TSH) increases 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA)
      reductase gene transcription in FRTL-5 rat thyroid cells, and the effect of TSH
      can be mimicked by cAMP. Sequence analysis of the rat reductase promoter has
      revealed a hitherto unnoticed cAMP-responsive element (CRE)-like octamer. This
      octamer is located between 53 and 60 nucleotides downstream of the sterol
      regulatory element 1; its first 6 nucleotides are identical to the consensus
      somatostatin CRE, and the entire octamer is identical to the fos CRE. A synthetic
      oligonucleotide containing the HMG-CoA reductase CRE-like octamer (RED CRE)
      formed protein-DNA complexes with nuclear extracts from FRTL-5 cells, which could
      be prevented by unlabeled CRE-containing oligonucleotides whose flanking
      sequences were otherwise nonidentical. The complexes were specifically
      supershifted by anti-CREB antibodies. FRTL-5 cells transfected with a fusion
      plasmid carrying the bacterial chloramphenicol acetyl transferase (CAT) under the
      control of the HMG-CoA reductase promoter displayed CAT activity, which was
      specifically stimulated by TSH. In contrast, CAT activity in FRTL-5 cells
      transfected with similar constructs carrying mutations in the reductase CRE was
      significantly lower and did not increase after TSH challenge. We suggest that the
      HMG-CoA reductase gene contains a functional CRE, important for TSH regulation of
      transcription. The data presented provide the molecular basis for a novel
      regulatory mechanism for HMG-CoA reductase gene expression in rat thyroid cells,
      which involves the direct effect of cAMP.

PMID- 7797506
TI  - pH regulation of the F-actin binding properties of Dictyostelium elongation
      factor 1 alpha.
AB  - ABP50, an F-actin bundling protein from Dictyostelium, is also the protein
      synthesis co-factor, elongation factor 1 alpha (EF1 alpha). Concomitant with cAMP
      stimulation in Dictyostelium is a cytoplasmic alkalinization (Aerts, R. J.,
      DeWit, R. J. W., and Van Lookeren Campagne, M. M. (1987) FEBS Lett. 220, 366-370)
      and a redistribution of EF1 alpha (Dharmawardhane, S., Demma, M., Yang, F., and
      Condeelis, J. (1991) Cell Motil. Cytoskel. 20, 279-288). In addition, others have
      shown a correlation between intracellular pH and the level of protein synthesis
      in Dictyostelium (Aerts, R. J., Durston, A. J., and Moolenaar, W. H. (1985) Cell
      43, 653-657). The present study investigates the relationship between pH and the
      F-actin binding properties of EF1 alpha. We found that increasing pH over the
      physiological range 6.2-7.8 causes a loss of EF1 alpha-mediated F-actin bundling
      and single filament binding, with corresponding increases in the amount of free
      EF1 alpha in vitro. Similar results also were obtained by cell fractionation and
      confocal immunofluorescence microscopy. The EF1 alpha binding constant (Kd) for F
      actin is increased from 0.2 microM to > 2.2 microM over the same pH range. In
      addition, EF1 alpha-induced actin bundle formation is freely reversible by
      changes in pH. Thus, pH may be a potent modulator of cytoarchitecture in
      Dictyostelium and may also influence mRNA translation rates by modifying the
      interactions between the protein synthetic machinery and the actin cytoskeleton.

PMID- 7797508
TI  - Regulation of 3-hydroxy-3-methylglutaryl coenzyme A reductase gene expression in
      FRTL-5 cells. II. Down-regulation by v-K-ras oncogene.
AB  - 3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase activity and mRNA
      levels were significantly reduced in FRTL-5 cells transformed with the Kirsten
      Moloney sarcoma virus (KiMol); these cells have lost thyrotropin dependence and
      express high levels of p21ras. FRTL-5 cells, transformed with a temperature
      sensitive mutant of the v-K-ras oncogene (Ats cells: 33 degrees C, permissive; 39
      degrees C, nonpermissive), showed significant reduction of HMG-CoA reductase
      expression when exposed to 33 degrees C. In KiMol cells, as well as in Ats cells
      at 33 degrees C, the transcription driven by cAMP-responsive element was probed
      by measuring chloramphenicol acetyl transferase (CAT) levels after transfection
      with a chimeric plasmid containing the reporter gene linked to the rat reductase
      promoter. Basal CAT activity in KiMol cells transfected with wild-type promoter
      was lower than in FRTL-5 cells but was increased by forskolin to the levels
      attained in thyrotropin-stimulated FRTL-5 cells. Forskolin failed to increase CAT
      activity in KiMol cells transfected with the plasmid harboring a reductase
      promoter in which the cAMP-responsive element octamer was mutated to a
      nonpalindromic sequence. The effect of v-K-ras could be mimicked in FRTL-5 cells
      by tetradecanoyl phorbol acetate and reverted in KiMol and Ats cells, expressing
      active Ras protein, by increasing intracellular cAMP and/or by protein kinase C
      inhibition. The data are consistent with the contention that v-K-ras, through
      protein kinase C and depletion of intracellular cAMP, is inhibitory for the
      protein kinase A pathway. This is the first demonstration that active v-K-ras
      down-regulates HMG-CoA reductase expression.

PMID- 7797510
TI  - Identification and characterization of ICH-2, a novel member of the interleukin-1
      beta-converting enzyme family of cysteine proteases.
AB  - Interleukin-1 beta converting enzyme (ICE) is a cytoplasmic cysteine protease
      required for generating the bioactive form of the interleukin-1 beta cytokine
      from its inactive precursor. We report the identification of ICH-2, a novel human
      gene encoding a member of the ICE cysteine protease family, and characterization
      of its protein product. ICH-2 mRNA is widely expressed in human tissues in a
      pattern similar to, but distinct from, that of ICE. Overexpression of ICH-2 in
      insect cells induces apoptosis. Purified ICH-2 is functional as a protease in
      vitro. A comparison of the inhibitor profiles and substrate cleavage by ICH-2 and
      ICE shows that the enzymes share catalytic properties but may differ in substrate
      specificities, suggesting that the two enzymes have different functions in vivo.

PMID- 7797509
TI  - Interaction of the microtubule cytoskeleton with endocytic vesicles and
      cytoplasmic dynein in cultured rat hepatocytes.
AB  - In a recent study (Goltz, J.S., Wolkoff, A.W., Novikoff, P.M., Stockert, R.J.,
      and Satir, P. (1992) Proc. Natl. Acad. Sci. U.S.A. 89, 7026-7030), we found that
      ligand- and receptor-containing endocytic vesicles bind to endogenous
      microtubules in vitro after 60 min of receptor-mediated endocytosis of asialo
      orosomucoid. In the presence of ATP, ligand-containing endocytic vesicles are
      released from microtubules, while those containing receptor are not. We
      hypothesized that cytoplasmic dynein may associate with ligand-containing, but
      not receptor-containing, domains of endocytic vesicles and might be involved in
      the movement of ligand-containing vesicles along microtubules during sorting of
      ligand from receptor. Direct evidence in support of this hypothesis has been
      obtained in the present study. Binding of ligand-containing vesicles to
      microtubules correlates highly (p < 0.001) with binding of dynein, but not
      kinesin, under a variety of conditions. Binding of receptor-containing vesicles
      to microtubules is independent of both cytoplasmic dynein and kinesin binding.
      Tight association of cytoplasmic dynein with a population of ligand-containing
      vesicles is seen directly by immunoprecipitation. These results support the view
      that in receptor-mediated endocytosis, ligand-containing vesicles become bound to
      microtubules by cytoplasmic dynein. While receptor domains of endosomes remain
      attached to microtubules in an ATP-independent manner, ligand-containing domains
      might be moved away toward pericentrosomal lysosomes by this motor molecule.

PMID- 7797511
TI  - Natural catalytic antibodies: peptide-hydrolyzing activities of Bence Jones
      proteins and VL fragment.
AB  - Monoclonal human light chains, i.e. Bence Jones proteins, and their recombinant
      variable fragments (VL) were screened for proteolytic activity using peptide
      methylcoumarinamide (peptide-MCA) conjugates and vasoactive intestinal
      polypeptide (VIP) as substrates. Sixteen of 21 Bence Jones proteins and one of
      three VL fragments were capable of detectable cleavage of one or more substrates.
      The magnitude and kinetic characteristics of the activity varied with different
      substrates. Among the peptide-MCA substrates, the presence of tripeptide or
      tetrapeptide moieties with a basic residue at the scissile bond generally favored
      expression of the activity. The influence of N-terminal flanking residue
      recognition was evident from differing values of Km and kcat (turnover number)
      observed using different Arg-containing peptide-MCA substrates. Different light
      chains displayed different kinetic parameters for the same substrate, suggesting
      unique catalytic sites. Hydrolysis of VIP was characterized by nanomolar
      Michaelis-Menten constants (Km), suggesting comparatively high affinity
      recognition of this peptide. The 25-kDa monomer and the 50-kDa dimer forms of one
      light chain preparation were resolved by gel filtration in 6 M guanidine
      hydrochloride. Following renaturation, the monomer displayed 51-fold greater
      peptide-MCA-hydrolyzing activity than the dimer. A renatured VL domain prepared
      by gel filtration in 6 M guanidine hydrochloride displayed VIP-hydrolyzing
      activity in the 12.5-kDa peak fractions. These results provide evidence for the
      proteolytic activity of certain human light chains and imply that this phenomenon
      may have a pathophysiological significance.

PMID- 7797512
TI  - Endothelin-converting enzyme-2 is a membrane-bound, phosphoramidon-sensitive
      metalloprotease with acidic pH optimum.
AB  - Endothelins (ET) are a family of potent vasoactive peptides that are produced
      from biologically inactive intermediates, termed big endothelins, via a
      proteolytic processing at Trp21-Val/Ile22. We recently cloned and characterized a
      membrane-bound metalloprotease that catalyzes this proteolytic activation,
      endothelin-converting enzyme-1 (ECE-1) (Xu, D., Emoto, N., Giaid, A., Slaughter,
      C., Kaw, S., deWit, D., and Yanagisawa, M. (1994) Cell 78, 473-485). This enzyme
      was shown to function in the secretory pathway as well as on the cell surface.
      Here we report molecular cloning of another novel enzyme, ECE-2, that produces
      mature ET-1 from big ET-1 both in vitro and in transfected cells. The cDNA
      sequence predicts that bovine ECE-2 is a metalloprotease structurally related to
      ECE-1, neutral endopeptidase 24.11, and human Kell blood group protein. The
      deduced amino acid sequence of ECE-2 is most similar to ECE-1, with an overall
      identity of 59%. ECE-2 resembles ECE-1 in that it is inhibited in vitro by
      phosphoramidon and FR901533 but not by thiorphan or captopril, and it converts
      big ET-1 more efficiently than big ET-2 or big ET-3. However, ECE-2 also exhibits
      the following striking differences from ECE-1. (i) The sensitivity of ECE-2 to
      phosphoramidon is 250-fold higher as compared with ECE-1, while FR901533 inhibits
      both enzymes at similar concentrations. (ii) ECE-2 has an acidic pH optimum at pH
      5.5, which is in sharp contrast to the neutral pH optimum of ECE-1. ECE-2 has a
      narrow pH profile and is virtually inactive at neutral pH. Chinese hamster ovary
      (CHO) cells, which lack detectable levels of endogenous ECE activity, secrete
      mature ET-1 into the medium when doubly transfected with ECE-2 and prepro-ET-1
      cDNAs. However, ECE-2-transfected CHO cells do not efficiently produce mature ET
      1 when present with an exogenous source of big ET-1 through coculture with prepro
      ET-1-transfected CHO cells. These findings suggest that ECE-2 acts as an
      intracellular enzyme responsible for the conversion of endogenously synthesized
      big ET-1 at the trans-Golgi network, where the vesicular fluid is acidified.

PMID- 7797513
TI  - Factors determining specificity of signal transduction by G-protein-coupled
      receptors. Regulation of signal transfer from receptor to G-protein.
AB  - Among subfamilies of G-protein-coupled receptors, agonists initiate several cell
      signaling events depending on the receptor subtype (R) and the type of G-protein
      (G) or effector molecule (E) expressed in a particular cell. Determinants of
      signaling specificity/efficiency may operate at the R-G interface, where events
      are influenced by cell architecture or accessory proteins found in the receptor's
      microenvironment. This issue was addressed by characterizing signal transfer from
      R to G following stable expression of the alpha 2A/D adrenergic receptor in two
      different membrane environments (NIH-3T3 fibroblasts and the pheochromocytoma
      cell line, PC-12). Receptor coupling to endogenous G-proteins in both cell types
      was eliminated by pertussis toxin pretreatment and R-G signal transfer restored
      by reconstitution of cell membranes with purified brain G-protein. Thus, the
      receptor has access to the same population of G-proteins in the two different
      environments. In this signal restoration assay, agonist-induced activation of G
      was 3-9-fold greater in PC-12 as compared with NIH-3T3 alpha 2-adrenergic
      receptor transfectants. The cell-specific differences in signal transfer were
      observed over a range of receptor densities or G-protein concentration. The
      augmented signal transfer in PC-12 versus NIH-3T3 transfectants occurred despite
      a 2-3-fold lower level of receptors existing in the R-G-coupled state (high
      affinity, guanyl-5'-yl imidodiphosphate-sensitive agonist binding), suggesting
      the existence of other membrane factors that influence the nucleotide binding
      behavior of G-protein in the two cell types. Detergent extraction of PC-12 but
      not NIH-3T3 membranes yielded a heat-sensitive, macromolecular entity that
      increased 35S-labeled guanosine 5'-O-(thiotriphosphate) binding to brain G
      protein in a concentration-dependent manner. These data indicate that the
      transfer of signal from R to G is regulated by a cell type-specific, membrane
      associated protein that enhances the agonist-induced activation of G.

PMID- 7797515
TI  - Role for NF-kappa B in the regulation of ferritin H by tumor necrosis factor
      alpha.
AB  - Ferritin is a ubiquitously distributed iron-binding protein that plays a key role
      in cellular iron homeostasis. It is composed of two subunits, termed H (heavy or
      heart) and L (light or liver). In fibroblasts and other cells, the cytokine tumor
      necrosis factor-alpha (TNF) specifically induces synthesis of the ferritin H
      subunit. Using nuclear run-off assays, we demonstrate that this TNF-dependent
      increase in ferritin H is mediated by a selective increase in ferritin H
      transcription. Transfection of murine fibroblasts with chimeric genes containing
      the 5'-flanking region of murine ferritin H fused to the human growth hormone
      reporter gene reveals that the cis-acting element that mediates this response is
      located approximately 4.8 kilobases distal to the start site of transcription.
      Deletion analyses delimit the TNF-responsive region to a 40-nucleotide sequence
      located between nucleotides -4776 and -4736, which we term FER-2. Electrophoretic
      mobility shift assays and site-specific mutations indicate that this region
      contains two independent elements: one contains a sequence that binds a member of
      the NF-kappa B family of transcription factors, and a second contains a novel
      sequence that partially conforms to the NF-kappa B consensus sequence and may
      bind a different member of the NF-kappa B/Rel transcription factor family. Thus,
      effects of an inflammatory cytokine on ferritin are mediated by a family of
      transcription factors responsive to oxidative stress.

PMID- 7797514
TI  - A constitutive heat shock element-binding factor is immunologically identical to
      the Ku autoantigen.
AB  - Analysis of the heat shock element (HSE)-binding proteins in extracts of rodent
      cells, during heat shock and their post-heat shock recovery, indicates that the
      regulation of heat shock response involves a constitutive HSE-binding factor
      (CHBF), in addition to the heat-inducible heat shock factor HSF1. We purified the
      CHBF to apparent homogeneity from HeLa cells using column chromatographic
      techniques including an HSE oligonucleotide affinity column. The purified CHBF
      consists of two polypeptides with apparent molecular masses of 70 and 86 kDa.
      Immunoblot and gel mobility shift analysis verify that CHBF is identical or
      closely related to the Ku autoantigen. The DNA binding characteristics of CHBF to
      double-stranded or single-stranded DNA are similar to that of Ku autoantigen. In
      gel mobility shift analysis using purified CHBF and recombinant human HSF1, CHBF
      competes with HSF1 for the binding of DNA sequences containing HSEs in vitro.
      Furthermore, when Rat-1 cells were co-transfected with human Ku expression
      vectors and the hsp70-promoter-driven luciferase reporter gene, thermal induction
      of luciferase is significantly suppressed relative to cells transfected with only
      the hsp70-luciferase construct. These data suggest a role of CHBF (or Ku protein)
      in the regulation of heat response in vivo.

PMID- 7797516
TI  - Rhodopsin kinase autophosphorylation. Characterization of site-specific
      mutations.
AB  - Upon illumination, rhodopsin kinase (RK) phosphorylates the visual pigment
      rhodopsin, which is thought to partially terminate the biochemical events that
      follow photon absorption. RK enzymology was explored by mutagenesis of the
      residues Ser488, Thr489 (major autophosphorylation sites), and Lys491 (a distal
      residue). We found the following to be true. (i) Double mutations at residues
      Ser488 and Thr489 to Ala or Asp decrease autophosphorylation to
      substoichiometrical levels, while single mutations at either residue
      independently reduce autophosphorylation by half. (ii) Phosphorylation of residue
      Ser488 influences the affinity of RK for heparin-Sepharose only moderately,
      whereas Thr489 and Lys491 are important for this interaction. RK K491A does not
      phosphorylate acidic peptides, suggesting that this residue participates in
      substrate binding. (iii) Mutations in the autophosphorylation region affect the
      Km for ATP, suggesting that this region is involved in binding of ATP to the
      catalytic site. (iv) RK mutants S488A or S488D and RK S488A and T489A have an
      increased ability to phosphorylate Rho in the dark. (v) Mutations at the
      autophosphorylation region change the initial site of phosphorylation on
      photolyzed rhodopsin (Rho*), implying that this region may regulate selectivity
      of the site of phosphorylation.

PMID- 7797518
TI  - A conserved domain and membrane targeting of Nef from HIV and SIV are required
      for association with a cellular serine kinase activity.
AB  - Among the primate lentiviruses (human immunodeficiency virus (HIV) -1, HIV-2, and
      simian immunodeficiency virus (SIV), the nef gene is highly conserved and encodes
      a myristylated protein of approximately 27 kDa (HIV-1) or approximately 34 kDa
      (HIV-2, SIV). Previously, we found Nef expressed either as a CD8-Nef fusion
      protein or as a native protein in virally infected T cell lines associates with a
      cellular serine kinase. This kinase activity phosphorylated two proteins of 62
      and 72 kDa that coimmunoprecipitate with Nef in in vitro kinase assays. Using
      transient expression, various Nef alleles and mutants have been analyzed for
      association with the cellular kinase activity. The ability of Nef to associate
      with the kinase activity is conserved among several alleles of HIV-1 as well as
      SIVmac239 and is observed in non-lymphoid cell lines of simian and murine
      origins. Two separate regions of HIV-1SF2 Nef are critical for the associated
      kinase activity. One domain overlaps with a central highly conserved region found
      in all primate lentivirus nef genes and has been provisionally mapped to amino
      acids 45-127. Because membrane localization of Nef is important for the
      associated cellular kinase activity, the second domain represents a membrane
      targeting signal. Moreover, point mutations within the central region that
      abrogate the Nef-associated kinase activity in HIV-1SF2 Nef have the same effect
      when introduced into SIVmac239open Nef.

PMID- 7797517
TI  - Chloroplasts can accommodate inclusion bodies. Evidence from a mutant of
      Chlamydomonas reinhardtii defective in the assembly of the chloroplast ATP
      synthase.
AB  - We identified two neighboring missense mutations in the chloroplast atpA gene
      which are responsible for the defect of ATP synthase assembly in the FUD16 mutant
      from Chlamydomonas reinhardtii. The two corresponding amino acid substitutions,
      Ile184-->Asn and Asn186-->Tyr, occurred at strictly conserved sites among the
      alpha and beta subunits of (C)F1 complexes from bacteria, mitochondria, and
      chloroplasts. The altered region in the alpha polypeptide chain is located 7
      amino acids downstream of the P-loop, which forms most of the conserved
      nucleotide binding site. Although the resulting chloroplast mutant fails to
      accumulate most of the ATP synthase subunits, it displays an increased
      intracellular content in both the alpha and beta subunits. We demonstrate that
      the two subunits do not bind to the thylakoid membranes but associate and
      overaccumulate in the chloroplast stroma as inclusion bodies. Increased rates of
      synthesis of the two subunits in the mutant point to an early interaction between
      the two subunits during their biogenesis.

PMID- 7797519
TI  - Catalytic activities of glycogenin additional to autocatalytic self
      glucosylation.
AB  - Glycogenin is the autocatalytic, self-glucosylating protein that initiates
      glycogen synthesis in muscle and other tissues. We have sequenced the cDNA for
      rabbit muscle glycogenin and expressed and purified the protein in high yield as
      well as two mutant proteins in which Phe or Thr replaces Tyr-194, the site of
      glucosylation. While the wild-type protein can self-glucosylate, the mutants
      cannot, but all three utilize alternative acceptors by intermolecular glucose
      transfer for which the mutants have altered specificity. Tyr-194 is therefore not
      essential for the catalytic activity of glycogenin. All three proteins also
      hydrolyze UDP-glucose to glucose at rates comparable with the rate of self
      glucosylation. The hydrolysis is competitive with glucose transfer to p
      nitrophenyl alpha-maltoside. Self-glucosylation, glucosylation of other
      acceptors, and hydrolysis all appear to be catalyzed by the same active center.
      In the absence of peptidase inhibitors, the homogenous recombinant proteins of
      M(r) 37,000 break down to equally active species having M(r) 32,000. The kinetics
      of self-glucosylation catalyzed by the wild-type enzyme suggest that the reaction
      could be intermolecular rather than, as previously reported, intramolecular. The
      wild-type recombinant enzyme and native muscle glycogenin, which is
      phosphorylated, are inhibited quite differently by ATP at physiological
      concentration.

PMID- 7797520
TI  - Purification and properties of wild-type and exonuclease-deficient DNA polymerase
      II from Escherichia coli.
AB  - Wild-type DNA polymerase II (pol II) and an exonuclease-deficient pol II mutant
      (D155A/E157A) have been overexpressed and purified in high yield from Escherichia
      coli. Wild-type pol II exhibits a high proofreading 3'-exonuclease to polymerase
      ratio, similar in magnitude to that observed for bacteriophage T4 DNA polymerase.
      While copying a 250-nucleotide region of the lacZ alpha gene, the fidelity of
      wild-type pol II is high, with error rates for single-base substitution and
      frameshift errors being < or = 10(-6). In contrast, the pol II exonuclease
      deficient mutant generated a variety of base substitution and single base
      frameshift errors, as well as deletions between both perfect and imperfect
      directly repeated sequences separated by a few to hundreds of nucleotides. Error
      rates for the pol II exonuclease-deficient mutant were from > or = 13- to > or =
      240-fold higher than for wild-type pol II, depending on the type of error
      considered. These data suggest that from 90 to > 99% of base substitutions,
      frameshifts, and large deletions are efficiently proofread by the enzyme. The
      results of these experiments together with recent in vivo studies suggest an
      important role for pol II in the fidelity of DNA synthesis in cells.

PMID- 7797521
TI  - Potassium channel structure and function as reported by a single glycosylation
      sequon.
AB  - Inwardly rectifying K+ channels (IRKs) are highly K(+)-selective, integral
      membrane proteins that help maintain resting the membrane potential and cell
      volume. Integral membrane proteins as a class are frequently N-glycosylated with
      the attached carbohydrate being extracellular and perhaps modulating function.
      However, dynamic effects of glycosylation have yet to be demonstrated at the
      molecular level. ROMK1, a member of the IRK family is particularly suited to the
      study of glycosylation because it has a single N-glycosylation consensus sequence
      (Ho, K., Nichols, C. G., Lederer, W. J., Lytton, J., Vassilev, P. M., Kanazirska,
      M. V., and Herbert, S. C. (1993) Nature 362, 31-38). We show that ROMK1 is
      expressed in a functional state in the plasmalemma of an insect cell line
      (Spodoptera frugiperda, Sf9) and has two structures, glycosylated and
      unglycosylated. To test functionality, glycosylation was abolished by an N117Q
      mutation or by treatment with tunicamycin. Whole cell currents were greatly
      reduced in both of the unglycosylated forms compared to wild-type. Single channel
      currents revealed a dramatic decrease in opening probability, po, as the
      causative factor. Thus we have shown biochemically that the N-glycosylation
      sequon is extracellular, a result consistent with present topological models of
      IRKs, and we conclude that sequon occupancy by carbohydrate stabilizes the open
      state of ROMK1.

PMID- 7797522
TI  - The SH3 domain of Crk binds specifically to a conserved proline-rich motif in
      Eps15 and Eps15R.
AB  - The Crk protein belongs to the family of proteins consisting of mainly Src
      homology 2 and 3 (SH2 and SH3) domains. These proteins are thought to transduce
      signals from tyrosine kinases to downstream effectors. In order to understand the
      specificity and effector function of the SH3 domain of Crk, we screened an
      expression library for binding proteins. We isolated Eps15, a substrate of the
      epidermal growth factor receptor (EGFR) tyrosine kinase, and Eps15R, a novel
      protein with high sequence homology to the carboxyl-terminal domain of Eps15.
      Antibodies raised against a fragment of the Eps15R gene product
      immunoprecipitated a protein of 145 kDa. Eps15 and Eps15R bound specifically to
      the amino-terminal SH3 domain of Crk and coprecipitated equivalently with both c
      Crk and v-Crk from cell lysates. The amino acid sequences of Eps15 and Eps15R
      featured several proline-rich regions as putative binding motifs for SH3 domains.
      In both Eps15 and Eps15R, we identified one proline-rich motif which accounts for
      their interaction with the Crk SH3 domain. Each binding motif contains the
      sequence P-X-L-P-X-K, an amino acid stretch that is highly conserved in all
      proteins known to interact specifically with the first SH3 domain of Crk.
      Furthermore, we found that immunoprecipitates of activated EGFR-kinase stably
      bound in vitro-translated Eps15 only in the presence of in vitro-translated v
      Crk. Crk might therefore be involved in Eps15-mediated signal transduction
      through the EGFR.

PMID- 7797523
TI  - A minimal motor domain from chicken skeletal muscle myosin.
AB  - The myosin head (S1) consists of a wide, globular region that contains the actin-
      and nucleotide-binding sites and an alpha-helical, extended region that is
      stabilized by the presence of two classes of light chains. The essential light
      chain abuts the globular domain, whereas the regulatory light chain lies near the
      head-rod junction of myosin. Removal of the essential light chain by a mild
      denaturant exposes the underlying heavy chain to proteolysis by chymotrypsin. The
      cleaved fragment, or "motor domain" (MD), migrates as a single band on SDS
      polyacrylamide gel electrophoresis, with a slightly greater mobility than S1
      prepared by papain or chymotrypsin. Three-dimensional image analysis of actin
      filaments decorated with MD reveals a structure similar to S1, but shorter by an
      amount consistent with the absence of a light chain-binding domain. The actin
      activated MgATPase activity of MD is similar to that of S1 in Vmax and Km. But
      the ability of MD to move actin filaments in a motility assay is considerably
      reduced relative to S1. We conclude that the globular, active site region of the
      myosin head is a stable, independently folded domain with intrinsic motor
      activity, but the coupling efficiency between ATP hydrolysis and movement
      declines markedly as the light chain binding region is truncated.

PMID- 7797524
TI  - Complex interactions between yeast TFIIIB and TFIIIC.
AB  - Transcription of yeast class III genes requires the sequential assembly of the
      general transcription factors TFIIIC and TFIIIB, and of RNA polymerase III, into
      an initiation complex composed of at least 25 polypeptides. The 70-kDa subunit of
      TFIIIB (TFIIIB70) is central in this network of interactions as it contacts both
      TATA-binding protein and a subunit of polymerase III. We show here that the TATA
      binding protein interacts with the carboxyl-terminal part of TFIIIB70. TFIIIB70
      also contacts TFIIIC (factor tau) via its tau 131 subunit. The protein domains of
      tau 131 and TFIIIB70 involved in this interaction, either positively or
      negatively, were mapped using the two-hybrid system. We provide evidence that
      intramolecular interactions mask functional domains in both polypeptides.

PMID- 7797526
TI  - Two Drosophila genes that encode the alph and beta subunits of the brain soluble
      guanylyl cyclase.
AB  - We identified two Drosophila genes (dgc alpha 1 and dgc beta 1) that encode the
      soluble guanylyl cyclase alpha and beta subunits, respectively. The putative Dgc
      alpha 1 protein is 76 kDa, has 35% amino acid identity with previously isolated
      alpha subunits, and was immunolocalized to the adult retina, to the optic lobes,
      and throughout the brain neuropil. The Dgc beta 1 protein is 86 kDa and exhibits
      59% amino acid identity with the rat beta 1 protein. However, the Dgc beta 1
      protein has an additional 118 amino acids inserted near the amino terminus, which
      makes it significantly larger than the rat beta 1. The Dgc beta 1 protein was
      immunolocalized to the optic lobes and throughout the brain neuropil, with no
      detectable expression in the retina. The Dgc alpha 1 and Dgc beta 1 cDNAs were
      stably transfected into human kidney 293 cells. Expression of the individual
      subunits and mixing of the individually expressed subunits failed to generate
      significant guanylyl cyclase activity. Only coexpression of the subunits resulted
      in significant guanylyl cyclase activity. Our results indicate that Dgc alpha 1
      and Dgc beta 1 are soluble guanylyl cyclase alpha and beta subunits that are
      capable of forming a functional guanylyl cyclase heterodimer.

PMID- 7797525
TI  - Translocation of the 85-kDa phospholipase A2 from cytosol to the nuclear envelope
      in rat basophilic leukemia cells stimulated with calcium ionophore or
      IgE/antigen.
AB  - The rat mast cell line RBL-2H3.1 contains an 85-kDa cytosolic phospholipase A2
      (cPLA2) that is very likely involved in liberating arachidonate from membrane
      phospholipid for the synthesis of eicosanoids following stimulation with either
      calcium ionophore or IgE/antigen. In this study, the intracellular location of
      cPLA2 was determined using immunofluorescence microscopy and immuno-gold electron
      microscopy. In nonstimulated cells, cPLA2 is distributed throughout the cytosol
      and is excluded from the nucleoplasm. Following cell activation with calcium
      ionophore, most of the cPLA2 translocates to the nuclear envelope, and the enzyme
      remains there during the entire period that ionophore is present. With
      IgE/antigen stimulation for 5 min, approximately 20-30% of the cPLA2 translocates
      to the nuclear envelope, and after 30 min of stimulation, most of the enzyme
      returns to the cytosol. Measurement of intracellular calcium using the dye Fura
      2/AM shows that the level of calcium rises immediately after antigen is added,
      remains high for about 30 s, and then declines back to resting levels. Activation
      with calcium ionophore produces a 10-fold larger release of arachidonate than
      does stimulation with IgE/antigen. Thus, the results suggest that the extent of
      membrane binding of cPLA2 correlates with the release of arachidonate and that
      the site of arachidonate liberation is the nuclear envelope where many of the
      enzymes that oxygenate this fatty acid are located.

PMID- 7797527
TI  - T antigens encoded by replication-defective simian virus 40 mutants dl1135 and
      5080.
AB  - We present a preliminary biochemical characterization of two simian virus 40
      mutants that affect different T antigen replication functions. SV40 T antigen
      mutants dl1135 (delta 17-27 amino acids) and 5080 (P-L) have been studied
      extensively with regard to their ability to transform cells in culture and induce
      tumors in transgenic mice. Both mutants are defective for viral DNA replication
      in vivo. In order to assess in more detail the molecular basis for the in vivo
      replication defects of 5080 and dl1135, we expressed the mutant proteins using
      the baculovirus system and purified them by immunoaffinity chromatography. With
      each of the purified proteins, we examined some of the biochemical activities of
      T antigen required for replication, viz. ATPase, binding to the origin of
      replication (ori) and assembly on ori, DNA helicase and unwinding, and
      replication in in vitro assays. Consistent with previous studies, we found that
      the 5080 protein is defective for multiple biochemical activities including
      ATPase, helicase, ori-specific unwinding, and ATP-induced hexamerization.
      However, this mutant retains some sequence-specific DNA binding activity. In
      contrast, the dl1135 protein exhibited significant levels of activity in all
      assays, including the ability to drive SV40 DNA replication in vitro. Thus,
      dl1135 is one of several mutants with an altered amino-terminal domain which can
      replicate DNA in vitro, but not in vivo. Thus, while the 5080 mutation affects a
      T antigen enzymatic function directly required for viral DNA synthesis, dl1135
      may alter an activity required to prepare the cell for viral replication.

PMID- 7797528
TI  - Differentiation of embryonal carcinoma cells to a neural or cardiomyocyte lineage
      is associated with selective expression of endothelin receptors.
AB  - Endothelins (ETs) were initially characterized as potent vasoactive peptides
      acting through at least two distinct receptors, ETA and ETB. Subsequently, their
      significant growth- and hypertrophy-promoting properties in cardiac and other
      cells were recognized. We investigated the expression of endothelin receptors
      during differentiation of a pluripotential embryonal carcinoma cell line (P19) to
      a cardiomyocyte or a neural lineage. These cells resemble those of the inner cell
      mass of the blastocyst, and their differentiation is believed to closely mimic
      critical events in early embryogenesis. Differentiation of P19 to a cardiomyocyte
      lineage, by aggregation and exposure to dimethyl sulfoxide resulted in induction
      of ETA receptors as demonstrated by radioligand binding studies, Northern
      blotting, and reporter gene analysis. Moreover, the P19 differentiated to a
      cardiac lineage responded to ET-1 with a 3-fold increase in the secretion of
      atrial natriuretic peptide. In contrast, differentiation to a neural lineage, by
      aggregation and exposure to retinoic acid, was associated with the induction of
      predominantly ETB. Therefore, selective differentiation of the P19 led to the
      differential expression of endothelin receptors in a pattern consistent with that
      observed in normal myocardial and neural tissue. The induction of endothelin
      receptors in a model system of early embryogenesis provides strong support for
      the critical role of this peptide/receptor family in differentiation and
      development. As well, this model system is well suited for the study of the
      mechanisms controlling endothelin receptor expression during differentiation.

PMID- 7797529
TI  - Neuroendocrine-specific expression of the human prohormone convertase 1 gene.
      Hormonal regulation of transcription through distinct cAMP response elements.
AB  - Prohormone convertases are involved in the tissue-specific endoproteolytic
      processing of prohormones and neuropeptide precursors within the secretory
      pathway. In the present study, we have isolated genomic clones comprising the 5'
      terminal region of the human prohormone convertase 1 (PC1) gene and identified
      and characterized the PC1 promoter region. We found multiple transcription start
      sites located within a 15-base pair region, 205 base pairs upstream of the
      translation start codon. The promoter region is not G+C-rich and does not contain
      a canonical TATA box nor a CAAT box. Transient expression assays with a set of
      human PC1 gene fragments containing progressive 5' deletions demonstrate that the
      proximal promoter region is capable of directing high levels of neuroendocrine
      specific expression of reporter gene constructs. In addition, the proximal
      promoter region confers both basal and hormone-regulated promoter activity. Site
      specific mutagenesis experiments demonstrate that two closely spaced cAMP
      response elements within the proximal promoter region direct cAMP-mediated
      hormonal regulation of transcription of the PC1 gene.

PMID- 7797530
TI  - Addition of an endoplasmic reticulum retention/retrieval signal does not block
      maturation of enzymatically active peptidylglycine alpha-amidating monooxygenase.
AB  - Peptidylglycine alpha-amidating monooxygenase (PAM) catalyzes the COOH-terminal
      alpha-amidation of neural and endocrine peptides via a two-step reaction carried
      out in sequence by the monooxygenase and lyase domains contained in this
      bifunctional protein. Peptide alpha-amidation is thought to take place primarily
      in the secretory granules in which mature bioactive peptides are stored, and it
      is not known where in the secretory compartment newly synthesized PAM protein
      becomes enzymatically active. To address this question, PAM-3, a soluble
      bifunctional protein, was modified by addition of the KDEL endoplasmic reticulum
      (ER) retention/retrieval signal to its COOH terminus. PAM-3-KDEL protein stably
      expressed in hEK-293 cells or in AtT-20 cells was efficiently retained in the ER
      based on immunocytochemistry, pulse-chase experiments, and maintained
      endoglycosidase H sensitivity. The effect of the KDEL sequence was specific since
      PAM-3 with an inactive ER retention/retrieval signal (PAM-3-KDEV) moved through
      the secretory pathway like wild type PAM-3. In AtT-20 cells, PAM-3-KDEL was not
      subjected to the COOH-terminal endoproteolytic cleavage that generates a 75-kDa
      PAM protein from PAM-3 and PAM-3-KDEV. PAM-3-KDEL protein exhibited both
      monooxygenase and lyase activities with specific activities similar to those of
      the wild type PAM-3 and PAM-3-KDEV proteins. Thus, although PAM catalyzes a
      reaction that occurs primarily in the secretory granules, newly synthesized PAM
      protein becomes enzymatically competent in the ER.

PMID- 7797531
TI  - Purification of cranin, a laminin binding membrane protein. Identity with
      dystroglycan and reassessment of its carbohydrate moieties.
AB  - Cranin was described in 1987 as a membrane glycoprotein expressed in brain and
      many other tissues, which binds laminin with high affinity in a calcium-dependent
      manner. Dystrophin-associated glycoprotein ("dystroglycan") is a laminin-binding
      protein cloned in 1992 whose relation to cranin has remained uncertain. Here we
      describe the purification of cranin to homogeneity from sheep brain, show cranin
      to be a form of dystroglycan, and localize the N terminus of beta-dystroglycan to
      amino acid residue 654. We find that brain alpha-dystroglycan is tightly
      associated with membranes, and localizes to regions of synaptic contact as
      assessed by immunocytochemistry of rat cerebellum. Brain alpha-dystroglycan
      expresses high mannose/hybrid N-linked saccharides, terminal GalNAc residues, and
      the HNK-1 epitope. Although dystroglycan has previously been presumed to be a
      proteoglycan, the amino acid sequence, pI, O-sialoglycoprotease susceptibility,
      lectin-binding profile, and laminin-binding properties of brain dystroglycan are
      more typical of mucin-like proteins. Furthermore, using CHO mutant cell lines
      deficient in xylosyltransferase and galactosyltransferase I, which are required
      for glycosaminoglycan biosynthesis, it is shown that chondroitin sulfate and
      heparan sulfate are not critical for laminin binding, and indeed are apparently
      not expressed at all in dystroglycan from CHO cells.

PMID- 7797533
TI  - Intracellular cholesterol transport and compartmentation.

PMID- 7797534
TI  - The human apolipoprotein E gene is negatively regulated in human liver HepG2
      cells by the transcription factor BEF-1.
AB  - Apolipoprotein E (apoE) is a major constituent of plasma lipoprotein that
      functions in lipid transport and redistribution (reverse cholesterol transport)
      and probably plays an important role in inhibiting the development and/or
      progression of atherosclerosis. While cis-acting regions involved in basal and
      tissue-specific control of the apoE gene have been identified by promoter mapping
      studies, much less is known about factors that regulate the gene. In this study,
      we demonstrate that the region between -94 and -84 upstream of transcriptional
      start site of the human apoE gene contains a binding site for the transcriptional
      repressor factor BEF-1, a tyrosine-phosphorylated nuclear protein that was first
      identified in HeLa cells. Using gel retardation assays, we show that HeLa cell
      derived BEF-1 binds the apoE BEF-1 homology, and this binding can be competed
      with the prototype BEF-1 sequence, but not by a mutated sequence. Furthermore, we
      demonstrate that the apoE- producing human liver HepG2 cell produces significant
      levels of BEF-1, which could bind to both the prototype BEF-1 sequence and the
      apoE homology, and be competed equivalently with cold BEF-1 or apoE homology. To
      determine if BEF-1 affected the expression of apoE, we performed competition
      experiments using plasmids containing the intact or mutated BEF-1 homology. The
      introduction of the intact BEF-1 site into HepG2 cells resulted in an induction
      of apoE mRNA, whereas control and mutated BEF-1-containing plasmids had no
      significant effect. We also found that increasing the level of nuclear BEF-1 by
      treatment of cells with orthovanadate resulted in a reduction in the level of
      apoE mRNA. Overall, our data suggest that the endogenous apoE gene in the human
      HepG2 cell line is repressed by the trans-acting influence of nuclear factor BEF
      1.

PMID- 7797532
TI  - CuZn superoxide dismutase (SOD-1):tetanus toxin fragment C hybrid protein for
      targeted delivery of SOD-1 to neuronal cells.
AB  - Increased levels of CuZn superoxide dismutase (SOD-1) are cytoprotective in
      experimental models of neurological disorders associated with free radical
      toxicity (e.g. stroke, trauma). Targeted delivery of SOD-1 to central nervous
      system neurons may therefore be therapeutic in such diseases. The nontoxic C
      fragment of tetanus toxin (TTC) possesses the nerve cell binding/transport
      properties of tetanus holotoxin and has been used as a vector to enhance the
      neuronal uptake of proteins including enzymes. We have now produced a
      recombinant, hybrid protein in Escherichia coli tandemly joining human SOD-1 to
      TTC. The expressed hybrid protein (SOD:Tet450) has a subunit molecular mass of 68
      kDa and is recognized by both anti-SOD-1 and anti-TTC antibodies. Calculated per
      mol, SOD:Tet450 has approximately 60% of the expected SOD-1 enzymatic activity.
      Analysis of the hybrid protein's interaction with the neuron-like cell line, N18
      RE-105, and cultured hippocampal neurons by enzyme immunoassay for human SOD-1
      revealed that SOD:Tet451 association with cells was neuron-specific and dose
      dependent. The hybrid protein was also internalized, but there was substantial
      loss of internalized hybrid protein over the first 24 h. Hybrid protein
      associated with cells remained enzymatically active. These results suggest that
      human SOD-1 and TTC retain their respective functional properties when expressed
      together as a single peptide. SOD:Tet451 may prove to be a useful agent for the
      targeted delivery of SOD-1 to neurons.

PMID- 7797535
TI  - Identification and functional expression of a receptor selectively recognizing
      parathyroid hormone, the PTH2 receptor.
AB  - We have identified a G-protein-coupled receptor specifically activated by
      parathyroid hormone, which we refer to as the PTH2 receptor. Parathyroid hormone
      (PTH) and parathyroid hormone-related peptide (PTHrP, hypercalcemia of malignancy
      factor) activate a previously identified PTH/PTHrP receptor, which has a
      widespread tissue distribution. The PTH2 receptor is much more selective in
      ligand recognition and appears to have a more specific tissue distribution. It is
      activated by PTH and not by PTHrP and is particularly abundant in the brain and
      pancreas.

PMID- 7797537
TI  - Expression of human RAD52 confers resistance to ionizing radiation in mammalian
      cells.
AB  - Processing of mutagenic DNA damages by the double strand breaks (DSB) in
      eukaryotes is most likely achieved by multiple pathways, including homologous
      recombination. Although RAD52 has been shown to be important for DSB repair in
      yeasts, its role in DSB repair in mammalian cells has not been demonstrated. This
      study reports for the first time that the overexpression of human RAD52 confers
      enhanced resistance to gamma-rays and induces homologous intrachromosomal
      recombination in cultured monkey cells. Recombination frequency synergistically
      increased by the combination of overexpression of RAD52 and ionizing radiation.
      These observations suggest that homologous recombination mediated by RAD52 is
      involved in double-stranded break repair in mammalian cells.

PMID- 7797538
TI  - A two-step model for lipoprotein(a) formation.
AB  - Lipoprotein(a) (Lp(a)), a risk factor for coronary artery disease, is a LDL-like
      particle with apolipoprotein(a) (apo(a)) covalently linked to apolipoprotein B
      (apoB), the main protein component of LDL. Apo(a) is highly homologous to
      plasminogen and its gene probably arose by duplication of the plasminogen gene.
      It has many repeats of kringle-4-like domain, classified as type 1 through type
      10 (T1-T10). T9 is responsible for the covalent linkage between apo(a) and LDL.
      However, we found that T9 has no affinity for LDL. Therefore, an initial
      noncovalent interaction between apo(a) and LDL is necessary to bring T9 and LDL
      together. T6 and possibly T7 of apo(a) were identified as the kringles which
      mediate this initial interaction. With these findings, a two-step model for Lp(a)
      formation is proposed. This model should be useful in the design of Lp(a)
      formation inhibitors. These inhibitors are potential antihyperlipoprotein(a)
      drugs.

PMID- 7797536
TI  - Role of heterogeneous N-terminal acylation of recoverin in rhodopsin
      phosphorylation.
AB  - Recoverin, a new member of the EF-hand superfamily, plays a critical role in the
      light/dark adaptation of retinal rods by regulating rhodopsin phosphorylation in
      a Ca(2+)-dependent manner. Recoverin is composed of four isoforms, each of which
      is modified at its N terminus by myristate (C14:0) or its structurally related
      fatty acid (C12:0, C14:2, or C14:1). Although the N-fatty acylation is implicated
      in protein-membrane and protein-protein interactions, the functional difference
      among the recoverin isoforms and the significance of the heterogeneous acylation
      have not been defined. Here we separated the heterogeneous recoverin into three
      fractions, C14:0-recoverin, C14:1-recoverin, and a mixture of C14:2- and C12:0-
      (C14:2/C12:0-) recoverin to evaluate the individual properties. Recoverin in
      every fraction bound Ca2+ as assessed by fluorescence spectroscopy and inhibited
      the light-dependent rhodopsin phosphorylation in the same range of free Ca2+
      concentration (0.3-0.8 microM). However, the magnitude of the inhibition at
      higher Ca2+ concentration was different among the isoforms and ranked in the same
      order of the hydrophobicity of the N-fatty acyl groups: C14:0 > C14:1 >
      C14:2/C12:0. These results indicate that the diverged hydrophobicity of the
      recoverin N terminus plays an important role in the interaction with the
      membranes and/or its target protein but not with Ca2+.

PMID- 7797539
TI  - Reversible phosphorylation of both Tyr7 and Tyr10 in the alpha-chain of pig
      stomach H+,K(+)-ATPase by a membrane-bound kinase and a phosphatase.
AB  - When pig stomach membrane H+,K(+)-ATPase preparations were incubated with [gamma
      32P]ATP and Mg2+ with vanadate, 32P was incorporated into the alpha-chain of
      H+,K(+)-ATPase to a steady-state level of approximately 0.7 mol of
      phosphotyrosine (Tyr(P))/mol of phosphoenzyme intermediates. The addition of a
      membrane H+,K(+)-ATPase preparation with Mg2+ accelerated the liberation of 32P
      from Tyr(P) residues in the alpha-chain. Mild tosylphenylalanyl chloromethyl
      ketone-trypsin treatment solubilized 32P-containing peptides from the alpha-chain
      almost completely. A reverse-phase column chromatography of the supernatant gave
      two peaks of 32P-peptide with similar total radioactivities. The amino acid
      sequence of both peaks was shown to be Gly-Lys-Ala-Glu-Asn-Tyr-Glu-Leu-Tyr-Gln--,
      which is consistent with the amino-terminal sequence of the alpha-chain of
      H+,K(+)-ATPase deduced from cDNA from pig stomach except that the initial Met was
      absent. The comparison of the recovery of amino acid from each Edman cycle showed
      that the phosphorylation of Tyr10 occurred preceding the phosphorylation of Tyr7.
      These data and others suggested the presence of a novel membrane-bound enzyme
      system to participate in reversible phosphorylation of both Tyr residues in the
      alpha-chain of H+,K(+)-ATPase.

PMID- 7797540
TI  - Calf thymus Hsc70 protein protects and reactivates prokaryotic and eukaryotic
      enzymes.
AB  - The heat-shock 70 protein (Hsp70) chaperone family is very conserved and its
      prokaryotic homologue, the DnaK protein, is assumed to form one of the cellular
      systems for the prevention and restoration of heat-induced protein denaturation.
      By using anti-DnaK antibodies we purified the DnaK homologue heat-shock cognate
      protein (Hsc70) from calf thymus to apparent homogeneity. This protein was
      classified as an eukaryotic Hsc70, since (i) monoclonal antibodies against
      eukaryotic Hsc70 recognized it, (ii) its amino-terminal sequence showed strong
      homology to Hsp70s from eukaryotes and, (iii) it had an intrinsic weak ATPase
      activity that was stimulated by various peptide substrates. We show that this
      calf thymus Hsc70 protein protected calf thymus DNA polymerases alpha and epsilon
      as well as Escherichia coli DNA polymerase III and RNA polymerase from heat
      inactivation and could reactivate these heat-inactivated enzymes in an ATP
      hydrolysis dependent manner, likely leading to the dissociation of aggregates
      formed during heat inactivation. In contrast to this, DnaK protein was
      exclusively able to protect and to reactivate the enzymes from E.coli but not
      from eukaryotic cells. Finally, the addition of calf thymus DnaJ co-chaperone
      homologue reduced the amount of Hsc70 required for reactivation at least 10-fold.

PMID- 7797541
TI  - Porcine m2 muscarinic acetylcholine receptor-effector coupling in Chinese hamster
      ovary cells.
AB  - The relationship between porcine m2 muscarinic receptor coupling to inhibition of
      cAMP formation and stimulation of phosphatidylinositol metabolism in Chinese
      hamster ovary cells was examined. Reduction of the number of receptors per cell
      with the slowly dissociating antagonist (-)-quinuclidinyl benzilate caused a
      decrease in maximal response with no effect on EC50 for coupling to
      phosphatidylinositol metabolism. Inhibition of cAMP formation showed the opposite
      dependence with no effect on maximal response but an increase in EC50 value as
      receptor density decreased. Pilocarpine appeared to be a partial agonist at low
      cell receptor density but displayed full agonism at higher receptor density.
      These results are compatible with a two-state model describing m2 muscarinic
      receptor acting via two different G proteins. This model is compatible with
      observations of negative antagonism where antagonists stimulated cAMP formation
      in adenylyl cyclase inhibition assays, and can also be used to estimate receptor
      affinities for G proteins in systems which display negative antagonism.

PMID- 7797542
TI  - Inhibition and labeling of the coated vesicle V-ATPase by 2-azido-[32P]ATP.
AB  - Previous studies have indicated that the 73-kDa A subunit of the coated vesicle V
      ATPase possesses a nucleotide-binding site essential for activity (Arai, H.,
      Berne, M., Terres, G., Terres, H., Puopolo, K., and Forgac, M. (1987)
      Biochemistry 26, 6632-6638) and have identified a cysteine residue (Cys254) whose
      modification leads to complete loss of activity (Feng, Y., and Forgac, M. (1992)
      J. Biol. Chem. 267, 5817-5822). To further characterize the structure of the
      nucleotide-binding sites of the V-ATPase, labeling studies using the
      photoactivated analog 2-azido-[32P]ATP have been carried out. We have observed
      that 2-azido-[32P]ATP is hydrolyzed by the V-ATPase at a rate (at 1 mM)
      approximately 4-fold lower than observed for ATP, indicating that 2-azido
      [32P]ATP is a good substrate for the V-ATPase. Irradiation of the V-ATPase in the
      presence of 0.5 mM 2-azido-[32P]ATP leads to inactivation of V-ATPase activity
      with a t1/2 of 3-5 min. The 73-kDa A subunit, the 58-kDa B subunit, and the 50
      kDa subunit of the AP-2 adaptin complex (Myers, M., and Forgac, M. (1993) J.
      Biol. Chem. 268, 9184-9186) are all labeled in an ATP-protectable manner on
      irradiation of the purified V-ATPase with 2-azido-[32P]ATP. The time course for
      inactivation most closely correlates with labeling of the A subunit. Measurement
      of the stoichiometry of 2-azido-[32P]ATP incorporation into the A subunit as a
      function of inactivation indicates that complete loss of activity is obtained on
      incorporation of 1.2 mol of 2-azido-[32P]ATP/mol V-ATPase complex. 2-Azido
      [32P]ATP labeling indicates that the V-ATPase possesses both rapidly (t1/2 < 2
      min) and slowly (t1/2 > 2 min) exchangeable nucleotide-binding sites. The A
      subunit is labeled upon modification of both rapidly and slowly exchangeable
      sites whereas the B subunit is labeled upon modification of only rapidly
      exchangeable sites. Inhibition of V-ATPase activity correlates with labeling of
      the rapidly exchangeable sites. Amino acid sequence analysis of peptides derived
      from the 2-azido-[32P]ATP-labeled A subunit indicates labeling of two peptides: a
      12-kDa fragment which begins at residue 511 and contains Cys532 and a 3-kDa
      fragment which begins at residue 233 and contains the glycine-rich loop and
      Cys254. Only the 12-kDa fragment is labeled upon modification of the rapidly
      exchangeable sites.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7797545
TI  - Purification of the spliceosome A-complex and its visualization by electron
      microscopy.
AB  - Pre-mRNA splicing occurs on spliceosomes, a family of ribonucleoprotein
      particles. Spliceosome assembly on exogenous adenovirus pre-mRNA was blocked at
      the A-complex (or pre-spliceosome) stage, either by destruction of the small
      nuclear ribonucleoproteins (snRNPs) that comprise the U4/U5/U6 tri-snRNP complex,
      or by interference in tri-snRNP assembly and interactions. The A-complex was
      isolated by size exclusion chromatography; homogeneity was shown by
      electrophoresis in nondenaturing polyacrylamide gels, gradient sedimentation, and
      electron microscopy. Northern hybridization showed U1 and U2 snRNAs to be present
      in the preparation, but not U4, U5, or U6. Antibodies specific for a component of
      the U1 snRNP or for a component that is common to all snRNPs (except U6) each
      precipitated an A-complex containing pre-mRNA, U1 and U2 snRNPs. Electron
      micrographs showed 230 x 270-A particles whose two components appear similar to
      individual U1 and U2 snRNPs. Electron micrographs of an A-complex-5'-biotinyl
      oligonucleotide-streptavidin-gold composite allowed identification of the U2
      snRNP within the structure and the localization of the 5'-segment of U2 snRNA at
      a unique site in the A-complex. This region of U2 RNA is adjacent to the
      developing catalytic center of the spliceosome.

PMID- 7797544
TI  - Calcium-induced troponin flexibility revealed by distance distribution
      measurements between engineered sites.
AB  - The contraction of vertebrate striated muscle is regulated by Ca2+ binding to
      troponin C (TnC). This causes conformational changes which alter the interaction
      of TnC with the inhibitory protein TnI and the tropomyosin-binding protein TnT.
      We have used the frequency domain method of fluorescence resonance energy
      transfer to measure TnT-TnC and TnT-TnI distances and distance distributions, in
      the presence of Ca2+, Mg2+, or EGTA, in TnC.TnI.TnT complexes. We reconstituted
      functional, ternary troponin complexes using the following recombinant subunits
      whose sequences were based on those of rabbit skeletal muscle: wild-type TnC;
      TnT25, a mutant C-terminal 25-kDa fragment of TnT containing a single Trp212
      which was used as the sole donor for fluorescence energy transfer measurements;
      Trp-less TnI mutants which contained either no Cys or a single Cys at position 9,
      96, or 117. Energy acceptor groups were introduced into TnC or TnI by labeling
      with dansyl aziridine or N-(iodoacetyl)-N'-(1-sulfo-5-naphthyl)ethylenediamine.
      Our results indicate that the troponin complex is relatively rigid in relaxed
      muscle, but becomes much more flexible when Ca2+ binds to regulatory sites in
      TnC. This increased flexibility may be propagated to the whole thin filament,
      releasing the inhibition of actomyosin ATPase activity and allowing the muscle to
      contract. This is the first report of distance distribution measurements between
      troponin subunits.

PMID- 7797543
TI  - Phosphatidylinositol 3-kinase, but not p70/p85 ribosomal S6 protein kinase, is
      required for the regulation of phosphoenolpyruvate carboxykinase (PEPCK) gene
      expression by insulin. Dissociation of signaling pathways for insulin and phorbol
      ester regulation of PEPCK gene expression.
AB  - Phosphoenolpyruvate carboxykinase (PEPCK) catalyzes the rate-limiting step in
      hepatic gluconeogenesis. Glucagon (via the second messenger cAMP) and
      glucocorticoids stimulate the transcription of the PEPCK gene, whereas insulin
      and phorbol esters inhibit, in a dominant fashion, these effects. Wortmannin, an
      inhibitor of phosphatidylinositol 3-kinase, prevents the stimulation of glycogen
      synthesis, glucose transport, mitogen-activated protein kinase, and p70/p85
      ribosomal S6 protein kinase by insulin. We now show that wortmannin can also
      block the inhibition of glucocorticoid- and cAMP-stimulated PEPCK gene expression
      by insulin. PEPCK-chloramphenicol acetyltransferase fusion gene experiments
      demonstrate that wortmannin blocks an activity that is required for insulin
      signaling to elements within the PEPCK promoter. Phorbol esters mimic the action
      of insulin on the regulation of PEPCK gene expression, but wortmannin does not
      block the effect of these agents. Thus, phosphatidylinositol 3-kinase is required
      for the regulation of PEPCK gene expression by insulin, but not by phorbol
      esters. The immunosuppressant rapamycin, a potent inhibitor of insulin or phorbol
      ester stimulation of p70/p85 ribosomal S6 protein kinase, has no significant
      effect on the regulation of PEPCK gene expression by insulin or phorbol esters.
      Thus, p70/p85 ribosomal S6 protein kinase does not have a role in signaling to
      the PEPCK promoter by insulin or phorbol esters.

PMID- 7797546
TI  - High affinity Ca(2+)-binding site in the serine protease domain of human factor
      VIIa and its role in tissue factor binding and development of catalytic activity.
AB  - Factor VIIa, in the presence of Ca2+ and tissue factor (TF), initiates the
      extrinsic pathway of blood coagulation. The light chain (amino acids 1-152) of
      factor VIIa consists of an N-terminal gamma-carboxyglutamic acid (Gla) domain
      followed by two epidermal growth factor-like domains, whereas the heavy chain
      (amino acids 153-406) contains the serine protease domain. In this study, both
      recombinant factor VIIa (rVIIa) and factor VIIa lacking the Gla domain were found
      to contain two high-affinity (Kd approximately 150 microM) Ca2+ binding sites.
      The rVIIa also contained approximately 6-7 low-affinity (Kd approximately 1 mM)
      Ca(2+)-binding sites. By analogy to other serine proteases, one of the two high
      affinity Ca(2+)-binding sites in factor VIIa may be formed involving Glu-210 and
      Glu-220 of the protease domain. In support of this, a synthetic peptide composed
      of residues 206-242 of factor VIIa bound one Ca2+ with Kd approximately 230
      microM; however, Ca2+ binding was observed only in Tris buffer (pH 7.5)
      containing 1 M NaCl and not in buffer containing 0.1 M NaCl. In both low or high
      salt +/- Ca2+, the peptide existed as a monomer as determined by sedimentation
      equilibrium measurements and had no detectable secondary structure as determined
      by CD measurements. This indicates that subtle changes undetectable by CD may
      occur in the conformation of the peptide that favor calcium binding in high salt.
      In the presence of recombinant TF and 5 mM Ca2+, the peptide inhibited the
      amidolytic activity of rVIIa toward the synthetic substrate, S-2288. The
      concentration of the peptide required for half-maximal inhibition was
      approximately 5-fold higher in the low salt buffer than that in the high salt
      buffer. From direct binding and competitive inhibition assays of active site
      blocked 125I-rVIIa binding to TF, the Kd for peptide-TF interaction was
      calculated to be approximately 15 microM in the high salt and approximately 55
      microM in the low salt buffer containing 5 mM Ca2+. Moreover, as inferred from S
      2288 hydrolysis, the Kd for VIIa.TF interaction was approximately 1.5 microM in
      the absence of Ca2+, and, as inferred from factor X activation studies, it was
      approximately 10 pM in the presence of Ca2+. Thus, Ca2+ decreases the functional
      Kd of VIIa.TF interaction approximately 150,000-fold.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 7797548
TI  - Identification of an essential second metal ion in the reaction mechanism of
      Escherichia coli adenylosuccinate synthetase.
AB  - This study reports that two Mg2+ ions are required for Escherichia coli
      adenylosuccinate synthetase activity. The first metal ion is presumably
      coordinated with beta- and gamma-phosphoryl groups of GTP to provide an electron
      sink, and the second one seems to interact with aspartate in the enzyme active
      site. Regarding the latter metal ion, kinetic studies show that aspartate and the
      second Mg2+ ion bind to the enzyme active site randomly with a kcat value of 1.47
      s-1 and with Km values for aspartate and Mg2+ of 225 and 114 microM,
      respectively. The dissociation constants for aspartate and Mg2+ of the
      enzyme.GTP.IMP.(aspartate or Mg2+) complex are 79.2 and 40.0 microM,
      respectively. However, variable amounts of aspartate or Mg2+ did not show any
      significant changes in the Km values for GTP and IMP. Kinetic studies using Mn2+
      and Ca2+ ions indicate that the kcat values (0.930 and 0.235 s-1, respectively)
      were slightly decreased compared with the value obtained using Mg2+; however, the
      Km values for aspartate and GTP in the presence of Mn2+ and Ca2+ were
      significantly decreased compared with those obtained using Mg2+ ion (4.5 and 4.6
      times for Mn2+ ion and 5.6 and 5.8 times for Ca2+ ion, respectively). On the
      other hand, the Km values for IMP were not significantly changed (1.9 and 1.8
      times for Mn2+ and Ca2+ ions, respectively). Taken together, these kinetic
      results imply that aspartate may interact with Mg2+ to form a Mg.aspartate
      complex in the enzyme active site. An inhibition study of the enzyme with ZnCl2
      (its Ki value is 29 nM) also suggested that Zn2+ competes with aspartate as well
      as Mg2+, implying that Zn2+ might form a complex with aspartate in the active
      site. On the basis of these results, it is suggested that Mg.aspartate complex
      formation in the active site of adenylosuccinate synthetase may be important in
      activation of the protonated amino group of aspartate, enhancement of the
      enzyme's binding affinity, and its specificity for aspartate.

PMID- 7797547
TI  - Regulation of malonyl-CoA metabolism by acyl-acyl carrier protein and beta
      ketoacyl-acyl carrier protein synthases in Escherichia coli.
AB  - The cessation of phospholipid biosynthesis by the inhibition of the sn-glycerol-3
      phosphate acyltransferase using a plsB mutant led to an accumulation of long
      chain acyl-acyl carrier proteins (acyl-ACP) and the concomitant inhibition of de
      novo fatty acid biosynthesis in Escherichia coli. Malonyl-CoA did not accumulate
      when phospholipid and fatty acid synthesis was blocked. However, the inactivation
      of beta-ketoacyl-ACP synthases I and II with the antibiotic cerulenin triggered a
      large increase in the accumulation of malonyl-CoA following the cessation of
      phospholipid synthesis, illustrating that the beta-ketoacyl-ACP synthases were
      responsible for the degradation of malonyl-CoA in the presence of long chain acyl
      ACP. The acyl-ACP requirement for malonyl-CoA degradation activity was confirmed
      by shifting enoyl-ACP reductase mutants (fabI(Ts)) to the non-permissive
      temperature, leading to the abrupt cessation of fatty acid synthesis and the
      accumulation of malonyl-CoA in the absence of cerulenin. Analysis of the ACP pool
      composition before and after the temperature shift showed that the fabI block did
      not result in the accumulation of long chain acyl-ACP. These data indicate a
      feedback regulatory loop that functions to recycle malonyl-CoA to acetyl-CoA
      following the down-regulation of fatty acid and phospholipid formation and
      provides a physiological rationale for the acyl-ACP-dependent, malonyl-ACP
      decarboxylase reaction catalyzed by beta-ketoacyl-ACP synthases I and II.

PMID- 7797549
TI  - Spectroscopic studies of the characterization of recombinant human
      dihydrolipoamide dehydrogenase and its site-directed mutants.
AB  - In this paper, we report the overexpression and single-step purification of
      recombinant wild-type and site-directed mutants of human dihydrolipoamide
      dehydrogenase in Escherichia coli and detailed spectroscopic studies aimed at
      understanding the catalytic mechanism of this enzyme. One mutation (K37E) has
      been identified in a patient lacking dihydrolipoamide dehydrogenase activity and
      has been reported previously (Liu, T.-C., Kim, H., Arizmendi, C., Kitano, A., and
      Patel, M. S. (1993) Proc. Natl. Acad. Sci. USA. 90, 5186-5190), while the other
      two mutations were previously generated specifically to address the role of the
      active-site base (His-452) and its ion pair (Glu-457). Circular dichroic and
      fluorescence spectroscopic data illustrate the role of these amino acids in
      maintaining the structure and function of human dihydrolipoamide dehydrogenase.
      While mutant H452Q is severely crippled in catalysis of the physiological
      reaction, the reverse reaction is affected in the E457Q mutant. The K37E mutant
      shows very little deviation from the wild-type enzyme.

PMID- 7797550
TI  - Identification of the active site nucleophile in nucleoside 2
      deoxyribosyltransferase as glutamic acid 98.
AB  - 2'-Fluoro-2'-deoxyarabinonucleosides are time-dependent inhibitors of nucleoside
      2-deoxyribosyltransferase. 2,6-Diamino-9-(2'-deoxy-2'-fluoro-beta-D
      arabinofuranosyl)-9H-purine (dFDAP) inhibited the enzyme by formation of a
      primary complex (Kd = 140 microM) that isomerized to a secondary complex with a
      first-order rate constant of 0.2 min-1. Inhibited enzyme contained stoichiometric
      amounts of covalently bound 2'-fluoro-2'-deoxyarabinosyl moiety, recovered less
      than 5% of its activity after storage for a week at 5 degrees C, but regained
      over 70% of the lost activity by treatment with 600 microM Ade. 6-Amino-9-(2'
      deoxy-2'-fluoro-beta-D-arabinofuranosyl)-9H-purine (dFAdo) was a product of the
      reactivation reaction. Proteolysis of inhibited enzyme identified a modified
      fragment that spanned residues 82-107 which could not be sequenced past Gly-96.
      dFDAP-inhibited enzyme and enzyme reacted with normal substrates (i.e. dThd and
      dAdo) were hydrolyzed between Met-97 and Glu-98 by 0.1 M NaOH. These findings and
      model studies on the base lability of peptides containing glutamyl esters
      suggested that the gamma-carboxylate of Glu-98 was esterfied during catalysis.
      The role of Glu-98 was confirmed by changing this residue to alanine. The
      specific activity of wild-type enzyme was 3 orders of magnitude greater than that
      of the mutant enzyme. Collectively, chemical modification and mutagenesis studies
      have identified Glu-98 as the active site nucleophile of nucleoside 2
      deoxyribosyltransferase.

PMID- 7797551
TI  - Nucleoside 2-deoxyribosyltransferase. Pre-steady-state kinetic analysis of native
      enzyme and mutant enzyme with an alanyl residue replacing Glu-98.
AB  - Nucleoside 2-deoxyribosyltransferase catalyzes cleavage of a 2'
      deoxyribosylnucleoside (A) to a nucleobase (P) with deoxyribosylation of the
      enzyme. Substrates quenched the intrinsic fluorescence of native enzyme (E) and a
      catalytically inactive mutant enzyme (E98A enzyme). The time courses of these
      reactions were analyzed in terms of the following scheme where EX is the 2
      deoxyribosyl ester of Glu-98. [formula: see text] The initial complexes between E
      and dAdo, dGuo, dIno, and dCyd or those between EX and the corresponding
      nucleobases were formed in a rapid equilibrium step. Native enzyme and E98A
      enzyme bound 2'-deoxyribosylnucleosides with similar affinities (k-1/k1). From a
      comparison of the time-dependent fluorescence changes associated with the
      reaction of native enzyme or E98A enzyme with these substrate, the kinetic step
      for 2-deoxyribosylation of Glu-98 was identified (k2 and k-2). dThd and dUrd
      quenched the fluorescence of native enzyme in a biphasic process. The late phase
      of this reaction was associated with 2-deoxyribosylation of Glu-98. The pre
      steady-state kinetic constants calculated from fluorescence quenching data for
      dAdo and Cyt were consistent with the experimental values for the steady-state
      kinetic coefficients and the equilibrium constant of the reaction.

PMID- 7797552
TI  - The mobile group I intron 3 alpha of the yeast mitochondrial COXI gene encodes a
      35-kDa processed protein that is an endonuclease but not a maturase.
AB  - Three mitochondrial mutants were characterized that block the splicing of aI3
      alpha, a mobile group I intron of the COXI gene of yeast mtDNA. Mutant C1085
      alters helical structures known to be important for splicing of group I introns.
      M44 and C1072 are point mutants in exon 3 that block correct splicing but allow
      some splicing at cryptic 5'-splice sites. M44 alters the P1 helix needed for 5'
      splice site definition, while the mutation in C1072 is a new kind of mutation
      because it is located upstream of the exon sequence involved in the P1 helix. All
      three mutants accumulate novel proteins of 35 and 44 kDa (p35 and p44,
      respectively) detected both by labeling of mitochondrial translation products and
      by Western blotting. Partial protease digestions indicate that p44 and p35 are
      closely related, probably as precursor and processed protein. The level of the
      intron-encoded endonuclease activity, I-SceIII, is elevated approximately 10-fold
      in the mutants. Partial purification of I-SceIII from the mutants showed that
      most, if not all, of the activity is associated with p35. Finally, because aI3
      alpha splices accurately in a petite mutant, we conclude that aI3 alpha splicing
      does not depend on a mtDNA-encoded maturase.

PMID- 7797554
TI  - Transactivation domain 2 (TA2) of p65 NF-kappa B. Similarity to TA1 and phorbol
      ester-stimulated activity and phosphorylation in intact cells.
AB  - The p65 subunit of the inducible transcription factor NF-kappa B contains at
      least two strong transactivation domains (TADs) within its C terminus. The first
      domain, TA1, is contained within the last 30 amino acids of p65, whereas TA2
      comprises the adjacent 90 amino acids. In this study, squelching experiments
      revealed that both TADs of p65, as well as the related subunit c-Rel, compete for
      the same cofactor(s) mediating transactivation. Both TADs of p65 share a common
      sequence motif, which is evolutionarily conserved and displays a remarkable
      degree of spatial organization when aligned on an alpha-helical surface. The
      functional importance of the common sequence motif was confirmed by deletion
      analysis of TA2. Within the conserved sequence motif, a 7-amino-acid repeat was
      noted. Idealized heptad repeats fused to the DNA binding domain of Gal4 were
      transcriptionally active, but only as multimers. Phosphorylation and
      transcriptional activity of a defined region within the TA2 domain was found to
      be stimulated by phorbol ester treatment of cells. In contrast, TA1 was
      constitutively phosphorylated, and its activity did not significantly respond to
      phorbol ester stimulation. The stimulatory effect of phorbol ester on
      transcription of the TA2 domain was completely blocked by the protein kinase C
      inhibitor. These data suggest that protein kinase C has a dual effect on NF-kappa
      B activity. It not only causes removal of I kappa B-alpha from cytoplasmic NF
      kappa B but also augments the transactivation potential of activated nuclear NF
      kappa B.

PMID- 7797553
TI  - Cloning of a cDNA for DNA supercoiling factor reveals a distinctive Ca(2+)
      binding protein.
AB  - DNA supercoiling factor is a protein capable of generating negative supercoils
      into a relaxed DNA in conjunction with eukaryotic DNA topoisomerase II. A cDNA
      clone encoding the Bombyx mori supercoiling factor has been isolated and
      characterized. The cDNA sequence contains an open reading frame of 322 amino
      acids rich in acidic residues. A local region of the predicted polypeptide shares
      a weak homology with the central portion of bacterial DNA gyrase A subunit. The
      cDNA sequence also predicts two direct repeats within the factor. Each repeat
      unit consists of a potential EF-hand domain. The factor contains three other
      potential EF-hand domains and actually binds Ca2+. Moreover, the supercoiling
      reaction has been shown to be activated by Ca2+. These results implicate Ca2+ in
      the control of the superhelical state of DNA.

PMID- 7797555
TI  - Cloning and characterization of COX14, whose product is required for assembly of
      yeast cytochrome oxidase.
AB  - Nuclear respiration-deficient mutants of Saccharomyces cerevisiae previously
      assigned to complementation group G93 lack cytochromes a and a3 and detectable
      cytochrome oxidase activity. Other respiratory chain carriers and the ATPase
      complex are present at near wild-type levels, indicating that the mutations
      specifically affect cytochrome oxidase. Since synthesis of the mitochondrially
      derived subunits 1, 2, and 3 of cytochrome oxidase is normal, the defect cannot
      be related to transcription of the endogenous genes or processing and translation
      of the corresponding RNAs. The results of Western analysis of the cytochrome
      oxidase subunits encoded in nuclear DNA also argues against an effect of the
      mutations on expression of these constituents. The G93 mutants are complemented
      by a nuclear gene, designated COX14. The product of this gene is a low molecular
      mass protein of 7,960 Da. A gene fusion expressing a biotinylated form of Cox14p
      complements cox14 mutants, indicating partial functional equivalence. The
      biotinylated derivative has been helpful in localizing Cox14p to the
      mitochondrial membrane and demonstrating that it is not a hitherto unrecognized
      subunit of cytochrome oxidase, although it does appear to be associated with a
      high molecular weight complex. This evidence, combined with the assembly-arrested
      phenotype of cox14 mutants, indicates that Cox14p, like several other recently
      described mitochondrial constituents, provides an important function at some late
      stage of the cytochrome oxidase assembly pathway.

PMID- 7797557
TI  - Incorporation of D-alanine into lipoteichoic acid and wall teichoic acid in
      Bacillus subtilis. Identification of genes and regulation.
AB  - The Bacillus subtilis dlt operon (D-alanyl-lipoteichoic acid) is responsible for
      D-alanine esterification of both lipoteichoic acid (LTA) and wall teichoic acid
      (WTA). The dlt operon contains five genes, dltA-dltE. Insertional inactivation of
      dltA-dltD results in complete absence of D-alanine from both LTA and WTA. Based
      on protein sequence similarity with the Lactobacillus casei dlt gene products
      (Heaton, M. P., and Neuhaus, F. C. (1992) J. Bacteriol. 174, 4707-4717), we
      propose that dltA encodes the D-alanine-D-alanyl carrier protein ligase (Dcl) and
      dltC the D-alanyl carrier protein (Dcp). We further hypothesize that the products
      of dltB and dltD are concerned with the transport of activated D-alanine through
      the membrane and the final incorporation of D-alanine into LTA. The hydropathy
      profiles of the dltB and dltD gene products suggest a transmembrane location for
      the former and an amino-terminal signal peptide for the latter. The incorporation
      of D-alanine into LTA and WTA did not separate in any of the mutants studied
      which indicates that either one and the same enzyme is responsible for D-alanine
      incorporation into both polymers or a separate enzyme, encoded outside the dlt
      operon, transfers the D-alanyl residues from LTA to WTA (Haas, R., Koch, H.-U.,
      and Fischer, W. (1984) FEMS Microbiol. Lett. 21, 27-31). Inactivation of dltE has
      no effect on D-alanine ester content of both LTA and WTA, and at present we
      cannot propose any function for its gene product. Transcription analysis shows
      that the dlt operon is transcribed from a sigma D-dependent promoter and follows
      the pattern of transcription of genes belonging to the sigma D regulon. However,
      the turn off of transcription observed before sporulation starts seems to be
      dependent on the Spo0A and AbrB sporulation proteins and results in a D-alanine
      free purely anionic LTA in the spore membrane. The dlt operon is dispensable for
      cell growth; its inactivation does not affect cell growth or morphology as
      described for L. casei.

PMID- 7797556
TI  - Src phosphorylation of the epidermal growth factor receptor at novel sites
      mediates receptor interaction with Src and P85 alpha.
AB  - Following ligand binding, the epidermal growth factor receptor (EGF-R)
      autophosphorylates itself on tyrosine residues located in its carboxyl terminus;
      in vitro, three sites are highly phosphorylated, while two other sites are
      phosphorylated to lesser extents. In the presence of the Src protein-tyrosine
      kinase, in vitro phosphorylation of the minor autophosphorylation sites was
      increased, and four additional residues were phosphorylated. Following EGF
      stimulation, two (Tyr-891 and Tyr-920) were found to be phosphorylated in a
      colorectal cell line (DLD-1) and in a breast tumor cell line (MCF7). The
      remaining in vitro sites were not found to be highly phosphorylated in vivo. The
      sequences surrounding Tyr-891 and Tyr-920 match the reported consensus binding
      sequences for the SH2 domains of Src and the regulatory domain of
      phosphatidylinositol 3-kinase (p85 alpha), respectively. In vitro, both of these
      proteins were found to bind to Src-phosphorylated EGF-R with approximately 100
      fold greater affinity than to autophosphorylated EGF-R, demonstrating that Src
      creates new sites for SH2 binding. Furthermore, Csk-inactivated Src was activated
      by interaction with Src-phosphorylated EGF-R but not by autophosphorylated EGF-R.
      Upon EGF treatment of MCF7 or three colorectal carcinoma cell lines (WiDr, DLD-1,
      and LS174T), the EGF-R coimmunoprecipitated with both p85 alpha and Src. Evidence
      is also presented that suggests that an EGF-R-related protein, ErbB2, may be
      involved in similar Src-mediated interactions. These data demonstrate that EGF-R
      is phosphorylated in vivo at non-autophosphorylation sites and that these novel
      sites can act as docking sites for Src, P85 alpha, and potentially other SH2
      containing proteins. In addition, the data suggest a tyrosine phosphatase
      independent mechanism for the elevation of Src activity in cells exposed to
      growth factors. Overexpression of Src, EGF-R, and/or ErbB2 in breast and
      colorectal tumor cells suggests the potential that such interactions may
      contribute to the transformed phenotype of these carcinomas.

PMID- 7797558
TI  - Kidd blood group and urea transport function of human erythrocytes are carried by
      the same protein.
AB  - The gene encoding the urea transporter of human erythrocytes (HUT11 clone) has
      been cloned recently (Olives, B., Neau, P., Bailly, P., Hediger, M. A.,
      Rousselet, G., Cartron, J. P., and Ripoche, P. (1994) J. Biol. Chem. 269, 31649
      31652). Now, this gene has been assigned to chromosome 18q12-q21 by in situ
      hybridization, as also found for the Kidd (Jk) blood group locus. In coupled
      transcription-translation assays, the HUT11 cDNA directed the synthesis of a 36
      kDa protein which was immunoprecipitated by a human anti-Jk3 antibody produced by
      immunized Jk(a-b-) donors whose red cells lack Kidd antigens. The anti-Jk3
      antibody also immunoprecipitated a protein material of 46-60 kDa from all red
      cell membranes, except those from Jk(a-b-) cells. After N-glycanase digestion the
      46-60-kDa component was reduced to 36 kDa. A rabbit antibody raised against the
      predicted NH2-terminal amino-acids of the HUT11 protein reacted on immunoblots
      with a 46-60-kDa component present in all human erythrocytes except those from
      Jk(a-b-) individuals. Jk(a-b-) red cells lack the Kidd/urea transport protein and
      have a selective defect of the urea transport capacity, but a normal water
      permeability and aquaporin-associated Colton blood group antigens. These findings
      indicate that the erythrocyte urea transporter is encoded by the Kidd locus and
      may have implications for the biology of urea transporters and their tissue
      specific regulation.

PMID- 7797559
TI  - Lysine-based structure in the proregion of procathepsin L is the recognition site
      for mannose phosphorylation.
AB  - The recognition of lysosomal enzymes by UDP-GlcNAc: lysosomal-enzyme GlcNAc-1
      phosphotransferase (phosphotransferase) is mediated by a protein structure on
      lysosomal enzymes. It has been previously demonstrated that lysine residues are
      required for phosphorylation of procathepsin L and are a common feature of the
      site on many lysosomal proteins. In this work, the procathepsin L recognition
      structure was further defined by identification of the region of the protein
      containing the structure and the critical lysine residues involved. Removal of
      the cathepsin L propeptide by low pH-induced autocatalytic processing abolished
      phosphorylation. The addition of either the purified propeptide or a glutathione
      S-transferase-propeptide fusion protein to the processed protein restored
      phosphorylation. Mutagenesis of individual lysine residues demonstrated that two
      propeptide lysine residues (Lys-54 and Lys-99) were required for efficient
      phosphorylation of procathepsin L. By comparison of the phosphorylation rates of
      procathepsin L, lysine-modified procathepsin L, and the procathepsin L
      oligosaccharide, lysine residues were shown to account for most, if not all, of
      the protein-dependent interaction. On this basis, it is concluded that the
      proregion lysine residues are the major elements of the procathepsin L
      recognition site. In addition, lysine residues in cathepsin D were shown to be as
      important for phosphorylation as those in procathepsin L, supporting a general
      model of the recognition site as a specific three-dimensional arrangement of
      lysine residues exposed on the surface of lysosomal proteins.

PMID- 7797560
TI  - Domain closure in the catalytic chains of Escherichia coli aspartate
      transcarbamoylase influences the kinetic mechanism.
AB  - The closure of the two domains of the catalytic chains of Escherichia coli
      aspartate transcarbamoylase, which is critical for completion of the T-->R
      transition, is stabilized by salt-bridges between Glu-50 and both Arg-167 and Arg
      234. Mutation of Glu-50 to Ala shifts the enzyme toward a low activity, low
      affinity state (Newton, C. J., and Kantrowitz, E. R. (1990) Biochemistry, 29,
      1444-1451). Kinetic isotope effects (KIE) and equilibrium isotope exchange
      kinetics (EIEK) have been used to probe the dynamic properties of the Glu-50-
      >Ala enzyme. Unlike the behavior of the wild-type enzyme, the observed kinetic
      isotope effect for 13C versus 12C at the carbonyl group of carbamoyl phosphate
      (CP) increased upon the binding of ligands which promote the formation of the R
      state (Asp, N-phosphonacetyl-L-aspartate (PALA), or ATP). The maximum rate for
      the [14C]Asp<-->Carbamoyl aspartate (CAsp) exchange with the Glu-50-->Ala enzyme
      was 500-fold slower than for the wild-type enzyme; however, the rate for the
      [14C]CP<-->CAsp exchange was only 50-fold slower, reversing the relative rates
      observed with the wild-type enzyme. In addition, upon variation of substrate
      pairs involving Asp or CAsp, loss of inhibition effects in the CP<-->CAsp
      exchange indicated that the Glu-50-->Ala substitution caused the kinetic
      mechanism for the mutant enzyme to shift from ordered to random. Computer
      simulations of the EIEK data indicate that the Glu-50-->Ala mutation specifically
      causes strong decreases in the rates of catalysis and association-dissociation
      for Asp and CAsp, with minimal effects on the CP and Pi on-off rates. With
      substrates bound, the Glu-50-->Ala enzyme apparently does not attain a full R
      state conformation. The PALA-activated Glu-50-->Ala enzyme, however, exhibits
      substrate affinities comparable to those for the wild-type enzyme, but fails to
      restore the preferred order substrate binding. Unlike the wild-type enzyme, both
      the T and R-states of the Glu-50-->Ala enzyme contribute to catalysis. A third
      state, I, is proposed for the Glu-50-->Ala enzyme, in which random order
      substrate binding is exhibited, and the catalytic step contributes significantly
      to overall rate limitation.

PMID- 7797561
TI  - Identification of novel DNA binding targets and regulatory domains of a murine
      tinman homeodomain factor, nkx-2.5.
AB  - A murine cardiac-specific homeodomain gene named csx (Komuro, I., and Izumo. S.
      (1993) Proc. Natl. Acad. Sci. U. S. A. 90, 8145-8149) and nkx-2.5 (Lints, T. J.,
      Parsons, L. M., Hartley, L., Lyons, I., and Harvey, R. P. (1993) Development 119,
      419-431) was identified as a potential vertebrate homologue of Drosophila tinman,
      a mesoderm determination factor required for insect heart formation (Bodmer, R.
      (1993) Development 118, 719-729). Bacterial expression of the nkx-2.5 homeodomain
      allowed us to identify downstream DNA targets from a library of randomly
      generated oligonucleotides. High affinity nkx-2.5 DNA binding sites, 5'-TNNAGTG
      3', represented novel binding sequences, whereas intermediate and weaker affinity
      sites, 5'-C(A/T)TTAATTN-3', contained the typical 5'-TAAT-3' core required by
      most homeodomain factors for DNA binding. We also observed that nkx-2.5 served as
      a modest transcription activator in transfection assays done in 10T1/2
      fibroblasts with multimerized binding sites linked to a luciferase reporter gene.
      Functional dissection of nkx-2.5 revealed a COOH-terminal inhibitory domain
      composed mainly of clusters of alanines and prolines, which appeared to mask a
      potent activation domain composed of hydrophobic and highly charged amino acids.

PMID- 7797562
TI  - A conformational change in the junctional foot protein is involved in the
      regulation of Ca2+ release from sarcoplasmic reticulum. Studies on polylysine
      induced Ca2+ release.
AB  - We investigated both conformational changes in the junctional foot protein (JFP)
      and Ca2+ release from sarcoplasmic reticulum (SR) in parallel after stimulation
      of triadic vesicles by the JFP-specific ligand, polylysine. To monitor protein
      conformational change, the JFP was labeled in a site-directed fashion with the
      fluorescent conformational probe methylcoumarin acetate (MCA) (Kang, J. J.,
      Tarcsafalvi, A., Carlos, A. D., Fujimoto, E., Shahrokh, Z., Thevenin, B. J.-M.,
      Shohet, S. B., and Ikemoto, N. (1992) Biochemistry 31, 3288-3293). The induction
      of SR Ca2+ release by polylysine produced a rapid increase in the fluorescence
      intensity of the JFP-bound MCA. The polylysine concentration dependence of the
      fluorescence change was essentially the same as that of Ca2+ release, suggesting
      that the two events are tightly coupled. However, the rate constant of MCA
      fluorescence change was much larger than that of Ca2+ release; i.e. the
      conformational change preceded Ca2+ release. Prevention of protein conformational
      change by lysine (0.2 M) inhibited Ca2+ release from SR. Inhibition of Ca2+
      release by Mg2+ (5 mM), however, had little effect on the conformational change.
      These results suggest that binding of polylysine to the JFP produces
      conformational changes in the protein, which in turn activates the Ca2+ channel,
      leading to Ca2+ release from the SR.

PMID- 7797563
TI  - Carboxypeptidase M is identical to the MAX.1 antigen and its expression is
      associated with monocyte to macrophage differentiation.
AB  - The two monoclonal antibodies MAX.1 and MAX.11 recognize cell surface antigens
      that are almost undetectable on monocytes but highly expressed on differentiated
      macrophages. Biochemical characterization revealed that both antibodies detect
      the same 58-64-kDa glycoprotein anchored to the plasma membrane by glycosyl
      phosphatidylinositol linkage. We purified the MAX.1/11 antigen by immunoaffinity
      chromatography using monoclonal antibody MAX.11. The NH2-terminal amino acid
      sequence was determined and turned out to be identical to the NH2-terminal
      sequence of the membrane-bound carboxypeptidase M. By precipitation with
      antibodies MAX.1 and MAX.11, membrane preparations of macrophages and placental
      microvilli were almost completely depleted of enzyme activity, indicating that
      the two antibodies indeed recognize carboxypeptidase M. Immunoreactivity of both
      antibodies correlates with the reported tissue distribution of enzyme activity.
      Expression of carboxypeptidase M on mRNA level and enzymatic activity markedly
      increase during in vitro differentiation of monocytes, according to the described
      increase in MAX.1 and MAX.11 antigen expression. Moreover, in vitro
      differentiated macrophages show the highest specific activity yet described in
      any tissue. In addition, carboxypeptidase M expression could be detected in HL
      60, U937, and THP-1 myeloid cell lines. Vitamin D3-induced monocytic
      differentiation resulted in an increased carboxypeptidase M expression in all
      three cell lines. Further studies are needed to elucidate the functional role of
      carboxypeptidase M during monocytic differentiation and activation.

PMID- 7797564
TI  - An amino-terminal domain containing hydrophobic and hydrophilic sequences binds
      the signal recognition particle receptor alpha subunit to the beta subunit on the
      endoplasmic reticulum membrane.
AB  - The signal recognition particle receptor consists of two subunits of 72 kDa (SR
      alpha) and 30 kDa (SR beta). Assembly of SR alpha on the endoplasmic reticulum
      membrane can occur independent of the signal recognition particle-mediated
      translocation pathway. To identify the sequences within SR alpha necessary for
      membrane binding, a series of amino-terminal and internal deletion mutants was
      constructed and translated in a cell-free system. In addition, nascent SR alpha
      polypeptides of varying lengths were generated by cycloheximide treatment of
      translation reactions. Microsome binding assays performed on these polypeptides
      revealed a membrane binding domain consisting of the amino-terminal 140 residues
      of SR alpha. This domain includes the two hydrophobic sequences originally
      proposed to bind to membranes and a highly charged region not previously
      implicated in membrane assembly. Furthermore, the domain forms a protease
      resistant folding unit that after proteolysis can target and anchor onto
      microsomes. Extraction of microsomal SR alpha at high pH supplemented with 1 M
      NaSCN suggests that SR alpha and the membrane binding domain are not integrated
      in the endoplasmic reticulum membrane. The membrane binding domain is also the
      major site of tight binding with SR beta, suggesting that SR beta plays a role in
      the membrane assembly of SR alpha.

PMID- 7797565
TI  - The SH2 domains of Src family kinases associate with Syk.
AB  - Src family kinases (Lyn, Fyn, Lck, and Blk) and Syk, a tandem SH2 domain
      containing tyrosine kinase, have been demonstrated to be associated with the
      antigen receptor in B cells. Both of these categories of tyrosine kinases are
      presumed to be critical players in the process of antigen-mediated signal
      transduction. Cross-linking of membrane immunoglobulin on the surface of B cells
      leads to the activation of Lyn, Fyn, and Blk, which presumably associate with the
      cytoplasmic tails of the membrane immunoglobulin-associated Ig alpha/beta
      heterodimer. Receptor ligation also leads to the tyrosine phosphorylation and
      catalytic activation of Syk, but the mechanism of association of this kinase with
      the antigen receptor remains to be established. A number of phosphoproteins that
      can associate with the SH2 domains of Blk, Lyn, and Fyn have been described in
      activated B cells. We demonstrate here that Syk is one of the proteins in the
      lysates of activated B cells which bind to the SH2 domains of Src family kinases.
      Syk binds directly to the SH2 domain of Blk and complexes in vivo with Lyn and
      Blk in activated B cells.

PMID- 7797567
TI  - Simultaneous overexpression of copper- and zinc-containing superoxide dismutase
      and catalase retards age-related oxidative damage and increases metabolic
      potential in Drosophila melanogaster.
AB  - The objective of this study was to elucidate the nature of the mechanisms by
      which overexpression of copper- and zinc-containing superoxide dismutase (Cu,Zn
      SOD) and catalase extends life span of Drosophila melanogaster. Experimental
      flies containing single extra doses of Drosophila Cu,Zn-SOD and catalase genes
      were compared with appropriate controls at different ages. Overexpression of
      Cu,Zn-SOD and catalase caused a retardation in the accumulation of 8
      hydroxydeoxyguanosine during aging and in response to the exposure of live flies
      to x-rays. The age-related loss of glucose-6-phosphate dehydrogenase activity
      (Glu-6-P dehydrogenase) and the increase in the rate of mitochondrial H2O2
      generation were less steep in the experimental than control flies. The rate of in
      vivo oxygen consumption in the latter two-thirds of life span was higher in the
      experimental than in the control flies. Furthermore, the metabolic potential, or
      the total amount of oxygen consumed during an average life span, was about 30%
      greater in the experimental than the control flies. Altogether, results of this
      study indicate that overexpression of Cu,Zn-SOD and catalase ameliorates the age
      related accumulation of molecular oxidative damage and susceptibility to such
      damage in response to acute oxidative stress while prolonging the metabolic life
      of flies. The concept that oxidative stress is a causal factor in the aging
      process is supported.

PMID- 7797566
TI  - Myogenic regulatory factors can activate TATA-containing promoter elements via an
      E-box independent mechanism.
AB  - We have studied the effect of several myogenic regulatory factors on the activity
      of the promoter for a mouse gene encoding a skeletal myosin heavy chain (MyHC)
      expressed in adult (type IIB) muscle fibers. Co-transfection of myogenic factors
      is necessary for activity of the IIB promoter in mouse C2 myotubes in culture but
      not in quail myotubes in culture. Although this promoter contains one E-box
      within the first 192 base pairs upstream of the transcriptional start site,
      mutations in this motif demonstrate that it is not required for the
      transactivation effect of the myogenic factors. Analysis of other mutants
      suggests that the MEF2 and MHox DNA-binding factor binds to an evolutionarily
      conserved AT-rich motif. In addition, the IIB promoter appears to require the
      conserved TATA motif (CTATAAAAG) in order to be activated by the AT-rich
      sequences. The IIB promoter constructs produce RNA transcripts which begin at the
      natural site of transcriptional initiation in quail myotubes and in mouse C2
      myotubes after co-transfection with myogenic factors; a second, minor, start site
      is also used in the co-transfected C2 myotubes. Results obtained after
      transfection of the mouse IIB promoter constructs in quail myotube cultures
      suggest that the overexpression of myogenic factors in C2 cultures does not
      result in an environment in which the control of IIB MyHC promoter activity is
      aberrant. Therefore, either the myogenic factors themselves, or other proteins
      induced by them, seem to interact directly with the basal transcription seem to
      interact directly with the basal transcription machinery to allow muscle-specific
      gene expression.

PMID- 7797568
TI  - A testicular protein important for fertility has glutathione S-transferase
      activity and is localized extracellularly in the seminiferous tubules.
AB  - A 24-kDa protein isolated by preparative gel electrophoresis from rat testes was
      reported by us as an active immunogen in rats. Anti-24-kDa antibodies inhibited
      murine sperm-oocyte binding in vitro. Here, we show similarity at the NH2
      terminus shared by this protein purified on Sephadex G-75 followed by anion
      exchange high performance liquid chromatography with glutathione S-transferase
      (GST)-mu subunits. This protein purified by glutathione affinity chromatography
      also demonstrated similarity to GST-mu NH2 terminus in a 30-amino-acid overlap.
      Both proteins showed activity toward the GST substrate 1-chloro-2,4
      dinitrobenzene (Km of 33 microM and 50 microM) which was inhibited by 17 beta
      estradiol 3-sulfate. Antisera against both proteins recognized liver GST-mu on
      Western blots and sperm acrosome of multiple species immunocytochemically. Both
      antisera significantly inhibited in vitro fertilization of goat oocytes by sperm
      preincubated with them while anti-liver GST sera did not. GST activity was
      localized on rat sperm, seminiferous tubular fluid, and Sertoli cells.
      Seminiferous tubular fluid 24-kDa protein shared similarity to the NH2 terminus
      of GST-mu subunits in a 20-amino-acid overlap. Time-dependent accumulation of GST
      was detected in the spent culture medium of seminiferous tubules from rats of
      different ages suggesting secretion.

PMID- 7797569
TI  - Retinol-binding protein and asialo-orosomucoid are taken up by different pathways
      in liver cells.
AB  - The intracellular transport and degradation of in vivo endocytosed retinol
      binding protein was compared with that of asialo-orosomucoid, a marker for
      receptor-mediated endocytosis through coated pits. The transport pathways were
      studied in rat liver cells by means of subcellular fractionation in Nycodenz and
      sucrose density gradients and by immunoelectron microscopy. Retinol-binding
      protein and asialo-orosomucoid were labeled by covalent attachment of
      radioiodinated tyramine cellobiose, an adduct which is incapable of crossing
      cellular membranes and thus provides a marker for the organelles where the
      protein has been taken up and degraded. The data obtained from subcellular
      fractionation studies, as well as from immunoelectron microscopy, showed that
      retinol-binding protein and asialo-orosomucoid were initially localized in
      different endocytic vesicles. Retinol-binding protein co-localized in density
      gradients with markers for potocytosis, an alternative endocytic pathway which
      uses internalization through caveolae instead of clathrin-coated pits. Later,
      retinol-binding protein and asialo-orosomucoid comigrated in the gradients and
      they were also observed in the same larger vesicles by immunoelectron microscopy.
      These data suggest that retinol-binding protein is taken up by liver cells by
      potocytosis and that a fraction of the retinol-binding protein is later
      transferred to larger vesicles located deeper in the cytoplasm where degradation
      takes place.

PMID- 7797571
TI  - A putative mammalian RNA helicase with an arginine-serine-rich domain colocalizes
      with a splicing factor.
AB  - We have cloned a rat cDNA whose deduced primary structure yields a protein of
      117.4 kDa. Because this protein contains RNA helicase consensus motifs, among
      them a "DEAD" box, we have termed it HEL117 (for helicase of 117.4 kDa). Besides
      the helicase consensus motifs, HEL117 contains an arginine-serine (RS)-rich
      domain, which occurs in some proteins involved in RNA splicing. Moreover, the
      COOH-terminal region of 78 residues of HEL117 is 38.5% identical and 59% similar
      to the COOH-terminal region of a yeast PRP5 protein that is involved in RNA
      splicing. Rabbit antibodies generated against a synthetic peptide of HEL117
      identified a single polypeptide not only in rat cells but also in cells of other
      mammals as well as chicken. The antibodies revealed a finely punctate and
      speckled intranuclear staining in immunofluorescence microscopy. A monoclonal
      antibody against a human splicing factor containing an RS domain (SC35) showed,
      in double immunofluorescence microscopy, largely overlapping staining consistent
      with HEL117 being involved in RNA splicing.

PMID- 7797570
TI  - Evidence for a regulated interaction between heterotrimeric G proteins and
      caveolin.
AB  - Caveolae are flask-shaped plasma membrane specializations. A 22-kDa protein,
      caveolin, is a principal component of caveolar membranes in vivo. As recent
      evidence suggests that caveolae may participate in G protein-coupled signaling
      events, we have investigated the potential interaction of caveolin with
      heterotrimeric G proteins. Using cell fractionation techniques, we found that
      mutational or pharmacologic activation of Gs alpha prevents its cofractionation
      with caveolin. In a second independent approach, we directly examined the
      interaction of G proteins with caveolin. For this purpose, we recombinantly
      expressed caveolin as a glutathione S-transferase fusion protein. Using an in
      vitro binding assay, we found that caveolin interacts with G protein alpha
      subunits (Gs, Go, and Gi). Mutational or pharmacologic activation (with guanosine
      5'-O-(thiotriphosphate)) of G alpha subunits prevents this interaction,
      indicating that the inactive GDP-bound form of G alpha subunits preferentially
      interacts with caveolin. This G protein binding activity is located within a 41
      amino acid region of caveolin's cytoplasmic N-terminal domain (residues 61-101).
      Further functional analysis shows that a polypeptide derived from this region of
      caveolin (residues 82-101) effectively suppresses the basal activity of purified
      G proteins, apparently by inhibiting GDP/GTP exchange. This caveolin sequence is
      homologous to a region of the Rab GDP dissociation inhibitor, a known inhibitor
      of GDP/GTP exchange for Rab proteins. These data suggest that caveolin could
      function to negatively regulate the activation state of heterotrimeric G
      proteins.

PMID- 7797572
TI  - Interactions of phosphorylation and dimerizing domains of the alpha-subunits of
      Na+/K(+)-ATPase.
AB  - Chemical cross-linking studies are among a number of experimental approaches that
      have suggested the functional significance of higher association states of
      alpha,beta-protomers of Na+/K(+)-ATPase. Formation of the phosphointermediate of
      the enzyme on Asp369 of the alpha-subunit is known to induce oxidative cross
      linking of the alpha-subunits catalyzed by Cu(2+)-phenanthroline. To localize the
      phosphorylation-induced alpha,alpha-interface, we cleaved alpha at Arg438-Ala439
      by controlled proteolysis and exposed the partially cleaved enzyme to the cross
      linking reagent. In addition to the alpha,alpha-dimer, two other phosphorylation
      induced cross-linked products were obtained. Using gel electrophoretic resolution
      of the cross-linked 32P-labeled enzyme, N-terminal analyses of the products, and
      their reactivities with sequence-specific antibodies, the two products were
      identified as a homodimer of the C-terminal 64-kDa fragment of alpha and a
      heterodimer of alpha and the 64-kDa peptide. The latter dimer was also obtained
      when the cross-linked alpha,alpha-dimer was formed first and then subjected to
      proteolysis. The findings localize the dimerizing domain to the C-terminal side
      of Ala439 and indicate that intersubunit proximities of dimerizing domains are
      regulated by phosphorylation-dephosphorylation of Asp369 during the reaction
      cycle of the enzyme.

PMID- 7797573
TI  - Dissociation of mitogen-activated protein kinase activation from the oxidative
      burst in differentiated HL-60 cells and human neutrophils.
AB  - In human polymorphonuclear leukocytes (PMNs), mitogen-activated protein kinases
      (MAPKs), also known as extracellular signal-regulated kinases (Erks), are
      activated within minutes upon stimulation with either chemoattractant formyl-Met
      Leu-Phe (fMLP) or phorbol 12-myristate 13-acetate (PMA). This activation of MAPKs
      coincides with the formation of superoxide anion, which occurs through the
      activation of a multiple-component NADPH oxidase pathway. MAPKs have thus been
      suggested to be involved in signal transduction leading to the oxidative burst.
      To investigate whether MAPK activation plays a central role in the oxidative
      burst, we evaluated the effect of cAMP on MAPK activation induced by fMLP and
      PMA. cAMP inhibits many PMN functional responses, including the oxidative burst,
      and has recently been shown to reduce growth factor- and PMA-induced MAPK
      activities in a variety of cells. We found that in differentiated, neutrophil
      like HL-60 cells, while cAMP reduced PMA-induced MAPK activation, it had no
      effect on fMLP-induced MAPK activation. Despite the presence of unchanged levels
      of activated MAPKs, the fMLP-induced oxidative burst was substantially diminished
      by cAMP. By contrast, O2-production induced by PMA remained the same even though
      MAPK activation was inhibited. In PMNs, although the levels of O2-induced by
      either 10 ng/ml or 100 ng/ml PMA were similar, only 100 ng/ml could stimulate
      MAPK activation, suggesting that the oxidative burst could occur in the absence
      of detectable activation of MAPKs. As in HL-60 cells, cAMP inhibited the O2
      production in fMLP-stimulated PMNs but had no effect on MAPK activity. These
      results demonstrate that, while MAPK activation coincides with PMN activation, it
      can be dissociated from the oxidative burst.

PMID- 7797574
TI  - Identification of a major subfamily of large hsp70-like proteins through the
      cloning of the mammalian 110-kDa heat shock protein.
AB  - A major mammalian heat shock protein of 110 kDa (hsp110) has long been observed,
      but has not been cloned. We have cloned the hamster cDNA for hsp110 and show that
      it hybridizes on a Northern blot to a 3.5-kilobase heat-inducible message in
      hamster and mouse. The hsp110 sequence was found to share an approximately 30-33%
      amino acid identity with members of the hsp70 family, most of which occurs in the
      conserved ATP-binding domain of these molecules. In addition, five sequences were
      found to be highly similar to hsp110. These are the sea urchin egg receptor for
      sperm (Foltz, K.R., Partin, J. S., and Lennarz, W.J. (1993) Science 259, 1421
      1425) and additional sequences from human and Caenorhaditis elegans and two from
      yeast. The carboxyl-terminal two-thirds of hsp110 and these five related proteins
      contain a pattern of highly conserved regions of sequence unique to this group. A
      probe containing these conserved sequences was found to strongly cross-react on a
      Southern blot with genomic sequences from yeast to man. A Western blot analysis
      of several murine tissues indicates that hsp110 is constitutively expressed in
      all mouse tissues and is highly expressed in brain. Therefore, hsp110 belongs to
      a new category of large and structurally unique stress proteins that are the most
      distantly related known members of the hsp70 family.

PMID- 7797575
TI  - Expression, domain structure, and enzymatic properties of an active recombinant
      human DNA topoisomerase II beta.
AB  - Human cells express two genetically distinct isoforms of DNA topoisomerase II,
      alpha and beta, which catalyze ATP-dependent DNA strand passage and are an
      important antitumor drug target. Here we report for the first time the successful
      overexpression of human topoisomerase II beta in yeast by cloning a topoisomerase
      II beta cDNA in a yeast shuttle vector under the control of a galactose-inducible
      promoter. Recombinant human topoisomerase II beta (residues 46-1621 fused to the
      first 5 residues of yeast topoisomerase II) was purified to homogeneity, yielding
      an enzymatically active polypeptide in sufficient quantity to allow analysis of
      its domain structure and comparison with that of recombinant human topoisomerase
      II alpha. Partial digestion of beta with either trypsin or protease SV8 generated
      fragments of approximately 130, 90, 62, and 45-50 kDa, arising from cleavage at
      three limited and discrete regions of the protein (A, B, and C) indicating the
      presence of at least four structural domains. Recombinant human topoisomerase II
      alpha and beta induced DNA breakage which was promoted by a variety of agents.
      Isoform differences in drug-induced DNA breakage were observed. These studies of
      human topoisomerase II beta in concert with alpha should aid the determination of
      their individual roles in cancer chemotherapy and should facilitate the design,
      targeting, and testing of cytotoxic antitumor agents.

PMID- 7797576
TI  - Enhancement of the binding of triglyceride-rich lipoproteins to the very low
      density lipoprotein receptor by apolipoprotein E and lipoprotein lipase.
AB  - The low-density lipoprotein (LDL) receptor plays a crucial role in cholesterol
      metabolism. A related protein, designated the very low density lipoprotein (VLDL)
      receptor, that specifically binds apolipoprotein (apo) E has recently been
      characterized and shown to be expressed in heart, muscle and adipose tissue and
      the human monocyte-macrophage cell line THP-1. The VLDL receptor binds and
      internalizes VLDL and intermediate density lipoprotein from Watanabe heritable
      hyperlipidemic (WHHL) rabbits as well as beta-migrating VLDL from cholesterol-fed
      rabbits but not LDL from WHHL rabbits. Chinese hamster ovary (CHO) cells
      transfected with the rabbit VLDL receptor cDNA have now been shown to bind or
      internalize VLDL (d < 1.006 g/ml) isolated from fasted normolipidemic human
      subjects with lower affinity than WHHL-VLDL or rabbit beta-VLDL. However, binding
      and internalization were markedly enhanced when fasted human VLDL was
      preincubated with either recombinant human apoE (3/3) or lipoprotein lipase (LPL)
      in CHO cells overexpressing the rabbit or human VLDL receptor. CHO cells
      transfected with both the rabbit VLDL receptor cDNA and the human LPL cDNA
      effectively bound, internalized, and degraded fasted human VLDL without
      pretreatment. Treatment of heparinase reduced the effect of LPL-mediated binding
      at 4 degrees C, but the inhibitory effect was lower at 37 degrees C. Pseudomonas
      LPL also enhanced the binding of human fasted VLDL to the VLDL receptor at 37
      degrees C in CHO cells overexpressing the human VLDL receptor. Taken together,
      LPL causes the enhancement of triglyceride-rich lipoproteins binding to the VLDL
      receptor via both the formation of bridge between lipoproteins and heparan
      sulfate proteoglycans and its lipolytic effect. Ligand blot analysis showed that
      the apparent molecular mass of the VLDL receptor is 118 kDa, which is smaller
      than that of the LDL receptor. These results indicate that the VLDL receptor
      recognizes both triglyceride-rich lipoproteins that are also relatively rich in
      apoE, as well as the remnants of triglyceride-rich lipoproteins after catabolism
      and the interaction with heparan sulfate proteoglycans by LPL. The VLDL receptor
      may thus function as a receptor for remnants of triglyceride-rich lipoproteins in
      extrahepatic tissues.

PMID- 7797577
TI  - Mammalian brain-specific L-proline transporter. Neuronal localization of mRNA and
      enrichment of transporter protein in synaptic plasma membranes.
AB  - The expression of a high affinity Na(+)- (and Cl-) dependent L-proline
      transporter (PROT) in subpopulations of putative glutamatergic pathways in rat
      brain raises the possibility of a specific physiological role(s) for this carrier
      in excitatory neurotransmission (Fremeau, R. T., Jr., Caron, M. G., and Blakely,
      R. D. (1992) Neuron 8, 915-926). However, the biochemical properties and
      regional, cellular, and subcellular distribution of the PROT protein have yet to
      be elucidated. Here, we document the brain-specific expression and neuronal
      localization of rat PROT mRNA. We also report the first identification and
      partial biochemical characterization of the mammalian brain PROT protein. An
      affinity-purified antipeptide antibody was produced that specifically recognized
      a single 68-kDa PROT protein on immunoblots of rat and human brain tissues.
      Deglycosylation of rat hippocampal membranes with peptide-N-glycosidase F reduced
      the apparent molecular mass of the native PROT protein from 68 to 53 kDa, the
      size of the primary PROT translation product determined by in vitro translation
      of the rat PROT cDNA in the absence of microsomes. Subcellular fractionation
      studies demonstrated that the PROT protein was enriched in synaptic plasma
      membranes but absent from postsynaptic densities. A differential distribution of
      PROT mRNA and protein was observed in rat striatum, suggesting that the
      transporter protein is synthesized in neuronal cell bodies in the cortex and
      exported to axon terminals in the caudate putamen. These findings warrant the
      consideration of a novel presynaptic regulatory role for this transporter in
      excitatory synaptic transmission.

PMID- 7797578
TI  - Identification of key charged residues of human interleukin-5 in receptor binding
      and cellular activation.
AB  - Interleukin-5 (IL-5) is a cytokine that plays a major role in the differentiation
      and activation of eosinophils. In order to identify which charged residues of
      human IL-5 are important in binding to its receptor and subsequent cellular
      activation, we have systematically replaced all of the clusters of charged amino
      acids with alanine residues. The mutants have been expressed in Escherichia coli,
      renatured, and purified. They were assayed for ability to cause proliferation of
      the erythroleukaemic cell line TF-1 and the up-regulation of eosinophil adhesion
      to ICAM-1. In addition, we studied receptor binding using either immobilized
      recombinant IL-5 receptor alpha-chain or the alpha/beta-receptor complex
      expressed on TF-1 cells. The key charged residue involved in binding to the beta
      chain of the receptor is Glu-12. This residue is in an identical position to
      those previously identified in IL-3 and granulocyte-macrophage colony-stimulating
      factor (GM-CSF) involved in binding to the receptor beta-chain. The alpha-chain
      binding site is shown to involve the side chains Arg-90 and Glu-109, located in
      the second beta sheet and after the end of the fourth helix, respectively. It is
      unique to IL-5 and does not occur in IL-3 or GM-CSF. Understanding the topology
      of the interaction of IL-5 with its receptor chains will help in the search for
      rationally designed antagonists of IL-5 function.

PMID- 7797579
TI  - The activation-resistant conformation of recombinant human plasminogen is
      stabilized by basic residues in the amino-terminal hinge region.
AB  - Fully activable recombinant human plasminogen (rPlg) was expressed in mammalian
      cells employing either recombinant vaccinia virus or stable lines coexpressing
      alpha 2-plasmin inhibitor. A panel of eight variants of rPlg was constructed, in
      which progressively up to 6 basic amino acid residues in the hinge region of rPlg
      between the NH2-terminal acidic domain ("proactivation peptide") and kringle 1
      were substituted by neutral residues. Analysis of the cleavage rates of these
      variants by plasmin revealed that the peptide bond at Arg68 is most susceptible,
      followed by Lys62 and Lys77. A variant with all 6 basic residues substituted was
      cleaved at Lys20. Three of these variants, PlgB (R68A, R70A), PlgF (R68A, R70A,
      K77H, K78H), and PlgG (R61A, K62A, R68A, R70A, K77H, K78H), as well as rPlg, were
      analyzed in more detail. The conformation of these plasminogens was analyzed by
      monitoring the change in intrinsic fluorescence upon binding of lysine analogs.
      This revealed that rPlg exhibits the native tight Glu1-plasminogen conformation,
      whereas PlgB, PlgF, and Plg G display an open conformation similar to Lys78
      plasminogen, leading to an increased affinity for lysine analogs. This allowed a
      direct study of the impact of the activation-resistant conformation on the
      properties of Glu1-plasminogen. The open conformation of rPlg variants leads to
      an increased rate of activation by urokinase-type plasminogen activator and
      streptokinase and increased binding to a fibrin clot. Fibrin clot lysis mediated
      by tissue-type plasminogen activator was accelerated for the variants as a result
      of a lower Km for tissue-type plasminogen activator-mediated plasminogen
      activation, resulting from the increased affinity of rPlg (variants) for intact
      fibrin. We conclude that the basic residues in the extremely plasmin susceptible
      hinge region of plasminogen are directly involved in maintaining the activation
      resistant Glu1-plasminogen conformation.

PMID- 7797580
TI  - Simian virus 40 T antigen-induced amplification of pre-parietal cells in
      transgenic mice. Effects on other gastric epithelial cell lineages and evidence
      for a p53-independent apoptotic mechanism that operates in a committed
      progenitor.
AB  - Gastric units in the glandular epithelium of the mouse stomach contain several
      types of continuously renewing epithelial cells. Acid-producing parietal cells
      are derived from a multipotent stem cell that also gives rise to mucus-producing
      pit cells and pepsinogen- and intrinsic factor-producing zymogenic cells. We used
      nucleotides -1035 to +24 of the mouse H+/K(+)-ATPase beta subunit gene (H+/K(+)
      ATPase beta subunit-1035 to +24) to examine the consequences of expressing simian
      virus 40 T antigen (SV 40 TAg) in the normally rare, nonproliferating, short
      lived pre-parietal cell progenitor. Light and electron microscopic morphologic
      studies plus multilabel immunohistochemical analyses of postnatal day (P) 14-80
      day transgenic mice revealed that SV40 TAg produces a 50-70-fold amplification of
      pre-parietal cells which become the predominant cell type in gastric units.
      Differentiation to mature parietal cells is blocked, resulting in hypochlorhydria
      and an associated systemic iron deficiency. SV40 TAg-induced pre-parietal
      proliferation is accompanied by apoptosis. Examination of adult transgenic mice
      homozygous for p53 wild type or p53 null alleles established that the apoptosis
      occurs through a p53-independent pathway. H+/K(+)-ATPase beta subunit -1035 to
      +24/SV40 Tag is not expressed during differentiation of the zymogenic lineage.
      Nonetheless, P28-P80 transgenic mice exhibit an apparent block in the conversion
      of pre-zymogenic to zymogenic cells. This block appears to be quite specific:
      conversion of preneck to neck cells and neck to pre-zymogenic cells is not
      affected. Comparison of normal and transgenic mice that are p53+/+ or p53-/-
      confirmed that the loss of mature zymogenic cells is not dependent upon p53.
      Although H+/K(+)-ATPase beta subunit -1035 to +24 is not active in pit cell
      progenitors or their differentiated descendants, there is a 2-3-fold increase in
      mature pit cells in transgenic animals. Our findings (i) demonstrate an approach
      for amplifying and characterizing pre-parietal or other progenitor cell
      populations in gastric units, (ii) reveal an SV40 TAg-inducible, p53-independent
      apoptotic mechanism that operates in a committed epithelial progenitor cell, and
      (iii) provide a transgenic mouse model for defining factors that may mediate
      progression through specific points in the differentiation programs of the
      parietal and zymogenic cell lineages or that may influence decisions about
      allocation to the pit cell lineage.

PMID- 7797581
TI  - Biochemical and molecular characterization of a barley seed beta-glucosidase.
AB  - A 60-kDa beta-glucosidase (BGQ60) was purified and characterized from seeds of
      barley (Hordeum vulgare L.). BGQ60 catalytic activity was restricted to the
      cleavage of short-chain oligosaccharides composed of (1-2)-, (1-3)-, and/or (1-4)
      beta-linked glucose or mannose units. These oligosaccharides are the primary
      products of endosperm cell wall polysaccharide hydrolysis by other enzymes. In
      keeping with this, complete hydrolysis of the major polysaccharide of barley
      starchy endosperm cell wall, (1-3,1-4)-beta-glucan, to free glucose was shown to
      require the concerted action of endo-(1-3,1-4)-beta-glucanase and BGQ60. The
      complete amino acid sequence of BGQ60 was determined by protein sequencing
      combined with the deduced sequence of the corresponding cDNA and genomic clones.
      The BGQ60 primary structure exhibits extensive homology to members of glycosyl
      hydrolase family 1 (EC 3.2.1.21). Southern and Northern blot analysis with the
      cDNA as probe indicated that BGQ60 is encoded by a single gene, and that BGQ60
      mRNA only accumulates in the starch endosperm tissue of late developing seeds.
      The bgq60 structural gene of approximately 5 kilobases contains an open reading
      frame encoding 485 amino acids interrupted by 9 introns. The complete nucleotide
      sequence of the bgq60 structural gene represents the first characterized plant
      gene encoding a beta-glucosidase. The barley BGQ60 is a novel plant beta
      glucosidase with a hitherto undescribed specific enzymatic activity. The possible
      biological functions of BGQ60 during barley seed development and germination are
      discussed.

PMID- 7797582
TI  - Proteolysis of glucagon within hepatic endosomes by membrane-associated
      cathepsins B and D.
AB  - The acidic glucagon-degrading activity of hepatic endosomes has been attributed
      to membrane-bound forms of cathepsins B and D. Endosomal lysates processed full
      length nonradiolabeled glucagon to 32 different peptides that were identified by
      amino acid analysis and full-length sequencing. These indicated C-terminal
      carboxypeptidase, endopeptidase as well as N-terminal tripeptidyl-aminopeptidase
      activities in endosomes. Glucagon proteolysis was inhibited 95% by E-64 and
      pepstatin A, inhibitors of cathepsins B and D, respectively. This was confirmed
      by the pH 6-dependent chemical cross-linking of [125I]iodoglucagon to a
      polypeptide of 30 kDa, which was immunodepleted by polyclonal anti-cathepsin B
      antibody, and the removal of greater than 80% of glucagon-degrading activity by
      polyclonal antibodies to cathepsins B and D. By similar criteria, insulin
      degrading enzyme was ruled out as a candidate enzyme for endosomal proteolysis of
      glucagon. Lysosomal contamination was unlikely since all forms of cathepsin B in
      endosomes, i.e. the major 45-kDa inactive precursor as well as the lesser amounts
      of the 32- and 28-kDa active forms, were tightly bound to endosomal membranes.
      Furthermore the mature 29-kDa single-chain and 22-kDa heavy-chain forms of
      cathepsin L were undetectable in endosomes, although high levels of the 37-kDa
      proform were observed. Membrane association of the cathepsins B and D was not to
      the mannose 6-phosphate receptor since association was unaffected by mannose 6
      phosphate and/or EDTA, thereby indicating a distinct endosomal receptor. Hence, a
      pool of active cathepsins B and D as well as a poorly defined tripeptidyl
      aminopeptidase is maintained in endosomes by selective membrane retention. These
      hydrolases degrade glucagon internalized into liver parenchyma early in
      endocytosis.

PMID- 7797583
TI  - A nucleotide sequence essential for the function of DRE, a common promoter
      element for Drosophila DNa replication-related genes.
AB  - Promoter regions of the Drosophila proliferating cell nuclear antigen (PCNA) gene
      and the DNA polymerase alpha 180-kDa catalytic subunit gene contain a common 8
      base pair (bp) promoter element, 5'-TATCGATA (DRE, Drosophila DNA replication
      related element). We have generated various base substitutions and internal
      deletions in and around DRE (nucleotide positions -93 to -100 with respect to the
      transcription initiation site) of the PCNA gene in vitro and subsequently
      examined their effects on the binding to DREF (DRE-binding factor) and PCNA gene
      promote activity in cultured Drosophila Kc cells as well as in living flies. Gel
      mobility shift assays using nuclear extracts of Kc cells with and without
      competitor DNA fragments carrying the mutations indicated that the 10-bp sequence
      from positions -91 to -100 is essential for complex formation with DREF.
      Transient expression assays of chloramphenicol acetyl-transferase (CAT) in Kc
      cells transfected with PCNA promoter-CAT fusion genes carrying the mutations
      revealed that the 8-bp sequence from -93 to -100 is essential for activation of
      the promoter in Kc cells. Examination of lacZ expression from PCNA promoter-lacZ
      fusion genes carrying the mutations, introduced into flies by germ-line
      transformation, revealed that the 8-bp sequence is also important for DRE
      function during development. However, we obtained two exceptional mutations in
      the 8-bp sequence that did not or only marginally affected the PCNA gene promoter
      activity in transgenic flies. Both of these mutations effectively reduced the
      promoter activity in CAT transient expression assay in Kc cells and the binding
      to DREF in vitro. Therefore, the 8-bp sequence requirement for DRE function
      appears to be less stringent in living flies than in the cultured cell or in
      vitro cases.

PMID- 7797584
TI  - A cis-acting element in Rous sarcoma virus long terminal repeat required for
      promoter repression by HeLa nuclear protein p21.
AB  - HeLa cell basic nuclear protein (p21), which represses Rous sarcoma virus long
      terminal repeat (RSV LTR) promoter activity, diminished v-src expression and the
      appearance at permissive temperature of the transformed phenotype in tsRSVLA23
      Rat-1, a cell line transformed with a temperature-sensitive mutant of RSV.
      Nuclear run-on analyses using COS-1 cells cotransfected with p21 cDNA and
      chloramphenicol acetyltransferase reporter indicated that p21 inhibits
      transcription initiation by targeting a region in the RSV LTR promoter between
      positions -108 and -85 upstream of the cap site. Insertion of this 24-base pair
      sequence in place of one of the 72-base pair enhancers in the SV40 early promoter
      rendered it sensitive to p21 repression. Electrophoretic mobility shift assays
      using a synthetic oligomer corresponding to the 24-base pair LTR promoter element
      revealed that p21 altered the pattern of protein.DNA complex formation apparently
      without binding DNA directly. Complex formation assayed by UV cross-linking and
      DNA affinity chromatography indicated further that a cellular factor which can
      interact with this element was decreased in cells transfected with p21 expression
      plasmid. The results indicate that p21 repression of RSV LTR is mediated by a cis
      acting element and may occur by alteration of protein complexes formed on this
      promoter element.

PMID- 7797585
TI  - Secretion and maturation study of endothiapepsin in Saccharomyces cerevisiae. A
      first step toward improving its substrate specificity.
AB  - The gene encoding endothiapepsin (EAP), an extracellular aspartic proteinase from
      the filamentous ascomycete Cryphonectria parasitica, was expressed into
      Saccharomyces cerevisiae. Efficient secretion of an active and correctly
      processed enzyme was achieved when expressing the entire cDNA encoding prepro-EAP
      under the control of the galactose-inducible GRAP1 yeast promoter. Since three
      independent, site-directed mutations of EAP, including the substitution of an
      aspartyl catalytic residue, resulted in the intracellular accumulation of zymogen
      forms, we assumed that the EAP propeptide was autocatalytically processed. As a
      prerequisite to further improve the specificity of EAP, we therefore attempted to
      bypass this self-processing step in three different ways: 1) introduction of a
      Kex2-like recognition site between the pro and the mature part, 2) deletion of
      the prosequence (pre-EAP), and 3) co-expression in trans of the pre-EAP with its
      preprosequence. No improvement in the secretion of mutant enzymes was obtained in
      any of these experiments. As an alternative, we finally replaced the EAP
      processing site by the chymosin cleavage sequence of kappa-casein. Such a
      modification remained efficient in directing the secretion of active EAP only
      when a putative alpha-helix structural motif was conserved at the C terminus of
      the pro region.

PMID- 7797587
TI  - The tumor suppressor maspin does not undergo the stressed to relaxed transition
      or inhibit trypsin-like serine proteases. Evidence that maspin is not a protease
      inhibitory serpin.
AB  - The role of tumor suppressor proteins in the development of malignancy has made
      the understanding of their molecular mechanisms of action of great importance.
      Maspin is a tumor suppressor produced by a number of cell types of epithelial
      origin. Exogenous recombinant maspin has been shown to block the growth,
      motility, and invasiveness of breast tumor cell lines in vitro and in vivo.
      Although belonging to the the serine proteinase inhibitor (serpin) superfamily of
      proteins, the molecular mechanism of maspin is currently unknown. Here we show
      that the reactive site loop of maspin exists in an exposed conformation that does
      not require activation by cofactors. The reactive site loop of maspin, however,
      does not act as an inhibitor of proteinases such as chymotrypsin, elastase,
      plasmin, thrombin, and trypsin but rather as a substrate. Maspin is also unable
      to inhibit tissue and urokinase type plasminogen activators. Stability studies
      show that maspin cannot undergo the stressed-relaxed transition typical of
      proteinase-inhibitory serpins, and the protein is capable of spontaneous
      polymerization induced by changes in pH. It is likely, therefore, that maspin is
      structurally more closely related to ovalbumin and angiotensinogen, and its tumor
      suppressor activity is independent of a latent or intrinsic trypsin-like serine
      proteinase-inhibitory activity.

PMID- 7797586
TI  - Purification and characterization of a rat liver enzyme that hydrolyzes
      valaciclovir, the L-valyl ester prodrug of acyclovir.
AB  - Valaciclovir is an oral prodrug of the antiherpetic agent acyclovir. An enzyme
      that hydrolyzes valaciclovir to acyclovir, valaciclovir hydrolase (VACVase), was
      purified from rat liver and characterized. VACVase was a basic (pI 9.4) protein
      associated with mitochondria. It was monomeric and had a molecular mass of 29
      kDa. Amino acid sequences of six VACVase peptides, including its NH2 terminus (13
      amino acids) and accounting for approximately 20% of its complete sequence, were
      not found in the SwissProt protein data base. VACVase hydrolyzed other amino acid
      esters of acyclovir in addition to valaciclovir (kcat/Km = 58 mM-1 s-1), with a
      preference for the L-alanyl (kcat/Km = 226 mM-1 s-1) and L-methionyl (kcat/Km =
      200 mM-1 s-1) esters. It did not hydrolyze other types of esters or numerous di-
      and tripeptides and aminoacyl-beta-naphthylamides. Hydrolysis of valaciclovir by
      VACVase was not inhibited by amastatin, antipain, aprotinin, bestatin,
      chymostatin, E-64, EDTA, ebelactone A, ebelactone B, elastatinal, leupeptin,
      pepstatin, or phosphoramidon. It was neither inhibited nor activated by Ca2+,
      Co2+, Mg2+, Mn2+, or Zn2+. Therefore, this enzyme is not a typical esterase or
      peptidase and, to our knowledge, it has not been described previously. Its
      physiological function is not known; however, it may play a significant role in
      the biotransformation of valaciclovir to acyclovir.

PMID- 7797589
TI  - Decreased phosphorylation of mutant insulin receptor by protein kinase C and
      protein kinase A.
AB  - We have recently reported that the Arg1152-->Gln insulin receptor mutation (QK
      single mutant) alters a conserved motif (RK motif) immediately next to the key
      tyrosine phosphorylation sites (Tyr1146, Tyr1150, Tyr1151) of the receptor and
      constitutively activates its kinase and metabolic signaling. To investigate
      further the function of the RK motif, we have expressed two additional mutant
      insulin receptors: a single mutant, in which the second basic residue in the RK
      motif (Lys1153) was substituted (RA mutant); and a double mutant, in which both
      the Arg and the Lys residues were replaced with noncharged amino acids (QA
      mutant). As compared with the transfected wild-type receptors (WT), both the
      single and the double mutant receptors were normally synthetized and transported
      to the plasma membrane and bound insulin normally. Whereas the double mutant
      receptor exhibited preserved insulin-dependent autophosphorylation, kinase
      activity, and 2-deoxyglucose uptake, all of these functions were grossly impaired
      in the two single mutant receptors. Two-dimensional analysis of tryptic
      phosphopeptides from receptor beta-subunits revealed that decreased
      autophosphorylation of the single mutant receptors mainly involved regulatory
      Tyr1150,1151 and carboxyl-terminal Tyr1316,1322. At variance with the insulin
      stimulated, insulin-independent tyrosine kinase activity toward poly(Glu-Tyr) 4:1
      was increased 3-fold in both the double and the single mutants. All mutant
      receptors induced a 2-fold increase in basal 2-deoxyglucose uptake in NIH-3T3
      cells. Treatment of WT transfected cells with 12-O-tetradecanoyl-phorbol-13
      acetate or 8-bromo-cAMP increased insulin receptor phosphorylation by 3-fold. No
      phosphorylation was observed in cells expressing the two single or the double
      mutant receptor. Consistently, purified preparations of PKC and PKA
      phosphorylated the WT but not the mutant receptors in vitro. A 17-amino acid
      synthetic peptide encoding the receptor sequence surrounding the RK motif
      inhibited phosphorylation of WT insulin receptors by both protein kinases A and
      C. A mutant peptide in which the RK sequence was replaced by QK (to mimic the
      mutation in the QK receptor) exhibited no inhibitory effect. Thus, the RK insulin
      receptor motif is required for insulin receptor phosphorylation by protein
      kinases C and A and may modulate insulin-independent receptor activity. The RK
      motif may also have an important structural role in allowing normal insulin
      regulation of the kinase.

PMID- 7797588
TI  - Two distinct cell attachment sites in entactin are revealed by amino acid
      substitutions and deletion of the RGD sequence in the cysteine-rich epidermal
      growth factor repeat 2.
AB  - The basement membrane glycoprotein, entactin, has previously been shown to
      promote cell attachment and chemotaxis. We have constructed a panel of
      glutathione S-transferase fusion proteins that encompasses the four major
      structural domains of entactin, G1, G2, E, and G3. These proteins have been
      synthesized in bacteria and purified by affinity chromatography. The connecting
      stalk of entactin, E, which contains four cysteine-rich EGF homology repeats and
      the integrin receptor RGD recognition sequence, has been modified by deletion of
      the RGD sequence and substituting glutamic acid for aspartic acid. Attachment
      assays reveal that the RGD sequence is one of the major cell attachment sites in
      entactin and that this sequence is recognized by the alpha v beta 3 integrin
      receptor. Analysis of cell attachment on mutant forms of full-length entactin
      expressed in the baculovirus expression system revealed a second attachment site
      that was independent of the RGD sequence. This second site was localized to a
      peptide of 39 amino acid residues in the second globular G2 domain of entactin.
      This peptide represents a cysteine-rich EGF repeat. Inhibition of cell attachment
      by anti-integrin receptor antibodies indicates that the second attachment site is
      recognized by a member of the beta 1 family of integrin receptors, possibly alpha
      3 beta 1.

PMID- 7797591
TI  - Irradiation increases manganese superoxide dismutase mRNA levels in human
      fibroblasts. Possible mechanisms for its accumulation.
AB  - Irradiation induces the production of superoxide radicals (O2.-), which play an
      important causative role in radiation damage. Manganese superoxide dismutase
      (MnSOD) is a mitochondrial enzyme involved in scavenging O2..-. This study
      examined MnSOD gene regulation by irradiation in WI38 human fibroblasts.
      Unstimulated fibroblasts constitutively expressed MnSOD activity and mRNA;
      irradiation markedly increased MnSOD activity and mRNA levels. The increase in
      MnSOD transcripts by irradiation was both time- and dose-dependent. WI38
      fibroblasts constitutively produce low levels of interleukin-1 (IL-1). The
      induction of MnSOD mRNA by irradiation was partially blocked by anti-IL-1
      antibodies, and treatment of cells with IL-1 also increased MnSOD mRNA levels.
      Inhibition of the cyclo-oxygenase pathway with indomethacin augmented the
      induction MnSOD mRNA by irradiation and prostaglandin E2 inhibited the
      accumulation of MnSOD mRNA by irradiation. Transcriptional run-on analysis showed
      that irradiation increased the rate of MnSOD transcription 2-fold. Stability
      studies of MnSOD mRNA in these cells showed that the half-life increased from <
      1.5 h in unirradiated cells to > 4 h in irradiated cells. These results suggest
      that induction of the MnSOD gene after irradiation is regulated, at least in
      part, by IL-1 production and that increased levels of MnSOD transcripts also
      occur through a pathway of endogenous prostaglandin E2 production. Our data
      indicate that the increase in MnSOD mRNA observed after irradiation occurs
      through both transcriptional and post-transcriptional mechanisms.

PMID- 7797590
TI  - Regulation of neurite outgrowth and SNAP-25 gene expression by the Brn-3a
      transcription factor.
AB  - SNAP-25 is a presynaptic nerve terminal protein which is also essential for the
      process of neurite outgrowth in vivo and in vitro. However the processes
      regulating its expression have not been characterized previously. We show that
      the gene encoding this protein, SNAP, is strongly activated by the Brn-3a POU
      (Pit-Oct-Unc) family transcription factor. Expression of both Brn-3a and SNAP-25
      increases when ND7 neuronal cells are induced to extend neurite processes by
      serum removal. Inhibition of Brn-3a expression in these cells inhibits SNAP-25
      expression and abolishes the neurite outgrowth that normally occurs in response
      to serum removal. These results identify Brn-3a as the first transcription factor
      having a role in process outgrowth in neuronal cells acting, at least in part,
      via the activation of SNAP-25 gene expression.

PMID- 7797592
TI  - Molecular cloning and pro-apoptotic activity of ICErelII and ICErelIII, members
      of the ICE/CED-3 family of cysteine proteases.
AB  - Cysteine proteases related to mammalian interleukin-1 beta-converting enzyme
      (ICE) and the nematode cell death abnormal ced-3 gene product have been
      implicated in the effector mechanism of apoptotic cell death. Two novel members
      of this new family of ICE/CED-3-related proteases, designated ICErel-II and
      ICErel-III, were cloned from human monocytic cells. Both were highly homologous
      to human ICE (52% identical) and CED-3 (25% identical) and both contained the
      absolutely conserved pentapeptide sequence Gln-Ala-Cys-Arg-Asp containing the
      catalytic cysteine residue. Other structural motifs that were comparable with ICE
      suggest that ICErel-II and ICErel-III are also synthesized as larger proenzymes
      which are proteolytically processed to form heterodimeric active enzymes. Pro
      interleukin-1 beta processing activity could not be detected in cells transfected
      with ICErel-II or ICErel-III, but pro-domain-less truncated forms of ICErel-II
      and ICErel-III were capable of effectively inducing fibroblast apoptosis. ICErel
      II and ICErel-III may, therefore, participate in proteolytic events culminating
      in the apoptotic death of human cells.

PMID- 7797593
TI  - Characterization of the murine mu opioid receptor gene.
AB  - The analgesic and addictive properties of morphine and other opioid drugs are
      thought to result from their interaction with mu opioid receptors. Using a delta
      opioid receptor cDNA as a probe, we have isolated a murine mu opioid receptor
      cDNA clone (mMOR). Stable expression of mMOR in Chinese hamster ovary cells
      conferred high binding affinity for mu receptor ligands including morphine and [D
      Ala2,N-methyl-Phe4,Gly5-ol]-enkephalin and low affinity for delta and kappa
      preferring ligands. Treatment of these cell lines with morphine and other mu
      agonists inhibited forskolin-induced cAMP accumulation, demonstrating a
      functional coupling of mMOR to the inhibition of adenylate cyclase. The predicted
      amino acid sequence of mMOR shares approximately 55% overall amino acid identity
      with the delta receptor and approximately 97% identity with the recently reported
      rat mu opioid receptor. Expression of the mu receptor in mouse brain as revealed
      by in situ hybridization parallels the reported pattern of distribution of mu
      selective ligand binding sites. Chromosomal localization (to mouse chromosome 10)
      and Southern analysis are consistent with a single mu opioid receptor gene in the
      mouse genome, suggesting that the various pharmacologically distinct forms of the
      mu receptor arise from alternative splicing, post-translational events, or from a
      highly divergent gene(s).

PMID- 7797594
TI  - The COOH-terminal domain of the RNA polymerase alpha subunit in transcriptional
      enhancement and deactivation at the bacteriophage T4 late promoter.
AB  - Many activator proteins generate their positive control of transcription through
      interactions with the COOH-terminal domain of the Escherichia coli RNA polymerase
      alpha subunit. We have examined the participation of this alpha-domain in
      transcriptional enhancement and suppression at bacteriophage T4 late promoters.
      Enhancement is generated by the T4 gene 45 protein, which is the DNA-tracking
      processivity factor of viral DNA replication; suppression of unenhanced
      transcription is generated by the RNA polymerase-binding co-activator T4 gene 33
      protein. Enhanced and unenhanced transcription by RNA polymerase reconstituted
      with intact and truncated alpha subunits and by RNA polymerase containing ADP
      ribosylated alpha has been compared; the internal structures of transcription
      complexes formed with these RNA polymerases have also been analyzed by
      footprinting and photocross-linking. Comparison of these structural and
      functional analyses suggests that enhancement of T4 late transcription by gp45 is
      not compatible with any significant role of the COOH-terminal domain of the RNA
      polymerase core alpha subunit in transcriptional initiation. Suppression of
      unenhanced T4 late transcription by the gene 33 protein also does not require the
      COOH-terminal domain of alpha.

PMID- 7797595
TI  - Maturation of pre-tRNA(fMet) by Escherichia coli RNase P is specified by a
      guanosine of the 5'-flanking sequence.
AB  - The C+1/A+72 base pair at the top of the acceptor stem of Escherichia coli
      tRNA(fMet) accounts for several of the specialized roles of this tRNA in
      translation initiation. According to the rules of RNA substrate recognition by
      RNase P, the C+1/A+72 pair is likely to disfavor the 5'-maturation of pre
      tRNA(fMet). Indeed, in contrast to other E. coli tRNA species, tRNA(fMet) was not
      properly matured when overproduced from a multicopy expression vector. Half of
      the recovered tRNA(fMet) retained an extension at the 5' side. Such a defect of
      tRNA(fMet) processing could be cured by changing bases C+1 and A+72 by a Watson
      Crick base pair or by non-paired bases, provided one of them was a G. It could
      also be compensated by either (i) over-expression of RNase P or (ii) introduction
      within the plasmid of one out of the three 5'-flanking sequences naturally
      occurring in the four E. coli tRNA(fMet) genes. The effect of these flanking
      sequences on the maturation of tRNA(fMet) could be accounted for by the presence
      of a G located 2 bases upstream from C+1. Notably, this G is the only residue
      that is conserved in the 5'-flanking sequences of all four E. coli tRNA(fMet)
      genes.

PMID- 7797596
TI  - A possible multiclonal development in human colonic carcinomas.
AB  - In order to define whether all colonic tumors develop from a single transformed
      cell, we compared two sites each in 40 early-stage colonic carcinomas by K-ras
      mutation and DNA ploidy pattern. These 40 colonic carcinomas consisted of 26
      protruding-type carcinomas and 14 superficial-type carcinomas. The two sites were
      selected in every tumor tissue and then DNA ploidy pattern and occurrence of K
      ras mutation were detected. In cases of "cancer in adenoma", we compared
      clonality between cancer cells and adenoma cells. In a cytofluorometrical study,
      it was shown that diploid patterns were predominantly seen in protruding-type
      carcinomas (76.9%), whereas many superficial-type carcinomas (64.3%) consisted of
      aneuploid cells. K-ras mutations were more frequently observed in protruding-type
      carcinomas: 42.3% in protruding-type compared to 21.4% in superficial-type
      carcinomas. These findings suggested that superficial-type carcinomas have a
      different mode of carcinogenesis from that of protruding-type carcinomas.
      Frequently, each pair of sites of the carcinoma tissue carried the same K-ras
      mutation, and DNA ploidy patterns were essentially the same. However, we
      encountered some cancers that showed different K-ras mutations in the cancer
      tissues. In particular, one case of cancer in adenoma demonstrated different K
      ras mutations in the cancer and adenoma tissue. These findings suggest that most
      colonic cancers develop monoclonally, but there are a few cancers (fewer than 5%)
      that start multiclonally.

PMID- 7797597
TI  - DNA repair synthesis following irradiation with 254-nm and 312-nm ultraviolet
      light is not diminished in fibroblasts from patients with dysplastic nevus
      syndrome.
AB  - The DNA excision repair capacity of 23 primary fibroblast lines from patients
      with dysplastic nevus syndrome was investigated and DNA repair synthesis
      ("unscheduled DNA synthesis") was determined after UV exposure. Seventeen
      fibroblast lines from normal donors served as controls. The dose/response
      experiments included up to ten dose levels and two wavelength ranges: UV-C (using
      a low-pressure mercury lamp emitting predominantly 254-nm light) and UV-B
      (artificial "sunlamp" radiation centering around 312-nm light). For each dose
      level, silver grains over fibroblast nuclei were counted by visual inspection.
      Twelve cell lines were also evaluated for both UV wavelength ranges using a new
      semi-automatic image analyzing system. This system included components for rapid
      sequential identification of both fibroblast nuclei and silver grains sited above
      them. Silver grains over 100 nuclei were determined for each UV dose level.
      Dose/response curves were established and analyzed by linear regression. As a
      quantitative term for assessing DNA excision repair capacity of a cell line we
      calculated the linear increase (G0) in the number of grains per nucleus, when the
      UV dose was multiplied by the factor e (i.e. 2.72). The sensitivity of grain
      detection and resolution of overlapping grains was approximately threefold better
      in visual than in automatic counting, especially when there were more than 70
      grains over nuclei. The time required for visual counting, however, was tenfold
      that of automatic counting. The variance-weighted mean G0v.w of all fibroblast
      lines from patients with dysplastic nevus syndrome was found to be 79.1 (+/- 1.8-
      grains/nucleus, that of fibroblast lines from normal donors was 74.2 (+/- 1.7)
      grains/nucleus. This difference revealed a slightly better repair capability for
      cell lines from patients but was at the borderline of detection and, therefore,
      should not be overinterpreted. From the experimental accuracy achieved by
      determination of the variance-weighted means of the two groups, we would have
      been able to detect a difference of 7 and more grains [> 2 x (sigma normal+sigma
      patients)]. The variance-weighted mean G0v.w of all fibroblast lines from
      patients with dysplastic nevus syndrome was found to be 76.4 (+/- 1.4)
      grains/nucleus, whereas that of fibroblast lines from normal donors was only 66.6
      (+/- 1.8) grains/nucleus. This difference was statistically significant and,
      contrary to expectation, revealed better, not worse post-UV DNA repair capability
      in cell lines from patients that in those from normal donors.(ABSTRACT TRUNCATED
      AT 400 WORDS)

PMID- 7797598
TI  - The effect of stem-cell factor, interleukin-3 and erythropoietin on in vitro
      erythropoiesis in myelodysplastic syndromes.
AB  - An inherent defect of erythroid differentiation at the colony-forming unit blast
      (CFU-blast) compartment and (or) an impaired response of early erythroid
      progenitors (BFU-E) to growth stimulation are both considered to contribute to
      anemia in myelodysplastic syndromes (MDS). With the intention of improving
      survival and growth of early erythroid progenitors we investigated the effect of
      stem-cell factor (SCF) and interleukin-3 (IL-3) alone and in combination with
      erythropoietin, on the in vitro erythropoiesis of 13 patients with MDS and of
      three normal controls. SCF and IL-3 alone did not promote erythroid colony growth
      in MDS, while 3 cases responded to erythropoietin alone. In each of these, BFU-E
      colony growth could be increased by SCF, which was also found in all normal bone
      marrows. Altogether 6 cases showed a significant enhancement of BFU-E colony
      numbers by the combination of SCF and erythropoietin as compared to
      erythropoietin alone (P = 0.036). Out of the 6 responding cases, 5 belonged to
      the FAB-classified subgroups refractory anemia (RA) and refractory anemia with
      ringed sideroblasts (RA/RS) (5/5), while 1 patient was classified as having
      refractory anemia with excess of blasts (RAEB) (1/4). No patient with refractory
      anemia with excess of blasts in transformation (RAEB-T) (0/4) responded. In spite
      of these positive effects, the absolute number of BFU-E colonies remained reduced
      in all MDS cases when compared to normal controls. IL-3 proved ineffective in
      increasing the response to erythropoietin in MDS although it increased
      erythropoietin-induced BFU-E formation in normal controls significantly. We
      conclude that the striking synergistic effect of SCF and erythropoietin on
      erythroid colony formation seen with normal bone marrow is conserved in most
      cases with RA and RA/RS. In RAEB and RAEB-T the intrinsic defect of the erythroid
      differentiation pathway cannot be overcome by SCF.

PMID- 7797599
TI  - Effects of pravastatin, a hydroxymethylglutaryl-CoA reductase inhibitor, on two
      human tumour cell lines.
AB  - Competitive inhibitors of 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA)
      reductase are currently used to treat patients with hypercholesterolaemia. These
      inhibitors affect not only cholesterol biosynthesis, but also the production of
      non-steroidal mevalonate derivatives, that are involved in a number of growth
      regulatory processes. As a consequence, their potential use as anticancer drugs
      has been suggested. In order to examine long-term effects of this potential
      therapeutic approach, we cultivated the gastric carcinoma cell line, EPG85-257,
      and the breast tumour cell line, MDA-MB231, in the presence of increasing
      concentrations of the HMG-CoA reductase inhibitor, pravastatin. For both cell
      lines, this procedure led to the selection of resistant variants able to
      proliferate in more than 1000 microM inhibitor. By competitive reverse
      transcriptase/polymerase chain reaction assay (cRT-PCR), the expression of the
      mRNA for two key proteins of cellular cholesterol metabolism, HMG-CoA reductase
      and low-density lipoprotein (LDL) receptor, were analysed in sensitive and
      resistant cells. Despite similar growth rates, MDA-MB231 cells expressed
      approximately four times more HMG-CoA reductase mRNA than EPG85-257 cells and
      over 30 times more LDL receptor mRNA. Both mRNA species were coordinately
      regulated in the parental and in the pravastatin-resistant variant cells.
      Expression was highly stimulated (3- to 4-fold for the HMG-CoA reductase and 2-
      to 3-fold for the LDL receptor) in the resistant variants when cultured in
      lipoprotein-deficient medium in the presence of 1000 microM pravastatin.
      Immunocytological analysis of the expression of the HMG-CoA reductase and LDL
      receptor protein were in accordance with the data on specific mRNA expression
      obtained by cRT-PCR. Southern blot analysis revealed a 1.5-fold amplification of
      the HMG-CoA reductase gene in resistant MDA-MB231 cells, but not in the resistant
      EPG85-257 variant. Our data provide evidence for resistance mechanisms to
      pravastatin that are independent of the amplification of the HMG-CoA reductase
      gene. By analogy to the cell-culture models employed in this study, it is
      conceivable that similar mechanisms might occur in human tumour cells in vivo
      during long-term treatment with HMG-CoA reductase inhibitors. This might limit
      their application as chemotherapeutic anticancer agents.

PMID- 7797600
TI  - Alkylphosphocholine-induced production of nitric oxide and tumor necrosis factor
      alpha by U 937 cells.
AB  - The human histiocytic cell line U 937, which expresses a number of monocyte
      markers and properties, was investigated with regard to its ability to be
      activated for NO and tumor necrosis factor (TNF) release after treatment with
      alkylphosphocholines (APC) and APC liposomes. Using APC multilamellar vesicles
      (MLV) a clear dose-dependent increase of NO production could be demonstrated for
      U 937 cells, whereas the corresponding soluble substances had no effect. The time
      course of NO release was characterised by a peak between 2 h and 12 h and a
      strong decrease after 24 h. LPS caused no NO release nor the production of TNF in
      U 937 cells. The simultaneous incubation of the cells with lipopolysaccharide and
      APC or APC-MLV, led to a strong increase in TNF production. Closer investigation
      of the time sequence of this synergistic effect demonstrated that cells, that had
      first been treated with hexadecylphosphocholine (HPC)-MLV and 4 h later with
      lipopolysaccharide secreted significantly more TNF into the supernatants than in
      the experiment where both substances were added simultaneously. From these
      results it was concluded that APC-MLV are possibly able to act as a primer in the
      process of lipopolysaccharide mediated TNF induction. Furthermore, a positive
      influence of phorbol 12-myristate 13-acetate (PMA) on the ability of U 937 cells
      to produce TNF following a treatment with HPC or HPC-MLV could be observed. PMA
      pretreated cells were shown to release much more TNF compared to control cells,
      which led to the supposition that the immunomodifying activity of APC becomes
      effective only in more highly differentiated cell types.

PMID- 7797601
TI  - Bcl-2 expression and its association with cell kinetics in human gastric
      carcinomas and intestinal metaplasia.
AB  - The bcl-2 protooncogene was initially discovered at the t(14;18) chromosomal
      breakpoint in follicular lymphomas. It has been demonstrated that bcl-2 protein
      (Bcl-2) expression blocks apoptosis and plays an important role in cell
      development and maturation. In the present study, Bcl-2 expression was
      immunohistochemically examined in 103 cases of gastric carcinoma, as well as 64
      cases of non-carcinous gastric mucosa, and its correlation with apoptosis, cell
      proliferation and p53 immunoreactivity was investigated. Bcl-2 was detected in
      18.0% of differentiated-type gastric carcinomas (9 of 50) and 7.5% of the
      undifferentiated type (4 of 53). In adjacent intestinal metaplastic gastric
      epithelium, the incidence of Bcl-2 positivity in the incomplete type (21/23,
      91.3%) was significantly higher than in the complete type (23/41, 56.1%) (P <
      0.04). Double immunostaining for Bcl-2 and Ki-67 clearly revealed the majority of
      Bcl-2-positive cancer cells to be in a nonproliferating state, although some
      cancer cells expressed both proteins together. Statistical assessment
      demonstrated that the average Ki-67 labeling index and apoptotic labeling index
      in Bcl-2-positive foci were significantly lower than in Bcl-2-negative foci (P <
      0.0001, P < 0.0003). In addition, a significant dissociation between Bcl-2 and
      p53 immunoreactivity was found in cancer tissues. These results indicate that
      aberrant Bcl-2 expression in gastric carcinomas possibly originates from
      intestinal metaplastic epithelium, and suggest a possible role in tumor
      development and growth.

PMID- 7797602
TI  - Efficacy of famotidine in patients with acute gastric mucosal injury after
      continuous infusion of cisplatin plus vindesine.
AB  - The effect of famotidine (H2 blocker) on the gastroduodenal mucosal injury
      induced by chemotherapy in non-small-cell lung cancer patients was prospectively
      evaluated from the clinical and endoscopic findings obtained in a randomized
      double-blind study. The patients, who were administered cisplatin (25 mg/m2/day,
      continuous infusion, days 1-5) and vindesine (3 mg/m2, bolus, days 1 and 8), were
      randomized into two groups, those administered famotidine (40 mg/day, oral) and
      those administered the placebo. The patients were examined by gastroduodenoscopy
      within 7 days before and after chemotherapy. There were 27 patients in the
      famotidine group and 28 patients in the placebo group. The gastric mucosal score
      after chemotherapy was significantly lower in the famotidine group than in the
      placebo group (P < 0.01), and in the 42 patients without symptoms than in the 13
      patients (placebo group: 8, famotidine group: 5) with upper gastrointestinal
      symptoms (P < 0.01). The pH of the gastric juice after the chemotherapy
      significantly decreased in the placebo group (P < 0.05), and was significantly
      lower in the placebo group than in the famotidine group (P = 0.01). The co
      administration of famotidine was effective in the prevention and control of
      chemotherapy-induced gastric mucosal injury.

PMID- 7797603
TI  - P53 accumulation and proliferating-cell nuclear antigen expression in human lung
      cancer.
AB  - Mutations in the p53 gene are currently the commonest genetic alterations in
      human malignant tumors, including non-small-cell lung cancer (NSCLC) and small
      cell lung cancer (SCLC). Alterations of the protein induced by gene mutations
      enables the mutant protein to become more stable, resulting in the accumulation
      of P53 in quantities detectable by immunohistochemistry. Although previous
      studies document the accumulation of P53 in lung cancer, there is little
      information regarding the usual frequency of accumulation based on a
      comprehensive number of lung tumors. A total of 328 paraffin-embedded lung
      carcinoma specimens were analyzed for P53 accumulation and for the expression of
      the proliferating-cell nuclear antigen (PCNA) by standard immunohistochemistry.
      Among 49 SCLC, 35% were positive for p53 and 51% were positive for PCNA. Out of
      279 NSCLC, 43% showed a positive P53 immunoreaction and 72% displayed detectable
      amounts of PCNA. In squamous-cell carcinomas a statistically significant
      increased accumulation of P53 was found compared to adenocarcinomas (P = 0.001).
      Among the 233 PCNA-positive tumors the relative number of P53-positive specimens
      was higher compared to the total number of tumors. Since immunohistochemical
      investigations should contribute to the improvement of the clinical diagnosis and
      treatment or give information on the prognosis, we conclude from our results that
      it seems to be legitimate to assess the P53 status exclusively in the specimens
      positive for PCNA. Immunohistochemical investigations under consideration of the
      PCNA status yielded good and fast recognition of p53 mutations leading to
      intracellular P53 protein accumulation.

PMID- 7797605
TI  - High-dose chemotherapy with blood stem-cell transplantation in the treatment of
      solid tumors and hematological malignancies. A one-day course in the continuing
      education program organized by the Tumor Center Heidelberg/Mannheim, February
      1995.

PMID- 7797604
TI  - Formestane: an effective first-line endocrine treatment for advanced breast
      cancer.
AB  - Formestane, a new selective aromatase inhibitor devoid of severe side-effects,
      has been shown to be active in patients with advanced breast cancer. To
      investigate the clinical activity and endocrinological effects of formestane as a
      first-line treatment, 52 patients were administered two different doses: 24
      received 250 mg formestane and 28 received 500 mg formestane i.m. fortnightly.
      All of the patients had a performance status of 2 or less (ECOG scale), 34 (65%)
      had a disease-free interval of at least 2 years and 21 (40%) were both oestrogen
      receptor- and progesterone-receptor-positive; 20 patients received hormone and
      13, received chemotherapeutical adjuvant treatment. Objective responses were
      obtained in 8 patients in the 250-mg group (33%; 95% CI: 14%-52%) and in 13
      patients in the 500-mg group (46%; 95% CI: 28%-64%). The median response duration
      in the two groups was respectively 11 and 12 months. E2 serum levels of
      oestradiol had significantly (P < 0.001) decreased to more than 40% below the
      baseline value in both groups after 15 days of treatment, and remained unchanged
      thereafter. Local and systemic tolerability was satisfactory. We conclude that
      formestane is an effective and well-tolerated agent in previously untreated
      patients, and that these results should be confirmed by further studies.

PMID- 7797606
TI  - Structure-activity study on antiulcer agents using Wiener's topological index and
      molecular connectivity index.
AB  - The relationship of Wiener's topological index and molecular connectivity index
      with antiulcer activity of a series of 4-substituted-2-guanidino thiazole analogs
      has been investigated. The values of Wiener's topological index and molecular
      connectivity index of 128 compounds were computed and active ranges were
      identified. The activity assigned to each analog using these topological
      descriptors was subsequently compared with the reported in vitro and in vivo
      activities against gastric hydrogen-potassium stimulated adenosine triphosphatase
      (H+K(+)-ATPase) enzyme. Predictions with an accuracy of the order of
      approximately 89% were observed with regard to in vivo activity using these
      topological indices.

PMID- 7797607
TI  - Structure-activity study on antiinflammatory pyrazole carboxylic acid hydrazide
      analogs using molecular connectivity indices.
AB  - The relationship between molecular connectivity indices and the antiinflammatory
      activity of a series of pyrazole carboxylic acid hydrazide analogs has been
      investigated. The values of molecular connectivity index, valence molecular
      connectivity index, and a modified index, termed as atomic molecular connectivity
      index for 76 compounds, were computed and active ranges were identified. Each
      compound was assigned an activity which was subsequently compared with the
      reported activity against lipoxygenase enzyme. Predictions with a degree of
      accuracy above 80% were observed using the valence molecular connectivity index.

PMID- 7797608
TI  - Electrostatic potential derived charges for enzyme cofactors: methods,
      correlations, and scaling for organic cofactors.
AB  - The correlations between electrostatic potential (ESP) derived atomic charges for
      a wide range of different quantum mechanical approaches and basis sets have been
      investigated for both small and large organic structures including several enzyme
      cofactors. The previously observed linear correlation between ESP charges
      calculated by different approaches has been verified to extend to many different
      basis sets and procedures including effective core potential (ECP) basis sets,
      density functional theory (DFT) approaches, a hybrid Hartree-Fock (HF)/DFT
      approach, and inclusion of electron correlation corrections. Above a threshold
      level of complexity, most procedures and basis sets give results that correlate
      very well (linear correlation coefficients > 0.99), including several procedures
      that have reasonable computational costs for large molecules. These procedures
      have been used to calculate ESP charges for five different types and forms of
      enzyme cofactors: biotin, pyridoxal-5'-phosphate, pyridoxamine-5'-phosphate, and
      the flavin mononucleotide in two different oxidation states.

PMID- 7797609
TI  - Bioactive conformations of small peptides: a method for selection of candidates
      based on conformations of active and inactive analogues and its application to
      muramyl dipeptide.
AB  - A method has been developed that selects a subset of candidates for the bioactive
      conformation based on the comparison of conformation clusters of the active and
      inactive ligands. Those conformations of the active ligand that cannot be reached
      by inactive ligands in spatially presenting preselected "target" atoms
      (conformations "unique" to the active ligand) are extracted. The method is
      applied to muramyl dipeptide (MDP); the selection of candidates was performed
      using two of its diastereomers that have no immunostimulative properties. A third
      diastereomer and a rigidified analogue, both inactive, and the protein-bound
      conformation of a related peptidoglycan containing the MurNAc-L-Ala-D-Glu
      sequence are used as test cases; the latter was found to be most similar to one
      member of the set of unique conformations of MDP.

PMID- 7797610
TI  - Eicosanoid production by rat cerebral endothelial cells: stimulation by
      lipopolysaccharide, interleukin-1 and interleukin-6.
AB  - The capacity of rat cerebral endothelial cells (RCEC) to form eicosanoids was
      determined after incubation with 14C-labelled arachidonic acid. Prostaglandin E2
      (PGE2) was the main metabolite formed by RCEC and was responsible for 54% of the
      total amount of eicosanoids produced. In contrast, in primary cultures of rat
      aorta endothelial cells, 32% of the amount of prostaglandins was 6-keto-PGF1
      alpha). RCEC treated with 50 ng/ml LPS for 24 h responded with an augmented PGE2
      synthesis and 6-keto-PGF1 alpha of 3.4-fold and 2.2-fold, respectively. Cultures
      treated with IL-1 beta (50 ng/ml) for 3 h showed a stimulation of the release of
      PGE2 and 6-keto-PGF1 alpha of 2.5- and 4.5-fold, respectively, and 2.0-fold and
      2.3-fold, respectively, after IL-6 (50 ng/ml) incubation for 3 h. PGE2 is the
      main eicosanoid formed by RCEC in response to inflammatory agents, suggesting an
      important role of the cerebral endothelial cells in the transduction of an
      inflammatory response in the central nervous system.

PMID- 7797611
TI  - Psychological stress and immunological responsiveness in normally cycling,
      follicular-stage women.
AB  - Nineteen women in the follicular stage of their menstrual cycles were assessed
      for immunological responsiveness to a 50-min series of three psychological tasks
      which reliably elicit cardiovascular and neuroendocrine stress responses. Ten
      follicular-stage women not subjected to stress served as controls. Stress
      decreased lymphocyte responsiveness to PHA and PWM, percent of CD4+ cells and the
      ratio of CD4+/CD8+ cells. Conversely, stress increased natural killer cell number
      and cytolytic activity, white blood cell, lymphocyte, T and B cell count. Except
      for natural killer cell number, none of these changes was exhibited by controls.
      Most of these stress responses are similar to those reported for men and form the
      basis for a continuing study of the effects of reproductive hormones and stress
      on cardiovascular and immunological function in women.

PMID- 7797612
TI  - TAP2 polymorphisms in Australian multiple sclerosis patients.
AB  - Polymorphism of the TAP2 gene locus, situated approximately 150 kb centromeric to
      the MHC class II loci HLA-DR, DQ was examined in 100 Australian patients with
      relapsing/remitting multiple sclerosis (MS), in 100 random controls and in 37
      selected HLA-DRB1*1501-positive controls. The results were correlated with HLA
      class I and class II phenotypes. TAP2 encodes a protein involved in the transport
      and presentation of antigenic peptides by MHC class I molecules and hence is a
      candidate locus for a putative MS susceptibility gene either through functional
      interactions with class I alleles or as an explanation, via linkage
      disequilibrium (LD), for the known association between MS and the alleles
      DRB1*1501, DQA1*0102, DQB1*0602. Strong LD was found between the allele TAP2*01
      and DRB1*1501 in both the MS and control populations. The MS-associated haplotype
      can therefore be extended to DRB1*1501, DQA1*0102, DQB1*0602, TAP2*01, and the
      putative gene locus could reside on the centromeric side of DQ. TAP2 typing,
      however, could not explain the DRB1*1501, DQA1*0102, DQB1*0602-negative patients
      in whom, interestingly, the frequency of TAP2*01 was decreased compared to
      controls. The results of this study exclude TAP2 as a locus for a necessary
      MS/MHC gene but indicate that an MS gene carried by the DRB1*1501, DQA1*0102,
      DQB1*0602 haplotype could reside centromeric of DQ.

PMID- 7797613
TI  - Postmortem delay effects on neuroglial cells and brain macrophages from Lewis
      rats with acute experimental allergic encephalomyelitis: an immunohistochemical
      and cytochemical study.
AB  - The effects of increasing postmortem delay (PMD) times on morphological,
      immunological and functional characteristics of various brain cells both in situ
      and in vitro were studied in postmortem brain tissue derived from rats with acute
      experimental allergic encephalomyelitis (EAE). A decline of the brain tissue
      structure was first noted after a PMD of 6 h. Radial glia in the cerebellum were
      frequently interrupted and retractions artifacts appeared around brain cells.
      However, even after the longest PMD interval of 18 h the quality of the cell and
      tissue structure was still good enough for immunohistochemical characterization.
      Immunohistochemical staining of frozen and fixed rat brain tissue sections
      resulted in an enhancement of the immunoreactivity after a PMD of 4 h, using a
      panel of mono and polyclonal antibodies directed against glial fibrillary acidic
      protein (GFAP), basement membranes (laminin), brain macrophage antigens (ED1 and
      ED2), and various immunologically important surface molecules, such as major
      histocompatibility complex (MHC) class II (Ia) antigen (OX6), CR3 complement
      receptor (ED8), and leukocyte common antigen (OX1). No increase in staining
      intensities with the ED1, ED8 and OX6 mAbs specific for macrophage antigens could
      be detected on brain macrophages that were isolated from brain tissue of rats
      with EAE obtained after various PMD intervals. Irrespective of the PMD interval,
      viable astrocyte cell cultures were obtained with comparable staining intensities
      for GFAP. These cultured astrocytes were capable of ingesting Latex beads and
      were highly proliferative as measured by BrdU uptake, at all investigated PMDs.
      Thus, even after long PMD intervals, brain material can be used successfully.
      Other data suggest that the situation is similar to human brain material, even
      though the PMD times may be somewhat different.

PMID- 7797614
TI  - Molecular cloning of the coding sequence of an interleukin-2 receptor alpha
      subunit cDNA in murine brain.
AB  - Interleukin-2 (IL-2) has various trophic and neuromodulatory actions in the
      mammalian central nervous system (CNS). The interleukin-2 receptor alpha (IL-2R
      alpha) is an accessory subunit of the IL-2 receptor heterotrimer complex which is
      essential for 'high' affinity IL-2 binding. Although an IL-2R alpha (or IL-2R
      alpha-like) epitope has been localized in brain by immunohistocytochemistry, it
      was unknown whether the IL-2R alpha subunit expressed in brain was derived from
      the same or a different gene than the lymphocyte IL-2R alpha. Therefore, in the
      present study, the cDNA comprising the full length coding region was cloned and
      sequenced from saline-perfused forebrain. The brain IL-2R alpha cDNA was found to
      be 100% homologous with the corresponding lymphocyte IL-2R alpha cDNA sequence.
      IL-2R alpha mRNA was expressed at very low levels in saline-perfused forebrain of
      non-challenged BALB/c mice as well as in saline-perfused forebrain from severe
      combined immunodeficiency (SCID) mice. The present data, demonstrating IL-2R
      alpha gene expression in both well-perfused normal and SCID mouse forebrain from
      which no CD3 gamma gene expression was detected by PCR, provides evidence that
      the IL-2R alpha clones isolated are from resident brain cells and not from blood
      lymphocytes (e.g. T lymphocytes). Thus, these findings demonstrate that the
      protein coding sequence of the mouse brain IL-2R alpha is derived from the same
      gene coding sequence as the lymphocyte IL-2R alpha, and indicate that previously
      reported differences in the size of their respective mRNA transcripts appear to
      be due to differences in untranslated regions.

PMID- 7797615
TI  - Sigma-1 receptors modulate functional activity of rat splenocytes.
AB  - Neuroleptics, opiates, and cocaine are commonly prescribed for or abused by
      humans. Although primarily used for their actions at other receptors in brain,
      these compounds also act at sigma receptors. We have previously identified sigma
      1 receptors on human peripheral blood leukocytes and rat spleen, and in the
      present study we demonstrate a correlation between the pharmacology of these
      receptors and the ability of drugs to suppress concanavalin A-induced splenocyte
      proliferation. These results support the hypothesis that sigma-1 receptors
      regulate functional activities of immune cells, and suggest that sigma agonists
      may cause changes in immune competence in vivo.

PMID- 7797616
TI  - Genetic analysis of susceptibility to Theiler's murine encephalomyelitis virus
      induced demyelinating disease in the SWR strain.
AB  - SWR/J mice are susceptible to immune-mediated central (CNS) demyelination
      following infection by Theiler's murine encephalomyelitis virus (TMEV). SWR/J
      susceptibility is genetically dominant, when outcrossed to resistant H-2b
      strains. Non-H-2 differences between C57BL/6 and C57L/J (both H-2b) alter effects
      of 'susceptibility' genes, especially H-2q, from SWR/J. Genetic analysis of
      differential susceptibility to demyelination between SWR/J and C57L/J indicates
      that one copy of H-2q is sufficient for disease, and that SWR/J mice carry a non
      H-2 gene which can lead to disease in the absence of H-2q. Differential
      susceptibility between SWR/J and C57BL/6 is determined by a single non-H-2 locus,
      which may or may not be the same as that differing between SWR/J and C57L/J.

PMID- 7797617
TI  - The relationship of TAP1 and TAP2 dimorphisms to multiple sclerosis
      susceptibility.
AB  - Transporters associated with antigen processing and presentation (TAP1 and TAP2)
      have been considered candidate genes in MS susceptibility based on evidence from
      experimental animal models confirming antigenic peptide selection by transporter
      polymorphisms and by the proximity of these transporter genes to the DR- and DQ
      associated alleles known to confer disease risk in man. We report here an
      association study examining the influence of TAP gene polymorphisms on MS
      susceptibility in a Canadian patient population. Our results do not support a
      role for the five polymorphisms examined in the etiology of this disease.

PMID- 7797618
TI  - beta-Amyloid(25-35) induces the production of interleukin-8 from human monocytes.
AB  - In an effort to unravel some of the cellular actions of beta-amyloid protein (A
      beta), we investigated its effects on interleukin-8 (IL-8) production from human
      monocytes. Supernatants harvested from cultured monocytes stimulated with the
      neurotoxic fragment 25-35 of beta-amyloid [A beta(25-35)] contained significant
      amounts of IL-8. Northern blot analysis demonstrated that A beta(25-35) also
      induced IL-8 mRNA accumulation. The effect of A beta(25-35) on IL-8 mRNA
      accumulation and secretion was not mimicked by a scrambled A beta(25-35) peptide,
      and was not affected by polymyxin B sulphate, which, on the other hand, almost
      completely abolished the effect of lipopolysaccharide. Our results uncover a new
      biological action of beta-amyloid: that of stimulating the production of a
      chemokine from monocytes.

PMID- 7797619
TI  - Changes in the expression pattern of blood-brain barrier-associated pericytic
      aminopeptidase N (pAP N) in the course of acute experimental autoimmune
      encephalomyelitis.
AB  - The role of cerebral pericytes in blood-brain barrier (BBB) mechanisms is still a
      matter of controversy. Because acute experimental autoimmune encephalomyelitis
      (EAE) is characterized by a transient and focal perturbation of the BBB, we have
      utilized the model of adoptive transfer EAE to correlate the expression of the
      pericytic aminopeptidase N (pAP N) with the acute functional state of the BBB. We
      demonstrate that a significant downregulation of microvascular pAP N expression
      occurs, and the observed perturbation of the enzymatic BBB complement seems to be
      a sustained effect which persists even after recovery from clinical disease. At
      the peak of clinical disease, numerous pAP N expressing invasive cells were
      detected in white matter of the lumbar spinal cord. Through the use of a panel of
      different immunocytochemical markers these pAP N-immunopositive cells were
      characterized as ED 1-positive, most likely hematogenous macrophages. Activated
      resident microglial cells participate in the EAE-induced inflammatory process to
      only a minor extent.

PMID- 7797620
TI  - Arecoline a muscarinic cholinergic agent conditions central pathways that
      modulate natural killer cell activity.
AB  - The central nervous system plays an active role in the regulation of the immune
      system. Modulation of immune activities appears to be in part under the control
      of the hypothalamic-pituitary-adrenal (HPA) axis. We investigated the effect of a
      muscarinic cholinergic agonist, arecoline, which stimulates the secretion of
      corticotropin-releasing hormone (CRF) and adrenocorticotropic hormone (ACTH) on
      the immune system. In this report we demonstrate that peripherally administered
      arecoline or ACTH can increase activity of pre-activated NK cells. Second, we
      show that central administration of arecoline at a dose too low to alter
      peripheral events is sufficient to induce a significant increase in the activity
      of pre-activated natural killer (NK) cells. Finally, we demonstrate by using a
      Pavlovian conditioning paradigm that the pairing of a novel odor (camphor) with
      administration of arecoline can be used to alter NK cell activity. Subsequent to
      the conditioning trial, exposure to the odor alone is sufficient to raise NK cell
      activity. From these observations, we infer that the pathway(s) that are
      conditioned reside in sites located within the CNS and the conditioned response
      is evoked in the peripheral compartment (NK cell activity).

PMID- 7797621
TI  - Trimethyltin increases interleukin (IL)-1 alpha, IL-6 and tumor necrosis factor
      alpha mRNA levels in rat hippocampus.
AB  - Within the central nervous system (CNS), cytokines are though to have active
      roles in pathophysiological changes seen in various neurological diseases and
      trauma. The present study was undertaken to examine the early response of pro
      inflammatory cytokines following exposure to a specific neurotoxicant
      (trimethyltin; TMT). mRNA levels for interleukin (IL)-1 alpha, IL-1 beta, IL-6
      and tumor necrosis factor (TNF) alpha were measured in the hippocampus of adult
      male Long-Evans hooded rats following an acute injection of trimethyltin
      hydroxide (8 mg TMT/kg body weight). At various times following exposure (6 h to
      8 days), hippocampal tissues were excised and relative changes in cytokine mRNA
      levels were assessed by reverse transcription and polymerase chain reaction. IL-1
      alpha, IL-6 and TNF alpha mRNA levels in the hippocampus increased within 6 h and
      remained elevated for 8 days. Quantitative analysis of mRNA transcripts revealed
      a two-fold increase in both IL-6 and TNF alpha within 6 h and a continued
      elevation of TNF alpha to 9-fold by 12 h. Within 96 h, glial fibrillary acidic
      protein (GFAP) mRNA levels were elevated in the hippocampus. Histological
      examination showed sparse individual neuronal necrosis at this time in both the
      pyramidal and granule cell regions with no increase in astrocyte GFAP
      immunoreactivity. However, an early, 24 h, response of microglial cells was
      indicated by increased lectin binding. This morphological profile progressed over
      time to a profound neuronal loss in the CA3-4 granule cell layer and marked
      astrocyte hypertrophy. The onset of pro-inflammatory cytokine mRNA expression
      appears to be temporally associated with histological evidence of elevated
      microglia in the hippocampus. It is proposed that microglia and pro-inflammatory
      cytokines play a modulatory role in the early stages of TMT-induced
      neurotoxicity.

PMID- 7797622
TI  - Importance of HLA-DRB1 and DQA1 genes and of the amino acid polymorphisms in the
      functional domain of DR beta 1 chain in multiple sclerosis.
AB  - The association of some HLA class II alleles with multiple sclerosis (MS) has
      been amply documented. In the present study the role of HLA class II haplotypes
      and genotypes and of polymorphic amino acids at the DR beta 1 locus, located in
      the antigen binding groove and the CD4 binding domain of the DR beta 1 chain,
      were studied in 78 unrelated Caucasian chronic progressive MS (CP MS) patients
      and 204 controls. The results confirmed the positive association of the DRB1*1501
      allele and through linkage also of the DRB1*1501-DQA1*0102 haplotype with MS. In
      addition, the results showed that the DRB1*1501/DRB1*0400 or DR beta 1Ala71+
      His13+ genotype conferred the highest relative risk for MS (RR = 9.14). Alleles
      encoding for DR beta 1Phe47+, DR beta 1Asp70+ and DR beta 1Thr140+, DQ alpha
      1Phe25+, DQ alpha 1Leu69+ residues were protective and the highest protection (RR
      = 0.24) was provided by the DR beta 1(Phe47+)-DQ alpha 1Phe25+ and DR beta
      1(Ser13+)-DQ alpha 1Phe25+ haplotypes. Our results suggest that both DQ and DR
      alpha beta heterodimers might contribute to the increased or decreased risk to
      develop MS by the shape of their antigen-binding groove.

PMID- 7797623
TI  - Lytic effector cell activity and major depressive disorder in patients with
      breast cancer: a prospective study.
AB  - The study examined lymphokine-activated killer cell (LAK) and natural killer (NK)
      cell activity in breast cancer patients prior to surgery as compared to effector
      cell lysis in patients with non-malignant breast tumors, further in connection
      with lifetime diagnosis of major depression, severity of current depression,
      anxiety and coping styles. Follow up studies covered a period of 6 and 12 months.
      Prior to surgery, life time diagnosis of major depressive disorder, trait anxiety
      and coping styles did not discriminate patients as far as effector cell lysis is
      concerned. LAK activity but not NK activity was reduced in patients with actual
      depressive symptoms (P < 0.01) and high state anxiety (P < 0.05). These findings
      support the hypothesis that LAK activity is a state marker of actually existing
      depression and anxiety prior to surgery. Affective rather than coping measures
      showed significant differences in LAK activity. For LAK activity, 1 year after
      surgery the only predicting factors were Tamoxifen therapy and chemotherapy.

PMID- 7797624
TI  - Increased deposition of extracellular matrix components in the thymus gland of
      MDX mouse: correlation with the muscular lesion.
AB  - The present work describes the expression of extracellular proteins in the thymus
      and skeletal muscle of the X-linked dystrophic MDX mouse which corresponds to an
      experimental model for the human disease Duchenne muscular dystrophy. MDX
      dystrophic mice showed marked alterations in the thymic cytoarchitecture
      including cortical atrophy that was paralleled by denser epithelial cell network
      with intense immunolabelling for cytokeratins pair 8/18 and increased
      vascularization assessed with monoclonal antibody anti-desmin. Consistent
      augmentation of intrathymic extracellular matrix components (ECM) was observed
      especially at weaning and by the onset of disease. Interestingly, the amount of
      ECM elements in the gastrocnemius muscle of MDX wild-type dystrophic mice also
      showed a prominent difference as compared to age-matched non-dystrophic BALB/cAn
      animals. A marked but uneven overdeposition of reticulin and collagen fibres
      (type I, type IV), laminin and fibronectin were often present in the skeletal
      muscle of dystrophic mice, mostly around lesioned fibres. Alterations in both
      organs positively correlated with the degree of dystrophy thus suggesting that
      similar stimuli may be enhancing ECM production in both thymus and skeletal
      muscle. Although the thymus gland might not be directly involved in the
      development of the murine X-linked muscular dystrophy, it should be considered as
      a further target in this disease.

PMID- 7797626
TI  - Electroencephalography of the elderly.

PMID- 7797625
TI  - Functional role and sequence analysis of a lymphocyte orphan opioid receptor.
AB  - Pharmacological evidence indicates that lymphocytes express opioid receptors, but
      this finding has been questioned. By DNA sequencing of reverse transcription
      polymerase chain reaction products, we have found that mouse lymphocytes express
      mRNA encoding an orphan opioid receptor. These mRNA transcripts were detected in
      the CD4+, CD8+, and CD4- CD8- lymphocyte subpopulations. Northern blot analysis
      confirmed that splenic lymphocytes express a 1.5-kb orphan opioid receptor mRNA.
      Fifteen bases encoding Tyr71-Arg75 in the first intracellular loop are
      alternatively spliced, suggesting that orphan opioid receptor mRNA encodes two
      receptor subtypes. Treatment of lipopolysaccharide-stimulated lymphocytes with
      orphan opioid receptor antisense oligonucleotides suppressed polyclonal IgG and
      IgM production by 50%. Our results provide direct evidence that lymphocytes
      express an opioid-like receptor gene, and suggest that this receptor plays a
      functional role in immunocompetence.

PMID- 7797627
TI  - Evoked potentials in the elderly.
AB  - Evoked potentials (EPs) provide a quantitative measure of function rather than
      structure of certain pathways and processes within the nervous system. These
      systems and processes change with maturation and senescence. There are minimal
      somatosensory EPs changes after maturation until senescence. There are moderate
      changes in interpeak latencies, but few changes in the central conduction time
      (CCT). Brainstem auditory EPs change minimally with aging, with the CCT
      prolonging by 1-4 ms/year, possibly in a gender-dependent fashion. Latencies of
      visual EPs prolong by 2-4 ms/decade after age 40 years. The P300 amplitude,
      latency, and distribution all change with age. An understanding of the
      characteristics of EPs in aging humans is essential to accurate clinical
      interpretation of these studies.

PMID- 7797629
TI  - Arousal fluctuations in non-rapid eye movement parasomnias: the role of cyclic
      alternating pattern as a measure of sleep instability.
AB  - Some non-rapid eye movement (NREM) parasomnias, such as sleep-walking (SW), sleep
      terror (ST) and, in some aspects, sleep enuresis (SE), are considered "arousal
      disorders" without significant polysomnographic changes in classic sleep
      macrostructure. The aim of our study was to evaluate sleep microstructure and
      oscillations of arousal level by cyclic alternating pattern (CAP) scoring in some
      NREM parasomnias. Nocturnal polysomnography and videotape recording was used to
      study 21 patients with motor and behavioral phenomena during sleep: 13 in Group A
      (seven SW, six ST) with delta sleep-related episodes, eight in Group B with other
      parasomnias (six sleep bruxism and two SE), and six healthy controls. Classic
      sleep macrostructural parameters were no different in the parasomniacs and
      controls. Compared with the controls, our patients' sleep microstructure, scored
      by CAP analysis, showed increases in CAP rate (a measure of NREM instability with
      high level of arousal oscillation), in number of the CAP cycles, and in arousals
      with EEG synchronization, the increases being more significant in Group A than in
      Group B. An increase in sleep instability and in arousal oscillation seems to be
      a typical microstructural feature of delta sleep-related parasomnias and probably
      plays a role in triggering abnormal motor episodes during sleep in these
      patients.

PMID- 7797628
TI  - Sleep and sleep disorders in older adults.
AB  - Complaints of sleep disturbance increase with age. Objective sleep assessments
      using polysomnography reveal sleep impairments (increased wakefulness and arousal
      from sleep; decreased slow wave sleep) even in healthy seniors. Both
      polysomnographic sleep and subjective sleep worsen in the presence of health
      impairments related to drug use, pain, cardiovascular disease, diabetes,
      depression, or other emotional disorders. In addition to normal aging and chronic
      disease, sleep complaints can also result from poor sleep habits, specific occult
      disorders during sleep, or some combination of these factors. Occult disorders
      include sleep apnea syndrome, periodic leg movements, and restless legs syndrome
      during sleep. Diagnosis and treatment of these and other sleep disorders is
      discussed. Both pharmacological and nonpharmacological treatments are considered,
      with an emphasis on behavioral and educative treatment approaches.

PMID- 7797630
TI  - Brain processing of stimulus deviance during slow-wave and paradoxical sleep: a
      study of human auditory evoked responses using the oddball paradigm.
AB  - Auditory evoked potentials (AEPs) to frequent (90%) and deviant (10%) tones were
      recorded during both wakefulness and all-night sleep in eight drug-free
      volunteers. During presleep waking (10:00-11:00 p.m.), deviant stimuli elicited,
      in all subjects, a prominent "P300" wave of parieto-central topography,
      culminating at 344 ms (average), which was absent in response to frequent tones.
      This "presleep P300" was delayed and reduced relative to values obtained during
      full wakefulness (3:00-7:00 p.m.) in a control group. Passage from waking to
      sleep stage I was characterized by a progressive attenuation and delay of the
      P300 wave in response to deviant stimuli, without major changes in AEP morphology
      as compared to the waking state. Thus, in terms of cognitive evoked potentials
      (EPs), sleep stage I appeared more as a "weak" state of wakefulness than a true
      phase of sleep. During sleep stages II, III, and IV, both frequent and deviant
      tones evoked AEPs that closely resembled K-complexes. Responses to rare stimuli
      were four-to-five times larger than those to frequent tones, this likely being
      the result of K-complex habituation to monotonous stimuli. During paradoxical
      sleep (PS), AEP morphology again became comparable to that of wakefulness.
      Notably, a "P3" wave with similar topography as the waking P300 appeared in
      response to deviant stimuli exclusively. Thus, even though the brain seems able
      to detect stimulus deviance during all sleep stages, only during stage I and PS
      were the electrophysiological counterparts of deviance detection comparable to
      those of the waking state. Our results support the view that PS is not a state of
      "sensory isolation"; failure to respond to external stimuli during this stage may
      depend upon mechanisms occurring only after the sensory input has undergone
      cognitive analysis.

PMID- 7797631
TI  - Auditory evoked responses in children during hypothermic cardiopulmonary bypass:
      report of cases.
AB  - Variations in core temperature and cerebral blood flow during open heart surgery
      may affect auditory brainstem responses (ABRs) and middle latency responses
      (MLRs) in both adults and children. We documented the changes in ABRs of two
      infants (ages 3 and 11 weeks, respectively) with variations in core temperature
      during hypothermic cardiopulmonary bypass and total circulatory arrest and
      compared them with those of a 19-year-old adult. Changes in MLRs that occurred in
      association with reductions in cerebral blood flow as monitored by transcranial
      Doppler are also reported in a 6-year-old child. With the reductions in
      temperature in both infants and the young adult, ABR latencies increased and
      amplitudes decreased. Effects of hypothermia on ABR latencies were completely
      reversed by rewarming. MLR amplitudes were transiently reduced during periods of
      normothermic hypoperfusion. Hypothermia partially prevented these changes, and
      normoperfusion after rewarming recovered MLRs. Monitoring ABRs and MLRs may be a
      useful technique for assessment of brain function during hypothermic
      cardiopulmonary bypass in children and infants.

PMID- 7797632
TI  - Auditory evoked magnetic fields to tones and pseudowords in healthy children and
      adults.
AB  - Neuromagnetic responses to tones and pseudowords were measured with a 24-channel
      magnetometer in nine adults and in 23 children, the latter aged 0.3-15 years.
      Both stimulus types elicited substantially similar responses in all subjects. At
      0.9-s interstimulus interval (ISI), the adult response was a stable P1m-N1m-P2m
      N2m sequence peaking at 50, 100, 200, and 250 ms, respectively. A biphasic P1m
      N1,2m response with peaks at 100 and 260 ms occurred in children up to 12 years
      of age. At longer ISIs (1.2-2.4 s), an adult-type N1m response appeared in most
      children. N1m amplitude suppression at short ISIs was stronger in children than
      in adults and may reflect a longer refractory period of the N1 generator neurons
      during early childhood than later in life. Peak latencies of P1m, N1m, and N2m
      decreased with age, most rapidly < 7 years of age. All deflections originated in
      nearby cortical areas within the posterior sylvian fissure, and may serve as
      functional landmarks for that anatomic area.

PMID- 7797634
TI  - Technology and equipment review. Quantitative sensory testing systems.

PMID- 7797633
TI  - P300 assessment of chronic fatigue syndrome.
AB  - The P3(00) event-related brain potential (ERP) was elicited with an auditory tone
      discrimination paradigm in 25 patients diagnosed with chronic fatigue syndrome
      (CFS) and 25 matched normal control subjects. Target stimulus probability was
      varied systematically (0.20, 0.50, 0.80) in different task conditions. No
      differences between the CFS and control subjects were found for either P3
      amplitude or latency. No group effects were observed for the N1, P2, and N2
      components. Despite the attentional and immediate memory deficits reported in
      CFS, the P3 ERP from auditory stimuli does not reliably discriminate CFS from
      matched control subjects.

PMID- 7797635
TI  - Regarding "Sounds trigger spikes in the Landau-Kleffner syndrome" by R. Paetau.

PMID- 7797636
TI  - Typicality range deficit in schizophrenics' recognition of emotion in faces.
AB  - Severity of thought disorder in schizophrenics was assessed by a task that
      involved recognition of joy and shame expression, with the expressions varied for
      typicality of the emotion category. Accuracy, typicality rating, and reaction
      time were measured in schizophrenic patients who were high or low on Whitaker's
      Index of Schizophrenic Thinking (WIST) and in depressive and normal controls. All
      groups had significant variation of typicality ratings for joy (normal typicality
      range), but the clinical groups had smaller typicality ranges for shame
      recognition and higher mean typicality ratings than did normals. High WIST
      schizophrenics were least accurate on low typical shame expressions. Results
      imply that, for shame recognition, schizophrenic and depressive groups used
      common categorization (no typicality variation in category members) rather than
      resemblance categorization.

PMID- 7797637
TI  - Agreement between patient self-report and clinician rating: concurrence between
      the BSI and the GAF among psychiatric inpatients.
AB  - Two rating scales were compared for 200 adult psychiatric inpatients at admission
      to, and discharge from, the hospital. Patients rated their own psychological
      symptoms on the Brief Symptom Inventory (BSI), and clinicians rated patients'
      psychological, social, and occupational functioning on the Global Assessment of
      Functioning (GAF) Scale. Analyses indicated no significant relationships between
      symptom distress reported by patients and global functioning rated by clinicians.
      These findings support previous research that has shown minimal congruence among
      criterion measures that differ in rating source.

PMID- 7797638
TI  - Suicidal behavior as related to social support and assertiveness among Swedish
      and Turkish high school students: a cross-cultural investigation.
AB  - Among 652 Swedish and 654 Turkish adolescents, the study found that 61 Swedish
      (9.4%) and 71 Turkish (10.9%) adolescents reported that they had made previous
      suicide attempts. Previous psychiatric contact, female gender, low perceived
      family support, and suicide attempts in the family for the Swedish group and
      suicide attempts in the family, low perceived family support, psychiatric
      disorder in the family, and previous psychiatric contact variables in the Turkish
      sample were found to be associated with previous attempts. Low perceived family
      support, previous suicide attempts, low perceived peer support, female gender,
      previous psychiatric contact, low positive assertion skills, and a small number
      of friends for the Swedish; and low perceived family support, previous suicide
      attempts, low perceived peer support, suicide attempts in the family, and
      previous psychiatric contact variables for the Turkish group were found to be
      significant predictors of current suicidal risk.

PMID- 7797639
TI  - Suicidal ideation in high school students: depression and other correlates.
AB  - English-Canadian high school students (129 boys, 117 girls) participated in a
      study of the relationship between suicidal ideation and selected personal
      variables, stress, and social support. Associations were found between suicidal
      ideation and the variables of gender, self-esteem, locus of control, depression,
      drug use, stress, perception of health, family status, academic performance,
      social support, and anomie. Multiple regression analysis identified depression
      and alcohol use as best individual predictors among these variables. Semi-partial
      correlation analyses showed that removal of the effect of depression resulted in
      a loss of initially significant relationships between suicidal ideation and the
      other variables except for alcohol use, drug use, and health satisfaction.

PMID- 7797640
TI  - Validating a multidimensional model of the psychopathology of bulimia nervosa.
AB  - In a recent preliminary report, a multidimensional model for bulimia nervosa was
      proposed with latent dimensions body dissatisfaction, restricting behaviors,
      bulimic behaviors, and affective and personality disorder. It was suggested that
      body dissatisfaction clearly represented a distinct dimension of the disorder. In
      the current investigation, we cross-validated the prior results on a larger
      sample with a different set of variables and tested the fit against alternative
      models. Subjects were 497 women diagnosed as having bulimia nervosa. We performed
      a confirmatory factor analysis using the LISREL 7 program. The results supported
      the fit of the four-dimensional model, but also suggested that self-injurious
      behaviors may represent additional separate dimensions of the disorder,
      relatively independent of the affective disturbance.

PMID- 7797641
TI  - The specificity of sociotropy-autonomy personality dimensions to depression vs.
      anxiety.
AB  - Previous cognitive vulnerability studies have identified sociotropy/dependency as
      a personality characteristic related to depression. We evaluated sociotropy in
      differential prediction of depression vs. anxiety. Participants (70 females, 42
      males) were tested on the Beck Depression Inventory (BDI) and the Beck Anxiety
      Inventory (BAI) at two points in time (T1 and T2), separated by an interval of 4
      weeks. The Sociotropy-Autonomy Scale (SAS) was administered at T1. Sociotropy was
      related moderately to the BDI at T1 and T2, but also to the BAI. Autonomy was
      related to neither. Hierarchical multiple regression analyses found sociotropy to
      predict anxiety at T2, but not depression. The issue of cognitive vulnerability
      marker specificity is discussed.

PMID- 7797642
TI  - Multivariate investigation of anxiety in a psychiatric population.
AB  - The purpose of the present research was to interrelate dimensions of anxiety in a
      psychiatric population, based primarily on the conceptual formulation of Templer,
      Corgiat, and Brooner (1984). Two hundred twenty outpatients served as subjects.
      The Fear Survey Schedule, State-Trait Anxiety Inventory, Hamilton Anxiety Scale,
      and a Likert-formated criterial symptom checklist for Generalized Anxiety
      Disorder (GAD) were employed to derive measures of Severity, Stimulus
      Specificity, Subjective Component (Cognitive vs. Somatic), Chronicity, and
      Temporal Constancy (Sometimes vs. Always present). Principal components factor
      analysis yielded three distinct dimensions of anxiety: Morbidity, Subjective
      Component, and Chronicity. Clinical and theoretical relevance of these findings
      are discussed specific to construction of a working model of anxiety, clinical
      assessment of anxiety response systems, and the feasibility of a dimensional
      approach to understanding psychopathology.

PMID- 7797643
TI  - The relationship of religious variables to death depression and death anxiety.
AB  - The present research explored the relationship of religious variables to death
      anxiety and death depression in 200 persons from the general population in what
      is apparently the first study to correlate religious variables with death
      depression. Persons with lower death depression had greater strength of
      conviction, greater belief in afterlife, and were less likely to say that the
      most important aspect of religion is that it offers the possibility of life after
      death. Persons with less death anxiety were found to have greater strength of
      conviction. The findings were discussed in relationship to previous research that
      has suggested that religious belief is associated more closely with death anxiety
      level than is religious practice.

PMID- 7797644
TI  - PSM-R: Revised Optimism-Pessimism Scale for the MMPI-2 and MMPI.
AB  - The Revised Optimism-Pessimism (PSM-R) scale was developed for use with either
      the MMPI-2 or the MMPI. The scale measures explanatory style on a continuum from
      optimistic to pessimistic by using 263 MMPI items of the original 298-item
      Optimism-Pessimism (PSM) scale. These 263 items are common to both the MMPI-2 and
      MMPI. PSM-R norms are based on a random sample of 1,408 normal adults who also
      were used for developing norms for the original PSM scale. Reliability estimates
      (.93 for men; .94 for women) indicate that the PSM-R scale is as accurate as the
      original PSM scale.

PMID- 7797645
TI  - The Clinical Anger Scale: preliminary reliability and validity.
AB  - This article reports preliminary evidence for the development and validation of
      the Clinical Anger Scale (CAS), an objective self-report instrument designed to
      measure the syndrome of clinical anger. Factor analysis of the CAS confirmed a
      unidimensional item structure; reliability analyses also demonstrated adequate
      internal consistency and test-retest stability for the CAS; other results
      indicated that the CAS was unrelated to social desirability influences.
      Additional findings indicated that clinical anger was associated positively with
      several anger-related concepts (e.g., trait anger, state anger, anger-in, anger
      out, anger-control) and that the CAS was related in predictable ways to people's
      psychopathological symptoms, personality traits, and early family environments.
      Implications for future research and therapeutic assessment with the Clinical
      Anger Scale are discussed.

PMID- 7797646
TI  - Reliability and factor structure of the Chinese GHQ-30 for parents with preschool
      mentally handicapped children.
AB  - The Chinese version of the General Health Questionnaire (GHQ-30) was administered
      to 381 parents of preschool mentally handicapped children, along with other
      instruments that assessed their stress, mental health, coping styles, and care
      giving patterns. The GHQ-30 was found to have high internal consistency as a
      scale and high item-total correlations for most of the items. Factor analysis
      with a four-factor solution showed that four factors were abstracted from the
      scale, namely, anxiety, depression, interpersonal dysfunctioning, and inadequate
      coping. It also was found that the factors extracted could be reproduced reliably
      in two random subsamples and that the factor structure derived from the present
      sample corresponds to the previously reported data on the dimensionality of the
      Chinese GHQ-30.

PMID- 7797647
TI  - Psychometric evaluation of the Social Phobia and Anxiety Inventory in college
      students.
AB  - The present study reports on the psychometric properties of the Social Phobia and
      Anxiety Inventory (SPAI; Turner et al., 1989a) in two nonclinical samples of
      college undergraduates. Exploratory principal-components analysis with varimax
      rotation replicated the five-factor solutions reported for the 32-item Social
      Phobia subscale (SP) in sample 1 (N = 200). Confirmatory factor analyses showed
      that the five-factor structure of the SP and the two-factor structure of the SPAI
      were appropriate for the second sample (N = 210) data. Coefficient alpha values
      were high for all the SP and the SPAI subscales. Furthermore, we examined the
      relations between the SPAI subscales and measures of social fear and anxiety,
      social desirability, and general psychopathology. Results support the research
      use of the SPAI in our undergraduate samples.

PMID- 7797648
TI  - Social desirability effects on measures of adjustment to university, independence
      from parents, and self-efficacy.
AB  - Results of regression analyses on data from 96 first-year undergraduates
      indicated that social desirability (Jackson and Marlowe-Crowne Social
      Desirability Scales), particularly scores on the Jackson scale, is related
      strongly to scores on measures of adjustment (Student Adaptation to College
      Questionnaire), self-efficacy (Hale-Fibel Generalized Expectation for Success
      Scale), and independence (Psychological Separation Inventory) from mother, but
      not from father. In addition, both the Jackson and Marlowe-Crowne scales were
      correlated highly. Independence from parents and self-efficacy each continued to
      show a relationship with adjustment to university after social desirability
      effects were removed. Failure to remove the effect(s) of social desirability from
      the present measures is likely to lead to inflated estimates of their relation to
      each other or to other measures.

PMID- 7797649
TI  - Saccadic tracking test--normal data and reliability.
AB  - A saccadic tracking test, which involves the scanning of a path guided by the
      direction of a sequence of arrows, was administered to 102 healthy control
      subjects. The data show a gender effect and a slight age and education effect.
      The internal consistency--estimated by Cronbach's alpha--was high, .94. The test
      promises to be a sensitive estimator of the capacity of a subject to explore a
      visual display, a skill necessary for a wide range of other test performances.

PMID- 7797650
TI  - Multivariate discriminant function analysis of neurologic, pain, and psychiatric
      patients with the MMPI.
AB  - The ability of the MMPI to classify five well-defined patient groups was
      investigated (N = 394; control, neurologic, psychiatric, chronic pain, and
      random). Clinical inspection and discriminant function analyses of basic clinical
      and research scales could not classify groups correctly, but discriminant
      function analyses of 37 variables loaded with CNS items (Cripe Neurologic Symptom
      items) correctly classified the groups with 78% overall accuracy (70% of
      neurologic, 62% of psychiatric, 81% of pain, 84% of controls, and 100% random).
      Results indicate that differential diagnosis is not possible with clinical
      inspection of scales, but complex statistical analysis of the MMPI is potentially
      useful in diagnosis and decision making. A method for applying the discriminant
      function analysis to individual cases is provided.

PMID- 7797651
TI  - Meditation as an adjunct to a happiness enhancement program.
AB  - This study investigated the impact that meditation has on Fordyce's (1977, 1983)
      Personal Happiness Enhancement Program (PHEP). Experimental subjects were divided
      into two groups, both of which received instruction on the PHEP. Subjects in one
      experimental group were taught a meditation exercise in addition to the PHEP. A
      control group received no instruction. The Happiness Measure, Psychap Inventory,
      Beck Depression Inventory, and State-Trait Anxiety Scale were dependent measures.
      The three (groups) x two (pre-post) mixed ANOVAs with Student Newman-Keuls found
      that the meditation plus PHEP group significantly improved on all dependent
      measures over both the PHEP only group and the control group. The PHEP only group
      improved significantly over the control group on all measures except state
      anxiety.

PMID- 7797652
TI  - Anxiety in community-based AIDS caregivers before and after personal construct
      counseling.
AB  - Personal construct counseling was provided for voluntary AIDS caregivers based in
      the community, with the goal of reducing their anxiety levels. Seventy-five
      caregivers participated in the project, 33 of whom received counseling. They were
      interviewed on three occasions--before, immediately after, and 3 months after
      counseling. Their responses to an open-ended question were subjected to six
      subscales of a content analysis scale in order to measure levels of anxiety from
      six different sources. At time 2, the anxiety of the counseled caregivers was
      significantly less than that of those not counseled, specifically their anxiety
      about bodily mutilation and guilt. These differences were not sustained at time 3
      because the anxiety of those not counseled dropped. Some criticisms of the
      project are examined before the meaning of these findings for meeting the mental
      health needs of AIDS caregivers is discussed.

PMID- 7797653
TI  - Treatment utility of the sociotropy/autonomy distinction: implications for
      cognitive therapy.
AB  - The treatment utility of the Sociotropy/Autonomy Scale was evaluated by matching
      or mismatching subjects to either individual or group cognitive therapy according
      to their dominant personality dimension. Both groups of subjects obtained
      statistically significant, but equivalent, reductions in depression. Consistent
      with Beck's (1983) interactional model, tests of clinical significance indicated
      a higher proportion of matched subjects who displayed marked improvement at
      follow-up. Implications for cognitive therapy and further research on the
      assessment of personality dimensions relevant to depression are discussed.

PMID- 7797654
TI  - A taxonomy of Rorschach autisms with implications for differential diagnosis
      among thinking-disordered patients.
AB  - A tripartite taxonomy of perceptual-cognitive errors on the Rorschach,
      abbreviated TRAUT, was reviewed. TRAUT classifies "autisms" as stemming from
      either an arrant disregard for the blot shapes (HYPO), an inordinate attention to
      unusual blot areas (HYPER), or an endorsement of counterfactual relationships
      among blot areas (RELER) included among Exner's Unusual Verbalizations. The
      scoring of HYPOs and HYPERs and the frequency of their occurrence among thought
      disordered groups were determined by examining Rorschachs of inpatient
      schizophrenics, outpatient schizophrenics, borderline personality disorders, and
      Cluster A personality disorders. Because HYPOs and HYPERs yielded better
      differential diagnoses than RELERs among these four groups, it was suggested that
      such percepts should be scored routinely as a screen for thought disorder.

PMID- 7797655
TI  - Rorschach assessment of the borderline child.
AB  - After nearly two decades of intensive investigation, adult borderline disorders
      have achieved wide currency, including a substantial psychological literature.
      The literature on the diagnostic psychological assessment of borderline children
      is, in contrast, quite sparse. This paper examines manifestations of childhood
      borderline conditions on the Rorschach, discusses them in light of current
      theoretical conceptualizations of adult borderline psychopathology, and explores
      the relationship between child and adult borderline disorders and the genesis of
      these conditions.

PMID- 7797656
TI  - The alcohol paradox: a psychological model.
AB  - The paradoxical continuation of excessive drinking by chronic alcoholics despite
      extremely aversive personal deterioration is addressed by a two-factor theory.
      The theory regards the increasing stereotypy of alcohol-related behaviors as a
      function of: (a) primary neuropsychological impairments that result from alcohol
      abuse and (b) secondary fears of catastrophic failure attendant upon brain
      dysfunction, which leads to acquired aversions to situations that require
      adaptive behaviors. A schematic quantitative model of this formulation is
      presented that may be useful to practicing psychologists in explaining
      perserverative behavior in a variety of brain syndromes.

PMID- 7797657
TI  - Using and misusing factor analysis to explore group cohesion.
AB  - Group cohesion is an important construct in understanding the behavior of
      different types of groups. However, controversy exists about how to conceptualize
      and measure cohesion, and a central issue is its dimensionality. Consequently,
      researchers have used factor analysis to examine the structure of the construct
      of cohesion and measures of it. Our goals in writing this article were to review
      critically how factor analysis has been used to understand group cohesion, make
      some recommendations for future factor analytic work, and point out some
      weaknesses and strengths in using factor analysis to explore cohesion.

PMID- 7797658
TI  - Color Doppler sonography: anatomic and physiologic assessment of the thyroid.
AB  - The purpose of this study was to assess the potential application of color
      Doppler sonography in thyroid imaging. Thyroid nodules and other thyroid
      pathology detected by color Doppler ultrasound and nuclear scintigraphy were
      compared in 115 patients. The majority of "cold" nodules demonstrated a
      peripheral rim of color flow and no internal color flow with color Doppler
      sonography. A large number of "hot" nodules demonstrated internal color flow.
      Color Doppler sonography was helpful in delineating nodules in otherwise
      inhomogeneous glands. We determined that color Doppler cannot reliably
      distinguish benign from malignant thyroid nodules; fine-needle aspiration biopsy
      remains the most accurate method in differentiating benign and malignant lesions.
      We suggest that color Doppler sonography plays only a limited role in the
      evaluation of nodular thyroid disease at this time. The color Doppler appearance
      of other thyroid disorders (including toxic multinodular goiter, Graves' disease,
      and thyroiditis) is discussed.

PMID- 7797659
TI  - Doppler velocity histogram analysis of hepatocellular carcinoma.
AB  - To study the characteristics of tumor blood flow, flow profiles from
      hepatocellular carcinomas (39 profiles) and normal hepatic arteries (23 profiles)
      were evaluated using velocity histograms obtained with Doppler ultrasound. The
      histograms were classified into three types: (1) high-peak, (2) flat, and (3) low
      peak. Characteristically, the low-peak types and the flat types, with flows in
      opposing directions, were seen only in the tumor vessels. The turbulence in a
      phantom flow model was of the low-peak type. Spectral analysis revealed that the
      velocity profile of tumor blood flow was different from that of noncancerous flow
      and that tumor blood flow was characterized by turbulence.

PMID- 7797660
TI  - Image-directed color Doppler ultrasonography in the evaluation of superficial
      solid tumors.
AB  - Image-directed color Doppler ultrasonography (ICDUS) studies of 86 patients with
      superficial solid masses yielded significantly lower resistive index (RI) values
      in acute inflammatory lesions, but no significant difference between the maximum
      systolic flow velocities (S) of the patient groups with malignant, benign, and
      acute inflammatory lesions. When analyzed separately, the malignant soft-tissue
      tumor subgroup was shown to have significantly higher mean RI compared to that of
      the malignant node subgroup. We conclude that RI may be useful in the
      differentiation of acute inflammatory masses from other pathological entities.
      Malignant soft-tissue tumors, especially sarcomas, may have different Doppler
      features from those of carcinomatous tumors.

PMID- 7797661
TI  - Image-directed and color Doppler ultrasonography in the diagnosis of postbiopsy
      arteriovenous fistulas of native kidneys.
AB  - Using image-directed and color Doppler ultrasonography (ICDUS), we examined 65
      patients with single kidney biopsy and diagnosed one arteriovenous fistula (AVF)
      in each of 8 kidneys. Three of them were associated with pseudoaneurysms. Three
      of the patients with AVF who presented with macrohematuria underwent angiography.
      Therapeutic percutaneous embolization was performed in 2 of them. The remaining 6
      patients were followed up with ICDUS. All the lesions had disappeared at the end
      of a 6-month period. We conclude that ICDUS is an easy and noninvasive imaging
      technique in the diagnosis of postbiopsy native renal AVFs.

PMID- 7797663
TI  - Placental infarction simulating a succenturiate lobe.

PMID- 7797665
TI  - Hepatic hydatid cyst communicating with the biliary tract.

PMID- 7797664
TI  - Ultrasound appearance of parotid Castleman's disease.

PMID- 7797662
TI  - Sonography of the costal cartilage: normal anatomy and preliminary clinical
      application.
AB  - Costal cartilages of 10 controls and 12 patients with Tietze's syndrome (n = 6),
      deformed (exaggerated bowing) cartilage (n = 4), focal enlargement (n = 1), and
      cancer-invaded cartilage (n = 1) were examined with ultrasonography. In controls,
      ultrasonography detected 237 of 240 costal cartilages (98.8%) and 58 of 105
      intercartilage connections (55%) with three variations. Correlation with CT was
      available in 7 patients (1 Tietze's syndrome, 4 deformities, 1 cartilage
      enlargement, and 1 cancer) among 8 patients whose CT results were known to the
      sonographer. Sonography showed normal (n = 4) or marginally blurred (n = 2)
      cartilages in 6 Tietze's syndromes. Ultrasonography is a promising technique in
      the examination of costal cartilages.

PMID- 7797666
TI  - Ultrasound-guided transperineal needle biopsy of the prostate after
      abdominoperineal resection.

PMID- 7797667
TI  - Candida fungus balls presenting as intraventricular masses in cranial sonography.

PMID- 7797668
TI  - An easily made, low-cost, tissue-like ultrasound phantom material.

PMID- 7797669
TI  - A global perspective.

PMID- 7797670
TI  - You're invited.

PMID- 7797672
TI  - Permanent continuing education of nurses in Hungary.

PMID- 7797671
TI  - Continuing education in nursing in Japan.

PMID- 7797673
TI  - Continuing professional education: individual responsibility, collective
      consciousness.
AB  - Continuing professional education in the United Kingdom is discussed and the
      influences examined. Within a framework of national, nursing, and local
      perspectives, the issues and implications for the various individual agencies and
      personnel are identified. An overview is provided to include agendas for action.

PMID- 7797674
TI  - Continuing education in nursing: the Icelandic experience.

PMID- 7797675
TI  - Continuing education for nursing staff development through technical cooperation
      of Southeast Asian countries.

PMID- 7797676
TI  - Continuing education in nursing in Jamaica, West Indies.

PMID- 7797677
TI  - Continuing education in Brazil.
AB  - In the present study, we discuss some specific aspects of the National Health
      System of Brazil in terms of nursing practice, education, and investigation,
      which require further professional training through continuing education. With
      this objective, we shall report a historic view of how this process occurred and
      is being transformed in this country in an attempt to meet the social realities
      of our time.

PMID- 7797678
TI  - Continuing education in nursing in Kuwait.

PMID- 7797679
TI  - Faculty development: a transcultural experience.
AB  - A collaborative education program between Schools of Nursing at the Jordan
      University of Science and Technology and the University of Windsor, funded by the
      Canadian International Development Agency (CIDA), provides advanced clinical and
      theoretical education for Jordanian faculty and thus enriches the education of
      nursing students. This article describes the preparation of the faculty
      development proposal and the implementation of the project in a transcultural
      context, and identifies strengths and limitations of the project. Recommendations
      for effective strategies regarding international development in nursing education
      are made and a discussion of the benefits that ensued to both faculties is
      included.

PMID- 7797680
TI  - Inservice education in Turkey.

PMID- 7797681
TI  - Continuing education in Greece.

PMID- 7797683
TI  - Critical thinking.

PMID- 7797682
TI  - Continuing education in Saudi Arabia: the missed sonata.

PMID- 7797684
TI  - Walking around the elephant: a critical-thinking strategy for decision making.
AB  - The parable of the blind men and the elephant provides a metaphor for emphasizing
      important characteristics of critical thinking and strategies for decision
      making. The article describes critical thinking as a process and cognitive skill
      that functions in identifying and defining problems and opportunities for
      improvement; generating, examining and evaluating options; reaching conclusions
      and decisions, and creating and using criteria to evaluate decisions. Critical
      thinking improves the quality of professional and personal decisions. Critical
      thinking also contributes to the effectiveness of group decision making by
      creating synergy and collaboration. The article presents evidence of the crucial
      nature of critical thinking in nursing practice, management, and executive roles,
      and in the practice of continuing education and staff development. The article
      identifies and develops the major defining characteristics of critical thinking.
      Illustrating the characteristics in practical examples, the article suggests ways
      to foster critical thinking for ourselves, with our learners, with managers, and
      with our colleagues.

PMID- 7797685
TI  - The generic research protocol: an innovative technique to facilitate research
      skills development and protocol preparation.
AB  - Hospitals are increasingly delegating responsibility for initiating nursing
      research to nursing staff whose knowledge of and experience in conducting
      research may be limited. As a result, nurses involved in continuing education and
      staff development are increasingly involved in helping staff develop their
      research skills and prepare research protocols. The generic research protocol
      (GRP) is a computerized learning package that assists nursing staff in preparing
      a scholarly research protocol through step-by-step instruction and guidance. When
      used in two unrelated nursing studies, research skills of participating nursing
      staff were developed and protocol preparation facilitated. The time and editorial
      effort required for protocol preparation were reduced, and novice researchers
      were familiarized with research terminology and issues related to study design.

PMID- 7797686
TI  - The challenge: developing a preceptorship program in the midst of organizational
      change.
AB  - The implementation of educational programs during ongoing organizational change
      is a challenge. Our hospital nursing education department was successful in
      developing a department-wide preceptorship program during significant
      institutional change. This article outlines an analysis of the process of
      implementing such a program from the perspective of the unfreezing, moving, and
      refreezing components of change theory. An examination of the driving and
      restraining forces before and after the initiation of the program provides
      rationale for the success of the program. Factors that contributed to achievement
      of our goals include effective communication, senior administrative support, and
      education. From this analysis one could conclude that it is possible to initiate
      major educational initiatives during concurrent organizational change.

PMID- 7797688
TI  - Continuing education in South Africa.
AB  - An overview of continuing education in South Africa reveals that despite strong
      philosophical support a number of factors impede the developmental of an
      effective system of such education. Existing inadequacies have been exacerbated
      by the introduction in 1986 of a comprehensive program for entry into the
      profession, resulting in an overwhelming demand for continuing education for
      nurses who trained prior to that. Rural nurses in particular are disadvantaged,
      with nondegree continuing education being largely inaccessible. However, efforts
      to meet these needs are afoot, and two recent initiatives are described.

PMID- 7797687
TI  - Adapting to change: reconsidering staff development organization, design, and
      purpose.
AB  - Staff development educators must perform a balancing act between maintaining the
      routine learning services and responding to and facilitating the emergent
      learning needs that shape success. This article proposes a dual-track structuring
      to address both needs and to create a cutting-edge approach to organizational
      learning needs.

PMID- 7797689
TI  - A synopsis of continuing nursing education in Kenya.

PMID- 7797690
TI  - Community-based nursing education in Pakistan.
AB  - The nursing profession is not looked on favorably by Muslim families. In one
      rural area there were only three nurses for 1 million people. Community health
      and public health care have been lacking in the nursing curriculum. Therefore,
      preparing recruits for the community health nursing (CHN) posts in the Community
      Health Sciences Department (CHSD) and for faculty of the School of Nursing has
      involved a sequence of continuing education: inservice and on-the-job training in
      the CHSD and courses in the new BScN program. Those who joined with a diploma in
      nursing and a year of midwifery, and who followed this sequence, could be
      selected as Aga Khan University (AKU) scholars, and be sponsored for support in
      the two-year BScN program with its community health orientation. After two more
      years of advanced experience, the CHN is given the opportunity to apply for
      master's studies abroad. All who were accepted have returned to work at the Aga
      Khan University and have increased their career opportunities.

PMID- 7797691
TI  - Continuing education nursing program in Thailand.

PMID- 7797692
TI  - Nursing staff development and continuing education in Korea.

PMID- 7797693
TI  - Assessing beginning level competencies: the first step in continuing education.

PMID- 7797694
TI  - A reinforcement technique: the goody bag.

PMID- 7797695
TI  - Listening to children: medical treatment and consent.

PMID- 7797696
TI  - Search for meaning in long-term cancer survivors.
AB  - The purpose of this study was to explore search for meaning in long-term
      survivors of malignant melanoma and the relationship of this meaning to self
      blame and well-being. The sample consisted of 31 long-term melanoma survivors who
      had been free of disease for 5 years or longer. Measures included the Search for
      Meaning scale, a single item on self-blame and the Index of Well-Being. Data were
      analysed by descriptive statistics and t-tests. Findings revealed that 52% (n =
      16) of the sample did search for meaning which resulted in an identifiable cause
      for their cancer and a quiet reassessment of life. Subjects indicating self
      responsibility for their cancer expressed a greater meaning search than the group
      who did not blame self (P < 0.01). Well-being scores were not significantly
      related to this search for meaning. Results suggest that for some survivors the
      cancer experience elicits a search for meaning which is significantly associated
      with self-blame. This study extends developing nursing theory on survivorship by
      providing insight into the meaning of the cancer experience in long-term
      survivors.

PMID- 7797697
TI  - Changing nurses' pain assessment practice: a collaborative research utilization
      approach.
AB  - It is not uncommon for a decade to pass between the time a research problem is
      identified and the time that research-based solutions are translated into
      standards for care. This quasi-experimental study demonstrated the effectiveness
      of a collaborative research utilization model directed towards the transfer of
      specific research-based knowledge (pain assessment) into practice for the purpose
      of helping to solve pain management problems. At the same time, nurses who
      participated in the model significantly improved their competency in research
      utilization and their attitudes towards research when compared to a control group
      who did not participate in the model.

PMID- 7797698
TI  - Health and memory in people over 50: a survey of a single-GP practice in England.
AB  - One hundred and forty people over the age of 50 randomly sampled from a single
      handed British general practice were screened for dementia using the Kendrick
      Cognitive Tests for the Elderly. The tests results were compared with actuarial
      data concerning health and health services provision. The results indicate that
      there are clear interrelations between low but non-dementing scores in memory and
      speed performance with the use of services, mobility levels and chronic
      disorders.

PMID- 7797699
TI  - Gender differences in care delivery and supervisory relationship: the case of
      psychogeriatric nursing.
AB  - In this paper the impact of gender differences within nursing is examined.
      Previous work has highlighted the disproportionate number of men in senior
      managerial positions in nursing and the perceived benefits which more males
      entering the profession may bring, for example increased status and higher pay.
      The present work addresses two domains where the impact of gender differences may
      importantly affect both policy and practice; first in the realm of care delivery
      and second in the area of supervisory relationships. The care received by male
      and female patients is studied, with particular attention being given to mixed
      wards. Differences between the care delivery of male and female ward staff are
      also discussed. Finally, differences in the supervisory roles of male and female
      charge nurses are examined. The research concludes that the inter-relationships
      between male and female ward staff and the way in which these impact upon the
      care received by patients is, as yet, little understood. However, as increasing
      numbers of males enter traditional female preserves within nursing, the need for
      a debate regarding the impact of gender differences is now essential.

PMID- 7797700
TI  - Older women's attitudes to cervical screening and cervical cancer: a New Zealand
      experience.
AB  - An in-depth series of interviews was undertaken amongst a small group of older,
      caucasian women, in Auckland, New Zealand. The study was part of the region's
      cervical screening programme. The aim of the study was to determine how the older
      woman's perceptions of cervical cancer and cervical screening services might be
      affecting her health-seeking behaviour. Healthy, caucasian women between 45 and
      70 years of age were invited to participate. These women had either declined or
      delayed having regular cervical smears. Interviews were recorded and transcribed,
      then subjected to thematic analysis. Although small, the study is important in
      that it highlights cognitive, emotional, socio-economic and ego integrity
      barriers to regular cervical screening. Nurse clinicians have a major role in
      disease prevention and education for healthy older women. The findings provide a
      useful background for developing strategies to increase the uptake of cervical
      smears amongst older Caucasian women. They may also be viewed as a pilot for the
      development of questionnaires, or for further investigation of perceptions of
      older women in other ethnic groups.

PMID- 7797701
TI  - Pain: the views of elderly people living in long-term residential care settings.
AB  - While an individual's beliefs and attitudes have long been considered important
      factors in how people respond to pain, few studies have attempted to provide in
      depth descriptions of the nature of such pain beliefs and attitudes. The aim of
      this research was to investigate the views of pain and pain management practices
      held by elderly people living in long-term residential care settings. Ten 60-90
      minute focus group interviews, each involving around five elderly people, were
      conducted in four large, long-term residential care settings in Brisbane,
      Australia. Categories of beliefs and attitudes regarding pain were identified
      following analysis of the verbatim transcripts of these interviews. Findings
      suggest that many elderly people living in long-term residential care settings
      may have become resigned to pain, that they are ambivalent about the benefit of
      any action for their pain and that they may be reluctant to express their pain.
      Implications of these beliefs and attitudes are discussed.

PMID- 7797702
TI  - Low-intensity, range-of-motion exercise: invaluable nursing care for elderly
      patients.
AB  - This study looked at the effect of a single session of mild exercise in a group
      of cognitively unimpaired institutionalized elderly patients, aged 70+, on tests
      of cognitive performance. Results indicate that mild exercise, such as range-of
      motion, does improve the ability to recall and that the effect lasts for at least
      half an hour. Mild exercise programmes appear to be a practical, low-cost nursing
      intervention that can enhance memory and independence. Programmes that are
      designed to meet individual needs and that are incorporated into daily routine
      and activities without imposing extra effort or inconvenience are more appealing
      to elderly patients. Exercise can be easily learned and implemented by nurses,
      personal care attendants or nurse aides. This is an extremely important
      consideration in a health care system that demands low-cost quality care.

PMID- 7797703
TI  - The process of social support: adjusting to life in a nursing home.
AB  - This study was designed to explore the process of social support during the
      course of adjusting to life in a nursing home. Qualitative data were gathered,
      through four sequential interviews of residents newly admitted to a nursing home,
      and from 12 months of participant observation in the setting. Residents'
      perceptions of supportive and non-supportive behaviours and their sources were
      identified and described. The findings indicated negligible change in perceptions
      of type or source of support over time. Emotional support and practical
      assistance emerged as the primary supportive and non-supportive behaviours from
      others, mainly nursing staff. Advice/guidance support was not mentioned.
      Residents who had lived in the nursing home for more than 1 year differed from
      new residents in the ability to extend support to others. Support interventions
      are suggested.

PMID- 7797704
TI  - Feminist teaching and the older nurse: the journey from resistance through anger
      to hope.
AB  - Some of the material presented in the journals of mature student registered
      nurses in two nursing research methodology courses are analysed. The classes were
      taught from a critical feminist perspective; that is, gender, race, sexual
      orientation and class issues were addressed as the science of ideas was explored.
      The students kept journals of their experiences throughout the process. While
      this was not a 'research' project in the usual sense of the word, material
      evolved which was primarily an evaluation of my teaching approach and their
      responses to it. Excerpts of this material were kept as they provide rich data
      providing insights into teaching strategies. Students cannot be identified in
      this analysis. It was found that, initially, most resisted the ideas of feminist
      theory, research and praxis. As the classes progressed, many feelings were of
      anger about the oppression they had experienced in the past at work and
      personally but had not understood. Finally, towards the end of term, many
      students expressed hope that they would be able to bring about some social change
      within the profession as a result of the ideas discussed in classes. However,
      several students remained unconvinced that feminism was the way to evoke change.

PMID- 7797705
TI  - Women's experiences of rheumatoid arthritis.
AB  - This paper is based on findings drawn from research undertaken within a
      qualitative framework of analysis. The purpose of the research was to explore
      women's experiences of rheumatoid arthritis. Three areas of concern to the women
      are identified and discussed in the light of relevant literature. They are as
      follows: seeking help, searching for meaning and uncertainty about symptoms. A
      major theoretical concern of both authors is to demonstrate the importance of
      placing patients' personal accounts of their experiences and understandings at
      the centre of nursing interest and practice. It is argued that there is a need to
      develop research studies of how patients experience disease, in order to develop
      a basis for good practice.

PMID- 7797706
TI  - Unequal access to midwifery care: a continuing problem?
AB  - For women of an ethnic minority the maternity services have been described as
      inappropriate, inaccessible and inadequate. It is hoped that the contents of this
      paper will raise awareness amongst health professionals of the continuing
      problems faced by women trying to overcome a language barrier.

PMID- 7797707
TI  - The process of analysis during a grounded theory study of men during their
      partners' pregnancies.
AB  - This research builds on the work of Barclay (1993) who studied couples during
      pregnancy and discovered that there was a mismatch between sexual interest levels
      of men and women during pregnancy. As well, little is known about the social and
      emotional experiences of men during their partners' pregnancies. One antenatal
      group consisting of six men, whose partners were in the second trimester of
      pregnancy, attended a series of five meetings and subsequent individual
      interviews. Additional data and insights were gained by the researcher and the
      research assistant attending other antenatal classes with men and women present.
      The research data consisted of transcripts of tape-recorded interviews, group
      discussions, observations and field notes made by the researcher and co-leader
      following each of the group sessions. The aim was systematically to develop a
      substantive grounded theory which was drawn from the experiences of the men
      during this transitional period in their lives. This paper discusses the process
      of analysis which led to the central phenomenon, the core category of the
      research, around which the grounded theory is built. Five theoretical constructs
      emerged from the data collected: (a) ambivalence in the early stages of
      pregnancy, (b) relationship with baby not real, (c) how should I be as a father?,
      (d) coping with the changing roles and lifestyle, and (e) disequilibrium in
      relationship with female partner. The last construct emerged as the basic social
      process. The nature of this relationship changed over the duration of the
      pregnancy. Emotional turmoil and anxiety in men contributed to the 'mismatch' in
      male and female expectations of the relationship.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7797709
TI  - The application of the ideas of Frantz Fanon to the practice of mental health
      nursing.
AB  - This paper is based on an extensive review of the published literature which
      refers to the clinical and social psychology of Frantz Fanon, and seeks to
      establish the relevance of Fanon's psychological thought to the practice of
      mental health nursing in the 1990s. The writer sets out the key principles of
      Fanon's clinical and social psychology, and engages with the theoretical problems
      which arise from the close relationship between Fanon's psychological theories
      and his involvement with violent revolutionary politics. After discussing the
      links between Fanon's unique psychology and the work of the anti-psychiatrists of
      the 1960s and later critiques of mental health care, the writer argues that the
      development and adoption of a neo-Fanonist approach to the practice of mental
      health nursing would address many of the problems of current mental health care
      practice. In particular, the principles of Fanon's psychology address many of the
      concerns about disempowerment of service users which have been highlighted in
      work by feminist and anti-racist writers, and by members of the Mental Health
      Service Users' Movement.

PMID- 7797710
TI  - Meaning attached to compliance with self-care, and conditions for compliance
      among young diabetics.
AB  - This paper presents a hypothetical model of the compliance with self-care of
      young diabetics, its features, its meaning to them and the preconditions for
      compliance with self-care. The aim of this research was to develop a model to
      clarify and expand existing knowledge concerning compliance with self-care among
      young diabetics and to produce new ideas for planning and implementing this care.
      Four categories of behavioural pattern were identified. Those young people with
      good compliance experienced a sense of well-being, health, and freedom. They were
      responsible, active, and well motivated in voluntarily implementing self-care.
      The second group were those whose actions deviated only slightly from health
      regimens but who had undergone many negative experiences with self-care. Their
      actions were guided only by compulsion. The third group were consciously non
      compliant. Their constant neglect of health regimens was associated with feelings
      of poor health, fears and indifference. They were not motivated to comply, felt
      that the aims set were too high and the self-care programme too tightly
      regimented. They felt that they received no encouragement. The young people
      belonging to the fourth group frankly refused to pursue self-care. Their non
      compliance was seen by them as an issue of freedom. In effect, their friends
      controlled their lives, and they felt that their self-care was all the more
      unnecessary since nobody encouraged them to keep to it.

PMID- 7797711
TI  - Evaluating clinical educators: an employer's perspective.
AB  - An Australian school of nursing's attempt to introduce an evaluation process
      required by management for clinical educators involved in undergraduate
      preregistration education is discussed. Reliance on student feedback and clinical
      agencies' perceptions of the quality of teaching were seen as inadequate
      mechanisms for evaluation. The evaluation process adopted incorporated
      observation of the educators together with self-reflection on their performance.
      We conclude that post-briefings were poorly used and generally not reflective.
      Educators relied heavily on their clinical skills and used a limited range of
      teaching strategies. Whilst evaluation of clinical educators was time consuming
      and therefore costly, it is argued that it is essential to the integrity of the
      course. The evaluation process has provided direction for support and development
      of clinical educators within the context of the curriculum.

PMID- 7797708
TI  - Parental participation in care: a critical review of the literature.
AB  - The literature reviewed demonstrates that parental participation is a complex
      issue which has been viewed mainly in a fragmented manner which does not
      recognize the integrated holistic nature of parent-nurse partnership. There is a
      dearth of research which focuses upon parents' perspectives and expectations of
      participation. Furthermore, there is an assumption that parental participation is
      unproblematic which precludes the identification of social and environmental
      constraints. The current level of knowledge about nurses' attitudes regarding
      parental participation is limited. There is an absence of clear indicators of how
      parental participation may be facilitated and supported in the institutional
      setting. It is proposed that further research is required which determines the
      extent of parental participation and which considers the lived experiences of
      both the parents and nurses of parental participation. Improved care for children
      and families could result from efforts directed to those endeavours.

PMID- 7797713
TI  - Collegiality, adaptation and nursing faculty.
AB  - Many nurse educators in the United Kingdom are currently faced with the challenge
      of change, of leaving the culture of the British National Health Service and
      integrating into the culture of tertiary education. This paper reports on a study
      of the process of developing collegial relationships in the context of a new
      collaboration to develop a combined curriculum for nurses within a tertiary
      institution. The aims of the study were to analyse this process of integration
      and to identify the conditions that enhanced the development of collegiality
      between members of the nursing group. The case study centred on the analysis of
      data collected on video during unstructured interviews with the five members of
      the group. Data were analysed using Burnard's method of thematic content
      analysis. The paper argues that during the transition from the National Health
      Service to tertiary education, individual nurse educators and their managers must
      address problems related to issues such as 'ingroupism', nursing the students,
      perceived difference between nurse academics and other academics, and
      expectations of power-relationships.

PMID- 7797712
TI  - Nursing faculty practice: challenges for the future.
AB  - Just as artists need to create their own art, so nursing instructors need to
      practise nursing. However, traditional educational settings and clinical
      placements limit the capacity of nursing instructors to practice nursing directly
      with clients. The creation of a nursing faculty practice model in Canada, whereby
      teaching roles and responsibilities are combined with clinical practice, is
      discussed within the context of a community college environment. A nurse-managed
      health centre is suggested as an innovative practice arena which is more in line
      with the changes in the health care system.

PMID- 7797714
TI  - Staff perceptions of organization change of treatment delivery on an addiction
      unit.
AB  - The Work Environment Scale was used to assess staff perceptions of a change in a
      treatment programme for problem drinkers. A more cost-effective 2-week research
      based day-patient programme, which included the concept of matching, replaced a 5
      week cognitive behavioural in-patient programme. The maintenance of a positive
      work environment was attributed to the meeting of staff expectations, a cognitive
      behavioural ideology, and the establishment of a research culture. The study
      highlights the importance of the thorough preparation of staff for change, and
      their active involvement in the process in settings where work satisfaction is
      already above the average level for mental health facilities.

PMID- 7797715
TI  - Continuing professional education: luxury or necessity?
AB  - The author sets out to define what is meant by continuing professional education,
      the implications of the terminology and the contribution that it makes to
      nursing. She then moves on to discuss the distinction between education and
      learning, and the importance of 'life-long learning' to nursing. The relative
      merits of voluntary and compulsory education are considered and the attitudes and
      expectations of both nurses and their managers are examined. Obstacles to the up
      take of educational opportunities are outlined, and some of the issues behind
      this are explored. The assessment of educational requirements and the evaluation
      of educational offerings are reviewed, along with the importance of assuring
      quality, not only in the context of proposals for postregistration education and
      the current market ethos in the United Kingdom, but also with regard to the
      potential benefits to be gained in the health care of the general public.

PMID- 7797716
TI  - Planning nursing education for the 21st century.
AB  - In looking towards the 21st century, the faculty at the Presbyterian Hospital
      School of Nursing, along with the Presbyterian Health Services Corporation and
      Queen's College, adopted a 1-2-1 programme. The process of developing a new
      nursing curriculum is presented as the task force proceeded from the philosophy
      and goals to conceptual framework and curriculum objectives. After discussions
      with nurse administrators and educators, extensive literature reviews and
      brainstorming sessions, concepts and subconcepts were chosen to form a
      philosophy. The metaparadigm of nursing and other related concepts were then
      organized into a conceptual framework. Ongoing communication and feedback from
      the faculty ensured group ownership of all documents. The eclectic organizational
      scheme was a good fit for a large faculty with differing beliefs and values about
      a nursing curriculum. The process of developing a future orientated nursing
      curriculum has been exciting, challenging and rewarding. The faculty is committed
      to the new philosophy, goals and conceptual framework and believe that the 1-2-1
      programme will educate future practitioners who are prepared to meet the
      challenges and changes in health care for the 21st century.

PMID- 7797717
TI  - Talking realistically about nursing: a thematic analysis of nursing course
      selection interview discourse.
AB  - This study examines the dialogue within selection interviews for places on a
      graduate nursing programme. The analysis focuses upon the way in which a
      'realistic' knowledge of nursing is tested for, and demonstrated through,
      particular discursive themes. These themes reflect a wider social acceptance of
      accountable rational decision-making. It is argued that applicants who are able
      to draw upon the interpretative resources necessary to justify their nursing
      course application in these terms are more likely to be evaluated positively.

PMID- 7797718
TI  - Hindsight bias in reflective practice: an empirical investigation.
AB  - Reflection is seen as a central component in the education and practice of
      nurses. It is through critical reflection on one's practice that expertise can be
      assured. This faith in the process of reflection has influenced much of pre and
      post registration nurse education. It is only in the past few years that
      reflection as a technique has being criticized. A small-scale study investigating
      the phenomenon of hindsight bias and its consequence on the reflective process is
      described. The effects of the hindsight bias is to influence people's
      recollection of events once they know the final outcome. The present study does
      indicate that nurses are susceptible to such a bias, which would question the
      validity of reflection as a way to enhance patient care. There is an urgent need
      to clarify the reflective process and then to examine its effect on patient
      outcomes.

PMID- 7797719
TI  - Managerial strategy and nursing commitment in Australian hospitals.
AB  - This study examined the relationship of managerial strategy and nursing
      commitment in Australian hospitals. The general principles of managerial strategy
      and employee response were illustrated and the meaning of commitment and
      resistance were defined. Data were collected by questionnaire survey and
      interviews. The result demonstrated that the middle manager/nurse unit manager
      played an important role in generating nursing commitment in the workplace. Trust
      and identification were the most relevant components of nursing commitment.
      However, the study also found that there was still a high degree of distrust
      between senior management and nurses. Change strategies which nurse managers
      could apply to promote greater organizational commitment in nursing are
      discussed.

PMID- 7797720
TI  - Correlates of nursing diagnosis quality in public health nursing.
AB  - The purpose of this study was to identify the relationship between the number and
      quality of nursing diagnoses generated by public health nurses (PHNs), and the
      use of different assessment databases (nursing or medical). In addition, the
      effect of experience with theory-based nursing practice on the number and quality
      of the diagnoses was examined. A convenience sample of 37 PHNs employed in two
      county health units provided the subjects for this study. One agency had
      implemented theory-based nursing practice; the other had not. Analysis of the
      results revealed that use of a nursing database significantly affected the number
      of diagnoses generated by PHNs. However, the database type did not significantly
      affect the quality of the diagnoses. PHNs' experience with theory-based practice
      had no significant effect on the number or quality of nursing diagnoses generated
      by PHNs, irrespective of database.

PMID- 7797721
TI  - Dancing with regulators.

PMID- 7797722
TI  - Managed care and dentistry.

PMID- 7797723
TI  - California clarification.

PMID- 7797724
TI  - Dental implants.

PMID- 7797725
TI  - Bleaching patients pleased with long-term results.

PMID- 7797726
TI  - Smoking inhibits healing after periodontal treatment.

PMID- 7797727
TI  - The sweet smell of serenity.

PMID- 7797728
TI  - Super-strong ceramic restorative developed.

PMID- 7797729
TI  - Treatment regimens in preventive and restorative dentistry.
AB  - Due in part to a lack of appropriate training and the incentive of adequate
      compensation, preventive dentistry in the United States has focused on
      prophylaxis and fluoride application. Dentistry must shift its attention to
      developing standardized protocols for "preservative dentistry"--diagnosing
      caries, assessing and monitoring caries risk, arresting active caries and
      remineralizing non-cavitated lesions. This article addresses shortcomings in
      preventive dentistry and proposes a plan for treatment standardization that can
      ensure optimum treatment and, ideally, lead to adequate compensation.

PMID- 7797730
TI  - Percutaneous injuries in dentistry: an observational study.
AB  - The authors conducted an observational study of the frequency and circumstances
      of percutaneous injuries among dental residents. Their findings suggest that most
      percutaneous injuries sustained by these dental residents occurred extraorally
      and were associated with denture impression procedures. Some injuries may be
      preventable with changes in techniques or instrument design.

PMID- 7797731
TI  - Comparing the resistance of dentin bonding agents and pins in amalgam
      restorations.
AB  - This in vitro study involving 84 caries-free molar specimens examined the
      resistance of complex amalgam restorations retained by two dentin bonding agents-
      Amalgambond and Amalgambond Plus--four regular TMS pins, six regular TMS pins and
      four pins in conjunction with Amalgambond. Analysis indicated that the
      Amalgambond restorations were significantly weaker than the other types.
      Amalgambond Plus restorations were significantly stronger than the Amalgambond
      restorations but not different from the remaining groups. The authors concluded
      that complex amalgam restorations should be retained with a combination of
      adhesive and mechanical retention.

PMID- 7797733
TI  - How dentists perceive the effects of orthodontic extraction on facial appearance.
AB  - In recent years, orthodontic treatment, particularly that involving premolar
      extractions, has been alleged to cause flat facial profiles. Those who make such
      assertions also claim to be able to instantly identify from a distance faces of
      patients who have received orthodontic treatment. These are strong claims that
      could profoundly affect the public's perception of dentistry and its specialties.
      This study examined whether dentists could distinguish between profiles of
      treated and untreated patients as well as between patients who had undergone
      extraction and those who had not.

PMID- 7797732
TI  - Using air-abrasive technology to diagnose and restore pit and fissure caries.
AB  - National Institute of Dental Research surveys indicate that the incidence of pit
      and fissure caries constitutes a higher proportion of the total caries incidence
      among U.S. teens and children than in the past. Air-abrasive technology may
      provide a more conservative alternative in the diagnosis and treatment of pit and
      fissure caries than traditional techniques using handpieces. The authors review
      characteristics of pit and fissure lesions and discuss methods for diagnosing and
      treating these lesions using air-abrasive technology.

PMID- 7797734
TI  - General dentists' patterns of restoring endodontically treated teeth.
AB  - The manner in which endodontically treated teeth are restored influences tooth
      longevity and the cost of treatment. This article describes a study of how
      surveyed general dentists restored endodontically treated teeth and whether their
      methods were consistent with those suggested in the literature. Some patterns of
      restoration did reflect the literature's recommendations, but overall the
      findings call into question some of the ways in which post-endodontic restorative
      care is carried out.

PMID- 7797735
TI  - A promising new category of dental cements.

PMID- 7797736
TI  - The oral health of U.S. Hispanics: evaluating their needs and their use of dental
      services.
AB  - Data from the 1985-1986 National Survey of Oral Health in U.S. Adults and Seniors
      showed that the oral health of Hispanic American adults and seniors was
      comparable to that of black adults and seniors. White adults and seniors had
      better oral health than their minority counterparts for all measures observed and
      were better able to afford dental care.

PMID- 7797737
TI  - Percutaneous revascularization of chronic coronary occlusions: an overview.
AB  - Patients with a chronic coronary occlusion often undergo coronary angiography
      after weeks to months of occlusion. The published reports underestimate the
      extent of this problem because such patients are often arbitrarily assigned to
      receive medical therapy or undergo bypass surgery as a result of poor success
      with percutaneous revascularization and substantial restenosis. Thus, there is
      controversy about the role of angioplasty in this patient cohort. The goal of
      this overview was to evaluate the available information about angioplasty in
      chronic coronary occlusions. The primary indication for attempted recanalization
      of a chronic coronary occlusion has been symptomatic angina pectoris. Anginal
      status often improves after successful procedures (70% vs. 31% with a failed
      procedure); left ventricular function may improve; and subsequent referral for
      coronary artery bypass graft surgery is uncommon (3% vs. 28% in unsuccessful
      cases). Successful recanalization is achieved in approximately 65% of attempted
      procedures. Inability to cross the stenosis with a guide wire is the most common
      cause of procedural failure. Statistically significant predictors of procedural
      success include older occlusions (75% < 3 months old vs. 37% > or = 3 months
      old), absence of any anterograde flow through the occlusion (76% with vs. 58%
      without), angiographically abrupt-appearing occlusions (50% vs. 77% with tapered
      occlusions), presence of bridging collateral vessels (23% with vs. 71% without)
      and lesions > 15 mm. Procedural complications occur at a slightly lower incidence
      than in angioplasty of high grade subtotal stenoses. Long-term success is
      limited, and restenosis can be expected in > 50% of the patients. The experience
      with chronic total occlusions of saphenous vein bypass grafts is small, but there
      appear to be limited procedural success and significant procedural complications,
      particularly associated with distal emboli. The role of new pharmacologic agents
      has yet to be defined and that of new devices has been disappointing so far, but
      further technologic advances are on the horizon.

PMID- 7797738
TI  - Effect of prolonged catecholamine infusion on immunoregulatory function:
      implications in congestive heart failure.
AB  - OBJECTIVES: This study sought to characterize the effects of prolonged
      catecholamine infusion on immunoregulatory cell traffic and activation.
      BACKGROUND: Immunoregulation has been shown to be partially controlled by the
      sympathetic nervous system. Although short-term elevation of catecholamine levels
      is known to alter immunoregulatory cell traffic and activation, the effects of
      prolonged heightened sympathetic nervous system activity have not adequately been
      studied. We believe that the alterations in immune function seen in patients with
      congestive heart failure are linked to a prolonged elevation of circulating
      catecholamine levels. METHODS: To characterize the effects of prolonged elevation
      of catecholamine levels, rats received 4 weeks of constant infusion of
      epinephrine or norepinephrine through implanted osmotic minipumps. Peripheral and
      splenic leukocyte subsets, T cell proliferation and interleukin-2 receptor
      expression were quantified. Antibody production to the novel antigen keyhole
      limpet hemocyanin was assessed over the 4-week treatment period. RESULTS: Both
      epinephrine and norepinephrine caused significant splenic atrophy and cardiac
      hypertrophy; both were blocked by propranolol. Epinephrine induced lymphocytosis;
      both catecholamines caused an increase in natural killer cells. In the spleen,
      both epinephrine and norepinephrine led to a dose-dependent decrease in total T
      cells, suppressor/cytotoxic T cells and natural killer cells and a significant
      increase in B cells. Epinephrine at the low dose enhanced mitogen-induced
      proliferation and interleukin-2 receptor expression. Norepinephrine at the low
      dose appeared to diminish proliferation. Epinephrine tended to inhibit IgG
      antibody production, whereas norepinephrine had no effect. CONCLUSIONS: The
      results of our study indicate that prolonged elevation of catecholamine levels
      alters immune cell proliferation and differentiation. These alterations differ
      greatly from those induced by short-term stimulation but, for the most part,
      parallel those found in patients with congestive heart failure. We postulate that
      the shifts in immunoregulatory cell type and function seen in patients with
      congestive heart failure are due, in part, to longstanding increases in
      circulating catecholamine levels and may play an important role in the
      pathogenesis and progression of disease.

PMID- 7797739
TI  - Myocardial contrast echo effect: the dilemma of coronary blood flow and volume.
AB  - Despite the useful information provided by myocardial contrast echocardiography,
      the meaning of myocardial contrast intensity remains elusive. This review is
      meant to define the contribution of physical and biologic factors in producing
      myocardial contrast and to elucidate the relative roles of coronary blood flow
      and intramyocardial blood volume in determining contrast effect. The main
      physical factors influencing the contrast echo effect include the properties of
      microbubbles as scattering elements (mainly their radius, compressibility,
      stability and concentration), electronic signal processing, instrument setting
      and contrast-induced signal attenuation. The effect of these factors can be
      limited by an appropriate experimental or clinical setup. Biologic factors are
      less easily controllable, and changes in coronary blood flow and alterations in
      myocardial blood volume appear to be the main determinants of myocardial contrast
      intensity. Moreover, these factors influence contrast intensity in opposite
      directions. Both the area under the time-intensity curve and the mean transit
      time of myocardial contrast are inversely related to coronary blood flow but
      directly related to myocardial vascularity and blood volume. Therefore, an
      increase in coronary flow not accompanied by an increase in myocardial
      vascularity and volume is accompanied by a decrease in the area under the curve
      and mean transit time of contrast. Conversely, an increase in coronary flow
      mediated by augmented myocardial vascularity and volume will produce an increase
      in the area under the curve and mean transit time. A better understanding of the
      physical and biologic determinants of contrast echo intensity will be fundamental
      in the clinical application of new agents and technologies.

PMID- 7797740
TI  - Coronary angioplasty, atherectomy and bypass surgery in cardiac transplant
      recipients.
AB  - OBJECTIVES: This study sought to analyze the outcomes of revascularization
      procedures in the treatment of allograft coronary disease. BACKGROUND: Allograft
      vasculopathy is the main factor limiting survival of heart transplant recipients.
      Because no medical therapy prevents allograft atherosclerosis, and
      retransplantation is associated with suboptimal allograft survival, palliative
      coronary revascularization has been attempted. METHODS: Thirteen medical centers
      retrospectively analyzed their complete experience with percutaneous transluminal
      coronary angioplasty, directional coronary atherectomy and coronary bypass graft
      surgery in allograft coronary disease. RESULTS: Sixty-six patients underwent
      coronary angioplasty. Angiographic success (< or = 50% residual stenosis)
      occurred in 153 (94%) of 162 lesions. Forty patients (61%) are alive without
      retransplantation at 19 +/- 14 (mean +/- SD) months after angioplasty. The
      consequences of failed revascularization were severe. Two patients sustained
      periprocedural myocardial infarction and died. Angiographic restenosis occurred
      in 42 (55%) of 76 lesions at 8 +/- 5 months after angioplasty. Angiographic
      distal arteriopathy adversely affected allograft survival. Eleven patients
      underwent directional coronary atherectomy. Angiographic success occurred in 9
      (82%) of 11 lesions. Two periprocedural deaths occurred. Nine patients are alive
      without transplantation at 7 +/- 4 months after atherectomy. Bypass graft surgery
      was performed in 12 patients. Four patients died perioperatively. Seven patients
      are alive without retransplantation at 9 +/- 7 months after operation.
      CONCLUSIONS: Coronary revascularization may be an effective palliative therapy in
      suitable cardiac transplant recipients. Angioplasty has an acceptable survival in
      patients without angiographic distal arteriopathy. Because few patients underwent
      atherectomy and coronary bypass surgery, assessment of these procedures is
      limited. Angiographic distal arteriopathy is associated with decreased allograft
      survival in patients requiring revascularization.

PMID- 7797742
TI  - Angioscopic findings during coronary angioplasty of coronary occlusions.
AB  - OBJECTIVES: This study sought to elucidate angioscopic findings in totally
      occluded vessels before and after intervention. BACKGROUND: Coronary angioscopy
      allows direct visualization of the lumen surface of the coronary arteries;
      however, the utility of coronary angioscopy during coronary angioplasty of
      vessels with a total occlusion is unknown. METHODS: Twenty-one consecutive
      patients (mean [+/- SD] 58 +/- 9 years, range 39 to 77; 3 women, 18 men)
      undergoing dilation of an occluded vessel were studied with coronary angioscopy.
      Occlusions were classified as functional in 8 patients (Thrombolysis in
      Myocardial Infarction [TIMI] flow grade 1) and anatomic in 13 (TIMI flow grade
      0). Once the guide wire had crossed the occlusion, coronary angioscopy was
      attempted before and after angioplasty. RESULTS: In all patients, coronary
      angioscopy before dilation visualized protruding material occluding the coronary
      lumen where the guide wire was wedged. The occlusion consisted of red thrombus in
      19 patients (90%) (2 with isolated occlusive thrombus, 17 with thrombus
      associated with atherosclerotic plaque) and protruding yellow plaque in 2
      patients (10%). However, on angiography only 7 occlusions (33%) had data
      consistent with thrombus (p < 0.01 vs. coronary angioscopy). Successful dilation
      was obtained in 20 patients. After dilation, coronary angioscopy was repeated in
      18 patients, revealing residual thrombus with plaque in 16 (89%) and a residual
      yellow plaque in 2. In addition, coronary angioscopy revealed coronary
      dissections in 13 patients (72%); however, angiography revealed dissections only
      in 10 patients (55%) and residual thrombus in 2 (10%) (p < 0.001). In one
      patient, coronary angioscopy visualized silent distal embolization of a red
      thrombus not previously recognized on angiography. CONCLUSIONS: Before
      intervention, coronary angioscopy provides unique insights into the pathologic
      substrate of occluded coronary vessels. An occlusive plaque with thrombus is the
      most common underlying substrate in these lesions. After successful dilation,
      angiographically silent mural thrombus is seen in most patients. This information
      could be used to assist in the selection of candidates and type of coronary
      interventions and could also prove to be of prognostic value in patients with
      occluded vessels.

PMID- 7797741
TI  - Dynamic cardiomyoplasty: effect of discontinuing latissimus dorsi muscle
      stimulation on left ventricular systolic and diastolic performance and exercise
      capacity.
AB  - OBJECTIVES: This study sought to assess the short-term effect of discontinuing
      latissimus dorsi muscle stimulation on left ventricular systolic and diastolic
      performance and exercise tolerance in patients with improved functional status by
      cardiomyoplasty, in whom latissimus dorsi muscle was fully conditioned.
      BACKGROUND: Cardiomyoplasty has consistently improved the functional status of
      patients, but the short-term effect of latissimus dorsi muscle contraction has
      not been assessed in these patients. METHODS: Right-heart catheterization,
      Doppler-echocardiography and maximal exercise testing with expired gas analysis
      were performed in 10 patients with congestive heart failure who had undergone
      cardiomyoplasty at least 6 months earlier. Data were obtained when the latissimus
      dorsi muscle was stimulated every other systole and after stimulation was
      discontinued for 1 h. The power of this study to detect a 10% difference was >
      80%. RESULTS: After cardiomyoplasty, left ventricular ejection fraction increased
      from 0.22 +/- 0.08 (mean +/- SD) to 0.27 +/- 0.07 after 6 months (p < 0.02 vs.
      before cardiomyoplasty) and to 0.24 +/- 0.09 after 1 year; functional class went
      from 3.0 +/- 0.0 to 2.0 +/- 0.5 after 6 months and to 2.0 +/- 0.7 after 1 year
      (both p < 0.001 vs. before cardiomyoplasty). After discontinuation of latissimus
      dorsi muscle stimulation, cardiac index did not change (2.28 +/- 0.45 vs. 2.30 +/
      0.46 liters/min per m2). Mean systemic arterial and pulmonary capillary wedge
      pressures were also similar (85.2 +/- 6.0 vs. 88.4 +/- 5.6 mm Hg and 14.9 +/- 7.1
      vs. 13.6 +/- 6.8 mm Hg, respectively). Doppler E/A ratio decreased from 1.04 +/-
      0.33 to 0.83 +/- 0.25 (p < 0.02), suggesting that left ventricular diastolic
      function may have been improved by latissimus dorsi muscle stimulation. Peak
      oxygen consumption was unaltered (1,633 +/- 530 vs. 1,596 +/- 396 ml/min).
      CONCLUSIONS: Alterations in left ventricular diastolic rather than systolic
      function may be responsible for the long-term clinical benefits of
      cardiomyoplasty.

PMID- 7797745
TI  - Comparison of transesophageal and intracardiac electrophysiologic studies in
      characterization of supraventricular tachycardia in pediatric patients.
AB  - OBJECTIVES: This study sought to determine the accuracy of transesophageal
      electrophysiologic studies in diagnosing and characterizing various mechanisms of
      supraventricular tachycardia in pediatric patients. BACKGROUND: Transesophageal
      electrophysiologic studies are a relatively noninvasive means of characterizing
      supraventricular tachycardia. Although widely used, to our knowledge no data
      exist that directly compare information obtained from transesophageal
      electrophysiologic studies with that from intracardiac electrophysiologic
      studies. METHODS: We reviewed the records of 57 pediatric patients undergoing
      both transesophageal and intracardiac electrophysiologic studies at our
      institution. The results of these studies were compared with respect to mechanism
      of tachycardia, localization of accessory atrioventricular (AV) connections (if
      present) and characterization of anterograde accessory connection conduction
      properties. RESULTS: Tachycardia mechanisms were concordant in 56 of 57 patients:
      orthodromic reciprocating tachycardia in 43, antidromic reciprocating tachycardia
      in 1, both orthodromic and antidromic tachycardia in 2, AV node reentrant
      tachycardia in 5, atrial reentrant tachycardia in 4 and ectopic atrial
      tachycardia in 2. Of 29 patients with orthodromic reciprocating tachycardia using
      a concealed accessory connection, transesophageal study predicted the accessory
      connection site through changes induced by transient bundle branch block in 12.
      By the Bland-Altman method in 14 patients with pre-excitation, the anterograde
      accessory connection effective refractory period determined by transesophageal
      study compared favorably with that determined by intracardiac study (mean
      difference 5.0 ms, limits of agreement -55 and 65 ms). CONCLUSIONS:
      Transesophageal electrophysiologic studies are a highly accurate means of
      diagnosing and characterizing various mechanisms of supraventricular tachycardia
      in pediatric patients.

PMID- 7797743
TI  - Percutaneous transluminal coronary angioplasty as a first revascularization
      procedure in single-, double- and triple-vessel coronary artery disease.
AB  - OBJECTIVES: We sought to compare in-hospital and long-term outcome after
      angioplasty in patients with single-, double- and triple-vessel disease.
      BACKGROUND: Coronary angioplasty is increasingly used in patients with
      multivessel disease. METHODS: The source of data was the clinical data base at
      Emory University. Patients who had previous coronary revascularization or who
      underwent angioplasty in the setting of acute myocardial infarction were
      excluded. RESULTS: Of 10,783 patients, 71% had one-vessel, 24% two-vessel and 5%
      three-vessel disease. Age, male gender, diabetes, hypertension, history of
      previous myocardial infarction, Canadian Cardiovascular Society class III or IV
      angina and congestive failure all increased with severity of disease. Complete
      revascularization was achieved in most patients with one-vessel disease, in a
      minority with two-vessel disease and rarely in those with three-vessel disease.
      Emergency coronary bypass surgery increased from 1.7% with one-vessel disease to
      3.2% with three-vessel disease. Q wave myocardial infarctions could not be shown
      to vary significantly with severity of disease. The mortality rate increased from
      0.2% with one-vessel disease to 1.2% with three-vessel disease. The number of
      vessels diseased was a multivariate correlate of in-hospital and long-term
      mortality. The 1-, 5- and 10-year survival was 0.99, 0.93 and 0.86 for one-vessel
      disease and 0.97, 0.89 and 0.76 for two-vessel disease, respectively. The 1-, 5-
      and 9-year survival was 0.95, 0.85 and 0.70 in three-vessel disease,
      respectively. Freedom from myocardial infarction, coronary bypass surgery and
      repeat angioplasty was also lower with more severe disease. CONCLUSIONS: Patients
      have increasing in-hospital and long-term mortality as the severity of disease
      increases. There is also an increased incidence of myocardial infarction and
      revascularization procedures with more severe disease.

PMID- 7797744
TI  - Transesophageal echocardiography predicts mortality in critically ill patients
      with unexplained hypotension.
AB  - OBJECTIVES: This study sought to determine the prognostic yield and utility of
      transesophageal echocardiography in critically ill patients with unexplained
      hypotension. BACKGROUND: Transesophageal echocardiography is increasingly
      utilized in the intensive care setting and is particularly suited for the
      evaluation of hypotension; however, the prognostic yield of transesophageal
      echocardiography in these patients is unknown. METHODS: We prospectively studied
      61 adult patients in the intensive care unit with sustained (> 60 min)
      unexplained hypotension. Both transthoracic and transesophageal echocardiography
      were performed, and results were immediately disclosed to the primary physician,
      who reported any resulting changes in management. Patients were classified on the
      basis of transesophageal echocardiographic findings into one of three prognostic
      groups: 1) nonventricular (valvular, pericardial) cardiac limitation to cardiac
      output; 2) ventricular failure; and 3) noncardiac systemic disease (hypovolemia
      or low systemic vascular resistance, or both). Primary end points were death or
      discharge from the intensive care unit. RESULTS: A transesophageal
      echocardiographic diagnosis of nonventricular limitation to cardiac output was
      associated with improved survival to discharge from the intensive care unit (81%)
      versus a diagnosis of ventricular disease (41%) or hypovolemia/low systemic
      vascular resistance (44%, p = 0.03). Twenty-nine (64%) of 45 transthoracic
      echocardiographic studies were inadequate compared with 2 (3%) of 61
      transesophageal echocardiographic studies (p < 0.001). Transesophageal
      echocardiography contributed new clinically significant diagnoses (not seen with
      transthoracic echocardiography) in 17 patients (28%), leading to operation in 12
      (20%). CONCLUSIONS: Transesophageal echocardiography makes a clinically important
      contribution to the diagnosis and management of unexplained hypotension and
      predicts prognosis in the critical care setting.

PMID- 7797746
TI  - Left ventricular dimensions and autonomic balance during head-up tilt differ
      between patients with isoproterenol-dependent and isoproterenol-independent
      neurally mediated syncope.
AB  - OBJECTIVES: This study sought to elucidate differences in mechanisms of neurally
      mediated syncope between patients with syncope induced by head-up tilt alone and
      those requiring isoproterenol infusion to induce syncope during head-up tilt.
      BACKGROUND: Some patients with neurally mediated syncope require isoproterenol to
      induce syncope during head-up tilt (isoproterenol dependent), and others do not
      (isoproterenol independent). Differences in mechanisms between these two groups
      have not been well elucidated. METHODS: A 60 degrees head-up tilt test was
      performed in 13 patients with isoproterenol-independent syncope (Group I, mean
      [+/- SD] age 28 +/- 12 years), 14 patients with isoproterenol-dependent syncope
      (Group II, mean age 34 +/- 14 years) and 20 control subjects without syncope
      (Group III, mean age 32 +/- 12 years). Left ventricular size and contractility
      were determined by echocardiography, and sympathovagal balance was determined
      with power spectral analysis of heart rate variability using a maximal entropy
      method. RESULTS: Group I patients had smaller left ventricular dimensions than
      Group II and III during baseline tilt. During head-up tilt with isoproterenol
      infusion (0.01 to 0.04 microgram/kg body weight per min), left ventricular
      dimensions decreased to the same extent in Groups II and III, but fractional
      shortening was greater in Group II than in Group III at the end of the tilt. The
      ratio of low (0.05 to 0.15 Hz) to high frequency (0.15 to 1.0 Hz) component
      became greater in Group I than in Groups II and III during the last period of
      baseline tilt. However, the ratio was greater in Group II than in Group III
      during the last period of the tilt with isoproterenol. CONCLUSIONS: Patients with
      isoproterenol-independent syncope had an exaggerated decrease in left ventricular
      size and sympathetic predominance preceding syncope during head-up tilt. In
      contrast, in patients with isoproterenol-dependent syncope, similar changes in
      autonomic nervous balance were evident only during isoproterenol infusion in
      addition to head-up tilt.

PMID- 7797747
TI  - Dispersion of QT interval in patients with and without susceptibility to
      ventricular tachyarrhythmias after previous myocardial infarction.
AB  - OBJECTIVES: The aim of this study was to estimate the value of QT dispersion
      measurement from the standard 12-lead electrocardiogram (ECG) in identifying
      patients susceptible to reentrant ventricular tachyarrhythmias after a previous
      myocardial infarction. BACKGROUND: Variability in QT interval duration on the
      different leads of the 12-lead ECG has been proposed as an indicator of risk for
      ventricular arrhythmias in different clinical settings, but the value of QT
      dispersion measurement in identifying patients at risk for reentrant ventricular
      tachyarrhythmias after myocardial infarction is not known. METHODS: The QT
      interval duration, QT dispersion and clinical and angiographic variables were
      compared between 30 healthy subjects; 40 patients with a previous myocardial
      infarction but no history of arrhythmic events or inducible ventricular
      tachycardia during programmed electrical stimulation; and 30 postinfarction
      patients with a history of cardiac arrest (n = 12) or sustained ventricular
      tachycardia (n = 18) and inducible, sustained monomorphic ventricular tachycardia
      by electrical stimulation. RESULTS: Dispersion of the corrected QT interval (QTc)
      differed significantly between the study groups and was significantly increased
      in patients with susceptibility to ventricular tachyarrhythmias ([mean +/- SD]
      104 +/- 41 ms) compared with that in both healthy subjects (38 +/- 14 ms, p <
      0.001) and postinfarction patients with no susceptibility to arrhythmias (65 +/-
      31 ms, p < 0.001). Maximal QT interval duration was also prolonged in the group
      with arrhythmias compared with that in the other groups (p < 0.001). Multivariate
      analysis, including clinical and angiographic variables, QT dispersion and
      maximal QT interval, showed that QT dispersion was the independent factor that
      most effectively identified the patient groups with and without susceptibility to
      ventricular tachyarrhythmias (p < 0.001). CONCLUSIONS: Increased QT dispersion is
      related to susceptibility to reentrant ventricular tachyarrhythmias, independent
      of degree of left ventricular dysfunction or clinical characteristics of the
      patient, suggesting that the simple, noninvasive measurement of this interval
      from a standard 12-lead ECG makes a significant contribution to identifying
      patients at risk for life-threatening arrhythmias after a previous myocardial
      infarction.

PMID- 7797748
TI  - Stress echocardiography: comparison of exercise, dipyridamole and dobutamine in
      detecting and predicting the extent of coronary artery disease.
AB  - OBJECTIVES: This study was designed to compare exercise, dipyridamole and
      dobutamine echocardiography in the same patients and to evaluate, by measuring
      physiologic and echocardiographic variables, the mechanisms by which exercise and
      dobutamine induce ischemia. BACKGROUND: The diagnostic value of stress
      echocardiography has been widely reported, but the specific effects of exercise,
      dipyridamole and dobutamine have not been directly compared. Furthermore, no
      echocardiography study has evaluated left ventricular volume changes at ischemic
      threshold during exercise and dobutamine administration. METHODS: One hundred
      patients with suspected (Group A, n = 60) or known (Group B, n = 40) coronary
      artery disease underwent all three tests in random order. RESULTS: In Group A,
      the sensitivities of exercise (mean 76%, 95% confidence interval [CI] 58% to 94%)
      and of dobutamine echocardiography (72%, 95% CI 53% to 91%) were higher than that
      of dipyridamole (52%, 95% CI 31% to 73%; p = 0.01 and p = 0.02, respectively).
      Specificity did not differ significantly among tests (94% for exercise [95% CI
      86% to 100%] and 97% for dipyridamole and dobutamine [95% CI 91% to 100%]).
      Accuracy was identical for exercise and dobutamine (87%) and higher than that for
      dipyridamole (78%, p = 0.06). In Group B, the accuracy in predicting coronary
      disease extent was 71% for exercise, 33% for dipyridamole and 75% for dobutamine.
      At ischemic threshold, end-systolic volume index and the ratio of systolic blood
      pressure to end-systolic volume, a variable related to myocardial contractility,
      were significantly lower and higher, respectively, with dobutamine than during
      exercise (p < 0.05). CONCLUSIONS: In a clinical setting, exercise
      echocardiography should represent the first diagnostic approach because it has
      high diagnostic efficacy and provides additional information on exercise
      capacity; pharmacologic stress, particularly that of dobutamine, provides a
      pivotal diagnostic tool when exercise is not feasible or its results are
      nondiagnostic. Our preliminary data on echocardiographic evaluation at ischemic
      threshold support the view that myocardial contractility is a major factor in
      inducing ischemia during dobutamine infusion.

PMID- 7797749
TI  - Motor vehicle accidents in patients with an implantable cardioverter
      defibrillator.
AB  - OBJECTIVES: This study was designed to examine driving safety in patients at risk
      for sudden death after implantation of a cardioverter-defibrillator. BACKGROUND:
      Cardioverter-defibrillators are frequently implanted in patients at high risk for
      sudden death. Despite concern about the safety of driving in these patients,
      little is known about their actual motor vehicle accident rates. METHODS: Surveys
      were sent to all 742 physicians in the United States involved in cardioverter
      defibrillator implantation and follow-up. Physicians were questioned about
      numbers of patients followed up, numbers of fatal and nonfatal accidents,
      physician recommendations to patients about driving and knowledge of state
      driving laws. RESULTS: Surveys were returned by 452 physicians (61%). A total of
      30 motor vehicle accidents related to shocks from implantable defibrillators were
      reported by 25 physicians over a 12-year period from 1980 to 1992. Of these, nine
      were fatal accidents involving eight patients with a defibrillator and one
      passenger in a car driven by a patient. No bystanders were fatally injured. There
      were 21 nonfatal accidents involving 15 patients, 3 passengers and 3 bystanders.
      The estimated fatality rate for patients with a defibrillator, 7.5/100,000
      patient-years, is significantly lower than that for the general population
      (18.4/100,000 patient-years, p < 0.05). The estimated injury rate, 17.6/100,000
      patient-years, is also significantly lower than that for the general public
      (2,224/100,000 patient-years, p < 0.05). Only 10.5% (30 of 286) of all
      defibrillator discharges during driving resulted in accidents. Regarding
      physician recommendations, most physicians (58.1%) ask their patients to wait a
      mean (+/- SD) of 7.3 +/- 3.4 months after implantation or a shock before driving
      again. CONCLUSIONS: The motor vehicle accident rate caused by discharge from an
      implantable cardioverter-defibrillator is low. Although restricting driving for a
      short period of time after implantation may be appropriate, excessive
      restrictions or a total ban on driving appears to be unwarranted.

PMID- 7797750
TI  - Electrophysiologic characteristics of cells spanning the left ventricular wall of
      human heart: evidence for presence of M cells.
AB  - OBJECTIVES: The present work was designed to provide an initial characterization
      of M cells in the normal human heart. BACKGROUND: Recent studies have uncovered a
      unique population of cells in the midmyocardial region of the canine ventricle.
      These cells, named M cells, were found to possess electrophysiologic features and
      a pharmacologic responsiveness different from those of other myocardial cells.
      Although well characterized in the dog, their presence or absence in the human
      heart is unknown. METHODS: Standard microelectrode techniques were used to map
      slices of ventricular free wall obtained from normal human hearts (n = 4).
      Preparations were paced at cycle lengths ranging from 1 to 10 s. RESULTS: We
      identified three cell subtypes: endocardial, subepicardial (M cells) and
      epicardial cells. The principal features differentiating M cells from the other
      cell subtypes were their longer action potential duration, more accentuated
      action potential duration rate relations and greater maximal rate of increase in
      action potential upstroke (Vmax). Our findings suggest that M cells represent
      approximately 30% of the cellular mass of the left ventricular wall. Concordance
      between changes in their repolarization and changes in QTU interval provide
      support for the role of M cells in the generation of the electrocardiographic
      (ECG) U wave. CONCLUSIONS: This study provides evidence for the existence of M
      cells in the human heart that contribute to heterogeneity of repolarization
      within the ventricular wall. Our findings provide strong support for the
      hypothesis that M cells contribute importantly to the manifestation of the U wave
      on the ECG.

PMID- 7797751
TI  - The U wave and the M cell.

PMID- 7797752
TI  - Geometric changes allow normal ejection fraction despite depressed myocardial
      shortening in hypertensive left ventricular hypertrophy.
AB  - OBJECTIVES: This study of hypertensive left ventricular hypertrophy 1) assessed
      myocardial shortening in both the circumferential and long-axis planes, and 2)
      investigated the relation between geometry and systolic function. BACKGROUND: In
      hypertensive left ventricular hypertrophy, whole-heart studies have suggested
      normal systolic function on the basis of ejection fraction-systolic stress
      relations. By contrast, isolated muscle data show that contractility is
      depressed. It occurred to use that this discrepancy could be related to geometric
      factors (relative wall thickness). METHODS: We studied 43 patients with
      hypertensive left ventricular hypertrophy and normal ejection fraction (mean +/-
      SD 69 +/- 13%) and 50 clinically normal subjects. By echocardiography, percent
      myocardial shortening was measured in two orthogonal planes; circumferential
      shortening was measured at the endocardium and at the midwall, and long-axis
      shortening was derived from mitral annular motion (apical four-chamber view).
      Circumferential shortening was related to end-systolic circumferential stress and
      long-axis shortening to meridional stress. RESULTS: Endocardial circumferential
      shortening was higher than normal (42 +/- 10% vs. 37 +/- 5%, p < 0.01) and
      midwall circumferential shortening lower than normal in the left ventricular
      hypertrophy group (18 +/- 3% vs. 21 +/- 3%, p < 0.01). Differences between
      endocardial and midwall circumferential shortening are directly related to
      differences in relative wall thickness. Long-axis shortening was also depressed
      in the left ventricular hypertrophy group (18 +/- 6% in the left ventricular
      hypertrophy group, 21 +/- 5% in control subjects, p < 0.05). Midwall
      circumferential shortening and end-systolic circumferential stress relations in
      the normal group showed the expected inverse relation; those for approximately
      33% of the left ventricular hypertrophy group were > 2 SD of normal relations,
      indicating depressed myocardial function. There was no significant relation
      between long-axis shortening and meridional stress, indicating that factors other
      than afterload influence shortening in this plane. CONCLUSIONS: High relative
      wall thickness allows preserved ejection fraction and normal circumferential
      shortening at the endocardium despite depressed myocardial shortening in two
      orthogonal planes.

PMID- 7797753
TI  - Chiari's network: normal anatomic variant or risk factor for arterial embolic
      events?
AB  - OBJECTIVES: This study was performed to assess the prevalence of Chiari's network
      in patients undergoing transesophageal echocardiography and to determine whether
      this anomaly is associated with other cardiac lesions or is characterized by
      typical clinical findings. BACKGROUND: Chiari's network is a congenital remnant
      of the right valve of the sinus venosus. It has been found in 1.3% to 4% of
      autopsy studies and is believed to be of little clinical consequence. METHODS:
      Video recordings of 1,436 consecutive adult patients evaluated by transesophageal
      echocardiography over a 30-month period were reviewed for the presence of
      Chiari's network. Echocardiographic contrast studies had been performed in all
      patients with Chiari's network and were compared with those of 160 consecutive
      patients without a Chiari net, serving as a control group. RESULTS: Chiari's
      network was present in 29 of 1,436 patients (prevalence 2%). A frequently
      associated finding was a patent foramen ovale in 24 (83%) of the 29 patients with
      Chiari's network versus 44 (28%) of 160 control patients (p < 0.001). Intense
      right-to-left shunting occurred significantly more often in patients with
      Chiari's network than in control patients (16 [55%] of 29 patients vs. 19 [12%]
      of 160 control patients, p < 0.001). Another frequent association was an atrial
      septal aneurysm in 7 (24%) of 29 patients. The indication for transesophageal
      echocardiography was a suspected cardiac source of arterial embolism in 24 (83%)
      of 29 patients with a Chiari net, 13 of whom (54%) had recurrent embolic events.
      Chiari's network was significantly more common in patients with unexplained
      arterial embolism than in patients evaluated for other indications (24 [4.6%] of
      522 patients vs. 5 [0.5%] of 914 patients, p < 0.001). Potential causes for
      arterial embolism were present in 9 of the 24 patients with a Chiari net and
      embolic events (atrial septal aneurysm in 7, cerebrovascular lesion in 2). In 15
      (62%) of 24 patients only a patent foramen ovale could be identified. Three
      patients had deep venous thrombosis and pulmonary embolism at the time of
      arterial embolism; none had a thrombus detected within the network. CONCLUSIONS:
      In patients undergoing transesophageal echocardiography, the prevalence of
      Chiari's network was 2%, which is consistent with autopsy studies. By maintaining
      an embryonic right atrial flow pattern into adult life and directing the blood
      from the inferior vena cava preferentially toward the interatrial septum,
      Chiari's network may favor persistence of a patent foramen ovale and formation of
      an atrial septal aneurysm and facilitate paradoxic embolism.

PMID- 7797754
TI  - Cardiac function in smokers and nonsmokers: the CARDIA study. The Coronary Artery
      Risk Development in Young Adults Study.
AB  - OBJECTIVES: This study assessed clinical and echocardiographic measures of
      cardiac function at rest in smokers and nonsmokers to determine the associations
      of cigarette smoking with various measures of left and right ventricular
      performance. BACKGROUND: Whereas the immediate cardiovascular effects of
      cigarette smoking have been well described, the long-term effects in an otherwise
      healthy cohort have not. Of particular interest were associations with heart
      rate, left ventricular end-systolic stress and left ventricular mass because
      higher levels of these measures would suggest increased myocardial oxygen
      consumption. METHODS: In year 5 of the Coronary Artery Risk Development in Young
      Adults (CARDIA) study, 3,366 smokers and nonsmokers (ex-smokers were excluded)
      underwent echocardiography as well as assessment of heart rate, anthropometric
      measurements and blood pressure. Participants ranged in age from 23 to 35 years
      and were equally distributed by race and gender. Echocardiographic measures
      included pulsed Doppler pulmonary artery acceleration time (a decrease suggests
      increased pulmonary artery pressure), left ventricular mass, left ventricular end
      systolic stress and left ventricular fractional shortening. RESULTS: All
      comparisons were between smokers and nonsmokers. Heart rate at rest was
      significantly higher in smokers by 1.5 to 5 beats/min in all race/gender groups
      except black men. In men who smoked, pulmonary artery acceleration time was
      significantly lower by 4 to 8 ms. Except for black male smokers, there was a
      trend toward increased left ventricular mass (3 to 8 g) in all race/gender
      groups, significant in black women. Left ventricular end-systolic stress was
      significantly higher in women who smoked (4 to 6 dynes/cm2). There were no
      differences for systolic blood pressure or left ventricular fractional
      shortening. CONCLUSION: In an assessment of cardiovascular function at rest in
      young adults, quantifiable differences between smokers and nonsmokers that
      predict increased rest myocardial oxygen consumption in smokers were found. Some
      of these differences were gender specific.

PMID- 7797755
TI  - Myocardial velocity gradient as a new indicator of regional left ventricular
      contraction: detection by a two-dimensional tissue Doppler imaging technique.
AB  - OBJECTIVES: This study was performed to assess a new indicator of regional left
      ventricular contraction determined by a two-dimensional tissue Doppler imaging
      technique. BACKGROUND: Recent studies have demonstrated that instantaneous tissue
      motion velocity can be noninvasively assessed by tissue Doppler imaging. However,
      quantitative assessment of regional left ventricular contraction is still
      difficult because of the effects of the Doppler angle of incidence and parallel
      motion of the whole heart. METHODS: We assessed left ventricular wall motion in
      11 normal subjects, 14 patients with an old myocardial infarction (anteroseptal
      in 7, posterior in 7) and 8 patients with dilated cardiomyopathy. Tissue Doppler
      velocity was corrected by the Doppler angle of incidence after the hypothetical
      center of contraction was set. Subsequently, the myocardial velocity gradient
      between the endocardium and epicardium was determined from the velocity profile
      along each radial line from the center of contraction by using least squares
      linear regression. RESULTS: In normal subjects, peak myocardial velocity gradient
      was lower in the anteroseptal wall (mean [+/- SD] 1.69 +/- 0.53 s-1) than in the
      posterior wall (3.28 +/- 0.67 s-1, p < 0.01). Myocardial velocity gradient in the
      infarct regions was significantly lower (anteroseptal 0.58 +/- 0.41 s-1, p <
      0.05; posterior 0.17 +/- 0.27 s-1, p < 0.01) than that in normal subjects as well
      as that in the corresponding noninfarct regions (2.84 +/- 0.37 s-1 and 1.48 +/-
      0.25 s-1, p < 0.01, respectively). In patients with dilated cardiomyopathy,
      myocardial velocity gradient was generally lower (anteroseptal 0.72 +/- 0.59 s-1;
      posterior 0.93 +/- 0.67 s-1) than that in normal subjects (p < 0.01).
      CONCLUSIONS: These results demonstrate that regional left ventricular contraction
      can be quantitatively assessed by the myocardial velocity gradient derived from
      two-dimensional tissue Doppler imaging. We suggest that myocardial velocity
      gradient has potential for the quantitative assessment of regional left
      ventricular contraction abnormalities in patients.

PMID- 7797756
TI  - Left ventricular blood flow patterns in normal subjects: a quantitative analysis
      by three-dimensional magnetic resonance velocity mapping.
AB  - OBJECTIVES: Magnetic resonance velocity mapping was used to investigate the
      hypothesis of a vortex motion within the left ventricle interacting with mitral
      valve motion and inflow velocity. BACKGROUND: In vitro flow visualization studies
      have suggested the presence of a large anterior vortex inside the left ventricle
      during mitral inflow. However, to our knowledge the occurrence of this phenomenon
      has not been demonstrated in the human left ventricle. METHODS: Magnetic
      resonance velocity mapping was performed in 26 healthy volunteers using a flow
      adjusted gradient sequence for three-dimensional flow velocity acquisition in the
      long-axis plane of the left ventricle. By computer processing, the flow vectors
      in the left ventricle were visualized and animated dynamically. RESULTS: The
      early diastolic mitral inflow was apically directed, and a large counterclockwise
      anterior vortex was created within the left ventricle shortly after the onset of
      the mid-diastolic semiclosure of the anterior mitral leaflet. During mid
      diastolic diastasis, mitral inflow ceased until the flow accelerated again at
      atrial systole. The final closure of the mitral valve was preceded by a smaller
      vortex seen at the tips of the mitral leaflets. At systolic ejection, all flow
      vectors were directed toward the left ventricular outflow tract. The anterior
      vortex had a radius of 1.62 +/- 0.24 cm (mean +/- SD), and the average angular
      velocity (i.e., the rotation of an element about the center of the vortex within
      the central core) was 30.08 +/- 9.98 radians/s. The maximal kinetic energy of the
      anterior vortex was 4.3 x 10(-4) +/- 7.1 x 10(-5) J. CONCLUSIONS: The hypothesis
      of a diastolic vortex formation in the human left ventricle was confirmed, and
      its close temporal relation to the motion of the anterior mitral leaflet was
      demonstrated.

PMID- 7797757
TI  - Simultaneous measurement of pulmonary venous flow by intravascular catheter
      Doppler velocimetry and transesophageal Doppler echocardiography: relation to
      left atrial pressure and left atrial and left ventricular function.
AB  - OBJECTIVES: The aim of our study was to compare measurements of pulmonary venous
      flow velocity obtained either by transesophageal Doppler echocardiography or by
      intravascular catheter Doppler velocimetry. Furthermore, the relation among
      pulmonary venous flow velocity, left atrial compliance and left atrial pressure
      was evaluated. BACKGROUND: Data about the relation between left atrial pressure
      and pulmonary venous flow velocity are controversial. METHODS: A total of 32
      patients undergoing elective open heart surgery for coronary artery bypass
      grafting were included prospectively in the study. Pulmonary venous flow velocity
      (Doppler catheter) and left atrial pressure (microtip pressure transducer) were
      recorded simultaneously with recordings of pulmonary venous flow velocity
      obtained by transesophageal Doppler echocardiography. RESULTS: Agreement between
      Doppler catheter and Doppler echocardiographic measurements of pulmonary venous
      flow velocity (n = 18 patients) was analyzed using the Bland-Altmann technique.
      The 95% limits of agreement were -0.16 to +0.11 m/s for systolic peak velocity, 
      0.14 to +0.09 m/s for diastolic peak velocity and -0.12 to +0.10 m/s for atrial
      peak velocity. The closest agreement between both methods was found for the ratio
      of systolic to diastolic peak velocity, the ratio of systolic to diastolic flow
      duration and the time from Q deflection on the electrocardiogram to maximal flow
      velocity. Mean left atrial pressure was strongly correlated with the ratio of
      systolic to diastolic peak velocity (r = -0.829), systolic velocity-time integral
      (r = -0.653), time to maximal flow velocity (r = 0.844) and the ratio of systolic
      to diastolic flow duration (r = -0.556). The ratio of systolic to diastolic peak
      velocity and the time to maximal flow velocity were identified as strong
      independent predictors of mean left atrial pressure. Left atrial compliance was
      not found to be an independent predictor of mean left atrial pressure.
      CONCLUSIONS: Flow velocity in the left upper pulmonary vein can be reliably
      recorded by transesophageal pulsed wave Doppler echocardiography. Our data reveal
      further evidence that mean left atrial pressure can be estimated by the pattern
      of pulmonary venous flow velocity.

PMID- 7797758
TI  - Evolution of coronary artery pattern according to short-axis aortopulmonary
      rotation: a new categorization for complete transposition of the great arteries.
AB  - OBJECTIVES: We studied the correlation between coronary artery pattern and
      aortopulmonary rotation in complete transposition of the great arteries.
      BACKGROUND: Classifications of the coronary arteries in complete transposition
      are puzzling and incomplete. METHODS: Coronary artery anatomy and relation of the
      great arteries were identified at angiography, echocardiography, surgical
      intervention or autopsy in 76 patients with complete transposition from 1988 to
      1993. Five main types (type 0 and Shaher types 1,2,4 and 9) and their similar
      variants of epicardial configuration were categorized into five patterns (O, I,
      II, IV and IX). In addition, data from 568 cases from published reports were
      collected for analysis. RESULTS: As the aorta rotated from a left anterior to a
      directly anterior location relative to the pulmonary trunk, the left anterior
      descending coronary artery arose from the left-hand sinus together with the right
      coronary artery (type 0, one case decreased to no cases); then it gradually
      shifted to the left to have the same origin as the left circumflex coronary
      artery from the right-hand sinus (type 1, 10 cases increased to 146, p < 0.0003).
      When the aorta rotated farther clockwise from directly anterior to right anterior
      (type 1, 146 cases increased to 235; type 2, 9 cases increased to 50, p < 0.0006)
      or from right anterior to right lateral (type 1, 235 cases decreased to 6 cases;
      type 2, 50 cases decreased to 20, p < 0.00000), the left circumflex coronary
      artery tended to move retropulmonically and originated from the left-hand sinus
      with the right coronary artery (type 2). When the aorta moved from right anterior
      to right lateral (type 2, 50 cases decreased to 20; type 4, 13 cases increased to
      14, p < 0.031) or from right lateral to right posterior (type 2, 20 cases
      decreased to 1; type 4, 14 cases increased to 16, p < 0.0003), the right coronary
      artery shifted to the right-hand sinus anteaortically to join the left anterior
      descending coronary artery (type 4). Finally, the left anterior descending
      coronary artery combined with the left circumflex coronary artery (type 9, 12
      cases increased to 21, p = 0.407) to become the usual pattern for normally
      related great arteries. Eta-square analysis showed that the evolution from
      pattern O to IX was dependent on clockwise aortopulmonary rotation. CONCLUSIONS:
      The coronary arteries in complete transposition of the great arteries can be
      classified into five patterns and their evolution deduced on the basis of
      aortopulmonary rotation. Dependence of coronary artery type on aortopulmonary
      rotation made it possible to anticipate the coronary pattern from the relation of
      the great arteries in transposition.

PMID- 7797760
TI  - Enhanced detection of myocardial ischemia by stress dobutamine echocardiography
      utilizing the "biphasic" response of wall thickening during low and high dose
      dobutamine infusion.
AB  - OBJECTIVES: We sought to assess the ability of the "biphasic" response (i.e.,
      initial improvement in wall thickening followed by reduced wall thickening)
      during serial dobutamine stress echocardiography to detect ischemia in patients
      with a wall motion abnormality. Furthermore, we compared the power of the
      biphasic echocardiographic response with that of myocardial perfusion imaging for
      the detection of myocardial ischemia. BACKGROUND: Stress echocardiography has
      been shown to be less sensitive than radionuclide perfusion imaging for detecting
      ischemia in patients with a wall motion abnormality. Peak stress wall thickening
      in such areas may not give a full account of the intermediate changes, whereas
      initial improvement (the biphasic response) may enhance diagnosis. METHODS:
      Patients with a wall motion abnormality and documented coronary artery disease
      underwent simultaneous graded dobutamine (5 to 40 micrograms/kg body weight per
      min) stress echocardiography and radionuclide perfusion imaging with single
      photon emission computed tomography using either technetium-99m sestamibi or
      technetium-99m tetrofosmin. Semiquantitative analyses of image groups were
      performed in blinded manner by two separate groups of observers. RESULTS:
      Myocardial ischemia was detected by perfusion imaging in 45 of the 54 patients.
      High dose dobutamine echocardiography detected ischemia in only 25 (56%) of these
      patients. However, when the biphasic response was taken into account, ischemia
      was detected in 44 (98%) of the 45 patients (p < 0.001). Agreement between
      radionuclide imaging and echocardiographic findings for the detection of ischemia
      was significantly enhanced (p = 0.03) when the biphasic response was used (89%,
      kappa = 0.51) instead of high dose stress dobutamine echocardiography (56%, kappa
      = 0.10). CONCLUSIONS: The detection of myocardial ischemia may be significantly
      enhanced by utilizing the biphasic response during serial stress dobutamine
      echocardiography in patients with a wall motion abnormality.

PMID- 7797759
TI  - Effect of late postoperative atrial septal defect closure on hemodynamic function
      in patients with a Lateral tunnel Fontan procedure.
AB  - OBJECTIVES: The aim of this study was to evaluate prospectively the effect of
      late atrial septal defect closure on cardiac output and oxygen delivery in
      patients who have undergone the Fontan procedure. BACKGROUND: An adjustable
      atrial septal defect is incorporated in patients undergoing the Fontan procedure
      who have increased pulmonary vascular resistance or poor ventricular function, or
      both. After the Fontan procedure, the atrial septal defect is test occluded.
      Patients with mean right atrial and pulmonary artery pressures > 15 mm Hg are
      discharged with the atrial septal defect open. METHODS: Twelve patients (20
      months to 12 years old) underwent evaluation and closure of the atrial septal
      defect at a mean interval of 3.8 months (range 1 to 18) after the Fontan
      procedure. Each patient underwent full right and left heart catheterization.
      Cardiac output was obtained using the cine-volume method. The study included six
      patients with a high transpulmonary gradient or poor ventricular function
      preoperatively, or both (high risk group) and six who had only borderline
      increased pulmonary vascular resistance (low risk group). Patients in both groups
      had a mean right atrial pressure > 15 mm Hg when the atrial defect was test
      occluded in the first week after the Fontan procedure. RESULTS: All results are
      given as mean value +/- SD. Ventricular end-diastolic pressure was significantly
      lower (p = 0.03) with the atrial septal defect open in low risk patients (6 +/- 3
      mm Hg) than in high risk patients (10 +/- 3 mm Hg). With the atrial septal defect
      open, low risk patients had a significantly higher (p = 0.04) cardiac index (4.87
      +/- 0.81 liters/min per m2) than the high risk patients (3.96 +/- 0.47 liters/min
      per m2). There was no significant difference (p = 0.14) in cardiac index between
      the two groups with occlusion of the atrial septal defect. Oxygen delivery was
      also significantly higher (p < 0.05) with the atrial septal defect open in low
      risk patients (836 +/- 99 ml/min per m2) than in high risk patients (704 +/- 106
      ml/min per m2). There was no significant difference (p = 0.89) in oxygen delivery
      between the two groups with occlusion of the atrial septal defect. With the
      atrial septal defect open, the interatrial gradient was not significantly
      different in low risk patients (4 +/- 1 mm Hg) from that in high risk patients (4
      +/- 1 mm Hg). CONCLUSIONS: These data show that an interatrial communication
      results in increased postoperative systemic perfusion and oxygen delivery in
      patients with good diastolic ventricular function after the Fontan procedure.

PMID- 7797761
TI  - Incidence of aneurysm formation after Dacron patch aortoplasty repair for
      coarctation of the aorta: long-term results and assessment utilizing magnetic
      resonance angiography with three-dimensional surface rendering.
AB  - OBJECTIVES: Magnetic resonance angiography with three-dimensional surface
      rendering was performed to determine its value in assessing anatomic detail in
      patients with suspected aortic aneurysms. BACKGROUND: Dacron patch aortoplasty
      repair of coarctation of the aorta carries an inherent risk of aneurysm
      development. Sudden death from aortic rupture prompted discontinuing this
      operation and evaluating 39 patients (16 girls; mean age 6.3 years, range 10 days
      to 14.5 years) undergoing repair between January 1976 and October 1987. The aorta
      ruptured in 10 patients; 6 died at a mean interval of 8.1 years (range 0.75 to
      12.4) after repair. All 33 survivors were interviewed and examined. METHODS:
      Conventional magnetic resonance imaging was performed in 26 patients, magnetic
      resonance angiography in 18. Angiographic slices were used to reconstruct three
      dimensional images. No catheterization or contrast angiography was performed.
      Surgical intervention was based on clinical findings and magnetic resonance
      images. RESULTS: Twenty patients (11 girls) developed aneurysms, of which nine
      were detected in patients studied by magnetic resonance. Ruptures occurred in
      eight female patients, three of whom were pregnant. Surface renderings accurately
      defined aortic anatomy or aneurysms in all patients. On follow-up, no aneurysms
      have been detected in patients with negative magnetic resonance study results.
      Precise anatomic correlation with operative findings was reported. CONCLUSIONS:
      Magnetic resonance angiography with three-dimensional surface rendering provides
      noninvasive, radiation-free and contrast agent-free high resolution images of the
      thoracic aorta. These images can be reviewed and have three-dimensional form and
      perspective. These techniques were preferred over invasive angiography by
      surgeons and clinicians as definitive, risk-free procedures before surgical
      intervention.

PMID- 7797762
TI  - Evaluation of pulmonary artery histopathologic findings in congenital heart
      disease: an in vitro study using intravascular ultrasound imaging.
AB  - OBJECTIVES: This study aimed to 1) compare in vitro intravascular ultrasound
      images of human pulmonary arteries with corresponding histologic sections, and 2)
      correlate the relation between intravascular ultrasound findings and Heath
      Edwards pathologic grade of pulmonary vascular changes. BACKGROUND: The
      pathologic assessment of the pulmonary vascular bed is essential for diagnosis
      and management of congenital heart disease with pulmonary hypertension. METHODS:
      We evaluated and compared intravascular ultrasound images with histologic
      findings at identical sites in 40 pulmonary artery segments from 17 autopsy
      studies: group 1 = 7 patients with pulmonary hypertension (Heath-Edwards grade I
      to V, 20 segments); group 2 = 10 patients without cardiopulmonary disease (20
      segments). RESULTS: In group 2, the pulmonary artery wall echo consisted of a
      single layer. In group 1, 1) all segments of pulmonary arteries from patients
      with pulmonary hypertension showed a three-layered appearance; 2) in patients
      with mild pulmonary hypertension (Heath-Edwards grades I and II), intravascular
      ultrasound demonstrated increased thickness of the echoluscent zone due to medial
      hypertrophy with no intimal reaction; 3) patients with severe pulmonary
      hypertension (Health-Edwards grade III or higher) had intravascular ultrasound
      findings of increased medial thickness and a bright inner layer from intimal
      hyperplasia; 4) percent wall thickness derived from intravascular ultrasound
      showed a significant correlation with that determined by histologic examination
      (r = 0.89, p = 0.0001, n = 20). CONCLUSIONS: Changes observed with intravascular
      ultrasound imaging correlate well with histopathologic grade. Thus, intravascular
      ultrasound may have significant utility in the evaluation of pulmonary vascular
      morphology in patients with pulmonary hypertension.

PMID- 7797763
TI  - Idiopathic atrial fibrillation in dogs: electrophysiologic determinants and
      mechanisms of antiarrhythmic action of flecainide.
AB  - OBJECTIVES: This study sought to determine the mechanisms of idiopathic atrial
      fibrillation and the atrial antifibrillatory action of flecainide in dogs.
      BACKGROUND: In a small subset of dogs, sustained atrial fibrillation can be
      readily induced in the absence of vagal tone. The electrophysiologic mechanisms
      underlying this ability to sustain atrial fibrillation, and of flecainide action
      on the arrhythmia, are unknown. METHODS: Six dogs with inducible sustained atrial
      fibrillation were studied before and after flecainide administration and compared
      with a control group of 10 dogs. RESULTS: Dogs with atrial fibrillation differed
      in displaying more shortening of the atrial refractory period with increased
      rate, resulting in a significantly shorter refractory period and wavelength for
      reentry at rapid rates, and in increased regional dispersion in refractoriness.
      Activation maps during sustained fibrillation showed a mean (+/- SE) of 6.3 +/-
      0.4 coexistent zones of reentry, compatible with short wavelengths, whereas in
      control dogs activation during self-limited atrial fibrillation was better
      organized, and the number of reentrant circuits was smaller. Quantitative
      analysis demonstrated significantly greater inhomogeneity of activation during
      atrial fibrillation in dogs with atrial fibrillation than in control animals.
      Flecainide terminated atrial fibrillation by increasing the duration and
      homogeneity of atrial refractoriness at rapid rates, thereby reducing the number
      of reentry circuits and the heterogeneity of activation. CONCLUSIONS: The ability
      of atrial fibrillation to sustain itself resulted from enhanced rate-dependent
      shortening of atrial refractoriness and increased regional heterogeneity.
      Flecainide reversed these changes and restored sinus rhythm. These results
      suggest potential mechanisms of idiopathic atrial fibrillation and are pertinent
      to understanding the clinical actions of flecainide.

PMID- 7797765
TI  - President's page: expanding the role of the American College of Cardiology.

PMID- 7797764
TI  - The decline of the doctor-patient relationship.

PMID- 7797766
TI  - American Heart Association consensus panel statement on preventing heart attack
      and death in patients with coronary disease.

PMID- 7797767
TI  - AHA consensus panel statement. Preventing heart attack and death in patients with
      coronary disease. The Secondary Prevention Panel.

PMID- 7797768
TI  - Giant cell myocarditis study group.

PMID- 7797769
TI  - Guidelines for training in adult cardiovascular medicine.

PMID- 7797770
TI  - Coagulation activity is increased in the left atrium of patients with mitral
      stenosis.

PMID- 7797771
TI  - Coagulation activity is increased in the left atrium of patients with mitral
      stenosis.

PMID- 7797772
TI  - Methodology of quantitating intracoronary ultrasound.

PMID- 7797773
TI  - Noninvasive identification of acute myocardial ischemia and reperfusion with
      contrast ultrasound using intravenous perfluoropropane-exposed sonicated dextrose
      albumin.
AB  - OBJECTIVES: The purpose of this study was to determine whether intravenous
      dextrose albumin sonicated with a commonly used gas of low blood solubility and
      diffusivity (perfluoropropane) could identify acute myocardial ischemia and
      reperfusion. BACKGROUND: Recently, it has been demonstrated that dextrose albumin
      sonicated with gases that have low blood solubility and diffusivity results in
      microbubbles capable of consistently producing myocardial ultrasound contrast
      after intravenous injection. It remains to be determined, however, whether this
      contrast agent can visually detect the myocardial blood flow abnormalities seen
      with acute ischemia or stunned myocardium after reperfusion. METHODS: We gave
      intravenous injections (0.06 ml/kg body weight) of perfluoropropane-exposed
      sonicated dextrose albumin to 10 open chest dogs. The measured degree of
      myocardial contrast (0+ to 2+) and background-subtracted peak anterior myocardial
      videointensity produced from each injection were measured at three stages: 1)
      under baseline conditions, 2) during acute ischemia produced by a proximal left
      anterior descending coronary artery ligation lasting 10 to 120 min, and 3) after
      reflow was established. Coronary blood flow was monitored during all injections
      by using an ultrasound flow probe placed around the left anterior descending
      artery. RESULTS: Coronary blood flow ranged from 0 to 137 ml/min, and peak
      myocardial videointensity after intravenous administration of perfluoropropane
      exposed sonicated dextrose albumin ranged from 0 to 70 gray scale U. There was
      consistent visual myocardial opacification in all dogs during baseline conditions
      and a visually evident decrease in myocardial contrast in the left anterior
      descending artery distribution after ligation. A relative increase in contrast in
      this same distribution after intravenous contrast agent administration occurred
      in 7 of the 10 dogs during reflow. Quantitatively, there was an excellent
      correlation in individual dogs between peak myocardial videointensity and
      coronary flow at all stages (mean correlation coefficient 0.95 +/- 0.04, range
      0.87 to 0.99). CONCLUSIONS: Perfluoropropane-exposed sonicated dextrose albumin
      is an ultrasound contrast agent that can visually identify myocardial perfusion
      abnormalities from a peripheral venous injection.

PMID- 7797774
TI  - Epicardial vasomotor responses to acetylcholine are not predicted by coronary
      atherosclerosis as assessed by intracoronary ultrasound.
AB  - OBJECTIVES: The purpose of this study was to use intravascular ultrasound to
      determine the morphologic appearance of the coronary arteries, relating the
      absence, presence and extent of atherosclerosis to the response of the coronary
      arteries to acetylcholine infusion. BACKGROUND: Endothelial function plays a
      major role in the pathophysiology of myocardial ischemia and angina pectoris. The
      response of the coronary arteries to selective infusion of acetylcholine has been
      used to examine endothelial function, with vasoconstriction occurring in the
      absence of intact endothelial function. Vasoconstriction to acetylcholine
      infusion in humans without overt coronary artery disease has been attributed to
      early atherosclerosis not detected by coronary angiography. METHODS: Twenty-nine
      patients without overt coronary artery disease underwent selective coronary
      angiography and selective intracoronary infusion of increasing concentrations of
      acetylcholine (10(-6), 10(-5) and 10(-4) mol/liter), followed by intravascular
      ultrasound imaging. RESULTS: The response of the coronary arteries to
      acetylcholine infusion was not dependent on the absence or presence of
      atherosclerotic plaque, as detected by intravascular ultrasound. The percent
      change in epicardial coronary artery diameter during acetylcholine infusion
      versus baseline was -14 +/- 28% (mean +/- SD) in the seven patients with no
      visible atherosclerosis on intravascular ultrasound versus -9 +/- 20% in the 22
      patients with visible atherosclerosis on intravascular ultrasound (p = NS,
      confidence interval -14% to 25%). There was a greater vasoconstrictive response
      to acetylcholine infusion in patients with risk factors for coronary artery
      disease than in those without risk factors (p = 0.003). CONCLUSIONS: The
      vasoreactive response to acetylcholine is not necessarily dependent on ultrasound
      detection of the presence or absence of atherosclerosis.

PMID- 7797775
TI  - Absence of vascular tolerance in conductance vessels after 48 hours of
      intravenous nitroglycerin in patients with coronary artery disease.
AB  - OBJECTIVES: We examined whether reflex neurohormonal constrictor forces attenuate
      the vasodilator action of nitroglycerin on large peripheral conductance vessels.
      BACKGROUND: Continuous nitroglycerin therapy is associated with the development
      of early tolerance with respect to its hemodynamic effects. It remains to be
      demonstrated whether vascular tolerance of large conductance vessels is an
      important contributory factor. METHODS: Radial artery diameter and forearm blood
      flow velocity were measured before and 24 and 48 h after continuous intravenous
      nitroglycerin infusion (0.5 microgram/kg body weight per min) in 10 patients with
      coronary artery disease (mean age +/- SEM 59 +/- 4 years) by using a high
      resolution ultrasound device. Blood flow (ml/min) was calculated from mean blood
      flow velocity and cross-sectional area. RESULTS: Increasing concentrations of
      nitroglycerin led to a dose-dependent increase in radial artery diameter (maximal
      +24 +/- 2%) and heart rate. Forearm vascular resistance and forearm blood flow
      were unchanged. After 24 and 48 h of treatment, additional nitroglycerin did not
      further increase radial artery diameter, indicating that the nitroglycerin
      induced dilation of the radial artery was maintained and was still maximal. In
      addition, radial artery diameter measured before and after 48 h of nitroglycerin
      infusion and after withdrawal of nitroglycerin in five additional patients showed
      that, after withdrawal, arterial diameter returned to baseline values within 35
      min. Plasma renin activity and serum aldosterone and vasopressin levels increased
      significantly at 24 and 48 h, accompanied by a decrease in hematocrit.
      CONCLUSIONS: Continuous intravenous administration of nitroglycerin exerts a
      sustained vasodilator effect for 48 h in large conductance vessels. Neurohormonal
      activation and compensatory intravascular volume expansion do not attenuate the
      vasodilator effects of nitroglycerin on peripheral conductance vessels during the
      1st 48 h of treatment.

PMID- 7797777
TI  - Implications of recurrent ischemia after reperfusion therapy in acute myocardial
      infarction: a comparison of thrombolytic therapy and primary angioplasty.
AB  - OBJECTIVES: The purpose of this study was to examine the incidence and
      implications of recurrent ischemia after different reperfusion strategies in
      acute myocardial infarction. BACKGROUND: The rates and effects of recurrent
      ischemia after reperfusion with thrombolytic therapy and with primary
      percutaneous transluminal coronary angioplasty have not been compared. METHODS:
      At 12 centers 395 patients presenting within 12 h of the onset of acute
      myocardial infarction were prospectively randomized to receive recombinant tissue
      type plasminogen activator (rt-PA) or primary coronary angioplasty. Sixteen
      clinical variables were examined by using univariate and multiple logistic
      regression analysis to identify the predictors of recurrent ischemia. The
      relation of recurrent ischemic events to patient outcome was analyzed. RESULTS:
      Recurrent ischemia developed in 76 patients (19.2%) before hospital discharge,
      resulting in reinfarction in 18 patients (4.6%) and death in 5 (2.6%). Recurrent
      ischemia occurred in 56 patients (28.0%) after rt-PA but in only 20 patients
      (10.3%) after coronary angioplasty (p < 0.0001), directly contributing to a
      higher rate of death or reinfarction (7.5% vs. 3.1%, p = 0.05), catheterization
      and revascularization procedures and prolonged hospital stay after thrombolysis.
      By multivariate analysis, treatment with coronary angioplasty rather than rt-PA
      was the strongest predictor of freedom from recurrent ischemia. Although the
      incidence of recurrent ischemia after angioplasty and after rt-PA was similar
      within the 1st 2 days of admission (9.2% vs. 14.5%, p = 0.11), after hospital day
      2 recurrent ischemia occurred in only 2 patients who received primary angioplasty
      compared with 27 patients who received rt-PA (1.1% vs. 13.5%, p < 0.0001).
      CONCLUSIONS: The development of recurrent ischemia adversely affects patient
      outcome, increasing morbidity, mortality and resource utilization. The much lower
      rate of recurrent ischemia after primary coronary angioplasty than after rt-PA
      results in improved survival without reinfarction and allows a shorter, less
      complicated hospital stay. Given the extremely low rate of recurrent ischemia
      after hospital day 2, safe early discharge on day 3 after primary coronary
      angioplasty should be feasible in selected patients with acute myocardial
      infarction.

PMID- 7797778
TI  - Value of radionuclide rest and exercise left ventricular ejection fraction in
      assessing survival of patients after thrombolytic therapy for acute myocardial
      infarction: results of Thrombolysis in Myocardial Infarction (TIMI) phase II
      study. The TIMI Study Group.
AB  - OBJECTIVES: This study sought to determine the prognostic value of rest and
      exercise left ventricular ejection fraction in patients receiving thrombolytic
      therapy as part of the Thrombolysis in Myocardial Infarction (TIMI) trial.
      BACKGROUND: In the prethrombolytic era, ejection fraction at rest as well as
      during exercise was an important prognostic index in patients recovering from
      acute myocardial infarction. The prognostic value of these measurements in the
      thrombolytic era is not clear. METHODS: As part of the TIMI II protocol, we
      obtained radionuclide left ventricular ejection fraction at rest and during
      symptom-limited submaximal supine exercise. Measurements were related to 1-year
      all-cause as well as cardiac mortality. In addition, the relation between
      ejection fraction obtained at rest and 1-year cardiac mortality in this study was
      compared with the relation established previously in the prethrombolytic era by
      the Multicenter Postinfarction Research Group. RESULTS: A distinct relation was
      noted between left ventricular ejection fraction at rest and all-cause mortality.
      The highest mortality rate (9.9%) was noted in patients with an ejection fraction
      < 30%. Those not undergoing a study had a 1-year mortality rate of 6.2%. Peak
      exercise ejection fraction provided prognostic information similar to that of
      rest ejection fraction. Likewise, change in ejection fraction from rest to
      exercise did not appreciably improve prognostic impact. CONCLUSIONS: Rest left
      ventricular ejection fraction is an important prognostic index in patients
      receiving thrombolytic therapy. Peak exercise ejection fraction and the change in
      ejection fraction from rest to exercise do not provide appreciable prognostic
      data beyond those obtained at rest. Patients unable to exercise or those not
      having a rest study have a poor prognosis. When compared with the Multicenter
      Postinfarction Research Group data, there was strong evidence of a difference in
      survival in the two studies. At any level of ejection fraction, mortality was
      lower in TIMI II patients than in patients in the prethrombolytic era.

PMID- 7797776
TI  - Randomized trial of insulin-glucose infusion followed by subcutaneous insulin
      treatment in diabetic patients with acute myocardial infarction (DIGAMI study):
      effects on mortality at 1 year.
AB  - OBJECTIVES: We tested how insulin-glucose infusion followed by multidose insulin
      treatment in diabetic patients with acute myocardial infarction affected
      mortality during the subsequent 12 months of follow-up. BACKGROUND: Despite
      significant improvements in acute coronary care, diabetic patients with acute
      myocardial infarction still have a high mortality rate. METHODS: A total of 620
      patients were studied: 306 randomized to treatment with insulin-glucose infusion
      followed by multidose subcutaneous insulin for > or = 3 months and 314 to
      conventional therapy. RESULTS: The two groups were well matched for baseline
      characteristics. Blood glucose decreased from 15.4 +/- 4.1 to 9.6 +/- 3.3
      mmol/liter (mean +/- SD) in the infusion group during the 1st 24 h, and from 15.7
      +/- 4.2 to 11.7 +/- 4.1 among control patients (p < 0.0001). After 1 year 57
      subjects (18.6%) in the infusion group and 82 (26.1%) in the control group had
      died (relative mortality reduction 29%, p = 0.027). The mortality reduction was
      particularly evident in patients who had a low cardiovascular risk profile and no
      previous insulin treatment (3-month mortality rate 6.5% in the infusion group vs.
      13.5% in the control group [relative reduction 52%, p = 0.046]; 1-year mortality
      rate 8.6% in the infusion group vs. 18.0% in the control group [relative
      reduction 52%, p = 0.020]). CONCLUSIONS: Insulin-glucose infusion followed by a
      multidose insulin regimen improved long-term prognosis in diabetic patients with
      acute myocardial infarction.

PMID- 7797780
TI  - Differential localization of atrial natriuretic peptide and skeletal alpha-actin
      messenger RNAs in left ventricular myocytes of patients with dilated
      cardiomyopathy.
AB  - OBJECTIVES: This study was designed to determine whether atrial natriuretic
      peptide and skeletal alpha-actin messenger RNAs (mRNAs) are co-localized in
      ventricular myocytes of patients with dilated cardiomyopathy. BACKGROUND: Atrial
      natriuretic peptide and skeletal alpha-actin are known as augmented genes with
      cardiac hypertrophy. However, the expression and localization of both genes in
      chronic failing heart remain unclear. METHODS: Left ventricular biopsy specimens
      were obtained from 14 patients with dilated cardiomyopathy. Atrial natriuretic
      peptide and skeletal alpha-actin mRNAs were detected by in situ hybridization
      with specific sulfur-35 uridine triphosphate-labeled RNA probes in the serial
      sections. RESULTS: Atrial natriuretic peptide mRNA was detected in 10 patients,
      and intense signals were localized in the myocytes located in the subendocardium
      and around the interstitial fibrous area. By contrast, skeletal alpha-actin mRNA
      was homogeneously detected in all myocytes in seven patients. By left
      ventriculography, patients with skeletal alpha-actin-positive findings had a
      lower ejection fraction (37.1 +/- 6.0%) than those with negative findings (46.3
      +/- 5.8%, p < 0.05), but atrial natriuretic peptide mRNA expression was not
      related to left ventricular function. CONCLUSIONS: These results indicate that
      the expression of atrial natriuretic peptide and skeletal alpha-actin mRNAs are
      not always co-localized in the left ventricle of patients with dilated
      cardiomyopathy and suggest that the mechanisms of the regulation of these two
      genes in the chronic failing heart are different.

PMID- 7797781
TI  - Economic outcomes of withdrawal of digoxin therapy in adult patients with stable
      congestive heart failure.
AB  - OBJECTIVES: This study sought to analyze the health and economic outcomes of
      withdrawal of digoxin therapy among U.S. adult patients with stable congestive
      heart failure. BACKGROUND: New information regarding the outcomes of digoxin
      withdrawal has been provided by the Prospective Randomized Study of Ventricular
      Failure and Efficacy of Digoxin (PROVED) and Randomized Assessment of Digoxin and
      Inhibitors of Angiotensin-Converting Enzyme (RADIANCE) trials. We interpreted and
      extrapolated the results of these trials to describe implications on a national
      level. METHODS: We used a decision-analytic model to estimate the outcomes of two
      alternative strategies to 1) continue and 2) withdraw digoxin in patients with
      congestive heart failure with normal sinus rhythm, New York Heart Association
      functional class II or III and left ventricular ejection fraction < or = 35%.
      Epidemiologic assumptions were derived from published reports and expert opinion.
      Assumptions regarding the effectiveness of digoxin therapy were derived from the
      RADIANCE and PROVED digoxin withdrawal trials. Hospital and Medicare data were
      used for economic assumptions. Calculated outcomes included treatment failures,
      cases of digoxin toxicity and health care costs. RESULTS: The continuation of
      digoxin therapy in these patients with congestive heart failure nationally would
      avoid an estimated 185,000 clinic visits, 27,000 emergency visits and 137,000
      hospital admissions for congestive heart failure. After accounting for an
      estimated 12,500 cases of digoxin toxicity, the net annual savings would be $406
      million, with a 90% range of uncertainty of $106 to $822 million. One-way
      sensitivity analysis indicated that digoxin therapy is cost-saving when the
      assumed annual incidence of digoxin toxicity is < or = 33%. CONCLUSIONS: The
      continuation of digoxin therapy in patients with stable congestive heart failure
      should be strongly considered, because this strategy is likely to lead to both
      lower costs and greater health benefits on the basis of available information.

PMID- 7797782
TI  - A one-year perspective on MedWatch: the Food and Drug Administration's new
      medical products reporting program.

PMID- 7797779
TI  - Long-term outcome of patients with biopsy-proved myocarditis: comparison with
      idiopathic dilated cardiomyopathy.
AB  - OBJECTIVES: The study objectives were 1) to assess the long-term outcome of
      patients with biopsy-proved lymphocytic myocarditis (Dallas criteria), and 2) to
      compare the outcome of these patients with that of patients with idiopathic
      dilated cardiomyopathy. BACKGROUND: Endomyocardial biopsy is frequently performed
      in patients presenting with dilated cardiomyopathy to identify lymphocytic
      myocarditis. Most previous studies of the natural history of myocarditis were
      performed before the establishment of the Dallas criteria. Thus, it is important
      to evaluate the prognostic value of positive endomyocardial biopsy findings in
      patients presenting with dilated cardiomyopathy, using standardized criteria for
      lymphocytic myocarditis. METHODS: All endomyocardial biopsy results from the Mayo
      Clinic (October 1979 to April 1988) with a diagnosis of myocarditis were
      reclassified according to the Dallas criteria. Patients whose biopsy specimens
      showed borderline or lymphocytic myocarditis were included in the study group;
      those with systemic inflammatory diseases known to be associated with myocardial
      involvement were excluded. Study group survival was compared with that for a
      cohort of patients with idiopathic dilated cardiomyopathy seen at the Mayo Clinic
      from 1976 to 1987 who had endomyocardial biopsy findings negative for
      myocarditis. RESULTS: Biopsy specimens from 41 patients met the Dallas criteria
      for a diagnosis of myocarditis (n = 28) or borderline myocarditis (n = 13). Of
      these 41 patients, 9 were excluded because of the presence of systemic diseases
      known to be associated with myocarditis, and 5 patients were excluded because of
      lack of available follow-up data. The myocarditis study group therefore included
      27 patients (10 with borderline myocarditis, 17 with myocarditis). Fifty-eight
      patients with a diagnosis of idiopathic dilated cardiomyopathy who underwent
      endomyocardial biopsy served as the comparison cohort. Ejection fraction was
      lower in patients with idiopathic dilated cardiomyopathy ([mean +/- SD] 25 +/-
      11%) than in those with myocarditis (38 +/- 19%, p = 0.001), even though a higher
      proportion of myocarditis group patients were in New York Heart Association
      functional class III or IV (63%) than patients in the dilated cardiomyopathy
      group (30%, p = 0.005). There was no difference in 5-year survival rate between
      the myocarditis and idiopathic dilated cardiomyopathy groups (56% vs. 54%,
      respectively). CONCLUSIONS: This study demonstrates that the long-term outcome of
      patients with biopsy-proved myocarditis seen in a referral setting is poor,
      although no different from that of patients with idiopathic dilated
      cardiomyopathy. With the current lack of proved effective treatment for
      lymphocytic myocarditis and no demonstration of survival benefit for patients
      with myocarditis, these data suggest that endomyocardial biopsy performed to
      exclude myocarditis is of limited prognostic value in the routine evaluation of
      dilated cardiomyopathy.

PMID- 7797783
TI  - Indoor allergen levels in day nurseries.
AB  - BACKGROUND: Because allergic sensitization seems to occur especially during
      infancy, we decided to evaluate such an exposure in day nurseries. METHODS:
      Thirty day nurseries in Marseilles, which were selected at random, were visited
      during 2 weeks in April 1993. Routine cleaning includes daily cleaning of smooth
      floors, weekly laundering of sheets, and monthly cleaning of soft toys.
      Mattresses are encased in synthetic covers. Dust samples were collected from four
      settings: infants' mattresses and pillows, smooth floors, and soft toys. Levels
      of mite, cockroach, cat, and dog allergens were analyzed with a monoclonal
      antibody-based ELISA. RESULTS: Mite allergen levels were lower than the proposed
      threshold level for sensitization (2 micrograms/gm of dust) on 94% of mattresses
      and soft toys and on 100% of floors and pillows. Cat allergen levels in
      mattresses ranged from less than 0.1 to 4.5 micrograms/gm dust. On floors, cat
      allergen levels ranged from less than 0.1 to 2.4 micrograms/gm dust. Only 10% of
      pillows and soft toys had levels greater than 2 micrograms/gm of dust. Fel d I
      levels were significantly higher (p < 0.03) in mattresses from nurseries with
      curtains and were correlated with the percentage of children with a cat at home.
      In almost all day nurseries, cockroach allergen (Bla g I and Bla g II) levels
      were very low. Only three samples from mattresses had dog allergen levels greater
      than 2 micrograms of Can f I allergen per gram of dust. On floors the level was
      always lower than 2 micrograms/gm. CONCLUSIONS: These data clearly show that
      indoor allergen levels are much lower in day nurseries than in most houses. Most
      samples contain allergen levels below threshold levels for sensitization. Thus
      children of atopic parents are less likely to become sensitized to indoor
      allergens in day nurseries than in their own homes. In addition, this study
      emphasizes the efficacy of avoidance measures such as use of synthetic protective
      mattress covers, frequent washing of sheets and soft toys, and avoidance of
      carpets and curtains.

PMID- 7797784
TI  - Cat shedding of Fel d I is not reduced by washings, Allerpet-C spray, or
      acepromazine.
AB  - BACKGROUND: No published studies have compared the effectiveness of several
      treatments proposed to reduce cat allergenicity. Cat washing studies
      demonstrating efficacy involved very small sample sizes or infrequent washings.
      Allerpet-C (Allerpet, Inc., New York, N.Y.), a widely advertised topical spray,
      and acepromazine, a tranquilizer advocated as efficacious in subsedating doses,
      have never been scientifically studied. OBJECTIVE: We compared the effects of cat
      washing, Allerpet-C spray, and acepromazine with that of no treatment on the
      shedding of the primary cat allergen, Felis domesticus I by cats. METHODS: In a
      blinded, comparative, controlled study, we measured the amounts of Fel d I shed
      during an 8-week treatment period with a sample of 24 female mongrel cats
      randomly assigned to four groups; one group received weekly distilled water
      washings, one received weekly Allerpet-C spray applications, one received daily
      oral acepromazine, and one had no treatment (control). Thirty-minute, twice
      weekly air samples were collected from each cat with a laminated plastic-acrylic
      chamber and air sampler. RESULTS: One-sample, two-sided t tests comparing
      baseline to final-week measurements revealed no significant change in Fel d I
      within each group (mean change +/- SD: washing; 487.6 +/- 1896.4 mU per 30
      minutes, p = 0.63; Allerpet-C spray, 429.2 +/- 871.6 mU per 30 minutes, p = 0.46
      acepromazine; -620.6 +/- 1031.2, p = 0.52 per 30 minutes). Furthermore, analysis
      of covariance revealed no significant change in Fel d I levels between groups (p
      = 0.72). CONCLUSIONS: Out data do not show significant reductions in Fel d I
      shedding as a result of any of these treatments. Therefore we cannot recommend
      them to patients allergic to cats.

PMID- 7797785
TI  - Chronotherapy of asthma with inhaled steroids: the effect of dosage timing on
      drug efficacy.
AB  - BACKGROUND: Studies in asthma with systemic corticosteroids given at 3:00 PM have
      shown a superior therapeutic benefit compared with dosing at other time points.
      OBJECTIVE: The study was designed to compare beneficial and systemic effects of
      800 micrograms of inhaled triamcinolone once daily at 3:00 PM (QD group) versus
      200 micrograms conventional four times a day dosing (QID group). METHODS:
      Efficacy outcome measures included forced expiratory volume in 1 second (FEV1),
      peak expiratory flow rates, bronchial responsiveness, and use of beta-agonist.
      Systemic effects were blood eosinophil and cortisol levels, 24-hour urinary
      cortisol, and evaluation for oral candidiasis and dysphonia. RESULTS: The
      baseline FEV1 was comparable in the two groups: QD = 67% +/- 2% and QID = 66% +/-
      2% of predicted value. After 4 weeks of treatment, FEV1 increased similarly in
      the QD group to 77% +/- 4% and in the QID group to 74% +/- 4% of predicted value.
      Likewise, the improvement in morning and evening peak expiratory flow rates was
      not significantly different between the groups. Both QD and QID groups
      experienced comparable daily decrements in beta-agonist use. The systemic
      responses to the two regimens as assessed by eosinophil count, morning serum
      cortisol, and 24-hour urinary cortisol were also comparable. CONCLUSIONS: The
      single daily administration of inhaled triamcinolone at 3:00 PM has no increased
      systemic effects and produces similar improvement in efficacy variables. A dosing
      strategy based on once daily dosing should increase compliance of inhaled steroid
      use in the clinical setting.

PMID- 7797786
TI  - The development and prediction of atopy in high-risk children: follow-up at age
      seven years in a prospective randomized study of combined maternal and infant
      food allergen avoidance.
AB  - BACKGROUND: The natural history of allergic disease and its potential for
      prevention merit close examination because of the explosive worldwide increase in
      the prevalence and morbidity of atopic disorders. This study examines the
      development of atopy at age 7 years in 165 children in a high-risk cohort,
      previously reported from birth to age 4 years. METHODS: In this prospective,
      randomized, controlled study of food allergen avoidance in infancy, the
      prophylactic-treated group consisted of infants whose mothers avoided cow's milk,
      egg, and peanut during the last trimester of pregnancy and lactation and who,
      themselves, avoided cow's milk until age 1 year (casein hydrolysate
      supplementation before age 1), egg until age 2 years, and peanut and fish until
      age 3 years. The control group consisted of maternal/infant pairs who followed
      standard feeding practices. RESULTS: Despite a significant reduction in food
      allergy and milk sensitization before age 2 years, none of the following differed
      between the groups at age 7 years: food allergy, atopic dermatitis, allergic
      rhinitis, asthma, any atopic disease, lung function, food or aeroallergen
      sensitization, serum IgE level, or presence of nasal eosinophils or nasal
      basophilic cells. Children with food allergy by 4 years evidenced higher 7-year
      (current) prevalences of allergic rhinitis and asthma (p < 0.01). Atopic
      diseases/parameters at age 7 years were shown, by multivariate analysis (p <
      0.05), to be associated with several genetic and environmental risk factors (male
      gender, maternal nonwhite ethnicity and asthma, and household smoking), as well
      as predictive atopic markers during infancy (elevated serum IgE level; egg, cow's
      milk, and peanut sensitization; and nasal eosinophils and nasal basophilic
      cells). CONCLUSIONS: These findings help to: (1) elucidate the natural history of
      atopic disease in high-risk children; (2) document the progression of allergy
      from atopic dermatitis, food allergy, and food sensitization to respiratory
      allergy and aeroallergen sensitization despite food allergy prevention in
      infancy; (3) identify allergy predictive markers; and (4) expand our appreciation
      of the interactions of genetic and environmental factors in the development of
      atopy.

PMID- 7797787
TI  - Reproducibility of allergen-induced early and late asthmatic responses.
AB  - BACKGROUND: Constant-dose allergen inhalation challenges are frequently used to
      examine the effect of antiasthma drugs on the allergen-induced early and late
      asthmatic responses. The end-point measurements in such studies are the maximal
      early and late percent decreases in the forced expiratory volume in 1 second
      (FEV1). OBJECTIVE: Our purpose was to observe the reproducibility and to
      determine the sample sizes required for such studies. METHODS: Twenty-eight
      subjects with allergen-induced early and late responses were studied with two
      constant-dose allergen challenges separated by 2 to 12 weeks. The early response
      was measured as the maximum percent decrease in FEV1 during the first 2 hours and
      the late response as the maximum percent decrease in FEV1 between 3 to 7 hours.
      RESULTS: The mean +/- SEM early responses were 23.1% +/- 1.0% and 24.7% +/- 2.0%,
      whereas the mean late responses were 23.3% +/- 2.0% and 24.5% +/- 2.2%.
      Reproducibility of measurements were such that fewer than eight subjects are
      required, to show 50% attenuation of either the early or late response (with 90%
      power). CONCLUSIONS: The method of constant-dose allergen challenge is a
      sensitive tool for detecting changes in early and late asthmatic responses after
      the use of antiasthma medication.

PMID- 7797788
TI  - Serum reactivities to latex proteins (Hevea brasiliensis).
AB  - BACKGROUND: In recent years there has been an increasing incidence of allergy to
      latex among health care workers and children with spina bifida. The allergic
      response in these individuals can be severe and occasionally fatal. Several
      allergens have been identified with the use of sera from different patient
      groups. In our effort to identify reagents for in vitro testing and clinical use,
      we investigated the reactivities of latex proteins to sera collected from a wide
      range of patients with latex allergy. METHODS: Twenty-six serum samples were
      obtained from adult patients with latex allergy, both hospital workers and non
      hospital workers. Serum pools were made either from sera of children with spina
      bifida or sera of adult patients with latex allergy. Proteins from C-serum and
      latex particles of latex sap (nonammoniated) were separated by different gel
      electrophoresis techniques and evaluated for specific IgE binding by
      immunoblotting. RESULTS: More than 50% of the sera tested reacted to an 18 kd
      protein, a 25.6 kd acidic protein with an isoelectric point of 3.5, or to both
      proteins; whereas only 23% of the individual serum samples tested reacted to the
      rubber elongation factor, which has been reported to be a major latex allergen.
      The immunoreactive patterns of children's and adults' serum pools were similar
      but not identical. CONCLUSIONS: With the use of gel electrophoresis and
      immunoblotting techniques, different immunoreactive proteins were identified in C
      serum and particles of latex. Rubber elongation factor, which reacted to only 23%
      of sera tested, did not appear to cross-react immunologically with other latex
      allergens.

PMID- 7797789
TI  - Characterization of the isoforms of the group I allergen of Cynodon dactylon.
AB  - BACKGROUND: The group I allergen of Cynodon dactylon, Cyn d I, was found to
      consist of four to 10 isoforms. METHODS: We studied the isoforms with the use of
      two-dimensional gel electrophoresis. The antigenic difference of the isoforms was
      evaluated by radioimmunoprecipitation with monoclonal antibodies (MAbs). The
      acidic isoforms and the basic and neutral isoforms were further isolated by MAb
      affinity chromatography for RAST and competitive RAST. In addition, the N
      terminal sequence was evaluated by microsequencing. RESULTS: A total of 11
      isoforms were found in Cyn d I in extracts prepared from different sources of
      Bermuda grass pollen (BGP). They were either acidic (Cyn d I-A, I-B, I-C, I-D, I
      E, I-F, I-G, I-H, and I-I), neutral (Cyn d I-X), or basic (Cyn d I-J). Cyn d I-G,
      with an isoelectric point of approximately 6.4, was constantly present in all the
      pollen preparations, whereas the content of the basic Cyn d I-J varied from less
      than 5% to greater than 20%. The molecular weight of the basic and neutral
      isoforms were slightly lower than those of the acidic isoforms. All isoforms
      shared a common antigenic determinant(s) recognizable by MAb 4-37, and the basic
      and neutral isoforms possessed a unique antigenic determinant(s) recognizable by
      MAb 1-61. RAST showed that both the acidic Cyn d I and the basic and neutral Cyn
      d I were recognized by human IgE in the pooled sera of persons allergic to BGP.
      Competitive RAST showed a high crossreactivity between the acidic and the basic
      and neutral isoforms. A 95% sequence identity also existed between the N-terminal
      20 amino acid residues of basic Cyn d I-J and the dominant acidic isoform Cyn d I
      G. CONCLUSIONS: The present study disclosed that basic Cyn d I-J is an important
      allergen and that the content of this isoform varies in different lots of BGP.

PMID- 7797790
TI  - Relationship between oral challenges with previously uningested egg and egg
      specific IgE antibodies and skin prick tests in infants with food allergy.
AB  - BACKGROUND: Positive skin prick test (SPT) and RAST reactions to egg that had
      never previously been ingested have been observed in infants with food allergy.
      The likelihood of having clinical hypersensitivity reactions when egg is first
      ingested and the predictive value of SPT and RAST remain to be elucidated.
      OBJECTIVE: We investigated the relationship between egg-specific IgE antibodies
      and positive SPT reaction to egg, and the development of clinical
      hypersensitivity on the first exposure, in infants with food allergy. METHODS:
      The patient group consisted of 21 infants with food allergy and positive SPT
      and/or RAST reaction to egg, which they had never previously ingested; the
      control group of 12 infants had food allergy and negative test results. All
      subjects underwent double-blind placebo-controlled food challenges with egg.
      RESULTS: Thirteen of 21 patients (61%) and one of 12 control subjects (8%) had
      positive reactions to challenges (p < 0.01). Thirteen positive reactions to
      challenges (93%) elicited immediate symptoms. Late-onset eczema occurred in two
      children. SPT results showed a high sensitivity (0.92) and negative predictive
      accuracy (0.92), whereas specificity (0.57) and positive predictive accuracy
      (0.61) were poor. RAST did not have any diagnostic advantage over SPT.
      CONCLUSIONS: In infants with food allergy SPT with egg may be helpful in
      predicting which patients will react to the first exposure.

PMID- 7797791
TI  - IgE antibodies to recombinant forms of Fel d I: dichotomy between fluid-phase and
      solid-phase binding studies.
AB  - BACKGROUND: The major cat allergen Fel d I consists of two polypeptide chains
      linked by disulfide bonds, each of which has been expressed in bacteria. To
      investigate the antigenic structure of Fel d I, antibody binding to the native
      molecule and to each recombinant chain were compared. METHODS: Polyclonal human
      IgE and IgG antibodies and monoclonal antibodies (mAbs) to Fel d I were compared
      for binding to Fel d I, chain 1, or chain 2 by fluid-phase inhibition
      radioimmunoassay, RAST, and immunoabsorption. RESULTS: In the fluid-phase assay,
      neither recombinant chain significantly inhibited the binding of antibody to
      native Fel d I at concentrations of up to 10 micrograms/ml. Partial inhibition
      was observed when chain 1 was used, which inhibited the binding of two mAbs by
      40% and 75%. In contrast, when the solid-phase RAST assay was used, IgE
      antibodies bound both chains with high specificity, and there was a good
      quantitative correlation between IgE antibody binding to Fel d I and both chain 1
      (r = 0.58, p < 0.01) and chain 2 (r = 0.47, p < 0.01). Up to 70% of IgG or IgE
      anti-Fel d I antibodies could be absorbed by either chain 1 or chain 2, and both
      chains in combination produced similar absorption values in response to native
      Fel d I. Four mAbs were fully absorbed by chain 1, but not chain 2, and three
      mAbs were not absorbed by either chain. CONCLUSIONS: The results demonstrate a
      dichotomy between antibody binding to recombinant Fel d I chains, which may be
      explained by confirmational differences between the chains in the fluid phase or
      on solid supports. The results also suggest that chain 1 is an important site for
      mAb-defined B-cell epitopes on Fel d I.

PMID- 7797792
TI  - Potential role of interleukin-1 in allergen-induced late asthmatic reactions in
      guinea pigs: suppressive effect of interleukin-1 receptor antagonist on late
      asthmatic reaction.
AB  - Interleukin (IL)-1 is a pluripotential proinflammatory cytokine and is thought to
      be involved in the pathogenesis of bronchial asthma and late asthmatic reactions
      (LARs). To determine whether IL-1 plays a role in LAR, guinea pigs sensitized
      with Ascaris antigen were used. We evaluated IL-1 production by immunostaining
      with anti-IL-1 beta antibody and elucidated the action of IL-1 in LAR with
      recombinant IL-1 receptor antagonist. Immunostaining revealed that IL-1 beta-like
      immunoreactivity-positive cells increased in the airway walls and in
      bronchoalveolar lavage fluid after the antigen challenge. IL-1 receptor
      antagonist protein pretreatment reduced the generation of LAR in terms of
      pulmonary resistance. IL-1 receptor antagonist protein pretreatment did not
      change cellular components but reduced the percentage of hypodense eosinophils in
      bronchoalveolar lavage fluid. We also studied the direct effect of recombinant
      human IL-1 beta on pulmonary resistance and eosinophil activity measured as
      released eosinophil peroxidase activity. Recombinant human IL-1 beta did not
      change pulmonary resistance but primed eosinophils to release eosinophil
      peroxidase activity in response to platelet activating factor. Therefore these
      results suggest that IL-1 was produced in sensitized pulmonary tissue of guinea
      pigs by allergen exposure and played a role in the generation of LAR, at least
      partially by modulating the activation of eosinophils.

PMID- 7797793
TI  - IgE regulation by nematodes: the body fluid of Ascaris contains a B-cell mitogen.
AB  - Nematode infection of human beings or laboratory animals leads to markedly
      increased levels of circulating IgE, most of which is not specific to worm
      antigens. This phenomenon is known to be interleukin-4-dependent, but little is
      known about the mechanism of activation of the response. In an attempt to
      elucidate this mechanism, we have used a reductive approach with worm products
      rather than infections. In a previous article we showed that injection of the
      body fluid of the nematode Ascaris yields a marked increase in circulating IgE.
      In this study we demonstrate that the body fluid contains a B-cell mitogen.
      Incubation with purified splenic B cells with 50 micrograms/ml body fluid yields
      marked proliferation of B cells, as measured by tritiated thymidine uptake.
      Similarly, Ascaris body fluid stimulates G0 B cells to enter the cell cycle. T
      cells are unaffected by the mitogen, and the response is dependent on viable
      accessory cells. Contamination of Ascaris body fluid or reagents by bacterial
      lipopolysaccharide has been ruled out as a source of artefactual data. A model is
      proposed, which suggests that the B-cell mitogen in Ascaris body fluid stimulates
      polyclonal B-cell activity and that other nematode factors either stimulate the
      release of interleukin-4 or act in an interleukin-4-like manner to cause class
      switch to IgE.

PMID- 7797794
TI  - Homology of a bovine allergen and the oligomycin sensitivity-conferring protein
      of the mitochondrial adenosine triphosphate synthase complex.
AB  - We have characterized bovine allergens by constructing and analyzing a
      complementary DNA library from bovine skin. Clones producing proteins that
      reacted with IgE antibodies from persons with allergy were purified and
      sequenced. One set of the allergen-coding clones showed an almost complete
      homology with the bovine oligomycin sensitivity-conferring protein of the
      mitochondrial adenosine triphosphate synthase complex. The IgE antibodies
      adsorbed with the recombinant allergen reacted with an 11 kd protein in the cow
      dander extract. Binding of the IgE from patients allergic to the recombinant
      allergen expressed in Escherichia coli confirmed the allergen-coding ability of
      the complementary DNA sequence. The prevalence of the IgE-positive sera among
      patients with cow allergy and control subjects suggests that the recombinant
      allergen represents one of the minor allergens in cow dander. This is the first
      time a mammalian allergen has been identified as a protein with a known function.

PMID- 7797796
TI  - Lol p I-specific IgE and IgG synthesis by peripheral blood mononuclear cells from
      atopic subjects in SCID mice.
AB  - BACKGROUND: The development of an animal model representative of the in vivo
      situation of human atopic diseases is always of interest for a better
      understanding of IgE production and regulation. Along these lines, mice with
      severe combined immunodeficiency (SCID mice) engrafted with lymphocytes from
      atopic subjects might be a suitable model for such studies. OBJECTIVE: This study
      aims to analyze the production of Lol p I-specific IgE and IgG antibodies in SCID
      mice after transplantation of human peripheral blood mononuclear cells from
      atopic patients sensitive to grass pollens and from nonatopic donors. METHODS:
      Peripheral blood mononuclear cells were transplanted into SCID mice, which were
      then challenged with Lol p I, and antibody responses (IgG and IgE) were analyzed
      over a 6-week period. RESULTS: Total IgG antibody was measured in each mouse
      serum after transplantation. Also, most mice (regardless of whether donors were
      atopic) that were challenged with Lol p I produced specific IgG antibody. Total
      IgE antibody production was observed only in mice grafted with cells from atopic
      patients. Lol p I-specific IgE antibodies were also produced after immunization
      with Lol p I. Although IgG antibody/response tended to plateau, the IgE antibody
      response increased until it peaked and declined thereafter. Interferon-gamma was
      detected in sera from mice producing IgE antibody, which supports a possible role
      of interferon-gamma in the decrease of IgE response. CONCLUSION: This study
      suggests that the SCID mouse model could represent an interesting approach to
      studying specific, total IgG and IgE antibody production, and ultimately their
      regulation.

PMID- 7797795
TI  - Eosinophil-active cytokine from mononuclear cells cultured with L-tryptophan
      products: an unexpected consequence of endotoxin contamination.
AB  - BACKGROUND: The eosinophilia-myalgia syndrome, caused by a contaminant or
      contaminants in epidemiologically implicated L-tryptophan products, is
      characterized by eosinophilia and eosinophil degranulation. We hypothesized that
      immune cells are stimulated by implicated L-tryptophan and produce eosinophil
      active cytokines. OBJECTIVES: This study was designed to identify substances in L
      tryptophan causing the eosinophilia-myalgia syndrome. METHODS: Peripheral blood
      mononuclear cells were cultured with L-tryptophan products, and supernatants were
      tested for their ability to enhance eosinophil degranulation and survival in
      vitro and for their cytokine content. Subsequently, 46 different L-tryptophan
      lots were analyzed for their in vitro biologic activities. RESULTS: After
      peripheral blood mononuclear cells were cultured with implicated L-tryptophan,
      their supernatants enhanced eosinophil degranulation and survival. These
      activities were blocked by anti-granulocyte-macrophage colony-stimulating factor
      (GM-CSF) antibody; immunoreactive GM-CSF was measurable in the supernatants.
      Monocytes, but not T lymphocytes, were the responding cells. However, no
      correlation was observed between the in vitro biologic activity and lots of
      epidemiologically implicated L-tryptophan products. This biologic activity in the
      L-tryptophan products was characterized as endotoxin. CONCLUSION: Although L
      tryptophan products stimulate peripheral blood mononuclear cells to produce GM
      CSF, this response is caused by endotoxin contamination of the L-tryptophan
      products and not by a specific L-tryptophan contaminant. Endotoxin contamination
      must be considered as a possible cause of eosinophil-active cytokine production
      by peripheral blood mononuclear cells.

PMID- 7797797
TI  - Occupational allergy caused by urticating hair of Brazilian spider.

PMID- 7797799
TI  - Dietitians' advice = positive change.

PMID- 7797798
TI  - Fatal asthma attack during an inhalation challenge with ultrasonically nebulized
      distilled water.

PMID- 7797800
TI  - What dietetics can learn from molecular biology.

PMID- 7797801
TI  - Barley as high-chromium food.

PMID- 7797802
TI  - State and federal efforts to trim health care costs embrace Medicaid waivers and
      managed care.

PMID- 7797803
TI  - Dietetics goes into therapy.

PMID- 7797804
TI  - Positive association between dietetics recommendations and achievement of enteral
      nutrition outcomes of care.
AB  - OBJECTIVE: To identify planned dietetics outcomes of care, dietitians activities
      performed an recommendations made, and outcome achievement and its relationship
      to recommendations followed. DESIGN: A multisite, single-group prospective pilot
      study was conducted to describe the care provided by dietitians to patients
      receiving enteral nutrition care. SUBJECTS/SETTING: Participants were 172
      patients (16 of whom died during hospitalization) receiving at least 75% of
      nutrient requirements from enteral nutrition products. Subjects were from six
      acute-care facilities and one rehabilitation facility in the Chicago metropolitan
      area. MAIN OUTCOME MEASURES: Dietitians identified planned outcomes of care to be
      accomplished and documented activities performed during the provision of care.
      Data were collected to measure outcome achievement and to determine whether
      dietitians' recommendations were followed. STATISTICAL ANALYSES PERFORMED:
      Descriptive data are reported as frequencies or means +/- standard error. Odds
      ratios were constructed to estimate the association between dietitians' enteral
      care recommendations and the achievement of planned outcomes of care. RESULTS:
      Whether or not enteral nutrition outcomes of care were achieved was positively
      associated with dietitians' recommendations. The odds of patients' achieving the
      recommended energy intake goal (P < .001) or increasing (P < .01) or maintaining
      (P < .04) visceral protein stores were at least four times greater when
      dietitians' recommendations were followed than when they were not. In addition,
      dietetics activities performed at the local level were similar to established
      practices. APPLICATIONS: Dietitians can identify and measure outcomes of
      dietetics-related care that demonstrate positive contributions to the
      interdisciplinary enteral nutrition care process.

PMID- 7797805
TI  - Fat preferences and fat consumption of 3- to 5-year-old children are related to
      parental adiposity.
AB  - OBJECTIVE: To examine differences in preferences for high-fat foods, dietary fat
      intake, anthropometric measurements, and parental body mass index (BMI) among 3-
      to 5-year-old children. DESIGN: Children's fat intake was measured using 30-hour
      weighed food intake data from a standard menu. Children's fat preferences were
      assessed using a subset of foods from the standard menu. We obtained parents' BMI
      scores and children's anthropometric measurements including weight-for-stature,
      triceps, and subscapular skinfolds. SUBJECTS: Participants were children 3 to 5
      years of age (n = 18, 10 girls and 8 boys; mean [+/- standard deviation] age = 52
      +/- 1.9 months) who were without food allergies, food sensitivities, or chronic
      illness, and the children's parents (18 mothers and 16 fathers). STATISTICAL
      ANALYSES PERFORMED: Correlational analyses and maximum likelihood contingency
      tables were used to examine children's fat preferences and fat intake, children's
      anthropometric measurements, and BMI scores of parents. RESULTS: Although all
      children were offered the same daily menu, children's dietary fat intakes ranged
      from 25% to 42%. Children indicating strong preferences for high-fat foods had
      high total fat intakes (r = .54, P < .05; chi 2 = 3.96, df = 1, P < .05).
      Children's fat preferences were also related to their triceps skinfold
      measurements (r = .61; P < .01). Finally, those children with the strongest
      preferences for high-fat foods (r = .75, P < .01; chi 2 = 10.68, df = 1, P < .05)
      and the highest total fat intakes (r = .67, P < .01; chi 2 = 5.28, df = 1, P <
      .05) had heavier parents than did children with low scores. CONCLUSIONS: Offering
      children a nutritionally adequate diet is necessary but may not be sufficient to
      ensure dietary quality; children's food preferences are influential determinants
      of macronutrient intake. The association of children's fat preferences and intake
      with parental adiposity suggests that dietary influences may mediate familial
      patterns of adiposity.

PMID- 7797806
TI  - Evaluation of menus planned in Mississippi child-care centers participating in
      the Child and Adult Care Food Program.
AB  - OBJECTIVES: To collect information from licensed child-care centers in
      Mississippi on their foodservice operations relative to participation in the
      Child and Adult Care Food Program sponsored by the US Department of Agriculture
      (USDA); to collect information on who planned the menus; and to evaluate the
      energy and nutrient content of the planned menus relative to the suggested goal
      of one third of the Recommended Dietary Allowances (RDAs) and the recommendations
      made in the Dietary Guidelines for Americans. DESIGN: Survey questionnaire.
      SETTING: Licensed child-care centers in Mississippi. SAMPLES: Ninety-two licensed
      child-care centers provided cycle menus for analysis. One hundred eighteen
      centers returned the questionnaire. MAIN OUTCOME MEASURES: Content of the menus
      relative to the meal-pattern guidelines established for the Child and Adult Care
      Food Program; the energy and nutrient content of the menus relative to the RDAs
      and the Dietary Guidelines for Americans. STATISTICAL ANALYSES PERFORMED: One-way
      analysis of variance and frequencies. RESULTS: Seventy-five percent of the
      centers reported participating in the Child and Adult Care Food Program. All but
      one of the centers planned menus that met the meal-pattern requirements
      established by the program, licensure, and Head Start Performance Standards.
      Results showed that following the established meal-pattern guidelines for the
      child nutrition programs may not guarantee consistent nutritional quality of
      planned menus in child-care centers. The mean amounts of energy and many
      nutrients were significantly lower (P < .05) for centers that reported
      participating in the Child and Adult Care Food Program. Mean fat levels for all
      centers exceeded the recommendation of no more than 30% of total energy from fat:
      40.8% of total energy from fat was reported by centers that participated in the
      program and 38% by those that said they did not. APPLICATIONS: Additional
      guidance is needed for menu planning in child-care centers to ensure compliance
      with the nutritional goal of meeting one third of the RDAs and Dietary Guidelines
      for Americans.

PMID- 7797807
TI  - Vegetables, fruits, and legumes: effect on urinary isoflavonoid phytoestrogen and
      lignan excretion.
AB  - OBJECTIVE: To compare the effect of vegetable, fruit, and legume consumption on
      urinary isoflavonoid phytoestrogen and lignan excretion. DESIGN: After 4 days of
      data collection, during which subjects consumed their habitual diets, subjects
      were randomly placed on four 9-day controlled experimental diets with each
      subject receiving each diet in a random order. SUBJECTS: Seven men and three
      women, aged 20 to 35 years, were recruited from the University of Minnesota Twin
      Cities community. INTERVENTIONS: All subjects consumed four experimental diets in
      an assigned random order: a controlled basal diet, a legume/allium diet
      (containing garbanzo beans, garlic, and onions), and diets low or high in
      vegetables and fruits (containing apples, pears, potatoes, and carrots). MAIN
      OUTCOME MEASURES: Urine samples that were collected while subjects consumed their
      habitual diets and during the last 3 days of each feeding period were analyzed
      for isoflavonoid and lignan content using isotope dilution gas chromatography
      mass spectrometry. STATISTICAL ANALYSIS PERFORMED: The effect of vegetable and
      fruit intake on urinary isoflavonoid and lignan excretion was analyzed using the
      general linear model procedure. Post hoc comparisons were made using Duncan's
      multiple range test. RESULTS: Subjects excreted more of the lignan enterodiol on
      the high vegetable/fruit diet compared with the basal and legume/allium diets (P
      = .03); more of the isoflavonoids O-desmethylangolensin (O-DMA), genistein, and
      sum of isoflavonoids on the legume/allium diet compared with the other controlled
      diets (P < .05); and more of the isoflavan equol on the basal and legume/allium
      diets compared with the high vegetable/fruit diet (P < .01). Subjects who
      excreted higher levels of equol on the basal and legume/allium diets also
      consumed more of the milk-based pudding provided as part of the controlled diets.
      CONCLUSIONS: Urinary lignan and isoflavonoid excretion changed in response to
      alterations in vegetable, fruit, and legume intake under controlled dietary
      conditions.

PMID- 7797808
TI  - Effect of antioxidant-rich foods on plasma ascorbic acid, cardiac enzyme, and
      lipid peroxide levels in patients hospitalized with acute myocardial infarction.
AB  - OBJECTIVE: To determine whether a fat- and energy-reduced diet rich in
      antioxidant vitamins C and E, beta carotene, and soluble dietary fiber reduces
      free-radical stress and cardiac enzyme level and increases plasma ascorbic acid
      level 1 week after acute myocardial infarction. DESIGN: Randomized, single blind,
      controlled study. SETTING: Primary- and secondary-care research center for
      patients with myocardial infarction. SUBJECTS: All subjects with suspected acute
      myocardial infarction (n = 505) were considered for entry to the study. Subjects
      with definite or possible acute myocardial infarction and unstable angina
      (according to World Health Organization criteria) were assigned to either an
      intervention diet (n = 204) or a control diet (n = 202) within 48 hours of
      symptoms of infarction. INTERVENTIONS: Intervention and control groups were
      advised to consume a fat-reduced, oil-substituted diet. The intervention group
      was also advised to eat more fruits, vegetable soup, pulses, and crushed almonds
      and walnuts mixed with skim milk. MAIN OUTCOME MEASURES: Reduction in plasma
      lipid peroxide and lactate dehydrogenase cardiac enzyme levels, increase in
      plasma ascorbic acid level, and compliance with diet, especially with vitamin C
      intake as determined by chemical analysis. STATISTICAL ANALYSIS: A two-sample t
      test using one-way analysis of variance for comparison of data. RESULTS: Plasma
      lipid peroxide level decreased significantly in the intervention group compared
      with the control group (0.59 pmol/L in the intervention group and 0.10 pmol/L in
      the control group; 95% confidence interval of difference = 0.19 to 0.83). Lactate
      dehydrogenase level increased less in the intervention group than in the control
      group (427.7 vs 561.2 U/L; confidence interval of difference = 82.9 to 184.7).
      Plasma ascorbic acid level increased more in the intervention group than in the
      control group (23.38 vs 7.95 mumol/L; confidence interval of difference = 12.85
      to 26.13). APPLICATIONS/CONCLUSIONS: Consumption of an antioxidant-rich diet may
      reduce the plasma levels of lipid peroxide and cardiac enzyme and increase the
      plasma level of ascorbic acid. Antioxidant-rich foods may reduce myocardial
      necrosis and reperfusion injury induced by oxygen free radicals.

PMID- 7797809
TI  - Improving food frequency questionnaires: a qualitative approach using cognitive
      interviewing.
AB  - In an attempt to improve data quality and ease of administration of standard self
      administered food frequency questionnaires, various alternative approaches were
      tried for inquiring about frequency of consumption, portion size, seasonal
      intake, and food preparation. Evaluation consisted of a cognitive interviewing
      method in which respondents verbalize their thought process while completing
      several variations of a questionnaire. Interviewers observed and asked follow-up
      probe questions to evaluate problems or inconsistencies verbalized by
      respondents. Consensus and judgment by interviewers and observers suggested
      several problematic features of food frequency questionnaires: formatting of
      questions about frequency and portion size; computing average frequencies for
      aggregated food items or for foods eaten seasonally; comprehension of many items;
      and ordering of foods. These findings led to cognitive refinement and
      innovations, which included detailed questions regarding preparation or use of
      low-fat varieties or other alternatives to help better describe specifics of
      intake for some foods; questions on seasonal intake for several foods; inclusion
      of portion size ranges; and additional response categories for frequency of
      intake. Cognitive interviewing is an important step in pinpointing cognitive
      problems in dietary questionnaires.

PMID- 7797810
TI  - Potential renal acid load of foods and its influence on urine pH.
AB  - The purpose of this study was to calculate the potential renal acid load (PRAL)
      of selected, frequently consumed foods. A physiologically based calculation model
      was recently validated to yield an appropriate estimate of renal net acid
      excretion (NAE); the model depends primarily on nutrient intake data. When
      nutrient data from actual food composition tables were used, the calculation
      model yielded PRAL values that ranged from an average maximum of 23.6 mEq/100 g
      for certain hard cheeses over 0 mEq/100 g for fats and oils to an average minimum
      of approximately -3 mEq/100 g for fruits and fruit juices and vegetables. By
      means of these PRAL data (summed according to the amounts of foods and beverages
      consumed daily and by an estimate of excretion of organic acids [based on body
      size]), the daily NAE can be calculated. This calculation methodology, primarily
      based on PRAL, allows an appropriate prediction of the effects of diet on the
      acidity of urine. For practical applicability in dietetic prevention of recurrent
      urolithiasis or in other fields of dietetics, the additionally determined
      correlation (r = .83; P < .001) between NAE and urine pH can be used to ascertain
      NAE target values for a desired urine pH modification.

PMID- 7797811
TI  - Plasma and dietary vitamin C and E levels of tobacco chewers, smokers, and
      nonusers.

PMID- 7797812
TI  - Overweight in Cree schoolchildren and adolescents associated with diet, low
      physical activity, and high television viewing.

PMID- 7797814
TI  - Validity of a food frequency questionnaire for estimating calcium intake among
      Japanese and white women.

PMID- 7797813
TI  - Current caffeine intake of young children: amount and sources.

PMID- 7797815
TI  - Referrals to dietitians after cardiovascular screening program held in
      supermarket.

PMID- 7797816
TI  - Position of the American Dietetic Association: nutrition services for children
      with special health needs.

PMID- 7797817
TI  - Dietetics professionals' charge is to promote nutrition and physical activity.

PMID- 7797818
TI  - Food, physical activity, and fun: inspiring America's kids to more healthful
      lifestyles.

PMID- 7797819
TI  - Toxic effects of carbofuran and glyphosate on semen characteristics in rabbits.
AB  - The present study was undertaken to investigate the effect of chronic treatment
      with two sublethal doses of Carbofuran (carbamate insecticide) and Glyphosate
      (organophosphorus herbicide) on body weight and semen characteristics in mature
      male New Zealand white rabbits. Pesticide treatment resulted in a decline in body
      weight, libido, ejaculate volume, sperm concentration, semen initial fructose and
      semen osmolality. This was accompanied with increases in the abnormal and dead
      sperm and semen methylene blue reduction time. The hazardous effect of these
      pesticides on semen quality continued during the recovery period, and was dose
      dependent. These effects on sperm quality may be due to the direct cytotoxic
      effects of these pesticides on spermatogenesis and/or indirectly via hypothalami
      pituitary-testis axis which control the reproductive efficiency.

PMID- 7797820
TI  - Long-term mercury accumulation in the presence of cadmium and lead in Oreochromis
      aureus (Steindachner).
AB  - The effects of cadmium and lead on chronic mercury accumulation were investigated
      in O. aureus. After 140 days' exposure the accumulation of mercury in the liver,
      brain, gill filaments, intestine, caudal muscle, spleen, trunk kidney and eye was
      analysed. The exposure concentrations were 0.05, 0.10 and 0.20 mg/L for mercury
      alone. O. aureus was also exposed to mixtures of 0.05 mg/L mercury with lead
      (0.05 mg/L and 0.50 mg/L or cadmium (0.05 mg/L) and 0.10 mg/L mercury with 0.10
      mg/L cadmium. In food fish, a knowledge of toxic metal accumulation patterns is
      of great importance because of their contribution to the human diet and, as
      fishmeal, to the diet of agricultural animals. The trunk kidney consistently
      accumulated higher concentrations of mercury than any of the other tissues
      investigated.

PMID- 7797821
TI  - Gallstones and upper abdominal discomfort. Innocent bystander or a cause of
      dyspepsia?
AB  - Many physicians consider gallstones to be a cause of vague upper abdominal
      discomfort. However, both dyspepsia and gallstones are common conditions in the
      general population, and the relationship between the two has continued to
      generate controversy. In this editorial, I review the evidence for and against a
      relationship between gallstones and dyspepsia. The data suggest that upper
      abdominal discomfort, heartburn, bloating, and other vague symptoms are not
      related to gallstones and the routine ordering of an ultrasound in the patient
      with dyspepsia is not warranted.

PMID- 7797822
TI  - Esophageal dilation can be done safely using selective fluoroscopy and single
      dilating sessions.
AB  - Maxims for safe esophageal dilation have included recommendations to use
      fluoroscopy in all instances and to limit dilation sessions to 2-mm increments.
      We reviewed a 34-month experience of all esophageal dilations undertaken at a
      large multispecialty clinic to define adherence to these recommendations and to
      delineate whether deviation was associated with significant complications. Four
      hundred thirty-two patients underwent 716 courses of esophageal dilation during
      this time, 92% of whom had benign disease. Eighty-nine percent of patients were
      dilated with polyvinyl dilators (Savary/American) and only 8% of these patients
      required fluoroscopic monitoring for the bougienage. Seventy-eight percent of the
      dilating sessions for patients without achalasia were undertaken using either a
      single large dilator (> or = 45 Fr) or employed incremental dilator sizes > 2 mm
      (6 Fr) in a single session. There was a single perforation in 662 nonachalasia
      dilations and this was a consequence of attempted placement of an esophageal
      endoprosthesis. We conclude that use of guide wire technology and newer dilating
      techniques do away with the need for routine fluoroscopic control. Moreover,
      single large dilators or dilator increments > 2 mm may be safely used, contingent
      on endoscopic stricture assessment.

PMID- 7797823
TI  - Endoscopic intrasphincteric injection of botulinum toxin for the treatment of
      achalasia.
AB  - Three patients with achalasia were treated with endoscopic injection of botulinum
      toxin (BoTx). BoTx (80 U) was injected via a sclerotherapy needle into the lower
      esophageal sphincter (LES). One patient complained of transient heartburn that
      resolved after omeprazole treatment. Two patients reported sustained symptomatic
      improvement. They were able to eat normally 48 h after treatment and have
      remained symptom free for 5 and 6.5 months, respectively. In these patients,
      esophageal manometry 4 months after treatment showed a marked reduction of
      resting LES pressure and the appearance of a previously absent LES relaxation
      after swallowing. The third patient had only a transient clinical improvement,
      with occasional dysphagia beginning 3 months after treatment. All patients showed
      unchanged aperistalsis of the esophageal body. Its less invasive nature compared
      with other therapeutic alternatives may give BoTX injection a role in the
      treatment of some patients with achalasia.

PMID- 7797825
TI  - Nonsteroidal antiinflammatory drugs are associated with gastric outlet
      obstruction.
AB  - Nonsteroidal antiinflammatory drug associated gastric ulcerations are often
      prepyloric and painless; when recurrent, such ulcers may lead to pyloric scarring
      and gastric outlet obstruction. We performed a retrospective case control study
      to seek an association between gastric outlet obstruction and nonsteroidal
      antiinflammatory drug use. The use of nonsteroidal antiinflammatory drugs in
      cases with gastric outlet obstruction was compared to an age- and sex-matched
      outpatient control group undergoing endoscopy. The proportion of drug use by
      patients with gastric outlet obstruction, seven of nine, was significantly higher
      than the proportion in controls, 29 of 90. The duration of nonsteroidal
      antiinflammatory drug use was also significantly longer in patients with gastric
      outlet obstruction than in control patients. Chronic nonsteroidal
      antiinflammatory drug use is associated with gastric outlet obstruction.

PMID- 7797824
TI  - Comparative trial of pantoprazole and ranitidine in the treatment of reflux
      esophagitis. Results of a German multicenter study.
AB  - In 249 patients with acute symptomatic reflux esophagitis grade II and III
      (Savary-Miller classification), we compared the efficacy and safety of
      pantoprazole, a newly developed proton pump inhibitor given at a once-daily dose
      of 40 mg, with a standard dose of the H2 receptor antagonist ranitidine (150 mg
      b.i.d.) in a randomized, double-blind, multicenter study. Complete healing was
      achieved after 4 and 8 weeks of therapy (protocol-correct) in 69 and 82%
      (pantoprazole) and 57 and 67% (ranitidine), respectively (p = 0.054 at 4 weeks
      and p < 0.01 at 8 weeks). The predominant symptoms of gastroesophageal reflux,
      i.e., heartburn and acid eructation, were more effectively reduced in
      pantoprazole- than in ranitidine-treated patients. The frequency of adverse
      events was low and did not differ between the two treatment groups. We conclude
      that pantoprazole is superior to ranitidine in the acute treatment of reflux
      esophagitis.

PMID- 7797826
TI  - Can the radiologist recognize Helicobacter pylori gastritis?
AB  - To evaluate radiologic findings of Helicobacter pylori (H. pylori) in the upper
      gastrointestinal (UGI) tract, we retrospectively reviewed consecutive records of
      676 symptomatic adults with gastric biopsies (224 positive) and 150 symptomatic
      adults with rapid urease tests (57 positive). All the UGI series of patients with
      positive biopsies or urease tests for H. pylori were compared with the UGI series
      of patients with negative urease tests. UGI examinations were evaluated blindly
      by two gastrointestinal radiologists without knowledge of clinical findings,
      original radiologic interpretations, or test results. They agreed that 8 of 18
      (44%) UGIs of patients with H. pylori had abnormally increased gastric folds in
      the fundus, body, or antrum as compared with none of 14 (0%) UGIs of patients
      without H. pylori (p < 0.01) (P.P.V. = 1.0). Interobserver agreement was good
      (kappa = 0.63). Endoscopy in the eight patients with radiographic evidence of
      enlarged gastric folds all demonstrated marked abnormalities such as prominent
      gastric folds, gastric erythema, erosions, or peptic ulcers. Our findings
      indicate that enlarged gastric folds on the UGI series of a symptomatic adult are
      very suggestive of H. pylori gastritis.

PMID- 7797827
TI  - A controlled double blind multicenter study of the effectiveness of 5
      aminosalicylic acid in patients with Crohn's disease in remission.
AB  - We evaluated the efficacy of an oral formulation of 5-amino-salicylic acid in
      lowering the relapse rate after remission of Crohn's disease. Included were 59
      patients who had proven Crohn's disease of at least 1 year's duration, and who
      had been in continuous remission for at least 6 months, while taking only 5
      aminosalicylic acid or no therapy at all. Remission was defined as a Harvey
      Bradshaw index score (Softley-Clamp modification) of < 4. Patients were given
      coded mesalzaine 250 mg or placebo tablets (2 x 2 day). They were seen at 0, 1,
      and 2 months, and then every 2 months until the end of the study. Trial endpoints
      were 1 year of follow-up, or clinical relapse results. After randomization, 31
      patients were included in the placebo arm, and 28 in the treatment arm. There
      were no significant differences between the two groups at entry. Ten patients
      were withdrawn from the trial because of noncompliance, loss of follow-up, or
      headache. There were more clinical relapses in the placebo arm (15 patients, 55%)
      than in the treatment arm (6 patients, 27%) (p < 0.05). Mesalazine had a
      significant advantage over placebo (p < 0.05) only in the subgroups of patients
      with ileal Crohn's disease and in those older than 30 years. We conclude that
      mesalazine has a moderate but significant benefit in preventing relapse in
      Crohn's disease in remission; this occurred only in patients with small-bowel
      involvement or in those older than 30 years.

PMID- 7797828
TI  - Intravenous cyclosporine for steroid-refractory attacks of Crohn's disease. Short
      and long-term results.
AB  - A prospective, open trial was conducted to test whether i.v. cyclosporine was
      effective in the treatment of refractory Crohn's disease. Eight patients with
      acute steroid-refractory attacks were included. Intravenous cyclosporine, 5
      mg/kg/day, was added to ongoing drug therapy. Patients who responded were then
      switched to oral cyclosporine for a mean 2.6-month period, and steroids were
      discontinued when possible. Six patients improved, with a mean latency time to
      onset of improvement of 9 days. Two did not improve, and both underwent urgent
      operation. On oral cyclosporine, five patients maintained remission and
      discontinued steroids, whereas one relapsed and underwent surgery. After
      discontinuation of oral cyclosporine, the five remaining patients relapsed, and
      two underwent surgery. One reversible episode of hepatobiliary toxicity and one
      of gastrointestinal intolerance were recorded. We conclude that i.v. cyclosporine
      effectively and rapidly induces improvement of acute steroid-refractory flare-ups
      of Crohn's disease, but after discontinuation relapse is to be expected.

PMID- 7797829
TI  - Colonic transit in soccer players.
AB  - To evaluate the effects of exercise on colonic function, we measured total and
      segmental transit times in 11 male soccer players and nine male radiology student
      technicians. Diet was kept constant in all subjects, who maintained their normal
      activities. For the soccer players, normal activities included 15 h of training
      and one match each week. Transit times were measured with radioopaque markers,
      using the multiple-ingestion, single-radiograph technique. No overall difference
      in large bowel transit was observed between the two groups. Right colon transit
      was considerably slower in the soccer players, whereas left colon and rectal
      transit were slightly accelerated. We conclude that an intensive sport activity
      only modifies regional differences in large bowel function. This may be of
      importance in extreme conditions, such as those experienced by marathon runners.
      Data should be obtained before prescribing exercise to treat constipation.

PMID- 7797830
TI  - Serum lipid and fat-soluble vitamin levels in primary sclerosing cholangitis.
AB  - We reviewed the initial lipid and fat-soluble vitamin levels in 56 patients with
      primary sclerosing cholangitis (PSC) enrolled in a randomized, placebo-controlled
      trial evaluating ursodeoxycholic acid. We also evaluated lipid and vitamin levels
      in a group of 87 patients with advanced PSC being evaluated for liver
      transplantation. Of the patients entering the therapeutic trial, 41% had total
      serum cholesterol levels greater than the 95th percentile, whereas only 20% had
      high-density lipoprotein cholesterol levels above normal, and only one (2%) had
      an elevated triglyceride level. Total cholesterol levels were correlated with
      serum bilirubin levels and were lower in early versus later histologic stages
      (206 +/- 61 vs. 248 +/- 79, p = 0.04). Of the 87 pretransplant patients, 29% had
      elevated serum cholesterol levels and 17% had elevated serum triglyceride levels.
      Total serum cholesterol levels correlated inversely with total serum bilirubin
      levels in this group. In patients in the therapeutic trial, vitamin A deficiency
      was seen in 40%, vitamin D deficiency in 14%, and vitamin E deficiency in 2% of
      those tested. More prominent deficiencies of fat-soluble vitamins occurred in the
      pretransplant group of patients, with 82% deficient in vitamin A, 57% deficient
      in vitamin D, and 43% deficient in vitamin E. We conclude that
      hypercholesterolemia and fat-soluble vitamin deficiencies are frequent in
      patients with PSC and are more common with more severe disease. Patients with
      PSC, especially with advanced liver disease, should be screened for fat-soluble
      vitamin deficiencies and supplemented accordingly.

PMID- 7797831
TI  - The leading role of hepatitis B and C viruses as risk factors for the development
      of hepatocellular carcinoma. A case control study.
AB  - A double case control study evaluated the role of hepatitis C virus (HCV) and
      hepatitis B virus (HBV), alcohol drinking, and tobacco smoking as potential risk
      factors for cepatocellular carcinoma (HCC). Fifty-one patients with HCC, 34 of
      whom had underlying cirrhosis, were analyzed against 51 hospital controls and 34
      patients with cirrhosis, respectively. Sera from patients of all three groups
      were tested for HBV markers and anti-HCV antibodies. The polymerase chain
      reaction technique was used to detect HCV RNA in the anti-HCV-positive samples.
      Alcohol drinking and smoking habits were recorded for all patients. HCC risk was
      significantly related to the presence of hepatitis B surface antigen (HBsAg)
      [relative risk (RR) = 18], HCV infection (RR = 8), and alcohol abuse (RR = 4).
      When the presence of cirrhosis was taken into account, only HBsAg positivity was
      significantly associated with HCC development (RR = 6.7), indicating that HCV
      infection and alcohol abuse are related to HCC indirectly through the cirrhotic
      process. No significant interaction between HCV and HBV infection in the
      causation of HCC was found. Through the computation of population-attributable
      risk, it was found that 46% of the HCC cases in Greece could be attributed to
      HBsAg positivity but only 4% to HCV infection. In conclusion, HBV infection is
      the major risk factor in the development of HCC in Greece, either by inducing
      cirrhosis or by direct oncogenic effect. HCV infection is also related to HCC
      development, albeit indirectly through the cirrhotic process.

PMID- 7797832
TI  - Protean manifestation of gastrointestinal tuberculosis: report on 130 patients.
AB  - Over the past 8 years, 820 patients with tuberculosis were seen at the Armed
      Forces Hospital, Riyadh, Kingdom of Saudi Arabia. A total of 292 of these
      patients (35.6%) had pulmonary tuberculosis, and 130 patients (15.8%) had
      alimentary tract tuberculosis, making this the second commonest site of
      involvement. In these 130 patients, the disease was located in the upper
      gastrointestinal tract in 11 patients (8.5%), small bowel 44 patients (33.8%),
      large bowel 29 patients (22.3%), peritoneum 40 patients (30.7%), and liver 19
      patients (14.6%). The diagnosis in most patients was made by specimens from
      endoscopy or laparoscopy, or liver or surgical specimens. Gastrointestinal
      tuberculosis is not uncommon in developing countries, and its incidence is
      increasing in developed countries due to immigration and in patients with AIDS or
      those receiving immunosuppressive therapy. It can mimic any diseases affecting
      the gastrointestinal tract and may present with very different symptoms, so a
      high index of suspicion is required.

PMID- 7797833
TI  - Metachronous small-bowel adenocarcinoma in celiac sprue.
AB  - Celiac sprue, or nontropical sprue, is associated with an increased incidence of
      digestive tract malignancy. We report a patient with celiac sprue who developed
      two primary adenocarcinomas of the jejunum > 2 years apart. The second cancer was
      asymptomatic and detected by surveillance computed tomography. Small-bowel
      cancers are unusual, and frequency of follow-up has not been established, so that
      it is important to have a high index of suspicion for these malignancies in
      celiac patients with vague gastrointestinal symptoms.

PMID- 7797835
TI  - Hepatorenal syndrome: resolution after transjugular intrahepatic portosystemic
      shunt.
AB  - Hepatorenal syndrome (HRS), a functional renal failure associated with severe
      liver disease, is believed to result from diminished effective arterial volume
      and altered renal hemodynamics. Death is almost inevitable after its development
      and therapeutic options are limited. Surgical shunts carry an increase in
      morbidity and mortality, and peritoneovenous shunts are frequently complicated by
      infection and coagulopathy. We report a case of hepatorenal syndrome successfully
      treated with transjugular intrahepatic portosystemic shunt (TIPS). This is an
      unusual therapeutic option for HRS and may lead to future indications for TIPS.

PMID- 7797834
TI  - Tuberculous pancreatitis: a diagnostic problem. Case report and review of
      literature.
AB  - A 22-year-old Pakistani man presented with a 1-year history of recurrent attacks
      of pancreatitis of unknown etiology that had required hospitalization and
      extensive investigation in Pakistan. He was admitted with abdominal pain, fever,
      and weight loss. An ultrasound and computed tomographic scan of the abdomen
      revealed abdominal lymphadenopathy, bulky and inhomogeneous pancreas, and a large
      fluid collection anterior to the right lobe of the liver. The collection was
      aspirated but Gram-stain, Ziehl-Neelsen stain for acid-fast bacilli, and DNA
      analysis by a highly specific polymerase chain reaction-based assay were
      negative. Because of a strong clinical suspicion of tuberculosis, the patient was
      started on antituberculous chemotherapy; 4 weeks later the aspirate grew
      Mycobacterium tuberculosis (hominis). The patient improved rapidly and has
      remained well after 18 months follow-up. A high index of clinical suspicion and
      appropriate microbiological investigation is required for the diagnosis of this
      rare, but potentially curable cause of pancreatitis.

PMID- 7797836
TI  - Hepatotoxicity and accelerated fibrosis following 3,4
      methylenedioxymetamphetamine ("ecstasy") usage.
AB  - 3,4-Methylenedioxymetamphetamine ("ecstasy") has previously been reported to
      cause an acute hepatitis that may progress to liver failure. We present the first
      recorded case of ecstasy-induced accelerated hepatic fibrosis.

PMID- 7797837
TI  - Multiple angiomyolipoma of the liver.
AB  - Angiomyolipoma (AML) of the liver is extremely rare; we believe only about 60
      cases, all solitary, have been reported. We present here the first reported case,
      to our knowledge, of multiple AMLs in the liver. Two masses were found in the
      liver of a 43-year-old Japanese woman complaining of abdominal discomfort by
      ultrasonography and computed tomography. With a preoperative diagnosis of
      hepatocellular carcinoma, a tumor in the right lobe 4.0 cm in largest diameter
      and one in the left lobe measuring 2.4 cm were resected. Histologically, both
      tumors were composed of smooth-muscle cells, fat cells, and blood vessels, and
      contained foci of extramedullary hematopoiesis. Although the smooth-muscle cell
      component was predominant and both tumors exhibited some pleomorphism, no mitosis
      was found. These histologic findings are consistent with the diagnosis of AML.

PMID- 7797839
TI  - Epstein-Barr virus-associated typical gastric carcinoma detected by in situ
      hybridization and polymerase chain reaction.

PMID- 7797838
TI  - Impaired gastric emptying following revision gastrostomy.

PMID- 7797840
TI  - Symptomatic peptic ulcer (PU): is there any seasonal variation? An endoscopic
      retrospective study.

PMID- 7797842
TI  - Primary malignant lymphoma of common bile duct presenting as acute obstructive
      jaundice: report of a case.

PMID- 7797841
TI  - 5-Aminosalicylic acid enemas to maintain remission in left-sided ulcerative
      colitis: a meta- and economic analysis.

PMID- 7797843
TI  - Recurrent acute pancreatitis and pancreatic pseudocyst as the presenting
      manifestation of HIV infection.

PMID- 7797844
TI  - Transverse myelitis heralding hepatitis A.

PMID- 7797845
TI  - Successful treatment of hepatitis B virus-associated polyarteritis nodosa by
      interferon alpha alone.

PMID- 7797846
TI  - Fatal hepatic failure due to prolonged amiodarone treatment.

PMID- 7797847
TI  - Severe hyponatremia and bradycardia associated with intravenous vasopressin
      therapy for variceal hemorrhage.

PMID- 7797848
TI  - Sjogren's syndrome with antimitochondrial antibody-negative primary biliary
      cirrhosis: a case of autoimmune cholangitis.

PMID- 7797850
TI  - Chronic wrist pain.

PMID- 7797849
TI  - Acute back pain in children.

PMID- 7797852
TI  - Assessment and treatment of common sites and causes of arthrosis in the wrist.

PMID- 7797851
TI  - Wrist arthroscopy.

PMID- 7797853
TI  - Arthroscopic assessment of carpal instabilities and ligament injuries.

PMID- 7797854
TI  - Endoscopic carpal tunnel release: Chow dual-portal technique.

PMID- 7797855
TI  - Endoscopic carpal tunnel release: single portal Agee technique.

PMID- 7797857
TI  - Current concepts in the treatment of fractures of the radial head, the olecranon,
      and the coronoid.

PMID- 7797856
TI  - Social and economic costs of carpal tunnel surgery.
AB  - In conclusion, we estimate the incidence of carpal tunnel surgery to be between
      400,000 and 500,000 cases annually in the United States, with economic costs in
      excess of $2 billion per year. The costs incurred in workers' compensation cases
      are almost three times those of other workers and five times those of nonworkers.
      Despite an increase in medial costs for endoscopic carpal tunnel release, the
      procedure has a potential to decrease overall costs by lowering productivity and
      wage reimbursement losses. With better surveillance and data collection systems,
      workers at risk can be identified and the incidence of occupational carpal tunnel
      syndrome reduced through appropriate worksite intervention.

PMID- 7797858
TI  - Complex fractures of the distal part of the humerus and associated complications.

PMID- 7797860
TI  - Arthroscopy of the elbow.

PMID- 7797859
TI  - Fractures about the elbow.

PMID- 7797863
TI  - Primary arthroplasty of the hip in patients younger than 21 years of age.

PMID- 7797861
TI  - Fractures of the proximal part of the femur.
AB  - The orthopaedic surgeon has a multitude of internal fixation devices and
      techniques available for use in the treatment of subtrochanteric fractures of the
      proximal femur. The successful use of second-generation locking nails is
      technically demanding. Close attention to positioning of the patient, reduction
      of the fracture, placement of the guide-wire, and insertion of the nail and of
      the proximal and distal locking screws is mandatory. The newer, high-strength hip
      screws allow good fixation of a fracture that extends into the piriformis fossa.
      If medial comminution is present, this technique is best performed in conjunction
      with indirect reduction and bone-grafting. With proper technique, these devices
      allow the surgeon to manage predictably a complex subtrochanteric fracture that
      previously had to be treated with traction or extensive dissection and with
      (frequently inadequate) internal fixation.

PMID- 7797862
TI  - Fractures of the femur in children.

PMID- 7797864
TI  - Complex primary total hip arthroplasty: the difficult femur.

PMID- 7797865
TI  - Heterotopic ossification following total hip arthroplasty.
AB  - Although heterotopic ossification following total hip arthroplasty is frequently
      observed radiographically, it fortunately is much less commonly of clinical
      importance. There are, however, a group of patients that develop significant
      heterotopic bone formation, which can be symptomatic and, in some cases, can
      require repeat surgery. Careful surgical technique seems indicated in all
      patients undergoing total hip arthroplasty to try to reduce the incidence of this
      problem. Patients who are recognized to be at risk should be treated with
      prophylaxis. These include patients with active ankylosing spondylitis, skeletal
      hyperostosis, and prior heterotopic bone formation. Both low-dose radiation and
      nonsteroidal anti-inflammatories have been shown to be effective. The choice
      between these two modalities depends on the patient's individual circumstances,
      the availability of radiotherapy support (including custom shielding for ingrowth
      components), and the presence of areas of bone grafting and any osteotomies or
      fractures. Nonsteroidal anti-inflammatories, particularly Indomethacin, are a
      very acceptable form of prophylaxis and may be preferred in certain patients,
      including young women of childbearing age. Radiation is preferred in those
      patients with known GI intolerance to these medications or with a prior history
      of peptic ulcer disease. Excision of heterotopic bone, if symptomatic, should not
      be performed before 6 to 12 months and then only once it is clear that the
      process is mature. Bone scans can be helpful in assessing the maturity of
      heterotopic bone and can guide the timing of excision. Prophylaxis should be
      carried out in all patients following excision of heterotopic bone.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7797866
TI  - Fractures of the femur after hip replacement.

PMID- 7797867
TI  - Metabolic bone disease.

PMID- 7797868
TI  - The role of antibiotic-loaded cement in the treatment of an infection after a hip
      replacement.

PMID- 7797869
TI  - Ankle fractures in children.

PMID- 7797870
TI  - Arthroscopic surgery of the ankle.

PMID- 7797871
TI  - Evaluation and emergent treatment of patients with thoracolumbar trauma.

PMID- 7797872
TI  - Reconstruction of the lateral ankle ligaments.

PMID- 7797874
TI  - Surgical management of fractures of the os calcis.

PMID- 7797873
TI  - Current methods for the evaluation of ankle ligament injuries.

PMID- 7797876
TI  - Women and their shoes: unrealistic expectations?
AB  - Is it unrealistic for a woman to consistently expect fashion and comfort in the
      same shoe? Probably so, unless, of course, the current fashion is shoes with a
      low heel, round toe, and cushioned sole. But, if the fashion trends of the last
      300 years are any indication, it is doubtful that this will be the case any time
      soon. However, a woman who is willing to compromise with a properly fitting, low
      heeled, extra-depth or combination last pump augmented with a good quality
      cushioned insole has a better chance of finding comfort in a shoe. Although it is
      possible to have an orthopaedically sound shoe in a reasonably fashionable style,
      there is still room for the manufacturers and designers of shoes to improve the
      details of design. It is important to recognize that as long as society defines
      "fashionable" as a thin-soled, stiletto-heeled, narrow-pointed shoe, comfort and
      fashion are, to some extent, mutually exclusive. Any woman who wants the comfort
      of a tennis shoe will probably have to wear a tennis shoe.

PMID- 7797875
TI  - The high price of high-fashion footwear.

PMID- 7797877
TI  - Trends in women's shoewear.

PMID- 7797878
TI  - Anterior cruciate ligament reconstruction: why do failures occur?

PMID- 7797879
TI  - Revision ACL surgery: technique and results utilizing allografts.

PMID- 7797880
TI  - Revision ligament reconstruction of failed prosthetic anterior cruciate
      ligaments.

PMID- 7797881
TI  - The anatomic and surgical considerations for posterior cruciate ligament
      reconstruction.

PMID- 7797882
TI  - Posterolateral instability of the knee.

PMID- 7797883
TI  - Alignment in total knee replacement.

PMID- 7797884
TI  - Circular external fixation in high tibial osteotomy.

PMID- 7797885
TI  - Surgical management of thoracolumbar fractures.

PMID- 7797887
TI  - Pin and wire technique for external fixation.

PMID- 7797886
TI  - Management of the multiply injured patient with fractures.

PMID- 7797888
TI  - Walking, running, and sprinting: a three-dimensional analysis of kinematics and
      kinetics.
AB  - Just as in running, the two-joint muscles acting at the hip and at the knee work
      to transfer energy efficiently between body segments. This can be seen in Figure
      12. The powers at the hip and knee are overlaid to show that when power is
      generated at the hip, it is absorbed at the knee and vice versa. For example, a
      concentric contraction of the hamstrings proximally at the hip is coupled with an
      eccentric contraction at the knee just prior to initial contact in terminal
      swing. The rectus femoris functions in a similar way but in an opposite direction
      in initial swing. For the three conditions discussed, the relative contribution
      of work occurring at each joint is different. Figure 13 shows that the muscles
      about the ankle are the most important source of work in walking and that the
      knee musculature does not significantly contribute to the work done for walking.
      In walking, the knee is felt to be important for the smoothing of gait. The
      quadriceps are a much more important source of energy at the knee in both running
      and sprinting, as can be seen in Figure 13. Finally, the hip musculature becomes
      the dominant source of work in sprinting in our group of untrained subjects with
      significant contributions from both the hip flexors and extensors. One would
      expect that the relative importance of each of the muscle groups about each of
      these joints in terms of sources of energy might change with training. The intent
      of this work was to evaluate the three conditions of walking, running, and
      sprinting. I hope that it will stimulate further interest and research in this
      area in order to come to a greater understanding of human locomotion. As more
      knowledge and experience are gained, the motion analysis lab will be able to
      offer insight into training strategies, injury prevention, and the treatment of
      pathologic running and sprinting conditions.

PMID- 7797889
TI  - The clinical use of kinetics for evaluation of pathologic gait in cerebral palsy.

PMID- 7797890
TI  - Computer applications for orthopaedic surgeons: CD-ROM and beyond.

PMID- 7797891
TI  - Computers for surgical planning of orthopaedic procedures.

PMID- 7797892
TI  - Database construction and use issues.

PMID- 7797893
TI  - Nonsurgical treatment of patients with thoracolumbar fractures.

PMID- 7797894
TI  - Treatment of acute injury of the cervical spine.

PMID- 7797895
TI  - Cervical spondylosis and myelopathy.

PMID- 7797896
TI  - Evaluation and management of cervical spondylotic myelopathy.

PMID- 7797897
TI  - Increased anti-influenza A virus cytotoxic T cell activity following vaccination
      of the chronically ill elderly with live attenuated or inactivated influenza
      virus vaccine.
AB  - The possible enhancement of anti-influenza A virus memory cytotoxic T cell (CTL)
      responses to inactivated influenza virus vaccine by coadministration of
      intranasal live attenuated influenza A virus vaccine was investigated. Fifty
      elderly nursing home residents received inactivated trivalent influenza virus
      vaccine intramuscularly and simultaneously were randomly assigned to receive
      either bivalent live attenuated influenza A virus vaccine or saline placebo
      intranasally in a blinded fashion. A larger proportion of volunteers who received
      live attenuated virus vaccine than of those who received placebo experienced a
      postvaccination rise in anti-influenza A virus CTL activity (15 of 23 vs. 8 of
      24; P < .05). Anti-influenza A virus cytotoxicity was primarily mediated by CD8+
      T cells and was influenza A virus-specific and HLA-restricted. There was a
      possible advantage of administering live attenuated with inactivated virus
      vaccine because of enhanced memory anti-influenza A virus CTL activity.

PMID- 7797898
TI  - Massive activation of immune cells with an intact T cell repertoire in acute
      human immunodeficiency virus syndrome.
AB  - In 8 patients with symptomatic, acute primary infection with human
      immunodeficiency virus (HIV), a dramatic and persistent decrease in CD4+
      lymphocytes was seen, accompanied by a marked increase in activated/memory CD8+ T
      cells (CD38+, CD45R0+, HLA-DR+, with high amounts of cell adhesion molecules),
      which represented most circulating lymphocytes, but no gross alterations in V
      beta T cell repertoire. Extremely high plasma levels of proinflammatory cytokines
      were observed. Three patients were followed for 2-3 years: The number of CD4+
      cells, extremely low at first, increased significantly in a few months but
      decreased rapidly after a short stable period. Cytotoxic T lymphocytes bearing
      markers of immunologic activation/memory could play an important role in the
      earliest phases of the disease. It remains to be established how such a dramatic
      onset could determine the rapid progression of the infection that seems
      characteristic of patients with acute HIV syndrome.

PMID- 7797899
TI  - Use of human papillomavirus type 6 capsids to detect antibodies in people with
      genital warts.
AB  - Human papillomavirus (HPV) type 6 capsids were produced by recombinant vaccinia
      viruses and used in a capture ELISA to screen 901 human sera from three studies
      of genital HPVs. The highest seroprevalence was observed among subjects with
      recurrent genital warts. In a population-based case-control study of genital
      warts, 26 (58%) of 45 women with recurrent genital warts were seropositive
      compared with 19 (19%) of 101 control women with no history of genital warts
      (odds ratio, 6.5; 95% confidence interval, 3.0, 14.1). Among a cohort of pregnant
      women, 7 (88%) of 8 with recurrent warts were seropositive compared with 24 (30%)
      of 79 pregnant women with no such history. A significant association between
      seropositivity to HPV-6 capsids and the detection of HPV-6/11 DNA from genital
      specimens by polymerase chain reaction was also observed. Men with genital warts
      were less likely to be seropositive than were women with genital warts, and a
      positive association between the number of sex partners and seropositivity was
      observed among only the female university students.

PMID- 7797900
TI  - Protective effect of a 21-aminosteroid during experimental pneumococcal
      meningitis.
AB  - This study investigated whether the 21-aminosteroid U74389F, an inhibitor of
      lipid peroxidation, attenuates pathophysiologic changes in experimental
      pneumococcal meningitis. Infected rats injected intravenously with vehicle of
      [corrected] U74389F developed increases in regional cerebral blood flow (rCBF),
      intracranial pressure (ICP), brain water content, and white blood cells (WBC) in
      cerebrospinal fluid (CSF) within 8 h after intracisternal challenge. Pretreatment
      with or administration of U74389F 4 h after infection significantly reduced the
      increase in ICP but had no effect on rCBF increase. Moreover, U74389F
      pretreatment significantly reduced brain water content and CSF WBC count. In
      vitro, U74389F inhibited iron-dependent lipid peroxidation of astrocyte cultures
      and the production of tumor necrosis factor-alpha, interleukin-6, and nitric
      oxide by stimulated macrophages. These data suggest that U74389F modulates early
      pathophysiologic alterations in experimental pneumococcal meningitis.

PMID- 7797901
TI  - The role of pneumolysin and autolysin in the pathology of pneumonia and
      septicemia in mice infected with a type 2 pneumococcus.
AB  - Mice were infected intranasally with a serotype 2 pneumococcus, a pneumolysin
      negative derivative (PLN-A), or an autolysin-negative derivative (AL-2). Numbers
      of wild type pneumococci were seen in the lung from approximately 12 h after
      infection and were first detected in the blood around this time.
      Immunofluorescent staining of lung sections showed that pneumolysin was produced
      in vivo. Pneumococcal infection resulted in alteration of the composition of the
      blood but not the bone marrow. Some of the hematologic changes did not occur
      after PLN-A. PLN-A had a slower growth rate in the lung and bacteremia was
      delayed. AL-2 was rapidly cleared from the lungs and was not detected in the
      blood. These events paralleled the pattern of histology in the lung, with the
      severity of inflammation reduced with PLN-A and no inflammation or hematologic
      changes with AL-2.

PMID- 7797902
TI  - Epidemic streptococcal disease among Army trainees, July 1989 through June 1991.
AB  - Outbreaks of group A streptococcal infection occurred at four of seven US Army
      basic training installations between 1 July 1989 and 30 June 1991. Study data
      were collected through a respiratory disease surveillance program and on-site
      epidemiologic investigations. Although hospitalizations were frequent (range, 191
      334) during each outbreak, average rates of hospitalization were low (2.4-4.8
      hospitalizations/1000 trainees/week). Outbreak-associated morbidity included
      streptococcal toxic shock syndrome (2 cases, 1 fatal), acute rheumatic fever (6),
      acute glomerulonephritis (1), scarlet fever (1), and numerous other invasive
      sequelae. Four serotypes of Streptococcus pyogenes (M-1, -3, -5, and -18) were
      identified; M-18 caused significant disease at 2 installations. Disease control
      was rapidly achieved through prophylaxis programs using benzathine penicillin G
      in nonallergic trainees. These outbreaks extend other reports that document an
      evolution of the nature and severity of circulating S. pyogenes in the United
      States.

PMID- 7797903
TI  - Epidemiology of nasopharyngeal colonization with nontypeable Haemophilus
      influenzae in the first 2 years of life.
AB  - Two hundred children were followed from birth through 2 years of age with
      nasopharyngeal cultures to determine the normal colonization pattern of
      nontypeable Haemophilus influenzae. Forty-four percent of the children were
      colonized on one or more occasions; the acquisition rate was greatest in the
      first year. Monthly prevalence rates were 11%. Colonization with the initial
      strain persisted 1-5 months (median, 2). Children carried 1 predominant strain at
      a time but became colonized with up to 7 different strains (mean, 2.2). Children
      colonized with a single strain for < or = 2 months produced a greater
      nasopharyngeal secretory IgA to nontypeable H. influenzae response than did
      children colonized with different strains (log 2.35 +/- 0.68 vs. 1.89 +/- 0.25 U
      of P6 secretory IgA/ng/mL of total secretory IgA, P < .01). The duration of
      colonization with a strain and acquisition of a new strain may be affected in
      part by the local production of specific secretory IgA.

PMID- 7797904
TI  - Inhibition of endotoxin-induced cytokine release and neutrophil activation in
      humans by use of recombinant bactericidal/permeability-increasing protein.
AB  - To investigate the effects of a recombinant endotoxin-binding protein,
      bactericidal/permeability-increasing protein (rBPI23), on cytokine release and
      neutrophil activation in endotoxemia in humans, 8 volunteers were challenged
      twice with endotoxin and concurrently received either rBPI23 or placebo in a
      randomized, placebo controlled, double-blind crossover study, rBPI23 treatment
      significantly lowered circulating endotoxin levels (P = .02) and resulted in a
      significant reduction in the release of tumor necrosis factor (TNF), soluble TNF
      receptors p55 and p75, interleukin (IL)-6, IL-8 (P < .01 for each), and IL-10
      levels (P = .02) but did not prevent the endotoxin-induced rise in body
      temperature. The early endotoxin-induced leukopenia was blunted (P = .08), and
      neutrophil degranulation, as measured by circulating levels of elastase/alpha 1
      antitrypsin complexes (P = .03) and lactoferrin (P < .01), was largely prevented
      by rBPI23. The results of this study indicate that rBPI23 is capable of
      neutralizing many of the biologic effects of endotoxin in humans.

PMID- 7797906
TI  - Oral immunization with recombinant Helicobacter pylori urease induces secretory
      IgA antibodies and protects mice from challenge with Helicobacter felis.
AB  - Helicobacter pylori, a gram-negative spiral bacterium, is the cause of chronic
      superficial (type B) gastritis and peptic ulcer disease. The urease enzyme of H.
      pylori was expressed as an inactive recombinant protein in Escherichia coli,
      purified as particulate structures of 550-600 kDa molecular mass with a diameter
      of approximately 12 nm. Given orally, 5 micrograms of urease with an appropriate
      mucosal adjuvant, such as the labile toxin of E. coli, protected 60%-100% of mice
      against challenge with virulent Helicobacter felis. Protection correlated with
      the level of secretory IgA antibodies against urease. Oral administration of
      antigen was as effective or better than intragastric administration. Parenteral
      injection of antigen or intragastric administration of high-dose antigen without
      adjuvant elicited serum IgG but no IgA antibodies and did not confer protection.
      Recombinant urease as an oral vaccine candidate deserves further investigation as
      an approach to the prevention of Helicobacter-induced chronic gastroduodenal
      diseases in humans.

PMID- 7797905
TI  - Synergistic effect of E5, imipenem, and volume support during fulminant
      intraabdominal sepsis in rats.
AB  - The protective effect of volume support, imipenem, and the anti-endotoxin
      antibody E5 given as mono- or combination therapy was studied in fulminant
      intraabdominal sepsis in rats. Mortality, blood levels of bacteria, endotoxin,
      tumor necrosis factor (TNF), and lactate, and packed cell volume were measured.
      All monotherapy regimens improved survival, and protection decreased with delayed
      intervention. Volume support prevented dehydration and lactate accumulation but
      had no effect on levels of bacteria, endotoxin, or TNF. Imipenem killed bacteria
      and released endotoxin, and lactacidosis was reduced. E5 reduced endotoxin, TNF,
      and lactate but not bacteremia. The imipenem-induced increase in plasma endotoxin
      was abolished by E5. When E5 was added to a regimen of volume support plus
      imipenem 6 h after induction, it gave an extra improvement of survival, but this
      synergism disappeared when intervention was delayed 4 h more. The primary effect
      of E5 was a reduction in plasma endotoxin level.

PMID- 7797907
TI  - The emerging diversity of the electrophoretic types of Vibrio cholerae in the
      Western Hemisphere.
AB  - Since the Latin American cholera epidemic began in 1991, 447 isolates of Vibrio
      cholerae O1 from the Western Hemisphere have been assayed by multilocus enzyme
      electrophoresis (MEE) to determine allelic variation among 16 enzyme-encoding
      genes. Two electrophoretic types (ETs) were identified among toxigenic isolates
      from Latin America: 323 were ET 4, the ET associated with the Latin American
      epidemic, and 29 were ET 3. Twenty-three of these ET 3 isolates had a distinctive
      antimicrobial resistance pattern also seen in isolates imported into the United
      States from Latin America and Southeast Asia. These resistant isolates had an
      identical ribotype and nearly identical pulsed-field gel electrophoresis (PFGE)
      patterns. Most nontoxigenic isolates analyzed were not precursors or descendants
      of toxigenic epidemic strains. MEE provided a population genetic frame-work for
      the interpretation of PFGE and ribotype data from the isolates in this study. All
      three methods identified 2 distinct strains of toxigenic V. cholerae O1 currently
      epidemic in Latin America.

PMID- 7797908
TI  - Experimental human gonococcal urethritis: 250 Neisseria gonorrhoeae MS11mkC are
      infective.
AB  - Neisseria gonorrhoeae MS11mkA (mkA) expresses one 3.6-kDa lipooligosaccharide
      (LOS). Variant MS11mkC (mkC), expressing four larger LOSs, occurs in vitro among
      mkA at a frequency of 10(-3). Infectivity of these variants was compared in 2
      groups of volunteers inoculated with approximately 40,000 piliated, Opa-
      gonococci of either strain. The mkC variant infected 5 of 5 while mkA infected
      only 2 (40%) of 5. Gonococci recovered from the mkA infections showed a
      transition toward the mkC LOS phenotype. The mkA inoculum contained approximately
      40 mkC gonococci. These data confirmed earlier studies and suggested that small
      numbers of mkC gonococci would be infective. This hypothesis was tested in three
      more experiments. In two, volunteers were inoculated with 250 or 1250 mkC,
      infecting 3 of 7 in each group, and in the third, 1600 mkC infected 2 of 6,
      resulting in a total of 8 of 20 infected by < or = 1600 mkC. Gonococci shed by
      infected volunteers maintained the mkC LOS phenotype but shifted from Opa- to
      Opa+. Thus, LOS and opacity protein, as well as pilus, are gonococcal virulence
      factors.

PMID- 7797909
TI  - Inflammatory cytokines produced in response to experimental human gonorrhea.
AB  - Inflammatory cytokine production in men was examined after intraurethral
      challenge of volunteers with Neisseria gonorrhoeae MS11mkA or MS11mkC. Increased
      interleukin (IL)-8, IL-6, and tumor necrosis factor-alpha (TNF-alpha) were
      detected in urine before the onset of symptoms and peaked simultaneously with the
      detection of IL-1 beta at the onset of symptoms. Urine cytokine levels returned
      to baseline or near baseline within 48 h after antibiotic therapy. In plasma, IL
      8, TNF-alpha, IL-1 beta, and IL-6 were elevated at the onset of symptoms in 9, 5,
      4, and 3 of 10 subjects, respectively, and returned to near normal within 48 h
      after treatment. IL-1 alpha and granulocyte-macrophage colony-stimulating factor
      were not consistently detected in urine or plasma after challenge. Cytokine mRNA
      transcripts in peripheral blood mononuclear cells were not altered by the
      infection. The findings suggest that IL-8, IL-6, and possibly TNF-alpha were
      produced at the local site of infection, whereas IL-1 beta was derived from
      infiltrating leukocytes.

PMID- 7797911
TI  - Differences in oxidant release by human polymorphonuclear leukocytes produced by
      stimulation with different phases of Coccidioides immitis.
AB  - Human polymorphonuclear leukocytes (PMNL) inhibit growth of arthroconidia and
      young spherules but not mature spherules of Coccidioides immitis. To evaluate
      these differences, oxidants were measured when PMNL were exposed to C. immitis or
      other particulate stimuli. Concentrations of arthroconidia, young spherules,
      mature spherules, and Candida glabrata were adjusted to result in equivalent
      superoxide release. Hydrogen peroxide and hypochlorous acid were stimulated by
      arthroconidia or young spherules but were undetectable after exposure to mature
      spherules. Levels of catalase in mature spherules were too low to account for the
      low levels of hydrogen peroxide and hypochlorous acid. When mature spherules were
      added to arthroconidia or zymosan, stimulation of hydrogen peroxide and
      hypochlorous acid occurred. The results suggest that mature spherules stimulate
      superoxide release but interfere with hydrogen peroxide and hypochlorous acid
      production. The low levels of these antimicrobial oxidants may contribute to
      resistance of C. immitis to human PMNL.

PMID- 7797910
TI  - Serologic response to human papillomavirus type 16 (HPV-16) virus-like particles
      in HPV-16 DNA-positive invasive cervical cancer and cervical intraepithelial
      neoplasia grade III patients and controls from Colombia and Spain.
AB  - A human papillomavirus (HPV) type 16 virus-like particle-based ELISA was used to
      assess antivirion immune responses in 300 women participating in cervical cancer
      case-control studies in Colombia and Spain. Virion IgG antibodies were detected
      in the sera of 51% and 59% of women with HPV-16 DNA-positive invasive cervical
      cancer and 81% and 73% of women with HPV-16 DNA-positive cervical intraepithelial
      neoplasia grade III (CIN III) in Colombia and Spain, respectively. Capsid
      antibodies were detected in 22% and 3% of cancer controls (P < .001) and in 43%
      and 10% of CIN III controls (P = .010) from Colombia and Spain, respectively.
      Since Colombia has an 8-fold higher incidence of cervical cancer, these results
      demonstrate an association between ELISA positivity and cancer risk. Capsid
      antibody responses did not correlate with humoral responses of the same women to
      HPV-16 E6 and E7 oncoproteins.

PMID- 7797913
TI  - Crude extract and recombinant protein of Cryptosporidium parvum oocysts induce
      proliferation of human peripheral blood mononuclear cells in vitro.
AB  - Cryptosporidium parvum preparations were studied for their ability to induce
      specific proliferation of cultured human peripheral blood mononuclear cells
      (PBMC) from both immunocompetent and human immunodeficiency virus-positive
      persons, some of whom had transient cryptosporidiosis. The proliferation of PBMC
      from sensitized donors induced by C. parvum preparations was due mainly to
      antigen-specific rather than nonspecific activation, as indicated by the kinetics
      of the proliferative response, inhibition of the PBMC proliferation by a
      monoclonal antibody directed against major histocompatibility complex class II
      specific HLA-DR molecule, and lack of proliferation of umbilical cord blood PBMC.
      PBMC from immunocompromised patients did not proliferate in response to C. parvum
      specific antigens. The supernatants of PBMC obtained from immunocompetent donors
      contained interleukin-10 and interferon (IFN)-gamma after PBMC were exposed to C.
      parvum preparations. High IFN-gamma values were found in patients who had
      recovered from cryptosporidiosis, suggesting that IFN-gamma plays a role in
      resolving this infection.

PMID- 7797912
TI  - Irreversible effects of ivermectin on adult parasites in onchocerciasis patients
      in the Onchocerciasis Control Programme in West Africa.
AB  - Ivermectin is an effective drug for the treatment of human onchocerciasis, a
      disease caused by the parasitic filarial nematode Onchocerca volvulus. When
      humans are treated, the microfilariae normally found in the skin are rapidly and
      very nearly completely eliminated. Nonetheless, after a delay, microfilariae
      gradually reappear in the skin. This study is concerned with the causes of this
      delay. Hypotheses are tested by comparing the results of model calculations with
      skin microfilaria counts collected from 114 patients during a trial of five
      annual treatments in the focus area of Asubende, Ghana. The results obtained
      strongly suggest that annual treatment with ivermectin causes an irreversible
      decline in microfilariae production of approximately 30%/treatment. This result
      has important implications for public health strategies designed to eliminate
      onchocerciasis as a significant health hazard.

PMID- 7797914
TI  - Safety and cellular and humoral immune responses of a booster dose of varicella
      vaccine 6 years after primary immunization.
AB  - Four hundred nineteen children and adolescents immunized with live varicella
      vaccine 4-6 years earlier were enrolled in a study to evaluate the safety and
      immune response to a booster dose containing approximately 3300 pfu of virus. Of
      the subjects, 99% (414/419) maintained antibody to varicella zoster virus (VZV)
      with a geometric mean titer of 25.7 and mean stimulation index (SI) for VZV
      specific lymphoproliferation response of 40.3 +/- 5.3 (SE). Some 7-10 days after
      the booster immunization, seropositivity rates increased to 100% (302/302), and
      GMT was 143.6 (anamnestic response). At 6 weeks after the booster inoculation, a
      subset of subjects had 100% seropositivity (74/74) with a GMT of 218.8 and an SI
      of 58.6. After 3 months, seropositivity was 100% (358/358), GMT was 119.0, and SI
      was 61.4.

PMID- 7797915
TI  - Establishment of novel lymphoid cell lines dually infected with human T cell
      lymphotropic viruses types I and II.
AB  - With the goal of establishing an in vitro system of dual infection with human T
      cell lymphotropic viruses (HTLV) types I and II, rabbit lymphocytes were
      cocultured with a mixture of lethally irradiated HTLV-I-producing Ra-1 and HTLV
      II-producing RII cell lines. This gave rise to a lymphoid cell line, RW-1, that
      was dually infected with HTLV-I and -II as detected by immunofluorescence
      staining, electron microscopy, and polymerase chain reaction using primers
      specific for the pol and env regions of each virus and by Southern blot
      hybridization. Two clonal cell lines derived from RW-1 were also coinfected with
      the viruses, indicating that dual infection had occurred at the single cell
      level. The coinfection could be readily propagated to fresh lymphocytes by
      coculture with RW-1. In contrast, attempts to superinfect HTLV-I-infected
      lymphoid cell lines with HTLV-II and vice versa were consistently unsuccessful,
      suggesting receptor interference between HTLV-I and -II.

PMID- 7797916
TI  - Foscarnet decreases human immunodeficiency virus RNA.
AB  - Foscarnet inhibits human immunodeficiency virus (HIV) replication in vitro and
      decreases p24 antigenemia in patients with cytomegalovirus (CMV) retinitis. To
      evaluate the effect of foscarnet on HIV replication, HIV RNA was quantitated in
      17 patients before and during foscarnet therapy. Fifteen patients had CMV
      retinitis, 1 had CMV encephalitis, and 1 had intractable zoster. A decrease in
      HIV RNA was observed in 16 of 17 patients. Before the introduction of foscarnet,
      mean HIV RNA was 5.82 +/- 0.24 log RNA/mL and, after a median of 13 days of
      therapy, mean HIV RNA was 5.30 +/- 0.27 log RNA/mL (P < .001). Among patients
      with detectable p24 antigen at baseline, a significant decrease was observed (P =
      .017). This decrease in HIV RNA demonstrates that foscarnet is a potent
      antiretroviral drug.

PMID- 7797918
TI  - Transplantation of skin from human immunodeficiency virus type 1-transgenic mice
      to normal congenic mice results in graft rejection.
AB  - Skin from mice transgenic (Tg) for part of the human immunodeficiency virus type
      1 (HIV-1) genome was transplanted onto normal mice of the same strain. All Tg
      grafts were rejected within 29 days. In contrast, skin from normal mice that was
      transplanted to HIV-1-Tg recipients remained viable for > 67 days. Histologic
      examination of Tg grafts on normal mice showed evidence of monocytic infiltrates.
      Monocytic infiltrates were not observed, however, when either normal or Tg skin
      was transplanted onto Tg mice. Immunohistologic staining verified the presence of
      gp120 protein expression in the Tg-transplanted skin but not in adjacent normal
      skin. It is concluded that the Tg mice are immunologically tolerant to the HIV-1
      gene products they express.

PMID- 7797917
TI  - Human immunodeficiency virus (HIV) type 1 infection status and in vitro
      susceptibility to HIV infection among high-risk HIV-1-seronegative hemophiliacs.
AB  - Blood samples were obtained from 16 hemophiliacs who had a 50%-94% defined risk
      of human immunodeficiency virus (HIV) type 1 infection on the basis of treatment
      history and from 14 controls not at risk for HIV infection. HIV-1 was not
      detected in any of 12 patient samples by cocultivation nor in 14 patient samples
      by the polymerase chain reaction. Peripheral blood cells from 7 seronegative
      hemophiliacs at highest risk of seroconversion (94%) were less susceptible to HIV
      1 infection in vitro than were cells from healthy controls (P < .025, one-tailed
      Wilcoxon rank sum test). In contrast, the susceptibility to HIV-1 infection of
      lymphocytes from 6 seronegative hemophiliacs at moderate risk (50%-56%) of
      seroconversion did not differ from that of cells from controls or from high-risk
      hemophiliacs. Therefore, prolonged periods of seronegative HIV-1 infection are
      not common in this high-risk population. In addition, among hemophiliacs there
      may exist heterogeneity in susceptibility to HIV-1 infection in vitro and in
      vivo.

PMID- 7797919
TI  - Incidence of venereal warts in human immunodeficiency virus-infected and
      uninfected women.
AB  - A cohort of human immunodeficiency virus (HIV)-infected (n = 253) and uninfected
      (n = 658) women was prospectively studied to assess the relationship between
      venereal warts and HIV status, adjusting for self-reported and biologic measures
      of sexual risk behavior. Participants were assessed every 6 months for venereal
      warts and other sexually transmitted diseases, self-reported sexual behavior, and
      CD4 cell counts. The incidence of venereal warts was significantly increased in
      HIV-infected women (8.2 vs. 0.8/100 person-years of follow-up). This difference
      remained after adjusting for measures of high-risk sexual behavior and was
      observed in women at all levels of immune function, including those with > or =
      500/mm3 CD4 cells. The increased risk of venereal warts in HIV infection can
      occur relatively early in HIV disease and appears chiefly attributable to a
      higher risk of progression from subclinical to clinical human papillomavirus
      (HPV) disease rather than to a higher risk of HPV acquisition.

PMID- 7797920
TI  - Frequency of UL97 phosphotransferase mutations related to ganciclovir resistance
      in clinical cytomegalovirus isolates.
AB  - Cytomegalovirus (CMV) isolates from subjects who received ganciclovir therapy
      were tested for susceptibility to ganciclovir by a plaque reduction assay.
      Results were correlated with restriction enzyme and sequence analysis of the CMV
      UL97 phosphotransferase gene. Of the 30 isolates, 20 had one or more mutations in
      UL97 affecting amino acid encoding at codons 460, 520, or 591-596. All 20 were
      resistant to ganciclovir, with an IC50 of > 6.0 microM (range, 6.7-50.0). The
      remaining 10 isolates had no mutations at these loci; 8 were susceptible to
      ganciclovir while the other 2 were borderline resistant (IC50s, 6.6 and 7.2
      microM). None of 40 control CMV isolates from untreated subjects contained any
      amino acid changes at these loci. The three most common mutations at codons 460,
      594, and 595 were detected by restriction digest analysis in 16 (80%) of 20
      isolates and in 16 (73%) of 22 isolates with ganciclovir IC50s > 6.0 microM.
      These results indicate that the majority of ganciclovir-resistant clinical
      isolates contain diagnostically useful mutations in UL97.

PMID- 7797921
TI  - Topical immunoglobulin is an effective therapy for parainfluenza type 3 in a
      cotton rat model.
AB  - A cotton rat model was used to test the efficacy of topical immunotherapy against
      parainfluenza type 3 (PIV3) infection. On day 3 after experimental infection with
      10(5.5) pfu of PIV3, animals were treated with 2-fold dilutions of convalescent
      cotton rat serum or with one of two purified human immunoglobulin preparations;
      all three had moderate titers of anti-PIV3 neutralizing antibody (range, 1:200
      1:1000). Therapy with high concentrations of all three preparations resulted in
      significant reductions of > or = 2 logs (> or = 100-fold) of pulmonary virus
      titers compared with titers for control animals. Little or no reduction in virus
      titers were seen in nasal tissues.

PMID- 7797922
TI  - Three summertime outbreaks of influenza type A.
AB  - In the Northern Hemisphere, sporadic cases of influenza occur during the summer,
      yet summertime outbreaks are rare. From 12 August through 2 September 1993, three
      influenza outbreaks in Louisiana were investigated using medical-record review,
      interviews, viral cultures, serology, and active surveillance for influenza-like
      illness in Louisiana. Attack rates in the outbreaks were 61% (69/114), 42%
      (24/57), and 45% (23/51). Viruses isolated were most closely related to influenza
      A/Beijing/32/92 (H3N2). The identification of influenza A as the cause of the
      first two outbreaks led to the recommendation for amantadine use in the third
      outbreak. Active surveillance did not detect any other outbreaks of influenza
      like illness during August or September 1993. Out-of-season influenza A outbreaks
      can therefore occur when little influenza-like illness is present in a community.
      Evaluation of outbreaks of acute, febrile respiratory illness outside the
      influenza season should include this possibility, since rapid detection can lead
      to the timely use of amantadine or rimantadine.

PMID- 7797923
TI  - Hepatitis C virus viremia in SCID-->BNX mouse chimera.
AB  - Chimpanzees are currently the only nonhuman animal model for reproducible
      propagation of hepatitis C virus (HCV). A chimeric mouse model was used for the
      induction of hepatitis C viremia, using BNX (beige/nude/X-linked immunodeficient)
      mice preconditioned by total body irradiation and reconstituted with SCID mouse
      bone marrow cells. HCV-infected liver fragments from patients with HCV RNA
      positive sera were transplanted under the kidney capsule of the chimeric mice.
      HCV-specific RNA sequences were detected by reverse transcriptase nested
      polymerase chain reaction (RT-PCR) in serum of approximately 50% of grafted
      animals. In addition, normal liver specimens were incubated with HCV serum and
      transplanted into chimeric mice, leading to viremia in approximately 25% of
      animals. Sequential histologic evaluation of the liver implants, from day 2 to
      week 14 after transplantation, revealed loss of lobular architecture within the
      implants. However, viremia persisted for 10-50 days after transplantation. These
      results offer a new HCV model.

PMID- 7797925
TI  - Comparison of trivalent cold-adapted recombinant (CR) influenza virus vaccine
      with monovalent CR vaccines in healthy unselected adults.
AB  - A trivalent cold-adapted recombinant (CR) influenza virus vaccine containing
      types A and B viruses was compared with monovalent vaccines of each virus in a
      double-blind, placebo-controlled trial. Adults with a wide range of preexisting
      antibody titers received one 0.5-mL dose intranasally of trivalent vaccine;
      monovalent A/H1N1, A/H3N2, or B vaccine; or placebo. All vaccines were well
      tolerated. Serum antibody response frequencies and postvaccination geometric mean
      antibody titers were similar for recipients of trivalent or the corresponding
      monovalent vaccine for each of the vaccine components. Stepwise logistic
      regression analysis of the antibody responses of trivalent vaccine recipients
      demonstrated that response to one vaccine virus did not adversely affect the
      likelihood of response to the other viruses. This study failed to find serologic
      evidence of interference between vaccine viruses, suggesting that trivalent CR
      influenza virus vaccine may be useful for preventing influenza in adult
      populations.

PMID- 7797924
TI  - Replication of influenza A viruses in a green monkey kidney continuous cell line
      (Vero).
AB  - A Vero cell line was investigated as a suitable host system for primary isolation
      and cultivation of influenza A viruses. The efficiency of primary isolation for
      currently circulating (H3N2) strains was similar in Vero and MDCK cells. Of 72
      egg-adapted strains investigated, 90.3% were detectable hy hemagglutinin (HA)
      titration in Vero cells after the first passage and 51.4% after the second. The
      amino acid sequences of the HA1 region of influenza A viruses isolated and
      passaged in Vero cells were identical to those of their MDCK-grown counterparts.
      At low MOI, high yields of influenza virus were achieved in Vero cells by
      multiple additions of trypsin to the medium. After 20 passages of A/England/1/53
      (H1N1) in Vero cells, the titer of infectious virus was 8.37 log10 TCID50/mL, and
      virus protein yields were as high as in MDCK cells.

PMID- 7797927
TI  - Quasispecies of hepatitis C virus and genetic drift of the hypervariable region
      in chronic type C hepatitis.
AB  - The sequential variations of amino acid sequences in the hypervariable region
      (HVR)-1 of hepatitis C virus (HCV) and changes of viremia in 2 patients with
      different clinicopathologic courses of chronic hepatitis C were studied. By using
      polymerase chain reaction amplification, cloning, and sequencing of HVR-1,
      genetic heterogeneity of HCV was shown. The highest annual rate of consensus
      amino acid variation per 100 sites in HVR-1 of a patient with acute exacerbation
      was 15.4 versus 2.3 in a patient without acute exacerbation. The serial serum HCV
      titers were also quantified. An abrupt elevation of serum titer was associated
      with acute exacerbation, whereas constant viremia was observed when acute
      exacerbation did not occur. These results show that a quasispecies of HCV exists
      and patients with different courses of chronic hepatitis may have different
      sequential changes in virus titer and genetic drift of HVR-1.

PMID- 7797926
TI  - A 3-week hepatitis B vaccination schedule provides rapid and persistent
      protective immunity: a multicenter, randomized trial comparing accelerated and
      classic vaccination schedules.
AB  - Hepatitis B (HB) vaccinations given once weekly for 3 weeks can provide early
      seroprotection. This study compared immune responses induced by the accelerated
      (A; days 0, 10, 21) and classic (C; days 0, 28, 56) HB vaccination schedules. Two
      hundred seventy healthy subjects (95 men, 175 women) with a mean age of 23.8
      years received 3 doses of GenHevac B, a recombinant vaccine produced in mammalian
      cells. The subjects were randomly assigned to schedules A or C. A booster dose
      was given 1 year later. One month after the third dose, 70% (schedule A) and 92%
      (schedule C) of the subjects were seroprotected and 100% (A) and 99% (C) had
      developed anti-pre-S2 antibodies. Before booster injections, 93% (A) and 95% (C)
      of the subjects were seroprotected, and 1 month after the booster, almost all
      subjects were seroprotected. A 3-week HB vaccination schedule with GenHevac B can
      confer early protective immunity lasting up to 1 year.

PMID- 7797928
TI  - Detection of anti-Chlamydia pneumoniae IgE in children with reactive airway
      disease.
AB  - An association of Chlamydia pneumoniae infection and reactive airway disease has
      been demonstrated in children. To determine if C. pneumoniae infection triggers
      production of C. pneumoniae-specific IgE, sera were examined from 45 children
      with and without C. pneumoniae infection. Anti-C. pneumoniae IgE was demonstrated
      by immunoblotting in 12 (85.7%) of 14 culture-positive asthmatic patients with
      wheezing compared with only 1 (9.1%) of 11 culture-positive patients with
      pneumonia, 2 (18.2%) of 11 culture-negative asthmatic children with wheezing, and
      2 (22.2%) of 9 culture-negative asymptomatic patients. The most commonly
      recognized proteins were at 98 (82.4%), 78 (58.8%), 58-60 (70.6%), and 36 kDa
      (64.7%). The presence of anti-C. pneumoniae IgE by immunoblotting was not
      associated with the presence of anti-C. pneumoniae IgG and IgM by
      microimmunofluorescence. These results suggest that production of specific IgE
      may be an underlying mechanism leading to reactive airway disease in some
      patients with C. pneumoniae infection.

PMID- 7797930
TI  - Enterococcus faecalis cytolysin without effect on the intestinal growth of
      susceptible enterococci in mice.
AB  - A murine model was developed to determine whether the Enterococcus faecalis
      cytolysin, through its bacteriolytic action on gram-positive bacteria, could
      promote intestinal overgrowth of cytolytic strains. Sets of E. faecalis strains
      with varying cytolytic production and susceptibility to cytolytic activity were
      mixed 1:1 and allowed to compete in vitro in broth or in vivo after orogastric
      administration in mice pretreated with antibiotics. In general, cytolytic strains
      outgrew, by as much as 2000-fold, competing cytolysin-susceptible or 
      hypersusceptible strains in vitro. In contrast, no growth advantage was observed
      in vivo, despite similar transient colonization of the murine intestinal tract by
      both cytolytic and cytolysin-susceptible strains. These data suggest that
      cytolysin plays little role in promoting intestinal overgrowth of enterococci
      through bacteriolytic activity.

PMID- 7797929
TI  - Extent and kinetics of genetic change in the omp1 gene of Chlamydia trachomatis
      in two villages with endemic trachoma.
AB  - Variants of Chlamydia trachomatis in two Gambian villages with hyperendemic
      trachoma were analyzed by omp1-based polymerase chain reaction and sequencing
      from conjunctival swabs. Samples collected over a 22-month period included a
      complete cross-sectional study of each village. Overall, 4 genovar A and 4 B
      variants were characterized by point mutations in the omp1 gene, resulting in
      changes in the inferred amino acid sequence. Two genovar A and 2 B variants
      accounted for 87% of the total ocular chlamydial infection in both villages.
      Although some flux in the prevalence of individual variants was observed
      overtime, their overall distribution remained remarkably stable. There was no
      evidence of major antigenic shift arising from recombination events at the omp1
      locus as described for genital tract infection. These results indicate that omp1
      variation in these two trachoma-hyperendemic communities is limited and unlikely
      to hamper development of trachoma vaccines based on the major outer membrane
      protein.

PMID- 7797931
TI  - Incidence of antibiotic resistance in Listeria species.
AB  - To define the prevalence of antibiotic resistance in Listeria species pathogenic
      for humans and animals, 1100 isolates (60 from cases of listeriosis and 1040 from
      food and environment) collected worldwide were screened. Of the 61 tetracycline-
      and minocycline-resistant strains (37 Listeria monocytogenes), 57 harbored
      tet(M); 4 non-L. monocytogenes isolates contained tet(S). One Listeria innocua
      isolate was also resistant to streptomycin and contained the tet(M) and aad6
      genes. An L. monocytogenes isolate was trimethoprim-resistant, a characteristic
      not reported previously in Listeria species, because of the presence of a yet
      uncharacterized gene. Three clinical isolates of L. monocytogenes were resistant
      to low levels of streptomycin. Since the tet(M), tet(S), and aad6 genes are
      common in enterococci and streptococci, these data suggest transfer from the
      latter to Listeria species. Uniform susceptibility to tetracycline, minocycline,
      trimethoprim, and streptomycin cannot be assumed any longer for Listeria species.

PMID- 7797932
TI  - Comparison of polymerase chain reaction with microagglutination test and culture
      for diagnosis of leptospirosis.
AB  - Polymerase chain reaction assay (PCR) amplifying a fragment of the Leptospira rrs
      gene was compared with culture and microagglutination test (MAT) for the
      diagnosis of leptospirosis in a study of 200 patients with various clinical
      syndromes compatible with leptospirosis. For the first group of samples tested,
      PCR identified the 14 cases that later were unequivocally confirmed to be
      leptospirosis. Thirteen other systemic cases presenting decreasing leptospiral
      antibody titers were also detected by PCR. The average persistence of leptospiral
      DNA in serum was estimated at 12 days, with a maximum of 56 days in a culture
      confirmed case. The possibility of detecting leptospires in aqueous humor during
      the ocular complications of the disease was confirmed. The results suggest that
      PCR is an efficient tool for early diagnosis of leptospirosis during the first 10
      days of the disease, especially when the clinical expression of the disease is
      confusing.

PMID- 7797933
TI  - Lyme disease in human DR4Dw4-transgenic mice.
AB  - The evolution of Lyme arthritis in DR4-transgenic mice infected with Borrelia
      burgdorferi was studied because chronic Lyme arthritis in humans is associated
      with an increased frequency of the HLA-DR4 allele. B10 nontransgenic and DR4
      transgenic mice expressing chimeric human-mouse major histocompatibility complex
      class II genes in which the human alpha 1 and beta 1 domains of DR4Dw4 replaced
      the corresponding domains of the mouse I-E(d) were inoculated with B. burgdorferi
      and examined at up to 180 days for infection and disease. All mice were infected
      throughout the 180 days, and arthritis evolved to equal severity in transgenic
      and control mice within 30 days and resolved by day 120. Both groups of mice
      developed high antibody titers to B. burgdorferi, but antibodies to outer surface
      proteins A and B were not readily detectable. The DR4Dw4 transgene did not
      predispose mice to the development of chronic Lyme arthritis.

PMID- 7797934
TI  - Analysis of genetic diversity in cytotoxin-producing and non-cytotoxin-producing
      Helicobacter pylori strains.
AB  - Analysis of 32 Helicobacter pylori strains indicated a strong association between
      the presence of the cagA gene and a specific type of vacA allele found
      predominantly in cytotoxin-producing strains (P < .001). To determine whether
      tox+/CagA+ and tox-/CagA- strains constituted two separate noncombining lineages,
      sequences of the H. pylori ureC gene, cysS homologue, and the intergenic region
      between cysS and vacA were determined for multiple strains. The mean levels of
      nucleotide identity in the three regions were 96.7% +/- 0.5%, 95.0% +/- 1.0%, and
      89.0% +/- 2.9%, respectively. Multiple sequence alignments and dendrograms based
      on these three regions failed to identify two clonal populations of organisms for
      which cagA and vacA genotypes were markers. The presence of a 63- to 64-bp
      insertion in the cysS-vacA intergenic region was unrelated to the vacA genotype
      of the strains. These data suggest that recombination between Helicobacter
      genomes may occur in vivo.

PMID- 7797935
TI  - Plasma levels of cytokines in primary septic shock in humans: correlation with
      disease severity.
AB  - Thirteen patients (median age, 20 years) with life-threatening primary septic
      shock (10 meningococcal, 3 pneumococcal infections) were studied prospectively.
      All had a short history of sepsis (< or = 24 h) and no severe underlying disease.
      Two (15%) died. The logarithm of the initial plasma levels of tumor necrosis
      factor (TNF)-alpha, interleukin (IL)-1 beta, IL-6, IL-1 receptor antagonist (ra),
      and plasminogen activator inhibitor (PAI)-1 correlated significantly with APACHE
      II scores (r2 = .67, .57, .68, .81, and .68, respectively). The plasma levels of
      endotoxin, TNF-alpha, IL-1 beta, and PAI-1 decreased toward normal levels within
      the first 24 h of treatment, but IL-6 and IL-1ra levels remained high until
      clinical recovery. On admission, the molar excess of IL-1ra to IL-1 beta was >
      2000-fold in 11 of the 13 patients. Acute plasmapheresis in 11 of the 13 patients
      significantly increased the plasma clearance of TNF-alpha (P = .02).

PMID- 7797936
TI  - Assessment of a possible imbalance between tumor necrosis factor (TNF) and
      soluble TNF receptor forms in tuberculous infection of the central nervous
      system.
AB  - Distributions of tumor necrosis factor (TNF) and its soluble receptor forms, R55
      BP and R75-BP, were analyzed in the cerebrospinal fluid of patients with severe
      acute or chronic central nervous system infections. Tuberculous infections were
      associated with high ratios of R55-BP and R75-BP to TNF, 27.2 and 28.0,
      respectively, suggesting a small biologically active fraction of TNF. The
      opposite was found in subjects with acute bacterial meningitis. They had large
      fractions of biologically active TNF and thus low ratios of R55-BP and R75-BP to
      TNF, 3.7 and 4.0, respectively. It is hypothesized that chronic infectious
      diseases, such as tuberculous infections, may be associated with inadequate
      production of TNF and a concomitant relative increase of soluble TNF receptors,
      which may prolong the disease.

PMID- 7797937
TI  - Phospholipase A2 is a circulating mediator in typhoid fever.
AB  - Circulating proinflammatory mediators have not been found in studies on typhoid
      fever, although the patients suffer from a systemic disease with characteristic
      protracted fever. The 14-kDa group II extracellular phospholipase A2 (PLA2) is
      induced by interleukin-1 and tumor necrosis factor and may mediate some of the
      effects of these cytokines. Circulating PLA2 concentrations were measured in 12
      typhoid fever patients on various days after admission and after recovery. On
      admission, mean concentrations of PLA2 were elevated (1444 +/- 1560 ng/mL) and
      decreased gradually and significantly to day 14 (55 +/- 48 ng/mL). patients with
      complicated disease had significantly higher PLA2 levels on admission. PLA2 was
      not produced in a lipopolysaccharide-stimulated whole blood culture, indicating
      that PLA2 originates from other types of cells. These data indicate that PLA2 may
      be a mediator of disease in protracted inflammatory diseases such as thyroid
      fever.

PMID- 7797938
TI  - Coagulation of whole blood stimulates interleukin-1 beta gene expression.
AB  - To study interleukin (IL)-1 beta gene expression, reverse transcription
      polymerase chain reaction was used on 25-microL whole blood samples from 11
      healthy subjects. Coagulated and unclotted whole blood was compared. There was no
      evidence of IL-1 beta gene expression in any time zero samples (i.e., whole blood
      from which mRNA was immediately extracted) from 11 subjects, whereas a 388-bp
      band representing IL-1 beta mRNA was detected in all coagulated samples. No mRNA
      for IL-1 beta was detected in EDTA-anticoagulated whole blood, although in these
      samples the addition of lipopolysaccharide as a positive control induced the
      expression of IL-1 beta. In time course studies on samples allowed to clot, mRNA
      for IL-1 beta was detectable after 30 min. These findings demonstrate that IL-1
      beta gene expression is not present in circulating cells of healthy subjects and
      that coagulation is a stimulus for IL-1 beta gene expression. This may be a
      mechanism by which thrombosis produces inflammation and fever.

PMID- 7797939
TI  - Experimental hepatitis E in pregnant rhesus monkeys: failure to transmit
      hepatitis E virus (HEV) to offspring and evidence of naturally acquired
      antibodies to HEV.
AB  - In an attempt to reproduce experimentally the fulminant hepatitis of pregnant
      women infected with hepatitis E virus (HEV), 4 nonpregnant and 6 pregnant rhesus
      monkeys in the first, second, or third trimester of pregnancy were inoculated
      intravenously with approximately 10(5.5) ID50 of HEV. Comparison of biochemical,
      histopathologic, and serologic profiles in pregnant and nonpregnant monkeys did
      not reveal an increase in the severity of hepatitis in the pregnant animals.
      Hematology and serum clinical chemistry values were in the normal range in all
      animals during the study. No evidence of neonatal infection with HEV was found in
      offspring. Two rhesus monkeys (1 pregnant, 1 nonpregnant) had naturally occurring
      anti-HEV antibodies prior to inoculation as detected by a standard ELISA and
      confirmed by a competition ELISA with hyperimmune chimpanzee serum. These animals
      demonstrated an anamnestic response when they were challenged with HEV.

PMID- 7797941
TI  - Genetic regulation of fever in Plasmodium falciparum malaria in Gambian twin
      children.
AB  - The role of genetic factors in determining the clinical response of children to
      Plasmodium falciparum infection is not fully understood. A longitudinal survey of
      malaria morbidity in a cohort of 258 pairs of twin children was conducted in a
      rural area of Gambia to assess the extent to which genetic factors determine the
      host's susceptibility and clinical response to infection. The marginal
      correlation (which measures the excess probability of both twins being affected
      above that expected assuming independence) for malaria was higher in dizygous
      (DZ) than in monozygous (MZ) twin pairs, indicating that infection per se is
      largely determined by environmental factors. Once infected however, both members
      of an MZ pair were more likely to develop fever than were twins of a DZ pair,
      suggesting that genetic factors influence the presentation of clinical disease.

PMID- 7797940
TI  - Empirically treated Pneumocystis carinii pneumonia in Los Angeles, Chicago, and
      Miami: 1987-1990.
AB  - Many patients infected with the human immunodeficiency virus (HIV) with symptoms
      suggestive of pneumonia are treated empirically for Pneumocystis carinii
      pneumonia (PCP), although other bacterial infections (e.g., tuberculosis) and
      pulmonary Kaposi's sarcoma may cause identical symptoms. Empiric treatment for
      PCP may result in misdiagnosis and mistreatment. When the outcomes of
      cytologically confirmed versus empirically treated PCP cases were evaluated, the
      most important predictors of in-hospital mortality were severity of illness and
      use of bronchoscopy. Persons who did not undergo bronchoscopy had higher
      mortality rates than patients negative by bronchoscopy or cytologically confirmed
      as positive for PCP (22% vs. 11% vs. 14%, P < .01), although severity of illness
      and timing of anti-PCP medications did not differ significantly. Compared with
      cytologically confirmed cases, persons who did not have bronchoscopy were more
      likely to die than were bronchoscopy-negative patients (P < .05), after adjusting
      for severity of illness. Bronchoscopy use may have contributed to better outcomes
      for persons treated for HIV-related PCP.

PMID- 7797942
TI  - Potential of the polymerase chain reaction in the diagnosis of active Toxoplasma
      infection by detection of parasite in blood.
AB  - Blood samples from 54 patients presenting with acute toxoplasmic lymphadenopathy
      were tested for the presence of Toxoplasma gondii DNA using a nested polymerase
      chain reaction (PCR). PCR test results of a single blood sample obtained 2-23
      weeks after onset of illness were positive for 19 (35%) of the 54 patients. Nine
      (53%) of 17 patients were positive by PCR when the initial blood sample was
      collected within the first 5 weeks of illness. In 7 of the 19 patients found
      positive, further blood samples were available, and subsequent clearance of T.
      gondii DNA from the blood was demonstrated. On the basis of positive findings
      among patients with acute toxoplasmosis and the absence of positive findings
      among 10 uninfected persons and 43 with past Toxoplasma infection, a positive PCR
      result appears to be a helpful indicator of active disease. However, since only
      53% of patients with lymphadenopathy persisting < or = 5 weeks were positive, a
      negative PCR result does not exclude recent infection.

PMID- 7797943
TI  - Leishmania-human immunodeficiency virus coinfection in the Mediterranean basin:
      isoenzymatic characterization of 100 isolates of the Leishmania infantum complex.
AB  - Isoenzymatic characterization was done on 100 isolates obtained from visceral
      leishmaniasis (VL) patients coinfected with human immunodeficiency virus (HIV);
      isolates had been received between 1986 and 1993 at the International Leishmania
      Cryobank and Identification Centre in Montpellier, France. Electrophoresis was
      done with 15 isoenzymes using the starch gel technique combined, where
      appropriate, with isoelectrofocusing. Nine Leishmania infantum zymodemes were
      identified; L. infantum zymodeme MON-1, the most common parasite of human VL in
      the Mediterranean basin, was the most frequent in coinfections. It could also
      occasionally be responsible for localized cutaneous leishmaniasis lesions.
      Several dermotropic zymodemes, which were responsible for localized cutaneous
      leishmaniasis in immunocompetent patients, caused VL in HIV-positive patients. In
      addition, in 10 patients, a second isolate obtained during relapses occurring
      between 1.5 and 9.0 months after treatment was identical to the original isolate.

PMID- 7797945
TI  - First detection of group C rotavirus in fecal specimens of children with diarrhea
      in the United States.
AB  - Group C rotaviruses cause sporadic cases and outbreaks of acute diarrhea in
      children and adults in many countries but have never been identified from
      patients in the United States. Fecal specimens from children with diarrhea who
      were hospitalized in Providence, Rhode Island, were screened for group C
      rotaviruses if rotavirus was detected by electron microscopy but the specimens
      were negative for group A rotavirus by ELISA. Of 16 specimens examined, 3 were
      positive for group C rotavirus by ELISA using reagents specific to the Cowden
      strain of porcine group C rotavirus and all 16 were positive using a more
      sensitive assay: reverse transcriptase-polymerase chain reaction. Group C
      rotavirus infections occurred primarily among infants in winter in 4 of the 5
      years examined and were acquired both in community and nosocomial settings.
      Future clinical and epidemiologic studies with group C rotavirus will require
      development of assays that are more sensitive and simpler to perform.

PMID- 7797944
TI  - A macaque model for hantavirus infection.
AB  - Cynomolgus macaques (Macaca fascicularis) were experimentally infected with
      Puumala virus (strain Hallnas), which causes nephropathia epidemica in humans in
      western Europe. During the first week after intratracheal inoculation, the
      monkeys exhibited signs of lethargy followed by mild proteinuria and
      microhematuria. Histopathologic changes during the first 7 weeks after infection
      were largely confined to abnormalities in medullary tubular cells of the kidneys,
      which coincided with the demonstration of viral antigen and viral RNA. The
      development of different classes of virus-specific plasma antibodies to the
      respective viral antigens were similar to those observed in humans with
      nephropathia epidemica. This first description of a nonhuman primate model for
      hantavirus infection shows that the cynomolgus macaque provides a suitable model
      with which to study the pathogenesis of Puumala virus infections and to evaluate
      new diagnostic methods, immunization strategies, and therapies.

PMID- 7797946
TI  - Seroprevalence of human T cell lymphotropic virus type II infection, with or
      without human immunodeficiency virus type 1 coinfection, among US intravenous
      drug users.
AB  - Seroprevalence of human T lymphotropic virus (HTLV) and human immunodeficiency
      virus type 1 (HIV-1) was determined among 7841 intravenous drug users (IVDUs)
      from drug treatment centers in Baltimore, Chicago, Los Angeles, New Jersey
      (Asbury Park and Trenton), New York City (Brooklyn and Harlem), Philadelphia, and
      San Antonio, Texas; 20.9% had evidence of HTLV infection, as determined using a
      p21e EIA for screening and p21e blot for confirmation. With a type-specific EIA
      and blot used in combination, HTLV-II was identified in 97.6% of HTLV-positive
      IVDUs whose sera could be subtyped. HIV-1 seroprevalence was 13.2%. HTLV-II
      without HIV-1 was most common in Los Angeles and San Antonio. HIV-1 without HTLV
      II was most common in New York, New Jersey, and Baltimore. Dual infection was
      most common in New York and New Jersey. Logistic regression analysis revealed
      that seroprevalence of HTLV-II was significantly greater with HIV-1 infection and
      increasing age and among women, blacks, and Mexican-Americans. In conclusion, it
      appears that among US IVDUs, nearly all HTLV infection is attributable to HTLV
      II, and HTLV-II infection is associated with HIV-1 and sociodemographic
      background.

PMID- 7797947
TI  - Zidovudine treatment prolongs survival and decreases virus load in the central
      nervous system of rhesus macaques infected perinatally with simian
      immunodeficiency virus.
AB  - To assess the potential therapeutic effects of zidovudine, rhesus macaques were
      inoculated with simian immunodeficiency virus (SIV) strain SMM/B670 at birth and
      infused either continuously or intermittently with zidovudine for 6-7 months.
      Zidovudine did not prevent infection but did significantly increase survival
      time, which was associated with lower serum p26 viral core antigen levels, a
      lower virus burden in the cerebrospinal fluid (CSF), and lower CSF quinolinic
      acid levels than in untreated monkeys. Two of 5 infected, untreated monkeys
      developed motor impairment within 6 months following infection, whereas motor
      impairments did not occur in infected, zidovudine-treated monkeys until after the
      drug was discontinued. Zidovudine treatment was well tolerated by rhesus infants
      with minimal, transient side effects. These results demonstrate that zidovudine
      treatment significantly decreases virus load within the central nervous system
      (CNS) and delays the onset of CNS dysfunction and immune disease in rhesus
      monkeys perinatally infected with SIV.

PMID- 7797950
TI  - [69th annual meeting of the Japanese Association for Infectious Diseases. Fukuoka
      City, Japan. April 13-14, 1995. Abstracts].

PMID- 7797948
TI  - In vitro T cell function, delayed-type hypersensitivity skin testing, and CD4+ T
      cell subset phenotyping independently predict survival time in patients infected
      with human immunodeficiency virus.
AB  - Human immunodeficiency virus type 1 (HIV-1)-infected patients (n = 335) in the US
      Air Force HIV Natural History Program were followed for 3 years (mean) after skin
      testing, immunophenotyping of CD4+ cell subsets, and measurement of in vitro
      interleukin-2 production after stimulation by phytohemagglutinin, alloantigens,
      tetanus toxoid, and influenza A virus. The T cell functional assay predicted
      survival time (P < .001) and time for progression to AIDS (P = .014). Skin
      testing for tetanus, mumps, and Candida antigen and the total number of positive
      tests (P < .001 for each) stratified patients for survival time. In a
      multivariable proportional hazards model, the T cell functional assay (P = .008),
      the absolute number of CD4+ T cells (P = .001), the percentage of CD4+ CD29+
      cells (P = .06), and the number of reactive skin tests (P < .001) predicted
      survival time. Thus, cellular immune functional tests have significant predictive
      value for survival time in HIV-1-infected patients independent of CD4+ cell
      count.

PMID- 7797951
TI  - [Analysis of the drill hole orientation in anterior cruciate ligament
      reconstruction].
AB  - In the reconstructive procedure of the anterior cruciate ligament (ACL), the
      relationship was investigated between the orientation of the drill holes from the
      isometric points and the deformity in the ligament graft. We first investigated,
      by numerical analysis, the optimal orientation of the drill holes for minimal
      deformation. Secondly, we experimentally by using eight fresh cadaveric knees,
      measured the relationship between the orientation of the drill holes and the
      bending angle in the grafts. The optimal orientation of the drill hole in the
      femur was found to be tilted 20 degrees laterally in the coronal plane and 23
      degrees anteriorly in the sagittal plane. In the tibia, the drill hole should be
      directed 24 degrees medially and 50 degrees anteriorly from the isometric point.
      The numerically analysed bending angle corresponded well to the results from the
      experimental study. The deformation in the graft on the femoral side was larger
      than that on the tibial side. Therefore, the orientation of the femoral drill
      hole was concluded to be more important than the orientation of the tibial drill
      hole.

PMID- 7797949
TI  - The predictive value of T cell function in vitro and pre-AIDS zidovudine use for
      survival after AIDS diagnosis in a cohort of homosexual men in Amsterdam.
AB  - The best independent predictors of survival after AIDS diagnosis were determined
      in 160 homosexual men from the Amsterdam Cohort Study (1987 CDC case definition).
      In a Cox model, all pre-AIDS laboratory markers gathered during follow-up in the
      study did not independently predict survival after AIDS. A second analysis, using
      data available only at AIDS diagnosis, revealed that T cell reactivity after
      stimulation with phytohemagglutinin and monoclonal CD3 antibodies and the CD4+
      cell count at diagnosis were independent predictors of survival. In an interval
      based Cox model, the predictive value of pre-AIDS zidovudine use was determined.
      One year after AIDS diagnosis, participants with pre-AIDS zidovudine use had a
      worse survival probability (relative hazard = 3.99). In conclusion, the survival
      probability of homosexual men with AIDS can be estimate adequately using
      information obtained at clinical AIDS diagnosis. Analysis revealed the important
      predictive value of T cell function tests in vitro.

PMID- 7797953
TI  - Antitumor effects of liposomes containing adriamycin on chemically-induced rat
      malignant fibrous histiocytoma.
AB  - Malignant fibrous histiocytoma (MFH) is the most common soft tissue sarcoma. No
      effective chemotherapeutic agents, however, have been reported. Here we report
      our evaluation of the antitumor effects of liposomes containing adriamycin (LADM)
      against chemically-induced rat MFH. Either free adriamycin (ADM) or LADM was
      administered at dosages of 4.0, 8.0 or 12.0 mg/kg by intravenous injection. The
      tumor responded to LADM with prolonged growth delay, but equivalent doses of free
      ADM were less effective. Additionally, LADM prolonged the life span of rats
      longer than did free ADM. Also, the body weight loss was less with LADM than with
      equivalent doses of free ADM. In tissue distribution studies, we observed that
      the ADM level in the blood and in the tumor with LADM remained higher than with
      free ADM. These results indicate that liposomes alter in vivo ADM tissue
      distribution and increase antitumor activity against rat MFH with reduced toxic
      side effects.

PMID- 7797952
TI  - [An experimental study on preserving the intervertebral discs, in dog--prior to
      disc allografting].
AB  - Disc grafting is a new surgical procedure that may be suitable for preserving
      mobility of the spine. This experimental study was designed to determine a method
      of favorably preserving a disc prior to allografting. The lumber vertebrae of
      adult mongrel dogs were aseptically excised, regarded as the vertebral body-disc
      unit, and preserved at -80 degrees C, or at 4 degrees C. In the preservation at 4
      degrees C, UW solution, Euro-Collins solution, EP-II solution, Ham's F-12, or
      physiological saline solution was used for preservation. Isotopes were used for
      determining the activities of the disc cells. In the preservation at -80 degrees
      C, it was difficult to maintain the activity regardless of the preservation
      period. There was no difference among these preservative solutions in the
      preservation at 4 degrees C on the nucleus pulposus, but the 2-day preservation
      in UW solution provided the best results in terms of the annulus fibrosus. Based
      on the results of these experiments, at -80 degrees C it was difficult to
      maintain the activity of disc cells while at 4 degrees C the UW solution was the
      most effective for preserving the anulus fibrosus. However the period of
      preservation was very short, and a new method to enable longer periods of
      preservation should be developed.

PMID- 7797954
TI  - Canine cadaveric study of flexor tendon repair using tendon splint: tensile
      strength and the work of flexion.
AB  - A total of 128 flexor tendon repairs in zone II were performed with various
      suture techniques using a canine cadaver model to determine the tensile strength,
      gap strength, and resistance to tendon gliding as measured by the work of
      flexion. The ultimate tensile strength in kilogram force (kgf) following tendon
      laceration and repair was the greatest after repair by the Savage technique (4.84
      kgf) and the dorsal tendon splint technique (4.89 kgf), while the standard
      Kessler technique showed a strength of only 1.48 kgf. The greatest gap strength
      values were also obtained for the Savage and dorsal tendon splint techniques. The
      work of flexion increase was the greatest at 85.5% after repair using a mesh
      sleeve technique. While, the Savage and dorsal tendon splint techniques showed an
      increase of 24.3% and 25.1% with no significant difference compared to the other
      technique studied. Considering the values of these biomechanical parameters, we
      believe that the best flexor tendon repair techniques in the canine model are the
      Savage and dorsal tendon splint.

PMID- 7797955
TI  - [Pathogenesis of acute and chronic compression neuropathy].
AB  - The purpose of this study was to clarify the morphological changes in the cell
      body following acute, and chronic, nerve compression injuries. One hundred and
      fifty-eight adult male Wistar rats were used for the experiments. Acute
      compression was produced by clamping the sciatic nerve (ca. 1.3 mm diameter)
      using a stainless steel Micro-Tube-Clamp (1.6 mm-width and an internal diameter
      of 1.0 mm). To produce chronic entrapment neuropathy, we used Mackinnon-Dellon's
      procedure, in which a 1.0 cm length of Silastic tube with an internal diameter of
      1.51 mm was wrapped around the nerve trunk. The morphological and functional
      changes in the nerve trunks were then studied. Histological examinations and
      morphometric measurements of the nerve cell bodies in the L5 dorsal root ganglion
      were also carried out for up to 15 months after the procedure. Degeneration of
      large myelinated nerve fibers, interfascicular edema, interruption of the blood
      nerve barrier and a delay in the fast orthodromic axonal transport were found as
      early as 1 day after clamping, a decreased in the motor nerve conduction velocity
      on the third day, and a thickening in the perineurium after 1 week. In the
      chronic experiment, these changes were found at 4, 4, 2, 8, 8, and at 2 months
      after wrapping, respectively. A significant change in the nuclear eccentricity
      was morphometrically discovered in both types of nerve compressions-on the third
      day after clamping, and at 6 months after wrapping. In addition, dispersion of
      Nissl substance, dislocation of cell organelles and an increase in the number of
      cytoskeletons were observed in the somata. Acute and chronic nerve compression
      induced morphologic changes in the nerve cell body as well as in the peripheral
      nerve fibers. These findings suggested that compression of the peripheral nerve
      fiber changed the metabolic activity of the nerve cell body. We concluded that
      compression neuropathy affected the whole neuron including the nerve cell body.

PMID- 7797956
TI  - [Pathology and treatment of temporomandibular joint disorders--intra-articular
      injection therapy and arthroscopic surgery].

PMID- 7797958
TI  - Metacarpophalangeal joint prostheses. A review of the clinical results of past
      and current designs.
AB  - The clinical results of past and current hinge, flexible and third generation
      designs of MP prosthetic joints are reviewed. The hinged prostheses did not
      achieve acceptable short term clinical results while the silastic and third
      generation prostheses provided good results with with correction of deformity and
      adequate range of motion (ROM). These good short term results did, however, get
      progressively worse with the recurrence of deformities and loss of ROM. It is
      evident that while most of the existing prostheses can relieve pain and restore
      appearance, none provide the degree of stability and ROM that is required to
      restore normal function to the MP joint. The moderate results could be partly due
      to the stage of the disease at which the surgery is carried out. At present,
      surgery on patients with rheumatoid arthritis is undertaken at a stage in the
      disease where the muscles and the ligaments surrounding the joint, and the bone,
      are generally in a poor condition. Surgery at this stage is really only a salvage
      procedure.

PMID- 7797960
TI  - Fibrous stabilization of the rheumatoid wrist.
AB  - 19 patients (mean age 59.8 years) underwent fibrous stabilization of the wrist
      for rheumatoid arthritis. 17 patients were reviewed after a mean follow up of
      24.5 months (range 13-40 months). There were four excellent, 11 good, and two
      poor results according to modified Koka and D'Arcy (1989) criteria. The poor
      results were due to deep infection in one patient and an unbalanced wrist due to
      ruptured radial extensors in another. The pre-operative range of wrist movement
      was an important determinant of the frequency of radio-carpal and/or mid-carpal
      fusion and the final post-operative range of movement.

PMID- 7797957
TI  - [Pathomechanism and treatment of cervical disc herniation].

PMID- 7797959
TI  - Perichondrial arthroplasty incorporating costal cartilage.
AB  - A technique of IP joint arthroplasty is described using costal cartilage with
      accompanying perichondrium. All patients presented following trauma to the IP
      joints; their ages ranging from 15 to 45 years. Five out of six cases showed
      improvement of symptoms and function following reconstruction of the traumatized
      joint.

PMID- 7797961
TI  - Radiological evolution of the rheumatoid wrist after radio-lunate arthrodesis.
AB  - Radio-lunate arthrodesis of the rheumatoid wrist is an established technique
      which has been in use for more than 12 years. The evolution of 26 operated wrists
      and 20 non-operated wrists has been studied with a mean follow-up of 5 years. The
      results show that although radio-lunate arthrodesis can prevent dislocation of an
      unstable wrist, it cannot prevent deterioration. Collapse, ulnar translation,
      tilt of the lunate, and the inter-carpal instability continued with time, whether
      the wrists were operated on or not. The speed of deterioration was dependent on
      the type of rheumatoid arthritis and is faster in the disintegration type than in
      the osteoarthritis or the ankylosis type. The technique is applicable to the
      osteoarthritis type of rheumatoid arthritis, in the middle stage (2 to 4a
      according to the Larsen-Alnot classification). At that stage, the ankylosis type
      and the disintegration type, and the osteoarthritis type at an advanced stage,
      are better treated by total arthrodesis or total prosthetic arthroplasty.

PMID- 7797962
TI  - Distal ulnar instability following wrist arthrodesis in men.
AB  - 11 male patients with rheumatoid arthritis and 14 with osteoarthritis had total
      arthrodesis of the wrist. All patients with rheumatoid arthritis and ten (71%) of
      those with osteoarthritis had distal ulnar excision, two of the latter as a
      secondary procedure for impingement. Seven patients with osteoarthritis and none
      of the rheumatoid patients developed painful instability of the distal end of the
      ulna following excision. It is suggested that, in male patients with rheumatoid
      arthritis, distal ulnar excision with wrist arthrodesis produces excellent
      results with no complications. However, in male patients with osteoarthritis
      attempts should be made to avoid excessive shortening and ulnar impingement. If
      distal ulnar surgery is required, a procedure that does not affect the stability
      of the distal radio-ulnar joint should be performed rather than distal ulnar
      excision.

PMID- 7797963
TI  - Physical equilibrium of the normal wrist and its relation to clinically defined
      "instability".
AB  - The rotational stability of the proximal carpal row was tested on six unembalmed
      human cadaver hand specimens. The physiological load conditions were stimulated
      by loading the wrist flexor and extensor tendons. Pure torque was introduced to
      the lunate, scaphoid and triquetrum, one at a time, by means of a dynamometer
      wrench, forcing the bones loaded to perform a flexion-extension motion. A truly
      stable state of equilibrium could be found in the normal wrist only under axial
      load. A uni-directional coupling was observed through the scapho-lunate ligament
      as a counteraction to a tendency for the lunate to extend and the scaphoid to
      flex. The triquetrum and lunate moved together, showing close coupling in both
      directions. As conclusion: a stable wrist can be defined as one which, while
      being loaded within a physiological range of stress, does not deviate from a
      stable state of equilibrium (the ability to return to a single position when
      disturbed) at any point within the whole physiological range of motion.

PMID- 7797964
TI  - Wrist kinematics. Row, column or both?
AB  - Analysis of radiographs of 52 wrists showed that, from ulnar to radial deviation,
      the amount of scaphoid shortening and ulnar translation of the scaphoid varies in
      a normal distribution. There is a significant correlation between the two
      measurements, such that the more the scaphoid shortens the less it translates and
      vice versa. Females subjects were more likely to have greater scaphoid shortening
      and less translation. It is felt that carpal kinematics thus cover a spectrum
      from the "row" theory to the "column" theory which is normally distributed and
      that women are more likely to have a column type wrist. This variation may affect
      the result of treatment of scapholunate dissociation by techniques such as scapho
      lunate fusion. A "CR index" is proposed so that the tendency of a wrist towards
      row or column theory can be quantified. This may be used to predict the success
      of some surgical procedures in the treatment of scapho-lunate dissociation.

PMID- 7797965
TI  - The ulno-carpal abutment syndrome. Follow-up of the wafer procedure.
AB  - Seven wrists in six patients with ulno-carpal abutment syndrome were treated by a
      subchondral distal ulna resection (wafer procedure). The average follow-up was 36
      months. Wrist function was evaluated using a clinical scoring chart. The
      parameters were pain, range of motion, grip strength and activities. One patient
      had a poor result, one a fair result and the remaining had good to excellent
      results. In all cases grip strength showed dramatic improvement. Complications
      were limited to palpable subcutaneous nylon sutures requiring removal in three
      patients and extensor carpi ulnaris tendinitis in one.

PMID- 7797966
TI  - A new technique of reattachment after traumatic avulsion of the TFCC at its ulnar
      insertion.
AB  - One female and seven male patients (median age 25.5) presented with traumatic
      avulsion of the triangular fibrocartilage complex (TFCC), type 1B according to
      Palmer's classification. Reattachment of the TFCC near its anchoring point was
      combined with an intraarticular shortening osteotomy of the ulnar head. This
      provides an excellent approach to the TFCC and a well vascularized anchoring
      surface. The mooring point is biomechanically appropriate and the tissues with
      the best biomechanical properties are used. The functional results with a mean
      follow-up of 3 years were encouraging, as demonstrated by the significant
      improvement of pain (P = 0.017). All patients were able to return to their
      previous occupation; no further surgery was necessary to the distal radio-ulnar
      joint and no impairment of pronation and supination was detected. The final wrist
      score reflects the subjective results defined by the patient. However the
      correlation is not linear and the wrist scores are superior to the degree of
      satisfaction defined by the patient.

PMID- 7797967
TI  - Open dislocation of the trapezoid.
AB  - Isolated dislocation of trapezoid is rare. We report here a new case of open
      dorsal dislocation of the trapezoid following a high energy crush injury of the
      left hand in a factory worker. It was associated with multidigital mutilation and
      metacarpal fractures.

PMID- 7797968
TI  - Pattern of scaphoid fracture union detected by macroradiography.
AB  - Stereoscopic macroradiography was used to study the pattern of union of scaphoid
      fractures. Of 21 patients who had partial union of a scaphoid fracture, 13 united
      on the ulnar side and five on the radial side only. In three it was on both sides
      but delayed in the centre. Where there was initial union on the ulnar side, all
      progressed to complete union, including two patients with displaced fractures.
      Four out of five patients with initial union on the radial side had displaced
      fractures, and three of these went on to non-union. We conclude that in those
      patients with partial union of a scaphoid fracture, if union is seen on the ulnar
      side, the fracture is likely to unite completely, whereas if there is partial
      union on the radial side, there is a high risk of non-union.

PMID- 7797969
TI  - Anterior wedge-shaped bone graft for old scaphoid fractures or non-unions. An
      analysis of relevant carpal alignment.
AB  - For appraisal of anterior wedge-shaped grafts for the humpback deformity of the
      scaphoid, a retrospective study of 27 cases with old scaphoid fractures or non
      unions was carried out. 11 cases were treated with Herbert screw fixation and
      anterior wedge-shaped graft and the other cases with other methods. For the
      assessment of carpal alignment, radio-lunate and scapho-lunate angles were
      measured with peri-operative radiographs. For the clinical assessment, the
      scoring system of Cooney was applied. In 25 cases, primary bone union was
      obtained with one attempt and in two cases, with the second operation. Union was
      achieved in a mean of 3.4 months. The post-operative wrist score ranged from 65
      to 100 with an average 81.2 points. There was a statistically significant
      relationship between the wrist score and the post-operative scapho-lunate
      angulation of the affected wrist. The humpback deformity of scaphoid non-union
      should be treated precisely with carpal realignment surgery or anterior wedge
      shaped bone graft.

PMID- 7797970
TI  - Analysis of proximal fragment sclerosis and surgical outcome of scaphoid non
      union by magnetic resonance imaging.
AB  - 32 patients with scaphoid non-union were examined to clarify the relationship
      between pre-operative radiographic sclerosis in the proximal fragment and signal
      intensity on magnetic resonance imaging (MRI). In addition, the correlation
      between changes in signal intensity in the proximal fragment and surgical outcome
      after bone grafting and internal fixation was investigated. Proximal fragment
      sclerosis was observed in seven patients. Comparison of the T1 and T2-weighted
      images with those of the 25 patients without proximal fragment sclerosis revealed
      no differences. Therefore, there was no relationship between sclerotic changes on
      plain radiography and the degree of avascularity of the proximal fragment
      assessed by MRI. None of the patients who had low signal intensity on both T1 and
      T2-weighted images achieved union within 5 months after surgery. Thus the
      detection of signal intensity on both T1 and T2-weighted images can be useful to
      predict the prognosis after the surgery.

PMID- 7797971
TI  - Lunate dislocation with ulnar nerve paresis.

PMID- 7797972
TI  - Occult injury of the median nerve.
AB  - A case of median nerve injury caused by an unsuspected foreign body is described.
      The mechanism was not recognized at the time of injury. The suspicion of a
      penetrating missile injury was raised only with the aid of radiographs. At
      operation the foreign body was found in the substance of the median nerve.

PMID- 7797973
TI  - Low velocity gun shot wounds of the brachial plexus.
AB  - 28 patients with low velocity gunshot wounds of the brachial plexus were treated
      at Groote Schuur Hospital from 1980 to 1991. Delayed exploration of the brachial
      plexus (up to 7 months after injury) was performed in nine (30%) of the patients.
      The other 19 patients did not have exploration of the plexus; most of these
      patients showed signs of recovery within 2 to 4 weeks of injury. Injury to the
      subclavian or axillary artery occurred in nine (30%) of the cases. The average
      length of follow-up of the patients was 19 months (range 2-90 months). Of the 19
      patients treated non-operatively, 15 (79%) had an excellent or good result and
      four (21%) a fair result. The indications for surgery were the absence of
      improvement within 3 months of injury or persistent pain. Surgery was indicated
      for significant pain in five of the nine patients; postoperatively two had
      complete relief of pain, two improvement in the pain and one no improvement. Of
      the nine surgically treated patients, three (33%) had a good result, two (22%) a
      fair result and four (45%) a poor result. The potential for recovery was not
      dependent on the severity of the injury at presentation or the presence of
      vascular injury but on the appearance of signs of recovery within 4 weeks of
      injury.

PMID- 7797974
TI  - Vascularized pedicle graft of the lower trunk for reconstruction of the branchial
      plexus.
AB  - The middle trunk of an injured brachial plexus was reconstructed using a
      vascularized graft of the lower trunk, which was expendable because of
      irreparable damage to the C8 and T1 nerve roots. The graft was transferred on a
      vascular pedicle of mesoneurium. Useful recovery was achieved at 3 years. This
      technique helps to overcome the problems of limited supply and secondary sensory
      deficit of grafts from peripheral nerves, but is possible only if the plexus is
      explored early, before mobilization and transfer of nerve trunks is precluded by
      scarring.

PMID- 7797975
TI  - Digital nerve compression by hyperplastic Pacinian corpuscles. A case report and
      immunohistochemical study.
AB  - A 68-year-old lady developed digital pain within days of the excision of a palmar
      ganglion. This was found to be due to a mass of hyperplastic Pacinian corpuscles
      compressing the digital nerve. Immunohistochemistry was carried out on the
      resected corpuscles using antisera to a range of neuropeptides. Possible
      mechanisms of hyperplasia are discussed.

PMID- 7797976
TI  - Risk and complications in endoscopic carpal tunnel release.
AB  - Single portal endoscopic carpal tunnel release was carried out in 107 hands of 88
      patients. There were 11 complications. These included incomplete release (2),
      post operative scarring around the median and ulnar nerves (2), laceration of the
      superficial palmar arterial arch (1), reflex sympathetic dystrophy (2), palmar
      fasciitis (1), and wound inflammation (3). In two cases there was no relief of
      symptoms. In one there was incorrect diagnosis and in another, incorrect
      indication for endoscopic carpal tunnel release. The follow-up was from 3 to 18
      months with an average of 6.8 months. The overall results of the patients in this
      series are being presented in another paper. Of the 107 procedures, 73 were rated
      as having an excellent, 25 good, three fair, and six poor results. The case of
      laceration of the superficial palmar arterial arch is discussed in detail in the
      paper. The two cases of reflex sympathetic dystrophy and the one case of palmar
      fasciitis had mild clinical features and resolved within 3 months. The
      inflammation in three of the wounds at the wrist resolved within 2 days of
      removal of the percutaneous sutures. These three patients had returned to heavy
      hand activities within a few days of surgery.

PMID- 7797977
TI  - Early mobilization following carpal tunnel release. A prospective randomized
      study.
AB  - A prospective randomized study was undertaken of 50 consecutive patients
      undergoing surgery for idiopathic carpal tunnel syndrome to determine the value
      of splintage of the wrist following open carpal tunnel release. Patients were
      randomized to either be splinted for 2 weeks following surgery or to begin range
      of-motion exercises on the first post-operative day. Subjects were evaluated at 2
      weeks, 1 month, 3 months, and 6 months after surgery by motor and sensory
      testing, physical examination, and a questionnaire. Variables assessed included
      date of return to activities of daily living, dates of return to work at light
      duty and at full duty, pain level, grip strength, key pinch strength, and
      occurrence of complications. Patients who were splinted had significant delays in
      return to activities of daily living, return to work at light and full duty, and
      in recovery of grip and key pinch strength. Patients with splinted wrists
      experienced increased pain and scar tenderness in the first month after surgery;
      otherwise there was no difference between the groups in the incidence of
      complications. We conclude that splinting the wrist following open release of the
      flexor retinaculum is largely detrimental, although it may have a role in
      preventing the rare but significant complications of bowstringing of the tendons
      or entrapment of the median nerve in scar tissue. We recommend a home
      physiotherapy programme in which the wrist and fingers are exercised separately
      to avoid simultaneous finger and wrist flexion, which is the position most prone
      to cause bowstringing.

PMID- 7797978
TI  - The provision of innervated skin cover for the injured thumb using dorsal
      metacarpal artery island flaps.
AB  - Provision of stable sensate skin is of great importance in reconstruction of the
      injured thumb. Island flaps based on the dorsal metacarpal arteries were used to
      resurface ten injured thumbs, and the degree of retained sensibility was assessed
      using static and moving two-point discrimination and the pick-up test. Results
      show that these flaps are capable of providing stable full-thickness skin cover
      in a single procedure and functional sensibility is retained in most cases. The
      second dorsal metacarpal artery island flap, previously advocated for use in
      small thumb defects only, has been successfully used as a large wraparound flap
      in two cases. In one of these it was used with free bone graft to increase the
      length of the thumb and an excellent functional result was achieved.

PMID- 7797980
TI  - Comparison of ulnar and radial arterial blood-flow at the wrist.
AB  - Historical descriptions of the ulnar artery as the dominant vessel to the hand
      appear to be inconsistent with clinical experience. Anatomical dissections and
      radionucleotide flow studies of the ulnar and radial arteries at the wrist were
      performed. These failed to demonstrate any difference between the anatomical
      dimensions of these vessels, but the radial artery was shown to have a
      statistically greater blood flow compared to the ulnar artery. This finding
      suggests that, contrary to popular opinion, the radial artery is the dominant
      vessel to the hand.

PMID- 7797979
TI  - Cold-induced vasospasm after digital replantation does not improve with time. A
      12-year prospective study.
AB  - The incidence of cold-induced vasospasm after hand injuries has been reported to
      be as high as 100%, following replanted digital amputations. The exact cause of
      this problem is obscure, no specific treatment is available and little is known
      about the long-term prognosis. Further knowledge is therefore needed in order to
      advise patients concerning future job potential at an early stage. In a previous
      paper we evaluated the incidence and severity of cold intolerance 2 years after
      digital replantation. The incidence of cold-induced vasospasm then was high as
      well as the discomfort experienced by the patients. We carried out a follow-up of
      patients previously examined 10 years ago. Our results show that cold induced
      vasospasm in replanted digits does not improve with time. Patients with moderate
      symptoms may perceive improvement, probably due to a change of habits. Patients
      with severe problems did not experience improvement and should be given early
      advice to seek work in warm surroundings to reduce the discomfort.

PMID- 7797981
TI  - Traumatic avulsion of the ulnar collateral ligament of the IP joint of the thumb.
AB  - We present a previously undescribed injury of avulsion of the ulnar collateral
      ligament of the thumb IP joint. Stress radiographs may be used to confirm the
      diagnosis in cases of clinical suspicion.

PMID- 7797982
TI  - Bone suture anchors in hand surgery.
AB  - The recent development of small bone suture anchors has created potential
      applications in reconstructive surgery of the hand and wrist. A combined
      laboratory and clinical study was devised to evaluate their use. 16 paired
      fingers (32 in all) from eight cadaveric hands were disarticulated at the MP
      joint with a 10 cm tail of FDP tendon. The FDP insertion was released in all
      specimens. In 16 fingers reinsertion was performed with the classic Bunnell
      technique; in the paired 16 fingers, the repair utilized Acufex 2 mm anchors.
      There was no significant difference between the two groups regarding load-to
      failure at approximately 40 Newtons. The mean stiffness of the anchor repairs was
      significantly greater than the Bunnell repairs. 19 consecutive patients were
      prospectively enrolled with a tendon or ligament repair of the hand or wrist
      using bone anchors. The average age was 41 years and the average length of follow
      up was 24 months. All repairs were stable at the time of follow-up. Bone anchors
      were simple to insert, required less dissection and surgical time than the
      Bunnell technique and appeared to be reliable in both laboratory and clinical
      settings.

PMID- 7797983
TI  - Combined fourth and fifth metacarpal fracture and fifth carpometacarpal joint
      dislocation.
AB  - Three cases of hamato-metacarpal fracture-dislocation with fracture of the shaft
      or base of the fourth metacarpal and dorsal dislocation of the fifth metacarpal
      are described. In one case this was associated with coronal fracture of the
      hamate. An oblique radiograph of the hand with the forearm pronated 15 degrees
      and 45 degrees provided a good view of the extent of the fourth and fifth
      carpometacarpal injury. Treatment with open reduction and internal fixation
      achieves good clinical results.

PMID- 7797985
TI  - Swan-neck deformity as a complication of the Agee technique.
AB  - Unstable dorsal fracture dislocations of the PIP joint of a finger commonly
      result in joint stiffness following immobilization or open reduction and internal
      fixation (Green and Rowland, 1984). The Agee dynamic external fixator, or force
      couple splint (Agee, 1978; 1987), was introduced in an attempt to avoid this
      complication and maintains a concentric reduction whilst allowing a full range of
      joint movement. The splint is constructed from three Kirschner wires and is
      activated by a single rubber band. A force couple is created across the proximal
      interphalangeal joint levering the base of the middle phalanx towards the palm
      whilst simultaneously lifting the distal end of the proximal phalanx dorsally to
      restore joint reduction. However, this technique is not without complications
      (Agee, 1987). We report a swan-neck deformity resulting from this treatment.

PMID- 7797986
TI  - Injuries to the nail bed in childhood.
AB  - Many fingertip injuries in childhood involve the nail bed. Deformities of the
      nail are a frequent result of failure to repair the nail bed at the time of
      injury. Secondary correction of nail deformities seldom achieves good results. We
      present the results of our experience in the management of 19 children with 22
      injuries involving the nail bed. All achieved normal nail growth and the overall
      result of the repair was good in 91%. Complications were few and parental
      satisfaction with the management was high. Every effort should be made to perform
      a meticulous primary repair of all nail bed injuries.

PMID- 7797984
TI  - Double dislocation of the fifth metacarpal.
AB  - A case of traumatic, simultaneous, double dislocation of the fifth metacarpal
      bone is presented. Closed reduction was easily achieved and held with
      transarticular, crossed Kirschner wire fixation.

PMID- 7797987
TI  - Dorsal intercalated segment instability (DISI) and scapho-trapezio-trapezoid
      (STT) osteoarthritis.

PMID- 7797988
TI  - The acoustic neuroma saga.

PMID- 7797989
TI  - 'A brilliant surgical result, the first recorded': Annandale's case, 3 May 1895.

PMID- 7797990
TI  - Hearing preservation in vestibular schwannoma surgery: fact or fantasy?
AB  - This study reviews 57 papers dealing with the issue of hearing preservation in
      vestibular schwannoma surgery published in otolaryngologic and neurosurgical
      literature between the years 1977 and 1994. The authors', in this review, have
      made an attempt to verify whether the claims of hearing preservation are real,
      whether there is a price to be paid in terms of morbidity and whether there are
      univocal criteria for reporting results. The review shows that there is a wide
      disarray in reporting hearing results and the claims of hearing preservation are
      often unreal and misleading. On retabulating the results of a few series
      according to the minimal prerequisites for normal hearing (PTA < or = 30 dB and
      SDS > or = 70 per cent) and according to other various commonly reported
      criteria, it became evident that rates of hearing preservation differed a lot
      depending upon criteria. While any measurable hearing could be preserved in many
      cases, only a few had normal hearing preserved.

PMID- 7797991
TI  - The molecular genetics of vestibular schwannoma.
AB  - Vestibular schwannoma occurs both as a sporadic tumour and in the dominantly
      inherited familial cancer syndrome neurofibromatosis type 2 (NF2). The gene for
      NF2 has recently been isolated on chromosome 22, and the demonstration of
      inactivating germline mutations in NF2 patients and NF2 associated tumours
      suggests that it acts as a tumour suppressor. The results of recent research in
      Cambridge suggest that somatic mutations of the NF2 tumour suppressor gene are a
      critical step in the pathogenesis of both familial and indeed non-familial
      unilateral sporadic vestibular schwannoma and that the mechanism of
      tumourigenesis complies with the 'two-hit' model. This paper represents a brief
      review of the current status of molecular biology in relation to vestibular
      schwannoma in particular and is discussed in relation to the molecular pathology
      of skull base tumours as a whole.

PMID- 7797992
TI  - The restoration of hearing in neurofibromatosis type 2.
AB  - Central electrical stimulation of the auditory pathway can allow hearing in
      patients suffering from deafness localized in the auditory nerve. Developments in
      a multi-channel auditory brainstem implant based on the Nucleus Mini 22 Cochlear
      implant with transcutaneous signal transmission is discussed. The devices have
      been implanted in nine European patients suffering from Neurofibromatosis Type 2.
      Preliminary speech perception results and patient satisfaction are encouraging,
      and the data presented include some limited open speech recognition.

PMID- 7797993
TI  - Middle ear pressures in patients with nasopharyngeal carcinoma and their clinical
      significance.
AB  - There is a paucity of studies investigating middle ear pressures (MEPs) in
      patients with nasopharyngeal carcinoma (NPC). This paper prospectively examines
      MEPs in patients with nasopharyngeal carcinoma before and after radiotherapy and
      discusses their clinical significance. Newly diagnosed patients with
      nasopharyngeal carcinoma were studied before and at three to 12 months (mean 7.5
      months) after radiotherapy. MEPs were measured by tympanometry. Thirty-three
      patients completed the study. The mean MEP before and after radiotherapy was 
      55.2 mm water (range -250 to 45 mm water) and -73.1 mm water (range -215 to 35 mm
      water) respectively. About two-thirds of assessable ears had an increase in
      negative MEPs after irradiation and the rest had less negative MEPs after
      irradiation. Those ears which developed post-irradiation middle ear effusions
      were found to have pre-irradiation negative middle ear pressures of at least -45
      mm water. These findings provide possible explanations for some unexplained
      audiometric observations previously made in patients with nasopharyngeal
      carcinoma after radiotherapy. Tympanometry before radiotherapy may prove to be
      useful in identifying ears with a high risk of developing post-irradiation middle
      ear effusion.

PMID- 7797994
TI  - Role of magnetic resonance imaging in predicting late facial motor function after
      removal of vestibular schwannomas by the translabyrinthine approach.
AB  - Facial motor function was assessed in 61 patients 18 months after surgical
      resection, by the translabyrinthine approach, of vestibular schwannoma involving
      both the cerebellopontine angle (CPA) and the auditory canal. Pre-operative
      magnetic resonance imaging (MRI) was performed to measure the maximum
      extracanalicular diameter of the tumour between the porus and the farthest
      extension in the CPA on transverse slices and to calculate extracanalicular
      tumour volume. Post-operative facial motor function was graded according to the
      House and Brackmann system. There was a statistically significant relationship
      between late facial motor function and extracanalicular diameter. The best cut
      off point for good and poor results was 20mm. There was no relationship between
      the tumour volume and the late post-operative facial motor function grade. In
      this study the best pre-operative radiological predictor of the late facial motor
      function in patients operated on by the translabyrinthine approach was the
      maximum diameter measured by MRI.

PMID- 7797995
TI  - An evaluation of mucus glycoproteins in the larynges of victims of sudden infant
      death syndrome.
AB  - Larynges from 24 victims of Sudden Infant Death Syndrome (S.I.D.S.) and 10
      controls, with ages ranging from two days to 24 weeks in the controls and from
      two to 116 weeks in the S.I.D.S. victims, were transversely, step-serially
      sectioned and then stained to show acid, neutral and mixed mucus glycoproteins.
      The proportion of sulphated mucus glycoprotein and sialylated mucus glycoprotein
      to total acid mucus glycoprotein was determined by the use of various staining
      techniques and a comparison was made for each type between S.I.D.S. and controls.
      The differences were significant with a mean of 27 per cent in the controls
      compared to 59 per cent in the S.I.D.S. for sulphomucin (difference 32 per cent;
      standard error of difference 6 per cent; p < 0.01) and 73 per cent in the
      controls compared to 41 per cent in the S.I.D.S. larynges (difference 32 per
      cent; standard error of difference six per cent; p < 0.01) for sialomucin. The
      results suggest that sulphated mucus glycoprotein is secreted in excess in some
      victims of Sudden Infant Death Syndrome.

PMID- 7797996
TI  - Evolution of speech and voice following supracricoid partial laryngectomy.
AB  - The evolution of voice and speech parameters following supracricoid partial
      laryngectomy (SCPL) has been evaluated in a prospective fashion over an 18-month
      period of time in three patients using the Computerized Speech Lab (from Kay
      Elemetrics). Preliminary results demonstrate the post-operative instability of
      voice parameters. Speech parameters remain stable with time. Our data stresses
      that voice is attained post-operatively even if one arytenoid cartilage is
      disarticulated at time of resection.

PMID- 7797997
TI  - A comparison between two methods of measuring pressure in the pharyngeal airway:
      transducer probe versus open catheter.
AB  - A new multi-transducer probe system for measuring pharyngeal pressures was
      compared with an established open catheter system. Pharyngeal pressure
      measurements were made at the same time, and site, in subjects awake, at
      unmodified and with artificially increased nasal airway resistances, and during
      sleep documented by polysomnography. The two systems yielded almost identical
      results. It is anticipated that the multi-transducer probe system will prove of
      clinical value.

PMID- 7797998
TI  - Multidisciplinary management of dysphagia: the first 100 cases.
AB  - A report of the first 100 patients treated in the multidisciplinary Dysphagia
      Clinic in Salisbury District Hospital is presented. It was established in January
      1992 and involves the Departments of ENT Surgery, Clinical Radiology and Speech
      and Language Therapy. In the first 18 months, 100 patients have been assessed and
      treated. These included 46 males and 54 females, between the ages of four and 93
      years. Neurological problems accounted for 39 cases. The management comprised the
      assessment clinic, videofluoroscopy in 83 patients, and finally the appropriate
      treatment. Forty-four patients were treated primarily by swallowing therapy.
      Seventy-three patients showed complete recovery, resolution of their symptoms or
      did not require treatment. Two patients were still under treatment at the time of
      writing this paper.

PMID- 7797999
TI  - Cochlear implant extrusion in a young child--a preventive procedure.
AB  - A Cochlear Mini System 22 Channel cochlear implant extruded through the skin of a
      young girl. The implant was saved by use of a transposition flap. Extrusion
      appeared to be due to pressure necrosis from the implant on the overlying
      tissues. It is believed that this problem can be prevented by angulation of the
      implant before insertion so that it conforms to the curvature of the skull, so
      avoiding pressure on the tissues. The method of angulation is described.

PMID- 7798000
TI  - Thrombosed posterior-inferior cerebellar artery aneurysm: a rare cerebellopontine
      angle tumour.
AB  - A case report of a thrombosed posterior-inferior cerebellar artery aneurysm is
      described. The tumour masqueraded as a vestibular schwannoma on imaging but the
      presenting features were unusual, the facial pain and weakness predominating
      despite well preserved hearing. This is an example of a rare cerebellopontine
      angle tumour and highlights the need for suspicion when lesions present
      atypically.

PMID- 7798001
TI  - Verbal auditory agnosia with focal EEG abnormality: an unusual case of a child
      presenting to an ENT surgeon with "deafness".
AB  - Verbal auditory agnosia implies the failure to recognize sounds in a patient who
      is nevertheless not deaf. We present a child referred to the ENT outpatients for
      suspected hearing loss investigation. At one point she had grommets inserted on
      the basis of a flat tympanogram but with no effect. All hearing tests, including
      electrocochleography and distraction tests, revealed normal hearing thresholds.
      At the age of three years and three months, and on direct questioning of the
      parents, we discovered that the child responded remarkably well to music.
      Paediatric neurologists made the diagnosis of verbal auditory agnosia. The
      condition is very similar to another acquired language disorder called Landau
      Kleffner syndrome. It is unusual for such a case to present primarily to an ENT
      surgeon.

PMID- 7798003
TI  - Bleeding after tonsillectomy in severe von Willebrand's disease.
AB  - A case is reported of a HIV-positive patient with severe von Willebrand's disease
      describing the bleeding complications during and after tonsillectomy. This
      patient underwent surgery for asymmetrical tonsillar hypertrophy. The tonsils
      were spontaneously haemorrhaging and there therefore was a suspicion of
      neoplasia. Despite close cooperation between the ENT Department and the
      Haemophilia Centre, involving per-operative Factor VIII monitoring and
      replacement, the patient suffered both protracted primary and secondary
      haemorrhages. We report this as a cautionary tale as our previous experience with
      mild to moderate haemophilia has been uncomplicated, but on this occasion there
      was massive haemorrhage. We feel that tonsillectomy should not be undertaken in a
      patient with a severe bleeding disorder without an absolute indicate.

PMID- 7798002
TI  - Inherited degenerative chondropathy--an autosomal dominant new clinical entity:
      report two cases and follow-up of four cases.
AB  - Four cases of the rare disorder, inherited degenerative chondropathy have been
      previously reported (Kurien et al., 1989). A five-year follow-up of these
      patients and two additional cases are presented in this report. The progress of
      this disease appears to be arrested after regular dapsone therapy and there was
      no other organ involvement noted during the follow-up period.

PMID- 7798004
TI  - Tension pneumoperitoneum as an early complication after adenotonsillectomy.
AB  - Pneumoperitoneum as a result of pneumomediastinum has been described already.
      Amongst the causes pneumoperitoneum due to a complication of adenotonsillectomy,
      has not previously been described. We describe a five-year-old girl with tension
      pneumoperitoneum with respiratory and circulatory insufficiency half an hour
      after adenotonsillectomy. Removal of the intra-abdominal air with a 14 gauge
      needle restored normal respiration and circulation.

PMID- 7798005
TI  - The use of leeches in a case of post-operative life-threatening macroglossia.
AB  - A case of severe macroglossia, following intraoral surgery, causing respiratory
      distress is described. Because conventional therapy appeared inadequate, leeches
      were used and proved an efficient method of reducing this life-threatening
      swelling of the tongue.

PMID- 7798006
TI  - Heterotopic pleomorphic adenoma in the neck.
AB  - Cervical heterotopic salivary tissues are rare and are predominantly found in the
      anterior triangle of the neck especially at the anterior border of the
      sternocleidomastoid muscle. We report a case of pleomorphic adenoma arising in
      the left posterior triangle of the neck.

PMID- 7798007
TI  - Computed tomographic findings in peritonsillar abscess and cellulitis.
AB  - The differentiation of a peritonsillar abscess from peritonsillar cellulitis,
      although difficult on physical examination, is required in order to determine the
      appropriate treatment. Peritonsillar cellulitis can be treated with antibiotics
      alone, while a peritonsillar abscess should be drained. Computed tomography (CT)
      of the neck is often performed to identify the formation of a deep abscess in the
      neck, but is rarely used to diagnose peritonsillar infections. We report a
      patient in whom CT was a useful diagnostic tool for distinguishing peritonsillar
      abscess from peritonsillar cellulitis.

PMID- 7798008
TI  - The value of radiographic assessment for oropharyngeal foreign bodies.
AB  - A double-blind, controlled study to assess the accuracy of interpretation of
      lateral soft tissue radiographs of 60 patients with suspected foreign body
      impaction in the oro/hypopharynx was carried out by 18 respondents from three
      different specialities. All the patients had endoscopy carried out and foreign
      bodies were present in 25. Of these, foreign bodies were diagnosed on the
      radiograph in only 38.3 per cent. False-positive diagnoses were made in a mean of
      26.3 per cent of those patients who did not have a foreign body.

PMID- 7798009
TI  - Atypical carcinoid tumour of the larynx.
AB  - The case of an atypical carcinoid tumour of the larynx is described in a 65-year
      old man. This rare tumour may present diagnostic difficulties, but the diagnosis
      should be considered in a patient presenting with symptoms of local or referred
      pain and an apparently small, non-ulcerating supraglottic tumour.
      Immunocytochemistry has an important role in establishing the diagnosis. A very
      unusual feature of this case was positive staining for S-100 protein by
      sustentacular cells. Atypical carcinoid tumours do not respond well to
      radiotherapy so the primary treatment should be surgical resection.

PMID- 7798010
TI  - Polypoidal carcinosarcoma of the oropharynx: a clinicopathological and
      immunohistochemical study.
AB  - Polypoidal squamous cell carcinomas, with a sarcomatous stroma, in the upper
      aerodigestive tract are very rare but well described tumours. They are associated
      with a multifarious nomenclature because of different opinions regarding their
      histology and histogenesis. The main issue is whether the stroma component is a
      true sarcoma or a benign reactive lesion. In order to draw the attention of
      otolaryngologists and pathologists to the characteristic features of this rare
      tumour, two cases originating from the oropharynx are presented. Both tumours
      were pedunculated and polypoidal, and their bulk consisted of a bizarre sarcoma
      like stroma covered with granulation tissue. In some areas of the surface,
      however, atypical squamous cell epithelium with foci of invasive carcinoma was
      found. In the vicinity of the latter both tumours contained areas of
      adenocarcinoma. After surgical excision followed by radiation therapy, there was
      no recurrence after two and five years, respectively. The histological and
      immunohistochemical findings support the assumption that these two tumours are
      carcinosarcomas. Adenocarcinomatous elements in this type of tumour have to our
      knowledge been reported only twice previously and have never been observed in the
      pharynx.

PMID- 7798011
TI  - Terminal duct adenocarcinomas of the parotid gland.
AB  - The major salivary glands are considered to rarely be the sites of primary
      terminal duct adenocarcinomas, a neoplasm with a considerable predilection for
      origin from intraoral minor salivary glands. We present a clinicopathological
      study of 22 terminal duct adenocarcinomas of the parotid gland, the largest
      single series to date. A comparison between the parotid neoplasms and over 200
      minor salivary gland terminal duct adenocarcinomas indicates there is little
      difference in biological behaviour and confirms the low-grade quality of the
      carcinomas, regardless of site of origin.

PMID- 7798012
TI  - Button batteries.

PMID- 7798013
TI  - Metastatic papillary thyroid carcinoma: an important differential diagnosis for
      aberrant thyroglossal cyst.

PMID- 7798014
TI  - Transport of protein hormones through the vascular endothelium.

PMID- 7798015
TI  - The effect of diabetes mellitus on urinary calcium excretion in pregnant rats and
      their offspring.
AB  - The effect of maternal diabetes mellitus on renal calcium excretion in pregnant
      rats and their offspring has been examined in order to ascertain the role of the
      kidney in the disturbed calcium homeostasis of infants born to diabetic mothers.
      Diabetic pregnant (DP) rats exhibited severe hypercalciuria which greatly
      exceeded the urinary calcium losses (UCaV) in non-diabetic pregnant (CP) or non
      pregnant diabetic (D) rats. Means +/- S.E.M. for UCaV at day 21 (mmol/24 h) were:
      DP = 1.12 +/- 0.09 (n = 7); CP = 0.06 +/- 0.01 (n = 7); D = 0.63 +/- 0.06 (n = 7)
      (P < 0.001 DP vs CP and DP vs D). The profile for urinary calcium excretion in
      the three groups was different from that of other measured ions. The degree of
      natriuresis, for example, was comparable in DP and D rats at all stages studied.
      Although magnesium output was significantly greater in DP than D rats on days 14
      and 21, this appeared to result from an additive effect of the magnesiuresis seen
      when pregnancy and diabetes were studied separately. The marked renal calcium
      wasting of diabetic pregnancy will have implications for overall calcium balance
      in the mother. For example, an enhanced intestinal calcium absorption was seen in
      DP rats in the second half of gestation. Means +/- S.E.M. for day 21 (mmol/24 h)
      were: DP = 3.8 +/- 0.8 (n = 7); CP = 1.4 +/- 0.3 (n = 7); D = 1.6 +/- 0.3 (n = 7)
      (P < 0.05 DP vs CP and DP vs D).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798017
TI  - IGF-I administration advances the decrease in hypersensitivity to oestradiol
      negative feedback inhibition of serum LH in adolescent female rhesus monkeys.
AB  - Developmental increases in serum LH were assessed in female rhesus monkeys to
      test the hypotheses that (1) the final stages of puberty are characterized by a
      decrease in hypersensitivity to oestradiol negative feedback of LH and (2) that
      increases in IGF-I secretion accelerate this decrease in hypersensitivity. In
      order to test the first hypothesis, serum LH in the absence of oestradiol and in
      response to three doses of oestradiol were compared between ovariectomized adult
      (n = 6) and adolescent female monkeys (control group; n = 6). The control females
      were not treated with oestradiol until serum LH had risen to within the 95%
      confidence interval of serum LH observed in ovariectomized adults. Doses of
      oestradiol achieved serum levels of approximately 80 ('low'), 160
      ('intermediate'), and 250 ('high') pmol/l. For control group females, treatment
      with the next higher dose of oestradiol was not initiated until serum LH was no
      longer suppressed by the lower dose. Treatment with oestradiol produced a dose
      dependent suppression in serum LH in adults. In contrast, low-dose oestradiol
      maximally suppressed serum LH throughout the initial treatment period in the
      control group compared with the adult females. The low oestradiol dose
      effectively suppressed serum LH throughout the study period in 4/6 of the control
      group and became ineffective at suppressing LH after 8 months of treatment in 2/6
      control group females. Initiation of the intermediate dose of oestradiol to these
      females again maximally suppressed LH compared with adult females. In order to
      determine whether IGF-I regulates this change in hypersensitivity to oestradiol
      negative feedback, a second group of ovariectomized, adolescent monkeys (n = 6)
      were treated chronically with IGF-I to elevate serum IGF-I levels above those of
      control group females. Using the same protocol described for the control females,
      developmental changes in serum LH in the absence of oestradiol and in response to
      oestradiol negative feedback were evaluated. Treatment with IGF-I had no effect
      on the initial increases in serum LH occurring in the absence of oestradiol. In
      contrast, the decrease in hypersensitivity to the negative feedback effects of
      the low oestradiol dose was significantly accelerated in IGF-I-treated females,
      as the interval from the initiation of treatment to the point at which serum LH
      was no longer suppressed was shorter in IGF-I-treated (4.4 +/- 0.7 months; mean
      +/- S.E.M.) compared with control group females (8.4 +/- 1.9 months).(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 7798016
TI  - Oxytocin modulates the luteinizing hormone response of the rat anterior pituitary
      to gonadotrophin-releasing hormone in vitro.
AB  - Although GnRH is believed to be the primary secretagogue for LH, oxytocin has
      also been shown to stimulate LH release from the anterior pituitary. We
      investigated the possibility that the two secretagogues interact in the
      modulation of LH release. Anterior pituitaries were removed from adult female
      rats at pro-oestrus, and tissue pieces were pre-incubated in oxytocin for 3 h
      prior to being stimulated with 15 min pulses of GnRH. LH output over the 1 h
      period from the beginning of the GnRH pulse was determined. Control incubations
      were carried out in the absence of oxytocin, and background secretory activities
      without GnRH stimulation were also determined. Tissue which was pre-exposed to
      oxytocin (0.012-1.25 microM) had an increased LH response to GnRH (1.25 nM). The
      increase was larger than the sum of the LH outputs obtained with oxytocin and
      GnRH separately, revealing that oxytocin synergistically enhanced LH secretion
      elicited by GnRH (P < 0.05; ANOVA). If stimulation by GnRH was delayed for 2 h
      after incubation with oxytocin, an increase in LH secretion was still observed,
      indicating that oxytocin-induced modulation did not rapidly disappear. Oxytocin
      pre-incubation was observed to result in an increase of maximal GnRH-induced LH
      output (P < 0.001; t-test), as well as an increase of intermediate responses. The
      LH response of the anterior pituitary to subsequent pulses of GnRH was modified
      by the self-priming process. The effect of oxytocin pretreatment on the response
      of primed tissue to GnRH was also investigated.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798019
TI  - Peptide amidating activity and gastrin processing in the developing sheep
      pancreas.
AB  - Gastrin is a regulator of both gastric acidity and gastrointestinal growth and is
      expressed transiently in the neonatal ovine and human pancreas. C-terminal
      amidation of glycine extended gastrin (G-gly) to gastrin amide (G-amide) by
      peptidylglycine alpha-amidating mono-oxygenase (PAM) is the final processing
      step. To investigate the relationship between PAM and gastrin synthesis in the
      developing pancreas, we measured PAM activity and the concentrations of gastrins
      in ovine pancreatic extracts from 95 days of gestation onwards. Pancreatic PAM
      activity was highest in the 95-day-old fetus (138 +/- 29 pmol/h/mg protein, mean
      +/- S.E.M.) and decreased to 9.5 +/- 3.7 pmol/h/mg protein in the adult. The
      circulating enzyme was also highest in the youngest fetus (1840 +/- 165 pmol/h/ml
      plasma) decreasing to approximately 50% in the 135-day-old fetus, with no further
      significant changes. The concentration of bioactive G-amide in the pancreas was
      2.0 +/- 0.6 pmol/g at 95 days of gestation, 3.4 +/- 0.9 pmol/g at 135 days and
      decreased to 0.7 +/- 0.1 pmol/g in the adult. The precursor G-gly followed a
      similar pattern but its concentration was less than 10% of G-amide. These results
      show that: (a) there are high levels of PAM activity in the ovine fetal pancreas
      and in the fetal circulation, (b) PAM activity is apparently not rate-limiting in
      the bioactivation of pancreatic gastrin and (c) the dual expression of both PAM
      and gastrin in the fetal pancreas is similar to that observed in peptide
      secreting tumours of the adult.

PMID- 7798018
TI  - Effects of thyroid hormone on coenzyme Q and other free radical scavengers in rat
      heart muscle.
AB  - Active oxygen species are reported to cause organ damage. This study was
      therefore designed to determine the behaviour of antioxidants and free radical
      scavengers so as to reveal changes in animals in the hyper- and hypothyroid
      state. Levels of antioxidant factors (i.e. coenzyme Q (CoQ)10, CoQ9 and vitamin
      E) and free radical scavengers (catalase, glutathione peroxidase (GSH-PX) and
      superoxide dismutase (SOD)) were measured in the heart muscles of rats rendered
      hyper- or hypothyroid by 4 weeks of thyroxine (T4) or methimazol treatment. Serum
      levels of CoQ9 and total SOD were also measured. A significant reduction in CoQ9
      levels was observed in the heart muscles of both hyper- and hypothyroid rats when
      compared with control hearts. There was no difference in serum CoQ9 levels in
      thyroid dysfunction when compared with control animals. Levels of vitamin E in
      the heart muscles of hyperthyroid rats were significantly increased, and there
      was no reduction in vitamin E levels in hypothyroid rats when compared with
      control hearts. GSH-PX levels in the heart muscle were reduced in hyperthyroid
      rats and increased in hypothyroid rats when compared with control hearts.
      However, there were no differences in catalase levels in heart muscle between
      hyper- and hypothyroid rats. The concentration of SOD in heart muscle was
      increased in hyperthyroid rats and was not decreased in hypothyroid rats compared
      with control rats, suggesting the induction of SOD by excessive production of O2
      . These data suggest that the changes in these scavengers have some role in
      cardiac dysfunction in the hyper- and hypothyroid state in the rat.

PMID- 7798020
TI  - Starvation-induced changes in the hypothalamic content of prothyrotrophin
      releasing hormone (proTRH) mRNA and the hypothalamic release of proTRH-derived
      peptides: role of the adrenal gland.
AB  - The purpose of this study was to investigate the mechanisms involved in the
      reduced thyroid function in starved, young female rats. Food deprivation for 3
      days reduced the hypothalamic content of prothyrotrophin-releasing hormone
      (proTRH) mRNA, the amount of proTRH-derived peptides (TRH and proTRH160-169) in
      the paraventricular nucleus, the release of proTRH-derived peptides into
      hypophysial portal blood and the pituitary levels of TSH beta mRNA. Plasma TSH
      was either not affected or slightly reduced by starvation, but food deprivation
      induced marked increases in plasma corticosterone and decreases in plasma thyroid
      hormones. Refeeding after starvation normalized these parameters. Since the molar
      ratio of TRH and proTRH160-169 in hypophysial portal blood was not affected by
      food deprivation, it seems unlikely that proTRH processing is altered by
      starvation. The median eminence content of pGlu-His-Pro-Gly (TRH-Gly, a presumed
      immediate precursor of TRH), proTRH160-169 or TRH were not affected by food
      deprivation. Since median eminence TRH-Gly levels were very low compared with
      other proTRH-derived peptides it is unlikely that alpha-amidation is a rate
      limiting step in hypothalamic TRH synthesis. Possible negative effects of the
      increased corticosterone levels during starvation on proTRH and TSH synthesis
      were studied in adrenalectomized rats which were treated with corticosterone in
      their drinking water (0.2 mg/ml). In this way, the starvation-induced increase in
      plasma corticosterone could be prevented. Although plasma levels of thyroid
      hormones remained reduced, food deprivation no longer had negative effects on
      hypothalamic proTRH mRNA, pituitary TSH beta mRNA and plasma TSH in starved
      adrenalectomized rats. Thus, high levels of corticosteroids seem to exert
      negative effects on the synthesis and release of proTRH and TSH. This conclusion
      is corroborated by the observation that TRH release into hypophysial portal blood
      became reduced after administration of the synthetic glucocorticosteroid
      dexamethasone. On the basis of these results, it is suggested that the reduced
      thyroid function during starvation is due to a reduced synthesis and release of
      TRH and TSH. Furthermore, the reduced TRH and TSH synthesis during food
      deprivation are probably caused by the starvation-induced enhanced adrenal
      secretion of corticosterone.

PMID- 7798021
TI  - Effect of glycoprotein and protein hormones on human meningioma cell
      proliferation in vitro.
AB  - Speculation that meningiomas are subject to female hormone influence is supported
      by their higher incidence in women and reports of exacerbation of symptoms during
      pregnancy and the luteal phase of the menstrual cycle. Previous reports have
      concentrated on the effects of the steroid hormones oestradiol and progesterone
      on meningioma proliferation. In this study we have investigated the roles of the
      glycoproteins LH, FSH and human chorionic gonadotrophin (hCG), and the protein
      hormones prolactin (PRL) and human placental lactogen (hPL) on the proliferation
      of human meningiomas in vitro. The three glycoproteins had an inhibitory effect
      on meningioma proliferation ranging from 5.0-50.0%, 10.0-63.0% and 2.4-34.0% at
      the highest concentrations of LH (25 mIU/ml), FSH (15 mIU/ml) and hCG (30 IU/ml)
      respectively. Cultures were also treated with PRL (100 and 200 ng/ml) and hPL (5
      and 10 ng/ml) and the protein hormones had a stimulatory effect on cell
      proliferation of 12.0-55.5% and 11.4-73.6% when treated with 200 ng/ml PRL and 10
      micrograms/ml hPL respectively. Our data suggest that increasing levels of the
      protein hormones PRL and hPL, falling levels of hCG and the absence of LH and FSH
      in the second and third trimesters of pregnancy may play a role in the
      acceleration of meningioma growth in these stages of pregnancy.

PMID- 7798022
TI  - Augmentation of the effectiveness of porcine GH with swine antibodies induced by
      a synthetic GH peptide.
AB  - An effort was made to evaluate the potential usefulness of a peptide vaccine in
      improving the growth performance of farm animals. It was previously reported that
      a murine PS-7.6 monoclonal antibody (mAb) which was specific to porcine GH (pGH)
      enhanced the growth-promoting activity of pGH in an experimental
      hypophysectomized rat model. Additional data from a epitope mapping study
      suggested that PS-7.6 mAb recognized a pGH fragment corresponding to an amino
      acid sequence 54-95. In this report, therefore, a peptide pGH(54-95) was
      synthesized in an attempt to induce PS-7.6-like antibodies in swine. It was
      demonstrated that the peptide pGH(54-95) competed with PS-7.6 mAb for the binding
      to radioactive pGH in a competition radioimmunoassay and also caused pigs to
      elicit polyclonal antibodies immunoreactive to pGH protein. The association and
      dissociation rate constants of the swine antibody to pGH were 1.9 x 10(2) M-1 s-1
      and 3.2 x 10(-4)s-1 respectively, thus producing an overall binding affinity of
      Kd = 1.6 x 10(-6) M. The swine antibody partially competed with murine PS-7.6 mAb
      for the binding to pGH, suggesting that the pGH-recognizing sites for both
      antibodies might be closely related. The biological effect of the swine antibody
      was examined in hypophysectomized rats and shown to significantly augment pGH
      activity in promoting the growth of these GH-deficient animals. The present
      findings suggest that a synthetic peptide may be developed as a potential growth
      vaccine for swine to generate antibodies capable of enhancing the effectiveness
      of endogenous pGH.

PMID- 7798023
TI  - Epitope mapping and analysis of a growth-enhancing monoclonal antibody by limited
      tryptic digestion of porcine GH.
AB  - In this study, the epitope of a murine PS-7.6 monoclonal antibody (mAb) which was
      raised against the recombinant porcine GH (pGH) and subsequently shown to enhance
      the growth-promoting activity of pGH in a hypophysectomized rat model, was mapped
      by the limited tryptic digestion of pGH. A pGH fragment corresponding to amino
      acid residues 70-95 was separated by reverse-phase HPLC and also
      immunoprecipitated by PS-7.6 mAb. This fragment was found in an RIA to compete
      with radiolabelled pGH for the binding of PS-7.6 mAb in a dose-dependent fashion.
      Several peptides covering this potential epitope region of pGH(70-95) were
      synthesized and assayed by competitive RIA. The results suggested that pGH(75-90)
      was the optimal sequence recognized by PS-7.6 mAb. Sequential alanine
      substitution of each residue of pGH(75-90) revealed that the side chains of
      Leu76, Ile83 and Leu87 were critical for binding to PS-7.6 mAb. Other residues
      could be replaced by alanine without substantially altering the binding affinity.
      The region of amino acids 75-95 comprises the C-terminal end of the second helix
      of pGH and the repeating pattern of i and i + 3 (i + 7) of the critical amino
      acids appears consistent with PS-7.6 mAb binding to the hydrophobic side of the
      helix. The sequence and the helical structure of the epitope of PS-7.6 mAb
      provide the basis for designing the effective peptide vaccines to enhance the
      growth performance of animals.

PMID- 7798024
TI  - Effect of the level of oestradiol on oxytocin-induced prostaglandin F2 alpha
      release in the cow.
AB  - We have investigated the effects of oestradiol-17 beta on the development of the
      luteolytic signal (prostaglandin F2 alpha (PGF2 alpha) release to an oxytocin
      challenge) using a steroid-treated ovariectomised cow model. Long-term
      ovariectomised cows were pre-treated with progesterone for 14 days followed by
      oestradiol-17 beta for 2 days to induce oestrus (day 0), and were then treated
      for a further 16 days with physiological doses of progesterone and oestradiol-17
      beta to simulate a luteal phase. On day 11 oestradiol was either withdrawn (low
      group; n = 4), maintained (normal group; n = 4) or increased (high group; n = 4),
      generating mean (+/- S.E.M.) plasma concentrations of oestradiol from days 12-16
      of 0.9 +/- 0.1, 2.3 +/- 0.4 and 3.7 +/- 0.2 pg/ml respectively. Basal and
      oxytocin-stimulated PGF2 alpha secretion was monitored by measuring
      concentrations of the principal metabolite of PGF2 alpha, 13,14-dihydro-15-keto
      PGF2 alpha (PGFM), in plasma samples collected before and after daily i.v.
      injection of 50 IU oxytocin from days 12-16. Basal PGFM was unaffected by the
      level of oestradiol treatment. In the normal group significant rises in plasma
      PGFM were seen following oxytocin on days 12, 13 and 14 (P < 0.05) as well as
      days 15 and 16 (P < 0.01). In the low group significant elevations in PGFM were
      only seen on days 15 and 16 (P<0.05), and were smaller (P<0.05) than those seen
      in the normal group.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798025
TI  - Corpuscles of Stannius and blood flow regulation in freshwater North American
      eels, Anguilla rostrata LeSueur.
AB  - Cardiac output (CO), heart rate (HR), stroke volume (SV), dorsal aortic blood
      flow (DABF), dorsal aortic blood pressure (PDA) and plasma electrolytes were
      monitored in stanniectomized and sham-operated freshwater eels over a 3-week
      period; branchial shunting and systemic resistance (RSYS) were estimated. DABF
      was significantly reduced by 45% from 11.72 +/- 0.48 (control) to 6.55 +/- 0.41
      (n = 6; day 21) ml.min-1.kg-1 within 3 weeks after the removal of the corpuscles
      of Stannius. This large reduction in blood flow was due to a 25% decrease in CO
      and a 100% increase in estimated branchial shunting which preceded the fall in
      CO. CO was decreased from 16.07 +/- 0.31 (control) to 11.91 +/- 1 (n = 6; day 21)
      ml.min-1.kg-1 through a reduction in SV; there was no significant change in HR.
      Estimated branchial shunting, a relative measure of branchial arterio-venous
      blood flow, corresponded to 2.53 +/- 0.18 ml.min-1.kg-1 (control; n = 12), which
      represents 16% of baseline CO. Ventral and dorsal aortic pulse flows also
      decreased following stanniectomy. The decrease in DABF occurred in conjunction
      with a reduction in PDA which was measured for 12 days in a separate group of
      eels. Baseline PDA (3.03 +/- 0.1 kPa) significantly decreased by 15% to 2.55 +/-
      0.13 kPa 4 days after stanniectomy. However, this fall in PDA was transient and
      accompanied by an elevation in derived RSYS. These results support the hypothesis
      that the corpuscles of Stannius are closely linked to cardiovascular regulation
      in freshwater eels. Electrolyte changes (hypercalcemia, hypomagnesia,
      hyperkalemia and hyponatremia) were temporally coupled to the changes in blood
      flows. Impaired cardiovascular function and altered patterns of blood flow to
      osmoregulatory organs such as the gills, kidney and skin may have led to some or
      all of the electrolyte disturbances which followed stanniectomy.

PMID- 7798027
TI  - Divergent regulation of rat adipocyte GLUT1 and GLUT4 glucose transporters by GH.
AB  - The effect of GH, in vivo, on the glucose transport systems of rat adipocytes has
      been investigated. Lowering of serum GH levels, by treatment of rats with an
      antiserum specific for rat GH (anti-rGH), significantly decreased serum levels of
      both IGF-I and insulin. Treatment with anti-rGH also increased glucose oxidation
      and the conversion of glucose to lipid by isolated adipocytes. Adipocyte glucose
      oxidation and lipid synthesis were measured in the presence of a limiting
      concentration of glucose and therefore reflect changes in glucose transport.
      Immunoblot analysis of adipocyte subcellular fractions revealed that anti-rGH
      induced an increase in the amount of the glucose transporters GLUT1 (1.6-fold)
      and GLUT4 (2.5-fold) present in plasma membranes and a decrease (39%) in the
      amount of GLUT4 present in low-density microsomal fractions. Lowering of serum GH
      also increased, by 36%, the amount of GLUT1 present in a total membrane fraction
      but had no such effect on GLUT4 levels. Replenishment of serum GH, by concurrent
      administration of ovine GH to rats, prevented all of these effects of anti-rGH.
      It was concluded that GH in vivo down-regulates the amount of both GLUT1 and
      GLUT4 present in rat adipocyte plasma membranes. This reflects a decrease in the
      total cellular levels of GLUT1 and modification of the subcellular distribution
      of GLUT4 and results in restriction of adipocyte glucose uptake.

PMID- 7798026
TI  - The reduction of circulating growth hormone and prolactin in streptozocin-induced
      diabetic male rats is possibly caused by hypothalamic rather than pituitary
      changes.
AB  - To gain further information on diabetes-related disorders in the somatotrophic
      and lactotrophic axes, we undertook a functional, morphometrical and
      densitometrical study of the arcuate nucleus (AN), median eminence (ME) and
      anterior pituitary gland of adult male rats one month after streptozocin-induced
      diabetes (STZ-D). The basal secretory activity of somatotrophs and lactotrophs
      was tested by the reverse haemolytic plaque assay (RHPA) and plasma GH and
      prolactin (PRL) levels were determined by RIA. The number of GH-releasing factor
      (GRF)-labelled axons and the amount of axonal tyrosine hydroxylase (TH)
      immunoreactivity increased in STZ-D. There were no significant differences in any
      of the other densitometrical measurements performed on GRF-, somatostatin-,
      thyrotropin-releasing hormone- and TH-labelled ME axon cross-sections as well as
      those on tuberoinfundibular-dopaminergic neurones of the AN in STZ-D compared
      with control rats. Plasma GH and PRL levels and measurements on anterior
      pituitary GH- and PRL-labelled structures were decreased in STZ-D. However, the
      GH and PRL plaque areas were increased after RHPA implying that the secretory
      capacity of somatotrophs and lactotrophs was not impaired. Taken together, these
      results suggest that the accumulated GRF in the ME is due to reduced GRF release.
      This could account for the reduced amplitude and/or frequency of GH secretory
      pulses. The increased axonal TH-immunoreactivity may indicate an increased
      dopamine synthesis. If coupled to increased release this could, in turn, be
      partly responsible for the reduced plasma and anterior pituitary PRL
      concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798028
TI  - Expression of mRNA and immunocytochemical localization of inhibin alpha- and
      inhibin beta A-subunits in the fetal sheep testis.
AB  - In order to investigate the ontogeny of gonadal inhibin production in the male
      fetal sheep, testes were collected from male fetuses at days 70, 100, 130 and 140
      of gestation (term = 145 days). The expression and localization of inhibin alpha-
      and inhibin beta A-subunit mRNA and protein were evaluated using in situ
      hybridization and immunocytochemistry. The expression of inhibin alpha-subunit
      mRNA was localized within the seminiferous cords of the developing fetal testis
      and progressively increased with gestational age. Immunostaining corresponding to
      immunoreactive inhibin alpha-subunit was detected in Sertoli cells within the
      seminiferous cords at days 100, 130 and 140 of gestation. In addition,
      immunostaining was detectable in a small proportion of Leydig cells. No
      expression of inhibin beta A-subunit mRNA or immunoreactivity was detected in any
      testicular tissue at any stage of gestation. These data show that the Sertoli
      cells of the developing fetal sheep testis have the capacity to produce inhibin
      alpha-subunit by day 100 of gestation and that production increases during late
      gestation.

PMID- 7798029
TI  - Regulation of the TRH-like peptide pyroglutamyl-glutamyl-prolineamide in the rat
      anterior pituitary gland.
AB  - TRH-like peptides share the N- and C-terminal amino acids with TRH (pGlu-His-Pro
      NH2) but differ in the middle amino acid residue. One of them, pGlu-Glu-Pro-NH2
      (< EEP-NH2; EEP) is present in the rat pituitary gland, but its biological
      significance is unknown. We investigated the localization and regulation of this
      tripeptide in the rat pituitary gland. To distinguish between TRH and EEP two
      antisera were used for RIA: specificity of antiserum 4319 for the TRH-like
      peptides pGlu-Phe-Pro-NH2 and EEP was equal to or greater than that for TRH,
      whereas antiserum 8880 is TRH-specific. Our RIA data showed the presence of a TRH
      like peptide in the anterior pituitary gland (AP) and of TRH in the posterior
      pituitary gland (PP). The TRH-like peptide in the AP was identified on anion
      exchange chromatography and subsequent HPLC as EEP. Pathophysiological conditions
      such as altered thyroid and adrenal status and suckling did not affect pituitary
      gland levels of EEP. In general, however, there is a clear sex difference: levels
      of EEP are higher in male than in female rats. In both sexes gonadectomy leads to
      a substantial two- to threefold rise in EEP levels, abolishing the sex
      difference. Testosterone administration to gonadectomized male rats normalizes
      levels of EEP again. Disulfiram, an inhibitor of the enzyme peptidylglycine alpha
      amidating monooxygenase, reduced levels of EEP in the AP by approximately
      50%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798030
TI  - Effect of systemic glucagon administration on ACTH secretion in anaesthetized
      rats.
AB  - The effect of glucagon on ACTH secretion was studied in anaesthetized rats
      injected with either saline (0.1 ml i.m.) or glucagon (0.02 mg/kg i.m.). For the
      first 90 min after glucagon injection, plasma ACTH fell by 50% from the basal
      value of 23 +/- 4 pmol/l (mean +/- S.E.M.) to 11 +/- 2 (P = 0.011), after which
      an abrupt return to baseline occurred (120 min value: 26 +/- 2 pmol/l). In saline
      injected rats, the baseline ACTH value was not significantly different from
      either the 90 min value or the 120 min value (27 +/- 3 vs 21 +/- 4 and 24 +/- 3
      pmol/l respectively; P > 0.10). Plasma glucose after glucagon peaked at 11.6 +/-
      1.1 mmol/l by 15 min but subsequently fell rapidly, attaining the baseline by 60
      min. Insulin levels increased sharply after glucagon, from 381 +/- 78 pmol/l to
      3172 +/- 668 pmol/l at 15 min, and plateaued at approximately 1000 pmol/l
      thereafter. No changes in glucose or insulin were seen in saline injected rats.
      The magnitude of suppression of ACTH after glucagon was not affected either by
      sustained hyperinsulinaemia (congruent to 1400 pmol/l), induced with continuous
      glucose infusion to maintain plasma glucose > 12 mmol/l, or by pretreatment with
      the long-acting somatostatin analogue octreotide (50 micrograms/kg s.c.).
      However, the return to baseline between 100 and 120 min was prevented both by
      hyperinsulinaemia induced with sustained hyperglycaemia, and by octreotide. It is
      postulated that glucagon may inhibit ACTH secretion either by a direct effect on
      the hypothalamus or indirectly through insulin, which is known to stimulate
      endogenous somatostatin release.

PMID- 7798031
TI  - Inhibitory and stimulatory effect of oestrogens upon ovarian 17 alpha
      hydroxylase/C17,20-lyase in immature hypophysectomized rats treated with
      gonadotrophin.
AB  - A study was designed to compare the effects of exogenous and endogenous
      oestrogens upon the expression of steroid 17 alpha-hydroxylase/C17,20-lyase
      (CYP17) in the immature hypophysectomized rat ovary. C17,20-lyase activity was
      measured ex vivo using [21-14C]progesterone, while serum concentrations of
      androstenedione indicated in vivo activity. Immunocytochemistry was used to
      localize the enzyme within the ovary. Activity of CYP17 increased dramatically
      and remained high in thecal and interstitial cells after injection of equine
      chorionic gonadotrophin, even though serum oestradiol (OE2) levels exceeded 2
      nmol/l. Production of comparable serum levels by the use of Silastic capsules
      containing OE2 greatly suppressed but did not stop, expression of the enzyme
      induced by repeated doses of human chorionic gonadotrophin (hCG). Subcutaneous
      implantation of Silastic capsules (1 cm) containing diethylstilboestrol (DES)
      stimulated follicular growth and increased ovarian weight by 67%, 5 days later.
      Injection of 50 IU hCG at various times after removal of the implant produced
      time-dependent changes in CYP17 activity and serum androstenedione levels, when
      measured 30 h later. Although the initial effect of removal of DES was an
      increase in CYP17 activity, delaying injection of hCG resulted in a reduced
      response. The results indicated that: (1) endogenous oestrogens do not inhibit
      CYP17 expression; (2) exogenous oestrogens only reduce the number of
      thecal/interstitial cells expressing CYP17 when they are exposed to hCG; (3)
      pretreatment with oestrogen removes the ovarian interstitial but not the thecal
      cell expression of CYP17 in response to hCG; and (4) oestrogens can be
      stimulatory for CYP17 expression in thecal cells.

PMID- 7798032
TI  - Effect of gonadectomy on growth and GH responsiveness in dwarf rats.
AB  - Normal rats are sexually dimorphic in their growth and GH secretion. Gonadectomy
      (Gnx) changes the GH secretory pattern and this could explain differential growth
      rates in male and female rats. Gonadal steroids may also affect tissue growth
      directly, or by changing their responsiveness to GH. The effects of Gnx on
      growth, GH responsiveness, and hepatic GH receptors have now been studied in
      young (4-7 weeks old) GH-deficient dwarf rats in which the effects of steroid
      induced alterations in residual endogenous GH secretion will be much less
      pronounced. Groups of intact and Gnx dwarf rats (n = 5-7) were infused with
      recombinant human GH (144 micrograms/day) either continuously or in a pulsatile
      pattern (every 3 h) for 7 days, whilst control groups received saline infusions.
      Gains in weight, length and tibial bone growth were measured. Female dwarf rats
      grew significantly more slowly than male dwarfs. Gnx in male dwarfs inhibited
      growth significantly, whereas ovariectomy had a lesser stimulatory effect in
      females. Hepatic lactogenic and somatogenic receptors were higher in females and
      ovariectomy lowered their values towards male levels. Pulsatile GH infusions were
      more effective than continuous infusions of the same daily GH dose, but when the
      different underlying growth rates (measured in saline-infused Gnx animals) were
      taken into account, the responsiveness to pulses of hGH was not different between
      males and females or between intact and Gnx animals. We have concluded that Gnx
      in dwarf rats does affect growth, but the effects are small in comparison with
      those seen in normal rats. Since pulsatile GH infusions stimulated growth more
      effectively than continuous GH, irrespective of the gonadal steroid status, and
      the responsiveness to exogenous GH was not changed by Gnx, the results imply that
      changes in the GH secretory pattern induced by gonadal steroids may have a larger
      impact on the growth rate than direct effects at the tissue level, at least in
      the rat.

PMID- 7798033
TI  - Mechanism of phospholipase D activation induced by extracellular ATP in
      osteoblast-like cells.
AB  - We have previously reported that extracellular ATP stimulates Ca2+ influx from
      extracellular space, resulting in the production of prostaglandin E2 which
      mediates, at least in part, its proliferative effect on osteoblast-like MC3T3-E1
      cells, and that the activation of protein kinase C (PKC) stimulates phospholipase
      D in these cells. In the present study, we examined the effect of extracellular
      ATP on phosphatidylcholine-hydrolysing phospholipase D activity in MC3T3-E1
      cells. ATP stimulated the formation of both choline and inositol phosphates dose
      dependently in the range between 0.1 and 1 mM. The formation of choline by a
      combination of ATP and NaF, an activator of GTP-binding protein, was synergistic,
      whereas that of inositol phosphates was not. A combination of ATP and 12-O
      tetradecanoylphorbol-13-acetate, a PKC activating phorbol ester, additively
      stimulated the formation of choline. Staurosporine, an inhibitor of PKC, had
      little effect on ATP-stimulated formation of choline. Choline formation was
      significantly reduced by chelating extracellular Ca2+ with EGTA, while being
      inhibited by W-7, an antagonist of calmodulin. These results suggest that
      extracellular ATP stimulates phospholipase D in a Ca2+/calmodulin-dependent
      manner in osteoblast-like cells, and that neither PKC activation nor GTP-binding
      protein is involved in this mechanism.

PMID- 7798034
TI  - Ovine placental lactogen lacks direct somatogenic and anticatabolic actions in
      the postnatal lamb.
AB  - The metabolic effects of ovine placental lactogen (oPL) alone and in combination
      with bovine GH (bGH) were investigated in comparison with the identical dose of
      bGH alone in the well-fed postnatal lamb. The animals were treated by twice daily
      intramuscular injection for 5 days with oPL (n = 7), bGH (n = 7) or bGH+oPL (n =
      7) at a dose of 0.3 mg/kg per day or saline (n = 9). bGH and bGH+oPL treatments,
      but not oPL treatment, resulted in significantly (P < 0.01) higher plasma IGF-I
      levels than saline treatment. The rate of net protein catabolism (NPC) was
      significantly (P < 0.05) reduced to the same extent by bGH and bGH+oPL treatment
      compared with saline treatment. In contrast, oPL did not affect the rate of NPC.
      Blood glucose and insulin:glucose ratio were significantly (P < 0.05) elevated in
      the bGH+oPL group, whereas they were not significantly altered by either bGH or
      oPL treatment. These results suggest that oPL alone is not somatogenic or
      anticatabolic in the postnatal lamb despite the earlier evidence that oPL can
      bind to the oGH receptor (oGHR). However, oPL appeared to augment some of the
      effects of bGH when administered together, particularly with respect to
      carbohydrate metabolism. Potentiation of the diabetogenic effect of bGH by oPL
      may lead to insulin resistance during pregnancy. The lack of any obvious actions
      by oPL treatment alone may support the hypothesis that oGHR homo-dimerization is
      required for the full activation of GHR-mediated effects, since oPL binding does
      not initiate homo-dimerization of the oGHR.

PMID- 7798035
TI  - Oxytocin antagonists delay the initiation of parturition and prolong its active
      phase in rats.
AB  - The physiological importance of oxytocin for the initiation and maintenance of
      labour and delivery is controversial. We investigated the effects of two novel
      peptide oxytocin antagonists on the onset and the progress of delivery in rats
      implanted with a jugular vein cannula one day before term. During delivery rats
      were given either an oxytocin antagonist (OVT16, n = 10, or F382, n = 7, 30
      micrograms/kg) or vehicle (n = 10, 9) after the birth of the second pup and the
      time to deliver five more pups was recorded. Other rats were given an injection
      of F382 (30 micrograms/kg, n = 7) or vehicle (n = 9) after the birth of the
      fourth pup and the time to deliver three more pups was recorded. In another
      experiment rats were given repeated injections of F382 (30 or 60 micrograms/kg, n
      = 13, 11) or vehicle (n = 32) prepartum on the day of expected term and the time
      of onset and the progress of delivery was recorded. Rats given an antagonist
      after the second pup delivered the next five pups in 100 +/- 8 min (F382) and 83
      +/- 12 min (OVT16), significantly slower than the respective controls (51 +/- 6
      and 49 +/- 6 min, U-test, P < 0.05). Four of the 7 rats given F382 after the
      fourth pup showed no prolongation of delivery (time between pups 4-7: 24.7 +/-
      2.9 vs 27.5 +/- 3.1 min in controls), while in the other three rats delivery was
      prolonged (time between pups 4-7: 86 +/- 4.3 min).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7798036
TI  - Public health medicine and primary health care: convergent, divergent, or
      parallel paths?

PMID- 7798037
TI  - International variation in socioeconomic inequalities in self reported health.
AB  - STUDY OBJECTIVE: To assess the extent to which the size of socioeconomic
      inequalities in self reported health varies among industrialised countries.
      DESIGN: Cross sectional data on the association between educational level and
      several health indicators were obtained from national health interview surveys.
      This association was quantified by means of an inequality index based on logistic
      regression analysis. SETTING: The national, non-institutionalised populations of
      the United Kingdom, Sweden, Denmark, Germany, The Netherlands, Italy, the United
      States, and Canada were studied. The age group was 15-64 years, and the study
      period was 1983-90. PARTICIPANTS: Representative population samples with the
      number of respondents ranging from approximately 6000 (Denmark) to 90,000 (the
      United States) were studied. MAIN RESULTS: For men, the smallest health
      inequalities were observed for the United Kingdom and Sweden, and the largest
      inequalities for Italy and the United States. Other countries held an
      intermediate position. The same international pattern was observed for women,
      except that relatively small inequalities were also observed for Dutch women.
      CONCLUSIONS: The results agree to a large extent with those of previous
      comparative studies. The international pattern observed here may be partly
      related to "subjective" aspects of self reported health, such as the propensity
      to complain and illness behaviour. The results challenge the view that disease
      and disability are distributed less equally in the UK than in countries like
      Sweden.

PMID- 7798038
TI  - Sickness absence as a measure of health status and functioning: from the UK
      Whitehall II study.
AB  - STUDY OBJECTIVE: To investigate the relationship between self reported health
      status and sickness absence. DESIGN: Analysis of questionnaire and sickness
      absence data from the first phase of the Whitehall II study--a longitudinal study
      set up to investigate the degree and causes of the social gradient in morbidity
      and mortality. SETTING: London offices of 20 civil service departments.
      PARTICIPANTS: Altogether 6895 male and 3413 female civil servants aged 35-55
      years. Analysis was conducted on 88% of participants who had complete data for
      the present analysis. MAIN RESULTS: A strong inverse relation between the grade
      of employment (measure of socioeconomic status) and sickness absence was
      observed. Men in the lowest grade had rates of sickness absence six times higher
      than those in the highest grade. For women the corresponding differences were two
      to five times higher. In general, the longer the duration of absence, the more
      strongly did baseline health predict rates of absence. However, the health
      measures also predicted shorter spells, although to a lesser extent. Job
      satisfaction was strongly related to sickness absence with higher rates in those
      who reported low job satisfaction. After adjusting for health status the
      association remained for one to two day absences, but was greatly reduced for
      absences longer than three days. CONCLUSION: There was a strong association
      between ill health and sickness absence, particularly for longer spells. The
      magnitude of the association may have been underestimated because of the strength
      of the association between grade of employment and sickness absence. It is
      proposed that sickness absence be used as an integrated measure of physical,
      psychological, and social functioning in studies of working populations.

PMID- 7798039
TI  - Health status: does it predict choice in further education?
AB  - STUDY OBJECTIVE: To study the significance of a young person's health to his or
      her choice of further education at age 16. DESIGN: A cross sectional population
      survey SETTING: The whole of Finland. PARTICIPANTS: A representative sample of
      2977 Finnish 16 year olds. The response rate was 83%. MEASUREMENTS AND MAIN
      RESULTS: The three outcome variables reflected successive steps on the way to
      educational success: school attendance after the completion of compulsory
      schooling, the type of school, and school achievement for those at school.
      Continuing their education and choosing upper secondary school were most typical
      of young people from upper social classes. Female gender and living with both
      parents increased the probability of choosing to go on to upper secondary school.
      Over and above these background variables, some health factors had additional
      explanatory power. Continuing their education, attending upper secondary schools,
      and good achievement were typical of those who considered their health to be
      good. Chronically ill adolescents were more likely to continue their education
      than the healthy ones. CONCLUSIONS: School imposes great demands on young people,
      thus revealing differences in personal health resources. Adaptation to the norms
      of a society in which education is highly valued is related to satisfying health
      status. In a welfare state that offers equal educational opportunities for
      everyone, however, chronically ill adolescents can add to their resources for
      coping through schooling. Health related selection thus works differently for
      various indicators of health and in various kinds of societies. Social class
      differences in health in the future may be more dependent on personally
      experienced health problems than on medically diagnosed diseases.

PMID- 7798040
TI  - Passive smoking by self report and serum cotinine and the prevalence of
      respiratory and coronary heart disease in the Scottish heart health study.
AB  - STUDY OBJECTIVE: To explore the relationship between self reported environmental
      tobacco smoke exposure (or passive smoking), the serum cotinine concentration,
      and evidence of respiratory or coronary disease in men and women who have never
      smoked. DESIGN: Cross sectional random population survey identifying disease
      markers and relating them to measures of passive smoking. Disease markers were
      previous medical diagnoses, response to standard symptom questionnaires, and
      electrocardiographic signs. SETTING: Samples of men and women aged 40-59 years
      drawn from general practitioner lists in 22 local government districts of
      Scotland, between 1984 and 1986. PARTICIPANTS: A total of 786 men and 1492 women
      who reported never having smoked tobacco, and who had serum cotinine
      concentrations below 17.5 ng/ml, the cut off point for smoking "deceivers", took
      part. RESULTS: Fewer than one third of never smokers reported no recent exposure
      to environmental tobacco smoke and the same proportion had no detectable
      cotinine. Women had lower cotinine values than men but reported more exposure to
      smoke. The correlation between the measures of exposure was poor. Self-reported
      exposure showed strong, statistically significant, dose response relationships
      with respiratory symptoms and with the coronary disease markers. These
      relationships were weak or absent for serum cotinine, except for diagnosed
      coronary heart disease. Here the dose response gradient was as strong as that for
      self report, with an odds ratio of 2.7 (95% CI 1.3, 5.6) for the highest v the
      lowest exposure group, adjusted for age, housing tenure, total cholesterol, and
      blood pressure, and not explained by fibrinogen. CONCLUSIONS: The validity of
      different measures of tobacco smoke exposure needs further investigation. The
      gradient of diagnosed coronary heart disease with both self reported exposure and
      serum cotinine was, however, surprisingly strong, statistically significant, and
      unexplained by other factors. These findings reinforce current policies to limit
      passive tobacco smoke exposure.

PMID- 7798041
TI  - Coronary risk factor levels: differences between educational groups in 1972-87 in
      eastern Finland.
AB  - STUDY OBJECTIVE: To compare differences in coronary heart disease (CHD) risk
      factor levels between educational groups in the 1970s and 1980s in eastern
      Finland. DESIGN AND PARTICIPANTS: Independent, cross sectional population surveys
      were undertaken in 1972, 1977, 1982, and 1987 of randomly selected men and women
      aged 30-59 living in two provinces in eastern Finland. Altogether 20,096 subjects
      participated. The lowest observed level of participation in either sex or
      province in any year was 77%. Serum cholesterol values and blood pressure
      measurements, body mass index, smoking, and the level of education were
      determined in each survey using comparable methodology. MAIN RESULTS: More poorly
      educated men and women had higher levels of all risk factors at the end of the
      study period (1987). There was no change between 1972 and 1987 in differences
      between educational groups in mean serum cholesterol values and the diastolic
      blood pressure level in either sex, and in smoking in men. In women, the
      proportion of smokers was highest in the better educated in the 1970s but lowest
      in this group in the 1980s (interaction between year of examination and
      educational level p < 0.01). Differences between educational groups in mean body
      mass index increased with time in both men (p < 0.001) and women (p = 0.06).
      CONCLUSIONS: Relative differences between socioeconomic groups in CHD mortality
      have increased in Finland in the 1970s and 1980s. Present results from eastern
      Finland show no reduction in differences between educational groups in risk
      factor levels, and even some evidence of increasing differences. Although a
      comparison between mortality trends and risk factor trends is problematic, trends
      in the risk factors analysed do not seem to be a major cause for the increasing
      differences in CHD mortality in Finland, at least in men. On the other hand, the
      risk factor trends analysed show no progress towards reducing inequalities in
      health, a major goal of public health policy.

PMID- 7798042
TI  - Establishing baseline data in cancer registration in northern England:
      implications for Health of the Nation targets.
AB  - OBJECTIVE: To assess the completeness and accuracy of cancer surveillance data
      relevant to Health of the Nation targets. DESIGN: A comparison of locally
      ascertained data on cancer with recorded cancer registry sources in selected
      diagnoses. SETTING: The district of South West Durham within the Northern
      Regional Health Authority. PATIENTS: All patients with lung, skin, and malignant
      cervical cancer who were resident and diagnosed in the district or identified in
      the Northern Region Cancer Registry during the calendar period 1989-91. MAIN
      RESULTS: Of 544 cases of cancer identified from all available sources, 448
      (95.8%) were registered, ranging from 93.9% for malignant cervical cancer to
      96.7% for skin cancer. In 448 cases which were both identified locally and
      registered, 53 (11.8%) showed disagreements between local sources and register
      data, involving classification of site and timing of registration. Twenty three
      cases were identified locally but were not registered, 22 registered but not
      identified locally, and 51 registered with the casenotes missing locally.
      CONCLUSIONS: Any real achievement of Health of the Nation targets may be masked
      by changes over time in the accuracy and completeness of information systems. In
      assessing the achievement or otherwise of targets, it is important to be aware of
      any differences in the completeness and accuracy of the baseline data compared to
      future measurements.

PMID- 7798043
TI  - Cervical cancer: incidence and survival in migrants within Spain.
AB  - STUDY OBJECTIVE: This study examined the incidence of cervical cancer and
      survival rates according to migrant experience of women from different regions of
      Spain to Girona, Catalonia (Spain). DESIGN: Using data from the population based
      cancer registry of Girona for the period 1980-89, crude and age adjusted
      incidence rates were calculated for local-born and first generation migrants from
      other Spanish regions. The age standardised rate ratio (SRR) was calculated and
      Cox's regression model was used to adjust survival according to migrant status
      for age and stage at diagnosis. MAIN RESULTS: The incidence of cervical cancer
      was significantly higher in first generation Spanish migrants compared with
      locally born women (SRR: 2.02; 95% CI 1.40:2.92). The stage at diagnosis was more
      advanced among migrants. Survival probability was significantly associated with
      stage at diagnosis, but age and region of birth were not. CONCLUSIONS: Migrants
      from the southern Spanish regions show a twofold excess in the incidence of
      cervical cancer compared with the Girona-born female population. Cases of
      cervical cancer in migrants are diagnosed at a more advanced stage and as a
      consequence have a poorer prognosis.

PMID- 7798044
TI  - Childhood cancers: space-time distribution in Britain.
AB  - STUDY OBJECTIVES: To examine a national data set of all childhood cancers for
      evidence of space-time interactions within three distinct sets of dates and
      places (at birth, at diagnosis, and at death), to show whether the patterns found
      for these events represent separate phenomena or statistically interdependent
      processes, and to see whether the childhood leukaemias and the childhood solid
      cancers have separate distinctive patterns in these respects. DESIGN: This was a
      space-time cluster analysis. The large number of cases enabled division of the
      data into two sets, one for hypothesis generation and the other for hypothesis
      testing. SETTING: England, Scotland, and Wales. SUBJECTS: A national collection
      of 22,360 children aged 0-15 years with fatal cancers and leukaemias in the
      period 1953 to 1980. MAIN RESULTS: There was significant clustering among the
      leukaemias and lymphomas on date and place of birth (particularly among cases
      born within 1 km and up to 5 months apart), and on date and place of diagnosis
      (particularly among cases diagnosed from 3 to 5 km apart and up to 9 months
      apart). There was no clustering among the solid cancers. These findings were
      confirmed in two separate analyses of two separate sets of data. CONCLUSIONS: The
      birth clustering was significant among pairs diagnosed at differing ages, and
      diagnosis clustering was significant among pairs born at different times, and it
      was concluded that the two types of clustering must be regarded as separate and
      statistically independent phenomena. Both the birth and the diagnosis clusters
      comprised many independent pairs of cases, with no large multiple case clusters.
      This suggests the involvement of multiple time-space localised exposures to
      hazards with short and constant latent intervals; probably an infectious agent or
      an environmental toxin. Given the separate nature of the two types of clustering,
      exposure to more than one hazard may be involved.

PMID- 7798045
TI  - Down's syndrome: prevalence and ionising radiation in an area of north west
      England 1957-91.
AB  - OBJECTIVE: To analyse the prevalence of Down's syndrome in a specific,
      geographical area and seek to explain variations with particular reference to
      ionising radiation. DESIGN: Cases were ascertained by one paediatrician as part
      of a prospective survey of major congenital malformations in children born to
      residents of an area of Lancashire between 1957 and 1991. Temporal changes in
      prevalence rates were detected by a grid search technique using Poisson log
      linear models. These models were also used to determine the association between
      prevalence and ionising radiation from atomic fall out. SETTING: The Fylde
      district of Lancashire in the north west of England. PATIENTS: There were 167
      cases, including five stillbirths and eight terminations, among 124,015 total
      births in a population which increased from about 250,000 to over 300,000 during
      the study period. MAIN RESULTS: There was significant increase in the prevalence
      of all cases conceived in 1963 and 1964, and a lesser peak in 1958 which did not
      quite reach statistical significance. There was no evidence that the increased
      prevalence in 1963-64 was a result of changes in the maternal age distribution in
      the population. Babies of mothers aged 35 years and over accounted for more of
      the variation, especially in 1958 when their increase was significant. There was
      a highly significant association between prevalence and radiation from fallout
      produced by atmospheric testing of atomic weapons. The 1963-64 peak coincided
      with the maximum estimated radiation dose. The lesser peak in 1958 also coincided
      with increased exposure to radiation from fallout, possibly enhanced by ground
      deposits after a fire at the Windscale reactor in October 1957. CONCLUSION: This
      study provides further support for low dose ionising radiation as one
      aetiological factor in Down's syndrome.

PMID- 7798046
TI  - Birth prevalence of malformations in members of different ethnic groups and in
      the offspring of matings between them, in Birmingham, England.
AB  - STUDY OBJECTIVES: The aims were: (1) to compare the birth prevalence of
      malformations in different ethnic groups and (2) to explore the reasons for the
      ethnic variations found by examining birth prevalence in the offspring of matings
      between ethnic groups. DESIGN: Analysis of data from a register of malformations
      and register of births. SETTING: Birmingham, England. SUBJECTS: A total of
      432,778 infants (including stillbirths) born in 1960-84. MAIN RESULTS:
      Significant differences (p < 0.01) between ethnic groups were exhibited by the
      birth prevalence of neural tube defects (NTD), cleft palate, cleft lip,
      oesophageal atresia/fistula, hypospadias, hip dislocation, clubfoot, polydactyly,
      and syndactyly. In the offspring of matings between parents of European and
      Caribbean origin, the birth prevalence of NTD, cleft lip, hypospadias, hip
      dislocation, polydactyly, and syndactyly seemed more likely to be influenced by
      the ethnicity of both parents than by that of the mother alone. The reverse was
      true for the birth prevalence of NTD in subjects with one parent of Irish origin
      and on of British. CONCLUSIONS: Genetic differences may be responsible for
      Europeans being at lower risk of polydactyly and at higher risk of NTD, cleft
      lip, hypospadias, hip dislocation, and syndactyly than Caribbeans. Variations in
      the intrauterine environment are more likely to account for NTD being more common
      in Irish than in British subjects.

PMID- 7798047
TI  - Physical fitness of 9 year olds in England: related factors.
AB  - STUDY OBJECTIVE: To examine the influence of social factors, passive smoking, and
      other parental health related factors, as well as anthropometric and other
      measurements on children's cardiorespiratory fitness. DESIGN: This was a cross
      sectional study. SETTING: The analysis was based on 22 health areas in England.
      PARTICIPANTS: The subjects were 299 boys and 282 girls aged 8 to 9 years. Parents
      did not give positive consent for 15% of the eligible sample. A further 25% of
      the eligible sample did not participate because the cycle-ergometer broke down,
      study time was insufficient, or they were excluded from the analysis because they
      were from ethnic minority groups or had missing data on one continuous variable.
      MEASUREMENTS AND MAIN RESULTS: Cardiorespiratory fitness was determined using the
      cycle-ergometer test. It was measured in terms of PWC85%-that is, power output
      per body weight (watt/kg) assessed at 85% of maximum heart rate. The association
      between children's fitness and biological and social factors was analysed in two
      stages. Firstly, multiple logistic analysis was used to examine the factors
      associated with the children's ability to complete the test for at least four
      minutes. Secondly, multiple linear regression analysis was used to examine the
      independent association of the factors with PWC85%. In the logistic analysis,
      shorter children, children with higher blood pressure, and boys with a larger
      sibship size had poorer fitness. In the multiple regression analysis, only height
      (p < 0.001) was positively associated, and the sum of skinfold thicknesses at
      four sites (p = 0.001) was negatively associated with fitness in both sexes. In
      girls, a positive association was found with pre-exercise peak expiratory flow
      rate (p < 0.05), and there were negative associations with systolic blood
      pressure (p < 0.05) and family history of heart attack (p < 0.05). In boys an
      association was found with skinfold distribution and fitness (p < 0.05), so that
      children with relatively less body fat were fitter. Social and health behaviour
      factors such as father's social class, father's employment status, or parents'
      smoking habits were unrelated to child's fitness. CONCLUSION: Height and obesity
      are strongly associated, and systolic blood pressure to a small extent, with
      children's fitness, but social factors are unrelated.

PMID- 7798050
TI  - The hospital admissions study in England: are there alternatives to emergency
      hospital admission?
AB  - STUDY OBJECTIVE: To assess the potential for substituting alternative forms of
      care for admission to an acute hospital in particular groups of patients. DESIGN:
      A screening tool, the intensity-severity-discharge review system with adult
      criteria (ISD-A), developed for hospital utilisation review in the USA, was used
      in a cohort of hospital admissions to identify a group of patients who could
      potentially have been treated outside the acute hospital. These patients were
      further assessed by a panel of general practitioners (GPs) to determine the most
      appropriate alternative form of care. A cost analysis was performed on the
      results obtained. SETTING: General medicine and geriatric specialties in one
      acute hospital in the south western region. PATIENTS: Patients comprised a sample
      of 701 admitted to general medical and geriatric specialties. MAIN RESULTS: The
      screening tool identified 19.7% of admissions for whom there was potential for
      treatment outside the acute hospital. Assessment by the GP panel reduced this
      potential to between 9.8% and 15.0% of emergency admissions. The alternatives
      most frequently identified as "most appropriate" were the community hospital/GP
      bed and the urgent outpatient assessment (within either 24 or 48 hours).
      Potential resource savings based on the average cost were relatively small. This
      potential seemed to be greater for the alternative of the urgent outpatient
      assessment. CONCLUSIONS: Potential exists for treating a proportion of patients
      in lower intensity alternatives to the acute hospital. If this potential were
      exploited few resource savings would occur.

PMID- 7798049
TI  - Risk factors for childhood burns: a case-control study of Ghanaian children.
AB  - STUDY OBJECTIVE: To study risk factors for childhood burns in order to identify
      possible preventive strategies. DESIGN: Case-control design with pair matching of
      controls to cases in relation to age, sex, and area of residence. The cases and
      controls were identified by a community based, multisite survey. The effects of
      host and socioenvironmental variables reported by mothers were investigated in a
      multivariate analysis using conditional logistic regression. SETTING: A
      developing country setting the Ashanti Region in Ghana. PARTICIPANTS: These
      comprised 610 cases aged 0-5 years who had been burned (as evidenced by a visible
      scar) and 610 controls with no burn history. MAIN RESULTS: The presence of a pre
      existing impairment in a child was the strongest risk factor in this population
      (OR = 6.71; 95% CI 2.78, 16.16). Other significant risk factor included: sibling
      death from a burn (OR = 4.41; 95% CI 1.16, 16.68); history of burn in a sibling
      (OR = 1.79; 95% CI 1.24, 2.58); and storage of a flammable substance in the home
      (OR = 1.51; 95% CI 1.03; 2.21). Maternal education had a protective effect
      against childhood burns, although this effect was not strong (OR = 0.76; 95% CI
      0.55, 1.05). CONCLUSIONS: Community programmes to ensure adequate child
      supervision and general child wellbeing, particularly for those with impairments,
      as well as parental education about burns are recommended, to reduce childhood
      burns in this region of Ghana. The public should bed advised against storing
      flammable substances in the home.

PMID- 7798048
TI  - Child pedestrian deaths: sensitivity to traffic volume--evidence from the USA.
AB  - STUDY OBJECTIVE: In case centred epidemiological studies, traffic volume has been
      shown to be a potent risk factor for child pedestrian injuries. Nevertheless,
      over the past two decades child pedestrian death rates have fallen in many
      countries despite large increases in traffic volumes, suggesting that other
      factors are responsible for the long term decline in death rates. This study
      aimed to investigate the relationship between short term changes in traffic
      volume and child pedestrian death rates. DESIGN: The relationship between child
      pedestrian death rates and traffic volume in the USA for the period 1970-88 was
      investigated. Trends in death rates and in traffic volume were removed by the
      time series method of differencing. RESULTS: After removing the long term trends,
      there was a close relationship between the year to year variation in traffic
      volume and the year to year variation in the child pedestrian death rate. Most
      notably, in the two periods when traffic volume actually fell, the falls in the
      child pedestrian death rate were considerably larger than those seen at any other
      time. Overall, decelerations in the rate of increase in traffic volume were
      accompanied by accelerations in the rate of decline in the child pedestrian death
      rate. CONCLUSION: While other factors may determine long term trends in child
      pedestrian death rates, they are very sensitive to short term changes in traffic
      volume. Public policy changes which limit the growth in traffic volume have the
      potential to accelerate the decline in child pedestrian death rates.

PMID- 7798052
TI  - Estimating the sexual mixing patterns in the general population from those in
      people acquiring gonorrhoea infection: theoretical foundation and empirical
      findings.
AB  - STUDY OBJECTIVES: To describe mathematically the relationship between patterns of
      sexual mixing in the general population and those of people with gonorrhoea
      infection, and hence to estimate the sexual mixing matrix for the general
      population. DESIGN: Integration of data describing sexual behaviour in the
      general population, with data describing sexual behaviour and mixing among
      individuals infected with gonorrhoea. Use of these data in a simple mathematical
      model of the transmission dynamics of gonorrhoea infection. SETTING: The general
      population of London and a genitourinary medicine (GUM) clinic in west London.
      PARTICIPANT: These comprised 1520 men and women living in London who were
      randomly selected for the national survey of sexual attitudes and lifestyles and
      2414 heterosexual men and women who presented to the GUM clinic with gonorrhoea.
      MAIN RESULTS: The relationship between sexual mixing among people with gonorrhoea
      and sexual mixing in the general population is derived mathematically. An
      empirical estimate of the sexual mixing matrix for the general population is
      presented. The results provide tentative evidence that individuals with high
      rates of acquisition of sexual partners preferentially select other individuals
      with high rates as partners (assortative mixing). CONCLUSIONS: Reliable estimates
      of sexual mixing have been shown to be important for understanding the evolution
      of the epidemics of HIV infection and other sexually transmitted diseases. The
      possibility of estimating patterns of sexual mixing in the general population
      from information routinely collected in gonorrhoea contact tracing programmes is
      demonstrated. Furthermore, the approach we describe could, in principle, be used
      to estimate the same patterns of mixing, using contact tracing data for other
      sexually transmitted diseases, thus providing a way of validating our results.

PMID- 7798051
TI  - Assessing equity in access to health care provision in the UK: does where you
      live affect your chances of getting a coronary artery bypass graft?
AB  - STUDY OBJECTIVES: Equity should be monitored routinely for all health care
      services, but ideal studies for each service would be prohibitively expensive and
      time consuming. A simple, quick, and cheap method for the preliminary exploration
      of equity in health care provision using routine data was devised. This method
      was illustrated by examining whether coronary artery bypass graft (CABG)
      operations reflect socioeconomic differences in ischaemic heart disease (IHD)
      mortality. DESIGN: Ecological comparison of operation rates was undertaken for
      CABG for 1991 and IHD mortality for 1981-85 by quartiles of Townsend deprivation
      score. SETTING: North East Thames Regional Health Authority, London, UK.
      SUBJECTS: All residents of this region aged 35-74 were the denominator
      population. Numerators were 26,834 IHD deaths and 1041 CABG operations for the
      defined time periods. MAIN RESULTS: IHD mortality showed a steady, significant
      increase with increasing area deprivation scores for both men and women. CABG
      rate ratios increased linearly for women, while for men there was a U shaped
      pattern, being lowest for the second and third quartiles. This pattern was
      attenuated, but not abolished, when adjusted for geographical proximity to
      cardiothoracic surgical units. The ratio of CABG operations to IHD mortality by
      deprivation was relatively constant in women suggesting equitable provision. In
      men, this ratio was significantly lower for the third quartile. CONCLUSIONS:
      Inequities may exist in the provision of CABG operations for men in this region
      and this finding should be the stimulus for further detailed studies. Other
      health care systems should also examine equity in provision.

PMID- 7798054
TI  - Growth and relative stability of the proportion permanently sick in English
      family health service authorities, 1981-91.

PMID- 7798053
TI  - Components of small area variation in death rates: a method applied to data from
      Sweden.
AB  - STUDY OBJECTIVES: The study aimed to develop and evaluate a method for small area
      analysis of different non-random components of the variation in death rates. The
      method was applied to incidence and mortality data for selected malignant
      neoplasms in 26 administrative health areas in Sweden. DESIGN: Variation in
      mortality and incidence rates for malignant neoplasms of the trachea, bronchus,
      and lung; colon; rectum; and cervix uteri in the 26 health areas were analysed
      after standardisation for age. In addition, the systematic and random components
      of variance were estimated. The systematic component of variance in mortality was
      divided into two additive components-one component was dependent on the variation
      in the corresponding incidence rates and the other remained after adjustment for
      incidence. SETTING AND PARTICIPANT: All cases diagnosed between 1972 and 1983 and
      all deaths between 1974 and 1985 for selected malignant neoplasms in Swedish
      citizens and other residents in Sweden, aged between 0 and 64 years, were
      analysed. MAIN RESULTS: Much of the observed variation in mortality was explained
      by the estimated random variation. For malignant neoplasms of the trachea,
      bronchus, and lung the systematic variation in mortality was mainly explained by
      the variation in incidence. For cancer of the cervix uteri, alone, there was
      significant systematic variation of moderate magnitude that was not explained by
      the incidence rates. CONCLUSIONS: These methods made it possible to divide the
      observed variance in mortality into different components. Random effects and
      variance in incidence rates were found to be of great importance when analysing
      the variance in death rates between health areas. By studying different
      systematic components of variation it is possible to identify fields for in depth
      studies on the quality of prevention and treatment.

PMID- 7798055
TI  - Aetiology of peptic ulcer in Norway.

PMID- 7798056
TI  - Pap smear compliance among norplant users.

PMID- 7798058
TI  - Vaginal smears after hysterectomy.

PMID- 7798057
TI  - Vaginal smears after hysterectomy.

PMID- 7798059
TI  - Telemedicine.

PMID- 7798060
TI  - Structure and financing of health care.

PMID- 7798062
TI  - A common basis for general practice/family medicine in Europe.

PMID- 7798061
TI  - Pearls from geriatrics, or a long line at the bathroom.

PMID- 7798063
TI  - Physicians and organizations: an uneasy alliance or a welcome relief?
AB  - BACKGROUND: Physicians are increasingly practicing within structured or organized
      practice settings, even though it is frequently assumed that such organizations
      are inherently dissatisfying to physicians. In this study, a sensitive measure of
      physician satisfaction is used to compare physicians working in four types of
      practice settings: private group practice, solo practice, a closed-panel health
      maintenance organization (HMO), and a hospital-based practice. METHODS: A
      questionnaire was mailed to all physicians in a four county area in western
      Massachusetts, from which 1302 practicing physicians were identified. Based on
      responses to the questionnaire, the physicians were placed into one of the four
      practice arrangements. Satisfaction was measured by using an index methodology,
      with six statistically acceptable measures of satisfaction. RESULTS: All
      physicians surveyed were most satisfied with the personal and lifestyle factors
      related to their practice, regardless of practice setting. Those in a private
      group practice were the most satisfied. However, physicians in an HMO setting
      were more satisfied with medicine as a profession and less dissatisfied with the
      state's medical practice climate than physicians in the other practice settings.
      It appears that HMOs provide professional satisfaction by buffering physicians
      from the external regulatory climate, permitting them to focus more on patient
      care. CONCLUSIONS: Identifying the factors that cause physician satisfaction and
      dissatisfaction within the various types of practice settings becomes
      increasingly important as current health care reform efforts continue to promote
      more structured practice environments. More research is needed to identify the
      various organizations physicians are involved with so that physicians'
      professional level of satisfaction can be maximized.

PMID- 7798065
TI  - Disqualifying criteria in a preparticipation sports evaluation.
AB  - BACKGROUND: This study was undertaken to demonstrate the relative frequency of
      disqualifying criteria in a complete history and physical sports examination.
      METHODS: A review was conducted of 2574 preparticipation physical evaluations
      (PPEs) performed on 11- to 18-year-old student athletes to determine which
      factors are associated with denial of unrestricted sports participation. RESULTS:
      Eighty-five percent of the student athletes passed the screening. Of those who
      did not, the denial decision was based on the medical history alone in 58% of
      cases (P < .05). A logistic regression analysis identified seven items associated
      with denial: dizziness with exercise, history of asthma, body mass index,
      systolic blood pressure, visual acuity, heart murmur, and musculoskeletal
      examination. CONCLUSIONS: Although physicians often take a complete history and
      perform physical examinations, relatively few variables appear related to denial
      of eligibility for participation in organized sports. The history is one of the
      most important aspects of the PPE. A directed PPE may be more efficient, thereby
      allowing more time to address other important issues.

PMID- 7798064
TI  - Prostate cancer screening: a decision analysis.
AB  - BACKGROUND: The issue of whether to screen men for prostate cancer is
      controversial. No randomized clinical trials have been completed to confirm the
      efficacy of screening for prostate cancer. We created a mathematical model of the
      clinical risks and benefits of screening for prostate cancer. METHODS: A Markov
      decision-analytic model evaluated the outcomes of annually screening asymptomatic
      men for prostate cancer beginning at age 50 years. The screening and testing
      algorithm included the digital rectal examination, transrectal ultrasound, and
      prostate-specific antigen test. A sample of 10 male patients with no history of
      prostate disease were interviewed to assess their utilities (preferences)
      regarding the various adverse outcomes of prostate cancer treatment. RESULTS: The
      model indicated that no screening was preferred to screening when patients'
      utilities were considered (24.14 vs 23.47 quality-adjusted life years expected).
      The optimal decision was sensitive to the utilities of impotence and urethral
      stricture, the most common adverse outcomes for patients under the age of 65
      years. When adverse outcomes of treatment were ignored, screening was favored
      (24.86 vs 24.22 years of life expectancy. CONCLUSIONS: When quality-of-life
      preferences of men are considered, the annual screening of asymptomatic patients
      for prostate cancer is not recommended.

PMID- 7798067
TI  - Prevalence of lead poisoning in a suburban practice.
AB  - BACKGROUND: The purpose of this study was to determine the prevalence of elevated
      blood lead levels (EBLLS, lead > or = 10 micrograms/dL [0.48 mumol/L]) in a
      suburban family practice setting and to assess the utility of a questionnaire as
      an alternative to universal screening in identifying individuals with EBLL in a
      low-risk population. METHODS: Parents bringing children aged 1 through 3 years
      into the office for any type of visit were offered the opportunity to complete a
      questionnaire concerning risk for lead poisoning and to obtain free blood lead
      testing for their child. No child in this study had previously been tested for
      lead toxicity. The lead levels found on testing were correlated with the
      questionnaire results. RESULTS: Two hundred thirty-two children with an average
      age of 20 months were tested. Blood lead levels ranged from 0 to 53 micrograms/dL
      (2.56 mumol/L). Elevated blood lead levels were found in 5.6% of the study
      population. The five questions suggested by the Centers for Disease Control and
      Prevention (CDC) were taken as a group, and any "yes" or "don't know" response
      was considered a risk factor. These questions had a sensitivity of 84.6% and a
      specificity of 41.6% in identifying children with EBLL. An additional question
      regarding residence in a home built before 1960 (or not knowing the age of the
      home) was a better screening test for EBLL (sensitivity 92.3%, specificity 57.1%)
      than the five CDC questions. Lower household income was associated with an EBLL,
      but sex, race, and home location (urban, suburban, rural) were not. CONCLUSIONS:
      Risk-assessment questionnaires are useful tools in selecting children who are at
      risk for an EBLL from low-risk populations. Comparison of this study with similar
      studies suggests that the most useful questions for this purpose may vary
      according to location. In this and other studies to date, however, questionnaires
      show less than 100% sensitivity in identifying children with EBLL.

PMID- 7798066
TI  - Selection of skin test antigens to evaluate PPD anergy.
AB  - BACKGROUND: A purified protein derivative (PPD) tuberculin skin test may be
      nonreactive because of cutaneous anergy, technical problems with the test, or
      absence of tuberculosis infection. This study investigated the sensitivity and
      specificity of five test agents in measuring cutaneous anergy when the PPD test
      is nonreactive. Agents evaluated include antigens for Candida, mumps,
      histoplasmin, tetanus, and Trichophyton. METHODS: Delayed-type hypersensitivity
      skin test records were analyzed in 1113 patients admitted to the University of
      Texas Health Center at Tyler from December 1988 through June 1993. These patients
      were admitted with initial diagnoses of diseases other than active tuberculosis
      or human immunodeficiency virus infection. RESULTS: Patients with a negative PPD
      test reacted most often to the control skin test Candida (63.5%), followed by
      mumps (52.2%), histoplasmosis (37.2%), tetanus (35.7%), and Trichophyton (6.1%).
      Analysis of these data indicates that the use of more than three of the four most
      commonly reactive control tests (Candida, mumps, and histoplasmin or tetanus)
      yielded minimal additional precision in the determination of skin test anergy
      compared with using all five control skin tests. This finding remained constant
      whether the PPD was considered negative at < 5 mm, < 10 mm, or < 15 mm of
      induration. CONCLUSIONS: In controlling for false-negative PPD tests, the use of
      three skin test antigens, Candida, mumps, and tetanus, should provide reliable
      control for delayed-type hypersensitivity anergy.

PMID- 7798069
TI  - Drug interactions with antibacterial agents.
AB  - Antibacterial drugs, such as quinolones, macrolides, rifampin, isoniazid, and
      trimethoprim-sulfamethoxazole, can interact with other drugs in a wide variety of
      clinically significant ways. They are frequently administered with other
      prescription and nonprescription medications. Antibacterial agents may interact
      by causing a change in the pharmacokinetics or pharmacodynamics of a second drug.
      In other cases, the antimicrobial may be affected by the action of another drug.
      Interactions involving antimicrobials often result from alterations in the
      absorption of the antimicrobial from the gastrointestinal tract or changes in the
      hepatic metabolism or renal elimination of the drugs concurrently administered.
      While certain classes of antibacterial drugs are known to interact with many
      other drugs, the interaction potential of most classes of antimicrobials is not
      uniform among members of the class. This diversity in interaction potential
      provides the clinician with an opportunity to avoid potential interactions by
      means of appropriate drug selection. An understanding of the common, clinically
      significant drug interactions involving antibacterial agents will enable the
      physician to avoid unnecessary adverse drug reactions.

PMID- 7798068
TI  - Conversion from 2.5 mg to 1.25 mg indapamide in patients with mild to moderate
      hypertension.
AB  - BACKGROUND: Indapamide is an effective antihypertensive drug with diuretic and
      vasodilating activities. The common starting dose has been 2.5 mg to 5 mg. A
      lower dose formulation (1.25 mg) is now available. The safety and efficacy of
      switching patients from indapamide 2.5 mg to indapamide 1.25 mg was evaluated in
      this randomized, double-blind, multicenter clinical trial. METHODS: Three hundred
      seventy-eight adult patients with mild to moderate essential hypertension were
      enrolled in a washout period, during which patients received single-blind placebo
      for 4 weeks. All 378 patients qualified for the study and received open-label
      treatment with indapamide 2.5 mg for 8 weeks. Of the 378 patients, 265 responded
      to indapamide 2.5 mg and were randomized to receive double-blind treatment with
      either indapamide 1.25 mg (n = 132) or 2.5 mg (n = 133) for 8 weeks. Overall, 245
      of the 378 patients who were initially enrolled completed the study. The primary
      efficacy variable was the number of patients in each treatment group who
      maintained a supine diastolic blood pressure of < or = 90 mm Hg (treatment
      success) by the end of the double-blind period (week 16). RESULTS: Treatment with
      indapamide 1.25 mg once daily was as efficacious as the 2.5-mg once-daily dose.
      No significant difference was observed for the percentage of patients who
      achieved treatment success between the patients switched from indapamide 2.5 to
      1.25 mg (74%) and the control group maintained on indapamide 2.5 mg (70%). The
      incidence of drug-related adverse events during the double-blind period was
      similar between the two treatment groups. The mean change from pretreatment
      baseline to endpoint in serum potassium was -0.2 mEq/L (-0.2 mmol/L) in the
      indapamide 1.25 mg treatment group, compared with -0.4 mEq/L (-0.4 mmol/L) in the
      indapamide 2.5 mg treatment group. CONCLUSIONS: Indapamide 1.25 mg given once
      daily for 8 weeks was as effective as 2.5 mg once daily in reducing systolic and
      diastolic blood pressure in patients with mild to moderate hypertension.

PMID- 7798070
TI  - Treatment of drop attacks with nifedipine: a case report.
AB  - Drop attacks are sudden, unexpected, nonsyncopal falls, which are not preceded or
      accompanied by loss of consciousness, dizziness, lightheadedness, or loss of
      balance. They can be a manifestation of epilepsy, brain stem tumors, and a
      variety of other conditions. In the elderly, they have been associated with
      vertebrobasilar insufficiency, cervical spondylosis, or both. However, the
      specificity and etiology of drop attacks have come under some scrutiny in recent
      years. The patient described in this case report experienced frequent drop
      attacks that were effectively prevented with nifedipine. Possible
      pathophysiologic mechanisms are discussed and the relevant literature is
      reviewed.

PMID- 7798071
TI  - Screening for lead poisoning in a suburban practice.

PMID- 7798072
TI  - Bed rest, exercises, or ordinary activity for acute low back pain?

PMID- 7798073
TI  - Quinine and leg cramps.

PMID- 7798074
TI  - Parent drug use, parent personality, and parenting.
AB  - This study examined the relationship of parent drug use and specific parent
      personality traits with four indicators of the parent-child bond: affection,
      child-centeredness, involvement, and nonconflictual relations. The participants
      (N = 71) were young mothers or fathers who have participated in a longitudinal
      study of 1,000 children and their parents from 1975 to the present. They answered
      a self-administered questionnaire about themselves and their oldest child.
      Regression analyses indicated that the domains of parent drug use and parent
      personality had independent effects on most of the parent-child variables.
      Specific parent personality traits buffered the effect of drug use on aspects of
      the bond. The implications of these findings are that reducing parental drug use
      can have direct and positive effects on the bond and can enhance some parent
      personality traits, thus strengthening the bond. Protective personality
      characteristics can mitigate the impact of drug use on the bond.

PMID- 7798075
TI  - The influences of goal-related action and goal information on children's
      perceptions of trying and wanting: an action-perception approach.
AB  - The influences of goal-related actions and goal information on children's try-and
      want perceptions were investigated with an action-perception approach (i.e.,
      Heider, 1958). Kindergartners, second graders, and fifth graders heard stories
      that depicted actors engaged in one action, that same action three times, or
      three equifinal actions to attain a positive or negative goal. The children rated
      how much actors tried and wanted to attain the goal. The findings indicate that
      the actors who engaged in only one action were perceived to have tried and wanted
      the least, and the actors who engaged in equifinal actions were perceived to have
      tried and wanted the most. The actors who engaged in one action were not
      significantly differentiated from those who engaged in repetitive actions.
      However, the actors who engaged in repetitive actions were significantly
      differentiated from those who engaged in equifinal actions. For try ratings only,
      the children made all expected differentiations of actors by goal-related action
      in negative goal conditions, whereas fewer differentiations were made of actors
      in positive goal conditions. Age-related findings indicate that only younger
      children perceived that the actors who pursued positive goals tried and wanted
      more than those who pursued negative goals.

PMID- 7798076
TI  - Gifted and talented: fourth-, fifth-, and sixth-grade students' evaluations of a
      gifted program.
AB  - A pull-out program for gifted students was evaluated in reports (qualitative
      evaluations) from a sample of 60 program participants from the fourth, fifth, and
      sixth grades. The students identified six areas in their evaluations: cognitive
      aspects, program satisfaction, self-expression, self-esteem, boredom, and
      learning environment. Students who identified cognitive aspects of their program
      also were likely to identify program satisfaction and not being bored. Statements
      about opportunities to be self-expressive were made more by girls than by boys
      and more by fifth and sixth graders than by fourth graders.

PMID- 7798078
TI  - Secrets and reasons for secrecy among school-aged children: developmental trends
      and gender differences.
AB  - The substance and dynamics of secrets were elicited and analyzed for 180 children
      at three grade levels, to examine developmental trends and gender differences.
      The recorded frequencies were subjected to loglinear analyses. The results, which
      revealed a grade effect regarding topics of secrets, indicated a developmental
      shift in topics with age from secrets pertaining to possessions to secrets
      pertaining to interpersonal relations, heterosexual involvement, and moral
      transgressions. A grade effect also emerged regarding reasons for secrecy; a
      shift was indicated from need for exclusiveness typical of younger children to
      socially embedded reasons for secrecy characteristic of older children. A gender
      main effect regarding topics of secrets indicated that boys more often than girls
      bear secrets pertaining to possessions and moral transgressions, whereas girls
      tend more often than boys to bear secrets pertaining to family issues. No gender
      effect was evident, however, in regard to reasons for secrecy. The developmental
      trends in both aspects of secrecy investigated may be conceived in the framework
      of a dual shift from separateness to relatedness and from true latency to late
      latency.

PMID- 7798077
TI  - Chinese adolescents' perceptions of parenting styles of fathers and mothers.
AB  - Father Treated and Mother Treated subscales of the Parent Image Differential were
      used to assess recalled parental treatment styles of 2,150 Chinese secondary
      school students. Results from reliability and factor analyses showed that both
      scales were internally consistent, and two factors (Concern and Restrictiveness)
      were abstracted from each of these scales. The data on gender differences in
      parenting revealed significant differences, across socioeconomic classes, between
      paternal and maternal treatment styles, with the fathers perceived to be
      relatively more restrictive and showing less concern than the mothers. The data
      suggest that differences between paternal and maternal treatment styles exist in
      the Chinese context but that signs of gradual change in the differences are
      appearing.

PMID- 7798080
TI  - Characteristics of school children who are choosy eaters.
AB  - Choosiness, manifested in refusal of foods, eating little, and disinterest in
      food, was studied with regard to prevalence, stability, sociodemographic
      characteristics, health problems, weight, and associated problem behaviors in a
      sample of 240 Swedish primary school children. Questionnaires were used, and data
      on sociodemographic variables, health problems, weight, and height were collected
      from child health-care and school health records. Choosiness was present in one
      third of the children, but only 8% showed choosy behavior both at home and in
      school. The choosy children had no more health problems than others, nor were
      they significantly thinner. Choosiness was not related to gender, social class,
      or ethnic background. The choosy children had modestly elevated levels of
      externalizing, hyperactive, and internalizing behavior. The choosy children with
      a history of refusal to eat in infancy or preschool age had more pronounced
      choosy behavior and had more problem behaviors than the other choosy children.
      Choosiness can not easily be categorized within an eating disorders or main
      problem syndromes of childhood frame of reference.

PMID- 7798079
TI  - Educational and occupational aspirations of "common man" boys: Kahl's study
      revisited.
AB  - The relationships between parents' getting-ahead-getting-by orientations,
      adolescents' perceptions of those parental orientations, and aspirations for
      adolescents with different levels of intellectual ability and from various social
      status backgrounds were examined. Data were collected from 516 Australian 16-year
      olds (250 boys, 266 girls) and their parents. The adolescents were classified
      into four contexts defined by the median split of scores on intellectual ability
      and family social status. Within each ability-status context, relationships among
      the variables were examined by constructing regression surfaces that were formed
      from models that included terms to test for possible linear, interaction, and
      curvilinear associations. The findings suggest that (a) in each context,
      perceptions of parents' orientations had strong associations with adolescents'
      aspirations; (b) for adolescents from low ability-lower status contexts,
      perception of parents' orientations acted as a threshold variable such that they
      were related to aspirations only at medium to high perception levels; and (c) in
      each context, parents' aspirations were related to adolescents' educational
      aspirations at each level of adolescents' perceptions of parents' orientations.

PMID- 7798081
TI  - Measuring grade-school children's ability to represent the Euclidean horizontal
      coordinate.
AB  - Seventy-five grade-school children were administered three tasks that measured
      their ability to represent the Euclidean horizontal coordinate: a traditional
      water-level test (WLT) that used a square-shaped vessel, a WLT that used a
      spherical vessel, and a task that used a crossbar apparatus. The latter two tasks
      differed from the traditional task in terms of the degree to which the apparatus
      presented a frame of reference that conflicted with environmental Euclidean
      coordinates. Performance was analyzed according to Piaget and Inhelder's (1956)
      stage-scoring system; that is, the testing procedures (a) allowed children to
      inspect the apparatus when it was rotated to discrete orientations; (b) corrected
      initial errors; and (c) included 0 degrees, 30 degrees, 60 degrees, and 90
      degrees trials. Age-related stages were identified on each task. Levels of
      performance on one task were significantly correlated with levels on each of the
      other two tasks. Performance was less accurate on the traditional WLT than on
      either of the other two measures. These results provide evidence of the validity
      of the alternative tasks to measure children's horizontality representation. The
      findings suggest that horizontality assessment procedures should include
      orthogonal and oblique rotations and contain an inspection phase. Use of
      apparatuses with conflicting frames of reference renders tasks more difficult but
      is not necessary to observe age-related developmental progress during the grade
      school years.

PMID- 7798082
TI  - Alexithymia and physiological reactivity to emotion-provoking visual scenes.
AB  - Alexithymia, a syndrome that involves a marked inability to name feelings, has
      been linked to psychosomatic illness. This study addressed the question of
      whether alexithymic tendencies are related to heightened levels of autonomic
      response to extrinsic cues. Alexithymia was assessed with the Toronto Alexithymia
      Scale and by the emotional content of stories written to five TAT-like printed
      pictures. Seventy-two college students were exposed to a series of emotion
      provoking slides while their heart rates and electrodermal responses were
      recorded. Results indicated a trend for alexithymic tendencies to be associated
      with less heart rate increase and fewer electrodermal responses while viewing the
      slides. Alexithymia was also associated with a small but significant elevation in
      baseline heart rate. These findings are discussed as part of a pattern of results
      which calls into question the hypothesis that alexithymia is related to illness
      because it produces hyperarousal to situational stressors; it is suggested that
      future research on the relationship between alexithymia and health status should
      be broadened to explore health-maintenance behaviors and other possible
      mechanisms.

PMID- 7798083
TI  - Assessment of personality disorders in anorexia nervosa and bulimia nervosa. A
      comparison of self-report and structured interview methods.
AB  - Interest in assessing Personality Disorders (PDs) in association with anorexia
      nervosa (AN) and bulimia nervosa (BN) has been accompanied by the development of
      several structured interview and self-report measures. In an attempt to see how
      the self-report Millon Clinical Multiaxial Inventory (MCMI-II) compared with the
      Structured Clinical Interview for DSM-III-R (SCID-II) in the assessment of PDs,
      we gave both instruments to 43 inpatients with a diagnosis of AN or BN.
      Correlation coefficient values for both categorical and dimensional comparisons
      were generally less than .4. Although comparable rates of positive PDs occurred
      for each of the three clusters (A: 30.2% vs. 34.9%, B: 25.6% vs. 18.6%, and C:
      62.8% vs. 81.4% for SCID-II vs. MCMI-II), agreement for individual diagnosis and
      individual subjects was poor. In conclusion, the MCMI-II did not prove to be a
      reliable instrument for assessing axis II PDs in patients with AN and BN when
      compared with the SCID-II.

PMID- 7798084
TI  - A comparison of the structured clinical interview for DSM-III-R and clinical
      diagnoses.
AB  - The relationship between diagnoses generated by the Structured Clinical Interview
      for DSM-III-R Personality Disorders (SCID) and by nonstructured psychiatric
      interviews was examined. The purposes were to evaluate which DSM-III-R diagnoses
      were most reliably chosen, and to compare diagnostic practices between two
      clinical sites. Diagnoses generated by researchers using the patient version of
      the SCID and by psychiatric interviews were compared for 100 patients. The
      participants had been randomly assigned to one of two acute treatment sites
      within the same institution, as part of a larger study of an alternative to
      inpatient hospitalization. Overall reliability between the SCID and the
      clinicians, as determined by weighted Kappa, was poor. There was considerable
      variability among the major diagnostic categories, with higher agreement for
      schizophrenia and bipolar disorder than for others. The agreement for
      schizoaffective disorder was extremely low. There were also significant
      differences in the patterns of diagnosis between the two sites. The patient
      version of the SCID appears to produce results that are very different from
      clinical practice, which, in turn, may be influenced strongly by location.

PMID- 7798085
TI  - Changes in self-destructiveness of borderline patients in psychotherapy. A
      prospective follow-up.
AB  - Thirty-seven female inpatients with borderline personality disorder were followed
      prospectively for up to 5 years to assess changes in two forms of self
      destructiveness: suicidal behavior/ideation, and self-harm behavior/ideation. It
      was found that suicidal behavior declined significantly at 1-, 2-, 3-, 4-, and 5
      year follow-up; self-harm behavior showed trends but no significant decline over
      5 years. Ideation (both suicidal ideation and self-harm) did not decline notably.
      Three alternate courses of self-harm behavior are identified: "fluctuating,"
      "consistently low," and "steadily declining." The majority of patients fell in
      the fluctuating category. The fluctuating group showed higher baseline dysphoria
      than did the consistently low group, while the latter reported higher baseline
      drug use. Intercorrelations showed that self-harm behavior and suicidal behavior
      were not associated, nor were suicidal behavior and suicidal ideation. Clinical
      and research implications are discussed.

PMID- 7798086
TI  - An etiological model of attempted suicide among Vietnam theater veterans.
      Prospective generalization to a treatment-seeking sample.
AB  - The etiology of attempted suicide was investigated using both retrospective and
      prospective data from 402 Vietnam theater veterans who were receiving treatment
      in the Department of Veterans Affairs Posttraumatic Stress Disorder Clinical
      Teams Program. An etiological model that was developed previously for a community
      sample of Vietnam theater veterans was examined for its generalizability to this
      treatment-seeking sample. Structural equation modeling was used to first
      determine the similarity of significant paths in the treatment-seeking and
      community samples, and then to examine the applicability of the community-based
      model to the treatment-seeking sample. The community-based model achieved a very
      high fit with reasonably good parsimony with the treatment-seeking data. Causal
      paths in the treatment-seeking sample mirrored those in the community sample in
      that psychiatric symptoms (including posttraumatic stress disorder) were the sole
      factors contributing directly to attempted suicide. Traumatic military
      experiences played a substantial role, but only indirectly as they contributed to
      the development of psychiatric symptoms. The similarity of findings for previous
      and subsequent attempts eliminated a possible ambiguity in the direction of
      causation modeled for previous attempts.

PMID- 7798087
TI  - Psychiatric morbidity associated with acquired immune deficiency syndrome-related
      grief resolution.
AB  - This study examined acquired immune deficiency syndrome (AIDS)-related grief
      resolution and psychiatric morbidity in 286 human immunodeficiency virus (HIV)
      positive and HIV-negative gay men examined between 1989 and 1993 in San Diego,
      CA. Psychiatric morbidity, mood ratings, and bereavement assessments were
      obtained using the Structured Clinical Interview for DSM-III-R, Hamilton Rating
      Scales for Depression and Anxiety, and Texas Revised Inventory of Grief. Sixty
      percent of the men (N = 171) reported a loss within the previous 12 months.
      Eighteen percent of the bereaved met criteria for unresolved grief. No
      differences were evident in lifetime psychiatric disorders, yet men with
      unresolved grief demonstrated an elevated prevalence of current major depression
      and panic disorder when compared with resolved grievers. Clinician sensitivity to
      the grief process and its relationship to psychiatric complications is an
      important component of comprehensive psychiatric and medical care of men at high
      risk for HIV during this era of AIDS.

PMID- 7798088
TI  - Effects of a natural disaster on immigrants and host population.
AB  - The psychosocial effects of the 1989 Newcastle earthquake on 250 immigrants from
      non-English-speaking backgrounds (NESB) were compared with a matched sample of
      250 Australian-born subjects. The NESB subjects had higher levels of both general
      (General Health Questionnaire-12) and event-related (Impact of Event Scale)
      psychological morbidity. Furthermore, NESB females had the highest levels of
      distress, particularly those who were older on arrival in Australia and those who
      experienced high levels of disruption. The results suggest that NESB immigrants,
      particularly women, appear to be more at risk for developing psychological
      distress following a natural disaster. However, level of exposure and an
      avoidance coping style contributed more substantially to psychological distress
      than ethnicity.

PMID- 7798089
TI  - Mothers with severe mental illness caring for children.
AB  - This research identifies and describes the Massachusetts population of Department
      of Mental Health (DMH) case-managed women with severe mental illness who are
      caretakers of their minor children (N = 314), and compares their demographic and
      clinical characteristics and service utilization with those of a matched,
      randomly selected group of DMH case-managed noncaretaking women (N = 328) using
      the Client Tracking System database. Caretakers were significantly younger, had
      less formal education, and had higher rates of marriage than did noncaretakers.
      They are diagnosed more often with major affective disorders and less often with
      psychotic disorders. Caretakers demonstrate higher levels of functioning and are
      less likely to have a representative payee. Although caretakers function better,
      the groups do not differ significantly in their use of DMH services. This is the
      first systematic, statewide effort to specify the unique characteristics of this
      substantial group of women with severe mental illness who are caring for their
      children.

PMID- 7798090
TI  - Tardive dyskinesia prevalence rates during a ten-year follow-up.
AB  - We followed up patients in the State Psychiatric Hospital Mauer-Ohling, Mauer
      Ohling, Austria, who had been examined in 1982 to determine the prevalence of
      tardive dyskinesia (TD). Of the 861 patients examined in 1982, 270 were still in
      hospital 10 years later. Only these patients were included in our study. The
      SKAUB (Skala fur abnorme unwillkurliche Bewegungen, i.e., The German version of
      the Abnormal Involuntary Movement Scale) was used to quantify the occurrence of
      TD. The prevalence rate of TD was 3.7% in 1982 and 12.7% in 1992. The 1992
      prevalence rate in patients who had not shown TD symptoms in 1982 was 11.4%. The
      major risk factor for TD was advanced age.

PMID- 7798091
TI  - Does neurosurgery for obsessive-compulsive disorder produce personality change?
AB  - Seventeen patients suffering from intractable obsessive-compulsive disorder
      treated with neurosurgery were assessed before surgery and a mean 10 +/- 5.1
      years after surgery. Change in personality was assessed using a special 34-item
      schedule on patients and informants. The majority of subjects had not noted any
      significant changes in personality. The subjects were rated by themselves and
      their informants to have improved overall in the following characteristics: they
      were less obsessional, cried less, demonstrated a greater depth of feelings,
      laughed more, were more sociable, and were less anxious or dependent. Six
      subjects were judged by informants to have improved in their degree of
      obsessionality, which was distinguishable from the impact on obsessive-compulsive
      symptoms. The traits that showed an overall negative change were initiative/drive
      and energy level. Four subjects (2/4 open and 2/13 stereotactic surgery) were
      judged to have a negative personality change. Ratings of neuroticism, anxiety,
      depression, and capacity for pleasure showed significant improvement. We conclude
      that while most obsessive-compulsive disorder patients treated with stereotactic
      surgery do not experience a personality change, a small proportion report a
      positive or negative impact. Of note is the improvement in obsessionality in some
      patients, and an adverse personality change of the "frontal lobe type" in a few
      patients.

PMID- 7798092
TI  - Long-term results of aseptic cemented Charnley revisions.
AB  - One hundred eighty low-friction arthroplasties of the hip in 164 patients in
      first-time revision surgery were operated between 1973 and 1985. This series used
      only cement fixation, and aseptic loosening and femoral stem fractures were the
      only indications for revision. The average follow-up period was 11.5 years. Intra
      operative and postoperative complications were frequent: femoral shaft fracture
      (13 cases), femoral shaft perforation (12 cases), deep infection (14 cases), and
      dislocation (15 cases). Twenty-eight hips were rerevised or removed (resulting in
      a total cumulative probability of rerevision of 20% after 16 years, according to
      survivorship analysis). Nineteen cups were rerevised (13% after 16 years,
      according to survivorship analysis), and 24 femoral stems were rerevised (16%
      after 16 years, according to survivorship analysis). Radiographic cup and femoral
      loosening appeared in 29 and 36 cases, respectively (24 and 22% after 16 years,
      respectively, according to survivorship analysis). Good results were observed
      when there was a healthy and intact bone bed, whereas poor results were related
      to inadequate bone stock in the acetabulum and femur. Radiolucent lines were
      frequent in both components; radiolucent lines less than 2 mm wide were frequent
      in acetabular zone 1. Pistoning of the prosthesis and the cement within the bone
      and calcar pivot was the most frequent type of stem loosening.

PMID- 7798093
TI  - Relationship of surgical volume to short-term mortality, morbidity, and hospital
      charges in arthroplasty.
AB  - In 1992, the Agency of Health Care Administration in Tallahassee, Florida,
      started releasing, as part of the patient discharge information, the names of the
      treating physicians, in addition to demographic and diagnostic data. This
      information is available to the general public for a small price and is being
      used by health planners, hospital administrators, finance departments, third
      party payers, and other agencies involved in health care. Patient discharge
      information was used to assess the effects of volume on the short-term outcome of
      primary and revision hip and knee arthroplasty as a function of surgeon and
      hospital in the State of Florida, during 1992. A total of 19,925 primary and
      2,536 revision arthroplasties of the hip and knee were performed during 1992 in
      Florida and were available for study. After the doctors and hospitals were
      arbitrarily divided into three case volume groups (low, medium, high), results
      showed that in primary arthroplasty, surgeons with a low volume of primary cases
      (< 10) have a significantly higher mortality rate (24%), higher average charges
      ($25,000), and increased average length of hospital stay (9.3 days). In revision
      surgery, physicians with a low volume of cases (< 10) have a higher mortality
      rate (13%) and increased average length of hospital stay (9.8 days). Patients
      discharge information has many potential uses for investigators interested in the
      short-term outcome of arthroplasty. In their present form, these databases should
      not be released to the general public or the media. Lastly, the volume-outcome
      relation for a specific surgical procedure should, in addition to case severity,
      account for characteristics affecting the degree of technical difficulty.

PMID- 7798094
TI  - Patient outcomes following unicompartmental or bicompartmental knee arthroplasty.
      A meta-analysis.
AB  - The purpose of this study was to summarize the literature describing patient
      outcomes following unicompartmental and bicompartmental knee arthroplasty.
      Original studies were included in this meta-analysis if they enrolled 10 or more
      patients at the time of an initial knee arthroplasty and measured patient
      outcomes using a global knee rating scale. Forty-six studies on unicompartmental
      prostheses and 18 studies on bicompartmental prostheses met these criteria. For
      unicompartmental studies, the total number of enrolled patients was 2,391, with a
      mean enrollment of 47 patients and a mean follow-up period of 4.6 years. The mean
      patient age was 66 years; 67% were women, 75% had osteoarthritis, and 16%
      underwent bilateral knee arthroplasty. The mean postoperative global rating scale
      score was 80.9. The overall complication rate was 18.5% and the revision rate was
      9.2%. Studies published after 1987 reported better outcomes, but also tended to
      enroll older patients and patients with osteoarthritis and higher preoperative
      knee rating scores. For bicompartmental studies, the total number of enrolled
      patients was 884, with a mean enrollment of 44 patients and a mean follow-up
      period of 3.6 years. The mean patient age was 61 years; 79% were women, 31% had
      osteoarthritis, and 29% underwent a bilateral arthroplasty. The mean
      postoperative global rating scale score was 78.3. The overall complication rate
      was 30% and the revision rate was 7.2%. Although bicompartmental studies reported
      lower mean postoperative global rating scale scores, these studies tended to
      enroll patients with worse preoperative knee rating scores. Recent improvements
      in patient outcomes following unicompartmental knee arthroplasty appear to be
      due, at least partially, to changes in patient selection criteria. Patient
      outcomes appear to be worse for bicompartmental arthroplasties than for other
      prosthetic designs; however, patients enrolled in these studies had more poorly
      functioning knees before surgery and actually had greater absolute improvements
      in global knee rating scores.

PMID- 7798095
TI  - Single-stage, bilateral, cementless total hip arthroplasty.
AB  - Single-stage, bilateral, cementless total hip arthroplasties were performed in 92
      patients (184 arthroplasties) between March 1984 and December 1989. The clinical
      and radiographic findings were retrospectively evaluated, and the effects of
      weight bearing on the clinical and radiographic outcomes of the patients'
      prostheses were assessed. With a follow-up period ranging from 24 to 77 months
      (average, 44 months), the postoperative Harris hip scores averaged 94.6.
      Radiographic assessment at the most recent follow-up examination showed that 70%
      of the femoral components were optimally fixed, 26% were stable, and 4% had
      failed. Ninety-six percent of the acetabular components were optimally fixed.
      There were six acetabular component failures. These results indicate that single
      stage, bilateral, cementless total hip arthroplasty can be performed without
      compromise to either hip if initial fit is achieved in both the metaphyseal and
      diaphyseal portions of the femur. Moreover, weight bearing did not adversely
      affect the initial stability and possible bone ingrowth, further implicating
      initial rigid fixation as paramount among the factors influencing the amount of
      ingrowth into the prosthesis.

PMID- 7798096
TI  - Bone ingrowth and wear debris in well-fixed cementless porous-coated tibial
      components removed from patients.
AB  - Bone ingrowth and the distribution of wear debris within the porous coating of 13
      primary cementless porous-coated tibial components removed for reasons unrelated
      to fixation or infection were quantitatively described. The average length of
      implantation was 15.3 months (range, 3-30 months). The implants were all of the
      same design, made for Ti6A14V with a commercially pure titanium fiber-metal
      porous coating, which covered the undersurface of the tray and the four fixation
      pegs. In all but one component, supplemental screw fixation was used. The average
      extent of bone ingrowth within the tray was 27.1 +/- 16.1%, and the average
      volume fraction was 9.5 +/- 7.5%. There was significantly more bone ingrowth
      within the fixation pegs than within the tray and also more bone ingrowth in the
      anterior half of the tray than posteriorly. There was no correlation between the
      amount of bone ingrowth and the length of implantation, age, or sex of the
      patient; however, the depth and orientation of the resection plane were found to
      correlate with the topographic distribution of bone ingrowth. Particulate debris
      appeared to gain access to the interface via soft tissue pathways both at the
      periphery and through the holes for adjuvant screw fixation.

PMID- 7798097
TI  - Health and quality of life before and after hip or knee arthroplasty.
AB  - The impact of hip and knee arthroplasty based on the patients' own evaluations of
      their health, quality of life, and physical ability was assessed using a cross
      sectional study design. The eligibility criteria were a diagnosis of primary
      arthrosis, primary operation, and total joint arthroplasty. Preoperative hip and
      knee patient groups were compared with similar groups who underwent arthroplasty
      2 or 5 years previously. Subjective health outcome was assessed with the
      Nottingham health profile and a 15-dimensional, health-related quality of life
      measure. Patients' physical ability was assessed using a measure of activities of
      daily living. Major improvements were observed for pain, sleep, range of motion,
      and physical ability. However, after surgery, patients were less healthy than the
      general population of the same age. The health status of patients operated on 2
      or 5 years ago was similar, suggesting that health gains persist for several
      years.

PMID- 7798098
TI  - Implant standardization for total hip arthroplasty. An implant selection and a
      cost reduction program.
AB  - Total hip arthroplasty (THA) has been targeted by the United States federal
      government for cost control because of its high cost and rising incidence in the
      aging population. The hospital cost for THA during the 1980s was controlled by
      utilization review and a reduction in the volume of services delivered for each
      THA. The single largest increase in the cost of THA during the 1980s was the cost
      of hip implants. The Lahey Clinic Hip Implant Standardization Program was
      developed to provide objective guidelines for hip implant selection. These
      guidelines are based on the demands a patients is expected to place on his or her
      hip prosthesis. Because not every patient requires an expensive high-demand hip
      prosthesis, the standardization program also has the potential to reduce the
      hospital cost for hip implants without compromising patient care. Patients are
      assigned to four demand categories based on five objective criteria: age, weight,
      expected activity, general health, and bone stock. Selection of the prosthesis in
      each of the four demand categories is intended to match the implant's capacity
      with expected patient demand. The standardization program was retrospectively
      applied to 103 THAs performed during 1991. Analysis of variance demonstrated that
      patient variables and demand categories were statistically significant groupings.
      The cost of hip implants would have been reduced by 25.7% with the Lahey Clinic
      Hip Implant Standardization Program. A prospective outcome study is required to
      determine the long-term validity of this standardization program.

PMID- 7798099
TI  - Optimal timing of wound drain removal following total joint arthroplasty.
AB  - Closed suction drains reduce postoperative hematoma formation, but create an
      entry portal for bacteria and thus increase the risk of infection. This study
      attempts to establish when the risks of wound drainage outweigh the benefits. In
      a prospective clinical trial, wound drains were used in all patients having a
      total knee or total hip arthroplasty. Timing of drain removal and amount drained
      were recorded. Drain-site swabs were sent with drain tips for bacteriology.
      Results suggest that the likelihood of bacterial colonization increases while
      wound drainage decreases with time. The authors conclude that the optimal time to
      remove drains is 24 hours after total joint arthroplasty.

PMID- 7798101
TI  - Patellofemoral complications following total knee arthroplasty. Correlation with
      implant design and patient risk factors.
AB  - Results of 211 total knee arthroplasty operations were retrospectively evaluated
      to identify patients with knees at greatest risk for the development of
      patellofemoral complications and to determine the incidence and type of
      patellofemoral complications associated with different patellar implants.
      Patellofemoral complications occurred in 27 knees (12.8%). Osteoarthritis and
      obesity were associated with an increased incidence of patellofemoral problems.
      Significantly higher rates of patellofemoral complications were noted with metal
      backed patellar implants and with patellar components implanted without cement.
      The loosening rate with cementless fixation was 13.5%. The lowest rate of
      patellofemoral complications following total knee arthroplasty was obtained with
      all-polyethylene domed patellar components implanted with cement.

PMID- 7798100
TI  - Hip arthroplasty in patients with chronic renal failure.
AB  - Patients with chronic renal failure who underwent total hip arthroplasty were
      retrospectively evaluated. Thirty hips in patients with renal transplants and 16
      hips in patients on chronic renal dialysis were reviewed. The average follow-up
      period was 54 months. The renal transplant patients exhibited generally
      satisfactory results. Their postoperative course was comparable to that of
      patients with avascular necrosis undergoing hip reconstruction without underlying
      renal disease. However, patients undergoing hip arthroplasty while on chronic
      renal dialysis had poor results (81%), including a deep infection rate of 19%. It
      was concluded that total hip arthroplasty be reserved for patients who are
      expecting a renal transplant or preferably those who have already received a
      successful transplant.

PMID- 7798102
TI  - An unusual cause of thigh pain after total hip arthroplasty.
AB  - The aim of total hip arthroplasty surgery is to relieve pain. There are many
      postulated causes of thigh pain following total hip arthroplasty,  some of which
      are not easily corrected. Muscle hernia as a result of hip surgery is a cause of
      thigh pain that is disabling, relatively easy to diagnose, and may be
      preventable.

PMID- 7798103
TI  - Avascular necrosis of the hip treated by hemiarthroplasty. Results in renal
      transplant recipients.
AB  - Osteonecrosis of the femoral head is common complication in renal transplant
      recipients. Despite the young age of these patients, replacement arthroplasty is
      often used in treating symptomatic individuals. Between 1983 and 1990, 22
      cemented biarticular hemiarthroplasties were performed in 16 consecutive patients
      with advanced osteonecrosis of the hip. The average interval from initial
      transplant to arthroplasty was 28 months (range, 11-63 months). The mean age at
      the time of arthroplasty was 40 years (range, 21-66 years), and all patients were
      treated with steroids and immunosuppressants at the time of surgery. The average
      preoperative Harris hip score was 27 points (range, 4-46 points). The mean follow
      up period was 40 months (range, 24-71 months). All patients had improvement in
      pain. Eighty percent of the patients reported a slight or mild limp, although
      only 25% demonstrated a positive Trendelenburg sign. The average postoperative
      Harris hip score was 88 points (range, 71-96 points), with 9 hips rated
      excellent, 12 good, and 1 fair. One patient fractured her acetabulum 26 months
      after arthroplasty, which resulted in progressive subluxation of the prosthesis.
      It was revised to a total hip arthroplasty. Another patient developed symptomatic
      aseptic loosening after 30 months. Apart from this patient there was no other
      radiologic evidence of loosening in the remainder of the series. Only one patient
      had demonstrable acetabular protrusion. Twenty percent of the hips had
      asymptomatic heterotopic ossification. The early results of using a cemented,
      biarticular hemiarthroplasty in this young group of renal transplant recipients
      appear encouraging. There was no evidence that this prosthesis causes accelerated
      acetabular erosion or early loosening.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798104
TI  - Rush rod fixation of supracondylar fractures above total knee arthroplasties.
AB  - The authors report on 22 displaced supracondylar femur fractures and total knee
      arthroplasties treated with Rush rod (Berivon, Meridian, MI) fixation. The
      average age at the time of total knee arthroplasty was 67 years. Fractures
      occurred at an average of 5 years after surgery. In only five cases was notch in
      the anterior cortex noted. The follow-up period averaged 7 years. There were no
      nonunions. All knees healed between 3 and 4 months after surgery. Postoperative
      flexion averaged 108 degrees (preoperative average, 102 degrees). Only two knees
      demonstrated a flexion contracture before surgery (5 degrees-10 degrees), and
      both had flexion contractures after surgery as well (each 10 degrees). All other
      knees achieved full extension. The average alignment prior to fracture was 7
      degrees of anatomic valgus. At the most recent follow-up evaluation this averaged
      10 degrees with two knees in 15 degrees of valgus. The only complications noted
      were two intraoperative technical errors. No postoperative complications
      occurred. For supracondylar fractures above a total knee arthroplasty, the
      authors suggest closed reduction, Rush supracondylar rod fixation, early range of
      motion, and protected weight bearing until fracture healing. In all cases, an
      extensive surgical procedure was not required.

PMID- 7798105
TI  - Insall-Burstein posterior-stabilized knee prosthesis in rheumatoid arthritis.
AB  - The authors reviewed 65 Insall-Burstein (Zimmer, Warsaw, IN) total condylar
      posterior-stabilized knee prostheses in 50 patients with rheumatoid arthritis
      with a follow-up period of at least 5 years (range, 5-13 years). Forty-two knees
      in 31 patients were evaluated using the Knee Society knee and functional rating
      scores. Radiographic assessment was performed using standing long radiographs
      (hip to ankle). Radiolucent lines were studied using fluoroscopic-centered views.
      Excellent or good clinical results were obtained in 95% of the cases, and the
      average knee score improved from 22.5 to 90 points. No cases of radiologic
      loosening were observed. Incomplete radiolucent lines around the tibial component
      were detected in only 17% and were nonprogressive. Two patients developed
      hematogenous late deep infection, which required removal of the prosthesis in
      both, followed, at a second stage, by arthrodesis in one and prosthesis
      reimplantation in the other. Three knees (7%) had a painful impingement of the
      patella. Two of these were successfully reoperated with arthroscopic debridement
      of the peripatellar synovial tissues. Survivorship analysis, based on endpoints
      such as prosthesis removal for any cause or radiologic loosening (complete
      radiolucent line thicker than 1 mm, tilt, or subsidence of the component), showed
      a cumulative success rate of 96.2% at 13 years.

PMID- 7798106
TI  - Micromotion secondary to axial, torsional, and shear loads in two models of
      cementless tibial components.
AB  - Tibial component loosening and lack of bone ingrowth remain serious problems in
      uncemented knee arthroplasty. Initial implant stability is the most important
      factor in achieving bone ingrowth. Eccentric axial loading causing liftoff has
      been identified as a potential problem, but the role of torsion and shear
      stability is unclear. This study assesses the micromotion in two uncemented
      components subjected to eccentric axial (lateral, medial, posterior, anterior),
      shear, and torsional loads. Four configurations were tested: Tricon M (pegs)
      (Smith and Nephew Richards, Memphis, TN), Genesis (stem only) (Smith and Nephew
      Richards), Genesis with screws, and Genesis with pegs. Nine pairs of cadaver
      tibias were implanted, and cyclic loads were applied. Micromotion was measured
      with two linear variable differential transformers. Micromotion values for each
      mode of loading were compared using a one-way analysis of variance. Genesis with
      screws had the least micromotion for all applied loads (14-33 micrometers),
      whereas Genesis with stem only has the maximum value of micromotion (27-212
      micrometers). Genesis wit and Tricon had intermediate ranges of micromotion (32
      121 and 107-140 micrometers, respectively). It is concluded that peg fixation and
      stem fixation are inadequate and result in significant micromotion. Stem plus
      screws provides the most stable fixation and may be compatible with bone
      ingrowth.

PMID- 7798107
TI  - Joint motion of bipolar femoral prostheses.
AB  - From 1982 to 1992, 251 bipolar hip arthroplasties were performed on 213 patients.
      Among them, 117 bipolar femoral prostheses were randomly selected to examine the
      behavior of abduction motion under weight-bearing loads. Roentgenographic motion
      study was performed at an average of 46.5 months after surgery (range, 2-110
      months). One hundred one prostheses used in dysplastic osteoarthritic,
      rheumatoid, and revised failed total hip arthroplasty patients moved 18.2% at the
      outer bearing and 81.8% at the inner bearing, while 16 prostheses used in femoral
      neck fracture and osteonecrosis of the femoral head patients moved 49.7% at the
      inner bearing and 50.3% at the outer bearing. There was a statistical difference
      in the motion pattern between the two groups. The abduction motion behavior of
      the bipolar femoral prostheses was not affected by the length of the follow-up
      period, the diameter of the outer heads, or the position of the prostheses on
      immediate postoperative roentgenograms.

PMID- 7798109
TI  - Supracondylar fractures above a total knee arthroplasty: a novel use of the
      Huckstepp nail.

PMID- 7798108
TI  - Influence of disodium (1-hydroxythylidene) diphosphonate on bone ingrowth into
      porous, titanium fiber-mesh implants.
AB  - The influence of disodium (1-hydroxythylidene) diphosphonate on the bonding
      between bone and porous, titanium fiber-mesh implants was studied. Rectangular,
      porous, titanium fiber-mesh implant (15 x 10 x 2.4 mm) were implanted into the
      tibial bone of mature male rabbits. The rabbits were divided into six groups.
      Disodium diphosphonate was administered daily by subcutaneous injection to groups
      1-5. Groups 1-4 received doses of 5.0, 2.5, 1.0, and 0.1 mg per kilogram of body
      weight per day for 8 weeks, respectively. Group 5 received a dose of 5 mg per
      kilogram of body weight per day for 4 weeks. Group 6 (control group) was given
      saline injections. At 8 weeks after implantation, the rabbits were killed. The
      tibiae containing the implants were dissected out and subjected to detachment
      tests. The failure load, when an implant became detached from the bone or when
      the bone itself broke, was measured. The interface of the bone and implant was
      investigated by Giemsa surface staining and contact microradiography. Giemsa
      surface staining and contact microradiography showed that porous implant bonding
      to bone tissue was inhibited by a high dose of disodium diphosphonate in groups
      1, 2, and 5. Soft tissue was observed at the interface. In groups 3, 4, and 6,
      bone tissue ingrowth was observed at the interface between the porous implant and
      bone tissue. Growth of bone into the porous fiber-mesh implant of a cementless
      prosthesis is possible if a low dose of diphosphonate below 1.0 mg per kilogram
      of body weight is given subcutaneously.

PMID- 7798110
TI  - Long-term results of cemented total hip arthroplasty in patients 45 years old or
      younger: a 16-year follow-up study.

PMID- 7798111
TI  - A note on the relative rates of degeneration in the crossed and the uncrossed
      retinofugal fibres in the opossum Didelphis marsupialis.
AB  - The rates at which the crossed and the uncrossed components of the retinofugal
      pathway degenerate in Didelphis has been studied by light and electron
      microscopical methods. We have found that in Didelphis, as in Monodelphis the two
      components can be clearly distinguished at the level of the chiasm. However, in
      contrast to the situation previously described for Monodelphis, where the
      uncrossed component degenerates more rapidly than the crossed, both components
      degenerate at the same rate.

PMID- 7798112
TI  - The structural relations between nerve fibres and muscle cells in the urinary
      bladder of the rat.
AB  - Intramuscular nerve fibres in the bladder of adult female rats were investigated
      by means of serial sections. The following observations were made. (1) Upon
      penetrating into the musculature the nerve bundles branch repeatedly, and almost
      all turn into single fibres; their axons become varicose, the Schwann cell sheath
      is attenuated, incomplete or absent, and the separation between axonal membrane
      and muscle cell membrane is reduced to tens of nanometres. (2) All single axons,
      and some of those within bundles, are varicose, but the characteristic of being
      varicose is expressed by degrees, and is not an all-or-none state. (3)
      Varicosities contain vesicles (mostly of the agranular type), microtubules (with
      little connection with the axolemma or the vesicles), some neurofilaments (scarce
      or absent in the best developed varicosities), mitochondria (whose size is on
      average smaller than those of the perikaryon, and a minute amount of endoplasmic
      reticulum. (4) Terminal varicosities, the true anatomical ending of an axon, are
      often devoid of Schwann cell sheath, are packed with vesicles, rarely contain
      microtubules or neurofilaments, and lie close to a muscle cell: the gap is often
      reduced to approximately 10 nm. (5) Schwann cells accompany the axons within the
      muscle strands. Unlike the area of the axonal profiles, the area of glial sheath
      changes little along the length of the nerve fibre, except towards its end. (6)
      The Schwann cell sheath around a varicosity is often incomplete; the area of the
      axolemma thus exposed is covered by the basal lamina, and is here referred to as
      a 'window'. While some varicosities have a window only a few tens of nanometres
      in width, others have more than one window, and some are devoid of Schwann cell
      altogether, so that their entire axolemma is in contact with the basal lamina.
      The Schwann cell never extends beyond the axon, whereas very often (and possibly
      always) the axon extends beyond the Schwann cell. (7) Intervaricose segments vary
      in length and diameter, the narrowest ones accompanying the more clear-cut
      varicosities. Some intervaricose segments are as small as 50 nm in diameter,
      contain a single microtubule and lack a Schwann cell sheath. Others, sheathed by
      a Schwann cell, contain a single neurofilament or no organelles at all.(ABSTRACT
      TRUNCATED AT 400 WORDS)

PMID- 7798113
TI  - Pathologic alterations in pre- and postsynaptic elements in aged mouse
      sympathetic ganglia.
AB  - Dysfunction of the sympathetic autonomic nervous system is an increasingly
      recognized, although poorly understood, complication of increasing age in
      experimental animals and man. In this study of young adult (4-6 months old) and
      aged (12-24 months old) mice we have examined the ultrastructural appearance of
      perikarya, dendritic processes, preterminal axons, and synapses in selected
      sympathetic ganglia as well as the three-dimensional structure of the dendritic
      arborizations of principal sympathetic neurons using intracellular injections of
      Lucifer Yellow. Ultrastructural examination demonstrated numerous markedly
      enlarged presynaptic terminal axons and synapses which distorted the contours of
      perikarya and dendrites of neurons within the prevertebral celiac/superior
      mesenteric and paravertebral superior cervical and stellate sympathetic ganglia
      of aged mice. Dilated preterminal axons had the distinctive ultrastructural
      appearance of neuroaxonal dystrophy, a pathologic process described in a wide
      variety of clinical and experimental entities. Dystrophic axons were identical in
      ultrastructural appearance in young and old animals, differing only in frequency.
      A distinctive type of ultrastructural alteration, characterized by markedly
      distended neurites containing numerous vacuoles, was confined to the superior
      cervical ganglia and also increased in frequency with aging. Although many
      intraganglionic vacuolated processes disappeared with surgical interruption of
      the cervical sympathetic trunk, which contains the preganglionic axons
      innervating the superior cervical ganglia, others persisted. In addition, the
      presence in some processes of admixed ribosomes, lipofuscin, or continuity with
      the cell body indicated that numerous neuritic alterations within aged
      sympathetic ganglia were likely of dendritic origin. Intracellular injections of
      Lucifer Yellow into principal sympathetic neurons demonstrated that the dendritic
      arborizations of the celiac/superior mesenteric ganglia neurons of young adult
      mice were significantly more complex and extensive than those of the superior
      cervical ganglia. Sympathetic neurons of aged superior cervical ganglia, but not
      superior mesenteric ganglia, appeared significantly smaller with regard to total
      dendritic length, extent, and branching when compared to those of young animals.
      In the aged superior cervical ganglia, short, stunted dendritic processes also
      exhibited large, focal, often multiple, swellings, a phenomenon infrequently
      observed in the superior cervical ganglia of young animals. The celiac/superior
      mesenteric ganglia of aged or young adult mouse failed to exhibit comparable
      dendritic swellings.

PMID- 7798114
TI  - Three-dimensional organization of stable microtubules and the Golgi apparatus in
      the somata of developing chick sensory neurons.
AB  - Microtubules play a role important in regulating cell shape and in mediating
      organelle movements. These functions are especially important in elaborately
      branched neurons, which have many stable microtubules that are resistant to cold
      and to microtubule depolymerizing drugs. We examined the three-dimensional
      organization of microtubules in cell bodies of cultured chick embryo sensory
      neurons, using confocal laser scanning microscopy. Microtubules were visualized
      with antibodies against alpha-tubulin and post-translationally modified forms of
      alpha-tubulin that accumulate in older microtubules. Optical sections were
      collected through neuronal somata, and the images were reconstructed in three
      dimensions. In neuronal perikarya a dense network of older microtubules is co
      localized with the Golgi apparatus. This complex of the Golgi and older
      microtubules usually lies beneath the cell nucleus and is oriented toward the
      substratum. From this region, older microtubules extend into each neurite. A cage
      of older microtubules extends around the nucleus to the top of the perikaryon.
      The stability of these microtubules was confirmed by their resistance to the
      depolymerizing drug, nocodazole. This arrangement of stable microtubules in a
      developing neuron provides a supporting cytoskeleton and a transport pathway for
      movement of cytoplasmic components between the Golgi apparatus, the perikaryon
      and developing neurites.

PMID- 7798115
TI  - Growth-related alterations in motor endplates of type-identified diaphragm muscle
      fibres.
AB  - Using a double-labelling technique, and dual-channel confocal microscopy, we
      examined the three-dimensional and two-dimensional morphologies of motor
      endplates on type I and II muscle fibres of 21-day-old and adult rat diaphragms.
      Motor endplates were visualized with fluorescein-conjugated alpha-bungarotoxin,
      and muscle fibre type was immunocytochemically determined using an anti-fast
      (type II) myosin antibody with a Cy5-conjugated label. Surface (three
      dimensional) and planar (two-dimensional) areas were obtained from three
      dimensional reconstructions of confocal optical sections of labelled endplates.
      Muscle fibre diameters were also measured. Total branch lengths were measured
      from projection images of the three dimensional reconstructions. The surface and
      planar areas of endplates on type I fibres at day 21 were larger than those on
      type II fibres, and this difference increased with maturation. In adults, the
      surface area of endplates was positively correlated to muscle fibre size, but
      such a correlation was not found at day 21. When normalized for fibre diameter,
      the surface areas of endplates on type I fibres were still significantly larger
      than those on type II fibres in both age groups. The normalized endplate surface
      area for type II fibres remained constant with maturation, whereas for type I
      fibres, the increase in endplate surface area was disproportionate to fibre
      growth.

PMID- 7798117
TI  - The medullary vascular syndromes revisited.
AB  - There are two major vascular syndromes of the medulla oblongata: the medial and
      the lateral. The medial medullary syndrome is characterized by the triad of
      ipsilateral hypoglossal nerve palsy with contralateral hemiparesis and loss of
      deep sensation. Lateral medullary infarction commonly presents with Horner's
      syndrome, ataxia, alternating thermoanalgesia, nystagmus, vertigo and hoarseness.
      Combinations of the two major syndromes occur as bilateral medial medullary,
      hemimedullary and bilateral lateral medullary syndromes. Each of these syndromes
      frequently manifests with incomplete or atypical findings depending on the extent
      of the lesion. Magnetic resonance imaging has been useful in the clinical
      diagnosis of medullary infarctions. The site of the lesion may help predict the
      arteries involved.

PMID- 7798118
TI  - Early-onset cerebellar ataxia, myoclonus and hypogonadism in a case of
      mitochondrial complex III deficiency treated with vitamins K3 and C.
AB  - A 16-year-old girl presented with early-onset cerebellar ataxia, myoclonus,
      elevated lactic acidosis and hypogonadotropic hypogonadism. Muscle biopsy
      specimens revealed fibres with a "ragged" appearance with increased mitochondria
      and lipid droplets. Biochemical investigation revealed a deficiency of complex
      bc1 (complex III) of the mitochondrial respiratory chain. Genetic analysis did
      not show either deletions or known mutations of mitochondrial DNA (mtDNA).
      Phosphorus magnetic resonance spectroscopy (31P-MRS) showed defective energy
      metabolism in brain and gastrocnemius muscle. A decreased phosphocreatine (PCr)
      content was found in the occipital lobes accompanied by normal inorganic
      phosphate (Pi) and cytosolic pH. These findings represented evidence of a high
      cytosolic adenosine diphosphate concentration and a relatively high rate of
      metabolism accompanied by a low phosphorylation potential. Muscle 31P-MRS showed
      a high Pi content at rest, abnormal exercise transfer pattern and a low rate of
      PCr post-exercise recovery. These findings suggested a deficit of mitochondrial
      function. Therapy with vitamins K3 and C normalized brain 31P-MRS indices,
      whereas it did not affect muscle bioenergetic metabolism. In this patient, the
      endocrinological disorder is putatively due to a mitochondrial cytopathy.
      Although an unknown mtDNA mutation cannot be ruled out, the genetic defect may
      lie in the nuclear genome.

PMID- 7798116
TI  - Electrophysiological evidence of "nerve entrapment syndromes" and subclinical
      peripheral neuropathy in progressive systemic sclerosis (scleroderma).
AB  - We report the electrophysiological findings and the management of 5 subjects with
      progressive systemic sclerosis (PSS) and clinical evidence of nerve entrapment.
      Three had carpal tunnel syndrome (CTS), 1 bilateral CTS and right tarsal tunnel
      syndrome (TTS) and 1 Guyon's canal syndrome. Only 1 patient (with CTS) showed
      significant clinical improvement after surgical decompression; the other 4
      demonstrated a slight recovery of conduction without lasting clinical relief
      after conventional treatment. To explain these failures we hypothesized that
      these entrapment syndromes were the clinical expression of underlying diffuse
      damage to the peripheral nervous system (PNS). The conduction values of nerves
      unaffected by entrapment syndromes were within normal limits, but almost all
      distal velocities were below the mean of controls. Such subclinical distal
      peripheral neuropathy was also verified in a selected sample of 17 patients with
      PSS, without clinical symptoms or signs of PNS involvement. In these 17 cases the
      mean distal sensory and motor conduction findings of the median, ulnar, sural and
      tibial nerves were significantly lower than those of a control group, while no
      significant differences were found in the more proximal tracts of the same
      nerves. Furthermore, 3 of the 17 patients showed classical electrophysiological
      evidence of TCS and TTS without any clinical symptoms. We conclude that the
      subjects with PSS had subclinical polyneuropathy which may become plain
      polyneuropathy or nerve entrapment syndromes perhaps induced by other risk
      factors.

PMID- 7798120
TI  - Cold: a risk factor for stroke?
AB  - A retrospective study was performed to investigate seasonal variation in stroke
      incidence and to evaluate the hypothesis that cold might be a risk factor. Data
      were obtained from the central registry of the Hospital de S. Joao, Porto,
      Portugal, concerning 4048 patients consecutively admitted for cerebrovascular
      disease during a period of 33 months. Monthly admissions for stroke and its
      subtypes were related to mean values of ambient temperature using linear
      correlation. There was a strong inverse correlation between average temperature
      and total admissions for cerebrovascular disease (r = -0.72, P < 0.00005),
      intracerebral haemorrhage (r = -0.66, P < 0.00005), ischaemic stroke (r = -0.46,
      P = 0.007) and transient ischaemic attack (r = -0.41, P = 0.017). These
      correlations were independent of any seasonal variation in the number of hospital
      admissions due to all causes. No relation was found between temperature and
      subarachnoid haemorrhage. The rhythmometric analysis showed the presence of a
      statistically significant rhythm with an acrophase in the coldest months. These
      results support the hypothesis of stroke being a chronorisk disease to which cold
      might represent a triggering factor.

PMID- 7798119
TI  - Multiple paraneoplastic syndromes in a patient with antibodies to neuronal
      nucleoproteins (anti-Hu).
AB  - We report the clinical and autopsy studies of a patient with an unusual
      combination of multiple paraneoplastic neurological syndromes in association with
      antibodies to a 35-40 kDa neuronal nucleo-protein (anti-Hu). Neurological disease
      preceded the detection of a small cell carcinoma of the lung. The patient had
      combined sensory and motor neuronopathy or neuropathy, cerebellar degeneration,
      brain-stem and limbic encephalitis, and clinical evidence of the Lambert-Eaton
      myasthenic syndrome and gastrointestinal pseudo-obstruction of paraneoplastic
      origin.

PMID- 7798121
TI  - Dizziness following head injury: a neuro-otological study.
AB  - Dizziness is a frequent and debilitating complications of head injury and
      accounts for increasing numbers of medico-legal claims. A detailed neuro
      otological study was carried out from the records of 100 patients with post
      traumatic dizziness to explore the neuro-otological basis of their symptoms: 50
      patients presenting for medico-legal purposes (group I) and 50 presenting for
      management of their vestibular symptoms (group II). The two groups showed a
      similar sex distribution, a similar range of causes of head injury and similar
      severity of head injury (72 minor, 24 moderate and 4 severe). Of the 100, 88
      showed at least one audio-vestibular abnormality on testing. Vertigo of the
      benign positional paroxysmal type was the commonest vestibular diagnosis in both
      groups (61/100), and only 8 patients showed central vestibular abnormalities.
      Fifty-three patients had audiometric abnormalities attributable to the head
      injury, the commonest of which was a high-tone sensorineural hearing loss. There
      was no significant difference in the incidence of any of the abnormalities in the
      medico-legal group (group I) when compared with the symptom management group
      (group II). The results provide strong evidence for an organic basis to recurring
      dizziness after head injury, whether or not a claim for compensation is pending,
      and emphasize the need for specialist neuro-otological investigation if
      abnormalities are to be identified and managed correctly.

PMID- 7798123
TI  - A soluble form of tumour necrosis factor receptor in cerebrospinal fluid and
      serum of HTLV-I-associated myelopathy and other neurological diseases.
AB  - Paired samples of cerebrospinal fluid (CSF) and serum from 17 patients with human
      T-cell lymphotrophic virus I (HTLV-I)-associated myelopathy, 5 patients with
      multiple sclerosis and 11 controls with non-inflammatory disorders (migraine,
      idiopathic epilepsy and myelopathy of unknown aetiology) were examined by enzyme
      linked immunosorbent assay for the presence of the 60-kDa soluble form of tumour
      necrosis factor receptor (sTNF-R). The results were compared with blood-CSF
      barrier function, cell count and the intrathecal synthesis of HTLV-I antibodies.
      No correlation could be demonstrated. High levels of sTNF-R were found in CSF of
      patients with HTLV-I-associated myelopathy and multiple sclerosis. In addition,
      intrathecal sTNF-R was also detected in the patients with non-inflammatory
      diseases, indicating that sTNF-R is definitively a normal constituent of CSF.

PMID- 7798125
TI  - Acute necrotizing measles encephalitis in a child with AIDS.

PMID- 7798124
TI  - Beneficial vascular and metabolic effects of cobalt-ATP in spontaneously
      hypertensive rabbits with diffuse chronic cerebral ischaemia.
AB  - The in vivo effects of adenosine triphosphate (ATP) have not been investigated in
      cerebrovascular diseases. The use of the long-acting cobalt-ATP complex (Co-ATP)
      permits us to observe the effects of ATP without the influence of its
      metabolites. This study was designed to compare the effects of intravenous Co-ATP
      on the cerebral blood flow (CBF), polarographically detected oxygen currents
      (O2a), mean arterial blood pressure (MABP), heart rate, respiration rate,
      cerebral electrical activity, arterial blood gases, pH, and glucose in 13
      normotensive (NT) rabbits to those in 14 stroke-prone spontaneously hypertensive
      (HT) animals. CBF was measured by the hydrogen and heat clearance methods. In
      response to Co-ATP, MABP decreased and CBF increased significantly in both
      groups. The decrease in MABP was more marked in HT rabbits, while CBF response
      was 25% smaller than in NT animals. The ratio of O2a to CBF diminished moderately
      and simultaneously with the CBF increase in NT rabbits. In HT rabbits, the
      decrease in O2a/CBF was larger and began when CBF response reached its maximum.
      We suggest that despite the restricted CBF response, long-acting ATP should still
      be taken into consideration as a supplementary treatment of hypertensive
      encephalopathy because of its beneficial effects on cerebral metabolism and
      hypertension.

PMID- 7798126
TI  - Rapid aggravation of aphasia by vigabatrin.

PMID- 7798122
TI  - Spontaneous internal carotid artery dissection: early diagnosis and management in
      44 patients.
AB  - First symptoms and initial clinical, ultrasonographic and neuroradiological
      findings ascertained a mean of 5.6 days (SD = 5.6 days), 7.7 days (7.0), and 11.2
      days (8.0) after symptom onset were analysed in 44 patients who suffered a
      spontaneous internal carotid artery dissection (ICD) verified by magnetic
      resonance imaging, angiography, or both. Common symptoms signalling dissection
      were unilateral headache in 68%, transient ischaemic attack in 20%, and cerebral
      infarction in 9%. Severe pain preceded cerebral ischaemia by more than 3 days in
      60% of those patients who eventually suffered a stroke. However, only 2 were
      admitted because of pain alone and 33 for evolving neurological deficits. During
      the first month, ipsilateral severe headache occurred in 89%, neck pain in 36%,
      ipsilateral cerebral ischaemia in 82%, ocular ischaemia in 16%, oculosympathetic
      palsy in 48%, and cranial nerve palsy in 5%. Recent "trivial" head or neck trauma
      was elicited in 41%. Doppler and duplex sonography confirmed the clinical
      suspicion of ICD in 91.5% and in 96% of those with a significant stenosis or
      occlusion. MRI demonstrated a thickened vessel wall in all 33 imaged carotid
      dissections and a mural haematoma in 30. None of the 32 patients who received
      anticoagulant treatment subsequently deteriorated. Monitoring anticoagulant
      treatment with ultrasonographic follow-up studies demonstrated recanalization in
      70% and persistent occlusion in 30%. The results demonstrate that familiarity
      with the initial symptoms, especially headache, and performance of an
      ultrasonographic study without delay are the cornerstones of an early
      diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798127
TI  - Improvement following interferon beta in chronic inflammatory demyelinating
      polyradiculoneuropathy.

PMID- 7798129
TI  - Fisher's syndrome associated with chickenpox and anti-GQ1b antibody.

PMID- 7798130
TI  - All the news that's fit to print. The ACNM sets the record straight.

PMID- 7798128
TI  - Recurrent respiratory failure in a patient with 3243 mutation in mitochondrial
      DNA.

PMID- 7798131
TI  - Asthma. A comprehensive review.
AB  - Asthma is common among women of childbearing and childrearing age. As a primary
      health care provider, the certified nurse-midwife is often called upon to play a
      direct role in diagnosis and collaborative co-management. This article reviews
      the pathogenesis of asthma and its natural history during pregnancy. Patient
      symptoms and findings on physical examination are described in depth, enabling
      clinicians to detect subtle presentations and avoid common pitfalls. A section on
      pulmonary function tests and other laboratory tools provides a foundation for
      objective monitoring of pulmonary function. Environmental control measures and
      pharmacologic therapies are described in detail. An algorithm for treatment
      strategies allows certified nurse-midwives to play an active role in co
      management of their asthmatic patients, while a section on patient education
      highlights the essential teaching points her clients will require. Specific
      issues regarding antenatal fetal well-being and intrapartal management are
      discussed. With a sound knowledge base, and through their expertise in client
      education and counselling, the certified nurse-midwife is in a special position
      to optimize care for women with asthma.

PMID- 7798132
TI  - Using an ovarian monitor as an adjunct to natural family planning.
AB  - The need to identify a reliable ovulation predictor has received attention by the
      scientific community in recent years. For couples practicing natural family
      planning, a more precise identification of the fertile phase would be a welcome
      adjunct to their method. A home ovarian monitor invented by Professor J. B. Brown
      of Melbourne, Australia, enables couples to measure the principal urinary
      metabolite of ovarian estrogen and progesterone. The charted results reveal the
      hormonal pattern of the menstrual cycle and thus identify the beginning, peak,
      and end of the fertile period. A study involving 21 couples was conducted with
      the purpose of assessing overall acceptability, including ease of use,
      motivation, and client satisfaction. At the completion of the study, 12 couples
      indicated a high degree of motivation and satisfaction with the monitor. None
      reported difficulty with the test procedure. Increased confidence in natural
      family planning was cited as the most positive evaluation and the time required
      to perform the test, as the most negative.

PMID- 7798133
TI  - Assessing fit. A key indicator of family health.
AB  - Attending to how family members behave in relation to their emotional involvement
      with each other, as it is demonstrated in the family's structural, functional,
      communicational, and developmental patterns or fit, is essential to truly
      understanding the behavior of individual clients. Family assessment is important
      to certified nurse-midwives working with childbearing and childrearing women.
      Assessing families can help certified nurse-midwives to promote women's health
      and to assist with skill development for subsequent generations of women,
      children, and families. This paper is an overview of basic concepts of family
      assessment, with particular emphasis on clinical application of family theory.
      The focus is on assessing fit and on skills that the certified nurse-midwife can
      use for family assessment in daily clinical practice.

PMID- 7798134
TI  - The hsp70 gene family of Neurospora crassa: cloning, sequence analysis,
      expression, and genetic mapping of the major stress-inducible member.
AB  - The gene encoding the major heat shock-inducible member of the HSP70 family of
      Neurospora crassa was cloned and characterized. The 5' nontranscribed region
      shows the presence of consensus sequence motifs resembling the classical heat
      shock elements found in many heat shock-responsive eukaryotic promoters, as well
      as metal-responsive-element sequences. The coding region of the gene contains
      four introns with boundaries and internal consensus motifs typical of genes of
      filamentous fungi. None of the other stress-inducible hsp70 genes of fungal
      origin have, so far, been reported to contain introns. The sequence adjoining the
      transcriptional initiation zone shows the presence of prominent CT-rich
      stretches, characteristic of highly expressed fungal genes. The deduced amino
      acid sequence corresponds to a 646-residue polypeptide, with a calculated
      molecular mass of 70,561 Da and an average pI of 6.01, exhibiting strong sequence
      homology with many other eukaryotic HSP70s, with typical HSP70 family signatures
      1 and 2 and a bipartite nuclear targeting sequence. Experiments with primer
      extension revealed the presence of one minor and two major transcriptional start
      sites. This gene, designated hsps-1, was mapped to a locus on the left arm of
      linkage group II, in close proximity to the AR-30 translocation breakpoint.

PMID- 7798135
TI  - Gin mutants that can be suppressed by a Fis-independent mutation.
AB  - The Gin invertase of bacteriophage Mu mediates recombination between two inverted
      gix sites. Recombination requires the presence of a second protein, Fis, which
      binds to an enhancer sequence. We have isolated 24 different mutants of Gin that
      are impaired in DNA inversion but proficient in DNA binding. Six of these mutants
      could be suppressed for inversion by introduction of a second mutation, which
      when present in the wild-type gin gene causes a Fis-independent phenotype. Only
      one of the six resulting double mutants shows an inversion efficiency which is
      comparable to that of the wild-type Gin and which is independent of Fis. The
      corresponding mutation, M to I at position 108 (M108I), is located in a putative
      alpha-helical structure, which in the homologous gamma delta resolvase has been
      implicated in dimerization. The properties of the M108I mutant suggest that in
      Gin this dimerization helix might also be the target for Fis interaction. The
      five other mutants that show a restored inversion after introduction of a Fis
      independent mutation appear to be completely dependent on Fis for this inversion.
      The corresponding mutations are located in different domains of the protein. The
      properties of these mutants in connection with the role of Fis in inversion will
      be discussed.

PMID- 7798136
TI  - Purification and characterization of 6-chlorohydroxyquinol 1,2-dioxygenase from
      Streptomyces rochei 303: comparison with an analogous enzyme from Azotobacter sp.
      strain GP1.
AB  - The enzyme which cleaves the benzene ring of 6-chlorohydroxyquinol was purified
      to apparent homogeneity from an extract of 2,4,6-trichlorophenol-grown cells of
      Streptomyces rochei 303. Like the analogous enzyme from Azotobacter sp. strain
      GP1, it exhibited a highly restricted substrate specificity and was able to
      cleave only 6-chlorohydroxyquinol and hydroxyquinol and not catechol, chlorinated
      catechols, or pyrogallol. No extradiol-cleaving activity was observed. In
      contrast to 6-chlorohydroxyquinol 1,2-dioxygenase from Azotobacter sp. strain
      GP1, the S. rochei enzyme had a distinct preference for 6-chlorohydroxyquinol
      over hydroxyquinol (kcat/Km = 1.2 and 0.57 s-1.microM-1, respectively). The
      enzyme from S. rochei appears to be a dimer of two identical 31-kDa subunits. It
      is a colored protein and was found to contain 1 mol of iron per mol of enzyme.
      The NH2-terminal amino acid sequences of 6-chlorohydroxyquinol 1,2-dioxygenase
      from S. rochei 303 and from Azotobacter sp. strain GP1 showed a high degree of
      similarity.

PMID- 7798137
TI  - Growth and buoyant density of Escherichia coli at very low osmolarities.
AB  - The growth and buoyant densities of two closely related strains of Escherichia
      coli in M9-glucose medium that was diluted to produce osmolarities that varied
      from as low as 5 to 500 mosM were monitored. At 15 mosM, the lowest osmolarity at
      which buoyant density could be measured reproducibly in Percoll gradients, both
      ML3 and ML308 had a buoyant density of about 1.079 g/ml. As the osmolarity of the
      medium was increased, the buoyant density also increased linearly up to about 125
      mosM, at which the buoyant density was 1.089 g/ml. From 150 up to 500 mosM, the
      buoyant density again increased linearly but with a different slope from that
      seen at the lower osmolarities. The buoyant density at 150 mosM was about 1.091
      g/ml, and at 500 mosM it was 1.101 g/ml. Both strains of E. coli could be grown
      in M9 medium diluted 1:1 with water, with an osmolarity of 120 mosM, but neither
      strain grew in 1:2-diluted M9 if the cells were pregrown in undiluted M9. (Note:
      undiluted M9 as prepared here has an osmolarity of about 250 mosM.) However, if
      the cells were pregrown in 30% M9, about 75 mosM, they would then grow in M9 at
      45 mosM and above but not below 40 mosM. To determine which constituent of M9
      medium was being diluted to such a low level that it inhibited growth, diluted M9
      was prepared with each constituent added back singly. From this study, it was
      determined that both Ca2+ and Mg2+ could stimulate growth below 40 mosM. With
      Ca2+ - and Mg2+ -supplemented diluted M9 and cells pregrown in 75 mosM M9, it was
      possible to grow ML308 in 15 mosM M9. Strain ML3 would only haltingly grow at 15
      mosM. Four attempts were made to grow both ML3 and ML308 at 5 mosM. In three of
      the experiments, ML308 grew, while strain ML3 grew in one experiment. While our
      experiments were designed to effect variations in medium osmolarity by using NaCl
      as an osmotic agent, osmolarity and salinity were changed concurrently.
      Therefore, from this study, we believe that E. coli might be defined as an
      euryhalinic and/or euryosmotic bacterium because of its ability to grow in a wide
      range of salinities and osmolarities.

PMID- 7798138
TI  - The TyrR protein of Escherichia coli is a class I transcription activator.
AB  - The purified TyrR protein and phenylalanine were sufficient to activate in vitro
      transcription from the tyrP promoter by wild-type RNA polymerase. Such TyrR
      mediated activation did not occur when the mutant alpha 235 RNA polymerase was
      used, indicating that TyrR is a class I transcription activator.

PMID- 7798139
TI  - hlyM, a transcriptional silencer downstream of the promoter in the hly operon of
      Escherichia coli.
AB  - Transcription of the hly operon of transmissible plasmids in Escherichia coli is
      subject to a tight regulation which also involves various chromosomal genes, such
      as hha. We have identified a 200-bp region within the hlyC gene, designated hlyM,
      which modulates hemolysin expression. The deletion of hlyM increased the activity
      of hly::galK fusion 20-fold. hlyM does not contain any internal promoter, nor is
      it capable of acting in trans. Our data suggest that the chromosomal Hha protein
      interacts with hlyM in order to silence the hly promoter. In addition, hlyR, a
      positive activator of hemolysin expression, seems to suppress the modulatory
      effect dictated by the Hha protein on the hlyM region.

PMID- 7798140
TI  - Isolation, sequencing, and mutagenesis of the gene encoding NAD- and glutathione
      dependent formaldehyde dehydrogenase (GD-FALDH) from Paracoccus denitrificans, in
      which GD-FALDH is essential for methylotrophic growth.
AB  - NAD- and glutathione-dependent formaldehyde dehydrogenase (GD-FALDH) of
      Paracoccus denitrificans has been purified as a tetramer with a relative
      molecular mass of 150 kDa. The gene encoding GD-FALDH (flhA) has been isolated,
      sequenced, and mutated by insertion of a kanamycin resistance gene. The mutant
      strain is not able to grow on methanol, methylamine, or choline, while
      heterotrophic growth is not influenced by the mutation. This finding indicates
      that GD-FALDH of P. denitrificans is essential for the oxidation of formaldehyde
      produced during methylotrophic growth.

PMID- 7798142
TI  - Physical mapping of the Mycoplasma gallisepticum S6 genome with localization of
      selected genes.
AB  - We report the construction of a physical map of the Mycoplasma gallisepticum S6
      genome by field-inversion gel electrophoresis of DNA fragments generated by
      digestion of genomic DNA with rare-cutting restriction endonucleases. The size of
      the M. gallisepticum S6 genome was calculated to be approximately 1,054 kb. The
      loci of several genes have been assigned to the map by Southern hybridization
      utilizing specific gene probes.

PMID- 7798141
TI  - Nucleotide sequence of pvdD, a pyoverdine biosynthetic gene from Pseudomonas
      aeruginosa: PvdD has similarity to peptide synthetases.
AB  - Pseudomonas aeruginosa secretes a fluorescent siderophore, pyoverdine, when grown
      under iron-deficient conditions. Pyoverdine consists of a chromophoric group
      bound to a partly cyclic octapeptide. As a step toward understanding the
      molecular events involved in pyoverdine synthesis, we have sequenced a gene,
      pvdD, required for this process. The gene encodes a 2,448-residue protein, PvdD,
      which has a predicted molecular mass of 273,061 Da and contains two highly
      similar domains of about 1,000 amino acids each. The protein is similar to
      peptide synthetases from a range of bacterial and fungal species, indicating that
      synthesis of the peptide moiety of pyoverdine proceeds by a nonribosomal
      mechanism. The pvdD gene is adjacent to a gene, fpvA, which encodes an outer
      membrane receptor protein required for uptake of ferripyoverdine.

PMID- 7798143
TI  - Bordetella pertussis fur gene restores iron repressibility of siderophore and
      protein expression to deregulated Bordetella bronchiseptica mutants.
AB  - We report the isolation and preliminary phenotypic characterization of manganese
      resistant Bordetella bronchiseptica mutants with respect to deregulation of
      siderophore and iron-regulated protein expression. The fur gene of Bordetella
      pertussis was cloned by genetic complementation of this deregulated phenotype and
      confirmed as fur by nucleotide sequence analysis.

PMID- 7798144
TI  - Agrobacterium tumefaciens VirB11 protein requires a consensus nucleotide-binding
      site for function in virulence.
AB  - virB11, one of the 11 genes of the virB operon, is absolutely required for
      transport of T-DNA from Agrobacterium tumefaciens into plant cells. Previous
      studies reported that VirB11 is an ATPase with autophosphorylation activity and
      localizes to the inner membrane even though the protein does not contain the
      consensus N-terminal export sequence. In this report, we show that VirB11
      localizes to the inner membrane even in the absence of other tumor-inducing (Ti)
      plasmid-encoded proteins. To facilitate the further characterization of VirB11,
      we purified this protein from the soluble fraction of an Escherichia coli extract
      by fusing VirB11 to the maltose-binding protein. The maltose-binding protein
      VirB11 fusion was able to complement a virB11 deletion mutant of A. tumefaciens
      for tumor formation and also localized properly to the inner membrane of A.
      tumefaciens. The 72-kDa protein, purified from E. coli, exhibited no
      autophosphorylation, ATPase activity, or ATP-binding activity. To study the
      importance of the Walker nucleotide-binding site present in VirB11, mutations
      were generated to replace the conserved lysine residue with either alanine or
      arginine. Expression of the virB11K175A mutant gene resulted in an avirulent
      phenotype, and expression of the virB11K175R mutant gene gave rise to an
      attenuated virulence phenotype. Both mutant proteins were present at levels three
      to four times higher than that of VirB11 in the wild-type strain. The mutant
      genes did not exhibit a transdominant phenotype on tumor formation in bacteria
      that were expressing wild-type virB11. The mutant proteins also localized
      properly to the inner membrane of A. tumefaciens, but the VirB11K175R protein
      appeared to be unstable after lysis of the cells.

PMID- 7798145
TI  - Two genes encoding uracil phosphoribosyltransferase are present in Bacillus
      subtilis.
AB  - Uracil phosphoribosyltransferase (UPRTase) catalyzes the key reaction in the
      salvage of uracil in many microorganisms. Surprisingly, two genes encoding
      UPRTase activity were cloned from Bacillus subtilis by complementation of an
      Escherichia coli mutant. The genes were sequenced, and the putative amino acid
      sequences were deduced. One gene showed a high level of homology to UPRTases from
      other organisms, whereas the other gene with a low level of homology to other
      UPRTases turned out to be the pyrR gene--the repressor of the pyr operon. The
      role of these genes in uracil metabolism was established by an analysis of the
      phenotypes of upp and pyrR mutants.

PMID- 7798146
TI  - The torR gene of Escherichia coli encodes a response regulator protein involved
      in the expression of the trimethylamine N-oxide reductase genes.

PMID- 7798147
TI  - Phylogenetic comparison of retron elements among the myxobacteria: evidence for
      vertical inheritance.
AB  - Twenty-eight myxobacterial strains, representing members from all three
      subgroups, were screened for the presence of retron elements, which are novel
      prokaryotic retroelements encoding reverse transcriptase. The presence of retrons
      was determined by assaying strains for a small satellite DNA produced by reverse
      transcription called multicopy, single-stranded DNA (msDNA). An msDNA-producing
      retron appeared to be absent from only one of the strains surveyed. DNA
      hybridization experiments revealed that retron elements similar to retron Mx162,
      first identified in Myxococcus xanthus, were found only among members of the
      Myxococcus subgroup; that is, each of the seven different genera which constitute
      this subgroup contained a Mx162 homolog. Another retron element also appeared to
      have a clustered distribution, being found exclusively within the Nannocystis
      subgroup of the myxobacteria. A retron element of the Mx162 type was cloned from
      Melittangium lichenicola, and its DNA sequence was compared with those of similar
      elements in M. xanthus and Stigmatella aurantiaca. Together, the degree of
      sequence diversity, the codon bias of the reverse transcriptase genes, and the
      clustered distribution of these retrons suggest a possible evolutionary scenario
      in which a common ancestor of the Myxococcus subgroup may have acquired this
      retroelement.

PMID- 7798148
TI  - Specific binding of the NikA protein to one arm of 17-base-pair inverted repeat
      sequences within the oriT region of plasmid R64.
AB  - Products of the nikA and nikB genes of plasmid R64 have been shown to form a
      relaxation complex with R64 oriT DNA and to function together as an oriT-specific
      nickase. We purified the protein product of the nikA gene. The purified NikA
      protein bound specifically to the oriT region of R64 DNA. Gel retardation assays
      and DNase I footprinting analyses indicated that the NikA protein bound only to
      the right arm of 17-bp inverted repeat sequences; the right arm differed from the
      left arm by a single nucleotide. The binding site is proximal to the nick site
      and within the 44-bp oriT core sequence. Binding of the NikA protein induced DNA
      bending within the R64 oriT sequence.

PMID- 7798149
TI  - Site-specific deletions of chromosomally located DNA segments with the multimer
      resolution system of broad-host-range plasmid RP4.
AB  - The multimer resolution system (mrs) of the broad-host-range plasmid RP4 has been
      exploited to develop a general method that permits the precise excision of
      chromosomal segments in a variety of gram-negative bacteria. The procedure is
      based on the site-specific recombination between two directly repeated 140-bp
      resolution (res) sequences of RP4 effected by the plasmid-borne resolvase encoded
      by the parA gene. The efficiency and accuracy of the mrs system to delete
      portions of chromosomal DNA flanked by res sites was monitored with hybrid mini
      Tn5 transposons in which various colored (beta-galactosidase and catechol 2,3
      dioxygenase) or luminescent (Vibrio harveyi luciferase) phenotypic markers
      associated to res sequences were inserted in the chromosome of the target
      bacteria and exposed in vivo to the product of the parA gene. The high
      frequencies of marker excision obtained with different configurations of the parA
      expression system suggested that just a few molecules of the resolvase are
      required to achieve the site-specific recombination event. Transient expression
      of parA from a plasmid unable to replicate in the target bacterium was
      instrumental to effect differential deletions within complex hybrid transposons
      inserted in the chromosome of Pseudomonas putida. This strategy permits the
      stable inheritance of heterologous DNA segments virtually devoid of the sequences
      used initially to select their insertion.

PMID- 7798152
TI  - Nicotinate catabolism is dispensable and nicotinate anabolism is crucial in
      Azorhizobium caulinodans growing in batch culture and chemostat culture on N2 as
      The N source.
AB  - When Azorhizobium caulinodans was grown in chemostat cultures with N2 as the N
      source at a constant dilution rate of 0.1 h-1 in media with a constant
      concentration (50 mM) of succinate and variable concentrations (1.5 to 585
      microM) of nicotinate, neither the growth yield on succinate, the specific rate
      of O2 consumption, nor the specific rate of CO2 production showed linear
      regression with the concentration of nicotinate. Moreover, for transient
      continuous cultures in which the nicotinate concentration was gradually lowered,
      growth parameters remained unchanged until an apparently critical level of 0.7
      microM nicotinate was reached. Below this nicotinate level, an immediate washout
      of the chemostat population began. A. caulinodans nicotinate hydroxylase-negative
      mutant 61007, unable to catabolize nicotinate, and the wild type behaved
      similarly. Thus, for continuous cultures supplied with N2 as the N source,
      submicromolar concentrations of nicotinate both sustained pyridine nucleotide
      biosynthesis at sufficient levels and precluded the use of nicotinate as a
      catabolic substrate. Furthermore, when more nicotinate was provided, dual
      succinate-nicotinate limitation in continuous cultures did not occur. Finally,
      when nicotinate is present in suboptimal concentrations, the specific growth rate
      is directly proportional to the amount of nicotinate present per unit of biomass.
      By contrast, in batch cultures with different nicotinate concentrations and with
      either succinate or lactate as the carbon and energy source, anomalous growth
      curves were obtained. With a low concentration (1.5 microM) of nicotinate, growth
      on N2 occurred, albeit at low rates. With a high concentration (195 microM) of
      nicotinate, growth on N2 was temporarily stimulated, but nicotinate was quickly
      exhausted and growth was thereafter nicotinate limited. Continuous
      supplementation of batch cultures with nicotinate allowed only transient
      exponential growth followed by linear growth. Thus, also for batch cultures,
      nicotinate catabolism is dispensable, although a high concentration of nicotinate
      temporarily stimulates growth on N2. Ut us concluded that A. caulinodans is a
      true diazotroph.

PMID- 7798153
TI  - Lack of production of (p)ppGpp in Halobacterium volcanii under conditions that
      are effective in the eubacteria.
AB  - The stringent halobacterial strain Haloferax volcanii was subjected to a set of
      physiological conditions different from amino acid starvation that are known to
      cause production of guanosine polyphosphates [(p)pp Gpp] in eubacteria via the
      relA-independent (spoT) pathway. The conditions used were temperature upshift,
      treatment with cyanide, and total starvation. Under none of these conditions were
      detectable levels of (p)ppGpp observed. This result, in conjunction with our
      previous finding that (p)ppGpp synthesis does not occur under amino acid
      starvation, leads to the conclusion that in halobacteria both growth rate control
      and stringency are probably governed by mechanisms that operate in the absence of
      ppGpp. During exponential growth, a low level of phosphorylated compounds with
      electrophoretic mobilities similar, but not identical, to that of (p)ppGpp were
      observed. The intracellular concentration of these compounds increased
      considerably during the stationary phase of growth and with all of the treatments
      used. The compounds were identified as short-chain polyphosphates identical to
      those found under similar conditions in Saccharomyces cerevisiae.

PMID- 7798150
TI  - Identification of mycobacterium tuberculosis DNA sequences encoding exported
      proteins by using phoA gene fusions.
AB  - The activity of bacterial alkaline phosphatase (PhoA) is dependent on it being
      exported across the plasma membrane. A plasmid vector (pJEM11) allowing fusions
      between phoA and genes encoding exported proteins was constructed to study
      protein export in mycobacteria. Introduction of the Mycobacterium fortuitum beta
      lactamase gene (blaF*) into this vector led to the production in M. smegmatis of
      protein fusions with PhoA activity. A genomic library from M. tuberculosis was
      constructed in pJEM11 and screened in M. smegmatis for clones with PhoA activity.
      Sequences of the M. tuberculosis inserts directing the production of protein
      fusions in these PhoA-positive clones were determined. They include part of the
      already-known exported 19-kDa lipoprotein, a sequence with similarities to the
      exported 28-kDa antigen from M. leprae, a sequence encoding a protein sharing
      conserved amino acid motifs with stearoyl-acyl-carrier-protein desaturases, and
      unknown sequences. This approach thus appears to identify sequences directing
      protein export, and we expect that more extensive screening of such libraries
      will lead to a better understanding of protein export in M. tuberculosis.

PMID- 7798151
TI  - A cluster of four genes encoding enzymes for five steps in the folate
      biosynthetic pathway of Streptococcus pneumoniae.
AB  - Two genes, sulB and sulC, in a folate biosynthetic gene cluster of Streptococcus
      pneumoniae were identified after determination of the DNA sequence between two
      previously reported genes, sulA and sulD, in a cloned segment of chromosomal DNA
      containing a mutation to sulfonamide resistance. The gene products, SulB and
      SulC, correspond to polypeptides of 49 and 21 kDa, respectively. SulC has GTP
      cyclohydrolase activity and catalyzes the first step in the folate biosynthetic
      pathway. SulB apparently has dihydrofolate synthetase activity in that it
      complements a folC mutant of Escherichia coli and thus catalyzes the last step in
      the pathway. Prior work showed that SulA, a dihydropteroate synthase, and SulD, a
      bifunctional enzyme, catalyze three intervening steps. Mapping of the mRNA
      transcribed from the operon was consistent with its beginning at a promoter with
      a -35 site (gTGtCc) and an extended -10 site (T-TG-TAaAAT) and its termination at
      the end of a hairpin structure, which would give a transcript 3,745 nucleotides
      in length. SulC showed a considerable conservation of sequence by comparison with
      proven or putative GTP cyclohydrolases from four unrelated species, with 38 to
      53% of the residues being identical. A similar comparison of SulB with
      dihydrofolate synthetases showed an identity of only 26 to 37%. Overall,
      comparisons of the five folate biosynthetic enzymes in different species suggest
      that S. pneumoniae is related more closely to other gram-positive bacteria, less
      closely to eucaryotes, and least closely to the gram-negative E. coli. The varied
      arrangements of folate biosynthetic genes in different species imply an early
      evolutionary period of fluidity in genomic rearrangement.

PMID- 7798154
TI  - The rec locus, a competence-induced operon in Streptococcus pneumoniae.
AB  - To study competence and the process of transformation (TFN) in pneumococci, we
      developed a method for isolating TFN- mutants using insertional inactivation
      coupled with fusions to the gene for alkaline phosphatase (phoA). One TFN- mutant
      transformed 2 log units less efficiently than the parent strain. Reconstitution
      of the mutated region revealed a locus, rec, that contains two polycistronic
      genes, exp10 and the previously identified recA (B. Martin, J. M. Ruellan, J. F.
      Angulo, R. Devoret, and J. P. Claverys, Nucleic Acids Res. 20:6412, 1992). Exp10
      is likely to be a membrane-associated protein, as it has a prokaryotic signal
      sequence and an Exp10-PhoA fusion localized with cell membranes. On the basis of
      sequence similarity, pneumococcal RecA is a member of bacterial RecA proteins
      responsible for homologous recombination of DNA. DNA-RNA hybridization analysis
      showed that this locus is transcribed as a polycistronic message, with increased
      transcription occurring during competence. With an Exp10-PhoA chimera used as a
      reporter, there was a 10-fold increase in the expression of the rec locus during
      competence while there was only minimal expression under growth conditions that
      repressed competence. The TFN- mutant containing the exp10-phoA fusion produced
      activator, a small extracellular polypeptide that induces competence, and the
      expression of rec was induced in response to activator. Therefore, the rec locus
      is directly required for genetic transformation and is regulated by the cell
      signaling mechanism that induces competence.

PMID- 7798156
TI  - Durable remissions following prolonged plasma exchange in thrombotic
      thrombocytopenic purpura.
AB  - We evaluated the efficacy of prolonged plasma exchange (PEX) for attaining
      durable remissions in thrombotic thrombocytopenic purpura (TTP). A recent review
      using steroids or PEX in initial management showed an 80% response rate but
      produced a relapse rate of 67-84%. Records of 50 patients starting PEX treatment
      for TTP/HUS were reviewed to identify and select those whose course of treatment
      had ended over 1 year earlier, whether or not the result was satisfactory.
      Records were evaluated for outcome, especially remission associated with
      treatment by "prolonged" plasma exchange. "Prolonged" was defined as continuing
      PEX beyond the stage where a normal platelet count was attained and until
      evidence of hemolysis was "minimal or at least compensated." If disease activity
      as judged by the criteria of hemolysis became accelerated or resumed, PEX was
      increased by volume of FFP (e.g., from 3 to 4 L) or rate (from less than daily to
      daily). Of 50 consecutive patients treated by PEX for TTP/HUS there were 40 cases
      after which at least one year had passed since the end of treatment. These 40
      patients were evaluated for the results of treatment by PEX. Eight failed to
      achieve remission, dying in hospital within 1 month of admission. Twenty-eight
      achieved remission, sustained for 1 year or more in all. These are the reasons
      for our enthusiasm about this report. Four achieved remission lasting less than 1
      year. Splenectomy was performed to obtain a sustained remission in one patient
      following administration of three 2 mg doses of vincristine and two
      relapses.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798157
TI  - Goodpasture's syndrome in childhood: treatment with plasmapheresis and
      immunosuppression.
AB  - Goodpasture's syndrome rarely affects children. Therefore, we present our
      experience in a young boy whose pulmonary hemorrhage was dramatically resolved by
      three plasma exchanges. We believe the hemorrhage was caused primarily by acute
      capillaritis. He received cytoxan and steroids and a series of plasma exchanges
      which removed/suppressed his anti-glomerular basement membrane (anti-GBM)
      antibody production. However, after a year, his renal function did not return,
      and he required renal transplantation and continues to do well.

PMID- 7798158
TI  - Synchronization of plasma exchange and cyclophosphamide in severe and refractory
      autoimmune hemolytic anemia.
AB  - Two cases of severe autoimmune hemolytic anemia (AIHA) that failed multiple
      treatment modalities obtained complete and long-lasting remissions with a
      combination of three one volume plasma exchange (PE) on succeeding days followed
      6 hours later on the 3rd day by cyclophosphamide (cyc) 750 mg/m2 IV, and
      cyc/prednisone (pred) qd tapering to either no therapy or minimal therapy over a
      6 month period. Both cases remain without evidence of AIHA after 43 and 19 months
      follow-up. Possible non-exclusive mechanisms that explain this favorable outcome
      are enhanced cytotoxic effect of cyc on proliferating lymphocytes participating
      in the antibody rebound phenomena, suppression of B lymphocytes with daily
      cyc/pred, and/or formation of anti-idiotype antibodies.

PMID- 7798155
TI  - Transcriptional and posttranslational regulation of the general amino acid
      permease of Saccharomyces cerevisiae.
AB  - The cellular level and activity of the general amino acid permease, the product
      of the GAP1 gene of Saccharomyces cerevisiae, are regulated at the level of
      transcription by two systems, the products of URE2/GLN3 and NIL1 in response to
      the nitrogen sources of the growth medium and inactivation in response to the
      presence of glutamine or glutamate. Active permease is phosphorylated. The
      addition of glutamine causes rapid dephosphorylation and inactivation of the
      permease with the same kinetics, which is followed by slower disappearance of the
      protein. These results suggest that inactivation of the permease results from its
      dephosphorylation.

PMID- 7798159
TI  - Decrease of thyroid hormones in patients with familial hypercholesterolemia
      during dextran sulphate low-density lipoprotein apheresis.
AB  - Removal of low-density lipoproteins from plasma by dextran sulfate adsorption
      (DSA) in FH patients entails a decrease in plasma levels of thyroid hormones (
      28.5% and -18.7%, respectively, for T3 and T4). This suggests that FH patients
      have a greater than normal fraction of thyroid hormones bound to lipoproteins,
      due to their expanded lipoprotein pool.

PMID- 7798160
TI  - Integration of concurrent collection of plasma into a plateletpheresis program.
AB  - We have reviewed our initial experience with a program of concurrent collection
      of plasma (CCP) during plateletpheresis, which was instituted to increase the
      number of units of fresh frozen plasma produced by our hospital-based donor
      service. Sixty percent of eligible donors (1,006 of 1,682) participated in CCP,
      and 21 donors subsequently dropped out of the program. Of these, only one of four
      first-time donors have returned, whereas the majority of established
      plateletpheresis donors (16 of 17) have continued to donate platelets. Additional
      plasma was collected at a minimum of 8-week intervals on the Fenwal CS-3000 Plus
      or COBE Spectra without a change in the requirements for donor testing or the
      collection procedure. The quality of these platelet products was compared to that
      of those donated without CCP. There was a small decrease in platelet yield for
      products with CCP on the CS-3000 Plus (mean yield 4.5 x 10(11) with CCP versus
      4.9 x 10(11) without CCP, P < .01). No negative effects were seen on the
      percentage of products with a minimum yield of 3 x 10(11) platelets or on
      leukocyte contamination. In addition, there was no difference in the rate of
      adverse donor reactions. During a 12-month interval, CCP provided 34% (3,798 of
      11,266 units) of all fresh frozen plasma for our hospital without additional
      staff or equipment. The results of this retrospective study suggest that CCP
      merits further evaluation.

PMID- 7798162
TI  - Effects on recipients of exposure to allogeneic donor leukocytes.
AB  - Blood transfusion recipients are exposed to allogeneic donor leukocytes at the
      time of transfusion. Exposure to allogeneic donor leukocytes has been linked to a
      variety of complications of transfusion including primary HLA alloimmunization
      and platelet refractoriness, febrile nonhemolytic transfusion reactions,
      transmission of leukotropic viruses, transfusion-associated graft versus host
      disease, and transfusion-induced immune suppression. The development of high
      performance leukodepletion blood filters and of low-leukocyte plateletapheresis
      machines has provided the technology to reduce recipient exposure to allogeneic
      donor leukocytes. This article provides a brief review of current information on
      the utility and shortcomings of these technologies for the prevention of
      leukocyte-mediated transfusion complications.

PMID- 7798163
TI  - Cellular gene therapy: an overview.
AB  - Recombinant DNA technology has provided the tools for gene-based cellular
      therapies. The increasing ability to characterize disease in molecular terms
      affords the scientific rationale for gene therapy, while advances in cell
      biology, cytokine physiology, and gene delivery have made somatic cell gene
      therapy feasible. In 1990, the first successful human gene therapy was performed
      to correct severe combined immunodeficiency resulting from an inherited disorder,
      adenosine deaminase deficiency. Peripheral blood lymphocytes were used to deliver
      a gene product as temporary therapy. Today more than a dozen clinical protocols,
      using a variety of cell types and gene vectors, are in different stages of
      development. Some promise to be curative. Potential target illnesses include a
      variety of inherited genetic diseases, as well as such acquired disorders as
      cancer and AIDS. Although basic problems relating to gene transfer efficiency and
      expression, assay systems, and quality assurance remain, the technology to
      collect large numbers of cells, to purify cell subsets, to gene-modify these
      cells, and to expand them for human infusion suggest practical new strategies for
      cellular gene therapy.

PMID- 7798161
TI  - Effects on donors of repeated leukocyte losses during plateletpheresis.
AB  - All blood components collected by automated cytapheresis contain donor
      leukocytes. The possibility that repeated cytapheresis donation might lead to
      clinically important leukocyte losses and immunodeficiency has been a long
      standing concern. Although convincing data do not exist to substantiate this
      concern, it is common practice to limit the number of annual cytapheresis
      donations per donor and to monitor donors for developing lymphocytopenia.
      Clinically significant immunodeficiency is unlikely to occur unless donors lose >
      1 x 10(11) lymphocytes within a few weeks period of time or unless donor
      lymphocyte counts fall persistently to < 0.5 x 10(9)/L. Each plateletpheresis
      procedure, when performed using modern cell separators that are designed to
      produce a relatively "pure" platelet concentrate, leads to the loss of 1.0 x
      10(6) to 5.0 x 10(7) leukocytes. Thus, automated plateletpheresis as performed in
      1994 is extremely unlikely to cause clinically significant lymphocyte depletion
      and consequent immunodeficiency.

PMID- 7798165
TI  - Manual plasmapheresis in the treatment of Guillain-Barre syndrome.
AB  - We report on 41 patients with Guillain-Barre Syndrome (GBS) with disability grade
      4 and 5 who were treated with manual plasma exchange (PE). Approximately 20-40
      ml/kg body weight of plasma was removed with each manual PE; 63% of patients
      needed one PE, 24% needed two, 10% needed three, and 2% needed four plasma
      exchanges. Normal saline, human serum albumin (NSA) and fresh frozen plasma were
      used in varying proportions as replacement solutions. Ninety-one percent of the
      patients resumed walking with very little assistance ranging from 4 to 56 days
      with an average of 25 days from the commencement of the first PE. Manual PE in
      our series was effective and safe as the reported experience of automated
      apheresis and less volume of plasma was exchanged in our patients undergoing
      manual PE when compared to those treated in other studies employing automated PE.

PMID- 7798164
TI  - Rapid red cell transfusion by apheresis.
AB  - Packed red cells (RBC) are customarily infused slowly to allow time for re
      equilibration of intravascular volume, but they may be given rapidly for
      convenience during hemodialysis or partial RBC exchange when blood volume can be
      adjusted extracorporeally. We describe an apheresis procedure for rapid
      transfusion of RBC to patients with chronic anemia in which an equivalent volume
      of recipient plasma is withdrawn as donor RBC are infused. Fifteen such
      procedures, transfusing 3 to 5 RBC units each, have been performed on nine
      patients (4 of them outpatients) with either COBE Spectra or COBE 2997. Mean +/-
      SD procedure duration was 1.79 +/- .44 hr; patient hemoglobin rose from 7.3 +/-
      1.5 to 12.0 +/- 1.5 g/dl. Comparison to conventional transfusion was possible for
      nine procedures on six patients in which rapid transfusion required .52 +/- .12
      vs. 2.70 +/- .37 hr per unit (P < .001) and raised hemoglobin by 1.22 +/- .30 vs
      .88 +/- .34 g/dl per unit (P < .02). Pink plasma noted during one procedure was
      attributable to infusion of an older AS-1 unit with extensive storage hemolysis.
      Rapid transfusion was subjectively well tolerated. Immediate post-procedure
      systolic blood pressures did not differ significantly from baseline, although one
      hypertensive patient had headache followed by increased blood pressure 4 hours
      after a procedure. We conclude that rapid transfusion of RBC is a technically
      feasible and more time efficient means for RBC transfusion. It is particularly
      attractive in the outpatient setting, and could also prevent fluid overload
      associated with RBC transfusion in some volume-sensitive patients.

PMID- 7798166
TI  - The conversion of xanthine dehydrogenase to xanthine oxidase and the role of the
      enzyme in reperfusion injury.
AB  - Although mammalian xanthine oxidase exists originally as a dehydrogenase form in
      freshly prepared samples, it is converted to an oxidase form during purification,
      either irreversibly by proteolysis or reversibly by sulfhydryl oxidation of the
      protein molecule. However, avoiding proteolysis the mammalian enzyme can be
      purified as an interconvertible form and thus can be used to compare directly the
      properties of xanthine dehydrogenase and the oxidase derived from the same enzyme
      molecule. The cDNAs encoding the enzyme have been cloned from several sources,
      and structural information is becoming available. The most significant difference
      between the two forms is the protein conformation around FAD, which changes the
      redox potential of the flavin and the reactivity of FAD with the electron
      acceptors, NAD and molecular oxygen. The flavin semiquinone is thermodynamically
      stable in xanthine dehydrogenase, but is unstable in xanthine oxidase. Detailed
      analyses by stopped-flow techniques suggest that the flavin semiquinone reacts
      with oxygen to form superoxide anion while the fully reduced flavin reacts to
      form hydrogen peroxide. Although xanthine dehydrogenase can produce greater
      amounts of superoxide anion than xanthine oxidase during xanthine-oxygen
      turnover, it seems to be physiologically insignificant because NAD inhibits
      almost completely the formation of superoxide anion. Although the involvement of
      this enzyme in reperfusion injury has been proposed, this seems to be more
      complex than originally envisaged and still remains to be established.

PMID- 7798167
TI  - Energy metabolism of spermatozoa of the sand dollar Clypeaster japonicus: the
      endogenous substrate and ultrastructural correlates.
AB  - Energy metabolism in spermatozoa of the sand dollar-sea urchin Clypeaster
      japonicus was examined. The spermatozoa contained triglyceride and cholesterol
      ester besides several kinds of phospholipids and cholesterol. Glycogen and
      glucose were present at extremely low levels. Following incubation of spermatozoa
      in seawater, the triglyceride content decreased rapidly. Other lipids, however,
      remained at constant levels. High lipase activity was demonstrated in the
      spermatozoa. Also, [1-14C]oleic acid was oxidized to 14CO2. Ultrastructural study
      showed that lipid globules were present at the bottom of the midpiece. After
      incubation in seawater, morphological changes in the lipid globules were observed
      and vacuoles of various sizes appeared near the lipid globules. Thus, it is
      concluded that C. japonicus spermatozoa obtain energy through oxidation of fatty
      acid from triglyceride stored in the lipid globules at the midpieces.

PMID- 7798169
TI  - Calcium-dependent regulation of smooth muscle calponin by S100.
AB  - Calponin, a major calmodulin-, actin-, and tropomyosin-binding protein in smooth
      muscle, interacted with brain S100 and the properties of the interaction were
      investigated in detail. From fluorescence labeling and chemical cross-linking
      experiments, the apparent Kd value was calculated to be 7 x 10(7) M-1 in the
      presence of Ca2+ with 1 mol of S100 bound per mol of calponin. The addition of
      S100 to the mixture of calponin and F-actin caused the removal of calponin from
      actin filaments in the presence of Ca2+ but not in the presence of EGTA or Zn2+.
      Ca2+ and S100 could relieve calponin-induced actomyosin Mg(2+)-ATPase inhibition.
      Both the removal of calponin from F-actin and the restoration of ATPase
      inhibition by S100 were more effective than those by calmodulin. At low ionic
      strength, the binding was observed irrespective of Ca2+ concentration and it was
      greatly weakened with increasing salt concentration. The formation of the complex
      in the presence of Ca2+ was less sensitive, with only 45% inhibition at 100 mM
      NaCl, where the complex in the absence of Ca2+ had almost disappeared. This was
      confirmed by S-100 Sepharose 4B chromatography. Addition of Ca2+ and S100 also
      led to a decrease in the affinity of calponin for tropomyosin. Domain mapping
      with chymotryptic digestion revealed that the S100 binding site resided within
      the N-terminal 22 kDa fragment of calponin, where the bindings of calmodulin and
      actin also occur.

PMID- 7798168
TI  - Purification and amino- and carboxyl-terminal amino acid sequences of alanine
      glyoxylate transaminase 1 from human liver.
AB  - In order to confirm the amino acid sequence predicted from the nucleotide
      sequence of cDNA and also to elucidate the intracellular localization and
      molecular evolution, human liver alanine-glyoxylate transaminase 1 (AGT1) was
      purified and subjected to partial amino acid sequence determination, with special
      attention to posttranslational modification. The enzyme was purified to
      homogeneity from the 10,000 x g supernatant of human liver homogenate. The
      purified enzyme showed only a single protein band at about 43 kDa on SDS-PAGE,
      indicating that it is a homodimer of two identical subunits, because the native
      enzyme has a molecular mass of about 80 kDa. Both the amino- and carboxyl
      terminal peptides of the enzyme were isolated from a cyanogen bromide digest of
      the S-carboxyl-methylated protein and subjected to amino acid sequence
      determination. The alpha-amino group of the amino-terminal peptide was shown to
      be blocked by an acetyl group. The carboxyl-terminal sequence contained a
      putative N-glycosylation sequence (-Asn-Ala-Thr-), the only one present in the
      whole molecule, but this sequence was normally determined, indicating that the
      enzyme is not N-glycosylated. Purdue et al. [J. Cell Biol. 111, 2341-2351 (1990)]
      have reported that Pro-11, Gly-170, and Ile-340 in normal human AGT1 were
      replaced by Leu, Arg, and Met, respectively, in a patient with primary
      hyperoxaluria type 1. We confirmed that residue-11 was Pro. Both the amino- and
      carboxyl-terminal sequences of the enzyme showed extensive similarity with those
      of rat liver mitochondrial serine-pyruvate aminotransferase and the small chain
      of hydrogenase from a thermophilic unicellular cyanobacterium, Synechococcus PCC
      6716.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798170
TI  - A survey of genes expressed in undifferentiated mouse embryonal carcinoma F9
      cells: characterization of low-abundance mRNAs.
AB  - As a first step to catalogue mRNAs present in mouse embryonal carcinoma F9 cells,
      879 clones corresponding to low-abundance mRNAs were selected from among 2,896
      randomly picked up clones of undifferentiated F9 cDNA libraries, using DNA probes
      complementary to poly(A)+RNAs prepared from undifferentiated F9 cells and to ones
      prepared from mouse fibroblast L cells. Five-hundred and eighty-two of the 879
      clones were partially sequenced, and the subsequent homology search revealed that
      201 corresponded to 180 known genes or known DNA sequences, which include not
      only housekeeping genes but also various tissue-specific genes. Interestingly, at
      least 24 of the 180 genes are development-related genes in mammals. Among these
      24, those for midkine (growth and/or differentiation factor) and interferon-beta
      are reportedly up-regulated, and those for ECA39 (target for c-Myc regulation),
      REX-1 (zinc finger protein), and OCT-3 (POU-domain transcription factor) are down
      regulated during the development of mouse embryonal carcinoma cells. Thirty-seven
      of the 582 clones matched the 36 previously reported unidentified ESTs (expressed
      sequence tags) and the remaining 344 corresponded to 329 novel ESTs. Therefore,
      partial sequencing of F9 cDNA clones corresponding to low-abundance mRNAs in F9
      cells not only provides valuable information concerning development-related genes
      in mammals, but also many novel ESTs useful for studying mammalian genomes.

PMID- 7798172
TI  - Preparation of separated alpha and beta subunits of electron-transferring
      flavoprotein in unfolded forms and their restoration to the native holoprotein
      form.
AB  - Electron-transferring flavoprotein (ETF) isolated from pig kidney is a
      heterodimer containing one FAD and one AMP [Sato, K. et al. (1993) J. Biochem.
      114, 215-222]. This paper presents a method for separation of the alpha and beta
      subunits on a preparative scale. The subunits were separated by cation-exchange
      chromatography in the presence of 6 M urea at pH 7.6. The subunits were obtained
      in unfolded forms with denaturant. The unfolded subunits were restored to the
      heterodimeric form having FAD and AMP with high yield after incubation with FAD
      and AMP under non-denaturing conditions. The far-UV CD spectrum, the fluorescence
      and absorption spectra of the bound FAD, and the enzyme activity of the
      reconstituted ETF were all identical to those of the ETF isolated from pig
      kidney. Thus, an experimental system was established for the reconstitution of
      ETF from the four components, alpha, beta, FAD, and AMP. Analyses of the
      absorption spectra of the separated subunits suggested that the contents of
      aromatic residues were one tryptophan and six tyrosines in alpha and one
      tryptophan and one tyrosine in beta. The possibility that one subunit binds with
      FAD or AMP in the absence of the other subunit was examined by measuring the
      flavin and protein fluorescence spectra, but no spectral changes reflecting such
      binding were detected. This result suggests that the coexistence of both the
      subunits is necessary for the binding of FAD and AMP with the protein.

PMID- 7798171
TI  - Effect of brefeldin A on ganglioside metabolism in cultured neurons: implications
      for the intracellular traffic of gangliosides.
AB  - The effect of BFA on the metabolic processing and intracellular traffic of
      gangliosides was studied in cerebellar granule cells, fed in culture for
      different periods with radiolabeled ganglioside GM1. The following results were
      obtained: (a) degradation of taken-up GM1 was markedly inhibited by BFA; this
      effect was rapid, reversible, and affected by reduced temperature, ATP depletion,
      and microtubule disruption: (b) direct glycosylation of internalized GM1 to GD1a
      was completely blocked by BFA; (c) the portion of GM1 that escaped BFA inhibition
      was degraded with formation of sphingosine, that was recycled for the
      biosynthesis of less glycosylated glycolipids (glucosyl-ceramide, GM3 and GD3);
      (d) in BFA-treated cells highly glycosylated gangliosides were undetectable, and
      the formation of sphingomyelin from liberated sphingosine was markedly reduced.
      These results suggest that, in the cells used: (a) the delivery of endocytosed
      gangliosides to lysosomes, (b) the flow of poorly glycosylated glycolipids from
      the Golgi stacks to the trans-Golgi network, and (c) the direct transport of part
      of endocytosed gangliosides to the late sites of glycosylation (possibly TGN) are
      mediated by BFA-sensitive vesicles. We propose that in cultured granule cells a
      BFA-sensitive mechanism regulates ganglioside traffic to and from the plasma
      membrane.

PMID- 7798173
TI  - Reconstitution of import-competent outer membrane vesicles from mammalian
      mitochondria.
AB  - Protein insertion into mitochondrial outer membrane (OM) vesicles isolated from
      Neurospora crassa has recently been reported. The N. crassa OM vesicles retained
      the features of the intact mitochondria concerning the dependency of insertion on
      the receptor protein [A. Mayer et al. (1993) J. Cell Biol. 121, 1233-1243]. In
      this study, OM vesicles were purified from bovine adrenal cortex mitochondria,
      and unilamellar proteoliposomes were reconstituted from OM vesicles using heptyl
      beta-thioglucoside. Both OM vesicles and the reconstituted outer membrane
      vesicles (ROM) were able to import porin, but unable to import the precursor of
      adrenodoxin, which translocates across both the outer and inner membranes of
      intact mitochondria. Porin insertion into both OM vesicles and ROM was inhibited
      in the presence of purified recombinant adrenodoxin precursor and also by ATP
      depletion, and was dependent on the trypsin-sensitive membrane surface factor,
      suggesting that the purified OM vesicles as well as ROM retained the properties
      of the intact OM concerning porin insertion. The protein import machinery of OM
      seems to be functional for the outer membrane protein without the participation
      of the inner membrane. The successful reconstitution of the protein import
      activity from solubilized OM will pave the way for further biochemical
      characterization of the protein import machinery of OM.

PMID- 7798174
TI  - The transmembrane region of microsomal cytochrome P450 identified as the
      endoplasmic reticulum retention signal.
AB  - Microsomal-type cytochrome P450s are integral membrane proteins bound to the
      membrane through their N-terminal transmembrane hydrophobic segment, the signal
      anchor sequence. To elucidate the determinants that enable the P450s to be
      located in the ER, we constructed cDNAs encoding chimeric proteins in which a
      secretory form of carboxyesterase, carboxyesterase Sec, was connected to the N
      terminus of the full-length or truncated forms of a microsomal-type P450,
      P450(M1), and the constructed plasmids were expressed in COS cells. Since
      carboxyesterase Sec is an N-glycosylated secretory protein, endo H treatment
      could be used to determine whether these chimeric proteins were located in the ER
      or not. Carboxyesterase Sec with the N-terminal 20 amino acids, containing the
      transmembrane region, of P450(M1), was located in the ER, as determined from the
      endo H sensitivity of the expressed protein and immunofluorescence staining of
      the cells. As the expressed protein exhibited carboxyesterase activity, it was
      not retained in the ER through the BiP-dependent quality control system
      recognizing unfolded proteins. Another chimeric protein construct in which
      carboxyesterase Sec was connected to the C-terminal region of rat UDP
      glucuronosyltransferase (UDP-GT), that contained a double-lysin ER retention
      motif, was also located in the ER, as determined from the endo H sensitivity and
      immunofluorescence staining. On the other hand, the sugar moiety of the
      carboxyesterase Sec connected to the transmembrane segment of UDP-GT, Sec/GTd,
      was partially resistant to the endo H treatment. From the results of
      immunofluorescent staining and cell fractionation, it was concluded that the
      Sec/GTd product was located in the Golgi apparatus. These observations indicated
      that the N-terminal hydrophobic segment of P450(M1) is sufficient for the ER
      membrane retention, whereas the transmembrane segment of UDP-GT is not. To
      determine whether microsomal P450s are recycled between the ER and Golgi
      compartments or not, a DNA construct encoding cathepsin D connected to the N
      terminus of P450(M1) was prepared and expressed in COS cells. The fusion protein
      was phosphorylated, but the phosphorylation was sensitive to alkaline
      phosphatase. As a control, authentic cathepsin D was subjected to phosphorylation
      of its oligosaccharide chain that was resistant to the alkaline phosphatase
      treatment. Since GlcNAc-P-transferase, which forms the alkaline phosphatase
      resistant phosphodiester in the sugar chains of lysosome-targeting proteins, is
      located in the Golgi apparatus, it was concluded that the oligosaccharide chain
      of the cathepsin D portion of the fusion protein was not phosphorylated, and that
      the chimeric protein did not go to the Golgi apparatus.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 7798175
TI  - Role of the conserved glycyl residues located at the active site of leucine
      dehydrogenase from Bacillus stearothermophilus.
AB  - A tetrapeptide sequence, Gly-Gly-(Gly/Ala)-Lys, containing a catalytically
      important lysyl residue, is highly conserved in NAD(P)+-dependent amino acid
      dehydrogenases. To elucidate functional roles of the glycyl residues in this
      conserved sequence Gly-77, Gly-78, and Gly-79 of the recombinant leucine
      dehydrogenase from Bacillus stearothermophilus have been individually replaced
      with Ala by site-directed mutagenesis. All of the mutant enzymes had Michaelis
      constants for alpha-keto-iso-caproate and ammonia several times larger than the
      wild-type enzyme while retaining considerable catalytic activities. However,
      inhibition constants for a substrate analog without an alpha-carbonyl group were
      unchanged by the mutations. On the other hand, the rate of inactivation by
      pyridoxal 5'-phosphate and the microenvironment of aromatic residues, in
      particular of the sole tryptophanyl residue (Trp-46) located in the vicinity of
      the active site, were affected by the mutations of the glycyl residues. All of
      these results suggest that the conserved glycyl residues are important for fine
      tuning of the position and/or orientation of the epsilon-amino group of Lys-80 at
      the active site to function efficiently as a general-base catalyst. Furthermore,
      the Gly-77 and Gly-78 mutant enzymes had markedly decreased thermal stabilities,
      showing that these two glycyl residues are also critical for the conformational
      stability of this thermostable enzyme.

PMID- 7798176
TI  - Studies on an artificial trypsin inhibitor peptide derived from the mung bean
      trypsin inhibitor: chemical synthesis, refolding, and crystallographic analysis
      of its complex with trypsin.
AB  - The active fragment with Lys at the reactive site of mung bean trypsin inhibitor
      (MBILF) is composed of two peptide chains, A1 of 26 residues and A2 of 9 residues
      linked via two disulfide bonds. In the present study, a peptide of 22 residue
      comprising the sequence of chain A1 from position 3 to 24 was synthesized by the
      solid-phase method. This synthetic peptide with six Cys residues contains a
      reactive site at position Lys11I-Ser12I (I denotes an inhibitor residue). Air
      oxidation and HPLC purification resulted in two antitrypsin active components,
      SPC1 and SPC2. Neither SPC1 nor SPC2 can stoichiometrically inhibit trypsin. The
      Ki values of SPC1 and SPC2 are 1.2 x 10(-7) and 4.0 x 10(-8) M, respectively. The
      complexes of SPC1 and SPC2 with bovine beta-trypsin (BTRY) were crystallized by
      ammonium sulphate precipitation at pH 6.4 and 6.0, respectively. The two crystals
      have the same crystal form with space group P2(1)2(1)2(1) and cell dimension of a
      = 63.2(2) A, b = 63.5(6) A, and c = 69.8(4) A. The crystal structure of one
      complex, SPC1-BTRY, was determined and refined at 2.2 A resolution to a final R
      value of 19.2%. From the resulting electron density map, 9 residues of SPC1, from
      position 9I to 17I, were identified clearly and three-dimension atomic model of
      the 9-residue reactive loop formed by a disulfide bridge, Cys9I-Cys17I, was
      built. No electron density corresponding to the other 13 residues was observed in
      the present map.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798177
TI  - Characterization of glycophorin A transcripts: control by the common erythroid
      specific promoter and alternative usage of different polyadenylation signals.
AB  - Glycophorins A (GPA) and B (GPB) are specifically expressed in human erythrocytes
      and express MN and Ss blood group antigens. While the GPB gene produces one
      transcript, the GPA gene produces three or four transcripts of different sizes.
      To understand the mechanisms of production of the different transcripts and
      erythroid-specific expression, we characterized the transcripts and the
      transcriptional regulatory regions of the glycophorin A gene. The transcriptional
      start site was determined by primer extension and S1 nuclease protection
      analysis, and it was found that all of the transcripts start at one major site.
      The nucleotide sequence of the newly isolated longest GPA cDNA revealed several
      polyadenylation signal sequences. To determine which polyadenylation signals are
      utilized, cDNA clones encoding GPA were isolated from a cDNA library of human
      erythroleukemia cell line K562 and the 3'-regions of the cDNAs were specifically
      amplified by the polymerase chain reaction. These results showed that five
      different polyadenylation signals of the GPA gene are utilized and the size and
      abundance of the transcripts are consistent with those detected by Northern blot
      analysis of K562 mRNAs. The 5'-flanking sequence was found to contain several
      binding motifs for the transcription factors, which were also found in other
      erythroid-specific genes. These motifs include the binding sites for the GATA-1
      and NF-E2 erythroid-specific transcription factors, in addition to Sp1
      transcription factor. The 5'-sequence from -750 to +36 relative to the
      transcriptional start site could confer only a low basal transcriptional activity
      in K562 cells and Friend erythroleukemia cells. This activity was significantly
      increased after Friend erythroleukemia cells were differentiated by
      dimethylsulfoxide. These results suggest that the 5' region regulates the
      glycophorin gene expression in erythroid-specific fashion.

PMID- 7798178
TI  - Contribution of Ad4BP, a steroidogenic cell-specific transcription factor, to
      regulation of the human CYP11A and bovine CYP11B genes through their distal
      promoters.
AB  - We analyzed the upstream regions of the human CYP11A and bovine CYP11B genes, and
      identified a distal promoter in each gene. The distal promoters are located at 
      1.8 to -1.5 kb in the upstream region of the CYP11A gene and -1.5 to -1.1 kb in
      the upstream region of the CYP11B gene. Transient transfection of CAT plasmid
      carrying each of the two distal promoters indicated that the regions had a
      transcriptional activating function and that the function was stimulated by cAMP.
      The basal and cAMP-stimulated transcriptional activities were detected only in
      steroidogenic cells. On structural analyses of the regions, we identified two Ad4
      sites and a cAMP responsive element in the distal promoter of CYP11A, and two Ad4
      sites and one NF-IL6 binding site in the distal promoter of CYP11B. The presence
      of an Ad4 site in common suggests its major contribution of the transcriptional
      activation. We also investigated the functional interactions between the distal
      promoters and basal promoters of both genes. Interestingly, the two distal
      promoters showed different requirements as to the basal promoter.

PMID- 7798179
TI  - Purification and characterization of four Ca(2+)-dependent lectins from the
      marine invertebrate, Cucumaria echinata.
AB  - Four Ca(2+)-dependent, N-acetylgalactosamine/galactose-specific lectins were
      purified from the marine invertebrate, Cucumaria echinata (Holothuroidea), by
      column chromatography on lactosyl-Sepharose 4B, Sephacryl S-200, and Q-Sepharose.
      The molecular masses of these lectins were estimated to be 27 kDa (CEL-I), 35 kDa
      (CEL-II), 45 kDa (CEL-III), and 68 kDa (CEL-IV) on SDS-PAGE under nonreducing
      conditions. Among these lectins, CEL-I and CEL-IV strongly agglutinated rabbit
      and human erythrocytes, and were found to recognize N-acetylgalactosamine and
      galactose-containing carbohydrates from the results of a hemagglutination
      inhibition assay. In contrast, CEL-II failed to agglutinate any erythrocytes
      tested, although its carbohydrate-binding ability was confirmed by a carbohydrate
      binding assay involving asialofetuin-horseradish peroxidase. Interestingly, CEL
      III caused hemolysis of rabbit and human erythrocytes, while it showed only
      hemagglutination of chicken and horse erythrocytes at relatively high
      concentrations. The hemolytic activity of CEL-III was also dependent on the
      Ca(2+)-concentration, and inhibited by N-acetylgalactosamine and galactose
      containing carbohydrates, suggesting that the hemolysis was caused by Ca(2+)
      dependent binding of CEL-III to specific carbohydrate chains on the erythrocyte
      surface and the following partial destruction of the membrane.

PMID- 7798180
TI  - Morphological and physicochemical changes in the myosin molecules induced by
      hydrostatic pressure.
AB  - Hydrostatic pressure-induced morphological and physiochemical changes in
      monomeric myosin were investigated. The turbidity of a myosin solution increased
      after release of pressure, indicating aggregation of the molecules. Some
      molecules were single headed after exposure to 100-200 MPa, in contrast with an
      intact molecule having two heads. Small-sized oligomeric species, composed of
      several molecules, appeared after pressurization at 200 MPa. The oligomers were
      formed only through head-to-head association. Neither head-to-tail nor tail-to
      tail interaction was observed. With increasing pressure to 300 MPa, monomeric
      myosin remarkably decreased, and most molecules formed oligomers, in which the
      myosin heads were tightly associated, forming a clump, the tails of the myosin
      molecules extending radially from the clump. Such an oligomer was shaped like a
      daisy wheel and its morphology was quite similar to that formed on heating
      reported previously [Yamamoto et al. (1990) J. Biochem. 108, 896-898]. The
      aggregation of myosin molecules upon pressurization was concomitant with an
      increase in hydrophobicity, which was measured spectrofluorometrically with 8
      anilino-1-naphthalene sulfonate, a probe for apolar binding sites. Although the
      turbidity increased continuously with increasing pressure, the hydrophobicity
      remained at a constant level above 200 MPa at pH 6.0 and above 300 MPa at pH 7.0.
      The loss of myosin ATPase activity was accompanied by aggregation of the
      molecules. These results indicate that hydrophobic groups in the heads of myosin
      are exposed to the surface of the molecule on pressurization, so that hydrophobic
      interaction among the heads occurs, yielding aggregates. Beside the hydrophobic
      interaction, the contribution of other interaction(s) is also suggested.

PMID- 7798181
TI  - Human complex II (succinate-ubiquinone oxidoreductase): cDNA cloning of the
      flavoprotein (Fp) subunit of liver mitochondria.
AB  - Complex II (succinate-ubiquinone oxidoreductase) is an important enzyme complex
      in both the tricarboxylic acid cycle, and the aerobic respiratory chains of
      mitochondria in eukaryotic cells and prokaryotic organisms. In this study,
      homology probing with mixed primers for the polymerase chain reaction and
      subsequent sequence analysis were successfully applied to clone cDNA for the
      flavoprotein (Fp) subunit of human liver complex II. The isolated clone contains
      an open reading frame of 1,992 nucleotides and encodes a mature protein of 621
      amino acids with a molecular weight of 68,011. The amino acid sequence was highly
      homologous with that of bovine heart Fp (93.2%) and was quite different from the
      partial sequence of human placental Fp reported previously [Malcovati et al.
      (1991) in Flavins and Flavoproteins 1990, pp. 727-730], which showed striking
      homology to that of Bacillus subtilis. To solve this discrepancy, the partial
      cDNA sequences of the stomach and placental Fp subunits of human complex II were
      determined in addition to the full length cDNA of liver. The sequence data,
      sensitivity to thiol reagents and antigenic properties indicated that the major
      from of FP subunit in human complex II is unique at least among the three tissues
      analyzed, and is more similar to the Fp subunit of bovine heart than to that of
      B. subtilis.

PMID- 7798182
TI  - Purification and primary structure of a new guanylic acid specific ribonuclease
      from Pleurotus ostreatus.
AB  - A guanine nucleotide-specific RNase (RNase Po1) was isolated from caps of the
      fruit bodies of Pleurotus ostreatus. RNase Po1 is most active towards RNA at pH
      8.0. The effect of heating on the molar ellipticity at 210 nm of RNase Po1 showed
      that RNase Po1 is more stable than RNase T1. The primary structure of RNase Po1
      was determined to be <
      ETGVRSCNCAGRSFTGTDVTNAIRSARAGGSGNYPHVYNNFEGFSFSCTPTFFEFPVFRGSVYSGGSPG ADRVIYD-
      QSGRFCACLTHTGAPSTNGFVECRF. It consisted of 101 amino acid residues, with a
      molecular weight of 10,760. RNase Po1 has relatively higher sequence homology
      with RNase T1 family RNase. It contains 6 half cystine residues. The locations of
      four of them are superimposable on those of RNase U1 and RNase U2. The amino acid
      residues forming the active site of RNase T1 were well conserved in this RNase.
      Therefore, RNase Po1 is a unique member of the RNase T1 family in respect of the
      location of one disulfide bridge, and its stability.

PMID- 7798183
TI  - Point mutations at glycine-121 of Escherichia coli dihydrofolate reductase:
      important roles of a flexible loop in the stability and function.
AB  - To elucidate the role of a flexible loop in the stability and function of
      Escherichia coli dihydrofolate reductase, glycine-121 in a flexible loop
      (residues 117-131), separated by 19 A from active site Asp27, was substituted by
      site-directed mutagenesis with eight amino acids (Ala, Val, Leu, Asp, Ser, Cys,
      Tyr, and His). The free energy change of unfolding decreased in the order of
      G121A > G121D > G121C > G121S, wild-type > G121H > G121Y > G121L > G121V. The
      thermal denaturation temperature decreased with all mutations, accompanied by a
      decrease in the calorimetric enthalpy of denaturation. The steady-state kinetic
      parameter for the enzyme reaction, Km, was only slightly influenced, but kcat was
      significantly decreased by the mutations, there being 3- (G121C) to 42-fold
      (G121L) decreases in kcat/Km compared to that of the wild-type enzyme. The
      effects of mutations on the stability and enzyme activity were statistically
      examined as a function of the hydrophobicity and volume of amino acids
      introduced. The diminished stability and activity with increases in the
      hydrophobicity and volume of amino acids suggest that the main effect of the
      mutations would be modification of the flexibility of the loop due to
      overcrowding of the bulky side chains, overcoming the enhancement of the
      hydrophobic interaction.

PMID- 7798185
TI  - Sequence requirements for endoproteolytic processing of precursor proteins by
      furin: transfection and in vitro experiments.
AB  - We have recently presented some sequence rules that govern the endoproteolytic
      processing of precursor proteins within the constitutive secretory pathway
      [Watanabe, T. et al. (1992) J. Biol. Chem. 267, 8270-8274; Watanabe, T. et al.
      (1993) FEBS Lett. 320, 215-218]. This cleavage seems to be catalyzed by furin, a
      mammalian homologue of the yeast processing endoprotease Kex2. In this study, not
      only by coexpression of furin and substrate precursors in a furin-deficient cell
      line but also by in vitro experiments using purified recombinant furin and
      substrate precursors, we determined the substrate specificity of furin. The
      sequence requirements of furin determined by the coexpression and in vitro
      experiments were essentially the same, and were consistent with the sequence
      rules for precursor cleavage within the constitutive secretory pathway.

PMID- 7798184
TI  - Possible differences in the regenerative roles played by thioltransferase and
      thioredoxin for oxidatively damaged proteins.
AB  - A possible involvement of thioltransferase (also known as glutaredoxin) in the
      regenerative reaction of proteins inactivated by oxidative stress were examined
      in vitro using the enzyme purified from bovine liver. Thioltransferase at
      physiological concentrations, together with glutathione, glutathione reductase
      and NADPH, regenerated the oxidatively damaged proteins with a comparable potency
      to that of thioredoxin. Experiments performed with protein substrates with their
      critical cysteine residues oxidized differently, that is, phosphofruktokinase and
      glyceraldehyde 3-phosphate dehydrogenase with mixed disulfide bonds and
      glyceraldehyde 3-phosphate dehydrogenase with sulfenyl or sulfinyl groups,
      indicated that thioltransferase regenerated the proteins inactivated by mixed
      disulfide formation more efficiently than thioredoxin, whereas thioredoxin
      preferentially regenerated the proteins inactivated by monothiol oxidation to
      sulfenic or sulfinic acid. These findings suggested that thioltransferase exerted
      regenerative effects on oxidatively damaged proteins like its cognate protein,
      thioredoxin, but with different substrate specificity, and their relative
      contribution to the regeneration reaction is dependent on the form of the
      oxidized thiols of the damaged proteins.

PMID- 7798186
TI  - Purification and molecular cloning of cDNA for an inducible antibacterial protein
      from larvae of the coleopteran, Tenebrio molitor.
AB  - Antibacterial activity was induced in the hemolymph of larvae of the coleopteran
      Tenebrio molitor by injection of Escherichia coli. An antibacterial protein,
      named tenecin 1, was purified to homogeneity from the larval hemolymph and
      characterized. A cDNA clone for tenecin 1 was isolated and its complete sequence
      was determined. This protein was found to inhibit the growth of Gram-positive
      bacteria and to consist of 43-amino acid residues including six cysteine
      residues. The disulfide structure of tenecin 1 was determined by sequencing
      cysteine containing peptides obtained by digesting tenecin 1 with endopeptidase
      Lys-C, trypsin, and thermolysin. The amino acid sequence and its disulfide bonds
      were similar to those of sapecin and sapecin C, antibacterial proteins of
      Sarcophaga peregrina.

PMID- 7798187
TI  - Demonstration of high-molecular-weight kininogen in kininogen-deficient rat
      kidneys.
AB  - Brown Norway Katholiek (B/N-Ka) is a mutant rat strain deficient in plasma high
      molecular-weight (HK) and low-molecular-weight kininogen (LK). It has been
      reported that the deficiency, caused by defective secretion of HK and LK by the
      liver, is associated with a point mutation of alanine (163) to threonine in the
      common heavy chain. In this report we demonstrate by specific radioimmunoassay
      that the amount of immunoreactive HK antigen in the B/N-Ka kidney was almost the
      same as that found in the normal Brown Norway rat (Brown Norway Kitasato, B/N
      Ki). HK antigen in the kidneys of both strains was immunohistochemically
      localized at distal tubules with similar intensity in both strains. Among the
      subcellular fractions of the kidney homogenates, HK antigen was predominantly
      found in the microsomal fraction of both strains. To see whether this HK antigen
      is derived from plasma HK or is synthesized in the kidneys, we examined uptake of
      HK by the tubular cells after incubation with 125I-HK. Only 0.6% of the
      radioactivity of added 125I-HK was found in the tubular cells of both strains
      after a 60-min incubation. Messages of HK mRNA from both strains of rats were
      visualized by PCR at almost the same intensity. These results suggest that HK
      antigen found in the kidney may be derived mainly from biosynthesis in the kidney
      itself and partly from uptake of HK from blood. There was no difference in these
      features of HK between the kidneys of the deficient and the normal B/N rats.

PMID- 7798188
TI  - Substrate specificity and subsite affinities of rabbit liver acid alpha
      glucosidase.
AB  - The substrate specificity of rabbit liver acid alpha-glucosidase was
      investigated. The enzyme showed a wide specificity for various substrates, and
      hydrolyzed alpha-glucans such as glycogen and soluble starch. The k0 values (s-1)
      for maltose, kojibiose, nigerose, isomaltose, phenyl alpha-glucoside, panose,
      phenyl alpha-maltoside, soluble starch, beta-limit dextrin, amylopectin,
      shellfish glycogen, and rabbit liver glycogen were estimated to be 94.8, 18.8,
      143, 3.6, 11.8, 27.8, 115, 99.2, 155, 83.5, 126, and 108, and the Km values
      (concentration of non-reducing terminal) for these substrates were 2.1, 1.8, 7.5,
      36, 5.4, 1.9, 1.2, 0.90, 9.1, 1.0, 16, and 13 mM, respectively. Isomaltose and
      phenyl alpha-glucoside were unfavorable as substrates. The acid alpha-glucosidase
      is characterized by a relatively high activity toward glycogen. The k0 values (s
      1) for maltotriose, -tetraose, -pentaose, -hexaose, -heptaose, and -octaose, and
      maltodextrin (n = 17) were 140, 140, 131, 132, 134, 132, and 74.3, and the Km
      values, 2.1, 1.8, 1.9, 3.4, 5.0, 4.9, 4.9 and 2.6 mM, respectively. Based on the
      rate parameters for the series of maltooligosaccharides, the subsite affinities
      (Ais) in the active site were evaluated as 0.54 (A1), 5.34 (A2), and 0.34 (A3)
      kcal/mol for subsites 1, 2, and 3, respectively. These three subsites were
      considered to be predominantly responsible for the binding of substrates to the
      active site.

PMID- 7798189
TI  - Purification and cDNA cloning of human liver CYP4A fatty acid omega-hydroxylase.
AB  - Laurate omega-hydroxylase activity of human liver microsomes was strongly
      inhibited by an antibody against rabbit fatty acid omega-hydroxylase P450 4A5,
      and Western blot analysis with this antibody showed the presence of two
      immunochemically related proteins with apparent molecular weights of
      approximately 50 and 52 kDa in all of 14 human liver specimens examined. A fatty
      acid omega-hydroxylase (designated P450HL omega) was purified to a specific
      content of 15 nmol of P450/mg of protein from microsomes of a single human liver
      on the basis of its laurate omega-hydroxylase activity and its reactivity with
      the P450 4A5 antibody. This P450HL omega showed an apparent molecular weight of
      52 kDa on SDS-PAGE. Furthermore, a cDNA clone (designated HL24) has been isolated
      from a human liver cDNA library by using the cDNA for P450 4A5 as a probe. The
      sequence of residues 5 through 25 deduced from cDNA HL24 was identical to the NH2
      terminal amino acid sequence of P450HL omega except for one undetermined residue.
      This cDNA encoded a protein of 519 amino acids with a molecular weight of 59,347.
      The amino acid sequence predicted from the cDNA showed 82% identity with that of
      P450 4A5. Northern blot analysis showed that the mRNA hybridized to the cDNA is
      expressed in the human liver and kidney. (ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798190
TI  - Preparation and characterization of human rheumatoid arthritic synovial fluid
      phospholipase A2 produced by recombinant baculovirus-infected insect cells.
AB  - We prepared human rheumatoid arthritic synovial fluid phospholipase A2 (PLA2) [EC
      3.1.1.4] from insect cells infected with a recombinant baculovirus. The PLA2 DNA
      was designed, changing the original codons to those used frequently in the
      polyhedrin gene. Sixteen oligo-deoxynucleotides ranging from 40 to 70 nucleotides
      were chemically synthesized and then assembled to form the whole PLA2 gene. The
      gene thus synthesized was then placed under the control of the polyhedrin
      promoter of Autographa californica nuclear polyhedrosis virus. The recombinant
      virus was infected into Spodoptera frugiperda cells. The infected cells secreted
      protein having PLA2 activity into the culture medium. The enzyme level in the
      medium reached about 3 mg/liter on day 4 after infection. The secreted protein
      was purified to a single band of 14,000 Da on SDS-PAGE, by means of cation
      exchange chromatography and reverse-phase HPLC. N-terminal amino acid sequence
      analysis revealed that the recombinant protein was recognized and cleaved at the
      signal sequence in the insect cell. The purified enzyme had almost the same
      specific enzyme activity, substrate specificity, pH optimum, Ca2+ ion dependency,
      and kinetic values as those of the natural enzyme.

PMID- 7798191
TI  - Nitric oxide reductase cytochrome P-450 gene, CYP 55, of the fungus Fusarium
      oxysporum containing a potential binding-site for FNR, the transcription factor
      involved in the regulation of anaerobic growth of Escherichia coli.
AB  - A unique cytochrome P-450 (P-450) is involved in fungal denitrification, acting
      as a nitric oxide reductase. The phylogenetic classification of the P-450 (P
      450nor) into the group of bacterial P-450s along with its involvement in the
      anaerobic process are of evolutional interest. The corresponding gene, CYP 55, of
      the fungus Fusarium oxysporum was isolated and sequenced. The P-450nor gene
      contained 7 introns that consisted of 49 to 55 bp. The presence of the introns
      suggested that horizontal transfer of the gene from bacteria to the fungus, if it
      has occurred, was an early event in evolution. Besides a TATA box, several
      inverted repeats were found in the 5'-upstream flanking region. One inverted
      repeat exhibited the same sequence as the binding site of FNR (fumarate and
      nitrate reduction), a DNA-binding, O2 (dioxygen)-sensor protein that positively
      regulates expressions of many hypoxic genes in Escherichia coli and other
      bacteria. The result suggested that the expression of P450nor is regulated in
      response to oxygen tension by an FNR-like system. Northern blot analyses showed
      that both nitrate and nitrite are the actual inducers of P-450nor and that its
      expression is predominantly regulated at the transcriptional level. These results
      raise the interesting possibility that the expression of the fungal
      denitrification system is regulated, as in the case of bacterial nitrate
      respiration, by a set of mechanisms, i.e., a combination of an FNR-like system
      and a system responding to nitrate/nitrite.

PMID- 7798192
TI  - X-ray crystallographic study of pyridoxal 5'-phosphate-type aspartate
      aminotransferases from Escherichia coli in open and closed form.
AB  - We determined the three-dimensional structures of aspartate aminotransferase
      (AspAT) from Escherichia coli and its complex with inhibitor (2-methyl-L
      aspartate) at 1.8A resolution. This enzyme reversibly catalyzes the
      transamination reaction and is a dimer of two identical subunits. Each subunit
      has 396 amino acid residues and one pyridoxal 5'-phosphate as a cofactor, and is
      divided into two domains, one large and the other small. Upon binding of the
      inhibitor, the small domain rotates by 5 degrees toward the large domain to close
      the active site. This domain movement is caused mainly by small but important
      main-chain conformational changes in the residues located over the domain
      interface of the small domain. In chicken mitochondrial AspAT, the domain
      movement was larger, with a rotational angle of 13 degrees. By comparison of
      these two structures, the difference in the rotational angles was found to be
      caused by the larger opening of the domain in the open form of chicken
      mitochondrial AspAT. Although the overall structures of these two enzymes were
      almost identical, the surface area of the domain interface in the E. coli enzyme
      was larger than that in mitochondrial AspAT, suggesting that the structure of the
      domain interface is responsible for the degree of movement of the small domain.

PMID- 7798193
TI  - Platelet-derived growth factor receptor signals.

PMID- 7798194
TI  - A region in Shc distinct from the SH2 domain can bind tyrosine-phosphorylated
      growth factor receptors.
AB  - Shc is a ubiquitously expressed Src homology 2 (SH2) domain protein that can
      transform fibroblasts and differentiate PC12 cells in a Ras-dependent fashion.
      Shc binds a variety of tyrosine-phosphorylated growth factor receptors presumably
      via its carboxyl-terminal SH2 domain. We cloned a fragment of Shc when screening
      a bacterial expression library with tyrosine-phosphorylated epidermal growth
      factor (EGF) receptor. Surprisingly, this fragment encodes the amino terminus of
      Shc, a region that has no significant similarity to an SH2 domain. When expressed
      as a glutathione S-transferase fusion protein, this amino-terminal domain binds
      to autophosphorylated EGF receptor, as well as HER2/neu and TrkA receptors. This
      fragment acts like an SH2 domain in that it does not bind non-phosphorylated EGF
      receptor or EGF receptor with all tyrosine phosphorylation sites mutated or
      deleted. Our data define a novel domain in Shc that has the potential to interact
      with growth factor receptors and other tyrosine-phosphorylated proteins.

PMID- 7798195
TI  - Identification of the major chromaffin granule-binding protein, chromobindin A,
      as the cytosolic chaperonin CCT (chaperonin containing TCP-1).
AB  - Chromobindin A is a multisubunit complex ATPase that binds to chromaffin granule
      membranes in a calcium-dependent manner and requires ATP for release from the
      membrane (Martin, W. H., and Creutz, C. E. (1987) J. Biol. Chem. 262, 2803-2810).
      Here we report that the seven previously characterized subunits of chromobindin A
      cross react with antisera specific to subunits of CCT, the chaperonin containing
      TCP-1 (Kubota, H., Hynes, G., Carne, A., Ashworth, A., and Willison, K. (1994)
      Curr. Biol. 4, 89-99). The chromobindin A subunits previously called
      chromobindins 12, 13, 14, 15, 16, 18, and 19 cross-react specifically with
      subunits beta, delta, theta, alpha, zeta, xi, and gamma, respectively, of CCT.
      Additional similarities in subunit molecular weights, isoelectric points, and the
      morphologies of the two protein complexes as determined by electron microscopy
      support identification of chromobindin A as an adrenal medullary form of CCT. The
      chromobindin A/CCT complex was found to bind at least 7-fold more efficiently to
      affinity columns of chromaffin granule membranes than of adrenal medullary
      cytosol proteins, suggesting a specific interaction occurs between the complex
      and membrane components. The results indicate that the previously described
      characteristics of chromobindin A are likely to be relevant to the functions of
      CCT and suggest that the adrenal medullary form of CCT may play a role in the
      activities of secretory vesicle membranes.

PMID- 7798196
TI  - Evidence of a self-catalytic mechanism of 2,4,5-trihydroxyphenylalanine quinone
      biogenesis in yeast copper amine oxidase.
AB  - Copper amine oxidases are representative of a new class of redox enzymes that
      contain a peptide-bound quinone cofactor, generated by posttranslational
      modification of amino acid side chain(s). We have investigated the mechanism for
      the biogenesis of 2,4,5-trihydroxyphenylalanine quinone (TPQ) in amine oxidase
      with two site-specific mutants of the yeast methylamine oxidase. Our results show
      that the capacity for TPQ formation in vivo is abolished when a putative ligand
      to copper, His-456, is changed to Asp; this H456D mutant binds copper at a low
      level (approximately 4.1%), relative to the wild-type protein. In contrast,
      altering the active site consensus sequence that contains the precursor tyrosine
      does not affect TPQ production. The data implicate a self-catalysis mechanism for
      TPQ biogenesis, in which the protein-bound copper plays a key role. We propose
      that the minimal information required for TPQ biogenesis lies in a structural
      motif consisting of the copper site and the precursor tyrosine.

PMID- 7798197
TI  - The cytotoxic T cell proteinase granzyme B does not activate interleukin-1 beta
      converting enzyme.
AB  - Murine granzyme B (cytotoxic cell proteinase-1 (CCP1)) is a member of a family of
      seven serine proteases found in cytoplasmic granules of cytotoxic T lymphocytes
      (CTLs). Evidence has suggested that it is involved in target cell DNA
      fragmentation during CTL-mediated cytotoxicity, although intracellular substrates
      for granzyme B have not yet been identified. The substrate specificity of
      granzyme B, requiring an aspartic acid residue at site P1, is unique among
      eukaryotic serine proteases and is shared with only one other known eukaryotic
      protease, interleukin-1 beta-converting enzyme (ICE). ICE is responsible for
      processing pro-interleukin-1 beta to produce biologically active interleukin-1
      beta and is itself synthesized as an inactive precursor. Recent evidence has
      suggested a role for ICE in programmed cell death, which led to a model for CTL
      mediated cytotoxicity. In this proposal granzyme B activates ICE in the target
      cell by proteolytically processing the ICE precursor, resulting in active ICE
      heterodimer that induces apoptosis in the target cell. We have isolated the cDNA
      encoding murine ICE and generated in vitro translated ICE precursor. Using
      lysates from COS cells expressing granzyme B we show that ICE precursor is not a
      substrate for granzyme B and propose an alternate mechanism for CTL-mediated
      cytotoxicity.

PMID- 7798198
TI  - Depletion of intracellular Ca2+ stores activates a maitotoxin-sensitive
      nonselective cationic current in beta-cells.
AB  - Glucose stimulation of beta-cell insulin secretion is initiated by membrane
      depolarization coupled with an elevation in intracellular Ca2+ concentration
      ([Ca2+]i). Both depolarization-dependent Ca2+ entry and intracellular Ca2+ store
      release contribute to the sugar-induced rise in [Ca2+]i. Here we show that
      maneuvers depleting intracellular Ca2+ stores induce membrane depolarization and
      a sustained nitrendipine-sensitive Ca2+ influx, whereas interventions promoting
      Ca2+ store refilling produce a hyperpolarization and inhibit Ca2+ influx. Both
      intracellular Ca2+ store depletion and maitotoxin activated a depolarizing
      nonselective cation current carried principally by Na+ in the physiological range
      of membrane potentials. The activation of such a current may form the paradigm by
      which excitable cells refill depleted intracellular Ca2+ stores by depolarization
      driven opening of voltage-activated Ca2+ channels.

PMID- 7798199
TI  - A helical element in the C-terminal domain of the N. plumbaginifolia F1 beta
      presequence is important for recognition by the mitochondrial processing
      peptidase.
AB  - The mitochondrial processing peptidase (MPP) in lower eucaryots and mammals is a
      matrix enzyme, whereas MPP in plants constitutes an integral part of the bc1
      complex of the respiratory chain. The isolated spinach leaf bc1 complex catalyzes
      cleavage of the precursor of Nicotiana plumbaginifolia F1 beta subunit of the ATP
      synthase, resulting in a production of mature protein and a presequence that
      consists of 54 amino acids. A synthetic peptide derived from the C-terminal part
      of the presequence, containing 17 amino acids with a helical structural element,
      p-F1 beta(38-54), was an efficient inhibitor of the processing, whereas a peptide
      derived from the N-terminal part of the presequence, p-F1 beta(1-18), was much
      less effective. ATIII, a helical peptide derived from antithrombin III, was not
      recognized by MPP. Synthetic peptides corresponding to 4, 6, and 11 amino acids
      of the C terminus of the presequence, p-F1 beta(51-54), p-F1 beta(49-54), and p
      F1 beta(44-54) were almost completely inert. Competition studies show that MPP
      recognizes the C-terminal domain of the presequence rather than the N-terminal
      domain. Furthermore, the alpha-helical element of the C-terminal domain is shown
      to be required for the recognition event.

PMID- 7798200
TI  - Biochemical and genetic characterization of PepF, an oligopeptidase from
      Lactococcus lactis.
AB  - Lactococcus lactis possesses a complex proteolytic system which is essential for
      its growth in milk. We characterized one of the peptidases of this system,
      oligopeptidase PepF, together with its structural gene. PepF hydrolyzed peptides
      containing between 7 and 17 amino acids with a rather wide specificity. It was
      purified to homogeneity. The N-terminal sequences of PepF and of peptides
      resulting from tryptic digestion of PepF were determined and used to design
      degenerate oligonucleotides which served to amplify a DNA fragment internal to
      pepF. This fragment was used as a probe to screen a lactococcal genomic library
      in Escherichia coli and to clone the entire gene pepF. The gene coded for a 70
      kDa protein and was located on a 55-kilobase lactose-protease plasmid. A motif
      His-Glu-X-X-His, characteristic of metallopeptidases was evidenced. Two regions
      of PepF were found similar, first to a stretch of 43 amino acids around the zinc
      binding site of several other peptidases, second to a stretch of 33 amino acids
      well conserved among creatine and arginine kinases. Preliminary results suggest
      the presence of a second copy of pepF.

PMID- 7798201
TI  - Species difference in the G protein selectivity of the human and bovine A1
      adenosine receptor.
AB  - The purified bovine brain A1-adenosine receptor has previously been shown to
      discriminate among closely related G protein alpha-subunits. To obtain analogous
      information for the human receptor, the cDNA coding for the human A1-adenosine
      receptor was inserted into a plasmid placing the synthesis of the receptor
      protein under the control of the MalE promoter. Following induction by maltose,
      active receptor accumulated in Escherichia coli membranes. Binding of the
      antagonist 8-[3H]cyclopentyl-1,3-dipropylxanthine to E. coli membranes (KD
      approximately 2 nM, Bmax approximately 0.2-0.4 pmol/mg) showed the appropriate
      pharmacological profile. Incubation of E. coli membranes with purified Go,i
      reconstituted guanine nucleotide-sensitive high affinity binding of the agonist (
      )[125I] N6-3-(iodo-4-hydroxyphenylisopropyl)adenosine to the receptor (KD
      approximately 1 nM). In the presence of purified beta gamma-subunit, the
      recombinant receptor interacted equally well with the recombinant G protein alpha
      subunits Gi alpha-1, Gi alpha-2, Gi alpha-3; G(o) alpha displayed a lower
      affinity for the receptor while Gs alpha was inactive. Parallel experiments were
      carried out in bovine and human brain membranes pretreated with N-ethylmaleimide
      to inactivate the endogenous G(o)/Gi proteins; Gi alpha-3 was most potent in
      reconstituting 125I-HPIA binding to bovine membranes, while Gi alpha-1, Gi alpha
      2, and G(o) alpha displayed similar affinities. However, in human membranes, Gi
      alpha-1, Gi alpha-2, and Gi alpha-3, were equipotent and high concentrations of
      G(o) alpha were required to promote 125I-HPIA binding. These observations show
      (i) that functional human A1-adenosine receptors were synthesized in E. coli;
      (ii) that the pattern of G protein coupling is identical for the recombinant
      human A1-receptor and its counterpart in the native membrane; (iii) and that
      species differences between bovine and human receptor exist not only in their
      pharmacological profile but also in their G protein specificity suggesting that
      species homologues of receptors may use different signaling mechanisms.

PMID- 7798202
TI  - Purification and properties of protoporphyrinogen oxidase from the yeast
      Saccharomyces cerevisiae. Mitochondrial location and evidence for a precursor
      form of the protein.
AB  - Protoporphyrinogen oxidase, the molecular target of diphenylether-type
      herbicides, was purified to homogeneity from yeast mitochondrial membranes and
      found to be a 55-kDa polypeptide with a pI of 8.5 and a specific activity of
      40,000 nmol of protoporphyrin/h/mg of protein at 30 degrees C. The Michaelis
      constant (Km) for protoporphyrinogen IX was 0.1 microM. Due to the high affinity
      of the enzyme toward oxygen, the Km for oxygen could only be approximated to 0.5
      1.5 microM. The purified enzyme contained a flavin as cofactor. Studies with
      rabbit antibodies to yeast protoporphyrinogen oxidase showed that the enzyme is
      synthesized as a high molecular weight precursor (58 kDa) that is rapidly
      converted in vivo to the mature (55 kDa) membrane-bound form. Protoporphyrinogen
      oxidase activity was found only in purified yeast mitochondrial inner membrane
      (not in the outer membrane). Acifluorfen-methyl, a potent diphenylether-type
      herbicide, competitively inhibited the purified enzyme (Ki = 10 nM). The mixed
      inhibition by acifluorfen-methyl previously reported for the membrane-bound
      protoporphyrinogen oxidase (Camadro, J.M., Matringe, M., Scalla, R., and Labbe,
      P. (1991) Biochem. J. 277, 17-21) was shown to be related to partial proteolysis
      of the enzyme.

PMID- 7798203
TI  - Molecular cloning of a mammalian hyaluronidase reveals identity with hemopexin, a
      serum heme-binding protein.
AB  - Hyaluronan is the most abundant glycosaminoglycan of the extracellular matrix and
      is a critical substrate for cellular attachment and locomotion. Little is known
      about the class of enzymes, termed hyaluronidases, that are responsible for
      hyaluronan catabolism in mammals. We have determined a partial amino acid
      sequence from a purified preparation of porcine liver hyaluronidase and have used
      this information as the basis for cloning complementary DNA that encodes the
      corresponding protein. When expressed in a recombinant baculovirus system, the
      protein exhibited hyaluronidase activity in a substrate-gel assay. The deduced
      sequence of this mammalian hyaluronidase is that of a 459-amino-acid polypeptide
      bearing four potential N-glycosylation sites as well as a copy of a proposed
      hyaluronan binding motif. Remarkably, amino acid sequence comparisons and
      immunologic cross-reactivities strongly suggest that the cloned protein is
      identical to hemopexin, an abundant, heme-binding serum protein. Although
      hemopexin has not previously been reported to possess any enzymatic activity, it
      includes a conserved domain found in collagenases, stromelysins, and other
      enzymes that metabolize the extracellular matrix. We conclude that hemopexin is
      the predominant hyaluronidase expressed in mammalian liver.

PMID- 7798204
TI  - Glucose deprivation and acute cycloheximide treatment stimulate system L amino
      acid transport in cultured vascular smooth muscle cells.
AB  - The effect of glucose deprivation on the uptake of leucine has been examined in
      cultured vascular smooth muscle cells isolated from rat aortae. Equimolar
      substitution of sucrose or fructose for glucose in the culture medium enhanced
      the uptake of leucine in a time- and concentration-dependent manner. The effect
      was first detectable after 12 h and reached the maximum, 2-fold, after 48 h with
      an apparent half-maximal effect at 1 mM glucose and could be reversed after 48 h
      of glucose refeeding. The enhanced leucine uptake was completely inhibited by 2
      amino-2-norbornane-carboxylic acid, a specific substrate for System L, but not by
      alpha-(methylamino)isobutyric acid or lysine. Kinetic analyses indicated that
      this stimulation was mediated via a homogenous system with a 1.7-fold increase in
      the Vmax without any change in the Km (0.15 mM). Prolonged treatments with
      cycloheximide (10 micrograms/ml) or actinomycin D (10 micrograms/ml) blocked this
      glucose deprivation effect and its reversal. However, cycloheximide also very
      rapidly stimulated leucine uptake, reaching the maximum, 2.5-fold over the basal
      at 1 h. This effect occurred at concentrations that matched its inhibition on
      protein synthesis (half-maximal at 0.1 micrograms/ml) and could be reproduced
      with puromycin as well as actinomycin D. The stimulatory effect of cycloheximide
      was also accompanied by an increase in the Vmax but not in the Km, being
      sensitive to 2-amino-2-norbornane-carboxylic acid inhibition only, and appeared
      to occur in an additive manner to that of glucose deprivation. Although the
      uptake of leucine was stimulated by glucose deprivation and brief exposure to
      cycloheximide, these treatments had no effect on the efflux of the substrate.
      These results are all consistent with the System L amino acids transport activity
      in cultured rat vascular smooth muscle cells being under the control of at least
      two non-hormonal regulatory mechanisms, one that is likely to involve a labile
      repressor molecule and the other involving de novo protein synthesis as a result
      of chronic glucose deprivation.

PMID- 7798205
TI  - Smooth muscle caldesmon controls the strong binding interaction between actin
      tropomyosin and myosin.
AB  - We have demonstrated that caldesmon does not alter the affinity of weak binding
      actomyosin complexes when it inhibits actin-tropomyosin activation at
      physiological ratios (1 per 14 actins), and we proposed that it acts upon the
      strong binding complexes in the same way that troponin-tropomyosin does. We
      therefore compared the effect of caldesmon, caldesmon fragments, and troponin
      upon the interaction of the strongly bound complexes S-1.ADP, S-1.adenylyl
      imidodiphosphate (AMP.PNP), and N-ethylmaleimide-treated myosin subfragment-1
      (NEM-S-1) with actin-tropomyosin. In 0.17 M ionic strength buffer
      [14C]iodoacetamide-labeled S1.ADP bound to actin-smooth muscle tropomyosin with
      no evidence of cooperativity; Kd = 0.8 +/- 0.3 microM (n = 5). Inhibitory
      concentrations of sheep aorta caldesmon or rabbit skeletal muscle troponin made
      the binding highly cooperative. At low levels of saturation the apparent Kd was
      10-40 microM with 10 microM caldesmon and 8-20 microM with 6 microM troponin; at
      > 50% saturation the binding was indistinguishable from actin-tropomyosin alone.
      A similar result was obtained for the binding of [14C]iodoacetamide-labeled S
      1.AMP.PNP to actin-smooth muscle tropomyosin at 0.03 M ionic strength (Kd = 0.47
      +/- 0.05 microM). Binding was slightly cooperative and became highly cooperative
      in the presence of inhibitory concentrations of troponin, caldesmon, and the
      human caldesmon fragments H7 (amino acids 622-767) and H9 (amino acids 726-793).
      We conclude that caldesmon and troponin both act as allosteric effectors of the
      "on"/"off" equilibrium of actin-tropomyosin. 0.1 NEM-S-1/actin potentiated actin
      smooth muscle tropomyosin activation of myosin MgATPase 7-fold at 0.03 M ionic
      strength. Caldesmon inhibited the ATPase in the presence and absence of 0.5
      microM NEM-S-1. NEM-S-1 reactivated actin-tropomyosin, which had been inhibited
      by troponin, caldesmon, H7, or H9. This is compatible with opposing effects of
      NEM-S-1 and caldesmon or troponin upon the actin-tropomyosin on/off equilibrium.

PMID- 7798206
TI  - Discrete structural domains determine differential endoplasmic reticulum to Golgi
      transit times for glucose transporter isoforms.
AB  - The rate of movement of the glucose transporter isoforms Glut1 and Glut4 from the
      endoplasmic reticulum (ER) to the Golgi apparatus was investigated by pulse
      labeling and monitoring endoglycosidase H resistance in mRNA-injected Xenopus
      oocytes and in 3T3-L1 adipocytes, a cell line that naturally expresses both
      transporter isoforms. Despite their high degree of sequence identity, Glut1 and
      Glut4 exhibited dramatically different transit times. The t1/2 values for ER to
      Golgi transit for Glut1 and Glut4 were < 1 and 24 h, respectively, in oocytes and
      approximately 5 and 20 min, respectively, in 3T3-L1 adipocytes. Pulse-chase in
      conjunction with sucrose density gradient analysis revealed that the rate
      limiting step in the ER to Golgi processing of Glut4 was exit from the ER and not
      retention in an early Golgi compartment. We analyzed the biosynthesis of
      Glut1/Glut4 chimeric transporters in Xenopus oocytes in order to determine
      whether specific domains in Glut1 and Glut4 were responsible for their distinct
      transit times. The first exofacial glycosylated loop and the cytoplasmic carboxyl
      terminal domain of Glut4 were crucial for its delayed exit from the ER. The first
      transmembrane, the first exofacial, and the cytoplasmic COOH-terminal domains of
      Glut1 were largely responsible for Glut1's rapid processing in the ER. Some of
      the chimeric transporters were not fully processed. Approximately 50% of chimeric
      molecules containing the cytoplasmic COOH-terminal domain of Glut1 and either the
      first transmembrane or first exofacial domain of Glut4 were retained in early
      Golgi compartments and prevented from complete maturation. Normal processing of
      these chimeras was achieved by replacing the cytoplasmic COOH-terminal domain of
      Glut1 with that of Glut4. These data suggest that amino acid residues within the
      glycosylated exofacial loop and the cytoplasmic COOH terminus participate in a
      rate-limiting step in the folding of both Glut1 and Glut4 or could act as
      transient ER retention signals. Additionally, these results show that even
      chimeric molecules constructed from two highly homologous proteins can exhibit
      aberrant folding and post-translational processing.

PMID- 7798208
TI  - Biochemical mechanism of HIV-1 Vpr function. Oligomerization mediated by the N
      terminal domain.
AB  - The human immunodeficiency virus, type 1 (HIV-1) genome encodes a 15-kDa
      accessory gene product, Vpr, that is essential for virus replication in primary
      monocytes/macrophages. Being present in the virion, Vpr is believed to function
      in the early phases of HIV-1 replication, including nuclear migration of the pre
      integration complex and/or transcription of the provirus genome. By gel
      filtration analysis of highly purified Vpr protein and its mutants, we
      demonstrate that HIV-1 Vpr exists as an oligomer. The N-terminal domain of Vpr
      (amino acids (aa) 1-42) is sufficient for oligomerization; however, deletion of
      aa 36-76 from Vpr disrupts oligomerization, suggesting that aa 36-42 are critical
      for Vpr oligomerization. As a result of Vpr oligomerization, basic aa residues
      within Vpr aa 1-73 are highly resistant to trypsin digestion, while those within
      Vpr aa 74-96 are easily accessible. Mutations within the leucine-/isoleucine-rich
      domain (aa 60-81), which was previously identified to be involved in Vpr
      interaction with a host cellular protein, rendered Arg62 more susceptible to
      trypsin digestion. Thus, the Vpr oligomeric structure must be extended into this
      domain. These results suggest a novel feature of HIV-1 Vpr that may be important
      for its functions.

PMID- 7798209
TI  - Characterization of a deaminated neuraminic acid-containing glycoprotein from the
      skin mucus of the loach, Misgurnus anguillicaudatus.
AB  - Using NMR spectroscopy and mass spectrometry, the major sialic acid of the skin
      mucus of the loach, Misgurnus anguillicaudatus was found to be 3-deoxy-D-glycero
      D-galacto-2-nonulosonic acid (KDN). We have subsequently devised a method to
      isolate a KDN-containing glycoprotein preparation from loach skin mucus. The
      method involves the sonication of the skin mucus with 0.05 M Tris-HCl, pH 8.0, to
      solubilize the glycoprotein, followed by DE52-cellulose chromatography of the
      extract, Nuclease P1 treatment, and Sepharose CL-4B gel filtration. The purified
      glycoprotein preparation was found to contain 38.5% KDN, 0.4% NeuAc, 24.6%
      GalNAc, 3.3% Gal, and 28.2% amino acids (w/w). The amino acid composition of this
      glycoprotein preparation revealed that it is unusually rich in Thr, and 6 amino
      acids, Thr, Ser, Glu (or Gln), Pro, Gly and Ala, account for 83% of the total
      amino acids. This glycoprotein is extremely poor in Cys, Met, Tyr, Phe, Arg, and
      Trp. Treatment of this glycoprotein with alkali resulted in the destruction of
      83% of Thr suggesting that most of the sugar chains in this glycoprotein are
      linked through Thr. Alkaline borohydride treatment of 100 mg of the glycoprotein
      preparation, followed by Sephadex G-25 (superfine) gel filtration, yielded two
      major oligosaccharide alditols, I (15.4 mg) and II (15.6 mg). Using liquid
      secondary ion mass spectrometry and methylation analysis, I was identified to be
      KDN alpha 2-->6GalNAc-ol and II, KDN alpha 2-->6(KDN alpha 2-->3)-GalNAc-o1. KDN
      alpha 2-->6GalNAc is structurally similar to NeuAc alpha 2-->GalNAc found in
      ovine submaxillary glycoprotein while II represents a novel structure which
      contains two sialic acids linked to a GalNAc through both alpha 2-->3 and alpha 2
      ->6 linkages. This structure has never been found in mucin type glycoproteins
      including mammalian epithelial mucin glycoproteins. This is the first report of
      the presence of a mucin type glycoprotein which contains KDN instead of NeuAc or
      NeuGc in fish skin mucus.

PMID- 7798207
TI  - Cloning, sequence analysis, and expression of the genes encoding the two subunits
      of the methylotrophic bacterium W3A1 electron transfer flavoprotein.
AB  - The genes encoding the two different subunits of the electron transfer
      flavoprotein (ETF) from the methylotrophic bacterium W3A1 have been identified,
      cloned, and sequenced. A 0.8-kilobase pair DNA fragment was generated for use as
      a molecular probe by the amplification of genomic sequences using the polymerase
      chain reaction and a primer pair with degenerate sequences derived from the NH2
      terminal amino acid sequences determined for the ETF subunits purified from W3A1.
      The screening of a partial genomic minilibrary containing size-selected BamHI
      SalI fragments using this probe identified a 2.2-kilobase pair insert containing
      the complete coding sequences for both W3A1 ETF subunits. The genes are arranged
      in tandem in the genomic DNA with only 2 bases between the TAG translation
      termination codon of the small subunit and the ATG translation initiation codon
      of the large subunit. The deduced amino acid sequences of each of the W3A1 ETF
      subunits exhibit only approximately 30% identity with the corresponding subunits
      of the ETF from human, rat, and Paracoccus denitrificans, which as a group are
      greater than 50% identical. Thus, the ETF from W3A1 may exhibit some unique
      structural features that, like other differences in some of its physical and
      functional properties, may distinguish this ETF from others in this family. A
      highly homologous region near the COOH terminus of the large subunit in all the
      ETF proteins was found to contain a sequence that matches in several ways the ADP
      binding motif of flavoproteins and other dinucleotide-binding proteins,
      suggesting that the large subunit forms a portion of the FAD (or AMP) binding
      site in these proteins. Under control of the tac promoter, the cloned ETF subunit
      genes were co-expressed in Escherichia coli producing the heterodimeric
      holoprotein with physical, spectral, and electron-accepting properties
      essentially identical to the ETF isolated from W3A1. The recombinant ETF serves
      as the electron acceptor for W3A1 trimethylamine dehydrogenase in vitro,
      accumulating as the air-stable anionic semiquinone in the presence of excess
      trimethylamine. Fully reduced ETF could not be obtained even after prolonged
      enzymatic reduction.

PMID- 7798211
TI  - The stability of the molecular chaperonin cpn60 is affected by site-directed
      replacement of cysteine 518.
AB  - Cysteine 518 of the molecular chaperonin cpn60 (groEL) has been replaced with
      serine (C518S) by site-directed mutagenesis. The resulting mutant chaperonin
      protein is still functional and it can: (a) arrest the spontaneous folding of
      rhodanese in the absence of GroES and ATP, (b) assist refolding of the enzyme
      rhodanese in the presence of GroES and ATP/Mg2+, and (c) permit the urea-induced
      release and refolding of rhodanese from its complex with cpn60. ATP/Mg2+, alone,
      could discharge active rhodanese from cpn60 complexes formed with either wild
      type or C518S. In contrast with wild type cpn60, C518S has: (a) reduced stability
      of its quaternary structure, (b) reduced ability to reassemble tetradecamers
      after dissociation by urea; (c) reduced ATPase activity; and (d) more easily
      exposed hydrophobic surfaces. The data suggest that replacement of Cys-518 with
      Ser in cpn60 destabilizes its oligomeric structure, but there is no significant
      effect on cpn60 function or the stability of the monomers formed in urea.

PMID- 7798210
TI  - Analysis of an invariant cofactor-protein interaction in thiamin diphosphate
      dependent enzymes by site-directed mutagenesis. Glutamic acid 418 in
      transketolase is essential for catalysis.
AB  - A homologous expression system and a purification protocol for pure, highly
      active recombinant yeast transketolase have been developed. The invariant
      transketolase residue Glu418, which forms a hydrogen bond to the N-1' nitrogen
      atom of the pyrimidine ring of the cofactor thiamin diphosphate has been replaced
      by glutamine and alanine. Crystallographic analyses of the mutants show that
      these amino acid substitutions do not induce structural changes beyond the site
      of mutation. In both cases, the cofactor binds in a manner identical to the wild
      type enzyme. Significant differences in the CD spectra of the mutant
      transketolases compared with the spectrum of wild-type enzyme indicate
      differences in the electron distribution of the aminopyrimidine ring of the
      cofactor. The E418Q mutant shows 2% and the E418A mutant shows about 0.1% of the
      catalytic activity of wild-type enzyme. The affinities of the mutant enzymes for
      thiamin diphosphate are comparable with wild-type transketolase. The hydrogen
      bond between the coenzyme and the side chain of Glu418 is thus not required for
      coenzyme binding but essential for catalytic activity. The results demonstrate
      the functional importance of this interaction and support the molecular model for
      cofactor deprotonation, the first step in enzymatic thiamin catalysis.

PMID- 7798213
TI  - Structural and functional analysis of NF-kappa B. Determinants of DNA binding
      specificity and protein interaction.
AB  - The NF-kappa B transcription factors display a high degree of sequence
      conservation in a domain initially described in the rel oncogene. Two family
      members, NF-kappa B1 and NF-kappa B2, have distinct DNA binding properties and
      functionally distinct effects on different enhancers. NF-kappa B1, for example,
      binds to the kappa B site from the human immunodeficiency virus (HIV) with
      approximately 15-fold higher affinity than NF-kappa B2. In this study, we have
      defined regions within the Rel domain which determine DNA binding specificity and
      interaction with other proteins. We find that the COOH-terminal putative Rel
      dimerization domain of NF-kappa B1 is required for preferential binding to the
      HIV kappa B site. In contrast, preferential stimulation of the HIV enhancer by NF
      kappa B2 with RelA(p65) is determined by both the NH2- and COOH-terminal Rel
      domains of NF-kappa B2. These two regions of NF-kappa B2 also mediate
      preferential synergy with Bcl3. These data suggest that a specific subdomain of
      the Rel conserved region has evolved to control the fine specificity of DNA
      binding, and two distinct subregions within the Rel domain determine the
      specificity of interaction with other transcription factors. These specific Rel
      conserved domains therefore determine the specificity of NF-kappa B interactions
      and contribute to selective gene activation.

PMID- 7798212
TI  - Isolation and characterization of HL-60 cells resistant to nitroprusside-induced
      differentiation.
AB  - Sodium nitroprusside and sodium nitrite, which generate nitric oxide and increase
      the intracellular cGMP concentration, and 8-bromo-cGMP, a membrane-permeable cGMP
      analog, induce myelomonocytic differentiation of HL-60 cells (Boss, G. R. (1989)
      Proc. Natl. Acad. Sci. U. S. A. 86, 7174-7178). We have selected HL-60 cells
      resistant to nitroprusside-induced differentiation as assessed by acquisition of
      the OKM-1 antigen, reduction of nitro blue tetrazolium, and morphologic
      maturation. The variant cells were also resistant to differentiation induced by
      sodium nitrite and two cGMP analogs but still differentiated in response to other
      inducing agents such as dimethyl sulfoxide and cAMP analogs and showed the same
      changes in c-myc and c-fos expression in response to the latter drugs as occurred
      in parental cells. We studied the early steps of the NO/cGMP signal transduction
      pathway in the variant cells and found that basal and nitroprusside-stimulated
      guanylate cyclase activity was similar in parental and variant cell extracts and
      that nitroprusside increased the intracellular cGMP concentration to the same
      extent in parental and variant cells. As part of these studies we found that HL
      60 cells expressed only alpha 2 and beta 2 guanylate cyclase mRNA; the abundance
      of these two mRNA species was similar in parental and variant cells. Neither
      nitroprusside nor 8-bromo-cGMP changed the intracellular calcium concentration in
      parental or variant cells. The data suggest that the defect in the variant cells
      is after guanylate cyclase activation in the NO/cGMP transduction pathway and
      that the cGMP and cAMP transduction pathways operate independently in inducing
      differentiation of HL-60 cells.

PMID- 7798215
TI  - Investigation of the active site and the conformational stability of nucleoside
      diphosphate kinase by site-directed mutagenesis.
AB  - Nucleoside-diphosphate kinase (EC 2.7.4.6) catalyzes phosphate exchange between
      nucleoside triphosphates and nucleoside diphosphates. Its 17 kDa subunits are
      highly conserved throughout evolution in both sequence and tertiary structure.
      Using site-directed mutagenesis we investigated the function of 8 amino acids
      (Lys16, Tyr56, Arg92, Thr98, Arg109, Asn119, Ser124, and Glu133) that are totally
      conserved among all nucleoside diphosphate kinases known to date. The mutant
      proteins all show decreased specific activity and support roles for these
      residues in catalysis, substrate binding, or both, as was previously proposed on
      the basis of the x-ray structure (Morera, S., Lascu, I., Dumas, C., LeBras, G.,
      Briozzo, P., Veron, M., and Janin, J. (1994) Biochemistry 33, 459-467).
      Furthermore, residues Lys16, Arg109, and Asn 119 were identified to play
      important roles in conformational stability or subunit interactions. We show that
      Lys16 and Asn119 form a rigid structure that is important for enzymatic function
      and that Arg109, known to interact with the phosphate moiety of the substrate,
      also plays an important role in subunit association. The dual roles of Lys16,
      Arg109, and Asn119 in both substrate binding and subunit assembly provide further
      evidence for a functional coupling between catalytic activity and quaternary
      structure in nucleoside diphosphate kinase.

PMID- 7798216
TI  - Functional and molecular characterization of the transcriptional regulatory
      region of the proacrosin gene.
AB  - Proacrosin, the zymogen form of the serine protease acrosin, is located within
      the acrosomal vesicle of mammalian spermatozoa and has been suggested to be
      involved in the fertilization process. In mouse and rat, expression of the
      proacrosin gene starts in pachytene spermatocytes and continues through the early
      stages of spermiogenesis. We have shown recently that 2.3 kilobase pairs of the
      5'-flanking region of the rat proacrosin gene is sufficient to direct
      chloramphenicol acetyltransferase gene expression in a germ cell-specific and
      developmental stage-specific manner in the mouse. Additional transgenic lines
      have been generated which include two deletions in the 5'-flanking region and a
      tyrosinase minigene as marker for gene expression. Transgenic mice bearing these
      two truncated fragments showed different patterns of reporter gene expression.
      Transgenic lines (BM, B3, B2) harboring the 397-base pair (bp) fragment (from 45
      to 442 bp upstream of ATG) showed no chloramphenicol acetyltransferase (CAT)
      activity in either testis or other tissues, but analysis via reverse
      transcription polymerase chain reaction confirmed low levels of reporter gene
      transcription in testis. Transgenic line TC bearing a longer fragment of 877 bp
      (from 45 to 922 bp upstream of ATG) showed a reporter gene expression and
      chloramphenicol acetyltransferase enzyme activity which was identical to that
      found in mice harboring the 2.3-kilobase pair 5'-flanking region. The analysis of
      the CAT gene expression during testicular development showed diploid
      transcription and haploid translation. It can be concluded that all sequences
      required for a basic level of testis-specific transcription of transgene are
      present within the 397-bp fragment, and other DNA sequences located outside of
      the 397-bp fragment but present within the 877-bp fragment can function as
      enhancer elements. Two fragments within the 877-bp region were identified by gel
      retardation assays as binding exclusively to nuclear factor(s) from testis
      protein extracts. In both fragments we identified sequence elements which are
      present in the promoter region of the germ cell-specific genes for histone H2B
      and protamine 1, respectively.

PMID- 7798214
TI  - Molecular characterization of native and recombinant apolipoprotein A-IMilano
      dimer. The introduction of an interchain disulfide bridge remarkably alters the
      physicochemical properties of apolipoprotein A-I.
AB  - The disulfide-linked dimer of apolipoprotein A-IMilano (A-IM/A-IM), a natural
      Arg173-->Cys variant of apoA-I, was purified from carriers' plasma and produced
      in Escherichia coli. The recombinant A-IM/A-IM is identical to native A-IM/A-IM,
      by mass spectrometry, SDS-polyacrylamide gel electrophoresis, and isoelectric
      focusing. Lipid-free A-IM/A-IM undergoes concentration-dependent self-association
      similar to apoA-I, but at all concentrations apoA-I is more self-associated than
      A-IM/A-IM. Far-ultraviolet CD spectra of A-IM/A-IM reveal a highly alpha-helical
      structure predicted to be approximately 65% in the lipid-free and approximately
      78% in the lipid-associated states, versus 43 and 73% for apoA-I. A significant
      loss of alpha-helix occurs below pH 3.5 and above pH 10 in both apoA-I and A-IM/A
      IM; A-IM/A-IM constantly shows a higher alpha-helical content than apoA-I over
      the entire pH range (1.7-12.8), suggesting that hydrophobic forces stabilize the
      interaction between the two A-IM chains. Indeed, and differently from apoA-I, the
      alpha-helical content of A-IM/A-IM is minimally affected by solvent ionic
      strength. The aromatic side chains in both lipid-free and lipid-bound A-IM/A-IM
      are immobilized in a more asymmetric and hydrophobic environment than in lipid
      free apoA-I, the conformation of A-IM/A-IM being instead similar to that achieved
      by apoA-I following interaction with lipids. The present findings prove that rA
      IM/A-IM is structurally identical to the native protein; the conformation of A
      IM/A-IM is remarkably different from that of apoA-I, thus possibly explaining
      some of the peculiar functional properties of the apoA-IMilano dimer.

PMID- 7798217
TI  - A secondary phosphorylation of CREB341 at Ser129 is required for the cAMP
      mediated control of gene expression. A role for glycogen synthase kinase-3 in the
      control of gene expression.
AB  - The cAMP-dependent protein kinase (PKA) phosphorylates CREB327/341 at a single
      serine residue, Ser119/133, respectively. Phosphorylation at this site creates
      the sequence motif SXXXS(P), a consensus site of the glycogen synthase kinase-3
      (GSK-3) enzyme (Fiol, C.J., Mahrenholz, A.M., Wang, Y., Roeske, R.W., and Roach,
      P.J. (1987) J. Biol. Chem. 262, 14042-14048). We examined the phosphorylation of
      CREB at the SXXXS(P) consensus site and its role in CREB transactivation to cAMP
      induction. Neither isoform of the GSK-3 enzyme (GSK-3 alpha or beta) utilizes
      CREB as its substrate unless CREB is already phosphorylated at Ser119/133. A 13
      amino acid peptide containing the sequence surrounding Ser119/133 was
      phosphorylated by GSK-3, at Ser115/129, only after the primary phosphorylation of
      the peptide by PKA (at Ser119/133), suggesting that Ser115/129 is a GSK-3
      phosphoacceptor site. Mutant CREB327/341 proteins containing Ser-->Ala
      substitutions confirmed Ser115/129 as the only GSK-3 phosphorylation site.
      Transfection assays of wild type and mutant Gal4-CREB fusion proteins in PC12
      cells demonstrated that Ser-->Ala substitution of residue 129 of CREB341 impairs
      the transcriptional response to cAMP induction. Analogous mutation in CREB327
      results in 70% decrease in its transactivation response to cAMP. In
      undifferentiated F9 cells, which are refractory to cAMP induction, transfected
      GSK-3 beta kinase induces a 60-fold increase in cyclic AMP response element
      dependent transcription, mediated via the endogenous CREB protein. We propose
      that the hierarchical phosphorylation at the PKA and GSK-3 sites of CREB are
      essential for cAMP control of CREB.

PMID- 7798218
TI  - Molecular characterization of phagosomes.
AB  - The transformation of newly formed phagosomes into mature phagolysosomes is a
      process that involves a complex series of interactions between phagosomes and
      other vacuolar organelles. The machinery required by phagosomes to mediate these
      interactions is poorly understood. In this study, we allowed human and various
      rodent cells to take up latex beads whose density facilitates a simple
      purification of phagosomes using discontinuous sucrose gradients. With this
      system, we initiated a systematic study of phagosome proteins using two
      dimensional gel electrophoresis and the currently available two-dimensional gel
      protein data bases. By this approach, we were able to recognize a group of
      polypeptides associated with mouse J774 phagosomes-phagolysosomes including
      annexin II, annexin VI, the beta-1 and beta-2 subunits of trimeric G proteins,
      and a group of actin-binding proteins. While the amount of annexin II associated
      to phagosomes was similar at all times of latex internalization, the levels of
      annexin VI were higher on late phagosomes. Phospholipid analysis of J774
      phagosomes isolated at early and late time points during phagolysosome formation
      also revealed significant differences in their lipid composition. In the human
      phagosomes, we resolved over 200 polypeptides on the two-dimensional gels. These
      included the proteins described in the mouse, as well as 32 polypeptides that
      were found to be highly enriched in phagosomes, 15 of which are not present in
      the current data bases. The results demonstrate that the use of latex bead
      phagosomes is a powerful system to identify key molecules involved in
      phagolysosome biogenesis.

PMID- 7798220
TI  - Cleavage of the thyrotropin receptor does not occur at a classical subtilisin
      related proprotein convertase endoproteolytic site.
AB  - The human thyrotropin receptor (TSHR) undergoes proteolytic cleavage closely
      upstream to amino acid 317. Between residues 261 and 313 are three clusters of
      positively charged amino acids, arginines (Arg) and lysines (Lys), which are
      potential subtilisin-related proprotein convertase sites. We used oligonucleotide
      directed mutagenesis to perform conservative amino acid substitutions within
      these regions (Arg or Lys to glutamine, Gln). Chinese hamster ovary cells stably
      transfected with mutant receptor cDNA TSHR-CS1 (Gln261) and TSHR-CS3 (Gln312,
      Gln313) bound radiolabeled TSH with an affinity similar to the wild-type TSHR.
      Mutant cDNA TSHR-CS2 (Gln290, Gln291) and TSHR-CS4 (Gln261, Gln290, Gln291,
      Gln312, Gln313) did not express a protein on the cell surface capable of specific
      TSH binding. After covalent cross-linkage of radiolabeled TSH to TSHR-CS1 and
      TSHR-CS3, the mutant receptors dissociated into two subunits under reducing
      conditions. The most prominent cluster of basic amino acids in the TSHR
      extracellular region (residues 287-293) was studied in a second series of
      mutations designed to eliminate the classical proprotein convertase sites in this
      region and yet be compatible with TSHR function. All three mutant receptors, TSHR
      CS5 (Gln290), TSHR-CS6 (Gln291), and TSHR-CS7 (Gln291, Gln293) bound TSH with an
      affinity similar to that of wild type, and none of these amino acid substitutions
      prevented proteolytic cleavage of the extracellular domains of the TSHR. Thus,
      cleavage of the TSHR extracellular domain does not involve a classical subtilisin
      related proprotein convertase cleavage site, raising the possibility that TSHR
      cleavage occurs after processing and trafficking of the protein to the plasma
      membrane.

PMID- 7798219
TI  - The major kidney AE1 isoform does not bind ankyrin (Ank1) in vitro. An essential
      role for the 79 NH2-terminal amino acid residues of band 3.
AB  - The AE1 (band 3) protein mediates the exchange of anions across the erythrocyte
      plasma membrane and, via association with the adapter molecule, ankyrin (Ank1),
      forms the major link between the membrane and the underlying spectrin
      cytoskeleton. The major kidney isoform of AE1 (kAE1), a protein that is otherwise
      identical to erythroid AE1 but lacks the NH2-terminal 79 amino acids, is
      localized to the basolateral plasma membrane of acid-secreting (alpha-type)
      intercalated cells of distal nephron. It has been proposed that this polarized
      distribution of kAE1 is due, at least in part, to its association with the
      ankyrin-spectrin cytoskeleton. In this study, we have used cell-free binding
      assays to investigate the interaction of anion exchangers with an Ank1 fragment,
      R13-H, that contains the AE1 binding site. Microsomes from cells expressing full
      length erythroid AE1 bound 125I-labeled R13-H, revealing the presence of both
      high (Kd = 12.5 nM) and low (Kd = 166 nM) affinity sites. This binding was
      specific, as evidenced by the failure to observe high affinity binding of 125I
      R13-H to microsomes from cells transfected with vector alone or with AE1m, a
      mutant lacking the approximately 400 amino acid NH2-terminal cytoplasmic ankyrin
      binding domain. Using this assay, we could detect no high affinity association
      between kAE1 and 125I-R13-H. We conclude that the NH2-terminal 79 amino acids
      play an essential role in high affinity and specific binding of AE1 to Ank1.

PMID- 7798221
TI  - Heat-stable inhibitors of cAMP-dependent protein kinase carry a nuclear export
      signal.
AB  - The heat-stable inhibitor of cAMP-dependent protein kinase (PKI) was shown
      previously to export the kinase catalytic subunit (C) from the nucleus (Fantozzi,
      D. A., Harootunian, A. T., Wen, W., Taylor, S. S., Feramisco, J.R., Tsien, R. Y.,
      and Meinkoth, J. L. (1994) J. Biol. Chem. 269, 2676-2686), in addition to its
      ability to inhibit kinase activity. In this study, the mechanism of PKI export is
      investigated. The injection of a C-PKI complex containing both labeled PKI and C
      subunit revealed that both proteins exit the nucleus in unison. A fusion protein
      of C-subunit with glutathione S-transferase (GST) (140 kDa) cannot transverse the
      nuclear membrane in either direction, but can be exported from the nucleus when
      complexed with PKI, supporting the presence of a nuclear export signal (NES) in
      the C-PKI complex. Fusions of PKI alpha with GST (70 kDa) or PKI beta 1 with
      maltose-binding protein (MBP) (50 kDa) remain effective at exporting complexes
      with C-subunit. The export of C-PKI is also sensitive to temperature and energy
      depletion. Taken together, these results demonstrate that export is both energy-
      and temperature-dependent, but size-independent, consistent with an active signal
      mediated export process. GST-PKI exits from the nucleus even in the absence of C
      subunit, indicating that the NES resides entirely on PKI, but suggesting that
      fusion of PKI to GST leads to a conformational change that mimics the exposure of
      the NES caused by the binding of C. Since both PKI alpha and PKI beta 1 can
      export C-subunit, the predicted export signal is likely to reside on the residues
      conserved between PKI alpha and PKI beta 1.

PMID- 7798222
TI  - Properties of recombinant mouse thrombospondin 2 expressed in Spodoptera cells.
AB  - A baculovirus system was used to express full-length recombinant mouse
      thrombospondin 2 (rTSP2) as a disulfide-bonded homotrimer with an NH2 terminus
      beginning with Asp20.rTSP2, like TSP1, was more sensitive to trypsin digestion if
      depleted of calcium ion. The trypsin digestion pattern of rTSP2 and TSP1 differed
      in that trypsin cut between the first and second type 1 modules of rTSP2. For
      bovine aortic endothelial cells adhering to TSP-coated polystyrene plates,
      reduction after coating caused both TSPs to be much more adhesive; these
      adhesions were blocked completely by RGDS peptide or antibody to alpha v beta 3
      integrin.rTSP2 and TSP1 also mediated the adhesion of HT-29 human colon
      adenocarcinoma cells that carry alpha v beta 5 but not alpha v beta 3 integrin.
      Antibody to alpha v beta 5 did not inhibit adhesion of HT-29 cells to TSP1 or
      rTSP2. Rather, adhesion of HT-29 cells was decreased by treatment of TSPs with
      EDTA, abolished by reduction of the TSPs, and, in the case of rTSP2, blocked by
      heparin. Adhesion of MG63 cells to both TSPs was complex. Treatment with EDTA
      enhanced the adhesive activity of rTSP2 but decreased the adhesive activity of
      TSP1. These results show that TSP2 can be processed and secreted when
      overexpressed using baculovirus, TSP1 and rTSP2 differ in protease susceptibility
      in the type 1 module region, and TSP1 and rTSP2 mediate cell adhesion by complex
      and similar but not identical mechanisms.

PMID- 7798223
TI  - 1,25-dihydroxyvitamin D3 alters the effect of cAMP in thyroid cells by increasing
      the regulatory subunit type II beta of the cAMP-dependent protein kinase.
AB  - 1,25-Dihydroxyvitamin D3 (1,25(OH)2D3) attenuates the stimulatory effects of cAMP
      on proliferation and iodide uptake in rat thyroid FRTL-5 cells. This study
      examines the effects of 1,25-(OH)2D3 on the cAMP-dependent protein kinase (PKA).
      Cytosol proteins separated by anion exchange chromatography showed increased
      [3H]cAMP binding activity as well as increased kinase activity in the fractions
      containing PKA type II in 1,25-(OH)2D3 (10 nM)-treated cells compared to the
      control cells. Western blot analysis of 1,25-(OH)2D3-treated cells revealed a 4
      fold increase in the cytosolic amount of the PKA regulatory subunit RII beta,
      whereas no changes were detected in the regulatory subunits RI alpha and RII
      alpha or the catalytic (C) subunit. Northern blot analyses showed a similar
      increase in RII beta mRNA in cells treated for 12 h with 1,25-(OH)2D3 (10 nM),
      and RII beta mRNA increased further to 10-fold above control cell level after 96
      h of incubation. Iodide uptake was synergistically stimulated with both PKAI- and
      PKAII-directed pairs of cAMP analogs. The PKAI synergism was, however, inhibited
      by 1,25-(OH)2D3 treatment of the cells, whereas the PKAII synergism was
      unaffected. In conclusion, 1,25-(OH)2D3 attenuates both PKAI formation and PKAI
      stimulated iodide uptake in rat thyroid FRTL-5 cells by increasing the level of
      RII beta without altering the other PKA subunit levels.

PMID- 7798224
TI  - Expression and characterization of human and chimeric human-Paracoccus
      denitrificans electron transfer flavoproteins.
AB  - Electron transfer flavoprotein (ETF) is a heterodimer that contains a single
      equivalent of FAD and accepts electrons from nine flavoprotein dehydrogenases in
      the mitochondrial matrix. Human ETF was expressed in Escherichia coli using the
      expression vector previously employed to express Paracoccus denitrificans ETF
      (Bedzyk, L. A., Escudero, K. W., Gill, R. E., Griffin, K. J., and Frerman, F. E.
      (1993) J. Biol. Chem. 268, 20211-20217). cDNAs encoding the beta and alpha
      subunits of the human protein were inserted into the vector, mimicking the
      arrangement of the P. denitrificans genes in which coding sequences are joined by
      overlapping termination and initiation codons. A human ETF containing 30% P.
      denitrificans sequence at the amino terminus of the beta subunit was also
      expressed and purified. This chimeric ETF has 64% sequence identity with the
      human sequence in the substituted region. Kinetic constants of medium chain and
      short chain acyl-CoA dehydrogenases for the chimeric ETFs were slightly changed
      from those of human ETF; but, there are marked differences in the kinetic
      constants of sarcosine dehydrogenase and electron transfer flavoprotein
      ubiquinone oxidoreductase with the two ETFs. Absorption spectra of the three
      redox states of human, chimeric, and P. denitrificans ETF flavins are identical.
      However, the flavin circular dichroism spectra of the three ETFs are
      characteristic for each species. The spectrum of the chimeric ETF has both human
      and P. denitrificans ETF features. The amplitude of the 436 nm band is identical
      to that of the of the human ETF flavin, but the amplitude of the 375 nm band is
      identical to that of the P. denitrificans ETF flavin. Thus, flavin in the
      chimeric ETF appears to be exposed to dipoles in the protein framework provided
      by human and bacterial sequences. These spectral data indicate that the flavin is
      located in the vicinity of the amino-terminal region of the beta subunit. The
      kinetic data suggest that the amino-terminal region of the beta subunit comprises
      part of the docking site for some primary dehydrogenases and electron transfer
      flavoprotein-ubiquinone oxidoreductase.

PMID- 7798225
TI  - The regulation of capacitative calcium entry by calcium and protein kinase C in
      Xenopus oocytes.
AB  - Agonists linked to the phosphoinositide signaling pathway evoke capacitative
      calcium entry in Xenopus oocytes. This entry pathway can also be activated by
      injection of inositol 2,4,5-trisphosphate, application of thapsigargin, or
      incubation in calcium-free medium. A variety of protocols revealed highly
      nonlinear behavior of the calcium entry in thapsigargin-treated oocytes
      suggestive of positive and negative feedback by calcium at the level of its own
      entry. These feedback mechanisms may account for the highly damped calcium
      oscillations we observed in thapsigargin-treated oocytes. Low level activation of
      protein kinase C potentiated calcium influx in thapsigargin-treated oocytes,
      apparently by blocking the inactivation of the calcium influx. Higher levels of
      protein kinase C activity inhibited capacitative calcium entry.

PMID- 7798226
TI  - Identification of chloroplast envelope proteins in close physical proximity to a
      partially translocated chimeric precursor protein.
AB  - Translocation intermediates of the chimeric protein precursor Oee1-Dhfr were
      generated and used to identify envelope components in close proximity to the
      arrested precursor. The translocation of Oee1-Dhfr across the chloroplast
      envelope can be arrested at low ATP levels or by prebinding the fusion precursor
      with anti-Dhfr IgGs. The arrested Oee1-Dhfr precursor appears to span both the
      outer and inner envelope membranes. Translocational arrest of Oee1-Dhfr by low
      ATP levels was reversible, and import was restored upon resupplementation with
      higher ATP levels. Chemical cross-linking and co-immunoprecipitation with
      monospecific antibodies indicate that two outer envelope membrane proteins (Com44
      and Com70) and at least one inner envelope protein (Cim44 and Cim97) were found
      to be in close proximity to Oee1-Dhfr during translocation. The Com70 protein was
      further studied and additional evidence for its role in chloroplast protein
      import is presented.

PMID- 7798227
TI  - Effects of neurohormonal stress and aging on the activation of mammalian heat
      shock factor 1.
AB  - The mammalian heat shock response has been investigated extensively using tissue
      culture cells with only a limited amount of information available on animals and
      intact tissues. The neurohormonal stress response mediated by the hypothalamic
      pituitary-adrenal axis leads to the activation of heat shock factor (HSF) in rat
      adrenal tissue. Here we show through the use of antibodies specific to each
      member of the HSF family that restraint-induced stress in intact Wistar rats and
      adrenocorticotropic hormone treatment of hypophysectomized animals leads to the
      activation of HSF1 monomers to trimers with DNA-binding activity. Because HSF1 is
      also the target factor for metabolic and environmental stress, these data reveal
      an intersection of pathways leading to HSF1 activation. Comparison of the
      biochemical properties and levels of HSF1 in the Wistar and Fischer 344 rat
      strains reveals that HSF1 is constitutively present in an activated DNA-binding
      state in the adrenals of Fischer 344 rats. During aging, the levels of HSF1
      remain constant, yet the transcription factor from aged animals exhibits a
      decreased ability to bind DNA.

PMID- 7798228
TI  - Purified yeast translational initiation factor eIF-3 is an RNA-binding protein
      complex that contains the PRT1 protein.
AB  - Eukaryotic initiation factor-3 (eIF-3) plays a pivotal role in the initiation
      phase of protein synthesis where it promotes dissociation of 80 S ribosomes into
      subunits, stabilizes methionyl-tRNAi binding to 40 S ribosomal subunits, and is
      required for mRNA binding. Mammalian eIF-3 is comprised of eight subunits, but no
      mammalian cDNA encoding these proteins has been cloned and sequenced, nor has the
      corresponding factor been characterized in yeast. Since many initiation factors
      are strongly conserved between mammalian and yeast systems, we employed a
      mammalian assay for initiation, the synthesis of methionyl-puromycin, to detect
      eIF-3 activity in yeast subcellular fractions. Yeast eIF-3 was purified from the
      high salt wash of ribosomes by Superose 6 molecular sieve and MonoS ion exchange
      chromatography. Yeast eIF-3 contains eight subunits with masses of 16, 21, 29,
      33, 39, 62, 90, and 135 kilodaltons all of which coelute with an apparent mass of
      550 kilodaltons from the Superose 6 column. Immunoblotting shows that the 90-kDa
      subunit corresponds to the product of the PRT1 gene whose mutant form, prt1-1,
      exhibits destabilization of methionyl-tRNAi binding to 40 S ribosomal subunits.
      eIF-3, and specifically the 62-kDa subunit, bind to RNA. These biochemical
      approaches to defining yeast eIF-3 complement genetic methods so far used in
      characterizing the initiation factors and provide another route to defining the
      yeast translational machinery.

PMID- 7798229
TI  - Receptor-mediated endocytic uptake of methylglyoxal-modified serum albumin.
      Competition with advanced glycation end product-modified serum albumin at the
      advanced glycation end product receptor.
AB  - Methylglyoxal binds and irreversibly modifies arginine and lysine residues in
      bovine serum albumin (BSA) under physiological conditions, producing a protein
      with an increased net negative charge at physiological pH. At 4 degrees C,
      methylglyoxal-modified BSA (MG-BSA) was bound by cell surface receptors on murine
      P388D1 macrophages. The apparent dissociation constant KD value was 435 +/- 2 nM,
      and there were 8.89 +/- 0.02 x 10(5) receptors/cell (n = 6), compare with an
      apparent KD value of 263 +/- 52 nM and 10.17 +/- 0.93 x 10(5) receptors/cell (n =
      11) for advanced glycation end product-modified BSA (AGE-BSA). AGE-BSA competed
      with MG-BSA for binding to a common receptor; however, a component of AGE-BSA
      receptor binding could not be displaced by MG-BSA, and a component of MG-BSA
      receptor binding could not be displaced by AGE-BSA, suggesting that there are
      binding sites for both AGE-BSA and MG-BSA, competitive and noncompetitive, to MG
      BSA and AGE-BSA on P388D1 cells at 4 degrees C. At 37 degrees C, receptor binding
      of AGE-BSA and MG-BSA was followed by endocytosis and lysosomal degradation of
      the modified protein. Methylglyoxal-modified proteins are ligands for the AGE
      receptor, and their formation and metabolism may be linked to the development of
      diabetic complications.

PMID- 7798230
TI  - Binding and modification of proteins by methylglyoxal under physiological
      conditions. A kinetic and mechanistic study with N alpha-acetylarginine, N alpha
      acetylcysteine, and N alpha-acetyllysine, and bovine serum albumin.
AB  - The physiological alpha-oxoaldehyde methylglyoxal binds and modifies arginine,
      lysine, and cysteine residues in proteins. The kinetics and mechanism of these
      reactions were investigated with N alpha-acetylamino acids and bovine serum
      albumin at pH 7.4 and 37 degrees C. The reaction of methylglyoxal with N alpha
      acetylarginine involved the initial reversible formation of glycosylamine and 4,5
      dihydroxy-5-methylimidazolidine derivatives, with further slow irreversible
      conversion to an imidazolone, N alpha-acetyl-N delta- (5-methyl-4-imidazolon-2
      yl)ornithine. The imidazolone was fluorescent with an excitation lambda max value
      of 320 nm and an emission lambda max value of 398 nm. Methylglyoxal reacted
      reversibly with N alpha-acetyllysine to form glycosylamine and bisglycosylamine
      derivatives. Further reaction of these glycosylamines occurred to form brown,
      fluorescent oligomers that were not characterized. Methylglyoxal reacted rapidly
      and reversibly with N alpha-acetylcysteine to form the hemithioacetal adduct. The
      reaction of methylglyoxal with bovine serum albumin (BSA) at pH 7.4 and 37
      degrees C involved the reversible and irreversible formation of methylglyoxal-BSA
      adducts. Irreversible modification of BSA occurred mainly on arginine residues to
      form imidazolone. The formation of methylglyoxal-modified proteins involves
      glycoxidation leading to advanced glycation end product-like fluorescence. It is
      expected to be increased in diabetes mellitus and may be linked to the
      development of diabetic complications.

PMID- 7798231
TI  - Transition state structures for the hydrolysis of alpha-D-glucopyranosyl fluoride
      by retaining and inverting reactions of glycosylases.
AB  - Secondary tritium and primary 14C kinetic isotope effects were measured for the
      hydrolysis of alpha-D-glucopyranosyl fluoride catalyzed by sugar beet seed alpha
      D-glucosidase, forming alpha-D-glucose, and by Rhizopus niveus glucoamylase
      forming beta-D-glucose. The data provided a novel opportunity to model and
      directly compare the transition state structures for the hydrolysis of a
      substrate promoted with retention or inversion of configuration according to the
      enzyme catalyst. The isotope effects for the reaction catalyzed by each enzyme
      are most consistent with an SN1 rather than an SN2 mechanism. The modeled
      transition state structures for the hydrolysis promoted by the alpha-glucosidase
      and the glucoamylase both bear significant oxocarbonium ion character, with the D
      glucosyl residue having a flattened 4C1 conformation and a C-1-O-5 bond order of
      1.92, even though opposite D-glucose anomers were produced from the substrate.
      The transition states show some modest differences, but their general similarity
      strongly suggests that the stereochemical outcome of glycosylase reactions does
      not predict the transition state structure, nor does the transition state
      structure of such reactions predict the stereochemical outcome. The results
      support previously reported evidence for the separate topological control of
      product configuration by protein structures in these and other glycosylases.

PMID- 7798232
TI  - Second-site suppressor mutations at glycine 218 and histidine 245 in the alpha
      subunit of F1F0 ATP synthase in Escherichia coli.
AB  - The alpha-like subunits of F1F0 ATP synthases share primary structural homology
      in two segments near their carboxyl termini. However, the amino acids at the
      functionally important positions occupied by alpha Gly-218 and alpha His-245 in
      Escherichia coli vary depending upon organism and organelle. The alpha G218-
      >D,H245-G and alpha G218-->K,H245-->G double mutations were constructed in the E.
      coli uncB(alpha) gene to model the chloroplast ATPase IV subunit and alkaliphilic
      bacterial alpha subunit, respectively. Strains carrying each of the single
      mutations, alpha G218-->D, alpha G218-->K, and alpha H245-->G, had marked
      reductions in F1F0 ATP synthase function. The alpha G218-->K mutation was alone
      sufficient to virtually eliminate enzyme function. Membranes prepared from the
      alpha G218-->D mutant exhibited increased levels of ATP hydrolysis activity
      without a corresponding increase in active proton transport, suggesting a
      mechanistic uncoupling of catalytic activity and proton translocation. However,
      much of the lost F1F0 ATP synthase activity was restored in the alpha G218-
      >D,H245-->G and alpha G218-->K,H245-->G double mutant strains demonstrating that
      these mutations act as mutual intragenic second-site suppressors. The evidence is
      consistent with a close spatial interaction between alpha Gly-218 and alpha His
      245.

PMID- 7798233
TI  - The calcium current activated by T cell receptor and store depletion in human
      lymphocytes is absent in a primary immunodeficiency.
AB  - Stimulation of antigen receptors of lymphocytes triggers a transitory release of
      Ca2+ from internal stores and the opening of a transmembrane Ca2+ conductive
      pathway. The latter underlies the sustained increase of intracellular free
      calcium concentration, and it seems to be a key event in the Ca(2+)-dependent
      biochemical cascade leading to T cell proliferation. Alternatively,
      pharmacological depletion of internal stores by itself activates Ca2+ influx.
      This has led to the hypothesis that antigen-triggered Ca2+ influx is secondary to
      Ca2+ release from internal stores. However, the precise relationship between
      antigen and Ca2+ release-activated Ca2+ currents remains unclear, particularly
      since neither of them has been electrophysiologically recorded in normal
      lymphocytes. Using the whole-cell and the perforated configurations of the patch
      clamp technique on peripheral blood lymphocytes, we found that a low amplitude
      Ca(2+)-selective current was triggered when intracellular stores were depleted by
      stimuli such as the intracellular perfusion of inositol triphosphate or
      thapsigargin and the extracellular perfusion of ionomycin. A similar current was
      elicited by the cross-linking of the T cell receptor-CD3 complex. This current
      displayed an inward rectification below 0 mV and was completely blocked by the
      divalent cation Cd2+. It was very selective for Ca2+ over Na+ and insensitive to
      changes in chloride concentration. The physiological relevance of this
      conductance was investigated with the analysis of abnormal Ca2+ signaling in
      lymphocytes from a patient suffering from a primary immunodeficiency associated
      with a defective T cell proliferation. Using fura-2 video imaging, an absence of
      Ca2+ influx was established in the patient's lymphocytes, whereas the Ca2+
      release from internal stores was normal. This was the case whether cells were
      stimulated physiologically through their antigen receptors or with store
      depleting pharmacological agents. Most importantly, no Ca(2+)-selective current
      was elicited in these cells. Our data strongly suggest that the Ca2+ release
      activated current underlies the sustained Ca2+ influx during antigenic
      stimulation and that it plays a key role in the immune function.

PMID- 7798235
TI  - Activation of protein kinase C family members by the novel polyphosphoinositides
      PtdIns-3,4-P2 and PtdIns-3,4,5-P3.
AB  - The effect of phosphoinositides on the activity of protein kinase C (PKC)
      isotypes was investigated. PKC alpha, beta I, beta II, gamma, delta, epsilon,
      eta, and zeta were expressed in baculovirus-infected insect cells and purified by
      column chromatography. The calcium-activated PKC isotypes alpha, beta I, beta II,
      and gamma were not significantly activated by any of the phosphoinositides
      investigated (phosphatidylinositol-4-phosphate (PtdIns-4-P), PtdIns-3-P, PtdIns
      4,5-P2, PtdIns-3,4-P2, and PtdIns-3,4,5-P3) when added in the presence of
      concentrations of phosphatidylserine that give maximal stimulation. The calcium
      insensitive PKC isotypes delta, epsilon, and theta also showed little response to
      PtdIns-3-P, PtdIns-4-P, or PtdIns-4,5-P2 when these lipids were added in the
      presence of phosphatidylserine. In contrast, PtdIns-3,4-P2 and PtdIns-3,4,5-P3
      caused a 5-15-fold stimulation of these enzymes compared with phosphatidylserine
      alone. 50% maximal stimulation of PKC epsilon by PtdIns-3,4,5-P3 occurred when
      this lipid was present at about 1% of the carrier PtdIns-4,5-P2 (about 100 nM).
      These lipids had little effect on baculovirus-expressed PKC zeta, which was
      constitutively active. A short chain version of PtdIns-3,4,5-P3, dioctanoyl
      PtdIns-3,4,5-P3, activated PKC delta, epsilon, and eta in the absence of other
      lipids, whereas a short chain version of PtdIns-4,5-P2, dihexanoyl-PtdIns-4,5-P2,
      did not. Since PtdIns-3,4-P2 and PtdIns-3,4,5-P3 are nominally absent in
      unstimulated cells and appear within seconds to minutes of stimulation by various
      cell activators, these lipids could act as second messengers to activate PKC
      delta, epsilon, or eta in vivo.

PMID- 7798236
TI  - Co-expression of cholesteryl ester transfer protein and defective apolipoprotein
      E in transgenic mice alters plasma cholesterol distribution. Implications for the
      pathogenesis of type III hyperlipoproteinemia.
AB  - Despite the definite etiologic link between apolipoprotein (apo) E mutations and
      type III hyperlipoproteinemia (HLP), it is not clear what additional factors are
      involved in the development of florid hyperlipidemia and how to explain the wide
      variability in the expression of the hyperlipidemic phenotype in carriers of
      receptor binding-defective apoE variants. The present study was designed to
      determine whether the overexpression of cholesteryl ester transfer protein
      (CETP), a plasma protein that transfers cholesteryl esters from the high density
      lipoproteins (HDL) to the very low density lipoproteins (VLDL) and whose activity
      is increased in hyperlipidemic states, plays a role in the development of
      hyperlipidemia and beta-VLDL accumulation in type III HLP. We produced double
      transgenic mice that co-expressed high levels of simian CETP and either high or
      low levels of a human receptor binding-defective apoE variant, apoE(Cys-142). We
      previously reported that apoE(Cys-142) high-expresser mice showed spontaneous
      hyperlipidemia and accumulation of beta-VLDL, whereas the low-expresser mice
      showed only a modest increase in VLDL cholesterol. Co-expression of CETP induced
      a massive transfer of cholesteryl esters from the HDL to the VLDL in both lines
      of double-transgenic mice. As a result, HDL cholesterol and apoA-I levels were
      reduced to about 50% of normal, VLDL cholesterol increased 2.5-fold, and the
      cholesteryl ester content of VLDL reached values similar to those observed in
      human beta-VLDL. The ratio of defective to normal apoE in VLDL was unaffected by
      CETP co-expression and was higher in animals expressing high apoE levels.
      Finally, in spite of an increased accumulation of beta-VLDL in the high-expresser
      mice, the VLDL of the low-expresser mice maintained pre-beta mobility upon co
      expression of CETP. The results of this study demonstrate that the ratio of
      defective to normal apoE on the VLDL, rather than the cholesteryl ester content
      of VLDL, is the major factor determining the development of severe hyperlipidemia
      and the formation and accumulation of beta-VLDL in type III HLP.

PMID- 7798234
TI  - Stimulation of yeast adenylyl cyclase activity by lysophospholipids and fatty
      acids. Implications for the regulation of Ras/effector function by lipids.
AB  - A reconstituted system containing membranes prepared from various Saccharomyces
      cerevisiae strains (CYR1 ras1 ras2) and a recombinant RAS2 protein was used to
      evaluate the effect of lipids on adenylyl cyclase activity. Incubation of wild
      type membranes with lysophosphatidylinositol, lysophosphatidylserine, or
      lysophosphatidylcholine stimulated adenylyl cyclase activity in the absence and
      presence of RAS between 2-10-fold depending upon the individual lipid.
      Unsaturated fatty acids preferentially increased activity 2-3-fold in the
      presence of RAS. Other phospholipids as well as several detergents had only
      marginal effects on adenylyl cyclase activity. Lipids had no effect on either the
      binding or hydrolysis of GTP by RAS. LysoPI decreased both the Km for ATP and the
      amount of RAS required for enzyme activation. Four catalytically active deletion
      mutants of the CYR1 protein including one containing only the C-terminal 417
      amino acids were similarly responsive to lysoPI when compared to the wild-type
      enzyme. These data suggest that lysophospholipids and fatty acids, metabolites of
      the mitogenically responsive enzyme phospholipase A2, may represent a novel
      mechanism for modulating the activity of downstream effector molecules and their
      interaction with Ras proteins.

PMID- 7798237
TI  - Rational reconstruction of the active site of a class mu glutathione S
      transferase.
AB  - Isoenzymes 3-3 and 4-4 of the mu class glutathione S-transferases share 77%
      sequence identity but have distinctly different catalytic properties. Analysis of
      the crystal structure of isoenzyme 3-3 in complex with the diastereomeric
      products of the addition of GSH to phenanthrene 9,10-oxide (Ji, X., Johnson, W.
      W., Sesay, M. A., Dickert, L., Prasad, S. M., Ammon, H. L., Armstrong, R. N., and
      Gilliland, G. L. (1994) Biochemistry 33, 1043-1052) reveals that 3 residues that
      are in van der Waals contact with the xenobiotic portion of the product are
      different in the type 4 subunit. The three mutations, V9I, I111A, and S209A, have
      been introduced into isoenzyme 3-3 individually and in combination in an attempt
      to minimally reconstruct the active site of the enzyme to mimic the type 4
      subunit in structure and function. The results suggest that the V9I mutation is
      an important determinant in the stereoselectivity of the enzyme toward enones and
      epoxides. The I111A mutation increases the catalytic efficiency of the enzyme
      toward para-substituted 4-phenyl-3-buten-2-ones (XPBO) as measured by kcat/KmXPBO
      but does not affect kcat. The S209A mutation has no effect on catalysis. The
      double and triple mutants V9I/I111A and V9I/I111A/S209A exhibit both a high
      stereoselectivity and high kcat/KmXPBO comparable to that of isoenzyme 4-4.
      Analysis of substituent effects on the kinetics and stereoselectivity of the
      enzyme toward the enone substrates suggests that the mechanistic bases for the
      catalytic behavior of the isoenzyme 4-4 and the reconstructed mutants are not
      identical. The results provide functional evidence for the catalytic importance
      of specific residues previously identified by x-ray crystallography.

PMID- 7798238
TI  - Molecular cloning of a proteolytic antibody light chain.
AB  - The cDNA for an antibody light chain raised by immunization against vasoactive
      intestinal peptide (VIP) was cloned in a bacterial expression vector, and the
      recombinant light chain was purified to electrophoretic homogeneity. The light
      chain catalyzed the hydrolysis of VIP efficiently owing to its comparatively high
      affinity for the substrate. In control experiments, the catalytic activity was
      preserved at a constant level after further chromatography of the light chain on
      anion-exchange and gel-filtration fast protein liquid chromatography columns, and
      it was removed by immunoadsorption with immobilized anti-mouse light chain
      antibody. The amide bond linking methylcoumarinamide (MCA) and arginine in a
      tripeptide unrelated in sequence to VIP was cleaved by the light chain with lower
      affinity and kinetic efficiency (kcat/Km). Hydrolysis of the peptidyl-MCA
      conjugate was inhibited competitively by the alternate substrate, VIP. The Ki and
      Km values for VIP were in the same range, indicating that peptide-MCA and VIP
      hydrolysis occurs at a common catalytic site in the light chain. Molecular
      modeling suggested the presence of a serine protease-like site in the light
      chain. This was supported by inhibition of the hydrolytic activity by serine
      protease inhibitors, but not by inhibitors of other classes of proteases. These
      observations suggest a poorly discriminatory catalytic site, with specificity for
      VIP arising chiefly by means of the antigen recognition function of the light
      chain combining site.

PMID- 7798240
TI  - Amino acid residues of the kringle-4 and kringle-5 domains of human plasminogen
      that stabilize their interactions with omega-amino acid ligands.
AB  - Regions of the human plasminogen (Pg) cDNA containing its kringle 4 (K4) and K5
      domains have been expressed in Escherichia coli, and binding constants of omega
      amino acid ligands for recombinant (r)-[K4Pg] and r-[K5Pg] have been obtained. In
      each case, the results showed that of a series of aliphatic alpha, omega-amino
      acid analogues, 6-aminohexanoic acid showed maximal affinity for these modules,
      and all ligands interacted more strongly with r-[K4Pg] than with r-[K5Pg]. Site
      directed mutagenesis investigations demonstrated that the major amino acid side
      chain contributors to ligand binding were similar for each of these kringles.
      Ligand binding was stabilized by charged groups at Asp56 of r-[K4Pg] and Asp57 of
      r-[K5Pg] as well as by Arg69 of both r-[K4Pg] and r-[K5Pg]. Some hydrophobic
      amino acids that contributed significantly to the binding strength of the ligands
      were identified. These were provided by homologous residues in each of the
      domains, viz. Trp60 and Trp70 of r-[K4Pg] and Trp62 and Tyr72 of r-[K5Pg]. Tyr74
      of r-[K5Pg] also substantially contributed to its ligand binding energy.

PMID- 7798239
TI  - The Caenorhabditis elegans small GTP-binding protein RhoA is enriched in the
      nerve ring and sensory neurons during larval development.
AB  - p21 Ras has been implicated in vulval differentiation in Caenorhabditis elegans.
      We now describe the characteristics during nematode development of the related
      p21 RhoA which has been ascribed a morphological role in mammals. The CeRhoA cDNA
      isolated in this study encodes a sequence of 192 amino acids residues with 87.6%
      identity to human RhoA. Genomic Southern analysis indicates the presence of a
      single Rho gene in C. elegans. Its 2-kilobase mRNA is expressed at the highest
      levels during embryogenesis and decreases gradually thereafter. However, the
      level of the 24-kDa protein detected by the anti-CeRhoA antibody is high at the
      larval stages but low in embryos. The glutathione S-transferase/CeRhoA fusion
      protein expressed in Escherichia coli displays conserved biochemical activities.
      Unlike its counterpart in mammalian cells which is predominantly cytosolic, most
      of CeRhoA is associated with the membrane and the cytoskeleton throughout
      development. Indirect immunofluorescence analysis indicates an ubiquitous
      expression of CeRhoA throughout development with a particular enrichment at
      larval stages in the pharyngeal nerve ring and at the tip of the head containing
      chemosensory and mechanosensory neurons. This suggests a stage-specific role for
      p21 RhoA in mediating the signaling pathway underlying the sensory circuitry in
      C. elegans post-embryonic development.

PMID- 7798241
TI  - Dynamin 1 antisense oligonucleotide treatment prevents neurite formation in
      cultured hippocampal neurons.
AB  - Dynamin 1 (D100) is a microtubule-activated GTPase that is believed to play a
      role in the early steps of receptor-mediated endocytosis. Previous studies on the
      characterization of the Drosophila dynamin gene homolog, known as shibire,
      suggest that this protein may also participate in the formation of neuronal
      processes. To understand the role of rat brain dynamin 1 in neuronal
      morphogenesis, we correlated the intracellular levels of dynamin with the
      formation of neurites in rat hippocampal neurons and neuroblastoma N1E-115 cells
      in vitro. Quantitative Western and Northern blot analyses show that dynamin
      levels increase during neurite formation in both the hippocampal neurons and N1E
      115 cells and decrease in N1E-115 cells during serum-induced neurite retraction.
      Furthermore, using antisense technology, we investigated the effect of decreased
      intracellular levels of dynamin on neurite formation in cultured embryonic
      hippocampal neurons. Antisense oligonucleotides against sequences surrounding the
      initiation codon of the rat brain dynamin gene (D100) reduce the intracellular
      levels of dynamin by approximately 90% and impair the formation of the minor and
      axon-like processes in a dose-dependent manner. Taken together, these results
      suggest that dynamin-mediated processes are necessary for normal neuronal
      morphogenesis.

PMID- 7798242
TI  - Clustering of the platelet Fc gamma receptor induces noncovalent association with
      the tyrosine kinase p72syk.
AB  - The Fc receptor for IgG in platelets was identified as the integral membrane
      isoform encoded by the Fc gamma RIIA gene. Functional analysis of this molecule
      determined that activated Fc gamma RIIA is tyrosine phosphorylated and that
      activation induced the physical association with the protein tyrosine kinase
      p72syk. Other tyrosine-phosphorylated molecules also co-immunoadsorbed with the
      activated receptor. Tyrosine kinase activity co-immunoadsorbing with the platelet
      Fc gamma R was enhanced upon activation and specifically induced the
      phosphorylation, on tyrosine residues, of a physically associated 72-kDa protein.
      These data support a model of Fc gamma receptor-mediated platelet activation
      where signal is transduced through inducible association of the tyrosine kinase
      p72syk with the low affinity Fc gamma receptor. Thrombin, a potent platelet
      agonist, has been shown to up-regulate the activity of the tyrosine kinase p72syk
      in platelets. Consequently, our findings identify a second pathway by which
      p72syk is activated in platelets.

PMID- 7798243
TI  - Activation of prothrombin by a novel membrane-associated protease. An alternative
      pathway for thrombin generation independent of the coagulation cascade.
AB  - We herein report that a novel membrane-associated protease capable of activating
      prothrombin is present in several mammalian cells. This protease can directly
      convert prothrombin to active thrombin and induces blood clotting both in vivo
      and in vitro but is apparently different from coagulation factor Xa, which has
      been thought to be the only physiological activator of prothrombin. This protease
      activity was initially found and was very high in 8C feline kidney fibroblast
      cells, and we characterized its enzymological features using this cell line.
      Activity was detected in neither the cytosolic fraction nor the culture medium
      but found in the membranes and identified on the surface of intact cells. The
      activation of prothrombin required Ca2+ ions, and the apparent Km value for
      prothrombin was 0.2 microM. The activity was irreversibly inhibited by exposure
      to EDTA, but various inhibitors for serine proteases including antithrombin III
      were without effect. Based on these results, we propose that this novel enzyme,
      membrane-associated prothrombin activator, catalyzes an alternative pathway for
      generation of thrombin, which is independent of the blood coagulation cascade,
      and that the thrombin generated is involved in certain pathological states and/or
      in activation of cells that are spatially separated from the bloodstream.

PMID- 7798244
TI  - Protein kinase C zeta is associated with the mitotic apparatus in primary cell
      cultures of the shark rectal gland.
AB  - Protein kinase C zeta (PKC zeta) is an atypical PKC isoform that has recently
      been implicated in cell division and cell growth. However, there has been no
      morphologic evidence for the involvement of PKC zeta in mitogenic signal
      transduction. Here we use immunocytochemistry to demonstrate that PKC zeta co
      localizes with microtubules in both interphase and metaphase cells of the shark
      rectal gland in primary culture. This co-localization is present after non-ionic
      detergent treatment and is disrupted by nocodazole. During mitosis, PKC zeta is
      associated with the mitotic apparatus and co-localizes with beta-tubulin in
      spindle microtubules, while entirely sparing astral microtubules. These findings
      provide the first evidence that PKC zeta is associated with the mitotic
      apparatus. The striking presence of PKC zeta in the central portion of the
      mitotic apparatus suggests a functional role for this kinase isoform in cell
      division.

PMID- 7798245
TI  - Structural organization of the human oxytocin receptor gene.
AB  - We isolated and characterized the human oxytocin receptor gene. Southern blots
      indicated that the human genome has a single copy of the gene. Chromosomal
      localization by fluorescence in situ hybridization also showed that the gene was
      a single copy, assigned to 3p26.2 of the human chromosome. The gene spans
      approximately 17 kilobases and contains 3 introns and 4 exons. Exons 1 and 2
      correspond to the 5'-non-coding region, followed by exons 3 and 4 encoding the
      amino acids of the receptor. Intron 3, which is the largest at 12 kilobases,
      separates the coding region immediately after the putative sixth transmembrane
      spanning domain. The transcription start sites, demonstrated by primer extension
      analysis, lie 618 and 621 base pairs upstream of the methionine initiation codon.
      Near these putative transcription start sites, we found a TATA-like motif and a
      potential SP-1 binding site at about 30 and 65 base pairs, respectively. We also
      found other known binding sites of transcription regulating factors, such as AP
      1, AP-2, GATA-1, Myb, nucleofactor-interleukin 6 binding consensus sequence, and
      an acute phase reactant-responsive element. No estrogen-responsive element was
      observed except three half-palindromic estrogen-responsive element motifs. Our
      findings of the oxytocin receptor gene structure should help to elucidate the
      mechanism by which the gene expression is induced drastically at parturition in
      the uterus and how the gene is regulated in other organs such as the mammary
      gland or central nervous system.

PMID- 7798246
TI  - Molecular model of the extracellular lectin-like domain in CD69.
AB  - CD69 is described as a T cell activation antigen, but the ligand and
      physiological function of CD69 are currently unknown. The sequence of the
      extracellular domain of CD69 shows some similarity with that of calcium-dependent
      (C-type) lectins. Using comparative computer modeling and inverse folding
      calculations, we have generated and analyzed a detailed three-dimensional model
      of the extracellular domain of CD69 based on the crystal structure of the mannose
      binding protein. The sequence of CD69 appears to be highly compatible with the C
      type lectin fold, and assessment of the model using inverse folding calculations
      suggests its overall correctness. Compared with mannose binding protein and the
      selectins, CD69 displays significant deletions in loop regions. In addition,
      residues that form conserved calcium binding sites found in the C-type lectin
      family are not conserved in CD69. This suggests the presence of structural
      features in CD69 that depart from some of the conserved motifs seen in two
      crystal structures of C-type lectins. The CD69 model shows cavity-shaped
      hydrophobic regions surrounded by charged residues. One of these cavities is
      proximal to a potential low affinity calcium binding site and may be implicated
      in specific interactions with ligands.

PMID- 7798247
TI  - Annexin IV inhibits calmodulin-dependent protein kinase II-activated chloride
      conductance. A novel mechanism for ion channel regulation.
AB  - Ca(2+)-activated Cl- current (ICl,Ca) in colonic T84 cells is inhibited by the
      specific peptide inhibitor of Ca2+/calmodulin-dependent kinase II (CaM KII).
      Annexin IV, a Ca(2+)-dependent phospholipid binding protein also inhibits Ca(2+)
      dependent anion current activation (Kaetzel, M.A., Chan, H.-C., Dubinsky, W.P.,
      Dedman, J.R., and Nelson, D.J. (1994) J. Biol. Chem. 269, 5297-5302).
      Intracellular injection of antibodies against annexin IV enhances current
      activation; this activation is inhibited by the peptide inhibitor of CaM KII.
      Intracellular application of autonomously active CaM KII in the presence of ATP
      induced a Cl- current similar to that activated by the Ca2+ ionophore A23187.
      Current activation by the exogenous kinase was completely inhibited in the
      presence of purified annexin IV. In vitro, annexin IV does not inhibit CaM KII
      activity nor does it act as a substrate for CaM KII. Thus, it appears that
      annexin IV inhibits phosphorylation-dependent anion conductance activation by
      preventing CaM KII-ion channel interaction rather than by direct interaction with
      the enzyme itself. These findings suggest a novel mechanism by which Ca(2+)
      dependent membrane binding proteins, cytoplasmic kinases, and ion channels
      interact to regulate membrane conductance. The characterization of unique channel
      regulatory pathways in Cl- transporting epithelia may identify potential avenues
      of alternate therapy to compensate for the loss of functional Cl- channels in the
      disease of cystic fibrosis.

PMID- 7798248
TI  - Identification and characterization of LTBP-2, a novel latent transforming growth
      factor-beta-binding protein.
AB  - Latent transforming growth factor-beta (TGF-beta)-binding protein (LTBP) is a
      component of the latent TGF-beta complex in human platelets. LTBP is composed of
      two different cysteine-rich repeat sequences, i.e. epidermal growth factor (EGF)
      like repeats and a repeat containing 8 cysteine residues. The overall structure
      of LTBP is similar to those of the microfibrillar proteins fibrillin-1 and
      fibrillin-2. Here we report the identification of a novel protein termed LTBP-2,
      which is structurally related to LTBP. cDNA for LTBP-2 was obtained from human
      foreskin fibroblast cDNA libraries using a fragment of the LTBP cDNA as a probe.
      LTBP-2 is composed of 20 EGF-like repeats and four copies of the 8-cysteine
      repeat. The amino acid sequence of LTBP-2 is 41% identical to that of LTBP and
      25% identical to that of fibrillin-1. LTBP-2 is synthesized as a 240-kDa protein
      by human foreskin fibroblasts and also by COS cells transfected with the isolated
      LTBP-2 cDNA. Similar to LTBP, a considerable part of LTBP-2 was found to be
      associated with extracellular matrix. Co-transfection of cDNAs for LTBP-2 and TGF
      beta 1 revealed that LTBP-2 forms a high molecular weight complex with the TGF
      beta 1 precursor. The LTBP-2 gene was assigned to chromosome 14q24. These results
      indicate that different forms of latent TGF-beta complexes occur and suggest that
      the different associated proteins may function to target the complexes to
      specific sites.

PMID- 7798249
TI  - Tyrosine kinases regulate the cytoskeletal attachment of integrin alpha IIb beta
      3 (platelet glycoprotein IIb/IIIa) and the cellular retraction of fibrin
      polymers.
AB  - Integrins promote cell-substratum and cell-cell adhesion by acting as
      transmembrane linker molecules between extracellular adhesion proteins and the
      actin-rich cytoskeleton. The integrin alpha IIb beta 3 (platelet glycoprotein
      IIb/IIIa) is essential for platelet spreading, aggregation, fibrin clot
      retraction, and for the transduction of extracellular signals. We examined the
      effect of the specific tyrosine kinase inhibitor herbimycin A on integrin and
      cytoskeletal-mediated events in thrombin-stimulated platelets. Incubation of
      washed platelets for 24 h with herbimycin A (5 microM) abolished the thrombin
      stimulated cytoskeletal enzyme activity of pp60c-src in parallel with a reduction
      in the tyrosine phosphorylation of multiple platelet proteins, as assessed with
      anti-phosphotyrosine immunoblots. However, thrombin-induced activation of protein
      kinase C and the production of thromboxane A2 were not altered by herbimycin A.
      Despite the absence of cytoskeletal pp60c-src enzyme activity, platelet shape
      change, aggregation, and serotonin release were unaltered following platelet
      stimulation with thrombin (0.05-1.0 unit/ml). Herbimycin A-treated platelets also
      demonstrated normal platelet aggregation in response to collagen (5
      micrograms/ml), ionophore A23187 (2 microM), and ADP/adrenaline (10 microM each).
      However, the ability of herbimycin A-treated platelets to retract fibrin gels was
      significantly reduced. This defect in clot retraction was associated with reduced
      incorporation of integrin alpha IIb beta 3 into the cytoskeletal fraction of
      thrombin-aggregated platelets. Our studies suggest that tyrosine kinases in
      platelets regulate the cytoskeletal attachment of alpha IIb beta 3, as an
      essential process for the transmission of cellular contractile forces to fibrin
      polymers.

PMID- 7798250
TI  - Structural requirements for inducible shedding of the p55 tumor necrosis factor
      receptor.
AB  - Induced shedding of the p55 tumor necrosis factor receptor (p55-R) was previously
      shown to be independent of the amino acid sequence properties of the
      intracellular domain of this receptor. We now find it also independent of the
      sequence properties of the transmembrane domain and of the cysteine-rich region
      that constitutes most of the extracellular domain of the receptor. The shedding
      is shown to depend solely on the sequence properties of a small region within the
      spacer that links the cysteine-rich region in the extracellular domain to the
      transmembrane domain. Detailed tests of effects of mutations in the spacer on the
      shedding indicate that the process is independent of the amino acid side-chain
      identity in this region except for a limited dependence on the identity of 1
      residue (Val-173), located downstream to the putative major cleavage site of the
      receptor. It is strongly affected, however, by some mutations that seem to change
      the conformation of the spacer region. These findings suggest that a short amino
      acid sequence in the p55-R is essential and sufficient for its shedding and that
      the shedding is mediated either by a protease with limited sequence specificity
      or by several different proteases that recognize different amino acid sequences,
      yet it strictly depends on some conformational features of the cleavage region in
      the receptor.

PMID- 7798251
TI  - Functional expression of the human angiotensinogen gene in transgenic mice.
AB  - The renin-angiotensin system is a major determinant of arterial pressure and
      volume homeostasis in mammals through the actions of angiotensin II, the
      proteolytic digestion product of angiotensinogen. Molecular genetic studies in
      several human populations have revealed genetic linkage between the
      angiotensinogen gene and both hypertension and increased plasma angiotensinogen.
      Transgenic mice were generated with a human angiotensinogen genomic clone to
      develop an animal model to examine tissue- and cell-specific expression of the
      gene and to determine if overexpression of angiotensinogen results in
      hypertension. Human angiotensinogen mRNA was expressed in transgenic mouse liver,
      kidney, heart, adrenal gland, ovary, brain, and white and brown adipose tissue
      and, in kidney, was exclusively localized to epithelial cells of the proximal
      convoluted tubules. Plasma levels of human angiotensinogen were approximately 150
      fold higher in transgenic mice than that found normally in human plasma. The
      blood pressure of mice bearing the human angiotensinogen gene was normal but
      infusion of a single bolus dose of purified human renin resulted in a transient
      increase in blood pressure of approximately 30 mm Hg within 2 min. These results
      suggest that abnormalities in the angiotensinogen gene resulting in increased
      circulating levels of angiotensinogen could potentially contribute in part to the
      pathogenesis of essential hypertension.

PMID- 7798252
TI  - The mechanical properties of actin gels. Elastic modulus and filament motions.
AB  - To address large discrepancies reported in the literature, the viscoelastic
      properties of gels formed by purified actin filaments have been measured by five
      different techniques and five different instruments using actin preparations
      purified separately in four different laboratories. These measurements
      consistently showed that the elastic shear modulus of 2 mg/ml F-actin is on the
      order of several hundred pascals, and depends very strongly on the length of the
      filaments and on the history of the sample prior to measurement. Shortening of
      actin filaments with gelsolin and mechanical perturbations reduce the shear
      modulus to low values identical to some reported in the literature, indicating
      that such perturbations account for low shear moduli and poor responsiveness to
      filament modifying treatments reported previously. The structures of individual
      actin filaments within gels very similar or identical to those studied
      rheometrically were also examined by dynamic light scattering and fluorescence
      microscopy. Dynamic light scattering data were analyzed by a new method to
      confirm that actin filaments have no stable associations with each other and
      fluctuate in solution at a rate governed by the filament bending modulus or
      persistence length, determined to be approximately 10 microns. Fluorescence
      microscopy confirmed that applying even small shear stresses to F-actin can
      orient and rupture the filaments, and that in a minimally perturbed viscoelastic
      gel, long actin filaments are free to diffuse within a limit of constraints
      formed by their neighbors. These findings confirm that relatively isotropic F
      actin networks are sufficiently strong to stabilize cells.

PMID- 7798253
TI  - Sequestration of muscarinic acetylcholine receptor m2 subtypes. Facilitation by G
      protein-coupled receptor kinase (GRK2) and attenuation by a dominant-negative
      mutant of GRK2.
AB  - Sequestration of m2 receptors (muscarinic acetylcholine receptor m2 subtypes),
      which was assessed as loss of N-[3H]methylscopolamine ([3H]NMS) binding activity
      from the cell surface, was examined in COS 7 and BHK-21 cells that had been
      transfected with expression vectors encoding the m2 receptor and, independently,
      vectors encoding a G protein-coupled receptor kinase (GRK2) (beta-adrenergic
      receptor kinase 1) or a GRK2 dominant-negative mutant (DN-GRK2). The
      sequestration of m2 receptors became apparent when the cells were treated with
      10(-5) M or higher concentrations of carbamylcholine. In this case, approximately
      40% or 20-25% of the [3H]NMS binding sites on COS 7 or BHK-21 cells,
      respectively, were sequestered with a half-life of 15-25 min. In cells in which
      GRK2 was also expressed, the sequestration became apparent in the presence of 10(
      7) M carbamylcholine. Approximately 40% of the [3H]NMS binding sites on both COS
      7 and BHK-21 cells were sequestered in the presence of 10(-6) M or higher
      concentrations of carbamylcholine. When DN-GRK2 was expressed in COS 7 cells, the
      proportion of [3H]NMS binding sites sequestered in the presence of 10(-5) M or
      higher concentrations of carbamylcholine was reduced to 20-30%. These results
      indicate that the phosphorylation of m2 receptors by GRK2 facilitates their
      sequestration. These results are in contrast with the absence of a correlation
      between sequestration and the phosphorylation of beta-adrenergic receptors by the
      GRK2 and suggests that the consequences of phosphorylation by GRK2 are different
      for different receptors.

PMID- 7798254
TI  - Thapsigargin and di-tert-butylhydroquinone induce synergistic stimulation of DNA
      synthesis with phorbol ester and bombesin in Swiss 3T3 cells.
AB  - The specific inhibitors of the endoplasmic reticulum Ca2+ pump, thapsigargin and
      2,5-di-tert-butylhydroquinone (DBHQ), stimulated reinitiation of DNA synthesis in
      synergy with either phorbol 12,13-dibutyrate or bombesin in Swiss 3T3 cells.
      Maximum stimulation was achieved at 0.5 nM thapsigargin and 7.5 microM DBHQ.
      Kinetics of [3H]thymidine incorporation were consistent with exit from G0 and
      entry into S phase. Autoradiography of labeled nuclei showed that the increase in
      [3H]thymidine incorporation was due to an increase in the proportion of cells
      entering into DNA synthesis. Down-regulation or selective inhibition of protein
      kinase C abolished this synergistic stimulation of DNA synthesis. Thapsigargin
      and DBHQ did not potentiate protein kinase C-mediated signals such as direct
      phosphorylation of myristoylated alanine-rich C-kinase substrate, activation of
      mitogen-activated protein kinase, and tyrosine phosphorylation of bands 110,000
      130,000 and 70,000-80,000. Thapsigargin and DBHQ caused a marked reduction in the
      ability of bombesin to induce a rapid and transient increase in intracellular
      Ca2+ via depletion of total cellular Ca2+, measured by 45Ca2+ content. The
      synergistic stimulation of DNA synthesis by DBHQ and phorbol 12,13-dibutyrate was
      dependent on a high concentration of extracellular Ca2+ (ED50 = 410 microM) and
      was preferentially inhibited by the inhibitor of Ca2+ influx econozole. This
      suggests a role for Ca2+ entry in growth control. This is the first time that
      either thapsigargin or DBHQ has been shown to stimulate the reinitiation of DNA
      synthesis in any target cell.

PMID- 7798256
TI  - Identification of an internal topogenic signal sequence in human Band 3, the
      erythrocyte anion exchanger.
AB  - The insertion of Band 3, the human erythrocyte anion exchanger, into microsomal
      membranes was studied in an in vitro reticulocyte lysate translation system. Band
      3 consists of a 43-kDa amino-terminal cytosolic domain and a carboxyl-terminal 52
      kDa membrane domain containing up to 14 transmembrane segments with a single N
      glycosylation site at Asn-642. Insertion of truncated Band 3 molecules into
      microsomal membranes was assayed by glycosylation, resistance to alkaline
      extraction, and tryptic removal of the cytosolic domain. Truncations containing
      either the first four or the last eight putative transmembrane segments were
      stably integrated into microsomes showing that an intact membrane domain was not
      required for membrane integration. Furthermore, the extracytosolic domain
      following the seventh transmembrane segment was properly translocated across the
      microsomal membrane and glycosylated whether the seventh transmembrane segment
      was the first, last, or the only transmembrane segment in the construct. The
      ability of the entire membrane domain, the truncated domain beginning with the
      seventh transmembrane segment, or the seventh transmembrane segment to insert
      into microsomes was dependent on the presence of the signal recognition particle
      receptor. The seventh transmembrane segment in Band 3 therefore has the topogenic
      properties of an internal signal sequence.

PMID- 7798255
TI  - Molecular cloning and site-directed mutagenesis of glutathione S-transferase from
      Escherichia coli. The conserved tyrosyl residue near the N terminus is not
      essential for catalysis.
AB  - Glutathione S-transferase (GST) was purified from Escherichia coli K-12, and its
      N-terminal sequence was determined to be MKLFYKPGAXSLAS. The gene encoding this
      sequence was cloned and mapped at 1731-1732 kilobases on the E. coli gene map. It
      encoded a polypeptide of 201 amino acid residues with a calculated molecular
      weight of 22,860. The overexpressed product of the gene was confirmed to have GST
      activity toward 1-chloro-2,4-dinitrobenzene and ethacrynic acid and GSH-dependent
      peroxidase activity toward cumene hydroperoxide. The relative molecular mass of
      the gene product was determined to be 40,000 by gel chromatography and 25,000 by
      SDS-polyacrylamide gel electrophoresis, indicating a homodimeric structure. The
      deduced amino acid sequence was 54% identical with that of Proteus mirabilis GST.
      Although the homologies between the GSTs from E. coli and mammals were low, many
      of the residues assigned to be important for the enzymatic function or structure
      in mammalian cytosolic GSTs were found to be conserved in E. coli GST. Therefore,
      E. coli GST is considered to have diverged from the same ancestor with other
      cytosolic GSTs. A specific tyrosyl residue in the vicinity of the N terminus is
      conserved in all of the known cytosolic GSTs and has been shown to function as a
      catalytic residue in alpha, mu, and pi class GSTs from mammals. Although Tyr5 in
      E. coli GST appeared to be the counterpart of the catalytic residue, its
      replacement with phenylalanine did not significantly affect the enzymatic
      activity. Therefore, this apparently conserved tyrosyl residue is not essential
      for catalytic activity in E. coli GST.

PMID- 7798257
TI  - Overlapping Egr-1 and Sp1 sites function in the regulation of transcription of
      the mouse thrombospondin 1 gene.
AB  - We have evaluated the basis for the constitutive and serum-regulated expression
      of the mouse thrombospondin (TSP) gene in both transiently and stably transfected
      NIH-3T3 cells. Experiments with deleted and mutated mouse promoter/CAT constructs
      and gel mobility assays demonstrated that an Egr-1 binding site in the proximal
      promoter, flanked by overlapping GC boxes and an adjacent GC-rich region,
      functioned to positively regulate the constitutive activity of the gene. These
      motifs, and their cognate transcription factors, appear to act in concert, with
      partial redundancy, so that discrete mutations were only partially effective in
      reducing transcriptional activity. The Egr-1 site corresponds in position to an
      NF-Y binding site which functions synergistically with a distal serum-response
      element to mediate the serum response of the human TSP1 gene. However, neither
      the Egr-1 motif nor the surrounding proximal promoter region upstream from the
      TATA box participates in the serum response of mouse TSP1. These experiments add
      support to the growing realization that similar physiologic responses of
      homologous genes in mouse and man need not utilize similarly placed cis-acting
      elements.

PMID- 7798258
TI  - Mitogenicity and transforming activity of the insulin-like growth factor-I
      receptor with mutations in the tyrosine kinase domain.
AB  - We have investigated the effect of mutations in tyrosines 1131, 1135, and 1136 of
      the human insulin-like growth factor-I receptor (IGF-IR) on the growth and
      transformation of mammalian cells. We have used for this purpose R- cells, which
      are 3T3-like fibroblasts derived from mouse embryos with a targeted disruption of
      the IGF-IR genes. These cells have no IGF-IR, do not grow in serum-free medium
      supplemented with the growth factors that sustain the growth of 3T3 cells, and
      cannot be transformed by simian virus 40 large tumor antigen or other oncogenes.
      The R- cells were transfected with plasmids expressing: 1) a wild type human IGF
      IR cDNA; 2) a receptor with a triple mutation in the above mentioned tyrosines;
      and 3) receptors with single tyrosine mutations. Cells expressing the wild type
      or the single tyrosine mutants Y1 (Y1131F) and Y2 (Y1135F) grew in serum-free
      medium supplemented solely with IGF-I. Cells expressing the triple tyrosine
      mutant YF or the single mutant Y3 (Y1136F) failed to grow in response to IGF-I
      only. All mutants, though, failed to form colonies in soft agar, indicating that
      a fully functional IGF-IR is more critical for anchorage-independent growth than
      for monolayer growth. The triple mutant expression plasmid also functioned as a
      dominant negative, inhibiting the growth of wild type cells transformed by the
      simian virus tumor antigen.

PMID- 7798259
TI  - Enhancer activity of upstream hypersensitive site 2 of the chicken beta-globin
      cluster is mediated by GATA sites.
AB  - Upstream of the chicken beta-globin gene cluster are four DNase I-hypersensitive
      sites (HS1-4). Hypersensitive sites located upstream of the mammalian beta-globin
      clusters have enhancer activity and mediate position-independent gene expression.
      In contrast, a region inside the chicken cluster has enhancer activity and
      mediates position-independent expression. Here we investigate the function of the
      chicken upstream sites, which are different from the mammalian ones in sequence,
      number, and distance from the genes. Each was tested for its effect on reporter
      gene expression in transfected primary erythroid cells. HS2 and HS3 (4.4 and 6.4
      kilobases upstream of rho-globin) showed significant enhancer activity while HS1
      and HS4 (1.6 and 11 kilobases upstream of rho-globin) did not. A 237-base pair
      region of HS2 contained the sequences necessary for enhancer activity. Proteins
      from erythroid extracts bound HS2 in seven different regions; six of these sites
      were characterized. GATA-1 bound to four of the sites. Each site contributed to
      the enhancer activity of HS2. Two other sequences bound proteins that may be
      related to Sp1 and erythroid kruppel-like factor. Surprisingly, mutations in
      these elements, which disrupted protein binding, did not affect enhancer
      activity. Thus, the observed enhancer activity of HS2 is due to the four GATA
      sites. The existence of multiple GATA sites in both chicken HS2 and the mammalian
      upstream sites may be due to evolution from a common element with preservation of
      only very short sequences or to convergent evolution. These observations
      highlight the crucial role for GATA proteins in globin regulation.

PMID- 7798260
TI  - Bone morphogenetic protein-1 and a mammalian tolloid homologue (mTld) are encoded
      by alternatively spliced transcripts which are differentially expressed in some
      tissues.
AB  - Bone morphogenetic protein-1 (BMP-1) is a metalloprotease purified from extracts
      capable of inducing ectopic bone formation. In humans, it has a domain structure
      similar to that of the Drosophila dorsal-ventral patterning gene-product tolloid
      (Tld), but is considerably shorter. Here we show that, in humans and mice,
      alternatively spliced transcripts encode BMP-1 and a longer protein, designated
      mammalian tolloid (mTld), with a domain structure identical to that of Drosophila
      Tld. A third alternatively spliced product, in which a novel domain is inserted
      near the BMP-1 C terminus, is also reported. Low levels of transcripts for mTld
      were found in all adult human tissues surveyed, while BMP-1 transcripts were
      detectable in all adult tissues except brain. This differential expression was
      mirrored in embryonic mouse tissues where in situ hybridization found high levels
      of mTld transcripts, but was unable to detect BMP-1 transcripts, in the floor
      plate of the neural tube of the developing central nervous system. The third
      alternatively spliced form was not detected in adult human tissues. In situ
      hybridizations found punctate signals for all three forms localized to
      trophoblast giant cells in 17.5-day mouse placenta, with highest levels of
      expression, especially for BMP-1, near the maternal interface.

PMID- 7798261
TI  - The protein tyrosine kinase ZAP-70 can associate with the SH2 domain of proto
      Vav.
AB  - Stimulation of the T cell antigen receptor (TCR) leads to tyrosine
      phosphorylation of a number of cellular proteins, including the vav proto
      oncogene product. We now report the detection of several phosphotyrosine proteins
      (80, 74, and 70 kDa) from TCR-stimulated T cells that bind to the Src homology 2
      (SH2) domain of proto-Vav (Vav-SH2) and co-immunoprecipitate with the proto-Vav
      product. Their binding to Vav-SH2 differs from that observed with SH2 domains
      from other proteins. None of the Vav-SH2-associated phosphoproteins bind to
      either of the Src homology 3 (SH3) domains of proto-Vav or to mutant Vav-SH2
      proteins. The association of the phosphoproteins with Vav-SH2 requires induction
      of tyrosine phosphorylation of cellular proteins since proteins from lysates of
      herbimycin A-treated TCR-activated T cells fail to associate with Vav-SH2. Among
      the proteins from T cells that co-immunoprecipitate with the proto-Vav product
      and bind to its SH2 domain, specific antibodies identified the 70-kDa tyrosine
      phosphoprotein as ZAP-70, a protein tyrosine kinase (PTK) involved in TCR signal
      transduction. Binding of this PTK to Vav-SH2 is inhibited by a ZAP-70-specific
      synthetic tyrosine phosphopeptide. We suggest that ZAP-70 may function as a PTK
      for proto-Vav.

PMID- 7798262
TI  - Activation of mitogen-activated protein kinases by arachidonic acid and its
      metabolites in vascular smooth muscle cells.
AB  - Previous studies from this laboratory and others suggest that arachidonic acid
      and its metabolites play important roles in a variety of biological processes
      such as signal transduction, contraction, chemotaxis, and cell growth and
      differentiation. Here we studied the effect of arachidonic acid on mitogen
      activated protein (MAP) kinases in vascular smooth muscle cells (VSMC).
      Arachidonic acid activated MAP kinases in VSMC in a time- and dose-dependent
      manner. Nordihydroguaiaretic acid (NDGA), a potent inhibitor of the lipoxygenase
      system, significantly blocked the arachidonic acid-induced activation of MAP
      kinases, whereas indomethacin, an inhibitor of cyclooxygenase, had no effect. In
      VSMC, arachidonic acid was converted to 15-hydroxyeicosatetraenoic acid (15
      HETE); NDGA inhibited the formation of this HETE. Exogenous addition of 15-HETE
      to VSMC caused stimulation of MAP kinases. Depletion of protein kinase C
      attenuated both the arachidonic acid- and 15-HETE-induced activation of MAP
      kinases in VSMC. Together these results suggest that 1) arachidonic acid
      activates MAP kinases in VSMC; 2) 15-HETE, a 15-lipoxygenase product of
      arachidonic acid, at least in part, mediates the arachidonic acid effect on MAP
      kinases; and 3) protein kinase C appears to be important in arachidonic acid
      activation of MAP kinases. Therefore, MAP kinases may play an important role in
      arachidonic acid signaling of VSMC growth and function.

PMID- 7798263
TI  - Cadmium tolerance mediated by the yeast AP-1 protein requires the presence of an
      ATP-binding cassette transporter-encoding gene, YCF1.
AB  - Elevations in gene dosage of the transcriptional regulatory protein yAP-1 in
      Saccharomyces cerevisiae can elicit pronounced phenotypic increases in tolerance
      of a variety of drugs including the toxic heavy metal cadmium. While a large
      elevation in cadmium tolerance occurs in response to overproduction of yAP-1, the
      target genes under yAP-1 control have not yet been identified that are
      responsible for this increase. We show here that the YCF1 gene, encoding a likely
      integral membrane protein, is required for yAP-1 to exert its normal effects on
      cadmium tolerance. Mutant strains of yeast that lack the YCF1 gene are
      hypersensitive to cadmium and this hypersensitivity is epistatic to yAP-1
      overexpression. YCF1 mRNA levels and the expression of a YCF1-lacZ reporter
      construct positively correlates with changes in YAP1 gene dosage. A set of 5'
      truncation derivatives of the YCF1-lacZ fusion gene identified the region from 
      201 to +47 as being sufficient for the yAP-1-dependent increase in expression.
      DNase I footprinting using a probe from this segment of the YCF1 promoter showed
      that bacterially-produced yAP-1 protein was capable of binding a novel DNA
      element we have designated the yAP-1 response element. Insertion of the yAP-1
      response element upstream of a CYC1-lacZ gene fusion led to the production of
      beta-galactosidase in a yAP-1-dependent fashion. These data establish that an
      important physiological target of yAP-1 transcriptional regulation is the YCF1
      structural gene.

PMID- 7798264
TI  - Evidence for a second receptor binding site on human prolactin.
AB  - The existence of a second receptor binding site on human prolactin (hPRL) was
      investigated by site-directed mutagenesis. First, 12 residues of helices 1 and 3
      were mutated to alanine. Since none of the resulting mutants exhibit reduced
      bioactivity in the Nb2 cell proliferation bioassay, the mutated residues do not
      appear to be functionally necessary. Next, small residues surrounding the helix 1
      helix 3 interface were replaced with Arg and/or Trp, the aim being to sterically
      hinder the second binding site. Several of these mutants exhibit only weak
      agonistic properties, supporting our hypothesis that the channel between helices
      1 and 3 is involved in a second receptor binding site. We then analyzed the
      antagonistic and self-antagonistic properties of native hPRL and of several hPRLs
      analogs altered at binding site 1 or 2. Even at high concentrations
      (approximately 10 microM), no self-inhibition was observed with native hPRL; site
      2 hPRL mutants self-antagonized while site 1 mutants did not. From these data, we
      propose a model of hPRL-PRL receptor interaction which slightly differs from that
      proposed earlier for the homologous human growth hormone (hGH) (Fuh, G.,
      Cunningham, B. C., Fukunaga, R., Nagata, S., and Goeddel, D. V., and Well, J. A.
      (1992) Science 256, 1677-1680). Like hGH, hPRL would bind sequentially to two
      receptor molecules, first through site 1, then through site 2, but we would
      expect the two sites of hPRL to display, unlike the two binding sites of hGH,
      about the same binding affinity, thus preventing self-antagonism at high
      concentrations.

PMID- 7798265
TI  - The sperm acrosomal matrix contains a novel member of the pentaxin family of
      calcium-dependent binding proteins.
AB  - The sperm acrosome is a regulated secretory granule that undergoes exocytosis
      during fertilization. To elucidate the structural organization of the contents
      within the acrosome, guinea pig sperm acrosomal apical segments were isolated and
      mapped by two-dimensional polyacrylamide gel electrophoresis (PAGE). Although
      complex, the two-dimensional PAGE map was dominated by two M(r) 50,000
      polypeptides (p50 and proacrosin), a M(r) 67,000 polypeptide (p67), and a M(r)
      32,000 polypeptide (sp32). Proacrosin (pI > 8.0), p67, and sp32 were extracted
      from apical segments by 1 M NaCl. Protein p50, a relatively acidic polypeptide,
      was not extracted in 1 M NaCl and/or 1% Triton X-100 at 4 degrees C, but was
      solubilized with 6 M urea. Protein p50 was purified from the urea extract by
      elution from DEAE-Sephacel with 100 mM guanidine HCl and appeared homogeneous by
      SDS-PAGE. Antibodies to p50 were monospecific as judged by Western blot analysis.
      Indirect immunofluorescence indicated that p50 was restricted to the acrosomal
      apical segment. Incubation of apical segments at pH 7.5 in the presence of 1 mM
      EDTA at 37 degrees C resulted in the release of p50 into the 200,000 x g
      supernatant fluid, a process that was reversed by a subsequent incubation with
      1.5 mM CaCl2, but not with MgCl2. The Ca(2+)-dependent reassociation of p50 with
      the acrosomal apical segments was reversed by the addition of 2.0 mM EGTA,
      indicating that p50 binding is dependent on free Ca2+ concentrations. When
      acrosomal matrices were purified following Triton X-100 extraction, p50 was the
      major component, with p67, proacrosin, and sp32 as less prominent constituents.
      Molecular cloning demonstrated that p50 is a unique, testis-specific member of
      the pentaxin family of calcium-dependent binding proteins.

PMID- 7798266
TI  - Apexin, an acrosomal pentaxin.
AB  - We report the initial biochemical characterization and the primary structure of a
      guinea pig sperm acrosomal pentaxin (apexin). Pentaxins are a family of penta- or
      decameric serum proteins that includes serum amyloid protein and C-reactive
      protein. Apexin consists of disulfide-linked 50-kDa subunits that give rise to an
      oligomeric protein. Apexin and a sperm protein related to complement receptors
      coelute with affinity-purified fertilin (PH-30), a potential sperm-egg membrane
      fusion protein. However, no evidence for a functional association of apexin with
      fertilin was found. Apexin is localized to the acrosome of mature guinea pig
      sperm and is thus the first pentaxin for which a defined intracellular
      localization has been reported. Whereas the C-terminal portion of apexin is
      clearly related to serum pentaxins, the N-terminal domain shows no strong
      homology to other known proteins. Northern blot analysis of different tissues
      revealed expression in the testis. Apexin is distinct from the pentaxins serum
      amyloid protein and C-reactive protein and may have evolved to perform functions
      other than those performed by serum pentaxins, such as intracellular protein
      sorting to the acrosome.

PMID- 7798267
TI  - The signaling pathway coupling epidermal growth factor receptors to activation of
      p21ras.
AB  - Epidermal growth factor (EGF) treatment causes autophosphorylation of the
      epidermal growth factor receptor (EGFR) leading to increased guanine nucleotide
      exchange factor (GEF; Sos) activity and enhanced formation of p21ras-GTP. The
      connection of the EGFR to p21ras activation can occur through binding of Grb2.Sos
      complexes to the EGFR or through the adaptor protein Shc via EGFR.Shc.Grb2.Sos
      multimeric complexes. Therefore, we investigated the importance of Shc in
      coupling the EGFR to activation of ras GEF (Sos). EGF treatment led to rapid
      tyrosine phosphorylation of Shc. Although phosphorylated EGFR can bind to both
      Shc and Grb2, the predominant linkage was observed between EGFR and Shc.
      Similarly, more Grb2 was associated with Shc than with EGFR after EGF
      stimulation. Immunoprecipitation of Shc from EGF-stimulated cells removed almost
      all EGFR-associated Grb2. Furthermore, immunodepletion of Shc proteins from
      membrane fractions of EGF-stimulated cells removed 93% of the ras GEF activity,
      whereas, precipitation of EGFR had only a small effect on ras GEF activity. These
      data indicate that coupling to Shc provides the major pathway linking activated
      EGFRs to Grb2.Sos and stimulation of the p21ras pathway.

PMID- 7798268
TI  - A 30-base pair element is responsible for the myeloid-specific activity of the
      human neutrophil elastase promoter.
AB  - Human neutrophil elastase (HNE), a serine protease, is expressed only in the
      promyelocytic stages of granulocyte maturation. We examined several regions of
      the promoter for transcriptional activity and report that a 30-base pair (bp)
      element located between -76 and -106 in the 5'-flanking region of HNE is
      sufficient for myeloid-specific expression of HNE. Gel shift assays using nuclear
      extracts from myeloid and non-myeloid cells reveal several myeloid-specific
      complexes binding to the 30-bp element. Examination of DNA-protein interactions
      shows that at least two myeloid-specific proteins of 38 and 55 kDa bind to this
      element. DNase I protection analysis reveals two distinct footprints between -80
      to -91 and -94 to -104 within this element. Transient expression studies using
      deletion constructs of the HNE 5'-flanking region show that the 30-bp element is
      active in myeloid cells K 562 and U 937 but not in HeLa cells. Internal deletion
      of this element results in a 60-85% loss of promoter activity in myeloid cells.
      Additional functional studies also show that a 19-bp region between -112 and -131
      contributes to transcriptional activity of the elastase promoter as well.

PMID- 7798269
TI  - Bone matrix decorin binds transforming growth factor-beta and enhances its
      bioactivity.
AB  - In an effort to clarify the regulation of distribution and actions of
      transforming growth factor (TGF)-beta in bone, TGF-beta 1 binding to extracted
      bone matrix proteins and the influence of such binding on TGF-beta 1 actions were
      examined. In-gel binding of 125I-TGF-beta 1 using extracts from mineralized
      bovine bone matrix demonstrated that 125I-TGF-beta 1 was almost exclusively bound
      to a proteoglycan, decorin. The binding was via the core protein of decorin.
      Scatchard analysis of the binding of 125I-TGF-beta 1 to immobilized decorin
      purified from osteoblastic MC3T3-E1 cell conditioned medium revealed that there
      were two specific binding sites with high and low affinities for TGF-beta 1 (Kd =
      0.3 and 5 nM, respectively). The addition of decorin along with TGF-beta 1
      enhanced the inhibitory effect of TGF-beta 1 on MC3T3-E1 cell proliferation.
      Decorin in itself did not affect their proliferation. These cells possessed types
      I and II TGF-beta receptors and betaglycan, and the addition of decorin increased
      the binding of 125I-TGF-beta 1 to all these receptors. These results demonstrate
      that the core protein of decorin specifically binds TGF-beta 1 with high
      affinities and that the binding of TGF-beta 1 to decorin increases TGF-beta 1
      binding to its receptors and enhances its bioactivity. Because TGF-beta is
      released by bone resorption along with matrix proteins, including decorin, and
      because it stimulates the synthesis of these proteins, it is suggested that the
      binding and enhancement of the activities of TGF-beta by decorin may play a role
      in maintaining bone formation during bone remodeling process.

PMID- 7798270
TI  - Exon 11 enhances insulin binding affinity and tyrosine kinase activity of the
      human insulin proreceptor.
AB  - Data presented here show that there are significant differences in the insulin
      binding affinity and the tyrosine kinase activity of the insulin proreceptor
      isoforms which contain or lack exon 11. The exon 11(+) proreceptor does not show
      significant variations from the mature processed insulin receptor and has only a
      3- to 4-fold reduced affinity for insulin. In contrast, the exon 11(-)
      proreceptor showed a markedly reduced insulin binding (25- to 50-fold less) when
      assayed on intact cells. Upon solubilization of the cells, exon 11(-) proreceptor
      bound insulin with somewhat higher affinity. Mild trypsin treatment of the cells
      expressing either isoform of the insulin proreceptor restored insulin binding to
      near-normal levels. Analysis of tyrosine kinase activity revealed that the exon
      11(+) proreceptor required somewhat higher concentrations of insulin than the
      mature processed receptor to achieve maximal autophosphorylation. The exon 11(-)
      proreceptor failed to fully phosphorylate even at 10(-6) M insulin. Thus, the
      presence or absence of this short sequence of 12 amino acids affects the folding
      and/or conformation of the proreceptor so as to confer altered binding of
      insulin. We suggest that in the absence of exon 11 the proreceptor assumes a
      strained conformation that disrupts the insulin binding site. Cleavage of the
      proreceptor at the alpha-beta-subunit junction then allows the alpha-subunit to
      achieve its normal binding conformation.

PMID- 7798271
TI  - ETS transcription factors regulate the expression of the gene for the human
      mitochondrial ATP synthase beta-subunit.
AB  - Elements responsible for the transcriptional activity of the human ATP synthase
      beta-subunit (ATPsyn beta) gene promoter have been studied through transient
      expression in HepG2 hepatoma cells of a CAT gene connected with various 5'
      deletion mutants of the 5'-flanking region. Promoter activity was mostly
      dependent upon a single CCAAT motif as well as a nearby Ets domain binding
      region. This last region contains two sites that bind Ets-related proteins
      present in liver nuclear extracts as well as recombinant purified Ets-1 protein.
      The ATPsyn beta promoter was trans-activated by Ets-1 and Ets-2 expression
      vectors, and this effect was lost when the Ets binding region was deleted. The
      Ets binding region of the ATPsyn beta promoter increased basal expression and
      conferred Ets-1- and Ets-2-dependent trans-activation to the herpes symplex
      thymidine kinase minimal promoter. A double-point mutation of the main Ets
      binding site, which suppresses Ets binding, blocks Ets-dependent trans
      activation. It is concluded that the gene for the mitochondrial ATPsyn beta is a
      target of transcriptional activation by members of the Ets family of
      transcription factors. It is suggested that Ets transcription factors may be
      involved in the enhanced expression of the ATPsyn beta gene in highly
      proliferating cells and in the coordinate transcription of nuclear genes for
      mitochondrial proteins.

PMID- 7798272
TI  - Topoisomerase III, but not topoisomerase I, can support nascent chain elongation
      during theta-type DNA replication.
AB  - Topoisomerase III, but not topoisomerase I, could, in the absence of DNA gyrase,
      support bidirectional DNA replication in an oriC plasmid DNA replication system
      reconstituted with purified proteins. The initial rate of DNA synthesis and the
      efficiency of nascent chain elongation showed that topoisomerase III-stimulated
      DNA replication was as efficient as gyrase-stimulated DNA replication. In
      addition, topoisomerase III was also able, in the absence of DNA gyrase, to
      decatenate the replicating daughter DNA molecules to form monomer product. Thus,
      of the four topoisomerases in Escherichia coli, three, topoisomerases III and IV
      and DNA gyrase, can support nascent chain elongation, whereas only two,
      topoisomerases III and IV, can topologically resolve the daughter molecules.

PMID- 7798274
TI  - Characterization of human Gadd45, a p53-regulated protein.
AB  - GADD45 (growth arrest and DNA damage) is a DNA-damage-inducible gene regulated in
      part by the tumor suppressor p53. A role in negative growth control has recently
      been suggested based on significant (more than 75%) reduction of colony formation
      following over expression of Gadd45. To better understand the role of Gadd45, we
      have developed specific rabbit and murine antibodies raised against the human
      recombinant protein. Using these antibodies, we have found that in ML-1 cells
      Gadd45 is predominantly a nuclear protein. MyD118, a protein induced by terminal
      differentiation sharing 57% homology with Gadd45, does not cross-react with any
      of the antibodies produced. As expected, the induction of Gadd45 protein by
      ionizing radiation (IR) was also found to be dependent on a wild type p53
      phenotype. Interestingly, WI-L2-NS, a human lymphoid cell line, showed very high
      basal levels of Gadd45 mRNA and protein in addition to a high constitutive level
      of a mutated p53 protein. In this cell line, the high levels of GADD45 did not
      inhibit cellular growth in spite of the fact that no mutations were found in
      GADD45 sequence. These results indicate that some cell line(s) can tolerate high
      levels of Gadd45 and abrogate its growth suppression function.

PMID- 7798273
TI  - Arginine becomes an essential amino acid after massive resection of rat small
      intestine.
AB  - We compared effects of feeding arginine- and/or proline- deficient diets (-Arg, 
      Pro, and -Arg, Pro) with those of a complete diet (Complete) in rats whose small
      intestine had been massively resected. After 4 weeks, the rats fed -Arg and -Arg,
      Pro lost weight (a mean of 28 and 32 g, respectively), whereas those fed Complete
      and -Pro gained 80 and 58 g, respectively. The average nitrogen balance was about
      117,100, -20 and -14 mg/day for Complete, -Pro, -Arg, and -Arg, Pro diets,
      respectively. The concentration of arginine in skeletal muscle was about 310,
      330, 91, and 65 nmol/g for Complete, -Pro, -Arg, and -Arg, Pro, respectively;
      while plasma arginine concentration averaged 95, 107, 56, and 46 microM,
      respectively. The weight loss, the negative nitrogen balance, and the markedly
      reduced arginine concentration in the muscle observed in rats fed -Arg and -Arg,
      Pro clearly indicate that arginine becomes a strictly essential amino acid in the
      rats with massive resection of the small intestine. However, sufficient proline
      can be synthesized from arginine in tissues such as the liver and kidney in the
      absence of the small intestine. Plasma glutamine, citrulline in the muscle and
      plasma, urinary excretion of orotic acid and nitrate (to assess nitric oxide
      formation from arginine) were also measured, and the changes in these metabolites
      are discussed.

PMID- 7798275
TI  - Novel approach to molecular cloning and polynucleotide synthesis using vaccinia
      DNA topoisomerase.
AB  - Construction of chimaeric DNA molecules in vitro relies traditionally on two
      enzymatic steps catalyzed by separate protein components. Site-specific
      restriction endonucleases are used to generate linear DNAs with defined termini
      that can then be joined covalently at their ends via the action of DNA ligase. A
      novel approach to the synthesis of recombinant DNAs exploits the ability of a
      single enzyme, vaccinia DNA topoisomerase, to both cleave and rejoin DNA strands
      with extreme specificity at each step. Placement of the CCCTT cleavage motif for
      vaccinia topoisomerase near the end of a duplex DNA permits efficient generation
      of a stable, highly recombinogenic protein-DNA adduct that can religate only to
      acceptor DNAs that contain complementary single-strand extensions. Linear DNAs
      containing CCCTT cleavage sites at both ends (bivalent substrates) can be
      activated by topoisomerase and inserted into a plasmid vector in a simple and
      rapid in vitro procedure that is especially well suited to the molecular cloning
      of polymerase chain reaction-amplified DNAs. Activation of polyvalent (e.g.
      branched) DNA substrates by topoisomerase offers a potentially powerful method
      for the synthesis of two- and three-dimensional polynucleotide networks.

PMID- 7798276
TI  - Single amino acid changes alter the repair specificity of Drosophila Rrp1.
      Isolation of mutants deficient in repair of oxidative DNA damage.
AB  - Drosophila Rrp1 has several tightly associated enzymatic activities, including
      double-strand DNA 3'-exonuclease, apurinic/apyrimidinic endonuclease, 3'
      phosphatase, and 3'-phosphodiesterase. The carboxyl-terminal third of Rrp1,
      homologous to Escherichia coli exonuclease III, is sufficient to repair oxidative
      and alkylation-induced DNA damage in vivo. Using a screen for partial
      complementation of repair-deficient E. coli, we isolated three mutants of the
      nuclease domain of Rrp1: T462A, K463Q, and L484P, that protect against methyl
      methanesulfonate (MMS)-induced but not t-BuO2H-induced DNA damage. Thr-462 and
      Lys-463 are highly conserved residues found in a cluster of 5 conserved amino
      acids (LQETK), while Leu-484 is poorly conserved. Gln-460 Glu-461, Thr-462, and
      Lys-463 and Leu-484 were altered by site-directed mutagenesis using a plasmid
      including the entire Rrp1 gene and mutant proteins were purified. Mutants of the
      three residues Glu-461, Thr-462, and Lys-463 demonstrate 8-200-fold lower
      phosphodiesterase specific activity than wild-type Rrp1. E461A has a 30-fold
      reduction in AP endonuclease and is MMS-sensitive, but all other mutants have
      near-normal AP endonuclease and are MMS-resistant. Glu-461 appears to be
      essential for the nuclease function for Rrp1. Lys-463 and, to a lesser extent,
      Thr-462 influence the substrate specificity of the Rrp1 nuclease.

PMID- 7798278
TI  - In vivo isomerization of retinoic acids. Rapid isomer exchange and gene
      expression.
AB  - The in vivo isomerization of all-trans- and 9-cis-retinoic acids (RAs) was
      evaluated by high performance liquid chromatography after oral administration to
      rats. All-trans (2 ng/ml)- and 13-cis (1.8 ng/ml)-RAs, but not 9-cis-RA, were
      detected in the serum of normal rats. When an excess of either all-trans-RA or 9
      cis-RA (100 micrograms/rat) was intragastrically administered to the retinoid
      depleted rats, a rapid isomer exchange between 9-cis- and all-trans-RAs along
      with appearance of the administered RA occurred shortly after the dose (30 min).
      RA rapidly isomerized when an excess of either all-trans- or 9-cis-RA (1 mg/rat)
      was administered to normal rats. To examine whether the isomerized RAs elicit
      biological actions in vivo, the induction of target genes-[cellular retinol
      binding protein type II (CRBP II) for 9-cis-RA and all-trans-retinoic acid
      receptor beta (RAR beta) for 9-cis- and all-trans-RAs] was determined. The degree
      of induction of the two genes did not differ 4 h after administration of either 9
      cis-RA or all-trans-RA. However, unlike all-trans-RA, the RAR-specific synthetic
      retinoids did not induce the CRBP II gene. These results suggested that the
      apparent actions of 9-cis- and all-trans-RAs on gene expression in vivo may be
      mediated to some extent by the converted stereoisomer.

PMID- 7798277
TI  - Evidence for the uptake of a vitamin D analogue (OCT) by a human carcinoma and
      its effect of suppressing the transcription of parathyroid hormone-related
      peptide gene in vivo.
AB  - The present study was undertaken to clarify the pharmacokinetics of 22-oxa-1,25
      dihydroxyvitamin D3 (22-oxa-1,25-(OH)2D3, OCT), a vitamin D3 analogue with little
      calcemic activity, and its effect on the transcription of parathyroid hormone
      related peptide (PTHRP) gene in nude mice bearing a human carcinoma (FA-6)
      associated with humoral hypercalcemia. FA-6 tumor expressed vitamin D receptor
      (VDR) mRNA, and its nuclear extract contained a specific and saturable 1,25
      (OH)2D3 binding activity. Although [3H]OCT administered intravenously into FA-6
      tumor-bearing nude mice was cleared from the circulation more rapidly than
      [3H]1,25-(OH)2D3, the uptake of [3H]OCT into the tumor tissue, relative to the
      radioactivity in the circulation, was greater than that of [3H]1,25-(OH)2D3.
      Intravenous or oral administration of OCT reduced the steady-state levels of
      PTHRP mRNA in FA-6 tumor, and nuclear run-off assays demonstrated that the effect
      of OCT on PTHRP gene expression occurred at a transcriptional level. RNase
      mapping analysis revealed that both upstream and downstream promoters of the
      human PTHRP gene were down-regulated by OCT. Finally, OCT exerted a preventive as
      well as therapeutic effect on cancer-associated hypercalcemia with a marked
      prolongation of the survival time in tumor-bearing animals. These results suggest
      that OCT is effectively taken up by a VDR-positive human carcinoma in vivo and
      has a therapeutic potential for cancer-associated hypercalcemia through
      suppression of PTHRP gene transcription.

PMID- 7798279
TI  - Drosophila kinesin motor domain extending to amino acid position 392 is dimeric
      when expressed in Escherichia coli.

PMID- 7798280
TI  - Two strategies of transferring from sit-to-stand; the activation of monoarticular
      and biarticular muscles.
AB  - In this study, two different strategies of rising from a chair were compared,
      using integrated biomechanical and electromyographic analyses. Nine healthy
      subjects were instructed to rise using two different strategies: natural sit-to
      stand transfer (NSTS) and a sit-to-stand transfer with full flexion of the trunk
      (FSTS). Sagittal kinematics and ground reaction forces were registered. Muscle
      activity of nine muscles of the right leg were recorded by means of surface EMG.
      All signals were synchronized at seat-off. The results show that no differences
      occur between the kinematics of knee and ankle, whereas the hip flexion is, as
      expected, higher during FSTS. The higher moment about the knee during NSTS is
      shifted to proportionally higher moments about the hip and ankle during FSTS. It
      is mainly the differences in the EMG-levels of the biarticular hip and knee
      muscles which might explain the differences in net moment. These results are in
      accordance with a theory about a particular role of biarticular muscles. On the
      other hand, the shift from knee to ankle cannot be associated with a particular
      increase in activity of the biarticular m.gastrocnemius. It is hypothesized that
      about the ankle, control of stability is preferred over movement control. An
      important conclusion for rehabilitation medicine is that a lower net moment about
      the knee in FSTS does not automatically imply that this reduces the load on the
      knee extensors.

PMID- 7798281
TI  - Mechanical behavior of damaged trabecular bone.
AB  - The mechanical behavior of damaged trabecular bone may play a role in the
      etiology of age-related spine fractures since damaged bone exists in and may
      weaken the elderly vertebral body. To describe some characteristics of damaged
      trabecular bone, we measured the changes in modulus and strength that occur when
      bovine trabecular bone is loaded in compression to various strains beyond its
      elastic range. Twenty-three reduced-section specimens, taken from 17 different
      bones, were loaded from 0-X-0-9% strain, where X was one of four strains: 1.0% (n
      = 7), 2.5% (n = 6), 4.0% (n = 5), or 5.5% (n = 5). We found that modulus was
      reduced for all applied strains, whereas strength was reduced only for strain
      levels > or = 2.5%; the percentage changes in modulus and strength were
      independent of Young's modulus but were highly dependent on the magnitude of the
      applied strains; modulus was always reduced more than strength; and simple
      statistical models, using knowledge of only the applied strains, predicted well
      the percentage reductions in modulus (r2 = 0.97) and strength (r2 = 0.74). The
      modulus reductions reported here are in qualitative agreement with those for
      cortical bone in tensile loading, supporting the concept that the damage
      behaviors of cortical and trabecular bone are similar for low strains (< or =
      4.0%). In addition, because modulus was always reduced more than strength,
      damaged trabecular bone may be stress protected in vivo by redistribution of
      stresses to undamaged bone.

PMID- 7798282
TI  - Pressure development within a sac-type pneumatically driven ventricular assist
      device.
AB  - Intrinsic features of the pumping process of a pneumatically driven ventricular
      assist device (VAD) and the effects of different types of pneumatic drivers upon
      its performance were investigated in vitro by analysing the pressure
      distributions within the device and the motions of the prosthetic valves. It was
      found that the stretching of the flexible, elastic diaphragm in both late systole
      and diastole initiates a pressure oscillation which directly affects the timing
      of the pumping process. The timing was also found to be dependent on the length
      and stiffness of the cannulae which link the VAD to the model circulation system.
      During the stretch-induced oscillation in late systole, the VAD housing
      experiences partial collapse due to fluid momentum effects, which tends to
      increase the effective stroke volume of the device, and reduce the amplitude of
      the pressure oscillation. Reducing the rising (falling) rate of driving pressures
      (dpd/dt) may not necessarily reduce the maximum rate of change of the blood
      chamber pressure (dpch/dtmax) but may upset the stability of the pumping process.
      This is because a minimum dpch/dtmax exists, which is determined by the stretch
      induced oscillation. In order to minimize dpch/dtmax and to provide the device
      with a stable working condition, dpd/dt should match the dpch/dtmax.

PMID- 7798283
TI  - Compliance of normal, dystrophic and transplanted mouse muscles.
AB  - Parallel and series compliances have been studied in extensor digitorum longus
      (fast) and soleus (slow) muscles in normal (strain C57BL/10) and dystrophic
      (strain mdx) mice, and in muscles regenerated after transplantation. Resting
      elasticity was analysed by measuring the tension-length relationship in
      unstimulated muscles. Passive tension is larger in mdx and in transplanted
      muscles than in their normal controls: at 1.15L0, passive tension is 0.12P0 in
      controls, 0.32P0 in mdx, and 0.40P0 in transplanted muscles. The differences are
      statistically significant. This indicates that passive tension is mainly
      determined by the amount of connective tissue. The stress-strain relationship of
      the series compliance was analysed by the method of isotonic releases during
      tetani. It is adequately described by a single exponential equation, with a rate
      constant of about 8P0/P. No difference was found between the various muscles
      studied. Extension of the series compliance at P0 is 0.02L0. Compliance is about
      3% (L0/P0) at 0.2P0, and is not significantly different from zero at P0. Series
      compliance is thus very low in mouse muscles, substantially lower than in frog
      and rat muscles. Consequently, it can be neglected in studies of whole mouse
      muscle in which tension is higher than 0.4P0.

PMID- 7798284
TI  - A model of foot placement during gait.
AB  - Foot placement is known to affect balance during gait; however, how foot
      placements are chosen is unknown. Objectives of this research were to analyze
      swing trajectories of the foot during gait with respect to the pelvis, and to
      propose a model of foot placement control which provides a stable base of
      support. Effects of gait speed and vision on this model of foot placement were
      then examined. Foot trajectories were analyzed using spherical coordinates
      referenced to the pelvis, termed the pelvic spherical coordinates (PSCs). A model
      was developed based on this coordinate system which predicts foot placement in
      terms of position and velocity with respect to the pelvis. It is proposed that
      foot placements are chosen to minimize the sum of PSC coordinates of the stance
      and swing feet. Foot velocity at heel contact is proposed to minimize the sum of
      the PSC stance and swing angular velocities. Experimental data were collected to
      test this model during walking trials of different speeds, both with and without
      vision. Results showed that sums of stance and swing feet PSCs were very close to
      zero at heel contact, supporting the positional control hypothesis. Sums of PSC
      velocities, however, were not zero at heel contact. Rather, individual swing leg
      PSC velocities were zero at heel contact, suggesting independent swing leg
      velocity control. Vision did not have an effect on position or velocity variables
      at heel contact. Gait speed did have an effect, particularly on PSC velocities at
      heel contact.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798285
TI  - An asymptotic solution for the contact of two biphasic cartilage layers.
AB  - This study addresses the hypothesis that interstitial fluid plays a major role in
      the load support mechanism of articular cartilage. An asymptotic solution is
      presented for two contacting biphasic cartilage layers under compression. This
      solution is valid for identical thin (i.e. epsilon = h'/a'0 << 1), frictionless
      cartilage layers, and for the 'early' time response (i.e. t' << (h')2/HAk) after
      the application of a step load. An equilibrium asymptotic solution is also
      presented (i.e.t'-->infinity). Here h' is the thickness, a'0 is a characteristic
      contact radius, HA is the aggregate modulus and k is the permeability of the
      cartilage layer. A main conclusion from this analysis is that the fluid phase of
      cartilage plays a major role in providing load support during the first 100-200 s
      after contact loading. Further, the largest component of stress in cartilage is
      the hydrostatic pressure developed in the interstitial fluid. For tissue fluid
      volume fraction (porosity) in the range 0.6 < or = phi f < or = 0.8, k = O(10(
      15) m4/Ns) and HA = O(1 MPa), the peak magnitude of the principal effective (or
      elastic) stress may be as low as 14% of the peak hydrostatic pressure within the
      tissue, or the contact stress at the surface. In effect, the interstitial fluid
      shields the solid matrix from high normal stresses and strains. The asymptotic
      solution also shows that pressure-sensitive film measurements of intra-articular
      contact stress do not measure the elastic stress at the surface, but they rather
      provide a measure of the interstitial fluid pressure. Finally, this analysis
      provides strong support for the hypothesis that, if sudden loading causes shear
      failure within the cartilage-bone layer structure, this failure would take place
      at the cartilage-bone interface, and the plane of failure would be either
      parallel or perpendicular to this interface.

PMID- 7798286
TI  - Skeletal muscle stiffness in static and dynamic contractions.
AB  - Series elastic stiffness of rat gastrocnemius medialis muscle was determined by
      means of sinusoidal movements (180 Hz, 0.25% of muscle length) for various
      contraction conditions. The effects of muscle length, activation level, velocity,
      prestretch, and temperature on the force-stiffness relationship were
      investigated. All force-stiffness curves were transformed to a linear force-alpha
      curve (Ettema and Huijing, 1993; Morgan, 1977) to distinguish mathematically two
      series elastic components; a force dependent and force independent compliance.
      For all isometric conditions a typical force-stiffness curve was found, where
      stiffness increased with force, and this increase levelled off at higher forces.
      Stiffness in dynamic shortening and lengthening contractions is related to force
      in a completely different way than in isometric condition. An increase in
      temperature caused a decrease in muscle stiffness for a given force, and the
      effects of muscle length, activation level, and prestretch were small. It was
      concluded that the series elastic component of skeletal-muscle-tendon complex is
      probably located in more than two morphologically identifiable elements.
      Furthermore, we concluded that using a single series elastic element in muscle
      modelling is not appropriate to describe muscle behaviour under all conditions
      that occur during in vivo activation.

PMID- 7798287
TI  - A squeeze flow phenomenon at the closing of a bileaflet mechanical heart valve
      prosthesis.
AB  - In vivo cavitation in cardiovascular flow fields may occur under very unusual
      circumstances as a localized transient phenomenon which are confined to very
      small regions in the vicinity of the valve body or leaflet surface. The violent
      collapse of cavitation bubbles induces local erosion that may lead to structural
      damage. The fluid mechanical factors that may cause in vivo cavitation inception
      in mechanical heart valve (MHV) prostheses are investigated. It is established
      that the closing velocity of the leaflet holds the key to MHV cavitation. During
      the final phase of valve closing, the fluid mass in the gap space between the
      closing occluder and the valve's body is squeezed into motion by the rapidly
      approaching boundaries. The flow pattern created by this motion (termed 'squeeze
      flow'), is found to be related to the valve geometry, and the impact velocity of
      the closing leaflet. Given the closing velocity of the leaflet and the geometry
      of the MHV, computational flow dynamics (CFD) are made to determine the velocity
      distributions in the gap flow field of a bileaflet MHV in the mitral position. A
      two dimensional, time dependent model of the gap space show that flow velocity in
      the gap space can reach values as high as 30 ms-1 in regions near the edge of the
      inflow surface of the Edwards Duromedics (ED) MHV leaflet. This high speed stream
      ejected from the gap channel can create the conditions that characterize
      cavitation. The location of the isolated high speed region corresponds to the
      surface erosion that was observed in a number of damaged ED-MHV explants.

PMID- 7798288
TI  - Modeling of the wave transmission properties of large arteries using nonlinear
      elastic tubes.
AB  - We propose a new, simple way of constructing elastic tubes which can be used to
      model the nonlinear elastic properties of large arteries. The tube models are
      constructed from a silicon elastomer (Sylgard 184, Dow Corning), which exhibits a
      nonlinear behavior with increased stiffness at high strains. Tests conducted on
      different tube models showed that, with the proper choice of geometric
      parameters, the elastic properties, in terms of area-pressure relation and
      compliance, can be similar to that of real arteries.

PMID- 7798289
TI  - A method for the fatigue testing of pedicle screw fixation devices.
AB  - Spinal devices/instrumentation are used to augment the stability of a
      decompressed spinal segment during surgery. Like any other mechanical component,
      the device can fail. A standard in vitro test protocol, was developed to
      determine load vs number of cycles to failure curve for a pedicle screw-plate/rod
      type spinal device. The protocol based on the use of an 'artificial spine' model,
      is clinically relevant. The protocol was used to characterize the load-carrying
      capacities and failure modes of a specific pedicle screw-rod type fixation device
      to demonstrate its appropriateness. The devices (Kaneda) were tested in the quasi
      static as well as fatigue bending modes. In the bending fatigue mode, the devices
      failed at loads significantly smaller than the corresponding quasi-static failure
      load magnitude (806 N). The device exhibited an endurance limit in the fatigue
      bending mode. The device is not likely to exhibit failure if subjected to cyclic
      loads which cause less than 380 N axial compression (and an accompanying bending
      moment relative to the device of less than 13.57 Nm). The failures observed in
      specimens subjected to the fatigue tests ranged from complete to partial breakage
      of the paraspinal rods as opposed to failure due to permanent deformation
      (yielding) of the rods in the quasi-static bending test specimens. The protocol
      developed can be used for any other screw-plate/rod type spinal instrumentation.
      The use of a standard protocol by researchers would enable a comparison of
      various devices currently available in the market. Such comparative data would be
      useful for the scientific community, and agencies such as the FDA and
      ASTM.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798290
TI  - A physiological approach to the simulation of bone remodeling as a self
      organizational control process.
AB  - Although the capacity of bone to adapt to functional mechanical requirements has
      been known for more than a century, it is still unclear how the bone adaptation
      processes are regulated. We hypothesize that osteocytes are sensitive to
      mechanical loading and control the regulation of bone mass in their environment.
      Recently, simulation models of such a process were developed, using the finite
      element method. It was discovered that these models produce discontinuous
      structures, not unlike trabecular bone. However, it was also found that severe
      discontinuities violate the continuum assumption underlying the finite element
      method and that the solutions were element mesh dependent. We have developed a
      simulation model (which is physiologically and mechanically more consistent)
      which maintains the self-organizational characteristics but does not produce
      these discontinuities. This was accomplished by separating the sensor density and
      range of action from the mesh. The results clearly show that predicted trabecular
      morphology, i.e. sizes and branching of struts, depend on the actual relationship
      between local load, sensor density and range of influence. We believe that the
      model is suitable to study the relationship between trabecular morphology and
      load and can also explain adaptation of morphology, in the sense of 'Wolff's
      law'.

PMID- 7798291
TI  - Revisiting the debate: the use of new agents in previously untreated patients
      with small cell lung cancer; quality versus duration of survival.

PMID- 7798293
TI  - Antiproliferative effects of interferon gamma in combination with alpha
      difluoromethylornithine on human carcinoma cell cultures.
AB  - The antiproliferative effects of human recombinant interferon gamma (IFN gamma)
      in combination with alpha-difluoromethylornithine (DFMO) or as single agents were
      assessed on human cell cultures derived from carcinomas of the breast (MCF-7),
      the ovary (EFO-27) or the kidneys (EGI-4). Results were obtained in proliferation
      assays by direct cell counting. The cell lines differed considerably in their
      sensitivities to the antiproliferative effect of IFN gamma as compared by the 50%
      inhibition doses of the growth (ID50). In contrast to the findings with IFN
      gamma, similar antiproliferative effects resulted from the application of
      comparable doses of DFMO. While IFN gamma induced cytotoxic effects in EGI-4
      cells, DFMO produced only cytostatic actions in the cell lines analyzed.
      Synergistic growth inhibition resulted from the combined application of IFN gamma
      and DFMO in EFO-27 cell cultures. This finding was most pronounced after
      treatment with IFN gamma or DFMO doses below the respective ID50 values. However,
      antagonistic effects occurred in cells of the line EGI-4 after DFMO had been
      combined with IFN gamma at concentrations below the cytotoxic dose range. Within
      the sensitivity of our proliferation assay, no synergistic interactions were
      found in MCF-7 cell cultures. In the cell lines tested, no relation between the
      sensitivity for the single agents and the effectivity of the drug combination was
      identified. Despite promising synergistic effects in the moderately IFN gamma
      sensitive ovarian carcinoma cell line EFO-27, the efficacy of the IFN gamma/DFMO
      combination was restrained by possible antagonistic effects as demonstrated in
      the highly IFN gamma-sensitive EGI-4 renal carcinoma cell cultures. We conclude
      that the differential interaction patterns in the cell cultures analyzed preclude
      general suggestions for clinical studies using IFN gamma and DFMO.

PMID- 7798292
TI  - Growth inhibition of human gastrointestinal cancer cells by cyclosporin A.
AB  - We have studied the ability of cyclosporin A (CsA) to inhibit the growth of human
      AGS gastric and HT29 colon carcinoma cells in vitro. Using continuous drug
      exposure in growth assays of cultured tumour cells we found that CsA produced a
      dose-dependent growth inhibition in gastric and colon cancer cells with a half
      maximal effect at 5 microM and 6 microM CsA respectively. The growth inhibition
      of CsA was reversible in AGS cells, when the tumour cells were incubated in
      normal growth medium following CsA treatment. Trypan blue dye exclusion in AGS
      cells indicated a cytostatic rather than a cytotoxic effect in the concentration
      range used. Coincubation of CsA-treated cells with 10-400 U/ml interleukin-2 (IL
      2) could not abrogate this growth inhibition, suggesting an IL-2 independent
      mechanism of action. Flow-cytometric analysis did not reveal a phase arrest of
      the gastric cancer cells within the cell cycle. We conclude from our experiments
      that CsA cytostatically and reversibly inhibits the growth of human gastric
      cancer cells in a dose-dependent manner. In contrast to its mechanism of action
      in lymphocytes, this direct antiproliferative effect of CsA seems not to be
      mediated by an IL-2-dependent pathway or a cell-cycle-phase arrest of the tumour
      cells.

PMID- 7798294
TI  - A new cytogenetic subgroup in lipomas: loss of chromosome 16 material in spindle
      cell and pleomorphic lipomas.
AB  - Six spindle cell lipomas and two pleomorphic lipomas were analyzed
      cytogenetically. One spindle cell lipoma had a supernumerary ring chromosome as
      the sole anomaly. The other five spindle cell lipomas and both pleomorphic
      lipomas had hypodiploid stemlines with monosomy 16 or unbalanced aberrations
      leading to loss of 16q13-qter, a feature distinguishing these lipoma subtypes
      from other benign and borderline adipose tissue tumor histotypes. unbalanced
      aberrations of chromosomes 13 and 10 were found in five and three cases
      respectively; 13q12 was lost in all of these cases, whereas there was no common
      deleted segment in chromosome 10. No aberrations involving 12q13-15, which are
      frequent in typical lipomas, were found. Both pleomorphic lipomas, but none of
      the spindle cell lipomas, had hypotetraploid sidelines, multiple nonclonal
      aberrations, and telomeric associations. The present findings reveal a new
      cytogenetic/histopathological association in adipose tissue tumors.

PMID- 7798295
TI  - Sublethal damage repair after fractionated irradiation in endometrial cancer cell
      lines tested with the 96-well plate clonogenic assay.
AB  - Two long-established and seven newly established endometrial adenocarcinoma cell
      lines were tested for their capacity to repair sublethal damage after
      fractionated irradiation. Cell survival was determined with the 96-well plate
      clonogenic assay based on limiting dilutions. Total radiation doses of 0.75 Gy,
      1.25 Gy, 2.50 Gy, 5.00 Gy and 7.50 Gy were used either as a single dose or
      divided into two or three equal fractions with a 24 h interval. Survival data
      were fitted to the linear quadratic model, and the area under the survival curve
      (AUC), equivalent to the mean inactivation dose, was obtained with numerical
      integration. The amount of sublethal damage repair (SLDR) was expressed as an
      area-under-the-curve (AUC) ratio comparing survivals from fractionated-dose with
      those from single-dose experiments. SLDR capacity of the cell lines expressed as
      an AUC ratio varied between 1.00 and 1.59, and the mean was 1.17. Two highly
      radiosensitive cell lines were found to be SLDR-deficient, but most of the cell
      lines studied had some SLDR capacity. We have earlier shown that endometrial
      cancer cell lines as a group are more radiosensitive than squamous-cell carcinoma
      (SCC) lines. Data obtained in this study suggest that the capacity for SLDR in
      these cell lines is rather limited compared with the majority of SCC lines
      tested. This finding underlines further the high radioresponsiveness of
      endometrial cancer.

PMID- 7798296
TI  - Effects of differentiation-inducing agents on purine nucleotide metabolism in an
      ovarian cancer cell line.
AB  - The effects of the differentiation-inducing agents sodium butyrate (NaOBt),
      dimethylsulfoxide (DMSO) and mycophenolic acid (MA), on purine nucleotide
      metabolism, was studied in an ovarian carcinoma cell line (GZL-8). Exposure to
      these agents inhibited cell proliferation, but did not affect cell viability.
      Three hours following exposure, NaOBt and DMSO moderately decelerated purine
      synthesis de novo, but MA accelerated it three-fold, this being associated with a
      two-fold increase in the excretion of hypoxanthine and xanthine into the
      incubation medium. NaOBt and DMSO did not affect the cellular nucleotide content,
      but MA caused a 73% decrease in GTP content and about a 50% increase in the
      cellular content of UTP. The following alterations in cellular enzyme activity
      were observed 72 h following exposure: NaOBt decreased the activity of
      hypoxanthine-guanine phosphoribosyltransferase and increased the activity of IMP
      and of AMP 5'-nucleotidases, DMSO increased the activity of IMP 5'-nucleotidase,
      and MA increased the activity of the two nucleotidases. The results suggest that,
      in the carcinoma cell line studied, the differentiation process induced by NaOBt
      and DMSO may be associated with a general shift in the direction of purine
      metabolism from anabolism to catabolism, whereas that induced by MA is associated
      with a specific decrease in the production of GTP.

PMID- 7798297
TI  - Argyrophilic nucleolar organizer regions in the evaluation of tumour progression
      in the oral mucosa: correlation with tissue pathology.
AB  - The present study has analysed the numbers of argyrophilic nucleolar organizer
      regions (AgNOR) in normal tissues and in premalignant and malignant lesions of
      the oral mucosa in order to assess their potential as a biological marker for
      tumour progression. On comparison of AgNOR numbers in different lesions,
      carcinomas showed the highest number (4.65 +/- 0.98) compared to leukoplakias
      (2.38 +/- 0.47) and normal tissues (1.53 +/- 0.39). Spindle cell carcinomas and
      poorly differentiated squamous cell carcinomas had higher AgNOR counts than well
      differentiated carcinomas. In various clinically different types of oral
      leukoplakia, the lowest AgNOR counts were observed in homogenous leukoplakia and
      the highest in speckled leukoplakia. No significant difference in AgNOR number
      was observed between non-dysplastic and dysplastic leukoplakia, although a
      significant difference was evident between dysplastic leukoplakia and normal oral
      mucosa. Correlating the AgNOR count and tumour progression, a significantly high
      positive correlation coefficient (r = 0.7969, P = 0.0000) was observed.

PMID- 7798298
TI  - Aberrations of the APC gene in primary breast carcinoma.
AB  - Aberrations of the APC gene, which plays an important role in the genesis of
      familial adenomatous polyposis and colorectal carcinoma, were investigated in 31
      surgical specimens of primary breast carcinoma. These studies utilized the
      polymerase chain reaction followed by restriction-fragment-length polymorphism
      and single-strand-conformation polymorphism analyses combined with tumor cell
      enrichment by cell sorting. Loss of heterozygosity at the APC locus was detected
      in 8 (38%) of 21 informative cases, but only 2 (6%) of 31 tumors carried a
      mutated APC gene. Direct DNA sequencing analysis confirmed mutations at codon
      1081 (AGC to ATC) resulting in an amino acid substitution of serine for
      isoleucine, and at codon 1096 (CAG to CAT) resulting in a substitution of
      glutamine for histidine. There were no significant correlations between the loss
      of heterozygosity or mutation at the APC locus and any clinicopathological
      characteristics. Our present observations suggest that the mutations of the APC
      gene may play an important role in the genesis of certain breast carcinomas, and
      that another tumor-suppressor gene, which is the true target of frequent loss of
      heterozygosity, may exist near the APC gene.

PMID- 7798301
TI  - 85th annual meeting of the American Association for Cancer Research. San
      Francisco, California, April 1994.

PMID- 7798299
TI  - Occasional loss of constitutive heterozygosity at 11p15.5 and imprinting
      relaxation of the IGFII maternal allele in hepatoblastoma.
AB  - The 11p15.5 chromosomal region contains one or more loci involved in congenital
      developmental abnormalities and in the genesis of embryonal tumors, such as
      Wilms' tumor, embryonal rhabdomyosarcoma, and hepatoblastoma. In these tumors, a
      loss of constitutive heterozygosity, selectively involving a specific parental
      allele, suggests both the presence of onco-suppressor genes and a phenomenon of
      genomic imprinting. We present evidence that both genetic events could be
      occasionally involved in hepatoblastoma. In fact, loss of heterozygosity at
      11p15.5 could be documented in 3 of 13 patients with hepatoblastoma, and in 2
      cases the paternal origin of the residual allele in the tumor was assessed.
      Moreover, imprinting of the paternal IGFII allele and the maternal H19 allele was
      confirmed in normal tissues of 5 informative patients. Finally, imprinting
      relaxation of IGFII was detected in the tumor tissue of 1 patient.

PMID- 7798302
TI  - 30th annual meeting of the American Society of Clinical Oncology. Dallas, Texas,
      May 1994.

PMID- 7798300
TI  - Coexpression of HER-2/neu and p53 is associated with a shorter disease-free
      survival in node-positive breast cancer patients.
AB  - Breast cancer tissue was examined for overexpression of HER-2/neu and p53
      oncogene proteins. Samples from 105 breast cancer patients were investigated by
      Western-blot analysis and their relationship to other established markers and
      clinical outcome was examined. In 21.0% of the cases HER-2/neu was overexpressed,
      and in 46.7% the p53 protein level was increased. Expression of these two
      oncogene products was closely correlated. Overexpression of both oncogenes was
      associated with larger tumour size and negative hormone receptor. The percentage
      of HER-2/neu and p53 overexpression was higher in node-positive patients,
      although statistical evaluation was not significant. While overexpression of HER
      2/neu as well as p53 in node-positive patients was associated insignificantly
      with shorter disease-free survival, a significant difference could be documented
      when the disease-free survival of patients with overexpression of both oncogene
      proteins was compared to that of patients with no overexpression.

PMID- 7798303
TI  - Gastric and esophageal cancers: perspectives from a U.S.-Japan meeting. Hawaii,
      February 6-7, 1993.

PMID- 7798304
TI  - Preliminary results of a phase I/II trial of paclitaxel in patients with relapsed
      or cisplatin-refractory testicular cancer.
AB  - Paclitaxel represents a novel antitumour agent with demonstrated activity in
      cisplatin-sensitive tumours, particularly ovarian cancer. In addition, responses
      to paclitaxel have been observed in patients with cisplatin-refractory ovarian
      cancer. The role of paclitaxel in the treatment of testicular cancer has not been
      explored so far. Despite the generally high cure rates in patients with
      metastatic testicular cancer, patients with relapsed disease not responding to
      platin-based salvage chemotherapy have an extremely poor prognosis. In a phase
      I/II trial 10 patients with relapsed, cisplatin-refractory malignant germ-cell
      tumours were treated with paclitaxel as 6-h infusions (8 patients) or 3-h
      infusions (2 patients) at doses from 135 mg/m2 to 310 mg/m2 at 3-week intervals.
      Three patients achieved a response to paclitaxel, but disease recurred shortly in
      two patients after two and four cycles of therapy, respectively. One patient has
      remained in marker-negative partial response for more than 5 months. The toxicity
      of paclitaxel was tolerable for a dose range from 135 mg/m2 to 225 mg/m2.
      Granulocytopenia, WHO grades 3 and 4, occurred in all patients but was of short
      duration (median 3 days; range: 2-7 days). Other toxicities such as mucositis (5
      patients grade 1), neurotoxicity (1 patient grade 1, 2 patients grade 2),
      infection (1 patient grade 3) and diarrhoea (1 patient grade 2) were not dose
      limiting. There were no hypersensitivity reactions, but 1 patient developed
      severe myalgias during therapy with paclitaxel. Six patients with documented
      cisplatin-refractory disease were retreated with cisplatin-based chemotherapy
      after paclitaxel treatment and, in 4 of these, tumour responses of 3, 4, 5 and
      more than 5 months duration were achieved. In order to explore the role of
      paclitaxel in relapsed and/or cisplatin-refractory testicular cancer a phase II
      study using a 3-h infusion of 225 mg/m2 paclitaxel every 3 weeks, conducted by
      the German Testicular Cancer Study Group, is ongoing.

PMID- 7798305
TI  - An end in sight: tropomodulin.

PMID- 7798306
TI  - The Alzheimer's disease sphinx: a riddle with plaques and tangles.

PMID- 7798307
TI  - NAP57, a mammalian nucleolar protein with a putative homolog in yeast and
      bacteria.
AB  - We report the identification and molecular characterization of a novel nucleolar
      protein of rat liver. As shown by coimmunoprecipitation this protein is
      associated with a previously identified nucleolar protein, Nopp140, in an
      apparently stoichiometric complex and has therefore been termed NAP57 (Nopp140
      associated protein of 57 kD). Immunofluorescence and immunogold electron
      microscopy with NAP57 specific antibodies show colocalization with Nopp140 to the
      dense fibrillar component of the nucleolus, to coiled bodies, and to the
      nucleoplasm. Immunogold staining in the nucleoplasm is occasionally seen in the
      form of curvilinear tracks between the nucleolus and the nuclear envelope,
      similar to those previously reported for Nopp140. These data suggest that Nopp140
      and NAP57 are indeed associated with each other in these nuclear structures. The
      cDNA deduced primary structure of NAP57 shows a protein of a calculated molecular
      mass of 52,070 that contains a putative nuclear localization signal near its
      amino and carboxy terminus and a hydrophobic amino acid repeat motif extending
      across 84 residues. Like Nopp140, NAP57 lacks any of the known consensus
      sequences for RNA binding which are characteristic for many nucleolar proteins.
      Data bank searches revealed that NAP57 is a highly conserved protein. A putative
      yeast (S. cerevisiae) homolog is 71% identical. Most strikingly, there also
      appears to be a smaller prokaryotic (E. coli and B. subtilis) homolog that is
      nearly 50% identical to NAP57. This indicates that NAP57 and its putative
      homologs might serve a highly conserved function in both pro- and eukaryotes such
      as chaperoning of ribosomal proteins and/or of preribosome assembly.

PMID- 7798308
TI  - Tpr, a large coiled coil protein whose amino terminus is involved in activation
      of oncogenic kinases, is localized to the cytoplasmic surface of the nuclear pore
      complex.
AB  - From a panel of monoclonal antibodies raised against fractions of rat liver
      nuclear envelopes (NEs), we have identified an antibody, RL30, which reacts with
      novel nuclear pore complex (NPC) antigens that are not O-glycosylated. By
      immunofluorescence staining of cultured cells, RL30 reacts exclusively with the
      NE in a punctate pattern that largely coincides with that of identified NPC
      proteins. RL30 labels only the cytoplasmic surface of the NPC in immunogold
      electron microscopy, predominantly in peripheral regions nearby the cytoplasmic
      ring. In immunoblots of isolated rat liver NEs and cultured rat cells, RL30
      recognizes a 265-kD band, as well as a series of 175-265-kD bands in rat liver
      NEs that are likely to be proteolytic products of p265. Sequencing of peptides
      from the 175- and 265-kD RL30 antigens of rat liver revealed that they are both
      closely related to human Tpr, a protein whose amino-terminal 150-250 amino acids
      appear in oncogenic fusions with the kinase domains of the met, trk, and raf
      protooncogenes. We found that in vitro translation of human Tpr mRNA yields a
      major 265-kD band. Considered together, these data indicate that the 265-kD RL30
      antigen in the NPC is the rat homologue of Tpr. Interestingly, Tpr contains an
      exceptionally long predicted coiled coil domain (approximately 1600 amino acids).
      The localization and predicted structure of Tpr suggest that it is a component of
      the cytoplasmic fibrils of the NPC implicated in nuclear protein import.
      Immunofluorescence microscopy shows that during NPC reassembly at the end of
      mitosis, Tpr becomes concentrated at the NE significantly later than O-linked
      glycoproteins, including p62. This indicates that reassembly of the NPC after
      mitosis is a stepwise process, and that the Tpr-containing peripheral structures
      are assembled later than p62.

PMID- 7798310
TI  - Translation of the psbA mRNA of Chlamydomonas reinhardtii requires a structured
      RNA element contained within the 5' untranslated region.
AB  - Translational regulation is a key modulator of gene expression in chloroplasts of
      higher plants and algae. Genetic analysis has shown that translation of
      chloroplast mRNAs requires nuclear-encoded factors that interact with
      chloroplastic mRNAs in a message-specific manner. Using site-specific mutations
      of the chloroplastic psbA mRNA, we show that RNA elements contained within the 5'
      untranslated region of the mRNA are required for translation. One of these
      elements is a Shine-Dalgarno consensus sequence, which is necessary for ribosome
      association and psbA translation. A second element required for high levels of
      psbA translation is located adjacent to and upstream of the Shine-Dalgarno
      sequence, and maps to the location on the RNA previously identified as the site
      of message-specific protein binding. This second element appears to act as a
      translational attenuator that must be overcome to activate translation. Mutations
      that affect the secondary structure of these RNA elements greatly reduce the
      level of psbA translation, suggesting that secondary structure of these RNA
      elements plays a role in psbA translation. These data suggest a mechanism for
      translational activation of the chloroplast psbA mRNA in which an RNA element
      containing the ribosome-binding site is bound by message-specific RNA binding
      proteins allowing for increased ribosome association and translation initiation.
      These elements may be involved in the light-regulated translation of the psbA
      mRNA.

PMID- 7798309
TI  - Facilitated nuclear transport of calmodulin in tissue culture cells.
AB  - Calmodulin (CaM) potentiates Ca(2+)-dependent signaling pathways in both the
      cytoplasm and nucleus. We have investigated the mechanism of CaM nuclear
      transport using tissue culture cell microinjection and a permeabilized cell
      import assay. The inhibition of CaM import by the translocation inhibitor wheat
      germ agglutinin (WGA) and by chilling, indicates that CaM import is facilitated,
      but because ATP depletion does not affect CaM import, the mechanism does not
      appear to be active. Chilling and WGA arrest persist in ATP-depleted cells,
      indicating that CaM is not retained in the cytoplasm by an ATP-dependent
      mechanism. In permeabilized cells, both Ca(2+)-CaM and Ca(2+)-free CaM are
      sensitive to extract-dependent WGA and chilling import inhibition. Titration
      experiments in microinjected and permeabilized cells indicate that a saturable
      cytosolic factor(s) mediates chilling and WGA arrest.

PMID- 7798311
TI  - Mitochondrial protein import: biochemical and genetic evidence for interaction of
      matrix hsp70 and the inner membrane protein MIM44.
AB  - The import of preproteins into mitochondria involves translocation of the
      polypeptide chains through putative channels in the outer and inner membranes.
      Preprotein-binding proteins are needed to drive the unidirectional translocation
      of the precursor polypeptides. Two of these preprotein-binding proteins are the
      peripheral inner membrane protein MIM44 and the matrix heat shock protein hsp70.
      We report here that MIM44 is mainly exposed on the matrix side, and a fraction of
      mt-hsp70 is reversibly bound to the inner membrane. Mt-hsp70 binds to MIM44 in a
      1:1 ratio, suggesting that mt-hsp70 is localizing to the membrane via its
      interaction with MIM44. Formation of the complex requires a functional ATPase
      domain of mt-hsp70. Addition of Mg-ATP leads to dissociation of the complex.
      Overexpression of mt-hsp70 rescues the protein import defect of mutants in MIM44;
      conversely, overexpression of MIM44 rescues protein import defects of mt-hsp70
      mutants. In addition, yeast strains with conditional mutations in both MIM44 and
      mt-hsp70 are barely viable, showing a synthetic growth defect compared to strains
      carrying single mutations. We propose that MIM44 and mt-hsp70 cooperate in
      translocation of preproteins. By binding to MIM44, mt-hsp70 is recruited at the
      protein import sites of the inner membrane, and preproteins arriving at MIM44 may
      be directly handed over to mt-hsp70.

PMID- 7798313
TI  - The small GTP-binding protein rab6 functions in intra-Golgi transport.
AB  - Rab6 is a ubiquitous ras-like GTP-binding protein associated with the membranes
      of the Golgi complex (Goud, B., A. Zahraoui, A. Tavitian, and J. Saraste. 1990.
      Nature (Lond.). 345:553-556; Antony, C., C. Cibert, G. Geraud, A. Santa Maria, B.
      Maro, V. Mayau, and B. Goud. 1992. J. Cell Sci. 103: 785-796). We have
      transiently overexpressed in mouse L cells and human HeLa cells wild-type rab6,
      GTP (rab6 Q72L), and GDP (rab6 T27N) -bound mutants of rab6 and analyzed the
      intracellular transport of a soluble secreted form of alkaline phosphatase (SEAP)
      and of a plasma membrane protein, the hemagglutinin protein (HA) of influenza
      virus. Over-expression of wild-type rab6 and rab6 Q72L greatly reduced transport
      of both markers between cis/medial (alpha-mannosidase II positive) and late
      (sialyl-transferase positive) Golgi compartments, without affecting transport
      from the endoplasmic reticulum (ER) to cis/medial-Golgi or from the trans-Golgi
      network (TGN) to the plasma membrane. Whereas overexpression of rab6 T27N did not
      affect the individual steps of transport between ER and the plasma membrane, it
      caused an apparent delay in secretion, most likely due to the accumulation of the
      transport markers in late Golgi compartments. Overexpression of both rab6 Q72L
      and rab6 T27N altered the morphology of the Golgi apparatus as well as that of
      the TGN, as assessed at the immunofluorescence level with several markers. We
      interpret these results as indicating that rab6 controls intra-Golgi transport,
      either acting as an inhibitor in anterograde transport or as a positive regulator
      of retrograde transport.

PMID- 7798312
TI  - Localization of the Lys, Asp, Glu, Leu tetrapeptide receptor to the Golgi complex
      and the intermediate compartment in mammalian cells.
AB  - The carboxyl-terminal Lys-Asp-Glu-Leu (KDEL), or a closely-related sequence, is
      important for ER localization of both lumenal as well as type II membrane
      proteins. This sequence functions as a retrieval signal at post-ER
      compartment(s), but the exact compartment(s) where the retrieval occurs remains
      unresolved. With an affinity-purified antibody against the carboxyl-terminal
      sequence of the mammalian KDEL receptor, we have investigated its subcellular
      localization using immunogold labeling on thawed cryosections of different
      tissues, such as mouse spermatids and rat pancreas, as well as HeLa, Vero, NRK,
      and mouse L cells. We show that rab1 is an excellent marker of the intermediate
      compartment, and we use this marker, as well as budding profiles of the mouse
      hepatitis virus (MHV) in cells infected with this virus, to identify this
      compartment. Our results demonstrate that the KDEL receptor is concentrated in
      the intermediate compartment, as well as in the Golgi stack. Lower but
      significant labeling was detected in the rough ER. In general, only small amounts
      of the receptor were detected on the trans side of the Golgi stack, including the
      trans-Golgi network (TGN) of normal cells and tissues. However, some stress
      conditions, such as infection with vaccinia virus or vesicular stomatitis virus,
      as well as 20 degrees C or 43 degrees C treatment, resulted in a significant
      shift of the distribution towards the trans-TGN side of the Golgi stack. This
      shift could be quantified in HeLa cells stably expressing a TGN marker. No
      significant labeling was detected in structures distal to the TGN under all
      conditions tested. After GTP gamma S treatment of permeabilized cells, the
      receptor was detected in the beta-COP-containing buds/vesicles that accumulate
      after this treatment, suggesting that these vesicles may transport the receptor
      between compartments. We propose that retrieval of KDEL-containing proteins
      occurs at multiple post-ER compartments up to the TGN along the exocytotic
      pathway, and that within this pathway, the amounts of the receptor in different
      compartments varies according to physiological conditions.

PMID- 7798314
TI  - Sorting of synaptophysin into special vesicles in nonneuroendocrine epithelial
      cells.
AB  - Synaptophysin is a major transmembrane glycoprotein of a type of small vesicle
      with an electron-translucent content (SET vesicles), including the approximately
      50-nm presynaptic vesicles in neuronal cells, and of similar, somewhat larger (<
      or = approximately 90 nm) vesicles (SLMV) in neuroendocrine (NE) cells. When
      certain epithelial non-NE cells, such as human hepatocellular carcinoma PLC
      cells, were cDNA transfected to synthesize synaptophysin, the new molecules
      appeared in specific SET vesicles. As this was in contrast to other reports that
      only NE cells were able to sort synaptophysin away from other plasma membrane
      proteins into presynaptic- or SLMV-type vesicles, we have further characterized
      the vesicles containing synaptophysin in transfected PLC cells. Using
      fractionation and immunoisolation techniques, we have separated different kinds
      of vesicles, and we have identified a distinct type of synaptophysin-rich, small
      (30-90-nm) vesicle that contains little, if any, protein of the constitutive
      secretory pathway marker hepatitis B surface antigen, of the fluid phase
      endocytosis marker HRP, and of the plasma membrane recycling endosomal marker
      transferrin receptor. In addition, we have found variously sized vesicles that
      contained both synaptophysin and transferrin receptor. A corresponding result was
      also obtained by direct visualization, using double-label immunofluorescence
      microscopy for the endocytotic markers and synaptophysin in confocal laser scan
      microscopy and in double-immunogold label electron microscopy. We conclude that
      diverse non-NE cells of epithelial nature are able to enrich the "foreign"
      molecule synaptophysin in a category of SET vesicles that are morphologically
      indistinguishable from SLMV of NE cells, including one type of vesicle in which
      synaptophysin is sorted away from endosomal marker proteins. Possible mechanisms
      of this sorting are discussed.

PMID- 7798316
TI  - Direct association of occludin with ZO-1 and its possible involvement in the
      localization of occludin at tight junctions.
AB  - Occludin is an integral membrane protein localizing at tight junctions (TJ) with
      four transmembrane domains and a long COOH-terminal cytoplasmic domain (domain E)
      consisting of 255 amino acids. Immunofluorescence and laser scan microscopy
      revealed that chick full-length occludin introduced into human and bovine
      epithelial cells was correctly delivered to and incorporated into preexisting TJ.
      Further transfection studies with various deletion mutants showed that the domain
      E, especially its COOH-terminal approximately 150 amino acids (domain E358/504),
      was necessary for the localization of occludin at TJ. Secondly, domain E was
      expressed in Escherichia coli as a fusion protein with glutathione-S-transferase,
      and this fusion protein was shown to be specifically bound to a complex of ZO-1
      (220 kD) and ZO-2 (160 kD) among various membrane peripheral proteins. In vitro
      binding analyses using glutathione-S-transferase fusion proteins of various
      deletion mutants of domain E narrowed down the sequence necessary for the ZO-1/ZO
      2 association into the domain E358/504. Furthermore, this region directly
      associated with the recombinant ZO-1 produced in E. coli. We concluded that
      occludin itself can localize at TJ and directly associate with ZO-1. The
      coincidence of the sequence necessary for the ZO-1 association with that for the
      TJ localization suggests that the association with underlying cytoskeletons
      through ZO-1 is required for occludin to be localized at TJ.

PMID- 7798315
TI  - The polymeric immunoglobulin receptor accumulates in specialized endosomes but
      not synaptic vesicles within the neurites of transfected neuroendocrine PC12
      cells.
AB  - We have expressed in neuroendocrine PC12 cells the polymeric immunoglobulin
      receptor (pIgR), which is normally targeted from the basolateral to the apical
      surface of epithelial cells. In the presence of nerve growth factor, PC12 cells
      extend neurites which contain synaptic vesicle-like structures and regulated
      secretory granules. By immunofluorescence microscopy, pIgR, like the synaptic
      vesicle protein synaptophysin, accumulates in both the cell body and the
      neurites. On the other hand, the transferrin receptor, which normally recycles at
      the basolateral surface in epithelial cells, and the cation-independent mannose 6
      phosphate receptor, a marker of late endosomes, are largely restricted to the
      cell body. pIgR internalizes ligand into endosomes within the cell body and the
      neurites, while uptake of ligand by the low density lipoprotein receptor occurs
      primarily into endosomes within the cell body. We conclude that transport of
      membrane proteins to PC12 neurites as well as to specialized endosomes within
      these processes is selective and appears to be governed by similar mechanisms
      that dictate sorting in epithelial cells. Additionally, two types of endosomes
      can be identified in polarized PC12 cells by the differential uptake of ligand, a
      housekeeping type in the cell bodies and a specialized endosome in the neurites.
      Recent findings suggest that specialized axonal endosomes in neurons are likely
      to give rise to synaptic vesicles (Mundigl, O., M. Matteoli, L. Daniell, A.
      Thomas-Reetz, A. Metcalf, R. Jahn, and P. De Camilli. 1993. J. Cell Biol.
      122:1207-1221). Although pIgR reaches the specialized endosomes in the neurites
      of PC12 cells, we find by subcellular fractionation that under a variety of
      conditions it is efficiently excluded from synaptic vesicle-like structures as
      well as from secretory granules.

PMID- 7798318
TI  - How an actin network might cause fountain streaming and nuclear migration in the
      syncytial Drosophila embryo.
AB  - We show here using time-lapse video tapes that cytoplasmic streaming causes
      nuclear migration along the anterior-posterior axis (axial expansion) in the
      early syncytial embryo of Drosophila melanogaster. Using confocal microscopy and
      labeled phalloidin we explore the distribution of F-actin during axial expansion.
      We find that a network of F-actin fibers fills the cytoplasm in the embryo. This
      actin network partially disassembles around the nuclei during axial expansion.
      Our observations of normal development, fixed embryos, and drug injection
      experiments indicate that disassembly of the actin network generates cytoplasmic
      movements. We suggest that the cell cycle regulates disassembly of the actin
      network, and that this process may be mediated directly or indirectly by the
      microtubules. The cytoplasmic movements we observe during axial expansion are
      very similar to fountain streaming in the pseudopod of amoebae, and by analogy
      with the pseudopod we propose a working hypothesis for axial expansion based on
      solation-contraction coupling within the actin network.

PMID- 7798317
TI  - Tropomodulin caps the pointed ends of actin filaments.
AB  - Many proteins have been shown to cap the fast growing (barbed) ends of actin
      filaments, but none have been shown to block elongation and depolymerization at
      the slow growing (pointed) filament ends. Tropomodulin is a tropomyosin-binding
      protein originally isolated from red blood cells that has been localized by
      immunofluorescence staining to a site at or near the pointed ends of skeletal
      muscle thin filaments (Fowler, V. M., M. A., Sussman, P. G. Miller, B. E.
      Flucher, and M. P. Daniels. 1993. J. Cell Biol. 120: 411-420). Our experiments
      demonstrate that tropomodulin in conjunction with tropomyosin is a pointed end
      capping protein: it completely blocks both elongation and depolymerization at the
      pointed ends of tropomyosin-containing actin filaments in concentrations
      stoichiometric to the concentration of filament ends (Kd < or = 1 nM). In the
      absence of tropomyosin, tropomodulin acts as a "leaky" cap, partially inhibiting
      elongation and depolymerization at the pointed filament ends (Kd for inhibition
      of elongation = 0.1-0.4 microM). Thus, tropomodulin can bind directly to actin at
      the pointed filament end. Tropomodulin also doubles the critical concentration at
      the pointed ends of pure actin filaments without affecting either the rate of
      extent of polymerization at the barbed filament ends, indicating that
      tropomodulin does not sequester actin monomers. Our experiments provide direct
      biochemical evidence that tropomodulin binds to both the terminal tropomyosin and
      actin molecules at the pointed filament end, and is the long sought-after pointed
      end capping protein. We propose that tropomodulin plays a role in maintaining the
      narrow length distributions of the stable, tropomyosin-containing actin filaments
      in striated muscle and in red blood cells.

PMID- 7798319
TI  - Bypassing anaphase by fission yeast cut9 mutation: requirement of cut9+ to
      initiate anaphase.
AB  - A novel anaphase block phenotype was found in fission yeast temperature-sensitive
      cut9 mutants. Cells enter mitosis with chromosome condensation and short spindle
      formation, then block anaphase, but continue to progress into postanaphase events
      such as degradation of the spindle, reformation of the postanaphase cytoplasmic
      microtubule arrays, septation, and cytokinesis. The cut9 mutants are defective in
      the onset of anaphase and possibly in the restraint of postanaphase events until
      the completion of anaphase. The cut9+ gene encodes a 78-kD protein containing the
      10 34-amino acid repeats, tetratricopeptide repeats (TPR), and similar to budding
      yeast Cdc16. It is essential for viability, and the mutation sites reside in the
      TPR. The three genes, namely, nuc2+, scn1+, and scn2+, genetically interact with
      cut9+. The nuc2+ and cut9+ genes share an essential function to initiate
      anaphase. The cold-sensitive scn1 and scn2 mutations, defective in late anaphase,
      can suppress the ts phenotype of cut9.

PMID- 7798320
TI  - Regulation of Chlamydomonas flagellar dynein by an axonemal protein kinase.
AB  - Genetic, biochemical, and structural data support a model in which axonemal
      radial spokes regulate dynein-driven microtubule sliding in Chlamydomonas
      flagella. However, the molecular mechanism by which dynein activity is regulated
      is unknown. We describe results from three different in vitro approaches to test
      the hypothesis that an axonemal protein kinase inhibits dynein in spoke-deficient
      axonemes from Chlamydomonas flagella. First, the velocity of dynein-driven
      microtubule sliding in spoke-deficient mutants (pf14, pf17) was increased to wild
      type level after treatment with the kinase inhibitors HA-1004 or H-7 or by the
      specific peptide inhibitors of cAMP-dependent protein kinase (cAPK) PKI(6
      22)amide or N alpha-acetyl-PKI(6-22)amide. In particular, the peptide inhibitors
      of cAPK were very potent, stimulating half-maximal velocity at 12-15 nM. In
      contrast, kinase inhibitors did not affect microtubule sliding in axonemes from
      wild-type cells. PKI treatment of axonemes from a double mutant missing both the
      radial spokes and the outer row of dynein arms (pf14pf28) also increased
      microtubule sliding to control (pf28) velocity. Second, addition of the type-II
      regulatory subunit of cAPK (RII) to spoke-deficient axonemes increased
      microtubule sliding to wild-type velocity. Addition of 10 microM cAMP to
      spokeless axonemes, reconstituted with RII, reversed the effect of RII. Third,
      our previous studies revealed that inner dynein arms from the Chlamydomonas
      mutants pf28 or pf14pf28 could be extracted in high salt buffer and subsequently
      reconstituted onto extracted axonemes restoring original microtubule sliding
      activity. Inner arm dyneins isolated from PKI-treated axonemes (mutant strain
      pf14pf28) generated fast microtubule sliding velocities when reconstituted onto
      both PKI-treated or control axonemes. In contrast, dynein from control axonemes
      generated slow microtubule sliding velocities on either PKI-treated or control
      axonemes. Together, the data indicate that an endogenous axonemal cAPK-type
      protein kinase inhibits dynein-driven microtubule sliding in spoke-deficient
      axonemes. The kinase is likely to reside in close association with its
      substrate(s), and the substrate targets are not exclusively localized to the
      central pair, radial spokes, dynein regulatory complex, or outer dynein arms. The
      results are consistent with a model in which the radial spokes regulate dynein
      activity through suppression of a cAMP-mediated mechanism.

PMID- 7798321
TI  - Long-range signaling in growing neurons after local elevation of cyclic AMP
      dependent activity.
AB  - Cyclic AMP-dependent activity at the growth cone or the soma of cultured Xenopus
      spinal neurons was elevated by local extracellular perfusion of the neuron with
      culture medium containing 8-bromoadenosine 3',5'-cyclic monophosphate (8-br-cAMP)
      or forskolin. During local perfusion of one of the growth cones of multipolar
      neurons with these drugs, the perfused growth cone showed further extension,
      while the distant, unperfused growth cones were inhibited in their growth. Local
      perfusion of the growth cone with culture medium or local perfusion with 8-br
      cAMP at a cell-free region 100 microns away from the growth cone did not produce
      any effect on the extension of the growth cone. Reduced extension of all growth
      cones was observed when the perfusion with 8-br-cAMP was restricted to the soma.
      The distant inhibitory effect does not depend on the growth of the perfused
      growth cone since local coperfusion of the growth cone with 8-br-cAMP and
      colchicine inhibited growth on both perfused and unperfused growth cones, while
      local perfusion with colchicine alone inhibited only the perfused growth cone.
      The distant inhibitory effect was abolished when the perfusion of 8-br-cAMP was
      carried out together with kinase inhibitor H-8, suggesting the involvement of
      cAMP-dependent protein kinase and/or its downstream factors in the long-range
      inhibitory signaling. Uniform exposure of the entire neuron to bath-applied 8-br
      cAMP, however, led to enhanced growth activity at all growth cones. Thus, local
      elevation of cAMP-dependent activity produces long-range and opposite effects on
      distant parts of the neuron, and a cytosolic gradient of second messengers may
      produce effects distinctly different from those following uniform global
      elevation of the messenger, leading to differential growth regulation at
      different regions of the same neuron.

PMID- 7798322
TI  - Altered gene expression in neurons during programmed cell death: identification
      of c-jun as necessary for neuronal apoptosis.
AB  - We have examined the hypothesis that neuronal programmed cell death requires a
      genetic program; we used a model wherein rat sympathetic neurons maintained in
      vitro are deprived of NGF and subsequently undergo apoptosis. To evaluate gene
      expression potentially necessary for this process, we used a PCR-based technique
      and in situ hybridization; patterns of general gene repression and selective gene
      induction were identified in NGF-deprived neurons. A temporal cascade of induced
      genes included "immediate early genes," which were remarkable in that their
      induction occurred hours after the initial stimulus of NGF removal and the
      synthesis of some required ongoing protein synthesis. The cascade also included
      the cell cycle gene c-myb and the genes encoding the extracellular matrix
      proteases transin and collagenase. Concurrent in situ hybridization and nuclear
      staining revealed that while c-jun was induced in most neurons, c-fos induction
      was restricted to neurons undergoing chromatin condensation, a hallmark of
      apoptosis. To evaluate the functional role of the proteins encoded by these
      genes, neutralizing antibodies were injected into neurons. Antibodies specific
      for either c-Jun or the Fos family (c-Fos, Fos B, Fra-1, and Fra-2) protected NGF
      deprived neurons from apoptosis, whereas antibodies specific for Jun B, Jun D, or
      three nonimmune antibody preparations had no protective effect. Because these
      induced genes encode proteins ranging from a transcription factor necessary for
      death to proteases likely involved in tissue remodeling concurrent with death,
      these data may outline a genetic program responsible for neuronal programmed cell
      death.

PMID- 7798323
TI  - Recessive mutations in a common pathway block thymocyte apoptosis induced by
      multiple signals.
AB  - The glucocorticoid receptor (GR) is a ligand-regulated transcription factor that
      controls genes necessary to initiate glucocorticoid-induced thymocyte apoptosis.
      We have performed a genetic analysis of thymocyte cell death by isolating and
      characterizing a panel of GR+ dexamethasone-resistant mutants of the murine
      WEHI7.2 thymocyte cell line. These apoptosis-defective (Apt-) mutants were used
      to identify previously unknown early steps in the apoptotic pathway. The Apt-
      mutants contain nonglucocorticoid receptor, recessive mutations in genes that
      represent multiple complementation groups. These mutations block apoptosis
      induced by dexamethasone, gamma irradiation, and c-AMP treatment before the point
      where Bcl-2 exerts its protective effect. We propose that different signals share
      a common apoptotic pathway, and that the induction of apoptosis involves multiple
      precommitment steps that can be blocked by recessive mutations.

PMID- 7798325
TI  - A potential role for tetranectin in mineralization during osteogenesis.
AB  - Tetranectin is a protein shared by the blood and the extracellular matrix.
      Tetranectin is composed of four identical, noncovalently bound polypeptides each
      with a molecular mass of approximately 21 kD. There is some evidence that
      tetranectin may be involved in fibrinolysis and proteolysis during tissue
      remodeling, but its precise biological function is not known. Tetranectin is
      enriched in the cartilage of the shark, but the gene expression pattern in the
      mammalian skeletal system has not been determined. In the present study we have
      examined the expression pattern and putative function of tetranectin during
      osteogenesis. In the newborn mouse, strong tetranectin immunoreactivity was found
      in the newly formed woven bone around the cartilage anlage in the future bone
      marrow and along the periosteum forming the cortex. No tetranectin
      immunoreactivity was found in the proliferating and hypertrophic cartilage or in
      the surrounding skeletal muscle. Using an in vitro mineralizing system, we
      examined osteoblastic cells at different times during their growth and
      differentiation. Tetranectin mRNA appeared in the cultured osteoblastic cells in
      parallel with mineralization, in a pattern similar to that of bone sialoprotein,
      which is regarded as one of the late bone differentiation markers. To explore the
      putative biological role of tetranectin in osteogenesis we established stably
      transfected cell lines (PC12-tet) overexpressing recombinant tetranectin as
      evidenced by Northern and Western blot analysis and immunoprecipitation. Both
      control PC12 cells and PC12-tet cells injected into nude mice produced tumors
      containing bone material, as evidenced by von Kossa staining for calcium and
      immunostaining with bone sialoprotein and alkaline phosphatase antiserum. Nude
      mice tumors established from PC12-tet cells contained approximately fivefold more
      bone material than those produced by the untransfected PC12 cell line or by the
      PC12 cells transfected with the expression vector with no insert (Mann Whitney
      rank sum test, p < 0.01), supporting the notion that tetranectin may play an
      important direct and/or indirect role during osteogenesis. In conclusion, we have
      established a potential role for tetranectin as a bone matrix protein expressed
      in time and space coincident with mineralization in vivo and in vitro.

PMID- 7798326
TI  - A comparison of the early development of ischaemic damage following permanent
      middle cerebral artery occlusion in rats as assessed using magnetic resonance
      imaging and histology.
AB  - Recent developments in diffusion-weighted imaging (DWI) have enabled the
      pathological changes that occur during cerebral ischaemia to be studied. The
      present studies utilised DWI to investigate the development of early ischaemic
      changes following permanent middle cerebral artery (MCA) occlusion in the rat,
      which represents a model of stroke. An increased DWI signal was seen in the
      region of the occluded MCA and this was detectable as early as 1 h postocclusion.
      DWI images were obtained at nine stereotactic levels throughout the brain,
      providing a quantifiable measure of the volume of increased signal intensity in
      each animal. At 1 h post-MCA occlusion the hyperintense areas were seen in the
      frontoparietal cortex and lateral caudate nucleus; these areas represent the core
      of the infarct and no protection is seen with any compounds in these areas. There
      was a progressive increase in the area of hyperintensity up to 4 h post-MCA
      occlusion, and at this time point the hyper-intensity was seen in the
      dorsolateral cortex and caudate nucleus. At 4 h post-MCA occlusion there was a
      significant correlation between the volume of hemispheric and cortical ischaemic
      damage measured using DWI and histology. Thus, it appears that the increased DWI
      signal seen during the early time points after MCA occlusion was demarcating
      tissue that was destined for infarction. The area beyond the hyperintense region
      at 1 h represents the so-called "penumbral" region, because with increasing time
      (post-MCA occlusion) this area became incorporated into the infarct. There was
      also a slight increase in infarct size between 4 and 24 h, when assessed using
      DWI or histology, although two groups of animals were being compared, as opposed
      to the time-course study, in which just one group of animals was used. At 24 h
      post-MCA occlusion there was a good correlation between DWI, histology, and
      conventional T2 weighted imaging. There was no further increase in size of the
      infarct between 24 h and 7 days as assessed using histology and T2-weighted
      imaging. DWI could not be used to quantify infarct volume at 7 days because there
      was no uniform signal in the damaged area. At 7 days the area of infarction
      actually appeared to be darker in the diffusion-weighted images. The
      hyperintensity seen in diffusion-weighted images appears to decrease some time
      between 24 h and 7 days.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7798327
TI  - Photic stimulation study of changing the arterial partial pressure level of
      carbon dioxide.
AB  - To investigate the effect of the level of baseline cerebral blood flow (CBF) on
      local CBF augmentation by activation, we have used positron emission tomography
      to measure regional CBF (rCBF) in 12 normal volunteers with and without photic
      stimulation during hypocapnia, normocapnia, and hypercapnia. The increase in rCBF
      in the primary visual cortex by photic stimulation was 10.8 +/- 3.1, 18.6 +/-
      9.3, and 19.5 +/- 6.1 ml 100 ml-1 min-1 in hypo-, normo-, and hypercapnia,
      respectively. The increase was significantly smaller in hypocapnia than in
      normocapnia (p < 0.005). The fractional CBF increase caused by the photic
      stimulation was the same in all breathing conditions. This result indicates that
      the magnitude of the CBF increase induced by neuronal activity correlates
      proportionally with the level of baseline CBF.

PMID- 7798324
TI  - Bone morphogenetic protein-2 converts the differentiation pathway of C2C12
      myoblasts into the osteoblast lineage.
AB  - The implantation of bone morphogenetic protein (BMP) into muscular tissues
      induces ectopic bone formation at the site of implantation. To investigate the
      mechanism underlying this process, we examined whether recombinant bone
      morphogenetic protein-2 (BMP-2) converts the differentiation pathway of the
      clonal myoblastic cell line, C2C12, into that of osteoblast lineage. Incubating
      the cells with 300 ng/ml of BMP-2 for 6 d almost completely inhibited the
      formation of the multinucleated myotubes expressing troponin T and myosin heavy
      chain, and induced the appearance of numerous alkaline phosphatase (ALP)-positive
      cells. BMP-2 dose dependently induced ALP activity, parathyroid hormone (PTH)
      dependent 3',5'-cAMP production, and osteocalcin production at concentrations
      above 100 ng/ml. The concentration of BMP-2 required to induce these osteoblastic
      phenotypes was the same as that required to almost completely inhibit myotube
      formation. Incubating primary muscle cells with 300 ng/ml of BMP-2 for 6 d also
      inhibited myotube formation, whereas induced ALP activity and osteocalcin
      production. Incubation with 300 ng/ml of BMP-2 suppressed the expression of mRNA
      for muscle creatine kinase within 6 h, whereas it induced mRNA expression for
      ALP, PTH/PTH-related protein (PTHrP) receptors, and osteocalcin within 24-48 h.
      BMP-2 completely inhibited the expression of myogenin mRNA by day 3. By day 3,
      BMP-2 also inhibited the expression of MyoD mRNA, but it was transiently
      stimulated 12 h after exposure to BMP-2. Expression of Id-1 mRNA was greatly
      stimulated by BMP-2. When C2C12 cells pretreated with BMP-2 for 6 d were
      transferred to a colony assay system in the absence of BMP-2, more than 84% of
      the colonies generated became troponin T-positive and ALP activity disappeared.
      TGF-beta 1 also inhibited myotube formation in C2C12 cells, and suppressed the
      expression of myogenin and MyoD mRNAs without inducing that of Id-1 mRNA.
      However, no osteoblastic phenotype was induced by TGF-beta 1 in C2C12 cells. TGF
      beta 1 potentiated the inhibitory effect of BMP-2 on myotube formation, whereas
      TGF-beta 1 reduced ALP activity and osteocalcin production induced by BMP-2 in
      C2C12 cells. These results indicate that BMP-2 specifically converts the
      differentiation pathway of C2C12 myoblasts into that of osteoblast lineage cells,
      but that the conversion is not heritable.

PMID- 7798328
TI  - Cerebral blood flow and metabolic responses to sustained hypercapnia in awake
      sheep.
AB  - This investigation determined the effects of sustained hypercapnia on cerebral
      blood flow (CBF; radiolabeled microspheres), cerebral metabolic rates for O2 and
      glucose (CMRO2 and CMRglc), and brain water content in conscious sheep
      instrumented with aortic, left ventricular, vena cava, and brain sagittal sinus
      catheters. PaCO2 was elevated from 38 +/- 3 to 53 +/- 3 (mean +/- SD) mm Hg and
      PaO2 from 109 +/- 7 to 131 +/- 4 mm Hg for 96 h in an environmental chamber.
      Hypercapnia did not alter sheep behavior, food and water intake, arterial
      pressures, core temperature, or brain lactate release. Total and regional CBF and
      CBF/CMRO2 reached peak values at 1 h and then readjusted, to stabilize at lower,
      but still elevated levels at 24 h and thereafter. CMRO2 and CMRglc increased at 6
      h and thereafter during hypercapnia. PaCO2, CBF, CMRO2, and CMRglc remained
      elevated at 3 h after restoration to room air, while CBF/CMRO2 returned to the
      control value. Frontal and occipital lobe wet-to-dry weight ratios increased
      modestly but significantly after hypercapnic exposure. It is concluded that
      sustained hypercapnia induces stable and nonadapting increases in both CBF and
      brain metabolism that persist for at least 3 h after restoration to room air in
      association with hypoventilization and modest elevations of brain water.

PMID- 7798330
TI  - Simultaneous measurements of pial arteriolar diameter and laser-Doppler flow
      during somatosensory stimulation.
AB  - We simultaneously measured pial arteriolar diameter and changes in cortical blood
      flow during activation of the somatosensory cortex by sciatic nerve stimulation.
      The pial vasculature was visualized with a closed-cranial window technique in
      chloralose-anesthetized rats (n = 13). Local blood flow was monitored with laser
      Doppler flowmetry. During stimulation of the sciatic nerve (0.2 V, 5 Hz, 20 s),
      vascular diameter and laser-Doppler flow consistently displayed similar response
      profiles. With 0.5-ms stimulation pulses, the responses showed an initial peak
      followed by a smaller but sustained plateau dilation. In contrast, 5-ms pulses
      evoked a monotonically rising response. Our results support the concept that pial
      arteriolar diameter changes reflect cortical blood flow responses during
      somatosensory stimulation.

PMID- 7798329
TI  - Simultaneous determination of the rates of the TCA cycle, glucose utilization,
      alpha-ketoglutarate/glutamate exchange, and glutamine synthesis in human brain by
      NMR.
AB  - 13C isotopic tracer data previously obtained by 13C nuclear magnetic resonance in
      the human brain in vivo were analyzed using a mathematical model to determine
      metabolic rates in a region of the human neocortex. The tricarboxylic acid (TCA)
      cycle rate was 0.73 +/- 0.19 mumol min-1 g-1 (mean +/- SD; n = 4). The standard
      deviation reflects primarily intersubject variation, since individual
      uncertainties were low. The rate of alpha-ketoglutarate/glutamate exchange was 57
      +/- 26 mumol min-1 g-1 (n = 3), which is much greater than the TCA cycle rate;
      the high rate indicates that alpha-ketoglutarate and glutamate are in rapid
      exchange and can be treated as a single combined kinetic pool. The rate of
      synthesis of glutamine from glutamate was 0.47 mumol min-1 g-1 (n = 4), with 95%
      confidence limits of 0.139 and 3.094 mumol min-1 g-1; individual uncertainties
      were biased heavily toward high synthesis rates. From the TCA cycle rate the
      brain oxygen consumption was estimated to be 2.14 +/- 0.48 mumol min-1 g-1 (5.07
      +/- 1.14 ml 100 g-1 min-1; n = 4), and the rate of brain glucose consumption was
      calculated to be 0.37 +/- 0.08 mumol min-1 g-1 (n = 4). The sensitivity of the
      model to the assumptions made was evaluated, and the calculated values were found
      to be unchanged as long as the assumptions remained near reported physiological
      values.

PMID- 7798331
TI  - Role of the cerebellar fastigial nucleus in the physiological regulation of
      cerebral blood flow.
AB  - Local cerebral blood flow (ICBF) was measured with [14C]iodoantipyrine in
      conscious, unrestrained rats during electrical stimulation of the fastigial
      nucleus (FN). Electrode position in the FN was determined by blood pressure
      (MABP) responses to stimulation under anesthesia. In nine rats in which MABP
      responses had been variable under anesthesia, bipolar stimulation (50 Hz, 0.5 ms,
      1 s on/1 s off) with currents of 30-100 microA after recovery from anesthesia
      produced stereotypic behavior but little effect on MABP and ICBF. In seven other
      conscious rats currents could be raised to 75-200 microA without inducing
      seizures, resulting in sustained MABP elevations during the ICBF measurement and
      significantly increased ICBF in the sensory-motor (+45%), parietal (+31%), and
      frontal cortices (+56%) and the caudate-putamen (+27%) above control values (n =
      9). Glucose utilization, measured with [14C]deoxyglucose, in rats similarly
      stimulated was significantly increased in six structures, including some of the
      above, indicating increases in ICBF due to metabolic activation. Unilateral or
      bilateral electrolytic lesions of the FN, placed 6-7 days before ICBF
      measurement, had negligible effects on resting ICBF and on autoregulation in
      conscious rats. These results fail to support a specific role for the FN in
      physiological regulation of cerebral blood flow in unanesthetized rats.

PMID- 7798332
TI  - The role of angiotensin II in the regulation of blood flow to choroid plexuses
      and cerebrospinal fluid formation in the rat.
AB  - The effect of peripherally administered angiotensin II (AII) on blood flow to
      choroid plexuses was examined in pentobarbital-anesthetized rats. The indicator
      fractionation method with 123I- or 125I-N-isopropyl-p-iodoamphetamine as the
      marker was employed to measure blood flow. Basal blood flow to choroid plexus of
      the lateral cerebral ventricle (LVCP) (3.19 +/- 0.23 ml g-1 min-1) was lower than
      that to choroid plexuses of the third (3VCP) and fourth (4VCP) ventricles (3.90
      +/- 0.38 and 3.95 +/- 0.36 ml g-1 min-1, respectively). The effect of AII on
      choroidal blood flow varied depending on peptide dose and anatomical location of
      the choroidal tissue. AII infused intravenously at rates of 30 and 50 ng kg-1 min
      1 decreased blood flow to both LVCP and 4VCP by 12-20%. Both lower (10 ng kg-1
      min-1) and higher (100 and 300 ng kg-1 min-1) AII doses did not alter blood flow
      to LVCP and 4VCP. Blood flow to the 3VCP was not affected by any dose of the
      peptide used. In comparison, blood flow to cerebral cortex increased by 33%
      during intravenous AII infusion at a rate of 300 ng kg-1 min-1. The choroidal
      blood flow-lowering effect of moderate AII doses was abolished by both AT1
      (losartan) and AT2 (PD 123319) receptor subtype antagonists (3 mg kg-1 i.v.). To
      determine whether the hemodynamic changes observed in choroid plexuses with
      moderate AII doses influence CSF formation, the ventriculocisternal perfusion was
      performed in rats (under the experimental conditions described) with Blue Dextran
      2000 as the indicator.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798333
TI  - Benzodiazepine receptor quantification in vivo in humans using [11C]flumazenil
      and PET: application of the steady-state principle.
AB  - Carbon-11-labeled flumazenil combined with positron emission tomography (PET) was
      used to measure the concentration (Bmax) of the benzodiazepine (Bz) receptor in
      the brain and its equilibrium dissociation constant (KD) for flumazenil in five
      normal subjects. The steady-state approach was used injecting the tracer as a
      bolus of high specific activity. In each subject two studies were carried out.
      The first study was performed at essentially zero receptor occupancy, the tracer
      alone study. The second study was performed at a steady-state receptor occupancy
      of about 50%, achieved by a prolonged constant infusion of nonlabeled ("cold")
      flumazenil starting 2h before the bolus tracer injection and continuing until the
      end of scanning period. In this second study the free concentration of
      unmetabolized flumazenil in plasma water was measured in multiple blood samples.
      The observed tissue and plasma tracer curves, calibrated in the same units of
      radioactivity per millimeter, were analyzed in two ways: (a) by the
      noncompartmental (stochastic) approach making no assumptions regarding number of
      compartments in the tissue, and (b) by the single-compartment approach assuming
      rapid exchange (mixing) of tracer between all tissue compartments. The
      noncompartmental and the compartmental analyses gave essentially the same values
      for the distribution volume of the tracer, the parameter used for quantitation of
      the Bz receptor. As the compartmental approach could be applied to a shorter
      observation period (60 min instead of 120 min) it was preferred. The five
      subjects had a mean KD value of 12 nM/L of water and Bmax values of the grey
      matter ranging from 39 +/- 11 in thalamus to 120 +/- 14 nM/L of brain in
      occipital cortex. Most previous studies have been based on the pseudoequilibrium
      approach using the brain stem as a receptor-free reference region. This yields
      practically the same KD but lower Bmax values than the steady-state approach
      presented here.

PMID- 7798334
TI  - Expression of interleukin-6, c-fos, and zif268 mRNAs in rat ischemic cortex.
AB  - The expression of interleukin-6 (IL-6) mRNA in the focal ischemic rat cortex was
      studied by means of Northern hybridization. IL-6 mRNA was induced after permanent
      occlusion of the middle cerebral artery, reached a significant level at 3 h, and
      peaked at 12 h, i.e., approximately 10-fold increase in the ischemic zone
      compared with the nonischemic cortex or sham-operated controls. The increased IL
      6 mRNA was elevated for at least 24 h. Low levels of IL-6 mRNA were detected in
      sham-operated rats or in the contralateral nonischemic cortex. The expression of
      c-fos and zif268 mRNAs, two early response genes, was rapid (increased by 1 h
      postischemia) and transient (returned to basal levels by 24 and 12 h,
      respectively), clearly having different kinetic patterns from that of IL-6 mRNA.
      The early response kinetic pattern of c-fos and zif268 mRNAs in focal ischemia
      suggests their transcriptional regulatory roles in response to ischemic insult,
      while the delayed induction pattern of IL-6 mRNA suggests a role for this
      pleiotropic cytokine in the inflammatory response to the focal ischemic damage of
      the brain.

PMID- 7798336
TI  - Autoregulatory plateau: does it exist?

PMID- 7798335
TI  - Contribution of cerebral edema to the neuronal salvage elicited by stimulation of
      cerebellar fastigial nucleus after occlusion of the middle cerebral artery in
      rat.

PMID- 7798337
TI  - Concomitant EEG, lactate, and phosphorus changes by 1H and 31P NMR spectroscopy
      during repeated brief cerebral ischemia.
AB  - Pilots of high-performance aircraft are subject to transient loss of
      consciousness due to cerebral ischemia resulting from sudden high gravitational
      stress. To assess the effects of gravitational stress-induced blackout on
      cerebral metabolism and electrical function, we developed an animal model in
      which global cerebral ischemia is produced repeatedly at short intervals. Rats
      were prepared by ligation of subclavian and external carotid arteries and the
      right carotid artery was cannulated bidirectionally to measure circle of Willis
      and systemic pressures. Ischemia was induced by inflation of an occluder about
      the left carotid artery. Interleaved 31P and 1H NMR spectra were acquired on a
      4.7-T Biospec system simultaneously with EEG recordings. We report results from
      20 experiments of 30-min duration in which rats were subject to 30 1-min
      ischemia:reflow cycles of 10I:50R, 20I:40R, 30I:30R, and 40I:20R [numbers are
      seconds of ischemia (I) and reflow (R) during each 1-min cycle]. During ischemia
      the graded delivery of the ischemic insult permitted direct correlations between
      2- to 5- and 7- to 20-Hz EEG activity and progressive changes in pH, lactate,
      ATP, phosphocreatine (PCr) and Pi. The best correlations were found between EEG
      activity and pH and PCr; correlation coefficients ranged from 0.93 to 0.95. A
      loss of EEG activity was observed without significant sustained energy loss in
      all but the most severe cycle.

PMID- 7798338
TI  - Induction of CL100 protein tyrosine phosphatase following transient forebrain
      ischemia in the rat brain.
AB  - Protein tyrosine phosphorylation is thought to play an important role in the
      regulation of neural function. To elucidate the role that protein tyrosine
      phosphatases (PTPs) may play in the postischemic brain, PTPs expressed in regions
      of the rat brain vulnerable to transient forebrain ischemia were examined. With
      the reverse-transcriptase polymerase chain reaction using degenerate primers,
      three PTPs, STEP, PTP delta, and SH-PTP2, were identified. They were expressed in
      the hippocampus 12 h after transient ischemia for 20 min. During the reperfusion
      period, the mRNA levels of these PTPs were not different from those in sham
      operated rats. In contrast, a fourfold increase in the mRNA level of CL100
      (3CH134), a PTP that is inducible by oxidative stress, was detected by Northern
      blotting in the hippocampus and cerebral cortex 1 h after the onset of
      reperfusion. In situ hybridization histochemistry showed a slight increase in the
      level of CL100 mRNA in neuronal cells in the hippocampus and cortex of
      postischemic rats compared to control rats. These findings suggest that PTPs play
      a role in the normal function of the hippocampus and cerebral cortex and
      demonstrate that ischemia induced CL100 expression.

PMID- 7798339
TI  - Immunohistochemical localization of superoxide dismutase in the hippocampus
      following ischemia in a gerbil model of ischemic tolerance.
AB  - Pretreatment of the gerbil brain with a 2-min period of sublethal ischemia
      protects against neuronal damage following a subsequent 3-min period of ischemia,
      which normally destroys pyramidal neurons in the CA1 region of the hippocampus.
      To clarify the role of superoxide dismutase (SOD) in this ischemic tolerance, we
      immunohistochemically investigated the alterations in copper-zinc SOD (CuZnSOD)
      and manganese SOD (Mn-SOD) in the gerbil hippocampus following 3-min ischemia
      with or without the first mild ischemia. Normal hippocampus showed an intense
      CuZnSOD immunostaining in pyramidal neurons but relatively less MnSOD
      immunostaining. MnSOD, but not CuZnSOD, immunoreactivity increased after the
      first ischemia. Both CuZnSOD and MnSOD immunoreactivities decreased throughout
      the hippocampus 4 h after 3 min of ischemia both with and without the first
      ischemia. The immunostaining recovered in resistant regions (CA3 and dentate
      gyrus) after 1 day in both groups and in the pretreated CA1 after 2 days. Without
      pretreatment, however, the immunostaining never recovered in the vulnerable CA1
      region. The results suggest that ischemic tolerance is induced in part by
      enhanced synthesis of MnSOD in the tolerance-acquired hippocampus. Both CuZnSOD
      and MnSOD immunoreactivities decreased after the second ischemia even in the
      pretreated hippocampus in the early reperfusion periods, but ischemic tolerance
      facilitated the recovery from the postischemic reductions in SOD
      immunoreactivity.

PMID- 7798340
TI  - A simple method for evaluation of superoxide radical production in neural cells
      under various culture conditions: application to hypoxia.
AB  - To evaluate the potential deleterious influence of oxygen-derived free radicals
      following hypoxia in a model of primary culture of neurons obtained from the
      fetal rat brain, superoxide radicals were measured as a function of time in the
      extracellular medium. Neuronal cells were grown for 8 days in the presence or
      absence of serum, then incubated in a buffered Krebs-Ringer solution containing
      60 microM acetyl-cytochrome c. The rate of superoxide radical formation was
      quantified spectrophotometrically by measuring the specific reduction of acetyl
      cytochrome c. Under normoxic conditions (95% air-5% CO2), basal production of
      superoxide that increased with time was recorded. It was significantly more
      pronounced in cells grown in serum-free medium. Under both culture conditions,
      acute hypoxia (95% N2-5% CO2) for 6 h increased superoxide radical amounts in the
      extracellular medium, and they were still enhanced 3 h after reoxygenation. The
      addition of superoxide dismutase to the incubating medium abolished the detection
      of superoxide radicals. The present study describes a new reliable method for
      superoxide radical measurement in cells in vitro and demonstrates
      hypoxia/reoxygenation-induced overproduction of superoxide in cultured neurons
      that may account for cell injury.

PMID- 7798341
TI  - The influence of acidosis on hypoglycemic brain damage.
AB  - The objective of the study was to explore whether hypoglycemic brain damage is
      affected by super-imposed acidosis. To that end, animals with insulin-induced
      hypoglycemic coma, defined in terms of a negative DC potential shift, massive
      release of K+, or cellular uptake of Ca2+, were exposed to excessive hypercapnia
      (PaCO2 approximately 200 or approximately 300 mm Hg) during the last 25 min of
      the 30-min coma period. Animals were allowed to survive for 7 days before their
      brains were fixed by perfusion, and the cell damage was assessed by light
      microscopy. Other animals were analyzed with respect to changes in extracellular
      pH (pHe) or extracellular K+ or Ca2+ concentrations (K+e and Ca2+e,
      respectively). The total CO2 content (TCO2) was also measured to allow derivation
      of intracellular pH (pHi). The increase in PaCO2 to 190 +/- 15 and 312 +/- 23 mm
      Hg (means +/- SD) reduced the pHe from a predepolarization value of approximately
      7.4 and a postdepolarization value (after the first 5 min of coma) of
      approximately 7.3 to 6.8 and 6.7, respectively. The corresponding mean pHi values
      were 6.7 and 6.5. The hypercapnia did not alter the K+e, which rose to 50-60 mM
      at the onset of hypoglycemic coma, but it increased the Ca2+e from approximately
      0.05 to 0.10-0.16 mM. Normocapnic animals with induced hypoglycemic coma of 30
      min duration showed the expected neuronal lesions in the neocortex, hippocampus,
      and caudoputamen. Hypercapnia clearly aggravated this damage, particularly in the
      caudoputamen, subiculum, and CA1 region of the hippocampus, and caused additional
      damage to cells in the CA3 region and piriform cortex. A rise in CO2 tension from
      approximately 200 to 300 mm Hg did not further aggravate the damage. The results
      thus demonstrate that relative moderate acidosis aggravates damage that is
      believed to be mostly neuronal, sparing glia cells and vascular tissue.

PMID- 7798342
TI  - Tirilazad pretreatment improves early cerebral metabolic and blood flow recovery
      from hyperglycemic ischemia.
AB  - Acidosis may augment cerebral ischemic injury by promoting lipid peroxidation. We
      tested the hypothesis that when acidosis is augmented by hyperglycemia,
      pretreatment with the 21-aminosteroid tirilazad mesylate (U74006F), a potent
      inhibitor of lipid peroxidation in vitro, improves early cerebral metabolic
      recovery. In a randomized, blinded study, anesthetized dogs received either
      tirilazad mesylate (1 mg/kg plus 0.2 mg/kg/h; n = 8) or vehicle (n = 8).
      Hyperglycemia (400-500 mg/dl) was produced prior to 30 min of global incomplete
      cerebral ischemia. Intracellular pH and high energy phosphates were measured by
      phosphorus magnetic resonance spectroscopy. During ischemia, microsphere
      determined CBF decreased to 8 +/- 4 ml min-1 100 g-1 and intracellular pH
      decreased to 5.6 +/- 0.2 in both groups. During the first 20 min of reperfusion,
      ATP partially recovered in the vehicle group to 57 +/- 21% of baseline, but then
      declined progressively in association with elevated intracranial pressure. By 30
      min, ATP recovery was greater in the tirilazad group (77 +/- 35 vs. 36 +/- 19%),
      although postischemic hyperemia was similar. By 45 min, the tirilazad group had a
      higher intracellular pH (6.5 +/- 0.5 vs. 5.9 +/- 0.6) and a lower intracranial
      pressure (18 +/- 6 vs. 52 +/- 24 mm Hg). By 180 min, blood flow and ATP were
      undetectable in seven of eight vehicle-treated dogs, whereas ATP was > 67% and pH
      was > 6.7 in six of eight tirilazad-treated dogs. Thus, tirilazad acts during
      early reperfusion to prevent secondary metabolic decay associated with severe
      acidotic ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798343
TI  - Labeling of metabolic pools by [6-14C]glucose during K(+)-induced stimulation of
      glucose utilization in rat brain.
AB  - [6-14C]Glucose is the tracer sometimes recommended to assay cerebral glucose
      utilization (CMRglc) during transient or brief functional activations, but when
      used to study visual stimulation and seizures in other laboratories, it
      underestimated CMRglc. The metabolic fate of [6-14C]glucose during functional
      activation of cerebral metabolism is not known, and increased labeling of
      diffusible metabolites might explain underestimation of CMRglc and also reveal
      trafficking of metabolites. In the current studies cerebral cortex in conscious
      rats was unilaterally activated metabolically by KCl application, and CMRglc was
      determined in activated and contralateral control cortex with [6-14C]glucose or 2
      [14C]deoxy-glucose ([14C]DG) over a 5- to 7-min interval. Local 14C
      concentrations were determined by quantitative autoradiography. Labeled precursor
      and products were measured bilaterally in paired cortical samples from funnel
      frozen brains. Left-right differences in 14C contents were small with [6
      14C]glucose but strikingly obvious in [14C]DG autoradiographs. CMRglc determined
      with [6-14C]glucose was slightly increased in activated cortex but 40-80% below
      values obtained with [14C]DG. [14C]Lactate was a major metabolite of [6
      14C]glucose in activated but not control cortex and increased proportionately
      with unlabeled lactate. These results demonstrate significant loss of labeled
      products of [6-14C]glucose from metabolically activated brain tissue and indicate
      that [14C]DG is the preferred tracer even during brief functional activations of
      brain.

PMID- 7798344
TI  - Leadership: a new conception.
AB  - The article summarizes the common wisdom regarding leadership that informs our
      present understanding of leadership. It articulates a new understanding of
      leadership, referred to as the postindustrial paradigm of leadership; comments on
      this new paradigm; contrasts it with the industrial paradigm of leadership; and
      ends with some comments on leadership as an episodic affair.

PMID- 7798345
TI  - Transformational leadership: the feminist connection in postmodern organizations.
AB  - The article describes the changes occurring in the world and organizations and
      argues that the contemporary theory of transformational leadership can provide
      guidance for nursing leaders, who are predominantly women. Transformational
      leadership is defined and described. The feminist literature is briefly reviewed.
      A comparison of the attributes of women, who are constructed knowers, and those
      of transformational leaders is made, including the web of inclusion, caring,
      moral responsibility, reciprocity and cooperation, integration of voices,
      intuition, and hierarchic and patriarchal paradigms. It is argued that a new way
      of leading and new organizational structures are emerging that will provide a
      favorable environment for female leaders.

PMID- 7798346
TI  - A challenge to nursing: promoting followers as well as leaders.
AB  - It is believed that 70% of our lives is spent in the role of follower. Even so,
      the focus in formal education and seminars remains leadership issues because of
      the unfavorable stereotypes that accompany the term follower. Nurturing effective
      followership requires doing away with the misconception that leaders do all the
      thinking and followers mindlessly heed orders. Can followers and leaders ever be
      deemed separate but equal? It is vital to understand that, without effective
      followers in nursing, our leaders face severe limitations. Current leaders and
      educators must share and promote the vision of enlightened followership if
      nursing is to achieve its potential.

PMID- 7798348
TI  - Ethical aspects of transformational leadership.
AB  - The requirements of leadership in the current environment of health care reform
      necessitate a clear distinction between leadership and management, an alteration
      in traditional leadership roles, and an evaluation of the knowledge and skills
      needed to address the ethical issues that arise from such reform.
      Transformational leadership is well suited to the current climate in health care
      because of the manner in which it actively embraces and encourages innovation and
      change. The article explores the elements of transformational leadership,
      describes the need for transformational leaders to be cognizant of the ethical
      aspects of their roles, and outlines the responsibilities of transformational
      leaders as moral agents.

PMID- 7798347
TI  - The coaching, precepting, and mentoring roles of the leader within an
      organizational setting.
AB  - The article examines the use of learning relationships to develop followers. The
      concepts of mentoring, precepting, and coaching are differentiated. Leader values
      are examined. The process of performing an environmental assessment and assessing
      organizational values is explored in a case study format. Four possible outcome
      assessments and the role of the leader are described. The use of theory and
      concepts to create change and to structure win-win situations is explored.

PMID- 7798349
TI  - Leadership preparation: an examination of master's degree programs in nursing.
AB  - The study was designed to examine the differences between leadership and
      management and to compare the leadership content in a sample of graduate programs
      in nursing with those conceptual differences. A review of seven components
      contained within the National League for Nursing self-study reports of 10
      accredited programs in four regions of the country was conducted. Data analysis
      revealed that leadership, as defined in the literature, was included in most
      curriculum components in the graduate programs studied. The emphasis in the 10
      graduate programs analyzed clearly was leadership development rather than
      management preparation.

PMID- 7798350
TI  - Organizational innovations that nourish staff leadership.
AB  - Health care is experiencing a paradigm shift that has the potential to redefine
      traditional roles, systems, and practices. At Albert Einstein Medical Center in
      Philadelphia, Pennsylvania, the nursing organization has capitalized on this
      potential and has been energized by the array of opportunities for innovation and
      experimentation. The results of these efforts suggest that many of these changes
      not only are positive approaches to patient care but also promote staff
      leadership and an entrepreneurial spirit at the front line.

PMID- 7798351
TI  - The arts and humanities: a creative approach to developing nurse leaders.
AB  - There are many ways by which leadership skills can be developed, but an effective
      approach that is rarely considered by educators, administrators, or individuals
      is the use of the arts and humanities. The article explores the nature of
      leadership and ways to develop leadership skills. It then examines how the
      humanities relate to leadership development and provides specific examples of
      arts and humanities that individuals can use in their quest to evolve as
      effective leaders.

PMID- 7798352
TI  - A decade of nursing leadership research.
AB  - A review of the published nursing leadership research from 1983 to 1993 is
      presented. The review identifies three categories of research: predicting
      leadership, leadership development, and leadership effectiveness. Comparisons are
      made with a previous research review. Recommendations for future research include
      the relationship between leader and follower, comparison studies of leaders in
      multiple settings, further analysis of mentorship, continued qualitative
      analysis, and quantitative research utilizing established instruments. As the new
      leadership roles of nurse leaders emerge in health care reform, so will new
      issues for future research.

PMID- 7798353
TI  - Leadership for the future.
AB  - Leaders are responsible for guiding others through a future that may be
      anticipated but is ultimately unknown. In addition, leaders are responsible for
      creating a positive future. If nurse leaders are to be successful in this
      process, they would benefit from knowing trends that are projected for the
      future, reflecting on the kinds of skills that are needed to meet the challenges
      presented by those trends, and proposing strategies that can be used for
      effective leadership in our uncertain future.

PMID- 7798354
TI  - Leadership: can it be holistic?
AB  - The article looks at new trends toward holistic leadership as opposed to older
      models focused on the tasks of managers. Transformational leadership and Heider's
      leadership by Tao are given as illustrations, as is the recent upsurge of
      interest in the spiritual aspect of care. It is noted that leadership is provided
      in many settings among persons with and without organizational managerial
      positions. The need for holistic leadership in a time of environmental flux and
      unpredictability is discussed.

PMID- 7798355
TI  - The temporoparietal fascial flap in reconstruction of the cranio-maxillofacial
      area.
AB  - An improved understanding of the vascular supply of the layers of the temporal
      fossa has increased the potentiality of reconstructive techniques involving this
      area. Each separate vascularized layer of this region can be used, yet the
      temporoparietal fascial flap is the more useful for treating a wide range of
      composite defects. It represents an ultra thin coverage which is useful in
      resurfacing exposed bone, tendons and vital structures such as nerves and
      vessels, in providing neovascularity as a recipient graft bed and in providing
      coverage or lining in major facial reconstructions. We describe our experience
      with the temporoparietal fascial flap which represents our choice for
      reconstructing composite defects in orbital, malar, auricular and cheek areas
      when what is required is a thin, pliable, well vascularized flap to carry a scalp
      or skin graft, to resurface exposed cartilage, bone and nerve, and to fill soft
      tissue contour defects. Illustrative cases from the authors' clinical experience
      are presented, to demonstrate various combinations of the temporoparietal fascial
      pedicle with other tissues in the reconstruction of the ear, eyebrows, eyelids,
      malar, cheek and parotid areas.

PMID- 7798356
TI  - Early evaluation of necrotizing fasciitis with use of CT.
AB  - Gas bubbles are one of the important signs in the clinical diagnosis of
      necrotizing fasciitis, and radiographs are mandatory. An instance where gas
      bubbles not found on the plain radiographs were clearly shown by CT, which is a
      useful method for close monitoring and decompression of gas bubbles situated
      deeply in the spaces of the maxillo-facial and neck regions.

PMID- 7798357
TI  - Incidence of velopharyngoplasty following various techniques of palatoplasty.
AB  - A total of 474 patients with cleft palates were treated at the Department for
      Maxillofacial Surgery of Rostock University from 1971 to 1991. In 145 cases
      velopharyngoplasty was indicated. Primary velopharyngoplasty was performed on 36
      and secondary velopharyngoplasty on 109 patients. In our opinion today primary
      velopharyngoplasty should be the exception. Intravelar veloplasty according to
      Kriens (1970) created particularly favorable conditions for good velar function
      so that secondary pharyngoplasty was only rarely indicated. Secondary
      pharyngoplasty should be performed and timed only in agreement with the speech
      therapist.

PMID- 7798358
TI  - The popliteal pterygium syndrome: an analysis of two families.
AB  - The popliteal pterygium syndrome is characterized by multiple anomalies of the
      face, genito-urinary system and extremities with autosomal dominant inheritance
      with variable expression. Also sporadic cases probably based upon spontaneous
      mutation can be recognized. The plastic, orthopaedic, and maxillofacial surgeon
      should be aware of the variable nature of the syndrome and should consult a
      medical geneticist. A coordinated team approach appears to be most adequate for
      diagnosis, counselling and treatment.

PMID- 7798359
TI  - Evaluation of the slot osteosynthesis technique in mandibular advancement. With
      focus on occlusion and lower lip sensibility.
AB  - The slot osteosynthesis technique (SLOT) was evaluated in 25 mandibular
      advancements. SLOT was successfully used to readjust skeletal and occlusal
      malpositioning in 48% of the cases. Neurosensory tests in the lower lip and chin
      region revealed a low disturbance rate (immediately postsurgery 20% of patients,
      at 7 months 8%). This may be due to the specific splitting and fixation
      techniques applied.

PMID- 7798360
TI  - A prospective study on changes in the sensibility of the oral mucosa and the
      mucosa of the upper lip after Le Fort I osteotomy.
AB  - A prospective study on 21 patients was performed in order to investigate the
      changes in the sensibility of the oral mucosa and the mucosa of the upper lip
      after a Le Fort I osteotomy. Patients were followed-up 1 month, 3 months and 6
      months postoperatively. The sensibility of the mucosa was tested using electrical
      sensimetry (Laitinen, 1987). The teeth were tested with carbon dioxide snow
      (Obwegeser and Steinhauser, 1963). A picture of the marked hypoaesthetic area was
      performed and magnified 1:1 if a hypoaesthesia of the cutaneous distribution of
      the infraorbital nerve was found. The area was measured using a Macintosh II CX
      computer. It was demonstrated, that after 3 months the infraorbital nerve
      regained its function completely. The greater palatine nerve and the posterior
      superior alveolar nerve demonstrated an incomplete recovery of sensory function
      after 6 months. After 6 months 92.8% of the teeth reacted to carbon dioxide snow.
      Within the first 6 months postoperatively, no pulpe necrosis was observed. No
      correlation could be found between the amount of anterior maxillary movement and
      the degree of hypoaesthesia of the infraorbital nerve. Dentate Le Fort I
      osteotomies showed a better sensory regeneration of the greater palatine nerve
      than edentulous Le Fort I osteotomies. After Le Fort I osteotomies in 2 parts,
      more hypoaesthesia of the greater palatine nerve was observed than after Le Fort
      I osteotomies in 1 part. After miniplate osteosynthesis, more hypoaesthesia of
      the posterior superior alveolar nerve was observed than after wire
      osteosynthesis. The results are discussed and compared with the results found in
      the literature.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798361
TI  - Clinical investigation into the incidence of direct damage to the lingual nerve
      caused by local anaesthesia.
AB  - The aim of this study was to investigate the amount of damage to the lingual
      nerve by mandibular block anaesthesia alone. For this purpose the records of
      12,104 patients in whom mandibular block anaesthesia was administered without any
      type of surgery were reviewed. The reason for treatment in those patients was, in
      72.4% fillings and crown preparations, in 27.13% periodontal procedures and in
      0.30% other treatment. The records showed a lingual sensory disturbance in 18 out
      of 12,104 patients (0.15%). In 17 out of these 18 patients the tongue sensation
      recovered after a period of 6 months. Only in one patient (0.008%) was there a
      slight sensory diminution of the tongue, even after one year.

PMID- 7798363
TI  - Laser Doppler imaging of axial and random pattern flaps in the maxillo-facial
      area. A preliminary report.
AB  - Objective, non-invasive examination, techniques in addition to clinical
      parameters, are required to follow-up the wound healing of flaps. With the new
      laser Doppler Scanner (LDI DIM 1.0 Lisca Development AB, Sweden) it is possible,
      for the first time, to measure and image the microcirculation continuously, non
      invasively and without contact with the wound, in an area of 12 cm square
      maximum. We performed measurements and simultaneous two-dimensional imaging of
      the microcirculation 24, 48, 72 h and 5 and 14 days postoperatively in 20
      patients, who had had reconstruction procedures performed using random or axial
      pattern flaps. The perfusion diagrams were correlated to the clinical appearance.
      Necrotic areas, venous stasis and normal course of wound healing can be clearly
      visualized and differentiated from one another. The new laser Doppler imaging
      system seems to be an excellent aid for following up and planning of flaps in
      plastic and reconstructive surgery.

PMID- 7798364
TI  - Lingual thyroid: a new surgical approach--a case report.
AB  - Ectopic lingual thyroid is a rare developmental anomaly, presenting in the adult
      with obstructive symptoms during respiration, deglutition and speech. The main
      therapeutic issue after exact diagnosis is the restoration of thyroid function,
      and surgical intervention, when necessary, has to deal with problems related to
      the site and function of the ectopic gland. A case of a 25-year-old female with
      dyspnoea and dysphagia due to a 3 x 4 cm ectopic lingual thyroid, excised by an
      original peroral approach via a mandibular midline osteotomy, is reported. Our
      surgical technique is described and the diagnostic and therapeutic problems are
      reviewed.

PMID- 7798362
TI  - Autogenous transplantation of third molars in irradiated jaws--a preliminary
      report.
AB  - Our experience with third molar autotransplants in 2 patients, into an area
      irradiated at an early age, is described and discussed. It is shown that such
      autotransplantations are possible.

PMID- 7798366
TI  - Penetration of the skull base by dissecting keratocyst--Jackson et al. J.
      Craniomaxillofac. Surg. (1993) 21, 319-325.

PMID- 7798365
TI  - The surgical approaches to nasopharyngeal angiofibroma.
AB  - After a short summary of the aetiopathogenesis, the routes of extension and the
      diagnostic features of nasopharyngeal angiofibroma, the importance of early
      diagnosis and careful surgical planning is underlined. In particular the
      extension and topographic localization allows the choice of the best approach to
      optimize surgical radicality--the prime concern in the treatment of
      nasopharyngeal angiofibroma. Different surgical approaches are proposed for the
      tumour removal according to our experience in 17 patients.

PMID- 7798367
TI  - Penetration of the skull base by dissecting keratocyst--Jackson et al. J.
      Craniomaxillofac. Surg. (1993) 21, 319-325.

PMID- 7798368
TI  - Developmental outcome of very low birth weight infants as a function of
      biological risk and psychosocial risk.
AB  - The relative contribution of biological and psychosocial risk factors to
      developmental outcome of 102 very low birth weight infants (< 1500 g) was
      delineated through 24 months corrected age. Biological risk, assessed by the
      Neurobiologic Risk Score (NBRS), accounted for significant amounts of variance in
      Bayley Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI)
      at the 6-, 15-, and 24-month assessment points. Psychosocial risk, reflected in
      maternal appraisals of daily stress, accounted for a significant increment in
      cognitive outcome (MDI), over and above that accounted for by the NBRS, at each
      assessment point. Cognitive functioning at each assessment point differed as a
      function of biological risk and psychosocial risk status. The findings are
      discussed in terms of maternal stress as a marker of, and salient intervention
      target for, caregiving environments that can maximize or minimize the effects of
      biological vulnerability.

PMID- 7798369
TI  - What do minority elementary students understand about the causes of acquired
      immunodeficiency syndrome, colds, and obesity?
AB  - Elementary school-age children's conceptual understanding and factual knowledge
      about the causes of acquired immunodeficiency syndrome (AIDS), colds, and obesity
      are poorly understood, particularly among black children living in low-income,
      urban neighborhoods. We examined minority children's conceptual understanding
      about the causes of these illnesses. In addition, children's knowledge and
      misconceptions about the causal agents of AIDS, colds, and obesity were
      investigated. A developmentally based, semistructured interview was developed to
      measure children's level of understanding about the causes of each condition.
      Interviews were conducted with 239, predominately black, first, third, and fifth
      grade students attending two public elementary schools in a low income city in
      northern California. Interviews were verbally administered and tape recorded for
      later verbatim transcription. Children's responses to questions about causality
      first were scored based on their level of conceptual sophistication. Responses
      then were assigned to thematic categories reflecting the children's factual
      knowledge about the causes of AIDS, colds, and obesity. Increases in grade level
      were associated with higher scores for causality of AIDS (p < .0001), colds (p <
      .0001), and obesity (p < .01). In all three conditions, causality scores
      increased between first and fifth grades, but did not significantly vary between
      third and fifth grades. Gender, socioeconomic status, and number of adults living
      in the household were not significantly associated with causality scores. Within
      each grade, the finding of lower causality scores for AIDS, as compared to colds
      and obesity, points out the need for developmentally appropriate explanations to
      children about the causes of AIDS.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798370
TI  - School achievement and failure in very low birth weight children.
AB  - The extent to which low birth weight confers a risk for poor school function
      remains an important question. Children (N = 1868) in four birth weight
      categories [extremely low birth weight (ELBW; children weighed < or = 1000 g at
      birth, n = 247), other very low birth weight (1001 through 1500 g, n = 364),
      heavier low birth weight (1501 through 2500 g, n = 724), and normal birth weight
      (NBW > 2500 g, n = 533)] were compared on indicators of school achievement which
      included grade failure, placement in special classes, classification as
      handicapped, and math and reading achievement scores (Woodcock-Johnson Battery).
      Our results indicate that as birth weight decreases, the prevalence of grade
      failure, placement in special classes, and classification as handicapped
      increases, even when controlling for maternal education and neonatal stay.
      Moreover, ELBW children score lower than all other birth weight groups on math
      and reading achievement tests. Even among children with IQ scores above 85, ELBW
      children still obtain lower math scores than NBW children, suggesting the
      potential for future educational needs.

PMID- 7798371
TI  - Hypnosis in the prevention of chemotherapy-related nausea and vomiting in
      children: a prospective study.
AB  - To study the effectiveness of hypnosis for decreasing antiemetic medication usage
      and treatment of chemotherapy-related nausea and vomiting in children with
      cancer, we conducted a prospective, randomized, and controlled single-blind trial
      in 20 patients receiving chemotherapy for treatment of cancer. Patients were
      randomized to either hypnosis or standard treatment. The hypnosis group used
      hypnosis as primary treatment for nausea and vomiting, using antiemetic
      medication on a supplemental (p.r.n.) basis only, whereas the control group
      received a standardized antiemetic medication regimen. Nausea, vomiting, and
      p.r.n. antiemetic medication usage were measured during the first two courses of
      chemotherapy. Anticipatory nausea and vomiting were assessed at 1 to 2 and 4 to 6
      months postdiagnosis. Patients in the hypnosis group used less p.r.n antiemetic
      medication than control subjects during both the first (p < .04) and second
      course of chemotherapy (p < .02). The two groups did not differ in severity of
      nausea and vomiting. The hypnosis group experienced less anticipatory nausea than
      the control group at 1 to 2 months postdiagnosis (p < .02). Results suggest self
      hypnosis is effective for decreasing antiemetic medication usage and for reducing
      anticipatory nausea during chemotherapy.

PMID- 7798372
TI  - Age differences in parent and child responsibilities for management of cystic
      fibrosis and insulin-dependent diabetes mellitus.
AB  - Mothers (n = 26) of children and young adolescents (ages 4 to 14) with insulin
      dependent diabetes mellitus (IDDM) and mothers (n = 26) of children and young
      adolescents with cystic fibrosis (CF) (ages 4 to 14) described family
      responsibilities for treatment-related tasks and their children's general
      independence. Contrary to prediction, children and adolescents with CF and IDDM
      demonstrated comparable levels of independence concerning treatment-related
      responsibilities and their general adaptive behavior. As hypothesized, older
      children assumed higher levels of independence in managing their conditions, as
      well as sharing of treatment-related responsibilities with their parents.
      However, parents, especially mothers, continued to be very involved in most
      tasks, even for young adolescents. Independence in assuming treatment-related
      responsibilities was highly related to general independence among children and
      adolescents with both conditions. Children's independence in chronic illness
      management was not related to help mothers received from others as measured by
      the frequency and/or number of people helping. Findings have implications for
      pediatricians' monitoring and support of adaptive family responsibilities for
      chronic illness management.

PMID- 7798373
TI  - Managed care: good or bad news for children?

PMID- 7798374
TI  - Behavioral assessment and treatment of pediatric feeding disorders.
AB  - Pediatric feeding disorders are estimated to occur in as many as one in every
      four infants and children, and when serious can require numerous, costly and
      sustained interventions. For over a decade research has cumulated evidence on the
      contributions of Behavior Analysis in understanding and remediating some types of
      pediatric feeding disorders. The systematic use of this body of evidence in
      conjunction with other approaches (medical, nutrition, occupational therapy,
      physical therapy, and so forth) is being carried out on an inpatient treatment
      unit at the Kennedy Krieger Institute. Key aspects are described here, including
      direct observation behavior assessment, approaches for increasing and decreasing
      feeding behavior, skill acquisition, transfer of treatment gains, and parent
      training. The results based on case studies and overall program evaluation
      indicate that medically complicated, severe feeding disorders can be treated
      successfully in a few months with a multidisciplinary approach which incorporates
      behavioral procedures.

PMID- 7798375
TI  - Distribution of histamine-, 5-hydroxytryptamine-, and tyrosine hydroxylase
      immunoreactive neurons and nerve fibers in developing rat brain.
AB  - Although the general patterns of the developing histaminergic system in the rat
      brain are known, no comparative studies between the development of the brain
      histaminergic system and the development of other neuroactive substances have yet
      been published. Interestingly, separate immunohistochemical studies on the
      development of the 5-HT system and on the catecholaminergic system in the rat
      imply common features in the different aminergic systems. Therefore, the spatial
      distribution of histamine-immunoreactive (HA-ir) neurons and nerve fibers was
      compared to the distribution of 5-hydroxytryptamine (5-HT)-, and tyrosine
      hydroxylase-immunoreactive (TH-ir) ones in the developing rat brain between
      embryonic days 12 (E12) and 20 (E20) by using a double-immunostaining method. The
      high-pressure liquid chromatography (HPLC) fluorometric method was used for
      determination of histamine concentration in different brain regions during the
      same period of development and synthetic oligonucleotide probes complementary to
      the rat histidine decarboxylase (HDC) to determine the origin of HA in the brain
      during the development with in situ hybridization. The immunohistochemical
      results revealed co-localization of HA and 5-HT within a subgroup of cells in the
      developing raphe nuclei between E14 and E18. From E18 onwards HA immunoreactivity
      started to gradually disappear from the rhombencephalon, and was totally
      abolished by E20, while 5-HT-ir cells continued to establish their adult
      positions. No significant colocalization of HA and TH immunoreactivities was
      detected. The biochemical results were in agreement with the immunohistochemical
      ones and confirmed that histamine detected in the early developing brain is
      authentic. A positive in situ hybridization signal for HDC was detected in a
      small area in the ventrolateral pons in the same areas as HA- and HDC-ir cell
      bodies at E16, suggesting that at least some HA may be synthesized locally. These
      results confirm that HA is one of the first neurotransmitters to appear in the
      developing brain. In addition, the transient co-localization of HA and 5-HT
      immunoreactivities and the transient HDC expression at E16 within the developing
      pontine raphe nuclei may imply an interesting and a more general role for HA in
      modification of brain development.

PMID- 7798376
TI  - Distribution of corticospinal motor neurons in the postnatal rat: quantitative
      evidence for massive collateral elimination and modest cell death.
AB  - The postnatal development of rat corticospinal motor neurons (CSMN) was studied
      by retrograde tracing with cholera toxin B subunit (CTB) injected into the upper
      cervical dorsal spinal cord on the first postnatal day (P0), P3, P10, P20, and at
      adulthood. CTB-labeled neurons were visualized by immunocytochemistry and
      extensively quantified throughout the cortex. At P0, CSMN were found to an extent
      similar to that reported in P3 animals with other neuronal tracers, now
      permitting in vitro studies of neonatal CSMN. Between P0 and P3, the number of
      labeled neurons increased by 30% to a total maximum of approximately 185,000 in
      both cortices. The increase occurred throughout the cortex. At P10, the number of
      labeled CSMN had decreased to 60% of the number at P3. Fewer CSMN were evident
      particularly in the perirhinal cortex. Between P10 and P20, the number of CSMN
      decreased further to 52% of the maximal number at P3. This decrease occurred
      predominantly in the cingulate and parietal cortex. The number of labeled CSMN in
      rats injected at P0 and analyzed at P20 was 10% lower than the number in P0
      injected littermates that were analyzed at P3, which suggests that only a small
      portion of the "disappearing" CSMN undergoes developmental neuronal death. Thus,
      the spinal projection of the remaining 38% is apparently eliminated between P3
      and P20. Detailed quantitative analysis of the CSMN distribution demonstrated
      that neuronal death occurs predominantly in the perirhinal cortex. In contrast,
      axonal elimination of corticospinal projections occurred throughout the CSMN
      field, i.e., primarily in the frontal, occipital, and perirhinal cortex between
      P3-P10 and in the cingulate and parietal cortex between P10-P20.

PMID- 7798377
TI  - A reticuloreticular commissural pathway in the rat thalamus.
AB  - To further characterize the communication between the thalami of the two
      hemispheres, a connection linking the rostral reticular nuclei of the two
      thalamic sides was investigated in the rat by retrograde and anterograde tracing.
      The rostral reticular nucleus can be divided into a medial region, with densely
      packed fusiform neurons, and a lateral region, with less densely packed,
      polymorphic neurons. After injections of Fluorogold (FG) in the medial region,
      retrogradely labeled, small fusiform neurons were found in the corresponding
      contralateral region. The retrograde labeling data were confirmed by the
      anterograde-tracing experiments. Thin, beaded axons, anterogradely labeled after
      injection of biocytin or biotinylated dextranamine in the medial region,
      innervate the corresponding region in the contralateral reticular nucleus. The
      present data suggest the existence of a commissural pathway specifically devoted
      to the crosstalk between the rostral reticular nuclei of the two thalamic sides.
      The commissural gamma aminobutyric acid (GABA)-ergic input on the GABAergic
      neurons of the rostral reticular nucleus could modulate the generation of sleep
      spindles. The reticuloreticular pathway may, moreover, synchronize the diffuse
      modulatory effect of the rostral reticular nucleus on nonprimary cortical areas
      through the bilateral projections of the nucleus to the ventromedial,
      intralaminar, and anterior thalamic nuclei.

PMID- 7798378
TI  - Cone bipolar cells as interneurons in the rod pathway of the rabbit retina.
AB  - In the mammalian retina, rod signals are transmitted by rod bipolars to the
      narrow-field, bistratified (AII) amacrine cell. This neuron, in turn, makes gap
      junctions with the axonal arborization of cone bipolar cells that reside in the
      vitreal half (sublamina b) of the inner plexiform layer (IPL). After examining
      rod bipolars and AII amacrines in the rabbit retina, we have now reconstructed
      from electron micrographs of continuous series of thin sections the synaptic
      connections of the axonal arborizations of cone bipolar cells that make the
      highest number of gap junctions with AII amacrines. These axonal arborizations
      were narrowly confined to stratum 4 (S4) of the IPL and made ribbon synapses to
      dyads of postsynaptic dendrites that belonged to either ganglion or amacrine
      cells. In the population of postsynaptic processes, 30% were ganglion cell
      dendrites. These dendrites were probably originating, at least in part, from on
      center ganglion cells because their course was confined to sublamina b of the
      IPL. Of the remaining postsynaptic processes, 51.7% belonged to amacrine cells
      and 18.3% were not identified. Among the postsynaptic amacrine cell processes,
      33.3% returned a reciprocal synapse onto the cone bipolar endings. These
      reciprocal synapses represented 21.3% of the total input onto the axonal
      arborizations, the remaining fraction (78.7%) arising from a heterogeneous
      population of amacrine dendrites that were purely presynaptic to the cone
      bipolars endings. Pre- and postsynaptic amacrines were part of several distinct
      microcircuits which suggest complex local processing of both rod and cone
      signals. Thus, the cone bipolars that make gap junctions with AII amacrines in
      sublamina b of the rabbit IPL exhibit a substantial output onto ganglion cells.
      This fact, in conjunction with our previous observations that in this sublamina
      ganglion cells receive negligible input from rod bipolars and AII amacrines,
      demonstrates that in the rabbit cone bipolars represent a necessary link in the
      pathway followed by rod signals to enter on-center ganglion cells. Thus, rod and
      cone signals ultimately share the same integrating mechanisms and converge onto
      the same set of ganglion cells.

PMID- 7798379
TI  - Differential expression of five N-methyl-D-aspartate receptor subunit mRNAs in
      the cerebellum of developing and adult rats.
AB  - Five N-methyl-D-aspartate (NMDA) receptor subunits have been identified thus far:
      NR1, NR2A, NR2B, NR2C, and NR2D. Here, we have analyzed the expression patterns
      of mRNAs for the NMDA receptor subunits in the developing and adult rats by in
      situ hybridization. The developmental changes of the expression patterns were
      most salient in the cerebellum. In the external granular layer, hybridization
      signals of mRNAs for NR1, NR2A, NR2B, and NR2C appeared by postnatal day 3, but
      no NR2D mRNA was expressed at any developmental stage examined. The NR1 mRNA was
      expressed in all cerebellar neurons at all developmental stage examined. The NR1
      mRNA was expressed in all cerebellar neurons at all developmental stages
      examined. The signals for the NR2A mRNA appeared in Purkinje cells and granule
      cells during the second postnatal week. The signals for the NR2B mRNA in granule
      cells were seen transiently during the first 2 weeks after birth. The signals for
      NR2C mRNA appeared in granule cells and glial cells during the second postnatal
      week. The signals for NR2D mRNA appeared transiently in Purkinje cells during the
      first 8 postnatal days; in adult rats, these were seen in stellate and Golgi
      cells. In the cerebellar nuclei, mRNAs for NR1, NR2A, NR2B, and NR2D were more or
      less expressed on postnatal day 0, while expression signals for the NR2C mRNA
      were first detected in postnatal day 14. Thus, the most conspicuous changes of
      expression patterns were observed in the cerebellar cortex during the first 2
      weeks after birth, when development and maturation of the cerebellum proceed most
      rapidly.

PMID- 7798380
TI  - Distribution of motoneurons supplying dorsal and ventral suboccipital muscles in
      the feline neck.
AB  - A combination of retrograde tracers was used to compare the relative
      distributions of motoneurons supplying the ventral and lateral suboccipital
      muscles, rectus capitis anterior (RCA), and rectus capitis lateralis (RCL), with
      those supplying dorsal muscles, including rectus capitis posterior muscles (RCP),
      complexus (CM), and the medial head of obliquus capitis superior (OCS). Three of
      the tracers, horseradish peroxidase, fluororuby, and fluorescein-conjugated
      dextran, were applied to cut nerve ends. Fast blue was applied by intramuscular
      injection, and fluorogold was delivered both by injection and by cut nerve
      exposure. Motoneurons supplying RCA and RCL were clustered on the medial wall of
      the ventral horn in a restricted region defined previously as the commissural
      nucleus. Labelled cells supplying RCL were confined to the C1 segment, but those
      supplying RCA were distributed from C1 to rostral C4. Motoneurons supplying RCA
      tended to lie more dorsomedially than those supplying RCL, but there was
      substantial overlap between the two populations. Motoneurons supplying dorsal
      muscles had a separate, more ventral distribution. RCP motoneurons were located
      primarily in the ventromedial nucleus, but a small proportion of cells was found
      in the white matter of the ventral funiculus or the gray matter surrounding the
      central canal. Motoneurons supplying CM and OCS were located dorsomedially to the
      RCP cell population. These results suggest that neck motoneurons are arranged
      according to a "musculotopic" pattern in which dorsal muscles have the most
      ventral locations, and progressively more lateral and then ventral muscles are
      layered dorsomedially along the medial wall of the ventral horn.

PMID- 7798381
TI  - Ontogeny and effect of activity on proenkephalin mRNA expression during
      development of the chick spinal cord.
AB  - Numerous studies have shown in the adult nervous system that mRNA expression can
      be regulated by neuronal activity. To examine the effect of activity during
      embryogenesis, the ontogeny of proenkephalin mRNA expression and expression
      following activity blockade was investigated during development of chick spinal
      cord. A cDNA fragment (ca. 0.5 kb) coding for chick proenkephalin was cloned and
      sequenced. With this cDNA, a cRNA probe was made to examine proenkephalin mRNA
      expression in the spinal cord during embryogenesis. Proenkephalin mRNA was
      expressed in spinal cord in clusters of cells located in the developing dorsal
      horn and intermediate lamina at the earliest stages examined (stage 22; E4).
      Proenkephalin-positive cells in the intermediate lamina were located immediately
      adjacent to the ventricular zone. At stage 28 (E6) an additional cluster of
      proenkephalin mRNA-positive cells was seen at the lateral border of the
      developing intermediate lamina. At stage 33 (E7.5-5-8) the pattern of
      hybridization positive cells was similar to earlier stages, but individual cells
      could be identified. At stage 39 (E13) densely labeled cells were seen throughout
      the dorsal horn and intermediate laminae including the column of Terni. To
      determine whether neural activity affects proenkephalin mRNA expression, d
      tubocurarine (an inhibitor of neural activity) was injected into developing
      embryos. Following administration of d-tubocurarine a dramatic decrease was seen
      in proenkephalin mRNA hybridization in the dorsal horn and intermediate lamina of
      the spinal cord. This study demonstrates in vivo that changes in the level of
      neural activity can alter gene expression during embryogenesis and suggests that
      activity is required for expression of nervous system-specific genes.

PMID- 7798382
TI  - Brainstem network controlling descending drive to phrenic motoneurons in rat.
AB  - Contraction of the diaphragm is controlled by phrenic motoneurons that receive
      input from sources that are not fully established. Bulbospinal (second-order)
      neurons projecting to phrenic motoneurons and propriobulbar (third-order) neurons
      projecting to these bulbspinal neurons were investigated in rat by transsynaptic
      transport of the neuroinvasive pseudorabies virus. Bulbospinal neurons were
      located predominantly in the medullary lateral tegmental field in two
      functionally described regions, the ventral respiratory group and Botzinger
      complex. An intervening region, the pre-Botzinger complex, contained essentially
      no phrenic premotoneurons. Bulbospinal neurons were also located in ventral,
      interstitial, and ventrolateral subnuclei of the solitary tract, and
      gigantocellular, Kolliker-Fuse, parabrachial, and medullary raphe nuclei. A
      monosynaptic pathway to phrenic motoneurons from the nucleus of the solitary
      tract was confirmed; monosynaptic pathways from upper cervical spinal cord,
      spinal trigeminal nucleus, medical and lateral vestibular nuclei, and medial
      pontine tegmentum were not verified. Locations of third-order neurons were
      consistent with described projections to the ventral respiratory group, from
      contralateral ventral respiratory group, Botzinger complex, A5 noradrenergic cell
      group, and the following nuclei; solitary, raphe, Kolliker-Fuse, parabrachial,
      retrotrapezoid, and paragigantocellular. Novel findings included a projection
      from locus coeruleus to respiratory premotoneurons and the lack of previously
      described pathways from area postrema and spinal trigeminal nucleus. These second
      and third-order neurons from the output network for diphragm motor control which
      includes numerous behaviors (e.g., respiration, phonation, defecation). Of the
      premotoneurons, the rostral ventral respiratory group is the primary population
      controlling phrenic motoneurons.

PMID- 7798383
TI  - Morphological maturation of thalamic neurons as studied in fetal neural
      transplants.
AB  - This study attempts to determine whether fetal thalamic neuroblasts from rat
      embryos (embryonic age 15 days) labeled with horseradish peroxidase (HRP) can
      differentiate into their normal dendritic phenotype when transplanted as a cell
      suspension into a lesioned site in the adult somatosensory thalamus. The HRP
      labeling provided a Golgi-like staining of numerous neurons up to 12-14 days
      after transplantation. There were three main results. 1) As early as 2 days after
      transplantation three morphologic cell types were observed: Two were bipolar and
      the third multipolar. These cellular profiles are characteristic of adult
      ventroposterolateral, reticular, and ventroposteromedial neurons and suggest that
      transplanted neurons can take shape in the absence of specific arrangements of
      afferent fibers. 2) The initial stage of dendritic growth was characterized by
      numerous growing specializations and consisted of a rapid, arborizing growth that
      appeared to proceed at an accelerated rate relative to normal development. During
      the later stage, which was characterized by the great reduction of growing
      specializations, dendritic remodeling resulted in a simpler morphology, and the
      transplanted neurons did not achieve an adult morphology. 3) Putative axons
      exhibiting growth cones were present in impressive densities in the transplants,
      and a number of them grew into the neuron-depleted host thalamus. A very small
      number of axons grew into host gray matter outside the lesioned area, indicating
      that neurodegenerative areas provide a better substrate for neurite outgrowth
      than intact tissue. In rare instances axons were visible in the internal capsule,
      indicating that the biochemical inhibition provided by mature myelin and
      oligodendrocytes may not be an absolute obstacle to axonal growth.

PMID- 7798384
TI  - Idiopathic plantar hidradenitis: a neutrophilic eccrine hidradenitis occurring
      primarily in children.
AB  - Neutrophilic eccrine hidradenitis (NEH) has been described in a variety of
      clinical settings but is most often seen in leukemic patients receiving
      chemotherapy. We have recently encountered 6 healthy individuals, of whom 5 were
      children, who developed NEH localized to the feet. The patients were from 9 to 21
      years of age. The presenting complaint was rapid development of tenderness of the
      feet with varying degrees of morbidity. At clinical evaluation, tender,
      erythematous papules and nodules were confined to the feet, primarily the plantar
      surfaces. The major differential diagnoses were erythema nodosum and vasculitis.
      Laboratory studies were non-contributory. Histologically, the findings were
      generally similar to those of NEH with certain exceptions, most notably the
      absence of syringosquamous metaplasia and the presence, in most cases, of
      neutrophilic abscesses in eccrine coils. Inflammatory and degenerative changes
      involved primarily the eccrine duct (coiled and dermal), and tended to spare the
      secretory apparatus. Stains for microorganisms were negative. There were brief
      recurrences in some of the patients, but those followed over time have remained
      well. We suggest the term idiopathic plantar hidradenitis for this condition.

PMID- 7798385
TI  - Melanocytes in human skin express bcl-2 protein.
AB  - The bcl-2 gene was initially identified through its participation in the
      translocation 14:18 in B-cell lymphomas of follicular center cell origin. This
      classic translocation juxtaposes the transcriptionally active immunoglobulin
      heavy-chain locus on chromosome 14 to the bcl-2 gene on chromosome 18, resulting
      in overexpression of bcl-2 protein. The oncogene bcl-2 is thought to prolong cell
      survival through interference with programmed cell death. To date, bcl-2
      expression has been reported in normal lymphoid, hemopoietic, neural, breast and
      prostatic tissues. Since melanocytes are neural crest derivatives and have an
      extended life-span, our objective was to determine whether the bcl-2 protein is
      expressed in human melanocytes. We analyzed normal skin biopsies for bcl-2
      expression using standard immunohistochemistry. As hypothesized, dendritic cells
      in the basal epidermal layer stained strongly for bcl-2. The distribution and
      morphology of these cells was typical for melanocytes. Additionally, eccrine
      sweat glands, lymphocytes and the dermal papilla of hair follicles demonstrated
      bcl-2 positivity. We believe this to be the first report of bcl-2 expression in
      normal melanocytes.

PMID- 7798386
TI  - Characterization of the mononuclear infiltrate involved in regression of halo
      nevi.
AB  - Halo nevi are characterized by progressive degeneration of nevus cells surrounded
      by a mononuclear cell infiltrate. We studied the morphological features of the
      nevus cells and the composition of the mononuclear cell infiltrate in 15 cases of
      halo nevi using immunohistochemical techniques and a battery of antibodies to
      different subsets of lymphocytes and histiocytes. Regression could be divided
      into four more or less identifiable stages, associated with different subsets of
      lymphocytes and monocyte-macrophage lineage cells. Stage I (preregression): nests
      of unremarkable nevus cells were surrounded by a moderate number of T lymphocytes
      (relatively small percentage of helper inducer T cells), occasional B cells and
      macrophages. Stage II (early regression): large number of T lymphocytes and
      FXIIIa-positive cells were in close contact with nevus cell clusters which showed
      ragged edges. Lysozyme-positive cells and epidermal Langerhans cells were mildly
      increased. Stage III (late regression): single nevomelanocytes showing mild
      atypia were present. Numerous T lymphocytes and macrophages positive for
      lysozyme, KP1 and/or FXIIIa were interspersed between the nevus cells. Increased
      numbers of epidermal Langerhans cells were present. Stage IV (complete
      regression): no nevus cells were observed and moderate numbers of T lymphocytes
      only remained. These results suggest that T cells, especially T-suppressor cells,
      and different subsets of macrophages participate in the regression of the nevi.

PMID- 7798387
TI  - Pseudoepitheliomatous hyperplasia in chronic cutaneous wounds. A flow cytometric
      study.
AB  - Cutaneous squamous cell carcinomas (SCC) arising in a setting of chronic
      regeneration and repair tend to be highly aggressive lesions prognostically
      distinct from SCC arising in solar-damaged skin. Full thickness thermal injury
      and chronic nonhealing ulcers are predisposing conditions in up to 2% of SCC. A
      significant association has been suggested to exist between pseudoepitheliomatous
      hyperplasia (PH) and SCC. Three-hundred-eighty-six surgical cases of skin excised
      secondary to severe burns (n = 254) or chronic ulcers (n = 132) were reviewed,
      yielding 43 (11%) with PH. Flow cytometric DNA analysis was performed on paraffin
      embedded sections. Thirty cases without PH were studied in addition to the 43
      cases with PH. The majority (39/43) of the PH cases showed a single diploid
      population with a mean S-phase of 13.7%. Four cases (9.3%) showed an aneuploid
      peak. All cases without PH were diploid with a mean S-phase of 9.0%. In this
      study, PH was present in 11% of cases reviewed, and showed a 50% mean higher S
      phase than comparable cases without PH. Aneuploidy was present in 9.3% of the PH
      cases studied. SCC may arise from a subgroup of PH in a background of rapidly
      proliferating keratinocytes.

PMID- 7798388
TI  - Altered p53 expression and epidermal cell proliferation is seen in vulval lichen
      sclerosus.
AB  - Aberrant p53 immunoreactivity has been found in skin pre-malignancies and
      dysplasias such as Bowen's disease and actinic keratoses. Vulval lichen sclerosus
      (LS) has been reported to be pre-malignant, with an association of vulval
      carcinoma in 3% to 6% of patients. In contrast, non-genital LS appears to have no
      malignant potential. In this immunocytochemical study, we investigated p53
      expression in 10 cases of histologically proven vulval LS and 9 cases of non
      genital LS using the murine monoclonal antibody Do-1 raised against recombinant
      human p53 which reacts with both wild-type and mutant p53. None of the vulval
      specimens had epithelial dysplasia or malignancy. Normal vulval (7 cases) and non
      genital skin (5 cases) were used as tissue controls, respectively. The cell
      proliferation index was also studied using the MIB 1 monoclonal antibody which
      detects the cell-cycle associated Ki-67 antigen. The technique of microwave
      irradiation for antigen unmasking was employed on formalin-fixed and paraffin
      embedded tissues. There was a significant increase in p53 immunoreactivity in
      vulval LS (32.13 +/- 15.11 epidermal cells per 100 basal cells) compared to
      normal vulval skin (7.52 +/- 5.04 epidermal cells per 100 basal cells) (p <
      0.001), whereas the MIB 1 labelling index was lower in vulval LS (39.45 +/- 15.88
      epidermal cells per 100 basal cells) than in normal controls (86.26 +/- 32.31
      epidermal cells per 100 basal cells) (0.001 < p < 0.01). In contrast, there was
      no significant difference in p53 immunoreactivity or MIB 1 labelling index
      between non-genital LS and normal controls.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798389
TI  - Techniques in immuno-electron microscopy. I. Cryosubstitution.
AB  - Normal skin was cryoprotected by submerging it in a mixture of 30%
      dimethylformamide (DMF) in PBS or RPMI. Subsequently it was frozen in liquid
      propane gas. Cryosubstitution was carried out at -90 degrees C by using methanol
      to which uranyl acetate or osmium tetroxide were added. The tissue was embedded
      in either Lowicryl K4M at -40 degrees C or in Epon at +60 degrees C. The tissue
      was evaluated by its overall preservation of ultrastructural details and by its
      labeling intensity after incubation with either anti-desmoglein or anti-type VII
      collagen monoclonal antibodies. The mixture of DMF and PBS caused an electron
      dense precipitate within the cell. The overall morphology was better in Epon
      embedded material than in K4M-embedded material. However, the labeling was best
      in K4M material. Regardless of whether the tissue was embedded in Epon or K4M,
      the addition of osmium tetroxide markedly reduced the degree of labeling.

PMID- 7798390
TI  - DNA determination of human hair bulbs in normal and androgenetic alopecia.
AB  - We carried out a cytophotometric study of the DNA content of matrix cells from
      normal hair follicles and those affected by androgenetic alopecia (early and
      established baldness), using the Feulgen technique. We thereby obtained a 2C
      reference value from lymphocyte nuclei from normal skin, from which we
      established a 2C-4C and 4C DNA content. The results obtained showed 71.75% of
      matrix cells in normal scalp to have a 2C content, while the remaining 28.25% was
      distributed between the values of 2C-4C and 4C. However, in early baldness, the
      number of 2C cells dropped to 48%, with a notable increase in cell populations
      with a 2C-4C and 4C content, which varied from 29.45% and 22.55% respectively.
      Finally, in established baldness, the 2C values decreased to as low as 29.56%,
      with the percentage of cells with a 2C-4C content reaching 38.71% and those of
      4C, 31.73%.

PMID- 7798391
TI  - Arteriovenous hemangioma: a clinicopathological and immunohistochemical study.
AB  - The clinicopathological and immunohistochemical properties of 6 examples of
      arteriovenous hemangioma, including 2 intraoral lesions, were reviewed. This
      distinct benign, acquired vascular lesion, infrequently encountered in the
      literature, is characterized by multiple thick- and thin-walled vascular spaces
      resembling arteries and veins, respectively. In our study, we performed elastic
      stains that revealed a prominent venular component, whereas the arterial aspect
      was inconspicuous to absent. Our aim was also to elucidate the possible
      histogenesis of this lesion. Previous reports suggest as pathogenetic mechanisms
      hamartomatous proliferation either of the subpapillary vascular plexus or of the
      Suquet-Hoyer canal of the true glomus. Our immunohistochemical studies failed to
      identify typical glomus cells. In addition, we investigated the mast cell count
      in all lesions and it was found increased. These findings, as well as recent
      evidence directly implicating mast cells in angiogenesis, can support the theory
      of hamartomatous proliferation of the subpapillary plexus. One should also not
      exclude the possibility of a reactive process resulting in the characteristic
      features of arteriovenous hemangioma.

PMID- 7798392
TI  - Eruptive xanthomata with urate-like crystals.
AB  - The microscopic manifestations of eruptive xanthomata are variable and although
      they are most frequently characterized by aggregations of foamy macrophages in
      the dermis, they can, on occasion, simulate granuloma annulare. We have recently
      encountered a further unusual histopathological variant of eruptive xanthomata in
      3 skin biopsies from 2 patients with hypertriglyceridemia. The lesions had a
      granuloma annulare-like pattern at low magnification, the exceptional feature
      being their content of polarizable, needle-shaped crystals. These bore a strong
      resemblance to monosodium urate monohydrate and displayed negative birefringence
      under polarized light. In the case of each patient, an initial pathological
      diagnosis of gout was rendered, and the true nature of the lesions came to light
      only after clinicopathologic correlation. While it is clear that the chemical
      composition of these crystals requires further study, recognition of this
      microscopic variant of eruptive xanthomata should help to reduce errors in
      diagnosis.

PMID- 7798393
TI  - Low-grade fibromyxoid sarcoma: case report and immunohistochemical study.
AB  - A case is presented of low-grade fibromyxoid sarcoma involving the arm of a 52
      year-old man. Low-grade fibromyxoid sarcoma is a recently described neoplasm of
      the deep and subcutaneous soft tissue which demonstrates a spectrum of histologic
      images. The current case demonstrated the typical patterns of intermixed,
      sweeping bands of fibrous and myxoid tissue, homogeneous foci of fibrous and
      myxoid tissue, focal areas of storiforming, and concentric perivascular cuffs of
      slender spindle cells, all lacking the nuclear anaplasia, mitotic activity, and
      necrosis generally associated with sarcoma. Immunohistochemical analysis
      performed on paraffin-embedded sections demonstrated strong labeling of the tumor
      cells by anti-CD34 antibody, moderate labeling for vimentin, and rare, focal
      positivity for muscle-specific actin. Tumor cells were negative for markers of
      epithelial, muscular, neural, histiocytic, melanocytic, and vascular
      differentiation. The constellation of histopathologic features described in this
      and previous reports is characteristic of low-grade fibromyxoid sarcoma. Based on
      this case, it appears that the immunohistochemical features of low-grade
      fibromyxoid sarcoma can help to exclude many cutaneous and deep soft tissue
      tumors from the differential diagnosis. The findings support the interpretation
      that the neoplasm is essentially fibroblastic in nature.

PMID- 7798394
TI  - Diffuse dermal angiomatosis: a variant of reactive cutaneous
      angioendotheliomatosis.
AB  - Reactive angioendotheliomatosis (RA) is a rare, benign disease. Affected patients
      present with self-limited, erythematous to violaceous plaques. The clinical
      lesions are due to intravascular hyperplasia of cytologically banal endothelial
      cells in the dermis. We report 2 patients who presented with ulcerated,
      violaceous plaques on the lower extremities. Both had severe peripheral vascular
      atherosclerotic disease requiring bypass grafts. Unlike previously described
      cases of RA, our patient's lesions were due to a diffuse proliferation of
      endothelial cells in the reticular dermis with only minimal, focal intravascular
      proliferation of these cells. Positive immunostaining with antibodies to Factor
      VIII-related and CD34 antigens adds evidence that the proliferated cells in the
      dermis were endothelial cells.

PMID- 7798395
TI  - Dermatomyofibroma: report of two cases.
AB  - Dermatomyofibroma is a recently described, benign acquired cutaneous
      proliferation of fibroblasts and myofibroblasts. We report 2 additional cases,
      both in young women. The lesions measured 0.5 and 1.0 cm and were located on the
      breast and upper back. Follow-up at 8 months and 3 years revealed no evidence of
      recurrence. Both lesions exhibited a uniform population of spindle cells forming
      intersecting long fascicles with a tendency to horizontal orientation in the
      reticular dermis. Cytologic atypia was absent and mitotic figures were minimal or
      absent. Collagen was present as thin fibers separating individual cells and as
      thicker bundles between the fascicles. A fine reticulin network surrounded the
      spindle cells. Elastic fibers were mostly preserved and appeared thicker or even
      increased in number. The spindle cells were immunoreactive for vimentin and
      muscle actin and negative for desmin, S-100 protein, factor XIIIa, and CD34.
      Electron microscopic studies confirmed the presence of myofibroblasts. The
      differential diagnosis was made with cellular and fibrous dermatofibroma,
      piloleiomyoma, hypertrophic scar, and dermatofibrosarcoma protuberans, both
      classic and plaque type. The data presented supports the histologic distinction
      of dermatomyofibroma from other fibroblastic proliferations of the skin.

PMID- 7798396
TI  - Cutaneous Rosai-Dorfman disease presenting as a suspicious breast mass.
AB  - Cutaneous Rosai-Dorfman disease in a male patient presented as a clinically
      malignant left breast mass. The intra-operative frozen section indicated a benign
      inflammatory lesion and a simple excision was performed. The disease was
      apparently limited to the skin and subcutis of the left breast with no lymph
      nodes or other organs involvement. While the lesion demonstrated the
      characteristic morphology of Rosai-Dorfman disease, the diagnosis of
      granulomatous mastitis, epithelioid sarcoma and other cutaneous xanthohistiocytic
      proliferations were considered. In the absence of lymphadenopathy, a high index
      of diagnostic awareness is required to recognize the uncommon, solitary cutaneous
      Rosai-Dorfman disease.

PMID- 7798397
TI  - Designing preclinical instruction for psychomotor skills (I)--theoretical
      foundations of motor skill performance and their applications to dental
      education.

PMID- 7798398
TI  - Designing preclinical instruction for psychomotor skills (II)--instructional
      engineering: task analysis.

PMID- 7798399
TI  - The International Cochrane Collaboration Oral Health Group--making the results of
      controlled trials properly accessible.

PMID- 7798400
TI  - Dental school teaching clinics as cost centers.
AB  - Increasing net patient revenues from teaching clinics is one of the alternatives
      available to dental schools seeking to alleviate economic pressures. Managerial
      decisions directed to this end require accurate and useful data on clinic
      finances and economic organization. An important step in this direction can be
      taken by defining the teaching clinic as a cost center, that is as an economic
      entity in a dental school with identifiable specific resources, costs, and
      revenues. This paper describes the accounting and economics frameworks within
      which resources and costs are classified and allocated into direct and indirect,
      and fixed and variable categories. The development and structure of a cost
      revenue model designed for the teaching clinics at the University of Connecticut
      School of Dental Medicine is described to illustrate an application of the cost
      center concept.

PMID- 7798401
TI  - An application: the cost of clinic care by undergraduate dental students and its
      relationship to clinic fees.

PMID- 7798402
TI  - Outcomes assessment of a predoctoral research program.

PMID- 7798403
TI  - Responsibilities of faculty managers in predoctoral general practice programs.

PMID- 7798404
TI  - An application of team learning in dental education.

PMID- 7798406
TI  - The future of dental education.

PMID- 7798405
TI  - PENN PASS: a program for graduates of foreign dental schools.
AB  - An increasing number of graduates of foreign dental schools who enroll in
      advanced standing programs to qualify for licensure calls for dental schools to
      be prepared to handle not only the curricular demands but also the growing
      cultural diversity among its student population. The "reeducation" of this
      student group not only meets the need of foreign dentists for an American degree
      but may also provide health professionals to service various ethnic populations
      whose language and culture they are able to understand and identify with. A
      survey of students and graduates of a two-year Program for Advanced Standing
      Students (PASS) for graduates of foreign dental schools representing 34 countries
      aimed to arrive at an understanding of this student group through
      characterization of the foreign dentists and identification of their attitudes
      and feelings toward various aspects of the program, the school and faculty and
      their experience of stress. This report includes description of the distinctive
      features of the program which cater to specific needs and concerns of this non
      traditional group of dental students. PASS students are accepted on the basis of
      their grades in dental school in home country, scores in the National Dental
      Board Examination Part I, Test of English as Foreign Language (TOEFL), and
      ratings in personal interviews. They complete an intensive summer program
      consisting of didactic and laboratory courses which prepares them for integration
      with four-year students for the last two years of didactic and clinical
      curriculum. Cultural diversity seminars, a special English class, PASS class
      meetings and seminars are unique additions to their program and aim to assist
      them adjust to the educational, social and cultural systems in an American
      school. Results of the survey show a majority of the PASS students feel that they
      are part of the school and that there is someone in the school whom they can
      approach for problems. An understanding of their ethnic and educational
      background is seen as a significant factor in their second basic dental
      education. Implications for education of foreign dental graduates amidst
      increasing diversification of the student body are discussed.

PMID- 7798407
TI  - Dermabrasion. Taking the frost off the fraise.

PMID- 7798408
TI  - Stump the experts. Eccrine acrospiroma.

PMID- 7798409
TI  - Elliptical donor stereoscopically assisted micrografting as an approach to
      further refinement in hair transplantation.
AB  - BACKGROUND: Multiple surgical methods are currently used for hair
      transplantation. Each method has a specific technique, morbidity, and relatively
      predictable cosmetic result. OBJECTIVE: To describe a methodology that combines
      elliptical excision of donor tissue and dissection under stereoscopic
      magnification into small grafts to obtain an improved final cosmetic result. For
      the purposes of this paper, any graft small enough to be easily inserted into a
      16-, 18-, or 20-gauge needle tunnel will be referred to as a micrograft. METHOD:
      Three hundred thirty patients underwent transplantation by this method over a 6
      year period. All patients were photographed before, during, and upon completion
      to monitor results. RESULTS: Cosmetic results as documented by examination and
      photography represent a further refinement due to the large number and small size
      of grafts placed. CONCLUSION: The author considers the method described as a
      viable alternative technique in hair transplantation for both limited and
      extensive androgenetic alopecia.

PMID- 7798410
TI  - The removal of cutaneous pigmented lesions with the Q-switched ruby laser and the
      Q-switched neodymium: yttrium-aluminum-garnet laser. A comparative study.
AB  - BACKGROUND: The Q-switched ruby laser (QSRL) (694 nm) has been used successfully
      in the removal of tattoos and a variety of cutaneous pigmented lesions. The
      frequency-doubled Q-switched neodymium:yttrium-aluminum-garnet laser (QSNd:YAG)
      (1064 and 532 nm) has also been shown to be effective in the treatment of
      tattoos, however, little has been published regarding the QSNd:YAG laser in the
      removal of cutaneous pigmented lesions. OBJECTIVE: The purpose of this study is
      to compare the efficacy and side effect profile of the QSRL and the frequency
      doubled QSNd:YAG lasers in the removal of cutaneous pigmented lesions, including
      lentigines, cafe-au-lait macules, nevus of Ota, nevus spilus, Becker's nevus,
      postinflammatory hyperpigmentation, and melasma. METHODS: Twenty patients with
      pigmented lesions were treated with the QSRL and the frequency-doubled QSNd:YAG
      lasers. Clinical lightening of the lesion was assessed 1 month after a single
      treatment. Side effects and patient satisfaction were also evaluated. RESULTS: A
      minimum of 30% lightening was achieved in all patients after only one treatment
      with either the QSRL or the frequency-doubled QSNd:YAG laser. The QSRL seems to
      provide a slightly better treatment response than the QSNd:YAG laser. Neither
      laser caused scarring or textural change of the skin. Most patients found the
      QSRL to be more painful during treatment, but the QSNd:YAG laser caused more
      postoperative discomfort. CONCLUSION: Both the QSRL and the frequency-doubled
      QSND:YAG laser are safe and effective methods of treatment of epidermal and
      dermal pigmented lesions.

PMID- 7798411
TI  - Dermabrasion using tumescent anesthesia.
AB  - BACKGROUND: Dermabrasion is a very useful and versatile technique. However, it
      suffers from side effects and difficulties that limit its popularity among
      operating dermatologic surgeons and the public. OBJECTIVE: To show that it is
      possible to eliminate the need for chlorofluorocarbons, improve the standard
      dermabrasion technique, decrease the healing time, improve its side effect
      profile, and reduce risks to the operating surgeon. METHODS: Tumescent fluid
      containing dilute Xylocaine, bicarbonate, and epinephrine in saline was
      infiltrated before coarse wire brush dermabrasion. Eutectic mixture of local
      anesthetic (EMLA) was also used topically. The first 14 patients dermabraded by
      this method are reported on here. Their healing, progress, side effects, and
      results are described. A patient questionnaire was completed by 12 of the
      patients who describe the procedure and results from the patient's viewpoint.
      RESULTS: The procedure was found to be effective in producing anesthesia,
      eliminating the use of freezing the skin, and limiting the necessity for
      sedatives, narcotics, and other anesthesia. It gives a firm surface to dermabrade
      against, makes the procedure more rapid and technically easier, and produces less
      splatter and therefore less risk for the surgeon. The results subjectively and
      objectively would appear to be at least as good as standard techniques. The
      healing in this small sample would appear to be faster both to
      reepithelialization and to reestablishment of normal color. There was only one
      case of transient hyperpigmentation lasting less than 1 week. Otherwise there
      were no cases of pigmentary or scarring side effects. CONCLUSION: Tumescent
      dermabrasion is safe, effective, and has many benefits over traditional methods.

PMID- 7798412
TI  - CO2, argon, and pulsed dye laser treatment of angiofibromas.
AB  - BACKGROUND: Tuberous sclerosis is a complex disorder of hamartoma formation in
      many organs, particularly the skin, brain, eye, kidney, and heart. The
      characteristic skin lesions are angiofibromas (AF), the shagreen patch,
      periungual fibromas, and "ash-leaf" white macules. Treatment for AF has
      previously included electrocoagulation, electrodesiccation and curettage,
      dermabrasion, excision, cryosurgery, and oral 13-cis retinoic acid. Both argon
      and CO2 lasers have been used in isolated cases to treat AF. OBJECTIVE: The
      purpose of this work is the study of the application of three different lasers in
      the treatment of facial AF. METHODS: Ten patients with facial AF were treated
      with CO2, argon, and pulsed dye lasers. Patients' AF were graded with regard to
      the size and color of the lesions. A 2-3-cm2 test was assayed on the face of all
      patients with each laser before performing a complete treatment and in order to
      choose the best laser. RESULTS: Results were considered excellent in seven
      patients and good in three patients, with decrease of erythema and flattening of
      the AF. Minimal scarring was noted in two patients. Transient erythema was
      observed in patients treated with the CO2 laser. All patients or their parents
      considered the treatment cosmetically satisfactory. CONCLUSION: We found the CO2
      laser to be a better therapeutic tool than the argon laser to treat AF,
      especially in those patients with multiple and protuberant AF. The argon laser
      would be more useful in those patients with very red AF and light complexion, and
      the pulsed dye laser in those with very red and flat AF.

PMID- 7798413
TI  - Standardizing chemical peel solution formulations to avoid mishaps. Great
      fluctuations in actual concentrations of trichloroacetic acid.
AB  - BACKGROUND: Chemical peeling using trichloroacetic acid (TCA) is a popular and
      long utilized procedure in dermatology and cosmetic surgery. OBJECTIVE: To
      determine the actual concentration of TCA in four disparate methods of
      preparation of solutions, expressed in the standard pharmaceutical method of
      weight to volume (wt/vol). METHODS: Method I was wt/vol, method II was weight to
      weight (wt/wt), method III was grams of TCA added to 100 cc water, and method IV
      was the usage of saturated TCA, and calling it 100%, then making appropriate
      dilutions. The amounts of TCA in each solution for methods II, III, and IV were
      converted, by calculation, to the wt/vol method. RESULTS: The relative
      concentrations of TCA, ranked by the wt/vol pharmaceutical standard, showed that
      from strongest to weakest: method IV > method II > method I > method III.
      CONCLUSIONS: Tremendous variations were found in the relative concentrations of
      TCA in these solutions. To avoid mishaps and complications, the wt/vol method
      should be used.

PMID- 7798414
TI  - Acral lentiginous melanoma. A histological type without prognostic significance.
AB  - BACKGROUND: Acral lentiginous melanoma (ALM) is reported to have a poorer
      prognosis than melanomas of other histotypes. OBJECTIVE: The purpose of this
      paper is to verify if ALMs, per se, have a more aggressive behavior or if the
      poorer prognosis of these patients is due to a later diagnosis. METHODS: Clinical
      charts of 165 patients with acrally located melanoma were reviewed as well as all
      histological slides. In all patients, histotype, Clark's level, Breslow
      thickness, pigmentation, presence of ulceration, and regression were reported.
      Mitotic index, vascular invasion, and microscopic satellitosis were also
      determined. Survival of the 64 patients with ALM was compared with survival
      observed in the remaining 101 acral (nonlentiginous) melanomas. RESULTS: Melanoma
      localized at acral sites constitute 8.9% of the 1845 patients with melanoma
      treated at our Institute from 1975 to 1990. All were Caucasian, 57 were males,
      and 108 females. Out of the 165 patients with this localization, 64 (38.8%) were
      classified as ALM. Disease-free and overall survival of the 64 ALM patients were
      not different at a statistically significant level compared with the areas
      observed in the other acral nonlentiginous melanoma. CONCLUSION: The survival
      difference between ALM and other histological types is due to a later diagnosis
      and not to a more aggressive behavior of ALM.

PMID- 7798415
TI  - Oral transmucosal fentanyl citrate premedication in patients undergoing
      outpatient dermatologic procedures.
AB  - BACKGROUND: Oral transmucosal fentanyl citrate (OTFC) is a novel lozenge dosage
      form of fentanyl used for premedication. Many dermatology patients undergoing
      surgical procedures could benefit from such a medication. OBJECTIVE: The study
      compared the safety and efficacy of 400-vs 800-micrograms dosage forms for their
      sedative and anxiolytic effects in adults undergoing a variety of dermatologic
      outpatient surgical procedures. METHODS: Patients received OTFC 30 minutes before
      the procedure. Vital signs, oxygen saturation, sedation, and anxiety scores were
      measured before OTFC administration and every 15 minutes thereafter. RESULTS:
      Significant sedation and anxiolysis developed in both dosage groups. No
      clinically significant changes in respiratory rate, heart rate, or blood pressure
      occurred during the study period. Common drug-induced side effects included
      dizziness, nausea, pruritus, and vomiting. CONCLUSION: OTFC is safe and effective
      for outpatient dermatologic procedures; however, the risk of opioid-related side
      effects must be carefully weighed against the benefits when deciding to use OTFC
      in an outpatient setting.

PMID- 7798416
TI  - Split skin grafting on severely damaged skin. A technique using absorbable tissue
      adhesive.
AB  - BACKGROUND: Patients with severely damaged skin are more likely to develop skin
      malignancies. However, suturing following excision of tumors is difficult due to
      their fragile skin. OBJECTIVE: To evaluate the effectiveness of a technique using
      butyl-2-cyanoacrylate tissue adhesive in split skin grafts in patients with
      severely damaged skin. METHOD: The technique was used in 19 patients with 24 skin
      tumors. Two patients also had multiple skin biopsies to assess the
      biodegradability of the adhesive. RESULTS: Split skin grafts were applied
      successfully in all patients. The adhesive was completely absorbed without a
      foreign body reaction within 6 months. CONCLUSION: We recommend the use of butyl
      2-cyanoacrylate in split skin grafting patients with severely damaged skin.

PMID- 7798417
TI  - Q-switched ruby laser treatment of labial lentigines in Peutz-Jeghers syndrome.
AB  - BACKGROUND. The Q-switched ruby laser emits energy with a 694-nm wavelength and
      has a pulse duration in the nanosecond range, which allows selective treatment of
      benign pigmented lesions. Labial and perioral pigmented macules associated with
      Peutz-Jeghers syndrome are often numerous and cosmetically disfiguring.
      RESULTS/CONCLUSION. We report successful treatment of these lentigines with the Q
      switched ruby laser and consider it the treatment of choice for these lesions.

PMID- 7798418
TI  - Treatment of pyoderma gangrenosum with cultured keratinocyte autografts.
AB  - BACKGROUND: Pyoderma gangrenosum is an uncommon chronic skin disease
      characterized by rapidly enlarging cutaneous ulcers. Immunosuppressive agents,
      such as corticosteroids, are the mainstay of therapy. OBJECTIVE: We describe a
      patient with pyoderma gangrenosum treated with cultured keratinocyte autografts
      for a full-thickness ulcer located on the dorsal and lateral aspects of the foot.
      METHODS: After stabilizing the ulcer with intralesional and systemic
      corticosteroids, the ulcer was debrided and cultured keratinocyte autografts were
      secured with nylon mesh. An outer dressing of gauze and elastic bandage was used.
      RESULTS: The patient had > 95% "take" of the grafts and the ulcer was fully
      healed in less than 1 month. The grafted area preserved the clinical phenotype of
      the palmar skin from which the original biopsy was taken. CONCLUSION: Cultured
      keratinocyte autografts can provide permanent wound coverage for patients on high
      doses of immunosuppressive medications.

PMID- 7798419
TI  - Eccrine angiomatous hamartoma.
AB  - BACKGROUND: Eccrine angiomatous hamartoma (EAH) is a rare benign lesion that
      mimics a capillary ("strawberry") hemangioma (CH) in appearance. EAH slowly grows
      and becomes symptomatic whereas CH typically regresses over time. OBJECTIVE: To
      increase awareness of this rare hamartoma and emphasize the need for
      histopathologic evaluation of similar appearing lesions and thus prompt excision
      versus observation. METHODS: Literature review and report of an illustrative
      case. RESULTS: Histopathologic confirmation of EAH in a lesion clinically
      indistinguishable from CH and successful surgical extirpation. CONCLUSION: EAH is
      a rare hamartomatous neoplasma clinically similar to CH in appearance.
      Histopathologic examination of suspected lesions is recommended for delineation
      as CH generally involutes spontaneously whereas EAH may require surgical excision
      due to pain and hyperhidrosis.

PMID- 7798420
TI  - Repair of the soft triangle of the nose.
AB  - BACKGROUND: Notching of the soft triangle is a complication of excisional and
      some reconstructive surgery that is difficult to repair. OBJECTIVE: This article
      provides a simple single-stage procedure to correct the complication of notching
      of the soft triangle. METHODS: A detailed description of a turnover flap from the
      inferior tip covered with a full-thickness skin graft is provided. RESULTS: The
      method described has provided uniformly satisfactorily results based on the
      author's experience. CONCLUSION: This simple method is the treatment of choice
      for a one-stage repair of a soft triangle notch.

PMID- 7798421
TI  - The use of hyaluronidase as an adjunct to surgical procedures.
AB  - BACKGROUND: Although the use of hyaluronidase as an adjunct to anesthesia is
      frequently described for plastic surgery and ophthalmologic procedures, its use
      in dermatologic surgery has not been well investigated. OBJECTIVE: In this report
      we review the advantages and disadvantages of using hyaluronidase in dermatologic
      procedures. METHODS: The effect of adding hyaluronidase to local anesthesia was
      evaluated in 72 operations performed over a 1-year period. RESULTS: Although the
      duration of anesthesia is slightly decreased, the addition of hyaluronidase to
      local anesthesia offers the benefits of minimizing loss of surface contour and
      enhanced ease in undermining and dissection through subcutaneous tissue planes.
      The onset of anesthesia using hyaluronidase is immediate and the area of
      anesthesia appears increased over anesthesia without hyaluronidase. CONCLUSION:
      We therefore recommend the adjunct of hyaluronidase to local anesthesia as a
      useful advancement in surgical technique.

PMID- 7798422
TI  - Basal cell carcinoma arising in a surgical scar: reconstructive surgical
      treatment.

PMID- 7798423
TI  - Malignant fibrous histiocytoma at the site of total knee replacement.

PMID- 7798424
TI  - Dohi Memorial Lecture. New therapeutic rewards from clinical research in atopic
      dermatitis.

PMID- 7798425
TI  - Detection of human papillomavirus type 60 in plantar cysts and verruca plantaris
      by the in situ hybridization method using digoxigenin labeled probes.
AB  - BACKGROUND: Since 1987, many cases have been reported in which human
      papillomavirus (HPV) could be associated with epidermoid cysts of the palms and
      soles. In 1989, the HPV found in an induced epidermoid cyst was cloned and named
      HPV 60. OBJECTIVE: Our purpose was to examine the relationship of HPV 60 to
      plantar cysts. METHODS: Ten cases of plantar cysts and two cases of verruca
      plantaris containing single inclusion bodies were obtained by biopsy and examined
      by the in situ hybridization (ISH) method with a digoxigenin labeled HPV 60 DNA
      probe. RESULTS: Six of ten cases were found to have cytopathic effect (CPE) in
      the cyst wall and inner contents of the cyst. HPV 60 was detected in these cases
      by ISH. Two cases of verruca plantaris showing CPE also demonstrated the presence
      of HPV 60. Of the six HPV type 60 positive cases, four cases also showed CPE in
      the overlying epidermis. CONCLUSION: At first, punctate keratotic lesions are
      induced by HPV 60. HPV 60 induces irregular elongation of the rete ridges into
      the dermis. Plantar cysts probably form as a result of the traumatic implantation
      of HPV 60 infected epidermis with irregularly long and narrow rete ridges into
      the dermis.

PMID- 7798426
TI  - Interferon-gamma-induced HLA-DR, but not ICAM-1, expression of human
      keratinocytes is down-regulated by calmodulin antagonist.
AB  - Interferon-gamma (IFN-gamma) has been shown to induce or enhance the expression
      of MHC class II and intercellular adhesion molecule-1 (ICAM-1) in a variety of
      human and murine cell types, including epidermal keratinocytes (KC). However, the
      expression of MHC class II and ICAM-1 molecules induced by IFN-gamma is not
      necessarily coordinated. We investigated the inhibitory effects of the calmodulin
      antagonist, W-7, and its chlorine deficient inactive analogue, W-5, on the
      expression of MHC class II (HLA-DR) and ICAM-1 by human KC incubated with IFN
      gamma. We found that the IFN-gamma-induced expression of HLA-DR was reproducibly
      and dose-dependently inhibited by W-7. However, the expression of ICAM-1 was
      highly resistant to the inhibitory effects of W-7. Neither HLA-DR nor ICAM-1
      expression was affected by W-5. These data suggest that the IFN-gamma-induced HLA
      DR, but not ICAM-1, expression is mediated, if not exclusively, by calmodulin in
      human KC.

PMID- 7798427
TI  - Immunopathologic demonstration of MAC387+ UCHL1+ cells in bullous skin diseases.
AB  - Immunopathologic aspects of bullous skin diseases were studied in paraffin
      sections of thirty-three skin biopsy specimens utilizing monoclonal antibodies
      directed against histiocytes, helper/inducer T lymphocytes, and Langerhans cells
      in skin lesions. Laboratory examinations revealed that either more or fewer of
      the standard number of helper/inducer T lymphocytes (UCHL1+) were observed in the
      upper dermis in 84.8% of the cases examined, particularly in the various forms of
      pemphigus; histiocytes (MAC387+) were also found to occur in the upper dermis in
      45.5% of the cases and blisters in 27.3% of the cases, particularly in pemphigus
      erythematosus and dermatitis herpetifomis. In 54.5% of all the cases, both UCHL1+
      and MAC387+ cell infiltrates predominated in the upper dermis. These findings
      suggest that a cell-mediated immune response may also be important in the
      pathogenesis of bullous skin diseases. It may be possible that antigen from
      keratinocytes can produce ETAF, and that IL1 activating T lymphocytes and
      histiocytes also produce IL1 activating T cells, particularly helper/inducer T
      cells. Such activities would further promote the increase of B cell function and
      immunoglobulin synthesis.

PMID- 7798428
TI  - Probable mechanisms of loss of Merkel cells in completely depigmented skin of
      stable vitiligo.
AB  - Vitiligo is frequently associated with segmental involvement. It spares paralyzed
      limbs in transverse myelitis. There is spontaneous repigmentation of vitiligo
      lesional skin (VL) in diabetic neuropathy. Increased neuropeptide in VL and
      adjacent normal skin of vitiligo (ANS) along with thickened nerve fibers showing
      ultrastructural abnormalities all indicate a neural pathogenesis (1). Loss of
      Merkel cells has been observed in early vitiligo lesional skin (2). Recently,
      catecholamines have been found to play a major role in initiating the cascade of
      events leading to loss of melanocytes (1, 3, 4). To investigate the presence of
      Merkel cells in the completely depigmented skin of stable vitiligo (SV), a study
      was undertaken using TROMA 1, a monoclonal antibody specific for adult Merkel
      cells. No TROMA 1-positive cells were observed in SV, whereas normal numbers of
      these cells were seen in ANS. This new finding further supports the hypothesis of
      neural involvement in vitiligo.

PMID- 7798429
TI  - Nodulocystic acne: oral gugulipid versus tetracycline.
AB  - Twenty patients with nodulocystic acne were randomly allocated to one of two
      treatment schedules: 1) Tetracycline 500 mg or 2) Tab. Gugulipid (equivalent to
      25 mg guggulsterone). Both were taken twice daily for 3 months, and both produced
      a progressive reduction in the lesions in the majority of patients. With
      tetracycline, the percentage reduction in the inflammatory lesions was 65.2% as
      compared to 68% with gugulipid; on comparison, this difference was statistically
      insignificant (P > 0.05). Follow-up at 3 months showed a relapse in 4 cases on
      tetracyline and 2 cases on gugulipid. An interesting observation was that the
      patients with oily faces responded remarkably better to gugulipid.

PMID- 7798430
TI  - Pre-existing cutaneous changes in basal cell carcinomas of the lower extremities.
AB  - Basal cell carcinomas (BCCs) of the lower extremities are not frequently
      reported. Some pre-existing or predisposing conditions are thought to be
      implicated in their development. In this study, we investigated the possible
      relationships between pre-existing cutaneous changes and the development of BCCs
      of the lower extremities, possible sex and age differences, and the histologic
      patterns involved. Among 1053 patients with BSSc, BCCs of the lower extremities
      were observed in 48 (4.5%): 25 men and 23 women. Lesions appeared on the thighs
      (16 cases), the lower legs (27 cases), or the feet (5 cases). Histologic patterns
      were nodular and micronodular (18 cases), superficial (27 cases), or infiltrative
      (3 cases). No differences were observed between sexes. The relative degree of
      elastosis was higher in the lower limbs of women than of men (2.25 vs 1.53). Pre
      existing cutaneous changes were observed in 7 cases. The frequency of these BCCs
      of the lower limbs and the higher degree of elastosis observed in the women seem
      to be related to sun exposure. The histologic pattern seems not to be affected by
      environmental factors but rather characteristic of body site. Pre-existent
      cutaneous changes are not thought to be possible etiologic factors.

PMID- 7798431
TI  - The rash of measles is caused by a viral infection in the cells of the skin: a
      case report.
AB  - Measles skin rash was immunohistochemically examined in an effort to detect virus
      antigen in skin samples taken from a 15-year-old girl with measles. A sectioned
      specimen obtained by punch biopsy from a 2nd-day skin lesion showed localized
      parakeratosis and acanthosis with multinucleated giant cells in the epidermis,
      thickening and cellular edema of epithelia in the hair follicles, and vascular
      dilation in the papillary plexus. Measles virus antigen was detected by ABC
      immunoperoxidase in the epidermis, follicular epithelia, and lympho-histiocytic
      cell infiltrates in the upper of the dermis. This rash deemed to be caused in
      part by direct viral infection of the epidermal cells.

PMID- 7798432
TI  - An aggressive spindle cell squamous carcinoma arising in a patient with long
      standing erythroderma.
AB  - Spindle cell squamous carcinoma (SCSC) of the left hand arising in a patient with
      long-standing erythroderma is reported. Histopathologically, spindle shaped
      atypical cells were observed neighboring the cells of well differentiated
      squamous cell carcinoma. These two types of tumor cells, spindle cells and well
      differentiated cells, were present side by side and merged into each other. The
      erythroderma had been present for over 20 years, and both clinical and
      histopathological findings suggested cutaneous T cell lymphoma, but were not
      diagnostic for mycosis fungoides, Sezary syndrome, or adult T cell lymphoma. Flow
      cytometry of peripheral blood cells showed a low CD4/CD8 ratio which suggested
      impaired T cell function. Multiple metastases of SCSC occurred in a short period
      and the patient died ten months after his first visit to us. The aggressive
      course of this case was unusual, and may be due to immunological abnormalities
      associated with the long standing erythroderma with impaired T cell function.

PMID- 7798433
TI  - Nodular scleroderma in a worker using a silica-containing abrasive.
AB  - A patient with progressive systemic sclerosis and high levels of serum IgE
      developed multiple papules at/on an area of non-sclerotic skin. Histologic
      examination of the papule revealed the typical features of scleroderma. For
      several years, the patient had been working on polishing watches with an abrasive
      agent composed mainly of aluminum, chromium dioxide, and silica. An association
      of the abrasive agent, especially of the silica component, with the scleroderma
      was circumstantially suspected. To the best of our knowledge, this is the first
      report of nodular scleroderma which occurred in the course of PSS being
      associated with chemical agents.

PMID- 7798434
TI  - Neural blockade, urokinase and prostaglandin E1 combination therapy for acute
      digital ischemia of progressive systemic sclerosis.
AB  - To treat severe painful digital ulcers on progressive systemic sclerosis (PSS)
      patients, we developed a new combination therapy which included neural blockade,
      intravenous urokinase, and prostaglandin E1 infusion. All of these are already
      recognized treatments for circulatory disturbances in PSS. Although each of them
      alone has a limited effect on the painful ischemic attack in PSS; in stepwise
      combination, neural blockade for release of vascular spasm and pain,
      prostaglandin E1 for further vasodilatation, and urokinase for thrombolysis were
      effective in the treatment of digital ischemia in two PSS patients. This therapy
      reduced the necrotic areas predicted before therapy and saved fingers from
      amputation. It also relieved the intolerable digital pain and effected the
      recovery of digital function.

PMID- 7798435
TI  - Mid dermal elastolysis: case report and review of the literature.
AB  - A new case of typical mid dermal elastolysis was studied with electron
      microscopy. Elastic fibers were irregularly branched or lumpy, but subcomponents
      of these fibers were often normal. In some fibers, loose assembly of skeleton
      fibrils and aggregation of dense substances were observed. Phagocytosis of normal
      and abnormal elastic fibers by dermal macrophages was observed.

PMID- 7798436
TI  - Interferon-alpha (INF-alpha) and etretinate in the treatment of mycosis
      fungoides.
AB  - A combination therapy of mycosis fungoides (MF) with interferon-alpha (INF-alpha)
      and etretinate was reported. A 53-year-old patient suffering from MF was treated
      with intramuscular administration of INF-alpha at a dosage of 9 x 10(6) IU daily;
      skin lesions poorly responded to the treatment. After oral etretinate with a
      dosage of 50 mg daily was combined with INF-alpha, marked clinical improvement
      was seen in skin lesions with minor side effects. INF-alpha in combination with
      etretinate can have beneficial effects in the treatment of MF.

PMID- 7798437
TI  - Three cases of organoid nevus on the trunk and extremity.
AB  - Organoid nevi are most commonly observed on the scalp. Although they are rarely
      found on the trunk and extremities, we were able to study 3 cases of organoid
      nevi involving distributions of this sort. These included a 39-year-old male with
      a 2 x 6 cm brown area on the left flank (case 1), an 8-year-old female with a 5 x
      6 cm hypopigmented macule on the lower left leg (case 2), and a 45-year-old male
      with a 1.5 x 3 cm brown spot on the back (case 3). All these were
      histopathologically confirmed to be organoid nevi. The lesion in case 1 revealed
      basal cell epithelioma, that in case 2 exhibited hypohidrosis caused by poorly
      developed sweat glands, and the lesion in case 3 was typical, as was an
      additional one on the same patient's scalp.

PMID- 7798438
TI  - A case of giant cell tumor of the tendon sheath developing on the palm.
AB  - A 22-year-old Japanese woman with a giant cell tumor of the tendon sheath on the
      palm is described. The location of the tumor is rare. Light microscopically, the
      tumor consisted of round or polygonal cells, giant cells, and foam cells.
      Electron microscopically, histiocyte-like cells and fibroblast-like cells were
      mainly observed, suggesting that the tumor may have originated from the synovial
      membrane.

PMID- 7798439
TI  - Two cases of eosinophilic pustular folliculitis treated by acemetacin.
AB  - The report deals with two cases of eosinophilic pustular folliculitis in a 45
      year-old man and a 25-year-old woman. After their conditions failed to respond to
      oral and topical corticosteroids, minocycline, anti-allergic drugs, aspirin and
      several types of nonsteroidal anti-inflammatory drugs, good results were obtained
      with acemetacin.

PMID- 7798440
TI  - Hepatitis C virus infection and oral erosive lichen planus.

PMID- 7798441
TI  - Airway resistance--an old friend re-visited.

PMID- 7798442
TI  - Splanchnic perfusion in shock.

PMID- 7798443
TI  - Predicting bacteremia in critically ill patients: a clinically relevant effort?

PMID- 7798444
TI  - Tracheal gas insufflation reduces the tidal volume while PaCO2 is maintained
      constant.
AB  - OBJECTIVE: The aims of the present study were two-fold: first, to confirm the
      effect of tracheal gas insufflation (TGI) throughout the respiratory cycle on
      alveolar ventilation at various catheter flows and constant total inspired VT as
      an adjunct to conventional volume cycled mechanical ventilation in patients with
      acute lung injury; second, to test the efficacy of TGI in the reduction of toal
      VT, peak and mean airway pressure while maintaining PaCO2 in its baseline value.
      The hemodynamic effect and the consequences on oxygenation as result of the
      reduction of VT, were also estimated. DESIGN: Prospective study of patients with
      acute lung injury requiring mechanical ventilation. SETTING: 12 bedded, adult
      polyvalent intensive care unit in a teaching hospital. PATIENTS: 7 paralyzed and
      sedated patients with acute respiratory failure were studied. All patients were
      clinically and hemodynamically stable without fluctuation of the body
      temperature. All patients were orally intubated with cuffed endotracheal tubes,
      and mechanically ventilated with a standard circuit of known compliance.
      INTERVENTIONS: Continuous flows (4 and 6 l/min) were delivered through a catheter
      positioned 1 cm above carina while tidal volume or PaCO2 were maintained constant
      at their baseline value. RESULTS: In this study a modest level of TGI
      significantly enhanced CO2 elimination in patients with acute respiratory
      failure. Improved ventilatory efficiency resulted from the functional reduction
      of dead space during TGI allowing the same PaCO2 to be maintained at the same
      frequency with lower tidal volume and lower airway pressure requirement. Tidal
      volume, peak and mean airway pressure decreased linearly with catheter flow,
      without significant changes in oxygenation, while PaCO2 remained stable.
      CONCLUSION: The results of this study suggest that TGI may be an useful adjunct
      mode of mechanical ventilation that limits alveolar pressure and minute
      ventilation requirements.

PMID- 7798445
TI  - Heterogeneous regional vascular responses to simulated transient hypovolemia in
      man.
AB  - OBJECTIVE: To describe the evolution of systemic and regional blood flows during
      and after hypovolemia in humans. DESIGN: Simulation of hypovolemia by a prolonged
      application of lower body negative pressure (LBNP). SETTING: Laboratory of
      Clinical Research, Surgical Intensive Care Unit of an University Hospital.
      PARTICIPANTS: 8 healthy male volunteers. INTERVENTIONS: 3 successive and
      increasing 15 min-levels of LBNP were followed by a progressive return (10 min)
      to atmospheric pressure, then a 60 min-recovery period. MEASUREMENTS AND MAIN
      RESULTS: Simulated hypovolemia induced a parallel one-third decrease in cardiac
      output (bioimpedance), musculocutaneous (venous plethysmography) and splanchnic
      (ICG clearance) blood flows. Adrenergic-mediated peripheral vasoconstriction
      prevented any change in mean arterial pressure. The decrease in renal blood flow
      (PAH clearance) was limited, glomerular filtration rate (inulin clearance)
      unchanged and thus filtration fraction increased. All the cardiovascular and
      biological variables returned to pre-LBNP values during the recovery period
      except for splanchnic blood flow which remained below control values 60 min after
      the return to atmospheric pressure. CONCLUSIONS: Since a sustained splanchnic
      vasoconstriction follows a transient normotensive hypovolemia in healthy men
      despite adequate treatment considering arterial pressure and cardiac output, the
      therapeutic goals of fluid resuscitation after hypovolemic shock might be
      revisited and a supranormal value of cardiac output proposed.

PMID- 7798446
TI  - Evaluation of respiratory system resistance in mechanically ventilated patients:
      the role of the endotracheal tube.
AB  - OBJECTIVE: To investigate the role played by the endotracheal tube (ETT) in the
      correct evaluation of respiratory system mechanics with the end inflation
      occlusion method during constant flow controlled mechanical ventilation. SETTING:
      General ICU, university of Rome "La Sapienza". PATIENTS: 12 consecutive patients
      undergoing controlled mechanical ventilation. METHODS: We compared the values of
      minimal resistance of the respiratory system (i.e. airway resistance) (RRS min)
      obtained: i) subtracting the theoretical value of ETT resistance from the
      difference between P max and P1, measured on airway pressure tracings obtained
      from the distal end of the ETT; ii) directly measuring airway pressure 2 cm below
      the ETT, thus automatically excluding ETT resistance from the data. RESULTS. The
      values of RRS min obtained by measuring airway pressure below the ETT were
      significantly lower than those obtained by measuring airway pressure at the
      distal end of the ETT and subtracting the theoretical ETT resistance (4.5 +/- 2.8
      versus 2.5 +/- 1.6 cm H2O/l/s, p < 0.01). CONCLUSION: When precise measurements
      of ohmic resistances are required in mechanically ventilated patients, the
      measurements must be obtained from airways pressure data obtained at tracheal
      level. The "in vivo" positioning of ETT significantly increases the airflow
      resistance of the ETT.

PMID- 7798447
TI  - Can bacteremia be predicted in surgical intensive care unit patients?
AB  - OBJECTIVES: To determine which clinical features are associated with bacteremia
      in a SICU. To determine if infections are identified prior to bacteremia via
      culturing of other body fluids. To determine if antibiotic regimens are changed
      after the results of the blood culture were obtained. DESIGN: A retrospective,
      unit-based, case control study. SETTING: A 10 bed SICU in a 552-bed, tertiary
      care and Level I Trauma center. PATIENTS: All SICU patients with one or more
      positive blood cultures over a 2 year period (n = 24) were matched by diagnosis,
      procedure, and age to SICU patients with negative blood cultures (n = 48).
      MEASUREMENTS AND RESULTS: Bacteremic and control patients had similar APACHE II
      scores though death was more likely in bacteremic patients (p < 0.05) and they
      had higher hospital charges (p < 0.02). There was no difference in any of the
      clinical variables studied (minimum and maximum temperature, maximum white blood
      cell count, minimum mean arterial blood pressure) between the bacteremic and
      control groups on the days leading up to and the day of the positive blood
      culture. Coincident infections of lung, bladder, wound, and central venous
      catheters were identified in 42% of bacteremic patients. The identification of
      organisms found in the blood had a direct impact on the antibiotic regimen of 54%
      of the bacteremic patients. CONCLUSIONS: A better screen for obtaining blood
      cultures in this SICU was not identified. If antibiotics are begun empirically
      before the results of blood cultures are known, the results of other body fluid
      cultures can be used to guide therapy initially. However, the data obtained from
      positive blood cultures was often helpful in changing empirical therapy.
      Therefore, blood cultures remain important diagnostic tools.

PMID- 7798448
TI  - Influence of continuous haemofiltration-related hypothermia on haemodynamic
      variables and gas exchange in septic patients.
AB  - OBJECTIVE: To investigate the influence of continuous haemofiltration (CHF) on
      haemodynamics, gas exchange and core temperature in critically ill septic
      patients with acute renal failure. PATIENTS AND METHODS: In 20 patients (17 male,
      3 female) ultrafiltration rate, core temperature, gas exchange and haemodynamic
      variables were measured at regular intervals during the first 48 h of
      haemofiltration. Baseline data were compared to those obtained 30 min after
      initiating CHF and also to those during hypothermia (if observed). MAIN RESULTS:
      Haemodynamic variables remained remarkably constant throughout the study period.
      In patients with a relatively low ultrafiltration rate (855 +/- 278 ml/h)
      temperature did not change, while in patients with a high ultrafiltration rate
      (1468 +/- 293 ml/h) core temperature significantly decreased from 37.6 +/- 0.9
      degrees C to 34.8 +/- 0.8 degrees C (p < 0.001). There was a statistically
      significant correlation between temperature decrease and ultrafiltration rate (r
      = -0.68, Y = 1.8-0.003 X, p < 0.01). Hypothermic patients also showed a mean
      decrease in VO2 from 141 +/- 22 ml/min/m2 to 112 +/- 22 ml/min/m2 (p < 0.01) with
      a concomitant increase in PaO2 from 103 +/- 37 mmHg to 140 +/- 42 mmHg (p <
      0.001) and in PvO2 from 35 +/- 4 mmHg to 41 +/- 5 mmHg (p < 0.001). CONCLUSIONS:
      1) Continuous haemofiltration does not cause significant alternations in
      haemodynamic variables. 2) Hypothermia frequently occurs in patients undergoing
      continuous haemofiltration with high ultrafiltration rates. These hypothermic
      patients show a reduction in VO2 leading to an increase in PvO2 and PaO2. This
      mild hypothermia in these circumstances has no evident deleterious effects.

PMID- 7798450
TI  - Non-operative management of gastric perforation secondary to cardiopulmonary
      resuscitation.
AB  - We report the case of a 72-year-old male who suffered a cardiac arrest during an
      early positive treadmill stress test. After successful resuscitation the patient
      had evidence of a gastric perforation. Because of his hemodynamic stability, lack
      of peritoneal signs, and prohibitively high surgical risk, a non-operative
      management approach was successfully administered. Although not the standard
      approach to traumatic gastric perforation, this case is not unlike the management
      of peptic ulcer perforations. A non-operative approach should be considered as an
      option in selected patients.

PMID- 7798449
TI  - Severe malaria in African adults living in a seasonal endemic area.
AB  - OBJECTIVE: This study investigates severe malaria in African adults living in a
      seasonal endemic area. DESIGN: A prospective study of all adults admitted with
      severe malaria over 2 consecutive seasons: October 1990 till January 1991 and
      October 1991 till January 1992. SETTING: ICU (15 beds) of Hopital Principal,
      Dakar, Senegal. PATIENTS: 23 patients: 14 men and 9 women with a mean age of 30
      +/- 3 years were included in the study; all fulfilled the 1990 WHO criteria for
      severe malaria. RESULTS: At admission, 12 patients were comatose (Glasgow Coma
      Scale < 10), 7 had generalized convulsions. Parasitaemia was 135 +/- 52 x
      10(9)/l. Biological indications of severity were as follows: hypophosphataemia <
      0.8 mmol/l in 14 cases, serum creatine phosphokinase > 500 IU/l in 15 cases; and
      PaO2 < 70 mmHg in 5 cases. Serum TNF alpha levels, measured in 16 cases, were
      increased at 298.4 +/- 63.5 pg/ml, serum levels of IL-6 and IL-2SR were also
      elevated: 609.5 +/- 304.2 pg/ml and 297.6 +/- 35.6 pg/ml respectively.
      Circulating IgM and IgG antibodies were found in 14 out of 16 patients. Serum
      levels of TNF alpha, IL-6 and IL-2SR correlated positively with each other. TNF
      alpha and IL-2SR were also positively correlated to parasitaemia. Intravenous
      therapy with quinine at loading dose was favorable in 19 patients. Four patients
      died during the study, 3 from multiple organ failure. CONCLUSIONS: This work
      demonstrated that severe malaria in a seasonal endemic area displays original
      clinical features with a high rate of either cerebral malaria or multiple organ
      failure.

PMID- 7798452
TI  - The use of the laryngeal mask airway to facilitate the insertion of a
      percutaneous tracheostomy.
AB  - We report the use of the laryngeal mask airway to facilitate the insertion of a
      percutaneous tracheostomy (Ciaglia kit) in two patients. This method has not been
      reported previously. We believe that in selected patients the technique described
      increases the ease of placement of a percutaneous tracheostomy.

PMID- 7798451
TI  - Effects of norepinephrine on right ventricular function in septic shock patients.
AB  - OBJECTIVE: To study the effects of norepinephrine on right ventricular function
      in patients with hyperdynamic septic shock. DESIGN: Prospective, open study.
      SETTING: A 15 bed ICU in a university hospital. PATIENTS: 9 patients with
      hyperdynamic septic shock (SBP < 90 mmHg, Cl > or = 4 l.min-1.m-2, SVRI < or =
      850 dynes.s.cm-5m-2 and oliguria). INTERVENTIONS: Plasma volume expansion was
      used to correct a suspected volume deficit and then, norepinephrine infusion was
      started and titrated to restore systemic blood pressure to the normal range (mean
      infusion rate: 1.1 +/- 0.2 mcg.kg-1.min-1). Norepinephrine was the only
      vasoactive agent used in these patients. MEASUREMENTS AND RESULTS: A modified
      Swan-Ganz catheter mounted with a fast response thermistor was inserted in each
      patient, allowing repeated measurements of RVEDVI and RVEF. At time of inclusion
      to the study, all but one patient had elevated MPAP (23 +/- 4 mmHg) and RVEF < or
      = 50%, and all patients had RVEDVI > or = 90 ml.m-2. During norepinephrine
      infusion, MAP increased from 51 +/- 9 to 89 +/- 10 mmHg (p < 0.0001), PVRI
      increased from 204 +/- 35 to 286 +/- 63 dynes.s.cm-5.m-2 (p < 0.05), and despite
      this increase in right ventricular afterload, no detrimental effect in RVEF (36
      +/- 11 to 36 +/- 10%) or in RVEDVI (116 +/- 30 to 127 +/- 40 ml.m-2) was
      observed. A Frank-Starling relationship for the right ventricle was constructed
      by plotting an index of ventricular performance (RVSWI) against an index of
      ventricular preload (RVEDVI). A significant upward shift to the right of the
      relationship was observed during norepinephrine infusion. CONCLUSION: It was
      concluded that norepinephrine exerted a favourable effect on right ventricular
      function.

PMID- 7798453
TI  - Usefulness of central venous oxygen saturation monitoring during cardiopulmonary
      resuscitation. A comparative case study with end-tidal carbon dioxide monitoring.
AB  - The usefulness of continuous monitoring of central venous oxygen saturation
      (ScvO2) in comparison with the capnogram during cardiopulmonary resuscitation
      (CPR) was demonstrated in a cardiac arrest patient. ScvO2 and end-tidal carbon
      dioxide (ETCO2) decreased following cessation of chest compression or increased
      during recovery of systemic circulation. During the complete stasis of systemic
      circulation, when defibrillation was done, ScvO2 did not change, while ETCO2
      gradually decreased. However the larger decrease in ScvO2 temporally occurred
      when chest compression was resumed. And also the ScvO2 monitoring had great
      advantage to detecting peripheral tissue oxygenation. ScvO2 seems to be no less
      accurate and reliable monitoring than the capnogram during CPR procedures. Since
      the capnogram is non-invasively and easily used in cardiac arrest patients, ScvO2
      monitoring combined with the capnogram is a more preferable method for assessing
      the efficacy of ongoing CPR.

PMID- 7798454
TI  - Tonometry to assess the adequacy of splanchnic oxygenation in the critically ill
      patient.
AB  - Tonometry, a relatively non-invasive technique for indirectly measuring the
      intramucosal pH (pHi) of the gastrointestinal tract, has recently been developed
      for use in critically ill patients. Reports in the literature suggest that the
      technique is of greatest benefit to patients at risk of developing reductions in
      splanchnic oxygenation (decreased O2 delivery) in whom early detection of the
      ischemic episode could possibly guide treatment. Tonometry, although still at a
      relatively early stage in its clinical development, could be of value for
      selected patient groups although further evaluation of the technique is
      necessary.

PMID- 7798455
TI  - Continuous veno-venous hemofiltration and mortality after cardiac surgery.

PMID- 7798456
TI  - Reversed Fick principle versus indirect calorimetry: do systematic differences
      between methods represent intrapulmonary oxygen consumption?

PMID- 7798457
TI  - Impact of SDD on ICU ecology.

PMID- 7798458
TI  - Isoflurane sedation and atmospheric pollution.

PMID- 7798459
TI  - The reliability of endotoxin and cytokine measurements in polytrauma patient and
      their relationship to the development of sepsis.

PMID- 7798460
TI  - Prolonged paralysis after long-term infusion of neuromuscular blocking agents.

PMID- 7798461
TI  - The role of psychosocial and biological variables in separating chronic and non
      chronic major depression and early-late-onset dysthymia.
AB  - Psychosocial (sociodemographic characteristics, loss and separation and family
      atmosphere in childhood, recent life events) and biological (family history, DST,
      TRH-test) variables were investigated in 180 patients with Major Depression (MD)
      and Dysthymic Disorder (DD). The aim of the study was to reveal certain
      differences between the chronic and non-chronic course of MD and the early- and
      late-onset subtypes of dysthymia. When comparing the two course patterns of MD, a
      higher rate of malignant tumours among first-degree relatives, a greater number
      of long-lasting stress situations before the index depressive episode, longer
      duration of the previous episodes, less frequent DST nonsuppression, and a
      blunted TSH response to TRH were found in patients with a chronic course of MD.
      Several factors seem to influence the course pattern of MD, or else the chronic
      form represents a subgroup within MD. The late-onset dysthymics were mainly women
      with a low level of education, a lower suicidal tendency, normal suppression in
      DST, and a lack of blunted TSH responses to TRH administration during the period
      of double depression. The early-onset dysthymics showed a higher number of
      persons who had never married, who presented a more traumatic and frustrating
      childhood background, and who had a higher rate of DST non-suppressors and
      blunted TSH responses after TRH administration during the period of their double
      depression. Our data suggest that late-onset dysthymia might be a biologically
      distinct subgroup of chronic depression.

PMID- 7798462
TI  - Decreased hedonic responsiveness during a brief depressive mood swing.
AB  - Female volunteers completed the Fawcett-Clark Pleasure Capacity Scale (FCPCS) and
      rated the pleasantness and desirability of a taste stimulus (cheese), before and
      during a depressive mood swing. Mood change was induced by reading negative self
      referent statements, with additional 'booster' periods of mood induction to
      prolong the duration of the mood swing. The mood induction procedure (MIP) caused
      a decrease in contentment and alertness, as derived from a set of visual analogue
      mood scales, and also decreased hedonic capacity, as measured by responses to the
      taste stimulus and by the FCPCS. No changes on any measure were shown by a
      control group who read an equivalent set of positive self-referent statements.
      Prior to the MIP, there were no significant correlations between mood measures
      and hedonic measures, or between taste responses and the FCPCS. However, there
      were significant correlations between the size of the changes in these various
      measures following the depressive MIP. The results suggest that hedonic capacity
      is responsive to acute depressive mood swings.

PMID- 7798463
TI  - Effects of exclusion criteria in depression treatment studies.
AB  - We investigated the effects of exclusion criteria in depression treatment studies
      by applying simulated exclusion criteria to a relatively unselected sample. The
      criteria were borderline personality disorder, drug/alcohol dependence, and
      exclusion criteria from the Treatment of Depression Collaborative Research
      Program and the Maintenance Therapies for Recurrent Depression Protocol. Each set
      of criteria substantially distorted demographic characteristics and Axis I and II
      comorbidity but did not yield higher rates of study completion or, in general,
      response to tricyclics. Excessive exclusion criteria in depression treatment
      studies have many adverse effects and should be applied only when overwhelmingly
      compelling reasons exist.

PMID- 7798464
TI  - Binding of [3H]paroxetine to platelets of depressed patients: seasonal
      differences and effects of diagnostic classification.
AB  - [3H]Paroxetine is a more reliable ligand for studying the serotonin (5-HT)
      transporter complex than [3H]imipramine. The present study investigates
      [3H]paroxetine binding to platelets in 54 depressed in-patients (18 minor, 16
      simple major and 20 melancholic depressed patients) and 16 healthy controls.
      There were no significant differences in maximal number of binding sites between
      depressed subjects and normal controls. There was no correlation between
      [3H]paroxetine binding to platelet membranes and severity of depression.
      [3H]Paroxetine binding to platelets was significantly higher in spring than in
      summer, fall and winter.

PMID- 7798465
TI  - Acute tryptophan depletion aggravates premenstrual syndrome.
AB  - The dietary technique of acute tryptophan depletion was used to suppress brain
      serotonin synthesis in 16 women with documented premenstrual syndrome. Each
      subject was tested at distinct phases of each of two menstrual cycles. Baseline
      amino acid levels did not vary across the menstrual cycle, except for tyrosine
      which showed a significant premenstrual decrement. Compared to a sham procedure,
      actual tryptophan depletion caused a significant aggravation of premenstrual
      symptoms, particularly irritability. Symptom magnitude was correlated with
      diminution of tryptophan relative to other amino acids. This result supports
      other evidence implicating serotonin in premenstrual syndrome.

PMID- 7798466
TI  - Do depressed patients with higher pretreatment stress levels respond better to
      cognitive therapy than imipramine?
AB  - Forty-eight unipolar depressed patients were randomly assigned to 12 weeks of
      treatment with either imipramine (IMI) (n = 32) or cognitive therapy (CT) (n =
      16). Prior to treatment assignment, all patients were rated for severity of a
      variety of psychosocial stressors. The interaction effect between pretreatment
      stress and type of treatment, CT or IMI, on symptom improvement was evaluated. We
      hypothesized that patients with greater pretreatment stress would respond better
      to cognitive therapy. Patients treated with either CT or IMI showed equivalent
      reductions of depressive symptoms. There was no interaction effect between
      pretreatment stress and type of treatment on improvement of depressive symptoms.
      Based on this preliminary study it does not appear that depressed patients with
      higher pretreatment levels of stress respond better to cognitive therapy than
      they do to imipramine.

PMID- 7798467
TI  - Panic attacks and panic disorder in Japanese non-patient population: epidemiology
      and psychosocial correlates.
AB  - To investigate the prevalence rates of panic disorder and panic attacks in the
      general population of Japan, a set of questionnaires were administered to 207
      people aged 18 or over, who were then interviewed. Seven (3.4%) had experienced
      one or more unexpected panic attacks in their lifetime. Two subjects (1.0%) had
      had panic disorder (DSM-III-R), and five (2.4%) had had panic attacks not meeting
      the criteria for panic disorder. Seventy percent of the persons with panic
      disorder or panic attacks had sought medical care. There was comorbidity with
      agoraphobia in two cases, and with major depression in five. Harsh discipline,
      frequent quarrel, between parents, and serious illness before the age of 16 were
      more frequent in individuals suffering from panic attacks, compared to those
      without.

PMID- 7798468
TI  - The relationship of premorbid personality to subtypes of an affective illness. A
      replication study by means of an operationalized procedure for the diagnosis of
      personality structures.
AB  - The hypothesis of a relationship between types of premorbid personality and
      subtypes of an affective illness was tested on the basis of a diagnostically
      'blind' assignment of biographical case history data on patients' premorbid
      development to patterns of personality traits. Data sets of 261 cases with
      various psychiatric disorders were examined. The rater (R.T.) had to score each
      item in a list of traits relevant for the diagnosis of the types that had been
      conceived by D.v.Z. and J.P. The assignment of the ratings to the type concepts
      was then performed by means of a computer programme. The results regarding the
      distribution of types over the clinical diagnoses yielded a statistically
      significant association of the 'affective types' of premorbid personality
      ('melancholic type' and 'manic type') with affective disorders and the 'neurotoid
      types' ('anxious insecure type' and 'nervous tense type') with non-affective
      disorders. Previous findings on the basis of a global rating of types in a
      smaller sample (n = 42) regarding personality types and subtypes of an affective
      illness could be replicated by means of the new, operationalized procedure in an
      enlarged sample (n = 80): On the one hand, a marked preponderance of the 'manic
      type' of personality was found in bipolar I patients, particularly pronounced in
      those with a predominantly manic course of the disorder; on the other hand, the
      'melancholic type' of personality prevailed in bipolar II and unipolar depressive
      patients.

PMID- 7798469
TI  - A world without water fluoridation.

PMID- 7798470
TI  - Surgical, nonsurgical therapies.

PMID- 7798471
TI  - Economic compression.

PMID- 7798472
TI  - Specialty and general practice communication.

PMID- 7798473
TI  - Local anesthetics: dentistry's most important drugs.
AB  - One hundred and fifty years ago, Horace Wells opened the door to local
      anesthetics. Since then, many advances have been made in pain control. The
      development of dentistry's most important drugs is highlighted here.

PMID- 7798474
TI  - Dentistry's answer to 'the humiliating spectacle'. Dr. Wells and his discovery.

PMID- 7798476
TI  - What others said about Wells. Memorials, tributes, affirmations.

PMID- 7798475
TI  - Remembering Dr. Menczer. Champion of Horace Wells.

PMID- 7798477
TI  - Dr. Wells' impact on dentistry and medicine.

PMID- 7798478
TI  - Spotlight on today's major issues. Five share their views.

PMID- 7798479
TI  - Panoramic radiography: an aid in detecting patients at risk of cerebrovascular
      accident.
AB  - Some individuals at risk for a cerebrovascular accident can be identified in the
      dental office by appropriate review of their panoramic radiographs. Radiographs
      were evaluated for 304 outpatients, 55 years or older, to check the presence of
      calcifications associated with artery disease. Three percent of the sample had
      such opacities.

PMID- 7798480
TI  - Epidemiology of chronic facial pain: diagnostic usefulness in patient care.
AB  - Three chronic facial pain conditions--temporomandibular pain and dysfunction
      syndrome, phantom tooth pain and burning mouth syndrome--can puzzle dentists
      trying to provide diagnoses and treatment plans. Epidemiologic data and their
      usefulness in providing diagnostic criteria for these conditions are explored.

PMID- 7798481
TI  - Treating severe partial anodontia: a 10-year history of patient treatment.
AB  - Severe partial anodontia is relatively rare. This case report describes the 10
      year treatment history of a patient with partial anodontia, beginning with
      removable partial overlay dentures and culminating with fixed implant prostheses.

PMID- 7798482
TI  - Treating growth and TMJ abnormalities in juvenile rheumatoid arthritis.
AB  - Two case reports illustrate the orofacial aspects of juvenile rheumatoid
      arthritis. The disease can affect facial growth and cause TMJ abnormalities.
      Children may vary in the degree to which they are affected by JRA, and dentists
      should investigate JRA as a cause of these abnormalities or deformities.

PMID- 7798483
TI  - Staying excited about dentistry.

PMID- 7798484
TI  - 26th Bethesda Conference: recommendations for determining eligibility for
      competition in athletes with cardiovascular abnormalities. January 6-7, 1994.

PMID- 7798485
TI  - COCATS Guidelines. Guidelines for Training in Adult Cardiovascular Medicine, Core
      Cardiology Training Symposium. June 27-28, 1994. American College of Cardiology.

PMID- 7798486
TI  - Guidelines for training in adult cardiovascular medicine. Core Cardiology
      Training Symposium (COCATS). Task Force 2: training in electrocardiography,
      ambulatory electrocardiography and exercise testing.

PMID- 7798487
TI  - Left ventricular function in chronic mitral regurgitation: preoperative and
      postoperative comparison.
AB  - OBJECTIVES: The present study was designed to evaluate the effects of surgical
      procedure on left ventricular systolic and diastolic function in patients with
      mitral regurgitation. BACKGROUND: Left ventricular systolic function has been
      shown to decline after operation in patients with chronic mitral regurgitation.
      METHODS: Using simultaneous cineangiography and left ventricular micromanometry,
      we evaluated left ventricular systolic and diastolic function in 14 patients with
      chronic mitral regurgitation both preoperatively and at an average of 22 months
      after operation. Eight patients underwent mitral valve reconstruction, and six
      had a valve replacement with interruption of the chordae tendineae. We compared
      these patients with 10 control subjects. RESULTS: Preoperatively, patients with
      mitral regurgitation demonstrated normal global and regional left ventricular
      systolic function. Peak rate of diastolic filling was increased (p < 0.01), and
      passive chamber stiffness was decreased, compared with that in control subjects
      (p < 0.01), and there was normal myocardial stiffness. Postoperatively, systolic
      and diastolic function returned to normal in patients undergoing mitral valve
      reconstruction. In contrast, global systolic function was depressed in patients
      after valve replacement (p < 0.05), with regional dysfunction in the area of
      papillary muscle attachment (p < 0.01). Diastolic function was depressed in this
      group, with a prolonged time constant of pressure decay (p < 0.01) and a
      depressed rate of early diastolic filling and strain rate (p < 0.05). Passive
      elastic stiffness was within the normal range in all postoperative patients.
      CONCLUSIONS: The type of operation performed to correct chronic mitral
      regurgitation has an important effect on postoperative left ventricular function.
      Systolic and diastolic function are preserved after mitral valve reconstruction.
      Mitral valve replacement with chordal interruption is associated with global and
      regional systolic dysfunction and early diastolic filling and relaxation
      abnormalities.

PMID- 7798488
TI  - Effect of dobutamine stress echocardiography on mitral regurgitation.
AB  - OBJECTIVES: This study was performed to examine the effect of dobutamine stress
      echocardiography on mitral regurgitation and to test the hypothesis that mitral
      regurgitation will increase in patients with an ischemic response. BACKGROUND:
      New or worsening mitral regurgitation during stress testing has been proposed as
      a marker of ischemia. However, it is unclear whether ischemia induced by
      dobutamine is associated with mitral regurgitation because the hemodynamic
      effects of dobutamine may vary with regard to mitral regurgitation, depending on
      left ventricular function and maximal dose attained. METHODS: Dobutamine stress
      echocardiography was performed in 102 consecutive patients with suspected or
      known coronary artery disease. Color flow Doppler was used to determine the
      presence and change in mitral regurgitation at baseline and peak dobutamine
      infusion (up to 40 micrograms/kg body weight per min). The mitral regurgitation
      color flow Doppler area was semiquantitatively graded as mild (< 4 cm2), moderate
      (4 to 8 cm2) or severe (> 8 cm2). Patients were assigned to ischemic and
      nonischemic groups according to the dobutamine stress echocardiographic results.
      RESULTS: The two groups achieved the same maximal dose and demonstrated similar
      blood pressure and heart rate responses to dobutamine infusion. Only two patients
      developed new mitral regurgitation during dobutamine infusion, and both had a
      normal dobutamine echocardiographic result. More patients without ischemia had no
      mitral regurgitation compared with patients with ischemia. There was an
      insufficient number of patients with coronary angiographic data to determine the
      effects of mitral regurgitation on the sensitivity and specificity of dobutamine
      stress echocardiography. Of 23 patients with a rest ejection fraction < 50%, 61%
      had an improvement in mitral regurgitation grade compared with 25% of patients
      with a rest ejection fraction > or = 50% (p < 0.02). CONCLUSIONS: These data
      indicate that although dobutamine infusion often improves mitral regurgitation in
      patients with left ventricular dysfunction during stress echocardiography, it
      does not induce or worsen mitral regurgitation in those who demonstrate an
      ischemic response. Future studies are necessary, with large numbers of patients,
      to determine the effects of mitral regurgitation on the sensitivity and
      specificity of dobutamine stress echocardiography.

PMID- 7798489
TI  - Observations suggesting a high incidence of exercise-induced severe mitral
      regurgitation in patients with mild rheumatic mitral valve disease at rest.
AB  - OBJECTIVES: The aim of this study was to determine the hemodynamic effects of
      upright bicycle ergometry in symptomatic patients with mild, mixed mitral
      stenosis and regurgitation. BACKGROUND: Patients with seemingly mild rheumatic
      mitral valve disease often complain of exertional dyspnea or fatigue. These
      symptoms are usually ascribed to flow-dependent increases in the gradient across
      the stenotic mitral valve. Although catheterization studies in these patients may
      demonstrate an increase in mitral valve gradient proportional to an increase in
      cardiac output, this approach does not specifically address the underlying
      mechanism of any observed increases in mitral gradient or left atrial (i.e.,
      pulmonary capillary wedge) pressure. Exercise echocardiography is uniquely suited
      to the dynamic assessment of exercise-induced hemodynamic changes. METHODS:
      Fourteen symptomatic patients with exertional dyspnea and mild mitral stenosis
      and regurgitation at rest performed symptom-limited upright bicycle ergometry
      with quantitative two-dimensional, Doppler and color Doppler echocardiographic
      analysis. RESULTS: Average pulmonary artery systolic pressure in the 13 patients
      with adequate spectral signals of tricuspid regurgitation increased from 36 +/- 5
      mm Hg (mean +/- SD) at rest to 63 +/- 14 mm Hg at peak exercise (p < 0.001). The
      mean transmitral pressure gradient in all patients increased from 4.5 +/- 1.4 mm
      Hg at rest to 12.7 +/- 2.7 mm Hg at peak exercise (p < 0.001). Five patients
      developed severe mitral regurgitation during exercise. CONCLUSIONS: Patients with
      exertional dyspnea and mild mitral stenosis and regurgitation at rest demonstrate
      a marked increase in pulmonary artery systolic pressure and mean transmitral
      pressure gradient during dynamic exercise. In a subset of these patients, marked
      worsening of mitral regurgitation appears to be the underlying mechanism of this
      hemodynamic deterioration. Because of the small sample size, this novel
      observation must be considered preliminary with respect to the true prevalence of
      exercise-related development of severe mitral regurgitation. If additional
      studies confirm the importance of this phenomenon, it has important implications
      for the management of patients with rheumatic mitral valve disease.

PMID- 7798490
TI  - Anterior leaflet procedures during mitral valve repair do not adversely influence
      long-term outcome.
AB  - OBJECTIVES: This study was done to assess the impact of anterior mitral leaflet
      reconstructive procedures on initial and long-term results of mitral valve
      repair. BACKGROUND: It has been suggested that involvement of the anterior
      leaflet in mitral valve disease adversely affects the long-term outcome of mitral
      valve repair. Our policy has been to aggressively repair such anterior leaflets
      with procedures that include triangular resections in some cases. METHODS: From
      June 1979 through June 1993, 558 consecutive Carpentier-type mitral valve repairs
      were performed. The anterior mitral leaflet and chordae tendineae were repaired
      in 156 patients (mean age 58 years). The procedures included anterior chordal
      shortening in 78 patients (50%), anterior leaflet resections in 44 (28%),
      resuspension of the anterior leaflet to secondary chordae in 42 (27%) and
      anterior chordal transposition in 27 (17%). Concomitant cardiac surgical
      procedures were performed in 75 patients (48%). RESULTS: The operative mortality
      rate was 2.5% (2 of 81) for isolated mitral valve anterior leaflet repair and
      3.8% (6 of 156) for all mitral valve anterior leaflet repair. Freedom from
      reoperation at 5 and 10 years was, respectively, 89.7% (n = 160) and 83.4% (n =
      24) for the entire series of 558 patients, 91.9% (n = 51) and 81.2% (n = 10) for
      patients with anterior leaflet procedures, 88.8% (n = 109) and 84.4% (n = 14) for
      patients without anterior leaflet procedures and 91.7% (n = 118) and 88.9% (n =
      18) for patients without rheumatic disease. Logistic regression showed that
      rheumatic origin of disease (odds ratio 2.99), but not anterior leaflet repair,
      increased the risk for reoperation. CONCLUSIONS: These results demonstrate that
      expansion of mitral valve techniques to include anterior leaflet disease yields
      immediate and long-term results equal to those seen in patients with posterior
      leaflet disease.

PMID- 7798491
TI  - Pseudoaneurysms of the mitral-aortic intervalvular fibrosa: dynamic
      characterization using transesophageal echocardiographic and Doppler techniques.
AB  - OBJECTIVES: The aim of this study was to provide a detailed description of
      echocardiographic and Doppler features of pseudoaneurysms involving the mitral
      aortic intervalvular fibrosa and to compare echocardiographic and aortographic
      findings. BACKGROUND: Infection of the aortic valve may spread to the aortic
      annulus, resulting in ring abscesses or pseudoaneurysms, or both, of the
      intervalvular fibrosa, which can alter patient management and prognosis. METHODS:
      The echocardiographic and Doppler findings of 20 patients with pseudoaneurysms or
      ring abscesses, or both, were reviewed and compared with surgical and
      aortographic results. RESULTS: A total of 23 lesions were identified, of which 16
      were intervalvular pseudoaneurysms, and 7 were ring abscesses. Transthoracic
      echocardiography detected 43% of the lesions, whereas transesophageal
      echocardiography identified 90% (p < 0.01). The most distinct feature of the
      pseudoaneurysms was marked pulsatility, with systolic expansion and diastolic
      collapse (mean systolic area [+/- SD] 4.1 +/- 3.4 cm2 vs. diastolic mean area 1.8
      +/- 2.2 cm2, p < 0.05). Using color Doppler, two types were identified:
      unruptured pseudoaneurysms (n = 9), which communicated only with the left
      ventricular outflow tract and had a distinct flow pattern, and ruptured
      pseudoaneurysms (n = 7), which, in addition, communicated with the left atrium or
      aorta. Compared with pseudoaneurysms, ring abscesses were smaller and
      nonpulsatile and showed either no flow or continuous systolic and diastolic flow,
      the site of paravalvular aortic insufficiency. In 10 patients who underwent
      aortography, three lesions were identified, and findings were concordant with
      echocardiography. However, in seven patients aortographic findings were normal,
      whereas echocardiography identified intervalvular pseudoaneurysms, all of which
      were documented at operation. CONCLUSIONS: Intervalvular pseudoaneurysms are more
      frequently detected by transesophageal echocardiography than by aortography or
      transthoracic examination and exhibit distinct dynamic features and Doppler
      patterns that can further help characterize cavitary lesions in the aortic root
      and guide appropriate surgical intervention.

PMID- 7798492
TI  - Guidelines for training in adult cardiovascular medicine. Core Cardiology
      Training Symposium (COCATS). Task Force 3: training in cardiac catheterization
      and interventional cardiology.

PMID- 7798493
TI  - Evidence for reduction of norepinephrine uptake sites in the failing human heart.
AB  - OBJECTIVES: This study investigated the role of neuronal uptake of norepinephrine
      (uptake-1) in human heart failure as a local factor for altering concentrations
      of norepinephrine at the cardiac myocyte membranes. BACKGROUND: Several beta
      adrenergic neuroeffector defects occur in heart failure. Whether an alteration in
      norepinephrine uptake-1 occurs is still unresolved. METHODS: The role of
      norepinephrine uptake-1 was studied in electrically stimulated (1 Hz, 37 degrees
      C) human ventricular cardiac preparations and isolated myocardial membranes.
      RESULTS: The effectiveness of norepinephrine in increasing the force of
      contraction was decreased in relation to the degree of heart failure. In
      contrast, the potency of norepinephrine was increased in failing hearts (New York
      Heart Association functional class IV) in relation to the concentrations
      producing 50% of the maximal effect (EC50). The EC50 values for isoproterenol,
      which is not a substrate for norepinephrine uptake-1, were reduced in myocardium
      in functional classes II to III and IV compared with those in nonfailing
      myocardium. The uptake inhibitors cocaine and desipramine (3 mumol/liter)
      potentiated the positive inotropic effects of norepinephrine in nonfailing
      myocardium (p < 0.05) but not in functional class IV myocardium. Radioligand
      binding experiments using the uptake inhibitor hydrogen-3 mazindol revealed a
      significant decrease by approximately 30% in norepinephrine uptake-1 carrier
      density in functional classes II to III and IV myocardium versus nonfailing
      myocardium (p < 0.05). CONCLUSIONS: In human heart failure, there is a
      presynaptic defect in the sympathetic nervous system, leading to reduced uptake-1
      activity. This defect in the failing heart can be mimicked by the effects of
      uptake blocking agents, such as cocaine and desipramine, in the nonfailing heart
      only. Compromised norepinephrine uptake-1 in functional class IV cannot be
      further increased by cocaine and desipramine. The pathophysiologic consequences
      could be an increased synaptic concentration of norepinephrine predisposing to
      adenylyl cyclase desensitization.

PMID- 7798494
TI  - Predictors of systolic and diastolic improvement in patients with dilated
      cardiomyopathy treated with metoprolol.
AB  - OBJECTIVES: The aim of this study was to determine which patients will have
      systolic and diastolic improvement after beta-blockade with metoprolol.
      BACKGROUND: Beta-adrenergic blocking agents improve systolic and diastolic
      function in patients with heart failure. However, it is unclear which patients
      will respond best to therapy. METHODS: We retrospectively examined baseline
      characteristics of 24 patients who underwent double-blind then open-label
      treatment with metoprolol to determine which characteristic predicted improvement
      in systolic and diastolic function. Degree of improvement in systolic function
      (22 patients) was defined by the change in left ventricular ejection fraction
      after 3 months of therapy. Degree of improvement in diastolic function (15
      patients) was defined as the change in left ventricular end-diastolic pressure
      and change in the slope of the isovolumetric relaxation rate-end-systolic
      pressure relation. RESULTS: Both systolic blood pressure at baseline (r = 0.54, p
      = 0.009) and the maximal positive value of the first derivative of left
      ventricular pressure with respect to time (peak +dP/dt) at baseline (r = 0.39, p
      = 0.07) correlated with improvement in ejection fraction after metoprolol
      treatment. Stepwise logistic regression demonstrated that only peak systolic
      pressure was an independent predictor of systolic improvement. Baseline heart
      rate, ventricular volumes, ejection fraction and adrenergic activation, as
      reflected by coronary sinus norepinephrine, did not predict response. Patients
      with the most diastolic impairment at baseline had the most favorable diastolic
      improvement. Those with the lowest myocardial respiratory quotient (most fatty
      acid utilization) at baseline also had the most marked reduction in left
      ventricular end-diastolic pressure. CONCLUSIONS: These data suggest that those
      patients with the highest peak systolic pressure, highest left ventricular end
      diastolic pressure and most prolonged isovolumetric relaxation at baseline will
      respond best to therapy with metoprolol. However, other patients without these
      characteristics may also benefit.

PMID- 7798495
TI  - Guidelines for training in adult cardiovascular medicine. Core Cardiology
      Training Symposium (COCATS). Task Force 4: training in echocardiography.

PMID- 7798496
TI  - Improvement in exercise capacity of candidates awaiting heart transplantation.
AB  - OBJECTIVES: This study determined the frequency of improvement in peak oxygen
      uptake and its role in reevaluation of candidates awaiting heart transplantation.
      BACKGROUND: Ambulatory candidates for transplantation usually wait > 6 months to
      undergo the procedure, and during this period symptoms may lessen, and peak
      oxygen uptake may improve. Whereas initial transplant candidacy is based
      increasingly on objective criteria, there are no established guidelines for
      reevaluation to determine who can leave the active waiting list. METHODS: All
      ambulatory transplant candidates with initial peak oxygen uptake < 14 ml/kg per
      min were identified. Of 107 such patients listed, 68 survived without early
      deterioration or transplantation to undergo repeat exercise. A strategy of
      reevaluation using specific clinical criteria and exercise performance was tested
      to determine whether patients with improved oxygen uptake could safely be
      followed without transplantation. RESULTS: In 38 of the 68 patients, peak oxygen
      uptake increased by > or = 2 ml/kg per min to a level > or = 12 ml/kg per min
      after 6 +/- 5 months, together with an increase in anaerobic threshold, peak
      oxygen pulse and exercise heart rate reserve and a decrease in heart rate at
      rest. Increased peak oxygen uptake was accompanied by stable clinical status
      without congestion in 31 of 38 patients, and these 31 were taken off the active
      waiting list. At 2 years, their actuarial survival rate was 100%, and the
      survival rate without relisting for transplantation was 85%. CONCLUSION:
      Reevaluation of exercise capacity and clinical status allowed removal of 31 (29%)
      of 107 ambulatory transplant candidates from the waiting list with excellent
      early survival despite low peak oxygen uptake on initial testing. The ability to
      increase peak oxygen uptake, particularly with increased peak oxygen pulse, may
      indicate improved prognosis as well as functional capacity and, in combination
      with stable clinical status, may be an indication to defer transplantation in
      favor of more compromised candidates.

PMID- 7798497
TI  - Incidence and severity of transplant coronary artery disease early and up to 15
      years after transplantation as detected by intravascular ultrasound.
AB  - OBJECTIVES: The purpose of this study was to quantify the severity of transplant
      coronary artery disease and to assess lesion characteristics early and up to 15
      years after heart transplantation by using intracoronary ultrasound. BACKGROUND:
      Intravascular ultrasound has the ability to measure the components of the
      arterial wall and has been shown to be a sensitive method for detection of
      transplant coronary artery disease. METHODS: A total of 304 intracoronary
      ultrasound studies were performed in 174 heart transplant recipients at baseline
      and up to 15 (mean 3.3 +/- 0.2) years after transplantation. Mean intimal
      thickness and an intimal index were calculated, and lesion characteristics
      (eccentricity, calcification) were assessed for all coronary sites imaged (mean
      3.0 +/- 0.1 sites/study). The Stanford classification was used to grade lesion
      severity. RESULTS: Compared with findings in patients studied at baseline (< 2
      months after transplantation, n = 50), mean intimal thickness (0.09 +/- 0.02 vs.
      0.16 +/- 0.02 mm, p < 0.01), intimal index (0.07 +/- 0.01 vs. 0.14 +/- 0.02, p <
      0.01) and mean severity class (1.5 +/- 0.2 vs. 2.3 +/- 0.2, p < 0.01) were
      significantly higher at year 1 (n = 52) after transplantation. Thereafter, all
      three variables further increased over time and reached highest values between
      years 5 and 15. Calcification of lesions was detected in 2% to 12% of studies up
      to 5 years after transplantation, with a significant increase to 24% at years 6
      to 10 (p < 0.05). CONCLUSIONS: Severity of transplant coronary artery disease
      appeared to progress with time after transplantation in this cross-sectional
      study. This characteristic was most prominent during the 1st 2 years after
      transplantation, whereas calcification of plaques occurred to a significant
      extent only later in the process. These data may serve as a reference for
      comparison of intravascular ultrasound findings in other studies of patients with
      transplant coronary artery disease.

PMID- 7798498
TI  - Clinical outcome of deferring angioplasty in patients with normal translesional
      pressure-flow velocity measurements.
AB  - OBJECTIVES: The objective of this study was to determine the feasibility, safety
      and outcome of deferring angioplasty in patients with angiographically
      intermediate lesions that are found not to limit flow, as determined by direct
      translesional hemodynamic assessment. BACKGROUND: The clinical importance of some
      coronary stenoses of intermediate angiographic severity frequently requires
      noninvasive stress testing. Direct translesional pressure and flow measurements
      may assist in clinical decision making in patients with such stenoses. METHODS:
      Translesional spectral flow velocity (Doppler guide wire) and pressure data were
      obtained in 88 patients for 100 lesions (26 single-vessel and 74 multivessel
      coronary artery lesions) with quantitative angiographic coronary narrowings (mean
      +/- SD diameter narrowing 54 +/- 7% [range 40% to 74%]). Target lesion
      angioplasty was prospectively deferred on the basis of predetermined normal
      values, defined as a proximal/distal velocity ratio < 1.7 or a pressure gradient
      < 25 mm Hg, or both. Patients were followed up for 9 +/- 5 months (range 6 to
      30). RESULTS: In the deferred angioplasty group, translesional velocity ratios
      were similar to those of a normal reference group (mean 1.1 +/- 0.32 vs. 1.3 +/-
      0.55) and significantly lower than those of a reference cohort of patients who
      had undergone angioplasty (2.27 +/- 1.2, p < 0.05). The mean translesional
      pressure gradient in the deferred angioplasty group was also lower than that in
      the angioplasty group (10 +/- 9 vs. 45 +/- 22 mm Hg, p < 0.001). At follow-up in
      the deferred angioplasty group, four, six, zero and two patients, respectively,
      had had subsequent angioplasty, coronary artery bypass graft surgery or
      myocardial infarction or had died. In one patient, death was related to
      angioplasty of a nontarget artery lesion, and one patient with multivessel
      disease had a cardiac arrest due to ventricular fibrillation 12 months after
      lesion assessment. Among the 10 patients requiring later angioplasty or coronary
      artery bypass grafting, only six procedures were performed on target arteries. No
      patient had a complication of translesional flow or pressure measurements.
      CONCLUSIONS: These data demonstrate the safety, feasibility and clinical outcome
      of deferring angioplasty of coronary artery narrowings associated with normal
      translesional coronary hemodynamic variables. Given the practice of performing
      angioplasty without ischemic testing or when testing is inconclusive,
      translesional hemodynamic data obtained at diagnostic catheterization can
      identify patients in whom it is safe to postpone angioplasty.

PMID- 7798499
TI  - Internal thoracic artery grafts: 20-year clinical follow-up.
AB  - OBJECTIVES: This study compared the long-term clinical results of coronary artery
      bypass surgery in patients with internal thoracic artery grafts with those in
      patients with vein grafts only. BACKGROUND: Aortocoronary artery bypass surgery
      has been performed for > 25 years, primarily utilizing the saphenous vein and
      internal thoracic artery as conduits. Although the internal thoracic artery has
      been shown to confer a clinical advantage, it is not known for how many years
      this benefit will continue. METHODS: All consecutive patients undergoing initial
      coronary artery bypass surgery between 1970 and 1973 were followed for up to 20
      years. Clinical evaluation included survival, late myocardial infarction, need
      for reoperation and recurrence of angina. Patients were analyzed in three groups:
      vein grafts only (214 patients); a single internal thoracic artery graft with or
      without associated vein grafts (490 patients); and bilateral internal thoracic
      artery grafts (39 patients). Use of the operating microscope was also analyzed
      with regard to effect on survival. RESULTS: The internal thoracic artery graft
      and use of the operating microscope were independent predictors of mortality and
      reduced the risk of dying by a factor of 0.68 and 0.76, respectively. An internal
      thoracic artery graft resulted in a mean survival of 4.4 years longer than that
      with vein grafts alone. The internal thoracic artery graft compared with vein
      grafts was associated with fewer reoperations (p < 0.001), fewer late myocardial
      infarctions, lower associated mortality rates (p < 0.04) and less early
      recurrence of angina (p = 0.03). CONCLUSIONS: The internal thoracic artery graft
      and use of the operating microscope confer a superior clinical advantage over the
      saphenous vein graft throughout a 20-year follow-up period. The advantage of an
      internal thoracic artery graft does not decrease with time, suggesting that the
      choice of conduit at the initial operation is more important clinically than
      progression of coronary artery disease.

PMID- 7798500
TI  - Guidelines for training in adult cardiovascular medicine. Core Cardiology
      Training Symposium (COCATS). Task Force 5: training in nuclear cardiology.

PMID- 7798501
TI  - Relation of saphenous vein graft obstruction to serum cholesterol levels.
AB  - OBJECTIVES: To determine the potential of lipid-lowering therapy to reduce
      saphenous vein graft obstruction, we retrospectively studied the association
      between graft obstruction and serum cholesterol levels. BACKGROUND:
      Atherosclerosis is the major cause of vein graft obstruction. Approximately 50%
      of grafts are occluded by 10 years after operation. It remains to be established
      whether lipid control affects long-term graft survival. METHODS: We carried out a
      retrospective review of all 284 patients who had undergone coronary artery bypass
      graft surgery at Juntendo University Hospital between 1976 and 1991 and met the
      following additional criteria: at least one saphenous vein graft, repeat coronary
      arteriography at some point after coronary artery bypass graft surgery and a
      serum cholesterol level > or = 200 mg/dl before operation. Saphenous vein graft
      obstruction rates were compared among three groups classified by serum
      cholesterol levels at follow-up arteriography: group I < 200 mg/dl; group II 200
      to 239 mg/dl; group III > or = 240 mg/dl. A vein graft was considered obstructed
      if it was narrowed by > or = 70%. RESULTS: In group I, 88% of grafts were not
      obstructed 7 years after operation. The respective rates were 61% in group II and
      57% in group III (p < 0.005). This relation was true for vein grafts to the left
      anterior descending and other coronary arteries. CONCLUSIONS: Lower serum
      cholesterol levels are associated with lower rates of vein graft obstruction for
      up to 7 years. This suggests that cholesterol-lowering therapy may improve long
      term saphenous vein graft survival after coronary artery bypass surgery.

PMID- 7798502
TI  - Right coronary artery stenosis: an independent predictor of atrial fibrillation
      after coronary artery bypass surgery.
AB  - OBJECTIVES: This study attempted to determine the importance of severe proximal
      right coronary artery disease as a predictor of atrial fibrillation in patients
      after coronary artery bypass surgery. BACKGROUND: Studies in patients undergoing
      noncardiac surgery have suggested that ischemia in the right coronary artery
      distribution is associated with a high incidence of atrial fibrillation. However,
      the importance of right coronary artery disease as a predictor of atrial
      fibrillation after bypass surgery is unknown. METHODS: The occurrence of
      sustained postoperative atrial fibrillation was studied prospectively in 168
      consecutive patients undergoing coronary artery bypass grafting. Patients were
      followed up postoperatively until discharge. Severe right coronary artery
      stenosis was defined as > or = 70% lumen narrowing. RESULTS: Of 104 patients with
      proximal or mid right coronary artery stenosis, 45 (43%) had atrial fibrillation
      postoperatively compared with 12 (19%) of the 64 patients without significant
      right coronary disease (p = 0.001). Univariate predictors of atrial fibrillation
      included right coronary artery stenosis (p = 0.001), advancing age (p = 0.0001)
      and lack of beta-adrenergic blocking agent therapy after bypass surgery (p =
      0.0004). Multivariate adjusted risk of developing atrial fibrillation after
      bypass surgery increased with the presence of severe right coronary artery
      disease (odds ratio 3.69, 95% confidence interval [CI] 1.61 to 8.48), advancing
      age (odds ratio 2.24/10 years, CI 1.48 to 3.41) and male gender (odds ratio 2.36,
      CI 1.01 to 5.49). The use of beta-blockers postoperatively was associated with a
      protective effect (odds ratio 0.4, CI 0.17 to 0.80). CONCLUSIONS: The presence of
      severe right coronary artery stenosis is an independent and powerful predictor of
      atrial fibrillation after coronary artery bypass surgery. In association with
      age, gender and postoperative beta-blocker therapy, these variables can be used
      to identify patients at increased risk for developing this arrhythmia.

PMID- 7798503
TI  - Thrombin generation and activity during thrombolysis and concomitant heparin
      therapy in patients with acute myocardial infarction.
AB  - OBJECTIVES: This prospective study investigated the behavior of thrombin
      generation and activity during thrombolysis and concomitant heparin
      administration. BACKGROUND: It has been shown that during thrombolytic therapy
      there is an increase in thrombin generation and activity. Increased thrombin
      activity is suppressed by concomitant intravenous heparin, but it is unknown
      whether thrombin generation is also affected. METHODS: Thrombin generation was
      assessed by measuring prothrombin fragment 1 + 2 and thrombin-antithrombin
      complex plasma levels and thrombin activity by measuring fibrinopeptide A plasma
      levels. Serial blood samples were obtained before and at 90 min and 24 and 48 h
      after the administration of streptokinase (15 patients), recombinant tissue-type
      plasminogen activator (15 patients) or anistreplase (13 patients). An intravenous
      bolus of heparin (5,000 IU) was administered before the start of thrombolytic
      therapy, followed by an infusion of 1,000 U/h to maintain an activated partial
      thromboplastin time > 1.5 times baseline. RESULTS: During thrombolytic and
      concomitant heparin therapy, there was an increase in the plasma levels of
      prothrombin fragment 1 + 2 (baseline 1.08 vs. 2.73 nmol/liter, p < 0.001) and
      thrombin-antithrombin complex (baseline 6.5 vs. 17.1 micrograms/ml, p < 0.01) at
      90 min, whereas no change was observed in fibrinopeptide A at 90 min (baseline
      2.8 vs. 3.0 nmol/liter, p = NS). CONCLUSIONS: During thrombolytic therapy with
      both fibrin-specific and non-fibrin-specific drugs, there is an increase in
      thrombin generation despite concomitant administration of intravenous heparin.

PMID- 7798504
TI  - Rest-redistribution thallium-201 scintigraphy to determine myocardial viability
      early after myocardial infarction.
AB  - OBJECTIVES: This study attempted to determine the utility of early rest
      redistribution thallium-201 imaging in detecting residual myocardial viability
      after myocardial infarction. BACKGROUND: The early detection of myocardial
      viability after myocardial infarction would have clinical relevance. METHODS:
      Thirty-one patients with acute myocardial infarction had early (mean [+/- SD] 2
      +/- 1 day) rest-redistribution thallium-201 imaging followed by radionuclide and
      coronary angiography. Late studies included stress-redistribution-reinjection
      thallium-201 imaging or radionuclide angiography, or both. Viability was defined
      by the rest thallium-201 scan as an initial mild rest defect or any defect that
      demonstrated redistribution. RESULTS: Group 1 (n = 15) was predicted to have
      viable and Group 2 (n = 16) nonviable myocardium in the infarct zone. Group 1
      patients were more likely to have a patent infarct-related artery (15 of 15 vs.
      10 of 16, p < 0.03), higher initial ejection fraction (61 +/- 12% vs. 53 +/- 9%,
      p < 0.05), higher infarct wall motion score (p < 0.0001) and fewer abnormal
      thallium-201 segments (p < 0.0001). On follow-up studies, ejection fraction
      improved in Group 1 (from 57 +/- 13% to 66 +/- 10%, p < 0.05, n = 9) and
      deteriorated in Group 2 (from 53 +/- 10% to 46 +/- 8%, p < 0.05, n = 13). On late
      stress testing with thallium-201 reinjection, Group 1 patients had fewer abnormal
      segments (p < 0.03) and higher infarct zone counts during exercise (p < 0.05) and
      after reinjection (p < 0.05) than Group 2 patients. CONCLUSIONS: If confirmed by
      larger studies, early rest-redistribution thallium-201 imaging may be a useful
      technique for identifying residual viability after myocardial infarction.

PMID- 7798505
TI  - Frequent reocclusion of patent infarct-related arteries between 4 weeks and 1
      year: effects of antiplatelet therapy.
AB  - OBJECTIVES: This study assessed the effect of the combination of aspirin and
      dipyridamole on patency of the infarct-related artery between 4 weeks and 1 year
      after myocardial infarction. BACKGROUND: Patency of the infarct-related artery is
      an important determinant of prognosis after myocardial infarction. The incidence
      of late reocclusion and the effects of antiplatelet therapy are unknown. METHODS:
      To investigate the importance of antiplatelet therapy for the prevention of late
      reocclusion, 215 patients who had a patent infarct-related artery 4 weeks after
      myocardial infarction were randomized in a double-blind manner to receive either
      a combination of 25 mg of aspirin and 200 mg of dipyridamole twice daily or
      placebo. One hundred fifty-four patients underwent further coronary arteriography
      1 year later. RESULTS: At 1 year, 38 (25%) of 154 patients had reocclusion of the
      infarct-related artery; 18 (23%) of 79 patients receiving aspirin and
      dipyridamole had late reocclusion versus 20 (27%) of 75 who received placebo (p =
      NS). The rate of reocclusion was related to the severity of the residual coronary
      artery stenosis at 4 weeks (< 50% stenosis 9.2%; 50% to 69% stenosis 11.6%; 70%
      to 89% stenosis 30.4%; > or = 90% stenosis 70%, p < 0.01). The majority of
      reocclusions were silent, and only 17 (45%) of 38 were clinically associated with
      further infarction. There were no differences for a hierarchic end point of
      cardiac death, myocardial infarction or revascularization (14.8% aspirin and
      dipyridamole vs. 17.8% placebo). CONCLUSIONS: Late reocclusion of the patent
      infarct-related artery is a frequent event, occurring in 25% of patients.
      Antiplatelet therapy with the combination of aspirin and dipyridamole does not
      alter the overall rate of late reocclusion. Other strategies are required to
      reduce late reocclusion.

PMID- 7798506
TI  - Coronary reactivity to nitroglycerin: intravascular ultrasound evidence for the
      importance of plaque distribution.
AB  - OBJECTIVES: This study was designed to assess the extent and timing of
      vasodilation after intracoronary administration of nitroglycerin using
      intravascular ultrasound. We also sought to relate the magnitude of nitroglycerin
      induced dilation to the distribution of atherosclerotic plaque. BACKGROUND:
      Although previous angiographic studies have shown that nitroglycerin can dilate
      both normal and stenotic coronary arteries, it remains uncertain whether
      atherosclerotic vessels can respond to nitroglycerin to the same extent as normal
      arteries in the clinical setting. METHODS: We analyzed a total of 48 segments
      from 48 patients by means of a multielement 3.5F to 5.5F 20-MHz intravascular
      ultrasound system before and after intracoronary administration of nitroglycerin
      (250 micrograms). Videotaped images were digitized, and the lumen cross-sectional
      area was measured with an electronic cursor. In noncircumferential lesions, the
      perimeters of the normal and diseased portions were measured separately to
      compare the reactivity to nitroglycerin in each portion. RESULTS: Of 48 sites
      examined 14 were normal by ultrasound, and 34 revealed atherosclerotic lesions.
      In the 14 normal segments nitroglycerin produced a large increase in cross
      sectional area (31 +/- 16% [mean +/- SD]) within 60 s after injection. In the 34
      atherosclerotic segments, nitroglycerin-induced dilation was impaired, and the
      cross-sectional area increased only 12 +/- 8% (p < 0.01). In 15 of 34
      atherosclerotic segments, a noncircumferential lesion was identified, and the
      cross-sectional area after nitroglycerin increased an average of 17 +/- 6%. In
      the remaining 19 sites, circumferential disease was present, and the cross
      sectional area increased by only 8 +/- 7% (p < 0.05 vs. normal or
      noncircumferential atherosclerotic segments). In noncircumferential lesions, the
      increase in the perimeter of the normal portion of the wall was significantly
      greater (14 +/- 6%) than the increase in the diseased portion (5 +/- 3%, p <
      0.05). CONCLUSIONS: These data indicate that vasoreactivity after nitroglycerin
      administration is reduced in segments with atherosclerosis by ultrasound. We
      suggest that nitroglycerin-induced vasodilation at the stenotic segments can be
      produced primarily by expansion of the nondiseased portion of the vessel wall.

PMID- 7798507
TI  - Guidelines for training in adult cardiovascular medicine. Core Cardiology
      Training Symposium (COCATS). Task Force 6: training in specialized
      electrophysiology, cardiac pacing and arrhythmia management.

PMID- 7798508
TI  - Medical treatment to reduce total ischemic burden: total ischemic burden
      bisoprolol study (TIBBS), a multicenter trial comparing bisoprolol and
      nifedipine. The TIBBS Investigators.
AB  - OBJECTIVES: We compared the effects of bisoprolol on transient myocardial
      ischemia with those of nifedipine in patients with chronic stable angina.
      BACKGROUND: Both beta-adrenergic blocking agents and calcium antagonists reduce
      transient ischemic episodes, but comparisons of these agents have been made in
      only a few larger studies. METHODS: The Total Ischemic Burden Bisoprolol Study
      (TIBBS) was a randomized double-blind controlled study with two parallel groups;
      330 patients from 30 centers in seven European countries with stable angina
      pectoris, a positive exercise test and more than two transient ischemic episodes
      during 48 h of Holter monitoring (central evaluation) were included. Of these
      patients 161 were randomized to receive bisoprolol and 169 to receive nifedipine
      slow release. There were two treatment phases of 4 weeks each, with 48-h Holter
      monitoring after each phase. During phase 1, patients received either 10 mg of
      bisoprolol daily or 2 x 20 mg of nifedipine slow release. During phase 2, they
      received either 20 mg of bisoprolol daily or 2 x 40 mg of nifedipine slow
      release. RESULTS: In phase 1 of the trial, 4 weeks of bisoprolol therapy (10 mg
      daily) reduced the mean [+/- SD] number of transient ischemic episodes from 8.1
      +/- 0.6 to 3.2 +/- 0.4/48 h. Nifedipine (2 x 20 mg) reduced transient ischemic
      episodes from 8.3 +/- 0.5 to 5.9 +/- 0.4/48 h. Total duration of ischemia was
      reduced from 99.3 +/- 10.1 to 31.9 +/- 5.5 min/48 h with bisoprolol and from 101
      +/- 9.1 to 72.6 +/- 8.1 min/48 h with nifedipine. Reductions were statistically
      significant for both drugs; the difference between bisoprolol and nifedipine was
      also significant (p < 0.0001). Bisoprolol reduced the heart rate at onset of
      episodes by 13.7 +/- 1.4 beats/min from a baseline value of 99.5 +/- 1.2
      beats/min (p < 0.001). Heart rate was unchanged with nifedipine. Bisoprolol had
      significantly higher responder rates than nifedipine. Doubling of the dose in
      phase 2 of the trial had small additive effects. Only bisoprolol showed a marked
      circadian effect by reducing the morning peak of transient ischemic episodes (by
      68% at peak time, 8:00 to 8:59 AM). CONCLUSIONS: Both bisoprolol and nifedipine
      reduced the number and duration of transient ischemic episodes in patients with
      chronic stable angina. Bisoprolol was significantly more effective than
      nifedipine in both doses tested and reduced the morning peak of ischemic
      activity.

PMID- 7798509
TI  - Correlation between cardiac involvement and CTG trinucleotide repeat length in
      myotonic dystrophy.
AB  - OBJECTIVES: Because sudden death due to complete atrioventricular (AV) block or
      ventricular arrhythmias is the most dramatic event in myotonic dystrophy, we
      assessed the relation of cardiac disease to cytosine-thymine-guanine (CTG)
      triplet mutation in adults affected with myotonic dystrophy. BACKGROUND: The
      myotonic dystrophy mutation, identified as an unstable deoxyribonucleic acid
      (DNA) sequence (CTG) prone to increase the number of trinucleotide repeats,
      produces clinical manifestations of the disease in skeletal muscle, the heart and
      many organ systems. METHODS: Forty-two adult patients underwent
      electrocardiography and echocardiography; in addition, signal-averaging
      electrocardiography was performed in 22, and 24-h Holter monitoring was recorded
      in 32. The diagnosis was established by neurologic examination, electromyography,
      muscle biopsy and DNA analysis. The patients were then classified into three
      subgroups on the basis of the number of CTG trinucleotide repeat expansions: E1 =
      18 patients with 0 to 500 CTG repeats; E2 = 12 patients with up to 1,000 repeats;
      E3 + E4 = 10 patients with up to 1,500 repeats and 2 patients with > 1,500
      repeats. RESULTS: The incidence of normal electrocardiographic (ECG) results was
      found to be significantly different in the three subgroups (55%, 50%, 17% in E1,
      E2, E3, + E4, respectively, p = 0.04), with the highest values in the group with
      fewer repeat expansions. The incidence of complete left bundle branch block was
      also significantly different among the groups (5% in E1, 0% in E2, 42% in E3 + E4
      p = 0.01) and was directly correlated with the size of the expansion. A time
      domain analysis of the signal-averaged ECG obtained in 12 patients in E1, 4 in
      E2, 5 in E3 and 1 in E4 showed that abnormal ventricular late potentials were
      directly correlated with CTG expansion (33% in E1, 75% in E2, 83% in E3 + E4, p =
      0.05). Moreover, the incidence of ventricular couplets or triplets showed a
      positive correlation with size of CTG expansion (0 in E1, 0 in E2, 29% in E3 +
      E4, chi square 0.02). CONCLUSIONS: Our findings suggest that the involvement of
      specialized cardiac tissue, accounting for severe AV and intraventricular
      conduction defects, is related to CTG repeat length. In addition, the presence of
      abnormal late potentials directly correlates to CTG expansion. Abnormal late
      potentials, caused by slowed and fragmented conduction through damaged areas of
      myocardium, represent a substrate for malignant reentrant ventricular
      arrhythmias. In the future, therefore, molecular analysis of DNA should identify
      patients with cardiac disease at high risk for development of AV block or lethal
      ventricular arrhythmias.

PMID- 7798510
TI  - Angiotensin II inhibits the forearm vascular response to increased arterial
      pressure in humans.
AB  - OBJECTIVES: This study tested the hypothesis that angiotensin II may inhibit the
      forearm vascular resistance response to an increase in arterial pressure in
      normal humans. BACKGROUND: Angiotensin II inhibits baroreflex-mediated reductions
      in heart rate and peripheral sympathetic activity during increases in arterial
      pressure in experimental animals. If present in humans, such effects could
      contribute to the pathophysiologic role of angiotensin II in hypertension and
      heart failure. METHODS: Two investigations were performed. In the first, forearm
      vascular resistance responses were compared during equipressor infusions of
      angiotensin II and phenylephrine. In the second, heart rate, forearm vascular
      resistance and systemic venous norepinephrine spillover responses were compared
      during head-down tilt and head-down tilt plus phenylephrine with concomitant
      angiotensin II or vehicle infusions. RESULTS: In the first study, forearm
      vascular resistance increased from 44 +/- 12 (mean +/- SD) to 54 +/- 13 U (p <
      0.05) during angiotensin II but did not change during phenylephrine infusions (39
      +/- 8.5 to 40 +/- 14 U) that increased mean arterial pressure comparably (88 +/-
      9.8 to 103 +/- 14 mm Hg during angiotensin II, p < 0.001; 91 +/- 7.6 to 104 +/-
      9.2 mm Hg during phenylephrine, p < 0.001). In the second study, the decrease in
      heart rate and forearm vascular resistance during the combination of head-down
      tilt and phenylephrine were both attenuated during concomitant angiotensin II
      compared with vehicle infusions: delta HR/delta MAP = -2.2 beats/min per mm Hg
      during vehicle and -0.87 beats/min per mm Hg during angiotensin II (p = 0.07);
      delta FVR/delta MAP = -2.8 U/mm Hg during vehicle and -0.19 U/mm Hg during
      angiotensin II (p = 0.01), where delta HR = change in heart rate; delta MAP =
      change in mean arterial pressure; and delta FVR = change in forearm vascular
      resistance. Norepinephrine spillover declined during vehicle infusions (612 +/-
      367 to 418 +/- 196 ng/min, p < 0.05) but not during angiotensin II infusions
      despite a greater increase in mean arterial pressure when the subpressor
      angiotensin II was combined with head-down tilt and phenylephrine (6.0 +/- 7.0 mm
      Hg during vehicle; 14 +/- 9.4 mm Hg during angiotensin II, p < 0.01).
      CONCLUSIONS: Both pressor and nonpressor infusions of angiotensin II immediately
      inhibit the forearm vascular response to mild baroreflex loading in normal
      humans. If present over the long term, such effects could contribute to
      inappropriate peripheral resistance in diseases such as hypertension and
      congestive heart failure.

PMID- 7798511
TI  - Muscular and cardiac adenosine-induced pain is mediated by A1 receptors.
AB  - OBJECTIVES: This study attempted to establish whether bamiphylline, a selective
      antagonist of A1 adenosine receptors, prevents the algogenic effects of adenosine
      in humans. BACKGROUND: Experimental findings indicate that the sympathoexcitatory
      response elicited by adenosine is mediated by A1 receptors. METHODS: An
      intrailiac infusion of increasing doses (from 125 to 2,000 micrograms/min) of
      adenosine was given to 20 patients. Adenosine infusion was then repeated after
      intrailiac infusion of either bamiphylline or saline solution. In 14 other
      patients with angina, increasing doses of adenosine (from 108 to 1,728
      micrograms/min) were infused into the left coronary artery. Adenosine infusion
      was then repeated after the intravenous infusion of either bamiphylline or
      placebo. Coronary blood flow velocity was monitored by a Doppler catheter. Data
      relative to pain severity are expressed as median and all other data as mean
      value +/- 1 SD. RESULTS: Bamiphylline prolonged the time to pain onset caused by
      the intrailiac adenosine infusion from 444 +/- 96 to 749 +/- 120 s (p < 0.001)
      and reduced pain severity from 45 to 24 mm (p < 0.01). After placebo infusion,
      the time to pain onset and pain severity were similar to that of baseline (428 +/
      112 vs. 430 +/- 104 s, p = 0.87 and 44 vs. 43 mm, p = 0.67, respectively).
      Bamiphylline prolonged the time to pain onset caused by intracoronary adenosine
      infusion from 519 +/- 128 to 603 +/- 146 s (p < 0.01) and reduced pain severity
      from 58 to 28 mm (p < 0.02). After placebo infusion, the time to pain onset and
      pain severity were similar to that at baseline (542 +/- 87 vs. 551 +/- 79 s, p =
      0.14 and 55 vs. 50 mm, p = 0.61). Maximal coronary blood flow velocities before
      and after bamiphylline administration were similar (47 +/- 22 vs. 49 +/- 24 cm/s,
      p = 0.36) as well as before and after placebo administrtion (40 +/- 20 vs. 41 +/-
      20 cm/s, p = 0.07). CONCLUSIONS: Bamiphylline reduces adenosine-induced muscular
      and cardiac pain but does not affect adenosine-induced coronary vasodilation.
      These findings indicate that at the dose used in this study, bamiphylline does
      not detectably block vascular A2-receptor-mediated adenosine effects in humans,
      which suggests that the muscular and cardiac algogenic effects of adenosine are
      mediated mainly by A1 receptors.

PMID- 7798513
TI  - Guidelines for training in adult cardiovascular medicine. Core Cardiology
      Training Symposium (COCATS). Task Force 7: training in cardiovascular research.
AB  - It is vital to the future intellectual health of cardiovascular medicine and the
      welfare of patients with cardiovascular disease that all future cardiologists be
      familiar with the principles and tools of research. Training in research requires
      the intense involvement of productive and established investigators. Those
      trainees preparing for a career in investigative cardiology require a carefully
      developed but flexible educational plan that will permit them to be successful in
      their research careers over an extended period.

PMID- 7798512
TI  - Recovery and viability of an acute myocardial infarct after transmyocardial laser
      revascularization.
AB  - OBJECTIVES: The short- and long-term effectiveness of transmyocardial laser
      revascularization was evaluated in the setting of an acute myocardial infarction.
      BACKGROUND: Theoretically, transmyocardial laser revascularization allows direct
      perfusion of the ischemic area as ventricular blood flows through the channels to
      the myocardium. METHODS: Infarcts were created by coronary occlusion in 30 sheep.
      Eighteen of these sheep were studied to assess short-term efficacy. The infarct
      was reperfused after 1 h by either removing the occlusion or by laser drilling
      using a high power carbon dioxide laser. The occlusions were left in place for
      the control group. To monitor regional recovery, percent systolic shortening was
      measured. To evaluate long-term effectiveness, 12 additional sheep underwent
      creation of an infarct. Six were treated with the laser, and six were untreated.
      The animals were restudied 30 days later. RESULTS: In the short-term experiment,
      the control and reperfusion groups exhibited no recovery of regional
      contractility. The laser group demonstrated improvement throughout the recovery
      period. There was a significant difference in the area of necrosis within the
      same area at risk (reperfusion group 44 +/- 6% and control group 39 +/- 5% vs.
      laser group 6 +/- 2%). After 30 days, none of the control animals showed evidence
      of contraction in the infarct, whereas the laser-treated animals did. Histologic
      analysis of the laser-treated infarcts revealed patent channels surrounded by
      viable myocardium. The control-group infarcts were necrotic and scarred.
      CONCLUSIONS: On the basis of both short- and long-term improved contractility, as
      well as diminished necrosis in the area at risk, these results indicate that
      transmyocardial laser revascularization may be an alternative method of treating
      ischemic heart disease.

PMID- 7798514
TI  - Doppler evaluation of severity of mitral regurgitation: relation to pulmonary
      venous blood flow patterns in an animal study.
AB  - OBJECTIVES: This study examined the influence of regurgitant volume on pulmonary
      venous blood flow patterns in an animal model with quantifiable mitral
      regurgitation. BACKGROUND: Systolic pulmonary venous blood flow is influenced by
      atrial filling and compliance and ventricular output and by the presence of
      mitral regurgitation. The quantitative severity of the regurgitant volume itself
      is difficult to judge in clinical examinations. METHODS: Six sheep with chronic
      mitral regurgitation produced by previous operation to create chordal damage were
      examined. At reoperation the heart was exposed and epicardial echocardiography
      performed. Pulmonary venous blood flow waveforms were recorded by pulsed Doppler
      under color flow Doppler guidance using a Vingmed 750 scanner. The pulmonary
      venous systolic inflow to the left atrium was expressed as a fraction of the
      total inflow velocity time integral. Flows across the aortic and mitral valves
      were recorded by electromagnetic flowmeters balanced against each other.
      Pressures in the left ventricle and left atrium were measured directly with high
      fidelity manometer-tipped catheters. Preload and afterload were systematically
      manipulated, resulting in 24 stable hemodynamic states. RESULTS: Simple
      logarithmic correlation between the regurgitant volume and size of a positive or
      negative pulmonary venous inflow velocity time integral during systole was good
      (r = -0.841). By stepwise linear regression analysis with pulmonary venous
      negative systolic velocity time integral as a dependent variable compared with
      the regurgitant volume, fractional shortening, left atrial v wave size, systemic
      vascular resistance and left ventricular systolic pressure, only contributions
      from v wave size and regurgitant volume (r = 0.80) reached statistical
      significance in determining pulmonary venous negative systolic flow. CONCLUSIONS:
      Evaluation of systolic pulmonary venous blood flow velocity time integral can
      give valuable information helpful for estimating the regurgitant volume secondary
      to mitral regurgitation.

PMID- 7798516
TI  - Academic subspecialties at the crossroad.

PMID- 7798515
TI  - Potentiation of endogenous nitric oxide with superoxide dismutase inhibits
      platelet-mediated thrombosis in injured and stenotic arteries.
AB  - OBJECTIVES: We tested the hypothesis that dismutation of superoxide anion
      increases endogenous levels of nitric oxide, resulting in inhibition of cyclic
      variations in blood flow in arteries that are injured and stenotic. BACKGROUND:
      Platelet adhesion and aggregation leading to cyclic flow variations might result,
      in part, from generation of superoxide anion that can deplete endogenously
      produced nitric oxide. METHODS: Spontaneous cyclic flow variations, monitored
      with a proximal Doppler probe, were induced in the carotid artery of anesthetized
      rabbits by clamping the vessel with forceps and placing a high grade stenosis at
      the site of injury. Bovine copper/zinc superoxide dismutase (12 mg/kg body
      weight, n = 5), a synthetic low molecular weight mimetic (12 mg/kg, n = 8) or
      buffer vehicle (n = 8) was administered intravenously as divided boluses over 45
      min, and the frequency of cyclic flow variations was monitored for 4 h. RESULTS:
      Cyclic flow variations remained stable for 4 h in vehicle-treated animals (15 +/-
      1 [mean +/- SEM]/30 min at baseline and 16 +/- 1/30 min after 4 h, n = 8) but
      exhibited a marked and persistent reduction in animals given copper/zinc
      superoxide dismutase (from 14 +/- 1/30 min at baseline to 4 +/- 1/30 min after 4
      h) or the mimetic (from 15 +/- 1/30 min at baseline to 3 +/- 1/30 min after 4 h,
      p < 0.005). They were restored in three of four mimetic-treated animals during
      infusion of NG-monomethyl- L-arginine (100 mg/kg), an inhibitor of nitric oxide
      production. In addition, levels of cyclic guanosine 5'-monophosphate in platelets
      were elevated after administration of the mimetic (from 2.4 +/- 0.5 fmol/10(6)
      platelets at baseline to 4.9 +/- 0.6 fmol/10(6) platelets 45 min after the
      mimetic, p < 0.03, n = 6), whereas mean arterial blood pressure was decreased and
      flow velocity in the carotid artery was increased consistent with mediation of
      the effect on cyclic flow variations by increased endogenous nitric oxide.
      CONCLUSIONS: Dismutation of superoxide anion appears to attenuate platelet
      thrombus formation at a site of vessel injury by potentiation of endogenously
      produced nitric oxide. This approach may have utility to inhibit platelet-rich
      thrombosis in injured and stenotic arteries where production of superoxide anion
      is increased.

PMID- 7798517
TI  - President's page: work force issues in cardiology.

PMID- 7798518
TI  - Exercise echocardiography.

PMID- 7798520
TI  - Guidelines for training in adult cardiovascular medicine. Core Cardiology
      Training Symposium (COCATS). Task Force 9: training in the care of adult patients
      with congenital heart disease.

PMID- 7798519
TI  - Guidelines for training in adult cardiovascular medicine. Core Cardiology
      Training Symposium (COCATS). Task Force 8: training in heart failure and
      transplantation.

PMID- 7798521
TI  - Guidelines for training in adult cardiovascular medicine. Core Cardiology
      Training Symposium (COCATS). Task Force 10: training in preventive cardiovascular
      medicine.

PMID- 7798522
TI  - Advance directives: do they work?
AB  - Advance directives have been widely endorsed, and empiric work has taken place
      that can aid clinicians in the appropriate use of validated documents. This
      report reviews philosophic and methodologic issues and offers practical
      illustrations. Despite the evidence that advance directives can work, there are
      serious barriers to their actual use. Therefore, these barriers are evaluated and
      potential solutions suggested.

PMID- 7798523
TI  - Modulation of atrioventricular conduction by ablation of the "slow"
      atrioventricular node pathway in patients with drug-refractory atrial
      fibrillation or flutter.
AB  - OBJECTIVES: We hypothesized that modulation of atrioventricular (AV) node
      conduction, allowing a reduction in ventricular rate during atrial fibrillation
      or flutter without affecting AV conduction during sinus rhythm, might be achieved
      through ablation of the "slow" AV node pathway. BACKGROUND: In patients with
      atrial fibrillation or flutter not amenable to a direct atrial approach, ablation
      of the His bundle is performed to induce complete AV block. This procedure causes
      pacemaker dependence. METHODS: Fourteen patients with drug-refractory paroxysmal
      atrial flutter or fibrillation underwent ablation of the slow AV node pathway.
      Radiofrequency current was delivered in six patients during sinus rhythm, in six
      during atrial flutter and in two during atrial fibrillation. RESULTS: The
      anterograde effective refractory period of the AV node was prolonged from 270 +/-
      50 (mean +/- SD) to 390 +/- 87 ms (p = 0.005) and the Wenckebach cycle from 346
      +/- 33 to 458 +/- 75 ms (p = 0.004) in six patients during sinus rhythm. Mean AV
      ratio increased from 1.6 +/- 0.5 to 3.0 +/- 0.6 (p = 0.02) in six patients with
      atrial flutter. Mean ventricular rate decreased from 157 +/- 38 to 67 +/- 10
      beats/min in two patients with atrial fibrillation. Complete AV block was induced
      in two patients (transient in one, permanent in one). During a follow-up period
      of 5.8 +/- 3.5 months, 11 patients experienced a recurrence of atrial
      fibrillation at 60 to 95 beats/min. No patient had progression to any degree of
      AV block. CONCLUSIONS: Ablation of the slow AV node pathway allows reduction of
      ventricular rate during atrial fibrillation or flutter while maintaining intact
      AV conduction during sinus rhythm. Modulation of AV node conduction is effective
      in most patients as an alternative to His bundle ablation for control of
      ventricular rate in paroxysmal atrial fibrillation or flutter.

PMID- 7798524
TI  - Guidelines for training in adult cardiovascular medicine. Core Cardiology
      Training Symposium (COCATS). Task Force 1: training in clinical cardiology.

PMID- 7798525
TI  - Characterization of return cycle responses predictive of successful pacing
      mediated termination of ventricular tachycardia.
AB  - OBJECTIVES: The purpose of this study was to characterize response patterns
      during overdrive pacing that predict successful termination of ventricular
      tachycardia. BACKGROUND: Overdrive pacing during ventricular tachycardia
      typically results in entrainment at slow pacing rates and in termination or
      acceleration at faster rates. The factors that determine the critical paced cycle
      length that results in tachycardia termination have not been extensively studied.
      METHODS: Ventricular tachycardias in 14 patients with coronary artery disease
      were studied with overdrive pacing at several cycle lengths. Return cycles were
      measured after each additional paced beat at each paced cycle length. The return
      cycle responses during pacing trials that resulted in tachycardia termination and
      those that resulted in entrainment were compared. RESULTS: Three return cycle
      responses were identified: flat, plateau and increasing. Twenty trials of
      overdrive pacing resulted in tachycardia termination; all were characterized by
      an increase in the return cycle with the delivery of each successive beat in the
      pacing drive until the tachycardia terminated (increasing response). Thirty-four
      pacing trials resulted in entrainment and not termination; these were
      characterized either by a constant return cycle (flat response) or an initial
      increase in return cycle followed by a longer, constant return cycle (plateau
      response) with the delivery of additional paced beats. The longest paced cycle
      length that resulted in tachycardia termination correlated with the relative
      refractory period of the circuit, defined as the tachycardia cycle length minus
      the fully excitable gap (r2 = 0.764, p = 0.0001). Tachycardia termination was not
      observed unless the paced cycle length was shorter than the relative refractory
      period of the circuit. CONCLUSIONS: The critical paced cycle length that causes
      termination of ventricular tachycardia depends on the relative refractory period
      of the circuit because this factor determines whether the nth + 1 beat of the
      pacing drive will encounter partially recovered tissue. These data provide
      insights into the mechanism of pacing-mediated tachycardia termination and
      entrainment and are applicable to the development of improved antitachycardia
      pacing algorithms.

PMID- 7798526
TI  - Long-term outcome of verapamil-sensitive sustained left ventricular tachycardia
      in patients without structural heart disease.
AB  - OBJECTIVES: This study attempted to determine the long-term outcome of verapamil
      sensitive sustained left ventricular tachycardia in patients without apparent
      structural heart disease. BACKGROUND: Several types of idiopathic ventricular
      tachycardia have been reported, and their clinical, electrophysiologic and
      electropharmacologic characteristics are different. It is possible that the
      prognosis of each type of ventricular tachycardia might also be different.
      METHODS: We studied mortality and morbidity in 37 consecutive patients (27 male,
      10 female; mean [+/- SD] age 33 +/- 14 years) with verapamil-sensitive sustained
      left ventricular tachycardia who had no apparent structural heart disease.
      Patients were followed up for 1 to 13 years (mean 5.8). Verapamil repeatedly
      terminated ventricular tachycardia in all patients. Ventricular tachycardia
      originated from the inferior and inferoseptal regions of the left ventricle in 33
      patients and the superior and superioseptal regions in 4. Severity of ventricular
      tachycardia was classified according to the extent to which symptoms limited
      daily activities. Ventricular tachycardia was mild (minimal limitation) in 14
      patients, moderate (some limitation) in 17 and severe (severe limitation) in 6.
      RESULTS: Fourteen patients with mild ventricular tachycardia were followed up
      without any drug therapy, and the ventricular tachycardia remained mild in all
      patients. Antiarrhythmic therapy was initiated empirically in the 23 patients
      with moderate and severe ventricular tachycardia (verapamil in 20, propranolol in
      2, digoxin in 1). Moderate ventricular tachycardia became mild ventricular
      tachycardia after drug therapy in all patients, but the six patients with severe
      ventricular tachycardia showed no improvement. The six patients with severe
      ventricular tachycardia had nonpharmacologic therapy (cryosurgery in one,
      catheter ablation in four, antitachycardia pacing device in one). During the
      follow-up period, all patients remained alive except for one who died suddenly
      after implantation of an antitachycardia pacing device. CONCLUSIONS: 1) The long
      term prognosis of verapamil-sensitive sustained left ventricular tachycardia in
      patients without apparent structural heart disease is good. 2) Verapamil is the
      drug of choice for alleviating symptoms, but nonpharmacologic therapy is
      necessary in some patients.

PMID- 7798527
TI  - A new form of long QT syndrome associated with syndactyly.
AB  - OBJECTIVES: The purpose of this study was to characterize a possible association
      between long QT syndrome and syndactyly. BACKGROUND: Long QT syndrome causes
      syncope and sudden death from ventricular arrhythmias. Syndactyly is a
      developmental disorder that causes webbing of the hands and feet. Both disorders
      can be inherited as isolated, autosomal dominant traits, but an association
      between them has not been established. METHODS: We identified three children with
      long QT syndrome, atrioventricular (AV) block and simple syndactyly. Phenotypic
      and laboratory data were obtained from families, attending physicians and medical
      records. RESULTS: All patients had bilateral cutaneous syndactyly and were
      diagnosed with long QT syndrome within the 1st 2 years of life. Structural heart
      disease, particularly a patent ductus arteriosus, was present in all three
      patients. Analysis of electrocardiograms showed marked prolongation of the QT
      intervals with rate-corrected QT intervals of 633, 628 and 680 ms, respectively.
      Transient AV block was also noted. Two of the three children died suddenly
      despite treatment with beta-adrenergic blocking agents and permanent pacing.
      CONCLUSIONS: We postulate that these children have a new form of long QT syndrome
      associated with syndactyly and a high risk of sudden death. The association of
      syndactyly with long QT syndrome may provide insight into the mechanisms
      underlying both disorders. Patients with syndactyly should be evaluated for the
      presence of long QT syndrome, and if it is found, aggressive treatment may be
      warranted.

PMID- 7798528
TI  - Limitations of head-up tilt test for evaluating the efficacy of therapeutic
      interventions in patients with vasovagal syncope: results of a controlled study
      of etilefrine versus placebo.
AB  - OBJECTIVES: This study assessed the efficacy of oral etilefrine (10 mg three
      times a day) in preventing a positive response to head-up tilt testing.
      BACKGROUND: Previous reports have suggested that oral etilefrine can be effective
      either in preventing a positive response to head-up tilt testing or in reducing
      syncopal recurrences in patients with vasovagal syncope. Up to now most studies
      assessing drug therapy in these patients have been uncontrolled. METHODS: This
      was a randomized double-blind crossover study of etilefrine versus placebo in 30
      consecutive patients with syncope and a baseline positive head-up tilt test.
      After the first test, patients had no treatment for 3 days and were randomized to
      receive etilefrine or placebo for 4 additional days. They underwent tilt testing
      under treatment and again after 3 days of washout; they then received the
      alternative treatment for 4 days, and a third test was performed. RESULTS: Head
      up tilt test results were negative in 13 (43%) patients with etilefrine and 15
      (50%) with placebo (p = NS). Therefore, the statistical power of the study was
      only 10%. The rate of positive responses decreased with repeated testing
      irrespective of the assigned treatment: A positive response was obtained during
      the second head-up tilt test in 20 patients (10 with placebo, 10 with etilefrine)
      but in only 12 during the third (7 with etilefrine, 5 with placebo) (p < 0.05).
      CONCLUSIONS: Oral etilefrine (10 mg three times a day) was not superior to
      placebo in preventing a positive response to head-up tilt testing. Despite a low
      statistical power, the high rate of negative response with placebo (50%) suggests
      that controlled trials are needed to assess the real efficacy of any treatment in
      patients with vasovagal syncope.

PMID- 7798529
TI  - Characterization of subcutaneous microvascular blood flow during tilt table
      induced neurally mediated syncope.
AB  - OBJECTIVES: This study aimed to characterize subcutaneous blood flow changes
      during neurally mediated syncope and to determine whether microvasculature
      oscillation (vasomotion) is characteristically altered in conjunction with
      syncopal events. BACKGROUND: Marked pallor is commonly associated with neurally
      mediated syncope. However, little attention has been paid to the evaluation of
      subcutaneous blood flow and vasomotion in this setting. METHODS: This study
      utilized laser Doppler flowmetry to assess changes in subcutaneous microvascular
      blood flow during head-up tilt table testing in 13 patients with syncope and 6
      control subjects. Blood flow and vasomotion frequency were measured continuously
      before, during and after completion of 80 degrees head-up tilt testing (< or = 25
      min duration). RESULTS: Among the 13 patients with syncope, tilt testing
      reproduced syncopal symptoms in 9 (tilt-positive group) but not in 4 (tilt
      negative group). None of the six control subjects developed symptoms during
      testing. Baseline mean subcutaneous blood flow did not differ significantly among
      the three groups. However, during upright tilt, blood flow gradually diminished
      in the tilt-positive group, reaching a nadir of 0.8 +/- 0.33 ml/min per 100 g of
      tissue (mean +/- SD), but remained relatively constant in the tilt-negative group
      and control subjects. The difference in mean blood flow response to tilt was
      statistically significant when the tilt-positive group was compared with either
      the tilt-negative group or control subjects (p < 0.001). Similarly, baseline
      blood flow oscillation frequency did not differ significantly in the three
      subgroups (tilt-positive group 0.2 +/- 0.11 Hz; tilt-negative group 0.2 +/- 0.02
      Hz; control subjects 0.2 +/- 0.11 Hz). Subsequently, during tilt testing only the
      tilt-positive group exhibited increased oscillation frequency; oscillation
      frequency remained essentially constant throughout the tilt test in the tilt
      negative group and control subjects (p < 0.001, tilt-positive group vs. either
      the tilt-negative group or control subjects). CONCLUSIONS: These findings
      document an expected diminution of subcutaneous blood flow in association with
      neurally mediated syncope and indicate that characteristic changes in
      microvasculature oscillation frequency occur in conjunction with syncopal
      symptoms. To the extent that microvasculature vasomotion is influenced by neural
      control, the changes in vasomotion frequency are consistent with relative
      diminution of peripheral sympathetic neural influence during neurally mediated
      syncopal episodes.

PMID- 7798530
TI  - Influence of age and gender on the presence of coronary calcium detected by
      ultrafast computed tomography.
AB  - OBJECTIVES: This study sought to determine the relation between coronary
      calcification detected with ultrafast computed tomography and lumen narrowing
      defined with angiography and evaluated whether this relation is influenced by age
      and gender. BACKGROUND: Ultrafast computed tomography has been shown to be a
      sensitive method for detection of coronary calcification associated with
      atherosclerotic disease, but the relation between the extent of coronary
      calcification and degree of lumen narrowing and the possible influence of gender
      or age, or both, on this relation have not been clarified. METHODS: Seventy men
      and 70 women were studied with ultrafast computed tomography for analysis of
      coronary calcification and coronary angiography. Coronary atherosclerosis was
      considered present if any lumen irregularity was noted on angiography, and
      obstructive coronary artery disease was defined as a lumen diameter narrowing >
      or = 70%. RESULTS: Coronary calcification had a sensitivity of 88% for
      identification of patients with atherosclerotic disease and 97% for those with
      obstructive disease, with corresponding specificities of 55% and 41%,
      respectively. The sensitivity of coronary calcium for detection of
      atherosclerotic disease in women < 60 years old was 50%, significantly less than
      the 97% sensitivity in women > 60 years old and the 87% sensitivity in men < 60
      years old (p < 0.05 for each comparison). Logistic regression analysis revealed a
      1.81-fold increase in the likelihood of detecting coronary calcification in the
      atherosclerotic lesions of men compared with those in women (95% confidence
      interval 1.12 to 2.93, p = 0.016) when controlled for age and severity of
      coronary disease by angiography. CONCLUSIONS: Atherosclerotic lesions in women
      are less likely to have coronary calcium than lesions with a similar degree of
      lumen narrowing in men. Differences in the pattern of coronary calcification
      between men and women may provide insight into the gender differences observed in
      the clinical development of symptomatic coronary artery disease.

PMID- 7798532
TI  - Influence of left ventricular hypertrophy on left ventricular function during
      dynamic exercise in the presence or absence of coronary artery disease.
AB  - OBJECTIVES: We investigated the influence of left ventricular hypertrophy in the
      presence or absence of coronary artery disease on hemodynamic characteristics
      during exercise in subjects without previous myocardial infarction. BACKGROUND:
      Left ventricular hypertrophy has been found to increase the vulnerability of the
      myocardium to the development of ischemia. However, the independent influences of
      left ventricular hypertrophy and coronary artery disease have not been assessed
      in humans. METHODS: Symptom-limited supine leg exercise tests were performed by
      78 patients. They were classified into the following subgroups: no coronary
      artery disease or left ventricular hypertrophy (group I, n = 30), left
      ventricular hypertrophy only (group II, n = 12), coronary artery disease only
      (group III, n = 20) and both left ventricular hypertrophy and coronary artery
      disease (group IV, n = 16). Mean left ventricular mass index was 105, 158, 109
      and 159 g/m2 in groups I to IV, respectively. RESULTS: Pulmonary artery wedge
      pressure increased from 6 +/- 3 (mean +/- SD) mm Hg at rest to 10 +/- 5 mm Hg at
      peak exercise in group I, from 8 +/- 2 to 18 +/- 8 mm Hg in group II (p < 0.05
      vs. group I), from 6 +/- 3 to 23 +/- 6 mm Hg in group III (p < 0.01 vs. group I)
      and from 8 +/- 4 to 30 +/- 7 mm Hg in group IV (p < 0.01 vs. group I; p < 0.01
      vs. group II; p < 0.05 vs. group III). Multiple regression analysis showed that
      the number of diseased coronary vessels and left ventricular mass index were
      independent predictors of peak pulmonary artery wedge pressure (F = 59.2 and
      19.1, respectively; multiple correlation coefficient r = 0.74, p < 0.0001).
      CONCLUSIONS: Left ventricular hypertrophy and coronary artery disease
      independently increased left ventricular filling pressure during supine leg
      exercise. Severe left ventricular dysfunction was induced by exercise when both
      conditions were present.

PMID- 7798531
TI  - Association of carotid atherosclerosis and left ventricular hypertrophy.
AB  - OBJECTIVES: This study was undertaken to determine the prevalence of carotid
      atherosclerosis in a large group of asymptomatic hypertensive and normotensive
      adults and to examine its relation to the presence of left ventricular
      hypertrophy. BACKGROUND: Both electrocardiographic and echocardiographic left
      ventricular hypertrophy predict an increased risk of cardiovascular events and
      mortality, including cerebrovascular disease, but the mechanism of association is
      unknown. METHODS: Four hundred eighty-six (277 normotensive and 209 untreated
      hypertensive) adults, free of clinical evidence of cardiovascular disease, were
      studied prospectively with echocardiography to determine left ventricular mass
      and carotid ultrasound to detect atherosclerosis and to measure common carotid
      artery dimensions. RESULTS: Carotid atherosclerosis was present in 16% of
      normotensive and 23% of hypertensive participants (p < 0.05) and was associated
      with older age, higher systolic and pulse pressures and larger left ventricular
      mass index ([mean +/- SD] 91 +/- 19 vs. 82 +/- 18 g/m2, p < 0.0001). The
      difference in mass persisted after adjustment for baseline differences in age and
      blood pressure. Subjects with left ventricular hypertrophy were twice as likely
      to have carotid atheromas (35% vs. 18%, p < 0.01). Logistic regression analyses,
      including standard risk factors, indicated that only age and left ventricular
      mass index independently predicted the presence of carotid plaque, both in the
      entire study group and when normotensive and hypertensive subjects were
      considered separately. CONCLUSIONS: We believe that the present study provides
      the first evidence that higher left ventricular mass as detected by
      echocardiography is associated with the presence of carotid plaque. The
      association between cardiac hypertrophy and systemic atherosclerosis may
      contribute to the pathogenesis of the high incidence of vascular events that is
      well documented in patients with left ventricular hypertrophy.

PMID- 7798533
TI  - Adenosine pharmacologic stress myocardial perfusion tomographic imaging in
      patients with significant aortic stenosis. Diagnostic efficacy and comparison of
      clinical, hemodynamic and electrocardiographic variables with 100 age-matched
      control subjects.
AB  - OBJECTIVES: This study assessed the safety and diagnostic accuracy of adenosine
      stress myocardial perfusion scintigraphy for the detection of coronary artery
      disease using single-photon emission computed tomography (SPECT) in patients with
      significant aortic stenosis. BACKGROUND: Exercise cardiac stress testing in
      patients with significant aortic stenosis is generally avoided because of
      concerns for safety. In addition, those studies that have analyzed the utility of
      exercise testing both with and without myocardial thallium-201 scintigraphy for
      the diagnosis of coronary artery disease have yielded low specificity. Currently,
      no safe and accurate means exists to noninvasively assess the presence, extent
      and severity of coronary artery disease in patients with significant aortic
      stenosis. METHODS: The study included 35 patients with moderate to severe aortic
      stenosis (mean [+/- SD] aortic valve area 0.84 +/- 0.16 cm2, range 0.5 to 1.2;
      mean maximal instantaneous aortic valve gradient 44.4 +/- 15.9 mm Hg, range 20 to
      84). All patients underwent a 6-min adenosine infusion (140 micrograms/kg body
      weight per min) protocol and either separate acquisition rest thallium-201/stress
      technetium-99m sestamibi or stress and 4-h redistribution thallium-201 SPECT:
      Visual 20-segment SPECT analysis used a standard five-point scoring system from 0
      (normal tracer uptake) to 4 (absent uptake). The SPECT results were considered
      abnormal if more than two segments had a stress score > or = 2. Hemodynamic,
      electrocardiographic and clinical responses were compared with those in a
      reference group of 100 consecutive age-matched patients undergoing adenosine
      SPECT who did not have aortic stenosis. RESULTS: Hemodynamic responses during
      adenosine stress testing between the study and control patients demonstrated no
      significant difference in the net change in systolic blood pressure (18% of
      baseline vs. 14%, patients with aortic stenosis vs. control subjects), heart rate
      (21% vs. 19%), rate-pressure product (0% vs. 2%) or incidence of chest pain (23%
      vs. 35%) or transient second-(9% vs. 9%) or third-degree atrioventricular block
      (3% vs. 1%). In the 20 patients who had coronary angiography, sensitivity for
      detection of coronary artery disease was 92% (12 of 13) and specificity was 71%
      (5 of 7). CONCLUSIONS: In this preliminary study, adenosine was found to be well
      tolerated and diagnostically accurate in patients with moderate to severe aortic
      stenosis.

PMID- 7798534
TI  - Immunochemical analysis of sulfonamide drug allergy: identification of
      sulfamethoxazole-substituted human serum proteins.
AB  - BACKGROUND: Sulfonamides undergo oxidative metabolism to yield reactive
      metabolites that haptenate proteins readily. Although it has been shown that
      sulfonamide metabolites bind covalently to murine microsomes, sulfonamide
      conjugated serum proteins have not been analyzed in the peripheral blood of
      treated individuals. OBJECTIVE: We hypothesized that during treatment with
      sulfamethoxazole, intracellular proteins are haptenated by drug metabolites, and
      some of these are destined for secretion into the serum. METHODS: Using
      antibodies specific for sulfamethoxazole and an alkaline phosphatase
      immunoblotting technique, we attempted to demonstrate the presence of
      sulfamethoxazole-substituted proteins in the serum of individuals during a course
      of treatment. RESULTS: Five days into therapy, serum protein haptenation by
      sulfamethoxazole was demonstrated in two of the three individuals studied. In
      addition, Western blot analysis revealed that haptenation is not indiscriminate,
      but highly selective. A single 30 kd protein is the target of haptenation in all
      instances. A kinetic analysis revealed that substituted proteins can be detected
      early, within hours of administration. Moreover, haptenated proteins remain
      detectable in the serum 48 hours after discontinuation of the drug. CONCLUSION:
      The results presented here constitute the first direct evidence that
      sulfonamides, on being metabolized, covalently haptenate human serum proteins
      during a course of therapy.

PMID- 7798535
TI  - Effect of inhaled beclomethasone dipropionate on expression of proinflammatory
      cytokines and activated eosinophils in the bronchial epithelium of patients with
      mild asthma.
AB  - Increasing evidence suggests that cytokines play a role in airway inflammation by
      attracting and activating inflammatory cells. This may lead to epithelial cell
      damage and airway hyperresponsiveness. Bronchial provocative concentration of
      histamine causing a 20% fall in forced expiratory volume in 1 second was measured
      in patients with mild asthma, and bronchial biopsy specimens were stained for
      granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-8,
      and activated eosinophils (EG2) in the bronchial epithelium. The effect of
      inhaled beclomethasone dipropionate was also assessed in a placebo-controlled
      double-blind manner. There was a correlation between GM-CSF expression and EG2
      staining cells (r = 0.484 p < 0.05) in the epithelium. Provocative concentration
      of histamine causing a 20% fall in forced expiratory volume in 1 second was
      correlated with GM-CSF expression (r = -0.462, p < 0.05). Treatment with inhaled
      beclomethasone dipropionate 500 micrograms twice a day led to a significant
      decrease in both the expression of GM-CSF (p < 0.01) and IL-8 (p < 0.02) and the
      number of EG2-staining cells (p < 0.01) in the epithelium. The changes in GM-CSF
      (r = 0.798, p < 0.01) and IL-8 (r = 0.653, p < 0.02) expression were correlated
      with the changes in EG2-staining cells after treatment. These results suggest
      that GM-CSF may influence eosinophil activation in the epithelium in vivo and
      participate in the etiology of bronchial hyperresponsiveness in mild asthma.
      Also, beclomethasone dipropionate may inhibit eosinophil activation partly by
      downregulating the expression of GM-CSF and IL-8 in the bronchial epithelium.

PMID- 7798536
TI  - The human nasal response to capsaicin.
AB  - Airway sensory nerves play a role in reactions to inhaled allergens, irritants,
      and physical stimuli. Capsaicin, the pungent principle of hot peppers, stimulates
      a subcategory of sensory nerves. To study the consequences of selective
      activation of airway sensory nerves in the human nose, we administered capsaicin
      nasal challenges to eight volunteers (four normal subjects and four subjects with
      perennial allergic rhinitis). Capsaicin (20 mumol/L), when sprayed into the nose,
      induced burning, rhinorrhea, and lacrimation. Capsaicin also induced a
      significant increase in total protein content of nasal lavage fluid after
      challenge compared with vehicle (increase from before challenge to 1 minute after
      challenge, 172 +/- 55 vs 46 +/- 29 micrograms/ml, p < 0.001). In contrast to many
      animal studies, capsaicin did not increase vascular permeability in the airway,
      because albumin content of nasal lavage fluid was not increased (p = 0.86). On
      the other hand, lactoferrin, a marker of glandular secretion, was increased (p <
      0.005). Repetitive capsaicin challenge every 10 minutes led to tachyphylaxis of
      symptoms, total protein secretion, and lactoferrin secretion. Compared with
      vehicle, unilateral capsaicin (6 mmol/L) disk challenge induced significant
      secretion both ipsilateral (21.3 +/- 4.2 vs 4.9 +/- 2.1 mg, p < 0.01) and
      contralateral (18.2 +/- 4.4 vs 7.4 +/- 1.9 mg, p < 0.04) to challenge. Thus we
      have shown that capsaicin challenge to the human nose leads to airway sensory
      nerve activation. Further, we have demonstrated that capsaicin stimulates a
      predominantly central neuronal response and that the induced secretory response
      is of glandular rather than vascular origin.

PMID- 7798538
TI  - Increased levels of soluble serum interleukin-2 receptor in extrinsic allergic
      alveolitis correlate with interleukin-2 receptor expression on alveolar
      macrophages.
AB  - In a group of 20 patients with extrinsic allergic alveolitis (10 with farmer's
      lung, 9 with bird-breeder's lung, and 1 with humidifier's lung), we observed
      increased levels of soluble serum interleukin-2 receptor (ssIL-2R) with an
      average of 75.2 pmol (control group average, 40.6 pmol). Analysis of
      bronchoalveolar lavage cells by immunocytochemistry with a CD25 antibody revealed
      only a slight increase to 4.2% IL-2R+ cells among alveolar lymphocytes but a
      pronounced rise to 21.2% IL-2R+ cells among alveolar macrophages. Furthermore,
      cytometry revealed a fourfold higher IL-2R expression on a per cell basis for
      alveolar macrophages as compared with alveolar lymphocytes. A clear-cut positive
      correlation (p = 0.006) was found for ssIL-2R and IL-2R+ alveolar macrophages,
      but only a borderline correlation was found for ssIL-2R and IL-2R+ alveolar
      lymphocytes (p = 0.04). The finding of a concomitant decrease of IL-2R+ alveolar
      macrophages and of ssIL-2R on allergen avoidance further supports the notion that
      alveolar macrophages may be the main source of the increased ssIL-2R in patients
      with extrinsic allergic alveolitis.

PMID- 7798537
TI  - Direct evidence for a role of the mast cell in the nasal response to aspirin in
      aspirin-sensitive asthma.
AB  - BACKGROUND: A subset of patients with asthma experience adverse nasoocular
      reactions after ingestion of aspirin or agents that inhibit cyclooxygenase.
      Recent evidence has implicated the leukotrienes in the nasoocular reaction, but
      the cellular sources and mechanism of activation are unknown. We used nasal
      lavage with and without a 5-lipoxygenase inhibitor, zileuton, to define the role
      of leukotrienes and to profile nasal cellular activation during this reaction.
      METHODS: A group of eight patients with asthma shown to have adverse reactions to
      aspirin documented by a 15% or greater decrease in forced expiratory volume in 1
      second, accompanied by an elevation in urinary leukotriene E4 after ingestion of
      aspirin, received aspirin or placebo in a study with a crossover design. Nasal
      symptoms and nasal tryptase, histamine, leukotriene, and eosinophil cationic
      protein levels were evaluated. Serum tryptase and urinary histamine levels were
      also assessed. Subjects were then randomized to receive a week of treatment with
      zileuton or placebo, according to a double-blind, crossover design followed by
      aspirin challenge and measurement of the same mediators. RESULTS: Aspirin
      ingestion produced a marked increase in nasal symptoms from a baseline symptom
      score of 2.1 +/- 0.7 to a maximum of 8.4 +/- 1.2 (p < 0.0007). Aspirin ingestion
      produced a mean maximal increase in nasal tryptase of 3.5 +/- 2.6 ng/ml, whereas
      placebo ingestion produced a mean maximal increase of 0.1 +/- 0.2 ng/ml (p <
      0.05, aspirin vs placebo). Mean maximal nasal histamine increased 1.73 +/- 1.16
      ng/ml versus 0.08 +/- 0.08 ng/ml from baseline (p < 0.05, aspirin vs placebo).
      Aspirin produced a mean maximal increase in nasal leukotriene value of 152 pg/ml
      versus a 16 pg/ml decrease after placebo ingestion (p < 0.05). Zileuton treatment
      blocked the increase in nasal symptoms after aspirin ingestion (maximum nasal
      symptom score of 1.6 +/- 0.6 with zileuton vs 5.5 +/- 0.9 with placebo [p <
      0.0053]). It also blocked the rise in nasal tryptase (p = 0.011) and nasal
      leukotriene (p < 0.05) levels after aspirin ingestion. Zileuton treatment had no
      significant effect on the recovery of nasal histamine. CONCLUSION: The increase
      in nasal symptoms in aspirin-sensitive patients with asthma after aspirin
      ingestion is associated with increases in nasal tryptase, histamine, and
      cysteinyl leukotriene levels. This mediator profile is consistent with mast cell
      activation during the nasal response to aspirin and suggests that 5-lipoxygenase
      products are essential for the nasal response to aspirin.

PMID- 7798539
TI  - Investigating severe and fatal asthma.
AB  - BACKGROUND: Severe asthma continues to present a major therapeutic problem
      despite advances in our understanding of the disease. Innovative ideas for
      investigating the underlying causes and treatment of severe asthma are few, and
      many patients still become dependent on oral steroids. We describe two separate
      studies: first, a prospective investigation measuring the responses of persons
      with severe asthma to an allergen-free environment; second, a retrospective
      analysis of factors associated with eight fatalities and one near fatality caused
      by asthma exacerbations. METHODS: In the prospective study 17 persons with severe
      asthma were admitted to a hospital clinical research unit containing an allergen
      free room for steroid dose reduction. Peak flow measurements, treatment
      requirements, and evidence of infection were followed up. In the retrospective
      study, the cases of nine patients who had been evaluated for asthma and who
      subsequently died during an asthma attack were reviewed; where possible allergen
      levels in their house dust and specific IgE antibodies to common indoor allergens
      were measured. RESULTS: Analysis of the patients in the prospective study
      revealed two categories of responses to steroid dose reduction: (1) asthmatic
      persons who either maintained or improved peak flow values on steroid reduction;
      these patients were predominantly allergic to indoor allergens; (2) asthmatic
      persons whose condition deteriorated; these patients were unable to tolerate
      reduction in steroid dose. The second group included persons with sensitization
      to fungal antigens who had asthmatic exacerbations in association with culture
      documented fungal colonization. The retrospective study revealed that in five of
      the eight fatalities caused by asthma, exposure to a relevant allergen had
      occurred at home before death. CONCLUSION: Some steroid-dependent persons with
      severe asthma are allergic to inhalant allergens and may benefit from avoiding
      allergens. In some cases there is no evidence that antigen exposure from diet,
      inhalants, fungal infections, or sinusitis is relevant to their disease. However,
      persons with severe asthma include individuals infected with and sensitized to
      fungal antigens. The results suggest that cases of severe asthma should be
      investigated to identify treatable causes.

PMID- 7798540
TI  - House dust mite allergen import into a naturally mite-free environment.

PMID- 7798541
TI  - Core content outline for clinical and laboratory immunology. AAAI Training
      Program Directors' Committee.

PMID- 7798542
TI  - Gene therapy in the treatment of disease.

PMID- 7798543
TI  - Relationships between total serum IgE, atopy, and smoking: a twenty-year follow
      up analysis.
AB  - BACKGROUND: A number of cross-sectional studies have demonstrated that higher
      levels of IgE are found in subjects who currently smoke cigarettes and/or who are
      atopic and that IgE levels decline with age. OBJECTIVE: This report examines the
      interactions among atopic status, smoking, and IgE with longitudinal data and
      methods. METHODS: Subjects were participants in the Tucson Epidemiological Study
      of Airways Obstructive Disease and were 6 years of age and older. Total serum IgE
      measures and allergen skin test results were obtained during three surveys
      spanning a period of up to 20 years. RESULTS: The results showed no significant
      gender differences between nonatopic nonsmoking subjects, who were considered the
      reference group. Nonatopic current smokers had IgE levels similar to those of the
      reference subjects initially, but IgE levels did not decline with age at the same
      rate as in the reference subjects, causing significant differences at older ages.
      There was a significant relationship between number of cigarettes smoked and IgE
      level. CONCLUSIONS: Atopy and smoking are both associated with elevated total
      serum IgE levels. Although the exact mechanism for elevated IgE levels in smokers
      is not known, the significant dose relationship is suggestive of a causal
      association.

PMID- 7798544
TI  - The role of eosinophils and eosinophil cationic protein in monitoring oral
      challenge tests in children with food-sensitive atopic dermatitis.
AB  - To investigate the role of peripheral blood eosinophils and eosinophil cationic
      protein as parameters in monitoring oral food challenges, we monitored 25 infants
      and children with atopic dermatitis for up to 48 hours after 47 placebo
      controlled oral food challenges with cow's milk, hen's egg, cow's milk and hen's
      egg, or placebo for up to 48 hours. Six healthy young nonatopic adult volunteers
      served as control subjects. Compared with baseline values, peripheral blood
      eosinophils decreased significantly immediately after clinical reaction in
      positive challenges (p < 0.0004), independent of the kind of reaction. Eosinophil
      cationic protein increased significantly 8 hours after provocation, with a
      maximum at 24 hours (p < 0.03). This increase was predominantly related to
      eczematous reactions (p < 0.005). Blood sampling immediately after clinical
      reaction (for eosinophils) and at 24 hours (for eosinophil cationic protein)
      seems to be useful in monitoring oral food challenges in children with atopic
      dermatitis.

PMID- 7798545
TI  - A dose-ranging study of the efficacy and safety of azelastine nasal spray in the
      treatment of seasonal allergic rhinitis with an acute model.
AB  - BACKGROUND: Oral azelastine, a nonsteroidal antiinflammatory respiratory
      investigational drug has demonstrated activity in the treatment of allergic
      rhinitis and asthma with a good safety profile. METHODS: Azelastine nasal spray
      was compared with sustained-release oral chlorpheniramine maleate and placebo for
      efficacy and safety in the treatment of seasonal allergic rhinitis in a double
      dummy, two-center, 2-day, double-blind, randomized, dose-ranging, parallel
      groups, onset and duration of action study. Two hundred sixty-four subjects
      reported to an outdoor park on Saturday morning during the height of the fall
      pollen season and remained there for 8 hours that day and the next to ensure
      maximal exposure to seasonal aeroallergens. Symptom diary cards were collected
      hourly Saturday from 8:00 AM to 10:00 AM (baseline period). Subjects who had
      sufficient symptoms were randomized into five groups and received medication at
      10:00 AM and 10:00 PM on Saturday and at 10:00 AM on Sunday: azelastine 0.1% (1
      spray [0.12 mg] per nostril every 12 hours, 2 sprays per nostril every every 12
      hours, or 2 sprays per nostril once daily), Chlor-Trimeton Repetabs (12 mg twice
      daily), or placebo (twice daily). Diary cards were completed hourly (11:00 AM to
      4:00 PM) and at 6:00, 8:00, and 10:00 PM on Saturday and again hourly on Sunday
      (from 8:00 AM to 4:00 PM) to evaluate rhinitis symptoms and adverse events.
      RESULTS: Two hundred fifty-nine subjects completed the study. The groups that
      received 2 sprays of azelastine per nostril once and twice daily and the
      chlorpheniramine group had statistically significantly more improvement in total
      rhinitis symptoms than the placebo group without serious adverse events.
      CONCLUSIONS: This study supports a once to twice daily dosing regimen for 2
      sprays of 0.1% azelastine in the acute treatment of allergic rhinitis with onset
      of action within 2 to 3 hours.

PMID- 7798546
TI  - Total serum IgE and eosinophil count in children with and without a history of
      asthma, wheezing, or atopy in an urban community in Indonesia. The Respiratory
      Disease Working Group.
AB  - AIM: The objectives of the study were to assess total serum IgE and eosinophil
      count in a random sample of 20% of the children between 12 and 54 months old in a
      suburban community of Bandung, Indonesia, and to investigate a possible
      relationship between these values and atopy, asthma or wheezing and parasite
      infestation. METHODS: Two hundred sixty-nine children were examined at the
      Integrated Primary Health Care Unit, and the parents or guardians were
      interviewed with the use of a standardized questionnaire. RESULTS: The overall
      median value of IgE was 436 IU/ml (range, 18 to 9707 IU/ml); almost 94% of the
      children showed an IgE value of more than 100 IU/ml, and 29% showed a value of
      more than 1000 IU/ml. The median value for eosinophils was 580/mm3 (range, 70 to
      5090/mm3); only 31% of the children had less than 400 eosinophils/mm3. IgE levels
      and eosinophilia were not related to age but showed a significant, although not
      high, correlation with each other (p < 0.05). In about 36% of the children
      parasites were demonstrated in a single stool sample; in those subjects
      eosinophilia and IgE values tended to be greater, but the difference was not
      significant. About 7% of the children had asthma, and in those subjects the
      eosinophil counts and IgE levels were much more increased (p < 0.001 and p
      approximately 0.01, respectively). No difference was found in IgE or eosinophil
      count in relation to other forms of atopy in the child (milk-induced dermatitis,
      urticaria, eczema, rhinitis) or in relation to a history of asthma or atopy in
      other family members. Yet, the occurrence of asthma in the child was
      significantly related to a history of asthma in other family members.
      CONCLUSIONS: IgE values and eosinophilia are markedly increased in these children
      under 5 years of age in Bandung, Indonesia, and the highest values are found in
      the 7% with asthma.

PMID- 7798547
TI  - Characterization of Der p V allergen, cDNA analysis, and IgE-mediated reactivity
      to the recombinant protein.
AB  - A lambda gt11 library for cDNA from Dermatophagoides pteronyssinus was screened
      by plaque immunoassay, and a number of related clones that produced IgE-binding
      proteins were isolated. Their sequences were homologous to that of a cDNA
      described previously, which contained a reading frame encoding a 17 kd
      polypeptide and which as determined by serologic analysis corresponded to a
      protein with relative molecular mass of 14 kd in mite extracts. The cDNA from the
      lambda gt11 clones was truncated so it was used to obtain longer clones from a
      lambda gt10 library. Analysis of the sequence of these clones showed that the
      allergen now designated Der p V is produced from a 132-residue polypeptide, which
      has a putative 19-residue leader peptide and a 113-residue mature protein. This
      would have a molecular weight of 14 kd, corresponding to that found in mite
      extracts. IgE binding studies with the lambda gt11 clone and a fusion of the
      mature sequence in a pGEX construct showed that it reacted with 50% of allergic
      sera. Further studies with skin tests indicated that it caused reactions in about
      60% of patients with asthma and 29% of those with allergic rhinitis alone.

PMID- 7798549
TI  - The Role of Basophils and Eosinophils in Human Disease. Proceedings of a meeting.
      Cabo San Lucas, Mexico, March 10-13, 1994.

PMID- 7798548
TI  - Modulation by interleukin-4 of cytokine release from mononuclear phagocytes in
      asthma.
AB  - BACKGROUND: Interleukin (IL)-4 is involved in IgE upregulation and downregulates
      cytokine release by mononuclear phagocytes. Mononuclear cells release greater
      amounts of IL-1, tumor necrosis factor-alpha, and IL-6 in patients with asthma
      than in control subjects, but the effect of IL-4 on cells from patients with
      asthma is unknown. The effects of IL-4 on the release of IL-1, tumor necrosis
      factor-alpha, and IL-6 by monocytes and alveolar macrophages were compared in 19
      patients with asthma and 18 control subjects. METHODS: The release of IL-1, tumor
      necrosis factor-alpha, and IL-6 from unstimulated and lipopolysaccharide
      stimulated monocytes and alveolar macrophages was measured by ELISA. The effect
      of 30 U of IL-4 on the release of these cytokines was studied. RESULTS:
      Lipopolysaccharide-stimulated monocytes released significantly fewer cytokines in
      patients with asthma than in control subjects. IL-4 significantly inhibited
      cytokine release by monocytes of both groups. Unstimulated alveolar macrophages
      from patients with asthma released more cytokines than those of control subjects.
      Lipopolysaccharide induced a significantly greater increase in cytokine release
      in alveolar macrophages of control subjects in comparison with asthmatic
      subjects. IL-4 abolished the release of cytokines in alveolar macrophages from
      control subjects and had a minimal inhibitory effect on alveolar macrophages from
      patients with asthma. CONCLUSIONS: Alveolar macrophages from patients with asthma
      are hyperreactive but less prone to lipopolysaccharide stimulation and IL-4
      downregulation than those from normal subjects.

PMID- 7798550
TI  - Similarities in the ultrastructural morphology and developmental and secretory
      mechanisms of human basophils and eosinophils.

PMID- 7798551
TI  - Initial events in Fc epsilon RI signal transduction.
AB  - Our current model of the events that occur in the first few seconds after Fc
      epsilon RI cross-linking focuses primarily on the role of tyrosine
      phosphorylation and its ability to direct specific protein-protein interactions
      through SH2 domains. Contact of a mast cell bearing appropriately liganded Fc
      epsilon RI with multivalent antigen results in the approximation of receptors
      initially into chains. The proximity of receptors in these chains allows the
      phosphorylation of their ARAMs by the lyn tyrosine kinase. ARAM phosphorylation
      results in binding of syk specifically to cross-linked receptors and its probable
      subsequent phosphorylation and activation by lyn. Activated syk then
      phosphorylates and activates PLC gamma 1 and PLC gamma 2, resulting in their
      activation and translocation to the membrane. The presence of active PLC gamma 1
      and PLC gamma 2 on the cell membrane results in hydrolysis of membrane
      phosphatidyl inositol and the production of 1,4,5 inositol triphosphate. Inositol
      1,4,5 triphosphate diffuses to the sarcoplasmic reticulum and causes the release
      of sequestered calcium. This model represents a snapshot of the current body of
      knowledge about Fc epsilon RI-mediated signal transduction. Given the rapid pace
      of research in this field, it will likely be incorrect or incomplete in at least
      some respects by the time of publication. Ideally, the information presented here
      should provide a framework on which to build for those interested in learning
      more about Fc epsilon RI in particular and multisubunit antigen receptors in
      general.

PMID- 7798552
TI  - Signal transduction: mechanisms in basophils.

PMID- 7798553
TI  - Lipid bodies: intracellular sites for eicosanoid formation.
AB  - Lipid bodies, therefore, represent specialized intracellular domains that form
      rapidly in response to agents that activate protein kinase C. These structures
      contain eicosanoid-precursor arachidonate esterified in specific phospholipids.
      Arachidonate-releasing phospholipases probably act at lipid bodies, and an
      eicosanoid-forming enzyme, PGH synthase (cyclooxygenase), definitely localizes to
      lipid bodies. In addition, the heightened presence of lipid bodies in cells
      likely to be producing eicosanoids as part of inflammatory reactions indicates
      that lipid bodies are dynamic, specialized intracellular domains with roles
      pertinent to the metabolic transformation of arachidonate into paracrine
      mediators of inflammation. With their prominence in cells in association with
      inflammation, lipid bodies constitute specialized sites at which eicosanoid
      formation could occur for the heightened generation of eosinophil eicosanoid
      mediators of inflammation. This compartmentalization of eicosanoid formation at
      lipid bodies would provide a nonmembrane pool of arachidonate whose metabolic
      utilization could occur without perturbation of membranes if membranes were the
      sole stores of substrate fatty acid used for quantities of eicosanoids
      synthesized as paracrine mediators of inflammation. Moreover, lipid bodies would
      serve as sites at which the coordinated and regulated enzymatic events involved
      in arachidonate mobilization and oxidative metabolism could occur.

PMID- 7798554
TI  - Function and expression of adhesion molecules on human basophils.

PMID- 7798555
TI  - Eosinophil adhesion in allergic inflammation.
AB  - Eosinophil adhesion has been studied in some detail in recent years, and a number
      of interesting observations have emerged. As with other aspects of eosinophil
      biology, there appears to be a greater similarity with basophils than with
      neutrophils in their pattern of adhesion interactions. A number of important
      differences with respect to neutrophils have emerged, which could be exploited
      for the treatment of eosinophil-mediated disease, including the observations that
      eosinophil adhesion can be modulated by selective cytokines such as IL-5 and that
      eosinophils, unlike neutrophils, express VLA-4 and alpha 4/beta 7. There is also
      tantalizing evidence emerging that eosinophils interact differentially with the
      selectins, with differing degrees of affinity of binding and possibly different
      counterreceptors. The extent to which these observations will be useful in
      treating allergic disease remains to be seen.

PMID- 7798556
TI  - Distinguishing features of basophil and neutrophil activation by major basic
      protein.

PMID- 7798557
TI  - The phenotype of human eosinophils, basophils, and mast cells.

PMID- 7798558
TI  - Cytokine generation by eosinophils.

PMID- 7798559
TI  - Cytokine generation by human basophils.

PMID- 7798560
TI  - Acquisition of lymphokine-producing phenotype by CD4+ T cells.

PMID- 7798561
TI  - The effects of glucocorticoids on human eosinophils.
AB  - It is readily apparent that eosinophils are important targets of steroid effects.
      Disruption of the cytokine network by glucocorticoids can indirectly diminish
      eosinophil generation, survival, and function. In addition, glucocorticoids
      appear to have direct effects on the survival, and perhaps on the function, of
      these cells. Rapid advances in our knowledge of the biochemistry of signal
      transduction, as well as the interaction between cell surface receptors and RNA
      transcription machinery, will allow detailed analysis of the mechanisms by which
      the function and life cycle of eosinophils are influenced by glucocorticoids.

PMID- 7798562
TI  - The high-affinity IgE receptor on eosinophils: from allergy to parasites or from
      parasites to allergy?

PMID- 7798563
TI  - Mechanisms of allergic pulmonary eosinophilia in the mouse.

PMID- 7798565
TI  - Development of markers for human basophils and mast cells.

PMID- 7798564
TI  - The eosinophil-mediated antitumor activity of interleukin-4.

PMID- 7798566
TI  - The skin as a model to study the pathogenesis of IgE-mediated acute and late
      phase responses.

PMID- 7798567
TI  - Cytokine control of eosinophils in pulmonary diseases.

PMID- 7798568
TI  - Tyrosine phosphorylation and inositol phosphate production: are early events in
      human eosinophil activation stimulated by immobilized secretory IgA and IgG?
AB  - Eosinophils are implicated as major inflammatory cells in parasite infection and
      allergic reactions. Among various mediators, eosinophil granule cationic proteins
      play an important role in the pathophysiology of diseases. However, little is
      known about the actual physiologic stimuli for eosinophil degranulation and the
      signaling events for triggering eosinophil degranulation. A series of in vivo and
      in vitro studies suggest that the interaction between antibody coated parasites
      and Fc receptors on eosinophils is one of the most effective triggers for
      eosinophil degranulation. Similarly, eosinophil degranulation can be induced in
      vitro by Sepharose beads coated with human sIgA or IgG. Eosinophil degranulation
      induced by these stimuli is mediated by PTX-sensitive membrane-bound
      heterotrimeric G protein(s), and is accompanied by the rapid turnover of inositol
      phosphates. The production of inositol phosphates is inhibited by PTX. Eosinophil
      activation by sIgA and IgG also involves tyrosine phosphorylation of several
      proteins and is inhibited by tyrosine kinase inhibitors. Thus phospholipase C
      coupled G protein(s) and tyrosine kinases are key molecules in early signal
      transduction of eosinophil activation induced by sIgA and IgG. Although further
      studies are needed to identify which tyrosine kinase(s) is specifically involved
      in the eosinophil degranulation mechanism, these molecules could be a target for
      therapies of human diseases where eosinophils are involved.

PMID- 7798569
TI  - Biochemical properties, activities, and presence in biologic fluids of eosinophil
      granule major basic protein.
AB  - The existence of a proform of MBP is predicted from the sequence of MBP cDNA
      clones. ProMBP has been purified from the supernatants of CHO cells transfected
      with cDNA encoding prepro MBP. Purification involved heparin-Sepharose affinity
      purification followed by two sequential size fractionation steps over Sephadex G
      100 and yielded proMBP with a molecular mass of 33 kd. Recombinant proMBP from
      the heparin-Sepharose column was subjected to isoelectric focusing followed by
      SDS-PAGE and Western blot analysis. The results indicated that most of the 33 kd
      form of proMBP focused predominantly between pI 4.2 and 5.1, with a major peak at
      a pI of approximately 4.9. Analyses of the carbohydrates associated with the
      purified 33 kd form of recombinant proMBP indicated the addition of 4856 to 5150
      Da by carbohydrates characteristic of the complex type. Consistent with the
      hypothesis that the function of the propiece is to neutralize MBP toxicity during
      granule processing, proMBP lacked MBP cytostimulatory properties and actually
      blocked the effect of MBP in two different systems, basophil histamine release
      and neutrophil activation. In addition, as a measure of toxicity, proMBP did not
      inhibit protein synthesis, whereas MBP markedly reduced protein synthesis. The
      mechanisms by which MBP exerts its actions both as a cytostimulant and as a toxin
      are not known; however, it is known that cationic MBP readily reacts with acidic
      lipids. Using artificial liposomes as targets, MBP caused a disordering of the
      lipid bilayer membrane, resulting in fusion and lysis. Therefore, MBP may act
      both as a cytostimulant and as a toxin because of its marked cationicity and its
      ability to disorder lipid membranes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798570
TI  - Cytokines and allergy.

PMID- 7798571
TI  - Eosinophils in atopic dermatitis.

PMID- 7798572
TI  - Response of six patients with idiopathic hypereosinophilic syndrome to interferon
      alfa.

PMID- 7798573
TI  - Using a bony landmark to measure waist circumference.

PMID- 7798574
TI  - Visionary leaders are key to success in foodservice.

PMID- 7798575
TI  - New 'healthy meals' legislation promises improved child nutrition programs but
      GOP 'contract' may dismantle progress.

PMID- 7798576
TI  - Practical and legal considerations of private nutrition practice.

PMID- 7798577
TI  - Resting energy expenditures measured by indirect calorimetry are higher in
      preadolescent children with cystic fibrosis than expenditures calculated from
      prediction equations.
AB  - OBJECTIVE: This study compared measured resting energy expenditures to resting
      energy expenditures calculated using Harris-Benedict equations (HBEs) and the
      Cystic Fibrosis Consensus Committee equations (CFCCEs). DESIGN: We studied 31
      preadolescent boys and girls with cystic fibrosis who ranged in age from 3.25 to
      12.75 years old. The patients were afebrile and not in pulmonary distress.
      Measured resting energy expenditures were determined using a portable metabolic
      measurement cart with fully automated calibration and data management. The
      measured resting energy expenditures obtained were compared with values obtained
      using HBEs and CFCCEs. RESULTS: For each patient, the measured resting energy
      expenditure value was above the predicted resting energy expenditure values
      derived from HBEs (P < or = .0001) and CFCCEs (P < or = .01). APPLICATIONS: The
      HBEs and the CFCCEs underestimated the energy expenditures of the study
      population by 13% and 8%, respectively. These findings support the usefulness of
      the measurement of energy expenditures in determining the energy needs of
      preadolescent patients with cystic fibrosis. In clinical practice, the resting
      energy expenditures would be multiplied by activity coefficients to determine the
      total daily energy expenditures of this population.

PMID- 7798578
TI  - Moderators and determinants of satisfaction with diet counseling for patients
      consuming a therapeutic diet.
AB  - OBJECTIVE: To identify moderators and key determinants of patient satisfaction
      with diet counseling. DESIGN: Survey questionnaire. SETTING: A French-Canadian
      acute-care urban hospital. SUBJECTS: Population of eligible patients hospitalized
      for a minimum stay of 5 days. Patients excluded from the study were those with
      notable physical, cognitive, or emotional limitations; those receiving enteral
      and parenteral nutrition; and those from long-term-care units. Analyses were
      performed on 49 patients who consumed a therapeutic diet and who received diet
      counseling during their current hospital stay. MAIN OUTCOME MEASURES: Overall
      satisfaction with diet counseling, compliance intentions, and satisfaction with
      four components of diet counseling. Measures were taken on seven-point graphic
      scales and five-point semantic scales. STATISTICAL ANALYSIS: Reliability
      estimates with Cronbach's alpha correlation coefficient, stepwise multiple
      regression analyses, t tests, and one-way analyses of variance. RESULTS:
      Facilitation skills and knowledge components of diet counseling were the key
      determinants of patient satisfaction. Among the moderators of patient
      satisfaction with diet counseling, women and patients with a good appetite were
      more satisfied with the knowledge components and had stronger compliance
      intentions. Patients who spent more than 50% of the time at rest were less
      satisfied than more active patients. APPLICATIONS: Enhancing patient satisfaction
      implies having a good understanding of a patient's social and cultural context,
      developing problem-solving skills, and demonstrating greater flexibility and
      creativity about the means of providing diet counseling.

PMID- 7798580
TI  - Protein quality of enteral nutrition products is consistent with label claims
      during shelf life and beyond expiration date.
AB  - OBJECTIVE: Eternal formulas were monitored during their shelf life and beyond
      expiration date to examine protein quality. DESIGN: Protein quality was
      determined by protein efficiency ratio (PER) bioassays and amino acid analyses.
      SETTING: A certified laboratory performed the PER tests according to procedures
      established by the Association of Official Analytical Chemists and recognized by
      the US Food and Drug Administration (FDA). The amino acid analyses were performed
      in our laboratory using validated methods. SAMPLES: Commercially available
      formulas (Ensure, Osmolite HN, TwoCal HN) that contained protein blends of
      caseinates or caseinates with soybean protein isolate were studied. MAIN OUTCOME
      MEASURES: Achievement of protein-quality values greater than or equal to 70% of
      the fresh reference casein value as determined by the PER method would be
      consistent with adequate protein quality as described by the FDA. Levels of
      indispensable amino acids that meet or exceed the standards established by the
      National Research Council of the National Academy of Sciences are considered high
      quality proteins. Levels of amino acids throughout shelf life were compared with
      published label claims. RESULTS: Amino acid analyses, which included measurement
      of tryptophan and total sulfur amino acids, revealed that both fresh and outdated
      products met or exceeded standards for proteins of high biologic value and were
      consistent with label claims. The PER values ranged from 90% to 96% of the
      control diet for fresh product and 82% to 87% for products evaluated after
      expiration. CONCLUSION: The enteral products studied provide high-quality protein
      throughout the shelf life of the product.

PMID- 7798579
TI  - Corn bran supplementation of a low-fat controlled diet lowers serum lipids in men
      with hypercholesterolemia.
AB  - OBJECTIVE: The purpose of this study was to determine the lipid-lowering effects
      of dietary corn bran fed in moderate supplemental doses to men with
      hypercholesterolemia consuming a low-fat diet. DESIGN: The 98-day study was
      divided into one 2-week preperiod and two 6-week experimental periods in a cross
      over design. SETTING: The study was conducted in the metabolic diet kitchen of
      the Department of Home Economics and the Nutrition Research Laboratory of the
      Department of Agriculture at Illinois State University, Normal. SUBJECTS: Twenty
      nine sedentary men with hypercholesterolemia, aged 38 to 70 years, participated
      in the project. All of them completed the study. INTERVENTIONS: After a 2-week
      adjustment period in which subjects consumed a low-fat controlled diet, subjects
      were assigned to one of two experimental treatments: low-fat controlled diet plus
      20 g corn bran supplement or low-fat controlled diet plus 20 g wheat bran
      supplement. MAIN OUTCOME MEASURES: Lipid measurements included total cholesterol,
      low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol
      (HDL-C), very-low-density lipoprotein cholesterol (VLDL-C), and triglyceride
      concentrations. STATISTICAL ANALYSES PERFORMED: Differences in lipid parameters
      were analyzed using two-way analysis of variance with repeated measures (P <
      .05). A paired t test was used to assess differences between treatment periods
      for each subject. RESULTS: The low-fat controlled diet significantly lowered all
      serum parameters analyzed except HDL-C. Corn fiber supplementation resulted in an
      additional lowering of serum total cholesterol, triglyceride, and VLDL-C
      concentrations. Serum LDL-C and HDL-C concentrations were not significantly
      altered by corn fiber or wheat fiber supplementation. APPLICATIONS: This study
      suggests that supplementing a low-fat diet with corn bran is affective in
      reducing serum lipid concentrations for men with hypercholesterolemia.

PMID- 7798581
TI  - Advances in molecular biology: implications for the future of clinical nutrition
      practice.
AB  - Advances in molecular biology during the past decade have substantially
      contributed to our understanding of how genes influence physiologic processes
      and, ultimately, our health. Genes associated with many nutrition-related chronic
      diseases are being identified and characterized. Nutrients may directly or
      indirectly influence the transcription and/or translation of specific gene
      products. Identifying genetic markers for specific diseases and exploring gene
      therapy will provide new opportunities and challenges for clinical nutrition
      practice in the 21st century. Nutrition practitioners must be cognizant of
      developments in molecular biology to meet the challenges of providing nutrition
      care in the future.

PMID- 7798582
TI  - Waist-to-hip ratio in a biracial population: measurement, implications, and
      cautions for using guidelines to define high risk for cardiovascular disease.
AB  - Cutoff points for high waist-to-hip ratio (WHR) that may define high risk for
      cardiovascular disease have been suggested for men (0.95) and women (0.80). The
      WHRs of groups defined by age, race, and sex among 3,118 South Carolina adults
      were compared with these cutoff points. Measurement methodology, mean WHRs, and
      prevalence of elevated WHR in this biracial study population were compared with
      data from other populations. A review of anthropometric measurement methods used
      in recent epidemiologic studies indicates that a standard method for measuring
      waist and hip girth is required before comparisons of mean levels can be valid.
      The paucity of evidence that a high WHR is associated with cardiovascular disease
      mortality in black populations, and the high number of women who have an elevated
      WHR in this and other epidemiologic studies, support the following conclusion:
      Current WHR cutoff points, which are based on evidence from primarily white
      populations, may not be appropriate for women, older age groups, and some racial
      or ethnic groups in the United States.

PMID- 7798583
TI  - Continuous quality improvement in inpatient clinical nutrition services.
AB  - Defining quality patient care is a complex and often confusing issue. This
      article describes one hospital's experience in applying quality improvement
      theories to inpatient clinical nutrition practice. The key to measuring quality
      was the use of standardized practice guidelines. In this article, terms such as
      continuous quality improvement are clarified and fundamental assumptions such as
      "quality is defined as conformance to requirements" are discussed. We review a
      working model for the 10-step plan of the Joint Commission on Accreditation of
      Healthcare Organizations (JCAHO) and its application in practice, including the
      indicators and measurement tools used. Actual results from ongoing quality
      improvement efforts are addressed and compared to the JCAHO nine components of
      quality patient care. Because of preexisting nutrition practice guidelines at the
      Yale-New Haven Hospital, improvements in the delivery of patient nutrition care
      could be demonstrated; these included enhanced efficiencies in screening and
      intervention. Continuous quality improvement initiatives do work, and
      practitioners can use the practice experience presented here as a conceptual
      framework to justify or validate the quality of patient nutrition care in their
      own institutions.

PMID- 7798584
TI  - Criteria for acceptance to preprofessional dietetics programs vs desired
      qualities of professionals: an analysis.
AB  - The objectives of this analysis were to examine the literature and compare and
      contrast (a) qualities preferred in preprofessional dietetics students by
      directors of internships and approved preprofessional practice programs (AP4s),
      (b) characteristics needed to succeed in a scientific field, (c) traits
      emphasized by dietetics training programs compared with those most valued by
      employers, (d) skills needed by high-level managerial dietitians and those in
      business and communications, and (e) qualities dietitians have aspired to develop
      for increased competitiveness in the marketplace. Even though the revised
      Standards of Education have been in place since 1988, recent evaluation of
      criteria for internship and AP4 admission has shown traditional emphasis on
      academic performance and the importance of work experience. Success in scientific
      pursuits has been linked with more than innate intelligence; a drive for success
      and enthusiasm for learning are also involved. Internships foster mostly
      technical learning, so development of skills in human and conceptual areas are
      somewhat lacking. These skills, which have been identified as valuable to
      employers, need greater development or more consistent identification in the
      selection and training process. Perhaps serious consideration should be given to
      applicants for preprofessional programs who have shown leadership qualities
      through extracurricular activities or who have given themselves the opportunity
      to develop and improve these skills. Such students might hasten the metamorphosis
      of dietetics practitioners toward improved levels of compensation and
      professional fulfillment.

PMID- 7798585
TI  - Tea and coffee brews are not dietary sources of vitamin K-1 (phylloquinone).

PMID- 7798586
TI  - Consumer preferences among nutrition labeling formats in a restaurant.

PMID- 7798587
TI  - Value of theoretically based cooking classes for increasing use of commodity
      foods.

PMID- 7798588
TI  - Position of The American Dietetic Association: cost-effectiveness of medical
      nutrition therapy.

PMID- 7798589
TI  - Summary: weighing the options--criteria for evaluating weight-management
      programs. Committee to Develop Criteria for Evaluating the Outcomes of Approaches
      to Prevent and Treat Obesity Food and Nutrition Board, Institute of Medicine,
      National Academy of Sciences.

PMID- 7798590
TI  - The induction of cytokine gene expression in murine peritoneal macrophages by
      Pseudostellaria heterophylla.
AB  - We have previously shown that a mitogenic fraction (PH-I) separated from
      Pseudostellaria heterophylla (P. heterophylla) could act as a priming agent for
      the release of tumor necrosis factor-alpha (TNF-alpha) in mice. In the present
      study, PH-I was further purified by gel filtration chromatography and the
      resulting three fractions (PH-I A, PH-I B and PH-I C) were assessed for the
      induction of TNF-alpha, interleukin-1-alpha (IL-1-alpha) and IL-1-beta gene
      expression in mice by enzyme-linked immunosorbent assay and polymerase chain
      reaction. It was found that fraction PH-I C from P. heterophylla was the most
      potent priming fraction among the three fractions for the induction of TNF-alpha
      in serum and the TNF-alpha mRNA in murine macrophages. Moreover, all three
      fractions were found to increase the expression of IL-1-alpha mRNA while PH-I C
      showed the most potent activating effect on the expression of IL-1-beta mRNA.

PMID- 7798591
TI  - Induction of apoptosis in mouse thymocytes by cyclosporin A: in vivo study.
AB  - We investigated the in vivo effect of cyclosporin A (CsA) on mouse thymus and
      thymocytes. Administration of CsA (10 mg/kg of body weight) was found to induce a
      marked reduction in the size, weight and consistency of the thymus. These
      modifications were associated with thymic reticulo-epithelial cells (TREC) and
      thymocyte damage. Some of the damaged thymocytes displayed characteristic of
      cells undergoing apoptosis. Ultrastructural study of thymocytes and thymic
      tissue, as well as DNA electrophoresis of thymocytes, showed chromatin
      condensation, cellular shrinkage, and nuclear fragmentation in oligonucleosomal
      fragments. DNA labeling with propidium iodide (PI) of thymocytes from CsA treated
      mice cultured for 24 hrs showed an increased number of apoptotic nuclei.
      Furthermore, flow cytometric analysis using monoclonal antibodies (mAbs) specific
      for thymocyte subsets confirmed that CsA induces a large decrease in the relative
      number of mature single positive (SP) CD4+CD8- and CD8+CD4- thymocytes expressing
      high densities of CD3 and T cell receptor ab (TCR alpha beta) surface molecules,
      but also a decrease in the absolute number of the other thymocyte subsets. These
      results suggest that CsA causes macroscopic and ultrastructural modifications of
      the thymus, associated with an active process of cell death in mouse thymocytes
      in vivo. In line with these results we formulate a hypothesis concerning the
      stage of T-cell development at which CsA induces apoptosis.

PMID- 7798592
TI  - Inhibition of phytohaemagglutinin-induced lymphocyte proliferation by
      immunosuppressive drugs: use of whole blood culture.
AB  - A whole blood lymphocyte proliferation assay was compared to a standard method
      requiring the isolation of lymphocytes from blood. Both methods were used to
      measure inhibition of proliferative responses of phytohaemagglutinin (PHA1)
      stimulated human peripheral blood lymphocytes by tacrolimus (FK 506(1)),
      cyclosporine A (CsA1), rapamycin (RA1), dexamethasone (DEX1), prednisolone (PR1),
      and methylprednisolone (MP1). Three of the drugs studied (FK 506, CsA, and DEX)
      yielded similar IC50 values with both methods. The whole blood proliferation
      assay produced modestly lower IC50 values for RA, PR and MP. The whole blood
      lymphocyte proliferation method is simple and can be used when only limited
      volumes of blood can be obtained or isolation of cells gives unsatisfactory
      yields.

PMID- 7798593
TI  - Prothymosin alpha and factors from calf thymic cells decrease expression of Thy
      1.2 antigen among small thymocytes from C57BL/6 mice.
AB  - In this work we studied the effect of Prothymosin alpha (ProT alpha) and other
      thymic factors on the expression of Thy 1.2 antigen (a T-cell marker) and the
      activities of adenosine deaminase (ADA, E.C. 3.5.4.4), N-acetyl-beta-D
      glucosaminidase (NABG, E.C. 3.2.1.30), beta-glucuronidase (BG, E.C. 3.1.1.1) and
      serine-esterase (SE, E.C. 3.4.21)., the levels of which change during the T-cell
      differentiation process among small thymocytes obtained from C57BL/6 mice.
      Incubation of small thymocytes in the presence of ProT alpha, Thymus Extracts
      (TE) or supernatants prepared from thymic stromal cells (TSCS) or thymocytes (TS)
      reduced the proportion of cells killed by anti-Thy 1.2 monoclonal antibodies but
      did not affect the enzymatic activities studied. This is the first evidence that
      ProT alpha affects Thy 1.2 expression in vitro.

PMID- 7798594
TI  - Modulation of amphotericin B activity by association with mannose ester.
AB  - The biological and molecular properties of a new formulation of Amphotericin B
      complexed with the surfactant palmitoyl mannose were studied in in vitro as well
      as in in vivo situations. The properties analyzed include toxicity towards two
      types of mammalian cells and four fungi strains, effect on macrophage activity,
      inflammatory properties, acute toxicity in mice and spectral behavior in presence
      of foetal calf serum or 6% propanol. The results demonstrate that, in presence of
      palmitoyl mannose, the cytotoxicity of AmB is decreased towards both, fungal and
      mammalian cells while its fungistatic potential is increased, its inflammatory
      properties are conserved and its acute toxicity is significantly diminished.
      These effects can be potentially explained by the formation of a complex between
      AmB and the sugar ester that impedes the interaction of the drug with either
      serum components or cell membrane constituents. The overall properties of AmB in
      the complex would be expected to favor an increase in the immunoadjuvant
      properties of the drug, a more localized inflammation during fungal infection and
      consequently a better therapeutic efficiency.

PMID- 7798596
TI  - Immunomodulating effect of met-enkephalin on different stages of lymphocyte
      proliferation induced with concanavalin A in vitro.
AB  - Met-enkephalin (ME) in the range of concentrations 10(-15) M to 10(-9) M has
      exhibited an immunomodulating effect on concanavalin A (Con A) induced
      proliferation of mice lymphocytes from lymph nodes in vitro. The effect of ME was
      shown to vary with the stage of lymphocyte activation and to depend on the
      mitogen dose. In the case that ME and Con A were injected simultaneously, at the
      zero time of proliferation, maximum inhibition was observed on the first and
      fourth days. In an other set of experiments when ME was added at intervals of 4
      hours before measuring the proliferation response value, both inhibition (after
      24 hours of proliferation) and stimulation (after 28 and 96 hours) were observed.
      Opioid ligands of various classes were found to act in the same manner as ME.
      Naloxone was shown to block the immunomodulating effect of opioids.

PMID- 7798595
TI  - In vivo effect of omeprazole on HLA-DR expression and the monocyte-macrophage
      function in patients with duodenal ulcer disease.
AB  - It is not known if omeprazole possesses any action on immune system. Therefore,
      we examined the effect of omeprazole on parameters of cellular immunity [T-cell
      subsets-CD3+, CD4+, CD(8+)- and HLA-DR expression on peripheral blood lymphocytes
      (PBLs)] and on function of peripheral blood monocyte-macrophages (PBMMs) [random
      migration (RM), directed migration (DM), phagocytosis index (P-I) and HLA-DR
      expression] in 13 duodenal ulcer patients before and during 3-mo omeprazole
      treatment. The number of T-cell subsets varied at pretreatment values (p > 0.05),
      whereas the percentage of HLA-DR positive PBLs increased significantly after 3-mo
      therapy (p < 0.001). On the other hand, all studied parameters concerning PBMMs
      (RM, DM, P-I and HLA-DR expression) increased significantly after 3-mo therapy (p
      < 0.001, p < 0.001, p < 0.003, p < 0.001, respectively vs. baseline values). In
      conclusion, omeprazole exerts an immunopotentiating effect on functions of PBMMs
      and may also influence T-cell function. These effects can be considered as an
      advantage of omeprazole in long-term treated patients with peptic ulcer disease.

PMID- 7798597
TI  - Gay and lesbian studies in art history.

PMID- 7798598
TI  - Ambiguity and the image of the king.
AB  - The following essay explores problems posed by a recently-published fresco (dated
      to the first century AD) that depicts Alexander the Great standing opposite an
      unknown female figure. The fresco is unusual in its use of conventional or
      codified figure types, in particular a widely-found statue type known as the
      "Alexander with the Lance," and for its placement of Alexander in anecdotal
      relation with a woman. While discussions of the picture thus far have tried to
      identify the scene depicted (by reference to histories of Alexander's life), the
      following analysis takes the difficulty of doing so itself as a motivated aspect
      of the image. I argue that the fresco's mode of representation is to bring
      together figure types whose conventional fields of meaning are in conflict with
      one another, and then to highlight this conflict in order to comment upon the
      fields (or figure types) themselves. In this case, the fresco's ambiguity in
      signification (the undecidability of its reference) enables a highly strategic
      critique of the "Alexander with the Lance" because the latter, as a prototypical
      "image of the king," depends upon the necessary and transparent extension of its
      signs. By virtue of the anecdotal relation between "Alexander" and the depicted
      female figure (an Aphrodite type) the fresco's critique reveals the close
      association between the claims for representation made by the image of the king
      and the patriarchal structures of power they seek to instantiate. The fresco thus
      offers remarkably direct data for understanding the intersection of
      representation and gender in the early Roman empire. I suggest in conclusion that
      because the image seems also to posit a specifically gendered (male) gaze, its
      critique is extended to the spectator and thereby provides data for understanding
      the intersection of the practice of representation (here, viewing) and gender.

PMID- 7798599
TI  - Lesbian sightings: scoping for dykes in Boucher and Cosmo.
AB  - In Cosmopolitan magazine and in the work of the eighteenth-century French painter
      Francois Boucher, lesbians are visible, but nobody seems to notice. The operation
      of covert invisibility in such disparate cultural products suggests that the
      closet metaphor and the common idea that queer visibility generates queer
      empowerment must be retained but rethought. It also suggests that queer scholars
      and activists can benefit from occasionally working as historical-specificity
      outlaws, which here brings into focus the distinct ideological affects of each
      product, as well as some shared ones that demand our attention, including the
      disarticulation of female political activism, and the promotion rather than
      subversion of hetero-hegemony.

PMID- 7798601
TI  - The abject gaze and the homosexual body: Flandrin's Figure d'Etude.
AB  - This article charts the history of the reception, reproduction and appropriation
      of a single image that has recently become a kind of "gay icon"--the Figure
      d'Etude in the Louvre, painted by Hippolyte Flandrin in 1835. Initially no more
      than a neo-classical academic exercise, the formal emptiness of this picture
      meant that it could be re-invested and reinscribed with new meanings and new
      titles at every turn. Emblematic of the anxious visibility/invisibility of the
      newly discovered homosexual body during a period when the gaze still had to be
      kept a dark secret, Flandrin's image only "came out" in its later photographic
      reworkings by Frederick Holland Day and Baron von Gloeden. After being reproduced
      for a specifically homosexual audience early this century, the popular Romantic
      pose of the young man curled-up in profile became a standard one, reappearing
      recently in the photographs of Robert Mapplethorpe. The inactive, abject and
      inward-turned isolation of the figure with its narcissistic self-absorption makes
      it, in my view, a profoundly negative stereotype of the gay gaze and the
      homosexual body. Flandrin's figure nonetheless appears today on gay merchandise
      world-wide as a sign of our separate and secluded subject positions and our
      community's unwillingness to radically alter older imposed and inherited
      classical stereotypes.

PMID- 7798600
TI  - Winckelmann divided: mourning the death of art history.
AB  - The discipline of art history is often said to have been invented in the writing
      of J.J. Winckelmann (1717-1768). In his Reflections on the Imitation of Greek
      Works in Painting and Sculpture (1754) and History of Ancient Art (1764),
      Winckelmann dealt with the homoerotic meanings of Greco-Roman arts in complex
      ways. To do so, he imagined a split between his subjective position as an
      observer with specific erotic and political interests and his objective position
      as an historian. His importance for art historians today derives from his own
      recognition and further elaboration of his "division," an awareness manifested in
      his principal metaphor for the status of the art historian as a "maiden" mourning
      her "lover," the "lost object" of her desire, namely, ancient representations of
      beautiful young men. This metaphor and related features of Winckelmann's texts
      situated the homoeroticism of art and of the art historian in mutual relations
      that enable the art historian to reconcile, if not to resolve, his fundamental
      "division." Winckelmann's image of art history presents a more adequate sense of
      the enterprise than the misleading polarization of "objective" history and
      "subjective" interpretation frequently encountered today.

PMID- 7798602
TI  - Making history: the Bloomsbury group's construction of aesthetic and sexual
      identity.
AB  - This essay examines the way England's well-known Bloomsbury group in the first
      decades of this century negotiated the legacy of prominent figures of the
      generation before in order to create its own identity. Looking at the group's
      ideas about both aesthetics and sexuality, the author shows how the group
      privileged Leo Tolstoy over J. A. M. Whistler, and Oscar Wilde over Walter Pater.
      The introduction and conclusion seek to set this study in the context of current
      issues in gay and lesbian studies.

PMID- 7798603
TI  - Urination and its discontents.
AB  - "Urination and Its Discontents" is an attempt to answer why various twentieth
      century artists have made works that use or are about urination. Andy Warhol's
      act of "pissing" onto a canvas in his Oxidation Paintings is related to
      homosexual "sex clubs," but also to the iconoclasm of Mapplethorpe, Serrano,
      Duchamp, and Pollock. Freud's idea that civilization began with the renunciation
      of the "homosexual competition" of urinating on the fire is discussed and
      compared to Ellis's idealization of the erotics of bodily functions. Weinberg
      suggests that artists follow Ellis instead of Freud in undermining the boundaries
      society places on what is clean and dirty and what is sexually permissible.

PMID- 7798604
TI  - Lesbian identity and the politics of representation in Betty Parsons's gallery.
AB  - Although Betty Parsons had been unusually open about her love relationships with
      women in the twenties and thirties, she later became reticent, retiring to the
      closet. Her increased discretion after World War II, during the Cold War,
      coincided with her rise as the art dealer most prominently associated with the
      international emergence of Abstract Expressionism. Parsons incurred the
      objections of her Abstract Expressionists, however, by showing artists who
      included both abstraction and naturalism in their work, such as Sonia Sekula,
      Forrest Bess, and Hedda Sterne. This article examines her definition of
      abstraction as difference through her friend Theodoros Stamos's notion of camp
      and helps to explain her admiration of Barnett Newman despite her refusal to
      devote her gallery exclusively to his narrower version of significant
      abstraction.

PMID- 7798605
TI  - Looking for love: a reading of Apartment Zero.
AB  - Asserting that gay male identity exists in the unstable frontier between
      culturally-defined notions of femininity and masculinity, this paper makes a
      close reading of the recent film Apartment Zero. This reading highlights the
      paradoxically aggressive and loving contest over the signs or trophies of
      masculinity--ranging from a soldier's cape to the phallus itself--which
      characterizes both homosocial and homosexual relations among men. Concluding that
      contrary to recent critical cliches, no subject can possess "the gaze," this
      paper describes the powerful desire to appropriate the signifiers of masculinity:
      a desire which can never be fully satisfied.

PMID- 7798606
TI  - Wear your hat: representational resistance in safer sex discourse.
AB  - Through an analysis of four posters used by the AIDS Action Committee of
      Massachusetts, this article asks how representation can effectively promote safer
      sex practices. The images under investigation have different targeted groups--one
      is aimed at African-American men, one at Latinas, and two at gay men. Using a
      frame-work that connects definitions of sex in the respective communities with
      differences surrounding gender, race, and class, the imagery is unpacked in order
      to expose the effects of safer sex representation. This essay then argues that
      the degree to which ingrained definitions of sex are challenged constitutes a
      determining factor in the success or failure of safer sex representations.

PMID- 7798607
TI  - Cruising twelfth-century pilgrims.
AB  - When taken together, the Moissac Luxuria, a miracle story from the Book of St.
      James, and the twelfth-century pilgrims who experienced them seem to show that
      sexual energy and an instability of gender characterized certain encounters among
      male pilgrims. I believe that this influenced what people saw when they looked at
      the Luxuria, and I try to situate this thesis in the context of Lesbian and Gay
      Studies. At the outset I adopt a "performative" view of homosexual relationships,
      and I close by relating the word "cruising" to the structural homology between
      myself and the people I study.

PMID- 7798608
TI  - Queering boundaries: semen and visual representations from the Middle Ages and in
      the era of the AIDS crisis.
AB  - In this essay I address some of the ways in which certain images, which share
      visual and verbal vocabularies of body fluids, visualize male-male sexual
      identities and body practices. Through the articulation of these terms, and most
      especially semen, body boundaries are at once delineated and transgressed. The
      differential relatedness of these images from the Middle Ages and the late 1980s
      and 1990s is underlined by the ways they subvert contemporary conventions of
      visual representation while always remaining accessible. It is this efficacy
      which allows me to link these representations, and which I attempt to articulate.
      To put this in other terms, I am interested in the ways in which boundaries of
      the body prove themselves fluid, as fluids of the body cross body-boundaries.

PMID- 7798609
TI  - Lesbian (in)visibility in Italian Renaissance culture: Diana and other cases of
      donna con donna.
AB  - Current conceptualizations of sexual identity in the West are not necessarily
      useful to an historian investigating "lesbianism" in the social history and
      visual representations of different periods. After an overview of Renaissance
      documents treating donna con donna relations which examines the potentially
      positive effects of condemnation and silence, the paper focuses on Diana, the
      goddess of chastity, who bathed with her nymphs as an exemplar of female bodies
      preserved for heterosexual, reproductive pleasures. Yet the self-sufficiency and
      bodily contact sometimes represented in images of this secluded all-female
      gathering might suggest "deviant" responses from their viewers.

PMID- 7798610
TI  - Genetic alterations in non-melanoma skin cancer.
AB  - Non-melanoma skin cancer is common and offers unrivaled opportunities to relate
      genetic changes to clinical and biologic behavior. Recent technical advances in
      molecular biology render genetic analysis of even the smallest skin cancers
      possible. In this review I will discuss the role of p53 gene in skin
      carcinogenesis, the relation between p53 immunostaining and p53 mutation, and
      recent evidence for the involvement of putative tumor suppressor genes both on
      chromosome 9 and other chromosomes in non-melanoma skin cancer.

PMID- 7798611
TI  - Selective accumulation of T cells according to T-cell receptor V beta gene usage
      in skin cancer.
AB  - To investigate whether specific T-cell populations are overrepresented in tumor
      infiltrating lymphocytes (TIL) in skin cancer, we determined the T-cell receptor
      (TCR) diversity in biopsy specimens of basal cell carcinoma and squamous cell
      carcinoma. Immunostaining of tissue sections indicated that the majority of T
      cells expressed alpha beta TCRs. To assess diversity of the TCR beta chain, RNA
      was isolated directly from the tumor specimens and peripheral blood mononuclear
      cells (PBMC) from the same patient, cDNA was synthesized, and variable (V) beta
      chain gene usage was determined by the polymerase chain reaction (PCR). In each
      basal cell (n = 11) and squamous cell (n = 7) carcinoma studied, several V beta
      families were overrepresented in TIL versus PBMC, in that they accounted for
      greater than 5% of the repertoire in TIL and were at least 2% higher in TIL than
      in PBMC. The predominant V beta gene segments overrepresented in TIL generally
      differed from individual to individual. Simultaneous comparison of the V beta
      repertoire of TIL to that of uninvolved skin and PBMC from the same individual
      revealed preferential expression of V beta families within the TIL in three of
      five basal cell and four of four squamous cell carcinomas. Again, the predominant
      V beta s differed from individual to individual. Comparison of the TCR repertoire
      in uninvolved skin versus PBMC did indicate that some V beta families were
      overexpressed in the resident T-cell compartment in skin, although the
      overrepresented families were not constant from individual to individual. These
      data indicate the selective concentration of T cells bearing specific alpha beta
      TCRs in the local immune response to basal cell and squamous cell carcinomas.

PMID- 7798612
TI  - Human leukocyte antigen-DQB1*03 alleles are associated with alopecia areata.
AB  - Alopecia areata (AA) is characterized by hair loss in patches (patchy AA), over
      the entire scalp (AT, totalis), or universally (AU). An autoimmune mechanism has
      been hypothesized, because the inflammatory infiltrate targeted to the hair
      follicles includes activated T cells. To investigate whether or not genetic
      polymorphism of the human leukocyte antigen (HLA) region contributes to disease
      susceptibility, we used sequence-specific oligonucleotides and amplified genomic
      DNA to define HLA-DQA1, -DQB1, and -DPB1 alleles in a cohort of 85 white
      patients. The frequency of DQB1*0301 was significantly increased to 41% in all
      patients, and to 47% in AT/AU patients relative to controls (27%). Analyzed
      together, DQB1*03 alleles (DQB1*0301-*0303) were increased to 80% (all patients)
      and to 92% (AT/AU) (odds ratio = 12.14, p = 0.00003, corrected). This striking
      association implicates the DQB1*03 alleles in the pathogenesis of AA. DQB1*06 was
      decreased relative to controls (56%) in all patients (32%, odds ratio = 0.37, p =
      0.0045, corrected). An increase was observed in the HLA-DRB1*11(DR5) allele
      DRB1*1104, which may result from linkage disequilibrium with DQB1 alleles.
      Sequence comparison among the allele products associated with AA indicates that
      the DQB1*03 alleles carry a unique proline at position 55 that is not present in
      alleles that are neutral or negatively associated with the disease. This highly
      significant association may exert considerable control over immune responsiveness
      and the initiation or persistence of a T-cell autoimmune response against the
      hair follicle.

PMID- 7798613
TI  - Topical retinaldehyde on human skin: biologic effects and tolerance.
AB  - The present study was designed to explore if *etinaldehyde, a natural metabolite
      of vitamin A, has any biologic activity and is tolerated by human skin. Biologic
      activity was shown by the induction of cellular retinoic acid-binding protein
      type 2 (CRABP 2) mRNA and protein; the rank order for CRABP-2 increase was
      retinoic acid > retinaldehyde > 9 cis retinoic acid > retinol > beta carotene. In
      volunteers treated 1-3 months with 0.5, 0.1, and 0.05% retinaldehyde, there was a
      dose-dependent and significant increase in epidermal thickness, keratin 14
      immunoreactivity, and Ki67-positive cells. The area of distribution of
      involucrin, transglutaminase, and filaggrin immunoreactivity was also increased
      in a dose-dependent manner, and keratin 4 immunoreactivity was induced in the
      upper epidermis. In pilot clinical tolerance studies, 229 patients received
      topical retinaldehyde at different concentrations; the 1% preparation was
      tolerated by up to 70% of the treated subjects; tolerance of the 0.5% preparation
      was slightly better, whereas both 0.1 and 0.05% preparations applied on facial
      skin were well tolerated and allowed prolonged use (up to 3 years) in patients
      with inflammatory dermatoses. These findings indicate that topical retinaldehyde
      has biologic activity and is well tolerated on human skin.

PMID- 7798614
TI  - Retinoic acid upregulates human Langerhans cell antigen presentation and surface
      expression of HLA-DR and CD11c, a beta 2 integrin critically involved in T-cell
      activation.
AB  - Immunomodulatory effects of retinoids may be part of their anti-carcinogenic and
      anti-inflammatory properties. We studied the in vivo effects of retinoic acid
      (RA) on antigen-presenting activity of human epidermal Langerhans cells and on
      accessory cell activity of keratinocytes. Two skin sites from each volunteer were
      treated in vivo with 0.1% RA or vehicle, respectively, once a day for 4 d. RA
      treated epidermal cell (RA-EC) alloantigen presentation to CD4+ T cells in each
      volunteer tested was consistently greater than that induced by vehicle EC.
      However, this increased antigen-presenting activity did not lead to autoreactive
      CD4+ T-lymphocyte proliferation. Elevated unfractionated epidermal antigen
      presenting activity of RA-EC was not due to increased keratinocyte major
      histocompatibility complex (MHC) or intercellular adhesion molecule expression or
      to other keratinocyte accessory signaling, because incubation of CD1a
      fluoroscence-activated cell sorter (FACS)-purified RA-EC inhibited alloantigen
      presentation, presumably through increased keratinocyte transforming growth
      factor-beta. By contrast, Langerhans cell function was upregulated; FACS-purified
      CD1a+ Langerhans cells derived from RA-EC displayed a markedly increased ability,
      relative to Langerhans cells from vehicle EC, to present alloantigen to T cells.
      Triple color flow-cytometric analysis of RA-EC and vehicle EC suspensions
      revealed that RA treatment did not modify the number of DR+ and CD1a+DR+EC, but
      did result in statistically significant increases in Langerhans cells expression
      of HLA-DR, CD11c, and CD1c. Another novel finding was that HLA-DR-dependent
      Langerhans cells antigen-presenting activity in both normal and RA-treated skin
      was completely blocked by anti-CD11c antibody. Thus, retinoid upregulation of
      antigen-presenting activity may be due to upregulation of Langerhans cell CD11c,
      as well as class II MHC. Upregulation of cutaneous immune responsiveness in human
      skin without autoreactivity has not (to our knowledge) been reported previously,
      and the Langerhans cell phenotypic and functional state achieved is distinct from
      previously reported states of Langerhans cell activation.

PMID- 7798615
TI  - Epidermal differentiation enhances CRABP II expression in human skin.
AB  - The cellular retinoic acid-binding proteins (CRABP I and II) are thought to
      mediate the effects of retinoic acid on target cells. We have used riboprobes
      complementary to CRABP I and II mRNAs to study the expression of these messages
      in normal and abnormal human skin. CRABP II was expressed predominantly in the
      suprabasal layers of the epidermis, with stronger expression in newborn than in
      sun-protected adult skin. Interestingly, the epidermis adjacent to or overlying
      squamous cell or basal cell carcinomas also showed strong expression, whereas the
      tumor cells were negative, with the exception of more differentiated cells
      surrounding the "keratin pearls" within squamous cell carcinomas. CRABP II mRNA
      was also found in the more differentiated cells of the hair follicles, in the
      outer root sheath. CRABP I message was undetectable in the epidermis or in the
      dermis of normal skin but was detected in the cells of the papillary dermis
      surrounding basal and squamous cell carcinomas. These data suggest that increased
      levels of CRABP II mRNA accompany keratinocyte differentiation in vivo.

PMID- 7798616
TI  - Suppressive effect of antioxidants on intercellular adhesion molecule-1 (ICAM-1)
      expression in human epidermal keratinocytes.
AB  - Intercellular adhesion molecule-1 (ICAM-1) is strongly expressed by human
      epidermal keratinocytes during the course of inflammatory skin diseases. To test
      the possibility that reactive oxygen species produced in the skin during an
      inflammatory response affect ICAM-1 expression, cultured human epidermal
      keratinocytes were treated with H2O2 at concentrations that did not damage the
      cells, and cell-surface ICAM-1 expression was analyzed. Expression of ICAM-1 was
      induced on keratinocytes by treatment with 300 microM H2O2 for 1 h. The
      antioxidant N-acetyl-L-cysteine strongly inhibited H2O2-induced ICAM-1
      expression, whereas the antioxidants pyrrolidine dithiocarbamate and alpha
      tocopherol were less inhibitory. N-acetyl-L-cysteine also suppressed keratinocyte
      surface expression of ICAM-1 induced by the cytokines interferon-gamma (IFN
      gamma) or tumor necrosis factor-alpha (TNF-alpha), whereas pyrrolidine
      dithiocarbamate and alpha-tocopherol suppressed IFN-gamma-induced surface
      expression but not TNF-alpha-induced expression. We found that N-acetyl-L
      cysteine treatment reduced ICAM-1 mRNA levels when keratinocytes were stimulated
      with either IFN-gamma or TNF-alpha; however, pyrrolidine dithiocarbamate and
      alpha-tocopherol had no effect on either IFN-gamma- or TNF-alpha-induced ICAM-1
      mRNA levels. Our results indicate that reactive oxygen species may be involved in
      the skin inflammatory process by increasing epidermal ICAM-1 expression and that
      some antioxidants may be effective in suppressing the epidermal ICAM-1 expression
      induced by reactive oxygen species and cytokines in inflammatory skin diseases.

PMID- 7798617
TI  - Experimental photoaging in C3H/HeN, C3H/HeJ, and Balb/c mice: comparison of
      changes in extracellular matrix components and mast cell numbers.
AB  - Chronic exposure of human or murine skin to ultraviolet B (UVB) radiation alters
      dermal extracellular matrix composition and increases the number of mast cells
      and inflammatory cells. Experiments were designed to test the possible role of
      UVB-induced tumor necrosis factor-alpha in these photoaging changes based on
      reports that C3H/HeN, but not C3H/HeJ or Balb/c mice, produce excess TNF-alpha in
      response to UVB exposure. Pigmented C3H/HeN and C3H/HeJ strains were exposed to a
      total of 75 J/cm2 of UVB radiation, and unpigmented Balb/c mice were exposed to
      19 J/cm2. The UVB-induced increases in collagen, glycosaminoglycans, and
      neutrophil number were similar or the same in all three strains. The elastin
      increase was greater in C3H/HeJ than in C3H/HeN mice. The most striking
      difference between the strains was a 7.7-fold UVB-induced increase in mast cells
      in C3H/HeN mice compared to no increase in irradiated C3H/HeJ mice and a 2.3-fold
      increase in Balb/c mice. These results suggest that excess TNF-alpha (or other
      mediator) produced in C3H/HeN skin (but not C3H/HeJ skin) in response to UVB
      exposure is involved in the mast cell increase and partial inhibition of elastin
      increase, but that neither these mediators nor mast cell products are important
      mediators for the chronic UVB-induced increases in neutrophils,
      glycosaminoglycans, and collagen. When a possible source of the excess TNF-alpha
      was investigated, it was found that isolated epidermal cells from all three
      strains produced increases in TNF-alpha in response to UVB radiation. These
      results, as well as the previous results showing differences between these
      strains in UVB-induced effects on cutaneous immune function, are consistent with
      a model in which UVB-induced mediators from the epidermis stimulate another cell
      type to produce excess TNF-alpha (and other mediators) in the C3H/HeN but not
      C3H/HeJ or Balb/c mice.

PMID- 7798618
TI  - Differential photoimmunoprotection by sunscreen ingredients is unrelated to
      epidermal cis urocanic acid formation in hairless mice.
AB  - A series of experimental sunscreen preparations based on a common vehicle,
      containing increasing concentrations of either octyl-N-dimethyl-p-aminobenzoate
      (o-PABA) or 2-ethylhexyl-p-methoxycinnamate (2-EHMC) as the ultraviolet B (UVB)
      absorber, has been tested in the hairless mouse for the ability to protect from
      erythema, from the systemically suppressive effects of UVB (280-320 nm) radiation
      on contact hypersensitivity, and from photoisomerization of epidermal urocanic
      acid. All the preparations protected efficiently from the edema component of the
      erythema response when mice were exposed to UVB radiation equivalent to three
      times the minimal erythema dose (MED). However, when mice were exposed to UVB
      radiation equivalent to 15 x MED, protection from erythema was observed only at
      the higher concentrations of each UVB absorber (10% 2-EHMC and 10% or 15% o
      PABA). Protection from the UVB-induced suppression of contact hypersensitivity
      was shown to be dependent on both the nature of the UVB absorber and its
      concentration. Photoimmunoprotection by the sunscreens containing 2-EHMC was
      evident at lower concentrations (5% and 10% 2-EHMC) than with o-PABA, following
      both 3 x MED and 15 x MED of UVB exposure. Photoimmunoprotection by o-PABA
      containing sunscreens was observed only at 15% o-PABA following 3 x MED, and
      failed at all tested concentrations after 15 x MED of UVB exposure. Regardless of
      the photoimmunoprotective capacity, sunscreen preparations containing either of
      the UVB absorbers prevented the UVB-induced formation of cis urocanic acid in the
      mouse epidermis and in vitro under all conditions tested. Thus, there appeared to
      be a correlation between protection from edema and from cis urocanic acid
      formation at 3 x MED of UVB, but a dissociation of these variables at 15 x MED of
      UVB. There was no relation apparent at either UVB dose between either edema or
      cis urocanic acid formation and protection from suppression of contact
      hypersensitivity.

PMID- 7798619
TI  - Functional human epidermal Langerhans cells that lack Birbeck granules.
AB  - Birbeck granules (BG) are cytoplasmic organelles that are only found in
      Langerhans cells (LC). The function of BG is still unclear, although it has been
      claimed that they are actively involved in receptor-mediated endocytosis and
      participate in the antigen-processing/presenting function of LC. We have
      identified a healthy white 29-year-old man whose LC completely lack the presence
      of BG as determined by electronmicroscopic studies. This was observed repeatedly
      using skin biopsy specimens taken from several places on the body during a period
      of 2.5 years. The absence of BG in these LG was documented further by the lack of
      staining with a BG-specific monoclonal antibody. Despite the complete lack of BG,
      LC were present in normal numbers, had all the usual morphologic characteristics,
      and were CD1a and human leukocyte antigen (HLA) class II positive. Two
      observations indicate that these BG-negative LC display normal antigen-presenting
      capacity. First, the individual could be sensitized by the hapten
      diphenylcyclopropenone. This was accompanied by a strong increase in the cell
      surface expression of HLA class II antigens on his LC, suggesting LC activation.
      Second, his epidermal cells elicited a normal positive response in an allogeneic
      mixed epidermal cell lymphocyte reaction. Together these observations strongly
      suggest that BG are not a prerequisite for normal LC function in vivo and in
      vitro.

PMID- 7798620
TI  - Interleukin-10 inhibits the elicitation phase of allergic contact
      hypersensitivity.
AB  - Interleukin-10 (IL-10) is known to play a major role in suppressing immune and
      inflammatory responses by inhibiting the production of proinflammatory cytokines.
      Therefore, we hypothesized that IL-10 might be capable of suppressing allergic
      contact hypersensitivity. BALB/c mice were sensitized on the dorsal skin with
      dinitrofluorobenzene and challenged on the ears 6 d later. The effect of IL-10 on
      the elicitation phase of contact sensitization was determined by its intradermal
      injection into the pinnae of the mice at doses of 0.1-100 ng. At 24 and 48 h
      after challenge, ear swelling was suppressed in a dose-dependent manner by
      injection of IL-10 at doses of 10-100 ng. Maximal inhibition of ear swelling
      (46.9%) was observed after injection of 100 ng of IL-10. IL-10-injected ear skins
      showed less inflammatory cell infiltration and decreased edema at the dermis
      compared with controls. Because IL-10 is known to inhibit Th1 cytokines such as
      interferon-gamma, we examined whether the suppressive effect of IL-10 on ear
      swelling was accompanied by IL-10-induced inhibition of interferon-gamma. We
      found that IL-10 application suppressed interferon-gamma mRNA upregulation in
      challenged skin. Our results suggest that IL-10 significantly modifies the
      elicitation of allergic contact sensitivity reactions.

PMID- 7798621
TI  - Involucrin mRNA is more abundant in human hair follicles than in normal
      epidermis.
AB  - Involucrin is a precursor protein of the cornified cell envelope in epidermal
      keratinocytes, where it has been located by immunohistochemistry in the upper
      spinous and granular layers of human epidermis. In the hair follicle, involucrin
      has been found in the inner root sheath and in the upper layers of the
      infundibulum and the isthmus (upper outer root sheath), whereas its presence in
      the lower outer root sheath and the cortex has been controversial. Therefore, we
      analyzed the distribution of involucrin mRNA in adult scalp by Northern blotting
      and in situ hybridization. Northern blots showed more abundant involucrin mRNA in
      the follicular fraction than in the epidermal fraction of dissected scalp. In
      situ hybridization matched the immunohistologic results; transcripts of
      involucrin were expressed not only in the infundibulum and isthmus, but also in
      the hair cortex and medulla, in all layers of the inner root sheath, and in the
      inner cells of the lower outer root sheath (all of which lack a cell envelope at
      the ultrastructural level). However, involucrin was absent in the hair cuticle,
      which is the only compartment of the follicle possessing a morphologically
      distinct cell envelope. Our results suggest, first, that involucrin does not
      serve as a precursor protein of the cornified cell envelope in adult hair
      follicles, and second, that it is perhaps not necessary for the formation of the
      cell envelope in keratinocytes of the hair cuticle, as we did not find this
      precursor protein with highly sensitive methodology.

PMID- 7798622
TI  - Functional and immunoreactive thrombomodulin expressed by keratinocytes.
AB  - In an immunohistopathologic study using two monoclonal antibodies that recognize
      independent epitopes on human thrombomodulin, we detected expression of
      thrombomodulin on Malpighian-layer keratinocytes, but not on the basal or upper
      granular-layer keratinocytes. Western blotting and thrombomodulin-specific enzyme
      linked immunosorbent assay performed on both shaved skin and cultured SV40
      transformed keratinocytes showed the expression of full-length thrombomodulin,
      indistinguishable from endothelial thrombomodulin. Thrombomodulin was expressed
      by keratinocytes in 1 mM calcium but not in reduced calcium. A functional assay
      for thrombomodulin revealed that epidermal-derived thrombomodulin possessed
      cofactor activity for thrombin-catalyzed protein C activation. The limited
      pattern of expression of thrombomodulin in epidermis implies that this molecule
      may be a differentiation marker of keratinocytes in addition to being a potent
      anticoagulant in the skin.

PMID- 7798623
TI  - Abnormal Bcl-2 and "tissue" transglutaminase expression in psoriatic skin.
AB  - Cell death by apoptosis plays a key role in skin development and homeostasis.
      Previous studies have shown that increased apoptosis characterizes several
      pathologic conditions affecting human skin. Thus, the pathogenesis of cutaneous
      diseases may involve an imbalance in the homeostatic mechanisms determining
      whether the death of keratinocytes will occur by terminal differentiation or
      apoptosis. We investigated the involvement of apoptosis in psoriasis. For this
      purpose, we assessed, in addition to morphology and DNA fragmentation, the
      expression of two putative apoptotic genes, bcl-2 and "tissue" transglutaminase,
      in normal and psoriatic skin. A large number of keratinocytes showing biochemical
      and morphologic features of cells undergoing apoptosis was observed in all the
      suprabasal layers of the psoriatic epidermis. The plaques from all patients
      analyzed showed a dramatic reduction in the number of bcl-2-positive cells
      localized in the basal cell compartment. In contrast, the psoriatic lesions
      presented a marked induction in "tissue" transglutaminase, which was localized
      specifically to the cytoplasm of apoptotic keratinocytes. "Tissue"
      transglutaminase protein staining was undetectable in normal epidermis. The bcl-2
      and "tissue" transglutaminase staining pattern observed in psoriasis also was
      found in the skin of patients affected by lichen planus. These findings indicate
      that these two genes are regulated in an opposite fashion in psoriatic
      keratinocytes undergoing apoptosis, thus confirming their antithetic role in the
      cascade of events leading to the establishment of the mature apoptotic phenotype.

PMID- 7798624
TI  - Occlusion lowers cytokine mRNA levels in essential fatty acid-deficient and
      normal mouse epidermis, but not after acute barrier disruption.
AB  - Acute disruption of the permeability barrier by either tape stripping or acetone
      treatment and chronic disruption by feeding an essential fatty acid-deficient
      diet increase the mRNA levels of tumor necrosis factor-alpha (TNF alpha),
      interleukin (IL)-1 alpha, IL-1 beta, IL-1ra, and granulocyte/macrophage-colony
      stimulating factor in murine epidermis. Furthermore, epidermal TNF alpha protein
      levels also are stimulated by barrier disruption. To understand the relation of
      epidermal cytokine production to barrier function, we studied the effect of the
      application of a water vapor-impermeable membrane on epidermal cytokine
      production both in normal epidermis and after barrier disruption. Latex occlusion
      of essential fatty acid-deficient mice for 24-48 h lowered the mRNA levels of
      epidermal TNF alpha, IL-1 alpha, and IL-1ra to nearly control values, but not the
      levels of IL-1 beta mRNA. Occlusion of normal mice for 8, 24, and 48 h did not
      alter the levels of epidermal mRNAs encoding TNF alpha, IL-1 beta, or IL-1ra. Yet
      mRNA levels of IL-1 alpha, the major constitutively produced epidermal cytokine,
      were reduced by 40% after 24 h and by 80% after 48 h of occlusion of normal mouse
      epidermis. In contrast, latex occlusion of mice immediately after acute barrier
      disruption by either tape stripping or acetone treatment blocked neither the
      stimulation of epidermal mRNAs for TNF alpha, IL-1 alpha, IL-1 beta, or IL-1ra,
      nor the increase in epidermal TNF alpha protein. Taken together, these results
      suggest that barrier status regulates the production of specific cytokines in
      essential fatty acid-deficient and normal mouse epidermis. However, the signals
      that regulate epidermal cytokine production in response to acute barrier
      disruption do not appear to be influenced by occlusion.

PMID- 7798625
TI  - International symposium on epidermolysis bullosa. The William and Ida Friday
      Continuing Education Center, The University of North Carolina at Chapel Hill,
      Chapel Hill, North Carolina, April 25-26, 1994. Abstracts.
AB  - An international symposium on inherited epidermolysis bullosa was held at the
      University of North Carolina at Chapel Hill on April 25-26, 1994. All areas
      currently of clinical and research interest pertinent to this disease were
      discussed, ranging from basic epidemiologic issues to the definition of molecular
      defects in each of the three major types of epidermolysis bullosa and the
      potential for gene therapy. A major focus of this meeting was the presentation of
      data collected by the National Epidermolysis Bullosa Registry.

PMID- 7798626
TI  - Use of a serum-free epidermal culture model to show deleterious effects of
      epidermal growth factor on morphogenesis and differentiation.
AB  - The presence of serum has limited the utility of many culture models for the
      study of cytokine effects because its complexity and variability can confound the
      interpretation of data. In the present study, a serum-free skin co-culture model
      was used to investigate the effect of exogenous epidermal growth factor (EGF) on
      epidermal proliferation and differentiation. Human keratinocytes cultured on
      collagen rafts at the air-liquid interface produced a well-differentiated
      epithelium that resembled normal epidermis. Keratin filaments, membrane-coating
      granules, and keratohyalin granules were all observed. Epidermal differentiation
      markers keratin K1/K10, involucrin, and transglutaminase were localized in most
      of the suprabasal layers, whereas profilaggrin/filaggrin was confined to the
      granular layers and stratum corneum. In the continual presence of 10-20 ng/mL
      EGF, the epidermis was less organized, thinner, and less proliferative. EGF also
      depressed several indicators of differentiation: The number of keratohyalin
      granules and membrane-coating granules was greatly decreased; antigen expression
      of profilaggrin/filaggrin appeared diminished by immunocytochemical staining;
      frequent nuclear retention was noted in the relatively thickened stratum corneum
      like layers. As detected by immunohistochemical staining, the expression of EGF
      receptor in the epidermis was reduced by exogenous EGF. These data illustrate
      that EGF cannot be considered a simple mitogen. Our findings also underscore the
      importance of using sophisticated culture models to assess complex cytokine
      effects that may be dependent on the architecture of a differentiating epidermis.

PMID- 7798627
TI  - Both dendritic cells and memory T lymphocytes emigrate from organ cultures of
      human skin and form distinctive dendritic-T-cell conjugates.
AB  - Prior studies of mouse skin in organ culture have shown that dendritic cells
      selectively emigrate from the explants over 1-3 d. This emigration may model the
      movements of dendritic cells that can occur in situ, as in transplantation and
      contact sensitivity. In this study, we cultured explants of normal human skin
      that had been removed with a dermatome. Dendritic cells with characteristic
      morphology and mixed leukocyte response-stimulatory activity emigrated. The
      dendritic cells had the expected phenotype, e.g., rich in major
      histocompatibility complex class II and accessory molecules such as B7-1,
      intercellular adhesion molecule-1, and leukocyte function-associated antigen-3.
      Small lymphocytes also were present in the emigrated populations and proved to be
      T cells exclusively, almost entirely of the TcR alpha beta and memory type
      (CD45RAweak, CD45RO LFA-3/CD58+), with a CD4:CD8 subset ratio of about 2:1. Some
      of the T cells were bound tightly to the dendritic cells. These conjugates did
      not dissociate after exposure to trypsin or to calcium- and magnesium-free
      medium, or during cytofluorography. This made it possible to sort distinct
      populations of single dendritic cells, single T cells, and conjugates of the two
      cell types. Conjugates would continue to form from mixtures of separated
      dendritic cells and T cells in culture. Therefore, cutaneous dendritic cells and
      memory T lymphocytes emigrate from human skin explants, and some of these cells
      form distinctive conjugates that we hypothesize contribute to immunologic recall
      reactions.

PMID- 7798628
TI  - The antiproliferative and differentiative activities of 1,25-dihydroxyvitamin D3
      are potentiated by epidermal growth factor and attenuated by insulin in cultured
      human keratinocytes.
AB  - 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) is a potent inhibitor of keratinocyte
      proliferation, as well as a stimulator of epidermal terminal differentiation. In
      the present studies, we investigated the influence of epidermal growth factor
      (EGF) and insulin on the antiproliferative and differentiation activities of
      1,25(OH)2D3. Our results indicate the following: (1) EGF caused a dramatic
      potentiation of the 1,25(OH)2 D3-induced inhibition of 3H-thymidine incorporation
      into keratinocytes in a dose-dependent manner; (2) insulin acted antagonistically
      on the EGF-dependent potentiation of the 1,25(OH)2D3-induced antiproliferative
      activity; (3) transforming growth factor-alpha potentiated 1,25(OH)2D3-induced
      antiproliferative activity similar to EGF; (4) the EGF effect was not dependent
      upon 1,25(OH)2D3 receptor mRNA up-regulation; and (5) removal of insulin from
      medium supplemented with growth factors significantly potentiated the 1,25(OH)2D3
      induced inhibition on the number of basal cells and the 1,25(OH)2D3-dependent
      cornified envelope formation. In conclusion, the antiproliferative activity of
      1,25(OH)2D3 in cultured normal human keratinocytes is greatly enhanced by EGF or
      transforming growth factor-alpha and reduced by insulin. Insulin also inhibits
      1,25(OH)2D3-induced terminal differentiation of cultured normal human
      keratinocytes.

PMID- 7798629
TI  - Different effects of basic fibroblast growth factor and transforming growth
      factor-beta on the two platelet-derived growth factor receptors' expression in
      scleroderma and healthy human dermal fibroblasts.
AB  - Previous studies have demonstrated that platelet-derived growth factor (PDGF)
      alpha receptor expression is up-regulated by transforming growth factor-beta 1
      (TGF-beta 1) in scleroderma dermal fibroblasts, but not in healthy control
      fibroblasts. We asked whether this selective effect in scleroderma cells was TGF
      beta 1-specific or a general response by studying responses to other growth
      factors. In this study, we compared the expression of alpha and beta PDGF
      receptor subunits (mRNA and protein levels) in these two cell types in response
      to basic fibroblast growth factor (bFGF) and TGF-beta 1. bFGF coordinately
      stimulated mRNA levels of alpha and beta receptor subunits in healthy
      fibroblasts, but did not change PDGF receptor expression in scleroderma
      fibroblasts. Conversely, and in agreement with previous observations, TGF-beta 1
      induced PDGF alpha receptor expression in scleroderma fibroblasts, but not in
      healthy fibroblasts. PDGF beta receptor mRNA levels were induced to similar
      degrees by TGF-beta 1 in both cell types. PDGF alpha receptor protein levels
      correlated directly with mRNA levels, induced by bFGF only in healthy fibroblasts
      and by TGF-beta 1 only in scleroderma fibroblasts. However, PDGF beta receptor
      protein levels were not altered by either growth factor in either cell type.
      Thus, the activated state of scleroderma fibroblasts does not include receptor
      signaling pathways to bFGF. This distinct pattern of expression of PDGF alpha
      receptors in scleroderma fibroblasts suggests a possible role for the
      coordinately expressed PDGF AA ligand/alpha receptor system in the development of
      fibrosis.

PMID- 7798630
TI  - Oncostatin M stimulates collagen and glycosaminoglycan production by cultured
      normal dermal fibroblasts: insensitivity of sclerodermal and keloidal
      fibroblasts.
AB  - It is thought that normal fibrotic repair progresses to dermal fibrosis when
      fibroblasts are activated persistently by chronic exposure to cytokines such as
      transforming growth factor-beta. However, additional cytokines and mechanisms may
      play a role in the development of fibrosis. Thus, we examined a recently
      described T-lymphocyte/macrophage-derived cytokine, oncostatin M, for its effect
      on the production of collagen and glycosaminoglycan by microcultures of normal
      dermal, sclerodermal, and keloidal fibroblasts. Treatment with oncostatin M for
      48 h induced dose-dependent (1-100 ng/ml) increases in the collagen and
      glycosaminoglycan production of nine normal fibroblast strains, which in the
      absence of fetal bovine serum at 100 ng/ml averaged 196% and 244%, respectively.
      Oncostatin M treatment increased both types I and III procollagens and their mRNA
      transcripts, as well as levels of hyaluronic acid, chondroitin-4/6 sulfates, and
      dermatan sulfate, but not fibronectin or general noncollagenous protein
      synthesis. In contrast, the collagen production of six of eight sclerodermal and
      keloidal fibroblast strains was essentially unresponsive to oncostatin M
      treatment, with 100 ng/ml inducing an average increase of only 34% for the eight
      fibrotic strains. Oncostatin M stimulation of fibrotic fibroblast
      glycosaminoglycan production was also hyporesponsive, as 100 ng/ml of oncostatin
      M induced an average increase of only 101%. These results indicate that
      oncostatin M could function as a stimulator of normal fibrotic repair via
      activation of fibroblast collagen and glycosaminoglycan synthesis and that the
      persistent activation of sclerodermal and keloidal fibroblasts is accompanied by
      a loss of sensitivity to oncostatin M stimulation.

PMID- 7798631
TI  - Ultrastructural evidence for nerve fibers within all vital layers of the human
      epidermis.
AB  - To prove the existence of human intraepidermal nerve fibers at the electron
      microscopic level, we used both conventional and immunohistochemical
      ultrastructural techniques. Specimens were obtained from skin of the back, one of
      the most densely innervated areas of the human epidermis. The immunohistochemical
      marker protein gene product 9.5 was chosen because it is highly potent in
      labeling nerves. Thin nerve fibers were found in the basal, spinous, and granular
      layers of the epidermis with both techniques used, although it was more difficult
      to identify the nervous structures with the conventional method. The nerves
      appeared in the intercellular spaces and contacted keratinocyte cell bodies or
      cilia by membrane-membrane apposition, but without any specialized structures.
      Nerve fibers in the very superficial part of the vital human epidermis have not
      been described before at the ultrastructural level.

PMID- 7798632
TI  - Antibodies to the E4, E6, and E7 proteins of human papillomavirus (HPV) type 16
      in patients with HPV-associated diseases and in the normal population.
AB  - In a cross-sectional study, titers of antibodies to the E4 and E7 proteins of
      human papillomavirus (HPV) type 16 were measured by peptide-based enzyme-linked
      immunosorbent assay in 1707 sera. Sera were obtained from healthy individuals
      (ages 1 to 95 years), from patients with HPV-associated infection (cervical
      intraepithelial neoplasia and cervical cancer), and from patients who were at
      high risk for HPV infection (attending a sexually transmitted disease clinic or
      referred to a colposcopist because of an abnormal Papanicolaou smear). The
      prevalence of anti-E7 antibodies increased with age, although the overall
      prevalence in the adult population was low (10.36%) compared to the frequent
      detection of HPV 16 DNA in the population. This suggests that only a fraction of
      patients infected with HPV 16 develop an anti-E7 response. The age distribution
      of anti-E4 antibodies showed a different pattern, i.e., the prevalence was low in
      the adult population (1.14%) but exceeded 20% in children and teenagers. As the
      specificity of the anti-E4 reaction was supported by a highly significant
      association with anti-E6 positivity in children's sera (p = 0.002), it was
      assumed that infection with HPV 16 can occur frequently early in life. As
      compared to healthy controls, patients at high risk for HPV infection had a
      significantly higher frequency (p < 0.001) of antibodies to the HPV 16 E4 protein
      (but not to the E6 or the E7 protein) in their sera. Therefore, we conclude that
      in adults E4-specific antibodies may be a marker for virus replication.

PMID- 7798633
TI  - Direct imaging of molecular transport through skin.
AB  - Scanning electrochemical microscopy (SECM) was used to image spatial variations
      in the molecular flux of Fe(CN)6(-4) across excised hairless and nude mouse skin.
      The SECM response is specific to electroactive molecules, allowing selective
      imaging of the flux of Fe(CN)6(-4) in multicomponent ionic solutions.
      Quantitative SECM image analysis demonstrated that 40% to 60% of the total
      Fe(CN)6(-4) flux occurred through appendages in the skin. SECM analysis of skin
      samples exposed to a known transport enhancer, sodium dodecylsulfate, indicated
      that the increase in the ion transport rate occurred exclusively in nonporous
      skin tissue.

PMID- 7798634
TI  - Adhesion molecules. I: Keratinocyte-keratinocyte interactions; cadherins and
      pemphigus.
AB  - During the last few years, considerable progress has been made in our
      understanding of the structure and function of cadherins and of the
      pathophysiology of pemphigus. Cadherins are a multiple gene family of Ca(++)
      dependent cell adhesion molecules with a typical single-spanning transmembrane
      structure. Cadherins have two major subfamilies, classic cadherin and desmosomal
      cadherin. Classic cadherins, including E-, P-, and N-cadherins, are characterized
      by a homophilic binding specificity. They localize at adherens junctions and
      mediate physiologic interaction with the involvement of cytoplasmic anchoring
      molecules, catenins, and the actin-based cytoskeleton network. Desmosomal
      cadherins, the desmocollins and desmogleins, localize at desmosomes and are
      linked to the intermediate keratin filaments network via plakoglobin and
      desmoplakin. Molecular cloning has demonstrated that the autoantigens of both
      pemphigus vulgaris and pemphigus foliaceus are members of the desmoglein
      subfamily of the cadherin supergene family. Thus, pemphigus is characterized as
      an anti-cadherin autoimmune disease. Furthermore, a baculovirus recombinant
      protein of pemphigus vulgaris antigen was capable of absorbing out the pathogenic
      autoantibodies from patients' sera, providing a possibility of antigen-specific
      therapeutic strategies for pemphigus.

PMID- 7798635
TI  - Suppressive and enhancing effects of ultraviolet B radiation on expression of
      contact hypersensitivity in man.
AB  - Ultraviolet B (UVB) radiation has multiple effects on the immune system, and
      these effects contribute to the development of UVB-induced skin cancers in mice,
      and probably man. Depending upon dose and duration of UVB exposure, the resultant
      immune aberrations may be strictly local (at the irradiated skin site) or
      systemic. One important local effect of acute, low-dose UVB regimens is impaired
      induction of contact hypersensitivity (CH). Because a significant proportion of
      humans who develop CH when hapten is painted on UVB-exposed skin fall to display
      a primary allergic reaction at that site, we inquired into the effects of UVB
      radiation on the expression of CH in man. A high proportion of individuals who
      were first exposed to a sensitizing dose of hapten via UVB-exposed skin displayed
      CH when challenged on unirradiated (normal) skin 11 d later. However, only 50% of
      these subjects developed CH when challenged simultaneously on skin that had been
      exposed to UVB radiation 11 d previously. Because the density of epidermal
      antigen-presenting cells was comparable in both responders and non-responders, we
      interpret these findings to mean that UVB radiation can create a sustained
      immunosuppressive microenvironment that inhibits the expression of CH. In
      separate experiments, when normal volunteers were sensitized with hapten via
      unirradiated (normal) skin, expression of CH at UVB-exposed challenge sites 11 d
      later was found to be enhanced, at least in some individuals, compared to
      expression of CH at unirradiated challenge sites. Thus, the local effects of UVB
      radiation on expression of CH in man may be enhancing or inhibitory, depending
      upon whether initial sensitization occurred through normal or through UVB-exposed
      skin.

PMID- 7798636
TI  - No evidence for Borrelia burgdorferi-specific DNA in lesions of localized
      scleroderma.
AB  - A possible association of Borrelia burgdorferi with localized scleroderma is
      currently the focus of intense research and discussion. Skin biopsies from 30
      patients with localized scleroderma (28 of the plaque type/morphea; two linear
      scleroderma) were analyzed for the presence of Borrelia burgdorferi using three
      different polymerase chain reaction systems for amplification of segments of
      borrelial genes. Formalin-fixed, paraffin-embedded biopsies of 14 patients and
      fresh-frozen, cryo-conserved biopsies of 16 patients with localized scleroderma
      were obtained. Lesions of all patients showed clear signs of scleroderma and
      disease progression at the time of biopsy. Fresh-frozen as well as formalin-fixed
      biopsies from patients with erythema migrans or acrodermatitis chronica
      atrophicans were used as positive controls. With all three polymerase chain
      reaction systems, borrelial DNA was detected in none of the 30 specimens of
      localized scleroderma. In contrast, with one polymerase chain reaction system,
      Borrelia burgdorferi-specific DNA was found in 24 of 27 frozen biopsies from
      patients with erythema migrans and in all 5 analyzed frozen biopsies of patients
      with acrodermatitis chronica atrophicans. In approximately half of the paraffin
      embedded biopsies from patients with erythema migrans (nine of 23) and
      acrodermatitis chronica atrophicans (13 of 27), Borrelia burgdorferi-specific DNA
      was identified. These results question the association of localized scleroderma
      with known subtypes of Borrelia burgdorferi.

PMID- 7798637
TI  - Interleukin-10 production by cultured human keratinocytes: regulation by
      ultraviolet B and ultraviolet A1 radiation.
AB  - Keratinocytes are the primary cellular target for ultraviolet radiation in human
      skin, and ultraviolet radiation-induced therapeutical effects may thus be
      mediated by keratinocyte-derived, antiinflammatory mediators. Interleukin-10 is
      capable of exerting antiinflammatory effects by virtue of its capacity to
      suppress the production of interferon-gamma. The present study therefore assessed
      the ability of cultured human keratinocytes to produce interleukin-10 following
      ultraviolet irradiation. Exposure of long-term cultured normal human
      keratinocytes to ultraviolet B (280-320 nm) or to ultraviolet A1 (340-400 nm)
      radiation caused a time- and dose-dependent induction of interleukin-10 mRNA
      expression and interleukin-10 protein secretion, with ultraviolet A1 radiation
      being the strongest stimulus. Ultraviolet radiation-induced interleukin-10
      production by normal human keratinocytes was enhanced by a factor of two, when
      cells were cultured in high- rather than low-calcium medium. Neither addition of
      the ultraviolet radiation-inducible cytokines tumor necrosis factor-alpha or
      interleukin-1 alpha to unirradiated keratinocytes nor presence of their
      respective neutralizing antibodies in cultures of irradiated keratinocytes
      induced or inhibited interleukin-10 synthesis. Modulation of eicosanoid
      production by addition of prostaglandin E2 to keratinocyte cultures or
      disturbance of cyclooxygenase activity by indomethacin did not affect interleukin
      10 production in resting or irradiated cells. These studies demonstrate that
      cultured human keratinocytes are capable of producing interleukin-10. Human
      keratinocyte interleukin-10 production is dependent on the differentiation state
      of the cell and induced by ultraviolet B and, in particular, ultraviolet A1
      radiation exposure. This novel property of ultraviolet radiation may account at
      least in part for the efficacy of phototherapy in inflammatory skin diseases.

PMID- 7798638
TI  - Pemphigus IgG, but not bullous pemphigoid IgG, causes a transient increase in
      intracellular calcium and inositol 1,4,5-triphosphate in DJM-1 cells, a squamous
      cell carcinoma line.
AB  - It is still unclear what kinds of mechanisms are involved in blister formation
      after antibodies bind to the antigens in pemphigus and bullous pemphigoid. The
      effects of IgGs from pemphigus vulgaris, pemphigus foliaceus, and bullous
      pemphigoid sera on intracellular calcium concentration ([Ca++]i) and inositol
      1,4,5-trisphosphate were examined in a human squamous cell carcinoma cell line
      (DJM-1 cells) and in cultured human keratinocytes to clarify whether signal
      transduction via calcium is involved. IgGs were purified with protein A affinity
      column from the sera of five pemphigus vulgaris patients, three pemphigus
      foliaceus patients, eight bullous pemphigoid patients, and 14 normal volunteers.
      Keratinocytes were cultured in Eagle's minimum essential medium containing 1.8 mM
      Ca++ and loaded with fura-2/AM, followed by addition of the IgGs. Subsequently,
      [Ca++]i was determined by measuring the fluorescence ratio (F340/F360) with
      videomicroscopy. Pemphigus IgGs (seven of eight cases) induced a rapid and
      transient increase in [Ca++]i in both the cells, whereas a [Ca++]i increase was
      caused by very few IgGs from bullous pemphigoid (one of eight cases) and normal
      sera (two of 14 cases). The pemphigus IgG-induced transient [Ca++]i increase was
      not affected by chelating extracellular Ca++ with ethyleneglycol-bis(beta
      aminoethyl ether)-N,N,N',N'-tetracetic acid. In addition, monoclonal antibodies
      acid. In addition, monoclonal antibodies against 180-kD and 230-kD antigens did
      not exert this change. Pemphigus IgGs that caused a [Ca++]i increase induced
      rapid and transient production of inositol 1,4,5-trisphosphate, peaking at 20
      seconds. These findings suggest that IgG from pemphigus induces Ca++ mobilization
      by inositol 1,4,5-trisphosphate from internal stores, and that mechanisms of
      antibody-transmitted signaling in pemphigus may differ from those in bullous
      pemphigoid.

PMID- 7798639
TI  - Structure-function relations in the inhibition of murine contact hypersensitivity
      by amiloride.
AB  - Topical application of amiloride, a potent inhibitor of the Na+/H+ antiport,
      inhibits cutaneous inflammation induced by ultraviolet radiation or contact
      hypersensitivity in mice. Amiloride analogues with greater and lesser inhibition
      of the Na+/H+ exchange were tested to determine whether anti-inflammatory effects
      correlate with this activity. Structural analogues of amiloride without
      significant activity at the Na+/H+ antiport (pyrazine, pyrazinamide, and
      chloropyrazine) failed to inhibit contact hypersensitivity. N-amidino-3-amino-5
      dimethyl amino-6-chloropyrazinecarboxamide (DMA) has a 23-fold greater affinity
      for the Na+/H+ antiport compared to amiloride, but failed to inhibit contact
      hypersensitivity in this assay. 3,5-diamino-6-chloropyrazine-amido-guanidine
      (DCG), which has only 7% of the affinity of amiloride for the antiport,
      suppressed contact hypersensitivity as well as amiloride. Experiments examining
      the ability of these agents to diffuse through mouse skin revealed amiloride to
      be superior to both DCG and DMA, which were approximately equal. DMA, with
      greater inhibition of the Na+/H+ antiport but lesser ability to inhibit contact
      hypersensitivity, inhibited protein synthesis and induced cell death more than
      amiloride or DCG. Amiloride and DCG hold promise as topical anti-inflammatory
      agents. Their anti-inflammatory properties do not correlate with affinity for the
      Na+/H+ antiport, ability to penetrate murine skin, or inhibition of protein
      synthesis.

PMID- 7798640
TI  - Enhancement of delayed hypersensitivity inflammatory reactions in guinea pig skin
      by 12(R)-hydroxy-5,8,14-eicosatrienoic acid.
AB  - Delayed-type hypersensitivity (DTH) reactions are initiated by sensitized T
      cells. Their progression is dependent upon the local release of various
      autacoids, including cytokines and eicosanoids, by T cells, infiltrating
      inflammatory cells, and resident tissue cells. 12(R)-hydroxy-5,8,14
      eicosatrienoic acid [12(R)-HETrE], an eicosanoid produced by skin and cornea,
      possesses potent proinflammatory properties at picomolar concentrations including
      vasodilation, increase in membrane permeability, neutrophil chemotaxis, and
      angiogenesis. Because DTH reactions are associated with many of these same
      phenomena, we examined the effect of 12(R)-HETrE and related 12
      hydroxyeicosanoids on the expression of DTH to purified protein derivative of
      tuberculin in sensitized guinea pigs. In the absence of purified protein
      derivative of tuberculin, none of the eicosanoids evoked erythema or edema after
      intradermal injection at doses up to 100 pmol. When injected together with
      purified protein derivative of tuberculin, 12(R)-hydroxy-5,8,10,14
      eicosatetraenoic acid [12(R)-HETE], but not its enantiomer 12(S)-HETE,
      significantly inhibited macroscopic expression of delayed reactivity (erythema)
      only at the highest dose tested, 10 pmol. In contrast, 12(R)-HETrE significantly
      enhanced expression of DTH at doses between 1 fmol and 1 pmol (50% and 30%
      increases above control, respectively). Its stereoisomer, 12(S)-HETrE, did not
      enhance DTH at any tested dose, but was able to block the activity of 12(R)-HETrE
      when injected simultaneously. Enhancement or inhibition of visible skin responses
      was not associated with qualitative or quantitative changes in cellular
      infiltrates at the reaction site. 12(R)-HETrE had no effect on the nonimmunologic
      inflammatory skin reaction induced by phorbol myristate acetate, suggesting
      selectivity toward DTH. We conclude that 12(R)-HETrE enhances DTH via a yet to be
      determined mechanism and that its stereoisomer, 12(S)-HETrE, may be a useful
      antagonist for studying the inflammatory actions of this eicosanoid.

PMID- 7798641
TI  - Agonist-induced expression of tissue inhibitor of metalloproteinases and
      metalloproteinases by human macrophages is regulated by endogenous prostaglandin
      E2 synthesis.
AB  - The regulatory effect of endogenously synthesized eicosanoid metabolites on the
      expression of tissue inhibitor of metalloproteinases (TIMP), interstitial
      collagenase, and 92-kDa gelatinase by human macrophages was examined. TIMP and
      metalloproteinase production were stimulated with three agonists that produce
      distinct patterns of eicosanoid synthesis: lipopolysaccharide (10 micrograms/ml),
      denatured collagen (10 micrograms/ml), or zymosan (1 mg/ml). Indomethacin (3
      micrograms/ml) or MK886 (3 microM), a specific inhibitor of 5-lipoxygenase, was
      used to examine the role of endogenous metabolites of arachidonic acid.
      Regardless of the agonist used, TIMP production by macrophages was inhibited 65%
      by indomethacin, synthesis of interstitial collagenase was reduced 70%, and
      expression of 92-kDa gelatinase was decreased 40%. In contrast, inhibition of
      leukotriene synthesis had no effect on metalloproteinase or TIMP production. The
      agonist-stimulated increase in TIMP and collagenase production was directly
      correlated to the cumulative prostaglandin E2 level induced by the agonist used.
      However, if response to an agonist was poor, the exogenous addition of
      prostaglandin E2 could not increase TIMP or collagenase production more than
      twofold, indicating an important permissive effect of the agonist on the
      regulation of each protein's expression. The mechanism of indomethacin inhibition
      of TIMP and collagenase production was studied by labeling the cells with [35S]
      methionine and performing immunoprecipitation using specific antiserum.
      Indomethacin markedly inhibited the lipopolysaccharide-induced biosynthesis of
      both TIMP and collagenase. Northern analysis revealed parallel suppression of
      TIMP and collagenase steady-state mRNA levels by indomethacin, indicating
      pretranslational control. The regulation of inflammatory-cell TIMP and
      interstitial collagenase expression by prostaglandin E2 suggests that therapy
      inhibiting the cellular response to prostaglandins may be useful in cutaneous and
      systemic disease states involving macrophage-mediated connective-tissue
      destruction.

PMID- 7798642
TI  - Ultraviolet B-induced apoptosis of keratinocytes in murine skin is reduced by
      mild local hyperthermia.
AB  - Two components of sunlight, ultraviolet (UV) B (290-320 nm) and infrared (greater
      than 700 nm), each cause damage to the skin. However, we recently identified a
      protective response in which heat reduces UVB-induced killing of cultured
      keratinocytes. Here, this investigation is extended to the living epidermis. The
      effects of hyperthermic preconditioning upon UVB-induced apoptosis were studied
      morphologically with hematoxylin and eosin staining, and biochemically with TUNEL
      (terminal deoxynucleotide transferase nick-end labeling) to measure
      endonucleolytic cleavage of DNA in situ. Anesthetized SKH-1 hairless mice were
      exposed to UVB light (0 to 120 mJ/cm2), after which their skin was biopsied at 24
      h and paraffin sections were stained with hematoxylin and eosin or with TUNEL.
      Apoptotic keratinocytes were found to increase after UVB in a dose-related
      manner. In contrast, if one flank of the mouse was pretreated at 40 degrees C for
      1 h and both flanks subsequently were UVB-irradiated at 6 h, the resulting
      formation of apoptotic cells was reduced twofold or more in the heated flank.
      Protection appeared by 3 h, reached a maximum at 6 h, and disappeared by 12 h. In
      summary, heat induces a transient protective effect that reduces UVB-mediated
      death of keratinocytes in skin at physiologically attainable doses of heat and
      UVB.

PMID- 7798643
TI  - Repair of ultraviolet B and singlet oxygen-induced DNA damage in xeroderma
      pigmentosum cells.
AB  - Ultraviolet B (UVB) (290-320 nm) is capable of damaging the DNA molecule directly
      by generating predominantly pyrimidine dimers. UVA (320-400 nm) does not alter
      the DNA molecule directly. However, when it is absorbed by cellular
      photosensitizers, it can damage the DNA molecule indirectly, e.g., by mediation
      of singlet oxygen, generating predominantly 8-hydroxyguanine. These indirect
      effects have been implicated in the mutagenic, genotoxic, and carcinogenic
      effects of UVA. To study the processing of directly and indirectly UV-induced DNA
      damage in intact, DNA-repair-proficient and -deficient human cells, we used the
      replicating plasmid pRSVcat, either irradiated with up to 10 kJ/m2 UVB or treated
      with the photosensitizer methylene blue plus visible light (which generates
      singlet oxygen). These treated plasmids were introduced into lymphoblast lines
      from normal donors or from patients with xeroderma pigmentosum (XP)
      complementation groups A, C, D, E, and variant. DNA repair was assessed by
      measuring activity of reactivated chloramphenicol-acetyl-transferase enzyme,
      encoded by the plasmid's cat gene, in cell extracts after 3 d. As expected, the
      repair of UVB-induced DNA damage was reduced in all XP cell lines, and the degree
      varied with the complementation group. XP-A, -D, -E, and -variant cells were
      normally efficient in the repair of singlet oxygen-induced DNA damage. Only three
      of four XP-C cell lines showed a markedly reduced repair of these lesions. This
      indicates differential DNA-repair pathways for directly and indirectly UV-induced
      DNA damage in human cells and suggests that both may be affected in XP-C.

PMID- 7798644
TI  - Human keratinocytes express the three major splice forms of vascular endothelial
      growth factor.
AB  - Vascular endothelial growth factor is a powerful mitogen for endothelial cells,
      recently reported to be produced by keratinocytes. In the present work, we
      examined human keratinocytes in primary culture for the splice variants of
      vascular endothelial growth factor. In situ hybridization revealed that 100% of
      cultured human keratinocytes expressed mRNA for this cytokine, and analysis by
      reverse transcriptase-polymerase chain reaction indicated that three species of
      mRNA were produced. Southern hybridization and size calculations of PCR products
      revealed mRNA species corresponding to 121, 165, and 189 amino-acid forms of this
      cytokine. Using a rabbit anti-vascular endothelial growth factor antiserum, we
      radioimmunoprecipitated two molecular weight forms (approximately 45 and 58 kDa,
      non-reducing conditions) from keratinocyte culture supernatants. Under reducing
      conditions, three bands of approximately 15, 20, and 24 kDa appeared,
      corresponding with the predominant forms of vascular endothelial growth factor
      described. We propose that secretion of vascular endothelial growth factor by
      human keratinocytes in vivo sustains angiogenesis during physiologic tissue
      repair and in pathologic states accompanied by neovascularization.

PMID- 7798645
TI  - Neurofibromatosis 2 and neurilemmomatosis gene are identical.
AB  - Neurofibromatosis 2 (NF2) is an autosomal dominant disorder characterized by the
      occurrence of bilateral acoustic neuromas, as well as meningiomas and
      schwannomas. The gene locus for NF2 resides on chromosome 22q12 and has been
      cloned recently. Neurilemmomatosis is characterized by multiple cutaneous and
      spinal neurilemmomas without other signs of NF1 or NF2. Many cases with this
      disorder include the diagnosis of neurofibromatosis or other rare diseases
      unexplained by current nosology. In this study, we analyzed the peripheral
      leukocytes and tissue from cutaneous neurilemmomas of seven patients with
      neurilemmomatosis using DNA markers for different regions of chromosome 22. We
      detected allelic losses in three of seven tumors from seven patients with a probe
      for the NF2 region of the long arm of chromosome 22 and the germ-line mutations
      in two of three tumors from the same three patients. Mutations in the NF2 gene
      were a deletion from at least codon 334 to 579 and G insertion at codon 42. We
      conclude that the neurilemmomatosis locus lies within the NF2 region and that
      these diseases might be identical.

PMID- 7798647
TI  - Nle4DPhe7 alpha-melanocyte-stimulating hormone increases the
      eumelanin:phaeomelanin ratio in cultured human melanocytes.
AB  - In mammals, melanin exists in two chemically distinct forms: the red-yellow
      phaeomelanin and the brown-black eumelanin. Although administration of the
      pigmentary hormone alpha-melanocyte-stimulating hormone (alpha MSH) and its
      synthetic analogue Nle4DPhe7 alpha MSH induces skin darkening in man, the
      increases in melanogenesis in cultured human melanocytes in response to these
      peptides are relatively small. However, it is possible that MSH affects the
      eumelanin:phaeomelanin ratio rather than total cellular melanin. Thus, this study
      examined the specific effects of Nle4DPhe7 alpha MSH on the two melanins in
      cultured human melanocytes, quantifying eumelanin and phaeomelanin by high
      performance liquid chromatography. Nle4DPhe7 alpha MSH induced significant
      increases in the eumelanin content of these cells while having lesser and varied
      effects on the levels of phaeomelanin. As a consequence, the
      eumelanin:phaoemelanin ratio was increased in every culture. These results
      demonstrate that Nle4DPhe7 alpha MSH affects melanin type in human melanocytes
      and suggest a possible mechanism by which this peptide induces skin darkening in
      man.

PMID- 7798646
TI  - Changes in expression of apoptosis-associated genes in skin mark early catagen.
AB  - Programmed cell death is central to hair biology, as the hair follicle undergoes
      cycles of growth (anagen), regression (catagen), and rest (telogen). During
      catagen, the hair follicle shortens via a pathway of programmed cell death and
      apoptosis. The molecular mechanisms involved in this process have not been
      elucidated yet. Using reverse transcriptase-polymerase chain reaction, we
      examined in this study the expression in total skin, throughout one hair cycle,
      of a series of regulatory genes associated with apoptosis. We show that gene
      expression within skin is hair-cycle-dependent. Transforming growth factor-beta
      was expressed immediately before catagen; therefore, it might be involved in the
      early signaling of this process. Tumor necrosis factor-beta was expressed during
      catagen and might be involved in follicular apoptosis. Several proto-oncogenes
      and transcription factors have been described in the regulation of apoptosis in
      other systems. Here we show that the transcript levels of c-myc, c-myb, and c-jun
      changed immediately before or during early catagen and thus could be involved in
      the signaling or regulation of catagen. Levels of p53 remained constant
      throughout anagen and catagen, suggesting that p53 is not involved in the
      developmentally induced apoptosis of the hair follicle. The variable expression
      throughout the hair cycle of the genes described demonstrates the dynamic changes
      of the skin and underscores the importance of studying the complete hair cycle
      when characterizing any molecule in skin.

PMID- 7798648
TI  - Differences between connective tissue-epithelial junctions in human skin and the
      anagen hair follicle.
AB  - Although the ultrastructure of the dermal-epidermal junction has been well
      characterized, little is known about the junctions between the dermal papilla and
      the surrounding epithelial cells of the hair bulb, or between the connective
      tissues and the epithelial cells on the outside of the hair follicle. Because the
      dermal papilla plays a major role in controlling the hair follicle, we also
      examined the ultrastructure of the potentially important dermal papilla
      epithelial junction in normal scalp anagen follicles. The dermal-epidermal
      junction in skin was a trilaminar basement membrane characterized by the
      anchoring points of hemidesmosomes and tonofilaments in keratinocytes. In the
      hair follicle, the junction that separated the dermal papilla and epithelial
      cells was a trilaminar basement membrane, but relatively few putative anchoring
      points were seen. These were similar to modified dermal-melanocyte junctions, in
      which the intercellular cytoplasmic filaments do not come together at an
      attachment plaque, the laminar components tend to be thinner, and the anchoring
      fibrils beneath the lamina densa are fewer. A trilaminar membrane also was
      interposed between the connective and epithelial tissues on the outside of the
      follicle, but nothing that resembled a hemidesmosome or any other type of
      anchoring structure was seen. The difference in structure of the junctional
      complex between skin and hair follicles probably reflects the relatively
      permanent state of the epidermis, compared to the dynamic processes involved
      during the anagen phase of the hair follicle.

PMID- 7798649
TI  - Protective and disease-enhancing immune responses to respiratory syncytial virus.
AB  - The National Institutes of Health, Centers for Disease Control and Prevention,
      and World Health Organization jointly sponsored a workshop on protective and
      disease-enhancing immune responses to respiratory syncytial virus (RSV). The
      primary purpose of the meeting was to discuss protective and disease-enhancing
      immune responses to RSV in the context of opportunities and barriers to the
      development of RSV vaccines. Although both live attenuated and subunit vaccines
      have been developed, it is not yet clear if any of these vaccines will be safe
      and effective. The fact that neither the disease-enhancing nor the protective
      immune response to RSV is well understood or well characterized is an important
      barrier to development of these vaccines. Studies in animal model systems and
      newly developed immunologic tools, however, provide hope that these barriers can
      be overcome and a safe and effective RSV vaccine can be developed.

PMID- 7798650
TI  - Comparison of different beta-lactam-glycopeptide-gentamicin combinations for an
      experimental endocarditis caused by a highly beta-lactam-resistant and highly
      glycopeptide-resistant isolate of Enterococcus faecium.
AB  - A synergistic bactericidal effect between penicillin, vancomycin, and gentamicin
      has been described against enterococci highly resistant to beta-lactams and
      glycopeptides. Since such a synergy was also observed in vitro between
      ceftriaxone, teicoplanin, and gentamicin against Enterococcus faecium 70/90, the
      efficacy of different combinations including penicillin or ceftriaxone,
      vancomycin or teicoplanin, and gentamicin was compared in vivo in experimental
      endocarditis. In vitro, all four triple combinations provided a bactericidal
      effect. In rabbits, after a 5-day treatment, the ceftriaxone-vancomycin
      gentamicin combination was the most effective, both in reducing the total
      bacterial titers and in eradicating the subpopulation resistant to the synergy.
      Compared with the 5-day regimen, 10- and 20-day regimens of ceftriaxone
      vancomycin-gentamicin, each followed by a 3-day antibiotic-free period, increased
      the number of sterilized animals but failed to avoid the emergence of resistant
      bacteria, which occurred in 10%-20% of animals.

PMID- 7798651
TI  - The effect of variations in the expression of pili on the interaction of
      Neisseria meningitidis with human nasopharyngeal epithelium.
AB  - Bacterial adherence is essential to colonization of the nasopharynx by Neisseria
      meningitidis, and pili may facilitate adherence. Scanning electron microscopy and
      immunogold labeling were used to study the interaction of 2 piliated and 1
      nonpiliated variant of N. meningitidis with nasopharyngeal mucosa in an adenoid
      organ culture system with an air-mucosal interface. Meningococcal infection
      caused epithelial damage, loss of ciliated epithelium, and ciliary
      disorganization, which progressed with time and were greater with the piliated
      strains. Pili increased adherence of meningococci to the mucosa, and there was
      tropism of piliated strains for nonciliated cells containing microvilli, damaged
      epithelium, and sites of cell separation. Bacterial adherence was associated with
      a change in the appearance of the microvilli.

PMID- 7798652
TI  - Correlation between susceptibility of infants to infections and interaction with
      neutrophils of Escherichia coli strains causing neonatal and infantile
      septicemia.
AB  - The ability of Escherichia coli strains causing invasive infections to associate
      to human neutrophils and induce oxygen radicals was studied in three groups of
      blood isolates from neonates and infants: low-virulence septicemia strains (LVS),
      normal septicemia strains (NS), and meningitis strains (M). Infants were
      classified by susceptibility to infection as low- (LR) or high-risk (HR). All LVS
      strains were isolated from HR infants and showed higher association to
      neutrophils (P < .05) and induced a higher oxidative response (P < .05) compared
      with that of NS and M strains from LR infants. Three LVS strains caused the cells
      to release oxidative metabolites extracellularly. Thus, impaired interaction with
      neutrophils is characteristic of virulent clones of E. coli capable of causing
      invasive infection in healthy full-term neonates. Furthermore, increased
      extracellular release of oxygen metabolites could harm the surrounding tissue and
      potentiate the inflammatory process.

PMID- 7798653
TI  - Age-related differences in cell-mediated immunity to varicella-zoster virus among
      children and adults immunized with live attenuated varicella vaccine.
AB  - Live attenuated varicella vaccine elicits protection against varicella-zoster
      virus (VZV), but adults require two doses to achieve optimal seroconversion
      rates. To assess the potential role of cell-mediated immunity (CMI), T cell
      proliferation to VZV antigen was compared in children and adults. Mean
      stimulation indices (SI) in two cohorts of 39 children tested 6 weeks after
      vaccination were 28.6 +/- 6.21 and 22.1 +/- 3.84, whereas 20 adult vaccines had a
      mean SI of 9.1 +/- 0.99 (P = .04). Vaccinees had significant increases in CMI
      after a second dose of vaccine. At 1 year, VZV CMI was significantly lower in
      adults after two doses (10.0 +/- 1.13 vs. 15.6 +/- 1.77; P = .02), even though
      82% of children received one dose. Limitations in the adult helper T cell
      response to VZV antigens may explain the need for booster doses to elicit
      effective immunity and the more frequent occurrence of varicella when adult
      vaccines are exposed to wild type virus.

PMID- 7798654
TI  - Effects of endotoxin in the lungs of neonatal rats: age-dependent impairment of
      the inflammatory response.
AB  - Age-dependent maturation of the intrapulmonary inflammatory responses to
      bacterial lipopolysaccharide (LPS) was studied because nosocomial gram-negative
      infections cause morbidity in newborn infants. Escherichia coli LPS or live E.
      coli were injected into the airways of neonatal or adult rats; intrapulmonary
      recruitment of leukocytes was measured 6 h later. Neonates showed age- and dose
      dependent impairment of intrapulmonary neutrophil recruitment after intratracheal
      administration of LPS or live E. coli that persisted for the first 28 days of
      life. Neonatal and adult alveolar macrophages released similar amounts of
      neutrophil chemotactic activity and tumor necrosis factor in response to
      incubation with LPS in vitro. Treatment of neonates with intratracheal or
      systemic interferon-gamma did not augment the response to LPS. Thus,
      intrapulmonary inflammatory responses to LPS and gram-negative bacteria are
      impaired early in life and do not approach adult levels until approximately 4
      weeks of age.

PMID- 7798655
TI  - Protective effects of a recombinant amino-terminal fragment of human
      bactericidal/permeability-increasing protein in an animal model of gram-negative
      sepsis.
AB  - Bactericidal/permeability-increasing protein (BPI) has bactericidal properties
      and also binds lipopolysaccharide (LPS). The ability of a recombinant amino
      terminal fragment of BPI to protect mice from death after challenge with a number
      of different strains of Escherichia coli was tested. BPI prevented death in
      animals challenged with the J5 rough strain but not with smooth strains O111:B4
      and O7K1. Protection was associated with a reduction in serum LPS and tumor
      necrosis factor-alpha levels but not with reduction in blood bacterial counts.
      BPI was effective at protecting against death in mice injected with purified
      O111:B4 LPS. Lack of protection after injection with live O111:B4 and O7K1 may be
      due to production by these models of approximately 1000-fold higher blood
      bacterial count compared with J5. Thus, BPI is a promising therapy in the
      treatment of gram-negative septic shock, although the range of organisms against
      which it is effective remains to be determined.

PMID- 7798656
TI  - Effect of interleukin-1 receptor antagonist and soluble tumor necrosis factor
      receptor in animal models of infection.
AB  - Intracisternal or intraarticular inoculation of rabbit recombinant interleukin
      (IL)-1 beta and rabbit tumor necrosis factor-alpha combined with IL-1 receptor
      antagonist (IL-1RA) and soluble tumor necrosis factor receptor (sTNFR),
      respectively, produced significantly less inflammation in rabbits than after
      inoculation of these cytokines alone. In contrast, when Haemophilus influenzae
      type b (Hib) or Hib lipooligosaccharide (LOS) was given intraarticularly with IL
      1RA, sTNFR, or the combination, there was no significant or consistent modulation
      of synovial inflammation and cartilage proteoglycan degradation. In the
      experimental meningitis model, IL-1RA and sTNFR did not significantly reduce the
      meningeal inflammatory response associated with intracisternal inoculation of Hib
      LOS. These data indicate that specific cytokine inhibitors (sTNFR and IL-1RA) may
      not be effective in modulating inflammation induced by a broad inflammatory
      stimulus such as gram-negative bacteria or their products and suggest caution in
      using them to treat these infectious conditions in humans.

PMID- 7798657
TI  - Temporal trends and transmission patterns during the emergence of multidrug
      resistant tuberculosis in New York City: a molecular epidemiologic assessment.
AB  - To ascertain the role of human immunodeficiency virus (HIV) and Mycobacterium
      tuberculosis transmission on multidrug-resistant (MDR) tuberculosis (TB)
      emergence in New York City, medical records, drug susceptibilities, and
      restriction fragment length polymorphisms (RFLPs) of TB cases at a city hospital
      between two 9-month periods (1987-1988 and 1990-1991) were reviewed. The
      proportion of TB patients with MDRTB increased from 10% (27/267) to 17% (38/222;
      P = .03). Among MDRTB patients of known HIV status, the proportion with HIV
      increased from 16% (3/19) to 58% (22/38; P = .006). HIV-infected MDRTB patients
      were more likely than the seronegative ones to have initial MDRTB (88% vs. 56%; P
      = .03). Among 56 MDR cases with RFLP results, 12 had unique patterns; 44 belonged
      to one of six clusters. During 1990-1991, 27 (75%) of 36 MDRTB patients were
      infected with strains isolated from HIV-seronegative patients during 1987-1988.
      The increase in MDRTB caused by transmission from immunocompetent to
      immunocompromised persons underscores the urgency of TB control in populations
      with increasing HIV prevalence.

PMID- 7798658
TI  - Quantitation of human cytomegalovirus DNA from peripheral blood cells of human
      immunodeficiency virus-infected patients could predict cytomegalovirus retinitis.
AB  - Human cytomegalovirus (CMV) DNA copy number in white blood cells from both human
      immunodeficiency virus (HIV)-seronegative and HIV-seropositive patients was
      amplified from the immediate-early region of CMV DNA and quantified by
      colorimetric detection of the hybridization of the amplification product to a
      detector oligonucleotide probe in microtiter wells. By Mann-Whitney U test,
      significantly higher (P < .05, two-tailed) copy numbers of CMV DNA were detected
      in HIV-seropositive patients with retinitis than in either patients with < 100
      CD4 cells/mm3 and no symptomatic CMV disease or HIV-seropositive patients with >
      100 CD4 cells/mm3. By prospective monitoring for increases in CMV DNA copy
      number, it may be possible to identify HIV-seropositive patients who are at
      imminent risk for development of symptomatic CMV retinitis.

PMID- 7798659
TI  - Formulation of an immunogenic human cytomegalovirus vaccine: responses in mice.
AB  - The immunogenicity of a vaccine formulation consisting of recombinant-derived
      human cytomegalovirus (HCMV) glycoprotein B (UL55) combined with a chemically
      defined adjuvant derived from saponin, QS-21, was evaluated in mice. The immune
      responses of mice given the gB/QS-21 formulation were compared with those induced
      by gB combined with either Freund's adjuvant or aluminum hydroxide. The gB/QS-21
      combination induced higher levels of virus-binding antibodies and significantly
      higher levels of virus-neutralizing antibodies than gB combined with either
      Freund's adjuvant or aluminum hydroxide. Animals given gB/QS-21 exhibited IgG
      subclass switching and produced significant titers of virus-specific IgG2a
      antibodies. Furthermore, animals given gB/QS-21 produced antigen-specific
      cytotoxic spleen cells. Because of its immunogenicity, a subunit vaccine
      containing HCMV gB and QS-21 offers a potential approach to the immunoprophylaxis
      of HCMV disease.

PMID- 7798660
TI  - Virus-specific antibody responses to human cytomegalovirus (HCMV) in human
      immunodeficiency virus type 1-infected persons with HCMV retinitis.
AB  - Human cytomegalovirus (HCMV) causes retinitis and is the leading cause of
      blindness in patients infected with the human immunodeficiency virus (HIV). While
      most patients with HIV are HCMV seropositive, not all will develop clinical
      complications from it. The immune responses that can prevent the development of
      HCMV retinitis are unknown. The levels of anti-HCMV antibodies, including
      responses to the two major envelope proteins, gpUL55 (gB) and gpUL75 (gH), which
      are the targets of neutralizing antibody (NA), were examined in HIV-infected
      patients with and without retinitis. No specific deficiency in the antibody
      response of retinitis patients was observed. However, higher levels of NA were
      associated with a more favorable clinical course. These results indicate that
      antibodies may modulate progression of disease, and they suggest a possible role
      for the exogenous administration of NA in patients who develop HCMV retinitis.

PMID- 7798661
TI  - Enhancement of NK cell-mediated antibody-dependent lysis of recombinant gp120
      coated CD4 cells by complement.
AB  - The contribution of complement to NK cell lysis of CD4 cells expressing
      recombinant gp120 (rgp120) was investigated. Peripheral blood mononuclear cells
      were used as effector cells in a Cr release assay against purified CD4 target
      cells that had been coated with rgp120. Assays included human immunodeficiency
      virus (HIV) antibodies and a complement source alone and in combination to
      determine their importance in mediating cytotoxicity. NK cells were confirmed to
      be the effector cells in the lysis of rgp120-coated CD4 targets. Anti-HIV was
      crucial for lysis and cytotoxicity was enhanced by C3 deposition on targets.
      However, a prozone effect was observed, with reduced IgG binding, C3 deposition,
      and NK cell lysis at serum concentrations > 10 micrograms IgG/mL. The
      susceptibility of these CD4-gp120-antibody-C3 complexes to NK cell lysis may
      contribute to progressive depletion of CD4 cells in HIV infection.

PMID- 7798662
TI  - Infection of oral mucosal cells by human immunodeficiency virus type 1 in
      seropositive persons.
AB  - Molecular studies have revealed significant amounts of human immunodeficiency
      virus type 1 (HIV-1) provirus DNA in saliva of HIV-infected persons. However,
      cellular localization has not been determined. In situ polymerase chain reaction
      (IS-PCR) was done on saliva-associated cells for localization of HIV-1 provirus
      DNA. Results indicate its presence in the nuclei of saliva-associated epithelial
      cells in 29 (83%) of 35 HIV-1-seropositive subjects. In 24 (83%) of the 29 IS-PCR
      positive samples, 0.1%-4.0% of the mucosal epithelial cells exhibited nuclear
      localization of HIV-1 DNA. In addition, HIV-1 provirus DNA was detected in
      monocytes or lymphocytes of all salivary samples from the 35 subjects. The
      localization of HIV-1 provirus DNA indicates that epithelial cells are another
      cell type infected by HIV-1 in vivo. These findings suggest epithelial cells in
      other body sites might also be infected with HIV-1.

PMID- 7798663
TI  - Detection of hepatitis B virus precore TAG mutant by an amplification-created
      restriction site method.
AB  - A new method for detecting the hepatitis B virus (HBV) precore 1896 G-->A
      mutation is described. This mutation prevents hepatitis B e antigen production by
      introducing a TAG stop codon and has been associated with severe chronic and
      fulminant hepatitis. The method is based on a polymerase chain reaction (PCR)
      that creates a restriction enzyme (Bsu36I) cleavage site if the mutation is
      present. After incubation of the PCR product with Bsu36I and a subsequent agarose
      gel electrophoresis, the presence of the TAG mutant is revealed by an altered
      position of the DNA band. The method was compared with direct sequencing on 36
      serum samples and correctly identified all samples containing mutant HBV. The TAG
      mutant was present in 17 cases (as mixed wild type and mutant virus in 4). Twelve
      of 18 patients with advanced liver disease confirmed by biopsy carried mutant
      HBV. This method of detecting HBV precore 1896 G-->A should be useful for
      evaluation and follow-up of patients and for prevalence studies.

PMID- 7798664
TI  - Parenteral influenza vaccination induces a rapid systemic and local immune
      response.
AB  - The kinetics of the local immune response in the upper respiratory tract to
      parenterally administered inactivated split trivalent influenza vaccine were
      examined in 19 healthy subjects. Influenza virus-specific antibody-secreting
      cells (ASC) could be detected as early as 2 days after vaccination in peripheral
      blood and tonsils, with a peak at approximately 1 week after vaccination and a
      decline to insignificant levels after 6 weeks. Circulating ASC produced IgG, IgA,
      and IgM, whereas ASC in tonsils produced mainly IgA and IgM. Influenza virus
      specific antibodies were predominantly IgG and IgM in serum and IgA in oral
      fluid; they rose after 1 week and were elevated at 6 weeks. This may indicate a
      secretory involvement of the anti-influenza virus response in the upper
      respiratory tract. Parenteral influenza vaccination induced an immediate and
      significant immune response in both the upper respiratory tract and peripheral
      blood.

PMID- 7798665
TI  - Brazilian purpuric fever caused by Haemophilus influenzae biogroup aegyptius
      strains lacking the 3031 plasmid.
AB  - Brazilian purpuric fever (BPF) is a life-threatening pediatric infection caused
      by Haemophilus influenzae biogroup aegyptius (Hae), an organism formerly
      associated with only self-limited purulent conjunctivitis. Strains of Hae causing
      BPF have a 24-MDa plasmid with a specific AccI restriction pattern designated
      3031. This plasmid was thought to code for a virulence factor because it had been
      detected only among Hae strains isolated from BPF cases or their contacts. From 3
      typical BPF cases recently identified in Sao Paulo State, sterile-site Hae
      isolates were obtained; these isolates were similar to earlier BPF-associated Hae
      except they did not possess a 3031 plasmid. HindIII restricted chromosomal DNA
      from these strains was probed with purified 3031 plasmid DNA under high
      stringency conditions. There was no evidence that 3031 plasmid DNA had become
      chromosomally integrated. It appears that the 3031 plasmid does not code for BPF
      specific virulence factors.

PMID- 7798666
TI  - Flagellar serotypes of Salmonella typhi in Indonesia: relationships among
      motility, invasiveness, and clinical illness.
AB  - While the H1-d flagellar serotype of Salmonella typhi has been found worldwide,
      the H1-j serotype occurs only in Indonesia. A cross-sectional survey in Indonesia
      compared epidemiologic, clinical, and pathogenetic characteristics of these two
      serotypes. S. typhi isolates were collected from patients with acute typhoid
      fever in four Indonesian cities. Flagellar serotype was determined by polymerase
      chain reaction amplification of the fliC locus of the flg gene. Of 321 isolates,
      51 (15.9%) were H1-j. Patients with H1-j infection were older than those with H1
      d (P < .001). Among 30 patients with known clinical outcomes, H1-j infection was
      associated with milder clinical illness than H1-d (P = .06). In vitro, H1-j
      isolates were both less motile on semi-solid agar plates (P = .004) and less
      invasive of HEp-2 cells (P = .002) than H1-d isolates. The association of
      decreased severity of illness with decreased motility and invasiveness suggests
      that flagellar properties are a component of S. typhi's virulence.

PMID- 7798667
TI  - Nasal carriage of Staphylococcus aureus as a major risk factor for wound
      infections after cardiac surgery.
AB  - To evaluate the importance of nasal carriage of Staphylococcus aureus as a risk
      factor for the development of wound infection at the sternotomy site after
      cardiac surgery, a case-control study was done. The study population consisted of
      1980 consecutive patients. Cases were all patients who developed a sternal wound
      infection from which S. aureus was cultured. Forty cases were identified, and 120
      controls were selected. Preoperative nasal carriage of S. aureus, insulin
      dependent diabetes mellitus, and younger age were identified as significant risk
      factors. The crude odds ratio of nasal carriage was 9.6 (95% confidence interval,
      3.9-23.7). The median postoperative length of hospital stay for cases was 30 days
      longer than for controls. Mortality was also significantly higher for cases than
      for controls (10.0% and 0.8%, respectively).

PMID- 7798668
TI  - Potentiation of Staphylococcus epidermidis catheter-related bacteremia by lipid
      infusions.
AB  - Lipid infusions given to low-birth-weight neonates are associated with coagulase
      negative staphylococcal bacteremia. A rabbit model of catheter-related
      Staphylococcus epidermidis bacteremia was used to compare infection rates between
      animals receiving 20% lipid infusions with those receiving 10% glucose infusions.
      Bacterial growth was detected in 43 (66%) of 65 blood cultures obtained during
      lipid infusions but only 6 (7%) of 91 blood cultures obtained during glucose
      infusions (P < .001). S. epidermidis was cultured from 7 of 9 catheters recovered
      from lipid-infused rabbits but from only 3 of 13 catheters from glucose-infused
      rabbits (P = .016). Lipid but not glucose solutions containing low levels of
      protein (0.1%-1.0%) supported the survival and growth of S. epidermidis. These
      results suggest that lipids contribute to the survival and growth of S.
      epidermidis on contaminated catheters, enhancing the potential of these organisms
      to disseminate and cause bacteremia.

PMID- 7798670
TI  - High levels of interleukin-10 during the initial phase of fulminant meningococcal
      septic shock.
AB  - Interleukin (IL)-10 has an important antiinflammatory effect by inhibiting
      endotoxin-induced production of proinflammatory cytokines, such as tumor necrosis
      factor-alpha and IL-1. Since both cytokines are produced in massive amounts
      during fulminant meningococcal septic shock and are associated with severity of
      disease, IL-10 was measured in plasma samples of 25 consecutive children with
      fulminant meningococcal septic shock shortly after admittance to a pediatric
      intensive care unit. High levels of IL-10 (median, 6021 pg/mL; range, 137-24,600)
      were found in surviving patients (median, 1268 pg/mL; range, 137-24,600) and in
      those who died (median, 9915 pg/mL; range, 3996-14,100). IL-10 levels correlated
      weakly (r = .38; P = .055) with severity of disease as measured by the Glasgow
      meningococcal septicemia prognostic score. The findings indicate that IL-10 is
      produced in massive amounts in the initial phase of fulminant meningococcal
      septic shock.

PMID- 7798669
TI  - Increase in interleukin-6 serum level preceding fever in granulocytopenia and
      correlation with death from sepsis.
AB  - Serum interleukin (IL)-6 levels measured by ELISA were correlated with the
      clinical course of 53 adults with hematologic malignancies in 95 episodes of
      chemotherapy-induced leukocytopenia (< 1000/microL). The median IL-6 level was 15
      pg/mL (range, < 3-123) in 27 episodes without fever. This level was 14.5 pg/mL
      (range, < 3-187) 72-48 h before onset of fever, 78 pg/mL (range, < 3-170) 24 h
      before fever in episodes with unexplained fever (FUO), and 182 pg/mL (range, 63
      1076) 24 h before fever in episodes with positive blood cultures (P < .001).
      Within 24 h after onset of fever, median IL-6 level was 171 pg/mL (range, 53
      1134) in episodes of FUO, 444 pg/mL (range, 38-7973) in episodes with gram
      negative bacteremia, and 2017 pg/mL (range, 76-7253) with gram-positive
      bacteremia (P < .01). IL-6 levels increased before death in all 13 patients who
      died of sepsis. Median level was 7253 pg/mL (range, 445-95,906) within 3 days of
      death. Determination of IL-6 may be useful for early assessment and as a
      prognostic tool in leukocytopenic fever.

PMID- 7798671
TI  - Increased plasma levels of human interleukin for DA1.a cells/leukemia inhibitory
      factor in sepsis correlate with shock and poor prognosis.
AB  - Animal study results have suggested a role in sepsis for human interleukin for
      DA1.a cells/leukemia inhibitory factor (HILDA/LIF). HILDA/LIF and interleukin-6
      (IL-6) levels were prospectively studied by serial ELISAs in 34 septic patients.
      HILDA/LIF was detected in 11 of 34 patients at plasma levels of 100-37,000 pg/mL.
      Peak HILDA/LIF levels correlated with increased temperature and creatinine and IL
      6 and with decreased arterial CO2 (P < .05). Multivariate analysis showed that
      shock and decreased arterial CO2 accounted for 75% of peak HILDA/LIF plasma
      variations (R2 = .753). Fatal outcome was most often associated with detectable
      HILDA/LIF (> 56 pg/mL) and peak IL-6 plasma levels > 850 pg/mL (sensitivity, 83%;
      specificity, 87%), but both (at respective levels of > 480 and > 850 pg/mL) were
      associated with fatal outcome. HILDA/LIF was detected in septic patients
      exhibiting shock, and its levels correlated with higher mortality and shorter
      survival.

PMID- 7798672
TI  - Catalase expression, katG, and MIC of isoniazid for Mycobacterium tuberculosis
      isolates from Sao Paulo, Brazil.
AB  - The MIC of isoniazid, peroxidase-catalase expression, and the presence of the
      katG gene for 102 Mycobacterium tuberculosis isolates from patients in Sao Paulo
      were compared. Fifty-three isoniazid-resistant and 49 isoniazid-sensitive
      isolates were analyzed by polymerase chain reaction (PCR) for the presence of
      katG sequences. All isoniazid-sensitive and 43 (81%) isoniazid-resistant isolates
      expressed catalase (P = .001). None of isoniazid-sensitive and 4 (7%) of 53
      isoniazid-resistant isolates lacked katG sequences. Among 6 isolates with MICs >
      50 micrograms/mL, 5 (83%) did not express catalase and 2 lacked katG sequences;
      only 1 had complete gene deletion shown by Southern blot analysis. These findings
      indicate a correlation between loss of catalase and isoniazid resistance among
      highly resistant isolates, but these isolates were a small proportion of
      resistant clinical M. tuberculosis isolates from Sao Paulo.

PMID- 7798674
TI  - Disseminated microsporidiosis due to Septata intestinalis in patients with AIDS:
      clinical features and response to albendazole therapy.
AB  - Five patients with AIDS had disseminated infection due to Septata intestinalis, a
      recently described organism. S. intestinalis infection was suspected after
      detection of spores in stools and urine and confirmed by transmission electron
      microscopy of duodenal biopsies or of cell culture of urine sediment. Clinical
      features included chronic diarrhea that was usually associated with fever,
      cholangitis, sinusitis, bronchitis, or mild bilateral conjunctivitis. Mean CD4
      cell count was 22/microL. Patients treated with albendazole (400 mg orally twice
      a day) for a mean of 19 days had a dramatic and rapid clinical response to
      therapy. Significant reduction of parasite shedding was also observed during
      therapy; S. intestinalis was cleared from stools of all patients and from urine
      of 3. In 2 patients, however, microsporidian spores were detected in feces during
      follow-up and mild diarrhea recurred. Therefore, albendazole seems to have a
      significant but transient effect in treatment of S. intestinalis infection.

PMID- 7798673
TI  - Rapid identification of a point mutation of the Mycobacterium tuberculosis
      catalase-peroxidase (katG) gene associated with isoniazid resistance.
AB  - The complete catalase-peroxidase (katG) gene DNA sequence was determined for 15
      strains of Mycobacterium tuberculosis with a wide range of susceptibility to
      isoniazid. Five of 9 strains with isoniazid MICs > or = 1.0 microgram/mL had one
      or more missense mutations and all 5 strains had a common G-->T transversion in
      codon 463, causing the replacement of arginine with leucine and the loss of an
      NciI or MspI restriction site. None of 6 strains with an isoniazid MIC < 1.0
      microgram/mL had mutations affecting codon 463. Restriction analysis of 43
      strains with isoniazid MICs > or = 1.0 microgram/mL showed that 19 (44.2%) had
      lost the NciI-MspI restriction site at the locus of codon 463 while only 1 of 32
      strains with isoniazid MICs < or = 1.0 microgram/L had this restriction
      polymorphism. These results indicate that the mutation arginine-->leucine in
      codon 463 of the catalase-peroxidase gene occurs in a significant fraction
      (44.2%) of M. tuberculosis strains with isoniazid MICs > or = 1.0 microgram/mL.

PMID- 7798675
TI  - Gamma delta T cells and acute primary Toxoplasma gondii infection in mice.
AB  - A murine model of Toxoplasma gondii infection was used to investigate whether
      gamma delta T cells are required to resist primary acute toxoplasmosis. The
      surface phenotype of peritoneal exudate and spleen cells obtained from T. gondii
      infected mice was examined using anti-gamma delta T cell-specific reagents and
      flow cytometry. Survival of mice depleted of gamma delta T cells was also
      followed during the acute phase of toxoplasmosis. Numbers of gamma delta T cells
      did not increase in spleen or peritoneal exudates of mice infected with T.
      gondii. Moreover, infected mice depleted of gamma delta T cells survived as long
      as untreated infected mice. These results indicate that gamma delta T cells do
      not play an important role in host defense against T. gondii infection in mice.

PMID- 7798677
TI  - Increased human papillomavirus infection with the increasing number of
      pregnancies in Indian women.

PMID- 7798676
TI  - Mefloquine prophylaxis in pregnancy.

PMID- 7798678
TI  - Serum IgA antibody response to Cryptosporidium parvum is mainly represented by
      IgA1.

PMID- 7798679
TI  - Immunity induced by primary human cytomegalovirus infection protects against
      secondary infection among women of childbearing age.
AB  - To determine if immunity to human cytomegalovirus (HCMV) protects women from
      acquiring HCMV from their children, a blinded, randomized protocol was used to
      monitor seronegative women who received placebo or Towne vaccine (approximately
      500 pfu) and seropositive women. Each group was similar for mean maternal (33
      years) and child age (18 months) and duration of viral shedding by the child (15
      months). Among 19 placebo recipients, 9 developed primary infection; 8 of 19
      vaccines but only 3 of 42 naturally seropositive subjects had evidence of
      acquiring HCMV from their child. Wild type infection and Towne vaccine induced
      similar mean lymphoproliferative responses to HCMV antigens, but one dose of
      Towne vaccine produced mean neutralizing titers 10- to 20-fold lower than those
      after wild type infection. Thus, a vaccine that induces immune responses equal to
      those induced by wild type virus may protect healthy women from acquiring HCMV
      from their children.

PMID- 7798680
TI  - Cervical but not urinary excretion of cytomegalovirus is related to sexual
      activity and contraceptive practices in sexually active women.
AB  - The relationship between sexual activity and genitourinary excretion of
      cytomegalovirus (CMV) was evaluated in 1481 women at a sexually transmitted
      disease (STD) clinic. Among 951 who were CMV-seropositive, 16.6% had CMV
      isolated, from cervix alone in 9.4%, urine alone in 3.8%, and both sites in 4.2%.
      Isolation rates were highest in young women (P < .001). Compared with those with
      only cervical infection, women shedding from both cervix and urine were younger,
      began sexual activity when younger, had more recent partners, and a higher
      frequency of CMV-specific IgM, suggesting recent CMV infection. By logistic
      regression, cervical CMV excretion was associated with concomitant gonococcal
      infection (P = .008) and was less frequent in those using barrier contraception
      (P = .036). Isolated urinary excretion of CMV was not associated with sexual
      activity, concomitant cervical infections, or use of contraception. Cervical CMV
      infection is related to sexual activity, acquisition of other STDs, or exogenous
      reinfection, and urinary CMV is not.

PMID- 7798681
TI  - Cytomegalovirus infection is associated with absence of alveolar epithelial cell
      HLA class II antigen expression.
AB  - Cytomegalovirus (CMV) pneumonia is associated with the development of secondary
      immunosuppression with resultant bacterial and fungal superinfections. Because
      class II HLA expression within the lung may be important in normal pulmonary cell
      mediated immunity, the association of CMV infection of alveolar epithelial cells
      (AEC) with an absence of HLA class II antigens was tested. Using dual-labeling
      immunohistochemistry to detect CMV, AEC, endothelial cells, macrophages, and HLA
      class II antigens, lung tissue from patients whom died with CMV pneumonia was
      examined. Seventy-five percent of infected cells were AEC. In contrast to
      adjacent noninfected AEC, which expressed HLA-DR antigens, 91% of infected AEC
      were negative. There was no difference in this expression pattern between
      patients with or without AIDS. The absence of HLA class II antigens on infected
      AEC may account, in part, for the secondary immunosuppression associated with CMV
      pneumonia.

PMID- 7798682
TI  - The molecular epidemiology of human immunodeficiency virus type 1 in Edinburgh.
AB  - Human immunodeficiency virus (HIV) type 1 sequences obtained from HIV-infected
      persons in different risk groups in Edinburgh were studied to determine the
      number and origin of virus variants and patterns of virus transmission.
      Phylogenetic analysis revealed that 12 of 14 hemophiliac patients who had been
      exposed to a single common batch of factor VIII had closely related gag gene
      sequences. Sequences from intravenous drug users and patients infected through
      heterosexual contact formed another distinct group, and 2 other hemophiliacs
      formed a third group. However, epidemiologic relationships inferred from analysis
      of the V3 region of the env gene were less conclusive, especially when the V3
      loop was taken in isolation. This appears to be due to the length of time since
      infection and the action of selection, which has favored the independent
      appearance of similar V3 loop variants.

PMID- 7798683
TI  - Long-term efficacy of active postexposure immunization of infants for prevention
      of hepatitis B virus infection. United States-People's Republic of China Study
      Group on Hepatitis B.
AB  - Perinatal transmission of hepatitis B virus (HBV) contributes to the high
      prevalence of chronic infection in China and many other countries. In a placebo
      controlled trial among 166 infants, the 12-month efficacy of active postexposure
      prophylaxis to prevent chronic perinatal HBV infection varied by vaccine (range,
      45%-89%). In a 5-year follow-up study, 2 additional infants became chronically
      infected with HBV, and the efficacy of active prophylaxis was estimated to be 38%
      and 72% for the two vaccines at 5 years. In addition, 80% of immunized infants
      continued to have protective levels of antibody at the end of 5 years. However,
      among 27 infants who received passive-active immunoprophylaxis with high-dose
      hepatitis B immune globulin, only 60% (11/19) had protective antibody levels.
      These data indicate that active postexposure immunization initiated soon after
      birth continues to provide protection during early childhood when there is a high
      risk of chronic HBV infection.

PMID- 7798685
TI  - Summary of the 29th United States-Japan joint Conference on Cholera and Related
      Diarrheal Diseases.

PMID- 7798684
TI  - Selective depletion of V beta-bearing T cells in patients with severe invasive
      group A streptococcal infections and streptococcal toxic shock syndrome. Ontario
      Streptococcal Study Project.
AB  - The V beta repertoire of T cells of patients with gram-positive group A
      streptococcal (GAS) and non-GAS infections was analyzed to seek evidence for the
      role of superantigens in streptococcal toxic shock syndrome. No evidence of V
      beta overexpression but a consistent pattern of depletion of V beta 1, V beta
      5.1, and V beta 12 was observed in patients with severe GAS infections. This
      pattern of V beta depletion was not observed in patients with nonsevere GAS
      infections or with severe non-GAS gram-positive infections. T cells from patients
      with severe GAS infections showed evidence of apoptosis; no apoptosis was found
      when there was no evidence of V beta depletion. There was no correlation with
      streptococcal M or T serotype or known spe genes. The depletion of specific V
      beta-bearing T cells in patients with severe GAS infections supports the role of
      a superantigen in these infections. The in vivo pattern of V beta specificity
      implicates a novel superantigen(s) in this disease.

PMID- 7798686
TI  - A role for fibrinogen in the streptokinase-dependent acquisition of plasmin(ogen)
      by group A streptococci.
AB  - Acquisition of plasmin(ogen) by group A streptococci occurs by two distinct
      pathways. In addition to the well-characterized direct interaction of plasmin
      with cell-surface receptors on group A streptococci, a second pathway dependent
      on streptokinase and a nonplasminogen factor(s) present in human plasma was
      identified. The role of streptokinase in the second pathway was not merely as a
      plasminogen activator, since substitution of the plasminogen activator urokinase
      did not result in the capture of plasmin(ogen) by bacteria in the presence of
      plasminogen-depleted plasma. However, if streptokinase was added to plasmin that
      had been generated by treatment of plasminogen with urokinase, the ability of the
      bacteria to capture plasmin in the presence of plasminogen-depleted plasma was
      restored. Fibrinogen present in human plasma was identified as the major factor
      required for streptokinase-dependent uptake of plasmin(ogen) by group A
      streptococci.

PMID- 7798687
TI  - The impact of conjugate vaccine on carriage of Haemophilus influenzae type b.
AB  - Conjugate vaccines against Haemophilus influenzae type b (Hib) may modify Hib
      pharyngeal colonization. Hib colonization was compared in 371 infants and their
      families. In Oxfordshire, infants received PRP-T (polyribosylribitol phosphate
      conjugated to tetanus toxoid) and in Buckinghamshire they did not (controls).
      Infants were followed at 6, 9, and 12 months of age. Also, 6 unvaccinated Hib
      carriers were vaccinated and followed for 6 weeks. Hib acquisition was lower in
      vaccinees than controls (P < .01). During surveillance, 1.5% of vaccinees and
      6.3% of controls carried Hib (P = .04). Among those with family Hib exposure, the
      carriage rates were 8.7% and 38.5% (P = .07), respectively. Hiv carriage rates
      were lower among vaccinees' unvaccinated siblings. Giving conjugate vaccine to a
      child carrying Hib did not rapidly terminate carriage. Thus, a primary means by
      which herd immunity to Hib is induced in a vaccinated population may be through
      reduction or delay in the initial acquisition of Hib.

PMID- 7798688
TI  - Transplacental antibody transfer following maternal immunization with
      polysaccharide and conjugate Haemophilus influenzae type b vaccines.
AB  - Passive transfer of antibody to infants born to women immunized during the third
      trimester of pregnancy with a Haemophilus influenzae type b (Hib) vaccine (PRP
      polysaccharide or Hib conjugates PRP-D or HbOC) was studied in 50 mothers and
      infants and 47 nonimmunized mother-infant pairs. Geometric mean total PRP
      antibody by RIA was 1.2 micrograms/mL at delivery in unimmunized women and 21,
      149, and 171 micrograms/mL in women who received PRP, PRP-D, and HbOC,
      respectively. Mean cord PRP antibody levels were 0.29, 3.0, 17.5, and 29.3
      micrograms/mL for the corresponding groups. Postimmunization and cord PRP
      antibody levels were higher after maternal immunization with conjugate vaccines
      than with PRP vaccine (P < .01). PRP IgG1 subclass was transmitted more
      efficiently than IgG2 (56% vs. 35%, P < .01). The proportion of anti-PRP IgG
      transmitted from immunized mothers to infants correlated with time between
      immunization and delivery. Administration of PRP conjugate vaccines to women
      during pregnancy resulted in higher levels of PRP antibodies in infants than did
      polysaccharide or no vaccine.

PMID- 7798689
TI  - The radial forearm flap in orofacial reconstruction.
AB  - This review on the radial forearm flap deals with the multiple applications
      possible in orofacial reconstruction using this graft. The variations are
      illustrated and some salient points of the method are discussed.

PMID- 7798690
TI  - Repair of the radial forearm flap donor site with a full-thickness graft.
AB  - A method of closing the radial forearm free flap donor site defect with a
      defatted, full-thickness skin graft is described. Its advantages of improved
      patient mobilization, protection of tendons, and cosmesis are discussed with
      reference to 16 consecutive patients treated over a period of 1 year.

PMID- 7798691
TI  - Mandibular reconstruction with the free fibula osteocutaneous flap.
AB  - Experience with 17 mandibular reconstructions by the free fibula flap is
      presented. The main advantages of this reconstruction method include the
      bicortical structure of the bone and its adaptability to conform to the
      mandibular contour. The only real disadvantage is the limited height of the bone
      graft, which does not allow alveolar ridge reconstruction. An implant-borne
      dental prosthesis can, however, generally be made for functional occlusal
      rehabilitation.

PMID- 7798692
TI  - The bilobed myocutaneous pectoralis major flap in closure of combined intra- and
      extraoral defects.
AB  - Oral carcinomas may eventually invade the perioral soft tissues. In such cases,
      tumor resection creates through and through defects. Similar defects are seen in
      patients with gunshot wounds. The versatility of the bilobed myocutaneous
      pectoralis major flap in closure of these defects is emphasized. The results in
      nine patients treated by this method are discussed.

PMID- 7798693
TI  - Reconstruction of the severely resorbed (Class VI) maxilla. A two-step procedure.
AB  - The medium-term results of 12 patients that underwent reconstruction of the
      severely resorbed maxilla are reported. The method described entails a two-step
      procedure including Le Fort I osteotomy and grafting of the floor of the sinus
      and nose with particulate bone and hydroxyapatite (HA). The implants were placed
      in a second procedure. A 5% failure rate was noted in those patients that were
      grafted with particulate bone mixed with HA.

PMID- 7798694
TI  - Localized alveolar ridge augmentation before orthodontic treatment. A case
      report.
AB  - Extraction spaces are usually characterized by narrow, atrophic alveolar ridges,
      which make it difficult to move teeth orthodontically within these areas. Guided
      tissue regeneration is often used for alveolar ridge augmentation in
      implantology. In the case presented, localized alveolar ridge augmentation was
      performed as a preliminary procedure before orthodontic closure of an edentulous
      space. Guided tissue regeneration enhances the possibilities of orthodontic
      treatment in adult patients.

PMID- 7798695
TI  - The Dautrey procedure in recurrent dislocation: a review of 12 cases.
AB  - The Dautrey procedure was used to treat 12 patients with chronic recurrent
      dislocation of the temporomandibular joint. There was no recurrent dislocation in
      11 patients during a follow-up period of up to 5 years and 2 months, and joint
      function appeared to be undisturbed. The surgical procedure and evaluation of the
      results are presented.

PMID- 7798696
TI  - The pathogenesis of hypertrophic/keloid scarring.
AB  - The formation of hypertrophic and keloid scars after cutaneous wounding is of
      particular relevance to the practice of maxillofacial surgery. This paper reviews
      current knowledge of the local and systemic factors underlying the formation of
      these scars and outlines the current and potential treatment modalities for these
      lesions.

PMID- 7798697
TI  - Restoration of mandibular nonunion bone defects. An experimental study in rats
      using an osteopromotive membrane method.
AB  - Standardized through-and-through critical size defects were created in rat
      mandibles. After 12 weeks, the sites revealed a massive ingrowth of soft
      connective tissue, forming a transosseous core filling the defects. Upon reentry,
      the soft tissue inside the remaining bone defects was removed. On one side of the
      jaw, the defect was covered both buccally and lingually with an expanded
      polytetrafluoroethylene (e-PTFE) membrane, but on the other side no membrane was
      placed. Histologic analysis after 6 weeks revealed an essentially complete
      healing with bone of the membrane-covered defects. No cartilage was present in
      any of the specimens. At the control sites (no membrane), the amount of newly
      produced bone showed variations, most through defects revealing the presence of a
      remaining central portion of connective tissue. This investigation thus showed
      that predictable and successful bone regeneration can be achieved by the
      osteopromotive membrane method in treatment of nonunion defects filled with
      mature connective tissue.

PMID- 7798698
TI  - Cephalometric studies on the upper airway space in normal Chinese.
AB  - A detailed cephalometric analysis of the soft and hard tissues of the upper
      airway was conducted with lateral cephalographs from 116 normal Chinese, aged
      between 18 and 25 years. Normal values and deviation range were preliminarily
      established for the size of the tongue, soft palate, nasopharynx, oropharynx, and
      hypopharynx, and for the relative position of the hyoid bone and vallecula in
      both sexes. Statistical findings showed that there were significant differences
      between the sexes. Significant relationships (P < 0.001) were observed 1) between
      the hypopharyngeal depth and the position of the hyoid bone and the vallecula, in
      which the horizontal position of vallecula appears to be the best predictor of
      the hypopharyngeal depth, as confirmed by the multiple regression equation; 2)
      between the upper airway depths at four different levels; and 3) between the naso
      oropharyngeal area and tongue, soft palate, and oral area. The present data can
      be used to investigate further the upper airway in abnormal states.

PMID- 7798699
TI  - [Transcranial Doppler measurement of middle cerebral artery blood flow during
      continuous retrograde cerebral perfusion].
AB  - This is the first report of cerebral blood flow measurement with transcranial
      Doppler (TCD) during aortic arch reconstruction using continuous retrograde
      cerebral perfusion (CRCP) with deep hypothermia. Cerebral blood flow velocity was
      measured in 6 patients. CRCP was performed via the superior vena cava (SVC) at 30
      cmH2O of internal juglar vein pressure and at 18 degrees C or lower of minimum
      bladder temperature. During the operation, the flow velocity of the middle
      cerebral artery (MCA) was continuously measured with TCD fixed on the temple. The
      cerebral blood flow during CRCP was different in each of the 6 patient. The
      retrograde MCA flow could be measured during CRCP in 3 patients, and the flow
      velocity was 11-60% of the MCA flow velocity before cardiopulmonary bypass. In
      the other 3 patients, retrograde MCA flow could not be detected during CRCP, but
      antegrade MCA flow could be found after antegrade perfusion was resumed. The
      antegrade flow velocity right after CRCP became more than the MCA flow before
      CRCP, which was regarded as a reaction due to cerebral ischemia. All the patients
      awoke within several (2-9) hours after operations and had no permanent
      neurological complications. But 2 patients developed drowsiness for several days
      after the operations; their CRCP times were 127 and 131 minutes. It is concluded
      that CRCP is a simple technique for brain protection, but the cerebral blood flow
      during CRCP is a simple technique for brain protection, but the cerebral blood
      flow during CRCP is different in each patient.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798700
TI  - [Clinical results of selective cerebral perfusion during reconstruction of the
      transverse aortic arch].
AB  - Selective cerebral perfusion (SPC) has become a reliable method for brain
      protection during reconstruction of the transverse aortic arch. However, arterial
      cannulation technique for the branches of the aortic arch varies among groups,
      and the necessity of perfusion for the left subclavian artery is controversial.
      To avoid atheroembolism to the brain and malperfusion of the vertebral arterial
      system, we carefully selected the arterial cannulation technique according to the
      result of preoperative ultrasonographic and angiographic evaluation of the
      branches of the aortic arch, and decided the necessity of perfusion for the left
      subclavian artery according to the dominance of the two vertebral arteries and
      the result of pressure monitoring of all three branches. In this report, we
      analyzed our clinical results of selective cerebral perfusion on 22 consecutive
      patients, which was performed between April 1992 and December 1993. There were 14
      atherosclerotic aneurysms and 8 aortic dissections. The flow rate for SCP was
      controlled by a single blood pump separate from that for systemic perfusion, with
      the mean value being 13.1 ml/kg/min. Mean of minimum left superficial temporal
      arterial pressure was 51 mmHg, mean duration of SCP was 134 minutes, and mean of
      the lowest esophageal temperature was 17.9 degrees C. Blood pH was regulated with
      alpha-stat strategy. Arterial cannula for SCP was inserted directly into the
      vessels through a stab wound in most cases. In three of four patients in whom
      dissection extended to the branches, a balloon catheter was introduced through
      the lumen of the aortic arch.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798701
TI  - [Effects of amrinone on left ventricular function following open heart surgery-
      analysis with left ventricular pressure volume loops].
AB  - The effects of Amrinone on cardiac function soon after extracorporeal circulation
      (ECC) were studied in 5 patients including mitral valvuloplasty, VSD closure,
      Fontan operation and coronary AV fistel closure. In all patients, left
      ventricular volume load decreased postoperatively. To evaluate the efficacy, we
      obtained left ventricular pressure-volume loops (P-V loop) before and after ECC
      and after intravenous administration of Amrinone (1 mg/kg) following ECC. P-V
      loops were produced by measuring left ventricular pressure using a Miller
      catheter which was retrogradely advanced from the ascending aorta into the left
      ventricle and by measuring left ventricular diameter to calculate left
      ventricular volume with Teichholtz' formula. Although no apparent difference of
      Emax was recognized before and after ECC, Emax increased from 3.2 +/- 2.5
      mmHg/cm3 to 5.9 +/- 4.7 mmHg/cm3 after the administration of Amrinone. The left
      ventricular "systolic" pressure-volume area (PVA) which is the sum of stroke work
      (SW) and elastic potential energy decreased from 34.4 +/- 16.4 gm to 30.9 +/-
      17.8 gm after Amrinone. No difference was also recognized in left ventricular end
      diastolic pressure. Ejection fraction increased from 50 +/- 17.5% to 56.1 +/-
      17.3%. These results suggested that Amrinone could improve the left ventricular
      function without prominent change in myocardial oxygen consumption immediately
      after open heart surgery.

PMID- 7798702
TI  - [Coronary artery bypass grafting only with arterial grafts in patients with low
      left ventricular function].
AB  - The advantage of arterial grafts in coronary artery bypass grafting (CABG) has
      been recognized and the application of these grafts has spread widely. But, the
      possibility of insufficient blood flow immediately after operation is pointed
      out. The present study was conducted in order to answer whether or not arterial
      grafts are applicable for patients with low left ventricular function. CABG only
      with arterial grafts was performed in 125 patients from December 1989 to October
      1993. Comparison was made between L-group (n = 21) with a preoperative ejection
      fraction (EF) of 0.4 or less, and N-group (n = 104) with a preoperative EF of
      more than 0.4. The proportion of patients requiring postoperative IABP (33%:9%)
      and the incidence of mediastinitis (14%:3%) were higher in the L-group. But the
      mortality rate (5%:3%) or the postoperative NYHA stage (1.2:1.2) showed no
      significant difference between these two groups. This favorable result suggests
      that CABG only with arterial grafts was also useful in patients with low left
      ventricular function.

PMID- 7798703
TI  - [Reduction in cellular immunity in diabetics receiving coronary artery bypass
      grafting].
AB  - We studied the changes in peripheral lymphocyte subsets, mitogen responsiveness,
      natural killer (NK) cell activity, and interleukin-2 (IL-2) production in
      patients with or without diabetes receiving coronary artery bypass surgery. Group
      I (GI): 9 diabetic patients comprising three on oral diabetics during therapy,
      two on insulin therapy, and four on alimentary therapy. Group II (GII): 12 non
      diabetic patients (borderline diabetics excluded). age, amount of blood
      transfusion, number of grafts, aortic cross-clamp time (ACC), cardio-pulmonary
      bypass time (CPB), and operative time (OP) did not significantly differ between
      the groups. Lymphocyte subsets were measured using monoclonal antibodies and IL-2
      production was measured by radio-immuno assay using IL-2 labeled with I125. All
      variables were measured the day before, the day after, 3 days after and 7 days
      after the operation. The number of lymphocytes and their subsets (CD3+, CD+,
      CD8+, 4/8 ratio, IL-2R+) did not significantly differ between the groups, but in
      GI patients, the number of OKIa1 positive lymphocytes were significantly lower
      than in GII the day before and 7 days after the operation. II-2 production on the
      day after the operation was significantly (p < 0.05) reduced from the
      preoperative level in both groups. On 3 days, there was a significant difference
      (p < 0.05) between the two groups: IL-2 production in GI (3.1 +/- 2.6 U) was
      remarkably lower than in GII (6.6 +/- 4.0 U). IL-2 production in GII was
      significantly correlated to the number of CD4 positive lymphocytes, but this was
      not true in GI. Mitogen responsiveness to stimulation with PHA was not
      significantly different between the groups. NK cell activity on the first
      postoperative day was significantly reduced (p < 0.01) in the both groups, but
      there was no difference between the groups. The % change in IL-2 production (%IL
      2) in GII on 3 days after the operation was significantly correlated to the
      amount of blood transfusion (r = -0.7, p = 0.0077) but that in GI was not. %IL-2
      was not significantly correlated to ACC, CPB, OP, or age in both groups. This
      study clearly showed that diabetics who underwent coronary artery bypass surgery
      suffered depression of cellular immunity, in particular, IL-2 production, which
      might be a key factor in cellular immunity. It showed a decrease in helper T
      lymphocyte function after surgery, implying postoperative immunodeficiency in
      diabetics.

PMID- 7798704
TI  - [Monitoring of electroencephalogram during the operation under the extracorporeal
      circulation].
AB  - Generally speaking, it is difficult to know the occurrence of brain complication
      until the patient becomes awake from anesthesia. But if we can detect the
      occurrence of of brain complication during the operation, we can start its
      therapy even during the operation. In order to detect the occurrence of brain
      complication during the operation under extracorporeal circulation (ECC), we
      monitored intraoperative electroencephalogram (EEG). Since June 1992, forty-two
      patients were operated on using ECC. Usual ECC was applied in 39 cases (Group-A),
      and circulatory arrest with retrograde cerebral perfusion was applied in
      remaining three cases (Group-B). We studied the amplitude of EEG using actual
      value (by Fujimori method), and compressed EEG acquired by slow-paper-feed
      recording. In terms of the frequency of EEG, we studied compressed spectral array
      (CSA). In Group-A, there was no brain complication identified after operation.
      Actual values of amplitude were 23 +/- 4.0 microV (before ECC), 19 +/- 4.0 microV
      (during ECC), 23 +/- 4.9 microV (after ECC). There was a significant decrease (p
      < 0.001) of amplitude during ECC compared with that before ECC. The ratio of
      amplitude during ECC to that before ECC (D/B ratio) was 0.82 +/- 0.16. The ratio
      of amplitude after ECC to that before ECC (A/B ratio) was 1.01 +/- 0.15.
      According to compressed EEG, it was observed that the amplitude changes following
      the up-down of esophageal temperature. In CSA, influence of esophageal
      temperature on the power spectrum of alpha and delta wave band was recognized. In
      Group-B, there was one brain complication identified after operation.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7798705
TI  - [Result of sequential coronary artery bypass grafting only with arterial grafts].
AB  - The indication of percutaneous transluminal coronary angioplasty is getting wide,
      and surgical case is getting more severe and more serious. We have, as a rule,
      performed bypass surgery only with arterial grafts and we have conducted
      sequential bypass surgery to cope with multiple vessel disease. Coronary artery
      bypass grafting (CABG) only with arterial grafts was performed in 120 patients
      from January 1991 to November 1993. Comparison was made between sequential group
      (n = 20 cases) and non-sequential group (n = 100 cases). The patency rate of
      sequential group was 98% (39 branches/40 branches). It was 96% (27/28) in the
      left internal thoracic artery (LITA) sequential group and 100% (12/12) in the
      right gastroepiplotic artery (RGEA) sequential group. There was no death. The
      patency rate of non-sequential group was 98% (248/253). It was 98% (95/97) in the
      LITA group, 97% (60/62) in the right internal thoracic artery (RITA) group, and
      99% (93/94) in the RGEA group. Three patients (3%) died in hospital. Operation
      time, extracorporeal circulation time, and aortic crossclamp time was found to be
      shorter in the sequential group on two and three vessel bypass surgery. Because
      the patency rate of sequential bypass were favorable and the operating time could
      be reduced, sequential bypass method is thought to be usefull in CABG only with
      arterial grafts.

PMID- 7798706
TI  - [Comparison of duodenogastric reflux (DGR) to esophageal substitute between retro
      sternal route and posterior mediastinal route].
AB  - To elucidate superiority of route among surgery of esophageal cancer with stomach
      tube, duodenogastric reflux (DGR) were examined in nine cases of retro-sternal
      bypass (RS) and 18 cases of posterior mediastinal group (PM) by means of
      questionnaire of reflux esophagitis, esophageal transit scintigram and 24 hour pH
      monitoring to those patients. Firstly, in order to readily compare the two
      groups, each section of reflux symptoms was expressed as a brief score by
      dividing each symptom into strength (0-3) and frequency (0-3). Mean score of
      reflux sensation was less in RS than in PM significantly (0.9 vs. 2.9, p < 0.01).
      The median value showed that patients in PM had much DGR symptoms than those in
      RS significantly (8.5 vs. 5.5, p < 0.01). In esophageal transit scintigram, TcO4-
      (85 MBq) was counted by gamma camera at the upper (ROI-1), center (ROI-2), and
      lower (ROI-3) sites of the sternum bone in the upright position. The descending
      time of RI peak from ROI-1 to ROI-3 in RS was shorter than PM (2.1 sec vs. 3.9
      sec, N.S.). At ROI-2, clearance rate of RI in RS was similar to that in PM. At
      ROI-3, clearance rate of RI in RS was better than that in PM significantly (80.0%
      vs. 49.6%, p < 0.05). Scintigram revealed RI stasis in PM, which might be
      presumably concerned to DGR. Intragastric pH was measured continuously 5 and 15
      cm below the esophagogastrostomy using 2-channeled antimony pH sensors.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7798707
TI  - [Preliminary clinical results of surgery for type A acute aortic dissections
      using gelatin-resorcin-formaldehyde glue].
AB  - We used gelatin-resorcin-form-aldehyde (GRF) glue to fuse the false lumen of type
      A acute aortic dissection in four patients. All were operated on within 3-24
      hours after onset, and gluing of the two cylinders of the dissecting aorta could
      be done safely in a short time. Initial intimal tears were located in the
      transverse aorta in three patients and in the proximal descending aorta in one.
      Simple transection and end-to-end anastomosis of the ascending aorta was done for
      the first two cases. But in the last two patients, we resected the intimal tear
      in the transverse aorta and applied GRF glue to the stump of the aortic arch and
      to that of the aortic root, followed by graft replacement of the ascending aorta.
      There were no hospital deaths. But we had to reoperate on one patient five months
      after the first operation due to potentially residual dissection in the aortic
      root. GRF glue is a very useful adhesive for acute aortic dissection operations,
      but further refinement of the operative technique using it is necessary.

PMID- 7798708
TI  - [Pre-operative screening tests for lung cancer using the analysis of expired gas
      with exercise testing--principally VO2 max/m2].
AB  - The analysis of expired gas with exercise testing was conducted preoperatively
      with lung cancer patients in order to examine the relationship between maximum
      oxygen consumption (VO2 max) and postoperative complications, determining the cut
      off of VO2 max/m2. The usefulness of the test as a preoperative screening test
      for both pulmonary ventilation and circulation was evaluated in comparison to
      pulmonary ventilation tests with spirometry and pulmonary circulation tests with
      Swan-Ganz catheter. Preoperative VO2 max/m2 was calculated from VO2 max in 111
      patients with lung cancer who underwent lobectomy of more than one lobe. Also
      preoperatively conducted were pulmonary ventilation tests by spirometry and
      pulmonary circulation tests using the Swan-Ganz catheter to measure VC, %VC,
      FEV1.0, FEV1.0%, mean pulmonary arterial pressure (PPA) and cardiac output
      coefficient (C.I.). Form theses measurements, VC/m2, FEV1.0/m2 and total
      pulmonary vascular resistance (TPVR) were calculated. After the cut-off values of
      VO2 max/m2 were set tentatively at three stages, 600, 650 and 700 ml/min/m2 based
      on the incidence of postoperative complications, the 111 patients were divided
      into two groups in each cut-off value; one with VO2 max/m2 greater than the cut
      off value and the other less than the cut-off value. Comparison of measurements
      obtained by spirometry between the two groups disclosed significant differences
      (p < 0.001) in VC/m2, %VC and FEV1.0/m2 in all cut-off values. Similarly,
      comparison of measurements obtained using the Swan-Ganz catheter between the two
      groups yielded significant differences (p < 0.05 to p < 0.01) in PPA and TPVR in
      all cut-off values.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798710
TI  - [Study on development of linear-traction type skeletal muscle powered pump].
AB  - We successfully developed Linear-Traction Type Skeletal Muscle Powered Pump
      (LSMPP). Unlike the Insertion-Type SMPP (ISMPP), previously used by us, in which
      a polyurethane chamber is inserted between skeletal muscle and chest wall, this
      pump can utilize the traction of muscle fiber in a linear direction. This pump
      also enabled us to obtain a sufficient flow with a low preload by the use of a
      spring for the filling of the pump. Comparison was made between the measurement
      of flow using the origin side of Latissimus Dorsi Muscle (o-group) (n = 6) and
      that using the upper arm side (i-group) (n = 6), both measured with the Linear
      Traction Type equipment, and the result obtained with the ISMPP (s-group) (n =
      6). Under a rate of 60 beat/min and a preload of 40 mmHg, the flows (ml/min) of o
      group, i-group and s-group were 668.0 +/- 108.0, 1202 +/- 478.6 and 620.0 +/-
      188.0, respectively. In i-group (n = 6), different rate, preload and spring
      constant were given to examine how the flow would vary with them. Mean flow (Mean
      +/- Std ml/min) was 815.0 +/- 378.0 at 60 beat/min, significantly different in
      comparison with that of 80 beat/min and that of 100 beat/min. For 40, 30 and 20
      mmHg of preloads, mean flows were 877.0 +/- 366.0, 625.0 +/- 311.0 and 422.0 +/-
      270.0, respectively. This showed that, as far as the rate remains low, even low
      preload can provide some 30% of the cardiac output of a dog as compensate cardiac
      flow. In contrast, there were no significant differences in mean flow with spring
      constants such as 0, 80, 160, 240 and 320 g/cm.

PMID- 7798709
TI  - [The efficacy of both antegrade and retrograde cardioplegia in coronary artery
      bypass surgery].
AB  - We evaluated the efficacy of the cardioplegic myocardial protection by combining
      antegrade cardioplegic induction via the aortic root with retrograde cardioplegia
      via the coronary sinus in patients who had LAD stenosis or occlusion with
      collateral circulation. In study I, forty-six patients were divided into two
      groups: antegrade group (group A; 32 cases), which were perfused by only
      antegrade fashion via the aortic root, and bi-directional group (group B; 14
      cases), which were perfused by combining antegrade with retrograde fashion. In
      study II, patients were divided into four groups: 32 cases in group A were divide
      into three subgroups by the direction of the collateral circulation to LAD in
      preoperative coronary angiograms: group I (antegrade collateral circulation; 18
      cases), group II (retrograde collateral circulation; 7 cases), group III (99%
      stenosis with delayed filling; 7 cases) and group B was as group IV. Myocardial
      injury was assessed with the use of enzyme indexes (total CPK, CPK-MB, %MB, peak
      CPK, peak CPK-MB and peak % MB) in study I and study II. There was no significant
      difference between the two groups in study I and the four groups in study II in
      terms of patients' profile, graft materials, number of grafts, aortic cross
      clamping time, total cardiopulmonary bypass time and surgical results. Total CPK
      level in group B was significantly lower (p < 0.05) compared with group A at the
      point of 12 hr and 1 day after surgery and peak CPK level was also significantly
      lower (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798712
TI  - [Intraoperative pulmonary angioscopy to undergo pulmonary embolectomy for acute
      massive pulmonary embolism].
AB  - An urgent pulmonary embolectomy on a patient under intraoperative angioscopy for
      the treatment of massive pulmonary embolism was performed and successfully saved
      the patient. The case was a 19-year-old man who had been bedridden over along
      period of time. He developed pulmonary embolism immediately after the initiation
      of walking rehabilitation. Although anticoagulation therapy was immediately
      carried out, hemodynamics deteriorated, and as a result, it became necessary to
      treat this patient with the urgent surgical procedure. Under extracorporeal
      circulation with the clamping of the aorta, the pulmonary artery was opened.
      Following embolectomy for the left pulmonary artery, the right pulmonary artery,
      where the presence of clots had not been confirmed with the naked eye, was
      inspected using an flexible fiberoptic choledochoscope 4.9 mm in diameter.
      Consequently, amount of clots were removed using forceps or an aspirating tube.
      The patient recovered from hypoxemia after surgery. The use of intraoperative
      angioscopy in the pulmonary artery proved to be very useful to examine the
      presence of emboli up to tertiary branches of pulmonary artery.

PMID- 7798711
TI  - [Lung resection for lung carcinoma with idiopathic interstitial pneumonia].
AB  - Of 12 patients who underwent lung resections for lung cancer with idiopathic
      interstitial pneumonia (IIP), eight patients survived and four patients died due
      to acute exacerbation of IIP after the operation. The preoperative values for
      percent forced vital capacity, predicted postoperative percent vital capacity,
      percent one-second forced expiratory volume index and serum level of C-reactive
      protein were significantly different between the group of patients who survived
      and that of having died. Three days after the operation, the percentage of
      lymphocytes among leukocytes and serum level of lactate dehydrogenase in the two
      groups were both significantly different. These findings showed that the
      operative strategy for patients with lung cancer and IIP needs specifically
      careful consideration for operative procedure, and preoperative serum levels of C
      reactive protein and postoperative lactate dehydrogenase and the percentage of
      lymphocytes in leukocytes would be useful in evaluation of the severity of IIP.

PMID- 7798713
TI  - [A case of bronchogenic cyst in the esophageal wall].
AB  - A 73-year-old man with a right aortic arch was admitted because of stridor and
      dyspnea. We diagnosed a cervico-mediastinal cyst associated with bilateral
      recurrent laryngeal nerve palsy. Median sternotomy revealed a cystic tumor
      located in the esophageal wall. Microscopic examination of the resected cyst
      showed cartilage, smooth muscle and mucous gland, so the final diagnosis was
      bronchogenic cyst. The bilateral recurrent laryngeal nerve palsy was caused by
      chronic pressure from the cyst. Mediastinal cysts should be found and treated as
      early as possible, because these cysts may sometimes cause fatal complications.

PMID- 7798714
TI  - [A case of surgical treatment of Swyer-James syndrome].
AB  - Swyer-James syndrome was usually diagnosed on the past history and the radiologic
      features, and almost all the cases were followed by the conservative therapy.
      Therefore, the examination of the pathologic features was rare. We recently
      experienced a patient with Swyer-James syndrome, who had a history of respiratory
      infection from his childhood onward and whose chest radiograph revealed
      hyperlucency of the right lower lung field. A standard right middle and lower
      lobectomy was performed. Histological examination of the resected specimens
      revealed hypoplasia of alveoli and pulmonary artery.

PMID- 7798715
TI  - [Nearly total aortic replacement for DeBakey type-I aortic dissection in a
      patient with Marfan's syndrome].
AB  - A successful nearly total aortic replacement for DeBakey type-I aortic dissection
      in a patient with Marfan's syndrome is reported. A 36-year-old woman developed a
      DeBakey type-I aortic dissection in October 1987. We replaced the ascending aorta
      and resuspended the aortic valve urgently, when she had not been diagnosed with
      Marfan's syndrome. In August 1989, we replaced the distal portion of the
      descending aorta and the infra-renal abdominal aorta because of dilatation in the
      diameter of these regions. In September 1990, she had sudden severe chest pain.
      Computed tomography and Doppler ultrasonography revealed that a new aortic
      dissection developed in the aortic arch and the descending aorta (three-channeled
      dissection) and that the new false lumen compressed the true and the old false
      lumens obstructing the blood flow to the abdominal aorta. She was immediately
      placed an axilo-femoral bypass, and in January 1991 she underwent the arch and
      descending aorta replacement using permanent bypass to the supra-aortic branches
      and partial extracorporeal circulation (first reported by Larmi et al).
      Postoperative course was satisfactory, and she has been well at 3 years after the
      operation. Because progressive dilatation of an untreated dissecting aorta is
      common in patients with Marfan's syndrome, aggressive replacement of the diseased
      aorta is indicated in these patients.

PMID- 7798716
TI  - [A case of metastatic lung tumor from acinic cell tumor of the parotid gland].
AB  - A 59-year-old man with metastatic lung tumor from acinic cell tumor of the
      parotid gland was reported. Five years after resection of the parotid tumor, the
      abnormal shadow on chest X-ray film was detected in the mass screening. The tumor
      was located in S10c of the right lung, and resected by partial lung resection. As
      pathological findings showed the same histology between the parotid gland and the
      lung, we diagnosed the metastatic lung tumor from acinic cell tumor of the
      parotid gland. Acinic cell tumor shall be slowly growing and occasionally
      developing the pulmonary metastasis. So, we have to carefully follow the patient
      in long-term periods.

PMID- 7798718
TI  - [A case report of primary fibrosarcoma originated in the heart invading adjacent
      organs ].
AB  - A rare case of cardiogenic fibrosarcoma is reported. A 66 y.o. male with dyspnea,
      cough and fatigue was examined. B-mode echo, MRI, and angiography disclosed a
      large tumor in the left atrium. A large fibrosarcoma and 2 cm of the left atrial
      wall around the tumor pedicle were removed. The atrial defect and right lower
      pulmonary vein were repaired with a patch. Four months later, the tumor recurred
      in the right lung, mediastinum, and left atrium. The tumor, middle and lower
      lobes of the right lung, and part of the left atrial wall were excised. One year
      after the first operation, the patient died of air way obstruction due to another
      recurrence of the fibrosarcoma in the left lung, esophagus, and mediastinum.
      Cardiogenic fibrosarcoma invading outward for the mediastinal organs is rare.

PMID- 7798717
TI  - [A case of ACTH-releasing lung carcinoid tumor presenting Cushing's syndrome].
AB  - The patient was a 47-year-old female who had undergone hypophysectomy due to
      Cushing's syndrome when 46 years old. In April 1992, about 1 month after the
      operation, chest CT-scan revealed a lesion of 8 x 8 mm in size in the right upper
      lobe. A high value of serum ACTH was obtained from the A3b wedge blood by cardiac
      catheterization. She was operated on suspicion of ACTH releasing lung tumor.
      During the operation, it was histologically diagnosed as lung carcinoid by a
      frozen section of the lesion. In addition, ACTH of the blood obtained from the
      right superior pulmonary vein was as high as 37,300 pg/ml, but that in the right
      main pulmonary artery or the radial artery was 850-970 pg/ml. Right upper
      lobectomy with dissection of mediastinal lymph nodes was so performed. Post
      operative value of serum ACTH was significantly decreased. She was in good
      course, and is still asymptomatic 8 months after the operation.

PMID- 7798719
TI  - [A case of pseudoxanthoma elasticum underwent coronary artery bypass grafting].
AB  - A case of pseudoxanthoma elasticum (PXE) underwent coronary artery grafting is
      reported. Coronary angiography of a woman with age of 41 with PXE revealed three
      vessels lesions. Coronary artery bypass grafting using saphenous vein grafts was
      performed. The left internal mammary artery was not able to use because of
      obstruction. Her postoperative course is uneventful for 3 years to date.
      Histological examination of a segment of ascending aorta revealed changes of PXE
      underwent CABG is extremely rare. This is the third reported case in Japan.

PMID- 7798720
TI  - [A case-report of pacemaker malfunction caused by dry pocket after replacement of
      pulse generator].
AB  - Pacemaker malfunction was attributed to the increasing in impedance to current
      flow caused by a pocket of air separating the anodal contact plate of a unipolar
      generator from the overlying connective tissue (so-called dry pocket). Lack of
      capture was noted just after replacement of pulse generator. The malfunction was
      permanently corrected by bediside infusion of saline to pacemaker pocket.

PMID- 7798721
TI  - [A successful use of VAS for bridge to heart transplantation after oversea
      transportation in a 18-year-old patient with dilated cardiomyopathy].
AB  - An 18-year-old boy with dilated cardiomyopathy developed a relatively rapid
      deterioration and went into severe congestive heart failure. After short-while
      use of percutaneous cardiopulmonary support system (PCPS) and IABP, LVAS was
      indicated because of persisting low cardiac output syndrome and deterioration of
      organ functions. An LVAS (TOYOBO) was implanted on June 26, 1992 in a fashion of
      left atrium to ascending aorta bypass. Satisfactory circulatory support (flow
      rates of 4-5 L/min) was achieved resulting in complete recovery of the organ
      functions. After two months of LVAS support, the patient was transported to
      U.S.A.. The LVAS system was working well without any problems during 17 hrs
      flight under low atmospheric pressure (0.8 atm) in the plane. The patient
      successfully underwent heart transplantation (HTx) at Texas Heart Institute after
      119 days support of LVAS. The patient is doing well enjoying active life after
      HTx. This is the first case of successful bridge use of extracorporeal LVAS to
      HTx in Japan.

PMID- 7798722
TI  - [A case of chronic hemorrhagic pyothorax treated by extraperiosteal air plombage
      method].
AB  - A 64-year-old female patient was admitted with severe exertional dypnea. She had
      undergone left pneumonectomy because of lung tuberculosis at the age of 31. Her
      chest X-ray showed total opacity of the left hemithorax and mediastinal deviation
      to the right. The examination of the pleural effusion revealed neither malignant
      cells nor micro-organisms. She underwent surgery, by extraperiosteal air plombage
      method, successfully. Five months after the operation, her lung function and
      chest X-ray improved dramatically and exertional dyspnea was diminished. We
      conclude that the extraperiosteal air plombage method is a useful technique for
      patients with chronic hemorrhagic pyothorax.

PMID- 7798723
TI  - [A case report of tricuspid valve valvoplasty for tricuspid endocarditis].
AB  - A successful repair of tricuspid valve insufficiency due to endocarditis related
      to VSD is reported. Combined quadrangular resection and repair of anterior
      leaflet, pericardial patch plasty of anterior-septal commissure, Carpentier ring
      annuloplasty and VSD closure was performed with good clinical results.

PMID- 7798724
TI  - [A case of mitral valve replacement with chronic idiopathic thrombocytopenic
      purpura after high-dose immunoglobulin infusion].
AB  - A 60-year-old female patient diagnosed as having mitral stenosis with chronic
      idiopathic thrombocytopenic purpura (ITP), with a platelet count of 6.8 x
      10(4)/mm3, was scheduled to undergo mitral valve replacement. High-dose
      immunoglobulin infusion (400 mg/kg/day for five days) was begun four days before
      the operation and increased the platelet count to 9.1 x 10(4)/mm3 just before the
      operation. Intraoperative hemostasis was excellent, and the postoperative course
      was uneventful. High-dose immunoglobulin therapy appears to be a first choice for
      controlling hemorrhagic tendency in ITP patients undergoing heart surgery.

PMID- 7798725
TI  - [Congenital esophago-bronchial fistula in adult--report of a case].
AB  - A 52-year-old man had been having cough on drinking water since 30 years. He
      coughed out blood 20 years ago. Chest roentgenogram showed the infiltrating
      shadow in the right lower lung field and the left hilum. Chest computed tomogram
      in the left atrium level showed fistulous communication between the bronchus and
      the esophagus and cavity lesion. Esophagogram showed fistulous communication
      between the bronchus (rt. B7) and the middle third of the esophagus. Bronchogram
      showed the stenotic lesion of the right B7a and B*. And abnormal bronchus was
      revealed and fistula was suspected. The orifice of the fistula was seen by
      esophageal endoscopy. Through the right posterolateral thoracotomy, fistelectomy
      and covering with pleural flap over the esophageal suturing site were performed.
      Histologic finding of the resected specimen revealed fistula's wall composing of
      smooth muscle lined with squamous cell layer. This case is categorized as
      Braimbridge type II. The postoperative course was uneventful and the patient is
      now in free of complaints at the 6th month's P.O.D.

PMID- 7798727
TI  - Genetic teaching for the retinoblastoma patient.
AB  - Retinoblastoma is the most common primary intraocular tumor in children.
      Retinoblastoma can be hereditary (familial) or nonhereditary (nonfamilial).
      Nurses who have an understanding of the genetic patterns for retinoblastoma can
      participate in the counseling of these patients. A chart is provided as a tool
      for teaching patients about family patterns of retinoblastoma.

PMID- 7798726
TI  - Electrophysiology testing and the ophthalmic registered nurse.
AB  - Ophthalmologists employ electrophysiologic testing to diagnose and manage a
      variety of ocular conditions. The most common reason these tests are performed is
      to diagnose inherited vitreoretinal diseases. Patients of all ages may require
      electrophysiologic testing. The purpose of this article is to provide the
      ophthalmic registered nurse with a working knowledge of the three most commonly
      used electrophysiologic tests. We will provide background and practical
      information on how we perform electroretinography (ERG), electroculography (EOG),
      and dark adaptometry. Knowledge of the basics of this specialized testing will
      allow the ophthalmic nurse to provide more information for the patient. This
      knowledge will hopefully reduce patient anxiety and with better cooperation
      produce more accurate test results.

PMID- 7798728
TI  - Complications of indirect laser photocoagulation.
AB  - Potential complications of indirect laser photocoagulation for retinopathy of
      prematurity are: corneal burn; iris burn; lens burn; choroidal hemorrhage or
      neovascularization; inadvertent photocoagulation of fovea; preretinal membrane
      formation; late onset retinal detachment; and retinal, preretinal, or vitreous
      hemorrhage.

PMID- 7798730
TI  - The future through high-tech spectacles.

PMID- 7798731
TI  - Role delineation study for ophthalmic registered nurses.

PMID- 7798729
TI  - Overview and new technology in cyclodestructive procedures.
AB  - When all medical and surgical measures have failed to lower intraocular pressure
      (IOP) in patients with severe and uncontrolled glaucoma, ophthalmologists must
      turn to cyclodestructive procedures to decrease aqueous production. Several
      months ago, the FDA (Food and Drug Administration) came through with an approval
      for a new technology in cyclophotocoagulation therapy. The IRIS Medical G-Probe
      used in conjunction with a semiconductor diode laser may be the superior
      alternative to previously available cyclodestructive techniques for which
      ophthalmologists have been searching.

PMID- 7798732
TI  - "Stones in the eye": post cataract suture irritation--a transcultural study from
      Sierra Leone, West Africa.
AB  - A retrospective study of 1214 outpatients in Sierra Leone, West Africa was done
      to answer the question, "What is the visual acuity following extracapsular
      cataract extraction (ECCE) with an intraocular lens (IOL) for patients in a
      developing country?" Only 24% achieved uncorrected pseudophakic visual acuity of
      20/20 to 20/50. Additionally, postoperative complications and patient complaints
      were tracked. Results showed suture irritation was less prevalent in those
      patients when 10-0 nylon suture was used, cut close, and the knot rotated and
      buried.

PMID- 7798733
TI  - [Internal medicine in the 21st century].

PMID- 7798734
TI  - [Basic study of hematopoietic stem cells and the clinical application].

PMID- 7798736
TI  - [Basic and clinical study of Helicobacter pylori infections].

PMID- 7798735
TI  - [Clinical study of AIDS].

PMID- 7798738
TI  - [Takatsuki disease found in Japanese patients].

PMID- 7798737
TI  - [Basic and clinical study of Alzheimer-type dementia].

PMID- 7798739
TI  - [Autoimmune insulin syndrome found in Japanese patients].

PMID- 7798740
TI  - [HTLV-I associated myelopathy found in Japanese patients].

PMID- 7798741
TI  - [Vascular endothelial cells and arteriosclerosis].

PMID- 7798742
TI  - [Vascular smooth muscle cells and arteriosclerosis].

PMID- 7798744
TI  - [Cytokines, growth factors and arteriosclerosis].

PMID- 7798743
TI  - [Macrophages and arteriosclerosis].

PMID- 7798745
TI  - [Recent advance on chemotherapy of leukemia].

PMID- 7798746
TI  - [Optimal administration of 5-FU and cisplatin based on biochemical modulation in
      the treatment of non-resectable non-small cell lung carcinoma].

PMID- 7798748
TI  - [Progress on chemotherapy in patients with non-resectable stomach cancer].

PMID- 7798747
TI  - [Clinical application of adoptive immunotherapy in patients with progressive lung
      cancer].

PMID- 7798749
TI  - [Angiotensin II-induced hypertension chemotherapy in patients with progressive
      non-resectable digestive system cancer].

PMID- 7798750
TI  - [Treatment of progressive non-resectable hepatoma].

PMID- 7798751
TI  - [Proton radiation therapy of non-resectable liver neoplasm].

PMID- 7798752
TI  - [Epidemiologic study of obstructive sleep apnea syndrome].

PMID- 7798753
TI  - [Physiopathology of sleep apnea].

PMID- 7798754
TI  - [Diagnosis of sleep apnea].

PMID- 7798755
TI  - [Symptoms associated with sleep apnea].

PMID- 7798756
TI  - [Treatment of obstructive sleep apnea syndrome].

PMID- 7798757
TI  - [Diagnosis of anemia--analysis of erythrocyte ferritin].

PMID- 7798758
TI  - [Recent progress on the diagnosis and therapy of secondary hypertension].

PMID- 7798759
TI  - [Cardiac sudden death].

PMID- 7798760
TI  - [Respiratory failure and respiratory muscle fatigue].

PMID- 7798762
TI  - [Prevention and therapy of osteoporosis].

PMID- 7798761
TI  - [Non-invasive therapy of Cushing's syndrome].

PMID- 7798763
TI  - [Treatment of diabetic nephropathies].

PMID- 7798764
TI  - [Basic and clinical study of alcoholic liver and digestive system injuries].

PMID- 7798765
TI  - [Dystonia and botulinum toxin therapy].

PMID- 7798767
TI  - [Blood platelet disorders].

PMID- 7798766
TI  - [Lipoproteins and coronary arteriosclerosis].

PMID- 7798768
TI  - [Roll of endothelin-1 in mechanism of cell communication system].

PMID- 7798769
TI  - [Insulin receptors and diabetes mellitus].

PMID- 7798770
TI  - [Viral myocarditis].

PMID- 7798771
TI  - [Antisense therapy].

PMID- 7798772
TI  - [Basic and clinical study of bacterial biofilm].

PMID- 7798773
TI  - [Mitochondrial encephalomyopathies].

PMID- 7798774
TI  - Antitrust reform: equality at the bargaining table.

PMID- 7798775
TI  - ECG of the month. Dead beats. Pacemaker rhythm.

PMID- 7798776
TI  - Disorders of taste and smell.
AB  - Chemosensory dysfunction involves deficits in taste or smell. Aberrations in
      these senses can be quite distressing to the patient and can negatively impact on
      nutritional well-being. A thorough history and physical examination are important
      in isolating the etiology of the sensory loss from the numerous causes of taste
      and smell disorders. The diagnosis can be simplified by the fact that only a few
      causes (nasal and sinus disease, viral-induced loss, and head trauma) are
      responsible for the vast majority of chemosensory dysfunctions. Therapy is
      limited, but one should be aware of the existing medical and surgical treatment
      modalities.

PMID- 7798777
TI  - A five-step approach to settling a dispute over futile care.

PMID- 7798778
TI  - The journal 100 years ago. October 1844-1894.

PMID- 7798779
TI  - Ceftazidime as monotherapy for fever and neutropenia: experience in a community
      hospital.
AB  - Fever and neutropenia is occurring in a wider variety of clinical settings, and
      the proper antibiotic therapy for its treatment is an area of debate. Our study
      is a retrospective analysis of the experience of the Oncology Division of the
      Medical Center of Baton Rouge, which used ceftazidime as monotherapy in the
      empiric treatment of fever and neutropenia. A total of 53 episodes in 38 patients
      were studied. Using ceftazidime as monotherapy in our study population was
      associated with an 8% mortality rate, indicating that monotherapy is a viable
      option for the treatment of fever and neutropenia.

PMID- 7798781
TI  - Progression of experimental chronic renal failure: does platelet-activating
      factor play a role?

PMID- 7798780
TI  - Air quality and respiratory functioning in children with pulmonary disorders.
AB  - This study was conducted to examine the relation between daily ambient air
      conditions, contaminants (eg, aeroallergens such as mold spores and pollen), and
      respiratory health indices of children with respiratory disorders (eg, asthma)
      residing in metropolitan Baton Rouge, Louisiana. Daily measures of peak
      expiratory flow rate (PEFR), respiratory symptoms, and other indices of health
      were monitored as subjects went about their normal daily activities. The results
      of this study suggest that high summer temperatures had the greatest impact on
      children's health status and activity level, with humidity and mold counts also
      contributing significantly to a decline in respiratory health indices.

PMID- 7798782
TI  - Endotoxin transfer during dialysis: less than meets the eye?

PMID- 7798783
TI  - Direct effects of the adrenergic system on cardiac hypertrophy: molecular
      analysis of the heterotopically transplanted heart.

PMID- 7798784
TI  - Tumor necrosis factor and endothelins: team players in shock?

PMID- 7798785
TI  - Cellular and molecular basis of renal repair in acute renal failure.
AB  - Experimental data suggest that the recovery of renal function after ischemic or
      nephrotoxic acute renal failure is due to a replicative repair process dependent
      on predominantly paracrine release of growth factors. These growth factors
      promote renal proximal tubule cell proliferation and a differentiation phase
      dependent on the interaction between tubule cells and basement membrane. These
      insights identify the molecular basis of renal repair in ischemic and nephrotoxic
      acute renal failure and may lead to potential therapeutic modalities that
      accelerate renal repair and lessen the morbidity and mortality associated with
      these renal disease processes.

PMID- 7798786
TI  - Fibrogenesis and type I collagen gene regulation.

PMID- 7798787
TI  - Apoptosis: physiologic cell death.

PMID- 7798788
TI  - Behavioral neurophysiology of the motor cortex.
AB  - The study of the motor cortex in behaving monkeys during the past 20 years has
      provided important information on the brain mechanisms underlying motor control.
      With respect to reaching movements in space, several aspects of motor cortical
      function concerning the specification of the direction of movement have now been
      elucidated and are reviewed in this article. The activity of single cells in the
      motor cortex is broadly tuned with respect to the direction of reaching, so that
      the discharge rate is highest with movements in a preferred direction and
      decreases progressively with movements made in directions more and more away from
      the preferred one. Thus the neural command for the direction of reaching can be
      regarded as an ensemble of cell vectors, with each vector pointing in the cell's
      preferred direction and having a length proportional to the change in cell
      activity. The outcome of this population code can be visualized as a vector that
      points in the direction of the upcoming movement during the reaction time, during
      an instructed delay period, and during a memorized delay period. Moreover, when a
      mental transformation is required for the generation of a reaching movement in a
      different direction from a reference direction, the population vector provides a
      direct insight into the nature of the cognitive process by which the required
      transformation is achieved.

PMID- 7798789
TI  - Platelet-activating factor receptor antagonist improves renal function and
      glomerular lesions in renal ablation.
AB  - In the renal ablation model hemodynamic changes, glomerular hypertrophy, and the
      release of inflammatory mediators contribute to structural damage and functional
      changes. Platelet-activating factor (PAF) has both hemodynamic and immune
      mediating properties. We therefore examined the role for a PAF receptor
      antagonist (WEB 2170) on glomerular hemodynamic function, albuminuria, and
      structural alterations in a rat model of renal ablation (Nx). WEB 2170 treatment
      was started 10 weeks after renal ablation, and the variables were assessed at 36
      weeks after surgery. WEB 2170 significantly improved inulin and PAH clearances at
      36 weeks (inulin clearance: Nx, 182 +/- 28 microliters/min/100 gm body weight; Nx
      plus WEB, 284 +/- 19 microliters/min/100 gm body weight; p < 0.05; PAH clearance:
      Nx, 718 +/- 85 microliters/min/100 gm body weight; Nx plus WEB, 1215 +/- 103
      microliters/min/100 gm body weight; p < 0.05). Glomerular prostaglandin E2 (PGE2)
      formation was significantly increased in nephrectomized rats treated with WEB
      2170 when compared with nephrectomized animals not treated (PGE2: Nx, 103 +/- 16
      pg/min/mg protein; Nx plus WEB, 182 +/- 19 pg/min/mg protein; p < 0.01). The PAF
      receptor antagonist did not change albuminuria (Nx, 205 +/- 56 mg/24 hr; Nx plus
      WEB, 178 +/- 48 mg/24 hr). Glomeruli of rats treated with WEB 2170 had
      significantly fewer sclerotic lesions at 36 weeks when compared with untreated
      animals (Nx, 36.5 +/- 4.4%; Nx plus WEB, 19.3 +/- 3.7%; p < 0.05). The results
      demonstrate that a PAF receptor antagonist significantly improves whole kidney
      clearances and glomerular morphology.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798790
TI  - The role of plasma in the transfer of Escherichia coli cytokine-inducing
      substances across high-flux cellulosic membranes.
AB  - It has been previously reported that the presence of plasma in the blood side
      compartment of cellulosic membranes enhances the transfer of cytokine-inducing
      substance (CIS) present in the dialysate compartment. This apparent enhancement
      could either be a result of (1) improved membrane permeability to CIS, (2)
      transfer of plasma components to the dialysate compartment thereby causing
      dissaggregation of CIS with subsequent backtransfer to the blood compartment, or
      (3) improved detection of transferred CIS resulting from carryover of plasma from
      the blood compartment to the mononuclear cell incubation step. An in vitro
      dialysis model was used to determine which of the above mechanisms were involved
      in this phenomenon. Results showed that enhanced detection of CIS could not be
      attributed to improved detection resulting from carryover plasma. Both addition
      of plasma to the dialysate compartment of pre-exposure of membranes to plasma
      resulted in enhanced transfer of CIS in a fashion similar to that seen when
      plasma was added to the blood compartment. These observations suggest that the
      transfer of Escherichia coli culture filtrate-derived CIS across cellulosic
      membranes is enhanced on exposure to 10% plasma because of alterations in the
      permselectivity of the membrane.

PMID- 7798791
TI  - Effects of adrenergic agonists on the growth and gene expression of the
      transplanted heart.
AB  - Cardiac growth occurs in response to changes in hemodynamic demand and results
      primarily from cellular hypertrophy without cellular hyperplasia. In addition to
      changes in cardiac work, various reports have demonstrated that adrenergic
      stimulation, specifically of the alpha 1 adrenergic receptor of cultured
      myocytes, can produce changes in cardiac-specific gene expression and increases
      in protein synthesis and cell growth. To study the effects of adrenergic
      stimulation in the absence of alterations in cardiac work we have used the model
      of the heterotopically transplanted heart, which is a spontaneously beating,
      vascularly perfused, and histologically normal heart that is hemodynamically
      unloaded. Seventy-two hours after transplantation, the hemodynamically unloaded
      transplanted heart had decreased in size by 20% when compared with the control
      host heart that was growing in situ. Treatment with either the alpha-adrenergic
      agonist phenylephrine (2.5 mg/kg/day) or the beta-adrenergic agonist
      isoproterenol (250 micrograms/kg/day) while increasing the spontaneous heart rate
      had no effect on the size of the transplanted heart. Simultaneous measurements
      demonstrated that both of these drugs produced a 10% increase in weight of the
      corresponding hemodynamically loaded host heart. We previously demonstrated that
      cardiac unloading caused a change in the expression of the myosin heavy chain
      (MHC) genes with a significant increase in the beta MHC isoform. In the present
      studies treatment with either isoproterenol or phenylephrine did not alter MHC
      gene expression either in the in situ host or transplanted hearts.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7798793
TI  - Bacterial characterization in Staphylococcus epidermidis septicemia.
AB  - An analysis of the in vitro characteristics of Staphylococcus epidermidis strains
      isolated from patients with true S. epidermidis septicemia was undertaken. From a
      potential population of 921 cultures from adult patients with coagulase-negative
      bacteremia, highly defined selective criteria limited the population to 20
      patients with S. epidermidis sepsis, from whose blood cultures the study
      organisms were isolated. Another population of 11 S. epidermidis blood isolates,
      clinically determined to be contaminants, were tested as a control group. In
      vitro assays performed on all isolates included slime quantification,
      hydrophobicity, surface hexoses, and capsule presence. Murine spleen phagocytosis
      of intravenously administered isolates was measured in vivo. The assayed quantity
      of cell-associated bacterial hexose sugars positively correlated with organism
      virulence to the host (p = 0.02). This bacterial population was also low in slime
      but varied as to the presence of capsule and ease of phagocytosis. Permanent
      catheter-bearing patients' bacteria were somewhat more hydrophobic (p = 0.07). We
      conclude that in vitro assays can differentiate bacteremic cultures from
      contaminants and that the characteristic that best relates to host toxicity in
      these S. epidermidis isolates was bacterial cell surface-associated carbohydrate.

PMID- 7798792
TI  - Big-endothelin release in baboon bacteremia is partially TNF dependent.
AB  - Big-endothelin (big-ET) is one of the endothelium-derived vasoactive substances
      that plays an important role in regulating the vascular tone. Because the role of
      this agent in bacteremia remains unknown, we investigated whether bacteremia
      induces the release of big-ET in a subhuman primate model and whether tumor
      necrosis factor (TNF) is an important mediator of big-ET release. To study this,
      we infused 8 male baboons (17 to 19 kg body weight) intravenously for 2 hours
      with Escherichia coli (5 x 10(8) CFU/kg) and observed them for 72 hours. Plasma
      was obtained at various intervals and assayed for big-ET by using immunoassay.
      Four bacteremic animals given vehicle only showed a peak big-ET plasma
      concentration of 15.1 +/- 4.6 fmol/ml at 10 hours, as compared with a baseline
      concentration of 0.9 +/- 0.5 fmol/ml. Administration of anti-TNF monoclonal
      antibodies (CB6, 15 mg/kg) 2 hours before E. coli infusion in additional animals
      prevented the rise in plasma TNF levels (5.7 +/- 2.5 ng/ml versus nondetectable)
      and significantly (p < 0.01) attenuated the release of big-ET. Hemodynamic
      measurements revealed the typical pattern of sepsis, with generally more stable
      circulatory conditions in the anti-TNF-treated animals. Moreover, the mortality
      rate decreased from 100% to 0% with anti-TNF treatment. These studies, therefore,
      lead us to conclude that TNF, directly or indirectly through another mediator,
      plays an important role in the endothelin production/release during bacteremia
      and that neutralization of circulating TNF appears to be beneficial for improving
      the survival after bacteremia.

PMID- 7798794
TI  - Sweat electrolytes in patients with advanced renal failure.
AB  - The sweat gland has some similarity with the convoluted tubules of the kidney.
      Little is known about sweat secretion and electrolyte content of sweat in the
      uremic gland. A pilocarpine ionotophoresis sweat test was performed in 40
      patients with advanced renal failure (RF). Sweat secretion was measured and
      analyzed for Na, K, and Cl and correlated to blood parameters, type, and duration
      of dialysis. The sweat weight was significantly lower in all RF patients when
      compared with this parameter in healthy controls (p < 0.0001). No difference was
      noted between patients undergoing hemodialysis, those undergoing continuous
      ambulatory peritoneal dialysis, and those not undergoing dialysis. Men sweated
      more than women among RF patients and among controls (p < 0.0001). An inverse
      correlation was found between sweat weight and blood calcium levels (p < 0.001).
      Sweat K concentration was significantly higher (p < 0.0001) in patients with RF
      than in healthy controls, while the concentrations of Na and Cl were similar.
      Several mechanisms are suggested as possible explanations for these changes.

PMID- 7798795
TI  - Evaluation of the significance of elevated levels of systemic and localized tumor
      necrosis factor in different animal models of inflammation.
AB  - Elevated tumor necrosis factor (TNF) levels have been reported in various models
      of acute and chronic inflammation and used by many investigators to determine the
      stage of disease and effectiveness of treatment. Because of the documented
      involvement of TNF in the mechanism of septic shock, experiments were done to
      determine whether serum TNF levels paralleled the pathology in endotoxic shock
      and other models of inflammation. When mice received an intraperitoneal injection
      of lipopolysaccharide, serum TNF levels increased dramatically, peaking 90
      minutes after injection. In a dose-response experiment with lipopolysaccharide
      alone, we found no correlation between serum levels of TNF and survival rate of
      mice. All three lipopolysaccharide concentrations resulted in comparable
      elevations of serum TNF, yet only in the high-dose group did the animals die. In
      a second model of endotoxic shock, TNF-alpha levels in serum were again compared
      with the survival rate of mice receiving lipopolysaccharide plus galactosamine.
      As in the first model, we found no relationship between the level of TNF in mouse
      serum and mouse survival rate. The two lowest concentrations of
      lipopolysaccharide/galactosamine induced identically low levels of serum TNF, yet
      in one group all of the animals survived and in the other all died. Discrepancies
      between serum TNF level and mortality rate were also seen in drug treatment
      experiments. GI 147404X, a standard phosphodiesterase type IV inhibitor,
      inhibited lipopolysaccharide/galactosamine-induced elevation of serum TNF by 90%
      at doses of 1 and 10 mg/kg. However, the high dose resulted in 66% protection
      while the low dose afforded no protection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798797
TI  - Stimulation of glomerular epithelial cell growth by doxorubicin.
AB  - Although doxorubicin nephrosis is commonly used as a model of nephrotic syndrome
      in the rat, the mechanism of glomerular injury remains unknown. Since a study by
      others using nonrenal cell lines showed that doxorubicin could increase cell
      growth at concentrations below the cytotoxic range, experiments were performed to
      determine whether doxorubicin had similar effects on glomerular cells. At low
      concentrations (approximately 10(-10) to 10(-7) mol/L), doxorubicin causes a 1.5
      fold to three-fold stimulation of primary culture and cloned, passaged glomerular
      epithelial cell (GEC) growth, as assessed by cell counting, incorporation of
      tritiated thymidine, and by a fluorescence assay of cell growth. At these
      concentrations, doxorubicin had no effect on the growth rate of mesangial cells
      (MCs). Higher doxorubicin concentrations (> 10(-6) mol/L) inhibited the growth of
      GECs and MCs to a similar degree. Exposure to low concentrations of doxorubicin
      increased GEC growth under low serum conditions after doxorubicin treatment.
      Conditions that promoted high rates of GEC proliferation before doxorubicin
      exposure (pre-exposure to high serum concentrations, or use of subconfluent
      "stock" cultures) abrogated the growth response to doxorubicin, suggesting that
      doxorubicin stimulates GEC growth by substituting for growth-promoting factors
      present in serum. These studies demonstrate that unlike the growth-inhibiting
      effect of higher concentrations, the growth-promoting effect of low
      concentrations of doxorubicin is specific for GECs, the glomerular cell
      population that shows pathologic and functional evidence of injury in doxorubicin
      nephrosis in vivo. These findings, along with those of others, lead to the
      hypothesis that at higher concentrations, doxorubicin and other exogenous or
      endogenous growth-promoting compounds may cause GEC injury by "overstimulation"
      of the same pathways that promote growth at lower concentrations.

PMID- 7798796
TI  - Species diversity of 11 beta-hydroxysteroid dehydrogenase in the cardiovascular
      system.
AB  - Mineralocorticoid (MC) receptors are found in classic (e.g., kidney) and
      nonclassic (e.g., heart and aorta) tissues. MC receptor specificity at either
      site is conferred by the enzyme 11 beta-hydroxysteroid dehydrogenase (11 beta
      HSD), which metabolizes glucocorticoids to inactive 11-ketosteroids. Because the
      heart and vasculature may be target tissues for aldosterone, this study was
      undertaken. Its objectives were to measure 11 beta-HSD at these sites and to
      compare levels of activity in the atria and ventricles of different species.
      Toward this end we first determined levels of plasma corticosterone (B) and
      cortisol (F) (by using radioimmunoassay), in a variety of species, for subsequent
      correlation with cardiac 11 beta-HSD activity. 11 beta-Dehydrogenation of
      glucocorticoids was then assayed in ventricles and atria as well as aorta. Tissue
      homogenates containing 1 to 5 mg protein were incubated for 1 hour in the
      presence of 1 muCi 5 x 10(-9) mol/L tritiated B or tritiated F and 5 x 10(-4)
      mol/L oxidized nicotinamide adenine dinucleotide phosphate. Steroid separation
      and quantitation were achieved by using reverse-phase high-performance liquid
      chromatography coupled to an online radioisotope detector. For species in which B
      circulates at relatively high concentrations (rat, rabbit, pig), high levels of
      dehydrogenation of B to 11-dehydrocorticosterone (A) were observed in both atria
      and ventricles. Overall, cardiac B to A conversion levels corresponded to between
      0.3 and 0.4 pmol A formed/mg protein/hr. 11 beta-HSD activity was also detected
      in the aorta.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798798
TI  - Human liver-derived HEP G2 cells produce functional properdin.
AB  - Properdin stabilizes the alternative complement pathway C3 convertase and is
      synthesized by monocytes and myelomonocytic cell lines. Hepatic production of
      properdin has never been documented, although most other complement components
      are synthesized by liver. Human liver-derived Hep G2 cells were examined for the
      ability to produce properdin by using the polymerase chain reaction (PCR).
      Amplified properdin message was detected by using Southern transfer and
      hybridization to a murine properdin cDNA probe. Sequencing of the PCR product
      revealed that the Hep G2 message was nearly identical to the cDNA sequence from
      U937 cells. Subsequently Hep G2 cultures were stimulated with interleukin (IL-6),
      25 micrograms/ml, and culture supernatants were assayed for the presence of
      properdin by using dot blots. Properdin concentration increased over time, and we
      found no obvious difference between properdin production by IL-6-stimulated and
      unstimulated Hep G2 cells. Finally, alternative pathway decay assays confirmed
      the presence of functionally active properdin in the culture supernatant. Thus,
      functional properdin is a product of Hep G2 cells, suggesting that biosynthesis
      of properdin may occur in hepatocytes. Properdin synthesis was not augmented by
      IL-6, a finding that is consistent with previous observations that properdin is
      not an acute phase reactant.

PMID- 7798801
TI  - [A new cause of hereditary thrombophilia: activated protein c resistance].

PMID- 7798799
TI  - Aging increases ischemia-reperfusion injury in the isolated, buffer-perfused
      heart.
AB  - Survival after acute myocardial infarction is decreased in elderly patients as
      compared with the overall adult population. Although several cardiac and
      noncardiac causes could contribute to the increased mortality rate, little is
      known regarding the relative susceptibility of aging myocardium to injury during
      ischemia and reperfusion. We hypothesized that the elderly heart is intrinsically
      more susceptible to damage than the adult heart. The recovery of isolated, buffer
      perfused rat hearts from elderly animals (Fischer 344 rats, 24 months of age) was
      compared with that of adult hearts (6 months of age) obtained from the same
      strain. Hearts underwent 25 minutes of ischemia followed by 30 minutes of
      reperfusion. Hemodynamic recovery was decreased in elderly (n = 5) as compared
      with adult (n = 5) hearts, including developed pressure (% of preischemic
      baseline: elderly 31% +/- 4% vs adult 57% +/- 4%, p < 0.01). Elderly hearts also
      sustained greater tissue damage, with a markedly increased release of creatine
      kinase (elderly 2950 +/- 500 U vs adult 860 +/- 345 U, p < 0.01) during the 30
      minute reperfusion period. The release of total protein and lactate
      dehydrogenase, other markers of myocyte injury, was also increased. Thus the
      elderly rat heart is more susceptible than the adult rat heart to ischemia
      reperfusion injury. Greater injury during ischemia and reperfusion in an
      experimental model of aged myocardium raises the possibility of a more rapid
      progression of ischemic damage in elderly patients suffering acute myocardial
      infarction.

PMID- 7798800
TI  - Iron and zinc nutriture of premenopausal women: associations of diet with serum
      ferritin and plasma zinc disappearance and of serum ferritin with plasma zinc and
      plasma zinc disappearance.
AB  - The Second National Health and Nutrition Examination Survey found low iron and
      zinc intakes and low serum ferritin in many premenopausal women. Therefore food
      frequency history, serum ferritin, plasma zinc, plasma zinc disappearance, and
      zinc turnover rate were measured in healthy premenopausal women. Plasma zinc
      disappearance and turnover rate were determined by inductively coupled plasma
      mass spectroscopic analysis of the plasma ratio of zinc 67 to zinc 68 before and
      30 to 60 minutes after intravenous injection of 67Zn. Food frequency predicted
      serum ferritin concentration in 38 women and plasma zinc disappearance in 19.
      Frequent red meat intake was associated with higher serum ferritin concentration
      and a "normal" plasma zinc disappearance. Frequent milk intake was associated
      with lower serum ferritin concentration and a rapid plasma zinc disappearance.
      After exclusion of an outlier, in 18 women serum ferritin concentrations were
      lower when plasma zinc was < 70 micrograms/dl (p < 0.03), and plasma zinc
      disappearance and turnover rate were higher when serum ferritin was < 20 ng/ml (p
      < 0.05). Serum ferritin concentration and plasma zinc disappearance constant were
      inversely and nonlinearly related (R2 = 0.777, p = 0.0003). These findings
      suggest that avoidance of red meat increases the risk of iron and zinc
      deficiencies, and low serum ferritin concentrations suggest the possibility of
      low zinc nutriture.

PMID- 7798802
TI  - [Surgical treatment of deep venous reflux. Techniques, indications and results].
AB  - INTRODUCTION: complications of deep venous insufficiency can lead to surgery if
      one fails with medical treatment. The etiology can be primitive or secondary, the
      symptoms are identical. They go from heaviness of the legs to chronic leg ulcers.
      Indication and technic of surgery depend on the etiology and the preoperative
      evaluation. PREOPERATIVE EVALUATION: it has to be anatomical and functional.
      Invasive investigations as venous blood pressure, ascending and descending
      venography, and non invasive investigations as duplex or triplex Doppler and
      plethysmography are used. TECHNICS: one can use three techniques. Valvuloplasty
      with or without venotomy, and with or without Dacron cuff. Transplantation of an
      axillary valvulated venous segment to femoral or popliteal vein. Transposition to
      a valvulated and competent great saphenous vein or deep femoral vein.
      INDICATIONS: one can propose transplantation or transposition for secondary deep
      venous insufficiency, and valvuloplasty for primary deep venous insufficiency.
      Stage 2 or 3 can be a clinical indication for surgery. RESULTS: valvuloplasty has
      good results with 60 to 80% free of clinical recurrence at 2 years. The results
      of the other technics seem to be less good. CONCLUSION: the fair results of
      surgery allow the use of it for some patients with a good evaluation. The
      improvement of the surgical results lie on the development of paraclinical
      evaluation and research on venous valvular hemodynamic.

PMID- 7798803
TI  - [Venous disease in France: an unrecognized public health problem].
AB  - Different reasons explain that chronic venous insufficiency remains ill
      recognized as a public health problem in France: very few epidemiologic studies
      have been undertaken in this pathology; this disease is very heterogeneous in
      terms of gravity and clinical evidence: from isolated symptoms to localized
      clinical signs, with or without severe complications. Clinical semiology is
      actually not standardised. The analysis of available informations suggests that
      this pathology represents approximatively 2.6% of the whole health expenditures
      in France, that is to say an amount of 14.7 billion of Francs for the year 1991.
      The number of patients suffering from chronic venous insufficiency can be
      estimated to about 11 millions, whose 7 millions present symptomatic signs (leg
      heaviness, pain, moderate edema). The number of hospitalizations is around
      200,000 per year, of which 63% are in surgery in private clinics. One half of
      these hospital stays concerned varicose veins (the 8th cause of hospitalization
      in France). Forty of the patients consulting for chronic venous insufficiency are
      at work and about 7 to 8% of them get sick leaves for this pathology: around
      362,000 sick leaves per year representing 6.4 millions of day lost. On the basis
      of the medical consumption survey performed by INSEE/CREDES, an extrapolation was
      made to estimate the different components of costs of chronic venous
      insufficiency: 41% (drugs), 34% (hospital care) and 13% (medical fees).

PMID- 7798804
TI  - [Plasminogen activation and erythrocyte aggregation in diabetic patients].
AB  - To better understand the abnormalities of red blood cell (RBC) hyperaggregation
      and elevation of fibrinogen during diabetes mellitus, we have studied the effect
      of plasminogen activation on RBC aggregation phenomenon. The plasminogen was
      activated in vitro by adding streptokinase in blood suspensions of 26 diabetic
      patients and 11 healthy subjects. RBC aggregation measurements were performed by
      means of the Sefam erythroaggregometer. Results show decreases in either RBC
      aggregation and fibrinogen level as a result of the plasminogen activation in
      blood suspensions of healthy subjects. In blood suspensions of diabetic patients,
      although RBC aggregation and fibrinogen level are decreased following the
      plasminogen activation, however decreases are less pronounced than those obtained
      in blood suspensions of healthy subjects. These results mean a decreased
      degradation of fibrinogen by plasmin in diabetes mellitus and could explain in
      part the excess of fibrinogen and so the hyperaggregation tendency of red blood
      cells.

PMID- 7798805
TI  - [Determination of reference temperatures for a cold test in digital
      plethysmography].
AB  - BACKGROUND: The purpose of this study was to determine optimal warm and cold
      temperatures for performance of a cold test. METHODS: Thirty-six healthy
      volunteers (22 women and 14 men; mean age 40, 94 years, range: 20-58) were
      included in the study. Plethysmographic signal amplitudes were evaluated at
      different temperatures (47, 45, 43, 40, 35, 20, 15, 13, 11 and 9 degrees C) under
      standardized conditions, using digital strain-gauge plethysmographic (Perivein
      Janssen). Reproducibility was assessed by repetition in the same subject of six
      digital plethysmography signal measurements at 45 degrees C performed at
      different times and days. Clinical tolerance was estimated according to an
      analogue scale. RESULTS: Maximal warm amplitude was obtained at 45 degrees C and
      maximal vasoconstriction at 13 degrees C. The thermal test was well tolerated for
      the temperature range between 11 and 45 degrees C. Reproducibility of the
      measurements was satisfactory. CONCLUSIONS: 45 degrees C is the non-nociceptive
      reproducible vasoparalyzing reference temperature, allowing measurement of
      maximal digital circulatory capacities. 11 degrees C should be adopted as the
      optimal vasoconstriction temperature for performance of a cold test.

PMID- 7798806
TI  - [Experimental simulation of blood flow perturbations induced by the placement of
      caval filters and thrombi].
AB  - Implantation of caval filters to prevent thrombo-embolism is a common medical
      option for twenty years, since the standard Greenfield model. The numerous new
      models with various geometries have been the subject of many studies aimed at
      testing their effectiveness in clot capture and the stability of their fixation
      to the vein, but very few ones are dedicated to the influence of their shape on
      blood flow, and to the flow disturbances induced by trapped clots shape and
      location. So, we have designed a caval blood flow simulation test bench of
      different filters and clot models. Opcetra and LGM filters were furnished with a
      reference regular input flow of physiological viscosity fluid. Rigid thrombus
      model, trapped in filter middle, was a one centimetre diameter sphere; and a
      recent soft one, which could model itself on the final part of the capture zone,
      was a two centimetres high cone. Perturbations, eddies, trajectories and
      velocities were recorded by particles visualization and ultrasound velocimetry.
      Downstream the Opcetra, velocity vectors were practically axial, no eddies could
      be seen; the central cylinder had changed the input parabolic flow into a one
      with two symmetrical maxima. For LGM, on the one hand, from the middle, the sheet
      branches perturbed the flow and induced several jets. On the other hand, the end
      ring had created an helicoidal wake which extended up to three centimetres. With
      thrombi models, for Opcetra, a central spherical clot induced eddies inside the
      filter, but smoothed the two maxima of the profile, which vanished more rapidly.
      For the LGM, a central spherical clot increased the perturbations, whereas a
      final conical one decreased them. Finally, it was clear that filter shape,
      capture location and clot aspect were the leading causes of the hydrodynamic
      induced disturbances and might be important for the trapped clots evolution.

PMID- 7798807
TI  - [Focus on a quick reading of nailfold capillaroscopy].
AB  - The diagnostic value of nailfold capillaroscopy was assessed through blind
      analysis of a continuous series of 307 examinations and a method for quick
      reading of nailfold capillaroscopy was elaborated with discriminant analysis. The
      best criteria for predicting the existence of a systemic disease were: major
      dystrophies (megacapillary, neocapillary and regressive capillary), minor
      dystrophies and capillary bed abnormalities, especially in patients presenting
      with vascular disorders of the upper extremities. Capillaroscopic stages and
      existence of systemic disease were significantly correlated. Discriminant
      analysis could globally predict the existence of a systemic disease with age and
      4 criteria. In subjects with vascular disorders of the upper extremities it
      needed only age and 3 criterias (abnormal coloration, major dystrophy presence
      and percentile of minor dystrophies greater than 15%) but without higher
      diagnostic value (94.2% of patients with systemic disease and 65.6% of patients
      without systemic disease were correctly classified). Discriminant analysis allows
      quick reading of nailfold capilloroscopy in the first examination of patients
      with vascular disorders of the upper extremities.

PMID- 7798809
TI  - [Why and when to preserve the saphenous veins of varicose patients to serve as an
      arterial bypass?].
AB  - The greater saphenous veins (GSV) are the best substitute for arterial in several
      locations and are often the only convenient graft. As patients consult for
      varicose veins at an increasingly younger age and since surgery for varicose
      veins has become quite popular, there is a risk of unneeded destruction of
      saphenous veins which will be lacking later. Approximately 80% of the GSV veins
      in patients consulting for varcosities are normal, slightly dilated or simply
      have one or more minor areas of dilatation. A special Dacron sheath can be used
      to maintain these areas of dilatation. The cases presented here demonstrate that
      these bypass remain patent and that non-sheated areas do not undergo undue
      dilatation. This technique makes it possible to widen the use of GSV in a larger
      number of patients with varicose veins. Consequently, it is necessary to verify
      the caliber of the trunk of GSV during the echo-Doppler examination before
      treating patients with varicose veins. Suitable GSV should be conserved during
      initial treatment. Patients should be well informed of the rationale for such
      decisions, especially concerning the chronological delay between the occurrence
      of venous varicosities and arterial disease.

PMID- 7798808
TI  - [History of the treatment of varices].
AB  - Diseases of the vein and particularly varicose veins have been recognized since
      antiquity. The Ebers papyrus, dated 1550 b.c., mentions serpent-shaped dilatation
      of the lower limbs. The Acropolis tablet of the IVth century b.c. concerning Dr
      Amynos allows us to visualize an enlarged lower limb clearly showing a
      varicosity. From 460-377 b.c., Hippocrates noted that a loose tourniquet leads to
      haemorrhages but that when the tourniquet is tight gangrene ensues and finally
      that standing up can exaggerate leg ulcerations. Of course much progress has been
      made since Hippocrates. The school at Alexandria, with Herophilus and
      Erasistrates speak of vascular ligatures. Their work was unfortunately lost in
      the fire of the Alexandria library in 391 a.d. Galien himself described varicose
      vein ligatures in 200 a.d. Leonardo de Vinci's magnificent anatomic studies of
      veins are widely known. In 1525, Ambroise Pare described leg bandaging for ulcers
      beginning from the foot up to the knee. In 1585, Fabrice d'Acquapendente
      described venous valves. In 1676, Wiseman invented the first supportive stockings
      made of leather and in 1854, Unna described in Vienna the supportive boot which
      now carries his name. Shortly thereafter new medical and surgical techniques were
      developed for the treatment of varicose veins. Pravaz, in 1860, invented a
      syringe which now carries his name and initiated sclerotherapy. At the end of the
      XIXth century, Trendelenburg performed the first ligatures of the greater
      saphenous veins. In 1905, and 1906, Keller and Mayo performed the first ablation
      of the greater saphenous vein and in 1906, Carrel reported the first venous
      transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798810
TI  - [Personalized treatment of varices. Indications in thirty-two cases].
AB  - During the 28th Meeting of the College Francais de Pathologie Vasculaire, twelve
      experts, six angiologists and six surgeons were asked to choose a first intention
      treatment for 32 case reports of patients with varicose veins based on physical
      examinations and echo-Doppler findings. The audience made their choice
      simultaneously by an electronic voting system. In a large number of cases,
      several therapeutic options were possible. The greater saphenous vein can often
      be retained in first intention situations with the possibility that several years
      later the prognosis of the limb may depend on the presence of this vein,
      particularly in life threatening cases where it is needed for arterial bypass
      surgery. In some cases it is clear that the greater saphenous vein does not need
      to be removed and in others, deterioration is clearly sufficient to justify
      removal. In many cases, the choice between the two options is a decision to be
      made. Indications depend on the clinical presentation and echo-Doppler findings.
      The caliber of the greater saphenous vein must be determined for the entire
      length of the vein. Whenever possible, veins with a diameter below 8 mm should be
      preserved and the patients should be informed on why the choice was made.
      Whatever treatment has been chosen, recurrence may be observed and periodic
      follow-up is required.

PMID- 7798811
TI  - [Coarctation of the subrenal abdominal aorta revealed by aortic thrombosis].
AB  - The authors report the case of a 44 year-old female patient with no particular
      history who presented with a suddenly occurring severe ischemia of the lower
      limbs during exercise which revealed a total thrombosis of the subrenal abdominal
      aorta. Angiography confirmed the diagnosis and demonstrated a partial
      compensation of the lesion by an important collateral network developed from the
      parietal and mesenteric arteries. Ultrasonography and computerized tomography
      showed an extensive coarctation of the abdominal aorta. The main visceral
      (particularly renal) arterial branches were not involved. The pathologic subrenal
      aortic segment was surgically resected, and a prosthetic aortobifemoral bypass
      provided. The further course was marked by several occlusions of the low
      anastomoses by fibrous hyperplasia. Coarctation of the abdominal aorta is briefly
      reviewed. This disorder is infrequent, and its infrarenal form can be compatible
      with a normal life. It can be revealed late, particularly when a thrombotic
      complication occurs.

PMID- 7798812
TI  - [Pancreatic-duodenal artery aneurysm ruptured in the digestive tube. Report of a
      case].
AB  - We report the successful treatment of an aneurysm of the pancreatoduodenal artery
      which ruptured into the duodenum in a 78-year-old patient. The pancreatoduodenal
      arcades were excluded by aorto-mesenteric bypass and ligature of the
      gastroduodenal artery. Aneurysm are rarely located in pancreatoduodenal artery.
      Surgical repair is often difficult due to the close relations with the pancreatic
      parenchyma. Arteriography is essential to guide the operation.

PMID- 7798813
TI  - [Importance of complementary peroperative examinations in the treatment of
      adventitial cystic degeneration of the popliteal artery].
AB  - We report a case of cystic adventicial disease of the popliteal artery in a 67
      years old man. The realisation of the intra arterial pressure measurements, and
      the peroperative echography permit to diagnose important associated lesions of
      the intimal part of the arterial wall.

PMID- 7798814
TI  - [Multiple intracranial aneurysms in relation to Recklinghausen's disease. Report
      of a case].
AB  - Recklinghausen disease which usually appears by tumors of the nervous system
      peripheral and central can present anomalies of other systems, particularly
      vascular anomalies. The damage of renal arteries is well known. Intracerebral
      aneurysms are rare. Multiple intracerebral aneurysm has been reported in only
      four cases. We report a case of a patient presenting three intracerebral
      aneurysms. The patient died of a meningial haemorrhage. This leads us to search
      for intracerebral aneurysms in Recklinghausen's disease, specially in presence of
      arterial hypertension.

PMID- 7798815
TI  - Unit cost analysis in a university hospital: an example from Srinagarind
      Hospital, Khon Kaen.
AB  - This is the first analytic study to identify the unit cost in the University
      Hospital using the standard method of analysis in health economics. The unit
      costs in the report can be used to calculate the cost of each service for any
      disease. The costs of the hospital administration cost center and the supportive
      cost center were both allocated to the patient care service center by the
      simultaneous allocation method. The cost of teaching personnel was excluded from
      the analysis because it is quite difficult to estimate and differentiate the
      ratio of teaching costs to service costs. The hotel cost of the inpatient ward
      varied from 77.81 baht to 604.7 baht per day. The unit cost per service per day
      is different from the charge which is presently used at Srinagarind Hospital.
      Some services, such as in-house transportation are not included in the charge.
      This study was conducted to identify the unit cost of each service. The decision
      to establish charges can depend partly on this data and partly on the
      administrator's judgement. Other factors, such as patient poverty can dictate the
      final decision. In any case, the hospital and health service center should
      identify their own unit costs to be able to plan for effective budget management.

PMID- 7798816
TI  - Observation on the short and long term response to anti-lipemic drugs in southern
      Thailand.
AB  - Patients with dyslipidemia were evaluated with regard to the 5 drugs regimen:
      simvastatin (average dose, 11.8 mg/day), gemfibrozil (dose 963 mg/day),
      bezafibrate (433 mg/day), fenofibrate (211 mg/day) and acipimox (667 mg/day). The
      responses to the drug were divided into different time periods and the magnitude
      of responses were presented either as average changes in per cent from baseline
      or as proportion of patients (also in %) whose levels changed by a predetermined
      percentage. These predetermined percentage took into account the variation
      observed among patients who had more than 3 measurements during baseline. These
      levels for significant changes were 16 per cent for total cholesterol (TC), 25-30
      per cent for high- and low-density lipoprotein (HDL and LDL), and 44 per cent for
      triglyceride (TG). Our subjects responded to the drugs within the range reported
      by other investigators except for acipimox which produced no alteration. Sixty to
      100 per cent of patients reduced their TC by 16 per cent with an average change
      in TC of around -16 per cent to -24 per cent. Simvastatin and fenofibrate
      appeared most effective in altering TC. The HDL increased 10 per cent to 29 per
      cent depending on the drug but in terms of proportion that responded by an
      increment greater than 25 per cent, this was seen in only 23 per cent to 45 per
      cent of the patients. Long term follow-up which was possible only on 42 patients
      showed 11 who lessened their response and 6 whose response became more
      marked.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798817
TI  - Risk factors for HIV infection among Thai laborers during 1992-1993.
AB  - From June 1992 to May 1993, 39,939 Thai men attended the clinic for laborers
      going abroad at Siriraj Hospital in Bangkok for a pre-assignment physical exam
      and mandatory blood screen for HIV and syphylis. Of this total, 438 tested
      positive for HIV antibody (1.1%). Of these, 215 men returned for post test
      interview and physical exam and were compared with 1,348 men randomly selected
      HIV-1 seronegative men. None of the HIV-1 seropositive had a history of injecting
      drug use or had received blood transfusion in the past seven years. HIV-1
      seropositivity was associated with the TPHA serological marker for syphylis >
      1.160 (p = 0.015, odd ratio 1.8), history of urethritis (p = 0.009, odd ratio
      1.92) (Table 4). This study found that HIV-1 seropositive men were mostly single,
      were likely to be from the rural northern provinces of Thailand or Bangkok.
      History of purchase of low-fee commercial sex and less condom use were
      significantly associated with HIV-1 seropositivity as was a history of STD in the
      year prior to interview. Information on HIV disease and pre-test/post test
      counselling is needed for Thai laborers who are applying for work abroad to
      countries which require HIV and syphylis screening. In this effort, the Ministry
      of Labor and Social Welfare, the Ministry of Public Health and the clinic for
      laborers going abroad should join forces to provide this service. This will serve
      to increase awareness and self-determination among an increasingly vulnerable
      segment of the population who also have the potential to spread HIV infection to
      their spouse and other sex partners.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798818
TI  - Comparison of morphine slow release tablet (MST) and morphine sulphate solution
      (MSS) in the treatment of cancer pain.
AB  - A cross-over, single blind trial of MST and MSS in relieving pain of advanced
      cancer patients is described. Forty-nine cases completed the study. Both MST and
      MSS gave equally excellent pain relief in the patients as judged by the pain
      score of VAS and pain rating scale by a nurse, and the duration of sleep. The
      daily effective dose was 55.5 +/- 19.7 mg for MST and 61.0 +/- 11.0 mg of MSS.

PMID- 7798819
TI  - Gastric acid secretion in Thai patients with particular reference to the
      characteristics differentiating types of gastric and duodenal ulcer.
AB  - Acid secretion in both basal and stimulated states (using augmented histalog
      test) was studied in 31 normal control patients, 64 duodenal ulcer patients and
      101 gastric ulcer patients. Having had the result of acid output study, the 64 DU
      patients could be classified according to their acid secretion results as 35 DU
      type I or Normosecretor (54.7%) and 29 DU type II or Hypersecretor (45.3%). For
      the GU patients which were classified according to the sites of lesions as GU
      type I (GU above angulus), GU type II (GU associated with DU) and GU type III (GU
      below the angulus). Their acid output study showed that the GU type I had a
      rather low BAO and a high MAO close to that of the Normosecretor, but the GU type
      II and III had their BAO and MAO significantly higher than that of the normal
      control and close to that of the Hypersecretor. Comparison of acid secretion in
      this study group to other racial groups showed that the Thai population had acid
      secretion patterns close to other Asian populations, except that the Chinese in
      Singapore had a higher proportion of Normosecretor (69.0%) than Hypersecretor
      (31%). The MAO of the Asian population was found to be lower than that of
      Europeans.

PMID- 7798820
TI  - Postoperative elective ventilation in babies with "marked anastomotic tension"
      after repair of esophageal atresia.
AB  - The repair of esophageal atresia, preserving the patient's own esophagus is the
      surgical procedure of choice. In "long-gap" type or in "tension anastomosis"
      cases, anastomotic complications were known to be higher than in usual cases.
      From this report, postoperative elective ventilation for 5 days together with
      neck flexion position reduced such complications with minimal subsequent
      complications related to the mechanical ventilation.

PMID- 7798821
TI  - Calcium and phosphate solubility curves for parenteral nutrient solutions
      containing aminoplasmal-paed, Aminovenos-N-pad or Moripron-F.
AB  - We investigated the calcium and phosphate compatibility in three amino acid
      products: Aminoplasmal-paed, Aminovenos-N-pad, Moripron-F. The final TPN sample
      solution contained 10 per cent dextrose, 1-3 per cent amino acids, 4 mmol/L
      magnesium sulphate and various combinations of calcium gluconate and dipotassium
      phosphate. Precipitates and crystallization were inspected visually and
      microscopically after 24 hrs standing at room temperature. Calcium-phosphate
      solubility curve were drawn. Among the three amino acid products, Moripron-F gave
      the highest buffer capacity. These curves are extremely helpful to predict the
      compatibility of a calcium-phosphate dose in the TPN solution using these three
      amino acid products.

PMID- 7798822
TI  - Improvement of inhaler efficacy by home-made spacer.
AB  - The delivery of aerosol from a metered dose inhaler (MDI) was reported to be more
      efficient with a spacer. Hence, a home-made spacer modified from a 950 ml low
      cost plastic bottle, was compared with a MDI and with a 750 ml imported spacer
      (Nebuhaler). On three consecutive days, at the same time of day, 20 adult
      patients with chronic asthma inhaled two puffs of terbutaline sulphate (0.5 mg),
      delivered from MDI alone, MDI with a 750 ml Nebuhlaer and MDI with a home-made
      spacer. The following measurements were made: forced expiratory volume in one
      second (FEV1), forced vital capacity (FVC) and pulse rate. These measurements
      were carried out immediately before and at 5, 20, 60 min after inhalation of
      terbutaline. FEV1 was significantly increased (P < 0.05) at 5, 20 and 60 min
      after administration of terbutaline with MDI via either spacers than with MDI
      alone but no significant difference was observed between Nebuhaler and the home
      made spacer. FVC and pulse rate showed no significant change with each method of
      administration. In conclusion, terbutaline delivered by MDI and home-made spacer
      was more effective in bronchodilatation than by MDI alone and was just as
      effective as MDI and Nebuhaler. The home-made spacer therefore offers a simple,
      inexpensive and more effective method for delivering aerosol drug.

PMID- 7798823
TI  - Elevation of depressed skull fracture in the neonate by obstetrical vacuum
      extractor.
AB  - In this article, three cases of neonatal depressed skull fracture were
      successfully elevated by means of an obstetrical vacuum extractor. No
      complications from the procedure were observed. Neonatal depressed skull
      fractures which are not associated with neurological signs may be safely elevated
      without surgery by using the obstetrical vacuum extractor. This simple,
      atraumatic procedure should be considered first for the management of
      uncomplicated depressed skull fracture in the newborn.

PMID- 7798824
TI  - A comparative study of coumadin and aspirin for primary cardioembolic stroke and
      thromboembolic preventions of chronic rheumatic mitral stenosis with atrial
      fibrillation.
AB  - The comparative study of the efficacy of coumadin and aspirin in primary
      cardioembolic stroke prevention of chronic rheumatic heart disease (mitral
      stenosis) with atrial fibrillation was conducted at Siriraj Hospital, Mahidol
      University, Bangkok, Thailand. Seventy-nine patients were enrolled in the trial.
      Allocation of patients into coumadin or aspirin groups depended upon the
      patients' choice. Nineteen patients were given coumadin at the adjusted dosage to
      maintain the therapeutic range of International Normalised Ratio between 1.5-3.
      Sixty patients were given aspirin at the fixed dosage of 75 mg per day. Six
      patients were lost to follow-up over the 3 yr period; four in the aspirin group
      and 2 in the coumadin group. There were three patients with nonfatal
      cardioembolic stroke in the aspirin group but none in the coumadin group after
      three years of follow-up. Six patients had mitral valve replacement during the
      study (i.e. three patients in each group). There were complications in 12
      patients, 10 in the aspirin (16.6 per cent) and 2 in the coumadin (10.5 per cent)
      group. The complications in coumadin group were minor bleeding over the thigh in
      one patient and generalised ecchymosis over the whole body in one other. In the
      aspirin group, the complication was gastrointestional symptoms, mainly epigastric
      pain, but no frank bleeding was observed. Primary prevention of cardioembolic
      stroke in chronic rheumatic heart disease was found to be more effective with
      coumadin than aspirin. Our study does not support the use of aspirin in primary
      prevention of cardiac embolism in chronic rheumatic heart disease.

PMID- 7798825
TI  - "Simplified IVF": program for developing countries.
AB  - The aim of this study is to assess the results of the "Simplified IVF" program at
      Ramathibodi Hospital. Ramathibodi IVF program has been in operation since
      October, 1991. Some steps of the conventional IVF procedures have been modified
      due to the limitation of resources. The embryo laboratory is a simple, clean room
      situated in a different building from the oocyte recovery room. Short protocol of
      GnRHa/HMG is used for ovarian stimulation. Monitoring of the follicular
      development is performed by ultrasound alone with limited number of scans (2-3
      times/cycle). Oocyte retrieval is carried out under transvaginal ultrasound
      guidance and the aspirate transported to the embryo laboratory in a simple
      insulated box. Luteal phase is supported by giving micronized progesterone.
      Eighty five couples have undergone 105 ovarian stimulation cycles. OR was done in
      100 cycles from 80 couples. Total oocytes collected is 1091. The fertilization
      rate is 75 per cent. Embryos were transferred in 97 cycles. Clinical pregnancy
      occurred in 25 cycles. Pregnancy rate per OR and ET is 25 and 25.8 per cent
      respectively. Nineteen patients have delivered (6 twins, 13 singletons).
      Simplification of procedures has enabled the IVF service to be available in a
      center with limited resources without compromising the results. Other advantages
      are improvement of the patient's convenience, cost savings and less time consumed
      as well as being less stressful.

PMID- 7798826
TI  - Rotational deformity of the distal humerus in cubitus varus.
AB  - The medial rotation deformity of the distal humerus usually exists in the cubitus
      varus deformity but has received little attention. Study of this deformity in 29
      cases of cubitus varus was carried out using the osteotomized bony specimens that
      were removed during closed wedge osteotomy in order to determine the actual bone
      deformity. The average duration of the varus deformity was 5.6 yrs (range 1 to
      11). The medial rotation deformity of the distal humerus averaged 27 degrees
      (range 15 to 45). There was no correlation between the degree of rotation and
      that of the varus deformity (correlation coefficient r = 0.15). The affected-side
      shoulder compensated well in both internal and external rotation, and had a
      greater arc of rotation than that of the normal side. The affected-side shoulder
      exhibited an internal rotation deformity with an average of 16 degrees (range 5
      to 25), with restriction of external rotation of only 13 degrees (range 0 to 20)
      in comparison to normal side shoulder.

PMID- 7798827
TI  - The performances of newer free thyroxine assays vs equilibrium dialysis.
AB  - The performances of 5 different commercial kits for the measurement of serum FT4
      concentration; Amerlex-M Free T4 RIA, Gammacoat 125I FT4 2 step RIA, Enzymune
      test FT4, Amerlite FT4, Berilux FT4 were compared with equilibrium dialysis. All
      assays demonstrated FT4 values in good correlation with those measured by
      equilibrium dialysis (r = 0.84-0.89, p < 0.001). The intra-assay coefficients of
      variation were good and comparable. All methods yielded good separation of
      uncomplicated hypo/hyperthyroid patients from euthyroid controls. However, only
      equilibrium dialysis gave consistently normal results of FT4 values throughout
      pregnancy. All methods other than equilibrium dialysis gave falsely low values in
      majority of women in the 2nd and 3rd trimester of pregnancy.

PMID- 7798828
TI  - Comparison study between fasting total serum bile acid and post prandial bile
      acid in hepatic diseases: a preliminary study.
AB  - Fasting bile acid, two-hour post prandial bile acid and other liver function
      tests (Bili, AST, ALT, ALB, Glob, ALP) were measured in 22 normal and 28 liver
      diseased patients. In normal volunteers, the mean value of fasting total serum
      bile acid (FTBA) and postprandial serum bile acid (PTBA) were 3.08 mumole/L (S.D.
      1.65) range 0.21-6.26 mumol/L, and 8.07 mumole/L (S.D. 2.99) range 4.06-15.65
      mumole/L. Comparison between FTBA, PTBA and other liver function tests in various
      liver diseases from this study the PTBA was not statistically significant
      superior to FTBA. Therefore, it is not necessary to do the PTBA at this time
      until more data is available.

PMID- 7798829
TI  - Five years survival result of twenty-two breast cancers treated by breast
      conserving therapy at NCI Bangkok.
AB  - From November 1984 to July 1992 Breast Conserving Therapy (BCT) has been offered
      to clinical stage 1 & 2 breast cancers. Twenty two breast cancers were treated
      and passed the five year period. Only one patient was lost in follow-up. The
      treatment consisted of tumorectomy, full axillary nodal dissection and total
      breast irradiation with a booster dose at the biopsy site. Adjuvant chemotherapy
      is administered in cases of positive axillary nodes. There are seventeen living
      and four deaths. The 5 year survival was 80.95 per cent. The four deaths were
      node negative and in the young age group (under 36 years of age). Three out of
      four who died of distant metastasis showed precedent local recurrence. Local
      recurrence was noted in four patients (19.04%). Second primary breast cancers
      were found in four patients and two of them died of distant metastasis and one of
      these two had local recurrence in the first breast carcinoma. There were two
      survivors from distant metastasis, one with single pulmonary metastasis and
      another with spine and pelvic bony metastases. Slight to moderate arm edema was
      found in 5 patients. (22.73%). From our study we have been convinced that BCT
      seems to give poorer results in terms of survival in the young age group
      (especially under 36 years of age). Those who are under 36 years of age and have
      T2 lesion with negative node or local recurrence as well as second primary breast
      carcinoma should receive adjuvant chemotherapy.

PMID- 7798830
TI  - Background and mental health status of students who are "well-behaved" in their
      teacher's perspective.
AB  - Two hundred and eighty-five students were considered well-behaved, and two
      hundred thirty-seven students as control group were assessed for their mental
      health background and mental status. The quality of well-behaved students'
      parents regarding their ability in bringing up their children was better than
      that of parents of the control group. Well-behaved students have a higher I.Q.
      than the control group. They possessed sociable extraversive stable
      personalities. Regarding their expressions for social acceptance, they needed
      control people showing them acceptance and wanted to be supervised by others.
      However, the well-behaved and the students of the control group had no
      significant signs of difference in expressing love and concern towards oneself.
      Regarding mental health of the well-behaved, they had normal level of stress and
      average level of anxiety. The mental health of both groups, for example, stress
      and anxiety from social-adjustment and being evaluated was not different. Thus,
      teachers have accurate judgement in distinguishing the well-behaved from the
      control students. The mental health status of both groups of students was not
      different. Consequently, the teachers have no worries towards behaviour and
      mental health status of well-behaved. They can concentrate more on students with
      problems and behavioural deviations.

PMID- 7798831
TI  - Routine or selective intraoperative cholangiography.
AB  - IOC is definitely indicated in patients with clinical indications. It avoided
      unnecessary exploration of the common bile duct in 32.7 per cent. Of all the
      clinical indications, palpable common bile duct stone was the most accurate.
      Dilated common bile duct, dilated cystic duct, elevated serum alkaline
      phosphatase, multiple small stones and positive imaging investigations were a
      statistically significant prediction of common bile duct stones. IOC is not
      justified in patients without clinical indications because of the low incidence
      of unsuspected common bile duct stone (0.66%) and on the basis of cost
      effectiveness. The results support the view that IOC is invaluable and should be
      used selectively.

PMID- 7798832
TI  - Transabdominal fetal reduction in quadruplet pregnancy during first trimester: a
      case report.
AB  - Multifetal pregnancy reduction was performed in a patient with quadruplet
      pregnancy at the 12th week of gestation. Reduction of the fetuses to two was
      carried out by injecting potassium chloride solution into the fetal chest under
      transabdominal ultrasound guidance. No complications were encountered and the
      woman was delivered of healthy twins at 37 weeks of gestation.

PMID- 7798833
TI  - The advantages of upper gastrointestinal tract brush cytology.
AB  - A two-year study of endoscopic brush cytology and biopsy histology was carried
      out in 63 patients suspected of having malignant lesions in the stomach and the
      eosophagus. The study was designed to evaluate the accuracy and usefulness of
      combined cytological examination with biopsy histological examination in the
      diagnosis of malignancy of the upper gastrointestinal tract. The rate of
      diagnostic accuracy of the combined technique was found to be high and comparable
      with those of other published studies. Correlations between the cytological and
      histological findings were observed in 52 cases (82.53%). The combined method
      detected malignancy in 27 cases, whereas, the brush cytology alone detected
      malignancy in 19 cases. The findings of our study indicate that combined brush
      cytology and biopsy histology under direct vision using fibrescope are of value
      for the diagnosis of gastroeosophageal malignancy.

PMID- 7798834
TI  - Epidermolysis bullosa letalis (Herlitz disease): a case report.
AB  - A case of junctional epidermolysis bullosa was reported. A four-month-old boy was
      presented with generalised blisters after minor trauma since birth. There was no
      family history of blistering diseases or consanguinity. Skin examination revealed
      blisters primarily on the upper and lower extremities. Erosions were also noted
      on the face, abdomen and buttocks. The lesions healed without milia or scarring
      formation. Anonychia of all fingers and toe nails were noted. Skin biopsy from
      the blisters showed subepidermal bulla with a few inflammatory cells. Electron
      microscopic examination revealed cleavage plane at the lamina lucida and the
      absence of hemidesmosomes. These findings supported a diagnosis of junctional
      epidermolysis bullosa. The patient was treated with topical and systemic
      antibiotics. However, the blisters gradually increased. He died of uncontrolled
      sepsis and diarrhea.

PMID- 7798835
TI  - Hepatocellular adenoma in a beta-thalassemic woman having secondary iron
      overload.
AB  - An 18-year-old woman had a hepatocellular adenoma of 4 cm across in the right
      lobe of the liver which was severely hemosiderotic because of beta-thalassemia
      hemoglobin E disease with numerous blood transfusions. The lesion was an
      accidental postmortem finding. To our knowledge, this is the second example of
      liver-cell adenoma occurring in a patient with beta-thalassemia hemoglobin E
      disease with secondary iron overload. It is suggested that this is an association
      between hepatocellular adenoma and secondary iron overload of liver cells, a
      similar event to the relation observed in hepatocellular carcinoma and secondary
      iron overload of hepatocytes.

PMID- 7798836
TI  - Echocardiographic features in patients with beta thalassemia/hemoglobin E: a
      combining effect of anemia and iron load.
AB  - Hemoglobin concentration, iron parameters and cardiac status of 25 patients with
      beta thalassemia/hemoglobin E disease were measured. Two-dimensional
      echocardiography was employed to evaluate chamber size, ejection fraction and
      muscle fiber shortening. The seventeen patients who had a mean hemoglobin
      concentration of less than 7.7 g/dl were found to have significantly larger
      cardiac chambers and higher cardiac output than the patients with higher
      hemoglobin concentrations. A statistically significant difference in ejection
      fraction and per cent of fractional shortening of cardiac muscle fibers was not
      found. A comparison of subjects with ferritin concentrations above and below
      1,500 micrograms/L showed no significant difference in chamber sizes, ejection
      fraction and in per cent fractional shortening. However, a comparison of 14
      patients with transferrin saturation > or = 80 per cent with those less than 80
      per cent showed a significant decrease in both ejection fraction and fiber
      fractional shortening in the more highly saturated subjects. By using stepwise
      multiple regression analysis, the hemoglobin level was shown to significantly
      determine cardiac enlargement, while ejection fraction and percentage fractional
      shortening were significantly associated with transferrin-iron saturation. Thus,
      anemia leads to chamber enlargement, while high transferrin iron saturation is
      associated with cardiac muscle dysfunction. The findings in the individual
      patient reflect the integration of these two effects.

PMID- 7798837
TI  - Hypertension perioperative splenectomy in thalassemic children.
AB  - We retrospectively studied the intraoperative hemodynamic changes in 100
      thalassemic children undergoing general anesthesia for elective splenectomy. They
      were divided into 2 groups owing to the postoperative hemodynamic response.
      Eighty-four patients who had an unremarkable postoperative course were group 1,
      while 16 patients who developed immediate postoperative hypertension were group
      2. There were no differences between the groups regarding age, body weight, sex,
      anesthetic time and operation time, except for the preoperative hematocrits of
      group 1 patients were slightly but significantly higher. Both groups similarly
      showed significant increase of the systolic as well as diastolic blood pressure
      throughout the anesthetic course. The heart rate was significantly increased at
      the beginning but declined to normal toward the end of the operation. Although
      none of the patients died postoperatively, all of group 2 patients needed
      aggressive treatment with diuretic and antihypertensive drugs. Despite the proper
      management, 3 of 16 patients developed convulsion and one of them had persistent
      neurological deficit. Since intraoperative and postoperative hypertension which
      commonly occur in these patients may lead to more serious neurological
      complications, the authors suggest that careful hemodynamic monitoring must be
      considered for all thalassemic children undergoing general anesthesia for
      splenectomy.

PMID- 7798838
TI  - Effects of pentoxifylline on sperm motility characteristics and motility
      longevity of postthaw cryopreserved semen using computer-assisted semen analysis
      (CASA).
AB  - Computer-assisted sperm movement analysis was used to study the effect of
      pentoxifylline on human sperm motility characteristics and motility longevity of
      postthaw cryopreserved semen. This study focused on the following issues: the
      changes in individual movement characteristics in response to pentoxifylline, the
      persistence of the response during drug treatment. Computerized analysis was
      started at 30 min, 3 hrs and 24 hrs, after addition of pentoxifylline. Data
      obtained showed that pentoxifylline significantly increased percentage of sperm
      motility, average path velocity (VAP), curvilinear velocity (VCL), straight line
      velocity (VSL), amplitude of lateral head displacement (ALH) at two of the three
      time periods (p < 0.05). But, it did not significantly increase linearity (LIN),
      straightness (STR), and beat cross frequency (BCF) at any time. After 24 hrs, all
      motility variables were significantly decreased in both groups. However, the 24
      hr motility longevity in the treatment group was greater than that of the control
      group. The present analysis shows interest in the use of pentoxifylline as a
      sperm movement enhancer for postthaw cryopreserved semen. It shows a beneficial
      effect in the majority of sperm movement parameters and motility longevity which
      may increase pregnancy rates after insemination. However, whether this change
      leads to an increase in fertilizing ability requires further study.

PMID- 7798839
TI  - Developmental outcome of infants with neonatal polycythemia.
AB  - The study of the developmental outcome of neonatal polycythemia was performed on
      47 polycythemic and 21 controlled infants who were born at the same period of
      time. It was found that at the age of 1 1/2 to 2 years the number of infants with
      abnormal DQ was higher in the group of total polycythemic infants (47%) and in
      the group of asymptomatic polycythemic infants (45%) than that of the control
      groups (19% and 5.6% of the groups including twin sibs and excluding twin sibs
      respectively). There was no difference in the developmental test between the
      symptomatic and asymptomatic patients. In asymptomatic infants the benefit of
      partial plasma exchange transfusion on developmental outcome was not found and
      only low birthweight and small for gestational age infants are the risk factors
      for poor developmental outcome.

PMID- 7798840
TI  - Significance of an absent or reversed end-diastolic flow velocity in Doppler
      umbilical artery waveforms.
AB  - Doppler velocity waveform analysis has been introduced as part of antenatal fetal
      biophysical assessment. Abnormal waveforms are associated with maternal and fetal
      complications. The most severe waveform patterns observed, absent end-diastolic
      velocity (AEDV) and reversed end-diastolic velocity (REDV), are of ominous
      significance in many cases but the incidence of these waveforms is low and the
      outcome is varied. The purpose of this study is to assess perinatal outcome in
      patients showing absent end-diastolic velocity (AEDV) and reversed end-diastolic
      velocity (REDV) in umbilical artery flow velocity waveforms. We reviewed our
      experience of patients showing AEDV and REDV in the umbilical artery flow
      velocity waveforms over nineteen months. Fifteen patients, all in high risk
      pregnancies, were identified during this period; 9 with AEDV and 6 with REDV. The
      results were not used in the clinical management. Twelve babies died (3 fetal
      deaths, 4 stillbirths and 5 neonatal deaths); giving the perinatal mortality is
      this group as 80 per cent. The interval between the abnormal waveform recording
      and fetal death or delivery was between 2 hours and 4 weeks. In three fetuses
      with abnormal diastolic flow, analysis of umbilical vein blood gases revealed
      severe acidosis and hypoxia. There was also significant perinatal morbidity as
      judged by low Apgar scores, days in neonatal intensive care, growth retardation
      and lethal anomalies. These findings suggest that once the diastolic component of
      umbilical artery flow velocity waveforms become absent or reversed, the fetus is
      in a state of hypoxia and acidosis and perinatal outcome is
      catastrophic.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798841
TI  - Leukocytic count in the diagnosis of acute appendicitis.
AB  - Two hundred and thirty-three patients with a pathological diagnosis of acute
      appendicitis from 1989 to 1990 were reviewed. A comparative series of 235
      elective cases who were admitted during the same period, was similarly reviewed.
      Using these data, the binary tables could be constructed and the cutoff point was
      obtained by plotting the positive and negative predictive values. This series
      yielded the clinically significant laboratory findings that the cutoff point of
      total leukocytic count, percentage of neutrophils and total neutrophilic count
      were 11,500 mm3, 75 per cent and 8,000 mm3 respectively. Combined specificity of
      all three tests is higher (95.74%), but the sensitivity is lower (61.55%).

PMID- 7798842
TI  - Malignant Brenner tumor: a case of aggressive clinical course and cutaneous
      metastases.
AB  - Malignant Brenner tumor is a very rare ovarian tumor of which the definition of
      this entity and its biologic behavior remain controversial to this day. In this
      case report a 30-year-old patient with malignant Brenner tumor was presented with
      an aggressive clinical course and cutaneous metastases. The disease progressed
      from apparently unilateral ovarian involvement to intraabdominal, lung and
      cutaneous metastases. She expired within two months of diagnosis of disease. The
      histopathology of the ovarian tumor and the metastatic skin lesion are
      illustrated. In the authors' opinion this case should be categorized as a
      transitional cell carcinoma of the ovary.

PMID- 7798843
TI  - Hypouricemia, hypokalemia, proximal and distal tubular acidification defect
      following administration of outdated tetracycline: a case report.
AB  - A Thai female patient developed muscular weakness, hypouricemia, hypokalemia and
      hyperchloremic metabolic acidosis after taking outdated tetracycline. A
      pathophysiologic study shows a proximal tubular defect for reabsorption of urate
      and bicarbonate and a distal tubular acidification defect, probably caused by
      outdated tetracycline.

PMID- 7798844
TI  - Congenital pseudarthrosis of the tibia: treatment with free vascularized fibular
      graft.
AB  - Five children with congenital pseudarthrosis of the tibia were treated by
      resection of the lesion and reconstruction of the extremity with a free
      vascularized fibular graft (FVFG). Two of five cases had had multiple surgical
      procedures before FVFG. These two cases were complicated with the non-union of
      the proximal grafthost junction. Of these, one case achieved bone union after
      further resection of the non-union and adding allogenic bone graft and another
      case denied further operation and was lost to follow-up 6 months postoperatively.
      Three cases, two of which underwent FVFG as a primary treatment and another one
      after failure from the Sofield procedure respectively, were initially treated
      successfully and solid union of the grafthost junctions was within four months
      postoperatively. Problems including: anterior bowing, refracture, valgus
      deformity of the ankle and leg length discrepancy occurred in all four followed
      cases.

PMID- 7798845
TI  - Detection of various types of human papillomaviruses in premalignant and
      malignant cervical lesions using DNA-DNA in situ hybridization.
AB  - Detection of human papillomavirus (HPV) in formalin-fixed paraffin embedded
      tissue sections by in situ hybridization technique employing biotinylated (HPV)
      DNA probe 6/11, 16/18 and 31/33/35 was done retrospectively in 25 cases of
      cervical dysplasia, 32 cases of cervical squamous cell carcinoma in situ, 52
      cases of invasive cervical squamous cell carcinoma and 7 cases of adenocarcinoma.
      HPV could be demonstrated in 10 cases (40.00%) of cervical dysplasia, 8 cases
      (25.00%) of cervical squamous cell carcinoma in situ and 31 cases (59.61%) of
      invasive cervical squamous cell carcinoma and 4 cases (57.14%) of adenocarcinoma.
      Among the dysplastic cases, 4 cases showed HPV 31/33/35, 4 cases showed HPV 16/18
      together with HPV 31/33/35, 1 case showed mixed typing of HPV 6/11 and 31/33/35,
      and 1 case showed mixed typing of HPV 6/11, 16/18 and 31/33/35. In 32 cases of
      squamous cell carcinoma in situ, 1 case of HPV 6/11; 3 cases of HPV 16/18, 3
      cases of HPV 31/33/35 and 1 case of mixed typing of HPV 16/18 and 31/33/35 were
      present. A case of HPV 6/11, 10 cases of HPV 16/18 and 9 cases of HPV 31/33/35
      could be detected among the cases of invasive squamous cell carcinoma. Mixed
      typing of HPV 6/11 and 16/18; HPV 6/11 and 31/33/35; HPV 16/18 and 31/33/35; HPV
      6/11, 16/18 and 31/33/35 were revealed in 2, 1, 3 and 5 cases of invasive
      squamous cell carcinoma, respectively. In 7 cases of adenocarcinoma, 1, 2 and 1
      cases exhibited positivity for HPV 16/18; HPV 6/11 and HPV 16/18; and HPV 16/18
      and HPV 31/33/35.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798846
TI  - Adrenal function after prednisolone treatment in childhood nephrotic syndrome.
AB  - Nephrotic syndrome in children is a very common disease in Thailand. Most of the
      patients respond well to oral prednisolone treatment but side effects of the drug
      especially adrenal insufficiency remains a threat to all. We studied the adrenal
      function by studying the response to ACTH stimulation test in 14 Thai children,
      nine girls and five boys, with idiopathic nephrotic syndrome: immediately, 3, 6
      and 9 months after discontinuation of oral prednisolone treatment. Average age on
      entry to the study was 104.4 months (25-183 months). Prednisolone was given every
      day for 29 days (6-64 days) then every other day for 542 days (178-1,562 days).
      Side effects of steroid treatment were gross obesity BMI > 30 (one patient),
      moderate hypertension (one patient), and marked cushingoid features (two
      patients). ACTH stimulation tests were normal in 64 per cent of patients within 7
      days, 64 per cent at 3 months, 73 per cent at 6 months, and 90 per cent at 9
      months after discontinuation of oral prednisolone. We suggest that adrenal
      insufficiency has to be considered in all children on prolonged prednisolone unit
      at least 9 months of treatment-free period.

PMID- 7798847
TI  - Early response of hyperlipidemic subjects to simvastatin.
AB  - Seventy eight patients with hypercholesterolemia from 4 major hospitals were
      studied with regard to their responses to an adjustable dose of simvastatin, a
      HMG-CoA reductase inhibitor. They were followed for up to 6 months with 4 sample
      points during the drug and 2 prior to therapy. The average dose was 10.2 mg/day
      (S.D. 5.5). Four were controlled on 5 mg and 4 needed 30 mg per day. Thirty seven
      per cent had elevated serum transaminases but none to greater than twice normal.
      Only a third of these showed elevation of transaminases during drug therapy
      alone. The mean total cholesterol (TC) was 304 mg/100 ml and low density
      lipoprotein (LDL) was 221 mg/100 ml. These fell 70 and 60 per cent respectively
      and over 90 per cent of the patients reduced their TC and LDL more than the
      limits defined from previous long term monitoring of patients (i.e. TC fell by
      more than 17% and LDL by 25%). High density lipoprotein, HDL, started off at 45
      mg/100 ml and rose to an average of 115 per cent. Triglyceride, TG, started off
      at 207 mg/100 ml and fell to about 86 per cent during simvastatin. However, in
      terms of the proportion of patients who responded greater than the limit
      previously determined (i.e. more than a 25% change for HDL and 45% for TG), only
      about 20 per cent significantly responded with elevation of HDL and 13 per cent
      dropped their TG. The response of TG was more marked at TG greater than 300
      mg/100 ml.

PMID- 7798848
TI  - A direct radioimmunoassay for free progesterone in saliva.
AB  - The direct radioimmunoassay using iodinated tracer (125I-HIS-3CMO) has been
      developed for the determination of salivary progesterone of healthy volunteers
      with regular menstrual cycles. Lack of significant diurnal variation either in
      the follicular or luteal phase indicated that collections of saliva could be
      tailored to the need of individuals making the study somewhat easier. Salivary
      progesterone has shown to correlate significantly with free serum progesterone
      reflecting the unbound biologically active progesterone fraction in blood.
      Moreover, salivary progesterone concentration ranges are similar to those found
      in other studies. Our findings indicated that determination of progesterone in
      saliva could be used in place of serum or plasma. Since firstly, it is non
      invasive, easy for sample collection and a stress-free technique. Secondly, it is
      much more accurate in prediction of corpus luteum function and ovulation than the
      basal-body temperature or endometrial biopsy or other clinical predictors
      currently in use. Finally, determination of daily salivary progesterone levels
      throughout the menstrual cycle may be advantageously employed as a non-invasive
      serial sampling technique for the assessment of corpus luteum and ovarian
      functions.

PMID- 7798850
TI  - Human corticotropin releasing hormone stimulation test in normal subjects.

PMID- 7798849
TI  - Mid-trimester abortion using hypertonic saline or prostaglandin E2 gel: an
      analysis of efficacy and complications.
AB  - A total of 149 mid-trimester termination of pregnancies using hypertonic saline
      infusion (125) or prostaglandin E2 gel (24) have been analyzed for efficacy and
      complications. The mean induction to abortion time (I-A) was 31.7 +/- 9.2 hours
      in hypertonic saline (HSI) group and 28.4 +/- 27.7 hours in prostaglandin (PGE2)
      group. Retained placenta occurred in 76 (63.3%) in HSI group and 6 (25%) in PGE2
      group. Four (3.3%) in HSI group had pyrexia over 38.5 degrees C and the only one
      case with proven sepsis developed disseminated intravascular coagulation defect
      (DIC) which accounted for one case (0.8%) of blood loss of more than 500 ml.
      There was also one case of mildly disturbed electrolytes in HSI group occurring
      during the instillation. Minor side-effects of nausea and vomiting occurred in 4
      (16.7%) in the PGE2 group only.

PMID- 7798851
TI  - Intradermal simulated rabies postexposure prophylaxis using purified chick embryo
      rabies vaccine.
AB  - The antibody responses of 65 volunteers receiving an i.d. regimen (0.1 ml given
      at two sites on days 0, 3, 7 and 0.1 ml given at one site on days 30 and 90) were
      compared with the control group of 35 volunteers receiving the standard i.m.
      regimen. By day 14, seroconversion was observed in all vaccinees in both groups.
      Geometric Mean Titers remained higher than 0.5 IU/ml throughout the study period.
      At the end of the observation period on day 365, antibodies persisted in all
      subjects. The multisite i.d. PCEC regimen has been proved as immunogenic as the
      standard i.m. regimen. Both regimens were well tolerated. Thus, it would be the
      effective and cheapest available rabies post-exposure treatment using tissue
      culture vaccine.

PMID- 7798852
TI  - Management of cobra bite by artificial respiration and supportive therapy.
AB  - During the period when the hospital ran out of cobra antivenom, 4 patients bitten
      by cobra with neuromuscular symptoms and respiratory depression were treated with
      artificial respiration. Complete recovery was noted within 36 to 72 hours. The
      data are interpreted to indicate the reversible binding of the venom to
      receptors. Artificial ventilation appears to be another alternative to specific
      antivenom treatment and may be used when the antivenom is not available or if
      there is antivenom hypersensitivity.

PMID- 7798853
TI  - Splenic cystic lymphangiomatosis: an unusual cause of massive splenomegaly:
      report of a case.
AB  - A 29-year-old woman had a history of an upper quadrant abdominal mass for about 6
      years. An ultrasound examination revealed splenomegaly containing several cysts.
      On exploratory laparotomy, multiple cysts were found in the spleen. Because of
      the extensive involvement of the spleen, splenic salvage could not be performed,
      and total splenectomy was done. Both morphological and histological features of
      the removed spleen were typical of cystic lymphangiomatosis.

PMID- 7798854
TI  - America's most important specialty.

PMID- 7798855
TI  - The family in family medicine revisited, again.

PMID- 7798856
TI  - Levels of physician involvement with patients and their families. A model for
      teaching and research.
AB  - BACKGROUND: We present an educational model that describes physician skills for
      addressing psychosocial concerns of patients, ranging from basic medical
      questions to in-depth psychotherapy. This model improves upon previously
      published models by integrating into one hierarchy levels of physician
      involvement with individual patients and levels of involvement with families.
      METHODS: Ten faculty family physicians were videotaped during 200 office visits.
      Interviews were categorized according to the model, with a 79% interrater
      agreement. RESULTS: Most visits involved the lower three levels of physician
      involvement (41%, level 1; 35.5%, level 2; and 23%, level 3). Discussion of
      family context occurred in a majority (58.5%) of visits, primarily when another
      family member was in the room and during preventive care visits. Higher levels
      were associated with longer visits--about 3 minutes more for each additional
      level. CONCLUSIONS: This investigation suggests that the levels of physician
      involvement model can be reliably measured. This model may be a useful tool for
      education and research, particularly the study of physician interview skills
      appropriate to family medicine.

PMID- 7798857
TI  - Referrals for alternative therapies.
AB  - BACKGROUND: The purpose of this study was to examine how allopathic physicians
      participate in the decision to refer patients for alternative therapies. METHODS:
      A pretested, self-administered, structured questionnaire was distributed
      simultaneously to all area physicians at community locations in Washington State,
      New Mexico, and southern Israel. The primary outcome measures were monthly and
      yearly rates of referral to alternative therapies. RESULTS: More than 60% of all
      physicians made referrals to alternative providers at least once in the preceding
      year and 38% in the preceding month. Referrals were generally based on patient
      requests, synergy between the alternative therapy and the patients' cultural
      beliefs, failure of conventional treatment, and the belief that patients have
      "nonorganic" or "psychological" disease. There was no relationship between the
      rate of referral and the referring physician's level of knowledge about, beliefs
      about the effectiveness of, or familiarity with alternative therapies.
      CONCLUSIONS: Primary care physicians are more likely than other medical
      specialists to be knowledgeable about, personally subscribe to, and refer
      patients for alternative therapies. Physicians who use alternative techniques for
      themselves and their families or who adopt complementary therapies into their
      practices have higher rates of referrals. Referral rates and patterns were
      similar between sites despite considerable cross-cultural and health system
      differences. Given the high rate of referral and the absence of an apparent
      internal logic for such recommendations, guidelines and physician education may
      be advisable.

PMID- 7798858
TI  - Pain and cramping associated with cryosurgery.
AB  - BACKGROUND: Many different cryosurgery methods have been described for the
      treatment of cervical intraepithelial neoplasia (CIN). The purpose of this study
      was to evaluate the pain and cramping perceived by patients undergoing four
      specific cryosurgical methods. METHODS: Seventy women consented to the
      prospective trial and were assigned to one of four cryosurgery techniques: a 2
      minute double freeze, a 3-minute double freeze, a 5-minute single freeze, and a 5
      minute double freeze. Immediately following the procedure, a trained interviewer
      recorded each woman's perceptions of pain and cramping. Age, parity, marital
      status, financial class, race or ethnicity, lesion severity, and pretreatment
      with a nonsteroidal anti-inflammatory drug (NSAID) were included in the analysis.
      RESULTS: The median pain scores for the 2-minute double freeze, the 3-minute
      double freeze, the 5-minute single freeze, and the 5-minute double freeze were 4,
      3, 3, and 7, respectively, on a scale of 0 to 10. The median cramping scores for
      the procedures were 0, 0, 0, and 7, respectively. The median pain and cramping
      scores were significantly higher for the 5-minute double freeze than for any of
      the other procedures (P = .012 and P = < .001, respectively). CONCLUSIONS: Pain
      and cramping are associated with cryosurgery, but the 5-minute double freeze
      caused the most pain and cramping of all the cryosurgery methods tested.
      Pretreatment with an NSAID did not lessen the cramping or pain perceived during
      the 5-minute double freeze.

PMID- 7798860
TI  - Patient attitudes regarding physician inquiry into spiritual and religious
      issues.
AB  - BACKGROUND: Most physicians do not address spiritual and religious issues with
      patients, although there are data documenting the relationship between religious
      variables and disease, health, and well-being. The purpose of this study was
      twofold: to examine patient attitudes regarding physician-directed inquiry about
      issues related to spiritual matters and faith; and to identify screening
      variables that would identify patients who would be receptive to such a
      discussion. METHODS: A Spiritual and Religious Inquiry (SRI) questionnaire was
      administered to patients presenting for care in a family practice center.
      RESULTS: Patients' frequency of religious service attendance (at least monthly)
      predicted their acceptance of physician inquiry into their religion and personal
      faith (P < .01) and acceptance of physician referral to pastoral professionals
      for spiritual problems (P < .01). CONCLUSIONS: This study supports the use of
      frequency of religious service attendance as a screening variable for patients
      receptive to physician-directed inquiry into religious and spiritual issues. It
      also confirms that patients are accepting of physicians' referring patients to
      pastoral professionals (ie, clergy) for spiritual problems.

PMID- 7798859
TI  - Comparison of home glucose monitoring with the oral glucose tolerance test to
      detect gestational glucose intolerance.
AB  - BACKGROUND: Recent evidence suggests that infant morbidity is increased among
      women who have abnormal prenatal glucose screening tests but who do not have
      gestational diabetes mellitus (GDM). These women fall into a diagnostic gray zone
      and historically have not been treated. METHODS: Forty-eight pregnant women with
      abnormal oral glucose challenge test results performed self-monitored blood
      glucose (SMBG) testing seven times per day for 1 week before undergoing a
      diagnostic 100-g oral glucose tolerance test (OGTT). At delivery, perinatal
      complications and birthweights were recorded. Results of SMBG tests for women
      with normal OGTTs were correlated with infant birthweights. RESULTS: Thirteen
      infants (37%) were found to be large for gestational age (LGA). Significant
      correlation was found between increasing birthweight and increasing average
      fasting SMBG values (P < .001), increasing percentage of SMBG values above 120
      mg/dL (6.7 mmol/L) (P < .01), and increasing average SMBG values (P < .016).
      CONCLUSIONS: Maternal home glucose values at 28 weeks correlate with the risk of
      LGA infant births among women in the diagnostic gray zone. Women with average
      fasting SMBG values > 95 mg/dL (5.3 mmol/L) are at increased risk for giving
      birth to LGA infants and may be more likely to exhibit complications usually
      associated with GDM.

PMID- 7798861
TI  - A multivariate model for specialty preference by medical students.
AB  - BACKGROUND: Numerous studies have demonstrated differences among students
      regarding their preference of a medical specialty. The goal of the present
      research was to develop a model for the selection of a primary care specialty
      (ie, family practice, general internal medicine, medicine/pediatrics, and general
      pediatrics). METHODS: A self-administered questionnaire was mailed to 822 first
      year through fourth-year medical students at the University of Michigan Medical
      School in Ann Arbor. Students listed their first preference for medical
      specialty, anticipated income and work hours, and the influence of attitudinal
      and social factors on their preference. A total of 645 (78.5%) students
      responded. Average age was 25; 58% were male, and 77% resided in Michigan.
      RESULTS: Overall, 34.3% of the medical students who responded to the
      questionnaire expressed a preference for a surgical specialty; 27.3%, primary
      care; 19.9%, a hospital-based practice; and 18.5%, nonprimary care and non
      hospital based practice. A multiple logistic regression model developed on
      preference for a primary care specialty achieved a classification accuracy of
      82%. The most important factors influencing specialty preference were sex,
      expected income, attitudes about general medicine issues, attitudes about
      surgery, and the influence of other people. CONCLUSIONS: No single factor
      dominates a student's preference for primary care. Students preferring primary
      care were most strongly influenced by their perceptions of practice variations.
      Students preferring nonprimary care specialties were more interested in income,
      prestige, and hospital-based practice. Medical school faculty had no significant
      impact on the preferences of either group of students.

PMID- 7798862
TI  - Vas deferens occlusion during no-scalpel vasectomy.
AB  - The increasing popularity of the no-scalpel vasectomy (NSV) technique in the
      United States is driven by patient demand for surgical procedures presumed to be
      less invasive and by the somewhat lower complication rate of the NSV technique.
      The NSV technique addresses vasal delivery but not vasal occlusion. Intraluminal
      red-hot wire cautery with sheath closure over the inguinal end of the cut vas
      (Schmidt's method) has the lowest failure rate of all reasonable vas occlusion
      methods. The anatomical relationships of scrotal layers can be unclear during the
      NSV technique. Accurate identification of the sheath layer is critical to sheath
      interruption if this method of occlusion is to be used. Placement of an
      absorbable purse-string suture for sheath interruption during the NSV procedure
      is described. Special attention must be given to placement of one suture bite in
      the deep (posterior) sheath wall. The vasal occlusion technique described in this
      paper blends a refined method of vasal delivery (NSV) with the most effective
      method of vasal occlusion (cautery with sheath interruption).

PMID- 7798863
TI  - Neurocysticercosis: an old disease with new questions.
AB  - Cysticercosis is a parasitic infection of the central nervous system that occurs
      in some geographic regions and is transmitted through contaminated food or by the
      fecal-oral route. Treatment depends on the degree of central nervous system
      involvement. Ventricular cysts require surgery. Parenchymal involvement requires
      systemic antiparasitic therapy. Computed tomography and magnetic resonance
      imaging are used to image patients with neurocysticercosis. Magnetic resonance
      imaging is more sensitive for cerebral involvement than in computed tomography.
      Computed tomography is more sensitive to calcifications than is magnetic
      resonance imaging.

PMID- 7798864
TI  - Suspected trimethoprim/sulfamethoxazole-induced hypoprothrombinemia.
AB  - The following report illustrates a case of trimethoprim/sulfamethoxazole-induced
      hypoprothrombinemia in a patient receiving ongoing warfarin therapy for atrial
      fibrillation and aortic valve replacement. He was treated with
      trimethoprim/sulfamethoxazole (TMP/SMX) for sinusitis. During this time, the
      patient's prothrombin time international normalized ratio (INR) increased 3.5
      times higher than the baseline value. The INR values decreased when the
      antibiotic was discontinued. If a patient is on warfarin and TMP/SMX is added,
      INR values should be monitored closely.

PMID- 7798865
TI  - Predicting large-for-gestational-age infants.

PMID- 7798866
TI  - Guidelines for managing ankle injuries: the Ottawa ankle rules.

PMID- 7798867
TI  - Taking the gravel.

PMID- 7798868
TI  - Study of the regenerating newt retina by electrophysiology and
      immunohistochemistry (bipolar- and cone-specific antigen localization).
AB  - Immunohistochemical and electrophysiological examinations were carried out to
      investigate the sequence of appearance of the retinal neurons during regeneration
      after a complete surgical removal of the original retina of the newt. We produced
      a monoclonal antibody, RB-1, specific for cone photoreceptors and a subtype of
      bipolar cells in adult newt retina. This antibody was used as a major tool for
      this analysis. Appearance of spiking activity as a possible marker of ganglion
      cell differentiation was examined with whole-cell patch-clamp techniques. Spiking
      cells, which possessed voltage-dependent Na+, K+, and Ca2+ channels similar to
      those of mature ganglion cells, appeared in the regenerating retina by 24 days
      before cone photoreceptors had been labeled by the RB-1 antibody. Cones and
      ganglion cells differentiated before the retina had been segregated into distinct
      synaptic layers. The RB-1-labeled bipolar cells as well as PKC-immunoreactive
      bipolar cells appeared in the regenerating retina after the segregation of the
      synaptic layers. Their appearance seemed to coincide with the appearance of
      immunoreactive amacrine cells described previously (Negishi et al. [1992] Dev.
      Brain Res. 68:255-264). During embryonic development of the newt retina, cone
      photoreceptors appeared prior to bipolar cells. Thus the process of reformation
      of a functional retina seems to follow the same steps as differentiation of
      retina during development.

PMID- 7798869
TI  - Ontogeny of cardiac function in the brine shrimp Artemia franciscana Kellogg 1906
      (Branchiopoda: Anostraca).
AB  - In newly hatched brine shrimp (Artemia franciscana) cardiac organogenesis and
      function could only take place with the onset of segmentation. Consequently
      differences in age, body size and temperature (in the range 22-34 degrees C)
      affected the ontogeny of cardiac activity only indirectly, through their
      influence on developmental stage. Once present the frequency of cardiac activity
      (heart beat) increased with increasing body size and concomitant differentiation
      of cardiac tissue. At least initially, (dry body weight 11-16 micrograms) heart
      rate was independent of temperature and weight specific heart rate was
      independent of body size. When differentiation neared completion, and cardiac
      growth switched to elongation (dry body weight > 16 micrograms), there was a
      change in the pattern of cardiac function. There was now a decrease in heart beat
      with increasing body size and weight specific heart rate showed an inverse
      relationship with body weight. Heart rate also became temperature dependent,
      although it remained relatively insensitive. In conclusion it is suggested that
      the ontogeny of cardiac function in Artemia is constrained by an anamorphic
      (direct) pattern of development where segment formation occurs post hatch. Early
      cardiac functioning cannot be predicted on an allometric basis, as cardiovascular
      structure and function changes qualitatively during ontogeny.

PMID- 7798870
TI  - Fraud and abuse revisited. Current schemes and scams in Florida.

PMID- 7798871
TI  - Neurosurgical malpractice insurance survey. Florida 1993.
AB  - A survey of Florida neurosurgeons was conducted in April 1993 with a 68% response
      rate. One hundred twenty-three (81%) had malpractice insurance. Of the 29 (19%)
      without insurance, all but one practiced in South Florida. Cost was the major
      factor in dropping coverage. The cutoff appeared to be in excess of $100,000 per
      year for coverage for $250,000 per incident. Over 50% have considered early
      retirement. Those without coverage are limiting patient access. The number unable
      to afford minimal coverage is likely to increase; consequently patient access
      will continue to decline unless reforms allow coverage at a reasonable cost.

PMID- 7798872
TI  - Non 0-1 Vibrio cholerae septicemia and culture negative neutrocytic ascites in a
      patient with chronic liver disease.
AB  - Non 0-1 Vibrio cholerae infection is often associated with ingestion of
      contaminated seafood and its common presentation is gastroenteritis. Septicemia
      may be found in immunocompromised hosts resulting in mortality approaching 50%. A
      case is reported of non 0-1 Vibrio cholerae infection presenting with septicemia
      in a patient with neutrocytic ascites suggestive of spontaneous bacterial
      peritonitis.

PMID- 7798874
TI  - Workers' compensation course required.

PMID- 7798873
TI  - The time has come to lift the economic embargo against Cuba.
AB  - The United States embargo against Cuba, which makes trade illegal, contributes to
      that country's death and disease. The policy is obsolete, counterproductive and
      should be changed to bring peace between the two nations and help restore the
      health of the Cuban people. Along with the ban on trade is the ban on traveling.
      The United States' controls contradict the most fundamental values upon which
      this country stands. Despite current restrictions, physicians can travel to Cuba
      and they should in order to observe the island's system for themselves.

PMID- 7798875
TI  - Recent advances in neural transplantation. Relevance to neurodegenerative
      disorders.
AB  - Anatomical and behavioral characterizations of neural transplants, whether within
      (allograft) or across (xenograft) species, have provided evidence that the
      transplant survives, integrates with the host tissue, and may lead to functional
      recovery. Several animal models of neurodegenerative disorders demonstrate the
      feasibility of using neural transplantation as an alternative treatment for these
      human diseases. While more elaborate basic animal studies are needed, clinical
      trials have begun. Neural transplantation is currently used as an experimental
      treatment for Parkinson's disease and several investigators have suggested using
      the same treatment procedure for other neurodegenerative disorders, such as
      Huntington's and Alzheimer's disease.

PMID- 7798876
TI  - Domestic violence.

PMID- 7798877
TI  - A cup of hemlock.

PMID- 7798878
TI  - Other side of the controversy.

PMID- 7798879
TI  - HTLV-I/II infection in a high viral endemic area of Zaire, Central Africa:
      comparative evaluation of serology, PCR, and significance of indeterminate
      western blot pattern.
AB  - The frequency of indeterminate Western blot (WB) seroreactivities against HTLV-I
      "gag encoded proteins" only, and the use of low specific diagnostic WB criteria
      led to the overestimation of HTLV-I seroprevalence in initial studies in
      intertropical Africa and Papua New Guinea. In order to clarify the meaning of
      such seroreactivity, 98 blood samples of individuals from a high HTLV-I endemic
      area in Zaire, Central Africa were studied by a WB assay containing HTLV-I
      disrupted virions enriched with a gp 21 recombinant protein and a synthetic
      peptide from the gp 46 region (MTA-1), and by the polymerase chain reaction (PCR)
      with 3 primers pairs and 4 different HTLV-I and or HTLV-II-specific probes. These
      98 samples were taken mainly from patients with neurological diseases and from
      their relatives. Using stringent WB criteria, 28 sera (29%) were considered as
      HTLV-I-positive, 3 as negative and 67 (68%) as indeterminate. A large proportion
      of these indeterminate sera would have been considered as HTLV-I-positive samples
      according to previous low specific WB diagnostic criteria. After PCR, 35 samples
      (36%) were considered as positive for the presence of HTLV-I proviral DNA. Out of
      the 67 WB seroindeterminate, 10 (15%) were found HTLV-I-positive by PCR. These 10
      individuals exhibited in WB multiple band reactivity with p19 and/or p24 (7 cases
      of both) associated in 6 cases with rgp 21, but never with MTA-1. No samples were
      found PCR-positive for HTLV-II despite the findings of 11 sera suggestive of HTLV
      II by WB.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798881
TI  - Atypical strain of hepatitis E virus (HEV) from north India.
AB  - Hepatitis E virus (HEV) infection was detected during an epidemic in North India.
      Virus particles present in the stool of an acutely ill patient (YAM-67) was
      transmitted intravenously into rhesus monkeys (M. mulata) and orally to a human
      volunteer. Virus-like particles (VLPs) of 32-34 nm were detected in the bile of
      monkeys and in the stools of the human volunteer by means of solid phase immune
      electron microscopy (SPIEM) with acute homologous and heterologous sera. The VLPs
      were confirmed to be HEV by a reverse transcription polymerase chain reaction (RT
      PCR). Virus-like particles from human volunteer stools were passaged further into
      rhesus monkeys. A bimodal rise in aminotransferase levels were observed in the
      animals, and liver histopathology indicated mild to severe form of hepatitis.
      Further, SPIEM and RT-PCR analysis in monkey bile revealed presence of virus from
      15 to 45 days post-inoculation. Rechallenge of the animals 6 months after
      recovery with the same viral inoculum failed to produce abnormal liver function
      tests indicating the presence of protective immunity during this period. The VLPs
      in the stool from the patient (YAM-67) with epidemic hepatitis were found to
      retain infectivity even after several cycles of freeze-thawing and exposure at 37
      degrees C for 2 days. Moreover, these VLPs from the patient, human volunteer, and
      monkeys did not react with an anti-HEV chimpanzee serum from NIH, Bethesda, MD.
      These findings indicate that this North India isolate of HEV is an atypical
      strain of HEV. The present study further validates that the rhesus monkey is a
      suitable experimental model for HEV.

PMID- 7798880
TI  - Novel application of a point mutation assay: evidence for transmission of
      hepatitis B viruses with precore mutations and their detection in infants with
      fulminant hepatitis B.
AB  - Mutations of the precore region of hepatitis B virus (HBV) genome have been
      associated with fulminant and severe chronic hepatitis. However uncertainty
      remains about the clinical significance and transmissibility of these mutant
      strains. A point mutation assay (PMA) was developed to identify qualitatively and
      quantitatively mutations affecting precore amino acids 1 and 28. We have analysed
      serum samples from six mother-infant pairs where perinatal transmission of HBV
      has occurred and where the mothers were HBV carriers without detectable serum
      HBeAg. In three cases fulminant hepatitis developed in the infant, in two cases
      acute hepatitis resolved, and in one case the infant was immunised and did not
      become infected. We also examined serum from a healthcare worker, an anti-HBe
      seropositive HBV carrier, believed to have transmitted HBV infection to a
      patient. The PMA results were confirmed in all cases by direct sequencing of
      polymerase chain reaction (PCR) products using nested and double-nested PCR with
      primers to the precore and X region. Precore aa28 mutant-type virus was detected
      in the serum of one mother at the time of delivery of three of her children, two
      of whom developed fulminant hepatitis. Another mother of an infant with fulminant
      hepatitis had no precore mutations. In one mother-infant pair a mixed viral
      population was found; the acute hepatitis B in the infant resolved. The HBV
      sequence from the healthcare worker was also of aa28 mutant type. No mutations of
      aa1 were detected in any of the specimens. The study supports the association of
      precore mutations with some cases of transmission of HBV infection from HBeAg
      negative mothers to their infants.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798882
TI  - Elevated rubella antibodies in patients with chronic liver disease.
AB  - Patients with autoimmune chronic active hepatitis (AICAH) and certain other
      chronic liver disorders often have very high titres of haemagglutination
      inhibition (HI) antibodies to rubella virus. In this study it is shown, using
      floatation centrifugation, that the high rubella HI reactivity is not caused by
      nonspecific lipoprotein inhibitors but rather by antibodies specific for the
      rubella haemagglutinin (E1 glycoprotein). After sucrose density gradient
      ultracentrifugation of sera the major HI reactivity was recovered in the IgG
      containing fractions. The IgG antibody fraction was strongly reactive by an
      indirect enzyme-linked immunosorbent assay (ELISA). Higher prevalence and titres
      of rubella antibodies were also demonstrated by the complement fixation (CF) test
      using a haemagglutinin-free antigen, and by an indirect haemagglutination (IHA)
      test (Rubacell) using a cell-associated antigen which is distinct from the
      antigens used in the HI and CF tests. This high rubella antibody response is
      therefore demonstrated using three distinct antigen-antibody systems. By means of
      absorption experiments and radioimmunoprecipitation assays the coating antigen
      used in the IHA test was shown to reside in the E2 glycoprotein. The cause of
      this enhanced antibody response to rubella virus structural proteins remains
      elusive.

PMID- 7798883
TI  - Humoral immune responses and cytomegalovirus excretion in children with
      asymptomatic infection.
AB  - Forty-two seropositive children aged 3 to 5 years attending a kindergarten were
      followed up for 1 year in order to examine the relationship between humoral
      immunity and cytomegalovirus (CMV) excretion status. Anti-CMV antibodies were
      measured at the beginning and end of the study by enzyme-linked immunosorbent
      assay, neutralizing antibody test, and immunoblot techniques. Among these
      children, 32 persistently shed virus in urine, 2 intermittently shed CMV, and 4
      experienced reactivation during the study. Virus was never isolated from 4
      seropositive children. The level of anti-CMV IgG antibody in seropositive
      children who remained nonshedders was significantly higher than in children who
      shed virus during follow-up. On immunoblots, all seropositive nonshedders reacted
      to a CMV-specific 65 kD antigen, whereas most shedders (80%) did not. These
      findings suggest that humoral immunity plays a role in controlling persistent CMV
      infection in children with asymptomatic infection. However, the humoral immunity
      measured by the neutralizing test and the presence of antibodies against CMV
      specific envelope antigens (116 kD/55 kD) apparently play a limited role in
      modifying persistent excretion and regulating reactivation of latent CMV. Immune
      evasion by CMV to block these antigens may explain these results.

PMID- 7798884
TI  - Hepatitis C virus infections in transplant patients: serological and virological
      investigations.
AB  - Hepatitis C virus (HCV) is transmitted by organs of HCV antibody-positive donors
      to transplant recipients. This study investigated the serological and virological
      responses of 14 initially HCV antibody-negative transplant patients who received
      organs from four HCV antibody-positive donors (A-D) (before donor screening for
      HCV infection was introduced in 1991). Second generation HCV enzyme immunoassay
      (Abbott HCV EIA) was used to detect anti-HCV antibody. Recombinant immunoblot
      (RIBA-2; Chiron Corporation) and Wellcozyme Western blot (Wwb) assays were
      compared as confirmatory assays of positive EIA results. Reverse transcription
      (RT) followed by "nested" polymerase chain reaction (PCR) was performed to detect
      viral RNA. HCV RNA was only found in the sera of donors B and C, however,
      transplantation of organs from all donors resulted in infection of all
      recipients. HCV RNA was found in recipient sera within 30 days after transplant
      and remained detectable throughout the period of sampling. An anti-HCV antibody
      response was found in only 6 (of the 14) recipients and only after 300 days. Much
      longer periods passed before detection of HCV antibody in six recipients. For
      detection of HCV infection in transplant recipients it is essential that testing
      for HCV RNA by RT-PCR is carried out.

PMID- 7798885
TI  - Hepatitis C virus antibody prevalence among human immunodeficiency virus-1
      infected individuals: analysis with different test systems.
AB  - Sera of 383 human immunodeficiency virus (HIV)-1-infected individuals from
      Frankfurt (Main)/Germany were assayed by two hepatitis C virus (HCV) screening
      tests (Abbott second generation, Ortho second generation). This population showed
      a prevalence for reactivity with both tests of 20.8% (80/383). Examination of all
      reactive sera (91/383) by a supplemental assay (Chiron RIBA 2) gave for 46 sera a
      positive, for 33 sera an indeterminate, and for 12 sera a negative result.
      Further analysis focussed on these RIBA 2-indeterminate and -negative samples.
      Analysis of the sera using an in-house Western blot with three different
      Escherichia coli-expressed HCV proteins revealed that none of the RIBA 2
      negative, but 24 of the 33 RIBA 2-indeterminate sera, including 3 of 4 c33c (NS3)
      reactive samples, were reactive with a recombinant core protein. Twenty-one of 22
      c22-3 (core) indeterminates stained the core antigen in the in-house Western blot
      and 3 of them in addition a NS5 moiety. HCV-polymerase chain reaction (PCR) was
      positive for 14 of the 24 RIBA 2-indeterminate sera, but for none of the RIBA 2
      negative or Western blot nonreactive samples. Discrepant results between the two
      screening tests could not be explained by differences in the antigen compositions
      (i.e., a NS3-NS4 moiety of 111 amino acids present in the Ortho enzyme-linked
      immunosorbent assay (ELISA), not present in the Abbott or RIBA 2 assays).

PMID- 7798886
TI  - Case report: psychosis associated with hepatitis B.
AB  - An acute disintegrative disorder in a child with acute hepatitis B virus (HBV)
      infection is described. Both hepatitis B surface antigen (HBsAg) and HBV-DNA were
      detected in cerebrospinal fluid (CSF) by means of enzyme-linked immunosorbent
      assay (ELISA) and the polymerase chain reaction (PCR) technique respectively. A
      markedly elevated level of CSF adenylate kinase (AK), which normalised as the
      patient recovered spontaneously, suggested an organic brain disorder.
      Demonstration of intra-blood-brain barrier production of IgG supported the
      possibility of local infection by HBV within the central nervous system.

PMID- 7798887
TI  - Rapid detection of virus genome from imported dengue fever and dengue hemorrhagic
      fever patients by direct polymerase chain reaction.
AB  - Serum specimens from patients with imported dengue fever and dengue hemorrhagic
      fever were directly subjected to reverse transcription and polymerase chain
      reaction (RT-PCR) without any RNA purification. The amplified virus genome was
      detected within 3 hours. The results of PCR corresponded closely to the results
      of virus isolation using cultured mosquito cells, suggesting that direct RT-PCR
      procedure greatly facilitates rapid diagnosis of dengue infection.

PMID- 7798888
TI  - RB tumor suppressor gene expression in hepatocellular carcinomas from patients
      infected with the hepatitis B virus.
AB  - Hepatitis B virus (HBV) infection is closely associated with the development of
      hepatocellular carcinoma (HCC), but definite mechanisms by which it could play an
      etiologic role have not yet been identified. Modifications of the function of the
      RB tumor suppressor gene, which regulates the cell cycle, could provide such a
      mechanism. In the present study, the expression of the protein product of RB,
      pRB, was evaluated by immunohistochemical staining in HCC tissues from 25
      patients from China and the United States, adjacent nontumorous liver from 19 of
      those patients, five human HCC cell lines, three human hepatoblastoma cell lines,
      and five specimens of normal human liver. Representative samples were also
      evaluated by western blot. Altered expression of RB was detected in eight HCC
      tissues (pRB undetectable in five HCCs and detected in < 1% of nuclei of HCC
      cells in three others); all eight had detectable hepatitis B surface or core
      antigen in the adjacent nontumorous liver, indicating active HBV infection. pRB
      was detected in 10-95% of nuclei (normal expression) in the remaining 17 HCCs,
      and in many nuclei in all 19 nontumorous livers, and in the 5 normal livers. No
      pRB staining was detected in the nuclei of three HCC cell lines, but pRB was
      detected in > 90% of nuclei of the other HCC and hepatoblastoma cell lines. The
      relationship of pRB expression to mutations of the p53 tumor suppressor gene was
      also examined. The absence of detectable nuclear pRB by immunohistochemical
      staining was associated with the presence of presumed mutant p53 detected by
      immunohistochemical staining in four out of five HCC cases.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7798889
TI  - Genotype distribution of hepatitis C virus infection in Taiwan.
AB  - To investigate the prevalence of genotype distribution of hepatitis C virus (HCV)
      infection in Taiwan, genotypes were identified in 122 (36 anti-HCV-positive blood
      donors, 44 anti-HCV-positive aborigines, 28 hemodialysis patients, and 14
      patients with chronic liver diseases) of 280 subjects, using polymerase chain
      reaction by Okamoto's type-specific primer method. Type II was the dominant
      (66.7%) type among anti-HCV-positive blood donors, followed by type III and type
      IV with the same percentages (16.7%), while none of type I was detected. The
      prevalence of genotype distribution were 75.0%, 81.1%, and 64.3% for type II,
      4.6%, 17.9%, and 21.4% for type III, 13.6%, 0%, and 7.1% for type IV, for the
      aborigines, hemodialysis, and chronic liver diseases groups, respectively. Four
      subjects revealed mixed infections by two different genotypes: two cases of II
      and III; and each one case of II and IV, and III and IV. Diverse genotype
      distributions in two hemodialysis groups disclose the existence of obvious
      regional differences even within a region. The results reveal the highest
      prevalence of type II as in Japan. However, there is a higher prevalence rate of
      type IV than in Japan.

PMID- 7798890
TI  - Detection of respiratory syncytial virus by RNA-polymerase chain reaction and
      differentiation of subgroups with oligonucleotide probes.
AB  - The polymerase chain reaction (RNA-PCR) was used for specific detection of
      respiratory syncytial virus (RSV) genomes in clinical specimens. A set of primers
      was selected from conserved regions of the 1B and N genes for detection of both
      subgroups. The primers were found to be RSV specific, all RSV strains generated a
      218 bp product, and no RSV specific amplified product was obtained when nucleic
      acids from a variety of micro-organisms from the respiratory tract were subjected
      to the RNA-PCR. We took advantage of the sequence heterogeneity of the amplified
      products to discriminate between the A and B strains by hybridisation with
      subgroup specific oligonucleotide probes. This additional hybridisation assay
      increased the sensitivity of the RNA-PCR tenfold. The RNA-PCR was tested on
      clinical specimens from children with symptoms of an infection of the respiratory
      tract. The results were compared with isolation of RSV in cell culture and direct
      immunofluorescence. From 93 specimens tested, 31 were found positive by all three
      techniques. Six additional positive results were detected using RNA-PCR. From
      these 37 RSV positive specimens 33 (92%), including all 6 additional positives,
      were subgroup A and only 4 were subgroup B strains. Thus, the RNA-PCR is a
      specific and sensitive technique for the detection and subgroup classification of
      RSV genomes.

PMID- 7798891
TI  - Racial differences in the seroprevalence of hepatitis A virus infection in
      Natal/KwaZulu, South Africa.
AB  - The age- and race-specific seroprevalence of hepatitis A virus (HAV) infection
      was determined by radioimmunoassay (RIA) in 786 subjects between the ages of 6
      months to 60 years. More than 50% of African children were seropositive by the
      age of 5 years. In blood donors (17-60 years), 50% (93/187) of Whites, 67%
      (110/163) of Indians, 85% (117/137) of Coloureds, and 91% (115/127) of Africans
      were seropositive. There was a significant difference in the seroprevalence of
      HAV infection between White blood donors and blood donors from the other three
      racial groups [Coloureds (P < 0.0001), Africans (P < 0.0001), and Indians (P <
      0.001)] and between Indians and Coloureds (P < 0.0001) and Indians and Africans
      (P < 0.0001). There was no significance difference in HAV infection between
      Coloureds and Africans (P < 0.200). Eighty-seven per cent (32/37) of rural
      Africans had previous infection. In the African population HAV infection is
      acquired in childhood. There are significant racial differences in the
      seroprevalence of HAV infection. The surveillance of HAV infection may be used as
      a valuable yardstick to monitor the changing standards of hygiene and
      socioeconomic conditions of a community in transition in South Africa and to make
      rational public health decisions regarding a hepatitis A vaccination policy.

PMID- 7798892
TI  - Differences in the entire nucleotide sequence between hepatitis B virus genomes
      from carriers positive for antibody to hepatitis B e antigen with and without
      active disease.
AB  - The entire nucleotide sequence was determined for eight hepatitis B virus (HBV)
      genomes from three symptom-free carriers, two patients with chronic persistent
      hepatitis and one patient with chronic active hepatitis, who were positive for
      antibody to hepatitis B e antigen (HBeAg). The two patients with chronic
      persistent hepatitis were tested again after they developed chronic active or
      fulminant hepatitis, making a total of eight samples. Six had a point mutation in
      the preC region prohibiting the encoding of HBeAg precursor, while the remaining
      two had a deletion of 8 or 21 nucleotides within the X gene upstream of the preC
      transcription initiation sites which would affect the X gene and the putative
      preC/C promoter. Most genomes from the three symptom-free carriers and the two
      patients with chronic persistent hepatitis, with HBV DNA levels of 10(2)
      10(3)/ml, had deletion, frameshift mutation, initiation failure or a premature
      stop codon, rendering them replication-incompetent. In contrast, such mutations
      were rarely seen in HBV genomes from the two patients with chronic persistent
      hepatitis after they had developed active or fulminant hepatitis and from the
      patient with chronic active hepatitis, all of whom had vigorous HBV replication
      with serum HBV DNA from 10(6) to 10(9)/ml. Unique mutations for amino acid
      changes were more frequent in HBV genomes with a higher replicative activity.
      These results indicate two kinds of HBV genomes with an HBeAg-minus phenotype,
      one with defects seriously affecting viral replication and the other without such
      defects, which would account for different clinical profiles in carriers with
      antibody to HBeAg.

PMID- 7798893
TI  - Enhanced synthesis of metallothionein as a possible cause of abnormal copper
      accumulation in LEC rats.
AB  - Long-Evans rats with a cinnamon-like coat color (LEC) is an inbred strain
      accumulating copper (Cu) in the liver abnormally and showing spontaneous
      hepatitis and hepatoma. The present study was intended to clarify how Cu
      accumulates in the LEC rat liver. For this purpose, the distribution profiles of
      Cu and zinc (Zn) and the inducibility of metallothionein (MT) synthesis were
      examined in the liver between Cu-loaded Long Evans agouti (LEA, the original
      strain of LEC) rats and were compared with those in control LEC rats. LEA rats
      (female, five weeks old) were injected subcutaneously with CuCl2 daily at a dose
      of 3 mg Cu/kg body weight for 2, 4, 6, and 9 days. The concentration of Cu (124
      micrograms/g) accumulated in the LEA rat liver after four injections was
      comparable to that in control LEC rats. Only 20% of Cu in the liver of LEA rats
      was recovered in the supernatant fraction in the form of MT, while Cu in the LEC
      rat liver (113 micrograms/g) was recovered mostly in the supernatant fraction,
      and was bound to MT. Although the increased concentration of Cu in the LEA rat
      liver was further elevated after additional injections of Cu, the amount of MT
      did not increase further. The MT mRNA content in the LEA rat liver remained lower
      than that of LEC rats even after further injections of Cu. Therefore, the present
      results suggest that LEC rats can accumulate Cu at a high concentration in the
      liver because of their extremely high inducibility of MT.

PMID- 7798894
TI  - Purification and active-site characterization of equine plasma amine oxidase.
AB  - An improved purification scheme for an amine oxidase from equine plasma (EPAO), a
      nonruminant source, is described and the protein's active-site is characterized.
      EPAO is dimeric and contains one Type-2 Cu(II) ion per monomer. The EPAO Cu(II)
      site is spectroscopically very similar to the Cu(II) sites in other amine
      oxidases. Unlike the extensively investigated nonruminant amine oxidase from
      porcine plasma, EPAO does not display half-of-the-sites reactivity; titrations
      with p-nitrophenylhydrazine and phenylhydrazine indicate two active cofactors per
      dimer. This cofactor is determined to be the same as that of other copper
      containing amine oxidases, 6-hydroxydopa quinone (topa quinone). Upon anaerobic
      reduction with substrate at ambient temperature, the EPR spectrum of EPAO
      exhibits a sharp signal at g congruent to 2, attributable to the topa
      semiquinone. Equine plasma amine oxidase possesses novel in vitro substrate
      specificity; while other mammalian amine oxidases oxidize norepinephrine only
      slowly or not at all, EPAO displays significant activity toward this biogenic
      amine.

PMID- 7798895
TI  - Generation of thiyl and ascorbyl radicals in the reaction of peroxynitrite with
      thiols and ascorbate at physiological pH.
AB  - Electron spin resonance (ESR) spin trapping was utilized to investigate the
      reaction of peroxynitrite with thiols and ascorbate at physiological pH. The spin
      trap used was 5,5-dimethyl-1-pyrroline N-oxide (DMPO). The reaction of
      peroxynitrite with DMPO generated 5,5-dimethylpyrrolidone-(2)-oxy-(1) (DMPOX).
      Formate enhanced the peroxynitrite decomposition but did not generate any
      detectable amount of formate-derived free radicals. Thus, the spin trapping
      measurements provided no evidence for hydroxyl (.OH) radical generation in
      peroxynitrite decomposition at physiological pH. Thiols (glutathione, cysteine,
      and penicillamine) and ascorbate reacted with peroxynitrite to generate the
      corresponding thiyl and ascorbyl radicals. The one-electron oxidation of thiols
      by peroxynitrite may be one of the important mechanisms for peroxynitrite-induced
      toxicity and ascorbate may provide a detoxification pathway.

PMID- 7798896
TI  - Chromium toxicity in Neurospora crassa.
AB  - A comparative study has been made on the mechanisms of toxicities of trivalent
      and hexavalent forms of chromium in Neurospora crassa. Of the two forms, Cr6+ is
      more toxic than Cr3+. The toxicity of Cr3+ was found to be due to its specific
      antagonism with iron uptake. Fe3+ was found to be very effective in reversing the
      toxicity of Cr3+ by concomitantly suppressing its uptake. That the Cr3+ toxicity
      caused a conditional intracellular iron deficiency was indicated by the decrease
      in the activities of catalase and uricase and a progressive increase in the
      excretion of iron binding compound into the medium. The toxicity of Cr6+ (as
      Cr2O7(2-)) was found to be due to its specific antagonism of sulfate uptake.
      Methionine was found to be more effective in reversing dichromate toxicity than
      sulfate, probably by repressing the synthesis of sulfate permeases responsible
      for dichromate (Cr6+) uptake. Maximal uptake of Cr6+ was nearly tenfold lower and
      Vmax much higher than that of Cr3+. Evidence has been adduced to show that Cr6+
      and Cr3+ were toxic by themselves and that interconversion between the tri- and
      hexavalent forms of chromium did not occur to any detectable extent.

PMID- 7798897
TI  - Vanadium in ascidians: changes in vanadium coordination and oxidation state upon
      cell lysis.
AB  - Changes in vanadium coordination during cell lysis have been followed by EPR
      spectroscopy of the blood cells of the phleborbranch ascidians Ascidia ceratodes
      and PHallusia julinea. The spectra obtained for A. ceratodes whole blood samples
      can be mainly ascribed to aquated oxovanadium(IV) in which the signals are
      broadened in freshly frozen blood relative to when the cells are lysed by
      thawing. The sources of this broadening are discussed and it is shown that the
      oxovanadium(IV) signal has its origin in a small percentage of damaged or lysed
      cells which release vanadium into a low sulfate, low acid environment in fresh
      samples. When thawed, the cells lyse releasing acid and sulfate into the
      environment of the oxovanadium(IV), with consequent narrowing of the EPR spectral
      linewidth. Freshly frozen P. julinea blood cell samples have EPR spectra with
      parameters intermediate between aquated oxovanadium(IV) and the "type I"
      parameters observed in a previous investigation of tissue samples of this species
      (S. G. Brand, C. J. Hawkins, A. T. Marshall, G. W. Nette, and D. L. Parry, Comp.
      Biochem. Physiol. 93B, 425 (1989)). A. ceratodes tissue samples also have EPR
      spectra that differ from that of the blood. It is suggested that EPR studies on
      tissue samples are more indicative of the resting state of vanadium in the cells
      as there is more physiological material to provide a pH buffering effect to
      stabilize the cells. Schemes are presented which incorporate all of the EPR
      observations in ascidian literature, where cellular lysis is proposed to be
      accompanied by vanadium undergoing oxidation and a series of chelate exchanges
      from a "type I" complex to aquated oxovanadium(IV). Protons released during these
      exchanges are suggested to provide the acidity characteristic of blood cell
      lysates. The biological implications of the concomitant release of vanadium and
      tunichrome (S. W. Taylor, D. L. Parry, C. J. Hawkins, and J. H. Swinehart, Comp.
      Biochem. Physiol. 106A, 531 (1993)) from the blood cells, to the process of wound
      repair are discussed.

PMID- 7798898
TI  - Kinetics of the reaction of platinum(II) complexes with metallothionein.

PMID- 7798899
TI  - Generation of SO3.- and OH radicals in SO3(2-) reactions with inorganic
      environmental pollutants and its implications to SO3(2-) toxicity.
AB  - Electron spin resonance (ESR) spin trapping and high performance liquid
      chromatography (HPLC) with electron chemical detection were utilized to
      investigate the generation of free radicals in reactions of sulfite (SO3(2-))
      with inorganic environmental pollutants. The spin trap used was 5,5-dimethyl-1
      pyrroline N-oxide (DMPO). Incubation of SO3(2-) with nitrite (NO2-) generated
      sulfur trioxide anion radical (SO3.-), whose yield approached saturation levels
      in approximately four minutes. Fe2+ promoted SO3.- formation. Molecular oxygen
      was required for radical generation. This was demonstrated by experiments carried
      out in an argon environment as well as by oxygen consumption measurements.
      Transition metal ions, CrO4(2-), VO2+, Fe3+, Mn2+, Ni2+, and Fe2+ enhanced SO3.-
      generation from SO3(2-) either through direct SO3(2-) oxidation by metal ions or
      by metal ions-catalyzed SO3(2-) oxidation by molecular oxygen. Incubation of
      SO3(2-) with H2O2 generated both SO3.- and .OH radicals as verified by spin
      trapping competition measurements using ethanol and formate as .OH radical
      scavengers. HPLC measurements showed that .OH radicals generated by reaction of
      SO3(2-) with H2O2 caused 2'-deoxyguanine hydroxylation to generate 8-hydroxy-2'
      deoxyguanine, a DNA damage marker. The implications of SO3.- and .OH radical
      formation in relation to SO3(2-) toxicity are discussed.

PMID- 7798901
TI  - Effect of Hg(II) on the spectroscopic properties of DNA bases: circular dichroism
      of deoxyadenosine and thymidine monomers and dimers.
AB  - The addition of Hg(ClO4)2(Hg(II)) to 2'-deoxyadenosine (dA), thymidine (dT), to
      their respective 5'-monophosphates (dAp,dTp) as well as to the dinucleoside
      phosphates 2'-deoxyadenylyl-(3'-->5')-2'-deoxyadenosine (d(ApA)), 2-deoxyadenylyl
      (3'-->5')thymidine(d(ApT)), thymidylyl-(3'-->5')-2'-deoxyadenosine (d(TpA)), and
      thymidylyl-(3'-->5')thymidine (d(TpT))--all dissolved in 0.1 M NaClO4, 5 mM
      cacodylic acid buffer, pH 7--produces major alterations in the circular dichroism
      (CD) of the dimers but no or only small changes in the CD of the monomers. Of
      particular interest are the Hg(II)-induced changes in the CD of d(ApT) and
      d(TpA): they are strongly sequence-dependent and, within reason, progress in a
      "mirror"-like fashion when the concentration of Hg(II) is varied. In the absence
      of Hg(II), the CD of the dimers is conservative (d(TpT)), or near-conservative
      (d(ApA), d(ApT), d(TpA)), but becomes nonconservative upon the addition of
      Hg(II). The rotational strength R of the various Cotton effects of the dimers was
      evaluated as a function of Hg(II) concentration. Features of the CD spectra of
      mercurated d(ApA) and d(TpT) persist in the CD spectra of mercurated
      poly[d(A).(T)], but there is little obvious agreement of the CD spectra of
      mercurated d(ApT) and d(TpA) with the CD of mercurated poly[d(A-T).d(A-T)].

PMID- 7798900
TI  - Iron core formation in horse spleen ferritin: magnetic susceptibility, pH, and
      compositional studies.
AB  - Horse spleen ferritin (HoSF) reconstituted with small iron cores ranging in size
      from 8 to 500 iron atoms was studied by magnetic susceptibility and pH
      measurements to determine when the added Fe3+ begins to aggregate and form
      antiferromagnetically coupled clusters and also to determine the hydrolytic state
      of the iron at low iron loading. The Evans NMR magnetic susceptibility
      measurements showed that at iron loadings as low as 8 Fe3+/HoSF, at least half of
      the added iron atoms were involved in antiferromagnetic exchange interactions and
      the other half were present as isolated iron atoms with S = 5/2. As the core size
      increased to about 24 iron atoms, the antiferromagnetic exchange interactions
      among the iron atoms increased until reaching the limiting value of 3.8 Bohr
      magnetons per iron atom, the value present in holo HoSF. HoSF containing eight or
      more Fe3+ to which eight Fe2+ were added showed that the Fe2+ ions were at sites
      remote from the Fe3+ and that the resulting HoSF consisted of individual,
      noninteracting Fe2+ and the partially aggregated Fe3+. pH measurements for core
      reduction showed that Fe(OH)3 was initially present at all iron loadings but that
      in the absence of iron chelators the reduced iron core is partially hydrolyzed.
      Proton induced x-ray emission spectroscopy showed that Cl- is transported into
      the iron core during reduction, forming a stable chlorohydroxy Fe(II) mineral
      phase.

PMID- 7798902
TI  - Isolation and expression of an arrestin cDNA from the horseshoe crab lateral eye.
AB  - Electrophysiological studies of photoreceptors from the horseshoe crab Limulus
      polyphemus continue to provide fundamental new knowledge of the photoresponse in
      invertebrates. Therefore, it is of particular interest to characterize the
      molecular components of the photoresponse in this system. Here we describe an
      arrestin cloned from a cDNA library constructed using poly(A)+ RNA isolated from
      Limulus lateral eyes. The protein, deduced from the arrestin cDNA, is most
      similar to arrestin from locust antennae (56% identity) and Drosophila phosrestin
      I (53% identity). Limulus arrestin was expressed in a heterologous system, and
      its properties were compared with those of a 46-kDa light-regulated
      phosphoprotein (pp46A) in Limulus photoreceptors described in previous studies
      from this laboratory. Arrestin and pp46A (a) have the same apparent molecular
      weight on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, (b) have an
      isoelectric point in the basic pH range, (c) require calmodulin and elevated Ca2+
      levels for phosphorylation, (d) are immunoreactive with monoclonal antibody
      C10C10 directed against a sequence in bovine arrestin (S-antigen) that is
      perfectly conserved in the deduced arrestin protein, and (e) are associated with
      photoreceptors. We conclude that the arrestin described here and pp46A are the
      same protein. The results of this and previous studies show that in Limulus
      photoreceptors, light regulates the phosphorylation of arrestin in complex ways.

PMID- 7798903
TI  - Activation of metabotropic glutamate receptors prevents neuronal apoptosis in
      culture.
AB  - Cultured granule cells grown in serum-containing medium with a "low K+"
      concentration (10 mM) underwent apoptosis after maturation for 5 days in vitro (5
      DIV), a time that coincides with the developmental decline in the activity of
      metabotropic glutamate receptors (mGluRs) coupled to polyphosphoinositide
      hydrolysis. The mGluR agonist (1S,3R)-1-aminocyclopentane-1,3-dicarboxylic acid
      (1S,3R-ACPD) prevented the development of low K(+)-induced apoptosis and the
      presence of the drug was critical at 6 and 7 DIV, i.e., after the drop of mGluR
      activity. The neuroprotective action of 1S,3R-ACPD was prevented by the mGluR
      antagonist (RS)-alpha-methyl-4-carboxyphenylglycine (MCPG) and was mimicked by N
      methyl-D-aspartate or carbamylcholine but not by agonists of the mGluR subtypes
      negatively linked to adenylyl cyclase. In cultures treated either with Li(+)
      which reduced polyphosphoinositide response to concentrations of glutamate (5
      microM) that approximate those physiologically present in the incubation medium-
      or MCPG, the development of low K(+)-induced apoptosis already occurred at 4 DIV.
      Thus, the activation of mGluRs coupled to polyphosphoinositide hydrolysis by
      endogenous glutamate could contribute to protect cultured granule cells against
      apoptosis during early stages of maturation.

PMID- 7798904
TI  - Developmental characterization of thymosin beta 4 and beta 10 expression in
      enriched neuronal cultures from rat cerebella.
AB  - The beta 4 and beta 10 thymosins are G-actin binding proteins that exhibit
      complex patterns of expression during rat cerebellar development. Their
      expression in vivo is initially high in immature granule cells and diminishes as
      they migrate and differentiate, ceasing altogether by postnatal day 21. Thymosin
      beta 4 is present in a subset of glia throughout postnatal development, and its
      synthesis is also induced in maturing Bergmann glia. In contrast, thymosin beta
      10 is only present at very low levels in a very small subpopulation of glia in
      the adult cerebellum. To study the factors differentially regulating expression
      of the beta-thymosins, we characterized their patterns of expression in primary
      cultures of rat cerebellum. Both beta-thymosins were initially expressed in
      granule cells, although expression, especially of thymosin beta 4, was truncated
      compared with the in vivo time course. As in vivo, thymosin beta 4 was
      synthesized at much higher levels in astrocytes and microglia in cultures from
      postnatal cerebellum than was thymosin beta 10. Unlike in vivo, the latter was
      expressed in glia cultured from fetal cerebellum. The similarities between the in
      vivo and in vitro expression of the beta-thymosins show that modulation of tissue
      culture conditions could be used to identify factors regulating beta-thymosin
      expression in vivo. The differences would identify regulatory mechanisms that are
      not evident from the in vivo studies alone.

PMID- 7798905
TI  - myc-immortalized microglial cells express a functional platelet-activating factor
      receptor.
AB  - The autacoid platelet-activating factor (PAF) takes part in a complex network of
      interactions regarding the cellular components of nervous tissues. Efforts aimed
      at characterizing the effects of PAF in the brain have been recently focalized on
      neurons because PAF exerts pleiotropic effects on these cells. Less attention has
      instead been paid to the glial component of the brain. We have used microglial
      cell lines immortalized from 13-day-old mouse embryo brains by a myc-transducing
      retrovirus. When exposed to physiological doses of PAF, immortalized microglial
      cells showed increases in intracellular free calcium concentrations due to
      release of calcium from internal stores, as well as to extracellular calcium
      influxes. These profiles of reactivity were independent from the immortalizing
      process, being observable in primary microglial cultures and in immortalized
      clones showing different proliferative rates. PAF was also able to induce
      transient expression of the c-fos protooncogene in serum-starved cultures and
      induced a strong chemotactic response in microglial cells. In contrast with
      control macrophage cultures, PAF did not promote prostaglandin or leukotriene
      synthesis in immortalized cells. This was most likely due to the low amount of
      total arachidonic acid found in immortal microglia, with respect to that observed
      in freshly isolated cells. Our data suggest that several of the effects observed
      after PAF stimulation might be independent from PAF-induced arachidonic acid
      metabolism. The availability of an in vitro microglial model might now help in
      studying the proinflammatory effects of PAF, both direct or microglia mediated,
      in the neural environment.

PMID- 7798906
TI  - Melatonin receptor-mediated stimulation of phosphoinositide breakdown in chick
      brain slices.
AB  - The direct effect of melatonin and related agonists on Li(+)-amplified
      phosphoinositide breakdown was studied in chick brain slices prelabeled with myo
      [2-3H]-inositol. The melatonin receptor agonist 6-chloromelatonin (10-100 microM)
      increased, in a concentration-dependent manner, the accumulation of inositol
      phosphates (IP) in chick brain slices. This effect of 6-chloromelatonin (10
      microM) was rapid as transient increases in IP3/IP4 (maximal increase, 29% at 20
      s) and IP2 levels (maximal increase, 36% at 1 min) were observed, followed by a
      slower but sustained increase in IP1 level (30% at 5 min), when the amount of
      IP3/IP4 and IP2 had already been decreased to the control level. The
      phosphoinositide response elicited by 6-chloromelatonin (10 microM) was dependent
      on the presence of extracellular calcium. Direct stimulation of membrane
      phospholipase C by 6-chloromelatonin (10 microM) in isolated myo-[2-3H]inositol
      prelabeled optic tectum membranes was dependent on the presence of guanosine-5'-O
      (3-thio)triphosphate (1 microM), thus suggesting that G protein(s) link melatonin
      receptor activation to phospholipase C stimulation. The competitive melatonin
      receptor antagonist luzindole (10-100 microM) inhibited in a concentration
      dependent manner the IP1 accumulation stimulated by 6-chloromelatonin (10-100
      microM); however, it did not affect the accumulation stimulated by 5
      hydroxytryptamine (10 microM). By contrast, methysergide (10 microM) completely
      inhibited 5-hydroxy-tryptamine (10 microM)-, but not 6-chloromelatonin (10
      microM)-, induced IP1 accumulation. Melatonin receptor agonists increased IP1
      accumulation in a concentration-dependent manner reaching different maximal
      responses.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798907
TI  - Isolation and characterization of a cytosolic phospholipase A2 from bovine
      adrenal medulla.
AB  - We have recently demonstrated that bovine adrenal medulla contains a soluble
      phospholipase A2 (PLA2), which is localized in the cytosol. In the present study,
      this PLA2 was purified 1,097-fold using sequential concanavalin A, hydrophobic
      interaction, anion exchange, gel filtration, and an additional anion exchange
      chromatography. The enzyme is activated over the range of 20-1,000 microM Ca2+
      and has a pH optimum near 8.0. On sodium dodecyl sulfate-polyacrylamide gel
      electrophoresis, the protein has a molecular mass of 26 kDa and an isoelectric
      point of 4.6 as revealed by isoelectric focusing. The cytosolic PLA2 is not
      inhibited by NaCl, and the enzymatic activity is stimulated at low concentrations
      of Triton X-100 (0.01%) and deoxycholate (1 mM) but inhibited at higher
      concentrations (0.1% and 3 mM, respectively) of these detergents. Furthermore,
      heat treatment (57 degrees C, 5 min) reduced the enzymatic activity by 80%,
      whereas glycerol (30%) increased the activity. p-Bromophenacylbromide, a
      frequently used irreversible inhibitor of type II PLA2, has little effect until
      100 microM, and 2-10 mM dithiothreitol totally inactivated the enzyme. The
      purified PLA2 displays a preference for phosphatidylcholine as a substrate but
      hydrolyzes phospholipid substrates with arachidonic acid or linoleic acid
      esterified at the sn-2 position to the same extent. It is concluded that the
      chromaffin cell cytosolic PLA2, which was isolated and characterized in this
      study, represents a type of PLA2 that has not been formerly reported in
      chromaffin cells. Additional research on the chromaffin cell cytosolic PLA2 will
      help to reveal whether the enzyme is important for exocytosis.

PMID- 7798908
TI  - Characterization and distribution of a cloned rat mu-opioid receptor.
AB  - We have cloned and expressed a rat brain cDNA, TS11, that encodes a mu-opioid
      receptor based on pharmacological, physiological, and anatomical criteria.
      Membranes were prepared from COS-7 cells transiently expressing TS11 bound
      [3H]diprenorphine with high affinity (KD = 0.23 +/- 0.04 nM). The rank order
      potency of drugs competing with [3H]diprenorphine was as follows: levorphanol (Ki
      = 0.6 +/- 0.2 nM) approximately beta-endorphin (Ki = 0.7 +/- 0.05 nM)
      approximately morphine (Ki = 0.8 +/- 0.5 nM) approximately [D-Ala2, N-Me-Phe4,Gly
      ol5]-enkephalin (DAMGO; Ki = 1.6 +/- 0.5 nM) uch much greater than U50,488 (Ki =
      910 +/- 0.78 nM) > [D-Pen2,5]- enkephalin (Ki = 3,170 +/- 98 nM) > dextrorphan
      (Ki = 4,100 +/- 68 nM). The rank order potencies of these ligands, the
      stereospecificity of levorphanol, and morphine's subnanomolar Ki are consistent
      with a mu-opioid binding site. Two additional experiments provided evidence that
      this opioid-binding site is functionally coupled to G proteins: (a) in COS-7
      cells 50 microM 5'-guanylylimidodiphosphate shifted a fraction of receptors with
      high affinity for DAMGO (IC50 = 3.4 +/- 0.5 nM) to a lower-affinity state (IC50 =
      89.0 +/- 19.0 nM), and (b) exposure of Chinese hamster ovary cells stably
      expressing the cloned mu-opioid receptor to DAMGO resulted in a dose-dependent,
      naloxone-sensitive inhibition of forskolin-stimulated cyclic AMP production. The
      distribution of mRNA corresponding to the mu-opioid receptor encoded by TS11 was
      determined by in situ hybridization to brain sections prepared from adult female
      rats. The highest levels of mu-receptor mRNA were detected in the thalamus,
      medial habenula, and the caudate putamen; however, significant hybridization was
      also observed in many other brain regions, including the hypothalamus.

PMID- 7798909
TI  - Uptake and release of D-aspartate, GABA, and glycine in guinea pig brainstem
      auditory nuclei.
AB  - This study attempts to determine if the medial (MSO) and lateral superior olive
      (LSO), medial nucleus of the trapezoid body (MNTB), ventral nucleus of the
      lateral lemniscus (VNLL), and central nucleus of the inferior colliculus (ICc)
      contain glutamatergic synaptic endings. Micropunch and microdissection procedures
      provided fresh samples of these auditory nuclei for the measurement of the high
      affinity uptake and electrically evoked release of exogenous D-[3H]ASP. The study
      also determined if the LSO and MSO contain glycinergic synaptic endings by
      measuring uptake and release of [14C]Gly in these nuclei, and whether the MNTB,
      VNLL, and ICc contain GABAergic endings by assessing the uptake and release of
      [14C]GABA in these structures. Several strategies optimized the evoked Ca(2+)
      dependent release of the labeled amino acids. These included the enhancement of
      high-affinity uptake during loading of the markers into the tissues, inhibition
      of uptake during the subsequent measurement of release, and use of an electrical
      stimulus current that evoked maximal Ca(2+)-dependent release. Each of these
      nuclei manifested the high-affinity uptake and the evoked Ca(2+)-dependent
      release of D-[3H]Asp, suggesting the presence of synaptic endings that may use
      Glu or Asp as a transmitter. Similar findings suggest the presence of glycinergic
      synaptic endings in the LSO and MSO, and of GABAergic synaptic endings in the
      MNTB, VNLL, and ICc.

PMID- 7798911
TI  - Persistent enhancement of sustained calcium-dependent glutamate release by
      phorbol esters: requirement for localized calcium entry.
AB  - Sustained activation of protein kinase C significantly enhanced a secondary
      (slow) phase in the depolarization-induced release of glutamate from isolated
      hippocampal nerve endings. The phorbol ester, 4 beta-phorbol 12,13-dibutyrate,
      was used to sustain the activation of presynaptic protein kinase C for a
      prolonged (10-min) period, and then this relatively water-soluble phorbol ester
      was removed by superfusion before a 2-min stimulus of continuous membrane
      depolarization. These conditions were used to investigate the persistent effects
      of sustained protein kinase C activation on the magnitude of the slow phase of
      evoked glutamate release, in which the efficiency of synaptic vesicle
      mobilization and recycling may be primary determinants of response magnitude. It
      is reported here that sustained protein kinase C activation selectively increased
      the Ca(2+)-dependent component of glutamate release during a prolonged phase of
      K(+)-induced depolarization. The magnitude of this persistent effect on Ca(2+)
      dependent glutamate release was directly related to the dose of 4 beta-phorbol
      12,13-dibutyrate and the duration of exposure that was used to prime the release
      apparatus, was observed using two alternative synaptosomal preparations, and was
      evident regardless of the depolarizing stimulus used (elevated [KCl] or 4
      aminopyridine). However, 4 beta-phorbol 12,13-dibutyrate did not alter the
      release induced by the Ca2+ ionophore ionomycin. Thus, the persistent effects of
      protein kinase C activation on a prolonged phase of glutamate release were
      dependent on the route of Ca2+ influx. The finding that voltage-regulated Ca2+
      channel blockers were able to neutralize completely the 4 beta-phorbol 12,13
      dibutyrate-dependent facilitation of K(+)-evoked glutamate release provided
      further support for this conclusion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798910
TI  - Evidence for glutamatergic projections from the cochlear nucleus to the superior
      olive and the ventral nucleus of the lateral lemniscus.
AB  - This study attempts to determine if projections ascending from the guinea pig
      cochlear nucleus (CN) could be glutamatergic and/or aspartatergic. Multiple radio
      frequency lesions were made to ablate the right CN. The ablation was verified
      histologically. To identify the principal targets of CN efferents, silver
      impregnation methods were used to localize the preterminal degeneration of fibers
      in transverse sections of the brainstem 5 and 7 days after CN ablation. CN
      efferents projected heavily to the lateral superior olive (LSO) ipsilaterally,
      the medial superior olive (MSO) bilaterally, and contralaterally to the medial
      (MNTB) and ventral (VNTB) nuclei of the trapezoid body, the ventral (VNLL) and
      intermediate nuclei of the lateral lemniscus and the central nucleus of the
      inferior colliculus (ICc). There were smaller projections to the lateral nucleus
      of the trapezoid body ipsilaterally, the dorsal and dorsomedial periolivary
      nuclei bilaterally, and the dorsal nucleus of the lateral lemniscus
      contralaterally. There were sparse projections to the VNLL and ICc ipsilaterally
      and the CN contralaterally, and a very sparse projection to the contralateral
      LSO. To determine if CN efferents were glutamatergic and/or aspartatergic, the
      fresh brainstem was sectioned transversely and samples of the LSO, MSO, MNTB,
      VNLL, and ICc were taken to measure the electrically evoked release and the
      uptake of D-[3H]Asp and [14C]Gly or [14C]GABA 3-5 days after the CN ablation. The
      release studies suggest that only certain of the histologically identified
      projections ascending from the CN may be glutamatergic and/or aspartatergic. CN
      ablation depressed D-[3H]Asp release in the MSO bilaterally and in the
      contralateral MNTB and VNLL, suggesting that the CN efferents to these nuclei may
      use glutamate or aspartate as a transmitter. It was unclear whether a marginal
      depression of D-[3H]Asp release in the ipsilateral LSO reflected the presence of
      glutamatergic CN projections to this nucleus. D-[3H]Asp release in the ICc was
      unaffected, suggesting that CN efferents to this nucleus may not be
      glutamatergic. There were no deficits in D-[3H]Asp uptake. [14C]Gly release from
      the LSO and MSO was unchanged. [14C]Gly uptake was unchanged in the MSO and
      depressed only in the contralateral LSO, possibly reflecting subnormal uptake
      activity in endings contributed by contralateral MNTB cells that had lost their
      CN efferents.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7798912
TI  - Persistent enhancement of sustained calcium-dependent glutamate release by
      phorbol esters: role of calmodulin-independent serine/threonine phosphorylation
      and actin disassembly.
AB  - The phorbol ester 4 beta-phorbol 12,13-dibutyrate increases the final extent of
      Ca(2+)-dependent glutamate release during the continuous depolarization of the
      synaptosomal plasma membrane. Based on this finding, we suggested that the
      sustained activation of protein kinase C has a positive influence on the
      efficiency of synaptic vesicle recycling in the presence of saturating
      concentrations of Ca2+. Previous work from our laboratory demonstrated that this
      4 beta-phorbol 12,13-dibutyrate-dependent enhancement of synaptic vesicle
      recycling persists following the removal of 4 beta-phorbol 12,13-dibutyrate,
      requires localized Ca2+ entry through voltage-regulated channels, and is
      insensitive to the protein kinase inhibitor staurosporine. In the present study,
      we examined the possibility that the facilitation of glutamate release may be
      propagated through interactions between the protein kinase C- and multifunctional
      Ca2+/calmodulin-dependent protein kinase pathways. However, our data argue
      strongly against the involvement of such a mechanism in the persistent
      enhancement of sustained glutamate release. We observed that 4 beta-phorbol 12,13
      dibutyrate did not increase the availability of cytosolic free calmodulin or the
      level of autonomous Ca2+/calmodulin-dependent protein kinase activity. In
      addition, we determined the effects of various serine/threonine kinase and
      phosphatase inhibitors on the phorbol ester-dependent enhancement of sustained
      glutamate release and found that protein kinase C increased the extent, but not
      the duration, of Ca(2+)-dependent glutamate release through a kinase-independent
      mechanism. Given our finding that the actin-depolymerizing agent cytochalasin D
      totally occluded the eb1ect of 4 beta-phorbol 12,13-dibutyrate on release, we
      postulate that protein kinase C signals may be transduced through direct
      interactions between protein kinase C isoforms and cytoskeletal protein kinase C
      binding proteins.

PMID- 7798914
TI  - Serotonin 5-HT2C receptor stimulates cyclic GMP formation in choroid plexus.
AB  - The serotonin 5-HT2C receptor (formerly designated the 5-HT1C receptor) of the
      choroid plexus triggers phosphoinositide turnover. In the present study, we
      demonstrate that receptor activation also triggers the formation of cyclic GMP
      (cGMP). Application of 1 microM 5-HT to porcine choroid plexus tissue slices
      resulted in stimulation of cGMP formation to a maximum of five-fold basal level,
      with an EC50 of 11 nM. This response was not inhibited by muscarinic or beta
      adrenergic receptor antagonists. Serotonin receptor antagonists inhibited cGMP
      formation with apparent Ki values of 1.3 (mianserin), 200 (ketanserin), and 5,500
      (spiperone) nM, respectively. Neither serotonin-stimulated cGMP formation nor PI
      turnover was inhibited by pertussis toxin pretreatment. Preliminary biochemical
      studies suggested that serotonin-stimulated cGMP formation was calcium,
      phospholipase A2, and lipoxygenase dependent, as incubation in low calcium
      buffers or inclusion of the phospholipase A2 or lipoxygenase inhibitors p
      bromophenacylbromide or BW 755c resulted in significant reduction of cGMP
      formation. The present results suggest that in addition to triggering
      phosphoinositide turnover, choroid plexus serotonin 5-HT2C receptors trigger cGMP
      formation in a calcium-sensitive manner.

PMID- 7798913
TI  - Dopamine transporter-dependent and -independent endogenous dopamine release from
      weaver mouse striatum in vitro.
AB  - The weaver mutant mouse (wv/wv) has an approximately 70% loss of nigrostriatal
      dopamine (DA) neurons, but the fractional DA release evoked by amphetamine (but
      not a high potassium level) has been shown to be greater from striatal slices of
      the weaver compared with +/+ mice. In the present work we tested the hypothesis
      that fractional DA release from weaver striatum would be greater when release was
      mediated by the DA transporter. Serotonin (5-HT)-stimulated fractional DA release
      was greater from weaver than from +/+ striatum. The release evoked by 5-HT in the
      presence of 10 microM nomifensine (an antagonist of the DA transporter) was less
      than in its absence, but the difference between weaver and +/+ striatum remained.
      In the presence of nomifensine, 1-(m-chlorophenyl)biguanide, classified as a 5
      HT3 agonist, also induced a greater fractional release from weaver compared with
      +/+ striatum. When veratridine was used at a low concentration (1 microM), the
      fractional evoked release of DA was higher from the weaver in the presence and
      absence of nomifensine. These findings suggest that the reason for the difference
      in the responsiveness of the two genotypes to these release-inducing agents is
      not related to DA transporter function.

PMID- 7798915
TI  - Glucocorticoids enhance histamine-evoked catecholamine secretion from bovine
      chromaffin cells.
AB  - The synthetic glucocorticoid dexamethasone enhanced histamine-evoked
      catecholamine secretion from cultured bovine chromaffin cells. Dexamethasone
      enhanced the effects of histamine on both adrenergic (epinephrine-rich) and
      noradrenergic (norepinephrine-rich) chromaffin cells but had a more dramatic
      effect on noradrenergic cells. Histamine-evoked secretion in noradrenergic cells
      appeared to become rapidly inactivated, whereas the rate of secretion in
      adrenergic cells was nearly constant for up to 2 h; dexamethasone treatment
      attenuated the inactivation seen in noradrenergic cells. The effect of
      dexamethasone appeared after a lag of several hours and was maximal by 24 h. The
      EC50 for dexamethasone was approximately 1 nM. The effect of dexamethasone was
      mimicked by the glucocorticoid agonist RU 28362 and was blocked by the antagonist
      RU 38486, indicating that the effects of these steroids were mediated by the
      glucocorticoid or type II corticosteroid receptor. Histamine-evoked catecholamine
      secretion in both dexamethasone-treated and untreated cells was blocked by the H1
      histamine receptor antagonist mepyramine but was not affected by the H2
      antagonist cimetidine; thus, dexamethasone appeared to enhance an H1 receptor
      mediated process. In the absence of glucocorticoids, H1 receptor mRNA levels were
      higher in adrenergic than in noradrenergic cells. Dexamethasone increased H1
      receptor mRNA levels in both cell types. The increased expression of H1 receptors
      presumably contributes to the enhancement of histamine-evoked catecholamine
      secretion by glucocorticoids. Glucocorticoids may play a physiological role in
      modulating the responsiveness of chromaffin cells to histamine and other stimuli.

PMID- 7798916
TI  - Nerve growth factor amplifies cyclic AMP production in the HT4 neuronal cell
      line.
AB  - There has been considerable interest and controversy in the relationship between
      nerve growth factor (NGF) and the cyclic AMP (cAMP) second messenger system. We
      have used a novel, neuronal cell line (HT4) to investigate the effect of NGF on
      the adenylyl cyclase signaling system. Treatment of cells with NGF (100 ng/ml, 15
      min) amplified cAMP accumulation (approximately 75%) in response to activation of
      adenosine A2 receptors (5 min) with 5'-N-ethylcarboxamidoadenosine or activation
      of adenylyl cyclase directly with forskolin. Basal cAMP accumulation was not
      altered by NGF. This amplification appears to be mediated by activation of
      protein kinase C (PKC) because (1) it was mimicked by activators (phorbol esters
      and a diacylglycerol analogue) of PKC, (2) the effects of NGF and phorbol ester
      on cAMP accumulation were not additive, (3) NGF amplification of cAMP
      accumulation was abolished by down-regulation of PKC, (4) NGF increased cytosolic
      PKC activity, and (5) inhibitors of PKC blocked the NGF-induced amplification of
      cAMP accumulation. Although NGF-induced amplification of cAMP accumulation was
      dependent upon PKC, mechanisms other than the classic activation pathway (i.e.,
      hydrolysis of inositol phospholipids or the production of diacylglycerol)
      appeared to mediate PKC activation by NGF. The tyrosine kinase inhibitor,
      lavendustin A, blocked NGF-mediated amplification of cAMP accumulation,
      suggesting a novel interaction between a tyrosine kinase and protein kinase C.

PMID- 7798917
TI  - Intracerebral dialysis and the blood-brain barrier.
AB  - The aim of the study was to evaluate how implantation of a dialysis probe
      influences the blood-brain barrier. Leakage of endogenous serum albumin was
      evaluated by Evans blue/albumin staining and by immunohistochemistry. The passage
      from blood to dialysate of two substances that normally do not pass into the
      brain, [3H]-inulin and glutamate, was studied 3 and 24 h after insertion of a
      dialysis probe. Evans blue, given 20 min before rats were killed, was observed
      around the probe and surrounding brain tissue. Albumin immunoreactivity was seen
      at considerable distance from the probe with larger spread at 24 h than at 3 h
      after probe insertion. Glutamate and [3H]inulin were detected in the dialysate
      with no significant further increase of radioactivity after intracarotid infusion
      of protamine sulfate that enhances the permeability over the blood-brain barrier.
      When protamine was followed by infusion of glutamate, the concentrations of
      taurine increased in the dialysate in four of eight rats. That plasma
      constituents have access to the brain around the dialysis probe is essential to
      consider, particularly in studies using substances and drugs that do not pass an
      intact blood-brain barrier.

PMID- 7798918
TI  - Heat-shock 70 messenger RNA levels in human brain: correlation with agonal fever.
AB  - Systematic review of antemortem clinical information on randomly selected
      Alzheimer disease (AD) patients revealed that approximately 40% of the patients
      had a recorded fever of > or = 39.2 degrees C at or near death. Using isolation
      and quantitation techniques appropriate for analysis of human brain mRNAs, we
      found that low levels of inducible heat-shock protein 70 (hsp70) mRNAs were
      present in cerebellum of afebrile AD patients and that mRNA levels were usually
      lower in two brain regions affected in AD, i.e., hippocampus and temporal cortex.
      Levels of hsp70 mRNAs were increased three- to 33-fold in cerebellum of febrile
      patients compared with levels in patients whose recorded temperatures were < or =
      37.5 degrees C. Levels of hsp70 mRNAs were also increased in hippocampus and
      cortex of these febrile patients, but to a lesser extent than cerebellum. Heat
      shock cognate 70 (hsc70) mRNAs were present at highest levels in afebrile
      cerebellum and were also present in the other brain regions. In cerebellum of
      patients with the highest temperatures, hsc70 mRNAs were induced severalfold over
      basal levels. Although there was a low and variable induction of hsc70 mRNAs in
      temporal cortex of these patients, there was no evidence for any induction in
      hippocampus. Increased heat-shock 70 mRNA levels did not correlate with hypoxia,
      coma, hypertension, hypoglycemia, seizures, or medication. These results indicate
      that a specific agonal stress, namely fever, can increase the levels of heat
      shock 70 mRNAs in AD brain; however, there is no evidence to suggest that
      affected regions of AD brain have higher overall levels of these mRNAs. Failure
      to obtain adequate agonal state information could result in inaccurately
      identifying short-term stress-related changes in postmortem brain as
      neuropathology characteristic of a chronic disease state.

PMID- 7798919
TI  - Loss of protein kinase C-alpha beta in brain of heroin addicts and morphine
      dependent rats.
AB  - The biochemical status of human brain protein kinase C (PKC)-alpha beta during
      opiate dependence was studied by means of immunoblotting techniques in postmortem
      brain of heroin addicts who had died by opiate overdose. In the frontal cortex, a
      marked decrease (53%, p < 0.05) in the immunoreactivity of PKC-alpha beta was
      found in heroin addicts compared with matched controls. The loss of PKC-alpha
      beta in the brain of human addicts paralleled that observed in the frontal cortex
      of rats after chronic treatment with morphine (10-100 mg/kg i.p. for 5 days) (PKC
      alpha beta decreased by 34%, p < 0.05). Chronic treatment with naloxone (1 mg/kg
      i.p. every 12 h for 5 days) did not alter PKC-alpha beta immunoreactivity in the
      rat brain. However, in morphine-dependent rats, naloxone-precipitated withdrawal
      induced a rapid and strong behavioral reaction with a concomitant up-regulation
      of PKC-alpha beta immunoreactivity to control values. These results indicated
      that the decrease of brain PKC-alpha beta induced by heroin/morphine is a mu
      opioid receptor-mediated effect. The chronic administration of opiates has been
      associated with a marked sensitization of the adenylyl cyclase/cyclic AMP system,
      although this phenomenon is not exclusive of the opioid system but the general
      cellular adaptation to chronic inhibition of adenylyl cyclase. In this context,
      chronic treatment of rats with other inhibitory agonists (e.g., clonidine, 1
      mg/kg i.p. every 12 h for 14 days) acting through receptors (e.g., alpha 2
      adrenoceptors) also coupled to adenylyl cyclase did not alter brain PKC-alpha
      beta immunoreactivity.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798920
TI  - Mutagenesis of rat dopamine beta-hydroxylase: examination in cell-free system.
AB  - Dopamine beta-hydroxylase (DBH; EC 1.14.17.1) exists as membrane-bound and
      soluble forms in neurosecretory vesicles. The features of DBH required for
      glycosylation and incorporation into membranes were studied in a cell-free
      system. Translation of full-length DBH with microsomal membranes generated two
      glycosylated products (GH and GL) depending on the magnesium concentration.
      Carboxyl-terminal, in contrast to amino-terminal, truncations gave translation
      products that were glycosylated by microsomal membranes. Site-directed mutants
      were generated with the second AUG codon and the region of a putative signal
      sequence cleavage site modified. Translation without membranes indicated that the
      second AUG is not used to initiate translation. The mutant with Glu41-->Leu41 and
      Ser43-->Thr43 yielded only the GH form with membranes, whereas mutation of Ser43-
      >Ala43 generated both GH and GL forms. Both glycosylated forms comigrated with
      the microsomal membranes on sucrose gradients. Endoglycosidase H digestion
      indicated that the differences between the GH and GL forms are not due to the
      sugar moiety. The results suggest a role for cleavage of a signal sequence in the
      formation of different forms of DBH. The possibility that these mutations change
      the secondary structure near the signal cleavage site, affecting processing, is
      discussed.

PMID- 7798922
TI  - Inflammatory mediator stimulation of astrocytes and meningeal fibroblasts induces
      neuronal degeneration via the nitridergic pathway.
AB  - The role of inflammatory cytokines in the pathogenesis of neurological disorders
      is not entirely clear. The neurotoxic effects of cytokines, and perhaps
      indirectly bacterial endotoxins, could be mediated by the stimulation of
      immunocompetent cells in the brain to produce toxic concentrations of nitric
      oxide (NO) and reactive nitrogen oxides. NO is a short-lived, diffusible molecule
      that has a variety of biological activities including vasorelaxation,
      neurotransmission, and cytotoxicity. Both constitutive and inducible NO synthase
      has been described in astrocytes in vitro. Here we demonstrate that newborn mouse
      cortical astrocytes, when coincubated with neonatal mouse cerebellar granule
      cells or hippocampal neurons, induced neurotoxicity upon stimulation with
      endotoxin (lipopolysaccharide) (ED50 30 ng/ml). Astrocytes were unresponsive to
      the cytokines tumor necrosis factor-alpha or interleukin-1 beta individually, but
      exhibited a marked synergistic stimulation in their combined presence. Moreover,
      meningeal fibroblasts treated with tumor necrosis factor-alpha, but not
      interleukin-1 beta or lipopolysaccharide, elaborated neurotoxicity for cocultured
      granule cells (ED50 30 U/ml). In cocultures of immunostimulated astrocytes or
      meningeal fibroblasts, neurotoxicity was blocked by the NO synthase inhibitors N
      omega-nitro-L-arginine and N omega-nitro-D-arginine methyl ester, and by
      oxyhemoglobin, which inactivates NO. Astroglial-induced neurotoxicity was not
      affected by N-methyl-D-aspartate receptor antagonists. Superoxide dismutase,
      which degrades superoxide anion, attenuated astrocyte- and fibroblast-mediated
      neurotoxicity, indicating that endogenous superoxide anion may react with NO to
      form toxic peroxynitrite and its breakdown products. These findings suggest a
      potentially important role for glial- and meningeal fibroblast-induced NO
      synthase in the pathophysiology of CNS disease states of immune or inflammatory
      origin.

PMID- 7798921
TI  - Structure-activity analyses of beta-amyloid peptides: contributions of the beta
      25-35 region to aggregation and neurotoxicity.
AB  - The neurodegeneration of Alzheimer's disease has been theorized to be mediated,
      at least in part, by insoluble aggregates of beta-amyloid protein that are widely
      distributed in the form of plaques throughout brain regions affected by the
      disease. Previous studies by our laboratory and others have demonstrated that the
      neurotoxicity of beta-amyloid in vitro is dependent upon its spontaneous adoption
      of an aggregated structure. In this study, we report extensive structure-activity
      analyses of a series of peptides derived from both the proposed active fragment
      of beta-amyloid, beta 25-35, and the full-length protein, beta 1-42. We examine
      the effects of amino acid residue deletions and substitutions on the ability of
      beta-amyloid peptides to both form sedimentable aggregates and induce toxicity in
      cultured hippocampal neurons. We observe that significant levels of peptide
      aggregation are always associated with significant beta-amyloid-induced
      neurotoxicity. Further, both N- and C-terminal regions of beta 25-35 appear to
      contribute to these processes. In particular, significant disruption of peptide
      aggregation and toxicity result from alterations in the beta 33-35 region. In
      beta 1-42 peptides, aggregation disruption is evidenced by changes in both
      electrophoresis profiles and fibril morphology visualized at the light and
      electron microscope levels. Using circular dichroism analysis in a subset of
      peptides, we observed classic features of beta-sheet secondary structure in
      aggregating, toxic beta-amyloid peptides but not in nonaggregating, nontoxic beta
      amyloid peptides. Together, these data further define the primary and secondary
      structures of beta-amyloid that are involved in its in vitro assembly into
      neurotoxic peptide aggregates and may underlie both its pathological deposition
      and subsequent degenerative effects in Alzheimer's disease.

PMID- 7798923
TI  - Persistent translocation of Ca2+/calmodulin-dependent protein kinase II to
      synaptic junctions in the vulnerable hippocampal CA1 region following transient
      ischemia.
AB  - The influence of brain ischemia on the subcellular distribution and activity of
      Ca2+/calmodulin-dependent protein kinase II (CaM kinase II) was studied in
      various cortical rat brain regions during and after cerebral ischemia. Total CaM
      kinase II immunoreactivity (IR) and calmodulin binding in the crude synaptosomal
      fraction of all regions studied increase but decrease in the microsomal and
      cytosolic fractions, indicative of a translocation of CaM kinase II to
      synaptosomes. The translocation of CaM kinase II to synaptic junctions occurs but
      not to synaptic vesicles. The translocation in neocortex and CA3/DG (dentate
      gyrus) is transient, whereas in the hippocampal CA1 region, it persists for at
      least 1 day of reperfusion. The Ca2+/calmodulin-dependent activity of CaM kinase
      II in the subsynaptosomal fractions of neocortex is persistently decreased by up
      to 85%, despite the increase in CaM kinase II IR. The decrease in activity is
      more pronounced than the decline in IR, suggesting that CaM kinase II is
      covalently modified in the postischemic phase. The persistent translocation of
      CaM kinase II in the vulnerable ischemic CA1 region indicates that a pathological
      process is sustained in the area after the reperfusion phase and this may be of
      significance for ischemic brain injury.

PMID- 7798924
TI  - Time-related cortical amino acid changes after basal forebrain lesion: a
      microdialysis study.
AB  - Cholinergic basal forebrain (BF) lesions in experimental animals have been used
      as a potential model for cholinergic deficits in cortex and hippocampus that
      occur in normal aging and Alzheimer's disease (AD). Glutamatergic cortical
      neurons are also affected in AD and could be part of the neurodegenerative
      process. In the present study, the effect of bilateral BF lesion with ibotenic
      acid microinjection on cortical extracellular amino acid levels was determined.
      Samples were collected every 20 min with microdialysis probes in awake, freely
      moving rats under basal and potassium stimulation conditions and measured by HPLC
      with fluorescence detection. Microdialysis experiments were performed 13 days, 21
      days, and 30 days after BF lesion. The effectiveness of the lesion was shown by a
      significant 30% depletion in acetyl-CoA:choline O-acetyltransferase (EC 2.3.1.6)
      activity in the frontal cortex. Under basal conditions at 13 days only
      extracellular levels of taurine (Tau) and Glu were significantly reduced. Tau and
      Glu levels were recovered after 21 days and 30 days, respectively. In contrast,
      increase in Gly levels reaches its significance only at 30 days after lesion.
      Significant increases of Gln levels were observed at 21 days and 30 days. Asp and
      Ser levels remained constant throughout the period studied. Potassium stimulation
      led to increased Asp, Glu, Gly, and Tau levels, whereas Gln content decreased and
      Ser remained unaltered. As Ser is not believed to be a neurotransmitter, its lack
      of variation in any of the experimental conditions studied supports specific
      neuronal changes of the other amino acids. Results are discussed with reference
      to data observed in AD patients and possible mechanisms underlying the changes
      are suggested.

PMID- 7798925
TI  - Comparison of postasphyxial resuscitation with 100% and 21% oxygen on cortical
      oxygen pressure and striatal dopamine metabolism in newborn piglets.
AB  - The present study tests the hypothesis that ventilation with 100% O2 during
      recovery from asphyxia leads to greater disturbance in brain function, as
      measured by dopamine metabolism, than does ventilation with 21% oxygen. This
      hypothesis was tested using mechanically ventilated, anesthetized newborn piglets
      as an animal model. Cortical oxygen pressure was measured by the oxygen-dependent
      quenching of phosphorescence, striatal blood flow by laser Doppler, and the extra
      cellular levels of dopamine and its metabolites by in vivo microdialysis. After
      establishment of a baseline, both the fraction of inspired oxygen (FiO2) and the
      ventilator rate were reduced in a stepwise fashion every 20 min over a 1-h
      period. For the subsequent 2-h recovery, the animals were randomized to breathing
      21 or 100% oxygen. It was observed that during asphyxia cortical oxygen pressure
      decreased from 36 to 7 torr, extracellular dopamine increased 8,300%, and
      dihydroxyphenylacetic acid and homovanillic acid decreased by 65 and 60%,
      respectively, compared with controls. During reoxygenation after asphyxia,
      cortical oxygen pressure was significantly higher in the piglets ventilated with
      100% oxygen than in those ventilated with 21% oxygen (19 vs. 11 torr). During the
      first hour of reoxygenation, extracellular dopamine levels decreased to
      approximately 200% of control in the 21% oxygen group, whereas these levels were
      still much higher in the 100% oxygen group (approximately 500% of control). After
      approximately 2 h of reoxygenation, there was a secondary increase in
      extracellular dopamine to approximately 750 and approximately 3,000% of baseline
      for the animals ventilated with 21 and 100%, respectively.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7798927
TI  - Iron levels modulate alpha-secretase cleavage of amyloid precursor protein.
AB  - The amyloid precursor protein (APP) is a membrane-spanning glycoprotein that is
      the source of beta A4 peptides, which aggregate in Alzheimer's disease to form
      senile plaques. APP is cleaved within the beta A4 sequence to release a soluble N
      terminal derivative (APPsol), which has a wide range of trophic and protective
      functions. In the current study we have examined the hypothesis that iron
      availability may modulate expression or processing of APP, whose mRNA contains,
      based on sequence homology, a putative iron response element (IRE). Radiolabeled
      APP and its catabolites were precipitated from lysates and conditioned medium of
      stably transfected HEK 293 cells using antibodies selective for C-terminal, beta
      A4, and N-terminal domains. The relative abundance of the different APP
      catabolites under different conditions of iron availability was determined by
      quantitative densitometry after separation by sodium dodecyl sulfate
      polyacrylamide gel electrophoresis. The data show a specific effect on the
      production of APPsol. Using standard conditions previously established for IRE
      studies, it was found that iron chelation reduces APPsol production, whereas iron
      level elevation augments it. No changes were observed in levels of immature and
      mature APP holoprotein or in the C-terminal alpha-secretase derivative C83, beta
      A4, and p3 peptides. The specificity for modulatory changes in APPsol suggests
      that iron acts at the level of alpha-secretase activity. In addition to its
      modulatory effects, iron at very high levels was found to inhibit maturation of
      APP and production of its downstream catabolites without blocking formation of
      immature APP. The data establish a potential physiological role for iron in
      controlling the processing of APP.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798926
TI  - Structural characterization by affinity cross-linking of glucagon-like peptide
      1(7-36)amide receptor in rat brain.
AB  - Specific binding of glucagon-like peptide (GLP)-1(7-36)amide was detected in
      several rat brain areas, with the highest values being found in hypothalamic
      nuclei and the nucleus of the solitary tract. In hypothalamus and brainstem
      homogenate binding of 125I-GLP-1(7-36)amide was time, temperature, and protein
      content dependent and was inhibited by unlabeled proglucagon-derived peptides.
      The rank order of potency was GLP-1(7-36)amide >> GLP-1(1-36)amide > GLP-1(1-37)
      approximately equal to GLP-2 > glucagon. Scatchard analysis of the steady-state
      binding data was consistent with the presence of both high- and low-affinity
      binding sites in hypothalamus and brainstem. Brain 125I-GLP-1(7-36)amide-binding
      protein complexes were covalently cross-linked using disuccinimidyl suberate and
      analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. A single
      radiolabeled band of M(r) 56,000 identified in both hypothalamus and brainstem
      homogenates was unaffected by reducing agents. An excess of unlabeled GLP-1(7
      36)amide abolished the band labeling, whereas glucagon had no effect. Other
      unlabeled GLPs inhibited M(r) 56,000 complex labeling with the following order of
      potency: GLP-1(1-36)amide > GLP-1(1-37) > GLP-2. The binding of 125I-GLP-1(7
      36)amide and the intensity of the cross-linked band were similarly inhibited in a
      dose-response manner by increasing concentrations of unlabeled GLP-1(7-36)amide.
      Covalent M(r) 56,000 125I-GLP-1(7-36)amide-binding protein complexes solubilized
      by Triton X-100 were adsorbed onto wheat germ agglutinin.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7798928
TI  - Evaluation of potential effectors of agonal glycolytic rate in developing brain
      measured in vivo by 31P and 1H nuclear magnetic resonance spectroscopy.
AB  - Previously we have shown that hypercarbia produces a larger decrease in agonal
      glycolytic rate in 1-month-old swine than in newborns. In an effort to understand
      the mechanism responsible for this difference, we tested the hypothesis that
      hypercarbia produces age-related changes in the concentration of one or more
      effectors of phosphofructokinase activity. Specifically, in vivo 31P and 1H NMR
      spectroscopy was used to compare changes in lactate levels, intracellular pH,
      free magnesium concentration, and content of phosphorylated metabolites for these
      two age groups at three intervals during the first 1.5 min of complete ischemia
      in the presence or absence of hypercarbia (PaCO2 = 102-106 mm Hg). Hypercarbia
      produced the same drop in intracellular brain pH for both age groups, but the
      decrease in phosphocreatine level and increase in inorganic phosphate content
      were greater in 1-month-olds compared with newborns. During ischemia there was no
      difference between the magnitude of change in intracellular pH and levels of
      phosphocreatine and inorganic phosphate in hypercarbic 1-month-olds versus
      newborns. Under control conditions, i.e., normocarbia and normoxia, the free Mg2+
      concentration was lower and the fraction of magnesium-free ATP was higher for
      newborns than 1-month-olds. However, there was no change in these variables for
      either age group during hypercarbia and early during ischemia. Thus, age-related
      differences in the relative decrease in agonal glycolytic rate during hypercarbia
      could not be explained by differences in intracellular pH, inorganic phosphate
      content, or free magnesium concentration. The [ADP]free at control was higher in
      newborns compared with 1-month-olds, and there was no age-related difference in
      [AMP]free. These variables did not change for newborns when exposed to
      hypercarbia, but for 1-month-olds [ADP]free and [AMP]free increased during
      hypercarbia relative to control values. High-energy phosphate utilization during
      ischemia for hypercarbic 1-month-olds was reduced by 74% compared with
      normocarbic 1-month-olds during ischemia, whereas the reduction in energy
      utilization (14%) was not significant for hypercarbic versus normocarbic newborns
      during ischemia.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7798929
TI  - Production of polyclonal antisera that recognize and distinguish between the
      extracellular domains of neuronal nicotinic acetylcholine receptor subunits.
AB  - Ligand-gated ion channels are oligomeric transmembrane proteins that usually
      contain more than one kind of monomer. The variety of monomers available to
      participate in oligomer formation and the apparent latitude in acceptable monomer
      combinations allows considerable diversity. Mechanisms for identifying the
      monomers comprising specific receptors are needed. We have generated affinity
      purified polyclonal antisera that recognize the extracellular domain of nine
      neuronal nicotinic acetylcholine receptor (nAChR) subunits and distinguish
      between them. We prepared these antisera by immunizing rabbits with bacterially
      expressed recombinant protein representing the N-terminal extracellular domain of
      each neuronal nAChR subunit followed by affinity purification of antibodies
      against synthetic peptides corresponding to residues 68-81 of the alpha 1
      subunit. We demonstrate subunit specificity of each affinity-purified antisera by
      western blots of the bacterially expressed protein and immunoblot against
      peptide. We further used these antibodies to demonstrate expression of neuronal
      nAChR subunits on the surface of transiently transfected simian kidney (COS-7)
      cells.

PMID- 7798932
TI  - Two stages in neurite formation distinguished by differences in tubulin
      metabolism.
AB  - Changes in tubulin solubility during neurite formation were studied biochemically
      using rat dorsal root ganglion neurons in culture. When fractionated with Ca(2+)
      containing buffer at low temperature, a considerable proportion of total cellular
      tubulin was recovered in the insoluble fraction. We designated this cold/Ca(2+)
      insoluble tubulin (InsT) and distinguished it from cold/Ca(2+)-soluble tubulin
      (SoIT). From the relative amount of InsT, neurite formation was found to proceed
      through two distinct stages. The first 6 days after plating (stage 1) in which
      the proportion of InsT increased dramatically (from 5 to 60%) coincided with
      neurite outgrowth. In the following period (stage 2), a constant level of InsT
      was maintained, whereas neurite maturation took place. Pulse-labeling experiments
      further revealed that the two stages differed significantly in terms of tubulin
      metabolism. High rates of synthesis as well as conversion from SoIT to InsT were
      observed in stage 1, whereas stage 2 was characterized by a decrease in both of
      these rates and an increase in the rate of degradation. The results show for the
      first time the coordinated changes in tubulin metabolism that underlie the
      process of neurite formation.

PMID- 7798930
TI  - Molecular cloning of a novel G protein-coupled receptor related to the opiate
      receptor family.
AB  - A cDNA clone encoding a novel G protein-linked receptor was isolated from a rat
      cerebral cortex cDNA library using a polymerase chain reaction-amplified cDNA
      fragment as a probe. This 2.4-kb clone encodes a 367 amino acid protein with
      seven putative transmembrane spanning domains. The protein is highly homologous
      to the cloned micro, delta, and kappa opioid receptors and shares with them
      structural features such as three glycosylation sites in the amino terminus, a
      cyclic AMP-dependent kinase phosphorylation site in the third cytoplasmic loop,
      an aspartic acid residue in the second transmembrane domain, and a palmitoylation
      site on the intracellular carboxy terminus. The receptor is also homologous with
      members of the somatostatin receptor family, yet it binds neither opiate nor
      somatostatin ligands. Northern blot analysis reveals two transcripts of 3.2 and
      7.6 kb that are predominantly expressed in the cerebral cortex and hypothalamus.
      In situ hybridization analysis also shows a high abundance of mRNA in the
      cerebral cortex, hippocampus, amygdala, hypothalamus, thalamus, and dorsal raphe
      nuclei. It is suggested that the endogenous ligand for this receptor may
      represent a novel neuropeptide that may be closely related to the opiate peptide
      family.

PMID- 7798931
TI  - Rat brain protein phosphatase 2A: an enzyme that may regulate autophosphorylated
      protein kinases.
AB  - Protein phosphatase 2A (PP2A) isolated from whole rat brain homogenate
      supernatants has been compared with that extracted from rat synaptosomal
      membranes. Both purified enzymes are comprised of the three known PP2A
      polypeptide chains of 65 (A subunit), 55 (B/B' subunit), and 38 (C subunit) kDa
      and have okadaic acid inhibition curves (Ki = 0.05 nM) nearly identical to that
      reported for skeletal muscle PP2A. The isolated 38-kDa subunit of rat brain PP2A
      appears to contain phosphotyrosine based on cross-reactivity with a specific
      monoclonal antibody (PY-20). Amino acid compositions and sequences of peptides
      isolated from the 65- and 38-kDa species correspond to regions of the cDNA
      deduced sequences of the regulatory and catalytic subunits of protein phosphatase
      2A from several sources. Studies reported here also demonstrate that
      autophosphorylated protein kinases, particularly Ca2+/calmodulin-dependent
      protein kinase II (CaM kinase II), are excellent substrates for brain PP2A.
      Furthermore, Ca(2+)-dependent K(+)-depolarization of hippocampal synaptosomes was
      accompanied by a sequential increase, then decrease, in CaM kinase II
      phosphorylation level over a 45-s time course. The decrease was blocked by 1 nM
      okadaic acid. These data demonstrate that the type 2A protein phosphatase is
      present at the synapses of CNS neurons where its localization could alter the
      functions of phosphoproteins involved in synaptic plasticity.

PMID- 7798933
TI  - Fatty acyl-CoA inhibits 1-alkyl-sn-glycero-3-phosphate acetyltransferase in
      microsomes of immature rabbit cerebral cortex: control of the first committed
      step in the de novo pathway of platelet-activating factor synthesis.
AB  - Microsomal fractions of cerebral cortices of 15-day-old rabbits were used to
      study the 1-alkyl-sn-glycero-3-phosphate (AGP) acetyltransferase that generates 1
      alkyl-2-acetyl-sn-glycero-3-phosphate in the de novo path of platelet-activating
      factor synthesis. The AGP acetyltransferase activity was inhibited by small
      concentrations of medium-long chain fatty acyl-CoA thioesters. In contrast, the
      AGP acyltransferase used oleoyl-CoA as substrate and was not inhibited by the
      presence of acetyl-CoA in high molar excess. The inhibition of AGP
      acetyltransferase was seen at concentrations of oleoyl-CoA as low as 0.5 microM
      using 12.5 microM AGP and 200 microM acetyl-CoA. The inhibition by oleoyl-CoA was
      noncompetitive for the acetyl-CoA substrate. However, there was evidence that the
      oleoyl-CoA was competing with AGP in the acetyltransferase reaction, as the
      inhibition was lessened by increasing the AGP substrate concentration. Several
      acyl-CoA thioesters were effective as inhibitors of the AGP acetyltransferase,
      including oleoyl-, palmitoyl-, lauroyl-, and octanoyl-CoA. Propionyl- and butyryl
      CoA were less effective as inhibitors, and propionyl-CoA was found to be a
      competitive inhibitor for acetyl-CoA. We have noted earlier that MgATP is an
      effective inhibitor of the AGP acetyltransferase and here we show that the
      inhibition by oleoyl-CoA can be increased by the presence of 0.1 mM MgATP. In
      brain ischemia, a decline in ATP levels would likely lead to a corresponding fall
      in acyl-CoA concentrations, thereby relieving the inhibition of AGP
      acetyltransferase and permitting the flow of AGP into the de novo pathway of
      platelet-activating factor synthesis.

PMID- 7798934
TI  - Production and characterization of monoclonal antibodies to bovine brain succinic
      semialdehyde reductase.
AB  - Monoclonal antibodies against bovine brain succinic semialdehyde reductase were
      produced and characterized. A total of nine monoclonal antibodies recognizing
      different epitopes of the enzyme were obtained, of which two inhibited the enzyme
      activity and three stained cytosol of rat spinal cord neurons as observed by
      indirect immunofluorescence microscopy. When unfractionated total proteins of
      bovine brain homogenate were separated by gel electrophoresis and immunoblotted,
      the antibodies specifically recognized a single protein band of 34 kDa, which
      comigrates with purified bovine succinic semialdehyde reductase. Using the
      antisuccinic semialdehyde reductase antibodies as probes, we investigated the
      cross-reactivities of brain succinic semialdehyde reductases from some mammalian
      and an avian species. The immunoreactive bands on western blots appeared to be
      the same in molecular mass--34 kDa--in all animal species tested, including
      humans. The result indicates that brain succinic semialdehyde reductase is
      distinct from other aldehyde reductases and that mammalian brains contain only
      one succinic semialdehyde reductase. Moreover, the enzymes among the species are
      immunologically very similar, although some properties of the enzymes reported
      previously were different from one another.

PMID- 7798935
TI  - Effect of cytidine on membrane phospholipid synthesis in rat striatal slices.
AB  - Using rat striatal slices, we examined the effect of cytidine on the conversion
      of [3H]choline to [3H]-phosphatidylcholine ([3H]PC), and on net syntheses of PC,
      phosphatidylethanolamine (PE), and phosphatidylserine, when media did or did not
      also contain choline, ethanolamine, or serine. Incubation of striatal slices with
      cytidine (50-500 microM) caused dose-dependent increases in intracellular
      cytidine and cytidine triphosphate (CTP) levels and in the rate of incorporation
      of [3H] choline into membrane [3H]PC. In pulse-chase experiments, cytidine (200
      microM) also increased significantly the conversion of [3H]choline to [3H]PC
      during the chase period. When slices were incubated with this concentration of
      cytidine for 1 h, small (7%) but significant elevations were observed in the
      absolute contents (nmol/mg of protein) of membrane PC and PE (p < 0.05), but not
      phosphatidylserine, the synthesis of which is independent of cytidine-containing
      CTP. Concurrent exposure to cytidine (200 microM) and choline (10 microM) caused
      an additional significant increase (p < 0.05) in tissue PC levels beyond that
      produced by cytidine alone. Exposure to choline alone at a higher concentration
      (40 microM) increased the levels of all three membrane phospholipids (p < 0.01);
      the addition of cytidine, however, did not cause further increases. Concurrent
      exposure to cytidine (200 microM) and ethanolamine (20 microM) also caused
      significantly greater elevations (p < 0.05) in tissue PE levels than those caused
      by cytidine alone. In contrast, the addition of serine (500 microM) did not
      enhance cytidine's effects on any membrane phospholipid. Exposure to serine
      alone, however, like exposure to sufficient choline, increased levels of all
      three membrane phospholipids significantly (p < 0.01).(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7798936
TI  - Characterization of sialyltransferase-IV activity and its involvement in the c
      pathway of brain ganglioside metabolism.
AB  - To characterize the sialyltransferase-IV activity in brain tissues, the
      activities of GM1b-, GD1a-, GT1b-, and GQ1c-synthases in adult cichlid fish and
      rat brains were examined using GA1, GM1, GD1b, or a cod brain ganglioside mixture
      as the substrate. The GD1a-synthase activity in the total membrane fraction from
      cichlid fish brain required divalent cations such as Mg2+ or Mn2+ and Triton CF
      54 for its full activity. The Vmax value was 1,340 pmol/mg of protein/h at an
      optimal pH of 6.5, whereas the apparent Km values for CMP-sialic acid and GM1
      were 172 and 78 microM, respectively. Cichlid fish and rat brains also contained
      GM1b-, GT1b-, and GQ1c-synthase activities. The ratio of GM1b-, GD1a-, and GT1b
      synthase activities in fish brain was 1.00:0.89:1.13, respectively, and in rat
      brain 1.00:0.60:0.63. Incubation of fish brain membranes with a cod brain
      ganglioside mixture, which contains GT1c, and [3H]CMP-sialic acid produced
      radiolabeled GQ1c. It is interesting that the adult rat brain also contains an
      appreciable level of GQ1c-synthase activity despite its very low concentrations
      of c-series gangliosides. The GD1a- or GQ1c-synthase activity in fish and rat
      brain was inhibited specifically by coincubation with the glycolipids that serve
      as the substrates for other sialyltransferase-IV reactions. Thus, the GD1a
      synthase activity was inhibited by GA1 and GD1b, but not by LacCer, GM3, or GD3.
      In a similar manner, the synthesis of GQ1c was suppressed by GA1, GM1, and GD1b,
      but not by LacCer, GM3, or GD3.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798937
TI  - Coupling of corticotropin-releasing hormone receptors to adenylyl cyclase in
      human Y-79 retinoblastoma cells.
AB  - In human Y-79 retinoblastoma cells, corticotropin-releasing hormone (CRH)
      stimulates adenylyl cyclase activity and increases cyclic AMP accumulation.
      Different CRH analogues mimic the CRH stimulation of adenylyl cyclase and show
      similar sensitivity to the CRH receptor antagonist alpha-helical CRH9-41.
      Vasoactive intestinal peptide (VIP) also increases the enzyme activity but less
      potently than CRH, and its effect is counteracted by the VIP receptor antagonist
      [D-p-Cl-Phe6,Leu17]VIP. The VIP antagonist does not affect the response to CRH.
      The CRH-stimulated adenylyl cyclase activity is amplified by Mg2+, is inhibited
      by submicromolar concentrations of Ca2+, and requires GTP. Moreover, the CRH
      stimulation is reduced by pretreatment of cells with cholera toxin and by
      incubation of membranes with the RM/1 antibody, which recognizes the C-terminus
      of the alpha subunit of Gs. In immunoblots, the RM/1 antibody identifies a
      doublet of 45 and 52 kDa. Two proteins of similar molecular weights are ADP
      ribosylated by cholera toxin. These data demonstrate that in human Y-79
      retinoblastoma cells, specific CRH receptors stimulate cyclic AMP formation by
      interacting with Gs and by affecting a Ca(2+)-inhibitable form of adenylyl
      cyclase.

PMID- 7798938
TI  - Human Y-79 retinoblastoma cells exhibit specific corticotropin-releasing hormone
      binding sites.
AB  - In this study we have identified specific binding sites for corticotropin
      releasing hormone (CRH) in human Y-79 retinoblastoma cell membranes by using 125I
      Tyr-ovine CRH (125I-oCRH) as radioligand. Binding at 19 degrees C was rapid with
      steady state being reached within 20 min, reversible and linear with membrane
      protein concentration. The 125I-oCRH binding was enhanced by Mg2+ and inhibited
      by the GTP analogue guanosine 5'-O-(3'-thiotriphosphate). Y-79 cell membranes
      exhibited two populations of binding sites, a high-affinity site with an apparent
      dissociation constant (KD) of 1 nM and a low-affinity site with an apparent KD of
      500 nM. 125I-oCRH binding was completely antagonized by human/rat CRH,
      [Met(O)21]oCRH, alpha-helical CRH9-41, urotensin I, and sauvagine with a rank
      order of potency similar to that displayed by CRH receptors of other tissues.
      These data describe for the first time the presence of specific CRH-binding sites
      in retinal cells. The Y-79 cell line may therefore constitute a valuable model in
      which to study CRH action on retinal cells.

PMID- 7798939
TI  - Nerve regeneration and cholesterol reutilization occur in the absence of
      apolipoproteins E and A-I in mice.
AB  - Apolipoproteins have been implicated in the salvage and reutilization of myelin
      cholesterol during Wallerian degeneration and the subsequent nerve regeneration.
      Current evidence suggests that myelin cholesterol complexes with apolipoproteins
      E and A-I to form lipoproteins that are taken up via low-density lipoprotein
      receptors on myelinating Schwann cells. We recently reported, however, that
      apolipoprotein E is not required for nerve regeneration or reutilization of
      myelin cholesterol. We have now investigated nerve regeneration and the
      reutilization of cholesterol in mutant mice deficient in both apolipoproteins E
      and A-I. Morphologic examination of nerves 4 and 12 weeks after crush injury
      revealed that regeneration proceeded at a normal rate in the absence of these
      apolipoproteins. Autoradiography of regenerating nerves indicated that prelabeled
      myelin lipid was reutilized in the regenerating myelin. 3-Hydroxy-3
      methylglutaryl-CoA reductase, the rate-limiting enzyme in cholesterol synthesis,
      was down-regulated in the regenerating nerves, indicative of cholesterol uptake
      via lipoproteins. Prelabeled myelin cholesterol was present in lipoprotein
      fractions isolated from crushed nerves of mutant mice. These data suggest that
      there is considerable redundancy in the process of cholesterol reutilization
      within nerve, and that apolipoproteins other than apolipoproteins E and A-I may
      be involved in the recycling of myelin cholesterol.

PMID- 7798940
TI  - Beta 2-adrenoreceptors stimulate c-fos transcription through multiple cyclic AMP-
      and Ca(2+)-responsive elements in cerebellar granular neurons.
AB  - Neurons from the granular layer of the cerebellum express functional beta 2
      adrenoreceptors (beta 2-ARs). We show that stimulation of beta 2-ARs with
      isoprenaline increases cyclic AMP (cAMP) production and stimulates transcription
      of genes containing the cAMP-responsive element (CRE; TGACGTCA). This effect is
      mediated by cAMP-dependent protein kinase and the trans-acting factor CRE binding
      protein. Transcriptional regulation by the beta 2-AR was investigated by using
      the c-fos protooncogene as a model system. We show that beta 2-ARs stimulate c
      fos mRNA accumulation, increase AP1 binding activity, and stimulate transcription
      through the phorbol ester-responsive element (TGACTCA). The transcriptional
      regulation of c-fos itself was studied with reporter constructs driven by c-fos
      promoter sequences. Deletion studies revealed that beta 2-ARs stimulate c-fos
      transcription through at least three distinct regulatory sequences: (a) the CRE
      located at -60 bp 5' to the initiation site, (b) the fos AP1-like element (-291
      to -297), and (c) the serum-responsive element (-297 to -317). The regulation of
      these elements by the two putative second messengers of the beta 2-AR, cAMP and
      Ca2+, was analyzed. We report that all three of these regulatory sequences are
      coregulated by both second messengers. These results indicate that beta 2-ARs
      stimulate c-fos transcription by multiple cAMP- and Ca(2+)-dependent regulatory
      elements in neurons.

PMID- 7798942
TI  - Lipid composition of neuronal cell bodies and neurites from cultured dorsal root
      ganglia.
AB  - The lipid composition of neuronal somata and neuritic processes of cultured root
      ganglia has been determined. Neuronal soma contained 37% of dry weight as lipid
      (15.4% cholesterol, 4.8% galactolipid, and 57.1% phospholipid). The major
      phospholipids were phosphatidylcholine and phosphatidyl ethanolamine.
      Galactolipids consisted of cerebroside and sulfatide in molar ratio 2:1. The
      neuronal soma contained tetrasialo-, disialo-, and monosialoganglioside. In
      contrast, neurites contained 15% of the dry weight as lipid (22.1% cholesterol,
      7.7% galactolipid with cerebroside and sulfatide in molar ratio 2:1, and 56.4%
      total phospholipid). The neuritic galactolipid content was higher, as was the
      percentage of sphingomyelin, and phosphatidyl serine. The higher cholesterol
      content in neuritic lipid reflected the higher percentage of plasma membrane in
      this compartment. The ganglioside pattern of neurites was distinct from that of
      the neuronal soma and consisted entirely of gangliosides GQ1b, GT1b, GD1b, GD1a,
      and GD3, with no monosialogangliosides. The results indicate a preferential
      phospholipid and glycolipid sorting to the neuritic plasma membrane that may be
      related to the distinctive functions of this neuronal compartment.

PMID- 7798941
TI  - Glucose metabolism in the developing cerebral cortex as detected by 1H(13C)
      nuclear magnetic resonance spectroscopy ex vivo.
AB  - Metabolism of [1-13C]glucose was monitored in superfused cerebral cortex slice
      preparations from 1-, 2-, and 5-week-old rats using 1H-observed/13C-edited
      (1H(13C)) NMR spectroscopy. The rate of label incorporation into glutamate C-4
      did not differ among the three age groups: 0.52-0.67% of total 1H NMR-detected
      glutamate/min. This was rather unexpected, as oxygen uptake proceeded at 1.1 +/-
      0.1, 1.9 +/- 0.1, and 2.0 +/- 0.1 mumol/min/g wet weight in brain slices prepared
      from 1-, 2-, and 5-week-old animals, respectively. Steady-state glutamate C-4
      fractional enrichments in the slice preparations were approximately 23% in all
      age groups. In the acid extracts of slices glutamate C-4 enrichments were
      smaller, however, in 1- and 2-week-old (17.8 +/- 1.7 and 16.8 +/- 0.8%,
      respectively) than in 5-week-old rats (22.7 +/- 0.7%) after 75 min of incubation
      with 5 mM [1-13C]glucose. We add a new assignment to the 1H(13C) NMR
      spectroscopy, as acetate C-2 was detected in slice preparations from 5-week-old
      animals. In the acid extracts of slice preparations acetate C-2 was labeled by
      approximately 30% in 5-week-old rats but by 15% in both 1- and 2-week-old
      animals, showing that the turnover rate was increased in 5-week-old animals. In
      the extracts 3-4% of the C-6 of N-acetyl-aspartate (NAA; CH3 of the acetyl group)
      contained label as determined by both NMR and mass spectrometry, which indicated
      that there was no significant labeling to other carbons in NAA.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7798943
TI  - Aspartate aminotransferase and glutamate dehydrogenase activities in the squid
      giant nerve.
AB  - The present study sought to investigate the presence and distribution of some
      enzymatic activities involved in the metabolism of glutamate in the giant nerve
      fiber of the tropical squid Sepioteuthis sepioidea. Specific activities of
      aspartate aminotransferase and glutamate dehydrogenase were evaluated in
      homogenates of the isolated giant fiber, extruded axoplasm, and axoplasm-free
      giant nerve fiber sheaths. The activities of both enzymes were present in the
      tissue. The specific activity of aspartate aminotransferase was similar in
      axoplasm and sheaths. However, the specific activity of glutamate dehydrogenase
      was an order of magnitude higher in the sheaths. This finding is discussed in the
      framework of the hypothesis that proposes that a differential distribution of the
      enzymes of the glutamatergic system between the axonal and neuroglial
      compartments forms part of a system of communication between these cells whose
      neuronal signal may be glutamate.

PMID- 7798944
TI  - Elevated levels of the endosomal-lysosomal proteinase cathepsin D in
      cerebrospinal fluid in Alzheimer disease.
AB  - Lysosomal hydrolases are normally intracellular enzymes but are abundant
      extracellularly within senile plaques in Alzheimer disease and in other
      conditions where beta-amyloid accumulates. To examine whether acid hydrolases
      released from abnormal hydrolase-laden neurons are detectable in CSF, we measured
      levels of the major aspartic proteinase of lysosomes, cathepsin D (Cat D), in
      ventricular CSF collected after death from 30 patients with Alzheimer disease, 14
      patients with Huntington disease, and seven patients with other neurodegenerative
      diseases. The levels of Cat D-immunoreactive protein, expressed as micrograms per
      milliliter of protein, determined by western blot immunoassay using a polyclonal
      antiserum against human brain Cat D, were more than fourfold higher in the
      Alzheimer patients than in the other patient groups (p < 0.0005). Cat D activity,
      assayed separately against [14C]methemoglobin at pH 3.2, was also significantly
      elevated but less than Cat D content. The lower specific activity of Cat D in
      Alzheimer CSF therefore indicated that the abnormally accumulated Cat D included
      a high proportion of inactive enzyme. These results indicate that abnormal Cat D
      release from affected neurons into the extracellular space is an active, ongoing
      process in Alzheimer brain. In addition, the levels of this enzyme and possibly
      other lysosomal hydrolases in CSF may prove to be useful biological markers of
      Alzheimer disease.

PMID- 7798945
TI  - The degradative pathway of gangliosides GM1 and GM2 in Neuro2a cells by
      sialidase.
AB  - Gangliosides GM1 [3H-labeled at the sphingosine (Sph) moiety] and GM2 [3H-labeled
      at the Sph or N-acetylgalactosamine (GalNAc) moiety] were administered to
      cultured Neuro2a cells for varying pulse (1-4 h) and chase (up to 4 h) periods,
      and their metabolic processing was followed. The main and earliest formed 3H
      metabolites of [Sph-3H]GM1 were GM2, asialo-GM1 asialo-GM2, and lactose-ceramide,
      and those of [Sph-3H]GM2 were asialo-GM2 and lactose-ceramide. The asialo-GM1 and
      asialo-GM2 formed were isolated and chemically characterized. [3H]Asialo-GM2 was
      produced in identical amounts after treatment with equimolar [Sph-3H]GM2 and
      [GalNAc-3H]GM2. At low temperature or in the presence of chloroquine, the
      formation of all 3H-metabolites, including asialo-GM2 and asialo-GM1, was
      undetectable, indicating that ganglioside metabolic processing was an endocytosis
      and lysosome-dependent process. These results demonstrate that in Neuro2a cells
      exogenous GM1 (and GM2) is mainly degraded through the pathway GM1-->GM2-->asialo
      GM2-->-->Sph, with a minor fraction of GM1 undergoing degradation with the
      sequence GM1-->asialo-GM-1-->asialo-GM2-->-->Sph. These findings are consistent
      with the hypothesis that Neuro2a cells contain a sialidase (likely of lysosomal
      nature) affecting ganglioside GM1 and GM2. The sialidase-mediated degradative
      pathway of GM1 and GM2 in Neuro2a cells might be related to the tumoral nature of
      these cells.

PMID- 7798946
TI  - NMDA receptor involvement in toxicity to dopamine neurons in vitro caused by the
      succinate dehydrogenase inhibitor 3-nitropropionic acid.
AB  - Exposure of mesencephalic dopamine neurons to an irreversible inhibitor of
      succinate dehydrogenase (SDH), 3-nitropropionic acid (3-NPA), for 24 h on day 12
      in vitro, produced a dose-dependent loss of high-affinity dopamine uptake when
      measured 48 h following 3-NPA removal. ATP concentrations in the cultures were
      reduced by 57% after 3 h of treatment with the highest concentration of 3-NPA
      tested (500 microM). To determine whether glutamate receptors mediated the
      dopamine toxicity by 3-NPA, cultures were examined for their sensitivity to
      excitatory amino acid-induced toxicity. Mesencephalic cultures exposed to either
      100 microM NMDA or kainate, on day 12 for 24 h, showed complete loss of dopamine
      uptake following 48 h of recovery. The NMDA and non-NMDA antagonists, MK-801 (1
      microM) or 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX; 15 microM), completely
      prevented the effects of NMDA or kainate, respectively, when present at the time
      of toxin exposure. In cultures treated with 3-NPA, MK-801, but not CNQX,
      significantly attenuated the loss of dopamine uptake. Direct measurement of the
      effect of 3-NPA on SDH activity showed that 3-NPA dose-dependently inhibited SDH
      in vitro in a manner commensurate with the loss of dopamine uptake by 3-NPA. MK
      801 had no effect on basal SDH activity or on 3-NPA inhibition of SDH. These data
      are consistent with the interpretation that metabolic inhibition in dopamine
      neurons can trigger a secondary excitotoxicity that is mediated by NMDA
      receptors.

PMID- 7798947
TI  - Proadrenomedullin N-terminal 20 peptide (PAMP), an endogenous anticholinergic
      peptide: its exocytotic secretion and inhibition of catecholamine secretion in
      adrenal medulla.
AB  - In cultured bovine adrenal medullary cells, stimulation of nicotinic receptors by
      carbachol evoked the Ca(2+)-dependent exocytotic cosecretion of proadrenomedullin
      N-terminal 20 peptide (PAMP) (EC50 = 50.1 microM) and catecholamines (EC50 = 63.0
      microM), with the molar ratio of PAMP/catecholamines secreted being equal to the
      ratio in the cells. Addition of PAMP [1-20]NH2 inhibited carbachol-induced 22Na+
      influx via nicotinic receptors (IC50 = 2.5 microM in a noncompetitive manner and
      thereby reduced carbachol-induced 45Ca2+ influx via voltage-dependent Ca2+
      channels (IC50 = 1.0 microM) and catecholamine secretion (IC50 = 1.6 microM). It
      did not alter high K(+)-induced 45Ca2+ influx via voltage-dependent Ca2+ channels
      or veratridine-induced 22Na+ influx via voltage-dependent Na+ channels. PAMP
      seems to be a novel antinicotinic peptide cosecreted with catecholamines by a
      Ca(2+)-dependent exocytosis in response to nicotinic receptor stimulation.

PMID- 7798948
TI  - Down-regulation of AMPA receptor subunit GluR2 in amygdaloid kindling.
AB  - Alterations in glutamatergic transmission are postulated to be important in
      kindling and epilepsy. The levels of alpha-amino-3-hydroxy- 5-methylisoxazole-4
      propionic acid (AMPA) receptor subunits (GluR1, 2, and 4) were compared in
      amygdala-kindled and sham-operated animals using subunit-specific antibodies and
      quantitative western blotting. Four limbic regions were examined: limbic
      forebrain, piriform cortex/amygdala, hippocampus, and entorhinal cortex. When
      subunit levels were examined 24 h after the last stage 5 seizure, levels of GluR2
      were found to be selectively reduced in limbic forebrain (30%) and piriform
      cortex/amygdala (25%), with no changes in other regions examined. In addition, no
      changes in the other subunits were observed in any region. The decrease in GluR2
      that was observed in kindled animals at 24 h was no longer present at 1 week and
      1 month after the last stage 5 seizure. Because the GluR2 subunit uniquely
      determines the calcium permeability of these receptors and because the piriform
      cortex has been implicated as a source of excitatory drive for limbic seizures,
      reduced GluR2 expression may be important in increasing neuronal excitability in
      kindling-induced epilepsy, or may reflect a compensatory mechanism resulting from
      kindling.

PMID- 7798949
TI  - A function for butyrylcholinesterase?

PMID- 7798950
TI  - A negative regulatory element in the rat dopamine beta-hydroxylase gene
      contributes to the cell type specificity of expression.
AB  - Dopamine beta-hydroxylase (DBH) catalyzes the synthesis of the neurohormone
      norepinephrine and is expressed only in noradrenergic and adrenergic cells of the
      nervous and endocrine systems. We have previously described a positive-acting
      genetic regulatory element of the DBH that contributes to the restricted
      expression of this gene. In the study described here, we identify and
      characterize a negative-acting regulatory element within the 5'-flanking region
      of the rat DBH gene. This negative regulatory element, which is located between 
      282 and -232, represses transcription from the DBH promoter in cell lines of
      noncatecholaminergic origin and binds to nuclear factors found in extracts from
      both the catecholaminergic cell line SHSY-5Y and the noncatecholaminergic cell
      lines JEG-3 and C6. The negative regulatory region will reduce transcription from
      a heterologous promoter in two noncatecholaminergic cell lines. These experiments
      demonstrate that the selective expression of the DBH gene is controlled by both
      positive- and negative-acting genetic regulatory elements.

PMID- 7798951
TI  - Ca(2+)- and nitric oxide-dependent stimulation of cyclic GMP synthesis in
      neuronal cell line induced by P2-purinergic/pyrimidinergic receptor.
AB  - The mechanism by which cyclic GMP synthesis is activated through a nucleotide
      receptor was studied in mouse neuroblastoma x rat glioma hybrid cells [108CC15
      (NG 108-15)]. The transient increase in cyclic GMP level induced by ATP reached
      its maximum at 20 s and lasted for approximately 1 min. The maximal rise in
      cyclic GMP level achieved was highest for ATP and decreased in the following
      order: ATP = adenosine 5'(gamma-thio)triphosphate > UTP = 2-methylthio-ATP > ADP
      much greater than CTP, AMP, alpha,beta-methylene-ATP, 2'- and 3'-O-(4
      benzoylbenzoyl)ATP. The EC50 of 1 +/- 0.2 microM for UTP was significantly lower
      than that for ATP (14 +/- 8 microM) and for all the other nucleotides tested. The
      rank order of potency is consistent with the pharmacology of a P2u receptor. At
      submaximal concentrations of the nucleotides ATP and UTP, the rise in cyclic GMP
      level was inhibited by suramin (IC50 = 40-60 microM) or the pyridoxal phosphate
      analogue pyridoxal phosphate-6-azophenyl-2',4'-disulfonic acid (IC50 = 20-30
      microM). Pretreatment of cells with the Ca2+ ionophore ionomycin or with 2,5
      di(tert-butyl)-1,4-benzohydroquinone, an inhibitor of Ca(2+)-ATPase in the
      endoplasmic reticulum, a maneuver to deplete internal Ca2+ stores, suppressed the
      ATP- or UTP-induced stimulation of cyclic GMP synthesis. Similarly, loading of
      the cells with the Ca2+ chelator 1,2-bis(2-aminophenoxy)-ethane-N,N,N',N'
      tetraacetic acid inhibited cyclic GMP formation by ATP. Preincubation with
      forskolin to raise the cyclic AMP level potentiated the ATP-induced rise in
      cyclic GMP level by 60%.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7798952
TI  - A Ewing's sarcoma cell line showing some, but not all, of the traits of a
      cholinergic neuron.
AB  - The Ewing's sarcoma cell line ICB 112 was examined in detail for a cholinergic
      phenotype. Choline acetyltransferase activity (12.3 +/- 2.9 nmol/h/mg of protein)
      was associated with the presence of multiple mRNA species labeled with a human
      choline acetyltransferase riboprobe. Choline was taken up by the cells by a high
      affinity, hemicholinium-3-sensitive transporter that was partially inhibited when
      lithium replaced sodium in the incubation medium; the choline taken up was
      quickly incorporated into both acetylcholine and phosphorylcholine. High-affinity
      binding sites for vesamicol, an inhibitor of vesicular acetylcholine transport,
      were also present. The mRNAs for synaptotagmin (p65) and the 15-kDa proteolipid
      were readily detected and were identical in size to those observed in cholinergic
      regions of the human brain. Cumulative acetylcholine efflux was increased by
      raising the extracellular potassium level or the addition of a calcium ionophore,
      but the time course of stimulated efflux was slow and persistent. These results
      show that this morphologically undifferentiated cell line is capable of
      acetylcholine synthesis and expresses markers for synaptic vesicles as well as
      proteins implicated in calcium-dependent release but lacks an organized release
      mechanism.

PMID- 7798954
TI  - (+)-(S)-dihydroaeruginoic acid, an inhibitor of Septoria tritici and other
      phytopathogenic fungi and bacteria, produced by Pseudomonas fluorescens.
AB  - Three antibiotics were isolated from a CH2Cl2 extract of the liquid culture of
      Pseudomonas fluorescens strain PFM2. Two of the antibiotics were identified as
      2,4-diacetylphloroglucinol and pyoluterin. The structure elucidation, absolute
      stereochemistry, synthesis, and biological activities of the new antibiotic (+)
      (S)- dihydroaeruginoic acid [1] are reported.

PMID- 7798953
TI  - 5'-(N-ethylcarboxamido)adenosine inhibits Ca2+ influx and activates a protein
      phosphatase in bovine adrenal chromaffin cells.
AB  - We investigated the effect of the adenosine receptor agonist 5'-(N
      ethylcarboxamido)adenosine (NECA) in catecholamine secretion from adrenal
      chromaffin cells that exhibit only the A2b subtype adenosine receptor. NECA
      reduced catecholamine release evoked by the nicotinic agonist 1,1-dimethyl-4
      phenylpiperazinium (DMPP) in a time-dependent manner. Inhibition reached 25%
      after 30-40-min exposure to NECA. This effect on DMPP-evoked catecholamine
      secretion was mirrored by a similar (27.7 +/- 3.3%), slowly developing inhibition
      of [Ca2+]i transients induced by DMPP that peaked at 30-min preincubation with
      NECA. The capacity of the chromaffin cells to buffer Ca2+ load was not affected
      by the treatment with NECA. Short-term treatment with NECA failed both to modify
      [Ca2+]i levels and to increase endogenous diacylglycerol production, showing that
      NECA does not activate the intracellular Ca2+/protein kinase C signaling pathway.
      The inhibitory effects of NECA were accompanied by a 30% increase of protein
      phosphatase activity in chromaffin cell cytosol. We suggest that
      dephosphorylation of a protein involved in DMPP-evoked Ca2+ influx pathway (e.g.,
      L-type Ca2+ channels) could be the mechanism of the inhibitory action of
      adenosine receptor stimulation on catecholamine secretion from adrenal chromaffin
      cells.

PMID- 7798955
TI  - Chemical and bioactive constituents from Zanthoxylum simulans.
AB  - Two new benzo[c]phenanthridine alkaloids, 6-methyldihydrochelerythrine [1] and 6
      methylnorchelerythrine [2], together with 23 known compounds, were isolated from
      the root bark of Zanthoxylum simulans. Structures were elucidated by spectral
      analysis. Among them, the pyranoquinoline alkaloids, zanthosimuline [3], and
      huajiaosimuline [4], exhibited cytotoxic activity. In addition, compound 4 showed
      significant antiplatelet aggregation activity and induced terminal
      differentiation with cultured HL-60 cells.

PMID- 7798957
TI  - Four new dimeric peptide alkaloids, anchinopeptolides B-D, and
      cycloanchinopeptolide C, congeners of anchinopeptolide A, from the Mediterranean
      marine sponge Anchinoe tenacior.
AB  - Following the characterization of anchinopeptolide A[1], three new congeneric
      dimeric peptide alkaloids, named anchinopeptolides B [2], C[3], and D[4], have
      been isolated from the Mediterranean sponge Anchinoe tenacior. A fourth compound,
      cycloanchinopeptolide C[5], which is related to anchinopeptolide C[3] by a head
      to-head intramolecular [2+2] cyclo-addition reaction, has also been isolated. The
      structures of these peptide alkaloids have been elucidated on the basis of
      spectral evidence. Anchinopeptolides bind to the somatostatin, human B2
      bradykinin, and neuropeptide Y receptors.

PMID- 7798956
TI  - Bioactive terpenoids from Octocorallia, I. Bioactive diterpenoids: litophynols A
      and B from the mucus of the soft coral Litophyton sp.
AB  - Two new eunicellin-type diterpenoids, litophynols A [1] and B [2], and the known
      diterpenoids litophynins E [3], H [11], and I monoacetate [12], were isolated
      from the mucus secreted by the soft coral Litophyton sp. Their structures have
      been elucidated on the basis of spectral and single crystal X-ray analyses. These
      compounds have hemolytic activity.

PMID- 7798958
TI  - Synthesis of quercetin-3-O-beta-D-glucopyranosyl-(1-->2)-beta-D- xylopyranoside
      via orthoester methodology.
AB  - The synthesis of quercetin-3-O-beta-D-glucopyranosyl-(1-->2)-beta-D
      xylopyranoside [10], a flavonoid recently isolated from Kalanchoe prolifera, has
      been carried out via orthoester methodology.

PMID- 7798959
TI  - Antibacterial triterpenoid acids from Dillenia papuana.
AB  - Three new oleanene-type triterpenoids, dillenic acids A [1], B [2], and C [3],
      and two known compounds, 3-oxoolean-1,12-dien-30-oic acid [4] (a new natural
      product) and the lupene derivative betulinaldehyde, have been isolated from the
      Papua New Guinean medicinal plant Dillenia papuana. The structures of the new
      compounds were elucidated as 2 alpha-hydroxy-3-oxoolean-12-en-30-oic acid, 2-oxo
      3 beta-hydroxyolean-12-en-30-oic acid and 1 alpha-hydroxy-3-oxoolean-12-en-30-oic
      acid. The 1H- and 13C-nmr data of all new compounds were assigned unambiguously
      using a variety of 2D nmr experiments including 1H-1H-COSY, HMQC, HMBC, and NOESY
      experiments. Of these compounds, 1-4 showed antibacterial activities against
      Bacillus subtilis, Escherichia coli, and Micrococcus luteus.

PMID- 7798960
TI  - Isolation and structure elucidation of new nitrile and mustard oil glycosides
      from Moringa oleifera and their effect on blood pressure.
AB  - Bioassay-guided analysis of an EtOH extract of Moringa oleifera leaves showing
      hypotensive activity led to the isolation of two nitrile glycosides, niazirin [1]
      and niazirinin [2], and three mustard oil glycosides, 4-[(4'-O-acetyl-alpha-L
      rhamnosyloxy)benzyl]isothiocyanate [4], niaziminin A, and niaziminin B. Glycoside
      2 is a new compound. Niaziminins A and B have previously been obtained from the
      left extract as a mixture, while compound 4 is new from this source. Structural
      determination was accomplished by means of spectroscopic methods including
      appropriate 2D nmr experiments and chemical reactions. This is the first report
      of the isolation of nitriles, an isothiocyanate, and thiocarbamates from the same
      plant species. Isothiocyanate 4 and the thiocarbamate glycosides niaziminin A and
      B showed hypotensive activity while nitrile glycosides 1 and 2 were found to be
      inactive in this regard.

PMID- 7798961
TI  - Insect antifeedant activity of clerodane diterpenoids.
AB  - Fourteen clerodane-type diterpenoids isolated from plants in the genera
      Baccharis, Teucrium, and Salvia were assayed for antifeedant activity against
      Tenebrio molitor larvae in order to establish structure-activity relationships.
      Among the compounds tested, furanoditerpenes with alpha, beta-unsaturated-gamma
      lactone moieties, or C-4-epoxy substitution with C-5-methylacetoxy or C-12
      acyloxy functionalities, exhibited maximal antifeedant and repellent activities.

PMID- 7798962
TI  - Antiplatelet aggregation principles of Dendrobium loddigesii.
AB  - The MeOH extract of the stem of Dendrobium loddigesii was found to inhibit the
      aggregation of rabbit platelets induced by arachidonic acid and collagen. Two
      active compounds, moscatilin [1] and moscatin [2], were isolated. Moscatilin
      diacetate [3] also exhibited antiplatelet aggregation activity.

PMID- 7798963
TI  - Triterpenoid saponins from Bellis sylvestris, I. Structures of the major
      deacylsaponins.
AB  - Two major saponins from Bellis sylvestris have been isolated and their structures
      determined, mainly by high-field nmr spectroscopy. One of these [2] was identical
      with bellissaponin BS1 from Bellis perennis, while the second is a new
      triterpenoid saponin [1], named besysaponin C12, and identified as 3-O-alpha-L
      rhamnopyranosyl-2 beta,3 beta,16 alpha,23-tetrahydroxyolean-12-en-28-oic acid 28
      O-beta-D-xylopyranosyl(1-->4)-alpha-L-rhamnopyranosyl(1-->2)-beta-D-
      fucopyranoside.

PMID- 7798964
TI  - Cylindol A, a novel biphenyl ether with 5-lipoxygenase inhibitory activity, and a
      related compound from Imperata Cylindrica.
AB  - Cylindol A [1] and B [2], two novel substances, have been isolated from Imperata
      cylindrica, and their structures have been elucidated on the basis of their
      spectral data coupled with chemical evidence and total synthesis. Cylindol A [1]
      showed 5-lipoxygenase inhibitory activity.

PMID- 7798965
TI  - (+/-)-Gelliusines A and B, two diastereomeric brominated tris-indole alkaloids
      from a deep water new caledonian marine sponge (Gellius or Orina sp.).
AB  - Two new diastereomeric brominated tris-indole alkaloids occurring as enantiomeric
      pairs, (+/-)-gelliusines A [1] and B [2], have been isolated from a deep water
      New Caledonian sponge (Gellius or Orina sp.), whose crude extract exhibited
      cytotoxicity against KB cells. Their structures were elucidated by spectroscopic
      methods including one- and two-dimensional nmr spectroscopy. The major compound,
      (+/-) gelliusine A [1], which showed very weak cytotoxicity, proved to be active
      at the serotonin receptor.

PMID- 7798966
TI  - Nepheliosyne A, new C47 acetylenic acid from the Okinawan marine sponge
      Xestospongia sp.

PMID- 7798967
TI  - Two new flavones from Calliandra californica.
AB  - Two new flavones were isolated from the medicinal plant Calliandra californica,
      7,2',4',5'-tetramethoxyflavone [1] and 5-hydroxy-7,2',4',5'-tetramethoxyflavone
      [2]. The structures were determined from spectral evidence and both compounds
      were synthesized. Compound 2 exhibited antimicrobial activity for two test
      bacterial strains.

PMID- 7798968
TI  - Binding of quinolizidine alkaloids to nicotinic and muscarinic acetylcholine
      receptors.
AB  - Fourteen quinolizidine alkaloids, isolated from Lupinus albus, L. mutabilis, and
      Anagyris foetida, were analyzed for their affinity for nicotinic and/or
      muscarinic acetylcholine receptors. Of the compounds tested, the alpha-pyridones,
      N-methylcytisine and cytisine, showed the highest affinities at the nicotinic
      receptor, while several quinolizidine alkaloid types were especially active at
      the muscarinic receptor.

PMID- 7798969
TI  - Yunnanxane and its homologous esters from cell cultures of Taxus chinensis var.
      mairei.
AB  - From cell cultures of Taxus chinensis var. mairei, yunnanxane [2 alpha, 5 alpha,
      10-beta triacetoxy-14 beta-(2'-methyl-3'-hydroxyl)-butyryloxy-4(20),11-taxadiene,
      [1], and four new homologous esters, 2 alpha, 5 alpha, 10 beta, 14 beta- tetra
      acetoxy-4(20),11-taxadiene [2], 2 alpha, 5 alpha, 10 beta- triacetoxy-14 beta
      propionyloxy-4(20),11-taxadiene [3], 2 alpha, 5 alpha, 10 beta- triacetoxy-14
      beta-isobutyryloxy-4(20),11- taxadiene [4], and 2 alpha, 5 alpha, 10 beta-
      triacetoxy-14 beta-(2'-methyl)-butyryloxy-4(20),11- taxadiene [5] have been
      isolated. Their structures were determined by spectroscopic methods.

PMID- 7798971
TI  - Management of neurological disorders: dementia.

PMID- 7798970
TI  - Growth factors: potential therapeutic applications in neurology.

PMID- 7798972
TI  - Cerebral amyloid angiopathy.

PMID- 7798973
TI  - White matter magnetic resonance hyperintensities in dementia of the Alzheimer
      type: morphological and regional cerebral blood flow correlates.
AB  - In a prospective MRI study the presence, appearance, volume, and regional
      cerebral blood flow (rCBF) correlates of periventricular hyperintensities (PVHs)
      and deep white matter hyperintensities (DWMHs) were examined in 18 patients with
      probable Alzheimer's disease and in 10 age matched healthy control subjects, all
      without major cerbrovascular risk factors. The 133Xe inhalation method and the
      [99mTc]-d,l-hexamethyl-propylene-amine-oxime (HMPAO) technique with single photon
      emission computed tomography (SPECT) were used to measure rCBF. Rating scores for
      PVHs were significantly higher in the Alzheimer's disease group (p < 0.01) and
      correlated significantly with the volume of ventricles (p < 0.05) and with
      systolic arterial blood pressure (p < 0.01), but not with rCBF. By contrast,
      there was no significant difference in the rating scores or volumes of DWMHs
      between the two groups, although three patients had extensive DWMH lesions in the
      central white matter. In the group of patients with Alzheimer's disease as a
      whole, the volume of DWMHs correlated well with rCBF in the hippocampal region (
      r = -0.72; p < 0.001), but not with frontal, temporal, parietal, or occipital
      rCBF. Postmortem histopathology of extensive DWMH lesions in one patient with
      definite Alzheimer's disease showed a partial loss of myelin and astrocytic
      gliosis, but no ischaemic changes. It is concluded that DWMH lesions may be
      associated with reduced rCBF in the hippocampal region. The heterogenous
      topography of neocortical rCBF deficits in Alzheimer's disease could not be
      explained by deafferentation from underlying white matter hyperintensities and
      therefore may reflect variations in the topography of cortical abnormalities.

PMID- 7798974
TI  - Dorothea Lynde Dix (1802-87).

PMID- 7798976
TI  - Cerebral glucose metabolism in neurofibromatosis type 1 assessed with [18F]-2
      fluoro-2-deoxy-D-glucose and PET.
AB  - Cerebral PET with [18F]-2-fluoro-2-deoxy-D-glucose has been performed in four
      patients with neurofibromatosis type 1 (NF1) to assess the relation between
      cerebral metabolic activity, MRI, and the presence of neurological symptoms,
      including seizures, as well as mental and language retardation. Widespread
      hypometabolism occurred in three of the patients. The lesions on MRI, which were
      localised in the subcortical white matter and grey structures, had normal rates
      of glucose metabolism. This finding suggests that the abnormalities seen on MRI
      are not due to defective blood supply, localised oedema, or grey matter
      heterotopic foci as previously hypothesised. The presence of the hypometabolic
      areas seems to be inconsistently related to the occurrence of seizures and is not
      proportional to the degree of mental impairment. This study provides evidence of
      a widespread cerebral hypometabolism that is not related to the presence of MRI
      abnormalities; conversely normal metabolism was present in the areas with an
      abnormal MRI signal.

PMID- 7798977
TI  - Radiological and neurophysiological changes in Japanese encephalitis.
AB  - Six patients with Japanese encephalitis, four males and two females whose age
      ranged between 2 and 47 years, were subjected to neurophysiological and
      radiological studies. An EEG in five of the patients showed diffuse delta wave
      activity and one had an alpha coma. Delta activity seems to be due to thalamic
      involvement, which was seen on CT of two and MRI of all the patients. The
      thalamic lesions were characteristically bilateral and were haemorragic in five.
      Changes on MRI included abnormalities of the brainstem in three and the basal
      ganglia and spinal cord in one patient each. Lower motor neuron signs were
      present in three patients but abnormal MRI signals in the spinal cord were
      present in only one out of three patients in whom spinal MRI was carried out.
      Central motor conduction time in the upper limb was prolonged in three patients
      (five sides) and in the lower limbs in one (both sides), which was consistent
      with involvement of the cerebral cortex, thalamus, brainstem, and spinal cord.
      Changes in MRI and EEG in the acute stage may provide early diagnostic clues in
      patients with Japanese encephalitis.

PMID- 7798975
TI  - Comparison of magnetic resonance angiography, duplex ultrasound, and digital
      subtraction angiography in assessment of extracranial internal carotid artery
      stenosis.
AB  - The results of a prospective study comparing ultrasound, intra-arterial digital
      subtraction angiography, and magnetic resonance angiography in the assessment of
      the degree of extracranial internal carotid artery stenosis are reported in
      patients with symptoms of recent carotid territory ischaemia. A total of 70
      patients and 137 vessels were examined by all three techniques. The results
      obtained by each technique were reported blind. The mean difference (SD) for the
      comparison of magnetic resonance angiography and digital subtraction angiography
      was -0.7 (14)%, for ultrasound and digital subtraction angiography 3.1 (15)%, and
      for magnetic resonance angiography and ultrasound -3.8 (15)%. The level of
      agreement was greater for the more tightly stenosed vessels. With the assumption
      that the results of the digital subtraction angiogram reflect the true situation,
      the sensitivity and specificity in the detection of > or = 30% stenoses were 93%
      and 82% with ultrasound and 89% and 82% with magnetic resonance angiography; for
      stenoses > or = 70% 93% and 92% with ultrasound and 90% and 95% with magnetic
      resonance angiography; and for stenoses of 70-99% 89% and 93% with ultrasound and
      86% and 93% with magnetic resonance angiography. For occlusion the values were
      93% and 99% with ultrasound and 80% and 99% with magnetic resonance angiography.
      Increased sensitivity and specificity were obtained when analysis was confined to
      those vessels in which ultrasound and magnetic resonance angiography were in
      agreement over classification. It is thus possible to accurately categorize the
      degree of stenosis of the extracranial internal carotid artery from a combination
      of ultrasound and magnetic resonance angiography. The adoption of this
      combination for the investigation of patients before carotid endarterectomy
      removes the risk associated with conventional angiography and represents an
      important advance in the management of carotid stenosis.

PMID- 7798978
TI  - Presynaptic inhibition of soleus Ia afferent terminals in Parkinson's disease.
AB  - The possible role of changes in presynaptic inhibition of muscle spindle primary
      afferent terminals in Parkinson's disease was investigated. The pathway from
      tibialis anterior Ia afferents to soleus Ia terminals was assessed in 20 patients
      with Parkinson's disease and in 17 age matched controls, both at rest and during
      maintenance of tonic plantar flexing torques about the ankle. At all torques less
      presynaptic inhibition was present in the patients with Parkinson's disease than
      in the controls. The difference was significant at rest (p < 0.03) and at 2 Nm (p
      < 0.05) but not at 5 Nm and 7 Nm torque. The amount of presynaptic inhibition did
      not change with torque in either group. The observed alteration in presynaptic
      inhibition in Parkinson's disease is likely to make only a small contribution to
      the rigidity and impaired movement control.

PMID- 7798980
TI  - Gangliogliomas: clinical, radiological, and histopathological findings in 51
      patients.
AB  - Clinical, radiological, and histopathological features of 51 surgically treated
      gangliogliomas were evaluated retrospectively. The most common presenting
      symptoms were epileptic seizures (47 patients (92%)). Focal neurological deficits
      occurred in 8% of the patients. The duration of symptoms at the time of operation
      ranged from three months to 45 years, mean 11 years. The temporal lobe was
      affected in 43 patients (84%), the frontal lobe in five patients (10%), and the
      occipital lobe in one patient (2%). Two of the tumours (4%) were localised
      infratentorially. On MRI, solid tumour parts usually showed a pronounced signal
      increase on proton density images and a less pronounced signal increase on T2
      weighted images, whereas solid components were mainly isointense on T1 weighted
      images. Contrast enhancement was noted in 16 of 36 patients (44%). Cystic tumour
      parts were found in 23 of 40 patients (57%), all characterised by signal increase
      on T2 weighted images and decreased T1 signals. Signal deviation of cystic tumour
      parts on proton density images was variable. Computed tomography was performed in
      17 patients and showed hypodense lesions in 10 (59%), and calcifications in seven
      (41%) cases. Surgery included complete tumour removal in 44 patients (86%) and
      partial resection in seven (14%). In six patients (12%) there were transient
      postoperative complications. One patient (2%) died postoperatively due to
      pulmonary embolism. Histopathological examination of the surgical specimens
      showed low grade gangliogliomas in 49 cases (96%) and anaplastic gangliogliomas
      in two (4%). Control MRI of 31 patients with a mean follow up period of 16 months
      was uneventful in all but one case of an anaplastic ganglioglioma. In all
      patients in whom the ganglioglioma was associated with medically intractable
      seizures the operation resulted in complete relief of seizures or a noticeable
      improvement of the epilepsy.

PMID- 7798979
TI  - Brain and muscle energy metabolism studied in vivo by 31P-magnetic resonance
      spectroscopy in NARP syndrome.
AB  - Phosphorus magnetic resonance spectroscopy (31P-MRS) was used to study in vivo
      the energy metabolism of brain and skeletal muscle in two members of an Italian
      pedigree with NARP syndrome due to a point mutation at bp 8993 of mtDNA. In the
      youngest patient, a 13 year old girl with retinitis pigmentosa, ataxia, and
      psychomotor retardation, there was an alteration of brain energy metabolism shown
      by a decreased phosphocreatine content, increased [ADP] and decreased
      phosphorylation potential. The energy metabolism of her skeletal muscle was also
      abnormal, as shown by resting higher inorganic phosphate and lower
      phosphocreatine concentrations than in normal subjects. Her mother, a 41 year old
      woman with minimal clinical involvement, showed a milder derangement of brain
      energy metabolism and normal skeletal muscle. Findings with MRS showed that this
      point mutation of mtDNA is responsible for a derangement of energy metabolism in
      skeletal muscle and even more so in the brain.

PMID- 7798981
TI  - Extrapyramidalism in Alzheimer's disease: prevalence, psychiatric, and
      neuropsychological correlates.
AB  - The prevalence and clinical correlates of extrapyramidal signs in a consecutive
      series of 78 patients with Alzheimer's disease attending a neurology clinic, and
      20 age comparable normal controls, were examined. Based on the unified
      Parkinson's disease rating scale (UPDRS) findings, 18 patients (23%) met criteria
      for parkinsonism, 44 (56%) had isolated extrapyramidal signs, and 16 (21%) had no
      extrapyramidal signs. Whereas the control group showed a similar prevalence of
      isolated extrapyramidal signs (57%), none of them showed parkinsonism. No
      significant differences were found for age, sex, duration of illness, and
      severity of dementia among the three Alzheimer's disease groups. Patients with
      Alzheimer's disease-parkinsonism, however, showed a significantly higher
      frequency of major depression and dysthymia and significantly higher Hamilton
      depression scores than patients with isolated or no extrapyramidal signs.
      Patients with Alzheimer's disease-parkinsonism also showed significantly more
      deficits on frontal lobe related tasks such as the Wisconsin card sorting test,
      trail making test, and verbal fluency, as well as on tests of constructional
      praxis and abstract reasoning than patients with Alzheimer's disease but no
      extrapyramidal signs. In conclusion, the study showed a specific association
      between Alzheimer's disease and parkinsonism, as well as significant relations
      between parkinsonism, deficits in executive functions, and depression among
      patients with Alzheimer's disease.

PMID- 7798982
TI  - A neuropsychological instrument adding to the description of patients with
      suspected cortical dementia: the Milan overall dementia assessment.
AB  - A new, short, neuropsychologically oriented test for dementia assessment--the
      Milan Overall Dementia Assessment (MODA)--is described. Age and education
      adjusted norms based on 217 healthy controls are given. A validation study on 312
      outpatients suspected of dementia (121 with probable Alzheimer's disease) showed
      that the MODA differentiated patients with cognitive impairment from normal
      subjects more effectively than did the DSM III-R. The correlation between the
      MODA and the mini mental state examination was 0.63 in controls and 0.84 in
      patients with Alzheimer's dementia. The MODA test-retest reliability was 0.83.
      The test proved to be well suited to longitudinal studies.

PMID- 7798983
TI  - Emotion-related learning in patients with social and emotional changes associated
      with frontal lobe damage.
AB  - A group of patients with damage to the ventral part of the frontal lobes was
      severely impaired relative to a group of patients without damage in this area
      (the non-ventral group) in the reversal and in the extinction of simple visual
      discrimination tests. In these tests they continued to make responses to a
      previously rewarded stimulus. Patients often reported verbally that the
      contingencies had changed, but were unable to alter their behaviour
      appropriately. These impairments occurred independently of IQ or verbal memory
      impairments. The perseverative touching of a previously rewarded stimulus is
      consistent with work with non-human primates showing impaired reversal and
      extinction after orbitofrontal lesions. Performance on these reversal and
      extinction tests was highly correlated with scores obtained on a behaviour
      questionnaire, which reflected the degree of disinhibited and socially
      inappropriate behaviour exhibited by patients. It is suggested that a difficulty
      in modifying responses, especially when followed by negative consequences, as
      manifested in these simple laboratory tests, may contribute to the inappropriate
      behaviour shown in daily life by patients with frontal lobe damage.

PMID- 7798984
TI  - Chronic idiopathic axonal polyneuropathy: a five year follow up.
AB  - Seventy five patients with chronic idiopathic axonal polyneuropathy (CIAP) were
      studied for five years. The standardised and quantified neurological examination
      shows that progression of CIAP is slow, and handicap, if present, is not severe.
      During the follow up period a definite cause of the neuropathy was found in only
      four patients (two hereditary motor and sensory neuropathy type 2, one sensory
      chronic inflammatory demyelinating polyneuropathy, one alcoholic neuropathy). At
      the end of the follow up CIAP was not related to malignancy or gammopathy.
      Routine repetition of laboratory tests was not informative and these tests should
      be performed on clinical grounds only.

PMID- 7798985
TI  - Clinical and magnetic resonance imaging study of extrapyramidal symptoms in
      multiple system atrophy.
AB  - Slit-hyperintensity in the outer margin of the putamen on T2 weighted MRI was
      found in 17 out of 28 patients with clinically diagnosed multiple system atrophy.
      Thirteen of these 17 patients showed extrapyramidal signs. Five patients had only
      unilateral slit-hyperintensity; four of them had contralateral rigidity; and one
      had bradykinesia. Despite mild rigidity, one case showed no slit-hyperintensity.
      One of the 14 cases with parkinsonism showed no hyperintensity, and four of the
      14 cases without parkinsonism showed hyperintensity. On the other hand, slit
      hyperintensity was not seen in any of 25 patients with clinically diagnosed
      Parkinson's disease. Putaminal slit-hyperintensity is a useful MRI feature in the
      differential diagnosis between Parkinson's disease and multiple system atrophy
      predominantly affecting the extrapyramidal system.

PMID- 7798986
TI  - Ability to modulate walking cadence remains intact in Parkinson's disease.
AB  - Gait hypokinesia (slowness) is a characteristic feature of Parkinson's disease.
      It is not clear, however, whether the slowness is due to a problem in regulation
      of the timing of consecutive steps or the control of stride size. Examination of
      cadence control for slow to medium walking speeds has shown an increase in step
      frequency that was a compensation for reduced stride length. In this
      investigation the ability of Parkinsonian patients to modulate their cadence
      (steps per minute) at the fast walking speeds exhibited by age and height matched
      controls was examined. The findings indicated that cadence control remains
      unaffected throughout its entire range in Parkinson's disease and that gait
      hypokinesia is directly attributable to an inability to internally generate
      sufficiently large steps.

PMID- 7798987
TI  - Optimisation of botulinum treatment for cervical and axial dystonias: experience
      with a Japanese type A toxin.
AB  - Twenty two patients with cervical and axial dystonias were treated with Japanese
      type A botulinum toxin. Injections were given repeatedly at intervals of 28-30
      days to carefully chosen muscles with increased activities, with a maximum dose
      per session of 300 units. The maximum improvements in subjective and objective
      ratings were obtained only after repeated injections. No anti-toxin antibodies
      were detected; nor did any muscle fail to respond to the toxin. During the
      treatment, previously "silent" muscles were activated to reproduce the original
      abnormal posture, as if driven by a central motor programme. This resistance to
      treatment was overcome by injecting the toxin into newly activated muscles.
      Repeated injections are thus required to override central mechanisms in dystonias
      or to maximise drug delivery to large muscles. Antibody development may be
      controlled by the use of a less immunogenic toxin.

PMID- 7798988
TI  - Click-evoked vestibular activation in the Tullio phenomenon.
AB  - Click-evoked vestibulocollic reflexes were studied in a patient with a unilateral
      Tullio phenomenon (sound induced vestibular symptoms) and the findings were
      compared with those of a group of normal subjects. Compared with normal subjects,
      the reflexes elicited from her symptomatic side were large and had an abnormally
      low threshold, but retained a normal waveform. The click-evoked responses in this
      patient show changes consistent with her symptomatology and are indicative of a
      pathological increase in the normal vestibular sensitivity to sound.

PMID- 7798990
TI  - Vertebrobasilar dolichoectasia and exertional headache.

PMID- 7798989
TI  - A patient with one limb interstitial myositis with localised lipoatrophy
      presenting with severe cramps and fasciculations.
AB  - A case of interstitial myositis associated with a localised lipoatrophy is
      reported. The patient is a 24 year old man who presented with severe painful
      cramps and fasciculations localised to one limb. The rarity of both disorders,
      and their likely common autoimmune mechanism, suggest that this is not a chance
      association.

PMID- 7798991
TI  - Cholinergic supersensitivity of the iris in Alzheimer's disease.

PMID- 7798992
TI  - Rheumatic chorea and lupus anticoagulant.

PMID- 7798993
TI  - Acute peripheral neuropathy, rhabdomyolysis, and severe lactic acidosis
      associated with 3243 A to G mitochondrial DNA mutation.

PMID- 7798994
TI  - Papilloedema and visual failure in a patient with nocturnal hypoventilation.

PMID- 7798995
TI  - Hemichorea reversible after operation in a boy with cavernous angioma in the head
      of the caudate nucleus.

PMID- 7798996
TI  - The nature of apraxia in corticobasal degeneration.

PMID- 7798997
TI  - Transient epileptic amnesia--a clinical update and a reformulation.

PMID- 7798998
TI  - Hypokinesia of associated movement in Parkinson's disease: a symptom in early
      stages of the disease.
AB  - We compared the degrees of impairment between intended voluntary movement and its
      simultaneous automatic associated movement in Parkinson's disease (PD). We
      studied wrist dorsiflexion as a movement associated with grip in 20 patients with
      PD and in 20 normal controls. The patients showed a significantly smaller
      dorsiflexion as compared with the controls. The decrease in associated movement
      was related to the severity of clinical stage of the disease, while gripping was
      performed well in each stage. The temporal relationship between grip and
      associated movement was the same for both groups of subjects. The patients showed
      no disturbance of amplitude or velocity for a single motor act of wrist
      dorsiflexion. Persons with PD have a greater reduction of automatic associated
      movement than intended voluntary movement. This may be one of the bases of
      clinical symptoms of PD patients in early stages of the disease.

PMID- 7798999
TI  - Astereopsis induced by repetitive magnetic stimulation of occipital cortex.
AB  - Three healthy subjects underwent repetitive transcranial magnetic stimulation (20
      Hz, 1 s) with a round oil-cooled coil held tangentially against the skull surface
      3 or 4 cm above the inion, while viewing a random-dot stereogram through red
      green glasses. The coil was positioned over the midline of the bilateral superior
      occipital lobes. All three subjects experienced loss of stereoscopic perception
      during stimulation. A stimulus duration of more than 0.2 s and a stimulus
      frequency of more than 10 Hz seem to be necessary to disrupt the cortical
      mechanisms involved in global stereopsis. Repetitive magnetic stimulation easily
      and painlessly produced a reversible disturbance in global stereopsis. The
      results suggest that the bilateral superior occipital cortices are involved in
      the perception of global stereopsis.

PMID- 7799001
TI  - The Dementia Rating Scale in Alzheimer's disease, Huntington's disease and
      progressive supranuclear palsy.
AB  - The Dementia Rating Scale (DRS) comprises a series of five subtests which assess
      attention, memory, initiation/preservation, construction, and conceptualisation.
      It can be delivered in full in approximately 30 min, making it a useful test for
      the detection and estimation of the overall level of dementia. We analysed the
      pattern of subscale test scores in patients with cortical and subcortical
      dementias, who were matched for their overall level of dementia on this scale.
      Patients with dementia of Alzheimer's type were more impaired than patients with
      Huntington's disease (HD) and progressive supranuclear palsy (PSP) on the memory
      subtest, whereas patients with HD and PSP were more impaired on the
      initiation/perseveration subtest. This is evidence in favour of the concept of
      cortical and subcortical dementias as separate, although overlapping, entities.
      Qualitative differences in the pattern of cognitive impairment in these disorders
      can be detected with a brief cognitive status examination.

PMID- 7799000
TI  - Differentiation of herpes simplex virus 1 and 2 in cerebrospinal fluid of
      patients with HSV encephalitis and meningitis by stringent hybridization of PCR
      amplified DNAs.
AB  - Differentiation of herpes simplex virus (HSV) types 1 and 2 in cerebrospinal
      fluid of 17 patients with serologically diagnosed HSV encephalitis and meningitis
      or acute limbic encephalitis was determined by stringent hybridization of
      polymerase chain reaction--amplified DNAs. Ten of 17 patients were positive; six
      with HSV 1 isolates and four with HSV 2 isolates. We detected HSV type 1 in two
      cases of meningitis, although meningitis is generally thought to be caused by
      type 2. Additionally, HSV type 2 was found in one case of acute adult
      encephalitis, which is generally due to HSV type 1. HSV DNAs could be detected
      for over 1 month after onset, although our patients included several prolonged
      and recurrent cases. HSV DNA genomes were not detected in three cases of acute
      limbic encephalitis. Our study indicates that this method can be used for type
      differentiation in HSV CNS infections.

PMID- 7799002
TI  - The "jerky dystonic unsteady hand": a delayed motor syndrome in posterior
      thalamic infarctions.
AB  - We report the cases of three patients with a thalamic infarct in the territory of
      the posterior choroidal artery involving the posterior thalamic nuclei. These
      patients developed delayed complex hyperkinetic motor syndromes, associating
      ataxia, tremor, dystonia, myoclonus and chorea, which we call "the jerky dystonic
      unsteady hand". One patient had a severe myoclonic and ataxic-dystonic
      choreoathetosis; another showed a so-called rubral tremor (myoclonic ataxia with
      resting, action, and wing-beating tremor) with dystonia; and the third one had a
      dystonic and ataxic hand with intermittent mild action myoclonus. All of them had
      sensory dysfunction; two had also presented with a painful Dejerine-Roussy
      syndrome. All had CT or MRI-proven infarcts in the territory of the posterior
      cerebral artery involving the posterior choroidal territory with an abnormal
      signal in the posterior area of the thalamus (pulvinar nucleus) but sparing the
      other thalamic, subthalamic and midbrain structures. These delayed myoclonic
      complex hyperkinetic syndromes have not been reported before, and we did not
      observe them in other topographic forms of thalamic infarcts. They may thus
      represent a new entity of movement disorders due to lesions in the posterior
      thalamic nuclei, with specificity for posterior choroidal artery infarcts.

PMID- 7799003
TI  - Usefulness of movement time in the assessment of Parkinson's disease.
AB  - Reaction time (RT) and movement time (MT) are reported to be delayed in
      Parkinson's disease (PD), but their clinical utility and relationship with
      clinical findings is still uncertain. We investigated RT and MT in 22 PD patients
      at baseline conditions and following acute oral trials of levodopa and biperiden,
      an anticholinergic drug. At baseline conditions, RT and MT of PD patients were
      abnormally delayed compared with those of 16 normal control subjects. Both RT and
      MT were longer in more severely affected patients compared with the mild PD
      patients; in the mild PD patients with asymmetrical signs both responses were
      longer on the more affected side. Bradykinesia was the clinical symptom that best
      correlated with the objective measurements, with a stronger correlation for MT
      than for RT. The oral administration of levodopa significantly improved both the
      responses, whereas biperiden was ineffective. The magnitude of RT and MT
      improvement after levodopa differed; MT improvement was related to PD severity,
      whereas RT improvement was not. These results suggest that MT, rather than RT, is
      an objective, simple, and reliable tool to evaluate bradykinesia and its levodopa
      induced modifications in PD.

PMID- 7799005
TI  - Central alveolar hypoventilation associated with paraneoplastic brain-stem
      encephalitis and anti-Hu antibodies.
AB  - We describe a patient with a paraneoplastic brain-stem encephalitis due to an
      occult small cell carcinoma of the lung. He developed episodes of central sleep
      apnoea culminating in acute respiratory failure. Antibodies resembling anti-Hu
      antibodies were demonstrated in both serum and cerebrospinal fluid.

PMID- 7799004
TI  - Laryngeal electromyography with separated surface electrodes in patients with
      multiple system atrophy presenting with vocal cord paralysis.
AB  - When recording the activity of the posterior cricoarytenoid muscle (PCA) with
      surface electrodes, there is contamination from the surrounding muscles such as
      the cricopharyngeal muscle. We therefore devised a new oesophageal catheter
      electrode of the separate type, having three individual surface electrodes for
      the PCA, cricopharyngeal muscle and diaphragm. The records obtained with this
      catheter demonstrated satisfactory separation between PCA and cricopharyngeal
      muscle activities. We used this catheter in patients with multiple system atrophy
      presenting with vocal cord paralysis, who were awake or asleep. There were two
      interesting electromyographical findings, which were inspiratory activity of the
      adductor muscle (the thyroarytenoid muscle) and fade-out of the abductor muscle,
      that is, PCA activity during sleep. Although vocal cord paralysis is one of the
      most serious life-threatening complications, the precise mechanism has not been
      clarified. We believe that our catheter may be useful in investigating the
      mechanism of vocal cord paralysis which could cause sudden death in
      neurodegenerative disorders, including multiple system atrophy.

PMID- 7799007
TI  - The "anterior operculum syndrome".

PMID- 7799006
TI  - Valproate encephalopathy and hypocarnitinaemia in diabetic patients.
AB  - Two patients with epilepsy and diabetes mellitus developed encephalopathy while
      on valproate monotherapy. Low plasma carnitine levels were found. Discontinuation
      of valproate was followed by clinical recovery and normalization of carnitine
      levels. Both valproate treatment and diabetes mellitus may contribute to
      secondary carnitine deficiency, with resultant encephalopathy. Thus, diabetic
      patients may be at increased risk of developing valproate encephalopathy
      associated with hypocarnitinaemia.

PMID- 7799008
TI  - Chemotherapy in acute myelogenous leukemia: high dose, higher expectations?

PMID- 7799009
TI  - Risk of second aerodigestive cancers increases in patients who survive free of
      small-cell lung cancer for more than 2 years.
AB  - PURPOSE: Patients who survived small-cell lung cancer (SCLC) for more than 2
      years were evaluated to determine the frequency and anatomic pattern of
      redevelopment of small-cell cancer and development of non-small-cell lung cancer
      (NSCLC) and aerodigestive cancers with the passage of time. PATIENTS AND METHODS:
      From April 1973 through December 1991, 578 patients with previously untreated
      SCLC were entered onto prospective therapeutic trials at the National Cancer
      Institute (NCI), Bethesda, MD. Sixty-two (11%) were cancer-free 2 years after
      initiation of therapy and were assessable for redevelopment of SCLC and
      development of NSCLC, and aerodigestive cancers. RESULTS: Twenty patients
      redeveloped SCLC 2.0 to 12.2 years after initiation of chemotherapy, of whom two
      patients were deemed to have a second primary small-cell cancer that involved the
      aerodigestive tract. Fifteen patients developed 16 cancers in the lung other than
      SCLC 3.4 to 14.9 years after initiation of therapy. Two developed other
      aerodigestive cancers that involved the larynx and lip. The risk of a NSCLC and
      aerodigestive cancer in these patients increased more than sixfold from 2% per
      patient per year during years 2 to 4 to 12.6% and 14.4%, respectively, after more
      than 10 years. The cumulative actuarial risk of a second primary NSCLC or
      aerodigestive cancer at 16 years is 69% and 72%, respectively. CONCLUSION: The
      increasing risk of second aerodigestive cancers with the passage of time is a
      mounting problem for patients cured of SCLC. Chemoprevention trials for these
      patients should be considered.

PMID- 7799010
TI  - Timed sequential chemotherapy for previously treated patients with acute myeloid
      leukemia: long-term follow-up of the etoposide, mitoxantrone, and cytarabine-86
      trial.
AB  - PURPOSE: To confirm and extend encouraging preliminary results of timed
      sequential chemotherapy (TSC) in patients with previously treated acute
      myelogenous leukemia (AML). PATIENTS AND METHODS: We report the results of the
      regimen of mitoxantrone on days 1 to 3, etoposide on days 8 to 10, and cytarabine
      on days 1 to 3 and 8 to 10 (EMA) in 133 patients, with a median follow-up of 40
      months. RESULTS: Sixty percent of patients, with a 95% confidence interval (CI)
      ranging from 51% to 68%, achieved complete remission (CR), including 44% (CI, 32%
      to 57%) of refractory patients and 76% (CI, 64% to 86%) of late first-relapse
      patients (P = .0002). Twenty-nine percent of patients did not respond to therapy,
      and 11% died from toxicity. Median duration of neutropenia and thrombocytopenia
      was 31 days and 29 days, respectively. Severe nonhematologic toxicity included
      sepsis in 54% of patients and mucositis in 23%. Postinduction therapy included a
      second course of EMA in 27 patients, maintenance in 10, autologous bone marrow
      transplantation (BMT) in 12, and allogeneic BMT in 13. Median survival of
      patients who did not have transplantation performed is 7 months, with 11% (CI, 4%
      to 18%) survival at 5 years. Median disease-free survival (DFS) is 8 months with
      20% (CI, 8% to 32%) DFS at 5 years. Twenty-eight percent (CI, 15% to 44%) of
      nontransplanted patients who achieved CR had an inversion of CR duration.
      Previous refractoriness was the main factor associated with poor prognosis for CR
      achievement, DFS, and survival. CONCLUSION: These results confirm initial reports
      on TSC and show that approximately 20% of patients with first relapse after
      therapy can enjoy prolonged DFS using chemotherapy only.

PMID- 7799011
TI  - Randomized phase III trial in childhood high-grade astrocytoma comparing
      vincristine, lomustine, and prednisone with the eight-drugs-in-1-day regimen.
      Childrens Cancer Group.
AB  - PURPOSE: In a previous randomized trial, the addition of adjuvant chemotherapy to
      postoperative radiotherapy proved beneficial in the treatment of childhood high
      grade astrocytomas. The present study tests the hypothesis that an eight-drug
      adjuvant chemotherapy regimen would improve survival in such children compared
      with the three-drug regimen of the prior study. PATIENTS AND METHODS: Between
      April 1985 and May 1990, patients between the ages of 18 months and 21 years with
      newly diagnosed high-grade astrocytomas were eligible for this study, as
      determined by the treating institution's histopathologic diagnosis. Treatment
      consisted of postoperative local-field radiotherapy and adjuvant chemotherapy,
      either lomustine (CCNU), vincristine, and prednisone (control regimen) or eight
      drugs-in-1-day chemotherapy (experimental regimen). Two cycles of postoperative
      preirradiation chemotherapy were administered in the experimental regimen.
      Patients were evaluated radiographically every 3 months after irradiation.
      RESULTS: Eighty-five eligible patients were randomized to the control regimen and
      87 to the experimental regimen. The progression-free survival (PFS) and overall
      survival (OS) at 5 years were 33% (SE = 5%) and 36% (SE = 6%), respectively.
      There was no statistical difference in outcome between the two chemotherapy
      regimens. In patients with confirmed diagnoses of anaplastic astrocytoma (AA) or
      glioblastoma multiforme (GBM), anaplastic astrocytoma, greater than 90%
      resection, and nonmidline tumor location were characteristics predictive of an
      improved PFS. There was a difference in toxicity between the two chemotherapeutic
      regimens, with greater myelosuppression and hearing loss in the experimental
      regimen. Tumor recurrence occurred primarily within the primary tumor site.
      CONCLUSIONS: There is no benefit to the treatment of high-grade astrocytomas in
      children with eight-drugs-in-1-day chemotherapy compared with CCNU, vincristine,
      and prednisone. Extent of tumor resection and histopathologic diagnosis are
      significant prognostic variables. The overall outcome for children with high
      grade astrocytomas remains poor.

PMID- 7799012
TI  - Results of the United Kingdom Children's Cancer Study Group first Wilms' Tumor
      Study.
AB  - PURPOSE: The first United Kingdom Children's Cancer Study Group (UKCCSG) Wilms'
      Tumor Trial (UKW1) applied treatment regimens stratified by stage and histology
      in accordance with National Wilms' Tumor Study (NWTS) criteria, seeking to reduce
      treatment of low-stage, favorable-histology (FH) tumors without impairing
      survival and to improve prognosis of stage III and IV (FH) and unfavorable
      histology (UH) tumors with more intensive chemotherapy. PATIENTS AND METHODS:
      Three hundred eighty-four consecutively diagnosed patients with Wilms' tumor were
      recruited from the 20 UKCCSG centers and Oslo, Norway, between January 1980 and
      June 1986. The regimen for stage I patients was vincristine (Vcr) only, while
      stage II patients received Vcr and dactinomycin (Act-D). Stage III patients
      received three-drug therapy and stage IV and UH patients four-drug regimens. Act
      D was given as pulsed doses of 1.5 mg/m2 every 3 or every 6 weeks. No lung
      irradiation was used in stage IV patients. No randomized comparisons were
      attempted. End points were survival and event-free survival (EFS). RESULTS:
      Survival at 6 years in FH patients was 96% for stage I, 93% for stage II, 83% for
      stage III, 65% for stage IV, and 50% for UH patients of all stages. CONCLUSION:
      Vcr alone is as effective for stage I FH tumors as the two-drug regimen used in
      the NWTS and International Society of Pediatric Oncology (SIOP) studies.
      Fractionation of Act-D is unnecessary. The poorer results for stage IV FH and UH
      patients compared with the NWTS may be due to treatment differences, such as the
      use of lung irradiation for stage IV FH patients in NWTS3, and/or to case
      selection bias.

PMID- 7799014
TI  - Patterns of survival in patients with recurrent follicular lymphoma: a 20-year
      study from a single center.
AB  - PURPOSE: To examine outcome of treatment for patients with recurrent follicular
      lymphoma. PATIENTS AND METHODS: Two hundred twelve newly diagnosed follicular
      lymphoma patients were studied. One hundred seventy-nine were initially treated
      successfully. Recurrent or progressive lymphoma developed in 116. Treatment was
      given according to disease stage and current protocols, mostly with single
      alkylating agents. A policy of repeated lymph node and bone marrow biopsy was
      pursued. RESULTS: The overall median survival duration was 9 years, with a median
      follow-up duration of 12 years. Following recurrence, the median survival
      duration was 4 1/2 years. Only eight of 116 patients with recurrent disease died
      of causes unrelated to lymphoma. The overall response rate to first re-treatment
      was 78% and showed slight decline with successive recurrences, reaching 48% after
      the fourth treatment. The median duration of second remission was 13 months, (v
      31 months for first remission), with the only significant predictive factor being
      quality of remission. Multivariate analysis showed only age at recurrence and
      number of prior treatments to correlate with survival after first recurrence.
      Survival after second remission was only correlated with age and quality of
      response: Kaplan-Meier estimates gave 53% of patients reaching second complete
      remission alive 10 years later, compared with 28% in partial remission.
      CONCLUSION: Age and previous and continuing responsiveness of follicular lymphoma
      to therapy are the principal determinants of survival following recurrence.
      Improvement in survival with new treatments will be demonstrated most readily in
      older patients, while more intensive approaches should be tested in younger
      patients in whom remission is achieved with difficulty.

PMID- 7799013
TI  - Gonadal function following chemotherapy for Hodgkin's disease: a comparative
      study of MVPP and a seven-drug hybrid regimen.
AB  - PURPOSE AND METHODS: Gonadal function was assessed in 89 patients after
      chemotherapy for Hodgkin's disease (HD). Thirty-seven patients had received
      mechlorethamine, vinblastine, prednisolone, and procarbazine (MVPP) and 52
      patients, a hybrid combination of chlorambucil, vinblastine, prednisolone,
      procarbazine, doxorubicin, vincristine, and etoposide (ChIVPP/EVA). Fifty men
      (MVPP, n = 21; ChIVPP/EVA, n = 29) with a median age of 26 years (range, 16 to
      54) and 39 women (MVPP, n = 16; ChIVPP/EVA, n = 23) with a median age of 30 years
      (range, 15 to 47) were studied at a median of 30 months (range, 4 to 83)
      following chemotherapy. RESULTS: Semen analysis showed azoospermia in 35 of 37
      men, and increased serum follicle-stimulating hormone (FSH) levels in this group
      confirmed severe germinal epithelial damage. Analysis of pretreatment semen in 28
      men showed azoospermia in one, oligospermia in four (sperm count < 20 x
      10(6)/mL), and a normal sperm count in the remaining 23. In the women, 26 of 34
      (76%) with a regular menstrual cycle before commencing chemotherapy became
      amenorrheic following treatment. Menses returned in 10 women, who had a median
      age of 25 years (range, 21 to 34), and there were two pregnancies in this group.
      In the other 16, with a median age of 36 years (range, 27 to 47), amenorrhea
      persisted and premature ovarian failure was confirmed by increased serum
      gonadotrophins and reduced estradiol (E2) concentrations. Of the original eight
      women in whom menses were maintained following treatment, two subsequently
      developed amenorrhea and the clinical and biochemical features of an early
      menopause. In total, 18 of 34 women (53%) required hormone replacement therapy
      for chemotherapy-induced ovarian failure. CONCLUSION: There was no statistically
      significant difference in the frequency or severity of gonadal dysfunction
      between MVPP- and ChIVPP/EVA-treated patients. We conclude that both of these
      chemotherapy schedules cause substantial damage to gonadal function in both
      sexes.

PMID- 7799015
TI  - Ketoconazole in the management of paraneoplastic Cushing's syndrome secondary to
      ectopic adrenocorticotropin production.
AB  - PURPOSE: To evaluate the safety and efficacy of ketoconazole treatment in the
      management of patients with paraneoplastic Cushing's syndrome (CS) secondary to
      ectopic adrenocorticotropin (ACTH) production by malignant neoplasms (ECS).
      PATIENTS AND METHODS: A retrospective chart review was undertaken for 15
      consecutive patients with ECS treated with ketoconazole. Strict criteria were
      defined for diagnosis of ECS and for clinical, biochemical, and hormonal
      responses. RESULTS: There were four women and 11 men with a median age of 59
      years (range, 44 to 84). Eleven patients had primary lung cancer (nine small-cell
      [SCLC], one mixed SCLC/non-SCLC, and one non-SCLC); two had carcinoid tumors (one
      bronchial, one pancreatic); one had hepatocellular carcinoma; and one had
      medullary carcinoma of the thyroid. Eight patients had ECS diagnosed at tumor
      presentation. Clinical findings included proximal muscle weakness (n = 10),
      peripheral edema (n = 8), and hypertension (n = 8). Biochemical abnormalities
      included hypokalemia (n = 14), metabolic alkalosis (n = 13), and new or worsened
      diabetes mellitus (n = 10). Patients received ketoconazole in dosages of 400 to
      1,200 mg/d titrated by changes in urinary free-cortisol (UFC) levels for a median
      duration of 26 days (range, 3 to 1,059), and nine also received chemotherapy with
      ketoconazole. Hypokalemia, metabolic alkalosis, diabetes mellitus, and
      hypertension improved in the majority of patients. Ten patients had a hormonal
      response, with seven complete responses (median duration, 25 days; range, 6 to
      989). The occurrence of symptomatic hypoadrenalism was definite in three patients
      and probable in one. Most patients died of progressive malignant disease
      accompanied by escape from hormonal control by ketoconazole. The median survival
      duration of the group was 19 weeks (range, 1 to 154). CONCLUSION: Ketoconazole
      results in biochemical and hormonal improvement for most patients with ECS. It
      has few adverse effects, but may impair the cortisol response to stress. For that
      reason, replacement corticosteroids should be considered for patients with
      hormonal response, and moderate- to high-dose corticosteroids should be given for
      any potential stress situations. The ultimate control of the syndrome is
      dependent on successful treatment of the underlying tumor.

PMID- 7799016
TI  - Monotherapy for fever and neutropenia in cancer patients: a randomized comparison
      of ceftazidime versus imipenem.
AB  - PURPOSE: To compare the efficacy of ceftazidime and imipenem monotherapy for
      fever and neutropenia, and to determine whether fewer antimicrobial modifications
      (additions or changes) are required by the broader-spectrum agent, imipenem.
      PATIENTS AND METHODS: Adult and pediatric patients undergoing chemotherapy for
      solid tumors, leukemias, or lymphomas were randomized to receive open-label
      ceftazidime or imipenem on presentation with fever and neutropenia. Success with
      or without modifications of the initial antibiotic was defined as survival
      through neutropenia; failure was death due to infection. Comparisons were based
      on numbers of modifications made to each monotherapy during the course of
      neutropenia, in patients stratified as having unexplained fever or a documented
      infection. RESULTS: Among 204 ceftazidime and 195 imipenem recipients, the
      overall success rate with or without modification was more than 98%, regardless
      of initial antibiotic regimen. Modifications occurred in half of all episodes,
      primarily in patients with documented infections on either monotherapy.
      Antianaerobic agents were more frequently added to ceftazidime (P < .001), but
      addition of other antibiotics, including vancomycin and aminoglycosides, was
      similar between the two monotherapy groups. Imipenem therapy was associated with
      significantly greater toxicity, manifested by Clostridium difficile-associated
      diarrhea and by nausea and vomiting, which required discontinuation of imipenem
      in 10% of recipients. CONCLUSION: Ceftazidime and imipenem are both effective in
      the management of fever and chemotherapy-related neutropenia, provided that
      modifications are made in response to clinical and microbiologic data that emerge
      during the course of neutropenia. Imipenem, despite its broader antimicrobial
      spectrum, does not significantly decrease the overall need for antibiotic
      modifications and is more often complicated by gastrointestinal toxicity.

PMID- 7799017
TI  - Effect of body position on ventricular CSF methotrexate concentration following
      intralumbar administration.
AB  - PURPOSE: Intralumbar methotrexate is one of the primary therapeutic modalities
      for the prevention and treatment of meningeal leukemia. However, methotrexate
      distribution to the ventricles is limited and highly variable following
      intralumbar dosing, and cytotoxic concentrations of methotrexate are not always
      achieved or sustained in the ventricular CSF. We used a nonhuman primate model to
      determine the effect of body position on the caudal distribution of an
      intralumbar dose of methotrexate. METHODS: Methotrexate (1.0 mg) was administered
      by intralumbar injection to four animals, which were then immediately placed
      either in an upright sitting position or in a prone position for 1 hour, then
      upright. Each animal served as its own control and was studied in each position
      on at least one occasion. RESULTS: The mean peak ventricular methotrexate
      concentration was 0.12 mumol/L (range, 0.091 to 0.20) in animals that were
      immediately placed upright, compared with 2.81 mumol/L (range, 0.21 to 8.9) in
      animals that remained prone for 1 hour. The mean area under the concentration
      versus-time curves (AUC) was 0.51 mumol/L.h (range, 0.26 to 1.1) in the upright
      animals and 12.0 mumol/L.h (range, 0.9 to 35.4) in the prone animals. CONCLUSION:
      Maintaining a prone position for 1 hour after an intralumbar dose increased the
      peak methotrexate concentration and drug exposure in ventricular CSF. CSF drug
      distribution following intralumbar therapy can be influenced by body position
      after the injection.

PMID- 7799018
TI  - Nonlinear pharmacokinetics and metabolism of paclitaxel and its
      pharmacokinetic/pharmacodynamic relationships in humans.
AB  - PURPOSE: To characterize and model the disposition of paclitaxel in humans and
      define a pharmacodynamic relationships between paclitaxel disposition and its
      toxicity and efficacy. PATIENTS AND METHODS: Paclitaxel pharmacokinetics were
      studied in 55 courses of therapy in 30 patients. Paclitaxel was administered at
      135 mg/m2 or 175 mg/m2 by either a 3- or a 24-hour infusion schedule to patients
      with advanced ovarian cancer (n = 15), or at 225 mg/m2 by 3-hour infusion to
      patients with advanced breast cancer (n = 15). Paclitaxel and 6 alpha
      hydroxylpaclitaxel were quantified by high-performance liquid chromatography
      (HPLC). Pharmacokinetics were assessed by noncompartmental and model-dependent
      methods. Pharmacodynamic correlations were evaluated statistically and by
      regression models. RESULTS: Paclitaxel disposition is nonlinear in humans and, on
      the 3-hour schedule, 6 alpha-hydroxylpaclitaxel was identified in the plasma of
      all patients treated. The plasma disposition of paclitaxel and 6 alpha
      hydroxylpaclitaxel was well described by a model that featured multiple nonlinear
      processes. Neutropenia was not related to the areas under the curves (AUCs) of
      paclitaxel or 6 alpha-hydroxylpaclitaxel, or to palitaxel peak concentrations
      (Cmax). Neutropenia was related to the duration that plasma concentrations were >
      or = 0.05 mumol/L, a relationship that is well described by a sigmoid maximum
      response (Emax) model. CONCLUSION: The disposition of paclitaxel in humans is
      nonlinear. Paclitaxel metabolism to 6 alpha-hydroxylpaclitaxel is likely an
      important detoxification pathway. Myelosuppression is related to the duration
      that plasma paclitaxel concentrations are > or = 0.05 mumol/L. Trials of new
      doses and schedules of paclitaxel should take into account its nonlinear
      disposition to rule out adverse clinical consequences, especially if the drug is
      administered by short infusion. Our pharmacokinetic model should prove to be a
      powerful tool in predicting paclitaxel disposition, regardless of dose and
      schedule, and should facilitate further pharmacodynamic investigations.

PMID- 7799019
TI  - Surgical/pathologic-stage migration confounds comparisons of gastric cancer
      survival rates between Japan and Western countries.
AB  - PURPOSE: Possible causes underlying the substantial differences in gastric cancer
      survival rates observed between Japan and the West were examined in a randomized
      trial comparing the Western R1 resection with limited lymphadenectomy and the
      Japanese R2 resection with extended lymphadenectomy. PATIENTS AND METHODS: The
      effect of four factors associated with lymphadenectomy on microscopic tumor-node
      metastasis (TNM) staging, and on stage-specific survival rates was assessed in
      473 curatively resected patients. RESULTS: After application of extended
      lymphadenectomy, additional information on N status was available, only in R2
      resections with up-staging to N2 status in 30% of patients. The calculated effect
      of this stage migration on known 5-year survival rates was as follows: an
      increase of 1% in TNM stage Ia, 2% in Ib, 7% in II, 15% in IIIa, and 15% in IIIb.
      A further increase in survival was observed by stage migration to N3 or N4
      status, due to selective extension of lymphadenectomy to clinically overt
      metastases located outside the allocated level of clearance (contamination).
      Incomplete lymphadenectomy of N1- or N2-level stations indicated for dissection
      (noncompliance) demonstrates that more migration can occur when strictly adhering
      to the protocol. Examining more nodes per N level (diligence) induces even more
      migration, since the number of nodes that were histologically examined per N
      level correlated significantly with nodal status (lymph node-negative [N-] or
      lymph node-positive [N+]). CONCLUSION: These factors explain, at least partially,
      superior stage-specific survival rates after R2 compared with R1 resections,
      without a real survival benefit in individual patients.

PMID- 7799020
TI  - Clinical and pharmacologic analysis of hyperfractionated daily oral etoposide.
AB  - PURPOSE: The antitumor effect of etoposide is increased by maintaining a low
      blood level, whereas high peak levels may cause myelotoxicity. We investigated
      whether a constant low blood level could be obtained by the administration of
      oral etoposide three times daily. PATIENTS AND METHODS: Nineteen patients with
      non-small-cell lung cancer were treated with oral etoposide (25 mg three times
      daily for 21 days) as monotherapy or in combination with cisplatin 80 mg/m2. A
      pharmacokinetic model that predicted the mean blood concentration (Cmean) was
      developed in the 10 patients on etoposide monotherapy and validated in the nine
      patients on combination chemotherapy. Pharmacodynamic relationships were
      evaluated in each group. RESULTS: Etoposide dose per body-surface area ranged
      from 45 to 63 mg/m2/d (median, 53), but did not correlate with plasma level.
      Cmean was 1.1 +/- 0.3 micrograms/mL. Peak concentrations ranged from 0.6 to 2.5
      micrograms/mL. The intrapatient coefficient of variation for plasma etoposide
      concentrations was 22% +/- 10%. Cmean was accurately estimated as follows: Cmean
      = 0.098 + 0.413 x C0 + 0.458 x C2 (r = .97, P = .0001), where C0 and C2 represent
      concentrations before and 2 hours after administration. This model was unbiased
      (mean predictive error [MPE], 0.0 microgram/mL) and precise (root mean square
      error [RMSE], 0.1 microgram/mL). Leukopenia was the major toxicity. The surviving
      fraction of leukocytes (SF; nadir count/pretreatment count) was correlated to
      Cmean as follows: SF = 0.87 - 0.34 x Cmean (r = .67, P = .03) in the monotherapy
      group and SF = 0.64 - 0.33 x Cmean (R = .77, P = .03) in the combination
      chemotherapy group. Two and four patients treated with monotherapy and
      combination chemotherapy showed responses, respectively. All responders had a
      Cmean > or = 1.0 microgram/mL. CONCLUSION: Hyperfractionated oral etoposide
      achieveda stable plasma level that could be predicted by measurement at only two
      times.

PMID- 7799021
TI  - Phase I clinical and pharmacokinetic study of oral etoposide phosphate.
AB  - PURPOSE: To determine the bioavailability (F) and the pharmacokinetic profile of
      both etoposide and its prodrug, etoposide phosphate, after oral and intravenous
      administration of etoposide phosphate, and to determine the maximum-tolerable
      dose (MTD) of oral etoposide phosphate administered daily for 5 consecutive days
      every 3 weeks. In addition, we sought to develop and validate two limited
      sampling models (LSMs) to predict the etoposide area under the curve (AUC) 24
      hours after administration of oral and intravenous etoposide phosphate. PATIENTS
      AND METHODS: In the F part of the study, patients were assessed for
      pharmacokinetic studies after one oral and one intravenous administration of the
      same dose of etoposide phosphate. Etoposide phosphate and etoposide plasma
      concentrations were assayed by high-performance liquid chromatography (HPLC). To
      develop LSMs after oral and intravenous administration, patients were randomized
      between the training and validation data sets. In the phase I part of the study,
      which followed the F part, the dose of etoposide phosphate was escalated from 50
      mg/m2/d for etoposide equivalents for 5 days to 220 mg/m2/d for 5 days. RESULTS:
      Forty adult patients with solid tumors or lymphoma entered the study and 35 were
      assessable for toxicity. The MTDs were defined as 175 mg/m2 and 220 mg/m2 in
      previously treated and untreated patients, respectively. Neutropenia was dose
      limiting, with high interpatient variability. Within 15 minutes after intravenous
      administration, etoposide phosphate was no longer detectable in plasma, and it
      was never detectable after oral administration. Plasma concentrations and
      pharmacokinetic parameters of etoposide following etoposide phosphate were
      comparable to those reported for etoposide. The relative F (mean +/- SD) of
      etoposide after oral etoposide phosphate was 76 +/- 27%, with a range of 37% to
      144%. CONCLUSION: The clinical and pharmacokinetic results of this study confirm
      the prodrug hypothesis of etoposide phosphate. Although firm conclusions cannot
      be drawn, the F of oral etoposide phosphate seems to be comparable to or only
      slightly better than that of oral etoposide.

PMID- 7799023
TI  - Phase I trial of the somatostatin analog octreotide acetate in the treatment of
      fluoropyrimidine-induced diarrhea.
AB  - PURPOSE: Diarrhea is one of the dose-limiting toxicities for administration of
      fluorouracil (5FU) in patients with gastrointestinal malignancies and can result
      in severe morbidities or mortality. The somatostatin analog octreotide acetate
      has been used in the treatment of 5FU-induced diarrhea with promising results. A
      phase I trial was initiated to determine the maximum-tolerated dose of octreotide
      acetate that could be administered in this setting. PATIENTS AND METHODS:
      Patients were required to have National Cancer Institute Common Toxicity Criteria
      > or = grade 2 diarrhea or watery diarrhea secondary to treatment with 5FU or a
      modulated 5FU regimen. At least three patients were treated at each dose level;
      after satisfactory completion of this dose level (zero of three or one of six
      patients with < or = grade 2 toxicity), additional patients were added at the
      next dose level. Doses of octreotide acetate studied were 50 to 2,500 micrograms
      subcutaneously three times daily for 5 days. RESULTS: A total of 35 patients
      received 49 courses of therapy. The only significant toxicities occurred at 2,500
      micrograms. At this dose level, one patient developed an allergic reaction with
      flushing, nausea, and dizziness after each of the first two injections. A second
      patient developed asymptomatic hypoglycemia with a serum glucose level of 26
      mg/dL. The maximum-tolerated dose was 2,000 micrograms. The efficacy of the
      treatment correlated significantly (P = .01) with the dose of octreotide
      administered, and more patients completed the course of therapy at the higher
      doses. CONCLUSION: Octreotide acetate can be safely administered for the
      treatment of fluoropyrimidine-induced diarrhea in patients with gastrointestinal
      malignancies. The dose-limiting toxicities were allergic (nausea, rash, and light
      headedness) and endocrine (hypoglycemia). There was a significant correlation
      between complete response to therapy and octreotide dose.

PMID- 7799022
TI  - Phase I and pharmacologic studies of the camptothecin analog irinotecan
      administered every 3 weeks in cancer patients.
AB  - PURPOSE: A phase I study was undertaken to determine the maximum-tolerated dose
      (MTD), principal toxicities, and pharmacokinetics of the novel topoisomerase I
      inhibitor irinotecan (CPT-11). PATIENTS AND METHODS: Sixty-four patients meeting
      standard phase I eligibility criteria were included (24 women, 40 men; median
      age, 51 years; primary sites: colon, head and neck, lung, pleura; 60 of 64 had
      been previously treated). Pharmacokinetics was determined by high-performance
      liquid chromatography (HPLC). RESULTS: One hundred ninety CPT-11 courses were
      administered as a 30-minute intravenous (IV) infusion every 3 weeks (100 to 750
      mg/m2). Grade 3 to 4 nonhematologic toxicities included diarrhea (16%; three
      hospitalizations), nausea and vomiting (9%), asthenia (14%), alopecia (53%),
      elevation of hepatic transaminases (8%), and one case of skin toxicity. An acute
      cholinergic syndrome was observed during CPT-11 administration. Diarrhea appeared
      dose-limiting at 350 mg/m2, but this was circumvented by using a high-dose
      loperamide protocol that allowed dose escalation. Dose-dependent, reversible,
      noncumulative granulocytopenia was the dose-limiting toxicity (nadir, days 6 to
      9; median recovery time, 5 days). Grade 3 to 4 anemia was observed in 9% of
      patients. One patient died during the study, 8 days after CPT-11 treatment. Two
      complete responses (cervix, 450 mg/m2; head and neck, 750 mg/m2) and six partial
      responses in fluorouracil (5-FU)-refractory colon cancer were observed (260 to
      600 mg/m2). Pharmacokinetics of CPT-11 and active metabolite SN-38 were performed
      in 60 patients (94 courses). CPT-11 plasma disposition was bi- or triphasic, with
      a mean terminal half-life of 14.2 +/- 0.9 hours (mean +/- SEM). The mean volume
      of distribution (Vdss) was 157 +/- 8 L/m2, and total-body clearance was 15 +/- 1
      L/m2/h. The CPT-11 area under the plasma concentration versus time curves (AUC)
      and SN-38 AUC increased linearly with dose. SN-38 plasma decay had an apparent
      half-life of 13.8 +/- 1.4 hours. Both CPT-11 and SN-38 AUCs correlated with nadir
      leukopenia and granulocytopenia, with grade 2 diarrhea, and with nausea and
      vomiting. CONCLUSION: The MTD of CPT-11 administered as a 30-minute IV infusion
      every 3 weeks is 600 mg/m2, with granulocytopenia being dose-limiting. At 350
      mg/m2, diarrhea appeared dose-limiting, but high-dose loperamide reduced this
      toxicity and allowed dose escalation. For safety reasons, the recommended dose is
      presently 350 mg/m2 every 3 weeks; more experience must be gained to establish
      the feasibility of a higher dose in large multicentric phase II studies. However,
      when careful monitoring of gastrointestinal toxicities is possible, a higher dose
      of 500 mg/m2 could be recommended in good-risk patients. The activity of this
      agent in 5-FU-refractory colorectal carcinoma makes it unique and mandates
      expedited phase II testing.

PMID- 7799024
TI  - Protracted intravenous fluorouracil infusion with radiation therapy in the
      management of localized pancreaticobiliary carcinoma: a phase I Eastern
      Cooperative Oncology Group Trial.
AB  - PURPOSE: The purpose of this study was to determine the maximum-tolerated dose
      (MTD) of fluorouracil (5-FU) administered as a protracted intravenous (IV)
      infusion with concurrent radiation in patients with pancreaticobiliary carcinoma.
      METHODS: Twenty-five patients with recurrent, residual, or unresectable carcinoma
      of the pancreas or biliary tract were treated on a phase I trial of protracted IV
      infusions of 5-FU, beginning at 200 mg/m2/d, concurrent with radiation therapy
      (59.4 Gy in 33 fractions over 6 to 7 weeks). Chemotherapy began on the first day
      of radiation and continued through the entire course of treatment. After each
      cohort of five patients had been treated and observed, the daily dose was
      escalated in 25-mg/m2 increments until dose-limiting toxicity was encountered. An
      additional cohort of five patients was treated at the MTD. Clinical examination
      and computed tomography (CT) were used to evaluate response and patterns of
      progression. RESULTS: The MTD of 5-FU was 250 mg/m2/d. The dose-limiting toxicity
      was oral mucositis. The median survival duration of all patients treated was 11.9
      months and the 2-year survival rate was 19%. Eleven of 25 patients remain free of
      local progression and four patients are without evidence of progression at 18+,
      18+, 34+, and 44+ months following treatment. CONCLUSION: Concurrent radiation
      with protracted 5-FU infusion at 250 mg/m2/d is well tolerated and shows evidence
      of activity against tumors of the pancreas and biliary system.

PMID- 7799025
TI  - Complications of indwelling venous access devices in cancer patients.
AB  - PURPOSE: We undertook this study to review our experience with indwelling
      vascular access devices in cancer patients to identify factors associated with
      complications. PATIENTS AND METHODS: A total of 322 indwelling devices were
      placed in 274 cancer patients by a single surgeon. Devices were placed via
      percutaneous insertion in 72% (231 of 322) and via venous cutdown in 28% (91 of
      322). We placed external catheters in 209 of 322 patients (65%) and subcutaneous
      infusion ports in 113 of 322 (35%). RESULTS: Pneumothorax occurred in four of 231
      (1.7%) of the percutaneously placed devices. Postoperative complications included
      sepsis and thrombosis, which necessitated premature removal of the devices.
      Device related sepsis occurred in 28 of 209 patients (13%) with catheters and six
      of 113 patients (5%) with subcutaneous ports. Thrombosis occurred in 21 of 209
      patients (10%) with catheters and seven of 113 (6%) with subcutaneous ports. In
      15 of 19 devices removed for thrombosis, the tip was above the T3 level.
      Seventeen devices were placed in the saphenous vein, with a complication rate
      similar to that observed in upper-body devices. CONCLUSION: We found a
      significantly (P < .05, chi 2 analysis) increased incidence of thrombotic
      complications in patients with triple-lumen catheters (10 of 48) compared with
      double-lumen catheters (11 of 160), as well as a significantly (P < .05)
      decreased mean time until catheter failure (40 v 146 days). We also observed a
      significant increase in the rate of thrombosis in patients with a catheter tip
      above the T3 level. We therefore recommend the use of fluoroscopy at the time of
      placement to assure adequate catheter length and tip position and the use of
      triple-lumen catheters only when necessary for concurrent drug administration.

PMID- 7799027
TI  - Prognostic significance of magnetic resonance imaging in patients with
      asymptomatic multiple myeloma.
AB  - PURPOSE: To assess the prognostic significance of magnetic resonance (MR) imaging
      in patients with newly diagnosed asymptomatic multiple myeloma. PATIENTS AND
      METHODS: Thirty-eight consecutive patients with asymptomatic myeloma of low tumor
      mass and negative skeletal surveys underwent MR imaging of the thoracic and
      lumbosacral spine. The presence and patterns of marrow involvement were
      correlated with standard laboratory parameters and time to disease progression.
      RESULTS: Nineteen patients (50%) had evidence of marrow involvement at spinal MR
      imaging. MR patterns of marrow involvement were classified as diffuse (five
      patients), variegated (nine), and focal (five). Patients with abnormal MR imaging
      studies required therapy after a median of 16 months, versus 43 months for those
      with normal MR studies (P < .01). CONCLUSION: Abnormal marrow patterns were
      present in half of patients with asymptomatic myeloma. An abnormal MR study of
      the spine identified asymptomatic patients who were likely to require treatment
      earlier than those with a normal MR study. A normal MR pattern provided
      additional justification to defer institution of chemotherapy. However, MR
      imaging remains an investigational tool to stage patients with multiple myeloma
      until more data are accumulated.

PMID- 7799026
TI  - Ciprofloxacin versus trimethoprim/sulfamethoxazole for prophylaxis of bacterial
      infections in bone marrow transplant recipients: a randomized, controlled trial.
AB  - PURPOSE: To compare the efficacy and safety of ciprofloxacin (CIP) and
      trimethoprim/sulfamethoxazole (TMS) for the prevention of bacterial infections in
      patients who received bone marrow transplantation (BMT) for the treatment of
      solid and hematopoietic neoplasms. PATIENTS AND METHODS: Adult inpatients about
      to undergo BMT for lymphoma, leukemia, or solid tumors were enrolled onto a
      prospective, randomized, double-blinded, controlled trial that compared CIP (750
      mg orally twice per day) with TMS (160 mg trimethoprim and 800 mg
      sulfamethoxazole orally twice per day). Subjects were stratified before
      randomization according to tumor and BMT type. Prophylaxis was begun within 96
      hours of initiation of the BMT preparative regimen and continued until the onset
      of fever, signs or symptoms of infection, serious adverse effects, or recovery of
      the absolute granulocyte count (AGC) to > or = to 400/microL. RESULTS: Seventy
      five CIP recipients and 71 TMS recipients were assessable for efficacy. No
      difference was noted between the two groups in occurrence of fever during
      neutropenia, time to onset of first fever, or overall infection rates. Ten
      bacteremias occurred in CIP recipients versus six in TMS recipients (P = .43).
      Ten episodes of Clostridium difficile enterocolitis occurred in TMS recipients
      versus no episodes in CIP recipients (P = .001). Four infections caused by gram
      negative bacilli, including one bacteremia, occurred in TMS recipients versus
      none in CIP recipients (P = .06). No differences were noted in the incidence of
      rash or organ toxicity. TMS recipients had longer durations of granulocytopenia
      at AGC levels < or = to 500/microL and < or = to 100/microL than did CIP
      recipients (P = .08 for both comparisons). Mean peak and trough serum levels of
      CIP decreased significantly between weeks 1 and 2 of prophylaxis. CONCLUSION: CIP
      and TMS were equally safe and effective in the prevention of bacterial infections
      in BMT patients when the overall infection rate was used as the principal end
      point. TMS prophylaxis was associated with a higher incidence of C difficile
      enterocolitis and infections caused by gram-negative bacilli, as well as a trend
      toward prolongation of granulocytopenia.

PMID- 7799028
TI  - Effectiveness of interferon alfa-2a combined with phototherapy for mycosis
      fungoides and the Sezary syndrome.
AB  - PURPOSE: To investigate the efficacy of combined topical therapy and systemic
      interferon alfa-2a in patients with mycosis fungoides (MF) and the Sezary
      syndrome (SS). PATIENTS AND METHODS: Between December 1987 and April 1993, 39
      patients with all stages of MF and SS were treated with combined phototherapy and
      systemic interferon alfa-2a as part of two institutional studies. The initial
      phase I study of 15 patients established the maximum-tolerated dose of interferon
      and has been previously reported. Subsequently, 24 patients have been entered
      onto a phase II trial. Long-term follow-up data are provided for both studies.
      RESULTS: The median follow-up duration for the entire cohort is 28 months.
      Patients with all stages of disease were enrolled (stage IB, n = 14; IIA, n = 5;
      IIB, n = 6; III, n = 8; IVA, n = 5; IVB, n = 1). Thirty-four patients had
      received previous therapy. Overall, 36 of 39 patients achieved a complete
      response (CR; 62%) or partial response (28%) to therapy. The median response
      duration is 28 months (range, 1 to 64). Twenty-nine of 39 patients are alive,
      with a median survival duration of 62 months (range, 1 to 66). CONCLUSION:
      Interferon alfa-2a combined with phototherapy is an effective, safe, durable
      therapy for MF and SS.

PMID- 7799029
TI  - Neuroprotective effect of reduced glutathione on cisplatin-based chemotherapy in
      advanced gastric cancer: a randomized double-blind placebo-controlled trial.
AB  - PURPOSE: We performed a randomized double-blind placebo-controlled trial to
      assess the efficacy of glutathione (GSH) in the prevention of cisplatin (CDDP)
      induced neurotoxicity. PATIENTS AND METHODS: Fifty patients with advanced gastric
      cancer treated with a weekly CDDP-based regimen were included in this study. In
      patients randomized to receive GSH, GSH was given at a dose of 1.5 g/m2 in 100 mL
      of normal saline solution over a 15-minute period immediately before CDDP
      administration, and at a dose of 600 mg by intramuscular injection on days 2 to
      5. Normal saline solution was administered to placebo-randomized patients.
      Clinical neurologic evaluation and electrophysiologic investigations have been
      performed at baseline and after 9 (CDDP dose, 360 mg/m2) and 15 (CDDP dose, 600
      mg/m2) weeks of treatment. RESULTS: At the 9th week, no patients showed
      clinically evident neuropathy in the GSH arm, whereas 16 patients in the placebo
      arm did. After the 15th week, four of 24 assessable patients in the GSH arm
      suffered from neurotoxicity versus 16 of 18 in the placebo arm (P = .0001). In
      confirmation of this neuroprotective effect, the neurophisiologic investigations,
      based on the evaluation of the median, ulnar, and sural sensory nerve conduction,
      showed a statistically significant reduction of these values in the placebo arm
      but not in the GSH arm, above all considering potential amplitude. In this trial,
      GSH also reduced hemotransfusion requirements (32 v 62 hemotransfusions) and
      treatment delay (55 v 94 weeks). The response rate was 76% (20% complete
      response) in the GSH group and 52% (12% complete response) in the placebo arm,
      confirming preliminary reports about the lack of reduction in activity of
      cytotoxic drugs induced by GSH. CONCLUSION: This study provides evidence that GSH
      is a promising and effective new drug for the prevention of CDDP-induced
      neuropathy, and that it does not reduce the clinical activity of chemotherapeutic
      drugs.

PMID- 7799030
TI  - Cytokine levels and systemic toxicity in patients undergoing isolated limb
      perfusion with high-dose tumor necrosis factor, interferon gamma, and melphalan.
AB  - PURPOSE: Isolated limb perfusion (ILP) with tumor necrosis factor (TNF),
      interferon gamma, and melphalan (M) has been reported to result in high response
      rates for extremity melanoma and sarcoma. We have evaluated the relationship of
      systemic TNF exposure to induction of several secondary mediators and incidence
      of systemic toxicity. PATIENTS AND METHODS: Nineteen patients with extremity
      melanoma (n = 16) or sarcoma (n = 3), underwent 90-minute ILP with TNF-alpha,
      interferon gamma (0.2 mg), and M (10 to 13 mg/L of limb volume) (TNF/IFN/M) (n =
      12), or M alone (n = 7). Continuous intraoperative monitoring (CIM) for systemic
      leak from the perfusion circuit was performed using radioactive iodine-131
      albumin. Cytokine levels in the perfusate and systemic circulation during and
      after ILP were measured by enzyme-linked immunosorbent assay. RESULTS: Systemic
      leaks > or = 1% from the perfusion circuit occurred in six patients who received
      TNF/IFN/M and in four who received M alone. Hypotension that required vasopressor
      support occurred in six of six patients with evidence of a leak (> or = 1%) and
      zero of six patients without a leak (< 1%). These six patients had significantly
      higher peak systemic TNF levels during and after perfusion than patients without
      a leak (2.8 and 8.2 ng/mL v 0.7 and 2.0 ng/mL, respectively; P < .05). All
      patients who received TNF/IFN/M had significantly greater increases in systemic
      interleukin-6 (IL-6) levels than in patients with M alone (12,395 +/- 10,374
      pg/mL v 79.4 +/- 7.2 pg/mL, respectively; P < .001). Intracellular adhesion
      molecule (ICAM), IL-8, and TNF-R levels were also increased after ILP with
      TNF/IFN/M. CONCLUSION: ILP with TNF/IFN/M can be safely performed, as I131
      albumin provides a sensitive measure of systemic leakage from the perfusion
      circuit. Patients with a measured leak of > or = 1% develop mild and transient
      postoperative hypotension with significantly higher systemic TNF levels and lower
      perfusate TNF levels than in patients without leaks.

PMID- 7799032
TI  - Treatment of testicular cancer and the development of secondary malignancies.
AB  - PURPOSE: Secondary neoplasia represents one of the worst possible long-term
      complications of therapy for testicular cancer, frequently leading to death in
      patients cured of the primary malignancy. The frequency and importance of
      secondary malignant disease will be reviewed. METHODS: The international
      literature was screened for reports concerning secondary solid cancers or
      leukemias in patients treated with chemotherapy or radiotherapy for malignant
      germ cell tumors. RESULTS: Patients with testicular germ cell tumors appear to
      have a twofold significantly increased risk (range, 0.7 to 3.4) for the
      development of secondary neoplasia. Apart from contralateral testicular cancers,
      which are not treatment-related, a largely elevated inherited risk for secondary
      cancers in patients with germ cell tumors seems unlikely. Radiotherapy is
      associated with a two- to threefold increased risk for secondary solid tumors
      (range, 1.3 to 7.5). A three- to sevenfold increased risk seems to exist for the
      development of solid tumors arising in the previous irradiation ports, such as
      stomach, pancreatic, bladder, and renal cell cancer, and sarcomas. To date, no
      significantly elevated risk for secondary solid tumors was observed after
      chemotherapy, even including regimens with alkylating agents, eg, cisplatin and
      ifosfamide. However, the risk associated with chemotherapy needs to be reexamined
      when the median follow-up of studies will exceed more than 10 years. An increased
      relative risk for secondary leukemias after chemotherapy (range, 1.3 to 3.4) has
      been reported in three of eight studies with more than 300 patients. Four large
      studies indicate a significantly elevated risk (range, 15 to 25) for the use of
      conventional-dose etoposide (< 2 g/m2 cumulative dose); however, with a 5-year
      cumulative incidence of less than 0.5% of all patients, this risk seems small.
      Concerning high-dose etoposide regimens (> 2 g/m2), further studies are
      necessary. CONCLUSION: Treatment for testicular cancer is associated with a
      small, but clearly identifiable, risk for secondary solid tumors that can be
      attributed to radiotherapy, and for secondary leukemia mainly associated with the
      use of chemotherapy. The frequency of secondary neoplasia observed is rather low,
      and in the light of the high cure rate, the risk for the individual patient
      appears negligible and should not alter current treatment strategies for
      metastatic testicular cancer.

PMID- 7799031
TI  - Molecular and cytogenetic studies in the diagnosis of patients with poorly
      differentiated carcinomas of unknown primary site.
AB  - PURPOSE: A minority of patients with poorly differentiated carcinoma achieve a
      complete response to cisplatin therapy. Recently, specific chromosomal
      abnormalities have been described for several solid tumor malignancies. Molecular
      and cytogenetic techniques were used to study tumors of patients with midline
      carcinoma of unknown primary site. MATERIALS AND METHODS: Forty patients with
      poorly differentiated carcinoma of unknown primary site had fresh tumor samples
      studied by cytogenetic analysis, Southern blot analysis for 12p copy number, and
      fluorescence in situ hybridization (FISH) for the identification of i(12p) and
      chromosome 12 aneuploidy. The response to cisplatin therapy was correlated to the
      diagnosis provided by the genetic studies. RESULTS: In 17 (42%) patients, a
      diagnosis was suggested by the genetic studies. This included a germ cell tumor
      in 12 (30%) patients by the finding of i(12p), increased 12p copy number, or a
      deletion of the long arm of chromosome 12. In five patients, a specific diagnosis
      other than germ cell tumor was suggested by tumor karyotype. These were
      neuroepithelioma, lymphoma, desmoplastic small-cell tumor, melanoma, and clear
      cell sarcoma. The 75% response proportion to cisplatin therapy in patients with
      tumors showing chromosome structural abnormalities of germ cell tumor was greater
      than the 18% response proportion in patients for whom no diagnosis was provided
      (P = .002). CONCLUSION: Molecular and cytogenetic studies are useful in
      establishing specific diagnoses in patients with poorly differentiated carcinomas
      of unknown primary site. This group of tumors is heterogeneous and is composed of
      germ cell tumors, melanoma, lymphoma, neuroepithelioma, and desmoplastic small
      round-cell tumor in addition to some that are not yet classifiable. Response to
      cisplatin therapy correlates with the finding of i(12p) in tumor by either
      molecular or cytogenetic studies.

PMID- 7799033
TI  - The eligibility of women for clinical research trials.

PMID- 7799034
TI  - The role of the American Society of Clinical Oncology in cancer control
      worldwide.

PMID- 7799035
TI  - Prognostic factors in bladder cancer after primary M-VAC.

PMID- 7799038
TI  - Radiation-recall dermatitis in a patient treated with paclitaxel.

PMID- 7799036
TI  - Multidrug-resistance modulation in metastatic breast cancer patients.

PMID- 7799037
TI  - Life-threatening hyperleukocytosis and pulmonary compromise after priming with
      recombinant human granulocyte-macrophage colony-stimulating factor in a patient
      with acute myelomonocytic leukemia.

PMID- 7799039
TI  - Ten-year results of a randomized trial evaluating prolonged low-dose adjuvant
      chemotherapy in node-positive breast cancer: a joint European Organization for
      Research and Treatment of Cancer-Dutch Breast Cancer Working Party Study.
      Cooperating Investigators.
AB  - PURPOSE: To investigate whether treatment with prolonged low-dose adjuvant
      chemotherapy could improve survival of patients with axillary node-positive
      breast cancer. PATIENTS AND METHODS: Four hundred fifty-two patients with
      axillary node-positive breast cancer who received postoperative irradiation were
      prospectively randomized in a trial (European Organization for Research and
      Treatment of Cancer [EORTC] 09771) that compared surgery followed by prolonged
      low-dose chemotherapy versus surgery alone. Chemotherapy was given for a period
      of 2 years and consisted of monthly courses of cyclophosphamide 50 mg/m2 orally
      on days 1 to 14, methotrexate 15 mg/m2 intravenously on days 1 and 8, and
      fluorouracil 350 mg/m2 intravenously on days 1 and 8 (CMF). RESULTS: At a median
      follow-up time of 10 years, the overall survival duration was significantly
      prolonged in the chemotherapy arm (hazards ratio, 0.75; 95% confidence interval,
      0.56 to 0.99; P = .04). Ten-year overall survival rates (+/- SE) were 59% (+/-
      3.6%) for the chemotherapy arm and 50% (+/- 3.7%) for the control arm. Time to
      local relapse was significantly prolonged in the chemotherapy arm (hazards ratio,
      0.63; 95% confidence interval, 0.42 to 0.94; P = .02). Patients with one to three
      positive axillary nodes and patients with estrogen receptor-negative tumors
      especially benefited from chemotherapy. Toxicity was observed in 93% of patients.
      CONCLUSION: We conclude that prolonged low-dose adjuvant CMF can significantly
      prolong overall survival in patients with node-positive breast cancer. However,
      considering the fact that toxicity was still considerable despite reducing the
      dose of chemotherapy by 50%, we believe that conventionally dosed short-term
      regimens are preferable in the treatment of node-positive breast cancer.

PMID- 7799041
TI  - Are axillary recurrence and overall survival affected by axillary extranodal
      tumor extension in breast cancer? Implications for radiation therapy.
AB  - PURPOSE: To determine the overall survival and local recurrence significance of
      axillary lymph node extranodal tumor extension (ETE) and whether axillary/chest
      wall irradiation influenced any of these outcomes. MATERIALS AND METHODS: The
      records of 81 breast cancer patients treated with radical or modified radical
      mastectomy at a single surgical practice were eligible for study. Thirty-four
      patients had ETE: 17 with focal ETE (< 10 x high-power field) and 17 with
      extensive ETE (> 10 x high-power field). RESULTS: With a median follow-up
      duration of 92 months, only two patients had an axillary recurrence (2%): one had
      focal ETE and one had no ETE. Neither of these patients received axillary
      radiation therapy. Overall survival and recurrence-free survival were
      significantly decreased with ETE in patients whether axillary radiation therapy
      had been administered or not. Analysis showed that the age of the patient
      correlated significantly with extensive ETE (P = .04) and that the number of
      positive lymph nodes (< or = three v > three) correlated significantly with ETE
      (whether focal or extensive) (P = .0001). A multivariate analysis of extranodal
      tumor extension and number of positive lymph nodes showed that ETE was associated
      with decreased survival (P = .05), although to a lesser degree than number of
      positive lymph nodes (P = .003). CONCLUSION: These results show that ETE is
      associated with decreased survival and increased recurrence rates regardless of
      the extent of the radiation therapy field. Also, ETE does not necessarily
      indicate a significantly increased incidence of axillary recurrence. Therefore,
      axillary irradiation based on this pathologic finding may not be indicated.

PMID- 7799040
TI  - Very low-dose warfarin prophylaxis to prevent thromboembolism in women with
      metastatic breast cancer receiving chemotherapy: an economic evaluation.
AB  - PURPOSE: A recent double-blind, randomized trial demonstrated that very low-dose
      warfarin (VLDW) reduced the incidence of venous thromboembolism (VTE) without
      increasing the rate of bleeding in women with metastatic breast cancer receiving
      chemotherapy. We have evaluated the economic impact on the health care system of
      using VLDW in such patients. METHODS: The records of patients entered onto the
      trial and a simultaneous, fully allocated, costing model for a tertiary care
      hospital in Hamilton, Canada were used to determine the difference in costs
      associated with the care of patients with and without VLDW. RESULTS: The cost of
      providing VLDW was $ 21,854 (Canadian dollars) per 100 patients. This therapy led
      to a reduction in costs of $ 24,297 per 100 patients, thus saving the health care
      system $ 2,443 per 100 patients. In the sensitivity analysis, VLDW prophylaxis
      still did not increase health care costs unless the cost of VLDW was greatly
      increased, the cost of treating thromboembolic episodes was markedly reduced, or
      the incidence of either VTE or bleeding with VLDW was increased above the rates
      observed in the trial. CONCLUSION: We conclude that for women receiving
      chemotherapy for metastatic breast cancer, the benefits of VLDW can be realized
      without increased health care costs.

PMID- 7799042
TI  - Is bigger better?

PMID- 7799043
TI  - Pepsinogen C is a new prognostic marker in primary breast cancer.
AB  - PURPOSE: Here we evaluate in breast cancer patients the prognostic value of
      pepsinogen C, a proteolytic enzyme involved in the digestion of proteins in the
      stomach that is also synthesized by a significant percentage of breast
      carcinomas. PATIENTS AND METHODS: Pepsinogen C expression was examined by
      immunoperoxidase staining in a series of 243 breast cancer tissue sections, and
      results obtained were quantified using the HSCORE system, which considers both
      the intensity and the percentage of cells staining at each intensity. Evaluation
      of the prognostic value of pepsinogen C was performed retrospectively in
      corresponding patients by multivariate analysis that took into account
      conventional prognostic factors. The mean follow-up period was 48.5 months.
      RESULTS: A total of 113 carcinomas (46.5%) stained positively for this
      proteinase, but there were clear differences among them with regard to the
      intensity and percentage of stained cells. Pepsinogen C values were significantly
      higher in well differentiated (grade I, 89.1) and moderately differentiated
      (grade II, 88.5) tumors than in poorly differentiated (grade III, 27.7) tumors (P
      < .001). Similarly, significant differences in pepsinogen C content were found
      between estrogen receptor (ER)-positive tumors and ER-negative tumors (85.9 v
      41.2, respectively; P < .05). Moreover, results indicated that low pepsinogen C
      content predicted shorter relapse-free survival duration and overall survival
      duration (P < .0001). Separate Cox multivariate analysis for relapse-free
      survival and overall survival in subgroups of patients as defined by node status
      showed that pepsinogen C expression was the strongest factor to predict both
      relapse-free survival and overall survival in node-positive patients (P < .0001
      for both) and node-negative patients (P < .005 and P < .01, respectively).
      CONCLUSION: Pepsinogen C is a new prognostic factor for early recurrence and
      death in both node-positive and node-negative breast cancer. In addition, and in
      contrast to most studies that concern the prognostic significance of proteolytic
      enzymes in cancer, pepsinogen C production by breast cancer cells is associated
      with lesions of favorable evolution.

PMID- 7799044
TI  - Cured of breast cancer?
AB  - PURPOSE: That patients can be ultimately cured of breast cancer has been
      questioned, because late deaths from the disease have been observed even several
      decades after the diagnosis. The purpose of this study was to investigate late
      mortality caused by breast cancer. PATIENTS AND METHODS: Using the files of local
      hospitals and the Finnish Cancer Registry, we identified all patients with
      histologically diagnosed invasive breast cancer in a defined urban area (city of
      Turku, Finland) from 1945 to 1969 (n = 601). In 563 cases (94%), clinical data
      and histologic and autopsy slides could be reviewed, and these women had been
      monitored for a median of 29 years (range, 22 to 44; n = 66) or until death (n =
      497). RESULTS: Mortality from breast cancer was observed even during the fourth
      follow-up decade, but if women who were diagnosed with contralateral breast
      cancer were excluded (n = 30), no deaths from breast cancer were identified after
      the 27th year of follow-up evaluation. The 30-year survival rates were 62% (95%
      confidence interval [CI], 54% to 70%), 19% (95% CI, 13% to 25%), and 0% for women
      with pN0 (node-negative) and pN1 or pN2 (node-positive) disease, respectively.
      High 30-year survival rates were found in small (pT1N0M0) unilateral cancers (80%
      alive; 95% CI, 66 to 94%), and in the lobular (45% alive; 95% CI, 31% to 59%) and
      the special histologic types (81% alive; 95% CI, 67% to 95%). These survival
      rates were obtained when correcting either for known intercurrent deaths or for
      mortality in the age- and sex-matched general population. CONCLUSION: Breast
      cancer, node-negative and node-positive, may be permanently cured even if treated
      with locoregional therapy only. The survival figures listed here may be
      considered as minimum values, because women with breast cancer diagnosed in the
      same area from 1970 to 1984 showed significantly improved short-term (< 20 years)
      survival rates over those diagnosed from 1945 to 1969.

PMID- 7799045
TI  - Value of P-glycoprotein, glutathione S-transferase pi, c-erbB-2, and p53 as
      prognostic factors in ovarian carcinomas.
AB  - PURPOSE: To determine the prognostic value of immunostaining of P-glycoprotein (P
      gp), glutathione S-transferase (GST) pi, c-erbB-2, and p53 in patients with
      advanced-stage ovarian carcinoma. PATIENTS AND METHODS: Immunostaining of P-gp,
      GST pi, c-erbB-2, and p53 was performed on 89 primary tumors and 38 residual
      tumors after chemotherapy (P-gp and GST pi) in patients with advanced ovarian
      carcinoma treated with platinum- and doxorubicin-containing chemotherapy. The
      results of immunostaining were related to clinicopathologic prognostic factors,
      response to chemotherapy, and progression-free survival (PFS) and overall
      survival. RESULTS: P-gp and GST pi immunoreactivity were present in 13 (15%) and
      79 cases (89%), respectively, and were not associated with any other prognostic
      factor or PFS or overall survival. C-erbB-2 immunoreactivity was present in 18
      cases (20%) and was associated with undifferentiated histiotype (P < .05), but
      not with PFS or overall survival. p53 immunoreactivity was present in the nuclei
      of 31 cases (35%) and cytoplasm of nine cases (10%). Nuclear p53 staining was
      associated with grade III tumors, presence of more than 1-L ascites, and residual
      tumor after first laparotomy more than 2 cm. Nuclear p53 staining was associated
      with shorter PFS (relative risk [RR], 3.3; 95% confidence interval [CI], 2.0 to
      5.6) and overall survival (RR, 2.6; 95% CI, 1.7 to 3.8). After adjustment for
      presence of more than 1-L ascites or age more than 50 years, nuclear p53 staining
      did not retain independent prognostic significance in stage III/IV tumors. The
      frequency of P-gp staining in residual tumors after chemotherapy (18 of 38 cases)
      was higher in comparison to untreated tumors (13 of 89 cases) (P < .001). No
      combination of prognostic parameters was able to predict response to chemotherapy
      adequately. CONCLUSION: Nuclear immunoreactivity of p53 in ovarian carcinomas is
      associated with shorter PFS and overall survival and determinants of more
      aggressive tumor growth. The higher frequency of P-gp immunoreactivity in
      residual tumors after chemotherapy points to induction of P-gp in ovarian
      carcinomas by doxorubicin-containing combination chemotherapy. The determination
      of P-gp, GST pi, c-erbB-2, and p53 does not permit more adequate prediction of
      response to chemotherapy.

PMID- 7799047
TI  - Oligometastases.

PMID- 7799046
TI  - Recombinant human granulocyte-macrophage colony-stimulating factor as an adjunct
      to conventional-dose ifosfamide-based chemotherapy for patients with advanced or
      relapsed germ cell tumors: a randomized trial.
AB  - PURPOSE: Ifosfamide-containing therapy with cisplatin plus either etoposide (VIP)
      or vinblastine (VeIP) can cure of patients with relapsed germ cell tumors (GCTs),
      but results in substantial myelotoxicity. This study sought to assess the impact
      of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF)
      on the severity of neutropenia and incidence of infectious complications in
      patients who receive ifosfamide-based chemotherapy for GCT. PATIENTS AND METHODS:
      One hundred and four assessable GCT patients from 20 centers were randomized to
      receive rhGM-CSF with either cycles 1 and 2 or cycles 3 and 4 of chemotherapy.
      Standard doses of VIP or VeIP were used. Efficacy data were analyzed using a
      parallel design for cycles 1 and 2 before the crossover. RESULTS: Fewer
      clinically relevant infections occurred in rhGM-CSF patients (13 of 55, 24%)
      versus observation patients (22 of 49, 45%) in cycle 1 (P = .01). Decreases were
      observed in infections during neutropenia (22% v 43%, P = .03), infections
      requiring intravenous antibiotics (20% v 43%, P = .01), and any infection
      irrespective of severity (29% v 55%, P = .01) in cycle 1. However, there were no
      significant differences among the treatment arms in cycle 2 in the proportion of
      clinically relevant infections (P = .23), infections associated with neutropenia
      (P = .11), infections requiring antibiotics (P = .22), or any infection (P =
      .65). rhGM-CSF was discontinued in 14% of cycles because of toxicity related to
      the growth factor. CONCLUSION: rhGM-CSF reduced the incidence of infections in
      the first cycle of chemotherapy, but no benefit beyond the initial chemotherapy
      cycle was evident. Based on the limited clinical impact and the high incidence of
      rhGM-CSF-related toxicity that required growth factor discontinuation, the
      routine administration of rhGM-CSF to prevent neutropenia and infection after
      ifosfamide-based chemotherapy for GCT patients is not recommended.

PMID- 7799048
TI  - Geographic, age, and racial variation in the treatment of local/regional
      carcinoma of the prostate.
AB  - PURPOSE: Prostate cancer is one of the most common cancers in men. Incidence
      rates increase with age and are substantially higher in black men than white men.
      This study examines the variations in the use of radical prostatectomy and
      radiation by geographic area, age, and race. MATERIALS AND METHODS: Data from the
      National Cancer Institute's Surveillance, Epidemiology, and End-Results Program
      (SEER) were used to examine treatment differences. Current treatments generally
      consist of prostatectomy, radiation, or careful observation for clinically
      localized or regional disease. RESULTS: The age-adjusted proportion of men, age
      50 and older, who received radical prostatectomy increased sharply between 1984
      and 1991, from 11.0% to 32.3% among men with local/regional disease. The choice
      of treatment varied widely by geographic regions. In 1991, the proportion that
      received prostatectomy was highest in Utah (47.8%) and lowest in Connecticut
      (22.5%) among men with localized and regional disease. The increase in radical
      prostatectomy was not limited to younger men. Although the rates increased for
      blacks, black men had lower age-adjusted rates of prostatectomy than whites in
      all years of the study. CONCLUSION: The SEER data show a clear trend toward more
      aggressive treatment, especially prostatectomy. However, the proportion of black
      men who received prostatectomy was substantially lower than that of white men and
      this disparity does not appear to be changing.

PMID- 7799049
TI  - Staphylococcal infections. Proceedings of an advisory workshop. Boston, September
      11-12, 1993.

PMID- 7799050
TI  - Nasal and hand carriage of Staphylococcus aureus in healthcare workers.
AB  - Six double-blind, randomised placebo-controlled clinical trials in the United
      States have evaluated the elimination of Staphylococcus aureus carriage in
      healthcare workers with mupirocin ointment. Consistent data from the six centres
      demonstrated that calcium mupirocin ointment administered intranasally for five
      days is safe and effective in eliminating nasal carriage of S. aureus. Hand
      cultures were also performed at one centre, showing that hand carriage rates were
      significantly decreased 72 hours post-therapy and at six months. Additionally,
      molecular typing of all isolates obtained from the nares and hands found
      identical strains at both sites in the majority of subjects, implicating the
      nares as the primary reservoir of S. aureus colonisation.

PMID- 7799051
TI  - Staphylococcus aureus infection in haemodialysis patients. Mupirocin as a topical
      strategy against nasal carriage: a review.
AB  - Staphylococcus aureus is isolated from 42% of the bacteraemic episodes occurring
      in haemodialysis patients. Several epidemiological studies indicate that nasal
      carriage of S. aureus is of pivotal importance in determining the risk of
      subsequent infections by this micro-organism in haemodialysis patients. First,
      nasal carriage is prevalent in about 42% of these patients, this high rate being
      observed from the onset of maintenance dialysis therapy. Second, there is a
      significant relationship between nasal and hand carriage of the organisms. Third,
      there is usually a similarity between infecting S. aureus strains and those
      isolated from nasal surveillance cultures obtained from the same patient. The
      nares are therefore an elective site for the prevention of S. aureus infections
      in haemodialysis patients; this was shown with oral rifampin. The studies
      demonstrating the effectiveness of nasal mupirocin for this indication are
      summarised. The need for continued chemosuppression with maintenance application
      (e.g. once per week) is underscored. Such a long-term application of nasal
      mupirocin in haemodialysis patients with nasal carriage is very cost-effective
      and is only very rarely associated with the emergence of mupirocin resistance in
      S. aureus.

PMID- 7799052
TI  - Cost-effectiveness of antibiotic prophylaxis of wound infection.
AB  - The estimated cost of a wound infection can vary substantially between countries
      and is dependent not only on the type of surgery performed, but also on varying
      medical practices and differing accounting methods. We therefore devised a
      flexible method to compare the cost-effectiveness of different antibiotic
      prophylactic regimens. Taking into account drug cost and the difference in
      infection rate between regimens, for any given wound infection cost, the analysis
      can indicate which regimen is most appropriate.

PMID- 7799053
TI  - Cost-containment using an outcome-based best practice model for the management of
      MRSA.
AB  - Prior to 1991, most patients at Christ Hospital and Medical Center from whom
      methicillin-resistant Staphylococcus aureus (MRSA) was cultured were isolated and
      treated with systemic antibiotics, irrespective of whether they were colonised or
      infected. The result of this practice was a confused, un-coordinated approach to
      the management of MRSA patients with a negative effect on the quality and cost of
      patient care. An interdisciplinary team set about developing and implementing a
      Best Practice Guideline over the years 1991 and 1992. This guideline provided a
      separate approach to infected and colonised patients. This intervention led to a
      decreased average length of stay in hospital of over 10 days, a reduction in the
      readmission rate of these patients from 8.7% in 1990 to 2.7% in 1992, and
      resulted in total cost savings of over $1.9 million.

PMID- 7799054
TI  - The choice of empirical antibiotic therapy for nosocomial pneumonia.
AB  - Nosocomial pneumonia has the highest crude mortality rate of all hospital
      acquired infections. The choice of empirical antibiotic therapy can be based on
      in vitro sensitivities of sputum bacterial isolates. Organisms recovered from
      purulent sputum of 500 intensive care unit (ICU) patients from five hospitals in
      Louisville, Kentucky, had antibiotic sensitivities measured by microbroth
      dilution. The most common isolates were Staphylococcus aureus (26.6%),
      Pseudomonas species (24.8%), Enterobacter species (11.8%), Escherichia coli
      (7.2%), Klebsiella species (7.0%), Streptococcus species (4.4%) and Serratia
      species (4.0%). These organisms were tested for susceptibility to amikacin,
      ciprofloxacin, imipenem/cilastatin, ticarcillin/clavulanate, piperacillin,
      ceftriaxone and ceftazidime. The antibiotics effective against more than 80% of
      the seven most common isolates included amikacin (97%), imipenem (94%),
      ciprofloxacin (92%) and ticarcillin/clavulanate (84%). These sensitivity patterns
      may serve as a guide to choosing empirical antibiotics for ICU-acquired pneumonia
      in Louisville. When the use of a beta-lactam antibiotic alone or in combination
      with an aminoglycoside is preferred, imipenem or ticarcillin-clavulanate may be
      considered the antibiotics of choice. Studies are in progress to delineate the
      clinical use of ciprofloxacin alone or in combination with beta-lactam
      antibiotics for treating nosocomial pneumonia.

PMID- 7799056
TI  - Epidemiology of staphylococcal infections--a USA perspective.
AB  - Data collected from the National Nosocomial Infection Surveillance show that Gram
      positive organisms, and Staphylococcus aureus in particular, are a major cause of
      nosocomial infections, especially wound infections, pneumonia and bacteraemia.
      Currently in the United States, approximately 18% of S. aureus isolates show
      intrinsic resistance to methicillin.

PMID- 7799055
TI  - The efficacy of amoxycillin/clavulanate (Augmentin) in the treatment of severe
      staphylococcal infections.
AB  - The experimental and clinical values of amoxycillin/clavulanate in severe
      Staphylococcus aureus infections are reviewed. Experimentally,
      amoxycillin/clavulanate was highly effective in the treatment of acute
      endocarditis due to methicillin-sensitive isolates of S. aureus (MSSA) in rats.
      In addition, high doses of amoxycillin/clavulanate also cured experimental
      endocarditis due to methicillin-resistant strains of S. aureus (MRSA) in the
      animal model. In the clinical setting, a review of 86 patients with either
      community- or hospital-acquired bacteraemia due to MSSA showed that intravenous
      treatment with amoxycillin/clavulanate was adequate for empirical (and apparently
      also long-term) therapy of such severe infections. However, the retrospective
      nature of the analysis did not allow assessment of the relative efficacy of
      amoxycillin/clavulanate as compared with standard anti-staphylococcal drugs, such
      as flucloxacillin or vancomycin. Further prospective studies are warranted to
      address this issue. Thus, amoxycillin/clavulanate appears to be a good candidate
      for empirical treatment of severe infections that may be caused by MSSA. Usage of
      amoxycillin/clavulanate against MRSA is, however, still experimental and is not
      currently advocated for the treatment of MRSA infections in humans.

PMID- 7799057
TI  - Epidemiology of staphylococcal infections--a European perspective.
AB  - Multiple resistant staphylococci are a major health concern worldwide. In Europe,
      the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) differs
      widely between countries in the south and those in the north. In The Netherlands,
      which has one of the lowest rates of MRSA infection in Europe, stringent
      infection control measures are in place which include the isolation of all
      carriers and the treatment of patients and staff carriers with mupirocin.

PMID- 7799059
TI  - Image registration of SPECT and CT images using an external fiduciary band and
      three-dimensional surface fitting in metastatic thyroid cancer.
AB  - Image registration of 131I SPECT with CT scans was performed in a patient with
      metastatic thyroid carcinoma using an external fiduciary band and a three
      dimensional surface-fitting algorithim. Areas of metastatic disease taking up
      131I were accurately localized to the liver, lungs and vertebral bodies;
      providing information that could not be obtained by planar or SPECT images alone.
      Based on these findings, further invasive diagnostic procedures were not
      performed, therefore considerably altering management in this patient. This
      approach to image registration has immediate clinical utility in the registration
      and interpretation of SPECT studies with corresponding CT or MRI scans.

PMID- 7799058
TI  - Comparison of radiolabeled octreotide and meta-iodobenzylguanidine (MIBG)
      scintigraphy in malignant pheochromocytoma.
AB  - METHODS: The results of in vivo somatostatin scintigraphy were correlated with
      those of MIBG from 14 patients, aged 22-66 yr, with metastatic pheochromocytoma
      (10 patients), malignant paraganglioma (3 patients) and metastatic
      ganglioneuroblastoma (1 patient). Twelve patients had elevated catecholamine
      excretion. A dynamic study and serial whole-body scans (4-48 hr) were obtained
      after injection of 130-187 MBq of 111In-DTPA-Phe-1-octreotide. When indicated,
      SPECT imaging was done. The results were compared to MIBG scans obtained after a
      diagnostic or a therapeutic dose. RESULTS: Three patients with more than 20 tumor
      sites on MIBG scans had only 1-9 sites on 111In-octreotide scintigraphy. Two
      patients had no MIBG uptake but one had lung uptake on octreotide scintigraphy.
      In the other 9 patients with a total of 41 foci of MIBG uptake, 33 sites of 111In
      octreotide uptake are found. All positive images with octreotide scintigraphy
      were seen at or before 4 hr, but the contrast improved at 24 hr. Uptake intensity
      was lower with 111In-octreotide than MIBG and the number of tumor sites was
      higher with MIBG. However, seven foci were positive only on octreotide
      scintigraphy and six of them could not be confirmed by other imaging modalities.
      CONCLUSION: Use of octreotide to identify somatostatin receptors seems promising,
      especially when results from MIBG scans are negative. Moreover octreotide images
      could aid in determining a treatment regimen as well as establishing the extent
      of disease and prognosis.

PMID- 7799060
TI  - Positional biliary stasis: scintigraphic findings following biliary-enteric
      bypass surgery.
AB  - Hepatobiliary scintigraphy has proven to be a reliable noninvasive imaging
      modality to evaluate postoperative biliary obstruction, which is a frequent
      complication following biliary enteric bypass surgery. We present a case of a
      patient who had biliary enteric bypass surgery with a scintigraphic pattern
      simulating partial obstruction on a 99mTc hepatobiliary study performed with the
      patient in a supine position. The biliary stasis seen in the supine images
      disappeared almost completely when the images were repeated after 30 min in an
      upright position. Progressive accumulation of activity initially seen in the
      region of the biliary enteric anastomosis was not present 3 days later on a
      repeat study with the patient in an upright position, confirming that biliary
      stasis in this patient was due to a positional phenomenon. This case illustrates
      that biliary stasis may be positional in nature. Position related stasis should
      be a consideration when interpreting hepatobiliary scintigraphic studies in
      postoperative patients and when suspected, patients should be imaged in the
      upright position.

PMID- 7799061
TI  - Thallium-201 uptake in eosinophilic granuloma of the frontal bone: comparison
      with technetium-99m-MDP imaging.
AB  - An 11-yr-old female presented with a 6-wk history of left upper lid tenderness
      and left eye lacrimation. Left lateral supraorbital mass and left preauricular
      lymph node were the only significant physical examination findings. On skull x
      ray, a left frontal bone defect was noted. CT and MRI showed a soft-tissue mass
      in the area of the bone defect. Bone scintigraphy exhibited peripheral uptake
      within the central photon deficient area. With 201TI SPECT, high uptake was noted
      on early and delayed images. Diagnosis of eosinophilic granuloma was performed by
      biopsy. Since thallium uptake was seen in the area where photon deficiency was
      exhibited by 99mTc-MDP scintigraphy, we speculate that thallium SPECT could
      detect eosinophilic granuloma when radiographic skeletal survey or radionuclide
      bone scan are equivocal. It could also rule out multiple bone involvement and
      recurrence or regrowth after therapy.

PMID- 7799062
TI  - Myocardial clearance kinetics of technetium-99m-teboroxime following
      dipyridamole: differentiation of stenosis severity in canine myocardium.
AB  - The purpose of the current study was to determine whether teboroxime clearance
      kinetics are useful in differentiating the severity of coronary artery flow
      restriction. METHODS: Groups of dogs received stenoses of the left circumflex
      coronary artery as follows: nine dogs received a mild-to-moderate stenosis (Group
      2) and eleven dogs received severe stenoses (Group 3). In three control dogs
      (Group 1), there was no stenosis. Using miniature cadmium-telluride radiation
      detectors, myocardial teboroxime activities were continuously monitored in both
      the control and stenosed zones following dipyridamole infusion. RESULTS: A
      significant difference in fractional myocardial clearance between the control
      zones (0.69 +/- 0.01, n = 26) versus mild-to-moderate (0.61 +/- 0.06, p < 0.05, n
      = 9) and severe (0.57 +/- 0.03, p < 0.01 versus control, p < 0.05 versus mild-to
      moderate, n = 11) flow-restricted zones was observed over a 1-hr period.
      Significant differences between normal and both stenosed zones became apparent
      after 7 min of clearance. Significant differences in myocardial clearance between
      mild-to-moderate and severe groups were detected within 15 min. CONCLUSION: Thus,
      in this canine model using dipyridamole, miniature probe-determined teboroxime
      myocardial clearance can differentiate among normal myocardium, myocardium distal
      to a mild-to-moderate stenosis and myocardium distal to a severe stenosis.

PMID- 7799063
TI  - Myocardial clearance kinetics of technetium-99m-teboroxime following dipyridamole
      injection.

PMID- 7799064
TI  - Assessment of scatter components in high-resolution PET: correction by
      nonstationary convolution subtraction.
AB  - This paper describes a new approach to determine individual scatter kernels and
      to use them for scatter correction by integral transformation of the projections.
      METHODS: Individual scatter components are fitted on the projections of a line
      source by monoexponentials. The position-dependent scatter parameters of each
      scatter components are then used to design non-stationary scatter correction
      kernels for each point in the projection. These kernels are used in a convolution
      subtraction method which consecutively removes object, collimator and detector
      scatter from projections. This method is based on a model which assumes that
      image degradation results exclusively from Compton interactions of annihilation
      photons, thus neglecting further Compton interactions of object scatters with
      collimator and detector. RESULTS: Subtraction of the object scatter component
      improved contrast typical of what is obtained with standard convolution
      subtraction methods. The collimator scatter component is so weak that it can be
      safely combined with object scatter for correction. Subtraction of detector
      scatter from images did not improve contrast because statistical accuracy is
      degraded by removing counts from hot regions while cold regions (background)
      remain unchanged. CONCLUSION: Subtraction of object and collimator scatter
      improves contrast only. The slight gain in image sharpness resulting from the
      subtraction of detector scatter does not justify removal of this component at the
      expense of sensitivity.

PMID- 7799066
TI  - Scattered photons as "good counts gone bad:" are they reformable or should they
      be permanently removed from society?

PMID- 7799065
TI  - Radiolabeled octreotide for the demonstration of somatostatin receptors in
      malignant lymphoma and lymphadenopathy.
AB  - This prospective study evaluated somatostatin receptor-specific scintigraphy as a
      clinical tool for routine detection of malignant lymphoma. METHODS: Forty-one
      consecutive patients were examined using 111In-DTPA-D-Phe-1-octreotide. Thirty
      four patients had diagnoses of Hodgkin's disease (n = 11) or non-Hodgkin's
      lymphoma (n = 23) previously verified and staged by hematology, histology and
      imaging methods (CT, chest x-ray and abdominal ultrasonography). The remaining
      seven patients initially suspected of presenting lymphoma (n = 5) or lymphoma
      recurrence after chemotherapy and radiotherapy (n = 2) were subsequently shown to
      have other diseases. Planar images were recorded 4, 24 and 48 hr after
      intravenous injection and evaluated without knowledge of other results. In case
      of negative planar scintigraphy, additional SPECT images were obtained. Since
      these failed to increase sensitivity, they were omitted after 15 negative
      recordings. RESULTS: Octreotide scintigraphy did not yield false-positive
      results. The sensitivity for detecting Hodgkin's disease was 70% and varied from
      88% in the neck and chest to 13% in the abdomen and pelvis. The sensitivity for
      non-Hodgkin's lymphoma was not influenced by localization and amounted uniformly
      to 35% but varied with the degree of malignancy between 44% (high-grade) and 29%
      (low-grade malignancy). CONCLUSION: Our results suggest that radiolabeled
      octreotide is better suited to characterize somatostatin receptor expressing
      lymphomas than to localize lesion sites. It is useful for imaging Hodgkin's
      disease, especially above the diaphragm.

PMID- 7799067
TI  - A study of the liver-heart artifact in emission tomography.
AB  - With the introduction of 99mTc-teboroxime, a previously undocumented artifact has
      shown up in cardiac SPECT imaging. In the images, the uptake values near the
      inferior wall are lower than expected. The artifact has been reported in the
      literature, but an adequate explanation has not yet been provided. The high
      uptake of 99mTc-teboroxime in the liver has been demonstrated to be the cause of
      this artifact. METHODS: With simulations we show that an artifact can be
      reproduced by applying filtered backprojection (without corrections for
      attenuation) of attenuated and blurred projections. The conclusions from the
      simulations are validated with SPECT and PET phantom measurements. Maximum
      likelihood expectation maximization (ML-EM) reconstruction is applied to evaluate
      the effect of accurate attenuation correction. The influence of the high liver
      uptake on the convergence of ML-EM was also evaluated. RESULTS: The artifact
      results mainly when the photon attenuation during reconstruction is ignored. This
      results in a distorted reconstruction of the liver. These distortions affect the
      neighboring inferior wall of the myocardium. While the use of opposite
      projections reduces the effect, accurate attenuation correction nearly eliminates
      it. A small additional deformation is caused by the position dependence of the
      spatial resolution of the gamma camera. It was also noted that the presence of
      the liver slows down the convergence of ML-EM in the heart region. CONCLUSION:
      The liver-heart artifact is an attenuation effect and is eliminated by
      attenuation correction. The local convergence of ML-EM is affected by the total
      image content.

PMID- 7799069
TI  - Estimating the diagnostic yields resulting from renography and deconvolution
      parameters: a logistic regression analysis.
AB  - METHODS: Seventy patients with established diagnoses of normal, parenchymally
      insufficient or acutely obstructed kidneys were subjected to gamma camera
      renography. Deconvolution was then performed using three main techniques
      subdivided into six variants. Parameters from time-activity curves as well as
      retention curves were calculated. Logistic regression analysis was performed to
      assess the ability of renography and deconvolution methods to differentiate
      between kidney groups. RESULTS: Discrimination between the groups was achieved by
      standard renography using six of 17 tested renogram parameters. Based on a set of
      six curve parameters, the correct classification rates ranged 86%-100%. Five of
      the six variants of the deconvolution technique used produced similar results.
      None, however, produced results which were as robust as those from renography.
      The sixth deconvolution method was consistently worse than the others.
      CONCLUSION: Standard renography was consistently better than any of the
      deconvolution techniques used in the separation of the kidney groups.
      Conceptually, the results of a logistic regression analysis of renogram
      parameters may raise possibilities in the field of computer-aided diagnosis.

PMID- 7799068
TI  - Canine myocardial beta-adrenergic, muscarinic receptor densities after
      denervation: a PET study.
AB  - In an effort to better understand cardiac neurotransmission, PET was serially
      used in dogs to assess changes in ventricular muscarinic (MR) and beta-adrenergic
      receptor (beta-AR) densities following chemical or surgical denervation. METHODS:
      Beta-adrenergic and MR receptor concentrations were studied in beagle dogs nine
      days after chemical sympathectomy (using the neurotoxin 6-hydroxydopamine) or 3-7
      wk and 23-28 wk after surgical intrapericardial denervation. RESULTS: In control
      dogs (n = 13), global beta-AR and MR concentrations were 32 +/- 4 and 62.2 +/-
      10.4 pmole/ml tissue, respectively. Nine days after 6-hydroxytk; 1opamine (n =
      8), hemodynamic tests and MIBG scintigraphy demonstrated the destruction of
      cardiac sympathetic innervation. Beta-adrenergic density increased by 190% (p <
      0.001) while MR density remained unchanged. Three to 7 wk after surgery (n = 5),
      hemodynamic tests and MIBG scintigraphy demonstrated both parasympathetic and
      sympathetic denervations. Beta-adrenergic density was increased by 219% while MR
      concentration remained unchanged. Twenty-three to 28 wk after surgery, atrial
      innervation was restored (hemodynamic tests) while ventricular sympathetic
      innervation was not (MIBG scintigraphy). Beta-adrenergic density remained high.
      CONCLUSION: The present study demonstrates the ability of PET to serially assess
      myocardial receptor concentrations. The absence of change in MR density and the
      prolonged up-regulation of beta-AR following heart denervation are the main
      findings of the present study.

PMID- 7799070
TI  - Quantitative myocardial mapping of perfusion and metabolism using parametric
      polar map displays in cardiac PET.
AB  - Most efficacy studies of cardiac PET in demonstrating myocardial ischemia and
      viability have been performed using one or more transversal static images of the
      heart. In contrast, in this paper we describe a method of functional imaging of
      the complete left ventricular myocardium for perfusion with nitrogen-13-ammonia,
      both at rest and during a dipyridamol stress test, and of glucose metabolism with
      18F-fluorodeoxyglucose (18FDG). METHODS: This was performed by using the data of
      each of 48 radial segments of 10 short-axis images as tissue data and LV cavity
      data of three basal planes as blood pool data. The study describes the results of
      19 normal volunteers and 36 patients with coronary artery disease. From the data
      of the normal volunteers a 95% normal confidence interval was calculated for each
      imaging modality. These intervals were then used to describe the patient data as
      normal, ischemic or infarcted. RESULTS: The results of analysis of the parametric
      images was compared with the results of static analysis of the same patient data
      and found to be less dependant on the detection threshold used. CONCLUSION: The
      described method enables the routine application of functional PET imaging of the
      total myocardium by the semi-automatic construction of parametric flow and
      metabolism polar maps. It thus provides an increased performance in the
      diagnosis, quantification and localization of myocardial ischemia and viability
      over conventional PET imaging.

PMID- 7799071
TI  - PET versus SPECT in distinguishing radiation necrosis from tumor recurrence in
      the brain.
AB  - Two cases of postsurgical brain tumor evaluation in which MRI was inconclusive
      are discussed. Functional imaging techniques, such as FDG-PET and 201TI SPECT,
      were used in both cases for distinguishing radiation necrosis from tumor
      recurrence. These methods proved to be complimentary. For Patient 1, FDG-PET
      showed more limitations compared to 201TI SPECT. FDG-PET results on the other
      hand, were consistent with the final diagnosis and the SPECT image was false
      positive for tumor recurrence in Patient 2.

PMID- 7799072
TI  - Will the nuclear medicine industry survive?

PMID- 7799073
TI  - Winter summit to discuss current crisis in nuclear medicine.

PMID- 7799074
TI  - Somatostatin receptor-based imaging in malignant lymphomas.

PMID- 7799075
TI  - Assessment of female fertility and carcinogenesis after iodine-131 therapy for
      differentiated thyroid carcinoma.
AB  - The aim of this study was to evaluate female fertility, carcinogenic, and genetic
      effects after treatment with 131I of differentiated thyroid carcinoma. METHODS: A
      total of 814 females of child-bearing age were studied. The fertility of 627
      females who received 131I therapy was compared to 187 untreated females. Birth
      histories of the children born from these women were registered. The carcinogenic
      effect was evaluated by comparing the incidence of tumors in 730 patients treated
      with 131I with an internal control group, as well as with local population
      incidence. RESULTS: There was no significant difference in the fertility rate,
      birth weight and prematurity between the two groups. Only one case of a
      ventricular septal defect was observed in a child born to a women treated with
      131I. The overall standardized incidence ratio (SIR) of second tumors was 1.19
      (95% CI: 0.76-1.77) in patients treated with 131I. An elevated SIR was registered
      for salivary gland tumors and melanoma. No case of leukemia was registered.
      CONCLUSION: The risk of long-term effects of 131I treatment of differentiated
      thyroid carcinoma is quite low. Iodine-131 may be safely used in treating cases
      with a high risk of recurrence.

PMID- 7799076
TI  - Smithsonian documents history of PET.

PMID- 7799077
TI  - How safe for the patient is iodine-131 therapy for differentiated thyroid
      carcinoma?

PMID- 7799078
TI  - Phosphorus-32-chromic phosphate for ovarian cancer: I. Fractionated low-dose
      intraperitoneal treatments in conjunction with platinum analog chemotherapy.
AB  - For many years, 32P-chromic phosphate (32P-CP) intraperitoneal instillations and
      platinum analogue chemotherapy have been used to treat disseminated ovarian
      cancer. To investigate possible enhancement of 32P-CP irradiation due to the
      concomitant administration of chemotherapy, in vitro studies were undertaken.
      Based on those laboratory investigations, a clinical regimen of combined 32P-CP
      and platinum analogue chemotherapy was developed. METHODS: In vitro enhancement
      of 32P-CP cytotoxicity by cisplatin was studied in cultured human ovarian
      adenocarcinoma (CHOA) cell lines and in a fibroblast cell strain. In addition,
      ovarian cancer cells obtained from the malignant abdominal ascites and pleural
      effusions of 10 individual patients were also studied ex vivo. As part of routine
      clinical care, 30 patients with disseminated ovarian adenocarcinoma underwent up
      to eight monthly cycles of platinum analogue chemotherapy with concomitant
      intraperitoneal instillation of 5 mCi of 32P-CP at each monthly chemotherapy
      cycle. RESULTS: There was an enhanced and possibly supra-additive effect of
      cisplatin on the cytotoxicity from 32P-CP irradiation. For the 30 patients, the
      survival rate at 3 yr was 63%. CONCLUSION: Phosphorus-32 CP low-dose
      intraperitoneal treatments in conjunction with platinum analogue chemotherapy is
      a promising approach for the treatment of disseminated intraperitoneal ovarian
      cancer.

PMID- 7799079
TI  - Planar and high-resolution SPECT bone imaging in the diagnosis of facet syndrome.
AB  - This study's goals were to determine the appearance of potentially symptomatic
      facet joints on planar and high-resolution SPECT radionuclide bone imaging,
      relate the relative sensitivity of the two techniques and assess the predictive
      value in a clinical setting. METHODS: Fifty-eight consecutive patients referred
      with a diagnosis of possible facet syndrome were imaged during the same visit
      using both a well-established planar and a SPECT technique developed to emphasize
      high spatial resolution. The standard of reference included facet injections with
      a marcaine and steroid mixture, with review of a pain journal completed by the
      patient included in the followup criteria. RESULTS: In the 43 patients comprising
      the final study group, 7 were diagnosed with facet syndrome, 5 with abnormal
      planar images and 7 with abnormal SPECT images. A total of 10 facet joints with
      abnormal increased uptake were seen on SPECT which were not demonstrated on
      planar imaging. There was high sensitivity (100% SPECT, 71% planar), but somewhat
      lower specificity (71% SPECT, 76% planar). The negative predictive value was high
      (100% SPECT, 93% planar). Radionuclide bone imaging additionally discovered a
      nonfacet joint etiology for patient symptoms in 16 of the 43 patients.
      CONCLUSION: Higher spatial resolution SPECT images are better accepted by
      referring physicians who correlate them with CT or MR images. The high negative
      predictive value allows radionuclide bone imaging to be used to select
      appropriate patients to undergo the invasive facet injection procedure.

PMID- 7799080
TI  - Choosing a strategy for the diagnostic management of suspected scaphoid fracture:
      a cost-effectiveness analysis.
AB  - To assess the cost-effectiveness of various strategies for the diagnostic
      management of clinically suspected scaphoid fracture, a decision-analytic model
      was built to evaluate three strategies and to compare them with a (clairvoyant)
      reference diagnostic management strategy. METHODS: Evaluated strategies were: (A)
      repeated radiography up to 2 wk; (B) repeat radiography up to 6 wk; and (C)
      radiography, followed by bone scintigraphy in patients with negative initial
      radiographs. Therapy consisted of 12 wk of immobilization for a radiographically
      or scintigraphically proven fracture. Diagnostic costs, therapeutic costs, period
      of immobilization and nonunion rate were calculated for all three strategies.
      Estimates were derived from a descriptive management study using bone
      scintigraphy and available literature. Sensitivity analyses were performed.
      RESULTS: Overall costs were 273.7, 317.7 and 316.1 European Currency Units (ECU)
      for Strategies A, B and C, respectively (1 ECU = 1.15 U.S. dollar). Strategy B
      led to the longest average period of immobilization (8.6 wk), while Strategy A
      resulted in the highest nonunion rate (4.7%). The costs per nonunion saved for
      the additional use of bone scintigraphy (Strategy C) was ECU 2618 when compared
      to Strategy A. CONCLUSION: The use of bone scintigraphy in the diagnostic
      management of scaphoid fractures is accurate, convenient for patients and cost
      effective.

PMID- 7799081
TI  - Diagnosis of scaphoid fractures: the role of nuclear medicine.

PMID- 7799082
TI  - Samarium-153-particulate hydroxyapatite radiation synovectomy: biodistribution
      data for chronic knee synovitis.
AB  - Biodistribution data for the radiation synovectomy agent samarium-153-particulate
      hydroxyapatite (153Sm-PHYP) are reported. METHODS: Mean extra-articular activity
      accumulation calculated from serial whole-body scans in 13 patients treated for
      chronic knee synovitis was 0.74% of injected activity (range 0%-3%). RESULTS: In
      four patients (31%), activity was noted in the lung (mean 0.68% of injected
      activity). In six patients (46%), 0.29% of injected activity accumulated in the
      regional lymph nodes and in three patients (23%), 0.62% of injected dose
      accumulated in the liver. Absorbed dose estimates were lung: 14 mGy, regional
      lymph nodes; 50 mGy, liver; 4 mGy. SPECT demonstrated good distribution of 153Sm
      PHYP throughout the anterior knee compartments, although distribution to the
      posterior compartment was variable. CONCLUSION: Distribution is dependent on
      adequate knee flexion immediately following injection and may be influenced by
      the size range of labeled particles. Favorable biodistribution data suggest that
      153Sm-PHYP is a potentially useful radiation synovectomy agent.

PMID- 7799084
TI  - Perfusion and ventilation scans in patients with extensive obstructive airway
      disease: utility of single-breath (washin) xenon-133.
AB  - The presence of extensive obstructive airway disease in many patients leads to an
      interpretation of intermediate or indeterminate probability for pulmonary emboli
      using ventilation/perfusion lung scans. We observed that patients with extensive
      obstructive airway disease having perfusion abnormalities matching those on a
      single-breath xenon image usually have a normal pulmonary angiogram. This study's
      objective was to further assess the utility of a single-breath image in
      evaluating patients with extensive obstructive airway disease and abnormal
      perfusion studies categorized as having intermediate or indeterminate probability
      of pulmonary embolism in an attempt to decrease the number of nondiagnostic
      studies. METHODS: We studied retrospectively 33 patients with extensive
      obstructive airway disease, with abnormal perfusion scans and no infiltrates on
      chest x-ray categorized as having intermediate or indeterminate probability of
      pulmonary embolism. We established the presence or absence of matching
      ventilation and perfusion abnormalities by comparing perfusion scan and single
      breath images. RESULTS: Among 25 patients with perfusion abnormalities matching
      the initial ventilation pattern on single-breath images, only 1 (4%) had
      pulmonary emboli as documented by pulmonary angiogram. Four out of the remaining
      8 patients with no matching perfusion and single-breath ventilation pattern had
      pulmonary emboli (50%). CONCLUSION: Patients categorized by ventilation/perfusion
      scintigraphy as having intermediate or indeterminate probability for pulmonary
      emboli due to the presence of extensive obstructive airway disease can be further
      subclassified using single-breath images. Patients with matching perfusion and
      single-breath ventilation pattern should be categorized as having low probability
      for pulmonary embolism, regardless of the extent of the ventilation
      abnormalities.

PMID- 7799083
TI  - Evaluation of technetium-99m-sestamibi lung uptake: correlation with left
      ventricular function.
AB  - Lung uptake of 201Tl is a reliable marker of left ventricular dysfunction. The
      goal of our study was to establish whether the evaluation of lung-to-heart uptake
      ratios (LHR) with 99mTc-sestamibi imaging may provide valuable information.
      METHODS: We studied 72 male subjects with recent anterior myocardial infarction
      undergoing 99mTc-sestamibi first-pass ventriculography and SPECT perfusion
      imaging. A group of 46 gender-matched subjects with low pre-test likelihood of
      CAD and normal exercise and rest 99mTc-sestamibi perfusion images was used as a
      control. The lung-to-heart count ratios (LHR) were calculated on planar
      projections from the sets of SPECT images. RESULTS: Both groups were studied at
      rest and after a symptom-limited exercise tolerance test. In the control group a
      significant decrease in LHR was observed during stress (p < 0.001). The infarcted
      group showed significantly higher LHR values both at rest and at stress. Exercise
      and rest LHR values did not differ significantly. A positive correlation was
      observed between LHR values and left ventricular ejection fraction at rest and
      stress. CONCLUSION: LHR, measured by 99mTc-sestamibi imaging, gives clinically
      useful information. Both resting and postexercise values are correlated with
      ejection fraction and should predict left ventricular dysfunction.

PMID- 7799085
TI  - Alveolar integrity in pulmonary emphysema using technetium-99m-DTPA and
      technetium-99m-HMPAO radioaerosol inhalation lung scintigraphy.
AB  - The alveolar integrity (AI) in 17 male patients with pulmonary emphysema (EMPH)
      diagnosed by chest x-ray was measured by 99mTc-DTPA and 99mTc-HMPAO radioaerosol
      inhalation lung scintigraphy. METHODS: The patients were divided into two groups:
      (A) nine patients with pulmonary emphysema and normal carbon monoxide diffusion
      capacity (DLCO) and (B) eight patients with pulmonary emphysema and abnormal
      DLCO. The degree of AI damage in EMPH was presented as the slope of the time
      activity curves from the dynamic left lung imagings in DTPA and HMPAO. The AI of
      EMPH patients were compared with the AI of 16 normal controls. RESULTS: The
      results show that: (1) the slope of DTPA is larger than that of HMPAO in each of
      the portions of the left lung for any of the study groups; (2) statistical
      differences were found between the normal controls and EMPH patients in HMPAO but
      not in DTPA; and (3) the correlation was not good between DLCO and DTPA/HMPAO in
      EMPH patients. CONCLUSION: Our results suggest that: (1) at least two different
      mechanisms in the lungs were at work; (2) the AI damage in EMPH developed mainly
      in the lipophilic part of the alveoli; and (3) the AI damage presented as slopes
      of DTPA/HMPAO in our study was different from the traditional pulmonary function
      such as DLCO.

PMID- 7799086
TI  - Indium-111 activity concentration in tissue samples after intravenous injection
      of indium-111-DTPA-D-Phe-1-octreotide.
AB  - METHODS: Indium-111 activity concentrations in human tumor and normal tissue
      samples were determined at 24, 48 and 120 hr after i.v. injection of 111In-DTPA-D
      Phe-1-octreotide. Fourteen patients were included in the study. Seven patients
      had medullary thyroid carcinoma, four had midgut carcinoid tumors, two had
      endocrine pancreatic tumors and one had chronic pancreatitis. RESULTS: For midgut
      carcinoids, the tumor-to-blood ratio was 51:220, for medullary thyroid carcinoma
      4:39, and for two endocrine pancreatic tumors 6 and 1500. Tumor-to-muscle ratios
      varied between 1 and 1200 and tumor-to-fat between 2 and 1500 depending on tumor
      type. CONCLUSION: The sometimes extremely high tumor-to-normal tissue ratios
      present the possibility for use of radiolabeled octreotide for radiation therapy
      of somatostatin receptor positive tumors.

PMID- 7799087
TI  - Effect of inhaled furosemide on lung clearance of technetium-99m-DTPA.
AB  - The diuretic furosemide has been reported to have a protective effect on allergic
      asthmatic reactions. This study was performed to investigate the effect of
      aerosolized furosemide on the lung clearance of 99mTc-diethylene triamine
      pentaacetic acid (99mTc-DTPA). METHODS: Pulmonary clearance rates of 99mTc-DTPA
      were measured by a computerized gamma camera with and without the inhalation of
      aerosol furosemide in 6 nonsmoking normal volunteers (Group 1), 7 smokers without
      pulmonary disease (Group 2) and 11 patients with asthma (Group 3). RESULTS: None
      of the six normal volunteers showed significant effects of inhaled furosemide on
      the 99mTc-DTPA clearance rates. Three of seven smokers presented an accelerated
      99mTc-DTPA clearance by inhaled furosemide and the other four showed no
      significant change of 99mTc-DTPA clearance by furosemide inhalation. However, in
      10 of 11 patients with asthma, there was significant suppression of 99mTc-DTPA
      clearance by furosemide inhalation. CONCLUSION: Asthmatics possess a furosemide
      sensitive mechanism. Pulmonary aerosol scintigraphy with 99mTc-DTPA will be
      useful in predicting the effect of inhaled furosemide therapy.

PMID- 7799088
TI  - Myocardial blood flow: comparison of oxygen-15-water bolus injection, slow
      infusion and oxygen-15-carbon dioxide slow inhalation.
AB  - This study investigates the most appropriate protocol for measuring regional
      myocardial blood flow (MBF) using 15O-water in clinical applications. METHODS:
      Regional MBF, perfusable tissue fraction (PTF) and arterial blood volume (Va)
      were measured using 15O-water and dynamic PET on five healthy volunteers based on
      previously published models. Calculated values were compared for the following
      three tracer administration protocols: 15O-water bolus injection, 15O-water slow
      (2 min) infusion and 15O-carbon dioxide slow (2 min) inhalation. For the two slow
      administration protocols, the three parameters MBF, PTF and Va were computed by
      fitting the model equations to the myocardial regional time-activity curve. For
      the bolus injection of 15O-water, only two parameters, MBF and PTF, were fitted
      by using a fixed Va value obtained by a carbon dioxide blood volume scan.
      RESULTS: All protocols provided consistent MBF values, and the calculated values
      were homogeneous throughout the whole myocardial segments for all subjects. PTF
      values were also homogeneous and consistent in the anterior and lateral wall
      regions, but were significantly greater in the septum (approximately 20%) when
      the slow 15O-carbon dioxide inhalation protocol was used. MBF and PTF values
      obtained from the bolus injection protocol showed the smallest intersubject and
      interregional variations. The simulation study also showed that the magnitude of
      error was smallest when the bolus injection protocol was employed. CONCLUSION:
      The data suggest that the 15O-water bolus injection protocol together with the
      two-parameter fitting procedure provides the most accurate results for MBF and
      PTF. However, it requires arterial cannulation and a separate carbon monoxide
      scan. For clinical studies, however, the 15O-water infusion protocol would be a
      good alternative, providing MBF and PTF results with an acceptable degree of
      accuracy and without the need for arterial cannulation.

PMID- 7799089
TI  - Clinical significance of reverse redistribution on 24-hour delayed imaging of
      exercise thallium-201 myocardial SPECT: comparison with myocardial fluorine-18
      FDG-PET imaging and left ventricular wall motion.
AB  - Clinical significance of reverse redistribution on 24-hr delayed images after
      exercise 201Tl myocardial SPECT was investigated in 16 patients with recent
      myocardial infarction. METHODS: Findings of 24-hr delayed 201Tl SPECT imaging
      were compared with those of glucose-loaded 18F-fluorodeoxyglucose (FDG) imaging
      by myocardial PET and with left ventricular wall motion obtained by bi-plane
      contrast left ventriculography. In each patient, transaxial thallium images and
      corresponding 18F-FDG images were divided into five ROIs. RESULTS: Reverse
      redistribution was found in 15 of 80 regions. The mean FDG activity score in
      regions with reverse redistribution was significantly lower than that in regions
      having normal or slightly decreased thallium activity on 24-hr delayed imaging;
      it was significantly higher than that in regions having severely decreased or no
      thallium activity on 24-hr delayed imaging. The mean wall motion score in regions
      with reverse redistribution was significantly lower than in regions with normal
      or slightly decreased thallium activity, however, it was significantly higher
      than that in regions with moderately or more decreased thallium activity.
      CONCLUSION: These findings demonstrate that in regions showing reverse
      redistribution on 24-hr delayed 201Tl imaging, myocardial exogenous glucose
      utilization and left ventricular wall motion had deteriorated, but were not on a
      level with the scar.

PMID- 7799090
TI  - Evaluation of an inexpensive screening scintigraphic test of gastric emptying.
AB  - Our goal was to study the accuracy of a limited assessment relative to the
      traditional and obtain a more detailed approach to measure gastric emptying.
      METHODS: We prospectively evaluated 35 patients referred to our laboratory with
      suspected fast or slow gastric emptying. Transit was measured
      radioscintigraphically after ingestion of an egg meal containing 99mTc-Amberlite
      pellets. Gastric emptying was analyzed by power exponential analysis. Diagnostic
      accuracy of simpler indices (gastric residual at 2 and 4 hr) was determined by
      comparing the categorization of patients as normal or abnormal relative to
      previously published normal data from our laboratory. RESULTS: Gastric residual
      at 2 hr showed greater diagnostic accuracy for accelerated gastric emptying with
      90% sensitivity at 90% specificity. Gastric residual at 4 hr was less accurate
      for accelerated emptying, but was more accurate at detecting delayed gastric
      emptying with 100% sensitivity at 70% specificity. In contrast, sensitivity and
      specificity of gastric residual at 2 hr for slow emptying were low (100%
      sensitivity with 20% specificity) emphasizing the importance of obtaining a scan
      later than 2 hr for detecting delayed gastric emptying. CONCLUSION: Selective
      scans taken at 2 and 4 hr provide an excellent screening test for detecting fast
      or slow gastric emptying; the accuracy of 2-hr data is optimal for accelerated
      emptying and that of the 4-hr data greater for delayed emptying. This strategy
      provides a simple, less expensive way to evaluate gastric emptying in clinical
      practice with acceptable sensitivity and specificity as an initial test for
      patients with clinically suspected gastric stasis or dumping syndromes.

PMID- 7799091
TI  - PET-FDG of pleomorphic xanthoastrocytoma.
AB  - A young patient with pleomorphic xanthoastrocytoma (PXA), a usually benign
      cerebral tumor, had two recurrences in a short time period. The clinical,
      pathological and neuroradiological features, including PET with [18F]
      fluorodeoxyglucose (FDG), are presented. The PET-FDG study revealed the recurrent
      tumor to be hypermetabolic. The diagnosis was confirmed histopathologically. As
      the clinical outcome of patients harboring PXA is not easy to predict because of
      possible recurrence and/or transformation into more aggressive gliomas, we
      discuss the predictive indicators of more aggressive clinical behavior.

PMID- 7799092
TI  - A model for critical thinking within the context of curriculum as praxis.
AB  - The curriculum may be informed by a technical, practical, or emancipatory
      interest. Curricula informed by these three interests are referred to as
      curriculum as product, curriculum as practice, and curriculum as praxis (Grundy,
      1989) respectively. When curricula are viewed from different perspectives, it is
      plausible to suggest that each perspective requires a different conceptualization
      of critical thinking. The literature search revealed that critical thinking has
      been equated with problem solving, which is congruent with a curriculum-as
      product orientation. The purpose of this paper is to provide an overview of a
      conceptual model for critical thinking that is congruent with an orientation to
      the curriculum as praxis. The model is derived from the work of Freire (1972),
      Habermas (1972), and Grundy (1989). The key concepts of the model are knowledge,
      critical reflection, and action. There is a reciprocal relationship between
      knowledge and action, which is mediated by critical reflection.

PMID- 7799093
TI  - Critical thinking disposition as a measure of competent clinical judgment: the
      development of the California Critical Thinking Disposition Inventory.
AB  - Assessing critical thinking skills and disposition is crucial in nursing
      education and research. The California Critical Thinking Disposition Inventory
      (CCTDI) uses the Delphi Report's consensus definition of critical thinking as the
      theoretical basis to measure critical thinking disposition. Item analysis and
      factor analysis techniques were used to create seven disposition scales, which
      grouped the Delphi dispositional descriptions into larger, more unified
      constructs: open-mindedness, analyticity, cognitive maturity, truth-seeking,
      systematicity, inquisitiveness, and self-confidence. Cronbach's alpha for the
      overall instrument, the disposition toward critical thinking, is .92. The 75-item
      instrument was administered to an additional sample of college students (N =
      1019). The alpha levels in the second sample remained relatively stable, ranging
      from .60 to .78 on the subscales and .90 overall. The instrument has subsequently
      been used to assess critical thinking disposition in high school through the
      graduate level but is targeted primarily for the college undergraduates.
      Administration time is 20 minutes. Correlation with its companion instrument, the
      California Critical Thinking Skills Test, also based on the Delphi critical
      thinking construct, was measured at .66 and .67 in two pilot sample groups.

PMID- 7799094
TI  - A critical thinking model for nursing judgment.
AB  - Increasingly, the characteristic that distinguishes a professional nurse is
      cognitive rather than psychomotor ability. Critical thinking is an essential
      component of nursing. Yet, no clear definition or conceptualization of critical
      thinking for nursing judgment has existed. Lack of consensus and overlapping
      definitions may well diminish the profession's ability to articulate this concept
      and facilitate its development. This article proposes the Critical Thinking Model
      for Nursing Judgment, which specifies five components: specific knowledge base,
      experience, competencies, attitudes, and standards. The model has three levels of
      critical thinking: basic, complex, and commitment. It provides a definition and
      conceptualization of critical thinking based on a review of the literature and
      input from nurses and nurse educators. The model provides a first step for
      development of further research and educational strategies to promote critical
      thinking as an essential part of autonomous, excellent nursing practice.

PMID- 7799095
TI  - Study groups: are they effective in preparing students for NCLEX-RN?
AB  - The effectiveness of faculty-directed study groups as an intervention to prepare
      nurse candidates for NCLEX-RN was evaluated. The NCLEX-RN performance of a
      baccalaureate class who had participated in study groups was compared to the
      performance of a prior class who had not participated in study groups. Academic
      subgroups within the classes were compared to determine if study groups were
      equally effective across levels of academic achievement. The possible reasons for
      the significant difference in the NCLEX-RN passing rate between "at-risk"
      students who participated in study groups and at-risk students who did not
      participate in study groups are discussed. Discussion also considers possible
      factors influencing the generally better performance of study group participants
      at all academic levels. Suggestions for future intervention research direct
      attention to time intensity of interventions and research control through random
      assignments to treatment groups.

PMID- 7799096
TI  - University-hospital research collaboration provides meaningful experience for
      student learning.
AB  - Having the faculty and clinicians work together to formulate a problem for study
      or to take some portion of an existing study is very useful. Students see that
      research has practical value and that practice can be affected by systematic
      investigation of existing nursing practice. Possibly the greatest benefit of
      students' involvement in this joint project was students' and staffs'
      realizations that nursing research planned and implemented jointly can benefit
      both the nurses in practice and the baccalaureate students. Involving students in
      active participation in joint projects developed and executed in collaboration
      between clinicians and faculty seems a feasible and worthwhile undertaking. Yet,
      these projects need to be carefully selected, taking into account the needs of
      the agency and the students as well as faculty's ability to cope with
      undergraduate students' inexperience.

PMID- 7799097
TI  - Effect of type of instructional format on nursing student cue recognition of
      pulmonary edema: a pilot study.

PMID- 7799098
TI  - A comparison of baccalaureate nursing programs in the United States and in
      Taiwan, R.O.C.

PMID- 7799099
TI  - From advanced practice to academia: developmental tasks and strategies for role
      socialization.

PMID- 7799101
TI  - Introduction to an automated hospital information system in baccalaureate
      education: a pilot project.

PMID- 7799100
TI  - Coping with declining resources and escalating enrollments: an alternative
      advisement strategy.

PMID- 7799102
TI  - Teaching students time management strategies.

PMID- 7799103
TI  - Age-related challenges in hypertension. Introduction.

PMID- 7799104
TI  - Alterations in neural cardiovascular control mechanisms with ageing.
AB  - AGEING AND MECHANISMS OF BLOOD PRESSURE CONTROL: Ageing is associated with
      functional and structural alterations to the cardiovascular system. Evidence is
      accumulating, however, that ageing also determines major changes in the
      effectiveness of mechanisms involved in blood pressure control and that this
      represents an important determinant of the cardiovascular changes that can be
      observed in the elderly. DIFFERENCES SEEN IN ELDERLY SUBJECTS: It has been
      observed that compared to young subjects, in the elderly (1) baroreceptor control
      of the heart rate and cardiac function is impaired; (2) baroreceptor modulation
      of the sympathetic drive to the peripheral circulation is impaired, particularly
      the speed of reflex adjustments to normal and abnormal stimuli; and (3)
      cardiopulmonary stretch receptors, which tonically inhibit sympathetic tone, the
      renal release of renin and vasopressin secretion, are impaired. These three
      factors may account, at least in part, for the raised blood pressure and
      sympathetic activity in the elderly. They certainly explain the reduced ability
      of elderly people to maintain blood pressure and blood volume homeostasis, and
      their increased blood pressure variability over 24 h. ASSOCIATION WITH
      HYPERTENSION: All these problems are exacerbated if ageing is associated with
      hypertension, and are highly relevant to antihypertensive treatment. Care should
      be taken that any antihypertensive drugs selected for treatment in the elderly do
      not aggravate these basic homeostatic problems.

PMID- 7799105
TI  - Are calcium antagonists the best option in elderly hypertensives?
AB  - SUITABILITY OF CALCIUM ANTAGONISTS FOR THE ELDERLY: The efficacy and safety of
      calcium antagonists have been clearly demonstrated in elderly hypertensive
      patients. In a double-blind placebo-controlled study in 31 elderly hypertensives
      treated with nicardipine, we found no consistent electrocardiogram changes, nor
      in the heart rate, plasma levels of potassium, sodium or creatinine, or uric
      acid; nor did we find any postural hypotension. The mechanism of action of this
      class of drugs appears to be particularly appropriate in the treatment of elderly
      patients, in whom hypertension is characterized by an increase in peripheral
      resistance and a decrease in arterial compliance. Since vascular tone is
      ultimately controlled by the intracellular calcium concentration in smooth
      muscles, agents such as calcium inhibitors, which inhibit calcium influx and
      induce dilation of small and large arteries, are of particular interest.
      EXPERIMENTAL EVIDENCE: There is some experimental evidence in hypertensive rats
      and hypercholesterolaemic rabbits that calcium antagonists can provide some
      protection against atherosclerotic degeneration. However, the validity of
      extrapolating these findings to humans is still disputed. POSSIBLE CEREBRAL
      EFFECT: Calcium antagonists might also have a beneficial cerebral effect. The
      acute administration of these drugs has been shown to increase cerebral blood
      flow. Moreover, several studies have shown a protective action against cerebral
      ischaemia and this may be of particular importance in the very elderly.

PMID- 7799106
TI  - Why is antihypertensive drug therapy needed in elderly patients with
      systolodiastolic hypertension?
AB  - OBJECTIVE: This paper presents a meta-analysis of eight outcome trials of
      antihypertensive drug treatment in elderly hypertensive patients, and uses the
      results of these trials to discuss day-to-day issues in the treatment of elderly
      hypertensive patients. META-ANALYSIS: In an intention-to-treat analysis,
      cardiovascular mortality was decreased on average by 22% (95% confidence interval
      -32% to -10%). This decrease was a result of reductions in both coronary and
      cerebrovascular mortality, by 26% (-40% to -9%) and 33% (-50% to -9%),
      respectively. So far, the effectiveness of antihypertensive therapy in reducing
      cardiovascular mortality has not been established with confidence in trials where
      the diastolic blood pressure at random allocation to treatment groups was below
      95 mmHg or in patients above 75 years of age. IMPLICATIONS FOR DAY-TO-DAY
      PRACTICE: No blood pressure treatment goal has been definitively established but
      a reduction in systolic blood pressure to about 150 mmHg may be optimal.
      Extrapolation of trial results to the elderly population with systolodiastolic
      hypertension at large seems acceptable for a Western population, but may be
      premature for elderly Asians and Africans. beta-Blockers and especially diuretics
      are recommended as first-line drugs in elderly patients with symptomless,
      uncomplicated hypertension, since the effectiveness of other drugs in reducing
      morbidity and mortality has not yet been established. Recommendations for the
      treatment of symptomless patients with isolated systolic hypertension may be
      premature. Ongoing trials on systolic hypertension in Europe (Syst-Eur) and China
      (Syst-China) may provide further information.

PMID- 7799107
TI  - Epidemiology of hypertension in the elderly.
AB  - DISTRIBUTION: Blood pressure tends to rise with increasing age. Six to eight per
      cent of people aged 60-69 years, and about 12-16% of those aged 70-79 years, are
      estimated to need treatment for raised systolic and diastolic blood pressures.
      DETERMINANTS: It seems likely that the rise in blood pressure with increasing age
      is partly explained by the determinants of blood pressure, such as sodium intake,
      body weight, physical exercise and alcohol consumption. MORTALITY: There is a
      linear relationship between the level of diastolic or systolic blood pressure and
      the risk of stroke or coronary heart disease. However, the relationship between
      blood pressure and mortality in later life may be obscured if concurrent illness
      lowers blood pressure; low blood pressure by itself may not be a risk factor for
      mortality. TREATMENT: Randomly allocated trials have consistently shown that the
      treatment of hypertension in men and women over 60 years of age reduces the
      incidence of stroke by about 40%, and some trials have also shown reductions in
      coronary events.

PMID- 7799108
TI  - Treatment of elderly hypertensives in Japan: National Intervention Cooperative
      Study in Elderly Hypertensives. The National Intervention Cooperative Study
      Group.
AB  - PREVALENCE OF HYPERTENSION IN ELDERLY JAPANESE PATIENTS: Data collected from post
      mortem information at the Tokyo Metropolitan Geriatric Hospital showed that the
      overall prevalence of hypertension in Japanese patients aged over 60 years was
      53%; one-third of these elderly hypertensives had isolated systolic hypertension.
      Isolated systolic and systolodiastolic hypertension were each associated with a
      similar degree of increased atherosclerosis and cardiovascular complications. In
      a placebo-controlled study antihypertensive treatment produced a reduction in
      withdrawal from treatment in elderly patients with mild hypertension. INTERIM
      TRIAL RESULTS: Some interim results have been obtained from a new trial which is
      currently under way in Japan, the National Intervention Cooperative Study for the
      Treatment of Elderly Hypertensives, a long-term study comparing the effects of a
      calcium antagonist (nicardipine) and a thiazide diuretic (trichlormethiazide) on
      cardiovascular complications in elderly patients with mild to moderate
      hypertension.

PMID- 7799109
TI  - Pathophysiology and end-organ damage in elderly hypertensives.
AB  - PATHOPHYSIOLOGY OF HYPERTENSION: Blood pressure increases with advancing age in
      most developed countries. The pathophysiology of elderly hypertension is
      characterized by changes in the structure and function of the cardiovascular
      system. Changes in arterial structure lead to a decrease in aortic compliance,
      which augments the aortic pressure component generated by the wave reflection
      mechanism. The age-related increase in the reflected-wave component of arterial
      pressure may contribute, at least in part, to the age-related rise in systolic
      blood pressure. Disproportionately elevated systolic blood pressure in the
      elderly may account for the progressive increase in left ventricular mass with
      advancing age. In addition to the changes in vascular and cardiac structures, the
      haemodynamic function of elderly hypertensives is characterized by increased
      peripheral resistance as well as reduced cardiac output, renal blood flow and
      intravascular volume. In contrast to younger hypertensives, the sympathetic and
      renin-angiotensin systems may not be major factors in the genesis of high
      peripheral resistance in this patient group. END-ORGAN DAMAGE: The most important
      end-organ damage in elderly hypertensives is left ventricular hypertrophy with or
      without coronary heart disease, cerebrovascular disease or renal impairment.
      Furthermore, this end-organ damage is frequently asymptomatic (silent). The
      prevalence of silent cerebrovascular disease in particular is surprisingly high
      in this elderly population. Asymptomatic cerebrovascular disease has been shown
      to be associated with various cardiovascular risk factors, and depressed
      neurobehavioural function. Diurnal blood pressure variations appear to be related
      to end-organ damage. The presence of occult end-organ damage and co-existing
      diseases common in elderly hypertensives has important clinical implications in
      the management of this disorder.

PMID- 7799110
TI  - Type 2 cryoglobulinemia and hepatitis C virus: its recognition and treatment.
AB  - Type 2 mixed cryoglobulinemia is a relatively common although rarely recognized
      consequence of chronic hepatitis C virus infection. Its detection should be
      pursued in individuals with lower extremity vasculitis which occurs in
      association with other signs of systemic disease such as proteinuria or a
      peripheral neuropathy. Importantly, HCV-associated cryoglobulinemia can occur in
      individuals with clinical evidence for cryoglobulinemia but without any evidence
      of detectable liver injury. Two cases recently seen in Oklahoma demonstrating
      these points are reported.

PMID- 7799111
TI  - Introduction to smart card technology and initial medical application.
AB  - Smart card technology is the name applied to the use of a plastic card with an
      embedded computer chip. Recent development of smart card software has allowed
      storage and retrieval of medical information, affording the opportunity to
      provide a standardized, portable, accessible medical record for use in
      prehospital and emergency department patient encounters. We describe the smart
      card concept and its initial deployment in a section of a large Midwestern urban
      area.

PMID- 7799112
TI  - Waynoka wisdom.

PMID- 7799113
TI  - Quo vadis?
AB  - There is an explosion of DNA and genetic research today. The dignity of life
      dictates caution be urged in the use of preembryos and fetal parts for these
      studies.

PMID- 7799114
TI  - Anesthesiology: where do we go from here?

PMID- 7799115
TI  - Intramuscular ketamine, midazolam, and glycopyrrolate for pediatric sedation in
      the emergency department.
AB  - PURPOSE: The safety and efficacy of a new sedation technique for children with
      facial injuries in the emergency department were prospectively evaluated.
      MATERIALS AND METHODS: Thirty-seven children between the ages of 12 months and 7
      years old who required sedation for minor surgical procedures were administered
      an intramuscular injection of ketamine (3 mg/kg), midazolam (0.05 mg/kg), and
      glycopyrrolate (0.005 mg/kg). A second 1-mg/kg intramuscular injection of
      ketamine alone was given if needed. Pulse rate, cardiac rhythm, respiratory rate,
      oxygen saturation, side effects, and behavior were recorded. RESULTS:
      Satisfactory sedation was achieved after a single injection in 32 children; five
      others required a second ketamine injection (1 mg/kg). Onset of anesthesia
      occurred within 6 minutes in 73% of the children who received one injection, and
      there were generally adequate working conditions for 30 minutes. The average time
      from initial injection to discharge was 76 minutes. Results of physiologic
      monitoring, behavioral ratings, and side effects are reported. Emergence delirium
      and hallucinations were not observed. Ketamine reliably produced dissociative
      anesthesia without loss of respiratory drive or protective airway tone. Midazolam
      reduced the incidence of ketamine-induced dysphoric reactions and muscular
      hypertonicity. CONCLUSION: The use of intramuscular ketamine, midazolam, and
      glycoyrrolate is a safe, effective, and practical approach to managing selected
      pediatric injuries in the emergency department. Advanced airway management
      proficiency is recommended for use of this technique.

PMID- 7799116
TI  - Use of ibuprofen and methylprednisolone for the prevention of pain and swelling
      after removal of impacted third molars.
AB  - PURPOSE: To test a combination treatment of ibuprofen and methylprednisolone for
      pain and swelling. METHODS: The efficacy of 32 mg methylprednisolone on pain and
      swelling when given 12 hours before and after surgery in combination with 400 mg
      ibuprofen three times a day given immediately on the day of the operation and on
      the two subsequent days following removal of impacted third molars was
      investigated in a placebo-controlled, intraindividual double-blind study.
      RESULTS: After use of ibuprofen/methylprednisolone, ultrasonic examination showed
      a reduction in swelling of 56% (P < .001) compared with the placebo group;
      measurement with a tape measure showed a 58% (P < .001) reduction in swelling.
      The visual analog scale showed a reduction of 67.7% in postoperative pain in
      comparison with placebo. CONCLUSION: The combination of ibuprofen and
      methylprednisolone has good analgesic and antiinflammatory action.

PMID- 7799117
TI  - Inhalation sedation with sevoflurane: a comparative study with nitrous oxide.
AB  - PURPOSE: To evaluate the possibility of using sevoflurane for inhalation
      sedation. PATIENTS AND METHODS: Thirty-five volunteers were divided randomly into
      two groups: sevoflurane group (n = 20) and nitrous oxide (N2O) group (n = 15). At
      the beginning of the sedation they all inhaled 100% O2, then a 0.1 minimum
      alveolar concentration (MAC) of sevoflurane or 10% N2O with oxygen, a 0.2 MAC of
      sevoflurane or 20% N2O with oxygen, and 0.3 MAC of sevoflurane or 30% N2O with
      oxygen for 10 minutes each. RESULTS: The respiratory and cardiovascular functions
      were stable during inhalation of the gas mixtures. There were five negative
      comments about breathing N2O, but none about breathing sevoflurane. CONCLUSION:
      All subjects in the sevoflurane group stated they would be willing to submit to
      the same inhalation procedure again.

PMID- 7799118
TI  - Early correction of the nose in unilateral cleft lip patients using an open
      method: a 10-year review.
AB  - PURPOSE: To review a 10-year follow-up of cases with rhinoplasty for a cleft lip
      associated nose deformity done during the preschool years. MATERIALS AND METHODS:
      Sixteen patients from 16 to 19 years of age were evaluated with two indices: the
      nasal index and the lobule portion of the columella index. RESULTS: Several years
      after surgery the results appeared to be reasonably satisfactory. However, as the
      patients approached their adolescent growth spurt at 15 years of age, undesirable
      features became obvious. Each patient showed a strikingly bulbous nose. The nasal
      index of male patients ranged from 68.8% to 82.7% (mean, 75.4%) and that of
      female patients ranged from 72.7% to 85.0% (mean, 79.2%). The mean value of the
      nasal index in the Japanese male and female is 58.5% +/- 1.5% and 59.0% +/- 1.0%,
      respectively. The lobule portion index of male patients ranged from 57.1% to
      72.0% (mean, 65.1%) and that of female patients ranged from 62.5% to 82.0% (mean,
      74.2%). The lobule portion of the columella constitutes 33% of the total
      columellar length on average. CONCLUSIONS: A possible cause of the undesirable
      deformities is use of an open surgical method. A second possible cause is
      mobilization and suspension of the alar cartilages. These undesirable features
      may occur only in Oriental noses.

PMID- 7799119
TI  - Perineural invasion in skin cancer of the head and neck: a review of nine cases.
AB  - PURPOSE: To review the management and outcome of skin cancer of the head and neck
      with perineural invasion, a relatively uncommon and complex condition, in nine
      patients treated between 1965 and 1991. PATIENTS: Seven patients had skin cancers
      that were larger than 2 cm. All lesions were moderately or poorly differentiated.
      Curative surgery was performed in all nine cases, with or without radiotherapy.
      RESULTS: Local recurrence or regional disease appeared in three individuals;
      surgical salvage produced satisfactory results. At last follow-up (median, 45
      months; range, 18 to 201 months), no one had developed intracranial or skull base
      metastasis; lung cancer was detected in one patient. The crude survival rate was
      33% at 5 years and 22% at 10 years. The median survival was 25 months in patients
      who presented with neurologic symptoms and was 49 months in asymptomatic persons.
      CONCLUSION: Although the prognosis in patients with skin cancer of the head and
      neck complicated by perineural invasion is expectedly poor, long-term disease
      free survival is attainable with the use of aggressive therapy.

PMID- 7799120
TI  - Type II and type III collagen in mandibular condylar cartilage of patients with
      temporomandibular joint pathology.
AB  - PURPOSE: This study was undertaken to examine the presence of type II and type
      III collagen in the cartilage of the mandibular condyle in different types of
      temporomandibular joint (TMJ) pathology, including rheumatoid arthritis (RA), to
      assess to what degree the newly formed tissue is cartilaginous. PATIENTS AND
      METHODS: Tissue samples from 46 TMJ surgery patients (37 women and 9 men; mean
      age, 37 years; range, 14 to 76 years) were investigated. The samples were
      obtained at surgery mostly from anteriorly situated osteophytes or the
      anterosuperior uneven articular surface of the condyle. Tissue sections were
      stained with hematoxylin-eosin, toluidine blue, and Gomori's reticular stain.
      Type II and type III collagens were demonstrated by immunohistochemical staining.
      RESULTS: The amount of type II collagen was variable in the mandibular condylar
      cartilage. Type III collagen was found in the new osteoid tissue as well as the
      new chondroid tissue that was synthesized in the most reactive situations.
      CONCLUSIONS: Type II collagen synthesis occurred mainly in condylar hypertrophy
      and the intermediate stage of internal derangement of the TMJ. Type III collagen,
      which is found in fibrous repair tissue, was also found in sites of repair of
      mandibular condylar cartilage, including RA and osteomyelitis.

PMID- 7799121
TI  - Experimental transplantation of hydroxylapatite-bone composite grafts.
AB  - PURPOSE: This study was undertaken to determine if autogenous bone can be
      cultivated in vivo in a porous hydroxylapatite (HA) matrix by ingrowth from
      underlying bone and if this autogenous HA-bone composite graft can then be
      transplanted. PATIENTS AND METHODS: Five Gottingen minipigs received
      subperiosteal implantation of one HA block each (40 x 10 x 10 mm), covered by a
      polylactic membrane, on the ascending ramus of the mandible. After 5 months, half
      of each implant was harvested and transplanted as an onlay graft to the
      horizontal ramus of the mandible with simultaneous insertion of a titanium
      implant. Polychrome fluorescence labeling was done 1, 2, 4, and 8 weeks
      postoperatively. After 3 months, the vascular system of the animals was filled
      with BaSO4 for microangiographic examination, and all blocks were retrieved.
      RESULTS: Fluorescence microscopy showed that there was a significant decrease in
      deposition of the label in the grafted blocks at 1 week when compared with later
      labels. After the second week, there were no significant changes. A 20% to 30%
      decrease in the frequency of fluorochrome staining was noted in the upper third
      of each block. In this region, microangiography demonstrated highly vascularized
      tissue and limited bone resorption. CONCLUSION: It was concluded that cultivation
      of mandibular bone in a porous matrix under guided bone regeneration is possible
      and that this autogenous HA-bone composite graft can be transplanted at a later
      date.

PMID- 7799123
TI  - Prophylactic antibiotics for third molar surgery: a dissenting opinion.

PMID- 7799122
TI  - Prophylactic antibiotics for third molar surgery: a supportive opinion.

PMID- 7799124
TI  - Vascular leiomyoma of the mandible: report of a case.

PMID- 7799125
TI  - Infantile osteomyelitis of the maxilla with concomitant subperiosteal orbital
      abscess: a case report.

PMID- 7799126
TI  - Papillary cystadenoma of a minor salivary gland.

PMID- 7799127
TI  - Recurrent facial metastasis from renal-cell carcinoma: review of the literature
      and case report.

PMID- 7799128
TI  - Tetanus: a case report and review.

PMID- 7799130
TI  - Kallmann syndrome with associated cleft lip and palate: case report and review of
      the literature.

PMID- 7799129
TI  - Trismus-pseudocampylodactyly syndrome: report of a case.

PMID- 7799131
TI  - Autogenous mandibular bone grafts for malar augmentation.

PMID- 7799133
TI  - A new method of tongue reduction for macroglossia.

PMID- 7799132
TI  - Dermatography as an adjunctive treatment for cleft lip and palate patients.
AB  - PURPOSE: To investigate dermatography as a treatment for cleft lip and palate.
      METHODS: The results of the treatment of 19 cleft lip patients with discoloration
      of scars and the vermillion border after secondary cleft lip and palate surgery
      by dermatography and intracicatricial keloidectomy are described. RESULTS: This
      group of patients has gained self-confidence after treatments, to the extent that
      their articulation has improved. CONCLUSION: Dermatography can be applied as an
      adjuvant treatment with good cosmetic and esthetic results.

PMID- 7799134
TI  - Taking a shot at the editor.

PMID- 7799135
TI  - Taking a shot at the editor.

PMID- 7799136
TI  - Taking a shot at the editor.

PMID- 7799137
TI  - Taking a shot at the editor.

PMID- 7799138
TI  - In vitro interaction of zinc(II)-phthalocyanine-containing liposomes and plasma
      lipoproteins.
AB  - We have studied the interaction of small unilamellar liposomes containing
      zinc(II)-phthalocyanine (Zn-Pc) with human plasma lipoproteins. High-, low- and
      very low-density lipoproteins (HDL, LDL and VLDL), were purified from plasma and
      combined in amounts reflecting their natural abundance in plasma. After short
      periods of incubation at 37 degrees C, the bulk of Zn-Pc was incorporated into
      HDL and LDL; very little 14C-labelled palmitoyl oleoyl phosphocholine, the most
      abundant phospholipid in the formulation, was associated with lipoproteins. When
      liposomes were incubated in pooled plasma, 73%-85% of Zn-Pc and 27%-34% of
      radiolabelled phospholipid were recovered with HDL and LDL, indicating a possible
      role for plasma lipid transfer proteins in the incorporation of phospholipid into
      lipoproteins. Some Zn-Pc was also found in association with VLDL. The buoyant
      density of Zn-Pc liposomes increased in a dose-dependent fashion when the
      particles were incubated with plasma, and it is suggested that this was due, at
      least in part, to opsonization of liposomes by plasma proteins.

PMID- 7799139
TI  - Photosensitizer targeting in photodynamic therapy. I. Conjugates of
      haematoporphyrin with albumin and transferrin.
AB  - Conjugates of haematoporphyrin (HP) with serum albumin and transferrin were
      prepared, purified by gel filtration and characterized by high performance liquid
      chromatography (HPLC), polyacrylamide gel electrophoresis (PAGE) and
      spectroscopy. Although the fluorescence was somewhat quenched, the conjugates had
      similar singlet oxygen quantum yields to free porphyrin. The albumin conjugate
      (HP-BSA) could be divided into monomeric and cross-linked fractions. In NIH 3T3
      and HT29 cells, native albumin could not compete with the uptake of HP-BSA and
      the uptake was greatly enhanced in the absence of serum and in the presence of
      poly-L-lysine. We infer that the conjugate was mostly associated with the plasma
      membrane in these cells. The uptake of HP-transferrin showed evidence of a
      receptor-mediated component in that it was partially inhibited by native protein
      and increased when transferrin receptors were upregulated by an iron chelator.
      J774 macrophage-like cells accumulated fluorescence from HP-BSA to a much higher
      degree than HT29 cells, even though the protein was extensively degraded (HT29
      cells did not appear to degrade the protein). The time course of the
      photocytotoxicity of HP-BSA was prolonged in J774 cells, although their response
      to free porphyrins was similar to that seen in HT29 cells. Chloroquine inhibited
      protein degradation without having an effect on the fluorescence uptake. J774
      cells acquired more fluorescence and degraded more protein when supplied with
      cross-linked HP-BSA compared with monomeric fraction. For a given fluorescence
      uptake, the cross-linked fraction was also more photocytotoxic. We conclude that
      macrophages can acquire photosensitizer-protein conjugates avidly and that these
      are delivered to the lysosomes. These types of conjugate may have applications in
      targeting fluorescent molecules for diagnostic imaging and for the photodynamic
      treatment of macrophage malignancies.

PMID- 7799140
TI  - Photoreactivity of biologically active compounds. VII. Interaction of
      antimalarial drugs with melanin in vitro as part of phototoxicity screening.
AB  - The drugs commonly used in the treatment of malaria are photochemically unstable.
      Several of these compounds accumulate in melanin-rich tissues and cause toxic
      reactions which may be light induced. As part of the screening of the
      photochemical properties and phototoxic capabilities of antimalarials, the in
      vitro interaction of eight antimalarials with melanin was studied. The
      dissociation constant for the drug-melanin complex and the relative number of
      binding sites on melanin were estimated for six of the drugs using a curve
      fitting program. The reaction rate for the formation of the melanin-drug complex
      was determined, and the complexes were further characterized by zeta potential
      measurements.

PMID- 7799141
TI  - Uterotrema Australispinosa n. gen., n. sp. (Digenea: Spirorchidae), a parasite of
      a freshwater turtle Emydura macquarii from southern Queensland, Australia.
AB  - Uterotrema australispinosa n. gen., n. sp. from the heart of the Murray River
      turtle Emydura macquarii (Pleurodira: Chelidae) is distinguished from other
      members of the Spirorchidae by the presence of a voluminous uterus; a single,
      lobed testis occupying the posterior quarter of the body; linear rows of 5-6
      spines arranged along the lateral margins of the hindbody from the posterior rim
      of the acetabulum to the posterior end of the body; and the posterior end
      ventrally curved with a dorsal cluster of spines near the terminal end. This is
      the first report of a spirorchid from a member of the family Chelidae and from
      Australia.

PMID- 7799142
TI  - On Genarchella isabellae (Digenea: Derogenidae) from cichlid and pimelodid fishes
      in Mexico.
AB  - Evaluation of comparative material, including type specimens, of 2 derogenid
      species (Digenea: Derogenidae) in freshwater fishes of the families Cichlidae and
      Pimelodidae in Mexico revealed the invalidity of Genarchella luistoddi (Jimenez,
      Guajardo, and Briseno, 1981), a parasite of cichlid fishes in northern Mexico.
      This taxon is considered to be conspecific with Genarchella isabellae (Lamothe
      Argumedo, 1977), originally described from the pimelodid Rhamdia guatemalensis
      (Gunther) and frequently occurring in cichlids of the genus Cichlasoma in
      southeastern Mexico.

PMID- 7799143
TI  - Light and electron microscopic examination of so-called piroplasms of fishes from
      Atlantic Canada and systematic revision of the Haemohormiidae (Incertae sedis).
AB  - Haemohormidium terranovae infections in American plaice and infections with a
      similar parasite in oceanpout were examined by light and electron microscopy. All
      plaice were infected at the time of capture and remained infected for over 2 yr.
      Prevalence in oceanpout varied seasonally between 0% and 80%. Uninucleate,
      binucleate, and tetranucleate forms were found in both species. In addition,
      octonucleate stages were observed in some erythrocytes of infected plaice. The
      presence of DNA in parasite nuclei was confirmed. There was no evidence of any
      ultrastructural feature characteristic of the phylum Apicomplexa. It is proposed
      that the genus Haemohormidium Henry, 1910 be considered incertae sedis and the
      senior synonym to Haematractidium Henry, 1910.

PMID- 7799144
TI  - Antitrypanosomal activity of phosphonylmethoxyalkylpurines.
AB  - Phosphonylmethoxyalkylpurines and -pyrimidines exhibit potent activity against a
      broad spectrum of DNA viruses. We evaluated some of these nucleotide analogues
      for antitrypanosomal activity in vitro and in mice. The most active compounds
      were (S)-9-(3-hydroxy-2-phosphonylmethoxypropyl) adenine (HPMPA) and (S)-9-(3
      hydroxy-2-phosphonylmethoxypropyl)-2,6-diaminopurine (HPMPDAP), which inhibited
      growth of Trypanosoma brucei brucei by 50% (EC50 value) when incubated in vitro
      for 24 hr with 0.23-5.69 micrograms drug/ml. Both compounds completely eliminated
      multidrug-resistant T. b. brucei in culture at 1 microgram/ml after 4-5 days
      exposure. Mice infected with drug-susceptible T. b. brucei were cured with 2
      doses of 10 mg/kg HPMPDAP. Two or 5 doses of 50 mg/kg 9-(2
      phosphonylmethoxyethyl) adenine (PMEA) or 9-(2-phosphonylmethoxyethyl)-2,6
      diaminopurine (PMEDAP), respectively, were necessary to eliminate T. b. brucei
      infections in mice. Mice infected with multidrug-resistant T. b. brucei were not
      cured with the above dosages. The most active compound against Trypanosoma
      congolense was PMEDAP with an EC50 value of 3.21-11.63 micrograms/ml. Thus, some
      of the phosphonylmethoxyalkyl purines showed potential as antitrypanosomal
      compounds at dosages that are below those toxic for mice.

PMID- 7799145
TI  - Cultivation of Leishmania braziliensis in an economical serum-free medium
      containing human urine.
AB  - Leishmania braziliensis cells are difficult to culture in vitro and usually
      require media supplemented with serum for sustained cell division. Fresh, sterile
      urine is an inexpensive substitute for serum in the culture of 2 strains of L.
      braziliensis, 1 infected with Leishmania RNA virus 1, and 1 uninfected. In the
      presence of urine, both the infected and the uninfected strains grew to the same
      final cell density as the same strains grown in the presence of serum. One strain
      of Leishmania major was also successfully cultured in urine-supplemented media.

PMID- 7799147
TI  - Further evidence of regular sporulation by Haplosporidium nelsoni in small
      oysters, Crassostrea virginica.
AB  - During a field study to determine the susceptibility of the Pacific oyster
      Crassostrea gigas to Chesapeake Bay oyster pathogens, sporulation of
      Haplosporidium nelsoni was observed in eastern oysters Crassostrea virginica
      being used as controls. The C. virginica were obtained from 2 sources on 19 May
      1993, a wild population in the upper Rappahannock River, Virginia (59.6 mm mean
      shell height) and a hatchery-reared population from Chesapeake Mari-culture that
      was held in the Wye River, Maryland (42.2 mm mean shell height); they were
      deployed in the York River, lower Chesapeake Bay on 29 June 1993. Both groups of
      C. virginica became heavily infected with H. nelsoni in early July 1993.
      Sporulation was observed in both groups on 8 September but was most prevalent in
      the smaller Maryland oysters where it reached 36% of infected oysters. Oysters of
      72.3 mm mean shell height deployed at the same location in May 1993 also became
      heavily infected with H. nelsoni, but no cases of sporulation were observed in
      these larger oysters. These results provide further evidence that sporulation of
      H. nelsoni occurs regularly only in oysters approximately 1 yr old or less.

PMID- 7799146
TI  - Host specificity of Rhabdochona canadensis (Nematoda: Rhabdochonidae) in
      Nebraska.
AB  - Intermediate and definitive host specificity of Rhabdochona canadensis in
      Nebraska were investigated. Mayfly nymphs Trichorythodes sp. and Caenis sp. were
      found to serve as experimental intermediate hosts. Development inside the nymphs
      required approximately 10 days, with the worms passing through 2 molts and then
      becoming encapsulated in the hemocoel as infective third-stage juveniles. Survey
      data revealed that only the red shiner Cyprinella lutrensis serves as definitive
      host for R. canadensis in nature. Laboratory infections of Notropis dorsalis, N.
      stramineus, and Fundulus zebrinus, all of which were uninfected in nature, were
      attempted to determine if observed specificity was due to physiological or
      ecological factors. Two individuals of N. dorsalis became infected with R.
      canadensis, but no development was observed. Both N. stramineus and F. zebrinus
      were incapable of becoming infected. Thus, definitive host specificity in this
      system seems to be mediated by both physiological and host ecological factors.

PMID- 7799149
TI  - Aeginina longicornis (Amphipoda: Caprellidea), new intermediate host for
      Echinorhynchus gadi (Acanthocephala: Echinorhynchidae).
AB  - Cystacanths of the acanthocephalan Echinorhynchus gadi were found infecting the
      caprellid amphipod Aeginina longicornis on Banquereau, an offshore bank on the
      Scotian Shelf east of Nova Scotia, Canada. Two of 229 amphipods (0.9%) were each
      infected with a single male cystacanth. This is the first report of an
      intermediate host for E. gadi in the western Atlantic Ocean and the first record
      of A. longicornis as an intermediate host for any helminth. The cystacanths are
      described.

PMID- 7799148
TI  - Influence of season and habitat on Ixodes scapularis infestation on white-footed
      mice in northwestern Illinois.
AB  - The effects of season and habitat on the infestation of the white-footed mouse
      (Peromyscus leucopus) by immature Ixodes scapularis were studied at Castle Rock
      State Park, northwestern Illinois, during June-October 1991. Relative density of
      larvae on mice was higher in mid-late summer (13.7 ticks per mouse) than during
      the rest of the study period, whereas prevalence of nymphal infestation was
      highest in early summer (33.3%). Relative density of I. scapularis larvae and
      prevalence of nymphs on mice did not differ significantly among bottomland
      forest, field-forest ecotone, and upland forest habitats. In bottomland forest,
      total number of ticks collected from mice (472 larvae and 13 nymphs) and P.
      leucopus population density (6.6 mice per 0.36 ha) were higher than in the other
      habitats. Temporal patterns of numbers of larvae collected from mice and through
      dragging in bottomland forest were significantly correlated.

PMID- 7799150
TI  - New host and geographic records for coccidia (Apicomplexa: Eimeriidae) from North
      American turtles.
AB  - Two-hundred-fifty-three turtles, representing 26 species within 5 families
      (Chelydridae, Emydidae, Kinosternidae, Testudinidae, Trionychidae) were examined
      for coccidia. Of these, 127 (50%) were found to harbor 1 or more of 28 species of
      eimerians, or isosporan, or both. One-hundred-thirteen (89%) of the infected
      turtles were aquatic species, whereas only 14 (11%) of the infected turtles were
      terrestrial species. Two-fold more aquatic turtles were infected with coccidia
      (113 of 200, 57%) compared to only 26% (14 of 53) of the terrestrial species.
      This report documents 14 new host and 8 new geographic records for eimerians from
      turtles in Arkansas and Texas.

PMID- 7799151
TI  - Study on the life cycle of a sexually transmitted nematode parasite of a
      terrestrial snail.
AB  - A technique for the artificial infection of the snail Helix aspersa by its
      parasite the nematode Nemhelix bakeri is described. The snail is relaxed by
      injection of an anesthetic, and 1 gravid female worm is introduced into the
      genitalia through the genital pore. Half of the injected snails were successfully
      infected. Following the course of infection over time indicated a 1:1 sex ratio,
      that the maximum number of progeny produced by injected female worms was 7, and
      that the development time of female worms was 56 days. The first generation of
      gravid females was found 100 days after infection. A survey of naturally
      parasitized snails was also conducted. The sex ratio of worms was in equilibrium,
      with a mean number of 2.4 larvae per female. The development time (56 days) and
      the body size (2.47-4.00 mm) of female N. bakeri are similar to those of a
      related species Cosmocercoides dukae (52-57 days and 1.66-4.34 mm), although the
      life cycle and biogeographic distribution for each of them are distinct.

PMID- 7799152
TI  - Second intermediate host-specificity of Haematoloechus complexus and
      Haematoloechus medioplexus (Digenea: Haematoloechidae).
AB  - Second intermediate host-specificity was examined for 2 species of the frog lung
      fluke genus Haematolechus. Nine species of freshwater arthropods were exposed to
      cercariae of H. complexus and H. medioplexus. Metacercariae of H. complexus
      developed in all arthropod species used. Metacercariae of H. medioplexus
      developed only in anisopteran odonate naiads. This difference in host utilization
      may have epizootiological implications. The potential development of H. complexus
      in a greater number of arthropods than H. medioplexus may increase the chances of
      ingestion of H. complexus by an anuran host. The range of arthropods parasitized
      by H. complexus indicates that host-specificity of the metacercarial stage of
      this fluke is not restricted by the phylogeny of aquatic arthropods.

PMID- 7799153
TI  - Presidential address. Toward a national plan for parasite collections.

PMID- 7799154
TI  - Introduction of Timothy P. Yoshino as the Henry Baldwin Ward medalist for 1994.

PMID- 7799155
TI  - Acceptance of the 1994 Henry Baldwin Ward Medal.

PMID- 7799156
TI  - Presentation of the President's Special Award for Distinguished Service.

PMID- 7799157
TI  - Parasites, immunology of hosts, and host sexual selection.
AB  - Parasite-mediated sexual selection is reviewed with special emphasis on the bird
      literature. Choosy females may benefit from choosing parasite-free mates if such
      males provide better parental care, do not transmit contagious parasites, or
      provide resistance genes to offspring. There is evidence in support of each of
      these mechanisms. The immunocompetence handicap hypothesis posits that secondary
      sexual characters reliably reveal the ability of males to resist parasites due to
      the immunosuppressive effects of testosterone and other biochemicals. Several
      aspects of these negative feedback mechanisms are supported by laboratory
      studies, but evidence from free-living animals is almost completely absent.
      Corticosterone rather than testosterone may potentially mediate the
      immunocompetence handicap mechanism. A simple version of the immunocompetence
      handicap is developed suggesting that body condition of male hosts is a
      sufficient mediator of the handicap mechanism of reliable sexual signaling.
      Sexual selection appears to be more intense in sexually dichromatic bird species,
      and comparative studies using pairwise comparisons of closely related taxa reveal
      that sexually dichromatic bird species have larger spleens, larger bursa of
      Fabricius, and higher concentrations of leukocytes than monochromatic species.
      Parasite-mediated sexual selection is proposed to affect parasite biology by
      increasing (1) the variance-to-mean ratio in parasite abundance, (2) variance in
      the intensity of natural selection affecting hosts, and (3) speciation rates
      among parasites exploiting hosts subject to intense sexual selection as compared
      to those subject to less intense selection.

PMID- 7799158
TI  - A chemokinetic response in Schistosoma mansoni cercariae.
AB  - Schistosoma mansoni cercariae have been shown to aggregate in the presence of
      glass slides treated with clear nail varnish and linoleic acid. In choice
      chambers cercariae move toward the stimulant, but this behavior is not seen when
      linoleic acid is omitted. After 30-45 min, the cercariae were concentrated near
      the end of the choice-chamber containing the linoleic acid slide. When the
      cercariae were added in the center of the choice chamber, they formed a diffuse
      cloud that dispersed slowly in both directions in the absence of linoleic acid.
      Cercariae aggregating in the vicinity of a stimulant surface are not immediately
      stimulated to commence penetration; this appears to be time and dose related.

PMID- 7799159
TI  - Demonstration of a novel UDPGalNAc:GlcNAc beta 1-4 N
      acetylgalactosaminyltransferase in extracts of Schistosoma mansoni.
AB  - It was recently demonstrated that complex-type N-linked oligosaccharides in
      glycoproteins synthesized by Schistosoma mansoni contain the unusual terminal
      sequence GalNAc beta 1-4GlcNAc beta 1-2Man alpha 1-2R. This structure suggests
      that the parasite might contain a novel glycosyltransferase that can add GalNAc
      to terminal GlcNAc residues in N-linked oligosaccharides. This report describes
      an assay for this enzyme, designated UDPGalNAc:GlcNAc beta 1-4 N
      acetylgalactosaminyltransferase (beta 1-4GalNAcT), and demonstrates the presence
      of the enzyme activity in schistosome extracts. As an acceptor for the beta 1
      4GalNAcT, we prepared from human fibrinogen a truncated biantennary glycopeptide
      that contained terminal GlcNAc residues. When this acceptor was incubated with
      schistosome extracts in the presence of UDP-[3H]GalNAc, Mn2+, and detergent,
      [3H]GalNAc was transferred to the glycopeptide acceptor. Approximately 75% of the
      radioactivity in the product isolated by lectin affinity chromatography was
      recovered as [3H]GalNAc following hydrolysis; likewise, a majority of the
      isolated product was bound by immobilized Wisteria floribunda agglutinin, a
      lectin that binds to schistosome-derived oligosaccharides containing terminal
      beta 1-4-linked GalNAc residues. The activity of the beta 1-4GalNAcT in
      schistosome extracts was dependent on time, protein, and UDPGalNAc.

PMID- 7799160
TI  - Infectivity and normal development of third stage Brugia malayi maintained in
      vitro.
AB  - Shipment of infective-stage filarial larvae (L3s) usually has been accomplished
      by transporting living infected vectors or L3s cryopreserved in liquid nitrogen.
      Our objective was to find culture conditions for transporting L3s that would
      promote survival of Brugia malayi larvae without altering their capacity to
      infect susceptible animals. In preliminary studies we observed that Ham's
      nutrient mixture F-12, with antibiotics and 1% fetal calf serum, could support
      L3s without apparent development for at least 10 days. In order to evaluate the
      effect of culture temperatures on infectivity, fresh L3s were divided into groups
      that were either immediately injected into jirds (infectivity control) or
      incubated for 24, 48, or 120 hr in tightly sealed tubes maintained horizontally
      at either 0 C, 20 C, or 37 C, before they were injected into jirds. Necropsies
      were performed on the jirds 120-130 days after injection to recover and count
      adult worms. Levels of microfilaremia were also determined. We found that L3s
      held overnight at 0 C, although apparently viable, were unable to survive in
      jirds. However, larvae kept at 20 C and 37 C produced patent infections with
      adult worms in normal locations even after 120 hr of in vitro cultivation. There
      was no statistical difference in mean worm recovery or size of worms from jirds
      infected with freshly harvested L3s and jirds injected with larvae that were
      maintained overnight at 20 C or 37 C. When cultured L3s were shipped from
      Michigan to Connecticut by overnight air courier, along with infected living
      mosquitos, the L3s appeared to be 99% viable upon arrival. L3s shipped in F-12
      produced patent infections in C.B.-17 scid/scid mice with worm recoveries
      comparable to those observed in mice injected with L3s freshly obtained from
      shipped mosquitos.

PMID- 7799161
TI  - Definition of populations at risk for Plasmodium falciparum infection in three
      endemic areas of Cameroon.
AB  - Blood samples were collected from 285 individuals attending hospitals in 1 of 3
      different regions of Cameroon. Of these, 89 had Plasmodium falciparum
      parasitemia. Prevalence in the Douala region was drastically reduced above the
      age of 19. In the Njinikom and Bamenda regions, on the other hand, an appreciable
      decline in prevalence was not observed until over the age of 49. Enzyme-linked
      immunosorbent assay (ELISA) values indicate that in Douala, high antibody titers
      to P. falciparum were present in all age groups tested. In Njinikom and Bamenda,
      an age dependence was seen in the response, with sera from individuals above 20
      having significantly higher ELISA values compared with those below age 20.
      Generally, individuals with high antibody titers had low or no parasitemia.
      Results suggest that future malaria control and treatment measures might target
      high risk populations such as those defined in this study.

PMID- 7799162
TI  - Annual cycle of Henneguya doori (Myxosporea) parasitizing yellow perch (Perca
      flavescens).
AB  - Henneguya doori Guilford, 1963 (Myxosporea) has an annual development cycle on
      the gills of adult Perca flavescens. The cycle involves a period of summer
      invasion, fall development of plasmodia and initiation of sporogenesis, winter
      completion of sporogenesis, and spring release of spores. An experiment revealed
      that rising water temperature in spring promotes cyst rupture and loss. The
      development of cysts is synchronized within individual fish and among members of
      the host population. As such, the parasite spends 8-9 mo in perch tissues to
      produce a single annual generation that culminates in a 4-6 wk period of spore
      dispersal. The parasite does not appear to be pathogenic. The observed cycle of
      H. doori repeated itself over 4 yr of sampling in Vinegar Lake, Nova Scotia.

PMID- 7799163
TI  - Endoreplication in the ovary, testis, and intestine of Strongyloides stercoralis.
AB  - During development of the free-living adults of the human parasitic nematode
      Stronglyoides stercoralis, cells in certain tissues grow by endoreplication in
      which rounds of DNA replication occur without cell or nuclear division. The DNA
      content of individual nuclei was measured by microdensitometry of Feulgen-stained
      preparations. In females, some ovarian cells have up to 800 times the haploid DNA
      content (800C). In males, some cells of the testis have up to 100C. Intestinal
      cells in both sexes have up to 16C, whereas most other somatic cells have 2C.

PMID- 7799164
TI  - Experimental immunization of ponies with Strongylus vulgaris radiation-attenuated
      larvae or crude soluble somatic extracts from larval or adult stages.
AB  - Protection from Strongylus vulgaris infection through immunization with radiation
      attenuated third-stage larvae (L3) or crude soluble homogenates from larval or
      adult stages was examined. Yearling ponies raised parasite-free were divided into
      3 immunization groups: radiation-attenuated L3; soluble adult somatic extracts;
      larval somatic extracts with excretory/secretory products (E/S) from in vitro
      culture; and 1 medium control group. Ponies were immunized twice; attenuated
      larvae were administered orally and somatic extracts or controls injected
      intramuscularly with adjuvant. Approximately 6 wk following the second
      immunization, all ponies were challenged. Necrospy examinations were performed 6
      wk following challenge. Irradiated larvae recipients had the fewest postchallenge
      clinical signs and lesions and were 91% protected from infection determined by
      larval recoveries from arterial dissections. Soluble antigen recipients and
      controls had similar larval recoveries and thus equal susceptibility to
      challenge. Soluble antigen recipients had more severe clinical signs and lesions
      than controls, suggesting that parenteral immunization exacerbated postchallenge
      inflammatory responses. Protection by immunization with irradiated larvae was
      associated with an anamnestic eosinophilia and postimmunization antibody
      recognition of S. vulgaris L3 surface antigens. Histologic staining of
      eosinophils within tissues of this group suggested that this immunization induced
      a cytophilic antibody response that facilitated degranulation.

PMID- 7799165
TI  - Mechanism of lysis of Trypanosoma brucei gambiense by human serum.
AB  - Resistance to lysis by human serum (HS) is an important parameter used to
      distinguish Trypanosoma brucei brucei from both Trypanosoma brucei rhodesiense
      and Trypanosoma brucei gambiense. Neither the exact nature of the trypanolytic
      factor (TLF) nor the mechanism of action by which HS lyses susceptible
      trypanosomes is well understood. This report tries to elucidate the role played
      by the variable surface glycoprotein (VSG) coat and trypanosome surface-related
      processes in the mechanism of HS lysis of HS-sensitive (HSS) and HS-resistant
      (HSR) trypanosomes. Procyclic forms of T. brucei gambiense transformed from
      either HSS or HSR bloodstream stages were found to be HSR. These procyclic forms
      were shown to have lost their VSG coat. However, the addition of excess soluble
      VSG from HSS trypanosomes did not block lysis of HSS trypanosomes. Human serum
      lysis was significantly inhibited if the trypanosomes were incubated with
      membrane stabilizers, i.e., including cytochalasins (B, D, and E specifically),
      zinc acetate, vinblastine, and benzyl alcohol, or with the lysosomotropic agents
      ammonium chloride and chloroquine. The inhibition exerted by these compounds was
      always reversible. The results in this report, taken together, strengthen the
      hypothesis that the lytic factor interacts with and moves along the trypanosome
      surface to be internalized eventually.

PMID- 7799166
TI  - Immunization against Taenia crassiceps cysticercosis: identification of the most
      promising antigens in the induction of protective immunity.
AB  - Cross immunity between Taenia solium and Taenia crassiceps parasites points to T.
      crassiceps cysticercosis as a convenient model to test promising antigens aimed
      at the development of a vaccine against T. solium cysticercosis. Since total
      antigens from T. crassiceps metacestodes induce significant levels of protection
      in pigs against T. solium cysticercosis, we initiated this work to identify the
      most interesting antigens involved in protection. Twelve different antigen
      fractions isolated from T. crassiceps cysticerci were evaluated with respect to
      their capacity to induce resistance against a challenge with 10 T. crassiceps
      cysticerci in male BALB/cAnN mice. Mice were intraperitoneally immunized with 2
      doses of each antigen, 5 or 15 micrograms per mouse. The 12 antigen fractions
      were classified as protecting (200, 123, 74, 66, 56, 40-50, 27 and 8-14 kDa),
      facilitating (220-205 kDa), or irrelevant (150-160, 93, 108 kDa), according to
      their effect on the parasite load. The 3 most promising antigen fractions were
      reevaluated via subcutaneous immunization with Freund's complete adjuvant. A high
      level of protection was obtained when antigen fractions of 56, 66, and 74 kDa
      were used together. Interestingly, antigens with similar molecular weights were
      also detected in early steps of differentiation in T. solium cysticercosis. These
      observations may be helpful in the development of a synthetic or a recombinant
      vaccine against cysticercosis.

PMID- 7799167
TI  - On the occurrence and morphology of Gyrodactylus pterygialis from saithe
      Pollachius virens in a Norwegian fjord.
AB  - A total of 308 Pollachius virens from a fjord near Bergen, western Norway, were
      examined for Gyrodactylus pterygialis over a 14-mo period; G. pterygialis showed
      the highest prevalence and density in winter/spring (November, January, March,
      and April pooled) but was absent in some months (August, September, and
      November). The morphology of the opisthaptoral hard parts of G. pterygialis were
      studied throughout the survey, and their variation is discussed with respect to
      host species, host locality, and different temperatures. On the basis of the
      present and previous descriptions, it is suggested that G. pterygialis is a
      parasite infecting gadine fishes of the genera Pollachius and Gadus, and that
      records from Pacific Eleginus and White Sea herring are distinct from G.
      pterygialis sensu Bychowsky and Poljansky, 1953.

PMID- 7799168
TI  - Localization of phenol oxidase in female Trichuris suis.
AB  - A phenol oxidase (E.C. 1.10.3.1) preparation from adult female Trichuris suis was
      assayed by both polarographic and spectrophotometric techniques. The T. suis
      enzyme oxidized most diphenols including 4-methylcatechol (4MC) and
      dihydroxyphenylalanine but did not oxidize tyrosine. The pH and temperature
      optima were 6.8 and 36 C, respectively. The Km measured using 4MC as a substrate
      ranged from 0.12 to 0.4 mM. The highest phenol oxidase activity was isolated in
      fractions from the adult females that were enriched in eggs relative to the
      activity in somatic tissue from females and all male tissues that were assayed.
      Phenol oxidase activity was localized on sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis substrate gels into 2 bands with M(r)'s of 44,000 and 53,000.
      An antibody to the 44,000 band recognized 2 bands of 40,000 and 45,000 M(r) on
      western blot analysis of the enzyme preparation. Immunocytochemical localization
      of anti-phenol oxidase antibody in serial cross sections of adult female worms
      indicates that the enzyme is found exclusively in the anterior part of the
      parasite in the proximal part of the uterus that is posterior to the junction
      with the stichosome. Eggs located in more distal parts of the reproductive system
      did not react with the antibody. The results indicate that a phenol oxidase is
      located in the fertilized eggs of adult female T. suis. It is likely that phenol
      oxidase contributes significantly to the chemical hardening process in the eggs
      when they pass out into the external environment. Inhibition of phenol oxidase
      may reduce the survivability of the eggs and thus minimize contamination of
      livestock facilities.

PMID- 7799169
TI  - A review of Neoheterocotyle (Monogenea: Monocotylidae).
AB  - The monocotylid genus Neoheterocotyle Hargis, 1955 is reviewed and the type
      species N. inpristi Hargis, 1955 is redescribed and illustrated. Neoheterocotyle
      ruggierii Cheung and Nigrelli, 1983 is synonymized with N. inpristi. Horricauda
      Tripathi, 1959 is synonymized with Neoheterocotyle, and the species previously
      assigned to Horricauda are transferred to Neoheterocotyle as N. bychowskyi
      (Timofeeva, 1981) n. comb., N. forficata (Timofeeva, 1981) n. comb., N. nagibinae
      (Timofeeva, 1981) n. comb., N. rhinobatidis (Young, 1967) n. comb., N.
      rhynchobatis (Tripathi, 1959) n. comb., and N. trilobata (Timofeeva, 1981) n.
      comb. A key to the species of the genus is included. Although most workers
      attribute Monocotylinae to Gamble, 1896, the correct authority is Taschenberg,
      1879.

PMID- 7799170
TI  - Phylogenetic relationship of Sarcocystis neurona to other members of the family
      Sarcocystidae based on small subunit ribosomal RNA gene sequence.
AB  - Sarcocystis neurona is a coccidial parasite that causes a neurologic disease of
      horses in North and South America. The natural host species are not known and
      classification is based on ultrastructural analysis. The small subunit ribosomal
      RNA (SSURNA) gene of S. neurona was amplified using polymerase chain reaction
      techniques and sequenced by Sanger sequencing reactions. The sequence was
      compared with partial sequences of S. muris, S. gigantea, S. tenella, S. cruzi,
      S. arieticanis, S. capracanis, Toxoplasma gondii, Eimeria tenella, and
      Cryptosporidium parvum. Alignments of available sites for all 10 species and
      alignments of the entire SSURNA sequence of S. neurona, S. muris, S. cruzi, T.
      gondii, and C. parvum were performed. Alignments were analyzed using maximum
      parsimony and maximum likelihood methods to determine relative phylogeny of these
      organisms. These analyses confirmed placement of S. neurona in the genus
      Sarcocystis and suggested a close relationship to S. muris, S. gigantea, and T.
      gondii. Molecular phylogeny suggests that Sarcocystis spp., which utilize the dog
      (Canis familiaris) as the definitive host, evolved from a common ancestor,
      whereas those species (including T. gondii) that utilize the cat (Felis
      domesticus) as the definitive host evolved from another common ancestor. This
      suggests a possible definitive host for S. neurona.

PMID- 7799171
TI  - Phylogenetic systematic analysis of the Trichostrongylidae (Nematoda), with an
      initial assessment of coevolution and biogeography.
AB  - Phylogenetic analysis of the subfamilies of the Trichostrongylidae based on 22
      morphological transformation series produced a single cladogram with a
      consistency index (CI) = 74.2%. Monophyly for the family was supported by the
      structure of the female tail and copulatory bursa. Two major clades are
      recognized: the Cooperiinae clade with the basal Cooperiinae and
      Libyostrongylinae+Trichostrongylinae, and the Graphidiinae clade with the basal
      Graphidiinae and Ostertagiinae+Haemonchinae. Dendrograms presented by Durette
      Desset (1985) (CI = 56.1%) and Lichtenfels (1987), based on the key to the
      Trichostrongylidae by Gibbons and Khalil (1982) (CI = 59.0%), were found to be
      relatively inefficient in describing character evolution and in supporting
      putative relationships among the subfamilies. Based on the current analysis, the
      intestine appears to have constituted the ancestral habitat for the
      trichostrongylids with the stomach/abomasum having been independently colonized
      in each clade. Assessment of host associations suggests extensive colonization
      but also a high degree of coevolution with Bovidae and Cervidae for
      Ostertagiinae+Haemonchinae. Biogeography for this assemblage is complex, but this
      analysis is compatible with a Palearctic or Eurasian origin for Cooperiinae,
      Haemonchinae, and Ostertagiinae.

PMID- 7799172
TI  - A new species of Metabenedeniella (Monogenea: Capsalidae) from the dorsal fin of
      Diagramma pictum (Perciformes: Haemulidae) from the great barrier reef, Australia
      with a revision of the genus.
AB  - Metabenedeniella parva n. sp. is described from the marine teleost Diagramma
      pictum from Heron Island, Queensland, Australia. The type species of the genus,
      Metabenedeniella hoplognathi, is redescribed and the generic diagnosis emended.
      Metabenedeniella parva differs from M. hoplognathi in many respects: M. parva is
      smaller; in M. parva the accessory sclerites and anterior hamuli are of similar
      length, but the posterior hamuli are smaller, whereas in M. hoplognathi the
      accessory sclerites are longer than the anterior hamuli and the anterior and
      posterior hamuli are of similar length; in M. parva the anterior hamuli span the
      distance between accessory sclerites and posterior hamuli and the anterior hamuli
      overlap the posterior hamuli considerably, but in M. hoplognathi the anterior
      hamuli partially overlap the posterior hamuli and do not extend anteriorly to
      reach the accessory sclerites; a sclerite close to the common genital aperture in
      M. parva is absent from M. hoplognathi. The 2 species differ also in some of
      their soft body parts. Specimens reported previously from the gills of
      Plectorhynchus chaetodonoides off Okinawa, Japan as M. hoplognathi are considered
      to be M. parva. The discovery of M. parva from only the dorsal fin of D. pictum
      at Heron Island enhances the notion that some benedeniine monogeneans from the
      body surfaces of fish exhibit strong site specificity.

PMID- 7799173
TI  - Sex offending among juveniles: development and response.
AB  - This article provides the health care provider with information on normal and
      aberrant sexual activity in children. It examines the characteristics and risk
      factors associated with juvenile sex offending behaviors and summarizes treatment
      approaches taken with children who molest. The primary issues in determining when
      a child's sexual behavior is abusive include the absence of equality and consent
      and the presence of coercion. Other than the loss of a parental figure and the
      presence of emotional problems, few demographic or specific psychologic variables
      distinguish juvenile offenders for their nonoffending peers. Thus offenders
      typically come to the attention of health care providers indirectly through their
      victims.

PMID- 7799174
TI  - Communicating research findings to readers of clinical nursing journals: guidance
      for prospective authors.
AB  - The dissemination of research through publication in professional journals is
      important for the advancement of pediatric nursing practice. Without knowledge of
      current research, practitioners cannot take actions to apply research to improve
      the health of the children and families they serve. To ensure that practitioners
      can make the most appropriate use of quantitative research findings, research
      publications must adhere to specific scientific standards for the conduct and
      reporting of research. This article is intended to guide nurse researchers to
      adhere to these standards and effectively communicate their research findings to
      nurses in clinical practice.

PMID- 7799175
TI  - Office management of the young child with cerebral palsy and difficulty in
      growing.
AB  - All infants and young children need adequate caloric intake for optimal growth
      and development. This is true for children with cerebral palsy, who are at
      increased risk for nutritional problems. When appropriate weight gain is
      difficult to attain, professionals must carefully evaluate the child's diet,
      feeding skills, and neurodevelopmental function; assess parenting behaviors; and
      look for complications of the child's cerebral palsy that could further impede
      intake and retention of calories. A number of therapeutic recommendations can be
      given to families to improve potential weight gain. The opportunity to influence
      the overall growth of young children with cerebral palsy begins when early and
      timely interventions are provided to the family.

PMID- 7799176
TI  - The lasting impact of fetal alcohol syndrome and fetal alcohol effect on children
      and adolescents.
AB  - The estimate is that thousands of infants are born each year with fetal alcohol
      syndrome (FAS) or fetal alcohol effect (FAE). The nursing literature has
      frequently treated FAS/FAE as something that happens only to infants; the effects
      of FAS/FAE do not end during infancy but persist into childhood, adolescence, and
      throughout adulthood. It is possible that many children and adolescents who have
      FAS or FAE are frequently seen by health care professionals for various reasons,
      but the fact that they have FAS/FAE may not be recognized. As a result, these
      children and their caretakers may not receive the care and counseling they need.
      This article describes how FAS/FAE occurs; how it may be recognized; the
      potentially devastating effects it can have on children, adolescents, and their
      caretakers; and how FAS/FAE can be prevented.

PMID- 7799177
TI  - Educating youths and their parents about the prevention of firearm injury.

PMID- 7799178
TI  - Hemangiomas.

PMID- 7799179
TI  - "The pediatric nurse practitioner and the physician assistant: how are we
      different?".

PMID- 7799180
TI  - Kawasaki disease.

PMID- 7799181
TI  - A pediatric nurse practitioner call to arms: new solutions needed for nation's
      growing public health problem.

PMID- 7799182
TI  - Promoting helmet use in recreational sports.

PMID- 7799183
TI  - Establishing a PNP faculty practice clinic for Medicaid EPSDT screening.
AB  - Faculty practice added a new dimension to teaching clinical skills in a Pediatric
      Advanced Practice Nursing program. It offered the student immediate feedback
      concerning didactic knowledge and clinical skills and added consistency to
      learning obtained in the classroom setting. Inclusion of the Medicaid EPSDT
      program further enhanced student learning by offering a framework of
      comprehensive services that the student could offer to the patient in providing
      holistic well-child care. Research opportunities for faculty and students are
      also prevalent with the large quantity of data available from administration of
      the EPSDT program. In addition, many children from indigent settings who would
      not otherwise receive routine well-child care have been given the opportunity
      because of this program. The use of a faculty practice model that provides the
      Medicaid EPSDT screening seems to meet the well-child needs of faculty, students,
      and patients alike and provides an education/service model congruent with the
      preventative goals of health care reform today.

PMID- 7799184
TI  - President's message: national primary care workforce--issues and PNPs.

PMID- 7799186
TI  - President's message: collaboration--my view.

PMID- 7799185
TI  - Societal child neglect.

PMID- 7799187
TI  - Domestic violence: children are victims too!

PMID- 7799188
TI  - The adolescent athlete. Part II: Injury patterns and prevention.
AB  - Injuries are some of the most universal and blatant downfalls of participation in
      adolescent sports, and statistics clearly support the need for improved awareness
      of injury prevention. Teenagers at risk of athletic injury must be identified
      through increased nurse practitioner knowledge of common adolescent injury
      (traumatic and overuse), injuries most prevalent in specific sports, training
      principles, and sports psychology. The role of other support personnel is also
      investigated. This article is the second of a three-part series addressing the
      nurse practitioner's role in health maintenance of the adolescent athlete.

PMID- 7799189
TI  - Comprehensiveness of well child checkups for children receiving Medicaid: a pilot
      study.
AB  - Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) is a Medicaid
      program designed to provide comprehensive well child care for children from low
      income families. Each EPSDT checkup should include a physical examination;
      medical history; assessment of development, nutrition, and immunizations;
      assessment of hearing, vision, and dental status; and anticipatory guidance. This
      pilot study of the medical records of 76 children receiving EPSDT checkups in six
      rural counties in North Carolina provided a preliminary assessment of whether
      EPSDT checkups included the required components. The study showed that health
      care providers frequently did not provide adequate documentation of the care
      provided at the checkup, and it raised questions as to whether children received
      the required components of the EPSDT checkup.

PMID- 7799190
TI  - Means, motive, and opportunity: case study research as praxis.
AB  - Pediatric nurse practitioner survival strongly depends on the implementation of
      nursing research. As active clinicians, pediatric nurse practitioners are always
      seeking ways to enhance health promotion, which should include research and
      practice. Case study research as praxis provides a method that enhances both
      health promotion and scientific knowledge. This article provides an overview and
      an example of research as praxis to give pediatric nurse practitioners an
      exciting research methodology alternative.

PMID- 7799191
TI  - School reentry and the child with a chronic illness: the role of the pediatric
      nurse practitioner.
AB  - Being attentive to the educational needs of chronically ill children is a
      relatively recent development in American education. Advances in medical sciences
      that have improved survival rates for some conditions and increased public
      acceptance of people who are different or disabled and legislation that has
      established education as an entitlement for all children have allowed for the
      entrance of many chronically ill children into mainstream education. Successful
      school reentry is essential if the child is to develop normally, in terms of
      intellect, social skills, and peer relationships. Caregivers must not lose sight
      of the fact that school provides opportunities for social, emotional, and
      cognitive development. Thus the pediatric nurse practitioner can promote the
      benefits gained from schooling in numerous ways and provide the child, family,
      and school personnel with the support and information needed for a smooth
      transition back into the school system.

PMID- 7799192
TI  - Epstein-Barr virus infection in children: implications for the treatment of
      infectious mononucleosis.

PMID- 7799193
TI  - Strabismus.

PMID- 7799194
TI  - What's so important about blue hands?

PMID- 7799195
TI  - The "Back To Sleep" campaign.

PMID- 7799196
TI  - Support for new parents.

PMID- 7799197
TI  - The teen years--not so fun today.

PMID- 7799198
TI  - The adolescent athlete. Part III: The role of nutrition and hydration.
AB  - Physically active adolescents have energy requirements far beyond those who are
      sedentary. Unfortunately, interest in nutrition is rare unless connected to
      improved performance. The nurse practitioner has the opportunity to instill
      enthusiasm in the teenager about adequate nutrition and to educate athletes and
      families on the effects of diet on growth and sports performance. Alternative
      nutritional practices are investigated, as are potential dangerous starvation and
      dehydration risks. This article is the third of a three-part series addressing
      the nurse practitioner's role in health maintenance of the adolescent athlete.

PMID- 7799200
TI  - Sick child care: a developmental perspective.
AB  - Sick child care programs provide an alternative when mildly ill children are
      excluded from their regular child care program. Although infectious disease
      implications have been addressed, little attention has been directed to the
      potentially negative consequences of care by unfamiliar providers in unfamiliar
      settings. Appropriate options for care during illness must be based not only on
      the physical but the emotional and developmental needs of young children.

PMID- 7799199
TI  - Levonorgestrel implant use among adolescents.
AB  - The levonorgestrel implant (Norplant System; Wyeth-Ayerst Laboratories,
      Philadelphia, Pa.) is a highly effective and desirable form of contraception for
      the adolescent population today. Not originally marketed toward this group of
      young women, it has become a very popular form of birth control for this age
      group. Even though common side effects are frequently experienced with the use of
      the Norplant System, timely and reassuring counseling from nurse practitioners is
      very effective in allaying fears and dissatisfaction. At the Pediatric Clinic for
      Denton County, Texas, nearly one half of all teenagers enrolled in the Teen
      Pregnancy Program in 1992 chose the Norplant System as their method of birth
      control, with very successful results.

PMID- 7799201
TI  - Diagnosis and management of lead-poisoned children: the pediatric nurse
      practitioner in a specialty program.
AB  - Lead poisoning, the leading environmental illness in this country, is a challenge
      to our health care and social systems. Because they provide routine health care
      in a variety of settings, including care to children from poor inner city
      families, who are most at risk for plumbism, nurse practitioners should be
      knowledgeable about this illness and prepared to care for children who have it.
      This article describes the role of a pediatric nurse practitioner in a specialty
      program who cares for children with lead poisoning and informs the general
      practitioner about prevention, education, treatment, coordination of care, and
      long-term follow-up for these children and their families.

PMID- 7799202
TI  - Smokeless tobacco.

PMID- 7799203
TI  - The use of new antiepileptic medications in pediatric patients with epilepsy.

PMID- 7799204
TI  - Roseola (human herpesvirus 6).

PMID- 7799205
TI  - Respiratory syncytial virus infections.

PMID- 7799206
TI  - Lobbying the "other" branch of government.

PMID- 7799207
TI  - The handgun as a consumer product.

PMID- 7799208
TI  - The doll clinic: a preschooler's guide to less fearful health care.

PMID- 7799209
TI  - Collagenase activity and tissue inhibitor of metalloproteinases-1 (TIMP-1)
      content in human whole saliva from clinically healthy and periodontally diseased
      subjects.
AB  - Total TIMP-1 concentration in whole saliva of periodontally diseased subjects,
      137 +/- 67 ng/ml (mean +/- SD), was clearly lower (p < 0.001) than that of
      clinically healthy subjects, 273 +/- 145, and that of edentulous subjects, 332 +/
      121. On the contrary, both active [1.58 +/- 0.35 units/ml (mean +/- SD)] and
      total (2.08 +/- 0.25) collagenase activities in TIMP-1-free whole saliva of
      diseased subjects were significantly higher than the activities (0.14 +/- 0.14
      and 0.50 +/- 0.27, respectively) in TIMP-1-free whole saliva of healthy subjects.
      Most of the total collagenase in whole saliva of healthy subjects consisted of
      procollagenase, while mainly active collagenase was present in whole saliva from
      patients with periodontal diseases. Significant reciprocal changes of TIMP-1 and
      collagenase levels, that is, increase in TIMP-1 concentration and decrease in
      collagenase activity, were observed after the initial therapy of periodontitis
      patients.

PMID- 7799210
TI  - Effects of cytokines on gingival fibroblasts in vitro are modulated by the
      extracellular matrix.
AB  - Fibroblast function in gingival tissue is thought to be regulated by the local
      cellular environment--both the extracellular matrix and soluble factors. In an
      attempt to artificially re-create this situation fibroblasts have been cultured
      within 3-dimensional collagen gels in an environment more physiologically
      comparable to connective tissue. Using such a model we investigated the effects
      of the extracellular matrix on gingival fibroblast growth and synthetic activity
      and on the cellular responsiveness to 4 soluble factors--epidermal growth factor
      (EGF), platelet-derived growth factor (PDGF), transforming growth factor-beta
      (TGF-beta 1) and interleukin-1 beta (IL-1 beta). Fibroblasts cultured within
      collagen gels showed similar growth rates, an increased production of collagen
      but reduced levels of hyaluronan synthesis in comparison to cells in monolayer
      culture. Cellular responsiveness to soluble mediators was also modulated by the
      collagen matrix, with a generalised reduction in response by cells embedded
      within the matrix. The stimulatory effects of EGF and PDGF on cell growth in
      monolayer over a 14-day period were only found during the initial stages of
      culture within gels. Similarly the stimulation of matrix production by cells
      induced by TGF-beta 1 on plastic was reduced or even negated when cells were
      cultured in collagen gels. On plastic IL-1 beta significantly stimulated cell
      growth but had no effect on either collagen or hyaluronan production by
      fibroblasts. In gel cultures, this cytokine had no effect on cell proliferation,
      but significantly inhibited both collagen and hyaluronan synthesis.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7799212
TI  - Periodontal treatment needs in 12 and 15 to 19-year-old school children in the
      Caribbean Island of Antigua, 1990.
AB  - A national survey was undertaken in 1990 to investigate the periodontal treatment
      needs in 12 and 15 to 19-year-olds residing in urban and rural areas of Antigua.
      Using the CPITN procedure, examination of 246 12 year-old children and 456
      adolescents (15-19 years) revealed that the CPITN scores of healthy, gingival
      bleeding, calculus, 4 or 5 mm and > or = 6 mm periodontal pockets were
      distributed similarly in urban and rural areas. Calculus was the most commonly
      recorded score, with a prevalence of 46% in 12-year-olds and 56% in 15-19 year
      olds. 4 or 5 mm pockets were found in 14% of adolescents, affecting on average
      less than one sextant per subject, but deep pockets were uncommon, 26% of 12-year
      olds and 14% of adolescents had periodontally healthy mouths. Scaling and oral
      hygiene instruction were the predominant treatment needs in both age groups, but
      the requirement for complex periodontal care in adolescents was low -3% only.

PMID- 7799211
TI  - Cytotoxicity in bacterial cultures: interaction and cell-specificity, possible
      factors in periodontal disease.
AB  - Cytotoxicity in culture media of various growing bacterial strains was estimated
      by Cr-51 release of labelled target-cells. Interaction studies were made by
      adding each of the different UV-killed bacteria to the medium with viable
      bacteria. The reference oral bacterial strains were: Actinobacillus
      actinomycetemcomitans Y4, Porphyromonas gingivalis, Fusobacterium nucleatum and
      Streptococcus mitis, which were compared with the reference bacteria
      Staphylococcus aureus 209 and Staphylococcus epidermidis. The target cells were:
      gingival fibroblasts (GF), periodontal membrane fibroblasts (PMF), pulpal
      fibroblasts (PF), HeLa-cells (HeLa), and lymphoid neoplasm cells (LN).
      Synergistic, as well as antagonistic, effects on target cells were observed. The
      cytotoxicity of A. actinomycetemcomitans in presence of P. gingivalis is
      neutralized while in presence of S. aureus it was increased. Bacterial
      interactions with F. nucleatum and P. gingivalis cytotoxicity were observed. The
      cytotoxicity of F. nucleatum was increased when cultured together with A.
      actinomycetemcomitans. Each cell type reacted differently to the toxicity of the
      supernatant of growth medium in which the same bacterial strain had been
      cultivated, which indicates cell specificity of the toxins.

PMID- 7799213
TI  - Cyclic-tension force stimulates interleukin-1 beta production by human
      periodontal ligament cells.

PMID- 7799215
TI  - Cumulative nature of periodontal attachment loss.

PMID- 7799214
TI  - Diacylglycerol in peripheral blood neutrophils from patients with localized
      juvenile periodontitis.
AB  - Neutrophils from patients with localized juvenile periodontitis (LJP) show
      several functional abnormalities. Recently, it has become increasingly apparent
      that the reason for these changes lies in part at the post receptor level of
      cellular metabolism. In this study we have analyzed intracellular diacylglycerol
      (DAG), a second messenger and an endogenous activator of protein kinase C, in
      unstimulated and agonist-stimulated neutrophils, from five LJP patients showing a
      chemotaxis defect and matched normal individuals. No difference was observed in
      the basal cellular DAG between the two groups. In neutrophils from LJP patients
      the DAG levels increased by 67% and 111% from the basal level following
      stimulation with N-formyl-methionyl-leucyl-phenylalanine (FMLP) and unopsonized
      zymosan particles, respectively, while in control cells the mean increases were
      36% and 65%, respectively. Incubation with serum-opsonized zymosan particles
      produced an identical rise in DAG in both groups. These data indicate that the
      stimulation of receptors for FMLP and unopsonized zymosan may produce an enhanced
      accumulation of DAG in neutrophils from LJP patients. In addition to DAG mass
      analysis, we determined the effect of R59022, a DAG-kinase inhibitor, on zymosan
      stimulated luminol-amplified chemiluminescence (CL) of neutrophils. In control
      cells R59022 significantly enhanced unopsonized zymosan induced CL, but it had no
      effect on cells from LJP patients, suggesting a possible change in the regulation
      of DAG-kinase in LJP.

PMID- 7799216
TI  - Occurrence and identity of proteolytic bacteria in adult periodontitis.

PMID- 7799217
TI  - TNF alpha and IL-1 beta in serum of LJP patients with normal and defective
      neutrophil chemotaxis.

PMID- 7799218
TI  - Porphyromonas gingivalis may multiply and advance within stratified human
      junctional epithelium in vitro.

PMID- 7799219
TI  - Differential beta-adrenergic regulation and phenotypic modulation of voltage
      gated calcium currents in rat aortic myocytes.
AB  - 1. We studied the beta-adrenergic regulation of voltage-gated Ca2+ channel
      currents using the whole-cell patch-clamp technique (18-22 degrees C) in freshly
      isolated and in cultured (1-20 days) rat aortic vascular smooth muscle cells
      (VSMCs). These currents include a transient low-voltage-activated (LVA) current
      and two L-type-related high-voltage-activated currents (HVA1 and HVA2,
      respectively). 2. At 10 microM, the beta-adrenergic agonist, isoprenaline,
      increased the HVA2 current (65 +/- 30%, n = 10) but had no effect on LVA and HVA1
      currents. This potentiation was dose dependent in the range 0.01-10 microM,
      developed with a slow time course and was mimicked by elevating intracellular
      cyclic AMP using the permeant analogue dibutyryl cyclic AMP (100 microM). 3. In
      the well-differentiated freshly isolated myocytes, only the HVA1 current was
      recorded. In cultured cells, a predominant frequency of occurrence of LVA and
      HVA1 currents was observed in modulated and differentiated myocytes,
      respectively. The occurrence of the HVA2 current was stable during culture but
      this current disappeared when the cells were confluent. It was retrieved when the
      confluent cells were dispersed and subcultured. 4. In conclusion, we present
      evidence for a differential beta-adrenergic regulation of three types of Ca2+
      channel current in adult rat aortic VSMCs. The differential expression of these
      currents, associated with marked changes in cell phenotypes in vitro, suggests
      that they serve distinct physiological functions.

PMID- 7799220
TI  - Na(+)-activated K+ channels localized in the nodal region of myelinated axons of
      Xenopus.
AB  - 1. A potassium channel activated by internal Na+ ions (K+Na channel) was
      identified in peripheral myelinated axons of Xenopus laevis using the cell
      attached and excised configurations of the patch clamp technique. 2. The single
      channel conductance for the main open state was 88 pS with [K+]o = 105 mM and pS
      with [K+]o = 2.5 mM ([K+]i = 105 mM). The channel was selectively permeable to K+
      over Na+ ions. A characteristic feature of the K+Na channel was the frequent
      occurrence of subconductance states. 3. The open probability of the channel was
      strongly dependent on the concentration of Na+ ions at the inner side of the
      membrane. The half-maximal activating Na+ concentration and the Hill coefficient
      were 33 mM and 2.9, respectively. The open probability of the channel showed only
      weak potential dependence. 4. The K+Na channel was relatively insensitive to
      external tetraethylammonium (TEA+) in comparison with voltage-dependent axonal K+
      channels; the half-maximal inhibitory concentration (IC50) was 21.3 mM (at -90
      mV). In contrast, the channel was blocked by low concentrations of external Ba2+
      and Cs+ ions, with IC50 values of 0.7 and 1.1 mM, respectively (at -90 mV). The
      block by Ba2+ and Cs+ was more pronounced at negative than at positive membrane
      potentials. 5. A comparison of the number of K+Na channels in nodal and paranodal
      patches from the same axon revealed that the channel density was about 10-fold
      higher at the node of Ranvier than at the paranode. Moreover, a correlation
      between the number of K+Na channels and voltage-dependent Na+ channels in the
      same patches was found, suggesting co-localization of both channel types. 6. As
      weakly potential-dependent ('leakage') channels, axonal K+Na channels may be
      involved in setting the resting potential of vertebrate axons. Simulations of Na+
      ion diffusion suggest two possible mechanisms of activation of K+Na channels: the
      local increase of Na+ concentration in a cluster of Na+ channels during a single
      action potential or the accumulation in the intracellular axonal compartment
      during a train of action potentials.

PMID- 7799221
TI  - GABA receptor mediation of median preoptic nucleus-evoked inhibition of
      supraoptic neurosecretory neurones in rat.
AB  - 1. This study evaluated the influence of focal electrical and chemical
      microstimulation in the median preoptic nucleus (MnPO) on the excitability of
      putative vasopressin and oxytocin neurones recorded in the supraoptic nucleus of
      urethane- or pentobarbitone-anaesthetized rats. 2. In vasopressin neurones,
      single 1 Hz stimulation reduced the excitability of 120/139 cells. Trains of
      repetitive 5-30 Hz stimulation, or microinfusion of glutamate into the MnPO,
      similarly induced a cessation in spontaneous phasic or continuous firing in 17/18
      and 17/20 vasopressin neurones, respectively. In 20/21 cells, locally applied
      bicuculline (100 microM) attenuated MnPO-evoked depressant responses whereas
      strychnine (100 microM) and timolol (20 microM) were without effect on 5/5
      vasopressin neurones. In three cells, bicuculline applications were associated
      with marked increases in MnPO-evoked excitations. 3. In oxytocin neurones, single
      pulse (1 Hz) electrical stimulation in MnPO evoked an increase in the
      excitability in 51/59 cells. However, in 6/7 oxytocin cells tested, glutamate
      microinfusions into MnPO induced prolonged suppression in firing. During trains
      of stimuli (5-30 Hz), 26/44 cells displayed an initial increase in firing
      associated with the first few impulses but this was then replaced by suppression
      of activity; another ten cells displayed excitation alone, and eight cells
      demonstrated only suppression. The depressant responses evoked during trains of
      MnPO stimulation were blocked by 100 microM bicuculline (6/6 cells tested)
      whereas strychnine was ineffective (2/2 cells tested). 4. These results suggest
      that the MnPO provides a mainly depressant influence on supraoptic vasopressin
      and oxytocin neurones, perhaps through the activation of postsynaptic GABAA
      receptors.

PMID- 7799223
TI  - Spatial integration of local transmitter responses in motoneurones of the turtle
      spinal cord in vitro.
AB  - 1. Integration of responses to local activation of transmitter receptors in the
      dendrites of motoneurones was investigated in a slice preparation of the turtle
      spinal cord. Membrane-active substances were applied from up to three independent
      iontophoresis electrodes during intracellular recording from the cell body. 2.
      Responses to glutamate could be evoked from dendrites closer than 20 microns from
      the tip of the glutamate electrode. The effects of other substances were more
      widespread. 3. In normal medium the configuration of a glutamate response was
      affected by time-dependent anomalous rectification. In the presence of muscarine
      the sum of glutamate responses from two different dendrites recruited a voltage
      sensitive plateau potential. 4. The response to glutamate from one dendrite could
      be attenuated by local application of gamma-aminobutyric acid (GABA) without
      effects on soma conductance or glutamate responses from other dendrites. 5. The
      response to glutamate from one dendrite could be selectively enhanced by local
      application of tetraethylammonium (TEA) or N-methyl-D-aspartate (NMDA) without
      effects on soma conductance or glutamate responses from other dendrites. 6. NMDA
      could convert a tonic glutamate response from one dendrite into a phasic response
      without affecting the configuration of glutamate responses from other dendrites.
      7. The effects of TEA and NMDA were facilitated by depolarization and reduced by
      hyperpolarization. 8. We conclude that the cable structure of motoneurones and
      the distribution of synapses and voltage-sensitive ion channels provide relative
      autonomy to non-linear synaptic processing and modulation in confined dendritic
      regions.

PMID- 7799222
TI  - Lemniscal and non-lemniscal synaptic transmission in rat auditory thalamus.
AB  - 1. The central auditory pathway linking the inferior colliculus (IC) and the
      medial geniculate body (MGB) of the thalamus consists of a segregated ventral
      lemniscal and dorsal non-lemniscal projection whose synaptic transmission
      mechanisms remain unknown. Extracellular and intracellular recordings combined
      with axonal tract tracing and cell staining were made from lemniscal and non
      lemniscal divisions of adult rat MGB maintained acutely in in vitro explants
      containing parallel tectothalamic projections. 2. Biocytin deposition within the
      brachium of the IC revealed dense axonal fibres projecting to the MGB. Thin
      axonal terminals were found throughout the ventral (MGv) and dorsal (MGd)
      divisions of the MGB. Bushy cells with tufted or bitufted dendritic branches were
      primarily found in the MGv. In the MGd, cells were mainly seen as stellate
      neurones having a radiate dendritic arbor. 3. Electrical stimulation of the
      brachium of IC invariably elicits fast, excitatory synaptic potentials in both
      MGv and MGd cells. The evoked responses occurred monosynaptically and were
      exclusively mediated by glutamate acting on both N-methyl-D-aspartate (NMDA) and
      non-NMDA receptors. Non-lemniscal MGd neurones recorded extracellularly exhibited
      a strong tendency to discharge in bursts in response to brachium stimulation. In
      contrast, a large proportion of ventral lemniscal cells tended to discharge in
      single or dual spikes. Intracellularly, MGd cells, but not MGv cells, showed a
      predominant, slow synaptic potential mediated by NMDA receptors. 4. It is
      concluded that the central auditory circuitry linking the tectum and the thalamus
      is connected monosynaptically via glutamatergic synapses. Lemniscal and non
      lemniscal thalamic neurones possess distinct response properties which cannot be
      accounted for by a differential transmitter system or polysynaptic delays as
      postulated previously.

PMID- 7799224
TI  - Selective phototoxic destruction of rat Merkel cells abolishes responses of
      slowly adapting type I mechanoreceptor units.
AB  - 1. The fluorescent dye quinacrine which accumulates in Merkel cells in touch
      domes was administered to rats and the effects of excitation light irradiation on
      the mechanical responses of slowly adapting (SA) type I units innervating the
      touch domes were investigated. 2. Histological examination showed that after 10
      min of irradiation degeneration was specifically localized to Merkel cells loaded
      with quinacrine. Nerve terminals associated with Merkel cells remained intact,
      even after treatment. 3. In SA type I units, responses to standard stimulation (a
      100 ms ramp followed by a 2.9 s plateau of 400 microns constant displacement)
      decreased significantly after irradiation of the domes with quinacrine-excitation
      light through a 'B' filter ('B' light). With 5 min irradiation, the response
      decreased to 52 +/- 7% (n = 10, mean +/- S.E.M.) of the pretreated value, to 17
      +/- 4% with a 10 min treatment and practically disappeared within 20 min. 4. In
      SA type I units with non-loaded Merkel cells, the response increased to 119 +/-
      8% (n = 13) with 5 min irradiation and was 99 +/- 9% with the 10 min treatment.
      At around 15 min after the onset of irradiation there was a gradual decrease and
      within 60 min the response disappeared. 5. When responses were divided into
      phasic (0-120 ms after the onset of stimulation) and tonic (120-3000 ms)
      components, 'tonic' responses were more affected than 'phasic' ones in quinacrine
      loaded SA type I units. 6. Stimulus-response curves shifted to the right and
      downwards in SA type I units with quinacrine-loaded Merkel cells after
      irradiation, but no significant change was seen in SA type I units without
      quinacrine. 7. Our observations are consistent with the hypothesis that Merkel
      cells are responsible for mechanoelectric transduction in SA type I units.

PMID- 7799225
TI  - Blood-borne interleukin-1 alpha is transported across the endothelial blood
      spinal cord barrier of mice.
AB  - 1. Previous work has shown that one mechanism by which blood-borne interleukin-1
      alpha (IL-1) may be able to affect the central nervous system (CNS) is by direct
      transport into the brain across the blood-brain barrier (BBB). The BBB of the
      brain consists of endothelial (between blood and interstitial fluid) and
      ependymal (between blood and cerebrospinal fluid) barriers. Which of these
      barriers IL-1 can cross has not previously been investigated. At the spinal cord,
      which could be the site of action for some of the effects of IL-1 such as
      analgesia, the BBB consists only of the endothelial barrier. 2. We show here that
      IL-1 labelled with 125I (I-IL) is transported across the BBB of the spinal cord
      by a saturable system similar to the one previously described for the brain. High
      performance liquid chromatography (HPLC) showed that most of the material
      entering the spinal cord represented intact I-IL. The BBB of the spinal cord was
      no more leaky to radioactively labelled albumin than the BBB of the brain and was
      not disrupted by 50 micrograms kg-1 of IL-1. 3. Capillary depletion showed that
      most of the I-IL entered the parenchymal-interstitial fluid space of the spinal
      cord with only a modest amount being sequestered by the endothelial cells of its
      BBB. 4. I-IL entered the cervical, thoracic and lumbar regions of the spinal cord
      equally well. I-IL entering at the brain and diffusing caudally was estimated
      only to account for about 1% of the total radioactivity found in the spinal cord
      after i.v. injection.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799227
TI  - Effect of arterial-portal glucose gradients and phloridzin on bile glucose levels
      in perfused rat liver.
AB  - 1. Bivascular perfused rat liver was used to study the effects of hepatic artery
      portal vein glucose gradients and the effects of phloridzin on bile glucose
      levels. 2. Bile glucose levels were examined when glucose concentrations in the
      hepatic artery (HA) and portal vein (PV) inflows were equal. When the
      concentration of perfusate glucose was 10 mM, bile glucose remained stable at
      less than 0.075 mM; when perfusate glucose exceeded approximately 16.0 mM, bile
      glucose increased rapidly; when 1.6 microM phloridzin and 10.0 mM glucose were co
      infused, phloridzin entered rapidly into bile and settled at a steady-state
      concentration of 0.45 +/- 0.04 mM, and bile glucose increased to 3.75 +/- 0.14
      mM. 3. During perfusion of HA-PV glucose gradients such that HA glucose was
      higher than that in the sinusoids, bile glucose levels were increased compared
      with their levels when HA glucose was equivalent to that in the sinusoids. The
      converse was also demonstrated. 4. The results regarding phloridzin-sensitive
      glucose transport in the biliary tree of the rat were consistent with those
      documented in vivo. The finding that bile glucose levels altered in a manner
      parallel to that of the HA, although the total inflow remained unchanged,
      strongly indicated that HA glucose level, rather than that of the PV, performs an
      important role in control of bile glucose levels.

PMID- 7799226
TI  - Electrophysiological properties of neonatal mouse cardiac myocytes in primary
      culture.
AB  - 1. The increasing utility of transgenic mice in molecular studies of the
      cardiovascular system has motivated us to characterize the ionic currents in
      neonatal mouse ventricular myocytes. 2. Cell capacitance measurements (30 +/- 1
      pF, n = 73) confirmed visual impressions that neonatal mouse ventricular myocytes
      in primary culture are considerably smaller than freshly isolated adult
      ventricular myocytes. With the use of electron microscopy, mitochondria and
      sarcoplasmic reticulum were found in close association with myofibrils, but
      transverse tubules were not observed. 3. Action potential durations, measured at
      50 and 90% repolarization, were 23 +/- 1 and 42 +/- 2 ms respectively (n = 46).
      Application of 4-aminopyridine (4-AP; 5 mM) prolonged action potential duration
      at 50% repolarization by 26 +/- 5% (n = 3). The brevity of the action potential
      is explained by the rapid activation of a transient outward K+ current upon
      voltage-clamp depolarization to plateau potentials. 4. Potassium currents
      identified include an inward rectifier, a large 4-AP-sensitive transient outward,
      a slowly inactivating 4-AP-insensitive outward, a slowly activating delayed
      rectifier and a small rapidly activating E-4031 (10 microM)-sensitive delayed
      rectifier K+ current. 5. Sodium currents (-305 +/- 50 pA pF-1, n = 21) were
      recorded in 40 mM Na+ with Ni2+ (1 mM) to block Ca2+ currents and with K+
      replaced by Cs+. The relative insensitivity of the Na+ current to block by
      tetrodotoxin (IC50 = 2.2 +/- 0.3 microM, n = 4) is distinctive of the cardiac Na+
      channel isoform. 6. Nitrendipine-insensitive (10 microM) Ba2+ currents elicited
      during steps from -90 to -30 mV measured -25 +/- 5 pA pF-1 (n = 7, 30 mM Ba2+).
      Decay of these currents was complete during 180 ms depolarizations, even with
      Ba2+ as the charge carrier. These currents were not present when the holding
      potential was set at -50 mV. These data support the presence of a low threshold,
      T-type Ca2+ current. 7. The maximal nitrendipine-sensitive L-type Ca2+ current
      density was -10 +/- 2 pA pF-1 (n = 8) in 2 mM Ca2+ and -38 +/- 5 pA pF-1 (n = 9)
      in 30 mM Ba2+. Exposure to isoprenaline (1 microM) resulted in an 82% increase (n
      = 3) in the amplitude of the Ba2+ currents elicited at 0 mV. 8. Neonatal mouse
      cardiac myocytes in primary culture possess surprisingly large inward currents
      given the brevity of their action potentials.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799228
TI  - Membrane potential dependence of the kinetics of cationic amino acid transport
      systems in human placenta.
AB  - 1. Mediated influx of L-lysine into human placental brush-border membrane
      vesicles occurs through two systems, one of lower affinity but high capacity, the
      other of very high affinity but low capacity. These transporters have features
      characteristic of systems y+ (the classical system) and y+L (recently described
      in the erythrocyte), respectively. 2. In solutions containing sodium the entry of
      lysine through the high-affinity system (y+L) is inhibited by the neutral amino
      acids L-leucine, L-methionine and L-glutamine with comparable high affinity. The
      removal of sodium reduces the affinity but not the maximal extent of this
      inhibition. Leucine and methionine, but apparently not glutamine, inhibit lysine
      entry through system y+ with a much lower affinity. 3. The influx of lysine
      through system y+ changes markedly in response to alterations of membrane
      potential. In the presence of an inwardly directed negative diffusion potential
      created by an inwardly directed thiocyanate (SCN-) gradient, the influx of lysine
      through this route is accelerated; with an inwardly directed positive potassium
      diffusion potential, lysine influx through this route is reduced. The influx of
      lysine through system y+L is much less sensitive to such alterations of
      potential. 4. Analysis of the kinetic constants characterizing system y+ shows
      that with a change of potential from zero to negative (approximately -60 mV) the
      maximum velocity (Vmax) is roughly doubled and the half-saturation constant (Km)
      halved leading to a 4-fold increase in permeability. For system y+L smaller
      changes are seen and Km does not change; the resulting increase in y+L
      permeability is 1.5-fold. 5. These findings are discussed with respect both to
      the mechanism of membrane transport and placental epithelial function.

PMID- 7799231
TI  - A comparison of noninvasive body temperature monitoring devices in the PACU.
AB  - Critical measurement of patient body temperature in the PACU is an important
      parameter in patient management. Failure to achieve minimal acceptable body
      temperature standards has been associated with physiological derangement, the
      application of additional therapy, and prolonged PACU stays. Newer methods to
      monitor temperature have been introduced into the PACU that have been touted to
      be adequate for detecting clinically significant changes in temperature. This
      study compares skin core temperature-corrected liquid crystal thermography,
      axillary electronic, and oral electronic thermistor readings with temperatures
      obtained by infrared tympanic membrane thermometry in 215 PACU patients.
      Regression analysis suggests that when compared with tympanic temperature, the
      oral method is more accurate and has greater precision than either the liquid
      crystal or axillary methods. That the incidence of hypothermia depends on the
      method chosen to assess body temperature is a significant nursing implication.

PMID- 7799230
TI  - Regulation of intracellular pH in smooth muscle cells of the guinea-pig femoral
      artery.
AB  - 1. Intracellular pH (pHi) of smooth muscle cells in isolated strips of guinea-pig
      femoral artery was measured using double-barrelled pH-sensitive microelectrodes.
      2. In modified Krebs solution equilibrated with 5% CO2, pHi was 7.26 +/- 0.14 (n
      = 36; mean +/- S.D. of an observation) and the membrane potential (Em) was -60.5
      +/- 5.5 mV. Removal of CO2 from the superfusing solution caused an immediate
      transient alkalosis before pHi stabilized at much the same value (7.28 +/- 0.14;
      n = 16) as in the presence of CO2. 3. The rate of recovery of pHi from
      experimentally induced acidosis was not measurably affected by the presence or
      nominal absence of CO2-HCO3-. 4. Application of amiloride (100 microM) blocked
      recovery from acidosis in the nominal absence of CO2-HCO3- and caused a
      progressive fall in pHi. In the presence of CO2-HCO3-, application of amiloride
      allowed a slow recovery to pHi 6.7-7.0, but completely prevented full recovery to
      the normal pHi. 5. Removal of extracellular Na+ (Na+o) caused a dramatic,
      progressive fall in pHi in both the presence and nominal absence of CO2-HCO3-. 6.
      The amiloride-insensitive extrusion of acid equivalents observed in the presence
      of CO2-HCO3- to pHi 6.7-7.0 was inhibited by removal of Na+o but was not affected
      by preequilibration with DIDS (see Methods). 7. It is concluded that Na(+)-H+
      exchange is largely responsible for the effective extrusion of acid equivalents
      in these arterial cells, at least from relatively small perturbations. A DIDS
      insensitive, Na(+)- and HCO3(-)-dependent mechanism provides some recovery from
      acidosis to a relatively low pHi. 8. Comparison with data obtained in exactly the
      same manner in smooth muscle cells of the guinea-pig ureter indicates that there
      are significant differences in the regulation of pHi in different smooth muscles.

PMID- 7799233
TI  - Increasing patient satisfaction: simple ways to increase the effectiveness of
      interpersonal communication in the OPS/PACU.
AB  - Because of changes in health care and reimbursement practices, nurses and staff
      are being required to do more with fewer measures while patients' needs increase.
      Nurses can make a difference in meeting those needs an in increasing patient
      satisfaction by using empathy, imagination, and the "human touch."

PMID- 7799232
TI  - Complications of autotransfusion with salvaged blood.
AB  - As a means of limiting homologous transfusions, many centers are using
      autotransfusion devices during the postoperative period. Although their use may
      limit the risks associated with homologous blood administration, various adverse
      effects have been reported including sepsis, disseminated intravascular
      coagulation, and renal insufficiency. The authors present the case of a 9-year
      old girl who developed acute cardiorespiratory dysfunction after reinfusion of
      salvaged blood. The use of autotransfusion devices and the probable mechanisms
      responsible for adverse effects are discussed.

PMID- 7799229
TI  - Regulation of intracellular pH in the smooth muscle of guinea-pig ureter: Na+
      dependence.
AB  - 1. Mechanisms involved in the regulation of intracellular pH (pHi) in smooth
      muscle cells of guinea-pig ureter have been investigated using double-barrelled
      pH-sensitive microelectrodes in isolated strips of tissue. 2. Removal of CO2-HCO3
      from the superfusing solution caused a fall in the steady-state pHi except in a
      few cells which had been excised from the animal for many hours (usually > 24 h).
      The pHi value was 7.22 +/- 0.09 (n = 89; mean +/- S.D. of an observation) in
      solution buffered with 5% CO2-21 mM HCO3-, compared with 6.92 +/- 0.24 (n = 67)
      in the nominal absence of CO2-HCO3-. Recovery from experimentally induced
      acidosis was faster in the presence, rather than nominal absence, of CO2-HCO3-
      (mean half-times of 2.7 +/- 0.7 min, n = 41, and 4.6 +/- 1.3 min, n = 12,
      respectively). These results suggest the presence of both HCO(3-)-dependent and 
      independent mechanisms for the effective extrusion of acid equivalents. 3.
      Recovery from acidosis was dependent on external Na+ (Na+o) in both the presence
      and nominal absence of CO2-HCO3-, with an apparent half-maximal activation at
      approximately 4 and 20 mM Na+o, respectively. Removal of Na+o in the steady state
      caused a fall in pHi which proceeded at a faster rate in the presence rather than
      in the nominal absence of CO2-HCO3-. 4. Amiloride (100 microM-1 mM) reversibly
      inhibited the recovery from acidosis and caused a fall in the steady-state pHi
      when applied in the nominal absence of CO2-HCO3-, but had no measurable effect on
      either the recovery from acidosis or steady-state pHi in the presence of CO2-HCO3
      . These results suggest that Na(+)-H+ exchange was responsible for extrusion of
      acid equivalents in the nominal absence of CO2 and HCO3-, but that it played
      little part under more physiological conditions. 5. Although Na(+)-H+ exchange
      appeared to be activated below a pHi of about 7.2, it was incapable of
      maintaining a 'normal' pHi in the nominal absence of CO2-HCO3- in freshly excised
      cells, where values between 6.06 and 6.89 were recorded. Only in aged
      preparations, in which the intrinsic intracellular acid loading was substantially
      reduced (as judged from the rate of acidification on application of amiloride in
      the nominal absence of CO2-HCO3-) did the steady-state value approximate to that
      observed in the presence of CO2-HCO3-, at about 7.2.

PMID- 7799235
TI  - Practical points in the use of ondansetron.
AB  - It is the purpose of this article to discuss ondansetron hydrochloride (Zofran
      Glaxo, Research Triangle Park, NJ) and its mechanisms of action, indications for
      use, dosage and administration, side effects, and nursing implications.

PMID- 7799234
TI  - Carbon dioxide toxicity related to a laparoscopic procedure.
AB  - Laparoscopy has become a routine part of many major and minor surgical
      procedures. During laparoscopic procedures, carbon dioxide (CO2) is insufflated
      into the peritoneal cavity to allow visualization of the abdominal viscera. Delay
      in the elimination of CO2 during the intraoperative and postoperative phases of a
      laparoscopic procedure has recently been identified. This case study discusses a
      patient with CO2 toxicity related to the insufflation of CO2 during a
      laparoscopic procedure. Nurses in the PACU must be alert to the signs of CO2
      toxicity after a laparoscopic procedure and be able to correctly interpret
      arterial blood gases.

PMID- 7799236
TI  - Research preceptors: assisting the postanesthesia nurse to advance from novice to
      expert researcher.
AB  - Benner proposed "novice to expert" to describe and explain the development of
      clinical skill acquisition in nursing students and practicing nurses. Frequently,
      nursing students' clinical skill acquisition is facilitated by a clinical
      instructor or preceptor; however, it is uncommon to facilitate research skills by
      this method. This article describes the novice-to-expert framework, its
      applications to practice competency development in students and nurses, and
      research skill expectations. Developing research skill in PACU nurses through the
      use of research preceptors is proposed.

PMID- 7799237
TI  - From juggling to balancing.
AB  - To survive a constantly changing environment, methods for problem solving and
      managing change must come from a new mind-set. Rather than looking at and fixing
      individual parts of a process, the focus must be one of looking at an entire
      process and determining how well the pieces of that process meet the anticipated
      outcomes. This involves a change from the deductive to the inductive, from
      juggling issues to balancing issues.

PMID- 7799239
TI  - Seven habits.

PMID- 7799238
TI  - Does your documentation defend or discredit?
AB  - Documenting medical records is often done hurriedly; it is a last responsibility
      before the patient is discharged, sometimes after the shift has actually ended.
      What seemed so clear at the time it was written may be barely legible,
      unbelievably incomplete, and perhaps legally indefensible later. The patient's
      chart is a permanent legal record that can powerfully defend or easily discredit
      the nurse when questions arise. A documentation review could be time well spent.

PMID- 7799240
TI  - Sleep disorders in anxiety and depression. Marrakech, Morocco, December 1993.
      Workshop proceedings.

PMID- 7799241
TI  - Sleep and psychiatric disorders.

PMID- 7799242
TI  - Sleep in panic disorders.
AB  - Panic disorder is a common anxiety disorder, which has relatively often its onset
      during adolescence. Besides panic attacks and avoidance behavior the patients
      often have sleep disturbances. They suffer from insomnia, nocturnal panic
      attacks, fear of going to bed or falling asleep and drug- or alcohol-related
      symptoms such as withdrawal phenomena.

PMID- 7799243
TI  - Anxiety or depression during withdrawal of hypnotic treatments.
AB  - The prescription of hypnotics, mostly benzodiazepines, continues at a high level,
      long-, medium- and short-acting compounds all being used. The indication for
      these hypnotics is the symptom of insomnia which is often secondary to a primary
      anxiety or depressive disorder. One problem with the use of hypnotics,
      particularly shorter-acting ones, is rebound insomnia in that discontinuation may
      be followed by sleep which is worse than pretreatment levels. Anxiety, which may
      well have been assuaged by the hypnotic treatment, may also rebound but
      depression, usually not really helped by the hypnotic, does not alter much. A
      second problem, on discontinuation of long-term treatment, particularly longer
      acting hypnotics, is a physical withdrawal syndrome characterized by general
      malaise, and perceptual symptoms as well as marked increases in anxiety and
      insomnia. In some patients, however, depressive symptoms predominate. These may
      be an exaggeration of an on-going depressive disorder or it may appear to arise
      de novo in patients hitherto free of such an illness. The depression can be quite
      severe and need rigorous treatment in its own right. It is always useful to
      enquire about hypnotic/anxiolytic withdrawal in patients presenting with a
      depressive disorder. Depression is also a prognostic indicator of poor outcome
      (failure to withdraw successfully) in patients taking benzodiazepine hypnotics
      chronically.

PMID- 7799244
TI  - Sleep patterns in depression and anxiety: theory and pharmacological effects.
AB  - Sleep is invariably disrupted in patients who have depression and in patients
      with anxiety disorders. Depression and anxiety frequently coexist and are
      associated with disturbances in various neurotransmitters. The authors explore
      the relationship between sleep and the two disorders as well as the effects of
      antidepressants and anxiolytics on sleep architecture. The effects on sleep of
      various neurotransmitter systems implicated in depression and anxiety are
      outlined. Lastly, various theoretical models are proposed to account for the
      above mentioned phenomena and further directions for research are suggested.

PMID- 7799245
TI  - Sleep disorders in the elderly: depression and post-traumatic stress disorder.
AB  - We report on two studies of sleep in the elderly. (1) One hundred and ninety
      eight Spanish outpatients aged over 65 who met ICD-10 criteria for either a
      depressive episode, a recurrent, or a persistent mood disorder were compared with
      a matched population of depressives aged under 55. Factorial analysis and
      multiple regression showed that sleep complaints in the older group correlated
      less with severity of depression and had a less stable response to
      pharmacological treatment. (2) Post-traumatic stress disorder (PTSD) symptoms and
      sleep complaints were studied in 817 World War II veterans from Alsace-Lorraine
      who had been forcibly drafted into the Wehrmacht and subsequently detained as
      prisoners of war in Russia. The diagnosis of PTSD was associated with more severe
      wartime stressors and long internment. Eighty percent of respondants still report
      recurrent distressing dreams of wartime or captivity events after over 45 years.
      We analyzed sleep complaints in two elderly populations. Part one describes a
      Spanish study which compared the nosological significance and treatment response
      of sleep complaints in depressives aged over 65 or under 55. In part two, we
      study sleep complaints in former Alsatian prisoners of war (POWs) and analyze the
      influence of previous stressors and the aging process.

PMID- 7799246
TI  - Cholinergic neurotransmission, REM sleep and depression.
AB  - It is known from animal experiments that the regulation of REM and Non-REM sleep
      is governed by cholinergic and serotonergic/adrenergic neurons in the brain stem.
      Cholinergic neurons in the gigantocellular field of the tegmentum seem to be
      responsible for the triggering and maintenance of REM sleep. These findings are
      of special interest for interpreting abnormalities of REM sleep in depression.
      Psychiatric sleep research in the last two decades has demonstrated that an early
      onset of REM sleep and heightened REM density frequently occurs in patients
      suffering from depression. Extrapolating from animal data on REM sleep
      regulation, the premature onset of REM sleep in depression may be interpreted as
      the consequence of a central nervous cholinergic overactivity or muscarinic
      supersensitivity. In our experimental work we have tested assumptions of the so
      called reciprocal interaction model of NonREM and REM sleep by
      cholinergic/anticholinergic stimulation strategies of sleep in healthy subjects.
      Furthermore, the impact of cholinergic stimulation on sleep in depression,
      healthy control subjects and other psychopathological conditions was
      investigated. These studies demonstrated that the most pronounced REM sleep
      response to cholinergic stimulation occurred in depression.

PMID- 7799247
TI  - Cost of anxiety disorders: impact of comorbidity.
AB  - The aim of this study was to assess the relative impact of co-mobidity and of
      symptom severity on the costs of caring for patients with generalized anxiety
      disorders (GAD). One thousand and forty-two patients with GAD according to DSM
      III-R were observed by psychiatrists using a cross-sectional methodology.
      Demographic, clinical, therapeutic as well as health care utilization data were
      collected at a single point in time. Patients were stratified according to
      prevalence of co-morbidity. An economic analysis was performed based on a
      societal perspective. Hospitalizations and losses of productivity were the two
      major components of costs both in patients with and without co-morbidity. On the
      other hand costs of pharmaceuticals remain a marginal component of costs
      associated with GAD in the two groups. Controlling for confounding variables, the
      prevalence of health care utilisation was found to be significantly higher in
      patients with co-morbidity for hospitalization, laboratory tests, medications and
      absenteeism from work. Most of cost components were found to be significantly
      higher in patients with co-morbidity. The relative risk of health care
      utilization was higher in patients with co-morbidity, past history of anxiety,
      high level of anxiety as well as in older patients. Overall our findings suggest
      that both co-morbidity and symptom severity play a role in cost generation in GAD
      patients.

PMID- 7799248
TI  - Insomnia and depression--sleep EEG changes.

PMID- 7799249
TI  - Insomnia in relation to depression and anxiety: epidemiologic considerations.
AB  - Epidemiologic studies show that psychopathology is a very powerful risk factor
      for the occurrence of insomnia. Depression and/or anxiety are quite prevalent
      among insomniacs, while insomnia is more than twice as prevalent in depressed
      than in non-depressed individuals. Moreover, recent data support a strong causal
      link of insomnia to both depression and anxiety. An exact cause-and-effect
      relationship between insomnia and psychopathology, however, has not as yet been
      definitively established. This is probably due to methodological differences
      across studies, related to design characteristics and the ways insomnia as well
      as various dimensions of psychopathology have been defined and detected. Thus,
      more refined psychometric techniques and multivariate methods of analysis should
      be utilized to elucidate the etiologic interface of insomnia and psychopathology.

PMID- 7799250
TI  - Hypersomnia associated with mood disorders: a new perspective.
AB  - Thirty-six subjects affected with hypersomnia associated with mood disorders, 31
      with a diagnosis of dysthymia, 4 with a diagnosis of bipolar disorder and one
      with a diagnosis of major recurrent depression underwent standardized
      polysomnographic procedures including night 1, MSLT and night 2 (uninterrupted).
      36.1% of these subjects had a reduced or intermediate mean sleep latency on the
      MSLT and 13.8% slept over 9 hr at night. In addition 17 of these subjects
      underwent prolonged polysomnography during day 2. In comparison with eight
      subjects affected with idiopathic hypersomnia, mean sleep latency on the MSLT was
      significantly longer and total sleep time during night 2 and during night 2 plus
      day 2 was significantly lower in subjects affected with hypersomnia associated
      with mood disorders. It is concluded that a positive diagnosis of hypersomnia
      associated with a mood disorder requires both behavioral observation and
      polysomnography. Among these subjects there may be subjects with well-documented
      hypersomnia and subjects with anergia facilitating or mimicking sleep.

PMID- 7799251
TI  - Is hypersomnolence a feature of seasonal affective disorder?
AB  - We examined hypersomnolence as experienced among individuals meeting standardized
      diagnostic criteria for Seasonal Affective Disorder (SAD). Data were available
      from 115 individuals attending a mood disorders clinic specializing in treatment
      of this disorder. Three modes of assessment were employed: retrospective self
      reports (Seasonal Patterns Assessment Questionnaire), cross-sectional interviews
      (Standardized Interview Guide for the Hamilton Depression Scale, SAD Version),
      and prospective sleep diaries. Results indicated that self-reported total hours
      of sleep varied significantly across the seasons, with longest sleep occurring in
      winter and shortest sleep in summer. Seasonal sleep changes, as indicated by the
      SPAQ did not correlate significantly, however, with severity of depressive
      symptoms as indicated by the Hamilton scale. Multiple regression analyses
      indicated that only social activity levels (one of seven SPAQ items) was
      significantly and uniquely related to the severity of depression. When data
      obtained by the three instruments were compared, self-reported hours of sleep
      (whether measured by SPAQ or Hamilton interview) were significantly higher than
      indicated by prospective sleep diaries. We conclude that hypersomnolence may not
      be a central feature of SAD and that the validity of the SPAQ as an index of this
      disorder requires further investigation.

PMID- 7799253
TI  - Sleep disturbances in depression and anxiety: issues in childhood and
      adolescence.

PMID- 7799254
TI  - Sleep disorders and anxiety: biochemical antecedents and pharmacological
      consequences.
AB  - Evidence is presented that the most widely used and effective drugs used in the
      treatment of anxiety and insomnia act by indirectly activating GABA-A receptors
      in limbic regions of the brain. Since the discovery of the benzodiazepines,
      different classes of benzodiazepine receptor ligands (such as the
      cyclopyrroliones and imidazopyridines) have been developed which alleviate
      anxiety and insomnia by activating different sites on the benzodiazepine-GABA
      receptor complex to those activated by the 'classical' benzodiazepines as
      exemplified by temazepam and diazepam. There is evidence that natural ligands
      also exist in the mammalian brain which can modulate the benzodiazepine-GABA
      receptor complex. This raises the possibility that insomnia and anxiety states
      may arise as a consequence of a deficit in the availability of endogenous ligands
      that act as agonists at these sites.

PMID- 7799255
TI  - Sleep disorders and stress.

PMID- 7799252
TI  - Sleep disorders in bipolar depression: hypnotics vs sedative antidepressants.
AB  - Ninety-six patients with bipolar disorder who attended a lithium clinic were
      reviewed in a retrospective study. Sleep disorders were studied in 85 depressive
      episodes. Eighty-one percent of the subjects presented with insomnia; the mixed
      type being the most frequent (49%) followed by early awakening (25%). The
      evolution of depression in the patients was compared according to the treatment
      received for insomnia: sedative antidepressants vs other anxiolytic or hypnotic
      drugs. Fifteen percent of patients shifted to mania, this group more frequently
      receiving sedative antidepressants (p < 0.05). Moreover, the patients who had
      received sedative antidepressants as therapy for insomnia (N = 61) showed a
      tendency to have a shorter asymptomatic interval before the following relapse (13
      months vs 19 months; p = 0.06). In view of these results, we consider that the
      use of sedative antidepressants as a treatment for insomnia during depressive
      episodes in bipolar patients could be a factor contributing to worse prognoses;
      in these cases it appears that the use of other hypnotic drugs would be more
      advisable.

PMID- 7799256
TI  - Sleep disorders and depression: the 'chicken and egg' situation.
AB  - The question of whether sleep disorders are part of the clinical picture of
      depression or of its aetiology remains unanswered. Still, clinical observation in
      general, polysomnographic studies and the observed antidepressant effect of sleep
      deprivation, clearly indicate the intimate relationship between sleep
      disturbances and depression.

PMID- 7799257
TI  - Insomnia in anxiety: sleep EEG changes.
AB  - Anxiety is often paired with sleep disturbances and both interact in a quite
      complex manner. Sleep (and vigilance) problems are often included in the
      descriptive definition or in the diagnostic criteria for anxiety disorders.
      Nevertheless, if anxiety may cause sleep disturbances, it is also known that
      sleep deprivation may produce symptoms which fall within the symptom complex of
      anxiety. In this paper, some of the methodological issues encountered when
      studying sleep and anxiety are discussed. Polygraphic recordings of sleep in
      anxious patients have consistently shown an increased sleep latency and, quite
      often, also exhibited a reduced sleep time, a reduced total sleep time, less slow
      wave sleep, a greater arousal index and an increased duration of wakefulness
      during sleep. From our own study, we also report anomalies of the first night
      cycle in anxious poor sleepers who are otherwise indistinguishable from normal
      controls (with regard to the 'classical' sleep parameters). We have also observed
      the large interindividual variability of numbers of sleep parameters in anxious
      people. The question of a potential heterogeneity of the studied groups with
      regard to their clinical presentation as well as their sleep profile has been
      raised through our research as well. It is apparent that strategies for exploring
      the source of the potential heterogeneity of anxiety disorders are still needed.

PMID- 7799258
TI  - Effective psychiatric nurses.

PMID- 7799259
TI  - Still a long way to go.

PMID- 7799260
TI  - Potential sequelae of family history of depression. Identifying family members at
      risk.
AB  - 1. There is increasing evidence that depressed clients with and without a family
      history of depression differ on several clinical features, such as learned
      resourcefulness, depressed cognitions, and coping capabilities. Subjects
      reporting a family history of depression do not differ from those with no
      familial depression in demographic characteristics, severity of depression, or
      adaptive functioning. 2. Depressed inpatients with a history of family
      depression, however, are significantly less resourceful and less optimistic than
      their counterparts with no family history of depression. 3. As resourcefulness
      and optimism are believed to be learned, nursing interventions for teaching
      specific skills would be particularly useful in preventing depression and
      promoting mental health for family members who are at risk for clinical
      depression.

PMID- 7799261
TI  - Anticholinergic syndrome. Avoiding misdiagnosis.
AB  - Anticholinergic syndrome can develop in multiple clinical situations. The
      disturbance of the central nervous system muscarinic transmission by
      acetylcholine antagonists or lack of acetylcholine can result in this
      unpredictable behavioral syndrome. Health care professionals should do the
      following: Be familiar with common drugs or drug combinations that may induce
      this condition; Be aware of patients who may be at greatest risk; Be able to
      identify the cluster of signs and symptoms of anticholinergic toxicity; and
      Implement appropriate nursing treatment interventions for patients with
      anticholinergic syndrome. Because this condition is constantly changing, it often
      is misdiagnosed. Much remains to be studied and understood about the
      neurophysiology of this condition. Central cholinergic transmission is blocked
      with the use of many anticholinergic drugs in numerous patient settings. Because
      acetylcholine plays a significant role in modulating the interactions among most
      other central transmitters, excessive blockage of this neurotransmitter may
      result in the unpredictable behavioral condition known as anticholinergic
      syndrome.

PMID- 7799262
TI  - A health profile of spousal Alzheimer's caregivers. Depression and physical
      health characteristics.
AB  - 1. For caregivers of persons with Alzheimer's disease (AD), each day holds
      unexpected challenges and losses of personal control. Both physical and emotional
      health are at risk for caregivers of persons with AD. 2. Depression is a problem
      for caregivers, whether the spouse with AD remains in the home or has been
      transferred to a nursing home. 3. It is important for clinicians to advise
      caregivers that depression is a treatable disorder. When a caregiver complains of
      sleep problems, a red flag for depression should go up.

PMID- 7799263
TI  - The importance of relationships in fostering hope.
AB  - 1. A person with mental illness, such as schizophrenia, can be mobilized to
      maintain hope. 2. A relationship seems to be the catalyst that allows hope to
      develop exponentially. 3. A belief in the client's abilities can be a powerful
      motivator for change.

PMID- 7799264
TI  - The developmentally disabled, psychiatrically impaired client. Proper treatment
      of dual diagnosis.
AB  - 1. As many as 30% to 35% of all developmentally disabled persons have a
      psychiatric impairment. Nurses must be aware that in a developmentally disabled
      client, psychiatric impairments are frequently exhibited as negative behaviors.
      2. Nursing interventions are the same as those used in general mental health
      settings, but are adapted to the client's needs. If needed, nurses should
      encourage the full range of psychiatric medications. 3. Care of these patients
      requires undertaking much investigative work and review of old files,
      interviewing persons who know the client well, and doing some guess work.

PMID- 7799265
TI  - Bibliotherapy: a valid treatment modality. Research-based practice.
AB  - Clients seem already to be reading on their own for help with difficult life
      situations. As nurses we can further help clients by referring them to
      appropriate literary resources.

PMID- 7799266
TI  - Aunt Janet's sick spells. A lay look at schizophrenia.

PMID- 7799267
TI  - How I learned to play chess.

PMID- 7799269
TI  - [Radiological contrast media].

PMID- 7799268
TI  - The surveyors are coming.

PMID- 7799270
TI  - [Mammography in the USA].

PMID- 7799271
TI  - [Ultrasound-guided cytopuncture of impalpable solid breast lesions].
AB  - We performed 64 echo-guided fine needle (21 G) biopsies of solid unpalpable
      breast lesions in 58 patients. There was a correlation with cytohistological
      results in 34 cases (53%): 24 cancers (69% of the biopsied carcinomas) and 10
      benign lesions (35% of the benign lesions biopsied). There were 4 false
      negatives, 7 false positives and biopsy did not contribute to diagnosis in 20
      cases (31%). Diagnosis was made in all cases on the combined evidence from
      mammography, echography and cytology. These results emphasize the problems
      involved in cytodiagnosis: determining the localization of small lesions, nature
      of the biopsied lesions (role of existing fibrosis and low cell population in the
      non-diagnostic biopsies), reading the histological slide.

PMID- 7799272
TI  - [Role of MRI in pre-clinical breast lesions. Preliminary results].
AB  - The purpose of this study is to assess the value of MR imaging in nonpalpable
      breast tumors. Thirty-two women whose mammogram showed opacity, architectural
      distorsionor microcalcifications, underwent preoperative dynamic MR studies with
      quantitative evaluation of contrast enhancement. MR showed early contrast
      enhancement in 10/12 breast cancers (2 false-negative) and in 6/20 benign lesions
      (false-positive). Quantitative study of contrast enhancement does not allow clear
      differentiation between these lesions. Further studies are required to confirm
      these findings and purpose MR imaging for aid in detection of carcinomas.
      Multifocal sudden enhancements are possible in benign lesions and incite to limit
      MR to focal mammographic abnormalities.

PMID- 7799273
TI  - [A technique of MRI signal processing for functional imaging].
AB  - Recent works show the possibility of MRI to study brain functionalities. Today,
      treatment relies essentially on addition and subtraction of images accumulated
      during rest and activity periods. But this technic is not discriminating and we
      have developed a software to see and treat images with filtering algorithm and
      statistical analysis of signal. The first results are given. Perfections are
      possible and are being realized.

PMID- 7799274
TI  - [Scanner in a medical emergency test of the nervous system].
AB  - Computed tomography is the essential examination in patients with severe
      manifestations of neurological disorders. We discuss emergency situations
      involving the central nervous system due to vascular and infections lesions.
      Trauma and acute complications of brain tumours, usually seen within a
      neurosurgical context, are not discussed here.

PMID- 7799275
TI  - [Diagnosis of broncholithiasis. Role of high resolution tomodensitometry].
AB  - PURPOSE: to evaluate high resolution computed tomography (HRCT) in the diagnosis
      of broncholithiasis. PATIENTS AND METHODS: 10 patients with broncholithiasis
      underwent chest X ray, fiberoptic bronchoscopy (FOB), CT and HRCT. RESULTS: in 9
      cases, chest X rays were abnormal but the diagnosis of broncholithiasis can't
      never be affirmed. In 9 cases, FOB was abnormal: broncholith were identified in
      only 2 cases; the other diagnosis were tumor like stenosis (n = 3), inflammatory
      stenosis (n = 3), extrinsic compression (n = 1). On conventional CT scan,
      broncholithiasis was suspected in 8 patients but because of volume averaging the
      relationship between calcified lymph nodes and bronchial tree was difficult to
      determine exactly. Only HRCT sections, sometimes tilted in the axis of the middle
      lobar bronchus, can affirm the endobronchial or peribronchial location of
      calcified lymph nodes in all patients. CONCLUSION: conventional CT scan can
      suggest the presence of broncholithiasis but HRCT sections are need to affirm the
      diagnosis.

PMID- 7799276
TI  - [Ultrasonographic diagnosis of appendicitis. Value and limitations].
AB  - Appendicitis is a frequently encountered surgical emergency which can be
      diagnosed by clinical and laboratory criteria. But there are some atypical cases
      that ultrasound can help to diagnose. From April the 9th 1992 to April the 11th
      1993, we have examined by ultrasound 465 patients entered in our hospital for
      right lower quadrant pain. 190 patients have been diagnosed as appendicitis and
      operated (true positive = 124 cases, false negative = 54 cases and false positive
      = 12 cases). 275 patients have been diagnosed as negative and they are not
      operated (true = 273 cases, false positive = 2 cases). So in our study, the
      sensitivity is 70%, the specificity is 95% and the accuracy is 85%. Our
      scientific report has the objective to show the usefulness and the limits of
      ultrasound in the diagnosis of appendicitis.

PMID- 7799277
TI  - [Giant Meckel diverticulum type II. Apropos of a case].
AB  - Giant Meckel diverticula type II are very rare. However, in contrast with classic
      Meckel diverticula the small bowel follow through is often abnormal and
      suggestive of the diagnosis.

PMID- 7799278
TI  - [Benign atypical cysts of the kidney: MRI aspects].
AB  - The aim of this study was to assess the magnetic resonance imaging (MRI)
      characteristics of 13 benign complex renal cysts using T1 and T2-weighted images
      and contrast-enhanced images. The results have been compared to CT and
      ultrasonographic findings in all cases and correlated with histopathologic data
      in 12 cases. Five groups have been defined according to the MR features. Group 1:
      homogeneous low signal intensity on T1-weighted images and homogeneous high
      signal intensity on T2-weighted images mimicking simple cyst (n = 2); group 2:
      homogeneous high signal intensity on both T1 and T2-weighted images mimicking
      hemorrhagic cyst (n = 1); group 3: caracterised by high signal intensity on T1
      weighted images and fluid-iron level on T2-weighted images (n = 3); group 4:
      characterised by fluid-iron level on both T1 and T2-weighted images (n = 3);
      group 5: pseudotumoral feature: heterogeneous signal intensity and/or wall
      contrast enhancement (n = 3). Among the 13 indeterminate lesions on
      ultrasonography and CT, MRI was of diagnostic value in 8 cases, whereas the 5
      remaining cases remained indeterminate on MR images. Our results suggest that MRI
      can be useful in the diagnosis of benign complex cyst of the kidney presenting as
      indeterminate cystic lesion on other modalities.

PMID- 7799279
TI  - [Beginning and development of radiology in Strasbourg].

PMID- 7799280
TI  - [Parathyroid echography in dialysed patients with chronic renal failure].

PMID- 7799281
TI  - [Romain Dumazer (1914-1993)].

PMID- 7799282
TI  - [Reliable results in MRI imaging of bone tumors].

PMID- 7799283
TI  - [Normal and pathological aspects of the glenoid labrum in opaque arthro-scanner].
AB  - The morphology of the glenoid labrum was studied by CT arthrography in 88
      patients. These were divided in 2 groups. In the first group, the patients
      underwent CT arthrography for a clinical instability of the shoulder. The second
      group was the reference group to study the morphology of the glenoid labrum, it
      included patients with rotator cuff tears or other pathology of the shoulder,
      without clinical instability. We described the normal labrum which presents
      important morphologic variations. Its study may be difficult because of the
      proximity of capsular structures of the shoulder, mainly the gleno-humeral
      ligaments. The normal variants and the pathologic aspects of the labrum were
      studied: the clefts, tears and degenerative phenomenous. The cleft aspect was
      studied comparatively in the instable population and in the reference population.

PMID- 7799284
TI  - [Early diagnosis by scintigraphy of segmental collapse of the femur head
      following femur neck fracture].
AB  - In order to obtain an early prediction for segmental collapse of the femoral head
      after femoral neck fracture, we have studied in 53 cases of the femoral neck
      fracture using 99mTC-MDP scintimetry. According to the radionuclide uptake ratio
      of the femoral heads, we can estimate the gravity of the avascular necrosis of
      the femoral head after fracture and recognize the repair process in the necrotic
      head. Fifty-three cases of fresh fracture were examined by sequential
      scintigraphy before operation and during follow up examinations after operation.
      The radionuclide uptake were all increased in 3 to 4 months after operation as
      comparing with that done before operation. The uptake ratios in 37 cases
      decreased gradually and approached 1 in 12 months after operation. All of them
      have an excellent result during follow up examination 36 months after surgery.
      The uptake ratios in 19 cases were also increased after operation, but still
      maintained at a high level in 6 to 12 months. They all showed radiographical
      signs of segmental collapse 18 to 24 months after operation. These results showed
      that uptake ratio of the radionuclide bone imaging is able to predict the
      occurrence of segmental collapse of the femoral head after femoral neck fracture.
      The time of the diagnosis by scintigraphy for segmental collapse of the femoral
      head is earlier than that by radiography.

PMID- 7799285
TI  - [Imaging of spinal osteochondroma of neurologic nature. Apropos of 7 cases].
AB  - In this work, on 7 cases of spinal neurological, the authors analyse the use of
      imaging in the diagnosis and pretherapeutic approach, as well as for the post
      operative follow-up. They insist mostly on the value of tomographic imaging
      methods, in particular: computed tomography, which allows the study of mineral
      structures, and determines the site of implant pedicle; magnetic resonance
      imaging important to precise the connections between tumor and spinal canal
      contents. They prove that other imaging methods still possess some interest,
      particularly standard X-ray, useful in estimating the characteristics of
      exostosis and identifying spinal lesions.

PMID- 7799288
TI  - [Value and clinical indications of measurements of the bone mass using X-ray dual
      photon absorptiometry].

PMID- 7799289
TI  - [Normal and pathological twin images of the human body].
AB  - The author demonstrates examples of symmetrical images in human pathology. He
      introduces the subject with arguments of the philosophical and cultural areas. He
      defines asymmetry and dissymmetry. The symmetrical images are linked to different
      planes (natural, artificial and mixed). With numerous symmetrical pathological
      images he demonstrates new teleonomical hypotheses: interchangeable,
      enantiomorphous, turned, rotated images. The concept of symmetry, asymmetry and
      dissymmetry leads to the concept of symmetrical thinking in clinical imaging.

PMID- 7799286
TI  - [A rare cause of multiple lacunae of the cranial vault and temporal bone in
      adults: histiocytosis X].
AB  - Histiocytosis X is an uncommon disease. Temporal bone involvement is a frequent
      head and neck manifestation. Most patients are under fifteen years of age. The
      authors report a case of a bilateral extensive temporal involvement complicated
      with vertigo and peripheric facial palsy. CT plays a dominant role in the
      diagnosis because of the ability to identify bone destruction, soft tissue
      involvement and intra-cranial histiocytosis more accurately.

PMID- 7799287
TI  - [Sacral metastasis of unrecognized renal adenocarcinoma, disclosed during an
      examination for low back pain. Apropos of a case].

PMID- 7799290
TI  - [Medical training in radiology in Vietnam].

PMID- 7799291
TI  - [Presentation of the ANDEM report. Evaluation of new techniques of endoluminal
      revascularization of arteries of the lower limbs].

PMID- 7799292
TI  - Caries prevention in infants and young children: which etiologic factors should
      we address?

PMID- 7799293
TI  - Impact of HIV on VA dental services: report of a survey.
AB  - OBJECTIVES: This study assessed knowledge, attitudes, and behaviors related to
      the treatment of HIV-infected patients by Department of Veterans Affairs (VA)
      dental personnel. METHODS: A questionnaire was mailed to all VA dentists,
      hygienists, and EFDA assistants and completed anonymously in May 1991.
      Descriptive results are reported along with comparisons between the findings from
      this study and a similar VA survey conducted in 1988, as well as several national
      surveys of non-VA dentists. RESULTS: Nearly all VA respondents reported
      participation in some type of continuing education on HIV and infection control.
      They also reported high compliance with recommended infection control procedures.
      Furthermore, the findings suggest that VA dentists and hygienists have a high
      willingness to treat HIV-infected patients, far exceeding that expressed by non
      VA dentists. However, a high level of anxiety related to occupational exposure to
      HIV seems to exist. Most respondents perceived a higher risk of HIV infection
      from commonly encountered occurrences in the workplace than actually exists based
      on current knowledge. CONCLUSIONS: While efforts to further reduce the risk of
      infection and improve care should continue, future efforts also should be
      directed toward reducing the anxiety of VA dental personnel in the treatment of
      infectious patients.

PMID- 7799294
TI  - Knowledge of and practices related to caries prevention among Koreans.
AB  - OBJECTIVES: This study assessed the knowledge and opinions of caries prevention
      and source of oral health information among Koreans. METHODS: A questionnaire
      consisting of 36 items was used to interview 2,000 Koreans 10 through 69 years of
      age. Results for only selected questions are reported. A multistage, stratified,
      random sampling method was used. RESULTS: Sixty-nine percent of the respondents
      had heard about fluoride. Only 16 percent knew that some community water supplies
      in Korea are fluoridated. Fifty-five percent of respondents who knew about
      community water fluoridation learned the information from television, whereas 28
      percent read about it in a newspaper. Among those respondents who reported
      hearing about community water fluoridation, only 30 percent had precise
      information about its purpose. Fifty-five percent of the respondents reported
      that toothbrushing is the best way to maintain good oral health. Almost all
      respondents (97 percent) reported brushing their teeth one or more times a day.
      CONCLUSIONS: These data indicate that there is a relatively low level of accurate
      knowledge about dental caries prevention among Koreans 10 through 69 years of
      age. The majority of respondents report learning information about oral health
      from the mass media.

PMID- 7799297
TI  - Setting the agenda for international collaboration in oral health.

PMID- 7799295
TI  - Understanding dental service use by older adults: sociobehavioral factors vs
      need.
AB  - OBJECTIVES: This study investigated correlates of dental care use in a
      representative sample of adults aged 70 and older throughout New England.
      METHODS: Data were collected in in-home interviews and dental examinations.
      Following Andersen's behavioral model of health services utilization, varied
      measures of sociodemographic characteristics, dental health attitudes and
      practices, perceived need for care, and need objectively determined by clinical
      examination were included as potential correlates. RESULTS: Recency of last visit
      was associated with positive attitudes toward dental care, regular dental
      hygiene, and having a usual source of care. Among dentulous subjects, recency of
      last visit also was related to sex and living arrangements. Frequency of visits
      for dentulous subjects was associated with the same variables, as well as with
      age and social class or education, in addition to need for care. For edentulous
      subjects, only a usual source of care and higher social class were associated
      with more frequent visits. CONCLUSIONS: Perceived need and attitudes toward
      dental care are important influences on use of care. Older persons must be
      convinced of the importance of regular dental care.

PMID- 7799296
TI  - A comparison of dental caries experience in Native American and Caucasian
      children in Oklahoma.
AB  - OBJECTIVES: In 1989 the Oklahoma Area Indian Health Service conducted an oral
      health survey of children attending public schools in Oklahoma to determine the
      extent of caries experience in the Native American population. Results were to be
      used to establish program priorities, gather baseline data, and compare the oral
      health status of Native American children with their non-Indian peers. METHODS: A
      total of 934 elementary schoolchildren 5-6 years of age were examined along with
      733 high school students 15-17 years of age. The study was designed so that
      approximately 50 percent of the students examined were Native American. RESULTS:
      The mean dmfs for the 5-6-year-olds was 5.06 for the Caucasian children and 10.35
      for the Native American children, a statistically significant difference (P <
      .001). For the 15-17-year-olds the mean DMFS for the Caucasian students (5.99)
      was significantly lower (P < .001) than the mean DMFS for the Native American
      students (10.12). CONCLUSIONS: The prevalence and severity of caries in these
      Native American students appear to be substantially higher than in their non
      Indian peers residing in the same communities. Further study is needed to
      identify factors contributing to these demonstrated differences in caries
      experience.

PMID- 7799298
TI  - Oral health for a healthy life.

PMID- 7799299
TI  - Building the capacity for the response of the dental profession to the global HIV
      pandemic: a case study in international collaboration.

PMID- 7799300
TI  - Developing vs importing oral health resources: the PHS experience in the Pacific.

PMID- 7799301
TI  - Public health testimony for the Institute of Medicine's Committee on the future
      of dental education.

PMID- 7799302
TI  - Roles of melatonin and prolactin in testicular crudescence in mink (Mustela
      vison).
AB  - Peripubertal male mink (Mustela vison) were treated with prolactin, melatonin or
      antibodies against melatonin to determine the effects of altered circulating
      concentrations of prolactin and melatonin throughout one season of testicular
      development. Treatment began on 1 October and continued until 4 March.
      Administration of 0.5 mg ovine prolactin day-1 by minipump increased the
      circulating concentration of prolactin for the duration of the study and
      increased serum concentrations of LH. This treatment had no effect on the
      testosterone concentration or on testis size. Neither chronic treatment with
      melatonin throughout the period of crudescence nor passive immunization against
      melatonin for 79 days affected the circulating concentrations of prolactin, LH,
      testosterone or testis size. These results show clearly that, unlike in other
      seasonally breeding species, prolactin does not play a significant role in testis
      growth in the mink. Administration of melatonin to male mink in October did not
      affect testis growth, presumably because the melatonin signal that cues
      photoperiodic events had already been received. Administration of antibodies
      against melatonin did not affect any of the features measured, suggesting that
      melatonin may have neural but not peripheral effects. Further support for this
      view can be found in the absence of an influence of melatonin on testis growth or
      on the plasma concentration of testosterone.

PMID- 7799304
TI  - Association between the duration of dominance of the ovulatory follicle and
      pregnancy rate in beef heifers.
AB  - After luteolysis, subluteal concentrations of progesterone or treatment with a
      synthetic progestagen result in an extended period of dominance (persistence) of
      the dominant follicle in cattle. Two experiments studied (1) the relationship
      between the duration of dominance of the ovulatory follicle and pregnancy rate
      and (2) the ability of a persistent dominant follicle to ovulate and form a
      normal functioning corpus luteum. In Expt 1, beef heifers were either untreated
      (n = 30) or given a synthetic progestagen implant (3 mg norgestomet) for 12 days
      starting on day 16 of their cycle (n = 32). The mean duration of dominance of the
      ovulatory follicle differed (P < 0.05) between treated and control heifers (10.8
      +/- 1.2 and 3.3 +/- 0.8 days, respectively) and 20 of 26 control and 7 of 30
      treated heifers were diagnosed pregnant 28 days after artificial insemination (P
      < 0.01). In Expt 2, on the first day of dominance of the second dominant
      follicle, heifers received either a PGF2 alpha analogue alone (controls; n = 18),
      or prostaglandin and a norgestomet implant for 6 (T6; n = 19) or 10 days (T10; n
      = 20). Increases in the duration of dominance of the second dominant follicle
      (controls, 4.1 +/- 0.2 days; T6, 8.6 +/- 0.2 days; T10, 12.1 +/- 0.2 days; P <
      0.05) resulted in a decrease in pregnancy rate (controls, 14 of 16; T6, 11 of 19;
      T10, 0 of 13; P < or = 0.05). Progesterone concentrations on days 7 and 12 and
      the area of luteal tissue on day 12 after artificial insemination were not
      different (P > 0.05) between treatments.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799303
TI  - A possible role for Ca(2+)-ATPase in human sperm capacitation.
AB  - Mammalian spermatozoa require extracellular Ca2+, some of which must be
      internalized, to undergo capacitation and acrosomal exocytosis. The mechanisms
      controlling the intracellular Ca2+ concentration are unclear, but current
      evidence suggests that a Ca(2+)-ATPase may be involved. Using treatments that
      potentially modulate enzyme activity, we investigated this possibility in human
      spermatozoa; the capacitation state and acrosomal integrity were monitored by
      chlortetracycline fluorescence. Incubation of cells in the presence of quercetin,
      a Ca(2+)-ATPase inhibitor, significantly accelerated the transition from the
      uncapacitated F pattern of chlortetracycline fluorescence to the capacitated,
      acrosome-intact B pattern within 1 h. This was followed by an increase in the
      number of cells displaying the capacitated, acrosome-reacted AR pattern. Since
      most Ca(2+)-ATPases in somatic cells are sensitive to calmodulin, we also
      investigated the effect of the calmodulin antagonist W-7 on chlortetracycline
      patterns. At 1-125 mumol l-1, W-7 significantly stimulated capacitation and
      acrosomal exocytosis. Furthermore, W-7 at 1 mumol l-1 proved to be more effective
      than W-5, a less potent antagonist, suggesting that the observed responses in
      human spermatozoa did reflect a calmodulin-sensitive mechanism. When the glucose
      concentration in the culture medium was varied (from 0 to 5.56 mmol l-1) to alter
      the availability of ATP for enzyme activity, it was found that a reduced
      concentration of glucose promoted capacitation more rapidly than did the standard
      concentration of 5.56 mmol glucose l-1. However, maximal changes, particularly in
      promoting the shift from the B to the AR pattern of chlortetracycline
      fluorescence, required millimolar concentrations of glucose during the last few
      minutes before assessment. Finally, the addition of partially purified mouse
      sperm decapacitation factor (proposed to activate a Ca(2+)-ATPase and thus
      maintain a low intracellular Ca2+ concentration) to capacitated human sperm
      suspensions caused a significant reversal in the capacitation state of cells
      (from the B to the F pattern). The F pattern of chlortetracycline fluorescence
      predominates in conditions favouring low concentrations of intracellular Ca2+.
      From these results, we suggest that a Ca(2+)-ATPase may play an important role
      during human sperm capacitation. A time-dependent decrease in endogenous enzyme
      activity would allow the intracellular concentration of Ca2+ to rise to a
      critical value necessary for initiation acrosomal exocytosis and subsequent
      successful fertilization.

PMID- 7799305
TI  - Effects of anoestrus and bromocryptine treatment on the expression of prolactin
      and LH receptors in the rabbit ovary during lactation.
AB  - The aim of the present study was to correlate the number of prolactin and LH
      receptors in the ovary with the changes in sexual behaviour that occur within a
      few days following parturition in rabbits. Multiparous New Zealand white rabbits
      at days 0, 3 and 10 of lactation were tested for their receptivity upon
      presentation to a male. Rabbits were classed as either receptive or nonreceptive
      at each stage of lactation; half of the animals in each class were treated with
      bromocryptine to examine the effects of prolactin deprivation. Ovarian receptors
      for LH and prolactin, as well as the concentration of their corresponding mRNA,
      were measured at each stage of lactation in every group. Results indicate that
      receptive behaviour is correlated with significantly more follicles on the rabbit
      ovary (diameter > 1 mm; P < 0.05) and an increase in the concentration of LH
      receptor mRNA (P < 0.001) and prolactin receptors (P < 0.05). In addition, on day
      4 of lactation, there were significantly fewer follicles in nonreceptive rabbits
      (P < 0.05). LH receptor content remained constant on days 1 and 4 of lactation
      but increased on day 11 (P < 0.05). Bromocryptine treatment had no effect on the
      number of follicles or on the amount of LH receptor mRNA in does, but it
      significantly increased LH receptors (P < 0.01), and the concentration of
      prolactin receptor mRNA (P < 0.001), particularly on day 11 of lactation (P <
      0.05), and prolactin receptor content (P < 0.001). Receptive rabbit ovaries
      therefore display more follicles that can respond to an LH surge via newly
      transcribed LH receptors than do nonreceptive.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799306
TI  - Increased LH receptor mRNA and extended corpus luteum function induced by
      prolactin and indomethacin treatment in vivo in hysterectomized pseudopregnant
      rats.
AB  - To assess the effects of prostaglandins and prolactin on corpus luteum function
      and regression, sterile-mated adult pseudopregnant rats hysterectomized on day 5
      after mating were injected with indomethacin or prolactin. Daily samples of blood
      were collected via the tail, from day 12 to day 21, and assayed for serum
      concentrations of progesterone, 20 alpha-dihydroprogesterone and LH, whereafter
      corpora lutea and the remainder of ovaries were separated and the tissue content
      of PGF2 alpha, PGE2 and LH receptor mRNA were measured. Injections of prolactin
      (8 iu) s.c. or a low dose of indomethacin (200 micrograms kg-1) s.c. were
      administered twice a day, beginning on day 13 after mating. Both indomethacin and
      prolactin significantly increased serum progesterone concentrations (P < 0.05; n
      = 8), and extended the period of functional corpora lutea when compared with
      controls. Indomethacin, but not prolactin, lowered the concentration of serum 20
      alpha-dihydroprogesterone. In the corpora lutea of indomethacin-treated animals,
      collected on day 21, both prostaglandins measured were reduced in concentration
      by 50% or more, compared with controls (P < 0.05; n = 8), whereas prolactin had
      no effect. Both prolactin and indomethacin treatment caused a substantial
      (tenfold) increase in the concentration of LH receptor mRNA, confined solely to
      the luteal compartment. These findings in vivo provide further evidence for a
      luteolytic role of locally synthesized prostaglandins in the rat ovary.
      Furthermore, prolactin can sustain corpus luteum function by exerting a
      luteotrophic effect during the late luteal phase, as judged by the stimulation of
      progesterone synthesis and the expression of LH receptors.

PMID- 7799307
TI  - Immunohistochemical localization of epidermal growth factor receptors, epidermal
      growth-factor-like and transforming-growth-factor-alpha-like peptides in chicken
      ovarian follicles.
AB  - The purpose of this study was to determine the presence of epidermal growth
      factor receptor and its potential ligands epidermal growth factor (EGF) and
      transforming growth factor alpha (TGF-alpha) in the tissues of the maturing
      follicles in the ovary of laying ISA-Brown hens using peptide-specific
      immunohistochemical methods. Cryostat sections, 6-8 microns thick, were made from
      fresh-frozen tissues of F1-F4 (largest to fourth largest) and large white
      follicles and they were immunostained for epidermal growth factor receptor,
      epidermal growth factor or transforming growth factor alpha using specific
      polyclonal antibodies. The EGF receptor and both ligands were detected in the
      granulosa, theca interna and theca externa layers of the follicles. The EGF
      receptor was localized both in the plasma membrane and cytoplasm of all cell
      types. EGF was predominantly cytosolic, whereas TGF-alpha was found in the plasma
      membranes and perinuclear areas of all cell types. The concentration of the
      receptor and both ligands decreased with follicular maturation. This observation
      is consistent with our previous observation that the response to EGF and TGF
      alpha decreases as follicles mature, and thus provides further evidence that the
      receptor or the ligands may have a regulatory role in avian ovarian function.

PMID- 7799308
TI  - Modulation of production of matrix metalloproteinases from ovine endometrial
      cells by ovine trophoblast interferon.
AB  - Ovine trophoblast interferon modulates the secretion of a number of proteins by
      ovine endometrium, but only one of these proteins has so far been identified. We
      examined the effects of trophoblast interferon on the secretion of matrix
      metalloproteinase-1, -2 and -3 by cultured ovine endometrial cells and determined
      whether they are mediated via effects on prostaglandin synthesis. Both ovine
      trophoblast interferon (30 ng ml-1) and human recombinant interferon alpha (50 U
      ml-1) inhibited the production of latent matrix metalloproteinase-1 and -3 (P <
      0.05), as measured by enzyme assays, but had no effect on the secretion of latent
      matrix metalloproteinase-2. These inhibitory effects were not overcome by PGE2 or
      PGF2 alpha (each 10 mumol l-1) either alone or in combination. Indomethacin (12
      mumol l-1) similarly inhibited the production of latent matrix metalloproteinase
      1 and -3, but production was partially restored by adding the prostaglandins
      either singly or in combination. PGE2 and PGF2 alpha together had no effect on
      enzyme production. These data were confirmed by gelatin and casein zymography.
      Northern analysis showed a 4.5-fold increase in the abundance of specific mRNA
      for latent matrix metalloproteinase-1 following treatment of cells with phorbol
      myristate acetate, but a marked decrease following interferon treatment. Thus,
      ovine trophoblast interferon inhibits the production of the latent forms of
      matrix metalloproteinase-1 and -3 by ovine endometrial cells, and this is
      independent of its effect on prostaglandin production.

PMID- 7799310
TI  - Uptake of a mixture of amino acids by mouse blastocysts.
AB  - Preimplantation mouse embryos exhibit growth at the blastocyst stage when there
      is a dramatic increase in protein content between days 4 and 5 after hCG
      treatment. This increse in protein synthesis requires the uptake of amino acids
      from the surrounding medium, but the consumption of individual amino acids
      present as a mixture has not been examined. We therefore measured the
      simultaneous depletion of 18 amino acids by mouse blastocysts in culture on days
      4 and 5 after hCG treatment. Two culture media were used: one with amino acids
      present at concentrations largely based on those reported to give optimal rates
      of embryo development (M16/mix AA), and a second with the amino acids each at 0.1
      mmol l-1 (M16/0.1 AA). After derivatization with o-phthaldialdehyde to yield
      highly fluorescent products, amino acid concentrations in the media were measured
      by HPLC. On day 4, seven amino acids were depleted from M16/mix AA at rates
      significantly greater than zero: aspartate, arginine, glycine, alanine,
      isoleucine, leucine and lysine; on day 5, nine amino acids were depleted at
      significant rates: aspartate, glutamate, asparagine, tyrosine, methionine,
      valine, phenylalanine, isoleucine and leucine. Average amino acid depletion from
      M16/mix AA was 32% greater on day 5 than on day 4. Aspartate, glutamate,
      arginine, isoleucine and leucine appeared to be the key amino acids sought by
      embryos on both days tested. Embryos grown in amino-acid-containing media
      appeared morphologically normal and their volume increased compared with embryos
      cultured in the absence of amino acids.

PMID- 7799309
TI  - Progestin content and biosynthetic potential of the corpus luteum of the African
      elephant (Loxodonta africana).
AB  - The aim of this study was to examine the progestin content and biosynthetic
      potential of the corpus luteum of the African elephant (Loxodonta africana).
      Luteal tissue was collected from nonpregnant and early, mid- and late pregnant
      elephants (n = 2 per group) shot in the Kruger National Park. Pieces of
      individual corpora lutea (2-3 per animal; 23 in total) were stored directly in
      ethanol before hormone analysis. Matching tissue pieces were incubated for 2 h
      with [3H]pregnenolone (2 x 10(5) c.p.m.), after which tissue plus medium were
      also stored in ethanol. Progesterone and 17 alpha-hydroxyprogesterone
      immunoreactivity in tissue extracts were determined by enzymeimmunoassay and
      radioimmunoassay, respectively, before and after reverse phase HPLC. Progesterone
      immunoreactivity predominated over that of 17 alpha-hydroxyprogesterone in all
      corpora lutea examined but concentrations of both hormones were very low (73-374
      ng g-1 and 3-93 ng g-1, respectively after HPLC). There were no obvious
      differences in hormone concentrations in corpora lutea from animals at different
      reproductive stages. Progesterone and 17 alpha-hydroxyprogesterone
      immunoreactivity assayed before HPLC was 10-30 times higher than that measured
      after chromatographic separation. HPLC consistently revealed two large
      immunoreactive peaks associated with relatively nonpolar compounds, which
      together accounted for most (at least 75%) of all progesterone immunoreactivity
      measured. Large amounts of radioactivity with the same retention times as these
      peaks were also detected after HPLC in samples incubated with [3H]pregnenolone.
      Analysis of conversion products from four corpus luteum incubations indicated
      that between 52% and 84% of [3H]pregnenolone had been converted; 19-33% was
      accounted for by progesterone, and 12-50% by the two substances represented by
      the unidentified peaks. Subsequent GCMS analysis identified the two
      immunoreactive peaks as 5 alpha-pregnane-3 alpha-ol-20-one and 5 alpha-pregnane
      3,20-dione (5 alpha-dihydroprogesterone). These results indicate that the major
      progestins contained within and biosynthesized by corpora lutea of African
      elephants are 5 alpha-reduced metabolites, and that progesterone and 17 alpha
      hydroxyprogesterone are quantitatively of minor importance.

PMID- 7799311
TI  - Plasma concentrations of FSH, LH, thyroid-stimulating hormone and growth hormone
      after exogenous stimulation with GnRH, TRH and GHRH in Booroola ewes that are
      homozygous carriers or non-carriers of the FecB gene.
AB  - The aim of the present study in Booroola ewes, either homozygous (BB) or non
      carriers (++) of the FecB gene, was to test the specificity of the pituitary
      responses to exogenous hypothalamic releasing hormones by examining the plasma
      concentrations of FSH, LH, thyroid-stimulating hormone (TSH) and growth hormone
      (GH) after injecting the animals with different doses of GnRH, thyroid-releasing
      hormone (TRH) or growth-hormone-releasing hormone, (GHRH) which were administered
      on separate occasions. The animals (n = 8 per dose) received 0, 3.1 or 12.5
      micrograms of thyroid-releasing hormone and GnRH (i.v.), whereas they (n = 9-13
      per dose) received 0, 6.0 or 16.0 micrograms GHRH (i.v.). For each experiment
      there were no differences between the genotypes in bodymass or age. Gene-specific
      differences in the mean pretreatment concentrations of plasma FSH (BB > ++; P <
      0.05) but not of LH, TSH or GH were noted. After treatment with GnRH, TRH or
      GHRH, significant effects of dose were noted for all the hormones; however, a
      gene-specific effect was observed only for FSH in response to GnRH (BB > ++; P <
      0.01) with no genotype x dose interaction (ANOVA). For LH, the effects of
      genotype and the genotype x dose interaction almost reached significance at the
      5% level (genotype, P = 0.055; genotype x dose, P = 0.067). For TSH and GH the
      respective genotype x dose interactions were not significant.(ABSTRACT TRUNCATED
      AT 250 WORDS)

PMID- 7799312
TI  - Paracrine activities of porcine trophoblastic interferons.
AB  - Interferon-gamma (IFN-gamma) and a type I IFN (spI IFN) are transiently
      coexpressed by trophoblastic cells of pig conceptuses at implantation between day
      12 and day 20 of gestation. The local effects of these trophoblastic IFNs were
      examined on endometrial cells and on trophoblast by measuring antiviral activity
      and the induction of (2',5')-oligoadenylate synthetase activity. Trophoblastic
      vesicles were shown to be susceptible to infection by vesicular stomatitis virus
      and transmissible gastroenteritis virus. Vesicular stomatitis virus multiplied by
      about 1000 times in trophoblastic vesicles, and endogenous trophoblastic IFNs or
      exogenous recombinant IFN-gamma or spI IFN had no effect on virus production. No
      (2',5')-oligoadenylate synthetase activity could be measured on the trophoblast,
      even after treatment with IFN-gamma or spI IFN. These results clearly show that
      trophoblastic IFNs cannot induce antiviral resistance or (2',5')-oligoadenylate
      synthetase activity in the trophoblast, suggesting that these IFNs have no
      autocrine function. Endometrial epithelial and stromal cells in primary cultures
      displayed distinct sensitivity to the antiviral effect of IFN-gamma and spI IFN.
      Stromal fibroblasts were highly sensitive to spI IFN but weakly sensitive to IFN
      gamma; epithelial cells were sensitive to both IFNs. The same sensitivity pattern
      was obtained when measuring the (2',5')-oligoadenylate synthetase activity.
      Flushing fluid, containing IFN-gamma and type I IFN, was a potent inducer of
      antiviral effect and (2',5')-oligoadenylate synthetase activity. It is therefore
      postulated that the endometrial epithelium is the most likely target of
      trophoblastic IFNs. It is possible that these IFNs play a role in the viral
      protection of conceptuses.

PMID- 7799313
TI  - Absence of normal sexual dimorphism of the genitofemoral nerve spinal nucleus in
      the mutant cryptorchid (TS) rat.
AB  - Sexual dimorphism of the genitofemoral nerve spinal nucleus has been demonstrated
      in normal rodents. Calcitonin gene-related peptide is a neurotransmitter, present
      in the genitofemoral nerve, that has been implicated in the regulation of
      gubernacular migration and inguinoscrotal testicular descent. A combination of
      retrograde fluorescent labelling of the genitofemoral nerve and
      immunohistochemistry for calcitonin gene-related peptide was used in 1-3-day-old
      mutant TS rats with 85% incidence of congenital cryptorchidism and an absence of
      the normal sexual dimorphism of the genitofemoral nerve spinal nucleus was
      demonstrated. There was no significant difference between male and female nuclei
      with respect to fluorescent-labelled neurones as well as those immunoreactive for
      calcitonin gene-related peptide, in contrast to an obvious sexual dimorphism
      present in normal control animals. This lack of normal sexual dimorphism of the
      genitofemoral nerve nucleus is likely to be important in the pathogenesis of
      cryptorchidism in this animal model.

PMID- 7799314
TI  - Histomorphology, oLH and hCG receptors, and testosterone secretion in vitro in
      Rambouillet rams from lines in which females had been selected for low or high
      reproductive rate.
AB  - The objective of this study was to determine whether gross or histomorphological
      components of the testes, capacity and dissociation constants (Kd) of testicular
      oLH and hCG receptors, and gonadotrophin-stimulated testosterone secretion in
      vitro differed among Rambouillet rams from lines selected for low or high female
      reproductive rate and from rams of a random-bred control line. Lines had been
      selected for approximately 20 years. Data were collected from 22-month-old rams
      during the late breeding season. Rams among lines did not differ (P > 0.05) in
      gross testicular characteristics or most histomorphological characteristics.
      However, the percentage volume of interstitial vascular tissue was greater (P <
      0.05) for rams from lines selected for low female reproductive rate than for rams
      from lines selected for high female reproductive rate. Receptor sites per Leydig
      cell and binding capacities of oLH and hCG receptors per testis, per gram of
      parenchyma, and per milligram of membrane protein did not differ (P > 0.05) among
      lines. The Kd values for oLH and hCG receptors did not differ (P > 0.05) among
      lines; however, receptor sites per Leydig cell, capacities of testicular
      parenchyma to bind gonadotrophin and Kd values were higher (P < 0.05) for oLH
      than for hCG receptors. Total oLH- and hCG-stimulated testosterone secretion in
      vitro did not differ (P < 0.05) among lines. In conclusion, selection for or
      against reproductive rate in Rambouillet ewes has not altered gross or most
      histomorphometric characteristics of the testes of male offspring, with the
      exception that selection against reproductive rate increased the proportion of
      testicular volume occupied by vascular tissue within the interstitium.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7799316
TI  - Mechanisms controlling corpus luteum function in the rhesus monkey (Macaca
      mulatta): inhibitory action of hCG on luteolysis induced by PGF2 alpha.
AB  - The aim of this study was to determine whether daily increasing doses of hCG
      could overcome luteal regression induced by PGF2 alpha in rhesus monkeys.
      Prostaglandin F2 alpha (10 ng microliters-1 h-1) or vehicle (tham buffer; 1
      microliter h-1) was infused directly into the corpus luteum for 7 days, beginning
      7 days after the preovulatory oestradiol surge. hCG was injected i.m. in
      increasing doses (15, 30, 60, 90, 180, 360 and 720 iu) for 7 days, starting on
      the eighth day after the preovulatory oestradiol surge, or 1 day after the
      initiation of luteal infusion of PGF2 alpha or vehicle. Monkeys receiving vehicle
      plus hCG on the same days served as controls. Daily progesterone, oestradiol and
      hCG concentrations were determined from blood drawn from the saphenous or femoral
      vein, and the duration of the luteal phases were recorded. Where intraluteally
      infused PGF2 alpha resulted in premature, functional luteolysis, hCG always
      inhibited the luteolytic effect of PGF2 alpha; the secretory patterns of
      progesterone and oestradiol were augmented, and peak values were reached in
      concert with the highest concentration of hCG in the blood, and the luteal phase
      was significantly increased compared with those of untreated monkeys or with
      monkeys treated with PGF2 alpha alone or vehicle. Treatment with hCG alone or
      with PGF2 alpha vehicle also resulted in maintained luteal function and a
      significantly longer luteal phase, but both progesterone and oestradiol
      concentrations began to decline before hCG reached peak values in the
      circulation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799315
TI  - Effect of parathyroid hormone-related protein (PTHrP) on the contractility of the
      myometrium and localization of PTHrP in the uterus of pregnant rats.
AB  - The effect of parathyroid hormone-related protein (PTHrP) on the contractility of
      uterine segments taken from pregnant rats and the localization of PTHrP in the
      uterus during pregnancy were investigated. PTHrP(1-34) had a potent inhibitory
      effect on spontaneous contractions of the longitudinal layer of uterine
      myometrium taken from rats at day 4 of pregnancy (IC50 1.6 nmol l-1). In low
      calcium De Jalon's solution, it also decreased base-line tension (IC50 1.5 nmol l
      1) in a concentration-dependent manner. The effect of PTHrP(1-34) on uterine
      motility decreased as pregnancy progressed until day 13, after which PTHrP(1-34)
      had no measurable effect on uterine contractility. In contrast, PTHrP(1-34) had
      no effect on the contractions of the circular smooth muscle of the uterus at any
      stage of pregnancy. PTHrP(50-69) had no effect on the contractility of either
      muscle layer of the myometrium. A temporal pattern of staining for PTHrP in the
      uterus of pregnant rats was observed, and the changes in the staining patterns in
      the endometrium and myometrium were different in each layer. These data suggest
      that PTHrP may have at least two distinct roles in the uterus, a relaxing action
      on longitudinal muscle that depends on the hormonal state of the rat and a novel
      effect either intraluminally or within the endometrial layer.

PMID- 7799317
TI  - Effects of sensory stimuli on the incidence of fetal resorption in a murine model
      of spontaneous abortion: the presence of an alien male and postimplantation
      embryo survival.
AB  - Pregnancy outcome may be altered by both genetic and environmental factors. The
      mating of CBA/J female mice with DBA/2 males normally results in pregnancies
      characterized by a relatively high incidence of early embryo compared with most
      other syngeneic or allogeneic matings. This study addressed the role of normal
      laboratory stress in the induction of early embryo loss. The previously studied
      'Bruce effect' describes the total loss of preimplantation embryos (pregnancy
      block) that is apparently caused by the stress induced by the presence of an
      alien male and mediated by neuroimmunological effects on prolactin activity. To
      determine whether this effect could be responsible for the high incidence of
      postimplantation embryo losses in the CBA/J x DBA/2 model, the original DBA/2
      male was replaced on day 6 of gestation by another DBA/2 male, a CBA/J, a C57Bl/6
      or a BALB/c male. The relatively high incidence of embryo loss was not affected
      by removing the original DBA/2 male or introducing another DBA/2 or a CBA/J male,
      indicating that stress induced by an alien male did not increase the
      postimplantation losses in this model. Furthermore, the introduction of a DBA/2
      male to a CBA/J female that had been mated with a BALB/c male did not elicit
      early embryo loss. However, the replacement of the original DBA/2 male by a
      BALB/c male dramatically reduced the incidence of early embryo loss in pregnant
      CBA/J female mice. The introduction of a C57Bl/6 male also reduced embryo loss
      but to a lesser extent.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799318
TI  - Seasonal effects on seminal and endocrine traits in the captive snow leopard
      (Panthera uncia).
AB  - The annual reproductive cycle of the male snow leopard (Panthera uncia) was
      characterized by evaluating seminal and endocrine traits monthly. Testicular
      volume was greatest (P < 0.05) during the winter months when the quality of
      ejaculate was optimal. Ejaculate volume, total sperm concentration ml-1, motile
      sperm concentration per ejaculate, sperm morphology and sperm motility index were
      lowest during the summer and autumn months compared with the winter and spring.
      Peripheral LH, FSH and testosterone concentrations were also lowest during the
      summer months, increasing during the autumn just before the increase in semen
      quality, and were maximal during the winter months. There was a direct
      relationship (P < 0.01) between: (1) testosterone and testicular volume, total
      sperm concentration ml-1, motile sperm concentration per ejaculate and ejaculate
      volume, and (2) LH and testicular volume and motile sperm concentration per
      ejaculate. In summary, although spermatozoa were recovered throughout the year,
      optimal gamete quality was observed during the winter and spring. Although
      previous studies in felids have demonstrated seasonal effects on either seminal
      or endocrine traits, this is the first study to demonstrate a distinct effect of
      season on both pituitary and testicular function.

PMID- 7799319
TI  - Growth-related changes in testicular mass and plasma testosterone concentrations
      in long-finned pilot whales, Globicephala melas.
AB  - Blood samples and testes were collected from long-finned pilot whales
      (Globicephala melas) off the Faroe Islands at irregular intervals over a period
      of 3 years (July 1986-December 1989). Changes in testis mass (n = 674) and plasma
      testosterone concentrations (n = 214), measured by radioimmunoassay, were
      examined with respect to age, bodylength and bodymass of the animals.
      Corresponding to a rapid testicular growth (from 0.25 kg up to 1.9 kg), puberty
      occurred in male pilot whales of 4.6-5.7 m in bodylength, 1.2-1.9 tonnes in
      bodymass and 11-22 years of age. Changes in plasma testosterone concentrations
      confirmed this result, with very low values (< 2 ng ml-1) in immature animals
      (testis mass < 0.2 kg), followed by a sharp increase (from 2 to 29 ng ml-1)
      during the pubertal period, and the maintenance of high concentrations with large
      variability (> 1.5 ng ml-1 to 14 ng ml-1) in mature males. Testosterone
      concentrations were significantly correlated with testis mass (P < 0.001), but
      not with bodylength or age, and very large individual variations were observed in
      mature males. The average age, length and mass at the attainment of sexual
      maturity were estimated at 16.99 +/- 0.30 years, 5.162 +/- 0.013 m and 1.403 +/-
      0.005 tonnes, respectively.

PMID- 7799320
TI  - Differences in blood flow to uterine segments and placentae in relation to sex,
      intrauterine location and side in pregnant rats.
AB  - The effects of location within the left or right uterine horn, position within
      each uterine horn, and fetal sex on fetal bodymass, blood flow to individual
      uterine segments associated with fetuses, and blood flow to the maternal portion
      of the placenta were investigated in rats. Sprague-Dawley rats were anaesthetized
      on day 5, 10, 15, 20, 21 or 22 of pregnancy, and radioactive microspheres with
      diameters of 15 mm were injected via a left ventricular cannula to measure blood
      flow to tissues. Tissues were weighed wet, and the rate of blood flow, corrected
      for wet mass (ml min-1 g-1 tissue), was calculated. Microspheres were not
      detected in fetuses, suggesting that they did not pass from maternal into fetal
      blood. Uterine blood flow was greater at the cervical and ovarian ends than in
      the middle of the uterus; on day 15 the rate of blood flow at the cervical and
      ovarian ends of each uterine horn was over twice that in the middle. The blood
      flow to the right uterine horn was greater than to the left horn. Blood flow to
      placentae increased dramatically between day 15 and day 20. There were marked
      differences in architecture between the uterine artery feeding the ovarian end of
      the right and left uterine horn, and blood flow to placentae located at the
      ovarian end of the right uterine horn was greater than to placentae in the same
      location in the left uterine horn. The blood flow to placentae and fetal bodymass
      were greater for female than for male fetuses on day 20, but on day 22 the
      reverse was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799321
TI  - Serum zinc and copper concentrations in relation to spontaneous abortion in cows:
      implications for human fetal loss.
AB  - The purpose of this study was to investigate the effect of the status of dietary
      zinc and serum zinc and copper concentrations on the risk of fetal loss in 570
      cows. three herds received no supplements (herds 1, 3, 4), while cows in herd 2
      received supplements of either 7 g zinc week-1 (n = 118), as zinc methionine, or
      a control diet containing methionine (n = 128). Serum zinc, copper and
      metallothionein concentrations were determined once a month throughout gestation.
      Logistic regression and survival analysis were used to examine for associations
      between risk of fetal loss and serum zinc, copper, copper:zinc, or
      metallothionein concentrations, supplement level, and maternal age at conception.
      The risk of fetal loss increased when both serum zinc decreased and copper
      concentrations increased (P < 0.0001; relative risk = 10.28, 95% confidence
      intervals = 4.69, 22.5). The attributable risk, for a decline in the zinc
      concentration by 10 mumol l-1 and an increase in the copper concentration by 5
      mumol l-1 was 90.27%. Methionine-supplemented cows had a higher risk of fetal
      loss compared with zinc-methionine-supplemented cows (one-tailed P = 0.0375;
      relative risk = 2.98). Cows in herds 1, 3 and 4 had a higher risk for abortion
      than did zinc-methionine-supplemented cows in herd 2 (relative risk = 26.27, 95%
      confidence intervals = 2.31, 299.38; relative risk = 40.87, 95% confidence
      intervals = 3.50, 458.43; relative risk = 41.53, 95% confidence intervals = 3.77,
      457.02, respectively). Our results suggest that inflammation and zinc nutriture
      may play an important role in fetal loss in dairy cows.

PMID- 7799322
TI  - Differential effects of LH and PGE2 on progesterone secretion by small and large
      porcine luteal cells.
AB  - This study examined the effects of LH and PGE2 on progesterone secretion by small
      and large porcine luteal cells with or without low-density lipoproteins. Corpora
      lutea were isolated from gilts 13-14 days after administering gonadotrophins;
      enzymatically dissociated and small and large cells were isolated by elutriation.
      Culture plates, 24-well, were then seeded with 150,000 small or 30,000 large
      luteal cells suspended in 1 ml M199 medium supplemented with 5 micrograms insulin
      ml-1, 40 ng hydrocortisone ml-1 and with or without low-density lipoproteins (50
      micrograms cholesterol ml-1) or PGE2. Cells were cultured for up to 24 h in a
      humidified incubator at 37 degrees C under 5% CO2 in air. The low-density
      lipoproteins stimulated (P < 0.05) progesterone secretion by large, but not
      small, luteal cells. Prostaglandin E2 stimulated (P < 0.05) progesterone
      production by large luteal cells in a dose-dependent manner, and the stimulatory
      effects of PGE2 were greater (P < 0.05) in the presence than in the absence of
      low-density lipoproteins. Progesterone secretion by small luteal cells was not
      significantly affected by PGE2. Progesterone production by small luteal cells was
      enhanced (P < 0.05) by LH, and the stimulatory effects of LH were greater (P <
      0.05) in the presence than in the absence of low-density lipoproteins. In the
      absence of these lipoproteins, LH had no effect on progesterone secretion by
      large luteal cells; however, in the presence of low-density lipoproteins, LH
      increased (P < 0.05) progesterone secretion by large cells, though to a lesser (P
      < 0.05) extent than the effect of LH on small cells. These data demonstrate that
      progesterone secretion by porcine luteal cells is stimulated differentially by LH
      and PGE2 and that small luteal cells are more responsive to LH and PGE2 acts
      primarily on large luteal cells.

PMID- 7799323
TI  - 3 beta-Hydroxysteroid dehydrogenase activity and gestagen concentrations in
      bovine cotyledons and caruncles during gestation and parturition.
AB  - 3 beta-Hydroxysteroid dehydrogenase (3 beta-HSD) activity in bovine cotyledons
      was much higher than in caruncles throughout the gestation period. The activity
      of this enzyme in cotyledons increased greatly to 150.6 +/- 5.8 pmol min-1 mg-1
      protein during the seventh month of gestation, reached a peak of 221.0 +/- 34.9
      pmol min-1 mg-1 protein during the eighth month, and decreased at parturition.
      Progesterone and 20 alpha-hydroxyprogesterone concentrations in cotyledons also
      increased sharply to 2.69 +/- 0.30 and 2.15 +/- 0.42 ng mg-1 protein,
      respectively, during the seventh month of gestation, reaching peaks of 2.86 +/-
      0.47 and 2.51 +/- 0.36 ng mg-1 protein, respectively, during the eighth month and
      decreasing at parturition, in a manner similar to the activity of 3 beta
      hydroxysteroid dehydrogenase. The fluctuation of 17 alpha-hydroxyprogesterone
      concentration in cotyledons was different from that of progesterone and 20 alpha
      hydroxyprogesterone. These findings indicate that the activity of 3 beta
      hydroxysteroid dehydrogenase in the placenta is enhanced during the third
      trimester, and progesterone synthesized in the cotyledons is converted
      concurrently to 20 alpha-hydroxyprogesterone before progesterone is transferred
      to the fetal blood.

PMID- 7799324
TI  - Influence of meteorological events on obstetrical data in cattle and swine.
AB  - In a interdisciplinary scientific cooperation involving human and veterinarian
      obstetricians and meteorologists, an attempt was made to correlate the
      obstetrical data of cows and pigs with meteorologically defined weather events.
      During the observation period of 10 years the parturitions of cattle (n = 645)
      showed no significant statistical connection to the weather on day of delivery,
      the day before parturition or the day after. The only significant result in
      cattle was a shortening of the gestation period by 4.9 days in a group of cows
      that went into labour on, or after, the sixth day of a constant weather
      situation. Significant variations in the duration of gestation in swine (n = 786)
      were related to the weather on the day of delivery; central high-gradient
      anticyclonic spring, summer and autumn weather was linked to an extension of the
      pregnancy by nearly 1 day, while cyclonic central low-gradient weather during
      autumn was related to a shortening of pregnancy by approximately 1 day. The
      weather on the day before parturition was also correlated with the duration of
      gestation in swine. In this respect, low-gradient cyclonic autumn weather
      coincided with gestation periods that were reduced by 0.95 days, while central
      anticyclonic winter and spring weather coincided with extensions of gestation of
      0.98 and 1.12 days, respectively. Compared with labour during low-gradient
      anticyclonic weather, the course of labour in pigs was significantly protracted
      by approximately 1.5 h during low-gradient cyclonic weather. Weather fronts on
      the day before, the day after or on the day of labour had no influence on the
      gestation and parturition data collected in either species.

PMID- 7799325
TI  - Characterization of freshly dispersed porcine myometrial cells: evidence for
      voltage-dependent Ca2+ channels and regulatory receptors.
AB  - A patch-clamp study of Ca2+ currents and spectrofluorometric detection of the
      intracellular Ca2+ concentration [Ca2+]i was performed on porcine myometrial
      cells that had been isolated by collagenase. Isolated myometrial cells were the
      typical long cylinder shape. The main length and diameter of myometrial cells
      were 505 +/- 20 and 11 +/- 0.5 microns (n = 40), respectively, in the prepartum
      period and 265 +/- 22 and 7 +/- 0.4 microns (n = 40), respectively, in the luteal
      phase. Immunocytochemistry with an antibody against desmin stained 90% of the
      cells positively, and about 95% of the cells excluded Trypan blue dye. The basal
      [Ca2+]i of myometrial cells in the luteal phase and the prepartum period was 119
      +/- 12 (n = 30) and 154 +/- 31 nmol l-1 (n = 48), respectively. In prepartum
      myometrial cells, oxytocin (10(-7) mol l-1) and carbachol (10(-4) mol l-1)
      increased [Ca2+]i in a biphasic pattern, with a sharp peak followed by a plateau.
      In cells in the luteal phase, adrenaline (10(-7) mol l-1) plus propranolol (10(
      6) mol l-1) produced a biphasic increase in [Ca2+]i. However, in the absence of
      propranolol, the increase in [Ca2+]i by adrenaline was small. Prostaglandin F2
      alpha (10(-6) mol l-1) induced a monophasic increase in the [Ca2+]i in cells in
      the luteal phase. By depolarizing the cells from -30 to +50 mV from a holding
      potential of -50 mV, Ca2+ currents were evoked with a threshold at -20 mV,
      reaching a maximum between 10 and 30 mV.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799326
TI  - Effects of progesterone pretreatment on the oxytocin receptor concentration and
      the response to oxytocin during the simulated early luteal phase in the
      ovariectomized ewe.
AB  - A steroid-treated ovariectomized ewe model was used to investigate the role of
      progesterone pretreatment in the control of functional oxytocin receptor
      concentrations during the early luteal phase. Ovariectomized ewes (n = 28) were
      injected with oestradiol for 2 days (final injection = day 0) with or without
      progesterone pretreatment (progestagen sponge for 10 days). Ewes were then given
      high or low concentrations of progesterone combined with high, low or zero
      concentrations of oestradiol in a pattern known to simulate the early luteal
      phase profile (n = 4 per group). Ewes were given 1 microgram oxytocin (i.v.) on
      day 4 and plasma was collected to assay 13,14-dihydro-15-keto PGF2 alpha. The
      concentration of progesterone and oestradiol administered had no effect on the
      concentration of 13,14-dihydro-15-keto PGF2 alpha following oxytocin
      administration (P > 0.05). However, the group that was not pretreated exhibited a
      small but significant 13,14-dihydro-15-keto PGF2 alpha response in comparison
      with the equivalent pretreated group (P < 0.05). In a subsequent study, ewes were
      divided into groups pretreated and not pretreated with progesterone; both groups
      were given oestrous concentrations of oestradiol and high concentrations of
      progesterone and oestradiol together. On day 0, 2, 3 or 4, ewes from each group
      (n = 3, 3, 4 and 4, respectively) were given 1 microgram of oxytocin i.v., and
      the endometrium was collected to measure the binding of oxytocin receptors.
      Oxytocin caused a significant (P < 0.05) increase in the concentration of 13,14
      dihydro-15-keto PGF2 alpha in all ewes on day 0 but not on days 2, 3 or 4.
      Oxytocin receptor concentrations were maximal on day 0 and basal by day
      4.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799327
TI  - Suppression of plasminogen activator production in sheep embryos in vitro after
      treatment with cycloheximide or ouabain.
AB  - Effects of the metabolic inhibitors cycloheximide and ouabain on development in
      vitro and plasminogen activator production by sheep embryos were investigated.
      Embryos (n = 152) from the eight-cell to the morula stage were surgically
      collected from naturally mated, oestrus-synchronized and superovulated Polypay
      ewes. In Expt 1, embryos (n = 104) were grouped by cell stage, cultured in
      Whitten's medium with 1.5% BSA containing 0, 0.1 or 1.0 microgram cycloheximide
      ml-1 for 24 h, washed and cultured in this medium for 168 h. In Expt 2, morulae
      (n = 48) were cultured for 48 h in Whitten's medium with 1.5% BSA transferred to
      the same medium containing 0 or 1.0 mmol ouabain l-1 and cultured for 24 h, and
      then washed and cultured in this medium for 120 h. At 24 h intervals in both
      experiments, the medium was recovered and analysed for plasminogen activator. In
      Expt 1, eight-cell embryos underwent limited development; little difference in
      the production of plasminogen activator due to cycloheximide treatment was
      therefore observed. Compared with medium without cycloheximide, treatment with
      1.0 microgram cycloheximide ml-1 reduced the number of 16-cell embryos (P < 0.05)
      and morulae (P < 0.05) (60% versus 10% and 77% versus 8%, respectively) that
      began to hatch. The mean production of plasminogen activator was greatest in
      embryos cultured initially as morulae compared with that of 16-cell and eight
      cell embryos (P < 0.05). Cycloheximide treatment suppressed the mean production
      of plasminogen activator in a dose-dependent manner (P < 0.05).(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7799328
TI  - Isolation of cell populations from the mare corpus luteum: comparison of
      mechanical and collagenase dissociation.
AB  - Corpora lutea were obtained from mares at days 3, 10 and 14 after ovulation, and
      examined histologically. The morphology of isolated luteal cells obtained by
      either mechanical or collagenase dissociation of the tissue was examined and the
      cells stained to detect the steroidogenic enzyme delta 5, beta-hydroxysteroid
      dehydrogenase. The ratio of large:small cells was significantly higher for cells
      obtained from mechanically dissociated luteal tissue than for cells obtained by
      collagenase dissociation (P < 0.01). Cells obtained by both mechanical and
      collagenase dissociation secreted progesterone, although neither cell population
      responded to exogenous gonadotrophin with an increase in progesterone secretion.
      Homogenates of equine luteal tissue bound 125I-labelled human LH with high
      affinity and specificity, and the specific activity and binding affinity of
      luteal LH receptors did not change significantly from day 3, to days 10 and 14
      after ovulation. However, mechanically dissociated cells on days 10 and 14 bound
      significantly more LH than did collagenase-dissociated cells on these days (P <
      0.05). These results indicate that (i) collagenase dissociation of mare luteal
      tissue yields a population of cells that is unrepresentative of the corpus
      luteum, and (ii) the mare corpus luteum is not responsive to LH in vitro at the
      stages examined.

PMID- 7799329
TI  - Preparation of highly purified porcine theca cells.
AB  - A novel method for purifying dispersed porcine theca cells, with less than 3%
      granulosa cell contamination, was developed by the repeated use of mechanical and
      enzymatic procedures. The steroidogenic criteria used for the identification and
      purity evaluation of both theca and granulosa cells were also improved. Purified
      theca and granulosa cells from medium-sized follicles displayed steroidogenic
      differences when they were cultured in the presence of 10% fetal bovine serum:
      (1) the theca cells synthesized oestradiol (239.1 +/- 35.1 pg ml-1 per 2.5 x
      10(5) cells in 40 h), but the granulosa cells did not synthesize it unless
      aromatizable androgens were added; (2) theca cells synthesized androstenedione
      (73.2 +/- 14.4 ng ml-1 per 2.5 x 10(5) cells in 40 h), but granulosa cells did
      not; (3) FSH did not affect progesterone production in theca cells; (4) the theca
      cells secreted androstenedione for up to 48 h; and (5) FSH significantly
      stimulated progesterone production in granulosa cells during a culture for 40 h
      (P < 0.05), but not during culture for 12 h. The lack of response to FSH was used
      as a reliable, functional indicator of the purity of porcine theca cells.
      However, this criterion proved not to be useful for cells cultured for 12 h;
      porcine FSH had no effect on the progesterone production of theca cells co
      cultured for this time with as many as 20% granulosa cells. However, after co
      culturing for 40 h, this criterion resulted in the detection of only 3% granulosa
      cell contamination.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799330
TI  - Cholesterol, phospholipid and phospholipase activity of ampullary and isthmic
      fluid from the bovine oviduct.
AB  - Cholesterol and phospholipid concentrations and phospholipase activity were
      measured in fluid from cannulae collected from the bovine oviductal isthmus and
      ampulla at different stages of the oestrous cycle. The cholesterol concentration
      and cholesterol normalized by protein were significantly (P = 0.03) greater in
      isthmic oviductal fluid (224.3 +/- 42.7 micrograms ml-1 over all stages) than in
      ampullary oviductal fluid (164.5 +/- 11.3 micrograms ml-1), and maximal
      concentrations (284.5 +/- 25.5 micrograms ml-1) were found during the luteal
      stage (serum progesterone concentration > or = 1.5 ng ml-1). The concentrations
      of the phospholipids sphingomyelin and lysophosphatidylcholine increased at
      different stages of the cycle and in different regions. In the ampulla, the
      concentration of sphingomyelin was significantly (P < 0.05) greater in oviductal
      fluid collected during the luteal phase (12.1 +/- 2.7% of total phospholipids)
      than in fluid collected near oestrus and ovulation (7.5 +/- 1.5% and 6.9 +/- 1%,
      respectively). The concentration of lysophosphatidylcholine was greater (P <
      0.01) in ampullary (19.2 +/- 1.6% of total phospholipids) than in isthmic
      oviductal fluid (9.9 +/- 1.1%) collected near ovulation. The ratio of cholesterol
      to total phospholipid was highest in oviductal fluid collected from the isthmus
      during all stages (2.3 micrograms ml-1:% total phospholipid), while the minimal
      ratio was found in ampullary fluid collected near ovulation (1.5). Phospholipase
      activity was higher (P = 0.03) in isthmic oviductal fluid (20.4 +/- 3.2% product
      formed) than in ampullary oviductal fluid (14.6 +/- 1.4%); the lowest activity
      (12.6 +/- 1.7% product formed) was in fluid collected during the phase of the
      oestrous cycle immediately before ovulation.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799331
TI  - Ovarian follicular development and endocrine responses in follicular-fluid
      treated and hemi-ovariectomized heifers.
AB  - The effects of charcoal-extracted bovine follicular fluid (BFF) on endocrine
      profiles and follicular development in intact and hemiovariectomized postpubertal
      heifers were examined. Oestrus-synchronized heifers received Norgestomet implants
      on day 1 and 7 of treatment and were then injected s.c. with 11 ml saline
      (control) or 11 ml BFF twice a day for 12 days. The ovary bearing the largest
      follicle (OV1) was removed on day 7 and the remaining ovary (OV2) was collected
      on day 13. Follicles were observed by daily ultrasonography and were classified
      according to diameter (size 1: 2-3 mm; size 2: 4-6 mm; size 3: 7-10 mm; size 4: >
      10 mm). After ovariectomy they were classified by diameter and histologically as
      normal or atretic. Intact control heifers had increased numbers of size 4
      follicles on OV1 on days 6 and 7; no increase was observed in BFF-treated heifers
      (P < 0.03). In BFF-treated heifers, the mean basal LH concentration was higher (P
      < 0.05) and that of FSH was lower (P < 0.04) than in controls. FSH concentrations
      in BFF-treated heifers decreased from 0.60 +/- 0.08 ng ml-1 (day 1) to 0.22 +/-
      0.05 ng ml-1 (day 7; P < 0.04). The concentration of oestradiol increased in
      control heifers, but not in BFF-treated heifers (P < 0.001). After
      hemicastration, OV2 underwent compensatory hypertrophy in control heifers, with
      an increase in the number of size 2, 3 and 4 follicles (P < 0.05), whereas BFF
      treated heifers did not. Thus, total follicular volume was much lower in BFF
      treated than in control heifers on day 13 (92.2 +/- 15.4 versus 1393.8 +/- 276.6
      mm3; P < 0.0002). A transient increase in FSH (P < 0.006) and oestradiol (P <
      0.01) concentrations occurred after hemiovariectomy in control but not in BFF
      treated animals. In control heifers, an analysis of temporal relationships showed
      negative correlations between the volume of size 3 and size 4 follicles, and
      between FSH concentrations and the volume of size 3 and 4 follicles. A positive
      correlation was found between the mean diameter of the largest follicle and the
      concentration of oestradiol, whereas negative relationships were found between
      the concentrations of FSH and oestradiol, and between FSH and the mean diameter
      of the largest follicle. Analysis of the histological data showed that the number
      and volume of follicles > 8.57 mm was lower in the BFF-treated OV1 ovary, whereas
      no differences were found for follicles < or = 8.57 mm.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7799332
TI  - Attempts to apply curve fitting models to the analysis of progression of
      radiographic damage in rheumatoid arthritis are laudable, but are the results
      believable?

PMID- 7799333
TI  - Advantages and limitations of ultrasound in the evaluation of the rheumatoid
      shoulder.

PMID- 7799334
TI  - Increased type I collagen degradation in early rheumatoid arthritis.
AB  - OBJECTIVE: To evaluate the serum concentration of the mature, crosslinked carboxy
      terminal telopeptide of type I collagen (ICTP) in patients with early onset
      rheumatoid arthritis (RA) and to assess its correlation with clinically relevant
      features of the disease. METHODS: The serum ICTP concentration was measured in 99
      adult patients with RA with a duration of disease less than one year. The main
      clinical outcome measures were joint count, modified Lansbury index, erythrocyte
      sedimentation rate (ESR), C-reactive protein (CRP), Larsen index and number of
      erosions in peripheral joints. RESULTS: There was a strong positive correlation
      (p < 0.001) between the serum ICTP concentration and the Lansbury joint index and
      a weaker but still significant correlation (p < 0.01) between the serum ICTP
      concentration and the number of eroded hand and foot joints. CONCLUSION: Serum
      ICTP may have value as a marker of tissue destruction in patients with early RA.

PMID- 7799335
TI  - Human mucosyl lymphocyte marker expression in synovial fluid lymphocytes of
      patient with rheumatoid arthritis.
AB  - OBJECTIVE: Human mucosyl lymphocyte marker (HML-1) antigen is an activation
      antigen and adhesion molecule of the beta 7 integrin family, which is generally
      restricted to T cells found in the intestinal epithelium. Expression of the
      membrane antigen as defined by the monoclonal antibody HML-1 was studied on
      peripheral blood (PB) lymphocytes and synovial fluid (SF) lymphocytes in 10
      patients with rheumatoid arthritis (RA) and in a control group of patients with
      osteoarthritis (OA). METHODS: Double fluorescence activated flow cytometry was
      used to assess HML-1 expression with T cell subtype antigens (CD3, CD4, CD8) or
      activation markers interleukin 2 receptor (IL-2R) (CD25), HLA-DR, and lymphocyte
      function associated antigen (LFA-1) (CD11a) were assessed by flow cytometry.
      RESULTS: HML-1 antigen expression in PB lymphocytes of patients with RA (7.3%)
      was found to be comparable to the control group (6.4%). In contrast, 25.4% (range
      14-43%) of SF lymphocytes expressed HML-1 antigen, compared to 13.6% of SF
      lymphocytes in patients with OA (p < 0.001). In RA, 62% of HML-1 positive cells
      from SF lymphocytes were the CD8 subtype, compared to 10.6% of PB lymphocytes (p
      < 0.003), and 18% of control SF lymphocytes (p < 0.05). Furthermore, HML-1
      antigen and HLA-DR antigen were coexpressed in 75% of RA SF lymphocytes compared
      to 29.6% of control SF lymphocytes (p < 0.01). In contrast, coexpression of LFA-1
      and the Il-2R did not differ from that of control. CONCLUSION: We describe
      overexpression of the adhesion molecule HML-1 in SF lymphocytes of patients with
      RA, preferentially in the CD8 subset. These results suggest a similarity between
      the expression of activation antigens in SF lymphocytes of patients with RA and T
      lymphocytes present in the intestinal epithelium.

PMID- 7799336
TI  - Phenotypic characteristics of bone marrow cells in patients with rheumatoid
      arthritis.
AB  - OBJECTIVE: Our previous study showed the presence of abnormal myeloid lineage
      cells in the epiphyseal bone marrow adjacent to joints affected with severe
      rheumatoid arthritis (RA). Now, we investigated whether there were any changes of
      other marrow cell populations related to RA, and whether there were any
      pathologically characteristic changes in the iliac bone marrow, which is one of
      the major systemic hematopoietic organs. METHODS: 2-Color flow cytometry was
      carried out to analyze the phenotypes of mononuclear cells (MNC) fractions in
      bone marrow aspirates and venous blood from 56 patients with RA and 7 non-RA
      controls. RESULTS: The absolute number of MNC in the iliac bone marrow was
      increased by 3-fold in the RA patients compared with the non-RA controls. In
      contrast, no significant increase of MNC was observed in the tibial epiphyseal
      bone marrow or peripheral blood. The ratio of each MNC fraction in the iliac bone
      marrow did not differ significantly between the RA patients and the non-RA
      controls. In lymphocyte subsets, the percentage of HLA-DR+CD8+ cells to all CD8
      cells in the iliac bone marrow increased significantly in the RA patients
      compared with the non-RA controls. Abnormal myeloid cells (MX-GA+MY4+ cells),
      specific to severe RA, were found to be more concentrated in the iliac bone
      marrow than in the tibial epiphyseal bone marrow. CONCLUSION: Characteristic
      pathologic changes of the iliac bone marrow suggest an important role of systemic
      bone marrow in the progression of RA.

PMID- 7799337
TI  - In vivo analysis of disease modifying drug therapy activity in rheumatoid
      arthritis by sequential immunohistological analysis of synovial membrane
      interleukin 1 beta.
AB  - OBJECTIVE: To assess sequential changes of synovial membrane interleukin 1 beta
      (IL-1 beta) in patients with rheumatoid arthritis receiving chrysotherapy and
      glucocorticoids. METHODS: Sequential synovial biopsies taken before and after 2
      and 12 weeks of treatment were analyzed by immunohistological techniques.
      RESULTS: Significant decreases in IL-1 beta staining occurred in biopsies taken
      after 12 weeks' chrysotherapy, while mononuclear cell numbers were unchanged.
      Results were similar in patients receiving glucocorticoid and gold, and in those
      receiving gold alone. CONCLUSION: These data suggest that chrysotherapy reduces
      IL-1 beta production in vivo, a property that has been shown in vitro, and that
      this change precedes changes in synovial membrane mononuclear cell numbers.

PMID- 7799339
TI  - Progression of erosion and joint space narrowing scores in rheumatoid arthritis
      assessed by nonlinear models.
AB  - OBJECTIVE: To determine whether the first order kinetics model or the function
      proportional to the square root of disease duration better represents the
      progression of radiographic damage according to the disease duration than a
      linear model in rheumatoid patients. METHODS: Two hundred twenty-eight patients
      assessed at a single time point were studied by using 2 nonlinear models of
      radiographic damage. In 44 patients a second radiographic analysis was taken
      within a 3-year period. RESULTS: In this data set, both models reveal the highest
      rate of progression in the first 3 years of the disease. The square root of the
      disease duration seems to better depict the whole disease course. CONCLUSION:
      Nonlinear models should be compulsory in the assessment of radiographic damage,
      especially when slow acting antirheumatic drug effects after 5 years of disease
      duration are studied.

PMID- 7799338
TI  - The severity of rheumatoid arthritis: a 6-year followup study of younger women
      with symptoms of recent onset.
AB  - OBJECTIVE: In rheumatoid arthritis (RA), not only outcome measurements taken at a
      single point in time, but also the severity during the entire disease period is
      important. In this investigation we measured severity in terms of the course of
      disease activity. It is the activity of the disease which leads to most suffering
      in the patient, and which we try to alleviate. METHODS: Patterns of disease
      activity were investigated in 132 female patients who were followed yearly from
      an early phase of the disease for a mean duration of 6 years. RESULTS: Sixty
      seven patients (50.8%) continuously had < or = 4 swollen joints (low activity),
      23 patients (17.4%) continuously had > or = 4 swollen joints (high activity), in
      10 patients (7.6%) disease activity decreased from high to low, in 8 patients
      (6.1%) disease activity increased from low to high, and 24 patients (18.2%) had
      fluctuating levels of disease activity. The outcome of the disease as measured by
      the functional ability, the radiological abnormalities, and number of prescribed
      2nd line drugs, was best in patients with continuously low levels of disease
      activity, and worst in patients with continuously high or increasing levels of
      disease activity. CONCLUSION: For about half of the female patients presenting to
      a rheumatology outpatient clinic, the severity of RA after 6 years of disease
      duration is characterized by continuous but low disease activity, and sufficient
      preservation of functional ability. For the other half of the patients RA is a
      progressive and disabling disease.

PMID- 7799340
TI  - Cyclosporine in common clinical practice: an estimation of the benefit/risk ratio
      in patients with rheumatoid arthritis.
AB  - OBJECTIVE: To investigate in common clinical practice the toxicity/efficacy ratio
      of low dose cyclosporine A (CsA) in patients with advanced rheumatoid arthritis
      (RA) after 12 months CsA administration. METHODS: One hundred and two patients
      with RA were included in the study. The initial dose of CsA was 2.5 mg/kg/day,
      the mean maximum dose was 3.2 mg/kg/day and the dose at 12 months was 2.8
      mg/kg/day. RESULTS: Sixty-nine (68%) patients completed 12 months of treatment.
      Seventeen (17%) patients discontinued for lack of efficacy and 16 (16%) for
      toxicity (of which 50% for gastrointestinal intolerance). The clinical efficacy
      variables improved significantly by 36-42% between entry and Month 6 and remained
      stable thereafter. The C-reactive protein decreased from 43 U/ml at entry to 22
      U/ml (p < 0.0001) at 12 months. Forty-four percent of the patients and 47% of the
      physicians judged the efficacy as good or very good. The median number of adverse
      events/patient was 3 but most adverse events were either not clinically important
      or disappeared after dose reduction. Gastrointestinal (GI) intolerance and
      nephrotoxicity (> 30% increase in serum creatinine) each occurred in 50% of the
      patients. GI intolerance was transient in 80% of the patients but accounted for
      50% of the premature discontinuations for toxicity. Nephrotoxicity persisted in
      the 50% of the patients in whom it occurred, despite dose reduction. The mean
      serum creatinine rose from 70 (13) mumol/l at entry to 86 (23) mumol/l at 12
      months (23% increase; p < 0.0001), and this increase had been entirely reached
      after 3 months. Variables that could significantly predict the occurrence of
      nephrotoxicity could not be identified. CONCLUSION: CsA can be safely and
      effectively administered to patients with RA for a duration of at least 12
      months. An acceptable renal function at entry, close monitoring of the serum
      creatinine concentration and dose reductions when appropriate are prerequisities.

PMID- 7799341
TI  - Intermittent treatment with D-penicillamine is effective in lower doses and with
      fewer adverse effects in patients with rheumatoid arthritis.
AB  - OBJECTIVE: To determine whether intermittent rather than daily administration of
      D-penicillamine (D-Pen) would effectively reduce the incidence of adverse effects
      without significantly diminishing the clinical benefits. METHODS: We conducted an
      open prospective trial comparing daily and intermittent schedules. Among 76
      Japanese patients with rheumatoid arthritis (RA), 37 underwent daily treatment
      with D-Pen while 39 were given D-Pen intermittently (every Monday, Wednesday, and
      Friday). RESULTS: The mean D-Pen dose was 166.8 and 99.4 mg/day for daily and
      intermittent groups, respectively, the difference being highly significant (p <
      0.0001, Mann-Whitney's U test). The incidence of adverse effects was
      significantly lower in the intermittent group. Both schedules significantly
      reduced the activity of RA, as evaluated by clinical and laboratory variables. No
      significant differences were observed in the degree of improvement between the 2
      schedules. CONCLUSION: Intermittent therapy with D-Pen is an effective treatment
      for patients with RA and its higher degree of flexibility can lead to maximum
      efficacy for management of patients with RA.

PMID- 7799342
TI  - Ultrasound evaluation of painful rheumatoid shoulders.
AB  - OBJECTIVE: To provide more information about various types of rheumatoid
      involvement of the painful shoulder by ultrasonography (US). METHODS: US
      examinations were performed in 44 patients (88 shoulders) with rheumatoid
      arthritis (RA). The technique of shoulder ultrasonography was standardized in
      studies of 30 healthy volunteers (60 shoulders) without shoulder complaints. US
      findings were compared with clinical, laboratory and radiographic data to find
      any relationship. RESULTS: Sonography could reveal inflammatory conditions at
      early stages of RA when no radiographic changes were seen. The most common US
      finding was subacromial-subdeltoid bursitis in 61 shoulders (69%) of 35 patients.
      Synovitis in the glenohumeral joint was seen in 51 shoulders (58%) of 32
      patients, biceps tendinitis in 50 shoulders (57%) of 29 patients and changes in
      the supraspinatus tendon in 29 shoulders (33%) of 20 patients. There were
      multiple rheumatoid symptoms in 61 shoulders (69%), one condition resulted in
      changes in 17 shoulders (19%) and no visible US findings in 10 shoulders (11%).
      Clinical findings were rather unspecific. Flexion, abduction and outward rotation
      were often restricted in shoulder symptoms, whereas inward rotation was rarely
      limited. Shoulder swelling indicated subacromial-subdeltoid bursitis. CONCLUSION:
      Ultrasonography is a very useful method for rheumatologists and orthopedists to
      see inside joints. It can provide remarkable help for local injection therapy and
      for planning surgery because of its suitability for evaluation of the extent of
      rheumatoid disease.

PMID- 7799344
TI  - T cell receptor V alpha repertoire of infiltrating T cells in labial salivary
      glands from patients with Sjogren's syndrome.
AB  - OBJECTIVE: To analyze the T cell receptor (TCR) V alpha repertoire of
      infiltrating T cells in labial salivary glands of patients with Sjogren's
      syndrome (SS). METHODS: TCR V alpha genes of infiltrating T cells in lips from 2
      patients with SS were examined, using the double step inverse polymerase chain
      reaction. Four and 7 clones encoding the VJC alpha region were established and
      sequenced, respectively. RESULTS: All 4 clones used the V alpha 17.1 gene in one
      patient, while 3 (42.8%) of 7 clones from the other patient used the V alpha 2
      family gene (V alpha 2.1, V alpha 2.2, V alpha 2.4), and the other 3 clones used
      the V alpha 11.1 family gene. A comparison using labial salivary glands and
      peripheral blood showed that the predominant expression of V alpha 2, V alpha
      11.1, and V alpha 17.1 gene segments is specific in the salivary glands.
      CONCLUSION: The TCR V alpha repertoire of infiltrating T cells from the lips of 2
      patients with SS was relatively restricted in individual patients, thereby
      suggesting the limited heterogeneity of these cells in salivary glands.

PMID- 7799343
TI  - Rheumatic manifestations in patients with myelodysplastic and myeloproliferative
      diseases.
AB  - OBJECTIVE: To evaluate the rheumatic complications in patients with
      myelodysplastic and myeloproliferative diseases. METHODS: A retrospective chart
      review of patients with a rheumatic disease and either a myelodysplastic or
      myeloproliferative disorder diagnosed on bone marrow examination. RESULTS: Nine
      patients were identified, 5 with myelodysplastic and 4 with myeloproliferative
      disorders. Polyarthritis was the most common rheumatic presentation, occurring in
      6 patients with a positive rheumatoid factor in 4. Necrotizing vasculitis
      complicated the course in 3 patients. Autoantibodies and hypergammaglobulinemia
      were present in the majority of patients. CONCLUSION: There is an association
      between hematologic disorders caused by proliferation of bone marrow derived
      pluripotent stem cells and rheumatic disorders.

PMID- 7799345
TI  - The prevalence of Sjogren's syndrome in Behcet's syndrome.
AB  - OBJECTIVE: The role of autoimmune mechanisms in Behcet's syndrome (BS) is
      debated. Sjogren's syndrome (SS) accompanies most autoimmune diseases. Thus we
      investigated the prevalence of SS in BS in a formal protocol. METHODS: The study
      was conducted in 2 phases. During the first phase subjective symptoms of dryness
      were blindly assessed by questionnaires and Schirmer I and Saxon tests were done
      in 67 patients with BS and 100 healthy and diseased controls. During the 2nd
      phase 30 patients with BS and 19 with rheumatoid arthritis (RA) had salivary
      gland biopsies along with rose bengal dye, Schirmer I and tear breakup time
      tests. RESULTS: During the first phase only patients with primary SS had
      significantly abnormal findings. However during the 2nd phase pathologic changes
      in salivary gland biopsies and positive RB tests were highly significantly more
      prevalent among patients with RA. CONCLUSION: SS is not a feature of BS.

PMID- 7799346
TI  - Systemic disease in subacute cutaneous lupus erythematosus: a controlled
      comparison with systemic lupus erythematosus.
AB  - OBJECTIVE: We sought to compare the prevalence of systemic disease in subacute
      cutaneous lupus erythematosus (SCLE) with systemic lupus erythematosus (SLE).
      METHODS: Clinical and laboratory features of 14 patients with SCLE were compared
      with 22 age and sex matched controls with SLE. RESULTS: Manifestations other than
      arthritis and skin disease were present in 11/14 (79%) SCLE cases compared with
      19/22 (82%) SLE cases. Severe systemic disease occurred in one-half of patients
      with SCLE (5/7 men, 1/7 women), and most had the papulosquamous pattern.
      CONCLUSION: Systemic manifestations may be as varied in SCLE as in SLE, and
      severe disease is not unusual. In particular, men with papulosquamous SCLE may be
      at higher risk for severe extracutaneous disease.

PMID- 7799347
TI  - Antineutrophil cytoplasmic antibodies in systemic lupus erythematosus.
AB  - OBJECTIVE: To evaluate the prevalence of cytoplasmic (c) and peripheral (p)
      antineutrophil cytoplasmic antibodies (ANCA) using the indirect
      immunofluorescence (IIF) slide kit (INOVA) in patients with systemic lupus
      erythematosus (SLE) to correlate the presence of ANCA with disease activity and
      to determine if ANCA is associated with specific clinical manifestations.
      METHODS: One hundred and fourteen consecutive patients with SLE seen at The
      Wellesley Hospital Lupus Clinic, Toronto, Ontario in May and June, 1992 were
      assessed clinically, and blood drawn for routine serology and ANCA. Disease
      activity was measured using the SLE Disease Activity Index (SLEDAI). ANCA was
      measured by IIF. RESULTS: Of the 114 patients, 12 (10.5%) had c-ANCA and 29
      patients (25.4%) had p-ANCA. The titers of ANCA varied from 1:20 to 1:160. SLEDAI
      was 0 in 6 patients (5%), and 108 patients had some disease activity. Eighty
      eight patients (77%) had mild to moderate active disease (SLEDAI < 10), and 20
      (18%) patients had severe active disease (SLEDAI > or = 10). CONCLUSION: No
      correlation was found between the presence of ANCA and SLEDAI either when
      analyzed as active-inactive (p = 0.75) or when correlated with degrees of disease
      activity (1-10: > 10) (p = 0.77). No correlation was found between p and c ANCA
      and the presence of vasculitis, renal, or CNS disease at the time of the
      assessment or at any time during the course of the disease. Thus ANCA was not
      associated with SLE disease activity or the presence of vasculitis in SLE.

PMID- 7799349
TI  - Association of antimitochondrial antibodies type 5 and anti-beta 2 glycoprotein I
      antibodies in the antiphospholipid syndrome.
AB  - OBJECTIVE: To evaluate if antimitochondrial type 5 antibodies (AMA5) might be
      included among antiphospholipid syndrome (APS) markers. METHODS: In a
      retrospective study, blood variables of 48 patients with AMA5 were analyzed in
      relationship with clinical and biological markers of APS and systemic lupus
      erythematosus (SLE). RESULTS: We observed a high prevalence of false biological
      test for syphilis (95%), lupus anticoagulant (LAC) (71%), anticardiolipin
      antibodies (aCL) of IgG (71%) and IgM (75%) isotype, positive direct Coombs' test
      (54%), thrombocytopenia (52%), anti-B2 glycoprotein I antibodies (38%). Twenty
      nine patients (61%) had at least one clinical manifestation of APS; 42% had
      recurrent arterial and/or venous deep thrombosis and 21% had recurrent fetal
      loss. But, for 2 patients, AMA5 were the sole detected immunological marker.
      Moreover, SLE was observed in 35% of the patients. These were different from 100
      control patients with SLE with the respect to skin involvement and dsDNA
      antibodies which were less frequent (p < 0.01) and aCL, LAC, false biological
      test for syphilis (p < 0.001), positive direct Coombs' test and thrombocytopenia
      (p < 0.05) which were more frequent. CONCLUSION: Our data suggests (1) AMA5 is
      another marker of the APS (2) in patients with SLE, AMA5 seems to be a marker of
      a subset of SLE. This appears to justify the routine detection of these
      antibodies.

PMID- 7799348
TI  - A 2 year, open ended trial of methotrexate in systemic lupus erythematosus.
AB  - OBJECTIVE: To investigate a possible role for methotrexate (MTX) in the treatment
      of patients with systemic lupus erythematosus (SLE) who require unacceptably high
      doses of glucocorticosteroids (GCS) for control of their disease. METHODS: Twelve
      patients with SLE participated in this open ended prospective study. Patients
      with active renal or central nervous system (CNS) disease were excluded as were
      patients with liver disease. Serological variables, SLE disease activity index,
      joint count, and prednisone dose were serially evaluated. Data were analyzed
      using paired t test and contingency table analysis. RESULTS: Arthritis was the
      major persistent problem in 7 patients: 1 patient had recurrent
      pleuropericarditis, 2 patients had refractory cutaneous lupus rashes and 2 had
      vasculitis. Three patients discontinued MTX because of side effects. The
      remaining 9 patients have been treated from 7-26 months. In 6 patients the GCS
      dose was reduced by an average of 42%. In 1 patient symptoms subsided and joint
      count was reduced without change in the GCS dose. GCS dosage was increased in 2
      patients: 1 with recurrent serositis, 1 with persistent vasculitis. No apparent
      effect on anti-dsDNA antibodies, complement or erythrocyte sedimentation rate
      (ESR) was noted. CONCLUSION: MTX appears to be useful in selected patients with
      SLE, especially those with persistent synovitis.

PMID- 7799350
TI  - Beta 2 glycoprotein I and placental anticoagulant protein I in placentae from
      patients with antiphospholipid syndrome.
AB  - OBJECTIVE: To investigate the immunohistological distribution of beta 2
      glycoprotein I (beta 2 GPI) and placental anticoagulant protein I (PAP-I) in
      normal and pathological placentae of patients with antiphospholipid (aPL)
      antibody associated recurrent fetal loss. These proteins are 2 natural
      anticoagulants able to interfere with aPL antibody binding. METHODS: Placentae
      from 4 patients with primary antiphospholipid antibody syndrome (pAPS), from 2
      patients with aPL negative systemic lupus erythematosus (SLE) and from 7 healthy
      women were studied. Cryostatic placental sections were tested by indirect
      immunofluorescence using polyclonal anti-PAP-I and anti-beta 2GPI antisera as
      well as purified IgG and anti-beta 2GPI monoclonal antibody. The same tissue
      sections were also tested by direct immunofluorescence with FITC-F(ab)2 goat
      antihuman IgG. RESULTS: We found that (a) the placental distribution of PAP-I was
      comparable in normal and pathological specimens; (b) on the contrary, increased
      beta 2GPI deposition was present on the trophoblast surfaces of placentae
      obtained from patients with persistent raised titers of aPL antibodies.
      Comparable IgG deposition on villi surface was also found in aPL positive but not
      in control placentae. CONCLUSION: Our data are consistent with the hypothesis
      that high titer aPL binds to a beta 2GPI phospholipid complex in placentae of
      women with recurrent fetal loss but that a quantitative deficiency of PAP-I does
      not play a pathogenetic role in aPL associated fetal loss.

PMID- 7799351
TI  - Defining spinal mobility in ankylosing spondylitis (AS). The Bath AS Metrology
      Index.
AB  - OBJECTIVE: To determine the most appropriate clinical measurements for the
      assessment of ankylosing spondylitis (AS) to develop the new metrology index.
      METHODS: One hundred and ninety-three individuals with AS were studied. The
      patients reflected the entire spectrum of cases of AS. Metrology was performed on
      327 occasions. First the metrology (20 measurements) of 43 patients was analyzed.
      From this, 5 simple clinical measurements were defined which most accurately
      reflect axial status: cervical rotation, tragus to wall distance, lateral
      flexion, modified Schober's, and intermalleolar distance. These measurements were
      assessed for reliability, speed and both inter and intraobserver variability in
      another 40 patients. RESULTS: Analysis of the first group of 43 patients and a
      subsequent group of 54 patients, using the 5 measurements that constitute this
      new Bath AS Metrology Index (BASMI), demonstrated that they accurately and
      reliably mirror the 20 clinical measurements assessed previously (r = 0.92, p <
      0.001). In a new group of 40 patients the measurements were demonstrated to be
      accurate and reproducible for both intraobserver variability (r = 0.99, p <
      0.001) and interobserver variability (r = 0.97, p < 0.001). In a further 56
      patients, admitted for inpatient therapy, an improvement in the BASMI from 3.34
      (SD 2.71) to 2.16 (SD 2.42) was noted over a period of 3 weeks (regardless of
      disease severity) which indicates a sensitivity to change (chi 2 = 6.55, p <
      0.01). The mean improvement over baseline was about 30%. CONCLUSION: Five
      clinical measurements provide a composite index (BASMI) and define disease status
      in AS. The BASMI is quick (7 min), reproducible and sensitive to change across
      the disease spectrum.

PMID- 7799352
TI  - Olsalazine in ankylosing spondylitis: a pilot study.
AB  - OBJECTIVE: To test the safety and efficacy of olsalazine in men with ankylosing
      spondylitis (AS) unresponsive to nonsteroidal antiinflammatory drugs and
      physiotherapy. METHODS: Four patients, including 2 who had not responded to
      sulfasalazine (SASP) and one who did not tolerate SASP, were treated with
      olsalazine, up to 3 g/dl for 24 weeks. RESULTS: One patient discontinued
      olsalazine due to diarrhea at 1 g/day. The other 3 experienced improvement in
      global spine self assessment by visual analog scale (VAS), 2 of 3 patients,
      spinal pain (VAS, 3 of 3), night pain (3 of 3), tender joint count (3 of 3) and
      enthesis score (3 of 3). Changes in Schober's test and chest expansion were
      minor. Erythrocyte sedimentation rate and C-reactive protein were normal. Loose
      stools were the only adverse effects observed. CONCLUSION: Olsalazine appears to
      be well tolerated and effective in men with AS. Further study of olsalazine and
      direct comparison with SASP in this population may illuminate mechanisms of drug
      action and add a new therapeutic option.

PMID- 7799354
TI  - Protracted febrile myalgia in patients with familial Mediterranean fever.
AB  - OBJECTIVE: We describe a newly defined syndrome of protracted febrile myalgia in
      patients with familial Mediterranean fever (FMF). METHODS: Fourteen patients with
      FMF were admitted with an attack of severe disabling myalgia accompanied by
      fever, high erythrocyte sedimentation rate, and hyperglobulinemia, lasting up to
      6 weeks. RESULTS: Unlike in the classical manifestations of FMF response to
      corticosteroids therapy was prompt. CONCLUSION: Protracted febrile myalgia is an
      uncommon dramatic manifestation of FMF that may occur despite colchicine therapy
      and requires treatment with corticosteroids.

PMID- 7799353
TI  - The specific antibacterial proliferation of reactive arthritis synovial T cells
      is not due to their higher proportion of CD45RO+ cells compared to peripheral
      blood.
AB  - OBJECTIVE: To determine the role of synovial fluid (SF) compared to peripheral
      blood (PB) CD45RO+ T cells in patients with reactive arthritis (ReA) and
      undifferentiated oligoarthritis. METHODS: We examined SF and PB of 8 patients
      with a specific lymphocyte proliferation to Yersinia enterocolitica (n = 5) and
      Chlamydia trachomatis (n = 3). After depletion of the CD45RA+ T cell subset by
      dynabeads, the remaining T cells (> 95% CD45RO+) from PB and SF of these patients
      were again stimulated with these bacterial antigens. RESULTS: The mean
      stimulation index (SI) of these 8 patients with ReA (n = 5) and undifferentiated
      oligoarthritis (n = 3) was 30.3 +/- 21.86 in SF compared to 1.36 +/- 0.75 in PB.
      The enrichment of CD45RO+ cells influenced the antigen specific proliferative
      response of T cells neither in PB (SI = 1.75 +/- 1.35) nor in SF (26.1 +/-
      24.05); the initial difference remained unchanged. CONCLUSION: Our findings
      suggest that the antigen specific lymphocyte proliferation obtained with SF cells
      is not due to abundance of nonspecific CD45RO+ T cells but can rather be taken as
      an indication of specific recognition of local bacterial antigens in ReA.

PMID- 7799355
TI  - Tumor necrosis factor-alpha receptor expression on chondrocytes isolated from
      human articular cartilage.
AB  - OBJECTIVE: To determine whether the previously observed enhanced susceptibility
      of osteoarthritic (OA) cartilage to tumor necrosis factor-alpha (TNF-alpha)
      induced degradation could be due to differences in receptor expression. METHODS:
      Using specific monoclonal antibodies flow cytometry was used to identify and
      quantify 2 TNF-alpha receptors on the surface of chondrocytes isolated from human
      articular cartilage. RESULTS: The proportion of chondrocytes expressing p55 TNF
      alpha receptor was significantly higher in populations from OA cartilage (p <
      0.01) when compared with similar populations from non-arthritic cartilage. The
      number of p55 receptors/chondrocyte was also significantly higher (p < 0.01) in
      OA. A significant correlation (r = 0.72, p < 0.18) was found in OA between the
      numbers of chondrocytes expressing p75 receptor and the number of
      receptors/chondrocyte. CONCLUSION: p55 TNF-alpha receptor expression is
      significantly increased on OA chondrocytes ex vivo. Enhanced expression of p55,
      purported to be the biologically active receptor, could contribute to OA
      cartilage degradation.

PMID- 7799356
TI  - Induction of increased levels of proteoglycan fragments in synovial fluid (SF)
      and increased levels of stromelysin in cartilage, synovium and SF by
      intraarticular injection of canine monocyte conditioned medium into dogs.
AB  - OBJECTIVE: To study the effects of the intraarticular injection of canine
      monocyte conditioned medium (cMCM) into dogs on proteoglycan fragment and
      stromelysin levels in the joint. METHODS: cMCM was injected intraarticularly into
      dogs, and the levels of proteoglycan fragments in synovial fluid (SF) as well as
      stromelysin levels in cartilage, synovium, and SF were assessed after 12 h.
      RESULTS: There was a 4-fold increase of proteoglycan fragment levels and a 6-fold
      increase in stromelysin levels in SF, and a 4.4-fold increase in stromelysin
      levels in cartilage extracts. Elevated mRNA levels were detected in both synovium
      and cartilage. By immunofluorescence staining, stromelysin was localized in
      chondrocytes throughout the cartilage and in synovial cells. CONCLUSION:
      Intraarticular injection of cMCM stimulated the expression of stromelysin mRNA
      and protein in cartilage and synovium and caused marked increases in stromelysin
      protein and proteoglycan fragment levels in SF.

PMID- 7799357
TI  - Growth promoting peptides in osteoarthritis and diffuse idiopathic skeletal
      hyperostosis--insulin, insulin-like growth factor-I, growth hormone.
AB  - OBJECTIVE: To investigate growth factors influencing bone and cartilage in
      patients with diffuse idiopathic skeletal hyperostosis (DISH). METHODS: Standard
      radioimmunoassays (INCSTAR, Stillwater, MN) quantified serum levels of insulin,
      insulin-like growth factor-I (IGF-I) and growth hormone (GH) in patients with
      DISH, in patients with osteoarthritis (OA) and in controls. Patients with DISH
      with comorbidity with obesity, hypertension, diabetes and coronary artery
      disease, also were studied. RESULTS: Patients with DISH demonstrated normal IGF-I
      levels; patients with OA had reduced IGF-I levels. Subjects with DISH or OA had
      elevated insulin and GH values. Patients with DISH with comorbidity had changes
      in growth factors similar to those found in patients with DISH only. There is
      frequent association of DISH with obesity, hypertension, coronary artery disease
      and diabetes mellitus suggesting that these associations are not random.
      CONCLUSION: Specific associations of skeletal abnormalities with clinical
      features in which skeletal change and clinical features combine with disturbances
      of insulin, IGF-I and GH exist in DISH that are distinct from OA. DISH is
      considered a multisystemic hormonal disorder with protean presentations.

PMID- 7799358
TI  - Repair characteristics of the articular cartilage surface following acute
      inflammatory arthritis.
AB  - OBJECTIVE: To investigate the repair characteristics of the surface protein in an
      acute arthritis of short duration. METHODS: Knee arthritis in rabbits was induced
      by intraarticular (ia) injection of 20 micrograms E. coli endotoxin into one knee
      of 12 rabbits. The contralateral knee served as control. Four animals were killed
      3, 6, and 10 days after ia injection. The articular cartilage surface was probed
      by quantitation of anticollagen type II (anti-CII) antibody binding. The
      suprapatellar bursae were washed, and the recovered cells counted. RESULTS: A
      significant increase in anti-CII antibody binding compared to control was
      measured 3 days after ia injection, coinciding with evidence of acute arthritis
      (injected joint: 1.1 x 10(7), control: 4.2 x 10(4) cells/joint; percent increase
      in anti-CII binding: 36.7 +/- 10.7; p < 0.02). Six days after ia injection, the
      acute arthritis showed a major decrease in intensity whereas anti-CII binding was
      still abnormal (injected joint: 1.7 x 10(6) cells/joint; percent increase in anti
      CII binding: 24.7 +/- 19.6; p < 0.05). On Day 10, there was minimal evidence of
      arthritis in 3 of 4 rabbits, and anti-CII antibody binding returned to normal
      (injected joint: 1.9 x 10(5) cells/joint; percent anti-CII binding: -5.8 +/-
      3.9). There was a strong positive correlation between individual synovial fluid
      cell counts and the percent increase in anti-CII binding (R = 0.72, p < 0.02).
      CONCLUSION: The magnitude of binding of anti-CII antibodies to the articular
      cartilage surface constitutes a sensitive probe for the detection of early damage
      following a transient inflammatory insult. Our studies indicate that after acute
      injury, the cartilage surface may show evidence of damage for at least 6 days
      when probed with anti-CII antibodies.

PMID- 7799359
TI  - Quantitative microfocal radiographic assessment of osteoarthritis of the knee
      from weight bearing tunnel and semiflexed standing views.
AB  - OBJECTIVE: Joint space width (JSW) in osteoarthritis (OA) knee radiography is
      reported to be optimally assessed from semiflexed standing and tunnel views
      although no detailed assessment of tunnel view radiography of OA knees has been
      done. The primary objective of our study was to determine the incidence of joint
      space narrowing (JSN) in semiflexed standing vs weight bearing tunnel views. The
      data were also analyzed to examined the degree and relationship of JSN and bony
      features of OA in the 2 views. METHODS: Ninety OA knees had macroradiographs at 5
      times magnification taken in weight bearing standing semiflexed and weight
      bearing tunnel views. JSW and OA related bony features were measured and compared
      with reference values obtained from the knees of 14 healthy volunteers without
      arthritis. RESULTS: Comparison of JSW between the 2 radiographic views identified
      3 locations of cartilage loss: JSN recorded in the tunnel only (22%), that in
      standing view only (8%), and that in both the views (30%). Subchondral sclerosis
      and osteophytes were significantly larger in 40% of OA knees despite a normal
      JSW. The tunnel view also enabled better visualization and measurement of
      osteophytes. CONCLUSION: Standing semiflexed view radiography alone failed to
      detect JSN in 22% of OA knees. Combined standing and tunnel radiographic views
      detected JSN more frequently than either view alone. Bony changes were
      radiographically evident without the presence of JSN indicative of cartilage
      thinning in as many as 40% of the patients with OA studied.

PMID- 7799360
TI  - Subclinical renal toxicity in rheumatic patients receiving longterm treatment
      with nonsteroidal antiinflammatory drugs.
AB  - OBJECTIVE: To study the possible renal toxicity of longterm treatment with
      nonsteroidal antiinflammatory drugs (NSAID), in a population of patients with
      rheumatic diseases. METHODS: Comparative study of 104 patients treated for more
      than 2 years with NSAID and 123 healthy controls, nonusers of these drugs. After
      fasting during 12 h the following tests were performed in both groups:
      urinalysis, creatinine clearance, osmolar clearance, negative free water
      clearance, and urinary excretion of sodium. RESULTS: In the patient group the
      urinary pH was higher than in the controls (5.9 +/- 0.7 versus 5.2 +/- 0.6 p <
      0.05) and in addition, they had an impaired renal concentration capacity, as it
      is shown by a significant decreased urinary density (1018.6 +/- 4.7 vs 1026.3 +/-
      5.4 in the controls p < 0.05), a decreased urinary osmolality (502.1 +/- 150.7 vs
      661.6 +/- 157.6 mOsm/ml p < 0.001), a lower osmolar clearance (1.26 +/- 0.25
      ml/min vs 1.83 +/- 0.4 ml/min p < 0.001) and an increased free water clearance (
      0.21 +/- 0.40 ml/min vs -0.98 +/- 0.41 ml/min, p < 0.001). This renal impairment
      was related to the cumulative intake of NSAID: CONCLUSION: The longterm treatment
      with NSAID is able to produce a subclinical renal dysfunction, consistent with
      the early stages of analgesic nephropathy.

PMID- 7799362
TI  - The challenge of sensorineural hearing loss in rheumatoid arthritis.
AB  - Patients with rheumatoid arthritis are exposed to a variety of pharmacologic
      agents capable of causing sensorineural hearing loss. We describe such a patient
      who was eventually found to have an acoustic neuroma. The case illustrates the
      difficulty of diagnosing acoustic neuroma and the need for a high index of
      suspicion when unilateral hearing loss is detected. The evaluation of patients
      with sensorineural hearing loss is discussed.

PMID- 7799361
TI  - The reduced expression of glucocorticoid receptors in synovial cells induced by
      nonsteroidal antiinflammatory drugs can be reversed by prostaglandin E1 analog.
AB  - OBJECTIVE: We examined the effect of 3 commonly used nonsteroidal
      antiinflammatory drugs (NSAID), indomethacin, naproxen and tiaprofenic acid, and
      a prostaglandin E1 analog, misoprostol, on the glucocorticoid receptor level in
      synovial fibroblasts. METHODS: Synovial fibroblasts were isolated by enzymatic
      digestion from human normal synovial membranes. These cells were incubated with
      therapeutic and pharmacological concentrations of NSAID in the presence or
      absence of misoprostol (0.1-100 ng/ml). The glucocorticoid receptor (GR) level
      was measured by binding assay using 3H-dexamethasone. RESULTS: Naproxen and
      indomethacin but not tiaprofenic acid, at therapeutic concentrations,
      significantly reduced the level of GR in synovial cells. This effect was reversed
      with the addition of misoprostol. CONCLUSION: Our findings bring insight into the
      differential effects of NSAID on the GR system and may provide an explanation for
      the reduced level of GR found in OA chondrocytes. The possible interference with
      the action of therapeutically administered corticosteroids is discussed.

PMID- 7799363
TI  - Systemic lupus erythematosus presenting with diffuse low density lesions in the
      cerebral white matter on computed axial tomography scans: its implication in the
      pathogenesis of diffuse central nervous system lupus.
AB  - We describe a patient with systemic lupus erythematosus (SLE) with severe organic
      brain syndrome, who showed diffuse low density areas in the cerebral white matter
      on computed axial tomography (CAT) scans. A 43-year-old woman with SLE showed
      disturbances in various intellectual functions, followed by the development of
      consciousness disturbances and urinary incontinence. CAT scans, single photon
      emission computed tomography (SPECT) and cerebrospinal fluid (CSF) interleukin 6
      (IL-6) were serially examined during the clinical course before and after
      treatment with high doses of prednisolone. CSF IL-6 activity paralleled the
      central nervous system (CNS) disease activity most consistently. By contrast, the
      diffuse low density areas in cerebral white matter on CAT scans as well as the
      decreased blood flow in the cerebral cortices on SPECT persisted long after the
      improvement of the CNS manifestations. Magnetic resonance imaging (MRI) scans
      also revealed the diffuse areas of increased signal intensity in the subcortical
      white matter on T2 weighted images. The diffuse lesions in the cerebral white
      matter are considered to reflect the edema as well as other irreversible changes
      that have resulted from the disturbed cerebral circulation presumably due to the
      diffuse microangiopathies in the cerebral cortices and not to be necessarily
      correlated with the CNS disease activities. Moreover, it is suggested that the
      inflammatory process evidenced by the elevation of CSF cytokines in addition to
      the disturbed circulation in the cerebral cortices might play an important role
      in the pathogenesis of CNS lupus in our patient.

PMID- 7799364
TI  - Combined effects of diltiazem and oxygen in pulmonary hypertension of mixed
      connective tissue disease.
AB  - A 45-year-old woman with pulmonary hypertension and mixed connective tissue
      disease (MCTD) underwent right heart catheterization to evaluate the effects of
      vasodilators. Nasal oxygen at 2 l/min in addition to 300 mg diltiazem improved
      pulmonary hemodynamics without adverse effects. After 1 year of diltiazem and
      home oxygen, sustained favorable hemodynamic effects were obtained, which were
      more marked than the acute effects. We conclude that this combination may be a
      potent treatment for pulmonary hypertension in patients with MCTD.

PMID- 7799365
TI  - Oral metronidazole, an effective treatment for Sweet's syndrome in a patient with
      associated inflammatory bowel disease.
AB  - A 39-year-old woman with chronic, recurrent Sweet's syndrome (acute febrile
      neutrophilic dermatosis) and possible Crohn's disease was successfully treated
      with oral metronidazole. After 4 years of recurrent skin lesions which involved
      the hands and face, our patient developed genital and perianal ulcerations which
      were also histopathologically characterized by a neutrophilic infiltrate. In
      addition, she had a nondeforming polyarthritis that accompanied recurrences of
      her skin lesions. The patient was given oral metronidazole, an agent frequently
      used for perianal Crohn's disease, and achieved complete resolution of the
      perianal and perineal ulcers, the cutaneous lesions of Sweet's syndrome and the
      associated polyarthritis.

PMID- 7799366
TI  - Osteomyelitis subsequent to abdominal-vaginal sacropexy.
AB  - Vertebral osteomyelitis is an uncommon complication of abdominal-vaginal
      sacropexy. Our patient developed polymicrobial osteomyelitis postoperatively,
      with the suspected route of infection attributed to contiguous spread from an
      infected mesh.

PMID- 7799367
TI  - Arthritis in a patient with psoriasis after interferon-alpha therapy for chronic
      hepatitis C.
AB  - A 27-year-old man with psoriasis was administered with leukocyte derived
      interferon-alpha for the treatment of chronic persistent hepatitis C. After 3
      weeks of injections and eventual normalization of serum levels of alanine
      aminotransferase, he began to experience polyarthritis, with worsening of
      psoriatic skin lesions. Tests for antinuclear antibodies and rheumatoid factor
      were negative, indicating a direct association between interferon therapy and
      occurrence of seronegative arthritis.

PMID- 7799368
TI  - Clinical measures in rheumatoid arthritis: which are most useful in assessing
      patients?

PMID- 7799369
TI  - Inflammatory myopathy--do we have adequate measures of the treatment response?

PMID- 7799370
TI  - More on inflammatory myopathy--measures of the treatment response.

PMID- 7799371
TI  - Disabling fibromyalgia: appearance vs reality.

PMID- 7799372
TI  - Interrelationship between interleukin 8 and neutrophils in synovial fluid of
      crystal induced arthritis.

PMID- 7799373
TI  - Gynecomastia in patients with rheumatoid arthritis treated with methotrexate.

PMID- 7799375
TI  - Epidemiology and clinical associations of NuMA (nuclear mitotic apparatus
      protein) autoantibodies.

PMID- 7799374
TI  - Longterm remission of corneal melting associated with rheumatoid arthritis after
      a short course of treatment with oral cyclophosphamide.

PMID- 7799376
TI  - Tidal irrigation in Milwaukee shoulder syndrome.

PMID- 7799378
TI  - Osteoarticular brucellosis resembling microcrystalline arthropathy.

PMID- 7799379
TI  - Vth joint World Health Organization and International League of Associations for
      Rheumatology task force meeting on rheumatic diseases. Geneva, Switzerland, 29
      June-2 July 1993. Proceedings.

PMID- 7799377
TI  - Chondrocalcinosis associated with Bartter's syndrome and hypomagnesemia.

PMID- 7799380
TI  - DC-ART: improvement and sustained improvement in function.
AB  - Implementation of the DC-ART category requires a quantitative definition of its
      descriptive components, the first of which is that such therapy "improve and
      sustain function." While function is generally taken to include physical, social,
      and emotional elements, a case is made for restricting function, in this context,
      to physical function. It is acknowledged that at present there are scanty data on
      which to determine the minimal size of improvement in function needed to satisfy
      DC-ART criteria and, in so doing, predict longer term benefit. Until more
      information is available on predictive data on patients with rheumatoid arthritis
      and natural course effects in healthy individuals, it is reasonable to use the
      arbitrary 25-50% improvements traditionally considered by clinicians to represent
      clinically important change.

PMID- 7799382
TI  - DC-ART: the concept.
AB  - The International League of Associations for Rheumatology (ILAR) and the World
      Health Organization (WHO) have ratified a new classification of antirheumatic
      therapy comprising two major categories, as follows: (1) Symptom modifying
      antirheumatic drugs (SMARD) improve the symptoms and clinical features of
      inflammatory synovitis; (2) Disease controlling antirheumatic therapy (DC-ART)
      changes the course of rheumatoid arthritis. The DC-ART category, a new group and
      a new concept, poses a number of problems and challenges but also generates a
      basis for setting management objectives for rheumatoid arthritis. It is uncertain
      whether any of the current SMARD would fulfill the stringent DC-ART criteria.

PMID- 7799381
TI  - DC-ART: decreased inflammatory synovitis.
AB  - As part of the proposal for drug development using the SMARD/DC-ART definitions,
      "decreased inflammatory synovitis" needs to be defined. We review the literature
      with respect to each of the indirect, clinical measures of decreased inflammatory
      synovitis and recommend a preliminary, testable definition based on a per patient
      response. It includes minimum disease activity criteria for patients entering
      studies and improvement in at least 5 of the following 6 criteria: greater than
      20% improvement in joint swelling count; greater than 20% improvement in joint
      tenderness count; greater than 20% improvement in erythrocyte sedimentation rate;
      greater than 30% improvement in physician/assessor global assessment; greater
      than 30% improvement in pain. While this definition is sensible within the
      confines of our knowledge to date, using these criteria prospectively in several
      clinical trials will allow better definition of the appropriate pooled index to
      define decreased inflammatory synovitis.

PMID- 7799383
TI  - DC-ART: preventing or significantly decreasing the rate of progression of
      structural joint damage.
AB  - Progressive joint damage, increasing deformity, and declining function
      characterize rheumatoid arthritis (RA). The evidence suggests structural joint
      damage is the predominant cause of functional impairment. Structural changes of
      joints are evaluated by imaging methods. Plain joint radiographs remain the best
      method for determining the extent and nature of structural changes at present.
      Newer technologies such as magnetic resonance imaging may eventually replace
      them. Clinical studies of antirheumatic drugs involving the assessment of
      prevention or significant decrease in the rate of progression of structural joint
      damage in RA should meet several standards. All patients who enter a study,
      whether they continue medication or not, must be assessed on its completion.
      Studies require sufficient power to determine realistic differences due to
      therapy. They should last long enough for a reliable analysis of the effects of
      joint damage; 1 year would be the minimal period for such a study, and 2 years
      would be preferable. Evaluation should concentrate on erosions and related
      structural changes in juxtaarticular bone; mapping osteoporotic areas in early
      disease may be a sensitive and objective measure. Assessments ought to use
      changes within the hands and wrists to indicate overall progression, with the
      feet included in evaluating early disease. There should be different therapeutic
      aims at various stages of RA, focussing on preventing new erosions developing in
      early disease (< 2 years from diagnosis), preventing new erosions occurring in
      established disease (2-5 years from diagnosis), reducing the rate erosions
      develop in established disease (< 5 years from diagnosis), and reducing the rate
      of joint destruction in late disease (> 5 years from diagnosis).

PMID- 7799385
TI  - Other special considerations in assessing DC-ART: The need for patient
      stratification.
AB  - Given the heterogeneity of rheumatoid arthritis (RA), even in disease of the same
      duration, it seems likely that some therapeutic regimens will satisfy DC-ART
      criteria to different degrees in different strata of patients with RA. Since it
      entails its own problems, it is recommended that the value and feasibility of
      stratification be evaluated before any attempt to design a DC-ART trial.

PMID- 7799384
TI  - Are there special considerations relevant to trials of biologic agents?
AB  - Although biologic agents have been developed to effect change in observed or
      hypothesized pathogenic pathways, discrepancies between biological and clinical
      effects are well recognized. In trials of these agents, biological and clinical
      effects need to be evaluated. While the biological effects require assessment to
      test the proposed primary effect and significant influences, clinical evaluation
      should use the same set of assessment procedures as pharmacological agents. The
      disease controlling antirheumatic therapy (DC-ART) classification with its
      requirement for longterm efficacy poses problems for the biological agents,
      which, in general, have demonstrated short term benefit. They may be best
      accommodated in a new "remission induction" category or, alternatively, as part
      of longterm combination therapy either with pharmaceuticals or with other
      biologicals to fulfill DC-ART requirements.

PMID- 7799387
TI  - DC-ART: what proportion of response constitutes a positive response?
AB  - In most clinical trials, patients' mean improvement scores are compared either
      for active against active treatment or active against placebo treatment. Testing
      drugs or strategies to qualify as disease controlling antirheumatic therapy will
      require treated patients to satisfy set criteria. But what proportion must
      fulfill the requirement if the therapy is to be classified as DC-ART? While the
      answer must address the problems of semantics, disease characteristics, and
      absolute levels of improvement, it may be easiest to begin by defining a
      significant degree of change in terms of a single disease activity index.

PMID- 7799386
TI  - Other special considerations in assessing DC-ART: potential application of newer
      technologies.
AB  - Developments in technology will change and improve methods of assessment of
      rheumatoid arthritis (RA) progress and outcome. Three areas are discussed:
      quantitative microfocal radiography; assessment of cartilage volume using
      magnetic resonance imaging and 3D computer reconstruction; polymerase chain
      reaction on tissue sections to allow simultaneous identification of multiple mRNA
      for cytokines, leukotrienes, and other participants in RA synovitis in serial
      blood samples or office-based arthroscopic synovial biopsy sections.

PMID- 7799388
TI  - Can observational studies replace or complement experiment?
AB  - The therapeutic effects of interventions in patients with rheumatoid arthritis
      (RA) are frequently modest. In the assessment of treatments effects, variability
      due to a variety of sources causes problems that are best controlled by
      randomized clinical trials. Currently most trials give only a short term picture
      of RA, a chronic disease whose outcome is multidimensional. Inclusion criteria of
      clinical trials are frequently very strict, raising concern about the external
      validity of the results. More longterm data is needed to guide clinical practice.
      Observational studies may contribute to the body of evidence, but have inherent
      shortcomings. They are liable to bias and supply weaker evidence. There must be
      creative development of trial designs suitable for evaluating longterm outcomes.
      Such trials may include many of the positive features of observational studies,
      but should not omit the principles of randomization and controlled comparison.

PMID- 7799389
TI  - Guidelines for testing slow acting drugs in osteoarthritis.
AB  - New compounds appear to improve symptoms of osteoarthritis (OA), and others are
      putative chondroprotective agents. We suggest experimental designs for studying
      the effects of these agents in subjects with hip and knee OA. The course of the
      articular cartilage lesion is the primary outcome measure to be assessed in
      putative chondroprotective agent trials. Serial radiographic studies suggest that
      the annual rate of joint space narrowing in patients with hip or knee OA is about
      0.25 mm. Other approaches to quantitation of cartilage loss, e.g., radiographic
      measurement of the area of joint space, ultrasonography, magnetic resonance
      imaging and fiberoptic arthroscopy (for knee OA) are under investigation.

PMID- 7799390
TI  - Intraarticular treatment of osteoarthritis and guidelines to its assessment.
AB  - Intraarticular treatment has been considered for osteoarthritis since the first
      attempts at local injection of steroid derivatives. To assess the effectiveness
      of intraarticular drugs, in view of the variability of the disease and the
      remarkable placebo response, a control group of patients is necessary. The main
      outcome measures are pain and joint effusion when using symptomatic slow acting
      drugs. If a chondroprotective effect is to be demonstrated the main criterion is
      measurement on standardized radiography of the knee medial femorotibial joint
      space.

PMID- 7799391
TI  - Guidelines for use of antirheumatic drugs.
AB  - The Vth WHO/ILAR Task Force Meeting on Rhemuatic Diseases ratified guidelines for
      the use of antirheumatic drugs. Indications for use, contraindications, dose,
      administration and other usage principles, toxicity, and advice to patients have
      been agreed for analgesics, nonsteroidal antiinflammatory drugs, slower acting
      antirheumatic drugs, corticosteroids, and hypouricemic agents.

PMID- 7799393
TI  - Protocol for evaluation of nonsteroidal antiinflammatory drugs.

PMID- 7799392
TI  - DC-ART classification: review of relevant clinical studies.
AB  - The proposed disease controlling antirheumatic therapy (DC-ART) definition
      requires that the therapy change the course of rheumatoid arthritis (RA) for at
      least 1 year, evidenced by (1) sustained improvement in physical function, (2)
      decreased inflammatory synovitis, and (3) slowing or prevention of structural
      joint damage. Selected studies are reviewed. All studies were at least 1 year in
      duration, but most did not include all 3 of the DC-ART requirements. In these
      studies, patients treated with placebo generally had no improvement in
      inflammatory synovitis and progressive structural joint damage, judged by serial
      joint radiographs. A minority of studies significantly favored one or another of
      the available agents (gold injections, D-penicillamine, auranofin, antimalarials,
      azathioprine, sulfasalazine, methotrexate), but the evidence for any one agent is
      not convincing. For future DC-ART clinical trials patients with early RA should
      be studied. A hybrid study design may be useful, combining an initial double
      blind randomized controlled clinical trial with continuing longterm observation
      of all withdrawals using specified clinical, radiographic, and self report
      assessments at regular intervals, and an intent-to-treat analysis comparing
      longterm response rates of the original control and experimental therapy groups.
      Responsive subgroups should be sought, their characteristics identified, and
      their responsiveness confirmed in additional trials limited to the identified
      subgroup.

PMID- 7799394
TI  - World Health Organization and International League of Associations for
      Rheumatology core endpoints for symptom modifying antirheumatic drugs in
      rheumatoid arthritis clinical trials.
AB  - The WHO/ILAR core set of endpoints for rheumatoid arthritis clinical trials
      signifies progress in a continuing worldwide effort. This core set includes the
      following measures: pain, patient global assessment, physical disability, swollen
      joints, tender joints, acute phase reactants, and physician global assessment; in
      studies of one or more years' duration, radiographs of joints should be
      performed.

PMID- 7799395
TI  - N-(acyloxyalkyl)pyridinium salts as soluble prodrugs of a potent platelet
      activating factor antagonist.
AB  - Pyrrolothiazole 4 is a potent antagonist of platelet activating factor-mediated
      effects in a variety of in vitro and in vivo assays. Despite its positive
      activity in models of inflammation and septic shock, 4 lacks the aqueous
      solubility necessary for intravenous administration. This deficit was overcome by
      conversion of 4 to water-soluble pyridinium prodrugs. A two-step procedure was
      used to prepare a series of N-(acyloxyalkyl)pyridinium salts, all of which
      exhibited aqueous solubility of greater than 20 mg/mL. The rate of conversion of
      these prodrugs to 4 was faster in human plasma than in pH 7 aqueous buffer. This
      rate difference was shown to be due to serum enzymes since the conversion in
      plasma was significantly slower in the presence of a serine esterase inhibitor. A
      strong correlation between prodrug structure and buffer/plasma half-life was
      established. The N-(acetyloxymethyl)pyridinium prodrug 11 (ABT-299) is currently
      undergoing clinical evaluation for the treatment of sepsis.

PMID- 7799396
TI  - Ligands for brain cholinergic channel receptors: synthesis and in vitro
      characterization of novel isoxazoles and isothiazoles as bioisosteric
      replacements for the pyridine ring in nicotine.
AB  - Ligands which activate neuronal nicotinic acetylcholine receptors (nAChRs)
      represent a potential approach for the palliative treatment for the symptoms of
      memory loss associated with Alzheimer's disease (AD). Based upon this approach, a
      series of novel 3,5-disubstituted isoxazoles and isothiazoles were prepared and
      evaluated in vitro as cholinergic channel activators (ChCAs) of neuronal nAChRs.
      Many of the 3-substituted 5-(2-pyrrolidinyl)isoxazoles were found to have
      nanomolar binding affinities comparable to (S)-nicotine (2a) in a preparation of
      whole rat brain. However, in a paradigm measuring the evoked release of
      [3H]dopamine from a preparation of rat striatum, there were differences in the
      agonist potencies and efficacies of these analogues relative to 2a. The
      differences in agonist potency observed between compounds of comparable binding
      potency may be due to differences in ligand interactions with various subtypes of
      neuronal nAChRs.

PMID- 7799397
TI  - Triazolinone biphenylsulfonamides as angiotensin II receptor antagonists with
      high affinity for both the AT1 and AT2 subtypes.
AB  - Angiotensin II (AII), the endogenous peptide ligand of the AII receptor, has
      equivalent high affinity for both the AT1 and AT2 receptor subtypes while most of
      the reported nonpeptide AII antagonists are AT1-selective. In an effort to
      identify dual AT1/AT2 nonpeptide AII antagonists, we have pursued modifications
      of previously prepared trisubstituted 1,2,4-triazolinone biphenylsulfonamides
      which exhibited subnanomolar in vitro AT1 (rabbit aorta) AII antagonism and AT2
      (rat midbrain) IC50 values of < 40 nM. Present results show that a suitable amide
      (or reversed amide) side chain appropriately positioned on the N2-aryl group of
      these compounds gave > 15-fold enhancement in AT2 binding affinity without
      sacrificing nanomolar AT1 potency (IC50). This added amide, combined with an
      appropriate choice of the N-substituent on the sulfonamide and the ortho
      substituent on the N2-aryl group, led to an analogue (46, L-163,-007) which
      exhibited subnanomolar AT1 binding affinity and an AT2/AT1 IC50 ratio of 3. This
      compound showed excellent iv activity at 1 mg/kg and oral efficacy at 3 mg/kg
      with > 6 h duration in a conscious rat model. Available data suggest that the
      newly introduced amide side chain, mandatory for low nanomolar binding affinity
      at the AT2 receptor, is well-tolerated by the AT1 receptor and has minimal effect
      on the in vivo properties of these molecules.

PMID- 7799398
TI  - The discovery of novel, structurally diverse protein kinase C agonists through
      computer 3D-database pharmacophore search. Molecular modeling studies.
AB  - A computer protein kinase C (PK-C) pharmacophore search on 206,876 nonproprietary
      structures in the NCI 3D-database led to the discovery of five compounds which
      were found to possess PK-C binding affinities in the low micromolar range and six
      others having detectable, but marginal, binding affinities. Molecular modeling
      studies showed that in addition to the presence of the defined pharmacophore,
      hydrophobicity and conformational energy are the two other important factors
      determining the PK-C binding affinity of a compound. The modeling results were
      confirmed by synthetic modification of two inactive compounds, producing two
      active derivatives. These newly discovered, structurally diverse lead compounds
      are being used as the basis for further synthetic modifications aimed at more
      potent PK-C ligands that will compete with the phorbol esters.

PMID- 7799399
TI  - kappa Opioid receptor selective affinity labels: electrophilic benzeneacetamides
      as kappa-selective opioid antagonists.
AB  - 2-(3,4-Dichlorophenyl)-N-methyl-N-[1-(3- or 4-substituted phenyl)-2-(1
      pyrrolidinyl)ethyl]-acetamides 3-6 were synthesized as kappa-selective affinity
      labels and evaluated for opioid activity. In smooth muscle preparations, the non
      electrophilic parent compound (+)-S-2 and the affinity labels 3-6 behaved as
      kappa agonists in that they were potently antagonized by norbinaltorphimine
      (norBNI). In addition to the high binding affinity and selectivity of the 3
      isothiocyanate 3 (DIPPA) to kappa opioid receptors, wash studies have suggested
      that this involves covalent binding. In the mouse tail-flick assay, the 3- and 4
      substituted isomers (3 and 5, respectively) produced long-lasting antagonism of
      the antinociceptive effect of the kappa opioid agonist, (+/-)-trans-2-(3,4
      dichlorophenyl)-N-methyl-N-[2-(1-pyrrolidinyl) cyclohexyl]acetamide ((+/-)
      U50,488). In contrast, the non-electrophilic parent compound (+)-S-2 and the
      fumaramate derivative 4 were devoid of antagonist activity in the tail-flick
      assay. At substantially different doses, DIPPA (3) and the 4-isothiocyanate 5
      also produced antinociception in the mouse abdominal stretch assay. In addition,
      DIPPA and the 3-fumaramate methyl ester 4 had improved in vivo kappa
      selectivities compared to the unsubstituted parent compound (+)-S-2 and the para
      substituted derivative 5. The improved kappa-selectivities of 3 and 4 and the
      different agonist and antagonist potencies of 3 and 5 may be explained
      respectively by the existence of multiple kappa agonist binding sites and
      distinct agonist and antagonist binding sites. In view of the antagonist
      selectivity and the apparent irreversible binding of DIPPA to kappa receptors, it
      may serve as a useful pharmacologic or biochemical tool to investigate kappa
      opioid receptors.

PMID- 7799400
TI  - A conformationally defined 6-s-trans-retinoic acid isomer: synthesis,
      chemopreventive activity, and toxicity.
AB  - A conformationally defined retinoic acid analog (1) which contains a dimethylene
      bridge to maintain the 6-s-trans orientation for two terminal double bonds in the
      polyene chain was synthesized. A Reformatsky reaction was utilized to extend the
      polyene chain of the starting enone, which provided exclusively the 9Z
      configuration for the intermediate aldehyde. A Horners-Emmons condensation with
      this aldehyde then produced retinoic acid analogs with both 9Z- and 9Z,13Z
      configurations. An I2-catalyzed isomerization of the intermediate 9Z-aldehyde
      yielded the all-E-aldehyde, which was olefinated as above to yield the (all-E)-
      and (13Z)-retinoic acid analogs of 1. Each configurational isomer of 1 was
      evaluated for its ability to inhibit the binding of retinoic acid to CRABP (chick
      skin) and to inhibit the chemical induction of ornithine decarboxylase in mouse
      skin. In each assay (all-E)-1 was the most active isomer, and this activity was
      comparable to or better than that for (all-E)-retinoic acid. (all-E)-1 and (13Z)
      1 were both shown to be equally effective as (13Z)-retinoic acid in suppressing
      the proliferation of human sebaceous cells in vitro. (all-E)-1 was further
      evaluated for its ability to prevent the induction of mouse skin papillomas and
      to induce signs of vitamin A toxicity in mice. The cancer chemopreventive
      activity of (all-E)-1 was comparable to that of (all-E)-retinoic acid, and the
      toxicity was comparable to or slightly better than that of the natural vitamin.

PMID- 7799401
TI  - Structural evolution and pharmacology of a novel series of triacid angiotensin II
      receptor antagonists.
AB  - cis-4-(4-Phenoxy)-1-[1-oxo-2(R)-[4-[(2-sulfobenzoyl)amino)-1H- imidazol-1
      yl]octyl]-L-proline derivatives represent a novel class of potent nonpeptide
      angiotensin II (Ang II) receptor antagonists. These compounds evolved from
      directed structure-activity relationship (SAR) studies on a lead identified by
      random screening. Further SAR studies revealed that acidic modification of the 4
      phenoxy ring system produced a series of triacid derivatives possessing oral
      activity in pithed rats. The most potent compound, cis-4-[4
      (phosphonomethyl)phenoxy]-1-[1-oxo-2(R)-[4-[(2-sulfobenzoyl+ ++) amino]-1H
      imidazol-1-yl]octyl]-L-proline (1e), inhibited the pressor response to
      exogenously administered Ang II for periods up to 8 h following oral dosing. The
      antihypertensive activity of 1e was evaluated in the Lasix-pretreated conscious
      spontaneously hypertensive rat (SHR) where it produced a dose-dependent fall in
      blood pressure following oral dosing lasting > 12 h. Antagonists such as 1e may
      serve as useful therapeutic agents for the treatment of hypertension as well as
      for studying the role of Ang II in various disease states.

PMID- 7799402
TI  - 2,4-Diamino-5-chloroquinazoline analogues of trimetrexate and piritrexim:
      synthesis and antifolate activity.
AB  - Ten heretofore undescribed 2,4-diamino-5-chloroquinazoline analogues of
      trimetrexate (TMQ) and piritrexim (PTX) were synthesized and tested as inhibitors
      of dihydrofolate reductase (DHFR) from rat liver, Pneumocystis carinii, and
      Toxoplasma gondii. The most active quinazolines against both the P. carinii and
      the T. gondii enzyme were those with an ArCH2-NH or ArNHCH2 side chain. Among
      ArNH(CH2)n compounds with n = 1-3 and either 2',5'-dimethoxyphenyl or 3',4',5'
      trimethoxyphenyl as the Ar moiety, activity decreased in the order n = 1 > n = 2
      > n = 3. The best inhibitor of P. carinii DHFR, 2,4-diamino-5-chloro-6-[(N-methyl
      3',4',5'-trimethoxyanilino)methy l] quinazoline (10) had an IC50 of 0.012 microM
      and was slightly more potent than TMQ and PTX. Compound 10 was also the best
      inhibitor of T. gondii DHFR, with an IC50 of 0.0064 microM corresponding again to
      a minor increase in activity over TMQ and PTX. However, as with these standard
      agents, 10 showed no appreciable selectivity for either the P. carinii or T.
      gondii enzyme relative to the rat liver enzyme. The highest selectivity achieved
      in this limited series was with 2,4-diamino-5-chloro-6-[N-(3',4',5'
      trimethoxybenzyl)-N-methylamino] quinazoline (17) against T. gondii DHFR. While
      17 (IC50 = 0.016 microM) was somewhat less potent than 10, its selectivity, as
      defined by the ratio IC50(rat liver)/IC50(T. gondii) was ca. 30-fold higher than
      that of TMQ or PTX. Two compounds, 2,4-diamino-5-chloro-6-[(3',4',5'
      trimethoxyanilino)methyl] quinazoline (9) and 2,4-diamino-5-chloro-6-[N-(3',4',5'
      trimethoxybenzyl) amino]quinazoline (15), were also tested against human DHFR and
      were found to have an IC50/[E] of 0.5, indicating that their binding was near
      stoichiometric.

PMID- 7799403
TI  - Structure of a covalent DNA minor groove adduct with a pyrrolobenzodiazepine
      dimer: evidence for sequence-specific interstrand cross-linking.
AB  - The structure of the interstrand cross-linked adduct formed between a C8-C8'
      linked pyrrolobenzodiazepine (PBD) dimer (DSB-120; 1,1'-(propane-1,3
      diyldioxy)bis[(11aS)-7-methoxy-1,2,3,11a-t etrahydro-5H- pyrrolo[2,1
      c][1,4]benzodiazepin-5-one]) and a self-complementary d(CICGATCICG)2 duplex has
      been determined from high-field 1D- and 2D-NMR data using a simulated annealing
      procedure. The refined structure supports earlier observations from solution NMR
      experiments and indicates that the covalently bound molecule spans six DNA base
      pairs in the minor groove, forming a symmetric cross-link between the spatially
      separated internal guanines and with active recognition of an embedded 5'-GATC
      bonding site. This result confirms that template-directed approaches are useful
      for the design of linked DNA-interactive PBD dimers with viable DNA cross-linking
      potential. Further, head-to-head connection of the PBD moieties results in an
      overall retention of 5'-GA bonding site preference for each alkylating PBD
      subunit. Structural analysis indicates that cross-link formation results in a
      localized perturbation of the DNA duplex, attributable in part to a mutual
      reduction in dynamic mobility or "covalent clamping" within the Gua4-Cyt7 base
      tract. However, ligand-induced distortion is confined to the Cyt7 and Ino8
      residues on each strand. The Gua(N2)-Gua(N2) cross-link is stabilized by two
      directed H-bonds from the formed animal residues to N3 acceptor atoms of adenine
      bases on the 3'-side of each covalently modified guanine. Evidence for sequence
      specific cross-linking with DSB-120 is provided by extended modeling studies
      which suggest that recognition of the favored d(.GATC.) motif is dominated by van
      der Waals steric factors, although electrostatic and H-bonded interaction terms
      also play a key role. This conclusion supports recent covalent footprinting
      studies revealing that this PBD dimer shows a selectivity for embedded base
      sequences of the type 5'-(pu/py)GATC(py/pu).

PMID- 7799404
TI  - Inhibition of human neutrophil elastase with peptidyl electrophilic ketones. 2.
      Orally active PG-Val-Pro-Val pentafluoroethyl ketones.
AB  - Valylprolyvalyl pentafluoroethyl ketones with different N-protecting groups were
      evaluated in vitro and in vivo as inhibitors of human neutrophil elastase (HNE).
      Several of these compounds were found to be orally active in HNE-induced rat and
      hamster lung hemorrhage models. The compound with 4-(4
      morpholinylcarbonyl)benzoyl as the protecting group, 71 (MDL 101,146), was
      studied in greater detail. Hydration and epimerization studies were performed on
      71 and related compounds in various media, including human blood serum. High
      performance liquid chromatography studies on a reversed-phase system as a measure
      of the lipophilicity of 71 and related compounds revealed a small range of
      relative retention times wherein the orally active compounds fell. The Ki value
      determined for 71 vs HNE was 25 nM.

PMID- 7799405
TI  - Pentamidine congeners. 2. 2-butene-bridged aromatic diamidines and diimidazolines
      as potential anti-Pneumocystis carinii pneumonia agents.
AB  - We have synthesized cis and trans geometric isomers 1-8 as semirigid congeners of
      pentamidine. Compounds 1-4 were more potent than pentamidine in treating
      Pneumocystis carinii pneumonia in immunosuppressed rats. These compounds also
      demonstrated no clinical toxicity or histopathologic abnormalities. Introduction
      of methoxy substituents meta to the amidine or imidazoline groups of the phenyl
      rings as in compounds 5-8 generally resulted in compounds with decreased anti-P.
      carinii activity and increased toxicity to the host. Compounds 1-4 were evaluated
      as DNA binders. These compounds showed greater affinity for poly(dA).poly(dT)
      than for calf thymus DNA. The cis isomers, 1 and 2, demonstrated greater affinity
      for DNA than their trans counterparts 3 and 4. This difference in DNA binding
      affinity, however, did not reflect in a corresponding difference in the anti-P.
      carinii activity of these compounds.

PMID- 7799406
TI  - A bioactive fullerene peptide.
AB  - The highly hydrophobic C60 (buckminsterfullerene) was water solubilized by
      covalently linking the synthon 1,2-dihydro-1,2-methanofullerene [60]-61
      carboxylic acid to the alpha-amino group of the hydrophilic 4-8 sequence of
      peptide T, known to display potent human monocyte chemotaxis. The resulting
      compound, characterized by a variety of analytical techniques, including a UV
      spectrum in aqueous solution, exhibits remarkable chemotactic potency, comparable
      to that of the parent pentapeptide. Furthermore, this fullerene-peptide conjugate
      inhibits, albeit weakly, HIV-1 protease.

PMID- 7799407
TI  - A novel and useful descriptor for hydrophobicity, partition coefficient micellar
      water, and its application to a QSAR study of antiplatelet agents.
AB  - Herein we describe the introduction and application of a novel and useful
      descriptor, logarithm of micelle-water partition coefficients (log Pmw), for
      hydrophobicity of compounds. A QSAR study using log Pmw on antiplatelet
      activities ex vivo of 2-substituted phenyl and benzimidazolyl-5-methyl-4-(3
      pyridyl)imidazoles showed its usefulness. Antiplatelet activities could be
      rationalized by means of only log Pmw with an excellent correlation (r = 0.772, s
      = 0.257, F = 11.07 **, n = 18), while use of other descriptors such as CLOGP
      values and retention factors (k') failed. Pmw values can easily be obtained using
      a normal HPLC system using a micelle aqueous solution as the mobile phase. HPLC
      techniques offer the advantage of tolerating lower sample purity, smaller sample
      size, and being dynamic range, compared with the flask-shaking method for
      measurement of logarithm of 1-octanol/water partition coefficients (log P), which
      is widely used in QSAR study. These indicated that log Pmw could be a useful
      descriptor for hydrophobicity of compounds.

PMID- 7799409
TI  - Derivatives of 4-(2'-methoxyphenyl)-1-[2'-(N-2"-pyridinyl-p
      iodobenzamido)ethyl]pipera zine (p-MPPI) as 5-HT1A ligands.
AB  - A series of new p-alkylbenzamido derivatives of 4-(2'-methoxyphenyl)-1-[2'-(N-2"
      pyridinyl)-p- iodobenzamido)ethyl]piperazines (p-MPPI) were prepared. In vitro
      binding studies suggest that p-methyl and p-ethyl substituents on the benzamido
      group display the same high binding affinity to 5-HT1A receptors (Ki = 2.2 and
      9.3 nM, rat hippocampal homogenates). However, when the substitution groups were
      larger than a C5 pentyl group, the affinity to 5-HT1A receptors dropped below a
      useful level (Ki > 50 nM). Several irreversible binding agents (CH2Cl, NHCOCH2Cl)
      and a photoaffinity labeling compound (m-iodo p-azido) which showed good binding
      affinity to 5-HT1A receptors were successfully prepared.

PMID- 7799410
TI  - Four amino acid exchanges convert a diazepam-insensitive, inverse agonist
      preferring GABAA receptor into a diazepam-preferring GABAA receptor.
AB  - Benzodiazepines (BZ) exert their effects through GABAA receptors, which belong to
      the superfamily of ligand-gated ion channels. Coexpression of recombinant alpha,
      beta, and gamma subunits in a cell culture system mimics the BZ binding sites.
      The alpha variants largely determine the nature of the BZ binding site in such
      alpha i beta j gamma k heteromultimers (i = 1-6; j = 1-3; k = 1-3). Notably, the
      alpha 1 and alpha 6 variants confer high and low affinity for BZ agonists to the
      resulting receptor subtype, respectively. Glycine/glutamate and
      histidine/arginine positions in the alpha subunits of alpha x beta 2 gamma 2
      receptors are involved in BZ I versus BZ II type selectivity. We now identify
      four amino acids in alpha 6 which together increase the affinity of the mutant
      alpha x beta 2 gamma 2 receptor for classical BZ receptor agonists above the
      level seen for any wild-type GABAA/BZ receptor. The most pronounced effect was
      due to an isoleucine to valine exchange. It simultaneously decreased the affinity
      for the BZ partial inverse agonist Ro 15-4513 20-fold and increased the affinity
      for diazepam 4-fold. The four amino acid residues stretch over most part of the N
      terminal extracellular domain of the alpha subunit, suggesting that amino acids
      distant in the primary sequence form the BZ binding pocket.

PMID- 7799408
TI  - Synthesis and anticonvulsant activities of alpha-acetamido-N-benzylacetamide
      derivatives containing an electron-deficient alpha-heteroaromatic substituent.
AB  - Recent studies have demonstrated that C(alpha)-substituted alpha-acetamido-N
      benzylacetamides displayed excellent anticonvulsant activities in mice. Analysis
      of the structure-activity relationship for this series of compounds has shown
      that placement of small, electron-rich aromatic and heteroaromatic groups at the
      C(alpha) site led to pronounced protection against MES-induced seizures. In this
      note, synthetic protocols are reported for the preparation of three novel
      nonnaturally occurring electron-deficient C(alpha)-aza aromatic alpha-acetamido-N
      benzylacetamides (i.e., pyrid-2-yl (11), pyrazin-2-yl (12), pyrimid-2-yl (13)).
      Expedient syntheses for 12 and 13 were developed using a phase-transfer,
      nucleophilic aromatic substitution process. All three adducts exhibited potencies
      comparable to or greater than phenytoin in the MES test (mice, ip). These
      findings required us to modify in part the previously proposed structure-activity
      relationship for this class of anticonvulsants.

PMID- 7799411
TI  - [Detection of Helicobacter pylori by the urease test in 244 patients].
AB  - The authors report the results of the detection of Helicobacter Pylori (HP) in
      gastric mucosa by the urease test, in 244 patients between January 1989 and
      August 1991. The overall prevalence of HP was 38.1%. It was 19.5% in patients
      with normal upper gastrointestinal endoscopy (UE), 61% in duodenal ulcer (p <
      0.001) and 68.7% in congestive antritis (p < 0.001), significantly higher than in
      controls. There was no significant difference between controls and patients with
      erosive antritis or healed duodenal ulcers. The prevalence of HP rises with age
      in all patients and in those with lesions at UE but not in those with normal UE.
      A rise of this prevalence seems to exist in the months of June and December. The
      authors conclude by pointing out the rise of the overall prevalence of HP in
      congestive antritis compared with erosive antritis, the similarity of prevalence
      in normal subjects and those with healed ulcer and the lack of influence of age
      on this prevalence in subjects with normal UE. These conclusions are in need of
      confirmation by further studies on much more longer series.

PMID- 7799412
TI  - [Diagnosis of recurrent bronchopulmonary infections in children].
AB  - One hundred and seven patients aged from nine months to eight years old have been
      studied to evaluate the diagnosis of broncho-pulmonary recurrent infection with a
      preliminary studies and an association of bronchoscopy and bronchography. The
      first step cheek-in revealed sixty-seven diagnosis, while the bronchoscopy, the
      bronchography and the IgG subclasses revealed respectively twenty-seven, five and
      three diagnoses. Only five patients remained without diagnosis.

PMID- 7799414
TI  - [Dyslipidemia: what every physician should keep in mind].

PMID- 7799413
TI  - The dysplastic melanocytic nevus: a helping hand in the prevention of malignant
      melanoma.

PMID- 7799415
TI  - Continuing medical education: the American approach.

PMID- 7799416
TI  - [Health situation in the world].

PMID- 7799417
TI  - Weight control in the management of hypertension. World Hypertension League.
AB  - This article, which includes a brief description of the mechanisms and some
      epidemiological findings in obesity and high blood pressure, sums up present
      knowledge on a complex subject and provides guidance to medical practitioners on
      the management of obese hypertensive patients. Weight reduction, together with
      drug therapy in severe and moderate hypertension, and other non-pharmacological
      methods and continuing observation in mild hypertension are the essential
      measures to be applied. In addition to the lowering of blood pressure, weight
      loss offers several other metabolic and haemodynamic benefits.

PMID- 7799421
TI  - Juvenile reflex sympathetic dystrophy: a case report.
AB  - We report a case of reflex sympathetic dystrophy in a 10-year-old girl who
      presented with a two months history of severe pain and paresthesia in her right
      lower extremity. The patient made a very good recovery after two months of
      treatment with steroids and physical therapy.

PMID- 7799422
TI  - [Ethics of pain in terminal stage: to inform, to care and to relieve the
      suffering].

PMID- 7799418
TI  - [Incidentally discovered adrenal tumor: myelolipoma].
AB  - The wider application of increasingly sensitive ultrasonography and CT scanning
      has created a new problem for clinical management: the incidental discovery of
      asymptomatic adrenal lesions. These lesions, also called "incidentalomas" may be
      due to a large variety of etiologies, and although most of them prove to be
      benign cortical adenomas, diagnostic confirmation is frequently impossible
      preoperatively. For this reason, a general approach, based on the relative
      prevalence of benign and malignant, clinically silent adrenal masses, has been
      defined. This same approach is usually needed in the case of myelolipoma, a rare
      form of benign and silent adrenal neoplasms, containing hematopoietic and fatty
      elements. Actually, computed tomographic aspect of such tumors is very evocative
      but not pathognomonic, so it doesn't eliminate the possibility of malignant
      lesions, especially in the presence of heterogeneities. Because of these
      limitations and awaiting the development of more specific diagnostic procedures,
      it seems cautious to approach these tumors like incidentalomas in general.

PMID- 7799419
TI  - Traumatic rupture of the thoracic aorta--case report.
AB  - Acute traumatic rupture of the thoracic aorta due to blunt trauma is a relatively
      common injury after deceleration accidents. However, only one fifth of these
      patients survive to reach medical facilities. The limiting factor to successful
      management is early diagnosis and prompt treatment. A case of acute traumatic
      rupture of the descending aorta due to blunt trauma is presented. Diagnostic and
      management modalities are discussed.

PMID- 7799420
TI  - [A case of trichinosis revealed by a protracted diarrhea and neurologic
      manifestations].
AB  - We report a case of trichinosis presenting with a subacute persistent diarrhea
      and neurologic complications. Gastrointestinal endoscopic as well as digestive
      and neurologic radiologic signs were observed. The mainstay of treatment was
      glucocorticoids associated with thiabendazole. The patient responded well to this
      regimen. A literature review to explain the gastrointestinal and neurological
      manifestations of trichinosis as well as their management was done.

PMID- 7799423
TI  - Cancer pain: pharmacological management (2).

PMID- 7799424
TI  - The measurement of intracellular antigens and DNA by multiparametric flow
      cytometry.
AB  - The aim of this paper is to provide a strategy for measuring intracellular
      antigens combined with DNA content in cells or nuclei. A series of protocols are
      included which enable the majority of such antigens to be labelled and further
      information is provided for cases in which the standard methods prove to be
      inadequate. The basic principles of cell permeabilization/fixation are described,
      thus explaining how methods can be divided into three basic categories: (a)
      alcohol fixation with or without detergent pretreatment; (b) paraformaldehyde
      fixation followed by permeabilization with alcohol or detergents; (c)
      permeabilization of unfixed cells. The preparation of nuclear suspensions from
      paraffin-embedded material is described and the possibilities and problems of
      staining such suspensions for nuclear antigens are discussed. Examples of results
      obtained with the detailed protocols are given for staining with antibodies
      directed against proliferating cell nuclear antigen (PCNA), Ki-67 antigen and Ki
      S1 antigen. Details of published studies of a variety of intracellular antigens
      are given in two tables. The power of multiparametric flow cytometry in the study
      of cell proliferation, differentiation and response of cells to damage is
      underlined.

PMID- 7799425
TI  - Rapid assay for pathogenic Salmonella organisms by immunofluorescence flow
      cytometry.
AB  - Multi-parameter flow cytometry was investigated for the rapid detection of
      specific serotypes of salmonellas (S. typhimurium and S. montevideo) labelled
      with fluorescent monoclonal antibodies, both in pure culture and in a typical
      food matrix (full-fat milk). In all cases, the method was accurate to levels of
      below 10(4) target cells per ml for a total assay time of about 30 min. After 6 h
      non-selective enrichment in the presence of a 10,000-fold excess of competing
      micro-organisms (Escherichia coli) the corresponding detection limit was about 20
      cells ml-1. These results suggest that flow cytometry has significant potential
      for the detection of pathogenic micro-organisms in the food industry.

PMID- 7799426
TI  - Scanning microphotolysis: a new photobleaching technique based on fast intensity
      modulation of a scanned laser beam and confocal imaging.
AB  - The fluorescence photobleaching method has been widely used to study molecular
      transport in single living cells and other microsystems while confocal microscopy
      has opened new avenues to high-resolution, three-dimensional imaging. A new
      technique, scanning microphotolysis (Scamp), combines the potential of
      photobleaching, beam scanning and confocal imaging. A confocal scanning laser
      microscope was equipped with a sufficiently powerful laser and a novel device,
      the 'Scamper'. This consisted essentially of a filter changer, an acousto-optical
      modulator (AOM) and a computer. The computer was programmed to activate the AOM
      during scanning according to a freely defined image mask. As a result, almost any
      desired pattern could be bleached ('written') into fluorescent samples at high
      definition and then imaged ('read') at non-bleaching conditions, employing full
      confocal resolution. Furthermore, molecular transport could be followed by
      imaging the dissipation of bleach patterns. Experiments with living cells
      concerning dynamic processes in cytoskeletal filaments and the lateral mobility
      of membrane lipids suggest a wide range of potential biological applications.
      Thus, Scamp offers new possibilities for the optical manipulation and analysis of
      both technical and biological microsystems.

PMID- 7799427
TI  - Direct imaging in a water layer of human chromosome fibres composed of
      nucleosomes and their higher-order structures by laser-plasma X-ray contact
      microscopy.
AB  - X-ray contact microscopy with a 300-ps-duration laser-plasma X-ray source has
      been used to image hydrated human chromosomes. Clearly imaged are individual
      nucleosomes and their higher-order particles (superbeads), elementary chromatin
      fibrils. c. 30 nm in diameter and their higher-order fibres of various sizes up
      to c. 120 nm in diameter. The results demonstrate that X-ray microscopy is now
      capable of opening a new path of investigation into the detailed structures of
      hydrated chromosome fibres in their natural state.

PMID- 7799428
TI  - Relocation accuracy on HOME computerized microscopes.
AB  - A major practical advantage of the HOME (highly optimized microscope environment)
      computerized microscope is the facility for relocating cells or other microscopic
      objects. Features can be marked directly on the microscope image using a mouse
      driven cursor, and an interactive finder can then be used to relocate the marked
      features. Tests on a prototype HOME microscope have shown that positions can be
      relocated with an accuracy of standard deviation (SD) < 7 microm. The marked
      features could also be relocated on a second HOME microscope, although with
      somewhat reduced accuracy (standard deviations of < 17 microm). The system
      provides a very user-friendly environment for tasks requiring relocation of
      microscopic objects.

PMID- 7799430
TI  - Order-disorder phenomena in myelinated nerve sheaths: V. Effects of temperature
      on rat sciatic and optic nerves, and structural differences between the two types
      of nerve.
AB  - We describe in this work X-ray scattering and electron microscope studies of rat
      sciatic and optic nerves as a function of temperature. The scattering experiments
      were analyzed as described in the previous papers of this series: a variety of
      parameters were determined, some of which characterize the lattice disorder,
      others the structure of the motif. The main results are the following. All the
      parameters determined by the X-ray scattering study vary with temperature and the
      temperature-dependence is specific for the type of nerve (sciatic or optic). Most
      of the disorder-related parameters display a minimum or a maximum in the vicinity
      of physiological temperature (38 degrees C in rat); this observation, strongly
      supported by the electron microscope study, shows that the degree of organization
      of myelin is highest near physiological temperature. The structure of the motif,
      as revealed by the electron density profile, is fairly different in the two types
      of nerves (in contrast with the assumption made by previous workers); the
      structure also varies with temperature and the temperature-induced alterations
      are nerve-type specific. In the two types of nerve the thickness of the lipid
      bilayer varies with temperature as expected for a lipid-containing system with
      hydrocarbon chains in the disordered conformation. In sciatic nerve the thickness
      of the (thinner) cytoplasmic polar layer, which is also the layer most affected
      by lattice disorder in this type of nerve, decreases dramatically with increasing
      temperature. In optic nerve, in which lattice disorder predominantly affects the
      extracellular layer, the thickness of both the cytoplasmic and the extracellular
      layer is barely affected by temperature.

PMID- 7799431
TI  - Mutational analysis of the prohead binding domain of the large subunit of
      terminase, the bacteriophage lambda DNA packaging enzyme.
AB  - Terminase, the DNA packaging enzyme of bacteriophage lambda, is made up of two
      subunits, gpNul and gpA, the products of the Nu1 and A genes. The activities of
      terminase include DNA binding, cos cleavage and prohead binding. Specificity
      domains within the structure of terminase have previously been defined by genetic
      studies of lambda-21 hybrids. The prohead binding domain of terminase is
      localized to the last 32 amino acid residues of gpA. Mutations in the prohead
      binding domain of gpA were constructed by introducing the corresponding amino
      acids from gp2, the gpA analog of bacteriophage 21. The last five residues of gpA
      can be replaced with little effect on the burst size of lambda. A phage with a
      replacement of the last six residues of gpA with the corresponding residues of
      gp2 was unable to form plaques, indicating that the sixth-to-last residues of gpA
      is crucial for prohead binding. Site-specific mutagenesis of the sixth-to-last
      position of gpA indicated that the sixth-to-last residue of gpA must be
      hydrophobic, of the seven amino acids tested, only isoleucine and valine can
      substitute for leucine at this position. Although the last five residues of gp2
      were functional when they replaced the last five residues of gpA, two results
      indicated that the last five residues of gpA functioned better than the
      corresponding residues of gp2. First, the presence of a valine residue at the
      sixth-to-last position of gpA allowed plaque formation, whereas replacement of
      the last six residues of gpA with those of gp2, which substitutes a valine
      residue at the sixth-to-last position, was lethal. The second set of results
      indicating that the last five residues of gpA function better than the gp2
      residues were obtained by study of revertants of lethal substitution mutations.
      In constructing the replacement mutations, a short linker was inserted into the C
      terminus of the A gene; this insertion created a short duplication of the end of
      the A gene, so that the normal C-terminal codons were located downstream of the
      stop codon of the A gene in the substitution mutants. Revertants of the lethal
      substitution mutations were obtained in which a mutation in the stop codon
      resulted in addition of the last five residues of gpA to the end of the
      substitution terminase.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7799429
TI  - Rapid estimation of bacterial antibiotic susceptibility with flow cytometry.
AB  - Bacterial antibiotic susceptibility was rapidly estimated for Escherichia coli
      and Staphylococcus spp. by flow cytometry. This was achieved by measuring the
      uptake of a negatively charged membrane potential sensitive dye bis-(1,3-dibutyl
      barbituric acid) trimethine oxonol and observing changes in low-angle light
      scatter (excitation light scattered by up to 15 degrees). Estimations of
      ampicillin, gentamicin and ciprofloxacin susceptibilities were possible within 2
      5 h from a plate culture, depending on the species and antibiotic used. This
      includes the time necessary to establish steady-state growth in liquid culture.

PMID- 7799432
TI  - Specific interaction of terminase, the DNA packaging enzyme of bacteriophage
      lambda, with the portal protein of the prohead.
AB  - Terminase, the bacteriophage lambda DNA packaging protein, is a heteromultimer of
      two subunits, gpNu1 and gpA, the products of genes Nu1 and A, resp. Phage 21 is a
      lambdoid phage that produces a terminase similar to that of lambda terminase, the
      subunits of 21 terminase, gp1 and gp2, have the same domain structures of their
      lambda analog, gpNu1 and gpA, respectively. The lambda and 21 terminases have
      different DNA binding and prohead binding specificities. When the C-terminal 32
      amino residues of gpA replace the C-terminal 32 residues of gp2, the resulting
      chimeric terminase specifically uses lambda proheads, indicating that the C
      terminal 32 residues of gpA are a specificity domain for prohead binding. A
      second chimeric terminase, in which the C-terminal six residues of gpA are
      replaced by the C-terminal six residues of gp2, is unable to utilize lambda
      proheads, and a lambda phage producing this terminase, lambda Are636, is unable
      to form plaques. In the present work, a pseudorevertant of lambda Are636 was
      isolated that contained a mutation Bms8, affecting the prohead. The B gene
      encodes the portal protein of lambda proheads, which forms the special vertex
      that is thought to serve as (1) the site of DNA entry into the prohead during
      packaging, (2) the site for DNA exit during DNA injection, and (3) the site of
      tail attachment during virion assembly. Bms8 is predicted to change residue 331
      of gpB from proline to serine. Burst size measurements and in vitro DNA packaging
      experiments demonstrated allele-specific interactions between the Are636
      terminase and Bms8 proheads. That is, wild-type terminase interacted more
      efficiently with wild-type proheads than with Bms8 proheads, and Are636 terminase
      interacted with Bms8 proheads more efficiently than with wild-type proheads.
      Prohead binding by lambda terminase is stimulated by an assembly catalyst, gpFI.
      In vitro packaging extracts lacking gpFI were used under conditions in which
      packaging was gpFI-independent. In the absence of gpFI, Are636 terminase
      interacted most efficiently with Bms8 proheads, and wild-type terminase
      interacted most efficiently with wild-type proheads. The allele-specific
      interactions in the absence of gpFI indicate that the Are636 and Bms8 mutations
      affect direct interactions between terminase and the portal protein, rather than
      acting indirectly by altering the interactions of terminase and gpB and gpFI.

PMID- 7799434
TI  - Trifluoroethanol-induced stabilization of the alpha-helical structure of beta
      lactoglobulin: implication for non-hierarchical protein folding.
AB  - Trifluoroethanol (TFE) is known to stabilize the alpha-helical structure in
      proteins and their fragments. However, the relationship between the TFE-induced
      structures and the native structure is not clear. Here we show that beta
      lactoglobulin, which consists predominantly of beta-sheets, exhibited a markedly
      high propensity to form an alpha-helical structure in the presence of TFE, as
      measured by far-UV circular dichroism. A cooperative transformation from the beta
      sheet structure to an alpha-helical structure occurred at a TFE concentration
      between 10% and 20%. These results were in contrast to a gradual beta-sheet to
      alpha-helix transition of the constant fragment of the immunoglobulin light
      chain, which is also a beta-sheet protein. To understand the significance of the
      high helical propensity of beta-lactoglobulin, we measured the TFE-induced
      conformational transition of more than 20 proteins of various secondary
      structural types. Whereas the alpha-helical proteins showed a propensity to form
      an extensive helical structure in TFE, the helical propensity of proteins with a
      low helical content in the native state varied. The helical content in TFE was
      correlated more with the helical content predicted by a secondary structure
      prediction than with the helical content of the native structure, suggesting that
      the stability of the helical structure in TFE is determined by local interactions
      between nearby amino acid residues. Our results suggest that an alpha-helical
      intermediate can accumulate during the refolding process of beta-lactoglobulin
      and that a hierarchical model of protein folding is not necessarily true for some
      beta-sheet proteins including beta-lactoglobulin.

PMID- 7799433
TI  - Structural and mechanistic analysis of two refined crystal structures of the
      pyridoxal phosphate-dependent enzyme dialkylglycine decarboxylase.
AB  - Two refined structures, differing in alkali metal ion content, of the
      bifunctional, pyridoxal phosphate-dependent enzyme dialkylglycine decarboxylase
      (DGD) are presented in detail. The enzyme is an alpha 4 tetramer, built up as a
      dimer of dimers, with a subunit molecular mass of 46.5 kDa. The fold of DGD is
      similar to those of aspartate aminotransferase, omega-amino acid aminotransferase
      and tyrosine phenol-lyase. The structure has two binding sites for alkali metal
      ions. DGD with potassium in site 1 (near the active site) and sodium in site 2
      (at the surface of the molecule) has been refined against 2.6A resolution data (R
      factor = 17.6%), and DGD with sodium at both sites has been refined against 2.1 A
      resolution data (R-factor = 17.8%). The proximity of site 1 to the active site
      accounts for the dependence of enzyme activity on potassium ions, and the
      observed active site structural changes caused by ion exchange at this site
      explain the inhibition of activity by sodium. DGD catalyzes both the
      decarboxylation of dialkylglycine species and the transamination of L-amino acids
      in its normal catalytic cycle. The active site structure of DGD is moderately
      homologous to that of aspartate aminotransferase, which catalyzes only
      transamination; both the differences and similarities provide mechanistic
      guidelines for the DGD-catalyzed reactions. Models of the L-isovaline and L
      alanine external aldimine intermediates suggest mechanisms by which the
      decarboxylation and transamination reactions could be accomplished within the
      single active site. Decarboxylation is proposed to be at least partially
      catalyzed by stereoelectronic activation of the C alpha-carboxylate bond achieved
      by orienting this bond perpendicular to the plane of the pyridinium ring in the
      dialkylglycine external aldimine intermediate. Transamination is proposed to be
      catalyzed by a similar effect on the C alpha-H bond of the L-amino acid external
      aldimine intermediate, combined with general base catalysis provided by Lys272,
      in analogy to the mechanism of aspartate aminotransferase.

PMID- 7799435
TI  - A yeast RNA binding protein that resembles the human autoantigen La.
AB  - The La protein is a 47 kDa polypeptide that frequently acts as an autoantigen in
      systemic lupus erythematosus and Sjogren's syndrome patients. A key property of
      this protein is its association with the U-rich termini of newly synthesized RNA
      polymerase III transcripts. Here we characterize a 32 kDa protein from
      Saccharomyces cerevisiae that shows sequence similarity to the N termini of
      vertebrate La proteins. This yeast protein also functionally resembles La in that
      it binds preferentially in vitro to RNAs ending with a series of U residues, and
      at least 53 amino acids can be deleted from the C terminus without impeding this
      activity. Such RNA binding activity can be detected in crude yeast extracts by
      immunoprecipitation of ribonucleoprotein particles by an antibody to frog La
      protein. However, the same antibody fails to react with the 32 kDa protein. In
      addition, the gene encoding this protein is not essential for viability.
      Together, these results suggest that additional La homologue(s) exist in yeast.

PMID- 7799436
TI  - Matching electrostatic charge between DNA and coat protein in filamentous
      bacteriophage. Fibre diffraction of charge-deletion mutants.
AB  - The virion of Ff (fd, f1, M13) filamentous bacteriophage consists of a long tube
      of coat protein subunits in a shingled, helical array, surrounding a genome of
      circular single-stranded DNA. Modified fd virions have been generated by a
      mutation (K48A) that removes one positive charge from each coat protein subunit
      in the C-terminal region of the polypeptide chain facing the DNA. The number of
      nucleotides in the mutant DNA is unchanged, but the K48A virions are 35% longer
      than wild-type. We have measured the X-ray diffraction attributable to single
      virions in hydrated gels of wild-type and K48A bacteriophages. Most of the
      diffraction pattern shows no significant difference between wild-type and K48A.
      Since the DNA is only about 12% by weight of the wild-type virion, the
      diffraction pattern is dominated by the protein contribution, and the absence of
      significant differences indicates that there are no significant changes in the
      symmetry or structure of the protein coat. But there is a change in the
      diffraction pattern in a region where the DNA and protein contributions are
      comparable. The diffraction pattern of the K48A mutant shows an increase in
      intensity of one of the weaker equatorial peaks, relative to wild-type, in a
      region where the protein contribution has negative sign but the DNA contribution
      has positive sign. This is consistent with a decrease in the ratio of DNA:protein
      per unit length of the K48A mutant. The results support the view that the protein
      forms a sheath lined with positive charges interacting electrostatically and non
      specifically with a negatively charged DNA core of matching charge density. The
      lower positive charge density lining the capsid in the K48A mutant means that
      correspondingly fewer nucleotides can be packaged per coat protein subunit, which
      in turn requires an elongation of the DNA inside the virion. A longer virion is
      thus required to package the same amount of DNA. Within the error of measurement,
      the number of positive charges on the protein interacting with the DNA is the
      same in K48A as in the wild-type, despite the fact that the mutant is 35% longer
      than the wild-type.

PMID- 7799437
TI  - In vitro replication of plasmids containing human c-myc DNA.
AB  - A chromosomal replication initiation zone was previously mapped in cell cultures
      to the 5' flanking DNA of the human c-myc gene. We have used an in vitro system
      to examine the replication of a plasmid, pNeo.Myc-2.4, containing 2.4 kb of the c
      myc initiation zone. In vitro, pNeo.Myc-2.4 generated high levels of DpnI
      resistant DNA above background incorporation into control plasmids. pNeo.Myc-2.4
      replicated semiconservatively to produce supercoiled and relaxed plasmid
      monomers, and replicative intermediates. [32P]dCMP incorporated into pNeo.Myc-2.4
      appeared in Okazaki fragments and low molecular weight strands which matured to
      full length plasmid DNA, whereas [32P]dCMP incorporated into control plasmids
      appeared as continuous smears on denaturing gels. Other assays also distinguished
      the processive replication of pNeo.Myc-2.4 from the dispersive labeling of
      control plasmids. A pNeo.Myc-2.4 replication time course showed a clear
      preference for initiation within a restriction fragment containing the c-myc DNA.
      Two-dimensional electrophoresis revealed that a restriction fragment bearing the
      c-myc origin zone generated an arc characteristic of replicative intermediates
      containing a central replication bubble, while vector fragments in the plasmid
      generated arcs of forked intermediates. Replication bubbles visualized by
      electron microscopy were centered within the replication initiation zone,
      approximately 1.4 kb upstream of c-myc promoter P1. Okazaki fragments
      radiolabeled during in vitro replication showed a switch in the asymmetry of
      template preference within the initiation zone identified by electron microscopy,
      two-dimensional electrophoresis and early labeling. These data show that
      bidirectional, semiconservative replication can originate preferentially in vitro
      in the 5' flanking DNA of the c-myc gene, and that replicative intermediates
      present at low levels can be distinguished from molecules generated by competing,
      repair-type processes.

PMID- 7799438
TI  - Development of craniofacial musculature in Monodelphis domestica (Marsupialia,
      Didelphidae).
AB  - Development of craniofacial muscles of Monodelphis domestica (Marsupialia,
      Didelphidae) is described. In a period of 4-6 days all craniofacial muscles in M.
      domestica progress from myoblast condensation, to striated myofibers that are
      aligned in the direction of adult muscles and possess multiple, lateral nuclei.
      This process begins 1 to 2 days before birth and continues during the first few
      days after birth. Compared to other aspects of cranial development, muscle
      development in M. domestica is rapid. This rapid and more or less simultaneous
      emergence of craniofacial muscles differs from the previously described pattern
      of development of the cranial skeleton in marsupials, which displays a mosaic of
      acceleration and deceleration of regions and individual elements. Unlike the
      skeletal system, craniofacial muscles show no evidence of regional specialization
      during development. M. domestica resembles eutherian mammals in the relatively
      rapid and more or less simultaneous differentiation of all craniofacial muscles.
      It differs from eutherian taxa in that most stages of myogenesis occur
      postnatally, following the onset of function. The timing of the development of
      muscular and skeletal structures is compared and it is concluded that the
      relatively early development of muscle is not reflected by any particular
      acceleration of the differentiation or growth of skeletal structures. Finally,
      the difficulties in accounting for complex internal arrangements of muscles such
      as the tongue, given current models of myogenesis are summarized.

PMID- 7799439
TI  - Localization and distribution of gap junctions in normal and cardiomyopathic
      hamster heart.
AB  - Gap junctions in mammalian heart function to provide low-resistance channels
      between adjacent cells for passage of ions and small molecules. It is clear that
      the almost unrestricted passage of ions between cells, ionic coupling, is
      required for coordinate and synchronous contraction. This knowledge of gap
      junction function has made it important to study their properties in normal and
      abnormal tissues. In the present study, we analyzed gap junction distribution in
      normal and cardiomyopathic heart tissue utilizing immunofluorescent and electron
      microscopy techniques. Frozen, unfixed sections of age-matched normal and
      cardiomyopathic cardiac tissues were immunofluorescently stained using an
      antibody directed against a specific peptide sequence of the connexin-43 gap
      junction protein. These studies revealed a characteristic punctate staining
      pattern for the intercalated discs in normal tissues. Some of the intercalated
      discs in cardiomyopathic hearts appeared to stain normally; however, others
      stained diffusely. The pixel intensity distribution of the confocal images
      demonstrated a marked difference of up to 90% increase in the number of pixels in
      cardiomyopathic myocardium (CM), yet the pixel intensity of gap junctions had a
      decrease of approximately 60%. This suggests the possibility that connexin-43 is
      present in CM cells in significant quantity; however, it does not become
      localized on the membranes as in normal cells. Electron-microscopic findings
      corroborate these observations on CM cells by showing an irregular distribution
      of intercalated discs relatively smaller in size with abnormal orientation and
      distribution.

PMID- 7799440
TI  - Allometry of cetacean forelimb bones.
AB  - This study examines the allometric scaling relationships of the cetacean humerus,
      radius, and ulna. Bone lengths and diameters were measured for 20 species of
      odontocete and three species of mysticete cetaceans, representing eight of the
      nine extant cetacean families. The scaling of individual bone proportions (bone
      length vs. cranio-caudal diameter, bone length vs. dorso-ventral diameter), and
      of individual bone dimensions against estimated body mass, are compared to models
      of geometric and elastic similarity. The geometric similarity model describes the
      scaling relationship of bone length vs. cranio-caudal diameter and body mass vs.
      cranio-caudal diameter for the humerus only; geometric similarity also describes
      the scaling relationship of body mass vs. bone length for all three bones. None
      of the scaling relationships fits the elastic similarity model. The scaling
      relationships of bone length vs. dorso-ventral diameter for all three bones, and
      bone length vs. cranio-caudal diameter for the radius and ulna, exhibit negative
      allometry, indicating that large bones are less robust than small bones. Negative
      allometry of structural support elements has not been previously described for
      terrestrial mammals or plants. The high relative swimming speeds of small
      delphinids may generate sufficient stresses to require more robust bones relative
      to those of larger whales.

PMID- 7799441
TI  - Ca(2+)-calmodulin mediated modulation of the electrical coupling of ventricular
      myocytes isolated from guinea pig heart.
AB  - The mechanism for the regulation of junctional conductance (gj) by Ca2+ was
      examined in paired ventricular myocytes isolated from guinea pig heart. One cell
      of the pair was voltage-clamped by a single-patch pipette, and gj was measured
      after perforation of the non-junctional membrane of the partner cell. The average
      value of gj under control condition at pCa 9.0 was 181 +/- 13 nS (n = 30). An
      elevation of calcium concentration ([Ca2+]i) in the intracellular perfusate from
      pCa 9.0 to pCa 5.7 resulted in a decrease of 32 +/- 5% in gj (n = 18). In
      myocytes pretreated with W7 (10(-4) M), a similar elevation of [Ca2+]i caused a
      decrease of only 10 +/- 3% in gj (n = 6), indicating a protective action of W7
      against Ca(2+)-mediated electrical uncoupling. W5 (10(-4) M), a non-chlorinated
      derivative of W7, did not show such a protective action. Calmodulin (10(-5) M)
      had no effects on gj at pCa 9.0. However, at moderately elevated [Ca2+]i
      condition at pCa 7.0, calmodulin (10(-5) M) decreased gj by 29 +/- 6% (n = 4).
      These results suggest that calmodulin may play an important role in the Ca(2+)
      mediated regulation of gap junctional channel function in the cardiac ventricular
      cells.

PMID- 7799442
TI  - Local mitochondrial enzyme activity correlates with myocardial blood flow at
      basal workloads.
AB  - To study whether heterogeneous myocardial blood flow relates to the local
      oxidative capacity of cardiac muscle, local blood flow at resting cardiac
      workloads and the activity of the mitochondrial enzyme succinate dehydrogenase
      (SDH) were determined in small regions of the left ventricle of seven
      anaesthetized, mechanically ventilated, open-chest pigs (25-35 kg). Following
      injection of radioactive microspheres (15 microns phi) into the left atrium, the
      heart was rapidly excised and cut into five transverse slices, which were
      simultaneously freeze-clamped between two aluminum blocks precooled at -80
      degrees C. The left ventricle was then subdivided into 84 samples of about 0.9 g.
      Myocardial blood flow was 0.88 +/- 0.34 ml/min/g wet weight (ww), and SDH
      activity 1.46 +/- 0.33 mumol/min/g ww (mean +/- S.D., n = 7). Local data were
      normalized to their respective mean values in each pig, and then pooled. Local
      blood flow ranged from 0.32 to 1.63 of the mean, and blood flow heterogeneity
      characterized by the coefficient of variation (CV = S.D./mean) was 18.4%.
      Normalized local SDH activity ranged from 0.16 to 1.94, with a CV of 21.8%,
      significantly exceeding measurement error (CV = 4.5%). Local blood flows and SDH
      activities did not vary among transmural sublayers of the left ventricle, but
      variation within each sublayer was considerable. In six of the seven pigs, local
      blood flow correlated (P < 0.05) with SDH activity, with correlation coefficients
      (r) ranging from 0.26 to 0.54 (for pooled data: r = 0.27, P < 0.0001). When
      expressed per gram dry weight, heterogeneity of SDH activity increased (P <
      0.05), and here also local blood flow correlated with SDH activity in all pigs
      (for pooled data: r = 0.45, P < 0.0001). Hence, heterogeneity of mitochondrial
      capacity within cardiac muscle partly explains the heterogeneity of myocardial
      blood flow, even though myocardial perfusion at rest was studied in relation with
      a maximal enzyme rate. The low correlation coefficient clearly indicates that at
      resting workloads other factors also play a role.

PMID- 7799444
TI  - Effects of a benzothiazepine calcium blocker on electrolyte alteration in human
      ischemic and reperfused myocardium.
AB  - Intracellular electrolyte alterations of the myocardial cells from the patients
      pretreated and non-treated with diltiazem in coronary surgery were measured by
      means of X-ray microanalysis. Myocardial biopsy specimens were obtained at the
      right atrial wall at non-ischemia, ischemia and reperfusion periods. The ion
      concentrations at non-ischemia which is the condition of pre-open heart surgery
      in patients were: Ca 0.8 +/- 0.05, K 108 +/- 2.3, Na 10 +/- 1.9, Cl 30 +/- 1
      (mean +/- S.E., mmol/kg wet weight, n = 100-130), and there were no significant
      differences for Ca, K, Na and Cl with diltiazem administration. The intracellular
      Ca increased without diltiazem in reperfusion after open heart surgery. However,
      there was no Ca increase in either the ischemia or reperfusion states with
      diltiazem. The K content was significantly lower, and the Na and Cl contents were
      higher than those of non-ischemia in both ischemia and reperfusion without
      diltiazem. The K loss, and Na and Cl increases in the reperfusion period were
      recovered to the levels in the non-ischemia state with diltiazem administration.
      This study showed that the use of calcium-free cardioplegic solution caused
      intracellular calcium accumulation in a hypothermic global ischemic and
      reperfused conditions during coronary surgery, whereas, diltiazem could suppress
      the calcium accumulation. The alterations of potassium, sodium and chlorine were
      also favourable in patients with diltiazem. The possible mechanism of the effects
      of diltiazem on the element alterations of myocardium are discussed.

PMID- 7799443
TI  - Mitochondrial gene expression during bovine cardiac growth and development.
AB  - The expression of both mitochondrial and nuclear genes encoding enzymes involved
      in electron transport and oxidative phosphorylation was examined in bovine
      cardiac tissue during early growth, development and aging. The steady state level
      of mRNAs for mitochondrial genes including ATPase 6. COXII and cyt b increased
      2.5-4-fold relative to early fetal levels in late fetal and young adult tissues
      and showed a marked decline (30-50%) in older adult tissues. Similar results were
      found with the nuclear genes, COXVB and ATP-beta synthase showing coordinate
      regulation of the two genomes. An increase in mtDNA copy number correlated with
      the increase in transcript level. Enzyme activity levels for NADH dehydrogenase
      and cytochrome c oxidase showed a similar trend, albeit of lesser magnitude.
      These activity levels contrasted with the activity level of an entirely nuclear
      encoded mitochondrial enzyme, citrate synthase, which increased not only
      throughout development but in the older adult tissue. This study indicates that
      there is a pattern of increasing mitochondrial and nuclear gene expression for
      OXPHOS enzymes in developing cardiac tissue and decreasing OXPHOS gene expression
      in the aging heart.

PMID- 7799445
TI  - Over-expression of CUG- or AUG-initiated forms of basic fibroblast growth factor
      in cardiac myocytes results in similar effects on mitosis and protein synthesis
      but distinct nuclear morphologies.
AB  - Initiation of translation from alternate codons in the same mRNA results in
      multiple forms of basic fibroblast growth factor (bFGF). High molecular weight
      species of bFGF make use of leucine translation initiation sites located upstream
      of the methionine residue used to produce the 18 kiloDalton (kDa) form. Although
      the addition of exogenous 18 kDa bFGF is known to stimulate DNA synthesis and
      proliferation of several cell types including embryonic chicken cardiac myocytes,
      little is known about the role of high molecular weight forms of bFGF. We
      modified the rat bFGF cDNA to yield high (22/21.5 kDa) or low (18 kDa) molecular
      weight species of bFGF. Expression of 22/21.5 kDa or 18 kDa bFGF in transfected
      embryonic chicken ventricular myocyte cultures was confirmed by protein blotting.
      Expression of both high and low molecular weight species of bFGF was associated
      with (i) a three-fold increase in overall thymidine incorporation as well as
      cardiomyocyte labelling index (fraction of cardiomyocyte nuclei incorporating
      tritiated thymidine); (ii) a two- to three-fold increase in cell number; (iii) an
      eight-fold increase in protein synthesis; and (iv) a three-fold decrease in
      myosin accumulation. Subcellular localization of bFGF in the transfected myocyte
      cultures was also assessed by immunofluorescence microscopy. Over-expression of
      cDNAs yielding high molecular weight bFGF resulted in predominantly nuclear bFGF
      staining. By contrast, both cytoplasmic and nuclear staining were observed
      following over-expression of 18 kDa bFGF. Over-expression of 22/21.5 kDa bFGF was
      associated with the formation of multiple DNA-containing "clumps" resembling
      condensed chromatin in cardiac myocyte nuclei. These DNA "clumps" were not
      observed in cardiac myocyte cultures over-expressing 18 kDa bFGF. These data
      indicate that over-expression of high as well as low molecular weight forms of
      bFGF can stimulate cardiac myocyte proliferative potential and decrease myosin
      accumulation. However, these forms possess distinct subcellular localizations and
      can have different biological functions in the nucleus.

PMID- 7799446
TI  - Effect of streptokinase on human neutrophil function in vitro and in patients
      with acute myocardial infarction.
AB  - The clinical benefit of streptokinase (SK) in the treatment of patients with
      acute myocardial infarction may be influenced by effects other than myocardial
      reperfusion per se. Polymorphonuclear leucocytes (PMNs) have been hypothesized to
      participate in the process of reperfusion injury in the postischemic myocardium.
      The purpose of the present study was therefore to investigate the effect of SK on
      human PMN function in vitro, and ex vivo in patients with acute myocardial
      infarction. SK was not in itself chemotactic to PMNs, and preincubation with SK
      did not alter the chemotactic response of PMNs to formyl-Met-Leu-Phe (FMLP) or
      zymosan-activated serum. However, incubation of fresh citrated plasma with SK
      resulted in the generation of chemotactic activity, and this effect was dependent
      on complement activation by SK. In experiments with PMNs from 20 health donors,
      preincubation of plasma and SK, followed by incubation with PMNs, primed the
      cells for enhanced chemiluminescence response to FMLP. The PMN priming by
      SK+plasma showed considerable interindividual variation, and was not mediated by
      a direct action of plasmin on PMNs. In 10 patients with acute myocardial
      infarction treated with SK, a reduction in superoxide production by PMNs was
      observed immediately following SK. The results suggest that SK modulates human
      PMN function in vivo, and these effects may influence the therapeutical value of
      this agent.

PMID- 7799448
TI  - Influence of cell isolation and recording technique on the voltage dependence of
      the fast cardiac sodium current of the rat.
AB  - We measured macroscopic sodium currents (INa) in preparations from adult rat
      ventricle under four different conditions (I-IV): using the cell attached
      configuration of the tight-seal patch clamp technique on cells isolated with
      either trypsin followed by collagenase (I) or with collagenase only (II), and
      using the loose patch technique on cells isolated with collagenase (II) as well
      as on multicellular preparations not subjected to enzyme treatment (IV). The
      voltage dependence of the steady-state activation of INa as well as of the steady
      state inactivation differed significantly among condition I and II. Moreover, the
      recordings were voltage shifted in comparison to the recording condition III and
      IV. The potentials of half maximal activation and inactivation were: [sequence
      data: see text] The shift of inactivation was time dependent and continued after
      3-5 min after the seal formation in condition I, but not in condition II. No time
      dependent shift was found in III and IV. We conclude, that the voltage dependence
      of cardiac sodium current is shifted by gigaseal patch recording. The degree of
      this shift depends on the type of enzymatic isolation procedure, with trypsin
      causing more pronounced effects than collagenase. The cell isolation itself seems
      not to interfere with the voltage dependence of INa, since loose patch recordings
      from multicellular preparations and from single cells isolated with collagenase
      show no obvious differences.

PMID- 7799447
TI  - Contribution of endothelium and cardiomyocytes to hypoxia-induced adenosine
      release.
AB  - The cellular source and role of adenosine in hypoxia-induced coronary
      vasodilatation was investigated. The endothelial adenine nucleotides of
      Langendorff-perfused rat hearts were prelabelled by perfusion with [3H]adenosine
      and the changes in specific radioactivities were employed to identify the source
      of the adenine compounds released. The contribution of ecto-5'-nucleotidase was
      evaluated in perfusions with the inhibitor alpha,beta-methylene adenosine
      diphosphate (AOPCP). Absorbance of the effluent perfusate at 260 nm was monitored
      continuously as a convenient means of detecting the output of total purines, and
      it showed a good correlation with HPLC-measured purines (r = 0.72, P < 0.001).
      Coronary flow increased sharply in hypoxia but tended to decrease after 2 min,
      while effluent radioactivity and absorbance increased steadily. The radioactivity
      to-absorbance ratio and the specific radioactivity of chemically measured total
      purines began to increase after 3 min. The changes in effluent concentrations of
      adenosine and inosine were much more prominent than those in free purines. The
      specific radioactivity of adenosine decreased sharply at the onset of hypoxia
      which indicates that hypoxia affects mainly working cardiomyocytes. This also
      means that endothelial adenosine release is delayed if compared to coronary
      vasoregulation. Although the inhibition of ecto-5'-nucleotidase caused a decrease
      in the release of adenosine and adenine moiety label from the heart it is most
      likely that adenosine was mainly derived from intracellular sources, because the
      hypoxia-induced increase in the concentration of adenosine was more excessive
      than that of AMP. In addition, AOPCP decreased the basal work load and coronary
      flow of the heart, slightly attenuated the hypoxia-induced flow increase and
      prevented adenylate loss during hypoxia. Thus, the data emphasize the role of
      cardiomyocytes in adenosine production and coronary vasoregulation.

PMID- 7799449
TI  - Hypothesis: apoptosis may be a mechanism for the transition to heart failure with
      chronic pressure overload.

PMID- 7799450
TI  - Some biochemical aspects of the protective effect of trimetazidine on rat
      cardiomyocytes during hypoxia and reoxygenation.
AB  - This study was undertaken to evaluate the direct cardioprotective effect of
      trimetazidine (TMZ), an anti-anginal drug devoid of haemodynamic action, on
      isolated myocytes. Cultured rat ventricular myocytes were treated with the drug
      16 h and 1 h before the experiments. The drug-treated cells and control cells
      were placed in a substrate free medium and submitted in a specially designed
      device to either normoxia (N4), or hypoxia (150 min, H2.5, or 240 min, H4), or
      150 min hypoxia followed by 90 min reoxygenation (HR). The treatment of the cells
      with TMZ (5 x 10(-4) M) resulted in a significant decrease of lactate
      dehydrogenase (LDH) leakage (-58% in H2.5, -36% in H4 and -37% in HR). The LDH
      release provoked by oxidizing agents. H2O2 and 13-s-HpOTrE (13(S)
      hydroperoxyoctadecatrienoic acid) during post-hypoxic reoxygenation was also
      lowered by TMZ. However, this effect reflected the beneficial action of TMZ
      during hypoxia since the drug was not efficient in altering the LDH leakage
      induced by the oxidizing agents in normal conditions. Moreover, the hypoxia
      induced decrease of ATP content was not affected by TMZ, and resynthesis of ATP
      during substrate-free reoxygenation was similar in TMZ-treated and control cells.
      The respiration parameters have been studied in rat heart mitochondria isolated
      from control and TMZ-treated rats, in the presence or absence of TMZ in the
      respiration medium (10(-4) M). The main result was a rapid and potent inhibition
      of palmitoylcarnitine oxidation, when TMZ was added to the respiration medium.
      The chronic treatment only resulted in a slight alteration of pyruvate oxidation.
      In conclusion, a pre-treatment of ventricular myocytes with TMZ resulted in an
      increased cell resistance to hypoxic stress, as evidenced by LDH leakage. This
      cytoprotective effect of TMZ should not be mediated through an antioxidant
      activity, but could be related to a modification of lipid metabolism.

PMID- 7799451
TI  - Explaining load dependence of ventricular contractile properties with a model of
      excitation-contraction coupling.
AB  - A theory is present which accounts for a very broad range of ventricular
      properties that have been noted in recent experiments. The theory is based upon a
      four-state biochemical scheme that accounts for the dynamic interaction between
      calcium, actin and myosin which includes a calcium-free force generating complex
      between actin and myosin. This original scheme was supplemented by incorporating
      two additional basic properties of cardiac muscle: length dependence of calcium
      binding affinity and load dependence of force generation. The biochemical scheme
      was used to provide the force-length-time properties of cardiac muscle which were
      used to construct a ventricle via a spherical geometry. In addition to being able
      to accurately interrelate previously measured calcium and muscle force
      transients, this theory was able to account for many fundamental aspects of
      ventricular performance including: a realistic contractility dependent
      curvilinearity of the end-systolic pressure-volume relationship: enhancement of
      contractile strength on ejecting compared to isovolumic beats; improved
      contractile efficiency on ejecting as compared to isovolumic beats; appropriate
      load-dependent changes in time to peak pressure, time constant of relaxation and
      duration of contraction on isovolumic and ejecting beats; realistic estimated
      time course of tension-dependent heat generation. The explanation for these
      phenomena were explored within the context of the theory and presented in detail.

PMID- 7799452
TI  - Chronic administration of nicardipine attenuates myocardial stunning in isolated
      rabbit hearts.
AB  - The purpose of this study was to evaluate the effects of the chronic
      administration of a calcium channel blocker, nicardipine, on systolic and
      diastolic alterations occurring during myocardial stunning in isolated rabbit
      hearts. Rabbits were pretreated with nicardipine 20 mg (O.I.D.) for 30 days. Then
      hearts were isolated (group II) and compared with control hearts (group I) in
      their response to 20 min of global ischemia and 30 min of reperfusion. Coronary
      flow and heart rate were kept constant. Left ventricular isovolumic developed
      pressure (LVDP), its first derivative (dP/dt), and end diastolic pressure (LVEDP)
      were measured. After isolation, no statistically significant changes were
      detected in LVDP, +dP/dtmax, LVEDP, or coronary resistance in hearts of rabbits
      with or without the pharmacological intervention. Early after the onset of
      reperfusion, LVDP and +dP/dtmax partially recovered in a similar way in groups I
      and II. Late in reperfusion LVDP stabilized at 48 +/- 7% in group I and 71 +/- 6%
      in group II (P < 0.05) and +dP/dtmax stabilized at 56 +/- 7% and 79 +/- 6% (P <
      0.05), respectively. Diastolic dysfunction was manifested by a 217 +/- 39%
      increase in LVEDP (P < 0.05) in group I, and 140 +/- 31% in group II (P < 0.05).
      The isovolumic relaxation time constant (tau, tau) increased from 70 +/- 5 to 151
      +/- 27 ms (P < 0.05), and from 66 +/- 6 to 97 +/- 10 ms. (NS) in groups I and II,
      respectively at 5 min of reperfusion. This relaxation parameter returned to
      normal values in the late reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799453
TI  - Comparison of the action potential prolonging and positive inotropic activity of
      DPI 201-106 and BDF 9148 in human ventricular myocardium.
AB  - The aim of our study was to compare the effects on contractile function and
      action potential duration of the new Na+ channel modulator BDF 9148 with the
      parent compound DPI 201-106 in human ventricular myocardium. Right ventricular
      papillary muscles were obtained from explanted hearts of heart transplant
      recipients or from non-failing hearts not suitable for transplantation. BDF 9148
      induced an increase in force of contraction that was accompanied by prolongation
      of action potential duration. The action potential duration prolonging effect of
      BDF 9148 was not significantly different to that of DPI 201-106. The effects of
      BDF 9148 were similar in muscles obtained from non-failing and failing hearts.
      Using Na(+)-sensitive electrodes, we have demonstrated that the positive
      inotropic effect of BDF 9148 is accompanied by an increase in intracellular Na+
      activity. Our results indicate: (i) that BDF 9148 is as effective as DPI 201-106
      in increasing force of contraction and prolonging action potential duration in
      human ventricular myocardium: (ii) that BDF 9148 is effective in enhancing force
      of contraction, in spite of heart failure; (iii) that the positive inotropic
      effect is related to an increased Na+ load; and (iv) due to action potential
      duration prolongation, changes in Q-T interval of the electrocardiogram could be
      possible during in vivo use of BDF 9148.

PMID- 7799455
TI  - Ocular manifestations of diabetes mellitus (continuing education credit).
AB  - 1. Within 15 to 20 years of being diagnosed as having diabetes mellitus, 90% of
      patients will have some degree of diabetic retinopathy and 25% will have
      proliferative diabetic retinopathy. 2. The majority of the cases of blindness
      from diabetic retinopathy could be prevented or significantly delayed by timely
      and appropriate management of diabetic retinopathy. 3. Until a cure for diabetes
      mellitus is discovered, all patients with diabetes mellitus should receive
      ophthalmic evaluation soon after the diagnosis is made.

PMID- 7799456
TI  - A key to preventing diabetic retinopathy: the link between nutrition and blood
      sugar.
AB  - 1. Complications associated with diabetes include diabetic retinopathy,
      nephropathy, and neuropathy. The most important factor in preventing or delaying
      chronic complications associated with diabetes is blood glucose control, which is
      achieved through diet, insulin therapy, and self-monitoring. 2. The American
      Diabetes Association's Exchange System is useful for the motivated, well-educated
      patient, although its complexity can lead to noncompliance. The system assists in
      meal planning and permits flexible selection from a variety of foods, taking into
      account each food's total protein, fat, and carbohydrate content. 3. Adequate
      calories and nutrients must be provided, along with behavioral modifications and
      medical treatment, to achieve optimal health.

PMID- 7799454
TI  - Protective effects of the SOD-mimetic SC-52608 against ischemia/reperfusion
      damage in the rabbit isolated heart.
AB  - An experimental model of myocardial ischemia/reperfusion injury was used to
      assess the cardioprotective effects of SC-52608, a low molecular weight
      superoxide dismutase mimetic. Langendorff perfused rabbit isolated hearts were
      subjected to 30 min of global ischemia followed by 45 min of reperfusion. Hearts
      perfused in the presence of 20 microM SC-52608 exhibited a decrease in the
      release of creatine kinase and intracellular potassium compared to hearts
      receiving vehicle (control). A progressive increase in left ventricular end
      diastolic pressure developed upon reperfusion in all hearts, but was
      significantly greater in control hearts when compared to hearts treated with SC
      52608 (P < 0.05). In addition, results obtained with a radiolabeled monoclonal
      antibody to the intracellular protein myosin, indicate an increased degree of
      irreversible damage in vehicle-treated hearts. Myocardial protection was not
      significant in an additional group of hearts treated with 10 microM SC-52608. The
      hemodynamic, biochemical, morphological, as well as the antimyosin binding data,
      demonstrate that pretreatment with SC-52608 protects the myocardium from damage
      associated with global ischemia and reperfusion. The mechanism by which SC-52608
      mediates the observed protective effect is most likely related to its ability to
      scavenge superoxide.

PMID- 7799457
TI  - Exercise options for people with diabetic eye complications.
AB  - 1. The first rule of exercise prescription is that the benefits must outweigh the
      risk. 2. It is recommended that patients with diabetic complications undergo a
      thorough physical examination prior to beginning an exercise program. 3. A
      program of daily, moderate aerobic exercise helps to maintain or improve
      cardiovascular functioning while improving insulin sensitivity and blood sugar
      control.

PMID- 7799458
TI  - Amaurosis fugax challenges: best met by multispecialty approach to management.
AB  - 1. Amaurosis fugax (AF) refers to transient, reversible loss of vision, typically
      monocular and of short duration. 2. Patients with AF present a diagnostic and
      therapeutic challenge, frequently requiring a multispecialty approach to
      management. It is important to determine whether or not there is an ocular cause
      of the problem. 3. In the absence of eye findings to explain the symptoms, the
      internist must direct the workup toward cardiogenic hypotension, migraine,
      carotid or vertebral-basilar artherosclerotic disease, cardiac embolic disorder,
      and other potential causes.

PMID- 7799460
TI  - Origins of beliefs and attitudes toward blindness.

PMID- 7799459
TI  - Amblyopia: etiology, diagnosis, and treatment. American Academy of Ophthalmology.
AB  - 1. Sometimes called "lazy eye," amblyopia is poor vision in an eye that did not
      develop normal sight during early childhood. Amblyopia is common, affecting
      approximately 2 or 3 out of every 100 people. The best time to correct amblyopia
      is during infancy or early childhood. 2. Amblyopia has three major causes:
      strabismus (misaligned eyes), unequal focus (refractive error), and cloudiness in
      the normally clear eye tissues. 3. To correct amblyopia, a child must be made to
      use the weak eye. This is usually done by patching or covering the strong eye.
      Amblyopia cannot be cured by treating the cause alone; the weaker eye must be
      made stronger in order to see normally.

PMID- 7799461
TI  - Self-assessment quiz. Sub-hyaloid hemorrhage.

PMID- 7799462
TI  - Positioning daily disposables in the contact lens practice.

PMID- 7799463
TI  - Lower tibial osteotomy for osteoarthritis of the ankle.
AB  - Ankle arthrodesis is still the treatment of choice for most disabling arthritic
      ankles. But in spite of its popularity, ankle arthrodesis has many disadvantages,
      including long immobilization, a high pseudoarthrosis rate, and load shift with
      increased stress on neighboring joints of ankle. Lower tibial osteotomy is one of
      the methods which attempts to halt ankle arthritis in the intermediate stage and
      trying to prevent ankle arthroadesis. From Aug. 1989, we performed 8 operations
      of lower tibial osteotomy in our hospital on intermediate arthritic ankle which
      included 4 post-traumatic ankle arthritis and 4 ankle osteoarthritis. The
      patient's ages ranged from 21y/o to 72y/o with an average of 41.6y/o. The mean
      time of followed up was 31.7 months. The patients were evaluated by the ankle
      functional scale preoperatively and during their followed up. The average
      preoperative functional score was 49.6 and the last follow up score was 88.5
      which is increasing year by year. Significant improvement occurred in function
      and pain relief and there was improvement of ankle motion in most patients except
      one. Complications included late infection in 1 patient and implant failure with
      subsequent revision surgery due to overcorrection in 1 patient. No nonunion was
      noted. Although our series was small, we had encouraging short-term results. We
      believe lower tibial osteotomy, by pressure redistribution on the joint surface,
      is an alternative for the treatment of ankle osteoarthritis and may save or delay
      arthritic ankle from the fate of fusion.

PMID- 7799464
TI  - Radionuclide esophageal transit test in the detection of esophageal dysmotility
      in Parkinson's disease.
AB  - Thirty-three patients of idiopathic Parkinson's disease (PD) and 25 volunteers
      were admitted to the study for comparison. Esophageal motility including
      esophageal mean transit time (MTT), residual fraction (RF), and retrograde index
      (RI) of the two groups were evaluated and calculated by the radionuclide
      esophageal transit test. The results show that 12% (4/33) of the cases of PD were
      abnormal in proximal, 15% (5/33) in middle, 0% (0/33) in distal, and 12% (4/33)
      in total MTT, as well as 6% (2/33) in RF, and 24% (8/33) in RI. In addition, the
      patients with high H-Y scale scores had a higher incidence of abnormality in
      proximal MTT than those with low scale (P < 0.05 by a Fisher's exact test). We
      consider that the radionuclide esophageal transit test has potential as an
      effective, simple and noninvasive screening tool to detect abnormal esophageal
      motility in patients suffering from Parkinson's disease.

PMID- 7799465
TI  - Abdominal wall hernia complicating continuous ambulatory peritoneal dialysis.
AB  - Continuous ambulatory peritoneal dialysis (CAPD) is a well-established treatment
      modality for end-stage renal disease. Abdominal wall hernia is not uncommon in
      patients on CAPD. Two factors are responsible for the occurrence of these
      hernias: anatomically weak sites and increased intraperitoneal pressure by the
      dialysate. Abdominal wall hernia was reviewed in 44 patients on CAPD from 1987
      through 1991. Eight abdominal hernias (5 inguinal, 2 incisional and 1 umbilical)
      were found during CAPD treatment (18.18%). Surgical treatment was applied in 6
      symptomatic hernias (5 inguinal and 1 incisional). After surgery, 5 patients
      returned to CAPD without recurrence and the remaining one died of strangulated
      incisional hernia. Our series shows that: (1) a detailed examination of the
      preexisting hernia and repair prior to CAPD treatment are suggested. (2)
      symptomatic abdominal wall hernia should be evaluated carefully and treated
      promptly. (3) awareness of the complication of these hernias can reduce the
      morbidity and mortality.

PMID- 7799466
TI  - [A replication of multidimensionality of activities of daily living(ADL): on the
      elderly in southern Taiwan].
AB  - The purpose of the present study is to test whether Wolinsky and Johnson's
      declaration that activities of daily living (ADL) can be divided into three
      subdimension (basic, household, and advanced ADL), and whether these three
      dimensions could be replicated or not in Taiwan. Furthermore, to confirm the
      relationship of advanced ADL and cognitive function. The analyses were based on a
      sample of 790 respondents over 65 years of age who lived in the community of
      Southern Taiwan. Fourteen items were adopted from the ADL section of OARS
      Multidimensional Functional Assessment (OMFAQ, Chinese Version) for performing a
      confirmatory factor analysis. In addition, 10 items from the Short Portable
      Mental Status Questionnaire (SPMSQ) were selected for a zero-order correlation
      and regression analyses to examine the relationship between the advanced ADL and
      cognitive function. The results support Wolinsky & Johnson's assertion, but some
      items that are comprised in each factor structure, however, are not consistent
      with those in Wolinsky & Johnson's study, such as taking medicine, grooming,
      eating, shopping, and transporting. Significant correlation between advanced ADL
      and cognitive function was also confirmed in the study (r = 0.612, p < 0.05).

PMID- 7799467
TI  - [Postpartum adjustment of women who were home during the "traditional Chinese one
      month postpartum period of confinement" and those who were in maternity care
      centers].
AB  - The purpose of this study was to explore the difference in postpartum adjustment
      between women who were at home for there "doing the month" and those who stayed
      in a maternity care center. A repeated measures design was conducted, with data
      collected at 1 and 4 weeks postpartum. A total of 120 postpartum women
      participated in this study. Data were analyzed by factor analysis to determine
      the relationships within categories of postpartum strssors and depression. Then,
      the data were analyzed by 2 x 2 repeated measure MANOVA to determine the
      variations among groups and time. The results indicated that women who were in
      maternity centers for the "doing the month" perceived significantly higher stress
      than did the home group, and that women perceived higher stress at 4 weeks
      postpartum than at 1 week postpartum. Factor analysis of the data defined four
      categories of postpartum stress. It was found that women at maternity care
      centers perceived significantly higher stress from factors named, "stress from
      lacking of support system" and "stress from identifying maternal role". In
      addition, women doing the month at maternity care centers showed significantly
      higher depression level than women doing the month at home. However, there is no
      significant difference in postpartum stress and postpartum depression between
      time 1 (1 week postpartum) and time 2 (4 weeks postpartum).

PMID- 7799468
TI  - Imaging diagnosis of cavernous hemangioma of the rib--one case report and review
      of the literature.
AB  - Osseous hemangioma is a benign neoplasm, rarely located in the ribs. A 56-year
      old female patient without specific complaint had a large extrapleural lesion on
      chest posteroanterior radiograph. Expansile destruction of left seventh rib and
      relatively fine trabeculation were noticed in the mass from plain roentgenogram
      and computed tomography (CT). Contrast enhancement in noncalcified component of
      the lesion was revealed. Pleural effusion, lung parenchymal or mediastinal
      abnormality were not identified. Resection of the lesion with part of the
      originating rib was carried out. The pathologic diagnosis was cavernous
      hemangioma. We present a case with a large rib hemangioma which often leads to
      difficulty in radiologically differential diagnosis with other common malignant
      rib tumors. We also review the literature about hemangioma and malignant
      neoplasms of the ribs.

PMID- 7799469
TI  - Subependymal giant cell astrocytoma with tuberous sclerosis--case report.
AB  - Tuberous sclerosis is a rare disease of autosomal dominant inheritance and may
      affect any organ, and less than 2% have a subependymal giant cell astrocytoma. In
      the present report, a 6-year-old girl with clinical features of tuberous
      sclerosis had an intraventricular tumor. CT scan and MRI of brain showed a tumor
      in the lateral ventricles extended into the Foramina of Monro and third ventricle
      causing severe hydrocephalus. She underwent left frontal craniotomy with partial
      removal of the tumor. The pathology was subependymal giant cell astrocytoma.
      Patient's neurological condition improved postoperatively and postoperative CT
      scan showed no hydrocephalus. Clinical and radiological follow-up of patients
      with tuberous sclerosis who had subependymal nodules in early childhood is
      important due to its possibility of subsequent transformation into
      intraventricular tumor.

PMID- 7799470
TI  - Factors affecting speed in human-powered vehicles.
AB  - It is shown how to derive the appropriate cubic equation relating power and the
      effects of friction, gradient and wind resistance on the speed of a human-powered
      vehicle (HPV). The effects of gradient and wind resistance are explored for
      parameters representing a typical racing cyclist. The principal conclusion may be
      summarized as follows: for optimum performance in a time trial, there should be
      no wind and the course should be level. Any deviation from these conditions will
      produce a decrement in performance.

PMID- 7799471
TI  - An examination of the cohesion-performance relationship in university hockey
      teams.
AB  - The objective of this study was to assess, using the Group Environment
      Questionnaire, whether team cohesion in university-level field hockey was a cause
      for, or an effect of, successful performance. A quasi-experimental longitudinal
      design with cross-lagged correlational analysis was adopted and measures of
      cohesion and performance were taken midway and later in the season. The results
      of the synchronous correlations showed a positive relationship (with good
      stationarity) between team cohesion and performance outcome. Although non
      significant cross-lagged differentials indicated a circular relationship, the
      magnitudes of both the cross-lagged correlations and the partial correlations,
      together with multiple-regression analyses, revealed that the stronger flow was
      from cohesion to performance. The socially oriented aspects of cohesion, in
      particular, had significant associations with performance. The results imply that
      cohesion-performance relationships should be examined within a circular model, in
      which cohesion and performance are interdependent.

PMID- 7799472
TI  - Aerobic exercise and Type A behaviour.
AB  - The Type A behaviour pattern is a well-documented, if controversial, risk factor
      for coronary heart disease. Surprisingly, relatively little work has been
      reported on ways of modifying this behaviour pattern. Aerobic exercise, with its
      demonstrated benefits for both cardiovascular reactivity and psychological 'well
      being', is a promising treatment. The literature is reviewed and recommendations
      are made for practical applications and future research.

PMID- 7799473
TI  - Accumulated oxygen deficit and short-distance running performance.
AB  - Recent studies have suggested that determining the accumulated oxygen deficit
      (AOD), in units of oxygen equivalents per kilogram body mass (ml O2 Eq.kg-1),
      during a short exhaustive run, may represent a non-invasive measure of anaerobic
      metabolism. However, there is little information either on the reproducibility of
      the laboratory determination or its relationship with human performance. The
      purpose of the present investigation was to determine the reproducibility of AOD
      during inclined treadmill running (study 1), and to examine its relationship with
      short-distance running performance (study 2). Twelve volunteers (11 males, 1
      female) took part in study 1 and AOD was determined (relative exercise intensity
      approximately 120% VO2 max) on two separate occasions at a treadmill inclination
      of 10.5%; the laboratory-measured AOD values were 65.2 +/- 10.9 vs 66.3 +/- 12.5
      ml O2 Eq.kg-1, respectively (r = 0.94, P < 0.01). A second subject group (10
      males, 4 females) undertook study 2, which investigated AOD values and track
      times over 100, 400 and 800 m. The mean calculated AOD value was 66.1 +/- 12.0 ml
      O2 Eq.kg-1, and the average track times were 13.6 +/- 1.3, 60.9 +/- 6.8 and 138.8
      +/- 18.5 s for the 100, 400 and 800 m, respectively. The r-values for the
      relationship between AOD and track time were -0.88, -0.82 (P < 0.01) and -0.61 (P
      < 0.05) for the 100, 400 and 800 m, respectively. The results of the present
      study suggest that the AOD (ml O2 Eq.kg-1) is a unique and reproducible
      physiological characteristic which is strongly correlated with sprint capacity.

PMID- 7799474
TI  - Aerobic and anaerobic contributions to exhaustive high-intensity exercise after
      sleep deprivation.
AB  - The purpose of this study was to determine the effect of one night's sleep loss
      on the performance of high-intensity exercise and on the contribution of
      anaerobic and aerobic energy systems to the exercise. Seven males and seven
      females performed an all-out cycling exercise test during baseline testing and
      then on three consecutive days after a sleepless night. The work rates were 5.0 W
      kg-1 for the females and 6.0 W kg-1 for the males. The aerobic contribution was
      determined based on measured VO2 and the anaerobic contribution was determined by
      subtraction of the aerobic contribution from the total amount of work performed.
      The results of baseline tests and of tests performed following sleep loss were
      compared for evidence of an effect of sleep deprivation. The 25-30 h of sleep
      deprivation did not affect total work, the anaerobic contribution or the aerobic
      contribution (all P > 0.1), although there was a tendency (P = 0.13) for mean VO2
      to decrease after the sleepless night. There were no interaction effects
      involving sex on total work, the anaerobic contribution or the aerobic
      contribution (all P > 0.1). The mean (+/- S.E.M.) values for total work (kJ)
      performed were: baseline, 21.9 +/- 2.7; after sleep loss, 21.1 +/- 2.5 (day 1),
      21.7 +/- 2.5 (day 2), and 21.9 +/- 2.7 (day 3). It is concluded that, in both
      males and females, there are no changes in the contributions of the aerobic and
      anaerobic energy systems to high-intensity exercise performed following the loss
      of one night's sleep.

PMID- 7799475
TI  - Effects of resistance exercise and cycling on recovery blood pressure.
AB  - The purpose of this investigation was to examine blood pressure responses during
      recovery from resistance exercise and cycling. Seven normotensive volunteers (5
      males, 2 females) were studied. Resistance exercise consisted of three sets of
      five exercises (arm curl, hamstring curl, squat, 'lat pull' and bench press) on
      four occasions: (1) twice using 40% one-repetition maximum (1RM) for 20-25
      repetitions, and (2) twice using 70% 1RM for 8-10 repetitions. The subjects also
      cycled for 25 min at 70% of heart rate reserve on two occasions. Measurements of
      recovery systolic and diastolic blood pressure were made at 2, 5, 10, 15, 30 and
      60 min post-exercise with subjects in the seated position. Analysis of variance
      with repeated measures revealed that there were no significant differences
      between recovery blood pressures after the cycling or resistance exercise
      treatments. Average systolic blood pressure after 2 min of recovery was elevated
      (115 +/- 2 mmHg, P < 0.0001) and diastolic blood pressure was depressed (48 +/- 3
      mmHg, P < 0.0001) in comparison to previously determined baseline values.
      Systolic blood pressure at 5 min and diastolic blood pressure at 15 min post
      exercise were not significantly lower than resting baseline values, and remained
      so after 60 min of recovery. It was concluded that different intensities of
      resistance exercise produce the same blood pressure response in recovery and that
      these changes were approximately equal to those produced by cycling.

PMID- 7799476
TI  - The physiological and ventilatory responses to repeated 60 s sprints following
      sodium citrate ingestion.
AB  - This study examined the influence of sodium citrate on changes in selected blood,
      ventilatory and performance variables in response to intermittent sprint
      exercise. Eight moderately active male students completed three tests over a 6
      day experimental period. The first test involved incremental exercise to
      determine VO2 max, while the second and third tests were identical in nature and
      involved five 60 s sprints cycling against 0.075 kg kg-1 body mass (BM); each of
      the five sprints was separated by 5 min passive seated recovery. Three days
      separated the VO2 max test and first interval test, while a further 3 days
      elapsed between the first and second interval tests. Ninety minutes prior to each
      interval test, the subjects consumed either a solution of sodium citrate (0.5 g
      kg-1 BM) or a placebo solution (1 g of calcium carbonate and 4 mg of sodium
      chloride). These were randomly administered in a double-blind crossover procedure
      so that every subject consumed each solution prior to the interval test over the
      6 day period. Measures of work, VE, VO2, VCO2, post-exercise plasma lactate, and
      changes in both venous blood pH and venous blood bicarbonate (HCO3-) were
      measured during each interval test. Although analysis of variance failed to
      identify differences in performance between the two solutions, both exercise VCO2
      and changes in venous blood HCO3- were higher in the citrate condition (P <
      0.05). In addition, both peak post-exercise plasma lactate concentrations and
      post-exercise venous blood pH were significantly higher following citrate
      ingestion. Although these data are consistent with greater clearance of lactate
      and H+ from the active muscle cells following citrate ingestion, performance
      between the two trials was the same.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799477
TI  - Loss of exercise training-induced bradycardia with continued improvement in
      fitness.
AB  - In sedentary individuals, the decrease in heart rate (HR) at a respiratory
      exchange ratio (R) of unity (HR/R = 1) is lost after 8 weeks of moderate
      intensity exercise training. The purpose of this investigation was to examine the
      effect of training on HR/R = 1, using the exercise intensity (EI) at R = 1 (EI/R
      = 1) and the HR at a set EI (HR/EIS). In nine healthy volunteers, these indices
      showed small measurement variability and detected changes associated with 16
      weeks of training in that EI/R = 1 and VO2/R = 1 increased, whereas HR/EIS, HR/R
      = 1 and HR/VO2 decreased. All of these changes were reversed when training ended.
      In a second trial in a further nine volunteers, the training programme was
      extended to 20 weeks, and again showed that the decrease in HR/R = 1 failed to
      progress after 8 weeks despite continued changes in other indices (increases in
      VO2/R = 1 and decreases in HR/VO2 elevation). The loss of HR/R = 1 decrease was
      attributed to equal and opposite effects on HR/EIS and EI/R = 1. However, the
      decreases in HR/EIS showed the same trend as HR/R = 1, with a lack of progression
      beyond 8-16 weeks. These findings suggest that different indices of
      cardiorespiratory fitness have different patterns of change and limitations
      during training. Those which rely on decreases in submaximal HR fail to detect
      adaptation during continued training. Using submaximal exercise test indices,
      detection of such changes is better achieved by the measurement of decreases in
      HR/VO2 elevation and increases in VO2/R = 1 values.

PMID- 7799478
TI  - From the Centers for Disease Control and Prevention. Mortality patterns--United
      States, 1992.

PMID- 7799479
TI  - From the Centers for Disease Control and Prevention. Infant mortality--United
      States, 1992.

PMID- 7799480
TI  - From the Centers for Disease Control and Prevention. Prevalence of selected risk
      factors for chronic disease by education level in racial/ethnic populations-
      United States, 1991-1992.

PMID- 7799481
TI  - Forecasting physician workforce requirements.

PMID- 7799482
TI  - Forecasting physician workforce requirements.

PMID- 7799483
TI  - Forecasting physician workforce requirements.

PMID- 7799484
TI  - Forecasting physician workforce requirements.

PMID- 7799485
TI  - Forecasting physician workforce requirements.

PMID- 7799486
TI  - A conversation with my mother.

PMID- 7799487
TI  - Editorial peer review.

PMID- 7799489
TI  - Hierarchical authorship.

PMID- 7799488
TI  - LDL density and atherosclerosis.

PMID- 7799490
TI  - Silicone breast implants and risk of cancer?

PMID- 7799491
TI  - The natural history of the systemic inflammatory response syndrome (SIRS). A
      prospective study.
AB  - OBJECTIVE: Define the epidemiology of the four recently classified syndromes
      describing the biologic response to infection: systemic inflammatory response
      syndrome (SIRS), sepsis, severe sepsis, and septic shock. DESIGN: Prospective
      cohort study with a follow-up of 28 days or until discharge if earlier. SETTING:
      Three intensive care units and three general wards in a tertiary health care
      institution. METHODS: Patients were included if they met at least two of the
      criteria for SIRS: fever or hypothermia, tachycardia, tachypnea, or abnormal
      white blood cell count. MAIN OUTCOMES MEASURES: Development of any stage of the
      biologic response to infection: sepsis, severe sepsis, septic shock, end-organ
      dysfunction, and death. RESULTS: During the study period 3708 patients were
      admitted to the survey units, and 2527 (68%) met the criteria for SIRS. The
      incidence density rates for SIRS in the surgical, medical, and cardiovascular
      intensive care units were 857, 804, and 542 episodes per 1000 patient-days,
      respectively, and 671, 495, and 320 per 1000 patient-days for the medical,
      cardiothoracic, and general surgery wards, respectively. Among patients with
      SIRS, 649 (26%) developed sepsis, 467 (18%) developed severe sepsis, and 110 (4%)
      developed septic shock. The median interval from SIRS to sepsis was inversely
      correlated with the number of SIRS criteria (two, three, or all four) that the
      patients met. As the population of patients progressed from SIRS to septic shock,
      increasing proportions had adult respiratory distress syndrome, disseminated
      intravascular coagulation, acute renal failure, and shock. Positive blood
      cultures were found in 17% of patients with sepsis, in 25% with severe sepsis,
      and in 69% with septic shock. There were also stepwise increases in mortality
      rates in the hierarchy from SIRS, sepsis, severe sepsis, and septic shock: 7%,
      16%, 20%, and 46%, respectively. Of interest, we also observed equal numbers of
      patients who appeared to have sepsis, severe sepsis, and septic shock but who had
      negative cultures. They had been prescribed empirical antibiotics for a median of
      3 days. The cause of the systemic inflammatory response in these culture-negative
      populations is unknown, but they had similar morbidity and mortality rates as the
      respective culture-positive populations. CONCLUSIONS: This prospective
      epidemiologic study of SIRS and related conditions provides, to our knowledge,
      the first evidence of a clinical progression from SIRS to sepsis to severe sepsis
      and septic shock.

PMID- 7799492
TI  - Use of the medical futility rationale in do-not-attempt-resuscitation orders.
AB  - OBJECTIVE: To describe the use of the medical futility rationale in do-not
      attempt-resuscitation (DNAR) orders written for medical inpatients. DESIGN:
      Structured interviews with medical residents. METHODS: Second- and third-year
      internal medicine residents (n = 44) were telephoned weekly and briefly
      interviewed about each patient who received a DNAR order in the preceding week.
      SETTING: Two university-affiliated hospitals: a veterans affairs medical center
      and a municipal hospital. PATIENTS: One hundred forty-five medical inpatients for
      whom DNAR orders were written during their hospitalization. RESULTS: Residents
      stated that the medical futility rationale applied for 91 patients (63%), but
      this rationale was invoked independent of patient or surrogate choice for only 17
      patients (12%). Of the 91 patients for whom futility applied, both quantitative
      futility (low probability of success) and qualitative futility (poor quality of
      life if cardiopulmonary resuscitation [CPR] were performed) applied to 45 (49%),
      quantitative futility alone to 30 (33%), and qualitative futility alone to 16
      (18%). Residents report that they discussed resuscitation issues with all
      communicative patients for whom the medical futility rationale was invoked. Among
      patients for whom quantitative futility applied, residents' predictions of the
      probability that patients would survive to hospital discharge after CPR varied
      from 0% (for 60% of patients) to 75%. For 32% of these patients, residents
      predicted survival at 5% or more. Logistic regression modeling showed that the
      presence of organ failure (odds ratio [OR], 8.9; 95% confidence interval [CI],
      3.3 to 23.9), the residents' estimates of the probability of surviving CPR (OR,
      0.94; 95% CI, 0.88 to 0.99), and nonwhite race (OR, 2.7; 95% CI, 1.1 to 6.3) were
      associated with the determination of quantitative futility. In one third of the
      cases where qualitative futility applied, residents made the judgment of
      qualitative futility without discussing quality of life with communicative
      patients. Logistic regression modeling showed immobility (OR, 3.2; 95% CI, 1.1 to
      9.0) and age > or = 75 years (OR, 0.3; 95% CI, 0.1 to 0.8) to be associated with
      the determination of qualitative futility. CONCLUSIONS: While residents did not
      appear to use the medical futility rationale to avoid discussing DNAR issues with
      patients, we found evidence of important misunderstandings of the concepts of
      both quantitative and qualitative futility. If the futility rationale is to be
      applied to withholding or withdrawing medical interventions, practice guidelines
      for its use should be developed, and education about medical futility must be
      incorporated into medical school, residency training, and continuing medical
      education programs.

PMID- 7799493
TI  - Quality-of-life outcomes in men treated for localized prostate cancer.
AB  - OBJECTIVE: To assess health-related quality of life (HRQOL) in men treated for
      clinically localized prostate cancer. DESIGN: A cross-sectional analysis of HRQOL
      after treatment with radical prostatectomy, pelvic irradiation, or observation
      alone for clinically localized prostatic adenocarcinoma, and in age-matched
      comparison patients. SETTING: A large managed care population in California.
      SUBJECTS: A total of 528 men, including 214 treated for clinically localized
      prostate cancer (41 with evidence of metastatic disease were excluded from this
      analysis) and 273 age-matched, ZIP code-matched comparison patients without
      prostate cancer. Cancer patients were analyzed in three treatment groups: radical
      prostatectomy (n = 98), primary pelvic irradiation (n = 56), and observation
      alone (n = 60). MAIN OUTCOME MEASURES: General HRQOL was measured with the RAND
      36-Item Health Survey 1.0. Cancer-specific HRQOL was measured with the CAncer
      Rehabilitation Evaluation System-Short Form and the Functional Assessment of
      Cancer Therapy-General form. Disease-targeted quality of life was measured with a
      new instrument assessing function and bother in three organ systems: sexual,
      urinary, and bowel. RESULTS: No differences among treatment groups were seen in
      comparisons of general HRQOL: Significant differences among treatment groups were
      seen in both function and bother in the prostate-targeted measures of sexual,
      urinary, and bowel domains. When cancer patients were compared with men of
      similar age without prostate cancer, differences were seen in the sexual,
      urinary, and bowel function and bother but not in general HRQOL measures.
      Although cancer-free men were found not to have full potency or continence,
      prostate cancer patients treated with surgery or radiation reported significantly
      worse sexual, urinary, and bowel function than men without cancer. Men who had
      undergone nerve-sparing prostatectomy did not differ from those who had undergone
      standard prostatectomy, but the power to detect a difference was low.
      CONCLUSIONS: Although no differences were seen in general HRQOL, three disease
      targeted domains were found to differ significantly among the treatment groups
      and comparison patients. Even after controlling for the sexual and urinary
      dysfunction experienced by older men without cancer, those receiving therapeutic
      interventions for their prostate cancer were found to have poorer disease
      targeted HRQOL: We conclude that in addition to general HRQOL, disease-targeted
      measures must be used to assess outcomes of care in men treated for localized
      prostate cancer.

PMID- 7799494
TI  - Risk stratification in unstable angina. Prospective validation of the Braunwald
      classification.
AB  - OBJECTIVES: To validate the Braunwald classification of unstable angina as a
      predictor of in-hospital cardiac complications; to determine which factors of the
      Braunwald classification contributed significantly to this prediction; and to
      devise a method of combining these predictive factors into an overall odds ratio
      for complications. DESIGN: A validation cohort of consecutive patients followed
      prospectively for in-hospital cardiac complications including myocardial
      infarction and death. SETTING: A community-based academic medical center.
      PATIENTS: A total of 393 patients admitted consecutively to the coronary care and
      intermediate care units with unstable angina. MAIN OUTCOME MEASURES: Major
      cardiac complications including death, myocardial infarction, congestive heart
      failure, cardiogenic shock, and severe ventricular dysrhythmias. RESULTS:
      Multiple logistic regression analysis identified four clinical factors used in
      the Braunwald classification that predicted the in-hospital occurrence of major
      cardiac complications: (1) myocardial infarction within less than 14 days (odds
      ratio [OR], 5.72; 95% confidence interval [CI], 1.92 to 16.97); (2) need for
      intravenous nitroglycerin (OR, 2.33; 95% CI, 1.31 to 4.17); (3) lack of beta
      blocker or calcium channel blocker prior to admission (OR, 3.83; 95% CI, 1.55 to
      9.42); and (4) baseline ST depression (OR, 2.81; 95% CI, 1.45 to 5.47). Two other
      clinical factors, diabetes and age, were also significant predictors. Validation
      of this model using parametric and nonparametric bootstrap techniques revealed
      excellent agreement between the CIs for adjusted ORs derived from the multiple
      logistic regression and those derived from the bootstrap. CONCLUSIONS: The
      classification of unstable angina proposed by Braunwald includes four factors
      that predict risk of major in-hospital cardiac complications. Specific factors
      used in this classification can be combined with diabetes and age to better
      stratify risk of major cardiac complications in this disorder using a simpler
      model.

PMID- 7799495
TI  - Benefits and costs of screening and treatment for early breast cancer.
      Development of a basic benefit package.
AB  - OBJECTIVE: To develop a basic benefit package for detection and treatment of
      early breast cancer by evaluating the effectiveness and costs for screening
      mammography, primary surgery, adjuvant therapy, and follow-up care. DATA SOURCES:
      Published articles were retrieved through MEDLINE; additional articles were
      obtained through searches of their bibliographies. Cancer statistics were taken
      from Surveillance, Epidemiology, and End Results (SEER) Program data, population
      statistics were taken from US Census data, and charges from 1993 Southern
      California Medicare fees were used to represent costs. STUDY SELECTION: Studies
      were selected on the basis of their design. Preference, in decreasing order, was
      given to meta-analyses of randomized trials, individual randomized clinical
      trials, prospective cohort studies, retrospective cohort studies, and case
      series. DATA EXTRACTION: Studies were examined for the effect of the intervention
      on overall survival, disease-free survival, and health-related quality of life.
      We evaluated effects on survival in terms of number of lives saved at 10 years
      and average years of life saved. Costs were related to the benefits observed and
      modeled onto a hypothetical health care organization of 500,000 lives. RESULTS:
      Based on this analysis, we recommend a basic benefit plan for the detection and
      treatment of early breast cancer that would include the following: (1) screening
      mammography only for women aged 50 to 69 years; (2) choice of mastectomy or
      breast-conserving surgery with radiation therapy for all women with early breast
      cancer; (3) adjuvant therapy for all women at risk of recurrence; and (4) only
      clinical follow-up without routine testing for metastatic disease. CONCLUSIONS:
      By choosing which services they provide to specific groups of patients, providers
      can substantially reduce their expenses and still provide quality health
      benefits.

PMID- 7799496
TI  - Efficacy of screening mammography. A meta-analysis.
AB  - OBJECTIVE: To determine the efficacy of screening mammography by age, number of
      mammographic views per screen, screening interval, and duration of follow-up.
      DESIGN: Literature review and meta-analysis. DATA IDENTIFICATION AND ANALYSIS:
      Literature search of English-language studies reported from January 1966 to
      October 31, 1993, using MEDLINE, manual literature review, and consultation with
      experts. A total of 13 studies were selected, and their results were combined
      using meta-analytic techniques based on the assumption of fixed effects. MAIN
      RESULTS: The overall summary relative risk (RR) estimate for breast cancer
      mortality for women aged 50 to 74 years undergoing screening mammography compared
      with those who did not was 0.74 (95% confidence interval [CI], 0.66 to 0.83). The
      magnitude of the benefit in this age group was similar regardless of number of
      mammographic views per screen, screening interval, or duration of follow-up. In
      contrast, none of the summary RR estimates for women aged 40 to 49 years was
      significantly less than 1.0, irrespective of screening intervention or duration
      of follow-up. The overall summary RR estimate in women aged 40 to 49 years was
      0.93 (95% CI, 0.76 to 1.13); the summary RR estimate for those studies that used
      two-view mammography was 0.87 (95% CI, 0.68 to 1.12) compared with 1.02 (95% CI,
      0.73 to 1.44) for those studies that used one-view mammography, and for those
      studies with 7 to 9 years of follow-up, the summary RR estimate was 1.02 (95% CI,
      0.82 to 1.27) compared with 0.83 (95% CI, 0.65 to 1.06) for those studies with 10
      to 12 years of follow-up. CONCLUSION: Screening mammography significantly reduces
      breast cancer mortality in women aged 50 to 74 years after 7 to 9 years of follow
      up, regardless of screening interval or number of mammographic views per screen.
      There is no reduction in breast cancer mortality in women aged 40 to 49 years
      after 7 to 9 years of follow-up. Screening mammography may be effective in
      reducing breast cancer mortality in women aged 40 to 49 years after 10 to 12
      years of follow-up, but the same benefit could probably be achieved by beginning
      screening at menopause or 50 years of age.

PMID- 7799497
TI  - Sepsis, sepsis syndrome, and the systemic inflammatory response syndrome (SIRS).
      Gulliver in Laputa.

PMID- 7799498
TI  - The organization of health care.

PMID- 7799499
TI  - Prognosis, diagnosis, or who knows? Time to learn what gene tests mean.

PMID- 7799500
TI  - Memories remain of Rwandan medical mission.

PMID- 7799501
TI  - Hearing elicits no plan to raise autopsy rates.

PMID- 7799502
TI  - Feds may fund study of existing embryos only.

PMID- 7799503
TI  - New program to SCOPE out resistant organisms.

PMID- 7799505
TI  - The polymerase chain reaction--expectations and realities.

PMID- 7799507
TI  - Peculiar histopathological features of giardiasis in distal duodenal biopsies.
AB  - Histological changes in 20 Giardia positive duodenal biopsies (Group A) were
      compared with 50, Giardia negative duodenal biopsies (Group B), taken during the
      same period. Stool examinations in Group B were negative for Giardia. Surface
      epithelium, villous and crypt architecture and cellular infiltrates were examined
      and compared between the groups. Atrophic changes in the villi were more common
      in Group A as compared to B(P < 0.0001). Intraepithelial neutrophil infiltration
      (P < 0.001), infiltration of the lamina propria with plasma cells (P < 0.5), and
      presence of eosinophils in the lamina propria (P < 0.001) were significant
      findings in group A. Some of the changes were related to the density of Giardia
      colonization e.g., the goblet cell depletion (P < 0.05) and the density of plasma
      cell infiltration in lamina propria (P < 0.01). Erosions and ulcerations were
      less commonly seen in group A. Thus we conclude that giardiasis manifests its
      peculiar features in the distal duodenal mucosa and a biopsy of this region is an
      important diagnostic tool for detection of this disease.

PMID- 7799504
TI  - From the Joint Commission on Accreditation of Healthcare Organizations.

PMID- 7799508
TI  - The effects of cigarette smoking on human gingival tissues (a histopathological
      study).
AB  - Gingival biopsy specimens were obtained from 9 smokers and 7 non-smokers during
      routine flap surgical procedure to investigate the effects of cigarette smoking
      on gingival epithelium and connective tissue. Although no remarkable
      histopathological difference was noted between gingival tissues of smokers and
      non-smokers, but smokers revealed relatively more epithelial keratosis,
      inflammatory cells, blood vessels and collagen fibres in connective tissue.
      Congestion of the capillaries were also more prominent in the smoker's gingival
      tissues.

PMID- 7799506
TI  - Pattern of malignant bone tumour in northern areas of Pakistan.
AB  - A review of 280 primary malignant bone tumours diagnosed during 1984-1988 is
      presented. These constituted 3.14% of all malignant tumours. Male to female ratio
      was 2.3:1. Majority of these patients presented with rapidly growing mass, pain
      and deformity. Histologically, osteosarcoma was the most frequent (36.4%) primary
      malignant tumour. Male to female ratio was 3.31:1. More than 49% of these cases
      were in their second decade of life. In females the greatest frequency was in 10
      15 years and in males 16-20 years age groups. Femur was the most frequent site.
      Other common malignant bone tumours included chondrosarcoma (22.1%), plasma cell
      myeloma (15.0%) and Ewings's sarcoma (8.6%). Miscellaneous cases of fibrosarcoma,
      chrodoma, adamentinoma and ameloblastoma were also seen. This study outlines the
      frequency, symptomatology and histological pattern of various malignant bone
      tumours in northern areas of Pakistan.

PMID- 7799509
TI  - Role of diet on the enterohepatic recycling of estrogen in women taking
      contraceptive pills.
AB  - The effect of diet on the enterohepatic recycling of estrogen after oral
      administration of 1 mg non-radioactive estriol (E3) was studied in six women
      using contraceptive pills. The women were followed for two consecutive menstrual
      cycles, firstly on a high fibre diet (HFD) and then changing on to low fibre diet
      (LFD) during the next cycle, hence each subject acted as its own control. The
      extent of enterohepatic recycling of estriol (E3) during the early follicular
      phase of menstrual cycle was assessed by monitoring during 48 hours, the urinary
      excretion of its two major metabolites, i.e., estriol-3-qlucuronide (E3-3-G) and
      estriol 16 alpha-glucuronide (E3-16 alpha-G). An increase in values of the
      variables including E3-3-G/E3-16 alpha-G output ratio, E3-3-G output as % of
      total (E3-3-G+E3-16 alpha-G) excretion and total E3 (E3-3-G+E3-16 alpha-G) output
      as % dose was noted as a result of change from high to low fibre diet. The
      urinary excretion of E3 in the form of its metabolites was also delayed as a
      result of dietary change. These findings reveal that extent of enterohepatic
      recycling of estrogen containing contraceptives could be higher in women on LFD
      as compared to those who are on HFD.

PMID- 7799510
TI  - The effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on the spontaneously
      beating isolated auricles of the rabbit heart.
AB  - The effects of NSAIDs (aspirin and indomethacin) on the isolated auricles of the
      rabbit heart were studied by observing the effects of these drugs on
      automaticity, excitability and contractility of the auricles. Aspirin (25,50,100
      uM) produced concentration dependent depression in the automaticity of the SA
      node while indomethacin (10 uM, 25 uM) has stimulant effects and 50 uM produced
      depressant action. Only low concentration of indomethacin (10 uM) produced
      significant effect. Aspirin (25,50,100 uM) and indomethacin (50 uM) have
      significant depressant effects on the excitability of the auricles. Aspirin (100
      uM) has suppressant effects (p < 0.05) on the normal contractility while the
      adrenaline stimulated contractility is not suppressed by aspirin and indomethacin
      significantly. The results obtained in this study with aspirin and indomethacin
      on chronotropicity and inotropicity of the rabbit atria have been discussed in
      the light of experimental work done by the workers regarding conventional
      antiarrhythmic drugs.

PMID- 7799511
TI  - A concentration technique for obtaining viable cysts of blastocystis hominis from
      faeces.

PMID- 7799512
TI  - Association between education and health-household survey of Faisalabad Tehsil.

PMID- 7799513
TI  - Amineptine dependence.

PMID- 7799514
TI  - Dysplasia and surveillance in ulcerative colitis.

PMID- 7799515
TI  - Prevalence of hepatitis B infection in professional and family/voluntary blood
      donors.

PMID- 7799516
TI  - Prevalence of HB infection in haemodialysis patients.

PMID- 7799517
TI  - Administration time-dependent change in the effect of spironolactone in rats.
AB  - The present study was undertaken to examine whether the natriuretic effect of
      spironolactone, a competitive antagonist of mineralocorticoid, varies with its
      time of administration. Wistar rat maintained under the condition of light from 7
      hr to 19 hr were divided into two groups. The first group had a bilateral
      adrenalectomy and received a 50-mg deoxycorticosterone acetate (DOCA) tablet
      intraperitoneally (DOCA group). The second group had a sham operation (control
      group). Spironolactone (50 mg/kg) was given orally at 12 hr or 24 hr, and the 8
      hr urine was collected. At the end of the experiment, the blood sample for
      measurement of aldosterone was obtained at 12 hr and 24 hr in the control group.
      The natriuretic effect of spironolactone in the 24 hr-trial was significantly
      greater than that of the 12 hr-trial in the control group. However, such a time
      dependent difference was diminished and did not reach statistical significance in
      the DOCA group. The plasma aldosterone concentration at 24 hr was significantly
      higher than that at 12 hr in the control group. These results suggest that the
      natriuretic effect of spironolactone varies with its time of administration.
      Daily variation in mineralocorticoid activity might be involved in this
      chronopharmacological phenomenon of spironolactone.

PMID- 7799519
TI  - Effects of NS-2, a new class 1 antiarrhythmic agent, and AFD-19, its active
      metabolite, on ventricular arrhythmias induced by coronary artery occlusion and
      reperfusion in anesthetized rats: comparison with disopyramide and mexiletine.
AB  - We studied the antiarrhythmic effects of NS-2 (4-diisobutylamino-1,1-diphenyl-1
      butanol maleate) and AFD-19 (active metabolite of NS-2) on early stage
      ventricular arrhythmias induced by coronary artery occlusion and reperfusion in
      anesthetized male rats. These effects were compared with those of disopyramide
      and mexiletine. Drugs were intravenously administered either before or after
      coronary occlusion. When administered 5 min before occlusion, 3 mg/kg of NS-2 and
      AFD-19 exhibited equivalent anti-arrhythmic activity to that of 5 mg/kg of
      disopyramide and mexiletine, as assessed by reductions in the number of premature
      ventricular complexes and in the incidences of ventricular tachycardia and
      ventricular fibrillation. In a dose of 5 mg/kg, the antiarrhythmic effects of NS
      2 and AFD-19 were more pronounced. When administered 5 min after coronary artery
      occlusion, only NS-2 and AFD-19 (in doses of 5 mg/kg) had significant
      antiarrhythmic effects. None of the drugs influenced the severe ventricular
      arrhythmias induced by reperfusion when administered 1 min before reperfusion. In
      conclusion, NS-2 might be effective in reducing the severity of the life
      threatening ventricular arrhythmias that occur during acute myocardial
      infarction.

PMID- 7799518
TI  - K(+)-linked release of oxidized glutathione induced by tert-butyl hydroperoxide
      in perfused rat liver is independent of lipid peroxidation and cell death.
AB  - The tert-butyl hydroperoxide (BHP)-induced release of oxidized glutathione (GSSG)
      and K+ was studied in relation to lipid peroxidation and cell death using
      isolated perfused rat livers. Infusion of BHP into the perfused liver resulted in
      an early and simultaneous release of GSSG and K+ and a sustained release of
      thiobarbituric-acid-reactive substances (TBARS) into the effluent perfusate,
      which was followed by further prenecrotic leakage of K+ followed by lactic
      dehydrogenase (LDH). These actions of BHP were not significantly affected by
      cutting or ligating the bile duct, and they were potentiated by omitting Ca2+
      from the perfusion medium. Co-infusion of desferrioxamine, propyl gallate and
      diethyldithiocarbamate suppressed TBARS release as well as the later leakage of
      K+ and LDH. Desferrioxamine was also effective under Ca(2+)-free conditions. N,N'
      diphenyl-p-phenylenediamine inhibited TBARS release, but it was not protective
      against cell death, although there was some delay. The action of dithiothreitol
      was only moderate. On the other hand, leakage of TBARS, K+ (prenecrotic) and LDH
      was enhanced by cysteamine and beta-mercaptoethanol and most markedly enhanced by
      ferrous iron. However, none of these agents markedly affected the early release
      of GSSG and K+. These observations, which support our previous findings, suggest
      that the early and coupled sinusoidal efflux of GSSG and K+ caused by BHP is
      independent of lipid peroxidation and cell death and that they represent a
      physiological mechanism of GSSG release. The results also suggest that lipid
      peroxidation is not the sole cause of BHP-induced cell death.

PMID- 7799520
TI  - Ca2+ inactivation of voltage-dependent Na+ channels in cultured bovine adrenal
      chromaffin cells: further studies on inhibition of veratridine-induced
      catecholamine secretion by external Ca2+.
AB  - The stimulatory actions of veratridine (VTD) on catecholamine secretion and Na+
      influx in cultured bovine adrenal chromaffin cells were studied in the presence
      of high concentrations of Ca2+ in the incubation mixture. Catecholamine secretion
      evoked by VTD was reduced by elevating the external Ca2+ concentration to higher
      than 2 mM. Under the same conditions, VTD-stimulated 22Na+ uptake into the cells
      was also reduced by elevating the extracellular Ca2+ concentration. In contrast,
      the secretory action of VTD was not significantly suppressed by preloading Ca2+
      to the cells. Furthermore, the effects of extracellular Ca2+ on the sensitivities
      of the cells to VTD and tetrodotoxin (TTX) were examined, and neither their
      sensitivities to VTD nor those to TTX were shown to be significantly altered by
      elevating the Ca2+ concentration in the incubation mixture. These results seem to
      indicate that the elevation of extracellular Ca2+ concentration may cause the
      inhibition of VTD-induced catecholamine secretion as a consequence of the
      inactivation of voltage-dependent Na+ channels, and suggest that Ca2+ may
      directly act on the cell surface, and the site of Ca2+ action is presumably
      distinct from the sites of both VTD and TTX actions in the plasma membranes of
      adrenal chromaffin cells.

PMID- 7799521
TI  - Antioxidative action of the nitrovasodilator nicorandil: inhibition of oxidative
      activation of liver microsomal glutathione S-transferase and lipid peroxidation.
AB  - Antioxidative effects of the nitrovasodilator nicorandil (SG-75) and denitrated
      SG-75 (SG-86) were examined in vivo and in vitro. When the isolated rat liver was
      reperfused with Krebs-Henseleit solution after a 90-min ischemia, microsomal GSH
      S-transferase activity was increased significantly by oxidative modification of
      the sulfhydryl group of the enzyme. The increase in the transferase activity
      after ischemia/reperfusion was depressed by SG-75 but not by SG-86. Furthermore,
      only SG-75 significantly inhibited lipid peroxidation and the activation of
      microsomal GSH S-transferase induced by hydrogen peroxide treatment of liver
      microsomes. These data indicate that SG-75 has an antioxidative action and the
      nitro group of SG-75 may play a critical role for this action.

PMID- 7799523
TI  - The effects of dobutamine, propranolol and nitroglycerin on an experimental
      canine model of congestive heart failure.
AB  - A new experimental model of acute congestive heart failure was established in
      open-chest dogs, and it was employed to examine the effects of dobutamine,
      propranolol and nitroglycerin. The model was induced by intracoronary
      administration of saponin, volume loading and intravenous infusion of
      methoxamine. Left ventricular end-diastolic pressure (LVEDP) increased from 7.9
      +/- 0.6 to 24.2 +/- 1.4 mmHg, and aortic blood flow (AoF) decreased from 0.89 +/-
      0.06 to 0.53 +/- 0.04 l/min. Systemic vascular resistance (SVR) increased from
      9618 +/- 585 to 16492 +/- 1213 dynes.sec/cm5 and right atrial pressure (RAP)
      increased from 2.5 +/- 0.2 to 4.2 +/- 0.4 mmHg. Furthermore, Vmax decreased from
      71.6 +/- 5.1 to 45.8 +/- 2.9 1/sec, and the time constant of left ventricular
      pressure decay (T) increased from 40.0 +/- 2.6 to 90.2 +/- 7.9 msec. These
      hemodynamic changes were stable for up to 80 min. Dobutamine improved cardiac
      function by increasing Vmax and by decreasing T. Consequently, dobutamine
      increased AoF and decreased LVEDP, while there was no change in SVR.
      Nitroglycerin reduced LVEDP, SVR and T; increased AoF; and did not change Vmax.
      Propranolol produced no improvement in the hemodynamics or cardiac function.
      These results indicate that the present congestive heart failure model is
      characterized by global left ventricular dysfunction with lowered cardiac output
      and increased peripheral vascular tone, and it is beneficial for evaluating the
      pharmacological properties of drugs for acute congestive heart failure.

PMID- 7799522
TI  - Effects of glibenclamide on negative cardiac responses to cholinergic and
      purinergic stimuli and cromakalim in the isolated dog heart.
AB  - We investigated the effects of an ATP-sensitive K+ channel blocker,
      glibenclamide, on the negative chronotropic and inotropic responses to
      intracardiac parasympathetic nerve stimulation, acetylcholine (ACh, a muscarinic
      receptor agonist), ATP (a P2-purinergic receptor agonist), adenosine (a P1
      purinergic receptor agonist) and cromakalim (a potassium channel opener) in the
      isolated, blood-perfused canine right atrium of left ventricle. A high dose of
      glibenclamide (3 mumol) did not affect the negative chronotropic and inotropic
      responses to parasympathetic stimulation (frequencies of 1-30 Hz), although it
      slightly but significantly attenuated the negative cardiac responses to exogenous
      ACh (0.3-10 nmol). Furthermore, adenosine (0.03-0.3 mumol)-induced negative
      chronotropic and inotropic responses were significantly inhibited by
      glibenclamide (3 mumol), but ATP (0.01-1 mumol)-induced negative cardiac
      responses were not affected. A cumulative administration of cromakalim (0.01-1
      mumol) dose-dependently caused much greater decreases in the contractile force of
      atrial and ventricular muscles than in sinus rate. Glibenclamide (0.3-3 mumol)
      similarly blocked the negative chronotropic and inotropic responses to cromakalim
      in a dose-dependent manner. These results suggest that glibenclamide modifies the
      negative cardiac responses to parasympathetic activation both in pre- and
      postjunctional sites and the responses to adenosine but not to ATP at K+ channels
      in the dog heart, although the modifications are minor under physiological
      conditions.

PMID- 7799524
TI  - Serotonin (5-HT)3-receptor antagonism of 4,5,6,7-tetrahydrobenzimidazole
      derivatives against 5-HT-induced bradycardia in anesthetized rats.
AB  - We investigated the mode of the 5-HT3-receptor antagonism of 4,5,6,7
      tetrahydrobenzimidazole derivatives, YM060, YM114 (KAE-393), YM-26103-2 and YM
      26308-2, against 5-HT-induced transient bradycardia in anesthetized rats. Results
      were compared with those of ondansetron and granisetron. YM060 (0.03-0.1
      microgram/kg, i.v.), YM114 (0.03-0.3 microgram/kg, i.v.), YM-26103-2 (0.01-0.03
      microgram/kg, i.v.), YM-26308-2 (0.01-0.03 microgram/kg, i.v.) and granisetron
      (0.3-3 micrograms/kg, i.v.) displaced the 5-HT dose-response curve to the right,
      with apparent DR2 values of 0.068, 0.068, 0.019, 0.011 and 0.69 microgram/kg,
      i.v., respectively. Higher doses of these compounds inhibited 5-HT-induced
      bradycardia with a reduced maximal response. In contrast, ondansetron displaced
      the 5-HT dose-response curve to the right without affecting the maximal response.
      Judged by the apparent DR2 values, YM060, YM114, YM-26103-2 and YM-26308-2 were
      approximately 13, 13, 50 and 79 times more potent than ondansetron, respectively,
      whereas granisetron was equipotent to ondansetron. Single i.v. doses of YM060 and
      granisetron inhibited 5-HT-induced bradycardia significantly longer than
      ondansetron. Moreover, inhibitory effects of p.o. doses of YM060 (3
      micrograms/kg), YM114 (80 micrograms/kg), YM-26103-2 (12 micrograms/kg), YM-26308
      2 (5 micrograms/kg) and granisetron (250 micrograms/kg) on the von Bezold-Jarisch
      reflex lasted for 3-6 hr, whereas ondansetron (700 micrograms/kg, p.o.)
      antagonized 5-HT3 receptors for only 1 hr. In isolated guinea pig colon, the
      inhibitory effect of YM-compounds on 5-HT-induced contraction persisted
      significantly longer than those of ondansetron and granisetron after washout of
      the bath containing compounds.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799525
TI  - Effect of trimebutine on contractile responses in skinned ileal smooth muscle.
AB  - The effects of trimebutine on Ca2+ release and modulation of Ca2+ sensitivity of
      contractile elements induced by carbachol (CCh) were investigated using a tension
      measuring method in beta-escin-treated skinned smooth muscle of the longitudinal
      muscle layer of guinea pig ileum. Trimebutine (10-100 microM) concentration
      dependently inhibited tension development brought about by Ca2+ release from
      intracellular stores induced by CCh (10 microM), but did not affect those induced
      by inositol 1,4,5-trisphosphate (IP3, 25 microM) or caffeine (5 mM). The
      inhibitory effect was reversible. Trimebutine (100 microM) neither altered the
      Ca2+ sensitivity of the contractile elements nor affected the effects of GTP
      gamma S (50 microM) and CCh (100 microM) in potentiating Ca2+ sensitivity of the
      contractile elements after the Ca2+ storage function had been eliminated by
      A23187. These results suggest that trimebutine inhibits CCh-induced Ca2+ release
      by acting at some point during the coupling of muscarinic receptors through a G
      protein to phospholipase C and thus reducing the accumulation of IP3.

PMID- 7799526
TI  - Thrombolysis of canine femoral artery thrombus by a novel modified tissue-type
      plasminogen activator (E6010).
AB  - The thrombolytic activity of a novel modified tissue-type plasminogen activator
      (t-PA) (E6010) was examined in a canine model with copper coil-induced femoral
      artery thrombus. This model, in which thrombolytic activity can be easily and
      directly quantified by determining changes in thrombus weight, should be useful
      for comparing the activities of various thrombolytic agents. Using this model,
      the present study showed that the thrombolytic activity of bolus intravenous
      injection of E6010 was identical to that of continuous intravenous infusion of
      recombinant t-PA at the same dose. This thrombolytic activity can be explained by
      changes in blood concentrations of the administered thrombolytic agents. On the
      other hand, administration of the thrombolytic agents dose-dependently caused
      significant changes in the levels of hemostatic and fibrinolytic factors. These
      changes were not so marked with administration of E6010, and therefore we
      concluded that E6010 is unlikely to cause bleeding complications after
      administration.

PMID- 7799527
TI  - Characterization of 5-hydroxytryptamine receptors on the isolated pig basilar
      artery by functional and radioligand binding studies.
AB  - 5-Hydroxytryptamine (5-HT)-receptor subtypes on pig basilar arteries were
      investigated by measuring the contractile responses to 5-HT agonists, the effects
      of antagonists on the responses and by carrying out a radioligand binding assay
      with [3H]5-HT. The rank order of contractile agonist potency (according to the
      pEC50 values) was 5-carboxamidotryptamine > or = 5-HT > alpha-methyl-5-HT > (+/-)
      8-hydroxy-dipropylaminotetralin. The contractile responses were not affected by
      endothelial denudation, and the 5-HT-induced contractions were antagonized
      competitively by ketanserin. Methiothepin shifted the 5-HT concentration-response
      curves to the right and downwards in a concentration-dependent manner. In the
      presence of ketanserin (10(-6) M), however, methiothepin antagonized the 5-HT
      induced contractions competitively. Specific [3H]5-HT binding to 5-HT receptors
      was saturable, reversible and showed high (Kd, 2.5 nM) and low (Kd, 710 nM)
      affinities, with respective Bmax values of 29.5 and 1950 fmol/mg protein. These
      results indicate that both 5-HT1 and 5-HT2 receptors are present on pig basilar
      arterial smooth muscle cells, and their stimulation results in contraction.

PMID- 7799528
TI  - The mechanism of muscarinic agonist-stimulated inositol phosphate formation in
      permeabilized ileal smooth muscle.
AB  - Muscarinic agonists and guanylyl-5'-imidodiphosphate (Gpp(NH)p) stimulated
      formation of inositol phosphates in permeabilized longitudinal smooth muscle of
      guinea pig ileum. Gpp(NH)p markedly potentiated the formation of inositol
      bisphosphate (IP2) and inositol trisphosphate (IP3) stimulated by carbachol, but
      increased inositol monophosphate formation (IP1) only slightly. Gpp(NH)p enhanced
      the formation of IP2 + IP3 induced by either acetylcholine or carbachol about
      fourfold in a synergistic manner, but enhanced the effects of oxotremorine and
      pilocarpine less than twofold in an additive manner. Elevation of Ca2+
      concentration resulted in increases of the inositol phosphate levels stimulated
      by both carbachol and Gpp(NH)p. The optimal concentration of Ca2+ for carbachol
      stimulated formations of IP2 + IP3 was shifted to a lower Ca2+ concentration in
      the presence of Gpp(NH)p. These findings suggest that muscarinic receptor
      stimulated polyphosphoinositide hydrolysis in ileal smooth muscle results in
      inositol polyphosphate formation via GTP binding protein (G-protein). The
      muscarinic receptor-activated G-protein decreases the Ca2+ requirement of
      polyphosphoinositide hydrolysis. Muscarinic agonists stimulate inositol
      polyphosphate formation by interaction of the G-protein activation of a
      phosphoinositide specific phospholipase C with Ca2+ influx.

PMID- 7799529
TI  - Spasmolytic effect of the NK2-receptor-selective antagonist MEN 10,627 in rat
      small intestine.
AB  - The effect of activation of tachykinin NK2-receptors on gastrointestinal
      propulsion was studied in vivo in conscious rats. The selective NK2-receptor
      agonist [beta Ala8]NKA-(4-10) produced an atropine-resistant specific increase of
      the small intestinal transit measured by the charcoal method. This effect was
      restricted to the small intestine since gastric emptying was not affected by
      [beta Ala8]NKA-(4-10). The newly developed polycyclic peptide NK2-receptor
      antagonist MEN 10,627 produced a dose-dependent inhibition of this stimulated
      transit. The spasmolytic effect of MEN 10,627 was highly selective because it did
      not affect stimulated intestinal transit induced by equieffective doses of
      carbachol and reserpine. These findings indicate that MEN 10,627 is a valuable
      tool for assessing the role of NK2-receptors in intestinal propulsive activity.

PMID- 7799530
TI  - Anticancer effects of adriamycin-loaded hydroxyapatite implants determined in a
      Swarm rat chondrosarcoma model.
AB  - We investigated the antitumor effects of adriamycin (ADR)-loaded hydroxyapatite
      (HAP) beads in a Swarm rat chondrosarcoma model. When one ADR-loaded HAP bead
      (ADR: 0.8 mg/bead) was implanted into the central portion of a rat bearing tumor,
      the ADR-loaded HAP beads showed good therapeutic effects, increasing the life
      span (ILS) by 90%. Significantly, leukopenia and diarrhea were not observed.
      These results suggest that HAP delivery offers an interesting and a potentially
      effective method.

PMID- 7799531
TI  - Inhibitory effects of 7-OH-DPAT, dopamine D3-receptor agonist, on nucleus
      accumbens neurons.
AB  - Effects of 7-hydroxy-2-(N,N-di-n-propylamino)tetralin (7-OH-DPAT), a dopamine D3
      receptor agonist, on neuronal activities of the nucleus accumbens (Acc) were
      examined in chloral hydrate-anesthetized rats. Spikes elicited by stimulation of
      the parafascicular nucleus were dose-dependently inhibited by microiontophoretic
      application of dopamine and 7-OH-DPAT. Glutamate-induced firing was also
      inhibited by these drugs. These findings suggest that D3 receptors are also
      involved in the postsynaptic inhibition of Acc neuron by dopamine.

PMID- 7799532
TI  - Law and ethics in psychiatry. Proceedings of the 8th Tokyo Institute of
      Psychiatry International Symposium. Tokyo, November 17-18, 1993.

PMID- 7799533
TI  - Criminal responsibility in amphetamine psychosis.
AB  - Historical changes in forensic psychiatric evaluation on criminal responsibility
      and proceedings in psychopathological findings of amphetamine psychosis are
      reviewed at first. The classification of amphetamine related mental disorders are
      proposed in 6 types. Among them, the clinical characteristics and
      psychopathological features of "Anxiety-situational reaction type" (Fukushima)
      are described. According to some reasonable grounds, offenders diagnosed as
      anxiety-situational reaction type should be evaluated as diminished
      responsibility in place of irresponsibility. Finally, two cases of murder
      committed under the influence of amphetamine, are reported in detail.

PMID- 7799534
TI  - Reform of mental health laws: not repeating the mistakes made in the United
      States.

PMID- 7799535
TI  - The Mental Health Act 1983 for England and Wales: contemporary issues and
      proposals for reform ten years on.

PMID- 7799536
TI  - Reform of "hogosha" system and psychiatric practice in Japan.
AB  - In this paper, the author examines the current working and drawbacks of the
      "hogosha" system as set out in the Mental Health Law of 1988, and goes on to
      suggest a plan for reform. Critics point to two main problems with the current
      system. One is that the hogosha's powers infringe on the patient's human rights.
      The other is that the system places too heavy a burden on hogoshas in its efforts
      to protect the community from the patient. The author argues that the hogosha
      should retain the power to consent for admission for medical care and custody,
      but other responsibilities should be reduced. The author stresses that local
      mayors must be prepared to take their responsibilities seriously when they assume
      the role of the hogosha.

PMID- 7799537
TI  - Reform in French legislation concerning psychiatric hospitalization 1838-1990.

PMID- 7799538
TI  - Criminal policy for offenders with mental disorder in Japan.

PMID- 7799539
TI  - Competence and responsibility in schizophrenia.
AB  - In a survey of the historical background it is shown that the classical doctrine
      on responsibility in schizophrenia has left its mark on the wordings of the
      psychiatric textbooks of the different countries. Closely combined with the
      imputation of enduring irresponsibility in schizophrenia was the opinion that
      civil rights are largely suspended if a person is given the diagnosis of
      schizophrenia. By the more recent research results of the studies of course and
      long-term outcome of schizophrenia and related psychoses and the development of
      the basic symptom concept has shown that it is not justified on principle to
      summarily deprive a person, diagnosed as schizophrenia, of civil rights as well
      as of criminal responsibility. New directions and some guidelines for an adequate
      assessment of competence and responsibility in schizophrenia are described. The
      knowledge of the newer findings and the application and utilization of the
      concept of basic symptoms and non-psychotic basic stages enable to overcome the
      doctrines of incurability, principle heterogeneity and numinous singularity and
      may lead to a rather appropriate and adequate social appreciation of the disease.
      Insight, freedom, responsibility, and competence of a person diagnosed as
      schizophrenia are in the postpsychotic pure residues and basic stages much more
      frequently preserved and available than hitherto assumed.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7799540
TI  - Ethical issues in psychotherapy.
AB  - The goal of psychotherapy is not only the dissolution of the symptoms, but also
      to attempt to bring about an improvement in adaptability and deepening the
      achievement of self-understanding. The nature of psychotherapy is based on the
      relationship between the therapist and patient. Such a goal and nature mean that
      some kinds of psychotherapy are beyond the medical model. In this paper ethical
      issues in psychotherapy are discussed as follows. 1) some complicated matters in
      informed-consent, 2) the hit or miss techniques of the poorly trained therapist,
      3) the protection of privacy, 4) the sexual misconduct of therapists with
      patients, 5) special consideration for child-adolescent patients.

PMID- 7799541
TI  - Ethical issues in sexual misconduct by clinicians.
AB  - Sexual misconduct by clinicians in the form of sexual relations with patients has
      long been recognized as an ethics violation and an activity suitable for
      assessment by the ethics committees of institutions and local and national
      professional organizations. The issue can be examined from the vantage point of
      several types of duties which bear ethical implications; these ethical duties
      proceed from the following four notions in this area: Sexual misconduct
      represents a violation of professional ethics as a fiduciary breach, abuse of a
      power asymmetry, exploitation of vulnerability and use of undue influence. While
      objections to these criteria may be raised in terms of freedom of association and
      consent, the violation of ethical principles by sexual misconduct remains clear.

PMID- 7799542
TI  - The patient as "subject" and capacity to give informed consent.
AB  - In line with Western countries, the idea of "capacity assessment" to determine a
      person's course of treatment is being introduced to Japanese psychiatry. Herein,
      some problems associated with the informed consent of mental patients are
      discussed, and a typical case is presented. The author points out that, when
      involuntary treatment is necessary, the clinician must consider, 1) the self as a
      "subject" of the incapable, 2) the dissociation between a subject and a choice,
      3) the nature of choice in life, 4) contextual assessment of mental intervention
      in the patient's life situation. Neglecting these issues will lead to inhumane
      medical practice in psychiatry.

PMID- 7799543
TI  - Personality disorders: conceptual issues and responsibility.
AB  - The historical roots of the concepts of abnormal personality, social deviance,
      delinquency and penal responsibility are described, demonstrating that former
      concepts of psychopathic personality often included negative social evaluations.
      Modern classification systems such as DSM-III-R and ICD-10 prefer a behavior
      oriented definition of personality disorders, which increases reliability but may
      lead to a reductionistic and purely criteriological assessment of personality. A
      checklist for the assessment of personality disorders (AMPS) according to ICD-10
      and DSM-III-R is presented, including four subaffective forms derived from the
      typology of personality disorders described by Kurt Schneider and Kretschmer. To
      justify statements of diminished legal responsibility or irresponsibility under
      the German Penal Code, a differentiation between psychopathological phenomena in
      personality disorders and pure social deviance is needed. The three notions of
      psychopathy, sociopathy and dissocial behavior are suggested to guide necessary
      decisions concerning prognosis and therapy chances.

PMID- 7799544
TI  - Ethical problems in psychiatric everyday practice.
AB  - For the ethical evaluation of psychiatric decisions the will of the patient-
      apart from his welfare, of course--has gained special importance in recent years.
      It is constitutionally protected in the form of self-determination. Accordingly
      the physician can only act with the patient's consent. The capacity of the
      individual to consent may be impaired or suspended because of a mental disease.
      It is often difficult, however, to recognize this impairment, to assess its
      extent, to evaluate its current relevance and to draw the correct conclusions.
      This becomes important when the psychiatrist deals with a patient whose will is
      in opposition to his welfare. Difficulties for the physician may also result
      because his therapy, regardless of whether it is somatic therapy or psychotherapy
      or involves social measures, though aiming to remove the mental disturbance and
      with the ultimate objective of the patient regaining his lost autonomy in mind,
      may at times curtail the self-determination of the patient. These difficulties
      are illustrated by some examples with the objective to maintain our awareness of
      these issues in our everyday work.

PMID- 7799545
TI  - Ethical issues in criminal forensic evaluation.
AB  - Psychiatric practices have been widely intervened by third parties, so that
      absolute confidentiality cannot be demanded. Forensic psychiatry holds a
      distinctive position in such practices. Ethics in forensic evaluations rely on
      the role of the psychiatrist. That role must be provided not only within the
      relationship with the truster, but also with the evaluee. The latter relationship
      has seldom been discussed. It is not therapist-patient-relationship, leaving some
      therapist attitude. A warning (lack of confidentiality, etc.) is necessary before
      the evaluation. Despite all, psychiatric evaluations cannot be conducted without
      some reliance. It is important to inform the evaluee of the evaluator's opinion
      prior to the trial, and involve the evaluee in the process of the evaluator's
      recognition.

PMID- 7799546
TI  - Treating the mentally disordered criminal offender in a hospital setting.
AB  - The author outlines the legislation and treatment system for mentally disordered
      criminal offenders in Japan, and reviews the recent studies on the treatment of
      refractory patients in mental hospitals. Involuntary admission of patients
      referred by a public prosecutor or by a head of a correctional institution is
      problematic regarding the judgment criteria for admission and discharge, and
      imposes a burden on practitioners. The author outlines the main problems of the
      treatment of criminal offenders in a hospital setting: reaction to the hospital
      environment, lack of motivation for treatment, therapists' reluctance to treat
      these patients, absence of support for rehabilitation and uncertainty about
      future risk. Suggested measures for the solution of these difficulties include
      the role of the Psychiatric Review Board, the psychiatric evaluation system, and
      therapeutic skills pertaining to dangerous patients.

PMID- 7799547
TI  - New directions in the assessment of dangerousness of the mentally ill.

PMID- 7799549
TI  - Forensic psychiatry in England: a system in transition.

PMID- 7799548
TI  - The treatment of mentally disordered offenders in Japanese medical prisons.
AB  - The author outlines the general trends of crime and the treatment of criminals in
      Japan, and trends of mentally disordered offenders in Japanese penal
      institutions. Further, he explains the treatment of the mentally disordered
      offenders in Japanese medical prisons. The author analyzes the Hachioji Medical
      Prison's treatment record, particularly in regards to the reincarceration rate,
      which markedly decreases when family support and psychiatric treatment are
      properly present after release. Finally, the author stresses the value of
      correctional psychiatric treatment in the medical prison; it is expected to play
      an important role in contributing to the rehabilitation of mentally disordered
      offenders and "patients difficult to treat," and bringing about more open and
      innovative community-centered mental health services.

PMID- 7799550
TI  - [Argyrophilic proteins of nucleolar organizer regions of macrophages and
      lymphocytes in bronchoalveolar lavage fluid from patients with diffuse lung
      diseases].
AB  - Alveolar macrophages and T-lymphocytes in bronchoalveolar lavage fluid from
      patients with diffuse lung diseases have been shown to be activated. The object
      of this study was to investigate whether the numbers of nucleolar organizer
      regions (NORs) in alveolar macrophages and lymphocytes were abnormally high in
      these patients or not. Alveolar macrophages and lymphocytes were collected by
      bronchoalveolar lavage from 7 control subjects, 36 patients with pulmonary
      sarcoidosis, 10 patients with hypersensitivity pneumonitis, 6 patients with
      measles pneumonia, 6 patients with mycoplasma pneumonia, and 6 patients with
      progressive systemic sclerosis related to interstitial pneumonitis. These cells
      were cytocentrifuged and stained by one-step silver staining. Argyrophilic
      proteins of the nucleolar organizer regions (Ag-NORs) were counted in 300
      alveolar macrophages and lymphocytes. The numbers found in control subjects were
      compared to those found in patients with diffuse lung diseases. In the patients
      with sarcoidosis, these numbers were also compared among subgroups divided
      according to staging, involvement of other organs, administration of steroids,
      and differences in deposition of 67Ga. We also examined correlations between Ag-
      NORs and known markers of activation in sarcoidosis. The numbers of Ag-NORs were
      significantly greater in patients with diffuse lung diseases than in control
      subjects. There were no significant differences in the numbers of Ag-NORs among
      subgroups of patients with sarcoidosis. No correlations were seen between the Ag
      NORs and the markers of activation of disease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799551
TI  - [Bronchial hyperresponsiveness before and after percutaneous transluminal mitral
      commissurotomy in patients with mitral stenosis].
AB  - To study the effects of percutaneous transluminal mitral commissurotomy (PTMC) on
      bronchial responsiveness to inhaled methacholine in patients with mitral valve
      stenosis (MS), methacholine inhalation tests and pulmonary function tests were
      done in 10 patients with MS before and one week after PTMC. The mean log
      cumulative dose producing a 35% decrease in respiratory conductance (PD35Grs) was
      significantly higher after PTMC in nine patients in whom PTMC was successful (p <
      0.05). There were no significant changes in the results of pulmonary function
      tests after PTMC. One patient had severe mitral regurgitation after PTMC, and a
      decrease in PD35Grs. Six of the other nine patients in whom PTMC was successful
      continued to be hyperresponsive to inhaled methacholine. These data show that
      bronchial hyperresponsiveness in patients with MS is less severe after PTMC,
      concomitant with the relief of pulmonary congestion, and they suggest that the
      remaining bronchial hyperresponsiveness is responsible for peripheral airway
      narrowing with organic remodeling.

PMID- 7799552
TI  - [Six cases of allergic bronchopulmonary aspergillosis].
AB  - Six cases of allergic bronchopulmonary aspergillosis (ABPA) were evaluated. In
      four cases, diagnosis and steroid therapy were delayed, which resulted in
      irreversible pulmonary dysfunction. The important points for early diagnosis
      were: (1) Differentiation from pulmonary tuberculosis, (2) the presence of
      bronchial asthma was not essential for diagnosis, and (3) fungi other than
      Aspergillus fumigatus might cause this syndrome.

PMID- 7799553
TI  - [Mechanism of hypoxemia after methacholine challenge].
AB  - Hypoxemia after the treatment of asthmatic attack continues for a while, and can
      even become worse after the treatment. This hypoxemia has been attributed to
      inhomogeneity of ventilation-to-perfusion ratios in the lungs of asthmatic
      patients. We studied post-hyperventilation hypoxemia in subjects with hypoxemia
      after a methacholine challenge test. Nineteen subjects who were hyperresponsive
      and hypoxemic after a methacholine challenge were studied. The methacholine
      challenge with incremental doses was stopped when the respiratory resistance
      doubled. Thereafter, oxygen and carbon dioxide concentrations in the expired air,
      mouth flow (VE), and oxygen saturation (using a pulse oximeter, SpO2) were
      monitored continuously. End-tidal PCO2 (PETCO2) as well as respiratory exchange
      ratio (R) were thus obtained. In 14 subjects, VE significantly increased from 8.6
      +/- 1.2 (mean +/- SD) to 13.4 +/- 2.6 l/min and then decreased gradually, while
      PETCO2 significantly decreased from 38.5 +/- 2.3 to 29.1 +/- 4.4 Torr and then
      increased gradually, SpO2 decreased from 97 +/- 1.3 to 89 +/- 2.4% concomitant
      with a significant decrease in R from 0.86 +/- 0.04 to 0.67 +/- 0.05. In
      contrast, in 5 subjects VE significantly increased from 7.5 +/- 2.8 to 12.4 +/-
      1.6 l/min and then remained unchanged, while PETCO2 significantly decreased from
      37.9 +/- 1.3 to 31.3 +/- 3.9 Torr and then remained unchanged, SpO2 decreased
      from 98 +/- 1.1 to 92 +/- 1.9% with no change in R (from 0.84 +/- 0.06 to 0.87 +/
      0.06).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799554
TI  - [Clinical bacteriology and empiric therapy for hospital-acquired pneumonia in the
      elderly at a national leprosarium].
AB  - Hospital-acquired pneumonia is one of the most important fatal respiratory
      diseases in the elderly. Prompt and precise empiric therapy is essential for
      recovery. Fourteen isolates from twelve elderly lepromatous leprosy patients (9
      men, 3 women, mean age of 75.8 years) with hospital-acquired pneumonia were
      studied. Subsequently, empiric therapy with gentamicin and beta-lactams for
      nosocomial pneumonia in the elderly was examined. Fourteen types of bacteria
      isolated from expectorated sputum specimens consisted mainly of ten strains of
      gram-negative bacilli (71%) six of Klebsiella pneumoniae, one each of Citrobacter
      freundii, Enterobacter agglomerans, Serratia liquefaciens, and Aeromonas
      hydrophilia and four strains of gram-positive cocci (29%) two of Staphylococcus
      sp., one each of Streptococcus sp. and Streptococcus pneumoniae. Methicillin
      resistant Staphylococcus aureus and Pseudomonas sp. were not detected. Resistance
      rates of the etiologic agents to the antibiotics showed that gentamicin was 7.7%,
      ceftazidime 0%, and cefmetazole 23.1%. Cephalosporins were superior to
      penicillins. As a result of empiric therapy, six elderly leprosy patients with
      nosocomial pneumonia were cured and one improved temporarily. This study shows
      the necessity of specific empiric therapy for hospital-acquired pneumonia in a
      hospital with many elderly patients. The combination of gentamicin and beta
      lactams is of value as an initial antibiotic therapy for hospital-acquired
      pneumonia in the elderly.

PMID- 7799555
TI  - [A case of Swyer-James syndrome--a morphological study with inflated fixed lung].
AB  - Morphological features of Swyer-James syndrome were studied in a specimen
      obtained during left pneumonectomy. A 67-year-old woman was admitted because her
      left lung was hyperlucent and contained a solitary nodule. Primary lung
      adenocarcinoma complicated with Swyer-James syndrome was diagnosed, and left
      pneumonectomy done. The left upper lobe was inflated and fixed for morphological
      study. The volume of the specimen was obviously lower than normal but the
      bronchial branching was normal. Macroscopically, the specimen had irregular
      bronchial walls, bronchiectatic changes, and dilation of distal air spaces,
      similar to panlobular emphysema. Microscopically, there was scarring in
      periarteriolar regions that suggested bronchiolitis obliterans, enlargement of
      distal airspaces, and an abnormally low number of capillaries. These findings
      suggest hypoplasia of the lung due to abnormal lung growth after birth.

PMID- 7799556
TI  - [A case of interstitial pneumonitis caused by inhalation of cadmium fumes].
AB  - A 48-year-old man who had been a welder for 25 years was admitted to our hospital
      on February 18, 1990 for investigation of a diffuse bilateral lung shadow that
      had a ground-glass appearance. On the day of admission, he had been welding
      copper water supply pipe and used silver brazing with an oxyacetylene torch.
      After almost 7 hours of work, he had a chill, high fever, and dyspnea. Blood gas
      analysis revealed severe hypoxemia (PaO2 34.5 Torr, PaCO2 29.4 Torr). The level
      of copper in serum was slightly higher than normal (174 micrograms/dl). A
      transbronchial lung biopsy specimen showed lymphocyte infiltration and fibrous
      changes of the alveolar walls, which seemed to be granulomatous pneumonitis.
      Steroid therapy was effective against the symptoms, and the radiographic findings
      also improved. We think this is a rare case of interstitial pneumonitis caused by
      inhalation of cadmium fumes contained in silver brazing.

PMID- 7799557
TI  - [Metastasis of an adenocarcinoma of unknown origin to mediastinal lymph nodes,
      and transient regression].
AB  - A 67-year-old woman was admitted to our hospital because of fever. Chest
      roentgenogram showed an enlargement of mediastinal lymph nodes. Despite thorough
      examination, no definite diagnosis could be made. The mediastinal lymph nodes got
      smaller over the next 3 weeks and a chest roentgenogram taken 4 months later
      showed no mediastinal lymphadenopathy. The mediastinal lymphadenopathy and fever
      recurred 5 months later. She underwent thoracotomy and the mediastinal lymph
      nodes were excised. Microscopic examination of pretracheal lymph node specimens
      showed invasion of poorly differentiated adenocarcinoma associated with abundant
      tumor-infiltrating lymphocytes. The other lymph nodes showed sarcoid reaction.
      Although she has been followed for one year and 11 months, no primary site of the
      cancer has been found. Metastasis of cancer of unknown origin to mediastinal
      lymph nodes is extremely rare. It is also interesting that the lymph node
      swelling diminished spontaneously. The tumor-infiltrating lymphocytes and sarcoid
      reactions may have been immunological responses to the cancer and may have caused
      the transient regression.

PMID- 7799558
TI  - [A case of Churg-Strauss syndrome associated with severe leg pain and necrotizing
      skin lesions].
AB  - A 68-year-old woman with bronchial asthma and a history of drug hypersensitivity
      came to our hospital because of severe pain, swelling, and ecchymoses in the
      lower extremity. The eosinophil count was 53.5%, therefore Churg-Strauss syndrome
      was diagnosed and she was given prednisolone (PSL) (30 mg/day). A skin specimen
      taken the next day showed tissue eosinophilia, acute and subacute necrotizing
      vasculitis. Immunofluorescence staining showed IgG in the blood vessels. After
      one month of PSL, biopsy specimens of muscle fiber revealed atrophy of type IIb
      fibers, and myxomatous degeneration of neuron-fibers. Eosinophilia decreased
      rapidly after administration of PSL, but the necrotizing lesions of the skin,
      muscle, and nerve were so severe that she needed orthopedic shoes.

PMID- 7799560
TI  - [A case of aspirin-induced cough without bronchoconstriction. A new type of
      aspirin hypersensitivity].
AB  - A 54-year-old woman was admitted to our hospital because of an asthmatic attack.
      Her first asthma attack occurred when she was 53 years old. It was followed by a
      flu-like infection, and was preceded for one year perennial rhinitis and loss of
      the sense of smell. Symptoms were perennial, and unrelated to the seasons.
      Because these clinical findings resembled those of aspirin-induced asthma (AIA),
      an aspirin-DL-lysine i.v. challenge test was done. Cough, perspiration, and
      flushing was provoked within 15 min after aspirin-DL-lysine injection, but FEV1
      did not change. Respiratory sounds were normal and no wheezing was audible. Other
      cyclooxygenase inhibitors (ketoprofen, sulpyrine and acetaminophen) provoked the
      same symptoms. Successively increasing doses of injected aspirin-DL-lysine
      resulted in complete tolerance to this stimulus. We propose that aspirin-induced
      cough without bronchoconstriction is a new type of aspirin hypersensitivity.

PMID- 7799559
TI  - [A case of pulmonary alveolar proteinosis with elevated serum angiotensin
      converting enzyme activity].
AB  - A 45-year-old man with diffuse infiltrates on the chest X-ray film was admitted
      to the hospital. At first, sarcoidosis was suspected due to the elevated serum
      angiotensin-converting enzyme (ACE) activity. Transbronchial lung biopsy and
      bronchoalveolar lavage, however, did not lead to that diagnosis. Pulmonary
      alveolar proteinosis (PAP) was diagnosed after an open lung biopsy. The diffuse
      infiltrates on his chest X-ray film diminished spontaneously. Two years later,
      diffuse infiltrates increased again with an elevated serum ACE activity. In this
      case, it seemed that the severity of PAP was associated with serum ACE activity.
      We review the literature on the relationship between serum ACE activity and
      dysfunction of alveolar macrophages in PAP.

PMID- 7799561
TI  - [Wegener's granulomatosis--report of four cases including two in patients who
      died of myocardial infarction].
AB  - The prognosis for Wegener's granulomatosis (W-G) is good if it is diagnosed early
      and a combination of corticosteroids and cytotoxic drugs is given. During the
      past fourteen years, we were encountered four cases of W-G, three were systemic
      and one was limited. Of the three patients, with systemic disease, two died of
      myocardial infarction caused by a delay in diagnosis and one died of fulminant
      renal and respiratory failure. Only the one patient with a limited form of the
      disease survived for more than 5 years. We emphasize the importance of early
      diagnosis with consideration of the systemic features of W-G.

PMID- 7799562
TI  - [A case of small cell lung cancer associated with fulminant hepatitis B].
AB  - A 48-year-old man was admitted to our hospital because of upper abdominal pain,
      and a cervical tumor, on Oct. 23, 1992. Chest X-ray, CT scan and MRI revealed a
      tumor (left-S10) and enlarged mediastinal lymph nodes. A pathological diagnosis
      of small cell lung cancer was made by transbronchial biopsy. Ultrasonography
      showed liver metastases. He received four courses of chemotherapy (Carboplatin,
      Ifosfamide, Etoposide). Three days after the completion of chemotherapy, his
      serum transaminase level was markedly increased, and he was disorientated on
      March 4, 1993. In spite of plasma exchange, the patient died due to hepatic
      failure on March 6, 1993. Fulminant hepatitis in a patient with lung cancer
      receiving chemotherapy is rarely reported.

PMID- 7799563
TI  - [Surgery of bilateral pulmonary aspergilloma].
AB  - A 60-year-old man with cough and fever was admitted to our hospital. Chest
      radiography revealed multiple bullae and fungus balls in both lungs. He was
      treated with MCZ and FCZ for about 2 months, but the chest radiograph shadows did
      not improve and the fever continued. A two-stage operation was performed. The
      bullae were incised and the fungus balls were removed, then a muscle flap
      plombage was made with a pectoralis major muscle, a latissimus dorsi muscle and
      an intercostal muscle. The postoperative course was uneventful and respiratory
      function was preserved.

PMID- 7799564
TI  - [A case of chronic type farmer's lung which led to severe pulmonary fibrosis and
      spontaneous pneumothorax].
AB  - We present a case of chronic type farmer's lung which showed progressive
      pulmonary fibrosis and spontaneous pneumothorax 12 years after the first
      admission. A 56-year-old woman was diagnosed as having farmer's lung in 1981.
      After the first hospitalization, her chest roentgenogram showed regression with
      steroid therapy. After that, she sometimes worked at a dairy farm and required
      rehospitalization three times for recurrence. In April 1993, she was readmitted
      complaining of sudden chest pain and dyspnea after cough. Her chest roentgenogram
      on admission showed spontaneous pneumothorax. After treatment, her chest
      roentgenogram revealed severe pulmonary fibrosis and loss of lung volume.

PMID- 7799565
TI  - [A case of interruption of the inferior vena cava with azygos continuation
      accompanied by anomalies of tracheobronchial branching].
AB  - A 31-year-old man, asymptomatic but with an abnormal shadow adjacent to the right
      tracheobronchial angle on chest roentogenogram, presented to our hospital. CT and
      MRI of the chest revealed this shadow to be a dilated azygos arch. The inferior
      vena cava was interrupted, at the intrahepatic portion, by the azygos
      continuation. There was also an abnormality of tracheobronchial branching. The
      right middle lobe bronchus gave rise to the upper lobe bronchus. The right B7 was
      absent though the left BX7 was present. The pulmonary arteries passed over the
      main bronchi bilaterally. Interruption of the inferior vena cava is often
      associated with significant cardiovascular and abdominal anomalies but only
      rarely with anomalies of tracheobronchial branching.

PMID- 7799567
TI  - N-terminal amino acid sequence of a 28 kDa major serum high density lipoprotein
      of the rainbow trout Oncorhynchus mykiss.
AB  - As there are few data on primary structures of fish apolipoproteins (apo), we
      determined the N-terminal sequence of a 28 kDa major serum protein of rainbow
      trout, a possible homologue of apoAI protein in higher vertebrates. Rainbow trout
      serum was separated by two-dimensional electrophoresis. A spot of the 28 kDa
      protein (pl 5.45) was cut out and directly applied to a protein sequencer. We
      succeeded in sequencing 30 amino acids from the N-terminal. The sequence of the
      28 kDa protein shared a high similarity with that of apoAI of Atlantic salmon
      (Salmo salar). These results showed that the 28 kDa protein is apoAI of rainbow
      trout.

PMID- 7799566
TI  - [A case of sarcoidosis associated with severe cardiac conduction disturbances and
      unilateral pleural effusion].
AB  - A 23-year-old man was admitted to our hospital because of non-productive cough.
      Chest X-ray demonstrated bilateral hilar lymphadenopathy, bilateral infiltration
      shadows and right pleural effusion. ECG showed complete A-V block and sinus
      arrest. Transbronchial lung biopsy and pleural biopsy specimens showed non
      necrotizing epithelioid cell granulomas. The patient was diagnosed as having
      sarcoidosis, and was treated with steroid and pacemaker. After steroid therapy,
      myocardial imaging with thallium-201 showed increase of uptake and the pleural
      effusion disappeared.

PMID- 7799568
TI  - The inhibitory effects of MgSO4 on the multiplication and transcription of mouse
      hepatitis virus.
AB  - The multiplication of mouse hepatitis virus (MHV) was inhibited by the treatment
      of infected cells with MgSO4 at concentrations higher than 50 mM. The inhibition
      of viral multiplication was more effective with the treatment of cells at the
      early stage of infection using MgSO4 than at the late stage. Viral adsorption to
      the cells was not inhibited by MgSO4 and pretreatment of the cells with MgSO4 did
      not show an inhibitory effect on the RNA synthesis of MHV. The synthesis of viral
      RNA was inhibited more effectively by the treatment of infected cells with MgSO4
      at 0-2 and 2-4 h postinfection (p.i.) than at 4-6 h p.i. The present study
      suggests that the stage at which viral multiplication is susceptible to MgSO4 may
      be the early stage of viral transcription and that Mg2+ may be a useful tool for
      the analysis of the early stage of MHV infection.

PMID- 7799569
TI  - [Investigation on the treatment of infection due to Mycobacterium Kansasii].
AB  - Mycobacterium kansasii infection responds well to antituberculous drugs, and in
      the initial phase of treatment, many patients with M. kansasii infection are
      regarded as tuberculosis. This study was carried out to know whether the regimen
      of chemotherapy be continued or changed after the confirmation of diagnosis as M.
      kansasii infection. The treatment result of 107 cases with M. kansasii infection
      of the lung encountered at Fukujuji Hospital was compared with that of pulmonary
      tuberculosis. Sputum culture of all patients treated with drug regimens
      containing RFP converted to negative within 3 months after starting chemotherapy,
      while sputum culture of many patients treated with regimens not containing RFP
      converted to negative 4 months or later after the start of chemotherapy. Hence,
      the effectiveness of RFP in treating M. kansasii infection was confirmed. Among
      65 patients with no relapse during a follow-up period of at least one year after
      the completion of chemotherapy, 58 patients (89.2%) were treated with drug
      regimens containing INH and RFP, and the treatment of 40 patients (61.5%) was
      finished within 12 months. Among three patients deteriorated during chemotherapy
      or relapsed within one year after the completion of chemotherapy, two patients
      were treated with drug regimens containing RFP and one of them had serious
      complications. The chemotherapy regimen for tuberculosis is considered to be
      sufficient for the initial treatment of pulmonary disease caused by M. kansasii.

PMID- 7799570
TI  - [Efficacy of PCR-microwell plate hybridization method (Amplicor Mycobacterium)
      for detection of M. tuberculosis, M. avium and/or M. intracellulare in clinical
      specimens].
AB  - Recently, a new kit to detect and identify mycobacteria in clinical specimens was
      developed by Japan Roche Co. Limited. The new method is based on amplification of
      DNA of mycobacteria in clinical specimens by PCR and hybridization of amplified
      DNA by microwell plate hybridization method, which is the "Amplicor Mycobacteria,
      Roche, (AMP-M)". Cooperative study was organized with 15 tuberculosis hospitals
      and institutions throughout Japan, and 349 clinical specimens from newly admitted
      tuberculosis patients and/or suspects were collected during July and August,
      1993. All the specimens were examined by smear microscopy (Ziehl-Neelsen's
      staining), culture on Ogawa egg media, culture on variant 7H9 liquid media and by
      AMP-M. Excluding 25 specimens which had failed to identify the species of
      mycobacteria because of contamination, disability to multiply on the transplanted
      solid media and so on, the results of the examinations in 324 specimens
      consisting of 167 specimens from previously untreated cases and those of 157
      specimens from previously treated cases were analysed. Main results obtained were
      as follows; 1. Of 70 smear positive specimens from previously untreated cases,
      culture positive on Ogawa media and 7H9 media, and by AMP-M positive were 59
      (84.3%), 61 (87.1%) and 66 (94.3%), respectively. Of 97 smear negative specimens,
      culture positive were 20 (20.6%), 22 (22.7%) and 27 (27.8%), respectively. The
      AMP-M showed the highest positive rate in both groups. 2. The sensitivity and the
      specificity of AMP-M in previously untreated cases were calculated by assuming
      that positive on Ogawa and/or variant 7H9 media is "positive". The sensitivity
      was 95.8% (68/71) and the specificity was 94.8% (91/96) for M. tuberculosis in
      previously untreated cases. The sensitivity and the specificity for M. avium and
      M. intracellulare were all 100%, although the numbers observed were small. 3. So
      called false positive of the AMP-M were observed in 5 cases out of 96 culture
      negatives on both Ogawa and variant 7H9 media. However, all 5 cases were positive
      by repeated AMP-M, 3 become culture positive later, and another 2 showed clinical
      findings consistent with tuberculosis. Hence, the authors considered that the
      false positive rate of the AMP-M method is to be very low in previously untreated
      cases. 4. Of 86 smear positive cases with history of previous chemotherapy, the
      positive culture on Ogawa media, variant 7H9 media and that by AMP-M method were
      64 (74.4%), 77 (89.5%) and 85 (98.8%), respectively. In the smear negative cases,
      culture positive was 10 out of 71 (14.1%), 13 (18.3%) and 24 (33.8%),
      respectively.

PMID- 7799571
TI  - [A therapeutic trial of experimental tuberculosis with gamma-interferon in an
      immunocompromised mouse model].
AB  - It has been well documented that IFN-gamma plays an important role in the host
      defense against Mycobacterium tuberculosis infection through activating
      macrophages to kill the organism. In the present study, we studied the effects of
      in vivo injection of monoclonal antibody against IFN-gamma (anti-IFN-gamma mAb)
      on the mycobacterial infection to confirm the role of this cytokine. The
      injection of anti-IFN-gamma mAb suppressed the enhanced expression of MHC class
      II and ICAM-1 on pulmonary parenchymal macrophages induced by intravenous
      injection of Mycobacterium bovis BCG. The number of bacilli recovered from lung
      of mice treated with anti-IFN-gamma mAb and injected with Mycobacterium
      tuberculosis H37Rv was significantly larger than that of the control infected
      mice. From these results, it was indicated that anti-IFN-gamma mAb blocked the
      activities of endogenously synthesized IFN-gamma, thus inhibited the activation
      of macrophages to kill the bacilli. Next, CD4+ T cell-depleted mice were prepared
      by injecting anti-CD4 mAb and used as immunocompromised animal. When infected
      with M. tuberculosis, the multiplication of the bacilli within the lungs of such
      immunocompromised mice was much more enhanced in comparison with the control mice
      with intact CD4+ T cells. Administration of IFN-gamma significantly reduced the
      number of the bacilli in lung. Further, in an in vitro study with human lung
      macrophages, IFN-gamma enhanced the killing activity of macrophages against M.
      tuberculosis in a dose dependent manner, and suboptimal dose of 1 alpha, 25
      dihydroxyvitamin D3 synergistically augmented the effect of IFN-gamma.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7799572
TI  - [A case of endobronchial tuberculosis with high serum CA19-9 and SLX level].
AB  - A 43-year-old female was admitted to our hospital with mild cough, sputum and
      right chest pain. The chest X-ray revealed an inhomogeneous shadow in the right
      upper lung field and mediastinal lymphadenopathy. At first we considered the
      patient had bronchogenic carcinoma, as her serum CA19-9 and SLX levels were high
      and the right upper bronchus was obstructed by necrotic tissues. However
      bronchoscopic specimen showed necrotizing epithelioid cell granulomas and
      Mycobacterium tuberculosis was detected, and her disease was diagnosed as
      endobronchial tuberculosis. The case responded well to anti-tuberculosis
      chemotherapy. The differential diagnosis between bronchogenic carcinoma and
      endobronchial tuberculosis was very difficult in this case because of high serum
      level tumor marker and endoscopic findings, which turned to normal after
      treatment. We discussed the cause of high serum level of CA19-9 and SLX in
      nonmalignant lung disease.

PMID- 7799573
TI  - [A case of pulmonary tuberculosis developed immediately after a chest wall
      injury].
AB  - A 75-year-old female was admitted to our hospital for further examination of the
      cause of blood-stained sputum and abnormal shadow on chest radiogram which had
      developed immediately after an injury of right chest wall. The bacteriological
      examination of sputum on admission revealed negative Gaffky score, but positive
      PCR, and Mycobacterium tuberculosis was isolated by culture. Her symptoms and
      chest radiogram were improved by the administration of isoniazid, ethambutol and
      rifampicin. Although development of pulmonary tuberculosis induced by chest wall
      injury is rare, in case of the aged persons such possibility should be
      considered. PCR may be useful for rapid diagnosis of tuberculosis, even in such
      case.

PMID- 7799574
TI  - [The 69th annual meeting symposium. II: Mechanism of necrotizing granuloma
      formation and its function].
AB  - Histological features of tuberculosis are caseation necrosis and epithelioid cell
      granuloma formation. Both phenomena are interpreted as expression of cellular
      immunity. Caseation necrosis is thought to be immunopathology and epithelioid
      cell granuloma formation is considered to be expression of protective immunity.
      Recently roles of cytokines for granuloma formation are gradually elucidated. In
      this symposium, mechanisms and functions of necrosis and granuloma formation Dr.
      Akagawa reported differentiation of two types of phenotypically different
      macrophages from human monocytes by GM (granulocyte-macrophage)-CSF or M
      (macrophage)-CSF. Interestingly such a basic differentiation induced by CSF was
      affected by IL-4 (interleukin-4). Langerhans-like dendritic cells were generated
      by cooperation of GM-CSF and IL-4, and multinucleated cells were generated by
      cooperation of IL-4 and M-CSF. Dr. Fukuda reported human Langerhans cell
      granulomatosis (LCG) from the pathological and immunohistochemical standpoints.
      In situ proliferation of LCs in the LCG was demonstrated by immunohistochemistry
      using antibody to PCNA (proliferating cell nuclear antigen) which is used to
      detect proliferating cells. In the course of granuloma formation, damage and
      disruption of lung structure such as alveolar basement membrane and elastic
      tissue framework, and reactive intraluminar fibrosis was observed. Mechanism of
      cystic dilation was also reported. Cytokines might play important roles in these
      events. Dr. Ina demonstrated experimental epithelioid cell granuloma formation.
      Extract (granuloma inducing factor, GIF) from Schistosoma mansoni Egg-induced
      granuloma, TNF -alpha, or IL-1 beta were coated, individually on the surface of
      beads, then these beads were inoculated to rat's skins or cultured with rat's
      monocytes. Four weeks later, epithelioid cell granuloma was demonstrated
      histologically and electronmicroscopically around beads in vitro and in vivo. GIF
      induced granuloma was more organized than cytokine-induced ones. In vitro using
      human monocytes, activated macrophages accumulated around beads of which
      cytokines or GIF were coated. It was suspected that many cytokines or other
      factors are needed to make epithelioid cell granuloma. Dr. Sakamoto showed the
      presence of acid fast bacilli and various inflammatory cells including
      lymphocytes and macrophages in the tuberculous caseous necrosis after exudative
      reaction (E-necrosis) by immunohistochemistry. But no acid fast bacilli or
      inflammatory cells were found in the caseous necrosis after productive reaction
      (P-necrosis). TNF-alpha (tumor necrosis factor-alpha) and IL-4 were stained in
      the E-necrosis and IL-4 and ICAM-1 (intercellular adhesion molecule-1) were
      positively stained in the cytoplasm of epithelioid cells by immunohistochemistry.
      It was suspected that many cells and cytokines were involved in epithelioid cell
      granuloma formation and caseous necrosis formation.(ABSTRACT TRUNCATED AT 400
      WORDS)

PMID- 7799575
TI  - [Phagocytic activity of neutrophilic granulocytes in patients with burns during
      enterosorption in combined treatment].

PMID- 7799576
TI  - [Use of enterosgel in middle-aged and aged patients with medium-severity burns].
AB  - The comparative dynamics of intoxication and natural humoral organism resistance
      indexes in elderly and senile patients with burn disease of middle degree
      severity while application of generally used therapy and incorporating in
      treatment complex the enterosgel preparation prescribed since 24 hours after
      injury occurrence was studied. Under the enterosgel influence the intoxication
      syndrome intensity has been markedly decreased, what promoted the skin loss
      restoration, favourable burn disease course, mortality reduction, and the
      shortening of patients hospital stay.

PMID- 7799577
TI  - [Use of anti-Bacillus pyocyaneus and anti-Proteus donor plasma in combined
      treatment of children with severe burns].

PMID- 7799578
TI  - [Treatment of burn wounds and wounds healing with secondary tightening using
      dressings with aerosil].
AB  - The results of treatment of burn wounds and the wounds, healing with secondary
      closure, using the dressings containing the layer of aerosil a 2-3 mm thick, were
      studied. In principal group earlier than in control the decrease of wound
      intoxication occurred, alike the normalization of electrolyte balance, acid-base
      balance, and haemodynamics, improvement of patients' general condition, and the
      shortening of their stay in hospital was noted.

PMID- 7799579
TI  - [Prevention of peritonitis after surgery of the stomach and large intestine].
AB  - We have used the combined preparation of foamy aerosol Gyposol-A and nitasol for
      the prophylaxis of postoperative peritonitis, originated due to gastrojejunal and
      colo-colonic anastomoses insufficiency. The introduction of preparation via the
      colonic tube ensures the physical hermetic control of anastomosis and allows to
      optimize the reparative processes by means of local antimicrobial,
      antiinflammatory, and stimulant action. Method was used in 76 patients. The
      frequency of postoperative peritonitis occurrence decreased from 20 to 2.3%.

PMID- 7799580
TI  - [Intralymphatic therapy of peritonitis].
AB  - The lymphatic system catheterization methods, the appropriate catheterization
      side choice were developed by the authors. It was established that the
      peritonitis progress is accompanied by endolymphatic therapy effect lowering,
      what demands the application of active organism detoxication methods,
      hepatoprotective and immunocompensatory therapy.

PMID- 7799581
TI  - [Combined endolymphatic therapy in patients with diffuse peritonitis].
AB  - The results of treatment of 25 patients with diffuse peritonitis whom the
      combined endolymphatic therapy was conducted in postoperative period, including
      the lymph irradiation with helium-neon laser and direct endolymphatic
      antibacterial therapy, are presented. Catheter was used introduced in peripheral
      lymph vessel on the dorsal surface of foot. The decrease of organism
      intoxication, more rapid than in control, was noted.

PMID- 7799582
TI  - [Diagnosis of endogenous intoxication, prognostication of the course of
      pathological process and principles of the establishment of a treatment program
      for patients with severe burns].
AB  - The experience of treatment of 300 patients with burns was summarized. The ways
      of development of diagnostics and treatment system for endogenous intoxication
      syndrome in injured persons with burns are proposed. The elaborated test-system
      permits to define the endogenous intoxication severity and the degree of
      functional possibilities suppression of antitoxic resistance cytological and
      humoral factors. The differentiated detoxication programs are compiled.

PMID- 7799583
TI  - [Prognostication of the course of pancreatogenic shock in a dynamic study of
      central hemodynamics indices in patients with pancreatic necrosis during
      enzymatic toxemia stage].
AB  - The investigation of central haemodynamics indexes dynamics with the use of the
      developed automatized system in 65 patients with pancreonecrosis was conducted
      for the aim of disease course prognostication and differentiated prescription of
      cardiotonics. Three stages of circulatory disorders were established. The
      possibility of patient's death significantly increases in the presence of
      prolonged depression of cardiac output when rapid effect of conservative therapy
      is absent.

PMID- 7799584
TI  - [Use of plasmapheresis in combined treatment of patients with severe form of
      generalized myasthenia].

PMID- 7799585
TI  - [Surgical treatment of multistage occlusion of the abdominal aorta and iliac and
      femoral arteries].
AB  - The results of surgical treatment of 26 patients with "multistage" occlusion, who
      underwent reconstructive operation on two segments (group 1), and 29 patients,
      who underwent ultrasound disobliteration of the femoral arteries together with
      the reconstructive operation (group 2), are presented. In group 1, a good
      immediate result was noted in 80.8%, a good long-term result--in 61.6%, in group
      2--79.4 and 70.8% of the patients, respectively.

PMID- 7799586
TI  - [Use of different methods of quantum hemotherapy in the treatment of suppurative
      wounds in middle-aged and aged patients].
AB  - The experience with the use of the different methods of quantum hemotherapy in
      the treatment of elderly and senile patients with purulent-inflammatory diseases
      of the soft tissues has been summarized. Comparative characteristic of their
      effectiveness is presented. The authors consider the most expedient the use of
      intravascular quantum hemotherapy and combined methods.

PMID- 7799587
TI  - [Surgical treatment of cerebral ischemia caused by multiple occlusions of major
      cerebral arteries].
AB  - The case records of 205 patients with brain ischemia of various degree severity
      accompanied by two and more main brain arteries occlusion are analyzed. In 176
      operated patients 241 revascularizing intervention was conducted. The advantages
      of surgical method versus conservative one were established.

PMID- 7799588
TI  - [Dynamics of the blood level of middle molecular mass peptides of patients with
      surgical endotoxicosis during plasmapheresis].

PMID- 7799589
TI  - [Dynamics of changes in blood immune indicators after intralymphatic
      administration of gentamycin and myelopid in combined prevention of complications
      in ulcerative colitis and Crohn disease].
AB  - To rise the effectiveness of preoperative preparation of patients with ulcerative
      colitis and Crohn's disease we used the endolymphatic injection of gentamycin and
      myelopid. This permitted to normalize the blood immune indexes in the course of 3
      days.

PMID- 7799590
TI  - [Surgical treatment of bile duct fistula].
AB  - Among 208 patients with extrahepatic biliary ducts fistula there were 60 with
      internal one, and 148--external one. The correction of main biliary ducts bile
      outflow was the principal stage of procedure. The method of correction was
      selected taking into account the character, level, and extent of pathological
      process the bile outflow impeded. The adequate surgical tactics and
      pathogenetically proven treatment allowed to achieve the favourable results in
      96.6% of patients.

PMID- 7799591
TI  - [Surgical treatment of cholelithiasis].
AB  - The experience with surgical treatment of cholelithiasis is presented. A method
      of organ-preserving operation on the gallbladder--cholecysto-extraction is
      presented. The operation was performed in 29 patients. The results of treatment
      are satisfactory.

PMID- 7799592
TI  - [Surgical correction of reflux gastritis].

PMID- 7799593
TI  - [Surgical treatment of radiation osteomyelitis of the sternum using cutaneo
      muscular-mammary flap].

PMID- 7799594
TI  - [Method of surgical treatment of complete intestinal fistula].

PMID- 7799595
TI  - [Differential diagnosis symptom of peritoneal irritation in obese patients].

PMID- 7799596
TI  - [Method of appendectomy in obturation of the vermiform process by Ascaridia].

PMID- 7799597
TI  - [Use of thermovision examination in hand burns].
AB  - With the use of thermovision set TVT-01 "Raduga" 17 healthy persons (control
      group) and 40 injured persons with the burn of various degree of severity were
      examined. In superficial I-II degree burn on the hand the temperature within the
      centre of injury exceeds normal level by 1.6-2 degrees C, and III A degree--by
      2.2-2.6 degrees C. The healing of the burn wound was followed by gradual fall of
      her temperature, although she normalizes after epithelialization completion. In
      III B degree burn on the hand the temperature within the centre of injury
      decreases by 1.6-2.0 degrees C in comparison with the normal level.
      Autodermoplasty is effective only in the presence of temperature gradient between
      transplant zone and healthy tissues no more than 1.5 degrees C.

PMID- 7799598
TI  - [Method of indirect intralymphatic antibiotic therapy in acute appendicitis].

PMID- 7799599
TI  - [Cutaneous-adipose plasty of the scrotum in Fournier's gangrene].

PMID- 7799600
TI  - [Enterosorption in combined treatment of injured patients with burns].

PMID- 7799601
TI  - [Use of film coatings in the treatment of wounds of injured with burns].

PMID- 7799602
TI  - [Healing of severe burns in a patient with hemophilia].

PMID- 7799603
TI  - [Combined surgical and therapeutic treatment of complicated ulcerative necrotic
      enterocolitis on the background of scleroderma using Salofalk preparation].

PMID- 7799604
TI  - [Rare forms of hernial strangulation].

PMID- 7799605
TI  - [Case report of internal paraduodenal hernia].

PMID- 7799606
TI  - [Treatment of acute appendicitis at the central district hospital].

PMID- 7799607
TI  - [Leiomyoma of the stomach complicated by severe hemorrhage].

PMID- 7799608
TI  - [Questions of surgery in the life and works of M. A. Bulgakov].

PMID- 7799609
TI  - [Evgenii Grigor'evich Cherniakhovskii (the 120th anniversary of his birth)].

PMID- 7799610
TI  - [Changes in immunological reactivity during the use of enterosorption in combined
      treatment of children with severe burns].
AB  - In 20 children with severe and extremely severe burns since the 3-4th day the
      enterosorption in the treatment complex was applied. The enterosorbents
      application have promoted the intoxication severity lowering, the decrease of the
      damaging action of blood formed elements on the erythrocytes of their own, the
      lowering of plasma toxic properties, rosette level in peripheral blood. On the 16
      18th day after injury the red blood indexes have normalized, allowing to prepare
      the patients to the operative treatment.

PMID- 7799611
TI  - [Meconium aspiration in the newborn infant--lack of long-term pulmonary
      sequelae].
AB  - The further development of newborns with meconium aspiration (MA) has been
      studied retrospectively by various investigators. However, results are
      inconsistent (2, 3, 5, 6). In the present study 25 children with MA were
      investigated in the age of 1 to 11 years. The parents answered a questionnaire,
      the children were examined physically. All the 11 children older than 5 years
      were subjected to spirometry, bodyplethysmography, and a histamine provocation
      test. An age matched control group of 28 children was investigated in the same
      way. No differences were found between children with MA and the control group
      concerning history and physical examination. Only the symptom "cough without
      cold" was found significantly more frequently in preschool children (1 to 5
      years) with MA as compared to control children (p < 0.01). However, none of the
      parameters of lung function testing revealed any difference between the two
      groups. Also, the medians of the histamine thresholds in both samples were normal
      and did not differ. In summary, in a group of 25 children with MA, when compared
      to children without MA, only the symptom "cough without cold" was found
      significantly more frequently during preschool age. No evidence of long term
      pulmonary sequalae was seen in children with MA.

PMID- 7799612
TI  - [Effect of corticosteroids on lung function and the clinical course of
      bronchopulmonary dysplasia in premature infants with a birth weight below 1,500
      g].
AB  - 11 very low birth weight infants (700-1480 g) with bronchopulmonary dysplasia
      were treated with dexamethasone (0.5 mg/kg/day for 3 days, 0.3 mg/kg/day for 3
      days), followed by hydrocortisone (tapering from 2 mg/kg/day-0.5 mg/kg/day, total
      4 days). Pulmonary function tests showed a significant improvement of lung
      compliance from initially 0.36 +/- 0.05 cm/ml H2O/kg to 0.54 +/- 0.16 cm/ml
      H2O/kg after 24 hours. Compliance remained within levels above baseline during
      the following 4 days. Steroid therapy was also associated with a significant
      reduction of FiO2 (0.45 to 0.34) and ventilator rates (48.9 to 29.3/min).
      Extubation was possible in all infants 11.9 (+/- 10) days after initial
      treatment.

PMID- 7799613
TI  - [Ultrasound morphologic changes in periventricular leukomalacia].
AB  - Therapeutic advances in neonatology cause fewer hypoxic conditions. In relation
      with this we observe fewer high grade brain haemorrhages. Therefore, ischemical
      brain changes through brain oedema (12%) and resulting colliquation necroses
      become the focal point of diagnostic and therapeutic work. 7.3% of intensively
      treated neonates showed the sonographic picture of a periventricular leucomalacy
      (PVL). The polycystic areas can be seen on the eight day after birth at the
      earliest and at six months they turn into a glia scar which is not very obvious
      on the sonograph. We found a relation between beta-mimetic tocolysis, hypocapnia
      and the development of a PVL. We were not able to prove statistically a
      connection with premature birth.

PMID- 7799614
TI  - [Cerebral infarct and hemorrhage in patients with sickle cell disease].
AB  - Two sickle cell patients with cerebral accidents, infarct and bleeding, are
      presented. Up to 15% of all sickle cell patients suffer cerebral events, 75% of
      which are infarcts, 25% intracranial hemorrhages. Infarcts occur predominantly in
      children with a clustering around age 7, while bleeding predominates in adult
      life. Cerebral events are due to intimal changes, proliferation and finally
      occlusion of both small and large cerebral arteries. Infarcts present with
      hemiparesis, aphasia, loss of vision and seizures whereas intracranial bleedings
      are associated with severe headache and/or loss of consciousness and coma. When
      cerebral infarct is suspected, magnetic resonance imaging is the diagnostic
      method of choice. Intracranial bleeding is best diagnosed by computed tomography
      or angiography. Partial exchange transfusion is indicated in both events to be
      followed by a chronic transfusion program of as yet undetermined length. Routine
      magnetic resonance angiogram and/or transcranial doppler sonography in young
      asymptomatic sickle cell patients may make it possible in the future to detect
      patients at risk and institute treatment prior to a cerebral accident.

PMID- 7799616
TI  - [Simplified determination of proteinuria in children using a single urine
      sample].
AB  - In children and adolescents the evaluation of proteinuria is cumbersome because
      of the need to obtain timed urine collections. The protein/creatinine ratio
      (using a Coomassie blue binding technique and a kinetic Jaffe reaction,
      respectively) measured in 134 pediatric patients with renal disease aged 2 months
      to 16 years correlated closely with the overnight urine protein excretion rates
      using the statistical approach suggested by Bland and Altman to compare methods
      of measuring some quantity. The upper limit of urinary protein/creatinine ratio
      measured in 252 healthy children and adolescents aged 4 to 19 years was shown to
      be 19 mg/mmol. No age-related differences in urinary protein excretion were noted
      in healthy subjects. The random urine protein/creatinine ratio provides an
      accurate assessment of quantitative protein excretion and avoids errors and
      difficulties associated with timed urine collection.

PMID- 7799615
TI  - [Cystic changes as an indication for infection-induced blockage of the
      ventriculoperitoneal shunt].

PMID- 7799617
TI  - [Comparison of the luminescence enhanced enzyme immunoassay Amerlite FT4/MAB-FT4
      and Amerlite FT3/MAB-FT3 in blood serum of children. Reference values].
AB  - Concentrations of free thyroxine (n = 225, male = 124, female = 101) and free
      triiodothyronine (n = 60, male = 35, female = 25) were determined using the
      luminescence enhanced enzyme immunoassay methods Amerlite FT4/MAB-FT4 and
      Amerlite FT3/MAB-FT3 in blood-serum of children. In contrast to the excellent
      agreement of the results between the Amerlite FT4 and MAB-FT4 method, a
      significant difference was found between the Amerlite FT3 and MAB-FT3 results.
      Therefore it was necessary to establish new reference ranges for the MAB-FT3
      method in childhood (cord blood = 50, n = 272, male = 183, female = 89).

PMID- 7799618
TI  - [Joubert syndrome combined with unilateral facial paralysis: a rare variant of
      Joubert syndrome].
AB  - We report the case of a mature newborn infant, which aroused attention 8 hours
      after birth due to an unexplainable paroxysmal tachypnea together with
      subsequently prolonged apnea. The combination of tachypnea, athetoid movement
      patterns, apraxia of the tongue, nystagmus and dysplasia of the cerebellum with
      dilation of the 4th ventricle, led to the diagnosis of Joubert-Syndrome. The
      child also showed a variation of a connatal unilateral facial nerve palsy, which
      has not previously been described in connection with a Joubert-Syndrome.

PMID- 7799619
TI  - [Fatal course of infectious mononucleosis in an 11-month-old girl].
AB  - Fatal infectious mononucleosis is vary rare in the human population. Only two
      case reports of girls suffering an Epstein-Barr virus-associated
      lymphoproliferation without evidence of an underlying immunodeficiency came to
      our knowledge. We report on the case of an 11-months-old girl with fatal
      infectious mononucleosis. Some findings allow distinct delineation from previous
      reports. Firstly, the present "pulmonary lymphoid hyperplasia" has been formerly
      described in patients with HIV infection exclusively. Secondly, only the EBV
      surface antigen LMP was expressed on infected B-cells. The nuclear antigen
      complex EBNA could not be demonstrated. Overall, the results suggest a so far
      unrecognised type of EBV-associated lymphoproliferation in a female infant.

PMID- 7799620
TI  - [Concordance of prune belly syndrome and VACTERL association].
AB  - We report on a male premature infant with hypoplastic abdominal wall musculature,
      urinary tract anomalies and kryptorchism--the main features of Prune-Belly
      syndrome. Furthermore the patient showed cardiac anomalies, urinary tract
      anomalies, limb defects, vertebral anomalies and anal atresia, which belong to
      the main features of VACTERL-association. As far as we know, the combination of
      the Prune-Belly-syndrome and the VACTERL-association has not been reported in
      literature until now.

PMID- 7799622
TI  - Adhesion strength of human ligament fibroblasts.
AB  - The adhesive interactions of cells with other cells and the extracellular matrix
      (ECM) play a fundamental role in the organization of cells in differentiated
      organs, cell motility, and the healing process. The adhesion characteristics of
      ligament fibroblasts depend on the expression of cell surface molecules and their
      interaction with the ECM. Although many receptors mediating the effects of ECM
      components on ligament cell function remain poorly defined, it is known that
      fibronectin (FN) allows ligament cells to adhere through the VLA-5 receptor
      (alpha 5 beta 1). A direct measurement of the adhesion between anterior cruciate
      ligament (ACL) or medial collateral ligament (MCL) fibroblasts and fibronectin
      matrix proteins was achieved by using a micromanipulation technique to determine
      the force required to detach an ACL or MCL cell from fibronectin-coated glass. We
      have found that the adhesion strength is not random, but has well-defined
      functional relationships with the FN concentration and the seeding time (time
      allowed for the cell to establish attachment). The adhesion strength (i.e., force
      required to detach) of ACL cells shows a stronger dependence on FN concentration
      (1, 2, and 5 micrograms/ml) for short seeding times (15-30 min) than for long
      seeding times (38-75 min). For MCL cells, the effect of the seeding time on
      adhesion strength was apparent for all concentrations. For all the seeding times
      studied and FN concentrations used, MCL cells had higher adhesion strength than
      ACL cells. The adhesion strengths of ACL and MCL fibroblasts to FN are correlated
      to cell adhesion area.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799623
TI  - A model for motion and sedimentation of cylindrical red-cell aggregates during
      slow blood flow in narrow horizontal tubes.
AB  - When blood flows slowly in a narrow tube, red-cell aggregation results in
      formation of an approximately cylindrical "core" of red cells, which moves as a
      rigid body. The core is denser than the surrounding fluid, and sedimentation is
      observed in horizontal tubes. To model this, the Stokes flow of a fluid
      surrounding a long solid cylinder (the core) contained in a long hollow cylinder
      (the tube) is considered. The cylinder axes are parallel but not coincident. An
      exact analytic expression for the resistance coefficient for motion perpendicular
      to the axes is given. This coefficient increases rapidly with the ratio of core
      radius to tube radius, and core eccentricity. The predicted rate of sedimentation
      is comparable to that observed experimentally. The apparent viscosity of a two
      phase medium consisting of a core of aggregated particles and surrounding pure
      fluid is calculated. For a core radius corresponding to experimental conditions,
      the apparent viscosity increases rapidly with increasing eccentricity of the
      core.

PMID- 7799624
TI  - A finite element model of skin subjected to a flash fire.
AB  - A variable property, multiple layer finite element model was developed to predict
      skin temperatures and times to second and third degree burns under simulated
      flash fire conditions. A sensitivity study of burn predictions to variations in
      thermal physical properties of skin was undertaken using this model. It was found
      that variations in these properties over the ranges used in multiple layer skin
      models had minimal effects on second degree burn predictions, but large effects
      on third degree burn predictions. It was also found that the blood perfusion
      source term in Pennes' bioheat transfer equation could be neglected in predicting
      second and third degree burns due to flash fires. The predictions from this model
      were also compared with those from the closed form solution of this equation,
      which has been used in the literature for making burn predictions from accidents
      similar to flash fires.

PMID- 7799621
TI  - [Association of Saethre-Chotzen and fra-X syndrome].
AB  - Report of an association of Saethre-Chotzen- and fragile X-Syndrome in a 19-years
      old imbecile with autism and aggressiveness. Both syndromes exhibit symptoms of
      minimal brain damage and disorders of personality.

PMID- 7799625
TI  - The simulation of discrete vessel effects in experimental hyperthermia.
AB  - The ability of two simple thermal models to predict experimentally measured in
      vivo temperature profiles was compared. These comparisons were done both with and
      without the inclusion of separate, discrete blood vessels. The two tissue models
      were: 1) Pennes' Bio-Heat Transfer equation (BHTE), and 2) an effective thermal
      conductivity equation (ETCE). The experimental temperature data were measured
      (Moros, 1990; Moros et al., 1993) in the thighs of anesthetized greyhound dogs
      under hyperthermic conditions generated by scanned focused ultrasound. Blood
      vessels were added to the thermal models in counter-current pairs transiting the
      model domain. The blood vessels in both models were assumed to have a constant
      heat transfer coefficient, and an axially varying mixed mean temperature. The
      vessel locations were determined a posteriori, via inspection of the experimental
      temperature data. Least square error fits of the predicted model temperatures to
      the experimental temperature data were obtained by adjusting both (a) the mass
      flow rate within and (b) the position of each blood vessel, and (c) the value of
      either the perfusion parameter (W) in the BHTE or the effective thermal
      conductivity parameter (Keff) in the ETCE. When small numbers (3-4) of blood
      vessel pairs were included, both of the models showed significant improvement in
      their ability to predict the experimental temperatures. Although both models
      performed well in terms of predicting temperatures near large vessels, the BHTE
      had a statistically significant better ability to predict the complete set of
      measured temperatures at all locations.

PMID- 7799626
TI  - A theoretical model of infant incubator dynamics.
AB  - A spatially lumped mathematical model was developed and used for a computer
      simulation of the neonate-incubator system for parametric analysis of the factors
      that influence neonatal thermo-regulation. The simulation examined the effects of
      the following parameters: (1) size of the infant; (2) respiratory rate; (3)
      metabolic rate; (4) heart rate; (5) thermal properties of the mattress; (6)
      specific heat capacity of the incubator wall; (7) air flow rate; (8) heater
      control mechanisms.

PMID- 7799627
TI  - Comparison of arm up and down in side impacts with BioSID and different armrests.
AB  - BioSID dummy tests were run with the arm down at the side during loading of
      different armrests in simulated side impact crashes. The Hyge sled tests
      duplicated previous studies of BioSID with the arm up, SID, and animals. When the
      BioSID arm is against the side, the arm extends from the shoulder to the bottom
      of the third rib and has a steel shank covered by foam and vinyl. Loading through
      the arm transfers force to the three chest ribs and shoulder. In comparison,
      direct armrest loading of the chest or abdomen primarily involves a single rib
      and substantial rib deflection, when the armrest crush-force exceeds the strength
      of the rib. The Viscous response in BioSID showed the greatest difference of all
      criteria for the arm up or down. The response of the third rib correlated with
      injury risks determined from animal tests using the different armrest designs in
      a simulated high position. While injury data are not available for the arm at the
      side or for the armrest in the low position, the STIFF armrest may cause injury
      when the arm is not at the side and the armrest loads the liver and spleen. Rib
      deflection in BioSID showed the protrusion of the STIFF armrest into the
      abdominal region in both arm positions, because the loading was below the arm
      even in the down position. However, the arm extends laterally so it involves the
      upper ribs earlier than in the arm-up condition where more space is
      available.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799628
TI  - Mechanical and dimensional adaptation of rat aorta to hypertension.
AB  - To investigate mechanisms of the mechanical adaptation of soft biological tissues
      to load, effects of hypertension on the mechanical properties and wall dimensions
      of thoracic aortas were studied in rats. Goldblatt hypertension was induced in
      male Wistar rats aged 8 to 9 weeks by constricting their left renal arteries.
      Two, 4, 8, or 16 weeks after the operation, thoracic aortas were excised and used
      to determine static pressure-diameter relations and wall dimensions. Wall
      thickness correlated significantly with the systolic blood pressure before
      sacrifice, Psys, at each period. The aortic hoop stress became almost constant at
      all Psys 2 weeks after the operation. On the other hand, the stress calculated
      for 100 and 200 mmHg correlated negatively with Psys. The incremental elastic
      modulus of the wall at Psys had a significant correlation with Psys having a
      positive slope at each period, although the correlation disappeared at 16 weeks
      after the operation. These results imply that: 1) thickness of the aortic wall
      increases very rapidly in response to hypertension; 2) wall stress developed by
      the in-situ blood pressure is kept constant at a normal level irrespective of
      hypertension; 3) elastic modulus of the wall of the hypertensive rats at the in
      situ blood pressure becomes equal to the normal value after relatively long
      period of time; 4) in response to the alteration of the applied force,
      dimensional change appears much earlier than the change in the elastic
      properties.

PMID- 7799629
TI  - Aortic walls in atherosclerotic rabbits--mechanical study.
AB  - Mechanical properties of the descending thoracic aortae harvested from
      endothelial cell-denuded and/or cholesterol diet-fed rabbits were studied
      primarily with their pressure-diameter relationships. Male Japanese white rabbits
      having 3.1 to 3.5 kg initial body weight were divided into 4 groups. The rabbits
      in Groups A and C were fed a regular chow, while those in Groups B and D were
      given 1 percent cholesterol diet; the luminal surfaces of the descending thoracic
      aortae in the rabbits of Groups C and D were injured by drawing catheter-tip
      balloons. These animals were sacrificed after keeping for 4, 8, 16 or 32 weeks
      and, then, their descending thoracic aortae were excised for the studies of
      pressure-diameter relationships. Stiffness parameter (beta") and incremental
      elastic modulus (H theta theta were used to quantitatively represent the
      structural stiffness of the aortic wall and the elastic modulus of the wall
      material, respectively. Denudation of endothelial cells thickened the aortic
      walls in Group C, but induced no significant changes in beta" and H theta theta.
      Shape of the pressure-diameter curve changed gradually with time in Group D, and
      beta", H theta theta, and thickness to wall radius ratio increased significantly,
      while those in Group B showed no significant changes with a few exceptions.
      Averaged percent fraction of the luminal surface area stained with Sudan IV (As)
      was around 50 percent in Group B and 100 percent in Group D at 32 weeks. Even if
      As is over 80 percent in Group D, 50 percent (7/14) of the walls gave
      significantly higher beta"- and H theta theta-values at 100 mm Hg than the
      others. Significantly increased calcification and intimal hyperplasia were
      observed in the walls with high beta"- and H theta theta-values.

PMID- 7799631
TI  - Preliminary analysis of the effects of blood vessel movement on blood flow
      patterns in the coronary arteries.
AB  - Blood flow patterns are believed to be involved in the formation and progression
      of arterial diseases. It is possible that the normal physiologic movement of
      blood vessels during the cardiac cycle affects blood flow patterns significantly.
      For example, the contraction of the heart in systole and subsequent relaxation in
      diastole create movements of the coronary arteries, as evidenced in real-time
      angiography. The effects of this movement on coronary artery flow patterns have
      never been previously analyzed. This work was undertaken to provide a preliminary
      estimate of the importance of the effects of such physiologic movements on blood
      flow patterns in the coronary arteries. A Womersley-type solution was used to
      determine the effect of axial movement on the wall shear rate in a simplified
      model of the coronary arteries. The pulsatile pressure gradient was derived from
      previously published coronary artery flow waveforms. The axial movement function
      was obtained from a three-dimensional reconstruction of a biplanar coronary
      angiogram. Significant changes in wall shear rate were noted when the movement
      was taken into account. The maximum and minimum wall shear rates were 10 percent
      smaller and 107 percent larger in magnitude respectively, and the Oscillatory
      Shear Index (OSI) was doubled. Most of the changes in wall shear rate were
      observed in systole, when the pressure gradient is minimal and the movement is
      strongest. The results indicate that blood vessel movement during the cardiac
      cycle has a significant effect on hemodynamic phenomena which have been
      associated with the development of atherosclerosis.

PMID- 7799630
TI  - The effect of wall distensibility on flow in a two-dimensional end-to-side
      anastomosis.
AB  - The development of intimal hyperplasia at the distal anastomosis is the major
      cause of long-term bypass graft failure. To evaluate the suspected role of
      hemodynamic factors in the pathogenesis of distal intimal hyperplasia, an
      understanding of anastomotic flow patterns is essential. Due to the complexity of
      arterial flow, model studies typically make simplifying assumptions, such as
      treating the artery and graft walls as rigid. In the present study this
      restriction is relaxed to consider the effects of vessel wall distensibility on
      anastomotic flow patterns. Flow was simulated in an idealized 2-D distensible end
      to-side anastomosis model, using parameters appropriate for the distal
      circulation and assuming a purely elastic artery wall. A novel numerical approach
      was developed in which the wall velocities are solved simultaneously with the
      fluid and pressure fields, while the wall displacements are treated via an
      iterative update. Both the rigid and distensible cases indicated the presence of
      elevated temporal variations and low average magnitudes of wall shear stress at
      sites known to be susceptible to the development of intimal hyperplasia. At these
      same sites, large spatial gradients of wall shear stress were also noted.
      Comparison between distensible-walled and corresponding rigid-walled simulations
      showed moderate changes in wall shear stress at isolated locations, primarily the
      bed, toe and heel. For example, in the case of a distensible geometry and a
      physiologic pressure waveform, the heel experienced a 38 percent increase in
      cycle-averaged shear stress, with a corresponding 15 percent reduction in shear
      stress variability, both relative to the corresponding values in the rigid-walled
      case.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799633
TI  - A computational method for solving arbitrary two-dimensional physiological flows.

PMID- 7799632
TI  - A computational study of a thin-walled three-dimensional left ventricle during
      early systole.
AB  - A numerical study was conducted to solve the three-dimensional Navier-Stokes
      equations for time-dependent flow in a compliant thin-walled, anatomically
      correct left ventricle during early systole. Model parameters were selected so
      that the simulation results could be compared to clinical data. The results
      produced endocardial wall motion which was consistent with human heart data, and
      velocity fields consistent with those occurring in a normally-contracting left
      ventricle. During isovolumetric contraction the posterior wall moved basally and
      posteriorly, while the septal wall moved apically and anteriorly. During
      ejection, the short axis of the ventricle decreased 1.1 mm and the long axis
      increased 4.2 mm. At the end of the isovolumetric contraction, most of the flow
      field was moving form the apex toward the base with recirculation regions at the
      small pocket formed by the concave anterior leaflet, adjacent to the septal wall
      and near the left ventricular posterior wall. Fluid velocities in the outflow
      tract matched NMR data to within 10 percent. The results were also consistent
      with clinical measurements of mitral valve-papillary muscle apparatus
      displacement, and changes in the mitral valve annular area. The results of the
      present study show that the thin-walled, three-dimensional left ventricular model
      simulates observed normal heart phenomena. Validation of this model permits
      further studies to be performed which involve altered ventricular function due to
      a variety of cardiac diseases.

PMID- 7799634
TI  - Steady expiratory flow in a model symmetric bifurcation.
AB  - A model symmetric bifurcation was employed to simulate steady expiratory flow in
      the upper part of the human central airways. A two color, two component laser
      Doppler anemometer was used to measure both the axial flow and the secondary flow
      at three different Reynolds numbers of 518, 1036, and 2089, corresponding to Dean
      numbers of 98, 196, and 395. The test section is a symmetric bifurcation of
      constant cross-sectional area with a branching angle of 70 degrees. The flow rate
      into the two daughter branches was about the same. Results show that in the
      junction plane, velocity profiles in the daughter branches are skewed towards the
      inner walls. In the parent tube, just downstream of the flow divider, the
      velocity profile is biconcave with a dip at the center but this is rapidly
      transformed into a velocity peak. In a plane transverse to the bifurcation plane,
      parabolic velocity distribution was conserved through the daughter branches. In
      the parent tube, the transverse profiles became flat downstream of the flow
      divider and developed a defect at the center further downstream towards the end
      of the parent tube part of the bifurcation. The velocity defect was confined to a
      small region in the vicinity of the centerline. Helical motion typified by
      symmetric vortices was observed in the daughter branches. In the parent tube, a
      set of four vortices induced by the turning of the flow was observed.

PMID- 7799635
TI  - Estimation of the thermal effect of blood flow in a branching countercurrent
      network using a three-dimensional vascular model.
AB  - A three-dimensional thermal model is presented in which convective heat transfer
      is defined in terms of the physical details of the vascular system. The
      convective heat exchange between prearteriole and postvenule vessels and the
      tissue across the vessel walls is calculated explicitly without using shape
      factors. Conduction in x-, y-, and z-direction is considered. This vascular model
      is applied to a human extremity. The spatial variations in the arterial, venous
      and tissue temperatures under basal conditions, hyperthermic conditions and in a
      cold environment are computed. Conclusions are drawn as to the validity of
      bioheat approaches.

PMID- 7799636
TI  - The effect of angle and flow rate upon hemodynamics in distal vascular graft
      anastomoses: a numerical model study.
AB  - Flow in distal end-to-side anastomoses of iliofemoral artery bypass grafts was
      simulated using a steady flow, three-dimensional numerical model. With the
      proximal artery occluded, anastomotic angles were varied over 20, 30, 40, 45, 50,
      60 and 70 deg while the inlet Reynolds numbers were 100 and 205. Fully developed
      flow in the graft became somewhat skewed toward the inner wall with increasing
      angle for both Reynolds numbers. Separated flow regions were seen along the inner
      arterial wall (toe region) for angles > or = 60 deg at Re = 100 and for angles >
      or = 45 deg at Re = 205 while a stagnation point existed along the outer arterial
      wall (floor region) for all cases which moved downstream relative to the toe of
      the anastomosis with decreasing angles. Normalized shear rates (NSR) along the
      arterial wall varied widely throughout the anastomotic region with negative
      values seen in the separation zones and upstream of the stagnation points which
      increased in magnitude with angle. The NSR increased with distance downstream of
      the stagnation point and with magnitudes which increased with the angle. Compared
      with observations from chronic in vivo studies, these results appear to support
      the hypothesis of greater intimal hyperplasia occurring in regions of low fluid
      shear.

PMID- 7799637
TI  - Pulsatile velocity measurements in a model of the human abdominal aorta under
      resting conditions.
AB  - Oscillations in near-wall velocity direction have been found to correlate with
      atherosclerotic plaque localization in the carotid sinus bifurcation. However, it
      remains unproven whether these conditions could account for the localization of
      the disease at other sites where atherosclerosis forms. The abdominal aorta is an
      important site of clinical disease in a relatively straight segment of artery.
      This study was initiated to quantify the velocity field in the abdominal aorta in
      order to determine if local differences in hemodynamic velocity directions could
      account for the localization of disease in this segment. Magnetic Resonance
      Imaging velocimetry was used to measure the pulsatile velocity profiles in an
      anatomically accurate in vitro model of the abdominal aorta. Velocities measured
      in the suprarenal aorta were laminar and reversed minimally, comparing well with
      theoretical solutions of Womersley flow (r = 0.96). The time-averaged velocity
      was +3.0 cm/s near-wall at a distance of 1 mm away from the wall. In the
      infrarenal aorta, the maximal velocities were skewed toward the anterior wall. At
      the posterior wall, velocity oscillated in direction and was retrograde for 82
      percent of the cardiac cycle. The time-averaged velocity near the posterior wall
      was -12.5 cm/s as compared to +3.00 cm/s near the anterior wall. At the aortic
      bifurcation, the locations of maximal and minimal velocities in this slice were
      concentrated near the lateral posterior walls. This study quantifies the
      magnitude of low and oscillatory velocity that may exist in the abdominal aorta
      and suggests that there is a strong relationship between the velocities in the
      retrograde direction under resting conditions and the distribution of
      atherosclerotic plaque.

PMID- 7799638
TI  - Influence of abdominal aortic curvature and resting versus exercise conditions on
      velocity fields in the normal abdominal aortic bifurcation.
AB  - Local hemodynamics are considered an important atherogenetic factor in the
      abdominal aortic bifurcation. This study addresses the quantitative flow fields
      in a pulsatile flow model of a normal abdominal aortic bifurcation when
      encountering realistic upstream anatomy, realistic inlet flow conditions and
      different physiologic flow conditions (rest vs. exercise). Two-dimensional laser
      Doppler anemometry measurements gave axial as well as radial velocities. The
      localization and magnitude of peak velocities, retrograde flow and secondary
      velocity patterns were found to be determined to a great extent by the curvature
      of the abdominal aorta, the triphasic flow wave form and the inlet velocity
      profile. Significant changes were also seen when simulating different physiologic
      flow conditions. Thus retrograde velocities were present at both the flow divider
      and the lateral vessel wall for the rest condition but not for the exercise flow
      conditions, and the location of low and retrograde velocities during diastole
      were as much determined by abdominal aortic curvature as by the bifurcation for
      nearly all flow conditions and locations. In conclusion, the anatomy and
      hemodynamics in the abdominal aorta cannot be neglected when studying the
      hemodynamics in the abdominal aortic bifurcation.

PMID- 7799639
TI  - Unsteady entrance flow development in a straight tube.
AB  - The entrance conditions for pulsatile flow are important in the understanding
      blood flow out of the heart and in developing regions at branches. The pulsatile
      entrance flow was solved using a spectral element simulation of the full unsteady
      Navier-Stokes equations. A mean Reynolds number of 200 and a range of Womersley
      parameters from 1.8 to 12.5 was used for a sinusoidal inlet flow waveform 1 + sin
      (omega t). Variations in the entrance length were observed during the pulsatile
      cycle. The amplitude of the entrance length variation decreased with an increase
      in the Womersley parameter. The phase lag between the entrance length and the
      inlet flow waveform increased for Womersley parameter alpha up to 5.0 and
      decreased for alpha larger than 5.0. For low alpha, the maximum entrance length
      during pulsatile flow was approximately the same as the steady entrance length
      for the peak flow. For high varies; is directly proportional to, the pulsatile
      entrance length was more uniform during the cycle and tended to the entrance
      length for the mean flow. The wall shear rate reached its far downstream value
      after only about half of the entrance length and also exhibited a dependence on
      alpha. The results quantify the entrance conditions typically encountered in
      studies of the arterial system.

PMID- 7799640
TI  - Derivation of shear rates from near-wall LDA measurements under steady and
      pulsatile flow conditions.
AB  - Atherosclerosis, thrombosis, and intimal hyperplasia are major forms of
      cardiovascular diseases in the United States. Previous studies indicate a
      significant correlation between hemodynamics, in particular, wall shear rate, and
      pathology of the arterial walls. While results of these studies implicate
      morphologic and functional changes related to wall shear rate magnitude, a
      standard technique for wall shear rate measurement has not been established. In
      this study, theoretical and in-vitro experimental fully developed steady and
      physiologic pulsatile flow waveforms have been used to obtain velocity profiles
      in the near-wall region. The estimated wall shear rates from these results are
      compared to the theoretical value to assess the accuracy of the approximating
      technique. Experimentally obtained results from LDA suggest that in order to
      minimize the error in velocity data, and subsequently, the wall shear rate, the
      first measured velocity has to be 500 microns away from the wall. While a linear
      approximation did not produce errors larger than 16.4 percent at peak systole,
      these errors substantially increased as the velocity magnitudes decreased during
      late systole and diastole. Overall, a third degree polynomial curve fit using
      four points produced the most accurate estimation of wall shear rate through out
      the cardiac cycle. Results of higher degree curve-fitting functions can be
      unpredictable due to potential oscillations of the function near the wall. Hence,
      based on the results of this study, use of a linear approximation is not
      recommended; a third degree curve-fitting polynomial, using four points provided
      the most accurate approximation for these flow waveforms.

PMID- 7799641
TI  - Pulsatile flow and endothelial cell morphology in a cell culture chamber model of
      an artificial cardiac ventricle.

PMID- 7799642
TI  - A multi-degree of freedom system for biomechanical testing.
AB  - A system is described that allows axial, torsional, and bending testing of
      biomechanical specimens. The system uses electric motors under closed loop
      control in its grips allowing application of pure bending moments. These grips
      attach to an axial/torsional testing system. Thus, it provides simultaneous
      closed loop control of all three degrees of freedom (D.O.F), so that under any
      given test condition either the loads or the displacements for each D.O.F. can be
      maintained at zero, selected constant values, or simultaneously controlled. This
      enables the expedient evaluation of the mechanical behavior of biological
      structures under complex loadings or simple loadings (one D.O.F.) with no
      artificially induced constraints in the other two D.O.F.'s due to specimen
      mounting.

PMID- 7799643
TI  - A note on the reduced creep function corresponding to the quasi-linear visco
      elastic model proposed by Fung.
AB  - For description of the visco-elastic behavior of soft biological tissues, Fung
      proposed a visco-elastic model formulated in terms of a relaxation function and
      corresponding relaxation spectrum. For the corresponding creep function, Fung
      proposed an expression which needs correction to obtain a consistent formulation.
      This creep function and the corresponding creep spectrum are derived in this
      note.

PMID- 7799644
TI  - Myocardial salvage by 1-O-hexadecyl-Sn-glycerol: possible role of peroxisomal
      dysfunction in ischemia reperfusion injury.
AB  - A recent study demonstrated biochemical and structural alterations of peroxisomes
      in rat kidney after ischemia/reperfusion. We examined whether peroxisomes play
      any role in the pathophysiology of myocardial ischemia/reperfusion injury.
      Isolated perfused rat heart was made ischemic for 30 min by terminating coronary
      flow (CF), followed by 30-min reperfusion. Experiments were divided into two
      groups; the experimental group received 1-O-hexadecyl-Sn-glycerol (chimyl
      alcohol) (25, 50, and 100 microM) before ischemia, and the control group received
      an equivalent amount of saline. Two of the experimental groups (50 and 100
      microM) demonstrated improved postischemic myocardial performance, as
      demonstrated by accelerated recovery in left ventricular developed pressure
      (LVDP) and CF, as well as reduction in the incidence of ventricular fibrillation
      (VF). However, because the heart rate (HR) was significantly reduced in the 100
      microM chimyl alcohol group, subsequent studies were performed with 50 microM
      chimyl alcohol as the optimal dose. Chimyl alcohol (50 microM) also reduced
      cellular injury, as evidenced by reduced creatine kinase (CK) release, and
      decreased development of oxidative stress, as evidenced by reduced formation of
      malonaldehyde (MDA). Peroxisomal catalase activity was decreased in the control
      group after ischemia/reperfusion, and chimyl alcohol treatment restored the
      activity of the enzyme. Our results indicate that chimyl alcohol, a precursor of
      ether-linked phosphoglyceride biosynthesis, can reduce myocardial
      ischemia/reperfusion injury, possibly by restoring catalase activity and reducing
      oxidative stress through synthesis of ether lipids, suggesting a possible role of
      peroxisomal disorder in ischemia/reperfusion injury.

PMID- 7799645
TI  - Inhibitory effect of perindopril, a novel angiotensin-converting enzyme
      inhibitor, on neointima formation after balloon injury in rats and cholesterol
      fed rabbits.
AB  - We investigated the effect of perindopril, a novel angiotensin-converting enzyme
      (ACE) inhibitor, on neointima formation in vessel walls after balloon injury in
      rats (carotid artery) and cholesterol-fed rabbits (thoracic aorta). Continuous
      treatment with perindopril significantly reduced neointima formation in both
      species, as compared with the control group: intima/media (I/M) ratio (rats -62%;
      p < 0.001; rabbits -25%, p < 0.05); neointima area (rats -65%, p < 0.01; rabbits 
      24%, p < 0.05). These changes involved reduction of intimal smooth muscle cells
      (SMC) in rats and of macrophages in rabbits. Furthermore, perindopril also
      significantly decreased ACE activity in both aortic tissue and serum [11.38 +/-
      0.87 vs. 34.93 +/- 6.44 pmol His-Leu (HL)/mg/min (p < 0.01) and 2.79 +/- 0.28 vs.
      38.50 +/- 5.41 pmol HL/mg/min (p < 0.001), respectively], aortic contraction
      evoked by angiotensin I (AI) and mean blood pressure (BP, 84.9 +/- 3.5 vs. 109.3
      +/- 3.8 mm Hg, p < 0.001) as compared with control values. These results indicate
      that perindopril may reduce neointima formation by suppressing the aortic renin
      angiotensin system (RAS). These findings indicate that perindopril may be capable
      of preventing restenotic lesions after angioplasty in humans [corrected].

PMID- 7799646
TI  - Clinical and experimental studies in treating diabetes mellitus by acupuncture.

PMID- 7799647
TI  - Treatment of 51 cases of hyperthyroidism by puncturing effective points.

PMID- 7799648
TI  - 124 cases of dyssomnia treated with acupuncture at sishencong points.

PMID- 7799649
TI  - Acupuncture at jianjing for treatment of achalasia of the cardia.

PMID- 7799650
TI  - Prompt pressure applied to peculiar points in the treatment of spasmodic
      infantile cerebral palsy--a report of 318 cases.
AB  - Infantile cerebral palsy is a nonprogressive central motor disturbance of varied
      etiology. The spasmodic type is its main form, accounting for 50-60% of the
      infants afflicted with the disease. The causal factors include multifarious
      conditions arising during parturition and in the pre- and postnatal periods. As
      yet there is no specific treatment for the disease. We have used a method of
      applying prompt pressure to peculiar points in treating it and received
      satisfactory results. The present group comprised 318 patients treated for the
      disease by the method of prompt pressure applied to peculiar points combined with
      appropriate orthopedic manipulations, resulting in a 73.27% rate of good to
      excellent therapeutic effect. Follow-up exam was done in 52 cases, among which
      the efficacy was assessed as stable in 21 cases, and the remaining 31 cases as
      being in an improved condition. Infantile peculiar points are points peculiar to
      infants, mostly located in the head and extremities, and constitute an important
      component part of the treasure-house of traditional Chinese medicine. The method
      recommended here is simple and convenient, causing little pain in the invalid yet
      showing a marked therapeutic effect, and therefore can be regarded as a new way
      for treating infantile cerebral palsy.

PMID- 7799652
TI  - Treatment of intraperitoneal inflammatory masses with the heat and stagnation
      dispelling decoction--a report of 32 cases.

PMID- 7799651
TI  - 52 cases of apoplexy treated with scalp acupuncture by the slow-rapid reinforcing
      reducing method.
AB  - 85 cases of apoplexy were treated with scalp acupuncture, including 52 cases by
      the method of slow-rapid reinforcing-reducing and 33 cases by the method of flat
      twisting. The total effective rates differed insignificantly between the 2
      methods. However, in respects of improving the myodynamia and motile functional
      disturbances of the limbs, the method of slow-rapid reinforcing-reducing was
      markedly superior to the method of flat twisting.

PMID- 7799653
TI  - Treating subluxation of sacroiliac joint by manipulation--a report of 100 cases.

PMID- 7799654
TI  - The effect of radix Salviae Miltiorrhizae Composita on peroxidation of low
      density lipoprotein due to copper dichloride.
AB  - It is well known that plasma lipoprotein, particularly oxidized LDL, plays an
      important role in the pathogenesis of atherosclerosis and atherosclerotic
      diseases. We used oxidized LDL generated by incubating LDL from healthy persons
      with copper dichloride as a model to investigate the antioxidate property of
      Radix Salviae Miltiorrhizae Composita (RSMC). On photos, the spot X1 and the spot
      X2 were clearly found in the control group after the dialysis into copper
      dichloride for 24 and 48 hours, but they could not found in the RSMC group. The
      analysis of the constituents of lipids in LDL (by charring method) showed that
      after dialysis the percentages of the spot X1 and the spot X2 in the RSMC group
      were significantly lower than those in the control group (P < 0.01). The results
      suggest that RSMC plays a potential role in antioxidation of lipids or LDL.

PMID- 7799655
TI  - Experimental study on effect of traditional bone-knitting drugs on traumatic gu
      bi (bone-rheumatoid lesions).
AB  - Traditional bone-knitting drugs (TBKD) are used frequently in the treatment of
      bone fractures. An animal model of Gu Bi (bone-related rheumatoid lesions) with
      defects of articular cartilage as the main lesion was developed by surgical
      trauma under the stereomicroscope in Wistar rats and treated with TBKD. The
      results showed that TBKD could promote proliferation of cartilage cells around
      the traumatic site and improve the osteogenetic function in the traumatic state,
      suggesting that TBKD can be used in combination with other Chinese drugs to treat
      Gu Bi, including bony lesions of the late-stage rheumatoid arthritis and bony
      arthritis. But the experimental results also suggested that TBKD might have an
      effect of promoting development of inflammation, and therefore, should be used
      with care in the acute phase of inflammation.

PMID- 7799656
TI  - Study on preventive and curative effects of liu wei di huang tang on tumors.
AB  - Liu Wei Di Huang Tang (LWDHT), a Chinese prescription for strengthening the body
      resistance, restoring the normal functions of the body to consolidate the
      constitution, and nourishing and invigorating the kidney yin, has been used to
      prevent and treat severe hyperplasia of esophageal epithelium for many years. The
      results of this experiment show that LWDHT can increase markedly the number of
      lymphocytes, mainly T lymphocytes, in tumor-bearing mice. Free-flow
      electrophoresis shows that in tumor-bearing mice the electrophoretic
      characteristics of T lymphocytes are changed, i.e., reduction of the number of T
      lymphocytes with a higher electrophoretic rate, but LWDHT can alleviate this
      disorder. Study on the cell membrane fluidity of carcinoma cells in EAC mice
      demonstrates that LWDHT can decrease the cell membrane fluidity, suggesting that
      it can inhibit division of carcinoma cells.

PMID- 7799657
TI  - The difference in EEG theta waves between concentrative and non-concentrative
      qigong states--a power spectrum and topographic mapping study.
AB  - The differences in EEG theta waves between concentrative and non-concentrative
      Qigong states were studied by means of power spectrum analysis and EEG mapping.
      The adult subjects included 20 practitioners of concentrative Qigong, 30
      practitioners of non-concentrative Qigong and 23 control subjects. The results
      showed frontal mid-line theta rhythm was related to concentrative Qigong state.
      As the theta rhythm has been suggested to be one of the normal EEG patterns
      occurring in mental concentration, it is concluded that the theta rhythm is an
      indicator of mental concentration during Qigong state. This finding clarifies the
      implication of the theta rhythms appearing in Qigong and other meditation.

PMID- 7799658
TI  - Achievements in the treatment of hyperlipidemia with TCM-WM.

PMID- 7799659
TI  - Studies on reducing and reinforcing manipulation of acupuncture during the past 4
      years.

PMID- 7799660
TI  - Treatment of chronic gastritis with acupuncture.

PMID- 7799661
TI  - Headache.

PMID- 7799662
TI  - [Changes in the cerebral flow velocity induced in the middle cerebral artery by
      acute stress studied by transcranial Doppler ultrasonography].
AB  - BACKGROUND: The behavior of brain flow on acute stress has not been previously
      evaluated. Transcranial Doppler ultrasonography (TD) is a bloodless method to
      evaluate the speed of cerebral flow in the arteries of the Willis polygon. The
      present study was designed to analyze the changes which occur in the same during
      two situations of acute stress. METHODS: The mean speed of cerebral flow (MS) and
      the pulsation rate (PR) of the right and left middle cerebral artery (MCA) were
      measured basally and following a mental stress test (calculation) and physical
      stress (cold test) by TD and through the temporal window. Twenty-five healthy
      volunteers (18 women and 8 men) with a mean age of 27.8 +/- 7.3 years were
      studied. RESULTS: In response to mental stress an increase was observed in MS in
      both the right MCA (10 +/- 8.6 cm/sec) and the left MCA (10.4 +/- 8.7 cm/sec)
      with a decrease in the MCA (0.14 +/- 0.23 in the right MCA, 0.14 +/- 0.18 cm/sec
      in the left MCA). In response to the cold test an increase in MS (7.3 +/- 7.5
      cm/sec in the right MCA, 14.8 +/- 14.7 cm/sec in the left MCA) was also observed
      with a decrease in the PR (0.2 +/- 0.2 in the right MCA and 0.2 +/- 0.16 in the
      left MCA). No significant differences were observed in the changes induced in the
      right or left artery or in those induced by the mental or cold tests.
      CONCLUSIONS: These results suggest that the acute stress produces an increase in
      cerebral flow in the arteries of the Willis polygon.

PMID- 7799663
TI  - [Dietary habits of 2 populations of the province of Barcelona (III): energy
      consumption and macronutrients].
AB  - BACKGROUND: The identification of an association between alimentary and
      nutritional factors and different diseases has led to the study of alimentary
      habits in different populations. The consumption of energy and macronutrients was
      analyzed in two urban populations in the province of Barcelona (Spain). METHODS:
      One thousand thirty-four randomly selected individuals from primary care centers
      (PCC) were studied by a systematic sampling of all the out patient consultations
      over one year and to those to whom a semiquantitative questionnaire of frequency
      foodstuffs was given to estimate their normal diet. The subjects included all
      those residents in the two towns studied from 13 to 80 years of age who attended
      the PCC during the study period. RESULTS: The percentage of subjects from
      Vilanova i la Geltru who were found to be high consumers of milk and derivatives,
      fish and vegetables was significantly higher in comparison with subjects from
      Gava. The males of both towns presented a higher mean consumption of
      carbohydrates and energy than the females. On comparison of the consumption
      between the 2 populations, the mean carbohydrate diet ingested was significantly
      greater in the population from Gava in both sexes as was the consumption of
      energy and total lipids between women and men, respectively. CONCLUSIONS: The
      population studied presented a clear pattern of Mediterranean diet consumption
      with elevated ingestion of carbohydrates and monounsaturated fats.

PMID- 7799664
TI  - [Mortality in the acute phase of cerebrovascular disease: the registry of La
      Alianza-Hospital Central of Barcelona].
AB  - BACKGROUND: Few studies have been performed on mortality from acute
      cerebrovascular disease (ACVD) during hospital admission, particularly in Spain.
      METHODS: A prospective clinical analysis was performed in 1,356 consecutive
      patients with ACVD included in the Registry of Cerebrovascular Disease of the
      Central La Alianza-Hospital in Barcelona (1986-1992) with the aim of analyzing
      the causes of mortality during the acute phase of the disease and the time of
      hospital survival. RESULTS: The mortality of the series was 16% (13% from
      cerebral infarction and 29% from cerebral hemorrhage; p < 0.0001). The causes of
      mortality were not neurologic in 49%, neurologic in 42% and of unknown cause in
      9%. The principal causes of death were: transtentorial herniation/compression of
      the cerebral trunk (TH/CCT) 34%, pneumonia 14%, sepsis 14% and heart disease 11%.
      TH/CCT was more frequent on hemorrhage than on cerebral infarction (50% vs 27%; p
      < 0.001) while heart diseases were more frequent in cerebral infarction (14% vs
      3%, p < 0.03). TH/CCT was the most common cause of death during the first seven
      days, with the pneumonia-sepsis-pulmonary thromboembolism being the most common
      after the third week. On the other hand, heart disease and sudden death showed
      homogeneous presentation with regard to frequency. CONCLUSIONS: The causes of
      death during the acute phase of acute cerebrovascular disease are principally non
      neurologic (49%) being potentially preventable with the most frequent causes of
      death being from pneumonia, sepsis and pulmonary thromboembolism. Mortality of
      these patients may be decreased on correct diagnosis and treatment.

PMID- 7799665
TI  - [Stress and the cerebral blood flow].

PMID- 7799666
TI  - [Health care according to the sex of patients].

PMID- 7799667
TI  - [Vasculitis associated with a myelodysplastic syndrome: a report of 5 cases].
AB  - In a study of 94 patients with myelodysplastic syndrome (MDS) associated
      vasculitis was observed in 5, which preceded hematologic diagnosis in 4.
      Leukocytoclastic vasculitis was observed in 5 cases being associated to lobular
      panniculitis in one. Three patients had refractory anemia, one sideroblastic
      anemia (SA) and another refractory anemia with excess blasts (RAEB). In the
      latter case lymphomatoid papulosis was also observed which, to date, has not been
      previously described in association with MDS. Another case presented seronegative
      polyarthritis and renal disease coinciding with vasculitis. Polyarteritis nodosa
      was diagnosed in a third patient in agreement with the criteria of the American
      College of Rheumatology, the association of which with MDS is exceptional. In the
      same case medullary cytogenetic study showed 46, XY,t (12;20), an abnormally
      which has not been described to date in cases of MDS. All the cases were treated
      with glucocorticoids in addition to cyclophosphamide in the patient with
      polyarteritis nodosa, with an improvement in the vasculitis being observed in all
      the patients. Two patients died, one (SA) due to pneumonia and the other (RAEB)
      due to subdural hematoma following transformation to acute myeloblastic leukemia.
      With 5% of the MDS studied presenting vasculitis, this syndrome should be
      included in the differential diagnosis of vasculitis observed in patients with
      cytopenia.

PMID- 7799668
TI  - [Malpractice accusations: causes, consequences and prevention].

PMID- 7799669
TI  - [The basic treatment of arterial hypertension (I). Changes in life style and the
      control of risk factors].

PMID- 7799670
TI  - [Lobular carcinoma in situ of the breast].

PMID- 7799671
TI  - [The neuroleptic malignant syndrome].

PMID- 7799672
TI  - [The neuroleptic malignant syndrome].

PMID- 7799673
TI  - [The neuroleptic malignant syndrome].

PMID- 7799674
TI  - [The neuroleptic malignant syndrome].

PMID- 7799676
TI  - [The neuroleptic malignant syndrome].

PMID- 7799675
TI  - [Hypocalcemia in a patient with the acquired immunodeficiency syndrome treated
      only with foscarnet].

PMID- 7799678
TI  - [The usefulness of different markers in the diagnosis of advanced HIV infection].
AB  - BACKGROUND: The aim of this study was to evaluate the usefulness of different
      markers to diagnose advanced infection by the human immunodeficiency virus (HIV)
      (AIDS or CD4 lymphocyte < 0.2 x 10(9)/L), establish the degree of correlation and
      define markers of advanced infection in primary health care. METHODS: Clinical,
      hematological, biochemical, cellular, serological and immunological variables
      were analyzed in 146 patients diagnosed for the first time with HIV infection.
      The patients were classified into three stages: A (II, III, CDC-1987), B (IV-A,
      IV-C2) and C or advanced (IV-C1, IV-D). The following data were compared: the
      results in the three stages, the degree of correlation, the specificity and
      sensitivity to the diagnosis of AIDS. Two multiple logistic regression models
      were established: the first for all the variables and the second for only those
      available in primary health care. RESULTS: All the markers except the
      triglycerides, IgG, IgM, and beta 2-microglobulin presented significant
      differences in the stages (p < 0.05). With the exception of the CD3+, CD4+ and
      CD8+ lymphocytes (r > or = 0.6 or -0.6) the remaining variables were independent.
      The decrease in CD4+ and the increase in neopterin were very sensitive markers (>
      95%) but only hyperamylasemia demonstrated a specificity greater than 95% for the
      diagnosis of advanced infection. Oropharyngeal candidiasis (OR = 4.80) and the
      CD4+ lymphocyte (OR = 0.99) had the greatest weight in the first model. In the
      second model the most significant markers were weight loss (OR = 4.41), a
      decrease in lymphocytes (OR = 7.65) and an increase in IgA (OR = 5.82) with p <
      0.01 and a predictive value of 85.16%. CONCLUSIONS: The presence of weight loss,
      lymphocyte count < 1 x 10(9)/L and an increase in IgA may be used in primary
      health care to diagnose advanced infection by the human immunodeficiency virus.
      Asymptomatic hyperamylasemia with no apparent cause suggests advanced infection.

PMID- 7799677
TI  - [Seroepidemiology of hepatitis C virus infection in pregnant women in Catalonia].
AB  - BACKGROUND: The aim of this study was to investigate the prevalence of hepatitis
      C virus (HCV) infection in a population of pregnant women in Catalonia and the
      sociodemographic variables and risk factors associated to this prevalence.
      METHODS: A representative sample of the pregnant women in Catalonia (n = 4,551)
      randomly selected by clusters (hospitals with maternity clinics) was studied.
      Detection of antiHCV antibodies was performed by the third generation ELISA test.
      Reactive cases were confirmed with RIBA 3 and MATRIX. RESULTS: The prevalence of
      antiHCV was found to be 1% and was not significantly associated with any of the
      sociodemographic variables studied (age, social and cultural level, origin and
      residence). A history of blood transfusion, intravenous drug consumption and
      hepatitis in the sexual partner were the only risk factors associated with the
      prevalence of infection found on univariate analysis although these were only
      present in 47% of the antiHCV positive cases detected. The association between
      the positivity of antiHCV and the history of hepatitis in the partner was lost on
      stratification of the cases according to the possible existence of history of
      drug addiction. CONCLUSIONS: A high proportion of young asymptomatic people (1%)
      were found to have hepatitis C virus infection with the possible mode of
      infection not being detected in approximately half of these subjects. In the
      other half of these cases the infection was found to have been acquired by an
      intravenous mechanism: blood transfusion or drug use.

PMID- 7799679
TI  - [Isolation, sequencing and ultrastructure of HTLV-I and HTLV-II retroviruses.
      Presence of the HTLV-II subtype b among Spanish intravenous drug addicts].
AB  - BACKGROUND: Six cases of HTLV-I/II infection were selected for isolation and
      characterization of these retrovirus. METHODS: Detection of anti-HTLV antibodies
      was carried out by enzyme immunoassay (EIA), immunofluorescence (IFI), and
      Western blot (WB). Analysis of proviral DNA was performed by PCR. Viral culture
      and partial sequencing of the pol and pX genes were carried out. Electron
      microscopy morphologically characterized the viral particles. RESULTS: Serologic
      study demonstrated four cases of HTLV-II, one of HTLV-I, and one non-typeable
      HTLV infections. This last case was confirmed as positive for HTLV-II by PCR.
      Five new HTLV-II and one HTLV-I infected cell lines have been established by co
      culture. Electron microscopy allowed morphologic characterization of the viral
      particles found in the infected cells. The sequence of the five strains of HTLV
      II was identical demonstrating a divergence of 0.49% in the pX region and of 4.5%
      in the pol region compared with the HTLV-II Mo prototype. Comparison of these
      sequences with those corresponding to different strains of HTLV-II isolates from
      American Indians (subtypes b) suggest that these Spanish strains are more closely
      related with the subtype b than with the subtype a (HTLV-II Mo). Genetic
      variability study did not reveal any change in the sequence of these stains
      suggesting that the variability of these retroviruses in very infrequent in the
      regions studied. The analysis of the pol region of the HTLV-I strain demonstrated
      a divergence of 3.4% with respect to the sequence of the ATK-1 prototype (Japan)
      and of 1.7% of the strain HS-35 (Caribbean) showing a greater relation with the
      Caribbean strains than with those from Japan. CONCLUSIONS: The presence of HTLV
      II subtype has been confirmed among intravenous drug addicts in Spain. Isolation
      and characterization of the HTLV-I strain demonstrated that this also circulating
      around Spain despite its South American origin.

PMID- 7799680
TI  - [Colchicine in the treatment of recurrent pericarditis].

PMID- 7799681
TI  - [Medical-clinical audit (II). Definitions and typology].

PMID- 7799682
TI  - [Evaluation and requirements of the HIV/AIDS test in pregnant women].

PMID- 7799683
TI  - [31-Year-old male with recurrent oral aphthae, myopericarditis and arthritis].

PMID- 7799684
TI  - [CD4+ lymphocytes and opportunistic infections and neoplasms in patients infected
      with the human immunodeficiency virus].

PMID- 7799685
TI  - [CD4+ lymphocytes and opportunistic infections and neoplasms in patients infected
      with the human immunodeficiency virus].

PMID- 7799686
TI  - I2C: a system for the indexing, storage, and retrieval of medical images by
      content.
AB  - Image indexing, storage, and retrieval based on pictorial content is a feature of
      image database systems which is becoming of increasing importance in many
      application domains. Medical image database systems, which support the retrieval
      of images generated by different modalities based on their pictorial content,
      will provide added value to future generation picture archiving and communication
      systems (PACS), and can be used as a diagnostic decision support tools and as a
      tool for medical research and training. We present the architecture and features
      of I2C, a system for the indexing, storage, and retrieval of medical images by
      content. A unique design feature of this architecture is that it also serves as a
      platform for the implementation and performance evaluation of image description
      methods and retrieval strategies. I2C is a modular and extensible system, which
      has been developed based on object-oriented principles. It consists of a set of
      cooperating modules which facilitate the addition of new graphical tools, image
      description and matching algorithms. These can be incorporated into the system at
      the application level. The core concept of I2C is an image class hierarchy. Image
      classes encapsulate different segmentation and image content description
      algorithms. Medical images are assigned to image classes based on a set of user
      defined attributes such as imaging modality, type of study, anatomical
      characteristics, etc. This class-based treatment of images in the I2C system
      achieves increased accuracy and efficiency of content-based retrievals, by
      limiting the search space and allowing specific algorithms to be fine-tuned for
      images acquired by different modalities or representing different parts of the
      anatomy.

PMID- 7799687
TI  - Worklists, preloading and archiving strategies; 3 years of clinical experience in
      the Barcelona PACS.
AB  - We present data on 3 years of clinical experience using PACS involving
      developments on worklists, preloading and archiving strategies in a teaching
      paediatric hospital with all modalities connected to a commercial PACS. A method
      allowing generation of and handling of different worklists for computed
      radiography examinations has been developed in our centre. Worklists and
      archiving strategies are presented and discussed. We conclude that, with adequate
      worklists and efficient preloading implementation, current PACS could be used
      successfully in several clinical settings of a multimodality department.

PMID- 7799688
TI  - A generic approach to the management of time-related signals and images in
      medicine.
AB  - A framework concept for design and implementation of medical workstations is
      described by (a) its underlying principles, (b) the handlers provided by the
      concept, (c) the available data structures and (d) the graphical user interface
      (GUI). The design principle takes care of a modular approach both for the
      framework and for the applications. The GUI provides a coherent look and feel for
      applications based on toolkits for displaying data objects and application
      control. The data handler allows management of n-dimensional data matrices in a
      multi-vendor environment, whereas the parameter handler takes care of the data
      object description. An implementation of a medical workstation exploiting the
      framework concept is presented.

PMID- 7799689
TI  - Multimedia E-mail systems for computer-assisted radiological communication.
AB  - In the film-based organization of communicating radiological results to the
      referring physician, the different media (text, images, graphics, voice) are
      separated. When using computer technology, multimedia reports containing links
      between these different media can be used. This changes the way radiological
      reports are generated, accessed, and possibly discussed. We performed experiments
      in a clinical setting using two different metaphors for communicating multimedia
      information. In the 'paper metaphor', labels in the report text are linked to
      annotations in selected images. In the 'slide presentation metaphor', annotated
      images are presented synchronously to a spoken report. With both systems
      additional interaction between radiologist and referring physician is supported
      using multimedia 'electronic mail'. The experiments indicate that multimedia does
      not only significantly increase the efficiency of information transfer, but also
      has the potential to make reporting itself more efficient. Given that the amount
      of image-related information keeps growing, multimedia links are a promising
      method to give efficient access to the most relevant information.

PMID- 7799690
TI  - Filmless digital radiology--feasibility and 20 month experience in clinical
      routine.
AB  - We present the clinical experiences of PACS based on 20 months routine operation
      of the first filmless radiology department worldwide. PACS planning and
      implementation strategies for potential vendors are discussed. The actual
      implementation status of this major teaching hospital with currently 560 acute
      care beds comprises three computed radiography systems, five digital fluoroscopic
      units, eight ultrasound machines, five mobile units, three angio suites and two
      CT's interconnected with a PACS, a RIS, which is coupled with three voice
      recognition systems for report generation during nights, and a HIS. Primary
      diagnosis is performed on 16 workstations with two to six high-resolution, high
      contrast monitors. Twenty-six peripheral viewing stations provide image display
      on the wards and in outpatient clinics. During the first 20 months 586.047 images
      have been acquired, resulting in 1.3 Tbyte of data stored on optical disks.
      Currently the daily data production is 5-6 Gbyte, the network traffic 15-18
      Gbyte. Benefits of PACS primarily are reliable access to image information,
      speeding up report cycle time, which contributes to the reduction of the average
      patient length of stay (LOS). The LOS in our hospital is the shortest (6.4 days)
      of all Austrian hospitals. So it may be stated that PACS improves the quality of
      health care.

PMID- 7799691
TI  - Design for user efficiency in a dedicated ICU viewing station.
AB  - The intensive care unit (ICU) is one application where significant benefit is
      expected from the use of digital technology in the acquisition, management and
      presentation of images. However, the potential benefits should not be outweighed
      by disadvantages of current digital technology. One of the bottlenecks is the
      efficiency of image viewing using a workstation, especially if this viewing
      station is implemented using affordable commonly available hardware. In this
      paper we describe the design concepts of a relatively low-cost but efficient
      viewing station for chest images, and discuss clinical experience with this
      system at an ICU ward. The user interface has been optimized towards the specific
      patterns of ICU image viewing. By anticipating user requests and preparing images
      during idle times of the computer, the mean image access time could be reduced by
      a factor of 4, while most images could be presented instantaneously. Information
      from the hospital information system (HIS) is exploited in the user interface,
      and a simplified PAC-HIS coupling has been implemented for the simultaneous
      presentation of images and reports.

PMID- 7799692
TI  - PAPYRUS 3.0: DICOM-compatible file format.
AB  - This paper describes the PAPYRUS 3.0 file format based on the new DICOM 3.0
      Standard which addresses the open interchange of medical images in files or on
      removable storage media. This specific implementation of the DICOM standard is
      intended as a generic solution for interchange of multi-modality medical images
      on removable media. It can also be used for convenient exchange of image data
      between different computer systems through industry standard file transfer
      mechanisms. Finally it can also be used for storage and archiving of medical
      image data in a DICOM-compatible format.

PMID- 7799693
TI  - PACER: a software tool for PACS decision makers.
AB  - This paper describes the development of the software package PACER as it evolved
      from a cost model to a software package for PACS decision making. PACER was
      developed as part of the TEASS topic from the EurIPACS project. EurIPACS is an EU
      subsidized project covering a wide area of PACS related research. The TEASS topic
      concerns the evaluation of prototype PACSystems in three European hospitals.
      PACER allows the user to evaluate costs of various PACS implementation scenarios
      and compare them to the costs of the current film based situation. Its cost
      calculation is based on a straight forward description of costs of a film based
      radiology department and of PACS. The PACER cost analysis can consider stepwise
      introduction of PACS and a corresponding stepwise disappearance of the film
      environment. This analysis includes effects of price developments. PACER
      calculates costs and expenses for a number of years in succession. The calculated
      results can be analysed using graphs, tables and sensitivity analysis tools.
      Preliminary tests in three hospitals indicate that PACER can indeed be a useful
      tool in the decision process concerning PACS.

PMID- 7799694
TI  - Legal aspects of digital image management and communication.
AB  - This paper outlines the legal issues that arise in digital image management and
      communication systems (IMACS). At the heart of this study is the digital image
      which is manipulated, processed, communicated, stored, compressed and archived,
      and which is difficult to ascertain from a legal point of view because of its
      intangible nature. On the one hand, personal data protection and the patient's
      right to privacy need to be protected through a data protection and security
      policy. This is particularly important in view of the capacity of IMACS to
      integrate with other systems such as HIS and RIS, since the information generated
      by the totality of these systems offers a very complete picture of any patient.
      On the other hand, the evanescent nature of the digital image creates legal
      uncertainties as to questions of evidence, of procedural and legal admissibility
      and acceptability and of liability.

PMID- 7799695
TI  - MIMOSA: a functional model of the management of medical images.
AB  - The concept of picture archiving and communication system (PACS) appeared in
      1982. Twelve years later most PACS prototypes still do not satisfy the medical
      community requirements: too much emphasis has been put on technical solutions and
      little effort devoted to the management of images itself. A common approach to
      this problem is needed more than ever to allow cost-effective systems to be
      developed. Modelling is a way to reach this objective, and the MIMOSA topic
      within the AIM/EurlPACS project aims at defining such a model of medical image
      management. This paper presents the MIMOSA approach with the three underlying
      constraints, i.e. genericity, implementation independence and performance. The
      MIMOSA group is building three interrelated models: a data model, a functional
      model and a dynamic model. However, in this report we focus only on the
      functional model, and explain how it was abstracted from various clinical
      scenarios in the first phase of the project. The availability level concept is
      introduced as a customizable and implementation independent solution to the
      problem of managing the delay of access to the information. The so-called
      contextual diagram and the acquisition of a new examination which are two
      representative parts of the model are detailed. The validation aspects and the
      relationships to projects working on the management of patient records are
      addressed as a conclusion.

PMID- 7799696
TI  - Proceedings of the 11th International EuroPACS Meeting. Rennes, France, 30
      September-2 October, 1993.

PMID- 7799697
TI  - Iodised salt in India.

PMID- 7799698
TI  - European medicines in the 21st century.

PMID- 7799699
TI  - Inhaled sodium cromoglycate in angiotensin-converting enzyme inhibitor cough.
AB  - Cough is a frequent side-effect of angiotensin-converting enzyme (ACE)
      inhibitors. We examined the effects of inhaled sodium cromoglycate in 10 patients
      with ACE-inhibitor cough in a double-blind crossover study. After a 2-week run
      in, patients were randomised to either 2 weeks' inhaled sodium cromoglycate or
      placebo followed by a further 2 weeks on the other treatment. Patients kept a
      cough diary during each study period. Cough severity was recorded on a scale from
      0 to 12. At the end of each study period the cough threshold to inhaled capsaicin
      was measured. 9 patients reported a reduction in cough after sodium cromoglycate.
      Median (range) daily cough scores during run-in and placebo periods were 3.6 (1.9
      6.4) and 4.1 (0.6-8.1), respectively (p > 0.05). Median daily cough score after
      sodium cromoglycate was 1.8 (0.4-3; p < 0.01). There was a significant relation
      between initial cough severity and benefit from sodium cromoglycate; and cough
      reflex sensitivity to inhaled capsaicin was significantly reduced. Inhaled sodium
      cromoglycate is an effective treatment for ACE-inhibitor cough. Its effect may be
      due to suppression of afferent vagal activity.

PMID- 7799701
TI  - Asthma deaths in New Zealand: whodunnit?

PMID- 7799700
TI  - Plasma (1-->3)-beta-D-glucan measurement in diagnosis of invasive deep mycosis
      and fungal febrile episodes.
AB  - (1-->3)-beta-D-glucan is a characteristic fungal cell-wall constituent. To assess
      the clinical usefulness of this glucan in screening for invasive fungal infection
      or fungal febrile episodes, we measured the plasma concentration at the time of
      routine blood culture in 202 febrile episodes by means of factor G, a horseshoe
      crab coagulation enzyme that is extremely sensitive to this polysaccharide. With
      a plasma cut-off value of 20 pg/mL, 37 of 41 episodes of definite fungal
      infections (confirmed at necropsy or by microbiology) had positive results
      (sensitivity 90%). All of 59 episodes of non-fungal infections, tumour fever, or
      collagen diseases had concentrations below the cut-off value (specificity 100%).
      Of 102 episodes of fever of unknown origin, 26 had plasma glucan concentrations
      of more than 20 pg/mL. With those 102 cases taken as non-fungal infections, the
      positive predictive value of the test was estimated as 59% (37/63), the negative
      predictive value as 97% (135/139), and the efficiency as 85% (172/202). The
      positive predictive value should improve if there were a sensitive gold standard
      that could discriminate fungal from non-fungal infections. Causative fungi
      included candida, aspergillus, cryptococcus, and trichosporon. Determination of
      plasma (1-->3)-beta-D-glucan with factor G is a highly sensitive and specific
      test for invasive deep mycosis and fungal febrile episodes, and will
      substantially benefit immunocompromised patients.

PMID- 7799703
TI  - Horizontal transmission of hepatitis B virus.
AB  - In 1991-92, a cross-sectional survey in Flanders (Belgium) for hepatitis B virus
      (HBV) markers among 277 relatives of institutionalised mentally handicapped
      persons to evaluate the prevalence of hepatitis B and the risk of infection
      showed that relatives of an HBV positive resident were 7.6 times more likely to
      be infected than relatives of an HBV seronegative mentally handicapped person.
      HBV infection among the family members could be attributed in 83% to exposure to
      an HBV positive resident. This study demonstrated the importance of horizontal
      transmission among relatives of institutionalised mentally handicapped people,
      even if family contact is reduced to weekend and holiday activities. We recommend
      that HBV vaccination policy should be expanded to include relatives of
      institutionalised mentally retarded people.

PMID- 7799702
TI  - Genetic abnormalities during transition from Helicobacter-pylori-associated
      gastritis to low-grade MALToma.
AB  - The helicobacter-associated transition from chronic gastritis to MALToma
      (lymphoma of mucosa-associated lymphoid tissue) may require genetic change in the
      host. We have studied gastrectomy specimens from twelve cases of primary B-cell
      gastric lymphoma showing evidence of chronic gastritis and low-grade or high
      grade MALToma to look for allele imbalance at microsatellites for six tumour
      suppressor genes. We detected allelic imbalance at two of these loci (DCC in
      three, APC in two). In two DCC cases allele imbalance was seen in the transition
      from chronic gastritis to low-grade MALToma and in the third between low-grade
      and high-grade. Allele imbalance between chronic gastritis and low-grade MALToma
      is not necessarily causal in the transition. Rather, genetic change has occurred
      in the process of transformation.

PMID- 7799704
TI  - Response to a specific antioestrogen (ICI 182780) in tamoxifen-resistant breast
      cancer.
AB  - We treated 19 patients with advanced breast cancer resistant to tamoxifen with a
      new specific antioestrogen (ICI 182780) which, in animal studies, has no agonist
      activity. 13 (69%) patients responded (7 had partial responses and 6 showed no
      change) to monthly intramuscular injections of ICI 182780 after progression on
      tamoxifen, for a median duration of 18 months with minimum side effects.
      Preliminary evidence suggests that the agent is without effects on the liver or
      the hypothalamic-pituitary axis. ICI 182780 appears to be a promising new agent
      for treatment of advanced and early breast cancer.

PMID- 7799705
TI  - Glue ear: prescribe, operate, or wait?

PMID- 7799706
TI  - Vitamin A.

PMID- 7799707
TI  - Is laparoscopic hysterectomy a waste of time?
AB  - Laparoscopic hysterectomy (LH) is a way to avoid laparotomy. However, there is
      evidence that most women treated by abdominal hysterectomy are suitable for
      vaginal surgery. To test this hypothesis, and to determine the relative merits of
      laparoscopic and vaginal hysterectomy (VH) and the best technique for LH, we
      prospectively studied 98 women who had relative contraindications for vaginal
      surgery by traditional criteria. 75 underwent LH and 23 VH. The LH group included
      22 women who had been assigned to this route of surgery as part of a prospective
      randomised controlled comparison with VH (23 women). Surgery was completed with
      the intended technique in 93.9% of cases. 5 women in the LH group (6.7%) and 2 in
      the VH group required laparotomy or additional procedures. In the prospective
      randomised study LH took longer than VH (mean duration 131 vs 77 min). VH was the
      faster procedure, irrespective of uterine size and need for oophorectomy. With
      LH, the operative time increased as more of the hysterectomy was carried out with
      laparoscopic rather than vaginal dissection. Complication rates, blood loss,
      analgesia requirements, and recovery were similar for the two techniques. Our
      study confirms that most hysterectomies could be performed vaginally, and that LH
      is a much slower procedure. If LH is done, it should be converted to a vaginal
      procedure as early as possible to reduce the overall operating time. LH does seem
      to be a waste of time for most patients.

PMID- 7799708
TI  - Risk of relapse in multibacillary leprosy.

PMID- 7799710
TI  - Drunken drivers beat a retreat.

PMID- 7799709
TI  - End of the New Zealand asthma mortality epidemic.
AB  - In 1989, a case-control study reported that inhaled fenoterol was associated with
      the epidemic of asthma deaths that had affected New Zealand since 1976. The New
      Zealand Department of Health issued warnings about the safety of fenoterol and
      restricted its availability. The associated time trends are consistent with the
      hypothesis that fenoterol was the main factor in the New Zealand asthma mortality
      epidemic. The epidemic commenced when fenoterol was introduced in 1976, and the
      New Zealand death rate remained the highest in the world for more than a decade.
      After publication of the case-control study, the death rate fell by half and has
      now remained low for a further 3 years (1990-92). Time-trend data do not suggest
      a class effect of inhaled beta-agonists in the epidemic: there was no association
      between beta-agonist sales and the start of the epidemic, and total sales of
      inhaled beta-agonists actually increased slightly during 1989-90 when the
      epidemic came to an end. Time-trend data are also inconsistent with the
      hypothesis that the epidemic may have occurred because of underprescribing of
      inhaled corticosteroids. Similarly, time-trend data is incosistent with
      hypotheses postulating a major role of social factors such as unemployment. Data
      on time trends should be assessed with caution, because time trends in asthma
      deaths can be affected by many factors. Nevertheless, the New Zealand time trends
      are consistent with fenoterol being the main cause of the New Zealand asthma
      mortality epidemic and are inconsistent with a significant role for other
      suggested causes.

PMID- 7799711
TI  - Pelvic exenteration: by whom and for whom?

PMID- 7799712
TI  - Deconstructing vulval pain.

PMID- 7799713
TI  - Safety and transcervical endometrial resection.

PMID- 7799714
TI  - Safety and transcervical endometrial resection.

PMID- 7799715
TI  - Safety and transcervical endometrial resection.

PMID- 7799716
TI  - Termination of trial of streptokinase in severe acute ischaemic stroke. MAST
      Study Group.

PMID- 7799717
TI  - Anticoagulant monitoring with transcranial Doppler.

PMID- 7799718
TI  - Iron status in Still's disease.

PMID- 7799719
TI  - Is Still's disease associated with parvovirus B19 infection?

PMID- 7799720
TI  - When to use fluconazole.

PMID- 7799721
TI  - Screening for codon 249 p53 mutation in lung cancer associated with domestic
      radon exposure.

PMID- 7799723
TI  - Routine chest radiographs in admissions to coronary care.

PMID- 7799722
TI  - Reversal of brain metabolic alterations with zidovudine detected by proton
      localised magnetic resonance spectroscopy.

PMID- 7799724
TI  - Aromagram for antibiotic activity.

PMID- 7799725
TI  - ECT and young minds.

PMID- 7799726
TI  - Placebos in medicine.

PMID- 7799727
TI  - Placebos in medicine.

PMID- 7799728
TI  - In-vitro fertilisation and health care coverage.

PMID- 7799729
TI  - Clustering of childhood peritoneal mesothelioma in the Midlands, UK.

PMID- 7799730
TI  - Intravascular line infection with Exophiala dermatitidis.

PMID- 7799731
TI  - Acute and recurrent airflow obstruction after exposure to artificial fog.

PMID- 7799732
TI  - Apolipoprotein E in Creutzfeldt-Jakob disease.

PMID- 7799733
TI  - Apolipoprotein E in Creutzfeldt-Jacob disease.

PMID- 7799734
TI  - Simultaneous outbreak due to Vibrio cholerae and Shigella dysenteriae in Kenya.

PMID- 7799735
TI  - Fat-soluble vitamins.

PMID- 7799736
TI  - Immunity to pneumococcal infections.

PMID- 7799737
TI  - Antibodies to HTLV-I in Sjogren's syndrome.

PMID- 7799738
TI  - Antibodies to HTLV-I in Sjogren's syndrome.

PMID- 7799739
TI  - Antibodies to HTLV-I in Sjogren's syndrome.

PMID- 7799740
TI  - Use of gene-modified virus-specific T lymphocytes to control Epstein-Barr-virus
      related lymphoproliferation.
AB  - Reactivation of Epstein-Barr virus (EBV) after bone-marrow transplantation leads
      in many cases to lymphoproliferative disease that responds poorly to standard
      therapy and is usually fatal. To prevent or control this complication, we
      prepared EBV-specific cytotoxic T-lymphocyte (CTL) lines from donor leucocytes
      and infused them into ten allograft recipients. Three of the patients had shown
      signs of EBV reactivation, with or without overt lymphoproliferation, and the
      others received CTL infusions as prophylaxis. No patient developed any
      complication that could be attributed to the CTL infusions. In the three patients
      with EBV reactivation, EBV DNA concentrations (measured by semiquantitative
      polymerase chain reaction [PCR]), which had increased 1000-fold or more, returned
      to the control range within 3-4 weeks of immunotherapy. The most striking
      consequence was the resolution of immunoblastic lymphoma in a 17-year-old patient
      who received four CTL infusions (two 1 x 10(7)/m2 and two 5 x 10(7)/m2). Because
      the CTL had been genetically marked before infusion, we were able to show by PCR
      analysis that they persisted for 10 weeks after administration. EBV-specific
      donor-type T-cell lines seem to offer safe and effective therapy for control of
      EBV-associated lymphoproliferation.

PMID- 7799742
TI  - Determination of efficient parameters for argon laser-assisted anastomoses in
      rats: macroscopic, thermal, and histological evaluation.
AB  - The aim of this study was to determine efficient parameters for an argon laser
      (spot diameter = 200 microns) to obtain and reproduce vessel anastomoses. It was
      performed in two groups of Wistar rats. In the first group (89 Laser impacts on
      10 carotids), the fluence was continuously adjusted from 30 to 3,000 J/cm2 in
      order to determine efficient sets of parameters (power from 90-200 mW, pulse
      duration from 0.1 to 5 seconds, pulsed or continuous mode). In the second group,
      30 end-to-end carotid anastomoses were performed. The results were evaluated by
      macroscopic thermal, and histological studies. The second group proved the
      efficiency of the selected parameters. Vessel welding was obtained with 100 mW, 3
      seconds, continuous mode (fluence = 950 J/cm2, irradiance = 320 W/cm2) for a mean
      temperature of 77 degrees C corresponding to collagen denaturation. In the second
      group the patency rate was 93% (28/30) with three pseudo-aneurisms and two
      thromboses. Histological studies noted slight modifications of the media.

PMID- 7799741
TI  - Lasers in neurosurgery.
AB  - Lasers have been used in neurosurgery for the past 25 years, undergoing
      modifications to suit the specific needs of this medical discipline. The present
      report reviews the current use of lasers in neurosurgical practice and examines
      the pros and cons of lasers in specific neurosurgical applications. In spite of
      their advantages, laser use is still not widespread in neurosurgery. One reason
      is the continued lack of complete control over real-time laser interactions with
      neural tissue. A greater acceptance and use of lasers by neurosurgeons will
      depend upon automated control over defined specific parameters for laser
      applications based upon the type of tissue, the desired effect on tissue, and
      application to the clinical situation without loss of precision and a lot of
      expense. This will require the integration of newer lasers, computers, robotics,
      stereotaxy, and concepts of minimally invasive surgery into the routine
      management of neurosurgical problems.

PMID- 7799743
TI  - Rate process model for arterial tissue thermal damage: implications on vessel
      photocoagulation.
AB  - A numerical model for thermal damage to human arterial tissue is presented, based
      on protein denaturation kinetics. The model involves determination of
      coefficients of rate processes A & delta E, which are tissue type-dependent
      (arterial tissue in this study), and definition of threshold damage. A feedback
      controlled constant surface temperature device was used to induce 80 coagulative
      lesions of arterial human tissue ranging in temperature from 66 degrees C to 76
      degrees C and in duration from 15 to 1,500 seconds. The measured coefficients
      were determined to be A = 5.6 x 10(63) s-1 and delta E = 430 KJ mole-1. These
      numerical values closely approximate the coefficients of the rate process for
      denaturation of collagen molecules. These and other histological observations
      strongly suggest collagen to be the primary coagulating component of arterial
      tissue at the onset of thermal coagulative damage. The ability of this model to
      predict onset of tissue coagulation during laser coagulation was studied using 10
      postmortem human arterial samples exposed to argon laser irradiation.

PMID- 7799744
TI  - Continuous measurement of the heat-induced changes in the optical properties (at
      1,064 nm) of rat liver.
AB  - The radiative transfer optical properties (absorption coefficient, scattering
      coefficient, and anisotropy of scattering) of slowly heated rat liver have been
      measured at 1,064 nm. Continuous measurements were made using double-integrating
      spheres and collimated illumination of the sample for up to 5,000 seconds heating
      with equilibrium temperatures of 48 degrees, 52 degrees, and 58 degrees C.
      Generally, the scattering increased, and the absorption and anistropy decreased
      at rates dependent on the heating temperatures. However, there was a large
      variability between samples.

PMID- 7799745
TI  - Trends in health policy: heading home.

PMID- 7799746
TI  - [Improvement of effectiveness of high frequency electrosurgical equipment].
AB  - The paper summarizes the results of the activities of the All-Russian Research
      Institute of Medical Industry on the development of electric stimulating
      equipment for anesthesiology and the experience in its application. It also deals
      with electrostimulations, such as transcranial (transcerebral) electroanalgesia,
      transdermal (transcutaneous) electroneurostimulation, epidural (peridural)
      electrostimulation, perineural electric neurostimulation, testing
      electrostimulation of peripheral nerves in making regional anesthesia, electric
      neurostimulating testing of neuromuscular transmission. The developed
      monofunctional Delta-101, Delta-102, Delta-301, Synapse-1 electric
      neurostimulators and a polyfunctional Anestim-PF apparatus used in
      anesthesiological care and other related medical fields.

PMID- 7799747
TI  - [Electric nerve stimulation devices in anesthesiology: research and development].

PMID- 7799748
TI  - [Optic unification of rigid medical endoscopes].

PMID- 7799750
TI  - [Improvement of technical knowledges of scientists and laboratory physicians in
      the field of radionuclide microanalysis].

PMID- 7799749
TI  - [Development of new ultraviolet therapy equipment for phototherapy].
AB  - The papers deals with the development of phototherapeutical ultraviolet radiation
      equipment, outlines the design and basic data of five new phototherapeutical
      radiation sources developed in the Laboratory of Medical Radiation Sources,
      VNIIMP-VITA joint stock company.

PMID- 7799751
TI  - [Computerized spirometers (analysis of problem solving)].
AB  - The basic constructive and algorigthmic designs which are widely used in the up
      to-date national computers to measure forced expiration parameters are analysed.
      The most frequently encountered circuits and basic metrological parameters are
      given and testing procedures are outlined.

PMID- 7799752
TI  - [Choice of equipment for the diagnosis of lung diseases].
AB  - The paper substantiates the principle of functional auxiliaries which ensure
      formation of mono- and polyfunctional devices from interchangeable functional
      elements (modules or units): universal, general for all apparatuses, as well as
      an auxiliary, specialized for one or some procedures, each devices being
      centralized in the universal element.

PMID- 7799753
TI  - [Systematic aspects in designing equipment for psychophysiological evaluation].

PMID- 7799754
TI  - [Systematic basis of analysis of action sequences in a "Binatest" device].
AB  - The paper presents a method for analysing and interpreting the results of
      patients' examination using a Binatest device. The examination was made in the
      situation of "optional choice" wherein multiple acts of choice from two
      alternative goal-oriented reactions lead only to positive results. The proposed
      analysis is based on the evaluation of previous quanta of behavior for further
      goal formation with limited analysis depth with three sequential events. The
      paper discusses what information may be derived from the analysis of monads,
      diads, and triads of step-by-step acts of choice. Four major parameters fit for
      the analysis and interpretation of the findings have been identified. These
      include diad asymmetry, runs, left and right stereotypies. Each parameter has its
      own value that is orthogonal towards the others, equal measurement limits, which
      are independent of their production, and fully determines the sequence of
      behavioral quanta at the depth of 3 events. It is shown that basic information on
      decision-making should be searched in the structure of sequential choice acts
      made by a patient during his/her examination rather than in the chosen behavioral
      acts themselves.

PMID- 7799755
TI  - [Local preventive antibacterial therapy with polymer biocompatible combination].
AB  - The paper provides data on the properties of the powdery antimicrobial absorbent
      Ambipor and the procedure of its use in the prevention of postoperative
      suppuration, which consists in application of the powder to the wound surface
      with a broken layer just before wound suture. It shows that a single application
      of Ambipor to wound suture. It shows that a single application of Ambipor to
      wound tissues at the end of an operation ensures high paravulnar tissue
      antibiotic concentrations which are many times higher those used in conventional
      antibacterial therapy. Implantation of Ambipor to operative wound tissue at the
      end of an operation aids to reduce the extent microbial dissemination by more
      than 100-1000 times, to accelerate reparative processes, stimulate early
      fibroplast activation, fibrillogenesis, scarring tissue maturation. Topical
      antibacterial therapy with the developed formulations is an effective tool in
      preventing postoperative wound complications. Its application to clinical
      practice enables the incidence of complications to be decreased by more than 4.5
      times higher than those in the controls.

PMID- 7799756
TI  - [Medical equipment and devices the International exhibition "Public Health-93"
      (review of exhibition)].

PMID- 7799757
TI  - [Basic problems and development of technical level in medical instruments
      industry].

PMID- 7799759
TI  - [Functional complementarity methods in the artificial life support equipment].

PMID- 7799758
TI  - [Biocompatible polymer implants in the pediatric orthopedics].

PMID- 7799760
TI  - The medical care of competitive athletes: the role of the physician and
      individual assumption of risk.

PMID- 7799761
TI  - Efficacy of magnetic resonance imaging of the elbow.
AB  - Elbow dysfunction is usually related to acute or chronic injury to the soft
      tissue components of the elbow. Prior to the development and application of
      magnetic resonance imaging (MRI), radiologic evaluation of the elbow was
      primarily limited to the detection of osseous abnormalities. The value of MRI to
      accurately determine the nature and extent of the pathologic changes in
      ligaments, tendons, muscles, and the osseous structures of the elbow joint is
      presented in the following discussion.

PMID- 7799762
TI  - Clinical biomechanics of the elbow in tennis: implications for evaluation and
      diagnosis.
AB  - Elbow injuries constitute a sizeable percentage of tennis injuries. Biomechanical
      analysis of the forces, loads, and motions on the elbow in tennis, and the
      constraint systems operating the control the forces, can lead to an understanding
      of the pathophysiology of these injuries. A biomechanically based evaluation
      framework can be used to document all of the clinical symptoms, anatomic
      alterations, and biomechanical alterations that are associated with the
      pathological problem.

PMID- 7799763
TI  - Wrist problems in the tennis player.
AB  - Although wrist injuries in tennis may occur from acute direct trauma, most
      injuries occur due to chronic overuse. Wrist biomechanics in tennis indicate that
      a wide range of wrist motion may not be necessary for effective play. The nature
      of the injury should be established as early as possible with the goals of
      restoring the wrist to a pain-free stable unit with normal range of motion. A
      secondary goal is to return the athlete to play as quickly as possible. Key
      points of the athlete's history are acute or chronic onset, progressive symptoms,
      and severity of symptoms, i.e., limitation of play. Key points of the physical
      examination include localization of maximal tenderness, edema, loss of range of
      motion, and bilateral grip strength. Plain roentgenograms should always be
      obtained. Specific imaging studies may be indicated and include bone scan,
      computed tomography, and arthrography. Specific and common wrist tennis injuries
      are discussed and treatment recommendations are given. Wrist problems in tennis
      are no uncommon and are responsible for a significant amount of lost playing
      time. Familiarity with the more common problems will enhance the physician's
      ability to evaluate and treat these athletes.

PMID- 7799764
TI  - Catecholamine response to exercise and training in individuals with spinal cord
      injury.
AB  - It is unknown whether the catecholamine (CAT) response to acute exercise and
      prolonged training in humans with spinal cord injury (SCI) is similar to that of
      neurologically intact man. Plasma samples were collected from seven subjects with
      chronic SCI (level of injury C5-T7) at rest and during voluntary arm-crank
      ergometry (ACE) before and after 6 months of training with functional electrical
      stimulation cycle ergometry (FES-CE). Similar plasma collections were made during
      one FES-CE exercise training session after 6 months of training. Norepinephrine
      (NE) and epinephrine (EPI) were measured by HPLC. After FES-CE training, resting
      NE decreased 37% (950 +/- 150 vs 1510 +/- 350 pmol.l-1 pretraining); resting EPI
      decreased 80% (54 +/- 10 vs 163 +/- 32 pmol.l-1 pretraining) (P < 0.05 by paired
      t-tests). No significant changes were observed in group means after training for
      the CAT response to submaximal ACE; however, five of seven subjects exhibited
      greater increments in plasma NE with ACE after FES-CE training. Acute FES-CE
      exercise elicited a 55-844% increase in NE, and a 35-350% increase in EPI above
      resting values with power outputs eliciting heart rates of 90-146 bpm. These data
      provide evidence for a systemic CAT response in subjects with SCI during acute
      FES-CE and reduced resting CAT following 6 months of training with FES-CE.

PMID- 7799766
TI  - Altered control of calcium in coronary smooth muscle cells by exercise training.
AB  - The increase in myoplasmic free Ca (Cam) is a primary trigger of contraction in
      vascular smooth muscle. We review data showing that the sarcoplasmic reticulum
      (SR) can buffer (attenuate) increases in Cam by: 1) sequestering a fraction of Ca
      entering the cell via sarcolemmal influx pathways, and 2) slowly releasing Ca
      from the SR toward the sarcolemma for extrusion from the cell, thereby decreasing
      subsequent agonist-induced Cam transients and contraction--so called "SR Ca
      unloading." Endurance exercise trained (EX), not sedentary (SED), Yucatan
      miniature pigs show SR Ca unloading via a ryanodine-sensitive SR Ca release
      pathway. The slow release of Ca from SR of EX cells may allow for efflux from the
      cell by close functional association with sarcolemmal Ca efflux mechanisms. In
      contrast, rapid, bolus release and resequestration of Ca by the SR of SED cells
      prevents Ca efflux from the cell. The endothelin-sensitive SR Ca store, a subset
      of the caffeine- and ryanodine-sensitive SR, is decreased in EX cells. Mildly
      increased resting Cam in EX cells may reflect a constant leak of Ca from the SR.
      The endothelin-sensitive SR Ca store was loaded above basal levels by
      depolarization-induced Ca influx. Collectively, these data indicate altered Cam
      regulation by the SR in coronary artery of EX animals. Future studies should
      focus on the molecular mechanisms of altered Cam regulation.

PMID- 7799765
TI  - The effects of gymnastics training on bone mineral density.
AB  - The purpose of this study was to examine the effect of 27 wk of gymnastics
      training on bone mineral density (BMD), body composition, insulin-like growth
      factor I (IGF-I), and osteocalcin. Subjects were 11 female intercollegiate
      gymnasts and 11 controls. Dual energy x-ray absorptiometry (Lunar DPX) was used
      to determine BMD (L2-L4 and femur) and to assess body composition. The gymnasts
      were significantly lower in weight (53.9 and 60.8 kg) and % body fat (22.6 and
      30.6) compared with controls. After training, body weights of gymnasts remained
      the same but there was a significant increase in lean tissue mass of 2.9 kg
      (6.7%, P < 0.05). No changes in body composition were observed in the controls.
      The gymnasts had significantly higher mean lumbar (1.321 vs 1.225), and femoral
      neck (1.163 vs 1.079) BMD (g.cm-2) than the controls. Lumbar BMD increased
      significantly (1.3%) in gymnasts following training but femoral neck BMD did not
      increase. No BMD changes occurred in the control group. Regarding serum IGF-I, no
      differences were seen between the groups or across time. Serum osteocalcin values
      were significantly higher in the gymnasts than the controls, but no differences
      were found across time. In conclusion, gymnasts had significantly higher BMDs
      than controls, and a significant increase in lumbar BMD was seen in the gymnasts
      following 27 wk of training.

PMID- 7799767
TI  - Exercise training-induced increase in coronary transport capacity.
AB  - The objective of this study was to measure effects of exercise training on
      coronary flow heterogeneity, microvascular transport, and hemodynamics. Five
      miniature swine were trained on a treadmill (ET) for 16 wk; five control pigs (C)
      were confined to cages for the same period. At the end of that period we used the
      multiple indicator dilution method to measure permeability-surface area product
      (PS) to EDTA over a range of flow (F) in an anesthetized, open-chest preparation.
      We found that the heterogeneity of flow as measured by microspheres decreased
      with increasing F, but that ET had no clear effect on heterogeneity. We evaluated
      PS from the indicator concentration curves, taking into account flow
      heterogeneity and variations in capillary recruitment throughout the bed. In both
      C and ET pigs we observed an increase in PS with F until a maximum value of PS
      was reached at full recruitment. This relationship between PS and F was unaltered
      by ET. However, hemodynamic resistance was significantly reduced by ET, and F was
      higher at a given perfusion pressure after training. Since PS increases with F,
      ET pigs had higher PS values at typical coronary artery pressures.

PMID- 7799768
TI  - Effects of exercise training on regulation of tone in coronary arteries and
      arterioles.
AB  - A large number of studies now support the concept that exercise training alters
      functional control of the coronary circulation. Recent work has approached this
      area using ex vivo coronary arterial preparations (proximal coronary arteries,
      near-resistance arteries, resistance arterioles) isolated from exercise-trained
      animals and contracting independently of confounding in vivo influences. The
      combined results of these studies indicate that training-induced alterations in
      vascular control mechanisms do not occur uniformly throughout the coronary
      vascular tree. Proximal epicardial coronary arteries (approximately 2.0 mm
      diameter) isolated from exercise-trained pigs exhibited significantly reduced
      contractile responsiveness to the alpha-adrenergic receptor agonist,
      norepinephrine, but unaltered contractile responsiveness to K+, acetylcholine,
      and endothelin. Also, proximal arteries from exercise-trained animals
      demonstrated enhanced sensitivity to the vasodilator effects of adenosine. At the
      other end of the vascular spectrum, in resistance arterioles (< 150 microns
      diameter) the relaxation responses to adenosine were unaffected by exercise
      training, but bradykinin-induced vasodilation (endothelium-dependent) was
      significantly enhanced. In near-resistance arteries (150-240 microns diameter)
      responses to both bradykinin and adenosine were enhanced by exercise training.
      Thus, exercise training is associated with intrinsic vessel size-dependent
      alterations in coronary smooth muscle and endothelium-mediated regulatory
      mechanisms.

PMID- 7799769
TI  - Clinical significance of coronary vascular adaptations to exercise training.
AB  - Coronary vascular adaptations to exercise training have been extensively studied
      at the microscopic level in animals and correlated with direct and indirect
      measurements of myocardial blood flow in patients with coronary artery disease.
      Animals have permitted more extensive study. These findings have generally
      supported an increased blood flow to the myocardium with exercise training.
      However, consistent positive structural and functional adaptations to training
      have not been observed in large animals. Clinical studies have been limited by
      methodological problems related to techniques for detecting ischemia and
      measuring myocardial blood flow and the variability in exercise stimulus. Well
      established ischemia and high-intensity, long-duration training were the factors
      that promoted vascular growth in exercising patients with coronary artery
      disease. Animals studies also have demonstrated the necessity for myocardial
      ischemia to be present to induce coronary collateral development with exercise
      training. Optimal promoters of vascular growth in patients with coronary disease
      may consist of pharmacological interventions combined with exercise training.

PMID- 7799770
TI  - Gastric emptying of ingested solutions in man: effect of beverage glucose
      concentration.
AB  - The purpose of this study was to compare the rate of gastric emptying of 20 g.l-1
      (2G), 40 g.l-1 (4G), and 60 g.l-1 (6G) glucose solutions with that of water (W).
      On separate occasions in randomized order, a 600-ml test solution was instilled
      into the stomach of each of six healthy male volunteers. Gastric emptying was
      measured at 10-min intervals for 1 h by a double sampling gastric aspiration
      method that allowed the volume of test drink and of the gastric secretion present
      in the stomach to be measured at each time point. All solutions emptied rapidly
      and followed an exponential emptying pattern. The 20 g.l-1 glucose solution was
      emptied at the same rate as water. After the first 10 min of rapid emptying, 4G
      and 6G were emptied slower (P < 0.05) than water. 6G delivered more (P < 0.05)
      glucose to the small intestine than 4G, and 4G delivered more glucose than 2G.
      The results indicate that a 20 g.l-1 glucose solution has no effect on gastric
      emptying compared with water, but that after the first 10 min of rapid emptying,
      glucose solutions at a concentration of 40 g.l-1 or more delay gastric emptying.

PMID- 7799771
TI  - Androgen turnover during marathon running.
AB  - The purpose of the study was to investigate the effect of prolonged physical
      stress on peripheral androgen turnover. Venous blood samples were taken from 18
      athletes 24 h before finishing a competitive marathon run and directly after
      running the race. Serum cortisol, testosterone (T), dehydroepiandrosteronesulfate
      (DHEAS), sex hormone binding globulin (SHBG), and 5 alpha-androstane- 3 alpha, 17
      beta-diolglucuronide (3 alpha-AdiolG) were determined and corrected for
      hemoconcentration. Marathon running caused a rise in serum cortisol concentration
      in all athletes. Furthermore, a significant (P < 0.01) rise in serum T and T
      index (index of free T) was observed. The significant (P < 0.01) rise in serum
      DHEAS concentration, a mainly adrenal cortical androgen, pointed toward a
      stimulation of the adrenal cortex or a reduced hepatic metabolic clearance rate.
      Finally, 3 alpha-AdiolG, an androgen metabolite exclusively formed in peripheral
      tissues, was increased in the sera of all athletes. These results suggest that
      marathon running leads to increased concentrations of serum adrenal and gonadal
      androgens. The simultaneously increased 3 alpha-AdiolG levels may be caused by
      increased androgen turnover in peripheral tissues containing 5 alpha-reductase.

PMID- 7799772
TI  - Heart rate responses during a 4-d cycle stage race.
AB  - The purpose of this study was to monitor the heart rates (HR) of seven, well
      trained (maximal oxygen uptake [VO2max] 5.0 +/- 0.5 l.min-1), competitive
      cyclists during a 4-d cycle stage race. On consecutive days, subjects competed in
      a 16.0-km individual time trial (TT), a 110.0-km mass-start road race (RR1), a
      5.5-km individual hill climb (HC), and a 105.0-km mass-start road race (RR2).
      Within 10 d of the final race, cyclists underwent a test to determine VO2max,
      peak power output, and maximal HR. Comparison of the HR responses to each race
      revealed that the individual events were performed at a relatively high and
      constant work rate (91.1 +/- 2.5% and 93.2 +/- 4.7% of the maximal HR as measured
      in the field (HRmax) for the TT and HC, respectively). In contrast, despite
      similar racing speeds (42.2 +/- 1.0, 39.9 +/- 0.2, and 40.6 +/- 0.5 km.h-1 for
      the TT, RR1, and RR2, respectively), the HR responses to the longer mass-start
      races were reduced to 81.9 +/- 9.6% and 78.6 +/- 8.9% of HRmax and were random in
      frequency and amplitude. Such stochastic changes in HR were seemingly unrelated
      to course terrain but may be due to the group dynamics of the cyclists. The
      results of this study reveal the stochastic nature of bunch cycle racing and show
      that the HR responses of competitive cyclists are more a function of tactical
      bunch riding than of terrain.

PMID- 7799773
TI  - Physiological comparison of uphill roller skiing: diagonal stride versus double
      pole.
AB  - The physiological responses to treadmill roller skiing with the double pole (DP)
      and diagonal stride (DS) techniques were compared at 1.7% and 7.1% grades among
      eight cross-country ski racers. Oxygen uptake (VO2) requirements were found to be
      lower (P < 0.05) for DP at the 1.7% grade, but similar at the 7.1% grade. In
      contrast, ratings of perceived exertion (RPE) and percentages of technique
      specific peak VO2 were similar between techniques at the 1.7% grade, and lower (P
      < 0.05) for DS at the 7.1% grade. RPE and percentages of technique-specific peak
      VO2 were strongly correlated (r = 0.89). The primary findings indicate that 1)
      the economies for DP and DS are dependent upon the incline, 2) it is possible for
      the economy of DP to be greater than DS although the percentages of technique
      specific peak VO2 are similar, and 3) the perceived effort associated with the
      use of DP and DS reflects the percentage of technique-specific peak VO2.

PMID- 7799774
TI  - Influence of rapid weight gain after the weigh-in on success in collegiate
      wrestlers.
AB  - We investigated whether acute weight gain between the weigh-in and competition
      was associated with success in a collegiate wrestling tournament. Wrestlers at
      the NCAA championships were weighed at the official weigh-in and again just
      before the first round of the tournament (20 h later). Weight gain and the weight
      discrepancy between first-round opponents were calculated (N = 607 excluding
      heavyweights). Indices of success included season record (% wins in total
      matches), tournament seeding, the sum of the advancement and placement points
      scored during the tournament (team points), and final placement in the
      tournament. ANOVA showed no differences in weight variation between placewinners
      and non-placewinners, or across placewinners only. Correlation coefficients among
      weight variables and indices of success were also low (P > 0.05). Multiple
      logistic regression, used to determine whether weight gain or weight discrepancy
      between opponents contributed to success in the first round of the tournament,
      revealed that neither variables was predictive of first-round outcome even after
      attempting to account for differences in ability (e.g., forcing team points into
      the regression first). CONCLUSION: neither acute weight gain after the weight-in
      or the weight discrepancy between opponents in the first round influenced success
      in a collegiate wrestling tournament.

PMID- 7799776
TI  - 26th Bethesda Conference: recommendations for determining eligibility for
      competition in athletes with cardiovascular abnormalities. January 6-7, 1994.

PMID- 7799777
TI  - Heterotrimeric G-protein effectors.

PMID- 7799775
TI  - Physical activity and hypertension.

PMID- 7799778
TI  - Transient expression assays for mammalian adenylyl cyclases.

PMID- 7799779
TI  - Specific peptide probes for G-protein interaction with effectors.

PMID- 7799780
TI  - Assays for G-protein regulation of phospholipase C activity.

PMID- 7799781
TI  - Chloride current assay for phospholipase C in Xenopus oocytes.

PMID- 7799782
TI  - Use of cytosol-depleted HL-60 cells for reconstitution studies of G-protein
      regulated phosphoinositide-specific phospholipase C-beta isozymes.

PMID- 7799783
TI  - Purification of phosphatidylinositol transfer protein from brain cytosol for
      reconstituting G-protein-regulated phosphoinositide-specific phospholipase C-beta
      isozymes.

PMID- 7799785
TI  - Purification of G-protein-regulated phospholipase C from turkey erythrocytes.

PMID- 7799784
TI  - Stimulation of phospholipase C by G-protein beta gamma subunits.

PMID- 7799786
TI  - Phospholipase C activity in Dictyostelium discoideum using endogenous
      nonradioactive phosphatidylinositol 4,5-bisphosphate as substrate.

PMID- 7799787
TI  - Purification of phospholipase C-beta 3 from rat brain.

PMID- 7799790
TI  - Amplification of phosphatidylinositol-specific phospholipase C-beta isoforms
      using degenerate primers.

PMID- 7799789
TI  - Purification of 110 kDa phosphoinositide phospholipase C activated by G-protein
      beta gamma subunits.

PMID- 7799788
TI  - Characterization of phospholipase C isozymes in bovine retina: purification of
      phospholipase C-beta 4.

PMID- 7799791
TI  - Analysis of guanine nucleotides associated with protooncogene ras.

PMID- 7799792
TI  - Measuring activation of kinases in mitogen-activated protein kinase regulatory
      network.

PMID- 7799793
TI  - Transcriptional activation analysis of oncogene function.
AB  - Because no single assay provides a complete analysis of the transformed
      phenotype, transactivation assays complement the cell growth and tumorigenicity
      analyses of oncogene function. Transactivation of ORE-containing genes is such a
      common feature of a diverse variety of viral and cellular oncogenes that it can
      be considered one aspect of the oncogene-induced phenotype. After the initial
      identification of oncogenes that activate transcription, studies of the
      mechanisms of activation and the identification of the downstream target genes
      should lead to a better understanding of the events leading to cellular
      transformation. The fact that cell type specificity of transactivation and
      transformation can be similar means that the transactivation assay may be a
      useful tool in dissecting cell type-specific transformation. The transactivation
      assay of oncogene function also has the advantage that it is easy to perform and
      significantly more rapid than assays based on altered cell growth. This is of
      particular advantage when one wishes to examine the function of a large number of
      oncogene mutants generated in vitro. Overall, transactivation assays provide
      another tool for examining transforming potential and a starting point for the
      analysis of the downstream targets of oncogenes.

PMID- 7799794
TI  - Biological assays for cellular transformation.
AB  - A number of standard and widely applied procedures have been used to determine
      whether expression of a particular gene triggers the growth alterations that are
      characteristic of most oncogenes. The assays have been used extensively to
      evaluate the transforming potential of a wide variety of genes that encode
      tyrosine or serine/threonine kinases, small and heterotrimeric GTP-binding signal
      transduction regulators, and nuclear transcription factors, among others.
      Therefore, the growth-promoting characteristics of a particular gene can be
      compared with the properties of other genes that have been characterized by the
      same assays. The assays described do not represent a complete evaluation of the
      transforming activity of a gene. Failure to detect growth-promoting activity in
      any of the assays does not definitively eliminate the possibility that a
      particular gene is an oncogene. Specialized assays that use (nonfibroblast)
      recipient cells more closely approximating the likely environment of the gene of
      interest may provide better approaches for subsequent studies. Other biological
      assays for transforming potential include measurements of the adhesion properties
      of cells on different substrata, the ability to grow on confluent monolayers of
      normal cells, the ability to invade into various artificial tissue matrices, and
      transgenic animal models. Finally, more specific assays for biochemical
      alterations that reflect the transformed state can also be employed. For example,
      as discussed in [23] in this volume, one widely used biochemical measure of
      transforming potential employs transcriptional activation of genes whose
      promoters contain so-called oncogene-responsive elements. This, as well as other
      biochemical assays, can be applied to complement the biological studies described
      in this chapter.

PMID- 7799795
TI  - Monitoring of receptor-mediated changes in intracellular calcium at the cellular
      and subcellular level by microfluorimetry and imaging.

PMID- 7799796
TI  - Purification of bovine retinal cGMP phosphodiesterase.

PMID- 7799797
TI  - Combination of microfluorimetric monitoring of cytosolic calcium and pH with
      patch clamp electrophysiological recordings in neutrophil granulocytes.

PMID- 7799798
TI  - Determination of adenylyl cyclase catalytic activity using single and double
      column procedures.

PMID- 7799800
TI  - Purification and reconstitution of N-type calcium channel complex from rabbit
      brain.

PMID- 7799799
TI  - G-protein-mediated pathways assayed by electrophysiology and confocal microscopy.

PMID- 7799801
TI  - Whole-cell patch recording in brain slices.

PMID- 7799802
TI  - Regulation of potassium channels by G-protein subunits and arachidonic acid
      metabolites.

PMID- 7799804
TI  - Regulation of Ca(2+)-sensitive adenylyl cyclases by calcium ion in vitro and in
      vivo.

PMID- 7799803
TI  - Preparation and use of "P"-site-targeted affinity ligands for adenylyl cyclases.

PMID- 7799805
TI  - Gi assays in transfected cells.

PMID- 7799807
TI  - The health care crisis: end or beginning of the heyday of medical decision
      support systems?

PMID- 7799806
TI  - Expression and purification of recombinant adenylyl cyclases in Sf9 cells.

PMID- 7799808
TI  - Health information, the fair information principles and ethics.
AB  - If advanced electronic patient records are construed as epistemic patient
      analogues in information space, then the traditional property-model of patient
      records is longer appropriate. A new paradigm is required. This paper suggests a
      new paradigm, examines its ethical implications and explores ways in which these
      could be reflected in legal and regulatory mechanisms. Special attention is paid
      to privacy, security and access relative to the so-called "fair information
      principles".

PMID- 7799809
TI  - Comments on: health information, the fair information principles and ethics.

PMID- 7799810
TI  - In search of rules for confidentiality: a critique of one proposal.

PMID- 7799811
TI  - Integrated Advanced Medical Information Systems (IAIMS): payoffs and problems.
AB  - IAIMS (Integrated Advanced Information Management Systems) is an initiative to
      improve the access to information needed to provide patient care, health-oriented
      education, biomedical research, and management of large medical center
      environments. This paper will review the goals, history, and accomplishments of
      the IAIMS initiative. Shortcomings and frustrations, lessons learned, and the
      future of such initiatives will also be discussed.

PMID- 7799813
TI  - Safety and decision support in oncology.
AB  - The management of patients with cancer involves the administration of complex
      treatment protocols with frequent monitoring of the effects of treatment on the
      malignant disease as well as on the general health of the patient. The number and
      wide variety of protocols used in treatment trials, and the amount of clinical
      data generated suggest the need for computer-based support. The toxicity of many
      of the treatments used and the severity of the disease itself underline the
      safety-critical nature of all decisions made by oncologists, the physicians and
      surgeons who treat cancer patients. This paper presents recent work on the
      analysis of safety issues arising from the design and implementation of a
      prototype decision-support system for oncologists. It illustrates the benefits of
      combining both informal and formal approaches to the analysis and representation
      of safety, firmly based on a thorough and detailed study of the domain in
      cooperation with oncologists, pharmacists and medical informaticians.

PMID- 7799814
TI  - Representation of medical concepts of the thyroid gland by physicians in anatomy
      and pathology.
AB  - An experimental study in cognitive psychology is described, concerning the
      categorization of medical concepts into specific classes, expressed by physicians
      specialized in anatomic pathology consultations of the thyroid gland. This study
      belongs to a medical computer science project, called ARISTOTLE, concerning
      Natural Language Processing of specialized medical reports in anatomic pathology
      of the thyroid gland. This research has been done for two reasons; first, to
      specify the characteristics of human expert categorization in an area of medical
      knowledge and, secondly, to validate the hierarchical organization of a prototype
      declarative knowledge base. In this experiment, physicians were asked to
      categorize 121 concepts into 10 proposed classes. These classes and concepts
      belong to expert knowledge represented in a conceptual graph that was constructed
      before the experiment. Results show variable semantic distances between concepts
      of a same class, and dynamic variations of these distances due to contextual
      representation.

PMID- 7799812
TI  - A temporal query system for protocol-directed decision support.
AB  - Chronus is a query system that supports temporal extensions to the Structured
      Query Language (SQL) for relational databases. Although the relational data model
      can store time-stamped data and can permit simple temporal-comparison operations,
      it does not provide either a closed or a sufficient algebra for manipulating
      temporal data. In this paper, we outline an algebra that maintains a consistent
      relational representation of temporal data and that allows the type of temporal
      queries needed for protocol-directed decision support. We also discuss how
      Chronus can translate between our temporal algebra and the relational algebra
      used for SQL queries. We have applied our system to the task of screening
      patients for clinical trials. Our results demonstrate that Chronous can express
      sufficiently all required temporal queries, and that the search time of such
      queries is similar to that of standard SQL.

PMID- 7799815
TI  - Human performance evaluation of a metaphor graphic display for respiratory data.
AB  - Metaphor graphics are data displays designed to look like corresponding variables
      in the real world, but in a non-literal sense of "look like". Evaluation of the
      impact of these graphics on human problem solving has twice been carried out, but
      with conflicting results. The present experiment attempted to clarify the
      discrepancies between these findings by using a complex task in which expert
      subjects interpreted respiratory data. The metaphor graphic display led to
      interpretations twice as fast as a tabular (flowsheet) format, suggesting that
      conflict between earlier studies is due either to differences in training or to
      differences in goodness of metaphor. Findings to date indicate that metaphor
      graphics work with complex as well as simple data sets, pattern detection as well
      as single number reporting tasks, and with expert as well as novice subjects.

PMID- 7799816
TI  - Evaluation of a decision-support system for inoperable non-small cell lung
      cancer.
AB  - The purpose of this study was to find out whether a decision-support system is
      able to assist a clinician in predicting patient outcome and in selecting optimal
      treatment in oncology. The domain of the evaluated decision-support prototype was
      primary therapeutic decision making in inoperable non-small cell lung cancer. The
      performance of the prototype was tested on retrospective material consisting of
      112 patients treated by radiotherapy. Survival was the endpoint for examining
      whether the treatment decision proposed by the system was more accurate than the
      decision actually made by the clinician. Certain prognostic variables were used
      by the system to classify patients into two treatment groups, radical or
      palliative radiotherapy. The median survival times of these groups were 15 and 7
      months, respectively, compared with 9 and 8 months in the corresponding groups
      classified by the clinician. Our results indicate that clinicians need support in
      treatment selection and that decision-support systems could be a potential
      answer.

PMID- 7799817
TI  - The relative accuracy of a variety of medical diagnostic programs.
AB  - Acute abdominal pain is one of the most widely studied applications of computer
      aided diagnosis. The usual approach is to apply Bayes' theorem with the
      assumption of conditional independence ("independence Bayes"). We compared
      various approaches to designing diagnostic programs for abdominal pain of
      suspected gynaecological origin. The methods range from statistical to knowledge
      based. All programs were evaluated using a database of 1,270 cases collected
      retrospectively. Our results suggest that in this application no significant
      improvement in accuracy can be made by taking interactions into account, either
      by statistical or by knowledge-based means; independence Bayes is near-optimal.
      As far as accuracy is concerned, there appears to be little point in pursuing
      knowledge-based approaches. However, the "nearest neighbours" method using a new
      metric appears to be at least as accurate as independence Bayes. We argue that
      the nearest neighbours method is more suitable than independence Bayes for
      clinical use because of greater accountability.

PMID- 7799818
TI  - An integrated knowledge-based system to guide the physician during structured
      reporting.
AB  - A routinely used system for report generation, based on direct physician data
      entry, has been combined with a knowledge-based module. The knowledge-based
      system is operating in the background, and guides the user by dynamically
      suggesting diagnoses and generating hints regarding the actual and possible
      further diagnostic procedures. Hybrid technology with neural networks and rules
      is used. A laboratory evaluation has shown good agreement between diagnoses
      suggested by the system and confirmed diagnoses, with a kappa coefficient of 0.85
      and an area under the ROC curve of 0.92. In a survey following a 14-day test
      period, physicians stated that the system was both sensible and helpful. The
      current application domain is ultrasound reporting.

PMID- 7799819
TI  - A physician-based architecture for the construction and use of statistical
      models.
AB  - Physicians need specially tailored computer tools to take advantage of published
      research results. We present a knowledge-based computer framework--the physician
      based (PB) architecture--for constructing such tools, and we use the problem of
      physicians' interpretation of two-arm parallel randomized clinical trials
      (TAPRCT) as a working example. Statistical models are represented by influence
      diagrams. The interpretation of influence-diagram elements are mapped into users'
      language in a domain-specific, physician-based user interface, called a patient
      flow diagram. Statistical-model transformations that maintain the semantic
      relationships of the model and that embody clinical-epidemiological knowledge are
      encoded in a mediating structure called the cohort-state diagram. The algorithm
      that coordinates the interactions among the knowledge representations uses
      modular actions called construction steps. This architecture has been implemented
      in a Bayesian system, called THOMAS, that supports physician decision making in
      light of TAPRCT data. This support entails assessing clinical significance, prior
      beliefs, and methodological concerns. We suggest that the PB architecture applies
      to a wide range of statistical tools and users.

PMID- 7799820
TI  - An intelligent Computer-Assisted Instruction system for clinical case teaching.
AB  - The use of computers in the field of medical education is common. Our purpose is
      to present a Computer-Assisted Instruction system which has been developed over
      ten years at the University of Compiegne and the University of Rennes Medical
      School. This system can be used to help the student to solve clinical cases by
      analyzing and critiquing their answers and by using a knowledge base which has
      been previously structured in a rule network. It is an intelligent Computer
      Assisted Instruction system comprising an author module, a pedagogical module and
      a student module. The CAI system can be used as a simulation model for any type
      of diagnostic or therapeutic problem. In this paper we present the author and
      pedagogical module which have been built using our previous work on intelligent
      computer-assisted instruction systems.

PMID- 7799821
TI  - The climacteric cross-culturally: the International Health Foundation South-east
      Asia study.

PMID- 7799822
TI  - Climacteric and menopause in seven South-east Asian countries.
AB  - The menopause is universal, but what about the climacteric? In an attempt to
      answer this question, a study was conducted in seven south-east Asian countries,
      namely, Hong Kong, Indonesia, Korea, Malaysia, the Philippines, Singapore and
      Taiwan. Samples of approximately 400 women in each country were questioned about
      a number of climacteric complaints, incontinence and dyspareunia, consultation of
      a physician, menopausal status and several background characteristics. Special
      care was taken to overcome linguistic and cultural problems, and the data
      collected were kept as objective as possible. From the results obtained we were
      able to show that the climacteric was indeed experienced in south-east Asian
      countries, although in a mild form. The prevalence of hot flushes and of sweating
      was lower than in western countries, but was nevertheless not negligible. The
      percentages of women who reported the more psychological types of complaint were
      similar to those in western countries. The occurrence of climacteric complaints
      affected perceived health status. A physician was consulted for climacteric
      complaints by 20% of the respondents, although this was most frequently
      associated with the occurrence of psychological complaints and less so with that
      of hot flushes and sweating. The median age at menopause (51.09) appeared to be
      within the ranges observed in western countries. Ethnic background and age at
      menarche were found to have a significant influence on age at menopause. The
      study clearly demonstrated that climacteric complaints occur in south-east Asia.
      The findings suggest, however, that vasomotor-complaint-related distress might be
      'translated' into psychological complaints, which are more frequently considered
      to warrant consulting a physician.

PMID- 7799823
TI  - The climacteric of Chinese factory workers.
AB  - Chinese factory workers (427) mainly of Fujian origin were found to have few
      climacteric symptoms. Of these, 65% and 50% reported having no circulatory and
      nervosity symptoms, respectively. Only 18% of women experienced hot flushes. The
      climacteric symptoms were more pronounced at the perimenopausal period (P <
      0.001) when these women experienced more irregular menstruation. Low socio
      economic status and educational level did not have adverse effects on the symptom
      reporting. High parity and employment may be positive factors in this period of
      change of life. A majority of women (74%) felt that the climacteric and menopause
      is a natural process which caused them no concern. Of those who were still
      menstruating 80% did not anticipate that they would have problems with the
      climacteric and menopause. These women's different climacteric pattern could be
      related to their introspective abilities to cope adequately or in an impersonal
      manner.

PMID- 7799824
TI  - Climacteric Filipino women: a preliminary survey in the Philippines.
AB  - In a survey of 500 Filipino women aged 40-50 years, of various professions and
      residing mostly in Metropolitan Manila, the average age of menopause was
      estimated at 48 years. The climacteric symptoms were seen to affect 83% of the
      respondents. Sixty-three percent reported menopause-related circulatory or
      vasomotor disorders and 79% mentioned psychological disorders. The incidence and
      frequency of climacteric symptoms were highest among the perimenopausals.
      Headache was the most common climacteric symptom, while the hot flush was the
      least prevalent. Only 31% consulted a physician for menopause-related ailments.
      Eighty-six percent of those who consulted were prescribed medication, however,
      only 52% of these followed the prescription. Eleven percent reported dyspareunia
      and only 36% consulted a doctor. Thirty-one percent suffered from urinary stress
      incontinence and only 16% consulted a doctor. The findings of this study suggest
      that the average Filipino woman has an attitude of forbearance towards the
      climacteric syndrome. This attitude is shaped by her Asian culture and Third
      World circumstances.

PMID- 7799825
TI  - Health of Indonesian women city-dwellers of perimenopausal age.
AB  - In the last few years more women of climacteric age, living in urban areas, have
      been seeking medical care. In 1989, on the invitation of 6 women's organizations
      in Jakarta and other cities, the Indonesian Menopause Society gave talks and held
      discussions in cooperation with the Department of Obstetrics and Gynaecology,
      Faculty of Medicine of the University of Indonesia/Dr. Cipto Mangunkusumo
      Hospital, Jakarta. These occasions were used to accumulate data from women
      participants of 40 years of age and older. The age of the respondents ranged
      between 40-59 years. Most were 42 years old (13.9%). Ninety-four percent were
      still married. Twenty-five percent had three living children. Sixty-three percent
      of the respondents were high school graduates who worked full time (33%), part
      time, or were unemployed. The average menarche age was 13 and menopausal age 50
      51. Menopausal complaints were rare, hence medical consultations were rare.
      Tranquilizers were prescribed for those who did seek medical help. This data
      constitutes the basis of the formulation of a strategy to solve menopause related
      problems in Indonesia, where female life expectancy, and the contribution of
      women to society, is on the increase.

PMID- 7799826
TI  - The prevalence of symptoms in menopausal women in the Far East: Singapore
      segment.
AB  - Questionnaires (4000) on experience of menopausal symptoms in Singaporean women
      aged 40-55 were distributed by students. In total, 524 envelopes were returned
      (13.1%) and of these 420 were analyzed. Of these, 366 were classified as either
      pre-, peri- or postmenopausal on the basis of their menstrual patterns.
      Menopausal symptoms in this sample of Singaporean women were, in general, similar
      to those experienced in the West though the prevalence was low compared to
      European studies. No significant differences in individual symptoms were found
      between the 3 groups but, taken together, symptoms were significantly highest in
      the perimenopausal and lowest in the other menopausal groups. In the
      postmenopausal group 50% had been menopausal for at least 1 year at 50.5 years.

PMID- 7799827
TI  - A study on the menopause in Malaysia.
AB  - In an attempt to gather data on the menopause in Malaysia, 400 women (13%
      Chinese, 70% Malays and 16% Indians), representing the three major ethnic groups
      in Malaysia, were interviewed. The majority (76%) of these women were still
      married and living with their husbands and 63% of them were working. Most of them
      (90%) had attained menarche by the age of 15 years and 50% of them had married
      before the age of 20. Their reproductive record was good, since 76% of them had 3
      or more children who were still alive. The mean age at menopause in the Malaysian
      women studied was 50.7 years. Analysis of the climacteric symptoms reported
      showed significant differences in the vasomotor and nervosity indices in the
      perimenopausal and postmenopausal groups. Eighty percent (80%) of the women saw
      no need to consult a doctor about their climacteric symptoms. When they did, most
      of them (84%) received medication, but 43% of them did not comply with the
      prescribed treatment. Dyspareunia and urinary incontinence were evidently
      regarded as embarrassing complaints in all three groups, since around 80% of the
      women did not seek medical advice. This is not surprising in view of the fact
      that 89% of them rated their health as good.

PMID- 7799828
TI  - Effect of a conjugated oestrogen (Premarin) cream on ageing facial skin. A
      comparative study with a placebo cream.
AB  - The effects of Premarin cream on ageing facial skin were studied in a randomised,
      double-blind, parallel group study. Fifty-four women aged 52-70 years who had
      moderate to severe facial cutaneous ageing, applied 1 g of either Premarin cream
      (0.625 mg conjugated oestrogens per gram of cream), or placebo cream (same
      composition with the exclusion of conjugated oestrogens) to the face nightly for
      24 weeks. Each morning these women protected their face with a sunblock SPF 15.
      Skin thickness was measured by B-scan ultrasonic echography, and skin microrelief
      by profilometry. Each subject's facial appearance was also evaluated by the
      subject herself and by the clinician. A statistically significant difference (P =
      0.013) in favour of Premarin cream was detected in skin thickness at week 24.
      Skin thickness (dermal plus epidermal) for the women who used Premarin cream
      increased from 1.56 +/- 0.20 mm at baseline to 1.68 +/- 0.19 mm, compared with
      1.52 +/- 0.20 mm at baseline to 1.59 +/- 0.19 mm in the placebo group. Premarin
      cream was also significantly more effective than placebo cream in improving fine
      wrinkles according to the results at weeks 12 and 24 (P = 0.010 and P = 0.012,
      respectively). Significant improvement from baseline was detected in both groups
      for roughness, laxity and mottled pigmentation and/or lentigines; however, there
      was no significant difference in these parameters between the two treatment
      groups. No subjects discontinued treatment for a safety reason. In conclusion,
      Premarin cream produced better results than the placebo cream; the difference was
      statistically significant for skin thickness and fine wrinkles. Premarin cream
      was well tolerated locally, and its general safety was good.

PMID- 7799829
TI  - Bleeding pattern and climacteric symptoms during different sequential combined
      HRT regimens in current use.
AB  - Four sequential combined oestrogen and progestogen regimens were compared in
      terms of bleeding pattern and relief of climacteric symptoms. Treatment was with
      either 2 mg 17 beta-oestradiol with 1 mg norethisterone acetate [E2 + NETA]; 2 mg
      oestradiol valerate with 75 micrograms levonorgestrel [E2V + LNG]; 2 mg
      oestradiol valerate with 10 mg medroxyprogesterone acetate [E2V + MPA]; or 1.5 mg
      17 beta-oestradiol with 150 micrograms desogestrel [E2 + DG]. A placebo
      controlled study lasting 12-24 months was completed by 143 healthy early
      postmenopausal women. Bleeding lengths were not substantially different; in all
      regimens the majority of women were bleeding for 3-6 days. Bleeding onset showed
      differences when related to the 11th day of progestogen addition; in the regimen
      with E2V + LNG, 21% of the women women were bleeding before the 11th day of
      progestogen addition 26% on, and 53% after that day. In the regimen with E2V +
      MPA, 56% of the women were bleeding before the 11th day, 28% on, and 17% after
      that day, whereas in the regimen with E2 + DG, 15% of the women were bleeding
      before the 11th day, 5% on, and 80% after that day. All regimens reduced
      climacteric symptoms to the same extent. Breast tenderness occurred in all the
      regimens, except in the E2 + DG. Conclusively, the differences between the
      responses to treatment were not conspicuous. However, our data indicate that one
      regimen (E2 + DG) resulted in optimal bleeding control, optimal effect on
      climacteric symptoms, and no production of breast tenderness.

PMID- 7799830
TI  - Is Livial diabetogenic?

PMID- 7799831
TI  - Polymerase chain reaction analysis of Borrelia species isolated in Japan.
AB  - Primer reactivities of 25 Borrelia burgdorferi sensu lato isolates from the
      ticks, Ixodes persulcatus and I. ovatus, in Japan and 10 isolates in Europe and
      North America were investigated. The methods used in this study were the
      polymerase chain reaction (PCR) on the flagellin structural gene (fla), the outer
      surface protein A gene (osp A) and the outer surface protein B gene (osp B), and
      the restriction fragment length polymorphism (RFLP) analysis of PCR products from
      osp A and osp B. The flagellin PCR primer set reacted with all the Borrelia
      strains tested. Four genospecies, B. burgdorferi sensu stricto, B. garinii, B.
      afzelii and B. japonica, were differentiated by PCR using osp A and osp B primers
      combined with RFLP analysis. Some Japanese isolates from I. persulcatus were
      identified as B. garinii or B. afzelii. The other isolates from I. persulcatus
      did not fit in any of the 4 genospecies. These results suggested that Japanese
      isolates from I. persulcatus are highly heterogeneous in their osp A and osp B
      structures. Furthermore, PCR primers targeting fla are applicable to the gene
      diagnosis for Lyme disease in Japan, and osp A and osp B primers can be used to
      classify B. burgdorferi sensu lato isolates into genospecies by PCR and RFLP
      analyses.

PMID- 7799832
TI  - Comparison of the virulence of methicillin-resistant and methicillin-sensitive
      Staphylococcus aureus.
AB  - The virulence of methicillin-resistant Staphylococcus aureus (MRSA) was compared
      with that of methicillin-sensitive S. aureus (MSSA), using 13 MRSA and 7 MSSA
      strains isolated from clinical specimens. The infectivity and lethality of the
      two groups were examined as to the inoculum required to infect 50% of guinea pigs
      (ID50) and to kill 50% of mice (LD50), respectively. The mean ID50 [log10 colony
      forming units (CFU)] for MRSA strains was 7.1 +/- 0.60 standard deviation, which
      was 1.5 higher than that for MSSA strains (P < 0.001). The mean LD50 (log10 CFU)
      for MRSA strains was 9.0 +/- 0.42, being 1.1 higher than that for MSSA strains (P
      = 0.001). Pretreatment of mice with cyclophosphamide decreased the mean LD50 for
      MRSA strains more than that for MSSA strains, resulting in the difference in the
      mean LD50 being insignificant (P = 0.502). These results indicate that MRSA is
      less virulent than MSSA in normal hosts, but that they are equally virulent in
      immunocompromised hosts. The growth of MRSA strains was much slower than that of
      MSSA strains in the lag phase, although their growth rates were almost the same
      in the exponential growth phase, suggesting that the difference in virulence
      between them may be at least partly due to such a difference in growth.

PMID- 7799833
TI  - The role of MRSA (methicillin-resistant Staphylococcus aureus) adherence and
      colonization in the upper respiratory tract of geriatric patients in nosocomial
      pulmonary infections.
AB  - The mechanism of nosocomial respiratory infections caused by MRSA (methicillin
      resistant Staphylococcus aureus) in geriatric patients was investigated.
      Seriously ill patients (SIP) undergoing naso-gastric tube feeding or intravenous
      hyperalimentation and moderately ill patients (MIP) who were orally fed, were
      examined for their colonization and infection by Staphylococcus aureus (S.
      aureus) in the respiratory tract. Colonization of MRSA in the upper respiratory
      tract in SIP was from six to ten times higher than that in MIP and was associated
      with a high incidence of MRSA pulmonary infections. In vitro S. aureus adherence
      to nasal or oropharyngeal cells demonstrated that bacteria binding to nasal cells
      was higher, which probably can be interpreted as an elevated occurrence of S.
      aureus colonization in the nasal cavity than in the throat. The binding activity
      of MRSA was not superior to that of MSSA (methicillin-sensitive S. aureus).
      Though MRSA binding to the nasal cells from SIP was not higher than those from
      MIP, MRSA colonization in the upper respiratory tract was more frequently seen in
      SIP (P < 0.01). A higher incidence of total infectious episodes (P < 0.02-0.001)
      and more frequent use of antibiotics (P < 0.02-0.001), which were potent against
      MSSA might be the basis for selection of MRSA in these patients. In fact, the
      rate of MRSA colonization on the skin (pressure sores) was also higher in SIP (P
      < 0.01). A low nutritional state in SIP (P < 0.01-0.02) might also be associated
      with MRSA colonization.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799834
TI  - A sandwich cup method for the penetration assay of antimicrobial agents through
      Pseudomonas exopolysaccharides.
AB  - We developed new sandwich cup method to assay the penetration of various
      antimicrobial agents through Pseudomonas exopolysaccharides. Using alginate
      extracted from mucoid-type Pseudomonas aeruginosa and gellan gum from Pseudomonas
      elodea, the role of exopolysaccharides as a barrier against drug penetration was
      examined. The penetration of positively charged hydrophilic drugs such as
      aminoglycosides and polypeptides was markedly inhibited by the gels tested, but
      that of beta-lactams, quinolones, and macrolides was not inhibited. The
      penetration of gentamicin was strongly influenced by the gel concentration, the
      solution to be used, and the presence of Ca2+. These results suggest that the
      microenvironment at the infection site could greatly influence drug penetration
      through biofilms in vivo.

PMID- 7799835
TI  - Infectivity and early antibody response to Borrelia burgdorferi sensu lato
      isolated in Japan in outbred mice.
AB  - Borrelia burgdorferi sensu lato isolated from Ixodes ovatus (B. japonica), I.
      persulcatus and patients with erythema migrans (EM) in Japan were determined on
      infectivity and arthritis induction-activity in outbred mice. Infectivity of B.
      japonica was weak and did not induce the development of footpad swelling by
      subcutaneous (s.c.) inoculation into the footpad. Challenged strain, NO129-M of
      B. japonica, to ddY mice were reinoculated to the mice at various cell numbers (1
      x 10-1 x 10(6) cells/mouse). The strain isolated from the mouse did not reinfect
      ddY mice and did not induce the production of specific antibody to the homologous
      strain. On the other hand, strains from I. persulcatus and patients with EM in
      Japan infected the mice and induced a serious inflammatory response in Borrelia
      inoculated footpad as well as strains belonging to the three genospecies, B.
      burgdorferi sensu stricto, B. garinii, and B. afzelii, related to Lyme disease,
      from North America and Europe. The mice were infected with 10 cells of strain HP1
      isolated from I. persulcatus in Hokkaido and of strain 297 isolated from a
      patient in the U.S.A. by subcutaneous inoculation into the hind footpad, or by
      intradermal inoculation into the back. Antigens of ca. 20, 23-24 (Osp C), 29, 39,
      41 (flagellin) and 45 kDa reacted with the pooled sera from mice inoculated with
      strains HP1 and 297, but Osp A and Osp B did not.

PMID- 7799836
TI  - Crystallization and analyses of crystals of various chemotypes of R-form
      lipopolysaccharides from Salmonella spp.
AB  - Various chemotypes (Re, Rd2, Rd1P-, Rd1, RcP-, Rc, Rb3, Rb2, Rb1, and Ra) of R
      form lipopolysaccharides (LPSs) of Salmonella spp. were crystallized by treatment
      with 70% ethanol containing 250 mM MgCl2, and crystals of the LPSs were observed
      electron microscopically and analyzed by electron diffraction and synchrotron X
      ray diffraction. All the LPSs tested formed three-dimensional crystals showing
      very similar shapes; hexagonal plate, solid column, discoid, square or
      rectangular plate, lozenge plate and truncated hexangular or rectangular pyramid
      forms. Electron diffraction patterns from the hexagonal plate crystals of all
      these LPSs obtained by electron irradiation from the direction perpendicular to
      the basal plane showed that they consist of hexagonal lattices with the lattice
      constant of 4.62 A. The crystals of all the LPSs thus formed gave ring-like X-ray
      diffraction patterns because of their small sizes. The long-axis values were
      calculated from the X-ray diffraction patterns from crystals of all the LPSs in
      the low-angle region and they corresponded roughly to the length of the proposed
      primary chemical structures of the R cores of the LPSs. The volume occupied by a
      single molecule of all the LPSs were calculated from the molecular weights based
      on the proposed structures and the crystallographic data obtained by electron
      diffraction, X-ray diffraction, and density determination.

PMID- 7799837
TI  - Possible mechanism of action of beta-lactam-enhancing factor on methicillin
      resistant Staphylococcus aureus.
AB  - We have recently found a factor (Factor T) in aged mixtures of tungstate and
      phosphate which greatly enhances the antibacterial effects of beta-lactams on
      methicillin-resistant strains of staphylococcal species such as methicillin
      resistant Staphylococcus aureus (MRSA), but shows only weak effects on
      methicillin-susceptible S. aureus and bacterial strains other than staphylococci.
      Factor T alone did not strongly inhibit cell metabolism and bacterial growth
      unless an excess amount was added. When Factor T was added to the culture medium
      beforehand, the growth of MRSA cells was rapidly suppressed just after addition
      of oxacillin (MPIPC). However, the growth of the cells was inhibited gradually
      when these two reagents were added in reverse order. For full expression of the
      enhancing effect, it seemed necessary for cells of MRSA strains to be incubated
      with Factor T for at least 2-3 hr. When the cells were washed after being
      sensitized by incubating them for 5 hr with Factor T, it took approximately 1 hr
      for the cells to recover their resistance to MPIPC. Factor T reduced the amount
      of penicillin-binding protein-2' (PBP 2'), and thus sensitized the MRSA strains
      to beta-lactams.

PMID- 7799838
TI  - Detection of human immunodeficiency virus-1 nucleic acid on inactivated filter
      paper disks by polymerase chain reaction and microtiter plate assay.
AB  - Human immunodeficiency virus type 1 (HIV-1) in cultured cells, peripheral blood
      samples and sera were adsorbed on filter paper disks and inactivated by heat or
      ethanol. Two procedures, the polymerase chain reaction (PCR) and microtiter plate
      assay (HMPA) were used to detect the nucleic acid. The sensitivity after
      different heat treatments with nested PCR for HIV-1 DNA (or nested reverse
      transcription-PCR for HIV-1 RNA) was identical regardless of whether the samples
      were examined immediately or one month later. Inactivation by ethanol treatment
      resulted in a slight loss of sensitivity. The HMPA proved to be as reliable and
      specific as the conventional PCR technique. We conclude that the heat-treated
      filter paper disk assay is suitable for identifying HIV nucleic acid in clinical
      samples sent to the laboratory from a distance, e.g. in an envelope.

PMID- 7799839
TI  - Binding of host-associated treponeme proteins to collagens and laminin: a
      possible mechanism of spirochetal adherence to host tissues.
AB  - The polypeptides of seven strains of human treponemes were investigated by
      immunoblot analysis for their binding to the human placental collagens and
      laminin. Of the treponemal polypeptides, eleven polypeptides, 45-kDa, 49-kDa, and
      62-kDa polypeptides from T. pallidum ATCC 27087, a 48-kDa polypeptide from T.
      phagedenis biotype Reiter, 51-kDa and 53-kDa polypeptides from T. vincentii ATCC
      35580, 30-kDa, 53-kDa and 63-kDa polypeptides from T. socranskii subsp. buccale
      ATCC 35534, a 52-kDa polypeptide from T. denticola ATCC 35405, and a 53-kDa
      polypeptide from T. denticola ATCC 33520 possessed an ability to bind to the
      laminin, type I, III, IV, or V collagen. An intermediate-sized human oral isolate
      strain G7201 did not possess any laminin- or collagen-binding polypeptides.
      Immunoelectron microscopy using intact treponemal cells with a single collagen
      binding polypeptide and the corresponding antisera demonstrated that the 51-kDa
      and 53-kDa polypeptides from T. vincentii, the 53-kDa polypeptide from T.
      socranskii subsp. buccale ATCC 35534 and the 52-kDa polypeptide from T. denticola
      ATCC 35405, were outer envelope proteins.

PMID- 7799840
TI  - Detection of DNA of causative agent of spotted fever group rickettsiosis in Japan
      from the patient's blood sample by polymerase chain reaction.
AB  - The polymerase chain reaction (PCR) was applied for the etiological diagnosis of
      spotted fever group (SFG) rickettsiosis in Japan. Nucleotide primers derived from
      the 17-kDa antigen gene of Rickettsia rickettsii primed a rickettsia-specific 246
      base-pair product for all of the Katayama, Abe, Misaka and Kojima strains, which
      we had isolated previously. Moreover, we were able to detect the same product by
      PCR amplification from the peripheral blood of a patient in the acute stage of
      the illness. The PCR method is considered to be useful for rapid etiological
      diagnosis of SFG rickettsiosis in Japan.

PMID- 7799841
TI  - Localization of apoptosis (programmed cell death) in mice by administration of
      lipopolysaccharide.
AB  - Localization of apoptotic cells by administration of lipopolysaccharide into mice
      was studied by using the in situ specific labeling of fragmented DNA. This method
      clearly stained the nuclei of thymocytes at the cortex of the thymus. The nuclei
      of cells in the bone marrow and in the spleen were also positively stained. It
      was suggested that the cortex in the thymus is where the LPS-induced programmed
      cell death occurs.

PMID- 7799842
TI  - Detection and typing of human rotavirus in reference to repeated acute
      gastroenteritis in infants.
AB  - Stool specimens from infants who visited a clinic because of acute
      gastroenteritis were tested for the presence of human rotavirus. Among the
      samples obtained were specimens taken from seven patients who had visited the
      clinic at two different times. In six of these seven children, human rotavirus
      (HRV) was detected in only one of the specimens taken (i.e. during only one of
      the two visits). One patient was shown to have excreted HRV twice; in both cases
      the HRV was serotyped to be type 1. The present results indicate that the
      symptomatic reinfection of HRV was not a widely occurring phenomenon in the group
      of infants tested.

PMID- 7799843
TI  - A similar expression pattern of adhesion molecules between intermediate TCR cells
      in the liver and intraepithelial lymphocytes in the intestine.
AB  - Two major populations of extrathymically differentiated T cells exist in the
      liver and intestine. Such T cells in the liver have TCR of intermediate intensity
      (i.e., intermediate TCR cells) and constitutively express IL-2 receptor beta
      chain (IL-2R beta), whereas those in the intestine, especially intraepithelial
      lymphocytes, have TCR of bright intensity, consisting of a mixture of IL-2R beta+
      and IL-2R beta-. All mature thymocytes and thymus-derived T cells seen in the
      peripheral immune organs are TCR-bright+ IL-2R beta- under resting conditions.
      When the expression pattern of adhesion molecules, including CD44, L-selectin,
      LFA-1 and ICAM-1, was compared among these T-cell populations, they displayed
      quite unique patterns of expression. All extrathymic T cells in the liver,
      intestine, and even other organs were CD44+ L-selectin-LFA-1++ICAM-1+, whereas
      thymocytes and thymus-derived T cells were CD44-L-selectin+LFA-1+ICAM-1-. This
      inverted expression of adhesion molecules between extrathymic T cells and thymus
      derived T cells might be associated with their unique tissue-localization.

PMID- 7799844
TI  - Drugs for asthma.

PMID- 7799845
TI  - [The fauna and ecology of blackflies (Diptera, Simuliidae) in the Republic of
      Guinea].
AB  - Twenty-nine Simulium species were recorded in the Republic of Guinea. The
      geographical distribution of the blackfly species in its areas is shown in the
      paper. The most probable vector of Onchocerca volvulus are S. damnosum s. str and
      S. sirbanum which predominate in the landscapes of Sudan and Guinea savannas. S.
      yahense, S. soubrense, and S. sanctipauli are likely to be vectors in the forest
      savannas and tropical rain forests.

PMID- 7799846
TI  - [The insecticidal activity of thermal aerosols of permethrin].
AB  - The aerosols derived from the designed 2% permethrine-containing pyrotechnical
      formulations (tablets and briquets) were tested for their effects in laboratory
      and field conditions. When tested in the chamber, its LC50 and LC99 were 0.056
      and 0.43 mg/m2 (as calculated for the active ingredient), respectively, for Ae.
      aegypti mosquitos exposed to 15 min in the polycarprolactam plastic trap and 2.99
      and 5.66 mg/m2 (for the active ingredient) for M. domestica flies exposed to an
      hour. LC99 for C. pipiens ranged 2 to 5 mg/m2 in the field conditions when
      treating the basements with varying airtightness. The effective dosage ensuring a
      100% death of M. domestica in the animal-breeding premises of various types is 10
      mg/m2 on an hour exposure.

PMID- 7799848
TI  - [The effect of hydraulic engineering construction in the Volga basin on the
      situation with opisthorchiasis and diphyllobothriasis. 2. The prognosis for a
      change in the parasitological situation in the area of small reservoirs].

PMID- 7799847
TI  - [The rate of infection of the taiga tick with Borrelia in the western Sayan].
AB  - The paper provides microscopic findings of taiga ticks collected for the
      causative agent of Lyme's disease in May to July 1993 in the West Sayan . A total
      of 1,016 specimens were examined, among them 124 (12.2%) were found to have
      Borreliae. The areas were demonstrated to vary greatly with their epidemiological
      risk. The number of ticks and hence the epidemiological risk were the most in the
      low-mountain and chern taiga areas.

PMID- 7799850
TI  - [The procedure for the wide use of praziquantel in a complex of measures to
      control opisthorchiasis. 1. The tolerance and efficacy of different doses of
      biltricide during outpatient use in foci].
AB  - The results of wide uses of praziquantel (bilthricide, Bayer, Merck) to treat
      2,440 persons in the outpatient setting of the endemic foci of opisthorchiasis in
      Tomsk Province suggest that the agent is highly effective (on the average of 97%)
      and well tolerable. There are no great differences in the efficiency of
      treatment, the frequency and magnitude of adverse reactions during out- and
      inpatient treatments. There are no either basic differences in the efficacy of
      praziquantel doses of 30, 40, and 60 mg used in the treatment of patients with
      Opisthorchis infection in whom 1 to 1.00 eggs per g feces are found. The use of
      praziquantel in a daily dose of 30 or 40 mg/kg in the outpatient setting permits
      the mass drug therapy of the population in the endemic foci, by reducing expenses
      on treatment. It is advisable to continue investigations of praziquantel used in
      small doses among the populations at low infection risk.

PMID- 7799849
TI  - [The action of insect developmental regulators on the housedust mites
      Dermatophagoides pteronyssinus (Trouessart, 1897) and D. farinae Hughes, 1961
      (Acari: Pyroglyphidae)].
AB  - Whether insect growth regulators, such as methoprene, telflubenzuron and
      flufenoxuron, can be used to suppress the populations of the house dust mites D.
      pteronyssinus and D. farinae has been studied in the laboratory setting. The most
      potent agent has been found to be methoprene used in concentrations of 0.05 =
      0.1%, in particular. Flufenoxuron at a concentration of < 0.1% has been shown to
      stimulate the reproduction of house dust mites.

PMID- 7799852
TI  - [The epizootiological problems of trematodiases in the Maritime Territory].
AB  - Five species of trematodes: Metagonimus yokogawai, M. katsuradai, Centrocestus
      armatus, Nanophyetus salmincola schikhobalowi and Paragonimus westermani
      ichunensis which are able to infect man have been found to develop with the
      participation of mollusks of the Juga genus from the rivers of the Maritime
      Territory. Some epizootiological aspects of the infections caused by these
      trematodes are considered in the paper.

PMID- 7799851
TI  - [Cases of trichinelliasis among the inhabitants of Lipetsk Province].

PMID- 7799853
TI  - [The distinctive epidemiology of parasitic diseases].

PMID- 7799855
TI  - [The pathomorphological changes in the kidneys of white mice with experimental
      trichocephaliasis and after the use of anthelmintic preparations].
AB  - The experiments were carried out with 170 white mice divided into 4 groups. The
      first group consisted on 72 intact animals, administered subcutaneous ivomek
      (0.01 ml/kg) and oxfendasole (10 mg/kg) per os; Group 2 consisted of 15 animals
      with induced trichocephaliasis, administered no anthelmintics. The third group,
      72 animals, were infected with Trichocephalus muris invasion eggs and
      administered anthelminthic agents on day 46 postinfection. The fourth group
      consisted of 11 intact animals, neither infected, nor treated (reference group).
      The animals were decapitated 3, 12, 24 and 72 h after the drug administration and
      histologic examination of the kidneys was carried out. The findings evidence that
      the morphologic changes in the kidneys of mice with trichocephaliasis are
      characterized by alternating proliferative processes. Both the drugs used were
      found characterized by a more or less pronounced nephrotoxicity. Ivomek induced
      the most marked structural changes in the kidneys of intact animals. The changes
      in the kidneys of intact mice were more manifest after the drugs administration
      than in intact animals.

PMID- 7799854
TI  - [The effect of emotional stress on the efficacy of chemotherapy in experimental
      trichochephaliasis].
AB  - In DBA/2st mice experimentally infected with Trichocephalus muris the emotional
      stress caused by a cat that was placed for 2 hours twice a day during 14 days or
      more was found to reduce the efficiency of specific drug therapy with
      albendasole. At the same time there was an increase in the ED84:ED16 ratio (the
      effective dose of the drug which allows 84 or 16% of helminths to be eliminated),
      which decreased elimination probability in the whole helminth populations.

PMID- 7799856
TI  - [The attack activity of Uranotaenia unguiculata Edwards, 1913 mosquitoes on man].
AB  - Field observations of the activity of U. unguiculata mosquitoes, carried out in
      the daytime, and 225-min estimations of their numbers against a white screen,
      lighted with an electric lamp, with half-an-hour intervals between the
      estimations, that were carried out in the evening and night hours in June, 1988,
      in the Divichinskii District of Azerbaijan, have demonstrated the aggressiveness
      of these mosquitoes towards humans. Daily changes in the activity of these
      mosquitoes were revealed, that consisted of an evening (high) and morning (poorly
      manifest) maximums and the high and daytime minimums. U. unguiculata bites were
      not so painful and the skin reactions poorly manifest in comparison with those of
      other mosquito species, which fact explains, in the authors' opinion, the
      inadequate interest of scientists to these mosquitoes.

PMID- 7799857
TI  - [The search for new antiparasitic agents. 12. The synthesis and study of the anti
      Echinococcus and anti-Hymenolepis activity of 6-[4-(4-alkylpiperazinyl-1)
      phenylamino]-1,2,5-thiadazolo[3 ,4-h] quinolines].
AB  - The paper describes the synthesis of 6-[4-alkylpiperazinyl-1)phenylamino]-1,2,5
      thiadiazolo[3,4-h ]quinolines where methyl (Drug G-1574) and ethyl (Drug G-1569)
      are alkyls. The two agents are as effective as mebendazole against the larval
      stage of Echinococcus multilocularis infection. Drug G-1574 has been demonstrated
      to ensure 100% recovery of spontaneously Hymenolepis nana-infected albino mice
      given doses 2.5-5 times lower than the effective dose of phenasal (niclosamide).

PMID- 7799859
TI  - [The comparative efficacy of commercial tests (of Russian and Swiss manufacture)
      for immunoenzyme analysis in echinococcosis].

PMID- 7799862
TI  - [Parasitological objects in myths and ancient cultural monuments (a lecture)].

PMID- 7799860
TI  - [Helminthiases in the Republic of Bashkortostan].

PMID- 7799858
TI  - [The ecological-epidemiological characteristics of opisthorchiasis in Sverdlovsk
      Province].
AB  - Opisthorchiasis has been recorded as the prevalent invasion in the adults over
      many years in the Sverdlovsk Region. The 1986-1991 studies have shown that there
      are Opisthorchis infection foci, by infecting 10.0-30.0% of the population, 12.0
      73.0 of the Cyprinidae fish, and 0.2% of the Codiella mollusks in Sverdlovsk
      Province that is central in the middle Urals economic area. The irregular
      anthropogenic loading, such as the number of water reservoirs, specific features
      of their constructions and operation, in the river basins of the Sverdlovsk
      Region varies, by affecting the living conditions, spread of intermediate hosts
      and circulation of the vector, by predetermining the heterogeneous functioning of
      Opisthorchis infection foci. Some display their development, the others exhibit
      their regression due to unfavourable conditions for the vector in the impact
      areas of hydrological constructions. The areas that are different in the
      endemicity of opisthorchiasis and the nature of vector transmission were
      identified and characterized. There were 4 area types in terms of the nature of
      opisthorchiasis vector transmission.

PMID- 7799861
TI  - [The prevalence of enterobiasis among the boarding-school pupils in the city of
      Ufa].

PMID- 7799864
TI  - Analytic modeling of photon scatter from flattening filters in photon therapy
      beams.
AB  - Analytic models for calculation of scatter distributions from flattening filters
      in therapy photon beams are presented. It is shown that the amount of scatter
      with high atomic number filters can vary from 2% in 4-MV beams to 10% for 24-MV
      beams. The use of low atomic number filters can increase the amount of scatter by
      a factor of 2. The dependence on the opening angle of the primary collimator is
      quite large since a larger opening angle requires a thicker filter, which
      increases the scattered fraction of the filtered beam. The scatter makes the
      filter act as an extended source of extra-focal radiation. The source
      distribution for monomedia filters is shown to be almost triangular. Integration
      in the calculation-point's eye view over the visible part of the filter scatter
      source yields the scatter fraction of the total energy fluence incident upon the
      patient. The experimentally well-known "tilt" of dose profiles for asymmetrical
      fields is explained by the model. For complete modeling of head scatter
      distributions in treatment planning, the model presented must be combined with
      models also describing the scatter from the collimators, auxiliary modulators
      such as wedges and compensating filters, and collimator backscatter to the beam
      monitor.

PMID- 7799863
TI  - [A method for stratifying malariogenic territories in order to construct a system
      of mathematical models of the prevalence of malaria. 1].
AB  - The paper describes procedures for stratifying malariogenic areas that are
      homogeneous in the development pattern for epidemic stratum rises, which will be
      used to design a set of mathematical malaria spread models. The first stage of
      the procedures is to stratify P. falciparum and P. vivax malaria on phase planes.
      The morbidity rate of P. falciparum and P. vivax malaria was analyzed in the
      north-western areas of India in 1975-1990. Eighty-two observations provided 4
      types of phase curves for tropic malaria, which form a polygon, a loop polygon, U
      shaped ones and those without any specific signs and 4 groups of phase curves for
      P. vivax malaria and the U-shaped phase curve with a loop for P. vivax malaria.
      It is shown that there is a steady-state pattern of phase curve changes in 71%.
      It is suggested that the pattern of a phase curve can be a diagnostic
      characterization of the given area.

PMID- 7799865
TI  - Dose calculation for photon beams with intensity modulation generated by dynamic
      jaw or multileaf collimations.
AB  - A dose calculation algorithm has been developed for photon beams with intensity
      modulation generated by dynamic jaw or multileaf collimations. First, an in-air
      fluence distribution is constructed based on the dynamic motion of the jaws or
      leaves, taking into account the variation of output with field size defined by
      the jaws. The fluence distribution is then convolved with the appropriate pencil
      beam kernel to give correction factors which are used to calculate the dose
      distribution for an intensity-modulated photon field. The proposed algorithm is
      strictly valid in homogeneous media only, patient heterogeneity correction is
      accounted for in an approximate manner. Dose distributions at several depths and
      for several field sizes were calculated for 6- and 15-MV x-ray beams for a set of
      standard wedges produced by dynamic jaws. Measurements were made with film and an
      ion chamber. Comparisons between calculated and measured data show good agreement
      (within 2%) for both dose profiles and wedge factors. Similar calculations and
      measurements were also made for a 25-MV intensity-modulated photon field produced
      by dynamic motion of a multileaf collimator. Agreement between calculations and
      measurements is also good (within 3%). The "tongue-and-groove" effect associated
      with a multileaf collimator design is also examined using a ring-shaped field
      produced by matching two component fields. The computation time for a dynamic
      collimated field is the same as that for an irregular field shaped by
      conventional blocks. The algorithm is applicable to any pattern of jaw or
      multileaf motions. The strengths and remaining problems of the algorithm are
      discussed.

PMID- 7799866
TI  - Dosimetry of centrally shielded electron beams.
AB  - In electron beams, the dose in phantom under the central shielding depends on
      electron-beam energy, depth in phantom, and shield area and thickness. In our
      experiments, all shield thicknesses were larger than the range of electrons in
      the shield material. At a given depth, the dose under the shield never exceeds
      the open field value; however, it can attain quite a large proportion of the open
      field value despite a shield thickness which exceeds the range of electrons in
      the shield material. The effects of shield area on the dose under the central
      shields were studied in detail and dose distributions are given as a function of
      shield lateral dimensions and electron-beam energy. It is shown that in clinical
      use of central shielding, the best approach to dose estimation under the shield
      is direct measurement in phantom under conditions of the actual clinical setup.

PMID- 7799867
TI  - The calibration and use of plane-parallel ionization chambers for dosimetry of
      electron beams: an extension of the 1983 AAPM protocol report of AAPM Radiation
      Therapy Committee Task Group No. 39.
AB  - This report is an extension of the 1983 AAPM protocol, popularly known as the TG
      21 Protocol. It deals with the calibration of plane-parallel ionization chambers
      and their use in calibrating therapy electron beams. A hierarchy of methods is
      presented. The first is to calibrate the plane-parallel chamber in a high energy
      electron beam against a cylindrical chamber which has an Ncylgas value that has
      been obtained from a NIST traceable 60Co beam calibration. The second method,
      which is recommended for implementation by the ADCLs is an in-air calibration
      against a NIST-traceable calibrated cylindrical chamber in a Cobalt-60 beam to
      obtain a plane-parallel-chamber calibration factor in terms of exposure or air
      kerma. The third method places the two chambers in a phantom in a Cobalt-60 beam,
      and leads to an Nppgas value for the plane-parallel chamber. This report also
      gives Nppgas/NxAion)pp and Nppgas/(NkAion)pp values for five commonly used
      commercially available plane-parallel chambers: the Capintec PS-033, the Exradin
      P-11, the Holt, the NACP and the PTW-Markus. The calculation of these Ngas ratios
      introduces a Kcomp factor which is also calculated for the five parallel plate
      chambers. The use of the plane-parallel chambers follows the 1983 AAPM protocol
      for absorbed dose calibrations of electrons, except that new energy-dependent
      Prepl values are given for the Capintec PS-033 and PTW-Markus chambers consistent
      with the consensus of reports in the literature. For all the chambers, however,
      Prepl is unity for 20 MeV electrons. This report does not address the issue of
      the use of plane-parallel chambers in calibrating photon beams.

PMID- 7799868
TI  - Addendum to the penumbra of a 6-MV x-ray beam as measured by thermoluminescent
      dosimetry and evaluated using an inverse square root function [Med. Phys. 20,
      1429-1438 (1993)].

PMID- 7799869
TI  - Noise analysis in real-time portal imaging. I. Quantization noise.
AB  - The limit at which quantization noise becomes dominant in video-based real-time
      portal imaging has been studied. Quantization noise due to truncation in integer
      frame averaging is shown to be dominant over the input analog-to-digital
      converter (A/D) quantization noise, unless image addition is used in video-based
      real-time portal imaging systems. Portal images acquired with the Newvicon camera
      by averaging more than 64 frames are found to be dominated by the quantization
      noise due to truncation. It has shown that the signal-to-noise ratio (SNR) is
      limited to 886.8 when using an 8-bit A/D with digital frame averaging, but higher
      values can be achieved with digital frame addition. It is also shown that digital
      frame addition together with 16-bit processing can achieve higher contrast
      resolution than digital frame averaging and 8-bit processing.

PMID- 7799870
TI  - Thick phosphor screens for on-line portal imaging.
AB  - Gd2O2S phosphor screens between 250 and 1000 mg/cm2 thick were evaluated for use
      in megavoltage imaging systems. The phosphor layers were placed on brass plates
      ranging from 1 to 5 mm thick, each with and without an optical back reflector
      (white paint). Light output and spatial resolution were measured at 6- and 23-MV
      x-ray energies. Light output was found to increase linearly with phosphor
      thickness up to 500 mg/cm2, reaching a plateau at 1000 mg/cm2. Spatial resolution
      [modulation transfer function (MTF)] decreased exponentially with phosphor
      thickness up to 750 mg/cm2, where a minimum was reached. The variation of MTF
      with phosphor thickness was found to obey a simple empirical relation.

PMID- 7799871
TI  - Performance of glass fiber antiscatter devices at mammographic energies.
AB  - Using fiber optic manufacturing techniques, it is possible to produce a
      radiographic grid that discriminates against scattered radiation in two
      dimensions. Such grids consist of septa composed of glass with a high lead
      content; the interspace material is air, so that approximately 80% of the grid
      area is open. In this way, effective high ratio grids can be produced with
      relatively low Bucky factors. The performance of samples of such grid material is
      characterized in terms of both scatter rejection and dose efficiency for
      application in digital mammography in both slot-beam and area-beam geometry. For
      area beams, five- to tenfold improved scatter rejection relative to conventional
      grids was observed. In slot configurations, such grids could provide improved
      SNR/dose performance and more effective utilization of the heat loading
      capability of the x-ray source.

PMID- 7799872
TI  - Improving the convergence of iterative filtered backprojection algorithms.
AB  - Several authors have proposed variations of the iterative filtered backprojection
      (IFBP) reconstruction algorithms claiming fast initial convergence rates. We have
      found that these algorithms are trying to minimize an unusual squared-error
      criterion in a suboptimal way. As a result, existing IFBP algorithms are
      inefficient in the minimization of the criterion, and may become unstable at
      higher iteration numbers. We show that existing IFBP algorithms can be modified
      to use the steepest descent technique by simply optimizing the step size at each
      iteration. Further gains in convergence rates can be achieved with conjugate
      gradient IFBP algorithms derived from the same criterion. The steepest descent
      and conjugate gradient IFBP algorithms are guaranteed to converge, unlike some
      IFBP algorithms, and will do so in fewer iterations than existing IFBP
      algorithms.

PMID- 7799873
TI  - The measurement of radiation dose profiles for electron-beam computed tomography
      using film dosimetry.
AB  - The unique geometry of electron-beam CT (EBCT) scanners produces radiation dose
      profiles with widths which can be considerably different from the corresponding
      nominal scan width. Additionally, EBCT scanners produce both complex (multiple
      slice) and narrow (3 mm) radiation profiles. This work describes the measurement
      of the axial dose distribution from EBCT within a scattering phantom using film
      dosimetry methods, which offer increased convenience and spatial resolution
      compared to thermoluminescent dosimetry (TLD) techniques. Therapy localization
      film was cut into 8 x 220 mm strips and placed within specially constructed light
      tight holders for placement within the cavities of a CT Dose Index (CTDI)
      phantom. The film was calibrated using a conventional overhead x-ray tube with
      spectral characteristics matched to the EBCT scanner (130 kVp, 10 mm A1 HVL). The
      films were digitized at five samples per mm and calibrated dose profiles plotted
      as a function of z-axis position. Errors due to angle-of-incidence and beam
      hardening were estimated to be less than 5% and 10%, respectively. The integral
      exposure under film dose profiles agreed with ion-chamber measurements to within
      15%. Exposures measured along the radiation profile differed from TLD
      measurements by an average of 5%. The film technique provided acceptable accuracy
      and convenience in comparison to conventional TLD methods, and allowed high
      spatial-resolution measurement of EBCT radiation dose profiles.

PMID- 7799874
TI  - Automated segmentation of regions of interest on hand radiographs.
AB  - Most radiologists do not use texture information contained in the trabecular
      patterns of hand radiographs to diagnose erosive changes and demineralization due
      to systemic inflammatory diseases that affect the skeletal system. However, high
      resolution digitization achievable by a laser digitizer now makes it possible to
      access texture information that may not be perceived visually. We are studying
      the feasibility of computer-assisted early detection of these processes with
      particular attention to patients with hyperparathyroidism. In this paper the
      methods used to extract a region of interest (ROI) for texture analysis are
      discussed. The techniques include multiresolution sensing, automatic adaptive
      thresholding, detection of orientation angle, and projection taken perpendicular
      to the line of least second moment. The methods were tested on a database of 50
      pairs of hand radiographs. We segmented the middle and the index fingers with an
      average success rate of 83% per hand. For the segmented finger strips, we located
      ROIs on both the middle and the proximal phalanges correctly over 84% of the
      times. Texture information was collected in the form of a concurrence matrix
      within the ROI. This study is a prelude to evaluating the correlation between
      classification based on texture analysis and diagnosis made by experienced
      radiologists.

PMID- 7799875
TI  - Voxel-based localization in frame-based and frameless stereotaxy and its
      accuracy.
AB  - The problem of accurate stereotactic localization and registration of targets in
      computed tomography (CT) data sets is addressed, in particular the effect of
      using a single transformation matrix to map voxel coordinates onto stereotactic
      coordinates. An algebraic approach to the calculation of stereotactic target
      coordinates in tomographic data acquired with conventional stereotactic
      localizers is presented. The volume transformation matrix (VTM) is discussed,
      which is useful for the registration of volumetric data sets, and also
      corresponds to the rigid body transformation matrix used in many so-called
      frameless registration methods. The VTM can lead to accuracy degradation, in
      particular due to patient movement during scanning. Simulations were performed
      and CT data sets acquired with patients fitted with the CRW or the GTC
      stereotactic localizer were analyzed. Comparison of STM- and VTM-derived
      stereotactic coordinates shows an average overall registration error of 0.1 mm
      for anesthetized patients and in the range 0.6-1.4 mm for nonanesthetized
      patient. Accuracy maps are described that enable the user to visualize the
      registration error in relation to the data. It is shown that the effect of
      fiducial point localization error and patient movement for VTM-based localization
      is minimized when all available fiducials in the region of interest are used. The
      significance of these results is discussed, and methods are proposed to minimize
      these effects for frame-based and frameless registration methods.

PMID- 7799876
TI  - Photon propagation and detection in single-photon emission computed tomography-
      an analytical approach.
AB  - An analytical theory of photon propagation and detection in single-photon
      emission computed tomography (SPECT) for collimated detectors is developed from
      first principles. The total photon detection kernel is expressed as a sum of
      terms due to the primary and the Compton scattered photons. The primary as well
      as contributions due to every order of Compton scattering are calculated
      separately. The model accounts for the three-dimensional depth dependence of the
      collimator holes as well as for nonhomogeneous attenuation. No specific
      assumptions about the boundary or the homogeneity of the attenuating medium are
      made. The energy response of the detector is also modeled by the theory.
      Analytical expressions are obtained for various contributions to the photon
      detection kernel, and the multidimensional integrals involved are calculated
      using standard numerical integration methods. Theoretically calculated
      projections and scatter fractions for the primary and the first through second
      scattering orders are compared with our own experimental results for a small
      cylindrical primary radiation source immersed at various positions in a uniform
      cylindrical phantom. Also, theoretically calculated scatter fractions for a small
      spherical (pointlike) source in a uniform elliptic phantom are compared with
      experimental and Monte Carlo simulation results taken from the recent literature.
      The results from the analytical method are essentially exact and are free from
      the inaccuracies inherent in the numerical simulation methods used to deal with
      the photon propagation and detection problem in SPECT so far. The method
      developed here is unique in the sense that it provides accurate theoretical
      predictions of results averaged over an infinite number of simulations or
      experiments. We believe that our theory enhances an intuitive understanding of
      the complex image formation process in SPECT and is an important step toward
      solving the inverse problem, that of reconstructing the primary radiation source
      distribution from the measured gamma camera projections.

PMID- 7799877
TI  - Laser-induced thermoelastic deformation: a three-dimensional solution and its
      application to the ablation of biological tissue.
AB  - Under certain conditions, laser light incident on a target material can induce an
      explosive removal of some material, a process called laser ablation. The
      photomechanical model of laser ablation asserts that this process is initiated
      when the laser-induced stresses exceed the strength of the material in question.
      Although one-dimensional calculations have shown that short pulsed lasers can
      create significant transient tensile stresses in target materials, the stresses
      last for only a few nanoseconds and the spatial location of the peak stresses is
      not consistent with experimental observations of material failure in biological
      tissues. Using the theory of elasticity, analytical expressions have been derived
      for the thermoelastic stresses and deformations in an axially symmetric three
      dimensional solid body caused by the absorption of laser light. The full three
      dimensional solution includes three stresses, radial, circumferential and shear,
      which are necessarily absent in the simple one-dimensional solution. These
      stresses have long-lived components that exist for eight orders of magnitude
      longer in time than the acoustic transients, an important point when the details
      of dynamic fracture are considered. Many important qualitative features are
      revealed including the spatial location of the peak stresses, which is more
      consistent with experimental observations of failure.

PMID- 7799878
TI  - Two-dimensional registration of magnetic resonance brain images.
AB  - A fully automated two-dimensional image registration technique based on cross
      correlation is presented. This technique is evaluated using magnetic resonance
      images of human brain. Results indicate that this algorithm is capable of
      accurately estimating both linear and angular offsets.

PMID- 7799879
TI  - Comment on "radio frequency eddy current losses for an annular conductor in MRI:
      theory and applications" [Med. Phys. 20, 1555-1560 (1993)].

PMID- 7799880
TI  - [Cystic fibrosis at present: current state and new perspectives].

PMID- 7799881
TI  - The side-effects of non-steroidal anti-inflammatory drugs.

PMID- 7799882
TI  - [Progressive chronic external ophthalmoplegia. Personal experience].
AB  - The author reports a case of mitochondrial myopathy which can be classified
      within the context of progressive chronic ophthalmoplegia and discusses the
      complex etiopathogenetic, histological and clinical aspects. In particular he
      underlines the severity of respiratory, muscular and bone symptoms and the
      important role played by histochemical and biochemical aspects in diagnosis.

PMID- 7799883
TI  - [Roseola infantum. Some epidemiologic, clinical and diagnostic aspects revisited.
      Personal experience].
AB  - Seventy-five children aged less than 3 yrs, affected by Roseola infantum
      (maculopapular rash following an acute onset illness characterized by high fever
      for 2-5 days) were included in this study, 40% of them were admitted with urgency
      to our clinic for febrile convulsions. Several bacterial or viral agents other
      than HHV6 were isolated from more than 10% of the children; the role of HHV6 was
      studied with an immunofluorescence test (IFA) for specific antibodies
      (seroconversion); 25 single serum samples of the acute phase and 30 acute and
      convalescent paired sera were available; high positivity was shown in three
      preexanthematous samples; a serological evidence of HHV6 infection was obtained
      in only 9 of the 30 paired sera; a coinfection was shown in two subjects
      belonging to the last group; viral or bacterial agents other than HHV6, were
      demonstrated in 4 seronegative children. In our experience, the etiologic role of
      HHV6 in exanthema subitum is not always confirmed; we cannot explain the
      controversy of our results compared with those of Japanese literature.

PMID- 7799884
TI  - [Body mass index, weight and height in school children in central Italy].
AB  - AIM: To study the pattern of distribution for body-mass index, weight and height
      in children of the Abruzzo region and to compare them with commonly used
      standards. STUDY DESIGN: Weight, height and body-mass index (BMI, weight/height2)
      were reported from 2858 school children (6 to 14 years old) of a town of Central
      Italy (Pescara). Data were detected in 1991. The conventional percentiles were
      calculated. Then we considered the first (25%), the median (50%) and the third
      (75%) quartile of all obtained data. Those of the BMI were superimposed on France
      (Rolland-cachera MF, Eur J Clin Nutr 1991;45:13) and USA (Hammer LD, Am J Dis
      Child 1991;145:259) standards. Those of weight and height were superimposed on
      the respective Tanner standards (Tanner JM, Arch Dis Child 1966;41:613). RESULTS:
      The percentiles are shown. The central point of distribution (quartiles) appear
      slid over. The nearer standard for BMI to our sample seems to be represented by
      France standards, in front of which our values result slid quite exactly of one
      quartile over. The comparison with USA standards shows an increase of our
      findings, but the slope of the curves is different (overall in the advanced
      ages). Both weight and height, compared with Tanner standards, show an increase
      of values. CONCLUSIONS: 1) Different growth patterns are observed in the studied
      sample; 2) to calculate the prevalence of wasting and fattening conditions using
      values of cutoff points from not own standards could load to not appropriate
      estimates.

PMID- 7799886
TI  - [Investigation of smoking habits in school-age subjects. Long-term results after
      a health education program].

PMID- 7799885
TI  - [Liver pathology in juvenile obesity: significance of the disorder and clinical
      contribution].

PMID- 7799887
TI  - [Fatal neonatal listeriosis after maternal infection acquired with ingestion of
      fresh home-made cheese].
AB  - The authors report on a newborn admitted to the Intensive Care Unit of Gaslini
      Institute for serious respiratory insufficiency who died on the third day of life
      because of a sepsis due to Listeria monocytogenes. The authors focus on the
      patient's history and clinical picture and on the histological evaluation of the
      lesions observed. The importance of infection in pregnancy and the possible
      severe consequences of listeriosis on the foetus are underlined, stressing the
      need for early diagnosis and adequate treatment.

PMID- 7799888
TI  - [Autoimmune hemolytic anemia with cold antibodies and hemoglobinuria secondary to
      EBV infection].
AB  - The infection caused by EBV can be followed by immunological complications. One
      of these is autoimmune hemolytic anemia that up to today has been observed during
      infective mononucleosis only a few times. The authors describe a patient with
      this rare complication of the EBV infection and discuss its main clinical,
      pathogenetic and laboratory aspects, with particular attention to the presence of
      hemoglobinuria and to the absence of anti-i-antibodies. The disease's evolution
      was spontaneously favorable. For this reason and for the possible risks secondary
      to transfusions and to other therapeutical interventions, the authors believe
      that in autoimmune hemolytic anemia a vigil wait is more opportune before
      beginning the therapy.

PMID- 7799889
TI  - [Aarskog syndrome. A case report].
AB  - A case of Aarskog syndrome in a 10-year-old boy born to an epileptic woman is
      reported. Clinical features and genetics of the condition are reviewed. An
      underestimated incidence of the syndrome related to its mild phenotypical
      appearance is suggested. Finally the association between Aarskog syndrome and
      maternal epilepsy is discussed.

PMID- 7799890
TI  - [Pharmacologic treatment and atopic dermatitis].
AB  - The role of etiology, pathogenesis and clinical symptoms in children with Atopic
      Dermatitis is evaluated. Eighteen patients with elimination diet were treated,
      without cow milk and egg, and with pharmacologic treatment (ketotiphene and cro
      molyn sodium) for two months. Dietary therapy and treatment however result in a
      large reduction in clinical symptoms in children affected with Atopic Dermatitis.

PMID- 7799891
TI  - [Diabetes, obesity, hypertension and the autonomic nervous system].
AB  - Functional changes of the autonomic nervous system may represent a common
      pathophysiologic factor in the association between non insulin-dependent
      diabetes, obesity, and essential hypertension. In all these conditions a number
      of sympathetic and/or parasympathetic dysfunctions consistent with autonomic
      neuropathy or simply with functional adaptations to haemodynamic changes have
      been reported. Autonomic neuropathy is a well known diabetic complication which
      is responsible for some clinical aspects of different severity. Subtle
      sympathetic and parasympathetic abnormalities possibly affecting thermogenesis
      have been shown in obese people. An increased sympathetic activity has been
      proposed as one of the pathogenetic mechanisms of essential hypertension.
      Finally, the association between diabetes, obesity, hypertension and sympathetic
      overactivity could be explained by a common trans-membrane ionic disturbance with
      an increase of intracellular calcium and a decrease of both intracellular
      magnesium and pH.

PMID- 7799892
TI  - [Low levels of dehydroepiandrosterone sulfate in adult males with insulin
      dependent diabetes mellitus].
AB  - Studies on animals and humans have suggested that dehydroepiandrosterone sulphate
      (DHEAS) has antiatherogenic effects. It has been hypothesized that insulin may
      have an atherogenic role and it has been reported recently that, surprisingly,
      DHEAS levels decreased in normal men and women during the hyperinsulinemic
      euglycemic technique. Since a hyperinsulinemia frequently occurs during insulin
      therapy in patients with insulin dependent diabetes mellitus (IDDM), the present
      work was undertaken to determine whether DHEAS serum concentrations were
      decreased in IDDM patients as compared to controls and if so, to discover the
      possible causes. To this, purpose, out of 805 outpatients afferent to our
      Diabetes Centre from 1989 to 1992, three groups were selected on the basis of the
      criteria described below. Known interferences with the DHEAS serum concentrations
      such as gender (all males), age (aged 20-40 years) and Body Mass Index (BMI < 30)
      were excluded. Group A (cross-sectional study) was made up of 15 IDDM patients on
      insulin treatment with good metabolic control (HbA1C < 8%); group B (control
      study) was made of 18 healthy subjects (these patients were selected also on the
      basis of their normal oral glucose tolerance test) and group C (longitudinal
      study) was made up of 7 IDDM patients who had been examined previously and who
      were on insulin treatment. METHODS: In all three groups serum concentrations of
      DHEAS, 17 OH progesterone (17 OHP), delta 4 androstenedione (A4) and cortisol (F)
      were measured. In 10 patients from group A and in 9 patients from group B the
      ACTH test (9.25 mg IM Synacthen) was administered and the same hormonal pattern
      was measured after 60 min. In group C the same hormonal evaluation was performed
      5 +/- 2.8 months after commencement of insulin therapy. RESULTS: DHEAS serum
      concentrations were significantly decreased in group A (median 2.9; range 1.1-5.2
      mumol/l) with respect to group B (median 5.7; range 3.0-9.5 mumol/l) (p <
      0.0012). However, the serum concentrations of 17 OHP (median 3.9 nm/l; range 2.9
      6.9 nm/l and A4 (median 5.2 nm/l; range 1.8-10.2 nm/l) were also significantly
      reduced, while cortisol levels and the 17 OHP/A4 ratio were comparable to group
      B. After administration of ACTH, the delta increment in cortisol percentage
      showed a frank increase (55.1%) in group A with respect to group B (33.1%) (p <
      0.01). The rise in DHEAS showed a lower increase in group A (10.2%) with respect
      to group B (65.5%) even though not statistically significant, while the other
      hormones showed an overlap between the two groups. In group C the serum
      concentrations of hormones before insulin therapy did not show any statistical
      differences with respect to the values in group B. A second evaluation, which was
      performed during insulin therapy, showed that only the 17 OHP/A4 ratio tended
      towards higher values with respect to pretherapy values (1.1 and 0.6
      respectively; p = 0.07). In conclusion our data confirm low DHEAS levels during
      chronic insulin administration therapy. The underlying mechanism could be a
      general aspecific reduction in the activity of P 450 C 21 SCC enzymes in contrast
      with the specific inhibition of 17.20-lyase obtained during insulin bolus.
      Whether the low serum concentrations of DHEAS can determine an atherogenic effect
      of insulin needs further investigation, but the hormone could constitute a new
      parameter for the follow-up of patients affected by diabetes mellitus.

PMID- 7799894
TI  - [Serum levels of the carboxyterminal telopeptide of type I collagen in patients
      with thyroid disorders].
AB  - Serum carboxyterminal cross-linked telopeptide of type I collagen (ICTP) levels,
      marker of bone resorption, were evaluated in 35 patients with hyperthyroidism
      (age range: 21-68 years) and in 35 with hypothyroidism (age range: 28-69 years).
      Data obtained were compared with those recorded in an age and sex matched control
      group. In patients with hyperthyroidism, serum ICTP levels were significantly
      higher than in controls (mean +/- SE: 9.1 +/- 0.7 vs 4.1 +/- 0.3 ng/ml; p <
      0.0001). In patients with untreated hypothyroidism ICTP levels were significantly
      reduced (2.5 +/- 0.2 ng/ml, p < 0.0001); seven patients with hypothyroidism,
      evaluated after substitutive L-thyroxine treatment, showed a significant increase
      of ICTP levels (6th month: 5.9 +/- 0.7 ng/ml, p < 0.02). Taking into
      consideration all the data recorded in patients with both hyper- and
      hypothyroidism, serum ICTP levels were positively correlated with those of free
      T3 and free T4 and negatively correlated with those of TSH. In conclusion, our
      data show that repeated determinations of ICTP levels, which directly reflect the
      bone resorption activity, might be usefully employed in the evaluation of bone
      turnover in patients with thyroid disorders.

PMID- 7799893
TI  - [ANP in the cirrhotic patient. A clinical contribution].
AB  - Pathogenesis of ascites in patients affected by liver cirrhosis is still debated;
      humoral and haemodynamic factors can play a role. Plasmatic renin activity (PRA),
      plasmatic aldosterone (PA), atrial natriuretic peptide (ANP) plasma levels, blood
      Na, K, urea, urinary K and Na were evaluated in 14 patients affected by liver
      cirrhosis (11 males and 3 females, aged from 38 to 62 years), 8 of them with
      ascites. The results were compared with those obtained in a control group poised
      to age and sex to the experimental group. 4 out of 14 patients suffering from
      ascites unresponsive to medical treatment were submitted to peritoneal venous
      jugular shunt (PVGS) and blood samples for PRA, PA and ANP were withdrawn
      immediately before, 4, 8 hours following surgery. The patients affected by liver
      cirrhosis without ascites showed PRA and PA levels similar to those observed in
      the control group, while ANP plasma levels were significantly higher (50.6 + 9.6
      vs. 39.7 + 9.5 Pg/ml) (p < 0.02). In patients with ascites ANP, PA and PRA levels
      were higher than those observed in non ascites patients (ANP = 147.8 + 97.3 vs.
      50.6 + 9.6 pg/ml; PA = 20.6 + 2.7 vs 7.8 + 0.8 ng/dl; PRA = 4.48 + 0.5 vs 1.9 +
      0.34 ng/ml/h). In patients submitted to PVGS, PA and PRA levels were reduced 4
      and 8 hours following the surgery, while ANP levels showed significant increase.
      A natriuretic and diuretic response has been observed even in the absence of ANP
      plasma levels variations.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799896
TI  - [Circulating levels of CoQ10 in hypo- and hyperthyroidism].
AB  - Coenzyme Q10 (CoQ10) plays an essential physiologic role in oxidative
      phosphorylation and its plasma and tissue concentration has been evaluated in
      various pathologic conditions, both endocrine and non endocrine; among the latter
      particularly in cardiac failure. Plasma CoQ10 determination has been reported in
      the literature an a useful diagnostic tool in differential diagnosis of thyroid
      diseases. In the present study we have evaluated CoQ10 circulating levels both in
      hypo- and hyperthyroidism. For this purpose plasma CoQ10, fT3-fT4 and TSH
      concentrations have been determined (HPLC, RIA and IRMA respectively) in a group
      of hypothyroid patients, hyperthyroid and control subjects. No patient was
      harbouring cardiovascular, metabolic or systemic disease. CoQ10 has resulted 0.97
      +/- 0.46 mcg/ml in the hypothyroid group, 0.51 +/- 0.35 in hyperthyroid and 0.73
      +/- 0.16 in control group, with a significative difference between first and
      second group only; more, the prevalence of high levels has appeared greater in
      hypo- towards hyperthyroid patients and that of low levels in the latter greater
      than in the former. Finally an inverse relation of CoQ10 with fT3 and tT3, but
      not with fT4 and tT4, has been shown. In conclusion, plasma CoQ10 levels have not
      given in this study a sharp distinction between euthyroidism on a side and hypo-
      and hyperthyroidism on the other, but necessity of longitudinal studies after
      therapy is outlined, both to know time of normalization of plasma concentrations
      and to verify the opportunity of exogenous administration of CoQ10 in
      hyperthyroid patients with risk factors for heart failure.

PMID- 7799895
TI  - [Serum levels of the tartrate-resistant isoenzyme, acid phosphatase, for the
      evaluation of bone remodeling in hyperthyroidism].
AB  - Tartrate-resistant acid phosphatase (TRAP) is one of the acid phosphatase
      isoenzymes. It is secreted by osteoclasts so it has been proposed as a marker of
      bone resorption. Bone turnover is high in hyperthyroidism due to an increase in
      both bone resorption and formation. The aim of the study was to measure serum
      TRAP as well as other markers of bone metabolism in 20 fertile age females
      affected by Graves-disease; 11 patients were also studied after euthyroid state
      was attained by means of a 6 month course of methimazole treatment. TRAP was
      measured with the colorimetric method using p-nitrophenylphosphate as substrate.
      Free thyroid hormones, TSH, serum calcium (corrected for albumin concentration),
      phosphate, osteocalcin, alkaline phosphatase, parathormone intact molecule, and
      urinary excretions of calcium, phosphate and hydroxyproline were measured, too.
      Twenty-eight healthy fertile women made up the control group. Untreated patients
      had a significant increase of TRAP, osteocalcin, serum calcium, alkaline
      phosphatase and urinary excretion of calcium and hydroxyproline. A significant
      fall in all these parameters but alkaline phosphatase was disclosed comparing
      patients before and after treatment, nevertheless only urinary calcium became not
      significantly different from the controls. TRAP showed a significant correlation
      with free T3 levels but not with hydroxyproline excretions. This survey on
      fertile age women with Graves' disease shows a significant increase in serum
      concentration of TRAP, which decreases, but doesn't get normalization, when
      euthyroidism is attained by a six month course of methimazole therapy.(ABSTRACT
      TRUNCATED AT 250 WORDS)

PMID- 7799897
TI  - [Sclerotherapy of thyroid cysts with tetracycline hydrochloride].
AB  - In order to verify sclerotherapy efficiency in solitary thyroid cysts, needle
      aspiration of the cyst followed by instillation of tetracycline hydrochloride
      into the cyst cavity was performed in 110 patients; in thirty of these the
      aspirations was ultrasonically guided. A tight dressing on the neck was applied
      for 48 hours in order to maintain pressure on the cyst cavity. All patients were
      treated with L-T4 in TSH-suppressive doses. In a few patients (< 155), the
      tetracycline instillation caused local pain, lasting less than two hours. In no
      case, did cytological examination of the sediment of the aspirated fluid reveal
      any evidence of malignant cells. In 82 patients (84.54% of the 97 controlled
      patients), the last ultrasonic follow-up (performed at 3, 6, 9, 12 or 24 months)
      showed a decrease in lesion size. In particular, 16 patients (16.50%) had a
      complete cyst disappearance, 41 patients (42.17%) had a volume reduction of the
      cyst between 85 and 65%, and in 25 patients (25.77%) the reduction was more than
      25%. In the remaining 15 patients (15.46%) a second treatment was performed, 3 of
      them also required a third treatment but in all these cases, the results seemed
      to be less satisfactory. The distinction in cyst size seemed to indicate that in
      the case of a large cyst (> 36 mm diameter), the treatment gives better results
      (92% success rate against 82% of the other patients). In conclusion, we are able
      to affirm that needle aspiration of the thyroid cyst with instillation of
      tetracycline hydrochloride is a simple, well tolerated and low cost
      technique.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7799898
TI  - [Iodine deficiency diseases and pregnancy].
AB  - Iodine is a fundamental element of diet since it is important in thyroid hormone
      biosynthesis. Dietary iodine deficiency can provoke not only thyroid enlargement,
      but also symptoms and signs of hypothyroidism of various degree, known as "iodine
      deficiency disorders" (IDD). Thus, the iodine supplementation is mandatory. It
      can be obtained, in our regions, where subendemic deficiency is frequent, by
      adding iodine to salt. This is the only way to avoid anatomo-functional lesions,
      that are dramatic in pregnancy and childhood.

PMID- 7799899
TI  - [Clinical tolerability of methimazole].

PMID- 7799900
TI  - Taking the pulse of medical technology.

PMID- 7799901
TI  - Minnesota public opinion on health care resource allocation.
AB  - Creating workable policies for allocating or rationing finite health care
      resources to meet the needs of individuals as well as the broader society vexes
      policymakers, providers, and consumers. This paper presents results of a March
      1994 Lou Harris survey of 1,006 Minnesotans about health care allocation.
      Minnesotans believe that allocative or rationing decisions are inevitable and can
      be discussed. Individualized bedside allocative decisions are preferable to
      categorical or universal exclusions of some health care benefits. People want
      comprehensive health care and are willing to let sound clinical judgment, perhaps
      informed by practice guidelines, selectively withhold some services. The
      integrity of plan-based allocation or rationing may be best secured and
      safeguarded by standards that ensure that the decisions are based on patients'
      best interests, involve trusted clinical decision makers, and include lay
      participation in the decision making.

PMID- 7799903
TI  - Minnesota Medical Association Guaranteed Benefits Task Force Report.

PMID- 7799904
TI  - Rational rationing.

PMID- 7799902
TI  - Using technology appropriately. Challenges for Minnesota's Health Technology
      Advisory Committee.

PMID- 7799905
TI  - Educating your patients about health records--the new notice law.

PMID- 7799907
TI  - Time to confront health care rationing.

PMID- 7799908
TI  - Asthma--United States, 1982-1992.
AB  - Asthma is characterized by variable airflow obstruction with airway
      hyperresponsiveness; prominent clinical manifestations include wheezing and
      shortness of breath. During the 1980s, the prevalence of and mortality associated
      with asthma increased in the United States and other countries (1,2). To describe
      national trends in disease burden for asthma in the United States, CDC analyzed
      data for 1982-1992 (the most recent year for which data are available) for
      deaths, hospital discharges, and self-reported morbidity. This report summarizes
      the findings of the analysis.

PMID- 7799906
TI  - Oregon physician makes health care a political priority.

PMID- 7799909
TI  - Changes in notifiable diseases data presentation.
AB  - The next issue of MMWR (dated January 13, 1995 [volume 44, number 1]), will
      incorporate modifications to Tables I and II, Cases of Notifiable Diseases,
      United States. The purposes of these modifications are to improve the usefulness
      of notifiable diseases data (1,2) and to respond to changing priorities in
      notifiable disease surveillance. This report describes the rationale for data
      dissemination in Table I and Table II.

PMID- 7799910
TI  - Lack of evidence for wild poliovirus circulation--United States, 1993.
AB  - Following the isolation of wild poliovirus type 3 during January-February 1993
      among members of a religious community objecting to vaccination in Alberta,
      Canada, surveillance for poliomyelitis was enhanced among related communities in
      the United States (1). In addition, during May-July 1993, a series of surveys was
      conducted in seven states (Iowa, Missouri, New York, Ohio, Pennsylvania,
      Washington, and Wisconsin) to determine whether wild poliovirus was circulating
      or had circulated recently among members of these religious communities residing
      in the states. This report summarizes the results of these surveys.

PMID- 7799912
TI  - Injuries associated with use of snowmobiles--New Hampshire, 1989-1992.
AB  - Recreational use of snowmobiles is popular in New Hampshire during the winter
      months; from 1982 to 1992, the annual number of registered snowmobiles ranged
      from approximately 21,200 to 42,500. During this period, 26 deaths associated
      with use of snowmobiles in New Hampshire accounted for 822 years of potential
      life lost before age 65 years. To assist in the development and evaluation of
      injury-prevention programs for users of off-highway recreational vehicles (OHRVs)
      (e.g., all-terrain vehicles, trail bikes, and snowmobiles), the State of New
      Hampshire Department of Fish and Game (DFG) and the New Hampshire Department of
      Health and Human Services examined reports of injuries resulting from OHRV use in
      New Hampshire from January 1989 through February 1992. This report summarizes
      information about snowmobile-associated fatal and nonfatal injuries during this
      period.

PMID- 7799911
TI  - Recommended childhood immunization schedule--United States, January 1995.
      Advisory Committee on Immunization Practices. American Academy of Pediatrics.
      American Academy of Family Physicians. National Immunization Program, CDC.

PMID- 7799913
TI  - Proportionate mortality from pulmonary tuberculosis associated with occupations-
      28 states, 1979-1990.
AB  - The risk for occupational exposure to tuberculosis (TB) is increased among
      healthcare and other workers exposed to persons with active TB, workers exposed
      to silica or other agents that increase the risk of progression from latent
      infection to active TB, and workers in occupations associated with low
      socioeconomic status (SES). Accurate estimates of and surveillance for
      occupationally associated TB are limited because reports of incident TB cases
      lack comprehensive occupational data (1). Although occupation is routinely
      recorded on death certificates, this information is not routinely coded and
      entered into vital statistics data files. To identify occupations associated with
      increased risk for TB mortality, CDC's National Institute for Occupational Safety
      and Health (NIOSH) used data from the National Occupational Mortality
      Surveillance (NOMS) database to conduct a proportionate mortality study of
      persons with pulmonary TB by occupation for 1979-1990 (the most recent year for
      which data were available). This report presents the findings of the study.

PMID- 7799914
TI  - Physician vaccination referral practices and vaccines for children--New York,
      1994.
AB  - Although vaccinations are among the most effective preventive public health
      measures available, many children are not vaccinated on time (1). One identified
      barrier to timely vaccination is referral of children by primary-care physicians
      to other medical settings for vaccination (2). This report summarizes a survey by
      the New York State Department of Health of vaccination referral practices among
      New York physicians and describes the implementation in New York of Vaccines for
      Children (VFC), a national program making federally purchased vaccines available
      at no cost to healthcare providers for administration to eligible children (3).

PMID- 7799915
TI  - Differences in maternal mortality among black and white women--United States,
      1990.
AB  - The risk for maternal mortality has consistently been higher among black women
      than white women. The 1990 national health objective of reducing maternal
      mortality to no more than five deaths per 100,000 live births for any
      racial/ethnic group was nearly achieved for white women, for whom the maternal
      mortality ratio was 5.7 in 1990 (1); for black women, however, the ratio was
      18.6. The year 2000 national health objectives include reducing the overall
      maternal mortality ratio to no more than 3.3 deaths per 100,000 live births and
      to no more than five for blacks (objective 14.3) (2). This report summarizes race
      specific differences in maternal mortality among black and white women for 1990
      and compares these with trends in mortality from 1940-1990.

PMID- 7799916
TI  - Four structurally distinct, non-DNA-binding subunits of human nuclear respiratory
      factor 2 share a conserved transcriptional activation domain.
AB  - Nuclear respiratory factor 2 (NRF-2) was previously purified to near homogeneity
      from HeLa cells on the basis of its ability to bind tandem recognition sites in
      the rat cytochrome oxidase subunit IV (RCO4) promoter. It consisted of five
      subunits, alpha, beta 1, beta 2, gamma 1, and gamma 2. Sequencing of tryptic
      peptides from alpha and from mixtures of the two beta or two gamma subunits
      revealed sequence identities with subunits of the mouse GA-binding protein
      (GABP), a ubiquitously expressed ETS domain activator composed of three subunits,
      alpha, beta 1, and beta 2. To understand the precise relationship between NRF-2
      and GABP, cDNAs for all five NRF-2 subunits have now been cloned and their
      products have been overexpressed. The results establish that the two additional
      NRF-2 subunits are molecular variants that differ from GABP beta 1 and beta 2 by
      having a 12-amino-acid insertion containing two serine doublets. PCR and RNase
      protection assays show that mRNAs for these variants are expressed in the human
      but not the rodent cells and tissues examined. The insertion did not alter the
      ability of the beta and gamma subunits to associate with alpha, the DNA-binding
      subunit, nor did it affect the ability of NRF-2 beta 1 or beta 2 to direct high
      affinity binding of alpha to tandem sites in the RCO4 promoter. In addition, the
      four NRF-2 beta and gamma subunits were equally proficient in activating
      transcription in transfected cells when fused to a GAL4 DNA-binding domain. The
      domain responsible for this transcriptional activation was localized by deletion
      mapping to a region of approximately 70 amino acids that is conserved in all four
      NRF-2 beta and gamma subunits. The repeated glutamine-containing hydrophobic
      clusters within this region bear a strong resemblance to those recently
      implicated in protein-protein interactions within the transcriptional apparatus.

PMID- 7799917
TI  - A novel cis-acting element required for lipopolysaccharide-induced transcription
      of the murine interleukin-1 beta gene.
AB  - Regulatory elements important for transcription of the murine interleukin-1 beta
      (IL-1 beta) gene lie within a DNase I-hypersensitive region located > 2,000 bp
      upstream from the transcription start site. We have identified within this region
      a novel positive regulatory element that is required for activation of an IL-1
      beta promoter-chloramphenicol acetyltransferase (CAT) fusion gene in the murine
      macrophage line RAW264.7. Electrophoretic mobility shift analysis of the 3'
      portion (-2315 to -2106) of the hypersensitive region revealed at least two
      nuclear factor binding sites, one of which is located between positions -2285 and
      -2256. Competitive inhibition studies localized the binding site to a 15-bp
      sequence between -2285 and -2271. Nuclear factor binding was lost by mutation of
      the 6-bp sequence from -2280 to -2275. The specific retarded complex formed with
      RAW264.7 nuclear extract was not detected under similar conditions with nuclear
      extracts from RLM-11, a murine T-cell line which does not express IL-1 beta RNA.
      Mutation of the 6-bp sequence (-2280 to -2275) in the chimeric IL-1 beta promoter
      -4093 +I CAT plasmid virtually eliminated the activation of this reporter gene by
      lipopolysaccharide (LPS) in transfected RAW264.7 cells. Multimerization of the 15
      bp sequence containing the core wild-type 6-bp sequence 5' of minimal homologous
      or heterologous promoters in CAT reporter plasmids resulted in significant
      enhancement of CAT expression compared with parallel constructs containing the
      mutant 6-bp core sequence. This element was LPS independent and position and
      orientation dependent. The multimerized 15-bp sequence did not enhance expression
      in RLM-11 cells. Methylation interference revealed contact residues from -2281 to
      -2271, CCAAAAAGGAA. Because a search of the NIH TFD data bank with the 11-bp
      binding site sequence found no homology to known nuclear factor binding sites, we
      have designated this sequence the IL1 beta -upstream nuclear factor 1 (IL1 beta 
      UNF1) target. UV cross-linking and sodium dodecyl sulfate-polyacrylamide
      electrophoresis identified an IL1 beta -UNF1-specific binding factor
      approximately 85 to 90 kDa in size.

PMID- 7799918
TI  - An overexpressed gene transcript in senescent and quiescent human fibroblasts
      encoding a novel protein in the epidermal growth factor-like repeat family
      stimulates DNA synthesis.
AB  - We carried out subtractive enrichment of a cDNA library derived from mRNA of
      senescent human diploid fibroblasts (HDF) established from a subject with Werner
      syndrome of premature aging. By differential screening, we isolated an
      overexpressed cDNA sequence (S1-5) that codes for a novel protein containing
      epidermal growth factor (EGF)-like domains which match the EGF-like consensus
      sequences within several known extracellular proteins that play a role in cell
      growth, development, and cell signalling. S1-5 mRNA is overexpressed in Werner
      syndrome and senescent normal HDF, is induced by growth arrest of young normal
      cells, but is significantly decreased by high serum, conditions which promote
      cellular proliferation. Paradoxically, microinjection into young HDF of two
      different lengths of S1-5 mRNA, containing different putative AUG translational
      start sites, consistently stimulated rather than inhibited DNA synthesis by an
      apparent autocrine/paracrine mechanism. Thus, the S1-5 gene product may represent
      a negative and/or positive factor whose ultimate activity is modulated by the
      cell environment as occurs with other members of EGF-like family.

PMID- 7799919
TI  - DNA-binding specificity of the cut repeats from the human cut-like protein.
AB  - The Drosophila Cut and mammalian Cut-like proteins contain, in addition to the
      homeodomain, three other DNA-binding regions called Cut repeats. Cut-like
      proteins, therefore, belong to a distinct class of homeodomain proteins with
      multiple DNA-binding domains. In this study, we assessed the DNA-binding
      specificity of the human Cut repeats by performing PCR-mediated random
      oligonucleotide selection with glutathione S-transferase fusion proteins. Cut
      repeat 1, Cut repeat 3, and Cut repeat 3 plus the homeodomain selected related
      yet distinct sequences. Therefore, sequences selected by one of the fusion
      proteins were often, but not always, recognized by the other proteins. Consensus
      binding sites were derived for each fusion protein. In each case, however, some
      selected sequences diverged from the consensus but were confirmed to be high
      affinity recognition sites by electrophoretic mobility shift assay. We conclude
      that Cut DNA-binding domains have broad, overlapping DNA-binding specificities.
      Determination of dissociation constants indicated that in addition to the core
      consensus, flanking sequences have a moderate but significant effect on sequence
      recognition. Evidence from electrophoretic mobility shift assay, DNase
      footprinting, and dissociation constant analyses strongly suggested that
      glutathione S-transferase/Cut fusion proteins bind to DNA as dimers. The
      implications of these findings are discussed in relation to the DNA-binding
      capabilities of Cut repeats. In contrast to other studies, we found that the
      human Cut-like protein does not preferably bind to a site that includes an ATTA
      homeodomain-binding motif. Here we demonstrate that the native human Cut-like
      protein recognizes more efficiently a site containing an ATCGAT core consensus
      flanked with G/C-rich sequences.

PMID- 7799920
TI  - Evidence for involvement of activin A and bone morphogenetic protein 4 in
      mammalian mesoderm and hematopoietic development.
AB  - Xenopus in vitro studies have implicated both transforming growth factor beta
      (TGF-beta) and fibroblast growth factor (FGF) families in mesoderm induction.
      Although members of both families are present during mouse mesoderm formation,
      there is little evidence for their functional role in mesoderm induction. We show
      that mouse embryonic stem cells, which resemble primitive ectoderm, can
      differentiate to mesoderm in vitro in a chemically defined medium (CDM) in the
      absence of fetal bovine serum. In CDM, this differentiation is responsive to TGF
      beta family members in a concentration-dependent manner, with activin A mediating
      the formation of dorsoanterior-like mesoderm and bone morphogenetic protein 4
      mediating the formation of ventral mesoderm, including hematopoietic precursors.
      These effects are not observed in CDM alone or when TGF-beta 1, -beta 2, or -beta
      3, acid FGF, or basic FGF is added individually to CDM. In vivo, at day 6.5 of
      mouse development, activin beta A RNA is detectable in the decidua and bone
      morphogenetic protein 4 RNA is detectable in the egg cylinder. Together, our data
      strongly implicate the TGF-beta family in mammalian mesoderm development and
      hematopoietic cell formation.

PMID- 7799921
TI  - Identification of the rel family members required for virus induction of the
      human beta interferon gene.
AB  - We have carried out experiments to determine which members of the rel family of
      transcription factors are involved in virus induction of the beta interferon (IFN
      beta) gene. First, we examined the inducibility of artificial DNA binding sites
      that preferentially interact with different homo- or heterodimeric combinations
      of rel proteins in vitro. We found that only those sites capable of binding the
      p50/p65 heterodimer are virus inducible. Second, we analyzed a series of mutant
      rel DNA-binding sites in the context of the intact IFN-beta promoter. We found a
      correlation between (i) sites capable of binding both the p50/p65 heterodimer and
      the high-mobility-group protein HMG I(Y) and (ii) virus inducibility. Third,
      cotransfection of the IFN-beta gene enhancer/promoter with plasmids capable of
      expressing several different rel proteins revealed that only the combination of
      p50 and p65 efficiently activated transcription. Finally, we have used antibodies
      directed against different rel proteins to show that virus-inducible protein-DNA
      complexes assembled on the IFN-beta enhancer in vitro contain both p50 and p65.
      We conclude that the p50/p65 heterodimer is responsible for the NF-kappa B
      dependent activation of the IFN-beta gene promoter in response to virus
      infection.

PMID- 7799922
TI  - Characterization of DNA synthesis and DNA-dependent ATPase activity at a
      restrictive temperature in temperature-sensitive tsFT848 cells with thermolabile
      DNA helicase B.
AB  - A temperature-sensitive mutant defective in DNA replication, tsFT848, was
      isolated from the mouse mammary carcinoma cell line FM3A. In mutant cells, the
      DNA-dependent ATPase activity of DNA helicase B, which is a major DNA-dependent
      ATPase in wild-type cells, decreased at the nonpermissive temperature of 39
      degrees C. DNA synthesis in tsFT848 cells at the nonpermissive temperature was
      analyzed in detail. DNA synthesis measured by incorporation of [3H]thymidine
      decreased to about 50% and less than 10% of the initial level at 8 and 12 h,
      respectively. The decrease in the level of thymidine incorporation correlated
      with a decrease in the number of silver grains in individual nuclei but not with
      the number of cells with labeled nuclei. DNA fiber autoradiography revealed that
      the DNA chain elongation rate did not decrease even after an incubation for 10 h
      at 39 degrees C, suggesting that initiation of DNA replication at the origin of
      replicons is impaired in the mutant cells. The decrease in DNA-synthesizing
      ability coincided with a decrease in the level of the DNA-dependent ATPase
      activity of DNA helicase B. Partially purified DNA helicase B from tsFT848 cells
      was more heat sensitive than that from wild-type cells. Inactivation of DNA
      dependent ATPase activity of DNA helicase B from mutant cells was considerably
      reduced by adding DNA to the medium used for preincubation, indicating that the
      DNA helicase of mutant cells is stabilized by binding to DNA.

PMID- 7799923
TI  - DNA synthesis generally initiates outside the simian virus 40 core origin in
      vitro.
AB  - The nucleotide positions at which DNA synthesis initiates in vitro, in the
      vicinity of the simian virus 40 origin, have been determined. Start sites for DNA
      synthesis are greatly suppressed over the simian virus 40 core origin. Relatively
      weak start sites are detected over the 21-bp repeats and T-antigen-binding site
      I; distal to these regions, stronger start sites are detected. Thus, studies
      using a model system for eukaryotic DNA replication indicate that DNA synthesis
      events initiate, in general, outside the core origin.

PMID- 7799924
TI  - Thymidylate synthase binds to c-myc RNA in human colon cancer cells and in vitro.
AB  - Using an immunoprecipitation-reverse transcription-PCR technique, we
      characterized a thymidylate synthase (TS) ribonucleoprotein complex in cultured
      human colon cancer cells that consists of TS protein and the mRNA of the nuclear
      oncogene c-myc. TS protein is complexed in intact cells with the C-terminal
      coding region of c-myc mRNA that includes nucleotide positions 1625 to 1790. RNA
      electrophoretic gel mobility shift assays confirm a specific interaction between
      TS protein and c-myc mRNA and provide additional evidence that the C-terminal
      coding region represents an important cis-acting regulatory element. Further
      evidence demonstrates that the in vitro translational efficiency of c-myc mRNA is
      inhibited as a result of its direct interaction with TS protein. In addition, the
      presence of exogenous c-myc mRNA specifically relieves the inhibitory effects of
      TS protein on TS mRNA translation.

PMID- 7799925
TI  - Association of p62, a multifunctional SH2- and SH3-domain-binding protein, with
      src family tyrosine kinases, Grb2, and phospholipase C gamma-1.
AB  - src family tyrosine kinases contain two noncatalytic domains termed src homology
      3 (SH3) and SH2 domains. Although several other signal transduction molecules
      also contain tandemly occurring SH3 and SH2 domains, the function of these
      closely spaced domains is not well understood. To identify the role of the SH3
      domains of src family tyrosine kinases, we sought to identify proteins that
      interacted with this domain. By using the yeast two-hybrid system, we identified
      p62, a tyrosine-phosphorylated protein that associates with p21ras GTPase
      activating protein, as a src family kinase SH3-domain-binding protein.
      Reconstitution of complexes containing p62 and the src family kinase p59fyn in
      HeLa cells demonstrated that complex formation resulted in tyrosine
      phosphorylation of p62 and was mediated by both the SH3 and SH2 domains of
      p59fyn. The phosphorylation of p62 by p59fyn required an intact SH3 domain,
      demonstrating that one function of the src family kinase SH3 domains is to bind
      and present certain substrates to the kinase. As p62 contains at least five SH3
      domain-binding motifs and multiple tyrosine phosphorylation sites, p62 may
      interact with other signalling molecules via SH3 and SH2 domain interactions.
      Here we show that the SH3 and/or SH2 domains of the signalling proteins Grb2 and
      phospholipase C gamma-1 can interact with p62 both in vitro and in vivo. Thus, we
      propose that one function of the tandemly occurring SH3 and SH2 domains of src
      family kinases is to bind p62, a multifunctional SH3 and SH2 domain adapter
      protein, linking src family kinases to downstream effector and regulatory
      molecules.

PMID- 7799926
TI  - Gene conversion as a secondary mechanism of short interspersed element (SINE)
      evolution.
AB  - The Alu repetitive family of short interspersed elements (SINEs) in primates can
      be subdivided into distinct subfamilies by specific diagnostic nucleotide
      changes. The older subfamilies are generally very abundant, while the younger
      subfamilies have fewer copies. Some of the youngest Alu elements are absent in
      the orthologous loci of nonhuman primates, indicative of recent retroposition
      events, the primary mode of SINE evolution. PCR analysis of one young Alu
      subfamily (Sb2) member found in the low-density lipoprotein receptor gene
      apparently revealed the presence of this element in the green monkey, orangutan,
      gorilla, and chimpanzee genomes, as well as the human genome. However, sequence
      analysis of these genomes revealed a highly mutated, older, primate-specific Alu
      element was present at this position in the nonhuman primates. Comparison of the
      flanking DNA sequences upstream of this Alu insertion corresponded to evolution
      expected for standard primate phylogeny, but comparison of the Alu repeat
      sequences revealed that the human element departed from this phylogeny. The
      change in the human sequence apparently occurred by a gene conversion event only
      within the Alu element itself, converting it from one of the oldest to one of the
      youngest Alu subfamilies. Although gene conversions of Alu elements are clearly
      very rare, this finding shows that such events can occur and contribute to
      specific cases of SINE subfamily evolution.

PMID- 7799927
TI  - Position-independent transgene expression mediated by boundary elements from the
      apolipoprotein B chromatin domain.
AB  - The human apolipoprotein B (apoB) gene resides within a 47.5-kb chromatin domain
      that is flanked by sequences that bind to the nuclear matrix. These matrix
      attachment regions (MARs) are boundaries between nuclease-sensitive and 
      resistant chromatin. As domain boundaries are thought to function as insulator
      elements, shielding sequences between them from effects of neighboring chromatin,
      this raised the possibility that the apoB MARs have functions that could be
      assayed by transfection. To test this possibility, we examined effects of the
      apoB MARs on transgene expression in transiently and stably transfected rat and
      human hepatoma cells. The apoB MARs had no effects on expression of transiently
      transfected reporters, but they altered expression of stably integrated
      transgenes in dramatic and reproducible ways. Single integrated copies of
      transgenes that contained the apoB promoter and second intron enhancer, which are
      sufficient for high-level expression in transient assays, were expressed at low
      and variable levels in stable transfectant clones. In contrast, transgenes
      containing the apoB 5' and 3' MARs were expressed at levels nearly 200-fold
      higher than levels of the minimal reporters in stable transfectants, and
      expression was position independent. Transgenes that contained the apoB MARs and
      an additional 3.3 kb of apoB 5' flanking sequence were also expressed in an
      elevated, position-independent manner. Surprisingly, tandem transgene arrays in
      multicopy transfectants were transcriptionally inactive. These observations
      suggest that the apoB MARs function as insulator elements, shielding transgene
      expression from effects of neighboring chromatin domains.

PMID- 7799928
TI  - Functional analysis of Met4, a yeast transcriptional activator responsive to S
      adenosylmethionine.
AB  - Transcription of the genes necessary for sulfur amino acid biosynthesis in
      Saccharomyces cerevisiae is dependent on Met4, a transcriptional activator that
      belongs to the basic region-leucine zipper protein family. In this report, we
      show that one mechanism permitting the repression of the sulfur network by S
      adenosylmethionine (AdoMet) involves inhibition of the transcriptional activation
      function of Met4. Using a wide array of deleted LexA-Met4 fusion proteins as well
      as various Gal4-Met4 hybrids, we identify the functional domains of Met4 and
      characterize their relationship. Met4 appears to contain only one activation
      domain, located in its N-terminal part. We demonstrate that this activation
      domain functions in a constitutive manner and that AdoMet responsiveness requires
      a distinct region of Met4. Furthermore, we show that when fused to a heterologous
      activation domain, this inhibitory region confers inhibition by AdoMet. Met4
      contains another distinct functional domain that appears to function as an
      antagonist of the inhibitory region when intracellular AdoMet is low. On the
      basis of the presented results, a model for intramolecular regulation of Met4 is
      proposed.

PMID- 7799931
TI  - The maf proto-oncogene stimulates transcription from multiple sites in a promoter
      that directs Purkinje neuron-specific gene expression.
AB  - L7 is expressed in all adult cerebellar Purkinje cells, although during
      development it appears in a stereotyped spatial and temporal pattern that is
      manifested as parasagittal domains of neurons. Mutations of the L7 promoter in
      transgenic mice have established that these domains represent functional
      compartments of Purkinje neurons. Therefore, it is hoped that by defining the
      transcriptional control of the L7 gene insights into the mechanisms that control
      functional fate and organization in the nervous system can be gained. Fragments
      of the L7 promoter were introduced into a selectable reporter gene in
      Saccharomyces cerevisiae, and these strains were used to select for cerebellar
      cDNAs encoding proteins that can bind to, and activate transcription from, these
      elements. This assay identified the c-Maf proto-oncogene as activating
      transcription from two sites in the L7 promoter. We did a functional domain
      analysis of vertebrate c-Maf based upon transcriptional activation in S.
      cerevisiae and showed the requirement for a transactivation domain, leucine
      zipper, and DNA-binding region in c-Maf. The c-Maf interaction site was mapped to
      the sequence G/TGG/CNG/TNCT CAGNN in the L7 promoter, which represents an
      atypical 12-O-tetradecanoate-13-acetate-responsive element-type Maf-responsive
      element. However, neither Fos nor Jun, either alone or in combination with each
      other or c-Maf, altered transcription from this element. In contrast, a Maf
      related protein, Nrl, completely mimicked c-Maf actions. These data suggest that
      Maf may interact with additional basic-zipper proteins that determine a subtype
      of Maf-responsive element binding.

PMID- 7799930
TI  - Long-range RNA interaction of two sequence elements required for endonucleolytic
      cleavage of human insulin-like growth factor II mRNAs.
AB  - Human insulin-like growth factor II (IGF-II) mRNAs are subject to site-specific
      endonucleolytic cleavage in the 3' untranslated region, leading to an unstable 5'
      cleavage product containing the IGF-II coding region and a very stable 3'
      cleavage product of 1.8 kb. This endonucleolytic cleavage is most probably the
      first and rate-limiting step in degradation of IGF-II mRNAs. Two sequence
      elements within the 3' untranslated region are required for cleavage: element I,
      located approximately 2 kb upstream of the cleavage site, and element II,
      encompassing the cleavage site itself. We have identified a stable double
      stranded RNA stem structure (delta G = -100 kcal/mol [418.4 kJ/mol]) that can be
      formed between element I and a region downstream of the cleavage site in element
      II. This structure is conserved among human, rat, and mouse mRNAs. Detailed
      analysis of the requirements for cleavage shows that the relative position of the
      elements is not essential for cleavage. Furthermore, the distance between the
      coding region and the cleavage site does not affect the cleavage reaction.
      Mutational analysis of the long-range RNA-RNA interaction shows that not only the
      double-stranded character but also the sequence of the stable RNA stem is
      important for cleavage.

PMID- 7799929
TI  - Two domains of p53 interact with the TATA-binding protein, and the adenovirus 13S
      E1A protein disrupts the association, relieving p53-mediated transcriptional
      repression.
AB  - The tumor suppressor gene product p53 can activate and repress transcription.
      Both transcriptional activation and repression are thought to involve the direct
      interaction of p53 with the basal transcriptional machinery. Previous work has
      demonstrated an in vitro interaction between p53 and the TATA-binding protein
      that requires amino acids 20 to 57 of p53 and amino acids 220 to 271 of the TATA
      binding protein. The present results show that a 75-amino-acid segment from the
      carboxy terminus of p53 also can bind to the TATA-binding protein in vitro, and
      this interaction requires amino acids 217 to 268 of the TATA-binding protein,
      essentially the same domain that is required for interaction with the amino
      terminal domain of p53. A carboxy-terminal segment of p53 can mediate repression
      when bound to DNA as a GAL4-p53 fusion protein. The amino- and carboxy-terminal
      p53 interactions occur within the domain on the TATA-binding protein to which the
      adenovirus 13S E1A oncoprotein has previously been shown to bind. The 13S E1A
      oncoprotein can dissociate the complex formed between the carboxy-terminal domain
      of p53 and the TATA-binding protein and relieve p53-mediated transcriptional
      repression. These results demonstrate that two independent domains of p53 can
      potentially interact with the TATA-binding protein, and they define a mechanism-
      relief of repression--by which the 13S E1A oncoprotein can activate transcription
      through the TATA motif.

PMID- 7799932
TI  - Mouse retinoid X receptor contains a separable ligand-binding and transactivation
      domain in its E region.
AB  - Steroid, thyroid, and retinoid hormones exert their biological functions by
      interacting with their cognate nuclear receptors. Upon binding receptors,
      hormones induce a protease-resistant structural change in the receptor ligand
      binding domain and subsequently activate the receptors. Utilizing partial
      proteolysis, we have been able to delineate a region in the mouse retinoid X
      receptor beta (mRXR beta) required for ligand binding. A separable activation
      domain within the mRXR beta E region has been identified. The activation domain,
      which is 21 amino acids in length, is located at the extreme C terminus of mRXR
      beta. This domain is not required for ligand binding since removal of this
      sequence neither eliminates the ligand-induced, protease-resistant conformational
      change nor alters the ligand-enhanced DNA binding. Furthermore, deletion of this
      activation domain converts the receptor into a transcriptional silencer. Finally,
      a further truncation of 9 amino acids (for a total of 30 amino acids) from the C
      terminus results in a mutant which does not undergo the protease-resistant
      conformational change and cannot bind DNA as a homodimer. Nevertheless, this
      mutant is still able to form a heterodimer with the thyroid hormone receptor.
      Therefore, homodimerization and heterodimerization can be distinguished by this
      nine-amino-acid sequence.

PMID- 7799933
TI  - Mouse mammary tumor virus chromatin in human breast cancer cells is
      constitutively hypersensitive and exhibits steroid hormone-independent loading of
      transcription factors in vivo.
AB  - We have stably introduced a reporter gene under the control of the mouse mammary
      tumor virus (MMTV) long terminal repeat (LTR) into human T47D breast cancer cells
      to study the action of the progesterone receptor (PR) on transcription from a
      chromatin template. Unexpectedly, the chromatin organization of the MMTV LTR in
      these human breast cancer cells differed markedly from what we have observed
      previously. The region adjacent to the transcription start site (-221 to -75) was
      found to be constitutively hypersensitive to restriction enzyme cleavage in the
      absence of hormone. This region is normally encompassed within the second
      nucleosome of a phased array of six nucleosomes that is assembled when the MMTV
      LTR is stably maintained in mouse cells. Characteristically, in these rodent
      cells, the identical DNA sequences show increased restriction enzyme cleavage
      only in the presence of glucocorticoid. The increased access of restriction
      enzymes observed in the human PR+ cells was not observed in adjacent nucleosomes
      and was unaffected by treatment with the progesterone antagonist RU486. In
      addition, exonuclease III-dependent stops corresponding to the binding sites for
      nuclear factor 1 and the PR were observed before and after hormone treatment.
      These results indicate that MMTV chromatin replicated in these cells is organized
      into a constitutively open architecture and that this open chromatin state is
      accompanied by hormone-independent loading of a transcription factor complex that
      is normally excluded from uninduced chromatin.

PMID- 7799934
TI  - Cloning and characterization of FAD1, the structural gene for flavin adenine
      dinucleotide synthetase of Saccharomyces cerevisiae.
AB  - The FAD1 gene of Saccharomyces cerevisiae has been selected from a genomic
      library on the basis of its ability to partially correct the respiratory defect
      of pet mutants previously assigned to complementation group G178. Mutants in this
      group display a reduced level of flavin adenine dinucleotide (FAD) and an
      increased level of flavin mononucleotide (FMN) in mitochondria. The restoration
      of respiratory capability by FAD1 is shown to be due to extragenic suppression.
      FAD1 codes for an essential yeast protein, since disruption of the gene induces a
      lethal phenotype. The FAD1 product has been inferred to be yeast FAD synthetase,
      an enzyme that adenylates FMN to FAD. This conclusion is based on the following
      evidence. S. cerevisiae transformed with FAD1 on a multicopy plasmid displays an
      increase in FAD synthetase activity. This is also true when the gene is expressed
      in Escherichia coli. Lastly, the FAD1 product exhibits low but significant
      primary sequence similarity to sulfate adenyltransferase, which catalyzes a
      transfer reaction analogous to that of FAD synthetase. The lower mitochondrial
      concentration of FAD in G178 mutants is proposed to be caused by an inefficient
      exchange of external FAD for internal FMN. This is supported by the absence of
      FAD synthetase activity in yeast mitochondria and the presence of both
      extramitochondrial and mitochondrial riboflavin kinase, the preceding enzyme in
      the biosynthetic pathway. A lesion in mitochondrial import of FAD would account
      for the higher concentration of mitochondrial FMN in the mutant if the transport
      is catalyzed by an exchange carrier. The ability of FAD1 to suppress impaired
      transport of FAD is explained by mislocalization of the synthetase in cells
      harboring multiple copies of the gene. This mechanism of suppression is supported
      by the presence of mitochondrial FAD synthetase activity in S. cerevisiae
      transformed with FAD1 on a high-copy-number plasmid but not in mitochondrial of a
      wild-type strain.

PMID- 7799936
TI  - An XPG DNA repair defect causing mutagen hypersensitivity in mouse leukemia L1210
      cells.
AB  - One of the most widely used antitumor drugs is cis-diamminedichloroplatinum(II)
      (cisplatin), and mechanisms of cisplatin resistance have been investigated in
      numerous model systems. Many studies have used mouse leukemia L1210/0 as a
      reference wild-type cell line, and cisplatin-resistant subclones have been
      derived from it. Increased DNA excision repair capacity is thought to play a key
      role in the acquired cisplatin resistance, and this has influenced development of
      drugs for clinical trials. We report here that the L1210/0 line is in fact
      severely deficient in nucleotide excision repair of damaged DNA in vivo and in
      vitro. L1210/0 cell extracts could be complemented by extracts from repair
      defective human xeroderma pigmentosum (XP) or rodent excision repair cross
      complementing (ERCC) mutant cells, except for XPG/ERCC5 mutants. Purified XPG
      protein could restore repair proficiency to L1210/0 extracts. Expression of mouse
      XPG mRNA was similar in all L1210 lines studied, suggesting a point mutation or
      small alteration of XPG in L1210/0 cells. The DNA repair capacity of a cisplatin
      resistant subline, L1210/DDP10, is similar to that of type culture collection
      L1210 cells and to those of other normal mammalian cell lines. Nucleotide
      excision repair of DNA is thus clearly important in the intrinsic cellular
      defense against cisplatin. However, in contrast to what is generally believed,
      enhancement of DNA repair above the normal level in these rodent cells does not
      appear to be a mechanism of acquired resistance to the drug.

PMID- 7799937
TI  - Pulling the ribosome out of frame by +1 at a programmed frameshift site by
      cognate binding of aminoacyl-tRNA.
AB  - Programmed translational frameshifts efficiently alter a translational reading
      frame by shifting the reading frame during translation. A +1 frameshift has two
      simultaneous requirements: a translational pause which occurs when either an
      inefficiently recognized sense or termination codon occupies the A site, and the
      presence of a special peptidyl-tRNA occupying the P site during the pause. The
      special nature of the peptidyl-tRNA reflects its ability to slip +1 on the mRNA
      or to facilitate binding of an incoming aminoacyl-tRNA out of frame in the A
      site. This second mechanism suggested that in some cases the first +1 frame tRNA
      could have an active role in frameshifting. We found that overproducing this tRNA
      can drive frameshifting, surprisingly regardless of whether frameshifting occurs
      by peptidyl-tRNA slippage or out-of-frame binding of aminoacyl-tRNA. This finding
      suggests that in both cases, the shift in reading frame occurs coincident with
      formation of a cognate codon-anticodon interaction in the shifted frame.

PMID- 7799935
TI  - Affinity enrichment and functional characterization of TRAX1, a novel
      transcription activator and X1-sequence-binding protein of HLA-DRA.
AB  - The promoters of all class II major histocompatibility (MHC) genes contain a
      positive regulatory motif, the X element. The DNA-binding proteins specific for
      this element are presumed to play a critical role in gene expression, although
      there is a paucity of functional studies supporting this role. In this study, the
      X-box-binding proteins of HLA-DRA were affinity purified from HeLa nuclear
      extracts. Fractions 46 to 48 contained an X-box-binding activity and were
      determined by electrophoretic mobility shift assays to be specific for the X1
      element. This X1 sequence-binding-protein, transcriptional activator X1 (TRAX1),
      was shown to be a specific transcriptional activator of the HLA-DRA promoter in
      an in vitro transcription assay. By UV cross-linking analysis, the approximate
      molecular mass of TRAX1 including the bound DNA was determined to be 40 kDa. When
      the TRAX1 complex was incubated with antibodies against a known recombinant X-box
      binding protein, RFX1, and tested in electrophoretic mobility shift assays, TRAX1
      was neither shifted nor blocked by the antibody. Further analysis with
      methylation interference showed that TRAX1 bound to the 5' end of the X1 sequence
      at -109 and -108 and created hypersensitive sites at -114, -113, and -97. This
      methylation interference pattern is distinct from those of the known X1-binding
      proteins RFX1, RFX, NF-Xc, and NF-X. Taken together, our results indicate that
      TRAX1 is a novel X1-sequence-binding protein and transcription activator of HLA
      DRA.

PMID- 7799939
TI  - A new platelet-derived growth factor-regulated genomic element which binds a
      serine/threonine phosphoprotein mediates induction of the slow immediate-early
      gene MCP-1.
AB  - The MCP-1 chemokine gene belongs to a cohort of immediate-early genes that are
      induced with slower kinetics than c-fos. In this study, we identified a cluster
      of four platelet-derived growth factor (PDGF)-responsive elements within a 240-bp
      enhancer found in the distal 5' flanking MCP-1 sequences. Two of the elements
      bind one or more forms of the transcription factor NF-kappa B. We focused on the
      other two elements which are hitherto unreported, PDGF-regulated genomic motifs.
      One of these novel elements, detected as a 28-mer by DNase I footprinting,
      restores PDGF inducibility when added in two copies to a 5' truncated MCP-1 gene.
      A single copy of the second novel element, a 27-mer, restores PDGF inducibility
      to a 5' truncated MCP-1 gene. The 27-base element interacts with a PDGF-activated
      serine/threonine phosphoprotein that is detected only within the nucleus of PDGF
      treated 3T3 cells. DNA binding of this phosphoprotein is activated by PDGF
      treatment with slow kinetics that match the time course of MCP-1 gene expression,
      and activation is not inhibited by cycloheximide. PDGF-activated binding to the
      27-mer is shown to involve a single 30-kDa protein by UV-cross-linking analysis.

PMID- 7799938
TI  - Irreversible repression of DNA synthesis in Fanconi anemia cells is alleviated by
      the product of a novel cyclin-related gene.
AB  - Primary fibroblasts from patients with the genetic disease Fanconi anemia, which
      are hypersensitive to cross-linking agents, were used to screen a cDNA library
      for sequences involved in their abnormal cellular response to a cross-linking
      challenge. By using library partition and microinjection of in vitro-transcribed
      RNA, a cDNA clone, pSPHAR (S-phase response), which is able to correct the
      permanent repression of semiconservative DNA synthesis rates characteristic of
      these cells, was isolated. Wild-type SPHAR mRNA is expressed in all fibroblasts
      so far analyzed, including those of Fanconi anemia patients. Correction of the
      abnormal response in these cells appears therefore to be due to overexpression
      after cDNA transfer rather than to genetic complementation. The cDNA contains an
      open reading frame coding for a polypeptide of 7.5 kDa. Rabbit antiserum directed
      against a SPHAR peptide detects a protein of 7.9 kDa in Western blots
      (immunoblots) of whole-cell extracts from proliferating, but not resting,
      fibroblasts. The deduced amino acid sequence of SPHAR contains a motif found in
      the cyclins, and it is proposed that SPHAR acts within the injected cell by
      interfering with the cyclin-controlled maintenance of S phase. In agreement with
      this proposal, normal cells transfected with an antisense SPHAR expression vector
      have a significantly reduced rate of DNA synthesis during S phase and a prolonged
      G2 phase, reflecting the need for postreplicative DNA processing before entry
      into mitosis.

PMID- 7799940
TI  - The Rb-related p107 protein can suppress E2F function independently of binding to
      cyclin A/cdk2.
AB  - The interaction of the retinoblastoma susceptibility gene product (Rb)-related
      p107 protein with the E2F transcription factor in S-phase cells facilitates the
      formation of a multicomponent complex also containing cyclin A and the p33cdk2
      kinase. We have created a series of p107 mutants to assess the ability of p107 to
      inhibit E2F function and the role of the cyclin A/cdk2 complex in this process.
      We find that p107 mutants that do not bind to E2F also fail to repress E2F
      dependent transcription. Moreover, we find that the ability of p107 to suppress
      E2F-dependent transcription is not dependent on the ability of p107 to associate
      with cyclin A/cdk2. Finally, an analysis of the ability of the p107 mutant
      proteins to suppress cell growth suggests that both E2F-dependent and E2F
      independent events correlate with this activity.

PMID- 7799941
TI  - Effects of phosphorylation by CAK on cyclin binding by CDC2 and CDK2.
AB  - The cyclin-dependent protein kinases (CDKs) are activated by association with
      cyclins and by phosphorylation at a conserved threonine residue by the CDK
      activating kinase (CAK). We have studied the binding of various human CDK and
      cyclin subunits in vitro, using purified proteins derived from baculovirus
      infected insect cells. We find that most CDK-cyclin complexes known to exist in
      human cells (CDC2-cyclin B, CDK2-cyclin A, and CDK2-cyclin E) form with high
      affinity in the absence of phosphorylation or other cellular components. One
      complex (CDC2-cyclin A) forms with high affinity only after CAK-mediated
      phosphorylation of CDC2 at the activating threonine residue. CDC2 does not bind
      with high affinity to cyclin E in vitro, even after phosphorylation of the CDC2
      subunit. Thus, phosphorylation is of varying importance in the formation of high
      affinity CDK-cyclin complexes.

PMID- 7799942
TI  - Alternative translation of human fibroblast growth factor 2 mRNA occurs by
      internal entry of ribosomes.
AB  - Alternative initiations of translation of the human fibroblast growth factor 2
      (FGF-2) mRNA, at three CUG start codons and one AUG start codon, result in the
      synthesis of four isoforms of FGF-2. This process has important consequences on
      the fate of FGF-2: the CUG-initiated products are nuclear and their constitutive
      expression is able to induce cell immortalization, whereas the AUG-initiated
      product, mostly cytoplasmic, can generate cell transformation. Thus, the
      different isoforms probably have distinct targets in the cell. We show here that
      translation initiation of the FGF-2 mRNA breaks the rule of the cap-dependent
      ribosome scanning mechanism. First, translation of the FGF-2 mRNA was shown to be
      cap independent in vitro. This cap-independent translation required a sequence
      located between nucleotides (nt) 192 and 256 from the 5' end of the 318-nt-long
      5' untranslated region. Second, expression of bicistronic vectors in COS-7 cells
      indicated that the FGF-2 mRNA is translated through a process of internal
      ribosome entry mediated by the mRNA leader sequence. By introducing additional
      AUG codons into the RNA leader sequence, we localized an internal ribosome entry
      site to between nt 154 and 318 of the 5' untranslated region, just upstream of
      the first CUG. The presence of an internal ribosome entry site in the FGF-2 mRNA
      suggests that the process of internal translation initiation, by controlling the
      expression of a growth factor, could have a crucial role in the control of cell
      proliferation and differentiation.

PMID- 7799943
TI  - PPAR gamma 2 regulates adipose expression of the phosphoenolpyruvate
      carboxykinase gene.
AB  - Phosphoenolpyruvate carboxykinase (PEPCK) is expressed at high levels in liver,
      kidney, and adipose tissue. This enzyme catalyzes the rate-limiting step in
      hepatic and renal gluconeogenesis and adipose glyceroneogenesis. The regulatory
      factors important for adipose expression of the PEPCK gene are not well defined.
      Previous studies with transgenic mice established that the region between bp 
      2086 and -888 is required for expression in adipose tissue but not for expression
      in liver or kidney tissue. We show here that a DNA fragment containing this
      region can function as an enhancer and direct differentiation-dependent
      expression of a chloramphenicol acetyltransferase gene from a heterologous
      promoter in cultured 3T3-F442A preadipocytes and adipocytes. We further
      demonstrate that the adipocyte-specific transcription factor PPAR gamma 2,
      previously identified as a regulator of the adipocyte P2 enhancer, binds in a
      heterodimeric complex with RXR alpha to the PEPCK 5'-flanking region at two
      sites, termed PCK1 (bp -451 to -439) and PCK2 (bp -999 to -987). Forced
      expression of PPAR gamma 2 and RXR alpha activates the PEPCK enhancer in non
      adipose cells. This activation is potentiated by peroxisome proliferators and
      fatty acids but not by 9-cis retinoic acid. Mutation of the PPAR gamma 2 binding
      site (PCK2) abolishes both the activity of the enhancer in adipocytes and its
      ability to be activated by PPAR gamma 2 and RXR alpha. These results establish a
      role for PPAR gamma 2 in the adipose expression of the PEPCK gene and suggest
      that this factor functions as a coordinate regulator of multiple adipocyte
      specific genes.

PMID- 7799944
TI  - Two functionally distinct RNA-binding motifs in the regulatory domain of the
      protein kinase DAI.
AB  - The RNA-binding domain of the protein kinase DAI, the double-stranded RNA
      inhibitor of translation, contains two repeats of a motif that is also found in a
      number of other RNA-binding proteins. This motif consists of 67 amino acid
      residues and is predicted to contain a positively charged alpha helix at its C
      terminus. We have analyzed the effects of equivalent single amino acid changes in
      three conserved residues distributed over each copy of the motif. Mutants in the
      C-terminal portion of either repeat were severely defective, indicating that both
      copies of the motif are essential for RNA binding. Changes in the N-terminal and
      central parts of the motif were more debilitating if they were made in the first
      motif than in the second, suggesting that the first motif is the more important
      for RNA binding and that the second motif is structurally more flexible. When the
      second motif was replaced by a duplicate of the first motif, the ectopic copy
      retained its greater sensitivity to mutation, implying that the two motifs have
      distinct functions with respect to the process of RNA binding. Furthermore, the
      mutations have the same effect on the binding of double-stranded RNA and VA RNA,
      consistent with the existence of a single RNA-binding domain for both activating
      and inhibitory RNAs.

PMID- 7799945
TI  - Structural requirements for double-stranded RNA binding, dimerization, and
      activation of the human eIF-2 alpha kinase DAI in Saccharomyces cerevisiae.
AB  - The protein kinase DAI is activated upon viral infection of mammalian cells and
      inhibits protein synthesis by phosphorylation of the alpha subunit of translation
      initiation factor 2 (eIF-2 alpha). DAI is activated in vitro by double-stranded
      RNAs (dsRNAs), and binding of dsRNA is dependent on two copies of a conserved
      sequence motif located N terminal to the kinase domain in DAI. High-level
      expression of DAI in Saccharomyces cerevisiae cells is lethal because of
      hyperphosphorylation of eIF-2 alpha; at lower levels, DAI can functionally
      replace the protein kinase GCN2 and stimulate translation of GCN4 mRNA. These two
      phenotypes were used to characterize structural requirements for DAI function in
      vivo, by examining the effects of amino acid substitutions at matching positions
      in the two dsRNA-binding motifs and of replacing one copy of the motif with the
      other. We found that both copies of the dsRNA-binding motif are required for high
      level kinase function and that the N-terminal copy is more important than the C
      terminal copy for activation of DAI in S. cerevisiae. On the basis of these
      findings, we conclude that the requirements for dsRNA binding in vitro and for
      activation of DAI kinase function in vivo closely coincide. Two mutant alleles
      containing deletions of the first or second binding motif functionally
      complemented when coexpressed in yeast cells, strongly suggesting that the active
      form of DAI is a dimer. In accord with this conclusion, overexpression of four
      catalytically inactive alleles containing different deletions in the protein
      kinase domain interfered with wild-type DAI produced in the same cells.
      Interestingly, three inactivating point mutations in the kinase domain were all
      recessive, suggesting that dominant interference involves the formation of
      defective heterodimers rather than sequestration of dsRNA activators by mutant
      enzymes. We suggest that large structural alterations in the kinase domain impair
      an interaction between the two protomers in a DAI dimer that is necessary for
      activation by dsRNA or for catalysis of eIF-2 alpha phosphorylation.

PMID- 7799947
TI  - ST-1, a 39-kilodalton protein in Trypanosoma brucei, exhibits a dual affinity for
      the duplex form of the 29-base-pair subtelomeric repeat and its C-rich strand.
AB  - In our attempt to identify telomere region-binding proteins in Trypanosoma
      brucei, we identified ST-1, a polypeptide with novel features. ST-1 was
      chromatographically purified from S-100 cell extracts and was renatured from a
      sodium dodecyl sulfate-protein gel as a 39-kDa polypeptide. It forms a specific
      complex with the trypanosome telomere repeats of TTAGGG, but more significantly,
      it shows a higher affinity for the 29-bp subtelomere repeats of T. brucei. These
      29-mer boxes are a large tandem series of telomere-derived repeats which separate
      the simple telomere DNA from middle-repetitive telomere-associated sequences on
      many chromosomes. ST-1 is the first example of a protein binding within such
      large repetitive subtelomere elements in trypanosomes or other organisms. ST-1 is
      also novel in that it has a selective affinity for the C-rich strands of both the
      subtelomeric 29-mer and the telomere repeats, comparable to that for the duplex
      form of the respective repeats. All previously described telomere-binding
      proteins have affinity for only the duplex form or for the G-rich strand. This C
      rich strand binding specificity of ST-1 may provide insight into this protein's
      mechanism of binding in vivo.

PMID- 7799946
TI  - A dominant-negative mutant of mSOS1 inhibits insulin-induced Ras activation and
      reveals Ras-dependent and -independent insulin signaling pathways.
AB  - The role of the Grb2-SOS complex in insulin signal transduction was investigated
      with a deletion mutant of mSOS1 that lacks the guanine nucleotide exchange domain
      of the wild-type protein. Cells over-expressing either wild-type (CHO-IR/SOS
      cells) or mutant (CHO-IR/delta SOS cells) mSOS1 were established by transfection
      of Chinese hamster ovary cells that express human insulin receptors (CHO-IR
      cells) with the appropriate expression plasmid. The mutant mSOS1 protein did not
      contain the guanine nucleotide exchange activity in vitro and associated with
      Grb2 both in vivo and in vitro. In both CHO-IR and CHO-IR/SOS cells, insulin
      rapidly stimulated the formation of GTP-bound Ras and the phosphorylation of
      mitogen-activated protein (MAP) kinase; both these effects of insulin were
      markedly inhibited in CHO-IR/delta SOS cells. Insulin-induced glycogen synthase
      and 70-kDa S6 kinase activities were not affected by expression of either wild
      type or mutant mSOS1. These results show that the mutant mSOS1 acts in a dominant
      negative manner and suggest that the Grb2-SOS complex mediates, at least in part,
      insulin-induced activation of Ras in intact cells. The data also indicate that
      Ras activation is not required for insulin-induced stimulation of glycogen
      synthase and 70-kDa S6 kinase.

PMID- 7799949
TI  - Expression of the chicken beta-globin gene cluster in mice: correct developmental
      expression and distributed control.
AB  - To investigate the regulation of gene clusters, we introduced the entire chicken
      beta-globin cluster into mice. This 35-kb region includes the four globin genes
      (rho-beta H-beta A-epsilon), the four upstream hypersensitive sites, and the
      intergenic beta A/epsilon enhancer. The chicken globins are not arranged in order
      of developmental expression, which is unlike the case for the human beta-globin
      cluster, in which gene order plays a role in the regulation of globin expression.
      Mice carrying the chicken cluster expressed the transgenes with the same
      developmental patterns as seen in the chicken. Therefore, stage-specific
      erythroid transcriptional milieus existed before the divergence of birds and
      mammals and have been conserved since then. Mice bearing the complete cluster
      except for a deletion removing the beta A/epsilon enhancer displayed markedly
      reduced expression of the beta H, beta A, and epsilon genes with efficient (but
      variable) rho expression. Mice carrying the four genes and beta A/epsilon
      enhancer but without the upstream hypersensitive sites showed reduced expression
      of rho, beta H, and beta A, with variable expression of epsilon. We conclude that
      (i) all of the genes (except possibly rho) are under the control of both the
      upstream hypersensitive sites and the enhancer, (ii) the influence of the control
      elements can extend beyond the nearest active gene, (iii) a single element (the
      enhancer) can influence more than one gene in a single developmental stage, (iv)
      the enhancer can work bidirectionally, and (v) neither the upstream sites (as a
      group) nor the enhancer showed developmental stage specificity. Thus, the
      regulation of this cluster is achieved by interaction of two distinct control
      regions with each of the globin genes.

PMID- 7799948
TI  - Raf-1 N-terminal sequences necessary for Ras-Raf interaction and signal
      transduction.
AB  - Raf-1 is a serine/threonine protein kinase that transduces signals from cell
      surface receptors to the nucleus. Interaction of Ras with a regulatory domain in
      the N-terminal half of Raf-1 is postulated to regulate Raf-1 protein kinase and
      signaling activities. To better understand molecular interactions of Ras with Raf
      1 and regulation of the Raf-1 kinase, a panel of Raf-1 N-terminal mutants
      expressed in the baculovirus-insect cell system was used for mapping the precise
      region necessary for Ras interaction in the context of full-length, functional
      Raf-1 kinase. An 80-amino-acid sequence in Raf-1 between positions 53 and 132 was
      found to confer the ability to bind Ras protein in vitro and in infected insect
      cells. Deletion of residues 53 to 132 abolished Raf-1 kinase activation by Ras in
      insect cells, indicating that activation of the Raf-1 kinase by Ras requires the
      capacity to physically interact with Ras. By contrast, deletion of this Ras
      binding site did not diminish activation of Raf-1 kinase by Src, implying that
      Src and Ras can activate Raf-1 through independent mechanisms. Significantly, Raf
      1 mutants lacking the entire zinc finger motif or containing substitutions of two
      critical cysteine residues in the zinc finger retained the ability to bind Ras
      and to be activated by this interaction. Consistent with results obtained in the
      baculovirus-insect cell system, deletion of residues 53 to 132 but not mutations
      in the zinc finger motif abrogated the ability of kinase-inactive, dominant
      negative Raf-1 to block Ras-mediated signaling in Xenopus oocytes. Together,
      these results provide evidence that the direct physical interaction of Ras with
      Raf-1 amino acids 53 to 132 is required for activation of the Raf-1 kinase and
      signaling activities by Ras but not by Src. Furthermore, the adjacent zinc finger
      motif in Raf-1 is not essential either for interaction with Ras or for activation
      of the Raf-1 kinase.

PMID- 7799950
TI  - Impaired cyclic AMP-dependent phosphorylation renders CREB a repressor of C/EBP
      induced transcription of the somatostatin gene in an insulinoma cell line.
AB  - Transcription factor CREB regulates cyclic AMP (cAMP)-dependent gene expression
      by binding to and activating transcription from cAMP response elements (CREs) in
      the promoters of target genes. The transcriptional transactivation functions of
      CREB are activated by its phosphorylation by cAMP-dependent protein kinase A
      (PKA). In studies of many different phenotypically distinct cells, the CRE of the
      somatostatin gene promoter is a prototype of a highly cAMP-responsive element
      regulated by CREB. We now report on a somatostatin-producing rat insulinoma cell
      line, RIN-1027-B2, in which transcription from the somatostatin gene promoter is
      paradoxically repressed by CREB. We find that CREB fails to transactivate a CRE
      containing somatostatin-chloramphenicol acetyltransferase reporter even when
      coexpressed with the catalytic subunit of PKA. CAAT box/enhancer-binding protein
      beta (C/EBP beta) and C/EBP-related activating transcription factor bind to the
      CRE in the promoter of the somatostatin gene and transactivate transcription.
      CREB binds competitively with C/EBP beta to the somatostatin CRE in vitro and
      represses C/EBP beta-induced transcription of the CRE-containing somatostatin
      chloramphenicol acetyltransferase reporter. The lack of CREB-mediated
      transcriptional stimulation is due to the presence of a heat-stable inhibitor of
      PKA that prevents activation of PKA and subsequent CREB phosphorylation in the
      nucleus. These findings indicate that dephosphorylated CREB is a negative
      regulator of C/EBP-activated transcription of the somatostatin gene promoter in
      RIN-1027-B2 cells.

PMID- 7799951
TI  - Spontaneous in vitro immortalization of breast epithelial cells from a patient
      with Li-Fraumeni syndrome.
AB  - Individuals with germ line mutations in the p53 gene, such as Li-Fraumeni
      syndrome (LFS), have an increased occurrence of many types of cancer, including
      an unusually high incidence of breast cancer. This report documents that normal
      breast epithelial cells obtained from a patient with LFS (with a mutation at
      codon 133 of the p53 gene) spontaneously immortalized in cell culture while the
      breast stromal fibroblasts from this same patient did not. Spontaneous
      immortalization of human cells in vitro is an extremely rare event. This is the
      first documented case of the spontaneous immortalization of breast epithelial
      cells from a patient with LFS in culture. LFS patient breast stromal fibroblasts
      infected with a retroviral vector containing human papillomavirus type 16 E7
      alone were able to immortalize, whereas stromal cells obtained from patients with
      wild-type p53, similarly infected with human papillomavirus type 16 E7, did not.
      The present results indicate a protective role of normal pRb-like functions in
      breast stromal fibroblasts but not in breast epithelial cells and reinforces an
      important role of wild-type p53 in the regulation of the normal growth and
      development of breast epithelial tissue.

PMID- 7799954
TI  - Analysis of biological selections for high-efficiency gene targeting.
AB  - A two-marker selection system that allows the efficient isolation of diploid gene
      knockouts by two sequential rounds of targeted homologous recombination has been
      developed. A systematic evaluation of the biological parameters that govern the
      selection process showed that a successful strategy must match the expression
      level of the target gene, the efficacy of the marker, and the selection
      stringency. An enrichment ratio of 5,000- to 10,000-fold, which resulted in a 30%
      targeting efficiency of the c-myc gene in a fibroblast cell line, has been
      achieved. Such efficiency brings the difficulty of gene targeting effectively
      down to the level of simple transfections, since only 10 to 20 drug-resistant
      clones need to be screened to recover several homologous hits. The general
      utility of the targeting strategy is of interest to investigators studying gene
      function in a large variety of mammalian tissue culture systems.

PMID- 7799953
TI  - Structurally related but functionally distinct yeast Sm D core small nuclear
      ribonucleoprotein particle proteins.
AB  - Spliceosome assembly during pre-mRNA splicing requires the correct positioning of
      the U1, U2, U4/U6, and U5 small nuclear ribonucleoprotein particles (snRNPs) on
      the precursor mRNA. The structure and integrity of these snRNPs are maintained in
      part by the association of the snRNAs with core snRNP (Sm) proteins. The Sm
      proteins also play a pivotal role in metazoan snRNP biogenesis. We have
      characterized a Saccharomyces cerevisiae gene, SMD3, that encodes the core snRNP
      protein Smd3. The Smd3 protein is required for pre-mRNA splicing in vivo.
      Depletion of this protein from yeast cells affects the levels of U snRNAs and
      their cap modification, indicating that Smd3 is required for snRNP biogenesis.
      Smd3 is structurally and functionally distinct from the previously described
      yeast core polypeptide Smd1. Although Smd3 and Smd1 are both associated with the
      spliceosomal snRNPs, overexpression of one cannot compensate for the loss of the
      other. Thus, these two proteins have distinct functions. A pool of Smd3 exists in
      the yeast cytoplasm. This is consistent with the possibility that snRNP assembly
      in S. cerevisiae, as in metazoans, is initiated in the cytoplasm from a pool of
      RNA-free core snRNP protein complexes.

PMID- 7799952
TI  - The serum response factor nuclear localization signal: general implications for
      cyclic AMP-dependent protein kinase activity in control of nuclear translocation.
AB  - We have identified a basic sequence in the N-terminal region of the 67-kDa serum
      response factor (p67SRF or SRF) responsible for its nuclear localization. A
      peptide containing this nuclear localization signal (NLS) translocates rabbit
      immunoglobulin G (IgG) into the nucleus as efficiently as a peptide encoding the
      simian virus 40 NLS. This effect is abolished by substituting any two of the four
      basic residues in this NLS. Overexpression of a modified form of SRF in which
      these basic residues have been mutated confirms the absolute requirement for this
      sequence, and not the other basic amino acid sequences adjacent to it, in the
      nuclear localization of SRF. Since this NLS is in close proximity to potential
      phosphorylation sites for the cAMP-dependent protein kinase (A-kinase), we
      further investigated if A-kinase plays a role in the nuclear location of SRF. The
      nuclear transport of SRF proteins requires basal A-kinase activity, since
      inhibition of A-kinase by using either the specific inhibitory peptide PKIm or
      type II regulatory subunits (RII) completely prevents the nuclear localization of
      plasmid-expressed tagged SRF or an SRF-NLS-IgG conjugate. Direct phosphorylation
      of SRF by A-kinase can be discounted in this effect, since mutation of the
      putative phosphorylation sites in either the NLS peptide or the encoded full
      length SRF protein had no effect on nuclear transport of the mutants. Finally, in
      support of an implication of A-kinase-dependent phosphorylation in a more general
      mechanism affecting nuclear import, we show that the nuclear transport of a
      simian virus 40-NLS-conjugated IgG or purified cyclin A protein is also blocked
      by inhibition of A-kinase, even though neither contains any potential sites for
      phosphorylation by A-kinase or can be phosphorylated by A-kinase in vitro.

PMID- 7799955
TI  - Nucleolin is a matrix attachment region DNA-binding protein that specifically
      recognizes a region with high base-unpairing potential.
AB  - A DNA affinity column containing a synthetic double-stranded nuclear matrix
      attachment region (MAR) was used to purify a 100-kDa protein from human
      erythroleukemia K562 cells. This protein was identified as nucleolin, the key
      nucleolar protein of dividing cells, which is thought to control rRNA gene
      transcription and ribosome assembly. Nucleolin is known to bind RNA and single
      stranded DNA. We report here that nucleolin is also a MAR-binding protein. It
      binds double-stranded MARs from different species with high affinity. Nucleolin
      effectively distinguishes between a double-stranded wild-type synthetic MAR
      sequence with a high base-unpairing potential and its mutated version that has
      lost the unpairing capability but is still A+T rich. Thus, nucleolin is not
      merely an A+T-rich sequence-binding protein but specifically binds the base
      unpairing region of MARs. This binding specificity is similar to that of the
      previously cloned tissue-specific MAR-binding protein SATB1. Unlike SATB1, which
      binds only double-stranded MARs, nucleolin binds the single-stranded T-rich
      strand of the synthetic MAR probe approximately 45-fold more efficiently than its
      complementary A-rich strand, which has an affinity comparable to that of the
      double-stranded form of the MAR. In contrast to the high selectivity of binding
      to double-stranded MARs, nucleolin shows only a small but distinct sequence
      preference for the T-rich strand of the wild-type synthetic MAR over the T-rich
      strand of its mutated version. The affinity to the T-rich synthetic MAR is
      severalfold higher than to its corresponding RNA and human telomere DNA.
      Quantitative cellular fractionation and extraction experiments indicate that
      nucleolin is present both as a soluble protein and tightly bound to the matrix,
      similar to other known MAR-binding proteins.

PMID- 7799957
TI  - Identification of a ras-activated enhancer in the mouse osteopontin promoter and
      its interaction with a putative ETS-related transcription factor whose activity
      correlates with the metastatic potential of the cell.
AB  - The role of RAS in transducing signals from an activated receptor into altered
      gene expression is becoming clear, though some links in the chain are still
      missing. Cells possessing activated RAS express higher levels of osteopontin
      (OPN), an alpha v beta 3 integrin-binding secreted phosphoprotein implicated in a
      number of developmental, physiological, and pathological processes. We report
      that in T24 H-ras-transformed NIH 3T3 cells enhanced transcription contributes to
      the increased expression of OPN. Transient transfection studies, DNA-protein
      binding assays, and methylation protection experiments have identified a novel
      ras-activated enhancer, distinct from known ras response elements, that appears
      responsible for part of the increase in OPN transcription in cells with an
      activated RAS. In electrophoretic mobility shift assays, the protein-binding
      motif GGAGGCAGG was found to be essential for the formation of several complexes,
      one of which (complex A) was generated at elevated levels by cell lines that are
      metastatic. Southwestern blotting and UV light cross-linking studies indicated
      the presence of several proteins able to interact with this sequence. The
      proteins that form these complexes have molecular masses estimated at
      approximately 16, 28, 32, 45, 80, and 100 kDa. Because the approximately 16-kDa
      protein was responsible for complex A formation, we have designated it MATF for
      metastasis-associated transcription factor. The GGANNNAGG motif is also found in
      some other promoters, suggesting that they may be similarly controlled by MATF.

PMID- 7799956
TI  - Ras-dependent and -independent pathways target the mitogen-activated protein
      kinase network in macrophages.
AB  - Mitogen-activated protein kinases (MAPKs) are activated upon a variety of
      extracellular stimuli in different cells. In macrophages, colony-stimulating
      factor 1 (CSF-1) stimulates proliferation, while bacterial lipopolysaccharide
      (LPS) inhibits cell growth and causes differentiation and activation. Both CSF-1
      and LPS rapidly activate the MAPK network and induce the phosphorylation of two
      distinct ternary complex factors (TCFs), TCF/Elk and TCF/SAP. CSF-1, but not LPS,
      stimulated the formation of p21ras. GTP complexes. Expression of a dominant
      negative ras mutant reduced, but did not abolish, CSF-1-mediated stimulation of
      MEK and MAPK. In contrast, activation of the MEK kinase Raf-1 was Ras
      independent. Treatment with the phosphatidylcholine-specific phospholipase C
      inhibitor D609 suppressed LPS-mediated, but not CSF-1-mediated, activation of Raf
      1, MEK, and MAPK. Similarly, down-regulation or inhibition of protein kinase C
      blocked MEK and MAPK induction by LPS but not that by CSF-1. Phorbol 12-myristate
      13-acetate pretreatment led to the sustained activation of the Raf-1 kinase but
      not that of MEK and MAPK. Thus, activated Raf-1 alone does not support MEK/MAPK
      activation in macrophages. Phosphorylation of TCF/Elk but not that of TCF/SAP was
      blocked by all treatments that interfered with MAPK activation, implying that
      TCF/SAP was targeted by a MAPK-independent pathway. Therefore, CSF-1 and LPS
      target the MAPK network by two alternative pathways, both of which induce Raf-1
      activation. The mitogenic pathway depends on Ras activity, while the
      differentiation signal relies on protein kinase C and phosphatidylcholine
      specific phospholipase C activation.

PMID- 7799958
TI  - Lack of an effect of the efficiency of RNA 3'-end formation on the efficiency of
      removal of either the final or the penultimate intron in intact cells.
AB  - Evidence exists from studies using intact cells that intron removal can be
      influenced by the reactivity of upstream and downstream splice sites and that
      cleavage and polyadenylation can be influenced by the reactivity of upstream
      splice sites. These results indicate that sequences within 3'-terminal introns
      can function in the removal of upstream introns as well as the formation of RNA
      3' ends. Evidence from studies using intact cells for an influence of RNA 3'-end
      formation on intron removal is lacking. We report here that mutations within
      polyadenylation sequences that either decrease or increase the efficiency of RNA
      3'-end formation have no effect on the efficiencies with which either the 3'
      terminal or the penultimate intron is removed by splicing. Northern (RNA) blot
      hybridization, RNase mapping, and an assay that couples reverse transcription and
      PCR were used to analyze the effects of deletions and a substitution of the
      polyadenylation sequences within the human gene for triosephosphate isomerase
      (TPI). TPI pre-mRNA harbors six introns that are constitutively removed by
      splicing. Relative to normal levels, each of the deletions was found to reduce
      the nuclear and cytoplasmic levels of TPI mRNA, increase the nuclear level of
      unprocessed RNA 3' ends, and decrease the nuclear level of processed RNA 3' ends.
      The simplest interpretation of these data indicates that (i) the rate of 3'-end
      formation normally limits the amount of mRNA produced and (ii) the deletions
      decrease and the substitution increases the efficiency of RNA 3'-end formation.
      While each of the deletions and the substitution altered the absolute levels of
      intron 6-containing, intron 5-containing, intron 6-free, and intron 5-free RNAs,
      in no case was there an abnormal ratio of intron-containing to intron-free RNA
      for either intron. Therefore, at least for TPI RNA, while the efficiency of
      removal of the 3'-terminal intron influences the efficiency of removal of either
      the 3'-end formation, the efficiency of RNA 3'-end formation does not influence
      the efficiency of removal of either the 3'-terminal or penultimate intron. The
      dependence of TPI RNA 3'-end formation on splicing may reflect the suboptimal
      strengths of the corresponding regulatory sequences and may function to ensure
      that TPI pre-mRNA is not released from the chromatin template until it has formed
      a complex with spliceosomes. If so, then the independence of TPI RNA splicing on
      3'-end formation may be rationalized by the lack of a comparable function.

PMID- 7799959
TI  - Modulation of cellular thermoresistance and actin filament stability accompanies
      phosphorylation-induced changes in the oligomeric structure of heat shock protein
      27.
AB  - Phosphorylation of heat shock protein 27 (HSP27) can modulate actin filament
      dynamics in response to growth factors. During heat shock, HSP27 is
      phosphorylated at the same sites and by the same protein kinase as during
      mitogenic stimulation. This suggests that the same function of the protein may be
      activated during growth factor stimulation and the stress response. To determine
      the role of HSP27 phosphorylation in the heat shock response, several stable
      Chinese hamster cell lines that constitutively express various levels of the wild
      type HSP27 (HU27 cells) or a nonphosphorylatable form of human HSP27 (HU27pm3
      cells) were developed. In contrast to HU27 cells, which showed increased survival
      after heat shock, HU27pm3 cells showed only slightly enhanced survival. Evidence
      is presented that stabilization of microfilaments is a major target of the
      protective function of HSP27. In the HU27pm3 cells, the microfilaments were
      thermosensitized compared with those in the control cells, whereas wild-type
      HSP27 caused an increased stability of these structures in HU27 cells. HU27 but
      not HU27pm3 cells were highly resistant to cytochalasin D treatment compared with
      control cells. Moreover, in cells treated with cytochalasin D, wild-type HSP27
      but not the phosphorylated form of HSP27 accelerated the reappearance of actin
      filaments. The mutations in human HSP27 had no effect on heat shock-induced
      change in solubility and cellular localization of the protein, indicating that
      phosphorylation was not involved in these processes. However, induction of HSP27
      phosphorylation by stressing agents or mitogens caused a reduction in the
      multimeric size of the wild-type protein, an effect which was not observed with
      the mutant protein. We propose that early during stress, phosphorylation-induced
      conformational changes in the HSP27 oligomers regulate the activity of the
      protein at the level of microfilament dynamics, resulting in both enhanced
      stability and accelerated recovery of the filaments. The level of protection
      provided by HSP27 during heat shock may thus represent the contribution of better
      maintenance of actin filament integrity to overall cell survival.

PMID- 7799960
TI  - A silencer element for the lipoprotein lipase gene promoter and cognate double-
      and single-stranded DNA-binding proteins.
AB  - Transfection experiments with constructs containing various 5'-deleted fragments
      of the human lipoprotein lipase (LPL) promoter and the chloramphenicol
      acetyltransferase reporter gene revealed an LPL silencer element (LSE) in the
      region of nucleotides -225 to -81 of the LPL gene that functioned in Chinese
      hamster ovary (CHO) and HeLa cells. Gel retardation competition analysis showed
      the presence of a nuclear factor(s) capable of binding to the sequence of
      nucleotides -169 to -152 of LSE (LSE-6) in a single-stranded (opposite-strand)
      and double-stranded specific fashion, the binding affinity being almost the same
      in the two binding forms. Site-directed mutagenesis indicated that almost the
      entire sequence of LSE-6 was necessary to form the complexes and also critical
      for silencing activity in CHO cells. The amounts of this binding factor(s) in CHO
      and HeLa cells were closely associated with transcriptional silencing activity.
      Photochemical cross-linking experiments indicated that the single- and double
      stranded elements recognized the same binding factor(s) with molecular masses of
      54 to 63 kDa and 109 to 124 kDa. The 109- to 124-kDa DNA binding factor(s) was
      found to be a doublet of that of the 54- to 63-kDa factor by isoelectric focusing
      or by increasing the time of exposure to UV irradiation. When inserted upstream
      of another gene such as that of the simian virus 40 enhancer/promoter of pSV2CAT,
      the sequence of nucleotides -190 to -143 (LSE-1) also suppressed transcription of
      the reporter gene in CHO cells. These results strongly suggest that the LSE plays
      a role in regulation of LPL gene expression by suppressing its transcription.

PMID- 7799962
TI  - Transcriptional activation by the parvoviral nonstructural protein NS-1 is
      mediated via a direct interaction with Sp1.
AB  - The nonstructural protein NS-1, encoded by the parvovirus minute virus of mice,
      is a potent regulator of viral gene expression. NS-1 does not bind DNA in a
      sequence-specific manner, and the mechanism by which it modulates viral promoter
      function is unclear. We have used Gal4-NS-1 fusion protein constructs to identify
      and characterize an activating domain encoded within the C-terminal 88 amino
      acids of NS-1 which competes effectively with the acidic activator domain of the
      herpes simplex virus VP16 protein. DNA affinity chromatography and
      immunoprecipitation experiments demonstrate that protein-protein interactions
      between the transcription factor Sp1 and NS-1 are required to bind NS-1 to
      promoter DNA in vitro. Cotransfection of Gal4-NS-1 and Sp1-VP16 acidic activator
      constructs into Drosophila melanogaster Schneider cells, which lack endogenous
      Sp1, stimulates transcription from a minimal promoter containing five Gal4
      binding sites, while single-construct transfections do not. Cotransfection of
      Schneider cells with wild-type NS-1 and Sp1 constructs activates transcription
      from a simian virus 40 promoter 10- to 30-fold over that of either construct
      alone. Thus, Sp1-NS-1 interactions in vivo can stimulate transcription from a
      heterologous promoter containing Sp1 binding sites.

PMID- 7799961
TI  - The Saccharomyces cerevisiae Leu3 protein activates expression of GDH1, a key
      gene in nitrogen assimilation.
AB  - The Leu3 protein of Saccharomyces cerevisiae has been shown to be a
      transcriptional regulator of genes encoding enzymes of the branched-chain amino
      acid biosynthetic pathways. Leu3 binds to upstream activating sequences (UASLEU)
      found in the promoters of LEU1, LEU2, LEU4, ILV2, and ILV5. In vivo and in vitro
      studies have shown that activation by Leu3 requires the presence of alpha
      isopropylmalate. In at least one case (LEU2), Leu3 actually represses basal-level
      transcription when alpha-isopropylmalate is absent. Following identification of a
      UASLEU-homologous sequence in the promoter of GDH1, the gene encoding NADP(+)
      dependent glutamate dehydrogenase, we demonstrate that Leu3 specifically
      interacts with this UASLEU element. We then show that Leu3 is required for full
      activation of the GDH1 gene. First, the expression of a GDH1-lacZ fusion gene is
      three- to sixfold lower in a strain lacking the LEU3 gene than in an isogenic
      LEU3+ strain. Expression is restored to near-normal levels when the leu3 deletion
      cells are transformed with a LEU3-bearing plasmid. Second, a significant decrease
      in GDH1-lacZ expression is also seen when the UASLEU of the GDH1-lacZ construct
      is made nonfunctional by mutation. Third, the steady-state level of GDH1 mRNA
      decreases about threefold in leu3 null cells. The decrease in GDH1 expression in
      leu3 null cells is reflected in a diminished specific activity of NADP(+)
      dependent glutamate dehydrogenase. We also demonstrate that the level of GDH1
      lacZ expression correlates with the cells' ability to generate alpha
      isopropylmalate and is lowest in cells unable to produce alpha-isopropylmalate.
      We conclude that GDH1, which plays an important role in the assimilation of
      ammonia in yeast cells, is, in part, activated by a Leu3-alpha-isopropylmalate
      complex. This conclusion suggests that Leu3 participates in transcriptional
      regulation beyond the branched-chain amino acid biosynthetic pathways.

PMID- 7799963
TI  - The yeast TATA-binding protein (TBP) core domain assembles with human TBP
      associated factors into a functional TFIID complex.
AB  - In mammalian and Drosophila cells, the central RNA polymerase II general
      transcription factor TFIID is a multisubunit complex containing the TATA-binding
      protein (TBP) and TBP-associated factors (TAFs) bound to the conserved TBP
      carboxy-terminal core domain. TBP also associates with alternative TAFs in these
      cells to form general transcription factors required for initiation by RNA
      polymerases I and III. Although extracts of human HeLa cells contain little TBP
      that is not associated with TAFs, free TBP is readily isolated from yeast cell
      extracts. However, recent studies indicate that yeast TBP can also interact with
      other yeast polypeptides to form multiprotein complexes. We established stable
      human HeLa cell lines expressing yeast TBP and several yeast-human TBP hybrids to
      study TBP-TAF interactions. We found that the yeast TBP core domain assembles
      with a complete set of human TAFs into a stable TFIID complex that can support
      activated transcription in vitro. The fact that the yeast TBP core, which differs
      from human TBP core in approximately 20% of its amino acid residues, has the
      structural features required to form a stable complex with human TAFs implies
      that Saccharomyces cerevisiae probably contains TAFs that are structurally and
      functionally analogous to human TAFs. Surprisingly, the non-conserved amino
      terminus of yeast TBP inhibited association between the yeast core domain and
      human TAFs.

PMID- 7799964
TI  - Molecular cloning of a novel mitogen-inducible nuclear protein with a Ran GTPase
      activating domain that affects cell cycle progression.
AB  - We have cloned a novel cDNA (Spa-1) which is little expressed in the quiescent
      state but induced in the interleukin 2-stimulated cycling state of an interleukin
      2-responsive murine lymphoid cell line by differential hybridization. Spa-1 mRNA
      (3.5 kb) was induced in normal lymphocytes following various types of mitogenic
      stimulation. In normal organs it is preferentially expressed in both fetal and
      adult lymphohematopoietic tissues. A Spa-1-encoded protein of 68 kDa is localized
      mostly in the nucleus. Its N-terminal domain is highly homologous to a human Rap1
      GTPase-activating protein (GAP), and a fusion protein of this domain (SpanN)
      indeed exhibited GAP activity for Rap1/Rsr1 but not for Ras or Rho in vitro.
      Unlike the human Rap1 GAP, however, SpanN also exhibited GAP activity for Ran, so
      far the only known Ras-related GTPase in the nucleus. In the presence of serum,
      stable Spa-1 cDNA transfectants of NIH 3T3 cells (NIH/Spa-1) hardly overexpressed
      Spa-1 (p68), and they grew as normally as did the parental cells. When NIH/Spa-1
      cells were serum starved to be arrested in the G1/G0 phase of the cell cycle,
      however, they, unlike the control cells, exhibited progressive Spa-1 p68
      accumulation, and following the addition of serum they showed cell death
      resembling mitotic catastrophes of the S phase during cell cycle progression. The
      results indicate that the novel nuclear protein Spa-1, with a potentially active
      Ran GAP domain, severely hampers the mitogen-induced cell cycle progression when
      abnormally and/or prematurely expressed. Functions of the Spa-1 protein and its
      regulation are discussed in the context of its possible interaction with the
      Ran/RCC-1 system, which is involved in the coordinated nuclear functions,
      including cell division.

PMID- 7799966
TI  - The bulk chromatin structure of a murine transgene does not vary with its
      transcriptional or DNA methylation status.
AB  - The DNA methylation status of HRD, a murine transgene, can be controlled by the
      genetic background upon which it is carried. We found the transgene to be
      transcribed in competent tissues only when undermethylated. Chromatin structure
      over the transgene was assayed by nuclear accessibility with DNase I, MspI, and
      PstI. While the transgene was up to fivefold more resistant to MspI when
      methylated than when not methylated, we observed no such difference with DNase I
      or PstI. We suggest that methyl-CpG-binding proteins are responsible for the
      difference observed with MspI, but that the chromatin structures are otherwise
      similarly compacted. Methylation could, therefore, play a regulatory role in gene
      expression beyond that which can be accomplished by bulk chromatin structure
      alone.

PMID- 7799965
TI  - Calspermin gene transcription is regulated by two cyclic AMP response elements
      contained in an alternative promoter in the calmodulin kinase IV gene.
AB  - The transcript for the high-affinity Ca2+/calmodulin-binding protein calspermin
      is generated from the gene encoding Ca2+/calmodulin-dependent protein kinase IV
      only in postmeiotic germ cells during spermatogenesis. We demonstrate that this
      testis-specific calspermin transcript can be produced in heterologous cells by
      utilization of a promoter located in an intron of the calmodulin (CaM) kinase IV
      gene. Critical motifs within this promoter are two cyclic AMP response element
      (CRE)-like sequences located about -70 and -50 bp upstream of the transcriptional
      initiation site. Both CRE motifs are footprinted by the authentic testis-specific
      transcriptional activator CREM tau or by CREM tau present in adult testis nuclear
      extract. Whereas a 2.1-kb DNA fragment containing the calspermin promoter is
      inactive when transfected into NIH 3T3 cells, activity can be restored by
      cotransfection of CREM tau and protein kinase A or CaM kinase IV but not CaM
      kinase II alpha. Restoration of activity is greatly reduced by mutation of the
      two CRE motifs. Since CRE-like motifs have been identified in many genes uniquely
      expressed in postmeiotic germ cells, which contain abundant CREM tau protein, we
      suggest that CREM tau may function as one transcription factor responsible for
      the expression of postmeiotic germ cell-specific genes.

PMID- 7799967
TI  - Monocyte expression of the human prointerleukin 1 beta gene (IL1B) is dependent
      on promoter sequences which bind the hematopoietic transcription factor Spi
      1/PU.1.
AB  - Interleukin-1 beta (IL-1 beta) is produced primarily by stimulated monocytes,
      suggesting that the IL1B gene, which codes for this protein, depends upon at
      least one cell-type-specific factor. Our previous characterization of the IL1B
      promoter indicated that the region between -131 and +12 is sufficient to direct
      cell-type-specific expression of a reporter gene (F. Shirakawa, K. Saito, C.A.
      Bonagura, D.L. Galson, M.J. Fenton, A.C. Webb, and P. E. Auron, Mol. Cell. Biol.
      13:1332-1344, 1993). We now show that a sequence located between positions -50
      and -39 of the IL1B promoter binds the tissue-restricted Ets domain transcription
      factor Spi-1/PU.1 (Spi-1). Mutation of this site abrogates binding of this factor
      and reduces the ability of the IL1B promoter to function in macrophages. A second
      Spi-1 binding site located between positions -115 and -97 also is required for
      maximal IL1B promoter activity in the presence of the proximal Spi-1 binding
      site. In addition, an activation domain-deficient Spi-1 expression vector acts as
      a dominant-negative inhibitor of reporter gene expression in a monocyte cell
      line. Finally, the IL1B promoter, which is inactive in Spi-1-deficient HeLa
      cells, is activated in these cells by cotransfection with a Spi-1 expression
      vector. Thus, the cell-type-specific expression of the IL1B promoter appears to
      be dependent on the binding of Spi-1.

PMID- 7799968
TI  - Selective expression of intracisternal A-particle genes in established mouse
      plasmacytomas.

PMID- 7799969
TI  - Notice of duplicate publication. Molecular genetic analyses of a 376-kilodalton
      Golgi complex membrane protein (giantin)

PMID- 7799970
TI  - Isoform-specific complementation of the yeast sac6 null mutation by human
      fimbrin.
AB  - The actin cytoskeleton is a fundamental component of eukaryotic cells, with both
      structural and motile roles. Actin and many of the actin-binding proteins found
      in different cell types are highly conserved, showing considerable similarity in
      both primary structure and biochemical properties. To make detailed comparisons
      between homologous proteins, it is necessary to know whether the various proteins
      are functionally, as well as structurally, conserved. Fimbrin is an example of a
      cytoskeletal component that, as shown by sequence determinations and biochemical
      characterizations, is conserved between organisms as diverse as Saccharomyces
      cerevisiae and humans. In this study, we examined whether the human homolog can
      substitute for the yeast protein in vivo. We report here that two isoforms of
      human fimbrin, also referred to as T- and L-plastin, can both substitute in vivo
      for yeast fimbrin, also known as Sac6p, whereas a third isoform, I-fimbrin (or I
      plastin), cannot. We demonstrate that the human T- and L-fimbrins, in addition to
      complementing the temperature-sensitive growth defect of the sac6 null mutant,
      restore both normal cytoskeletal organization and cell shape to the mutant cells.
      In addition, we show that human T- and L-fimbrins can complement a sporulation
      defect caused by the sac6 null mutation. These findings indicate that there is a
      high degree of functional conservation in the cytoskeleton, even between
      organisms as diverse as S. cerevisiae and humans.

PMID- 7799972
TI  - A selector of transcription initiation in the protozoan parasite Toxoplasma
      gondii.
AB  - The recent development of an efficient transfection system for the apicomplexan
      Toxoplasma gondii allows a comprehensive dissection of the elements involved in
      gene transcription in this obligate intracellular parasite. We demonstrate here
      that for the SAG1 gene, a stretch of six repeated sequences in the region 35 to
      190 bp upstream of the first of two transcription start sites is essential for
      efficient and accurate transcription initiation. This repeat element shows
      characteristics of a selector in determining the position of the transcription
      start sites.

PMID- 7799971
TI  - The tau 4 activation domain of the thyroid hormone receptor is required for
      release of a putative corepressor(s) necessary for transcriptional silencing.
AB  - The C terminus of nuclear hormone receptors is a complex structure that contains
      multiple functions. We are interested in the mechanism by which thyroid hormone
      converts its receptor from a transcriptional silencer to an activator of
      transcription. Both regulatory functions are localized in the ligand binding
      domain of this receptor superfamily member. In this study, we have identified and
      characterized several functional domains within the ligand binding domain of the
      human thyroid hormone receptor (TR beta) conferring transactivation.
      Interestingly, these domains are localized adjacent to hormone binding sites. One
      activation domain, designated tau 4, is only 17 amino acids in length and is
      localized at the extreme C terminus of TR. Deletion of six amino acids of tau 4
      resulted in a receptor that could still bind hormone but acted as a constitutive
      silencer, indicating that tau 4 is required for both transactivation and relief
      of the silencing functions. In addition, we performed in vivo competition
      experiments, the results of which suggest that in the absence of tau 4 or
      hormone, TR is bound by a corepressor protein(s) and that one role of hormone is
      to release corepressor from the receptor. We propose a general model in which the
      role of hormone is to induce a conformational change in the receptor that
      subsequently affects the action of tau 4, leading to both relief of silencing and
      transcriptional activation.

PMID- 7799974
TI  - Management strategies for congenital infections.
AB  - Information on congenital infection is continuously expanding. New diagnostic
      techniques are making significant contributions to the prenatal diagnosis of
      several fetal infections. In this review we highlight some of the most recent
      advances in the diagnosis and management of the most common fetal infections,
      those caused by cytomegalovirus, human immunodeficiency virus 1, Toxoplasma,
      varicella-zoster virus, and parvovirus B19.

PMID- 7799976
TI  - Multifetal pregnancy: risks and methods of reduction.
AB  - Multifetal pregnancy reduction offers an acceptable option to patients faced with
      the significant risk of long-term morbidity associated with multifetal gestation,
      especially gestation involving 4 or more fetuses. Until advances in reproductive
      technology eliminate the iatrogenic occurrence of multifetal gestation, and until
      progress in perinatal care decreases the threat of preterm delivery, multifetal
      pregnancy reduction offers hope for a good outcome in an otherwise dismal
      situation.

PMID- 7799975
TI  - Platelet disorders in pregnancy: implications for mother and fetus.
AB  - Platelet disorders in pregnancy are not uncommon. Most often, obstetricians are
      faced with a patient with undiagnosed thrombocytopenia and have the
      responsibility of deciding if the condition is ITP, gestational thrombocytopenia,
      or a process related to pre-eclampsia. Correct diagnosis is important because ITP
      can be associated with fetal thrombocytopenia, making route of delivery
      important. In alloimmune thrombocytopenia, the mother develops antibodies to a
      specific platelet antigen present on the fetal platelet but absent on her own.
      Severe AIT can cause intracranial hemorrhage and have disastrous consequences for
      the fetus and neonate. In preliminary studies antenatal intravenous gamma
      globulin therapy has shown promise in preventing the development of intracranial
      hemorrhage and ameliorating fetal thrombocytopenia. Essential thrombocythemia
      with a platelet count of greater than 600 x 10(9) platelet/L can occur in
      pregnancy; therapy consists of antiplatelet aggregating agents such as aspirin,
      and plateletpheresis. Platelet function disorders can be acquired or inherited.
      Acquired platelet dysfunction disorders are usually caused by drugs such as
      aspirin or indomethacin, or by a systemic disease. Hereditary disorders of
      platelet function can be diagnosed in utero, but cordocentesis may represent an
      unacceptably high risk. For prenatal diagnosis, other methods, such as chorionic
      villus sampling or amniocentesis, should be investigated as an alternative to the
      potentially high risk of cordocentesis.

PMID- 7799973
TI  - The BN51 protein is a polymerase (Pol)-specific subunit of RNA Pol III which
      reveals a link between Pol III transcription and pre-rRNA processing.
AB  - The three eukaryotic nuclear RNA polymerase (Pol) contain common and unique
      subunits. Cloning of the unique Pol III subunit genes in yeast cells has revealed
      a potential homolog in the mammalian system, the BN51 gene. The human BN51 gene
      was originally isolated as a suppressor of a temperature-sensitive cell cycle
      mutant of BHK cells (tsBN51). Although tsBN51 cells have a marked decrease in RNA
      Pol III activity at the nonpermissive temperature, direct biochemical evidence
      for the BN51 protein being a human Pol III subunit was lacking. Using antibodies
      directed against the BN51 protein, we show the following: (i) the BN51 protein
      copurifies with Pol III activity, (ii) Pol III activity can be specifically
      immunoprecipitated from HeLa nuclear extracts, and (iii) the immunopurified BN51
      complex is active in restoring both nonspecific and promoter-specific Pol III
      activity. Our findings provide direct biochemical evidence for BN51 being a Pol
      III-specific subunit. Despite the fact that BN51 is not a subunit of Pol I, the
      production of mature Pol I transcripts is inhibited in tsBN51 cells at the
      nonpermissive temperature. tsBN51 cells appear defective in processing the 32S
      precursor rRNA into mature 5.8S and 28S rRNA at the nonpermissive temperature. We
      surmise that ribosome assembly has halted because of the loss of Pol III
      transcripts. Thus, there is regulation of the synthesis of mature Pol I
      transcripts by a posttranscriptional mechanism based on the availability of Pol
      III transcripts.

PMID- 7799977
TI  - Development of the ability to make IgG and IgA in newborns and infants.
AB  - An understanding of the ontogeny of the human immune system may provide clues for
      methods to stimulate the immune response of neonates and young infants at an
      earlier age than is now possible. Knowledge of normal changes in immune response
      over time is necessary to evaluate infants for immunodeficiency.

PMID- 7799978
TI  - The lung of the premature infant: pathophysiology of disease and newer therapies.

PMID- 7799979
TI  - New perspectives on neonatal hyperbilirubinemia.
AB  - Notwithstanding a number of advances in the understanding of hyperbilirubinemia
      and its treatment in the newborn, controversy continues. The trend has been to
      decrease interventions and observe and manage infants with jaundice as
      outpatients. This trend will probably prove to be both medically and economically
      sound. In the absence of significant hemolysis or other underlying medical
      conditions such as infection, many physicians are now comfortable with expectant
      observation for those healthy full-term infants with serum bilirubin measurements
      of less than 18 mg/dL. New thinking about this condition and advances in
      treatment may transform hyperbilirubinemia in neonates into a medical curiosity.

PMID- 7799981
TI  - Influence of baclofen upon the alpha-motoneuron in spasticity by means of F-wave
      analysis.
AB  - Intrathecal baclofen dramatically improves severe spastic syndromes. This
      improvement is likely related to reduced excitability of alpha-motoneurons. To
      investigate the influence of baclofen upon the alpha-motoneuron, we analyzed F
      waves before and after intrathecal baclofen bolus injection (usually 50
      micrograms) as well as after administration of different, constantly delivered
      doses (60-200 micrograms/day). Intrathecal baclofen bolus decreased the maximum F
      wave amplitude (Fp) from an initial value of 9% of the maximum M amplitude (Mmax)
      (= F/M-ratio) to 2.4% of the Mmax after 130-180 min, reduced the mean F-wave
      amplitude 60% within 150 min, and shortened the mean duration by 40-60% after 130
      180 min. Constantly delivered baclofen of 100 micrograms/day reduced the F/M
      ratio from 5% to 2%, the mean F-wave amplitude by 40-80%, and the F-wave mean
      duration by 40-80%. The minimum F-wave latency did not change after bolus or
      during steady state administration. The findings indicate that the F-wave mean
      and maximum amplitude as well as the mean duration are altered in a quantifiable
      manner following intrathecal baclofen application.

PMID- 7799980
TI  - Spontaneous chromosomal aberrations in Fanconi anaemia, ataxia telangiectasia
      fibroblast and Bloom's syndrome lymphoblastoid cell lines as detected by
      conventional cytogenetic analysis and fluorescence in situ hybridisation (FISH)
      technique.
AB  - Several primary and transformed human cell lines derived from cancer prone
      patients are employed routinely for biochemical and DNA repair studies. Since
      transformation leads to some chromosomal instability a cytogenetic analysis of
      spontaneous chromosome aberrations in fibroblast cell lines derived from patients
      with Fanconi anaemia (FA), ataxia telangiectasia (AT), and in lymphoblastoid cell
      lines derived from patients with Bloom's syndrome (BS), was undertaken. Unstable
      aberrations were analysed in Giemsa stained preparations and the chromosome
      painting technique was used for evaluating the frequencies of stable aberrations
      (translocations). In addition, the frequency of sister-chromatid exchanges (SCEs)
      was determined in differentially stained metaphases. The SV40-transformed
      fibroblasts from these cell lines have higher frequencies of unstable aberrations
      than the primary fibroblasts. In the four lymphoblastoid cell lines derived from
      BS patients higher frequencies of spontaneously occurring chromosomal aberrations
      in comparison to normal TK6wt cells were also evident. The frequency of
      spontaneously occurring chromosome translocations was determined with
      fluorescence in situ hybridisation (FISH) and using DNA libraries specific for
      chromosomes 1, 2, 3, 4, 7, 8, 11, 14, 19, 20 and X. The translocation levels were
      found to be elevated for primary FA fibroblasts and lymphoblastoid cells derived
      from BS patients in comparison with control cell lines, hetero- and homozygote BS
      cell lines not differing in this respect. The SV40-transformed cell lines showed
      very high frequencies of translocations independent of their origin and almost
      every cell contained at least one translocation. In addition, clonal
      translocations were found in transformed control TK6wt and AT cell lines for
      chromosomes 20 and 14, respectively. The spontaneous frequencies of SCEs were
      similar in transformed fibroblasts derived from normal individuals and AT
      patients, whereas in SV40-transformed FA cells these were higher (4-fold). Among
      cell lines derived from BS patients, heterozygote lines behaved like control,
      whereas in homozygote cell lines very high frequencies of SCEs (about 12-fold)
      were evident.

PMID- 7799982
TI  - Selective finger drop in cervical radiculopathy: the pseudopseudoulnar claw hand.

PMID- 7799983
TI  - Amyotrophic lateral sclerosis associated with isolated adrenocorticotrophic
      hormone deficiency.

PMID- 7799984
TI  - Scalp-recorded P14 in median nerve SEPs is abolished by cuneate nucleus lesion.

PMID- 7799985
TI  - The effect of wrist size on the orthodromic median sensory nerve action
      potential.

PMID- 7799986
TI  - Riche-Cannieu anastomosis with partial transection of the median nerve.

PMID- 7799987
TI  - Chloroquine treated rat: a possible model for Alzheimer's disease.

PMID- 7799988
TI  - Dorsal rhizotomy for cerebral palsy.

PMID- 7799989
TI  - Deficits in the function of small and large afferent fibers in confirmed cases of
      CTS.

PMID- 7799990
TI  - Intrapontine generation of mykomia in multiple sclerosis.

PMID- 7799991
TI  - A retrospective study of 47 patients with highly elevated anti-GM1 antibodies.

PMID- 7799992
TI  - Diabetic muscle infarction: magnetic resonance imaging (MRI) avoids the need for
      biopsy.

PMID- 7799994
TI  - Sixth Annual Stuart Reiner Memorial Lecture: embryonic development of nerve and
      muscle.
AB  - This article provides a basic scheme of sequential anatomic and some physiologic
      events occurring during the course of embryonic development of motor neurons and
      muscles, leading to the establishment of mature nerve-muscle relationships. Motor
      neurons and muscles begin their development independently and during
      embryogenesis they become dependent on each other for further development and
      survival. Aspects of development which occur independently and those requiring
      mutual interactions are identified. The development of motor neurons is discussed
      with respect to their production, projection, neuromuscular transmission,
      myelination, sprouting, survival, and death. The development of muscles is
      discussed with respect to the origin, differentiation, and muscle fiber types.
      Discussion on the development of neuromuscular junction includes differentiation
      of presynaptic nerve terminal, postsynaptic components, and elimination of
      multiple axons.

PMID- 7799993
TI  - Efficacy of obidoxime in human organophosphorus poisoning: determination by
      neuromuscular transmission studies.
AB  - Six patients with organophosphorus compound intoxications developed an
      intermediate syndrome (weakness and fasciculations) and obidoxime was given on
      eight occasions. The efficacy of the acetylcholinesterase (AChE) reactivator was
      monitored electrophysiologically by neuromuscular transmission studies using
      single and repetitive nerve stimulation (20 and 50 Hz) and the activity of the
      serum (butyryl) cholinesterase (ChE). Dramatic electrophysiologic improvement was
      seen when obidoxime was given early within 12 h in 3 patients, although evidence
      of AChE inhibition did not subside completely. When administration of obidoxime
      was delayed 26 h or more after intoxication on five occasions, electrophysiologic
      improvement was mild or absent. In one case, 66 h after intoxication with
      oxydemeton-S-methyl, the neuromuscular block worsened, indicating that aging of
      the AChE had been completed. The electrophysiologic improvement was always
      accompanied with better motor function but not necessarily with improvement of
      the overall clinical status. Serum ChE did not predict the oxime effect at the
      motor endplate. In humans, the efficacy of oximes in AChE reactivation can be
      determined rapidly using electrophysiologic studies.

PMID- 7799995
TI  - Expression of heat-shock/stress proteins in Duchenne muscular dystrophy.
AB  - Heat-shock/stress proteins (HSPs) are induced in response to stressful conditions
      and are essential for survival during and after cellular stress. We investigated
      whether dystrophin deficiency in muscle from Duchenne muscular dystrophy (DMD)
      patients induces HSPs. Immunohistochemical studies were performed on cryosections
      from normal muscle, heat-shocked muscle, and muscle from patients with DMD,
      dermatomyositis, and mitochondrial myopathy using antibodies against HSP 72/73,
      HSP 72, HSP 90, groEL (HSP 65 homologue), and ubiquitin. Computer-assisted image
      processing revealed a significant (P < 0.05) induction of HSP 72/73, 72, 65, and
      ubiquitin in hypercontracted fibers; HSP 90 and ubiquitin in regenerating fibers;
      and ubiquitin in macrophage invaded necrotic fibers of DMD muscle. No significant
      induction of HSPs was observed in dermatomyositis or mitochondrial myopathies.
      The stress response induced in DMD may relate to the metabolic stress
      characteristic of the disease and could represent an autoprotective mechanism.
      Manipulation of this protective response may reduce injury and have potential
      therapeutic application.

PMID- 7799996
TI  - The medial calcaneal nerve: anatomy and nerve conduction technique.
AB  - We report a new technique for studying conduction in the medial calcaneal nerve
      (MCN). Dissection of 14 cadaver feet revealed the optimal G1 site to be one third
      of the way from the apex of the heel to a point midway between the navicular
      tuberosity and the prominence of the medial malleolus. Seventy-two feet (36
      healthy volunteers) were studied using surface stimulation of the tibial nerve 10
      cm proximal to the G1 surface electrode. Averaging technique was not required.
      Reference values (mean +/- 2 SD) were determined for MCN onset latency (2.0 +/-
      0.3 ms), peak latency (2.5 +/- 0.3 ms), onset conduction velocity (61 +/- 11
      m/s), peak conduction velocity (40 +/- 5 m/s), baseline-to-peak amplitude (18 +/-
      6 microV), and maximum intrasubject side-to-side differences in these values (0.3
      ms, 0.3 ms, 15 m/s, 5 m/s, and 17 microV, respectively). This study provides an
      easily performed, reproducible method for electrophysiologic evaluation of the
      MCN.

PMID- 7799997
TI  - Lymphocyte infiltration following allo- and xenomyoblast transplantation in mdx
      mice.
AB  - Human and mouse (C57BL/10SnJ+/+) myoblasts were injected separately in the
      muscles of C57BL/10ScSn mdx/mdx mice. Mouse myoblasts (C57BL/10SnJ+/+) were also
      injected in normal mice (C57BL/10SnJ+/+ and BALB/c+/+). Some muscles that
      received a xenotransplantation (i.e., human myoblasts) were previously injected
      with a myotoxin, i.e., notexin. This treatment was not used for the allografts
      (i.e., mouse myoblasts). Human myoblast injections did not increase the number of
      dystrophin-positive cells above the background level due to backmutation.
      Moreover, the human myoblasts detected with an anti-HLA antibody decreased
      rapidly during the 6-week follow-up. The injection of normal mouse myoblasts in
      mdx mice did, however, increase the number of dystrophin-positive fibers.
      Moreover, numerous cells expressing mouse MHC class II, macrophages,
      granulocytes, neutrophils, natural killer cells, and a subset of T lymphocytes
      were detected by immunohistochemistry in cryostat sections of myoblast-injected
      muscles. These cells were present within 1 week of the myoblast injection in the
      muscle regions containing injected human or mouse myoblasts, and progressively
      decreased during the 6-week follow-up in the human myoblast transplantation.
      Lymphocyte infiltration reached a significant level following xeno- and
      alloincompatible transplantations. Antibodies against the human myoblasts and
      against alloincompatible myoblasts were also detected in the serum of the
      recipients. These results suggest that humoral and cellular immune reactions are
      responsible for the poor outcome of myoblast transplantation in mice and could be
      involved in failure of transplantation in Duchenne muscular dystrophy patients.
      These results indicate that adequate immunosuppression must be used in these
      patients.

PMID- 7799998
TI  - Extensor digitorum brevis reflex in normals and patients with radiculopathies.
AB  - This prospective study evaluated the extensor digitorum brevis deep tendon reflex
      (EDBR) in a normal population and in patients with L-5 and S-1 radiculopathies.
      There were 88 subjects: 53 normals, 17 L-5, and 18 S-1 radiculopathy subjects.
      The clinical EDBR revealed a 91% specificity, with 18% sensitivity for L-5, and
      11% for S-1. The electrodiagnostic EDBR yielded increased sensitivities of 35%
      for L-5 (P = 0.07) and 39% for S-1 (P = 0.04), with 87% specificity. H-reflexes
      showed 50% sensitivity for the S-1 group (P = 0.0006) and 91% specificity. EDBR
      latencies were significantly related to age and leg length (r2 = 0.46, P <
      0.0001). Age alone explained 26% (P < 0.0001) of the EDBR variability and leg
      length 20% (P < 0.0001). EDBR clinical and electrodiagnostic reflexes have low
      sensitivities, high specificities, and do not discriminate L-5 from S-1 root
      involvement.

PMID- 7799999
TI  - Factors which influence alterations of phosphates and pH in exercising human
      skeletal muscle: measurement error, reproducibility, and effects of fasting,
      carbohydrate loading, and metabolic acidosis.
AB  - Previous studies have shown considerable variability in the metabolic response of
      human skeletal muscle during a standardized exercise protocol. The goal of these
      studies was to investigate the factors responsible for the broad range of
      metabolic changes produced by fatiguing exercise. Experiments were performed to
      quantitate the measurement error of 31P nuclear magnetic resonance spectroscopy
      of human muscle, the reproducibility of changes within a single subject, and the
      effects of fasting, carbohydrate loading, and metabolic acidosis. The results
      show that none of these factors appear to be responsible for the wide variation
      between subjects. However, the effects of training and genetic factors were not
      investigated and are likely to be responsible for the substantial variability
      between subjects.

PMID- 7800000
TI  - CMAP variability as a function of electrode site and size.
AB  - The site of the recording electrode influences the amplitude of the compound
      muscle action potential (CMAP) and its variation over a length of nerve. The
      effects of large electrodes on this source of intraindividual variability were
      assessed. Right median nerves of 20 healthy subjects were studied, and recordings
      made at three sites (at 1-cm intervals) using five electrode sizes (0.01, 1, 2,
      4, and 10 cm2). Site-induced variability was defined as the standard deviation
      (SDi) and coefficient of variation (CVi) of the measurements of the three sites.
      Site induced variability of all parameters (latency, duration, amplitude, area,
      MNCV, and the percentile changes of duration, amplitude, and area over the
      forearm) decreased significantly with electrode size. Decreases were most
      pronounced for amplitude and area: CVi fell from 29% and 30% (0.01-cm2 electrode)
      to 10% and 8% (10 cm2). It is argued that large electrodes record activity of
      more motor units than small electrodes, and that their measurement fields overlap
      to a greater extent. The use of large electrodes is recommended in order to
      reduce site-induced CMAP variability.

PMID- 7800001
TI  - Transfer function analysis of respiratory sinus arrhythmia: a measure of
      autonomic function in diabetic neuropathy.
AB  - Standard techniques measuring heart rate (HR) variability do not account for its
      dependence on the rate and depth of respiration or measure the time relationship
      between changes in lung volume and HR. We used transfer function analysis to
      determine the magnitude and time relationship of the HR response to a known
      change in lung volume in controls and diabetics. This technique demonstrated
      significant differences between controls and diabetics with varying degrees of
      autonomic dysfunction. Specifically, reduced supine vagal and increased supine
      sympathetic HR modulation was found with progression of the autonomic neuropathy.
      In response to postural change the normal diabetics displayed impaired
      sympathetic HR modulation. Transfer function analysis yields new insight into the
      sequence of changes that occur with diabetic autonomic neuropathy and provides an
      accurate, easily comprehensible measurement of respiratory induced HR
      variability.

PMID- 7800002
TI  - Mixed nerve action potentials in acquired demyelinating polyneuropathy.
AB  - Uncertainty about motor and sensory contributions in abnormal nerves has limited
      the use of mixed nerve action potentials (MNAPs). We recorded MNAPs in 21
      patients with an acquired demyelinating neuropathy, 18 age-matched control
      subjects, and 10 patients with an axonal polyneuropathy. Bipolar and unipolar
      recordings from median and ulnar nerves were made above the elbow after
      electrical stimulation of the nerves at the wrist. Antidromic digital sensory
      action potentials and motor conduction velocity were also recorded for both
      nerves. In 19 median and 12 ulnar nerves from demyelinating polyneuropathy
      patients, compared with control subjects, MNAP amplitudes were significantly
      reduced (mean, 6 microV vs. 31 microV), MNAP velocities were mildly reduced
      (mean, 50 m/s vs. 62 m/s), motor conduction velocities were significantly reduced
      (mean, 33 m/s vs. 57 m/s), and MNAPs were significantly dispersed, with markedly
      prolonged rise times (mean 2.0 ms vs. 1.0 ms). Compared with the axonal
      polyneuropathy group, MNAP amplitudes from the median nerve were similarly
      reduced (mean, 8 microV vs. 9 microV), MNAP velocities were only slightly slower
      (mean, 52 m/s vs. 58 m/s), but the rise times were significantly prolonged (mean,
      2.0 ms vs 1.2 ms). We conclude that, in acquired demyelinating neuropathies, the
      onset and, in some cases, the whole MNAP is from afferent fibers, which can be
      abnormally dispersed, and that, over the same segment MNAP velocity is less
      affected than motor conduction velocity.

PMID- 7800003
TI  - Monoclonal antibodies against ICAM-1 and LFA-1 prolong nerve allograft survival.
AB  - In a rat nerve allograft model, specific immunosuppression was approached with
      monoclonal antibodies (MAbs) against cell-surface molecules. After engraftment,
      recipients were treated with antiintercellular adhesion molecule-1 (ICAM-1) and
      antilymphocyte function-associated antigen-1 (LFA-1) MAbs for 14 days. Functional
      recovery was evaluated biweekly. Electrophysiological and histological
      assessments were performed at 6 and 16 weeks. Immunologic responsiveness in the
      recipients was assessed with a cytotoxic T lymphocyte (CTL) assay at 16 weeks and
      skin grafts at 18 weeks. The untreated allograft group demonstrated complete
      disruption of fascicular architecture with poor nerve regeneration. The MAb
      treated allografts maintained well-organized nerve architecture with a dense
      population of well-myelinated fibers. These animals showed functional and
      electrophysiological recovery. Suppression of CTL activity was nerve donor
      specific and the survival time of nerve donor skin grafts was prolonged,
      suggesting induction of alloantigen-specific tolerance. MAbs therapy directed
      against ICAM-1/LFA-1 presents a new approach for the management of the peripheral
      nerve allograft response.

PMID- 7800004
TI  - Asthma and wheezing in the first six years of life. The Group Health Medical
      Associates.
AB  - BACKGROUND: Many young children wheeze during viral respiratory infections, but
      the pathogenesis of these episodes and their relation to the development of
      asthma later in life are not well understood. METHODS: In a prospective study, we
      investigated the factors affecting wheezing before the age of three years and
      their relation to wheezing at six years of age. Of 1246 newborns in the Tucson,
      Arizona, area enrolled between May 1980 and October 1984, follow-up data at both
      three and six years of age was available for 826. For these children, assessments
      in infancy included measurement of cord-serum IgE levels (measured in 750
      children), pulmonary-function testing before any lower respiratory illness had
      occurred (125), measurement of serum IgE levels at nine months of age (672), and
      questionnaires completed by the children's parents when the children were one
      year old (800). Assessments at six years of age included measurement of serum IgE
      levels (in 460), pulmonary-function testing (526), and skin allergy testing
      (629). RESULTS: At the age of six years, 425 children (51.5 percent) had never
      wheezed, 164 (19.9 percent) had had at least one lower respiratory illness with
      wheezing during the first three years of life but had no wheezing at six years of
      age, 124 (15.0 percent) had no wheezing before the age of three years but had
      wheezing at the age of six years, and 113 (13.7 percent) had wheezing both before
      three years of age and at six years of age. The children who had wheezing before
      three years of age but not at the age of six had diminished airway function
      (length-adjusted maximal expiratory flow at functional residual capacity [Vmax
      FRC]) both before the age of one year and at the age of six years, were more
      likely than the other children to have mothers who smoked but not mothers with
      asthma, and did not have elevated serum IgE levels or skin-test reactivity.
      Children who started wheezing in early life and continued to wheeze at the age of
      six were more likely than the children who never wheezed to have mothers with a
      history of asthma (P < 0.001), to have elevated serum IgE levels (P < 0.01), to
      have normal lung function in the first year of life, and to have elevated serum
      IgE levels (P < 0.001) and diminished values for VmaxFRC (P < 0.01) at six years
      of age. CONCLUSIONS: The majority of infants with wheezing have transient
      conditions associated with diminished airway function at birth and do not have
      increased risks of asthma or allergies later in life. In a substantial minority
      of infants, however, wheezing episodes are probably related to a predisposition
      to asthma.

PMID- 7800005
TI  - Antibacterial treatment of gastric ulcers associated with Helicobacter pylori.
AB  - BACKGROUND: There is a strong association between infection with Helicobacter
      pylori and gastric ulcers that are unrelated to the use of nonsteroidal
      antiinflammatory medications. We studied the efficacy of antibacterial therapy
      without medication to suppress gastric acid for the treatment of patients with H.
      pylori infection and gastric ulcers unrelated to the use of nonsteroidal agents.
      METHODS: Patients with gastric ulcers seen on endoscopy and with H. pylori
      infection confirmed by smear or culture were randomly assigned to receive either
      a one-week course of antibacterial agents (120 mg of bismuth subcitrate, 500 mg
      of tetracycline, and 400 mg of metronidazole, each given orally four times a day)
      or a four-week course of omeprazole (20 mg orally per day). Follow-up endoscopies
      were performed after five and nine weeks. The patients and their physicians were
      aware of the treatment assignments, but the endoscopists were not. RESULTS: A
      total of 100 patients were randomly assigned to treatment, and 85 completed the
      trial. At five weeks, H. pylori had been eradicated in 41 of the 45 patients in
      the antibacterial-treatment group (91.1 percent; 95 percent confidence interval,
      82.9 to 99.3) and in 5 of the 40 in the omeprazole group (12.5 percent; 95
      percent confidence interval, 2.3 to 22.7; P < 0.001). The gastric ulcers were
      healed in 38 of the patients treated with antibacterial drugs (84.4 percent; 95
      percent confidence interval, 73.9 to 95.0) and in 29 of those treated with
      omeprazole (72.5 percent; 95 percent confidence interval, 58.6 to 86.4; P =
      0.28). At nine weeks, ulcer healing was confirmed in 43 of the patients receiving
      antibacterial therapy and in 37 of those receiving omeprazole (P = 1.0). The mean
      (+/- SD) duration of pain during the first week of treatment was 1.9 +/- 2.6 days
      in the omeprazole group, as compared with 3.6 +/- 3.0 days in the antibacterial
      treatment group (P = 0.004). One year after treatment, recurrent gastric ulcers
      were detected in 1 of 22 patients (4.5 percent) in the antibacterial-treatment
      group and in 12 of 23 (52.2 percent) in the omeprazole group (P = 0.001). H.
      pylori was detected in the 1 patient with a recurrent ulcer who had received
      antibacterial treatment and in 10 of the 12 patients with recurrent ulcers who
      had received omeprazole. CONCLUSIONS: In patients with H. pylori infection and
      gastric ulcers unrelated to the use of nonsteroidal antiinflammatory drugs, one
      week of antibacterial therapy without acid suppression heals the ulcers as well
      as omeprazole and reduces the rate of their recurrence.

PMID- 7800006
TI  - Age, thymopoiesis, and CD4+ T-lymphocyte regeneration after intensive
      chemotherapy.
AB  - BACKGROUND: Inadequate reconstitution of CD4+ T lymphocytes is an important
      clinical problem complicating chemotherapy, human immunodeficiency virus
      infection, and bone marrow transplantation, but relatively little is known about
      how CD4+ T lymphocytes regenerate. There are two main possibilities: bone marrow
      derived progenitors could reconstitute the lymphocyte population using a thymus
      dependent pathway, or thymus-independent pathways could predominate. Previous
      studies have suggested that the CD45RA glycoprotein on CD4+ T lymphocytes is a
      marker for progeny generated by a thymus-dependent pathway. METHODS: We studied
      15 patients 1 to 24 years of age who had undergone intensive chemotherapy for
      cancer. The absolute numbers of CD4+ T lymphocytes in peripheral blood and the
      expression of CD45 isoforms (CD45RA and CD45RO) on these lymphocytes were studied
      serially during lymphocyte regeneration after the completion of therapy.
      Radiographic imaging of the thymus was performed concomitantly. RESULTS: There
      was an inverse relation between the patients' ages and the CD4+ T-lymphocyte
      counts six months after therapy was completed (r = -0.92). The CD4+ recovery
      correlated quantitatively with the appearance of CD45RA+CD4+ T lymphocytes in the
      blood (r = 0.64). There was a higher proportion of CD45RA+CD4+ T lymphocytes in
      patients with thymic enlargement after chemotherapy than in patients without such
      enlargement (two-sided P = 0.015). CONCLUSIONS: Thymus-dependent regeneration of
      CD4+ T lymphocytes occurs primarily in children, whereas even young adults have
      deficiencies in this pathway. Our results suggest that rapid T-cell regeneration
      requires residual thymic function in patients receiving high-dose chemotherapy.

PMID- 7800007
TI  - Brief report: congenital hyperthyroidism caused by a mutation in the thyrotropin
      receptor gene.

PMID- 7800008
TI  - Images in clinical medicine. Post-tachycardia T-wave syndrome.

PMID- 7800009
TI  - Supraventricular tachycardia.

PMID- 7800010
TI  - Case records of the Massachusetts General Hospital. Weekly clinicopathological
      exercises case 2-1995. A 71-year-old man with masses in the pancreas, presacral
      region, and left kidney.

PMID- 7800011
TI  - Asthma and wheezing in young children.

PMID- 7800012
TI  - Age, the thymus, and T lymphocytes.

PMID- 7800013
TI  - Thyrotropin-receptor mutations and thyroid dysfunction.

PMID- 7800014
TI  - G proteins in medicine.

PMID- 7800015
TI  - Female circumcision.

PMID- 7800016
TI  - Female circumcision.

PMID- 7800018
TI  - Treatment of acid reflux.

PMID- 7800017
TI  - Female circumcision.

PMID- 7800019
TI  - More on surveillance of children with medulloblastoma.

PMID- 7800020
TI  - Improvement of paraneoplastic opsoclonus-myoclonus after protein A column
      therapy.

PMID- 7800021
TI  - Heliox in respiratory failure from obstructive lung disease.

PMID- 7800022
TI  - More on fluoroquinolone antibiotics and tendon rupture.

PMID- 7800023
TI  - More on fluoroquinolone antibiotics and tendon rupture.

PMID- 7800024
TI  - Buying Editorials.

PMID- 7800025
TI  - Popper's achievement.

PMID- 7800026
TI  - Research integrity.

PMID- 7800027
TI  - Eighteen ninety five and all that.
AB  - Anniversarial commemorations this year include the discovery of X-rays, the
      calculation of the position of the undiscovered planet Neptune, the emergence of
      syphilis and the mandatory serving of lime juice to British sailors.

PMID- 7800028
TI  - Uprooting the human family tree.

PMID- 7800029
TI  - Kaposi's sarcoma. A finger on the culprit.

PMID- 7800030
TI  - Neurobiology. Cold, pain and the brain.

PMID- 7800031
TI  - Nature and Le Monde.

PMID- 7800032
TI  - Visual perception. Seeing backwards in time.

PMID- 7800033
TI  - Primatology. The price of being at the top.

PMID- 7800034
TI  - Holliday junctions cleaved by Rad1?

PMID- 7800035
TI  - US National Cancer Institute chief quits.

PMID- 7800036
TI  - Stochastic resonance and the benefits of noise: from ice ages to crayfish and
      SQUIDs.
AB  - Noise in dynamical systems is usually considered a nuisance. But in certain
      nonlinear systems, including electronic circuits and biological sensory
      apparatus, the presence of noise can in fact enhance the detection of weak
      signals. This phenomenon, called stochastic resonance, may find useful
      application in physical, technological and biomedical contexts.

PMID- 7800037
TI  - Acetylcholine receptor channel imaged in the open state.
AB  - The structure of the open-channel form of the acetylcholine receptor has been
      determined from electron images of Torpedo ray postsynaptic membranes activated
      by brief (< 5 ms) mixing with droplets containing acetylcholine. Comparison with
      the closed-channel form shows that acetylcholine initiates small rotations of the
      subunits in the extracellular domain, which trigger a change in configuration of
      alpha-helices lining the membrane-spanning pore. The open pore tapers towards the
      intracellular membrane face, where it is shaped by a 'barrel' of alpha-helices
      having a pronounced right-handed twist.

PMID- 7800038
TI  - Graft copolymers that exhibit temperature-induced phase transitions over a wide
      range of pH.
AB  - There are many potential applications of 'intelligent' aqueous polymer systems in
      medicine, biotechnology, industry and in environmental problems. Many of these
      polymer systems undergo reversible phase transitions--for example, abrupt changes
      in volume--in response to external stimuli such as temperature, pH or the nature
      of the solvent. Most of the polymers studied previously are responsive to only
      one kind of stimulus. But for some applications, independent responsiveness to
      several factors, such as temperature and pH, may be required. Here we describe a
      polymer that undergoes marked solubility changes in water in response to
      temperature and/or pH changes. The polymer is prepared by grafting temperature
      sensitive side chains onto a pH-sensitive backbone. We also find that block
      copolymers, in which the temperature- and pH-sensitive units alternate along the
      chain, show similar behaviour.

PMID- 7800039
TI  - Reproductive constraints on aggressive competition in female baboons.
AB  - Competitive interaction between females of same social group is characteristic of
      most primate species. In Old World monkeys, females of high social rank maintain
      priority of access to scarce resources and harass low-ranking companions. But
      different field studies have found differing correlations between female
      dominance and reproductive success: several populations show an advantage of rank
      whereas others do not. Although such variation may reflect divergent levels of
      predation, food availability or social stress in different environments, female
      competitive ability may also be balanced by significant reproductive costs and
      thus be subject to strong stabilizing selection. We report here that high-ranking
      female baboons (Papio cynocephalus anubis) at Gombe National Park, Tanzania,
      enjoy shorter interbirth intervals, improved infant survival, and accelerated
      maturation of their daughters. These advantages, however, are countered by a
      significantly higher probability of miscarriage, and a proportion of high-ranking
      females suffer from reduced fertility.

PMID- 7800040
TI  - Visual attention modulates metacontrast masking.
AB  - How does the human visual system 'bind' different fragments in the visual scene
      to create enduring representations of objects? A visual illusion known as
      'metacontrast' or backward masking provides compelling evidence that perception
      is not instantaneous and that it occurs sequentially in distinct stages. If a
      solid white target square is displayed for 50 ms in a tachistoscope, switched
      off, and followed by a 50 ms display of two flanking mask squares, remarkably,
      subjects report seeing only the two flanking squares: the first square is simply
      not 'seen'. By plotting the magnitude of masking as a function of the delay
      between the target and mask (the stimulus onset asynchrony), one can obtain a
      characteristic 'U'-shaped function with optimum masking occurring at about 50 ms,
      and no masking with synchronous target and mask presentations or at delays higher
      than 300 ms. The illusion is also highly sensitive to elementary stimulus
      dimensions such as colour, orientation and spatial frequency, and it has been
      suggested that it is based on 'low level' autonomous visual mechanisms rather
      than cognitive processes. Here we describe a novel visual stimulus that
      demonstrates that metacontrast can be strongly modulated by 'top down' influence
      such as voluntary visual attention.

PMID- 7800041
TI  - Increased male fertility in Tribolium confusum beetles after infection with the
      intracellular parasite Wolbachia.
AB  - The cytoplasmically inherited microorganism Wolbachia pipientis behaves like a
      sexually selected trait in its host, the flour beetle Tribolium confusum,
      enhancing male fertility at the expense of female fecundity. Here we show that
      infected females have fewer offspring than uninfected females but infected males
      have a large fertility advantage over uninfected males within multiply
      inseminated infected or uninfected females. The male fertility effect accelerates
      the spread of the Wolbachia through the host population and expands the initial
      opportunity for hitch-hiking of host nuclear genes. Sperm competition in a host,
      mediated by endosymbionts, has not been previously described.

PMID- 7800042
TI  - A transcription factor controlling development of peripheral sense organs in C.
      elegans.
AB  - The basic-helix-loop-helix (bHLH) proteins constitute a class of transcription
      factors thought to be important in the control of cell-type determination. These
      transcription factors are believed to activate the expression of cell-type
      specific genes to generate stable differentiated cell types. The expression of
      bHLH proteins, in turn, is regulated by spatial cues, so that switches in cell
      type occur in a reproducible pattern. We report here that the lin-32 gene of
      Caenorhabditis elegans, which encodes a bHLH protein of the Drosophila achaete
      scute family of transcription factors, is necessary and in some cells sufficient
      for specification of the neuroblast cell fate. Similarity in the function and
      structure of the lin-32 protein (LIN-32) to transcription factors of the achaete
      scute gene family in Drosophila and vertebrates implies that this class of
      transcription factors functioned in a primitive ancestral form to specify
      neuronal cell fate, supporting the proposition that certain basic mechanisms of
      cell-type determination have been conserved through metazoan evolution.

PMID- 7800043
TI  - Role of a ubiquitin-conjugating enzyme in degradation of S- and M-phase cyclins.
AB  - Cell cycle progression in eukaryotes is controlled by the p34cdc2/CDC28 protein
      kinase and its short-lived, phase-specific regulatory subunits called cyclins. In
      Xenopus oocytes, degradation of M-phase (B-type) cyclins is required for exit
      from mitosis and is mediated by the ubiquitin-dependent proteolytic system. Here
      we show that B-type-cyclin degradation in yeast involves an essential nuclear
      ubiquitin-conjugating enzyme, UBC9. Repression of UBC9 synthesis prevents cell
      cycle progression at the G2 or early M phase, causing the accumulation of large
      budded cells with a single nucleus, a short spindle and replicated DNA. In ubc9
      mutants both CLB5, an S-phase cyclin, and CLB2, an M-phase cyclin, are
      stabilized. In wild-type cells the CLB5 protein is unstable throughout the cell
      cycle, whereas CLB2 turnover occurs only at a specific cell-cycle stage. Thus
      distinct degradation signals or regulated interaction with the ubiquitin-protein
      ligase system may determine the cell-cycle specificity of cyclin proteolysis.

PMID- 7800045
TI  - DNA structure-dependent requirements for yeast RAD genes in gene conversion.
AB  - In Saccharomyces cerevisiae, HO endonuclease-induced mating-type (MAT) switching
      is a specialized mitotic recombination event in which MAT sequences are replaced
      by those copied from a distant, unexpressed donor (HML or HMR). The donors have a
      chromatin structure inaccessible for both transcription and HO cleavage. Here we
      use physical monitoring of DNA to show that MAT switching is completely blocked
      at an early step in recombination in strains deleted for the DNA repair genes
      RAD51, RAD52, RAD54, RAD55 or RAD57. We find, however, that only RAD52 is
      required when the donor sequence is simultaneously not silenced and located on a
      plasmid. RAD51, RAD54, RAD55 and RAD57 are still required when the same
      transcribed donor is on the chromosome. We conclude that recombination in vivo
      occurs between DNA molecules in chromatin, whose structure significantly
      influences the outcome. RAD51, RAD54, RAD55 and RAD57 are all required to
      facilitate strand invasion into otherwise inaccessible donor sequences.

PMID- 7800044
TI  - Protein ubiquitination involving an E1-E2-E3 enzyme ubiquitin thioester cascade.
AB  - Ubiquitination of proteins involves the concerted action of the E1 ubiquitin
      activating enzyme, E2 ubiquitin-conjugating enzymes and E3 ubiquitin-protein
      ligases. It has been proposed that E3s function as 'docking proteins',
      specifically binding substrate proteins and specific E2s, and that ubiquitin is
      then transferred directly from E2s to substrates. We show here that formation of
      a ubiquitin thioester on E6-AP, an E3 involved in the human papillomavirus E6
      induced ubiquitination of p53 (refs 6-10), is an intermediate step in E6-AP
      dependent ubiquitination. The order of ubiquitin transfer is from E1 to E2, from
      E2 to E6-AP, and finally from E6-AP to a substrate. This cascade of ubiquitin
      thioester complexes suggests that E3s have a defined enzymatic activity and do
      not function simply as docking proteins. The cysteine residue of E6-AP
      responsible for ubiquitin thioester formation was mapped to a region that is
      highly conserved among several proteins of unknown function, suggesting that
      these proteins share the ability to form thioesters with ubiquitin.

PMID- 7800046
TI  - Eye-lens proteins: structure, superstructure, stability, genetics.
AB  - The eye lens in vertebrates and invertebrates is an avascular tissue which allows
      one to focus objects on the retina. The lens grows throughout life, maintaining
      transparency without significant turnover of its densely packed proteins. Apart
      from cytoskeletal and taxon-specific components, these proteins belong mainly to
      the alpha- and beta gamma-crystallin families. The detailed structural analysis
      of beta gamma-crystallins can explain the anomalous stability by the specific
      supersecondary structure ("Greek key" topology) of the domains and by strong
      domain and subunit interactions. The spatial correlation of the molecules at the
      given high concentrations in the fiber cells gives rise to "short-range order"
      with minimum light scattering, thus providing optimum transparency of the eye
      lens.

PMID- 7800047
TI  - [Light regulation of chloroplast enzymes].
AB  - The activity of various chloroplast enzymes is regulated by a covalent redox
      modification cycle driven by photosynthetic electron flow and oxygen, and is fine
      tuned by effectors specific for each target enzyme. The regulatory principle
      resembles the protein phosphorylation/dephosphorylation system. The primary
      structures of some redox-modulated enzymes reveal characteristic extra cysteine
      carrying peptides in addition to very conserved sequences.

PMID- 7800048
TI  - The nature of mercury in tap water.

PMID- 7800049
TI  - Transformation of the mycotoxin ochratoxin A in wheat and maize cell suspension
      cultures.

PMID- 7800050
TI  - Sex linkage in the honeybee Apis mellifera detected by multilocus DNA
      fingerprinting.

PMID- 7800051
TI  - Substance abuse treatment modalities.

PMID- 7800052
TI  - Illiteracy still a problem.

PMID- 7800053
TI  - "No fault," round three.

PMID- 7800054
TI  - "No fault", round three.

PMID- 7800055
TI  - Second-look laparoscopy.

PMID- 7800057
TI  - Facing the challenge of HIV. Primary care physicians have an obligation to care
      for those infected.

PMID- 7800056
TI  - Necrotizing fasciitis and myositis caused by group A streptococci. Epidemiology,
      diagnosis, and treatment of "flesh-eating bacteria".
AB  - Despite the absence of conclusive proof, the incidence of necrotizing fasciitis
      and myositis due to GAS may be increasing, possibly related to shifts in the
      proportion of GAS isolates of M-Types 1 and 3. These M-types (or the production
      of exotoxins and proteases associated with them) may lead to severe GAS
      infections in individuals who lack immunity. Recent television and newspaper
      reports underscore the potential virulence of GAS even in young and previously
      well individuals although they do this at the expense of raising fear in the
      general population. It is unfortunate that these reports often fail to emphasize
      the rarity with which GAS causes myositis and fasciitis. The overall incidence of
      these dreadful diseases is very low. In fact, by extrapolating the CDC estimates,
      we suspect that only 14-40 cases of GAS-induced myositis or fasciitis occur
      annually in North Carolina. Each of these infections is a true calamity for the
      affected patients and their physicians, but together they represent only a tiny
      fraction of all GAS infections that occur in North Carolinians each year. It is
      relatively easy to separate uncomplicated streptococcal cellulitis from GAS
      induced fasciitis and/or myositis by bedside exam and old-fashioned clinical
      judgment. Prompt and aggressive surgical debridement and antibiotic therapy are
      needed for all patients with myositis and/or fasciitis due to GAS; others can be
      treated with simple beta-lactam antibiotics and careful observation.

PMID- 7800058
TI  - HIV testing: a medical student's perspective.

PMID- 7800059
TI  - Can physicians deny treatment based on fear of AIDS infection?

PMID- 7800060
TI  - Managing medicine: "Dr." stands for doctor and director.

PMID- 7800061
TI  - Dermatology. Your skin.

PMID- 7800062
TI  - The use of donated oocytes for the treatment of infertility.

PMID- 7800063
TI  - Development of sports medicine.

PMID- 7800064
TI  - Continuing medical education in North Carolina. Emerging trends and new
      challenges.

PMID- 7800065
TI  - Patients suffer pyrogenic reactions in Philadelphia dialysis units.

PMID- 7800066
TI  - Dedication, ingenuity guide inventors in better the lives of kidney patients.
      Moncrief, Popovich receive NN&I's Quality of Life Award.

PMID- 7800067
TI  - Evaluation: a progress report on measuring ESRD outcome.

PMID- 7800068
TI  - International health care models: a comparative analysis. Part II.

PMID- 7800069
TI  - OIG scrutinizing lab discounting for dialysis units.

PMID- 7800070
TI  - [Mild exertional dyspnea is sometimes a serious symptom].

PMID- 7800071
TI  - [Therapeutic inhalation of nitric oxide in patients with pulmonary hypertension].

PMID- 7800072
TI  - [Carotid body tumors].

PMID- 7800073
TI  - [Value of serological determinations in the differential diagnosis of ulcerative
      colitis and Crohn's disease, and immunogenetic aspects].

PMID- 7800074
TI  - [Characteristics of patients with recurrence of primary melanoma at least 10
      years following surgical treatment].
AB  - OBJECTIVE: Assessment of incidence and risk factors of late recurrence (after a
      disease-free interval of at least 10 years) following treatment for primary
      melanoma. METHODS: Retrospective study taking into account a total of 2579
      melanoma patients admitted to the Netherlands Cancer Institute/Antoni van
      Leeuwenhoek Huis in the period 1956 to 1991; patients with ocular melanoma were
      excluded. RESULTS: Twenty-three patients had a disease-free interval of at least
      10 years (median 11 years; range: 10-21) after treatment for primary melanoma: 17
      women and 6 men, with a median age of 43 years (20-62). This group predominantly
      consisted of women with a primary melanoma localised on the extremities. Most of
      them had melanomas of intermediate thickness (Breslow thickness: 1-2 mm).
      Patients with a first recurrence locoregionally (16) had a 5-year survival rate
      of over 50%; 6 of the 7 patients with a first relapse at distant sites died
      within a few months. CONCLUSION: Melanoma patients who are discharged from follow
      up after a disease-free interval of 10 years are advised to continue loco
      regional self-examination.

PMID- 7800075
TI  - [Risk of tuberculosis in the inadequate handling of refugees seeking asylum].
AB  - OBJECTIVE: To describe screening for tuberculosis in a temporary centre for
      refugees, and contact investigation after a patient with open tuberculosis had
      been identified. DESIGN: Descriptive. SETTING: Regional Communal Health Centre
      Nijmegen. METHOD: The refugees waiting for official status were housed on three
      cruise ships during the winter period November 1993 to April 1994. Ventilatory
      capacity was insufficient. The people had thorax radiograms after 10 days on
      average as a screening for tuberculosis. When abnormalities were found sputum was
      examined (Ziehl-Neelsen staining and culture). The workers of the centre were
      Mantoux-tested. RESULTS: Of the 834 persons screened 4 had open tuberculosis.
      Contact investigation yielded three cases of infection among 5 contacts in the
      first ring, and 11 cases of infection and 2 cases of tuberculosis (one
      infiltrative pulmonary tuberculosis, the other cavernous pulmonary tuberculosis)
      among 215 contacts in the second ring. Fourteen of the infected persons were
      centre workers. The bacteria found were not resistant to tuberculostatics.
      CONCLUSION: Rapid transmission of tuberculosis occurred because of insufficient
      ventilation and a slow screening procedure. Tuberculosis in refugee centres is a
      serious problem that needs adequate attention.

PMID- 7800076
TI  - [Pulmonary hypertension following use of fenfluramine for obesity].
AB  - Pulmonary hypertension was diagnosed in a 41-year-old woman after 16 months' use
      of fenfluramine as a treatment for obesity. Despite discontinuation, pulmonary
      pressure remained elevated. Drug-induced pulmonary hypertension is rare but has
      been reported relatively often after use of the sympathicomimetic agent
      aminorexfumarate, but also, although more rarely, of fenfluramine.

PMID- 7800077
TI  - [Nitric oxide to combat pulmonary hypertension in an infant following heart
      surgery for septum defect].
AB  - A 5-month-old female infant with Down syndrome underwent surgical repair of a
      complete atrioventricular septal defect and a patent ductus arteriosus. The
      postoperative course was complicated by life-threatening pulmonary hypertensive
      crises which did not respond to conventional vasodilating therapy. Nitric oxide
      inhalation resulted in rapid decrease in pulmonary artery pressure and
      improvement of haemodynamics and oxygenation without causing any untoward side
      effects. Inhalation of NO was continued over the next 4 days, with a maximum NO
      concentration of 20 ppm during a period of 12 hours. The subsequent postoperative
      course was uneventful and the patient was discharged from the hospital in good
      health on the 23rd postoperative day.

PMID- 7800078
TI  - [Minors and mentally incompetent adult patients in the Law on Medical Treatment
      Agreement].

PMID- 7800079
TI  - [Medical treatment of mentally incompetent patients in the Law on Medical
      Treatment Agreement].

PMID- 7800080
TI  - [Manganese poisoning due to the use of Chien Pu Wan tablets].

PMID- 7800081
TI  - [Manganese poisoning due to the use of Chien Pu Wan tablets].

PMID- 7800082
TI  - [Disciplinary decisions and anesthesiological practice management].

PMID- 7800083
TI  - [Euthanasia; confusion concerning the reporting procedure].

PMID- 7800084
TI  - [No positive effect of preoperative exercise therapy and instruction in patients
      about to undergo hip arthroplasty].

PMID- 7800085
TI  - [The Law on Mass Screening].

PMID- 7800086
TI  - [Current status and developments in psychiatric care. A European comparison].
AB  - In most European countries several reform indicators point to a marked change in
      psychiatric care during the last three decades. Almost everywhere the size of
      psychiatric hospitals was reduced and the number of beds decreased. The
      development in the outpatient and complementary sector is less clear. Different
      European countries provide sheltered living accomodations, workshops and
      outpatient treatment to varying degrees. Comparably complex are financing and
      legal grounds of psychiatric treatment. Beside still existing institutional
      deficits, the negative attitude of the public toward mentally ill and psychiatric
      care is a serious obstacle for further implementation of community based
      psychiatric care.

PMID- 7800088
TI  - [Positive or negative symptoms. Which are more reliable in the diagnosis of
      schizophrenia?].
AB  - Due to the anticipated revisions concerning diagnostic criteria for schizophrenia
      in DSM-IV, recent Anglo-American research has been particularly concerned with
      the controversial problem whether positive or negative symptoms are more suited
      for the determination of these criteria. We addressed this problem in an
      empirical study. A total of 489 consecutive admissions to the Department of
      Psychiatry at the RWTH University, Aachen were assessed for the distribution of
      positive, negative and basic symptoms according to six ICD-10 double-digit
      diagnostic categories. Positive symptoms were shown to be more useful for
      diagnosis than the negative or basic symptoms. Basic symptoms, however, had a
      pattern of distribution which supports the notion that they may also be useful
      for the early diagnosis of schizophrenia.

PMID- 7800087
TI  - [Detection of early warning signs in schizophrenic patients. Possible
      applications in prevention of recurrence].
AB  - In the treatment of schizophrenia, two new strategies have been developed with
      the aim of adequate relapse prevention accompanied by lowest possible risk of
      side-effects. One strategy is to have the patient continue to take medication at
      a highly reduced dosage (10-20% of the standard dose). The other is to gradually
      stop neuroleptic medication after remission and to reinstitute medication only in
      the case of prodromal symptoms (termed targeted or intermittent treatment).
      According to Herz and Melville [13] many schizophrenic patients show signs of
      relapse well before recurrence of overt psychotic features. Monitoring to detect
      prodromal symptoms is especially important in targeted treatment because,
      otherwise, neuroleptic medication often cannot be initiated in time. In the
      present study of 51 schizophrenic patients we were able to replicate the results
      of Herz & Melville in the German-speaking countries. Prior to acute exacerbation
      of psychosis, most patients experience alterations of feelings and behaviour.
      These alterations may also be recognized by family members. Such early warning
      signs of relapse mainly consist of non-specific, non-psychotic symptoms:
      tenseness and nervousness, eating less, trouble concentrating and sleeping,
      depressive mood and seeing friends less. Furthermore, the regular monitoring and
      use of early warning signs specific to each patient in the aftercare of
      schizophrenic patients seems to be practicable, especially in psychoeducative
      family therapy.

PMID- 7800090
TI  - [Locus of control in chronic schizophrenia. Empirical data in an ambulatory group
      of patients].
AB  - In the present study loci of control as cognitive attitudes are investigated by
      repeated examinations in an out-patient therapy group of patients suffering from
      chronic schizophrenia. Loci of control are expressions of subjective intellectual
      evaluations to give an opinion of individual results of action. Present study
      data agree with first results in literature which show an external orientation of
      investigated patients and the constant markedness of cognitive attitudes in time.
      Furthermore study results about the connection of cognitive attitudes and
      psychopathological self ratings and ratings by the investigator as well as
      statements about changes of experience and behaviour are shown and discussed in
      the end. It is started out that knowledges of these cognitions can support long
      term out-patient care of patients with chronic schizophrenia. The consideration
      of cognitive attitudes is part of a concept of therapeutic interventions, which
      improve personal skills by finding a model of illness.

PMID- 7800089
TI  - [Prenatal developmental disorders of brain structures in schizophrenic
      psychoses].
AB  - In recent years neuroimaging techniques have revealed various cerebral and
      structural variances in patients with schizophrenic psychoses. The best
      established findings are the enlargement of the lateral ventricles and discrete
      structural deficits in temporobasal structures of the cortex. Neuropathological
      investigations have detected subcortical as well as cortical variances.
      Subcortically, the volume of the striatum and the globus pallidus have been found
      to be enlarged in schizophrenics. Among the cortical deviations, the
      cytoarchitectonic disturbances of the rostral entorhinal region have been well
      documented and are especially important. According to neuropathological criteria,
      they are derived from disturbances of prenatal cell migration within the central
      nervous system. Due to its close anatomical and functional connection with the
      hippocampal formation and its being the assembly point of all sensory cortical
      areas, disturbances of this area could seriously impede the processing and
      filtering of information within the limbic system. The other hitherto reported
      structural anomalies, such as the disturbance to the radial order of hippocampal
      neurons, and the abnormal structures in the frontobasal orbital regions and the
      rostroventral insula, could be connected to the disturbances of migration within
      the entorhinal region; the former could be secondary, but still prenatal
      developments. Well documented are the architectonic changes in the rostral
      cingulate gyrus which is itself connected with the entorhinal region via the
      Papez circuit. These findings are supported and supplemented by the results of
      epidemiological studies which indicate a disturbance of brain development during
      the second trimenon of the prenatal period. Viral infections (Influenza A2) of
      mothers during this critical period appear to play an especially important
      role.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7800091
TI  - [The world as inner space. Kafka's "The Burrow" as a paradigm of paranoid spatial
      experience].
AB  - The paranoid's experience of space is illustrated in the present study by means
      of an investigation of paraphrenic senile psychosis and an analysis of Kafka's
      short story, "The Burrow". This may be characterized as an experience of
      increasing permeability and disintegration of boundaries between one's own,
      private space and that belonging to others, or between inside and outside. At
      first, a latent ego-weakness is compensated by shifting the self-boundaries onto
      the territory of one's dwelling which serves as an "external shell" for the self.
      The emphasis on fencing-off and isolation from the external world, however,
      renders the hidden, inner spaces ever more threatening. The protecting barriers
      change into fragile facades through which enemies are able to attack. Finally,
      the sheltering but, nevertheless, exposed inner spaces fall prey to threats from
      the outside. Paradoxically, the disintegration of the inner space of self comes
      about by the paranoid constantly taking the view point of his fictitious enemies;
      he, thereby, sees through and penetrates the very barriers which he himself has
      erected.

PMID- 7800092
TI  - [Selective serotonin reuptake inhibitors in treatment of compulsive symptoms
      within the scope of schizophrenia].
AB  - We report the case history of two female schizophrenic in-patients who exhibited
      a significant reduction of accompanying obsessive-compulsive symptoms under the
      combined treatment of neuroleptics and selective serotonin reuptake inhibitors
      (SSRIs). Our results indicate that the basic psychotic disorder was not
      exacerbated as a result of this additional treatment.

PMID- 7800093
TI  - [Drug treatment of schizophrenic psychoses in puerperium].
AB  - Three schizophrenic patients and one schizophreniform patient, all experiencing
      puerperal psychosis, required a drug-induced delactation (bromocriptine)
      simultaneously to neuroleptic treatment. Taking into account the pharmacodynamic
      effects, an exacerbation of symptoms following bromocriptine (a D-2 receptor
      agonist) and an impairment of delactation following neuroleptic treatment
      (bringing about the blockade of D-2 receptors) are to be expected. In three
      cases, we carried out a combined bromocriptine-haloperidol treatment and, in one
      case, a bromocriptine-clozapine treatment. The above mentioned complications were
      not observed in any of the cases. The problems which may result from using
      clozapine during the puerperal period are also discussed.

PMID- 7800094
TI  - [Early dyskinesia with administration of clozapine (Leponex)].
AB  - A 51-year old, female patient suffering from schizophrenic disorder was treated
      with clozapine (Leponex). Four hours after the first parenteral, drug
      administration, she developed an acute dyskinesia.

PMID- 7800095
TI  - [Hypothermia caused by neuroleptics. 2 case reports and review of the
      literature].
AB  - The present paper discusses appearance and course of neuroleptic induced
      hypothermia of a 36 years old woman suffering from periodic catatonia and a 38
      years old seriously mentally handicapped man. Analysis of clinical studies and
      pharmacological tests with animals about body temperature changes caused by
      neuroleptics yields that these may lead to hypothermia as well as hyperthermia,
      depending on individual disposition and dose, which is mainly a result of their
      effect through dopaminergic neurons of the hypothalamus, which controls
      thermoregulation, and of their influence on vasomotoric mechanisms of vessels of
      the skin. Though hyperthermic changes are more hazardous and occur more
      frequently hypothermia by neuroleptic agents is clinically relevant as shown by
      the summarizing presentation of previously released case reports: hypothermia is
      found at neuroleptic medicated healthy volunteers and at psychiatric patients
      with or without physical illness, at which hypothyreosis and impair of the brain
      seem to represent special risks.

PMID- 7800097
TI  - [Schizophrenia: new results and models of the etiology].

PMID- 7800096
TI  - [Apolipoprotein E typology and dementia].

PMID- 7800098
TI  - [Is psychoanalytic psychotherapy an "alternative method"].

PMID- 7800099
TI  - [Is psychoanalytic psychotherapy an "alternative method"].

PMID- 7800100
TI  - [Is psychoanalytic psychotherapy an "alternative method"].

PMID- 7800101
TI  - Stroke data banks: challenges for research. Geneva, Switzerland, May 1993.
      Workshop proceedings.

PMID- 7800102
TI  - Overview of stroke data banks.
AB  - Stroke data banks (SDBs) used for clinical research are between traditional case
      series and population-based studies. They can serve a multitude of purposes:
      estimating the burden of disease treated in one or several centers, calculating
      the recruitment rates for clinical trials, or for the detection of stroke
      incidence or time trends by means of a long-time observation in a defined
      geographical area. Some SDBs restrict themselves to the systematic collection of
      rare cases of stroke or to recurring strokes. The strength of an SDB lies in its
      ability to accumulate a large set of data within specified time frames using a
      defined set of diagnostic procedures. One of the most attractive features of an
      SDB is its generation of research hypotheses that allow one to look for similar
      patterns in related and in unrelated disorders. The overview in this volume is
      based on a literature search of SDBs published since 1980 and a questionnaire
      sent to the principal investigators applying ten criteria considered essential
      for clinical research: diagnostic criteria, separate analysis of first-ever
      strokes, CT investigation rate > 70%, integration of autopsy data, collection of
      prospective data wherever possible, planning of a pilot phase and interrater
      studies, constant screening procedures to identify patients enrolled and constant
      time frame of examinations, a large spectrum of clinical and investigative data,
      12 months' follow-up examinations, and a baseline paper describing the procedures
      used. When applying these criteria to the literature only 8 SDBs fulfilled
      them.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7800103
TI  - Issues in analyzing data: experiences with three data bases.
AB  - Analytic issues in stroke data base research are reviewed, drawing upon relevant
      experiences in the analyses of three observational data bases from a variety of
      clinical fields. The specifics of the data base construct, statistical issues and
      variations in possible interpretations of results are discussed. Responsible
      analyses of and conservative inferences from observational data bases are
      stressed.

PMID- 7800104
TI  - Observational data bases in neurological disorders: selection bias and
      generalization of results.
AB  - Observational data bases in the neurological disorders may be an important source
      of information on etiology and natural history. The ability to make valid
      generalizations of results from a data base to the general population of patients
      with a particular disorder is not, however, guaranteed. The design or analysis of
      the study may result in selection biases that make inferences untenable. Examples
      are presented which demonstrate the potential for bias limiting the validity of
      inferences beyond the sample observed.

PMID- 7800105
TI  - Interactions between stroke data banks and clinical trials.
AB  - The number of clinical trials to evaluate new therapies for stroke treatment and
      prevention is growing rapidly. Although stroke data banks cannot answer treatment
      efficacy questions, they can have powerful interactions with the design and
      conduct of clinical trials. Through data banks one can generate hypotheses
      regarding treatment, estimate the frequency of outcome events, calculate sample
      size, determine stratification factors that may or may not be needed in a
      clinical trial, establish inclusion and exclusion criteria and decide on the
      elements to include in the data collection forms. Using a data bank one can
      estimate the number of patients that may be screened, eligible, refused, and
      enrolled in a clinical trial with given inclusion and exclusion criteria. Data
      banks are helpful for surveillance of all eligible subjects and calculating the
      proportion of the total cases who were randomized. With the more widespread
      analyses of stroke data banks we can design focused clinical trials and reach
      some definitive conclusions regarding the future treatment of stroke.

PMID- 7800106
TI  - Baseline measures and outcome predictions.
AB  - This paper reviews the methodological issues in the epidemiological study of the
      outcome from stroke. Data are presented from an unselected series of patients in
      whom the underlying stroke pathology is clearly defined. Although the natural
      history varies among the different pathological subtypes of stroke, simple
      clinical baseline measures of the severity of the neurological deficit
      (incontinence, loss of consciousness and severity of paresis) and premorbid level
      of disability and social functioning independently predict disability-free
      survival by 1 year, and may help direct management and research.

PMID- 7800107
TI  - Clinical methods for diagnostic confirmation of stroke subtypes.
AB  - Clinicians faced with a patient having a sudden-onset, focal neurological deficit
      must answer three fundamental questions: is it a stroke?, is it ischemia or
      hemorrhage? and what kind of ischemic stroke is it? Clinical information (that
      is, history and examination) is immediately available to every physician, and its
      role in answering these questions is extremely important, even though a 100%
      certainty can only be obtained with instrumental diagnostic tools. In fact, when
      diagnosis is based on properly designed clinical criteria, the percentage of
      diagnostic mistakes is quite low. Clinical methods are still the best way of
      orientating topographic and etiologic diagnosis, as well as prognosis. In
      addition, time might be saved if randomization in clinical trials could be done
      using clinical methods before complex investigations are applied.

PMID- 7800108
TI  - Value of stroke data banks for the analysis of clinical syndromes.
AB  - The diversity of clinical syndromes and etiologies of stroke make stroke data
      banks one of the best tools to improve current knowledge of stroke. Hospital
      based registries profit from a stroke team in the acute phase of the event and
      from access to special investigations. This leads to an earlier clinical and
      topographic diagnosis that may allow inclusion of the patient into acute trials
      within the therapeutic window. It also makes possible complete investigation in
      the acute period and broadens information on potential etiologies.

PMID- 7800109
TI  - Black-white differences in stroke frequency: challenges for research.
AB  - Studies of ethnic differences in frequency of disease can sometimes provide
      insights into etiologic mechanisms and, hopefully, lead to interventions that
      decrease risk and frequency of the disease. This principle can be applied to
      studies of stroke among blacks and whites. Blacks carry a disproportionate burden
      of strokes relative to the number of blacks in the population. In this paper,
      possible explanations for the differences are reviewed. It has been reported that
      certain risk factors for stroke, notably hypertension, are more common in blacks.
      However, it is unclear whether less access to medical care, difficulty with
      compliance in treatment programs, genetic differences in responsiveness to
      certain drugs or other genetic differences related to susceptibility are
      responsible for the consistently higher stroke frequency in blacks compared to
      whites. The frequency of stroke type also differs in these ethnic groups; whites
      are more prone to large vessel and embolic strokes whereas blacks suffer a higher
      frequency of small vessel and hemorrhagic stroke. When closely examining
      evidence, it is also unclear whether life-style, socioeconomic, or other factors
      can be implicated and even whether race plays any important role at all. All of
      these ethnic issues must carefully be considered in stroke data base research.

PMID- 7800110
TI  - Assessment of cerebrovascular risk profiles in healthy persons: definition of
      research goals and the Austrian Stroke Prevention Study (ASPS).
AB  - The advent of new laboratory methods and noninvasive imaging modalities has
      extended the diagnostic possibilities in normal individuals. This article
      elaborates the new options for the assessment of stroke risk offered by these
      techniques. In this context we present the Austrian Stroke Prevention Study,
      which is the first prospective long-term investigation of normals that includes
      Doppler sonography, magnetic resonance imaging and single photon emission
      computed tomography. The design, utility and limitations of this study are
      discussed.

PMID- 7800111
TI  - Quantitative assessment of carotid atherosclerosis in a healthy population.
AB  - To evaluate the prevalence and extent of carotid atherosclerosis in a general
      healthy population, duplex ultrasound imaging was performed in 909 men and women
      aged 40-79 years as part of the prospective Bruneck Ischemic Heart Disease and
      Stroke Prevention Study. Atherosclerotic lesions were found in 47.8% of men and
      36.3% of women. Sex differences in the prevalence rates were most pronounced from
      age 40 to 60 years with a convergence occurring in the 7th decade. The age range
      of 60-69 years was found to be the crucial period for the development of advanced
      carotid artery disease. The frequency of internal carotid artery stenosis (> 50%)
      in elderly men and women (60-79 years) was 10.5 and 5.5%. In nonstenotic carotid
      artery disease the lumen diameter turned out to be a useful indirect measure of
      the vascular status.

PMID- 7800112
TI  - Cardioembolic stroke: results from three current stroke data banks.
AB  - About 17% of all transient ischemic attacks (TIA) and ischemic strokes were due
      to cardiogenic embolism in three prospective stroke registries (Berlin, Giessen,
      Klosterneuburg). Most of these patients can be identified by history, clinical
      examination, conventional ECG, and appropriate use of echocardiography.
      Widespread screening of stroke patients with transesophageal echocardiography, as
      intented in the protocol of two registries, did not appreciably increase the
      portion of patients with the final diagnosis of cardiogenic embolism, although,
      in many cases, minor-risk embolic sources can be identified. Prognosis for death
      or early recurrence after cardiogenic brain embolism was not worse than assumed
      previously.

PMID- 7800113
TI  - Pathophysiologic assessment of data from a stroke data bank.
AB  - Stroke data banks have been instrumental in helping us to clarify stroke etiology
      and in the investigation of clinical-topographic correlations. For these purposes
      they have relied upon results from noninvasive vascular and cardiac methods,
      including extra- and transcranial Doppler sonography and echocardiography, as
      well as from procedures such as cranial computed tomography and magnetic
      resonance imaging. Conventional database concepts have also been used to assess
      pathophysiologic aspects of stroke. Although such applications have made
      important contributions in this multidiscipline area of investigation, they are
      limited by a lack of explicit representation of pathophysiologic knowledge for
      data interpretation. Recent results from artificial intelligence research suggest
      exciting new frontiers for medical database design with concepts stemming from
      second generation expert systems. We propose an extended concept for stroke data
      banks to include a knowledge-based system which incorporates current patient
      data, heuristic knowledge relating clinical features to functional impairment,
      and pathophysiologic models of neurological disease.

PMID- 7800114
TI  - The position of neuroimaging in the evaluation of stroke risk.

PMID- 7800115
TI  - Problems encountered with longitudinal neurological, psychometric and cerebral CT
      imaging among stroke data bank patients with dementia.
AB  - 41 patients (30 men, 11 women, mean age 65.3 +/- 9.7 years) with probable
      ischemic vascular dementia diagnosed according to stated clinical criteria at
      least 3 months after hospital discharge and among a few nonhospitalized subjects
      with thorough clinical, neurovascular and neuroimaging workup have been followed
      for the past 7 years with serial measures of neurological and cognitive status
      and cerebral blood flow using stable xenon-enhanced CT. Cognitive impairments
      correlated with cerebral ischemia rather than CT measurements of infarcted brain
      volume. A minimum of one follow-up was required and follow-up intervals ranged
      from 4 months to 6.6 years (mean 3.4 +/- 1.6 years). 9 patients (22.0%) were lost
      to follow-up, 4.9% died, 9.8% became incapacitated by additional strokes, 2.4% by
      cancer and 4.9% moved away. Cross-sequential designs adjust for problems of
      attrition. Mortality rates of 1.4%/year during 1986-1993 are significantly lower
      than 2.0%/year between 1983 and 1986. Declines in mortality are attributed to
      control of risk factors and antiplatelet treatment of atherosclerotic cerebral
      vascular disease and anticoagulant treatment of patients with cardiogenic
      embolism.

PMID- 7800116
TI  - Developmental expression of MOSP in cultured oligodendrocytes.
AB  - Myelin/oligodendrocyte specific protein (MOSP) is a recently characterized 48 kDa
      surface membrane protein that is expressed exclusively by oligodendrocytes in the
      CNS. In this report, evidence is presented for the identification of the stage in
      the oligodendrocyte lineage when MOSP is first expressed. MOSP initially appears
      on immature oligodendrocytes about four to five days postnatal, which is about
      one to two days after the appearance of galactocerebroside and sulfatide. The
      initial expression of MOSP occurs at the stage in development when
      oligodendrocytes are elaborating processes and just beginning to form membrane
      sheets. Since 1) MOSP is capable of signaling increases in microtubular
      structures in oligodendrocytes and 2) microtubular structures may be essential
      for extension of growing processes and the formation of membrane sheaths, MOSP
      may play an important role in differentiation of oligodendrocytes and the
      formation of myelin.

PMID- 7800118
TI  - Identification of novel mRNAs expressed in oligodendrocytes.
AB  - To identify new proteins, which are expressed in oligodendrocytes and which may
      have a functional role in myelination, a rat oligodendrocyte cDNA library was
      screened using differential and subtractive screening techniques. Ten clones that
      have elevated levels of expression in brain were isolated. Two of these clones
      were characterized further and one clone, pC26.H2, was found to be closely
      related to mouse stearoyl-CoA desaturase 2 (SCD2), which catalyzes the synthesis
      of unsaturated fatty acid. From Northern blot and in situ hybridization studies,
      SCD2 mRNA was expressed primarily in brain with lower levels found in lung and
      spleen. In brain sections, SCD2 mRNA was found primarily in oligodendrocytes,
      although mRNA was detected at a low level in neurons, in particular in Purkinje
      cells in the cerebellum. Northern blot analysis of the other clone, p973.HB,
      indicated that it was expressed more selectively in brain. In mixed glial
      cultures oligodendrocytes were the only cells that expressed this mRNA, whereas
      in brain, neurons expressed this mRNA at a higher level than in oligodendrocytes.
      This clone is being actively pursued because of its unique expression exclusively
      in oligodendrocytes and neurons.

PMID- 7800119
TI  - In vitro analysis of ion channels in periaxolemmal-myelin and white matter
      clathrin coated vesicles: modulation by calcium and GTP gamma S.
AB  - This study reports the analysis of K+ channel activity in bovine periaxolemmal
      myelin and white matter-derived clathrin-coated vesicles. Channel activity was
      evaluated by the fusion of membrane vesicles with phospholipid bilayers formed
      across a patch-clamp pipette. In periaxolemmal myelin spontaneous K+ channels
      were observed with amplitudes of 25-30, 45-55, and 80-100 pS, all of which
      exhibited mean open-times of 1-2 msec. The open state probability of the 50 pS
      channel in periaxolemmal-myelin was increased by 6-methyldihydro-pyran-2-one.
      Periaxolemmal-myelin K+ channel activity was regulated by Ca2+. Little or no
      change in activity was observed when Ca2+ was added to the cis side of the
      bilayer. Addition of 10 microM total Ca2+ also resulted in little change in K+
      channel activity. However, at 80 microM total Ca2+ all K+ channel activity was
      suppressed along with the activation of a 100 pS Cl- channel. The K+ channel
      activity in periaxolemmal myelin was also regulated through a G-protein. Addition
      of GTP gamma S to the trans side of the bilayer resulted in a restriction of
      activity to the 45-50 pS channel which was present at all holding potentials.
      Endocytic coated vesicles, form in part through G-protein mediated events; white
      matter coated vesicles were analyzed for G proteins and for K+ channel activity.
      These vesicles, which previous studies had shown are derived from periaxolemmal
      domains, were found to be enriched in the alpha subunits of G0, Gs alpha, and Gi
      alpha and the low molecular weight G protein, ras.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7800120
TI  - Special issue dedicated to Dr. Marjorie B. Lees.

PMID- 7800117
TI  - Brain, liver, and adipose tissue erucic and very long chain fatty acid levels in
      adrenoleukodystrophy patients treated with glyceryl trierucate and trioleate oils
      (Lorenzo's oil).
AB  - Brain, liver, and adipose lipids were studied in the postmortem tissues of four
      adrenoleukodystrophy patients who had been treated with a mixture of glyceryl
      trioleate and trierucate oils ("Lorenzo's Oil") and compared to 7 untreated ALD
      patients and 3 controls. The dietary therapy appeared to reduce the levels of
      saturated very long chain fatty acids in the plasma, adipose tissue and liver; in
      the brain they were reduced in only one of the four patients. While substantial
      amounts of erucic acid were present in some of the tissues even 12 months after
      therapy had been discontinued, the levels in brain did not exceed those in
      controls at any time. The failure of erucic acid to enter the brain in
      significant quantity may be a factor in the disappointing results of dietary
      therapy for adrenoleukodystrophy.

PMID- 7800123
TI  - Plasmolipin: the other myelin proteolipid. A review of studies on its structure,
      expression, and function.

PMID- 7800121
TI  - Overview: protein palmitoylation in the nervous system: current views and
      unsolved problems.
AB  - Palmitoylation refers to a dynamic post-translational modification of proteins
      involving the covalent attachment of long-chain fatty acids to the side chains of
      cysteine, threonine or serine residues. In recent years, palmitoylation has been
      identified as a widespread modification of both viral and cellular proteins.
      Because of its dynamic nature, protein palmitoylation, like phosphorylation,
      appears to have a crucial role in the functioning of the nervous system. Several
      important questions regarding the post-translational acylation of cysteine
      residues in proteins are briefly discussed: (a) What are the molecular mechanisms
      involved in dynamic acylation? (b) What are the determinants of the fatty acid
      specificity and the structural requirements of the acceptor proteins? (c) What
      are the physiological signals regulating this type of protein modification, and
      (d) What is the biological role(s) of this reaction with respect to the
      functioning of specific nervous system proteins? We also present the current
      experimental obstacles that have to be overcome to fully understand the biology
      of this dynamic modification.

PMID- 7800122
TI  - Expression and biological functions of sulfoglucuronyl glycolipids (SGGLs) in the
      nervous system--a review.
AB  - Sulfoglucuronyl carbohydrate linked to neolactotetraose reacts with HNK-1
      antibody. The HNK-1 carbohydrate epitope is found in two major glycolipids,
      several glycoproteins and in some proteoglycans of the nervous system. Most of
      the HNK-1 reactive glycoproteins so far identified are neural cell adhesion
      molecules and/or are involved in cell-cell interactions. HNK-1 carbohydrate is
      highly immunogenic. Several HNK-1-like antibodies, including IgM of some patients
      with plasma cell abnormalities and having peripheral neuropathy, have been
      described. This article summarizes published work mainly on sulfoglucuronyl
      glycolipids, SGGLs and covers: structural requirements of the carbohydrate
      epitope for binding to HNK-1 and human antibodies, expression of the lipids in
      various neural areas, stage and region specific developmental expression in CNS
      and PNS, immunocytochemical localization, loss of expression in Purkinje cell
      abnormality murine mutations, biosynthetic regulation of expression by a single
      enzyme N-acetylglucosaminyl transferase, identification of receptor-like
      carbohydrate binding neural proteins (lectins), and perceived role of the
      carbohydrate in physiological functions. The latter includes role in:
      pathogenesis of certain peripheral neuropathies, in migration of neural crest
      cells, as a ligand in cell-cell adhesion/interaction and as a promoter of neurite
      outgrowth for motor neurons. Multiple expression of HNK-1 carbohydrate in several
      molecules and in various neural cell types at specific stages of nervous system
      development has puzzled investigators as to its specific biological function, but
      this may also suggest its importance in multiple systems during cell
      differentiation and migration processes.

PMID- 7800124
TI  - Metabolic turnover of myelin glycerophospholipids.
AB  - The apparent half life for metabolic turnover of glycerophospholipids in the
      myelin sheath, as determined by measuring the rate of loss of label in a myelin
      glycerophospholipid following radioactive precursor injection, varies with the
      radioactive precursor used, age of animal, and time after injection during which
      metabolic turnover is studied. Experimental strategies for resolving apparent
      inconsistencies consequent to these variables are discussed. Illustrative data
      concerning turnover of phosphatidylcholine (PC) in myelin of rat brain are
      presented. PC of the myelin membrane exhibits heterogeneity with respect to
      metabolic turnover rates. There are at least two metabolic pools of PC in myelin,
      one with a half life of the order of days, and another with a half life of the
      order of weeks. To a significant extent biphasic turnover is due to differential
      turnover of individual molecular species (which differ in acyl chain
      composition). The two predominant molecular species of myelin PC turnover at very
      different rates (16:0, 18:1 PC turning over several times more rapidly than 18:0,
      18:1 PC). Therefore, within the same membrane, individual molecular species of a
      phospholipid class are metabolized at different rates. Possible mechanisms for
      differential turnover of molecular species are discussed, as are other factors
      that may contribute to a multiphasic turnover of glycerophospholipids.

PMID- 7800126
TI  - Vascular considerations and complications in cranial base surgery.
AB  - The technical evolution of cranial base surgery has resulted in approaches that
      allow more radical surgical extirpation of complex cranial base lesions. Our
      service has extensively applied these cranial base approaches for lesions of the
      cranial base. A subgroup of 100 patients who had cranial base tumors involving
      potential manipulation or sacrifice of carotid arteries underwent 20-minute
      balloon test occlusions coordinated with vascular assessments consisting of a
      combination of the following: 1) four-vessel cerebral angiogram with compression
      studies; 2) occlusion transcranial Doppler ultrasonography; 3) occlusion single
      photon emission computed tomography perfusion studies; and 4) xenon-133 cerebral
      blood flow studies. Transient neurological deficits associated with balloon test
      occlusion occurred in 7 of 100 patients (7%). Subsequently, 18 patients underwent
      permanent carotid occlusion by endovascular detachable balloons. Delayed ischemic
      complications (> 72 h) occurred in 4 of 18 (22%) patients. Additionally, a number
      of vascular complications not predicted by the balloon occlusion tests and
      vascular assessments were experienced. Repeat vascular assessments defined the
      causes and guided treatment of ischemic patients. Ischemic complications were
      caused by hemodynamic insufficiency, embolization, vasospasm, radiation
      vasculopathy, and venous anomaly. Our experience leads us to believe that no
      vascular assessment exists today that can predict the occurrence of vascular
      complications accurately. The current enthusiasm for cranial base surgery must be
      tempered with the sober reality that management of cerebrovascular anatomy and
      physiology remain significant limitations. Consideration of potential
      cerebrovascular complications is paramount to successful outcome and
      implementation of cranial base surgery.

PMID- 7800128
TI  - Surgical implications of magnetic resonance-enhanced dura.
AB  - The purpose of this study was to assess tissue changes responsible for dural
      enhancement of magnetic resonance imaging (MRI) and its clinical implications. A
      prospective surgical, histopathological, and MRI study was performed in 73
      patients with various types of disease, including meningiomas (n = 29),
      craniofacial tumors with possible direct intracranial extension (n = 21), gliomas
      and brain metastasis in close proximity to the dura mater (n = 9), and a variety
      of nonneoplastic processes (n = 14). Contrast-enhanced MRI was obtained within 5
      days before surgery and in some cases within 3 days after surgery as well.
      Histopathological examination of the dural specimens was performed in all 59
      patients with neoplasia and in selected patients with nonneoplastic processes.
      Dural invasion was noted in 18 of 29 meningiomas, 15 of 21 craniofacial
      neoplasms, 3 of 5 gliomas, and 3 of 4 brain metastases. In these patients
      invasion was focal and in direct continuity with the tumors. MRI disclosed that
      dura invaded by the tumor had a break in the continuity of enhancement, or that
      there was no discernible enhancement. Association between patterns of dural
      enhancement and tumor invasion of dura was statistically significant (P < 0.001).
      The thickened-enhanced portion of the dura represented reactive changes.
      Postoperative enhancement was seen as early as 24 hours after surgery and was
      shown histologically to be associated with vasodilation and reactive
      changes.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7800127
TI  - Recovery of the sutured facial nerve after removal of acoustic neuroma in
      patients with neurofibromatosis-2.
AB  - The authors compared the long-term recovery of sutured facial nerves after the
      removal of 8 neurofibromatosis-2 (NF2)-associated and 22 non-NF2 acoustic
      neuromas. The patients were from a series of 270 patients operated on for an
      acoustic neuroma between 1979 and 1989. The assessment was done with a modified
      House and Brackmann scale from video recordings. At least some facial movement or
      tone was achieved (Grade 5 or better) in all but three patients, but in none was
      the recovery excellent. The facial function, judged by the overall appearance in
      movement, recovered less in patients with NF2 (P = 0.048); a moderately good
      recovery (Grade 3 or better) was seen in one patient of eight with NF2, as
      compared with 13 of 22 with non-NF2. In conclusion, if the tumor cannot be peeled
      off easily from the facial nerve in patients with NF2, leaving a fragment of
      tumor behind is preferable to cutting and suturing the facial nerve.

PMID- 7800125
TI  - Myelination in the developing human brain: biochemical correlates.
AB  - To delineate the biochemical sequences of myelination in the human brain, we
      analyzed the protein and lipid composition of white matter in 18 baseline cases
      ranging in age from midgestation through infancy, the critical period in human
      myelination when the most rapid changes occur. Three adult cases were used as
      indices of maturity, and 4 cases with major disorders of CNS myelination (maple
      syrup urine disease, severe periventricular leukomalacia, idiopathic central
      hypomyelination, and metachromatic leukodystrophy) were analyzed. Brain samples
      were obtained < or = 24 hours after death. Sodium dodecyl sulfate-polyacrylamide
      gel electrophoresis and high performance thin-layer chromatography were used to
      separate and identify proteins and polar and neutral lipids in an average of 10
      sites/brain; computer-based densitometry was used to quantify polar lipids.
      Biochemical sequences, as manifested by the appearance of the myelin-associated
      lipids and myelin-specific proteins, closely followed previously described
      anatomic sequences both temporally and by region, and were identical in all sites
      sampled: sphingomyelin was followed simultaneously by cerebrosides, MBP, PLP, and
      nonhydroxy-sulfatide, followed by hydroxy-sulfatide. The onset and tempo of the
      expression of individual constituents, however, were quite variable among sites,
      suggesting a wide differential in vulnerable periods to insult in biochemically
      specific pathways in early life. Cholesterol ester was transiently elevated
      during late gestation and early infancy, prior to and around the time of the
      appearance of cerebrosides, sulfatides, PLP, and MBP. Distinctive lipid and
      protein abnormalities were detected in idiopathic central hypomyelination and
      metachromatic leukodystrophy. This study underscores the feasibility of the
      combined biochemical approaches in pediatric brains and provides guidelines for
      the assessment of disorders of myelination in early human life.

PMID- 7800129
TI  - Multimodality management of recurrent adult malignant gliomas: results of a phase
      II multiagent chemotherapy study and analysis of cytoreductive surgery.
AB  - Fifty-one adult patients with recurrent malignant gliomas were treated in a Phase
      II trial of multidrug chemotherapy (6-thioguanine, dibromodulcitol, procarbazine,
      1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea, 5-fluorouracil, and hydroxyurea).
      Thirty-one patients underwent radical tumor debulking, before the administration
      of chemotherapy. Fifty-seven percent of all patients had either an objective
      radiographic response or stabilization of disease after the institution of
      therapy. The overall median survival time (MST) was 40 weeks; it was 79 and 33
      weeks for anaplastic astrocytoma and glioblastoma patients, respectively. The
      overall median time to tumor progression (MTP) was 19 weeks--32 weeks for
      anaplastic astrocytoma patients and 13 weeks for glioblastoma patients. Serious
      chemotoxicity occurred in 35% of patients without permanent morbidity or
      mortality. The factors that affected response (including disease stabilization),
      MTP, and MST were identified through a multivariate statistical analysis. A
      longer MTP was associated with higher Karnofsky scores, lower grade initial
      histology, lack of prior chemotherapy, greater degree of myelotoxicity, smaller
      postoperative tumor volumes, greater extent of surgical resection, and a local
      versus diffuse recurrence pattern. A longer MST was associated with higher
      Karnofsky scores, lower grade histology at the time of recurrence, greater degree
      of myelotoxicity, and lobar versus deep tumor location. Response (including
      disease stabilization) correlated with higher Karnofsky scores, lower grade
      histology (initial and current), prior lower grade histology, smaller
      preoperative tumor volume, longer intervals from the time of initial diagnosis,
      and absence of prior chemotherapy. These results suggest that, in addition to
      established prognostic factors such as Karnofsky scores, other factors including
      prior chemotherapy administration, patterns of tumor recurrence, and tumor
      location may be important variables to consider in future Phase II-III clinical
      trials. Of the treatment variables analyzed, greater surgical debulking and
      smaller postoperative tumor volumes were associated with prolonged MTP but not
      MST, and greater myelotoxicity had a positive association with all outcomes. The
      significance of this latter relationship and its relevance to chemotherapy dosing
      will require further study. Standardization in the design and reporting of
      clinical trials and the use of computer-assisted tumor volume calculations to
      assess the extent of surgical resection and the response to therapy are
      advocated.

PMID- 7800130
TI  - Arteriovenous malformation draining vein physiology and determinants of
      transnidal pressure gradients. The Columbia University AVM Study Project.
AB  - Arteriovenous malformation (AVM) draining vein pressure (DVP) may have an
      influence on both the natural history of the disease and treatment outcome. The
      purposes of this study were to assess the relationship between DVP and other
      clinical and physiological variables and to characterize the transmission of
      arterial pressure across the AVM nidus. DVP measurements were carried out during
      elective AVM resection with isoflurane/nitrous oxide anesthesia with arterial
      carbon dioxide pressure of approximately 30 mm Hg. The gradient between the right
      atrium and operative measurement site was noted. Pre-excision feeding mean
      arterial pressure and DVP were measured with a 26-gauge needle simultaneously
      with systemic mean arterial pressure and central venous pressure (CVP). DVP was
      tested with systemic mean arterial pressure increased to approximately 20 mm Hg
      with phenylephrine or CVP increased with a Valsalva maneuver. Finally,
      preresection and postresection DVP values were compared. Relative to the site of
      measurement, DVP was 7 +/- 5 mm Hg at a CVP of -4 +/- 5 mm Hg (n = 45). There was
      no influence of presentation, presence of deep venous drainage, size, location,
      or prior embolization on DVP. In 19 patients, DVP decreased (8 +/- 4 to 5 +/- 3;
      P < 0.05) whereas CVP increased from pre- to postresection (-4 +/- 5 to -2 +/- 5;
      P < 0.05). For the phenylephrine challenge (n = 11), there was no difference (P =
      0.84) between the delta DVP (2 +/- 1 mm Hg) and the delta CVP (2 +/- 3 mm
      Hg).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7800131
TI  - Magnetic resonance imaging in the evaluation of spinal cord injury without
      radiographic abnormality in children.
AB  - Seven children aged birth to 17 years with spinal cord injury without
      radiographic abnormality (SCIWORA) were studied with magnetic resonance imaging
      (MRI) between 3 hours and 16 days after the injury. There were six cervical cord
      injuries and one thoracic cord injury. The MRI findings were divided into two
      groups: extraneural and neural. The extraneural findings included one case of
      anterior longitudinal ligament disruption and anterior C6-C7 disc herniation
      associated with hyperextension; one case of posterior longitudinal ligament
      disruption and C2-C3 disc herniation associated with lateral flexion; and one
      case of C6-C7 disc abnormality consistent with increased water content occurring
      with hyperflexion. These ligament and disc injuries did not correlate with late
      instability. The neural MRI findings included one case of cord transection with
      rostral cord stump hemorrhage and one case of hemorrhage involving the majority
      of the cord's transverse diameter, both associated with permanent complete cord
      injuries; one case of hemorrhage involving a minor portion of the cord and of the
      brain stem's transverse diameter associated with a severe partial cord injury but
      subsequent incomplete improvement; one case of edema without hemorrhage
      associated with Brown-Sequard syndrome and subsequent incomplete improvement; and
      three cases of normal cord signal and outline. Two of the latter patients had
      mild cord injuries that recovered completely. In the third, a child with complete
      T12 sensorimotor paralysis at presentation, the normal MRI findings predicted the
      subsequent complete recovery. No extraaxial compressive lesion was demonstrated
      in these seven children.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7800132
TI  - Intravertebral pressure changes caused by spinal microtrauma.
AB  - Clinical studies indicate variations in intravertebral pressures in patients with
      and without low back pain. It is known that not all patients with back pain have
      abnormal lumbar radiographs and, furthermore, microfractures of the endplate may
      be one of the causes in the origin of low back pain. Consequently, this study was
      conducted to determine the interrelationship between microtrauma and intraosseous
      pressures in the lumbar spine. Miniature pressure transducers were inserted into
      the vertebral bodies and spinous processes of human cadaver spinal units. Radio
      opaque medium was injected into the nucleus to fluoroscopically monitor the
      movement of the fluid from the disc as the preparation was loaded up to the
      initiation of microtrauma (before reaching the ultimate load-carrying capacity).
      The onset of injury was evidenced by the microfracture of one of the two
      endplates and impregnation of the contrast medium into the spongiosa. After
      relaxation, another cycle of loading was applied by limiting the deflections to
      the maximum compression sustained under the intact configuration. The load,
      stiffness, and energy-absorbing capacities were lower (P < 0.05) for the injured
      specimen compared with the intact configuration. The intraosseous pressures were
      higher (P < 0.05) in the vertebral body and the spinous process of the vertebra
      where the endplate exhibited microtrauma in the injured cycle compared with the
      intact cycle. In contrast, the intraosseous pressures in the vertebral body and
      the spinous process at the level where the endplate remained intact were not
      significantly different between the two cycles of loading.(ABSTRACT TRUNCATED AT
      250 WORDS)

PMID- 7800133
TI  - Posttraumatic meningitis: bacteriology, hydrocephalus, and outcome.
AB  - To investigate the conditions that have developed in the treatment of
      posttraumatic meningitis with the use of new antibiotics, the authors studied
      cases with this infection retrospectively for a period of 68 months. Among 860
      patients with moderate to severe head injuries, 12 (1.39%) sustained this
      complication. Of these, nine patients (75%) had a demonstrable basilar skull
      fracture and seven (58.3%) presented obvious rhinorrhea. Of these seven, four
      (57.1%) were treated conservatively and three (42.8%) finally underwent surgery
      for dural repair. The infecting agents were Gram-positive cocci (Staphylococcus
      haemolyticus, Staphylococcus warneri, Staphylococcus cohnii, Staphylococcus
      epidermidis, and Streptococcus pneumoniae) in five patients and Gram-negative
      bacilli in six patients (Escherichia coli in two, Klebsiella pneumoniae in two,
      and Acinetobacter anitratus in two). In one patient, the culture results were
      negative. All Gram-negative strains appeared resistant to ampicillin and third
      generation cephalosporins, but sensitive to imipenem and to the quinolone
      ciprofloxacin. Gram-positive strains were sensitive to vancomycin. Hydrocephalus
      finally developed in the two patients who had received intrathecal infusions of
      amikacin. No other report of the relation of intrathecal infusion of antibiotics
      and the development of hydrocephalus was found. All patients survived, indicating
      that, for the present, posttraumatic meningitis is a nonfatal complication of
      head injury.

PMID- 7800134
TI  - Organ culture of a glioblastoma from a patient with an unusually long survival.
AB  - Multicellular tumor spheroids were directly initiated in vitro from the biopsy
      specimens of a patient who is alive and who has had no neurological changes in 7
      years after the gross removal of a glioblastoma. The spheroids were studied alone
      and in confrontation with aggregates of fetal rat brain tissue. Both in the
      biopsy and in the tumor spheroids, a very high proportion of cells were
      proliferating, as flow cytometric deoxyribonucleic acid measurements showed that
      40% of the cells in the biopsy specimens and in the tumor spheroids were in the S
      and G2M phases of the cell cycle. Despite this high proliferation rate, the
      volume of the spheroids decreased, indicating an even greater cell loss. Light
      and scanning electron microscopic studies also indicated cell death in the
      spheroids. This behavior may be related to the long-time survival.

PMID- 7800135
TI  - Human acoustic neuromas secrete interleukin-6 in cell culture: possible autocrine
      regulation of cell proliferation.
AB  - Interleukin-6 (IL-6) secretion by cell cultures of human acoustic neuromas was
      examined. Secretory rates varied from 0.02 to 5.4 ng/10(5) cells per 4 days,
      depending on the tumor. The IL-6 immunoreactivity eluted from a Sephadex G-100
      column in a major peak corresponding to an M(r) of 30,000 and a lesser peak
      corresponding to an M(r) of 50,000. Western blot analysis revealed three IL-6
      immunoreactive bands with M(r)s corresponding to 53,000, 29,000, and 24,000.
      Tumor necrosis factor-alpha, interleukin-1-beta, and cholera toxin all stimulated
      IL-6 secretion. An antisense phosphorothioate oligonucleotide against IL-6
      messenger RNA inhibited both [3H]thymidine uptake and IL-6 secretion by acoustic
      neuroma cells in culture. In addition, [3H]thymidine uptake was inhibited by a
      specific polyclonal antibody against IL-6. We conclude that human acoustic
      neuroma cells produce and secrete IL-6, which may act in an autocrine manner to
      stimulate cellular proliferation.

PMID- 7800137
TI  - Experimentally-induced autonomic neuropathy: beneficial effect of a topical ACTH4
      9 analogue on oculomotor nerve regeneration.
AB  - Melanocortins, peptides related to corticotropin (ACTH) and melanocyte
      stimulating hormone, are known to exert beneficial neurotrophic effects in
      peripheral sensorimotor neuropathies. This has been demonstrated after both
      systemic and local administration of the peptides. By photographing the rat's
      pupil under standardized conditions, the authors have previously shown that
      systemic administration of a synthetic ACTH4-9 analogue can also be beneficial in
      autonomic neuropathies. The present study demonstrates that topical application
      of a synthetic ACTH4-9 analogue incorporated in a two-component fibrin glue
      enhances the speed of recovery of the parasympathetic nerve fibers in the
      oculomotor nerve after a crush lesion. This may have implications for future use
      in neurosurgery.

PMID- 7800136
TI  - T cell-mediated cytotoxicity of human gliomas: a tumor necrosis factor
      independent mechanism.
AB  - Cellular immune effector mechanisms are implicated as potential therapies for
      malignant gliomas. We have examined the potential for anti-CD3-activated human
      peripheral blood-derived CD4+ and CD8+ T cells to induce lysis of human glioma
      cell lines in vitro, the mechanism of action of these cells, and the capacity of
      the glioma to inhibit the effect. We found that activated CD4+ and CD8+ T cell
      preparations containing less than 5% natural killer cells could induce
      significant lysis of the glioma cell line U251, as measured by an 18-hour, but
      not 5-hour, chromium-51 or lactate dehydrogenase release assay. This effect was
      not reproduced using recombinant tumor necrosis factor or inhibited with
      antitumor necrosis factor antibody. Anti-lymphocyte functional antigen-1 and anti
      intercellular adhesion molecule antibodies also did not inhibit the effect.
      Glioma-derived supernatant could inhibit the proliferation of the T cells but not
      the cytotoxic effect. Human fetal astrocytes were also susceptible to the
      cytotoxic effect of the activated T cells. These results indicate that activated
      T cells can induce glioma cytotoxicity via a mechanism independent of tumor
      necrosis factor. The therapeutic potential of this effector mechanism will depend
      on its capacity to deliver these cells or their specific effector molecules to
      the tumor site or to augment the activity of such cells, which accumulate
      naturally in gliomas.

PMID- 7800138
TI  - Combined and three-dimensional rendered multimodal data for planning cranial base
      surgery: a prospective evaluation.
AB  - Magnetic resonance (MR), X-ray computed tomography (CT), and angiographic images
      best depict soft tissue, bone, and blood vessels respectively. No one on its own
      is sufficient in the preoperative assessment of cranial base lesions. We have
      developed and evaluated a computational technique for the three-dimensional (3D)
      combination and display of multimodality images for planning cranial base
      surgery. This evaluation was prospective and performed in such a way that the
      results could be quantified. Eight patients (three acoustic neuromas, four
      subfrontal and suprasellar meningiomas, and one petrous apex meningioma)
      underwent MR, CT, and MR angiographic investigations. These images were
      registered with anatomical landmarks rather than an external frame. Two
      techniques were used to display the resulting combined images: multiple slices in
      which bone from CT was overlaid on soft tissue from registered MR and pseudo-3D
      rendered movie sequences showing bone from CT, lesions and optic nerves from MR,
      and blood vessels from MR angiography. The advantages of the combined displays
      compared with those of conventional methods of viewing were assessed
      prospectively by the operating surgeon and by an independent surgeon, and the
      results were compared with operative findings. The preoperative assessment showed
      a significant improvement (P < 0.05, sign test) in the depiction of both
      individual structures (lesion and bone from overlaid slices and lesion and
      vasculature from 3D-rendered displays) and structural relationships (tumor-bone
      relationships from overlaid slices and of tumor-vasculature relationships from 3D
      rendered displays). The operative findings indicated that a more accurate
      interpretation of this information was possible from the combined images.

PMID- 7800139
TI  - Cranial base approaches to intracranial aneurysms in the subarachnoid space.
AB  - The use of cranial base approaches to aneurysm surgery is illustrated by means of
      patient examples. Over a 9-year period, cranial base approaches were used to
      expose and treat 38 aneurysms involving the anterior communicating artery
      complex, proximal internal carotid artery, basilar artery, or vertebral artery.
      The approaches included orbital osteotomy, orbitozygomatic osteotomy, petrous
      apicectomy, presigmoid petrosectomy, and extreme lateral transcondylar methods.
      Complications related to the approaches included one partial ptosis and two
      cerebrospinal fluid leaks, which resolved with treatment. The technique of three
      dimensional computed tomographic angiography was useful in delineating the
      vascular anatomy and its relation to the cranial base structures. This helped the
      surgeon plan the appropriate approach to the aneurysm. Cranial base approaches,
      used selectively, can provide improved exposure of deep-seated aneurysms and
      large or giant aneurysms, while minimizing brain retraction.

PMID- 7800140
TI  - Aggressive papillary middle ear tumors: a report of two cases with review of the
      literature.
AB  - Adenomatous tumors of the middle ear are rare, with only approximately 100 cases
      reported. A distinct subclass of this tumor demonstrates microscopic papillary
      architecture and has a propensity to erode the petrous bone and extend
      intracranially. The term "aggressive papillary middle ear tumor" has recently
      been proposed to describe this more invasive type of middle ear tumor. Thirty
      seven cases of aggressive papillary middle ear tumors have been reported. We
      present two additional cases and discuss the clinical, radiologic, histologic,
      and operative features of this locally aggressive neoplasm. The tumor affects
      adults of both sexes. The clinical prodrome is prolonged. Presenting signs and
      symptoms most often relate to the involvement of cranial nerves V-VIII. Imaging
      studies reveal large, enhancing, destructive tumors with a generous vascular
      supply. Intraoperatively, the tumors are bloody, fibrous, and adherent to
      surrounding structures. Various surgical approaches in combination or in series
      may be used. Preoperative embolization may be helpful. The role of adjunctive
      radiation is unclear. Aggressive papillary middle ear tumors are histologically
      benign tumors with clinically destructive behavior. However, it appears that
      aggressive surgical management affords prolonged survival with minimal worsening
      of cranial nerve deficits.

PMID- 7800142
TI  - Pseudotumoral lymphocytic hypophysitis successfully treated by corticosteroid
      alone: first case report.
AB  - We report the first case of pseudotumoral lymphocytic hypophysitis successfully
      treated by corticosteroids without surgery. A 27-year-old woman had been
      monitored for chronic headache 13 months after giving birth, associated with
      amenorrhea and galactorrhea. Cranial magnetic resonance imaging revealed a
      markedly enlarged pituitary gland with a suprasellar extension; the only
      biochemical abnormality was a mild hyperprolactinemia. Because of a putative
      diagnosis of prolactinoma, bromocriptine was prescribed at a dose of 5 mg daily,
      soon followed by the transitory appearance of menstruation. Two years later,
      panhypopituitarism was present and was revealed by acute adrenal insufficiency.
      Magnetic resonance imaging revealed that the pituitary mass was the same as
      previously described, but hormonal investigation showed evidence of complete
      hypopituitarism and no hyperprolactinemia. Nuclear antibodies were negative as
      well as other autoantibodies. Human leukocyte antigen serological Class II typing
      was DR3/DR4. Lymphocytic hypophysitis was then suspected; in the absence of
      visual complication and because this patient refused surgery, corticosteroids
      were attempted at a daily dose of 60 mg of prednisone for 3 months, progressively
      decreased for the next 6 months. Under this treatment, a gradual recovery of all
      pituitary hormones was observed and magnetic resonance imaging showed a reduction
      of two-thirds in pituitary mass. Five months after the end of corticoid
      treatment, our patient relapsed with panhypopituitarism and an increase of
      pituitary volume. She underwent steroid treatment, and a biopsy was performed and
      confirmed the diagnosis of autoimmune hypophysitis.(ABSTRACT TRUNCATED AT 250
      WORDS)

PMID- 7800141
TI  - Dural cavernous angiomas outside the middle cranial fossa: a report of two cases.
AB  - Cavernous angiomas of the dura mater are clinically and radiographically distinct
      from parenchymal cavernous angiomas. In this report, we present two cases of
      dural cavernous angiomas located outside the middle cranial fossa. The first
      patient is a 36-year-old woman with two dural cavernous angiomas, including one
      that enlarged during a 2-year period of observation. The second patient is a 33
      year-old man with medically intractable seizures from a dural cavernous angioma
      of the convexity, which was discovered at autopsy. From our experience and a
      review of the literature, we have identified two groups of dural cavernous
      angiomas that differ in incidence, natural history, and surgical management. Most
      dural cavernous angiomas arise from the middle fossa; in contrast, only 15 cases
      of dural cavernous angiomas outside the middle fossa have been reported. Those in
      the middle fossa are more clinically aggressive and more difficult to resect
      surgically, because they grow toward the cavernous sinus and the parasellar
      region. Most patients with dural cavernous angiomas outside the middle fossa
      present with headaches, whereas those patients with dural cavernous angiomas in
      the middle fossa present with ocular signs, visual field defects, endocrinopathy,
      and trigeminal symptoms. Radiographically, both of the angiomas resemble
      meningiomas. Because of their intimate association with the cavernous sinus,
      surgical resection of middle fossa cavernous angiomas often is incomplete and may
      require postoperative radiosurgery to control growth. In contrast, angiomas in
      other locations are easily and successfully resected with little blood loss. The
      location of dural cavernous angiomas is an important factor in making the
      surgical decision and in predicting the outcome.

PMID- 7800144
TI  - Spinal canal stenosis with hypophosphatemic vitamin D-resistant rickets: case
      report.
AB  - A 42-year-old woman with sex-linked hypophosphatemic vitamin D-resistant rickets
      presented with a 6-month history of progressive weakness and numbness in her
      lower extremities. Radiological studies revealed severe spinal canal stenosis
      extending from levels T4 to T10. Her symptoms improved markedly after extensive
      thoracic laminectomies.

PMID- 7800143
TI  - "Mickey Mouse" aneurysm presenting with cranial bruit: case report.
AB  - The production of a bruit associated with intracranial aneurysms is very rare. A
      patient with a bilobed aneurysm of the middle cerebral artery who was otherwise
      asymptomatic was admitted with both a subjective and an objective bruit. The
      bruit resolved with elective clipping of the aneurysm. After a thorough review of
      the literature, a total of 12 cases of proved intracranial aneurysms were found
      with associated bruit. Five of those were carotid artery aneurysms within the
      cavernous sinus. Most (67%) of those patients reviewed were admitted with
      hemorrhage that was present either into the cavernous sinus or in the form of
      subarachnoid hemorrhage, with the bruit only secondarily noted. A possible
      explanation for the production of bruits caused by intracranial aneurysms is
      discussed. We conclude that, although an audible bruit as the presenting symptom
      of an intracranial aneurysm is quite rare, it deserves serious surgical
      considerations.

PMID- 7800145
TI  - Language-activated single-photon emission tomography imaging in the evaluation of
      language lateralization--evidence from a case of crossed aphasia: case report.
AB  - We report a right-handed patient who developed a nonfluent aphasia after surgery
      for a right parietal arteriovenous malformation. Resting brain single-photon
      emission tomography displayed decreased regional cerebral blood flow only in the
      right hemisphere, with spared regional cerebral blood flow in the left
      hemisphere. Single-photon emission tomography performed after a language
      activation task (Boston Naming Task) showed a consistent area of increased
      regional cerebral blood flow in the right inferior and posterior frontal lobe,
      supporting a right hemisphere dominance for language. These results suggest a
      potential role for this noninvasive study in the evaluation of language
      lateralization.

PMID- 7800146
TI  - Brain stem compression secondary to adipose graft prolapse after
      translabyrinthine craniotomy: case report.
AB  - Three cases of fat graft prolapse into the cerebellopontine angle with clinical
      deterioration are presented. These patients had undergone translabyrinthine
      craniotomy for cerebellopontine angle tumors and had autologous abdominal fat
      strips placed to obliterate the dural defect and the mastoid cavity. Two patients
      suffered significant morbidity, and one patient died. Clinical presentation,
      computed tomographic scan findings, methods of treatment, and avoidance of this
      complication are discussed.

PMID- 7800147
TI  - A near-fatal complication of endoscopic third ventriculostomy: case report.
AB  - The authors treated a 14-year-old girl with posthemorrhagic hydrocephalus and an
      infected ventriculopleural shunt. She was taken for endoscopic third
      ventriculostomy with the hope of removing the hardware entirely, but she
      developed an arrhythmia and hypertension, followed rapidly by complete cardiac
      arrest. She was resuscitated successfully, made a complete recovery, and
      subsequently underwent a conventional shunt replacement. This is a newly reported
      life-threatening complication of neuroendoscopy that must be anticipated by any
      surgeon undertaking such a procedure.

PMID- 7800149
TI  - Partial hypoglossal to facial nerve anastomosis for reinnervation of the
      paralyzed face in patients with lower cranial nerve palsies: technical note.
AB  - Reanimation of the paralyzed face in patients who have coexisting lower cranial
      nerve palsies is a difficult management problem. Classic hypoglossal to facial
      nerve anastomosis may be devastating in these already compromised patients. We
      describe a technique of partial hypoglossal to facial anastomosis that can
      preserve hypoglossal nerve function and provide adequate facial reanimation.

PMID- 7800148
TI  - Fibrin sealing of mucoperichondrial flaps in endonasal-transsphenoidal pituitary
      surgery: technical note.
AB  - We describe a simple technique that helps to avoid nasal septum perforations and
      the related complications after endonasal-transseptal transsphenoidal pituitary
      surgery. At the end of the Hirsch procedure, the mucoperichondrium is fixed to
      the septal cartilage with a thin layer of fibrin glue. Two silicone splints are
      applied to both sides of the septum and left in place for 2 days. The technique
      is very useful in preventing possible displacement of the mucoperichondrium,
      which may lead to compression and ischemia of the doubled mucosa between the
      septal cartilage and the silicone splints. A firm fixing of the margins of a
      mucoperichondrial laceration to the septal cartilage creates conditions for
      optimal healing and reduces nasal-packing time and nasal-splinting time. The
      technique is recommended for all patients with and without mucosal tears and is
      also recommended for the transsphenoidal reoperations.

PMID- 7800150
TI  - Flow-directed atrial catheter placement for ventriculoatrial shunts: technical
      note.
AB  - The placement of the atrial portion of a ventriculoatrial shunt is occasionally
      rendered difficult by a tendency of the shunt catheter to pass into the
      contralateral jugular vein or into a subclavian vein instead of into the atrium.
      We report a simple flow-directed technique that may resolve this problem.

PMID- 7800151
TI  - Are the calcium antagonists really useful in cerebral aneurysmal surgery? A
      retrospective study.

PMID- 7800152
TI  - Are the calcium antagonists really useful in cerebral aneurysmal surgery? A
      retrospective study.

PMID- 7800153
TI  - Parasellar classification of pituitary adenomas.

PMID- 7800154
TI  - The piriformis muscle syndrome: a simple diagnostic maneuver.

PMID- 7800156
TI  - The impact of raising blood glucose on reaction times.
AB  - Although previous studies have demonstrated enhanced mood and memory in humans
      following the consumption of glucose drinks, the effect of increasing blood
      glucose levels on other tasks has not received the same attention. In the present
      study, inspection time was unaffected by glucose drinks and blood glucose levels.
      However, increasing blood glucose levels resulted in faster decision times when
      reaction time was measured. It is concluded that speed of processing is faster
      when the availability of glucose to the brain is increased. The possibility that
      the glucose-induced improvements in reaction time reflect an increased synthesis
      of acetylcholine is discussed.

PMID- 7800155
TI  - Effects of long-term treatment with the MAO-A inhibitor moclobemide on sleep EEG
      and nocturnal hormonal secretion in normal men.
AB  - Sleep EEG, nocturnal penile tumescence (NPT) and nocturnal hormone secretion were
      studied in four normal males during placebo, under up to 300 mg per day of
      moclobemide, the short-acting and reversible inhibitor of monoamine oxidase (type
      A), and after withdrawal. Under moclobemide, REM sleep was slightly suppressed.
      Drug cessation was followed by REM rebound. In contrast to REM sleep, NPT was not
      affected by the drug. The nocturnal cortisol concentration was elevated under
      moclobemide and this effect persisted after withdrawal. No influences on growth
      hormone, prolactin, testosterone, luteinizing hormone or follicle-stimulating
      hormone were found.

PMID- 7800157
TI  - Differences in P3 amplitudes between schizophrenics and healthy controls vary
      between the different events presented in a guessing task.
AB  - P3 amplitudes were often found to be reduced in schizophrenics, but in varying
      degree. We studied in a guessing task whether variations of group differences
      could even be obtained within the same task, by measuring P3 in the potentials
      evoked by the three qualitatively different events that occurred in each trial.
      We hypothesized that such variations were due to variations of subjective task
      relevance associated with each event. In each trial, a light or a sound was
      presented. Subjects had to confirm this 'primary event' by a delayed response,
      and then the current amount of money earned by correct responses was displayed.
      In the certain condition, the primary event was preceded by the appropriate cue
      on the screen ('light' or 'sound') whereas in the uncertain condition, the word
      'guess' appeared. The task-relevance hypothesis predicted that schizophrenics
      would have smaller P3s than the control group with the primary event in the
      uncertain condition, but that the groups would not differ for the P3s evoked by
      the other events (certain primary event, cue and earnings display in uncertain
      and certain conditions). Essentially, this predicted pattern of results was
      obtained, but additional assumptions are needed for the task-relevance hypothesis
      to account for the precise pattern of results. Analysis of subjects' guessing
      behavior showed that control subjects' guesses were affected by the outcome of
      their preceding guesses while schizophrenics' guesses were not. This result
      provides some additional support for the hypothesis that the guessing task is
      less relevant to schizophrenics than to control subjects.

PMID- 7800158
TI  - Does caffeine enhance or merely restore degraded psychomotor performance?

PMID- 7800159
TI  - Diazepam and sulpiride effects on frequency domain EEG source locations.
AB  - Effects of an anxiolytic (diazepam; n = 13) and an antipsychotic (sulpiride; n =
      6) on the location of EEG model sources in the frequency domain were studied in
      normal volunteers in 19-channel eyes-closed EEG before and 1, 15, 30, 45 and 60
      min after i.v. injections. Ten 2-second epochs from each recording were subjected
      to the fast Fourier transformation (FFT) Dipole Approximation which results in a
      single-source (in terms of phase angle) potential distribution map for each
      frequency point. Three-dimensional model dipole sources were fitted into the
      maps. Differences in source location before and after injection were computed,
      and differences between drugs were evaluated. The source location in the beta
      band shifted significantly more towards superior and anterior areas after
      diazepam than sulpiride, most prominently in the first minute after injection;
      during this time, conventional beta band power was significantly increased after
      diazepam versus sulpiride at all recording sites. The results demonstrate that
      the FFT dipole approximation adds direct 3-dimensional topographical information
      to power spectral results in pharmaco-EEG.

PMID- 7800160
TI  - Effects of cocaine on P3B in cocaine abusers.
AB  - Little is known about the effects of cocaine on cognitive tasks. Event-related
      potentials (ERP) were recorded in 7 cocaine abusers during the performance of the
      auditory oddball task before and after the intravenous injections of saline and
      cocaine (60-80 mg). The P3B and slow wave components of the ERP were
      significantly larger 60-210 min after the cocaine than after the placebo
      injection. The results suggest that cocaine abusers have difficulty in
      maintaining optimal stimulus processing during extended testing. Cocaine blocks
      this decrement in stimulus processing.

PMID- 7800161
TI  - Auditory information processing in sleep: habituation to repetitive stimuli.
AB  - Habituation to evoked responses is obvious in waking but still controversial in
      sleep. Single-response analysis proves short-term habituation of auditory evoked
      potentials in stage 2 NREM sleep. The data are discussed referring to the two
      system hypothesis of sensory processing in sleep and to DC instability and sleep
      maintenance mechanisms in stage 2 NREM. It is suggested that information
      processing might continue in sleep.

PMID- 7800162
TI  - Nonconvulsive status epilepticus as a cause of confusion in later life: a report
      of 5 cases.
AB  - Five patients (4 women, 1 man) presented with an acute confusional episode for
      the first time between the ages of 53 and 76. Their EEGs showed generalized
      paroxysmal activity indicating a diagnosis of nonconvulsive generalized status
      epilepticus (absence status). Two patients had tonic-clonic seizures just before
      the onset of the status, but none had a history of chronic epilepsy. Three
      patients had long-standing psychiatric disorders. Treatment with psychotropic
      drugs and medical illness (vascular disease, metabolic derangement) may have
      acted as precipitating factors for the status epilepticus in all patients. The
      diagnosis was never made on admission, since psychiatric history and ictal
      behavioral manifestations often raised intriguing problems of differential
      diagnosis. In all cases, only icta; EEG could provide a correct diagnostic
      assessment.

PMID- 7800163
TI  - Increase in serotonin 1A receptors in the dentate gyrus as revealed by
      autoradiographic analysis following repeated electroconvulsive shock but not
      imipramine treatment.
AB  - The effects of repeated treatment with electroconvulsive shock (ECS) and
      imipramine on [3H]8-OH-DPAT binding to serotonin1A (5-HT1A) receptors in the rat
      brain were studied by quantitative autoradiographic analysis. A large number of
      binding sites for [3H]8-OH-DPAT were observed in the hippocampus, especially the
      dentate gyrus, CA1+CA2 field, dorsal raphe nucleus and septum. Repeated treatment
      with ECS, but not repeated imipramine treatment, significantly increased [3H]8-OH
      DPAT binding sites in the dentate gyrus. These results suggest that the increase
      in [3H]8-OH-DPAT binding sites in the dentate gyrus may be important in ECS
      therapy for depressive illness.

PMID- 7800164
TI  - Psychoimmune investigation in obsessive-compulsive disorder: assays of plasma
      transferrin, IL-2 and IL-6 receptor, and IL-1 beta and IL-6 concentrations.
AB  - This study was carried out to investigate the immune function in obsessive
      compulsive disorder (OCD). Plasma levels of interleukin (IL)-1 beta, IL-6,
      soluble IL-6 receptor (sIL-6R), sIL-2R, and transferrin receptor (TfR), and
      baseline plasma cortisol levels were measured in 19 OCD patients and 19 normal
      controls. No significant differences in any of the above immune variables were
      found between subjects with OCD and normal controls. There was a significant
      positive correlation between IL-6 or sIL-6R concentrations and severity of
      compulsive--but not obsessive--symptoms. In subjects with OCD, there was a
      significant negative relationship between sIL-2R concentrations and plasma
      cortisol values. In subjects with OCD and in the study group as a whole, there
      were significant positive relationships between sIL-2R and TfR concentrations.

PMID- 7800165
TI  - Seasonal variation in the dexamethasone suppression test: a longitudinal study in
      chronic schizophrenics and in healthy subjects.
AB  - To evaluate seasonal influences on the dexamethasone suppression test (DST),
      cortisol and melatonin responses to dexamethasone were assessed in drug-treated
      chronic schizophrenics and in drug-free healthy volunteers in different seasons
      of the year, according to a longitudinal study design. In schizophrenic patients,
      there was a greater rate of cortisol non-suppression to DST in February as
      compared to November and May (chi 2 = 4.5, p = 0.03) with no significant
      differences in pre- and post-dexamethasone plasma cortisol levels. In healthy
      volunteers, in contrast, no seasonal variation in DST results was observed.
      Moreover, dexamethasone administration did not significantly affect morning
      plasma melatonin levels in either patients or healthy controls. These findings
      suggest that seasonality may be of critical importance in evaluating DST results
      in schizophrenic patients, but not in healthy subjects.

PMID- 7800166
TI  - Effect of an antidiencephalon immune serum on pain and sleep in primary
      fibromyalgia.
AB  - The results of a double-blind, randomized, therapeutical trial with SER282, an
      antidiencephalon immune serum (Serolab, Lausanne, Switzerland), in 36 women, aged
      24-56 years, with primary fibromyalgia are presented. Treatment was ambulatory
      and consisted of either SER282 (20 mg/ml) or amitryptiline (AMI, 50 mg) or
      placebo (PL) over an 8-week treatment course. Clinical and sleep EEG polygraphic
      data were obtained at baseline and after 4 and/or 8 weeks of therapy. Compared to
      an important PL response and moderate analgesia with AMI, pain and associated
      symptoms improved moderately with SER282. In contrast, polysomnographic
      recordings showed that SER282 tended to promote stage 4 sleep, while AMI and PL
      had few--if any--effect on sleep. These results are discussed together with the
      clinical characteristics of the patients and the relations between pain,
      associated symptoms, and sleep parameters in our patient population.

PMID- 7800168
TI  - Subjective assessment of sleep: statistical analysis in a population of healthy
      subjects.
AB  - A principal components analysis was carried out on subjective data obtained from
      the sleep questionnaire systematically used in our laboratory on the morning
      following a polysomnographic recording. This technique, based on 70 healthy
      subjects, revealed three principal axes which explore the questionnaire. The
      first axis reflects the subjective evaluation of the quality of sleep. The second
      underlines the importance of dreams and of the brief waking periods which
      immediately follow. Finally, the third axis brings out the subjective assessment
      of sleep efficiency. The third axis was the most ambiguous and the only one to
      show a gender difference. Women tend to better estimate general sleep events,
      while men tend to evaluate better the more circumstantial events. Finally, given
      the results, it would be interesting to apply a similar analysis to populations
      presenting sleep disorders in order to establish the presence of an eventual
      pattern specific to the disorder.

PMID- 7800167
TI  - Plasma magnesium levels in a population of psychiatric patients: correlations
      with symptoms.
AB  - Plasma magnesium levels were tested in a group of 155 psychiatric in-patients
      with a variety of diagnoses and were correlated with the severity of their
      symptoms. We hypothesized that lower Mg levels would correlate with a higher
      degree of anxiety, tiredness and other symptoms characteristic of Mg deficiency.
      No such correlations were observed. However, Mg levels varied widely, with 22.4%
      below, and 10.4% above the normal range. There was a strong association for more
      disturbed and excitable patients to have abnormal (either high or low) levels. We
      speculate that more disturbed patients might have some abnormality of Mg
      metabolism with possible therapeutic implications.

PMID- 7800169
TI  - The efficacy and safety of tianeptine in the treatment of depressive disorder:
      results of a controlled double-blind multicentre study vs. amitriptyline.
AB  - Three hundred in- and outpatients suffering from depressive disorder, as
      diagnosed using DSM-III criteria were treated for 6 weeks under double-blind
      conditions in a multicenter controlled study of tianeptine vs. amitriptyline.
      Both groups presented steady improvement of depressive syndrome from day 7 up to
      the end of the treatment, as shown by all evaluation scales: HDRS, SAD, CGI.
      Furthermore, anxiety linked to the depressive syndrome decreased equally in both
      groups, as shown by the HARS measurements. In addition to the improvement of
      mood, the tianeptine-treated patients presented less somatic complaints and side
      effects when compared to the reference antidepressant. These results confirm
      previous findings that tianeptine is an effective antidepressant with a lower
      side effect profile than amitriptyline.

PMID- 7800170
TI  - Orthostatic challenge during neuroleptic test dose: a possible predictor of short
      term outcome.
AB  - Cardiovascular measurements were used as indicators of autonomic arousal during
      an orthostatic challenge test without medication and after a test dose of 150 mg
      perazine in 20 acute schizophrenic patients. Unmedicated schizophrenics showed
      elevated heart rates and elevated systolic and diastolic blood pressure in
      comparison to healthy volunteers. After a test dose of 150 mg perazine,
      responders (using BPRS outcome criteria after 23 days) showed a pronounced
      orthostatic heart rate reaction in comparison to nonresponders. Results are
      discussed in relation to arousal theories and central dopaminergic activity in
      schizophrenia.

PMID- 7800171
TI  - Advanced trauma life support: is it adequate stand-alone training for military
      medicine?
AB  - Advanced Trauma Life Support (ATLS) is a 2-day course on handling the acutely
      injured patient. It has been developed by and is directed by the American College
      of Surgeons, and teaches a systematic approach to the care of the injured
      patient. It is relied upon as a teaching tool throughout the active and reserve
      military medical departments. This article will review its strengths and
      weaknesses, and will show that it is not an adequate "stand-alone" training tool.
      ATLS does not address the combat casualty, nor the combat scenario. Special
      courses must be utilized to train military medical providers for the conflicts
      and casualties of the future.

PMID- 7800172
TI  - The battle for Hue: casualty and disease rates during urban warfare.
AB  - Renewed nationalism with the ending of the Cold War has precipitated numerous
      conflicts between regions or countries that were formerly united. Hostilities
      between some ethnic and nationalistic factions have reached the point where
      regional security is threatened and United Nations-sanctioned military operations
      may be required. Because some U.N. operations could require the forcible removal
      of an entrenched faction from an urban setting, the present investigation seeks
      to determine the levels of medical casualties that might be sustained during
      urban warfare. Casualty rates and illness incidence were examined for U.S. Marine
      forces participating in the retaking of the city of Hue during the Tet offensive
      in 1968. The casualty rates were analyzed for different phases of the urban
      assault and contrasted with a different period of the Vietnam Conflict, and with
      the high intensity battle for Okinawa during World War II. Rates of casualties
      during the retaking of Hue were highest during the two phases of the operation
      that required close-quarter fighting. The house-to-house fighting south of the
      river yielded a wounded rate of 37.9 per 1,000 strength per day, while the
      fighting in the inner city yielded a rate of 44.4. Rate of wounded during the
      "mopping-up" phase was 5.8. The rate of illness incidence was stable over the
      month-long operation and showed no concomitant increase with battle intensity."

PMID- 7800173
TI  - Screening alcohol abuse potential among Army reservists with the Short Michigan
      Alcoholism Screening Test.
AB  - The Short Michigan Alcoholism Screening Test was psychometrically useful in
      screening a sample of 560 reservists from a midwest general hospital unit. The
      most conservative estimate of alcohol abuse potential was 11.3%, with possibly
      6.6% having symptoms of alcohol dependence. Comparisons with active duty
      military, Army, and civilian samples suggest that prevalence of abuse in the
      Reserve sample is similar to that of the combined military, but lower than that
      of the Army. Future research and policy choices are highlighted.

PMID- 7800174
TI  - Adapting the Ohmeda UPAC draw-over vaporizer for use in the modern operating
      room.
AB  - Until recently, the use of draw-over anesthesia (DA) for elective cases has been
      prohibited in American military hospitals. The reasons cited for this have
      included the possibility of increased patient risk and the delivery of a second
      level of care. In this article, the authors outline a method of employing DA so
      as to bring its use up to the safety level of the modern operating room. This
      allows for the clinical training of those military anesthesia care providers who
      may find themselves deployed with highly mobile surgical units whose missions
      demand this technique of anesthesia.

PMID- 7800175
TI  - Psychiatric stigma in the military.
AB  - There is potential for the stigma of mental health care to directly affect an
      active duty member's career. The authors are aware of cases in which fear of
      adverse career consequences has led service members to avoid needed mental health
      care. In order to investigate the legitimacy of this fear, the authors surveyed
      252 USN and USMC commanding and executive officers concerning their attitudes
      about service members who had received mental health and other services; 138
      responded. Overall the responses were neutral and there were relatively few
      negative evaluations of service members who had received services. Military
      health care providers should take an active role in diminishing the stigma of
      mental illness, and in allaying fears of adverse career consequences for seeking
      care.

PMID- 7800176
TI  - Dermatological manifestations in a tropical training environment: emphasis for
      the general medical officer.
AB  - Cutaneous disease in the tropical training environment will be of concern for the
      medical officer assigned to ensure the health of soldiers participating in
      training. A review of all "sick calls" recorded during deployment to the Jungle
      Operations Training Center at Fort Sherman, Panama showed that 50% of the medical
      complaints were dermatologically related. This should emphasize the need for
      medical officers to have significant dermatologic knowledge and appropriate
      supplies.

PMID- 7800177
TI  - Model program for interdisciplinary care of exceptional family members at a large
      USAF Medical Center.
AB  - Because we have a large population of exceptional family members, in November
      1990 our pediatric department developed a comprehensive interdisciplinary team to
      manage these complicated cases. The goals of this team were similar to those
      defined by the 1985 USAF Exceptional Family Member Program, Regulation 160-38. We
      describe the organization, membership, and categories of patients served, and
      benefits of this form of comprehensive care including identifying and
      coordinating supportive community services. By reporting our experience, we hope
      other military medical centers will benefit from this interdisciplinary approach.

PMID- 7800178
TI  - Adjustment disorder of conscripts as a military phobia.
AB  - Conscription entails many adjustment difficulties for the young soldier. When
      anxiety is sufficiently severe to impair performance and make discharge a
      possibility, a brief course of cognitive-behavioral therapy can rapidly restore
      the soldier to full functioning. This article explains the theoretical basis for
      such an approach, and describes three cases.

PMID- 7800180
TI  - Paddling permanent white water: managing within the paradigm shifts in military
      medicine.
AB  - The challenges of managing military medicine over the last three decades have
      been complicated by rapidly changing priorities and redirections. Inspired by
      Kuhn's theory of "paradigm shifts," we can identify five distinct paradigms and
      four paradigm shifts that have dominated military medicine over the last 25
      years. These shifts began in the early 1970s when military medicine was forced to
      make a transition from a focus on combat casualty care to the problems of
      becoming an all-volunteer force. These paradigm shifts continue in the form of
      the current challenges of simultaneously embracing new cost-conscious forms of
      health care delivery while downsizing the force. Each of the shifts has been
      characterized by a lack of anticipation and the onset of crisis. The present
      challenges faced by military medical leadership are not necessarily
      unprecedented; prescience in regard to inevitable future shifts could reduce
      turmoil and enhance adaptation.

PMID- 7800179
TI  - Predictors of basic infantry training success.
AB  - Because of shrinking resources, the United States military will be forced to
      carry out its mission in the future with maximum efficiency. Medical problems
      reduce the efficiency of the training of soldiers. Our project documents the
      medical problems that occurred in infantry basic trainees and tests easily
      obtainable information for its ability to predict the impact of medical problems
      on each trainee. The study involved 649 trainees undergoing a 13-week cycle of
      basic and advanced infantry training in one of three companies at the United
      States Army Infantry Training Center, Fort Benning, Georgia. The most common
      reason for sick call attendance among this group of trainees was upper
      respiratory infection. While medical illnesses were frequently seen, they did not
      cause a great deal of lost training time. Training injuries such as foot and
      lower leg overuse syndromes and patellofemoral knee pain were the primary causes
      of time lost. The average trainee made 1.58 +/- 1.61 visits to sick call during
      the cycle, with a total of 4.53 +/- 8.49 days of training time limited by
      profile. However, many trainees made no sick call visits and the majority of
      trainees lost no time due to medical problems. The strongest predictors of
      medical impact on training were a history of cigarette smoking and the initial
      performance of the trainee on the three events of the Army Physical Fitness Test.
      Based on the results of this study, we recommend that the military consider
      cigarette smoking as a negative factor in the selection of recruits and consider
      that recruits be required to meet some standard of fitness prior to induction.

PMID- 7800181
TI  - Bilateral chylothorax following thymectomy: resolution following unilateral
      drainage.
AB  - Chylothorax is a rare complication of thymectomy. Following thymectomy for
      myasthenia gravis, our patient developed bilateral chylous pleural effusions. The
      presence of a "mediastinal window" allowed adequate drainage with a unilateral
      chest tube.

PMID- 7800182
TI  - Continuous intra-arterial blood gas monitoring. A clinical experience.
AB  - Miniaturized sensors, based upon the principles of optical fluorescence, can
      measure in vivo the pH, pCO2 value and pO2 value of blood. In this report we
      studied continuous intra-arterial blood gas monitoring in 27 patients undergoing
      cardiac surgery (no. 16 coronary artery by-pass grafting, no. 2 valvular surgery)
      and major vascular surgery (no. 9 abdominal aortic aneurysms). Total duration of
      continuous intra-arterial blood gas monitoring was 677 hours, with a ratio of
      25.0 +/- 14.8 hours/patient (range 4-96 hours). The in vitro values of pH, pCO2
      and pO2 were compared to simultaneous records from the fiberoptic sensor for each
      of the 283 arterial blood gas samples obtained, by means of linear regression and
      Bland-Altman method, in order to test the correlation and the agreement between
      the two methods of measuring. For pH average bias was -0.023 and intersensor
      precision was 0.028, with a strong correlation (R = 0.92; p < 0.001) and
      agreement. For pCO2 the average bias was 0.91 and the inter-sensor precision was
      2.65, with a slight decrease in correlation (R = 0.89; p < 0.001) and agreement.
      For pO2 average bias was -2.69 and the intersensor precision was 12.16, with a
      strong correlation (R = 0.97; p < 0.001) and agreement. In addition, we tested
      the reliability of the system for values of pO2 above 100 mmHg and we found a
      strong correlation (R = 0.96; p20.001) and agreement even for these clinical
      conditions, largely out of physiologic parameters. This study demonstrates the
      feasibility and reliability of continuous intra-arterial three-component PB 3300
      (Puritan Bennett) blood gas monitoring.

PMID- 7800183
TI  - [Effects of age, body weight, and ventilatory pattern on the difference between
      arterial and end-tidal PCO2].
AB  - OBJECTIVE: To evaluate the effects of physiological ventilatory patterns on P(a
      ET)CO2 gradient and on the alveolar dead space production during controlled
      mechanical ventilation. DESIGN: Prospective and experimental comparison among
      three different ventilatory settings in three different groups of subjects.
      SETTING: General surgery's operating-theatre in university hospital. PATIENTS:
      Twenty-eight patients subdivided randomly in 3 groups differing for ventilatory
      setting. I group: constant tidal volume (VC = 8 ml.kg-1) and 3 different
      respiratory frequencies (f = 10, 12 and 14 breaths.min-1); II group: constant
      ventilation (112 ml.kg-1) but VC and f modified in three different ways; III
      group: inspiratory volume was set to give an end-tidal PCO2 (PETCO2) of about 35
      mmHg. The cases were subdivided, on the basis of P(a-ET)CO2 distribution, in
      three groups: group with values larger than mean plus 1 standard deviation, group
      with values between +/- 1 standard deviation and group with values lower than
      mean minus 1 standard deviation. Moreover in two homogeneous groups for age.
      INTERVENTIONS: General surgery but not important because measures were performed
      before surgical manoeuvres. MEASUREMENTS AND MAIN RESULTS: Anthropometrical data
      (age and body weight), PaCO2, PETCO2, heart rate, invasive arterial pressure,
      ventilatory parameters and airway pressure were collected for every subject and
      ventilatory setting; arterial to end-tidal difference P(a-ET)CO2 and P(a
      ET)CO2.PaCO2(-1) were calculated during data analysis. The P(a-ETFCO2 and P(a
      ET)CO2.PaCO2(-1) values were not significantly different among the three
      different ventilatory patterns both in the first and in the second group. P(a
      ET)CO2 values were significantly correlated with age, body weight and airway
      pressure. These parameters were correlated significantly also with P(a
      ET)CO2.PaCO2(-1) values. CONCLUSIONS: Ventilatory setting, used in a normal
      physiological range, don't affect P(a-ET)CO2 difference during mechanical
      ventilation. Age, body weight and airway pressure of the patient must be
      considered to obtain a correct value of PaCO2 by the measure of PETCO2.

PMID- 7800184
TI  - [Perioperative blood gas analysis in 100 patients in spontaneous respiration
      treated with ND-YAG laser for endoluminal tracheo-bronchial neoplasms].
AB  - OBJECTIVE: To determine the reliability on spontaneous ventilation of small
      continuously associated doses of ketamine and propofol during yag-laser therapy
      for upper airways neoplastic obstructions. DESIGN: Prospective description of
      blood gas analysis variation throughout the intervention and in the early
      postoperative period. SETTING: Operating theatre and postoperative Intensive Care
      Unit of the National Institute for Cancer Research. PATIENTS: A hundred
      consecutive cancer patients referred to our Institution for upper airways tumoral
      progressive obstruction. INTERVENTION: Yag-laser firing. MEASUREMENTS AND MAIN
      RESULTS: Pre-intra and postoperative blood gas analysis, BP, HR, Sat O2 have been
      registered every 10'. Mean intraoperative pCO2 rose to 47.3 mmHg (30-60), but
      within 2 to 3.20 hrs returned close to preoperative value (38.3 mmHg) allowing
      early patient discharge. CONCLUSIONS: The i.v. association of 0.7-1.0 mg/kg
      Ketamine and 1 mg/kg propofol, followed by 5 micrograms/kg/h and 3 mg/kg/h
      respectively, turned out to be satisfactory for both patients and anaesthetists
      in terms of anaesthesia and spontaneous breathing maintenance during yag-laser
      firing for obstructive upper airways cancer patients.

PMID- 7800185
TI  - [Difference between arterial and end-tidal carbon dioxide tension during surgery
      of lumbar herniated disk in general anesthesia].
AB  - OBJECTIVE: To determine the correlation of PaCO2 and ETCO2 during operations for
      lumbar disk herniation in prone position: the influence of position and
      deliberate hypotension. DESIGN: Prospective, to compare PaCO2, ETCO2, pH, SBE, Pa
      max, in a group of 10 patients undergoing elective intervention for lumbar disk
      herniation in prone position and in a control group of 10 patients undergoing
      interventions for elective non traumatologic orthopaedic surgery of the lower
      limbs in supine position. SETTING: Orthopaedic department of a non teaching
      hospital. MEASUREMENTS AND MAIN RESULTS: The results for the patients of the
      supine group were: mean PaCO2 35.26 mmHg (SD 3.045), mean P(a-ET)CO2 3.46 mmHg
      (SD 1.898), mean pH 7.433 (SD 0.044), mean SBE - 1.16 (SD 1.718), mean Pa max
      122.5 mmHg (SD 17.989). In the prone group: mean PaCO2 30.3 mmHg (SD 5.819), mean
      P(a-ET)CO2 1.4 mmHg (SD 4.445), mean pH 7.430 (SD 0.052), mean SBE-3.93 (SD
      3.255), mean Pa max 100.3 (SD 10.945). The difference was significant (p < 0.05)
      for pH, PaCO2, SBE; in the prone group the variability of P(a-ET)CO2 was greater
      and the values related with SBE. CONCLUSIONS: ETCO2 is a useful monitoring for
      PaCO2 in the situation evaluated but the accuracy of the correlation with PaCO2
      is lesser than during standard surgical techniques, the metabolic acidosis
      observed is probably related to the effects of the peculiar position and the
      anaesthetic technique.

PMID- 7800187
TI  - [Sudden infant death syndrome (SIDS): risk conditions and intervention
      strategies].
AB  - The term SIDS describes the unexpected and unexplained death of an apparently
      well infant. After congenital anomalies, SIDS is the most common cause of infant
      death in the industrial countries and it is the leading cause of death among
      infants older than 1 month. Descriptive epidemiological studies have shown a
      winter excess of cases and a peak of age distribution at about 3 months of age.
      Although many theories have been proposed to explain the etiology (i.e. fatal
      toxaemia, autonomic dysfunction, abnormalities of respiratory or cardiovascular
      control), an underlying cause for SIDS has not been identified. There are,
      however, a number of factors consistently associated with an elevated risk, the
      strongest of which are maternal smoking or exposure to substances of abuse during
      pregnancy, overheating and overinsulation, artificial feeding and prone sleeping
      position. A fall in the rate of the SIDS can be reasonably expected from changes
      in these risk factors, from home monitoring of infants suffering a near-SIDS
      episode and of siblings of SIDS victims, and from parental education programmes.

PMID- 7800186
TI  - [Sedation with benzodiazepine in ophthalmologic surgery: comparative study of
      diazepam and midazolam].
AB  - INTRODUCTION: To evaluate the effect of giving diazepam and midazolam,
      respectively 0.1 mg/kg and 0.03 mg/kg on: PAS, PAD, PAM, HR, SaO2 and sedation
      level at 10, 30, and 50 minutes from injection. These drugs were utilized as
      sedatives during retrobulbar blockade as anaesthetics technique in cataract
      surgery. Randomized double blind in operating room for opthalmic surgery in
      general hospital. MATERIALS AND METHODS: 40 patients (ASA II, III) with mean age
      78 +/- 7 divided in two groups with homogeneous morphological and clinic
      parameters, scheduled for elective cataract surgery. During retrobulbar blockade
      as anaesthetic technique the patients received diazepam and midazolam in
      equipotent quantities. Serial measurements of PAS, PAD, PAM, HR, SaO2 and
      sedation level. RESULTS: Both drugs proved significantly depressant on PAS, PAD,
      PAM, HR, SaO2. Midazolam proved more depressant than diazepam on SaO2 at 10
      minutes from injection; the depression was the same for both drugs at 50 minutes.
      Sedation level seems higher for midazolam group than diazepam at 10 and 30
      minutes, approximately the same for both groups at 50 minutes. CONCLUSIONS: Our
      results agree with there in the literature. The data show that midazolam is more
      depressant than diazepam on SaO2 at 10 minutes from injection and the necessity
      of a controlled "tritation" in small doses for intravenous use of midazolam.

PMID- 7800189
TI  - [Multiple organ failure (MOF) in tertian malaria. Report of a clinical case].
AB  - The authors describe a malignant malaria clinic case complicated by shock,
      disseminated intravascular coagulation (DIC) and multiple organ failure (renal,
      heart, lung failure): MOF. Early diagnosis and suitable therapy, with multiple
      organ failure intensive care allowed a good patient outcome.

PMID- 7800190
TI  - [Travel medicine in the era of the HIV pandemic].

PMID- 7800188
TI  - [Severe pulmonary gas embolism caused by intraoperative administration of
      hydrogen peroxide].
AB  - We report the case of a 3 year old boy who developed cardiac arrest during
      general anesthesia, immediately after the subcutaneous administration of hydrogen
      peroxide solution. Massive pulmonary embolization was hypothesized as the
      postoperative ECG showed an acute heart strain. However the occurrence of
      transient anisocoria, associated with a paresis affecting the left arm, remained
      unexplained. Since brain MR did not reveal any pathological data, a direct
      toxicity of hydrogen peroxide on a limited area of the CNS could be assumed.

PMID- 7800192
TI  - [Blood prolactin patterns in hepatic cirrhosis].
AB  - Variations in PRL secretion were observed during chronic hepatic disorders. The
      aim of our study was to evaluate the behaviour of PRL in patients affected by
      hepatic cirrhosis. 6 patients (4 males and 2 females) were studied and matched
      with a group of healthy controls. In all subjects PRL values were evaluated in
      basal conditions and after TRH stimulation. The results obtained showed higher
      basal levels of PRL, together with higher and more prolonged TRH responses in
      patients with hepatopathies than in controls (p < 0.01). These abnormalities in
      PRL secretion during hepatic cirrhosis could be due to alterations of
      neurotransmitters at central level.

PMID- 7800191
TI  - [Incidence and prevalence of anti-HVC antibodies and HBV markers in patients
      undergoing extracorporeal hemodialysis].
AB  - OBJECT: To assess the prevalence and the incidence of the anti-HCV and HBV
      markers in extracorporeal dialysis patients. METHOD: From 1990 to 1993, every six
      months, anti-HCV and anti-HBV markers were determined in 88 dialyzed patients, in
      24 health workers from the Nephrology and Dialysis Departments and checked with
      4143 blood donors. ALT values were also checked monthly. RESULTS: A 13.6
      prevalence of anti-HCV was found while no new anti-HCV case was seen in the three
      year observation period. Data referring to HBV infection were affected by
      vaccination. Statistical survey has shown a significant relation between anti-HCV
      and blood transfusions and between anti-HBV infection and duration of dialysis.
      The incidence of HCV infection was 4.1% among health workers who were all HBV
      vaccinated in the year before the research. COMMENT: We strongly recommend the
      observance of such rules as hygiene and prophylaxis, disinfection, sterilization
      and the use of disposable material. Also, a reduction of the number of
      transfusions seems to cut down the incidence of hematic infections.

PMID- 7800193
TI  - [Differential diagnosis of pathological and pseudo-pathological shoulder. Clinico
      ultrasonographic findings].
AB  - Clinical examination for rotator cuff tears is rarely conclusive and very
      difficult is the differential diagnosis with lesions of the axillary nerve. In a
      little hospital we chose to use first non invasive and cheaper tools for this
      diagnosis. 24 patients were first evaluated by a physiatric MD, and radiological
      and ultrasound studies were then performed. Ultrasonography (US) was done with a
      high frequency probe (7.5 MHz). More than 85% of our patients had, in this way a
      quick, cheap and non invasive diagnosis, and moreover a quick rehabilitation
      treatment. Only 3 patients were later studied invasively by arthrography or
      electromyography with needle, their treatment started later. In 3 patients US
      demonstrates a normal rotator cuff, and so a diagnosis of nervous lesion. Four
      patients had a complete large tear of the rotator cuff. In 14 patients US shows
      small or partial tear. Our non invasive diagnosis was quick, cheap and therapy
      started earlier with better final results.

PMID- 7800194
TI  - [Multidimensional diagnosis in general medicine. Comparative study of the use of
      various instruments].
AB  - This study was performed to test three instruments for functional status
      assessment in General Practice: the Dartmouth Coop Charts (COOP Charts), the
      Functional Status Questionnaire (FSQ) and the Duke University Health Profile
      (DUHP). All the instruments covered a score of functional aspects in physical,
      mental and social areas, providing a multidimensional measure of health status.
      We used these three instruments, validated by international studies, to acquire
      information concerning their feasibility and acceptability among patients from
      rural communities needing primary care and to test their validity in
      differentiating between patient subgroups. The COOP Charts, the FSQ and the DUHP
      were administered by physicians respectively to 98, 100 and 97 patients, waiting
      for a visit in the ambulatories of their General Practitioner. Answers relating
      to each instrument were analyzed according to sex, age and education of patients.
      All the instruments seemed to be feasible and acceptable, but only the COOP
      Charts and the FSQ were able to discriminate between different sex, age and
      scolarity groups. Taking into account the need to elaborate answers according to
      a formula when using the FSQ, we concluded that the best instrument for General
      Practice to provide a multidimensional measure of health status seems to be the
      COOP Charts.

PMID- 7800195
TI  - [Gastric endoscopic assessment after treatment with orally administered
      ketoprofen lysine salt (80 mg granular sachet). Controlled study vs placebo].
AB  - In this study, a new oral granular formulation of ketoprofen lysine salt, a non
      steroidal antiinflammatory drug (NSAID) derived from propionic acid, and placebo,
      were compared for their local effect on the gastric mucosa of healthy, human
      volunteers. The study was carried out with a double-blind, randomized, parallel
      group, design. 10 healthy volunteers were administered one sachet containing 80
      mg of ketoprofen lysine salt and 10 volunteers with placebo. The subjects were
      gastroscoped at baseline and following 10 days drug administration; tolerability
      was assessed by analysis of the hematology and biochemistry laboratory results,
      the adverse reaction reports and by the Investigator's and subject's global
      assessment at the final visit. No symptoms of gastric intolerance were referred
      in both groups. No statistically significant differences were found between
      treatments in laboratory results and in final post-treatment tolerability
      evaluation (Mann-Whitney's test U, Phi and Cramer tests).

PMID- 7800196
TI  - [Diabetes and prevention: which solution? Trying to solve the type I problem
      (review of the literature)].

PMID- 7800197
TI  - [Celiac disease (familial) associated with sarcoidosis. Clinical case and review
      of the literature].
AB  - The authors report a case of a 42 year-old patient, female, already suffering in
      1990 from pulmonary sarcoidosis at 0 radiological stage, together with uveitis
      and relapsing erythema nodosum, with dyspepsia and weight loss which benefited
      from corticosteroidal therapy, repeatedly applied at the relapses of Erythema
      Nodosum. This therapy induced clinical recovery and marked weight gain. After 3
      years (in 1993), the appearance of chronic diarrhoea, weight loss, oedemas of the
      lower limbs and altered laboratory findings which suggested malabsorbtive
      syndrome, made us verify with clinical-instrumental examinations (serum AGA IgA
      and IgG, Xilose test, perendoscopic jejunal biopsy) the diagnosis of fully
      clinically expressed adult coeliac disease. The screening of close relatives,
      showed that the patient's brother, HLA like (HLA A1-B8), was suffering from a
      less expressive coeliac disease. After a wide review of the literature, authors
      emphasize particular aspects of both diseases, reporting clinical manifestations,
      possible morbid linkage and prognostic factors. They underline epidemiological,
      pathogenetic and genetic/immunological similarity. bound to support a possible
      non-causal linkage of the diseases, even within the family. The authors think
      this linkage to be underestimated, because it is not often searched for on
      identified.

PMID- 7800198
TI  - [Exudative pericarditis with pleural plaques caused by exposure to asbestos,
      resolved with steroidal treatment].
AB  - We report a case of a 73-year old railwayman with an asymptomatic large
      pericardial effusion diagnosed by a routine echocardiogram. By clinical and
      laboratory tests we excluded an immune, infectious, tuberculous and neoplastic
      origin of the pericardial effusion. A computed tomography scan of the thorax
      showed left pleural plaques. Pleural and pericardial biopsies showed fibrohyaline
      plaques and diffuse aspecific, chronic inflammation consistent with asbestos
      exposure. By using steroid treatment there was no further evidence of pericardial
      inflammation or pericardial effusion at 8 month follow-up. Steroid drugs are
      therefore suggested as a first choice treatment in patients with
      pleuropericardial effusion as well as chronic asbestos exposure.

PMID- 7800199
TI  - Regulatory functions of protein kinase C isoenzymes in glomerular mesangial
      cells.

PMID- 7800200
TI  - Cell adhesion molecules and inflammatory renal diseases.

PMID- 7800201
TI  - Lipoprotein(a) in renal patients: is it a key factor in the high cardiovascular
      mortality?

PMID- 7800202
TI  - Nephropathy and coronary death--the fatal twins in diabetes mellitus.
AB  - In summary, the decreased concentration of heparan sulphate within the
      extracellular matrix of patients with insulin-dependent diabetes mellitus is
      caused by a combination of genetic factors and poor metabolic control. Decreased
      concentrations of heparan sulphate are seen in patients with diabetes mellitus
      and proteinuria and this might be the explanation for the proteinuria as well as
      the expansion of the mesangium and the intimal dysfunction, including increased
      permeability of the vessel wall to macromolecules, which is present in such
      patients. Thus, the effective remodelling of extracellular matrix might explain
      coincidence of proteinuria, decline in renal function and premature
      atherosclerosis in patients with diabetes mellitus.

PMID- 7800203
TI  - Observations in a Saudi-Arabian dialysis population over a 13-year period.
AB  - In contrast to Europe and the USA, data concerning dialysis treatment in Middle
      Eastern countries like Saudi Arabia are lacking. We therefore studied 325
      patients (150 females and 175 males) in one dialysis centre over a 13-year
      period. The number of primary renal diseases of uncertain aetiology and of
      pyelo/interstital nephritis caused by renal stone disease was high (46% and 4.9%
      resp.), that of diabetic nephropathy (14.8%) not much different from EDTA
      figures, while adult polycystic kidney disease was seen in only four patients
      (1.2%, versus EDTA: 5.5%). Sixty-one percent needed antihypertensive medication
      to control the blood pressure, less than reported by the EDTA. Nineteen patients
      (5.8%) had pericarditis, 38% radiographic signs of renal bone disease and eight
      patients required parathyroidectomy. Only two patients had carpal tunnel
      syndrome. Over the 13-year period the number of HBsAg-positive patients was 14%,
      reflecting the high prevalence of this disease in the country, but in the last 4
      5 years the incidence dropped markedly (3% in 1993). In 1993, 40% of the 67
      patients on dialysis had hepatitis C (HCV) antibodies of which 19 (70%) were HCV
      RNA positive. Although tuberculosis (mainly extra-pulmonary) was common (9.2%),
      no patient died because of this disease. Cardiovascular factors contributed in
      the same degree to the causes of death as in Europe: 63% versus 62%. One hundred
      and fourteen patients (35%) had a successful kidney transplant.

PMID- 7800204
TI  - Phagocytosis by glomerular endothelial cells in infection-related glomerulopathy.
AB  - Glomerulonephritis in BALB/c mice following infection with Trypanosoma brucei is
      characterized by albuminuria and glomerular deposition of immunoglobulins.
      Electron-dense deposits are present in the mesangium, as well as subendothelially
      and subepithelially along the glomerular capillary wall. In this study the nature
      of intracytoplasmic, electron-dense, round structures observed in glomerular
      endothelial cells was investigated by immunoelectron-microscopy and enzyme
      histochemistry. The presence of these structures was related in time with the
      development of proteinuria. Mice from the C57BL10 strain, which upon infection
      develop glomerular immune complexes without proteinuria, were examined as well.
      The results demonstrated that the first endothelial changes, occurring 3-4 weeks
      after infection, were swelling of endothelial cells containing intracytoplasmic,
      electron-dense, round structures. These changes were seen prior to the onset of
      proteinuria, and were not present in glomeruli of mice that did not develop
      proteinuria. The endothelial granules were shown to contain immunoglobulins and
      typical lysosomal enzymes, providing evidence for phagocytosis by the glomerular
      endothelial cells. Liver endothelial cells did not show comparable changes. Thus,
      local phagocytosis by glomerular endothelial cells is shown to be a specific
      event in the development of glomerular disease.

PMID- 7800205
TI  - Heparin inhibits the binding of immune complexes to cultured rat mesangial cells.
AB  - Glomerular mesangial cells bear Fc receptors which bind immune complexes. Cross
      linking of these receptors induces the release of cytokines chemotactic for
      macrophages; the receptors may also be involved in the localization of large
      circulating immune complexes to the mesangium. Heparin has been shown to enhance
      the removal of antigen from the glomeruli of rats with chronic serum sickness
      glomerulonephritis, and from the isolated perfused rat kidney, so we investigated
      the effect of heparin on the binding of immune complexes by rat glomerular
      mesangial cells in culture. Heparin was found almost to eliminate binding of
      radiolabelled immune complexes to cultured rat mesangial cells. Pretreatment of
      the cells with heparin for 24 h followed by washing before the addition of immune
      complexes had the same effect. A parallel study showed that heparin had no effect
      on immune complex binding to thioglycollate-elicited rat peritoneal macrophages.
      To investigate the molecular properties required for this effect we treated
      cultured cells with high- or low-molecular-weight dextran sulphate. High
      molecular-weight dextran sulphate was found to inhibit the subsequent binding of
      immune complexes to the mesangial cells, although the effect appeared to be
      smaller than with heparin. Low-molecular-weight dextran sulphate had no
      detectable effect. Subsequent studies showed that heparin is also capable of
      removing immune complexes which have already bound to mesangial cells in vitro.
      We conclude that heparin can block the binding of immune complexes to the Fc
      receptor of cultured mesangial cells, but not to peritoneal macrophages. The
      success of heparin pretreatment indicates that the effect is on the cells rather
      than on the complexes in suspension.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7800206
TI  - Influence of various calcium intakes on calcium-oxalate crystalluria in rats on
      sodium-oxalate diet.
AB  - Forty adult male Wistar rats were placed in metabolic cages on a Ca-deficient
      diet (0.1%) for 7 days and then on a Ca-deficient, Na-oxalate (NaOx) enriched
      diet (20 mg/100 g) for another 14 days. The animals were subdivided into three
      groups receiving three different types of mineral water: group I (n = 13), Badoit
      (Ca 222 mg/l); group II (n = 14), Contrexeville (Ca 467 mg/l); and group III (n =
      13), Evian (Ca 78 mg/l). Another series of 25 rats (group I, n = 9; group II, n =
      8; group III, n = 8) underwent the same study protocol, except that they received
      a normal Ca diet (1%). On the low-Ca diet, urinary Ca-Ox monohydrate (COM)
      crystals were observed only under the Na-Ox diet, with a mean crystal number
      significantly greater in group III (16.7 +/- 4.5 crystals/mm3) than in group I or
      II rats (2.5 +/- 1.5 or 4.1 +/- 1.5 crystals/mm3, respectively). Urinary Ca
      concentrations decreased in all groups (P < 0.001) under the Na-Ox diet, while
      urinary oxalate concentrations increased in all groups (P < 0.001). On the normal
      Ca diet, COM crystal excretion was observed only with the Na-Ox-enriched diet,
      but in this case feeding the Na-Ox diet did not modify urinary oxalate excretion.
      Ca/Ox ratio was significantly lower under 0.1% Ca diet than under normal Ca diet,
      related with the type and the number of crystals observed, demonstrating that
      assessment of crystalluria can provide an index of disease severity. Moreover,
      the hardness of the drinking water influences urinary COM crystal excretion only
      under a low-Ca, oxalate-rich diet, suggesting that the total calcium intake
      rather than the water calcium content is an important factor in the occurrence of
      Ca-Ox nephrolithiasis.

PMID- 7800207
TI  - Similar rate of progression in the predialysis phase in type I and type II
      diabetes mellitus.
AB  - Progression of diabetic nephropathy from the stage of macroproteinuria with near
      normal renal function until start of dialysis was compared in 16 patients with
      type I and 16 patients with type II diabetes mellitus. The mean creatinine
      clearance at the beginning of the study was 89 +/- 13 ml/min/1.73 m2 in patients
      with type I and 81 +/- 6 ml/min/1.73 m2 in those with type II diabetes. Dialysis
      was started after a mean interval of 77 (44-133) months, when creatinine
      clearance had decreased to 8 +/- 2 ml/min/1.73 m2 in type I diabetic patients.
      The respective figures for type II diabetic patients were 81 (40-124) months and
      7 +/- 2 ml/min/1.73 m2. The mean rate of decrease in creatinine clearance was
      1.05 +/- 0.45 ml/min/month in type I and 0.91 +/- 0.41 ml/min/month in type II
      diabetes. The mean rate of decrease was 1.46 +/- 0.30 ml/min/month in type I
      diabetic patients with a systolic BP > 160 mmHg versus 0.80 +/- 0.42 ml/min/month
      with < 160 mmHg (P < 0.01). In the type II diabetics the respective figures were
      1.38 +/- 0.40 ml/min/month versus 0.78 +/- 0.15 ml/min/month (P < 0.01). During
      the observation period the prevalence of coronary heart disease increased from 6
      to 50% in type I and from 31 to 87% in type II diabetes. In conclusion, the rate
      of progression of diabetic nephropathy during the predialytic phase is similar in
      type I and type II diabetes; BP adversely affects the rate of progression to the
      same extent in both groups.

PMID- 7800208
TI  - Hyperhomocysteinaemia: a significant risk factor for cardiovascular disease in
      renal transplant recipients.
AB  - Moderate hyperhomocysteinaemia has been shown to constitute an independent risk
      factor for cardiovascular disease (CVD), a frequent cause of morbidity and
      mortality in renal transplant recipients (RTR). In these patients few data
      regarding both total homocysteine levels and their influence on cardiovascular
      risk have been reported. We therefore studied serum homocysteine levels in deep
      frozen sera from 42 kidney transplant recipients with a follow-up of 11 +/- 4.5
      years (mean +/- SD) after transplantation. Eighteen patients had one or more
      ischaemic events (CVD (+)) and 24 patients had none (CVD (-)). Serum samples had
      been drawn 1-6 months prior to the first vascular event in CVD (+) patients and
      serum storage time was comparable in both CVD (-) and CVD (+) patients. Serum
      homocysteine levels were measured using a radioenzymatic method. Mean
      homocysteine level was significantly higher in 42 RTR males and females (15.5 +/-
      6.3, 13.5 +/- 5.5 microM respectively) compared with 35 control subjects matched
      for age and sex (8.7 +/- 1.9, 7.5 +/- 1.9 microM, P < 0.001). The difference in
      serum homocysteine levels between CVD (+) and CVD (-) RTR nearly reached
      statistical significance in male patients (18.6 +/- 7.8 versus 13.1 +/- 3.4
      microM, P < 0.06) but not in female patients (P = NS). In the CVD (+) group 11/18
      patients had homocysteine levels > 14 microM (the upper limit in healthy
      controls) versus 7/24 in the CVD (-) group (P = 0.04). In these patients we
      simultaneously measured in the same serum samples, serum triglycerides, and total
      and HDL cholesterol, and calculated LDL cholesterol. By stepwise discriminant
      analysis and by logistic regression analysis in this relatively small patient
      population, only serum triglycerides and homocysteine were selected as risk
      factors associated with CVD. We conclude that significant hyperhomocysteinaemia
      is present in renal transplant recipients and represents a potential risk factor
      for cardiovascular disease in these patients.

PMID- 7800209
TI  - Modulation of platelet cytosolic calcium during erythropoietin therapy in
      uraemia.
AB  - Erythropoietin therapy for uraemic anaemia is associated with a high rate of
      hypertensive and thrombotic complications. The mechanism is unknown, but a change
      in cellular calcium control may be relevant to changes in blood pressure and
      thrombosis. Platelets were utilized as a model of vascular smooth muscle cells.
      The effects of erythropoietin therapy on platelet cellular calcium, assessed by
      fura-2, were measured in 25 patients receiving renal replacement therapy during a
      6-month treatment period. Three patients failed to reach a target haemoglobin and
      were excluded from the analysis. Blood pressure increased in 11 of the remaining
      22 subjects, eight requiring an increase in antihypertensive medication. There
      were no differences in cellular calcium control between the group in whom blood
      pressure rose and patients with stable blood pressure. Overall there was a fall
      of 24% in resting cytosolic calcium (baseline 69.2 +/- 5.1 to 52.5 +/- 3.0
      nmol/l, P < 0.05) after 3 months of erythropoietin therapy. There was no change
      in the thrombin-stimulated peak response in the presence of extracellular calcium
      during therapy, although thrombin-stimulated intracellular release also fell at 3
      months (baseline 769 +/- 61 versus 3 months 559 +/- 49 nmol/l, P < 0.01). This
      study suggests that intracellular free calcium control within platelets improves
      in response to erythropoietin therapy. However these changes appear not to be
      related to the development of hypertension.

PMID- 7800210
TI  - Low-dose aspirin does not prevent thrombovascular accidents in low-risk
      haemodialysis patients during treatment with recombinant human erythropoietin.
AB  - Treatment of the anaemia of renal disease with recombinant human erythropoietin
      results in an improvement of haemostasis and an increased risk of thrombovascular
      accidents. In this prospective, placebo-controlled, double-blind, and cross-over
      study, the effects of low-dose acetylsalicylic acid (30 mg daily) on thrombotic
      and bleeding events during the initial period of treatment with erythropoietin in
      anaemic haemodialysis patients without previous thrombovascular accidents or
      known increased risk for thrombosis were investigated. During correction of the
      haematocrit and the first 3 months thereafter, group A (n = 68) received placebo
      and group B (n = 69) 30 mg acetylsalicylic acid daily. Cross-over took place
      after the 3rd month of a stable haematocrit. The study ended 3 months later.
      Target haematocrit (30-35%) was reached in 12.4 +/- 8 weeks (M +/- SD). In group
      A the bleeding time was 382 +/- 285 s, decreasing to 282 +/- 208 before cross
      over (P < 0.01), and increasing to 395 +/- 271 (P < 0.05) thereafter. In group B
      the bleeding time was 390 +/- 381 s, 406 +/- 267 (NS), and 285 +/- 238 (P < 0.05)
      respectively. Twenty-two thrombovascular accidents were seen (16%, 13 during
      acetylsalicylic acid and 9 during placebo, NS), including 17 fistula thromboses.
      The incidence of bleeding events was not significantly different between
      regimens. In conclusion, erythropoietin treatment resulted in a reduction of the
      bleeding time. When 30 mg acetylsalicylic acid was taken during the treatment,
      the bleeding time did not decrease.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7800211
TI  - Calcium acetate versus calcium carbonate as phosphate-binding agents in chronic
      haemodialysis.
AB  - Hyperphosphataemia plays a key role in the pathogenesis of renal osteodystrophy,
      and phosphate-binding agents are required in many chronic dialysis patients.
      Aluminium hydroxide and calcium carbonate are well-established phosphate binders,
      but their use is associated with toxicity or poor efficacy. Calcium acetate is
      known to be a potent phosphate binder, and has recently been used successfully in
      chronic dialysis patients. In this randomized cross-over trial in 31 chronic
      haemodialysis patients, equimolar doses of calcium acetate and calcium carbonate
      were administered for 6 weeks each. Compliance was estimated from tablet counts,
      and biochemical parameters were measured at the end of each treatment period. Of
      the 31 patients 23 completed both treatment arms; of the remainder, three
      withdrew due to adverse symptoms, hypercalcaemia necessitated treatment
      withdrawal in two, and three died. Non-compliance was significantly higher with
      acetate (18.3% tablets not taken) than with carbonate (8.7%). Serum phosphate was
      significantly lower after treatment with acetate (1.51 mmol/l) than with
      carbonate (1.80), as was the Ca x PO4 product (3.59 vs 4.18 respectively) and PTH
      (17.8 vs 25.4 pmol/l respectively). Serum calcium was significantly higher after
      acetate therapy (2.40 vs 2.32 mmol/l). No significant difference was found for
      sodium, potassium, bicarbonate, urea, creatinine, and haemoglobin. This study
      confirms that the treatment of hyperphosphataemia is more effective with calcium
      acetate than with calcium carbonate. For the first time an associated beneficial
      effect on secondary hyperparathyroidism has also been demonstrated. Patient
      tolerability of calcium acetate was considerably poorer, probably due in part to
      tablet formulation and bulkiness, as well as possible direct gastrointestinal
      effects of the acetate salt.

PMID- 7800213
TI  - Treatment of dialysis-induced hypotension with L-threo-3,4-dihydroxyphenylserine.
AB  - L-threo-3,4-dihydroxyphenylserine (L-DOPS), a precursor of noradrenaline
      (norepinephrine), which is converted into noradrenaline when orally administered,
      was given orally to haemodialysed patients exhibiting dialysis-induced
      hypotension. In five patients given 300 mg L-DOPS plasma concentrations reached a
      peak of 1.43 +/- 0.59 micrograms/ml 6 h after administration and decreased slowly
      to disappear after 36 h. Plasma noradrenaline concentrations showed a significant
      increase (P < 0.05), reaching a peak of 1.28 +/- 0.64 ng/ml after 24 h and
      declined to 0.75 +/- 0.47 ng/ml by 48 h. Administration of L-DOPS to six patients
      during dialysis for 6 consecutive weeks showed no accumulation in the blood. Oral
      administration of 200-400 mg L-DOPS to 34 patients 1 h before dialysis prevented
      dialysis-induced hypotension and decreased the number of concurrent treatments
      required for hypotension. The signs and symptoms of hypotension were improved in
      73.5% of the patients and persisted after dialysis in 64.7%. The preventive
      effect of L-DOPS was significantly more prominent in patients with predialysis
      systolic blood pressure less than 100 mmHg and in patients with non-diabetic
      nephropathy. L-DOPS appeared to be an effective and well-tolerated treatment for
      the prevention of dialysis-induced hypotension.

PMID- 7800212
TI  - Increased plasma levels of soluble tumor necrosis factor-receptors in uraemic
      patients: effects of dialysis, type of membrane, and anticoagulation method.
AB  - Enhanced levels of soluble TNF-receptors (sTNF-R) have been reported in patients
      with chronic renal failure. The aim of the present study was to evaluate the
      effects on sTNF-R levels in plasma of haemodialysis patients of the
      anticoagulation method and of the type of membrane used, as well as the
      variability of predialysis sTNF-R levels during time. All haemodialysis patients
      tested (n = 35) showed increased levels of both sTNF-R55 (72.4 +/- 5.7 ng/ml, P <
      0.001) and sTNF-R75 (18.2 +/- 2 ng/ml, P < 0.001) before dialysis, as compared
      with normal healthy controls (< 2.5 ng/ml for both sTNF-R), confirming previous
      observations. sTNF-R levels were determined before and during haemodialysis at
      different time intervals in patients receiving either heparin (2500 U, 5000 U, or
      10,000 U), low molecular weight heparin, or periodic saline flushing to prevent
      coagulation of the extracorporal circuit. A transient, small decrease in both
      sTNF-R levels occurred at the beginning of haemodialysis (t = 15 min) with all
      anticoagulation methods used. At the end of haemodialysis, sTNF-R55 and sTNF-R75
      concentrations were only minimally affected (P > 0.05). Predialysis sTNF-R levels
      were similar in patients dialysed on either cellulose diacetate or
      polyacrylonitrile. Finally, there were only minimal variations in predialysis
      sTNF-R levels in individual patients during the 1 week observation period.
      Although the biological consequences of the increased TNF-binding ability of
      serum from haemodialysis patients is still unclear, it could play a role in the
      complex immunological perturbations of uraemic patients.

PMID- 7800214
TI  - Comparative mortality from cardiovascular disease in patients with chronic renal
      failure.
AB  - Patients with chronic renal failure show an excess mortality from cardiovascular
      disease (CVD). Over a 4-year period (1983-1986) we have prospectively studied 305
      patients (177 men, 128 women) from a geographically constrained population
      entering a renal replacement therapy (RRT) programme. The development of new
      cardiovascular events and patient survival have been documented up to the end of
      1990. We have determined the incidence of CVD amongst the patients compared to
      the general population of the region and assessed the predictive value for future
      cardiovascular events of risk factors present at the start of RRT. One hundred
      and fourteen patients experienced a new cardiovascular event. One hundred and
      fifteen patients died, 89 from CVD. Stratification by age and sex identified
      diabetes, previous coronary heart disease, and cardiomegaly to be significantly
      associated with an increased risk of a cardiovascular event, and diabetes,
      previous coronary heart disease, and accelerated hypertension to be significantly
      associated with an increased risk of cardiovascular death. Mortality from CVD was
      10.1 times that of the corresponding general population, and was increased 44
      times for patients with diabetes. Duration of RRT did not influence mortality
      rates. This excessive early mortality has significant implications for RRT
      programmes and further research is necessary to identify individuals at risk and
      the modifiable risk factors that could receive targeted interventional therapy.

PMID- 7800215
TI  - Prevention of acute cyclosporin nephrotoxicity by verapamil and atrial
      natriuretic factor in the rat.
AB  - Nephrotoxicity is the most common and important side-effect of cyclosporin (CsA)
      therapy. CsA alters renal haemodynamics with a reduction in renal blood flow
      (RBF) and glomerular filtration rate (GFR) and a significant increase in renal
      vascular resistances (RVR). The present experimental study investigates whether
      verapamil or atrial natriuretic factor (ANF) are able to prevent the
      nephrotoxicity of CsA. All studies were conducted in an in-situ autoperfused rat
      kidney model which allows continuous measurement of renal blood flow without
      dissection of the renal artery. CsA as a 40 mg/kg bolus dose significantly
      decreased RBF (from 2.15 +/- 0.1 and 2.19 +/- 0.1 before CsA, to 1.29 +/- 0.16
      ml/min/100 g BW, 60 min after CsA administration) (P < 0.05), and GFR (from 0.14
      +/- 0.1 and 0.13 +/- 0.01 before CsA, to 0.08 +/- 0.01 ml/min/100 g BW, 60 min
      after CsA administration) (P < 0.05). CsA significantly increased RVR (from 9.5
      +/- 0.73 and 9.8 +/- 0.78 before CsA, to 16.7 +/- 2.9 mmHg x min/ml 60 min after
      CsA administration) (P < 0.05). Verapamil pretreatment (as continuous intrarenal
      infusion at the rate of 1.25 micrograms/kg/min) attenuated the fall in GFR (from
      0.16 +/- 0.01 and 0.19 +/- 0.03 ml/min/100 g before CsA to 0.20 +/- 0.05
      ml/min/100 g BW, 60 min after CsA administration) (NS) and in RBF (from 2.42 +/-
      0.2 and 2.6 +/- 0.22 ml/min/100 g before CsA to 1.79 +/- 0.17 ml/min/100 g BW, 60
      min after CsA administration (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7800217
TI  - 99mTc-DMSA imaging with tomography in renal transplant recipients with abnormal
      lower urinary tracts.
AB  - This study examined whether renal parenchymal imaging using 99mTc DMSA
      scintigraphy with tomography is a sensitive measure of renal scarring in renal
      transplant recipients with an abnormal lower urinary tract and whether such scars
      correlate with impairment of renal function. Three groups of patients were
      compared: group 1, patients with an abnormal lower urinary tract and
      deteriorating renal function (n = 9); group 2, abnormal lower urinary tract and
      stable renal function (n = 5); and group 3, normal lower urinary tract and
      deteriorating renal function (n = 8). Eight of the nine patients in group 1 had
      multiple scars visible on 99mTc DMSA scans and this correlated with histology
      when a renal biopsy was performed; the only patient without scars had a
      transplant glomerulopathy. The presence of scars was associated with either
      raised intravesical pressures or recurrent urinary tract infections (UTIs). Only
      one patient in each of groups 2 and 3 had visible scars and both these patients
      had a history of recurrent UTIs. Patients in group 3 with deteriorating renal
      function due to chronic rejection documented by biopsy did not have cortical
      scars visible with 99mTc DMSA tomography. 99mTc DMSA scanning with tomography is
      a useful investigation in the management of renal transplant patients with
      declining renal function; multiple scars may indicate abnormal lower urinary
      tract function and are not seen in chronic rejection.

PMID- 7800216
TI  - Acute haemodynamic and renal effects of cyclosporin and indomethacin in man.
AB  - A single oral dose of cyclosporin (12 mg/kg) was given to healthy volunteers (n =
      9) on day 2 with or without indomethacin pretreatment (100 mg day 1 + 100 mg day
      2). All parameters reported were analysed after a water-loading protocol on day
      2. As a peak drug effect within 4 h of drug ingestion on day 2 cyclosporin on its
      own increased mean arterial pressure by 13% (P < 0.05) without causing any sodium
      retention or renal vasoconstriction. Indomethacin pretreatment did not accentuate
      this hypertensive effect of cyclosporin. The earliest renal effect observed with
      cyclosporin on day 2 was on water handling with a marked antidiuretic effect.
      Free-water clearance decreased by a maximum of 48% (P < 0.05) following
      cyclosporin. Indomethacin pretreatment induced a similar antidiuresis on day 2
      but cyclosporin did not augment this antidiuresis any further. This suggests that
      inhibition of vasodilator prostaglandins within the kidneys may mediate the
      antidiuretic effect of cyclosporin such that in the presence of indomethacin,
      cyclosporin had no additional effect. The inhibition of intrarenal prostaglandins
      by a single dose of indomethacin did not, however, produce any acute cyclosporin
      induced change in glomerular filtration rate or renal blood flow.

PMID- 7800218
TI  - Characterization of the anti-A antibody binding in an ABO-incompatible living
      donor renal transplantation.
AB  - A 57-year-old female, blood group B, with polycystic kidney disease, received an
      ABO-identical, HLA-A,B,DR 5-mismatched renal allograft in 1986. Due to graft
      artery thrombosis and vascular rejection, she lost the kidney 6 months after
      transplantation and developed HLA antibodies with a panel reactivity of 99%.
      Despite 5 years on a European waiting list for highly immunized patients, she was
      not offered a second kidney. An attempt to remove her HLA antibodies by
      plasmapheresis combined with cyclophosphamide therapy did not succeed. Her 53
      year-old HLA-identical, but ABO-incompatible sister (blood group A1), was then
      accepted as a donor. After immunoadsorption on Biosynsorb-A columns,
      transplantation was performed. The post-transplant course was uneventful without
      any signs of rejection. Studies on the anti-A antibody binding characteristics
      before and after immunoadsorption and after transplantation, showed that IgM and
      IgG antibodies recognizing the A trisaccharide epitope based on the type 1, 2,
      and 4 core saccharide chains, were effectively removed by Biosynsorb-A
      adsorption, but the column failed to remove anti-A antibodies recognizing the A
      type 3 antigen. These antibodies probably requires part of the core saccharide
      chain for binding. The presence of these antibodies did not seem to influence the
      outcome of the ABO-incompatible transplantation.

PMID- 7800220
TI  - Acute hypernatraemia during bicarbonate-buffered haemodialysis.
AB  - Five patients on maintenance haemodialysis were exposed to varying degrees of
      hypernatric dialysate, leading to acute hypernatraemia (plasma sodium
      concentrations 158 mmol/l to 179 mmol/l). With the exception of one patient, who
      developed pulmonary oedema, symptoms were minimal and in each case hypernatraemia
      was corrected without residual complications. The hypernatric dialysate resulted
      from a granular and less soluble batch of sodium bicarbonate powder. The extra
      effort required to dissolve the powder caused CO2 to be shaken out of solution,
      producing sodium carbonate and raising the pH. Mixing calcium from the 'acid'
      concentrate with excess carbonate in the 'bicarbonate' concentrate led to rapid
      precipitation of calcium carbonate on the conductivity monitoring cells.
      Dialysate conductivity was incorrectly sensed as low by the coated conductivity
      cells, so that an increasing amount of 'acid' concentrate, with its accompanying
      electrolytes, was delivered to the patient. When the granular powder was ground
      to a fine powder, passed through a 125 microns sieve and gently dissolved, the
      machine operated normally. We recommend that sodium bicarbonate powder is
      supplied with a sieve size no greater than 125 microns, kept dry to prevent the
      formation of large crystals, and dissolved gently.

PMID- 7800219
TI  - Increased renal allograft thrombosis in CAPD patients.
AB  - In a retrospective analysis of 202 renal transplant procedures in the years 1989
      1992 we identified an excess of grafts lost from primary renovascular thrombosis
      in patients receiving continuous ambulatory peritoneal dialysis (CAPD) compared
      to haemodialysis (HD) patients (9 CAPD versus 0 HD, Chi-squared = 9.63; P <
      0.01). All graft losses from thrombosis occurred within 16 days of surgery.
      Possible predisposing causes were identified in three patients. Donor age was
      greater in CAPD patients losing their kidneys from thrombosis compared to the
      overall CAPD group [mean (SD) years, 43.0(12.9) versus 29.1(15.8); P = 0.01]
      whereas no significant difference in haematocrit, platelet count, antibody
      status, cyclosporin use, peroperative hypotension, primary diagnosis, smoking, or
      diabetes mellitus was found. Data from the EDTA registry for 1990-91 show that
      graft loss from primary renovascular thrombosis in UK-treated patients was
      reported in 7.1% of CAPD recipients compared with 1.8% in haemodialysis. We
      suggest that CAPD patients are at greater risk of graft loss from renovascular
      thrombosis than HD patients and may require more intensive fluid and
      anticoagulant treatment in the perioperative period.

PMID- 7800221
TI  - Bradycardia as a presenting feature of late postpartum eclampsia.

PMID- 7800222
TI  - Hypokalaemic paralysis as the presenting manifestation of primary Sjogren's
      syndrome.

PMID- 7800223
TI  - Renal involvement in type I glycogen storage disease. Report of one case.

PMID- 7800224
TI  - Acute interstitial nephritis with severe but reversible renal failure due to
      streptokinase.

PMID- 7800225
TI  - Endocarditis due to corynebacteriaceae in a kidney transplant patient.

PMID- 7800226
TI  - Renal allograft dysfunction due to vesicoureteric obstruction by nodular
      malakoplakia.

PMID- 7800227
TI  - Haemolytic uraemic syndrome in a renal transplant recipient during OKT3 therapy.

PMID- 7800228
TI  - Mucormycosis in transplant recipients: possible case-case transmission and
      potentiation by cytomegalovirus.

PMID- 7800230
TI  - Calciphylaxis in renal failure.

PMID- 7800229
TI  - Complete regression of recurrent diffuse malignant lymphoma after withdrawal of
      cyclosporin A in a renal transplant recipient.

PMID- 7800231
TI  - Improving the number of organ donors.

PMID- 7800232
TI  - Successful treatment of massive uraemic tumoral calcinosis with daily
      haemodialysis and very low calcium dialysate.

PMID- 7800233
TI  - Nocardial psoas and perinephric abscess in a renal transplant treated by surgery
      and antibiotics.

PMID- 7800235
TI  - Erythropoietin dose requirement in a patient with beta-thalassaemia and chronic
      renal failure.

PMID- 7800234
TI  - Cytomegalovirus infection in a renal transplant patient masked by hepatitis C.

PMID- 7800236
TI  - Treatment with expandable endovascular prosthesis (Palmaz) to resolve an
      aneurysmal zone in an arteriovenous fistula (AVF) in a haemodialysis patient.

PMID- 7800237
TI  - Efficacy of intradermal injection of recombinant hepatitis B vaccine in dialysis
      patients.

PMID- 7800238
TI  - International symposium on acute renal failure. 20-23 June 1993, Halkidi, Greece.
      Proceedings.

PMID- 7800239
TI  - Acute renal failure: the dawn of dialysis and the roaring 50s.

PMID- 7800240
TI  - Acute renal failure and multiorgan failure.
AB  - Acute renal failure is often seen in the context of multiorgan failure, and thus
      there is likely to be a common mechanism based on septicaemia or endotoxaemia.
      The role of gut mucosal dysfunction during shock or in infected ICU patients is a
      potential common factor. With that in mind the probable role of endotoxin as a
      causative agent in acute renal failure is addressed.

PMID- 7800241
TI  - Acute renal failure and myeloma.

PMID- 7800242
TI  - Virus-related acute renal failure. The clinical course and outcome of
      haemorrhagic fever with renal syndrome.

PMID- 7800243
TI  - Inhaled mycotoxins lead to acute renal failure.
AB  - Mysterious deaths of archeologists after opening Egyptian tombs have been
      suspected, but never proved, to be secondary to inhalation of mycotoxin. We
      observed a case of acute renal failure (ARF) due to inhalation of ochratoxin A
      produced by a mould of the species Aspergillus ochraceus. After working 8 h in a
      granary closed for several months, a farmer and his wife suffered respiratory
      distress; the woman developed non-oliguric ARF and biopsy revealed
      tubulonecrosis. A strain of Aspergillus ochraceus producing ochratoxin was
      isolated from the wheat.

PMID- 7800244
TI  - Acute renal failure in patients with severe civilian trauma.
AB  - We reviewed our experience with patients suffering from civilian trauma to
      identify risk factors for the development of acute renal failure (ARF) and ARF
      outcome. Of the 437 patients consecutively admitted to a surgical intensive care
      unit (SICU), 206 had a SICU stay of at least 1 day and ARF developed in 30 of
      these patients. All ARF patients had additional organ system failure (OSF). Pre
      existing chronic disease (including chronic renal failure), malnutrition, injury
      severity score (ISS), number of organs injured, sepsis, and all OSFs before the
      onset of ARF were factors predisposing to ARF. Mortality was 40%. Chronic
      disease, malnutrition, ISS, failure of cardiovascular, pulmonary, hepatic, and
      neurological systems (either before and after ARF) were significantly associated
      with mortality. When OSFs were considered in their temporal relationships to ARF,
      only cardiovascular and pulmonary failure before, and gastrointestinal failure
      after, the onset of ARF were related to mortality. An increasing number of OSFs
      increased mortality, both before and after the development of ARF. However, the
      number of OSFs before was significantly greater than after ARF. Sepsis was not
      associated with increased mortality. Thus, the outcome of ARF patients with
      critical trauma seems to be dependent on factors predisposing to ARF. Our results
      suggest that more attention must be paid to prevention of these precipitating
      conditions.

PMID- 7800246
TI  - Antibiotic-related nephrotoxicity.
AB  - The toxicity of aminoglycosides is related to their concentrative uptake by
      proximal tubular cells and their capacity to interact with critical intracellular
      targets. Concentrative uptake is mediated by adsorptive endocytosis across the
      apical membrane followed by sequestration within lysosomes. The fundamental
      mechanism underlying the toxicity of these organic polycations is their capacity
      to interact electrostatically with and disrupt the metabolism of anionic
      phospholipids, especially the phosphoinositides. Polyaspartic acid, a polyanionic
      peptide, protects against aminoglycoside nephrotoxicity by forming electrostatic
      complexes with these drugs and inhibiting their interaction with critical
      intracellular targets. The selective toxicity of beta-lactams towards renal
      proximal tubular cells is related to their concentrative uptake via the organic
      anion transport system. Lipid peroxidation appears to play a major role in the
      toxicity of cephaloridine. Depressed mitochondrial respiration secondary to
      acylation of the mitochondrial transporter for succinate has been implicated in
      the pathogenesis of toxicity caused by other cephalosporins and carbapenems. The
      predilection of the kidney for amphotericin B toxicity is unclear as little drug
      is excreted by the kidneys. Toxicity is manifested by increased renal vascular
      resistance, depression of RBF and GFR, and altered tubular function that reflects
      the capacity of this drug to interact with cholesterol-containing membranes and
      increase membrane permeability to ions including potassium, hydrogen, calcium,
      and magnesium.

PMID- 7800245
TI  - Metformin-associated lactic acidosis in diabetic patients with acute renal
      failure. A critical analysis of its pathogenesis and prognosis.
AB  - To determine the respective role of metformin accumulation and tissue hypoxia in
      triggering metformin-associated lactic acidosis (MALA), we measured plasma (PM)
      and red blood cell (RM) metformin concentrations in 14 patients with MALA and in
      58 diabetic patients on well-tolerated chronic metformin treatment. In this
      control group RM was 0.9 +/- 0.5 mg/l. In MALA, lactic acidosis was of comparable
      severity whether there was significant cellular metformin accumulation (9
      patients with severe renal failure) or not (5 patients with less severe renal
      failure). Factors of hypoxia were found in all patients except three with
      isolated anuria and major metformin accumulation. Early mortality was low in
      patients with metformin accumulation (no rapid death with the exception of two
      patients with end-stage hepatic failure) whereas it was high in those with
      metformin accumulation (4 patients died rapidly). In conclusion, MALA is not
      always associated with metformin accumulation. The prognosis of MALA depends
      mainly not upon the degree of metformin accumulation but rather upon the severity
      of hypoxic factors.

PMID- 7800247
TI  - Mechanism of gentamicin nephrotoxicity in rats and the protective effect of zinc
      induced metallothionein synthesis.
AB  - We examined the role of reactive oxygen metabolites and the protective effect of
      zinc-induced metallothionein (MT) synthesis on gentamicin nephrotoxicity both in
      vivo and in vitro. In vivo study we found that the MT content of renal cortex of
      the zinc preinjected rats was significantly increased, and proximal tubular
      necrosis and acute renal failure caused by injection of gentamicin were
      ameliorated. In suspended proximal tubules (PT), Na(+)-K(+)-ATPase activity and
      DNA synthesis were suppressed by the addition of gentamicin, but in zinc
      pretreated rats' PT, these were not suppressed by the addition of gentamicin.
      Meanwhile MDA and hydroxyl radicals were significantly less in zinc-pretreated
      rats' PT compared to that in the control. Finally, we found that gentamicin
      enhanced superoxide anion and hydroxyl radical productin in renal cortical
      mitochondria. Superoxide anion could be suppressed by SOD and hydroxyl radical
      could be scavenged by DMSO, DFO and CAT. Our data confirm that hydroxyl radicals
      play a role in the pathogenesis of gentamicin nephrotoxicity, gentamicin can
      induce suppression of Na(+)-K(+)-ATPase activity and DNA synthesis in rats'
      proximal tubules leading to renal injury; this injury may be relevant to reactive
      oxygen metabolites generated by gentamicin. Renal cortical mitochondria is the
      source of reactive oxygen metabolites, which induces renal injury, and zinc
      induced metallothionein synthesis could ameliorate gentamicin nephrotoxicity via
      scavenging reactive oxygen metabolites.

PMID- 7800248
TI  - Radiocontrast-induced nephropathy.
AB  - Significant renal insufficiency defined as a stable SCr > 1.5 mg/dl is the single
      most important risk factor for RCIN. Based on the outcome data summarized, the
      occurrence of RCIN should be avoided, since significant deterioration of renal
      function occurs in one of every four patients. Clearly volume depletion should be
      corrected before administering RCM. In high-risk patients a hydration protocol
      should be initiated before the procedure and continued for at least 2 h after the
      procedure. At least one large cooperative study has reported a significant
      reduction in RCIN when LORCM are compared to HORCM. Limiting the total volume of
      RCM used for an individual study also reduces the incidence of RCIN. While
      indications for invasive studies with RCM continue to expand, especially for
      elderly and other high-risk groups, using the above recommendations as guidelines
      should minimize the risk of RCIN while still providing the critical information
      needed to develop a clinical management plan.

PMID- 7800249
TI  - Mechanisms of cell injury in ATP-depleted proximal tubules. Role of glycine,
      calcium, and polyphosphoinositides.
AB  - Increase of intracellular free Ca2+ (Caf) plays an important role in the
      deterioration of cell structure that occurs during depletion of adenosine
      triphosphate (ATP). On the other hand a form of Ca2+ independent cell injury due
      to glycine deficiency has also been recognized. Normally high intracellular
      gradients of glycine are dissipated during ATP depletion. Under these
      circumstances exogenous glycine protects cells and preserves structure
      independently of metabolism. We have examined the specific contributions of
      calcium and glycine to the injury process in isolated rabbit proximal tubules
      depleted of ATP by exposure to a metabolic inhibitor, or additionally made
      permeable to calcium ions by an ionophore. Tubules were incubated in high or low
      Ca2+ media (1.25 mM or 100 nM Ca2+) to attain high concentrations of Caf or
      'clamp' Caf in the physiological range. Our results showed that structural
      breakdown in proximal tubule cells is compartmentalized. Increase of Caf leads to
      specific patterns of membrane damage and phospholipid hydrolysis. On the other
      hand glycine deficiency leads to a unique membrane defect that occurs
      independently of phospholipid breakdown and is fully expressed even if calcium
      mediated injury is prevented by low Ca2+ conditions. Furthermore, the specificity
      of glycine was emphasized by its ability to maintain membrane continuity and thus
      dramatically delay lethal injury in spite of severe structural damage caused by
      massive increases of Caf.

PMID- 7800250
TI  - International standardization in renal allograft biopsy reporting: a model for a
      new approach to renal pathology.
AB  - As we prepare to enter a new century it is reasonable to ask whether our current
      classification system of renal pathology and descriptive approach to renal biopsy
      interpretation will be appropriate to the medicine of the future. Assessment of
      that special category of acute renal failure represented by early post-transplant
      biopsies is becoming much more quantitative, therapy-oriented, and pathogenesis
      based. It would be highly beneficial to the field if similar changes occurred in
      our approach to native kidney biopsies. We need to provide tighter linkage
      between exciting new developments in the research laboratory and the clinical
      practice of renal pathology. In a field largely limited to traditional empirical
      therapies, we need to be developing new pathogenesis-oriented therapeutic
      approaches to native kidney disease based on the results of enlightened renal
      pathology research.

PMID- 7800251
TI  - Sepsis-associated acute renal failure: some potential pathogenetic and
      therapeutic insights.

PMID- 7800252
TI  - Loop diuretics and renal vasodilators in acute renal failure.
AB  - Loop diuretics are powerful drugs able to increase urinary sodium and water
      excretion even in conditions of marked impairment of renal function. Loop
      diuretics are useful in preventing or ameliorating the course of acute renal
      failure. This effect may be obtained when they are used within 18 h after the
      ischaemic and/or toxic event. Loop diuretics reduce tubular work, providing
      resistance to cellular ischaemia. Other important beneficial effects include
      tubular wash-out of cellular debris and inhibition of tubuloglomerular feedback.
      Among vasodilators, dopamine, when used at 'dopaminergic dosage' is useful in
      preventing acute renal failure. Its efficacy is demonstrated in several
      situations of renal hypoperfusion, i.e. salt depletion, cyclosporin
      administration, and therapy with recombinant interleukin 2 in cancer patients.
      According to our studies it appears that dopamine should be used in the early
      phases of acute renal failure to improve renal perfusion, re-establish glomerular
      filtration rate, and increase tubular flow.

PMID- 7800253
TI  - Factors related to multiple organ system failure and mortality in a surgical
      intensive care unit.
AB  - We retrospectively studied the relative contribution of factors related to the
      extent of multiple organ system failure (MOSF) and mortality, using multivariate
      methods to account for the interactions between studied factors, in 538
      consecutive patients admitted to a surgical intensive care unit during a 1-year
      period. MOSF (MOSF score > or = 5) occurred in 88 (16%) of patients. Multiple
      linear regression selected advancing age, malnutrition, APACHE II score, shock
      and coma on admission, number of blood transfusions, use of H2 receptor
      antagonists or antacids, bacteraemia and intra-abdominal infection as independent
      factors related to the MOSF score. MOSF mortality was 52% and was a major cause
      of death in critically ill surgical patients. Multiple logistic regression
      selected advancing age, malnutrition, bacteraemia, APACHE II and MOSF score as
      major predictors of mortality. Advancing age, malnutrition, shock and coma on
      admission, transfusion requirement and use of H2 receptor antagonists or antacids
      may impair host defences of the gastrointestinal tract and enhance the
      vulnerability for invasive infection, thereby aggravating the severity of
      existing MOSF. Together with the predominance of Enterobacteriaceae in infected
      patients, these results suggest that translocation of intestinal bacteria and
      endotoxin may be important in the evolution and perpetuating the MOSF syndrome.
      Our results may be useful in devising strategies to prevent or limit the
      evolution of MOSF and to improve survival in patients with critical illness.

PMID- 7800254
TI  - Risk factors influencing survival in ICU acute renal failure.
AB  - Factors influencing survival in ICU patients with acute renal failure (ARF)
      requiring dialysis were analysed from data collected prospectively in an ARF
      registry. A total of 363 patients were analysed. Overall mortality was 79.1% and
      did not differ between medical and surgical patients. Factors associated with an
      increased risk of dying included the development of any concomitant organ system
      failure, the number of failed organs, APACHE II score at the time of renal
      consultation for medical patients, pre-existing chronic liver disease, and the
      number of days from ICU admission to institution of dialysis. Male gender reached
      borderline significance. Survivors recovered renal function and discontinued
      dialysis in 65.7% of cases. We conclude that mortality rates for ARF in ICU
      patients continues to be high. Multi-system organ failure (MSOF) occurs
      frequently and is the major cause of death.

PMID- 7800255
TI  - Basic therapeutic requirements in the treatment of sepsis in acute renal failure.
AB  - Acute renal failure (ARF) is a common manifestation of a septic condition which
      very often complicates surgical and traumatic events. The release of endotoxin, a
      lipopolysaccharide (LPS) from the cell wall of Gram-negative bacteria, and
      subsequently of numerous host mediators, is the initiating event of sepsis
      syndrome and eventually of septic shock. Particularly interesting is the
      observation that not only endotoxins but also Staphylococcus aureus which does
      not produce endotoxins induce the same cardiovascular changes of septic shock.
      The main aspect of septic shock is the inadequate oxygen supply to the body
      tissues. However, despite the documented myocardial depression in the course of
      septic shock, myocardial ischaemia is not to be considered a contributing factor,
      and the coronary blood flow is normal or even increased. Protein hypercatabolism
      can be at best only limited; in any case the optimal protein-sparing effect was
      observed with 1.5 g/kg proteins. Recently monoclonal antibodies to endotoxin core
      glycolipid have been developed; they are: (a) E5, a murine IgM anti-lipid A
      monoclonal antibody; (b) HA-1A, a human monoclonal antibody to endotoxin core
      glycolipid. In conclusion, hypercatabolic septic patients should be managed in an
      intensive care environment where a continuous monitoring of fluids, electrolytes,
      and acid-base disorders can be achieved. Surgical search of septic foci, and wide
      spectrum antibiotic therapy are fundamental measures to combat cytokine and
      vasodilator production which impair tissue perfusion and create the premise of a
      shock status complicated by lactic acidosis. Dialysis treatment is a further
      complementary but fundamental approach that allows a large fluid and nutritional
      intake and a continuous correction of electrolyte and acid-base disorders.

PMID- 7800256
TI  - Continuous therapy for complicated acute renal failure.

PMID- 7800257
TI  - Continuous renal replacement therapies in the treatment of acute renal failure in
      intensive care patients. Part 1. Theoretical aspects and techniques.

PMID- 7800258
TI  - Continuous renal replacement therapies in the treatment of acute renal failure in
      intensive care patients. Part 2. Clinical indications and prescription.

PMID- 7800259
TI  - Plasmapheresis as a therapy in specific forms of acute renal failure.

PMID- 7800260
TI  - Nutritional considerations in the treatment of acute renal failure in septic
      patients.

PMID- 7800261
TI  - Cell shape changes and detachment in cell culture: models of renal injury.
AB  - Loss of tubular cell adhesion may be important in the pathophysiology of injury
      to renal tubular cell epithelium. In-vitro model systems have been utilized to
      examine altered cell adhesion in response to hypoxic/anoxic and oxidant-induced
      cell injury. Alterations in cell cytoskeleton and cell surface adhesion
      molecules, including L-CAM and integrins, have been demonstrated in these
      systems, and are probably important in the pathogenesis of altered structure and
      function in response to injury in renal tubular epithelium.

PMID- 7800262
TI  - Long-term follow-up of acute renal failure.

PMID- 7800263
TI  - Severity of acute renal failure: the need of measurement.

PMID- 7800264
TI  - Potential role of integrins in acute renal failure.
AB  - Many cell adhesion molecules probably contribute to the pathogenesis of acute
      renal failure. This review focuses on the potential importance of integrins.
      Integrins are a family of molecules that mediate cell-matrix and cell-cell
      adhesion, and are found on almost all cells. After acute renal injury, tubule
      epithelial cell-cell contacts (mediated by many molecules including uvomorulin
      and possibly integrins) are disrupted, as is the cytoskeleton. Detachment of
      viable tubule epithelial cells from the basement membrane has also been
      documented following acute renal injury. Such detachment would lead to back-leak
      of glomerular filtrate and could also be important in the production of cellular
      casts. As the attachment of the cytoskeleton to integrin is critical to cell
      matrix adhesion, it is likely that cytoskeletal disruption is one of the
      mechanisms contributing to cell detachment. Integrins are also likely to be
      important in repair, as integrins will probably participate in migration along
      the basement membrane and may also influence cell function during the
      redifferentiation process. Finally, leukocyte integrins will probably play a role
      in the migration of leukocytes into areas of injury and also be critically
      important to their function.

PMID- 7800265
TI  - Cellular defence mechanisms against ischaemic and toxic injury.

PMID- 7800266
TI  - Morphometric studies of acute renal failure using anti-brush-border and other
      antisera.
AB  - Correlations have been shown between renal excretory function and the extent of
      immunohistological staining in the kidney of proximal tubular brush border and
      Tamm-Horsfall protein. These findings confirm the importance of the integrity of
      the proximal tubule in control of the glomerular filtration rate and also show
      that the thick limb of the loop of Henle is damaged, as well as the proximal
      tubule, in renal failure.

PMID- 7800267
TI  - Role of infection in the genesis of acute renal failure.
AB  - While most experimental models of acute renal failure (ARF) involve ischaemic or
      toxic damage to the kidney in non-infected animals, a surprisingly large
      proportion of patients with ARF exhibit signs of septicaemia or systemic reaction
      to local infections. This clinical observation suggests an important role of
      infection-related mediator mechanisms in the genesis of ARF. Another important
      aspect is the occurrence of ARF in the context of infections with nephrotropic
      viruses (e.g. hantavirus accounting for approximately 5% of non-surgical ARF in
      Germany) and nephrotropic bacteria (e.g. leptospirosis).

PMID- 7800268
TI  - Bacterial factors in septic shock.

PMID- 7800269
TI  - Pathogenesis of acute renal failure during sepsis.
AB  - Acute renal failure (ARF) is often a component of multiple organ system failure
      in critically ill patients. Sepsis (i.e. systemic bacterial infection) is a major
      factor in the aetiology of ARF and this is primarily caused by sepsis-induced
      cardiovascular and pulmonary failure. This association suggests that systemic
      haemodynamic factors, leading to severe and persistent renal hypoperfusion, play
      a key role in the development of ARF. However, ARF in the course of sepsis or
      endotoxaemia may not be solely due systemic or renal haemodynamic changes, since
      humoral and cellular reactions may also have an adverse effect on renal function.
      This review will address the haemodynamic and non-haemodynamic factors and their
      interaction in the development of ARF during sepsis.

PMID- 7800270
TI  - Role of arachidonic acid metabolites in acute renal failure and sepsis.

PMID- 7800271
TI  - Renal epidermal growth factor and insulin-like growth factor I in acute renal
      failure.

PMID- 7800272
TI  - PAF-cytokine autocatalytic feed-back network in septic shock: involvement in
      acute renal failure.

PMID- 7800273
TI  - Role of endothelin and tumour necrosis factor in the renal response to sepsis.
AB  - A rapidly increasing body of evidence is implicating endothelin and TNF in the
      pathogenesis of septic acute renal failure. TNF causes renal damage by recruiting
      leukocytes, accelerating fibrin accumulation, promoting cell lysis, stimulating
      the release of vasoconstrictor substances, and other mechanisms. ET-1 causes
      renal dysfunction in sepsis and endotoxaemia primarily by evoking severe
      reductions in RBF and GFR. While these are only two of the many agents that
      mediate renal dysfunction during sepsis, they stand out by virtue of their
      combined ability to modulate numerous inflammatory pathways and to elicit marked
      alterations in renal function. Clearly the development of specific TNF and
      endothelin antagonists holds out promise for the treatment and prevention of
      septic acute renal failure.

PMID- 7800274
TI  - New aspects in pathogenesis of acute renal failure.

PMID- 7800275
TI  - Clinical studies on cytokines in sepsis: role of serum cytokines in the
      development of multiple-systems organ failure.
AB  - The universal finding of a persistently elevated serum TNF level after 12 h in
      patients who go on to develop MSOF and die suggests that factors other than peak
      intensity of intravascular proinflammatory response determine survival. The
      persistence of elevated levels of TNF in the serum of patients who progress to
      MSOF suggests an aetiological relationship between continual activation of the
      immune response and remote organ dysfunction in critically ill patients.

PMID- 7800276
TI  - Sepsis and SIRS.

PMID- 7800277
TI  - Commissioner Fishman takes oath of office.

PMID- 7800279
TI  - Environmental lung disease in New Jersey.
AB  - The lungs are peculiarly susceptible to insults that are experienced indoors and
      outdoors, infectious and noninfectious. Diagnosis is made through history and
      awareness of the increasing prevalence and number of causes of environmental lung
      disease.

PMID- 7800280
TI  - Current concepts in chronobiology and medicine.
AB  - Circadian rhythms must be considered as potential causes of medical problems if
      they are disrupted. These problems can be treated, with drugs, light, and
      chronotherapeutic techniques. Utilizing chronobiologic principles, some patients
      may be able to cope and overcome desynchronization.

PMID- 7800278
TI  - Human health effects associated with hazardous waste sites.
AB  - Many hazardous waste sites contain chemicals that cause serious disease in
      humans. However, adverse effects are uncommon. Evidence for harm comes
      principally from epidemiologic studies in which proof of exposure usually is
      lacking.

PMID- 7800281
TI  - Safe concentrations for dermal allergens in the environment.
AB  - Recent work studies have examined the relationship between allergen dose per unit
      of skin surface exposed and the elicitation of response for chromium. The use of
      such data to arrive at levels in environmental contactants is discussed with
      reference to soil contaminated with chromium.

PMID- 7800282
TI  - The environment and cancer in New Jersey.
AB  - Tumorigenesis involves a complex series of steps. These steps are influenced by
      genetic predisposition and by lifestyle, tobacco and alcohol use, diet, and
      occupation. The way a person chooses to or is forced to live will influence the
      risk of developing cancer.

PMID- 7800283
TI  - Cardiopulmonary effects of environmental tobacco smoke.
AB  - Passive smoking causes pulmonary and cardiovascular disease in children and
      adults. Environmental exposure to tobacco smoke in the home and in the workplace
      puts nonsmokers at risk and creates significant health and economic consequences.

PMID- 7800284
TI  - Sharing the toxic burden in New Jersey.
AB  - As toxic pollution spreads throughout New Jersey, the environment induces illness
      and the fear of illness in an ever-increasing population. The questions to ask
      physicians and residents of New Jersey are: Who will share the burden? What is
      the cost of this burden?

PMID- 7800285
TI  - Medical and environmental surveillance.
AB  - Comparisons and contrasts are made between medical and environmental surveillance
      in New Jersey. These two approaches can be used together to address questions of
      association and prevention in occupational and environmental medicine, a field
      that needs to be expanded.

PMID- 7800287
TI  - Long-term care for Californians.

PMID- 7800288
TI  - Law for the nurse manager: physician malpractice.

PMID- 7800286
TI  - Assessing human health effects from chemical contaminants in drinking water.
AB  - Epidemiologic studies in New Jersey have examined the relationship between
      exposure to water contaminants and the occurrence of leukemias, non-Hodgkin's
      lymphomas, and adverse reproductive outcomes. Public drinking water supplies need
      to be monitored on a continual basis.

PMID- 7800289
TI  - Marketing subacute care services.

PMID- 7800290
TI  - Ethics for, in, and about nursing administration.

PMID- 7800291
TI  - Legislative effects: what's next? A voice in the wilderness: what can I do?

PMID- 7800292
TI  - Technology: nursing the system. Taking the future on the CHIN.

PMID- 7800293
TI  - A follow-up evaluation to a needle-free i.v. system.
AB  - In 1989, one hospital noted a high rate of puncture wounds among healthcare
      workers, many injuries considered preventable. Beginning in 1990, strategies were
      developed in conjunction with the hospital's Blood and Body Fluid Exposure Task
      Force. In 1991, the hospital instituted a needle-free system in addition to
      employee and product educational programs. The study's results show a significant
      decrease in the number of injuries.

PMID- 7800294
TI  - Improving technology: blood glucose testing.
AB  - Nurses frequently monitor blood glucose at the patient's bedside, allowing timely
      assessment and interventions. To meet the Joint Commission on Accreditation of
      Health Organization's requirements and guidelines from National Committee on
      Clinical Laboratory Standards and College of American Pathologists, quality
      control compliance must be maintained. After testing three blood glucose
      monitors, one institution selected a machine that eliminated handwritten
      documentation, ensured quality control testing, and improved ease of use.

PMID- 7800295
TI  - Upgrading systems: a new pager.
AB  - A paging system was adopted to interface with an existing nurse call system to
      improve access and communication. A comprehensive, written message instantly
      reports the problem, location, urgency, and action to take. Contacting a nurse
      quickly and clearly is of paramount concern when delivering quality patient care.

PMID- 7800296
TI  - Health-oriented telecommunication: a community resource.
AB  - Telecommunication networks that link medical information with the community can
      support home caregivers while providing skills training and crisis intervention
      to prevent unnecessary hospitalization. Health-oriented telecommunications direct
      the traditional focus from intervention to prevention. Consumers become empowered
      with knowledge allowing them to participate in their healthcare and lifestyle
      decisions.

PMID- 7800297
TI  - A mentoring relationship: two viewpoints.
AB  - A mentoring relationship can be a dynamic process for both participants, one
      filled with increased self-awareness, commitment, and mutual respect. The time
      spent with a mentor guides the transition of theory into practice while clearly
      expressing the humanistic and caring qualities of the nurse administrator.

PMID- 7800298
TI  - The Midwest flood of 1993: surviving prolonged water loss.
AB  - The Midwest Flood of 1993 was one of the most devastating and challenging
      disasters in Iowa's history. The city's water supply became contaminated, leaving
      more than 250,000 residents and all seven metropolitan medical centers without
      water. Despite heroic sandbagging efforts, floodwaters invaded the Des Moines
      water treatment plant's filtration system. The major strategies used at this
      facility during the disaster provide a framework for effective, coordinated
      emergency response.

PMID- 7800299
TI  - Managing waste: reduce its generation.

PMID- 7800300
TI  - Facilitating surgical patients through home health intervention.

PMID- 7800301
TI  - Surviving implementation of a patient care information system.

PMID- 7800302
TI  - The ghost of Jacob Marley...

PMID- 7800303
TI  - The transitional years and beyond.

PMID- 7800304
TI  - Sonographic measurement of nuchal skinfold thickness for detection of Down
      syndrome in the second-trimester fetus: a multicenter prospective study. The
      AFDPHE Study Group. Association Francaise pour le Depistage et la Prevention des
      Handicaps de l'Enfant.
AB  - OBJECTIVE: To determine the sensitivity and specificity of soft-tissue nuchal
      fold measurement in the second-trimester fetus for the detection of trisomy 21.
      METHOD: Thirty-six investigators in 12 centers measured nuchal skinfold thickness
      in 3308 fetuses of 14-24 weeks' gestation. All mothers were referred for
      amniocentesis because of age, history of genetic disorder, or laboratory
      findings. Those referred with an ultrasound indication for amniocentesis,
      including nuchal-fold thickening, were excluded. RESULTS: Overall, nuchal
      skinfold was 6 mm or more in 8.5% of chromosomally normal fetuses and in 38% of
      those with trisomy 21. A false-positive rate below 5% was obtained by 81% of the
      investigators. Raising the cutoff of normality to 7 mm after 18 weeks' gestation
      improved specificity. CONCLUSION: Although the diagnostic value of this sign in
      skilled hands could allow its use as an indication for genetic amniocentesis at
      the second trimester, the method does not appear suitable for population
      screening because of the high variability in the results among the investigators.

PMID- 7800305
TI  - Clinical and biologic prognostic factors in breast cancer diagnosed during
      postmenopausal hormone replacement therapy.
AB  - OBJECTIVE: To ascertain the influence of hormone replacement therapy on clinical
      and biologic prognostic factors of breast cancer. METHODS: Between 1976-1992, we
      treated 1081 postmenopausal women for breast cancer at our institution. Of these,
      68 were undergoing postmenopausal hormone replacement therapy at the time of
      diagnosis. These patients were compared with a matched control group of 272
      breast cancer patients who had not undergone prior hormone replacement therapy.
      RESULTS: Patients who developed breast cancer during hormone replacement therapy
      had fewer locally advanced cancers (large tumors and extensive lymph node
      involvement) and more well-differentiated cancers (infiltrating lobular cancers
      and grade 1 cancer). The number of patients with estradiol or progesterone
      receptors was lower in the hormone-treated group. Metastasis-free survival curves
      showed a tendency (P = .05) for better prognosis in hormone-treated patients both
      overall and in stage T2. CONCLUSIONS: Hormone replacement therapy per se does not
      affect the prognosis of breast cancer. Regular surveillance during hormone
      replacement therapy reduces the number of locally advanced cancers and thus
      improves the survival rate. The higher number of well-differentiated cancers and
      the distribution of hormone receptivity may reflect interaction between
      neoplastic tissue and exogenous hormones.

PMID- 7800306
TI  - Needle modifications for invasive fetal procedures.
AB  - OBJECTIVE: To investigate the effect of needle size and siliconization on fetal
      blood sampling, transfusion, and electrocardiography. METHODS: Standard needles
      were modified by increasing the internal (but not the external) diameter and
      either siliconization of the bore or external Teflon coating. The siliconized
      needles were subjected to a series of flow experiments with either blood or
      saline at various driving pressures, and assessed in clinical use during fetal
      transfusion and fetal blood sampling. The Teflon-coated needles were used for
      fetal transfusion to try and facilitate the fetal electrocardiogram (ECG).
      RESULTS: Under conditions simulating fetal transfusion, the siliconized needle
      allowed a 93% increase in flow rate compared to the standard needle (P < .05).
      Samples obtained after fetal transfusion with the siliconized needles were free
      of clots, whereas 50% of the post-transfusion samples with the standard needle
      had clots present. Similarly, samples taken for fetal platelet count were free of
      platelet clumping and clots with siliconized needles, but not with standard
      needles. Fetal ECG recordings were recorded successfully when Teflon-coated
      needles were used to access the fetal circulation via the intrahepatic vein.
      CONCLUSIONS: Modifications to standard needles improved blood flow and reduced
      the activation of coagulation during both fetal intravascular transfusion and
      platelet count measurement. Direct fetal ECG recording was facilitated by Teflon
      coating the external surface of the needle, insulating the fetal signal from
      maternal electrical signals.

PMID- 7800307
TI  - Effect of dehydroepiandrosterone sulfate on uterine artery flow velocity
      waveforms in term pregnancy.
AB  - OBJECTIVE: To investigate the interrelation between estrogen synthesis by the
      fetoplacental unit and uteroplacental hemodynamics in term pregnancy. METHODS:
      Transvaginal color Doppler flow imaging and pulsed Doppler ultrasonographic
      assessments were made on ten normal full-term pregnant women before and 3, 5, 10,
      30, and 60 minutes after the administration of a 200-mg intravenous dose of
      dehydroepiandrosterone sulfate (DHAS) in 20 mL of 5% dextrose. Ten normal full
      term pregnant women received 20 mL of 5% dextrose as controls. The pulsatility
      index (PI) values for the uterine artery, heart rate, and mean arterial pressure
      were recorded. Plasma estradiol (E2) was measured before and 10 minutes after the
      infusion. RESULTS: In the DHAS group, uterine artery PI decreased from baseline
      by 26% (P < .05) after 5 minutes, and the mean reduction was 36% (P < .05) after
      10 minutes and 15% (P < .05) after 30 minutes. The PI returned to the baseline
      value 60 minutes later. In the control group, there was no change in uterine
      artery PI. No change was found in heart rate or mean arterial blood pressure in
      the control or DHAS groups. The mean plasma E2 increased from 22.3 +/- 6.6 to
      56.2 +/- 24.1 ng/mL (P < .05) 10 minutes after the infusion in DHAS subjects,
      whereas there was no significant change in plasma E2 in the controls. CONCLUSION:
      Dehydroepiandrosterone sulfate induces a significant decrease in the uterine
      artery PI, which suggests a possible decrease in uterine vascular impedance in
      term pregnancy.

PMID- 7800308
TI  - Fetal venous, arterial, and intracardiac blood flows in red blood cell
      isoimmunization.
AB  - OBJECTIVE: To investigate the effect of anemia on fetal venous, arterial, and
      intracardiac blood flows. METHODS: Color flow Doppler was used to record flow
      velocity waveforms from the atrioventricular valves, ductus venosus, right
      hepatic vein, inferior vena cava, middle cerebral artery, and descending thoracic
      aorta from 38 cases of red blood cell isoimmunized pregnancies. Immediately after
      the Doppler studies, funipuncture was performed and the fetal hemoglobin
      concentration was measured. RESULTS: Blood flow velocities in the thoracic aorta,
      middle cerebral artery, and the ductus venosus were increased compared to
      reference ranges established previously; however, a significant association with
      the degree of anemia was found only for the velocity in the thoracic aorta.
      Pulsatility indices in arteries and veins and the ratio of early to late
      atrioventricular inflow velocities were not significantly different from normal.
      CONCLUSIONS: Fetal anemia is associated with a hyperdynamic circulation in both
      arterial and venous vessels. Even in severe anemia, there is no evidence of
      congestive heart failure. Venous and intracardiac Doppler studies do not provide
      a clinically useful contribution in the management of red blood cell
      isoimmunization.

PMID- 7800309
TI  - Laparoscopically assisted vaginal removal of ovarian dermoid cysts.
AB  - Dermoid cysts were diagnosed by transvaginal sonography in 19 patients who
      subsequently underwent laparoscopy to confirm the nature and extent of the lesion
      and the mobility of the adnexa. Eighteen patients underwent surgery after the
      ovary was exteriorized through a posterior colpoceliotomy. No intraoperative
      complications were observed, and sonographic follow-up at 3 and 6 months after
      surgery showed a normal sonographic ovarian pattern. Laparoscopically assisted
      vaginal removal of dermoid cysts should be considered as an alternative to
      laparotomy and operative laparoscopy in cases when adnexal mobility is proven and
      vaginal extraction is feasible.

PMID- 7800310
TI  - Transumbilical placement of the vaginal probe in obese pregnant women.
AB  - Transabdominal ultrasonography in obese pregnant women is often unsatisfactory
      because of the poor transmission of ultrasound through a thickened abdominal
      wall. We report our experience with the placement of a transvaginal probe in the
      umbilicus to improve resolution in obese pregnant patients. The technique, which
      involves filling the umbilicus with ultrasound transmission gel and inserting the
      transvaginal probe into the umbilicus, was applied in 25 consecutive obese
      patients who had unsatisfactory fetal imaging by the standard transabdominal
      approach. The most frequent reason for incomplete fetal survey by the standard
      transabdominal approach was unsatisfactory imaging of the fetal heart (19 of 25
      cases, 76%). The transumbilical approach resulted in improved resolution and
      satisfactory cardiac examination in 18 of these 19 cases (95%). In two cases,
      color and pulsed Doppler interrogation of intrafetal vessels become possible. A
      complete fetal survey was accomplished in 96% of the cases.

PMID- 7800311
TI  - Interactive multimedia for prenatal ultrasound training.
AB  - This demonstration project examines the utility of interactive multimedia for
      prenatal ultrasound training. A laser-disc library was linked to a three
      dimensional (3-D) heart model and other computer-based training materials through
      interactive multimedia. A testing module presented ultrasound anomalies and
      related questions to house-staff physicians through the image library. Users were
      asked to evaluate these training materials on the basis of perceived
      instructional value, question content, subjects covered, graphics interface, and
      ease of use; users were also asked for their comments. House-staff physicians
      indicated that they consider interactive multimedia to be a helpful adjunct to
      their core fetal imaging rotation. During a 9-month period, 16 house-staff
      physicians correctly diagnosed 78 +/- 4% of unknown cases presented through the
      testing module. The 3-D heart model was also perceived to be a useful teaching
      aid for spatial orientation skills. Our findings suggest that interactive
      multimedia and volume visualization models can be used to supplement traditional
      prenatal ultrasound training. The system provides a broad exposure to ultrasound
      anomalies, increases opportunities for postnatal correlation, emphasizes motion
      video for ultrasound training, encourages development of independent diagnostic
      ability, and helps physicians understand anatomic orientation. We hypothesize
      that interactive multimedia-based tutorials provide a better overall training
      experience for house-staff physicians. However, these supplementary methods will
      require formal evaluation of effectiveness to better understand their potential
      educational impact.

PMID- 7800312
TI  - Fetal genital effects of first-trimester sex hormone exposure: a meta-analysis.
AB  - OBJECTIVE: To determine if first-trimester exposure to sex hormones, and oral
      contraceptives (OCs) specifically, is associated with an increased risk of
      external fetal genital malformations. DATA SOURCES: MEDLINE and Science Citation
      Index data bases were searched for the years 1966-1992 for relevant English
      language articles on first-trimester sex-hormone exposure and fetal genital
      changes. METHODS OF STUDY SELECTION: One hundred eighty-six articles were
      identified initially. Inclusion criteria were cohort or case-control studies,
      first-trimester sex-hormone exposure, and live infants or full-term stillborn
      infants with external genital malformations. Exclusion criteria were
      diethylstilbestrol exposure, spontaneous abortions, and teratogen exposure. DATA
      EXTRACTION AND SYNTHESIS: The Methods section of each study was reviewed
      independently by two authors and two outside reviewers, using the above criteria.
      Fourteen studies, seven cohort and seven case-control, involving 65,567 women,
      met the criteria for meta-analysis. Extracted data were entered into 2 x 2
      tables. The overall summary odds ratio (OR) was 1.09 (95% confidence interval
      [CI] 0.90-1.32); subanalysis of OC exposure identified an OR of 0.98 (95% CI 0.24
      3.94). CONCLUSION: There was no association between first-trimester exposure to
      sex hormones generally (or to OCs specifically) and external genital
      malformations. Thus, women exposed to sex hormones after conception may be
      assured there is no increased risk of fetal sexual malformation.

PMID- 7800313
TI  - Intrapartum electronic fetal heart rate monitoring versus intermittent
      auscultation: a meta-analysis.
AB  - OBJECTIVE: To use a meta-analysis of all published randomized trials to determine
      whether the use of continuous electronic fetal heart rate monitoring (EFM) as the
      main method of intrapartum fetal surveillance is associated with improved
      pregnancy outcome compared to intermittent auscultation. DATA SOURCES: We used
      the MEDLINE data base and reference lists of articles to identify all published
      randomized trials of EFM versus intermittent auscultation. METHODS OF STUDY
      SELECTION: A total of nine randomized trials published in peer-review journals
      were identified. The selection criterion was the use of EFM or intermittent
      auscultation as the main intrapartum fetal surveillance technique. DATA
      EXTRACTION AND SYNTHESIS: A total of 18,561 patients were included in the nine
      published randomized trials, 9398 in the EFM group and 9163 in the auscultation
      group. Measures of pregnancy outcome included cesarean delivery, cesarean for
      suspected fetal distress, overall use of forceps or vacuum, use of forceps or
      vacuum for suspected fetal distress, overall perinatal mortality, and perinatal
      mortality due to fetal hypoxia (intrapartum or early neonatal death) attributable
      to the method of intrapartum monitoring. The meta-analysis showed that the
      patients monitored electronically had a significantly higher overall cesarean
      rate (odds ratio [OR] 1.53, 95% confidence interval [CI] 1.17-2.01), higher
      cesarean rate for fetal distress (OR 2.55, 95% CI 1.81-3.53), overall increased
      use of forceps or vacuum (OR 1.23, 95% CI 1.02-1.49), increased use of forceps or
      vacuum for suspected fetal distress (OR 2.50, 95% CI 1.97-3.18), and decreased
      perinatal mortality due to fetal hypoxia (OR 0.41, 95% CI 0.17-0.98). CONCLUSION:
      Electronic fetal monitoring is associated with increased rates of surgical
      intervention and decreased perinatal mortality due to fetal hypoxia.

PMID- 7800314
TI  - Acupressure for nausea and vomiting of pregnancy: a randomized, blinded study.

PMID- 7800315
TI  - Prevention of neonatal group B streptococcal infection.

PMID- 7800316
TI  - The risk of repeating low birth weight and the role of prenatal care.

PMID- 7800318
TI  - Six hundred endometrial laser ablations.
AB  - OBJECTIVE: To report the effectiveness and safety of endometrial laser ablation
      in the treatment of menorrhagia, as determined by detailed follow-up of 600
      operations for at least 6 months. METHODS: Operative data from 600 endometrial
      laser ablations performed on 524 women were collected. Five hundred one (96%) of
      these women were followed with consultations and questionnaires. The mean
      duration of follow-up was 15 months (range 6-42). RESULTS: No major operative
      morbidity occurred. There were no cases of primary or secondary hemorrhage,
      uterine perforations with the operating instrument, or immediate laparotomy. A
      successful outcome was reported by 83.4% of patients. A second endometrial laser
      ablation was required in 14.3% of the women. Success increased with increasing
      age and low fluid absorption. Cavity length, operation time, duration of follow
      up, and whether it was a first or second procedure were not associated with any
      difference in the success rate, although the hysterectomy rate tended to rise
      with increasing length of follow-up. CONCLUSION: This study, the largest one
      published from a single institution, with a mean follow-up duration of 15 months,
      confirms that endometrial laser ablation is a safe and effective treatment for
      dysfunctional uterine bleeding.

PMID- 7800317
TI  - Guidelines to determine the route of hysterectomy.
AB  - OBJECTIVE: To 1) test the validity of a method of assigning patients
      prospectively to a vaginal, abdominal, or laparoscopy-assisted vaginal approach
      to hysterectomy for benign disease; 2) compare the outcomes of these options from
      the day of surgery to the first day of returning to normal activities; and 3)
      estimate the proportion of hysterectomies by each route when patients were
      assigned according to this system, and the impact on hospital charges. METHODS:
      Six hundred seventeen women were assigned to a route of hysterectomy on the basis
      of uterine size (greater or less than 280 g), presumptive risk factors, and
      uterine or adnexal immobility or inaccessibility. Data regarding the success of
      the procedure, complications, length of hospital stay and convalescence, and
      hospital charges were compiled. RESULTS: Vaginal hysterectomy alone (n = 548) or
      in conjunction with laparoscopy (n = 63) was successful in 99.5% of women
      assigned to these groups. Patients in whom the vaginal route was successful
      included 94% of those with uterine weights exceeding 280 g and 97% of those
      having risk factors often cited as reasons for selecting abdominal hysterectomy.
      Laparoscopic surgery was necessary to permit a transvaginal operation in only 12
      of 63 patients (19%). Use of the guidelines produced a potential savings of 615
      hospital days, $1,317,434 in hospital charges, and 7250 convalescent days
      relative to the 3:1 ratio of abdominal to vaginal hysterectomies prevalent in the
      United States. CONCLUSIONS: Specific guidelines for uterine size, risk factors,
      and uterine and adnexal mobility and accessibility are useful in selecting the
      operative approach to hysterectomy and will significantly reduce the number of
      abdominal operations performed. Laparoscopy is valuable in properly selected
      patients to determine the route of hysterectomy, but the need for laparoscopic
      techniques to permit a vaginal operation may be considerably less than some
      investigators have proposed.

PMID- 7800319
TI  - Synthetic hygroscopic cervical dilator use in patients with unsatisfactory
      colposcopy.
AB  - OBJECTIVE: To assess the ability of a synthetic hygroscopic cervical dilator to
      make an unsatisfactory colposcopic examination satisfactory, thereby avoiding
      cervical conization. MATERIALS: From April 1991 to March 1993, 30 women with
      unsatisfactory colposcopic examinations underwent repeat colposcopy after a
      synthetic hygroscopic cervical dilator had been placed in the endocervical canal
      for approximately 2 hours. RESULTS: The reasons for initial unsatisfactory
      colposcopy in the 30 patients were squamocolumnar junction not seen in its
      entirety (18 patients, 60%), lesion not seen in its entirety (ten, 33%), and
      neither transformation zone nor lesion seen in their entirety (two, 7%).
      Complications were encountered in one patient from whom the dilator could not be
      removed completely. Of 29 patients undergoing repeat colposcopy, 23 (79%) had
      satisfactory examinations. In 15 of 30 patients, conization was avoided; it was
      required in six of 30 (20%) women for persistent unsatisfactory colposcopy
      (including the patient in whom the dilator broke) and in nine of 30 (30%) for
      other indications. CONCLUSIONS: This experience suggests that a synthetic
      hygroscopic cervical dilator can be used in patients with an unsatisfactory
      colposcopy to achieve a satisfactory examination, thus avoiding cervical
      conization.

PMID- 7800320
TI  - Localization of blood vessels and qualitative assessment of blood flow in ovarian
      tumors.
AB  - OBJECTIVE: To study the localization of blood vessels within a tumor and the
      shape of the flow curve as a method of assessing ovarian neoplasms. METHODS: We
      studied 39 patients with malignant tumors and 63 patients with benign ovarian
      tumors by means of vaginal color Doppler ultrasound, noting the localization of
      blood vessels in the tumors, the shape of the flow curve, and peripheral
      resistance. RESULTS: Blood vessels could be visualized in 95% of the malignant
      tumors and in 70% of the benign tumors. Blood vessels tended to be localized
      centrally (65 versus 5%) in malignant tumors and peripherally in benign tumors
      (65 versus 0%). A diastolic notch was seen in 89% of the benign tumors, but in
      none of the malignant tumors. The mean resistance index (RI) +/- standard
      deviation was 0.48 +/- 0.19 in malignant and 0.69 +/- 0.09 in benign tumors (P <
      .05). The corresponding values for the pulsatility index (PI) were 0.56 +/- 0.13
      and 1.06 +/- 0.07, respectively (P < .01). CONCLUSIONS: Low RI and PI values are
      general indicators of tumor growth. The localization of blood vessels within an
      ovarian tumor and the presence or absence of a diastolic notch are the most
      useful variables in the evaluation of ovarian tumors.

PMID- 7800321
TI  - Prognostic significance of morphologic changes of the corpus luteum by
      transvaginal ultrasound in early pregnancy monitoring.
AB  - OBJECTIVE: To determine whether the ultrasound appearance, size, or change in
      size of the corpus luteum of early pregnancy correlated with serum progesterone,
      estradiol (E2), or 17-hydroxyprogesterone or were predictive of pregnancy
      outcome. METHODS: Transvaginal ultrasound assessment of the corpus luteum was
      performed prospectively on 55 women between 4-8 weeks' gestation. Forty-five
      (82%) subjects conceived in spontaneous cycles and ten (18%) conceived in cycles
      stimulated with clomiphene citrate. Fifty-three of 55 (96.4%) women had a second
      ultrasound assessment 5-8 days later (mean 6.7). Blood was drawn from each
      patient on the day of the ultrasound examination to measure hormone
      concentration. RESULTS: The appearance of the corpus luteum (macrocystic [more
      than 50% cystic], microcystic [less than 50% cystic], or noncystic) was not
      predictive of hormone concentration or pregnancy outcome. A nonviable pregnancy
      occurred in five of six (83%) women in whom a corpus luteum was undetectable by
      ultrasound and in 15 of 49 (31%) women in whom a corpus luteum was present (P =
      .01). There was no specific corpus luteum volume which could predict pregnancy
      failure. However, when a decreasing volume from first to second ultrasound
      examination was observed, 11 of 20 (55%) pregnancies resulted in nonviable
      outcomes compared to five of 27 (19%) when an increasing volume was observed (P <
      .01). There was no significant positive correlation between corpus luteum volume
      and plasma progesterone or 17-hydroxyprogesterone. A weak correlation was
      observed between corpus luteum volume and E2 (r = 0.38, P = .04). CONCLUSIONS:
      Our data reveal a lack of correlation between the size of the corpus luteum on
      ultrasound examination and known steroid products in pregnancies conceived during
      spontaneous cycles. Corpus luteum volume and steroid products were higher in
      those patients whose ovulation was induced with clomiphene citrate. Also,
      different morphologic appearances of the corpus luteum in early human pregnancy,
      based on the amount of cystic component, have no functional significance.
      However, a decreasing corpus luteum volume before 8 weeks' gestation is
      associated with a higher probability of early pregnancy loss.

PMID- 7800322
TI  - Transabdominal sonohysterography, transvaginal sonography, and hysteroscopy in
      the evaluation of submucous myomas.
AB  - OBJECTIVE: To assess the usefulness of transabdominal sonohysterography in the
      diagnosis and evaluation of submucous myomas. METHODS: Fifty-two premenopausal
      women hospitalized for hysterectomy for benign gynecologic indications underwent
      preoperative conventional transvaginal sonography, transabdominal
      sonohysterography, and hysteroscopy. The results of the three techniques in terms
      of diagnosis, size, intracavitary growth, and location of the submucous myomas
      were compared with those revealed by direct inspection of the surgical specimens.
      RESULTS: Conventional transvaginal sonography for the diagnosis of submucous
      myomas had a sensitivity of 90% and a specificity of 98%; the predictive values
      of abnormal and normal scans were 90 and 98%, respectively. Transabdominal
      sonohysterography had sensitivity, specificity, and predictive values of 100%, as
      did hysteroscopy. In all cases, the sonographic techniques measured tumor size
      more accurately than did hysteroscopy. The transabdominal sonohysterography
      measurements differed from direct evaluation by no more than 2 mm, and the
      hysteroscopic measurements were significantly different from those of the
      surgical specimens. The sonohysterographic evaluation of intrauterine growth was
      significantly more precise than that of the other techniques, differing from
      direct measurements by no more than 5-10%. Conventional transvaginal sonography
      failed to localize three of 11 myomas; hysteroscopy and transabdominal
      sonohysterography provided the exact location in all cases. CONCLUSION:
      Transabdominal sonohysterography is the most accurate technique for detecting
      submucous myomas and evaluating their size, intracavitary growth, and location.

PMID- 7800323
TI  - Transvaginal ultrasonography in the diagnosis of cystic teratoma.
AB  - OBJECTIVE: To assess prospectively the role of transvaginal ultrasonography in
      screening for cystic teratoma and in differentiating cystic teratoma from other
      ovarian masses. METHODS: Three hundred seventy-six premenopausal non-pregnant
      women underwent transvaginal ultrasonography 1 week before undergoing laparotomy
      or laparoscopy. The visualization of localized or diffuse echogenicity was chosen
      as the characteristic ultrasonographic finding of cystic teratoma.
      Endosonographic diagnosis was compared with surgical and pathologic findings.
      RESULTS: Sensitivity and specificity for the ultrasonographic screening were 57.9
      and 99.7%, respectively, calculated for each visualized ovary (n = 659), and 84.6
      and 98.2%, respectively, for differentiating cystic teratoma from other ovarian
      masses, calculated for each visualized cyst (n = 123). CONCLUSION: Transvaginal
      ultrasonography has a better predictive ability for differentiating cystic
      teratoma from other ovarian masses (kappa value 0.84) than in screening for
      cystic teratomas (kappa value 0.69).

PMID- 7800324
TI  - Use of the APACHE II scoring system to determine mortality of gynecologic
      oncology patients in the intensive care unit.
AB  - OBJECTIVE: To determine if an elevated score on the Acute Physiology and Chronic
      Health Evaluation II (APACHE II) scoring system is associated with mortality of
      acutely ill gynecologic oncology patients. METHODS: Gynecologic oncology patients
      admitted to the surgical intensive care unit (ICU) were identified from the ICU
      data base. Their admission APACHE II score and type of gynecologic cancer were
      also extracted from the data base. Charts were reviewed to determine the disease
      status and reason for admission to the surgical ICU. Patient mortality was
      correlated with APACHE II scores. RESULTS: Forty-five gynecologic oncology
      patients were admitted to the surgical ICU from June 1988 to January 1992. They
      had a mean age of 62 years and various cancers: ovarian (24), cervical (16), and
      endometrial (five). The mean APACHE II score was 12 (range 2-26). Eight of 45
      (18%) patients died. There was a significant correlation between APACHE II scores
      and mortality; patients with an APACHE II score of 20 or greater had a 78% risk
      of death compared to a 3% risk if the score was less than 20 (P < .001, chi 2
      test). CONCLUSION: Elevated APACHE II scores are associated with mortality in
      acutely ill gynecologic oncology patients.

PMID- 7800325
TI  - Developmental potential of microbiopsied murine blastocysts.
AB  - OBJECTIVE: To evaluate the frequency of mouse pups born following blastocyst
      biopsy and embryo transfer compared to nonbiopsied controls. METHODS: ICR Swiss
      albino and C57B1/6 mice served as embryo donors. Pregnant mare serum gonadotropin
      treatment was followed 46-52 hours later by hCG, when donors were paired with
      fertile males. Mating was confirmed the following day and embryos were collected
      on the afternoon of day 4. After overnight culture, hatching trophoblast was
      excised by micromanipulation with a fine-pulled glass pipette. Embryos (206
      controls, 206 biopsied) were transferred to 26 pseudopregnant recipients.
      Alternate mouse strains were used to identify pups born from control or biopsied
      embryos. RESULTS: The end point was percentage of pups born ((number born/number
      transferred) x 100), using angular transformation before analysis. There was no
      significant difference (P > .1) between percent live-born in control (27.7%) or
      biopsied (34.5%) embryos, nor were there any strain differences. CONCLUSION:
      These data support the hypothesis that the developmental potential of murine
      blastocysts is not affected adversely by the biopsy procedure.

PMID- 7800326
TI  - Use of menopausal estrogens and medroxyprogesterone in the United States, 1982
      1992.
AB  - OBJECTIVE: To describe trends in the prescription of menopausal estrogens and
      medroxyprogesterone in the United States. METHODS: Annual estimates of the number
      of prescriptions for menopausal estrogens and medroxyprogesterone and descriptive
      information on patients and providers were obtained from two pharmaceutical
      marketing research data bases, the National Prescription Audit and the National
      Disease and Therapeutic Index of IMS America. RESULTS: An estimated 13.6 million
      prescriptions were dispensed for oral menopausal estrogens in 1982, and 31.7
      million in 1992, a 2.3-fold increase (P = .0001). In 1992, Premarin, the only
      oral conjugated estrogen currently approved for use, was the most frequently
      dispensed brand-name pharmaceutical in the United States. Dispensed prescriptions
      for Estraderm, a transdermal estradiol first marketed in 1986, increased from 1.5
      million in 1987 to 4.7 million in 1992. Dispensed prescriptions for oral
      medroxyprogesterone also increased from 2.3 million prescriptions in 1982 to 11.3
      million in 1992, a 4.9-fold increase (P = .0001). An estimated one in six to one
      in four postmenopausal women were taking menopausal hormones in 1992. These drugs
      were prescribed mainly by obstetrician-gynecologists. CONCLUSION: The use of
      menopausal estrogens and medroxyprogesterone has increased substantially over the
      past decade. These trends indicate that American women are widely exposed to
      menopausal hormone replacement.

PMID- 7800327
TI  - Maternal serum uric acid levels in twin gestations.
AB  - OBJECTIVE: To establish normative values of serum uric acid levels in women with
      twin gestations and to compare maternal serum uric acid levels of twins and
      singletons, stratified by the presence or absence of preeclampsia. METHODS: Sixty
      seven normotensive and 16 preeclamptic women with twin gestations, who had no
      underlying chronic hypertension or renal insufficiency, had serum uric acid
      levels measured on admission to the labor and delivery unit. These levels were
      compared with those of 83 normotensive and 10 preeclamptic singleton gravidas
      admitted to the same unit. A receiver operating characteristic (ROC) curve was
      used to determine the optimal maternal serum uric acid cutoff value for twin
      gestations and to compare this value with that of singleton gestations. RESULTS:
      Women with non-preeclamptic twin pregnancies had significantly higher mean (+/-
      standard deviation) serum uric acid concentration than women with non
      preeclamptic singleton pregnancies (5.4 +/- 1.6 versus 4.7 +/- 1.2 mg/dL,
      respectively, P = .001). Gravidas with twin gestations complicated by
      preeclampsia had significantly higher serum uric acid levels than their
      preeclamptic singleton counterparts (7.7 +/- 1.3 versus 5.9 +/- 1.1 mg/dL,
      respectively, P = .001). Using a ROC curve, we determined that a maternal serum
      uric acid level of 6.5 mg/dL appeared to be the optimal cutoff for identifying
      preeclampsia in twin gestations, with a sensitivity of 94% and specificity of
      78%. CONCLUSION: With or without preeclampsia, women carrying twins have
      significantly higher serum uric acid levels than their singleton counterparts,
      which suggests a need for separate normative values for twin gestations. We
      propose that a serum uric acid level of 6.5 mg/dL or greater be used to identify
      those women with twin gestations who are at higher risk for preeclampsia.

PMID- 7800328
TI  - Pregnancy outcome in nulliparous women 35 years and older.
AB  - OBJECTIVE: To compare pregnancy and delivery complications of first births in
      women 35 years and older with women 25-29 years old. METHODS: Maternal and
      newborn records for first births at three suburban hospitals from July 1, 1986 to
      June 30, 1990 were studied retrospectively. RESULTS: The older women differed
      significantly in: 1) antepartum factors (type of insurance, marital status, prior
      pregnancy experience, weight gain, obesity, chronic and pregnancy-induced
      hypertension, gestational diabetes [without insulin], asthma, leiomyomas; and
      third-trimester bleeding), 2) intrapartum factors (anesthesia for vaginal
      delivery, gestational age at delivery, preterm labor, spontaneous labor, oxytocin
      use, malpresentation, cesarean births, and postpartum hemorrhage), and 3)
      neonatal outcomes (gestational age, birth weight, preterm births, abnormal
      karyotypes, neonatal intensive care unit admissions, low birth weight, and small
      for gestational age infants). Logistic regression determined that risk factors
      significantly predicting perinatal mortality were leiomyomas (odds ratio [OR]
      2.6, 95% confidence interval [CI] 1.3-5.0), preterm birth (OR 4.9, 95% CI 3.1
      7.7), and chorioamnionitis (OR 5.9, 95% CI 3.1-11.4), but not age. CONCLUSION:
      Nulliparous women 35 years and older had higher rates of antepartum, intrapartum,
      and newborn complications than nulliparas between the ages of 25-29 years, but
      not an increased perinatal mortality rate. Despite the increased risk of
      complications, maternal and perinatal outcomes were good.

PMID- 7800329
TI  - A randomized trial of management of pre-labor rupture of membranes at term in
      multiparous women using vaginal prostaglandin gel.
AB  - OBJECTIVE: To compare conservative management of pre-labor spontaneous rupture of
      membranes (SROM) with the use of prostaglandin (PG) E2 in healthy parous women at
      term (gestational age at least 37 weeks). METHODS: An open randomized study was
      conducted with 100 parous women; 50 were treated conservatively for 24 hours, and
      50 were managed actively using PGE2 gel (1 mg), administered at admission and
      repeated 6 hours later if labor was not established. Both groups received
      intravenous oxytocin if labor did not start within 24 hours after admission.
      RESULTS: The use of PGE2 gel led to a significant reduction in the mean interval
      (+/- standard error of the mean) from SROM to onset of labor: 17.26 +/- 1.51
      hours in the conservative group versus 6.50 +/- 1.23 in the PGE2 group. A
      significantly smaller proportion of subjects required oxytocin in the PGE2 group
      (12 versus 38%, P < .02). The two groups were comparable with respect to
      analgesic requirements. Within 24 hours of SROM, 80% of the women in the PG group
      and 56% in the conservative group had delivered (P < .02). Most women delivered
      vaginally, 96% of those managed conservatively and 100% of those managed actively
      with PGE2. CONCLUSION: Active management using PGE2 gel in parous women with pre
      labor SROM significantly improves the time to delivery without influencing the
      cesarean rate or fetal-maternal infective morbidity.

PMID- 7800330
TI  - Fetal acidemia associated with regional anesthesia for elective cesarean
      delivery.
AB  - OBJECTIVE: To determine the prevalence, magnitude, and type of fetal acidemia
      associated with contemporary obstetric anesthetic techniques. METHODS: Umbilical
      artery blood gases were obtained in 1601 singleton pregnancies delivered by
      elective cesarean. RESULTS: General anesthesia was used in 371 (23%) women,
      epidural in 286 (18%), combined spinal-epidural in 659 (41%), and spinal in 231
      (14%). Approximately 18% of infants exposed to regional anesthetics had umbilical
      artery blood pH values 7.19 or less, 42 (3%) infants had pH values less than
      7.10, and nine (1%) had values 6.99 or less. The incidence of fetal acidemia was
      greater in spinal and combined spinal-epidural procedures compared to epidural
      anesthetics. Fetal acidemia was predominantly respiratory in type because carbon
      dioxide pressure was abnormally increased when fetal acidemia was diagnosed.
      CONCLUSIONS: Regional anesthesia is associated with fetal acidemia, occasionally
      severe, and has features of an acute respiratory type of acidemia. Fetal acidemia
      is less frequent with epidural anesthesia compared to subarachnoid techniques.

PMID- 7800331
TI  - Limb defects after chorionic villus sampling.
AB  - OBJECTIVE: To clarify the association between limb defects and chorionic villus
      sampling (CVS). METHODS: Questionnaires were sent to 165 major obstetric units in
      Taiwan to survey the incidence of limb defects with and without CVS exposure
      during 1991. Limb defects with CVS exposure from September 1990 to June 1992 were
      also surveyed. The spectrum of limb defects in CVS-exposed and general
      populations were compared by the Poisson test. RESULTS: The incidence of limb
      defects in the surveyed general population in 1991 was 0.032% and that with CVS
      exposure was 0.294%, a statistically significant difference (P < .001). The
      incidence of severe limb defects in the general population was 0.0026% and that
      with CVS exposure was 0.22%, also statistically significant (P < .001). Twenty
      nine cases of limb defects after CVS were reported from September 1990 until June
      1992: 19 cases with transverse limb reduction, two with mid-palm reduction, seven
      with adactyly or hypodactyly, and one with syndactyly. Four cases also had
      oromandibular-limb hypogenesis syndrome. CONCLUSIONS: The incidence of limb
      defects, especially the severe types, was increased after CVS. The spectrum of
      limb defects with CVS exposure was more severe than the limb defects seen in the
      general population and showed a specific pattern ranging from hypodactyly,
      adactyly, and transverse limb reduction, to oromandibular-limb hypogenesis. A
      correlation between the severity of limb defects and the timing of CVS was
      suggested.

PMID- 7800332
TI  - Aggressive intrapartum management of lethal fetal anomalies: beyond fetal
      beneficence.
AB  - OBJECTIVE: To evaluate management recommendations from the current literature for
      patients whose fetuses are certain to have lethal anomalies or absent (or
      virtually absent) cognitive function. These recommendations include termination
      of pregnancy or, for cases in the third trimester, nonaggressive intrapartum
      management, avoiding cesarean delivery for fetal indications. METHODS: We report
      our experience with several patients who voiced opposition to nonaggressive
      intrapartum care and present a rationale for selectively aggressive, intrapartum
      management for some of these cases. RESULTS: Four women whose fetuses had lethal
      anomalies requested aggressive intrapartum management. For three of the four,
      standard aggressive management of labor resulted in vaginal delivery of live-born
      infants who died shortly thereafter. The patients found comfort in the live
      births. The fourth patient accepted a recommendation to avoid fetal monitoring
      during labor, and the fetus was stillborn. This patient found the intrapartum
      experience to be very stressful. CONCLUSION: When a patient's desire to avoid an
      intrapartum stillbirth is strong enough that substantial psychological harm might
      result from one, the physician's beneficence-based obligation to her and respect
      for maternal autonomy justify selectively aggressive intrapartum therapy, even if
      no beneficence-based obligation to the fetus exists.

PMID- 7800333
TI  - Characterization of the effect of cocaine on catecholamine uptake by pregnant
      myometrium.
AB  - OBJECTIVE: To characterize the effect of cocaine on catecholamine uptake by
      myometrium from pregnant women. METHODS: Slices of myometrium obtained from nine
      women during elective cesarean delivery at term were incubated with [3H]
      norepinephrine and various uptake inhibitors for 30 minutes. The radiolabeled
      material was extracted with perchloric acid, expressed as percent control (+/-
      standard error of the mean), and compared by one-factor analysis of variance and
      Fisher multiple range test. RESULTS: Myometrial uptake was inhibited by cocaine
      (42 +/- 9%) by neuronal (type 1) uptake inhibitors (desipramine 41 +/- 14%; N
      ethylmaleimide 53 +/- 8%), and by extraneuronal (type 2) inhibitors
      (normetanephrine 56 +/- 19%; corticosterone 73 +/- 9%). When uptake inhibitors
      were used in combination with cocaine, uptake was not decreased further in the
      presence of neuronal inhibitors (desipramine plus cocaine 40 +/- 20%; N
      ethylmaleimide plus cocaine 42 +/- 4%). However, the effect of cocaine appeared
      to be added to that of extraneuronal inhibitors (normetanephrine plus cocaine 25
      +/- 14%; corticosterone plus cocaine 32 +/- 1%). CONCLUSION: Catecholamine uptake
      by myometrium in pregnant women appears to be both extraneuronal and neuronal in
      nature, and cocaine inhibits the neuronal portion of this uptake. This mechanism
      may play a role in the increased rate of premature delivery associated with
      cocaine abuse.

PMID- 7800334
TI  - Levorotation of the fetal cardiac axis: a clue for the presence of congenital
      heart disease.
AB  - OBJECTIVE: To evaluate the use of the cardiac axis within the chest for the
      prenatal detection of congenital heart defects. METHODS: We reviewed
      retrospectively the sonographic findings of all fetuses scanned between 17 and 40
      weeks' gestation and diagnosed prenatally as having heart defects. The cardiac
      diagnoses were confirmed postnatally. The control group consisted of 75
      consecutive fetuses with normal fetal surveys and newborn follow-up examinations.
      The cardiac axes were measured retrospectively using an image of the four-chamber
      view of the heart and measuring the angle between the interventricular septum and
      a line bisecting the chest. Mean and standard deviations (SDs) of the axis
      measurements in normal and abnormal fetuses were compared by Student t test.
      RESULTS: The 75 fetuses with heart defects diagnosed by prenatal sonogram had a
      mean cardiac axis of 56 +/- 13 degrees, compared with 43 +/- 7 degrees in normal
      fetuses (P < .001). Using 57 degrees (two SDs above the mean for normal fetuses)
      as the upper limit of normal, 33 of 75 (44%) abnormal fetuses versus none of 75
      normal fetuses were identified. The frequency of cardiac rotation was greater in
      fetuses with truncus arteriosus, Ebstein's anomaly, pulmonic stenosis,
      coarctation of the aorta, and tetralogy of Fallot. CONCLUSION: The presence of a
      cardiac axis exceeding 57 degrees in the fetal chest is associated with a
      substantial risk of congenital heart defects. The finding of an abnormal axis
      should prompt further evaluation of the fetal heart.

PMID- 7800335
TI  - Modulation of CD4 antigen expression on the lymphocyte surface by
      immunosuppressive acidic protein in cancer patients.
AB  - The immunomodulatory effect of human immunosuppressive acidic protein (IAP) on
      lymphocyte surface antigens was investigated. IAP inhibited lymphocyte responses
      to phytohemagglutinin in a dose-dependent manner. By flow cytometry, using
      fluorescein-isothiocyanate-labelled antibodies, the mean fluorescence intensity
      on peripheral blood lymphocytes (PBLs) decreased for CD4, slightly decreased for
      CD3 but showed no change for the CD8 and T cell receptor alpha-beta antigens in
      the presence of IAP. This CD4 antigen modulation by IAP was observed in PBLs
      freshly isolated from patients with unresectable cancer but not in those isolated
      from patients with resectable tumor or from healthy volunteers. The modulation of
      the CD4 antigen by IAP on the lymphocyte surface was correlated with an increment
      of serum IAP levels in cancer patients. The CD4 modulation could be induced in
      PBLs from healthy volunteers by culturing them with IAP in vitro. It is suggested
      that IAP may play a role in cancer-related immunosuppression through the down
      modulation of the CD4 antigen on the lymphocyte surface.

PMID- 7800336
TI  - Leukocyte alkaline phosphatase as a probable predictor of the metastatic state in
      breast and colon cancer patients.
AB  - Leukocyte alkaline phosphatase (LAP) score in peripheral blood was determined in
      45 new cancer patients, 30 with breast cancer and 15 with colorectal cancer, with
      nonmetastatic disease. The LAP scores were performed immediately after diagnosis
      or surgery, and later at intervals of 1-3 months, until clinical detection of
      metastases. The preliminary data presented here show that there may be some
      utility in measuring LAP score in patients with solid tumors on a serial basis to
      detect evidence of metastatic disease prior to its clinical recognition. In 22
      out of 30 breast cancer patients and 11 out of 15 colon cancer patients, there
      were 'alarming signals' of metastases (defined in this study) in the data taken
      before the checkup in which metastases were diagnosed by other methods. We
      conclude that LAP scores should be introduced into routine checkup of breast and
      colon cancer patients and could be a helpful nonspecific additional element in
      detecting earlier metastatic disease during the follow-up of a patient. As an
      extrapolation from this study we suggest that work should be undertaken to
      explore the possibility that a sudden rise of LAP score in an otherwise healthy
      person, who has no known reason for an elevated LAP score, might be the very
      first measurable sign of cancer.

PMID- 7800337
TI  - Is CA242 really a new tumour marker for pancreatic adenocarcinoma?
AB  - CA 242, a sialylated carbohydrate epitope situated on the same macromolecule as
      CA 50 has been proposed as a new tumour marker for pancreatic cancer (PC). The
      aims of the present study were: (1) to evaluate serum CA 242 versus CA 19-9 in PC
      patients, and (2) to assess whether these markers can predict tumour spread or
      patient survival. We studied 59 healthy controls, 27 PC patients, 12 chronic
      pancreatitis cases, 107 with extra-pancreatic gastrointestinal tumours, 30 with
      benign jaundice and 24 with benign extra-pancreatic gastrointestinal diseases.
      Mean CA 242 values were significantly higher in PC than in any other group; CA 19
      9 showed a similar pattern. The best diagnostic efficacy (ROC curves analysis) in
      diagnosing PC was 86% for CA 242 and 84% for CA 19-9, using cut-off values of 60
      and 80 U/ml, respectively. In PC, serum levels of both markers were unrelated to
      tumour spread or size; in PC patients with high levels of CA 242 or CA 19-9
      survival was significantly shorter. CA 242 and CA 19-9 were correlated both when
      considering all the patients together (r = 0.962, p < 0.001) and PC alone (r =
      0.880, p < 0.001). Given the very close relationship between CA 242 and CA 19-9,
      we tested for cross-reactivity between CA 242 antigen and CA 19-9 antibody: CA
      242 antigen with CA 19-9 antibody produced a similar curve to CA 242 antigen and
      its corresponding antibody. In conclusion, CA 242 showed similar diagnostic
      values to CA 19-9 in assessing PC patients; both seem unrelated to tumour size or
      spread, but seem to predict survival. Their remarkably similar behaviour is due
      to cross-reactivity between CA 242 antigen and CA 19-9 antibody, so CA 242
      cannot, in our opinion, be considered a new tumour marker for PC.

PMID- 7800338
TI  - Treatment of non-small cell lung cancer with ifosfamide (IFO)+ 4'-epiadriamycin
      (EPI)+platinum vs. IFO+EPI: a GETLAC Study. Grupo de Estudio y Tratamiento
      Latinoamericano del Cancer Study.
AB  - 203 patients with inoperable non-small cell lung cancer (NSCLC) were randomized
      to receive ifosfamide (IFO) 2.5 g/m2 days 1-2 + epirubicin (EPI) 70 mg/m2 day 1
      with cisplatin (DDP) 70 mg/m2 day 1 (arm IEP), or without cisplatin (arm IE). For
      uroprophylaxis, mesna i.v. 20% of IFO dose, hour 0 and 3, and oral, 40% of IFO
      dose, hour 6 and 9, days 1-2 was given. Cycles were repeated every 28 days. Four
      cycles were required for evaluation purposes. After completion of chemotherapy,
      external beam irradiation 40 Gy was given over 4 weeks for stage III B
      responders. Most of the patients with stable disease, partial response or
      complete response (CR) received 6 cycles. The median follow-up of the trial is 30
      months. There were no differences in overall response rates: arm IEP: 52% (2%
      CR); arm IE: 51% (13.5% CR). Median time to progression was 6 months (arm IEP)
      and 4 months (arm IE) (p = 0.4844). Toxicity ranged from mild to moderate.
      Nephrotoxicity was not seen; only 6 patients had neurotoxic side effects of short
      duration. Median survival according to treatment was 12 months for IEP arm (12%
      at 2 years) and 10 months for IE arm (21% at 2 years). IFO/mesna+EPI or
      IFO/mesna, EPI plus DDP appeared to be an active and well tolerated combination
      for the treatment of NSCLC, with a good survival time.

PMID- 7800339
TI  - Modulatory influence of the oral contraceptive pill, Ovral, on 3
      methylcholanthrene-induced carcinogenesis in the uterus of mouse.
AB  - The present study examines the modulatory influence of the combined oral
      contraceptive pill, Ovral (0.05 mg ethynylestradiol plus 0.25 mg levonorgestrel
      per pill) on methylcholanthrene (MCA)-induced carcinogenesis in the uterus of
      Swiss albino mouse. Placement of cotton thread impregnated with beeswax
      containing approximately 600 micrograms of MCA, yielded endometrial squamous cell
      carcinomas in 53.33% animals in 90 days. Concomitant treatments with doses D1
      (1/200th of a pill) and D2 (1/200th of a pill) of Ovral yielded endometrial
      squamous cell carcinomas in 6.23 and 0% of animals in 90 days (p < 0.05; p <
      0.005) respectively. Ovral did not seem to increase the incidence of uterine
      hyperplasia.

PMID- 7800340
TI  - Surgical treatment and prognosis for patients with gastric cancer lesions larger
      than ten centimeters in size.
AB  - In 323 of 1,620 patients with gastric cancer, the lesion was > or = 10 cm in
      maximum diameter. Studies were done with respect to clinicopathologic features
      and the prognosis. Patients with tumors > or = 10 cm were younger and women
      patients were more numerous compared to those with tumors < 10 cm. Tumors were
      more advanced and noncurative resection was usually done for these patients. A
      multivariate analysis showed that serosal invasion, liver metastasis, lymph node
      metastasis, operative curability, tissue differentiation, and extended lymph node
      dissection to be independent prognostic factors. This retrospective study showed
      that patients with a larger tumor are at an increased risk for tumor advancement
      and that they will benefit from curative resection and extended lymph node
      dissection.

PMID- 7800341
TI  - Phase II study of the etoposide, leucovorin and fluorouracil combination for
      patients with advanced gastric cancer unsuitable for aggressive chemotherapy.
AB  - Many patients with advanced gastric cancer cannot be treated with intensive
      chemotherapy. In an attempt to provide a feasible regimen for such patients, the
      combination of etoposide, leucovorin and fluorouracil (ELF) has been developed
      with promising results. The present study involved 42 patients with advanced
      gastric cancer who where unsuitable for cisplatin- or anthracycline-containing
      regimens because of their age (24 patients over 65 years), poor performance
      status (12) or the presence of concomitant illness (6). The treatment consisted
      of etoposide 120 mg/m2 i.v., 1-leucovorin 150 mg/m2 i.v. and fluorouracil 500
      mg/m2 i.v. for 3 consecutive days every 3 weeks. Among the 41 evaluable patients,
      there was a 32% objective response rate (95% confidence interval 19-48%), with 7%
      of complete remissions. The median response duration was 4 months, the median
      time to progression in all patients was 5 months and the median overall survival
      was 10 months. No drug-related deaths or WHO grade 4 side effects were observed.
      On the basis of these results, we concluded that the ELF regimen is feasible and
      that its activity warrants randomized studies comparing the ELF combination with
      fluorouracil plus folinic acid.

PMID- 7800342
TI  - Lymph node metastases in gastric cancer: significance of positive number.
AB  - To investigate the significance of the number of node metastases in gastric
      cancer and its relationship to traditional anatomical classification, 305
      patients who underwent a radical gastrectomy and extended lymphadenectomy (R3/4)
      with curative intent were reviewed. Lymph node metastases was found in 191
      (62.6%) patients. The incidence of lymph node metastases was closely related to
      the depth of cancer invasion as well as the extent of lymph node group
      involvement. The frequency of metastases in different lymph node locations was
      related to the location of the primary tumor. The 3-year survival rates for
      patients with node involvement and without were 42.1 and 92.3%, respectively. In
      node number analysis, the distribution of the N1 group and the N4 group
      involvement was rather characteristic and could be predicted from a node number <
      4 or > 12. The predictability of N2 and N3 involvement from node numbers 4-8 and
      9-12 was less satisfactory. On the whole, patients with a metastatic node number
      < 4 could be considered to be N1 and had a relative good prognosis. Patients with
      node number 4-10 could be considered as N2 and > 10 as an incurable disease with
      distant metastases. Both had a poor prognosis. The data suggest that lymph node
      number represents the biologic behavior of cancer instead of the anatomic
      consideration of conventional N stage. The number of metastatic lymph node number
      is a good prognostic indicator with similar predicting power as the conventional
      node stage.

PMID- 7800343
TI  - Hyperthermia enhances the cytotoxicity against hypoxic cells of RP-170, a new 2
      nitroimidazole nucleoside hypoxic cell sensitizer.
AB  - The effect of the new hypoxic cell sensitizer, 1-[2-hydroxy-1-(hydroxymethyl)
      ethoxy]methyl-2-nitroimidazole (RP-170), combined with heat against EMT6/KU
      cells, was determined under conditions of in vitro hypoxia. Heat-induced
      cytotoxicity for the EMT6/KU cells was increased to a greater extent under
      conditions of hypoxia and a normal pH of the medium. Hypoxia also reduced the
      surviving fraction of the cells treated either with RP-170 alone or with RP-170
      plus heat. The concomitant treatment of RP-170 and heat inhibited the clonogenic
      activity of the EMT6/KU cells under conditions of in vitro hypoxia in all
      experimental groups, with a significant difference (p < 0.05). Therefore, RP-170
      combined with exposure to heat may be an effective treatment for hypoxic cells in
      a solid tumor, as these cells are resistant to radiation and/or to many
      chemotherapeutic agents.

PMID- 7800344
TI  - Effect of methotrexate, doxorubicin and mitoxantrone on human peritoneal
      mesothelial cell function in vitro.
AB  - Recent studies have demonstrated that intraperitoneal instillation of dialysis
      solutions and drug additives may adversely affect the function of peritoneal cell
      populations. Therefore the aim of the present investigation was to examine the
      short-term effects of antineoplastic agents on human peritoneal mesothelial cells
      (HPMC). We have assessed the integrity of HPMC membrane and mechanisms of
      intracellular potassium transport. There was no evidence of significant
      cytotoxicity (as measured by 86Rb release) during a 60-min exposure of HPMC to
      either methotrexate (10(-6)-10(-4) M), doxorubicin (10(-7)-10(-5) M) or
      mitoxantrone (10(-7)-10(-5) M). In HPMC exposed to doxorubicin (10(-6) M) the
      intracellular transport of potassium, as assessed with 86Rb as its analogue, was
      not affected. Methotrexate (10(-5) M) diminished Na,K-ATPase activity and
      simultaneously enhanced the 86Rb transport via furosemide-sensitive pathway.
      Mitoxantrone reduced the furosemide-sensitive 86Rb influx in a dose-dependent
      manner and at a concentration of 10(-4) M it also impaired the ouabain-dependent
      86Rb influx. These data demonstrate that antineoplastic agents interfere with
      HPMC function which might contribute to the oncostatic-induced peritoneal
      toxicity.

PMID- 7800345
TI  - [3H]-thymidine uptake and lipid peroxidation by tumor cells on embelin treatment:
      an in vitro study.
AB  - Using a rapid technique to assess drug-induced cell toxicity, a fibrosarcoma cell
      line was exposed in vitro to increasing concentrations of embelin, a benzoquinone
      derivative of Embelia ribes Burm., and simultaneously inoculated with [3H]
      thymidine. After regular time intervals, the cells were examined for
      incorporation of the labelled thymidine in DNA, lipid peroxide and glutathione
      levels. A dose-dependent decrease in labelled thymidine uptake, lipid peroxide
      and glutathione levels was observed on embelin administration.

PMID- 7800346
TI  - The effect of tumor necrosis factor alpha on a human renal cell carcinoma
      xenotransplanted into nude mice: comparison of intravenous and intraperitoneal
      injection.
AB  - The effect of recombinant human tumor necrosis factor alpha (TNF-alpha) on tumor
      growth and tumor cell proliferation of a human renal cell carcinoma transplanted
      into nude mice as well as on the body weight of the tumor-bearing animals has
      been studied. Due to differences of the effect of TNF-alpha after intravenous and
      intraperitoneal injection reported in the literature the influence of the two
      routes of application was presently studied. There was no effect on tumor growth
      with either route of application. Only the mode of growth showed a tendency to an
      increased rate of growth at the beginning of the treatment and a following
      increased growth deceleration. A slight change of the 3H-thymidine labeling index
      and the mitotic index was observed only after intraperitoneal injection of TNF
      alpha indicative of a more cytostatic than cytotoxic effect of the drug. This is
      supported by the lack of an increase of necrotic cells. Although a rather high
      dose of TNF-alpha was applied, no effect on the body weight of the animals, i.e.
      no toxic effect of the treatment, has been found.

PMID- 7800347
TI  - Genetic analysis of the arylamine N-acetyltransferase polymorphism in breast
      cancer patients.
AB  - The association of the arylamine N-acetyltransferase polymorphism and breast
      cancer has been investigated by analysis of genomic DNA from 160 breast cancer
      patients and 132 healthy women. Five mutations of the NAT2 gene were studied by
      using allele-specific PCR amplification and restriction mapping with the
      endonucleases FokI and Ddel. Eight allelic variants of the NAT2 gene were
      identified in both, patients with breast cancer and control groups, with relative
      frequencies. Wild-type 0.194 and 0.219, 341C+481T+803G 0.433 and 0.345, 341C+481T
      0.048 and 0.076, 282T+590A 0.205 and 0.222, 282T 0.059 and 0.044, 590A 0.011 and
      0.024, 803G 0.016 and 0.052, 857A 0.035 and 0.019, respectively. The prevalences
      for the poor acetylator genotypes were 53 and 51% for the patients with breast
      cancer and the control group, respectively. Seven patients with the rare lobular
      breast cancer showed reduced frequency for NAT2 mutations (p < 0.05) and all of
      them had the extensive acetylator genotype (p < 0.01). This preliminary
      observation suggests that extensive acetylation may be related to lobular breast
      cancer. No genetic support for association of the NAT2 polymorphism and other
      histologic types of breast cancer was found. Any differences in the acetylator
      rate between breast cancer patients and healthy subjects may be secondary to
      breast cancer itself, but not involved in the pathogenesis of the disease.

PMID- 7800348
TI  - Antitumor effects of intraarterial infusion of tumor necrosis factor/lipiodol
      emulsion on hepatic tumor in rabbits.
AB  - Human recombinant tumor necrosis factor (TNF) suspended in lipiodol (TNF/lipiodol
      emulsion) was injected via the hepatic artery, and its antitumor effects on VX2
      tumor inoculated into the liver were evaluated. In TNF/lipiodol-treated rabbits,
      soft-X-ray study revealed an accumulation of lipiodol in the liver tumor and the
      TNF concentration in the tumors was significantly higher than in rabbits treated
      with free TNF. 7 days after the various treatments, the tumor growth ratio
      evaluated macroscopically was found to be significantly lower in TNF/lipiodol
      emulsion-treated rabbits compared to rabbits treated with either free TNF or
      lipiodol (p < 0.05). Microscopically, the necrotic-area ratio of the tumors in
      the TNF/lipiodol emulsion-treated group was also significantly greater than in
      any other group (p < 0.01). Pathohistologically, liver tumors treated with
      TNF/lipiodol emulsion revealed massive necrosis associated with occlusive
      thromboangitis in the tumor vessels and fibrous capsule formation around the
      tumor. In these rabbits, the elevation of serum transaminase after the treatment
      was transient and tissue damage in the surrounding noncancerous liver tissue was
      minimal. These findings therefore suggest that the intraarterial infusion of
      TNF/lipiodol emulsion may produce prominent antitumor effects, possibly due to
      the retention of TNF in the tumors, which causes damage to the endothelium of the
      tumor vessels.

PMID- 7800349
TI  - Management of early breast cancer: an Australian consensus report. Clinical
      Oncological Society of Australia, the Australian-New Zealand Breast Cancer Trials
      Group, the Medical Oncology Group of Australia and the Breast Section, Royal
      Australasian College of Surgeons.

PMID- 7800351
TI  - Silent sinus syndrome.

PMID- 7800350
TI  - A phase II trial of vindesine in hepatocellular cancer.
AB  - Sixteen patients with histologically confirmed inoperable hepatocellular
      carcinoma were treated with vindesine 3 mg/m2 i.v. weekly. Anemia, leukopenia and
      neuritis were documented but no severe or life-threatening toxicity was seen.
      There were no objective responses among the 14 evaluable patients. Eight had a no
      change status (median duration of 16 weeks, range 6-33), while the remaining 6
      had progressive disease as their best evaluation. The median survival time was 20
      weeks. Vindesine does not have a therapeutic effect in patients with advanced
      hepatocellular carcinoma.

PMID- 7800352
TI  - More on macular holes.

PMID- 7800353
TI  - Is smoking a risk factor for nonarteritic AION?

PMID- 7800354
TI  - Confusing licensure with education: medicine's slippery slope.

PMID- 7800355
TI  - The course of visual recovery after optic neuritis. Experience of the Optic
      Neuritis Treatment Trial.
AB  - PURPOSE: To define the time course of visual recovery after optic neuritis and
      factors predictive of this course in the patients enrolled in the Optic Neuritis
      Treatment Trial. METHODS: The cohort for this study consisted of the 438 patients
      who completed the 6-month follow-up visit. Visual acuity was measured at baseline
      and at seven follow-up visits during the first 6 months. Factors predictive of
      recovery were evaluated with univariate and multivariate statistical tests.
      RESULTS: Visual recovery was rapid in all three treatment groups. In almost all
      patients, regardless of treatment group and initial severity of visual loss,
      improvement began within the first month. Among the 278 patients with baseline
      visual acuity of 20/50 or worse, all patients improved at least one line of
      visual acuity, and all except six improved at least three lines, during the 6
      month follow-up period. Baseline visual acuity was the best predictor of the 6
      month visual acuity outcome (P = 0.0001). Older age was statistically associated
      with a slightly worse outcome (P = 0.02), but this appeared to be of no clinical
      importance. CONCLUSIONS: In most patients with optic neuritis, visual recovery is
      rapid. The only factor of value in predicting the visual outcome is initial
      severity of visual loss. However, even when initial loss is severe, visual
      recovery is still good in most patients. Patients not following the usual course
      of visual recovery should be considered atypical. For such patients, further
      investigation in regard to etiology of the visual loss may be appropriate.

PMID- 7800356
TI  - Visual morbidity in giant cell arteritis. Clinical characteristics and prognosis
      for vision.
AB  - PURPOSE: To characterize visual morbidity in giant cell arteritis and to assess
      prognosis with respect to treatment. METHODS: Record review of 185 patients with
      coded diagnosis of giant cell (cranial) arteritis examined at the Bascom Palmer
      Eye Institute from January 1, 1980, to January 31, 1993. RESULTS: Forty-five
      patients with biopsy-proven giant cell arteritis had visual symptoms, and 41
      individuals (63 eyes) lost vision. The visual loss was unilateral in 19 patients
      (46%), sequential in 15 (37%), and simultaneous in 7 (17%). Anterior ischemic
      optic neuropathy developed in 88% of eyes, visual acuity was 20/200 or worse in
      70%, 21% had no light perception, and the majority of field defects in testable
      eyes, aside from central scotomas associated with loss, showed altitudinal or
      arcuate patterns. Six patients lost vision during corticosteroid therapy for
      systemic symptoms of giant cell arteritis, whereas in 39 patients visual symptoms
      prompted steroid treatment. For visual symptoms, 25 patients received intravenous
      methylprednisolone, whereas 20 received oral prednisone alone. In the 41 patients
      with visual loss, vision was unchanged in 20 (49%), it worsened in 7 (17%), and
      it improved in 14 (34%). Subsequent fellow eye involvement was observed only with
      oral therapy, and a greater percentage of patients (9/23 [39%] versus 5/18 [28%])
      improved after intravenous treatment. CONCLUSIONS: In the authors' series,
      patients with visual loss due to giant cell arteritis had a 34% chance for some
      improvement in visual function after corticosteroid treatment. Intravenous
      therapy may diminish the likelihood of fellow eye involvement and was associated
      with a slightly better prognosis for visual improvement.

PMID- 7800357
TI  - Ophthalmic manifestations of vertebral artery dissection. Patients seen at the
      Mayo Clinic from 1976 to 1992.
AB  - PURPOSE: To determine the ophthalmic manifestations of vertebral artery
      dissections. METHODS: Fifty-one separate episodes of vertebral artery dissections
      evaluated at the Mayo Clinic from 1976 through 1992 were studied. In all cases,
      the diagnosis had been documented with angiography. RESULTS: There were 28 men
      and 19 women (mean and median age, 39 and 40 years, respectively; range, 8-61
      years). There were ophthalmic findings in 86% of the episodes. Visual symptoms,
      in decreasing order of frequency, were diplopia (45% of the episodes), blurred
      vision (14%), transient visual dimming (8%), oscillopsia (4%), photophobia (4%),
      upside-down vision (2%), positional transient visual obscuration (2%), and
      unilateral dry eye (2%). Ophthalmic signs in decreasing order of frequency were
      nystagmus (37% of the episodes), ocular misalignment (cranial nerve palsy or
      skew) (33%), Horner syndrome (27%), decreased corneal sensation (22%), ptosis
      (16%), visual field defect (10%), abnormal pursuits and saccades (6%), ocular
      bobbing (4%), internuclear ophthalmoplegia (4%), anisocoria (4%), and pinpoint
      pupils (2%). CONCLUSION: Vertebral artery dissections occur in a relatively young
      population. Most of the patients in our study had ophthalmic manifestations at
      the time of diagnosis. Heightened awareness of this entity should enable the
      consulting ophthalmologist to have a role in the diagnosis and treatment of
      vertebral artery dissection.

PMID- 7800358
TI  - A report of 131 cases of endoscopic laser lacrimal surgery.
AB  - BACKGROUND: Despite the many advantages of endoscopic laser
      dacryocystorhinostomy, clinical data have been sparse, and the effectiveness of
      this procedure has not been fully evaluated. METHODS: Among 127 patients (131
      procedures) who underwent endoscopic laser lacrimal surgery, 92 procedures with
      longer than 3 months of follow-up were evaluated. The authors used endoscopic
      sinus surgery equipment, radiosurgical instruments, otodrill, microrongeur,
      holmium:YAG and contact neodymium:YAG lasers. RESULTS: After the primary
      operation, 71 (77.2%) of 92 cases were symptom-free and had positive results on
      primary Jones dye test. With simple revision of failed cases, 88 (95.7%) of 92
      cases were treated successfully. CONCLUSION: Improvement of surgical technique
      and use of adequate surgical instruments were essential in increasing the rate of
      success. Endoscopic laser surgery is useful in treating patients with lacrimal
      passage obstruction, but a longer period of observation is necessary to confirm
      its effectiveness.

PMID- 7800359
TI  - Herpes zoster ophthalmicus in Malawi.
AB  - OBJECTIVE: The objective was to describe the complications and outcomes of herpes
      zoster ophthalmicus in a population of young Africans with a high seroprevalence
      of human immunodeficiency virus type 1 in which treatment often is delayed and in
      which antiviral drugs are not available. METHODS: Twenty-seven patients with
      herpes zoster ophthalmicus presenting consecutively to a large urban hospital
      were examined and followed. Treatment was limited to that which was locally
      available. RESULTS: Visual outcomes were poor. Sixty-six percent of eyes had
      final visual acuity less than 20/60. Forty percent had light perception or no
      light perception visual acuity. Severe keratouveitis and corneal perforation were
      common and responsible for most poor visual outcomes. CONCLUSION: Young Africans
      with herpes zoster ophthalmicus are at a high risk for significant visual loss.

PMID- 7800360
TI  - Dapsone-induced neutropenia in patients treated for ocular cicatricial
      pemphigoid.
AB  - BACKGROUND: Dapsone is used widely in treating ocular cicatricial pemphigoid,
      leprosy, and dermatologic disorders. Hemolysis is a well-known complication of
      dapsone therapy. Rarely, neutropenia or agranulocytosis may occur, resulting in
      up to a 50% mortality rate. To the authors' knowledge, agranulocytosis has not
      been reported in patients treated with dapsone for ocular cicatricial pemphigoid.
      METHODS: The authors report two cases of dapsone-induced neutropenia with bone
      marrow suppression in patients with ocular cicatricial pemphigoid. RESULTS:
      Neutropenia was detected on routine laboratory examination 8 and 10 weeks after
      initiating dapsone therapy. Bone marrow biopsy showed acellular or hypocellular
      marrow. Leukocyte count returned to baseline value after cessation of dapsone.
      CONCLUSION: Patients with ocular cicatricial pemphigoid who were treated with
      dapsone are at increased risk for agranulocytosis. Dapsone-induced neutropenia
      may not be a dose-dependent phenomenon. The authors indicate that there is a need
      for routine monitoring of leukocyte counts, especially 8 to 10 weeks after
      initiating therapy. Signs or symptoms of infection require immediate
      investigation.

PMID- 7800361
TI  - Increased serum levels of eosinophil cationic protein and eosinophil-derived
      neurotoxin (protein X) in vernal keratoconjunctivitis.
AB  - PURPOSE: To evaluate whether the eosinophil preformed mediators, eosinophil
      cationic protein X, and eosinophil-derived neurotoxin/eosinophil protein X
      (EDN/EPX) are detectable in serum and can be used as markers of eosinophilic
      inflammation. METHODS: A competitive radioimmunoassay was used to detect serum
      levels of eosinophil cationic protein and EDN/EPX in 31 patients with vernal
      keratoconjunctivitis (VKC) and in 15 healthy controls. RESULTS: Mean serum levels
      of both eosinophil cationic protein and EDN/EPX were significantly higher in
      patients with VKC than in controls. There was a good correlation between serum
      levels of eosinophil cationic protein and EDN/EPX. No significant difference in
      mean serum eosinophil cationic protein levels was observed between patients with
      positive radioallergosorbent test (RAST) results and those with negative RAST
      results who have VKC, whereas mean EDN/EPX and total immunoglobulin E serum
      levels were significantly higher in patients with positive RAST results than in
      those with negative RAST results who have VKC. Serum eosinophil cationic protein,
      but not EDN/EPX, levels were significantly related to total immunoglobulin E
      levels. CONCLUSION: The authors' data indicate that serum levels of eosinophil
      cationic protein and EDN/EPX are useful markers of eosinophilic ocular
      inflammation in VKC.

PMID- 7800362
TI  - Granular corneal dystrophy. Visual results and pattern of recurrence after
      lamellar or penetrating keratoplasty.
AB  - BACKGROUND: Granular corneal dystrophy is a rare indication for corneal
      transplantation. Both penetrating and lamellar keratoplasty have been
      recommended, but because granular corneal dystrophy is known to recur within the
      donor material and multiple grafts may be necessary, the best surgical option has
      not been clearly established. The cellular cause of the dystrophy is unknown and
      the authors hypothesized that the rate and pattern of recurrence within lamellar
      and penetrating grafts might give clues to its etiology. METHODS: The authors
      compared the visual outcome, rate, and pattern of recurrence after 20 penetrating
      keratoplasties and 11 lamellar keratoplasties for granular corneal dystrophy.
      RESULTS: Penetrating keratoplasty and lamellar keratoplasty have a good visual
      outcome in granular corneal dystrophy. Visual acuities after both procedures were
      not statistically different. Recurrence of the dystrophy within the graft
      material was almost universal within 4 years. It first appeared centrally and
      superficially, occasionally adopting a vortex pattern suggesting epithelial
      involvement. The recurrence-free interval was independent of size and type of
      graft performed. CONCLUSION: The authors recommend lamellar keratoplasty as a
      primary procedure in managing visually disabling granular corneal dystrophy if
      the deposits are limited to the superficial cornea. This is particularly
      applicable in younger patients in whom multiple procedures may be necessary over
      a lifetime due to recurrence of the dystrophy, and the lower morbidity rate
      associated with lamellar keratoplasty becomes appreciable. Although granular
      corneal dystrophy generally is classified as a stromal dystrophy, the pattern of
      recurrence is more consistent with an epithelial or tear-borne abnormality than a
      disease of the stromal keratocyte.

PMID- 7800365
TI  - Long-term results after removal of dislocated intraocular lenses from the retinal
      surface through a limbal approach.
AB  - BACKGROUND: The authors describe the use of a limbal approach for removing
      dislocated intraocular lenses (IOLs) from the retinal surface to minimize
      surgical trauma and optimize visual outcome. METHODS: Thirteen consecutive
      patients underwent removal of a dislocated posterior chamber IOL (PC IOL) from
      the retinal surface through a limbal approach. The surgical technique used in all
      patients included a limbal incision from the 3- to 9-o'clock positions; open-sky
      vitrectomy, grasping the IOL at the angle between loops and optics with an iris
      hook; and IOL removal through the corneoscleral opening. In all except one
      patient, who had high-degree myopia, an IOL was re-implanted during the same
      surgical procedure (free sulcus fixation of a PC IOL over remnants of the
      capsular bag, 7 patients; sulcus fixation of a PC IOL over remnants of the
      capsular bag combined with 1 transscleral suture, 3 patients; and implantation of
      an anterior chamber IOL, 2 patients). RESULTS: No retinal or corneal
      complications secondary to IOL removal and re-implantation through a limbal
      approach could be detected over an average follow-up period of 22.3 months
      (range, 17-27 months). Best-corrected visual acuity was 20/40 or better in seven
      patients, between 20/50 and 20/400 in three, and less than 20/400 in three.
      Visual outcome worse than 20/40 was related to pre-existing macular degeneration
      in five patients and retinitis pigmentosa in an additional one. CONCLUSIONS: The
      use of a limbal approach allows removal of an IOL from the retinal surface and
      secondary IOL implantation in the preferred site during the same surgical
      procedure. Because no special instrumentation is needed, this technique also is
      suitable for primary removal if dislocation occurs intraoperatively. The visual
      outcome and the long-term absence of complications recorded in our series
      indicate that a limbal approach may offer a reasonable alternative in managing
      IOLs luxated onto the retinal surface.

PMID- 7800363
TI  - Dynamic shifts in corneal topography after radial and transverse keratotomy.
AB  - PURPOSE: The authors aimed to quantitate the dynamic patterns of change in
      corneal topography after multistaged radial and transverse keratotomy using
      digitized video-keratography. METHODS: Single and paired radial and transverse
      keratotomies, with videokeratoscopy between each stage and at the end of the
      procedure, were performed on fresh animal cadaver eyes using an artificial orbit
      system. RESULTS: All incisions led to central flattening. A single radial
      keratotomy caused flattening adjacent to the incision, and steepening 180 degrees
      away. A paired radial keratotomy caused increased flattening in the meridian of
      the incisions, and less flattening 90 degrees away. A single transverse incision
      caused steepening adjacent to the incision and diffuse flattening elsewhere. A
      paired transverse incision caused flattening near the optical center along the
      meridian bisecting the incisions and steepening 90 degrees away. CONCLUSION: The
      authors have demonstrated that computerized videokeratography can be used
      successfully to systematically quantitate dioptric shifts in multiple
      hemimeridians and measurement zone diameters after refractive surgery.

PMID- 7800366
TI  - Cutaneous melanoma-associated retinopathy.
AB  - PURPOSE: To define further the syndrome of cutaneous melanoma-associated
      retinopathy, of which only five affected patients have been reported previously.
      METHODS: Three men with melanoma-associated retinopathy were examined and studied
      electrophysiologically. Two were studied in detail psychophysically. RESULTS:
      Visual symptoms consisted of flickering black and white spots, shimmering patches
      of colors, and night blindness. The onset was acute and nonprogressive. Reduced
      amplitudes were observed in the flash electroretinographic b-wave and the pattern
      electroretinogram. Color vision, contrast sensitivity, and light- and dark
      adapted perimetric sensitivities were abnormal. In one patient, the rate of dark
      adaptation was normal with elevated final cone and rod thresholds. CONCLUSIONS:
      Melanoma-associated retinopathy is a paraneoplastic syndrome distinct from cancer
      associated retinopathy with a different visual prognosis. It may preferentially
      affect men.

PMID- 7800364
TI  - Retained lens fragments after phacoemulsification.
AB  - PURPOSE: The authors present the clinical features of patients with retained lens
      fragments after phacoemulsification and their outcome after pars plana
      vitrectomy. METHODS: The authors performed a retrospective chart review of 62
      patients who had surgical management of posteriorly dislocated lens fragments
      after phacoemulsification during the 3-year period from January 1990 to December
      1992. RESULTS: Eight of the 62 patients underwent vitrectomy on the same day as
      the cataract surgery. Of the remaining 54 patients examined in the outpatient
      clinic, initial clinical features included marked intraocular inflammation (87%),
      elevated intraocular pressure of 30 mmHg or higher (46%), and corneal edema
      (46%). Retinal detachment was present before vitrectomy in one patient and
      occurred after vitrectomy in two others. Initial visual acuity was 20/200 or
      worse in 68% of patients. After vitrectomy, final visual acuity was 20/40 or
      better in 68% of patients. Using the percentage of patients with 20/40 or better
      final visual acuity, there was no statistically significant difference in surgery
      performed within 7 days (70%), between 1 and 4 weeks (60%), and after 4 weeks
      (70%). Twenty (80%) of 25 patients with initial posterior chamber intraocular
      lenses (PC IOLs) and 16 (62%) of 26 patients with initial anterior chamber IOLs
      (AC IOLs) achieved 20/40 or better visual acuity. A visual acuity outcome of
      20/200 or worse occurred in all three patients with retinal detachment. Six of
      the eight patients who underwent vitrectomy on the same day as the cataract
      surgery achieved 20/30 or better visual acuity. CONCLUSIONS: The timing of
      vitrectomy did not influence visual acuity outcomes. Intraocular lenses inserted
      at the primary operation did not adversely affect the visual outcome. However,
      vitrectomy on the same day as cataract surgery generally yielded favorable visual
      acuity outcomes and eliminated the need for a second operation at a later date.
      In most patients with retained lens fragments, management with vitrectomy allowed
      good visual acuity outcomes.

PMID- 7800367
TI  - The detection of post-traumatic angle recession by gonioscopy in a population
      based glaucoma survey.
AB  - BACKGROUND: Blunt trauma is responsible for most eye injuries in urban
      populations. Anterior chamber angle recession has been reported to be the most
      common sign of previous blunt trauma to the eye. The cumulative lifetime
      prevalence of post-traumatic angle recession has not been reported previously,
      and the relation between angle recession and glaucoma in a population-based
      setting is unknown. METHODS: As part of a population-based glaucoma survey,
      gonioscopy was performed on 987 (82.7%) of 1194 inhabitants of the village of
      Mamre, near Cape Town, South Africa, who were 40 years of age or older. RESULTS:
      Some degree of angle recession was identified in one eye of 60 people and in both
      eyes of 86 people. Men were affected more than three times as often as women in
      the fifth, sixth, and seventh decades. The cumulative lifetime prevalence of
      angle recession in this community was 14.6%. The prevalence of glaucoma in people
      with angle recession was 5.5% (8/146). Of 87 eyes with 360 degrees of angle
      recession, only 7 (8.0%) had glaucoma. Excessive alcohol consumption was
      significantly related to the presence of angle recession in women (P < 0.001).
      The prevalence of monocular blindness due to trauma was 2.5% (25/987).
      CONCLUSION: Although the importance of the study may be limited to this
      community, the findings suggest that future population-based studies of ocular
      trauma should include gonioscopy on all individuals examined. Secondary
      glaucomas, especially those related to trauma, should be screened for in
      developing countries when trying to establish the prevalence of potential visual
      loss from glaucoma.

PMID- 7800369
TI  - Wegener's granulomatosis.

PMID- 7800368
TI  - The prevalence of primary open-angle glaucoma in a population-based study in The
      Netherlands. The Rotterdam Study.
AB  - PURPOSE: The objective of this study is to assess the prevalence of primary open
      angle glaucoma (POAG) in a defined population in Rotterdam, The Netherlands.
      METHODS: The Rotterdam Study is a single-center prospective cohort study of a
      total population of more than 10,000 people, 55 years of age or older. For the
      current analysis, the first 3062 consecutive, unselected, noninstitutionalized
      participants were examined according to standard protocols, including perimetry.
      The diagnosis of POAG was based on the presence of a glaucomatous visual field
      defect combined with either a vertical cup: disc ratio of 0.5 or more or a
      cup:disc ratio asymmetry of 0.2 or more, or an intraocular pressure (IOP) more
      than 21 mmHg, with open and normal anterior chamber angles. RESULTS: The overall
      prevalence of POAG in the current study was 1.10% (95% confidence interval [CI]:
      1.09, 1.11). Age-specific prevalence figures increased from 0.2% (95% CI: 0.16,
      0.24) in the age group of 55 to 59 years to 3.3% (95% CI: 2.57, 4.04) in the age
      group of 85 to 89 years. Men had a more than three times higher risk of having
      POAG than women (odds ratio, 3.6). In 52.9% of the patients, POAG had not been
      diagnosed previously. Of these patients, 38.9% had IOPs of 21 mmHg or lower. In
      8.8% of the eyes (2.9% of patients), visual acuity was 20/200 or less due to
      POAG. CONCLUSION: The overall prevalence of POAG in the current study was 1.1%.
      The prevalence of POAG was higher in men than in women. Of the untreated
      patients, 38.9% had IOPs of 21 mmHg or lower.

PMID- 7800371
TI  - Incompletely erupted third molars in the line of mandibular fractures. A
      retrospective analysis of 57 cases.
AB  - A retrospective investigation was carried out of 57 cases of mandibular angle
      fractures, where a completely or partially impacted third molar was present in
      the line of fracture. Closed reduction was used in all of the cases, using
      intermaxillary fixation over a period of 42 days. Antibiotics were given to all
      patients for a period of 1 week. Thirty-one patients (55%) were treated within
      the first 24 hours and 43 (75%) within 48 hours. Infection at the fracture site
      occurred in two patients (3.5%). Both of these patients had been treated within
      the first 24 hours. It is concluded that closed reduction with retention of the
      mandibular third molar within the line of a mandibular angle fracture can be
      carried out with less morbidity compared with cases in which rigid fixation is
      used and movement of the jaws permitted immediately. Because of the size of the
      study group, no relationship could be demonstrated between cases with infection
      and the time from trauma to fixation.

PMID- 7800370
TI  - Temporomandibular joint pathosis related to sex, age, and dentition in autopsy
      material.
AB  - The purpose of this autopsy study was to test the hypotheses that
      temporomandibular joint (TMJ) arthrosis is more common in women than in men,
      increases with age, and is more common in edentulous persons than in those with
      natural teeth. Two hundred forty-eight TMJs removed at autopsy from 224 fresh
      cadavers were investigated macroscopically with dissection or cryosectioning. Age
      was found to be a significant factor in prediction of TMJ arthrosis (p < 0.001)
      and of disk perforation (p < 0.05). No significant association was found between
      morphologic changes in the TMJ and the factor of sex for the whole group. Disk
      displacement and disk perforation were, however, more common in the joints of
      women than men in the group of persons 80 years of age or older (p < 0.05). There
      were significant associations (p < 0.001) between arthrosis, disk displacement,
      disk deformation, and disk perforation. There were no statistically significant
      differences in the prevalence of morphologic changes in the joints from persons
      with 10 or more natural teeth in each jaw compared with those from persons
      without natural teeth. The results of this study showed that TMJ arthrosis is
      more frequent in older than in younger persons. TMJ disk displacement generally
      appears necessary for the development of perforations. The findings of this study
      indicate that sex and dentition are not major factors for the development of TMJ
      pathosis in elderly individuals.

PMID- 7800372
TI  - Timing of facial osteotomies. A consensus conference.
AB  - A concensus conference on the timing of facial osteotomies was held in Jonkoping,
      Sweden. Seven teams consisting of a maxillofacial surgeon and an orthodontist
      representing five countries discussed treatment planning for young patients with
      maxillomandibular deformities with special emphasis on timing. Patients with
      severe syndromic facial deformities were not considered. Consensus was reached
      that for most deformities it is best advised to wait until growth has ceased, as
      determined by longitudinal cephalometric data. This rule is less tight for Angle
      Class II than for Class III cases. For asymmetries often there is still not
      enough scientific evidence to obtain well-founded uniform agreement.

PMID- 7800373
TI  - Cyclosporin A in an adhesive base for treatment of recalcitrant oral lichen
      planus. An open trial.
AB  - Patients with symptomatic oral lichen planus often require therapy to reduce
      signs and symptoms of the condition. For this purpose, corticosteroids are
      frequently used. In this study the effect of another immunosuppressive drug,
      cyclosporin A was evaluated; it was applied as a topical drug four times daily
      and contained 0.025% cyclosporin A. The study group was composed of nine
      symptomatic patients in whom the diagnosis of oral lichen planus was confirmed by
      histopathologic examination including immunofluorescence. All patients had
      unsuccessfully undergone previous treatment with topical or systemic
      corticosteroids. The minimum follow-up period in the present study was at least 4
      months. Four patients showed partial response to treatment with respect to signs
      and symptoms. None of the patients had a complete remission. Five patients showed
      no response or even complained of an increase of signs and symptoms. No adverse
      side effects of the drug were recorded during follow-up. Although the number of
      patients has been small, the results of this study indicate that topical
      application of cyclosporin A (0.025%) in the treatment of recalcitrant oral
      lichen planus does not offer a distinct advantage over the use of topical
      corticosteroids.

PMID- 7800375
TI  - Tongue necrosis as a complication of temporal arteritis.
AB  - Tongue necrosis is a rare complication in giant cell arteritis, an entity in
      which both temporal arteritis and rheumatic polymyalgia may be included as two
      different manifestations of the same pathologic process. The case of a 79-year
      old patient who had tongue necrosis 3 hours after ingestion of 2 mg of ergotamine
      tartrate is presented. This complication was the basis for the diagnosis of
      temporal arteritis. We reviewed possible clinical manifestations of temporal
      arteritis and cases of tongue necrosis in the world literature. The possible
      existence of triggering factors that seemed to be present in 11 of the published
      cases was analyzed. In seven of these cases ingestion of ergotamine derivates had
      taken place.

PMID- 7800374
TI  - Clinical and lymphocyte responses to beta-carotene supplementation in 11 HIV
      positive patients with chronic oral candidiasis.
AB  - Eleven HIV-positive patients with chronic oral candidiasis were supplemented with
      60 to 120 mg of beta-carotene daily for 3 to 7 months. Lymphocyte profiles were
      evaluated at intervals to help assess immune competence. Although there was a
      modest increase in some lymphocyte values at 2 months, there was a significant
      decrease in numbers of CD4 and CD8 cells and CD4 percentage of lymphocytes after
      6 months of beta-carotene supplementation. Serum triglyceride and liver enzyme
      levels were not affected by the beta-carotene supplementation. No improvement was
      observed in the control of the oral candidiasis. Under the conditions of the
      study, there was no indication that daily beta-carotene supplements enhanced
      immune competence or was of benefit in managing oral candidiasis.

PMID- 7800376
TI  - Hereditary gingival fibromatosis. Report of an extensive four-generation
      pedigree.
AB  - A Brazilian family with hereditary gingival fibromatosis is described with
      multiple affected subjects in four generations. A total of 50 (48%), of 105 at
      risk offspring in a family of 132 members were affected, consistent with an
      autosomal dominant mode of inheritance. This family appears to represent the
      largest pedigree with this condition reported in the literature.

PMID- 7800377
TI  - Necrosis in benign salivary gland neoplasms. Not necessarily a sign of malignant
      transformation.
AB  - Necrosis that occurs in a salivary gland neoplasm is usually considered to be an
      ominous sign, suggesting malignant transformation, particularly in lesions that
      have had no prior manipulation such as fine-needle aspiration. We describe five
      pleomorphic adenomas and two canalicular adenomas of salivary gland origin that
      exhibited necrosis, yet were otherwise benign. All lesions displayed a
      distinctive histopathologic pattern characterized by a narrow rim of viable tumor
      tissue at the periphery of the neoplasm combined with a diffuse central region
      that demonstrated apparent ischemic necrosis. No invasion of adjacent normal
      tissue was identified, and no recurrence or metastasis has been seen with these
      lesions. Caution should be exercised in the evaluation of salivary gland
      neoplasms with central necrosis to avoid misdiagnosis of all such lesions as
      malignant.

PMID- 7800378
TI  - A clinical trial of antioxidant supplements in the treatment of oral leukoplakia.
AB  - Seventy-nine patients with oral leukoplakia that was histologically verified as
      either hyperkeratosis or epithelial dysplasia with hyperkeratosis were enrolled
      in an antioxidant supplementation program for the treatment of the oral lesions.
      The patients received 30 mg of beta-carotene, 1000 mg of ascorbic acid, and 800
      IU of alpha-tocopherol per day for 9 months. Clinical improvement of the oral
      lesion was noted in 55.7% of the patients and was more likely to occur in
      patients who reduced their use of alcohol or tobacco (p = 0.0056). Although risk
      factor reduction was important, approximately half of the patients who did not
      alter their exposure to either alcohol or tobacco showed clinical improvement.
      The antioxidant supplementation significantly increased serum and tissue levels
      of beta-carotene, ascorbic acid, and alpha-tocopherol, but these changes did not
      correlate strongly with clinical improvement.

PMID- 7800379
TI  - Proliferative verrucous leukoplakia. Four cases with flow cytometric analysis.
AB  - Proliferative verrucous leukoplakia is a slow-growing but highly aggressive
      precancerous form of leukoplakia of unknown cause. Proliferative verrucous
      leukoplakia is though to possess a continuous spectrum of clinical and
      histopathologic expression, ranging from simple hyperkeratosis to invasive
      squamous cell carcinoma. Early diagnosis is difficult because of an initial
      innocuous character, but multiple and rapid multifocal warty recurrences are
      common. This article reports four additional archival cases of proliferative
      verrucous leukoplakia to determine if flow cytometric analysis can be useful in
      the early diagnosis of proliferative verrucous leukoplakia. Flow cytometric
      analysis was performed on available formalin-fixed paraffin-embedded specimens (N
      = 27). Flow cytometric analysis results showed DNA aneuploid cell lines in each
      proliferative verrucous leukoplakia case studied (DNA index range, 1.1 to 2.6).
      In all four patients the abnormal cell line DNA index appeared to be maintained
      throughout the sampling period. The results suggest flow cytometric analysis
      could be a possible aid in early recognition of proliferative verrucous
      leukoplakia and might enable aggressive therapy at an earlier stage.

PMID- 7800380
TI  - A case of histiocytic medullary reticulosis complicated with x-ray-irradiated
      oral cancer.
AB  - We report the case of a patient in whom oral squamous cell carcinoma and a fatal
      reactive form of histiocytosis were simultaneously manifested. Our conclusions
      indicate that such a hematophagocytic syndrome may occur in the setting of oral
      squamous cell carcinoma as previously described in other malignancies.

PMID- 7800381
TI  - Pathogenesis of induced rat periapical lesions.
AB  - Studies of the mechanisms of pathogenesis of periapical lesions were undertaken
      using a rat model of surgical pulp exposure. In this model, periapical lesions
      develop rapidly between days 0 and 15 (active phase) and more slowly thereafter
      (chronic phase). A Gram-negative anaerobic flora, similar to that seen in human
      beings, are quickly established. Lesions contain a mixed inflammatory cell
      infiltrate consisting of T cells, neutrophils, B cells, macrophages, and plasma
      cells. Helper T cells predominate during the active phase, whereas suppressor T
      cells are more frequent in the chronic phase. Extracts of periapical lesions
      contain bone-resorbing activity, the highest levels of which are present when
      lesions are actively expanding. Most bone-resorbing activity is mediated by the
      cytokine interleukin-1 alpha, as determined by biochemical criteria and antibody
      neutralization studies. Prostaglandin2 accounts for 10% to 15% of resorptive
      activity. Cells that express interleukin-1 alpha were identified in pulp
      beginning on day 2 after exposure and in periapical tissue beginning on day 7, as
      determined by in situ hybridization and immunostaining. Macrophages, fibroblasts,
      neutrophils, and osteoclasts were positive for interleukin-1 alpha mRNA and
      protein. Cells that express tumor necrosis factor alpha were also detected,
      whereas cells expressing interleukin-1 beta or tumor necrosis factor beta were
      absent. Finally, periapical bone destruction was inhibited by 60% by treatment
      with interleukin-1 receptor antagonist. These studies establish a key role for
      interleukin-1 alpha in the pathogenesis of periapical lesions in the rat model.

PMID- 7800382
TI  - Mediators of acute and chronic periradicular lesions.
AB  - Multiple mechanisms are involved in the pathologic changes associated with
      formation of acute and chronic periradicular lesions. Mechanical injury to the
      periradicular tissues can cause activation of several pathways of inflammation
      and release of nonspecific mediators. Continuous irritation of periradicular
      tissues can cause activation of several pathways of inflammation and release of
      nonspecific mediators. Continuous egress of antigens from a pathologically
      involved root canal can also result in one or a combination of the various types
      of immunologic reactions. A number of these reactions participate in the
      destruction of periradicular tissues. Because of complex interactions between the
      various components of these systems, the dominance of any one pathway or
      substance may be difficult to establish.

PMID- 7800384
TI  - Color coding of radiographic changes over time by means of image addition.
AB  - Differences between sequential radiographs may be displayed in color if the
      individual radiographs are transformed into monochromatic images and then added.
      Information in regions where the radiographs are identical is retained whereas
      differences are emphasized by the color coding that comes about in a quantitative
      manner from the gray level values in the sequence of radiographs. By using the
      three additive primary colors, red, blue, and green, two or three radiographs
      from a sequence may be added. Every possible state of a bone disease,
      progression, regression, or any combination, will produce a different and
      specific color code. Different development cycles are described, and the color
      coding that appears when color image addition is performed is analyzed. The color
      addition technique should constitute a useful substitute or alternative to
      subtraction.

PMID- 7800383
TI  - Taxonomy, ecology, and pathogenicity of the root canal flora.
AB  - The bacteria present in infected root canals include a restricted group of
      species compared with the total flora of the oral cavity. Conditions exist in the
      root canal that permit the growth of anaerobic bacteria capable of fermenting
      amino acids and peptides, whereas bacteria that mainly obtain energy by
      fermenting carbohydrates are restricted by lack of available nutrients. During
      the course of infection interrelationships develop between microbial species and
      population shifts are produced as a result of these interactions. Strong
      associations between certain species are present. These associations are most
      likely based on nutritional demands and nutritional relationships. The
      pathogenicity of the polymicrobial root canal flora is dependent on bacterial
      synergy.

PMID- 7800385
TI  - Angiography of the temporomandibular joint. Description of an experimental
      technique with initial results.
AB  - The vascular supply to the temporomandibular joint is not completely understood.
      To form a base for advancement in this area we developed a method for
      experimental angiography of the temporomandibular joint that was applied to fresh
      temporomandibular joint autopsy specimens. Via the external carotid artery the
      vessels were infused with a mixture of barium and an acrylic resin. The specimens
      were sectioned and contact radiographs were obtained. These showed the
      vascularity of the joint and the surrounding structures with great detail. Most
      of the vascular supply appears to come from the lateral and medial aspects of the
      condyle head and from the anterior and posterior disk attachments. The method was
      applied to both normal and abnormal joints and the results suggest that this
      method could be used to gather further understanding of the vascularity of the
      temporomandibular joint relative to disease.

PMID- 7800386
TI  - Exposure parameters and their effects on diagnostic accuracy.
AB  - A new method for analyzing diagnostic accuracy is introduced. A diagnostic
      accuracy curve may be obtained by plotting receiver operating characteristic
      analysis data, P(A), as a function of exposure. By means of diagnostic accuracy
      curves the effects on diagnostic accuracy of tube potential, exposure, and size
      of carious lesions was studied. It was found that the effect of the tube
      potential on the accuracy of caries diagnosis is negligible. About 25% of the
      variation in diagnostic accuracy depends on the exposure and about 80% on lesion
      depth. With the lesion depth constant, about 75% of the variance in diagnostic
      accuracy depended on observer performance. The peak of a diagnostic accuracy
      curve indicates optimum performance. This is found at an exposure that gives a
      radiographic density of about 1 in enamel and dentin although the tolerable
      exposure increases with increased lesion depth.

PMID- 7800388
TI  - [Pharmacokinetic study of dibromodulcitol in children with brain tumors].
AB  - Systemic pharmacokinetics of high-dose (500 mg/m2), orally administered
      dibromodulcitol (Elobromol) were studied in 16 chemotherapeutic courses
      administered to 5 patients. Cerebrospinal fluid dibromodulcitol levels were also
      analysed in two patients. Bromoepoxydulcitol, dianhydrodulcitol are cytotoxic,
      whereas bromoanhydrodulcitol, andhydroepoxydulcitol are inactive metabolites
      detectable during the biotransformation of dibromodulcitol. The HPLC method,
      developed by our team, is suitable for the determination of both dibromodulcitol
      and its main metabolites (dianhydrodulcitol and bromoanhydrodulcitol). Our
      publication is the first in the literature to describe the pharmacokinetic
      properties of these three hexite-derivatives in pediatric patients. With the
      exception of one patient, concentration-time curves were analysed by the one
      compartment model. From the 30th minute following administration, dibromodulcitol
      was detectable in all plasma samples for at least 12 hours, its concentration
      however was usually undetectable by the 24th hour. Though highly variable in
      value, dianhydrodulcitol concentrations were detectable during all but one
      therapeutic courses. The following peak concentrations were observed:
      dibromodulcitol: 3.46-30.63 microM; dianhydroldulcitol: 1.70-6.17 microM;
      bromoanhydrodulcitol: 0-5.63 microM. The correlation of area under the curve for
      bromoanhydrodulcitol and dibromodulcitol was exponential up to 200 microMxh with
      no additional increase detectable above this limit; the distribution of
      dianhydrodulcitol values were described by a maximum-curve. The possibility of
      enterohepatic recirculation could not be excluded for any of the compounds
      studied. Each of the three hexitol derivatives were detectable in the
      cerebrospinal fluid even if the concentration of the individual metabolite
      remained undetectable in plasma. The cerebrospinal fluid concentrations of
      dibromodulcitol were almost constant in the period from 2.5 to 8 hours following
      administration.(ABSTRACT TRUNCATED AT 250 WORDS)

PMID- 7800387
TI  - [Experience in the management of patients with artificial heart valves (analysis
      of the material of the Bekes County Cardiology Clinic)].
AB  - Authors report of 152 patients, 146 of whom underwent single mitral (n = 70),
      single aortic (n = 64), double aortimitral (n = 17) and aortic-mitral-tricuspid
      (n = 1) valve replacement with mechanical prostheses. 6 patients received
      bioprostheses. The mean age was 55 years. Follow-up ranged from 1 to 23 years
      (mean 5.1 years). The methodology of follow-up consisted patients examination in
      our office (at least twice a year) and questionnaire. Valve related complications
      were defined as paravalvular leak (6 cases), valve thrombosis (3 cases),
      thromboembolism (13 cases), anticoagulant-related hemorrhage (21 cases),
      infectious endocarditis (6 cases). During care 14 patients died. The most common
      causes of death were left-ventricle insufficiency (n = 6), infectious
      endocarditis (n = 3), prosthetic valve thrombosis (n = 1), cerebral hemorrhage (n
      = 2) and sudden death (n = 2). 138 patients (56 percent) are retired or invalid.
      Authors emphasize the importance of regular control and the significance of
      anticoagulant policy (in the target international normalized ratio to 2.5-3.5 and
      the provision of the antibiotic prophylaxis to avoid the late complications.

PMID- 7800389
TI  - [Management of childhood pseudocroup with budesonide inhalation].
AB  - The authors examined 85 children who had serious recurrent pseudogroup syndrome,
      and re-examined them 1-3 years later. 1/3 of the patients was also allergic,
      mostly to mites and grasspollens. The patients got either regular, daily two
      inhalation, or their parents were taught to inspire the drug in the case of
      stenotic cough of hoarseness. Half of the patients did not answer to our letter.
      The parents of 43 patients answered and described their observations according to
      the inquiry letter. 2/3 of treated children either amolioreted definitely of
      became symptom free. 12 patients had 30 laryngeal attacks before the budesonide
      treatment whereas only 3 attacks, needing hospitalisation, occurred after the
      budesonide treatment. 6 patients experienced definite amelioration and two
      children's state worsened. Budesonide therapy seemed to be useful in the
      prevention and therapy of recurrent laryngitic children. Further experiences
      using turbo-inhaler and placebo would be important for more definite statement.
      Nevertheless inhalative budesonide is the first drug promising fast remission of
      laryngeal edema.

PMID- 7800391
TI  - [Rupture of extrauterine pregnancy during simultaneous intrauterine pregnancy].
AB  - The authors report a case of a simultaneous extrauterine and intrauterine
      pregnancy which posed a problem of differential diagnosis for both the surgeon
      and the gynecologist. After surgical treatment of the ruptured ectopic pregnancy
      the patient was symptom free, and later requested the interruption of her normal
      intrauterine pregnancy. Diagnosis was confirmed by ultrasonographic examination.

PMID- 7800390
TI  - [Evaluation of syncope in medicolegal expertise].
AB  - The authors summarise the clinical characteristics of the syncope and
      neurological signs respectively caused by basilar vertebral artery insufficiency
      as well as carotid sinus hypersensitivity. Several authors have seen an increased
      number of patients with neurological symptoms caused by ischaemia in the region
      of the basilar artery occurring while driving and causing a traffic accident.
      Carotid sinus hypersensitivity as cause of driving accidents has much less
      importance. In the case of the authors on a 51 years old man after turning his
      head to the right a sudden transient loss of consciousness without signs of
      convulsion developed while driving a car. The attack resulted in a serious
      traffic accident. Vertebrobasilar insufficiency was presumed as the cause of the
      signs. Despite the rare incidence of isolated syncope caused by ischaemia in the
      region of basilar artery, after observation of one and half a year, chiefly
      supported by the pathological otoneurological findings, the definitive diagnosis
      could be established. The recurrence of the syncope could not be excluded. An
      inability to drive was established. The new hungarian legal regulation of 1992,
      of driving ability emphasises the extraordinary hazards in the traffic posed by
      processes the sinus of which occur associated with sudden loss of consciousness
      with great probability, perhaps rarely, but at any time.

PMID- 7800392
TI  - [On the centenary of Theodor Billroth (1829-1894)].

PMID- 7800393
TI  - [Pathography of Lorinc Szabo in his poetry].

PMID- 7800394
TI  - ["Integration"--more than a slogan].

PMID- 7800395
TI  - [The ideal sickroom].

PMID- 7800396
TI  - [Job rotation. A short report on work organization].

PMID- 7800397
TI  - ["The school is very effective..."].

PMID- 7800398
TI  - [Kaspar Feuerstein: "It is important to consider various opinions". Interview by
      Harald Verworner].

PMID- 7800399
TI  - Lateral ankle sprains, Part II: Acute and chronic treatment.

PMID- 7800400
TI  - An algorithmic approach to the treatment of Paget's disease of the spine.
AB  - An algorithmic approach to the treatment of Paget's disease of the spine is based
      on the authors' collective experience in managing 70 patients and a review of the
      literature. For patients with active disease, even if asymptomatic, cyclical
      treatment with etidronate is recommended until normalization of biochemical
      parameters is achieved. For patients with back pain and/or neurologic
      dysfunction, cyclical etidronate treatment in the blastic and mixed phase is
      advocated. Those who fail to respond to calcitonin in the lytic phase should be
      given the new generation of bisphosphonates and gallium nitrate. No antipagetic
      drug therapy is indicated for the sclerotic phase. Surgery for complications of
      Paget's disease should be preceded by intravenous therapy to minimize
      intraoperative bleeding. For cases of spinal stenosis with impending paraplegia,
      the new bisphosphonates, mithramycin (plicamycin), or gallium nitrate should be
      used. If conservative treatment fails, surgery should not be delayed.

PMID- 7800401
TI  - Arthroscopy language.
AB  - The authors have devised an "arthroscopy language" to make orthopaedic surgeons'
      intraoperative communication clear, comprehensive, and concise. This language
      specifically eliminates surgeons' "freestyle" conversation at the most crucial
      moments of their procedure, when concentration and the coordinated work of two
      surgeons are essential. The language uses current arthroscopic terminology and
      new words that have been adapted by the authors to describe all the basic
      maneuvers that are used during any arthroscopic procedure. The authors believe
      the language brings the necessary scientific sophistication into arthroscopic
      surgeons' speech in the operating theater.

PMID- 7800402
TI  - Comparison of intra-articular morphine and bupivacaine following knee
      arthroscopy.
AB  - A prospective study was conducted to investigate and compare the analgesic effect
      of morphine and bupivacaine injected intra-articularly following elective knee
      arthroscopy performed under general anesthesia without the use of a tourniquet.
      Cost-effectiveness of these agents was also evaluated. Patients in Group 1 (n =
      41) received 30 cc of 0.25% bupivacaine with 1:200,000 epinephrine; while Group 2
      (n = 40) received 2 mg morphine (1 mg/cc) in 28 cc normal saline (total volume 30
      cc). Postoperative pain scores and the amount of supplemental analgesic agents
      used in a 24-hour period were recorded. Results showed that patients in Group 2
      reported significantly less pain overall (P < .006) and significantly lower
      analgesic requirements (P < .0004) at a lower average patient cost than Group 1.
      We conclude that intra-articular morphine reduces postoperative pain and
      analgesic requirements more effectively and at a lower average patient cost than
      bupivacaine.

PMID- 7800403
TI  - Acute exertional compartment syndrome occurring after performance of the army
      physical fitness test.
AB  - Acute exertional compartment syndrome has been described as occurring after
      sustained maximal exertion. The case described is that of acute exertional
      compartment syndrome of the leg occurring in a soldier after he attempted to
      complete the Army physical fitness test. This condition was initially neglected;
      necrotic muscle and acute tubular necrosis were sequelae. Earlier intervention
      could have occurred if the signs and symptoms were considered by the treating
      health care professionals. All active duty troops are required to perform to
      maximum exertion. Their complaints should be considered with the same
      differential diagnosis as those of a highly trained athlete.

PMID- 7800404
TI  - Combined Monteggia and Galeazzi fractures in a child's forearm. A case report.
AB  - We report the occurrence of a previously undescribed combined Monteggia and
      Galeazzi fracture pattern of the left forearm in an 8-year-old boy. Previous
      reports do not address the combined injury described in this article, which
      consists of a left radius shaft fracture with dislocation of the distal
      radioulnar joint, and a left ulna shaft fracture with anterior dislocation of the
      radiohumeral joint. An excellent result was obtained with closed reduction.
      Radiographic evaluation is crucial in these disorders for both diagnosis and for
      treatment decisions. A review of the literature is provided with specific
      emphasis toward the classifications, mechanisms of injury, diagnosis, associated
      injuries, and treatment.

PMID- 7800405
TI  - A 38-year-old woman with recurrent swelling of the great toe.
AB  - The following case is presented to illustrate the roentgenographic and clinical
      findings of a condition of interest to the orthopaedic surgeon. Initial history,
      physical findings, and roentgenographic examinations are indicated below. The
      final clinical and roentgenographic differential diagnoses are presented on the
      following pages.

PMID- 7800406
TI  - Stabilization of the distal radioulnar joint after ulnar styloid nonunion using
      Mitek anchors.
AB  - Nonunion of the ulnar styloid is a relatively common injury that can often be
      ignored. In patients presenting with pain, compromised range of motion, and
      decreased grip strength, careful physical examination, and dynamic radiographic
      evaluation may document distal radioulnar joint instability. Mitek anchors
      provide a simple, effective means of triangular fibrocartilage complex
      reattachment, providing stabilization of the distal radioulnar joint.

PMID- 7800408
TI  - Characterization of the modes of action of anti-Pbs21 malaria transmission
      blocking immunity: ookinete to oocyst differentiation in vivo.
AB  - The impact of immune sera, and peripheral blood cells (PBC) from mice immunized
      with Plasmodium berghei ookinetes; and of purified immunoglobulin or Fab
      fragments from anti-Pbs21 monoclonal antibody 13.1, upon establishment of oocyst
      infections in the mosquito was studied. Infections were initiated either from
      gametocyte-infected mice, or membrane feeders which contained either gametocytes
      or mature ookinetes. PBC from ookinete-immunized mice presented with non-immune
      serum failed to show any transmission-blocking activity. Anti-ookinete serum,
      intact anti-Pbs21 monoclonal antibody 13.1 or its Fab fragments, all inhibited
      oocyst formation significantly. When gametocyte-infected mice or gametocytes in
      membrane feeds were used, inhibition did not directly correlate with antibody
      concentration. In membrane feeders that contained ookinetes and antibody,
      concentration-dependent inhibition usually occurred. The efficacy of purified
      13.1 IgG was dependent upon the ookinete concentration. The ookinete plasmalemma
      and cytoplasm were significantly disturbed after 12 h in bloodmeals that
      contained antibody 13.1, but not in the isotype controls. These changes may have
      caused the observed failure of the ookinete to migrate as rapidly as the controls
      from the destructive environment of the bloodmeal.

PMID- 7800407
TI  - Continuous cultivation of intraerythrocytic Plasmodium falciparum in a serum-free
      medium with the use of a growth-promoting factor.
AB  - Serum-free media were used to culture Plasmodium falciparum. A commercial
      preparation, Daigo's GF21 developed as a growth-promoting factor for many kinds
      of mammalian cells, and consisting of the 55-70% ammonium sulphate fraction of
      adult bovine serum, insulin, transferrin, ethanolamine and sodium selenite, was
      found to sustain growth of the parasite when Daigo's T was employed as a basal
      medium. The optimal Daigo's GF21 concentration for parasite growth was between 5
      and 20% (v/v), with the best results at 10%. Differential counts indicated that
      Daigo's GF21 is essential for schizogony. Established serum-free medium, GIT,
      consisting of Daigo's T basal medium and Daigo's GF21, yielded good parasite
      growth without any supplementation. Growth-promoting factor derived from adult
      bovine serum in Daigo's GF21 was shown to be crucial to parasite growth. The
      results presented here will not only be of practical value, but will provide
      important information about the developmental requirements for the parasite.

PMID- 7800409
TI  - Random mating in a natural population of the malaria parasite Plasmodium
      falciparum.
AB  - The genetic structure of a population of the malaria parasite Plasmodium
      falciparum has been examined in a village in Tanzania. Seventeen alleles of the
      merozoite surface protein MSP-1 and 23 of MSP-2 were detected by the polymerase
      chain reaction (PCR) among the blood parasites of the inhabitants. Most
      infections contained mixtures of genetically distinct parasite clones. PCR was
      then used to examine individual P. falciparum oocysts, the products of
      fertilization events, in wild-caught mosquitoes. Forty-five out of 71 oocysts
      were heterozygous for one or both genes, showing that crossing between clones was
      taking place frequently, following uptake of mixtures of gametocytes by the
      mosquitoes. The frequency of heterozygous forms showed that random mating events
      probably occurred within mosquito bloodmeals between gametes belonging to
      different parasite clones.

PMID- 7800410
TI  - Identification and diagnosis of Leishmania mexicana complex isolates by
      polymerase chain reaction.
AB  - Following cloning of Leishmania (L.) amazonensis kinetoplast DNA two recombinant
      clones were identified: one specific for L. (L.) amazonensis and the other
      specific for L. (L.) amazonensis and closely related isolates. DNA sequences from
      these clones were compared with those of other kinetoplastids and oligonucleotide
      primers were designed to be used in the polymerase chain reaction. A pair of
      these primers has been shown not only to be highly specific for L. mexicana
      complex isolates but can also be used to distinguish between L. (L.) mexicana and
      L. (L.) amazonensis isolates. These primers have been tested with water-lysed
      cultures, crude DNA extracts from human patients, potential host reservoirs,
      sandfly vectors and with cell pellets after isoenzyme characterization. The
      results of these tests indicate that the primers can be used specifically in the
      presence of excess host DNA originating from the majority of South American
      countries.

PMID- 7800411
TI  - A putative Leishmania panamensis/Leishmania braziliensis hybrid is a causative
      agent of human cutaneous leishmaniasis in Nicaragua.
AB  - As part of a survey of human leishmaniasis in Nicaragua we examined phenotypic
      and genotypic characteristics of 40 Leishmania isolates. We identified 3 distinct
      parasites associated with cutaneous disease in this area; Leishmania panamensis
      (40% of cases), Leishmania braziliensis (33%), and a strain which exhibits the
      heterozygous isoenzyme and DNA fingerprinting patterns expected of a L.
      panamensis/L. braziliensis hybrid (27%). There was complete correlation between
      the isoenzyme and DNA data for each of the putative hybrids examined. All of the
      'hybrids' were obtained from foci in the northern region of the country where L.
      panamensis and L. braziliensis occur sympatrically. These observations provide
      strong evidence for sexual reproduction in New World Leishmania populations and
      suggest that it is of taxonomic and epidemiological significance.

PMID- 7800412
TI  - Observations on the effects of different chemotherapy strategies on the
      transmission of Schistosoma mansoni in Machakos District, Kenya, measured by long
      term snail sampling and cercariometry.
AB  - Transmission of Schistosoma mansoni was monitored by routine snail sampling for
      Biomphalaria pfeifferi and by supplementary cercariometric measurements in 4
      neighbouring study areas in Machakos District, Kenya. After 1 year, extensive,
      population-based chemotherapy with a single dose of praziquantel was given in 3
      areas, but only minimal treatment in the fourth. In the year preceding treatment,
      seasonal transmission of S. mansoni and other non-human trematodes occurred in
      all 4 areas, despite some ecological differences and the effects of earlier
      treatment campaigns in 1 of the study areas. After treatment of all infected
      subjects in one area in which there had been earlier chemotherapy campaigns, S.
      mansoni transmission remained very low. It was reduced for at least 2 years after
      chemotherapy targeted at either all heavily infected subjects or all infected
      school children, but it was unaffected in an area where treatment was restricted
      to those few very heavily infected cases at risk of developing disease. Nowhere
      was transmission entirely eliminated by chemotherapy and that of non-human
      trematodes continued unabated. The snail data correspond well with the human,
      parasitological data. Targeting school children was as effective as more
      extensive campaigns, but chemotherapy alone never stopped S. mansoni
      transmission: reinfection was inevitable, at rates determined by ecological
      factors affecting snail populations.

PMID- 7800413
TI  - Platyhelminth FMRFamide-related peptides (FaRPs) contract Schistosoma mansoni
      (Trematoda: Digenea) muscle fibres in vitro.
AB  - Molluscan FMRFamide and two recently discovered platyhelminth FMRFamide-related
      peptides (FaRPs), GNFFRFamide from the cestode Moniezia expansa and RYIRFamide
      from the terrestrial turbellarian Artioposthia triangulata, cause dose-dependent
      contractions of individual muscle fibres from Schistosoma mansoni in vitro. The
      most potent FaRP tested was the turbellarian peptide RYIRFamide, which produced a
      concentration-dependent effect between 10(-9) and 10(-7) M. FMRFamide and
      GNFFRFamide were less potent, inducing contractions between 10(-8)-10(-6) M and
      10(-7)-10(-5) M respectively. The contractile effect of each of these peptides
      was blocked by the presence of 1 microM FMR-D-Famide. FMRF free acid did not
      elicit contraction of the muscle fibres. The FaRP-induced contractions did not
      occur if the Ca2+ was omitted and 0.5 microM EGTA was added to the extracellular
      medium. The FaRP-induced contractions were not blocked by the Ca2+ channel
      blockers nicardipine, verapamil or diltiazem, although high K+-induced
      contractions of these fibres were blocked by nicardipine. These data indicate the
      presence of FaRP receptors on schistosome muscle fibres and demonstrate their
      ability to mediate muscle contraction. The action of these endogenous flatworm
      peptides on schistosome muscle is the first demonstration of a direct excitatory
      effect of any putative neurotransmitter on the muscle of a flatworm, and
      establishes a role for FaRPs in neuromuscular transmission in trematodes. In
      addition, it provides the first evidence that the peptidergic nervous system is a
      rational target for chemotherapeutic attack in parasitic platyhelmiths.

PMID- 7800414
TI  - Activation of protein kinase C by phorbol esters disrupts the tegument of
      Schistosoma mansoni.
AB  - The tegument of the human parasite Schistosoma mansoni is critical for parasite
      survival within the mammalian host. The role of protein kinase C (PKC), a major
      effector molecule in the phosphoinositide pathway, in maintaining the structural
      organization of this syncytial layer was examined in adult worms. Phorbol 12
      myristate, 13-acetate (PMA) and phorbol 12,13-dibutyrate (PDB), phorbol esters
      that activate PKC, induced formation of surface vesicles as determined by light
      and scanning electron microscopy. Similar results were seen with sn-2-dioctanoyl
      glycerol, a synthetic analogue of diacylglycerol. No effect was seen in parasites
      incubated with 4-alpha-phorbol ester or alpha isomers of PMA or PDB, compounds
      that do not activate PKC. Vesicle formation was reversible in parasites treated
      with sn-2-dioctanoyl-glycerol but not with phorbol esters. The tegument of male
      worms was more sensitive to the effect of phorbol esters than females.
      Transmission electron microscopy revealed vacuolization of the tegument. These
      data suggest that signal transduction pathways may have a critical role in the
      maintenance of the structural integrity of the tegument of parasitic helminths.

PMID- 7800415
TI  - Altered behaviour of carbohydrate-bound molecules and lipids in areas of the
      tegument of adult Schistosoma mansoni worms damaged by praziquantel.
AB  - By using fluorescent probes the distribution and fluid properties of lipid and
      saccharide-bound molecules was assessed in the tegument of praziquantel (-)
      treated Schistosoma mansoni adult male worms. Our results show that higher
      amounts of glycoproteins and/or glycolipids are exposed in damaged areas of the
      membrane compared with undamaged ones. At damaged regions these molecules present
      high lateral diffusion coefficient and mobile fraction values which suggests that
      after praziquantel(-) treatment they are being shed by the worm into the medium.
      The lateral diffusion coefficient of the lipid analogue 5'-octadecanoyl
      aminofluorescein is unchanged in damaged or undamaged areas but the mobile
      fraction is significantly reduced at damaged areas. The immunological
      significance of these altered surface properties is discussed.

PMID- 7800416
TI  - Schistosomicidal activities of Lymnaea stagnalis haemocytes: the role of oxygen
      radicals.
AB  - Macrophage-like defence cells (haemocytes) of the pond snail Lymnaea stagnalis
      mediate cytotoxicity through reactive oxygen intermediates (ROIs). This activity
      is NADPH-oxidase dependent, as in mammalian phagocytes during the respiratory
      burst. In this study, mother sporocysts of schistosomes, the compatible
      Trichobilharzia ocellata and the incompatible Schistosoma mansoni evoke in vitro
      ROI activities (detected by luminol dependent chemiluminescence, LDCL) from L.
      stagnalis haemocytes. S. mansoni is encapsulated by haemocytes and eliminated,
      whereas T. ocellata escapes encapsulation and survives. Both schistosomes were
      equally susceptible to in vitro oxidative damage from exposure to hydrogen
      peroxide and to ROIs generated by a xanthine/xanthine oxidase system.
      Protocatechuic acid, a specific antagonist of NADPH-oxidase, delayed the killing
      of T. ocellata and S. mansoni sporocysts by haemocytes of resistant snails
      (Biomphalaria glabrata and L. stagnalis, respectively). We conclude that ROIs
      take part in haemocyte-mediated cytotoxicity. However, neither a snail's
      capability to generate ROIs, nor a schistosome's susceptibility to ROIs,
      determine snail/schistosome incompatibility. Snail/schistosome compatibility is
      rather determined by the parasite's ability to modulate haemocyte behaviour such
      that effective encapsulation and the generation of lethal concentrations of ROIs
      are prevented.

PMID- 7800417
TI  - Schistosoma mansoni host-parasite relationship: interaction of contrapsin with
      adult worms.
AB  - Contrapsin, a serine protease inhibitor (serpin) present in mouse serum, was
      compared with that found in adult Schistosoma mansoni worm homogenates, which
      although immunologically identical to contrapsin in mouse serum, had a higher
      molecular weight in Western blotting. Immunolocalization studies demonstrated
      parasite-associated contrapsin on the surface and interstitial cells of adult
      male worms. After extraction of these parasites with Triton X-114, contrapsin was
      found in the aqueous phase of the detergent, suggesting it is unlikely to be an
      integral membrane protein. Treatment of adult worms with deoxycholate resulted in
      a change in the electrophoretic behaviour of worm-derived contrapsin. Parallel
      studies with trypsin suggested this was due to interaction of the serpin with a
      protease. Using porcine pancreatic trypsin as a model for a putative schistosome
      protease reacting with contrapsin, we have shown that trypsin, following complex
      formation with contrapsin, loses immunogenicity. Thus, when contrapsin-trypsin
      complexes were used as immunogen, the resulting antisera contained antibodies to
      contrapsin and contrapsin-trypsin complexes only, and none to native trypsin.
      Thus, epitopes characterizing native trypsin were presumably either masked
      following complex formation with contrapsin, or their processing and presentation
      to antigen presenting cells was suppressed, so that an antibody response was not
      mounted against them. These observations encourage speculation that S. mansoni
      may be elaborating an immune evasion strategy whereby immunologically sensitive
      proteases are first complexed with host serpins, which would render them
      immunogenically inert, and then cleared from the circulation by the host's
      reticulo-endothelial system. In this way the immune system would be unable to
      'see' sensitive parasite proteases sufficiently to mount a response against the
      parasite.

PMID- 7800418
TI  - Trypanosoma (Nannomonas) godfreyi sp. nov. from tsetse flies in The Gambia:
      biological and biochemical characterization.
AB  - We provide evidence from isoenzyme analysis, hybridization with repetitive DNA
      probes, behavioural studies and morphometrics that 4 trypanosome isolates from
      Glossina morsitans submorsitans in The Gambia constitute a new species now named
      Trypanosoma (Nannomonas) godfreyi. The bloodstream trypomastigotes of T. (N.)
      godfreyi are relatively small with a mean length of 13.7 microns (range: 9.1-21.8
      microns) and a mean width of 1.65 microns (range: 0.65-2.69 microns). There is no
      free flagellum and the marginal kinetoplast is subterminal to a rounded posterior
      end; the undulating membrane is usually conspicuous. As with other Nannomonas, T.
      godfreyi developed in the midgut and proboscis of Glossina and infections matured
      in 21-28 days in laboratory G.m. morsitans. In The Gambia the normal vertebrate
      host appears to be the warthog, Phacochoerus aethiopicus, although elsewhere
      other wild and domestic suids may also be implicated in the life-cycle. T.
      godfreyi was identified unequivocally using a 380 bp DNA probe specific for a
      major genomic repeat sequence; its isoenzyme profile distinguished it clearly
      from T. simiae and three strain groups of T. congolense: savannah, riverine
      forest and kilifi.

PMID- 7800422
TI  - Urinary tract infections in children.

PMID- 7800419
TI  - A genetic analysis of reproduction in Strongyloides ratti.
AB  - Strongyloides ratti has a complex life-cycle with two adult generations, one free
      living and dioecious and one parasitic and female only. The parasitic females
      reproduce by parthenogenesis, but it is unclear whether this is mitotic or
      meiotic in nature. This question has been addressed genetically by analysing the
      progeny of parasitic females that were heterozygous at an actin locus for
      evidence of allelic segregation. Such progeny were similarly heterozygous showing
      that segregation had not occurred. It was therefore concluded that reproduction
      in the parasitic female of S. ratti is functionally mitotic.

PMID- 7800421
TI  - Is screening urinalysis worthwhile in asymptomatic pediatric patients?

PMID- 7800420
TI  - Characterization of a major surface-associated excretory-secretory antigen of
      Trichinella spiralis larvae with antibodies to keyhole limpet haemocyanin.
AB  - A multi-subunit antigen (native M(r) > 200 kDa, reduced M(r) 97-100 kDa) has been
      identified in homogenates of Trichinella spiralis larvae using affinity-purified
      rabbit anti-keyhole limpet haemocyanin (KLH) antibodies and its cross-reactivity
      with KLH was confirmed by competition blotting. The antigen was not present at
      the larval surface but was exposed after treatment of the larvae with the
      detergent cetyltrimethyl ammonium bromide (CTAB) which removed the surface coat.
      This correlated with a significant decrease in insertion of the surface
      restricted fluorescent lipid probe AF18, indicating that the surface coat must be
      lipidic in nature. Unlike KLH, the larval antigen blotted onto nitrocellulose was
      itself periodate insensitive. Periodate treatment of whole larvae, however,
      resulted in shedding of the surface, to which anti-KLH antibodies then bound
      intensely. Anti-KLH antibodies also recognized three (49, 55, 108 kDa) of the
      four most dominant antigens in excretory-secretory (ES) products of cultured
      larvae, whose excretion-secretion was increased with CTAB. The nature, location
      and function of the antigen is discussed.

PMID- 7800423
TI  - Hematuria in children.
AB  - A work-up of a child with suspected hematuria should be undertaken once the
      primary physician has determined that there actually are red blood cells in the
      urine and that the hematuria is persistent. Evaluation of a child with persistent
      microscopic hematuria is facilitated with the determination of whether the blood
      originates from the glomeruli or whether it comes from elsewhere in the urinary
      tract. Clues to a glomerular origin include the presence of other manifestations
      of glomerular disease such as significant proteinuria, RBC casts, and dysmorphic
      erythrocytes in the urinary sediment, hypertension, and renal insufficiency.
      Clues to the blood originating from the lower urinary tract include blood clots
      in the urine, normal erythrocyte morphology, and a pertinent history pointing to
      the lower tract such as that of trauma, urolithiasis, urological or vascular
      abnormality, or symptoms of bladder inflammation. The initial evaluation should
      include a detailed patient history and family history as well as a careful
      physical examination looking for clues to the presence of a familial, hereditary,
      or chronic kidney disease. A logical, stepwise initial work-up should follow with
      the goal of ruling out life-threatening and treatable diseases. If there are no
      indications for immediate further intervention and the cause of the hematuria
      remains unclear after the initial work-up has been completed, the parents and
      patient should be reassured that there are no life-threatening conditions and
      that although the etiology of the blood in the urine is yet unknown, there is
      time to follow the patient and plan for additional studies if and when they are
      indicated. The family's concerns (ie, "Is this cancer?," "Will my child require
      dialysis and transplantation?") should be addressed frankly, and the physician
      should mention those diagnoses that may lead to renal failure, but have not been
      absolutely ruled out yet before a kidney biopsy has been performed, such as
      Alport's syndrome and IgA nephropathy. The child with isolated microhematuria
      should be evaluated regularly with urinalyses looking for persistence of the
      hematuria and appearance of proteinuria, blood pressure measurements, and renal
      function tests. If the microhematuria persists for 6 to 12 months, a kidney
      biopsy should be considered.(ABSTRACT TRUNCATED AT 400 WORDS)

PMID- 7800424
TI  - The evaluation of the child with proteinuria.

PMID- 7800425
TI  - Nephrotic syndrome in children.

PMID- 7800426
TI  - Hemolytic uremic syndrome: the most common cause of acute renal failure in
      childhood.

PMID- 7800427
TI  - Inhibitory effects of theophylline, terbutaline, and hydrocortisone on
      leukotriene B4 and C4 generation by human leukocytes in vitro.
AB  - Leukotriene B4 (LTB4) and leukotriene C4 (LTC4) are considered to be important
      mediators in the pathophysiology of asthma. Theophylline, terbutaline, and
      hydrocortisone are drugs commonly used in the treatment of asthma. In the present
      study we have investigated the in vitro inhibitory effects of theophylline,
      terbutaline, and hydrocortisone on LTB4 and LTC4 generation from human
      leukocytes. After preincubation in the presence of these drugs, the cells were
      stimulated with the calcium ionophore A 23187 and the supernatants were analyzed
      for their LTB4 and LTC4 content using reverse-phase high-performance liquid
      chromatography (HPLC). Total leukotriene (LT) production (the combined amounts of
      LTB4 and LTC4) was dose-dependently inhibited by pretreatment with theophylline,
      terbutaline or hydrocortisone. Therapeutic levels of hydrocortisone (5 x 10(-6)
      M) plus theophylline (5 x 10(-5) M) inhibited LTB4 and LTC4 production in an
      additive way, as did the combination of hydrocortisone plus terbutaline (5 x 10(
      8) M). A statistically significant effect of diminished LTB4 generation was
      obtained after preincubation with therapeutic levels of theophylline plus
      terbutaline, but no such effect was seen for LTC4 levels. The in vitro inhibitory
      effects on LTB4 and LTC4 generation from human leukocytes by theophylline,
      terbutaline, and hydrocortisone, as well as the additive effect of hydrocortisone
      plus theophylline or terbutaline, add to our understanding of the therapeutic
      effects of these drugs in the treatment of bronchopulmonary obstruction.

PMID- 7800428
TI  - Legionella and Pneumocystis pneumonias in asthmatic children on high doses of
      systemic steroids.
AB  - Asthma is increasingly treated as an inflammatory disease with inhaled and/or
      systemic corticosteroids. We report 3 cases of unusual pneumonias associated with
      high doses of oral steroids. Two patients contracted Legionella pneumonia and one
      patient contracted Pneumocystis carinii pneumonia. With increasing usage, it is
      important for physicians to be aware of the possible infectious complications of
      high dose steroids. This report highlights the risk of corticosteroid treatment
      in asthma in predisposing to opportunistic infections that have not heretofore
      been readily associated with asthma.

PMID- 7800430
TI  - Forced expiratory maneuvers in children aged 3 to 5 years.
AB  - There is no consensus about reproducibility and reliability of spirometry in
      young children. We evaluated forced expiratory maneuvers from 98 children aged 3
      to 5 years with a variety of respiratory disorders before and after
      bronchodilator treatment. Forced vital capacity (FVC) and forced expiratory
      volume in 1 sec (FEV1) were analyzed for reproducibility by the American Thoracic
      Society criteria and for reliability based on the coefficient of variation (CV%).
      Over 90% of the patients cooperated, however, while 95% could exhale for at least
      1 second, very few generated an FEV1 on all 6 "best" efforts. This clearly
      improved with age. Of all patients nearly 60% performed reproducible pre- and
      postbronchodilator sets of FVC but only 32% performed reproducible sets of FEV1.
      Based on the CV%, those patients who could reproducibly perform an FVC and FEV1
      did it quite reliably (mean CV%, 9.38 and 7.01 for FVC and FEV1, respectively).
      We conclude that while some very young children can perform spirometry,
      reliability of performance cannot be assumed in this age group.

PMID- 7800429
TI  - The effect of transfusion on pulmonary function in patients with thalassemia
      major.
AB  - Pulmonary involvement has been documented in thalassemia major (TM). We studied
      12 patients with TM before and 24 hr after transfusion to evaluate the effect of
      transfusion on baseline lung function. Personal and family histories of
      respiratory illnesses were obtained by a questionnaire. Spirometry and carbon
      monoxide diffusion capacity (KCO) measurements were made. Blood gases (PO2 and
      SO2) were determined on arterialized samples. Baseline expiratory volumes and
      flows were within normal range in all patients. Transfusion resulted in a
      significant reduction of forced expiratory volume in 1 sec (FEV1) and forced
      expiratory flow between 25 and 75% vital capacity (FEF25-75%). In two subgroups
      of patients identified by the questionnaire, those with no history of airway
      disease had normal baseline flows and no posttransfusion changes; those with
      history of airway obstruction had lower pretransfusion flows and significantly
      decreased posttransfusion FEV1 and FEF25-75%. The mean pretransfusion KCO value
      of 80% predicted for the whole group, significantly increased after transfusion
      (P < 0.05). Blood gases also significantly increased after transfusion (P <
      0.05). When tested for the spirometric response to albuterol, patients with a
      history of asthma had a slightly greater increase in FEV1 and FEF25-75% than
      those who had never had asthma. We conclude that in our small study group,
      transfusion resulted in improved gas exchange and lung perfusion. The effect on
      flow limitation evident in some patients could, in part, be related to a
      preexisting bronchial hyperreactivity. Accurate evaluation of pulmonary function
      and of bronchial reactivity is advisable for patients with TM.

PMID- 7800431
TI  - Effects of administration of aerosolized recombinant human deoxyribonuclease on
      resting energy expenditure in patients with cystic fibrosis.
AB  - By improving pulmonary function in patients with cystic fibrosis (CF),
      recombinant human deoxyribonuclease (rhDNase) may affect resting energy
      expenditure (REE). To examine this hypothesis, we measured REE by indirect
      calorimetry in seven patients with CF before (day 0) and 2 weeks after (day 15)
      administration of aerosolized rhDNase. Baseline REE was higher in all patients
      than predicted for age, sex, and weight (mean +/- SEM 128 +/- 4.9%; range, 116
      147%). After 2 weeks of aerosolized rhDNase, mean forced vital capacity (FVC) (in
      % of predicted values) improved significantly from 54.1 +/- 2.2 to 66.3 +/- 4.2%
      (mean improvement, 12.3%; 95% CI, 2.8, 21; P < 0.05) and REE decreased by 11.0%
      (95% CI 3.2, 17.5; P < 0.05). In addition, the larger the improvement in FVC in
      response to rhDNase the greater the decrease in energy expenditure (r - 0.88).
      The REE decreased in all patients who had an increase in FVC and remained
      unchanged in two patients who had no change in FVC. We conclude that patients
      with CF whose lung function improve in response to aerosolized rhDNase have an
      acute and proportionate reduction in their resting energy expenditure.

PMID- 7800432
TI  - Ventilation-perfusion relationships in preterm infants after surfactant
      treatment.
AB  - Arterial-alveolar partial pressure differences for oxygen, carbon dioxide, and
      nitrogen were measured before and after surfactant replacement therapy on 15
      occasions in 14 ventilator-dependent preterm infants with hyaline membrane
      disease (HMD). Eight treatments resulted in a significant improvement in arterial
      partial pressure of oxygen (PaO2) 2 hr after treatment; 7 did not. Neither group
      showed any significant change in arterial-alveolar partial pressure differences
      for oxygen, nitrogen, and carbon dioxide. This observation suggests that if
      surfactant replacement therapy produces an improvement in PaO2 it does so by
      recruitment of atelectatic alveoli with a balanced ventilation/perfusion ratio
      rather than by redistribution of ventilation within already ventilated alveoli.

PMID- 7800433
TI  - The Hering-Breuer deflationary reflex in the newborn infant.
AB  - Initial observations on healthy term infants using the forced partial expiratory
      flow-volume technique with an inflatable jacket suggested that this technique was
      stimulating the Hering-Breuer deflationary reflex, a reflex which has not been
      systematically studied in man. To investigate this fully, esophageal pressure,
      jacket pressure, flow and volume at the mouth were recorded during the forced
      partial expiratory flow-volume maneuver on 10 infants (mean age, 3.1 days; birth
      weight, 3533 g; gestation, 39.8 weeks). A total of 186 measurements were
      performed at different points in the respiratory cycle. In 159 (85%) recordings
      inspiratory effort was evident with a fall in esophageal pressure within 166
      msec; in some cases this occurred before the jacket was fully inflated. This was
      associated with a reduction of 23.4 cm H2O in mean intrathoracic pressure, which
      was 2.5 times that occurring during normal tidal breathing. In the remaining 27
      measurements a plateau pressure was associated with closure of the upper airway.
      When the squeeze was applied at low lung volumes (end-expiration) the inspiratory
      effort occurred significantly earlier (133 msec) and stronger (reducing peak
      intrathoracic pressure to 15.8 cm H2O) than when applied at end-inspiration (181
      msec with a reduction in intrathoracic pressure to 25.2 cm H2O). The observed
      inspiratory response was highly consistent, representing the deflationary reflex
      as described by Hering and Breuer in 1868. The stronger and more rapid onset of
      inspiration at low lung volume supports the claim made by Breuer that it has a
      protective role on functional residual capacity (FRC) in young infants.

PMID- 7800434
TI  - Frequency distribution of breath sounds as an indicator of bronchoconstriction
      during histamine challenge test in asthmatic children.
AB  - In order to study changes in respiratory sounds associated with acute
      bronchoconstriction and -dilatation, breath sounds of 11 children with asthma
      (age range, 10-14 years) were recorded at the chest and at the trachea during
      histamine challenge test and after subsequent bronchodilatation. The changes in
      frequency spectra of breath sounds were compared with simultaneous changes in
      forced expiratory volume in 1 second (FEV1). In seven children who responded to
      histamine with a decrease in FEV1 of more than 15%, there was a significant
      relationship between percentage change in FEV1 (delta FEV1) and percentage change
      in median frequency (delta F50) of expiratory breath sounds recorded at the chest
      (r = 0.865; beta = -0.706, P = 0.0001) and at the trachea (r = 0.888; beta = 
      1.12, P = 0.0001). The association between breath sound intensity and FEV1 was
      weaker. Based on ANOVA, the increase of F50 during the challenge test was
      significantly larger in children who responded to histamine than in those who
      were non-responsive (P = 0.0016). At the chest, a decrease of 15% in FEV1
      corresponded to an increase of 8% in expiratory F50. The provocative dose of
      histamine inducing a decrease of 15% in FEV1 (PD15FEV1) and the provocative dose
      causing an increase of 8% in F50 (PD8F50) were significantly related (r = 0.927,
      P = 0.003). We conclude that spectral analysis of breath sounds can be used to
      indicate airway obstruction during bronchial challenge tests in children, and may
      be adapted for tests in pre-school children. The results suggest that the same
      mechanisms that induce airflow limitation due to inhaled histamine may generate
      an increase in frequency content of breath sounds in children with asthma.

PMID- 7800435
TI  - A new device for ambulatory cough recording.
AB  - Nocturnal cough reporting on diary cards has been shown to be unreliable and
      inconsistent. Whether subjective reporting of daytime cough is equally unreliable
      remains unknown. We have, therefore, developed a new and easily portable device
      (RBC-7) that records electromyographic (EMG) and audio cough signals for at least
      a 24-hr period, with a capacity of over 48 hr. Additional information is obtained
      from electrocardiographic (ECG) signals, and from an accelerometer indicating the
      level of the subject's activity. The RBC-7 can be set up with the aid of a
      notebook computer at the subjects home, school or workplace. Initial studies
      utilizing a prototype device were performed to determine the optimal position of
      the EMG leads and the microphone. The optimal position for the EMG leads was
      determined as the positive electrode in the sixth intercostal space (ICS) in the
      midclavicular line on the left, the negative electrode in the same position on
      the right, and the reference electrode in the midline over the abdomen. This
      position was shown to give the highest EMG voltages and the greatest difference
      in voltages between cough and other signals. The optimal microphone position for
      signal strength and comfort was over the first ICS, either right or left, close
      to the sternum. Recordings were performed simultaneously in 20 subjects with
      conventional tape recorders and the multiparametric cough monitoring system (RBC
      7). Conventional tape recordings limited the duration of the studies due to the
      inherent restrictions. No significant difference in the number of single coughs
      recorded by each system was detected (correlation coefficient = 0.996). The RBC-7
      offers a unique opportunity to obtain objective information on cough in
      ambulatory subjects over at least a 24-hr period, and to relate cough to time,
      activity and heart rate, while normal activities are pursued.

PMID- 7800436
TI  - Diaphragmatic paralysis in children: a review of 11 cases.
AB  - We reviewed 11 pediatric cases of diaphragmatic paralysis related to nonspinal
      cord injury which were managed in our Intensive Care Unit over the past 10 years.
      Three cases were secondary to birth trauma, 7 followed surgical procedures for
      congenital heart disease, and 1 occurred in association with injuries sustained
      in a motor vehicle accident. The paralysis was bilateral in 8 children. The
      diagnosis was initially suspected on clinical grounds because of respiratory
      distress, impossibility of weaning from the ventilator, and paradoxical abdominal
      respiratory movements. Confirmatory investigations included chest radiography,
      which revealed elevation of the affected hemidiaphragm, fluoroscopy and
      ultrasound, both of which demonstrated diminished diaphragmatic movement.
      Electromyography exhibited a failure of diaphragmatic response to phrenic nerve
      stimulation in 8 patients. All patients were mechanically ventilated;
      tracheostomy was required in 5 patients. Physiotherapy was considered a
      beneficial adjuvant measure. Diaphragmatic plication was attempted without
      success in 3 children. Seven children recovered without sequelae: Partial
      respiratory autonomy was achieved after an average of 2.6 months, complete
      autonomy after an average of 5.4 months. Two patients developed chronic lung
      disease; one of them remains unresponsive, and one child died following
      accidental extubation. We conclude that the diagnosis of diaphragmatic paralysis
      is predominantly clinical, and that the outcome of patients treated by adequate
      endotracheal mechanical ventilation is usually favorable.

PMID- 7800437
TI  - Role of MRI in the evaluation of ambiguous genitalia.
AB  - Diagnostic accuracy of magnetic resonance imaging (MRI) interpretation was
      assessed prospectively in patients with ambiguous genitalia or intersex problems.
      MRI depiction of the uterus was possible in 93%, the vagina in 95%, the penis in
      100%, the testis in 88%, and the ovary in 74% of patients. The strength of MRI
      lies in the multiplanar capability and tissue characterization by means of T1-
      and T2-weighted sequences. MRI contributes to accurate morphologic evaluation of
      mullerian duct structures, the gonads, and the development of the phallus, all of
      which are essential for appropriate gender assignment and planning of surgical
      reconstruction.

PMID- 7800438
TI  - Wilms' tumor arising in a multicystic kidney.
AB  - We describe a child with Wilms' tumor (WT) which occurred in an unequivocal
      multicystic dysplastic kidney (MDK). We indicate a current nonsurgical approach
      to MDK, but stress the probable malignant degeneration of blastemal cells, the
      need to search carefully for the WT in the MDK, and the necessity on 3-monthly
      follow-up US studies.

PMID- 7800439
TI  - Emergence of mature teratoma following treatment of sacrococcygeal endodermal
      sinus tumor: CT and MR imaging with pathological correlation.
AB  - We report a case of pseudoretroconversion in which, clinically and
      pathologically, it appeared that an endodermal sinus tumor retroconverted to
      mature teratoma. An 8-month-old white female infant with a sacrococcygeal tumor,
      diagnosed by biopsy as endodermal sinus tumor (yolk sac tumor), was treated with
      chemotherapy. The residual tumor after treatment was mature teratoma confirmed by
      imaging and by pathological examination. We present the computerized tomography
      (CT) and magnetic resonance imaging (MRI) findings with pathological correlation.

PMID- 7800441
TI  - Sonographic evaluation of traumatic spinal cord lesions in the newborn infant.
AB  - We present a case of spinal cord injury due to birth trauma and assess the value
      of sonography for diagnosis, lesion characterization, and follow-up. Sonography
      is a non-invasive and easily reproducible imaging method for examining a
      ventilated child, and its initial sensitivity is comparable to that of MRI.
      Sonography is the method of choice for guiding diagnosis in this type of
      traumatic lesion to the newborn.

PMID- 7800440
TI  - Ultrasound diagnosis of birth-related spinal cord trauma: neonatal diagnosis and
      follow-up and correlation with MRI.
AB  - Two neonates, one with complete and one with incomplete birth-related transection
      of the cervico-thoracic spinal cord, form the basis of this report. Ultrasound
      and MRI findings in primary diagnosis and follow-up are described. The aim of
      this contribution is to bring this serious birth complication to the attention of
      the reader, to present the obstetrical risk factors, to describe the clinical
      presentation of the newborns and to make suggestions to expand the field of
      indications for spinal sonography. The value of spinal ultrasound in the first
      six months of life is stressed, especially in comparison to MRI. For definitive
      assessment of the lesion (transectional or nontransectional) follow-up ultrasound
      studies for several weeks are required.

PMID- 7800442
TI  - Non-union of pediatric fibula fractures: easy to overlook, painful to ignore.
AB  - Fracture non-union in the pediatric population may span the age range from
      childhood to adolescence. Fracture non-union in children and adolescents is often
      due to an underlying cause such as affliction with neurofibromatosis or
      osteogenesis imperfecta. Although less commonly seen, non-union may occur in the
      otherwise healthy pediatric population. We report three cases of fracture non
      union of the distal end of the fibula in the pediatric age group. All three were
      characterized by persistent local pain and tenderness following injury with
      radiographic evidence of fracture non-union. All three had undergone conservative
      treatment with extended periods of immobilization. Following surgery, all three
      had marked improvement of their local symptomatology. One patient's course was
      complicated by reflex sympathetic dystrophy syndrome. In two patients, resection
      of the un-united fragment at the distal fibula resulted in marked relief from
      pain without any increase in ankle instability. We postulate that the fracture
      non-union resulted in a fibrotic reaction that was so extensive that ankle
      stability was maintained even after removal of the fracture fragment.

PMID- 7800443
TI  - Fractures of the acromion in young children and a description of a variant in
      acromial ossification which may mimic a fracture.
AB  - We report on six children, from 2 to 19 months old, with a defect across the root
      of the acromion (basiacromion) diagnosed as a fracture in four and as an
      anatomical variant (separate ossification center for the lateral half of the
      basiacromion) in the other two.

PMID- 7800444
TI  - Cystic angiomatosis of bone: MR findings.
AB  - Cystic angiomatosis of bone is a rare disorder characterized by widespread lytic
      bone lesions with or without associated soft tissue or visceral
      lymphangiomatosis. The disorder is often initially incorrectly diagnosed as
      Langerhans cell histiocytosis. Unfortunately, biopsy of long bone lesions will
      often yield only fluid, thereby making a histologic diagnosis difficult. This
      report describes the MR findings in a patient with cystic angiomatosis of bone.
      We believe that the MR findings are highly suggestive of the correct diagnosis
      and that MR should eliminate the need for excisional biopsy in future cases.

PMID- 7800445
TI  - MRI findings of lipoma arborescens of the knee in a child: case report.
AB  - Lipoma arborescens is an intraarticular lesion characterized by a frond-like mass
      of mature fat cells, usually involving the suprapatellar bursa. It is a rare
      lesion in adults and extremely rare in children. Because of the fatty nature of
      the lesion, the MRI findings of lipoma arborescens are specific. We present the
      MRI findings of lipoma arborescens of the knee in a 9-year-old girl.

PMID- 7800446
TI  - Radiographic abnormalities in Laron dwarfism.
AB  - Radiographic abnormalities in two children with Laron dwarfism are described. In
      addition to a characteristic bone age, which was retarded for the chronological
      age but advanced for the height of the patients, there were marked skull changes
      and minor skeletal abnormalities in the long bones and vertebrae. Such findings
      on a skeletal survey should lead the radiologist to suspect the disorder.

PMID- 7800447
TI  - Cavitary pulmonary lesions in type IV Ehlers-Danlos syndrome.
AB  - Type IV Ehlers-Danlos syndrome (EDS) is characterized by large vessel bleeding,
      visceral rupture and early death. Pulmonary complications are uncommon. We report
      an 18-year-old patient with EDS type IV who developed recurrent large, thick
      walled lung cavitary lesions, probably a manifestation of focal lung rupture.
      Such hemorrhagic cavities are probably the basis of the bullous disease and
      recurrent pneumothoraces occasionally observed in type IV EDS.

PMID- 7800448
TI  - The Chediak-Higashi syndrome: CT and MR findings.
AB  - Chediak-Higashi syndrome (CHS) is a rare autosomal recessive disorder postulated
      to result from lack of regulation of fusion of the primary lysosomes. In this
      report we present the MR and CT features of the brain in a patient with known
      CHS. These findings include diffuse atrophy of the brain with diffuse
      periventricular decreased density identified with CT, as well as increased signal
      on the T2-weighted images and lack of enhancement on the T1-weighted images in
      the periventricular and corona radiata regions.

PMID- 7800449
TI  - The echogenic thalamus in hypoxic ischaemic encephalopathy.
AB  - This paper reports 16 term infants in whom an echogenic thalamus was identified
      on cranial ultrasonography. Fourteen of the patients suffered severe birth
      asphyxia. The prognostic significance of this finding and the underlying
      pathogenesis is assessed.

PMID- 7800450
TI  - Sturge-Weber syndrome associated with a large left hemispheric arteriovenous
      malformation.
AB  - A patient with the characteristic changes of Sturge-Weber syndrome on the right
      side was found to have a large arteriovenous malformation on the left side which
      involved the superior ophthalmic vein. This association, although previously
      reported, is extremely rare.

PMID- 7800452
TI  - Inflammatory myofibroblastic tumor of the spleen: report of a case in an
      adolescent.
AB  - Inflammatory myofibroblastic tumor (IMT) is an uncommon quasineoplastic process
      occurring in young patients. Splenic involvement is uncommon and occurs
      predominantly in older, adult patients. We present the youngest patient reported
      to date with splenic inflammatory myofibroblastic tumor and discuss the clinical,
      pathological and imaging features of this lesion.

PMID- 7800453
TI  - Calcifications in untreated primary duodenal lymphoma: an exceptional entity.
AB  - Calcifications in lymphoma are rare findings prior to therapy. We report our
      experience with a 13-year-old boy who presented with a primary calcified duodenal
      Burkitt's lymphoma. US and CT findings are described. Two differential diagnoses
      are discussed.

PMID- 7800451
TI  - Recognition of malposition of the liver and spleen: CT, MRI, nuclear scan and
      fluoroscopic imaging.
AB  - Thirteen children initially suspected to have an intrathoracic or intraabdominal
      mass had malposition of the liver and/or spleen discovered by ultrasound. This
      group consisted of five children with diaphragmatic eventration or hernia and
      eight with wandering spleen or liver. Careful ultrasonographic examinations were
      diagnostic in all patients; seven had surgical confirmation. CT, MRI, nuclear
      scan and fluoroscopic imaging were useful in select instances. The liver and
      spleen have a characteristic anatomic configuration and sonographic appearance
      that should enable them to be recognized, and pathological alterations
      appreciated, even when these organs are ectopic in location or malformed.